PMID- 3654207 TI - [Inflammatory periproctal and anorectal conditions in HIV infections]. AB - Twenty-nine homosexual patients with anorectal symptoms were investigated by sigmoidoscopy. Nineteen patients were anti-HIV antibody positive; in this group severe haemorrhagic proctitis was diagnosed in seven cases and purulent cryptitis with abscess formation and fistulation in three cases. All patients showed a reduced OKT 4/OKT 8 ratio (below 1.0). It is concluded that the immunodeficient condition of HIV patients is the essential pathogenic factor for the occurrence of the anorectal inflammations observed. PMID- 3654208 TI - [Have new noninvasive study methods replaced invasive venous pressure measurement in dermatophlebology?]. AB - Preliminary answers are given to the question as to whether or not new, non invasive methods, such as light reflection rheography or infrared photoplethysmography, have replaced invasive venous pressure measurements (peripheral phlebodynamometry). The results of a recent study by the author are compared with opinions found in the literature. A detailed statistical analysis has confirmed the close relationship between phlebodynamometry and indirectly observed parameters. However, it has been shown that the prediction error can be important for the diagnosis and for the prognosis as to whether or not a chronic venous insufficiency can be improved by epifascial venous therapy. Therefore it may be advisable to confirm the results obtained with non-invasive methods by phlebodynamometry in complicated cases. Both non-invasive methods are certainly very useful for quick screening of the venous function. PMID- 3654209 TI - [Ulerythema ophryogenes and folliculitis ulerythematosa reticulata]. AB - Three fundamental alterations characterize keratosis pilaris syndrome: follicular keratosis, vasodilatation and atrophy. Ulerythema ophryogenes and folliculitis ulerythematosa reticulata are types of the syndrome that localize on the eyebrows and cheeks and sometimes affect the ears and scalp. Punctuate atrophy and hair rarefaction may result. The patients frequently exhibit keratosis simplex as well. The clinical picture is considered to be an autosomal dominant genodermatosis and its treatment is ineffective. PMID- 3654210 TI - [Changes in the oral mucosa in psoriasis pustulosa generalisata]. AB - A case of 7-year-old female patient with generalized pustular psoriasis associated with geographical tongu is described. Antipsoriatic therapy with etretinate caused a remarkable regression in the tongue lesions. In accordance with previous case reports, observations suggest that geographic tongue can after be a typical symptom of psoriasis pustulosa generalisata. PMID- 3654211 TI - [Contact allergy to Kathon CG]. AB - Among 671 consecutive patients who underwent the patch test with Kathon CG (100 ppm active ingredient), 23 (3.43%) showed a positive reaction (87% females). In 52.2% of these cases the clinical relevance of these reactions was considered to be proven. Most of the patients were suffering from contact dermatitis of the face or hands. Cosmetics were found to be the major cause of sensitization. In view of the widespread use of this preservative, testing with Kathon CG is recommended in all cases of contact dermatitis. PMID- 3654212 TI - [Norwegian scabies. Report of 2 cases]. AB - Two cases with an atypical form of Norwegian (or crusted) scabies are presented. It is suggested that a systemic (first case) or a local (second case) alteration of the immune system paved the way for the development of this atypical presentation. PMID- 3654213 TI - [Erythema exsudativum multiforme in rickettsiosis]. AB - A patient with Mediterranean spotted fever with a typical exanthema acquired in South Africa developed erythema multiforme 12 days after the beginning of the rickettsial infection. The exanthema caused by the rickettsial infection as well as the erythema multiforme were effectively treated with tetracyclines. PMID- 3654214 TI - [Sulfite hypersensitivity]. AB - Sulfites are widely used as preservatives and antioxidants in foods and drugs, often without specification. Sulfite can lead to severe hypersensitivity reactions, asthma being obviously the most frequent symptom, but also urticaria, angioedema, or other anaphylactoid symptoms may occur. Furthermore, allergic leukocytoclastic vasculitis and exacerbation of an atopic eczema have been observed. The pathomechanisms of sulfite hypersensitivity have not yet been completely elucidated. Asthmatic reactions have been attributed to reflectory activation of the parasympathetic system by the irritating effect of sulfites, possibly enhanced by a deficiency of sulfite oxidase. Besides this pseudo allergic mechanism, for at least some cases of sulfite hypersensitivity an IgE mediated immediate-type allergic reaction has to be considered. The diagnosis of sulfite hypersensitivity is based on provocation testing, which must be done with extreme caution. PMID- 3654215 TI - [Testing of cellular immune reactivity in melanoma patients with diphenylcyclopropenone in comparison to dinitrochlorobenzol]. AB - Ten patients with malignant melanoma were simultaneously sensitized with dinitrochlorobenzol (DNCB) and diphenylcyclopropenon (DPCP) (500 micrograms each). Fourteen days after sensitization the patients were challenged with 0.04 25 micrograms doses of DNCB and DPCP. The reactions of all of the subjects tested were the same for DNCB as for DPCP. The results were statistically significant. To achieve a skin reaction of the same intensity, the necessary doses of DPCP were much lower than those of DNCB. PMID- 3654216 TI - [Therapeutic use of alpha interferon in metastasizing malignant melanoma, disseminated Kaposi sarcoma and severe Behcet disease]. AB - Three types of human interferons (IFNs) are differentiated: alpha-interferon (with about 20 subtypes), beta-interferon, and gamma-interferon. In addition to their antiviral properties, these IFN types exert numerous other biological effects, which are increasingly exploited for therapeutic purposes. From 1982 to 1985 long-term recombinant alpha 1-interferon (rIFN-alpha A) was administered systemically in 39 patients with various severe dermatoses. In this study we report our preliminary experiences with systemic administration of rIFN-alpha A in malignant melanoma (MM, 9 patients), in disseminated Kaposi's sarcoma (KS, 8 patients), and in severe Behcet's disease (2 patients). In metastatic MM (clinical stage IV) the result was only moderate; the administration of IFN in earlier stages, for instance as a postoperative adjuvant therapy, appears more promising. In disseminated KS with acquired immune deficiency syndrome (AIDS) our experience was encouraging. In 7/8 patients the general condition was stabilized and partial remission of skin lesions was observed. In Behcet's disease both patients had good or excellent responses to IFN treatment. The side effects of systemic rIFN-alpha A were moderate, dose-dependent, and tolerable. PMID- 3654217 TI - [Vital capillary microscopy and with ophthalmoscope-detected findings in progressive systemic scleroderma]. AB - Nineteen patients suffering from scleroderma (average age 56.6 years; 18 women, 1 man) were examined by in vivo capillary microscopy of the nail fold. The possibility of achieving results with the ophthalmoscope was examined. The correspondence between ophthalmoscopic and television microscopic results was evaluated. With the ophthalmoscope hemorrhages were found in 68% of the patients, reduction in the number of capillaries in 79%, avascular areas in 79%, and dilated capillaries in 84%. The correspondence between the findings of the two methods was 80% and more, so that examination of the nail fold capillaries with an ophthalmoscope can help to verify the diagnosis of scleroderma. This method should be employed whenever scleroderma is suspected and microscopical equipment is not available. PMID- 3654218 TI - [Multiple simultaneous hematomas of the finger and toe nails with subsequent onychomadesis in pemphigus vulgaris]. AB - Multiple simultaneous subungual and intraungual haemorrhages were seen in eight fingernails and several toenails of a patient suffering from pemphigus vulgaris. As other causes of nail haematomas, such as traumas, were absent, this symptom was referred to the underlying disease. Nail and nailbed involvement in pemphigus vulgaris is extremely rare, and onychomadesis is the form that has been reported more frequently than any others. PMID- 3654219 TI - [Piebaldism]. AB - Piebaldism is a rare, congenital, autosomal dominant inherited pigmentary disorder, characterized by a white forelock and freckled depigmentation of the forehead, chin, ventral trunk and extremities. Normal pigmentation is found on the back, hands and feet. Within the non-pigmented areas, patches of hyperpigmentation are possible. A family with six affected members spanning three generations is presented, which displays the typical traits of this disorder. The clinical signs, genetic aspects and differential diagnosis of piebaldism are briefly reviewed. PMID- 3654220 TI - [Sweat glands in pseudohypoaldosteronism]. AB - Pseudohypoaldosteronism is a rare syndrome occurring during early infancy, which is mainly characterized by salt-depletion crises. Sodium chloride is lost via the kidneys resulting in a reduced sodium level and raised potassium level in the serum, leading to life-threatening disturbances of water and acid-base concentration. The excessive sodium loss seems to be caused by an unresponsiveness of the renal tubules to endogenous and exogenous mineralocorticoids. The colon, salivary and sweat glands, which are also involved in sodium reabsorption, may likewise be affected by the disease. We describe skin changes in two siblings suffering from pseudohypoaldosteronism, who developed seborrheic dermatitis, folliculitis or miliaria rubra-like lesions during salt depletion crises. Biochemical analysis revealed a highly increased sodium chloride concentration in the sweat, saliva, urine and stool of both patients. Destructive inflammatory reactions could be demonstrated histologically within and around the dermal sweat glands, thus indicating the important role of the sweat system in the pathogenesis of skin lesions in pseudohypoaldosteronism. PMID- 3654221 TI - [Malignant melanoma as cancer model]. AB - Malignant melanoma is a suitable model for studying the growth of malignant tumors in general, because there are no obstacles to observation during its course and it can easily be obtained. Local progression of the tumor implies stepwise changes from low to high malignancy. However, regression can also be recognized, often simultaneously with progression. Both phenomena can be explained with reference to heterogeneity of tumor cells and instability of phenotypes. These are reflected not only in morphologic differences but also in the production of enzymes and factors and the expression of antigens. Phenotypic dynamics are not haphazard but rather according to definite principles. Levels of early tumor-associated and HLA-A,B,C (class I) antigens decline with advancing progression, whereas those of some late "risk" antigens, including HLA-D (class II) antigens, increase. Tumor and host interact, apparently in alternating directions, until biologic preponderance is established. PMID- 3654222 TI - Effective removal of airborne 222Rn decay products inside buildings. AB - Comparisons were made of the effectiveness of various indoor air treatment methods in reducing the lung dose due to inhalation of 222Rn decay products. The comparisons were based upon measurements of the total steady-state concentrations of 218Po, 214Pb and 214Bi, and the concentrations of these nuclides not attached to particles. These measurements, which were made inside a 78-m3 room before and after air treatment, were used along with a state-of-the art lung dose model to predict reductions in the dose to the radiosensitive bronchial tissues. Results suggest that flow-through air-cleaning methods, such as filtration and electrostatic precipitation, although effective in reducing total potential alpha energy concentration, cause a greater quantity of airborne potential alpha energy to be unattached to particles. This may result in a substantial increase in the dose to bronchial tissues. The optimal form of air treatment appears to be a combination of nonuniform positive space charge generated by an ion generator and enhanced convection from a fan. This combination of air treatment gave reductions in the mean dose to the bronchial tissues of up to 87%. PMID- 3654223 TI - The daily intake of 234,235,238U, 228,230,232Th and 226,228Ra by New York City residents. AB - The daily intake of long-lived alpha-emitting members of the U, Th and Ac series by New York City residents has been estimated from measurements of diet, water and air samples. The total daily intakes from inhalation, food and water consumption in mBq are 18 (234U), 0.7 (235U), 16 (238U), 6 (230Th), 4 (232Th) and 52 (226Ra). From this, we infer that the total daily intakes of 228Th and 228Ra are 4 and 35 mBq, respectively. PMID- 3654224 TI - Inhalation deposition and retention patterns of a U-Pu chain aggregate aerosol. AB - Chain aggregate aerosol particles are normally formed during many high temperature combustion and vaporization processes. The shape of chain aggregate aerosol particles could have an effect on the pattern of inhalation deposition and retention of the particles in the respiratory tract. A chain aggregate aerosol of nuclear reactor fuel could be present as an inhalation hazard if it were released to the atmosphere after a meltdown, core-disruptive accident. Rats were exposed to a chain aggregate U-Pu aerosol made by laser vaporization of mixed-oxide, breeder reactor fuel (20% plutonium dioxide and 80% uranium dioxide), then sacrificed to measure the clearance and retention of the fuel aerosol particles. Deposition of the 0.7-micron (activity median aerodynamic equivalent diameter) aerosol particles resulted in an average initial lung burden of 4140 Bq alpha activity. The chain aggregate particle shape was not a major factor in the total deposition; however, it may have influenced the regional distribution of the activity deposited. Retention of the particles in the upper airways of the tracheobronchial tree was on the order of 1% of the concurrent lung burden, which is consistent with recent data of other investigations. This study indicates that insoluble chain aggregate particles are retained in the tracheobronchial airways to a degree similar to simple spherically shaped particles of equivalent volume diameter. PMID- 3654225 TI - Effect of wet and dry cycles on dissolution of relatively insoluble particles containing Pu. AB - Dissolution of gross alpha emitter radioactivity from particles composed of mixed uranium and plutonium oxides or of plutonium dioxide continually immersed in solvent typically display at least a two-phase dissolution pattern. Rapid dissolution of a small fraction of the total particulate mass is followed by much slower dissolution for the majority of the particulate mass. In this study, respirable particles of (U, Pu)O2 and PuO2 were subjected to dissolution using an alternate wetting and drying cycle. Particles were continuously immersed in solvent for 4 d and then dried in air for 3 d. This cycle was repeated weekly for 7 wk. Four solvents were used to represent a range of potential environmental conditions and a fifth solvent was used for comparison to other continuous immersion studies. In contrast to dissolution studies involving continuous immersion over periods of two or more weeks that exhibit a three-phase dissolution process, the alternate wet-dry cycling resulted in repetition of the first two phases of the dissolution pattern for each cycle. This led to significantly enhanced dissolution of both particulate materials. The enhancement in total dissolution ranged from two to ten times larger during each wet-dry cycle compared to studies involving continuous immersion. The results indicate a potential need to re-evaluate environmental models of actinide element bioavailability for particulate materials released to environments where wet-dry cycling may be routine, i.e. intermittent rainfall in an otherwise arid climate or in stream beds with intermittent flow. PMID- 3654226 TI - Biological concentration of 3H. AB - In a three-year study, the possible biological concentration of 3H in rabbits was investigated. Tritiated water was used to grow alfalfa that was used exclusively as feed for the rabbits. Feed and water were kept at a constant 3H-to-1H ratio. The foundation group consisted of 18 female rabbits maintained on a 3H diet for 2 wk before mating. The subsequent generations were maintained with tritiated water and feed. At appropriate intervals, animals were sacrificed and selected tissues were analyzed for 3H. The specific activity of 3H in aqueous and organic fractions of tissues of all the animals remained essentially equal to that in the original water and feed. Results of this experiment indicate that under the steady-state equilibrium conditions of the experiment, no preferential concentration of 3H in animals occurred. PMID- 3654227 TI - Bioaccumulation factor for 32P measured in bluegill, Lepomis macrochirus, and catfish, Ictalurus punctatus. AB - The ratio of the bioaccumulation factors for 32P and phosphorus was determined for edible tissue in two species of freshwater fish by measuring the specific activity (32P activity per milligram phosphorus) in muscle relative to feed. The 32P tracer was added to the feed at a uniform level throughout the study. Feeding was at two levels: ad libitum and at a lower but constant intake per body weight. In the main experiment, bluegill were maintained in a large flow-through tank and sacrificed at approximately weekly intervals for 51 d of 32P accumulation and 28 d of depuration to compare the specific activity with values predicted with a calculational model. In experiments performed in smaller aquaria, the specific activity in bluegill and catfish muscle was compared at two feeding levels and two temperatures. In addition, unfed fish were exposed to 32P in water at a known specific activity to determine the extent of phosphorus uptake directly from water. The pattern of specific activity increase and decrease in fish muscle during the accumulation/depuration experiment was consistent with a one compartment model, so that specific activity ratios at steady state could be predicted from measurements during relatively brief exposures. On this basis, the ratio of the bioaccumulation factors of 32P and phosphorus in fish feeding ad libitum was 0.081 for bluegill and 0.17 for catfish. Hence, at a mean phosphorus bioaccumulation factor of 70,000, the factors for 32P are 6,000 and 12,000, respectively. The ratios were less at lower phosphorus intakes associated with lower feeding rates; moreover, the lesser value for bluegill occurred at a much lower phosphorus intake than by catfish. The bioaccumulation factor ratio was lower by an order of magnitude at a water temperature of 11 degrees C than at 16 27 degrees C, and was lower by two orders of magnitude when phosphorus uptake was from water by unfed fish. PMID- 3654228 TI - Angular dependence of shallow dose from energetic electrons. AB - A definite angular dependence of shallow dose from energetic electrons was observed when measuring the angular response of several detectors. This angular dependence of dose appeared to be fundamental, not a detector artifact. The theoretical response of a detector is discussed and compared to measurements of shallow dose with tissue and phantom response detectors. The energy-dependent angular response of the dose observed could not be explained by simple trigonometric arguments. The response, which is backscatter-dependent, must be considered in detector design and dose measurements. It is not possible for standard detectors to follow this response. PMID- 3654229 TI - Comparison of purchased measurements with measurements in randomly selected houses as a source of information on 222Rn levels in houses. PMID- 3654230 TI - Nondestructive determination of selected U- and Th-series radionuclides in biological samples. PMID- 3654231 TI - Wt? No? ri? ali. PMID- 3654232 TI - The Moyer model and hadron transport calculations. PMID- 3654233 TI - Eleventh annual conference of the Australian Radiation Protection Society. 20-22 August 1986, Sydney, Australia. Selected abstracts of papers presented. PMID- 3654234 TI - A school health education program for children with asthma aged 8-11 years. AB - It was hypothesized that a health education program for children with asthma aged 8-11 years that was delivered in elementary schools, would increase children's asthma management skills, self-efficacy and influence on parents' management decisions; reduce school absences and improve school performance. The study population consisted of 239 low-income, predominantly Hispanic and black children from 12 elementary schools (six experimental and six control) in New York City. Parents did not attend educational sessions but received written materials. The program emphasized the child's responsibility for recognizing symptoms and taking appropriate management steps. Follow-up data obtained one year after the program showed that compared to controls experimental group children had higher scores on an index of asthma management (p less than 0.05), greater self-efficacy with respect to asthma management skills (p less than 0.05), more influence on parents' asthma management decisions (p less than 0.05), better grades in school (p = 0.05), and fewer episodes of asthma (p less than 0.01) of shorter average duration (p less than 0.01). No differences were observed for changes in number of school absences. These findings show that asthma health education designed for delivery to children can significantly increase management skills, reduce symptoms of asthma, and improve school performance. PMID- 3654235 TI - ACT-asthma control y tratamiento para ninos: a progress report. AB - A randomized clinical trial is in progress to evaluate an asthma educational program for Latino children and their parents. The intervention, "ACT-Asma Control y Tratamiento Para Ninos," was adapted from ACT for Kids, an asthma self management program for English-speaking families. Results of a pilot study indicated that socioeconomic status was a critical variable to be considered in the design of such programs. Latino children and parents encounter significant barriers to access and continuity of medical care. Therefore, the intervention was redesigned to include "linkages" using a nurse to reduce barriers and to coordinate care. The lesson plans emphasize concrete, experimental learning experiences, with repetition of key points in each session. PMID- 3654236 TI - Controlled studies of childhood asthma self-management in Italy using the "open airways" and "living with asthma" programs: a preliminary report. AB - The concept of self-management for childhood asthma was introduced to Italy through a scientific exchange agreement with the United States. Two self management programs, Living with Asthma (LWA) and Open Airways (OA), are being evaluated in three studies, two of which (Pilot and Atri-Viterbo) were conducted by the Respiratory Service of the Pediatric Department of the University "La Sapienza" in Rome and one by 14 Italian university pediatric respiratory centers (Project Italia). In October 1985, 20 children and their 40 parents were enrolled in the Pilot Study. One hundred percent of the mothers and children and 70% of the fathers attended all of the sessions. Theoretical knowledge about asthma and knowledge of asthma self-management behavior were assessed three times by a questionnaire: at the beginning of the program, at the end of the program and one year later. Significant improvements in knowledge of asthma and in knowledge of asthma self-management behavior were demonstrated by both parents and children at the end of the program and one year later. Analysis of clinical symptoms and drug consumption indicated a statistically nonsignificant trend towards a reduction of asthma severity in the year after the program. In the Atri-Viterbo study 8229 children were initially screened by a questionnaire. One hundred eighty-two children with asthma (2.4%) were identified and invited to participate in a self management program. Open Airways was used in a shortened version. Only 29 families in Atri (22% of the eligible families) and 24 families in Viterbo (50%) ultimately agreed to participate in the program. A comparison of these families with those who did not participate showed that higher social status (p less than 0.001) and more severe asthma (p less than 0.05) were significantly associated with participation. Attendance by mothers and children was 78% in Atri and 61% in Viterbo. Only 5% of the fathers regularly attended the program. Parents who received the program registered a statistically significant increase in knowledge of asthma and knowledge of asthma self-management behavior relative to controls (+13% versus -4%; p less than 0.05). Fourteen university-based pediatric respiratory centers participated in Project Italia, in which the LWA and OA programs were compared in both full length and shortened versions (8 versus 4 h). Four hundred children and their families were enrolled in the study.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3654237 TI - The effect of a structured education program on knowledge and psychomotor skills of patients using beclomethasone dipropionate aerosol for steroid dependent asthma. AB - The purpose of the study was to evaluate the efficacy of a structured education program on knowledge and psychomotor skills of subjects using inhaled beclomethasone dipropionate. The sample was comprised of 26 male outpatients with a mean age of sixty years (range 49-69 yrs) and mean educational level of 11 years (range 7-18 yrs). Subjects were tested to assess knowledge of drug action, self-administration, and side effects. Skill in self-administration was assessed by two independent raters who were blind to group assignment. Then, patients were randomly assigned to an experimental group (n = 13), who received a structured educational program, or a control group (n = 13), who received no structured educational interventions. Patients were retested four weeks after randomization. Subjects in the experimental and control groups did not differ significantly with respect to their initial mean knowledge and performance scores. The post-test mean knowledge score was significantly higher when compared to initial score for each group. Mean knowledge score at post-test did not differ significantly between groups. However, when comparing post-test performance scores to initial scores the experimental group had a significantly greater increase in mean score than the control group. It is concluded that a structured patient education program is an effective method for improving the psychomotor skills necessary for proper use of beclomethasone dipropionate aerosol. PMID- 3654238 TI - Promoting self-management in adults with asthma: an overview of the UAB program. AB - Most asthma self-management programs have focused on children, but the prevalence and impact, both personal and economic, of adult asthma is substantial. Moreover, failure to adhere to treatment regimens appears to be a significant problem in adult asthma. It appears important, therefore, to develop asthma self-management programs for adults. The UAB program is based on the Health Belief Model for health behavior and on the PRECEDE Model for patient education. A needs assessment and a review of existing educational materials were used to specify the content of a self-care workbook. This workbook seeks to increase cognitive skills, encourage daily self-assessment of asthma, demonstrate success in asthma self-management, and promote effective social support. The overall intervention integrates this workbook with systematic reinforcement of self-monitoring and self-management. A prospective controlled study is comparing patients receiving this "special intervention" with "usual care" patients who receive only routinely available pamphlets providing information about asthma. Patients are randomly assigned to treatments by the closed envelope technique. Sample sizes were determined on the basis of statistical power. Outcomes in five areas are assessed: (1) health care utilization, (2) functional status, (3) knowledge, (4) adherence, and (5) psychological reactions. PMID- 3654239 TI - Making childhood asthma management education happen in the community: translating health behavioral research into local programs. AB - The public health benefits of research can be realized only if proven new techniques are translated into readily usable processes and materials and widely adopted by professionals and patients alike. To accomplish this, a systematic technology transfer process is needed. One recent outcome of health behavior research has been identification of the skills needed by children and parents to effectively manage childhood asthma. Methods for teaching these skills were tested on hundreds of families in a variety of health care settings. They were then packaged in program manuals that guide health professionals through the teaching process and provide all necessary materials for conducting sessions. The resulting four programs teach attack prevention and control skills. They also emphasize coping skills and help families come to terms with the behavioral factors that impinge on asthma management and affect compliance with medical advice. A technology transfer project for getting initial community adoption of these programs is described. The evolution of the project, including the development of the programs themselves, packaging considerations, establishment of a unique partnership for dissemination, development of a model workshop for stimulating health professionals, implementation of programs, and follow up and evaluation, is described. Successful elements are identified at each step. PMID- 3654240 TI - Patient and family perception of projected functioning after discharge from a burn unit. PMID- 3654241 TI - Endocrine and psychologic responses of patients to cardiac pacemaker implantation. AB - The findings that all HPA and SAM indexes increased during the first postoperative days strongly suggest that transvenous, permanent cardiac pacemaker implantation is a stressor. Since the psychologic tests did not demonstrate marked changes in anxiety or affective mood states, and the former was only weakly related to the endocrine responses, psychologic stimuli cannot be ascribed a prominent role in causing the observed endocrine alterations. Thus, the data suggest that physiologic stressors, such as surgical trauma and the irritation of the tissue surrounding the pacemaker, were the primary stimuli that activated the HPA and SAM systems. Although the structured teaching program resulted in a marked improvement of the treatment groups's knowledge of the device and the follow-up care it requires, it did not affect the endocrine or psychologic responses of patients to cardiac pacemaker implantation. PMID- 3654242 TI - The Wenckebach phenomenon. PMID- 3654243 TI - Myocardial damage and electrocardiographic changes in acute cerebrovascular hemorrhage: a report of three cases and review. PMID- 3654244 TI - Efficacy of proactive information on self-care in radiation therapy patients. PMID- 3654245 TI - Learning needs of cardiac patients: a partial replication study. PMID- 3654246 TI - Accuracy of the closed injectate delivery system in measuring thermodilution cardiac output. PMID- 3654247 TI - Roles played by hospital visitors. PMID- 3654249 TI - The Miami vices in the CCU. Part II. Cardiac manifestations of AIDS. AB - Cardiac manifestations of AIDS probably occur more frequently than is appreciated -despite autopsy reports indicating that more than 50% of deceased AIDS patients had myocarditis. A high index of suspicion and the echocardiogram will help in revealing the true incidence of cardiac involvement in AIDS. PMID- 3654250 TI - The coping responses of female spouses of patients with myocardial infarction. PMID- 3654251 TI - VIIth International Symposium on Radioimmunology. Lyons, France, 8-10 April 1987. Proceedings. PMID- 3654252 TI - Chemical approach to synthetic immunogens in clinical chemistry. PMID- 3654253 TI - Utilization of synthetic peptides for the study of calcitonin and biosynthetic precursors for calcitonin. AB - By using synthetic peptides and a library of monoclonal anti-peptide antibodies, we have developed a panel of techniques that allow the dissection of circulating immunoreactive calcitonin in the serum. C Cells of the thyroid were found to release both mature calcitonin and biosynthetic intermediates in the circulation. Finally, these products were found to circulate as heterogenous molecular species. A methodology for the standardization of the measurement of calcitonin is proposed in the form of a two-site immunoradiometric assay specific for mature calcitonin. PMID- 3654254 TI - Endogenous digitalis-like compounds in essential and experimental hypertension. AB - The hypothesis that endogenous digitalis-like compounds might participate in body sodium and water homeostasis have led us to investigate the presence in plasma of compounds interacting with digoxin antibodies in man and rats. The apparent levels of digoxin-equivalents in plasma of control subjects (n = 21) and patients with essential hypertension (n = 48) or end-stage renal failure (n = 13) were 24.7 +/- 3.2, 34.4 +/- 4.4 and 98.7 +/- 17.4 pg/ml, p less than 0.05 and p less than 0.01 respectively. Positive correlations were observed between systolic and diastolic blood pressure and the apparent immunoreactivity of plasma. No relationship was found with the renal Na+ excretion or the plasma renin activity. The apparent digoxin-like immunoreactivity of the plasma was correlated with its ability to inhibit ouabain binding to the erythrocyte Na+ pump and to reduce the renal Na+,K+-ATPase activity. In rats with experimental hypertension, the plasma cross-reactivity with antidigoxin antibodies was also enhanced when compared to control rats (71.6 +/- 10.2 pg/ml, n = 12 and 57.3 +/- 5.0 pg/ml, n = 33 in Na+ loaded rats and in rats with reduced renal mass respectively compared to 43.4 +/- 3.7 pg/ml, n = 36, p less than 0.05). In spontaneously hypertensive rats (SHR), the apparent levels of digoxin- equivalents were higher than that of age-matched WKY normotensive rats. This increase was already present in prehypertensive SHR (3 week-old) (105.8 +/- 12.4 vs 40.0 +/- 6.5 pg/ml, n = 9 and 8, p less than 0.001) and persisted after hypertension has developed (134 +/- 12.6 vs 85 +/- 7.9 pg/ml, n = 7 and 8, p less than 0.005 in 30 week-old rats). The apparent affinity of the erythrocyte Na+,K+ cotransport for intracellular Na+ and the maximal rate of the Na+ pump were correlated with the plasma digoxin-like levels. These results confirm the presence in plasma of compounds possessing some of the functional and structural properties of cardioactive steroids, associated with a rise in blood pressure. PMID- 3654255 TI - The estrogen-regulated 52K-cathepsin-D in breast cancer: from biology to clinical applications. AB - We have studied estrogen-regulated proteins in an attempt to understand the mechanism by which estrogens stimulate cell proliferation and mammary carcinogenesis. In estrogen receptor positive human breast cancer cell lines (MCF7, ZR75-1) estrogens specifically increase the production into the culture medium of a 52,000 daltons (52K) glycoprotein. Several high affinity monoclonal antibodies to the partially purified secretory 52K protein have allowed to purify to homogeneity this protein and its cellular processed products. The 52K protein has been identified as the secreted precursor of a cathepsin-D like protease bearing mannose-6-phosphate signals and routed to lysosomes via mannose-6 phosphate receptor. The protease is mitogenic in vitro on estrogen deprived MCF7 cells and is able to degrade basement membrane and proteoglycans following its activation. The cellular related proteins, as detected by immunohistochemistry and immunoassay are more concentrated in proliferative mammary ducts than in resting ducts and their concentration in breast cancer cytosol appears to be more correlated with lymph nodes invasion and disease free survival (with S. Thorpe, Copenhagen) than with the estrogen receptor (RE) level. The protein is also produced constitutively by RE-negative cell lines, while in some antiestrogen resistant variants, it becomes inducible by tamoxifen, contrary to the wild type MCF7 cells. Cloning of its cDNA in lambda gt11 has allowed to show that the mRNA is rapidly induced by estrogens and to sequence the protein and compare it to that of the normal human kidney cathepsin-D.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654256 TI - Alpha-lactalbumin and GCDFP-15 as breast tumor markers (an opportunity to study breast tumors functionally). PMID- 3654257 TI - [The septic patient. General surgical therapy]. PMID- 3654258 TI - [One-stage sensible phalloplasty in the transsexual female]. PMID- 3654259 TI - [Total and partial reconstruction of the nose]. PMID- 3654260 TI - [Cranio-orbital-facial surgery]. PMID- 3654261 TI - [Fast volume replacement in hypovolemia: effect of the infusion solution containers, infusion tubing and catheters]. PMID- 3654262 TI - [Infection in the urologic patient]. PMID- 3654263 TI - [Swiss Society of Urology. Contributed papers and posters. Union of Swiss Surgical Specialties, 3d congress. Lucerne, 18-20 September 1986]. PMID- 3654264 TI - Hemoglobin Hobart or alpha 20(Bl)His----Arg: a new alpha chain hemoglobin variant. AB - A new alpha chain hemoglobin variant, Hb Hobart, alpha 20(Bl)His----Arg, was detected in a 60-year-old female of British nationality. The proposita had a history of severe rheumatoid arthritis and had been treated for many years for a refractory microcytic anemia and/or iron deficiency. A hemoglobin electrophoresis screen indicated the presence of a hemoglobin variant, with electrophoretic characteristics similar to a Hb Lepore. However, the level of the variant (17.9%) and the presence of a minor variant Hb A2 band (0.4%) suggested that further investigation was indicated. The variant hemoglobin was purified by column chromatography and the alpha chain subjected to aminoethylation and tryptic digestion. Peptide mapping and amino acid analysis indicated that the histidine residue 20 had been substituted by an arginine residue. The substitution in Hb Hobart is at the first residue in the B Helix of the alpha chain of hemoglobin. As this is an externally placed amino acid in the hemoglobin molecule, a substitution at this position of the hemoglobin molecule would not be expected to cause any functional problems. A family study has shown that at least three other relatives are heterozygous for Hb Hobart. These family members have normal hematological findings. PMID- 3654265 TI - A new unstable and low oxygen affinity hemoglobin variant: Hb J-Auckland [beta 25(B7)Gly----Asp]. AB - Hb J-Auckland is a new hemoglobin variant with the amino acid substitution beta 25(B7)Gly----Asp. It is mildly unstable and has a low oxygen affinity. The propositus and a son, both heterozygous for Hb J-Auckland, have marginally low Hb values but no apparent clinical symptoms. PMID- 3654266 TI - Clinical and morphological changes in non obstructive renal tuberculosis. PMID- 3654267 TI - The synergistic antitumor effect of natural-human TNF and anticancer drugs. PMID- 3654268 TI - A simple method for the observation of cultured rat hepatocytes by scanning electron microscopy. PMID- 3654269 TI - Effect of androgen and aging on ornithine decarboxylase activity of rat ventral prostate. PMID- 3654270 TI - Clinical analysis of 110 postoperative deaths of the patients with permanent implantable pacemaker. PMID- 3654271 TI - Preventive effect of proglumide on erosive gastritis in the rat. PMID- 3654272 TI - A case of ovarian strumal carcinoid. A histochemical, immunohistochemical and ultrastructural study. PMID- 3654273 TI - Systemic argyria secondary to breath freshener "Jintan Silver Pills". PMID- 3654274 TI - Bile acid and ammonia-induced brain edema in rats. PMID- 3654275 TI - Parathyroid cell variants may be provoked during immersion fixation. AB - Parathyroid glands of cattle, dogs, cats, mice and rats were immersed in glutaraldehyde or mixtures consisting of glutaraldehyde, formaldehyde and acrolein in either Na-phosphate, Na/K-phosphate or Na-cacodylate buffer, and postfixed with OsO4 in the same buffers or, alternatively, in s-collidine. Excellent preservation of bovine, feline and murine parathyroid glands was achieved with fixation mixtures containing 1% glutaraldehyde, 1.5-2% formaldehyde and 2.5-5% acrolein in 0.1 M Na-cacodylate with or without Ca2+ and Mg2+, Na phosphate or Na/K-phosphate at 4 degrees C followed by postfixation with 1% OsO4 in the same buffers or in s-collidine containing sucrose, Ca2+ and Mg2+. This procedure largely abolished the occurrence of parathyroid cell variants. Bovine parathyroid glands were also satisfactorily preserved with 1% glutaraldehyde and 2% formaldehyde whereas 1% glutaraldehyde and 2.5 or 5% acrolein, lower or higher buffer osmolarity, or immersion at room temperature led to vacuolization of RER and to breakdown of membranes. In contrast, all fixation protocols led to the formation of dark and light cell variants and to multinucleated syncytial cells in dog and rat parathyroids. The results thus show that parathyroid cell variants arise during immersion fixation and that aldehydes, buffers and temperature are important factors for provoking parathyroid cell variants. PMID- 3654276 TI - Significant depletion of NPY in the innervation of the rat mesenteric, renal arteries and kidneys in experimentally (aorta coarctation) induced hypertension. AB - The distribution and concentrations of neuropeptide Y (NPY) in kidneys, renal arteries, heart, aorta, mesenteric artery and adrenal glands from aorta-ligated hypertensive rats were studied by immunocytochemistry and radioimmunoassay. Immunocytochemistry showed that in the hypertensive animals NPY-immunoreactive fibres were decreased in both kidney and renal artery, above and below the ligation, and in mesenteric arteries. The depletion of NPY-containing nerves in the kidney was more pronounced around the juxtaglomerular apparatus than in other areas of the organ. By radioimmunoassay, the concentrations of NPY immunoreactivity were significantly lower in the hypertensive animals when compared with the controls, (kidney: hypertensive 1.0 +/- 0.1; controls 2.0 +/- 0.2 pmol/g, mean +/- SEM; p less than 0.05 renal artery: hypertensive 5.0 +/- 0.8; controls 12.1 +/- 2.0; p less than 0.05 and mesenteric artery: hypertensive 8.6 +/- 1.9; 17.6 +/- 3.0; p less than 0.01). While there were no statistically significant changes in the levels of NPY immunoreactivity in the other areas studied, there was a general trend for the level to fall in the renal artery below the ligation (hypertensive 10.6 +/- 1.5; control 15.3 +/- 2.4; p greater than 0.05). It is of interest that changes were observed in the vasoconstrictor peptide NPY in this commonly used model of hypertension. PMID- 3654277 TI - A quantitative and qualitative cytochemical analysis of glycosaminoglycan content in the zona pellucida of hamster ovarian follicles. AB - In this study the amount of neutral and acidic glycosaminoglycans in the zona pellucida and antrum of primary, preovulatory, and atretic follicles was analyzed. Serial sections of preovulatory hamster follicles were stained with PAS or alcian blue to estimate the content of neutral and acidic glycosaminoglycans, respectively. The amount of hyaluronic acid, chondroitin sulfate and sialic acid was determined using enzyme digestion procedures followed by alcian blue staining. Microdensitometric analyses showed that the strongest PAS staining was in the zona pellucida of atretic follicles, less staining in preovulatory follicles but more than in the antrum of preovulatory follicles. No hyaluronic acid was found in the zona pellucida of any follicular type, but there was a measurable amount in the antrum of preovulatory follicles. Chondroitin sulfate was present in the zona pellucida of primary and atretic follicles, as well as in the antrum of preovulatory follicles. Sialic acid was present in the antrum and zona pellucida of all follicular types. Sialic acid plays a role in receptor recognition and its presence may reflect the role of the zona pellucida in sperm recognition and fertilization. PMID- 3654279 TI - [The Wurzburg auditory field, a test for prosthetic audiometry]. AB - In the past audiology was used solely to provide data of hearing acuity only for diagnostic reasons. Even today hearing aids are selected and fitted based on various diagnostic test procedures. Our test called "Das Wurzburger Horfeld" yields primarily prosthetic data. That test is based on the principle of absolute category scaling of loudness and defines an acoustic sensation using the parameters of frequency and intensity. The test subject ranks a norrow band noise, 1/3 octave, presented at various intensities into one of the five categories: Very soft, soft, middle loud, loud and very loud. Results are presented for subjects with and without hearing aids. The difference of both scaling experiments is the functional gain of the aid. PMID- 3654278 TI - The relationship between the activities of the pentose phosphate pathway and glycolysis during early stages of floral induction in spinach. AB - A quantitative cytochemical study was made of fructokinase, glucokinase, and fructokinase (both PFK-ATP and PFK-PP + F-2:6-P) activities in shoot apices of 4 week old Spinacia oleracea. The rates of activity of these enzymes in the central zone of the shoot apex of plants kept on a short day regime were compared with those from plants transferred from a range of timing up to 24 h to a continuous light regime when floral induction occurred. A mechanism is suggested explaining how no measurable change in activities of the enzymes assayed could still account for the availability of adequate levels G-6-P as substrate for pentose pathway activity which is almost doubled early on in cells of the central zone of shoot apices induced to flower. PMID- 3654280 TI - [Functional plastic surgery of inflamed cavities: the fascination of tympanoplasty]. AB - Reconstructive middle ear surgery was introduced in the early fifties. Kley was one of the first to investigate the applicability of grafts and the functional restoration of the middle ear transformer. He also practiced a combined approach with anterior tympanoplasty and posterior mastoidectomy. On the occasion of his 65th birthday it can be said that his achievements such as the use of fascia for tympanic membrane reconstruction, the systematic stapes elevation etc. have contributed to the success of tympanoplasty. PMID- 3654281 TI - [Laterocaudal approaches to the clivus]. AB - The different lateral approaches to the skull base (including the clivus) are subsumed under the term infero-lateral approaches, and include: 1. The cervical approach. 2. The direct lateral approach. 3. The postero-inferior approach. Indications and technical details are discussed, and a few examples are demonstrated. The inclusion of microsurgery improves the results as regards survival, function and esthetics. Reconstructive surgery must be included in the rehabilitation of these difficult surgical problems. In special cases this problem can be better solved by co-operation between ENT and neurosurgeons. PMID- 3654282 TI - [Surgical treatment of choanal atresia]. AB - The indications for surgery of congenital choanal atresia and the different surgical approaches are discussed in detail. The transnasal approaches should be done only in emergency situations or as first-aid treatment; the transmaxillary approach is not important today. The transpalatinal approach in the head-down position under microsurgical conditions has proved to be much better. Thirty-six cases with congenital choanal atresia were observed in 15 years. Thirty-four patients were operated on in infancy or childhood and controlled later on. Four children showed bilateral choanal atresia; the other patients had unilateral complete atresia. In 8 patients a transnasal approach was done, in 6 cases there was a recurrence in the form of a complete stenosis and after transpalatinal re operations there was a relapse in only one case. One patient was operated on the transmaxillary approach. In 25 cases the transpalatinal approach was the method of operation; relapse was seen in 5 cases only and could be revised by transpalatinal approach, one case excepted. Own experience and the present results show that the transpalatinal approach is suitable for adults as well as newborn babies and infants. On account of the better view of the operating area and optimal reconstructive conditions, the transpalatinal approach appears to be safer and long-term results are good. PMID- 3654283 TI - [Status of various surgical technics in nose defects]. AB - The different methods of nasal reconstruction in respect to the number of operative steps, the esthetic and functional result and the risk of complications in the flap are initially examined. Such a review can be of value for the beginner in plastic reconstructive surgery, but it cannot lay down strict recommendations, because variation of the nasal defects with regard to size and site often require an individual technique for closure of the defect. PMID- 3654284 TI - [Reconstruction of function and esthetics in facial defects]. AB - The article describes the modern trends in cosmetic surgery as well as new techniques. Details, however, are not discussed. In the section on reconstructive surgery, the eye lids and the lips are dealt with and well-established methods are mentioned. PMID- 3654285 TI - [Secondary surgical voice rehabilitation]. AB - Surgical voice restoration is possible years after laryngectomy by using hypopharyngeal puncture and cricopharyngeal myotomy if necessary. We have developed a technique of insertion of the ESKA-Herrmann tracheostoma valve for fingerfree speech. The patient moistens and cleans the tracheostoma valve every day. The quality of fingerfree speech is the best of all known techniques. PMID- 3654286 TI - Adverse effect from use of 5% fluorouracil. PMID- 3654288 TI - Animal insurance and the veterinarian. PMID- 3654287 TI - Efficacy of ivermectin against Parascaris equorum. PMID- 3654289 TI - AVMA professional liability insurance guidelines. American Veterinary Medical Association. PMID- 3654290 TI - The cycle syndrome. PMID- 3654291 TI - Dog interaction with persons receiving institutional geriatric care. AB - A prospective study of 66 geriatric residents in 2 facilities was conducted to quantitate people-dog interactions. Residents were assigned randomly to sessions with dog activity and to sessions with other activity in a crossover design. This study involved a 12-week prestudy activity period and two 12-week activity periods, one before crossover and one after crossover. Systolic and diastolic blood pressures, psychologic evaluation of case histories, and other health and social variables were measured on all residents for dog activity and other combinations of programmed activity sessions. Frequence of attendance in both facilities was higher at dog activity sessions than at other activity sessions (P less than 0.01). Resident systolic blood pressures were lower in one facility during dog activity (P less than 0.02). Combined pre- and postactivity systolic and diastolic blood pressures at the same facility were lower when residents had 12 weeks of dog activity before 12 weeks of other activity (P less than 0.04). There were no significant differences in residents' blood pressures between measurements before and after dog activity (treatment mode) or between measurements before and after other activity. Psychologic scores of residents in both facilities were not significantly different between periods of the study. Of the 9 types of interaction between the residents and the dog, grooming and touching were the 2 most commonly used by residents. PMID- 3654292 TI - Radiotherapy of malignant nasal tumors in 67 dogs. AB - The nasal cavity of 67 dogs with malignant nasal neoplasia was treated with radiation. Preirradiation surgical cytoreduction of the tumor was done in 41 dogs. Fifty dogs were irradiated by use of 10 fractions over 22 days, and 17 dogs were given a similar total dose in 5 fractions over 35 days. The range of survival times (0.5 to 42 months), median survival time (8.5 months), and 1- and 2-year survival rates (38% and 30%, respectively) were better than those expected for other methods of treatment. Serious complications were few (4%). Survival times for dogs were determined on the basis of histologic tumor type and on the basis of megavoltage (cobalt or linear accelerator) vs softer deep radiation (cesium or orthovoltage) treatment, with or without cytoreductive surgery. Survival times of 10 dogs given softer radiation without surgery were shorter than those of 14 dogs that were given softer radiation and had cytoreductive surgery. Survival times of dogs that were given softer radiation and had surgery were similar to those of dogs that were given megavoltage radiation only. Cytoreductive surgery did not improve survival times for dogs that were given megavoltage radiation. Median survival time for 38 dogs with adenocarcinoma was 12 months, compared with 6 months for 14 dogs with squamous cell or undifferentiated carcinoma. Median survival time for 16 dogs with a variety of sarcomas was 11.2 months. Survival times of dogs with adenocarcinoma or sarcoma were significantly better (P less than 0.02 or 0.03) than for dogs with squamous cell or undifferentiated carcinoma. Necropsies were performed on 27 of 58 dogs that died or were euthanatized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654293 TI - Use of an external skeletal fixation device and bone graft for arthrodesis of the metacarpophalangeal joint in horses. AB - Arthrodesis of the metacarpophalangeal joint was attempted in 9 adult horses, using a new external skeletal fixation device and autogenous cancellous bone graft. Four horses had excellent results, 2 horses had fair results, arthrodesis failed in 2 horses, and 1 horse fractured the third metacarpal bone. The advantages of the technique included minimal surgical trauma to the area of injury, immediate rigid fixation of the metacarpophalangeal joint, and access for treatment of soft-tissue lesions at the site of injury. Although pin loosening and pin-track infection were complications when the device was in place, all pin tracks healed without complications after device removal. PMID- 3654294 TI - Toxicity of high doses of griseofulvin in cats. AB - Eight adult cats were treated with griseofulvin (110 to 145 mg/kg of body weight) daily for 11 weeks; 2 control cats were given a gelatin capsule daily. Hemograms and hepatic enzyme activities were monitored weekly for all cats. Bone marrow examinations were performed before administration of the drug and twice during the study. Cats were observed for untoward clinical effects. Signs of toxicosis (clinical, hematologic, or hepatic) were not found at any time during, or at the cessation of, the study. Although the sample number of treated cats was small, it was concluded that hematologic or hepatic abnormalities that develop with the use of high-dose griseofulvin treatment may be an idiosyncratic reaction found only in a few cats. PMID- 3654295 TI - Idiopathic hemorrhagic pericardial effusion with organized thrombi in a dog. AB - A dog was examined because of cardiac tamponade secondary to pericardial effusion. Masses adjacent to the right atrial and ventricular walls were revealed by echocardiography. Pericardectomy and biopsies of the masses established the diagnosis of idiopathic hemorrhagic pericardial effusion with organized thrombi. The dog was healthy 3 months after surgery. These organized thrombi mimicked cardiac neoplasia echocardiographically, and such a possibility should be included in the list of differential diagnoses of cardiac masses. PMID- 3654296 TI - Mesenteric and gastric volvulus in a dog. AB - Concomitant gastric and mesenteric volvulus was diagnosed in a 5-year-old Komondorok. Despite surgical correction of both displacements, the dog died 14 hours after surgery. Although gastric volvulus is a well-known syndrome in dogs, mesenteric volvulus has been reported infrequently. This report illustrates the importance of radiography in cases of suspected gastric volvulus to rule out other potential causes of acute abdominal distention, including mesenteric volvulus. PMID- 3654297 TI - Mitral valvular insufficiency associated with ruptured chordae tendineae in three foals. AB - Mitral valvular insufficiency associated with ruptured chordae tendineae was diagnosed in 3 foals with signs of congestive heart failure, which were believed to be secondary to the development of pulmonary hypertension associated with the valvular insufficiency. The septal leaflet of the mitral valve was affected in all 3 foals, and foal 2 also had ruptured chordae tendineae associated with the caudal mitral valve leaflet. Bacterial endocarditis and myocardial necrosis were associated with the ruptured chordae tendineae in foals 3 and 2, respectively. Idiopathic rupture was considered in foal 1. Two-dimensional echocardiography demonstrated a flail mitral valve leaflet in foals 2 and 3 and a ruptured chorda tendineae in foal 3. The ruptured chorda tendineae in foal 1 was not visualized with M-mode echocardiography. PMID- 3654298 TI - Surgical repair of a supraglenoid tubercle fracture in a horse. AB - A fractured right supraglenoid tubercle in a 15-month-old Thoroughbred gelding was repaired by partial biceps brachii tenotomy, interfragmentary compression, and tension band wiring. The horse is currently being ridden daily and has remained sound for 4 years. PMID- 3654299 TI - Omental fibrosarcoma in a horse. AB - A 13-year-old Thoroughbred mare had a 2-week history of weight loss and intermittent fever. Examination of abdominal and pleural fluid revealed peritonitis and pleuritis. Ultrasonography of the ventral abdominal midline revealed an intra-abdominal mass. Exploratory celiotomy was performed, but the mass was not surgically excisable. The mare was euthanatized and necropsied. Histologically, the mass was determined to be a fibrosarcoma of omental origin. PMID- 3654300 TI - Multiple myeloma in a horse. AB - Multiple myeloma was diagnosed in a horse on the basis of clinical signs, protein electrophoresis pattern, Bence-Jones proteinuria, and radiographic changes in bone. The horse had mild depression, weight loss, edema of the distal portion of the left hind limb, anemia, hyperproteinemia, and monoclonal gammopathy in the beta 2 region. Radiographically, punctate cortical lysis of bone was seen. Specific treatment for the multiple myeloma was not attempted and the horse was euthanatized. PMID- 3654301 TI - Pulmonary abscess caused by a Mycoplasma sp in a cat. AB - A Mycoplasma sp was isolated from an abscess of the right cranial lung lobe in a 6-year-old Persian cat. The cat responded well to resection of the affected lung lobe and to a 2-week course of tylosin treatment. PMID- 3654302 TI - Hyperadrenocorticism in a ferret. AB - A 7-year-old adult male ferret had progressive hair loss that was bilaterally symmetric. Also clinically evident were severe dehydration, polydipsia, muffled heart sounds, weak femoral pulses, hepatomegaly, lethargy, weakness, temporal muscular atrophy, dyspnea, and weakness. The blood profile of the ferret indicated profound leukopenia, eosinopenia, and high phosphorus, BUN, creatinine, and potassium concentrations, as well as high aspartate transaminase activity; the albumin concentration was low. The serum cortisol concentration was 8.1 micrograms/dl. Necropsy and histologic findings confirmed a diagnosis of hyperadrenocorticism, complicated by dilatative cardiomyopathy, chronic active hepatitis, and renal disease. PMID- 3654303 TI - Primary hyperparathyroidism in dogs: 21 cases (1976-1986). AB - Case records from 21 dogs with hypercalcemia and hyperparathyroidism were evaluated. The dogs were greater than or equal to 7 years old, and 6 were Keeshonds. The most common clinical signs were polydipsia/polyuria, listlessness, and muscle weakness. The serum calcium concentrations were 12.1 to 19.6 mg/dl. Serum phosphorus concentrations were low in 5 dogs, within the reference range in 13 dogs, and high in 3 dogs that also had high concentrations of BUN. Twenty dogs had a parathyroid adenoma, and 1 had a parathyroid carcinoma. Nineteen dogs had their parathyroid tumor surgically removed. Within 5 days of tumor removal, 11 of the 19 dogs became hypocalcemic and the remaining 8, normocalcemic. Nine of the 11 hypocalcemic dogs developed clinical signs. Iatrogenic hypercalcemia was induced in 7 of 16 dogs treated orally with calcium carbonate plus vitamin D. Only 1 of 19 dogs that had their parathyroid tumor excised died in hypocalcemic tetany. Two additional dogs died within 2 weeks of surgery, one because of pancreatitis, the other due to renal failure. Eight dogs died 9 to 37 months after surgery of unrelated problems. Eight dogs were alive for at least 7 to 28 months after surgery. PMID- 3654304 TI - What is your diagnosis? Osteomyelitis of the distal phalanx. PMID- 3654305 TI - Thoughts on euthanasia. PMID- 3654307 TI - Surgical removal of heartworms. PMID- 3654306 TI - Gray collie syndrome. PMID- 3654308 TI - Resistance to benzimidazoles. PMID- 3654309 TI - Diagnosis of enteritis. PMID- 3654310 TI - Income calculations. PMID- 3654311 TI - Killing fleas with ethanol. PMID- 3654313 TI - The human side of veterinary medicine. Idealized image. PMID- 3654312 TI - Reciprocal licensure. PMID- 3654314 TI - Clinical and endocrine responses to embryonic and fetal death induced by manual rupture of the amniotic vesicle during early pregnancy in cows. AB - Pregnancy was terminated in 4 cows by manual rupture of the amniotic vesicle on day 41 (n = 1) and day 46 (n = 3) after insemination. Each cow was necropsied 36 days after vesicle rupture, by which time only one cow had come into estrus. Luteal activity, monitored daily by plasma progesterone assay, was still evident in 2 cows 35 days after fetal death; in the remaining 2 cows, regression of the corpus luteum (CL) was achieved at 28 and 32 days, respectively. Uterine release of prostaglandin F2 alpha (PGF2 alpha), measured as the 15-keto metabolite (PGFM) PGF2 alpha, was monitored by a plasma sampling schedule; specimens were obtained every 4 hours. There were no appreciable releases of PGF2 alpha associated with fetal death. The first appreciable PGF2 alpha release in episodic form was seen only in conjunction with CL regression. In all cows, a palpable membrane slip was evident for 18 days after rupture of the amniotic vesicle, although at that time, uterine resilience was diminished in the 2 cows in which the CL subsequently regressed. After 18 days, the uterus was noticeably edematous and fluid-filled in all cows; in 1 of the cows with a regressed CL, the uterus had returned to prepregnancy size and tone by day 33.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654315 TI - Assessment of neutrophil function in dogs with primary ciliary dyskinesia. AB - Compared with neutrophils from healthy dogs, neutrophils from 2 dogs with primary ciliary dyskinesia had increased distance of random migration, but fewer of the neutrophils migrated. The affected dogs had an increase in the numbers of Staphylococcus aureus phagocytized. Lymphocyte blastogenesis in the affected dogs in response to standard mitogens was considered to be normal. PMID- 3654316 TI - Bacillus piliformis infection (Tyzzer's disease) in a calf. AB - A 1-week-old Jersey bull calf with a history of diarrhea, weakness, and lethargy was submitted for necropsy. Principal macroscopic findings were enteritis and multifocal necrotizing hepatitis. Histologically and ultrastructurally, organisms with characteristics of Bacillus piliformis were associated with the foci of necrosis in the liver. PMID- 3654317 TI - Cecal volvulus in a dairy cow: partial resection of the proximal portion of the ascending colon. AB - Cecal volvulus in a dairy cow with vascular compromise of the proximal portion of the ascending colon was corrected surgically with preservation of the ileocecocolic junction. Partial cecectomy was combined with resection of the proximal portion of the ascending colon and anastomosis of the remaining cecum to the distal portion of the ascending colon. The procedure was done with the use of mechanical suturing devices while the cow was standing. Previously, general anesthesia and relocation of the ileocecocolic junction had been suggested. PMID- 3654318 TI - Nasomaxillary fibrosarcomas in three young horses. AB - Nasomaxillary fibrosarcoma was diagnosed in 3 young horses. Clinical signs included epiphora, facial swelling, dyspnea, unilateral serosanguineous nasal discharge, or an external mass. Physical examination, radiography, and cytology were important diagnostic adjuncts. The definitive diagnosis in each case was based on biopsy. In one case, surgical removal of the tumor and extensive curettage of the affected sinus resulted in extended remission from neoplastic disease. PMID- 3654319 TI - Use of a double-hook plate to repair a subtrochanteric femoral fracture in an immature dog. AB - A subtrochanteric femoral fracture in a 5-month-old Doberman Pinscher was repaired by use of a 5-hole, 3.5-mm, double-hook plate. The double-hook plate afforded rigid 3-point fixation of the short proximal metaphyseal segment without impingement of the proximal femoral physis and allowed compression of the fracture fragments by placement of an interfragmentary screw through its pendulum hole. The fracture healed without complications, and the dog had a rapid return to function. Although designed for use in performing femoral osteotomies in dogs afflicted with hip dysplasia, the double-hook plate can be used to repair fractures with short proximal or distal segments. PMID- 3654320 TI - Zinc-induced hemolytic anemia in a dog. AB - A dog ingested a zinc nut that was retained in the stomach and caused a life threatening hemolytic crisis with renal, gastrointestinal, and hepatic dysfunction. The dog was stabilized by blood transfusion and was anesthetized, and the zinc nut was removed with a fiberoptic endoscope. With continued supportive care, the dog recovered. Metallic zinc is found in high concentrations in nuts, bolts, and pennies. Zinc toxicosis should be considered in cases of unexplained hemolytic anemia. PMID- 3654321 TI - Systemic paecilomycosis in a dog. AB - Disseminated paecilomycosis was diagnosed in an adult dog without underlying immunosuppressive disease. During the 3-month illness (before euthanasia), the dog had ulcerative granulomatous inguinal lymphadenitis, fever, anorexia, dyspnea, generalized lymphadenopathy, retinochoroiditis, and seizures. Fungal organisms isolated from inguinal and prescapular lymph nodes before the dog was euthanatized were identified histologically. Paecilomyces variotii was isolated from the prescapular lymph node specimen. Paecilomyces variotii may be more pathogenic (once it has gained bodily entry) than previously thought. PMID- 3654322 TI - Generalized demodicosis associated with diabetes mellitus in two cats. AB - Generalized demodicosis with concurrent diabetes mellitus was diagnosed in 2 cats. Both cats had generalized alopecia and a bilateral brown aural exudate. Mites were seen microscopically in skin scrapings and ear swab specimens. Histologic examination of the skin showed the follicular orientation of the mites. Abnormal results on oral dexamethasone suppression tests, clinical findings, and bilateral adrenal hyperplasia found on necropsy of one of the cats suggested concurrent hyperadrenocorticism. PMID- 3654323 TI - Pancreatic carcinoma in a cockatiel. AB - A female cockatiel was examined because of abdominal distention, decreased appetite, and weight loss. Although abdominocentesis, bacteriologic culture, radiography, and ultrasonography were performed, the diagnosis of pancreatic carcinoma was obtained only after exploratory laparotomy and histologic examination. The resected abdominal mass was pancreatic carcinoma. The bird survived for 56 days after surgery. Necropsy confirmed abdominal metastatic pancreatic carcinoma. PMID- 3654324 TI - Trends in veterinarians' incomes. PMID- 3654325 TI - The structure and innervation of the saccopleural membrane of the domestic fowl, Gallus gallus: an ultrastructural and immunohistochemical study. AB - Microscopic studies have shown the saccopleural membrane in the respiratory system of the domestic fowl to consist of a sheet of three dense layers of collagen fibres covered dorsally and ventrally by mainly simple squamous epithelium. On the ventral surface, which faces into the caudal thoracic air sac, there are occasional ridges of pseudostratified ciliated epithelium. Many nerve bundles are present throughout the membrane, the larger bundles of myelinated and unmyelinated axons being confined to the lamina propria under the dorsal epithelium (parietal pleura). In addition to axonal profiles with the ultrastructural appearance of cholinergic or adrenergic axons, peptidergic-type axons were identified. Immunofluorescence studies demonstrated VIP-, substance P , somatostatin- and enkephalin-immunoreactive fibres in the membrane. Although it has been suggested that receptors may be present in this region of the respiratory system, none of the axons have features suggestive of sensory terminals, although many axonal profiles are closely associated with the epithelia where no obvious effector cells are present. PMID- 3654326 TI - Cell death in the embryonic brain of Gallotia galloti (Reptilia; Lacertidae): a structural and ultrastructural study. AB - In the striatum, thalamus and cerebellum of a Lacertid reptile, we have found three types of cellular death during embryonic development, both at the light and electron microscopic level. The first affects the undifferentiated neuro epithelial cells and is commonest during the early stages (E. 32-E. 36). The second corresponds to the type of 'nuclear' death described in the bibliography and reaches a maximum in the middle embryonic period (E. 37-E. 39); nevertheless important variations were observed in different zones. The third is the same as the 'cytoplasmic' death type and appears in the perinatal stages. Phagocytosis involved in the elimination of dead cells is of two types. One is associated with early death and is carried out by undifferentiated neuro-epithelial cells. The other is carried out by microglial cells which appear around Stage 37. Much cellular debris was observed in the intermediate zone and this was associated with the second type of phagocytosis. In both cases lipid production was associated with the degenerative process. Comparison of the temporal cellular death pattern with synaptogenesis, gliogenesis and maturation of neuronal processes is consistent with the view that the various types of cellular death found by us had different causes. PMID- 3654327 TI - Age-related changes in the number of myelinated axons and glial cells in the anterior and posterior limbs of the mouse anterior commissure. AB - The total number of axons and the number of myelinated axons was estimated in both limbs of the anterior commissure of mouse brains from 5 to 31 months of age. The total number of glial cells and the percentage of each type of glial cell was estimated in both limbs of the anterior commissure at 25, 28 and 31 months since similar estimations had already been carried out in mice aged between 5 and 22 months. The total number of axons and the number of myelinated axons both appeared to fall between 9 and 12 months and to increase again between 22 and 25 months in the anterior limb whereas in the posterior limb the total number of axons remained constant but the number of myelinated axons increased between 22 and 28 months. Two types of abnormality were seen in myelinated fibres at all ages after 12 months. These consisted of degenerating axons enclosed in normal myelin sheaths and apparently normal axons surrounded by vacuolated sheaths. The total number of glial cells in both limbs decreased between 9 and 12 months and increased substantially between 22 and 25 months. There was a statistically significant correlation between the number of oligodendrocytes and the percentage of myelinated axons in both limbs at different ages. There was no change in the very small number of mitotic figures in the anterior commissure to account for the fluctuation in glial number. It is postulated that there is a continuous loss and replacement of myelinated axons in both limbs of the commissure from 12 to 31 months of age and that this is possible since the amount of axon loss is so small that there is no significant phagocytic or astrocytic response. An increased requirement for myelination appears capable of bringing about an increase in the number of oligodendrocytes even in aged animals. PMID- 3654328 TI - The effects of low birthweight on the ultrastructural development of two myofibre types in the pig. AB - An ultrastructural investigation of the postnatal development of oxidative and non-oxidative fibres from the deep and superficial portions of the semitendinosus muscle, respectively, was undertaken on 32 pure bred Large White pigs from a total of 11 litters. This study quantifies the changes in mitochondrial, lipid droplet and myofibrillar content of these two myofibre types between birth and 84 days of age, and evaluates differences between the largest male (mean birthweight of 1559 g), smallest normal male (1147 g), and runt (758 g) littermates. The oxidative and non-oxidative fibres, as well as possessing different complements of mitochondria, lipid droplets and myofibrils, showed different rates of myofibrillar accumulation. The relatively small postnatal change in the percentage volume of myofibrils of oxidative fibres, as opposed to the high change within the non-oxidative fibres, presented a cytological basis by which to explain the differential effects of growth retardation on these fibre types. The ultrastructural composition of myofibres was not impaired by reduced birthweight except when, as in two extreme cases, birthweight was severely reduced. In these instances the myofibrillar percentage volume of the non-oxidative fibres was greatly affected. PMID- 3654329 TI - The vascularisation of the central-peripheral transitional zone of rat lumbar ventral rootlets: a morphological and morphometric study. AB - The blood vessels supplying the central-peripheral transitional zone of rat fifth lumbar ventral spinal nerve rootlets were examined during development and at maturity. At all stages all vessels were either capillaries or postcapillary venules. They lay in the spaces between the rootlets, being entirely absent from the endoneurial spaces. A proportion of these vessels communicated with those supplying the adjacent spinal cord. In this respect they differed from those supplying the dorsal rootlet transitional zone, at least in the cat, where no such communication occurs. During the first week after birth, at least one capillary was directly related to each rootlet, generally over about half the length of the transitional zone. Subsequently vascularity increased considerably. At three weeks postnatum, and subsequently, capillaries outnumbered rootlets by up to 50% and almost the entire length of the transitional zone was related to one capillary or more. This change was related to the maturation of the transitional nodes of gamma axons, which is likely to be related to increased alpha and gamma motoneuron activity. These changes were somewhat offset due to the fact that rootlet diameter increased with age. As a result, the distance between the capillary wall and the centre of the rootlet almost doubled between 20 and 300 days postnatum. The diameter of the capillaries did not change with age but that of the postcapillary venules increased. PMID- 3654330 TI - Lipofuscin formation in the myocardium of juvenile golden hamsters: an ultrastructural study including staining for acid phosphatase. AB - Atrial and ventricular myocardium from young golden hamsters, 3-6 months of age, was examined under the transmission electron microscope, representative samples from each animal having been stained histochemically for acid phosphatase (AP) by a lead precipitation technique. Our observations indicated that AP positive primary lysosomes are produced at the sites of Golgi-endoplasmic reticulum lysosome (GERL) complexes and the main pathway for lipofuscin production is by fusion of primary lysosomes with mitochondria in both atrial and ventricular myocytes. The mitochondria are then progressively degraded, their matrix becomes denser and there is an accompanying increase of AP activity. After reaching a peak level, AP activity declines until an AP negative terminal pigment body with a smooth outline is produced. Another pathway, but much less frequent at this age leads to the formation of larger bodies, irregular in outline and containing small globules. Their genesis entails the participation of autophagic vacuoles which engulf lipid droplets, mitochondria or amorphous debris. Like the main variety of lipofuscin body, they contain AP while digestion progresses but eventually become AP negative. A few lipofuscin granules are eliminated by being pinched off within fine cell protrusions and are subsequently engulfed by scavenger cells. PMID- 3654331 TI - A study on the pattern of alkaline phosphatase activity correlated with observations on silver-impregnated structures in the developing mouse brain. AB - Alkaline phosphatase activity was localised in specific groups of cellular processes, nuclei and fibre tracts in fetal mouse brain at 9.5-17.5 days post coitum. A radial band of intense enzymatic activity extended longitudinally within the rhombencephalon at 10.5 to 15.5 days. This enzymatic band was topographically related to the efferent nuclei of the cranial nerves, except those nuclei which had migrated laterally to their final positions. The enzymatic activity was seen in some but not all silver-impregnated fibre tracts that appeared early in development, but such association disappeared upon further maturation of the brain. Alkaline phosphatase activity may be related to an enhanced metabolism occurring during the formation of the cranial nerve efferent nuclei and the establishment of neuronal connections in the fetal brain. PMID- 3654332 TI - Ultrastructure and arrangement of hepatocyte cords in the duckling's liver. AB - Hepatocytes are arranged in 30 microns diameter cords. A transverse section through a cord shows 4-6 wedge-shaped hepatocytes arranged around a central bile canaliculus Hepatocyte cords branch to form a continuous three dimensional meshwork which interlocks with an almost identical one of blood sinusoids. Bile canaliculi, at the centre of the cords, are formed by the biliary poles of 4-6 hepatocytes being joined together by tight junctions and collectively surrounding a small tube of extracellular space. Side branches are common and form between the lateral walls of hepatocytes radial to the main central canaliculus. PMID- 3654333 TI - A quantitative study of Australian aboriginal and Caucasian brains. AB - The brain volumes of 8 male Australian Aborigines and 11 male Caucasians were determined. Total brain volume was significantly smaller for Aborigines (1199 +/- 84 ml) compared to Caucasians (1386 +/- 98 ml). Significantly smaller volumes were also found for cerebellum, prosencephalon-mesencephalon unit, cerebral cortex, frontal cortex, parieto-occipitotemporal cortex, and hippocampus. Volumes of ponsmedulla oblongata unit (21 +/- 3 ml for Aborigines and 22 +/- 3 ml for Caucasians) and visual cortex (14.9 ml +/- 2.6 ml and 14.6 +/- 2.2 ml, respectively) did not differ significantly. The striate cortex extended further onto the lateral surface of the occipital lobe in Aboriginal brains. The frontal portion of cerebral cortex was larger in Aboriginal than in Caucasian brains. According to the specific growth periods for the areas studied, these differences could be explained by the higher incidence of malnutrition and infectious diseases for Aboriginals during the development of the brain in early childhood, especially after the 6th postnatal month. However, genetic influences cannot be excluded. The results for the visual cortex of Aborigines might represent an adaptation to living conditions in the bush and desert regions of Australia. PMID- 3654334 TI - The effect of hydrocortisone on the para-aortic body of the newborn mouse: an in vivo fraction of labelled mitoses study. AB - Information about the cell cycle of the mouse para-aortic body within the first 24 hours of postnatal life was derived from a fraction of labelled mitoses study. The total cell cycle time was 8 1/2 hours, being made up as follows: S phase-2 hours; G2 phase-1 hour; M phase-3 1/2 hours (by analysis of the results, not by assumption) and G1 phase-2 hours (by subtraction). Problems are discussed regarding the length of G2 and M phases and the consequences for G1. After hydrocortisone administration (40 mg/kg/day) to female mice for the last seven days of pregnancy, the pattern in newborn mice was disrupted. Values for G2 and M were similar to those of the untreated group, but no values were obtainable for the other phases of the cell cycle or for the total cell cycle time. These results after hydrocortisone treatment could be explained by the superimposition of the cell cycles of two or more different groups of cells. They are discussed with regard to the life span of the para-aortic body, and their implications are considered in the light of previously reported glucocorticoid-induced transformations of small granule cells from cervical sympathetic ganglia into catecholamine-storing chromaffin cells. The established hyperplastic effect of hydrocortisone on the para-aortic body is therefore not the result simply of an acceleration of the cell cycle, but it may involve the incorporation into the proliferative compartment of cells previously either moribund or nonproliferating. PMID- 3654335 TI - The embryonic origin of connective tissue mast cells. AB - To find out whether mast cells are derived from the neural crest or from mesoderm, explants of avian blastoderm, from which the neural crest was excluded, were grown on the chorio-allantoic membrane of chick hosts. The grafts were fixed in aldehyde fixatives and stained to demonstrate metachromatic connective tissue mast cells. In grafts of chick endoderm and mesoderm, mast cells were present despite the absence of neural crest derivatives. To ascertain whether these mast cells were perhaps of host origin, in a second experiment quail embryos were used as donors; explants included all three germ layers and were delimited so as to exclude neural crest cells. The proportion of the mast cells present that showed very large nucleoli such as are characteristic of quail cells was far in excess of that observed in mast cells of a young chick and much closer to that seen in these cells in a young quail. The same was true for grafts in which quail mesoderm had been combined with chick endoderm. Taken together, the results show that connective tissue mast cells are mesodermal rather than neural crest in origin. PMID- 3654336 TI - The morphology and morphometry of the adult normal baboon lung (Papio anubis). AB - The gross, histological and ultrastructural organisation of the baboon lung was found to be similar to that of the human lung. It is suggested that, in general, the lungs of the non-human primates would serve as ideal models for the study of the human lung. The baboon lung comprises the parenchyma, the gas exchange part of the lung which consists of alveoli, blood capillaries and the tissue of the interalveolar septum, and the non-parenchyma made up of the air conducting passages like bronchi, bronchioles, larger blood vessels, connective tissue and pleura. On morphometric analysis, the parenchyma was found to constitute 87% of the lung, the rest being made up of the elements of the non-parenchyma. The alveoli, blood capillaries and the interalveolar tissue respectively constituted 76, 8 and 16% of the parenchyma. The harmonic mean thickness of the blood-gas (tissue) barrier was 0.475 micron and the arithmetic mean 1.12 micron, the ratio being 1:2.3. The weight specific surface area of the blood-gas (tissue) barrier was 37 cm2/g and the surface density of the tissue barrier in the parenchyma 92 mm2/mm3. The total morphometric pulmonary diffusion per unit body weight was 4 ml O2/min/mmHg/kg and the volume of the pulmonary capillary blood per unit surface area of the tissue barrier 0.84 cm3/m2. Morphometrically the baboon lung was thus observed to be better adapted for gas exchange than that of man but less specialised than that of the smaller monkeys such as Macaca mulatta. PMID- 3654337 TI - Effects of hypothyroidism on the karyometric development of pyramidal neurons of the hippocampus (CA1), area 6 and area 17 in the male mouse. AB - This study has examined the karyometric changes within pyramidal neurons of the hippocampus, motor area 6 and visual area 17 in a hypothyroid group of male mice treated with propylthiouracil, with or without interruption of treatment at the 35th postnatal day. Hypothyroidism resulted in decrease of nuclear size in the three areas before puberty and even after puberty in the hippocampus. Where the treatment was continued throughout the experimental period there was a progressive increase of nuclear size in both visual and motor areas. PMID- 3654338 TI - A morphological study of the development of the chorion of rat embryos. AB - The morphology of the developing chorion of the rat has been studied from its initial formation from the extra-embryonic region of the amniotic fold until its fusion with the ectoplacental cone and allantois prior to the development of the chorio-allantoic placenta (that is from 8.25 to 10.25 days of gestation). The gross structural changes, the mitotic indices, the ultrastructure and the distribution of carbohydrate in the mesodermal and ectodermal cells of the chorion have been studied throughout this period of development. The chorion developed to form a diaphragm across the egg cylinder, separating the exocoelom from the ectoplacental cavity. With further development, the ectoplacental cavity became smaller until the chorion was lying against the ectoplacental cone, to which it fused. The mesodermal cells of the chorion formed a single layer of cells covering the ectodermal cells. Shortly before the fusion of the chorion with the ectoplacental cone or the allantois, the integrity of the mesodermal cell layer in the central region of the chorion was disrupted. Intercellular contact was lost and the mesodermal cells rounded up exposing the PAS-positive extracellular coat of the ectodermal cells. The allantois was only seen to fuse with the chorion in regions in which the ectodermal cells were exposed. It was suggested that the glycocalyx of the ectoderm cells may be of importance in the fusion of the allantois and chorion. PMID- 3654339 TI - Topographical variation of glycosaminoglycan content and cartilage thickness in canine knee (stifle) joint cartilage. Application of the microspectrophotometric method. AB - A recently developed microspectrophotometric method was used to measure local changes of thickness and glycosaminoglycan (GAG) content in articular cartilage. The intensity of the GAG stain was recorded from the superficial, intermediate, deep and calcified zones of articular cartilage. At each site of analysis, both the average stain concentration and the total stain content were determined. Of the 10 predefined locations of the Beagle knee (stifle) joint, the thickest cartilage was observed in the medial condyle of the tibia, which also possessed the highest GAG concentration. In the femur, the summits of the condyles had 33% thicker cartilage than the peripheral parts, while the GAG concentration was about equal in both of these regions. The thinnest cartilage and smallest GAG concentration was at the posterior end of the lateral condyle of the femur. The GAG content in the medial condyle and in the patellar surface of the femur was slightly greater than that in its lateral condyle. PMID- 3654340 TI - The development of Schmidt-Lanterman incisures: an electron microscope study. AB - The development of Schmidt-Lanterman incisures was investigated in the rat sural nerve during an active phase of postnatal myelination (5-21 days post partum). Two distinct populations of incisures were recognised and the following nomenclature for their developmental stages is proposed. Primary incisures which appear ab initio in myelination and always extend across the whole radial thickness of the myelin sheath but initially around only part of its circumference. Consequently they appear in transverse section as sectoral incisures (occupying less than half the circumference) and in longitudinal section as asymmetric incisures (involving one side only of the myelin sheath). Secondary incisures appear later, in regions of a compact myelin sheath, initially traversing only part of its radial thickness but commonly occupying its whole circumference. Thus they usually appear in transverse section as circumferential incisures and in longitudinal section as symmetric incisures (involving both sides of the myelin sheath). Less commonly secondary incisures may form in a sector of the myelin sheath but still in regions of compact myelin and thus appear asymmetric in longitudinal section and sectoral in transverse section. Secondary incisures appear mainly adaxonally in the earlier stages examined and mainly abaxonally in the later stages. The maturation of primary and secondary incisures into the radially and circumferentially complete incisure characteristic of the mature myelinated nerve fibre is described. The above mechanisms of incisural formation are contrasted with mechanisms previously suggested to occur during normal development and remyelination and related to the plasticity and ultrastructure of the myelin sheath. PMID- 3654341 TI - Effects of denervation on baroreceptor and chemoreceptor endings in the aorta and pulmonary trunk of the domestic fowl (Gallus gallus domesticus). AB - Denervation experiments were carried out on twelve adult domestic fowls in order to investigate the location of the cell bodies of baroreceptor and chemoreceptor endings of the aorta and pulmonary trunk. Soon after both distal vagal ganglionectomy and midcervical vagotomy, baroreceptor and chemoreceptor endings showed distinct signs of abnormalities. These abnormal signs included many irregular and deformed clear vesicles, large membranous whorls and vacuolated mitochondria. The endings which were severely affected became greatly swollen and almost empty except for a flocculent substance and disordered filamentous material. It is suggested that the cell bodies of the majority of baroreceptor and chemoreceptor endings are not in the distal vagal ganglion and may be in the proximal vagal ganglion and/or proximal or distal glossopharyngeal ganglia. The chief cells of the aortico-pulmonary bodies were also affected after denervation when their axonal endings degenerated. The degenerative changes took the form of many expanded membrane-bound empty spaces and increased size and number of the dense-cored vesicles. It is concluded that the axonal endings exert a trophic effect upon the granular cells. PMID- 3654342 TI - Effects of bilateral vagotomy on the ultrastructure of the cardiac ganglia in the monkey (Macaca fascicularis). AB - This study describes the effects of bilateral vagotomy on the ultrastructure of the cardiac ganglia of the monkey (Macaca fascicularis). One to three days after bilateral vagotomy there is widespread glycogen accumulation in the cytoplasm of the principal cardiac neurons. This is associated with distension of the granular endoplasmic reticulum and the loss of ribosomes from the cisternae. Between five and ten days after operation, about 10% of the neuronal profiles show an overall increase in electron density and intense darkening of the dendrites. From twenty one to twenty eight days postoperatively, the majority of the neuronal profiles have pale cytoplasm with reduction in granular endoplasmic reticulum and polyribosomes. The plasma membrane of the neuron is ruffled over the major portion of its surface. The satellite cells, which are reactive throughout the course of the experiments, exhibit a phagocytic capacity at this stage by removing portions of the neuronal cytoplasm. Vacuolation of the neuronal cytoplasm to a variable degree occurs in a small number of profiles between five to twenty eight days. The results suggest that bilateral vagotomy causes a widespread disturbance in the metabolic activity of the cardiac neurons. This is followed by transneuronal degenerative changes that are of a prolonged nature. PMID- 3654343 TI - Ultrastructural study of macrophages in the rat thymus, with special reference to the cortico-medullary zone. AB - Electron microscopic study of the normal rat thymus has demonstrated that macrophages with different ultrastructural features are positioned in the thymic cortex, in the cortico-medullary zone and in the medulla. Phagocytic cells, containing necrotic lymphocytes in various stages of degradation, are distributed throughout the thymic cortex. The cortico-medullary zone, in contrast, is populated with macrophages displaying specific ultrastructural features. These cells contain numerous vacuolar inclusions of different size, filled with homogeneous, flocculent material of very low electron density. The dense bodies, occasionally positioned to the inner side of the vacuolar membrane, selectively contrast with silver methenamine and contain polysaccharides, as demonstrated by the thiocarbohydrazide-silver proteinate method. Very rarely, these cells contain phagocytosed lymphocyte remnants. The predominant type of mononuclear phagocytic cells in the thymic medulla are the interdigitating cells. PMID- 3654344 TI - The significance of paired astrocyte nuclei in normal human nervous tissue. AB - A quantitative study of astrocytes was carried out in 80 microscopic fields and the number of paired nuclei in 100 consecutive astrocytes of the temporo occipital gyrus cortex was determined in 13 patients with no cerebral or liver disease. No significant correlation was found between astrocyte number and the percentage of paired nuclei. When studies on astrocytes in hepatic encephalopathy, liver cirrhosis and hepatosplenic schistosomiasis are taken into consideration it is suggested that these cells are in continuous variable renewal in normal adult human nervous tissue, as occurs in other animal species. PMID- 3654345 TI - Growth of the internal diameters in the pulmonary arterial tree in infants and children. AB - To provide a better understanding of the operability of the pulmonary arteries in children with tetralogy of Fallot or with pulmonary atresia, we investigated the growth of the internal diameters of the pulmonary arterial tree in fresh postmortem hearts and great arteries of infants and children of ages up to 10 years after birth, who died from non-vascular diseases. Linear correlations were found between, on the one hand, the internal diameters of the pulmonary ostium, pulmonary trunk and left and right pulmonary artery and, on the other, body length. Based on an approach used in clinical studies we also determined the ratios between the internal diameter of the pulmonary arterial tree and the ascending aorta and also the ratios of the internal diameters of the descending aorta and the sum of the size of the left and right pulmonary arteries. Comparison of the data from the postmortem material with observations on the internal diameters measured with two dimensional (sector) echocardiography echo indicates that the latter may slightly underestimate the true diameters. PMID- 3654346 TI - A histochemical study on the innervation of the pancreas of the one-humped camel (Camelus dromedarius). AB - Autonomic innervation of the pancreas of the camel has been studied using histochemical techniques for the demonstration of adrenergic and cholinergic (acetylcholinesterase-positive) nerves. Both extrinsic and intrinsic innervation of the pancreas were found. Distinct peri-acinar, perivascular, peri-insular and periductal plexuses were found as well as both adrenergic and cholinergic ganglia. The role of the autonomic nerves in the synthesis and release of insulin, glucagon and somatostatin is discussed. PMID- 3654347 TI - Haemopoiesis in the human yolk sac. AB - Haemopoiesis in human yolk sacs was examined using tissues obtained from a total of 27 cases in various stages of development from the fourth to eleventh week of pregnancy. In the early stages of development, the yolk sac was observed to be connected to the midgut by the vitelline duct, which became slender with later growth of the embryo. In the early stages of pregnancy, endodermal tissues were found to be a predominant component, whereas in the later stages, the mesenchymal tissues increased. The most immature blood cells and their mitotic figures were observed in the endodermal tissue. Haemopoiesis was found in endodermal tissue before mesenchymal tissue had developed. Electron microscopy revealed that maturation of the blood cells proceeded as the cells were formed in mesenchymal tissue and in blood vessels. PMID- 3654348 TI - Changes in the number of neurons in the mesencephalic and motor nuclei of the trigeminal nerve in the ageing mouse brain. AB - The number of neurons and neuronal nuclear diameter was estimated in the mesencephalic and motor nuclei of the mouse trigeminal nerve at 6, 9, 12, 15, 22, 25, 28 and 31 months of age. Analyses of variance showed that neuronal number decreased significantly (P less than 0.01) in the mesencephalic nucleus between 25 and 31 months, but, although lowest at 31 months of age in the motor nucleus, the decrease in neuronal number in the motor nucleus was not statistically significant. Neuronal nuclear diameter increased significantly in both nuclei between 25 and 31 months, being obvious first in the mesencephalic nucleus. The main histological features of ageing were a marked accumulation of lipofuscin granules in neurons of the mesencephalic nucleus and a loss of Nissl substance from the motor neurons of the trigeminal motor nucleus. PMID- 3654349 TI - Morphological analysis and computer-aided, three dimensional reconstruction of chondrocytic columns in rabbit growth plates. AB - Proximal tibial growth plates of New Zealand white rabbits were serially sectioned in parasagittal and horizontal planes for three dimensional, light microscopic analysis of the chondrocytic columns. A total of 431 columns was analysed. Of these, 258 columns extended through the full height of the growth plate. The remaining columns were considerably shorter, being located either predominantly in the epiphyseal half of the growth plate (100) or in the metaphyseal half of the growth plate (73). The epiphyseal and metaphyseal columns were found in clusters in the plate. Some columns in all three groups had interruptions along their length, while others had duplications. Computer-aided, three dimensional graphic reconstructions were prepared of a selected group of columns. The reconstructions illustrated the variability in the morphology and the dimensions of the neighbouring chondrocytic columns. The observations suggest that chondrocytic columns in rabbit growth plates are replaced regularly and that the small cell zone may play an important role as the cellular source for column renewal. PMID- 3654350 TI - The intra-ocular portion of the optic nerve in the turtle Mauremys caspica. AB - The cytoarchitecture of the intra-ocular optic nerve was investigated by light and electron microscopy. Glial cells in the intra-ocular portion are disposed among the axons, either scattered or forming columns, and bordering the nervous parenchyma. Astroglia forms the limiting glia that separates the optic nerve from the vitreous body, retina, choroid and sclera. Indentations of choroid-scleral tissue are observed in the limiting glial sheet as well as an abundance of hemidesmosomes in the astrocytic plasma membranes that abut onto the basal lamina. At the scleral level there is no connective tissue structure similar to the mammalian lamina cribrosa. However, astrocytes in this region are regularly arranged in thick columns and their processes cross throughout the nerve perpendicular to the axons, forming a framework through which the nerve fibres pass. Numerous myelinated and unmyelinated axons are present in the intra-ocular portion. Oligodendrocytes are also present in close relation with myelinated axons. A deep connective tissue septum arises from the ventral region of the optic nerve and extends along the intra-ocular portion. PMID- 3654351 TI - Presumptive sensory axons of the human urinary bladder: a fine structural study. AB - The mucosa of the human urinary bladder possesses an extensive plexus of suburothelial nerve fibres which are believed to be sensory in nature. Many of these presumptive sensory nerves occur as single axons whose vesicle-packed varicose regions are totally devoid of neurilemmal cell covering and occasionally penetrate the urothelial basal lamina. The axonal vesicles are of two types, small agranular vesicles (median diameter 47 nm, range 39-54 nm) and large granulated vesicles (median diameter 105 nm, range 62.5-187.5 nm). When compared statistically with intramuscular axon varicosities the suburothelial varicosities are shown to possess a significantly greater packing density of axonal vesicles and to contain a significantly greater proportion of large granulated vesicles. The latter finding may reflect the presence of substance P, a neuropeptide known to occur in primary sensory nerves. PMID- 3654352 TI - Autoradiographic studies of the localisation of androgen-binding cells in the genital tubercles of fetal rats. AB - Distribution of androgen-binding cells in the genital tubercles of male and female fetuses of rats was examined by steroid autoradiography. Binding of [3H]testosterone appeared in the preputial mesenchymal cells, mesenchymal cells around the urethra and in the urethral epithelial cells at 15.5 days of gestation, and in the precursor cells of the proximal and distal segments of the os penis and corpus cavernosum penis at 16.5-17.5 days of gestation in both the male and female fetuses. Mesenchymal cells were suggested to be target cells for androgens which cause the morphogenetic and histogenetic changes in the penis of rats. PMID- 3654353 TI - The response of the rat tibial growth plates to distal periosteal division. AB - The growth plate chondrocytes have been examined in the tibiae of normal immature rats and in similar rats after circumferential distal periosteal release. In control rats, calculation of the growth rate as the product of the rate of cell proliferation and the maximum hypertrophic cell height correlated with gross measurements. The labelling index also correlated with the calculated growth rate. During the period 28 to 46 days of age there was little change in the growth rate but a diminution in the height of the hypertrophic cells. Unilateral circumferential periosteal division produced bilateral increases in tibial growth rate and in the activity of both the proliferative and hypertrophic zones as part of the systemic response to the trauma. There was a 1% ipsilateral increase in tibial length, as compared to the contralateral side, which appeared to be related principally to an increase in the number of proliferative cells. This simple method of stimulating bone growth can usefully be undertaken at the same time as other operative procedures. PMID- 3654354 TI - Lack of cytochemically detectable cholesterol in rabbit vena cava endothelial plasma membrane. AB - The response of rabbit vascular endothelial plasma membranes to the cholesterol binding agents filipin and tomatin was investigated by freeze-fracture electron microscopy. In both single and double labelling experiments, the endothelial plasma membranes of the posterior vena cava were remarkably resistant to the agents compared with the endothelial plasma membranes of other vessels (aorta, pulmonary artery, and pulmonary and cardiac capillaries). This suggests that vena cava endothelium differs markedly from other endothelia, either by having exceptionally low cholesterol levels in its plasma membranes, or with respect to other membrane properties that influence the reaction to filipin and tomatin. PMID- 3654355 TI - A quantitative analysis of cellular and matrix changes in Meckel's cartilage in Xenopus laevis. AB - The changes in cell population and matrix volume fraction in Meckel's cartilage during metamorphic climax have been assessed using standard stereological techniques. The period of climax has been divided into three phases, a preliminary 'Lag' phase (NF Stages 57-60), a 'Division' phase (NF Stages 60-62) when the cell population rises rapidly and a 'Synthesis' phase (NF Stages 62-66) when the matrix content of the tissue also increases dramatically. These changes along with the membranous ossification occurring at the same time are postulated to be associated with the change in the feeding habit of the larvae from filtration prior to metamorphic climax to active predation in the young frog. PMID- 3654356 TI - The groove in the lateral wall of the human orbit. AB - The orbital groove, the groove for the orbital branch of the middle meningeal artery, the meningo-orbital foramen and the foramen spinosum have been studied in 100 human skulls. The orbital groove is present in about 30% of skulls. PMID- 3654357 TI - Human macrophage development: a morphometric study. AB - The development of macrophages from the blood monocytes of ten normal subjects has been studied at intervals over a six day period. Suspension cultures were used to obtain randomly orientated cells and morphometric measurements were made on electron micrographs. In order to meet the requirements for normality of distribution and homoscedasticity, data were logarithmically transformed. A two way analysis of variance was then carried out, taking subjects and time intervals as fixed effects, and using a least significant difference procedure to detect variations between culture time intervals. The whole cell and cytoplasmic volumes showed 3-4 fold increases during culture. The cell surface area more than doubled; this was partly attributable to the larger cell volume and partly to increased surface irregularity. The mitochondrial volume also showed a similar significant increase, attributable to an increase in both number and size of mitochondrial profiles, the cytoplasmic volume fraction remaining approximately constant. Although there was a statistically significant increase in nuclear surface area, the nuclear changes were relatively small. The results and the application of appropriate statistical methods have thus provided basic morphometric data for human macrophage development in culture. The experimental system should permit further investigation of factors governing impaired macrophage development in malignant disease. PMID- 3654358 TI - Sex ratio of hamster fetuses assessed by gonadal morphology: effect of mother's age. AB - This paper describes the assessment of phenotypic sex in hamster fetuses 12-15 days postcoitum. External morphometric parameters such as body weight, crown-rump length and anus-genital distance did not permit the differentiation of males from females. The sex was determined easily by inspection of the internal genital structures under low power magnification on Days 13-15 postcoitum. The size, shape and location of the gonads and the presence of a conspicuous blood vessel on the testis were the most useful criteria. An inverse relationship was found between the age of the mother at conception and the number of fetuses in mothers 2 to 7 months old. The decrease in the number of fetuses with increasing age of the mothers affected preferentially the population of phenotypic males. PMID- 3654359 TI - Quantitative and spectrum analysis of human mylohyoid nerves. AB - Histological analysis of 30 postmortem specimens of human mylohyoid nerve showed a mean fibre count of 1251 and, in each case, a bimodal fibre diameter distribution curve. No relationship was found between the fibre counts and the age, weight or sex of subjects. Counts in nerves from edentulous subjects were significantly lower (P less than 0.001) than those in nerves from dentate subjects. This apparent loss of fibres was not restricted to small diameter axons. PMID- 3654360 TI - Myelinated axon counts of human inferior alveolar nerves. AB - A quantitative, postmortem study of 36 human inferior alveolar nerves is described. The total myelinated fibre count (TMFC) of nerves was not related to sex or age of the subjects but significant positive correlations were found between TMFC and subject body weight in both dentate (r = 0.616) and edentulous (r = 0.676) groups. The TMFC was significantly lower in nerves from edentulous subjects than in nerves from dentate subjects. PMID- 3654361 TI - Evidence of turnover of mammalian Merkel cells. AB - The Merkel cells in the snout of the pig and the lips of the sheep were studied by transmission electron microscopy. They were subdivided into three main subgroups that are believed to represent different stages in the life cycle of the cells. A final dermal disintegration of the cells is proposed. The observations are discussed in relation to earlier reports on the avian Merkel cells. PMID- 3654363 TI - Comparative anatomy and significance of the sesamoid bone of the peroneus longus muscle (os peroneum). AB - The os peroneum is found in only a few primate families and seems to be completely absent in the non-primate pentadactyl mammals, in the Prosimii and in the Platyrrhinii (New World monkeys). In the Cercopithecidae (Catarrhinii, Old World monkeys) and the Hylobatidae, the os peroneum is a coffee bean-shaped constant, large and regular bone. The lateral surface of the bone is convex in all directions and non-articular. The medial surface is covered with hyaline cartilage and articulates by means of a synovial joint with the corresponding facet of the cuboid bone. The histological structure and the mode of ossification of the os peroneum are identical to that of other short bones of the skeleton. The os peroneum of the Cercopithecidae and Hylobatidae is an example of a new skeletal element that has appeared in a tendon subject to unusual mechanical stress. In the case of the peroneus longus tendon the stress is due to repetitive friction because of the functional importance of this muscle in the adduction and pseudo-opposability of the hallux. This osseous element is genetically fixed and hereditarily transmitted. Its mode of appearance is analogous to that accepted for the origin of the patella. In the Pongidae, the os peroneum is absent or rare. In man, this bone is relatively infrequent (approx 20% of mature individuals) and its shape is most irregular. In this case, the os peroneum appears as a regressive form of the typical bone observed in the above families, which is in the process of disappearing. Besides fundamental genetical factors, this regression is probably in relation to the disappearance of the functional importance of the peroneus longus muscle to the loss of the hallux opposability. Thus the mechanical factors cannot be dissociated from the genetic and phylogenetic factors in explaining the appearance and the regression of the os peroneum. PMID- 3654362 TI - Ultrastructure of nerve endings and synaptic junctions in rabbit intrapulmonary neuroepithelial bodies: a single and serial section analysis. AB - This study on the innervation of rabbit intrapulmonary neuroepithelial bodies (NEB) was undertaken to obtain more information about the detailed ultrastructure of morphologically afferent and efferent intracorpuscular NEB nerve endings, the extent to which they are in cytoplasmic continuity with one another, and the structure of the synaptic junctions they form with the NEB corpuscular cells. As in earlier studies, NEB exhibit intracorpuscular nerve endings containing predominantly either mitochondria (morphologically afferent) or synaptic vesicles (morphologically efferent). Both types of nerve endings form synaptic junctions with the NEB corpuscular cells, arranged so that a NEB corpuscular cell is the presynaptic element and the nerve ending the postsynaptic element. This arrangement implies that NEB can transmit nerve impulses to the central nervous system, thus arguing in favour of their hypothetical neuroreceptor function. Moreover, on serial sections, the morphologically afferent and efferent intracorpuscular nerve endings are often found in cytoplasmic continuity. Hence, transduction of stimuli in the NEB implies concomitant efferent modulation of the NEB corpuscular cells. In conclusion, intrapulmonary NEB apparently function as neuroreceptors that are locally modulated by axon reflexes. PMID- 3654364 TI - Frequency of occurrence and distribution of the intra-epithelial lymphoid cells in the follicle-associated epithelium in phenotypically normal and athymic nude mice. AB - We have determined the number and pattern of spatial distribution of intraepithelial lymphoid cells in the follicle-associated epithelium of Peyer's patches and in the villus epithelium in the small intestine of athymic nu/nu mice and of the phenotypically normal mice kept in specified pathogen-free conditions. The results were obtained by histometric analysis of semithin histological sections. It has been found that the lymphoid cells were scattered randomly in the villus epithelium, while those in the follicle-associated epithelium were non randomly distributed, occurring often in groups of several cells both for athymic nu/nu and phenotypically normal mice. The numbers of lymphoid cells in the follicle-associated and in the villus epithelium were found to be significantly lower in athymic nu/nu mice than in phenotypically normal mice kept in similar conditions. On the basis of the above results the proportions of thymus-dependent and thymus-independent lymphoid cells in the intestinal epithelium were deduced. PMID- 3654365 TI - Effect of functional change on cell differentiation in the condylar cartilage. AB - The zygomatic process of the temporal bone forming the articulating surface of the glenoid fossa was resected in 25 young New Zealand rabbits in order to investigate the effect of function on the growth of the condylar cartilage. The reactions were studied in dry skulls, X-rays and histological sections from the temporomandibular joints. The region of the fossa had regenerated by 100 days in all the animals and was located further forward than in controls. The mandible tilted upwards immediately after resection of the zygomatic process, and an anterior cross-bite developed in four out of eight animals by 100 days. The height of the mandible was unaltered when measured from the superior surface of the condyle to the inferior border of the mandible. No differences were found in the length of the mandible as measured from the anterior edge of the condyle to the incisors, molars or mental foramen, but the anteroposterior width of the condylar process increased in the experimental animals and the articulating portion of the condylar process was less prominent. The mesenchymal cell layer was thickened 10, 15 and 20 days after the operation but the metachromasia of the intermediate cell layer decreased, as also did the thickness of the whole condylar cartilage. The metachromasia reappeared in the course of fossa regeneration. The results support the hypothesis that the growth of the condylar cartilage is regulated by its articulating function, and demonstrate that pressure reduces proliferation of the mesenchymal cells, although it is needed for the continuation of chondrogenesis in the condylar cartilage. PMID- 3654366 TI - Genesis of cilia and microvilli of rat nasal epithelia during prenatal development. III. Respiratory epithelium surface, including a comparison with the surface of the olfactory epithelium. AB - During prenatal development the respiratory epithelium surface of the rat's nasal septum underwent the following changes. At intra-uterine day E14 there was a transformation from State I, cells with primary cilia only, to cells which also had microvilli (Stage II). Anterior parts of the nasal septum retained microvilli throughout further development. Posteriorly, centriole multiplication (Stage III) and formation of shafts of secondary cilia (Stage IV) occurred from around E16 and E18 onwards, respectively. From E18 to E20 numbers of cells with cilia increased at an overall rate of about 6 X 10(6) cells/cm2/day. Respiratory cilia and microvilli grew, on average, by about 0.3 micron/day and 0.1 micron/day, respectively. At Stage V, beginning around E19, the cilia became aligned within cells and, at Stage VI, beginning around E21, became synchronised between cells. Respiratory ciliogenesis in the nose is most precocious near the olfactory epithelium. The formation of respiratory cilia starts after that of olfactory cilia. However, unlike olfactory epithelium surfaces those of ciliated respiratory epithelia resembled those of adults around birth. PMID- 3654367 TI - The dorsal motor nucleus of the vagus nerve of the hamster: ultrastructure of vagal neurons and their responses to vagotomy. AB - The dorsal motor nucleus of the vagus nerve of the hamster was studied electron microscopically. Two types of neuron distinguished by their ultrastructural features were identified. Type I cells, which had an average dimension of 20 X 12 microns, were rich in cytoplasmic organelles. The smaller Type II cells (15 X 9 microns) had scanty cytoplasm and a deeply indented nucleus. Type I cells were labelled by horseradish peroxidase (HRP) following its injection into the vagus nerve, whereas Type II cells were not. Seven days after cervical vagotomy, Type I neurons underwent typical retrograde degeneration. By the fourteenth postoperative day, the density of the cells was greatly enhanced, an early sign of cell death. Type II cells were not affected by vagotomy. With the electron microscope, three types of axon terminals were identified in the neuropil of the DMN: (1) boutons containing round agranular vesicles, (2) boutons containing round and elongated dense-cored vesicles, and (3) boutons containing pleomorphic agranular vesicles, a few of which were dense-cored. All of them showed synaptic contacts with HRP-labelled dendrites. Occasional boutons containing pleomorphic vesicles showed degenerative changes after vagotomy. Moreover, a few of them were seen to contain HRP granules. The observations made in the present study strongly suggest that the Type I neurons send efferent fibres to the vagus nerve. The Type II cells which are not labelled by HRP nor affected by vagotomy, probably serve as interneurons, or they may be cells projecting to other areas of the brain. PMID- 3654368 TI - The volumetric composition of human term placentae: altitudinal, ethnic and sex differences in Bolivia. AB - Point counting volumetry has been used to decide whether or not altitudinal, ethnic and sex differences in birth weight in Bolivia are accompanied by changes in placental composition. Sixty eight placentae from healthy, term pregnancies were sampled from populations of Amerindian and non-Indian women living in Santa Cruz (400 m) and La Paz (3600 m). Altitudinal reductions in birth weight were not accompanied by significant alterations in placental weight yet highland placentae were substantially different in histological composition. On average, the highland placenta had a more voluminous intervillous space but reduced volumes of villi, juxtavillous fibrin and non-parenchyma. Whilst Amerindian newborn were heavier, placental weights were similar in both ethnic groups. However, the Amerindian placenta tended to possess more trophoblast and more villous stroma than its non-Indian counterpart. No sex differences were detected save for an interaction effect on fibrin which involved altitude, ethnic group and sex. Findings are discussed in the context of known morphometric and physiological differences between placentae in different experimental groups, notably in other types of pregnancy associated with reduced fetal growth. PMID- 3654369 TI - The CNS-PNS transitional zone of rat cervical dorsal roots during development and at maturity. A morphological and morphometric study. AB - Each seventh cervical dorsal nerve root is attached to the spinal cord surface by four to eight rootlets. A tapering outgrowth of central nervous tissue, the central tissue projection, extends distally into the proximal part of each rootlet in the immediate postnatal period. The central ends of the most proximal peripheral internodes surround this projection. Thus a length of rootlet contains both CNS and PNS tissue. This is termed the transitional zone. Material was processed by standard preparative techniques for electron microscopy. Serial semithin and ultrathin sections were made over the entire extent of several transitional zones at ages ranging from 2 to 300 days postnatum. Central tissue projections were reconstructed in three dimensions and analysed morphometrically. The morphology of the central tissue projection varies during development. At first, it forms an irregular projection into the anterior portion of the rootlet. It than elongates and takes the form of a dorsoventrally flattened, distally tapering wedge. By 20 days postnatum it has attained its definitive form. This consists of three segments: a proximal wedge-shaped portion, similar to that described above; continuous with this is a distally tapering, dorsoventrally flattened, cone-shaped segment which generally branches into two or more slender projections of central tissue. The latter comprise the third segment. The projection comes to form a substantial proportion of the anterior, proximal and distal surfaces of the dorsal rootlet from an early stage. The mean length of the central tissue projection increases progressively over all intervals studied, except that between 12 and 30 days postnatum, when a reduction in length is associated with reorganisation of the morphology of the projection. Projection length varies considerably between rootlets and is relatively weakly correlated with rootlet cross sectional area. There is a great deal of overlap between the distributions of projection lengths at all stages between 20 and 300 days. PMID- 3654370 TI - Variations of the interparietal bone in man. AB - In an adult skull a pre-interparietal bone was found to be present in two symmetrical pieces on either side of the midline. This is the result of failure of fusion of a third pair of centres with each other on the midline. The possibilities of variations due to non-fusion of various pairs of the centres in the interparietal area and their differentiation from surrounding sutural bones are discussed. PMID- 3654372 TI - Proceedings of the Anatomical Society of Great Britain and Ireland. January 1987, Oxford. Abstracts. PMID- 3654371 TI - Myelin formation in rat dorsal root ganglion cultured in a serum-free medium. AB - Compact myelin formation was first observed in rat dorsal root ganglion culture using a serum-free alpha modified Eagle's Minimum Essential Medium (alpha MEM) supplemented with nerve growth factor. However, myelin formation did not occur when Earl's MEM was used instead of alpha MEM. PMID- 3654373 TI - Changes in the medulla of the parathymic lymph nodes of the rat during acute gastro-intestinal inflammation. AB - The changes occurring in the medullary sinus and medullary cord of the parathymic lymph nodes were studied in rats after performing a small intestinal anastomosis. Polymorphonuclear leucocytes and eosinophils were phagocytosed by the macrophages of the medullary sinus. The sinus macrophages stained strongly for acid phosphatase and weakly for non-specific esterase. The medullary sinus macrophages were most numerous near the subcapsular sinus. After a small intestinal anastomosis the sinus macrophages increased in size and in number. The macrophages of the medullary cord differed from those of the medullary sinus both histochemically and ultrastructurally. The cord macrophages stained weakly for acid phosphatase, stained strongly for non-specific esterase and phagocytosed plasma cells, particularly in those specimens 2 and 5 days after the intestinal anastomosis. There was an initial significant decrease in IgA plasma cells at 2 days after the anastomosis but a subsequent increase in IgG and IgM plasma cells. The increase in IgM plasma cells preceded that of the other plasma cells. PMID- 3654374 TI - Ultrastructure of the ferret parotid gland. AB - Parotid glands of two male and two female adult ferrets were examined using electron microscopy. The acinar cells contained an abundance of rough endoplasmic reticulum, an extensive Golgi complex, and electron-dense granules with a denser spot in each. The acinar lumen and the intercellular canaliculi were lined by a large number of prominent microvilli. The intercalated ducts were long and in their proximal part the cells contained small electron-dense granules, whereas the distal portions were lined by agranular cells. The majority of cells in the intralobular striated ducts contained a large number of granules. These granules were of varying shapes and were moderately electron-dense. Each granule had a close fitting membranous envelope. The agranular cells had a prominent Golgi zone, free ribosomes and a few lysosomes. Both the granular and agranular duct cells had an abundance of mitochondria towards the basal regions of the cells. The excretory ducts resembled the intralobular striated ducts. No sexual dimorphism was observed in the ferret parotid. PMID- 3654375 TI - Rough endoplasmic reticulum and fine intracytoplasmic filaments in articular cartilage chondrocytes of young rabbits; a stereological morphometric study using transmission electron microscopy. AB - Articular cartilage of eight young NZW rabbits was investigated by electron microscopy. A simple and rapid stereological method was designed for quantifying the synthetic activity of the chondrocytes in the different zones of uncalcified articular cartilage by measuring the amount of rough endoplasmic reticulum (RER) on electron micrographs. The surface area of RER per unit volume of chondrocyte cytoplasm, of cartilage, and per chondrocyte, were determined. In addition the volume density, and mean diameter, of RER cisternae were computed. The surface area of RER was least in the superficial zone (402 micron 2) and largest in the deep zone (879 micron 2) chondrocytes. The RER surface area per unit volume of tissue was, however, significantly (P less than 0.05) greater in the superficial zone (12.8 X 10(-2) micron2/micron3) than in the deep zone (8.5 X 10(-2) micron2/micron3) of the articular cartilage. Percentages of chondrocytes displaying masses of intracytoplasmic fine filaments were also registered. 8.5% of the chondrocytes in the superficial, 48.8% in the middle, and 53.5% in the deep zone contained intracytoplasmic fine filaments. Chondrocytes containing filaments are probably degenerating cells. They contained diminished amounts of RER. The altered nutritional status in the deeper zones of the cartilage might have caused these changes in the cells. The formation of the calcified zone of the cartilage in the young rabbits, contributing to the cessation of the nutritional supply of chondrocytes from the subchondral bone marrow spaces, may have affected the process. Since the proportion of RER can be regarded as indicating the synthetic activity, and that of filaments as indicating the degree of degeneration, these parameters can be used in the evaluation of the functional status of the uncalcified articular cartilage chondrocytes. PMID- 3654376 TI - Ependyma of the central canal of the rat spinal cord: a light and transmission electron microscopic study. AB - Ependymal cells of the rat central canal were examined with a view to identifying features that distinguish them regionally and from their counterparts elsewhere in the ventricular system. The results revealed that the lining consisted for the most part of a pseudostratified layer of uniformly organised cuboidal to columnar ependymal cells present in largest numbers in lumbar and sacral segments and in the conus. Two cell variants were identified on the basis of the presence or absence of a radially directed cytoplasmic process originating from the base of the cell. The tanycytic form of ependymal cell was encountered along the entire length of the central canal but with increased frequency in caudalmost segments. Ependymal cells were largely similar in ultrastructural appearance along the length of the cord. Although they were also similar in appearance and orientation to their counterparts in the ventricles they did exhibit some unique features. The most notable were the prominent junctional complexes and associated filaments present along the lateral border of the cells near their apex and the abundance of intermediate filaments in tanycytes. The central canal of the filum differed most markedly from other segments of the cord and resembled in structure the primitive ependymal tube of the caudal cord in lower vertebrates. Ependymal cells of the cord were not sufficiently dissimilar morphologically from their counterparts in the ventricles to account for differences in proliferative capacity in response to localised injury. A factor that merits further study is the difference in numbers of tanycyte ependymal cells in the two locations for they may be the reactive elements that proliferate in response to injury. PMID- 3654377 TI - A Golgi study of the sixth layer of the cerebral cortex. III. Neuronal changes during normal and abnormal cortical folding. AB - During normal development in the cat Layer VI cortical neurons, including pyramidal cells, fusiform neurons, inverted pyramidal cells and bipolar neurons located in the gyral regions retain the vertical orientation characteristic of earlier developmental stages. However, Layer VI pyramidal neurons and the subtypes in the sulcal zones develop long horizontal basilar dendrites which seem to form dendritic bundles with those of neighbouring pyramidal cells; in addition, fusiform neurons and bipolar cells are tangentially orientated and horizontal pyramidal neurons appear in place of inverted pyramidal cells in the gyral and intermediate regions. In human cortical malformations, neurons of the external cellular layer (Layers V and VI) in lissencephaly are vertically arranged, but Layer VI neurons in polymicrogyria are tangentially orientated when located in microsulci. These features suggest that neuronal changes occur in Layer VI neurons as a consequence of cortical folding and that cortical folding determines the cellular shape of Layer VI neurons in normal as well as in abnormal development of the cerebral cortex. PMID- 3654378 TI - The origins and function of the interosseous muscles of the foot. AB - The dorsal and plantar interosseous muscles of the foot arise, not only from the metatarsal bones, but also from ligamentous tissue proximal to the tarsometatarsal joints. The interossei also take origin from the fascia of adjacent muscles, and the first dorsal interosseous muscle usually arises in part from a slip of the peroneus longus tendon. A means may thus exist to ensure that the interossei contract in a coordinated manner. Their positions and time of contraction during the gait cycle imply a possible role as stabilisers of the forefoot, rendering the tarsometatarsal joints rigid when weight is carried on the ball of the foot. PMID- 3654379 TI - Transmission of weight through the lower thoracic and lumbar regions of the vertebral column in man. AB - This study is an attempt to investigate the role of the neural arches in transmission of weight in the lower thoracic and the lumbar regions of the vertebral column. Based on simple mechanical principles of weight transmission, various parameters were chosen for measurements at each vertebral level. In 44 adult male dry vertebral columns measurements were made from T5 to L5 levels. The area of the inferior surface of the body at each vertebral level was compared with the area of the inferior articular facet, the cross sectional area of the laminae (lamina index), the pedicle index and the arch index. The inclination of the pedicles in relation to the body was also measured at each level. On the basis of the above measurements it was deduced that the compression force in the lower thoracic and lumbar regions is transmitted through two parallel columns, one anterior (formed by bodies and intervertebral discs) and one posterior (formed by successive articulations of laminae with each other at their articular facets). This study suggests that a considerable part of the weight of the upper limbs and the thoracic cage is transmitted through the ribs to the posterior column (laminae) through the costo-transverse articulations and ligaments. Because of the inclined position of the fifth lumbar vertebra, a significant part of the compressive force from the body is transmitted to the laminae in spite of the anterior inclination of the pedicles at this level. Because of the anterior concavity of the spine in the thoracic region, weight is transferred from the posterior to the anterior column through the inclined pedicles and in the lumbar region, where the concavity is posterior, a part of the compressive force of the anterior column is transmitted to the posterior. Thus, the compressive force in the curvilinear thoracolumbar column tends to deviate towards the line of gravity. The implications of these findings in relation to clinico-pathological disorders of the spine are discussed. PMID- 3654380 TI - The initial dream and analysability in beginning analysis. PMID- 3654382 TI - Change as a process in the self: what is the mutative factor? PMID- 3654381 TI - Masochism: the shadow side of the archetypal need to venerate and worship. PMID- 3654383 TI - The feminine in witchcraft: Part II. PMID- 3654384 TI - Functional properties of the crossed part of the medial olivo-cochlear bundle. AB - The efferent innervation of guinea pig cochleas was sectioned medially, at the level of the floor of the fourth ventricle, to study the effects of the crossed part of the medial efferent pathway on the compound action potential (CAP) masking phenomenon. Sectioning reduced CAP masking for a masker level varying with the frequency of the masker and the time elapsed between the masker onset and the probe onset. Functional properties of the crossed part of the medial efferent tracts: latency, thresholds and frequency selectivity, could be deduced from these data. PMID- 3654385 TI - Antagonistic effects of perilymphatic calcium and magnesium on the activity of single cochlear afferent neurons. AB - The dependence of the spontaneous and sound driven activity of single cochlear nerve fibers on the calcium and magnesium content of the perilymph was studied by perfusion of the perilymphatic space. It was possible to study these effects under steady-state conditions by continuously perfusing scala tympani at low rates while simultaneously recording from units in the chinchilla auditory nerve. Preparations were stable for many hours. As previously reported [Robertson and Johnstone (1979) Pflugers Arch. 380, 7-12], perfusion with solutions containing elevated concentrations of magnesium reduces both the spontaneous and driven activity. When calcium was eliminated from the perfusate, activity was completely abolished for stimuli with sound pressure levels below 100 dB. During partial blocks, a relatively frequency-independent threshold elevation was seen for frequencies well below the characteristic frequency (CF) of the unit, with greater elevations closer to CF. When the threshold elevation at CF was 30-40 dB, the width of the 'tip' portion of the tuning curve was reduced, resembling that of naturally-occurring units with low spontaneous rates of discharge. These effects are similar to that of raising the criterion for response during threshold measurement and are probably related to a frequency-dependent nonlinearity exhibited by the motion of the basilar membrane. The dynamic range for the growth of average rate with level was increased and saturation was shifted to higher stimulus levels during elevated magnesium perfusion. Raising the calcium content of the perfusate increased both spontaneous and driven rates, even in the saturated portion of the rate-intensity plot. Under these conditions, the response of the unit may more directly correspond to the intracellular potential of the presynaptic hair cell. It is argued that the primary site of divalent cation interaction is in the control of transmitter release. Inner hair cells of the mammalian cochlea apparently do not release transmitter in the absence of a calcium influx. The size of the pool of 'readily-available' transmitter appears to be influenced by divalent cations. Even though this synapse is probably specialized for the transmission of auditory signals, the mechanism of synaptic transmission is probably not fundamentally different from that of other well-characterized synapses. PMID- 3654386 TI - Correlative study of sensory cell density and cochlear length in humans. AB - In the group of 50 cochlea from 28 men aged 38-73 years a great variability in the length of the cochlear duct was found ranging from 28.0 to 40.1 mm. The variability in the number of inner and outer hair cells is not so prominent and the same holds for the variability in density. Average densities of the inner and outer hair cells decrease with increasing cochlear length. However, the long cochleae have a greater number of hair cells which indicates that long cochleae have more sensory cells in a given frequency region. PMID- 3654387 TI - Longitudinal flow of endolymph measured by distribution of tetraethylammonium and choline in scala media. AB - Longitudinal endolymph flow rate in the guinea pig cochlea was measured by determining the rate of migration of extrinsic ions, tetraethylammonium chloride (TEA) or choline, with a potassium sensitive ion-selective microelectrode (ISM). Low concentrations of iontophoretically injected TEA were detected with the ISM at various distances from the injection electrode. The results were variable when the ISM was used to record spread of TEA from turn II to turn I and vice versa. However, consistent data were obtained when the TEA spread was measured at different electrode separations (0.2, 0.5, 0.7 mm) within turn II. Electrode locations were systematically exchanged without changing their distance, i.e. the ISM electrode was placed basally or apically with respect to the TEA electrode. Comparison of data with a model, which combines the bulk diffusion of TEA and the flow of endolymph, is consistent with a rate of endolymph flow in turn II of about 0.2 mm/min, apex to base. A similar value was also obtained with the iontophoretic injection of choline. The endolymph flow rate may be different in turn I as indicated by measurements of compound action potential (CAP) changes. However, the results of experiments when TEA spread is measured at large distances must be interpreted cautiously because TEA may enter cellular walls of the cochlear duct and alternative routes of transport may be involved. PMID- 3654388 TI - Acoustic distortion products in rabbit ear canal. I. Basic features and physiological vulnerability. AB - In contrast to evoked otoacoustic emissions, acoustic distortion products (DPs) recorded from the ear canal are present at predictable frequencies with respect to their primary tones, f1 and f2. Such specificity may provide detailed frequency-place information concerning the functional state of limited regions of the organ of Corti following experimental intervention. However, to date, it is not clear whether emitted DPs solely reflect activity at the basilar-membrane regions of primary tones or if the remote DP site makes a significant contribution to the emitted signal measured in the ear canal. We have investigated a number of the general features of acoustic-DP generation in the rabbit so that, in later experiments, the contributions of specific basilar membrane regions involved in generating these DPs can be identified using techniques designed to manipulate their normal properties. The first report describes the outcome of systematic manipulations of a number of stimulus conditions and alterations to the physiological state of the cochlea by exposure to fatiguing sound or anoxia. Experimental findings for the 2f1-f2 DP showed that, in general, the relations of the levels and frequency of the primary tones to DP magnitude were consistent with previously published data from other mammalian species. Additional observations for other odd-order intermodulation DPs at the 3f1-2f2 and 2f2-f1 frequencies suggested that the basic attributes of the acoustic DPs were similarly affected by systematic manipulation of the basic parameters of the primary tones and the general metabolic state of the cochlea. General anesthesia, however, did not affect DP amplitude. A companion paper describes the results of a series of subsequent experiments using response suppression, interfering-tone, and temporary threshold shift techniques which address more directly the issue of which basilar-membrane sites contribute to the generation of different acoustic DPs. PMID- 3654389 TI - Acoustic distortion products in rabbit ear canal. II. Sites of origin revealed by suppression contours and pure-tone exposures. AB - Previous work on acoustic distortion products (DPs) recorded from the ear canal has not established unequivocally whether emitted DPs principally reflect basilar membrane nonlinearities at the frequency sites of the primary tones, f1 and f2, or if the DP-frequency place itself makes a significant contribution to the emitted response. Results from some studies on acoustic emissions attribute generation of the emitted DP almost exclusively to the regions of maximum primary tone interaction, while the findings of other investigations implicate reemission of the response from the DP locus as a significant contributor to response magnitude. Using suppression, interfering tones, and temporary threshold shift (TTS) procedures, the work reported here was designed to establish more definitively the precise contributions of the basilar-membrane regions involved in generating acoustic DPs in rabbits. Suppression tuning curves and interfering tone experiments indicated that for the DP at 2f1-f2, regions near the f1 or f2 frequencies were the major contributors to the emitted response. However, for the higher-frequency DP at 2f2-f1, the basilar-membrane region just basal to the DP site was implicated as the generator. Following brief episodes of TTS at frequencies related to either the DP or the primary tones, the locus of the exposure stimulus that most effectively reduced the magnitude of the 2f1-f2 response also implicated the region of maximal primary-tone interaction in the generation of the acoustic DP. In contrast, for the DP at 2f2-f1, basilar membrane sites nearer the DP were identified as the primary contributors to the emitted response. Both sets of results imply that different DPs recorded from the ear canal may originate from unique regions of primary-tone interaction along the basilar membrane. PMID- 3654390 TI - Formulae describing frequency selectivity as a function of frequency and level, and their use in calculating excitation patterns. AB - The auditory filter may be considered as a weighting function representing frequency selectivity at a particular centre frequency. Its shape can be derived using the power-spectrum model of masking which assumes: (1) in detecting a signal in a masker the observer uses the single auditory filter giving the highest signal-to-masker ratio; (2) threshold corresponds to a fixed signal-to masker ratio at the output of that filter. Factors influencing the choice of a masker to measure the auditory filter shape are discussed. Narrow-band maskers are unsuitable for this purpose, since they violate the assumptions of the power spectrum model. A method using a notched-noise masker is recommended, and typical results using that method are presented. The variation of the auditory filter shape with centre frequency and with level, and the relationship of the auditory filter shape and the excitation pattern are described. A method of calculating the excitation pattern of any sound as a function of level is presented, and examples and applications are given. The appendix gives a Fortran program for calculating excitation patterns. PMID- 3654391 TI - Mixed conductive and sensorineural hearing loss in LP/J mice. AB - Air and bone conduction thresholds for the detection of a compound action potential response were measured in mice of the LP/J inbred strain, which has been proposed as a possible model for human otosclerosis. Thresholds were compared with control data from CBA/Ca mice. Evidence of a mixed sensorineural and conductive hearing loss was obtained in LP/J mice. Few signs of hair cell degeneration or middle-ear bony lesions were found in 20-day old mice, although they generally showed raised thresholds to both air and bone conducted stimuli. The reason for the observed sensorineural component of the hearing loss at this age is not clear, since endocochlear potentials were normal in mice of this strain. By 225 days of age, hair cell loss was extensive and there was clearly excess bone growth in all middle-ear specimens studied, particularly on the incus and the cochlear wall facing the middle ear. Microbiological analysis of LP/J specimens revealed no evidence of a middle-ear infection specific to these mice which might explain the pathology. PMID- 3654392 TI - Effect of olivocochlear bundle transection on choline acetyltransferase activity in the rat cochlear nucleus. AB - Using a microdissection and quantitative microassay approach, choline acetyltransferase activities were mapped in the cochlear nuclei of rats having complete transections of the olivocochlear bundle on one side in the brain stem. In rats in which the trapezoid body was not significantly damaged by the lesion, consistent reductions of choline acetyltransferase activity in subregions of the lesion-side cochlear nucleus, as compared to the control side, averaged about 20%. Nevertheless, a profound lesion-side reduction of choline acetyltransferase activity was found in a branch connection from the olivocochlear bundle to the cochlear nucleus. The results suggest that branches from the olivocochlear bundle are cholinergic, but contribute a relatively minor proportion of the cholinergic synapses in all regions of the rat cochlear nucleus. In the light of previous results with more extensive lesions, it can be proposed that synapses in all regions of the rat cochlear nucleus. In the light of previous results with more extensive lesions, it can be proposed that most cholinergic input into the rat cochlear nucleus enters by a ventral route along the trapezoid body. It is noted that this represents a quantitatively somewhat different situation from that in the cat. PMID- 3654393 TI - Effects of trapezoid body and superior olive lesions on choline acetyltransferase activity in the rat cochlear nucleus. AB - Using a microdissection and quantitative microassay approach, choline acetyltransferase activities were mapped in the cochlear nuclei of rats having either transection of the trapezoid body or destruction of the superior olivary complex on one side in the brain stem. Lateral trapezoid body transection resulted in dramatic loss of choline acetyltransferase activity in all parts of the ipsilateral cochlear nucleus, while more medial transection had little effect. Destruction of the superior olivary complex resulted in dramatic loss of choline acetyltransferase activity in the ipsilateral cochlear nucleus, and detectable loss also contralaterally. The results suggest that most of the centrifugal cholinergic projections to the rat cochlear nucleus derive from or traverse the vicinity of the superior olivary complex bilaterally and enter the cochlear nucleus ventrally from the region of the trapezoid body. PMID- 3654394 TI - The human auditory brain stem: a comparative view. AB - This study compares human brain stem auditory centers with those of the cat in terms of their topography and cytoarchitecture. Graphic reconstructions of the brain stem pathway illustrate differences in configuration of human auditory centers, such as mediolateral elongation of the cochlear nuclei and rostral prolongation of the superior olivary complex. Greater human brain stem size creates a considerably longer auditory pathway: the distance traversed by axons passing from the cochlear nuclei to the ipsilateral inferior colliculus is approximately 14 mm in the cat and 35 mm in man, while the distance to the contralateral colliculus is about 22 mm in the cat and 46 mm in man. Neuronal groups which are well developed in the human brain stem are the populations of large relay neurons in the cochlear nuclei, the medial olivary nucleus, periolivary region, dorsal nucleus of the lateral lemniscus, and inferior colliculus. In contrast, a number of nuclei and cell groups are very poorly developed or absent in the human auditory system: these include several types of small neurons in the cochlear nuclei, the lateral olivary nucleus, nucleus of the trapezoid body, and ventral nucleus of the lateral lemniscus. The functional implications of these changes are discussed. PMID- 3654395 TI - The human auditory brain stem as a generator of auditory evoked potentials. AB - Data on the size, location, and orientation of human brain stem auditory nuclei are discussed here from the point of view of the potential role of these structures in generation of the brain stem auditory evoked response. Due to reduction in size of several nuclei in the human brain stem, the structures most likely to be generators of far-field potentials are the cochlear nuclei, medial olivary nuclei, dorsal lemniscal nuclei, inferior colliculi, and their axonal projections. Consideration of the anatomy of the human auditory brain stem pathway forms the basis for a model of generation of auditory evoked potentials. PMID- 3654396 TI - Inhibitory connections between AVCN and DCN: evidence from lidocaine injection in AVCN. AB - Principal cells of the dorsal cochlear nucleus (DCN) receive a variety of inhibitory influences, including some that are associated with the anteroventral cochlear nucleus (AVCN). Electrical stimulation in the caudal part of the AVCN produces long-lasting inhibition of DCN units [(1973) Exp. Brain Res. 17, 428 442], including unit type IV, which is associated with principal cells. This inhibition may be mediated either by orthodromic activation of AVCN axons that terminate in DCN or by antidromic stimulation of DCN inhibitory interneurons whose axons send collaterals to the AVCN. These two possibilities cannot be distinguished with electrical stimulation alone. In this study, microinjections of lidocaine were made in the AVCN. These injections should block AVCN to DCN axons without directly affecting the activity, within the DCN, of DCN interneurons. Two effects of lidocaine injections were observed. In some cases, all activity of DCN cells was abolished by lidocaine. These cases involved either spread of lidocaine to the recording site or into the auditory nerve. In other cases, the inhibitory responses of DCN type IV units were weakened by lidocaine without changing the units' thresholds or spontaneous activity. The latter result demonstrates that there are inhibitory pathways originating in AVCN or passing through AVCN and terminating in the DCN. PMID- 3654397 TI - Laser interferometric measurements on the dynamic behaviour of the cupula in the fish lateral line. AB - The motion of the cupula in the supra-orbital lateral line canal of the ruff in response to sinusoidal water movements was measured in vivo by means of a novel laser interferometer microscope. The interferometer utilized the laser light scattered back from a small bead (phi approximately equal to 1 micron) which was positioned under visual control on a selected location inside the cupula. The displacement of the cupula was measured in the range of 0.3 to 300 nm. The stimulus-response relation is found to be linear in this range. The frequency response of the cupula measured at the top is identical to that measured at the base near the sensory hair bundles. From this result it is concluded that the cupula is sliding over the sensory epithelium during motion in the physiological displacement range. A hydrodynamical model of cupular motion which incorporates a frequency dependent boundary layer around the cupula is presented. The model accurately describes the experimental data. PMID- 3654398 TI - Basilar membrane motion in the pigeon measured with the Mossbauer technique. AB - Vibration measurements were made of the basilar membrane (BM), limbi and columella footplate (CFP) of pigeon using the Mossbauer technique. Recordings were located at 0.23-1.33 mm from the basal end of the BM. The existence of a travelling wave mode, propagating from base to apex, was established for papillae in apparently good physiological condition. For these papillae the characteristic frequency (CF) of the BM isovelocity (0.08 mm X s-1) response was an exponential function of distance with a frequency mapping constant of 0.91 +/- 0.10 mm (equivalent to 0.63 +/- 0.07 mm X oct-1); BM CF at the base was 5.95 +/- 0.65 kHz. Travelling wave motion was not demonstrated for papillae in poor physiological condition; tonotopy of BM CF was still evident, although the correlation with distance was less (1.08 +/- 0.30 mm X oct-1; 4.35 +/- 0.73 kHz at the base). BM motion was linear and the isovelocity responses were less sensitive and less sharp than single unit threshold tuning curves: for papillae in good physiological condition the SPL at BM CF at 0.08 mm X s-1 was 51 +/- 6 dB SPL; Q10 dB was 1.24 +/- 0.38; high- and low-frequency slopes were 20 +/- 6 dB X oct-1 and -14 +/- 4 dB X oct-1, respectively. The response of the BM relative to the CFP for papillae in good physiological condition was reminiscent of a second order resonant system with damping constant of 0.33 +/- 0.06 and group delay at BM CF of 0.89 +/- 0.36 periods. PMID- 3654399 TI - Potassium concentration in the inner sulcus is perilymph-like. AB - Using potassium-selective microelectrodes and an improved observation technique, it is shown that the potassium concentration in the fluid of the inner sulcus of the guinea pig is like that of perilymph. The implications for the common concepts about the role of potassium in the cochlea are discussed. PMID- 3654400 TI - Salmonella and Campylobacter contamination of broiler chicken carcasses and scald tank water: the influence of water pH. AB - Scalding at 50 degrees +/- 0.5 degrees C, in water maintained at pH 9.0 +/- 0.2 by the addition of sodium hydroxide, had no effect on the incidence of salmonella or campylobacter contamination of chicken carcasses. There were significant reductions, however, in the numbers of these organisms in the water itself. PMID- 3654401 TI - Mutual and self-sensitivity among antibiotically active mutant derivatives from the inactive degenerate Aspergillus versicolor N5. AB - Antibiotically active producer mutants derived from the spontaneous degenerate parent Aspergillus versicolor N5 possessed not only mutual but also self sensitive activity. The producer mutants, like the inactive parent, were only 3.5 fold less sensitive than the most sensitive unrelated organism, Trichophyton rubrum. The germination of spores is generally more sensitive than growth of vegetative cells. The antifungal spectrum of these mutual and self-sensitive mutants was fairly wide, unlike the host range specificity of bacteriocinogenic strains acting on organisms closely related to the producers. The self and mutual growth inhibitory principle was finally identified as the antibiotics mycoversilin and versilin in the case of producer mutants (N5)17 and N5T10(7), respectively, or Vx, an antibiotic of unknown molecular species, in the case of another producer mutant N5T10(8). Thus self-sensitivity, instead of self resistance, of these antibiotically active mutant derivatives is a unique property among filamentous fungi in having simultaneously expressed two loci of contradictory functions, one for synthesis of, and the other for sensitivity towards, the same or related antibiotics. PMID- 3654402 TI - Design and performance of a new medium for the quantitative recovery of Staphylococcus aureus from recreational waters. AB - Several reports have suggested that staphylococci, and especially Staphylococcus aureus, are useful indicators of pollution of recreational waters. The lack of a selective, accurate and reliable recovery system for the quantification of Staph. aureus from water has been the principal obstacle to the evaluation of their use as indicators. In this study, several inhibitory substances and different nutrient sources have been evaluated for the formulation of a new selective medium. The medium designed, BFR-0 agar, recovers more than 75% of staphylococci and allows Staph. aureus to be identified. PMID- 3654403 TI - Cell surface proteins of encapsulated Streptococcus cremoris: identification and immunochemical characterization. AB - Cell surface proteins of two slime-forming, encapsulated Streptococcus cremoris strains, MLS96 and T5 from the fermented milk product viili, were extracted with the non-ionic detergent Triton X-100. The isolated protein antigens were characterized by sodium dodecyl sulphate polyacrylamide gel electrophoresis and immunoblotting with antisera produced against whole Strep. cremoris cells. When protein profiles of these strains were compared, seven prominent polypeptides were found common to both and were recognized by both antisera. Five of these polypeptides with molecular weights of 70,000, 54,000, 50,000, 47,000 and 40,000 were identified as cell wall components. The remaining two polypeptides with molecular weights of 42,000 and 26,000 are being studied further in connection with slime formation for which modified Triton X-100 extraction provides a suitable method for isolation of the surface-associated antigens of lactic streptococci. PMID- 3654404 TI - Influence of continuous challenge via the feed on competitive exclusion of salmonellas from broiler chicks. AB - In three replicate trials, chicks were treated orally with a culture of caecal contents from an adult hen and then exposed to continuous challenge from a strain of Salmonella kedougou incorporated in feed at a level of ca 10(2)/g. The contaminated feed was introduced at intervals from 0 to 48 h after treatment. Under these conditions, only one of 119 chicks in 12 separate groups was salmonella-positive at 7 d, compared with 36 of 119 controls, but thereafter protection was less consistent and in some cases the subsequent incidence of infected birds increased during the 3-week rearing period. At 21 d, 14 of 60 treated chicks were positive and 32 of 59 controls. Protection was more evident in chicks challenged 24 or 48 h after treatment than in those groups which received the salmonella-contaminated feed at 0 or 5 h and even untreated, control chicks showed greater resistance to salmonella infection from 24 h onwards. In some control and treated groups containing salmonella-positive birds, contamination of the litter reached ca 10(6) salmonellas/g, thus providing a considerable secondary challenge. Introduction of salmonellas via contaminated feed probably reduces the efficacy of protective treatment under field conditions and helps to explain the more limited success in commercial use. PMID- 3654405 TI - Protective antibodies in human sera against encapsulated strains of Staphylococcus epidermidis. AB - Passive protective antibodies in 100 samples of normal human sera against challenge with three representative capsular type strains of Staphylococcus epidermidis in mice were examined. Six of them passively protected mice against capsular type I; 17 protected against capsular type II; one against capsular type III; and one against both capsular types I and II. The activities were sensitive to 2-mercaptoethanol and were absorbed out either with rabbit anti-human IgG serum, rabbit anti-human IgA serum or rabbit anti-human IgM serum. Also, the sera activities absorbed out with cell surface polysaccharide extracted from three representative capsular type strains. These results indicate that the protective activities were specifically related to three major immunoglobulins against the above cell surface polysaccharides. PMID- 3654406 TI - In vivo contractile properties of fatigued diaphragm. AB - The effects of fatigue on diaphragmatic contractility in vivo are unknown. In this study we used sonomicrometry to examine the velocity of shortening and lengthening and the amount of shortening in the fresh and fatigued canine hemidiaphragm (8 dogs) including the force generated. Fatigue was produced by epiphrenic stimulation of the left phrenic nerve; the right hemidiaphragm acted as the control. We found that 1) hemidiaphragmatic fatigue caused an increase in frequency with reduced tidal volume; 2) fatigue resulted in a near complete cessation of tidal shortening during spontaneous breathing; 3) there was an initial decrease in central activation (electromyogram) to the fatigued hemidiaphragm, an indication of central fatigue; 4) force-frequency curves showed a considerable and prolonged loss of the amount of shortening, velocity, and force generated by the fatigued hemidiaphragm during supramaximal stimulation, an indication of peripheral fatigue; and 5) during spontaneous breathing in the fatigued hemidiaphragm, tidal shortening remained reduced for up to 3 h, whereas in the right right hemidiaphragm tidal shortening and electromyographic activity did not change. We conclude that fatigue of a hemidiaphragm alters the spontaneous breathing pattern and produces profound modifications in its contractile properties without altering contralateral hemidiaphragmatic performance. PMID- 3654407 TI - Upstream pressure for systemic to pulmonary flow from bronchial circulation in dogs. AB - Systemic to pulmonary flow from bronchial circulation, important in perfusing potentially ischemic regions distal to pulmonary vascular obstructions, depends on driving pressure between an upstream site in intrathoracic systemic arterial network and pulmonary vascular bed. The reported increase of pulmonary infarctions in heart failure may be due to a reduction of this driving pressure. We measured upstream element for driving pressure for systemic to pulmonary flow from bronchial circulation by raising pulmonary venous pressure (Ppv) until the systemic to pulmonary flow from bronchial circulation ceased. We assumed that this was the same as upstream pressure when there was flow. Systemic to pulmonary flow from bronchial circulation was measured in left lower lobes (LLL) of 21 anesthetized open-chest dogs from volume of blood that overflowed from pump perfused (90-110 ml/min) pulmonary vascular circuit of LLL and was corrected by any changes of LLL fluid volume (wt). Systemic to pulmonary flow from bronchial circulation upstream pressure was linearly related to systemic arterial pressure (slope = 0.24, R = 0.845). Increasing Ppv caused a progressive reduction of systemic to pulmonary flow from bronchial circulation, which stopped when Ppv was 44 +/- 6 cmH2O and pulmonary arterial pressure was 46 +/- 7 cmH2O. A further increase in Ppv reversed systemic to pulmonary flow from bronchial circulation with blood flowing back into the dog. When net systemic to pulmonary flow from bronchial circulation by the overflow and weight change technique was zero a small bidirectional flow (3.7 +/- 2.9 ml.min-1 X 100 g dry lobe wt-1) was detected by dispersion of tagged red blood cells that had been injected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654408 TI - Effect of estradiol on tissue glycogen metabolism in exercised oophorectomized rats. AB - The effect of both physiological and pharmacological doses of estradiol on exercise performance and tissue glycogen utilization was determined in oophorectomized estradiol-replaced (ER) rats. Doses of beta-estradiol 3-benzoate (0.02, 0.04, 0.1, 0.2, 1, 2, 4, or 10 micrograms.0.1 ml of sunflower oil-1.100 g body wt-1) were injected 5 days/wk for 4 wk. Controls were sham injected (SI). After treatment, the animals were run to exhaustion on a motorized treadmill. ER animals receiving the 0.02-microgram dose ran significantly longer and completed more total work than the SI group. ER animals receiving doses of greater than or equal to 0.04 microgram ran longer and performed more work than the 0.02 microgram group. At exhaustion, myocardial glycogen content was significantly decreased in animals that were ER with less than or equal to 0.1 microgram, whereas those replaced with doses greater than 0.1 microgram utilized significantly less glycogen. With the 10-micrograms dose no significant decrease in heart glycogen content was observed at exhaustion. A submaximal 2-h run significantly reduced glycogen content in heart, red and white portions of the vastus lateralis, and the livers of SI animals. The latter effect was attenuated in skeletal muscle and liver, and there was no effect in the hearts of the ER animals receiving 2 micrograms. These data indicate that estradiol replacement in oophorectomized rats influenced myocardial glycogen utilization during exhaustive exercise and spared tissue glycogen during submaximal exercise. These glycogen sparing effects may have contributed to the significant improvements in exercise performance observed in this study. PMID- 3654409 TI - Interaction of contractile responses in canine tracheal smooth muscle. AB - Concentration-response curves for norepinephrine, acetylcholine, and 5 hydroxytryptamine were obtained in vitro alone and after precontraction with histamine, 5-hydroxytryptamine, or acetylcholine. Responses obtained to each agonist after precontraction were greater than responses to the agonist alone after subtraction of the force due to the precontracting stimulus. Augmentation of responses after precontraction was the greatest for norepinephrine, less for 5 hydroxytryptamine, and least for acetylcholine. Verapamil had no significant effect on the augmentation of responses to either 5-hydroxytryptamine or acetylcholine caused by precontraction. When the efficacy of acetylcholine was decreased by receptor alkylation with phenoxybenzamine, the augmentation of responses to acetylcholine caused by precontraction with histamine was significantly enhanced. Differences in the magnitude of the effect of precontraction on responses to different agonists may reflect differences in their efficiency of stimulus-response coupling in canine tracheal smooth muscle, or they may result from an increased expression of distinct receptors or receptor mediated effects uncovered by the facilitory stimuli. PMID- 3654410 TI - Operation Everest II: elevated high-altitude pulmonary resistance unresponsive to oxygen. AB - High altitude increases pulmonary arterial pressure (PAP), but no measurements have been made in humans above 4,500 m. Eight male athletic volunteers were decompressed in a hypobaric chamber for 40 days to a barometric pressure (PB) of 240 Torr, equivalent to the summit of Mt. Everest. Serial hemodynamic measurements were made at PB 760 (sea level), 347 (6,100 m), and 282/240 Torr (7,620/8,840 m). Resting PAP and pulmonary vascular resistance (PVR) increased from sea level to maximal values at PB 282 Torr from 15 +/- 0.9 to 34 +/- 3.0 mmHg and from 1.2 +/- 0.1 to 4.3 +/- 0.3 mmHg.l-1 X min, respectively. During near maximal exercise PAP increased from 33 +/- 1 mmHg at sea level to 54 +/- 2 mmHg at PB 282 Torr. Right atrial and wedge pressures were not increased with altitude. Acute 100% O2 breathing lowered cardiac output and PAP but not PVR. Systemic arterial pressure and resistance did not rise with altitude but did increase with O2 breathing, indicating systemic control differed from the lung circulation. We concluded that severe chronic hypoxia caused elevated pulmonary resistance not accompanied by right heart failure nor immediately reversed by O2 breathing. PMID- 3654411 TI - Operation Everest II: preservation of cardiac function at extreme altitude. AB - Hypoxia at high altitude could depress cardiac function and decrease exercise capacity. If so, impaired cardiac function should occur with the extreme, chronic hypoxemia of the 40-day simulated climb of Mt. Everest (8,840 m, barometric pressure of 240 Torr, inspiratory O2 pressure of 43 Torr). In the five of eight subjects having resting and exercise measurements at the barometric pressures of 760 Torr (sea level), 347 Torr (6,100 m), 282 Torr (7,620 m), and 240 Torr, heart rate for a given O2 uptake was higher with more severe hypoxia. Slight (6 beats/min) slowing of the heart rate occurred only during exercise at the lowest barometric pressure when arterial blood O2 saturations were less than 50%. O2 breathing reversed hypoxemia but never increased heart rate, suggesting that hypoxic depression of rate, if present, was slight. For a given O2 uptake, cardiac output was maintained. The decrease in stroke volume appeared to reflect decreased ventricular filling (i.e., decreased right atrial and wedge pressures). O2 breathing did not increase stroke volume for a given filling pressure. We concluded that extreme, chronic hypoxemia caused little or no impairment of cardiac rate and pump functions. PMID- 3654412 TI - Influence of halothane on control of breathing in intact and decerebrated cats. AB - The effects of halothane anesthesia have been investigated in intact and in decerebrated cats. Pulmonary ventilation and breathing pattern were studied during room-air breathing, hypercapnia, and O2 inhalation. The following results have been demonstrated. First, halothane anesthesia does not modify pulmonary ventilation, but a tachypnea much more intense in intact than in decerebrated cats is observed. This indicates that halothane-induced tachypnea originates mainly in structures rostral to the brain stem. Second, decerebrated animals exhibit a breathing pattern and a ventilatory response to CO2 similar to those of intact conscious cats, suggesting that forebrain facilitatory and inhibitory influences on brain stem are cancelled out by decerebration. However, the tidal volume vs. inspiratory duration relationship observed in decerebrated cats differs from that in conscious cats. Finally, during halothane anesthesia, ventilatory response to CO2 is markedly depressed. Third, during O2 inhalation, except in decerebrated, anesthetized animals, ventilation is only slightly depressed. This suggests that central stimulatory effect of O2 is enhanced and/or that peripheral chemoreceptor drive is reduced. PMID- 3654413 TI - Effects of autonomic blockade on cardiac function at rest and during upright exercise in humans. AB - The cardiac function was studied by radionuclide cardiography in eight healthy subjects at rest and during submaximal upright exercise before and after autonomic blockade with metoprolol and atropine. At rest the median stroke volume was reduced by 21% during autonomic blockade (P less than 0.01), but cardiac output was maintained by a concomitant increase in heart rate. The systolic blood pressure was reduced from 120 to 105 mmHg (P less than 0.01), and left ventricular ejection fraction was reduced from 61 to 56% (P less than 0.05). After autonomic blockade the heart rate reached during exercise was the same. Stroke volume and cardiac output were maintained through cardiac dilation. The increase in left ventricular end-diastolic volume was 31 vs. 10% during control conditions (P less than 0.01). The systolic blood pressure was reduced from 174 to 135 mmHg (P less than 0.01). Left ventricular ejection fraction was reduced from 75 to 67% (P less than 0.05), but the increase from rest to exercise was preserved. Total peripheral resistance was reduced by 17% (P less than 0.05). These findings suggest that the heart possesses intrinsic mechanisms to maintain cardiac output during submaximal upright exercise. End-diastolic dilation results in a preserved stroke volume despite a reduced contractility. PMID- 3654414 TI - Structural and functional responses to prolonged hindlimb suspension in rat muscle. AB - The purpose of this study was to investigate alterations in structural and functional properties in the soleus (SOL) and extensor digitorum longus (EDL) muscles of rats after 1, 2, and 5 wk of tail suspension. Maximal O2 uptake was 19% lower after 5 wk suspension. Loss of muscle mass was greater in SOL (63%) than in EDL (22%) muscle. A reduction of type I distribution was accompanied by an increase of intermediate fiber subgroups (int I in SOL, int II in EDL). The cross-sectional area of all three fiber types was reduced by hypokinesia. The decrease in capillaries per fiber in SOL was greater than the decrease in citrate synthase and 3-hydroxyacyl-CoA dehydrogenase activities after 5 wk. No alteration in lactate dehydrogenase activity was noted. In EDL, no changes in fiber area, capillarization, and enzymatic activities occurred. Energy charge remained unchanged (0.91) whatever the muscle. These results suggest that type I fibers showed an earlier and greater susceptibility than type II fibers to suspension which is also accompanied by a decreased aerobic capacity. PMID- 3654415 TI - Human skeletal muscle function and metabolism during intense exercise at high O2 and N2 pressures. AB - The maximal contractile force (peak torque) of the quadriceps femoris was studied during 60 repeated unilateral dynamic knee extensions in nine subjects under three different conditions, viz., during air breathing at normal (1 ATA) and raised (6 ATA) ambient pressures and during O2 breathing at 1.3 ATA. In six subjects the electromyographic (EMG) activity of the working muscle was recorded. Muscle biopsies were obtained from the vastus lateralis before, immediately after, and 1 min after exercise. Tissue specimens were subsequently assayed for various muscle metabolites. Peak torque, as an average of the 60 knee extensions, was higher (P less than 0.05) at 1.3 ATA than at 6 or 1 ATA. Peak torque of the exercising muscle declined more rapidly at 1 ATA than at 1.3 ATA, differing in the final 24 contractions by 14%. At 6 ATA peak torque of the initial 12 contractions was 6% lower (P less than 0.05) than at 1 ATA but equaled 1-ATA values in the latter third of the exercise bout. Although the EMG activity at 1 ATA increased relative to that at 6 ATA as exercise proceeded, the rate of force decline was greater at 1 ATA. Despite greater total work produced at 1.3 ATA than at 1 ATA, the metabolic response to exercise was not substantially altered at increased O2 pressure. However, the restitution rate of energy-rich phosphagens and the elimination of lactate during recovery were greater (P less than 0.05) at 1.3 ATA. These results suggest that hyperoxia may enhance the rate of energy release, whereas high N2 pressure and/or high hydrostatic pressure seem to interfere with neuromuscular activity. PMID- 3654417 TI - Comparative effects of leukotrienes on porcine pulmonary circulation in vitro and in vivo. AB - The present study examined the effect of leukotrienes on porcine pulmonary vasculature both in vivo and in vitro. In vitro studies using isolated vascular strips demonstrated that pulmonary arterial smooth muscle contracted to leukotriene C4 (LTC4), whereas pulmonary vein smooth muscle did not. Pulmonary arterial contraction was due to both the direct action of LTC4 and secondarily generated thromboxane A2 (TxA2). In vivo, LTC4 injection caused a pronounced but transient increase in pulmonary arterial pressure and pulmonary arterial wedge pressure (Ppw), with a smaller effect on left ventricular end-diastolic pressure. Effects of LTD4 were smaller with comparable pressure changes at all three sites, suggesting a primary cardiac effect. Like LTC4, histamine caused a disproportionate increase in Ppw vs. left ventricular end-diastolic pressure. These observations suggest that LTC4 causes pulmonary venoconstriction in vivo despite its lack of effect on pulmonary vein smooth muscle in vitro. This discrepancy may be due to venoconstrictor effects of TxA2 generated from upstream pulmonary arterial vessels. PMID- 3654416 TI - Physiological responses of aged men to head-up tilt during heat exposure. AB - The effects of age on cardiovascular and thermoregulatory responses to passive tilting were investigated using six old (61-73 yr) and 10 young (21-39 yr) unacclimatized men. Experiments were carried out at 26 degrees C and after exposure to 40 degrees C and 40% relative humidity for 105 min. Continuous measurements of esophageal (Tes) and mean skin (Tsk) temperatures and heart rate (HR) were recorded. Other variables studied included blood pressure (BP), forearm blood flow (FBF), and cardiac output (CO), which were measured at 4- to 5-min intervals. Measurements were made in the supine position and after 70 degrees head-up tilt for 15 min. Cardioacceleration during the tilt test was greater in the young men than in the old. Other cardiovascular responses of the old men to orthostatism were qualitatively similar to that of the young except for FBF and forearm vascular conductance. The old men did not show significant changes in FBF during tilting, suggesting a deterioration in the sympathetic nervous reflex in the aged. However, other circulatory adaptations seemed to overcome this deficiency resulting in orthostatic tolerance similar to that of the young. During head-up tilt at 26 and 40 degrees C, Tes of both age groups increased. This may reflect a decrease in conductive heat transfer presumably due to diminished blood flow to the periphery. PMID- 3654418 TI - Metabolic and hormonal responses in theophylline-increased cold resistance in males. AB - The effects of theophylline (a phosphodiesterase inhibitor-adenosine receptor antagonist) and substrate feeding (Ensure, 250 kcal/235 ml) on cold resistance were studied in seminude males undertaking submaximal (50% maximum O2 consumption), intermittent (34% of total time) exercise in the cold (-5 to 15 degrees C, individually adjusted) for 3 h. Each subject (n = 7) served as his own control and was tested on a weekly schedule. Under control treatment, rectal temperature (Tre) decreased by 0.9 degrees C to approximately 36.2 degrees C after cold exposure, whereas under theophylline and Ensure, the decrease of Tre was only 0.4 degrees C, indicating a significant increase (P less than 0.05) in cold resistance (50% better than control). The plasma concentration of theophylline was 4.8-5.9 micrograms/ml and was positively correlated with plasma concentration of free fatty acids. Plasma norepinephrine (NE) increased significantly during cold exposure; the absolute concentration was significantly higher after theophylline pretreatment. The plasma concentrations of glucose, epinephrine, cortisol, and adenosine 3',5'-cyclic monophosphate did not change and the changes of free thyroxine and triiodothyronine were minor. Together, the effectiveness of theophylline + Ensure in acutely increasing cold resistance may be due to increased substrate availability for thermogenesis, part of which, through theophylline's potentiation of both sympathetic release of NE and NE stimulated lipolysis and part of which, through supplementary feeding of Ensure. PMID- 3654419 TI - Species variation in lung antioxidant enzyme activities. AB - Exposure of several different animal models to O2-induced lung injury has revealed marked differences in sensitivity of various species to O2 damage. These differences may be due in part to variation of cellular antioxidant defenses. To characterize lung antioxidant enzyme activities in different species, we measured lung activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT), and glutathione S-transferase (GSH S-trans) in rat, hamster, baboon, and human lung. Soluble lung fractions were also fractionated on Sephadex G-150-S columns and GSH-Px activity was measured using both cumene hydroperoxide and H2O2. This was done to evaluate non-Se-dependent GSH-Px activity in these lung samples. Human lung was obtained at surgery from patients undergoing lobectomy or pneumonectomy for localized lung tumors. SOD activity was similar for all four groups. GSH-Px activity was higher in rat lung than baboon or hamster lung. Lung CAT activity was variable with the highest activity present in the baboon which revealed a lung CAT activity 10 times higher than activity present in the rat. Lung GSH S-trans activities were higher in hamster, baboon, and human lung than in rat lung. Non-Se-dependent GSH-Px was present in rat lung but absent in hamster, baboon, and human lung. We conclude that the hamster was the best model of the animals studied for mimicking human lung antioxidant enzyme activities. Rat lung antioxidant enzyme activities were markedly different from any of the other species examined. PMID- 3654420 TI - Neuromuscular and mechanical responses to inspiratory resistive loading during sleep. AB - The purposes of this study were 1) to characterize the immediate inspiratory muscle and ventilation responses to inspiratory resistive loading during sleep in humans and 2) to determine whether upper airway caliber was compromised in the presence of a resistive load. Ventilation variables, chest wall, and upper airway inspiratory muscle electromyograms (EMG), and upper airway resistance were measured for two breaths immediately preceding and immediately following six applications of an inspiratory resistive load of 15 cmH2O.l-1 X s during wakefulness and stage 2 sleep. During wakefulness, chest wall inspiratory peak EMG activity increased 40 +/- 15% (SE), and inspiratory time increased 20 +/- 5%. Therefore, the rate of rise of chest wall EMG increased 14 +/- 10.9% (NS). Upper airway inspiratory muscle activity changed in an inconsistent fashion with application of the load. Tidal volume decreased 16 +/- 6%, and upper airway resistance increased 141 +/- 23% above pre-load levels. During sleep, there was no significant chest wall or upper airway inspiratory muscle or timing responses to loading. Tidal volume decreased 40 +/- 7% and upper airway resistance increased 188 +/- 52%, changes greater than those observed during wakefulness. We conclude that 1) the immediate inspiratory muscle and timing responses observed during inspiratory resistive loading in wakefulness were absent during sleep, 2) there was inadequate activation of upper airway inspiratory muscle activity to compensate for the increased upper airway inspiratory subatmospheric pressure present during loading, and 3) the alteration in upper airway mechanics during resistive loading was greater during sleep than wakefulness. PMID- 3654421 TI - Maturation of spontaneous fetal diaphragmatic activity and fetal response to hypercapnia and hypoxemia. AB - The electromyogram (EMG) of the diaphragm, lateral rectus, and nuchal and hindlimb muscles were studied during spontaneous activity and during hypercapnia or hypoxemia in eight fetal sheep from 0.5 to 0.8 gestation (73-128 days). At the earliest gestational age, diaphragmatic EMG activity was mainly tonic and associated with tonic activity of somatic muscles. The stimulus for the diaphragmatic activity originated centrally. Brief periods of a rapid-eye movement (REM) state characterized by phasic lateral rectus and diaphragmatic activity and absence of nuchal activity were recognized. Furthermore, from 0.5 to 0.7 gestation onward, activity of all muscles increased. Thereafter increased specificity of activity in relation to the apparent REM and non-rapid-eye movement (NREM) state occurred. With maturation, phasic diaphragmatic activity increased at the expense of tonic activity. The most striking effect of maturation on apnea was a greater proportion of apnea lasting greater than 1 min, but the total duration of apnea as a percent of a total recording remained unchanged. The quantitative response to hypercapnia during maturation was independent of the pattern of spontaneous diaphragmatic activity. Hypercapnia at 0.5 gestation changed the pattern of diaphragmatic EMG activity from mainly tonic to phasic. Thus the central chemoreceptors and appropriate neuronal pathways are present and functional as early as 0.5 gestation. Hypercapnia at 0.5 gestation caused a shift in diaphragmatic EMG power to lower frequencies similar to that found during control conditions in the older fetus. This might suggest that during maturation there is increased recruitment of phrenic motoneurons. Hypoxemia abolished tonic somatic activity at 0.5 gestation and decreased phasic diaphragmatic activity at more advanced gestational ages. Therefore the central inhibitory mechanisms of hypoxemia are developed by 0.5 gestation. PMID- 3654422 TI - Plasma fibronectin therapy and lung protein clearance with bacteremia after surgery. AB - Plasma fibronectin modulates macrophage phagocytic function and can also incorporate into the insoluble tissue pool of fibronectin where it influences endothelial cell adhesion and tissue integrity. We studied the effect of postoperative bacteremia on lung protein clearance in relation to plasma fibronectin levels using the unanesthetized sheep lung lymph fistula model and the effect of infusion of purified human plasma fibronectin on lung protein clearance. Sheep received live Pseudomonas aeruginosa (5 X 10(8) iv) at a time of normal plasma fibronectin (590 +/- 37 micrograms/ml) or 5 days later at a time corresponding to elevation of plasma fibronectin (921 +/- 114 micrograms/ml). After the first bacterial challenge, there was a 22% decrease (P less than 0.05) in plasma fibronectin. Lung lymph flow (QL) initially increased 308% (P less than 0.05) by 2 h (0 h = 4.7 +/- 1.1 ml/h; 2 h = 14.4 +/- 3.5 ml/h), and the total protein lymph-to-plasma concentration ratio (L/P) declined. This was followed by a sustained second phase response over 3-12 h which was characterized by a 202 393% elevation in QL (P less than 0.05), an increase in the L/P ratio, and a 240 480% (P less than 0.05) increase in lung transvascular protein clearance (TVPC = QL X L/P). Sheep with elevated fibronectin levels also manifested the early (2 h) elevation in QL (P less than 0.05) coupled with a decline in L/P ratio after the second bacterial challenge, but the second-phase increase in TVPC was markedly attenuated. Intravenous infusion of 500 mg of human plasma fibronectin into normal sheep to elevate the fibronectin level comparable to that in the hyperfibronectinemic sheep also attenuated (P less than 0.05) the second-phase (3 12 h) increase in lung protein clearance with sepsis. Thus elevation of plasma fibronectin during postoperative Gram-negative bacteremia may protect the lung vascular barrier. This response may be mediated by either fibronectin's opsonic support of phagocytic function or its influence on lung endothelial cell adhesion. PMID- 3654423 TI - Continuity of arterial and venous extra-alveolar interstitium in excised rabbit lungs. AB - We studied the interdependence of arterial and venous extra-alveolar vessel (EAV) leakage on the rate of pulmonary vascular fluid filtration (measured as the change in lung weight over time). Edema was produced in continually weighed, excised rabbit lungs kept in zone 1 (alveolar pressure = 25 cmH2O) by increasing pulmonary arterial (Ppa) and/or venous (Ppv) pressure from 5 to 20 cmH2O (relative to the lung base) and continuing this hydrostatic stress for 3-5 h. Raising Ppa and Ppv simultaneously produced a lower filtration rate than the sum of the filtration rates obtained when Ppa and Ppv were raised separately, while the lung gained from 20 to 95% of its initial weight. When vascular pressure was elevated in either EAV segment, fluid filtration always decreased rapidly as the lung gained up to 30-45% of its initial weight. Filtration then decreased more slowly. The lungs became isogravimetric at 60 and 85% weight gain when the Ppa or Ppv was elevated, respectively; when Ppa and Ppv were raised simultaneously substantial fluid filtration continued even after 140% weight gain. We conclude that the arterial and venous EAV's share a common interstitium in the zone 1 condition, this interstitium cannot be represented as a single compartment with a fixed resistance and compliance, and arterial and venous EAV leakage influences leakage from the other segment. PMID- 3654424 TI - Hypoxia and monosynaptic reflexes in humans. AB - The recruitment curves of the monosynaptic Hoffmann (H) reflex and of the direct motor (M) excitation of alpha-motor fibers of the posterior popliteal nerve were studied in seven human subjects in normoxic and hypoxic conditions at sea level. The amplitude of the H and M responses were determined from the computerized full wave rectified and integrated surface electromyographic (EMG) signal derived from bipolar surface electrodes placed over the soleus muscle. Hypoxic exposure [end tidal O2 fraction (FETO2) = 0.066 +/- 0.003 and end-tidal CO2 fraction (FETCO2) = 0.0504 +/- 0.001 (SE)] did not affect the maximal M (Mmax) response but decreased significantly (7%) the maximal H (Hmax) response. The Hmax/Mmax ratio decreased from 0.60 to 0.53. Furthermore, by fitting the rising phase of the recruitment curves of the H and M responses vs. stimulus intensity with linear regressions, hypoxia was found to produce a significant decrease of similar magnitude (6%) in the threshold of both the H and M responses with no change in slope. Using a constant stimulus strength eliciting an H response of half the maximum (H50%) of the control conditions, hypoxia resulted in a 50% increase in the amplitude of the H response within 12 min. These results suggest that the effects of hypoxia on the nervous system consist of a direct depolarizing action on the peripheral alpha-fibers and 1A sensory fibers and of a central effect on supraspinal structures affecting the spinal alpha-motoneurons. PMID- 3654425 TI - Plasma free and sulfoconjugated catecholamine responses to varying exercise intensity. AB - Plasma free catecholamines rise during exercise, but sulfoconjugated catecholamines reportedly fall. This study examined the relationship between exercise intensity and circulating levels of sulfoconjugated norepinephrine, epinephrine, and dopamine. Seven exercise-trained men biked at approximately 30, 60, and 90% of their individual maximal oxygen consumption (VO2max) for 8 min. The 90% VO2max period resulted in significantly increased plasma free norepinephrine (rest, 219 +/- 85; exercise, 2,738 +/- 1,149 pg/ml; P less than or equal to 0.01) and epinephrine (rest, 49 +/- 49; exercise, 555 +/- 516 pg/ml; P less than or equal to 0.05). These changes were accompanied by consistent increases in sulfoconjugated norepinephrine at both the 60% (rest, 852 +/- 292; exercise, 1,431 +/- 639; P less than or equal to 0.05) and 90% (rest, 859 +/- 311; exercise, 2,223 +/- 1,015; P less than or equal to 0.05) VO2max periods. Plasma sulfoconjugated epinephrine and dopamine displayed erratic changes at the three exercise intensities. These findings suggest that sulfoconjugated norepinephrine rises during high-intensity exercise. PMID- 3654426 TI - Cold-induced bronchoconstriction: role of cutaneous reflexes vs. direct airway effects. AB - To determine the relative contributions of direct airway vs. reflex cutaneous thermal receptor stimulation in cold-induced bronchoconstriction, we isolated these two aspects of cold exposure in 10 asthmatics and 13 normal subjects. Ice packs were applied to the skin of the face, chest, thigh, and upper arm in random sequence while serially measuring specific conductance. In this fashion a limited mapping of skin-mediated bronchoconstriction was established. Warm packs were applied to the same areas of control for any potential nonspecific stimulatory effects. Cooling the skin induced bronchoconstriction to a similar degree in both groups; this effect was very small, did not induce symptoms, and was only seen with stimulation of the face. At another time, the subjects performed isocapnic hyperventilation of frigid air to ascertain their response to direct airway cooling. A moderate but significant correlation existed between skin and airway sensitivity; however, the magnitude of the two responses differed markedly. Breathing cold air at rest had no effect on lung function; however, elevating ventilation promptly produced bronchial narrowing. Hence, in a cold environment, the most potent stimulus for the development of airway obstruction in asthmatics derives from a direct airway effect. PMID- 3654427 TI - Dive response of children in relation to cold-water near-drowning. AB - The strength of the dive response, as judged by the combination of breath-hold duration (BHD) and bradycardia, was compared in 87 children (4-13 yr old) and 68 adults (20-68 yr old) during simulated dives in 29 degrees C water. Mean BHD in children (16.1 s) was only 37.4% (P less than 0.001) of adult BHD (43.0 s). Within children, BHD was significantly (P less than 0.001) dependent on age (A in yr) according to the regression BHD = -1.46 + 2.27A. No age dependency of BHD occurred in adults. Due to the low BHD of children, only 14/87 (16.1%) were able to breath hold for the 25 s necessary to develop full diving bradycardia. For these 14 children, their bradycardia (36.1% reduction) was insignificantly different (P greater than 0.50) from that of adults (36.4%). These experimental findings demonstrate that the dive response of children is extremely weak, due mainly to their very low BHD. Since lower water temperature would probably accentuate the shortness of BHD (according to previous findings for adults), it is concluded that the dive response is unlikely to make a significant contribution to the prolonged resuscitatibility of children who are victims of cold-water near-drowning. PMID- 3654428 TI - Time-dependent effect of hypoxia on carotid body chemosensory function. AB - The time-dependent effects of hypoxia on the discharge rate carotid chemoreceptors were measured in anesthetized cats. Hypoxic exposure of two different durations were used: a short-term exposure (2-3 h) was used to measure the response of the same carotid chemoreceptors; and a long-term exposure (28 days at inspired PO2 of 70 Torr) to study carotid chemoreceptor properties in one group of cats relative to those of a control group. In the chronically hypoxic and control groups, determinations were made of the 1) steady-state responses to four levels of arterial PO2 (PaO2) at constant levels of arterial PCO2; 2) steady state responses to acute hypercapnia during hyperoxia; and 3) maximal discharge rates during anoxia. We found that the acute responses of carotid chemoreceptor afferents to a given level of hypoxia (PaO2 = 30-40 Torr) did not significantly change within 2-3 h. After long-term exposure the carotid chemoreceptor responses to hypoxia significantly increased, with no significant changes in the hypercapnic response and in the maximal discharge rate during anoxia. We conclude that isocapnic hypoxia may not elicit a sufficient cellular response within 2-3 h in the cat carotid body to sensitize the O2 responsive mechanism, but hypoxia of longer duration will sensitize such a mechanism, thereby augmenting the chemosensory activity. PMID- 3654429 TI - Surfactant-associated protein inhibits phospholipid secretion from type II cells. AB - Secretion of [3H]phosphatidylcholine ([3H]PC) from isolated rat pulmonary type II epithelial cells was inhibited by the surfactant-associated protein of Mr = 35,000 (SAP-35) purified from canine lung surfactant. SAP-35 inhibited [3H]PC secretion in a dose-dependent manner and significantly inhibited basal, phorbol ester, beta-adrenergic, and P2-purinergic agonist-induced [3H]PC secretion. SAP 35 significantly inhibited [3H]PC secretion from 1 to 3 h after treatment. The IC50 for inhibition of [3H]PC secretion by canine SAP-35 was 1-5 X 10(-6) g/ml and was similar for inhibition of both basal and secretagogue-stimulated release. Heat denaturation of SAP-35, addition of monoclonal anti-SAP-35 antibody, reduction and alkylation of SAP-35, or association of SAP-35 with phospholipid vesicles reversed the inhibitory effect on secretagogue-induced secretion. Inhibitory effects of SAP-35 were observed 3 h after cells were washed with buffer that did not contain SAP-35. Although SAP-35 enhanced reassociation of surfactant phospholipid with isolated type II cells, its inhibitory effect on secretion of [3H]PC did not result from stimulation of reuptake of secreted [3H]PC by type II cells. The inhibition of phospholipid secretion by SAP-35 was also not due to inhibition of PC or disaturated PC synthesis by SAP-35. SAP-35, the major phospholipid-associated protein in pulmonary surfactant, is a potent inhibitor of surfactant secretion from type II cells in vitro and may play an important role in homeostasis of surfactant in the alveolar space. PMID- 3654430 TI - Naloxone reduces ventilatory depression of brain hypoxia. AB - To assess whether endogenous opioids participate in respiratory depression due to brain hypoxia, we determined the ventilatory response to progressive carboxyhemoglobinemia (1% CO, 40% O2) before and after administration of naloxone (NLX, 0.1 mg/kg iv). Minute ventilation (VI) and ventral medullary surface pH (Vm pH) were measured in six anesthetized, peripherally chemodenervated cats. NLX consistently increased base-line hyperoxic VI from 618 +/- 99 to 729 +/- 126 ml/min (P less than 0.05). Although NLX did not alter the Vm pH response to CO [initial alkalosis, Vm pH +0.011 +/- 0.003 pH units, followed by acidosis, Vm pH 0.082 +/- 0.036 at carboxyhemoglobin (HbCO) 55%], NLX attenuated the amount of ventilatory depression; increasing HbCO to 55% decreased VI to 66 +/- 6% of base line before NLX and to 81 +/- 9% of base line after NLX (P less than 0.05). The difference in response after NLX was primarily the result of a linear increase in tidal volume (VT) with decreasing Vm pH (delta VT = 60.3 ml/-pH unit) which was absent before NLX. To assess whether the site of action of the endogenous opioid effect was the central chemosensors, the ventilatory and Vm pH response to progressive HbCO was determined in three additional cats before and after topical application of NLX (3 X 10(-4) M) to the ventral medullary surface. The effect of topical NLX was similar to systemic NLX; significant attenuation of the reduction in VI with increasing HbCO. We conclude that 1) endogenous opioids mediate a portion of the depression of ventilation due to acute brain hypoxia, and 2) this effect is probably at the central chemosensitive regions. PMID- 3654431 TI - Effect of airway wall flexibility on clearance by simulated cough. AB - In our previous study, we investigated the relationship between mucus rheology, depth of mucus layer, and clearance by simulated cough. The purpose of the present study was to examine the effect of airway wall flexibility on the clearance of mucuslike gels. Transient airflows similar to cough were generated by both positive and negative pressure, the latter to mimic the dynamic compression that occurs during real cough. As in the previous study, the trachea was modeled as a trough of rectangular cross section with only the bottom lined with the mucus simulant. Clearance was followed by observing the displacement of marker particles. Since cough clearance is intimately related to wave formation in the mucus blanket, we hypothesized that clearance might be impeded if the wave formation occurred simultaneously in the wall and its lining layer. Thus, in one set of experiments the bottom rigid surface of the model trachea was replaced with a frame over which a flexible membrane could be drawn, whereas in the other set the rigid top was replaced by the frame. We also examined the effect of negative-pressure cough in excised canine tracheae, comparing the case where the tracheal membrane was free to deform vs. the case where it was secured. For the rigid-walled model, clearance by positive or negative pressure, with matched flow pattern, was the same. With the mucus simulant lining the flexible bottom surface, clearance increased with increasing membrane flexibility for negative pressure cough and decreased for positive-pressure cough.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654432 TI - Patterns of EMG activity of rat plantaris muscle during swimming and other locomotor activities. AB - The purpose of the study was to examine the patterns of electromyographic (EMG) activity of the rat plantaris during loaded swimming in comparison with other locomotor activities. Five female Sprague-Dawley rats were implanted with chronic bipolar electrodes in the plantaris muscle of the left hindlimb under pentobarbital anesthesia. Characteristics of EMG bursts recorded while the conscious rat was performing treadmill walking (0.24 m/s) were stable and reproducible 10-14 days postsurgery. Following this stabilization period, records of EMG activity were obtained during walking, loaded swimming (6.5 g attached to tail), and several other locomotor tasks. Compared to walking, EMG bursts during loaded swimming were significantly higher (67%) in maximum amplitude, one-third as long in duration, and occurred at a greater rate (4.4 vs. 1.7 bursts/s, P less than 0.05). Swimming bursts were of higher amplitudes than those of all other activities examined and reached 65% of the EMG amplitude recorded following stimulation of the sciatic nerve with supramaximal voltage. The addition of a mass to the animal's tail during swimming did not increase the EMG burst amplitudes but resulted in a higher frequency of bursts. Compared with treadmill walking, loaded swimming elicited burst of high variability in amplitude. Swimming in the rat involves rapid, extensive activation of plantaris, thus providing an exercise model to study the adaptability of the neuromuscular system to prolonged activity of this type. PMID- 3654433 TI - Hysteresis in response to descending and ascending lower-body negative pressure. AB - We have investigated the pattern of fluid redistribution and cardiovascular responses during graduated orthostatic stress. Twelve men, age 30-39 yr, underwent a 25-min lower-body negative pressure (LBNP) test protocol that involved sequential stages of LBNP at -8 mmHg (1 min), -16 mmHg (1 min), -30 mmHg (3 min), -40 mmHg (5 min), -50 mmHg (5 min), -40 mmHg (5 min), -30 mmHg (3 min), 16 mmHg (1 min), and -8 mmHg (1 min). Data were recorded at the end of each stage. For many measured variables values during the descending phase of LBNP (-8 to -40 mmHg) were significantly different from values during the ascending phase of (-40 to -8 mmHg). These differences appear to be due to a component of fluid translocation that occurs during LBNP and cannot be reversed within the duration of the procedure. We hypothesize that this slowly reversed component is sequestration of fluid in the interstitial and lymphatic compartments. In contrast, venous pooling is a rapidly reversible component of fluid movement during LBNP. A scheme describing fluid and cardiovascular responses to LBNP based on these data and the data of other investigators is presented. PMID- 3654434 TI - O2 delivery to contracting muscle during hypoxic or CO hypoxia. AB - The consequences of a decreased O2 supply to a contracting canine gastrocnemius muscle preparation were investigated during two forms of hypoxia: hypoxic hypoxia (HH) (n = 6) and CO hypoxia (COH) (n = 6). Muscle O2 uptake, blood flow, O2 extraction, and developed tension were measured at rest and at 1 twitch/s isometric contractions in normoxia and in hypoxia. No differences were observed between the two groups at rest. During contractions and hypoxia, however, O2 uptake decreased from the normoxic level in the COH group but not in the HH group. Blood flow increased in both groups during hypoxia, but more so in the COH group. O2 extraction increased further with hypoxia (P less than 0.05) during concentrations in the HH group but actually fell (P less than 0.05) in the COH group. The O2 uptake limitation during COH and contractions was associated with a lesser O2 extraction. The leftward shift in the oxyhemoglobin dissociation curve during COH may have impeded tissue O2 extraction. Other factors, however, such as decreased myoglobin function or perfusion heterogeneity must have contributed to the inability to utilize the O2 reserve more fully. PMID- 3654435 TI - Cardiorespiratory responses to chemical activation of right ventricular receptors. AB - Previous reports have shown that activation of left ventricular receptors with sympathetic afferents elicits increases in respiratory output and arterial pressure. The purpose of the present study was to determine whether similar responses are produced by chemical activation of epicardial receptors in the right ventricle. Receptors were stimulated by applying either capsaicin (10 micrograms) or bradykinin (500 ng) to the epicardial surface of the right ventricle in anesthetized cats. Application of either chemical evoked an increase in respiratory output (phrenic nerve activity), a decrease in heart rate, and a nonsignificant increase in arterial pressure in intact cats. However, capsaicin and bradykinin produced significant increases in arterial pressure, heart rate, and respiratory output after bilateral cervical vagotomy. In contrast, a fall in both heart rate and arterial pressure with only small increases in respiratory output were evoked after bilateral removal of the stellate ganglia in cats with intact vagi. Only small responses to the chemical stimulation of right ventricular receptors persisted after combined vagotomy and stellate ganglionectomy. These findings suggest that 1) activation of epicardial receptors with sympathetic afferents originating in the right ventricle causes an increase in cardiorespiratory function, and 2) activation of right ventricular receptors with vagal afferents produces decreases in heart rate and arterial pressure. PMID- 3654436 TI - Factors producing elevated core temperature in spontaneously hypertensive rats. AB - Core temperature (Tco) of the spontaneously hypertensive rat (SHR) is consistently higher by approximately 1 degree C than that of normotensive controls. To analyze factors producing the elevated Tco, mean skin temperature (Tsk), metabolic heat production (M), respiratory evaporative heat loss (Eres), effective tissue thermal conductance (K), systolic blood pressure (BP), and Tco were determined in eight male SHR and nine male normotensive Wistar-Kyoto (WKY) rats habituated to rest quietly in neck stock restraint while exposed to ambient temperatures (Ta) of 12.5, 17, 23, 28.5, 32, 34, and 35 degrees C. At all temperatures steady-state BP, Tco, and M were higher for SHR's than for WKY's. SHR's could maintain thermal balance up to Ta 32 degrees C, and WKY's up to 34 degrees C. Eres from SHR's was greater than from WKY's at Ta of 12.5, 17, and 28.5 degrees C. K of SHR's was not different from or was higher than K of WKY's, and K for both groups was 2.6 times greater at Ta 32 degrees C than at 17 degrees C. These results indicate that the high Tco of SHR's is due to increased M uncompensated by increased K or Eres. PMID- 3654437 TI - Inhibitory effect of almitrine on dopaminergic activity of rat carotid body. AB - Almitrine increases ventilation by stimulating the peripheral arterial chemoreceptors. This study assessed the effects of acute and chronic almitrine treatments on the dopamine (DA) and norepinephrine (NE) contents and utilization rates in the rat carotid body. Almitrine (5 mg/kg ip) caused a 34% reduction in DA content after 30 min. Extending the almitrine treatment for 15 days (one daily ip injection) produced a further progressive diminution in DA stores (-55%; P less than 0.01). The utilization rate of DA measured after inhibiting catecholamine biosynthesis by alpha-methyl-p-tyrosine was strongly reduced by almitrine (-98% after 15 days; P less than 0.01). The effects of almitrine were dose dependent. The noradrenergic activity was much less altered by the drug. The data showed that almitrine can modify the dynamics of DA in rat carotid body producing a decrease in both content and utilization rate. PMID- 3654438 TI - Enhanced fibrin formation in high-altitude pulmonary edema. AB - Blood coagulation, fibrinolysis, and arterial blood gases were examined in 66 nonacclimatized mountaineers at 4,557 m. Subjects were classified according to a clinical score as healthy (n = 25), having mild acute mountain sickness (AMS) (n = 24), showing severe AMS (n = 13), and suffering from high-altitude pulmonary edema (HAPE) (n = 4). Coagulation times, euglobulin lysis time, and fibrin(ogen) fragment E were normal in all groups without significant changes. Fibrinopeptide A (FPA), a molecular marker of in vivo fibrin formation, was elevated in HAPE to 4.2 +/- 2.7 ng/ml (P less than 0.0001) compared with the other groups showing mean values between 1.6 +/- 0.4 and 1.8 +/- 0.7 ng/ml. FPA was normal in one patient with HAPE, however. Severe AMS was accompanied by a significant decrease in arterial PO2 due to an increase in alveolar-arterial O2 difference, whereas arterial PCO2 did not change significantly. We conclude that activation of blood coagulation is not involved in the pathogenesis of AMS and the impairment of gas exchange in this disease. Fibrin generation occurring in HAPE is probably an epiphenomenon of edema formation. PMID- 3654439 TI - Electrolyte composition changes of chronically K-depleted rats after K loading. AB - The responses of whole body, skeletal muscle, and plasma to oral K loading were studied in K-depleted male rats. Potassium depletion was induced by feeding the rats a K-deficient diet for 4 wk and injecting deoxycorticosterone acetate during the first week. After 4 wk, the rats were growth retarded and hypokalemic (1.9 mmol/l plasma) and had low whole-body and muscle K content, 188 +/- 27 and 276 +/ 19 mmol/kg fat-free dried tissue (FFDT), respectively, compared with 296 +/- 10 and 454 +/- 13 mmol/kg FFDT for the control group. Sodium and water retention also occurred in the K-deficient group. After K depletion, the rats were divided into four groups and received either 0, 1, 2, or 3 intragastric doses of 10 mmol KCl/kg at 8-h intervals. The rats were killed 8 h after the last dose. Control rats were treated similarly. K-depleted and control rats responded differently to K loading. In the normal rats, plasma K remained at 5.0 +/- 0.5 mmol/l, muscle K increased to 502 +/- 24 mmol/kg, and muscle K/N ratio increased from 3.0 to 3.4 mmol/g. In the K-depleted rats, plasma K increased to 7.2 +/- 0.7 mmol/l, muscle K increased to 453 +/- 50 mmol/kg, and muscle K/N ratio increased from 1.8 to 3.1 mmol/g. These data indicate that the capacity of the muscles to accumulate K was impaired after severe K depletion and caused elevated plasma K levels when repletion was complete. PMID- 3654440 TI - Three-dimensional reconstruction of the rat acinus. AB - This study provides a quantitative description of the small airways and alveolar duct-alveolar architecture of the rat lung. To accomplish this, quantitative three-dimensional reconstructions were made of small airways, the alveolar duct system, and alveoli. The branching pattern of the small airways immediately proximal to the alveolar ducts varied significantly. For example, the number of bronchiole-alveolar duct junctions per parent bronchus (terminal bronchiole) ranged from two to six. The number of bronchiole-alveolar duct junctions per lung was 7,280 +/- 250 (mean +/- SE). The general shape of the ventilatory unit arising from each bronchiole-alveolar junction was that of a space-filling sphere with an outer diameter of 1,490 +/- 130 microns. The average distance from the bronchiole-alveolar duct junction to alveoli at the end of the alveolar sac termination was 1,290 +/- 100 microns. Numerous trifurcations were found in the branching pattern of the alveolar ducts. The branching of the alveolar ducts did not fit a regular dichotomous pattern. The volume of the terminal branches (alveolar sacs) accounted for 64 +/- 5% of the volume of the ventilatory unit. Both of these factors, the pattern of branching and the substantial volume distributed in the most peripheral branches, contribute to the uniform distribution of gas within the ventilatory unit and thus minimize potential diffusion limitations to gas exchange. PMID- 3654441 TI - Changes in left ventricular geometry during spontaneous breathing. AB - The purpose of these experiments was to determine the effects of a spontaneously generated inspiration on the size and shape of the left ventricle (LV) in anesthetized supine dogs. We implanted markers in the LV to establish three perpendicular axes and recorded the motion of these markers using biplane cinefluoroscopy at 60 Hz. The primary changes in LV size that accompanied inspiration occurred at end diastole (ED). The largest change in LVED dimension was a 2.46-mm narrowing of the septal-lateral wall dimension, but the apex-base dimension decreased also, by 0.74 mm. The anteroposterior dimension actually widened by 1.07 mm. The septal-lateral narrowing was caused by both a 1.0-mm narrowing of the distance between the septal marker and the apex-base axis, as well as by a 1.4-mm narrowing between the apex-base axis and the lateral wall marker. Narrowing of the septal portion seemed expected because of presumed enhanced right ventricular filling during inspiration. Narrowing of the lateral portion of the LV, while the anteroposterior dimension widened, was surprising because a change in LVEDV shape is implied. Assuming ventricular homogeneity, this change in LVED shape implies that the forces applied to the epicardial surface were not uniform. There must have been a retraction on the anterior and posterior surface that was not experienced by the lateral LV wall. The net effect of these dimensional changes of the LV at end diastole (estimated from the product of the three ED axes) was a 3.5-cm3 reduction in LVED volume.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654442 TI - Percent carboxyhemoglobin in resting humans exposed repeatedly to 1,500 and 7,500 ppm CO. AB - Eleven nonsmoking male resting subjects were exposed to two transient CO profiles to examine whether the resultant carboxyhemoglobin (HbCO) differs with CO concentration for a fixed total CO dose and to determine the predictive capability of the theoretical model of Coburn et al. (J. Clin. Invest. 44: 1899 1910, 1965) using measured alveolar ventilation. One profile consisted of five sequential exposures to 1,500 ppm CO for 5 min each and spaced 3 min apart. The other consisted of five sequential exposures to 7,500 ppm CO for 1 min each and spaced 7 min apart. The subjects, therefore, were exposed to the same overall nominal dose of 37,500 ppm.min. During the experiment, the subject's ventilatory functions and respiratory gases were recorded continuously, and the resultant HbCO% was measured in venous blood samples by gas chromatography. Mean increase (+/- SD) in HbCO% per exposure was 2.08 +/- 0.27% for the 1,500 ppm CO exposures and 2.05 +/- 0.29% for the 7,500 ppm CO exposures with no significant difference between the two. When the measured values of the subject's alveolar ventilation were applied to the theoretical model of Coburn et al., the predicted rate of HbCO% formation was found to agree with the experimental results. PMID- 3654443 TI - Effects of blood pressure on force production in cat and human muscle. AB - In anesthetized cats reducing local arterial pressure from 125 to 75 Torr decreased blood flow (53 +/- 5%) and force production (57 +/- 7%) in soleus and medial gastrocnemius. Force was produced in these muscles by aerobic, slowly fatiguing fibers. Similar reductions in arterial pressure did not affect force production in caudofemoralis, which contains mainly fast-fatiguing fibers. In human subjects the electromyogram produced by the ankle extensors during rhythmic constant-force contractions increased as the contracting muscles were raised above the heart during legs-up tilt. This suggests that force production of active muscle fibers at a given level of activation fell with muscle perfusion pressure, thus requiring augmentation of muscle activity to sustain the standard contractions. Because aerobic fibers contributed to these contractions, it appears that force production of human muscle fibers is sensitive to small changes in perfusion pressure and, presumably, blood flow. The critical dependence of developed muscular force on blood pressure is of importance to motor control and may also play a significant role in cardiovascular control during exercise. PMID- 3654444 TI - Antioxidants protect cultured bovine lung endothelial cells from injury by endotoxin. AB - Endotoxin injures bovine pulmonary endothelial cells in culture but the cytotoxicity is unaffected by a host of antiinflammatory drugs. We hypothesized that agents which could decrease intracellular concentrations of toxic metabolites of O2 would prevent endotoxin effects on cultured pulmonary artery endothelial cells. We measured endotoxin-induced release of lactate dehydrogenase (LDH) from and production of prostanoids by cultured bovine pulmonary endothelial cells in the presence and absence of dimethyl sulfoxide (DMSO) and the xanthine oxidase inhibitor allopurinol. Escherichia coli endotoxin (0.001-10 micrograms/ml) caused a dose-related release of LDH and stimulated production of both prostacyclin [measured as 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha)] and prostaglandin E2 (PGE2). Both DMSO and allopurinol decreased endotoxin induced LDH release; this effect was related to concentration of the drugs (0-2% for DMSO and 0-0.3 mg/ml for allopurinol). Both drugs also prevented endotoxin induced changes in endothelial morphology. Endotoxin increased intracellular reduction of the redox dye nitro blue tetrazolium, caused intracellular oxidation of 2',7'-dichlorofluorescein diacetate and caused release of conjugated dienes from endothelial cells; both DMSO and allopurinol inhibited those responses. DMSO, but not allopurinol, prevented endotoxin-induced production of prostacyclin and PGE2 by endothelium. Direct injury of pulmonary endothelium by endotoxin is inhibited by two chemically dissimilar drugs which have a common potential for decreasing intracellular concentrations of toxic metabolites of O2; indirect evidence suggests that potential as a mechanism for the protective effects of the drugs. PMID- 3654445 TI - Does rib cage-abdominal paradox signify respiratory muscle fatigue? AB - Studies suggesting that abnormal motion of the rib cage (RC) and abdomen (Ab) may indicate respiratory muscle fatigue have not separated the influence of respiratory load from that of fatigue in its pathogenesis. We hypothesized that abnormalities on RC-Ab motion are primarily related to increased load rather than fatigue. We tested this hypothesis in subjects breathing against resistive loads while maintaining 30 and 60% of maximum mouth pressure (Pmmax). RC-Ab asynchrony and paradox and the degree of variation in compartmental contribution to tidal volume were measured by inductive plethysmography and quantitated by the Konno Mead method of analysis. Comparing measurements of base line and 30 and 60% of Pmmax indicated that the degree of asynchrony, paradox, and variation in compartmental contribution were significantly related to the level of the load; significant abnormalities were observed at even 30% of Pmmax, a target pressure that can be sustained indefinitely. In another group of subjects, fatigue was induced by sustaining 60% of Pmmax to the limits of tolerance. Indexes of abnormal RC-Ab motion increased from base line during the 1st min of loaded breathing but displayed no progression from the beginning to the end of the fatigue run. Immediately on discontinuation of the load, the indexes returned to levels similar to base line despite persistence of the fatigue state. These results in healthy subjects breathing against severe resistances indicate that RC Ab asynchrony and paradox and variation in compartmental contribution to tidal volume are predominantly due to increases in respiratory load rather than muscle fatigue. PMID- 3654446 TI - Detailed characterization of a tank used for head-out water immersion in humans. AB - Water immersion has long been known to produce marked diuresis, natriuresis, and kaliuresis and suppression of the renin-aldosterone system. These effects are mediated primarily by an increase in central blood volume. Immersion has therefore gained increased acceptance in human physiology for the investigation of the effects of central volume expansion on renal function and hormonal responsiveness without altering the composition of the extracellular fluid. An immersion tank used for studies in humans is described. Requisite features to ensure study reproducibility include a constant temperature, capability to alter the depth of immersion by adjusting water height, and the ability to maintain hygienic quality by means of constant circulation of the water through a sand filter. A constant temperature of 34.5 +/- 0.2 degrees C is maintained by thermostatically controlling the heat exchange to a unidirectional closed-circuit water system in the bottom of the immersion tank coursing through a stream source. The level of the water may be adjusted to any desired level by means of a waste line or an inlet of tap water. PMID- 3654447 TI - Estimating left ventricular offset volume using dual-frequency conductance catheters. AB - The measurement of left ventricular volume by the conductance-catheter technique has many advantages, but it is difficult to determine absolute volumes with this method. Current procedure requires that a bolus of concentrated hypertonic saline be injected to measure absolute volume. It also demands that the subject be in a steady state and that measurements only be made at discrete intervals. The saline bolus may affect the cardiovascular state of the subject. This paper describes a new technique for estimating absolute volume utilizing the conductance catheter that relies on the different frequency responses of blood and muscle. Good correlation between the salt-injection method and the dual-frequency method was found in nine closed-chest pigs anesthetized with pentobarbital sodium (r = 0.922). Further refinements may extend the utility of the dual-frequency approach. PMID- 3654448 TI - Operation Everest II: man at extreme altitude. AB - Rapid ascent to high altitude may cause serious problems for climbers, skiers, and aviators. In contrast, gradual ascent enables humans to function where the unacclimatized cannot. To examine changes in the O2 transport system that produce acclimatization, eight men were taken in a decompression chamber (without other stresses experienced on high mountains) to a simulated altitude of 8,840 m (29,028 ft, ambient PO2 = 43 Torr) in 40 days. Maximal O2 uptake fell to 1.2 l/min, and arterial PO2 and PCO2 were 30 and 11 Torr, respectively, with arterial pH of 7.56. Many sophisticated studies were done: Swan-Ganz catheterization and inert gas diffusion studies at three altitudes showed that normal cardiac function persisted, pulmonary vascular resistance increased and at extreme altitude was not lowered by O2, and pulmonary ventilation-perfusion mismatch increased, though variably. This appears to be an important factor limiting performance at extreme altitude. This paper presents the background, general approach, and a summary of major observations reported in detail in other papers. PMID- 3654449 TI - Regional trapping of microspheres in the lung compares well with regional blood flow. AB - Microspheres (MS) are often used to measure the distribution of pulmonary blood flow in the assumption that the number of MS trapped in a region is proportional to blood flow. However, regional distribution of trapped MS has not been directly compared with regional blood flow in the lung. Regional trapping of MS was compared with regional flow of erythrocytes (RBC's) in isolated, perfused left lungs of dogs. Radioactivity from labeled MS and RBC's was measured by external detection using a gamma camera. We defined six regions of interest in the image of the left lateral surface of the lung: a dorsocaudal, a caudal, two ventral, an apical, and a central region. In each lung, regional trapping of MS was measured from the image of radioactivity obtained after slow injection of a suspension of MS into the arterial perfusion tubing. A radioactive bolus of labeled RBC's was injected during rapid imaging of the lung to obtain radioactivity vs. time curves from each region. The peaks of the regional radioactivity vs. time curves were used to estimate regional flows, though compensation had to be made for overlap of the washout and washin phases of the bolus of labeled RBC's. The results indicated that there were no differences in the regional distribution of MS compared with the regional distribution of RBC flow in isolated, perfused dog lungs. PMID- 3654450 TI - Continuous monitoring of blood volume changes in humans. AB - The mass density of antecubital venous blood was measured continuously for 80 min/session with 0.1 g/l precision at a flow rate of 1.5 ml/min in six male subjects. Each person participated in two different sessions with the same protocol. To induce transvascular fluid shifts, the subjects changed from sitting to standing and from standing to supine positions. There was transient blood density shifts immediately after postural changes, followed by an asymptotic approach to a new steady-state blood density level. Additional deviations from a simple time course were regularly observed. Blood density increased by 3.5 +/- 1.4 (SD) g/l when standing after sitting and decreased by 5.0 +/- 1.2 g/l while supine after standing. The corresponding half time of the blood density increase was 5.6 +/- 1.4 min (standing after sitting) and 6.9 +/- 3.1 min (supine after standing) of the blood density decrease. Erythrocyte density was calculated and did not change with body position. Whole-body blood density was calculated from plasma density, hematocrit, and erythrocyte density, assuming an F-cell ratio of 0.91. Volume shifts were computed from the density data; the subject's blood volume density decreased by 6.2 +/- 1.2% from sitting to standing and increased by 8.5 +/- 2.1% from standing to supine. Additional discrete plasma density and hematocrit measurements gave linear relations (P less than 0.001) between all possible combinations of blood density, plasma density, and hematocrit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654451 TI - Control of ventilation in elite synchronized swimmers. AB - Synchronized swimmers perform strenuous underwater exercise during prolonged breath holds. To investigate the role of the control of ventilation and lung volumes in these athletes, we studied the 10 members of the National Synchronized Swim Team including an olympic gold medalist and 10 age-matched controls. We evaluated static pulmonary function, hypoxic and hypercapnic ventilatory drives, and normoxic and hyperoxic breath holding. Synchronized swimmers had an increased total lung capacity and vital capacity compared with controls (P less than 0.005). The hypoxic ventilatory response (expressed as the hyperbolic shape parameter A) was lower in the synchronized swimmers than controls with a mean value of 29.2 +/- 2.6 (SE) and 65.6 +/- 7.1, respectively (P less than 0.001). The hypercapnic ventilatory response [expressed as S, minute ventilation (1/min)/alveolar CO2 partial pressure (Torr)] was no different between synchronized swimmers and controls. Breath-hold duration during normoxia was greater in the synchronized swimmers, with a mean value of 108.6 +/- 4.8 (SE) vs. 68.03 +/- 8.1 s in the controls (P less than 0.001). No difference was seen in hyperoxic breath-hold times between groups. During breath holding synchronized swimmers demonstrated marked apneic bradycardia expressed as either absolute or heart rate change from basal heart rate as opposed to the controls, in whom heart rate increased during breath holds. Therefore the results show that elite synchronized swimmers have increased lung volumes, blunted hypoxic ventilatory responses, and a marked apneic bradycardia that may provide physiological characteristics that offer a competitive advantage for championship performance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654452 TI - Influence of the pericardium on right and left ventricular filling in the dog. AB - We compared the influence of the pericardium on left and right ventricular (LV, RV) filling by measuring LV and RV pressures and segment lengths (SL, LV free wall, and RV inflow and outflow tracts) in six open-chest, pentobarbital sodium anesthetized dogs before and after pericardiectomy. End-diastolic pressure (EDP) was varied by partial caval occlusion and dextran infusion. At each site the ln EDP-SL relation was fitted by linear regression and characterized by its slope and 1-Torr EDP intercept. The slope and 1-Torr intercept of the LV ln EDP-SL relation changed variably after pericardiectomy, but in each dog a change occurred that shifted this relation downward. In contrast, the RV inflow tract slope invariably decreased significantly after pericardiectomy, whereas its intercept was unchanged in all but one dog. The RV outflow tract results were similar to the inflow tract but less consistent. By the use of the raw EDP-SL data points, we calculated that the absolute contribution of the pericardium to EDP (i.e., the effective pericardial surface pressure) was similar at the three sites. However, as EDP values increased the proportional contribution of the pericardium to right ventricular end-diastolic pressure (RVEDP) increased, whereas that to left ventricular end-diastolic pressure (LVEDP) remained relatively constant. As a result, at the higher EDP values tested, the pericardium was responsible for a larger proportion of RVEDP than LVEDP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654453 TI - Changes in quantity, composition, and surface activity of alveolar surfactant at birth. AB - We hypothesized that when the lung makes the transition from the fluid- to the air-filled state at birth, there are changes in physical and functional properties of the alveolar surfactant. To test this hypothesis, newborn rabbits were killed at different times in the first 24 h of life, their lungs lavaged with ice-cold saline, and the lavage fluid subfractionated by differential centrifugation. The phospholipid and protein content and composition and the kinetics of surface tension lowering of the subfractions were examined. We found that with the onset of breathing, shifts occur in the distribution of surfactant subfractions as a surfactant apoprotein-free phospholipid fraction is generated. The ratio of rapidly sedimentable apoprotein-rich to slowly sedimentable, apoprotein-free fractions decreases from 31 at birth to 4 at 24 h of life. Concurrently, rates of surface tension lowering by the subfractions increase with time. The results suggest that the adult pattern of pool sizes and surface activity of alveolar surfactant is not present at birth but evolves slowly over the 1st day of life. PMID- 3654454 TI - Ventilatory effects of stimulation of phrenic afferents. AB - The diaphragm, a ventilatory muscle, has abundant sensory innervation. The effects of phrenic afferent activation on ventilation have been varied. In this study the proximal end of the phrenic nerve was electrically stimulated, and the effects on ventilation were measured in supine dogs anesthetized with either alpha-chloralose or pentobarbital sodium. We found a maximum increase in ventilation of 45 +/- 4% in the alpha-chloralose group and an increase in mean arterial blood pressure of 18 +/- 4%. This response was obtained at high stimulus intensities (60 times twitch threshold). Stimulation of the proximal end of the gastrocnemius nerve produced a similar ventilatory response (61 +/- 10%) but at lower stimulus intensities. During pentobarbital sodium anesthesia both the hyperventilation and the pressor response were produced; however, ventilation was increased by an increase in respiratory frequency. The reflex was abolished by sectioning of the cervical dorsal roots (C4-C7). Proximal cold blockade of the nerve abolished the response at a perineural temperature of 1.35 +/- 0.64 degrees C. The main effect of activation of phrenic afferents was an increase in ventilation and blood pressure that was mediated by unmyelinated fibers and possibly thin myelinated fibers. This response is similar to skeletal muscle afferent activation and may play a role in ventilatory drive during such conditions as exercise and respiratory muscle fatigue. PMID- 3654455 TI - Absence of regional differences in the size and oxidative capacity of diaphragm muscle fibers. AB - The oxidative capacity and cross-sectional area of muscle fibers were compared between the costal and crural regions of the cat diaphragm and across the abdominal-thoracic extent of the muscle. Succinate dehydrogenase (SDH) activity of individual fibers was quantified using a microphotometric procedure implemented on an image-processing system. In both costal and crural regions, population distributions of SDH activities were unimodal for both type I and II fibers. The continuous distribution of SDH activities for type II fibers indicated that no clear threshold exists for the subclassification of fibers based on differences in oxidative capacity (e.g., the classification of fast twitch glycolytic and fast-twitch oxidative glycolytic fiber types). No differences in either SDH activity or cross-sectional area were noted between fiber populations of the costal and crural regions. Differences in SDH activity and cross-sectional area were noted, however, between fiber populations located on the abdominal and thoracic sides of the costal region. Both type I and II fibers on the abdominal side of the costal diaphragm were larger and more oxidative than comparable fibers on the thoracic side. PMID- 3654456 TI - Effect of age on heat-activated sweat gland density and flow during exercise in dry heat. AB - Physiological responses of eight postmenopausal older women (age 52-62 yr) and eight younger women (age 20-30 yr) were compared during moderate intensity exercise in a hot dry environment (48 degrees C dry bulb, 25 degrees C wet bulb). The age groups were matched on the basis of maximal O2 consumption (VO2max), body surface area, and body fatness. After heat acclimation the women walked at 40% VO2max for up to 2 h in the hot dry environment while heart rate (HR), rectal temperature (Tre), mean skin temperature (Tsk), whole-body sweating rate (Msw), and local sweating rates (msw; forearm, chest, and scapula) were measured. Additionally, the density of heat-activated sweat glands (HASG) was determined and average sweat gland flow (SGF) was calculated for the scapular area. Although no differences between age groups were found in HR response (when analyzed as percent of maximal HR) or Tsk, the older women had a significantly higher Tre throughout the heat-exercise session. The greater heat storage of the older women may be explained by their significantly lower Msw and msw. There were no differences between the younger and older women in the density of HASG after 30 min; therefore, the lower msw reflects a diminished output per HASG rather than a decrease in the number of sweat glands recruited. The diminished thermoregulatory ability of the older women, unrelated to differences in VO2max, appears to reflect either 1) a diminished response of the sweat glands to central and/or peripheral stimuli, or 2) an age-related structural alteration in the eccrine glands or surrounding skin cells. PMID- 3654457 TI - Physiologically derived critical evaporative coefficients for protective clothing ensembles. AB - When work is performed in heavy clothing, evaporation of sweat from the skin to the environment is limited by layers of wet clothing and air. The magnitude of decrement in evaporative cooling is a function of the clothing's resistance to permeation of water vapor. A physiological approach has been used to derive effective evaporative coefficients (he) which define this ability to evaporate sweat. We refined this approach by correcting the critical effective evaporative coefficient (K for sweating efficiency (Ke,eta') since only a portion of the sweat produced under such conditions is evaporated through the clothing. Six acclimated men and women walked at 30% maximal O2 consumption (150-200 W.m-2) at a constant dry bulb temperature as ambient water vapor pressure was systematically increased 1 Torr every 10 min. Critical pressure was defined as the partial pressure of water vapor (Pw) at which thermal balance could no longer be maintained and rectal temperature rose sharply. Each test was performed in various clothing ensembles ranging from cotton shirt and pants to "impermeable" suits. This approach was used to derive he by solving the general heat balance equation, M - W +/- (R + C) = w.he.(Psk - Pw), where M is metabolic heat production, W is external work, R is radiant heat exchange, C is convective heat transfer, w is skin wettedness, and Psk is water vapor pressure of fully wet skin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654458 TI - Age-dependent effects of chronic hypoxia on pulmonary vascular reactivity. AB - Effects of age on the pulmonary vascular responses to histamine (HIST), norepinephrine (NE), 5-hydroxytryptamine (5-HT), and KCl were studied in isolated, perfused lungs from juvenile (7-wk-old), adult (14-wk-old), and mature adult (28-wk-old) normoxic rats and compared with age-matched rats exposed to chronic hypoxia for either 14 or 28 days. Chronic hypoxia changed vasoconstriction to HIST and NE to vasodilation in lungs from juvenile and adult rats. Mature adult lungs only vasoconstricted to these amines in both control and hypoxic animals. Pressor responses to 5-HT were not affected by chronic hypoxia regardless of age group. Pressor responses to KCl were also not altered by hypoxia, but lungs from older rats showed greater control responsiveness to KCl compared with lungs from juveniles. Only lungs from juvenile animals developed significant elevations of base-line resistance as a result of hypoxic exposure. To investigate the contribution of H1-, H2-, and beta-receptors in these changes, we employed chlorpheniramine, metiamide, and propranolol, respectively, as blocking agents in another series of experiments. Chlorpheniramine either reduced vasoconstriction or increased vasodilation to HIST in lungs from both control and hypoxic animals, whereas metiamide was without effect. Propranolol either increased vasoconstriction or reversed vasodilation to HIST and NE in all lungs studied. The present data demonstrate the important interaction between chronic hypoxia and age that can alter pulmonary vascular tone and reactivity. The inverse relationship between age and elevation of pulmonary vascular resistance after chronic hypoxic exposure may be the key element that changes pulmonary vascular reactivity observed during hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654459 TI - An analysis of decrements in vital capacity as an index of pulmonary oxygen toxicity. AB - Decrements in vital capacity (% delta VC) were proposed by the Pennsylvania group in the early 1970s as an index of O2-induced lung damage. These workers used the combined effects of PO2 and time of exposure to develop recommendations to limit expected % delta VC. Adopting this general approach, we fitted human pulmonary O2 toxicity data to the hyperbolic equation % delta VC = Bs.(PO2 - B1).(time)B3 using a nonlinear least squares analysis. In addition to the data considered in 1970, our analysis included new data available from the literature. The best fit was obtained when 1) an individual slope parameter, Bs, was estimated for each subject instead of an average slope; 2) PO2 asymptote B1 = 0.38 ATA; and 3) exponent B3 = 1.0. Wide individual variation imposed large uncertainty on any % delta VC prediction. A 12-h exposure to a PO2 of 1 ATA would be expected to yield a median VC decrement of 4%. The 80% confidence limits, however, included changes from +1.0 and -12% delta VC. Until an improved index of pulmonary O2 toxicity is developed, a simplified expression % delta VC = -0.011.(PO2 - 0.5).time (PO2 in ATA and time in min) can be used to predict a median response with little loss in predictability. The limitations of changes in VC as an index are discussed. PMID- 3654460 TI - Measurement of pleural pressure at low and high frequencies in normal rabbits. AB - In eight tracheotomized adult rabbits placed in the supine position, we employed a catheter-tip piezoresistive pressure transducer to measure esophageal pressure (Pes) and assessed the validity of taking the changes in Pes to be the changes in pleural pressure (Ppl). We applied an occlusion test in which the tracheal cannula was occluded during either spontaneous inspiratory efforts or body surface oscillations ranging from 3 to 50 Hz. The relationship between Pes and airway opening pressure (Pao) was recorded. In all instances, the changes in Pes and Pao were virtually identical in both amplitude and phase. We conclude that, as evaluated by the occlusion test, a catheter-tip pressure transducer placed in the esophagus of rabbits can give adequate estimation of local pleural changes up to at least 50 Hz. PMID- 3654461 TI - Increased bronchovascular permeability after allergen exposure in sensitive asthmatics. AB - To investigate the possibility that an increase in bronchovascular permeability is associated with allergen exposure in sensitive asthmatics we evaluated the amounts of serum proteins in bronchoalveolar lavage (BAL) effluents before and after local challenge with allergen. After exposure of sensitive asthmatic airways (n = 15) to allergen significant increases in total protein compared with controls were observed: 0.08 +/- 0.01 mg/ml in control airways and 0.13 +/- 0.02 mg/ml in challenged airways; P less than 0.05. The greatest changes induced by allergen exposure involved small-molecular-weight proteins (less than 345,000) and an inverse correlation was observed between log molecular weight and percent increase in the concentrations of the specific proteins; r = -0.61. BAL-serum distribution coefficients of serum proteins in airway fluids reflected a greater diffusability of low-molecular-weight proteins immediately after allergen exposure. We also evaluated the movement of serum proteins into lung after local allergen exposure using intravenously administered 99mTc-albumin (n = 10) and found an immediate 3.8-fold increase in amounts of radioactive albumin in allergen exposed airways compared with airways exposed to diluent. Most of the radioactivity was recovered in the first 5 ml of aliquot withdrawn, suggesting a marked increase in the permeability of the bronchial (large airway) vascular epithelial membrane. An increase in serum proteins was also observed in BAL fluid of asthmatics 2-4 h after aerosol challenge (n = 4), including all proteins in the molecular weight range 45,000-900,000. These studies suggest that allergen exposure in sensitive asthmatics causes an acute increase in bronchovascular permeability to serum proteins. PMID- 3654462 TI - Isometric contractile properties of diaphragm strips from alcoholic rats. AB - Chronic ethanol consumption alters the structure and function of human respiratory muscle. We have examined its effect on the active and passive mechanical properties of rat diaphragm strips in vitro. We conditioned eight rats using a liquid diet containing ethanol as 36% of calories. Eight control rats were pair-fed an isocaloric, ethanol-free liquid diet. Rats were killed after 23 wk. Two strips from the left hemidiaphragm were suspended in Krebs-Ringers solution at 25 degrees C, equilibrated with 5% CO2-95% O2. Isometric stresses were calculated from force transducer measurements. Strips were stimulated directly at supramaximal voltage. Twitch stress (Pt), measured at optimal length (Lo), was greater in ethanol-conditioned strips: 5.1 vs. 3.8 N/cm2. Times to peak Pt and twitch half-relaxation times were equal. Tetanic stress at Lo (Po) was also greater after ethanol conditioning: 17.2 vs. 12.8 N/cm2. Pt/Po ratios were equal. Expressed as %Po, tetanic stress-stimulation frequency curves and tetanic stress-length curves were identical. Ethanol-conditioned strips were marginally less compliant when passively stretched to lengths between Lo and 130% Lo. We postulate that ethanol may have increased active stress development by reducing intracellular free water. PMID- 3654463 TI - Collagen and elastin fibers in human pulmonary alveolar mouths and ducts. AB - To provide a quantitative basis for the understanding of the mechanical properties of the lung tissue, the morphology of the pulmonary alveolar ducts was studied and the dimensions of the collagen and elastin fiber bundles in the alveolar mouths were measured. Statistical data are presented in this report. It was found that the probability frequency functions of the widths of both the collagen and elastin fibers are skewed to the right, but the fourth roots of the widths are normally distributed. Hence, knowing the mean and standard deviation of (width)1/4, the probability of finding fiber bundles of width D is known. On the other hand, we already know the analytic expressions of the strain energy per unit length of fibers of given width. With the probability distribution of width and an estimation of the length of alveolar mouths, the strain energy of the alveolar mouths can be computed. Then the contribution of the alveolar mouths to the stress in the lung parenchyma due to any strain can be obtained by a differentiation of the strain energy function with respect to that strain. PMID- 3654464 TI - Airway deposition of hygroscopic heterodispersed aerosols: results of a computer calculation. AB - A new computer model is developed and used to calculate the deposition of inhaled heterodispersed hygroscopic aerosols for mouth breathing in a Weibel symmetric bronchial tree. The model was first validated by obtaining good agreement with recent experimental and theoretical data on regional and total airway deposition of monodispersed and heterodispersed nonhygroscopic aerosols. The model was then used to obtain predictions of regional and total deposition of heterodispersed hygroscopic aerosol particles (droplets of NaCl solutions). Parameters that were varied in the hygroscopic calculations include initial droplet NaCl concentration, time of inspiration and expiration, volume of aerosol inspired, period of breath holding, and initial inhaled lognormal aerosol mass median diameter and geometric standard deviation. Results of the computer calculations show that increasing heterodispersity tends to flatten and broaden regional deposition curves when fraction of inhaled mass deposited is plotted vs. inhaled mass median aerodynamic particle diameter. Hygroscopicity is shown to increase tracheobronchial and pulmonary airway deposition with hypertonic NaCl solution aerosols showing increases over isotonic and nonhygroscopic aerosols of up to 200%. PMID- 3654465 TI - Maximization of pulmonary hygroscopic aerosol deposition. AB - A newly developed computer model is used to predict the aqueous salt solution concentration, breathing pattern, and inhaled droplet size distribution parameters that will maximize pulmonary deposition of hygroscopic medicinal aerosols. The parameter values providing maximum pulmonary deposition include 1) a NaCl concentration in the aerosolized solution of 0.035 g/ml or higher if the subject can tolerate it, 2) as nearly a monodispersed inhaled aerosol size distribution as possible, 3) an aerosol mass median diameter of 2-3 micron, and 4) slow (7 breaths/min) uninterrupted breathing of 1.5-2 liters of aerosol/breath. With these values, the model predicts that pulmonary deposition can be increased by greater than 100% relative to the deposition achieved in conventional inhalation therapy with isotonic saline-based medications. PMID- 3654466 TI - Cooling different body surfaces during upper and lower body exercise. AB - The effect of varying the body surface area being cooled by a liquid microclimate system was evaluated during exercise heat-stress conditions. Six male subjects performed a total of six exercise (O2 uptake = 1.2 l/min) tests in a hot environment (ambient temperature = 38 degrees C, relative humidity = 30%) while dressed in clothing having low moisture permeability and high insulation. Each subject completed two upper body exercise (U; arm crank) tests: 1) with only the torso surface (T) cooled; and 2) with the surfaces of both the torso and upper arms (TA) cooled [coolant temperature at the inlet (Ti) was 20 degrees C for all upper body tests]. Each subject also completed four lower body exercise (L; walking) tests: 1) with only the T cooled (Ti = 20 degrees C); 2) with only the T cooled (Ti = 26 degrees C); 3) with torso, upper arm, and thigh surface (TAT) cooled (Ti = 20 degrees C); and 4) with TAT cooled (Ti = 26 degrees C). During U exercise, TA cooling had no effects compared with cooling only T. During L exercise, sweat rates, heart rates, and rectal temperature (Tre) changes were less with TAT cooling compared with cooling only the T. Altering Ti had no effect on Tre changes, but higher heart rates were observed with 26 than with 20 degrees C. These data indicate that cooling arms during upper body exercise provides no thermoregulatory advantage, although cooling the thigh surfaces during lower body exercise does provide an advantage. PMID- 3654467 TI - Cardiovascular responses to military antishock trouser inflation during standing arm exercise. AB - Military antishock trousers (MAST) inflated to 50 mmHg were used with 12 healthy males (mean age 28 +/- 1 yr) to determine the effects of lower-body positive pressure on cardiac output (Q), stroke volume (SV), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), total peripheral resistance (TPR), and O2 uptake (VO2) during graded arm-cranking exercise. Subjects were studied while standing at rest and at 25, 50, and 75% of maximal arm-cranking VO2. At each level, rest or work was continued for 6 min with MAST inflated and for 6 min with MAST deflated. Order of inflation and deflation was alternated at each experimental rest or exercise level. Measurements were obtained during the last 2 min at each level. Repeated measures analysis of variance revealed significant increases (P less than 0.001) in Q, SV, and MABP and a consistent decrease in HR with MAST inflation. There was no apparent change in Q/VO2 between inflated and control conditions. There was no effect of MAST inflation on VO2 or TPR. MAST inflation counteracts the gravitational effect of venous return in upright exercise, restoring central blood volume and thereby increasing Q and MABP from control. HR is decreased consequent to increased MABP through arterial baroreflexes. The associated decrease in TPR is not observed, being offset by the mechanical compression of leg vasculature with MAST inflation. PMID- 3654468 TI - Effect of aerobic training on forced expiratory airflow in exercising asthmatic humans. AB - Pulmonary function after exercise was evaluated in 22 asthmatic subjects before and after a 36-session training sequence of aerobic exercise. Training did not change pulmonary function values, except for a small increase in maximal voluntary ventilation (P less than 0.02), which was attributed to respiratory muscle training. After aerobic training, both external work at a given heart rate and peak O2 consumption increased by 30 and 15%, respectively. At the same minute ventilation (VE), immediate postexercise forced expiratory airflow was higher after training (P less than 0.02), and reduction in forced expiratory airflow during the first 9 min postexercise was less after training (P less than 0.01). The posttraining airflow response to the pretraining work load was, as expected, less than the pretraining response (P less than 0.02). Although the difference in maximal-to-minimal airflow at the same VE was similar before and after training, the airflow increase accounted for 50% of the response after training compared with 16% of the pretraining response. Furthermore the strong negative correlation (P less than 0.01) between maximal and minimal airflow both pre- and posttraining indicates that exercise-induced bronchospasm (EIB) severity is, in part, determined by the degree of exercise-induced bronchodilation. We conclude that aerobic training significantly increases exercise-induced bronchodilation and diminishes EIB. PMID- 3654469 TI - Relationship between distance running mechanics, running economy, and performance. AB - The relationships between biocmechanical aspects of distance running, running economy (VO2 submax), and performance were investigated. A variety of biomechanical measures for 31 subjects running at 3.6 m/s was obtained, including three-dimensional angular and translational kinematics, ground reaction forces and center of pressure patterns, mechanical power, and anthropometric measures. Physiological measures obtained included maximal and submaximal O2 consumption, muscle fiber composition, and measures of the ability to store and return elastic energy during knee bends. A subset of 16 runners was also evaluated in relation to performance in a 10-km run. Biomechanical variables were identified which showed significant differences or consistent trends between groups separated on the basis of VO2 submax, establishing the importance of biomechanical influences on running economy. It appears that no single variable or small subset of variables can explain differences in economy between individuals but rather that economy is related to a weighted sum of the influences of many variables. PMID- 3654470 TI - Effects of hyperthermia and hypothermia on oxygen extraction by tissues during hypovolemia. AB - As systemic delivery of O2 (QO2 = QT X CaO2) is reduced during progressive hemorrhage, the O2 extraction ratio [(CaO2 - CVO2)/CaO2] increases until a critical delivery is reached below which O2 uptake (VO2) becomes limited by delivery (O2 supply dependence). When tissue metabolic activity and O2 demand are increased or reduced, the critical QO2 required to maintain VO2 should rise or fall accordingly, unless other changes in the distribution of a limited QO2 precipitate the onset of O2 supply dependence at a different critical extraction ratio. We compared the critical QO2 and critical extraction ratio in 23 normothermic (38 degrees C), hyperthermic (41 degrees C), or hypothermic (34 decrees C) dogs during stepwise reduction in delivery produced by bleeding, as arterial O2 content was maintained. Dogs were anesthetized, paralyzed, and mechanically ventilated. Hypothermia reduced whole-body VO2 by 31%, whereas hyperthermia increased VO2 by 20%. The critical QO2 was significantly reduced during hypothermia (5.6 +/- 0.95 ml.min-1.kg-1) (P less than 0.05) and increased during hyperthermia (8.9 +/- 1.1) (P approximately equal to 0.06) compared with normothermic controls (7.4 +/- 1.2). The extraction ratio at the onset of supply dependency was significantly increased in hyperthermia (0.76 +/- 0.05) compared with hypothermia (0.65 +/- 0.10) (P less than 0.05), and the normothermic critical extraction was 0.71 +/- 0.1. These results suggest that higher body temperatures are associated with an improved ability to maintain a VO2 independent of QO2, since a higher fraction of the delivered O2 can be extracted before the onset of O2 supply dependence, relative to lower body temperatures. PMID- 3654471 TI - Regional differences in neutrophil margination in dog lungs. AB - We investigated the relationship between polymorphonuclear leukocyte (PMN) retention and erythrocyte (RBC) velocity in the lungs of mongrel dogs. Regional velocity was estimated by measuring regional RBC transit times and was correlated with the retention of PMN found in the same lung sample 10 min after the injection of a bolus of labeled cells. Data from the whole lung showed that the total number of cells marginated in the pulmonary vasculature was 2.4 times as great as the number present in the circulation and that this pool turned over at a rate of 1%/s. The regional data showed increased retention, indicating slower PMN turnover in the upper lung regions, which have longer transit times and therefore slower blood velocities than the RBC is attributed to a greater discrepancy between PMN and RBC is attributed to a greater discrepancy between PMN and capillary size and the fact that PMN are less deformable than RBC. The large number of capillary segments present in the lung allows neutrophils to move more slowly while RBC stream around them. We conclude that there are approximately 2.5 times as many PMNs marginated in the lung as there are in the total circulating blood volume of the dog and that the pulmonary marginated pool turns over at approximately 1%/s with slower turnover in the upper compared with the lower regions of the lung. PMID- 3654472 TI - Estimation of amount of stationary pulmonary blood from carbon monoxide uptake measurements. AB - A mathematical model of CO uptake from a single alveolus is modified to include stationary pulmonary blood arising from a pulmonary vascular obstruction. From this model an estimator model is developed that produces simultaneous estimations of the diffusing capacity of the lung for CO and the fraction of the pulmonary capillary blood that is stationary. The estimator model was tested using simulated data from uniform and non-uniform simulators and found to be only mildly sensitive to noise and incorrect values for the pulmonary capillary blood volume. Both the estimator model and breath-to-breath changes in the diffusing capacity of the lung for CO (exhaled) were found to be greatly affected by inhomogeneity of diffusing capacity and ventilation. At times both returned false positive results that limit their use as a screening test for stationary pulmonary blood. Although changes in CO uptake may at times indicate the presence of stationary pulmonary blood, the confounding effects of inhomogeneity of ventilation and diffusing capacity make the use of such changes impractical under most circumstances. PMID- 3654473 TI - Pulmonary edema with smoke inhalation, undetected by indicator-dilution technique. AB - Despite experimental evidence for an increase in extravascular lung water (EVLW) after inhalation injury, thermal-dye estimations of EVLW, extravascular thermal volume (EVTV), have repeatedly failed to demonstrate its presence in patients. This situation was evaluated in a sheep model. Under halothane anesthesia one lung was insufflated with cotton smoke and the other with air. EVTV values were 8.4 +/- 0.48 ml/kg at base line and were not elevated at 24 h after smoke inhalation (8.3 +/- 0.45 ml/kg; means +/- SE). Gravimetric analysis 24 h after smoke inhalation showed the development of edema in smoke-exposed lungs. The blood-free wet weight-to-dry weight ratio of the smoke-exposed lungs (5.4 +/- 0.32) was significantly higher compared with the contralateral unsmoked lungs (4.3 +/- 0.15; P less than or equal to 0.05). The thermal-dye technique thus underestimates EVLW. Poor perfusion of the smoke-exposed lungs 24 h after injury was demonstrated indirectly by killing a group of sheep with T-61, an agent that causes a dark red coloration of well-perfused lung areas, as well as directly by measurement of blood flow utilizing a radiolabeled microsphere technique. Thus the inability of the thermal-dye technique to detect the lung edema may be the result of poor perfusion of the injured lung. PMID- 3654474 TI - Body composition in adolescents: estimation by total body electrical conductivity. AB - This comparative study, conducted on 28 boys and girls of widely varying fatness, was designed to validate a new whole-body composition method [total body electrical conductivity (TOBEC)], based on bioelectrical properties of the human body. A significant correlation [r = 0.911; standard error of the estimate (SEE) = 5.3 kg] was demonstrated between the transformed TOBEC scores (TOBEC0.5 X Ht) and lean body mass (LBM) determined by hydrodensitometry and corrected for individual variations in hydration (LBMd + W). TOBEC determinations also correlated well with 1) total body water determined by deuterium oxide dilution (r = 0.877; SEE = 4.5 liters), 2) total body potassium determined by means of a 4 pi whole-body counter (r = 0.860; SEE = 430.7 meq), 3) LBM derived from skinfold thicknesses (r = 0.850; SEE = 5.8 kg). The residuals of the regression between LBMd + W and TOBEC scores did not show any significant correlation with either the potassium or the water content of the LBM. The results indicate that TOBEC is a simple, rapid, reliable, and noninvasive technique for delineating changes in body composition that occur in children during growth. PMID- 3654475 TI - A model of the respiratory pump. AB - The interaction of forces that produce chest wall motion and lung volume change is complex and incompletely understood. To aid understanding we have developed a simple model that allows prediction of the effect on chest wall motion of changes in applied forces. The model is a lever system on which the forces generated actively by the respiratory muscles and passively by impedances of rib cage, lungs, abdomen, and diaphragm act at fixed sites. A change in forces results in translational and/or rotational motion of the lever; motion represents volume change. The distribution and magnitude of passive relative to active forces determine the locus and degree of rotation and therefore the effect of an applied force on motion of the chest wall, allowing the interaction of diaphragm, rib cage, and abdomen to be modeled. Analysis of moments allow equations to be derived that express the effect on chest wall motion of the active component in terms of the passive components. These equations may be used to test the model by comparing predicted with empirical behavior. The model is simple, appears valid for a variety of respiratory maneuvers, is useful in interpreting relative motion of rib cage and abdomen and may be useful in quantifying the effective forces acting on the rib cage. PMID- 3654476 TI - Skin blood flow in sheep: comparison of xenon-133 washout and radioactive microsphere techniques. AB - Blood flow was measured in leg and torso skin of conscious or anesthetized sheep by using 15-micron radioactive microspheres (Qm) and the 133Xe washout method (QXe). There was a good relationship between Qm in the cutaneous compartment and QXe calculated from the fast component of the biexponential washout curves (QXe = 0.40.Qm + 6.2, r = 0.90, P less than 0.001) with QXe values substantially below those determined with microspheres. Only at low blood flow levels was there a tendency for QXe to overestimate capillary blood flow as assessed with microspheres, but at higher blood flow levels the 133Xe washout method resulted in values substantially below those determined with microspheres. The slope of the slow component of the washout curves was inversely related to the tissue blood partition coefficient in the subcutaneous tissue (r = 0.52, P less than 0.001), indicating an influence of the amount of subcutaneous fat on the washout rate. QXe calculated from the slow component of the washout curves was not significantly correlated with Qm in the subcutaneous compartment (r = 0.19, P greater than 0.10). In leg skin with dilated arteriovenous anastomoses, QXe was generally higher than in torso skin and leg skin with constricted arteriovenous anastomoses, indicating that shunt blood flow increases the washout of 133Xe. PMID- 3654477 TI - Gastrointestinal transit during mild exercise. AB - Although exercise is often recommended as therapy for constipation, almost nothing is known of the effects of exercise on rates of movement of material in the gastrointestinal tract. In this study we investigated the influence of mild exercise on transit of a liquid meal from the mouth to the large intestine. Orocecal transit time was determined by a consistent elevation of H2 concentration in a rebreathing apparatus after ingestion of 30 g lactulose; the lactulose was part of a 360-kcal, 350-ml liquid meal. Comparison of transit time was made, in 12 young healthy subjects, between seated rest and a treadmill walk at 5.6 km/h up a 2% grade. The walk elevated heart rate from 64 +/- 4 to 109 +/- 5 beats/min, O2 uptake (VO2) from 0.29 +/- 0.02 to 1.20 +/- 0.07 l/min STPD, and final rectal temperature from 37.0 +/- 0.1 to 38.3 +/- 0.1 degrees C (all P less than 0.01). Exercise speeded transit of the liquid meal, with mean rises in H2 concentration taking place 66 +/- 10 min after ingestion at rest, compared with 44 +/- 6 min after food intake during exercise (P less than 0.02). H2 concentrations in the rebreathing apparatus showed similar base lines in the two experiments, and quantitative increases in H2 concentration, although shifted in time by exercise, were otherwise identical. Subjects with the slowest resting transit rates showed the largest exercise effects (r = 0.79, P less than 0.05). These results indicate that mouth-to-cecum transit of at least the first portion of a liquid meal-based nonabsorbable carbohydrate marker is significantly accelerated during mild exercise. PMID- 3654478 TI - Chemical control of tracheal vascular resistance in dogs. AB - With anesthetized dogs we have measured upper tracheal vascular resistance on both sides of the trachea simultaneously by perfusing the cranial tracheal arteries and measuring inflow pressures at constant flows. The ratio of pressure to flow gave vascular resistance (Rtv). Lung airflow, blood pressure (BP), heart rate, and pressure in a cervical tracheal balloon (Ptr) were also measured. In paralyzed dogs, systemic hypoxia due to artificial ventilation with 10% O2-90% N2 increased Rtv by +8.1 +/- 1.0% (SE), Ptr by +76 +/- 22.8%, and BP by +18.9 +/- 24%. After bilateral cervical vagosympathectomy the increases in Rtv and BP were present (+8.8 +/- 0.9 and +22.3 +/- 0.3%, respectively). After carotid body denervation Rtv, Ptr, and BP increased (+6.4 +/- 1.3, +58.6 +/- 31.6, and +14.6 +/- 3.3%, respectively). After vagotomy Rtv and BP increased (+14.1 +/- 1.7 and +22.4 +/- 10.1%, respectively). Tracheal perfusion with hypoxic blood caused a small vasodilation (-2.2 +/- 1.1%). Systemic hypercapnia due to artificial ventilation with 8% CO2-92% air increased Rtv by +16.7 +/- 3.8%, Ptr by +67 +/- 2.0%, and BP by +12.9 +/- 9.9%. Tracheal perfusion with hypercapnic blood caused a small vasodilation (-2.5 +/- 1.2%). Stimulation of the carotid body chemoreceptors with KCN caused a small increase in Rtv (+1.2 +/- 0.5%) and increases in Ptr (+49.8 +/- 13.6%) and BP (+11.1 +/- 2.1%). Systemic hypoxia and hypercapnia caused tracheal vasoconstriction mainly by an action on the central nervous system. PMID- 3654479 TI - Ozone exposure alters tracheobronchial mucociliary function in humans. AB - Mucociliary function is a primary defense mechanism of the tracheobronchial airways, and yet the response of this system to an inhalational hazard, such as ozone, is undefined in humans. Utilizing noninvasive techniques to measure deposition and retention of insoluble radiolabeled particles on airway mucous membranes, we studied the effect on mucus transport of 0.2 and 0.4 ppm ozone compared with filtered air (FA) in seven healthy males. During 2-h chamber exposures, subjects alternated between periods of rest and light exercise with hourly spirometric measurement of lung function. Mechanical and mucociliary function responses to ozone by lung airways appeared concentration dependent. Reduction in particle retention was significant (P less than 0.005) (i.e., transport of lung mucus was increased during exposure to 0.4 ppm ozone and was coincident with impaired lung function; e.g., forced vital capacity and midmaximal flow rate fell by 12 and 16%, respectively, and forced expiratory volume at 1 s by 5%, of preexposure values). Regional analysis indicated that mucus flow from distal airways into central bronchi was significantly increased (P less than 0.025) by 0.2 ppm ozone. This peripheral effect, however, was buffered by only a marginal influence of 0.2 ppm ozone on larger bronchi, such that the resultant mucus transport for all airways of the lung in aggregate differed only slightly from FA exposures. These data may reflect differences in regional diffusion of ozone along the respiratory tract, rather than tissue sensitivity. In conclusion, mucociliary function of humans is acutely stimulated by ozone and may result from fluid additions to the mucus layer from mucosal and submucosal secretory cells and/or alteration of epithelial permeability. PMID- 3654480 TI - Hematologic aspects of systemic disease. PMID- 3654481 TI - Organ culture of chicken cecum: morphologic and physiologic observations after 24 and 48 h of culture. AB - Cecum from chickens, 4 wk old, can best be maintained for 24 h in a serum-free organ culture system using Trowell T8 medium agar sheet at 25 degrees C. As determined by light microscopy as well as scanning and transmission electron microscopy, mucosal architecture involving classic ultrastructure of chicken cecal mucosa was preserved. Protein content of cecal explants did not change up to 48 h of culture. DNA content of cecal explants did not change up to 24 h of culture but decreased significantly to two-thirds of control in 48 h of culture. Based on the morphologic and physiologic findings, it became evident that this organ culture system using Trowell T8 medium at 25 degrees C can be successfully used as an in vitro experimental model for as long as 24 h. The organ culture system could be a useful tool, from the structural integrity of ceca observed in this study, in investigating mucosal function and mucosal response to drugs, carcinogens, trophic factors, and pathogens. PMID- 3654482 TI - Cytoplasmic suppression of malignancy. AB - Using both normal and transformed rat liver epithelial cells to prepare cytoplasmic hybrids (cybrids) we have found evidence to support the theory that the cytoplasm from a normal cell can suppress tumorigenicity. A unique aspect of this study is that all of the cells utilized, both normal and malignantly transformed, were derived from an original cloned cell. We found that fusing cytoplasts from normal cells to malignantly transformed whole cells resulted in cybrid clones which, when injected into newborn rat pups, isogenic with those from which the cell culture was initiated, yielded tumors in 51% of the animals injected compared to 92% of the animals injected with the tumorigenic parent. Those animals that did develop tumors from the cybrid cells survived longer than those injected with cells from the tumorigenic parent. Thus, the cybrid, formed of cytoplasm from both parents, was less tumorigenic than the malignantly transformed parent cell. When reconstituted cells were prepared by fusing cytoplasts from normal cells with karyoplasts from malignantly transformed cells, a situation in which essentially all of the cytoplasm of the reconstituted cell is derived from normal cells, the tumorigenic phenotype was extinguished. PMID- 3654483 TI - Growth in serum-free medium of human colonic adenocarcinoma cell lines on microcarriers: a two-step method allowing optimal cell spreading and growth. AB - Human colonic adenocarcinoma cells have been successfully grown on polystyrene microcarriers by modifying the culture conditions used in monolayer culture. The method can be divided into two culture phases: a) a phase of spreading, wherein cells were seeded in presence of serum-supplemented medium; b) a phase of active growth wherein spread cells on the beads were allowed to grow in a serum-free medium. Under these conditions, optimal spreading and growth of HT 29 and HRT 18 cells on the microcarriers were obtained. A differential propagation was observed between HT 29-D4 and HT 29-D9 cells (both clonal populations derived from HT 29 cells) on the microcarriers that is tentatively related to the discrepancy observed in the spreading efficiency of these clonal cells on serum-coated culture flasks. An index of spreading efficiency (IS index) has been defined to quantify the efficiency of spreading of each cell line on microcarriers. These data gave the opportunity to develop serum-free, scale-up methods to culture cells like HT 29 which release potentially useful products. PMID- 3654484 TI - Lymphatic endothelial cell line (CH3) from a recurrent retroperitoneal lymphangioma. AB - An endothelial cell line derived from a massive recurrent chyle-containing retroperitoneal lymphangioma was isolated in monolayer culture. Scanning and transmission electron microscopy and immunohistochemistry confirmed a close resemblance to blood vascular endothelium with typical cobblestone morphology, positive immunofluorescence staining for endothelial marker Factor VIII associated antigen and fibronectin, and prominent Weibel-Palade bodies. The endothelial cells also exhibited other ultrastructural features characteristic of lymphatic endothelium, including sparse microvillous surface projections, overlapping intercellular junctions, and abundant intermediate filaments. This endothelial cell line represents a new source of proliferating lymphatic endothelium for future study, including structural and functional comparison to blood vascular endothelium. PMID- 3654485 TI - The effects of teacher intrusion on social play interactions between children with autism and their nonhandicapped peers. AB - This study investigated the effects of two levels of teacher intrusion upon the behavior of elementary age children with autism and nonhandicapped peers during dyadic play interactions occurring in two special education classrooms. High versus low levels of teacher intrusion were contrasted in a mixed between- and within-subjects design counterbalanced for order across the two conditions. There were few differences in behavior across the two conditions, though the low intrusion condition was associated with higher levels of toy contact, appropriate and inappropriate play, and lower levels of spontaneous verbalizations by the students with autism. There was no difference in the occurrence of excess behavior by condition. Results are discussed with respect to future investigations of effective teacher mediation to prepare children for positive peer interactions. PMID- 3654486 TI - Catecholamines metabolism in infantile autism: a controlled study of 22 autistic children. AB - In a group of 22 autistic children aged 5 to 16 years and a group of normal controls matched for age and sex, catecholamines metabolism was investigated in plasma, platelets, and urine. This investigation was part of a research project in which several biological parameters (including serotonin) were explored simultaneously in the same children. In the autistic group, epinephrine and norepinephrine were significantly elevated in plasma, while epinephrin, norepinephrine, and dopamine were significantly lower in isolated platelets. No significant difference was found between the two groups for the urinary excretion of epinephrine, norepinephrine, dopamine, DOPAC, and MHPG. Other differences between the two groups in the statistical correlations of several biochemical parameters also suggest abnormalities of bioamine metabolism in the platelets of autistic children. PMID- 3654487 TI - Nonverbal communication and play correlates of language development in autistic children. AB - The aim of this study was to determine the social and cognitive correlates of language acquisition in autistic children. Functional and symbolic play skills were shown to be associated with language abilities in a sample of young autistic children (mean CA 54.5 months), thereby replicating previous findings. Certain types of nonverbal communication skills were also shown to be significant correlates of language development in this group of autistic children. These involved the ability to use gestures to coordinate visual attention between social partners with respect to objects or events. The play and nonverbal communication variables were not significantly correlated, suggesting that these variables reflect independent psychological factors associated with language development in young autistic children. PMID- 3654488 TI - Hair minerals and diet of Prader-Willi syndrome youth. AB - This study investigated the relationships between mineral elements and Prader Willi syndrome (PWS) and determined which minerals, if any, separated a group of PWS individuals (N = 19) from a non-PWS mentally retarded control group (N = 60). The PWS group had significantly raised hair magnesium levels and significantly lower hair silicon levels than controls. The PWS group was also elevated in hair calcium, magnesium, and copper in relation to laboratory standards, while their hair silicon, chromium, and lithium levels were deficient in relation to laboratory norms. Discriminant function analysis revealed that by using 16 hair minerals subjects could be correctly classified as PWS or non-PWS with 89.5% and 95.0% accuracy, respectively. It is concluded that continuing research is needed to study the relationship between mineral element patterns and PWS. PMID- 3654489 TI - Increasing social interactions of severely handicapped autistic children. AB - A peer-initiation training procedure was implemented across multiple peer trainers to investigate social interactions between severely withdrawn autistic children and their nonhandicapped peers. For one subject, substantial increases in spontaneous interactions with training and nontraining peers occurred after the peer-initiation procedure was applied across two training exemplars. Spontaneous social interactions continued even after the training procedure was removed. Although experimental control was established with the second subject during training, spontaneous interactions during nontraining periods were primarily with training peers. The results contribute to an emerging data base on the social interactions of autistic and severely withdrawn handicapped children and on peer-initiation training procedures. PMID- 3654490 TI - Compulsive respiratory stereotypies in children with autistic features: polygraphic recording and treatment with fenfluramine. AB - Syncopes due to compulsive respiratory stereotypies were studied in eight patients with autistic features. Most had been referred for episodes thought to be intractable epileptic seizures. Polygraphic recording showed two types of syncope, one induced by prolonged apnea and the other by a prolonged Valsalva maneuver. Fenfluramine, 1.5-3 mg/kg per day, was given in an open trial. In four of five cases with frequent Valsalva maneuvers, respiratory stereotypies and syncopes were suppressed for 2-18 months. Patients with periodic apneas were more severely retarded and had less clear benefit. Side effects consisted of dose dependent sedation and mild weight loss which stabilized without interrupting treatment. We suggest that these syncopes are volitional and may be associated with pleasant sensations. A double-blind placebo-controlled trial of fenfluramine seems warranted in such patients. PMID- 3654491 TI - The presence or absence of certain behaviors associated with infantile autism in severely retarded autistic and nonautistic retarded children and very young normal children. AB - The modified Behavior Observation Scale adapted from Freeman et al. was used to compare normal, retarded, and autistic children with very low developmental ages and to determine the types of behavior that could differentiate these three diagnostic categories of children. Examination of the data revealed that there was much more overlap between autistic and retarded children than between autistic and normal children. However, a behavioral pattern of autism could be delineated and very retarded autistic children could be distinguished from the nonautistic retarded children. The autistic behavioral pattern included subclusters of symptoms that might be interpreted as disturbances of sensory modulation and motility. PMID- 3654492 TI - Humor in high-functioning autistic adults. AB - This study examined the humor used by a group of autistic adults. Subjects were nine autistic adults who were participating in a Social Skills Group. The jokes they told during a designated joke time over 15 consecutive group sessions were analyzed according to their developmental levels. The participants told a total of 87 unique jokes, almost all of which were riddles. The most common types were preriddles and those having lexical and phonological ambiguity. Along with empirically examining the jokes used by this group of high level autistic adults, the study demonstrates that they enjoy a wide range of jokes and that humor seems to enrich their lives. PMID- 3654493 TI - Visual versus auditory (musical) stimulus preferences in autistic children: a pilot study. AB - This study investigated perceptual preferences of autistic children comparing responses to auditory musical and visual stimuli. The results indicated a weak preference of autistic children for the auditory musical stimulus, however, without the data approaching statistical significance. The autistic children spent significantly more time with the musical stimulus than the two control groups of normal children, equated by chronological and developmental age, respectively. Implications of these findings for a music therapy treatment concept are discussed. PMID- 3654494 TI - Magnetic resonance imaging of high level autism. PMID- 3654495 TI - Open trial effects of beta-blockers on speech and social behaviors in 8 autistic adults. AB - We began open trials of beta-blockers, as adjunctive medication, in eight consecutive autistic adults. The immediate result across all patients was a rapid diminution in aggressivity (Ratey et al., 1987). As time on the drug increased, subtler changes in speech and socialization emerged. While results of open trials must be interpreted with caution, these changes were significant and lasting. We speculate that these effects may be the result of a lessening of the autistic individual's state of hyperarousal. As the individual becomes less anxious, defensive and dearousing behaviors are relinquished and more social and adaptive behaviors appear. There is a concomitant improvement in language, though it is unclear whether lost skills are recouped or new ones developed. Further research is indicated. PMID- 3654496 TI - Autism studied in Poland. PMID- 3654497 TI - Attachment in autism and other developmental disorders. PMID- 3654498 TI - Communicative interaction between mothers and their autistic children: application of a new instrument and changes after treatment. PMID- 3654499 TI - Temperament and home environment characteristics as causal factors in the early development of childhood psychopathology. PMID- 3654500 TI - Environment and developmental risk in children with sex chromosome abnormalities. PMID- 3654501 TI - Interactions between abused infants and strangers. PMID- 3654502 TI - Sleep habits in toddlers 18 to 36 months old. PMID- 3654503 TI - Insecure attachment in severely asthmatic preschool children: is it a risk factor? PMID- 3654504 TI - Compliance with pharmacological and cognitive treatments for attention deficit disorder. PMID- 3654505 TI - Comparison of DSM-III separation anxiety and overanxious disorders: demographic characteristics and patterns of comorbidity. PMID- 3654506 TI - Alprazolam in the treatment of anticipatory and acute situational anxiety in children with cancer. PMID- 3654507 TI - Empirical measurement of overanxious disorder in boys 8 to 12 years old. PMID- 3654508 TI - Measurement of anxiety in children and adolescents using semistructured interviews. PMID- 3654509 TI - A prospective psychiatric follow-up of children with speech/language disorders. PMID- 3654510 TI - Medical findings in child psychiatric inpatients. PMID- 3654511 TI - Hallucinations in psychotic children. PMID- 3654512 TI - Reliability of child diagnosis in a Hispanic sample. PMID- 3654513 TI - Gender role development in two clinical syndromes: Turner syndrome versus constitutional short stature. PMID- 3654514 TI - A pilot study surveying the educational needs of delinquent adolescents. PMID- 3654515 TI - Sequential patterns of five subconcepts of human and animal death in children. PMID- 3654516 TI - A child with right hemisphere deficit syndrome responsive to carbamazepine treatment. PMID- 3654517 TI - Fragile-X chromosome associated with primary learning disability. PMID- 3654518 TI - Diagnosis and treatment of a child with X-polysomy. PMID- 3654519 TI - Heterogeneous diagnoses in attempted suicide. PMID- 3654520 TI - Nerve conduction studies in chronic renal failure. PMID- 3654521 TI - Value of serial right precordial electrocardiogram in acute myocardial infarction. PMID- 3654522 TI - Multiple primary tumours associated with pulmonary tuberculosis. PMID- 3654523 TI - Study of plasma fibrinogen and platelet adhesiveness following an acute stroke. PMID- 3654524 TI - Triglyceride tolerance test: is it feasible? PMID- 3654525 TI - Quantification of mean pulmonary artery pressure by pulsed Doppler echocardiography. PMID- 3654526 TI - Acute myocardial infarction (AMI) in young adults (a study of risk factors and their early clinical course). PMID- 3654527 TI - Hepatitis B infection in a dialysis unit in South India. PMID- 3654528 TI - Readers' interest in JAPI: a critical analysis. PMID- 3654529 TI - Galactorrhoea-amenorrhea syndrome. PMID- 3654530 TI - Conjugal motor neurone disease. PMID- 3654531 TI - Angioimmunoblastic lymphadenopathy with dysproteinaemia. PMID- 3654532 TI - Acute renal artery occlusion. PMID- 3654533 TI - Primary hyperparathyroidism due to intrathyroidal parathyroid adenoma. PMID- 3654534 TI - Symptomatic colonic diverticulosis. PMID- 3654535 TI - Worsening of cardiac arrhythmia following drinking chilled water in a patient of acute myocardial infarction. PMID- 3654536 TI - Myocardial bridging of coronary artery in hypertrophic cardiomyopathy. PMID- 3654537 TI - Furosemide: absorption blockade or renal resistance. PMID- 3654538 TI - Pan masala: is it really safe? PMID- 3654539 TI - Prolonged P.R. interval on electrocardiogram following electric shock. PMID- 3654540 TI - Prolonged defibrination syndrome after Echis carinatus bite. PMID- 3654541 TI - Kala-azar with peripheral eosinophilia. PMID- 3654542 TI - Rupture of interventricular septum following acute MI. PMID- 3654543 TI - Testis involvement in sickle cell trait. PMID- 3654544 TI - Routine investigations in psychiatric patients. PMID- 3654545 TI - AIDS--the Indian scene. PMID- 3654546 TI - AIDS screening in North India: clinical spectrum of HIV infection. PMID- 3654547 TI - Clinical and morphological spectrum of glomerulonephritis (a hospital based study). PMID- 3654548 TI - Dysautonomia in Guillain Barre syndrome. PMID- 3654549 TI - Liver in heroin smokers. PMID- 3654550 TI - Symptomatology in hypertrophic obstructive cardiomyopathy--HOCM. PMID- 3654551 TI - Serum zinc concentration in pulmonary tuberculosis. PMID- 3654552 TI - Wilson's disease in India: clinical and laboratory manifestations in thirty patients. PMID- 3654553 TI - Aorto arteritis in India. PMID- 3654554 TI - Isolated valvular aortic stenosis. PMID- 3654555 TI - Pyoderma gangrenosum in ulcerative colitis. PMID- 3654556 TI - Relapsing polychondritis with high anticollagen-II antibody titers. PMID- 3654557 TI - Acquired immunodeficiency syndrome--a study of two case reports with manifest HIV infection. PMID- 3654558 TI - Choledochus cyst. PMID- 3654559 TI - Macleod's syndrome. PMID- 3654560 TI - Behcet's disease. PMID- 3654561 TI - Gynaecomastia, galactorrhoea and impotence--the uncommon side effects of cimetidine therapy. PMID- 3654562 TI - Precursors of atherosclerosis in children. PMID- 3654563 TI - Post infectious cerebellar ataxia. PMID- 3654564 TI - Sublingual nifedipine therapy in accelerated hypertension and acute cardiac ischaemia. PMID- 3654565 TI - Co-existence of rheumatic heart disease and rheumatoid arthritis. PMID- 3654566 TI - Monoclonal antibodies in treatment of digitalis toxicity. PMID- 3654567 TI - Drug-induced aplastic anaemia and prostaglandins: further discussion. PMID- 3654568 TI - Diabetic heart. PMID- 3654569 TI - Craniocerebral CT-findings in patients with myelomeningocoele. PMID- 3654570 TI - CT of "saber-sheath" trachea. PMID- 3654571 TI - [Contribution of computerized cerebral tomography in bacterial meningitis of children]. PMID- 3654572 TI - [Intra-appendicular foreign bodies]. PMID- 3654573 TI - Nonionic contrast media for gastro-intestinal studies in newborns and infants. PMID- 3654574 TI - [Computerized tomography of hydatid cyst of the heart in children]. PMID- 3654575 TI - Zellweger syndrome (cerebro-hepato-renal syndrome). PMID- 3654576 TI - [Calcifications of the breast]. PMID- 3654577 TI - Iopromid, a new non-ionic contrast medium. PMID- 3654578 TI - Protein synthesis during encystment of Azotobacter vinelandii. AB - Proteins synthesized during the encystment of Azotobacter vinelandii were radiolabeled with [35S]methionine and analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Pulse labeling was used to demonstrate that early encystment-specific proteins were beginning to be synthesized at 2 h and reached peak levels about 12 h after initiation of encystment. One such protein was identified as a beta-ketoacyl acyl-carrier protein synthase. The concentration of early proteins began to decrease at 16 h, when intermediate proteins specific to the differentiation process began to be synthesized. The cessation of synthesis of intermediate proteins began at 20 h postinitiation, and the labeling pattern of proteins then remained constant throughout the remaining 4 days of encystment. PMID- 3654579 TI - Sulfometuron methyl-sensitive and -resistant acetolactate synthases of the archaebacteria Methanococcus spp. AB - The herbicide sulfometuron methyl (SM) inhibited growth of some methanococci. Of 28 strains tested, the growth of 7 was completely inhibited by 0.55 mM SM. Growth of an additional 14 strains was partially inhibited, and the growth of 7 strains was unaffected by this concentration of SM. In some cases, the branched-chain amino acids protected growth. Growth inhibition was correlated with the Ki for SM of acetolactate synthase (ALS). For the enzymes from bacteria representative of the sensitive, partially resistant, and resistant methanococci (Methanococcus aeolicus, Methanococcus maripaludis, and Methanococcus voltae, respectively), the Ki for SM was 0.0012, 0.34, and greater than 1.0 mM, respectively. Inhibition was uncompetitive with respect to pyruvate. Based on these observations, ALS appeared to be the major if not the sole site of action of SM in the methanococci. The sensitivity of the ALS from these three methanococci to feedback inhibition by branched-chain amino acids was also quite different. Although all three were sensitive to feedback inhibition by valine, the Ki varied 20-fold, from 0.01 to 0.22 mM. Moreover, only the ALS from M. maripaludis was sensitive to inhibition by leucine, and the Ki was 1.8 mM. The Ki for isoleucine for the ALS from both M. maripaludis and M. voltae was about 0.1 mM. The ALS from M. aeolicus was not inhibited by isoleucine. In other respects, the ALSs from the methanococci were very similar. After dialysis, thiamine pyrophosphate but not FAD and Mg2+ was required for maximal activity, and they were all rapidly inactivated by oxygen. Although the methanococcal ALSs exhibited diverse properties, the range of catalytic and regulatory properties closely resembled those of the eubacterial enzymes. PMID- 3654580 TI - Mutations in an upstream regulatory sequence that increase expression of the bacteriophage T4 lysozyme gene. AB - A P22 hybrid phage bearing the bacteriophage T4 lysozyme gene (e), as well as T4 sequences upstream from the lysozyme gene, was constructed. Amber mutations were introduced into gene e in the hybrid phage, and the resulting mutant phages were tested for the ability to form plaques on amber suppressor strains. Revertant phages that were able to form plaques on amber suppressors that did not suppress the parent amber mutant phages were isolated following UV mutagenesis. Secondary site pseudorevertants were identified among the revertants by a genetic test. Four of the suppressing secondary site mutations were mapped and sequenced. They were found to consist of small sequence alterations immediately upstream from gene e, all of which would tend to destabilize potential base-pairing interactions in the transcript. The mutations were shown to increase lysozyme expression when introduced into an otherwise wild-type hybrid phage, but were found to have little effect on transcription of the lysozyme gene. PMID- 3654581 TI - Inhibition of bacteriochlorophyll synthesis in Rhodobacter sphaeroides subsp. denitrificans grown in light under denitrifying conditions. AB - The inclusion of nitrate or nitrite in cultures of Rhodobacter spaeroides subsp. denitrificans grown heterotrophically in light depressed the formation of bacteriochlorophyll a. The pigment biosynthesis was inhibited at the stage of the reduction of chlorophyllide (chlorin) to bacteriochlorophyllide (tetrahydroporphyrin) since 3-hydroxyethylchlorophyllide a accumulated in the culture medium. The addition of exogenous 5-aminolevulinic acid to these cultures resulted in a complete restoration of bacteriochlorophyll synthesis accompanied by the accumulation of 3-vinylbacteriopheophorbide. This indicates that under these conditions bacteriochlorophyll was formed via an alternative route, in which the reduction of chlorins to tetrahydroporphyrins precedes modifications of the C-3 side chain. The multiple forms of 5-aminolevulinic acid synthase were purified from cells grown with and without nitrate. Antibodies against these proteins were raised in rabbits and used in enzyme-linked immunosorbent assays for various forms of 5-aminolevulinic acid synthase. In denitrifying cells, the amount and activity of fraction I of the enzyme was reduced by approximately 40 and 30%, respectively. Partly active enzymes from both types of cells were activated by cystine trisulfide. PMID- 3654582 TI - Variability of the turgor pressure of individual cells of the gram-negative heterotroph Ancylobacter aquaticus. AB - Cells of Ancylobacter aquaticus were observed under phase microscopy in a chamber to which a measured pressure could be applied. The initial collapse pressure (Ca), i.e., the lowest pressure needed to collapse the most pressure-sensitive gas vesicles, was measured for 69 cells. The cells were taken from cultures in low-density balanced exponential growth, and the experiments were performed quickly so that the bacteria were in a uniform physiological state at the time of measurement. The turgor pressure, Pt, is the difference between the pressure, C, that would cause collapse of vesicles when removed from the cell and Ca. In this paper we focus on the variability of Pt from cell to cell. Part of the observed variability of Ca was due to the variability of the collapse pressure of individual vesicles (standard deviation [SD] = 90 kPa), but because there were about 100 vesicles per cell and because a change in refracted light after the fifth vesicle (approximately) collapsed probably could be detected by the human eye, the pressure would only have an SD of 18.6 kPa due to this type of sampling error. The observed SD of Pt was 42 kPa, indicating that turgor pressure did vary considerably from cell to cell. However, the turgor pressure was independent of cell size. Statistical analysis showed that Pt would decrease 6.9 kPa over a cell cycle, but with too large an SD (19.9 kPa) to be significant. This implies that the observed change in Pt over the cell cycle is not statistically significant. PMID- 3654583 TI - Kinetically resolved states of the Halobacterium halobium flagellar motor switch and modulation of the switch by sensory rhodopsin I. AB - Spontaneous switching of the rotation sense of the flagellar motor of the archaebacterium Halobacterium halobium and modulation of the switch by attractant and repellent photostimuli were analyzed by using a computerized cell-tracking system with 67-ms resolution coupled to electronic shutters. The data fit a three state model of the switch, in which a Poisson process governs the transition from state N (nonreversing) to state R (reversing). After a reversal, the switch returns to state N, passing through an intermediate state I (inactive), which produces a ca. 2-s period of low reversal frequency before the state N Poisson rate is restored. The stochastic nature of the H. halobium switch reveals a close similarity to Escherichia coli flagellar motor properties as elucidated previously. Sensory modulation of the switch by both photoattractant and photorepellent signals can be interpreted in terms of modulation of the single forward rate constant of the N to R transition. Insight into the mechanism of modulation by the phototaxis receptor sensory rhodopsin I (SR-I) was gained by increasing the lifetime of the principal photointermediate of the SR-I photochemical reaction cycle, S373, by replacing the native chromophore, all trans-retinal, with the acyclic analog, 3,7,11-trimethyl-2,4,6,8-dodecapentaenal. Flash photolysis of analog-containing cells revealed an eightfold decrease in the rate of thermal decay of S373, and behavioral analysis showed longer periods of reversal suppression than that of cells with the native chromophore over similar ranges of illumination intensities. This indicates that attractant signaling is governed by the lifetime of the S373 intermediate rather than by the frequency of photocycling. In this sense, SR-I is similar to rhodopsin, whose function depends on an active photoproduct (Meta-II). PMID- 3654585 TI - Structural specificity of diamines covalently linked to peptidoglycan for cell growth of Veillonella alcalescens and Selenomonas ruminantium. AB - Putrescine and cadaverine are essential constituents of the peptidoglycan of Veillonella alcalescens, Veillonella parvula, and Selenomonas ruminantium and are necessary for the growth of these organisms (Y. Kamio and K. Nakamura, J. Bacteriol. 169:2881-2884, 1987, and Y. Kamio, H. Poso, Y. Terawaki, and L. Paulin, J. Biol. Chem. 261:6585-6589, 1986). In this study, the structural specificity of the diamine requirement for normal cell growth of these bacteria was examined by using a series of diamines with a general structure of NH3+ X (CH2)n X NH3+. Diaminohexane (n = 6) which was incorporated into the peptidoglycan was as effective as putrescine (n = 4) and cadaverine (n = 5) for normal cell growth. However, diaminopropane (n = 3) and diaminoheptane (n = 7) were less effective for growth than diaminohexane, although they were incorporated into the peptidoglycan to the same extent. PMID- 3654584 TI - Organization and codon usage of the streptomycin operon in Micrococcus luteus, a bacterium with a high genomic G + C content. AB - The DNA sequence of the Micrococcus luteus str operon, which includes genes for ribosomal proteins S12 (str or rpsL) and S7 (rpsG) and elongation factors (EF) G (fus) and Tu (tuf), has been determined and compared with the corresponding sequence of Escherichia coli to estimate the effect of high genomic G + C content (74%) of M. luteus on the codon usage pattern. The gene organization in this operon and the deduced amino acid sequence of each corresponding protein are well conserved between the two species. The mean G + C content of the M. luteus str operon is 67%, which is much higher than that of E. coli (51%). The codon usage pattern of M. luteus is very different from that of E. coli and extremely biased to the use of G and C in silent positions. About 95% (1,309 of 1,382) of codons have G or C at the third position. Codon GUG is used for initiation of S12, EF-G, and EF-Tu, and AUG is used only in S7, whereas GUG initiates only one of the EF Tu's in E. coli. UGA is the predominant termination codon in M. luteus, in contrast to UAA in E. coli. PMID- 3654586 TI - Transport of Ca2+ by Yersinia pestis. AB - Low-calcium-response, or Lcr, plasmids of yersiniae are known to promote an in vitro nutritional requirement for 2.5 mM Ca2+ at 37 degrees C which, if not fulfilled, results in cessation of growth with induction of virulence functions (Lcr+). The mechanism whereby Ca2+ regulates this metabolic shift is unknown. Radioactive Ca2+ was not actively accumulated by yersiniae but was excluded by an exit reaction analogous to those described for other bacteria. Nevertheless, cultivation at 37 degrees C with 0.1 mM Ca2+, a level insufficient to prevent restriction of cell division, promoted significantly more binding of the cation by Lcr+ organisms than by plasmid-deficient Lcr- mutants. According, Lcr+ yersiniae may possess unique ligands capable of recognizing Ca2+. PMID- 3654587 TI - The chemical carcinogen-induced enzyme, GDP-fucose: GM1 alpha 1----2 fucosyltransferase in rat liver and hepatoma: modulation by and association with phospholipids. AB - The enzyme GDPFuc:GM1 alpha 1----2 fucosyltransferase, induced by chemical carcinogens in precancerous rat liver as well as rat hepatoma cells, was found previously to be membrane bound, and was inactivated by various detergents, while the activities of many other transferases are generally enhanced by detergents (Holmes, E.H. & Hakomori, S. (1983) J. Biol. Chem. 258, 3706-3717). The effects of phospholipids and detergents on rat hepatoma H35 cells, the conditions of solubilization and subsequent affinity chromatography of the enzyme, and a possible association of phospholipids with the enzyme have been studied with the following major results: The alpha 1----2 fucosyltransferase activity in Golgi membrane was diminished on treatment of membranes with phospholipase A1 or phospholipase C. The enzyme activity was stimulated 7-fold in the presence of cardiolipin or phosphatidylglycerol (and 3-fold by phosphatidylethanolamine) but not other phospholipids. The stimulatory effect of phosphatidylglycerol was eliminated when a variety of ionic or non-ionic detergents were added to the reaction mixture, with the exception of the cationic detergent G-3634-A, which provided a 10-fold total stimulation in the presence of phosphatidylglycerol. The kinetic analysis indicated that addition of phosphatidylglycerol has a negligible effect on apparent Km values but increases the Vmax of the enzyme 5- to 6-fold. The enzyme activity was solubilized by the dialyzable detergent CHAPSO without inhibition of the enzyme activity, and the solubilized enzyme in the presence of 0.4% CHAPSO is partially purified by chromatography on GDP-hexanolamine Sepharose. Removal of CHAPSO from the affinity purified enzyme by dialysis resulted in a 66% loss of the original activity, which was restored by addition of phosphatidylglycerol. Chromatography of the affinity-purified enzyme with 3H labeled phosphatidylglycerol on a Biogel A0.5 column indicated an association of the enzyme with the phospholipid that occurred only in the absence of detergent. These results suggest that phospholipid has a direct effect on the enzyme and that the inhibitory effect of detergents can be ascribable to disturbing interaction between phospholipids and the enzyme. A possible role of specific phospholipids on in vivo transferase activity for glycolipids is discussed. PMID- 3654588 TI - The induction of cyanide-resistant respiration in Hansenula anomala. AB - Cyanide-resistant respiration was induced in the yeast, Hansenula anomala in the presence of cyanide or antimycin A, which blocks the electron transport after ubiquinone. The de novo protein synthesis in cytosol and oxygen were deduced to be involved in this induction process. The period required for the induction varied during the growth stage, suggesting that involvement of additional physiological factor(s) in this induction process. The organism could multiply in the presence of antimycin A by developing cyanide-resistant respiration despite a decreased growth rate. PMID- 3654589 TI - Structural comparison of bovine erythrocyte, brain, and liver NADH-cytochrome b5 reductase by HPLC mapping. AB - NADH-cytochrome b5 reductases purified from bovine erythrocytes and from bovine brain and liver microsomes solubilized with lysosomal protease were subjected to structural analysis by using HPLC mapping, amino acid analysis of the resulting peptides, and NH2-terminal sequence analysis of apoproteins. HPLC maps of the tryptic peptides derived from these enzymes were very similar to each other, and amino acid analysis of the HPLC-separated peptides indicated that the structures of these enzymes are identical except for the NH2-terminal region. The NH2 terminal sequence of the brain enzyme determined by automated Edman degradation was as follows: NH2-Phe-Gln-Arg-Ser-Thr-Pro-Ala-Ile-Thr-Leu-Glu-Asn-Pro-Asp- Ile Lys-Tyr-Pro-Leu-Arg-Leu-Ile-Asp-Lys-Glu-Val-Ile- This sequence is identical to that of liver enzyme except that the liver enzyme started at the 3rd Arg or 4th Ser. The NH2-terminal amino acid residue of the soluble erythrocyte enzyme was not detected by automated Edman degradation. The sequence analysis of a tryptic peptide from the erythrocyte enzyme indicated that Leu is present before the NH2 terminal Phe of the brain enzyme. The recently reported sequence of the apparently identical protein (Ozols et al. (1985) J. Biol. Chem. 260, 11953 11961) differs in two amino acid assignments from our sequence. PMID- 3654590 TI - Variation of oleate/cis-vaccenate ratios and its regulation by substrates in hepatic tissues. AB - The oleate (delta 9-18:1)/cis-vaccenate (delta 11-18:1) ratios in phospholipids increased in the order of normal liver, host liver and hepatoma in rats. The amount of oleate increased in phospholipids and decreased in triacylglycerol in the same order, whereas the distributions of cis-vaccenate among the major lipid classes were relatively unchanged among the three kinds of cells. Biochemical bases for these differences were sought by characterizing the microsomal elongation system and by analyzing the elongation and desaturation products in vitro. Kinetic parameters for the elongations of palmitoyl-CoA and palmitoleoyl CoA did not account for the observed differences in the oleate/cis-vaccenate ratios in these cells. However, the oleate/cis-vaccenate ratios varied depending on the availability of substrates, NADH, NADPH, and malonyl-CoA, in the elongation and desaturation of palmitoyl-CoA. Based on the results, it is proposed that differences in the concentrations of substrates for the elongation and desaturation systems might account at least in part for the differences in the oleate/cis-vaccenate ratios among the three kinds of cells. PMID- 3654591 TI - Inhibition of microtubule polymerization by synthetic estrogens: formation of a ribbon structure. AB - Dienestrol, meso-hexestrol, and dl-hexestrol, synthetic nonsteroidal estrogens, were shown to be inhibitors of microtubule assembly in vitro using microtubule proteins isolated from porcine brains. The order of activity of the synthetic estrogens as inhibitors of microtubule assembly is: dienestrol greater than diethylstilbestrol greater than meso-hexestrol greater than dl-hexestrol greater than isodienestrol. The activity of dienestrol as an inhibitor was of the same order as that of (+)-griseofulvin, as determined by turbidity measurement. Electron microscopic observation revealed that twisted ribbon structures are formed from microtubule proteins in the presence of some synthetic estrogens (dienestrol, meso-hexestrol, and dl-hexestrol). PMID- 3654592 TI - Human placental sialidase: partial purification and characterization. AB - A sialidase [EC 3.2.1.18] has been partially purified from human placenta by means of procedures comprising Con A-Sepharose adsorption, ammonium sulfate precipitation, sucrose density gradient centrifugation, and high-pressure liquid chromatography on a Shim pack Diol 300 column. On high-pressure liquid chromatography, most of the beta-galactosidase that comigrated with the sialidase on sucrose density gradient centrifugation was removed. The sialidase was purified 3,600-fold from the preparation obtained by Con A-Sepharose adsorption. The enzyme liberated the sialic acid residues from (alpha 2-3) and (alpha 2-6) sialyllactose, colomic acid, fetuin, and transferrin, but not from bovine submaxillary mucin. The enzyme also hydrolyzed gangliosides GM3, GD1a, and GD1b in the presence of sodium cholate as a detergent, but GM1 and GM2 were less susceptible to the enzyme. The optimum pHs for 4-methylumbelliferyl-N acetylneuraminate, sialyllactose, fetuin, and GM3 lay between 4.0 and 5.0. PMID- 3654593 TI - Amino acid composition and NH2-terminal amino acid sequence of rat platelet secretory phospholipase A2. AB - The amino acid composition and partial NH2-terminal amino acid sequence of the phospholipase A2 secreted by stimulated rat platelets were determined. The most predominant amino acid in the phospholipase A2 was cysteine followed by lysine, suggesting that it is a basic one. This finding is consistent with its high affinity to a cation exchange column. The NH2-terminal 24 amino acids were found to be as follows: X-Leu-Leu-Glu-Phe-Gly-Gln-Met-Ile-Leu-Phe-Lys-Thr-Gly-Lys-Arg Ala-Asp- Val-Ser-Tyr-Gly-Phe-Tyr-Gly- The enzymes contains 5Phe, 8Met, 9Ile, 24Tyr, and 25Gly residues, all of which are conserved in the sequenced pancreatic phospholipase A2. This is the first report of the tentative characterization of a eukaryotic phospholipase A2, the cellular source of which is known, i.e., it does not originate from a venom or the pancreas. PMID- 3654594 TI - Transcriptional control of rat heme oxygenase by heat shock. AB - A heat shock element is located in the 5'-flanking region of the rat heme oxygenase gene (HO gene). The incubation of rat glioma cells at 42 degrees C or with hemin at 37 degrees C increased the levels of heme oxygenase mRNA within 1 h and produced a maximum at 3 h (at least a 20-fold increase). In both treatments, the heme oxygenase activity started to increase after a lag period of about 1 h and reached a maximum value at 5 h. There was an apparent additive effect of both treatments on the heme oxygenase induction. Studies with actinomycin D and cycloheximide suggested that both heat shock and hemin acted at the transcriptional level to induce heme oxygenase. Therefore, we analyzed the transient expression of chimeric fusion genes harboring the promoter of the rat HO gene ligated to the Escherichia coli gene gpt in rat glioma cells and in K1735 mouse amelanotic melanoma cells. The 5'-flanking region of the rat HO gene bearing the heat shock element conferred the heat inducibility of gpt RNA production in both cell lines; however, hemin treatment did not induce gpt RNA. These results indicate that rat heme oxygenase is a heat shock protein and that hemin induces heme oxygenase through a different mechanism from heat shock. PMID- 3654595 TI - Isolation of a cDNA clone for murine catalase and analysis of an acatalasemic mutant. AB - We have investigated the genetic control of murine catalase expression by analyzing catalase transcription and translation products from the tissues of control (Csa) and acatalasemic (Csb) mouse strains. Csb animals possess nearly normal catalase enzyme activity levels in liver, while displaying approximately 20 and 1% of normal activity levels in kidney and red blood cells, respectively. Immunoblot analyses of catalase in these tissues have revealed reduced levels of immunologically reactive catalase protein in Csb kidney and red blood cells, paralleling the reduction of catalase enzyme activity in these tissues. In order to determine the molecular basis for Csb acatalasemia, we have isolated a cDNA clone for murine catalase and have used this probe to analyze Csa and Csb genomic DNA and catalase mRNA. These studies have revealed: 1) no restriction fragment length polymorphisms between Csa and Csb genomic DNAs; 2) no differences in the levels of Csa and Csb catalase mRNA within a single tissue; and 3) no differences in the sizes of Csa and Csb catalase mRNAs. These observations suggest that the genetic defect that produces the tissue-specific reduction of catalase expression in Csb mice is not due to a marked rearrangement of DNA within the Csb catalase structural gene. Furthermore, the Csb mutation does not act at the level of gene transcription or mRNA stability, but rather at the level of mRNA translation and/or catalase protein turnover. PMID- 3654596 TI - Ligand recombination to the alpha and beta subunits of human hemoglobin. AB - The rebinding of CO, O2, NO, methyl, ethyl, n-propyl, and n-butyl isocyanide to isolated alpha and beta chains and intact hemoglobin at pH 7, 20 degrees C was examined both during and after a 30-ns dye laser pulse. The resultant absorbance changes were analyzed in terms of a linear three-step reaction scheme: Hb + X in equilibrium with C in equilibrium with B in equilibrium with A or HbX, where A is the final bound state, and C and B are geminate states. Rate constants were assigned for each of the transitions in this mechanism using fitting procedures described previously for analyzing ligand rebinding to sperm whale myoglobin at room temperature (Gibson, Q. H., Olson, J. S., McKinnie, R. E., and Rohlfs, R. J. (1986) J. Biol. Chem. 261, 10228-10239). Five major conclusions were obtained. First, initial geminate recombination phases for the NO and O2 complexes of hemoglobin and its isolated subunits exhibit half-times equal to approximately 12 and approximately 440 ps, respectively. These values are in excellent agreement with more direct, picosecond measurements of the geminate recombination of HbNO (Cornelius, P. A., Hochstrasser, R. M., and Steele, A. W. (1983) J. Mol. Biol. 163, 119-128) and HbO2 (Friedman, J. M., Scott, T. W., Fisanick, G. J., Simon, S. R., Findsen, E. W., Ondrias, M. R., and MacDonald, V. W. (1985) Science 229, 187 229) following extremely short laser pulses. Second, the correspondence between our nanosecond measurements and the published picosecond data suggests strongly that the intrinsic photochemical yield of all ferrous, hexacoordinate heme complexes approaches one. Third, the major differences between the isolated alpha and beta chains involve the rate of ligand migration to the solvent, kC----X and the extent of recombination from the second geminate state, C, as measured by the ratio kC----B/kC----X. Fourth, for both isolated chains and intact hemoglobin, the rate and equilibrium constants for the formation of the initial O2 geminate state starting from ligand in the solvent (i.e. kX----B and KX----B) are 5-10 times greater than the corresponding parameters for the formation of the first CO geminate state. Fifth, the rate-limiting step for NO, O2, and isonitrile binding to hemoglobin and its isolated subunits is ligand migration up to the initial geminate state (i.e. kX----B). In the case of CO binding, both migration to state B and iron-ligand bond formation (kB----A) affect the overall, bimolecular association rate constant. PMID- 3654597 TI - Sequence redesign and the assembly mechanism of the oxytocin/bovine neurophysin I biosynthetic precursor. AB - The structural organization of neurohypophysial hormone biosynthetic precursors and the interdependence between intramolecular folding and precursor self association were examined using sequence-engineered mutants of the semisynthetic oxytocin/bovine neurophysin precursor (pros-OT/BNPI). In [N alpha 1-Ac,N epsilon 30,71-diacetimidyl, Ala2,des-His106] Pro-Ot/BNPI or [N alpha 1-Ac,Ala2]pros OT/BNPI), two structural elements (Tyr2 and free alpha-amino group) were eliminated which were predicted to be critical for intramolecular conformation by stabilizing contact between hormone and neurophysin domains. This mutant was used to test the dependence of precursor self-association on intramolecular conformation. In the second mutant precursor, [N alpha 30,71-diacetimidyl,D Pro7,D-Leu8,des-His106]p ro-OT/BNPI (or [D-Pro7,D-Leu8]pros-OT/BNPI), the stereochemistry at L-Pro7-L-Leu8 was changed to test the extent to which precursor conformation depends on ordered structure in the processing/spacer sequence which connects the interacting hormone and neurophysin I domains. Intramolecular conformation was characterized for the precursor and mutants by analytical affinity chromatography on immobilized hormone analog Met-Tyr-Phe and by circular dichroism. Data obtained by both methods showed that, while pros OT/BNPI is folded, with hormone domain occupying the hormone-binding site of the neurophysin domain, the alpha-acetyl-Ala2 mutant is not so organized intramolecularly. When pros-OT/BNPI and the alpha-acetyl-Ala2 mutant were eluted on immobilized BNPII to measure self-association propensity, the native-like precursor was found to bind with 12-15-fold higher affinity than the assembly mutant. Thus, while pros-OT/BNPI assumes a molecular structure containing a high affinity self-association surface induced by intramolecular hormone domain neurophysin domain interaction, [N alpha 1-Ac,Ala2]pros-OT/BNPI does not. The results with the alpha-acetyl-Ala2 mutant show that intramolecular domain-domain interaction is the obligatory "trigger" which induces the high-affinity precursor self-association that likely drives precursor to aggregated forms in the concentrated intragranular environment that exists in peptide hormone synthesizing cells. In contrast, affinity chromatographic and circular dichroism properties of the D-Pro7,D-Leu8 mutant show that this intramolecular trigger is dependent, but only weakly, on the conformation of the peptide sequence between domains, as judged by native-like interaction properties below 40 degrees C but lowered stability to elevated temperature.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3654598 TI - Peptide YY. Structure of the precursor and expression in exocrine pancreas. AB - Peptide YY is a 36-residue gastrointestinal hormone which inhibits both pancreatic and gastric secretion. We have isolated a cDNA encoding the peptide YY precursor by screening a rat intestinal lambda gt11 cDNA library with an antiserum directed against the porcine hormone. The nucleotide sequence of the cDNA encodes a 98-residue protein (molecular weight, 11, 121) which has an amino acid sequence identical to that of porcine peptide YY. Rat peptide YY is preceded immediately by a signal sequence and followed by a cleavage-amidation sequence Gly-Lys-Arg plus 31 additional amino acids. Thus the peptide YY precursor is similar in structure to that of two related peptides, pancreatic polypeptide and neuropeptide Y. RNA blot hybridizations reveal that the peptide YY gene is much more actively expressed in pancreas than previously realized. In situ hybridizations localized peptide YY cells exclusively to the exocrine pancreas. The abundance of peptide YY in one of its target organs, the pancreas, suggests a paracrine mechanism for peptide YY in regulating pancreatic enzyme secretion. PMID- 3654599 TI - Binding of linker histones to the core nucleosome. AB - Binding of chicken erythrocyte linker histones H1/H5 to the core nucleosome has been studied. Histones H1/H5 bind very efficiently to the isolated core nucleosome in vitro. The binding of linker histones to the core nucleosome is associated with aggregation of the particles. Approximately one molecule of linker histone binds per core nucleosome in the aggregates, irrespective of the concentration of the linker histones and the salt used. Histone H5 shows greater binding affinity to the core nucleosome as compared to H1. The carboxyl-terminal fragment of the linker histones binds strongly to the core nucleosome while the binding of the central globular domain is weak. Each core nucleosome is capable of binding two molecules of carboxyl-terminal fragment of linker histone. The core nucleosome containing one molecule of carboxyl-terminal fragment of linker histone requires higher salt concentration for aggregation while the core nucleosome containing two molecules of carboxyl-terminal fragment of linker histone can self-associate even at lower salt concentrations. On the basis of these results we are proposing a novel mechanism for the condensation of chromatin by linker histones and other related phenomena. PMID- 3654600 TI - Purification and characterization of wheat germ 2',3'-cyclic nucleotide 3' phosphodiesterase. AB - The 2',3'-cyclic nucleotide 3'-phosphodiesterase which hydrolyzes nucleoside 2',3'-cyclic phosphates (N greater than p) to nucleoside 2'-phosphates has been purified 16,000-fold to near homogeneity from wheat germ. The purified enzyme is a single polypeptide with a molecular weight of 23,000-24,000. It has a pH optimum of 7.0. The apparent Km values for A greater than p, G greater than p, C greater than p, and U greater than p are 13.1, 9.2, 25.2, and 25.3 mM, respectively. Vmax values for A greater than p, G greater than p, C greater than p, and U greater than p are 2090, 280, 2140, and 600 mumol/min/mg of purified protein, respectively. Wheat germ 2',3'-cyclic nucleotide 3'-phosphodiesterase does not hydrolyze 2',3'-cyclic esters in cyclic phosphate-terminated oligoribonucleotides or in nucleoside 5'-phosphate, 2',3'-cyclic phosphate (pN greater than p). This is in contrast to the 3'-phosphodiesterase activity associated with a wheat germ RNA ligase which hydrolyzes cyclic phosphate terminated oligonucleotides and pN greater than p substrates much more efficiently than nucleoside 2',3'-cyclic phosphates. The enzyme characterized in this work appears to be the only known 2',3'-cyclic nucleotide 3' phosphodiesterase specific for 2',3'-cyclic mononucleotides. PMID- 3654601 TI - Fatty acid oxidation in rat brain is limited by the low activity of 3-ketoacyl coenzyme A thiolase. AB - In an attempt to clarify why the brain oxidizes fatty acids poorly or not at all, the activities of beta-oxidation enzymes present in rat brain and rat heart mitochondria were measured and compared with each other. Although the apparent Km values and chain-length specificities of the brain and heart enzymes are similar, the specific activities of all but one brain enzyme are between 4 and 50% of those observed in heart mitochondria. The exception is 3-ketoacyl-CoA thiolase (EC 2.3.1.16) whose specific activity in brain mitochondria is 125 times lower than in heart mitochondria. The partially purified brain 3-ketoacyl-CoA thiolase was shown to be catalytically and immunologically identical with the heart enzyme. The low rate of fatty acid oxidation in brain mitochondria, estimated on the basis of palmitoylcarnitine-supported respiration and [1 14C]palmitoylcarnitine degradation to be less than 0.5 nmol/min/mg of protein, may be the consequence of the low activity of 3-ketoacyl-CoA thiolase. Inhibition of [1-14C]palmitoylcarnitine oxidation by 4-bromocrotonic acid proves the observed oxidation of fatty acids in brain to be dependent on 3-ketoacyl-CoA thiolase and thus to occur via beta-oxidation. Since the reactions catalyzed by carnitine palmitoyltransferase (EC 2.3.1.21) and acyl-CoA synthetase (EC 6.2.1.3) do not seem to restrict fatty acid oxidation in brain, it is concluded that the oxidation of fatty acids in rat brain is limited by the activity of the mitochondrial 3-keto-acyl-CoA thiolase. PMID- 3654602 TI - Synthesis and degradation of H1 histone subtypes in mouse lymphoma L5178Y cells. AB - H1 histone of mouse lymphoma L5178Y was fractionated into five subtypes, I-V, by Bio-Rex 70 column chromatography. The rates of synthesis of subtypes III and V were higher than those of I, II, and IV, as determined by the measurement of [3H]lysine incorporation. The degradation of the subtype was estimated assuming first order kinetics; subtypes III and V had half-lives of 18 h and 25 h, respectively, and the three other subtypes all had half-lives of 63 h. The syntheses of these subtypes during the cell cycle were examined using synchronized cultures. The syntheses of subtypes I, II, and IV started at the beginning of S phase, whereas those of III and V started in mid-S phase. The syntheses of III and V were at least 1.5-2 times more rapid than those of I, II, and IV, and their active synthesis was accompanied by their rapid degradation. The five subtypes of H1 were further characterized in relation to phosphorylation. Each showed characteristic differences in its synthetic pattern or phosphorylation, and we concluded that each H1 subtype has its own specific function at least in the process of replication of chromatin. PMID- 3654603 TI - Evidence for distinct pathways in rabbit renal brush-border membrane vesicles for the transport of unsubstituted and alpha-hydroxysubstituted aliphatic monocarboxylic acids. AB - We evaluated the effects of unsubstituted and hydroxymonocarboxylic acids on the kinetics of Na+-dependent L-lactate uptake in brush-border membrane vesicles prepared from the whole cortex of rabbit kidney. Acetate, propionate, and butyrate reversibly inhibited Na+-dependent L-lactate influx with [I]0.5 values of 5.5, 0.50, and 0.25 mM, respectively. Dixon plots (1/V versus acetate, propionate, and butyrate) were curved concavely downward, indicating partial inhibition. The Hill coefficients were approximately 1.0, suggesting that these anions interact at a single site on the Na+-L-lactate cotransporter. Acetate and the two other unsubstituted short-chain fatty acids tested decreased Na+ dependent L-lactate influx by increasing Km and decreasing Vmax, indicating mixed type inhibition. In contrast, Na+-dependent L-lactate uptake was competitively inhibited by alpha-hydroxybutyrate and D-lactate. Finally, evidence is presented to show that D-lactate and alpha-hydroxybutyrate are mutually exclusive inhibitors of Na+-dependent L-lactate influx. Results from this and recent studies are interpreted as indicating that distinct transport systems serve for unsubstituted and alpha-hydroxymonocarboxylic acids in renal brush-border membrane vesicles. PMID- 3654604 TI - Role of single disulfide in recombinant human tumor necrosis factor-alpha. AB - Two analogs of tumor necrosis factor-alpha (TNF-alpha) were produced by in vitro site-directed mutagenesis. In these analogs, cysteine residues at positions 69 and 101, which form a disulfide bond, were changed to alanine or leucine. CD spectra showed that the analogs are apparently similar in secondary and tertiary structure to the natural sequence TNF-alpha. In addition, the molecular size of the analogs was identical to that of the natural sequence TNF-alpha as determined by gel filtration. However, fluorescence spectra and quenching indicated that the removal of the disulfide bond alters the local conformation around tryptophan residues. The cytolytic, macrophage activation, and lipogenic activities decreased in the order of the natural sequence TNF-alpha greater than the alanine analog greater than the leucine analog, suggesting that the surface involving the disulfide bond plays a role in these biological functions and the introduced modifications decrease the activity. Differential effect of the modifications was suggested in the antiviral activity, since in this assay only the leucine analog showed significantly lower activity. PMID- 3654605 TI - Characterization of neutral blood group B-active glycosphingolipids of rat gastric mucosa. A novel type of blood group active glycosphingolipid based on isogloboside. AB - The blood group active glycosphingolipids of rat gastric mucosa have been investigated. Only blood group B active structures were found, two of which have been structurally characterized by monoclonal antibodies, mass spectrometry, permethylation analyses, proton NMR spectroscopy, and exoglycosidase digestions. A six-sugar compound based on a gangliotetraosylceramide core was isolated and shown to have the following structure: (Formula: see text). The same compound was recently isolated from rat bone marrow cells and characterized by Taki et al. (Taki, T., Kimura, H., Gasa, S., Nakamura, M., and Matsumoto, M. (1985) J. Biol. Chem. 260, 6219-6225). The possible precursor compounds of this structure, gangliotriaosylceramide and gangliotetraosylceramide, were also found in the gastric mucosa. A seven sugar compound, based on isogloboside, was isolated from the gastric mucosa and shown to have the following structure: (formula; see text) The latter compound is novel and extends the list of different types of core structures found for blood group glycolipids. The epithelial cells of the stomach are unique among the cells lining the gastrointestinal tract in having blood group active glycolipids based on ganglio- and isogloboseries core structures. PMID- 3654606 TI - Existence of endogenous inhibitors of platelet-activating factor (PAF) with PAF in rat uterus. AB - Two kinds of phospholipids in normal rat uterus were found to inhibit the aggregation of washed rabbit platelets induced by 1-alkyl-2-acetyl-sn-glycero-3 phosphocholine (alkylacetyl-GPC) and were named Inhibitor I and Inhibitor II and identified by mass spectrometry. Inhibitor I was a mixture of 1-acyl (16:0, 18:0, 18:1, 18:2, and 20:4)-2-lyso-sn-glycero-3-phosphocholine (acyllyso-GPC) and 1 alkyl (16:0, 18:0, and 18:1)-2-lyso-sn-glycero-3-phosphocholine (alkyllyso-GPC). 16:0 acyllyso-GPC was the most inhibitory, followed by 18:1, 18:2, 20:4, and 18:0 acyllyso-GPCs and 16:0 alkyllyso-GPC. Their IC50 values were in the range of 1-4 X 10(-5) M against the platelet aggregation induced by 1 X 10(-10) M 16:0 alkylacetyl-GPC, indicating that they were about 100 times weaker inhibitors than CV-3988. Inhibitor II was a mixture of N-acyl sphing-4-enyl phosphocholine (18:1/18:0, 18:1/20:0, 18:1/24:0, and 18:1/24:2). The most inhibitory of these components were 18:1/20:0 and 18:1/24:0, followed by 18:1/24:2 and 18:1/18:0, and their IC50 values were in the range of 4-5 X 10(-5) M against platelet aggregation induced by the alkylacetyl-GPC. Quantitatively, about 10(5) times higher concentrations of these inhibitors should be necessary to inhibit platelet aggregation induced by 1 X 10(-10) M 16:0 alkylacetyl-GPC. In fact, the contents of Inhibitors I and II, respectively, were approximately 10(5) times (4.7 X 10( 2) and 7.1 X 10(-2) mol/mol lipid-phosphorus of the original uterine phospholipids) than that of 16:0 alkylacetyl-GPC (1.4 X 10(-6) mol/mol lipid phosphorus). The role of alkylacetyl-GPC in normal rat uterus is uncertain, but it coexists in situ with two kinds of endogenous inhibitors, choline containing lysoglycerophospholipids and sphingophospholipids. PMID- 3654607 TI - Size and shape of bovine interphotoreceptor retinoid-binding protein by electron microscopy and hydrodynamic analysis. AB - Individual molecules of interphotoreceptor retinoid-binding protein (IRBP), a protein likely to be important in the visual cycle, were visualized by means of electron microscopy. IRBP was coated with a very thin layer of tungsten and photographed by dark-field imaging. IRBP is seen to be a flexible, elongated molecule about 24 nm in length by 3-4 nm in width (statistical modes). These dimensions agree very well with those calculated from the frictional ratio obtained from sedimentation data. Approximately half of these rod-shaped IRBP molecules are straight, and half are bent in the middle, usually with an angle of 60-90 degrees between the two arms. A representation of IRBP as a bendable string of beads yields calculations of dimensions and of hydrodynamic parameters consistent with the electron microscopic and sedimentation data; the sedimentation coefficients derived from this representation are nearly insensitive to molecular bending. When IRBP is bound to saturating amounts of its endogenous ligands, all-trans- or 11-cis-retinol, its sedimentation behavior is unchanged, and the same types of particles are visualized by electron microscopy as with the free protein; however, a greater proportion of the molecules are bent. Deglycosylation of IRBP (with peptide:N-glycosidase F) results in a somewhat smaller molecule that retains its rod-like shape, as shown by gel filtration and sedimentation data. The results indicate that IRBP is an elongated molecule and suggest that a structural change may occur upon ligand binding. PMID- 3654608 TI - Perturbation of N-linked oligosaccharide structure results in an altered incorporation of [3H]palmitate into specific proteins in Chinese hamster ovary cells. AB - Increased [3H]palmitate incorporation into specific cellular proteins has been reported to occur in Chinese hamster ovary (Wellner, R. B., Ray, B., Ghosh, P. C., and Wu, H. C. (1984) J. Biol. Chem. 259, 12788-12793) and yeast (Wen, D., and Schlesinger, M. J. (1984) Mol. Cell. Biol. 4, 688-694) mutant cells. In this paper we report studies concerning the relationship between N-linked oligosaccharide structure and [3H]palmitate incorporation into proteins of Chinese hamster ovary (CHO) cells. We have compared the incorporation of [3H]palmitate into proteins of wild-type and four different mutant CHO cell lines defective in various steps of N-linked protein glycosylation. Sodium dodecyl sulfate-gel electrophoretic analysis showed that three of the mutants exhibited increased [3H]palmitate incorporation into several CHO cellular proteins (approximately 30,000-38,000 molecular weight) as compared to the wild-type cells. One of the affected mutants which accumulates the Man5Gn2Asn intermediate structure was examined in detail. In agreement with earlier reports, virtually all of the [3H] palmitate-labeled proteins of both wild-type and mutant cell lines are membrane-bound. Pretreatment of the mutant cell line with tunicamycin blocked the increased [3H]palmitate incorporation into the two specific proteins (both of approximately 30,000 molecular weight) observed in untreated cells; the decreased incorporation of [3H]palmitate into the 30,000 molecular weight species was accompanied by a concomitant increase in the incorporation of [3H]palmitate into two proteins of approximately 20,000 molecular weight. Pretreatment of wild type cells with tunicamycin also caused increased [3H]palmitate incorporation into the 20,000 molecular weight species. Endoglycosidase H treatment of [3H]palmitate-labeled extracts from the mutant cell line resulted in the disappearance of the heavily labeled 30,000 molecular weight species and the appearance of intensely labeled 20,000 molecular weight species. Pretreatment of the mutant cell line with either castanospermine or deoxynojirimycin reduced the [3H]palmitate incorporation in to the 30,000 molecular weight species increased in untreated cells, but did not cause increased [3H]palmitate incorporation into the 20,000 molecular weight species. Our results indicate that perturbation of N linked oligosaccharide structure results in altered incorporation of [3H]palmitate into specific proteins in CHO cells. PMID- 3654609 TI - Diphtheria toxin receptor. Identification of specific diphtheria toxin-binding proteins on the surface of Vero and BS-C-1 cells. AB - The biochemical characteristics of specific receptor molecules for diphtheria toxin on the surface of two toxin-sensitive cell lines (Vero and BS-C-1) were examined. Diphtheria toxin was found to bind to a number of different proteins in Nonidet P-40 solubilized extracts of 125I-labeled cells. In contrast, permitting diphtheria toxin to bind first to labeled intact cells, which were subsequently solubilized and subjected to immunoprecipitation with anti-diphtheria toxin, resulted in a far more restricted profile of diphtheria toxin-binding proteins that possessed Mrs in the range of 10,000-20,000. Direct chemical cross-linking of radioiodinated diphtheria toxin to cell surface proteins resulted in the appearance of several predominant bands possessing Mrs of approximately 80,000. The Mr approximately 80,000 complexes were shown to be composed of radiolabeled diphtheria toxin (Mr 60,000) and unlabeled Mr approximately 20,000 cellular proteins. These complexes were judged to be a result of specific binding in that their appearance could be preferentially inhibited by the addition of a 100-fold excess of unlabeled diphtheria toxin. The formation of the Mr approximately 80,000 complexes was sensitive to prior trypsin treatment of the cells and to known inhibitors of diphtheria toxin binding. Furthermore, prior incubation of the cells with diphtheria toxin at 37 degrees C ("down regulation") markedly and specifically reduced the subsequent formation of the Mr approximately 80,000 cross-linked complexes, and these down-regulated cells were less sensitive to diphtheria toxin in cytotoxicity assays. Further incubation of down-regulated cells at 37 degrees C restored their ability to form Mr approximately 80,000 complexes; this regeneration requires protein synthesis and restores the cells' sensitivity to diphtheria toxin-mediated cytotoxicity. These results strongly suggest that a Mr 10,000-20,000 cell surface protein is, or constitutes a portion of, the functional diphtheria toxin receptor. PMID- 3654610 TI - Regulation of human growth hormone gene expression by insulin-like growth factor I in transfected cells. AB - Insulin-like growth factor I (IGF-I), a target hormone for growth hormone (GH) action, has been shown to regulate rat GH gene transcription. We further investigated its direct action on the human GH gene transfected in human choriocarcinoma cells (JEG3) which possess abundant IGF-I receptors. The 2.6 kilobase (kb) hGH gene (EcoRI fragment) in pUC18 (phGH) was transfected into cells by calcium-phosphate-dimethyl sulfoxide shock. The cells were subsequently treated for 72 h, when GH gene expression was measured. 8-Bromo-cAMP (Br-cAMP, 2.5 mM) and hydrocortisone (100 nM), respectively, stimulated GH secretion in transfected cells by 50% over unstimulated control cells, while combined treatment with these two agents caused a 340% increase of GH secretion as measured by radioimmunoassay. IGF-I (6.5 nM) did not suppress the basal level of Gh secretion but did inhibit the stimulated GH secretion by over 50%. Immunoprecipitation analysis showed that 8-Br-cAMP + hydrocortisone markedly increased newly synthesized 22-kDa [35S]GH. This de novo GH synthesis was inhibited by IGF-I. Northern gel analysis of poly(A) RNA showed that 8-Br-cAMP + hydrocortisone induced a 1.0-kb mRNA species as detected with 32P-labeled hGH cDNA. IGF-I suppressed the GH mRNA induced by cAMP + hydrocortisone as well as suppressing a larger 2.2-kb GH mRNA precursor. The results show that the transfected human GH gene was expressed and regulated in homologous cells. The 2.6-kb hGH fragment therefore contains non-tissue-specific cis-acting regulatory elements responsive to cAMP, hydrocortisone, and IGF-I. Specific IGF-I-responsive GH DNA sequences may therefore reside in the 0.5-kb 5'-flanking region, or in an intron, as described for hydrocortisone. PMID- 3654611 TI - Link protein interactions with hyaluronate and proteoglycans. Characterization of two distinct domains in bovine cartilage link proteins. AB - Hyaluronic acid-binding region and trypsin-link protein were prepared from bovine nasal cartilage proteoglycan complex after trypsin digestion. Binary complexes were reformed between trypsin-link protein and hyaluronic acid-binding region or hyaluronate. Upon trypsin treatment of these complexes, two fragments deriving from trypsin-link protein were characterized. One of them, of 20 kDa, corresponds in fact to a 140-amino acid long fragment and bears the glycosylated site of trypsin-link protein; it appears to be involved in proteoglycan/link protein interaction. The other, of 22 kDa, corresponds to the 200 C-terminal amino acids of trypsin-link protein; it appears to be involved in the binding of link protein with hyaluronic acid. A structural model of bovine trypsin-like protein depicting two distinct domains involved in hyaluronate and proteoglycan subunit interactions is proposed. PMID- 3654612 TI - Characterization of amino acid transport during erythroid cell differentiation. AB - We have studied the changes in amino acid transport in fetal erythroid cells isolated from rat fetal liver at different gestation days. Our results show that System A transport as measured by the Na+-dependent uptake of 2 (methylamino)isobutyric acid (MeAIB) was conspicuous at day 13 but virtually disappeared between days 16 and 18. In contrast, the activity of System ASC measured by the Na+-dependent uptake of MeAIB-insensitive threonine uptake increased after day 14 and was optimal between days 16 and 18. This transport system regressed in activity with further maturation, but remained conspicuously saturable in the matured red blood cell. Interestingly, the newly discovered Na+ independent System asc (Vadgama, J. V., and Christensen, H.N. (1985) J. Biol. Chem. 260, 2912-2921), selective for the uptake of test substrates threonine, serine, and alanine, was present in these erythroid cells. Its activity increased during gestation days 16-18. System L transport was present simultaneously with the Na+-independent System asc. As we had previously demonstrated for the pigeon red blood cell, these two transport systems are kinetically independent as confirmed with inhibition studies and the special selectivity of System L to trans stimulation. Tryptophan uptake could be attributed predominantly to System L, as also observed for the nucleated pigeon red blood cells and certain other cells. Arginine showed its familiar Na+-independent mode of uptake as a cation throughout the interval of study. An exceptional Na+-dependent component of arginine uptake emerged after day 14, peaked at day 18, and then disappeared on further maturation of the erythroid cell. PMID- 3654613 TI - Transcriptional and translational control of the message for transition protein 1, a major chromosomal protein of mammalian spermatids. AB - The spermatid transition proteins comprise a set of basic chromosomal proteins that appear during the period when spermatids are undergoing nuclear elongation and condensation, about midway between the end of meiosis and the release of spermatozoa from the seminiferous tubule. The transition proteins replace the histones but are themselves subsequently replaced by protamines, and they are not found in sperm nuclei. We have used a cDNA clone for the smallest transition protein (TP1, 54 amino acids) to show that its message first appears postmeiotically in late round spermatids. Thus production of TP1 is an example of haploid gene expression. The message remains translationally inactive for some 3 4 days before translation occurs in early elongating spermatids. While translationally repressed, TP1 message is nonpolysomal and has a discrete size of about 590 bases, including a 140 residue poly(A) tail. In contrast, polysome associated message is of heterogeneous size due to variability of poly(A) lengths. PMID- 3654614 TI - cDNA cloning and inducible expression during pregnancy of the mRNA for rabbit pulmonary prostaglandin omega-hydroxylase (cytochrome P-450p-2). AB - We have isolated cDNA clones of the mRNA for prostaglandin omega-hydroxylase (cytochrome P-450p-2) (Yamamoto, S., Kusunose, E., Ogita, K., Kaku, M., Ichihara, K., and Kusunose, M. (1984) J. Biochem. (Tokyo) 96, 593-603) in rabbit lung by using synthetic oligonucleotides as probes. The cDNA sequence contains an open reading frame of 1,470 nucleotides, the first 9 amino acids of which correspond to the residues 17-25 of cytochrome P-450p-2 determined from protein analysis. The predicted primary structure contains amino acid sequences of 23 tryptic fragments of cytochrome P-450p-2 and the deduced amino acid composition is in agreement with that determined from the purified protein. The complete polypeptide, including residues 1-16, contains 506 amino acids with a calculated molecular weight of 58,515. Cytochrome P-450p-2 shared 74% amino acid similarity with rat hepatic lauric acid omega-hydroxylase (cytochrome P-450LA omega) (Hardwick, J.P., Song, B.-J., Huberman, E., and Gonzalez, F. J. (1987) J. Biol. Chem. 262, 801-810), whereas it showed less than 25% similarity to other forms of cytochrome P-450, indicating that the two cytochrome P-450s constitute a unique cytochrome P-450 gene family. DNA blot analysis of the total genomic DNA of rabbits suggest the presence of several genes or gene-like DNA sequences which cross-hybridized with the cloned cDNA. RNA blot analysis showed that progesterone treatment increased the amount of mRNA hybridizable to the cDNA by about 100-fold in the lung of rabbits as compared with the basal level without the treatment. This high level of the mRNA was also observed in the lung of pregnant rabbits. PMID- 3654615 TI - Purification and quantitation of a rat plasma selenoprotein distinct from glutathione peroxidase using monoclonal antibodies. AB - Studies with 75Se have shown the existence of a rat plasma selenoprotein in addition to glutathione peroxidase. Because the function of the protein is not known, it has been referred to as selenoprotein P. A partially purified preparation was used to produce a monoclonal antibody to selenoprotein P. The antibody did not bind glutathione peroxidase as evidenced by its failure to remove glutathione peroxidase activity from rat plasma by immunoprecipitation. An immunoaffinity column was prepared with the monoclonal antibody, and selenoprotein P was purified 1270-fold from rat plasma in a two-step procedure. The purified selenoprotein P migrated in a single band with an Mr of 57,000 on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Autoradiography demonstrated that this band contained 75Se when the protein was purified from rats which had received 75SeO2-(3). A competitive radioimmunoassay for selenoprotein P was developed. The selenoprotein P concentration in plasma of selenium-replete rats was determined with this assay to be 51 +/- 3.7 micrograms/ml. It was less than 5 micrograms/ml in plasma from selenium-deficient rats. Injection of 50 micrograms of selenium into selenium-deficient rats caused an increase in selenoprotein P from less than 10% of control to 52% of control in 6 h. Plasma glutathione peroxidase activity increased only from 2.2 to 3.1% of control. These experiments demonstrate that rat plasma contains a selenoprotein distinct from glutathione peroxidase. The concentration of this selenoprotein is depressed in selenium deficiency, as is glutathione peroxidase activity, but selenoprotein P increases more rapidly when selenium is supplied than does glutathione peroxidase activity. PMID- 3654616 TI - Formation of a covalent disulfide-linked antithrombin-albumin complex by an antithrombin variant, antithrombin "Northwick Park". AB - Antithrombin is a major proteinase inhibitor of the blood coagulation system. Its inherited deficiency or abnormality is often associated with thromboembolism. Antithrombin "Northwick Park," a functionally inactive variant antithrombin, has recently been shown by us (Lane, D.A., Flynn, A., Ireland, H., Erdjument, H., Samson, D., Howarth, D., and Thompson, E. (1987) Br. J. Haematol. 65,451-456) to be present in plasma, in part, as a high Mr (approximately 120,000) component which has a characteristic electrophoretic mobility in agarose gels in the absence of denaturing agents. In this communication, we present evidence that this Mr approximately 120,000 variant component is comprised of an antithrombin albumin covalent disulfide-linked complex. This proposal is supported by results of: (a) fast atom bombardment mass spectrometry of the isolated reduced, S carboxymethylated, trypsin-digested Mr approximately 120,000 complex; (b) sodium dodecyl sulfate-polyacrylamide gel electrophoresis of this complex and its reduced and S-carboxymethylated constituents; (c) immunoblotting of these polyacrylamide gels with antisera specific for antithrombin and albumin; (d) NH2 terminal sequence analysis of one of the isolated, S-carboxymethylated proteins that comprise the Mr approximately 120,000 complex; and (e) fast atom bombardment mass spectrometry of its tryptic peptides. PMID- 3654617 TI - Stabilization of iron in a ferrous form by ferritin. A study using dispersive and conventional x-ray absorption spectroscopy. AB - Stabilization of iron in a bioavailable form is the function of ferritin, a protein of 24 subunits forming a coat around a core of less than or equal to 4500 hydrated iron atoms. The core of ferritin isolated from tissues contains Fe3+, but Fe2+ is required for experimental core formation in protein coats; reduction of Fe3+ to Fe2+ facilitates iron removal from protein coats. Using the differences in x-ray absorption spectra (x-ray absorption near edge structure) between Fe2+ and Fe3+ to monitor reconstitution of ferritin from Fe2+ and protein coats, we observed stabilization of Fe2+, apparently inside the coat. Mixtures of Fe2+ and Fe3+ persisted for greater than or equal to 16 h in air indicating that, in vivo, some iron in ferritin could be stored as Fe2+ and with Fe3+ could yield magnetite. PMID- 3654618 TI - Definition of IgG- and albumin-binding regions of streptococcal protein G. AB - Protein G, the immunoglobin G-binding surface protein of group C and G streptococci, also binds serum albumin. The albumin-binding site on protein G is distinct from the immunoglobulin G-binding site. By mild acid hydrolysis of the papain-liberated protein G fragment (35 kDa), a 28-kDa fragment was produced which retained full immunoglobulin G-binding activity (determined by Scatchard plotting) but had lost all albumin-binding capacity. A protein G (65 kDa), isolated after cloning and expression of the protein G gene in Escherichia coli, had comparable affinity to immunoglobulin G (5-10 X 10(10)M-1), but much higher affinity to albumin than the 35- and 28-kDa protein G fragments (31, 2.6, and 0 X 10(9)M-1, respectively). The amino-terminal amino acid sequences of the 65-, 35-, and 28-kDa fragments allowed us to exactly locate the three fragments in an overall sequence map of protein G, based on the partial gene sequences published by Guss et al. (Guss, B., Eliasson, M., Olsson, A., Uhlen, M., Frej, A.-K., Jornvall, H., Flock, J.-I., and Lindberg, M. (1986) EMBO J. 5, 1567-1575) and Fahnestock et al. (Fahnestock, S. R., Alexander, P., Nagle, J., and Filpula, D. (1986) J. Bacteriol. 167, 870-880). In this map could then be deduced the location of three homologous albumin-binding regions and three homologous immunoglobulin G-binding regions. PMID- 3654619 TI - Structure, position, and biosynthesis of the high mannose and the complex oligosaccharide side chains of the bean storage protein phaseolin. AB - Phaseolin, the major storage protein of the common bean (Phaseolus vulgaris), is a glycoprotein which is synthesized during seed development and accumulates in protein storage vacuoles or protein bodies. The protein has three different N linked oligosaccharide side chains: Man9(GlcNAc)2, Man7(GlcNAc)2, and Xyl Man3(GlcNAc)2 (where Xyl represents xylose). The structures of these glycans were determined by 1H NMR spectroscopy. The Man9(GlcNAc)2 glycan has the typical structure found in plant and animal glycoproteins. The structures of the two other glycans are shown below. (Formula; see text) Phaseolin was separated by electrophoresis on denaturing gels into four size classes of polypeptides. The two abundant ones have two oligosaccharides each, whereas the less abundant ones have only one oligosaccharide each. Polypeptides with two glycans have Man7(GlcNAc)2 attached to Asn252 and Man9(GlcNAc)2 attached to Asn341. Polypeptides with only one glycan have Xyl-Man3(GlcNAc)2 attached to Asn252. Both these asparagine residues are in canonical glycosylation sites; the numbering starts with the N-terminal methionine of the signal peptide of phaseolin. The presence of the Man7(GlcNAc)2 and of Xyl-Man3(GlcNAc)2 at the same asparagine residue (position 252) of different polypeptides seems to be controlled by the glycosylation status of Asn341. When Asp341 is unoccupied, the glycan at Asn252 is complex. When Asn341 is occupied, the glycan at Asn252 is only modified to the extent that 2 mannosyl residues are removed. The processing of the glycans, after the removal of the glucose residues, involves enzymes in the Golgi apparatus as well as in the protein bodies. Formation of the Xyl-Man3(GlcNAc)2 glycan is a multistep process that involves the Golgi apparatus-mediated removal of 6 mannose residues and the addition of 2 N-acetylglucosamine residues and 1 xylose. The terminal N-acetylglucosamine residues are later removed in the protein bodies. The conversion of Man9(GlcNAc)2 to Man7(GlcNAc)2 is a late processing event which occurs in the protein bodies. Experiments in which [3H]glucosamine-labeled phaseolin obtained from the endoplasmic reticulum (i.e. precursor phaseolin) is incubated with jack bean alpha-mannosidase show that the high mannose glycan on Asn252, but not the one on Asn341, is susceptible to enzyme degradation. Incubation of [3H] glucosamine-labeled phaseolin obtained from the Golgi apparatus with jack bean beta-N-acetylglucosaminidase results in the removal of the terminal N-acetylglucosamine residues from the complex chain.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3654620 TI - Inhibition of human choriotropin binding to receptor by human choriotropin alpha peptides. A comprehensive synthetic approach. AB - Synthetic overlapping peptides of the alpha-subunit of human chorionic gonadotropin (hCG) were made by solid-phase peptide synthesis employing a comprehensive synthetic approach. The entire primary structure of the alpha subunit was synthesized as a series of nine consecutive peptides, each 15 residues in length, and overlapping with its two adjacent neighbors by 5 residues on each side. Receptor binding activity of each synthetic peptide was measured by the inhibition of binding of 125I-labeled hCG to rat ovarian receptor. Peptides alpha 21-35, alpha 31-45, alpha 71-85, and alpha 81-92 were shown to compete for binding with native hCG, thus demonstrating that at least two regions on the alpha-subunit may be part of the binding site(s) of the hormone. The low affinity of the peptides (10(-5)-10(-6) M) compared to native hormone (10(-10) M) for receptor is not unexpected due to the probability of discontinuous and multiple sites involved in receptor binding. An ultrapure preparation of hCG alpha-subunit also had low affinity (10(-5), suggesting that conformational changes upon combination with beta-subunit to form dimer or changes in conformation after binding are necessary for high affinity interaction. These results correlate with previous predictions of binding sites based on studies employing chemical and enzymatic modifications of intact hormone and show that synthetic peptide strategies are helpful in the elucidation of protein structure and function. PMID- 3654621 TI - Purification and characterization of a novel mycolic acid exchange enzyme from Mycobacterium smegmatis. AB - We have isolated and purified to homogeneity an alpha,alpha'-trehalose 6 monomycolate:alpha,alpha'-trehalose mycolyltransferase (trehalose mycolyltransferase) from Mycobacterium smegmatis that catalyzes the exchange of a mycolyl group between trehalose, trehalose 6-monomycolate (TM), and trehalose 6,6'-dimycolate (TD). This enzyme was prominent in M. smegmatis and it catalyzed the following reactions. TM + [14C]trehalose in equilibrium [14C]TM + trehalose [14C]TM + TM in equilibrium [14C]TD + trehalose This enzyme was purified by (i) ammonium sulfate fractionation, (ii) QAE-Sephadex A-50 column chromatography, (iii) gel filtration on a Sephadex G-75 column, and (iv) SP-Sephadex C-50 column chromatography. The purified protein yielded a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and its molecular weight was estimated to be 25,000. This enzyme was a glycoprotein, had no cofactor requirement, and was highly specific for alpha,alpha'-trehalose as the mycolate acceptor. It was less specific for the acyl donor group since the palmitoyl group in trehalose 6-monopalmitate was easily exchangeable. There was no TM acylhydrolase activity in the purified enzyme, suggesting that it is probably associated with the anabolic pathway of mycolic acid metabolism. We postulate the formation of a mycolyl-enzyme intermediate in this reaction. Such an intermediate could play a central role in the transfer of mycolic acid to form the prominent cell wall components of mycobacterial TD and possibly murein-arabinogalactan mycolate. PMID- 3654622 TI - The Mr 24,000 phosphoprotein from developing bone is the NH2-terminal propeptide of the alpha 1 chain of type I collagen. AB - Using nondegradative isolation procedures, we have purified and characterized the Mr 24,000 phosphoprotein from developing bovine and human bone where it constitutes 5% of the noncollagenous protein in the mineral compartment. This hydroxyproline-containing protein could not be cleaved by cyanogen bromide. The purified, intact product spontaneously formed a complex consistent with a collagen-like trimer that remained a trimer even in sodium dodecyl sulfate polyacrylamide gels. The ability to form the complex was lost upon treatment with bacterial collagenase, a treatment that resulted in an NH2-terminally blocked fragment of Mr 17,000. After deblocking, the NH2-terminus of the intact, Mr 24,000 bovine product was shown to have virtually the same amino acid sequence (residues 1-24 with asparagine rather than aspartic acid at position 20 as reported earlier by Horlein et al. (Horlein, D., Fietzek, P. P., Wachter, E., Lapiere, C. M., and Kuhn, K. (1979) Eur. J. Biochem. 90, 31-38) as the amino terminal segment of dermatosparatic calf skin alpha 1 type I procollagen. Furthermore, pulse-chase studies showed a precursor-product relationship between procollagen and the Mr 24,000 protein. Anti-serum made against the bovine bone protein bound to bands on electrotransfers that were consistent with the positions of both alpha 1(I) procollagen and the procollagen chain missing its COOH-terminal extension peptide (pN-alpha 1(I), as well as the original Mr 24,000 product in extracts of bone, skin, tendon, cornea, and other type I collagen containing tissues. Fetal calf serum contained an average of 106 micrograms/ml of the Mr 24,000 protein as determined by quantitative enzyme-linked immunosorbent assay. The only serine residue in the bovine bone protein was phosphorylated. It is unknown whether the corresponding collagen NH2-terminal pro-peptides in other tissues and serum are similarly phosphorylated. PMID- 3654623 TI - Hydrodynamics of concentrated proteoglycan solutions. AB - The dynamics of water transport in proteoglycan compartments has been studied in relation to osmotic flow (proteoglycan diffusion) and hydraulic permeability (proteoglycan sedimentation) in concentrated solutions of proteoglycan subunit and native proteoglycan aggregate isolated from Swarm rat chondrosarcoma. A central parameter that describes the kinetics of both types of water movement is the hydrodynamic frictional coefficient of water with proteoglycan. The frictional coefficient is markedly concentration dependent, increasing with increasing concentration, and highlights important structural features and types of organization of the proteoglycans in concentrated solutions. These include the requirements that proteoglycans in the extracellular matrix not to be immobilized but to have translational diffusive mobility and concentration gradients to be osmotically active, that chondroitin sulfate segmental mobility describing translational motion largely determines osmotic flow and hydraulic permeability of the proteoglycans, and that the proteoglycans exhibit an enhanced ability to resist flow as compared to other macromolecules. Additional dynamic studies suggest the formation of transient super-aggregate structures may occur at high concentrations which endows the proteoglycan subunit hydrodynamic properties similar to proteoglycan aggregate. PMID- 3654624 TI - Evidence for self-association of prothrombin fragment 1 in the absence of calcium ions. Implications for the interpretation of cooperativity of calcium binding. AB - Sedimentation equilibrium studies have demonstrated that prothrombin fragment 1 from either human or bovine plasma reversibly dimerizes in the absence of Ca2+ with an equilibrium constant of 1,000 M-1. In the presence of 10 mM Ca2+ this association constant increased to 10,000 M-1. A model for preferential binding of Ca2+ to the pre-existing dimer has been found capable of accounting quantitatively for the cooperative Ca2+ binding to this prothrombin fragment, and for the dependence of its sedimentation coefficient on protein concentration in the presence and absence of metal ion. Sedimentation equilibrium studies of intact bovine and human prothrombins have confirmed previous reports that these prothrombins dimerize. For both prothrombins the association constant is 10,000 M 1, both in the absence and presence of Ca2+. PMID- 3654625 TI - The activation of porcine pancreatic phospholipase A2 by dipalmitoylphosphatidylcholine large unilamellar vesicles. Analysis of the state of aggregation of the activated enzyme. AB - Previous work from this laboratory and others has shown that the hydrolysis of pure dipalmitoylphosphatidylcholine (DPPC) liposomes by porcine pancreatic phospholipase A2 in the vicinity of the gel-to-liquid crystal phase transition is characterized by a slow initial phase followed by an apparent burst of activity. In this article we report a detailed quantitative analysis of the early time course of the hydrolysis of dipalmitoylphosphatidylcholine large unilamellar vesicles at 38 degrees C. Several kinetic models to quantitatively describe the data were considered. The most conservative model consistent with the kinetic data is one in which the enzyme initially binds the bilayer and becomes activated via a process that requires the formation of protein dimers on the surface of the membrane. The relevant kinetic parameters of the model are reported. PMID- 3654626 TI - Reductions in methotrexate and folate influx in methotrexate-resistant lines of Leishmania major are independent of R or H region amplification. AB - The methotrexate (MTX) and folate transport properties of five MTX-resistant lines of Leishmania major have been examined. These resistant lines all show a decreased Vmax for MTX influx, with no change in apparent affinity (Kt). The Vmax of folate influx is also proportionately decreased without alteration in Kt, supporting our proposal that there is a single carrier mediating influx of both ligands. Amplifications of two regions of DNA, the R region (encoding dihydrofolate reductase-thymidylate synthase) and the H region (Beverley, S.M., Coderre, J.A., Santi, D.V., and Schimke, R.T. (1984) Cell 38, 431-439), were also observed. In a given line, the amplifications occurred singly, in combination, or not at all. No other regions of amplification were detected. The phenotype of reduced MTX transport was moderately stable in the highly resistant R1000 line, being retained for more than 200 generations in the absence of MTX in vitro and during one passage through an infected mouse; in contrast, R- and H-amplified DNA were less stable. The lack of correlation of R and H amplification with reduced MTX transport suggests that alterations in transport are not causally mediated by gene amplification in Leishmania, but are a separate mode of MTX resistance. The onset of decreased MTX transport was also examined; wild-type Leishmania developed a reduced Vmax of MTX influx within 24 h following exposure to 1 microM MTX, which is extremely unstable in the absence of drug pressure. A comparable decrease in the Vmax of influx is seen in cells exposed to MTX in media in which cytotoxicity is eliminated. As the folate/MTX transporter is regulated by exogenous folate, these data suggest that the initial rapid decrease in MTX transport may be a cellular regulatory response, in contrast to that found within the R1000 line which resembles a more stable genetic mutation. PMID- 3654627 TI - Affinity labeling of the catalytic and AMP allosteric sites of 3-hydroxy-3 methylglutaryl-coenzyme A reductase kinase by 5'-p fluorosulfonylbenzoyladenosine. AB - The nucleotide analogue 5'-p-fluorosulfonylbenzoyladenosine (FSBA) reacts irreversibly with rat liver cytosolic 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase kinase, causing a rapid loss of the AMP activation capacity and a slower inactivation of the catalytic activity. The rate constant for loss of AMP activation is about 10 times higher (kappa 1 = 0.112 min-1) than the rate constant of inactivation (kappa 2 = 0.0106 min-1). There is a good correspondence between the time-dependent inactivation of reductase kinase and the time dependent incorporation of 5'-p-sulfonylbenzoyl[14C]adenosine ([14C]SBA). An average of 1.65 mol of reagent/mol of enzyme subunit is bound when reductase kinase is completely inactivated. The time-dependent incorporation is consistent with the postulate that covalent reaction of 1 mol of SBA/mol of subunit causes complete loss of AMP activation, whereas reaction of another mole of SBA/mol of subunit would lead to total inactivation. Protection against inactivation by the reagent is provided by the addition of Mg2+, AMP, Mg-ATP, or Mg-AMP to the incubation mixtures. In contrast, addition of ATP, 2'-AMP, or 3'-AMP has no effect on the rate constants. Mg-ATP protects preferentially the catalytic site against inactivation, whereas Mg-AMP at low concentration protects preferentially the allosteric site. Mg-ADP affords less protection than Mg-AMP to the allosteric site when both nucleotides are present at a concentration of 50 microM with 7.5 mM Mg2+. Experiments done with [14C]FSBA in the presence of some protectants have shown that a close correlation exists between the pattern of protection observed and the binding of [14C]SBA. The postulate is that there exists a catalytic site and an allosteric site in the reductase kinase subunit and that Mg-AMP is the main allosteric activator of the enzyme. PMID- 3654628 TI - Degradation and resynthesis of adenine nucleotides in adult rat heart myocytes. AB - The degradation and short-term resynthesis of adenine nucleotides have been examined in a preparation of isolated rat heart myocytes. These myocyte preparations are essentially free of vascular and endothelial cells, contain levels of adenine nucleotides quite comparable to those of intact heart tissue, and retain these components remarkably well for up to 2 h of aerobic incubation in the presence of 1 mM Ca2+. When the cells are rapidly and synchronously de energized by addition of uncoupler, an inhibitor of respiration and iodoacetate, cellular ATP is degraded almost quantitatively to AMP. The AMP is then converted to either intracellular adenosine, which accumulates to high concentrations before release to the cell exterior, or to IMP. The relative contribution of these two pathways depends on the metabolic state of the cells just prior to de energization, with IMP production favored when respiring cells are de-energized and adenosine formation predominant when glycolyzing myocytes are subjected to this treatment. Cells de-energized by anaerobiosis in the absence of glucose lose ATP and adenine nucleotides with the production of IMP and adenosine. Upon reoxygenation, these cells restore a high adenylate energy charge and about 60% of control levels of GTP. There is a net resynthesis of 5-7 nmol of adenine nucleotides.mg-1 protein with a corresponding decline in IMP. Added [14C]adenosine labels the adenine nucleotide pool, but little net resynthesis of adenine nucleotides via adenosine kinase can be detected. It therefore appears that a rapid regeneration of adenine nucleotides can occur via the enzymes of the purine nucleotide cycle in heart myocytes and is limited by the size of the IMP pool retained. PMID- 3654629 TI - P-450 HFLa, a form of cytochrome P-450 purified from human fetal livers, is the 16 alpha-hydroxylase of dehydroepiandrosterone 3-sulfate. AB - In a reconstituted system containing NADPH, dilauroyl-L-3-phosphatidylcholine, and NADPH-cytochrome P-450 reductase purified from rat liver microsomes, cytochrome P-450 (P-450 HFLa) purified from human fetal livers catalyzed the 16 alpha-hydroxylation of dehydroepiandrosterone 3-sulfate (DHEA-sulfate). Addition of cytochrome b5 purified from rat liver microsomes to the reconstituted system resulted in a remarkable increase in the hydroxylase activity. The level of P-450 HFLa in liver homogenates from human fetuses highly correlated with the activity of DHEA-sulfate 16 alpha-hydroxylase. Antibodies to P-450 HFLa inhibited the 16 alpha-hydroxylation of DHEA-sulfate in a dose-dependent manner. The NH2-terminal amino acid sequence of P-450 HFLa was similar to that of P-450NF (Beaune, P. H., Umbenhauer, D. R., Bork, R. W., Lloyd, R. S., and Guengerich, F. P. (1986) Proc. Natl. Acad. Sci. U. S. A. 83, 8064-8068). We conclude that P-450 HFLa is a form of cytochrome P-450 involved in the 16 alpha-hydroxylation of DHEA-sulfate. PMID- 3654630 TI - Characterization of affinity-purified juvenile hormone esterase from Trichoplusia ni. AB - Juvenile hormone (JH) esterase was purified greater than 1000-fold in one step from hemolymph and whole larval homogenates from the last larval instar of Trichoplusia ni to give a single diffuse band that migrates at Mr = 64,000 on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The purification was based on an affinity chromatography procedure that employs trifluoromethyl ketone ligands. Isoelectric focusing of the purified preparations resulted in multiple bands that coincided to all significant hydrolysis of juvenile hormone detected in this manner. Kinetic experiments using optically pure enantiomers of JH II as substrates showed the two main electromorphs of JH esterase from the hemolymph to have apparently identical kinetic parameters as well as a similar capability to distinguish between substrates that differ in the orientation of the epoxide moiety of JH. However, the enzyme could hydrolyze esters lacking the JH structure. The proteins were shown to be monomers and to have asparagine-linked oligosaccharides, most likely of hybrid structure. Immunochemical and other evidence showed that the affinity-purified proteins were responsible for all significant JH esterase activity during periods of rapid esterolysis in vivo. PMID- 3654631 TI - Dihydrotestosterone blocks fetal lung fibroblast-pneumonocyte factor at a pretranslational level. AB - Fibroblast pneumonocyte factor (FPF) synthesis by fetal rat lung fibroblasts is augmented during gestation in the presence of cortisol. The control and cortisol augmented levels of FPF production, as determined by FPF ability to stimulate saturated phosphotidylcholine synthesis by lung epithelial Type II cells, is delayed during development in fibroblasts derived from male fetuses as compared to those derived from female fetuses. The mechanism by which this delay occurs has been addressed. Pregnant rats treated in vivo with dihydrotestosterone (DHT) showed decreased FPF activity from control or cortisol-treated fibroblasts derived from 20-day-old male or female fetuses. In vitro translated proteins of size-fractionated lung RNA from 19-day-old fibroblasts that were pretreated with DHT in vitro showed decreased FPF activity compared to nontreated samples. This decreased FPF activity was present even if the DHT-pretreated cells were stimulated with cortisol prior to RNA preparation. Using a mouse model of testicular feminization that contains no receptors for androgens showed no change in the cortisol augmented FPF activity when the fibroblasts were pretreated with DHT. These data taken together suggest that the delayed FPF production of male derived lung fibroblasts is a physiologic process which requires androgen receptors, and the mechanism by which androgens inhibit FPF production appears to affect events occurring mainly at a pretranslational level. PMID- 3654632 TI - Proteoglycans of fetal bovine tendon. AB - The proteoglycans (PG) of bovine fetal tendon (4-8 months in utero) were extracted with 4 M guanidine HCl and partially purified by ion exchange chromatography. Proteoglycans from fetal tendon were virtually entirely small molecules (Kav approximately equal to 0.55 by Sepharose CL-4B chromatography). These small proteoglycans had dermatan sulfate glycosaminoglycan chains and a core protein (after chondroitinase ABC digestion) with Mr approximately equal to 45,000 on sodium dodecyl sulfate-polyacrylamide gels. By electrophoretic mobility, immunocross-reactivity, and V8 protease sensitivity, these proteoglycans were determined to be of both PG I and PG II types. In contrast, adult tendon contains only the PG II type of small proteoglycan. Proteoglycans synthesized by fetal tendon explant cultures were, by both chromatographic and electrophoretic mobilities, somewhat larger than those extracted from the same tissue. There was no difference in the spectrum of proteoglycans observed between those regions of fetal tendon destined to receive only tensional forces (proximal) and those regions that will be subjected as well to compressive forces (distal) in the adult. These observations indicate that the proteoglycan content and synthetic capability of all regions of fetal tendon are constant and significantly different from those of both the tensional and fibrocartilaginous regions of adult tendon. PMID- 3654633 TI - Effect of rigor and cycling cross-bridges on the structure of troponin C and on the Ca2+ affinity of the Ca2+-specific regulatory sites in skinned rabbit psoas fibers. AB - Intrinsic troponin C (TnC) was extracted from small bundles of rabbit psoas fibers and replaced with TnC labeled with dansylaziridine (5 dimethylaminonaphthalene-1-sulfonyl). The flourescence of incorporated dansylaziridine-labeled TnC was enhanced by the binding of Ca2+ to the Ca2+ specific (regulatory) sites of TnC and was measured simultaneously with force (Zot, H.G., Guth, K., and Potter, J.D. (1986) J. Biol. Chem. 261, 15883-15890). Various myosin cross-bridge states also altered the fluorescence of dansylaziridine-labeled TnC in the filament, with cycling cross-bridges having a greater effect than rigor cross-bridges; and in both cases, there was an additional effect of Ca2+. The paired fluorescence and tension data were used to calculate the apparent Ca2+ affinity of the regulatory sites in the thin filament and were shown to increase at least 10-fold during muscle activation presumably due to the interaction of cycling cross-bridges with the thin filament. The cross bridge state responsible for this enhanced Ca2+ affinity was shown to be the myosin-ADP state present only when cross-bridges are cycling. The steepness of the pCa force curves (where pCa represents the -log of the free Ca2+ concentration) obtained in the presence of ATP at short and long sarcomere lengths was the same, suggesting that cooperative interactions between adjacent troponin-tropomyosin units may spread along much of the actin filament when cross bridges are attached to it. In contrast to the cycling cross-bridges, rigor bridges only increased the Ca2+ affinity of the regulatory sites 2-fold. Taken together, the results presented here indicate a strong coupling between the Ca2+ regulatory sites and cross-bridge interactions with the thin filament. PMID- 3654634 TI - Effect of apolipoprotein E-free high density lipoproteins on cholesterol metabolism in cultured pig hepatocytes. AB - We studied cholesterol synthesis from [14C]acetate, cholesterol esterification from [14C]oleate, and cellular cholesterol and cholesteryl ester levels after incubating cells with apoE-free high density lipoproteins (HDL) or low density lipoproteins (LDL). LDL suppressed synthesis by up to 60%, stimulated esterification by up to 280%, and increased cell cholesteryl ester content about 4-fold. Esterification increased within 2 h, but synthesis was not suppressed until after 6 h. ApoE-free HDL suppressed esterification by about 50% within 2 h. Cholesterol synthesis was changed very little within 6 h, unless esterification was maximally suppressed; synthesis was then stimulated about 4-fold. HDL lowered cellular unesterified cholesterol by 13-20% within 2 h and promoted the removal of newly synthesized cholesterol and cholesteryl esters. These changes were transient; by 24 h, both esterification and cellular unesterified cholesterol returned to control levels, and cholesteryl esters increased 2-3-fold. HDL core lipid was taken up selectively from 125I-labeled [3H]cholesteryl ester- and ether labeled HDL. LDL core lipid uptake was proportional to LDL apoprotein uptake. The findings suggest that 1) the cells respond initially to HDL or LDL with changes in esterification, and 2) HDL mediates both the removal of free cholesterol from the cell and the delivery of HDL cholesteryl esters to the cell. PMID- 3654635 TI - Transfected human neuropeptide Y cDNA expression in mouse pituitary cells. Inducible high expression, peptide characterization, and secretion. AB - An expression vector was constructed that placed the cDNA for human neuropeptide Y (NPY) under the control of the mouse metallothionein promoter and was used to transfect the AtT-20 mouse anterior pituitary corticotrope cell line. AtT-20 cells normally process the pro-ACTH/endorphin precursor but do not produce detectable levels of NPY. The resulting AtT-20/NPY cell line (Mt.NPY1a) was used to study the ability of the corticotrope cells to synthesize, process, and secrete the foreign proNPY-related peptide products. The stable cell line created contains approximately 40 copies of proNPY cDNA per cell. NPY mRNA levels and proNPY synthesis were increased at least 35-fold when maximally induced with cadmium; proNPY synthesis was also induced by glucocorticoids. Upon induction the NPY secretion rate was equimolar to that of the endogenous peptides. ProNPY, NPY, and the COOH-terminal peptide produced by this cell line had molecular weight and amino acid-labeling pattern predicted from cDNA sequence data and from previous isolation of NPY-related molecules from NPY-producing cells. The structures of secreted proNPY, NPY, and COOH-terminal peptide, as well as determination of the site of proteolytic cleavage between NPY and the COOH-terminal peptide, were determined by tryptic mapping and Edman degradation of secreted biosynthetically labeled peptide products. The proNPY molecule appears to be processed in the same pathway responsible for cleavage of the endogenous pro-ACTH/endorphin precursor. Secretion of proNPY-derived peptides paralleled secretion of endogenous pro ACTH/endorphin-derived products, under both basal and stimulated conditions. With induction proNPY expression there is a dose-dependent inhibition of both proNPY and pro-ACTH/endorphin proteolytic processing. PMID- 3654636 TI - Fusion of membrane vesicles bearing only the influenza hemagglutinin with erythrocytes, living cultured cells, and liposomes. AB - Membrane vesicles, bearing only the influenza viral hemagglutinin glycoprotein, were reconstituted following solubilization of intact virions with Triton X-100. The viral hemagglutinin glycoprotein was separated from the neuraminidase glycoprotein by agarose sulfanilic acid column. The hemagglutinin glycoprotein obtained was homogenous in gel electrophoresis and devoid of any neuraminidase activity. A quantitative determination revealed that the hemolytic activity of the hemagglutinin vesicles was comparable to that of intact virions. Incubation of fluorescently labeled hemagglutinin vesicles with human erythrocyte ghosts (HEG) or with liposomes composed of phosphatidylcholine/cholesterol or phosphatidylcholine/cholesterol/gangliosides, at pH 5.0 but not at pH 7.4, resulted in fluorescence dequenching. Very little, if any, fluorescence dequenching was observed upon incubation of fluorescently labeled HA vesicles with neuraminidase or glutaraldehyde-treated HEG or with liposomes composed only of phosphatidylcholine. Hemagglutinin vesicles were rendered non-hemolytic by treatment with NH2OH or glutaraldehyde or by incubation at 85 degrees C or low pH. No fluorescence dequenching was observed following incubation of non hemolytic hemagglutinin vesicles with HEG or liposomes. These results clearly suggest that the fluorescence dequenching observed is due to fusion between the hemagglutinin vesicles and the recipient membranes. Incubation of hemagglutinin vesicles with living cultured cells, i.e. mouse lymphoma S-49 cells, at pH 5.0 as well as at pH 7.4, also resulted in fluorescence dequenching. The fluorescence dequenching observed at pH 7.4 was inhibited by lysosomotropic agents (methylamine and ammonium chloride) as well as by EDTA and NaN3, indicating that it is due to fusion of hemagglutinin vesicles taken into the cells by endocytosis. PMID- 3654637 TI - Isolation and characterization of ferritin from soyabeans (Glycine max). AB - Ferritin from the soyabean Glycine max was isolated and characterized. The protein has many features in common with ferritin from mammalian systems, including extensive sequence homology, as determined by two-dimensional peptide mapping. No immunocross-reactivity between the plant and animal proteins was detected. The ferritin isolated by MgCl2 precipitation has a single subunit of 28 kDa, whereas the ferritin remaining in the supernatant exhibits marked heterogeneity, with a main subunit of 22 kDa. This form of the protein appears to be the result of specific proteolytic processing that is not affected by serine protease inhibitors, and appears only after the seeds have been soaked long enough to induce germination. The appearance of the 22-kDa form corresponds to the appearance of "crystalline arrays" of ferritin in the amyloplasts of the plant cotyledons and may represent a plant form of hemosiderin. In support of this hypothesis, the 22-kDa protein appears to be incompletely assembled, as determined by sucrose gradient centrifugation and iron uptake studies. Although ferritin is normally quite resistant to proteolysis, the 22-kDa protein is easily generated from the 28-kDa form by treatment with subtilisin, suggesting the presence of a specific, protease-sensitive sequence on the protein's surface, possibly used to mark the phytoferritin for conversion to hemosiderin and construction of ferritin crystalline arrays. PMID- 3654638 TI - Proteolysis of smooth muscle myosin light chain kinase. Formation of inactive and calmodulin-independent fragments. AB - Proteolysis by trypsin of gizzard myosin light chain kinase in the absence of Ca2+-calmodulin causes a biphasic effect on kinase activity. During the initial phase of proteolysis, Ca2+-calmodulin-dependent kinase activity is reduced over a thousand-fold. Further proteolysis, in the second phase, causes an increase in activity that is independent of Ca2+-calmodulin. Loss of activity is associated with the formation of a 64,000-dalton fragment. Calmodulin-independent activity is associated with the formation of a 61,000-dalton fragment. Procedures for the isolation of each fragment are outlined. Tryptic hydrolysis of the isolated 64,000-dalton peptide generates the 61,000-dalton peptide and increases calmodulin-independent activity. Km values for ATP and light chains for the native kinase and two fragments are the same, i.e. approximately 100 and 5 microM, respectively. Neither fragment binds to F-actin. Amino acid analyses of both fragments are given. Synthetic peptides corresponding to the calmodulin binding regions of the smooth and skeletal muscle kinases are potent inhibitors of the 61,000-dalton fragment. These data demonstrate the existence of an inhibitory region that is suggested to be located between the active site and the calmodulin-binding site. Whether it is distinct from or at the N-terminal end of the calmodulin-binding site cannot be determined from these data. PMID- 3654639 TI - Analysis of the carbohydrate composition of the pancreatic plasmalemmal glycoprotein affinity labeled by short probes for the cholecystokinin receptor. AB - Affinity labeling of the rat pancreatic cholecystokinin (CCK) receptor with decapeptide probes has identified an Mr = 85,000-95,000 protein, distinct from the Mr = 80,000 component previously labeled with 125I-Bolton Hunter-CCK-33. We have characterized the carbohydrate composition of this novel protein labeled with 125I-D-Tyr-Gly-[(Nle28,31)-CCK-26-33] and disuccinimidyl suberate by using chemical and enzymatic deglycosylation and lectin chromatography. The Mr = 85,000 95,000 component was demonstrated to be an N-linked sialoglycoprotein based on neuraminidase digestion to Mr = 75,000-85,000 and endo-beta-N acetylglucosaminidase F (Endo F) digestion to Mr = 42,000. This was distinct from the Mr = 65,000 product of Endo F digestion of the protein labeled with 125I Bolton Hunter-CCK-33. Lack of an effect of endo-beta-N-acetylglucosaminidase H demonstrated the absence of N-linked simple oligosaccharides, while products of chemical deglycosylation with hydrogen fluoride and endo-alpha-N acetylgalactosaminidase supported the absence of O-linked carbohydrate. The presence of at least four oligosaccharide chains on the core protein was suggested by Endo F digestion of the Mr = 85,000-95,000 protein using limiting enzyme conditions. This glycoprotein was retained on wheat germ agglutininagarose and eluted by N,N',N"-triacetylchitotriose. Identification of the Mr = 85,000 95,000 component on the ectodomain of the plasmalemma of intact pancreatic acini confirmed this to be the fully processed form of the CCK-binding protein. PMID- 3654640 TI - Intracellular calcium uptake activated by GTP. Evidence for a possible guanine nucleotide-induced transmembrane conveyance of intracellular calcium. AB - The GTP-activated Ca2+ release process we recently described (Gill, D. L., Ueda, T., Chueh, S. H., and Noel, M. W. (1986) Nature 320, 461-464) was revealed in the preceding report to operate via a mechanism likely to be induced by close membrane association but which appears not to involve membrane fusion (Chueh, S. H., Mullaney, J. M., Ghosh, T. K., Zachary, A. L., and Gill, D. L. (1987) J. Biol. Chem. 262, 13857-13864). To determine more about the GTP-activated Ca2+ translocation process, effects of GTP on cells loaded with Ca-oxalate were investigated. Using permeabilized cells of both the N1E-115 neuroblastoma and DDT1MF-2 smooth muscle cell lines, 10 microM GTP activates a profound uptake of Ca2+ in the presence of oxalate, as opposed to release observed without oxalate. GTP stimulation of Ca2+ uptake was observed at oxalate concentrations (2 mM) only slightly augmenting Ca2+ uptake without GTP; with 8 mM oxalate (which alone induces linear Ca2+ accumulation) GTP still increases the rate of uptake. GTP activated uptake in the presence of oxalate is completely reversed by 1 mM vanadate. 3% polyethylene glycol enhances the effect of GTP although GTP activated uptake is still observed without polyethylene glycol. The Km for GTP for activation of Ca2+ uptake is 0.9 microM. Uptake is not activated by guanosine 5'-O-(3-thio)triphosphate (GTP gamma S) or guanosine 5'-(beta, gamma imido)triphosphate (GppNHp); however, GTP gamma S (but not GppNHp) completely blocks the action of GTP. GDP gives a delayed uptake response which is blocked by ADP, indicating its action arises from conversion to GTP. In the presence of ADP, GDP blocks the action of GTP; guanosine 5'-O-(2-thio)diphosphate, which does not activate uptake, also blocks the action of GTP. These data reveal almost exact correlation between parameters affecting GTP-activated uptake and release, strongly suggesting the same process mediates both events. To explain the opposite effects of GTP in the absence and presence of oxalate, it is proposed that GTP activates a transmembrane conveyance of Ca2+ between oxalate-permeable and -impermeable compartments. PMID- 3654641 TI - Molecular cloning of a cDNA coding for human leukotriene A4 hydrolase. Complete primary structure of an enzyme involved in eicosanoid synthesis. AB - We have isolated a near full-length cDNA encoding human leukotriene A4 hydrolase, which synthesizes a potent chemotactic and spasmogenic compound, leukotriene B4. A human spleen cDNA library was screened with a 48-mer oligonucleotide probe, synthesized according to the partial amino acid sequence of the human leukocyte enzyme. The nucleotide sequence of the cDNA had an open reading frame of 1,833 base pairs, which contained regions coding for the N-terminal amino acid sequence, the amino acid sequence for the probe design, and several other peptide sequences of the enzyme. The complete primary structure of the enzyme composed of 610 amino acid residues (molecular weight, 69,153) was deduced from the cDNA. PMID- 3654642 TI - Molecular cloning of the structural gene for porcine thyroid peroxidase. AB - We have isolated and determined the nucleotide sequence of overlapping cDNA clones, representing the entire structural gene for pig thyroid peroxidase. The protein coding region extends from an ATG residue at base 252 to a termination codon at base 3030, coding for a 100.4-kDa apoprotein of 926 amino acids. The derived amino acid composition agrees well with the experimentally determined amino acid composition of purified pig thyroid peroxidase. Five potential glycosylation sites are present in the protein. Potential membrane spanning regions are present at the amino-terminal end (1-23) and near the carboxyl terminal end (845-870) of the protein. These data indicate that pig thyroid peroxidase is synthesized as a single polypeptide that is membrane-bound. PMID- 3654643 TI - Ligands which effect human protein C activation by thrombin. AB - This report documents attempts to mimic the rate enhancement effect of thrombomodulin on human alpha-thrombin-catalyzed activation of human protein C in the absence of exogenous calcium. Specifically the following tryptamine analogs at 1 mM concentration were shown to enhance the protein C activation rate relative to a control with no added effector at pH 8.3 (50 mM Tris-HCl, 0.1 M NaCl, 37 degrees C): serotonin, 1.2; tryptamine, 2.9; 5-fluorotryptamine, 4.4; 6 fluorotryptamine, 7.2. At much higher levels, e.g. 10 mM, all of the above effectors, as well as indole, showed a moderate inhibition of human protein C activation. ATP, a platelet release product, showed a sigmoidal inhibition pattern similar to that found previously for thrombin amidase, clotting, and esterase activity (Conery, B.G., and Berliner, L.J. (1983) Biochemistry 22, 369 375). Overall, the enhancement factors for human alpha-thrombin activation of protein C with the tryptamine analogs described above were remarkable when considering the effect of a simple ligand versus the natural activator, thrombomodulin. PMID- 3654644 TI - Conformational equilibria in the gamma chain COOH terminus of human fibrinogen. AB - The conformations of the gamma chain COOH terminus of intact fibrinogen and various fragments containing this region have been compared by an immunochemical analysis. Location of a major epitope in the sequence gamma 391-405 was successfully predicted from a hydrophobicity profile. An antibody population specific for the native epitope within the gamma 391-405 segment was isolated by immunoadsorption. Between 19.2 and 22.8% of antibodies were obtained from three different antisera, indicating that this region represents one of the major epitopes of native fibrinogen. Anti-gamma 391-405(N) antibodies were used to determine the value of Kconf, the equilibrium constant for the interconversion of the non-native and native conformations of this epitope. The measurements were done using native fibrinogen, fragments D1 and DD, gamma chain, and gamma 391 405. In addition, the effect of 5 M guanidine HCl on the conformation of fragments D1 and DD, which is known to abolish their antipolymerizing activity, was studied. Radioiodinated fibrinogen was used in the determination of Kconf, CI50%, and CIs (quantitative analytical parameters calculated from competitive inhibition radioimmunoassays) by measuring the competition between 125I fibrinogen and the fibrinogen derivatives under study for binding to the immunochemically purified antibody. The measurements indicated that the epitope is unperturbed by iodination of fibrinogen and that 38.5% of fragment D1, 8.9% of fragment DD, 3.6% of the gamma chain, and less than 0.008% of the gamma 391-405 molecules adopt in aqueous solution the native conformation within the epitope. Denaturation of fragment D1 with 5 M guanidine HCl affected only slightly the conformation of this gamma chain determinant. More significant changes in the conformation were observed when fragment DD was denatured. The results suggest that long-range interactions are necessary for the stabilization of the native structure in the region of fibrinogen that interacts with the antibody and which is in close vicinity to the polymerization site, cross-linking site, and platelet recognition site. PMID- 3654645 TI - Regulation of protein kinase C activity by cooperative interaction of Zn2+ and Ca2+. AB - cis-Fatty acids such as oleic acid or linoleic acid have been previously shown to induce full activation of protein kinase C in the absence of Ca2+ and phospholipids (Murakami, K., and Routtenberg, A. (1985) FEBS Lett. 192, 189-193; Murakami, K., Chan, S.Y., and Routtenberg, A. (1986) J. Biol. Chem. 261, 15424 15429). In this study, we have investigated the effects of various metal ions on protein kinase C activity without the interference of Ca2+ since cis-fatty acid requires no Ca2+ for protein kinase C activation. Here we report a specific interaction of Zn2+ with protein kinase C in either a positive or negative cooperative fashion in concert with Ca2+. At low concentrations (approximately 5 microM) of Ca2+, Zn2+ enhances protein kinase C activity induced by both oleic acid and phosphatidylserine/diolein. In contrast, Zn2+ inhibits the activity at higher concentrations (over 50 microM) of Ca2+. In the absence of Ca2+, Zn2+ shows no effect on protein kinase C activity. Our results suggest that Zn2+ does not recognize or interact with protein kinase C in the absence of Ca2+, that protein kinase C possesses high and low affinity Ca2+-binding sites, and that at least one Zn2+-binding site exists which is distinct from Ca2+-binding sites. PMID- 3654646 TI - Thyroxine transport in choroid plexus. AB - The role of the choroid plexus in thyroid hormone transport between body and brain, suggested by strong synthesis and secretion of transthyretin in this tissue, was investigated in in vitro and in vivo systems. Rat choroid plexus pieces incubated in vitro were found to accumulate thyroid hormones from surrounding medium in a non-saturable process. At equilibrium, the ratio of thyroid hormone concentration in choroid plexus pieces to that in medium decreased upon increasing the concentration of transthyretin in the medium. Fluorescence quenching of fluorophores located at different depths in liposome membranes showed maximal hormone accumulation in the middle of the phospholipid bilayer. Partition coefficients of thyroxine and triiodothyronine between lipid and aqueous phase were about 20,000. After intravenous injection of 125I-labeled thyroid hormones, choroid plexus and parts of the brain steadily accumulated 125I thyroxine, but not [125I]triiodothyronine, for many hours. The accumulation of 125I-thyroxine in choroid plexus preceded that in brain. The amount of 125I thyroxine in non-brain tissues and the [125I]triiodothyronine content of all tissues decreased steadily beginning immediately after injection. A model is proposed for thyroxine transport from the bloodstream into cerebrospinal fluid based on partitioning of thyroxine between choroid plexus and surrounding fluids and binding of thyroxine to transthyretin newly synthesized and secreted by choroid plexus. PMID- 3654647 TI - Primary structure of a protease isoinhibitor from bovine spleen. A possible intermediate in the processing of the primary gene product. AB - Sequence studies on the protease isoinhibitor I isolated from bovine spleen have revealed that it consists of two molecular variants which differ only in the presence of an additional COOH-terminal residue, asparagine, in the less abundant form. The complete amino acid sequence shows that they are composed of 65 or 66 residues and predicts Mr of 7223 or 7338, respectively. The sequences correspond exactly to the 58-residue polypeptide chain of spleen isoinhibitor II plus NH2- and COOH-terminal extensions of 2 and 5 or 6 amino acid residues, respectively. Moreover the entire sequences are located within the 100-residue structure deduced from the mRNA and DNA sequences of the putative precursor. These data support the idea that the molecular variants of isoinhibitor I are either mature proteins with distinct functional roles, or intermediates in the multistage processing of the primary product of gene expression, which eventually leads to the mature protein, i.e. inhibitor II. PMID- 3654648 TI - Characterization and crystallization of core streptavidin. AB - We have characterized a streptavidin product that had been reduced to a minimal size that still retained full biotin-binding activity. This core streptavidin is proteolyzed at both ends at points that correspond closely with the termini of hen egg white avidin. Core streptavidin is more soluble than is the parent molecule. We have grown three different types of crystals of core streptavidin. The symmetry properties of these crystals prove that the molecule is a tetramer organized in tetrahedral (D2) point symmetry. The crystallographic response to the interaction of biotin with core streptavidin indicates that some conformational change accompanies ligand binding. We are attempting to determine the three-dimensional structure of streptavidin and its complex with selenobiotin from these crystals of core streptavidin. PMID- 3654649 TI - Polysaccharide structural features that are critical for the binding of sulfated fucans to bindin, the adhesive protein from sea urchin sperm. AB - We have investigated the structural features of sulfated fucose-containing polysaccharides which are responsible for their selective binding to Strongylocentrotus purpuratus bindin. The data presented demonstrate that the sulfate esters and a molecular weight in excess of approximately 15,000 are required for high affinity binding of the fucans to bindin. Desulfation destroys the binding activity of the fucans, which can be fully restored by chemical resulfation. Fucan fragments of an average molecular weight of 15,000 were nearly as active as the starting material (Mr 10(6)). The observed IC50 value for fragments of Mr congruent to 10,000 and Mr congruent to 5,000 were 1 and 2 orders of magnitude higher, respectively. The binding of fucoidan to bindin is stable in high salt (50% at 1.2 M NaCl) whereas the binding of fucoidan to DEAE-cellulose or polylysine is inhibited by the concentrations of salt normally found in sea water (50% at 0.2 and 0.5 M NaCl, respectively). This result suggests that the binding mechanism is not a simple ionic interaction and that hydrogen bonding and cooperativity may also be important determinants of the binding mechanism. We also found that polyvinyl sulfate binds to bindin with high affinity and inhibits the bindin-mediated agglutination of sea urchin eggs. The results of these investigations suggest that the spatial orientation of the sulfate esters plays a critical role in determining the selectivity of sulfated polysaccharide binding and that the polysaccharide backbone does not play a direct role in the binding mechanism. PMID- 3654650 TI - Isolation, characterization, and pharmacological actions of peptide histidine valine 42, a novel prepro-vasoactive intestinal peptide-derived peptide. AB - The primary structure and biological activity of a novel prepro-vasoactive intestinal peptide (prepro-VIP)-derived peptide has been determined from an adrenal pheochromocytoma. The peptide was purified sufficiently for characterization by fast atom bombardment mapping after cation-exchange and reverse-phase fast protein liquid chromatography. The sequence of this novel peptide corresponds exactly to prepro-VIP-81-122 and has been designated peptide histidine valine 42 (PHV-42). Synthetic PHV-42 reduced both the force and frequency of spontaneous contractions of isolated rat uterus and was at least 12 times more potent than peptide histidine methionine (prepro-VIP-81-107), and over a hundred times more potent than noradrenaline. PHV-42 was also more potent than peptide histidine methionine in relaxing smooth muscle preparations of rat stomach and guinea pig trachea, but was approximately 4-fold less potent in reducing blood pressure than VIP. PHV-42 thus forms a separate subsystem in the VIP family of peptides and may be the most biologically active product of prepro VIP in certain tissues such as the uterus and trachea. PMID- 3654651 TI - Decidium. A novel fluorescent probe of the agonist/antagonist and noncompetitive inhibitor sites on the nicotinic acetylcholine receptor. AB - We have examined the interaction of the nicotinic acetylcholine receptor with decidium diiodide, a bisquaternary analogue of ethidium containing 10 methylene groups between the endocyclic and trimethylamino quaternary nitrogens. Decidium inhibits mono-[125I]iodo-alpha-toxin binding, inhibits agonist-elicited 22Na+ influx in intact cells, augments agonist competition with mono-[125I]iodo-alpha toxin binding, and enhances [3H]phencyclidine (PCP) binding to a noncompetitive inhibitor site. These effects occur over similar concentration ranges (half maximum effects between 0.1 and 0.4 microM). Thus, decidium binds to the agonist site and converts the receptor to a desensitized state exhibiting increased affinity for agonist and heterotropic inhibitors. These properties are similar to metaphilic antagonists characterized in classical pharmacology. At higher concentrations decidium associates directly with the noncompetitive inhibitor site identified by [3H]phencyclidine binding. Dissociation constants of decidium at this site in the resting and desensitized states are determined to be 29 and 1.2 microM, respectively. Analysis of fluorescence excitation and emission maxima reveal that binding to both the agonist and noncompetitive inhibitor sites is associated with approximately 2-fold enhancement of fluorescence. The excitation maximum for decidium bound at the agonist site appears at 490 nm while that for decidium bound at the noncompetitive inhibitor site appears at 530 compared to 480 nm in buffer. These results suggest that decidium experiences a more hydrophobic environment upon binding to the nicotinic acetylcholine receptor sites, particularly to the noncompetitive inhibitor site. Fluorescence energy transfer between N'-fluorescein isothiocyanate-lysine-23 alpha-toxin (FITC toxin), and decidium is not detected when each is bound to one of the two agonist sites on the receptor. This allows a minimal distance to be estimated between fluorophores. In contrast, energy transfer is observed between decidium nonspecifically associated with the membrane or with nonspecific sites and the FITC-toxin at the agonist sites. PMID- 3654652 TI - Evidence for the release of newly acquired ascorbate and alpha-aminoisobutyric acid from the cytosol of adrenomedullary chromaffin cells through specific transporter mechanisms. AB - Primary cultures of bovine adrenomedullary cells actively take up ascorbic acid and alpha-aminoisobutyric acid (AIB). Following a brief incubation with L-[14C] ascorbic acid and alpha-[methyl-3H]aminoisobutyric acid, cells stimulated with the nicotinic agonist 1,1-dimethyl-4-phenylpiperazinium iodide or by membrane depolarization with high [K+] or veratridine released newly acquired ascorbic acid (NA-ascorbate) and AIB. NA-ascorbate and endogenous catecholamines are differentially released under a variety of conditions suggesting that release of both substances cannot originate from the same subcellular compartment. In contrast, the release profile for NA-ascorbate and AIB, a putative cytosolic marker, suggest that both of these molecules are released from a cytosolic compartment. Cells permeabilized with the detergent digitonin release catecholamines only in the presence of external Ca2+, whereas release of NA ascorbate and AIB is Ca2+-independent and time- and detergent concentration dependent. If the osmolality of the external medium is made either hyper- or hypoosmotic, 1,1-dimethyl-4-phenylpiperazinium iodide-induced release of endogenous catecholamines is inhibited. Release of NA-ascorbate and AIB, however, is progressively inhibited with increasing osmolality and enhanced with decreasing osmolality. Furthermore, differential release of NA-ascorbate and AIB as compared to soluble acetylcholinesterase, which is apparently released form the cisternae of the endoplasmic reticulum, was also observed. To determine the mechanism by which NA-ascorbate and AIB are released from the cell, the requirements for their maximal release were investigated. Release of NA-ascorbate and AIB was sensitive to inhibitors (both metabolic and transport) and to changes in the external ionic environment. The metabolic inhibitors carbonyl cyanide p trifluoromethoxyphenylhydrazone and KCN (when incubated simultaneously with 2 deoxyglucose) inhibited NA-ascorbate and AIB release by greater than 75%. In contrast, the Na+-K+-ATPase inhibitor ouabain enhanced veratridine-induced release of NA-ascorbate by nearly 100% and had an even greater effect on AIB release. Changes in the external ionic environment (i.e. Na+ and/or Cl- substitution) inhibited both NA-ascorbate and AIB release to varying degrees. Substitution of Cl- by various anions inhibited NA-ascorbate and AIB release to a much greater degree than endogenous catecholamine release. Complete substitution of NaCl with sucrose inhibited release of NA-ascorbate and AIB release by greater than 80%, while Na+ substituted with Li+ inhibited release of all three molecules by about 50%.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3654653 TI - Accumulation of regulatory oxysterols, 32-oxolanosterol and 32-hydroxylanosterol in mevalonate-treated cell cultures. AB - In a previous publication (Saucier, S.E., A.A., Taylor, F.R., Spencer, T.A., Phirwa, S., and Gayen, A.K., J. Biol. Chem. (1985) 260, 14571-14579), we demonstrated that cultured Chinese hamster lung (Dede) cells contain 24(S),25 epoxycholesterol and 25-hydroxycholesterol in cellular concentrations within the range required to repress 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase. In this paper, we show that the addition to the culture medium of a concentration of mevalonate high enough to repress the reductase by 90% resulted in the appearance of two new regulatory oxysterols. The two new sterols are believed to be 32 oxolanosterol and 32-hydroxylanosterol on the basis of high performance liquid chromatography (HPLC) retention times and mass spectrometric and nuclear magnetic resonance spectroscopic data and by NaBH4 reduction of the putative aldehyde to material which had the HPLC retention time of the putative alcohol. The cellular concentrations of 24(S),25-epoxycholesterol and 25-hydroxycholesterol were not significantly changed by the presence of mevalonate. However, there was approximately a 30% increase in total HMG-CoA reductase repressor units which can be ascribed to the 32-oxolanosterol and 32-hydroxylanosterol, where 1 unit equals the repressor activity of 1 ng of 25-hydroxycholesterol. These results support the idea that the level of HMG-CoA reductase activity in growing cell cultures is determined by intracellular oxysterol metabolites and that relatively small changes in their numbers or concentrations can alter the level of HMG-CoA reductase activity. PMID- 3654654 TI - Structure of a triphosphonopentaosylceramide containing 4-O-methyl-N acetylglucosamine from the skin of the sea hare, Aplysia kurodai. AB - A novel phosphonoglycosphingolipid named SGL-I containing 3 mol of 2 aminoethylphosphonate residues was isolated from the skin of a sea gastropod, Aplysia kurodai. The saccharide moiety of the glycolipid was characterized as 4-O methyl-GlcNAc alpha 1----4GalNAc alpha-1----3 [6'-O-(2-aminoethylphosphonyl)Gal alpha 1----2] (2-aminoethylphosphonyl----6)Gal beta 1----4(2-aminoethylphosphonyl ---6) Glc beta 1----1-ceramide. The major aliphatic components of the ceramide portion were palmitic acid, stearic acid, octadeca-4-sphingenine, and anteisononadeca-4-sphingenine. This glycolipid is unique in containing 4-O-methyl N-acetylglucosamine and 3 mol of 2-aminoethylphosphonate residues, one of which is attached to C-6 of glucose. PMID- 3654655 TI - Characterization of tumor-associated fucogangliosides from PC 12 pheochromocytoma cells. AB - PC 12h pheochromocytoma cells were subcutaneously transplanted into rat. We found the transplanted tumors accumulated some fucogangliosides associated with PC 12 cells. These gangliosides were isolated and purified by DEAE-Sephadex A-25 and Iatrobeads column chromatographies. Their structures were determined by fast atom bombardment mass spectrometry, proton nuclear magnetic resonance spectrometry, permethylation study, and sequential degradation using various exoglycosidases and mild acid hydrolysis. Two tumor-associated fucogangliosides were found to possess the blood group B determinant as follows: G6: IV2Fuc alpha, IV3Gal alpha, II3NeuAc, GgOse4Cer; G11: IV2Fuc alpha, IV3Gal alpha, II3 (NeuAc)2, GgOse4Cer. A ganglioside with the similar structure as ganglioside G6 was isolated from rat hepatoma cells (Holmes, E.H., and Hakomori, S-I. (1982) J. Biol. Chem. 257, 7698 7703). However, ganglioside G11 has not previously been reported in the literature. These fucogangliosides reacted with the monoclonal antibody prepared by immunizing mice with PC 12h cells. Other fucogangliosides were also found to accumulate in the transplanted tumor tissues. They were identified as fucosyl-GM1 and fucosyl-GDlb. These fucogangliosides did not react with the monoclonal antibody against PC 12h cells. PMID- 3654656 TI - Studies on the mechanism of oxidative phosphorylation. Flow-force relationships in mitochondrial energy-linked reactions. AB - The relationship between the steady-state level of membrane potential (delta psi) and the rates of energy production and consumption has been studied in mitochondria and submitochondrial particles. The energy-linked reactions investigated were oxidative phosphorylation (with NADH, succinate, and beta hydroxybutyrate as respiratory substrates) and nucleoside triphosphate-driven transhydrogenation from NADH to NADP and uphill electron transfer from succinate to NAD. Results have shown the following. 1) Attenuation of the rates of the energy-producing reactions results in a parallel change in the rates of the energy-consuming reactions with little or no change in the magnitude of steady state delta psi. 2) At low rates of energy production and consumption, steady state delta psi decreases. However, this is due largely to the energy leak of the system which lowers static-head delta psi when the rate of energy production is slow. 3) When the rate of energy production and static-head delta psi are held constant, and the rate of energy consumption is diminished by partial inhibition or the use of suboptimal conditions (e.g. subsaturating substrate concentrations), then even a small decrease in the rate of energy consumption results in an upward adjustment of the level of steady-state delta psi. The lower the rate of energy input, the greater the upward adjustment of steady-state delta psi upon suppression of the rate of energy consumption. 4) The above results have been discussed with regard to the role of bulk-phase delta mu H+ or delta psi in the mitochondrial energy transfer reactions. PMID- 3654657 TI - Binding of fluorescent-labeled phosphatidylcholine to rat liver nonspecific lipid transfer protein. AB - The fluorescent-labeled phospholipid, 1-palmitoyl-2-[12-[(7-nitro-2,1,3 benzoxadiazol-4-yl)amino]dodecan oyl] phosphatidylcholine (P-C12-NBD-PC), is highly self-quenched when contained as a high mole percent in phospholipid vesicles. The addition of nonspecific lipid transfer protein (nsLTP), which is identical to sterol carrier protein2, to P-C12-NBD-PC self-quenching vesicles results in a large increase in the fluorescence yield. Evidence is presented that demonstrates that this fluorescence increase results from the binding of P-C12 NBD-PC to one or more low dielectric sites on the nsLTP molecule and that the P C12-NBD-PC.nsLTP complex can exist free in aqueous solution. The binding is inhibited in the presence of mersalyl, a thiol reagent, and can be reversed with excess cysteine. Transfer of the nsLTP-bound P-C12-NBD-PC to phospholipid vesicles is also demonstrated. The half-times for loading and unloading the P-C12 NBD-PC.nsLTP complex are both 3 orders of magnitude faster than the spontaneous P C12-NBD-PC transfer between vesicles. These data demonstrate that nsLTP has the necessary properties to bind and carry lipids between membranes. PMID- 3654658 TI - Characterization of the expression products of recombinant human choriogonadotropin and subunits. AB - Human choriogonadotropin (hCG) is a placental glycoprotein hormone composed of a 92-amino acid alpha subunit noncovalently linked to a 145-amino acid beta subunit. We report here the expression of biologically active hCG in mouse C127 cells transfected with expression vectors containing the DNA coding for both subunits. In addition, the same cell line was used to express the alpha subunit alone. The expression products were purified by affinity chromatography using specific monoclonal antibodies to hCG or its subunits. The system secreting biologically active hCG also produced a 10-fold or greater molar excess of free beta subunit. The dimeric hormone, as well as the excess beta subunit, resembles the standard urinary hCG and beta subunit by chemical and biological criteria. In contrast, when the vector encoding for the alpha subunit was expressed alone, the alpha subunit had a higher molecular weight than both standard alpha and the alpha found in the expressed dimeric hormone. The molecular weight difference between expressed alpha subunit and standard alpha was found to reside in the alpha peptide consisting of residues 52-91 which contained all of the carbohydrate of the alpha subunit. The N-asparagine-linked carbohydrate moieties in the recombinant alpha were found to be triantennary in contrast to biantennary in urinary alpha, and this hyperglycosylation was responsible for the higher molecular weight of the alpha subunit when it was expressed alone. We found no evidence of O-threonine glycosylation at position alpha 39 reported to be present in free forms of the alpha subunit; however, the companion paper (Corless, C.L., Bielinska, M., Ramabhadran, T. V., Daniels-McQueen, S. Otani, T., Reitz, B. A., Tiemeier, D. C., and Boime, I. (1987) J. Biol Chem. 262, 14197-14203) finds a small quantity of O-glycosylation. Since the excess beta subunit appears to be of normal size and contains the expected complement of sugars, only free alpha subunit seems to be a potential substrate for addition of extra sugar moieties. No large beta subunit forms have been found by others, while large alpha subunits have been described both clinically and in tissue culture systems. These observations imply that the conformation of the free alpha subunit, in the regions of the glycosylation recognition sites, allows easier access for glycosyltransferases than those same sites in the beta subunit. When alpha is combined with beta, the local structures around the alpha glycosylation sites are apparently altered so as to make the synthesis of triantennary chains less favorable. PMID- 3654659 TI - Isolation and characterization of novel glycolipids with blood group A-related structures: galactosyl-A and sialosylgalactosyl-A. AB - Two glycosphingolipids with the following novel structures have been isolated from human blood cells and characterized by NMR, direct probe mass spectrometry, fast atom bombardment-mass spectrometry, and methylation analysis: (Formula: see text). Both structure i and structure ii are characterized by substitution of beta-galactosyl or sialosyl-beta-galactosyl residue at the terminal alpha-GalNAc residue of blood group A determinant and are therefore specific products associated with the blood group A phenotype. PMID- 3654660 TI - Provasopressin-neurophysin II processing is cell-specific in heterologous cell lines expressing a metallothionein-vasopressin fusion gene. AB - Preprovasopressin-neurophysin II (prepro-AVP-Np), the precursor of the cyclic, amidated nonapeptide, arginine vasopressin (AVP), is present in the central and peripheral nervous systems, adrenal glands, and gonads of rats. To study cell specific processing of prepro-AVP-Np, a fusion gene consisting of the heavy metal inducible promoter of the mouse metallothionein I gene and the rat prepro-AVP-Np gene was introduced by cellular transfection into several defined cell phenotypes: a fibroblast line (BHK), a pituitary growth hormone and prolactin producing cell line (GH4), a pituitary cell line that produces several amidated peptides (AtT-20), and an insulin-producing pancreatic islet line (RIN- 1046-38). Clonal cell lines were isolated and prepro-AVP-Np-specific transcripts were detected by Northern blot hybridization analyses. Fibroblast BHK and pituitary GH4 cells transfected with the fusion gene synthesized a polypeptide (Mr = 18,000) characteristic of the glycosylated precursor, pro-AVP-Np; in metal treated cells, this protein was the major secreted cysteine-labeled polypeptide. Extracts of RIN-1046-38 and AtT-20 cells transfected with the fusion gene contained predominantly processed neurophysin and amidated arginine vasopressin, whereas extracts of BHK and GH4 cells contained mainly precursors of AVP and neurophysin. These observations indicate that the pathways involving specific post-translational processing of pro-AVP-Np are more efficiently utilized in the prohormone-producing AtT-20 and RIN-1046-38 cells than in GH4 and BHK cells that do not synthesize any recognized prohormones. PMID- 3654661 TI - The reversible oxidation of vicinal SH groups in 4-aminobutyrate aminotransferase. Probes of conformational changes. AB - 4-Aminobutyrate aminotransferase is inactivated by preincubation with iodosobenzoate at pH 7. The reaction of 2 SH residues/dimer resulted in formation of an oligomeric species of Mr = 100,000 detectable by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The subunits cross-linked via a disulfide bond are dissociated by addition of 2-mercaptoethanol which also restores full catalytic activity (Choi, S. Y., and Churchich, J.E. (1985) J. Biol. Chem. 260, 993-997). The substrate 2-oxoglutarate prevents inactivation of the enzyme by iodosobenzoate and the subsequent formation of one disulfide bond, whereas 4 aminobutyrate has no effect on the reactivity of SH groups with iodosobenzoate. Modified 4-aminobutyrate aminotransferase (containing 1 disulfide bond) catalyzes a half-transamination reaction; but it is unable to react with 2-oxoglutarate to generate the aldimine form of the enzyme. The spectroscopic properties (fluorescence yield and polarization of fluorescence) of PMP bound to the modified enzyme are different from those of pyridoxamine phosphate (PMP) bound to the native enzyme. The polarization of fluorescence values of PMP bound to the cross-linked enzyme, excited over the spectral range 310-370 nm, are greater (25%) than those of the cofactor of the native enzyme. An increase in the polarization values implies that the motion of PMP is restricted when the subunits are cross-linked via a disulfide bond. PMID- 3654662 TI - Preparation of enriched plasma membranes from bovine gallbladder muscularis for characterization of cholecystokinin receptors. AB - A method for the preparation of enriched plasma membranes from bovine gallbladder muscularis was developed, validated, and applied to the characterization of receptors for the gastrointestinal hormone cholecystokinin (CCK) on this target. Binding of radioiodinated CCK ligands to this preparation was rapid, reversible, temperature-dependent, saturable, and specific. Only structurally related peptides inhibited CCK binding, and good correlation existed between relative potencies for binding inhibition and for stimulating gallbladder contraction. Computer analysis of CCK-binding data using a nonlinear model-fitting program best fit a model with a single class of sites, with Kd 756 pm and binding capacity 4.5 +/- 1.3 pmol/mg of protein. This degree of enrichment for plasma membranes was adequate for the initial biochemical characterization of this CCK receptor. Affinity labeling using 125I-Bolton Hunter-CCK-33 and m maleimidobenzoyl-N-hydroxysuccinimide ester identified proteins with Mr = 70,000 85,000, Mr = 120,000-125,000, and Mr = 200,000. Labeling was inhibited in a concentration-dependent manner, with an IC50 of 1 nM CCK-8, and the electrophoretic mobility of these bands was not different under reducing and nonreducing conditions. The major labeled band of Mr = 70,000-85,000 has a lower apparent Mr than that of the analogous band in pancreas labeled with similar methods, supporting the molecular heterogeneity of CCK receptors on these two target tissues. PMID- 3654663 TI - The L- and R-type isozymes of rat pyruvate kinase are produced from a single gene by use of different promoters. AB - cDNA clones for rat R-type pyruvate kinase and a genomic clone encoding both L- and R-type isozyme mRNAs were isolated. Their sequences were compared with that of the L-type isozyme cDNA to determine the sequences of mRNA and protein of the R-type isozyme and the organizations of the L- and R-type genes. Results showed that the R-type isozyme mRNA had an identical nucleotide sequence to that of the L-type except in the 5'-terminal region including the coding sequence and the length of the 3'-untranslated region. The sequence upstream of the 5th coding residue of the L-type was replaced by a 98-nucleotide coding sequence plus a 5' untranslated region in the R-type isozyme. Therefore, the R-type subunit consists of 574 amino acids, which is 31 residues longer than the L-type at the amino terminus. The pyruvate kinase L gene is present as a single copy per haploid genome and is composed of 12 exons and 11 introns with a length of about 9.3 kilobase pairs. The first (exon R) and second (exon L) exons encode the 5' terminal sequences specific for the R- and L-types, respectively. The remaining downstream exons encode a sequence common to both isozymes. The last exon contains the entire 3'-untranslated region, including several putative polyadenylation signals. Alternative use of these signals is reported to be responsible for generation of multiple mRNA species for the L-type, whereas the R type uses only the first signal. The cap site is mapped 16 nucleotides upstream from the translation initiation site for the L-type, whereas multiple cap sites were suggested for the R-type. The canonical promoter of the TATA box was identified in the upstream sequence of exon L, but not in that of exon R. Instead, the 5'-flanking region of exon R contained another promoter sequence of the CAT box. Thus, we conclude that the L- and R-type isozymes of pyruvate kinase are produced from a single gene by use of different promoters. PMID- 3654664 TI - Helical motion analysis of the knee--II. Kinematics of uninjured and injured knees during walking and pivoting. AB - The knee kinematics of eight individuals with uninjured knees and of seven individuals with ruptured anterior cruciate ligaments have been investigated during walking and pivoting. The kinematics were measured using a six degree of freedom goniometer and quantitated using helical motion analysis. The helical motion variables reveal clearly that the knee is definitely neither a hinge nor a planar joint and its dynamic behavior changes over the stride. Ligamentous loss results in more adduction and external rotation during certain periods of the stride. Also, the range of translation of the tibia in the medial/lateral direction is reduced, and its average translation is more medial. PMID- 3654665 TI - Sprinting with banked turns. AB - Bank angle effects can attenuate peak running speed on the order of 10%. Experimental and theoretical results are presented here to quantify this phenomenon over a wide range of bank angles theta b and turn radii R. Experimentally, eleven subjects ran on a 34 m long plywood test track with variable radius and bank angle to sample the (R, theta b) space. From another study, ten subjects are borrowed to examine the theta b = 0 degrees case in greater detail. Various gait parameters were measured from high-speed film, and after parallax correction, compared with the theoretical predictions. The theory is a simple two-parameter constant force model requiring only the effective ankle pulley ratio beta and the runner's top speed vm. A closed-form dimensionless solution is presented for the speed ratio (v/vm) as a function of the radius number (Rg/v2) and the bank angle theta b. Agreement between theory and experiment is limited by experimental scatter. For twenty different subjects and twelve different combinations of R and theta b, the apparent ankle pulley ratio is beta = 0.27 +/- 0.22 based on 128 separate trials. Applications are discussed briefly for the design of indoor and outdoor running tracks. The theory allows a calculation of foot force, bone force, and tendon tension for the general case of arbitrary maximum speed, turn radius and bank angle. PMID- 3654666 TI - A constitutive model for the mechanical behaviour of soft connective tissues. AB - A model of the mechanical behaviour of soft connective tissue has been developed by considering the role of the collagen and glycosaminoglycan (GAG) components within the tissue in order to examine the mechanism by which a variation in the GAG components may exert a control over the mechanical properties of the tissue. It is proposed that the strain energy stored within the collagen fibrils of the loaded tissue can be transferred into a potential field created by the charged GAG components and their electrostatic interaction with the collagen fibrils. A fundamental mechanical unit is described to simulate this energy transfer and a combination of such units is used to represent the tissue. The computer implementation of the proposed tissue model shows it to reproduce many features which have been recognised in the rate dependent mechanical behaviour of soft tissues. These include the characteristic non-linearity of the force-deformation behaviour and the approximate invariance of the stress relaxation behaviour with deformation. The model is also consistent with earlier constitutive representations of tissue behaviour. PMID- 3654667 TI - Strains and micromotions of press-fit femoral stem prostheses. AB - Average femoral geometry was determined from sections of 25 human femurs. A 'stem design program' was used to determine the largest femoral stem that could be introduced into the canal. The stem was fine tuned by observations of fit in Plexiglass models of the 25 femurs. This stem was called the 'Exact-Fit'. Type 1 stem was formed by grinding the anterior and posterior faces flat. Type 2 stem was formed by additionally grinding the medial and lateral faces flat. Four fresh femurs were used for the experiments. Strain gages were located on the proximal medial area and level with the distal lateral tip. Displacement transducers were mounted proximally to measure stem-bone micromotion. Vertical and anterior posterior forces were applied to the femoral head and normal strain data obtained. The stems were then inserted in sequence and the strains and micromotions were measured. After the uncemented stems had been tested, a smaller size of 'exact-fit' stem was cemented and the tests repeated. The strains with the uncemented stems were closer to normal than with the cemented stems. For example, compressive calcar strains averaged 56% of normal uncemented compared with 30% cemented for the different loadings. The micromotion was higher uncemented, but was still at a low level. The 'exact-fit' stem gave less resultant micromotion than the type 1 and type 2 stems. The high variation of the strain results was attributed to variations in stem-bone contact and fit. The study provided information of direct application to press-fit stems in hip replacement surgery. PMID- 3654668 TI - Biphasic indentation of articular cartilage--I. Theoretical analysis. AB - A mathematical solution has been obtained for the indentation creep and stress relaxation behavior of articular cartilage where the tissue is modeled as a layer of linear KLM biphasic material of thickness h bonded to an impervious, rigid bony substrate. The circular (radius = a), plane-ended indenter is assumed to be rigid, porous, free-draining, and frictionless. Double Laplace and Hankel transform techniques were used to solve the partial differential equations. The transformed equations and boundary conditions yielded an integral equation of the Fredholm type which was analyzed asymptotically and solved numerically. Our asymptotic analyses showed that the linear KLM biphasic material behaves like an incompressible (v = 0.5) single-phase elastic solid at t = 0+; the instantaneous response of the material is governed by the shear modulus (mu s) of the solid matrix. The linear KLM biphasic material behaves like a compressible elastic solid with material properties defined by those of the solid matrix, i.e. (lambda s, mu s) or (mu s, v s) as t----infinity. The transient viscoelastic creep and stress-relaxation behavior, 0 less than t less than infinity, of this material is controlled by the frictional drag (which is inversely proportional to the permeability k) associated with the flow of the interstitial fluid through the porous-permeable solid matrix. For given values of the Poisson's ratio of the solid matrix v s and the aspect ratio a/h, where a is the radius of the indenter and h is the thickness of the layer, the creep behavior with respect to the dimensionless time H Akt/a2 is completely controlled by the load parameter P/2 mu sa2 and the stress relaxation behavior is completely controlled by the rate of compression parameter R0 = kH A/V0h where H A = lambda s + 2 mu s and the equilibrium strain u0/h. This mathematical solution may now be used to describe an indentation experiment on articular cartilage to determine the intrinsic material properties of the tissue, i.e. permeability k, and the elastic coefficients of the solid phase (lambda s, mu s) or (mu s, v s). PMID- 3654669 TI - A rigid-body method for finding centers of rotation and angular displacements of planar joint motion. AB - A rigid-body method for determining the center of rotation (CR) and the angular displacement in a plane is developed. A comparison of this method to the graphical method of Reuleaux (Theoretische Kinematik: Grundzuge einer Theorie des Maschinenwerens, 1875) is found to have fewer constraints while meeting or exceeding the Reuleaux method in accuracy. The rigid-body method is not constrained by the location of the markers, as they can be placed radially or juxtapositioned about the CR. Magnitude of the rotation angle does not affect the accuracy in calculating the rotation angle. When applying both methods to locate the CR in a simulated knee joint, a substantial decrease in error is found with the new method. In a comparison of optimal marker angles used to locate the CR and find the angular displacement, the rigid-body method is found to be more accurate in both the mean and range of error. Effects of parameters specified by Panjabi (J. Biomechanics 12, 911-920, 1979) are applied to both methods. Results are then used in setting up guidelines for increasing accuracy with the rigid body method. PMID- 3654670 TI - Photogrammetric technique applied to anthropometric study of hands. AB - Being concerned with physical anthropometric dimensions to explore avenues of research on hands and their working strategies, a research study was made to develop a suitable method by using available photogrammetric resources. The paper discusses the optimums of details found by this study, viz., the use of a Wild C 40 stereometric camera (for obtaining stereoscopic photographs) and the use of a Wild A7 stereorestitution instrument equipped with digital data acquisition accessories (for obtaining all dimensional information). Three-dimensional data at 21 specific points and for nine specific distances were obtained on each hand of ten persons. Test observations indicate, inter alia, a dimensional accuracy of the order of +/- 0.3 mm obtainable through the working system. Cartographic presentations made in support of the digital data are found to be of help. This also permits to obtain additional data as may be necessary at times. Photogrammetry has the advantage of reducing and maintaining to a minimum all sorts of manipulations necessary in such studies. PMID- 3654671 TI - A thin foot switch. AB - A common problem in determining a number of important gait parameters is a convenient means for indicating foot/floor contact. Various foot switches have been used in many forms, but still an ideal, commercially available switch has yet to materialize. This note describes one method for constructing very thin, (1 mm), durable, switches that have worked well in the Gait Analysis Lab at Texas Scottish Rite Hospital. PMID- 3654672 TI - Biomechanical study of the programming of anticipatory postural adjustments associated with voluntary movement. AB - The present research concerns anticipatory postural adjustments (APA), with the purpose of determining whether they are preprogrammed and of specifying their biomechanical finality. The experimental situation allowed us to distinguish between the voluntary movement itself (an upper limb elevation) and the postural adjustments associated with it. To this aim, the upper limb kinematics, evaluated from an accelerometer fixed at wrist level, were compared to the whole body dynamics, recorded by means of a force platform. Movements, executed in series of five, were studied according to three conditions: bilateral flexions (BF) and unilateral flexions (UF), with (IUF) and without (OUF) an additional inertia, of the stretched upper limb(s). Six right handed adults were tested twice. Results showed that the ground reaction resultant forces as well as the ground reaction resultant moment about the vertical axis presented reproducible variations before and after the onset of upper limb acceleration. The biomechanical organization of APA corresponded, for the three experimental conditions, to an upward and forward acceleration of the body center of gravity, and also, for UF, to a resultant moment directed towards the contralateral side. The duration of APA varied with the characteristics of the forthcoming voluntary movement, increasing significantly from BF to OUF and from OUF to IUF. It is concluded that APA correspond to dynamic phenomena which are centrally preprogrammed. The inertia forces associated with APA may, when the time comes, balance the inertia forces due to the movement of the mobile limb therefore counteracting the disturbance to postural equilibrium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654673 TI - Mechanical strength of tibial trabecular bone evaluated by X-ray computed tomography. AB - The prospects for the use of quantitative computed tomography (QCT) for evaluation of mechanical properties of tibial trabecular bone were investigated. Computed tomography (CT) data from the proximal tibial epi- and metaphysis of six human cadaver knees were correlated with mechanical data obtained from compression tests and penetration strength measurements. In addition CT and intraoperative penetration data were compared in 20 patients. If spatial agreement between CT and mechanical measurement sites is optimized, close correlations are found between the relative linear attenuation coefficient determined by CT and the ultimate strength (r = 0.84), the yield strength (r = 0.85), the elastic modulus (r = 0.78), the ultimate energy absorption (r = 0.83), the yield energy absorption (r = 0.81), and the penetration strength (r = 0.82). It is concluded that these correlations are sufficient to make QCT a valuable tool for non-invasive evaluation of the spatial distribution of bone properties in several clinical applications. PMID- 3654674 TI - Analysis of the asymmetrically loaded spine by means of a continuum beam model. AB - A continuum beam model of the human spine, proposed by Hjalmars (Proceedings of the Fourth International Conference on Continuum Models of Discrete Systems, 1981), and earlier used by the present author as a tool for the analysis of mild functional scoliosis, is here used for the study of a spine, asymmetrically loaded in the frontal plane. In order to validate the theoretical predictions of the model, preliminary experiments are carried out, which show that the model fairly well describes the lateral curvatures that occur when, for various loading conditions, the spine is adjusted into a muscle-relaxed state of equilibrium. Values of the flexural rigidity estimated from the experiments are found to be in reasonable agreement with values, estimated from earlier observations on dead material, reported in the literature. The experiments also indicate that the model may be developed to a tool for estimations of the effective flexural rigidity of the spine in vivo. PMID- 3654675 TI - Gait reaction reconstruction and a heel strike algorithm. AB - A mathematical model of gait ground loading is presented. The model allows the ground reactions produced by any particular single- or multiple-footfall pattern to be constructed, given a sufficient variety of other measured ground reactions. An algorithm which uses center of vertical pressure data only to determine the instants of successive heel strikes on a large force plate is then presented. Experiments show the high accuracy of the heel strike algorithm and show that reconstructions of the vertical component of ground reactions are typically within 3% of corresponding measured reactions. The techniques presented allow certain problems associated with small force plates and other problems associated with large force plates to be largely overcome. PMID- 3654676 TI - A possible role of the pleura in lung mechanics. AB - The pressure-volume behavior of excised visceral pleura is studied. The pleura is modeled as a thin incompressible membrane, and the requisite membrane tension is determined from a pseudostrain-energy function. Results are compared to pressure volume behavior of saline-filled and air-filled parenchyma and to experimental pleural data from the literature. Results suggest that the pleura may play a role as a volume limiter of lung expansion although the need for more detailed analysis is discussed. PMID- 3654677 TI - Simple constitutive model for a cortical bone. AB - This short study presents a simple, one-dimensional constitutive model for the cortical bone with haversian structure. The model is developed within the general framework of the continuum damage theory. The kinetic equation is derived (rather than assumed a priori) through consideration of the irreversible changes of the mesostructure. As a consequence the analytical results closely approximate experimental measurements even though the theory does not introduce a single experimentally unidentifiable material parameter. PMID- 3654678 TI - Trabecular bone density and loading history: regulation of connective tissue biology by mechanical energy. AB - The method of considering a single loading condition in the study of stress/morphology relationships in trabecular bone is expanded to include the multiple loading conditions experienced by bone in vivo. The bone daily loading histories are characterized in terms of stress magnitudes or cyclic strain energy density and the number of loading cycles. Relationships between local bone apparent density and loading history are developed which assume that bone mass is adjusted in response to strength or energy considerations. Three different bone maintenance criteria are described which are formulated based upon: (1) continuum model effective stress, (2) continuum model fatigue damage accumulation density, and (3) bone tissue strain energy density. These approaches can be applied to predict variations in apparent density within bone and among bones. We show that all three criteria have similar mathematical forms and may be related to the density (or concentration) of bone strain energy which is transferred (dissipated) in the mineralized tissue. The loading history and energy transfer concepts developed here can be applied to many different situations of growth, functional adaptation, injury, and aging of connective tissues. PMID- 3654680 TI - Cartilage is poroelastic but not biphasic. PMID- 3654679 TI - Experimental determination of mechanical shear stress about an anastomotic junction. AB - The present study is undertaken to determine whether the elastic tube model originally developed by Kuchar and Ostrach (Biomedical Fluid Mechanics Symposium, pp. 45-69, 1966) accurately provides a first approximation of the biomechanics of the anastomotic junction. The experimental protocol involves the use of canine carotid arteries as the host vessel and several graft materials including autogenous and prosthetic substitutes. The host artery-graft combinations are perfused in vitro in a pulsatile perfusion apparatus which simulates the natural hemodynamic environment. This apparatus provides accurate dynamic measurements of radial wall motion (measured at various longitudinal increments), associated pressures and rates of fluid flow. These data are then applied to the theoretical model for calculation of anastomotic induced bending stresses. The results indicate that the predictions derived from the elastic model consistently overestimate the measured radial change adjacent to the anastomotic junction. As a result shear stresses based on elastic theory deviate from values derived from a numerical curve fit to the experimental data. PMID- 3654681 TI - Role of the vagus in modulation by Ca2+ of the depressant action of adenosine and adenosine 5'-triphosphate on the canine sinus node in vivo. AB - 1 The effect of elevated plasma Ca2+ level on the depressant action of adenosine and adenosine 5'-triphosphate (ATP) on the sinus node was studied in a canine model in vivo. 2 Under baseline conditions, both adenosine and ATP (3 mumol/kg) administered as a rapid bolus injection into the right atrium, caused a transient (less than 120 s) prolongation of sinus cycle length (SCL) of 128 +/- 25 ms and 439 +/- 31 ms respectively (P less than 0.02). 3 Infusion of CaCl2 (0.025 mmol/kg/min for 40 min) prolonged SCL from 257 +/- 17 ms to 418 +/- 17 ms (at t = 40 min; P less than 0.05), but did not significantly change arterial blood pressure. 4 Ca2+ infusion had no significant effect on SCL prolongation caused by adenosine (128 +/- 25 ms vs 151 +/- 31 ms; before and at t = 40 min respectively), but caused pronounced enhancement of SCL prolongation caused by ATP (439 +/- 31 ms vs 1215 +/- 401 ms; before and at t = 40, respectively, P less than 0.02). 5 Atropine (0.2 mg/kg, i.v.) did not affect the action of adenosine before or during Ca2+ infusion. In contrast, atropine abolished SCL prolongation by Ca2+ and abolished Ca2+ enhancement of the action of ATP. 6 The present data give further support to the hypotheses that (a) calcium potentiates vagally mediated actions and (b) the vagus is involved in the differential electrophysiological actions of adenosine and ATP in the canine heart in vivo. PMID- 3654682 TI - Contractile responses of canine gastric muscle to peptides of the cholecystokinin group. AB - 1 Mechanical activity was recorded in isolated muscle preparations from the circular and longitudinal layers of different regions of canine stomach (16 dogs). At least eight muscle strips were excised from each stomach: longitudinal (lo) and circular (ci) strips from fundus (Fu), corpus (Co) and antrum (An), and circular strips from the inner and outer portion of the pyloric ring. 2 Cholecystokinin 33 (CCK 33), cholecystokinin octapeptide (CCK 8), caerulein and pentagastrin produced the same pattern of responses, with differences in their potencies: caerulein was 10 times more potent than CCK 8, and CCK eight to ten times more potent than CCK 33 and pentagastrin. 3 The most characteristic effect of the CCK peptides was an increase in frequency of the phasic activity of Fu-ci, Co and An preparations (threshold 10(-10) mol/l for CCK 8), usually combined with weak or moderate increases of amplitude. 4 Slight tonic activations were observed in Fu-lo, Co-lo and An-lo (around 10% of the ACH maximum), and stronger tonic activations in Fu-ci and Co-ci (around 50% of the ACH maximum). 5 No responses to CCK were seen in pyrolic preparations. 6 Experiments with receptor antagonists (adrenoceptors, muscarinic and histamine receptors), and with tetrodotoxin indicate that the peptides act by a direct effect on smooth muscle. PMID- 3654683 TI - Differential antagonism of the initial fast and secondary slow contractile responses of the rat isolated aorta to 5-hydroxytryptamine by mianserin and ketanserin. AB - 1 The rat isolated aorta is contracted by 5-hydroxytryptamine (5-HT) with an initial fast and secondary slow response. The secondary slow responses were greater than the initial fast. The effects of antagonists (prazosin, idazoxan, phentolamine, dihydroergotamine, methysergide, cyproheptadine, mianserin and ketanserin) on these initial fast and secondary slow contractile responses to 5 HT were studied. 2 Prazosin and idazoxan at 10(-7)M had no effect on responses to 5-HT. Thus all concentrations of 5-HT contract the aorta by stimulating receptors distinct from alpha-adrenoreceptors. 3 Phentolamine, dihydroergotamine, methysergide and cyproheptadine had similar inhibitory effects on the initial fast and secondary slow responses to 5-HT. Phentolamine at 10(-6)M caused parallel, whereas dihydroergotamine (10(-9)-10(-8)M), methysergide (10(-9)-10( 8)M) and cyproheptadine (3 X 10(-11)-10(-8)M) caused non-parallel rightward shifts of the concentration-response curves. 4 Mianserin and ketanserin had greater inhibitory effects on the initial fast than secondary slow responses. Mianserin (10(-9)-10(-7)M) caused a non-parallel and parallel rightward shift of the concentration-response curves to the initial fast and secondary slow responses to 5-HT, respectively. Ketanserin (10(-8)-10(-7)M) produced non parallel rightward shifts of the concentration-response curves. 5 One possible explanation of these results is that the rat aorta has no spare 5-HT2 receptors and that in inhibiting responses to 5-HT: (a) phentolamine is a competitive antagonist, (b) mianserin and ketanserin are slowly dissociating antagonists, and (c) dihydroergotamine, methysergide and cyproheptadine are irreversible antagonists. Furthermore, the competitive and irreversible antagonists have similar effects on initial fast and secondary slow responses to 5-HT, whereas the slow dissociating antagonists (mianserin and ketanserin) have a greater inhibitory effect on the initial fast than secondary slow response. PMID- 3654684 TI - Cholinoreceptors in the isolated costo-uterine muscle of the rat. AB - 1 The aim of this study was to examine the cholinoreceptor population in the rat costo-uterine muscle. 2 The nicotinic cholinoreceptor agonists nicotine and DMPP, and the ganglionic muscarinic cholinoreceptor stimulant McNeil A-343, had no effects upon isolated preparations of this tissue. 3 Acetylcholine was more potent than carbachol and approximately equipotent with methacholine (the mean EC50 values were 7.0, 6.3 and 6.7 respectively) in producing contractions of the preparation; each was a full agonist. The potencies of carbachol and methacholine were similar in preparations taken from animals in oestrus and in dioestrus. 4 Atropine competitively antagonised the effects of carbachol and methacholine, the pA2 values were 9.37 and 9.41 respectively. The pA2 value for pirenzepine with carbachol as the agonist was 6.69. 5 Pilocarpine produced phasic contractions of the tissue (EC50 value = 4.17), and competitively antagonised the effects of carbachol with a pA2 value of 5.26. The anticholinesterase, physostigmine, produced only a small potentiation of the effects of acetylcholine. 6 It is concluded that the cholinoreceptors which mediate contraction of the rat costo uterine muscle are muscarinic, homogeneous in nature and unaffected by fluctuating levels of ovarian hormones occurring during the oestrous cycle. The consequences of inhibition of cholinesterase activity in isolated preparations of the tissue are minimal. PMID- 3654685 TI - The evaluation of the interface between bone and a bioceramic dental implant. AB - Methods for evaluating the interface between bone and an experimental dental implant have been analyzed. The material studied was a titanium implant coated with a mixture of alumina and titanium dioxide by means of a plasma-jet system with the dog as the animal model. The evaluations were made on two levels: (1) in vivo, by analyzing radiographs of the peri-implant zone with a video display computer (2) in vitro, after explantation, by analyzing vertical and horizontal sections of the sample with an optical and a scanning electron microscope, and by a video display computer analysis of the microradiographs of these sections. PMID- 3654686 TI - Competition between adsorbed fibrinogen and high-molecular-weight kininogen on solid surfaces incubated in human plasma (the Vroman effect): influence of solid surface wettability. AB - The influence of the surface energy on the competition between fibrinogen and high-molecular-weight kininogen has been studied with the use of a recently described wettability gradient method. One finding is that the decrease in the antifibrinogen binding on plasma incubated gradient surfaces was not associated with an increase in anti-HMWK binding at all parts of the gradient surfaces. PMID- 3654687 TI - Theoretical and experimental analysis of cellular adhesion to polymer surfaces. AB - An exact discrete numerical solution to the Grabowski model for predicting cell adhesion to polymer surfaces is discussed. The solution technique allows the possibility of taking into account cell-cell interactions within the flow situation and the multistep process involved in thrombus formation. The proposed solution also allows modification of the wall reaction rate model into a two species reaction rate which distinguishes between the kinetics of contact adhesion and irreversible adhesion. The solution allows determination of effective diffusivity (De) and surface reaction rate (k) constants. Use of the model to examine available experimental data results in the following conclusions: (1) static or dynamic cell adhesion cannot be considered to be diffusion limited; (2) for flow conditions De is a monotonically increasing function of shear rate; (3) under static, i.e., zero flow conditions, De appears to be markedly larger than for flow conditions. PMID- 3654688 TI - The use of extraction replicas in scanning electron microscopy for the elemental analysis of marginal seals. AB - Elemental analysis of marginal seal material on 20 bulk samples of occlusally restored teeth have shown that, generally, more elements were detected in the seal material analyzed on the bulk restoration or fractured tooth surfaces than when such material was extracted using a nitrocellulose replica prior to analysis. No mercury was detected in any of the extracted seal material and only three of the replica specimens contained silver. This implies that the technique of using extraction replicas to remove material from the amalgam-tooth interface for subsequent x-ray microanalysis can provide an accurate elemental composition. The details of fabrication and the advantages of using high resolution nitrocellulose replicas for extracting marginal seal material from teeth for subsequent x-ray microanalysis are described. PMID- 3654689 TI - A new reconstituted connective tissue matrix: preparation, biochemical, structural and mechanical studies. AB - A fibrinogen derivative generated by thrombin was reacted with elastin to yield a new addition product or adduct between the two proteins. Addition of fibronectin, and then of collagen, did not interfere with the basic elastin-fibrinogen reaction and conferred the qualities of an artificial connective tissue to the product. Biochemical, structural and biomechanical aspects of the new matrix were studied. Aprotinin, heparin, thiomersal, and thiourea did not inhibit the main reaction; indeed, some of these ingredients improved the matrix cohesion. Scanning electron microscopy showed the genesis of a true network whose meshes were more reticulated by the addition of thiourea. Biomechanical studies, i.e., strength and elasticity showed the thiourea matrix to be the strongest. These intrinsic properties suggest the product could have biological and clinical applications. PMID- 3654690 TI - The influence of postcuring on the fracture properties of photo-cured dimethacrylate based dental composite resin. AB - The dependence of the fracture behavior of photocured dimethacrylate-based composite resins on the matrix crosslink density (varied by postcuring at various temperatures) was investigated. In general, the fracture toughness (KIc) was increased by postcuring as has been observed for epoxy-amine networks. The flexural and diametral tensile strength was also raised by postcuring. Calculation of the inherent flaw size (ao) from these properties produced conflicting dependencies on the state of cure. It is suggested that improved wear resistance and incisal edge strength of dental composite resin restoratives may be achieved by increased degree of cure. PMID- 3654691 TI - Conservatively treated tears of the anterior cruciate ligament. Long-term results. AB - Forty-nine patients who had a complete tear and forty-one who had a partial tear of the anterior cruciate ligament were examined as regards long-term healing. All had had a positive clinical diagnosis just after the injury, which was confirmed in the majority under anesthesia, at arthrotomy, on arthroscopy, or with a combination of these methods. The re-examination was performed an average of eight years after the injury. Besides a functional and objective evaluation, radiographic examination and evaluations of isokinetic and isometric strength were made. The multidimensional analysis revealed that in an unselected population the long-term results of the complete tears were poor, because of chronic instability. In many, reconstructive operations were needed, and post traumatic arthritis was common. In the patients who had a partial tear, the results were quite good even if the stability of the knees had not improved when compared with the initial post-traumatic status. Conservative treatment of complete tears of the anterior cruciate ligament cannot be recommended as a treatment of choice, whereas partial tears can be treated by non-operative methods. PMID- 3654692 TI - Resection arthroplasty as a salvage procedure for a knee with infection after a total arthroplasty. AB - Between 1970 and 1983, resection arthroplasty was done as a salvage procedure for twenty-eight knees (twenty-six patients) with infection after total arthroplasty. Eleven patients had multiarticular rheumatoid arthritis; fourteen, osteoarthritis; and one, multiarticular neuropathic arthropathy. Systemic signs of infection were eliminated in all patients and local signs, in 89 per cent of the patients. After resection arthroplasty alone, fifteen patients were able to walk independently. Six patients with monoarticular osteoarthritis who found the resection arthroplasty to be unacceptable had a successful secondary arthrodesis. In three patients a spontaneous bone fusion developed after the resection, with the knee in a good position. Two patients who were unable to walk before the resection arthroplasty were still unable to do so postoperatively. Neither the patient's disease nor the type of prosthesis that had been used was a reliable predictor of success of the resection arthroplasty. The patients who had had the most severe disability before the total knee arthroplasty were most likely to be satisfied. Patients who had had less disability were more likely to find the results of resection arthroplasty to be unsatisfactory. PMID- 3654693 TI - Anatomy of the abductor muscles of the hip as studied by computed tomography. AB - Computed tomography provides a non-invasive method for studying anatomy in live subjects. The abductor muscles of the hip were studied by using computed tomography to describe their position, size, and orientation. The outlines of the muscles were clearly identifiable; patterns that are associated with trauma, arthritis, and so on, differed from normal. The patterns in eighteen normal hips in twelve adults were mapped in detail. The cross-sectional areas of the abductor muscles were measured and vectors representing the total pull of the abductor muscle in the frontal and sagittal planes were constructed for each hip. The variations in individual and composite muscular anatomy were recorded. The inclination of the axis of the abductor muscle ranged from 17 to 26 degrees (standard deviation, 2.9 degrees) in the frontal plane and from -2 to 14 degrees (standard deviation, 4.2 degrees) in the sagittal plane. PMID- 3654694 TI - Subtrochanteric fracture of the femur. Fixation using the Zickel nail. AB - We divided 131 patients who had a subtrochanteric fracture into four clinical groups: elderly patients who had a fracture secondary to minor trauma, patients who had a fracture due to high-energy trauma, those who had a pathological fracture, and patients who had a fracture that previously had been treated unsuccessfully with internal fixation. In each patient operative fixation was performed using the Zickel device, and overall satisfactory results were obtained in 90 per cent. Considering the challenging nature of subtrochanteric fractures, complications, which included a rate of non-union of approximately 5 per cent, were minimum. Technical details for each of the four groups are emphasized. PMID- 3654695 TI - Isokinetic strength of the shoulder after repair of a torn rotator cuff. AB - The strength of the shoulder was measured isokinetically in forty patients who had undergone surgical repair of a torn rotator cuff. Thirty-three patients were tested six months postoperatively and twenty-four, after a year. There was an increase in strength between the two intervals (p less than 0.05) for abduction measured at 180 degrees per second, external rotation measured at 60 and 180 degrees per second, and flexion measured at 60 degrees per second. On the average, strength reached 80 per cent of normal in abduction and 90 per cent of normal in external rotation at one year postoperatively. Strength of forward flexion reached 75 per cent of normal. In seventeen patients with paired data (recorded at both six and twelve months), an increase in strength (p less than 0.05) was found for each motion and speed that was tested. Patients who had a small tear scored higher than those who had a large tear, but not to a significant degree. Whether the operation was done on the dominant extremity or on the non-dominant one did not appear to affect the results, nor did the timing of the repair after injury. PMID- 3654696 TI - Dislocation of the acromioclavicular joint. An end-result study. AB - The cases of 127 patients who had an acute dislocation of the acromioclavicular joint were studied. Fifty-two patients, with an average follow-up of 10.8 years, were managed operatively, and seventy-five patients, with an average follow-up of 9.5 years, were managed non-operatively. Using a rating system that included subjective, objective, and roentgenographic criteria, it did not appear that reduction of the acromioclavicular joint was necessary to obtain consistently good results. Operative management, using either coracoclavicular or acromioclavicular fixation, was associated with a higher rate of complications than non-operative treatment. The use of a sling for four weeks without reduction of the joint, followed by a graduated exercise program, led to acceptable clinical results. In patients who had persistent pain and stiffness of the acromioclavicular joint, or in whom symptomatic post-traumatic arthritis developed, resection of the distal part of the clavicle reliably produced significant improvement. PMID- 3654697 TI - The optimum position of arthrodesis of the ankle. A gait study of the knee and ankle. AB - Findings from biomechanical analyses of gait were used to estimate the optimum position of arthrodesis of the ankle. Nineteen patients who were followed for an average of 10.4 years (range, four to seventeen years) were studied. By including the knee in the analysis as well as studying the effects on gait of different ground conditions, objective data for the weight-bearing extremities in the transverse, sagittal, and coronal planes were generated. Genu recurvatum was shown to be associated with a plantar-flexion position of fusion of the ankle. Laxity of the medial collateral ligament of the knee was noted in twelve patients (63 per cent). Among these patients, in three (16 per cent) the laxity was graded as moderate to severe, possibly due to external rotation of the extremity during gait to avoid rolling over the rigid plantar-flexed ankle. The patterns of gait showed that a valgus position of the arthrodesis is more advantageous and provides more normal gait, particularly on uneven ground. To attain more normal function of the knee and improve performance on rough ground, the optimum position of arthrodesis of the ankle appears to be neutral flexion, slight (zero to 5 degrees) valgus angulation, and approximately 5 to 10 degrees of external rotation. Posterior displacement of the talus under the tibia tends to produce a more normal pattern of gait and decreases the stress at the knee. CLINICAL RELEVANCE: This study has shown the ideal position of fusion of the ankle to be neutral flexion, slight (zero to 5 degrees) valgus angulation of the hind part of the foot, and 5 to 10 degrees of external rotation. This position allows the greatest compensatory motion at the foot and places the least strain on the knee. PMID- 3654698 TI - The effect of antibiotics on the destruction of cartilage in experimental infectious arthritis. AB - In joints with bacterial arthritis, continuing prolonged destruction of cartilage may occur in spite of prompt, effective antibiotic therapy. We measured the extent to which early antibiotic therapy with ceforanide altered the degradation of the cartilage after arthritis due to Staphylococcus aureus had been produced in the knee joint in rabbits. Degradation of the cartilage was quantified by analyses for glycosaminoglycan and collagen. Three weeks after the infection was produced, the cartilage had lost more than half of its glycosaminoglycan whether the antibiotic therapy had been started at one, two, or seven days after infection. Beginning the antibiotic treatment one day after infection reduced over-all loss of collagen by 37 per cent and decreased the area of erosion of the infected articular surfaces. When antibiotic treatment was begun at four, eight, or twelve hours after infection, the loss of glycosaminoglycan averaged 18 per cent. Prophylaxis with antibiotics completely prevented any degradation of the cartilage. CLINICAL RELEVANCE: The findings reported here show how rapidly cartilage loses glycosaminoglycan when it is involved by arthritis caused by staphylococci and how early treatment of the infection reduces the loss of collagen. There is less protection against loss of glycosaminoglycan. The results emphasize the need for early diagnosis and treatment of infectious synovitis and support the rationale for early administration of antibiotics without waiting for identification of the responsible bacteria. PMID- 3654699 TI - Pyogenic osteomyelitis of the occiput, the atlas, and the axis. A report of five cases. AB - Pyogenic osteomyelitis rarely affects the first and second cervical vertebrae, and when it does it can progress to abscess formation, compressing the spinal cord. If the process is unrecognized, it can be fatal. The cases of five patients are reported. Two patients were treated by anterior debridement and posterior cervical-occipital arthrodesis; one, by transoral drainage; one, by posterior cervical-occipital arthrodesis; and the fifth, by posterior atlanto-axial arthrodesis. The causative organism was Staphylococcus aureus in four patients and Pasteurella multocida in one. In all patients, intravenous antibiotics were used, followed by prolonged administration of oral antibiotics. All five patients recovered. PMID- 3654700 TI - Surgical margins for soft-tissue sarcoma. AB - A retrospective analysis was done of the rates of local recurrence in eighty-one patients in whom soft-tissue sarcomas in the extremities and the trunk were treated by surgery only. The minimum length of follow-up was six years or until death. The surgical margin was wide in all patients according to the definition of the surgical staging system of Enneking et al., but we defined three types of wide margin. None of them included a whole anatomical compartment, so that the radical resection, as defined by the surgical staging system, was excluded from the study. The crude rates of local recurrence in the three subgroups that were studied differed significantly. There was no correlation between the rate of local recurrence and the histological grade of malignancy. Our findings suggest that the subclassification of the wide margin that we have applied to the surgical staging system of Enneking et al. is of value. The low rates of recurrence (less than 10 per cent) for subcutaneous lesions, and intramuscular lesions that were treated by primary myectomy, were comparable with those of radical resections and usually were followed by minor loss of function. The higher rate of recurrence (30 per cent) for the third subgroup, which included deep tumors that were not treated by myectomy, was comparable with the rates found in other studies. PMID- 3654701 TI - Synovial chondrosarcoma complicating synovial chondromatosis. Report of a case and review of the literature. PMID- 3654702 TI - Ewing sarcoma presenting as spondylolisthesis. Report of a case. PMID- 3654703 TI - Aseptic loosening of a total hip prosthesis secondary to tophaceous gout. A case report. PMID- 3654704 TI - Core decompression of the femoral head for osteonecrosis. PMID- 3654705 TI - Failure of stabilization of the spine with methylmethacrylate. A retrospective analysis of twenty-four cases. PMID- 3654706 TI - Dynamic external fixation for comminuted intra-articular fractures of the distal end of the radius. PMID- 3654707 TI - Public policy and orthopaedic surgery. PMID- 3654708 TI - Long-term follow-up of patients with grade-III and IV spondylolisthesis. Treatment with and without posterior fusion. AB - The outcome in eleven patients in whom Grade-III and IV spondylolisthesis was treated non-operatively (Group I) was compared with that in twenty-one patients in whom the same degrees of spondylolisthesis were treated by posterior interlaminar fusion (Group II). At an average eighteen-year follow-up of the eleven patients in Group I, four (36 per cent) were asymptomatic, six (55 per cent) had mild symptoms, and only one had significant symptoms. Five (45 per cent) had one or more neurological findings, but none were incontinent. All of the patients in this group led an active life, and all had required only minor adjustments in their life-style. At an average twenty-four-year follow-up of the twenty-one patients in Group II, twelve (57 per cent) were asymptomatic, eight (38 per cent) had mild symptoms, and only one had significant symptoms. Nine (50 per cent) of the eighteen patients who had a physical examination had one or more neurological findings. Roentgenographically demonstrated failure of fusion did not adversely affect the results, and the patients remained asymptomatic despite the development of pseudarthrosis in one patient and bending of the fusion mass in three (14 per cent). In situ arthrodesis provides acceptable results for the patient who has Grade-III or IV spondylolisthesis and pain that interferes with life-style and that is unresponsive to non-operative treatment. In the skeletally immature patient, in situ fusion is recommended for disturbances of gait secondary to tight hamstrings and when the spondylolisthesis progresses. PMID- 3654710 TI - An evolutionary perspective of the knee. AB - The complex asymmetrical design of the human knee is ancient in origin. The distinctive characteristics of this design were well established more than 300 million years ago. The knees of most classes of tetrapods exhibit similar morphological characteristics, including a bicondylar cam-shaped distal part of the femur, intra-articular ligaments, menisci, and asymmetrical collateral ligaments. The functional characteristics are also similar, with the dynamic point of femorotibial contact moving posteriorly on the tibia in flexion, approximating a four-bar linkage system. The common design and function among knees of tetrapods imply a profound underlying similarity of kinematic principles. Despite the over-all similarity of the design of knees in tetrapods, no ideal animal model exists for the human knee. The human is the only known species that is both plantigrade and biped. By taking into account the retained complex asymmetry of motion of the human knee, such as the differentially greater femoral rollback of the lateral compartment as compared with the medial compartment, external bracing systems and designs for total knee replacement might be improved. PMID- 3654709 TI - Synovectomy of the rheumatoid knee using intra-articular injection of dysprosium 165-ferric hydroxide macroaggregates. AB - One hundred and eleven patients who had seropositive rheumatoid arthritis and persistent synovitis of the knee were treated with intra-articular injection of 270 millicuries of dysprosium-165 bound to ferric hydroxide macroaggregates. A two-year follow-up was available for fifty-nine of the treated knees. Thirty-nine had a good result; nine, a fair result; and eleven, a poor result. Of the twenty five knees that had Stage-I radiographic changes, nineteen had a good result. Of the thirty-four knees that had Stage-II radiographic changes, twenty showed a good result. Systemic spread of the radioactivity from the injected joint was minimum. The mean whole-body dose was calculated to be 0.3 rad and that to the liver twenty-four hours after injection, 3.2 rads. The results indicated that dysprosium-165-ferric hydroxide macroaggregate is an effective agent for performing radiation synovectomy, particularly in knees that have Stage-I radiographic changes. Because of the minimum rate of systemic spread of the dysprosium-165, it offers a definite advantage over agents that previously have been used. PMID- 3654711 TI - Arthroplasty of the basal joint of the thumb using a silicone prosthesis. Long term follow-up. AB - Thirty-three hands were followed for an average of 7.8 years after arthroplasty of the basal joint of the thumb using a silicone prosthesis. The minimum length of follow-up was 5.6 years. All of the patients had relief of pain, but three complained of weakness. Radiographs of twenty hands showed that four prostheses had subluxated, three had dislocated, and thirteen had evidence of wear. Ten hands had destructive changes in the adjacent bones. We now recommend the use of a silicone prosthesis for arthroplasty of the basal joint only in elderly patients or in patients who have a low level of functional activity. In younger or more active patients, interpositional arthroplasty using tendon is recommended. PMID- 3654712 TI - Total wrist replacement using the modified Volz prosthesis. AB - Eighteen total wrist arthroplasties in sixteen patients were done using the modified Volz prosthesis. The length of follow-up ranged from twenty-four to sixty-six months, with a mean of forty months. A 100-point scoring system was used to evaluate the outcome. Muscle imbalance developed in five wrists, the carpal component became loose in three wrists, and two prostheses dislocated. In five patients six arthroplasties (33 per cent) were considered to have failed because one reoperation or more was required for loosening of the components in two wrists, dislocation in two wrists, and muscle imbalance in two wrists. Of the remaining twelve arthroplasties (eleven patients) eight (45 per cent) had an excellent result; two (11 per cent), a good; and two (11 per cent), a poor result. The over-all rate of complications was 44 per cent. Patients who had significant preoperative deformity did poorly postoperatively. The surgeon should be prepared to perform other types of arthroplasty or an arthrodesis if the extensor tendons are structurally inadequate, as this may lead to progressive flexion deformity postoperatively. PMID- 3654713 TI - Whose life is this, anyway? Nineteenth annual presidential address. American Burn Association. PMID- 3654714 TI - The impact of thermal injury. AB - From data collected by the Regional Burn Treatment Center at UCSD in San Diego and Imperial Counties in California, the incidence and economic cost of thermal injuries are extrapolated to the entire United States in order to estimate the impact of thermal injury on the public health. PMID- 3654715 TI - Haloperidol complications in burn patients. AB - Neuropsychiatric complications are commonly seen in major burn patients. Haloperidol is frequently used to treat severe psychopathic behavior. We have noted severe muscle rigidity-an extrapyramidal side effect of the agent-in a number of burn patients. Haloperidol causes a relative imbalance of dopaminergic and cholinergic neuronal activity in the basal ganglia with a relative increase in cholinergic activity being responsible for EPS. The burn patient may be more prone to extrapyramidal symptoms because of increased sensitivity of skeletal muscle neuromuscular junctions to acetylcholine after thermal injury. PMID- 3654716 TI - Patient self-reports three months after sustaining a major burn. AB - As survival rates of patients with major burns increase, it is becoming more important to study the course and quality of their recovery. Few studies of the recovery of these patients exist that use a prospective design and standardized measures. This paper describes a preliminary study of the self-reported health of patients three months after sustaining a major burn. An initial analysis was conducted on selected data gathered from 29 patients as part of a more comprehensive, prospective study of burn rehabilitation outcome. Measurements analyzed included the Sickness Impact Profile (SIP), the Health-Specific Locus of Control Scale (HLC), and the total body surface area burned (TBSA). Findings showed that TBSA was related to the degree to which patients perceived they had control over their health, but few correlations were found between TBSA, and HLC scale, and the SIP scale. On the SIP, most patients reported few or no problems, but a significant minority reported major problems in one or more areas of their lives. The problems that were reported tended to cluster in the areas of vocation and emotional adjustment. These results suggest that patients with major burns should not be considered a homogeneous group with respect to rehabilitation outcome. PMID- 3654717 TI - Adult psychosocial adjustment following childhood injury: the effect of disfigurement. AB - The literature investigating the psychosocial adjustment of burn survivors is limited and that addressing such adjustment in burned children is contradictory. Forty-two adults, burned in childhood, were assembled into burn severity cohorts and compared as to burn severity, intensity of stress, and extent of disfigurement and disability. The findings substantiated the hypothesis that the biologic variables of years since burn and severity would not explain psychosocial adjustment in adulthood; lower adjustment correlated with visible disfigurement and less peer support rather than with severity of burn. PMID- 3654718 TI - Psychological regression and marital status: determinants in psychiatric management of burn victims. AB - Major burn trauma is ordinarily associated with psychological regression, which regularly assumes either an immature, dependent (childlike), or primitive (animal like) form. Also, the severely burned patient is exquisitely responsive, both constructively and destructively, to behavioral nuances in his or her "significant other," typically, the spouse. Two variables, type of regression and marital status, provide an empirically derived rationale for the psychiatric treatment of behavioral problems affecting patient management, including especially (1) pain-related behavior, (2) intrusive reexperiencing of the trauma, (3) depletion/despair phenomena, and (4) problems related to scarring. Results are more favorable when regression is of the dependent type rather than primitive type. Treatment is enhanced when the partner in a committed relationship is included in the treatment program. PMID- 3654719 TI - Sexual satisfaction in burn patients. AB - One of the most frequent concerns of convalescent burn patients is that of sexual functioning. Using the degree of agreement between current performance and ideal performance as a measure of satisfaction with current performance, we have found a sex-related difference in 54 postburn patients. Postburn sexual functioning in males appears to be excellent; no specific factors could be identified by which this could be improved. However, in female patients, a much less satisfactory level of postburn sexual functioning is evident, which appears to be strongly correlated with physical dysfunction and with body image. PMID- 3654720 TI - Prevalence of postburn depression following burn injury. AB - We examined the prevalence of depression after burn injury in 139 adults treated at a major burn center. Interviews were held from one to eight years following the burn. Our subsample, taken from 882 patients treated over a six-year period, comprised all patients with 30% total body surface area burns and a random sample of those with burns of lesser severity. We considered 17 possible predictors of depression (including the severity and placement of the burn and the patient's age, educational background, medical history, employment status, income level, and emotional and psychiatric history). We found that it is the person, rather than the injury, that best predicts postburn depression. The factor most strongly linked with depression was a past history of emotional disturbance. However, after being burned, a significant number of even previously well-adjusted patients show clinical postburn depression. PMID- 3654721 TI - A survey of attitudes of burn unit nurses. AB - The staff of a burn unit was surveyed concerning attitudes about their patients and the treatment procedure. Previous research indicates that in such medical settings paradoxical interactions (double binds) may occur among staff, patient, and family. We hypothesized that the paradoxical environment of burn care units facilitates individuals who can change their perspective (or reframe these situations) and that this ability is related to attitudes and feelings about burn patients and their treatment. Contrary to expectation, however, reframing ability and attitudes about burn care were not related. Staff members are quite positive about burn treatment and agree that the staff instills hope. The staff's endorsement of providing accurate information, while behaving optimistically even if pessimistic about the patient's condition, does represent possible double binding communication patterns. Nursing managers with high reframing ability may facilitate staff coping with these issues. PMID- 3654722 TI - Pain management in the burn patient. Excerpts from a symposium on pain management, Seattle, Washington, July 23, 1986. PMID- 3654723 TI - A school reentry program for burned children. Part I: Development and implementation of a school reentry program. AB - Sustaining a burn injury is a devastating and painful experience. After acute concerns have been dealt with, continued support of the child and family is important in achieving a smooth return to normal activities. Reports from burned patients for whom physical therapy was a concern identified a need for physical therapy involvement in school reentry to facilitate a resumption of normal school routine. Physical therapy involvement in school reentry has been successful and rewarding with a reasonable commitment of manpower. Utilization of personnel in the administrative structure of state and local school systems promoted the acceptance of the program by local school personnel. Although this program is designed to meet the needs of burned children, the goals of the school reentry program may meet similar needs of children with other chronic illnesses. PMID- 3654724 TI - A school reentry program for burned children. Part II: Physical therapy contribution to an existing school reentry program. PMID- 3654725 TI - Bio-Concepts. PMID- 3654726 TI - Burns in school-age children: demographics and burn prevention. AB - Epidemiologic and demographic study of burn center patients and admission patterns can be useful in tailoring burn prevention programs. Such studies can pinpoint specific high-risk areas and seasons, thus allowing more efficient expenditure of resources. PMID- 3654727 TI - Mechanical performance of exertubing for isotonic hand exercise. AB - The purpose of this study was to determine the mechanical performance of hollow latex rubber tubes used for hand rehabilitation. The results of this investigation provide load extension profiles of each tube that document the forces required to elongate the tube to a specific length. By relating these mechanical performance tests to quantitative measures of hand strength, an individualized exercise prescription can be designed for rehabilitation of the injured hand. PMID- 3654728 TI - Feature protocol from North Carolina Jaycee Burn Center, Chapel Hill. PMID- 3654729 TI - Review from Harborview Medical Center, Seattle. PMID- 3654730 TI - Review from Shriners Burns Institute, Boston. PMID- 3654731 TI - Prognostic factors in the surgical treatment of aorto-iliac aneurysmal disease. Factors affecting survival and long-term results. AB - Factors governing the immediate and long-term outcome of surgical treatment of aorto-iliac aneurysmal disease were investigated in 182 elective and 116 ruptured consecutive cases. There was a 3.3% operative mortality for elective procedures and a 46.6% mortality for ruptured aneurysms. Long-term survival of elective resections was significantly reduced by age (0.01 less than p less than 0.025) and concomitant heart disease (0.025 less than p less than 0.05). Compensated renal insufficiency and chronic obstructive pneumopathy were not enough individually to preclude elective resection. In the emergency procedures the correlation of pre-, per- and postoperative factors to mortality was assessed: patient age (p = 0.01) and preoperative duration of symptoms less than 6 hours (p = 0.0076), arterial hypotension at the outset, during and at the end of operation (p = 0.0195; 0.0076 and 0.005 respectively), blood loss (p = 0.003), suprarenal extension of aneurysm (p = 0.0098) and intraperitoneal hemorrhage (p = 0.0094) were significant predictive factors in the univariate analysis. In the multivariate analysis peroperative duration of hypotension greater than 30 minutes was the strongest single independent discriminator (p = 0.0076), death being caused by myocardial ischemia in elderly patients, secondary to poorly tolerated severe hypovolemia. PMID- 3654732 TI - Aorto-enteric fistulas as postoperative complication. AB - This report is based on 15 own observations and 164 patients collected from the literature. The most frequent location both of primary and secondary aortic enteric fistulas (AEF) is the end part of the duodenum (60-70%). In the group of secondary AEF the paraprosthetic type represents the most frequent morphological finding. The best diagnostic approach should be seen in a gastroduodenoscopy. The choice of surgical repair is still controversal. Most of the surgeons insist on a radical repair (Type A: restoration of the intestinal tract, complete removal of the vascular prosthesis, blind closure of the infrarenal aortic stump, axillo bifemoral bypass). Type A repair is loaded with a high operative mortality (52%) and a number of secondary complications (e.g. recurrent AEF; bleeding from the aortic stump). As an alternative surgical approach the author present an in-situ repair (Type B: closing of the intestinal defect, partial exchange of inserted vascular prosthesis, an encircling omentum sleeve covering the prosthesis and anastomoses). The Type B repair offers a time saving procedure with a reduced operative mortality (26%) and a better outcome for the patients. This method is only contraindicated in the presence of a spread infection of the retroperitoneal space including the vascular prosthesis. PMID- 3654733 TI - Preservation of compliance in a small diameter microporous, silicone rubber vascular prosthesis. AB - Compliance is believed to be a significant factor in maintaining the patency of small diameter vascular grafts. This study evaluated the compliance changes with time of microporous Replamineform silicone rubber prostheses. The compliance of 15 canine femoral artery interpositions (4 mm internal diameter X 6 cm length) was measured by in-vivo electromagnetic rheoangiometry immediately following implantation and at intervals to eight months. At implantation, silicone rubber grafts were overcompliant (15.0 +/- 1.1% radial change/mmHg X 10(-2); mean +/- S.E.) compared to the proximal artery (7.7 +/- .6%). The compliance of the prostheses decreased within two weeks (6.3 +/- .9%) and remained isocompliant to the proximal artery for eight months. The compliance determinations for the silicone rubber grafts were compared with those from PTFE prostheses and vein grafts acquired by the same method in a previous study. The analysis demonstrates the preservation of isocompliance of the silicone rubber prostheses compared to the native arteries. In contrast, the minimally compliant vein grafts and PTFE prostheses continued to decrease in compliance following implantation. This microporous silicone rubber graft may improve the success of small internal diameter arterial reconstructions by eliminating failures caused by compliance mismatch between the artery and the prosthesis. PMID- 3654734 TI - Renovascular hypertension in pediatric patients. AB - Fifteen pediatric patients (ages 5-17 years) with renovascular hypertension (RVH) are reported. The diagnosis was made by arteriogram in all patients as the intravenous pyelogram was not helpful in this group. Five patients had a coarctation of the abdominal aorta. Four of these had associated renal artery stenosis. Renal artery stenosis alone was present in 14 patients, unilateral in 8, and bilateral in 6. Three of the former had a contralateral hypoplastic kidney. A nephrectomy was performed in 2 patients, both of whom continue to be hypertensive. Renal revascularization was performed in 13 patients; one of these died of sepsis. Eight are normotensive, 2 are improved (normotensive with diuretics), and 2 remain hypertensive. The follow-up is from 1 to 15 years. PMID- 3654736 TI - Assessment of a standard exercise test in peripheral arterial disease. AB - A recently proposed standard exercise procedure for the assessment of peripheral arterial disease has been tested in patients with unilateral intermittent claudication. The immediate post-exercise fall in systolic ankle pressure after a 1 minute walk at 4 km/h on a 10% slope has been compared with the results from the contralateral and control limbs. The test was acceptable to the patients and easy to perform but has not in this study proven sensitive enough, as described, to detect asymptomatic (but angiographically verified) arterial lesions. The test is found valuable, however, especially in patients with inconclusive resting pressure recordings i.e. with an ankle to brachial pressure index close to 0.9. A pressure drop of 30% or more in this group of patients seems to indicate functionally important arterial disease. PMID- 3654735 TI - Late arterial aneurysm proximal to corrected post-traumatic arteriovenous fistula. AB - A 60 year-old man presented with an extensive iliofemoral aneurysm discovered 11 years after the closure of a long-standing (28 years) post-traumatic arteriovenous fistula (AVF). Treatment by exclusion and bypass was successful. Fifteen other such cases have been reported in the literature in the last 15 years. While cardiomegaly is reversible once the AVF has been closed, arteriomegaly continues to increase or may begin only after closure. The mechanism for this phenomenon is debated. All arterial dilatations discovered during or after closure of AVF must be treated because of the risk of rupture. Prevention implies early treatment of all AVF. If the AVF is long-standing, the caliber of the artery proximal to the site of repair must be carefully measured and all dilated segments replaced. The patient should be warned of the possibility of late arteriomegaly proximal to the site of closure. PMID- 3654737 TI - Carotid occlusive disease: an electrophysiological macular investigation. AB - Thirteen patients with carotid stenosis were studied by the authors by the measuring the Visual Evoked Potentials (VEPs) before and after thromboendarterectomy. This test of retinal function measures the recovery time of the amplitude of the major positive peak (P100) after photostress. When compared to that we observed in controls, we found, a significant increase of the P100 recovery time in patients suffering from carotid disease with severe stenosis. The method proved suitable for the functional evaluation of the vascular reconstruction of the carotid area, since four weeks after surgery a physiological recovery of the amplitude of VEP was observed. This method is proposed by the authors for the long-term functional evaluation of patients subjected to carotid thromboendarterectomy for tight stenosis of the carotid bifurcation. PMID- 3654738 TI - Penetrating trauma of the internal carotid artery at the base of the skull. AB - A 42-year-old female sustained a partial transection of the internal carotid artery at the base of the skull from a stab wound of the external ear. The clinical presentation and technical aspects of the surgical treatment are presented. The lesion could not be repaired and was successfully treated by ligation. The various techniques of operative exposure of challenging and unusual high carotid injuries which can be employed to eliminate the risk of cerebral embolism, false aneurysm formation, or carotid artery thrombosis associated with conservative management are reviewed. PMID- 3654740 TI - Transaneurysmal aortic balloon tamponade. AB - A method consisting of direct transaneurysmal insertion of a double lumen balloon catheter designed to gain control of the inflow into ruptured or difficult to dissect aneurysms is presented. PMID- 3654739 TI - Total excision of a giant angiolipoma of chest wall with A-V malformation and with the use of an autotransfusion system. AB - An 18 year old girl suffering from a giant angiolipoma of back and chest wall with A-V malformation underwent total excision of the tumor in 4 stages. The first two stages included surgical ligation of the arterial blood supply to the tumor. In the third and fourth stages the tumor was resected with the use of an autotransfusion system. The last stage was complicated with massive bleeding and disseminated intravascular clotting. Control of bleeding was achieved by the use of autotransfusion system, right thoracotomy and massive transfusion of blood and its components. After long convalescence period associated with renal and respiratory failure the patient recovered completely without sequellae. This case demonstrates the complexity associated with the treatment of these rare tumors. PMID- 3654741 TI - Effect of addition of magnesium to potassium-containing fluorocarbon cardioplegic preparations. An experimental study. AB - The effect of magnesium on potassium fluorocarbon cardioplegia was studied in 20 rabbits. Isolated hearts with ascending aortas were perfused with oxygenated and cooled (+4 degrees C) fluorocarbon solutions. In 10 experiments, the solution contained 20 mmol/l of potassium, in 10 further experiments, 20 mmol/l of potassium and 15 mmol/l of magnesium. Ultrastructural preservation of the myocardium was studied using transmission electron microscopy. In addition, the cation contents of the myocardium were studied by flame atomic absorption spectrophotometry (calcium, magnesium) or electrothermal atomic absorption spectrophotometry (copper). After 120 minutes of ischaemia, areas of moderate or severe ultrastructural myocardial cell damage were observed in both groups but severe damage was more extensive and commoner in the group with no access to magnesium. Preservation of the capillary endothelium was also worse in that group. There was a highly significant increase in magnesium content, a decrease in calcium content and an increase in the magnesium/calcium ratio following magnesium-potassium fluorocarbon infusion. The copper content remained unchanged. A protective effect of magnesium was observed. The electrolyte content of cardioplegic solutions also alters the electrolyte content of the myocardium. This may be important in reperfusion. PMID- 3654742 TI - Cold induced endothelial cell detachment in human saphenous vein grafts. AB - The effect of profound (4 degrees C) and moderate cooling (20 degrees C) on the endothelium of human saphenous vein grafts for aortocoronary bypass was studied. When harvesting the vein, a piece (5-6 cm) was taken for the study and divided in two equal parts. The segments were incubated in cell culture medium for 45 minutes at 4 degrees C and 20 degrees C respectively. They were then perfused with cell culture medium at a flow rate of 100 ml/min, with a pressure of 85 mmHg and a temperature of 20 degrees C. After termination of perfusion the percentage of luminal surface without endothelial cells was determined by morphometry with scanning electron microscopy. The veins that were exposed to 4 degrees C had a significantly higher degree of endothelial cell detachment than those exposed to 20 degrees C (p less than 0.003). This study indicates that cooling to 4 degrees C may be harmful to the endothelial lining of veins which are prepared for grafting into the arterial system. Such cooling should therefore probably be avoided. PMID- 3654743 TI - Tricuspid incompetence resulting from retrograde aortic dissection. AB - This paper presents a 51 year old black female with known hypertension and an acute illness characterized by aortic regurgitation, cerebrovascular insufficiency, renal insufficiency, aortic valvular insufficiency, mediastinal widening and other features characteristic of acute Type I aortic dissection. An unusual feature in this individual is dissection extending into the membranous septum of the heart and into the aorto-atrial space with large hematoma, which partially disrupted the conduction system as well as dislodging the tricuspid septal leaflet in such fashion that major tricuspid regurgitation was present and interfered with termination of cardiopulmonary bypass. This patient presents a very unusual complication of which we wish to inform the readers. PMID- 3654744 TI - The choice of anticoagulation in pediatric patients with the St. Jude Medical valve prostheses. AB - Between February 1982 and January 1984 27 St. Jude Medical cardiac valve prostheses were implanted in 24 children ranging in age from 5 to 20 years (mean 12.38 years). There were 10 isolated aortic valve replacements, 14 isolated mitral valve replacements and one triple valve replacement (aortic, mitral and tricuspid). There was one operative and four late deaths. All patients were maintained on Aspirin and Dipyridamole from the early postoperative period. There were six documented thromboembolic events occurring in five patients. There were 0.68 thromboembolic events per patient year in the aortic valve group and 0.19 events in the mitral valve group. Because of the significant incidence of thromboembolic events in our patients, we now recommend universal anticoagulation with Coumadin in all pediatric age patients in whom the St. Jude Medical prosthesis is implanted. PMID- 3654745 TI - Intracavitary heart fibroma. A case of successful total excision. AB - Tumors of the heart are relatively rare events and fibromas represent no more than 5% of these. A central source of peripheral embolization suggests the possibility to kept in mind in the absence of other causes and is therefore worthy of closer investigation. PMID- 3654746 TI - Mycotic aneurysm of the pulmonary artery. Direct surgical approach with preservation of lung tissue. AB - A solitary mycotic aneurysm of the right apical lower segmental pulmonary artery developed in an 8 year old child with infective endocarditis, ventricular septal defect and pulmonary hypertension. Surgical treatment was undertaken to prevent rupture and achieved by direct ligation of the feeding vessel and endoaneurysmorrhaphy with preservation of all lung tissue. Successful surgical treatment has been described in eight previous cases of mycotic pulmonary artery aneurysm though in only one adult patient has lung resection been avoided. PMID- 3654747 TI - XVIII World Congress of the International Society for Cardiovascular Surgery. September 20-25, 1987, Sydney, Australia. Abstracts. PMID- 3654748 TI - Lamins A and C appear during retinoic acid-induced differentiation of mouse embryonal carcinoma cells. AB - The lamin complement of nuclear matrix isolated from F9 embryonal carcinoma cells was studied during retinoic acid-induced differentiation in culture. Differentiation of the original cells into parietal endoderm-like cells was accompanied by the gradual appearance of lamins A and C while lamin B was present throughout all stages. Lamins were identified by their molecular masses, isoelectric points, recognition by a monoclonal antibody and a polyclonal antiserum, and by peptide mapping. The increase in the amounts of lamins A and C found in the matrix was due to de novo synthesis as no extranuclear pools of these lamins were detected in the undifferentiated cells. These results provide biochemical evidence that, as in amphibian embryogenesis, there are variations in nuclear lamina composition during mammalian development. PMID- 3654749 TI - Transmembrane signaling by the B subunit of cholera toxin: increased cytoplasmic free calcium in rat lymphocytes. AB - It has previously been shown that the B subunit of cholera toxin, which binds solely to the plasma membrane ganglioside GM1, stimulates the proliferation of rat thymic lymphocytes (Spiegel, S., P. H. Fishman, and R. J. Weber, 1985, Science [Wash. DC], 230:1285-1287). The purpose of this study was to identify which transmembrane signaling system(s) are activated by the B subunit of cholera toxin. We compared the effects of B subunit and concanavalin A (Con A), a potent mitogenic lectin, on a number of second messenger systems that are putative mediators of T cell activation. Changes in the fluorescence of quin2-loaded cells revealed that mitogenic doses of either B subunit or Con A induced rapid and sustained increases in cytoplasmic free Ca2+ ([Ca2+]i). Within 5 min, [Ca2+]i increased from a basal level of 69 +/- 4 to 136 +/- 17 and 185 +/- 24 nM, respectively. The effects of B subunit and Con A were additive and largely dependent on the presence of extracellular Ca2+, though release of Ca2+ from intracellular stores could be detected for Con A, but not B subunit, using indo 1. The B subunit had no effect on either inositol phosphate levels or on the distribution of protein kinase C, indicating that, unlike Con A, the B subunit does not activate phosphoinositide hydrolysis. Fluorimetric measurements on cells loaded with bis(carboxyethyl)-5,6-carboxyfluorescein revealed that Con A induced a rapid cytoplasmic alkalinization via activation of Na+/H+ exchange, whereas B subunit had no effect on intracellular pH. Finally, by monitoring bis-oxonol fluorescence, we found that Con A induced a small hyperpolarization of the membrane potential, whereas B subunit had no acute effect. These data suggest that the biological effects of B subunit are mediated by an increase in [Ca2+]i resulting from a net influx of extracellular Ca2+. PMID- 3654750 TI - Biogenesis of the rat hepatocyte plasma membrane in vivo: comparison of the pathways taken by apical and basolateral proteins using subcellular fractionation. AB - We have used pulse-chase metabolic radiolabeling with L-[35S]methionine in conjunction with subcellular fractionation and specific protein immunoprecipitation techniques to compare the posttranslational transport pathways taken by endogenous domain-specific integral proteins of the rat hepatocyte plasma membrane in vivo. Our results suggest that both apical (HA 4, dipeptidylpeptidase IV, and aminopeptidase N) and basolateral (CE 9 and the asialoglycoprotein receptor [ASGP-R]) proteins reach the hepatocyte plasma membrane with similar kinetics. The mature molecular mass form of each of these proteins reaches its maximum specific radioactivity in a purified hepatocyte plasma membrane fraction after only 45 min of chase. However, at this time, the mature radiolabeled apical proteins are not associated with vesicles derived from the apical domain of the hepatocyte plasma membrane, but instead are associated with vesicles which, by several criteria, appear to be basolateral plasma membrane. These vesicles: (a) fractionate like basolateral plasma membrane in sucrose density gradients and in free-flow electrophoresis; (b) can be separated from the bulk of the likely organellar contaminants, including membranes derived from the late Golgi cisternae, transtubular network, and endosomes; (c) contain the proven basolateral constituents CE 9 and the ASGP-R, as judged by vesicle immunoadsorption using fixed Staphylococcus aureus cells and anti-ASGP-R antibodies; and (d) are oriented with their ectoplasmic surfaces facing outward, based on the results of vesicle immunoadsorption experiments using antibodies specific for the ectoplasmic domain of the ASGP-R. Only at times of chase greater than 45 min do significant amounts of the mature radiolabeled apical proteins arrive at the apical domain, and they do so at different rates. Approximate half times for arrival are in the range of 90-120 min for aminopeptidase N and dipeptidylpeptidase IV whereas only 15-20% of the mature radiolabeled HA 4 associated with the hepatocyte plasma membrane fraction has become apical even after 150 min of chase. Our results suggest a mechanism for hepatocyte plasma membrane biogenesis in vivo in which all integral plasma membrane proteins are shipped first to the basolateral domain, followed by the specific retrieval and transport of apical proteins to the apical domain at distinct rates. PMID- 3654751 TI - Dynamic shape changes of cytoplasmic organelles translocating along microtubules. AB - Transient shape changes of organelles translocating along microtubules are directly visualized in thinly spread cytoplasmic processes of the marine foraminifer. Allogromia laticollaris, by a combination of high-resolution video enhanced microscopy and fast-freezing electron microscopy. The interacting side of the organelle flattens upon binding to a microtubule, as if to maximize contact with it. Organelles typically assume a teardrop shape while moving, as if they were dragged through a viscous medium. Associated microtubules bend around attachments of the teardrop-shaped organelles, suggesting that they too are acted on by the forces deforming the organelles. An 18-nm gap between the organelles and the microtubules is periodically bridged by 10-nm-thick cross-bridge structures that may be responsible for the binding and motive forces deforming organelles and microtubules. PMID- 3654752 TI - Bending motion of Chlamydomonas axonemes after extrusion of central-pair microtubules. AB - Relatively little is known about the functions of central-pair microtubules (Tamm, S. L., and G. A. Horridge, 1970, Proc. Roy. Soc. Lond. B, 175: 219-233; Omoto, C. K., and C. Kung, 1979, Nature (Lond.). 279:532-534) and radial spokes (Warner, F. D., and P. Satir, 1974, J. Cell Biol., 63:35-63), although a sliding microtubule mechanism has been established for the flagellar movement (Summers, K. E., and I. R. Gibbons, 1971, Proc. Natl. Acad. Sci. USA., 68:3092-3096). In the present report, an attempt was made to determine the functions of central pair microtubules in flagellar motility. Central-pair microtubules were found to extrude from the tips of elastase-digested axonemes of demembranated Chlamydomonas flagella after the addition of ATP. The length of the extruded central-pair microtubules was approximately 70-100% that of the axoneme. After extrusion, axonemes continued to swim slowly backwards in the reactivation medium, with a trailing central pair attached like a tail to the flagellar tip. During bending movement of the axonemes, partially extruded central pairs rotated counterclockwise about the axoneme axis, as viewed from the distal end (Kamiya, R., 1982, Cell Motil. [Suppl.]:169-173). Axonemes swam backwards with a symmetric waveform and a beat frequency of approximately 10 Hz in the reactivation medium containing 10(-9)-10(-4) M Ca ions. Even at a lower Ca++ concentration, no ciliary-type swimming was noted on the axonemes. PMID- 3654753 TI - mRNAs for alpha- and beta-tubulin and flagellar calmodulin are among those coordinately regulated when Naegleria gruberi amebae differentiate into flagellates. AB - Three of four mRNAs that are specific to the differentiation of Naegleria gruberi amebae into flagellates (Mar, J., J. H. Lee, D. Shea, and C. J. Walsh, 1986, J. Cell Biol., 102:353-361) have been identified as coding for flagellar proteins. The products of these mRNAs, which are coordinately regulated during the differentiation, were identified by in vitro translation of hybrid-selected RNA followed by two-dimensional gel electrophoresis and antibody binding. Six cross hybridizing clones complementary to a 1.7-kb RNA (class II) all selected mRNA that was translated into two alpha-tubulins. The principal in vitro product, alpha-1, comigrated with a cytoplasmic alpha-tubulin, while the minor product with a more acidic pI, alpha-2, comigrated with flagellar alpha-tubulin. While Naegleria flagellar alpha-tubulin was found to be acetylated based on its reaction with a monoclonal antibody specific to this form, we suggest that alpha 2 is not likely to arise due to acetylation in vitro but probably represents the product of a second alpha-tubulin gene. The class III clone, also complementary to a 1.7-kb RNA, selected beta-tubulin mRNA. In the course of this work it was found, using monoclonal antibodies to the alpha- and beta-subunits of tubulin, that Naegleria alpha-tubulin migrated faster than beta-tubulin on SDS-PAGE. The class IV clone, which hybridizes with a 0.5-kb RNA, selected an mRNA that was translated into a heat stable calcium-binding protein, flagellar calmodulin. PMID- 3654754 TI - Genetic variants of C2 muscle cells that are defective in synthesis of the alpha subunit of the acetylcholine receptor. AB - We have analyzed two genetic variants of C2 muscle cells that have reduced levels of binding activity for alpha-bungarotoxin and have found that both synthesize only low levels of the alpha-subunit of the acetylcholine receptor. In both variants the uptake of 22Na in response to carbachol is diminished in proportion to the reduction in toxin-binding activity. In addition, the kinetic and sedimentation properties of the residual toxin-binding activity in both is indistinguishable from that seen in wild-type cells. Immunoblotting experiments on extracts of the variants using subunit-specific antibodies to alpha- and beta subunits of the acetylcholine receptor demonstrated that the beta-subunit was present, but failed to detect alpha-subunit. In both variants, the amount of alpha-subunit accumulated after a 5-min period of labeling with [35S]methionine was reduced by over 90%, leading to the conclusion that the alpha-subunit is synthesized at greatly reduced rates. Northern blot and S1 nuclease analysis showed no differences between the alpha-subunit mRNA in wild-type and variant cells. PMID- 3654755 TI - Calretinin: a gene for a novel calcium-binding protein expressed principally in neurons. AB - A novel gene of the calmodulin superfamily, encoding a 29-kD neuronal protein here named "calretinin," has been isolated as a cDNA clone from chick retina. The encoded sequence includes four putative calcium-binding sites and a fusion protein binds calcium. The most similar protein known is the 28-kD intestinal calcium-binding protein, calbindin (58% homology). Both genes date from before the divergence of chicks from mammals. The distribution of calretinin and calbindin mRNAs in chick tissues has been mapped using RNA gel blots and in situ hybridization. RNAs from both genes are abundant in the retina and in many areas of the brain, but calretinin RNA is absent from intestine and other nonneural tissues. Calretinin and calbindin are expressed in different sets of neurons throughout the brain. Calretinin RNA is particularly abundant in auditory neurons with precisely timed discharges. PMID- 3654756 TI - Sequential disassembly of myofibrils induced by myristate acetate in cultured myotubes. AB - The phorbol ester TPA induces the sequential disassembly of myofibrils. First the alpha-actin thin filaments are disrupted and then, hours later, the myosin heavy chain (MHC) thick filaments. TPA does not induce the disassembly of the beta- and gamma-actin thin filaments of stress fibers in presumptive myoblasts or fibroblasts, nor does it block the reemergence of stress fibers in 72-h myosacs that have been depleted of all myofibrillar molecules. There are differences in where, when, and how myofibrillar alpha-actin and MHC are degraded and eliminated from TPA-myosacs. Though the anisodiametric myotubes have begun to retract into isodiametric myosacs after 5 h in TPA, staining with anti-MHC reveals normal tandem A bands. In contrast, staining with mAb to muscle actin fails to reveal tandem I bands. Instead, both mAb to muscle actin and rhophalloidin brilliantly stain numerous disk-like bodies approximately 3.0 micron in diameter. These muscle actin bodies do not fuse with one another, nor do they costain with anti MHC. All muscle actin bodies and/or molecules disappear in 36-h myosacs. The collapse of A bands is first initiated in 10-h myosacs. Their loss correlates with the appearance of immense, amorphous MHC patches. MHC patches range from a few micrometers to over 60 micron in size. They do not costain with antimuscle actin or rho-phalloidin. While diminishing in number and fluorescence intensity, MHC aggregates are present in 30% of the 72-h myosacs. Myosacs removed from TPA rapidly elongate, and after 48 h display normal newly assembled myofibrils. TPA reversibly blocks incorporation of [35S]methionine into myofibrillar alpha-actin, MHC, myosin light chains 1 and 2, the tropomyosins, and troponin C. It does not block the synthesis of beta- or gamma-actins, the nonmyofibrillar MHC or light chains, tubulin, vimentin, desmin, or most household molecules. PMID- 3654757 TI - Skeletal muscle neural cell adhesion molecule (N-CAM): changes in protein and mRNA species during myogenesis of muscle cell lines. AB - Qualitative and quantitative changes in neural cell adhesion molecule (N-CAM) protein and mRNA forms were measured during myogenesis in G8-1 and C2 cell lines. Indirect immunofluorescence assay showed that N-CAM was constitutively expressed by myoblasts in culture and that myotubes appeared to be stained more strongly. These changes were quantified using a dot blot assay. N-CAM levels increased almost 4-fold in G8-1 cells and 15-fold in C2 cells during myogenesis. The kinetics of accumulation of N-CAM were not coordinate with other muscle markers such as creatine kinase or acetylcholine receptor levels, since N-CAM accumulated significantly ahead of these markers. Immunoblotting showed that myogenesis was not associated with changes in the extent of sialylation of N-CAM. However, distinct changes in desialo forms were observed after neuraminidase treatment. Myogenesis was accompanied by increases in 125- and 155-kD desialo forms with minor changes in 120- and 145-kD forms. Biosynthetic labeling studies showed that myoblasts specifically expressed a transmembrane isoform of 145 kD that was phosphorylated and was down-regulated in myotubes. Pulse-chase analysis of myotubes showed that the 120-kD isoform and an isoform of 145 kD that co-migrated with, but was distinct from, the 145 kD transmembrane isoform of myoblasts were precursors of the 125- and 155-kD isoforms, respectively, that accumulated in myotubes. The 125- and 155-kD isoforms in myotubes are linked to the cell membrane via phosphatidylinositol linkage and can be released by phospholipase C. Indirect immunofluorescence analysis showed that phosphatidylinositol specific phospholipase C specifically released N-CAM from the myotube membrane generating N-CAM-free myotubes, while myoblasts were unaffected by this treatment. Three N CAM mRNA species were observed in mouse muscle cell lines. Myoblasts were characterized by their expression of 6.7- and 5.2-kb transcripts while myotubes express 5.2- and 2.9-kb transcripts. Thus, myogenesis is qualitatively associated with a down regulation of the 6.7-kb transcript and an up regulation of the 5.2- and 2.9-kb transcript. PMID- 3654758 TI - Hexabrachion proteins in embryonic chicken tissues and human tumors. AB - Cell cultures of chicken embryo and human fibroblasts produce a large extracellular matrix molecule with a six-armed structure that we called a hexabrachion (Erickson, H. P., and J. L. Iglesias, 1984, Nature (Lond.), 311:267 269. In the present work we have determined that the myotendinous (M1) antigen described by M. Chiquet and D. M. Fambrough in chicken tissues (1984, J. Cell Biol., 98:1926-1936), and the glioma mesenchymal extracellular matrix protein described by Bourdon et al. in human tumors (Bourdon, M. A., C. J. Wikstrand, H. Furthmayr, T. J. Matthews, and D. D. Bigner, 1983, Cancer Res. 43:2796-2805) have the structure of hexabrachions. We also demonstrate that the M1 antigen is present in embryonic brain, where it was previously reported absent, and have purified hexabrachions from brain homogenates. The recently described cytotactin (Grumet, M., S. Hoffman, K. L. Crossin, and G. M. Edelman, 1985, Proc. Natl. Acad. Sci. USA, 82:8075-8079) now appears to be identical to the chicken hexabrachion protein. In a search for functional roles, we looked for a possible cell attachment activity. A strong, fibronectin-like attachment activity was present in (NH4)2SO4 precipitates of cell supernatant and sedimented with hexabrachions in glycerol gradients. Hexabrachions purified by antibody adsorption, however, had lost this activity, suggesting that it was due to a separate factor associated with hexabrachions in the gradient fractions. The combined information in the several, previously unrelated studies suggests that hexabrachions may play a role in organizing localized regions of extracellular matrix. The protein is prominently expressed at specific times and locations during embryonic development, is retained in certain adult tissues, and is reexpressed in a variety of tumors. PMID- 3654759 TI - Erythroid anion transporter assembly is mediated by a developmentally regulated recruitment onto a preassembled membrane cytoskeleton. AB - Analysis of the expression and assembly of the anion transporter by metabolic pulse-chase and steady-state protein and RNA measurements reveals that the extent of association of band 3 with the membrane cytoskeleton varies during chicken embryonic development. Pulse-chase studies have indicated that band 3 polypeptides do not associate with the membrane cytoskeleton until they have been transported to the plasma membrane. At this time, band 3 polypeptides are slowly recruited, over a period of hours, onto a preassembled membrane cytoskeletal network and the extent of this cytoskeletal assembly is developmentally regulated. Only 3% of the band 3 polypeptides are cytoskeletal-associated in 4-d erythroid cells vs. 93% in 10-d erythroid cells and 36% in 15-d erythroid cells. This observed variation appears to be regulated primarily at the level of recruitment onto the membrane cytoskeleton rather than by different transport kinetics to the membrane or differential turnover of the soluble and insoluble polypeptides and is not dependent upon the lineage or stage of differentiation of the erythroid cells. Steady-state protein and RNA analyses indicate that the low levels of cytoskeletal band 3 very early in development most likely result from limiting amounts of ankyrin and protein 4.1, the membrane cytoskeletal binding sites for band 3. As embryonic development proceeds, ankyrin and protein 4.1 levels increase with a concurrent rise in the level of cytoskeletal band 3 until, on day 10 of development, virtually all of the band 3 polypeptides are cytoskeletal bound. After day 10, the levels of total and cytoskeletal band 3 decline, whereas ankyrin and protein 4.1 continue to accumulate until day 18, indicating that the cytoskeletal association of band 3 is not regulated solely by the availability of membrane cytoskeletal binding sites at later stages of development. Thus, multiple mechanisms appear to regulate the recruitment of band 3 onto the erythroid membrane cytoskeleton during chicken embryonic development. PMID- 3654762 TI - Abstracts of papers presented at the twenty-seventh annual meeting of the American Society for Cell Biology. 16-20 November 1987, St. Louis, Missouri. PMID- 3654760 TI - Synthesis and assembly of membrane skeletal proteins in mammalian red cell precursors. AB - The synthesis of membrane skeletal proteins in avian nucleated red cells has been the subject of extensive investigation, whereas little is known about skeletal protein synthesis in bone marrow erythroblasts and peripheral blood reticulocytes in mammals. To address this question, we have isolated nucleated red cell precursors and reticulocytes from spleens and from the peripheral blood, respectively, of rats with phenylhydrazine-induced hemolytic anemia and pulse labeled them with [35S]methionine. Pulse-labeling of nucleated red cell precursors shows that the newly synthesized alpha- and beta-spectrins are present in the cytosol, with a severalfold excess of alpha-spectrin over beta-spectrin. However, in the membrane-skeletal fraction, newly synthesized alpha- and beta spectrins are assembled in stoichiometric amounts, suggesting that the association of alpha-spectrin with the membrane skeleton may be rate-limited by the amount of beta-spectrin synthesized, as has been shown recently in avian erythroid cells (Blikstad, I., W. J. Nelson, R. T. Moon, and E. Lazarides, 1983. Cell, 32:1081-1091). Pulse-chase experiments in the rat nucleated red cell precursors show that the newly synthesized alpha- and beta-spectrin of the cytosol turn over coordinately and extremely rapidly. In contrast, in the membrane-skeletal fraction, the newly synthesized polypeptides of spectrin are stable. In contrast to nucleated erythroid cells, in reticulocytes the synthesis of alpha- and beta-spectrins is markedly diminished compared with the synthesis and assembly of proteins comigrating with bands 2.1 and 4.1 on SDS gels. Thus, in nucleated red cell precursors, the newly synthesized spectrin may be attached to the plasma membrane before proteins 2.1 and 4.1 are completely synthesized and incorporated in the membrane. PMID- 3654763 TI - Cytogenetic evaluation of human endothelial cell cultures. AB - Cytogenetic evaluation of serially subcultivated human endothelial cells revealed significant differences between cultures derived from fetal umbilical cords and cultures derived from various vessel sites in adults. A rapid increase in the prevalence of polyploid cells, to levels of 100% in many cases, was detected in human umbilical vein endothelial cell cultures but not in endothelial cell cultures from adult vessels. Because the development of polyploidy has been viewed as one signpost of in vitro senescence, it may be that these in vitro observations of high levels of polyploidy are a reflection of the fact that umbilical tissue is at the end of its in vivo developmental lifespan when studied. Consistent karyotypic alterations also were observed in two clones from adult human abdominal aorta, even though these cultures exhibited low percentages of polyploid cells. Cultures of one clone exhibited a trisomy of chromosome 11, on which there are at least three onc gene loci, and a deletion of chromosome 13 through band q14. A loss of band 13q14 is a prezygotic chromosomal lesion known to predispose to retinoblastoma. In the other clone, two cell populations were observed, and each displayed a chromosomal abnormality. A trisomy of the long arm of chromosome 2 was noted in one cell population via a marker chromosome involving 2 and 14. The other cell population exhibited an abnormality of chromosome 2. Neither of these karyotypic alterations was detected in the parent culture from which the clones were derived. The results reported in this study have both practical and theoretical implications. The high incidence of polyploidy in serially cultivated umbilical cultures as well as the occurrence of chromosomal changes in umbilical and aortic cultures testify to the need for cytogenetic monitoring of cell cultures even though they are derived from presumably normal tissue. Cytogenetic changes in the endothelium may be important in atherogenesis and other pathologic states. The conversion of diploid endothelial cells into polyploid endothelial cells may provide a convenient model cell system for studying mechanisms of the development of polyploidy in cells and their relationship to in vitro senescence. PMID- 3654761 TI - Inhibition of capillary endothelial cell growth by pericytes and smooth muscle cells. AB - Morphological studies of developing capillaries and observations of alterations in capillaries associated with pathologic neovascularization indicate that pericytes may act as suppressors of endothelial cell (EC) growth. We have developed systems that enable us to investigate this possibility in vitro. Two models were used: a co-culture system that allowed direct contact between pericytes and ECs and a co-culture system that prevented physical contact but allowed diffusion of soluble factors. For these studies, co-cultures were established between bovine capillary ECs and the following growth-arrested cells (hereafter referred to as modulating cells): pericytes, smooth muscle cells (SMCs), fibroblasts, epithelial cells, and 3T3 cells. The modulating cell type was growth arrested by treatment with mitomycin C before co-culture with ECs. In experiments where cells were co-cultured directly, the effect of co-culture on EC growth was determined by comparing the mean number of cells in the co-cultures to the mean for each cell type (EC and modulating cell) cultured separately. Since pericytes and other modulating cells were growth arrested, any cell number change in co-cultures was due to EC growth. In the co-cultures, pericytes inhibited all EC proliferation throughout the 14-d time course; similar levels of EC inhibition were observed in SMC-EC co-cultures. Co-culture of ECs with fibroblasts, epithelial cells, and 3T3 cells significantly stimulated EC growth over the same time course (30-192% as compared to EC cultured alone). To determine if cell contact was required for inhibition, cells were co-cultured using Millicell chambers (Millipore Corp., Bedford, MA), which separated the cell types by 1-2 mm but allowed the exchange of diffusible materials. There was no inhibition of EC proliferation by pericytes or SMCs in this co-culture system. The influence of the cell ratios on observed inhibition was assessed by co-culturing the cells at EC/pericyte ratios of 1:1, 2:1, 5:1, 10:1, and 20:1. Comparable levels of EC inhibition were observed at ratios from 1:1 to 10:1. When the cells were co cultured at a ratio of 20 ECs to 1 pericyte, inhibition of EC growth at 3 d was similar to that observed at other ratios. However, at higher ratios, the inhibition diminished so that by the end of the time course the co-cultured ECs were growing at the same rate as the controls. These results suggest that pericytes and SMCs can modulate EC growth by a mechanism that requires contact or proximity. We postulate that similar interactions may operate to modulate vascular growth in vivo. PMID- 3654764 TI - Effects of dissolved oxygen concentration on hybridoma growth and metabolism in continuous culture. AB - Oxygen transport is a major limitation in large-scale mammalian cell culture. The effects of the dissolved oxygen concentration (DO; from 0.1 to 100% saturation with air) on Sp2/0-derived mouse hybridomas were investigated using continuous culture. The steady-state concentration of viable cells increased with decreasing DO until a critical dissolved oxygen concentration of 0.5% of air saturation was reached. The cell concentration declined at lower DO because of incomplete glutamine oxidation, and the specific lactate production from glucose increased to offset the reduced energy production from glutamine. Cell viability increased as the DO was decreased; the viability continued to increase even when the DO was reduced below 0.5%. The specific oxygen uptake rate was essentially constant for DO greater than or equal to 10% of air saturation and then decreased with decreasing DO. The P/O ratio (ATP molecules produced per O atom consumed) appears to change from 2 to 3 between 10 and 0.5% DO. The specific ATP production rate calculated using this assumption decreases only slightly with decreasing DO. The optimum DO of 50% for antibody production is different than the optimum (approximately 0.5% DO) for cell growth. PMID- 3654765 TI - Production of tumor growth-inhibiting protein by the neonatal mouse brain: dependence on intracellular glutamine metabolism. AB - We previously reported that the mouse brain at the neonatal stage but not at the adult stage secreted a carcinostatic factor of 62,000 Da, termed NBCF, which inhibited clonal growth and DNA synthesis of malignant cells preferentially over those of normal cells. In the present study, NBCF production by the neonatal mouse brain in culture was investigated. Addition of L-glutamine to the culture medium markedly promoted NBCF production in a concentration-dependent manner. The production seemed to be specific to glutamine, since no promotive effect was exerted by L-glutamic acid, its analogue DL-alpha-aminoadipic acid, L-aspargine, or L-aspartic acid or by other amino acids or vitamins. NBCF production was markedly reduced in culture medium either devoid of L-glutamine or containing 6 diazo-5-oxo-L-norleucine, a glutamine antagonist, or L-methionine sulfoximine, an inhibitor of glutamine synthetase. Thus NBCF production was promoted by extracellular supply, intracellular synthesis, and utilization of L-glutamine but was not affected by its deamidated form or homologue amino acids. On the other hand, NBCF production was completely repressed by addition of cycloheximide to the culture medium. The repressive effect was also exerted by actinomycin D although not completely, whereas cytosine beta-D-arabinofuranoside did not repress NBCF production. These results indicated that NBCF production by cultivation was independent of DNA replication but dependent mostly on a transcription stage and its following stages and partly on a translation stage from the preexisting mRNA to the protein. PMID- 3654766 TI - Effect of the mi allele on mast cells, basophils, natural killer cells, and osteoclasts in C57Bl/6J mice. AB - The osteopetrotic, microphthalmic (mi/mi) mouse lacks functional osteoclasts and has also been reported to be deficient in mast cells and natural-killer (NK) cells. The later deficiencies could be secondary to the osteopetrotic marrow, or a direct result of the mi allele. Therefore, heterozygotes were examined for these cell types, since these mice do not exhibit osteopetrosis. Adult +/mi animals have approximately 50%, and mi/mi animals examined by histologic techniques or tissue histamine levels have 0-10%, of the peritoneal, dermal, and intestinal mast cells compared with that of +/+ animals. Leukocyte histamine, indicative of the number of basophils, demonstrates the same pattern. Histamine content per mast cell in +/+ and +/mi animals is identical. The number of large granular lymphocytes (LGL) in splenic leukocyte preparations from +/mi animals is 50% that of +/+ animals, and these cells are undetectable in preparations from mi/mi mice. NK activity against YAC-1 cells paralleled the number of LGL present. The resorptive response of neonatal calvaria to parathyroid hormone was delayed in the case of cultured +/mi bone compared with that of +/+ bone, but the final rate of calcium release was identical. These data indicate that 1) the presence of one mi allele can affect the development of four distinct cell types, and 2) osteopetrosis alone does not account for the lack of mast cells, basophils, and NK cells in mi/mi mice. PMID- 3654768 TI - Degenerative arthritis. I. PMID- 3654767 TI - Comparison of oxidative metabolism in vitro in endothelial cells from different species and vessels. AB - Oxygen consumption was compared in confluent cultures of endothelial cells from human umbilical cord veins, rat pulmonary arteries, and bovine aortas. A microrespirometric method utilizing oxygenated hemoglobin as oxygen supply and indicator of respiration was used. Respiratory rate was equal in human and murine cells (2.0 X 10(-6) and 2.2 X 10(-6) microliters O2/cell/hour respectively), compared on a cell-to-cell basis, while respiratory rate of the bovine endothelium was significantly lower (0.4 X 10(-6) microliters O2/cell/hour) (P less than .001). PMID- 3654769 TI - Clinical features and medical management of osteoarthritis at the hand and wrist. AB - The epidemiology of osteoarthritis (OA) in the hand and wrist is reviewed. Clinical characteristics of primary and secondary OA are discussed, and differential diagnosis is outlined. Nonoperative management is detailed, including use of the nonsteroidal anti-inflammatory agents. PMID- 3654770 TI - Treatment of osteoarthritis in the hand and wrist. Nonoperative treatment. AB - Osteoarthritis should initially be treated conservatively with the use of oral medication, intra-articular steroid injections, hand therapy, and splinting. The reduction of pain and the resultant increase in function to the patient are the ultimate goals of this treatment. PMID- 3654771 TI - Osteoarthritis of the distal interphalangeal joint. AB - DIP joint arthritis may be painful and interfere with function of a finger or the entire hand. When conservative measures are no longer adequate to control the symptoms, operative intervention may be recommended. Arthrodesis is the procedure of choice in most situations, although specialized functional requirements may justify an attempt to maintain motion. Treatment of mucous cysts requires removal of the offending osteophyte as well as the cyst itself. Technique of skin closure depends on the situation and the surgeon's preference. Careful attention to the indications for surgery, to the education of the patient, to the anatomy, and to the surgical technique will usually lead to a beneficial result and will minimize complications. PMID- 3654772 TI - Osteoarthritis of the proximal interphalangeal joint. AB - Most patients with symptomatic osteoarthritis of the proximal interphalangeal joint should be managed nonoperatively. When operative intervention becomes necessary, therapeutic options include joint fusion or flexible implant arthroplasty. Both relieve pain; however, an implant, while preserving mobility, is subject to fatigue and ultimate failure. PMID- 3654773 TI - Proximal interphalangeal joint following traumatic arthritis. AB - The motivated patient with symptomatic post-traumatic PIP joint stiffness and discomfort has the potential for significant functional improvement. The specific treatment will depend on many factors, including residual joint architecture, alignment, and condition of the soft tissues. The careful surgeon will review all physical and roentgenographic data with the patient and involve her/him in the treatment plan. The function achieved eventually will depend as much on the motivated patient in the hands of a skilled therapist as on the surgeon's meticulous technique. PMID- 3654774 TI - Presumptive mesoderm cells from Xenopus laevis gastrulae attach to and migrate on substrata coated with fibronectin or laminin. AB - During amphibian gastrulation, presumptive mesoderm cells migrate from the blastopore towards the animal pole along the inner surface of the ectodermal layer. Their natural substratum is a network of anastomosing extracellular matrix fibrils, which contains fibronectin and laminin, as shown by immunostaining. If the fibril network is transferred onto a coverslip from the ectodermal layer, dissociated mesodermal cells readily attach to such conditioned surfaces and show active migration in a medium of high pH and low calcium ion concentration. In the present study, the surface of tissue culture dishes was coated with fibronectin, laminin, collagen type IV or heparan sulphate, to examine the effects on cell attachment and movement. The presumptive mesoderm cells from Xenopus laevis gastrulae showed rapid adhesion and active movement on the fibronectin- or laminin-coated surfaces. Cell adhesion was stronger and the mean rate of movement was higher on the fibronectin-coated surface than on the laminin-coated surface. The dissociated ectodermal cells did not attach to the fibronectin- or laminin coated surfaces. The mesodermal cells did not attach to the collagen-, or heparan sulphate-coated surfaces, showing that these components of the basement membrane cannot serve as an adequate substratum for the mesoderm cells, at least by themselves. PMID- 3654775 TI - Dissociation of basement membrane protein deposition and cell spreading in virally transformed rat mammary myoepithelial cells. AB - A myoepithelial-like cell line (Rama 401), isolated from rat mammary gland, has been transformed with a temperature-sensitive mutant of Rous sarcoma virus (tsRSV). Rama 401-tsRSV cells adopt a spindle morphology and fail to deposit basement membrane proteins when grown at the permissive temperature (35 degrees C). When switched to the non-permissive temperature (41 degrees C), the cells flatten (with a 5-fold increase in area), and deposit an extracellular matrix containing basement membrane proteins. When the cells are switched from 35 degrees C to 41 degrees C in the presence of monensin (an ionophore that inhibits protein secretion), basement membrane proteins are no longer deposited extracellularly although the cells flatten, their area increasing by ninefold. Cells switched from 35 degrees C to 41 degrees C in the presence of cycloheximide still flatten and deposit basement membrane proteins, whereas the morphological change on switching from 41 degrees C to 35 degrees C is inhibited by cycloheximide. These experiments indicate that the ability of Rama 401-tsRSV cells to spread on a plastic substratum is not dependent on the de novo synthesis and deposition of basement membrane proteins. PMID- 3654776 TI - Evidence for the persistence of a decondensed chromosome scaffold in the interphase nucleus. AB - Nuclei of in vitro cultured bovine liver cells, deprived of the membranes by Triton X-100, were treated with 2 M-NaCl and DNase. Changes in ultrastructure and protein composition were studied at successive steps during treatment. Electron micrographs of nuclei treated with 2 M-NaCl showed a peripheral lamina and an internal system of randomly coiled filaments embedded in a mass of DNA fibres. After partial removal of the DNA the filaments could be seen to serve as backbones for the DNA attachment. Artificial redistribution occurring during fixation with glutaraldehyde suggests that the salt-resistant filaments are not stably cross-bridged into a three-dimensional network. The existence of reversible cross-bridges in vivo cannot be excluded, however. From the available data it is inferred that the filaments represent a decondensed from of the chromosome scaffolds and play a basic role in the organization of the genome throughout the nuclear cycle. PMID- 3654777 TI - Assembly and remodelling of myofibrils and intercalated discs in cultured neonatal rat heart cells. AB - The reorganization of myofibrils and the re-formation of intercalated discs was examined in neonatal rat cardiac muscle cells during the first 72 h of culture. Rhodamine phalloidin was used to monitor the organizational state of the myofibrils and antibodies to desmoplakin and vinculin were used as markers for the presence of desmosomes and fasciae adherentes, respectively. Tiny punctate desmosomes were observed between muscle cells after 24 h and apparently increased in number and/or size between 24 and 48 h in culture. Fasciae adherentes were not detectable with antibodies to vinculin until after 48 h in culture. Well-defined sarcomeres were restored after 48 h in culture. Once formed the sarcomeric organization of the myofibrils was found to be stable provided they were attached to the sarcolemma via intercalated discs. However, if the myofibrils attached to regions of the membrane that lacked intercalated discs the sarcomeres appeared to break down gradually centripetally. When myofibrils attached to the membrane at the free edges of cells that were not in contact with other muscle cells, the striations stopped abruptly at a considerable distance before the myofibril attached to the membrane. These non-striated terminals elongated between 48 and 72 h and were associated with focal contacts that contained vinculin. Overall the results suggest that cell-cell contact may be critical for the stabilization of normal myofibrillar structure in the heart. PMID- 3654778 TI - Conditions for fibroblast adhesion without fibronectin. AB - Conditions that permit the adhesion of BHK fibroblasts to a variety of surfaces after inhibition of protein synthesis and competition of any adsorbed fibronectin or vitronectin with the fibronectin cell-binding tetrapeptide, Arg-Gly-Asp-Ser (RGDS), are defined. Exposure of the cells to serum components at any stage in the preparation prevents cell attachment if cycloheximide or fibronectin tetrapeptide is present. If leupeptin is used cell adhesion and spreading occur even when all fibronectin synthesis is suppressed by cycloheximide inhibition, or fibronectin binding by tetrapeptide competition. The adhesions formed under these conditions appear by interference-reflection microscopy and by general properties to be identical to those formed by cells under normal culture conditions. The cell suspensions produced in the presence of leupeptin rather than other trypsin inhibitors show good adhesion at low temperatures, though the cells hardly spread at all. The results suggest that the role of fibronectin in cell adhesion should be reinterpreted in terms of its possible action as an activator rather than as a bonding molecule. PMID- 3654779 TI - Microinjection of immaturin rejuvenates sexual activity of old Paramecium. AB - The sexual activity of aged Paramecium that underwent about 700 fissions after conjugation was remarkably decreased. Microinjection of a soluble cytoplasmic fraction prepared from young immature cells (about 20 fissions after conjugation) restored the sexual activity of the aged cells to that of presenescent mature cells. The factor responsible for the recovery of the sexual activity was shown to have the same characteristics as immaturin in terms of molecular size and net charge. Rejuvenation of sexual activity lasted up to 20 fissions after microinjection. However, cell division rate or fertility after self-conjugation was not increased by the microinjection. Our finding indicates that the decrease in sexual activity caused by aging was not due to defects in the genes for mating substances but to a decrease in the activity of a soluble protein responsible for the expression of mating activity. This is the first description of the restoration of a senescent defect by microinjection of young cytoplasmic components into Paramecium. PMID- 3654780 TI - Algal endosymbiosis in brown hydra: host/symbiont specificity. AB - Host/symbiont specificity has been investigated in non-symbiotic and aposymbiotic brown and green hydra infected with various free-living and symbiotic species and strains of Chlorella and Chlorococcum. Morphology and ultrastructure of the symbioses obtained have been compared. Aposymbiotic Swiss Hydra viridis and Japanese H. magnipapillata served as controls. In two strains of H. attenuata stable hereditary symbioses were obtained with Chlorococcum isolated from H. magnipapillata. In one strain of H. vulgaris, in H. oligactis and in aposymbiotic H. viridis chlorococci persisted for more than a week. Eight species of free living Chlorococcum, 10 symbiotic and 10 free-living strains of Chlorella disappeared from the brown hydra within 1-2 days. In H. magnipapillata there was a graded distribution of chlorococci along the polyps. In hypostomal cells there were greater than 30 algae/cell while in endodermal cells of the mid-section or peduncle less than 10 algae/cell were found. In H. attenuata the algal distribution was irregular, there were up to five chlorocci/cell, and up to 20 cells/hydra hosted algae. In the dark most cells of Chlorococcum disappeared from H. magnipapillata and aposymbiotic hydra were obtained. Chlorococcum is thus an obligate phototroph, and host-dependent heterotrophy is not required for the preservation of a symbiosis. The few chlorococci that survived in the dark seem to belong to a less-demanding physiological strain. In variance with known Chlorella/H. viridis endosymbioses the chlorococci in H. magnipapillata and H. attenuata were tightly enveloped in the vacuolar membrane of the hosting cells with no visible perialgal space. Chlorococcum reproduced in these vacuoles and up to eight daughter cells were found within the same vacuole. We suggest that the graded or scant distribution of chlorococci in the various brown hydra, their inability to live in H. viridis and the inability of the various chlorellae to live in brown hydra are the result of differences in nutrients available to the algae in the respective hosting cells. We conclude that host/symbiont specificity and the various forms of interrelations we show in green and brown hydra with chlorococci and chlorellae are based on nutritional-ecological factors. These interrelations demonstrate successive stages in the evolution of stable obligatoric symbioses from chance encounters of preadapted potential cosymbionts. PMID- 3654781 TI - The role of the micronucleus in stomatogenesis in sexual reproduction of Paramecium tetraurelia: laser microbeam irradiation of the micronucleus. AB - Fifteen amicronucleate cell lines and 22 cell lines with defective micronuclei were obtained following selective laser microbeam irradiation of the micronucleus. The amicronucleate cell lines showed reduced growth rate and formed abnormal oral apparatuses in asexual reproduction, and failed to produce any oral apparatus in autogamy, in agreement with previous observations on amicronucleate cells obtained by micropipetting. The 22 cell lines with defective micronucleus exhibited various abnormalities of the oral apparatus newly formed during autogamy. These abnormalities included the arrest of membranelle assembly, reduction in the length of the buccal cavity and oral membranelles, disruption of the organization of the membranelles, quadrulation of the dorsal peniculus, and failure of addition of membranellar basal body rows. Hence the micronucleus plays multiple roles in sexual stomatogenesis, deciding early steps of oral membranelle assembly and affecting their subsequent patterning. Our results agree with the notion that the micronucleus acts during a critical period between the second meiotic division and up to the formation of the zygotic nucleus to control the early stage of oral membranelle assembly. Laser microbeam irradiation might have created recessive mutations and/or chromosomal aberrations, which were expressed during this critical period with the formation of abnormal postmeiotic nuclei. PMID- 3654782 TI - The mobility of intramembrane particles in non-haemolysed human erythrocytes. Factors affecting acridine-orange-induced particle aggregation. AB - It has previously been shown that reversible intramembrane particle aggregation can be induced in non-haemolysed human erythrocytes. This phenomenon, which can be induced by the cationic dye Acridine Orange, has been further investigated using different experimental conditions that are expected to influence the rate of aggregation of the particles. In addition to the concentration of the dye, the rate of aggregation was also found to be dependent on the extracellular and intracellular pH, as well as on the type of buffer used. While lowering the pH of the Acridine Orange solutions resulted in decreased particle clustering, low intracellular pH increased and elevated intracellular pH decreased particle aggregation. Furthermore, at a given dye concentration and a given pH, Acridine Orange caused more intense aggregation in Tris-buffered saline than in isotonic phosphate buffer or phosphate-buffered saline. Under appropriate conditions Acridine Orange caused significant particle aggregation at concentrations as low as 0.25 mM within 30 s. During this period only discocyte-stomatocyte transformation occurred; neither agglutination nor vesiculation of the erythrocytes could be detected. Treatment of the erythrocytes with Diamide (Serva), which cross-links spectrin via disulphide bridges and thereby reduces lateral diffusion of integral membrane proteins over large distances, had no inhibitory effect on Acridine-Orange-induced particle aggregation. Heating the erythrocytes to 50 degrees C, at which temperature denaturation of spectrin and fragmentation of the erythrocytes occur, and subsequently incubating them in Acridine Orange at room temperature, caused an almost maximal rate of particle aggregation within 10-30 s, without haemolysis. The possible mechanism and significance of the particle aggregation phenomenon are discussed. PMID- 3654783 TI - The lack of attachment of transformed embryonic lung epithelial cells to collagen I is corrected by fibronectin and FXIII. AB - PER cells, a transformed pulmonary epithelial cell line that adhered to a large extent to a fibronectin substratum, were found to be attachment-deficient to collagen I. Although fibronectin can bind to collagen I monomers and polymers, the addition of exogenous fibronectin in the attachment medium induced the adhesion of these cells to collagen I polymers but not to monomers. By adding the transglutaminase of blood coagulation, FXIII, in the presence of fibronectin, the attachment of PER cells to collagen I monomers could be recovered while the minimal concentration of fibronectin needed to promote their adhesion to polymers was lowered. These studies indicate that FXIII enhances the fibronectin-mediated attachment of PER cells to collagen I. PMID- 3654784 TI - Weak bases partially activate Xenopus eggs and permit changes in membrane conductance whilst inhibiting cortical granule exocytosis. AB - At extracellular pH values close to their pKa values the weak bases, ammonia and procaine, elicited a series of events in non-activated Xenopus eggs, some of which resembled those normally occurring at fertilization. These included: (1) a transient increase in membrane conductance; (2) modification of the microvilli; (3) thickening of the cortical cytoplasm and displacement of the cortical granules; (4) pigment accumulation; (5) contractions and shape changes. However, these eggs did not undergo the cortical reaction nor emit the second polar body. Cortical granule exocytosis of inseminated or artificially stimulated eggs was inhibited if the eggs had been previously treated for 15 min with the weak base and subsequently rinsed. Multiple sperm-entry sites were exhibited by the inseminated eggs, suggesting polyspermy. However, such eggs did not cleave and although sperm had fused with the egg membrane, they were not incorporated. Nevertheless, a transient increase in membrane conductance was evoked, which was longer in duration and had a slightly different form from that normally accompanying fertilization. In these eggs cortical granules were intact but displaced away from the plasma membrane. Prolonged contact with the weak base rendered eggs totally unresponsive to sperm or artificial stimuli but eggs recovered when rinsed sufficiently. These effects of weak bases on unfertilized Xenopus eggs or during fertilization were completely absent at pH 7.4. Although changes in intracellular pH or Ca2+ may be involved in these phenomena, direct action by the weak base itself cannot be ruled out. PMID- 3654785 TI - Reactivation of cytoplasmic actomyosin in Physarum plasmodia extracted with glycerol and dimethylsulphoxide. AB - Thin-spread plasmodia of Physarum were subjected to extraction procedures using 50% glycerol or DMSO (dimethylsulphoxide) followed by labelling of actin with fluorescent phallotoxins. During the reactivation of the actomyosin system by 2 mM-MgATP fluorescent actin fibres contract isotonically, which results in numerous fluorescent 'contraction beads'. After short-term extraction 1 mM-Ca2+ has an inhibitory effect on the reactivation. This calcium sensitivity is abolished after long-term extraction with glycerol. Calcium at 10 mM irreversibly inhibits reactivation, irrespective of the duration of extraction. The inhibitory effect of 10 mM-calcium is prevented by phallotoxin labelling prior to incubation in Ca2+. The DMSO model shows an improvement in structural preservation when compared with the glycerol models. However, reactivation is inhibited by prolonged treatment with DMSO. PMID- 3654786 TI - Extracellular matrix and cell migration: locomotory characteristics of MOS-11 cells within a three-dimensional hydrated collagen lattice. AB - The locomotory trajectories of MOS-11 cells migrating in a three-dimensional hydrated collagen lattice have been determined using a computer-assisted optical sectioning unit. The trajectories have been quantified using a three-dimensional continuous-time Markov probability theory consisting of eight directional states and one stationary state; in the latter the cells are not locomoting. Markov analysis shows that these cells are locomoting in a random manner with regard to direction and remain stationary for about three times as long as they are locomoting. Analysis of persistence also implies random locomotion. Compilation of the distribution of angles between steps reveals that the cells exhibit a predilection for turns around 30 degrees and 150 degrees on either side of the previous step. Time-lapse video recordings show that the cells are bi-polar with ruffling membranes at opposite poles. Ruffling, and hence locomotion, occurs alternately at one pole and then the other, which would account for the distribution of angles encountered. The mean speed of the cells was of the order of 3 microns min-1 including the time stopped and approximately twice this if the time stopped (state 0) is not included. The results obtained provide base-line data on the locomotory characteristics of MOS-11 cells locomoting in a 1.2 mg ml 1 collagen gel. It is now possible to study the role of various matrix components in cell locomotion. Such studies are of importance to embryology, wound healing, host defence mechanisms and the invasion of cancer cells. PMID- 3654787 TI - Identification of protein antigens associated with the nuclear matrix and with clusters of interchromatin granules in both interphase and mitotic cells. AB - Monoclonal antibody 3C5 recognizes a family of protein antigens present predominantly within the nucleus of interphase cells. We have shown previously that the epitope recognized by 3C5 is phosphorylated and have concluded that the proteins defined by this antibody share a common phosphorylation site. Using a combination of immunofluorescence microscopy and immunogold labelling in conjunction with electron microscopy, we have studied the distribution of 3C5 reactive material within interphase and mitotic cells. Antibody 3C5 was found to label specific structures within the interphase nucleus that, on the basis of their characteristic granulofibrillar morphology and strong staining with bismuth, have been identified as clusters of interchromatin granules (IG clusters). Double-labelling experiments with 3C5 and monoclonal antibodies to DNA have shown that these structures contain no detectable DNA. However, by indirect immunofluorescence, we have shown that 3C5-reactive nuclear structures do label with human autoantibodies to the Sm antigen, a component of small nuclear RNP particles (snRNPs). Granulofibrillar structures that stained strongly with bismuth, and were morphologically identical to nuclear IG clusters, were observed in the cytoplasm of mitotic cells. These structures also labelled with 3C5 but not with anti-Sm antibodies. Our results suggest that IG clusters remain essentially intact through mitosis though some snRNP components are apparently lost. In situ extraction of cultured cells with Triton X-100, micrococcal nuclease and 1-2M-NaCl failed to deplete 3C5-reactive material in either interphase or mitotic cells, though some redistribution was evident. In addition, 3C5-reactive proteins were identified in nuclear matrices prepared from rat liver by high-salt extraction procedures. However, the recovery of such proteins was strongly influenced by the preparation technique employed. Our results suggest that 3C5-reactive proteins and IG clusters are anchored to, but not integral components of, salt-resistant structural elements of the interphase nucleus and the mitotic cytoplasm, presumably the nuclear matrix and the cytoskeleton, respectively. PMID- 3654788 TI - Onset of expression of the variant surface glycoproteins of Trypanosoma brucei in the tsetse fly studied using immunoelectron microscopy. AB - The acquisition of the variant surface glycoprotein (variable antigen) coat by metacyclic stage Trypanosoma brucei in the salivary glands of the tsetse fly, Glossina morsitans, has been studied in situ by transmission and scanning electron microscopy using monoclonal antibodies raised against metacyclic variable antigen types and complexed with horseradish peroxidase or colloidal gold. The coat is acquired after binary fission has ceased but while the parasite is still attached to the gland epithelium, i.e. before the mature metacyclic is released into the gland lumen. The variable antigen type heterogeneity previously observed in discharged mature metacyclics is here demonstrated in the nascent (attached) metacyclic population. The variant surface glycoprotein genes are thus not expressed in a fixed sequence since different metacyclic variable antigen types are present ab initio. The distribution of immunogold-marked nascent metacyclics of a particular variable antigen type, as shown by quadrat analysis of a scanning electron micrograph montage of the infected salivary gland epithelium, conforms to a Poisson series. This provides evidence that individual variant surface glycoprotein genes are stochastically activated and suggests that selective activation occurs after trypanosome division has ceased. PMID- 3654789 TI - Direct measurement of cell detachment force on single cells using a new electromechanical method. AB - We describe a new device in which an accurately measured force is applied to individual adherent cells while the topography of the adhesion zone is simultaneously monitored. The force is applied via a flexible glass micropipette, attached by suction to the cell under study, and is calculated directly from the measured pipette deflection. Regions of close contact in the adhesion zone are observed using interference reflection microscopy. We have used the device to measure the force required to detach human red blood cells from hydrophobic and hydrophilic glass surfaces, and to detach Dictyostelium discoideum amoebae from a hydrophobic glass surface. The measured forces per unit length of contact perimeter are within an order of magnitude of the tensions required for membrane rupture. PMID- 3654790 TI - Newt epidermal cell migration in vitro and in vivo appears to involve Arg-Gly-Asp Ser receptors. AB - The effect of a synthetic peptide consisting of Arg-Gly-Asp-Ser (RGDS), the amino acid sequence representing the fibroblast attachment site in fibronectin (FN), was tested on migrating newt epidermal cells. In one approach, skin explants were placed on the bottom of plastic dishes coated with human FN, human fibrinogen (FGN), human serum spreading factor (SF), or bovine type I collagen. The explants were then incubated overnight in serum-free medium with or without RGDS. In these experiments exposure to 50 micrograms ml-1 of RGDS reduced migration over FN, FGN and SF to 2-7% of control levels. Two peptides structurally dissimilar to RGDS (Val-Gly-Ser-Glu and Thr-Pro-Arg-Lys), and two that are structurally similar (Lys Gly-Asp-Ser and Arg-Gly-Glu-Ser), had no effect on explant migration even when used at concentrations higher than 50 micrograms ml-1. Upon removal of the RGDS peptide, inhibited explants quickly recovered. In collagen-coated dishes 50 micrograms ml-1 of RGDS was much less effective than in dishes coated with the other substrates. Raising the RGDS concentration in collagen-coated dishes tenfold did not greatly increase the RGDS effect. When added to the medium bathing wounded limbs, 50 micrograms ml-1 of RGDS only moderately inhibited wound closure. This concentration of peptide, however, severely inhibited migration from skin explants in newt-plasma-coated-dishes and migration over pieces of newt plasma-coated plastic placed under one edge of a skin wound. Increasing the RGDS concentration to 500 micrograms ml-1 resulted in almost total suppression of wound closure. Wounds exposed to this same concentration of Lys-Gly-Asp-Ser closed normally. These results indicate that newt epidermal cells possess RGDS receptors and that these receptors are involved in epidermal wound closure in vivo and in migration from skin explants onto plastic coated with FN, FGN, SF and collagen. The relative RGDS-insensitivity of wound closure in vivo and in migration from explants onto collagen may reflect in these instances the presence of a relatively high density of RGDS receptor binding sites on the substrate; the presence of RGDS receptor binding sites of relatively high affinity; or the participation of receptors other than those involved in migration over plastic coated with FN, FGN or SF. PMID- 3654791 TI - Interaction in vitro of non-epithelial intermediate filament proteins with supercoiled plasmid DNA. AB - Sucrose gradient analysis of reaction products obtained from non-epithelial intermediate filament (IF) subunit proteins and a mixture of supercoiled, relaxed and linearized plasmid pBR322 DNA at low ionic strength revealed that limited amounts of these polypeptides interacted exclusively with the supercoiled form of the plasmid DNA. These results were corroborated by electron-microscopic analysis of the reaction products, which showed that only circles of supercoiled pBR322 DNA were completely and smoothly covered with vimentin. IFs reconstituted from pure vimentin reacted with supercoiled pBR322 DNA only through their physical ends. The reaction of an aged preparation of vimentin with supercoiled pBR322 DNA produced large aggregates consisting of a central, axially oriented protein scaffold to which individual loops of DNA were attached at their bases in a halo like arrangement. The electron-microscopic appearance of such complexes was very reminiscent of that of histone-depleted metaphase chromosomes. Together with the previous observations that non-epithelial IF proteins have high affinities for single-stranded DNA and core histones and that they are structurally and functionally closely related to the nuclear lamins, these results were used to advance a novel hypothesis on the biological role of IF proteins in eukaryotic cells. PMID- 3654792 TI - Polarized pigment granule transport occurs in the absence of microtubules in squirrelfish erythrophores: studies of the effects of estramustine. AB - We have re-examined the involvement of microtubules in the process of pigment granule transport in squirrelfish erythrophores in situ (i.e. on scales). Light microscopic studies revealed that following exposure to 5 microM-nocodazole for 1 h at 4 degrees C erythrophores retained an ability to aggregate and disperse their pigment uniformly, though at reduced rates. Serial thick-section stereo high-voltage electron-microscopic studies showed that the entire microtubule population was removed by drug treatment and that the microtubules were not reassembled as a result of pigment translocation processes in the presence of reduced levels of nocodazole (0.4 microM). Immunofluorescence microscopic studies confirmed that nocodazole (0.5-1 microM) produced rapid disassembly of the microtubules. Whole-mount electron-microscopic studies showed that the pigment granules were suspended in a cross-linking network of 3-10 nm filaments, which appeared to support ordered pigment transport in situ in the absence of microtubules. Drug inhibition studies showed that micromolar levels of estramustine, a novel anti-MAPs (microtubule-associated proteins) drug, reversibly inhibited pigment transport. The results suggest that an estramustine sensitive cytomatrix component might produce polarized pigment transport in intact erythrophores. PMID- 3654793 TI - Metabolic encephalopathies: opportunities and challenges. PMID- 3654794 TI - Simultaneous 31P- and 1H-nuclear magnetic resonance studies of hypoxia and ischemia in the cat brain. AB - The objective of this study was to evaluate simultaneous 31P/1H nuclear magnetic resonance (NMR) spectroscopy as a technique for monitoring and correlating changes in brain energy metabolism during hypoxia and ischemia. Five cats were studied with a protocol that involved 20 min of hypoxia (PaO2 20 mm), 60 min of recovery, 10 min of hypoxia with relative ischemia (bilateral carotid occlusion, PaO2 20 mm), and 60 min of recovery. Bifrontal and biparietal electrocorticograms (ECoG) were monitored continuously during the entire protocol. The results demonstrate that the degree of metabolic response is different in individual cats, but a number of quantitative relationships between metabolic parameters are consistently observed for all cats. First, there is agreement between increases in lactate and changes in intracellular pH; the observed relationship corresponds to an in vivo cerebral buffer capacity of 29 mumol/g/pH unit. Second, the delayed recovery of PCr is due to the effect of metabolic acidosis on the creatine kinase equilibrium and not to a delayed recovery of the ATP/ADP ratio. Third, the observed rate of lactate clearance from the cell is zero-order (k = 0.36 mumol/g/min) for lactate levels greater than 5 microns/g and may be composed of both lactate efflux from the cell and lactate oxidation. PMID- 3654795 TI - Cerebral energy metabolism measured in vivo by 31P-NMR in middle cerebral artery occlusion in the cat--relation to severity of stroke. AB - The energy metabolism of the brain has been measured in a middle cerebral artery (MCA) occlusion model in the cat utilizing 31P-nuclear magnetic resonance (NMR). 31P-NMR spectra were serially obtained during 2 h of ischemia and a subsequent 4 h recovery period. The ratio of creatine phosphate (PCr) to inorganic phosphate (Pi) (PCr/Pi) showed a precipitous decrease in parallel with changes in electroencephalographic (EEG) amplitude in severe strokes during ischemia as well as during recirculation. Animals with mild strokes, as determined by EEG criteria, exhibited a much smaller decrease in PCr/Pi during ischemia. In the severe strokes, there was a splitting and significant shift of the Pi peak immediately after occlusion. In addition, the shifted Pi peak rapidly increased and remained elevated throughout the study. In the mild strokes, Pi also increased, but not as markedly. Intracellular pH determination by chemical shift of the Pi peak revealed a decrease from 7.1 to 6.2-6.3 during ischemia and the subsequent recovery period in the animals with severe strokes, whereas the pH in the animals with mild strokes did not show a significant change. A gradual decrease in adenosine triphosphate (ATP) to 57-79% of the control was exhibited in severely stroked animals during both the ischemia and the recovery period, whereas there was no change in ATP in the mild stroked animals. These results suggest that the dynamic process of pathophysiological changes in an MCA occlusion model in the cat leads to significant differences in cerebral metabolism between animals with mild and severe strokes. PMID- 3654796 TI - Effects of traumatic brain injury on cerebral high-energy phosphates and pH: a 31P magnetic resonance spectroscopy study. AB - Traumatic injuries to the CNS produce tissue damage both through mechanical disruption and through more delayed autodestructive processes. Delayed events include various biochemical changes whose nature and time course remain to be fully elucidated. Magnetic resonance spectroscopy (MRS) techniques permit repeated, noninvasive measurement of biochemical changes in the same animal. Using phosphorus MRS, we have examined certain biochemical responses of rats over an 8-h period following lateralized brain injury (1.5-2.5 atmospheres) using a standardized fluid-percussion model recently developed in our laboratory. Following injury, the ratio of phosphocreatine to inorganic phosphate (PCr/Pi) showed a biphasic decline: The first decline reached its nadir (4.8 +/- 0.4 to 2.8 +/- 0.7) by 40 min post-trauma with recovery by 100 min, followed by a second decline by 2 h that persisted for the remaining 6-h observation period (mean 2.5 +/- 0.5). The first, but not the second, decrease in PCr/Pi was associated with tissue acidosis (pH 7.10 +/- 0.03 to 6.86 +/- 0.11). No changes in ATP occurred at any time during the injury observation period. Such changes may be indicative of altered mitochondrial energy production following brain injury, which may account for the reduced capacity of the cell to recover from traumatic injury. PMID- 3654797 TI - A method for 14C and 3H double-label autoradiography. AB - The present study describes and validates a 3H/14C double-label autoradiographic method in which separation of the labels was obtained by sequential film exposures to film types sensitive to 14C only and to both 3H and 14C, respectively. The error in assuming a pure 14C image on the first film was 2-3%. A linear subtraction equation was developed for calculation of the 3H activity expressed in 14C equivalents as the difference in tissue activity between the second and the first film exposure. The actual 3H activity in the tissue could be obtained by multiplying the result by 25 (14C to 3H conversion factor). The subtraction procedure was validated for absolute 14C and 3H activities of 100 1,300 nCi/g and 600-11,000 nCi/g, respectively, and for relative 3H/14C activities between 5 and 10. Self-absorption of 3H in white matter was corrected for by multiplication by 1.61 (self-absorption coefficient). This factor was close to unity for 14C. PMID- 3654798 TI - Simultaneous determination of regional cerebral blood flow, glucose metabolism, and pH in acute experimental allergic encephalomyelitis. AB - Regional cerebral blood flow (rCBF), regional cerebral glucose metabolic rate (rCMR), and regional pH (r-pH) were measured simultaneously in fulminant acute experimental allergic encephalomyelitis (EAE) by the use of triple-label autoradiography. No changes were found in the absence of lesions (lymphocytic accumulations). In the lesions, rCBF was 79% increased and rCRM was 13% increased, whereas r-pH was unaltered compared to normal values. The reported changes result in a CBF/CMR ratio of almost 3 in the lesions compared to the normal value of 1.5. The changes may be interpreted as primary disturbances in glucose metabolism, resulting in a secondary increase in CBF. This theory is supported by quoted observations on abnormal morphology and abnormal enzyme content in brain mitochondria in EAE. PMID- 3654799 TI - Reflectance spectrophotometric measurement of in vivo local oxygen consumption in the cerebral cortex. AB - A simple method was developed to measure in vivo local oxygen consumption quantitatively in the brain cortex. Reflectance spectra of tissue hemoglobin at the brain's surface were measured for assessment of both local tissue hemoglobin content and its oxygen saturation. Local oxygen consumption was calculated from the spectral changes of tissue hemoglobin during complete cessation of blood flow by compression of the cortical surface in the suprasylvian gyrus with the tip of an optic probe. This procedure was performed without any brain damage and only took approximately 5 s. The calculated local oxygen consumption during this short period of compression remained constant for a few seconds. Then, it decreased rapidly, although the local tissue hemoglobin was not completely deoxygenated. The value of local cerebral oxygen consumption obtained by this method was 3.02 +/- 0.61 mL O2/100 g brain/min; it was not influenced by the change in systemic blood pressure. The effect of pentobarbital on cerebral oxygen consumption was also studied. At the stage of burst and suppression on electrocorticogram, cerebral oxygen consumption decreased significantly (p less than 0.001) to 1.03 +/- 0.07 mL O2/100 g brain/min. PMID- 3654800 TI - pH, K+, and PO2 of the extracellular space during ischaemia of primate cerebral cortex. AB - pH and K+ from the extracellular space, PO2, and CBF have been measured in the same region during progressive ischaemia of primate cerebral cortex. As blood flow was reduced, the other changes had the following sequence. PO2 fell rapidly to 30% of control levels at regional CBF (rCBF) of 30 ml 100 g-1 min-1. As CBF was further reduced, PO2 continued to fall. pH remained stable until around 20 ml 100 g-1 min-1, below which pH fell rapidly, with an exponential increase in H+ concentration. K+ showed the well-known relationship to CBF, remaining normal until around 10 ml 100 g-1 min-1, below which K+ rose rapidly. pHe and log K+ were lin-early related and confirmed that pH fell by 0.3 U before K+ rose significantly, and fell by 0.6 U before the massive rise in K+. The mechanisms involved in this sequence of events and the role of pH changes in the development of the so-called "ischaemic penumbra" are discussed. PMID- 3654801 TI - Effect of the muscarinic agonist carbachol on pial arteries in vivo after endothelial damage by air embolism. AB - Reactions of pial arteries to the muscarinic agonist carbachol were tested in vivo in chloralose anesthetized cats before and after endothelial damage. Moderate endothelial damage was induced by arterial air embolism and verified by electron microscopy for the vessels tested. The experiments had three phases; First, the normal reactivity of pial arteries to carbachol (10(-7) to 10(-5) M) was tested using the microapplication technique, then, after air embolism, the reactivity was reinvestigated at the same vessel. Finally, pial arteries were taken out for scanning electron microscopy. The results show carbachol (10(-6) and 10(-5) M) induced significant dilations under control conditions, also after repetition at the same vessel. After air embolism, the reactions to carbachol were abolished. Morphologic data revealed that whereas control pial arteries showed intact endothelium, the embolized vessels revealed various degrees of endothelial alterations. All showed flattening of endothelial nuclei, to a greater or lesser degree, and in many cases, the endothelium had a wrinkled appearance; several arteries showed severe degradation of the intercellular junctions. It is concluded that (a) carbachol-induced muscarinic vasodilatation of pial arteries in vivo can be abolished after a morphologically verified endothelial lesion--thus confirming in vitro studies in larger arteries and (b) disturbed vascular function does not require rubbing of the endothelium, but occurs already with moderate endothelial damage. PMID- 3654802 TI - Nimodipine does not affect cerebral lactate levels following complete ischemia in dogs. AB - Nimodipine is known to improve postischemic cerebral blood flow (CBF) and neurologic outcome in experimental animals. Whether or not the two observations are related is unknown. This study searched for a possible improved rate of brain metabolic recovery in animals treated with nimodipine postischemia. Complete cerebral ischemia was produced for 11 min in 16 dogs, followed by reperfusion for 70 min. Prior to ischemia, glucose was administered (0.75 g X kg-1) in 12 dogs. Half of the glucose-treated dogs were given i.v. nimodipine, beginning 5 min postischemia (10 micrograms X kg-1 bolus followed by 1 microgram X kg-1 X min-1). The other half were given only saline postischemia. The remaining four dogs were given no glucose and received saline only postischemia. In all dogs, serial brain biopsies were taken at 2, 20, 40, and 70 min postischemia. In 5 dogs, the integrity of the blood-brain barrier (BBB) was tested by injection of Evans blue dye and postmortem examination of the brains. Brain biopsies were assayed for concentrations of phosphocreatine, ATP, ADP, AMP, glucose, lactate, and pyruvate. In all dogs, there was rapid restoration of a normal brain energy state following reperfusion. Brain lactate had returned to near normal in all dogs by 70 min postischemia, and the rate of lactate depletion was not different between groups. The integrity of the BBB was only minimally affected. A portion of the brain lactate was converted to pyruvate rather than crossing the BBB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654803 TI - Interstitial fluid adenosine and sagittal sinus blood flow during bicuculline seizures in newborn piglets. AB - Changes of interstitial fluid adenosine concentrations and effects of O2 supply on interstitial fluid adenosine were studied by the brain dialysis technique in the frontal cortex of newborn piglets subjected to bicuculline-induced seizures. The O2 supply was changed globally by changing MABP and locally by varying PO2 in the artificial CSF perfusing the dialysis cannula. Sagittal sinus blood flow (SSBF), cerebrovascular resistance (CVR), and CMRO2 were also examined in the same animals. Seizures increased interstitial fluid adenosine 7.9-fold (p less than 0.05) when ictal MABP was maintained at preictal level and perfusate PO2 was 24 mm Hg (group 1, n = 6). Interstitial fluid adenosine increased 11.8-fold (p less than 0.05) during seizures associated with moderate systemic hypotension and the low perfusate PO2 (group 2, n = 6). By contrast, seizures increased interstitial fluid adenosine three-fold (p less than 0.05) when perfusate PO2 was increased to 182 mm Hg and ictal MABP was maintained at preictal level (group 3, n = 8). When ictal MABP was elevated from the preictal level and the perfusate was rich in oxygen, seizures failed to increase interstitial fluid adenosine (group 4, n = 7). In groups 1 and 3, the increase in interstitial fluid adenosine during seizures was associated with significant increases in SSBF and CMRO2, as well as significant decreases in CVR. These data suggest that the increase in O2 supply during seizures in piglets did not match completely the increase in O2 demand and resulted in enhanced release of adenosine into the interstitial space. PMID- 3654804 TI - Time-dependent changes of lumped and rate constants in the deoxyglucose method in experimental cerebral ischemia. AB - Time-dependent changes in the lumped and rate constants in a bilateral middle cerebral artery (MCA) occlusion in cats were evaluated. These variables were measured in 11 cats after a sham operation, in five after a 1-h occlusion, in two after a 2-h occlusion, in five after a 4-h occlusion, and in four after a 16-h occlusion. The time course of the cerebral tissue radioactivity [Ci* (t)] was monitored by external coincidence counting during a programmed infusion of [18F]2 fluorodeoxyglucose (FDG). Arterial plasma concentration [Cp* (t)] of tracer was kept constant during the first 45 min. Comparison of k2* and k3* in the sham operated group, estimated by external coincidence counting, and by the ratio of extraction fractions of glucose and [18F]2-FDG, demonstrated no significant difference between these rate constants in these two groups of animals. The rate and lumped constants were also estimated from Ci* (t) and Cp* (t), as well as from the ratio of extraction fractions of glucose and [18F]2-FDG, respectively, in the MCA occlusion group. Significant decrease in k3* was observed after 1 h of occlusion (20% lower than in the sham operation, p less than 0.05); in k1* decrease occurred within 4 h of occlusion (21% lower than in the sham operation, p less than 0.05). However, decrease in k2* was observed only after 16 h of occlusion (26% lower than in the sham operation, p less than 0.05). Namely, decrease of rate constants occurred first in k3* then in k1* and k2*.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654805 TI - The regional cerebral blood flow in patients under chronic hemodialytic treatment. AB - Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in an unselected group of nine chronic hemodialysis patients before and after a single hemodialytic treatment. All patients underwent neurological, neuropsychological, and biochemical evaluations on the same occasions. Predialysis rCBF values did not differ from those obtained in age-matched normal controls. Following hemodialysis, there was a mild reduction in the rCBF by a mean of 7 +/- 2.6% (p = 0.02). The posthemodialysis rCBF reduction was not associated with any neurological or cognitive dysfunction. The causes of hemodialysis-induced rCBF decreases are unknown, but increased blood viscosity and biochemical changes, such as urea reduction and blood alkalinization, may play a role. PMID- 3654806 TI - Pattern and progression of drug use among hyperactives and controls: a prospective short-term longitudinal study. AB - The pattern and progression in drug use across a 1-year interval was investigated for 54 hyperactives and 47 controls aged 13-18. Initiation and use rates between groups at Time 1 and Time 2 also were studied. Patterns of drug usage differed slightly between hyperactives and controls, with the hyperactives showing greater involvement with cigarettes. As well, the data for progression in use across the 1-year interval showed that hyperactives were by-and-large less predictable than controls in the progression of their drug use. Implications of these findings for future research are discussed. PMID- 3654807 TI - Positive and negative symptoms in psychotic and other psychiatrically disturbed children. AB - The positive and negative symptom distinction has been found to be valid in research on schizophrenia in adulthood. The present study examined age-related changes in the occurrence of positive and negative symptoms in psychiatrically disturbed children who were receiving psychiatric treatment for the first time. The effect of age on the manifestation of positive and negative symptoms was significant; positive symptoms increased linearly with age, while negative symptoms were most frequent in early childhood and late adolescence. This finding held for the entire sample of children, as well as the subsample of children with psychotic diagnoses. There were few sex differences in the rate of symptoms, although age trends varied somewhat by sex. Examination of the relation between symptomatology and IQ revealed that high-IQ children showed greater positive and fewer negative symptoms than low-IQ children. Results are discussed in terms of the importance of examining developmental differences in positive and negative symptoms. PMID- 3654808 TI - Classification of dyspraxia in hearing-impaired children using the Q-technique of factor analysis. AB - Identification of hearing-impaired children with the additional language-learning difficulty of dyspraxia, defined by Van Uden (1981, 1983), is explored. Results from 12 diagnostic subtests obtained by Van Uden's sample of profoundly deaf children and a Manchester sample with wider ranges of age and hearing loss were analysed by the Q-technique of factor analysis. Comparison of Q profiles revealed a dyspraxic/eupraxic profile for Van Uden's sample, but a linguistic/non linguistic profile for the Manchester sample. Two Manchester children who fulfilled the specified criteria and showed the dyspraxic profile had no known additional language-learning difficulties. Usefulness of the Q-technique for the profile analysis of hearing-impaired children is discussed, and comparisons made with the results from cluster analyses. PMID- 3654809 TI - The reliability of axis V of the multiaxial classification scheme. AB - In a reliability study concerning axis V (abnormal psychosocial situations) of the Multiaxial classification scheme for psychiatric disorders in childhood and adolescence, it was found that the level of agreement in scoring was adequate for only 2 out of 12 categories. A proposal for a modification of axis V was made, including a differentiation and regrouping of the categories and an adjustment of the descriptions in the glossary. With this modification of axis V another reliability study was carried out, in which the level of agreement in scoring was adequate for 12 out of 16 categories. PMID- 3654811 TI - Sixth International Symposium on High-Performance Liquid Chromatography of Proteins, Peptides and Polynucleotides. Baden-Baden, October 20-22, 1986. Proceedings. PMID- 3654810 TI - A comparison of child and parent ratings of depression for normal and clinically referred children. AB - Child and parent ratings of 14 items of the Children's Depression Rating Scale- Revised are compared for a non-clinical and clinical sample. Four hypotheses are tested: (1) children and parents differ in rating depressive symptoms; (2) children rate depressions less severely than parents; (3) parents report greater severity for behavioral and children for ideational symptoms; and (4) the relationship between child and parent ratings does not differ between samples. The first hypothesis was supported in the non-clinical sample and the second in the clinical sample. Support for the third hypothesis was equivocal. Finally, the fourth hypothesis was rejected. Implications of these results for the diagnosis of depression in childhood are discussed. PMID- 3654812 TI - High-speed preparative reversed-phase high-performance liquid chromatography of synthetic oligonucleotides. AB - A rapid method is described for the purification and analysis of synthetic oligonucleotides, based on reversed-phase high-performance liquid chromatography. Volatile buffers and a short column (40 mm X 4.6 mm) packed with Nucleosil 300-5 C4 were employed. Monitoring the column effluent with an UV detector provides an excellent means of controlling product quality. The method is suitable for the purification of crude synthesis products, as well as for desalting and removing gel contaminants from oligonucleotides eluted from polyacrylamide gels. The total time required per sample is less than 25 min. PMID- 3654813 TI - Polymer support synthesis. XII. Derivatization with the 4-decyloxytrityl group as an aid in the affinity chromatography of oligo- and polynucleotides. AB - In a continuation of previous studies on trityl groups substituted with long alkyl chains as affinity-protecting groups for oligonucleotides, the use of the (4-decyloxyphenyl)diphenylmethyl (DTr) group as an aid in the separation of solid phase products has been investigated. This substituent, which can be introduced and removed from the 5'-position in a similar manner to the di-p anisylphenylmethyl group, helps in the purification of deoxypolynucleotides with up to 140 bases. Their retention time was shown to depend not only on the length of the nucleotide chain and alkyl substituent, but also on the elution gradient rate. In oligoribonucleotide synthesis, the DTr group allows the purification of partially protected sequences, which are more stable to enzymatic degradation and, therefore, more suitable for handling and storage. PMID- 3654814 TI - High-performance agarose gel chromatography in octyl glucoside of integral membrane proteins from human red cells, with special reference to the glucose transporter. AB - Integral membrane proteins and lipids from human red cells were fractionated in the presence of octyl glucoside by high-performance gel chromatography on a 22-ml column of the small-bead cross-linked agarose gel Superose 6, at 5 degrees C, pH 7.6 and 30-50 mM detergent. To avoid aggregation a relatively high flow-rate, 9 ml/h, was chosen. At low ionic strength four main fractions were resolved, which contained anion transporter multimers(I), glycophorin oligomers(II), glucose transporter dimers(III) and phospholipids(IV). In 0.5 M sodium chloride the resolution was lower but the yield of the glucose transporter was markedly higher, and chromatography of partially purified glucose transporter gave a protein recovery of about 90%. The apparent Mr values for the octyl glucoside complexes of the main components were: anion transporter, 900,000; glycophorin A, 210,000-360,000, dependent on ionic strength; glucose transporter, 110,000 160,000; lipids, 70,000. Some components aggregated with time: at a flow-rate of 1 ml/h mainly glycophorins and the glucose transporter were eluted, but no anion transporter, and fractionation performed 20 h after solubilization showed extensive aggregation of proteins. Superose-6 chromatography of glucose transporter and membrane lipids that had been isolated on DEAE-cellulose partially resolved the transporter and the phospholipid fractions. In this case, the resolution was better with 50 than with 30 mM detergent. The maximum glucose transport activity was approximately one-tenth of that observed before fractionation and appeared in two main fractions, at the main transporter fraction as well as at the overlap between the transporter and the lipids. The activity level was the same in both fractions, although the protein concentration was much lower in the second one. Addition of 2 mM egg-yolk phospholipids to the eluent did not increase the activity. This strongly indicates that the glucose transporter needs some specific membrane lipids to retain high transport activity. At the concentration of ca. 0.3 mg/ml used, the glucose transporter was probably eluted as a dimer in the absence of phospholipids and as a monomer in their presence. PMID- 3654815 TI - Fractionation of plasma proteins by pseudo-ligand affinity chromatography. Elution from immobilized Brown Fractogel TSK-AF. AB - The fractionation of human plasma by chromatography on immobilized Brown Fractogel TSK-AF was analyzed by following the elution profile of 25 different plasma proteins. A three-step procedure was used to elute proteins from the column. First, a low-molarity buffer (30 mM sodium phosphate, pH 7.0, I = 0.053) was applied; then a linear salt gradient (0-1.0 M sodium chloride in the above buffer) was followed by an additional wash with four bed volumes of 1.0 M sodium chloride. Tightly bound proteins were finally stripped with 0.5 M ammonium thiocyanate. The elution profile of the proteins obtained by this procedure appears to be very reproducible. Comparison with the profiles obtained by chromatography on Cibacron Blue 3-GA and on Green TSK-AF indicates significant differences between the binding properties of the three gels. PMID- 3654816 TI - Enantiomeric resolution of amino acid derivatives on chiral stationary phases by high-performance liquid chromatography. AB - Chiral stationary phases (CSPs) containing urethane-blocked alpha-arylglycines as chiral groups were synthesized and found to have good enantioselectivity for several N alpha-acylamino acid esters. Depending on the derivatization pattern of the amino acids, two different mechanisms of adsorption, generating opposite elution orders, could be observed. The best results were obtained utilizing amino acids as their N alpha-3,5-dinitrobenzoylamino acid esters. The high resolution makes this method suitable for racemization studies in peptide and protein chemistry, as was demonstrated in some examples. The mechanism of enantiomeric adsorption of N alpha-3,5-dinitrobenzoylamino acid esters on such CSPs could be elucidated by a new method based on energy calculations for the reversible diastereomeric complexes. The calculated structures of the adsorption complexes agreed well with the observed elution orders of the amino acid derivatives. PMID- 3654817 TI - Separation of the valence intermediates of human haemoglobin by high-performance chromatofocusing. AB - Investigations into the properties of haemoglobin often require the isolation of the valence intermediates (alpha o2 beta+)2 and (alpha+ beta o2)2. Chromatofocusing with an anion-exchange gel (Mono PTM; Pharmacia, particle size 10 micron) in an HR5/20 column at various temperatures (10-25 degrees C) provides an excellent method for this task. A linearly decreasing pH gradient (8 to 7, generated by Polybuffer 96, Pharmacia) eluted sequentially the species methaemoglobin, (alpha o2 beta+)2, (alpha+ beta o2)2 and oxygenated haemoglobin. Calibration graphs help in quantitative analyses. This method is simpler and less time consuming and provides a similar or even better resolution than the traditional ion-exchange or isoelectric focusing methods. PMID- 3654818 TI - Poly(styrene-divinylbenzene)-based strong anion-exchange packing material for high-performance liquid chromatography of proteins. AB - An adsorbed polyethyleneimine coating was applied to sulfonated macroporous, microparticulate poly(styrene-divinylbenzene). The chemical, physical and chromatographic properties of the resulting strong anion-exchange packing material were thoroughly characterized. The dynamic load capacity of the experimental packing was comparable to that of large-pore diameter silica. Good recoveries of protein mass and enzyme activity were achieved. The new column withstood a variety of cleaning procedures and prolonged exposure to aqueous base. The retention times on the polystyrene-based column were similar to those on a silica and a commercial, polymeric, strong anion-exchange column. Chromatographic resolution of the new packing material was equal or superior to that provided by the other two packings. PMID- 3654819 TI - Characterization of estrogen receptors and associated protein kinase activity by high-performance hydrophobic-interaction chromatography. AB - We have determined that high-performance hydrophobic-interaction chromatography (HPHIC) with weakly hydrophobic columns permit the rapid separation of the labile isoforms of estrogen receptor proteins. Previously we reported the use of the SynChrom propyl 500 column for HPHIC of steroid receptors. However, due to the strongly hydrophobic characteristics of the ligand, [125I]iodoestradiol-17 beta, and the receptor protein, organic solvent was required in the mobile phase for greater recovery of receptor proteins. Here, we report separation of steroid receptors from human breast tumors and rat uteri, using the Beckman CAA-HIC, a non-ionic polyether-bonded column, without the need for organic solvents and with virtually 100% recoveries. Receptors were extracted in 10 mM phosphate buffer (pH 7.4). Maximum resolution and separation were achieved when a descending salt gradient of ammonium sulfate in phosphate buffer (pH 7.4) was used (2-0 M in 30 min). Estrogen receptor (ER) was resolved into two isoforms with tR = 22 +/- 1 min (n = 16, designated as peak I) and 27.5 +/- 0.5 min (n = 14, designated as peak II) and a purification of five- to twenty-fold in a single pass. Free steroid was eluted at tR = 35 +/- 1 min (n = 4). Separation was dependent on adjusting the ionic strength of cytosol to 1.5 M ammonium sulfate. ER, purified by HPHIC, retained ligand binding capacity and exhibited protein kinase activity, which was dominant in the less hydrophobic peak I (tR = 22 min) when immunoprecipitated with the monoclonal antibody D547. This method of rapidly purifying ER with high retention of biological activity may now be applied to the study of the molecular interrelationships of steroid receptor isoforms. PMID- 3654820 TI - Progestin receptors from tissues either exhibiting or lacking estrogen response mechanisms. Comparison of conventional and high-performance liquid chromatography methodology. AB - Evidence from a variety of target organs has shown that progesterone receptor (PR) is induced by estrogen receptor (ER) in normal and neoplastic tissues. However, approximately 12% of the normal human uterine samples exhibit only PR with no measurable ER, suggesting the expression of both inducible and constitutive receptor isoforms. We investigated several molecular properties of PR from tissues either exhibiting or lacking ER. All studies were conducted in potassium phosphate buffer containing 10 mM sodium molybdate with a synthetic progestin, [3H]R5020 as the ligand. Radioinert R5020 was used as competitor to assess nonspecific association. Competition analysis showed that PR from both sources exhibited similar ligand specificities and affinities. Relative affinities were ORG 2058 greater than R5020 greater than medroxy-progesterone acetate greater than progesterone much greater than testosterone (Kd values ranged from 10(-9) to 10(-10) M; testosterone showed no specific competition). We utilized high-performance liquid chromatography in the size-exclusion (HPSEC) and ion-exchange (HPIEC) modes to probe the size and ionic properties of PR. HPSEC profiles showed that the PR isoform from both sources was eluted as a single, sharp peak greater than 75 A. HPIEC elution profiles indicated no differences in the surface ionic properties in that PR from both tissue types eluted with ca. 100 mM phosphate. These experiments show no difference between the inducible and the putative constitutive form of PR. Thus, some PR species may not require estrogen for their formation. PMID- 3654821 TI - Determination of thymosin beta 4 in human blood cells and serum. AB - A simple one-step procedure for the determination of thymosin beta 4 in whole blood, various blood corpuscles, plasma and serum by reversed-phase high performance liquid chromatography (HPLC) is described. The blood cells were isolated by a Ficoll density gradient technique. The isolated cells were lysed and deproteinized with perchloric acid in the presence of an internal standard. The supernatant solution was neutralized by potassium hydroxide solution and thymosin beta 4 was measured by HPLC without further manipulations. The following amounts (fg per cell) were determined: polymorphonuclear leukocytes (409), mononuclear leukocytes (267) and platelets (22.3). Erythrocytes contained no thymosin beta 4. The average concentration of thymosin beta 4 in an extract of whole blood was 16.3 micrograms/ml. The concentration in plasma was less than 1% of that value. However, if serum was prepared and not immediately removed from the clotted blood, the concentration of the peptide increased from 0.04 to 2.1 micrograms/ml within 24 h. The biological significance of the findings is discussed. PMID- 3654822 TI - Performance evaluation of non-porous versus porous ion-exchange packings in the separation of proteins by high-performance liquid chromatography. AB - The performance of a non-porous, anion-exchange packing was evaluated and compared with a number of similar porous high-performance liquid chromatography packings. The non-porous columns were found to be equally efficient for proteins spanning a wide range of molecular weights, while the porous columns exhibited decreasing efficiency as the proteins became larger. The porous materials also exhibited size exclusion effects that were not seen with the non-porous materials, which partially accounts for the loss of efficiency with large proteins. When increasingly steep gradients were employed, the loss of resolution was less with the non-porous materials. PMID- 3654823 TI - Molecular weight determination of allergen extracts and isolation of allergenic molecules by high-performance liquid chromatography. AB - The usefulness of size-exclusion high-performance liquid chromatography (HPLC) for the molecular weight determination of allergen extracts as a method of process control was investigated by measuring seven different batches of timothy pollen extracts. Preparative HPLC was used for the isolation of the major allergen Cat 1, from a crude cat hair and skin scraping (CHSS) extract. The chromatograms of the seven batches of the timothy pollen extracts looked very similar, suggesting the same molecular weight distribution in each extract. The major allergen, Cat 1, could be isolated from the crude CHSS extract by preparative HPLC in acceptable purity, determined by crossed radioimmunoelectrophoresis. PMID- 3654824 TI - Combination of Zetaprep mass ion-exchange media and high-performance cation exchange chromatography for the purification of high-purity monoclonal antibodies. AB - A procedure involving diafiltration, mass ion exchange on a QAE Zetaprep disk, gel chromatography and cation-exchange chromatography was used for the purification of mouse monoclonal antibodies from hybridoma culture supernatant. Prior to the separation steps, the starting solution was adjusted to the desired pH and conductivity. Diafiltration was used for this purpose in order to keep the volume constant or even to reduce the volume of sample. A QAE Zetaprep disk was used to remove the main protein contaminants from the culture supernatant. After washing unbound proteins out of the Zetaprep disk, slightly bound protein was eluted with a buffer solution containing 50 mM sodium chloride. The monoclonal antibody was eluted with a solution containing 150 mM sodium chloride. The purity of the eluted antibody was 50%, and was increased to 99% by subsequent high performance cat-ion-exchange chromatography. The purity was determined by means of sodium-dodecyl sulphate polyacrylamide gel electrophoresis and silver staining. The advantage of the two high-performance techniques, mass ion exchange and high-performance cation-exchange chromatography, are the high-flow-rates and the high resolution that can be obtained. These techniques are suitable for the production of injectable therapeutic preparations. PMID- 3654825 TI - Purification of adenovirus hexon protein by high-performance liquid chromatography. AB - Adenovirus (Type 2)-infected HeLa cells were sonicated and treated with 1,1,2 trichlorotrifluoroethane. The water-soluble extract was ultracentrifuged and the supernatant, containing the dissociated proteins, was subjected to anion-exchange high-performance liquid chromatography on a Mono Q column in 50 mM bis-Tris-HCl (pH 6.5). Elution with a linear salt gradient resulted in a major peak, containing the hexon protein. PMID- 3654826 TI - Isolation of bovine cardiodilatin by fast protein liquid chromatography and reversed-phase high-performance liquid chromatography. AB - Cardiodilatin (CDD), a polypeptide exhibiting vasorelaxant and diuretic natriuretic bioactivity, was isolated from bovine atria. The isolation procedure reported here is different from that originally used for the purification of porcine and bovine CDD. Instead of cation-exchange chromatography on Fractogel TSK-CM 650 S and several purification steps on different high-performance liquid chromatographic (HPLC) columns, it is now possible to obtain CDD-88 by an automated fast-protein liquid chromatography system for repeated injections and a motor valve as fraction collector and only one final step of reversed-phase HPLC on a TSK-ODS-120T column. PMID- 3654827 TI - High-performance liquid chromatography of amino acids, peptides and proteins. LXXIV. Separation of heparin-binding growth factors by reversed-phase high performance liquid chromatography. AB - The separation of several immunologically related forms of the bovine brain basic heparin-binding growth factor by reversed-phase high-performance liquid chromatography is described. With Bakerbond C4 reversed-phase columns, it is possible to resolve the 0.8-1.0 M sodium chloride and the 1.0-1.3 M sodium chloride components from the preceding heparin-Sepharose affinity chromatographic step in the purification procedure for these polypeptide mitogens into multiple active forms, all of which exhibit similar molecular weights and immunoreactivity with specific polyclonal antisera. Structural characterisation suggests that it is likely that these forms represent different stages in the post-translational processing of these polypeptide mitogens. PMID- 3654828 TI - High-performance liquid chromatography of amino acids, peptides and proteins. LXXV. Isolation of isohormones of bovine thyrotropin and lutropin. AB - Purification of bovine thyrotropin and lutropin by conventional soft-gel chromatographic methods is shown to yield microheterogeneous products. High performance ion-exchange chromatography (HPIEC) can be used to purify these isohormones further for investigations into the structure/function role of glycoprotein microheterogeneity. Hormonal microheterogeneity is shown to be reflected in differences in surface-accessible charged groups, as demonstrated by HPIEC, and differences in net charge, as indicated by isoelectric focusing. Optimal separation of the glycoprotein hormones, based on protein charge, can therefore be achieved by a combination of these two methods. PMID- 3654829 TI - High-performance liquid affinity chromatography of liver plasma membrane proteins. AB - Plasma membrane proteins from liver were analysed by concanavalin A affinity and immunoaffinity high-performance liquid chromatography. In the method, four peptide bands with apparent molecular weights of 140,000, 120,000, 80,000 and 60,000 could be isolated. In the second method, with two immobilized monoclonal antibodies, two corresponding antigens--the membrane proteins dipeptidyl peptidase IV and GP 110--could be highly purified from plasma membrane extract with good yield in only one step. PMID- 3654830 TI - Use of Sep-Pak cartridges for on-line preparative high-performance liquid chromatography. AB - Sep-Pak C18 cartridges have found wide application to the extraction, concentration, and fractionation of peptides. Their use has hitherto been limited to stepwise loading, washing, and eluting procedures. By the use of commercially available plastic column end-fittings it was possible to connect steel tubing to both ends of the cartridges and allow low-pressure operation in a high performance liquid chromatography (HPLC) instrument. The cartridge was then able to function as a disposable, reversed-phase (RP) preparative column. Operation in a gradient mode gave several advantages over step-wise elution, including the direct UV absorption monitoring of the eluant. Gradient conditions could be optimised for sample recovery. The cartridge was compared with standard analytical RP-HPLC columns for the separation of both proteins and peptides. A test protein gave a single peak with good recovery. Experiments with peptide mixtures showed that the cartridge could resolve some components sufficiently to allow fractions of pure peptides to be collected. PMID- 3654831 TI - Isolation of apolipoprotein-B-48 from chylomicrons by high-performance liquid chromatography. AB - Apolipoprotein-B-48 (B-48) is a component of chylomicrons and chylomicron remnants and originates in the human gut wall. Its molecular weight represents 48% of the hepatic apolipoprotein-B-100 (B-100). So far, immunochemical assays are only available for B-100 and do not permit the specific determination of B 48. As a convenient immunochemical method is necessary for clinical and biochemical investigations of chylomicron remnants, we isolated B-48 in amounts sufficient to permit the production of monoclonal antibodies. After delipidation of the chylomicron fraction from 3 1 of human chylous ascites, size-exclusion chromatography was performed by using two serially connected TSK columns. B-48 was eluted as a second peak at about 35% of the total volume, well separated from B-100 (eluted as a first peak). After detection by UV absorption at 280 nm, the fractions collected from 25 automated runs were combined, ultrafiltered and examined for their protein composition by sodium dodecyl sulphate polyacrylamide gel electrophoresis. This indicated that we were able to isolate rapidly 3.4 mg of B-48 in a purity sufficient to perform immunization. PMID- 3654832 TI - High-performance sodium dodecyl sulfate polyacrylamide gel capillary electrophoresis of peptides and proteins. AB - High-performance capillary sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) has been developed for the separation and molecular weight (MW) determination of peptides and proteins. In this work, acrylamide was polymerized in fused-silica capillaries of 75 microns I.D. and 10 or 20 cm length. On-line UV detection was employed by placing the capillary in the optical path of the detector. Rapid separations of myoglobin fragments and of a mixture of standard proteins were demonstrated with efficiencies of the order of 40,000 plates for a column, 20 cm in length. Linear plots of log MW vs. mobility for the SDS protein complexes were observed. Variation in the percentage monomer composition (% T) of the polyacrylamide yielded the expected common intercept of log mobility vs. % T, confirming the size separation mechanism in the gel capillaries. The separation of the A and B chains of insulin with a 10-cm column in less than 10 min was also demonstrated. PMID- 3654833 TI - Analysis of tryptic digests of bovine beta-casein by reversed-phase high performance liquid chromatography. AB - Reversed-phase high-performance liquid chromatography (RP-HPLC) was used to separate the tryptic peptides of beta-casein. A gradient of 0-50% acetonitrile in 0.1% trifluoroacetic acid at a flow-rate of 0.8 ml/min resolved ten of the thirteen peptides. A modified gradient resolved the three peptides eluted at ca. 25% acetonitrile. RP-HPLC proved superior to high-voltage paper electrophoresis in analysis time, resolution and flexibility. The methods developed for the analysis of proteolysis of the milk protein, beta-casein, are now being applied to study the action of extracellular proteases from dairy bacteria on milk proteins. PMID- 3654834 TI - High-performance liquid chromatography of amino acids, peptides and proteins. LXXIII. Investigations on the relationships between molecular structure, retention and band-broadening properties of polypeptides separated by reversed phase high-performance liquid chromatography. AB - The gradient retention behaviour in reversed-phase high-performance liquid chromatography of a series of polypeptides related to human beta-endorphin has been investigated using different n-alkylsilica stationary phases and 0.1% trifluoroacetic acid in water-acetonitrile as mobile phase. In particular, the influence of changes in gradient time and flow-rate on retention parameters has been assessed with five different porous octadecylsilica phases with average particle diameters of 4 microns and 6 microns. Decreasing the pore size from 30 nm to 7.3 nm resulted in decreased S and log k'o values for most solutes. The effect of changes in the gradient steepness parameter, b, on the bandwidth behaviour of these polypeptides has also been investigated. Anomalous band broadening was observed for very steep and very shallow gradients, i.e. b greater than 0.7 or b less than 0.2. The significance of these results is discussed in relation to the presence of hydrophobic domains in the linear sequence, the probability of the formation of highly stabilised secondary structures and the possible involvement of multiple folded forms of a single solute in the chromatographic performance of these polypeptides. PMID- 3654835 TI - Size-exclusion high-performance liquid chromatography of peptides. Requirement for peptide standards to monitor column performance and non-ideal behaviour. AB - A series of five synthetic peptide polymers with the sequence Ac-(G-L-G-A-K-G-A-G V-G)n-amide, where n = 1-5, was employed to assess the resolving power of high performance size-exclusion columns in peptide separations. The peptide standards showed great versatility in monitoring both ideal (no interactions of solutes with the column material) and non-ideal (hydrophobic and/or ionic interactions of solutes with the column material) size-exclusion behaviour in volatile and non volatile mobile phases. The effectiveness of adding salts or organic solvents to overcome non-specific interactions of solutes with the column materials was well illustrated by the standards. In addition, the advantageous use of non-ideal size exclusion behaviour was highlighted. The ability to predict the position and/or elution order of peptides during size-exclusion chromatography (SEC) requires peptides to be separated by a pure size-exclusion process. Although the peptide standards demonstrated similar ideal size-exclusion profiles in non-denaturing medium on all the columns studied, this study suggested that, if the conformational character of a peptide-protein mixture in a particular mobile phase is uncertain and ideal size-exclusion behaviour is required, SEC should be carried out under highly denaturing conditions. PMID- 3654836 TI - Surface affinity chromatographic separation of blood cells. VI. Capacity factors of human peripheral blood cells on poly(propylene glycol) bonded chromagel columns and their correlation with surface hydrophobicities of the gel beads and the cells. AB - The chromatographic behaviour of human peripheral blood cells was investigated on poly(propylene glycol) (PPG)-bonded Chromagel. The mobile phase was 0.09 M phosphate-buffered 2% (w/w) dextran T40 solution at the pH of the respective isoelectric points of human blood cells. The elution order of four kinds of blood cells from PPG-C3-Chromagel columns coincided with that of the delta log K values of these cells determined by the hydrophobic affinity partition method using Pluronic P84 as a hydrophobic ligand. The capacity factors of granulocytes and lymphocytes increased with increase in the delta log K values of PPG-C3-Chromagel beads. Hydrophobic interactions contributed to the retention of the four kinds of blood cells on PPG-bonded Chromagel columns. PMID- 3654837 TI - Use of high-performance size-exclusion, ion-exchange, and hydrophobic interaction chromatography for the measurement of protein conformational change and stability. AB - Size-exclusion, ion-exchange, and hydrophobic interaction chromatographic techniques able to detect conformational changes induced by urea were developed for three globular proteins: bovine serum albumin, lysozyme, and trypsin. Alterations in tertiary structure were manifest chromatographically by highly reproducible changes in peak height, retention, and appearance of multiple peaks. Denaturation equilibria and kinetics obtained by classical physical methods, such as fluorescence intensity measurements for bovine serum albumin and enzyme activity for trypsin, could be correlated to particular changes in chromatographic behavior. The chromatographic methods utilized were selective toward specific structural changes and monitored independent denaturation steps via multiphasic kinetics. The correlation of chromatographic behavior to both independent measures of conformational changes and to assays which measure loss in biological activity, in the case of select proteins indicates that non denaturing high-performance liquid chromatography can be a useful tool to detect and quantitate perturbations of protein three dimensional structure which result in a loss in biological activity. PMID- 3654838 TI - Separation of some enantiomeric di- and tripeptides on chiral stationary phases. AB - The chromatographic behavior of the N-3,5-dinitrobenzoyl derivatives of twelve dipeptide esters and two tripeptide esters was investigated on three different chiral stationary phases (CSPs). It is observed that the stereoisomers present in each sample may be cleanly separated on each chiral phase. A degree of regularity is noted in the elution order of the enantiomers and often of the diastereomers. Elution order of the enantiomers is related to a chiral recognition model for each CSP. PMID- 3654839 TI - Enantiomeric composition analysis of amphetamine and methamphetamine by chiral phase high-performance liquid chromatography-mass spectrometry. AB - N-(Trifluoroacetyl)-l-prolyl- (N-TFA-l-prolyl-) d- and l-amphetamine diastereoisomers were separated by high-performance liquid chromatography and confirmed by an interfaced mass spectrometer system, using the commercially available N-3,5-(dinitrobenzoyl)phenylglycine chiral column. A separation factor of 1.52 and resolution of 3.8 were observed. N-TFA-l-prolyl-d- and -l methamphetamine diastereoisomers were only partially resolved. The chiral stationary phase-solute interactions were studied by varying the mobile phase (2 propanol in hexane). Results indicate the separation mechanism proceeds via dipolar and hydrogen-bond interactions between the chiral stationary phase and the solute. A modified "dipole-stacking" model takes into account these interactions and explains the difference in separability observed for N-TFA-l prolyl-d- and -l-amphetamine and N-TFA-l-prolyl-d- and -l-methamphetamine. PMID- 3654840 TI - Sulfate and phosphate analysis in glycoproteins and other biologic compounds using ion chromatography. Application to glycoprotein hormones and sugar esters. AB - An ion chromatography procedure was devised for the simultaneous determination of phosphate and sulfate in the same sample. In order to eliminate interference from zwitterionic compounds (particularly amino acids and peptides) generated during hydrolysis of the phosphate- or sulfate-containing compounds a pretreatment step with a cation-exchange column was required. The detection of sulfate is approximately twice as sensitive as phosphate on a molar basis. The useful working range for sulfate was 200 pmole to 35 nmole with the ion chromatography employed; the range for phosphate was 400 pmole to 65 nmole. Linearity in this range was very satisfactory. Representative analyses are presented for hydrolyzates of several glycoprotein hormones and sugar sulfates and phosphate esters. Replicate analyses were +/- 3.0% or better. The glycoprotein hormone analyses for sulfate did not indicate whole integers per mole, suggesting mixtures of isohormones as has been found by others using chromatofocusing or isoelectric focussing and immunoassay. PMID- 3654841 TI - Determination of organic acids in sugar cane process juice by high-performance liquid chromatography: improved resolution using dual Aminex HPX-87H cation exchange columns equilibrated to different temperatures. AB - The application of high-performance liquid chromatography to the quantitative analysis of organic acids in sugar cane process juice is described. Separation of these acids is achieved on Aminex HPX-87H cation-exchange columns. Resolution is improved by connecting two columns in series and equilibrating them at different temperatures. The acids in the sample are first isolated on DEAE-Sephadex A-25 anion-exchange resin equilibrated with 0.5 M isobutyric acid. They are then eluted with 0.5 M sulphuric acid and injected directly onto the HPLC column after filtration through a 0.45-micron membrane. This method allows the simultaneous determination of oxalic, cis-aconitic, citric, phosphoric, malic, trans-aconitic, succinic, glycolic, lactic, formic and acetic acids. Isobutyric acid is also separated on this system and provides a useful guide to the loading capacity of the anion-exchange resin. PMID- 3654842 TI - Manipulation of the mobile phase to achieve multiple step protein (calmodulin) purification using the same chromatographic material (a weak anion exchanger). PMID- 3654843 TI - Reversed-phase high-performance liquid chromatography of human growth hormone. PMID- 3654844 TI - Fast protein liquid chromatography-chromatofocusing of bovine and chicken alpha crystallin subunits under denaturing conditions. PMID- 3654845 TI - High-performance ion-exchange chromatography of proteins on non-porous ion exchangers. PMID- 3654846 TI - Rapid analysis of proteins and peptides by reversed-phase chromatography. PMID- 3654847 TI - High-performance hydroxyapatite chromatography of proteins. PMID- 3654848 TI - Quantitative determination of 1,2-butylene oxide in whole rat blood by gas chromatography-mass spectrometry. PMID- 3654849 TI - High-performance liquid chromatographic assay for vigabatrin and its primary degradation product in a pharmaceutical tablet formulation. PMID- 3654850 TI - Headspace liquid chromatographic technique for the determination of sulfite in food. PMID- 3654851 TI - Determination of cholesterol and its fermentation products by high-performance liquid chromatography. PMID- 3654852 TI - Affinity chromatography of pig heart malate dehydrogenase on the Remazol Brilliant Blue R derivative of hydroxyethyl methacrylate gel. PMID- 3654853 TI - Retention reproducibility of basic drugs in high-performance liquid chromatography on a silica column with a methanol-ammonium nitrate eluent. The effect of the mobile phase and the operating conditions. AB - The reproducibility of capacity factors and relative capacity factors are compared as methods for recording retentions for the high-performance liquid chromatography of basic drugs on a silica column with methanol-aqueous ammonium nitrate as the eluent. The effects of changing the column temperature and the ionic strength, pH and proportion of organic modifier in the eluent on the retentions and selectivity have been studied. The results suggest that the mobile phase and operating conditions must be closely defined in order to obtain results of adequate reproducibility to develop a data base of retention values for interlaboratory comparisons and/or for the identification of basic drugs. PMID- 3654854 TI - Advances in chromatography 1986. Part I. Proceedings of the twenty-second international symposium held in Houston, TX, September 15-17, 1986, and of the twenty-third international symposium held in Chiba, October 7-9, 1986. PMID- 3654855 TI - Interactive and multi-sensory analysis of complex mixtures by an automated gas chromatography system. AB - Methods are presented for increased human-computer interactions in the analysis of metabolic profiles of urinary organic acids. Complex mixtures of trimethylsilylated derivatives are separated by capillary gas-liquid chromatography on a 25-m bonded-phase, fused-silica column. Retention times and areas, determined by a printing integrator, are transferred to a personal computer along with the digitized output of the flame-ionization detector. Post run computer analysis gives enhanced visual graphic displays with software-driven zooming, scrolling, peak identification and quantitation. In addition, auditory (musical) forms can be produced that increase the scope of human interaction. This novel approach catalyzes simultaneous use of computer calculations and human intuition, optimizing their combined cognitive powers for accurate qualitative and quantitative analyses of these complex mixtures. PMID- 3654856 TI - Gas chromatography-mass spectrometry of some prostanoids with new derivatizing agents. Application to the analysis of 13,14-dihydro-15-ketoprostaglandin F2 alpha. AB - 13,14-Dihydro-15-ketoprostaglandin (PG) F2 alpha was separated completely from PGD2, PGE2 and PGF2 alpha within 10-15 min by gas chromatography-selected-ion monitoring on a capillary column after conversion to their methyl ester-n butyloxime-dimethylisopropylsilyl (ME-nBO-DMiPS) ether or ME-nBO-cyclic diethylsilylene (DES) derivatives. The mass spectra were characterized by their inherent ions of [M-43]+ at m/z 596 for the ME-nBO-DMiPS ether and of [M-73]+ at m/z 450 for the ME-nBO-DES derivatives, respectively. The appearance of the characteristic ions in the high-mass region with relatively high intensity and the use of these ions in selected-ion monitoring in a high-resolution mode (M/delta M = 3500) made it possible to enhance the selectivity in the detection of 13,14-dihydro-15-keto-PGF2 alpha in biological fluids. The detection limit of the ME-nBO-DES derivative of 13,14-dihydro-15-keto-PGF2 alpha was found to be 2 pg with a signal-to-noise ratio of 4:1 when the ion of [M-73]+ was monitored at m/z 450.30. PMID- 3654857 TI - Confirmation of clorsulon residues in cattle kidney by capillary gas chromatography-negative-ion chemical-ionization mass spectrometry. AB - A confirmatory assay for residues of the anthelmintic agent clorsulon [4-amino-6 (trichloroethenyl)-1,3-benzenedisulfonamide] in cattle kidney tissue has been developed. The assay involves isolation of a drug-containing fraction by solvent extraction, methylation of the analyte, and fused-silica capillary column gas chromatography-negative-ion chemical-ionization mass spectrometry of the pentamethyl derivative of clorsulon. The intensities of four negative ions [m/z 406 and 408 (trichloro species) and m/z 413 and 415 (dichloro species)] are monitored. Confirmation of the presence of drug in an analyte requires that all four ions appear at the appropriate retention time with their intensity ratios within 10-15% of those arising from analysis of the reference standard, methylated clorsulon; the lower limit of detection is 3 ppb. Quantification of the drug is based on the intensity of the m/z 406 ion. Identification and quantification of residues by the gas chromatographic-mass spectrometric assay gave results in good agreement with those obtained with an electron-capture gas chromatographic assay. PMID- 3654858 TI - Analytical methods for the study of urinary thioether metabolites in the rat and guinea pig. AB - Methods are described for the isolation and identification of three classes of bivalent sulfur metabolites characterized as neutral methylthio ethers, ethyl acetate-soluble acidic thioethers and ethyl acetate-insoluble acidic thioethers from rat and guinea pig urine. After extraction of the metabolites by the ammonium carbonate-ethyl acetate procedure, the individual metabolites are separated by capillary gas chromatography and/or by high-performance liquid chromatography with both mu Bondapak C18 and Porasil columns. Identification of the metabolites is based on gas chromatography-mass spectrometry (electron impact) and on fast atom bombardment mass spectrometry. Interesting species differences in metabolism were observed. The major ethyl acetate-soluble acidic thioethers in rat urine are mercapturic acids. In contrast, in the guinea pig a new pathway involving mercaptopyruvic, mercaptolactic and mercaptoacetic acids is operative. The thioether metabolites of styrene oxide and phenanthrene are described, but the procedures have been applied in studies of several drugs and environmental chemicals in our laboratory. PMID- 3654860 TI - Determination of reducing and non-reducing carbohydrates in food products by liquid chromatography with post-column catalytic hydrolysis and derivatization. Comparison with refractive index detection. AB - Post-column catalytic hydrolysis combined with 4-aminobenzoic acid hydrazide derivatization is employed for the determination of both reducing and non reducing carbohydrates in a variety of complex sample matrices such as dairy products, processed foods and tobaccos. Comparison with refractive index detection shows the post-column method to be superior from the standpoint of selectivity, sensitivity and simplicity of sample preparation. Limits of detection are in the low-nanogram range. Quantitative results are presented for the determination of sugars in potato extracts. The method is also applicable for the separation and detection of carbohydrate oligomers. PMID- 3654859 TI - Metabolism of bromobenzene. Analytical chemical and structural problems associated with studies of the metabolism of a model aromatic compound. AB - Our studies of bromobenzene metabolism have shown that the 3,4-oxide is metabolized to 3- and 4-bromophenol through an extended glutathione pathway. The mechanism of sulfur elimination from a dihydrobromobenzene metabolite is not known, although it is known that the aromatization reaction will occur in a 9000 g supernatant fraction of rat liver. The hepatotoxic and nephrotoxic metabolites of bromobenzene are most likely bromthiocatechols and a bromothiopyrogallol, respectively. PMID- 3654861 TI - High-performance gel permeation chromatography of glycosaminoglycans. Column calibration by gel electrophoresis. AB - High-performance gel permeation chromatography and sensitivity-enhanced polyacrylamide gel electrophoresis (SE-PAGE) have been combined to investigate the chromatographic properties of structurally related glycosaminoglycans. Enzymatically digested samples of hyaluronate, chondroitin 4-sulfate and dermatan sulfate were fractionated on a column series of TSK G4000SW and TSK G2000SW, eluted with 0.15 M sodium chloride. Isolated fractions were subjected to sensitivity-enhanced polyacrylamide gel electrophoresis for determination of molecular weight. These procedures allowed the rapid development of column calibration profiles for each glycosaminoglycan, under a given set of chromatographic conditions. The profiles obtained in 0.15 M sodium chloride yielded the following data: (1) at equal degrees of polymerization, hyaluronic acid chains have an apparently smaller hydrodynamic radius than the sulfated polymers, and (2) at equal molecular weights, all three glycosaminoglycans have approximately equal hydrodynamic radii. PMID- 3654862 TI - Application of high-performance liquid chromatography to the assessment of subunit heterogeneity in plant 11S storage globulins. AB - Plant 11S storage proteins from a wide range of species have been resolved into their component subunits by ion-exchange fast protein liquid chromatography under denaturing conditions. The complex profiles obtained were reproducible and characteristic for each plant species analysed. The technique is shown to have distinct advantages over the more conventional electrophoretic approaches used to assess 11S subunit heterogeneity. The potential for the fast protein liquid chromatographic method as a simple screening system is discussed. PMID- 3654864 TI - Stereoelectronic model to explain the resolution of enantiomeric ibuprofen amides on the Pirkle chiral stationary phase. AB - A chiral recognition model is proposed which incorporates the electronic and steric interactions between amide derivatives of ibuprofen and the (R)-N-(3,5 dinitrobenzoyl)phenylglycine-derived Pirkle chiral stationary phase during high performance liquid chromatography. Based on this rationale, amide derivatives of ibuprofen were prepared using 4-chloroaniline, 4-bromoaniline, aniline, 4 methoxyaniline and 1-aminonaphthylene to improve the enantiomer separation over previously reported results with this column. The amides prepared gave separation values of 1.16, 1.16, 1.19, 1.21 and 1.23, respectively. These high separation values are consistent with the proposed model. PMID- 3654863 TI - Elution behaviour of peropyrene-type polycyclic aromatic hydrocarbons in liquid chromatography. AB - The elution behaviour of peropyrene-type polycyclic aromatic hydrocarbons (PAHs) on variously bonded stationary phases in non-aqueous reversed-phase liquid chromatography has been investigated. The results clearly indicate that the retention behaviour is effected by the degree of planarity of the PAHs and by the properties of the stationary phases used. Solute planarity might also be influenced by solvation. Therefore, these factors combine to determine the retention of large PAHs. PMID- 3654865 TI - Isolation of high-molecular-weight nucleic acids for copy number analysis using high-performance liquid chromatography. AB - The Nucleogen DEAE 4000-10 high-performance liquid chromatography (HPLC) column was shown to isolate tRNA, rRNA, and DNA from crude cell lysates in the presence of a denaturant. Chromosomal DNA and plasmid DNA coeluted and retention was independent of size. An HPLC technique for plasmid copy number determination was then developed, verified, and optimized. The assay was successfully applied to a recombinant yeast system. Similar results were obtained earlier for recombinant Escherichia coli. The copy number can be calculated from the ratio of plasmid DNA to rRNA, then calculated to a per-cell basis using literature and measured constants. Chromosomal DNA coeluted with plasmid DNA and so was removed prior to analysis. For recombinant systems were the rRNA content is not constant, the plasmid area along with cell concentration can be used to calculate plasmid copy number. Nucleic acids' responses were linear, and plasmid copy number results using peak ratios had a low percent standard deviation. Errors increased when the absolute plasmid area was used to calculate plasmid copy number. PMID- 3654866 TI - Evaluation of disposable cartridges for trace enrichment from aqueous solutions. AB - Selected aromatic hydrocarbons, phthalate esters, and food, drug and cosmetic (FD&C) dyes are isolated from aqueous solutions with Chrom-Prep PRP-1 and Sep-Pak C18 cartridges. The Chrom-Prep cartridges demonstrate greater adsorption capacity for model aromatic hydrocarbons and phthalate esters than Sep-Pak C18 cartridges; however, the latter exhibits greater capacity for the FD&C dyes, which have breakthrough volumes that are a function of pH. Both cartridge types show a small amount of analyte leakage during the trace enrichment step, which is measured by monitoring the cartridge effluents for the presence of 14C-labeled solute. Two PRP-1 cartridges connected in tandem reduce the amount of activity in the effluent by approximately one half. PMID- 3654867 TI - Gas chromatographic-mass spectrometric determination of ethyl carbamate in alcoholic beverages. AB - A sensitive and specific method based on gas chromatography-mass spectrometry for the quantitative determination of ethyl carbamate in table wines, fortified wines (such as ports and sherries), distilled spirits, brandies and liqueurs has been developed. Three characteristic ions from ethyl carbamate [m/z 89 (molecular ion), 74 and 62] were monitored in the selected-ion monitoring (SIM) mode. The lowest detection limit (based on the response on the m/z 62 ion) was estimated to be 0.5 ng/g (ppb). Additional confirmation techniques, including high-resolution SIM, and methane or isobutane chemical ionization are described. PMID- 3654868 TI - Isolation and quantitation of metallothionein isoforms using reversed-phase high performance liquid chromatography. AB - Reversed-phase high-performance liquid chromatography (RP-HPLC) was used to isolate, characterize and quantitate liver and kidney metallothionein (MT) isoforms from a variety of animal species. The isoMTs were eluted from a radially compressed C18 column with a neutral sodium phosphate buffer and detected by UV absorbance (214 nm). Rabbit liver and horse kidney MTs were each found to be comprised of seven distinct isoforms. Pig liver and kidney MTs each exhibited three predominant isoforms, two of which were found to be subspecies of the MT-2 isoform. Rat liver MT was characterized by a less complex isoform pattern with only two major isoforms corresponding to the MT-1 and MT-2 isoMTs. Similarly, avian liver MT exhibited a distinct isoform pattern characterized by a low degree of complexity with the MT-2 isoform much more abundant than the MT-1 species. It was possible to apply the RP-HPLC separation to the resolution of individual MT isoforms from complex mixtures such as heat-treated cytosol. A standard curve was constructed using purified turkey hen liver MT-2 which demonstrated excellent linear correlation between integrated peak area and the quantity of MT injected onto the column. Recovery of MT from RP-HPLC was estimated to exceed 90%. Liver tissue from chicks injected on consecutive days with a dose of zinc was assayed for both MT-1 and MT-2 isoforms using the RP-HPLC analysis of cytosol samples. The MT-2 isoform was found to be preferentially expressed in response to zinc induction. PMID- 3654869 TI - Analysis of estrogen sulphate mixtures in pharmaceutical formulations by reversed phase chromatography. AB - The relative retention times of estrogen sulphates for reversed-phase, ion-pair and argentous chromatography have been determined. Detector wavelengths of 200 nm, 200 nm and 270 nm were used, respectively. Samples are prepared by dissolution of pharmaceutical formulations in the high-performance liquid chromatography (HPLC) eluent. With reversed-phase chromatography, the estrone, equilin and 17 alpha-dihydroequilin estrogen sulphates are resolved from other estrogen sulphates in 20 min. Any traces of free estrogens which might be present are eluted too slowly for the formation of chromatographic peaks. With ion-pair chromatography, any hydrolyzed estrogens would be eluted before the sulphates with the formation of resolved chromatographic peaks. With argentous chromatography the retention times of the estrogen sulphates varied by nearly a factor of four. The utility of HPLC for the analysis of estrogen sulphates in pharmaceuticals is discussed. PMID- 3654870 TI - Improved separation of perch liver metallothionein by fast protein liquid chromatography. AB - The separation of metallothionein isoforms by Mono-Q column chromatography by fast protein liquid chromatography is described and compared to separation on a DEAE-Sephadex A-25 ion-exchange column. The separation of two isoforms of rainbow trout (Salmo gairdneri) metallothionein was possible by DEAE-Sephadex A-25 chromatography, while only one form of perch (Perca fluviatilis) metallothionein was obtained with this method. However, by applying FPLC on a Mono-Q column it was possible to separate two isoforms of perch metallothionein. When comparing the chromatographic behaviour of rainbow trout and perch metallothioneins it was found that the two isoforms of perch metallothionein were eluted closer together than the two rainbow trout metallothioneins. Both forms of perch and rainbow trout metallothioneins lacked aromatic amino acids and histidine, and had a high cystein content (30 mol%). The molecular weight was estimated to be 6000 for the apothioneins. The results from this study demonstrate the usefulness of FPLC to improve the resolution of metallothionein separations. PMID- 3654871 TI - Simultaneous determination of nalidixic acid, oxolinic acid and piromidic acid in fish by high-performance liquid chromatography with fluorescence and UV detection. AB - A simple and rapid method for the simultaneous determination of nalidixic acid (NA), oxolinic acid (OXA) and piromidic acid (PMA) in cultured fish has been developed by high-performance liquid chromatography (HPLC). The drugs were extracted with 0.1% metaphosphoric acid-methanol (6:4), followed by a Sep-Pak C18 clean-up procedure. The HPLC separation was carried out on a Kaseisorb LC ODS 300 5 column (25 cm x 4.6 mm I.D.) using 5 mM phosphate buffer-acetonitrile (6:4) as a mobile phase. A fluorescence detector was used for NA and OXA at the excitation wavelength of 325 nm and the emission wavelength of 365 nm and an ultraviolet detector at 280 nm for PMA. The calibration graphs were rectilinear from 1 to 10 ng for OXA, from 2 to 20 ng for NA and PMA. The recoveries of NA, OXA and PMA added to fish were 81.5-85.3, 83.7-88.7 and 80.9-84.9%, respectively, with high accuracy. The limits of detection were 0.01 micrograms/g for each drug. PMID- 3654872 TI - Ion-pairing liquid chromatographic method for the determination of pirlimycin hydrochloride. PMID- 3654873 TI - Efficient isolation of insect growth inhibitory macrolide alkaloids using recycle high-performance gel permeation chromatography. PMID- 3654874 TI - Analysis of sodium cefazolin in ophthalmic ointment by high-performance liquid chromatography. PMID- 3654875 TI - Reversed-phase high-performance liquid chromatographic system for the rapid, automated purification of oligonucleotides. PMID- 3654876 TI - Quantitative analysis of oxytocin in pharmaceutical preparations by high performance liquid chromatography. PMID- 3654877 TI - Chiral separations of amino acids using di- and tri-peptides for zwitter-ion pair chromatography. AB - Separations of tryptophan enantiomers by zwitter-ion pair chromatography using small peptides as ion-pairing agents have been studied with emphasis upon the nature of the peptide, the mobile phase composition, and the nature of the chromatographic support. In addition, this procedure has been extended successfully to two other amino acids. PMID- 3654879 TI - High-performance liquid chromatography of 2-mercaptopropionylglycine and its metabolite 2-mercaptopropionic acid in plasma and urine after treatment with thiopronine. AB - 2-Mercaptopropionic acid has been identified as a normal metabolite of 2 mercaptopropionylglycine (thiopronine) when this drug was given to humans and dogs. A high-performance liquid chromatographic method was developed to resolve the derivatives of these two thiols and thus enable simultaneous determination of the two compounds in plasma and urine. PMID- 3654878 TI - High-performance liquid chromatographic determination of glyoxylic acid and other carbonyl compounds in urine. AB - A high-performance liquid chromatographic method for the determination of carbonyl compounds, namely aldehydes, ketones and keto acids in urine, has been developed. Pre-column derivatization with 2,4-dinitrophenylhydrazine offers sufficient sensitivity for the determination of glyoxylic acid in urine with a detection limit of 0.5 mg/l. The separation is performed on a C18 10-micron column and with an acetonitrile-aqueous buffer mobile phase, which also allows the resolution of the syn and anti geometric isomers. Matrix effects, precision, accuracy, limits of detection and structural selectivity of the method are discussed. PMID- 3654880 TI - Quantitative determination of porphyrins, their precursors and zinc protoporphyrin in whole blood and dried blood by high-performance liquid chromatography with fluorimetric detection. AB - Methods for the determination of porphyrins, delta-aminolevulinic acid (ALA), porphobilinogen (PBG) and zinc protoporphyrin of heme biosynthesis in whole blood and dried blood are described. Erythrocyte porphyrins and the precursors ALA and PBG were extracted from whole blood (50 microliter) with 0.3 ml of methanol and 1.5 M hydrochloric acid (2:1, v/v). Zinc protoporphyrin was extracted with an acetone-pyridine-Sterox solution. Other major interfering metabolites were removed by centrifugation. An aliquot of the supernatant was injected onto the reversed-phase C18 column for detection of porphyrins with excitation wavelength at 405 nm and emission wavelength at 630 nm. The mobile phase was 0.1 M phosphate methanol-tetrahydrofuran (18:30:16, v/v/v), pH 5.38. The ALA and PBG were derivatized with o-phthalaldehyde before injection. The detection excitation wavelength occurred at 330 nm and the emission wavelength at 418 nm. The mobile phase was 0.1 M phosphate-methanol (7.5:5), pH 3.38. For the dried blood specimen of filter paper, two 0.64-cm discs punched out from the blood-impregnated filter paper were placed in a test tube containing 200 microliter of 0.9% saline for 60 min or longer at room temperature and then treated as whole blood. PMID- 3654881 TI - Determination of benzoylecgonine and cocaine in biologic fluids by automated gas chromatography. AB - A method is described for extraction of the cocaine metabolite benzoylecgonine, conversion to the butyl ester derivative and gas chromatographic analysis using packed or capillary columns. Using a capillary column, cocaine and benzoylecgonine may be determined simultaneously. The extraction scheme has been designed to facilitate processing of large numbers of samples generated in pharmacokinetic studies. Structural analogues, m-toluylecgonine and m toluylecgonine methyl ester, are used as internal standards. Concentrations as low as 10 ng/ml in 1-ml samples of plasma or urine are readily determined. Between-run coefficients of variation were 1.01% for cocaine and 4.18% for benzoylecgonine for concentrations of 75 and 350 ng/ml, respectively. PMID- 3654882 TI - Rapid micromethod for the analysis of mitotane and its metabolite in plasma by gas chromatography with electron-capture detection. AB - A rapid micromethod for 50-microliter samples is described for the analysis in plasma of mitotane (o,p'-DDD) and its metabolite (o,p'-DDE), using p,p'-DDD as internal standard. The compounds are extracted with heptane without sample pretreatment, and an aliquot is directly analysed by gas chromatography with electron-capture detection. Absolute recoveries for all three compounds were ca. 87% and coefficients of variation were less than 5%. The method is being used successfully for monitoring patients with Cushing's syndrome who receive chronic oral mitotane therapy. PMID- 3654883 TI - Determination of propafenone in biological fluids by fused-silica capillary gas chromatography using electron-capture detection. AB - A gas-liquid chromatographic method with electron-capture detection using a capillary column with the inlet in the splitless injection mode is reported for the assay of propafenone. A 25 m X 0.31 mm cross-linked, 5% phenylmethylsilicone coated fused-silica capillary column was employed for all analyses. The present method provides improved selectivity and sensitivity over other existing gas chromatographic and high-performance liquid chromatographic (HPLC) methods. Linearity was observed in the ranges 2.5-50 and 10-100 ng/ml. The coefficient of variation was found to be less than 10% over the concentration ranges studied. Application of the developed method is demonstrated by measuring serum propafenone concentrations over 24 h in a normal healthy volunteer after a single oral dose of propafenone and by measuring trough plasma propafenone concentrations at steady state in patients receiving this new antiarrhythmic drug. Validity of the present method is further demonstrated by comparison of analytical results obtained from measurement of patient samples using a modified published HPLC method. PMID- 3654884 TI - Determination of sub-nanogram amounts of dihydroergotamine in plasma and urine using liquid chromatography and fluorimetric detection with off-line and on-line solid-phase drug enrichment. AB - A highly sensitive and selective high-performance liquid chromatographic method, involving sample pre-treatment, column switching and fluorimetric detection, is described for the determination of dihydroergotamine in plasma and urine samples. The pre-chromatographic sample treatment consists of extraction by means of an Extrelut column for plasma samples, and pre-separation with enrichment steps on a Sep-Pak column for urine samples. The samples are then injected onto a pre separation column (Aquapore), and the fraction containing dihydroergotamine are automatically diverted onto an analytical column (ODS reversed phase). An acetonitrile-ammonium carbamate gradient is used as the mobile phase. High recovery of dihydroergotamine from both plasma (87%) and urine (100%) and a detection limit as low as 100 pg/ml were achieved, with a linear response up to 5 ng/ml. The assay demonstrated a high degree of selectivity with regard to the extensive metabolism of dihydroergotamine especially to the main metabolite 8' hydroxydihydroergotamine. The assay was successfully applied for more than one year to the determination of plasma and urine concentrations of dihydroergotamine after parenteral administration. PMID- 3654885 TI - Determination of fluorescent diamidines in plasma of experimental animals by high performance liquid chromatography. AB - The fluorescent diamidines (E)-2,2'-vinylenedi-1-benzo [b] furane-5-carboxamidine dihydrochloride (I) and 2-[2-(6-amidinoindole-2-yl)-(E)-vinyl]-1-benzofurane-5-ca rbo xamidine dihydrochloride (II) were determined in the plasma of experimental animals by high-performance liquid chromatography with a mobile phase of methanol water (60:40, v/v) containing 0.005 M octanesulphonic acid and 0.003 M dimethyloctylamine. Samples were prepared by precipitation of plasma proteins with methanol-perchloric acid. Quantitation was performed by measuring the peak heights after monitoring the native fluorescence. The assay was linear over the range 5-750 ng/ml for I and 5-500 ng/ml for II, with limits of determination of 2.5 ng/ml for I and 1.5 ng/ml for II. Coefficients of variation were below 10% at all concentrations studied. PMID- 3654886 TI - Determination of metoprolol and two major metabolites in plasma and urine by column liquid chromatography and fluorometric detection. AB - Metoprolol and its alpha-hydroxy metabolite were determined in plasma down to 2 nmol/l (S.D. 10-15%) after solvent extraction and bonded-phase liquid chromatography with fluorometric detection. The major metabolite with a carboxylic function was also measured in plasma when liquid-solid extraction on a column activated with dodecyl sulphate was applied. In urine the three components were assayed by direct injection of a diluted sample. PMID- 3654887 TI - Liquid chromatographic determination of serum lipid peroxides as diphenylthiobarbituric acid-reactive substance to collagen disease patients--a preliminary study. PMID- 3654888 TI - Determination of plasma serotonin by high-performance liquid chromatography with pre-column sample enrichment and fluorimetric detection. PMID- 3654889 TI - Haemoglobin pyridoxylation: optimization and observation of an additional new pyridoxal phosphate-haemoglobin species by high-performance liquid chromatographic resolution. PMID- 3654890 TI - Fluorimetric determination of rat growth hormone in pituitary cell culture by high-performance liquid chromatography with post-column derivatization. PMID- 3654891 TI - Separation of prostaglandins and thromboxane by two-dimensional thin-layer chromatography. PMID- 3654892 TI - Analysis of benzbromarone in human plasma and urine by high-performance liquid chromatography and gas chromatography-mass spectrometry. PMID- 3654893 TI - Determination of the neuromuscular blocking drug gallamine in rat serum using high-performance liquid chromatography. PMID- 3654894 TI - Automated column liquid chromatographic determination of polythiazide in human serum. PMID- 3654895 TI - High-performance liquid chromatographic determination of amphotericin B in human urine. PMID- 3654896 TI - Column liquid chromatographic determination of cefpiramide in human serum and urine. PMID- 3654897 TI - Determination of amiodarone and its metabolite N-desethylamiodarone in serum by high-performance liquid chromatography--comparison of different extraction procedures. PMID- 3654898 TI - Rapid virus subunit visualization by direct sedimentation of samples on electron microscope grids. AB - Airfuge direct ultracentrifugation of viral samples on electron microscope grids offers a rapid way for concentrating viral particles or subunits to facilitate their detection and study. Using the A-100 fixed angle rotor (30 degrees) with a K factor of 19 at maximum speed (95,000 rpm), samples up to 240 microliters can be prepared for electron microscopy observation in a few minutes: observation time is decreased and structural details are highlighted. Using latex spheres to calculate the increase in sensitivity compared to the inverted drop procedure, we obtained a 10- to 40-fold increase in sensitivity depending on the size of particles. Application of this technique to rubella virus permitted better visualization of viral membrane subunits on the particles. Rubella hemagglutinin immuno-stimulating complexes preparations were also better visualized and their morphology conserved after direct ultracentrifugation on the specimen grids. Similar observations are reported for respiratory syncytial virus associated subunits. PMID- 3654899 TI - Production of monoclonal antibodies against rice dwarf virus and characterization of antigenic proteins with affinity media. AB - Hybridomas were developed which secreted antibodies to the core and outer capsids of rice dwarf virus (RDV). The reactive proteins of RDV were simply and rapidly analyzed using monoclonal antibody (MoAb)-coupled Affi-Gel 701 beads and SDS polyacrylamide gel electrophoresis and were isolated with a MoAb-coupled Sepharose 4B affinity column. PMID- 3654900 TI - Nonradioactive, photobiotin-labelled DNA probes for the routine diagnosis of barley yellow dwarf virus. AB - Photobiotin was used to prepare biotinylated, nonradioactive nucleic acid probes for the detection of the RNA of barley yellow dwarf virus (BYDV) in plant extracts. A 1.7-kb cDNA of the PAV isolate of BYDV in the plasmid pUC8 vector was biotinylated and then used intact or as sonicated double-stranded DNA fragments. Simple methods were developed for the preparation of partially purified nucleic acid extracts of cereals and their spotting, after formaldehyde treatment, onto nitrocellulose membranes. After hybridization, biotin-labelled DNA bound to BYDV RNA on the nitrocellulose was detected with an avidin-alkaline phosphatase conjugate. BYDV RNA was readily detected with a sensitivity similar to that found with the same probe labelled with 32P by nick translation. Healthy plant extracts gave colourless spots. PMID- 3654901 TI - Factors associated with the risk of second primary breast cancer: an analysis of data from the Connecticut Tumor Registry. AB - To examine further the epidemiology of contralateral primary breast cancer, a case-control analysis, utilizing information available from the Connecticut Tumor Registry, was conducted. Recent cases of second primary breast cancer were compared to control women who had survived a first breast cancer but had not developed a second. Three hundred and thirty eight incident cases of contralateral breast cancer diagnosed between 1979 and 1982 were identified and compared with an equal number of randomly selected controls and 336 controls frequency matched to the cases on the basis of age at initial cancer diagnosis and the calendar time elapsing since that diagnosis. Risk of second primary breast cancer was found to be significantly elevated among women whose initial cancer was lobular carcinoma and during the first year following diagnosis of the initial primary. Additionally, for women initially treated with radiotherapy, risk of a contralateral primary increased for 10-14 years following treatment, after which it declined. Among young women, having never married was protective whereas the opposite was found among older women. These findings and the methods used are discussed in the context of the epidemiology of both contralateral and initial breast primaries. PMID- 3654902 TI - Clinical profiles of cerebrovascular disorders in a population-based patient sample. AB - Clinical features of different types of stroke were investigated in a sample of 409 patients representative of all cases admitted for acute stroke, except subarachnoidal hemorrhages, within a well defined population. A specific cerebrovascular diagnosis was obtained by detailed clinical investigation, including CT scan. In people greater than 50 years old, men/women risk for stroke was estimated to be 1.40:1. The risk was higher in men up to the age of 80; above this age similar risk for the two genders was observed. Eleven per cent had intracerebral hemorrhage, 13% TIA, 51% non-embolic and 25% embolic brain infarction. In all diagnostic categories there were similar proportions of patients who had a history of hypertension and previous stroke, neither did hemoglobin and hematocrit levels differ between the different stroke disorders. TIA preceded intracerebral hemorrhage in 11% and brain infarction in 15-20%. As opposed to patients with ischemic lesions, subjects with intracerebral hemorrhage had higher systolic blood pressure levels and more severe symptoms on admission to hospital. Ischemic stroke was associated with male predominance, different ischemic manifestations of heart diseases and diabetes. PMID- 3654903 TI - Consistency and plausibility in epidemiologic analysis: application to breast cancer in relation to use of oral contraceptives. AB - Consistency and plausibility are fundamental criteria for judging cause and effect from observational studies. They are applied here to the interpretation of data from a population-based case-control study of oral contraceptives and breast cancer. A preliminary analysis of oral contraceptive use in young nulliparous women, who had no family history of either breast cancer or benign breast disease, showed a statistically significant dose-response, with long-term users (49 months or more) having an apparent 4-fold elevation in risk of early breast cancer. Further analyses, however, revealed striking inconsistencies which were biologically implausible. These effectively undermine cause and effect as an explanation for the initial finding. PMID- 3654904 TI - Breast cancer detection centers and case-control studies of the efficacy of screening. AB - Case-control studies of screening efficacy have been proposed as a cost- and time efficient alternative to randomized controlled trials. Possible source populations for such retrospective studies of breast cancer screening are considered, including women from (i) pre-existing randomized trials, (ii) non experimental population-based studies and (iii) detection centers. On practical grounds women attending detection centers are seen to comprise the most readily accessible source of adequate numbers of cases and controls. Potential biases are addressed, involving incomplete case ascertainment, self-selection, and different screening recommendations. Data from the Guttman Breast Diagnostic Institute are used for illustration. PMID- 3654905 TI - Kanji. PMID- 3654906 TI - Oral contraceptives and rheumatoid arthritis. Bias in observational studies of cause-effect relationships. PMID- 3654907 TI - A check-list for observational research? PMID- 3654908 TI - Factors influencing the age at natural menopause. AB - To examine sociodemographic, menstrual, reproductive, and other factors which may influence the age at natural menopause, the authors analyzed data from a large series of women participating in a nationwide breast cancer screening program conducted between 1973 and 1980. Standard life table techniques permitted assessment of factors suspected of varying the time to menstrual cessation among 983 premenopausal women, 1091 surgically menopausal women, and 1423 naturally menopausal women. The median age at natural menopause was 51.1 years. Multivariate analysis indicated that parity, irregularity of menstrual cycles before age 25 or first livebirth, and high socioeconomic status were significantly related to menopausal age. These data provide evidence for the hypothesis that certain environmental and hormonal factors which affect ovulation during reproductive years may ultimately postpone the menopause. PMID- 3654909 TI - Clinical usefulness of plasma androstanediol glucuronide measurements in women with idiopathic hirsutism. AB - Serum androstanediol glucuronide (3 alpha-diol G), a metabolite of the active androgens dihydrotestosterone and androstanediol, was elevated in 28 consecutive women with idiopathic hirsutism (IH). The mean 3 alpha-diol G level in the women with IH was 487 +/- 192 (+/- SD) ng/dL compared to 119 +/- 37 ng/dL in normal women (n = 50), and only 1 patient had a value overlapping with the normal range. Since 3 alpha-diol G appears to be formed entirely in target organs and has a long serum half-life, we studied its clinical usefulness by following women with IH during treatment. In 15 of 17 women with IH treated for 1-4 yr with glucocorticoids, contraceptives, or spironolactone, serum 3 alpha-diol G levels changed concordantly with clinical responses, in contrast to the poor concordance of serum testosterone (5 of 17), free testosterone (7 of 17), and androstenedione (7 of 17). Specifically, in IH patients treated with spironolactone, serum testosterone, free testosterone, and androstenedione levels changed little, yet clinical improvement frequently occurred, and this improvement was reflected by concomitantly lowered 3 alpha-diol G levels. Further, in 4 IH patients, discontinuation of effective therapy resulted in prompt increases in serum 3 alpha-diol G as harbingers of worsening hair growth. We, thus, conclude that serum 3 alpha-diol G measurements are clinically useful in evaluating hirsute women and correlate with the clinical responses to therapy. PMID- 3654910 TI - Characterization of serum growth hormone (GH) and insulin-like growth factor I in active acromegaly with minimal elevation of serum GH. AB - In most patients with acromegaly basal serum GH concentrations are elevated and remain above 5 micrograms/L after oral glucose administration. In some patients, however, serum insulin-like growth factor I (IGF-I) concentrations are elevated with only minimal elevations of serum GH. We studied the serum GH and IGF-I of two such patients to determine whether these peptide hormones are normal in this clinical situation. The serum GH of these patients was found to bind normally to receptors of the IM-9 lymphocyte. The elution pattern of IGF-I extracted from the patients' serum was similar to that of (Thr59) human IGF-I after passage through a Bio-Rad P-60 column in 0.5 M acetic acid. The IGF-I was further characterized by isoelectric focusing and C18 reverse phase high pressure liquid chromatography (HPLC). The isoelectric points of the IGF-I components were similar to those of IGF-I in normal serum. The IGF-I in one patient had two components by HPLC, while that of the other patient had only one major component. The IGF-I components isolated by HPLC were normally active in stimulating [3H] alpha-aminoisobutyric acid uptake by normal human fibroblasts. The elevated serum IGF-I concentrations of these two patients were GH dependent. Transsphenoidal adenomectomy in one patient resulted in a decline in serum IGF-I to a high normal concentration. Lowering the serum GH to subnormal concentrations by the administration of the somatostatin analog SMS 201-995 (Sandoz) restored normal IGF-I concentrations in the second patient. We conclude that the GH and IGF-I of these two patients cannot account for their apparent enhanced GH responsiveness. PMID- 3654911 TI - Human retroocular fibroblasts in vitro: a model for the study of Graves' ophthalmopathy. AB - Orbital connective tissue and extraocular muscles are histologically abnormal in patients with Graves' ophthalmopathy (GO). Although extraocular muscles have been extensively studied as a target for autoimmune attack in the disease, no system has been available to study retroocular fibroblasts in GO. We developed a technique to isolate fibroblasts from minced explants of connective tissue removed in the course of transantral orbital decompression surgery for GO. Postmortem specimens from individuals without evidence of thyroid disease were obtained from the same anatomical site. Confluent cells could be passaged at least 10 times with stable morphology and frozen with greater than 75% viability. An enzyme-linked immunosorbent assay was used to study the in vitro binding of serum immunoglobulin G (IgG) to these cells. We found no difference in the degree of specific binding between GO cells and cells from normal individuals. However, there was significantly greater binding of IgG from GO sera than of that from normal serum to retroocular GO fibroblasts. These results suggest that serum IgG autoantibodies against normal retroocular fibroblasts are present in some GO patients. PMID- 3654912 TI - Growth hormone treatment in short children: relationship between growth and serum insulin-like growth factor I and II levels. AB - Thirty-one children who were short but not GH deficient, whose serum GH responses to provocative tests were normal, and whose spontaneous GH secretion was low received daily sc injections of human GH (Crescormon; 0.1 IU/kg BW) for 1 yr. Their initial serum insulin-like growth factor I (IGF-I) and IGF-II responses to GH were compared with their 1-yr growth response to therapy. In the prepubertal group (n = 18) the growth rate of all but two children increased 3.4 +/- 0.2 (+/- SEM) cm (from 4.1 +/- 0.2 to 7.5 +/- 0.3 cm/yr). The mean increment in the growth rate of the pubertal group was 5.2 +/- 0.5 cm. In both groups the growth increase was strongly correlated with both the percent increase in serum IGF-I and the percent increase in serum IGF-II during the first 10 days of treatment. No correlation was found between the basal growth rate and basal serum IGF-I or IGF II levels. In the prepubertal group of children, both the percent increase in serum IGF-I levels in response to GH and the age at start of treatment were predictors of long term growth. We conclude that this subgroup of normal short children with low spontaneous GH secretion and high percent increase in serum IGF values benefits from GH treatment with an increased growth rate. PMID- 3654913 TI - Long term treatment of Graves' disease with iopanoic acid (Telepaque). AB - To investigate the long term utility of the cholecystographic contrast agent iopanoic acid (Telepaque) for treatment of Graves' hyperthyroidism, we studied 40 patients treated with 500 mg, orally, daily for 1-12 months. We measured thyroid size; body weight; serum T3, T4, and free T4 concentrations; and antithyroglobulin and antimicrosomal antibody levels at monthly intervals. Based on the effects of the therapy, the patients were divided into 3 groups: 6 patients had excellent responses with return of serum thyroid hormone levels to normal (group A); 12 patients had fair responses, but 1 thyroid hormone test remained elevated (group B); and 22 patients had minimal benefit (group C) with only slight clinical improvement and transient reduction of serum T3 concentration. Mean serum T3 levels decreased significantly after 1 month of therapy in all 3 groups and became normal in groups A and B, but the reduction in group C was not sustained. Mean serum T4 and free T4 levels remained above normal during the course of therapy in groups B and C. Sixty-eight percent of patients in group C had large goiters compared with 33% of group A and 25% of group B, and those in group C tended to have more severe biochemical hyperthyroidism initially. There were no significant changes in antibody titers during therapy. These data indicate that iopanoic acid is not effective therapy for many hyperthyroid patients. PMID- 3654914 TI - Distribution, plasma concentration, and in vivo prolactin-releasing activity of peptide histidine methionine in humans. AB - The distribution of immunoreactive peptide histidine methionine (PHM) in human tissues and its plasma concentrations were examined using a specific RIA and gel filtration chromatography. The effects of synthetic PHM on anterior pituitary hormone secretion also were studied. Immunoreactive PHM was found in all tissues studied; high concentrations were found in the gastrointestinal tract, lung, and parotid gland. Subsequent but smaller amounts of PHM were found in the hypothalamus, pituitary stalk, olfactory lobe, and cerebral cortex. The distribution of immunoreactive PHM in human tissues was very similar to that of vasoactive intestinal polypeptide (VIP), and PHM and VIP were in equimolar concentrations. Immunoreactive PHM was also detectable in plasma of normal subjects, and similar plasma concentrations were found in patients with prolactinomas. Molecular sieve chromatography of extracts of nonneural tissues and plasma extracts revealed only one peak, eluting in the position of synthetic PHM. Two peaks of immunoreactive PHM were found in brain tissue; one coeluted with synthetic PHM, and the other eluted in the high mol wt region. Bolus injections of synthetic PHM significantly increased plasma PRL levels in a dose dependent manner. However, PHM did not alter plasma GH, TSH, ACTH, LH, or FSH levels. These results indicate that PHM is distributed widely in human tissues, and posttranslational processing of the VIP-PHM precursor molecule may be different in different tissues. The finding of equimolar distributions of PHM and VIP is consistent with the notion that these two peptides are synthesized from a common precursor. The presence of immunoreactive PHM in human hypothalamic and pituitary stalk tissue and its specific in vivo PRL-releasing activity suggest that PHM may play an important role in the regulation of PRL secretion. PMID- 3654915 TI - Bone mass and its relationship to age and the menopause. AB - To examine the influence of age and the menopause on bone loss we studied 178 healthy women, aged 29-78 yr. Bone mass was measured at 2 forearm sites, in the total spine, in the lumbar spine, and in the whole body by single and dual photon absorptiometry. Women of the same age but different menopausal status had significantly different bone masses, whereas a 5-yr difference in age had no effect on bone mass in women with the same menopausal status. At the menopause the hormone changes (low serum estrogen and high serum gonadotropin levels) occurred simultaneously with the appearance of biochemical indices of increased bone turnover. Neither biochemical values nor bone measurements indicated significant bone loss before the menopause. We conclude that the menopause has a greater effect on bone loss than does chronological age. PMID- 3654916 TI - Production of 3 alpha-androstanediol glucuronide in human genital skin. AB - 3 alpha-Androstanediol glucuronide (3 alpha diol-G) is produced extrasplanchnically and is a good clinical marker of androgen action in peripheral tissues. However, the direct formation of androgen glucuronides in peripheral sites such as skin has not been determined in man. Genital skin from 21 premenopausal women and 8 men and foreskin from 6 neonates were incubated with either [14C]testosterone [14C]dihydrotestosterone (DHT) to determine the production of DHT glucuronide and 3 alpha diol-G in skin. After hydrolysis of incubation medium with glucuronidase, followed by extraction and sequential chromatography, constant 3H to 14C ratios of 3 alpha diol confirmed the production of DHT glucuronide and 3 alpha diol-g. The conversion of DHT to 3 alpha diol-G was higher than the conversion from testosterone (P less than 0.05), and conversion was higher in men than in women. These data provide evidence for the direct formation of C19 steroid glucuronides by human skin. PMID- 3654917 TI - Reevaluation of the effects of methylmercaptoimidazole and propylthiouracil in patients with Graves' hyperthyroidism. AB - The effects of methylmercaptoimidazole (MMI) and propylthiouracil (PTU) were compared in patients with Graves' hyperthyroidism. Firstly, the duration of action of the drugs was studied by the perchlorate discharge test, which was performed 2, 12, or 24 h after administering a single dose of 15 mg MMI or 300 mg PTU. After 2 h, the 9 MMI-treated patients who were tested had marked discharge (mean +/- SD, 65.0 +/- 15.8%), as did the 6 patients treated with PTU (57.6 +/- 26.6%). The mean values for the percent discharge 12 and 24 h after drug administration were 34.9 +/- 31.9% (4 patients) and 36.5 +/- 26.9% (69 patients), respectively, in the MMI group and 19.1 +/- 11.7% (11 patients) and 8.6 +/- 10.5% (7 patients) in the PTU group, indicating that the effect of MMI lasted longer. Secondly, the clinical effects of long term administration of the drugs were compared in a different group of patients with Graves' hyperthyroidism. Within 5 weeks after the onset of treatment, 34 (52%) of 66 patients treated with MMI (10 mg, 3 times daily) were euthyroid, while only 1 of 17 patients treated with PTU (100 mg, 3 times daily) was euthyroid. The average time required to achieve euthyroidism, namely normal serum T3 and T4 levels, was significantly shorter in the MMI group [6.7 +/- 4.6 (+/-SD) weeks] than in the PTU group (16.8 +/- 13.7). In spite of the well known effect of PTU on the extrathyroidal conversion of iodothyronines, the serum T3 level normalized much faster with MMI than with PTU. These results indicate that in our patient population 15 mg MMI had a longer inhibitory effect on the organification of iodide than did 300 mg PTU, and that MMI was more rapidly effective in the treatment of Graves' hyperthyroidism. PMID- 3654918 TI - Changes in oxytocin and vasopressin secretion during sexual activity in men. AB - We measured plasma oxytocin (OT) and arginine vasopressin (AVP) concentrations in 13 normal men during sexual arousal and ejaculation. Mean plasma AVP increased from 1.4 +/- 0.2 (+/- SE) to 5.3 +/- 1.7 pmol/L (P less than 0.05) during arousal, but there was no significant change in OT. In contrast, at ejaculation mean plasma OT rose from a basal value of 1.4 +/- 0.3 to 7.3 +/- 0.6 pmol/L (P less than 0.01) and then fell to basal concentrations in 30 min. AVP, however, had returned to basal levels at the time of ejaculation and remained stable thereafter. We conclude that in man AVP is secreted during sexual arousal, and there is, subsequently, a selective release of OT at the time of ejaculation. PMID- 3654919 TI - The sex pheromone precursor androsta-5,16-dien-3 beta-ol is a major early metabolite in in vitro pregnenolone metabolism in human testicular homogenates. AB - In an earlier report we described the early time sequence of the in vitro metabolism of [4-14C]pregnenolone ([4-14C]P5) to testosterone in homogenates of human and rat testes and demonstrated the appearance of mainly delta 5 (humans)- and delta 4 (rats)-steroids within minutes after starting the incubation. In this study strong evidence is presented for the substantial synthesis from P5 of the sex pheromone precursor androsta-5,16-dien-3 beta-ol (ADL) in human, but not rat, testicular homogenates. The 16-unsaturated C19 steroid ADL appeared after 1 min of incubation, and within 5 min reached values (17-23% of total radioactivity added as [4-14C]P5) comparable to those of the major delta 5-steroids 17 alpha hydroxypregnenolone and dehydroepiandrosterone. Thus, in humans, as in boars, the sex attractant precursor ADL is a major early testicular metabolite of P5. PMID- 3654920 TI - Effect of diet on oxidation of 17 beta-estradiol in vivo. AB - The effect of a high fat, low carbohydrate, low protein diet on the in vivo oxidation of 17 beta-estradiol was studied using radiometric methods. Five male chimpanzees were fed a normal (13%) fat diet or a high (65%) fat diet for 8 weeks. After a 4-week rest period, the animals were fed the alternative diet. The mean percent oxidation of 16 alpha-[3H]estradiol-17 beta 24 h after injection was 3.8 +/- 1.3% (+/- SD) on the normal diet vs. 18.4 +/- 4.7% on the high fat diet (P less than 0.01). In contrast, the mean percent oxidation of 2-[3H]estradiol 24 h after injection was 31.6 +/- 3.8% (+/- SD) on the normal diet vs. 20.0 +/- 3.5% on the high fat diet (P less than 0.05). These results suggest that the oxidation of 17 beta-estradiol to estriols relative to that to catechol estrogens is increased by a high fat diet. PMID- 3654921 TI - Dependence of mean levels of circulating luteinizing hormone upon pulsatile amplitude and frequency. AB - We investigated the relationship between mean serum LH levels and the amplitude and frequency of LH pulses in 23 women. Serum LH levels were determined every 10 min for 8-12 h in 6 normal cycling women during the follicular phase of the menstrual cycle, in 9 women with polycystic ovary syndrome, and in 8 postmenopausal women. A striking linear correlation (r = 0.98; P less than 0.00001) was found between the mean LH value during the study period (range, 11.1 137.7 IU/L) and the product of the mean LH pulse amplitude and frequency. The interdependence of these variables was further explored using a mathematical model which identifies two main determinants of the slope of the regression line relating the mean LH value to the product of mean pulse amplitude and frequency: 1) the set of constants that specify the biexponential disappearance pattern of LH from serum and 2) the fraction of LH associated with a given pulse which is released from the anterior pituitary after the peak peripheral LH level is reached. Our data, viewed in the light of this model, suggest that 1) the rate at which LH is cleared from the peripheral circulation (expressed as percentage removed per unit time) is independent of both LH concentrations and the sex steroid milieu, and 2) most circulating LH is released in discrete pulses and little, if any, is released in a nonpulsatile or "tonic" mode. PMID- 3654922 TI - Enhanced calcium bioavailability from a solubilized form of calcium citrate. AB - An improved formulation of calcium citrate with higher aqueous solubility and bioavailability was sought. Mixtures of calcium hydroxide and citric acid, with a calcium to citrate molar ratio ranging from 0.67-1.5, dissolved rapidly in water, creating a metastably supersaturated solution. The presence of an excess of citrate in the mixture delayed the precipitation of calcium citrate and kept calcium in solution longer. Thus, the mixture with a calcium to citrate molar ratio of 1.25, containing 500 mg elemental calcium, dissolved in 300 mL water within 2 min and could be kept in solution for 1 h at a wide pH range between 2 and 7. Intestinal calcium absorption, measured from the increment in urinary calcium during the second 2 h following an oral calcium load (500 mg) in 15 normal subjects was significantly higher from the mixtures (calcium to citrate molar ratios of 1.5 and 1.25) than from tricalcium dicitrate. The fractional calcium absorption, obtained from fecal recovery of radiocalcium after oral administration of 500 mg calcium prelabeled with 47Ca in 11 normal subjects, was also higher for the mixture with a calcium to citrate molar ratio of 1.25. The most efficient calcium absorption was obtained with the mixture of calcium hydroxide and citric acid with a calcium to citrate molar ratio of 1.25. The increment in urinary calcium after an oral load with this mixture was 62.4% greater than that obtained with tricalcium dicitrate [0.138 +/- 0.056 (+/- SD) vs. 0.085 +/- 0.086 mg/dL glomerular filtrate; P less than 0.05]. The fractional calcium absorption was 88.4% higher (0.324 +/- 0.107 vs. 0.172 +/- 0.061; P less than 0.05). This mixture provided the highest concentration of ionic calcium, indicating that calcium (rather than calcium-citrate complex) is the fraction absorbed from the intestinal tract. This study, therefore, suggests that a liquid calcium preparation formulated from the mixture of calcium hydroxide and citric acid is more effective than a solid preparation of tricalcium dicitrate in providing soluble and bioavailable calcium. PMID- 3654923 TI - The O-linked oligosaccharide structures are striking different on pregnancy and choriocarcinoma HCG. AB - hCG is a glycoprotein hormone which is detected in the serum and urine of pregnant women and of patients with hydatidiform mole and choriocarcinoma. The molecule contains 4 O-linked sugar chains. In an effort to identify cancer markers, the structures of these sugar units on the hCG produced in pregnancy and choriocarcinoma were compared. hCG molecules in patient urines were purified by immuno-affinity chromatography and gel filtration. beta-elimination was used to cleave the O-linked sugar units, radioactive sodium borohydride to label them, and gel filtration on Bio-Gel P4 to size them and compare their elution volumes with those of standard oligosaccharides of known structure. A trisaccharide, NeuAc alpha 2-3Gal beta 1-3GalNAc-, was found to be the principal unit attached to urinary hCG from pregnant women (10 samples). A hexasaccharide, NeuAc alpha 2 3Gal beta 1-3(NeuAc alpha 2-3Gal beta 1-4 GlcNAc beta 1-6)GalNAc-, which accounted for just 6% (mean, range 0-14%) of the O-linked sugar units on pregnancy hCG, was the principal unit (mean 52% of total, range 50-56%) attached to the hCG from choriocarcinoma patient urines (3 samples). These results indicate that hexasaccharide-abundant hCG is an indicator of choriocarcinoma. PMID- 3654924 TI - Absence of the plasma growth hormone-binding protein in Laron-type dwarfism. AB - We recently described a specific, high affinity binding protein (BP) for growth hormone (GH) in normal human plasma. Little is known about the source, regulation and biological role of this BP. Because its specificity is similar to that of the GH receptor, we considered the possibility that it represented a circulating receptor subunit or fragment. Laron-type dwarfism is a rare disorder characterized by severe growth failure, resistance to GH, and GH receptor deficiency. To probe the relationship between the receptor and the circulating binding protein, we measured the binding of GH to plasma from a child with Laron type dwarfism and compared it with that in plasma of normal children and adults. Normal plasma samples were supplemented with unlabeled GH to the endogenous GH level in the plasma of the Laron patient to yield comparable saturation of the BP. After incubation of plasma with radiolabeled GH, bound GH was separated from free GH by gel filtration on Sephadex G-100. There was no detectable binding (less than 1.5%) of GH in the plasma of the Laron-type dwarf, whereas in normal children the bound GH fraction averaged 24.0 +/- 6.1% (mean +/- SD). Thus, the GH BP is either absent or functionally abnormal in Laron-type dwarfism. This finding suggests that the circulating GH-BP is related to and/or may be derived from the GH receptor. Alternatively, it is possible that the BP plays an as yet poorly understood pivotal role in the promotion of somatic growth. PMID- 3654926 TI - Low LH receptor content in corpora lutea in luteinized unruptured follicle (LUF) syndrome. AB - Concentrations of LH receptors in ovarian corpora lutea were measured in four women with ultrasonically monitored cycles, [in which luteinized unruptured follicles (LUF) were observed] and in one woman with an LUF observed during laparotomy. LH receptor concentrations were also measured in four control patients with proven fertility. The LH receptor concentrations in cases of LUF syndrome were on average 60% lower (P less than 0.01) than in the control patients. These results suggest that in LUF patients there is a disorder in the mechanism of LH action in the developing follicles. PMID- 3654925 TI - Increased presence of common systemic lupus erythematosus (SLE) anti-DNA idiotypes (16/6 Id, 32/15 Id) is induced by procainamide. AB - Sixty-seven patients on treatment with procainamide were examined for the presence of two common idiotypes of anti-DNA antibodies (16/6 Id and 32/15 Id). These idiotypes have been shown previously to have clinical relevance in patients with systemic lupus erythematosus (SLE). An enzyme-linked immunosorbent assay (ELISA) with rabbit anti-Id antibodies revealed increased concentrations of the 16/6 Id and 32/15 Id in 25 (37%) and 16 (24%) patients, respectively. Five of eight patients with drug-induced lupus had elevated titers of both idiotypes. A high correlation (R = 0.56, P less than 0.001 for 16/6 Id) was found between Id levels and anti-single-stranded DNA (ssDNA) antibody titers and between 16/6 Id titers and antihistone antibodies (IgG, R = 0.43; IgM, R = 0.25). It seems that procainamide, a component known to be associated with drug-induced lupus, may induce an increased production of common anti-DNA idiotypes in apparently normal subjects. PMID- 3654927 TI - Metabolism and serum binding of RU 486 in women after various single doses. AB - The metabolism of RU 486 was studied in female volunteers following a single oral administration of 100, 400, 600 or 800 mg of RU 486. The serum concentrations of RU 486 were generally not affected by the dose within the range examined and they stayed at micromolar concentrations during the 48 h studied. RU 486 was metabolized extensively in a dose-dependent manner by two-step demethylation, and by hydroxylation. Serum levels of the monodemethylated metabolite always exceeded those of RU 486. The concentrations of the didemethylated and hydroxylated metabolites equalled or exceeded those of RU 486 when the ingested dose was 400 mg or more. Monodemethylation and hydroxylation were rapid high-capacity reactions, whereas didemethylation was a lower-capacity reaction. In each group of different dosage, positive correlations were found between the individual mean alpha 1-acid glycoprotein (AAG) concentrations and the peak concentration of RU 486 measured at 1-2 h, versus the plateau concentration of RU 486 measured at 6 h. The in-vitro studies showed that the specific serum transport protein of RU 486, AAG, was saturated by RU 486 concentrations exceeding 2.5 microM. In serum at 40 nM and 2.5 microM RU 486 concentrations, 2.7% and 2.4%, respectively, of [3H]RU 486 was not protein bound. Purified AAG in phosphate buffer was able to bind [3H]RU 486 in a similar manner to that of serum. Thus our results suggest that AAG regulates in part the serum concentrations of RU 486, and RU 486 exceeding the specific serum transport capacity is effectively metabolized. PMID- 3654929 TI - Preimplantation and early post-implantation diagnosis. Report of the first meeting of the ESHRE Working Group. European Society of Human Reproduction and Embryology. December 16, 1986, Strasbourg, France. PMID- 3654928 TI - Development and validation of a radioimmunoassay for human secretory 'pregnancy associated endometrial alpha 2-globulin' (alpha 2-PEG) and detection in serum during pregnancy. AB - A specific and sensitive radioimmunoassay has been developed for pregnancy associated endometrial alpha 2-globulin (alpha 2-PEG), the major secretory protein of the human endometrium during the mid- to late-luteal phase of the menstrual cycle and first trimester of pregnancy. This assay enabled alpha 2-PEG to be measured in the cytosolic extracts of endometrium, amniotic fluid, seminal plasma and in pregnancy sera. The concentration of alpha 2-PEG in cytosols prepared from mid-secretory endometrium was 44-fold higher than in those from proliferative endometrium and a further 30-fold increase during the first trimester in comparison with mid-secretory endometrium. Levels of alpha 2-PEG in amniotic fluid (15-20 weeks) and seminal plasma were 15 +/- 4 and 55 +/- 7 micrograms/ml, respectively. With the exception of sera, where alpha 2-PEG was undetectable using rocket immunoelectrophoresis, estimates of alpha 2-PEG levels in these compartments, measured by rocket immunoelectrophoretic and RIA assays were comparable, although for seminal plasma 2.5-fold higher estimates were obtained by RIA. Detectable levels of alpha 2-PEG were obtained in 253 of 275 (92%) pregnancy sera tested. During pregnancy, peak levels were detected between weeks 6 and 11 but these represented only 2% of the levels detected in amniotic fluid. These observations support evidence from in vitro studies that alpha 2-PEG is a product of the secretory glandular epithelium, a tissue prominent in the first trimester and whose principal secretory route during pregnancy is into the amniotic fluid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654930 TI - Diagnostic methods for human gametes and embryos. PMID- 3654931 TI - Assessment of different isolation procedures for blastomeres from two-cell mouse embryos. AB - As an extension of in-vitro fertilization and embryo transfer, detection of genetic and metabolic defects prior to implantation might be possible in the future. The objective of pre-implantation diagnosis would be to sample a minimal amount of cellular material of the conceptus for diagnosis prior to transfer. Different protocols for isolating individual blastomeres from two-cell mouse embryos were evaluated. Two-cell mouse embryos were collected and the zona pellucida was removed by enzyme treatment (pronase), by exposure to acid Tyrode (pH = 2.5) or by mechanical force (suction into a small pipette, removal with a microblade). Individual blastomeres were obtained by exposure to a chelating agent (EDTA-glycine mixture), to Ca2+-Mg2+-free PBS or after isolation by mechanical force (bisection with a microblade or suction in a small pipette). The isolated blastomeres were then cultured in vitro without zonae pellucidae. All isolation procedures had a negative impact on the growth patterns of the isolated blastomeres. Different abnormalities could be observed at the blastocyst stage including embryos lacking visible compaction features, embryos with double blastocoelic cavities and embryos with no inner cell mass (trophoblastic vesicles). PMID- 3654932 TI - Chromosome studies in oocytes and zygotes from an IVF programme. AB - Chromosome studies have been carried out in 117 oocytes, 17 one-cell zygotes and four, two- to four-cell zygotes in our IVF programme. Three apparently unfertilized oocytes were, in fact, diploid zygotes. Two of 14 apparently polyspermic zygotes were also diploid. One zygote with four pronuclei was pentaploid. This indicates that pronuclei can either be confused with other cytoplasmic structures, like vacuoles, or be eliminated. Endoreduplication was observed in one tetraploid, apparently polyspermic zygote, and in one two-cell degenerated zygote. The incidence of aneuploidy in unfertilized oocytes, taken as twice the level of hyperhaploidy, was 15.4%. Five oocytes showed fragmented metaphase II chromosomes (4.3%). The incidence of unreduced oocytes, due to a lack of extrusion of the first polar body, was 6.8%. Thus the total number of potentially aneuploid, polyploid or non-viable zygotes due to chromosome aberrations in the oocyte was 26.5%. PMID- 3654933 TI - Non-invasive methods for assessing embryos. AB - Non-invasive methods offer considerable potential in assessing the viability of human embryos conceived by IVF. Their use in diagnosing genetic defects appears to be more limited at the present time, but it would be premature to rule out this possibility. PMID- 3654934 TI - The use of probes for the Y chromosome in preimplantation embryo cells. AB - The use of Y chromosome repeated sequence probes for the assignment of sex in individual human and mouse cells by in situ hybridization is described. PMID- 3654935 TI - Analysing DNA in small numbers of cells. PMID- 3654936 TI - Influence of lysozyme on aggregation of Staphylococcus aureus. AB - The conditions under which lysozyme aggregates Staphylococcus aureus were studied. Lysozyme was found to aggregate S. aureus at concentrations found in human tear secretions. Aggregate size depended upon lysozyme concentration, ionic strength, and bacterial concentration. There was a low level of adherence of S. aureus to corneal epithelial cells, and the adherence of a recent clinical isolate was not influenced by lysozyme concentrations found in human tear secretions. Lysozyme may enhance bacterial clearance from the corneal surface of the eye by promoting particle aggregation. PMID- 3654937 TI - Comparison of modified Minitek system with Staph-Ident system for species identification of coagulase-negative staphylococci. AB - A modified Minitek system (BBL Microbiology Systems, Cockeysville, Md.) for species identification of coagulase-negative staphylococci was compared with the Staph-Ident system (Analytab Products, Plainview, N.Y.). The conventional method of Kloos and Schleifer (J. Clin. Microbiol. 1:82-88, 1975) was used as the reference method for identification. When tested with 78 coagulase-negative staphylococcal isolates from 63 children with cancer. Minitek concurred with the conventional identification in 67 (86%) isolates and Staph-Ident concurred in 61 (78%) isolates. Identification of species other than Staphylococcus epidermidis was better with Staph-Ident (19 of 23 isolates) than with Minitek (14 of 23 isolates). Concordance of results was likewise high, 88% (7 of 8) for Minitek and 100% (8 of 8) for Staph-Ident in studies with eight coagulase-negative staphylococcal strains obtained from the American Type Culture Collection (Rockville, Md.). We conclude that the modified Minitek system is a practical and reliable test for identifying coagulase-negative staphylococci in clinical microbiology laboratories. Its versatility and larger repertoire of biochemical tests may offer advantages over the Staph-Ident system. PMID- 3654938 TI - Immunoglobulin class and immunoglobulin G subclass enzyme-linked immunosorbent assays compared with microneutralization assay for serodiagnosis of mumps infection and determination of immunity. AB - Total immunoglobulin G (IgG) and IgG subclass reactivities with purified mumps glycoproteins (GP) and nucleoprotein (NP), measured in enzyme-linked immunosorbent assays (ELISAs), were compared with titers in a mumps microneutralization assay (NT). For determination of mumps immunity, the sensitivity of both ELISAs was 100% in comparison with the NT and the specificity was 90%. IgG1 was the dominant subclass against the two antigens found in seropositive healthy individuals. In samples from patients with clinical mumps infections and positive mumps IgM, titer rises of total IgG against NP were invariably seen before GP titer rises. Significant but often late titers rises in NT were found in all patients. Changes of IgG1 levels against both antigens followed the changes of total specific IgG. High levels of IgG3 against NP were diagnostic for mumps infection. In parainfluenza infections, titer rises in the mumps ELISAs and NT were found, but mumps IgM, NP IgG3, and the high ratio between the NP and GP titers found in early samples from patients with mumps infection were not observed. PMID- 3654939 TI - Naturally occurring auxotrophs of Campylobacter jejuni and Campylobacter coli. AB - The nutritional requirements for 439 Campylobacter jejuni isolates and 46 Campylobacter coli isolates were determined by using a previously described chemically defined medium, campylobacter defined medium. With this medium, 45% of both human and nonhuman C. jejuni isolates demonstrated auxotrophic requirements. None of the 46 C. coli isolates studied demonstrated requirements for amino acids on campylobacter defined medium. The most common auxotrophic requirement among C. jejuni isolates was for methionine, which was present as a single requirement or in combination with other markers in 21% of human and 28% of nonhuman isolates. There was no correlation between plasmid carriage and auxotype, and a comparison of the Lior serotypes of 472 of the strains showed a correlation only between proline auxotrophs and Lior serotype 11 for strains isolated in the Seattle-King County region. PMID- 3654940 TI - Antibody response to enteric adenovirus types 40 and 41 in sera from people in various age groups. AB - A total of 322 single and paired serum samples from children (newborn to 10 years old), young adults (18 to 20 years old), pregnant women and their cord serum samples, and elderly people (more than 70 years old) was tested for antibodies to enteric adenovirus types 40 and 41 by neutralization test. Serum samples were also tested for antibody to the common antigen of adenovirus by enzyme immunoassay. The incidence of antibodies rose gradually through childhood. Antibodies were found in 20% of children between 1 and 6 months old and in 50% of those 37 to 48 months old. Of serum samples from young adults, 48% had antibodies. Antibodies were found in 10% of serum samples from the aged. Of patients with acute gastroenteritis, 19% showed a significant rise in antibody to adenovirus type 40 or 41 or both, and 42% of the same serum samples had a significant rise in antibody to rotavirus by enzyme immunoassay. None of the serum samples tested was negative to adenovirus common antigen. PMID- 3654941 TI - Rapid identification of Campylobacter pylori (C. pyloridis) by preformed enzymes. AB - Campylobacter pylori (C. pyloridis) is a fastidious organism found in the gastric mucosa associated with histological gastritis and peptic ulceration. A rapid identification scheme that detects the presence of preformed enzymes (Rosco Diagnostica, Taastrup, Denmark) was applied to clinical isolates of C. pylori. The isolates tested were a very homogeneous group. They all produced oxidase, catalase, urease, alkaline phosphatase, gamma-glutamyl aminopeptidase, leucine aminopeptidase, and DNase. None produced any of 44 other enzymes tested. No other campylobacter strains produced gamma-glutamyl aminopeptidase, except the six strains of Campylobacter jejuni biotype 2. Different results were obtained with similar substrates produced by other manufacturers, probably due to small substrate differences. These tests are useful for the rapid identification of C. pylori but would be unhelpful in any biotyping scheme. They can also be used to help differentiate other groups within the genus Campylobacter. PMID- 3654942 TI - Combined genetic transformation and nutritional assay for identification of Moraxella nonliquefaciens. AB - A combined genetic transformation and nutritional assay is described that permits definitive identification of clinically isolated strains of Moraxella nonliquefaciens. Crude DNA preparations of strains of various Moraxella species were used to transform nutritional mutants of a stably competent strain of M. nonliquefaciens for ability to grow on a defined medium (Mn-B). DNA samples from 24 independently isolated strains of M. nonliquefaciens all resulted in massive (4+) transformation of each of two mutant assay strains. DNA samples from strains of M. bovis and M. lacunata frequently gave weak (1+) transformation of one of the mutant assay strains (Mn64) but almost always failed to transform another assay strain (Mn136). DNA samples from eight other Moraxella species failed completely to transform either of the mutant assay strains. When streaked on the defined medium used for the transformation assay (Mn-B), 23 of the 24 strains of M. nonliquefaciens grew well, but all strains of M. bovis and M. lacunata failed to grow on this medium. PMID- 3654943 TI - Selective and differential medium for recovery of Pseudomonas cepacia from the respiratory tracts of patients with cystic fibrosis. AB - A selective and differential medium, OFPBL (oxidation-fermentation base supplemented with agar, lactose, and two antimicrobial agents), for the isolation of Pseudomonas cepacia from respiratory specimens of patients with cystic fibrosis was developed and tested. Among 725 specimens submitted from seven centers over a 4- to 6-month period, 58 (8%) yielded P. cepacia on OFPBL; only 19 of these were recovered on MacConkey or sheep blood agar (P less than 0.001). No isolate was recovered on MacConkey or sheep blood agar alone. Ranges of recovery rates among centers were 0 to 15% on OFPBL and 0 to 10% on MacConkey or sheep blood agar. Ninety percent of P. cepacia isolates were detected on OFPBL in less than or equal to 3 days. Other nonfermenters and yeasts isolated on OFPBL were distinguished from P. cepacia by failure to acidify the medium. The new medium was clearly superior to MacConkey and sheep blood agars for the isolation of P. cepacia from the respiratory secretions of patients with cystic fibrosis. PMID- 3654944 TI - Comparison of agar disk diffusion, microdilution broth, and agar dilution for testing antimicrobial susceptibility of coagulase-negative staphylococci. AB - A collection of 120 oxacillin-susceptible and 120 oxacillin-resistant coagulase negative staphylococci (CNS) from six tertiary care hospital laboratories were tested by agar disk diffusion, three microdilution broth systems (Sensititre, Dynatech, and Alpkem), and the Vitek AutoMicrobic system for comparison with reference agar dilution results. The antimicrobial agents tested were oxacillin, cefazolin, cefotaxime, cefuroxime, cefamandole, fusidic acid, rifampin, and vancomycin. Incubation was at 30 or 35 degrees C for 24, 48, and 72 h. The broth media were supplemented with 2% NaCl for some antimicrobial agents, and the agar dilution method was used with and without the addition of 4% NaCl. The CNS were identified to species by the method of Kloos and Schleifer. The results showed a lack of concordance between two hospitals with respect to oxacillin susceptibility testing by agar dilution with no NaCl supplement. The reasons are not clear but may be related to variations in media. The 4% NaCl supplement or extended incubation to 48 h eliminated this difference. The cefazolin and cefotaxime susceptibility results in the agar disk diffusion test were unreliable if accepted at face value. Cefamandole testing correlated well with the reference method regardless of the method used, and salt supplementation is not recommended. Most of the oxacillin-resistant CNS were resistant to the other beta lactam drugs except cefamandole. Of 22 CNS resistant to cefamandole, 21 were S. haemolyticus. PMID- 3654945 TI - Prevalence and characterization of hippurate-negative Campylobacter jejuni in King County, Washington. AB - A total of 593 strains of thermophilic Campylobacter species were isolated either from humans with diarrhea or from poultry in King County, Washington. Of these strains, 98 (52 hippurate-positive strains and all 46 of the hippurate-negative strains) were selected for further phenotypic characterization and genetic classification. Hippurate hydrolysis, the test typically used to differentiate Campylobacter jejuni and C. coli, did not always correlate with the genetic classification. All hippurate-positive strains were classified as C. jejuni. Of the hippurate-negative strains, 20% were C. jejuni, 78% were C. coli, and 2% were C. laridis. Assuming that the remaining hippurate-positive strains were all C. jejuni, then hippurate-negative C. jejuni represented a small percentage (9 of 556 or 1.6%) of C. jejuni strains but a significant percentage (9 of 46 or 20%) of hippurate-negative strains. This finding suggests that hippurate hydrolysis should not be used as the sole criterion for differentiating thermophilic Campylobacter species, particularly when describing the disease states associated with these organisms. PMID- 3654946 TI - Quantitative antimicrobial susceptibility test for Streptococcus pneumoniae using inoculum supplemented with whole defibrinated sheep blood. AB - The National Committee for Clinical Laboratory Standards recommends the use of lysed horse blood-supplemented Mueller-Hinton broth for determining the quantitative antimicrobial susceptibility of Streptococcus pneumoniae. This procedure may be difficult for laboratories using previously prepared or commercial MIC systems. Therefore, a study was undertaken to determine whether previously prepared microdilution trays containing Mueller-Hinton broth without blood could be used for determining the antimicrobial susceptibility of S. pneumoniae by adding whole defibrinated sheep blood to the bacterial suspension used to inoculate the trays. The presence of alpha-hemolysis was used as an indicator of bacterial growth. One hundred isolates of S. pneumoniae selected to represent a distribution of susceptibility patterns were tested by the National Committee for Clinical Laboratory Standards method and the sheep blood supplemented-inoculum method. Greater than 94% agreement between the two methods was achieved. The sheep-blood-supplemented-inoculum procedure was highly reproducible and easy to perform and provides an acceptable alternative for determining the MICs for S. pneumoniae for laboratories using previously prepared or commercial microdilution systems. PMID- 3654948 TI - Determination of hippurate hydrolysis by gas-liquid chromatography. AB - A rapid gas-liquid chromatographic procedure was developed to determine hippurate hydrolysis by microorganisms. Bacterial cells were inoculated into 0.4 ml of 1% sodium hippurate and incubated for 2 h at 37 degrees C. Cells were removed by centrifugation, and the benzoate released by enzyme activity was converted to methyl benzoate and analyzed by gas-liquid chromatography. This procedure is sensitive, and its specificity provides a high degree of reliability for organisms with weak hippuricase activity. PMID- 3654947 TI - Immunization of elderly people with two doses of influenza vaccine. AB - A total of 104 elderly patients were immunized with one or two doses of the commercial 1985-1986 inactivated influenza vaccine formulation. Two types of vaccines (split virus [SV] vaccine and whole virus [WV] vaccine) and one or two doses 1 month apart were given. No difference in local or systemic reactions was noted among the four groups. The reciprocal geometric mean hemagglutination inhibition antibody titers against influenza A/Philippines/82 (H3N2) after one or two doses were: 78 for SV vaccine (one dose), 65 for SV vaccine (two doses), 55 for WV vaccine (one dose), and 51 for WV vaccine (two doses). Similar nonsignificant differences were observed for the other two antigens contained in the vaccine. The percentage with a hemagglutination inhibition titer of greater than or equal to 1:40 also did not differ after one or two doses. We then compared the postvaccination hemagglutination inhibition titers in young and old patients from previous studies in which apparent differences had appeared. We retested all sera simultaneously on the same day with the same reagents. No significant differences were apparent among age groups. In summary, the humoral immune response to inactivated influenza vaccine in healthy ambulatory elderly patients who have been previously immunized may not differ significantly from that of children and young adults. A booster dose 1 month after the first dose does not enhance immune responses in the elderly. PMID- 3654949 TI - Freeze-drying of respiratory syncytial viruses for transportation and storage. AB - The stabilities of eight strains of respiratory syncytial virus were compared after the strains were freeze-dried in the presence and absence of the stabilizer SPGA, which contains 218 mM sucrose, 7.1 mM dipotassium hydrogen phosphate, 3.76 mM potassium dihydrogen phosphate, 4.9 mM sodium glutamate, and 1% (wt/vol) bovine albumin. Strains freeze-dried in the presence of SPGA showed only small-to negligible losses at 4 degrees C and losses of approximately 2.0 log10 infectious units at 25 degrees C when held for 45 weeks. Losses at 37 degrees C for one strain were approximately 10-fold greater when the strain was freeze-dried in the absence of SPGA. These results indicate that respiratory syncytial virus strains freeze-dried in the presence of a suitable stabilizer can be transported as unrefrigerated samples without undue losses in infectivity. PMID- 3654950 TI - Rapid and improved gas-liquid chromatography technique for detection of hippurate hydrolysis by Campylobacter jejuni and Campylobacter coli. AB - A gas-liquid chromatographic method which requires no chloroform extraction of the split products has been investigated for the detection of hippurate hydrolysis by Campylobacter spp. This technique gave better reproducibility than other tests also used in this study and allows the routine use of the gas-liquid chromatographic method for identification of Campylobacter isolates. PMID- 3654951 TI - Meningitis caused by vancomycin-resistant Leuconostoc sp. AB - A rare case of purulent meningitis caused by vancomycin-resistant Leuconostoc sp. is reported. The patient was treated successfully with penicillin G, and there were no neurological sequelae. We recommend that all gram-positive cocci isolated from cerebrospinal fluid and blood be fully identified so as not to confuse Leuconostoc spp. with more commonly isolated pathogens such as pneumococci and other alpha-hemolytic streptococci. PMID- 3654952 TI - Association of Malassezia pachydermatis with systemic infections of humans. AB - Thirty-two Malassezia spp. isolates from human clinical specimens represented M. furfur and M. pachydermatis. Both species reportedly were obtained from patients with similar febrile systemic syndromes, including infections of the lungs or other tissues. PMID- 3654953 TI - Preliminary antimicrobial susceptibility interpretive criteria for cefetamet (Ro 15-8074) and cefteram (Ro 19-5247) disk tests. AB - Preliminary interpretive zone criteria were calculated for cefetamet (Ro 15-8074) and cefteram (Ro 19-5247) by using 10- and 30-micrograms disks and three possible MIC susceptibility breakpoints. Absolute interpretive agreement between MICs and zone size criteria ranged from 91.8 to 97.2%. Very major errors (false susceptibility) were less than or equal to 1.2% for both cephalosporin disk tests. Morganella morganii strains appeared to produce the highest rates of very major interpretive errors with cefetamet disks. PMID- 3654954 TI - Problems in identification of Campylobacter jejuni associated with acquisition of resistance to nalidixic acid. AB - In a patient with campylobacteriosis, we observed development of resistance to nalidixic acid and norfloxacin under adequate treatment with the latter antibiotic. Isolates before and after treatment differed in their total protein profile but were otherwise identical with respect to enzymatic activity, serotype, crude membrane protein profiles, and other phenotypic characteristics. PMID- 3654955 TI - Potassium contractures and asymmetric charge movement in extensor digitorum longus and soleus muscles from thyrotoxic rats. AB - Potassium contractures and asymmetric charge movement were recorded from extensor digitorum longus (EDL) and soleus muscle from normal rats and rats that had been made thyrotoxic by daily intraperitoneal injections of triiodothyronine (150 micrograms kg-1) for two to three weeks. Potassium contracture tension (relative to tetanic tension) in thyrotoxic rats was greater in EDL muscles and smaller in soleus muscles than in normal rats. As the relationship between membrane potential and potassium concentration was unaltered by thyroid treatment, it was concluded that the changes in potassium contracture tension were due to changes in excitation-contraction coupling. In thyrotoxic rats there was an average negative shift of -5 mV in the voltage sensitivity of tension in EDL fibres and a positive shift of 5 mV in soleus. As a result, the tension-membrane potential curves for EDL and soleus fibres essentially coincided. There was a corresponding average negative shift of -4 mV in the voltage sensitivity of asymmetric charge in EDL fibres, and a positive shift of 4 mV in soleus fibres from thyrotoxic rats. The dependence of asymmetric charge movement on membrane potential became essentially the same in EDL and soleus fibres from thyrotoxic rats. The maximum asymmetric charge in soleus fibres increased from an average value of 6.5 nC microF-1 in normal rats (n = 33) to 8.9 nC microF-1 in thyrotoxic rats (n = 32; p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3654956 TI - The distribution of the charged residues in myosin hinge region and its relationship to the distribution of charged residues in the rest of myosin rod. AB - Fourier transform analysis of the amino acid sequence of the hinge region from both rabbit skeletal myosin and nematode myosin indicates that the basic residues show strong periodicity of 25.7 residues whereas the periodicity of acidic residues is very weak. Other 100 residue segments of the rod sequence of nematode myosin show an alternation between regions in which the 28 residue repeat is predominantly basic and regions in which it is predominantly acidic. The strong basic and weak acidic near 28 residue repeat of the hinge region appears to form part of this pattern. This alternation suggests that the packing of myosin rods is more favourable when the neighbouring molecules are staggered by about 100 residues or odd multiples of 100 residues, which is consistent with the observed repeats (14.6 and 44.0 nm) of cross-bridges. PMID- 3654958 TI - One world or no world: the vision of Wendell Willkie. PMID- 3654959 TI - The role of medical schools in the second epidemiologic revolution. PMID- 3654957 TI - Crossbridges in insect flight muscles of the blowfly (Sarcophaga bullata). AB - Crossbridges in quick-frozen deep-etched blowfly flight muscles (from Sarcophaga bullata) were compared with those observed in the traditional waterbug preparation (Lethocerus) and found to be indistinguishable. Hence, blowfly was chosen as a fresher more accessible tissue for determining the effect of various fixatives and nucleotides on crossbridge structure. In rigor control, crossbridges were most regular in muscles that were stabilized before freezing by prefixation in glutaraldehyde followed by 'hardening' with neutralized tannic acid, so all nucleotide treatments were terminated by such fixation. MgATP (5 mM) converted the rigor pattern of crossbridges into a random array of disconnected thick filament projections. Lower levels of ATP (0.1 mM) caused a variable but generally lesser degree of crossbridge disconnection, as did 5 mM ADP (probably because it slowly converted to ATP inside the muscle fibres). Vanadate (1-2 mM) potentiated muscle relaxation in the latter two nucleotide treatments (i.e. produced a greater degree of crossbridge disconnection). Thus, differences in overall crossbridge abundance were readily apparent in chemically fixed muscles. Structural details within individual crossbridges were less well preserved, however. Chemical prefixation tended to collapse the muscle lattice, add a surface film to the filaments and thus obscure crossbridge details. Rigorous control of fixative pH largely prevented these problems and permitted recognition of the fact that in Sarcophaga flight muscle, as in Lethocerus muscle in rigor, the S1 'heads' of crossbridges attach to the thin filaments in the expected 'arrowhead' configuration. PMID- 3654960 TI - Redefining the public health agenda. PMID- 3654962 TI - Developing local food policies: one city's experiences. PMID- 3654961 TI - Alcohol and cigarette advertising in Ms. magazine. PMID- 3654963 TI - Health care for the elderly in Canada. PMID- 3654964 TI - The psychosocial impact of the nuclear threat on the Third World: the case of Colombia. PMID- 3654965 TI - The health workers' declaration on the arms race and the threat of nuclear war. World Conference of Health Workers on Social Well-being, Health and Peace, Moscow, May 29-June 1, 1987. PMID- 3654966 TI - On growing needs of urban health management. Summary of the Proceedings of the Sixth Annual Conference of the Indian Society of Health Administrators, Pune, November 17-19, 1985. PMID- 3654967 TI - Purification of a human liver cytochrome P-450 immunochemically related to several cytochromes P-450 purified from untreated rats. AB - Among characterized forms of liver microsomal cytochromes P-450 in rats are four related isozymes (P-450f-i) notable for their lack of inducibility. Immunoblot analyses demonstrated that human livers microsomes contained several proteins related to these rat P-450s. A human liver P-450, termed HLx, was purified and found by immunochemical assays to resemble rat P-450g. Analysis of the NH2 terminal amino acid sequence of HLx indicates that it is related to rat P-450s f i and human liver P-450MP. A monoclonal antibody was used to measure the amounts of HLx in 21 human liver specimens. No correlation between the levels of HLx protein in these specimens and the patients' environmental histories was observed. However, statistical analysis of the data suggests that the distribution of HLx is at least bimodal. We conclude that HLx is a member of a family of human liver P-450s that resembles in its structure, and possibly in its distribution, several liver P-450s found in other animals. PMID- 3654968 TI - Identification of glucocorticoid-inducible cytochromes P-450 in the intestinal mucosa of rats and man. AB - We used monoclonal antibodies and complementary DNAs (cDNAs) to glucocorticoid inducible liver cytochromes P-450 in rats (P-450p) and in man (HLp) to search for related cytochromes in intestinal mucosa. In rat enterocytes, we found two dexamethasone-inducible proteins related to the steroid-inducible liver cytochromes P-450. Induction of these proteins in enterocytes was associated with increases in the amount of a P-450p-related messenger RNA and of erythromycin demethylase, an activity highly characteristic of P-450p and HLp. Similar studies on human jejunal enterocytes revealed a microsomal protein indistinguishable from HLp on immunoblots and an abundance of RNA hybridizing with HLp cDNA. In human enterocytes the specific concentration of the HLp-related cytochrome (measured immunochemically or as erythromycin demethylase activity) was similar to that found in human liver and could account for all of the CO-binding hemo-protein detected. We conclude that the intestinal mucosa contains prominent form(s) of cytochromes P-450 similar to liver cytochrome P-450p in their structure, function, and some regulatory characteristics. PMID- 3654969 TI - Body composition, not body weight, is related to cardiovascular disease risk factors and sex hormone levels in men. AB - To clarify the independent relationships of obesity and overweight to cardiovascular disease risk factors and sex steroid levels, three age-matched groups of men were studied: (i) 8 normal weight men, less than 15% body fat, by hydrostatic weighing; (ii) 16 overweight, obese men, greater than 25% body fat and 135-160% of ideal body weight (IBW); and (iii) 8 overweight, lean men, 135 160% IBW, but less than 15% fat. Diastolic blood pressure was significantly greater for the obese (mean +/- SEM, 82 +/- 2 mmHg) than the normal (71 +/- 2) and overweight lean (72 +/- 2) groups, as were low density lipoprotein levels (131 +/- 9 vs. 98 + 11 and 98 + 14 mg/dl), the ratio of high density lipoprotein to total cholesterol (0.207 +/- 0.01 vs. 0.308 +/- 0.03 and 0.302 +/- 0.03), fasting plasma insulin (22 +/- 3 vs. 12 +/- 1 and 13 +/- 2 microU/ml), and the estradiol/testosterone ratio (0.076 +/- 0.01 vs. 0.042 +/- 0.02 and 0.052 +/- 0.02); P less than 0.05. Estradiol was 25% greater for the overweight lean group (40 +/- 5 pg/ml) than the obese (30 +/- 3 pg/ml) and normal groups (29 +/- 2 pg/ml), P = 0.08, whereas total testosterone was significantly lower in the obese (499 +/- 33 ng/dl) compared with the normal and overweight, lean groups (759 +/- 98 and 797 +/- 82 ng/dl). Estradiol was uncorrelated with risk factors and the estradiol/testosterone ratio appeared to be a function of the reduced testosterone levels in obesity, not independently correlated with lipid levels after adjustment for body fat content. Furthermore, no risk factors were significantly different between the normal and overweight lean groups. We conclude that (a) body composition, rather than body weight per se, is associated with increased cardiovascular disease risk factors; and (b) sex steroid alterations are related to body composition and are not an independent cardiovascular disease risk factor. PMID- 3654970 TI - Regulation of gastric acid secretion by neurotensin in man. Evidence against a hormonal role. AB - The present study was designed to evaluate neurotensin as a hormonal regulator of gastric acid secretion in man. After a fat-rich meal, the strongest known stimulus of neurotensin release, plasma neurotensin-like immunoreactivity (NTLI) was elevated from 7.6 +/- 1.9 to 15.5 +/- 2.5 pM. Plasma NTLI was measured with antiserum L170, which requires the biologically active carboxyl-terminal hexapeptide of the neurotensin molecule for recognition and does not crossreact significantly with any known natural catabolite in human plasma. Intravenous infusion of neurotensin at 25 pmol X kg-1 h-1 resulted in a plasma level of 14.7 +/- 2.1 pM, similar to the maximal physiological level observed after the fat rich meal. Intravenous infusion of neurotensin at 25 pmol X kg-1 h-1 during 2 h, however, failed to significantly inhibit peptone meal-stimulated gastric acid secretion measured by intragastric titration. The 2-h acid output to peptone was 40.8 +/- 6.2 and 41.3 +/- 6.9 mmol during the vehicle and the neurotensin infusion, respectively. Intravenous infusion of neurotensin at 100 or 400 pmol X kg-1 h-1 did not affect acid output, whereas at 1,600 pmol X kg-1 h-1, which resulted in a plasma neurotensin concentration of 725 +/- 80 pM, significantly reduced peptone meal-stimulated gastric acid secretion. The neurotensin-induced inhibition of acid output was independent of the hormone gastrin. The present results provide evidence against a hormonal role for neurotensin in the regulation of meal-stimulated gastric acid secretion in man. PMID- 3654971 TI - Effect of fetal adrenalectomy on catecholamine release and physiologic adaptation at birth in sheep. AB - Plasma catecholamine levels increase dramatically at birth. To determine the contribution of adrenal catecholamine secretion to the surge in catecholamines at birth and the role in newborn adaptation, we performed surgical adrenalectomy or sham operation on near-term ovine fetuses. After recovery in utero, the animals were delivered and supported by mechanical ventilation. Plasma catecholamine levels, heart rate, blood pressure, cardiac output, pulmonary function, surfactant secretion, and release of free fatty acids (FFA) and glucose were compared in control and adrenalectomized animals. Plasma epinephrine increased rapidly at birth in controls but was undetectable in adrenalectomized animals. Norepinephrine levels were not statistically different. Heart rate, blood pressure, cardiac output and contractility increased abruptly after cord cutting in controls but did not increase in adrenalectomized animals. Lung compliance, pulmonary function, surfactant pool size, glucose and FFA levels were significantly decreased in adrenalectomized animals. These results suggest that adrenal epinephrine secretion is vital to many of the adaptive events at birth. PMID- 3654972 TI - Demonstration of 2-hydroxybenzoylglycine as a drug binding inhibitor in newborn infants. AB - Newborn infants have drug binding defects that share similarities to those of uremic subjects. Since 2-hydroxybenzoylglycine has been chemically defined to be a major drug binding inhibitor in uremia, a search for the presence of a similar compound in the sera of newborn infants was made. An organic substance that has the characteristics of 2-hydroxybenzoylglycine as supported by the retardation factor values on thin-layer chromatograms, retention times of high performance liquid chromatograms, fluorescence emission spectra, and mass spectrum has been demonstrated to be present in the majority of the neonatal sera studied. A strong positive correlation between the levels of the binding inhibitor and the extent of binding defects for nafcillin has been observed. The substance could effectively reduce the total bilirubin concentration when added to the cord sera specimens. It is concluded that 2-hydroxybenzoylglycine plays an important role in drug binding defects observed in the newborn, and the inhibitor may also play a part in the precipitation of bilirubin-induced neurotoxicity in neonates when the substance is abnormally elevated. PMID- 3654973 TI - Metabolism and placental transfer of 125I-proinsulin and 125I-tyrosylated C peptide in the pregnant rhesus monkey. AB - 125I-Proinsulin or 125I-tyrosylated-C-peptide (125I-tyr-CP) was administered to pregnant Rhesus monkeys by bolus followed by constant infusion to examine placental transfer of these peptides. At the end of each infusion, fetuses were exsanguinated in situ via the umbilical vein. The bolus-constant infusion technique produced a steady state in maternal plasma of immunoprecipitable label, measured using excess insulin or C-peptide antiserum. In animals infused with 125I-proinsulin, analysis of umbilical venous plasma revealed no apparent transfer to the fetus of immunoprecipitable label. In animals infused with 125I tyr-CP, 3-13% of the umbilical venous plasma radioactivity was immunoprecipitable, representing 1.4-5.8% of the immunoprecipitable radioactivity in maternal plasma at delivery. Gel filtration chromatography of umbilical venous plasma revealed that the immunoprecipitated moiety was a fragment of 125I-tyr-CP. Analysis of maternal plasma showed that the predominant peak of radioactivity represented intact C-peptide. A peak corresponding to the fetal immunoprecipitable peak was also present. Analysis of simultaneous maternal arterial and uterine vein plasma samples showed that degradation of 125I-tyr-CP occurred across the uterus. Studies in one nonpregnant and three postpartum animals indicated that pregnancy increased the rate of metabolism of 125I-tyr-CP. When 125I-tyr-CP was incubated with trophoblastic cells in culture, degradation to a species corresponding on gel filtration to the immunoprecipitable fetal metabolite was found. We conclude that proinsulin, like insulin, does not traverse the placenta. Immunoreactive fragments of C-peptide do cross, however, and pregnancy alters the metabolism of 125I-tyr-CP, probably owing to placental degradation. PMID- 3654975 TI - Effect of adrenalectomy on transport in the rat medullary thick ascending limb. AB - Previous studies in adrenalectomized (Adx) rats suggest that aldosterone may regulate ion transport in the ascending portion of Helen's loop. In order to examine directly the effect of adrenalectomy on transport, medullary thick ascending limb (Mtal) segments were isolated from Adx, Adx replaced with aldosterone (Adx + Ald, 0.5 micrograms X 100 g X body wt X d), and control Sprague-Dawley rats. Both net sodium and net chloride fluxes were significantly less in the Mtal segments from Adx rats compared with those in the control or Adx + Ald group. Physiologic levels of exogenous aldosterone increased net sodium chloride flux toward control values in the Adx + Ald group. Net potassium flux was not different among the three groups. We conclude that adrenalectomy impairs reabsorptive NaCl but not K transport in the Mtal, and that aldosterone restores this process. This reabsorptive defect may contribute to the urinary concentrating and diluting abnormality associated with adrenal insufficiency. PMID- 3654974 TI - Dietary intake of phosphorus modulates the circadian rhythm in serum concentration of phosphorus. Implications for the renal production of 1,25 dihydroxyvitamin D. AB - We recently reported that in healthy men, changes in the production rate (PR) of 1,25-dihydroxyvitamin D [1,25-(OH)2D] accounted for the 80% increase and the 30% decrease in its serum concentration that was induced by restriction and supplementation, respectively, of dietary phosphorus. These changes in PR and serum concentration of 1,25-(OH)2D could be mediated by changes in serum concentrations of phosphorus that occur after the morning fasting period. To examine this hypothesis, we measured serum concentrations of phosphorus in blood drawn at hourly intervals for 24 h in six healthy men in whom dietary phosphorus was initially maintained at 1,500 mg/70 kg body weight per day for 9 d, then restricted to 500 mg/d (coupled with orally administered aluminum hydroxide) for 10 d, and then supplemented to 3,000 mg/d for 10 d. When dietary phosphorus was normal, the serum concentration of phosphorus exhibited the normal circadian rhythm: a rapid decrease in early morning to a nadir at 1100, followed by an increase to plateau at 1600 h and a further increase to an acrophase (peak) at 0030 h. The variation in serum levels of phosphorus can be described as the sum of sinusoidal functions with periodicities of 24 and 12 h. Phosphorus restriction for 10 d induced a 40% reduction in the 24-h mean serum level of phosphorus, abolished the early afternoon rise in its serum level (i.e., the 12-h periodic component of the time series), and delayed the acrophase by 3 h to 0330 h. Phosphorus supplementation for 10 d induced a 14% increase in the 24-h mean serum level of phosphorus but no significant change in its morning fasting level, exaggerated the early afternoon rise in serum phosphorus, and advanced the acrophase by 9 h to 1530 h. The changes in the PR of 1,25-(OH)2D induced by restriction and supplementation of dietary phosphorus varied inversely and significantly with those induced in the 24-h mean serum level of phosphorus (R = 0.88, P less than 0.001). These data demonstrate that in healthy men, dietary phosphorus is an important determinant of the serum concentration of phosphorus throughout most of the day. The data suggest that diet-induced changes in serum levels of phosphorus mediate the changes in PR and serum concentration of 1,25(OH)2D. PMID- 3654976 TI - Myocardial energy production and consumption remain balanced during positive inotropic stimulation when coronary flow is restricted to basal rates in rabbit heart. AB - The effect on myocardial energy balance of increasing oxygen demand without altering basal myocardial perfusion rate was assessed in isolated, isovolumic, retrograde blood perfused rabbit hearts. Myocardial energy requirements were increased with paired stimulation. The capacity of rapid paired stimulation to increase mechanical energy consumption was demonstrated in the presence of increased perfusion with the rate X pressure product and oxygen consumption increasing 86 and 148%, respectively, compared with control values. In contrast, rapid paired stimulation under constant, basal flow conditions did not alter the rate X pressure product, while oxygen extraction and consumption increased only 40% relative to control. Myocardial ATP, creatine-phosphate, and lactate content were identical under control and constant flow-paired stimulation conditions. The results of this study indicate that no detectable energy imbalance was produced by rapid paired stimulation with flow held constant at basal rates. These results suggest that the myocardium does not increase mechanical energy expenditure in response to inotropic or rate stimulation in the presence of restricted flow reserve and are inconsistent with the concept of "demand-induced" or "relative" myocardial ischemia. PMID- 3654977 TI - Transient elevation of messenger RNA encoding gastrin-releasing peptide, a putative pulmonary growth factor in human fetal lung. AB - Gastrin-releasing peptide (GRP), the mammalian homologue of the amphibian peptide bombesin, is present in pulmonary neuroendocrine cells and appears to be a growth factor for both normal and neoplastic pulmonary cells. Previously we have reported the cloning of the messenger RNAs (mRNAs) and gene that encode human GRP. We now report that GRP mRNAs are markedly elevated in human fetal lung during the canalicular phase of pulmonary development (from approximately 16 to 30 wk gestation). By RNA blot and in situ hybridization analyses, GRP mRNAs were first detectable in fetal lung at 9-10 wk, plateaued at levels 25-fold higher than in adult lungs from 16 to approximately 30 wk and then declined to near adult levels by 34 wk gestation. By contrast, GRP peptide levels remain elevated until several months after birth. Consistent with this, in situ hybridization and immunohistochemical studies showed that GRP mRNA and peptide consistently colocalized in early gestation lung but that in neonatal lung, many cells that contained GRP peptide no longer contained GRP mRNA. The transient expression of high levels of GRP mRNAs during an approximately 12-wk phase of fetal lung development suggests that the secretion of GRP or its COOH-terminal peptides from pulmonary neuroendocrine cells may play a role in normal lung development. PMID- 3654979 TI - Isolation of a complementary DNA clone for thyroid microsomal antigen. Homology with the gene for thyroid peroxidase. AB - The thyroid microsomal antigen (MSA) in autoimmune thyroid disease is a protein of approximately 107 kD. We screened a human thyroid cDNA library constructed in the expression vector lambda gt11 with anti-107-kD monoclonal antibodies. Of five clones obtained, the recombinant beta-galactosidase fusion protein from one clone (PM-5) was confirmed to react with the monoclonal antiserum. The complementary DNA (cDNA) insert from PM-5 (0.8 kb) was used as a probe on Northern blot analysis to estimate the size of the mRNA coding for the MSA. The 2.9-kb messenger RNA (mRNA) species observed was the same size as that coding for human thyroid peroxidase (TPO). The probe did not bind to human liver mRNA, indicating the thyroid-specific nature of the PM-5-related mRNA. The nucleotide sequence of PM-5 (842 bp) was determined and consisted of a single open reading frame. Comparison of the nucleotide sequence of PM-5 with that presently available for pig TPO indicates 84% homology. In conclusion, a cDNA clone representing part of the microsomal antigen has been isolated. Sequence homology with porcine TPO, as well as identity in the size of the mRNA species for both the microsomal antigen and TPO, indicate that the microsomal antigen is, at least in part, TPO. PMID- 3654978 TI - Molecular studies of ceruloplasmin deficiency in Wilson's disease. AB - Deficiency of serum ceruloplasmin is a characteristic biochemical abnormality of Wilson's disease, although the mechanism of this finding is unknown. Ceruloplasmin messenger RNA (mRNA) levels were therefore examined in five patients with Wilson's disease and five controls with other types of hepatic disease. Northern and dot blot hybridizations showed that detectable ceruloplasmin mRNA was present in all of the patients with Wilson's disease, including one patient with no detectable serum ceruloplasmin. However, the ceruloplasmin mRNA levels in the Wilson's disease patients were only 33% that of controls (P less than 0.001). In contrast, albumin mRNA levels in the Wilson's disease patients averaged 161% that of controls. In an attempt to better delineate the level of gene expression responsible for this decrease in ceruloplasmin mRNA, the nuclear run-on assay was used to analyze transcriptional rates. The amount of ceruloplasmin gene transcription in four Wilson's patients was decreased to 44% that of three controls. These results indicate that the diminished serum ceruloplasmin levels in patients with Wilson's disease are due at least in part to a decrease in ceruloplasmin gene transcription. PMID- 3654980 TI - Brave new medicine. Presidential address to the American Society for Clinical Investigation, San Diego, California, 2 May 1987. PMID- 3654981 TI - Dietary calcium intake and rates of bone loss in women. AB - We measured bone mineral density (BMD) at the midradius and lumbar spine in 106 normal women, ages 23-84 yr (61 were postmenopausal). Three to nine measurements (median, four) were made over 2.6 to 6.6 yr (mean, 4.1 yr). The correlation between calcium intake (range, 260-2,035 mg/d) and rate of change in BMD was not significant at the midradius (r = 0.06) or lumbar spine (r = 0.08), even after adjusting for age, menopausal status, and serum estrogen levels by multiple regression analysis. Women in the lower (mean, 501 mg/d) and in the upper (mean, 1,397 mg/d) quartiles of dietary intake had similar rates of change in BMD (%/yr [mean +/- SE], at midradius, -0.78 +/- 0.24 and -0.91 +/- 0.17 for lower and upper quartiles, respectively; at lumbar spine, -1.06 +/- 0.24 and 0.98 +/- 0.24). These data do not support the hypothesis that insufficient dietary calcium is a major cause of bone loss in women. PMID- 3654982 TI - Microcomputer software to facilitate costing in pathology laboratories. AB - A software program is described which will enable laboratory managers to calculate, for their laboratory over a 12 month period, the cost of each test or investigation and of components of that cost. These comprise the costs of direct labour, consumables, equipment maintenance and depreciation; allocated costs of intermediate operations--for example, specimen procurement, reception, and data processing; and apportioned indirect costs such as senior staff time as well as external overheads such as telephone charges, rent, and rates. Total annual expenditure on each type of test is also calculated. The principles on which the program is based are discussed. Considered in particular, are the problems of apportioning indirect costs (which are considerable in clinical laboratory work) over different test costs, and the merits of different ways of estimating the amount or fraction of staff members' time spent on each kind of test. The computer program is Crown copyright but is available under licence from one of us (JAS). PMID- 3654983 TI - Infections in British clinical laboratories, 1984-5. AB - During 1984-5 this continuing survey showed that 41 infections occurred in the staff of 193 laboratories, representing 23,043.5 person years of exposure. The community was the probable source of two cases each of hepatitis A and B, one of tuberculosis, two of campylobacter enteritis, and 12 of Norwalk viral diarrhoea. Occupational exposure was the probable cause of six hepatitis B infections (affecting haematology, biochemistry, and microbiology staff), three of tuberculosis (affecting mortuary and morbid anatomy workers), seven shigella, three salmonella (including one typhoid) and one pseudocholera infection (all in microbiology medical laboratory scientific officers), and a streptococcal infection in a mortuary technician. An episode of hepatitis of uncertain cause affected a carrier of hepatitis B. The incidence of reported infections of all types was 178 per 100,000 person years (91 for infections of suspected occupational origin). The highest incidence was in morbid anatomy and mortuary workers, followed by microbiology medical laboratory scientific officers. PMID- 3654984 TI - Protein A and coagulase expression in epidemic and non-epidemic Staphylococcus aureus. AB - Strains of Staphylococcus aureus were divided into groups on the basis of antimicrobial sensitivity and epidemiology and tested for protein A expression in a simple microtitre test, which detected the non-immunological binding of immunoglobulin to protein A on whole cells of S aureus. Isolates of the methicillin resistant strain prevalent in south east England (EMRSA) showed a low expression of protein A compared with the other strains of methicillin resistant S aureus (MRSA), other multiple resistant strains, and sensitive strains. Protein A and coagulase expression in 27 strains of MRSA from 15 countries associated with hospital outbreaks were compared with 27 strains of MRSA from 11 countries reported to be sporadic isolates. Twenty four of the 27 outbreak associated MRSA showed low expression of protein A and high expression of coagulase. Conversely, sporadic strains generally gave higher levels of protein A and a wide variety of coagulase reactions. The results suggest that many epidemic strains of MRSA may have phenotypic characteristics that distinguish them from sporadic strains. PMID- 3654985 TI - Campylobacter pyloridis and acid induced gastric metaplasia in the pathogenesis of duodenitis. AB - Biopsy specimens of gastric and duodenal mucosa from 290 patients were examined histologically for metaplasia and Campylobacter pyloridis. Estimates of pH on samples of fasting gastric juice from 55 of the patients were performed, and mucosal biopsy specimens from 33 patients were also cultured for C pyloridis. Active duodenitis was seen in 34 duodenal biopsy specimens. Thirty (88%) of the patients with active duodenitis had both greater than 5% gastric metaplasia in the duodenal specimen and C pyloridis associated gastritis. These two factors coexisted in only 0.43% of patients with no duodenal inflammation. When C pyloridis were seen histologically in duodenal biopsy specimens they were confined to areas of gastric metaplasia and never occurred in the absence of a polymorph infiltrate. Of the 55 patients with measurements of gastric juice pH, gastric metaplasia was present in the duodenum in 20 of 42 with a pH of less than 2.5, and in 0 of 13 with a pH of greater than 2.5. These results suggest that acid induced gastric metaplasia in the duodenum and C pyloridis associated gastritis may be synergistic in the pathogenesis of duodenitis; the metaplastic gastric epithelium allows C pyloridis to colonise the duodenal mucosa, where it produces an acute inflammatory response. PMID- 3654986 TI - Use of monoclonal antibodies in an ELISA to detect IgM class antibodies specific for Toxoplasma gondii. AB - Two monoclonal antibodies CH6 and C1E3 were used in an antibody class capture assay for the detection of IgM antibodies specific for Toxoplasma gondii. CH6 was used on the solid phase to capture human IgM. After a Toxoplasma gondii antigen had been added, specifically bound material was detected using C1E3 coupled to horseradish peroxidase. The assay was compared with an established system using polyclonal antisera at both the capture and antigen detection stages. A good correlation was found, with 97.3% (125 of 128) of sera giving the same classification in both assays. Three sera were positive only in the polyclonal system. No false positive results were found when 118 negative sera were examined. The two monoclonal antibodies provide a viable alternative to the use of polyclonal sera at the capture and antigen detection stages in the antibody class capture assay for the measurement of specific IgM against T gondii. PMID- 3654987 TI - Nucleolar organiser region associated proteins in cutaneous melanotic lesions: a quantitative study. AB - Using a silver staining technique, nucleolar organiser regions were identified in routinely processed paraffin sections of a range of dermal melanotic lesions. The technique shows argyrophilic NOR associated proteins (AgNORs), which are seen in nuclei as black dots. Although the nuclei of melanocarcinoma in situ, melanocarcinoma per se, and lentigo maligna contained similar numbers of AgNORs, in melanocarcinomas a mean of 7.9 AgNORs per nucleus was found, while in naevocellular naevi, this figure was 1.2. The AgNOR method, which is unknown to most histopathologists, could perhaps be used quantitatively or semiquantitatively to assist in the diagnosis of melanotic lesions in the skin (and elsewhere). PMID- 3654988 TI - "Mucin secreting" and "mucinous" primary thyroid carcinomas: pitfalls in mucin histochemistry applied to thyroid tumours. AB - Forty primary carcinomas of the thyroid of different histological types were reviewed and studied histochemically, with the aim of identifying and assessing "mucin secretion". The patterns of extracellular "pure alcianophilia" and "mixed alcianophilia" were noted in 7.5% and about 50% of these tumours, respectively. A critical review of the pitfalls in methods and interpretation of mucin histochemistry--as performed in previously reported cases of "mucin secreting" or "mucinous" primary thyroid tumours--is presented. The apparent "mucin secretion" described in these unusual neoplasms could be due to histochemical staining of carbohydrate components or breakdown products of thyroglobulin and colloid. PMID- 3654989 TI - Visceral brown fat necrosis in postperinatal mortality. AB - Fat necrosis was present in 22 of 400 cases of consecutive postperinatal mortalities investigated to assess the presence and pattern of deep fat necrosis. In just over 50% of the cases of fat necrosis the cause of death was categorised as sudden infant death syndrome, which also showed more severe degrees of necrosis. The mechanism of necrosis may be vascular hypoperfusion, possibly related to shock, and brown adipose tissue, on account of its high metabolic activity and rich capillary plexus, may be particularly vulnerable to infarction. The occurrence of fat necrosis in association with other causes of death did not provide any definite clue as to the nature of the alleged shock. PMID- 3654990 TI - Mesenteric venous thrombosis and antithrombin III deficiency. AB - Of the 123 patients with acute mesenteric infarction treated over the past 12 years, 16 (13%) had mesenteric venous thrombosis. Eight of the patients with mesenteric venous thrombosis survived the initial episode; two have since died. The remaining six patients were studied for evidence of haemostatic deficiencies or abnormalities. Antithrombin III deficiency, which is known to be associated with recurrent venous thrombosis, was found in three patients. It is recommended that all patients with mesenteric venous thrombosis should be screened for antithrombin III deficiency as treatment with coumarin anticoagulants may be indicated, providing effective prophylaxis against further thrombotic episodes. PMID- 3654991 TI - Some long term effects of smoking on the haemostatic system: a report from the Caerphilly and Speedwell Collaborative Surveys. AB - Data from two community studies on men from South Wales and the west of England suggest that the effects of smoking on the haemostatic system remain for many years after giving up. Long term correlations between several variables, including plasma fibrinogen and white cell count, and the length of time after giving up were seen in ex-smokers. Dose response relations were apparent in current smokers in terms of the white cell count and two haematological variables, the packed and mean cell volumes. These long term correlations probably reflect the toxicity of other agents in tobacco smoke besides nicotine and carbon monoxide, which act only in the short term. Identification of these agents may further our understanding of the mechanism by which cigarette smoking is associated with atherosclerotic disease. PMID- 3654993 TI - Demonstration of myocardial infarction in putrefying bodies. PMID- 3654992 TI - Evidence for the presence of lactoferrin in odontogenic keratocyst fluids. AB - Investigations into the possibility that X (an antigen consistently present in aspirated odontogenic keratocysts, but not in most fluids from other cyst types), represented a keratinocyte component failed to identify the antigen as a keratin, involucrin, or one of the blood group substances. Antigen X was detected in human mixed and parotid saliva and in colostrum, as well as in a commercially obtained preparation of colostral IgA. The antigen was similar biochemically to both secretory component and lactoferrin but proved to be identical antigenically with lactoferrin. The origin of lactoferrin in keratocyst fluids remains uncertain, though the lining epithelium seems a more likely source than does the very variable, and often negligible, inflammatory infiltrate found in these lesions. PMID- 3654994 TI - Linear track scanning of pathological tissue sections: an interdisciplinary approach to microscopy. PMID- 3654995 TI - Factors II, VII, IX, and X concentrations in patients receiving long term treatment with warfarin. PMID- 3654996 TI - Microvascular thrombosis of the bowel in paroxysmal nocturnal haemoglobinuria. PMID- 3654997 TI - Seminal vesicle epithelium in prostatic needle biopsy specimens. PMID- 3654998 TI - Weibel-Palade bodies in Kaposi's sarcoma cells. PMID- 3654999 TI - Comparative efficacy of pirmenol and procainamide in a drug-resistant population with ventricular tachycardia. AB - The acute antiarrhythmic properties of pirmenol were studied in 12 patients who failed clinical oral drug therapy with a history of a cardiac arrest or sustained ventricular tachycardia (VT). Programmed electrical stimulation studies were performed in ten men and two women with a mean age of 63 +/- 2 years. All patients had inducible ventricular tachycardia by programmed electrical stimulation when they were off all antiarrhythmic therapy. Patients were then tested on procainamide, 1000 mg, administered intravenously, and ventricular tachycardia could be provoked in nine of twelve patients. Pirmenol was given intravenously, 1.1 mg/kg bolus followed by 40 micrograms/kg/min over 40 minutes prior to drug testing. Pirmenol did not significantly change the baseline heart rate, blood pressure, or measured electrocardiographic values from control values. Ten of 12 patients were still inducible to ventricular tachycardia on pirmenol. Procainamide protected one of nine patients against VT induction. In patients still inducible on drug therapy, the VT rate was significantly slowed from 221 beats/min to 166 beats/min on pirmenol and to 200 beats/min on procainamide. The effects of this new antiarrhythmic agent were similar to procainamide in this drug-resistant study population. PMID- 3655001 TI - Chloroquine in human milk. AB - Simultaneous milk and saliva samples were collected over a seven-day period from five lactating subjects after they had ingested two tablets of chloroquine sulfate (300 mg base). The samples were analyzed for chloroquine content by use of a combination of thin-layer chromatography and spectrophotometry. Regression analysis of two variables subject to error was used to determine the milk:saliva levels relationship. The Student's t test for paired data at .05 level of significance was used to evaluate the relationship between chloroquine levels in milk and saliva. The milk:saliva chloroquine concentrations ratio obtained by regression analysis was 0.89 +/- 0.08 (r = .93; P less than .05), and this compared favorably with the value of 0.99 +/- 0.07 obtained from the ratio of the AUC. There were no significant differences in the Tmax, Cmax, AUC, clearance, and elimination half-life values of chloroquine in milk and saliva (P greater than .05). Milk and saliva appear to be part of the central compartment. The amount of chloroquine estimated to be consumed by a nursling over a 24-hour period is about 0.55% of a 300-mg dose consumed by the mother. The data suggest that milk chloroquine levels can be estimated from saliva levels. PMID- 3655000 TI - The novel therapeutic implications of azlocillin's dose-dependent pharmacokinetics: contributing physiologic mechanisms and a prospective, cross over designed trial. AB - Azlocillin is an important acylureido penicillin antibiotic for the management of complex gram-negative infections particularly those caused by Pseudomonas species. The current studies demonstrate that it manifests dose-dependent pharmacokinetics during the usual regimens of clinical dosing, that enterohepatic recirculation does not occur and that renal tubular secretion (maximum renal tubular secretory capacity 300 +/- 30 micrograms/min) and hepatic metabolism appear to be the dominant contributors to the dose-dependent nature of azlocillin. The possible therapeutic implications of azlocillin's dose dependency were evaluated by undertaking a six-day randomized, prospective, cross-over design study to evaluate the pharmacokinetic disposition of the drug during a 3-g q4h (typically used in adults) regimen versus a 5-g q8h regimen. By using the area under the serum-time concentration curve (AUC) as the major comparative parameter for these two regimens, the results demonstrate that both regimens provide approximately equal quantitative amounts of the drug systemically as a result of azlocillin's dose dependency. The AUC values, although not therapeutic end points, nonetheless correlate well with clinical response to antibiotic therapy. The 5-g q8h regimen was well tolerated. It is less disruptive for patients, requires half the number of intravenous administrations, 17% less drug, and is more cost effective than the 3-g q4h regimen. PMID- 3655002 TI - Renal tolerance of rubidium chloride: short-term clinical evaluation. AB - The rubidium and lithium ions are known to have opposite effects on a wide range of biochemical and behavioral parameters in experimental animals. Based on the proven effectiveness of lithium as an antimanic agent, several trials have been conducted with rubidium in the acute treatment of the depressive phase of bipolar illness. The results to date are promising. However, the 30- to 60-day biologic half-life of rubidium has mandated careful studies of potential toxicity before engaging in long-term administration of this ion to depressive subjects. One area of potential concern is the possibility of renal toxicity, which could be expressed as unexpectedly increased retention of rubidium. The data in this paper show that after 15 days of rubidium administration, there are no changes beyond the normal range in a variety of kidney function tests, including in four enzymes which are specific markers of tubule cell function. PMID- 3655003 TI - Alprazolam: effects on sleep and withdrawal phenomena. AB - Alprazolam was evaluated in chronic insomniacs in a 1-mg bedtime dose. The 16 night sleep laboratory protocol included four placebo-baseline nights followed by seven nights of drug administration and five placebo-withdrawal nights. On the first three drug nights (nights 5 to 7), the drug was highly effective in inducing and maintaining sleep with this short-term use. By the end of the one week of administration (nights 9 to 11), however, the drug had lost about 40% of its efficacy. During drug use, one subject reported some difficulty in controlling expression of inappropriate emotions when interacting with others, which suggested the presence of disinhibition. On the third night following drug termination, there was a significant increase in sleep difficulty above baseline levels (rebound insomnia). This worsening was of comparable magnitude to the peak improvement of sleep with drug administration. Thus, the clinical utility of alprazolam when administered to insomniac patients appears to be limited because of a relatively rapid development of tolerance and possible disinhibitory reactions during drug use and the occurrence of rebound insomnia following withdrawal. PMID- 3655004 TI - Pharmacokinetics of low-dose intravenous pethidine in patients with renal dysfunction. AB - The kinetics and elimination of pethidine (meperidine) after intravenous administration (150 micrograms/kg) to ten healthy volunteer subjects were compared with those obtained from 18 patients who suffered from varying degrees of renal dysfunction. In both groups of subjects, pethidine was eliminated triexponentially from plasma. However, plasma concentrations in the patients (who were subdivided into patients with severe dysfunction, moderate dysfunction, and mild dysfunction) were consistently higher. The mean +/- SEM elimination half life (t1/2) of pethidine was significantly longer in the three groups of renal patients: 7.9 +/- 1.1, 20.2 +/- 13.6, 16.6 +/- 5.4, and 14.3 +/- 3.1 hr, respectively, for healthy volunteers, patients with severe, moderate, and mild dysfunction; their mean +/- SEM creatinine clearances were 97.3 +/- 7.5, less than 9.5, 30.0 (3.7), and 63.3 +/- 8.5 mL/min respectively. The mean plasma clearance of the drug was higher in healthy subjects (342.7 +/- 62.5 mL/min) than various groups of renal patients (99.9 +/- 11.6, 120.9 +/- 45.8, and 123.8 +/- 34.1, respectively, for patients with severe, moderate, and mild dysfunction). Impairment of renal function also reduced total plasma protein binding: 58.2 +/- 5.0% in healthy subjects and 31.8 +/- 3.9%, 44.5 +/- 5.0%, and 42.5 +/- 5.6%, respectively, for the three renal patient groups. The percentage of pethidine recovered in the urine was significantly lower in the severe dysfunction group while norpethidine recovery was significantly lower in all three groups of renal patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655005 TI - Trends in drug development: the 1985-86 new drug approvals. AB - New drug approvals in 1985 and 1986 were analyzed to determine whether any new trends have emerged in the US drug development process. Fifty-three new drugs (including three biologic products) were approved during this period; 46 met the Center for the Study of Drug Development's definition of a new chemical entity (NCE). More than 70% of the 46 approvals were granted in the fourth quarter, 50% in December alone. Four were FDA classified as 1A (important therapeutic gain), 24 as 1B (modest gain), and 16 as 1C (little or no gain); two biologics were not classified. Nine drugs were given orphan status. For the 37 non-orphan drugs, the duration of the "development phase" (IND filing to NDA submission) was 5.6 years; the "review phase" (NDA submission to approval) was 2.6 years; and the "total time" (IND filing to NDA approval) was 8.2 years. Review phase for the four 1A drugs was 2.4 years; for the 24 1B drugs, 2.6 years; for the 16 1C drugs, 2.8 years; and for the nine orphan drugs, 2.7 years. Of the 46 drugs, 33 (71.7%) were available in foreign markets prior to US approval with a mean of 5.5 years of prior marketing. Although the total of 46 NCE approvals in 1985 and 1986 represents a two-year high, there has been a dramatic shift towards fourth quarter approvals. Lengths of the development and FDA review phases are in keeping with those values for previous years. PMID- 3655006 TI - Nighttime dosing of triazolam in patients with liver disease and normal subjects: kinetics and daytime effects. AB - This study was designed to determine whether the severity of liver dysfunction in cirrhosis affects the kinetics and next-day effects of triazolam after bedtime administration of a single oral dose. Eight patients with biopsy-proven cirrhosis and seven normal subjects matched for age, weight, and sex participated as paid volunteers. The first night was the control night, when no nighttime sedative was administered. The next day, psychomotor testing was performed at 8:30 AM, 2 PM, and 5 PM. Triazolam 0.25 mg was administered at 10:30 PM that evening. Psychomotor testing was repeated on the posttriazolam day in the same manner as on the control day. Blood samples were obtained from a venous catheter at 11 predetermined times in the 14 hours after triazolam administration. Memory testing was also performed. Apparent oral clearance of triazolam was directly related to albumin concentration and indocyanine-green elimination rate constant, and inversely related to partial thromboplastin time expressed as seconds over control. Clearance was 6.69 +/- 2.52 mL/min/kg in the normal subjects and 4.99 +/ 3.14 in the subjects with cirrhosis. There were no significant differences in Cmax between normal subjects (1.43 +/- 0.44 ng/mL) and subjects with cirrhosis (1.62 +/- 0.31 ng/mL) or in tmax (2.0 +/- 1.0 vs 2.5 +/- 1.9 hr) between normal and cirrhosis subjects, respectively. Posttriazolam, cirrhotic subjects took significantly longer to sort cards at 8:30 AM than on the control day. There was a significant correlation between extent of impairment on 8:30 AM card sorting by suit and AUC0-8 (r = 0.687; P = 0.0046).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655007 TI - Characterization of the dose-concentration-dependent hemodynamic effects of nifedipine in heart failure. AB - The hemodynamic effects of increasing oral doses of nifedipine (10 to 30 mg) were studied in 12 patients who had low output heart failure. With each set of hemodynamics, serum concentrations of nifedipine were measured to determine the concentration/response relationships. Eleven of twelve patients responded acutely to nifedipine, defined as a reduction in systemic vascular resistance (SVR), and an augmentation in cardiac index (CI) and stroke volume index (SVI). The differential dose effects (X +/- SD) for SVR and SVI for baseline (N = 11), 10 mg (N = 10), 20 mg (N = 3) and 30 mg (N = 4) were: 1913 +/- 486, 1102 +/- 221, 1128 +/- 166, 803 +/- 176 and 17.9 +/- 4.8, 23.8 +/- 4.5, 31 +/- 0.42, 33 +/- 3.5, respectively. All nifedipine doses reduced SVR and increased CI and SVI compared with baseline (P less than .001). The increase in CI and SVI was significantly correlated to the mg/kg dose of nifedipine (r = 0.79; P less than .001). Nifedipine administration resulted in no significant change in central venous pressure, pulmonary capillary wedge pressure, or pulmonary vascular resistance. No relationship could be demonstrated between serum concentrations of nifedipine and any hemodynamic effect. Conclusions drawn were: (1) the afterload reduction effects of nifedipine are acutely efficacious in a large portion of patients with heart failure and this activity supercedes the negative inotropic effects of the drug at doses between 10 and 30 mg; (2) the magnitude of the hemodynamic effects are dose dependent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655008 TI - Another look at the pentoxifylline efficacy data for intermittent claudication. AB - Porter et al have reported that pentoxifylline shows statistically significant superiority over placebo in a seven-center, double-blind, parallel group, randomized trial of outpatients with intermittent claudication secondary to chronic occlusive arterial disease. The objective of this report is convey results of the intention-to-treat population, paying careful attention to relevant methodologic issues relating to the analysis of clinical trials. At the same time, a new measure of clinical efficacy, minimum distance walked, is proposed. The rationale for this measure is discussed and results are compared with those for walking distances at each visit. The reanalysis of the Porter et al data by "intention to treat" and by use of the minimum-distance-walked measure confirms the published findings of efficacy of pentoxifylline for treatment of intermittent claudication. PMID- 3655009 TI - Bioavailability and disposition of metoclopramide after single- and multiple-dose administration in diabetic patients with gastroparesis. AB - The disposition of metoclopramide after acute and chronic administration was determined in four diabetic patients with gastroparesis who had a creatinine clearance of 70.8 +/- 10.7 mL/min (mean +/- SD). Single, 10-mg oral and intravenous doses were administered on days 1 and 2, respectively, followed by 10 mg orally every six hours for three weeks. A second, 10-mg intravenous bolus dose was administered on the last morning of chronic therapy. Metoclopramide concentrations were determined by high performance liquid chromatography. The elimination half-life, steady-state volume of distribution, and total body clearance after the initial intravenous dose were 3.9 +/- 1.2 hr, 2.7 +/- 0.3 L/kg, and 0.57 +/- 0.14 L/hr/kg, respectively. The initial bioavailability was 67.7 +/- 12.6%. After three weeks of chronic therapy, no significant differences in total body clearance (0.72 +/- 0.42 L/hr/kg) or bioavailability (77.5 +/- 16.8%) were observed. Thus the pharmacokinetics and bioavailability of metoclopramide were not altered during chronic therapy in these diabetic patients. PMID- 3655010 TI - Calcium channel blockade in experimental aminoglycoside nephrotoxicity. AB - Calcium channel blocker therapy has proved protective in certain models of ischemic-induced acute renal failure. This effect may be related to the prevention of calcium influx into injured cells or by the vasodilatory effects of verapamil that may result in an improvement in renal blood flow. In the current study, the effect of verapamil treatment on the development of renal insufficiency and renal tissue calcium accumulation following aminoglycoside administration was investigated. The degree of functional damage and cortical tissue calcium accumulation after six or nine days of gentamicin administration (120 mg/kg body weight/day) was not significantly different in rats whose drinking water contained verapamil (10 mg/100 cc) than corresponding values in control animals. The tissue calcium accumulation correlated with the degree of reduction of creatinine clearance and probably reflects the extent of lethal tubular cell injury. PMID- 3655011 TI - Sign iconicity: single-sign receptive vocabulary skills of nonsigning hearing preschoolers. AB - This study examined hearing preschoolers' ability to use iconic cues to comprehend signs. Twelve nonsigning 3-year-old hearing children served as subjects. Scores obtained from oral presentations of the Peabody Picture Vocabulary Test--Revised (PPVT-R) were compared with the scores obtained from the manual (signed) presentations of the PPVT-R. Results suggest that even in a limited choice context, the resemblance of signs to their referents does not enable hearing children to decipher the meaning of most of the presented signs. Discussion focuses on the relevance of these findings to the selection and use of adapted assessment instruments with young hearing-impaired children. PMID- 3655012 TI - Identification of dysarthria types based on perceptual analysis. AB - This study was conducted to investigate the degree of accuracy with which three groups of listeners could use perceptual analysis alone for identification of specific dysarthria types. The dysarthria types to be identified in this study were identical to those described by Darley, Aronson, and Brown (1969a): Flaccid, Spastic, Ataxic, Hypokinetic, Hyperkinetic Chorea, Hyperkinetic Dystonia, and Mixed. Each group demonstrated minimal success in the accurate identification of specific dysarthria types. Factors that possibly contributed to this poor success and potential implications are discussed. PMID- 3655013 TI - A comparison of stutterers and nonstutterers on masking level differences and synthetic sentence identification tasks. AB - Ten stutterers and ten nonstutterers, matched for sex, were tested for Masking Level Differences (MLDs) at 500 Hz, and were evaluated on the Synthetic Sentence Identification test with Ipsilateral Competing Message (SSI-ICM) under message-to competition ratios (MCRs) of 0, -10, and -20 dB. No significant differences on the SSI-ICM task were seen between groups, but the stutterers did produce significantly (p less than .01) poorer MLDs than the nonstutterers. This may be interpreted as support for Kent's (1983) hypothesis that stutterers may be poorer at temporal processing. In addition, the present results support the concept of a continuum of auditory processing ability, with normals and stutterers of different degrees of disfluency revealing decreasing performance measures. PMID- 3655014 TI - Relationships between oral sensory feedback skills and adaptation to delayed auditory feedback. AB - The relationship between adaptation to delayed auditory feedback (DAF) and oral sensory feedback as measured by tasks of oral form discrimination (OFD) was investigated. In addition, the interactions between OFD ability and attempts to heighten subjects' awareness of oral feedback while speaking under DAF conditions by giving instruction to subjects as well as the condition of instruction itself were studied with adaptation to DAF as the dependent variable. Analyses of the data indicated a relationship between OFD ability and adaptation to DAF and an interaction between OFD ability and instruction. The study's rationale and results are discussed within the context of servosystem theory. PMID- 3655015 TI - Partially hearing and hearing children's speaking, writing and comprehension of sentences. AB - Partially hearing, deaf, and hearing children's ability to say, write, and comprehend the same sentences, from the Sentence Comprehension Test (1979), were compared. It was hypothesized that writing sentences would be more difficult than saying the same sentences in all of the three groups. It was further hypothesized that the partially hearing would form an intermediate group between the hearing and deaf. The partially hearing made more errors in both the spoken and written conditions than the hearing who were 2 years younger. The number of phonetic and visual spelling errors made by the three groups were compared. PMID- 3655016 TI - The ability of normal and language-impaired children to produce grammatical corrections. AB - The ability of normal and language-impaired children to correct grammatical violations of word order was examined. Ten language-impaired and 10 linguistically normal subjects were sampled from the following age levels: 6, 7, 8, 9, and 10 years, resulting in a total of 100 subjects. Using a procedure designed to focus attention on language form, each of the children performed a task requiring the correction of 10 sentences containing word order errors. Normal 6-, 7-, and 8-year-olds performed significantly better than their language impaired age-matched peers. In addition, the performance of language-impaired 9-, and 10-year-olds was superior to that of the younger impaired groups. In the normal groups, the only age level differences were produced by the 6-year-olds, who performed significantly more poorly than two of the older (8- and 10-year old) groups. PMID- 3655017 TI - The effects of self-instruction training on a deaf child's semantic and pragmatic production. AB - Effects of self-instruction training on the communication skills of a profoundly hearing-impaired child were studied. Self-instruction training included modeling a series of problem-solving steps in order to direct communication production. Communication production was operationalized as signed semantic and pragmatic functions. A multiple baseline was used to assess treatment and generalization (treatment variations of person and setting) effects. There was evidence to suggest that self-instruction was immediately effective on pragmatic behaviors but such behaviors were reduced when another person administered treatment. In contrast, self-instruction training had a gradual influence on semantic behaviors and those effects were maintained when treatment included a different person and setting. Implications of the clinical study were discussed. PMID- 3655018 TI - Neuropeptide neuronal efferents from the bed nucleus of the stria terminalis and central amygdaloid nucleus to the dorsal vagal complex in the rat. AB - The lateral bed nucleus of the stria terminalis (BSTL) and central nucleus of the amygdala (Ce) are amygdaloid nuclei that have similar afferent and efferent connections within the brain. Previous studies have demonstrated that both regions send axonal projections to the dorsal vagal complex (dorsal motor nucleus and nucleus tractus solitarii). The present study used the combined retrograde fluorescence-immunofluorescence method to examine whether cells contributing to this pathway contained any of the following neuropeptides: corticotropin releasing factor, neurotensin, somatostatin, substance P, enkephalin, or galanin. The inputs to the dorsal vagal complex originated mainly from ventral BSTL and medial Ce, although a significant number of neurons within the dorsal BSTL and lateral Ce also contributed. Corticotropin-releasing factor, neurotensin, and somatostatin neurons mainly located within the dorsal BSTL and the lateral Ce contained retrograde tracer after injections into the vagal complex. Substance P neurons in the ventral BSTL and medial Ce provide a sparse input to the dorsal vagal complex. Enkephalin and galanin neurons within the BSTL and Ce did not appear to project to the dorsal vagal complex. Corticotropin-releasing factor and neurotensin neurons within the lateral hypothalamus also project to the dorsal vagal complex. Approximately 22% of the Ce and 15% of the BSTL retrogradely labeled neurons were peptide immunoreactive. Thus, it is concluded the Ce and BSTL are sources of a significant peptidergic pathway to the dorsal vagal complex. However, it is also apparent that the majority of putative transmitter types within the amygdaloid vagal projection still are unknown. The results suggest that the dorsal and ventral BSTL and the lateral and medial Ce, respectively, are homologous zones with regard to chemoarchitecture and connections. The data is discussed considering the possible function of peptides within descending amygdaloid pathways to the brainstem. PMID- 3655019 TI - Forms and spatial arrangement of neurons in the primary motor cortex of man. AB - The morphology and the spatial arrangement of neurons in the primary motor cortex (area 4) of the adult human brain have been investigated by the Golgi method. The human motor cortex displays a great variety of pyramidal and nonpyramidal cells, expressed as important differences in soma shape and size, and in the dimensions and the distribution of dendritic trees, which are described in detail. The neuronal composition of each layer and the white matter is analyzed. In sublayers III b and c, the somata and dendritic trees of pyramidal and nonpyramidal cells are grouped into columnar aggregations, 100-300 micron wide and separated by cell sparse spaces of 50-100 micron width. Within the aggregations, the apical dendrites of pyramidal cells form several bundles. The dendrites of most nonpyramidal cells do not surpass the columnar width. Sections in different planes reveal that the columnar aggregations observed in sections perpendicular to the long axis of the precentral gyrus are actually the cross-sectioned representatives of elongate strips running parallel to the long axis of the gyrus. The dendrites and somata of pyramidal cells in layers III and V show a preferential orientation in the same direction, parallel to the main axis of the gyrus. In layers II, IV, and V, aggregations like those in layer III are not recognizable; however, in layer V, loose assemblages of neurons of all sizes group around the giant Betz cells. Layer VI has a radial appearance due to the radii of myelinated fibers entering and leaving the white matter. The vertical, columnar organization of layer III and the asymmetry of somata and dendritic trees are not observed consistently throughout area 4, but are more pronounced at the boundary of the precentral gyrus and the central sulcus. PMID- 3655021 TI - Incidence of congenital melanocytic nevi in newborn babies in Denmark. AB - Three hundred fourteen unselected babies were examined within 96 hours of delivery. Three (1%) of the infants had clinically recognizable pigmented lesions. Two of the lesions (mean, 0.6%; range, 0.1%-2.3%; 95% confidence limits) proved histologically to be compound melanocytic nevi. The histology displayed almost identical patterns, with large nests of melanocytes at the dermoepidermal junction and only few nevus cells in the papillary dermis. A 0.6% incidence rate corresponds to 330 congenital melanocytic nevi in Denmark each year (range, 55 1265; 95% confidence limits). Because histology does not seem to be an accurate diagnostic tool to sort out the malignant potential of the small congenital melanocytic nevi, prospective studies are needed to characterize the premalignant melanocytic nevi, whether congenital or acquired. PMID- 3655020 TI - Treatment of resistant severe psoriasis with systemic cyclosporine. AB - Four patients with severe psoriasis have been treated with oral cyclosporine for 6 months. Two had generalized erythroderma and two had extensive plaque-type psoriasis; all had either become unresponsive to or were unable to use other accepted treatments. All four patients responded rapidly and were completely clear of psoriasis within 3 weeks of beginning therapy. Initial doses ranged from 7.5 to 8.5 mg/kg/day. Mild reversible nephrotoxicity occurred in the one patient whose cyclosporine trough level briefly exceeded 200 ng/ml. Cyclosporine may offer an alternative therapeutic modality in the management of erythrodermic or severe resistant plaque-type psoriasis. The effectiveness of cyclosporine in psoriasis underscores the putative role of cell-mediated immune factors in the pathogenesis of psoriasis. PMID- 3655022 TI - Atypical crusted scabies. AB - Five cases of an atypical form of crusted (or Norwegian) scabies are described. Three cases occurred in patients who suffered from a malignant tumor, and two additional cases occurred in mentally retarded and physically debilitated patients. These cases should draw attention to the possibility of a scabietic infestation whenever a widespread, scaly, itchy dermatosis develops in a debilitated immunosuppressed patient. PMID- 3655023 TI - Use of cyclophosphamide in azathioprine failures in pemphigus. AB - Four patients with pemphigus vulgaris are presented in which diagnosis was confirmed histologically and immunopathologically. Although these patients responded to high-dose prednisone therapy during the initial stages of acute disease, the addition of azathioprine failed to allow lower steroid doses and did not result in prolonged, complete remission. Indeed, the disease was exacerbated during azathioprine therapy, and significant side effects from prolonged high dose steroid therapy were observed. Both clinical and serologic remission resulted from the addition of cyclophosphamide and dapsone to prednisone therapy. Thus, when azathioprine fails to produce remission or a steroid-sparing effect, cyclophosphamide may be an effective alternative. During a prolonged follow-up period, no recurrences of pemphigus have been observed, and no significant side effects of cyclophosphamide (Cytoxan) have been encountered. The addition of dapsone produced enhanced anti-inflammatory effects without increasing the existing or potential side effects of steroid therapy. Dapsone was easily withdrawn at the onset of remission. Thus the anti-inflammatory effect of dapsone may prove valuable in patients for whom steroids are contraindicated, who develop significant side effects during long-term steroid therapy, or for whom increases of dose threaten to enhance the possibility of catastrophic side effects. PMID- 3655024 TI - Generalized eruptive histiocytoma in children. AB - Generalized eruptive histiocytoma is a papular, non-X, nonlipidic, self-healing histiocytosis affecting mainly adults. This article describes the clinical, histologic, ultrastructural, and immunologic findings in four children, aged 10 months to 4 years, who were suffering from this disease. Generalized eruptive histiocytoma of children differs from generalized eruptive histiocytoma of adults only in that the lesions are not symmetrically distributed, they do not affect the mucous membranes, and they may become xanthomatous. PMID- 3655026 TI - Bloom's syndrome. AB - Bloom's syndrome is a rare autosomal recessive disorder that characteristically shows a telangiectatic, sun-sensitive facial rash in conjunction with stunted growth. These patients are prone to respiratory and gastrointestinal infections along with immunologic abnormalities. Chromosomal aberrations include an elevated frequency of sister chromatid exchange in cultured lymphocytes, a phenomenon pathognomonic for this disorder. These patients exhibit a great tendency for neoplasia, particularly acute leukemia and lymphoma. Three cases are reported, including a follow-up of a patient diagnosed 16 years ago. PMID- 3655025 TI - Number of melanocytic nevi as a major risk factor for malignant melanoma. AB - A study of 121 melanoma patients and 139 control subjects from the University of California, San Francisco clinics was conducted among whites to examine the relationship between number of melanocytic nevi and cutaneous melanoma. Nevi that measured 2 mm or more in diameter were counted over the body by a dermatologist and a dermatology fellow. The average number of nondysplastic melanocytic nevi that were 2 mm or greater in diameter was 97 for melanoma patients and 36 for control subjects (p less than 0.001). Relative risks were 1.6 (p = 0.43) for 11 to 25 nevi, 4.4 (p = 0.01) for 26 to 50 nevi, 5.4 (p = 0.008) for 51 to 100 nevi, and 9.8 (p = 0.001) for more than 100 nondysplastic melanocytic nevi. Relative risks were 3.8 (p = 0.001) for 1 to 5 dysplastic nevi and 6.3 (p = 0.003) for 6 or more of these lesions. Report of blistering sunburns or of a previous skin cancer and having red or blond hair at the age of 20 were also independently associated with an increased risk of cutaneous melanoma. If confirmed in larger studies, the results presented on number of nevi and melanoma risk suggest a readily identifiable melanoma-prone group that could be followed to detect early malignant melanoma. PMID- 3655027 TI - Desmoplastic trichoepithelioma and intradermal nevus: a combined malformation. AB - We studied 13 desmoplastic trichoepitheliomas associated with intradermal nevi. Ten intradermal nevi were found among 76 new cases of desmoplastic trichoepithelioma (13%); three additional examples of the combined malformation were seen in consultation. Clinically, desmoplastic trichoepithelioma associated with an intradermal nevus was typically a small, firm or hard, sometimes annular, nodule on the face, particularly the cheek, of a relatively young woman. Microscopically, the combined malformation contained narrow strands of basaloid cells and keratinous cysts in a desmoplastic stroma, intimately mixed with intradermal nests of nevocytes. Melanocytic nevi have been associated with epidermal hyperplasia resembling seborrheic keratoses, follicular cysts, trichostasis spinulosa, syringomas, basal cell carcinomas, and hair follicle formation on the soles. The frequency of the occurrence of intradermal nevus with desmoplastic trichoepithelioma and the close anatomic association of the two elements may indicate that this combined malformation is another example of epithelial induction by melanocytic nevi. PMID- 3655028 TI - Fibrofolliculoma: solitary and multiple types. AB - Multiple skin tumors generally show autosomal dominant inheritance and are sometimes associated with other cutaneous and internal lesions. Solitary growths are typically nonhereditary and unassociated with other abnormalities. We found only two previous reports of solitary fibrofolliculoma and only one of multiple fibrofolliculomas without associated lesions; a few publications describe multiple fibrofolliculomas in patients with perifollicular fibromas, trichodiscomas, acrochordons, and connective tissue nevus. We studied five new cases of solitary nonhereditary fibrofolliculomas and one of multiple familial fibrofolliculomas without associated lesions. Clinically, fibrofolliculomas were typically small growths with a central dilated follicle containing horny material. Histologically, there was characteristically a hyperplastic follicular infundibulum with a central keratinous plug, and anastomosing strands of basaloid cells branching into an angiofibromatous stroma. Fibrofolliculoma is thus another skin tumor in which patients with multiple growths showing autosomal dominant inheritance sometimes have associated abnormalities, while solitary lesions with identical clinical and microscopic features are relatively trivial and nonhereditary. PMID- 3655029 TI - Etretinate and paternity. PMID- 3655030 TI - Subungual basal cell carcinoma versus acral lentiginous melanoma. PMID- 3655031 TI - Giant clear cell acanthoma. PMID- 3655032 TI - Pemphigus vulgaris probably induced by penicillin. PMID- 3655033 TI - Deaths associated with topical minoxidil therapy. PMID- 3655034 TI - Acrokeratosis paraneoplastica (Basex) in a patient with bronchial carcinoid tumor. PMID- 3655035 TI - Striae and persistent tinea corporis related to prolonged use of betamethasone dipropionate 0.05% cream/clotrimazole 1% cream (Lotrisone cream) PMID- 3655036 TI - Molluscum contagiosum among cross-country runners. PMID- 3655037 TI - Management of cutaneous atrophy after corticosteroid injection. PMID- 3655038 TI - In vivo validation of MR velocity imaging. AB - Calculations of left ventricular stroke volume obtained by summing the areas of multiple contiguous transverse magnetic resonance (MR) slices in systole and diastole using a spin echo sequence have been compared in 10 healthy volunteers with the stroke output derived from velocity maps in the ascending aorta using a field even-echo rephasing sequence. The results gave a correlation coefficient of 0.97 (p less than 0.001) and a standard error of estimate of 3.2 ml. Velocity maps have also been obtained in the pulmonary artery, the descending aorta, and the superior vena cava. The accuracy of this technique and the theoretical limitations of MR measurements have implications for the earlier detection of atheroma in the coronary and other arteries. PMID- 3655039 TI - Computed tomography of bowel infarction. AB - Bowel infarction is a potentially lethal disorder that is notoriously difficult to diagnose clinically and radiographically. Computed tomography is often used in the early radiographic evaluation of patients with severe abdominal pain of unknown etiology. This study defines the CT findings in patients with bowel infarction. The findings in 22 patients with mesenteric infarction were reviewed. Seven were due to mesenteric arterial occlusion, six due to mesenteric venous occlusion, and nine were nonocclusive. The CT abnormalities were diffuse or focal bowel wall thickening (19 patients), bowel dilatation without mural thickening (three patients), intramural low attenuation zones of edema (eight patients), intramural gas (11 patients), mesenteric gas (five patients), portal or mesenteric venous gas (one patient), mesenteric vascular occlusion (eight patients), and peritoneal gas or fluid (12 patients). The diagnosis of bowel infarction must be considered when performing CT in patients with abdominal pain of unknown etiology. PMID- 3655041 TI - Femoral neck torsion angle measurement by computed tomography. AB - To establish the accuracy and reproducibility of measuring femoral neck torsion angles (FNTA) on CT images, this angle was measured on 12 dry femora directly on the gross specimens, on plain radiographs, and on CT images. The selection of the CT level, both at the femoral neck and the condyles, that may affect the measurement of FNTA was analyzed. The CT measurements of FNTA were found to have a reproducibility of 2.5 and 0 degrees mean offset error when compared with readings on plain radiographs. A new CT method was developed to measure this angle particularly in patients with coxa valga in whom this measurement is difficult if not impossible to accomplish by current methods. For this purpose composite CT images were made of the femoral head and the femoral shaft, immediately below the lesser trochanter. On these images the line connecting the centers of the femoral head and shaft were inferred to represent the cervical plane. In comparison with the standard CT method, this new method had the same reproducibility, although it slightly overestimated this angle by 2 degrees. This degree of error is negligible when compared with the normal variations of this angle, which ranges from -20 to +38 degrees. Furthermore, it compares favorably with the limited accuracy of derotational osteotomy surgery. PMID- 3655040 TI - Renal xanthogranulomatosis: radiological, clinical, and pathological features in two cases. AB - Xanthogranulomatosis is a multicentric or systemic proliferative disorder of histiocytes. Two cases of xanthogranulomas are reported, each involving the kidneys. One patient also had concomitant orbital and CNS involvement. Primary renal involvement without associated retroperitoneal masses is an uncommon manifestation of this disorder. The CT appearance of renal involvement in both patients was distinctive and remarkably similar. Both patients had bilaterally enlarged kidneys in which the renal sinus fat was replaced by a fibrotic process that caused mild calicectasis. The clinical and roentgenographic features of xanthogranulomatosis bear a close resemblance to those seen in two fibrosclerosing syndromes: sinus histiocytosis with massive lymphadenopathy and retroperitoneal fibrosis. PMID- 3655042 TI - Design of custom hip stem prostheses using three-dimensional CT modeling. AB - Long life expectancy, demand for high activity levels, and bone loss at the time of revision motivate the search for reliable and successful noncemented hip stem designs. It is hypothesized that improved implant fit may increase the longevity of noncemented total joints. Quantitative X-ray CT has enabled the use of a computerized stem design program, which designs an optimal-fit hip stem for individual femurs. Computed tomography and interactive image processing methods are used to generate the individual three-dimensional femoral models, which are used by the stem design program. Optimal-fit design provides maximum stem-bone contact while satisfying the requirement of being surgically insertable. Previous methods of custom implant design, including those that use three-dimensional CT modeling, have not provided optimal stem-bone fit. Quantitative results of this new process are presented. PMID- 3655043 TI - Craniopharyngioma: CT and MR imaging in nine cases. AB - Magnetic resonance (MR) imaging and CT examinations were performed in nine patients with surgically proven craniopharyngioma. Computed tomography was found to be superior to MR in detection of calcification and cyst formation. Extent of involvement of adjacent structures (e.g., optic chiasm, third ventricle, and intracavernous carotid artery) was more clearly delineated by MR. Craniopharyngioma fluid collections were found to be uniformly bright on T2 weighted sequences. However, on T1-weighted sequences, the signal intensity of the fluid ranged from hypointense to hyperintense, reflecting the heterogeneous contents of cysts in these tumors. Since calcification and cyst formation are hallmarks of craniopharyngiomas, we believe that CT is more specific than MR in diagnosis of craniopharyngiomas. Magnetic resonance, however, offers a more accurate assessment of the tumor extent. PMID- 3655044 TI - Computed tomography of intracranial chondroma with emphasis on delayed contrast enhancement. AB - Intracranial chondroma is an unusual cartilaginous tumor originating from the base of the skull. We report on two cases of intracranial chondroma that showed delayed contrast enhancement on CT after high-dose administration of contrast medium. This CT feature may be useful to differentiate chondromas from other tumors of the skull base such as meningiomas and neurinomas. PMID- 3655045 TI - Tumor invasion of the anterior skull base: a comparison of MR and CT studies. AB - Seven patients who had tumors arising in the anterior face or paranasal sinuses and invasion of the anterior skull base were evaluated with magnetic resonance (MR) and high resolution CT. Magnetic resonance was superior in evaluating tumor encasement of the carotid artery and invasion of the cavernous sinus; for assessing the relationship of the tumor to the anterior brain, optic nerves, and optic chiasm; in providing coronal images free from dental artifact; and in determining tumor extent within the infratemporal fossa. Bone destruction was more easily observed on CT than MR. PMID- 3655046 TI - MR imaging of transverse/sigmoid dural sinus and jugular vein thrombosis. AB - Magnetic resonance (MR) imaging was performed on six patients with thrombosis involving the transverse/sigmoid sinus and jugular bulb/vein. Venographic confirmation was obtained in five cases. Thrombi were characterized by increased intraluminal signal on all planes of section and pulse sequences. The change in signal intensity from first to second echo for thrombi was qualitatively less than that found with slow flow. Partial thrombosis in one case was seen as a ring pattern of central intermediate intensity corresponding to the thrombus, surrounded by a peripheral ring of signal void related to flowing blood. The MR findings closely correlated with venography in predicting thrombosis. Evidence of thrombi was not available from CT. Magnetic resonance is well suited for the diagnosis of occlusive disease of the dural venous sinus and jugular bulb. PMID- 3655047 TI - MR imaging with gadolinium-DTPA in the differentiation of tumor, syrinx, and cyst of the spinal cord. AB - Intravenous Gd-diethylenetriamine pentaacetic acid was used in 16 patients to differentiate between syringomyelia, syringomyelia in association with tumor, and cystic tumor in the spinal cord. Contrast enhancement occurred in all 12 histologically proven cases of tumor and enabled clear demarcation of neoplastic tissue from syrinx or cyst. Eleven of the twelve tumors seen in association with spinal cord cavitation were malignant; all tumors apart from one (a schwannoma) were intramedullary in location. Enhanced scans were more helpful than unenhanced scans in diagnosing and defining the extent of tumors associated with a syrinx or cyst. PMID- 3655049 TI - Spinal MR imaging: multiplanar representation from a single high resolution 3D acquisition. AB - Evaluation of spinal disorders by magnetic resonance (MR) imaging is facilitated by the availability of images in multiple angles and views. Imaging in multiple angles is practically limited, however, by clinically prohibitive scan times, if separate acquisitions are necessary for each angle. Thin slices (0.8 mm) without interslice gaps are acquired with a three-dimensional (3D) acquisition. Images with high anatomical detail are rapidly derived from the single 3D data set in any desired plane without repeating the scan. High quality MR images in multiple planes improve the diagnostic capability of MR for many spinal abnormalities. This technique is demonstrated in a series of 11 subjects. PMID- 3655048 TI - MR imaging in the diagnosis of spontaneous spinal epidural hematomas. AB - Three patients with spontaneous (idiopathic) spinal epidural hematomas were diagnosed with magnetic resonance (MR) imaging. Magnetic resonance is an accurate, rapid method of localizing and characterizing the hematomas. We believe that MR (where available) should be the primary method of diagnosis in cases in which spinal epidural hematoma is suspected. PMID- 3655050 TI - MR imaging with surface coils in primary hyperparathyroidism. AB - The use of magnetic resonance (MR) to preoperatively evaluate patients with primary hyperparathyroidism was assessed using a 1.5 T system and surface coil reception. Twenty-five patients with primary hyperparathyroidism were studied before surgical exploration. Axial images, 5 mm thick, were obtained from the thyroid cartilage to the sternal notch. Both T1-weighted [short repetition time (TR), short echo time (TE)] and T2-weighted (long TR, long TE) spin echo sequences were performed in most cases. Parathyroid adenomas typically demonstrated greater signal than surrounding tissues on T2-weighted sequences, yet demonstrated signal intensity that was less than or equal to normal thyroid tissue on T1-weighted sequences. Using these criteria, MR correctly identified 17 of 20 surgically proven parathyroid adenomas in the neck. Magnetic resonance appeared less sensitive in two patients with parathyroid hyperplasia, identifying only one of six hyperplastic glands. We conclude that MR with surface coils provides high contrast, anatomic delineation of the neck and is useful for preoperative localization of parathyroid tumors. PMID- 3655051 TI - MR demonstration of the nasal cycle in the beagle dog. AB - Magnetic resonance (MR) imaging of periodic engorgement of the erectile tissue surrounding the turbinates in the beagle dog yields remarkably quiet data that are well fitted by a single sinusoidal wave form. This observation holds in spite of right-left asymmetries in the distribution of the MR signal. The nasal cycle also occurs normally in humans. Judging from the clarity of its MR representation in the dog, it is possible that this phenomenon could be confused in human MR with upper respiratory congestion associated with pathological processes. PMID- 3655052 TI - MR imaging of flow using the steady state selective saturation method. AB - The steady state selective saturation method is a fast and efficient technique to study flow with magnetic resonance imaging. The pulse sequence used generates no signal from stationary matter and simultaneously optimizes signal flowing into a predetermined volume. The method can be used to generate three-dimensional angiography in less than 5 min. Other modifications allow the quantitative measurement of flow velocities and distinction of veins and arteries according to the direction of flow. PMID- 3655053 TI - MR imaging of heterotopic gray matter. AB - Magnetic resonance imaging is the current method of choice to diagnose heterotopic gray matter and associated cerebral malformations. We report a case of an epileptic child in whom heterotopic gray matter is present without any associated ventricular distortion. PMID- 3655054 TI - Occipital aneurysmal bone cyst: CT features. AB - A case of aneurysmal bone cyst arising from the lower occipital squama with intracranial extension is presented. The case is unique in that the cyst showed fluid levels on CT. Another peculiarity of this case was postoperative recurrence. PMID- 3655055 TI - Computed tomography of calvarial and petrous bone sarcoidosis. AB - This report describes the radiographic features in a case of sarcoidosis involving both the frontal calvaria and the petrous bone. The plain radiographic and nuclear medicine findings were consistent with previous descriptions. High resolution CT demonstrated concentric growth with a lucent advancing margin, ghost-like remnant of partially replaced bone, crossing of suture lines, invasion of contiguous bones, and lack of associated soft tissue mass. PMID- 3655056 TI - MR imaging of a carcinoid tumor metastatic to the orbit. AB - This is a report of the magnetic resonance study in a case of orbital metastasis from a carcinoid tumor. A rather unusual feature of this lesion was its relatively short T2 as compared with other metastatic orbital lesions. PMID- 3655057 TI - The missing rectus: a CT observation from blow-out fracture of the orbital floor. AB - A patient with a blow-out fracture of the right orbital floor presented with impediment of the inferior rectus muscle. Coronal CT disclosed a lateral hinged fragment from the orbital floor and herniation of intrabulbar content into the maxillary sinus. The inferior rectus muscle could not be identified intraorbitally in three sequential 3 mm coronal sections and it was concluded that the muscle was incarcerated, a presumption that was verified at surgery. PMID- 3655058 TI - CT findings in synovial chondromatosis of the temporomandibular joint. AB - The purpose of this report is to document an additional case of synovial chondromatosis of the temporomandibular joint and to present its radiological features with emphasis on the CT findings. It should be stressed that the value of the radiologic examination primarily depends on the extent of calcification of the loose, intraarticular particles. PMID- 3655059 TI - Ameloblastoma associated with basal cell nevus (Gorlin) syndrome: CT findings. AB - Multiple jaw cysts are a characteristic manifestation of basal cell nevus (Gorlin) syndrome. In contrast to the frequent odontogenic keratocysts, ameloblastoma only rarely occurs in the jaw. Computed tomography is essential to delineate the extent of these radioresistant lesions, which must undergo marginal resection. We present such a case, not only to stress the importance of CT evaluation but also to briefly review the unusual association of ameloblastoma with Gorlin syndrome. PMID- 3655060 TI - CT findings in complications of acquired renal cystic disease. AB - A 42-year-old man with end-stage renal disease developed acquired renal cystic disease. The left kidney underwent tumorous degeneration necessitating nephrectomy. Eight months later acute hemorrhagic renal cyst rupture culminated in right nephrectomy. PMID- 3655061 TI - Computed tomography of bladder malakoplakia. AB - The CT findings in a case of malakoplakia involving the bladder and retroperitoneum are described. PMID- 3655062 TI - "Upside-down" contrast-urine level in glycosuria: CT features. AB - Contrast-urine levels are often encountered in CT of the urinary bladder. Opacified urine occupies the dependent portion of the bladder, while unopacified urine layers above it. We report a case in which this relationship was reversed. An explanation of this phenomenon is proposed. PMID- 3655063 TI - Gas in the psoas muscle secondary to an intravertebral vacuum cleft: CT characteristics. AB - Gas within the psoas muscle is usually due to primary or secondary infection necessitating aggressive therapy. We report a case of gas within the psoas muscle due to an intravertebral vacuum cleft, a benign manifestation of vertebral body necrosis. Identification of such a cleft in the proper clinical setting makes invasive evaluation unnecessary. PMID- 3655064 TI - MR imaging of osteoid osteoma of the talus. AB - Magnetic resonance (MR) imaging of the painful ankle of a 15-year-old boy revealed the nidus of a subarticular osteoid osteoma of the talus along with markedly abnormal signal intensity in the neighboring bone marrow. This MR appearance correlated with alterations in the neighboring bone marrow documented by histopathologic examination. PMID- 3655065 TI - Orbital roof blow-in fractures: CT demonstration. PMID- 3655066 TI - Cranial computed tomography in the morbidly obese patient. AB - A method for positioning the obese patient for cranial CT without using the CT cradle is described. This method allows diagnostic images to be obtained in patients who exceed the table weight limit. PMID- 3655067 TI - Closing forces of the bovine teat canal. AB - The magnitude of the forces causing closure of the bovine teat canal was estimated by measuring the pressure required to cause retrograde flow of milk into the canal from a manometer attached to the external teat orifice. Before milking, the hydrostatic pressure required to cause retrograde flow was 12 kPa or greater. Retrograde flow occurred at a pressure of 4-6 kPa once the teat canal surface had been wetted. This 2- or 3-fold fall in the closing forces presumably resulted from the combined effects of fracturing the teat canal epithelium and loss of initial resting tension in the smooth muscle fibres surrounding the teat canal. After milking, retrograde flow into any teat canal occurred at a pressure approximately 1 kPa lower than the wetted, pre-milking value. This small drop, and subsequent recovery approximately 30 min after milking, reflects the change in tonicity of the smooth muscle fibres which are stretched during milking. At hydrostatic pressures below 7-9 kPa, retrograde flow could be arrested momentarily by the occurrence of a teat contraction. At 4-7 kPa, the wave of contraction was also capable of expelling 4-14 microliters milk from the teat canal indicating the outwardly directed, peristaltic nature of the phasic muscular activity. PMID- 3655068 TI - Compressive load applied by the teatcup liner to the bovine teat. AB - The magnitude of the cyclic load applied to the teat apex by the collapsed liner during milking was estimated by measuring the pressure required to cause retrograde flow of milk into the teat canal from a manometer attached to the external teat orifice. The study was extended by observation of the milk flow cycle within a transparent teatcup assembly and by pressure recordings within the teat canal using a catheter-tip transducer. The source of the force compressing the teat is the small airspace, within the collapsed liner, directly below the teat apex. The total force generated is determined mainly by the size of this airspace and the pressure difference (PD) acting across the opposing liner walls. When the PD reached 80-90% of the liner vacuum, the load was just sufficient to occlude the teat canal. Further increase in PD provided the compressive load capable of offsetting vascular congestion of the teat apex. Increasing liner tension increased the load applied. The narrow range of compressive loads applied by conventional liners (5-12 kPa above atmospheric pressure) may be sufficient to offset congestion and oedema in the teat. Loads greater than the mean arterial pressure within the teat apex might serve only to expose the tissues to non productive compression. PMID- 3655069 TI - Dissemination of staphylococci in mice with experimental mastitis. AB - During the course of an acute, fatal mastitis in mice caused by intra-mammary injection of approximately 10(5) cfu of Staphylococcus aureus, small numbers of staphylococci were detected in liver, spleen, kidney and heart. Transport from the mammary gland was by the venous blood system with no evidence of lymph node involvement. Intravenous injection of 100 times more staphylococci (approximately 10(7) cfu) than were fatal by the intramammary route failed to kill the mice and small numbers of staphylococci were found in the visceral organs. However, intravenous injection of approximately 10(8) cfu of Staph. aureus was fatal and large numbers of staphylococci were found in the visceral organs. Treatment with cloxacillin (500 micrograms) by the intramammary or subcutaneous routes, or equally divided between these two routes, cleared the visceral organs of staphylococci; subcutaneous therapy had a limited and variable effect on numbers of staphylococci in the mammary gland while intramammary and divided treatments significantly reduced the numbers of staphylococci. Thus, staphylococci are disseminated to visceral organs during acute staphylococcal mastitis, but this makes a negligible contribution to the clinical disease. PMID- 3655070 TI - Evidence for temperate bacteriophages in two strains of Lactobacillus bulgaricus. AB - Lactobacillus bulgaricus strains LT1 and LT4 previously isolated from a yogurt factory were shown to be lysogenic and inducible by mitomycin C or u.v. irradiation, induction being optimal at the beginning of exponential growth. Five indicator strains (four of L. lactis, one of L. bulgaricus) were found in which the two phage lysates propagated well in a liquid medium, but formed plaques on bacterial lawns less readily. Ca2+ was required for the phage infection of the indicator strains to reach termination. Phage particles from each strain exhibited a comparable ultrastructural morphology under the electron microscope, having an isometric head, a triple collar and a noncontractile fibre-containing tail. PMID- 3655071 TI - Comparison of a simple butterfat agar medium with other media used for isolation and enumeration of lipolytic bacteria from dairy products. AB - A nutrient agar medium containing 0.1% of a low melting point fraction of butterfat was shown to be suitable for detection, enumeration and isolation of lipolytic bacteria from milk. Bacterial growth was not inhibited by the butterfat and lipolytic reactions were clearly visible and easily interpreted. Lipolytic counts on the butterfat agar compared favourably with lipolytic counts obtained with other commonly used media. PMID- 3655072 TI - Being certain the cancer is out. PMID- 3655073 TI - Cooperative frozen section surgery in perspective. PMID- 3655074 TI - International dermatosurgery: glabellar flap with geometric measurements- similarity to the Limberg and Dufourmentel flaps. PMID- 3655075 TI - Hair transplantation: using a power punch in the recipient area. AB - A useful technique for using a motorized punch for cutting recipient holes is presented. This technique minimizes the possibility of entangling surrounding hairs. It is easy to perform and requires no special instruments. PMID- 3655076 TI - Stump the experts. PMID- 3655077 TI - Electrosurgery using insulated needles: basic studies. AB - We conducted basic studies to evaluate the effectiveness of our insulated needles using raw egg white and fish meat as test material. The basic studies we carried out confirmed that the needles' insulation would withstand the high frequency electric current passed through them. This research served as the foundation for our clinical applications. PMID- 3655078 TI - Cooperative frozen section surgery. AB - Utilization of the office setting for frozen section evaluation of tumor removal in the treatment of skin cancer is of considerable value. The impact of such surgery includes (1) enhanced quality of surgery by reducing the possibility of incomplete removal of tumor, (2) decreased financial cost to the patient when compared to hospital treatment, (3) better utilization of the doctor's time and facilities, (4) decreased disruption in the life of the patient and his family in terms of time off from work, surgery schedule flexibility, and a decrease in patient anxiety. PMID- 3655079 TI - Verrucous hemangioma. AB - Verrucous hemangioma is an infrequent variety of deep-seated capillary or cavernous hemangioma with reactive epidermal hyperplasia and a superficial component indistinguishable from those of angiokeratoma. Four cases of verrucous hemangioma are reported herein. Verrucous hemangiomas are usually congenital lesions which do not resolve spontaneously and have a tendency to recur after excision if margins are inadequate. Careful histopathologic and clinical evaluation are required for an optimal therapeutic approach. PMID- 3655080 TI - An interdisciplinary approach to the management of basal cell carcinoma of the head and neck. AB - At the University of Michigan the dermatologic surgeon works closely with the head and neck surgeon in resecting extensive cutaneous malignancies that could benefit from the combined skills of both surgical specialists. Mohs surgery offers complete microscopic controlled resection of the cutaneous portion of skin cancers. Tumors extending deeply from the skin into underlying bone and soft tissue are resected with the assistance of the head and neck surgeon familiar with the anatomy and trained in the protection of the vital structures of the head and neck. It is evident that patients with large or aggressive basal cell carcinomas will best be served when this interdisciplinary approach has become commonplace. PMID- 3655081 TI - "Clear cell" atypical fibroxanthoma. AB - An 87-year-old man with extensive solar damage presented with a 2-month history of a dome-shaped, crusted lesion on the dorsum of the left hand. Microscopically, the tumor consisted of fascicles of spindle cells with bizarre nuclei and clear, vacuolated cytoplasm. Histochemical, immunohistochemical, and ultrastructural features supported the diagnosis of atypical fibroxanthoma. There was no evidence of metastatic disease. The lesion was completely excised, and there has been no recurrence in 3 months of observation. This unusual "clear cell" variant of atypical fibroxanthoma must be distinguished from other clear cell tumors, such as metastatic renal cell carcinoma, clear cell eccrine carcinoma, and clear cell sarcoma (malignant melanoma) of soft parts. Although atypical fibroxanthoma is usually cured by complete surgical excision, metastases have been reported. PMID- 3655082 TI - Stenosis of the external ear canal: prevention using hydroxylated polyvinyl acetal wicks. AB - Hydroxylated polyvinyl acetal wicks may be very helpful in preventing postsurgical stenosis of the external ear canal. The wick is inserted into the canal, wetted with Polysporin Otic, and changed periodically until scar tissue becomes stabilized. This method is simple, quick, and well tolerated by the patient. Polyvinyl wicks provide a useful adjunct in preventing stenosis of the external ear canal. PMID- 3655083 TI - Sclerosing epithelial hamartoma associated with a melanocytic compound nevus. AB - A case of sclerosing epithelial hamartoma in a 19-year-old female is reported. The lesion, presenting the distinctive clinical and histologic features, was associated with a melanocytic compound nevus. The unusual and interesting event is discussed. PMID- 3655084 TI - Safety of the entomopathogen Bacillus thuringiensis var. israelensis for mammals. PMID- 3655085 TI - Effects of synergists on bendiocarb and pyrethrins resistance in the German cockroach (Dictyoptera: Blattellidae). PMID- 3655086 TI - Wide-area treatment of cattle for horn flies and face flies (Diptera: Muscidae) in south-central Nebraska. PMID- 3655087 TI - Factors affecting control of Fannia spp. (Diptera: Muscidae) with cyromazine feed through on caged-layer facilities in southern California. PMID- 3655089 TI - Operational testing of electrocutor traps for fly control in dining facilities. PMID- 3655088 TI - Use of acaricide-impregnated ear tags for controlling the brown ear tick (Acari: Ixodidae) in South Africa. PMID- 3655090 TI - Reducing hospital costs through consignment. PMID- 3655092 TI - Skin care for patients receiving radiation therapy for rectal cancer. PMID- 3655091 TI - Perioperative management of the continent right colon urinary pouch: an experience with five cases. PMID- 3655093 TI - Principles of drug therapy. PMID- 3655094 TI - Pyoderma gangrenosum: an innovative wound care protocol. PMID- 3655095 TI - Decreasing percutaneous drainage problems. PMID- 3655096 TI - To glove--or not to glove. PMID- 3655097 TI - Experiences with Guillain-Barre syndrome in a pediatric intensive care unit. AB - During a 10-year period 16 children with acute Guillain-Barre syndrome were seen. Eleven were admitted to the Pediatric Intensive Care Unit, either because of difficulty of breathing and swallowing or because of symptoms of autonomic disturbance. Six patients were mechanically ventilated for a mean period of 17 days. Symptoms of autonomic disturbance were frequently seen especially in the mechanically ventilated patients. Two patients died because of cardiac arrhythmia. Methods of detecting patients at risk for cardiac dysrhythmia are suggested. PMID- 3655098 TI - Significance of the changes in plasma amino-acid levels in meningococcal infection. AB - A series of patients with meningococcal infections have been studied and divided in two groups: Group I patients with meningococcal sepsis and group II, those with meningococcal meningitis. Patients in group I presented with more severe encephalopathy, shock, DIC and acute systemic complications. Both groups showed a marked hypoaminoacidemia compared with normal controls (other than for the sulfur containing amino acids and phenylalanine). The concentration of aromatic and basic amino acids, the phenylalanine/tyrosine ratio, the transaminase levels and the negative nitrogen balance were higher in group I patients. The ratio of branched chain to aromatic amino acids was lower in group I. All these differences were statistically significant. The close association between the metabolic derangements and clinical manifestations may help in the understanding of several physiopathological aspects of meningococcal infections. PMID- 3655099 TI - Early onset pneumonia: a multicenter study in intensive care units. AB - A prospective multicenter study concerning the incidence, onset time, risk factors and mortality of pneumonia was carried out by the Intensive Care Units Collaborative Group for Infection Control in Lombardy, Northern Italy. Out of 1304 patients admitted over 3 months in 16 intensive care units (ICUs), 441 met the criteria for the protocol (no previous pulmonary infection or irreversible terminal illness, ICU stay greater than 48 h). The incidence of acquired pneumonia was 21.3% (94/441), with 54.2% of cases diagnosed within 4 days of admission (early onset pneumonia). Impairment of airway reflexes on admission and more than 24 h respiratory assistance were shown as significant risk factors (RR) for early onset pneumonia (respectively RR = 12.4, with 95% confidence interval (CI) = 5.3-28.9 and RR = 3.3, with 95% CI = 1.8-5.9). A suggested pathogenetic mechanism is aspiration of oropharyngeal contents at the onset of acute illness, due to depression of protective reflexes with delayed clearance of bacterial contamination. No protection was offered by routinely applied prophylactic antibiotic therapy. PMID- 3655100 TI - Colonization and infection in surgical intensive care patients--a prospective study. AB - Nosocomial infections are a major problem in intensive care patients. Thirty-nine patients, requiring intensive care for 5 days or more (mean 15.8 days) were prospectively investigated, to determine the relation between colonisation and nosocomial infection. Thrice weekly, cultures from the oropharynx, respiratory and digestive tract were obtained. Colonization with aerobic gram-negative microorganisms of the oropharynx, respiratory and digestive tract significantly increased during the stay in the Intensive Care Unit. In 29 patients (74%) 78 nosocomial infections were diagnosed. The most frequent nosocomial infections were pneumonia (26 patients, 66.6%), catheter-related bacteraemia (11 patients, 28.2%), and wound infections (7 patients, 17.9%). In 59 instances (75.6%), colonization with the same potential pathogenic microorganism preceded the nosocomial infection. The overall mortality was 25.6% (10 patients), bacteraemia with aerobic gram-negative microorganisms being the cause of death in 7 patients. PMID- 3655101 TI - Co-infection or early superinfection of pneumococcal pneumonia. AB - Two cases of co-infection or very early superinfection of pneumococcal pneumonia with Staphylococcus aureus in one case, and Enterobacter cloacae in the other, are reported. The two patients were not fully immunocompetent, had leukopenia and a mild intravascular coagulation, and were bacteremic. Mixed infection probably accounted for the lethal outcome because initial antibiotherapy was only directed against Streptococcus pneumoniae. Accurate bacteriologic methods are required to delineate contaminating and infecting pathogens when another bacteria is found in initial bronchial samples of patients with pneumococcal pneumonia, and the antibiotherapy might be directed against the two pathogens until quantitative bacteriologic results would be available, especially in old and debilitated patients. The incidence of mixed infection in pneumococcal pneumonia seems low. PMID- 3655102 TI - Efficacy of a heat and moisture exchange device during high-frequency jet ventilation. AB - A hygroscopic condensor humidifier has been tested during high-frequency jet ventilation, in an experimental set up. The influence of various ventilator settings on relative humidity, temperature and water content of the inspiratory and expiratory gases was investigated. The device provides adequate conditioning of the inspired gases with regard to relative humidity, temperature and water content at various ventilator settings. PMID- 3655103 TI - Hemoperfusion in severe chlorprothixene overdose. AB - Two to twelve hours after suicidal ingestion of an estimated dose of 10 g chlorprothixene, a 31-year-old female was admitted to the emergency ward of the clinic with cardiorespiratory arrest. After successful resuscitation, the further clinical course was complicated by persistent ventricular extrasystoles and ventricular fibrillation which necessitated repeated defibrillation. Since the patient did not respond satisfactorily to supportive treatment, a combined hemoperfusion/hemodialysis was performed. Under extracorporeal detoxication, elimination of chlorprothixene from plasma was accompanied by substantial improvement of the patient's clinical condition, although only about 1.6% of the estimated dose had been removed. This case seems to indicate that evaluation of the therapeutic efficacy of hemoperfusion should not be based exclusively on the relation of the amount of the eliminated drug to total absorbed dose. PMID- 3655104 TI - Intoxication with sulindac, tiaramide hydrochloride and diclofenac sodium. AB - Overdosage intoxication of sulindac, tiaramide and diclofenac caused excitability of central nervous system, followed by unconsciousness. The case was treated with ordinary therapies and direct hemoperfusion (DHP). Serum concentrations of these drugs and their metabolites were correlated well with the clinical symptoms. DHP may be effective to eliminate these drugs and their metabolites. PMID- 3655105 TI - Antipyretic therapy in intensive care. PMID- 3655106 TI - Non-cardiogenic pulmonary edema after oral ingestion of hydrochlorothiazide. PMID- 3655107 TI - Myasthenic crisis following the injection of an iodinated contrast medium. PMID- 3655108 TI - Sedation in intensive care: morphine and renal failure. PMID- 3655109 TI - Blood volume in diabetic coma. PMID- 3655110 TI - Preliminary observations on the use of duration as a cue to syllable-initial fricative consonant voicing in English. AB - Acoustic analyses were undertaken to explore the durational characteristics of the fricatives [f,theta,s,v,delta z] as cues to initial consonant voicing in English. Based on reports on the perception of voiced-voiceless fricatives, it was expected that there would be clear-cut duration differences distinguishing voiced and voiceless fricatives. Preliminary results for three speakers indicate that, although differences emerged in the overall mean duration of voiced and voiceless fricatives, contrary to expectations, there was a great deal of overlap in the duration distribution of voiced and voiceless fricative tokens. Further research is needed to examine the role of duration as a cue to syllable-initial fricative consonant voicing in English. PMID- 3655111 TI - The "overshoot" effect and sensory hearing impairment. AB - The threshold for the detection of a brief tone masked by a longer-duration noise burst is higher when the tone is presented shortly after the onset of the noise than at longer delay times. This finding has been termed the "overshoot" effect [E. Zwicker, J. Acoust. Soc. Am. 37, 653-663 (1965)]. The present letter compared the size of the effect in the better and more impaired ear of six subjects with high-frequency unilateral or asymmetric hearing losses of sensory origin. Thresholds were measured for 5-ms 4-kHz tones presented 10, 200, and 390 ms after the onset of a 400-ms, 2- to 8-kHz noise burst. The better ear of each subject was tested using two noise levels, one equal in sound-pressure level and one equal in sensation level to that used for the impaired ear. Thresholds for all subjects and all ears decreased monotonically with increasing delay time, with the size of the effect typically 5 dB. Thus a small overshoot effect was observed regardless of hearing impairment. PMID- 3655112 TI - Inversion of ultrasonic scattering data for red blood cell suspensions under different flow conditions. AB - Recent results for low-frequency scattering by correlated random distributions of nonspherical particles averaged over orientation are applied to invert ultrasonic data for red blood cell suspensions under different flow conditions. The inversion procedure isolates a correlation parameter (c) representing a process in which the volume fraction (w) of particles increases linearly, and also a cell population parameter P. Reduced data records of scattering versus hematocrit are compared with S(c;w)P, where the generalized fluctuation function S is proportional to the variance in particle number, and P is proportional to the backscattering cross section of an isolated particle. The peak scattering for the different flow processes occurs at values of w ranging from about 0.15 for the most uniform to 0.25 for the least, corresponding to c values of about 2.1 to 0.4, as compared with w approximately equal to 0.13 and c = 3 for hard (repulsive at contact) spheres or aligned ellipsoids. The lower values of c suggest weaker repulsion between the deformable cells and effective interparticle attraction (aggregative trends), and c approximately equal to 2 may also involve flow alignment of the discoids. PMID- 3655113 TI - Volume estimation of symmetrical branching structures by resonance mode analysis. AB - An exact resonance condition is derived for rigid symmetric second-order bifurcating structures. In the low-frequency range, the resonance condition can be reduced into forms that facilitate volume estimation of bifurcating structures. Two such volume approximation techniques are presented: (1) a fundamental frequency method, in which the lowest resonant frequency is inversely proportional to the structure volume, and (2) an equivalent-length method, in which an equivalent length of two daughter branches is calculated for all branches distal to the first bifurcation. An experimental study to determine the resonance modes of seven bifurcating glass structures was performed. The volume estimates obtained by either method were in very close agreement with the true volumes. PMID- 3655114 TI - Propagation of beluga echolocation signals. AB - The propagation characteristics of high-frequency echolocation signals (peak energies above 100 kHz) of the beluga (Delphinapterus leucas) were measured while the animal performed a target detection task. The whale was trained to station on a bite plate so that its transmission beam could be measured in the vertical and horizontal planes using hydrophone arrays. The transitional region between the acoustic near- and farfields was also located using an array of hydrophones that extended directly in front of the animal in the horizontal plane. Three distinct modes of signals were observed. Mode 1 signals had click intervals greater than the time required for the signals to travel to the target and back (two-way transit time). Mode 2 signals had click intervals shorter than the two-way transit time, and mode 3 signals had high repetition rates with an average click interval of 1.7 ms, approximately 2% of the two-way transit time. The average click intervals for the modes 1 and 2 signals were 193 and 44 ms, respectively. The vertical and horizontal beam patterns of the mode 1 signals had similar 3-dB beamwidths of approximately 6.5 degrees. The major axis of the vertical beam was directed approximately 5 degrees above the plane defined by the animal's teeth. The near- to farfield transition region was approximately 0.64-0.75 m from the tip of the animal's mouth. PMID- 3655115 TI - Sounds and source levels from bowhead whales off Pt. Barrow, Alaska. AB - Sounds were recorded from bowhead whales migrating past Pt. Barrow, AK, to the Canadian Beaufort Sea. They mainly consisted of various low-frequency (25- to 900 Hz) moans and well-defined sound sequences organized into "song" (20-5000 Hz) recorded with our 2.46-km hydrophone array suspended from the ice. Songs were composed of up to 20 repeated phrases (mean, 10) which lasted up to 146 s (mean, 66.3). Several bowhead whales often were within acoustic range of the array at once, but usually only one sang at a time. Vocalizations exhibited diurnal peaks of occurrence (0600-0800, 1600-1800 h). Sounds which were located in the horizontal plane had peak source spectrum levels as follows--44 moans: 129-178 dB re: 1 microPa, 1 m (median, 159); 3 garglelike utterances: 152, 155, and 169 dB; 33 songs: 158-189 dB (median, 177), all presumably from different whales. Based on ambient noise levels, measured total propagation loss, and whale sound source levels, our detection of whale sounds was theoretically noise-limited beyond 2.5 km (moans) and beyond 10.7 km (songs), a model supported by actual localizations. This study showed that over much of the shallow Arctic and sub-Arctic waters, underwater communications of the bowhead whale would be limited to much shorter ranges than for other large whales in lower latitude, deep-water regions. PMID- 3655116 TI - A model for directional and distance hearing in swimbladder-bearing fish based on the displacement orbits of the hair cells. AB - It is known that teleosts, without Weberian ossicles but with a swimbladder, can detect the direction of and, under appropriate conditions, the distance to a sound source [e.g., Schuijf and Hawkins, Nature 302, 143-144 (1983)]. It is hypothesized here that the underlying mechanism is the analysis of the parameters of the elliptical movement of the hair cells with respect to the otoliths. This movement results from the displacement wave impinging directly upon the labyrinth and the response displacement wave reradiated by the swimbladder. For a given swimbladder geometry, given the positions of the maculae of both labyrinths with respect to the swimbladder and the damping of the swimbladder, the displacement orbits of the maculae can be calculated [de Munck and Schellart, J. Acoust. Soc. Am. 81, 556-560 (1987)]. These calculations were made for the cod and the trout with the frequency, direction, and distance between the fish and the sound source as parameters with the source within the same horizontal plane as the fish. The orbit model predicts that the utriculus has the most strategic position to detect direction and distance of such a sound source. Moreover, the model predicts that this could basically be done monaurally. A hypothesis is proposed to describe how the utricular system analyzes the orbit parameters. The model is evaluated in relation to the results of behavioral experiments described in the literature. PMID- 3655117 TI - Acoustic comparison of soprano solo and choir singing. AB - Five soprano singers were recorded while singing similar texts in both choir and solo modes of performance. A comparison of long-term-average spectra of similar passages in both modes indicates that subjects used different tactics to achieve somewhat higher concentrations of energy in the 2- to 4-kHz range when singing in the solo mode. It is likely that this effect resulted, at least in part, from a slight change of the voice source from choir to solo singing. The subjects used slightly more vibrato when singing in the solo mode. PMID- 3655118 TI - An investigation of motor equivalence in the speech of children and adults. AB - Although the concept of motor equivalence (i.e., articulatory intercoordination) is generally accepted as functioning in normal speech production, few studies have experimentally demonstrated its existence. One purpose of the present study was thus to obtain additional data concerning this phenomenon. Because motor equivalence is often assumed to represent a rather sophisticated ability in speakers, another purpose of the study was to determine whether trends could be observed that might demonstrate a developmental progression toward more frequent occurrence of articulatory intercoordination with increasing age. A strain gauge transduction system was used to monitor inferior-superior upper lip, lower lip, and jaw movements produced by a group of adults and three groups of children ranging from 4-11 years of age, as they spoke in a normal condition and in two "perturbed" conditions (bite block and fast rate). Based on the assumption that the presence of a significant negative correlation between two articulators constitutes evidence of articulatory intercoordination, there was little indication of motor equivalence in the speech of the adults or the children. PMID- 3655119 TI - Speaking rate of adventitiously deaf male cochlear implant candidates. AB - No objective group data on speaking rate or speaking duration have been reported on the speech of adventitiously profoundly hearing-impaired adults. Results of the present study showed that speaking rate, i.e., number of syllables per second, was significantly slower and speaking duration was significantly longer for 25 adventitiously profoundly hearing-impaired adult male cochlear implant candidates than for 10 normal-hearing control subjects. The factors of length of time since onset of profound hearing loss and hearing aid use did not significantly affect speaking rate. Based on these objective data, a rationale and method are presented for aural rehabilitation of the profoundly hearing impaired who exhibit speaking rate abnormalities. PMID- 3655120 TI - Effects of stress and final-consonant voicing on vowel production: articulatory and acoustic analyses. AB - Durations of the vocalic portions of speech are influenced by a large number of linguistic and nonlinguistic factors (e.g., stress and speaking rate). However, each factor affecting vowel duration may influence articulation in a unique manner. The present study examined the effects of stress and final-consonant voicing on the detailed structure of articulatory and acoustic patterns in consonant-vowel-consonant (CVC) utterances. Jaw movement trajectories and F 1 trajectories were examined for a corpus of utterances differing in stress and final-consonant voicing. Jaw lowering and raising gestures were more rapid, longer in duration, and spatially more extensive for stressed versus unstressed utterances. At the acoustic level, stressed utterances showed more rapid initial F 1 transitions and more extreme F 1 steady-state frequencies than unstressed utterances. In contrast to the results obtained in the analysis of stress, decreases in vowel duration due to devoicing did not result in a reduction in the velocity or spatial extent of the articulatory gestures. Similarly, at the acoustic level, the reductions in formant transition slopes and steady-state frequencies demonstrated by the shorter, unstressed utterances did not occur for the shorter, voiceless utterances. The results demonstrate that stress-related and voicing-related changes in vowel duration are accomplished by separate and distinct changes in speech production with observable consequences at both the articulatory and acoustic levels. PMID- 3655121 TI - Frequency discrimination of complex signals, frequency selectivity, and speech perception in hearing-impaired subjects. AB - Frequency discrimination of spectral envelopes of complex stimuli, frequency selectivity measured with psychophysical tuning curves, and speech perception were determined in hearing-impaired subjects each having a relatively flat, sensory-neural loss. Both the frequency discrimination and speech perception measures were obtained in quiet and noise. Most of these subjects showed abnormal susceptibility to ambient noise with regard to speech perception. Frequency discrimination in quiet and frequency selectivity did not correlate significantly. At low signal-to-noise ratios, frequency discrimination correlated significantly with frequency selectivity. Speech perception in noise correlated significantly with frequency selectivity and with frequency discrimination at low signal-to-noise ratios. The frequency discrimination data are discussed in terms of an excitation-pattern model. However, they neither support nor refute the model. PMID- 3655122 TI - Perceptual organization of complex-tone sequences: a tradeoff between pitch and timbre? AB - Sequences of rapidly occurring sounds that differ from each other are often perceptually segregated into "streams" within which the range of differences is smaller [Bregman and Campbell, J. Exp. Psychol. 89, 244-249 (1971)]. Early research on streaming implied it to be pitch dominated, but Wessel [Comput. Music J. 3, 45-52 (1979)] demonstrated that timbre differences could also bring about segregation. In the present study, pitch and timbre attributes were put in competition in four-tone sequences of the form: T2P1-TmP1-T2Pn-TmPn, with the first pair assigned pitch P1 but different timbres T2 and Tm, and the second pair pitch Pn, and similarly contrasted timbres. Six listeners were asked to indicate whether perceived grouping of 49 such sequences was based on pitch proximity, timbre similarity, or ambiguous percepts not dominated by either cue. Results confirm that timbre can segregate sequences and imply that timbre and pitch compete in perceptually organizing complex sequences. Because timbre differences were provided by varying the locus of four equal-amplitude harmonics, and pitch differences were provided by varying their relative spacing, it is suggested that the tradeoffs observed may actually arise due to differences in perceived salience of "spectral pitch" and "virtual pitch" [Terhardt, J. Acoust. Soc. Am. 55, 1061-1069 (1974)] dependent on relative changes in spectral locus and spectral spacing over time. PMID- 3655123 TI - Infants' localization of sounds in the median sagittal plane: effects of signal frequency. AB - The purpose of this research was to determine if infants, like adults, show differential localization performance in the median sagittal plane (MSP) as a function of the spectrum of the signal. Infants 6-18 months of age were seated in a dark room facing an array of nine loudspeakers, with one loudspeaker positioned at ear level, 0 degrees, and four each positioned above and below ear level at 4 degrees, 8 degrees, 12 degrees, and 16 degrees. A two-alternative, forced-choice procedure was used in which a sequence of noise bursts was presented at 0 degrees and then shifted vertically, above or below 0 degrees, and continued to be presented until the infant made a directional head and/or eye movement; correct responses were visually reinforced. For each of three bandpass noise conditions (less than 4 kHz, 4-8 kHz, 8-12 kHz), minimum audible angle (MAA) for each listener, i.e., the smallest of the four angular shifts in vertical sound location that the listener could reliably detect, was estimated. Results indicated that MAA systematically decreased with increasing age, revealing an increasingly finer partitioning of auditory space. Moreover, performance at each age revealed the importance of high frequencies for localization in the MSP. Infants did not reliably localize the low-pass signal (less than 4 kHz) and showed the best performance to the signal comprising the highest frequencies (8 12 kHz). These findings reveal systematic age-related improvements in sound localization abilities during infancy, and suggest that spectral cues similar to those for adults operate for infants in vertical localization. PMID- 3655124 TI - The role of tactile aids in providing information about acoustic stimuli. AB - Devices that convert sound patterns into patterns of vibrotactile stimulation have been shown in laboratory and clinical studies to enable persons to appreciate many aspects of the acoustic environment, and thus are of potential benefit to deaf persons. In the present article, a framework is outlined for describing normal listening situations as a hierarchy of tasks requiring increasingly complex analysis of the acoustic waveform, including sound detection, environmental sound identification, syllable rhythm and stress categorization, phoneme and word identification, and comprehension of connected speech. The types of benefits provided by tactile aids in each of these tasks are exemplified using data from studies of single-channel commercially available devices and multichannel tactile vocoders in our own and other laboratories. The discussion of these data addresses such issues as the features of the acoustic environment that can or should be transmitted through a tactile aid, the differences in the information transmitted by commercially available versus experimental laboratory devices, the comparison of tactile aids and cochlear implants, and the technical problems that remain to be overcome in the design and evaluation of improved vibrotactile aids. PMID- 3655125 TI - Cochlear power flux as an indicator of mechanical activity. AB - The question of whether one can conclude just from basilar membrane (BM) vibration data that the cochlea is an active mechanical system is addressed. To this end, a method is developed which computes the power flux through a channel cross section of a short-wave cochlear model from a given BM vibration pattern. The power flux is an important indicator of mechanical activity because a rise in this function corresponds to creation of mechanical energy. The power flux method is applied to BM velocity patterns as measured by Johnstone and Yates [J. Acoust. Soc. Am. 55, 584-587 (1974)] and by Sellick et al. [Hear. Res. 10, 101-108 (1983)] in the guinea pig and by Robles et al. [Peripheral Auditory Mechanisms, edited by J.B. Allen, J.L. Hall, A.E. Hubbard, S.T. Neely, and A. Tubis (Springer, New York, 1986a), pp. 121-128, and J. Acoust. Soc. Am. 80, 1364-1374 (1986b)] in the chinchilla. Before the calculations are performed, the BM data are interpolated and smoothed in order to avoid numerical errors as a result of too few and noisy data points. The choice of the smoothing method influences the computed power flux function considerably. Nevertheless, the calculations appear to make a clear distinction between the "old" data, showing broad BM tuning (Johnstone and Yates, 1974), and the "new" data, in which the response is much more peaked (Sellick et al., 1983; Robles et al., 1986a, b). The former do not give rise to a significant increase of the power flux; the latter do, although less convincingly for the Sellick et al. (1983) data than for the Robles et al. (1986a,b) data. It is thus concluded that the recently obtained, sharply tuned BM responses reflect the presence of mechanical activity in the cochlea. PMID- 3655126 TI - Prediction of the incidence of motion sickness from the magnitude, frequency, and duration of vertical oscillation. AB - A method is proposed by which the incidence of motion sickness may be predicted from measurement of the motion exposure. The method is based on data from both field and laboratory studies involving large numbers of people and is applicable to marine and other environments where vertical oscillation occurs at frequencies below 0.5 Hz. The dependence of motion sickness on the frequency of oscillation requires the use of a weighting function between 0.1 and 0.5 Hz. The dependence of sickness on the duration of exposure is incorporated by the use of a cumulative measure of motion dose based on the product of root-mean-square (rms) acceleration magnitude and the square root of stimulus duration. The influence of population variables such as sex, age, and motion experience is discussed. The method enables separate predictions to be made of vomiting incidence and of feelings of illness. The prediction procedure, while not seeking to explain the underlying mechanisms of motion sickness occurrence, provides a generally applicable method which is simple to use and has an accuracy consistent with the experimental data on which it is based. PMID- 3655127 TI - The 114th meeting of the Acoustical Society of America. Miami, Florida, 16-20 November 1987. Abstracts. PMID- 3655128 TI - Single homeless people. PMID- 3655129 TI - Nursing in the 21st century: alternate paths. AB - The nursing profession has the opportunity to choose one of two alternate paths as it enters the 21st century. One is a dependent path the other is independent. By virtue of a licence nurses have authority to practice their profession independently. Yet some nurses, health care policy makers, and administrators of institutions and agencies, formulate and implement roles and activities for nurses in order to fulfil the aims of medicine and institutional bureaucracy. This problem 'forces' nursing to travel a dependent path. A view is set forth that the problem stems from the collective failure of nursing to articulate and implement a function and product distinct from that of medicine and of other professions. Making this distinction is critical to the charting of an independent path. Nursing's past and present are examined in terms of the service nursing does in fact provide for society. This operationally defined role of nursing is presented in marked contrast to the definition of nursing currently being promulgated by the American Nurses' Association. Collective articulation of a distinct function and product are set forth as a prerequisite for nurses to assume professional authority as they practise. This will safeguard consumers of professional nursing as well as the work and future of nursing as an independent profession. PMID- 3655130 TI - The relationship between quality of nursing care and the ward as a learning environment: developing a methodology. AB - This paper describes the development of a methodology to study the relationship between quality of care received by patients and the quality of the ward as a learning environment for nurses in training. Firstly, the literature review and background literature to the research question are described. Secondly, the methodology or rationale for the choice of methods is discussed. Key research perspective include (a) the role of the participant observer in generating low level grounded theory or working hypotheses and (b) triangulation of the data using a multi-method approach. The organization of the project is outlined schematically and the research setting and data collection described. The final section of the paper discusses preliminary findings as illustrative of the grounded theory approach, i.e. the analysis of the data as they are collected and the formulation of working hypotheses to be tested and developed as the research progresses. PMID- 3655131 TI - The relevance of research to the ward sister. AB - This paper addresses the relevance of research to practice under two headings using a policy analysis perspective. Firstly, the relationship of knowledge to action is considered within the context of a piece of longitudinal research into the welfare of children in hospital. The general difficulties of research application are discussed in terms of the different problem perceptions and time scales held by the policy makers who commission research, and the researchers themselves. The example cited demonstrates a useful compromise. The practical consequences arising from the distinct epistemological premises which underpin research into the natural and social worlds of nursing are considered. Secondly, the constraints on achieving research-based action are described briefly in terms of the resources of time, manpower and funding. It is concluded that an awareness of both conceptual and practical issues is essential in order to comprehend fully the complexity of, and the necessity for, a range of research approaches to nursing issues. PMID- 3655132 TI - Problematic situations in nursing: analysis of Orlando's theory based on Dewey's theory of inquiry. AB - Orlando's theory, proposed as a framework to use in problematic situations, was analysed using Dewey's theory of inquiry. This analysis revealed that Orlando's concepts are remarkably similar to those of Dewey. Each used an organizing principle that was derived from the meaning of experience and both view investigation as a serial process using facts and ideas to determine the problem and its solution. Several areas in Orlando's work could be enhanced and extended through the formulations of Dewey. The analysis supports the use of Orlando's theory in problematic situations. PMID- 3655133 TI - Maternal opinion of psychosocial support: evaluation of an antenatal programme. AB - The aim of the study was to investigate the significance of psychosocial screening and psychosocial support in antenatal care. Different methods were used. Three hundred and sixty-four pregnant women participated. There was no increase in obstetrical complications, premature births or growth retardation among the infants born to mothers with a high life stress score. A correlation between smoking and reduced birth weight was noted. Most women claimed that they had reduced their alcohol intake already before their first visit to the antenatal clinic. Those women who attended the most extensive psychosocial care had the most favourable attitudes towards the antenatal care. There was a positive correlation between intensive psychosocial support and sickness allowance. The question is raised whether all pregnant women should have the right to be out of work during the last 2 months of pregnancy without reduction of parent's allowance benefit. PMID- 3655134 TI - An analysis of senior nursing students' immediate responses to distressed patients. AB - The purpose of this study was to determine whether the effectiveness of senior nursing students' immediate responses to patients is influenced by type of distress presented by patients or by type of student degree programme. Forty-four ADN and 31 BSN seniors from four schools agreed to participate. Subjects viewed two videotaped simulations of 'patients' complaining of pain and two of 'patients' manifesting emotional distress. Content validity of simulations was established through nurse experts. After each tape, subjects answered four research questions based on Orlando's nursing process concept. The fourth question asked what subjects would say initially to 'the patient'. The data revealed eight response categories which were scored according to their congruence with Orlando's concepts. Independent categorization of responses yielded a 0.92 inter-related reliability; t-tests indicated that type of distress was related to response effectiveness (P less than 0.01) but type of degree was not (P greater than 0.01). The presumed emphasis on communication and psychosocial foundations in BSN curricula may not translate into more effective exploratory skills in these students. These skills are a key component of the complex assessment skills which enable nurses to 'diagnose human responses' to health problems. Orlando's model is recommended for teaching BSN students to conceptualize the interactional process and its goals. PMID- 3655135 TI - Inflammatory bowel disease: effects on lifestyle. AB - While there has been speculation in the literature about what life with inflammatory bowel disease (IBD) is like, patients have not, prior to this study, been asked about their perceptions. This paper reports the results of a study which measured the impact of having IBD on eight lifestyle variables. Eighty IBD patients completed the Inflammatory Bowel Disease Stress Index. Results showed that although the impact of IBD on relationships, school and employment, recreational activities, sexuality, psychosomatic symptomatology, body image and worry was minimal, the patients' satisfaction with life was impaired as a result of having IBD. Rationale for this discrepancy and the significance of the findings for nurses are presented. PMID- 3655136 TI - Identifying strategies nurses use to cope with work stress. AB - Although in occupational stress considerable attention has been given to identifying causes and consequences, relatively few attempts have been made to examine and identify the strategies nurses use to cope with stress. In a nationwide survey nurses were asked to complete a check list of coping behaviours developed from strategies nurses themselves said they used. The analysis identified six strategies. These included problem-oriented behaviour, trying to unwind and put things into perspective, expressing feelings or frustrations, keeping the problem to yourself and accepting the job as it is and trying not to let it get to you. The importance of these findings is discussed in terms of how coping has been defined, the role of palliative techniques and strategies for intervention. PMID- 3655137 TI - The changing composition of the British hospital nursing workforce 1962-1984. AB - The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) recently undertook a major project aimed at identifying the most appropriate future nurse staffing patterns. The results presented here were produced at the request of the UKCC in order that the recommendations stemming from their deliberations could be set against a wider backcloth. It proved possible to secure nurse staffing data from three of the countries of the United Kingdom, namely, England, Wales and Scotland. Most were secured from government publications but the appropriate government agencies also provided valuable assistance. The main trends emerging from a processing of the data are a steadily falling ratio of student nurses and midwives to their qualified counterparts and a steadily increasing contribution by state enrolled nurses. A number of other ratios are presented pictorially accompanied, where appropriate, by a commentary. The actual growth in whole time equivalent nurses is seen to be somewhat less than many people imagine when account is taken of the reduction in both the number of weeks and the number of hours per week worked. Indeed, there has been a levelling off of this last figure over the past few years. PMID- 3655138 TI - Towards effective clinical teaching in nursing. AB - During the last two decades, the structure and function of clinical learning and teaching have undergone significant changes. Nursing students demand quality teaching rather than supervision in the clinical area alone. At the same time, expectations and demands of university nursing faculty also change. Nurse educators are under increasing pressure to engage in scholarly activities. Clinical instruction in baccalaureate nursing programmes becomes the primary responsibility of either the inexperienced or part-time, sessional instructors. This pattern of faculty teaching assignment is not without problems. This paper critically examines these problems and proposes strategies for dealing with them. PMID- 3655139 TI - A model to guide development and application of multiple nursing theories. AB - Over the past decade there has been an explosion of interest and activity in the nursing profession directed toward the development of a theory base for nursing education and practice. Although we support the overall thrust of nursing theory development, we have concerns about its utility, scope and stated purposes. We are especially sensitive to the plight of the practising nurse who might attempt to use the current nursing theories to guide and explain choices made in daily practice. In this paper we examine current use of the word 'theory' and describe problems inherent in nursing's efforts to apply educationally derived conceptual frameworks to nursing practice. We identify a need for the development and use of many theories for nursing and argue that there is a logical need for a 'meta model' which will guide the use of multiple theories in practice. A model is presented which allows the practising nurse to examine the various theories in terms of their applicability to a given client situation. We believe the model is also useful to nurse educators and researchers who may be attempting to use nursing theories for educational purposes or develop nursing's knowledge base through empirical work. PMID- 3655140 TI - The practical management of the Alzheimer's disease patient in the hospital setting. PMID- 3655141 TI - Noninvasive assessment of left ventricular diastolic function by pulsed Doppler echocardiography in patients with hypertrophic cardiomyopathy. AB - Hypertrophic cardiomyopathy is a primary myocardial disease in which symptoms may frequently result from impaired left ventricular relaxation, filling and compliance. In the present investigation, Doppler echocardiography was utilized to measure transmitral flow velocity and thereby assess left ventricular diastolic performance noninvasively in a group of 111 patients representative of the broad clinical spectrum of hypertrophic cardiomyopathy. In patients with hypertrophic cardiomyopathy, all Doppler indexes of diastolic relaxation and filling differed significantly (p less than 0.001) from those obtained in 86 control subjects without heart disease, namely, prolongation of isovolumic relaxation (94 +/- 24 versus 78 +/- 12 ms) and of the early diastolic peak of flow velocity (244 +/- 55 versus 220 +/- 28 ms), as well as slower deceleration (3.4 +/- 1.4 versus 4.9 +/- 1.3 m/s2) and reduced maximal flow velocity in early diastole (0.5 +/- 0.2 versus 0.6 +/- 0.1 m/s). As an apparent compensation for impaired relaxation and early diastolic filling, the atrial contribution to left ventricular filling was increased, as shown by increased late diastolic flow velocity (0.4 +/- 0.3 versus 0.3 +/- 0.1 m/s) and reduced ratio of maximal flow velocity in early diastole to that in late diastole (1.4 +/- 0.8 versus 2.1 +/- 0.9). The vast majority of patients with hypertrophic cardiomyopathy (91 [82%] of 111) showed evidence of impaired left ventricular diastolic performance, as assessed from the Doppler waveform. Abnormal Doppler diastolic indexes were identified with similar frequency in patients with (78%) or without (83%) left ventricular outflow obstruction, as well as in patients with (84%) or without (80%) cardiac symptoms. However, patients with nonobstructive hypertrophic cardiomyopathy showed more severe alterations in the Doppler indexes of diastolic function than did patients with obstruction. Thus, abnormal diastolic performance as assessed by Doppler echocardiography was apparent in the vast majority of the study patients with hypertrophic cardiomyopathy, independent of the presence or absence of cardiac symptoms or a subaortic pressure gradient. The high frequency with which diastolic abnormalities are identified in asymptomatic patients with hypertrophic cardiomyopathy suggests that impaired diastolic performance may be present at a time in the natural history of the disease when functional limitation is not yet evident. PMID- 3655142 TI - Regional dysfunction by equilibrium radionuclide angiocardiography: a clinicopathologic study evaluating the relation of degree of dysfunction to the presence and extent of myocardial infarction. AB - The relation of degree of regional wall motion abnormality by equilibrium radionuclide angiocardiography to the presence and mural extent of regional necrosis or scar at autopsy was evaluated in 23 autopsy patients who had a history of myocardial infarction and had equilibrium radionuclide angiocardiography within 40 days of death. Of the 228 regions evaluated by equilibrium radionuclide angiocardiography, 135 had abnormal regional wall motion and 102 (76%) of these 135 regions had evidence of myocardial infarction at autopsy. The overall sensitivity, specificity and predictive values of regional wall motion abnormality for regional necrosis or scar were 69, 59 and 76%, respectively. Of the 33 false positive regions, 20 (61%) had severe narrowing of the coronary artery supplying that region, 13 (39%) were adjacent to a region with a myocardial infarction and almost half (16 [48%]) were in the lateral wall. Eighty-three (36%) of the 228 regions were akinetic or dyskinetic, 52 (23%) were hypokinetic and 93 (41%) were normal. Sixty-three (76%) of the 83 akinetic/dyskinetic segments had transmural myocardial infarction at autopsy, 14 (17%) had nontransmural myocardial infarction and only 6 (7%) contained no necrosis or scar. In contrast, 14 (27%) of 52 hypokinetic segments had transmural myocardial infarction, 11 (21%) had nontransmural myocardial infarction and 27 (52%) were normal. Thus, the most severe regional wall motion abnormality (akinesia/dyskinesia) almost always indicates regional myocardial infarction which is usually transmural whereas less severe dysfunction (hypokinesia) is not necessarily associated with regional necrosis or scar. The severity of regional dysfunction must be considered if equilibrium radionuclide angiocardiography is used to evaluate the presence and mural extent of myocardial infarction within a region. PMID- 3655143 TI - Silent ischemia predicts infarction and death during 2 year follow-up of unstable angina. AB - Silent myocardial ischemia as detected on Holter electrocardiographic (ECG) monitoring is present in greater than 50% of patients with unstable angina despite intensive medical therapy. The presence and the extent of silent ischemia have been correlated with an increased risk of early (1 month) unfavorable outcome including myocardial infarction and need for coronary revascularization for persistent symptoms. Seventy patients with unstable angina who had undergone continuous ECG monitoring for silent ischemia were followed up for 2 years; 37 patients (Group I) had Holter ECG evidence of silent ischemia at bed rest in the coronary care unit during medical treatment with nitrates, beta-receptor blockers and calcium channel antagonists; the other 33 patients (Group II) had no ischemic ST segment changes (symptomatic or silent) on Holter monitoring. Over a 2 year follow-up period, myocardial infarction occurred in 10 patients in Group I (in 2 it was fatal) compared with one nonfatal infarction in Group II (p less than 0.01 by Kaplan-Meier analysis); revascularization with either coronary bypass surgery or angioplasty for symptomatic ischemia was performed in 11 Group I and 5 Group II patients (p less than 0.05). Multivariate Cox's hazard analysis demonstrated that the presence of silent ischemia was the best predictor of 2 year outcome. Therefore, persistent silent myocardial ischemia despite medical therapy in patients with unstable angina carries adverse prognostic implications that persist over a 2 year period. PMID- 3655144 TI - Inducible polymorphic ventricular tachycardia and ventricular fibrillation in a subgroup of patients with hypertrophic cardiomyopathy at high risk for sudden death. AB - This investigation was undertaken to elucidate the underlying electrophysiologic substrate in hypertrophic cardiomyopathy and to identify possible predictors of sudden death in this patient population. Programmed stimulation was performed in 18 patients aged 14 to 64 years (mean 36) believed to be at high risk for sudden death on the basis of prior cardiac arrest or syncope, nonsustained ventricular tachycardia on Holter ambulatory electrocardiographic (ECG) monitoring or a family history of frequent sudden death. Polymorphic ventricular tachycardia that deteriorated to ventricular fibrillation was reproducibly induced in 8 (44%) of the 18 patients (Group A). This rhythm was induced in all three patients with a history of cardiac arrest. No sustained monomorphic ventricular tachycardia was induced. Group B comprised the 10 patients in whom a sustained arrhythmia could not be reproducibly initiated. The electrophysiologic substrate was distinctly different in patients with, than in those without, inducible sustained arrhythmia. The refractory period was shorter at the right ventricular outflow tract (232 +/- 22 ms) compared with the apex (264 +/- 12 ms) in Group A (p less than 0.005) whereas there was no difference in Group B (271 +/- 25 ms versus 271 +/- 13 ms). The local ventricular electrogram of most patients in both groups was prolonged and markedly multiphasic. However, 5 of the 8 Group A patients exhibited a double electrogram (V-V') with premature stimulation compared with 1 of the 10 patients in Group B (p less than 0.02). A positive R wave in lead aVR of the scalar ECG and poor R wave progression in the precordial leads were more common in Group A than in Group B (p less than 0.001 and p less than 0.001, respectively). The reason for the distinctly different electrophysiologic substrate and the high prevalence of inducible polymorphic arrhythmia is unclear. It may relate to the underlying myocardial architecture in these patients, characterized by myocardial cellular disarray and fibrosis. PMID- 3655145 TI - Signal averaging of the surface QRS complex predicts inducibility of ventricular tachycardia in patients with syncope of unknown origin: a prospective study. AB - Forty patients with syncope of unknown origin underwent quantitative signal averaging of the surface QRS complex before invasive electrophysiologic testing with programmed ventricular stimulation. Of 34 patients without bundle branch block, 12 had inducible ventricular tachycardia (Group I) and 22 did not (Group II). The duration of low amplitude signals, the root mean square voltage of the terminal 40 ms and the signal-averaged QRS vector duration were measured in each case. One or more abnormal signal averaging variables were present in 92% of patients in Group I, but in only 27% of patients in Group II (p less than 0.005). An abnormal root mean square voltage of the terminal 40 ms was the most significant distinguishing variable, being present in 83% of Group I patients and in only 14% of Group II patients (p less than 0.005). The QRS vector duration was prolonged in 58% of Group I patients, but in only 9% of Group II patients (p less than 0.05). Likewise, the duration of low amplitude signals was prolonged in 58% of Group I patients, but in only 19% of Group II patients (p less than 0.05). When compared with 24 hour ambulatory electrocardiographic monitoring, the presence of abnormal signal averaging variables was more predictive of inducible ventricular tachycardia. Seven (32%) Group II patients had greater than or equal to 10 ventricular premature beats/h, couplets or episodes of nonsustained ventricular tachycardia; however, none had abnormal late potentials recorded. In contrast, three patients (25%) in Group I had less than 10 ventricular premature beats/h, although all in that group had one or more abnormal signal-averaged variables.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655146 TI - Effect of 1.5 tesla nuclear magnetic resonance imaging scanner on implanted permanent pacemakers. AB - Patients with a permanent pacemaker are currently restricted from diagnostic nuclear magnetic resonance (NMR) imaging because of potential adverse effects on the pacemaker by the magnet. Previous work has shown that NMR imaging will result in asynchronous pacing of the pulse generator within a given distance of the magnet. The radiofrequency signal generated by the system may also result in rapid cardiac pacing, which may have deleterious effects. This study utilized a 1.5 tesla unit in an in vivo laboratory animal to evaluate the unit's effects on eight different pulse generators from two manufacturers. All pacemakers functioned in an asynchronous mode when placed within a certain distance of the magnet. In addition, transient reed switch inhibition was observed. Seven of the eight pulse generators paced rapidly when exposed to the radiofrequency signal and there was a dramatic decrease in arterial blood pressure. Whether effective rapid cardiac pacing would occur could not be predicted before exposure to the magnetic resonance unit. Nuclear magnetic resonance imaging with high magnetic fields in patients with a pacemaker should continue to be avoided until the mechanism of the rapid cardiac pacing can be further delineated and either predicted or prevented. PMID- 3655147 TI - Uses and limitations of exercise Doppler echocardiography in the diagnosis of ischemic heart disease. AB - This study tested the hypothesis that coronary artery disease might be identified by a decrease in Doppler measurements of flow velocity and acceleration. The response of aortic blood flow velocity and acceleration to exercise was determined in 102 subjects (28 young control subjects and 74 older patients) who underwent continuous wave Doppler echocardiographic examination before, during and immediately after near maximal treadmill exercise. Patients were grouped according to the results of thallium perfusion imaging: Group I = normal, Group II = ischemia with or without prior infarction and Group III = prior infarction only. A significant decrease in the level of velocity and acceleration achieved with exercise was observed both in patients in Group I (normal thallium study) (1.2 +/- 0.3 m/s and 36.8 +/- 14 m/s per s, p less than or equal to 0.005) and in patients in Group II (ischemia) (1.1 +/- 0.3 m/s and 27.7 +/- 11 m/s per s, p less than or equal to 0.0005) compared with values in young control subjects (1.4 +/- 0.2 m/s and 52.7 +/- 16 m/s per s). When groups of patients of similar age who differed in the presence (Group II) or absence (Group I) of ischemia on thallium scintigraphy were compared, no difference was found for maximal velocity (1.1 +/- 0.3 versus 1.2 +/- 0.3 m/s, p = NS), but acceleration was significantly lower in Group II (27.7 +/- 11 versus 36.8 +/- 14 m/s per s, p less than or equal to 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655148 TI - Influence of sampling site and flow area on cardiac output measurements by Doppler echocardiography. AB - In 40 patients cardiac output was simultaneously determined by pulsed Doppler echocardiography and thermodilution (range 4.0 to 10.2 liters/min). The sample volume was located in the center of the mitral anulus, at the tips of the mitral leaflets and in the center of the aortic anulus. Circular cross-sectional areas of the mitral anulus, aortic anulus and aortic bulbus were calculated from M-mode and two-dimensional echocardiographic diameters. The varying short axis of the elliptical mitral opening area was obtained from the diastolic leaflet separation in the M-mode, and the long axis was derived from the maximal mitral orifice area or mitral anulus diameter. Cardiac output was calculated by multiplying time velocity integrals with the different areas and heart rate. Doppler flow measurements correlated significantly with the thermodilution method (r = 0.79 to 0.93). Flow measurements at the aortic anulus were most accurate (r = 0.93, SEE = 0.589 liter/min) if the annular area was derived from the M-mode tracing. Measurement of the anulus in the apical five chamber view yielded a significant underestimation and the area of the aortic bulbus provided an overestimation of cardiac output. Left ventricular inflow was underestimated at the mitral leaflet tips and overestimated at the mitral anulus. The accuracy of pulsed Doppler cardiac output measurements strongly depends on the assumed flow area and sampling site. Both should be determined at the same level in the inflow or outflow tract of the left ventricle. Measurement of cardiac output in the center of the aortic anulus provided the highest accuracy. PMID- 3655149 TI - Mexiletine: an effective antiarrhythmic drug for treatment of ventricular arrhythmias in congenital heart disease. AB - The use of antiarrhythmic drugs to suppress ventricular arrhythmias in pediatric patients with a structurally or hemodynamically abnormal heart appears to improve long-term prognosis. The previously successful use of phenytoin to treat serious ventricular arrhythmias led to the investigation for an alternative antiarrhythmic agent, in the same antiarrhythmic drug class, for those patients who develop side effects or become intolerant to phenytoin's antiarrhythmic effect. Forty-two children and young adults (age range 5 months to 34 years, mean 15.5 years) were treated with mexiletine. Arrhythmias treated were ventricular tachycardia (25), ventricular couplets (8), multiform ventricular premature beats (4) and frequent uniform ventricular premature beats (5). Anatomic diagnoses included congenital heart disease (postoperative in 26, unoperated in 2), cardiomyopathy (7), no heart disease (4) and other (3). Thirty-three patients had been previously treated with 1 to 5 (mean 1.6) antiarrhythmic drugs. In the short term, ventricular arrhythmias were effectively suppressed in 30 (71%) of all 42 patients treated. During follow-up (ranging to 42 months, median 10.6), 18 (60%) of the 30 acute responders continued to have excellent control. Early suppression of ventricular arrhythmias was more effective in patients with congenital heart disease (89%) than in those with cardiomyopathy (29%) or no heart disease (43%) (p less than 0.01). Initial complexity of ventricular ectopic activity had no effect on treatment results. Of 25 patients previously treated with phenytoin, in whom alternative antiarrhythmic therapy was required, 40% had long-term arrhythmia control when treated with mexiletine. Mexiletine therapy was terminated for side effects in only five patients (12%). Mexiletine is recommended for young patients with congenital heart disease and serious ventricular arrhythmias. PMID- 3655150 TI - Effects of a new second generation calcium channel blocker, nilvadipine (FR34235), on exercise-induced hemodynamic changes in stable angina pectoris. AB - The mechanism of the antianginal actions of nilvadipine was investigated in 11 patients with effort angina pectoris. Hemodynamic data were obtained by angina limited supine multistage bicycle ergometer exercise testing before and after a single 6 mg dose of nilvadipine. Compared with chest pain during control exercise testing, pain at peak exercise disappeared or abated and the ST segment at peak exercise also showed less significant depression after administration of nilvadipine. At rest and at peak exercise, mean blood pressure, pulmonary artery wedge pressure and systemic vascular resistance decreased significantly, whereas heart rate and cardiac index increased significantly after nilvadipine. Rate pressure product and stroke volume index did not change significantly. Coronary sinus flow at peak exercise increased significantly and total coronary vascular resistance at rest and at peak exercise decreased significantly after nilvadipine. The plasma concentrations of nilvadipine 1.5 hours after administration ranged from 1.15 to 8.23 ng/ml. These data suggest that the principal factors in the antianginal actions of nilvadipine are an increase in myocardial oxygen supply due to increased coronary blood flow and a reduction in myocardial oxygen demand mainly by a decrease in afterload and additionally by a decrease in preload. PMID- 3655151 TI - Two-dimensional echocardiographic identification of complicated aortic root endocarditis: implications for surgery. AB - Two-dimensional echocardiography successfully displayed the location and extent of aortic root complications, annular abscess or mycotic aneurysm in nine patients with aortic valve endocarditis. Five of the nine patients had prosthetic valve endocarditis and four had native valve endocarditis. The infective process extended into the paravalvular structures, including the interventricular septum (seven patients), right ventricular outflow tract (three patients), interatrial septum (one patient) and anterior mitral valve leaflet (four patients). The amount of aorto-left ventricular discontinuity caused by these complications was quantitated in degrees of annular circumference on the parasternal short axis image and in distance on the parasternal long axis image. The echocardiographic findings were confirmed at surgery and were helpful in the preoperative anticipation of the type of surgical procedure required: aortic valve replacement or composite aortic valve and root replacement. Five patients had prosthetic valve endocarditis with calculated aorto-left ventricular discontinuity of 173 +/ 55 degrees on parasternal short axis images and 1.36 +/- 0.72 cm on parasternal long axis images. Initial surgical repair included three composite aortic root valve prosthesis implants, one reconstructive procedure with valve replacement and one simple aortic valve replacement. During a follow-up period of 18 months (range 1 to 35), a second reparative procedure was required for only one patient to repair an aortic conduit to coronary artery venous bypass graft. Four patients had native valve endocarditis with calculated aorto-left ventricular discontinuity of 100 +/- 17 degrees on parasternal short axis images and 0.88 +/- 63 cm on parasternal long axis images. Initial surgical repair included two reconstructive procedures with valve replacement and two simple aortic valve replacements. During a follow-up period of 30 months (range 16 to 42), three of these four patients required a second reparative procedure: one each for repair of a paraprosthetic leak, a ventricular septal defect and persistent aorto-left ventricular discontinuity. Two-dimensional echocardiography accurately detected aortic annular abscess and mycotic aneurysm complicating aortic valve endocarditis and the resultant degree of aorto-left ventricular discontinuity. Circumferential aorto-left ventricular discontinuity with these complications is greater for prosthetic than native valve endocarditis and predicts a more extensive surgical repair.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655152 TI - A standardized examination in the interpretation of electrocardiograms. AB - A standardized objective examination was developed by the Cardiovascular Subspecialty Board of the American Board of Internal Medicine to assess competence in the interpretation of electrocardiograms (ECGs). The questions consisted of 12 lead ECGs with lead II and V1 rhythm strips, accompanied by brief clinical statements. Examinees chose their answers from a comprehensive list of 129 choices; the list was the same for each question. The score from the ECG examination was combined with scores from the other sections of the examination to derive a single score for the Cardiovascular Board examination using a norm referenced method for determining the passing score. An additional trial was conducted to study the feasibility of testing for a minimal level of competence; the trial used a subset of "core" ECGs and a criterion-referenced scoring method based on a consensus of members of the Cardiovascular Board on the level of performance that should be expected of certified cardiologists. Fifty examinees (2.7%) failed the core ECG examination. If examinees had been required to pass both the core ECG examination and the remainder of the examination, 164 examinees (9%) would have changed their pass-fail status on the overall examination. The examination appeared to be a valid test for a minimal level of skill in this area of cardiology. The minimal level of competence was met by a large majority but not all of the examinees. PMID- 3655153 TI - Selective perfusion of ischemic myocardium during coronary venous retroinjection: a study of the causative role of venoarterial and venoventricular pressure gradients. AB - Coronary venous retroinjection is often associated with preferential distribution of flow to ischemic myocardium. The purpose of this study was to define the mechanism of such retrodistribution of flow. In 24 anesthetized open chest dogs, Monastral blue dye (10 ml) was injected by way of a balloon catheter in the distal great cardiac vein as a marker for retrograde flow distribution. The injection rate (0.6 to 2.4 ml/s) was adjusted such that systolic pressure in the anterior interventricular vein ranged between 60 and 85 mm Hg. In 11 dogs with no ischemia and normal myocardial perfusion pressure (96 +/- 8 mm Hg), no myocardial staining occurred despite retrograde filling of epicardial veins. One minute after occlusion of the left anterior descending coronary artery, dye injections caused selective staining of the cyanotic area in 15 of 18 episodes, sparing the normal myocardium within the zone of retroperfused veins. In five dogs, with the arterial pressure less than 55 mm Hg, retroinjection resulted in homogeneous staining of all the myocardium drained by the retroperfused veins. Selective staining of the ischemic myocardium caused by retroinjection was associated with the following pressure gradients: during systole from the anterior interventricular vein to the occluded coronary artery, 31 to 58 mm Hg, and during diastole from the retroperfused veins to the left ventricular chamber, 9 to 28 mm Hg. There was no diastolic venoarterial gradient in the ischemic myocardium. In normal myocardium, retroinjection did not reverse the arteriovenous pressure gradient. In conclusion, retrograde flow is primarily directed to myocardium with low anterograde perfusion pressure. Selective retrograde penetration of acutely ischemic myocardium can thus be achieved by a mechanism consistent with the development of venoarterial and venoventricular pressure gradients. PMID- 3655154 TI - Altered response of reperfused myocardium to repeated coronary occlusion in dogs. AB - It is hypothesized that myocardium subjected to a 5 minute period of coronary occlusion and a 30 minute period of reperfusion has latent abnormalities that become overt when the reperfused myocardium is "challenged" by a subsequent coronary occlusion. This hypothesis is clinically relevant because reperfused myocardium is frequently subjected to recurrent ischemia, as in patients with unstable angina, vasospastic angina or recurrent thrombosis after initial coronary occlusion and thrombolysis. In 19 open chest dogs, the response of regional myocardial function to brief coronary occlusions was studied. Systolic wall thickening and diastolic thinning were measured using a specially developed miniature 5 MHz echocardiographic transducer fixed to the epicardium by suction. All 19 dogs underwent an initial "challenge" coronary occlusion (30 seconds). Thereafter, the control group (n = 8) underwent no intervention for 30 minutes, while the intervention group (n = 11) underwent 5 minutes of coronary occlusion followed by 30 minutes of reperfusion. All dogs were then subjected to a second "challenge" coronary occlusion (30 seconds). In the control group, responses to the second challenge occlusion were the same as to the first occlusion. In the intervention group, regional and global systolic function and myocardial perfusion after the 5 minute coronary occlusion intervention returned to baseline levels, but the response to the second challenge coronary occlusion was significantly different in the intervention group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655156 TI - Calculations of cardiac valve stenosis: restoring an old concept for advanced applications. PMID- 3655155 TI - Diltiazem and progression of myocardial ischemic damage during coronary artery occlusion and reperfusion in porcine hearts. AB - This study was designed to investigate whether a cardioprotective intervention could delay the completion of necrosis so that subsequent reperfusion would be more useful. Thirty-six pigs were randomly allocated to treatment with diltiazem (15 micrograms/kg per min) or saline solution and to a 60 or 120 minute coronary occlusion period followed by reperfusion. The treatment was begun 15 minutes before coronary occlusion and terminated 75 minutes after reperfusion. Twenty four hours after the procedure, the heart was sliced and incubated in triphenyltetrazolium chloride. The infarct area and the maximal transmural area of extension of the infarct were calculated by planimetry. The total number of red blood cells in a transmural section was also counted. In the pigs with a 60 minute coronary occlusion, diltiazem (compared with saline solution) significantly reduced infarct size from 9.7 +/- 1.5% of left ventricular mass to 5.9 +/- 0.6% (p less than 0.05) and the percent transmural extension from 0.72 +/ 0.05 to 0.61 +/- 0.05% (p less than 0.05). Red blood cell extravasation in the infarcted area was reduced from 161,934 +/- 59,905 to 78,525 +/- 46,484 cells/mm3 (p less than 0.05) with diltiazem and the percent transmural extension of the hemorrhagic necrosis from 70 +/- 10 to 36 +/- 15% (p less than 0.05). No such differences were observed in the 120 minute coronary occlusion groups. Mean red blood cell counts and the extent of hemorrhagic necrosis did not correlate with either infarct size or transmural extension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655157 TI - The development of thrombolytic therapy. PMID- 3655158 TI - Guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of diagnostic and therapeutic cardiovascular procedures (subcommittee on coronary angiography). PMID- 3655159 TI - Food habits and nutrient intakes of Nigerian University students in traditional halls of residence. AB - Dietary intake analysis, over 7 days, of 120 randomly selected Nigerian University students aged 17-26 years, disclosed deviations from internationally accepted standards. The students were in residence at the University, where all meals were provided. Food preferences and habits were determined by questionnaire, and nutrient intake was calculated from weighed meals eaten over a 7-day period. Food intake of 95% of the students did not differ from that at home; 73% missed breakfast. The energy intake of the men (14.79 +/- 1.49 MJ/day) was significantly (p less than 0.01) higher than that of women (13.82 +/- 0.68 MJ/day); the differences increased in the older students. The energy ingested exceeded that recommended by the FAO/WHO. Protein intakes was 95.6 +/- 20.69 g/day and 102.2 +/- 10.9 g/day for women and men, respectively, also substantially above the FAO/WHO recommendations. Thiamin and vitamin A intakes were above and riboflavin intake of men and of the 20-26-year-old women was below requirements. The intakes of iron were above, and of calcium were below the FAO recommendation of 0.5 g/day. PMID- 3655160 TI - Permissive role of n-6 polyunsaturated fatty acids on carbohydrate oxidation in human infant skin fibroblasts: one possible mechanism of their intervention on coronary heart disease and diabetes. AB - Many publications indicate the beneficial effect of n-6 polyunsaturated fatty acids (n-6 PUFAs) in the control of coronary heart disease and diabetes, although the mechanism is not clear. Some of our previous results suggest that, in contrast to other lipids, n-6 PUFAs could have a permissive effect on carbohydrate oxidation. To check this hypothesis, we determined pyruvate dehydrogenase (PDH, decarboxylase: EC 1.2.4.1) activity in infant skin fibroblasts (ISF) incubated 6 hours in the presence of 0.25 mM linoleic (LI) or arachidonic (AR) acid, compared to oleic acid (OL) and control ISF incubated without addition of fatty acids. The four groups of cells were preincubated 36 hours either in the presence of fetal bovine serum (FBS), or in the presence of lipoprotein-deprived serum (LPDS). RESULTS: (1) When the ISF were maintained in the medium containing FBS, the two PUFAs had little inhibitory effect on PDH activity, in contrast with the effect of OL. (2) When the ISF were kept in the lipoprotein-deficient medium, PDH activity was low in controls and in the OL cells, but the addition of LI or AR increased the activity. This suggests the role of n-6 PUFAs in enhancing carbohydrate oxidation, under certain conditions. PMID- 3655161 TI - Evaluation of magnesium before and after jejuno-ileal versus gastric bypass surgery for morbid obesity. AB - Jejuno-ileal bypass surgery for morbid obesity can cause metabolic and electrolyte imbalances. Another case of severe, symptomatic magnesium deficiency after jejuno-ileal bypass surgery is described. This complication was not encountered in a prospective evaluation of the magnesium status after gastric restrictive bypass surgery. Significant (p less than 0.005) body weight decrease was not accompanied by any (serum, erythrocyte or urinary) evidence of magnesium loss for 12 months after surgery. PMID- 3655162 TI - Recommendations concerning supplement usage: ADA statement. PMID- 3655163 TI - Assessment of body fatness in childhood obesity: evaluation of laboratory and anthropometric techniques. AB - The identification of obesity as a pathological diagnosis depends on an accurate assessment of body fatness and a correlation of fatness with pathological consequences. Because total body fat varies with body weight, the proportion of body weight that is fat is probably a more reliable indicator of risk. Among obese children and adolescents, several problems have hindered the development of accurate clinical measures of percent body fat and total body fat. First, the use of direct methods to measure body composition is limited by expense and labor. Second, the relationship between anthropometric indexes and body composition in obese children and adolescents has not been intensively studied. Third, sample sizes of normal weight children have been too small to permit the development of diagnostic criteria. Fourth, the triceps skinfold is less reproducible in overweight subjects. Increases in lean body mass in obese adolescents may confound the use of the body mass index as a measure of adiposity. Current laboratory methods for the measurement of body composition include: (1) underwater weighing, (2) 40K counting, (3) isotopic dilution measures, (4) neutron activation, and (5) electrical impedance. This article examines relationships between those methods and anthropometry in the measurement of fatness in children and adolescents, as well as the difficulties in measuring body fatness and the importance of body fat distribution and its relationship to morbidity in children. Current evidence suggests an association of morbidity and upper segment obesity in adults. Corresponding studies in children and adolescents are yet to be carried out. PMID- 3655164 TI - Meat fat madness: conflicting patterns of meat fat consumption and their public health implications. AB - From 1979 to 1985, the University of Arizona's Household Refuse Analysis Project recorded packaging and food debris in household refuse to track the purchase of red meat and the discard of separable fat in sample neighborhoods with different income and age characteristics. From 1979 to 1982, the discard rate of meat fat remained relatively constant; in 1983, the rate of discard of meat fat nearly doubled and has remained stable in all neighborhoods measured. During the same period, the purchase of red meat with separable fat (steaks, roasts, and chops) declined, while the purchase of red meat with hidden, non-separable fat (hamburger, lunch meats, sausage, and bacon) held constant or increased. Thus, two "fat" trends have been identified at the household level: first, the purchase of less red meat with separable fat and the discard of a greater percentage of that fat, and second, the purchase of a greater percentage of red meat with substantial quantities of non-separable fat. Whether these seemingly contradictory choices are being made by a fully informed public is unclear. It is suggested that health promoters need to communicate the fat content of all types of red meat, especially those with hidden fat, more clearly. PMID- 3655165 TI - Food, supplements, and fortified foods: scientific evaluations in regard to toxicology and nutrient bioavailability. AB - Food, supplements, and fortified foods can all be appropriate sources of nutrients. It is the responsibility of nutrition educators to help consumers use those nutrient sources appropriately. Consumers should consider at least six factors when they select foods, supplements, and fortified foods: flavor, convenience, cost, nutrient content, toxic factors, and bioavailability of nutrients. Consumers are often less concerned about the latter two factors than they should be. For example, many case histories have been published on the symptoms caused by overconsumption of vitamins A, B-6, C, and D and nicotinic acid. Generally those toxic symptoms were caused by the ingestion of supplements, not foods. Current widespread use of supplements containing one or two nutrients may not only cause overt toxicity symptoms but also adversely affect the bioavailability of other nutrients. For example, ingestion of excessive amounts of vitamin C appears to interfere with copper metabolism in human subjects; ingestion of high levels of zinc impairs immune function, depresses copper absorption, and induces anemia; consumption of supplemental calcium as calcium phosphate dibasic is associated with renal calcification in rats; and ingestion of supplemental magnesium depresses the apparent absorption of calcium and retention of calcium in bone by rats. PMID- 3655166 TI - Validity of a food frequency questionnaire and a food diary in a short-term recall situation. AB - The purpose of this study was to compare intakes of eight nutrients computed from a food frequency questionnaire (FFQ) and from 3-day food diaries with known values. Total food intake of 19 healthy adult volunteers (10 men and 9 women) was monitored for 2 weeks. Each week, subjects completed a 3-day diary and a 1-week FFQ. Subjects had previously completed one diary and one FFQ with respect to their usual diets. FFQs and diaries were analyzed for calories, protein, fat, cholesterol, calcium, iron, vitamin A, and vitamin C. All nutrients were underestimated by the FFQ (all p less than .05). Subjects omitted foods from the FFQ and incorrectly reported consumption frequencies. Vitamin A (p less than .001) and calories (p less than .05) were underestimated by the food diary. It is concluded that factors such as frequency of eating, pairing of foods, and explicitness of FFQ items affect recall accuracy. Those factors could influence the choice of FFQ design and administration. PMID- 3655167 TI - Role and nature of an interview in the selection of CUP applicants. AB - The purposes of this research were to study the role of an interview in the selection of applicants in coordinated undergraduate programs (CUPs) in dietetics and to ascertain the nature of the interview in those programs in which it was used. A questionnaire sent to all CUP directors asked why they did or did not use an interview, the criteria used to determine which applicants would be interviewed, and the makeup of the interviewing team. Furthermore, the directors were asked to state the types of questions asked most frequently, the rationale for asking those questions, and the procedure used to evaluate applicants' responses. Finally, the directors were asked to rate the level of influence of selected factors that might be used in the decision regarding admission to CUP. The overall response rate was 81%. Results indicated that an interview is used in 80% of the programs. Difficulty in scheduling and in achieving a standardized method of evaluating an interview were the most frequently cited reasons for not using one. Thirty-seven percent of the respondents ranked an interview as high in influencing the decision regarding admission to CUP. In contrast, 90% of the respondents ranked completion of prerequisite courses and 86% ranked overall GPA as highly influential factors. PMID- 3655168 TI - Threat vs. benefit appeals for motivating adults to participate in a weight control class. PMID- 3655169 TI - Validation of the 24-hour dietary recall in preschool children. AB - The results of the current study indicate that data obtained by the dietary recall correlate highly with the children's weighed food intake if a parent or the primary caretaker providing the child's food responds to the interview. Meredith et al. found parents to be poor reporters of children's consumption outside the home. It is encouraging to note that parents can be reliable reporters of their children's food intake in the home environment. When errors did occur, they were errors in portion size, as 96% of foods eaten by the children were correctly identified by the parents. Parents under-reported only 4% of the time. This slight tendency to under-report is consistent with other reports of the validity of the 24-hour dietary recall. In younger children, parents appear to be reliable reporters of their children's in-home dietary intake. As children become older, they appear to be able to recall their own intake both within and outside the home. There are several possible explanations for these findings. First, several factors could have influenced the accuracy of parental reports of the child's intake during the day that we weighed foods. Because food was weighed in the homes, the parents undoubtedly attended more closely to their child's diet. Additionally, the dietary recalls were collected at the end of the day of observation. This was closer in time than most 24-hour recalls and may have reflected less memory decay than usual. Also, since our sample was primarily middle-class families who were well educated, the correspondence between actual vs. reported dietary intake may have been artificially enhanced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655171 TI - Position of the American Dietetic Association: Nutrition services in health maintenance organizations and alternative health care delivery systems. PMID- 3655170 TI - Computer methods in nutrition analysis: report of a prototype undergraduate course for dietetic students. PMID- 3655172 TI - The backbone of our profession. PMID- 3655173 TI - Acute transmural myocardial infarction in elderly patients hospitalized in the coronary care unit versus the general medical ward. AB - The hospital records of 126 patients over 75 years of age with transmural myocardial infarction initially treated in the coronary care unit were compared with a concurrent similar group of 94 patients admitted directly to the general medical wards. The in-hospital mortality rate for both groups together was 40%. The mortality rate within the coronary care unit was 24% as compared with 46% in the ward group (P less than 0.005). However, the mortality rate for the coronary care unit group as a whole (including those patients later transferred to the general ward) was 35 versus 46% in the ward group. Congestive heart failure and cardiogenic shock were the most frequent complications in both groups (47 and 30%, respectively), and they were the main cause of death. Patients with these complications were less likely to be successfully resuscitated, even in the coronary care unit. The overall incidence of serious ventricular arrhythmias and complete heart block was similar to that reported for younger patients. Eleven patients in the coronary care unit group were successfully resuscitated from these arrhythmias and eight survived to be discharged from hospital. In contrast, only two patients in the ward group were successfully resuscitated and eight (9%) patients died suddenly and the fatal event could not be diagnosed. We concluded that elderly patients with an acute myocardial infarction can benefit from early admission to a coronary care unit. PMID- 3655174 TI - Epidemiology of depression and dysphoria in an elderly Hispanic population. Prevalence and correlates. AB - Depression among older minority groups, including Hispanics, has not been well studied. Little is known of the true rates of depression, it correlates or how well it is treated. This research is part of a series examining health status of older Hispanics using the Comprehensive Assessment and Referral Evaluation (CARE). Seven hundred older Hispanics living in Los Angeles County were studied using an area-probability sampling method. The CARE items were regrouped to reflect Diagnostic and Statistical Manual III criteria for depression and dysphoria. More than 26% were found to have a major depression or dysphoria. These affective disorders were strongly correlated with physical health status. Without physical health complications, the rate was 5.5%. A number of socioeconomic, health behavior, and family variables were related to affective state. Treatment for affective disorder appeared to be very poor for this population. PMID- 3655175 TI - Major depression with melancholia: a comparison of middle-aged and elderly adults. AB - Patients admitted to an inpatient psychiatric service were screened to identify middle-aged (35 to 50 years of age) and elderly (60 years of age and over) patients suffering from a major depressive episode with melancholia. Thirty-seven subjects (18 middle-aged and 19 elderly) were identified. Criteria symptoms for depression and symptoms specifically associated with melancholic or endogenous depression did not differ across age groups, with few exceptions. Major depression with melancholia in this hospitalized population was symptomatically similar in the middle-aged and elderly. The syndrome is therefore relatively common on this inpatient service and should be easily recognized. PMID- 3655176 TI - Urinary incontinence in elderly women: clinical findings. AB - Two-hundred women self-described as having urinary incontinence, aged 55 to 90 years and living in the community completed a comprehensive history and physical examination. Initial presentation of urine loss was most commonly stress incontinence symptoms (35%). Scoring of peak response to volume lost and frequency revealed urine loss necessitating a clothing change for 78% and daily loss experienced by 73%. Over half had experienced a urine loss problem for more than five years. Most (65%) had sought treatment, but a minority reported current (11%) or previous (36%) treatment. Thirty-six percent were found to have severe atrophic vaginitis with severe urethocele (10%), cystocele (13%), rectocele (12%) less common. Pelvic floor strength by clinical scoring was weak (mean, 1.05 on a 5-point scale). The vaginal electromyograph first contraction peak mean was 5.94 microvolts sustained at 50% or better for 3.92 seconds. Clinical criteria established that 66% had stress, 27% a mixture of stress and urge, only 4% pure urge incontinence, and 4% other. PMID- 3655177 TI - Urinary incontinence in elderly women: urodynamic evaluation. AB - The objective of this study is to characterize urinary incontinence observed in elderly women and to assess the importance of various parameters used to evaluate urinary incontinence. Two hundred consecutive, ambulatory, outpatient, incontinent women 55 years of age and over who were seen at the Continence Program Clinic and completed a medical and urodynamic protocol are included in this paper. After a thorough medical history and a complete physical examination, urodynamic tests were performed. The urodynamic results showed that 77% of incontinent women had an incompetent urethra. Twenty-five percent had a hyperactive bladder, 8% had "other" types, and 7% had a normal study. Comparison of the clinical diagnosis with the actual urodynamic diagnosis for stress incontinence revealed a 78% accuracy and only a 6% false negative. In contrast, a similar comparison for urge incontinence found only 44% accurate and 45% false negative. Analysis of the urodynamic tests revealed that the simple provocative full-bladder stress test was as effective as the radiographic or electronic pressure measurement in detecting incompetent urethra producing stress urinary incontinence. Provocative upright cystometry was helpful in uncovering 33% of hyperactive bladders not provoked in the supine position. Complex urodynamic tests should be reserved for unexplained incontinence or when symptomatology is complex. PMID- 3655178 TI - Falls and ill-fitting clothing. PMID- 3655179 TI - A case for geriatric dentistry in the curriculum. PMID- 3655180 TI - Age at onset and rate of Alzheimer's disease. PMID- 3655181 TI - Tracing of afferent pathways from the femoral-saphenous vein to the dorsal root ganglia using transport of horseradish peroxidase. AB - The retrograde transport of horseradish peroxidase (HRP) was used to trace afferents from the femoral-saphenous vein to the dorsal root ganglia in the cat. Afferents arising along the entire length of the vein projected to very localized spinal levels; 63% of the labeled cells counted were located in the L6 dorsal root ganglion, 37% were located in the L5 ganglion and less than 1% were located at other levels. Most of the cell bodies labeled by the application of HRP to the femoral-saphenous vein were small in size (diameter less than 35 microns). However, some large cell bodies (diameter greater than 50 microns) were also noted. It was estimated that over two-thirds of the femoral-saphenous venous afferents were C fibers; at least 15% were estimated to be A fibers. The largest venous afferents were predicted to conduct action potentials at approximately 60 m/s. PMID- 3655182 TI - Vagal postganglionic innervation of the canine sinoatrial node. AB - Differential, selective distribution of parasympathetic, postganglionic innervation to the atrioventricular nodal (AVN) region of the canine heart was recently described. Ablation of parasympathetic pathways to the AVN by disruption of the epicardial fat pad at the junction of the inferior vena cava and inferior left atrium did not interfere with normal vagal control of the sinoatrial node (SAN) function. In sharp contrast, surgical dissection of the fat pad overlying the right pulmonary vein-left atrial junction interrupted the major right and left vagal inputs to the SAN region. The pulmonary vein fat pad (PVFP) in the dog heart is triangular in shape with roughly equilateral dimensions of approximately 1 cm, its base extending from superior to inferior veins, and its apex extending nearly to the sinus nodal artery as it courses rostrally in the sulcus terminalis. Careful dissection of smaller fat pads around the circumference of the pulmonary veins and particularly over the rostral-dorsal surfaces of the right superior pulmonary vein and adjacent right atrium, completed SAN parasympathetic denervation. Care in making these dissections left the vagal supply to the AVN region essentially intact, and preserved the sympathetic supplies to both SAN and AVN regions. Autonomic ganglia, varying in size from 1 or 2 cells to 80-100 cells, were found scattered throughout the ventral PVFP (overlying and surrounding the right pulmonary vein-left atrial junction). The ganglia were generally imbedded in fatty connective tissue, although they commonly rested very close to, or were loosely surrounded by epicardial muscle. Ganglia were also found in smaller fat pads on the dorsal surfaces of the atrium between the azygos and the right superior pulmonary vein. PMID- 3655183 TI - Effect of pentobarbital anesthesia on renal sympathetic nerve activity in the rabbit. AB - The effects of pentobarbital (PB) anesthesia on arterial pressure, heart rate, and renal nerve activity (RNA) were studied in chronically instrumented intact rabbits and rabbits with sinoaortic baroreceptor denervation (SAD). In intact rabbits, PB caused an initial decrease in mean arterial pressure from 82 +/- 2 to 42 +/- 5 mm Hg, which then returned to the control level within 5 min. RNA increased by 144 +/- 19% in response to hypotension induced by PB then also returned to the control level within 5 min. Heart rate increased by 56 +/- 10 from 244 +/- 11 beats/min and remained elevated for 60 min. Sensitivities of baroreflex control of heart rate and RNA were markedly impaired by PB anesthesia. In SAD rabbits, PB caused hypotension (-46 +/- 5 mm Hg), which lasted for 15 min. RNA decreased initially by 80 +/- 5%, then gradually returned toward the control level. However, at 45 min after injection of PB, RNA was still depressed significantly. Tachycardia induced by PB was abolished by SAD, i.e. heart rate actually decreased by 53 +/- 10 beats/min. These results suggest that in intact rabbits steady-state effects of PB were: no change in mean arterial pressure or RNA, and tachycardia, all due to baroreflex compensation. However, in the absence of baroreflex compensation, PB elicited hypotension, bradycardia, and a decrease in RNA. PMID- 3655185 TI - Herbicide levels in rivers draining two prairie agricultural watersheds (1984). AB - A monitoring survey was conducted during 1984 on the Ochre and Turtle Rivers, which flow into Dauphin Lake in western Manitoba, Canada, to determine levels of the herbicides MCPA, diclofop-methyl, dicamba, bromoxynil, 2,4-D, triallate and trifluralin which were widely used in each watershed. Triallate concentrations exceeded 4 ng/L in 50% and 10% of the 21 samples taken from each of the Turtle and Ochre River, respectively, during the period March to October 1984. Trifluralin concentrations exceeded 3 ng/L in 14% and 10% of the samples from the respective rivers. Maximum concentrations did not exceed 25 ng/L and were unrelated to changes in river flow. Bromoxynil and diclofop were detected in the Turtle River, at concentrations of 113 and 476 ng/L, respectively, following a major high water event in late June, but were undetectable (less than 2 and 12 ng/L, respectively) at other sampling times. Dicamba and 2,4-D were detectable throughout most of the sampling period in both rivers at low levels (less than 100 ng/L). High levels of dicamba and 2,4-D (5476 and 2568 ng/L respectively) were found in water from the Turtle River prior to the high water event event possibly caused by spraying of ditches or rights-of-way near the river. Discharges (grams/year) of all seven herbicides monitored in the study represented less than 0.1% of the amounts estimated to be used in each watershed. Unit loadings (mg/ha/year) of 2,4-D and dicamba were similar to those reported for Southern Ontario streams in the mid-1970's. The results indicate that herbicide contamination of Manitoba streams draining agricultural areas is generally low except when major runoff occurs during the application period in May and June. PMID- 3655184 TI - Effect of 60-minute head-down tilt on arterial baroreflex function in anesthetized dogs. AB - Arterial baroreflex control of heart rate was assessed in 6 anesthetized dogs with a bolus infusion of phenylephrine before and during cardiopulmonary receptor stimulation by 6 degrees head-down tilt (HDT) for 60 min. No difference in arterial baroreflex function was observed between the control and HDT conditions. It appears that the attenuation of baroreflex function that occurs during acute stimulation of cardiopulmonary baroreceptors disappears when cardiopulmonary baroreceptors reset after prolonged stimulation. PMID- 3655186 TI - Degradation of [14C]isofenphos in soil in the laboratory under different soil pH's, temperatures, and moistures. AB - The effects of three soil pH's, three soil temperatures, and three soil moistures on [14C]isofenphos degradation were investigated. All three factors interacted strongly and significantly affected the persistence of isofenphos as well as the formation of the degradation products (p less than 1%). Isofenphos degradation was greatest at the higher temperatures 35 degrees C greater than 25 degrees C greater than 15 degrees C (except under alkaline pH's), medium moisture 25% greater than 30% greater than 15%, and in both alkaline (pH = 8) and acidic soils (pH = 6) compared with neutral soil (pH = 7). Isofenphos oxon formation was greatest at higher temperatures 35 degrees C compared with 25 degrees C and 15 degrees C, in acidic soil greater than neutral soil greater than alkaline soil, and under high moisture (30%) compared with the 15% and 22.5% moistures. The formation of soil-bound residues was greatest at higher temperatures 35 degrees C greater than 25 degrees C greater than 15 degrees C, higher moisture 30% compared with 15% and 22.5%, and in alkaline soil compared with neutral and acidic soils. PMID- 3655187 TI - Pentachlorotoluene and pentabromotoluene: results of a subacute and a subchronic toxicity study in the rat. AB - Pentachlorotoluene (PCT) and pentabromotoluene (PBT) are environmental contaminants detected in the Great Lakes ecosystem. In view of the paucity of toxicity data and the potential for human exposure, a subacute (28 day) and a subchronic (91 day) study were conducted in the rat. In the subacute study, groups of 10 male and 10 female rats were fed the diet containing PCT or PBT at 0, 0.5, 5.0, 50 or 500 ppm for 28-days. In the subchronic study, the group size was increased to 15, the dose levels were 0, 0.05, 0.5, 5.0, 50 and 500 ppm in the diet and the exposure period was 91 days. Growth rate and food consumption were not affected by exposure to either chemical in the subacute and subchronic study. Clinical observations revealed no abnormalities. Decreased hemoglobin was observed in female rats fed 5.0 ppm PCT and higher levels in the subacute (28 day) study. In the same study the hematocrit value and erythrocyte numbers of females fed 5.0 or 500 ppm PCT diets were significantly lower than the control. In both subacute and subchronic studies mild dose-dependent histopathological changes were observed in the thyroid, liver and kidney of rats fed PCT and PBT diets. In general male rats were more susceptible than females to the treatment of PCT and PBT. Based on these data, it was concluded that the no observable adverse effect level for PCT was 50 ppm in the diet (3.5 mg/kg b.w./day) and that of PBT was 5.0 ppm (0.35 mg/kg b.w./day). PMID- 3655188 TI - Influence of adjuvants on physicochemical properties, droplet size spectra and deposit patterns: relevance in pesticide applications. AB - The influence of adjuvants on physicochemical properties, droplet size spectra and deposit patterns of five aqueous spray mixtures was studied under laboratory conditions, using two surfactants, Atlox 3409F and Triton X-114; two humectants, propylene glycol and glycerol; and one polymeric adjuvant, Agrisol FL-100F. For the sake of comparison, two fenitrothion formulations containing polymeric adjuvants, and water were also included in the study. Spray was applied at 25 degrees C and 75 +/- 5% relative humidity, in an enclosure using a twin fluid atomizer. Deposits were collected on Kromekote card/glass plate units. Physicochemical properties studied were: relative viscosity, surface tension, apparent viscosity-shear rate relationship, volatility, pH and conductance. The first four of these properties played significant roles on the droplet and deposit patterns on sampling units. However, the chemical nature of the adjuvants also played some role. Between the two surfactants tested, Triton X-114 provided a pseudoplastic medium, but both surfactant solutions provided similar droplet size spectra and deposit patterns. Between the two humectants, glycerol proved to be more advantageous than propylene glycol. The polymeric adjuvant provided droplet sizes similar to those of the two surfactants, although the recovery of the applied spray volume was higher. Among the two fenitrothion formulations, the one containing lower amounts of polymeric adjuvants showed some advantages, although deposits on the actual biological target should be examined before any definite conclusions can be drawn on the optimum adjuvant concentrations in end use formulations. PMID- 3655189 TI - The effects of various soil factors and amendments on the degradation of pesticide mixtures. AB - Soil disposal is the most common method of handling dilute pesticide wastes. The effects of several soil factors on the degradation of a pesticide mixture were investigated. Atrazine, captan, carbaryl, 2,4-D, diazinon, fenitrothion, and trifluralin were studied under varying laboratory conditions of soil type, pH, moisture content, organic matter content, microbial activity, and pesticide concentration. Of the variables investigated, pesticide concentration was the single most important factor with degradation rates much slower at high (1000 ppm) levels of fortification than moderate (100 ppm) levels. Under most conditions, chemical degradation was at least as significant as microbial degradation. Effects of other factors varied considerably and were pesticide dependent. PMID- 3655190 TI - Tissue distribution and elimination of trichlorobenzenes in the rat. AB - The tissue distribution and excretion of three trichlorobenzene isomers (TCB) were investigated in the rat. Single doses of TCBs were administered orally to groups of 5 fasted rats at 10 mg/kg body weight. Serial sacrifices were carried out and the radioactivity contents were determined in tissues and blood. For all three TCB isomers, radioactivity appeared in the blood and tissues at 0.5 h, and peaked around 2-4 h after dosing. Fat, skin, and liver had high concentrations of the parent compound while kidney and muscle had high levels of metabolites. Elimination of TCB from tissues and blood can best be described by a two compartmental open pharmacokinetic model. The terminal half-lives were 145, 93 and 68 h for 1,2,3-, 1,2,4 and 1,3,5-TCB isomer respectively. Ninety-five percent of the administered 1,2,3- and 89% of the 1,3,5-isomers were eliminated within 48 h in the urine and feces with the former being the major route. PMID- 3655191 TI - One third of all skeletal injuries in children affect the growth plate. PMID- 3655192 TI - Mitchell bunionectomy: an analysis of four hundred and thirty personal cases plus a review of the literature. AB - An analysis of 430 personal cases of Mitchell bunionectomy (517 feet) shows that there were 28 (6.5%) male patients and 402 (93.5%) female patients whose age ranged from 14 to 91 years with an average age of 48.5 years and follow-up periods ranging from 6 months to 14 years and 4 months. One hundred thirty-two (30.7%) second hammer toe operations accompanied these Mitchell bunionectomies, and all 430 patients had their second metatarsals longer than their corresponding first metatarsals by an average of 9.3 mm. The author employed a biplane plantar angulation and closing wedge valgus osteotomy of the first metatarsal neck that reduced the first metatarsophalangeal angle from an average of 30 to 13.8 degrees, and the first intermetatarsal angle from an average of 14.7 to 6.1 degrees, with an average first metatarsal shortening of 4.9 mm. The average lateral displacement of the first metatarsal head was 6.5 mm., and three cases of medial angulation and 13 cases of dorsal displacement of the first metatarsal head were encountered. By personally examining 100 randomly selected post Mitchell bunionectomy patients, the author found that 85% of them had good to excellent results, and 15% had fair to poor results. Avascular necrosis, nonunion, or osteomyelitis of the first metatarsal was not found in this series. A reasonably short first metatarsal and senior citizens with adequate pedal circulation and healthy first metatarsophalangeal joints were fairly good candidates for Mitchell bunionectomy, and early, full weight bearing in a postbunionectomy toe spica walking cast appeared to be quite desirable. However, painful arthrosis of the first metatarsophalangeal joint, a very short first metatarsal, a very wide first intermetatarsal angle, and dysvascular and diabetic feet are poor candidates for Mitchell bunionectomy. PMID- 3655193 TI - Keloids and hypertrophic scars in the foot. AB - The occurrence of keloids in the foot is rare but should always be a surgical consideration for those individuals who may be predisposed to this pathology. Failure to recognize the potential for keloids or hypertrophic scar development may result in a severe deformity that is functionally, cosmetically, and emotionally undesirable. PMID- 3655194 TI - Sesamoid pain secondary to a plantar neuroma. AB - Two cases are presented in which the necessity of a plantar incision for removal of a fibular sesamoid led to the incidental finding of an undiagnosed plantar neuroma and bursal sac. The first case presented a hypertrophic fibular sesamoid fused to the plantar aspect of the first metatarsal head. The second case presented a dystrophic fibular sesamoid consistent with a healing fracture or avascular necrosis. Plantar neuromas are a known cause of pain in the forefoot. The authors review the literature concerning plantar neuromas and provide a discussion of their etiology, clinical findings, and surgical treatment. Attention is directed to the use of a plantar incision as a viable alternative to the dorsal approach for excision of a fibular sesamoid and associated soft tissue masses. PMID- 3655195 TI - Monostotic fibrous dysplasia of the foot. AB - Fibrous dysplasia is a benign, nonfamilial disorder of the skeleton, characterized by expanding fibroosseous lesions occupying single or multiple bones with possible extraskeletal anomalies. Fibrous dysplasia begins in childhood and is not usually recognized until adolescence or adulthood. When fibrous dysplasia affects the foot, it is often the expression of the polystotic form of the disease. This paper will review the pathology of the disease and monostotic involvement of the first metatarsal. PMID- 3655196 TI - Metatarsus adductus and hallux abducto valgus: their correlation. AB - Metatarsus adductus has long been suspected to contribute to hallux abducto valgus. This paper gives statistical evidence on the relationship between metatarsus adductus and hallux abducto valgus in an attempt to support this long held belief. PMID- 3655197 TI - Malignant vascular tumor of the hallux. AB - A rare case of a malignant hemangioma of the great toe is reported. The etiology, incidence, clinical presentation, differential diagnosis, and pathology of an hemangioendothelioma is presented. The basis for surgical treatment and medical management to rule out metastases was discussed. Amputation remains the treatment of choice for hemangioendothelioma. PMID- 3655198 TI - Long-term follow-up of internal threaded Kirschner-wire fixation of the scarf bunionectomy. AB - The authors discuss the scarf ("Z") bunionectomy and report on results of their review of 230 procedures fixated with internal threaded Kirschner (K)-wires, at least 1 year in duration. PMID- 3655199 TI - Fibrous dysplasia: a case report and literature review. AB - The unusual case of fibrous dysplasia located in the distal phalanx of the hallux is presented with a review of literature. Fibrous dysplasia is a benign disorder that can affect one or many bones in any particular case. The bone involvement is characterized by the presence of fibro-osseous tissue within the interior of the affected bone. Pathologic, clinical, and radiographic findings will be discussed. PMID- 3655200 TI - Dwyer osteotomy: a retrospective study. AB - The authors present a retrospective study of 29 Dwyer osteotomies performed at Kern Hospital by the senior surgeon and resident assistants between 1975 and 1984. All operative procedures studied were supervised by one surgeon in order to demonstrate consistency in preoperative evaluation, surgical technique, and postoperative care. Subjective questionnaires were sent to each patient and the results analyzed. Additionally, an objective analysis of hospital and office records and a critical outcome assessment was undertaken. Results demonstrated significant improvement in the weight-bearing alignment of the involved foot, additional stability to the ankle, and improved rearfoot function. PMID- 3655201 TI - Use of a closed drainage system in implant surgery. AB - The authors advocate intracapsular placement of a closed drainage system in first metatarsophalangeal joint implant procedures. Materials and technique are reviewed. The advantages and disadvantages associated with drain usage are discussed. Preliminary results of a retrospective study are also presented. PMID- 3655202 TI - Diaphyseal lengthening for brachymetatarsia. AB - The authors present a case report of brachymetatarsia. The literature is reviewed, various surgical treatments are discussed, and the preferred surgical procedure that relieved symptoms and achieved cosmetic approval is described. PMID- 3655203 TI - Magnetic resonance imaging of podiatric disorders: a pictorial essay. AB - Cross-sectional imaging techniques, including computed tomography and magnetic resonance imaging, have become increasingly important in the evaluation of a variety of podiatric disorders. Illustrative cases are used to emphasize the relative merits of the two methods. Generally, magnetic resonance imaging is superior for soft tissue and bone marrow disease, whereas computed tomography affords optional depiction of cortical bone abnormalities. PMID- 3655204 TI - Magnetic resonance imaging of the foot: technical aspects. AB - The technical considerations relevant to magnetic resonance imaging of the foot are discussed. Case presentations underscore the importance of multiple image weighting for optimal identification and characterization of soft tissue pathology. PMID- 3655205 TI - Multiple sclerosis and autoimmunity. PMID- 3655206 TI - Clinical significance of childhood communication disorders: perspectives from a longitudinal study. AB - A group of 202 children who were referred for evaluation of communication disorders were also evaluated for psychiatric and learning disorders at two points in time. High rates of both psychiatric and learning disorders were found at initial evaluation, and even higher rates were found at follow-up 3 to 4 years later. Recovery from communication disorder occurred in approximately one fourth of the cases and varied widely depending on the type of disorder involved. Poor psychiatric outcome could be predicted by the presence and severity of initial disorders of language comprehension and expression, and by certain environmental factors (such as psychosocial stress). The high prevalence of linguistic, psychiatric, and development disorders at follow-up for the children in this study suggests the need for close monitoring of children with early communication impairments. PMID- 3655207 TI - Brain stem auditory evoked potentials as a tool in the clinical assessment of children with posterior fossa tumors. AB - The use of brain stem auditory evoked potentials (BAEP) as a diagnostic modality in children with posterior fossa neoplasms is described. Thirty-one patients were examined; their diagnoses were medulloblastoma (12), brain stem glioma (9), cerebellar astrocytoma (6), and ependymoma (4). Distinct differences in the type and severity of waveform abnormalities were observed among the different tumor types, possibly related to location and invasiveness. Medulloblastomas frequently demonstrate normal waveforms, while brain stem gliomas demonstrate severe disruption of BAEP patterns. Ependymomas may result in a variety of abnormal studies, while cerebellar astrocytomas induce mild abnormalities or result in a normal exam. The use of brain stem auditory evoked potentials in the diagnosis of pediatric brain tumors, as well as the underlying mechanisms of the abnormalities, is discussed. PMID- 3655208 TI - Congenital granuloprival hypoplasia of cerebellar and hippocampal cortex. AB - Two siblings with congenital granule cell hypoplasia of the cerebellum and hippocampus are reported. The patients, both male, showed severe psychomotor retardation, microcephaly, hypotonia, athetosis, and seizures; they died at the ages of 3 7/12 years and 5 10/12 years, respectively. Postmortem examinations in both cases revealed nearly complete absence of the granule cells of the cerebellum with relative preservation of the Purkinje cells. Also absent were the granule cells of the fascia dentata of the Ammon's horns of the hippocampus, without any detectable gliosis; this has not previously been reported. Twenty three autopsy cases of granuloprival cerebellar hypoplasia are reviewed. The present cases illustrate a singularly unique disease process, comparable to the classical cerebellar hypoplasia experimentally induced by parvoviruses, and suggest a granule cell specific insult to the brain during the late second trimester. PMID- 3655209 TI - Prognostic significance of the electrically elicited blink reflex in neonates. AB - The electrically elicited blink reflex was examined in ten normal neonates, 11 postasphyxial neonates, and 3 congenital hydrocephalus cases. The blink reflex was elicited in all cases. In normal neonates, the latencies and amplitudes were 10.9 +/- 0.7 msec and 159 +/- 62 microV at R1, 34.3 +/- 1.4 msec and 123 +/- 30 microV at R2, and 40.7 +/- 2.3 msec and 84 +/- 25 microV at R'2 respectively. Ischemic-hypoxic brain damage during the neonatal period mainly influenced the late components of the blink reflex. The blink reflex of the postasphyxial neonates showed significantly prolonged latencies of R2 and R'2. The amplitudes were increased in cases with a fair prognosis and decreased in cases with a poor prognosis. A case of congenital hydrocephalus with mental retardation also showed the prolonged latencies of R2 and R'2 in neonatal period. The blink reflex in neonates appears to be useful in predicting the outcome in cases of neonatal asphyxia and congenital hydrocephalus. PMID- 3655210 TI - Patterns of cerebral arterial injury in children with neurological disabilities. AB - We reviewed the data from 215 consecutively imaged children who were referred because of neurologic disease. We specifically looked for evidence of cerebral arterial infarction in the form of focal brain damage in an arterial vascular distribution. Twenty-eight showed an arterial infarction pattern. All the major cerebral arteries were involved: middle cerebral artery, 17/28; posterior cerebral artery, 7/28; anterior cerebral artery, 2/28; carotid, 2/28; and vertebro-basilar, 1/28. Six of the 28 subjects had disorders reported to be associated with cerebrovascular damage. Another 13 subjects had other associated disorders, including perinatal distress and presumed anoxia, closed head trauma, hydrocephalus, and dehydration with electrolyte imbalance. Despite a careful search of medical records, we were unable to find any evidence of an adverse event or associated illness for more than one third of the children. These data suggest that cerebral arterial infarction is a more common lesion in the static neurologic disabilities of childhood than previously thought. PMID- 3655211 TI - Comparative appraisal of CT scan and MRI in the diagnosis of Leigh encephalomyelopathy in two siblings. PMID- 3655212 TI - Public policy and the elderly. PMID- 3655213 TI - The implication of demographic trends as they affect the elderly. PMID- 3655214 TI - Filial care of the elderly and changing roles of women (and men). PMID- 3655215 TI - Becoming and being a widow: reconstruction of the self and support systems. PMID- 3655216 TI - Transference and countertransference issues in treatments involving older patients and younger therapists. AB - In this paper, I have described certain transference fantasies found in treatments involving older patients and younger therapists. These include the defense against the loss of objects, the resurrection in fantasy of prior lost objects, the bolstering of one's sense of oneself as phallic and masculine or as more acceptably feminine, and the fantasy of oneself as being younger and not likely to be nearing death. For individuals with a significant degree of envy of those younger than they are, the wish to steal the therapist's youth or to emasculate his therapeutic efficacy may lead to a need to defeat the therapy. The use of the analysis of dreams and fantasies as a means of monitoring countertransference feelings is of particular importance for the younger therapist working with the older patient, who may mobilize unresolved feelings toward both parental figures and the former analyst of the therapist. PMID- 3655217 TI - Life-event types and attributional styles as predictors of depression in elderly women. PMID- 3655218 TI - Cardiorespiratory responses to graded reductions of uterine blood flow in the sheep fetus. AB - Pregnant sheep were chronically instrumented with fetal and maternal catheters and an inflatable occluder and electromagnetic flow transducer were placed on the uterine artery. Uterine blood flow was reduced for approximately 15 minutes to 25 percent, 50 percent, or 75 percent of control uterine blood flow. Fetal blood gases, arterial blood pressure, heart rate and regional distribution of blood flow (by radioactive microspheres) were measured. With progressive reduction of uterine blood flow there was an increasing degree of fetal asphyxia, as measured by blood gases and acid base state. At moderate degrees of asphyxia the fetus responded by redistribution of blood flow to certain organs, namely heart, brain, and adrenal gland, thus preserving oxygenation of these organs. During the most severe degree of asphyxia induced by reduction of uterine blood flow to 25 percent of control there is a reduction of fetal blood flow due to generalized vasoconstriction of essentially all organs. We hypothesize that this is due to the inability of the vasodilator mechanisms to sufficiently oppose the vasoconstrictor mechanisms. Also, because the oxygen consumption of the "vital" organs would be decreased this can be described as the stage of decompensation. PMID- 3655219 TI - Fetal sympathetic activity, transcutaneous PO2, and skin blood flow during repeated asphyxia in sheep. AB - To improve detection of fetal distress, we examined whether increased fetal sympathetic activity during repeated episodes of asphyxia decreases skin blood flow, which can be monitored by recording transcutaneous PO2. Sympathetic activity was assessed by relating catecholamine concentrations in the fetal plasma to blood gas, acid-base, and heart rate variables which are commonly used to determine fetal distress. Fifteen experiments were conducted on 8 anaesthetised fetal sheep in utero between 125 and 145 days of gestation (term is at 147 days). They were subjected to 11 consecutive episodes of asphyxia of 30 (n = 3), 60 (n = 9), or 90 (n = 3) s over 33 min, achieved by arrest of uterine blood flow. Blood samples were drawn at 0, 33, and 60 min to determine arterial blood gases, acid base-balance, and concentrations of lactate, glucose, norepinephrine, and epinephrine. Fetal transcutaneous PO2, relative local skin blood flow, heart rate, arterial blood pressure, and arterial O2 saturation were recorded continuously. Fetal plasma concentrations of norepinephrine and epinephrine increased logarithmically as the duration of repeated asphyxia, anaerobic metabolism, and glucose concentrations increased, and as the mean O2 saturation, transcutaneous PO2, and local skin blood flow decreased. We conclude that during repeated episodes of asphyxia in fetal sheep near term, a significant increase in sympathetic activity can be detected indirectly by transcutaneous PO2 monitoring, because sympathetic activation reduces skin blood flow. PMID- 3655220 TI - Cardiovascular, metabolic and endocrine effects of chemical sympathectomy and of adrenal demedullation in fetal sheep. AB - A procedure in fetal sheep for causing peripheral sympathectomy by regular intravascular guanethidine sulphate administration and for causing adrenal demedullation by intragland injection of acid formalin is reported. Demedullation substantially removed adrenaline from the fetal circulation, but has a small effect only on noradrenaline. Plasma noradrenaline levels were depressed by 50% when demedullated fetuses were also subject to peripheral sympathectomy by guanethidine sulphate treatment. This provides some evidence that the paraganglia in the sheep fetus contributes to resting plasma catecholamines. Furthermore the ability of adrenal demedullation to increase markedly this pool of extra-adrenal chromaffin tissue indicates that in the fetus adrenal activity regulates the growth of these para-aortic bodies. In response to sympathectomy plasma vasopressin concentrations rose substantially, whilst adrenal demedullation caused a small rise. Demedullation and sympathectomy depressed fetal plasma glucose and elevated plasma cortisol. In both sympathectomised and adrenal demedullated fetuses resting heart rate and blood pressure was not depressed. However in those with a depleted peripheral nervous system periods of cardiovascular instability were apparent after 2-3 days of treatment with guanethidine sulphate. Hence there were regular episodes where fetal blood pressure and heart rate fell sharply followed 60-90s later by very large increases in blood pressure sustained for up to 10 min and associated with substantial production of plasma vasopressin and catecholamines. These results show that fine cardiovascular control in the fetus requires an intact sympathetic system as the endocrine system is too slow responding to effectively maintain reflex vascular control. PMID- 3655221 TI - Metabolism of glucose by fetus and placenta of sheep. The effects of normal fluctuations in uterine blood flow. AB - The metabolism by the fetus and placenta of [2-3H, U-14C]glucose infused into fetal sheep has been studied. Uptake of glucose from the fetus by the placenta and transfer to the ewe, as well as placental metabolism of glucose to fructose and lactate have been quantified. About two-thirds of the glucose removed from the fetal circulation was taken up by placenta. Less than 15% of this passed back into the maternal circulation, the remainder was converted, at roughly equivalent rates, into lactate and fructose, most of which was transferred back to the fetus. It seems likely that little of this glucose is oxidised by the placenta. This data indicates that there are substrate cycles between the placenta and fetus, one possible function of which is to limit fetal glucose loss back to the mother; lactate and fructose have limited placental permeability. At uterine blood flow rates in the middle of the normal range net glucose uptake by the placenta from the maternal circulation was about 7-fold higher than that from the fetus. About 20% of this was transported to the fetus, 50% was oxidised and much of the remainder converted to lactate and transferred back to the ewe. Labelling patterns in fructose and lactate make it unlikely that this placental pool of glucose mixes freely with that derived from uptake from the fetus. Net movement of glucose across the placenta is markedly influenced by fluctuations in uterine blood flow over the normal range of 500-3000 ml/min. At low flow rates there is net output of glucose from the fetus to the placenta, and in some instances from the placenta to the ewe, i.e. there is evidence of net utero-placental production of glucose to the ewe separate from output by the fetus. There is a close linear relationship between uterine glucose supply (maternal arterial concentration x uterine blood flow) and net balance across the placenta. As uterine supply of glucose falls there is increased uptake by the placenta of glucose from the fetal circulation and corresponding enhanced recycling of fructose and lactate to the fetus. This production of fructose and lactate by the placenta may function to reduce glucose loss from the fetus to the ewe. Hence at high rates of placental uptake of glucose from the fetus placental production of lactate and particularly fructose may approach saturation and allow significant backflow of glucose from the fetus to the ewe. Under these conditions glucose uptake may in part sustain placental oxygen consumption. PMID- 3655222 TI - Dupuytren's contracture and occupation. PMID- 3655223 TI - Vascularized free radius transfer for clavicle reconstruction concurrent with below elbow amputation. AB - In the course of a below elbow amputation, forearm composite tissue that would routinely be discarded was used as a microvascular free-tissue transfer for distant reconstruction. The principle of "spare part" microsurgical reconstruction should routinely be considered during the planning of an ablative operation. PMID- 3655224 TI - A reliable technique of free vascularized sural nerve grafting and preliminary results of clinical applications. AB - A technique of harvesting a free vascularized sural nerve graft based on either the cutaneous branch of the peroneal artery or the muscular perforating branch of the posterior tibial artery is described. Anatomic dissections with dye injection studies confirmed the reliability of this blood supply to a 25 cm long segment of the sural nerve. The sural nerve can be sectioned into as many as four segments while safely maintaining each segment's vascularity through intact fascia. A skin monitor can be elevated with the nerve to monitor vascular patency. The free vascularized sural nerve was used to reconstruct 16 nerve defects in the upper extremity. All 13 skin monitors elevated have survived. Early follow-up (range, 2 to 31 months) has shown encouraging clinical recovery. Although our preliminary results are difficult to compare with other series, this technique appears promising in clinical circumstances when interfascicular nerve grafting is indicated but the recipient bed is heavily scarred and poorly vascularized. PMID- 3655225 TI - Reliability of two-point discrimination measurements. AB - Both moving and static two-point discrimination are valid measurements of functional sensibility in the hand. The present study investigated the interobserver variability of these measurements when two observers used the same testing instrument and the same definition of the testing procedure's end point. In testing 30 nerve-injured patients, interobserver variability was found to vary within 1 mm, or less, for moving two-point discrimination in 93.3% of the measurements and for static two-point discrimination in 86.8% of the measurements. In only two of the 30 measurements of moving two-point discrimination and in four of the measurements for static two-point discrimination were interobserver differences equal to 2 mm. Measurements for both moving and static two-point discrimination were analyzed statistically by linear regression and correlation co-efficient techniques. The measurements for two-point discrimination obtained with the protocol employed in this study were found to have an interobserver reliability at the p less than 0.00001 level. PMID- 3655226 TI - Locating the lateral antebrachial cutaneous nerve. AB - Dissections of 20 antebrachial specimens were done to define the location of the proximal lateral antebrachial cutaneous nerve, which is the distal sensory extension of the musculocutaneous nerve. Our findings varied from those noted in most anatomic and surgical texts in that the nerve emerges from the lateral aspect of the biceps tendon at the level of the interepicondylar line. At the point defined, the distribution of the nerve in ten volunteers was successfully anesthetized with 1.5 ml of 1% lidocaine. The accurate anatomic localization of this nerve should be of interest to surgeons and anesthesiologists in supplementing failed axillary blockade, in diagnosing and treating the musculocutaneous impingement syndrome, in harvesting the proximal nerve for diagnostic tests or donor graft purposes, and in differentiating the sensory distribution of this nerve from that of the radial nerve. PMID- 3655227 TI - Validity of nerve conduction velocity studies after anterior transposition of the ulnar nerve. AB - To determine which anatomic position and marking techniques are valid for postoperative electrodiagnostic testing, ten patients were studied during anterior transposition of the ulnar nerve. Variables included skin and ulnar nerve distances measured anterior and posterior to the medial humeral epicondyle, and ulnar nerve conduction velocities over these distances, with the elbow flexed and extended, and with the ulnar nerve in the pretransposition and posttransposition location. The results of the study confirm that ulnar nerve conduction velocity is recorded as faster with elbow flexion preoperatively and elbow extension postoperatively when the skin measurement used for the distance is kept constant. Postoperatively, the most valid measurement of ulnar nerve conduction velocity was a skin distance that was posterior to the medial humeral epicondyle with the elbow extended. PMID- 3655228 TI - Intra-articular entrapment of the median nerve after elbow dislocation in children. AB - Two cases of intra-articular median nerve entrapment after reduction of elbow dislocations in children are described. The diagnosis of median nerve entrapment is often delayed. A proximal median nerve deficit, limited passive elbow motion, and an associated medial epicondyle avulsion after reduction of a child's posterior elbow dislocation should alert the surgeon to the possibility of nerve entrapment. Optimal management of this problem consists of early surgical exploration and nerve release. PMID- 3655229 TI - Variations of the median nerve in the carpal canal. AB - Eight hundred twenty-one median nerves were retrospectively and prospectively reviewed for variations during operations to treat carpal tunnel syndrome. Ninety two cadaver median nerves were also dissected to document the incidence of variations within the carpal canal. The combined incidence of anomalies at operation (Lanz groups 1 to 4) was 9.8% and in the cadaver series 18%. The discrepancy reported by Poisel, 54% in the Lanz group 1 series, versus ours of 1.42% cannot be explained. PMID- 3655230 TI - Carpal tunnel volume determination by magnetic resonance imaging three dimensional reconstruction. AB - Three-dimensional computer reconstruction of magnetic resonance images (MRI) of ten cadaveric specimens was used to determine carpal tunnel volume and carpal arch width. Magnetic resonance images-acquired data were compared with direct measurement of cadaveric carpal canal volume by means of a silicone-injection technique. Mean MRI three-dimensional reconstruction volume was 5.84 ml +/- 1.24 ml. Mean silicone-mold volume was 4.73 +/- 1.01 ml. A correction factor of 0.8161 was used to accurately calculate carpal tunnel volume from MRI-acquired data. There was no significant difference between calculated carpal tunnel volumes and silicone-mold volumes (p = 0.623), and there was a linear relationship between MRI-acquired volumes and silicone-mold volumes (correlation coefficient r = 0.97). Differences in MRI-volume determinations between observers were not significant (0.25 greater than or equal to p greater than 0.1). MRI three dimensional reconstruction, a valid and reproducible technique for measuring carpal tunnel volume and dimensions, has considerable research potential for the evaluation of the relationship between the carpal canal and its contents before and after carpal tunnel release. PMID- 3655231 TI - Reconstruction of a digitless hand. AB - A digitless left hand was reconstructed by transplanting a big toe skin-nail flap and the adjacent second and third toes taken from the left foot and the second and third toes taken from the right foot. Five months follow-up showed satisfactory functional recovery and cosmetic results. The digits have regained normal sensibility and possess independent motor ability. PMID- 3655232 TI - Macrodactyly and the epidermal nevus syndrome. AB - Macrodactyly is an uncommon congenital anomaly that affects the fingers and toes. Speculation as to cause is focused on the association with connective tissue abnormalities, such as neurofibromatosis. We report a highly unusual case of a patient with epidermal nevus syndrome, a specific connective tissue and skeletal disease, who also exhibited bilateral, four finger macrodactyly. Potential causes of linkage between these two specific and unusual syndromes are discussed. Treatment of the epidermal nevus may be nonoperative, differing from the philosophy of aggressive treatment of the similarly appearing premalignant congenital hairy nevus. PMID- 3655233 TI - Management of intrinsic spasticity in the hand with phenol injection or neurectomy of the motor branch of the ulnar nerve. AB - Thirty-nine adults with acquired spastic disorders who had 21 phenol injections and 21 neurectomies of the motor branch of the ulnar nerve in Guyon's canal for control of intrinsic spasticity in the hand were reviewed. Follow-up averaged 25.8 months for the patients with phenol blocks and 24.3 months for those who had a neurectomy. Intrinsic spasticity was relieved in all hands postoperatively. After the phenol block, which is a temporizing procedure, 13 hands had return of spasticity in 6 months. Eight hands had little or no return of spasticity and required no further treatment. Neurectomy was performed in predominantly nonfunctional hands with severe hygiene problems and with no potential for further neurologic recovery. Hand function was improved in six hands after phenol block and in one hand after neurectomy. Hygiene was improved in all hands after phenol block and in all except one hand after neurectomy. Two wound infections and one wound dehiscence occurred. PMID- 3655234 TI - Digital artery diameters: an anatomic and clinical study. AB - This study measured the diameter of the arteries at the level of the diaphysis of the proximal phalanges of the index, long, ring, and small fingers. We measured the diameter of the vessel on ten normal arteriograms and on six amputated specimens. The larger vessel was usually on the ulnar border of the index and long fingers and on the radial border of the ring and small fingers. By the Hagen Poiseuille equation, we assume that the larger vessel has the greater flow and, therefore, represents the dominant vessel to the digit. This observation may have clinical relevance in the reimplantation and revascularization of digits. PMID- 3655235 TI - Upper extremity injuries due to medications. AB - One hundred eleven patients were treated for upper extremity complications due to therapeutic agents. Forty-nine injuries were associated with chemotherapy and 62 with so-called "non-toxic" solutions. Twenty-five required debridement and skin coverage operations, and six required emergency fasciotomies. The most effective regimen included immediately stopping the intravenous line, elevation, avoidance of antidotes, late debridement and coverage, and early rehabilitation. PMID- 3655236 TI - Closed crush injury of the metacarpophalangeal joint. AB - Closed crush injuries from direct blows to the dorsum of the hand may produce significant metacarpophalangeal (MCP) joint symptoms or dysfunction. We have treated 11 patients who had chronic pain and swelling, but without extensor tendon subluxation, for an average of 7.4 months. Only two responded to nonoperative treatment. The nine who had exploratory surgery had a consistent anatomic lesion that consisted of a partial, arcuate tear of the sagittal fibers. All the patients improved postoperatively. Cadaver dissections of the dorsal MCP tendon mechanism in 11 fresh specimens (44 MCP joints) demonstrated that neither partial nor complete transection of the ulnar sagittal fibers produces radial dislocation of extensor tendons. Radial sagittal fiber transections frequently produced ulnar tendon dislocation. Patients who have closed impact injuries of the MCP joints and present with longstanding pain, swelling, and limited mobility without extensor tendon migration may have sustained unrecognized partial ulnar sagittal fiber disruption. Repair of the partial sagittal fiber tear and exploration of the MCP joint is indicated. PMID- 3655237 TI - Chronic compartment syndrome in the first dorsal interosseous muscle. AB - Fifteen patients with clinical signs that could indicate a chronic compartment syndrome of the first dorsal interosseous muscle of the hand were investigated by pressure recording at rest and during exercise. Objective data, verifying such a syndrome, were found in four of the patients. Increased muscle relaxation pressure during exercise and intramuscular pressure at rest after exercise compared with normal pressure were well correlated to the development of the symptoms of chronic compartment syndrome. Fasciotomy of the first dorsal interosseous muscle relieved the symptoms and normalized the pressure. PMID- 3655238 TI - Hamatometacarpal fracture-dislocation: classification and treatment. AB - Seventeen male patients with a fourth metacarpal fracture and fifth carpometacarpal joint injury were treated. Distinct patterns of injury were recognized and in each case fell into one of three categories. Type IA lesions were characterized by subluxation or dislocation of the fifth carpometacarpal joint without hamate avulsion fracture. Type IB lesions were identical to type IA lesions except for the appearance of a small dorsal rim hamate avulsion fracture. Type II lesions were distinguished by subluxation or dislocation of the fifth carpometacarpal joint and comminution of the dorsal hamate rim. Finally, type III lesions exhibited coronal splitting of the hamate. PMID- 3655239 TI - The effect of scapholunate ligament section on scapholunate motion. AB - Although the scapholunate interosseous ligament has been studied anatomically and functionally by several investigators, its exact role in wrist kinematics is still controversial. We designed and executed an experimental study with four cadaver specimens to compare various carpal motions before and after section of this ligament. Our results suggest that injury to this structure significantly changes carpal motion especially between the scaphoid and lunate. PMID- 3655240 TI - The effect of rotatory subluxation of the scaphoid on radio-scaphoid contact. AB - The effect of progressive rotatory subluxation of the scaphoid on radio-scaphoid contact area was examined in a cadaveric model. Five degrees of subluxation reduced the contact area of the proximal pole by 44%, with a shift to the dorsal lip of the radius. At 20 degrees of subluxation the contact area was reduced by 77%, with a shift radially to the dorsal lip of the radial styloid. These findings explain the progression of radio-scaphoid arthritis from the radial styloid to the remainder of the fossa and reemphasize the importance of operative reduction of a scapho-lunate disassociation in the prevention of degenerative arthritis. PMID- 3655241 TI - The effect of a simulated scaphoid malunion on wrist motion. AB - A scaphoid malunion results when a scaphoid fracture heals in a flexed position or when a scaphoid nonunion with carpal collapse is grafted without correction of the angular deformity. The effects of scaphoid malunion on wrist motion were simulated in a cadaveric study. It was found that the loss of wrist extension is proportional to the angular deformity. Loss of radiocarpal extension occurred at 15 degrees of angulation and loss of midcarpal extension occurred at 30 degrees of angulation. PMID- 3655242 TI - Ulna-minus variance and Kienbock's disease. AB - A 29-year-old woman meat wrapper with long-standing bilateral carpal tunnel syndrome had an incidental finding of severe unilateral ulna-minus variance caused by a childhood injury. Despite the strenuousness of the patient's occupation and the severity of the abnormality, there was no clinical or radiologic evidence of lunatomalacia (kienbock's disease) on the affected side, indicating that there is not necessarily a direct causal relationship between ulna-minus variance and lunatomalacia. PMID- 3655243 TI - Treatment of reflex sympathetic dystrophy of the hand with an active "stress loading" program. AB - Reflex sympathetic dystrophy (RSD) is a syndrome characterized by pain out of proportion to injury, vasomotor and trophic changes, stiffness, and decreased function. It is important to separate the active disease process of RSD from its resultant state of contracture and fibrosis. Our treatment program is based on active "stress loading," which consists of active traction and compression exercises that provide stressful stimuli to the extremity without joint motion. Fifty-two patients with RSD were treated during a 3-year period. Their results and long-term follow-up on 41 patients are presented. The "stress loading" program has been used consistently during the past 20 years. The advantages of the program are its effectiveness, simplicity, safety, and noninvasiveness. PMID- 3655244 TI - Thumb avulsion: results of replantation/revascularization. AB - During a 9-year period, 39 thumb avulsions required emergency replantation/revascularization at our institution. Amputation was complete in 28 (72%) cases and involved the dominant thumb in 31 (80%). Farm machinery was the source of injury in 33 (85%) cases. Follow-up ranged from 7 months to 6 years. Only 10 of the revascularization attempts (26%) were successful; the remaining attempts required amputation at the level of the injury. In two (18%) of the 11 partial amputations and in eight (29%) of the 28 complete amputations, revascularization was successful. In eight (31%) of the 26 thumbs in which vein grafts were used, revascularization was successful, while one of the other two successes involved a transfer of the radial digital artery of the index finger. In six of the ten successful revascularizations, nerve repair was attempted, but without further procedures, none of the six digits regained two-point discrimination of less than 1 cm. PMID- 3655245 TI - Three-loop technique for A2 pulley reconstruction. AB - A three-loop technique of secondary A2 pulley reconstruction has been developed by the authors. This method was applied to six fingers of six patients. The average follow-up period was 21 months and ranged from a minimum of 9 months to a maximum of 3 years. Total active motion of metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints improved by 30 degrees on the average from the preoperative 175 degrees to the postoperative 205 degrees. Similarly, tip palm distance showed an improvement of 10 mm on the average from the preoperative 32 mm to the postoperative 22 mm. Satisfactory grip functions were restored for all patients after the secondary pulley reconstruction. PMID- 3655246 TI - Osteoid osteoma of the hand and wrist. AB - The average age of 19 patients with osteoid osteoma of the hand or wrist was 23 years (range, 8 to 70 years). Nine lesions were in the proximal phalanx, four in the distal phalanx, one in a middle phalanx, and one in a metacarpal. Two lesions were in the capitate, one of the hamate, and one in the triquetrum. The average time from onset of symptoms to successful treatment was 16 months. Fifteen of the 19 patients had had treatment elsewhere; 14 had had unsuccessful operative procedures, usually related to incorrect diagnoses. Sixteen patients had a minimum follow-up of 5 months (range, 5 months to 31 years; mean, 11 years) after operation. Surgical failure occurred in four patients with phalangeal lesions (two proximal and two distal). Three of the four patients subsequently were cured by reoperation, and the other patient obtained further treatment elsewhere. PMID- 3655247 TI - A colonic metastatic tumor in the hand. AB - Secondary tumors in the hand are very uncommon. Of the reported cases the majority arise from primary bronchial carcinoma, with multiple secondary deposits into bone. A case is reported of bony metastasis to the middle phalanx of the small finger in a patient who had a resection of a colonic adenocarcinoma 2 years previously. PMID- 3655248 TI - Technique of percutaneous phenol block of the recurrent motor branch of the median nerve. PMID- 3655249 TI - Circumferential electric burns of the ring finger. PMID- 3655250 TI - Neurotropism and neurotrophism. PMID- 3655251 TI - Duplication of extensor carpi ulnaris tendon. PMID- 3655253 TI - Lead poisoning. PMID- 3655252 TI - Acute traumatic subluxation. PMID- 3655254 TI - Ulnar deficiency. PMID- 3655255 TI - Prevention of upper extremity occupational disorders. PMID- 3655256 TI - Cumulative trauma disorders. PMID- 3655257 TI - Ergonomics considerations in hand and wrist tendinitis. AB - The objectives of this article are to present (1) a historical perspective on hand and wrist tendinitis in workers, (2) new data that demonstrate a relationship between the repetitiveness and forcefulness of manual work and the prevalence of tendinitis, (3) possible biomechanical factors in tendinitis, and (4) possible job modifications for the prevention of tendinitis. Numerous studies during the last 100 years show that tendinitis is a major cause of worker suffering and workers' compensation in intensive hand work. Epidemiologic data show that the risk of hand and wrist tendinitis in persons who perform highly repetitive and forceful jobs is 29 times greater than in persons who perform jobs that are low in repetitiveness and force. A possible factor in this relationship is viscous deformation of the tendons and adjacent tissues. Although these data suggest that the risk of tendinitis among workers can be reduced by reduction of the repetitiveness and the forcefulness of the work, this hypothesis has not yet been fully tested. PMID- 3655258 TI - Medical surveillance for carpal tunnel syndrome in workers. AB - Carpal canal size was examined as a risk factor associated with carpal tunnel syndrome in the workplace. Seven of 14 electricians had symptoms of carpal tunnel syndrome. When cross-sectional areas were measured by computed tomography (CT), affected workers had a cross-sectional area of 1.75 +/- 0.21 cm2; control values were 2.53 +/- 0.15 cm2 (p less than 0.05). Subjects with a subclinical syndrome had an area of 1.83 +/- 0.22 cm2, which was similar to the group with symptoms. Wrist circumference was not a predictor of the smallest carpal canal area. Unusual bony and soft tissue structures within the carpal canal were easily identified with CT. PMID- 3655259 TI - Risk assessment in electronic assembly workers: carpal tunnel syndrome. AB - Symptoms that develop in workers after repeated mechanical injury may be overlooked until the disability affects their productivity and safety. Modifications in the design of hand-operated tools or adaptations in production ergonomics may prevent further damage and permit affected workers to recover while avoiding the development of repetitive cumulative trauma in workers who are new to the job task. This article describes the results of an on-site survey, a biomechanical analysis, and a special neurologic assessment in an electronic assembly plant and provides a structured approach to worker surveillance and intervention to reduce the risk of carpal tunnel syndrome caused by repetitive motions. PMID- 3655260 TI - Tool design for prevention of hand and wrist injuries. AB - Incorrect hand tool designs can cause a variety of cumulative trauma disorders. Design elements of size, shape, texture, purpose, ease of operation, shock absorption, and weight must be properly applied in the design process to fulfill the physical safety needs of consumers and working people and to prevent the appearance of pathologic changes in the tissues of the hand and wrist. PMID- 3655261 TI - Upper extremity musculoskeletal disorders in hospital workers. AB - Seventy-six women who worked in a hospital were surveyed for symptoms and signs of upper limb musculoskeletal disorders. The investigation was originally intended to study the effects of repetitive manual work that was performed by a group of garment assembly workers. Hospital workers were selected as the referent group on the assumption that they were unexposed to ergonomic stressors. However, the study showed that the prevalence of shoulder, wrist, and hand pain in these workers was sufficiently high (32%) to require that this assumption be reexamined. The hospital workers that were affected the most were employed in the nursing field and in manual work, i.e., food preparation, serving, and laundry. The women with upper limb pain were older and had been employed somewhat longer in hospital work than those without pain. Several jobs were observed to identify possible occupational risk factors for cumulative trauma disorders (CTDs). In addition to repetitive motion, these factors included forceful manual exertions and awkward postures required by work station design and layout. PMID- 3655262 TI - Cumulative trauma disorder controls: the ergonomics program at Ethicon, Inc. AB - Over the past 10 years, Ethicon, Inc., has developed a successful program for the management of cumulative trauma disorders. The program is based on a multidisciplinary approach created through the existence of an ergonomics task force. Various functions of the task force and examples of its operations are described. PMID- 3655263 TI - Work pace, stress, and cumulative trauma disorders. AB - This paper discusses the potential roles of work pace and work pressure as risk factors in the development of cumulative trauma disorders. Specifically, electromyographic (EMG) data were collected from the forearm flexor muscles of workers performing a highly repetitive task. This task had previously been identified as one that involved a high incidence of cumulative trauma disorders. Workers were asked to increase and decrease their work pace for short periods of time. The EMG data indicated that faster work paces were accompanied by higher forces. However, it was also noted that unsuccessful attempts to speedup or slowdown produced similar increases and decreases in EMG activity, indicating that speed of movement was not the only factor contributing to the changes in muscular activity. The results are discussed in relation to the stress and tension associated with work pressure caused by machine pacing, production standards, and incentive systems. PMID- 3655264 TI - The pathophysiology of nerve entrapment syndromes. PMID- 3655265 TI - Musculoskeletal disorders of the upper extremities: the use of epidemiologic approaches in industrial settings. AB - This article illustrates the use of a simple questionnaire in identifying those sections of a work force at risk for musculoskeletal disorders and chronic discomfort of the upper extremities. Two research studies are described. The first, conducted in a chicken-processing factory, illustrates the use of self administered questionnaires in the assessment of the musculoskeletal health of the work force and in the identification of groups of workers who may be at increased risk and for whom ergonomic reappraisal of the tasks performed may be beneficial. A second study of retail trade staff suggests that chronic musculoskeletal discomfort is widespread. The article further considers the importance of such data for those persons concerned with the allocation of health care. The need to consider the broader spectrum of musculoskeletal health from discomfort to clinical disorder is stressed. PMID- 3655266 TI - Vocational rehabilitation with the industrially injured worker. AB - The field of vocational rehabilitation has broadened beyond the traditional federal-state model into the private sector primarily through funding by the insurance industry via workers' compensation coverage. Most disabilities encountered by private vocational rehabilitationists are musculoskeletal injuries resulting from traumatic industrial accidents rather than congenital disabilities most often seen by the state's Department of Vocational Rehabilitation. In many cases reduction in physical tolerances, extremity use, and/or chronic pain results in the industrially injured worker not being released by the attending physician for return to work in the previous occupation. To be effective, private vocational rehabilitationists working with the industrially injured worker must have a working knowledge of residual tolerances associated with various disabilities, as well as knowledge of legal parameters of the vocational workers' compensation law for each state worked in. In addition, the ability to communicate effectively with attending physicians, attorneys, claims examiners, occupational and physical therapists, and rehabilitation nurses is concomitant with successful positive movement in the vocational rehabilitation process. As with federal and state vocational rehabilitation counselors, the ability to assess transferability of past work skills and current aptitudes is paramount in determining transferability of work skills to alternate occupations. Finally, growing networking between rehabilitation nurses, therapists, physicians, and vocational rehabilitationists is needed to improve the injured worker's ability to maximize his or her physical tolerances in viewing return to work in a position as close as possible to that performed at the time of injury. PMID- 3655267 TI - Proposed screening tool for the detection of cumulative trauma disorders of the upper extremity. AB - The incidence of cumulative trauma disorder (CTD) has become noteworthy in plants that rely on automated production. This rise was evident in an Ohio poultry company. The purpose of this study was to develop a screening tool to detect employees who might be at risk of sustaining a CTD injury and to identify trends of CTD at specific workstations. Thirty-five employees at three workstations completed a questionnaire and underwent a physical examination. Results identified 24 employees with a potential for CTD, and these employees were recommended for remediation. Job modifications and supportive devices were placed in the workplace. A newly designed industrial wrist splint was developed for this study. The personnel department has noted that employee complaints of upper extremity discomfort have decreased. PMID- 3655268 TI - An inside look: hand injury-prevention program. AB - The purpose of this article is to review the development of an industrial hand injury-prevention program to provide the impetus for other hand therapists to undertake such programs. The article includes a description of how to initiate a prevention program, the content of the training seminar, presentation methods, and marketing strategies. The "Handle with Care" program was effective in reducing the cost and incidence of industrial hand injuries and was favorably received by Oklahoma industry at its inception. A new program is currently being developed in California. PMID- 3655269 TI - Thermography in the detection of carpal tunnel syndrome and other compressive neuropathies. AB - Studies were conducted using liquid crystal thermography (FlexiTherm) and electronic thermography for the diagnosis of carpal tunnel syndrome. Studies were also conducted to differentiate carpal tunnel syndrome from peripheral neurovascular injuries. Ninety patients were included in the study, with an average follow-up time of 24 months. Fifty patients also had electric studies for comparison and contrast. Thermal patterns of carpal tunnel syndrome showed a decreased vascular heat emission pattern over the median nerve distribution. The procedures using thermography consisted of imaging of the cervical spine, shoulders, forearms, and hands by Wexlerian guidelines to obtain diagnostic thermograms and a stress series. Results of the studies showed that thermographic studies were efficacious and sensitive for the differential diagnosis of carpal tunnel syndrome from other peripheral compressive neuropathies, including cervical radiculitis, thoracic outlet syndrome, cubital tunnel syndrome, and Guyon's canal syndrome. Biomechanic and etiologic factors indict carpal tunnel syndrome to be an occupational disease. Thermographic technique use may lead to the early diagnosis, treatment, and preventative measures that could eliminate the high cost of manpower loss and of medical care often concomitant with carpal tunnel syndrome. PMID- 3655270 TI - Assessment of upper extremity-injured persons' return to work potential. AB - Therapists specializing in the rehabilitation of persons with upper extremity disorders--hand therapists--have developed an evaluation procedure to determine if and when an injured worker has the physical capacity to safely return to work. The Return to Work Evaluation has five components: (1) physical evaluation, (2) subjective effects of injury interview, (3) biomechanical job analysis, (4) work stimulation, (5) reevaluation. The therapist designs a work simulation based on the identification of the critical physical demand characteristics of the patient's work. After documenting the patient's response to the work simulation, the therapist formulates recommendations to the physician with regard to the patient's ability to safely return to the workplace. These recommendations may include the need for job/worker modifications or the need for a reconditioning program. The implementation of the Return to Work Evaluation has decreased the physician's liability in return-to-work decisions and has allowed injured workers to maintain optimal function after medical treatment. PMID- 3655271 TI - Work capacity evaluation for occupational hand injuries. AB - According to Matheson the current definition of work capacity evaluation is that it is "a process of measuring and developing an individual's capacity to dependably sustain performance in response to broadly defined work demands." This article will give a broad overview of the work capacity evaluation as it relates to hand injuries. Included in the discussion will be the history and philosophy of work capacity evaluation, as well as the application of the evaluation process to hand-injured patients. PMID- 3655272 TI - Demographics and replantation. AB - We reviewed demographic data on 761 patients who had one or more amputated parts replanted at Duke University Medical Center between 1972 and 1984 to learn more about the population that sustained amputation and replantation. Ninety-four percent were from North Carolina and its border states. Persons between ages 21 and 30 years were the most frequently injured. Eighty-five percent of patients were men. Seventy-eight percent of amputations occurred between 6:00 AM and 6:00 PM. No significant difference in the number of replantations was noted at various months of the year. Fifty-eight percent of amputations were job related, and laceration was the most frequent type of amputation. Time between injury and operation averaged 5 hours 50 minutes. Average operating time was 6 1/2 hours. Thumbs were replanted most frequently, the index and small finger least frequently. Length of hospital stay averaged 9 days. Time out of work averaged 3 months. This data suggest that efforts directed toward employee education, safety, and prevention of injury on the job have the potential of decreasing the largest single cause of amputations in the upper extremities of patients in our area of the United States. PMID- 3655273 TI - Sucralfate versus cimetidine in reflux esophagitis. A single-blind multicenter study. AB - A single-blind randomized multicenter study was performed in 42 patients with endoscopically documented reflux esophagitis. Patients were randomly given 400 mg cimetidine q.i.d. or a suspension of 1 g sucralfate q.i.d. for a period of 8 weeks. Forty patients were evaluated after 8 weeks. Symptomatic improvement was good and was comparable in both groups. We saw side-effects in only three patients, two on sucralfate and one on cimetidine, and these did not necessitate withdrawal from the study. Endoscopy showed improvement of esophagitis in 53% and healing in 31% of patients after sucralfate treatment. With cimetidine, improvement was seen in 67% and healing in 14%. One patient on cimetidine developed a stricture during treatment. We conclude that treatment with sucralfate improves symptoms and lessens severity of reflux esophagitis and that the results with sucralfate appear to be comparable to those obtained with cimetidine. Sucralfate is a valid alternative to H2-receptor antagonist therapy. PMID- 3655274 TI - Self-rating of pain in nonulcer dyspepsia. A methodological study comparing a new fixed-point scale and the visual analogue scale. AB - Little attention has been paid to methodological aspects in the recording of gastrointestinal symptoms. We compared a new fixed-point scale for the self recording of pain intensity with steps operationally linked to behavioral events and with additional monitoring of pain duration--termed the "duration-intensity behavior scale" (DIBS)--with the visual analogue scale (VAS) in 32 patients with nonulcer dyspepsia. After randomization, the patients either recorded pain intensity (VAS) or pain intensity and duration (DIBS) four times daily during a 4 week period for 1 preliminary week without medication, followed by 3 weeks of antacid treatment. For both scales there was a high degree of compliance, and they seemed equally reliable and sensitive to changes in pain experience. Since DIBS yields more clinically useful information, this scale appears to be preferable for the monitoring of gastrointestinal pain. PMID- 3655275 TI - Indium-111 leukocyte scanning of the abdomen. Analysis of its value for diagnosis and management of inflammatory bowel disease. AB - Indium-111 leukocyte scanning of the abdomen (IAS) was performed in 10 patients with ulcerative colitis and in 39 patients with Crohn's disease involving the small intestine (in 25 occasions) and/or the colon (17 cases). Radionuclide uptake by the gut was seen in 84% of the patients with active inflammation. We compared the extent of the disease displayed by IAS with the findings obtained by either radiological or endoscopic studies or at surgery. In two-thirds of the patients, the IAS gave an accurate evaluation of the extent of the disease (sensitivity 68%). False-positive IASs were not seen in small bowel disease (specificity 100%), but were observed on 4 occasions on the colon (specificity 86%). The intensity of the radionuclide uptake could not be correlated with the clinical activity of the disease as evaluated by the Crohn's disease activity index. These results suggest that IAS is not superior to the standard procedures used to detect and localize inflammatory bowel disease and that IAS cannot replace these techniques. However, the simplicity of IAS and the complete lack of complications associated with its use render it useful in the evaluation of the extent and distribution of inflammation in some patients, mainly those with severe disease in whom standard diagnostic procedures would be contraindicated. PMID- 3655276 TI - Laxative consumption in chronic nonorganic constipation. AB - We looked at laxative consumption and its relationship to bowel habits, total gastrointestinal transit time (TGITT), and symptoms in patients with chronic nonorganic constipation. Of the patients, 87.9% used laxative, 30% habitually. Laxative intake increased with age, so that habitual consumption was more frequent in patients with long-standing (greater than 10 years) constipation. Although habitual laxative users had a consistent trend toward lower bowel frequency and prolonged TGITT, no relationship was found among intake and observed bowel frequency, TGITT, or large bowel segmental transit time. Although laxatives induced more satisfactory or less difficult evacuations, they also caused diarrhea and mucus in the stool. Laxative consumption did not bring about any detectable improvement in the abdominal or extraabdominal symptoms usually associated with constipation. PMID- 3655277 TI - Pulmonary involvement in primary biliary cirrhosis. AB - Four patients with primary biliary cirrhosis (PBC) and Sjogren's syndrome presented with pulmonary disease manifested by fever, cough, and dyspnea. One patient had obstructive lung disease secondary to an autoimmune process documented by immunofluorescent staining of lung parenchyma. The other three patients had interstitial lung disease, pulmonary nodules, and multiple granulomas of the lung, respectively. Primary biliary cirrhosis is a complex autoimmune syndrome involving a disorder of the secretory immune system and its epithelial end organs. These four cases suggest that, in addition to biliary, lacrimal, intestinal, renal tubular, and salivary epithelium, lung tissue also is a possible site for autoimmune involvement in PBC. PMID- 3655278 TI - Isolated granulomatous gastritis. Treatment with corticosteroids. AB - Granulomatous disease of the stomach is a rare disorder with multiple causes. We successfully treated a patient who had granulomatous disease that was confined to the gastric antrum with corticosteroids. We believe this is the first such report. PMID- 3655279 TI - High grade dysplasia in Crohn's colitis characterized by flow cytometry. AB - A patient with Crohn's ileocolitis had high grade dysplasia. Preoperative evaluation of colonoscopic biopsies by flow cytometry demonstrated aneuploidy, a marker of malignancy. In the surgical specimen, however, carcinoma was not demonstrated despite extensive sampling. The detection of abnormal DNA content in this premalignant lesion suggests a useful role for this technique in selecting those patients with inflammatory bowel disease at risk for carcinoma. PMID- 3655280 TI - Sigmoid volvulus in adolescence. AB - Sigmoid volvulus in young adults is rare. It usually presents as chronic recurrent attacks of abdominal pain. The diagnosis is usually delayed because of a low level of suspicion. We present the case of a 17-year-old girl with recurrent episodes of sigmoid volvulus, to illustrate the problem. PMID- 3655282 TI - "Bubble-phobia". PMID- 3655281 TI - Liver sinusoids and sinusoidal cells in patients with agnogenic myeloid metaplasia. AB - The origin of sinusoidal portal hypertension often remains unknown in patients with agnogenic myeloid metaplasia. Four consecutive patients with agnogenic myeloid metaplasia had liver biopsies examined under light and electron microscopy. Two of the four had obvious clinical portal hypertension; of these two, only one had portal vein thrombosis. All four cases showed sinusoidal infiltration by myeloid cells (from very mild to obvious) and an increased perisinusoidal collagen network. Under electron microscopy we observed (a) the collagenization of the Disse space, (b) myeloid cells in the lumen and the Disse space, (c) the transformation of perisinusoidal cells into transitional cells, and (d) fragments of basement membrane-like material. It is possible that all these abnormalities, and not only sinusoidal infiltration, contribute to increase vascular resistance, even when there is no clinical evidence of portal hypertension unrelated to vascular thrombosis. PMID- 3655283 TI - Clinical significance of immunosuppressive substance as a marker for colorectal carcinoma. PMID- 3655284 TI - Filariasis. Proceedings of a seminar. Bombay, 12 May 1986. PMID- 3655285 TI - Administration of diethylcarbamazine citrate to rats-redistribution of lipids. PMID- 3655286 TI - Approach to the discovery of new drugs against filariasis. PMID- 3655287 TI - The cellular components of tissue changes in filariasis: functional aspects. PMID- 3655288 TI - Antifilarial activity of some Ciba-Geigy compounds in comparison with some known antiparasitic agents. PMID- 3655289 TI - Achievement of health for all by the year 2000 A.D. through primary health care: global strategy. PMID- 3655290 TI - "Achievement of Health for All by 2000 A.D. through Primary Health Care." Annual scientific conference of the Indian Society for Malaria and Other Communicable Diseases. 12-13 February 1987, Delhi. Proceedings. PMID- 3655292 TI - Malaria control as part of primary health care. PMID- 3655291 TI - Achievement of health for all by 2000 A.D. through primary health care: progress till date viz-a-viz targets. PMID- 3655293 TI - Current status of malaria control/eradication programme in India and future strategy in the context of "health for all by 2000 A.D.". PMID- 3655294 TI - Current status of National Leprosy Eradication Programme in India. PMID- 3655295 TI - Impact of EPI on health for all. PMID- 3655296 TI - Impact of maternity and child health services on health for all by 2000 A.D. PMID- 3655297 TI - Population stabilization strategy. PMID- 3655298 TI - Health manpower development in the context of goal of health for all and primary health care approach. PMID- 3655299 TI - Community participation in achieving health for all--influence of mass media. PMID- 3655300 TI - Intersectoral cooperation in HFA-2000 A.D. PMID- 3655301 TI - Factors determining the dynamics of malaria systems in South Asia. PMID- 3655302 TI - Practical implications of population movement on epidemiology of malaria in South East Asia. PMID- 3655303 TI - National tuberculosis control programme. PMID- 3655304 TI - Neurological manifestations in AIDS--a case report. PMID- 3655305 TI - A controlled trial of colchicine in primary biliary cirrhosis. Trial design and preliminary report. AB - Colchicine (1 mg/day), or an identical placebo, was given to 64 patients with primary biliary cirrhosis in a double-blind controlled trial. Due to a novel, pair-matched trial design, the two groups were exceptionally well matched at entry. In comparison with placebo, colchicine produced a beneficial effect on serum albumin and bilirubin levels at 3 months in patients who had abnormal liver function (bilirubin greater than 20 mumol/l) at entry: (albumin, P = 0.047; bilirubin, P = 0.022). In patients with normal liver function at entry (bilirubin less than 20 mumol/l), beneficial effects were noted on total globulin levels at 3 months (P = 0.013) and on immunoglobulin G levels at 3 and 6 months (P = 0.044 and 0.001, respectively). At 18 months, survival estimate in the colchicine and placebo groups were 84% and 69%, respectively. The difference did not reach significance. Colchicine produced an early improvement in liver function and immunoglobulin levels. Few serious side effects were encountered, and colchicine clearly merits long-term study in the treatment of primary biliary cirrhosis. PMID- 3655306 TI - Repeated paracentesis and i.v. albumin infusion to treat 'tense' ascites in cirrhotic patients. A safe alternative therapy. AB - To investigate the usefulness of paracentesis as an alternative treatment for ascites, 41 cirrhotic patients with 'tense' ascites were randomly assigned to treatment with either repeated paracenteses plus i.v. albumin infusion (n = 20) or diuretics (n = 21). Satisfactory mobilization of ascites was obtained with paracentesis in all but one case and with diuretics in all but two cases. Ascites disappeared within 3 or 4 days with paracentesis, but only after 15 days with diuretics. The rate of reaccumulation of ascites following paracentesis, without diuretic administration, exceeded 300 g/day in only 5 patients. The incidence of complications and the mortality rate were similar in both groups of patients during hospital stay and during follow-up. This was corroborated by the evidence that no negative changes were induced in clinical and laboratory parameters of hemodynamic, hepatic and renal function after evacuation of the ascites. These results confirm that repeated paracenteses combined with human albumin replacement are safe and effective for treating 'tense' ascites, and more rapid than traditional diuretic therapy. PMID- 3655307 TI - Highly symptomatic adult polycystic disease of the liver. A report of fifteen cases. AB - Fifteen patients were evaluated because of highly symptomatic adult polycystic liver disease. All of them had abdominal pain, two patients had obstructive jaundice, one had ascites and a large right-sided pleural effusion, and one had oesophageal varices. In 4 patients percutaneous aspiration of the largest cysts was performed, but this form of treatment only provided temporary relief. In 9 patients a fenestration operation was carried out. One of these patients died per operatively due to irreversible shock. The abdominal complaints disappeared post operatively in 7 of the other 8 patients, although a decrease of the liver span was uncommon. In the two patients with obstructive jaundice the serum bilirubin level normalized after the operation, and in the patient with oesophageal varices this abnormality disappeared post-operatively. Biochemical analysis of cyst fluid was performed in 7 of the cases. The mean ratios of the levels of most of the non protein-bound inorganic ions and other small molecules in cyst fluid and serum were about 1, whereas those of all proteins and protein-bound constituents were generally far below 1. PMID- 3655308 TI - Copper protects against galactosamine-induced hepatitis. AB - Although copper is believed to be hepatotoxic in Wilson's disease and Indian Childhood Cirrhosis (ICC), the rat shows only minimal hepatic damage on copper loading. To investigate the possibility that copper deposition may potentiate the effects of a superimposed hepatitis, D-galactosamine (GalN) was given to copper loaded and control rats. In the non-copper-dosed rats, GalN 0.85 g/kg i.p. produced elevated serum AST (3731 +/- 545 IU/l; normal 64.8 +/- 2.1), ALT (2090 +/- 190 IU/l; normal 18.0 +/- 0.7), and OCT (16.7 +/- 2.6 mmol/min/ml; normal 0.12 +/- 0), and liver cell necrosis with portal infiltration. In rats whose liver copper was elevated to 1298 +/- 169 micrograms/g (control 18.7 +/- 1.7) by oral copper supplementation, GalN produced much smaller increases in AST (825 +/- 122 IU/l), ALT (103 +/- 15 IU/l) and OCT (0.27 +/- 0.02 mmol/min/ml) and minimal histological damage. Viable bacterial cell counts from faecal homogenates showed that the anaerobically cultured bacteria were reduced on copper-dosing of rats. Therefore the protective effect of copper may be due to a decrease in gut-derived endotoxin acting on the liver, or to an impaired prostaglandin synthesis or perhaps to synthesis of acute phase reactants. PMID- 3655309 TI - Biologic and prognostic significance of hepatocyte hepatitis B core antigen expressions in the natural course of chronic hepatitis B virus infection. AB - To elucidate the biologic significance of hepatocyte hepatitis B core antigen (HBcAg) expression and its relation to the natural course of hepatitis B virus (HBV) infection, the patterns of HBcAg were correlated with HBV virus replication state and the disease activity in 598 needle liver biopsies performed on 569 hepatitis B surface antigen (HBsAg) carriers aged 1-81 years. A good correlation of liver HBcAg with serum HBeAg and HBV DNA status was demonstrated. HBcAg was present in the hepatocyte nuclei (nHBcAg) or cytoplasm (cHBcAg), or in both (mixed). Pure nHBcAg was seen mainly in children and young adults; 86% of the patients had non-aggressive disease, but rare cases of chronic active hepatitis (CAH) and HBeAg seroconversion were observed. In contrast, cHBcAg was predominantly associated with CAH (52%) and accompanied by a significantly higher HBeAg seroconversion rate (27%). The HBeAg-negative group, particularly the liver HBcAg-negative subgroup, had a lower frequency of CAH, but an increased incidence of non-aggressive disease as well as cirrhosis and/or hepatocellular carcinoma, indicating that HBeAg seroconversion to anti-HBe does not necessarily mean a favorable prognosis. The results suggest that expression of HBcAg correlates with the liver pathology and the three phases of chronic HBV infection: (1) the early immune tolerance phase is characterized by nHBcAg, mild disease and low HBeAg seroconversion rate; (2) the virus replication/elimination phase by cHBcAg or negative HBcAg, frequent CAH, and high HBeAg seroconversion rate; and (3) the inactive virus replication phase by negative HBcAg and a bipolar disease spectrum. PMID- 3655310 TI - Lymphoblastoid interferon therapy of chronic HBV infection. A comparison of 12 vs. 24 weeks of thrice weekly treatment. AB - This study set out to examine the relative effectiveness and tolerability of 12- versus 24-week courses of thrice weekly intramuscular lymphoblastoid interferon in the treatment of hepatitis B 'e' antigen (HBeAg)-positive chronic hepatitis B virus (HBV) infection, and to identify pretreatment factors predicting the outcome of therapy. Twenty patients were randomised to each treatment group. Treatment was associated with clearance of HBeAg and HBV-DNA in 59% of the 32 male patients, whereas none of the eight women responded (48% overall response rate). This response rate in males is at least three times the recorded spontaneous seroconversion rates in this population. Most of the women (5/8) were of Oriental origin and had minimal disease, factors that may have influenced response. The longer course was poorly tolerated and was therefore no more effective: eight of 20 patients withdrew because of side-effects. Variables associated with response included high AST (aspartate transaminase), short duration of disease and previous history of acute hepatitis. A response to antiviral therapy was accompanied by clinical and biochemical evidence of improvement in liver disease. PMID- 3655311 TI - Clinical and serological outcome of acute delta infection. AB - To assess the clinical and serological outcome of hepatitis delta virus (HDV) infection, 59 patients with acute delta hepatitis were followed for 6-28 months. Forty-two patients had simultaneous HDV and HBV coinfection (anti-HBc IgM positive, group I) and 17 were HBsAg carriers with HDV superinfection (anti-HBc IgM-negative, group II). Overall, serum HD-Ag and anti-HD IgM were the most sensitive markers for diagnosis of delta infection during the first 2 weeks after onset of symptoms. The clinical presentation was similar in both groups; 4 patients (1 in group I and 3 in group II) (7%) developed fulminant hepatitis, but none of them died. The majority of patients with HBV-HDV coinfection (group I) eventually recovered, whereas all HBsAg carriers with HDV superinfection (group II) developed chronic liver disease. Liver histology in these patients showed chronic active hepatitis and/or cirrhosis in 90%. The hepatic lesion was probably due to persistent HDV infection, as indicated by the presence of intrahepatic HD Ag and/or persistence of serum anti-HD IgM in 90% of the patients. PMID- 3655312 TI - Liver membrane autoantibodies in chronic active hepatitis. Studies on mechanically and enzymatically isolated rabbit hepatocytes. AB - Target antigens relevant for immune reactions in inflammatory liver diseases should be expressed on the hepatocellular membrane. Using mechanically or enzymatically isolated rabbit hepatocytes, we evaluated the influence of cell integrity on the detection of membrane-expressed antigens by sera from patients with chronic hepatitis and by murine monoclonal antibodies. Our results provide evidence that target antigens of liver membrane autoantibodies (LMA) as well as liver kidney microsomal antibodies (LKM) are not expressed on the hepatocellular membrane of viable and intact isolated rabbit hepatocytes. However, LMA were detected in the sera of 56% of patients with autoimmune chronic active hepatitis using mechanically isolated hepatocytes. These findings underline the diagnostic relevance of the autoantibodies. It is suggested that LMA are directed against constituents of the cytoskeleton. Therefore, it seems to be unlikely that this antibody is causally involved in the pathogenesis of autoimmune liver diseases. PMID- 3655313 TI - Alcohol-induced liver injury after jejunoileal bypass operation in rats. AB - The objective of this study was to investigate whether alcohol administration exerts a synergistic effect on jejunoileal bypass-induced liver dysfunction in rats. Male Wistar rats were subjected to 90% jejunoileal bypass or sham operation. For 10 weeks, subgroups were pair-fed either an alcohol-containing (36% of total calories) liquid diet or a liquid diet where alcohol was replaced isocalorically by starch. Alcohol feeding in rats with jejunoileal bypass increased hepatic triglyceride content about 6-fold as compared with bypassed rats receiving control diet. Neither jejunoileal bypass nor alcohol feeding led to significant changes in hepatic DNA and protein contents. Alcohol feeding increased cytochrome P-450 levels both in operated and in sham-operated rats. The administration of alcohol-containing diet decreased the activity of succinic dehydrogenase, the decrease being distinctly more pronounced in rats with jejunoileal bypass than in the sham-operated controls. Light microscopy revealed no significant morphological alterations in liver sections of rats fed the control diet after jejunoileal bypass or of rats receiving either the alcohol containing diet or the control diet after sham operation. Alcohol feeding in bypassed rats, however, produced marked diffuse accumulation of fat, and regularly led to other histological abnormalities in the liver. These abnormalities included ballooning of hepatocytes and disarray of the trabecular structure of the liver lobule, hyalin inclusions resembling megamitochondria, single-cell necrosis and focal clustering of necrosis, increased number of mitotic figures, and infiltrates with inflammatory cells. The histological lesions of the liver of bypassed rats receiving alcohol exhibited no obvious zonal distribution. The results demonstrate that alcohol feeding to rats subjected to jejunoileal bypass leads to marked liver injury which mimics, at least in part, that of alcohol-induced liver disease in man. Rats subjected to jejunoileal bypass may, therefore, provide a new model for the study of alcoholic liver disease. PMID- 3655315 TI - Acute appendicitis secondary to an obstructing carcinoma of the cecum: a case report. PMID- 3655314 TI - Oxygen and bile acid content in the azygos blood. Clues to the azygos derivation in patients with portal hypertension. AB - In patients with cirrhosis, elevation of azygos blood flow has been attributed on indirect grounds to cephalad portosystemic collaterals. To gather more information on the origin of the azygos blood, we studied the oxygen and bile acid content of the azygos and mixed venous blood in patients with portal hypertension. Azygos oxygen saturation was 59.6 +/- 6.0% in 8 controls, and significantly higher in 35 patients with cirrhosis (76.7 +/- 7.6%; P less than 0.01) as well as in 6 patients with noncirrhotic portal hypertension (84.0 +/- 8.2%; P less than 0.01). High oxygen saturation, however, was not correlated to azygos blood flow in patients with cirrhosis. In cirrhotic patients, total bile acid concentrations were 28.1 +/- 20.4 mumol/l in the pulmonary artery and 25.9 +/- 17.6 mumol/l in the azygos vein, giving an azygos to mixed venous ratio of 0.95 +/- 0.18. These results provide new evidence that elevated azygos blood flow in patients with portal hypertension is derived from the portal system, and perhaps predominantly from the splenic territory. PMID- 3655316 TI - La hierarchie de la fourchette et la maladie coronarienne. PMID- 3655317 TI - The Duchenne muscular dystrophy spectrum as clarified by the "outlier". PMID- 3655318 TI - Patient assaults on residents. PMID- 3655319 TI - A statewide survey of hospital policy and practice concerning cigarette sales: a follow-up study. PMID- 3655320 TI - Medicine's lighter moments. PMID- 3655321 TI - Digest of health and medical laws. 1987 Indiana General Assembly. PMID- 3655322 TI - 'Be All You Can Be!' Physicians respond to the Army's challenge. PMID- 3655323 TI - A model of protein-colloidal gold interactions. AB - We prepared homogeneous populations of colloidal gold particles of various sizes. These were analyzed for size distribution and number of particles per unit volume. On exposure to increasing concentrations of insulin, myoglobin, protein A, peroxidase, serum albumin, galactosylated serum albumin, lactoferrin, transferrin, catalase, low-density lipoprotein, ferritin, and polymeric IgA, protein binding was a saturable process. Using serum albumin, we verified that a reversible equilibrium was reached within 15 minutes. Scatchard analysis of the interactions between all of these proteins and the gold particles resulted in a single component, linear relation. For a given particle size, the number of binding sites for various proteins was inversely proportional to their molecular weight. Conversely, when the size of particles was varied, the number of binding sites was directly proportional to the average area of each gold particle. All results are compatible with a monomolecular shell of protein surrounding the particle at saturation, the binding capacity being inversely proportional to the projection area of the protein. We present direct morphological evidence for this model. The affinity of the various proteins for the colloid also increased with molecular weight, and was not related to the protein isoelectric point. For globular proteins, the monomolecular shell model makes possible prediction of the number of molecules that will saturate a gold particle, if the average diameter of the gold particles and the molecular weight of the protein are known. PMID- 3655324 TI - Tartrate-resistant acid phosphatase in mononuclear and multinuclear cells during the bone resorption of tooth eruption. AB - Tartrate-resistant acid phosphatase (TRAP) has been used as a cytochemical marker for the cell mediators of bone resorption, osteoclasts and their mononuclear precursors. We have applied a cytochemical method for TRAP to study the dependence of the osteoclast-mediated bone resorption of tooth eruption on the dental follicle, a connective tissue investment of the developing tooth, by analyzing the TRAP activity of mononuclear cells in the dental follicle before and during pre-molar eruption in dogs. The percentage of TRAP-positive monocyte cells increases until mid-eruption, slightly preceding a previously demonstrated rise in numbers of osteoclasts on adjacent bone surfaces. These data suggest an ontogenetic relationship between follicular mononuclear cells and osteoclasts on adjacent alveolar bone surfaces during tooth eruption. However, because TRAP occurs in other tissues and is not an exclusive indicator of pre-osteoclasts, proof of their relationship will have to await application of more definitive techniques. PMID- 3655326 TI - High-resolution localization of acetylcholinesterase at the rat neuromuscular junction. AB - To overcome the limited ultrastructural resolution of conventional acetylcholinesterase (AChE) ultrahistochemistry, acetylcholine (ATCh) was used to reduce the rate of enzymic thiocholine liberation. The conventionally limited resolution is mainly due to the high focal activity of the enzyme in neural structures, because cleavage of substrate is faster than histochemical trapping reactions. Therefore, using the copper-thiocholine method, we investigated the reduction of thiocholine liberation by acetylcholine (ACh). As examined biochemically, the apparent Ki for ACh was close to the Km for ATCh. The ACh/ATCh ratio, therefore, determined the reduction of thiocholine production in histochemical experiments. In addition, the morphological appearance of the precipitated reaction product after its changes during the histochemical procedure was monitored using electric eel AChE immobilized on Sepharose 4B. The improved fine structural resolution at 40- to 100-fold excess of ACh over ATCh is demonstrated at the neuromuscular junction of rat lumbricalis muscle. The highest focal enzyme activity is found at the presynaptic membrane and in the secondary cleft, but not on top of the junctional folds, indicating the separation of esterase and nicotinic receptors. The physiological events during neuromuscular transmission are discussed on the basis of the new "gradient switch hypothesis" suggested in this report. PMID- 3655325 TI - Demonstration of anionic sites on the luminal and abluminal fronts of endothelial cells with poly-L-lysine-gold complex. AB - An attempt was made to demonstrate the anionic sites on the endothelial cell (EC) surfaces of mouse brain micro-blood vessels (MBVs) after embedding of tissue samples in hydrophilic media: Lowicryl K4M, LR White, and Polyamph-10. As a cationic probe, poly-L-lysine-gold complex (PLG), prepared according to the procedure of Skutelsky and Roth (J Histochem Cytochem 34:693, 1986), was used. In ultra-thin sections of brain samples embedded in Lowicryl K4M and LR White, the anionic sites were demonstrated in the entire cross-section of the vessel wall. After embedding in Polyamph-10, however, the anionic sites could not be detected. Brain capillaries, representing blood-brain barrier type MBVs, showed polar distribution of anionic sites, evidenced by more intense labeling of luminal than of abluminal plasma membrane of the EC. Some differences in labeling of ECs and of basement membrane in arterioles and venules were also noted. The use of cationic gold and the ultra-thin sections of tissue samples embedded in hydrophilic media (Lowicryl K4M and LR White) seems to be a promising new method for detection of anionic constituents located on both luminal and abluminal surfaces of the EC, in the basement membrane, and in other components of the vessel wall. PMID- 3655327 TI - Different rhodopsin monoclonal antibodies reveal different binding patterns on developing and adult rat retina. AB - We used a battery of 10 monoclonal antibodies directed against different identified peptide sequences within the carboxyl, transmembrane loop, and amino terminal regions of rhodopsin to label retinas from early postnatal and adult rats. Intensity of label, age of initial appearance of staining, and distribution of label varied depending on the antibody. Most antibodies showed detectable labeling at postnatal day 1, and were eventually observed binding to the cell bodies and the inner and outer segments of the photoreceptors. One amino terminal and two carboxyl terminal antibodies, however, showed no detectable labeling until postnatal day 5 and were only transiently detectable in the cell body region. These patterns cannot be explained by accessibility of binding site, binding affinity, fixation artifact, or crossreactivity. The results indicate that physiological and experimental parameters can alter the apparent immunocytochemical localization of conformationally active molecules such as rhodopsin. The results also suggest that rhodopsin can undergo light-dependent conformational changes in several different compartments within rat retinal photoreceptors before the time of eye opening. PMID- 3655329 TI - Ultrastructural study of the nucleus Cuneiformis in the cat. AB - The Cuneiformis nucleus (Cu.n.) is a reticular nucleus of the mesencephalic tegmentum which is involved in several functions and particularly in locomotor activities. While the physiological properties and the nervous connections of the nucleus have been studied, there is no data about its ultrastructure. Therefore, we investigated this region in cat at the electron microscope and with morphoquantitative methods to clarify its ultrastructural organization and particularly the characteristics of its synaptic complex. The neurons are small and medium in size, with a high nucleo-cytoplasmic ratio and a modest rough endoplasmic reticulum organization. The neuropil is very extensive. Myelinated axons are very numerous. Dendritic profiles whose plasmalemma is almost completely covered by synaptic boutons are observed frequently. There are few somatic synapses; 81% have symmetrical junctions and 23% have round vesicles only. There are numerous synapses in the neuropil, 40% having asymmetrical junctions and 60% containing round vesicles only. The greater functional complexity indicated by the morphological data and the greater extension of the neuropil synapses with respect to that of the somatic ones, suggest that the neuropil is the main site of modulation and integration of the inputs to the nucleus. A highly significant statistical difference between the sizes of the somatic vesicles and those of the neuropil was found. This may point to the presence of distinct populations of vesicles, which may be correlated with the variety of substances (neurotransmitters, neuropeptides etc ...) found in the nucleus. The remarkable ultrastructural similarity between the Cu.n. and the periaqueductal gray matter is discussed. PMID- 3655328 TI - [Quantitative and comparative research or lamina V-pyramidal neurons in the regio retrosplenialis granularis in the rat]. AB - Large pyramidal neurons of lamina V of regio retrosplenialis granularis and regio cingularis anterior of adult male rats were analyzed quantitatively and compared statistically. In both regions, these pyramids showed nearly equal values for their apical and basal dendritic tree, which is typical for pyramidal neurons in intermediate cortices. In important quantitative parameters the large pyramidal neurons of the both regions were comparable. The total spine number per neuron was in the same range for the pyramidal neurons in both cortical regions, whereby the smaller dendritic tree of retrosplenial pyramids showed a higher spine density in comparison with the larger cingulate pyramids. This fact indicates a nearly equal number of synaptic spine contacts with incoming afferents for both cell types. Therefore, both regions are considered to belong to the intermediate cortex-formation "mesoneocortex". PMID- 3655331 TI - The endocranial cast of an early miocene edentate, Hapalops indifferens Ameghino (Mammalia, Edentata, Tardigrada, Megatheriidae). Comparative study with brains of recent sloths. AB - A natural endocranial cast which represents a complete brain of a specimen of Hapalops indifferens is described. Comparing this cast to brains of actual Tardigrada, it shows a telencephalic morphology and a pattern of neocortical sulci that resemble more the brain of Bradypus rather than that of Choloepus. The neocortical sulci homologate the lateral or corono-lateral, suprasylvian and pseudosylvian sulci. Taking into account the studies of cortical maps in Bradypus and the notable similitude of the pattern of neocortical sulci between Bradypus and H. indifferens, the possible representation of the primary sensitive and motor somatic areas, secondary sensitive somatic area, visual and auditory areas are inferred. As in Bradypus, the primary sensitive and motor somatotopic organizations would be overlapped and would not be mirror images; they would show a predominance of the area of the forelimb. The relative brain size of H. indifferens is similar or higher than that of sloths of the genus Bradypus. The close resemblance between Bradypus and Hapalops, with respect to its brain morphology and relative brain size. is congruent with the current hypothesis of the phylogenetic relations between fossil and recent Tardigrada. PMID- 3655330 TI - Effect of prolonged hypobaric hypoxia during postnatal development on myelination of the corpus callosum in rats. AB - Infant rats, together with the female, were exposed to a simulated altitude of 7,000 m every day from birth to the age of 17 days, excepting the 6th, 7th, 13th and 14th day. Animals were studied on the 18th day, 20 hours after the last exposure to hypoxia. Rats aged 12, 15 and 18 days acted as the controls. The number of myelinated axones of the corpus callosum rose from the 12th to the 18th day; the number in animals exposed to hypoxia did not differ significantly from the number in the 15-day-old controls. Axonal section area likewise increased from the 12th to the 18th day and again the value in animals exposed to hypoxia was no different from section area in 15-day-old animals. The number of myelin lamellae rose from the 12th to the 18th day, but in animals exposed to hypoxia it did not differ significantly from the value found in 12-day-old animals. The thickness of the myelin layer increased from the 12th to the 18th day; in the experimental animals it was the same as in the 12-day-old controls. The myelin lamellae likewise became thicker, between the 12th and the 15th day; in animals exposed to hypoxia this parameter was the same as the value in 12-day-old rats. In the electrophysiological part of the study, the development of the interhemispheric response was analysed. In animals exposed to hypoxia, the individual waves of the IHR had the same shape and latent periods as in 15-day old animals. The results demonstrate that hypoxia has a profound effect on morphological and functional maturation of the corpus callosum in infant rats. PMID- 3655332 TI - The fine structure of the subthalamic nucleus in the cat. II. Synaptic organization. Comparisons with the synaptology and afferent connections of the pallidal complex and the substantia nigra. AB - The synaptic organization of the subthalamic nucleus (Sth) of the cat has been investigated by means of electron microscopy. On the basis of the following criteria: the size and the shape of the synaptic boutons, their origin, the size and the shape of the synaptic vesicles, the distribution and density of the vesicular population, and the characteristics of the active synaptic zones, several types of synaptic boutons have been discriminated: F1, F2, SR, LR1, LR2, d.c.v., and "d" profiles. The F1 and F2 types have pleomorphic vesicles and form symmetrical synapses with the neuronal perikarya, the proximal dendrites and their spines, as well as with the initial axonal segments. The SR, LR1 and LR2 types contain round or oval vesicles and form asymmetrical synapses mainly with middle sized and small dendrites, and their spines. The d.c.v. boutons contain a mixed population of clear synaptic vesicles and dense core vesicles. The d.c.v. type forms asymmetrical synapses. The "d" profiles share identical features with the vesicle containing dendrites. The F2, SR, LR1, LR2, and "d" profiles take part in synaptic diads and/or triads, and occasionally participate in the synaptic glomeruli. The LR1 and LR2 take part in glomeruluslike formations. The Sth has a distinct synaptic pattern that permits its discrimination as a separate ultrastructural entity. The Sth seems to share some common ultrastructural features with the thalamic nuclei. On the other hand, the ultrastructural aspects of the Sth are much more different from its closest embryological allies: the both pallidal segments, and the zona reticulata of the substantia nigra. PMID- 3655333 TI - Fluorescent granular perithelial cells and granular pial cells in the brains of aged mice. AB - The majority of fluorescent granular perithelial cells (FGPs) in the brains of aged mice contain large honeycomb bodies which probably represent a specialised type of phagosome. The other characteristic feature of FGPs is the presence of large numbers of small coated vesicles in the cytoplasm. Granular pial cells are structurally identical to FGPs and in particular they contain large honeycomb bodies. The evidence indicates that FGPs and granular pial cells represent one cell type whose major function in the aged brain is to act as a scavenger of substances such as lipid but which does not phagocytose degenerating cells or large masses of cellular debris. FGPs and granular pial cells are different from intraventricular macrophages both structurally and in their response to ageing. The similarity between FGPs and granular pial cells in the ageing brain supports the view that FGPs are derived from pial cells. PMID- 3655334 TI - The development of retina and the optic tectum of petromyzon marinus, L. A light microscopic study. AB - Morphological evolution of the retina and optic tectum along the stage of ammocoete, transformation and young adult of sea lampreys (Petromyzon marinus L.) was studied using light microscopic techniques and quantitative morphometry. A retinal differentiated zone surrounding the optic nerve head with a kind of differentiated photoreceptors is present through all the stages studied until stage VI of transformation and its extension is almost unchanged since 60 mm. larve. From this length larval retina grows by extension of the lateral undifferentiated retina, that in large larvae subdivides in a lateral germinal zone and an intermediate differentiating zone more thickened were ganglion cells and the optic fibre layer differentiate early. In the largest larvae outer and inner neuroblastic layers were also recognized in these intermediate zone except in the most lateral retina. Mitotic activity was observed both in germinal and intermediate differentiating zones near the optic ventricle. The germinal zone disappears after the formation of an irideal retina in transforming stages and, with the exception of the photoreceptor layer, retinal layers were differentiated since stage III along the neural retina. The photoreceptor layer develops in the early stage VI along the retina. Adult pattern of retinal pigmentation is found in these stage. A periventricular and a lateral region were recognizable in the optic tectum of the larval period. Tectum of large larvae shows an outline of laminar organization. In the stage III of transformation the tectal lamination is the same of the young adults: the periventricular cell layer is subdivided by fibre bands and in the lateral region a stratum cellulare centralis and a stratum cellulare et fibrosum externum were distinguishable. A comparison between retinal and tectal growths was made. Most retinal and tectal growth and differentiation occurs before adult photoreceptors develop. PMID- 3655335 TI - Psychotherapy with homosexual men and women: integrated identity approaches for clinical practice. PMID- 3655336 TI - Treatment of identity and intimacy issues in gay males. AB - A psychodynamic analysis of the presenting problems of many gay male clients reveals the frequent presence of issues related to identity and intimacy. This paper explores these concepts from the viewpoint of observed clinical phenomena, their likely antecedents, and treatment strategies based on a model of psychological health which balances identity and intimacy. PMID- 3655337 TI - Dependency issues in lesbian relationships. AB - The focus of this paper is dependent relationship patterns or co-dependency in lesbian relationships. Co-dependent relationship patterns are identified, in general, as well as in lesbian relationships. Treatment strategies found to be successful in overcoming these co-dependent issues are illustrated with case studies. PMID- 3655338 TI - Sex therapy with lesbian couples: a four stage approach. AB - The many factors--social, cultural, psychological--that shape homosexual sexual expression render purely behavioral sex therapy models one-dimensional and ineffective for lesbian clients with sexual presenting problems. Though a behavioral approach may be useful later in the treatment of such problems, the effective clinician must first address the inimical social and cultural contexts that frame lesbian sexual impasses. This paper offers specific techniques, both direct and indirect, designed to illuminate and neutralize these contexts. Additionally, the author presents a sequence of sensate focus exercises tailored to the particular needs of lesbian couples. PMID- 3655339 TI - Causes and treatments of sexual desire discrepancies in male couples. AB - Multiple causes and treatments of sexual desire discrepancies in male couples are catagorized and discussed. Theoretical constructs and examples of such problems are extrapolated primarily from the existing literature on inhibited sexual desire and from clinical experience. Treatment suggestions are based on a well established multi-level model and adapted to apply more directly to homosexual couples. PMID- 3655340 TI - A sociological approach to counseling homosexual clients and their families. AB - Stigma lies at the root of many problems typically experienced by homosexual clients and their families. Sociological theory and research shed light on the dynamics of stigma and its consequences, both for the stigmatized population and for their heterosexual families and associates. This article summarizes key sociological research on the nature and development of sexual orientation. It considers the dynamics of homophobia and its implications for homosexual youngsters and their families. It offers practical tips for helping clients to understand their own or a family member's homosexual orientation, for coping with stigma, for reconciling issues of religion and morality, and for determining lifestyle. Suggestions for therapist office materials are also included. PMID- 3655341 TI - Group psychotherapy for bisexual men and their wives. AB - A significant number of men and women experience conflict surrounding homosexual expression within marriage. As the media focuses more attention on these relationships, more bisexual men and their wives seek counseling or psychotherapeutic assistance. Based upon the author's research and clinical experience, this article outlines a group psychotherapy strategy for bisexual men and their wives. Relevant research and background data on mixed-orientation marriages are summarized. Treatment strategy explores intervention processes, resistances to treatment, the unique supportive experiences of the group, and qualities of the co-therapist who may provide assistance to bisexual men and their wives. PMID- 3655342 TI - Clinical implications of lesbian mother studies. AB - Recent surveys of lesbians have revealed that one-third have been heterosexually married, and one-half of these have had children. Studies comparing lesbian mothers and their children with divorced heterosexual mothers and their children provide data of value to clinicians preparing to evaluate or treat members of this population. Studies show similarities between the two groups in marital history, pregnancy history, child-rearing attitudes, and lifestyle. Motherhood, not sexual orientation, is the most salient factor in both group's identity. Lesbian mothers had more congenial relations with ex-spouses and included men more regularly in their children's lives. Coupled lesbians had greater economic and emotional resources and provided children with a richer family life than did mothers of either group living alone with children. No difference in frequency not type of psychological problem was found in the children. Children benefited from group discussions to relieve anxiety about changes in their lives and in their mothers' sexual orientation. PMID- 3655343 TI - Helping gay fathers come out to their children. AB - This paper describes the treatment of seven gay fathers who were concerned about revealing their sexual identity to their children. A time-limited group was established for the purpose of developing strategies to help them past this juncture in their development as gay men. Role playing of specific situations was the modality chiefly employed. Discussions of the effects of internalized homophobia were also held. At the conclusion of the group (eight sessions) all participants rated the experience as "highly useful." Follow-up data are presented at 6 months. PMID- 3655344 TI - Psychotherapy with gay/lesbian couples and their children in "stepfamilies": a challenge for marriage and family therapists. AB - As increasing numbers of gay/lesbian parents and their children enter into "stepfamily-like" relationships with a gay partner, they are beginning to seek therapy for difficulties peculiar to stepfamily living involving two same-sex partners. This paper focuses on the difficulties experienced by gay parents and children in a step-relationship, and seeks to sensitize mental health professionals to issues specific to intervention with such families. Effective therapy with these families requires that therapists be sensitive to their personal biases and prejudices with regard to gay men and women in general and as parents, and be aware that such attitudes can intrude and negatively affect the therapeutic process and its outcomes. Guidelines for therapy are offered. PMID- 3655345 TI - Resources for families with a gay/lesbian member. AB - An exploratory mail survey was conducted with families having a gay/lesbian member, inquiring as to where they had received information about gays and lesbians and their lifestyles, and where they found support since their family member came out. The sample population was a 90-member support group, "Families and Friends of Gays and Lesbians." Responses to open-ended questions gave a personal account of these families' concerns, needs, and wants, which suggested answers as to how those in counseling professions might better prepare themselves to provide services to these families by making themselves more available and accessible to families. PMID- 3655346 TI - Developmental issues and their resolution for gay and lesbian adolescents. AB - The primary developmental task for homosexually oriented adolescents is adjustment to a socially stigmatized role. Although the individual homosexual adolescent reacts with diversity and great resilience to societal pressures, most pass through a turbulent period that carries the risk of maladaptive behaviors that may affect adult performance. Despite individual variation, certain issues have been found to concern most homosexual adolescents. Empirical data from the Institute for the Protection of Lesbian and Gay Youth, Inc. in New York City suggests that isolation, family violence, educational issues, emotional stresses, shelter, and sexual abuse are the main concerns of youth entering the program. If not resolved, the social, cognitive, and social isolation may extend into adulthood, and anxiety, depressive symptoms, alienation, self-hatred, and demoralization may result. In a non-threatening supportive environment that provides accurate information and appropriate peer and adult role models, many of the concerns are alleviated and internalized negative attitudes are either modified or prevented from developing. The authors discuss the effects of prejudice and the impact of negative societal attitudes on the developing social and personal identities of homosexual youths. PMID- 3655347 TI - Alcoholics anonymous and gay American men. AB - Self-help groups can be powerful tools for self-change. Thus, counselors and other professionals are wise to consider referrals to such groups when possible. In this article, the nature of self-help groups is explored in general, and Alcoholics Anonymous (A.A.) in particular. A.A. was chosen because it is the "grandparent" of all 12-Step groups, it has proven effective over time, and because of the pandemic incidence of alcoholism among homosexual American men. Therefore, professionals should be well aware of this invaluable resource for the treatment of alcoholism. This article explores the homosexual alcoholic man in relation to A.A., as well as how professionals may be supportive of the gay A.A. member. Finally, some suggestions are provided about how rural homosexual alcoholic men might be better treated. PMID- 3655348 TI - AIDS, sexuality, and sexual control. AB - The AIDS epidemic is discussed in terms of its effect on general sexual attitudes and behavior of homosexual and bisexual men, then, in particular, on the issue of control over one's sexual behavior. Problems encountered in the formulation of the concept of sexual control are discussed along with relevant theoretical constructs. A group treatment program for homosexual and bisexual men with problems of sexual control is described, along with findings and discussions regarding the effect of such treatment on sexual behavior. PMID- 3655349 TI - The worried well: maximizing coping in the face of AIDS. AB - This paper discusses the AIDS epidemic in terms of its impact on the psychology of individuals and their relationships. Special emphasis is given to treatment strategies that therapists may find useful in working with the worried well presenting with psychological and sexual difficulties in reaction to AIDS anxiety. Issues of denial, control, and compliance will be presented as central to working with this population. PMID- 3655350 TI - The individual and social psychology of aging: clinical implications for lesbians and gay men. AB - This article examines issues regarding aging for homosexual people in an attempt to provide a more comprehensive understanding and appreciation of the meaning age has for women and men in our society. Through the use of case examples, clinical concerns and interventions are discussed as they relate to three broad areas. Specifically, the interrelated effects of ageism and heterosexism, normal changes in sexual response with age, and "accelerated aging" are explored. The relationship between social context and individual psychology provides the framework for this discussion. As the literature reviewed here indicates, there is a great deal of diversity among homosexual women and men in their experiences with aging. The strengths and insights which characterize many older homosexual men and women, however, provide valuable lessons for all men and women. PMID- 3655351 TI - Therapeutic issues and intervention strategies with young adult lesbian clients: a developmental approach. AB - This paper examines the coming out process within an adult developmental context. Therapeutic issues which surface for the young adult lesbian client include separation from parents, development of social support, exploration of career/vocational goals, and the establishment of intimate relationships. Intervention strategies are suggested which facilitate the coming out process and help the client integrate her sexual orientation within her emerging adult identity. PMID- 3655352 TI - Internalized homophobia and lesbian identity. AB - This paper presents suggestions for therapists working with women who are having difficulty accepting their attractions to other women, lesbian behavior and identity, or both, with the goal of promoting self-acceptance and reducing internalized homophobia. After a discussion of the therapeutic relationship, several coping strategies which have been used successfully by many women are described and therapeutic applications are offered. These strategies include cognitive restructuring, avoiding a negative identity, adopting an identity label, self-disclosure, meeting other lesbians, and habituation to lesbianism. Finally, behavioral indications of success or failure to achieve the goal of self acceptance are presented. PMID- 3655353 TI - Ericksonian hypnosis and strategic interventions for sexual orientation confusion. AB - Erickson's utilization approach provides a model of hypnotic and strategic intervention for persons seeking psychotherapy because of sexual orientation confusion. Case studies outline examples of hypnotic and strategic short-term interventions. These cases include the use of metaphor, utilizing resistances, anchoring, and synesthesia. PMID- 3655354 TI - Therapy for male couples experiencing relationship problems and sexual problems. AB - This article examines four issues that need to be explored by the therapist as possible causes of stress for a male couple: stereotypic male roles, stereotypic sexual roles, homophobia, which includes the "coming out" process, and sexual dysfunctions. These issues can cause anxiety and stress, which may in turn cause relationship problems for a male couple. The role of the therapist is clarified and suggestions for treatment are given. PMID- 3655355 TI - Stage discrepancy in male couples. AB - Any characteristic in the developmental stages of relationships has the potential for being at the core of a stage discrepancy problem. A few of the more frequently seen stage discrepancies are (a) reappearance of the individual in Stage Three in conflict with the merging of Stage One, (b) reappearance of the individual in Stage Three threatening the dependability of the partner in Stage Four, and (c) the high limerence of Stage One in sharp contrast with the loss of limerence in Stage Two. As a side issue, and as has been stated elsewhere, one of the most common causes for terminating male relationships toward the end of the first year is the loss of limerence. Examples of characteristics in conflict are as numerous as the characteristics in male couples. In some instances, characteristics of later stages appear earlier as symptoms of insecurity, dependency, or difficulty in managing the aging process. Stage discrepancies often appear as behavioral manifestations, or as symptoms of the difficulties that the couple or individual is having in resolving the stage discrepancy problem. However, the conflicts are often presented to the psychotherapy as problems of: (a) developing or maintaining intimacy; (b) power, competition, or control issues; (c) jealousy; or (d) differences in dealing with expressions of anger or tenderness. Utilizing the framework of stages of relationships and the possibility of discrepancy in the developmental characteristics can give the psychotherapist added understanding of the presenting complaints of male couples, which in turn can lead to a better assessment of the couples' difficulties and the development of new strategies of treatment intervention. PMID- 3655356 TI - Assessment of sexual orientation. AB - This paper reviews the multitude of methods which have been utilized to assess sexual orientation. The basic assumption of most of the previous methods of assessment is that sexual orientation is determined by one's gender or genitalia and the gender or genitalia of the individual one is attracted to. This assumption is challenged and the complexity of sexual orientation is illustrated. Consequently, a model for assessment of sexual orientation is proposed which includes nine dimensions: current relationship status, self-identification identity, ideal self-identification identity, global acceptance of their current sexual orientation identity, physical identity, gender identity, sex-role identity, and sexual orientation identity as measured by behavior, fantasies and emotional attachments, and finally the individual's past and present perception of their sexual identity compared to their idealized future. PMID- 3655357 TI - The effects of stress on the psychological well-being of army wives: initial findings from a longitudinal study. AB - This study examines the relationships between marital and military-specific stress and the general psychological well-being of army wives. These data come from an ongoing three-year longitudinal panel study. Study participants (N = 277) were assessed at two different times 12 to 15 months apart. It was predicted that current marital stress and military life stress would have significant negative (and independent) relationships to well-being, even when prior levels of stress and well-being were taken into consideration. A path model was utilized to analyze the data. These data support the view that both military life stress and marital stress have important independent relationships to the general psychological well-being of army wives. Furthermore, it appears that the relationship between marriage and well-being takes on added importance the longer one stays in the military system. PMID- 3655358 TI - Comparison of the prevalence of type A behavior in boys and girls from two contrasting socioeconomic status groups. AB - The prevalence of Type A behavior in children from lower-class rural and upper class urban backgrounds was compared using the Hunter-Wolf A-B Self-Rating Scale (H-W A-B). Analyses of variance were performed for two levels of socioeconomic status (SES), two levels of race (black and white), two levels of gender, and two levels of age (9-11 and 13-14). A significant difference for SES was found in the predicted direction with a greater prevalence of Type A being found among upper urban children (p less than .001). There was also a significant effect for race (p less than .0001). Although there was a significant effect for gender with boys scoring higher (p less than .001), there was no difference between boys and girls within either SES group, and both boys and girls in the upper-urban group were more Type A than boys and girls in the lower-rural group (p less than .001). The possibility that the lack of sex differences within groups may reflect changing lifestyles for young women is discussed as a topic worthy of further epidemiological investigation. PMID- 3655359 TI - Assessment of type A behavior in children: a comparison of two instruments. AB - The agreement of classifications yielded from two instruments used to assess children's Type A-Type B behavior, the Matthews Youth Test for Health (MYTH) and Hunter-Wolf (HWolf), was evaluated with a sample of rural children from the southern United States. Fifth grade children (N = 276) served as subjects. MYTH and HWolf scores were found to be only weakly correlated and the agreement of Type A-Type B classifications occurred at a rate only slightly above chance. To assess the psychometric properties of the instruments, both were subjected to factor analysis and reliability/internal consistency estimates were obtained and compared with previous results. A factor structure remarkably similar to that of previous reports was found for the MYTH but not the HWolf. The results closely parallel those of another recent report and provide further support for the recommendation that these instruments should not be considered interchangeable measures of Type A behavior and that when multiple measures cannot be employed for research, the investigator should use the MYTH. Caution is indicated in interpreting scores of either measure, however, since neither has yet been shown to relate to later development of coronary heart disease. PMID- 3655360 TI - The relation of stress hormone excretion to type A behavior and to health. AB - The relation between catecholamine and cortisol excretion and Type A behavior, assessed using an 11-item self-report questionnaire based on the Jenkins Activity Survey, is examined in a Swedish sample of young adults (N = 149). Cluster analysis indicates that the items measure four aspects of Type A behavior: irritability, hurried behavior, work achievement, and competitiveness. These clusters are not correlated with measures of recent health care utilization. In both sexes, a higher total Type A behavior score is related to decreased daytime urine concentrations of norepinephrine and day and night concentrations of cortisol. In males, increased hurried behavior is related to lower night levels of norepinephrine; higher irritability and competitiveness predict lower night levels of epinephrine and cortisol and increased urine excretion rate. In females, higher irritability and lower competitiveness scores are related to increases in daytime urine excretion and slightly lower levels of cortisol. These results indicate that only certain aspects of the Type A syndrome are related to stress processes and imply that the behaviors serve to lower stress responses in early adulthood. PMID- 3655361 TI - Secretory IgA as a measure of immunocompetence. AB - The field of psychoimmunology has rapidly expanded in recent years and various parameters of the immune system have been examined in relation to psychological factors. The secretory immune system is one of the more interesting aspects of the entire immune system because it protects mucosal membranes from invading organisms. Stress-produced changes in secretory immunoglobulin A (s-IgA) as measured by radial immunodiffusion assays have been reported in several studies. We present three reasons why total s-IgA protein, the measure derived from radial immunodiffusion assays, may not be a reasonable measure of immune system functioning, and we suggest an alternative method for examining secretory IgA that focuses on s-IgA antibody response to a novel antigen. PMID- 3655362 TI - The primary role of murine bone marrow in the production of natural killer cells. A cytokinetic study. AB - The normal steady state production of natural killer (NK) cells in the bone marrow and spleen was characterized with cytokinetic technics. We developed a protocol to enrich for NK cells in bone marrow and demonstrate that target binding can be used as a criterion for marrow NK cells if nonspecifically "sticky" cells are eliminated. The selected population of B cell-depleted bone marrow lymphoid cells was comprised mainly of lymphocytes, of which 80% were NK 1.1+. B cell-depleted bone marrow lymphocytes that bound to YAC-1 could be characterized as two populations on the basis of morphology and proliferative status: large, proliferating target-binding cells (TBC), of which 25% were in S phase of the mitotic cycle, and small postmitotic TBC. Pulse and chase studies indicated that the small TBC in bone marrow were derived from an immediate proliferating precursor, presumably the large TBC, which were, in turn, derived from a precursor population that was more rapidly proliferating. In contrast, few if any splenic TBC were labeled after a 30-min pulse with [3H]TdR and significant numbers of labeled TBC did not appear in the spleen until 2 or more days after the pulse label. Surprisingly, some of the splenic TBC were relatively long lived and survived 2 mo or longer. These studies are the first to directly characterize the production of NK cells in situ in normal marrow. We demonstrate that the marrow is the primary site of production of NK cells and that little, if any, proliferation of NK cells occurs in the periphery of unstimulated mice. The data suggest the existence in the bone marrow of at least three compartments in the NK lineage: a rapidly proliferating NK precursor population, a less rapidly proliferating population of large TBC, and a population of small postmitotic TBC. PMID- 3655363 TI - Prominent IgM rheumatoid factor production by human cord blood lymphocytes stimulated in vitro with Staphylococcus aureus Cowan I. AB - We previously reported that Staphylococcus aureus Cowan I (SAC) is a potent stimulant of IgM rheumatoid factor (RF) production by normal adult peripheral blood mononuclear cells. In the current study, we compared the capacity of normal adult peripheral blood mononuclear cells and cord blood mononuclear cells to produce IgM RF. Although both populations of cells consistently produced IgM RF in response to SAC, the quantity of RF produced by cord blood cells (128 +/- 18 ng/ml, mean +/- SEM) greatly exceeded that of adult cells (37 +/- 5 ng/ml, p less than 0.0005) even though both populations of cells demonstrated comparable total IgM responses. Remarkably, 16.7% of total IgM produced by cord blood cells in response to SAC showed RF activity compared to only 3.4% (p less than 0.0001) of the total IgM produced by SAC-stimulated adult cells. Thus, precursors of IgM RF secreting cells are not only a consistent feature of the normal adult human B cell repertoire, but they are especially represented at the time of birth. These findings are consistent with the hypothesis that IgM RF originates from germ line genes and underscore the utility of SAC as a probe for analyzing the production of this autoantibody. PMID- 3655364 TI - Products of activated lymphocytes and macrophages inhibit mouse embryo development in vitro. AB - The effects of activated leukocyte products on embryonic development were assessed by adding mouse and human leukocyte culture supernatants and purified murine and human lymphokines and monokines to mouse embryos in tissue culture. Supernatants from mitogen-stimulated and mixed lymphocyte cultures arrested embryonic development at the two-cell to morula stage. Of a panel of six individual lymphokines and monokines tested for effects in this system, both murine and human forms of the lymphokines colony-stimulating factor, interferon gamma, and human B cell growth factor significantly arrested embryonic development over a wide concentration range. The monokines, interleukin 1 and tumor necrosis factor, also had significant effects but only at high doses. These results indicate that products of activated lymphocytes and macrophages can have detrimental effects on preimplantation embryos. Early abortion could result from local (intrauterine) production of such embryotoxic factors by activated lymphocytes and macrophages in response to stimulation by microorganisms or reproductive tissue antigens. PMID- 3655365 TI - Primary cultures of murine astrocytes produce C3 and factor B, two components of the alternative pathway of complement activation. AB - We have investigated the production of C3, C4, and factor B complement components in primary cultures of murine astrocytes and in clonal cell lines belonging to the astrocytic lineage by immunoprecipitation of secreted labeled polypeptides. Although C4 has not been detected, C3 appeared to be constitutively synthesized both by two transformed astroblastic cell lines and by astrocytes in primary cultures. In contrast, factor B was only secreted upon lipopolysaccharide stimulation both in astroglial primary cultures and in an immortalized astrocytic cell line. The eventual physiologic relevance of an endogenous brain production of components of the alternative pathway of complement activation is discussed. PMID- 3655366 TI - Monoclonal antibodies to adenosine receptor by an auto-anti-idiotypic approach. AB - Monoclonal antiadenosine receptor antibodies have been raised by an auto-anti idiotypic approach. BALB/c mice were immunized with adenosine 6-aminocaproyl bovine serum albumin. Hybridoma cell lines were raised and lines that secreted antibodies that bound to rabbit antiadenosine antibodies were obtained. Two such monoclonal antibodies, AA18 and AA21, were studied in detail and found to be directed at adenosine receptors by the following criteria. They inhibited the binding of [3H] adenosine to rabbit antiadenosine antibodies that had binding characteristics similar to those of adenosine receptors. They bound to rat brain membranes and binding could be inhibited by N6-cyclohexyladenosine and L-N6 phenylisopropyladenosine, both adenosine receptor agonists. They also inhibited the binding of [3H]L-N6-phenylisopropyladenosine to rat brain membranes. In functional assays, they inhibited adenylate cyclase of rat brain membranes, but had no effect on adenylate cyclase of rat hepatic membranes, indicating that they mimic agonists of the A1 receptor, therefore, carrying an "internal image" of the adenosine molecule. When adenosine receptors of rat brain membranes were solubilized with 1% cholic acid, partially purified on an adenosine 6 aminocaproyl AH-Sepharose column and analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis and Western blotting, both AA18 and AA21 recognized a 62,000 band under nonreducing conditions, and a major band of 36,000 under reducing conditions. We conclude that the auto-anti-idiotypic route has yielded specific antibodies that recognize the A1 adenosine receptor. PMID- 3655367 TI - Complete variable region sequences of five homologous high affinity anti-digoxin antibodies. AB - High affinity murine A/J anti-digoxin monoclonal antibodies exhibit diversity in binding specificity for structurally related cardiac glycosides. They utilize several VH and VL genes. Among this diverse set, however, five antibodies share V region amino-terminal sequences that are remarkably homologous. The five antibodies were divided into three subsets based on different fine specificity binding patterns. Therefore, complete V region sequences were determined by Edman degradation and by nucleotide sequence analysis. The VH region homology among the five antibodies was 84 to 100% and the VL region homology was 89 to 99%. The sequence data are consistent with the use of single (or closely related) VH and VL genes encoding the five antibodies. Four antibodies, derived from the same fusion (40-40, 40-120, 40-140, and 40-160), use identical D, JH2, and JK5 gene segments and identical junctions suggesting that they are clonally related. The fifth antibody (35-20) uses different D and JH1 gene segments but the same JK5 gene segment. All five antibodies share a cross-reactive idiotype. The three antibodies that exhibit the greatest degree of homology (40-40, 40-120, and 40 140) also share indistinguishable antigen-binding patterns as well as private idiotopes not present on the other two antibodies. Antibody 40-160, which has the next most homologous sequence, shares idiotopes with the first set but binds preferentially to different sites on the hapten, whereas antibody 35-20 has the most divergent sequence. In general, the degree of sequence homology among the five antibodies correlates with their hierarchical order based on hapten and idiotype fine specificity patterns. PMID- 3655368 TI - 125I-fibrin deposition in IgE-dependent immediate hypersensitivity reactions in mouse skin. Demonstration of the role of mast cells using genetically mast cell deficient mice locally reconstituted with cultured mast cells. AB - We investigated the clotting associated with IgE-dependent immediate hypersensitivity reactions in the mouse by injecting monoclonal mouse anti dintrophenyl IgE antibodies i.d. and, the next day, administering 125I-guinea pig fibrinogen i.v. 10 to 30 min before i.v. antigen (2,4-dinitrophenylated human serum albumin) challenge. In normal mice, 2-hr passive cutaneous anaphylaxis (PCA) reactions were associated with substantial leakage of 125I-fibrinogen and deposition of 125I-fibrin. Thus, ears injected with IgE contained up to six times the total cpm of 125I and up to 30 times the cross-linked 125I-fibrin-associated cpm of 125I than did control ears. Several lines of evidence indicated that the 125I-fibrin deposition associated with the PCA reactions was dependent on the activity of mast cells: 1) Mast cell degranulation occurred at sites of PCA reactions. 2) Antigen-induced influx of 125I-fibrinogen and deposition of 125I fibrin were virtually abolished by heating the IgE (56 degrees C, 1 hr) before i.d. injection. 3) Little or no IgE-dependent 125I-fibrinogen influx or 125I fibrin deposition occurred in mast cell-deficient WBB6F1-W/Wv or WCB6F1-S1/S1d mice X 4) Adoptive transfer of cutaneous mast cell populations into WBB6F1-W/Wv mice (by each of three approaches: i.v. transplantation of normal bone marrow cells or local i.d. injection of cultured, growth factor-dependent mast cells 2 days or 9 to 10 wk before antigen challenge) conferred on the recipients the ability to express the 125I-fibrinogen influx and 125I-fibrin deposition associated with PCA reactions. These data demonstrate that 125I-fibrinogen influx and 125I-fibrin deposition occurs in association with PCA reactions in the mouse, and that the reaction is largely or entirely dependent on the function of cutaneous mast cells. The experiments also demonstrate the utility of a novel model system for the analysis of mast cell function in vivo: WBB6F1-W/Wv mice locally reconstituted with mast cells by the injection of mast cell populations generated in vitro. PMID- 3655369 TI - Immunoglobulin chain recombination among antidigoxin antibodies by hybridoma hybridoma fusion. AB - Conditions necessary for in vitro chain recombination of high affinity (10(9) to 10(12) M-1) antidigoxin monoclonal antibodies resulted in decreased affinity for both intact "native" and chain recombinant molecules. Chain recombination by somatic cell fusion was used instead to study the effects on antigen specificity and idiotypy of recombinants in which an homologous light (L) chain substituted for the parental L chain. The antidigoxin antibody 26-10 utilizes a VL sequence highly homologous to that of antibody 40-20, an antidigoxin antibody which uses a different VH gene than does 26-10 and lacks significant reactivity with an anti 26-10 idiotypic serum. The drug-marked antidigoxin cell line 26-10 (gamma 2a, kappa) and a drug-marked light chain producing variant of antidigoxin hybridoma 45-20 (lambda 1) which lacks both digoxin binding and idiotypy were fused. The fusion progeny (gamma 2a, kappa, lambda 1) which binds digoxin and is idiotype positive, was selected for kappa loss (resulting in loss of digoxin and idiotype binding) and then fused with a heavy (H) chain loss variant of antidigoxin hybridoma 40-20 (kappa, digoxin nonbinding, idiotype negative). The resultant cell line CR-57 (gamma 2a, kappa, lambda) secretes antibodies which assemble the 26-10 H chain with both the 40-20 kappa-chain and the 45-20 lambda 1-chain. The affinity purified recombinant species consisting of 26-10 H chain and 40-20 kappa chain expresses complete 26-10 idiotypic determinants. However, this recombinant antibody binds digoxin with decreased affinity and altered specificity relative to native 26-10. The binding specificity pattern nonetheless is most similar to the H chain donor. Amino acid and nucleotide sequence analyses of the respective light chains demonstrate six variable region differences between them, two of which are in complementarity-determining regions and the remainder in the framework. Hybridoma-hybridoma fusion provides an alternative to in vitro chain recombination for studying the contribution of chain combinational diversity to antibody diversity, antigen binding, and idiotypy. PMID- 3655370 TI - Activation of plasma Hageman factor and kallikrein in ongoing allergic reactions in the skin. AB - Ten atopic subjects, sensitive to intradermal injection of less than or equal to 10 protein nitrogen units of ragweed or grass pollen antigen, underwent paired antigen and buffer skin chamber incubation over the base of denuded skin blisters. The chamber fluids were sampled over a 6-hr period for histamine and activated Hageman factor and plasma kallikrein which were complexed to C1 inhibitor. In 9 of 10 subjects significantly (p less than 0.01) increased histamine levels (74 +/- 11 ng/ml vs 1.5 +/- 0.55 ng/ml) and kallikrein-C1 inhibitor complexes (2.15 +/- 0.78 ng/ml/hr vs 0.51 +/- 0.09 ng/ml/hr, p less than 0.25) were detected at antigen sites compared with buffer sites, respectively. Increased levels of activated Hageman factor (ng/ml/hr) were detected at antigen sites (1.35 +/- 0.60) compared with buffer sites (0.11 +/- 0.05), (p less than 0.01), in 8 of 10 subjects. Whereas peak levels of histamine were obtained after 1 hr of challenge, both Hageman factor and kallikrein activation, as assessed by complex formation, tended to peak later from the 2nd to the 5th hr. This represents the first demonstration that cutaneous IgE mediated allergic responses are associated with local activation of the intrinsic plasma coagulation-kinin pathways. PMID- 3655372 TI - Evaluation of a method of production and purification of monoclonal antibodies for clinical applications. AB - A procedure is described for the purification of monoclonal antibodies (Mab) from ascitic fluids, which meets the quality control required for in vivo applications of immunoglobulins (Ig) in man. Additional assays were performed to calculate viral and DNA content of the purified Mab. These studies are important to prevent the possible side effects, oncogenic events and virus-related diseases which could follow immunotherapy with Mab. PMID- 3655371 TI - A one-step purification method for monoclonal antibodies based on salt-promoted adsorption chromatography on a 'thiophilic' adsorbent. AB - A convenient and fast method for the purification of mouse monoclonal antibodies from the culture media of cloned cells or from ascites fluids by means of salt promoted chromatography on a 'thiophilic' adsorbent is described. The adsorbent has a capacity to adsorb about 20 mg/ml of immunoglobulins and a broad specificity towards immunoglobulins derived from various animal species irrespective of the type or subclass to which they belong. The recovery of the purified IgG is better than 90% while that for IgM is considerably less, probably due to dissociation occurring during the adsorption-desorption process. This one step procedure also leads to a considerable concentration of dilute solutions of immunoglobulins. Moreover, the purified Igs are eluted by an essentially salt free buffer at near neutral pH thus obviating the need for post-treatment of the sample before storage or subsequent conjugation to enzymes for use in immunoassays. This purification method is also well suited for large-scale operations since sample preparation requires only the addition of 0.5 M K2SO4 to the ascited fluid or cell culture medium. The degree of purification obtained is, in certain instances, comparable to that obtained by biospecific affinity chromatography based on antigen-antibody interactions. In contrast to immunosorption and desorption methods, however, there is no risk of contamination of the immunoglobulins purified on the 'thiophilic' adsorbent by foreign proteins. PMID- 3655373 TI - Trichloroacetic acid (TCA) precipitability of 125I in the blood of mice fed 125I. AB - A recent study showed that after feeding 125I-labelled proteins or free 125I to mice, as much as 40% of total radioactivity in the circulation precipitated upon mixing whole blood with 10% trichloroacetic acid. We examined this potential limitation to the use of radiolabelled tracers for studies on intestinal digestion of proteins and protein uptake, and identified its mechanism. BALB/c mice were gavage-fed or injected intravenously (i.v.) with Na125I. Blood obtained at 15 min was added directly to 10% trichloroacetic acid (TCA) or was processed to obtain serum or plasma. On mixing with 10% TCA, 25-33% of the radioactivity in whole blood was precipitated; less than 2% of the radioactivity in plasma or serum was precipitated. In vitro studies identified hemoglobin as the primary carrier protein participating in this reaction. If hemoglobin was replaced by methemoglobin or cyanomethemoglobin, then the reaction with 125I did not occur, suggesting that iron in the heme group may be the site for 125I binding and that iron must be in its reduced or ferrous form (Fe2+). The administration of non radioactive NaI in vivo or its addition to reaction mixtures in vitro completely inhibited the precipitation of 125I by hemoglobin in the presence of TCA. Thus the addition of non-radioactive iodide to TCA stock solutions may effectively prevent non-specific binding of 125I to free hemoglobin released unintentionally during venipuncture or at other stages of blood processing. PMID- 3655374 TI - An affinity chromatography-gel filtration device for preparing thyroid microsomal antigen. AB - On the basis of conventional differential centrifugation for preparing crude thyroid microsomal antigen (TMAg), we have employed Sepharose 4B gel filtration and affinity chromatography separately to study the elution pattern in terms of absorbance and antigenic activity. The result indicates that thyroglobulin (TG) exists in two forms in crude TMAg, i.e., 'free TG' and 'membrane-bound TG'. TMAg is present in two forms in the eluate: (1) the TM fragment or TMAg polymer, which is produced at a higher rate and has greater antigenic activity, but which is less pure; (2) soluble TMAg, which is produced at a lower rate and has less antigenic activity, but which is more pure. We have developed an affinity chromatography-gel filtration (AC-GF) device which is a combination of affinity chromatography and a Sepharose 4B column. Sephadex G-50 is placed between the rubber stopper and Sepharose 4B in the GF column to ensure intactness of the entire system. With such a device, the AC removes the contaminated TG from TM homogenate, and allows the latter to pass directly from AC to GF for rechromatography. This device extracts the full advantages of both methods and each compensates for any deficiency of the other. Using this one-step procedure, one has the greatest chance of removing TG and obtaining TM fragments of TMAg polymers of higher antigenic activity, as well as separating small amounts of more purified soluble TMAg. Thus, the newly developed method meets the need of large quantities of TMAg for practical application, and at the same time the more purified preparations can be used for analytical purposes. PMID- 3655375 TI - Use of Histopaque for isolating mononuclear cells from rabbit blood. AB - This paper describes the use of Histopaque (Hp) density gradient medium and its advantage for separating mononuclear cells (mnc) from rabbit blood. Hp solutions of density (d) = 1.083 g/ml, 1.119 g/ml and 1:1 mixture of these solutions (final d = 1.103 g/ml) were compared to Ficoll-Paque (Fp, d = 1.077 g/ml) and Lymphopaque (d = 1.086 g/ml). The average leukocyte recovery was: Fp = 26% and Lp = 17%, while that with Hp was: Hp d = 1.083: 41%; Hp d = 1.119: 43%; Hp d = 1.103: 57%. Optimum mnc recovery (76%) was obtained with Hp d = 1.103. Average mnc purity for the various media was: Fp = 88% mnc; Lp = 91%mnc; Hp d = 1.083: 94% mnc; Hp d = 1.119: 93%; Hp d = 1.103: 94% mnc. Contamination was mainly from basophils. Viability was greater than 95% in all cases. Thus, Hp density gradient media provide increased recoveries of mnc from rabbit blood compared to Fp and Lp, while purity is not affected. Rabbit mnc appear to be denser than human mnc, which are recovered in greater numbers using Fp. PMID- 3655376 TI - Computer-assisted collection and analysis of enzyme-linked immunosorbent assay data. AB - Computer programs are presented for automating the collection, processing, and analysis of enzyme-linked immunosorbent assay (ELISA) data. The programs are written to run on an Apple Macintosh computer (equipped with at least 512 kilobytes of random access memory, a single disk drive, and an Apple Image-writer dot matrix printer) interfaced with a Bio-Rad EIA reader. The primary program is written in Pascal with associated data analysis performed by a programmable electronic spreadsheet. PMID- 3655377 TI - Effect of feeding rate on monoclonal antibody production in a modified perfusion fed fermentor. AB - Previously we described a perfusion system for production of high yields of monoclonal antibodies in a fermentor. This system incorporated a cylindrically shaped, stainless steel filter mounted around the stirring shaft for retention of cells within a 1 liter fermentor. Modification of this filter by increasing the pore size from 5 micron to 10 micron decreased its tendency to clog and allowed continuous operation for about 3 weeks. Fresh culture medium, containing 6.5 mg glucose/ml and 3% horse serum, was supplied continually at two different perfusion rates, 850 and 1100 ml/day. Spent culture medium containing monoclonal antibody was harvested concomitantly. Highest cell density (5 X 10(7)/ml) and best antibody yield (1.7 g/l culture per day) were obtained at the higher feeding rate. PMID- 3655378 TI - A rapid and efficient method for testing immunohistochemical reactivity of monoclonal antibodies against multiple tissue samples simultaneously. AB - A flexible, efficient and rapid method was developed whereby a small volume of monoclonal antibody could be used to immunohistochemically stain many different tissues, simultaneously, on one standard glass slide. This method is based on the preparation of 'cores' of paraffin-embedded tissue from standard histology blocks. The paraffin cores are straightened, inserted into a casing cut from an ordinary drinking straw, mounted in a paraffin block and sectioned. Over 120 individual tissue samples can be organized on a slide and stained for screening or characterization with 0.25 ml of diluted primary antibody. Advantages of this paraffin core method include: great economies in time, reagents, tissue specimens and antibodies; ease of producing multiple, regular, stable, easily handled tissue core samples; direct identification of intratissue regions of interest for inclusion; efficient use of rare tissue samples; versatility for rapid construction of multiple tissue slides containing any combination of relevant tissues from a 'library' of tissue cores; and, no need for deparaffinization and reembedding of tissues. PMID- 3655379 TI - Is that what you mean? PMID- 3655380 TI - Decreasing the spontaneous release in NK cell assays. PMID- 3655381 TI - Toxicity of light-exposed Hepes media. PMID- 3655382 TI - Reaction to the article: ELISA for measurement of secretory IgA distinct from monomeric IgA. PMID- 3655383 TI - Overnight storage at 1 degree C does not affect NK cytotoxicity. PMID- 3655384 TI - A radioimmunoassay for metoclopramide. AB - A radioimmunoassay for the anti-emetic drug, metoclopramide, in the pmol range was developed. The immunogen was prepared by photolytic coupling of metoclopramide to bovine serum albumin. A crosslinking reagent, N-hydroxy succinimidyl-4-azidobenzoate, was first reacted with serum albumin through nucleophilic substitution. Ultraviolet irradiation (lambda greater than 300 nm) of the photoactive serum albumin conjugate in the presence of metoclopramide resulted in covalent attachment of the drug to the protein. An 125I-labelled metoclopramide derivative was prepared by diazotisation of the aromatic amine group and substitution of the resultant diazo group with 125I-. Binding data of the antibody with radioiodinated metoclopramide gave a linear Scatchard plot indicative of a homogeneous antibody population. A dissociation constant of 3 X 10(-11) mol/l was calculated for the antigen-antibody interaction. The antibodies showed negligible cross-reactivity with lignocaine which is structurally closely related to metoclopramide. PMID- 3655385 TI - Radioimmunoassay of 5-hydroxymethyl-2'-deoxyuridine. AB - 5-Hydroxymethyl-2'-deoxyuridine is an antileukemic thymidine analogue. It is also a well known thymidine-derivative in DNA exposed to ionizing irradiation. We report the production and characterization of specific rabbit anti-5HmdUrd antisera. The antisera were used for the radioimmunological measurement of 5HmdUrd. The radioimmunoassay was capable of quantitating 2 pmol of 5 HmdUrd per tube corresponding to 0.2 mumol/l in a 10 microliter plasma sample. A good correlation between the results obtained with the radioimmunoassay and HPLC was demonstrated when the methods were applied to the measurement of plasma levels of 5HmdUrd in mice receiving experimental chemotherapy. PMID- 3655386 TI - Isolation of low-frequency class-switch variants from rat hybrid myelomas. AB - Class-switch variants have been isolated from rat-rat hybrid myelomas by sib selection using a simple assay based on red cell-labelled antiglobulins. The variants detected are consistent with the gene order deduced from molecular cloning. They appear to arise spontaneously at a rate approximately ten-fold lower than for mouse cell lines but the rate of switching back to the parental isotype is substantial in comparison. An IgG2b variant antibody having the same specificity as CAMPATH-1 for human lymphocytes and monocytes is active in antibody-dependent cell-mediated killing (unlike the parental IgG2a) and may prove to be a valuable therapeutic antibody for immunosuppression and treatment of leukaemia and lymphoma. PMID- 3655387 TI - Conventional isoelectric focusing does not dissociate immune complexes. AB - Contrary to some reports, isoelectric focusing (IEF) is unable to dissociate immune complexes (IC) into their constituent components. Six model IC systems prepared at various antigen/antibody ratios were readily dissociated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), but not by conventional IEF, independently of several modifications of the running conditions. IC preformed in situ in the IEF gel were not disrupted by subsequent electrophoresis. Moreover, formation of IC was demonstrable in IEF, when applying antigen and antibody preparations in the manner used for counterimmune electrophoresis. Nevertheless, IEF may be of value in the analysis of IC provided the complexes are of small enough size to enter the gel. PMID- 3655388 TI - Snake bite in India and its management. PMID- 3655389 TI - A profile of snake bite poisoning in Jammu region. PMID- 3655390 TI - Simplified scoring system for high risk pregnancy. PMID- 3655391 TI - Endometrial tuberculosis. PMID- 3655392 TI - Surgical management of typhoid perforation (a new approach). PMID- 3655393 TI - Assays of cell mediated immunity in human lymphomas: correlation with histology. PMID- 3655394 TI - Primary carcinoma of fallopian tube. PMID- 3655395 TI - Disseminated mucormycosis. PMID- 3655396 TI - Trichotillomania associated with depression. PMID- 3655397 TI - Menopause at 23 years. PMID- 3655398 TI - Symposium report: The Biological Significance of the Major Histocompatibility Complex. Sorrento, 15-19 April, 1986. PMID- 3655399 TI - HLA expression on human germinal cells. AB - Ejaculated human seminal plasma cells obtained from 46 healthy men and 48 infertile patients were tested for expression of HLA class I and II antigens by complement-mediated cytotoxicity, cell-binding radioimmunoassay (CB-RIA), and an ELISA involving monoclonal antibodies (mAbs). In a group of healthy men tested for HLA expression on human spermatozoa, 4 of 46 were positive for class I and II HLA antigens. However, the results were negative in a second examination of the same donors, possibly on account of alterations with time in the expression of various subpopulations of cells which are antigen positive or antigen negative. In a group of infertile patients, we found positive expression of HLA class I and II antigens in 7 of 48 men. The samples contained immature and mature sperm but no contaminating leucocytes or epithelial cells. PMID- 3655400 TI - The ELY-1 locus controls a di-allelic alloantigenic system on equine lymphocytes. AB - The ELY-1 locus controls the expression of a polymorphic cell surface antigen of equine lymphocytes which was detected using antibodies generated by alloimmunization with peripheral blood lymphocytes. The ELY-1 antigens were not detected on erythrocytes or platelets by absorption experiments. The two alleles, which have been designated ELY-1.1 and ELY-1.2, are expressed codominantly and appear to constitute a closed system at the population level. In family studies, the ELY-1 antigens segregated as products of an autosomal locus not linked to the major histocompatibility complex (MHC) of the horse. In the complement mediated lymphocyte microcytotoxicity test, antisera to the ELY-1 antigens selectively killed peripheral blood lymphocytes which did not express surface immunoglobulin. The ELY-1 antigens may be useful markers for equine T cells when assayed in this fashion. Three alloantisera were used in immune precipitation of iodinated and solubilized cell surface proteins from peripheral blood lymphocytes. Electrophoresis of the precipitates in sodium dodecyl sulphate (SDS) polyacrylamide gels demonstrated strong bands in the Mr 180-190K range that were shared in the three different preparations. These results suggest that the ELY-1 allospecificities are expressed on an equine equivalent of the murine T200 molecule. PMID- 3655401 TI - In vitro production of cholera toxin-like activity by Plesiomonas shigelloides. AB - Although Plesiomonas shigelloides is considered to cause diarrhea in humans, the mechanisms by which it might do so are not known. Enteric pathogens such as Vibrio cholerae and some strains of Escherichia coli produce enterotoxins that activate adenylate cyclase, increase production of cyclic AMP, and thereby cause elongation of Chinese hamster ovary (CHO) cells in tissue culture. We grew 28 strains of P. shigelloides and the type strain in an iron-depleted medium, and sterile filtrates were examined in CHO cell culture. Filtrates from 24 of the 29 strains produced elongation of CHO cells. These changes could be prevented by heating or by preincubation of the filtrate with cholera antitoxin. These data indicate that P. shigelloides elaborates a cholera-like toxin; such a substance might be important in the pathogenesis of P. shigelloides-associated diarrhea. PMID- 3655402 TI - Invasive disease due to Streptococcus pneumoniae in an area with a high rate of relative penicillin resistance. AB - During 1984 we conducted a population-based survey of culture-confirmed invasive disease due to Streptococcus pneumoniae among persons who lived in the Oklahoma City, Oklahoma, metropolitan area (population, 846,000) through the 20 clinical laboratories in the area. There were 139 residents identified with invasive pneumococcal disease (11 with meningitis and 128 with other bacteremic infections), for an infection rate of 16.4 per 100,000 population (meningitis, 1.3 cases per 100,000; other bacteremias, 15.1 cases per 100,000). Cases peaked in January-May and December (75% of cases). Rates were highest among infants less than 12 months old (97 cases per 100,000) and persons greater than or equal to 80 years old (87 cases per 100,000). Seventeen (12.2%) of the pneumococcal isolates were relatively penicillin resistant. These isolates were most prevalent among elderly persons greater than or equal to 70 years old (six [17.6%] of 34) and young children 0-4 years old (7 [15.9%] of 44) compared with persons 5-69 years old (four [6.6%] of 61). PMID- 3655403 TI - Enzymatic modification of glycocalyx in the treatment of experimental endocarditis due to viridans streptococci. AB - The presence of abundant surface polysaccharide, or glycocalyx, on viridans streptococci has been associated with failure to eradicate the organism from experimental cardiac vegetations during penicillin treatment. The role of glycocalyx in retarding sterilization was tested by in vivo administration of dextranase, an endohydrolase that attacks internally situated alpha (1-6) linkages. Dextranase and penicillin, either singly or in combination, were used to treat experimental endocarditis. After two days of therapy, 100% of animals treated with penicillin or dextranase alone had infected vegetations, whereas only 25% treated with penicillin and dextranase had infected vegetations (P less than .01). After five days of therapy, 100% of the animals treated with penicillin had infected vegetations, versus none that were treated with penicillin and dextranase (P less than .01). We conclude that glycocalyx acts to retard antibiotic activity in vegetations and that partial enzymatic digestion of the glycocalyx facilitates penicillin sterilization of the infected valve. PMID- 3655404 TI - Antigenic variation in rabies and rabies-related viruses: cross-protection independent of glycoprotein-mediated virus-neutralizing antibody. AB - Immunization experiments with vaccines prepared from the PM and ERA strains of rabies virus demonstrated that in mice, only ERA vaccine primes for an anamnestic response to the rabies-related strain Duvenhage (DUV6); in rabbits, both ERA and PM vaccines induced immunologic memory to DUV6 virus. In mice, ERA vaccine, but not an equal concentration of PM vaccine, conferred protection against a lethal challenge infection with DUV6 virus. This result indicated that the protective activity correlated with the vaccine's ability to induce immunologic memory. A vaccine prepared from a sequentially selected, neutralization-resistant, multiple variant virus conferred protection against challenge with the parental strain, a result indicating that antigenic variation of the glycoprotein may not be the sole factor in determining the relative efficacy of rabies prophylaxis. We found no correlation between titers of neutralizing antibody and mortality rates in mice immunized with purified glycoprotein from these viruses. PMID- 3655405 TI - The influence of fever on the development of experimental Streptococcus pneumoniae meningitis. PMID- 3655406 TI - Antigenic changes of Borrelia burgdorferi as a result of in vitro cultivation. PMID- 3655407 TI - Lyme disease in Japan and its possible incriminated tick vector, Ixodes persulcatus. PMID- 3655408 TI - Postcraniotomy mycetoma of the scalp and osteomyelitis due to Pseudallescheria boydii. PMID- 3655409 TI - Serological study of Campylobacter jejuni infection in slaughterhouse workers. PMID- 3655410 TI - [Coronary thrombolytic therapy in acute myocardial infarction: time dependence of beneficial effects assessed by two-dimensional echocardiography]. AB - To elucidate the effects of coronary thrombolytic therapy in acute myocardial infarction, we observed serially the degree of left ventricular (LV) wall motion immediately after on day 1, and on days 7, 14, 21 and 28 after thrombolytic therapy, in 22 patients with acute anteroseptal myocardial infarction. Base-line coronary arteriography revealed significant lesions in the proximal portions of the left anterior descending artery of all the patients. The patients were categorized according to results of thrombolytic therapy as Group I-a: seven patients with spontaneous or successful recanalization within three hours of onset of chest pain; Group I-b: nine patients with successful recanalization between three and seven hours, with a mean of 4.8 hours from onset; and Group II: six patients in whom thrombolytic therapy was unsuccessful and infarct-related vessels remained totally occluded. The LV wall motion index (WMI) was defined as the sum of point scores for the degrees of regional wall motion at nine segments on serial two-dimensional echocardiograms, and used for quantitative assessments of LV function. Results were as follows: On day 1, immediately after thrombolytic therapy, the WMI of Group I-a was smaller than that of Group II. However, there was no significant difference between Groups I-a and I-b and between Groups I-b and II. These findings suggest that LV function cannot be recovered immediately after recanalization of occluded arteries unless recanalization occurs exceptionally early. Percent improvement of the WMI from days 1 to 28 in Group I a, 65 +/- 14%, was significantly greater than that in Group I-b, 31 +/- 18%. However, Group II did not show significant improvement in the WMI. The WMI in Group I-a decreased significantly from days 1 to 7 (9.0 +/- 1.6 vs 7.1 +/- 1.8, p less than 0.05); whereas, the WMI in Group I-b showed no significant decrease until day 21. On day 1, the regional wall motion of the antero-apical wall was akinetic or dyskinetic in all patients studied. On day 28, it improved in six of seven patients in Group I-a, while it remained akinetic or dyskinetic in all patients in Groups I-b and II.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655411 TI - [Reversible ischemic myocardial damage: clinical observation using two dimensional echocardiography]. AB - Acute myocardial ischemia followed by protracted asynergy and subsequent resolution was defined as reversible ischemic myocardial damage. The purpose of this study was to confirm the existence of this entity and to illustrate the clinical features. The subjects consisted of 26 patients with typical acute myocardial ischemia who satisfied the above definition, and serial changes in left ventricular wall motion were observed by two-dimensional echocardiography. The left ventricle was divided into 11 segments and the movement was scored according to the dynamic behavior of each segment by five points ranging from normal (0) to dyskinesis (4), and evaluated semiquantitatively using the total score sum as the total asynergy score. Compared to the initial value, this score decreased to 57% after one week, 38% in two weeks, 22% in three weeks and 17% in four weeks. The asynergy persisted 23.7 +/- 13.5 days and ranged from two days to three months. The peak CPK ranged from 32 to 561 IU (mean 212 +/- 157 IU). Coronary arteriography revealed undisturbed flow of the responsible artery in both acute and chronic phases including four cases of successful PTCR. Comparison of the electrocardiographic changes and asynergy showed that diminished R wave amplitude, ST segment elevation and inverted T waves are frequently associated with persistence of asynergy, extensive asynergy can even occur in cases without a diminished R wave or abnormal Q wave and when asynergy resolves, ST segments tend to return to the baseline, but T wave inversion commonly persists. A transient Q wave was observed in 38% of the patients examined. The electrocardiogram became normal in an average of 111.3 +/- 75 days. In conclusion, there is a subgroup of reversible asynergy among cases of unstable angina pectoris or subendocardial infarction. The mechanism for this may be myocardial "stunning" following transient transmural ischemia. Recognition of this fact seems very important in the diagnosis and treatment of acute myocardial ischemia. PMID- 3655412 TI - [Mode of left ventricular diastolic filling in hypertrophic cardiomyopathy as studied by pulsed Doppler echocardiography and multigated blood pool scan]. AB - The clinical significance of the mode of left ventricular (LV) diastolic filling in hypertrophic cardiomyopathy was studied by the LV inflow velocity patterns (LVIF) of pulsed Doppler echocardiography and LV early diastolic filling rates (V2) of radionuclide (RI) angiography. The relationship between the deceleration time (DT) obtained from LVIF and the V2 was evaluated in 34 patients with nonobstructive hypertrophic cardiomyopathy (HCM) and in nine with obstructive hypertrophic cardiomyopathy (HOCM), and the results were compared with those of 10 patients with dilated cardiomyopathy (DCM), of two with restrictive cardiomyopathy (RCM), and of 19 normal subjects. HCM was subdivided into the following groups according to V1-DT relationships: Group 1 with prolonged DT and decreased V1, Group 2 with normal or short DT and normal V1, and Group 3 with normal or short DT and decreased V1. There were significant negative correlations between V2 and DT in Groups 1 and 2 of HCM, normal and HOCM. However, there were significant positive correlations in Group 3 of HCM, DCM and RCM. Nearly all patients in Group 3 had decreased LV ejection fraction and % fractional shortening, distinct B-B' step formation of the mitral valve echogram, and huge A wave of the apexcardiogram. These findings suggested that the LV rapid filling interval gradually became shorter because the LV contraction is decreased as myocardial fibrosis develops in HCM, and that we must pay attention to the diagnosis of such abnormalities, similar to those of DCM or RCM. PMID- 3655413 TI - [Left ventricular systolic performance during exercise in patients with hypertrophic cardiomyopathy]. AB - The clinical profiles in patients with hypertrophic cardiomyopathy who had exercise-induced deterioration in systolic performance of the left ventricle (LV) were investigated using exercise echocardiography. The materials consisted of 32 patients, which who categorized in two groups according to the extent of % shortening fraction of the LV (% SF) at the peak exercise; 21 whose % SF was increased (group I: from 40.9 +/- 7.2% at rest to 44.2 +/- 8.0% at the peak exercise) and 11 whose % SF was decreased (group II: from 40.8 +/- 7.3% to 34.8 +/- 6.9%). There were no significant differences between these two groups as to the resting echocardiographic data or the prevalence of pressure gradient in the LV outflow tract. The frequency of symptoms, such as chest pain and exertional dyspnea, was higher in the group II (73%) than in the group I (38%). The time of exercise tolerance was significantly shorter in group II than in group I (I: 9.2 +/- 1.9 min., II: 7.4 +/- 2.6 min., p less than 0.05). Five patients (45%) in group II and four (19%) in group I developed at least 2 mm ST segment depression during exercise electrocardiography. Twenty-four hour ambulatory ECG monitoring showed a high prevalence of ventricular arrhythmias in group II. Seven (78%) of nine patients in group II and five (28%) of 18 in group I had abnormal 201T1 myocardial scintigrams. Left ventricular ejection fraction was not significantly different between the two groups, but the end-diastolic pressure was higher in group II (19 +/- 6 mmHg) than in group I (15 +/- 4 mmHg). All patients who underwent coronary arteriography had no significant stenosis. Thus, there are significant differences in the clinical features between the two groups of patients who had reciprocal LV responses during exercise. These findings should be considered in the management of patients with hypertrophic cardiomyopathy. PMID- 3655414 TI - [Magnetic resonance diagnosis of aortic dissection: with special reference to the communicating orifice between the true and false lumens]. AB - Magnetic resonance imaging (MRI) was performed in thirty-one patients with aortic dissection to evaluate its usefulness in diagnosing the site of communicating orifice between the true and false lumens and the presence of retrograde dissection. MRI revealed the site of the entry as a defect in the intimal flap in the images of 12 of 15 patients (80%). The site of the communicating orifice between the true and false lumens in the abdominal aorta could be determined in six of eight patients (75%). MRI diagnosis of retrograde dissection was successful in three patients. Cross-sectional analysis of the abdominal aorta based on the location of the true lumen revealed that the celiac and superior mesenteric arteries tended to arise from the true lumen when the latter was situated in the anterior part of the abdominal aorta. The right and left renal arteries arose from the true lumen when it was positioned anterolaterally. In conclusion, MRI was a useful diagnostic method for aortic dissection, especially for determining the site of entry in the thoracic aorta. The changes in signal intensity in the false lumen provided useful information for locating the communicating orifice between the true and false lumens and for diagnosis of retrograde dissection. Cross-sectional analysis of dissection in the abdominal aorta was useful for predicting the branching of the main arteries from the true or false lumen. PMID- 3655415 TI - [Value of right ventricular and atrial collapse in identifying cardiac tamponade]. AB - Collapse of the right ventricle and right and left atria is observed in cardiac tamponade. To assess the diagnostic value of each collapse component in identifying cardiac tamponade, two-dimensional and M-mode echocardiograms were recorded simultaneously with the measurement of intrapericardial pressure in five patients as they underwent pericardiocentesis. Before pericardiocentesis, each patient had evidence of right ventricular and right atrial collapse. In addition, left atrial collapse was observed in four patients. During pericardiocentesis, left atrial collapse initially resolved accompanied by a drop in pressure in the pericardial sac. Continuous drainage of pericardial effusion resulted in significant symptomatic improvement and the cessation of paradoxical pulse at the point of resolution of right ventricular collapse. However, right atrial collapse persisted after resolution of right ventricular collapse, but it was absent when pericardiocentesis was completed. Injection of saline solution with heparin into the pericardial sac for cleansing initially caused right atrial collapse, while right ventricular collapse developed with the appearance of cardiac tamponade. In one patient, the simultaneous recording of right ventricular and intrapericardial pressures and two-dimensional echocardiograms demonstrated that right ventricular collapse occurred early in diastole, when intrapericardial pressure exceeded right ventricular pressure. In conclusion, right ventricular collapse is the most reliable sign of cardiac tamponade. Right atrial collapse occurs in the early stage of cardiac tamponade. Left atrial collapse appears very late in the course of hemodynamic deterioration due to cardiac tamponade. PMID- 3655416 TI - [Effect of age on left ventricular relaxation: pulsed Doppler echocardiographic evaluation]. AB - There is no noninvasive index to assess the left ventricular relaxation property during the isovolumic relaxation period except for the isovolumic relaxation time, which is derived from M-mode echocardiography or phonocardiography. The intracardiac blood flow can now be precisely observed using pulsed Doppler echocardiography. We evaluated the left ventricular relaxation property and studied the effect of age on the relaxation property using this method. Cardiac catheterization and pulsed Doppler echocardiography were performed for 27 patients with various heart diseases, none of whom had wall motion abnormalities on left ventriculography, to determine the relationships between invasive and noninvasive parameters. The effects of age were examined in 25 normal healthy persons ranging in age from 26 to 69 years. In all cases, the intracardiac blood flow during the isovolumic relaxation period (isovolumic relaxation flow) as obtained by pulsed Doppler echocardiography was laminar, and directed from the base toward the apex of the left ventricle. The duration of this flow (the time interval from the beginning to the end of this flow; IRT), the acceleration time (the time interval from the beginning to the peak velocity; ACT) and the acceleration rate (the slope of the beginning to the peak velocity; AcR) were measured, and IRT, ln AcT (natural logarithm of AcT) and ln AcR (natural logarithm of AcR) were compared with the parameters obtained by cardiac catheterization. The time constant T of the fall in left ventricular pressure during the isovolumic relaxation period, which was proposed as an index of the left ventricular relaxation property, correlated well with IRT (r = 0.82, p less than 0.001), ln AcT (r = 0.69, p less than 0.001) and ln AcR (r = -0.77, p less than 0.001), but there were no significant correlations with maximum blood pressure, left ventricular ejection fraction, maximal positive dp/dt or the left ventricular end-diastolic volume index. Age and these three Doppler indexes in normal healthy persons correlated significantly as follows; IRT (r = 0.80, p less than 0.001), ln AcT (r = 0.60, p less than 0.001) and ln AcR (r = -0.61, p less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655417 TI - Doppler two-dimensional echocardiographic determinations of right ventricular output and diastolic filling. AB - Two methods of measuring right ventricular cardiac output with pulsed Doppler two dimensional echocardiography were developed in 29 patients who underwent cardiac catheterization and angiography. Using tricuspid inflow and main pulmonary artery outflow methods we determined cardiac output, and good correlations were observed between thermodilution and Doppler measurements (r = 0.93 and 0.89, respectively). Results by the two methods correlated closely in patients without regurgitant lesions. In patients with tricuspid regurgitation, right ventricular inflow was always greater than right ventricular outflow volume while the reverse was true in those with pulmonary insufficiency. Furthermore, we investigated the right ventricular peak filling rate as the Doppler peak diastolic velocity X cross-sectional area of the tricuspid annulus and half filling right ventricular fraction derived from the time velocity integral of the Doppler-determined velocity curve. For the tricuspid valve morphologically, the Doppler-derived velocity profile in diastole resembled the first derivative of the angiographic right ventricular volume curve. A significant correlation was observed between the Doppler echocardiographic and angiographic peak filling rate (r = 0.84). The results of the present study validate the use of Doppler two-dimensional quantitative measurements of the right ventricular output, regurgitant fraction and indexes of diastolic function. PMID- 3655418 TI - [Pulmonary arterial end-diastolic pressure noninvasively estimated by continuous wave Doppler echocardiography]. AB - To estimate pulmonary arterial end-diastolic pressures noninvasively, we measured the pulmonary regurgitant flow velocity by continuous wave Doppler echocardiography in 17 patients with pulmonary hypertension (pulmonary arterial end diastolic pressure greater than or equal to 18 mmHg) and in 23 patients without pulmonary hypertension. Pulmonary regurgitation was successfully detected by continuous wave Doppler echocardiography in 14 of the 17 patients with pulmonary hypertension and in 14 of the 23 patients without pulmonary hypertension. The end-diastolic pulmonary artery-to-right ventricular pressure gradient was estimated from the Doppler-determined pulmonary regurgitant flow velocity by means of a simplified Bernoulli equation. The Doppler-determined end diastolic pulmonary artery-to-right ventricular pressure gradient correlated well with the catheter measurement (r = 0.94). It also correlated well with the pulmonary arterial end-diastolic pressure (r = 0.92). Thus, continuous wave Doppler echocardiography was useful in estimating noninvasively pulmonary arterial end-diastolic pressures. PMID- 3655419 TI - Right and left ventricular ejection patterns in D-transposition of the great arteries assessed by pulsed Doppler echocardiography. AB - Pulsed Doppler echocardiography (PDE) was performed to evaluate the flow velocity patterns of the right (RVOT) and left ventricular outflow tracts (LVOT) in 10 patients with transposition of the great arteries (D-TGA). Twenty normal children served as controls. Systolic time intervals (STIs) and acceleration times (AcT) of the right and left ventricles were measured using PDE. The following results were obtained. In normal controls, the right ventricular pre-ejection period (RPEP) was shorter than the left ventricular pre-ejection period (LPEP), and the right ventricular ejection time (RVET) was longer than the left ventricular ejection time (LVET). The mean RPEP/RVET was 0.33 (range 0.25-0.42) and the mean LPEP/LVET was 0.38 (range 0.28-0.55). In normal controls, the flow velocity pattern of the RVOT had a dome-like contour with a peak velocity in mid-systole, and the mean AcT/RVET ratio was 0.50 (range 0.41-0.62); that of the LVOT had a triangular shape with a mean AcT/LVET ratio of 0.31 (range 0.24-0.38). In patients with D-TGA, the RPEP was longer than the LPEP and the RVET was shorter than the LVET. The mean RPEP/RVET was 0.53 (range 0.39-0.76) in patients with intact ventricular septum and 0.52 (range 0.54-0.60) in patients with ventricular septal defect (VSD). The RPEP/RVET was significantly greater in patients with D TGA than in normal controls. The mean LPEP/LVET was 0.27 (range 0.16-0.42) in patients with intact ventricular septum, and 0.34 (range 0.23-0.40) in patients with VSD. The LPEP/LVET was significantly less in patients with intact ventricular septum than in normal controls. The flow velocity patterns of the RVOT and LVOT were the same as those for normal controls. The mean AcT/RVET ratio was 0.51 (range 0.49-0.55) in patients with intact ventricular septum and 0.49 (range 0.39-0.67) in patients with VSD. The mean AcT/LVET was 0.32 (range 0.27 0.38) in patients with intact ventricular septum and 0.28 (range 0.20-0.45) in patients with VSD. The flow patterns did not change after intraatrial baffle repair. Our studies indicate that the flow velocity patterns of the RVOT and LVOT in patients with D-TGA were not reversed, in spite of inverted afterloads. PMID- 3655420 TI - [Musical murmurs: phonocardiographic, echocardiographic and Doppler echocardiographic study]. AB - Musical murmurs are probably related to the vibrations of some structures in the cardiovascular system, and this may be reflected in the characteristic stripes which are recorded by the fast Fourier transformation (FFT) of the pulsed Doppler echocardiography (so-called FFT stripe). In the present study, we demonstrated new stripes by color Doppler echocardiography, which were composed of multiple warm and cold color bands which we termed color Doppler stripes (CD stripe). An experiment was performed to obtain Doppler signals from the surface of a vibrating tonometer at a frequency of 128 Hz. When the CD stripe was obtained, a similar FFT stripe was also recorded from the same sampling site. Fourteen patients with musical murmurs were selected from 2,000 consecutive phonocardiographic records made during the last one and a half years. The CD stripe was obtained in three and the FFT stripe in six. When both stripes were obtained, the FFT stripe was always obtained if we set carefully the sample site in the CD stripe, and these two were consistent in timing. We concluded that, in view of the close correlation between the CD stripe and the FFT stripe, the newly observed CD stripe is also a characteristic finding reflecting a regularly vibrating structure. The technical feasibility of color Doppler echocardiography to detect fine movements of structures may be helpful in the study of musical murmurs. PMID- 3655421 TI - [Postural effects in the jugular phlebogram in patients with complete absence of the left pericardium]. AB - To elucidate the function of the pericardium, alterations in jugular phlebograms, intracardiac pressures and cardiac volumes induced by postural changes were examined in seven patients with complete absence of the left pericardium. Ten patients with ischemic heart disease were studied as controls. Jugular phlebograms in patients with complete absence of the left pericardium showed decreased depths of the x descent and the tall v waves followed by the deep y descents (M-shaped pattern) in the supine position. These jugular abnormalities were exaggerated in the left lateral decubitus position. By contrast, the jugular phlebograms tended to return to normal, but remained abnormal in the right lateral decubitus position. Right atrial pressure curves showed similar postural effects. However, the jugular phlebograms and right atrial pressure curves in patients with ischemic heart disease were not altered by postural changes. The characteristic alterations of the jugular phlebograms are useful indicators for diagnosing complete absence of the left pericardium. The lack of a prompt decrease in pericardial pressure during ventricular ejection due to the absence of the pericardium is one of the causes of a decreased depth of the x descent in pericardial defect. However, this cannot explain the postural alteration of the jugular phlebogram. Another possible mechanism is the decreased excursion of the tricuspid ring during systole. As indicated in our previous report, there is anterior movement of the cardiac apex during systole in cases of pericardial defect, which is exaggerated in the left lateral decubitus position and decreased in the right lateral decubitus position due to the lack of normal pericardial support. This anterior swinging motion may inhibit the descent of the tricuspid ring toward the apex, resulting in a decreased depth of the x descent of the jugular phlebogram and the right atrial pressure curve and their postural alterations. The right ventricular volume as calculated from cardiac computerized tomography and the right ventricular end-diastolic pressure were not altered significantly by postural changes in the control cases. These indices increased to a greater extent in the left lateral decubitus position than in other postures in cases with pericardial defects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655422 TI - [Membranous tricuspid atresia with right ventricular dysplasia and absent pulmonary valve: echocardiographic findings in three cases]. AB - Membranous tricuspid atresia with right ventricular dysplasia and absent pulmonary valve is a very rare complex, and a unique type of tricuspid atresia. Three cases with this condition were presented with the echocardiographic evaluation. Two-dimensional echocardiography was performed in all patients, pulsed Doppler echocardiography in two, and contrast echocardiography in two patients. The echocardiographic findings characteristic of this complex were as follows: In the four chamber view, the interatrial and interventricular septa were aligned, and tricuspid valve atresia was of the membranous type. In the four chamber view, the right ventricular wall was thin, irregular in shape, and it protruded aneurysmally into the left ventricular outflow tract. With systemic venous contrast echocardiography, the right ventricular cavity was opacified with contrast, four to five cardiac cycles after the appearance of contrast in the left ventricle. With pulsed Doppler echocardiography at the main pulmonary artery, antegrade flow was observed in ventricular systole, and retrograde flow in diastole. We conclude that these echocardiographic findings are useful in recognizing the morphology and hemodynamics of this complex. PMID- 3655423 TI - [Non-invasive estimation of aortic flow by local electrical impedance changes]. AB - Aortic flow velocity was measured by catheter-tip flow transducer in 25 patients who underwent left cardiac catheterization for non-invasive estimates by the impedance method. Disk electrodes were attached to the skin at the levels of the second thoracic vertebra in the posterior median line and the V8 lead position for electrocardiography. Alternating current, 350 micro-amperes, 50 KHz constant, was applied to the outer electrode, and impedance changes were detected via the inner electrode. The e wave, or height of the first derivative dz/dt wave of the electrical impedance was lower in cases of old myocardial infarction and higher in cases of aortic valve regurgitation, as compared with the values of the healthy control group. The time lag between the start of the upward deflection and the peak value of the dz/dt wave coincided with that of the aortic flow curve as measured at the aortic arch and descending aorta. These time lags were about 20 to 30 msec as compared with the ascending aortic flow curve, and were -20 to 30 msec as compared with the abdominal aortic flow curve. There was a close correlation between the maximum flow velocity measured at the aortic arch and the height of the e waves. The regression equation was: Y = 0.21X - 1.53, r = 0.88, p less than 0.01. These data suggest that the first derivative of electrical impedance change as obtained by the disk electrode method reflects aortic flow at the arch and descending aorta. PMID- 3655424 TI - [Pheochromocytoma with normal blood pressure and dilated cardiomyopathy: a case report]. AB - A rare complication of normotensive pheochromocytoma with dilated cardiomyopathy is described. This 57-year-old man first experienced palpitation eight years ago when his blood pressure, electrocardiogram and chest radiograph were all within normal limits. Five years later he was admitted to another hospital because of palpitation and was diagnosed as having dilated cardiomyopathy on the basis of cardiac catheterization and cardiac muscle biopsy. In December, 1984, he was admitted to our hospital for treatment of congestive heart failure. On admission, his electrocardiogram revealed left atrial overloading, left axis deviation, left ventricular hypertrophy with intraventricular conduction disturbances and frequent premature ventricular contractions. Echocardiography revealed marked biventricular dilatation with severe hypokinesis of the interventricular septum and the posterior wall of the left ventricle, and a B-B' step of the anterior mitral leaflet. Fasting blood sugar was slightly elevated and a 75 g glucose tolerance test was abnormal. An abdominal echogram and abdominal CT revealed a 67 mm diameter mass immediately superior to the right kidney. Blood and urine catecholamine levels were significantly increased. He was diagnosed as having a pheochromocytoma. Interestingly, he had been normotensive during the eight years until his fatal outcome. He died of congestive heart failure. Needle necropsy findings of the adrenal revealed pheochromocytoma, and those of the cardiac muscle revealed enlarged muscle cells and mild fibrosis. PMID- 3655425 TI - [Mid-systolic ejection murmur with thrill caused by right ventricular outflow tract obstruction secondary to septal aneurysm following myocardial infarction: a case report]. AB - A 71-year-old woman with a history of previous myocardial infarction was transferred to our hospital for evaluation of chest pain and ventricular tachycardia. On admission, a loud mid-systolic ejection murmur accompanied by a thrill was found at the left sternal border in the third intercostal space, and it was significantly accentuated in the post-extrasystolic beat. Abnormal Q waves and ST elevations were noted in leads I, aVL and V5,6 on electrocardiograms. Echocardiograms, confirmed a septal-to-apical aneurysm, and a thin interventricular septum (IVS) with paradoxical motion. Right ventricular (RV) catheterization showed a pressure gradient of 21 mmHg between the outflow tract (RVOT) and the apex, and a mid-systolic ejection murmur was recorded in the RVOT on an intracardiac phonocardiogram. Coronary arteriograms revealed total occlusion of the left anterior descending artery in its proximal portion, and a 90% stenosis of the circumflex artery. A left ventriculogram demonstrated a septal-to-apical aneurysm with a markedly reduced ejection fraction of 0.16. A right ventriculogram showed obstruction to RVOT caused by systolic ballooning of the IVS. In this patient, the mid-systolic ejection murmur was probably caused by the obstruction of the outflow tract secondary to septal aneurysm following old myocardial infarction. PMID- 3655426 TI - [Metastatic thyroid cancer to the right ventricle causing obstruction of the right ventricular outflow tract and associated with disseminated intravascular coagulopathy: a case report]. AB - A case of thyroid cancer causing right ventricular outflow tract obstruction is described. A 72-year-old woman was admitted because of shortness of breath, some ecchymoses, and marked anasarca. Her liver was palpable four fingerbreadths below her costal margin. Laboratory findings included leukocytosis, marked thrombocytopenia, and an increase in fibrinogen degradation products due to disseminated intravascular coagulopathy. Two-dimensional echocardiography demonstrated a solid mass in the right ventricle, which protruded into the right atrium and main pulmonary artery. Right ventricular outflow tract obstruction and tricuspid regurgitation were demonstrated by contrast echocardiography. These findings were confirmed by CT scans, RI angiography, and contrast angiography. The mass was partially resected from her right ventricle and her tricuspid valve was replaced successfully, but she died of sepsis three weeks after surgery. At autopsy, undifferentiated thyroid cancer and cardiac metastasis were verified. To date, only eight cases with initial symptoms of congestive heart failure due to right ventricular outflow tract obstruction caused by metastatic intracavitary tumors have been reported. Very rarely have cardiac tumors resulted in disseminated intravascular coagulopathy. PMID- 3655427 TI - [Primary pericardial malignant mesothelioma associated with constrictive pericarditis: a case report]. AB - A case of primary pericardial malignant mesothelioma was presented, which initially had a relatively large quantity of pericardial fluid, followed by constrictive pericarditis. The patient was a 43-year-old woman whose chief complaint was dyspnea and admitted to our hospital in March, 1984. Because of a relatively large quantity of pericardial fluid was observed. In April, drainage of the fluid and pericardiotomy were performed with marked relief of symptoms. She was discharged, but her dyspnea recurred in August, and she was readmitted. After the second admission, the chest radiograph showed a cardiothoracic ratio of 62%, and her electrocardiogram showed low voltage. A pericardial knock was recorded, and the timing of this sound coincided with that of the peak of the early distolic wave of the mitral flow velocity pattern. A jugular pulse tracing showed a deep and sharp y descent. The diastolic pressure curve of the right ventricle revealed a dip and plateau pattern. The echocardiographic finding was characterized by abnormal systolic motion and an early diastolic dip of the interventricular septum, multiple abnormal echoes and thickening of the pericardium, and an abnormal mass echo in the left atrial cavity. Based on the above examinations, pericardiotomy was performed, but the tumor was not entirely resected. The histological diagnosis was malignant mesothelioma. PMID- 3655428 TI - Alkaline phosphatase activity in peripheral nerves and endothelial cell cultures in leprosy. AB - Alkaline phosphatase activity in leprosy nerves was studied. The activity was mainly in blood vessels and was maximum in healthy nerves. Low levels were seen in crush injury. In leprosy lower levels were in BT than LL cases. Endothelial cells (in vitro) released alkpase when infected with live bacilli only. No response was observed with heat killed bacilli. PMID- 3655429 TI - Patterns of immunoglobulins in the serum of leprosy patients. AB - There have been considerable variations in the levels of immunoglobulins in the serum of leprosy patients which needed elucidation. An attempt has been made in this direction to find out the levels of IgG, IgM and IgA in the serum samples of 145 cases of various grades of leprosy. The patients were selected in the age group of 11 to 60 years and have received treatment with DDS from a period ranging from 6 months to 5 years. A constant increase in the levels of immunoglobulins has been noted and the effect of treatment over variation in the levels has been discussed. PMID- 3655430 TI - Palmo-plantar lesions in paucibacillary leprosy--unusual clinical expressions. AB - Paucibacillary leprosy of the palmo-plantar skin is regarded as unusual. Three cases of Paucibacillary leprosy with such lesions are discussed and the relevent literature reviewed. PMID- 3655431 TI - Epithelioid and polygonal cells in histoid leprosy. AB - Salient histological features of 36 histoid leprosy were presented. Usual features like whorls and interlacing bundles of spindle cells, histoid habitus of the bacilli were noticed in all the cases. Pseudocapsule was present in 6 cases. Circumscribed islets of epithelioid cells were seen in the deeper part of the granuloma in 5 cases. Acid-fast bacilli were absent or rare in these cells. Polygonal, foamy macrophages were found in 12 cases. Presence of epithelioid and polygonal cells in histoid leprosy is rare and its significance needs to be explored. PMID- 3655432 TI - National leprosy eradication programme in India--an independent evaluation. PMID- 3655433 TI - Type 1 (reversal) lepra reaction in borderline leprosy with unusual clinical presentation--a case report. AB - A male 26 years old patient with BB type of leprosy was encountered with a typical clinical presentations of up-grading (reversal) Type 1 Lepra Reaction. These included sudden appearance of tender, erythematous nodular eruptions mimicking ENL, severe constitutional symptoms like high grade fever, malaise, vomiting, epistaxis, joint pain and tenosynovitis simulating Type 2 Lepra Reaction. To the best of our knowledge, this may be the first such case in our hand. PMID- 3655434 TI - Guidelines for personnel involved in collection of skin smears in leprosy control programmes for the prevention and control of possible infection with HIV. PMID- 3655435 TI - Temperature distribution during radiant heat whole-body hyperthermia: experimental studies in the dog. AB - A radiant heat system for whole-body hyperthermia (WBH) has been safely and effectively used in mice, pigs and humans. This report details our adaptation of this methodology to dogs. Mongrel dogs were used to study different anaesthesia methods including spontaneous ventilation with or without intubation, as well as mechanical ventilation. Temperature distribution was studied during 42 degrees C WBH; intraabdominal, liver, bone marrow, brain, rectal, lung, oesophageal and skin temperatures were monitored. When a target temperature of 42 degrees C was achieved, temperature gradients between organs were minimal with the possible exception of bone marrow. Results obtained are consistent with the concept that the liver is a major source of metabolic heat production. The establishment of a dog model for WBH allows for physiological and pharmacological studies. The existence of spontaneous neoplasms should promote the use of this species for trials combining hyperthermia with other modalities. PMID- 3655436 TI - Normal cells and malignant cells transfected with the HRas oncogene have the same heat sensitivity in culture. AB - Mouse embryo cells (C3H 10T1/2) were transfected with a plasmid (pAL8A) containing the HRas oncogene and neomycin resistance gene. Five transfected cell clones were isolated and established as cell lines, and these showed neomycin resistance. Two of these cell lines expressed a normal morphology while three showed a transformed morphology. Four of the cell lines produced tumours in nude mice. Flow cytometry measurements showed that exponentially growing cell cultures of the five transfected cell lines had the same cell cycle distribution as the normal parental cell line. The sensitivity to hyperthermia of the five transfected cell lines was the same as that of the normal cell line for temperatures ranging from 42.0 to 45.0 degrees C. Thus in these studies we found no difference in the thermal sensitivity of normal and malignant cells transfected by the Hras oncogene. PMID- 3655437 TI - In vitro response to hyperthermia or X-irradiation of diploid and tetraploid RIF 1 cells separated by centrifugal elutriation. AB - The RIF-1 cell line at the University of Utah is comprised of approximately 65 per cent diploid and 35 per cent tetraploid cells. Because sensitivity to heat cell killing has been shown to be ploidy dependent (Lucke-Huhle 1978), the responses of these subpopulations were examined independently. Diploid and tetraploid cells were separated from stock in vitro cultures by centrifugal elutriation and maintained entirely in vitro. No influence of ploidy on Do or Dq of heat dose survival curves could be detected. Neither did ploidy affect sensitivity to X-irradiation. However, separation of the diploid and tetraploid subpopulations was imperfect. The ratio of diploid to tetraploid cells in the separated and parent (mixed ploidy) lines was therefore monitored at each passage. Tetraploid contamination of the diploid cell subline was undetectable at the time of separation but regrew to 35 per cent by 40 days after separation. Diploid contamination of the tetraploid subline was initially less than 5 per cent and remained quite low until it became undetectable at 74 days. Differences in regrowth of the contaminating subline could not be accounted for by differences in plating efficiency or doubling time, but might result from subpopulation interactions. If so, such phenomena should be considered when using ploidy-dependent cytotoxic treatments. PMID- 3655438 TI - Evaluation of calculated temperature distributions for a 27 MHz ridged waveguide used in localized deep hyperthermia. AB - The computational model developed by van den Berg has been used to perform two dimensional simulations of tissue-equivalent phantoms heated by a 27 MHz ridged waveguide. The program is able to calculate temperature distributions for realistic inhomogenous tissue configurations (as derived from CT scans) in about 20 min on a PDP 11-44. Results for tissue-equivalent phantoms are evaluated with respect to their accuracy in predicting actual temperature distributions by comparing them with measured temperature distributions. In general the computer simulation tends to overestimate the depth of penetration; this can be ascribed to the two dimensional approach followed which does not take into account the divergence of the electric field in the third dimension. This effect can to a certain degree be compensated by assigning a higher value for the electrical conductivity of the medium. For homogenous phantoms this results in a satisfactory agreement between measured and calculated temperature distributions. Furthermore, a correct approximation for the electric field distribution over the aperture appears to be of importance, since it significantly influences the calculation results, especially for waveguide loads whose size exceeds the width of the ridge area. For inhomogeneous media the simulation results, using realistic (literature) values for the electrical conductivity, can be used with these limitations in mind, as a best-case estimate of the absorbed power distribution at depth. For more accurate simulations a three-dimensional computer model is ultimately needed. PMID- 3655439 TI - A multi-element ultrasonic hyperthermia applicator with independent element control. AB - Acoustic field patterns from a planar multi-element ultrasonic applicator were determined experimentally and compared with theory. Measurements were obtained from square arrays of 4 and 16 elements. The acoustic fields produced by various configurations of individual square elements (3.6 cm X 3.6 cm) driven at 1 MHz were measured in water. Transverse and axial scans paths were used to characterize the acoustic beam for different aperture sizes and individual element excitations. Unequal power excitation of adjacent elements produced multiple peaked acoustic intensity patterns. While a simple theoretical model was not able to account for all the experimentally determined transverse and axial field patterns, a model including mechanical damping improved the agreement between theory and experiment. However, less ripple in the axial pattern was measured than predicted by either theoretical model. The ability of the applicator to generate acoustic field patterns suitable for local tissue heating was demonstrated by an experimental study in dog thigh muscle. PMID- 3655440 TI - Determination of power deposition patterns for localized hyperthermia: a steady state analysis. AB - Hyperthermia applicator design has concentrated on developing systems that allow control of power deposition patterns. In this paper, a method is detailed which uses the steady-state bioheat transfer equation and the target temperature distributions in normal and tumour tissue to calculate the desired steady-state power deposition patterns. This prospective thermal dosimetry approach is demonstrated analytically for three tumour models: an infinite half-space model; an infinite cylinder model; and a spherical model. A three-dimensional numerical method is demonstrated for two different tumour geometries and further applications of this method are discussed. PMID- 3655441 TI - What is regional hyperthermia? PMID- 3655442 TI - [Experimental study on high frequency jet ventilation for tracheoplasty and bronchoplasty--hemodynamic effects of HFJV]. PMID- 3655443 TI - [Hemodynamic effects of atrial-ventricular sequential systole and physiological intra-ventricular contraction at various pacing rates]. PMID- 3655444 TI - [A clinical study on hereditary hemorrhagic telangiectasia (Osler's disease) and its relation to pulmonary arteriovenous fistula]. PMID- 3655445 TI - [The pathogenesis of cardiac cachexia--relationship between nutritional assessment and amino acid metabolism]. PMID- 3655446 TI - [Use of a silicone T-tube in the management of 15 patients with laryngeal or tracheal stenosis]. PMID- 3655447 TI - [Function of the stomach placed in the thoracic cavity after esophageal surgery]. PMID- 3655448 TI - [Surgical management of coarctation of the aorta with ventricular septal defect in neonate and early infancy]. PMID- 3655449 TI - [Influence of surgical incision into the atrium on the intra-atrial conduction in canine heart]. PMID- 3655450 TI - [Cardiopulmonary bypass using thawed red blood cell concentrates--experimental and clinical research]. PMID- 3655451 TI - [Left ventricular false aneurysm following repair of delayed left ventricular rupture after mitral valve replacement]. PMID- 3655452 TI - [Left ventricular rupture after mitral valve replacement with preservation of posterior papillary muscles and chordae tendineae--a case report]. PMID- 3655453 TI - [A case of mediastinal schwannoma originating in the right phrenic nerve]. PMID- 3655454 TI - [Unilateral hypoperfusion of the lung due to bronchial leiomyoma--a report of a case]. PMID- 3655455 TI - [A case report of pulmonary atresia and intact ventricular septum with large right ventricular coronary artery fistulas--an ischemic consequence after Brock's operation]. PMID- 3655456 TI - [A case report of mycotic thoracic aneurysm in a pediatric patient]. PMID- 3655457 TI - [A case of diffuse malignant mesothelioma of the pleura]. PMID- 3655458 TI - Association between regularity in dapsone (DDS) treatment and development of deformity. AB - The existence of an association between regularity in dapsone intake and the development of deformity was investigated in 5746 leprosy patients under treatment in South India. The incidence of deformity, year by year over a 5-year period, increased significantly with increasing levels of drug collection. The excess incidence in "more regular" patients was significant at all ages and in both sexes in nonlepromatous (N) cases. The same was true in intermediate (N?L) cases except in patients under 15 years of age. The evidence in lepromatous (L) cases was not so consistent. Independent confirmation of the presence of the association was sought through a matched case-control type of analysis with 140 N, 48 N?L, and 81 L cases, matching being undertaken with respect to sex, age, type of leprosy, year of starting treatment, and observation period. This showed that the mean regularity in cases (deformed patients) before the development of deformity was significantly higher than the mean regularity in the corresponding matched controls, the differences being particularly large among the N and N?L types. These findings raise the possibility of a causal link between regular dapsone intake and the development of deformity. PMID- 3655459 TI - Feasibility of multidrug therapy (MDT) in Hansen's disease in an urban population -Curupaiti State Hospital, Rio de Janeiro, Brazil. AB - The acceptance of the WHO regimen in a group of 220 patients was approximately 84.5%. Only 11% abandoned the treatment, and the substitution of ethionamide or prothionamide for clofazimine due to excessive hyperpigmentation was necessary in only eight cases. The WHO regimens adopted provided a more frequent (monthly) relationship between the patients and their health service. It was necessary to: a) reorganize the technical-administrative infrastructure, with the intention of providing an improved service to the patients for treatment and control; and b) pay more attention to the problem of deformities and health education activities. As for the side effects of the drugs, 54 patients showed alterations in their liver function tests, which were usually mild and which resolved despite continuation of the treatment. Of the reactional episodes observed during MDT, it would not appear that the therapeutic regimens contributed to their occurrence or aggravation. PMID- 3655460 TI - Certainty levels in the diagnosis of leprosy. AB - This paper describes a procedure for grading the degree of confidence with which it can be held that a diagnosis of leprosy is in fact correct, after considering all available clinical, historical, bacteriological, and histopathological information. Individual suspects are assigned to one of four categories corresponding to different levels of overall certainty of the diagnosis. The method is illustrated using data from the Lepra Evaluation Project in Northern Malawi, and validated in the context of an analysis of BCG's protective efficacy against clinical leprosy. Although the procedures described in this paper were designed for a specific epidemiological study, the method could be adapted for use in most leprosy research or control programs. PMID- 3655461 TI - An investigation of family size and birth order as risk factors in leprosy. AB - To investigate if early exposure to Mycobacterium leprae is a factor determining development of Hansen's disease in general, or of a particular form of the disease, we have studied the sibship size and birth order distribution of 187 leprosy cases and 528 hospitalized control patients. By the Greenwood-Yule analysis, a small deficit of cases in the earlier birth order in the tuberculoid form was observed. Such a deficit was not observed in lepromatous leprosy patients. In the multivariate analysis, where socioeconomic factors, current age, and leprosy status of the parents were taken into account, it was found that sibship size becomes a nonsignificant and nonconsistent predictor of leprosy in general or of a particular form of the disease. On the other hand, the logistic analysis supports the impression that tuberculoid leprosy patients belong to the later birth order in both sexes. Although the contrast is statistically nonsignificant in either sex, it suggests that early exposure in life predisposes to the tuberculoid form of leprosy. PMID- 3655462 TI - Social and demographic aspects of a leprosy epidemic on a Polynesian atoll: implications of pattern. AB - This study reports the results of field research on a leprosy epidemic among the Kapingamarangi people, Polynesians living in two communities on Ponape Island and Kapingamarangi Atoll in the Federated States of Micronesia. The patterns of infection in the two communities are seen to replicate in detail patterns of personal mobility by age and gender and patterns of kinship and friendship relations that order people's social interactions in the communities. These patterns of demographic and social relationship form the context of infectious contact, enabling us to differentiate between more- and less-probable means by which Hansen's disease is spread. We compare coughing and sneezing with inoculation through the frayed fibers of pandanus leaf floor mats and sleeping mats as alternative ways of spreading leprosy infection. We find that frayed mats, because they are ubiquitous in the contexts in which people interact, are more likely to spread infection than coughing and sneezing. Finally, we find that demographic patterns of the communities are not identical with genealogical relationships such that people with close genealogical relationships often do not interact on a regular basis. Thus, genealogical distance and social distance are independent of each other in this community. This makes genetic assessment of inheritance of resistance and susceptibility to Mycobacterium leprae an enterprise unencumbered by a necessarily linked demographic variable. PMID- 3655463 TI - Venous involvement in leprosy: a venographic and histopathological correlation. AB - Venous system involvement was studied by venography and vein histology in 30 leprosy patients irrespective of age, sex, duration of the disease, and treatment. Vascular abnormalities by venography were seen in 96.3% and by histopathological studies in 76.6% of patients. The percentage and severity of radiological and histological changes increased from tuberculoid to lepromatous in the disease spectrum. Perfect correlation of histology and venography was found in 40% of the paucibacillary patients and good correlation was found in 100%. In multibacillary patients perfect correlation was found in 29.4%, good correlation in 41.1%, and no correlation in 29.4% of the patients. PMID- 3655464 TI - Unusual histological lesions in the eye of a leprosy patient. AB - A pathological study of an eye from a leprosy patient is reported. In addition to the granulomatous lesions in the anterior aspect of the eye, microgranulomas are demonstrated in the retina of this patient, a very uncommon finding in leprosy. PMID- 3655465 TI - Autopsy findings in 35 cases of leprosy in Malaysia. AB - The findings of autopsies performed on 35 leprosy subjects in the University Hospital, Kuala Lumpur, between January 1981 and December 1985 are presented. This is the first report based on autopsy findings from Malaysia. The patients were elderly subjects with a mean age of 74 years. Sixty-six percent had lepromatous leprosy. None had active skin lesions. The most common cause of death was pyogenic infection, particularly bronchopneumonia. Tuberculosis was noted in 25% of the cases. The other important causes of death included cardiac and renal failure. Renal lesions were evident in 71% of the cases, and the most common pathology was interstitial nephritis. Generalized amyloidosis complicated six (17%) patients. PMID- 3655466 TI - Cimetidine inhibits suppressor factor production in Ethiopian lepromatous leprosy patients. PMID- 3655467 TI - Pityriasis rubra pilaris with leprophobia. PMID- 3655468 TI - Clinical and histopathologic findings in osteoarticular chronic hypertrophic neuritis and differentiation from leprosy. PMID- 3655469 TI - Air rotor and clinical micromotor induced sensory loss. PMID- 3655470 TI - Method for detecting sulfones in urine. PMID- 3655471 TI - [Roentgenological study of antero-posterior diameter in developmental canal stenosis of cervical spine]. AB - Developmental canal stenosis of the cervical spine is an important underlying condition of cervical spondylotic myelopathy. However, the criteria of the degree of narrowing is different among investigators and their rationales are unclear. To clarify this point, the antero-posterior diameter of the cervical spinal canal was measured in groups of normal subjects, patients with neck-shoulder-arm syndrome and cervical spondylosis. The measured values were analyzed statistically. The antero-posterior diameter was the widest in normal individuals and the narrowest in patients with the cervical spondylotic myelopathy. The point of differentiation of developmental canal stenosis was determined as 14 mm for males and 13 mm for females using the mean +/- 2SD of the values in normal subjects. Patients with values lower than this criteria comprised 82% of those with the cervical spondylotic myelopathy. These patients could be further classified into those that also showed clear cervical spondylotic changes and those that did not. PMID- 3655472 TI - [An electron microscopic study of malignant giant cell tumor of bone]. AB - Three cases of malignant giant cell tumors were studied by light microscope and electron microscope. Light microscopic observation revealed three different types of tumor cells, namely, malignant stromal cells, fibrosarcomatous cell and osteosarcomatous cells. Electron microscopic observation revealed that fibrosarcomatous cells had ultrastructure similar to that of malignant stromal cells. Both types of cells showed nuclear pseudo-inclusions (NPI), and well developed organellae related to matrix synthesis in the cytoplasm. Polysaccharide staining of the same cells revealed positive products in the cytoplasm. Osteosarcomatous cells showed irregular nuclei which contained NPI and well developed r-ER. The cells were located in the non-calcified matrix which consisted of collagen fibers. No alkaline phosphatase activity was observed in this area. These facts suggest that: (1) malignant stromal cells and fibrosarcomatous cells synthesize collagenous stroma as normal fibroblasts do, and (2) osteosarcomatous cells are devoid of the ability to promote matrix calcification. PMID- 3655473 TI - [Level diagnosis of cervical myelopathy using evoked spinal cord action potentials--clinical and experimental studies]. AB - The ESCAPs (evoked spinal cord action potentials) due to both median nerve and spinal cord stimulation were recorded from the interlaminal yellow ligaments posteriorly or intervertebral discs anteriorly on 12 neurologically normal adults, 50 patients with cervical myelopathy and 10 cats in order to determine the main lesion in the cervical cord electrophysiologically. The abnormal ESCAPs obtained from 50 patients with cervical myelopathy were classified into three groups as follows: Grade 1; slightly abnormal, Grade 2; moderately abnormal and Grade 3; severely abnormal which had the positive wave. In general, there was a tendency that the patients graded higher had lower evaluating score of the Japanese Orthopaedic Association. The spinal level on which the highest grade of ESCAPs was recorded generally corresponded to the level which was clearly diagnosed as the main lesion by neurological and radiological examinations, such as the case of single level disc hernia. Therefore, it has become possible to diagnose the main lesion of cervical myelopathy by recording ESCAPs. PMID- 3655474 TI - [Subcutaneous operation and examination under the universal endoscope]. AB - Endoscopes are mainly used to study the internal structures of organs and tissues with inherent space. These include the gastrointestinal tract, abdominal space and joint space. The standard endoscope, however, cannot be used to evaluate tissues without such space. We have invented a new type of operation tube to be used with the arthroscope. This combination enables us to study subcutaneous soft tissues without inherent space. Our new device is a powerful tool to be used for evaluation of subcutaneous soft tissues in any part of the body. Surgical procedures can also be carried out with this device. Areas of future applications of our device will be extremely wide including orthopaedic surgery, plastic surgery and general surgery. The presentation will discuss the procedure for utilizing this new instrument. PMID- 3655475 TI - [Cineradiographic study of wrist motion]. AB - To make clear the kinematics of the wrist in flexion-extension and radial-ulnar deviation, a cineradiographic study was carried out on twenty normal hands. The intercarpal angles were measured on each picture of the cineradiogram. The relationship between the wrist angle and the intercarpal angles were calculated by a micro-computer giving a 5th degree regression curve. From the maximal dorsiflexion to the neutral position, the wrist moves in the radiocarpal joint more than in the midcarpal joint, while, from the neutral position to the maximal palmar flexion, the wrist moves more in the latter. From the neutral position to the maximal radial deviation, the wrist motion occurs in the midcarpal joint more than in the radiocarpal joint, while, from the neutral position to maximal ulnar deviation, the wrist motion occurs equally in the two joints. The movements of the carpal bones were regulated by the tension and the relaxation of the carpal ligaments. PMID- 3655476 TI - [Effect of the autonomic nervous system on muscle blood flow during and after contraction]. AB - The effects of the autonomic nervous system on muscle blood flow during and after contraction were studied. Autonomic blocking agent or stimulant was infused into the ear vein of rabbits. Muscle blood flow was measured by heated thermocouple technique on the quadriceps femoris stimulated by current of 5Hz, 6V and 0,1 msec duration. There was a statistically significant reduction of the postcontraction hyperemia after infusion of phentolamine methylate. Isoproterenol also caused significant reduction in post-contraction hyperemia. On the other hand, epinephrine, norepinephrine and propranolol had no effect on the muscle blood flow. These results suggest that most of the changes in muscle blood flow are not affected by the autonomic nervous system but that, the system may play in the hyperemic reaction of the skeletal muscle. PMID- 3655477 TI - Replacement of femoral head using endoprosthesis (alumina ceramics vs metal)--an experimental study of canine articular cartilage. AB - In two groups of adult dogs with a femoral head prosthesis of either metal or ceramic implanted in the hip joint, the implanted prostheses were compared in terms of the associated gross, histologic changes of the articular cartilage. At 1 or 3 months after implantation the resulting damage to the articular cartilage was minimal in both groups. However, at 6 months a marked difference was noted between the groups: the articular cartilage was almost completely lost in the metallic group, whereas a considerable portion of the cartilage remained intact in the ceramic group. PMID- 3655478 TI - [Experimental study on the mechanism of femoral neck fractures]. AB - To investigate the mechanism of femoral neck fracture, experimental studies were conducted on 48 femurs from 24 cadavers and the relationship between the type of fracture and loss of bone strength due to osteoporosis was investigated. The following results were obtained. 1) Intracapsular fracture was produced with the loading parallel to the axis of the femoral neck and with no applied rotatory force. 2) Among trochanteric fractures, peritrochanteric fracture was produced with rotatory force applied to the femoral head, while intertrochanteric fracture was produced with the loading perpendicular to the femoral shaft. 3) The fracture strength along the seven loading axes on the femoral head decreased with the progress of osteoporosis to the same degree in all directions. The fracture strength on Singh index Grade II, III examples decreased to approximately 1/3-1/4 of Grade VI examples. 4) The type of fracture macroscopically depended upon the direction of the loading, and had no correlation with osteoporosis. PMID- 3655479 TI - [Radiographic estimation of vertebral rotation]. AB - Although there are various methods such as that of Nash and Moe, to measure the degree of vertebral rotation in patients with scoliosis, no decisive method has been established to date. In the present study, a formula for estimation of the pedicle rotation ratio (PRR) was obtained, based on the results of measurements of 5 dry cadaver vertebrae to establish a reasonably accurate quantitative determination of the degree of vertebral rotation on a routine antero-posterior roentgenogram of the spine. The formula could be written as: Y = AX - B(X: PRR, Y: a degree of vertebral rotation, A and B: variable according to the level of the vertebrae). The degree of vertebral rotation was obtained on antero-posterior roentgenograms of 150 vertebrae from 29 patients with idiopathic scoliosis, and was also measured on computerized tomograms of these patients for comparison. There was statistically significant relationship between the results of two methods. The present appears to be useful for clinical evaluation of scoliosis. PMID- 3655480 TI - [Potential role of phosphoprotein in collagen mineralization--an experimental study in vitro]. AB - To examine the potential role of phosphoprotein in collagen mineralization, a series of experiments were carried out in vitro using native type collagen fibrils containing phosphoprotein. Ten different preparations of decalcified chicken bone were used for nucleation experiments, employing experimentally established metastable solutions of 10 mg/100 ml, ionic strength 0.165, at 25 degrees C. The specimens were analysed at regular intervals for their calcium and phosphorus content. Amino acid analyses including quantitation of phosphoserine and phosphothreonine were performed on all the samples. The time lag between the incubation of the sample in the metastable solution and the initiation of nucleation was found to be directly related to the concentration of the phosphoaminoacids. The data suggest that phosphoprotein has an effect on the speed of the collagen mineralization, thus playing a significant role in initiation of the tissue calcification. PMID- 3655481 TI - Effect of diltiazem on the cardiotoxicity induced by adriamycin in rabbits. PMID- 3655482 TI - [Chemotherapy of nasopharyngeal carcinoma]. PMID- 3655483 TI - [Survival following preoperative loco-regional chemotherapy of locally advanced breast cancer]. PMID- 3655484 TI - [Clinicopathological study on carcinoma of the pancreas operated on at the Mayo Clinic and the National Cancer Center Hospital--a comparison of the diagnostic process in both institutions and an analysis of survival rates]. PMID- 3655485 TI - [Results of intraoperative radiotherapy of pancreatic carcinoma--studies on conformation radiotherapy applied to postoperative irradiation]. PMID- 3655486 TI - [Relationship between G2 accumulation and RNA content of PC 1 cells in unbalanced growth induced by antitumor agents]. PMID- 3655487 TI - [Comparative studies of genital organ tissues, and plasma concentrations, and urinary excretions of platin between intra-arterial and intra-venous injection of CDDP in rabbits]. PMID- 3655488 TI - [A study of cisplatinum dosage regimen with particular reference to its pharmacokinetics]. PMID- 3655489 TI - [The synergistic effect of human recombinant TNF in combination with hyperthermia]. PMID- 3655490 TI - [Individualization of YAG-laser treatment of early neoplasia of the uterine cervix]. PMID- 3655491 TI - [Vasoactive intestinal polypeptide content of neutrophils in diabetic patients]. PMID- 3655493 TI - [Clinical significance of exercise-induced negative U wave]. PMID- 3655492 TI - [Significance of anti-islet cell antibodies in patients with diabetes mellitus and autoimmune thyroid disorders]. PMID- 3655494 TI - [A case of benign asbestos pleurisy as pleural bloody effusion]. PMID- 3655495 TI - [A case of basal cell nevus syndrome with gastrointestinal polyposis accompanying the various endocrinological abnormalities]. PMID- 3655496 TI - [Fulminant pulmonary calcification in the case of chronic renal failure]. PMID- 3655497 TI - [Three cases of pseudoaldosteronism due to methanol extracts of licorice (FM 100)]. PMID- 3655498 TI - [A case of familial hypercholesterolemia associated with Basedow's disease]. PMID- 3655499 TI - [Fludrocortisone acetate-responsive hyponatremia observed in old patients after head injury]. PMID- 3655500 TI - [A case of toxic shock syndrome (TSS)]. PMID- 3655501 TI - [A case of left atrial myxoma associated with the pigmentation of the lips, palms and soles and the chordal rupture]. PMID- 3655502 TI - [A case of Behcet disease associated with bilateral pulmonary thromboarteritis]. PMID- 3655503 TI - [Effect of sodium load and furosemide administration on the chronic type of the syndrome of inappropriate secretion of antidiuretic hormone]. PMID- 3655504 TI - A microcomputer system for long term monitoring, collecting, analyzing and reporting noninvasive oxygen saturation. AB - The characteristics of a microcomputer based system for long term monitoring, collecting, analyzing and reporting oxygen saturation are described. Every two seconds SaO2 is transmitted to the microcomputer via the serial port of the oximeter and verified by the program. The microcomputer's real time display and internal data structures are updated. At the end of the data collection period, accumulated data is stored to disk. Report generation modules calculate summary statistics and generate graphs depicting the cumulative time distribution of SaO2, the frequency distribution of SaO2, and an hour by hour representation of the real time display. This inexpensive microcomputer based system allows accurate collection and timely presentation of oxygen saturation levels with monitoring periods of any length replacing tedius and time consuming manual recording, digitizing and analysis. PMID- 3655505 TI - The clinical use of the Ohmeda Automated Anesthesia Record Keeper integrated in the Modulus II Anesthesia System. A preliminary report. AB - While performing his complex array of tasks, the anesthesiologist is also responsible for maintaining an anesthetic record. Up to now, this has been done by hand. The clinical use of automated anesthesia record keeping is presently evaluated. The anesthesia records generated by the Ohmeda Automated Anesthesia Record Keeper integrated in the Modulus II Anesthesia System is compared to hand written records. The differences between the two records of identical patients are quantified as erroneous or missing data. With the criteria adapted, we found significant and clinically relevant differences which stress the importance of automated record keeping. PMID- 3655506 TI - Medical information networking and standardization. AB - There are few environments that generate and manage as much information as the hospital. Although computers are used extensively to manage this information, their application has been opportunistic rather than strategic. This has led to a multi-vendor information processing environment in many hospitals. Hospitals today have financial systems, order-entry communication systems, ADT systems, and clinical systems such as laboratory, pharmacy, etc. Communication between these islands of automation however are still, for the most part, primitive. Exceptions are in the large teaching hospitals where internal staff have been utilized to link systems together. The effort has traditionally been huge and fraught with difficulties related to the heterogeneous environment that is involved. In order to overcome these problems and enable us to truly bring the power of modern computing to bear on hospital-wide problems, as well as to make feasible, for example, the computerized medical record, we must develop an appropriate strategy. It seems unlikely that a single-vendor solution will entirely answer hospital information processing needs. Therefore, a perpetuation of the heterogeneous environment is inevitable. With this in mind, an alternative approach is proposed: to develop networking standards for the hospital, as has been done for the manufacturing and technical office environment, such that vendors can build systems that can be easily integrated. PMID- 3655507 TI - TRAM: a new concept in transport monitoring. AB - A new monitoring system has been designed to eliminate the need to interrupt monitoring to transport critically ill patients. The key innovation of the system is a self-contained multiparameter signal acquisition and processing module that contains a battery-backed microprocessor and retains monitor setup information when moved from one monitor to another. The module functions in Marquette Series 7010 surgical monitors and bedside monitors and in the new Marquette Transport Remote Acquisition Monitor (TRAM). Lines connecting the patient to the module remain connected. The TRAM module provides continuous, integrated multiparameter monitoring during transport. Monitored parameters include up to four simultaneous ECG leads, two invasive blood pressures, pulse rate, cardiac output and two temperatures (in place of cardiac output). PMID- 3655508 TI - The electronic clipboard: a semiautomatic anesthesia record. AB - An electronic clipboard has been designed, built, and tested, which produces an anesthesia record semiautomatically. Physiologic data are recorded up to once a minute automatically. Two keys number and time 'drug' and 'event' entries. The accurate monitoring of heart rate and blood pressure and the timing of event data are much improved over hand-written entries. PMID- 3655509 TI - The use of neurophysiologic monitoring during anaesthesia. PMID- 3655510 TI - Impaired rectal sensation in idiopathic faecal incontinence. AB - In 15 patients suffering from idiopathic faecal incontinence and in 15 matched controls, manometric studies of anorectal pressure and studies of the rectoanal reflex and rectal sensitivity were carried out. Patients with idiopathic faecal incontinence had normal resting pressure but reduced squeeze and stress pressures; the anal sphincter relaxed before a sensation of rectal distension occurred. The conclusion is that both reduced voluntary muscle contraction and impairment of rectal sensation are conducive to soiling in idiopathic faecal incontinence. PMID- 3655511 TI - Hair-containing lesions within the anal canal. AB - Hair-containing lesions located in the anal canal are an exceedingly rare clinical entity of which only five cases have been reported previously. We add five more cases, including two with a bundle of hairs rooted inside the anal canal and stemming out through a mucosal opening. PMID- 3655512 TI - Anal sphincter function after treatment of fissure-in-ano by lateral subcutaneous sphincterotomy versus anal dilatation. A randomized study. AB - Twenty patients with chronic anal fissure were randomized into two groups. Ten patients were treated with lateral subcutaneous sphincterotomy and 10 with anal dilatation. Anal dilatation was carried out preoperatively, and at 1 and 3 months after the operation in all patients. Preoperatively there was a significantly increased maximal resting pressure in the 20 fissure patients (80 mmHg median) compared with 20 control subjects (50 mmHg median). Postoperatively a significant decrease in pressure occurred in the dilated group (49 mmHg median p less than 0.05), whereas the pressure was not significantly reduced in the group that underwent sphincterotomy (65 mmHg median p less than 0.05). At 1 year three patients complained of recurrent symptoms of anal fissure in the dilated group compared with one in the sphincterotomy group. Minor continence disturbance was noted in two patients in both groups. PMID- 3655513 TI - Anal dilatation. PMID- 3655514 TI - The odyssey of a calcium ion: life in the biliary tract. PMID- 3655515 TI - Intestinal cytoprotection, also? PMID- 3655516 TI - Models of ischemic acute renal failure: do they reflect events in human renal failure? PMID- 3655517 TI - Absorption of biliary calcium from the canine gallbladder: protection against the formation of calcium-containing gallstones. AB - Calcium salts are the major components of pigment gallstones. The calcium species in bile that is critical for Ca++ precipitation is free ionized calcium, [Ca++]. Factors that regulate biliary [Ca++] in bile are therefore of great importance in the pathogenesis of pigment gallstones. The fate of biliary Ca++ on entry into the gallbladder has not previously been studied. We here report that a minimum of 51.3% +/- 8.8% (SEM) of Ca++ is absorbed from the canine gallbladder on concentration of bile during a 24-hour fast. In addition, there was absorption of least 70.9% +/- 6.2% of Na+, 56.5% +/- 8.6% of K+, and nearly all (greater than 98%) of Cl-. Absorption, neutralization, or both, of HCO3- was also nearly complete (greater than 98%). During concentration of bile by the gallbladder, the concentrations of all biliary cations increased as total bile salt concentration increased, whereas anion concentrations declined. These results are consistent with a Gibbs-Donnan effect induced by impermeable, negatively charged bile salt molecules. Comparison of bile/plasma [Ca++] ratios with those for [K+], a passively distributed ion, was also consistent with, although not proof of, the passive absorption and distribution of Ca++ across the gallbladder epithelium. The absorption of Ca++ by the gallbladder may be a factor in the prevention of pigment gallstones, because it limits free Ca++ ion in bile, and thus decreases the likelihood of precipitation of calcium. PMID- 3655518 TI - Partial aortic ligation: a hypoperfusion model of ischemic acute renal failure and a comparison with renal artery occlusion. AB - Ischemic acute renal failure (ARF) in humans typically results from hypoperfusion, not total blood flow interruption. However, experimental studies of ischemic ARF have relied on total blood flow cessation models because no reliable hypoperfusion model has been described. Therefore, the goal of this study was to develop a hypoperfusion model of ischemic ARF and then to contrast it to a blood flow cessation model (renal artery occlusion). Rats were uninephrectomized, and then temporary (30 or 45 minute) partial aortic ligation (PAL) was created just above the left renal artery, yielding a renal perfusion pressure of 15 to 20 mm Hg and a renal blood flow of 0.1 to 0.2 ml/min. The severity of renal injury was assessed 24 hours later. Azotemia (30-minute PAL: BUN 47 +/- 5 mg/dl; 45-minute PAL: 118 +/- 11 mg/dl), depressed inulin clearances, and extensive pars recta proximal tubular necrosis resulted. Comparing 30 minutes of PAL with 30 minutes of renal artery occlusion revealed far less severe ischemic adenosine triphosphate depletion (P less than 0.001), less azotemia (P less than 0.05), less medullary vascular congestion (P less than 0.05), and less cast formation (P less than 0.05) with PAL. However, both models induced comparable degrees of tubular necrosis, oxidant tissue stress (as assessed by oxidized-reduced glutathione tissue assay), and post-ischemic adenosine triphosphate depletion. Both similarities and differences exist between hypoperfusion and blood flow cessation-induced experimental ARF. The difference indicate that blood flow cessation models may not closely simulate clinical ischemic renal injury. PMID- 3655520 TI - Effect of magnesium salt anions on potassium balance in normal and magnesium depleted rats. AB - Potassium depletion often accompanies clinically significant magnesium depletion, and magnesium replacement is most frequently undertaken with magnesium sulfate. However, inorganic sulfate acts as a nonreabsorbable anion in the distal nephron, an effect that could potentially interfere with the correction of any associated potassium deficiency. We have investigated the effect of a variety of magnesium salts, including sulfate and nonsulfate forms, on cation balance and skeletal muscle ion composition in normal and magnesium-depleted rats. Even modest amounts of dietary sulfate increased the urinary excretion of potassium in both normal and magnesium-depleted rats. During a 7-day feeding period, diets containing MgSO4 or MgO with an equivalent amount of Na2SO4 resulted in significantly greater urinary excretion of potassium than diets without sulfate. In normal animals, this kaliuresis did not produce hypokalemia or muscle potassium depletion. Magnesium-deficient feeding produced magnesium depletion, kaliuresis, and a decline in both plasma and muscle potassium content. When magnesium was restored to the diet without sulfate, urinary potassium excretion decreased, and both magnesium and potassium deficits were corrected. However, when magnesium refeeding included sulfate salts, magnesium stores returned to normal, whereas the kaliuresis and potassium depletion persisted. When accompanied by a high sodium intake, the kaliuretic effect of sulfate was increased. PMID- 3655519 TI - Role for intrarenal adenosine in the renal hemodynamic response to contrast media. AB - The intrarenal injection of contrast media results in a transient fall in renal blood flow (RBF) and a decrease in glomerular filtration rate (GFR). These effects are enhanced by dietary sodium restriction and attenuated by sodium loading. A similar sodium-dependent response of RBF and GFR occurs with the intrarenal injection of adenosine. In view of these similarities, we sought to determine whether endogenous adenosine is involved in the renal hemodynamic response to contrast media. The intrarenal injection of contrast media (meglumine Na diatrizoate, 76%) in six sodium-depleted, anesthetized dogs resulted in a 17% +/- 4% decrease in RBF and a 31% +/- 5% decrease in GFR. The infusion of the adenosine receptor antagonist, theophylline (5 mumol/min), reduced the decrease in RBF to 6% +/- 2% and in GFR to 12% +/- 3% of control values. During the intrarenal infusion of dipyridamole (24 micrograms/kg/min), a potentiator of adenosine through its action to inhibit the cellular uptake of nucleosides, the hemodynamic response to contrast media was greater; RBF fell 25% +/- 4% and GFR fell 44% +/- 7%. In addition, the urinary excretion of endogenous adenosine increased after the injection of contrast media (388 +/- 79 vs. 830 +/- 231 nmol/min). In summary, the contrast media-induced fall in RBF and GFR was attenuated by theophylline and augmented by dipyridamole, and the administration of contrast media resulted in an increase in the excretion of endogenous adenosine. These results support the hypothesis that endogenous adenosine is involved in the renal hemodynamic response to contrast media. PMID- 3655522 TI - Synergism between Bacteroides fragilis and Staphylococcus aureus in experimental tibial osteomyelitis. AB - We explored the potential role of microbial synergy in an experimental rat osteomyelitis model. Osteomyelitis was assessed by gross pathologic conditions and quantitative cultivation of rat tibiae for the implanted organisms 21 days after challenge. When Staphylococcus aureus was used alone, the 50% infective dose (ID50) and the 100% infective dose (ID100) were 400 and 25,000 colony forming units (CFU), respectively. When Bacteroides fragilis was inoculated alone, the ID50 was 150,000 organisms, and the ID100 was not confidently determined. Subinfectious numbers of B. fragilis added to the staphylococcal inocula yielded an ID100 as low as 20 staphylococci. Mixed inocula with 20 or 200 staphylococci and increasing numbers of B. fragilis yielded a dose-dependent increase in the number of staphylococci isolated from osteomyelitic tibiae. Multiple linear regression analysis confirmed the two inocula and their interaction to be significantly predictive of the 21-day quantitative assessment of staphylococci (r = 0.80). Synergy was most striking at low bacterial inocula. When even large numbers of S. aureus were added to B. fragilis, the B. fragilis inoculum required to initiate B. fragilis osteomyelitis was essentially unchanged. We conclude that small numbers of B. fragilis allow remarkably low numbers of S. aureus (20 or 200 CFU) to establish osteomyelitis in the rat. PMID- 3655521 TI - Small intestinal regulation of iron absorption in the rat. AB - Ultrastructural, biochemical, and immunologic studies of the small intestinal mucosa of rats were undertaken to investigate factors associated with the regulation of iron absorption. The quantity of iron within mucosal cells was proportionate to the degree of iron repletion. Although the quantity of iron binding substances was similar in iron-deficient and iron-loaded animals, the unsaturated iron-binding capacity of mucosal cells varied inversely with the state of iron repletion of animals in ultrastructural, biochemical, and immunologic observations. Although only certain mucosal cells contained iron binding substances, their number was not increased in iron-deficient animals. Greater quantities of iron and iron-binding substances were observed in duodenal mucosa than in ileal mucosa. These findings are consistent with the hypothesis that the quantity of unsaturated iron-binding substances within intestinal mucosal cells regulates iron absorption. These findings are only partially explained by changes observed in the concentration of ferritin and transferrin within intestinal mucosa and suggest that other iron-binding substances may also participate in the regulation of iron absorption. PMID- 3655523 TI - High-performance liquid chromatographic characterization of neurophysins in chronic renal failure. AB - Levels of immunoreactive (IR) oxytocin (OT)-associated or estrogen-stimulated neurophysin (ESN) and vasopressin-associated or nicotine-stimulated neurophysin (NSN) were measured in plasma of patients with chronic renal failure before and after hemodialysis (HD) and intermittent peritoneal dialysis (IPD), and during continuous ambulatory peritoneal dialysis (CAPD). ESN-IR in 17 patients before HD was 24.4 +/- 2.7 ng/ml (mean +/- SEM) and increased after HD to 33.2 +/- 4.1 ng/ml (P less than 0.001). ESN-IR in 17 patients with CAPD was 15.2 +/- 3.4 ng/ml, significantly lower than in patients undergoing HD, P less than 0.001. In patients receiving IPD (n = 6), ESN was 11.6 +/- 3.7 ng/ml and did not change significantly after IPD. Levels of ESN in patients with renal failure were increased compared with levels in normal individuals, 1.0 +/- 0.1 ng/ml. Levels of ESN were not correlated with laboratory parameters that may be abnormal in renal failure. NSN levels in 16 of 17 patients undergoing HD were 3.2 +/- 0.34 ng/ml and in 14 of 17 patients with CAPD were 2.9 +/- 0.4 ng/ml, respectively. ESN before HD (r = 0.63, P less than 0.01), after HD (r = 0.85, P less than 0.001), and in patients with CAPD (r = 0.83, P less than 0.001) and IPD (r = 0.81, P less than 0.05) correlated significantly with an OT-like peptide previously found to be increased in renal failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655524 TI - Systems of membranes involved in peritoneal dialysis. AB - To evaluate whether the viscera contribute to the system of membranes used in peritoneal dialysis, dialysis rate studies were performed comparing control rats (n = 9, mean peritoneal area 509 +/- 38 cm2) with eviscerated rats (n = 12, mean peritoneal area 200 +/- 123 cm2). The mass transfer coefficient (MTC) and absorption from the peritoneal cavity were calculated for urea, creatinine, and inulin, which had been added to commercially available 1.5% hydrous dextrose dialysate. Rates of peritoneal blood flow to the peritoneal membranes remaining after evisceration were similar for both groups. Urea, creatinine, glucose, and inulin were used as markers to compare control and eviscerated animals. The MTC results were (in milliliters per minute, mean +/- SEM): urea 3.0 +/- 0.3, 4.1 +/- 0.5 (P less than 0.01); creatinine 1.4 +/- 0.2, 2.0 +/- 0.2 (P less than 0.05); glucose 1.2 +/- 0.3, 1.7 +/- 0.2 (P less than 0.09); inulin 0.3 +/- 0.02, 0.6 +/- 0.1 (P less than 0.01); and MTC inulin/MTC urea 0.16 +/- 0.01, 0.14 +/- 0.01. Absorption of urea, creatinine, glucose, and inulin from the peritoneal cavity was only 10% to 23% greater among control animals. Whether the results were caused by nonparticipation of the intestinal viscera or other mechanisms, such as improved contact between dialysate and membrane, awaits further study. PMID- 3655525 TI - Hypercalcemia can potentiate the nephrotoxicity of Bence Jones proteins. AB - Hypercalcemia is frequently observed in patients with multiple myeloma and renal failure. Whether Bence Jones protein (BJP) is directly nephrotoxic and how and whether hypercalcemia might contribute to this putative nephrotoxicity is currently unclear. To examine this issue, we studied the effect of modest hypercalcemia on the glomerular filtration rate (GFR) of rats exposed to a BJP that by itself had been found to be nonnephrotoxic. Three groups of rats were studied. All were anesthetized and underwent a baseline measurement of inulin clearance (Cin). After this, group 1 (n = 13) rats were given 2 ml of vehicle (phosphate-buffered saline solution [PBS]) and were then made hypercalcemic with an infusion containing 0.048 mol/L CaCl2. At the end of 2 hours a second Cin was measured. Group 2 rats (n = 8) were given 100 mg BJP in 2 ml PBS and a non calcium-containing infusate. Group 3 (n = 11) rats were given 100 mg of the BJP in 2 ml PBS and then the calcium-containing infusate used in group 1 rats. Rats in groups 2 and 3 also had a second Cin measured at the end of 2 hours. Renal blood flow was measured with an electromagnetic flow probe. At the completion of the second clearance, kidneys were processed for renal histologic assessment. The serum calcium level measured during the second Cin period was 13.5 mg/dl for group 1, 7.9 mg/dl for group 2, and 13.7 mg/dl for group 3. No significant decrement in GFR was observed in group 1 or 2 rats. In contrast, group 3 rats had a 46% fall in GFR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655526 TI - Evaluation of a filter aspiration technique to determine membrane deformability. AB - A filter aspiration technique for the measurement of red cell membrane deformability described by Brailsford et al. (Blood Cells 1977;3:25) was evaluated. Pore diameters of 0.6 and 1.0 micron were used. Portions of red cells were aspirated with various hydrostatic pressures between 1 and 9 mm H2O. After fixation the filter was removed and the length and radius of the pressure-induced tongues measured by scanning electron microscopy. One to several tongues per cell were observed. The number of tongues had no influence on the measurements at pressures less than or equal to 7 mm H2O. The elastic modulus of the red cell membrane was calculated; it yielded 2.9 (+/- 0.4) X 10(-3) dynes/cm. Data obtained with filter aspiration were compared with the results obtained concurrently with the micropipette technique. A good correlation was found for normal red cells (r = 0.74, P less than 0.001). Stomatocytes produced by chlorpromazine in vitro had an increased elastic modulus with both methods. For echinocytes produced by salicylate or adenosine triphosphate depletion, the elastic modulus as determined by filter aspiration was normal, but the modulus as measured by micropipette aspiration was increased. Possible reasons for the difference are discussed. We conclude that the filter aspiration is a valid technique to measure elastic properties of red cell membranes, except when there are surface irregularities, such as those in the echinocytes. PMID- 3655528 TI - Human endolymphatic sac: possible mechanisms of pressure regulation. AB - The ultrastructure of the normal human endolymphatic sac (ES) has been observed by transmission electron microscopy (TEM). The role of the epithelium, the various regions of the subepithelial space and the general anatomy of the ES in pressure regulation were morphologically studied to generate testable hypotheses of human ES function. Light microscopic (LM) and TEM evidence of pressure regulatory mechanisms by endolymph resorption, mechanical factors, and secretory activity are presented. These mechanisms may be useful in designing experimental studies of the ES, and in interpretation of retrospective LM and TEM studies of patients with Meniere's disease. PMID- 3655527 TI - Identical complement concentrations in blood obtained from central venous catheters, arterial lines, and antecubital phlebotomy. AB - In vitro complement activation has been detected during passage of blood through tubing used in hemodialysis and cardiopulmonary bypass surgery, in addition to tubing being investigated for vascular grafts. Because tubing from arterial lines and central venous catheters are composed of similar materials and are used when blood is withdrawn from patients for complement assays, a study was undertaken to assess the degree of complement activation in blood obtained from these sites. Complement activation was determined by a terminal complement complex enzyme linked immunosorbent assay (ELISA), C1rC1s-C1 inhibitor complex ELISA, and 50% complement hemolytic activity (CH50) assay. Blood simultaneously obtained from the arterial lines and central venous catheters had identical terminal complement complex, C1rC1s-C1 inhibitor complex, and CH50 levels when compared with blood withdrawn by antecubital phlebotomy. Because blood may be obtained from the arterial lines and central venous catheters for complement assays, the pain and possible bruising from antecubital phlebotomy could be eliminated. Furthermore, blood may now be withdrawn from indwelling catheters without fear of in vitro complement activation causing a misinterpretation of results. PMID- 3655529 TI - Tuning fork tests in children (an evaluation of their usefulness). AB - Despite the huge advances in clinical audiology over the past few decades, tuning fork tests are still used extensively in the diagnosis of hearing loss. This study investigates the usefulness, reliability and accuracy of tuning fork tests in a group of children involved in a prospective study of glue ear, and shows them to be of dubious value. PMID- 3655530 TI - The management of a population of tinnitus sufferers in a specialized clinic: Part I. Description of the clinic organization and the population seen. PMID- 3655531 TI - The management of a population of tinnitus sufferers in a specialized clinic: Part II. Identification of psychiatric morbidity in a population of tinnitus sufferers. PMID- 3655532 TI - The management of a population of tinnitus sufferers in a specialized clinic: Part III. The evaluation of psychiatric intervention. PMID- 3655533 TI - Nasal resistance to airflow (its measurement, reproducibility and normal parameters). AB - A method of rhinomanometry is described for use in clinical research work. The statistical distribution of nasal resistance values is studied in a sample of 59 normal individuals. The variation of nasal resistance within two individuals is studied over a period of 7 hours. The choice of appropriate statistical tests to be used when comparing nasal resistance values is discussed. The reproducibility of nasal resistance measurements is assessed in 47 normal individuals. The results were used to define a normal range of values for total nasal resistance to airflow. PMID- 3655534 TI - Tracheostoma valve for speech rehabilitation in laryngectomees. AB - In the newer surgical procedures for fistula speech, finger occlusion of the tracheostoma is mandatory for speech production. This can be embarrassing as it draws attention to the patient's stoma. Finger occlusion is unhygienic and at times inconvenient. A new tracheostoma valve has been designed to eliminate the need for finger occlusion for speech. It has been evaluated clinically in nine laryngectomees, all of whom retained a good objective quality of speech similar to that obtained by finger occlusion. Vocal efficiency measurements with the valve are very encouraging. The valve is simple to use, of universal size, self retaining, does not need any skin cleansing and obviates the need for skin adhesives to hold the valve in place. PMID- 3655535 TI - Electrolaryngography in near-total laryngectomy with myo-mucosal valved neoglottis. AB - Near-total laryngectomy with myo-mucosal valved neoglottis is the most recent of the various surgical procedures for speech rehabilitation. The site and mechanism of phonatory function of the neoglottis has been investigated in eight patients by means of electrolaryngography. Results demonstrate substantial similarity in the nature of function of the neoglottis when compared with the normal human glottis. PMID- 3655536 TI - Serum enzymes in head and neck cancer. II. Aliesterase. AB - Serum aliesterase levels have been estimated in 38 patients with head and neck cancer. The mean value was significantly lower than in controls. The decrease in activity was greater in patients with ulcerative growths and it progressed with advancement in the stage of cancer. With radiotherapy, a progressive and significant increase in serum aliesterase activity was observed. In patients with non-malignant growths the activity was comparable with that in controls. PMID- 3655537 TI - Pneumosinus dilatans. PMID- 3655538 TI - Cysts of the infant larynx. AB - We report the largest single-centre series in the literature of laryngeal cysts in infants. Most of these children presented with stridor within the first two weeks of life, and were found to have a supraglottic or vallecular cyst. Early endoscopic de-roofing of the cyst is the recommended form of treatment. PMID- 3655539 TI - Laryngopyocele (a report of two cases). AB - A laryngocele is an air-filled dilatation of the saccule of the larynx. An infected laryngocele is called a laryngopyocele. Our experience with two cases of laryngopyoceles are presented. Only 29 cases of laryngopyoceles have so far been reported in the literature (Illum and Nehen, 1980). Case one had a right-sided combined laryngopyocele and case two had a right-sided combined laryngopyocele and a left-sided combined laryngocele. Both our cases had their lesions excised via an external approach, as described by Yarington and Frazer (1966), with case two having a bilateral excision. PMID- 3655541 TI - Pedunculated intraluminal oesophageal hamartoma. AB - A case of pedunculated intraluminal oesophageal hamartoma in a 10-year-old male child, who presented with respiratory stridor, is reported. The clinical features of this clinical entity are so similar to other benign oesophageal neoplasms that a definite diagnosis can be made only after surgical excision and histopathology. PMID- 3655540 TI - Metastasis to the larynx revealing a renal cell carcinoma. AB - A rare case of laryngeal metastasis as the first sign of an unrecognized renal cell carcinoma, occurring in a 73-year-old man, is reported. The clinical picture, pathology, diagnosis, differential diagnosis and prognosis are discussed. PMID- 3655542 TI - An unusual complication following tracheo-esophageal puncture for alaryngeal voice restoration. AB - A laryngectomized patient who developed massive subcutaneous emphysema, pneumothorax, pneumomediastinum, and esophageal fistula with a retroesophageal collection following the creation of a tracheo-esophageal fistula for alaryngeal voice restoration is presented, together with its management. A review of the literature is made, and possible causes of the three complications are discussed. PMID- 3655543 TI - Fractured tracheostomy tubes in the tracheo-bronchial tree: (a report of nine cases). AB - A retrospective study of nine cases of fractured tracheostomy tubes presenting as foreign bodies in the tracheo-bronchial tree, seen over a period of about 8 years, has been made. The literature on this rare subject is reviewed. The presenting features, causes of failure of tracheostomy tubes and management of the problem are discussed. The causes of fracture were found to be repeated boiling, prolonged use, erosion by tracheo-bronchial secretions and manufacturing defects. PMID- 3655544 TI - Death due to a plastic medicine bottle top. PMID- 3655545 TI - Validating the learning disabled adult: a response to Lieberman. PMID- 3655547 TI - Lost in the learning maze. PMID- 3655546 TI - School consultation (Part I): An interdisciplinary perspective on theory, models, and research. PMID- 3655549 TI - Policy statement: learning disabilities, dyslexia, and vision. American Academy of Ophthalmology. PMID- 3655548 TI - Background information: learning disabilities, dyslexia, and vision. PMID- 3655550 TI - Management of dyslexia and related learning disabilities. PMID- 3655551 TI - Learning disabilities and giftedness: identification based on self-concept, behavior, and academic patterns. PMID- 3655552 TI - Developing job maintenance skills in learning disabled youth. PMID- 3655553 TI - Convergent-discriminant validity of the Jewish Employment and Vocational Service System. PMID- 3655554 TI - Behavioral contagion and manageability: learning disability and regular education teachers' perspectives. PMID- 3655555 TI - Component deficit and academic remediation of learning disabilities. PMID- 3655557 TI - Altered metabolism of bile alcohol and bile acid in complete extrahepatic cholestasis: qualitative and quantitative aspects. AB - Urinary excretion of bile alcohols and bile acids in patients with complete extrahepatic cholestasis before and after the release by external biliary drainage was studied. Following extraction, isolation, and hydrolysis, bile alcohols were determined by capillary gas-liquid chromatography-mass spectrometry as dimethylethylsilyl derivatives. During cholestasis, 8.89 mumol/day of bile alcohol and 140.4 mumol/day of bile acid were excreted in urine. The amount of bile alcohol excreted was 6.1% of that of bile acid. Positive correlation between excretion of bile alcohols and bile acids was observed. The major bile alcohols excreted were also present in urine from healthy individuals but in much smaller amounts. After the release of extrahepatic cholestasis, urinary excretion of bile acid decreased rapidly, but that of bile alcohol decreased only gradually. The latter often increased again and remained high. The results indicate that the increased excretion of bile alcohols in complete extrahepatic cholestasis may reflect the expansion of a normally existing pathway of bile alcohol synthesis and excretion leading to the modification of bile alcohols for their efficient urinary elimination. It is also suggested that the rate of synthesis of bile alcohols is determined partly by the size of the substrate pool available. PMID- 3655556 TI - Taurine increases bile acid pool size and reduces bile saturation index in the hamster. AB - There is evidence that increased availability of taurine enhances the proportion of taurine-conjugated bile acids in bile. To explore the possibility that taurine treatment could also influence hepatic cholesterol and bile acid metabolism, we fed female hamsters for 1 week and measured both the biliary lipid content and the microsomal level of the rate-limiting enzymes of cholesterol and bile acid synthesis. In these animals the cholesterol 7 alpha-hydroxylase activity was significantly greater in respect to controls (P less than 0.05). The total HMG CoA reductase activity, as well as that of the active form, was similarly increased. The stimulation of 7 alpha-hydroxycholesterol synthesis was associated with an expansion of the bile acid pool size in taurine-fed animals. Taurine feeding was observed to induce an increase in bile flow as well as in the rate of excretion of bile acids, whereas the secretion rate of cholesterol in bile was decreased. As a consequence, the saturation index was significantly lower in taurine-fed animals (P less than 0.05). The possible mechanisms through which taurine exhibits the modification of the enzyme activities and of the biliary lipid composition are discussed. PMID- 3655558 TI - Proliferation of unilocular fat cells in the primary culture. AB - Mature white fat cells (unilocular fat cells) have generally been considered to be in terminal differentiation and, hence, to have no proliferative ability. A new method, referred to as "ceiling culture," has been devised in our laboratory to culture unilocular fat cells in vitro. Under such culture conditions, the fat cells continue to exhibit specific functions of lipid metabolism and proliferate extensively. Intracytoplasmic lipid droplets did not inhibit division of the cells. There were two modes of proliferation of unilocular fat cells: "loculus dividing" cell division, in which the single loculus of fat in the dividing cell was broken down into multiple droplets and distributed evenly between the daughter cells, and "loculus-preserving" cell division, in which the loculus in the dividing cell was minimally broken down and inherited with its shape preserved by one of the daughter cells with the other getting only a small number of fine lipid droplets. Such findings suggest that unilocular fat cells in mature fat tissue in vivo are probably capable of proliferation in such modes under some conditions. PMID- 3655559 TI - Regulation of cholesterol esterification by micellar cholesterol in CaCo-2 cells. AB - The regulation of acylcoenzyme A:cholesterol acyltransferase (ACAT) activity by cholesterol was studied in an established enterocyte cell line. CaCo-2 cells were grown in culture to confluency and dome formation. They were characterized morphologically by light and transmission electron microscopy. During the culture period, ACAT activity remained stable while the activities of the brush border enzymes sucrase and alkaline phosphatase progressively increased with time and plateaued 12 days after plating. As determined by the rate of incorporation of oleic acid into the individual lipid classes, the rate of triglyceride synthesis was twice that of phospholipid and 15 times that of cholesteryl ester synthesis in these cells. Incubating CaCo-2 cells with cholesterol solubilized in taurocholate micelles resulted in a significant increase in ACAT activity (149 +/ 5 pmol/dish per 2 hr vs. 366 +/- 5, (P less than 0.001) without changing the rates of triglyceride or phospholipid synthesis. The stimulation of ACAT activity by micellar cholesterol was rapid, occurring within 5 min and reaching a maximal effect by 2 hr. The regulation of ACAT activity by cholesterol was directly dependent upon the concentration of cholesterol solubilized in the micelle and was independent of protein synthesis. Incubating CaCo-2 cells with micellar cholesterol did not increase the esterification of, nor did the cholesterol enter the pool of, newly synthesized or performed cholesterol within 2 hr. The micellar cholesterol that was taken up by the cells was esterified within 5 min after starting the incubation. Progesterone, a known ACAT inhibitor, significantly decreased the rate of esterification of intracellular micellar cholesterol proving that the cholesterol taken up by CaCo-2 cells was indeed entering the ACAT pool. Despite increasing amounts of unesterified cholesterol entering the cells via micelles, the percent of cholesterol that was esterified at any one time remained constant at 1%. The results suggest that ACAT activity in CaCo-2 cells is stimulated by cholesterol delivered to the cells by way of taurocholate micelles. The rapid entry of this sterol into the ACAT substrate pool suggests that ACAT activity in CaCo-2 cells is regulated by the expansion of the cholesterol substrate pool that is being utilized by an unsaturated ACAT enzyme. PMID- 3655560 TI - Acyl unsaturation and cholesteryl ester miscibility in surfaces. Formation of lecithin-cholesteryl ester complexes. AB - The surface behavior of a series of cholesteryl esters was studied in mixtures with a model phospholipid, 1-palmitoyl-2-oleoyl phosphatidylcholine. The cholesteryl esters were representative of the predominant forms occurring naturally and qualitative similarities in their phase behavior permits generalization of their surface properties. Quantitative differences, however, show that the availability of cholesteryl esters in all surface states is dependent on the structure of the acyl moiety. All except cholesteryl stearate were surface-active and formed preferred packing arrays, i.e., complexes, with the lecithin at compositions grouped around cholesteryl ester mol fractions of 0.015. Exceptions were cholesteryl arachidonate and docosahexaenoate, with complex stoichiometries of 0.034 and 0.032, respectively. Lecithin had the same apparent area in all complexes, 56.5 +/- 1.04 A2, which was larger than that of uncomplexed lecithin, 53.3 +/- 0.7 A2. This implies that the conformation or orientation of the two polyunsaturated species in complexes is markedly different than the others studied. The areas and hydrations of all uncomplexed cholesteryl esters were similar. Because mixing of complex with uncomplexed cholesteryl ester deviated positively from ideality, the apparent molecular areas of the uncomplexed cholesteryl esters ranged from 161 +/- 22 (complex-rich) to 107 +/- 15 A2 (cholesteryl ester-rich). The similarity of the monolayer phase complex stoichiometries and the bilayer miscibilities of cholesteryl oleate suggests a correspondence between states. If so, the availability of cholesteryl arachidonate or docosahexaenoate in bilayers should be approximately twice that of other naturally occurring cholesteryl esters. PMID- 3655561 TI - Human gallbladder mucin binds biliary lipids and promotes cholesterol crystal nucleation in model bile. AB - The binding of phosphatidylcholine and cholesterol in model bile to human gallbladder mucin was studied by means of a rapid filtration binding assay and sucrose density gradient ultracentrifugation. Numerous low affinity binding sites for phosphatidylcholine and cholesterol were present on gallbladder mucin. Binding of phosphatidylcholine and cholesterol to mucin increased as a function of cholesterol saturation index. Proteolytic digestion of mucin disaggregated the native mucin polymer and removed hydrophobic domains on the mucin peptide core that bind l-anilino-8-naphthalenesulfonic acid. Proteolytic digestion also resulted in a 91% and 78% decrease, respectively, in the binding of phosphatidylcholine and cholesterol to mucin. The ability of trypsin-treated and native mucin to promote the nucleation of cholesterol monohydrate crystals was compared in a model bile. The incidence of cholesterol monohydrate crystal nucleation with native mucin was significantly greater at 3 days than with trypsin-treated mucin or controls (P less than 0.001). After 3, 6, and 9 days of incubation, samples containing native mucin contained significantly more crystals than controls or trypsin-digested mucin samples (P less than 0.0001 for each). These data indicate that highly purified human gallbladder mucin binds phosphatidylcholine and cholesterol in model bile. Furthermore, this study demonstrates that structural integrity of the native mucin polymer and hydrophobic domains on the peptide core are essential for the nucleation of cholesterol monohydrate crystals by mucin in model bile. PMID- 3655562 TI - Turnover and tissue sites of degradation of glucosylated low density lipoprotein in normal and immunized rabbits. AB - Immunological mechanisms have been implicated in the atherogenic process since immunoglobulins are frequently found in the atherosclerotic aorta. We have previously shown that modifications of homologous low density lipoproteins (LDL) make it immunogenic. In particular we have demonstrated that immunization with homologous nonenzymatically glucosylated LDL (glcLDL) results in the generation of antibodies specific to the derivatized lysine residue, and that such antibodies do not react with native LDL epitopes. In the present study we immunized rabbits with reductively glucosylated rabbit LDL and then determined the effects of the circulating antibodies on the rates of plasma clearance and on the sites of degradation of LDL in which varying degrees of glucosylation had been achieved. In normal chow-fed animals, the plasma clearance of glcLDL was retarded in proportion to the extent of lysine derivatization. In contrast, in immunized animals the clearance of glcLDL was greatly accelerated. When 10% or more of lysine residues were derivatized, clearance of glcLDL was accelerated 50- to 100-fold. Even when only 5% of lysines were derivatized, plasma clearance was accelerated 2- to 3-fold. Cholesterol feeding inhibited LDL clearance from plasma and decreased LDL uptake of LDL receptor-rich tissues. In a similar manner, glucosylation of LDL inhibited its ability to bind to the LDL receptor and redirected sites of LDL degradation away from LDL receptor-rich tissues. Thus degradation of glcLDL by liver and adrenal was markedly diminished. The presence of antibodies to glcLDL also redirected sites of degradation of the modified LDL, primarily to the reticuloendothelial cells of the liver. There was no evidence for specific targeting of glcLDL-immunoglobulin complexes to the aorta; instead they were targeted to the liver. These data suggest that the presence of humoral antibodies to modified LDL acts to rapidly remove such LDL from plasma and specifically targets such complexes to reticuloendothelial cells, primarily in the liver. In this manner such antibodies may serve a useful purpose. PMID- 3655563 TI - Comparison of analytical methods for monitoring autoxidation profiles of authentic lipids. AB - Oxidation profiles of polyunsaturated fatty acids, their esters, and fatty alcohols were compared by several commonly employed analytical procedures. The extent of lipid peroxidation varied with the structure of the specific lipid class. The rate of oxidation was greater for polyenoic lipids than for dienoic counterparts. In general, the maximum diene conjugation and thiobarbituric acid reactivity occurred earlier for acids than for esters or alcohols containing identical numbers of carbon chains and double bonds. For each homologous series there were, initially, increasing levels of conjugated dienes and thiobarbituric acid-reactive products, which then diminished in association with rising levels of carbonyl and fluorescent products. At late stages of oxidation, conjugated diene or thiobarbituric acid reactivity was not indicative of total peroxidation products. Thus, supplementary measurements are required to detect secondary degradation products of polyunsaturated fatty acids. PMID- 3655564 TI - Separation and isolation of human apolipoproteins C-II, C-III0, C-III1, and C III2 by chromatofocusing on the Fast Protein Liquid Chromatography system. AB - Chromatofocusing, which separates proteins based on differences in isoelectric point, has been used on the Fast Protein Liquid Chromatography (FPLC) system (Pharmacia) to separate the C apolipoproteins from human very low density lipoproteins (VLDL). Using a Mono P column (Pharmacia), a pH gradient between pH 6.2 and pH 4.0 was generated using buffers containing 6 M urea, at a flow rate of 0.5 ml/min. Typically, runs took approximately 45 min. Chromatofocusing of delipidated whole VLDL produced sharp, well-resolved peaks for the C apolipoproteins. However, as determined by analytical isoelectric focusing (IEF), the apolipoprotein E isoforms were not separated from apoC-II, and they contaminated the other apoC species to a variable extent. In addition, apoC-II was not resolved from apoC-III0. Preliminary precipitation of VLDL with acetone prior to delipidation removed both apolipoproteins E and B. Using a start buffer of 25 mM histidine, pH 6.2, and a 1:30 dilution of the polybuffer exchanger (eluting buffer), apoC-II, C-III0, C-III1, and C-III2 were well resolved in run times of approximately 60 min. The C apoproteins proved to be pure by analytical IEF and immunoassay with monospecific antisera against apoC-II and C-III. Recovery was over 90% of the protein chromatographed. In addition, a variant of apoC-II present in VLDL of a hypertriglyceridemic subject was clearly resolved from the other C apolipoproteins. This technique is superior to conventional methodology in terms of its time saving and high resolution. The application of this technique to the study of C apolipoprotein variants and C apolipoprotein specific radioactivity determinations is possible. PMID- 3655565 TI - Inter- and intra-examiner reliability of the upper cervical X-ray marking system: a second look. AB - To determine the degree of reliability (stability over time) for six Pettibon practitioners, the scores resulting from the reading and re-reading of 30 X rays were analyzed using bivariate scattergrams, Pearson Product-moment correlation coefficient estimates and correlated samples t tests. To examine reliability (equivalence over experts) across the practitioners, a repeated measures analysis of variance approach was used. Liberal and conservative reliability coefficients for the upper angle and lower angle were computed. Examination of the data suggest that the reliability (stability over time) for the practitioners is very good. The data on reliability (equivalence over experts) across the practitioners also suggests reliability is very good. PMID- 3655566 TI - Inter- and intra-examiner reliability of palpation for sacroiliac joint dysfunction. AB - The purpose of this study was to operationally define and evaluate inter- and intra-examiner reliability of the standing sacroiliac mobility (Gillet) test on 53 college students. Both inter- and intra-examiner reliability data showed high mean percentages of agreement (85.3% and 89.2%, respectively.) Cohen's unweighted kappa statistic for concordance was applied yielding "fair" concordance for aggregate intra-examiner data and "slight" concordance for aggregate inter examiner data. The intra-examiner reliability data suggests that the Gillet test is clinically useful for a single examiner in assessing the sacroiliac joint for mobility dysfunction, especially at upper sacroiliac contact points. Linear regression analyses suggest that the test is sensitive, in that reliability improves with increasing perceived abnormality. Further revisions to the operational definition may improve both inter- and intra-examiner reliability of the Gillet test. PMID- 3655567 TI - Traumatic radial head subluxation in young children: a case report and literature review. AB - Traumatic radial head subluxation in young children is reviewed. This minor condition commonly results from a sudden longitudinal traumatic pull on pronated and extended forearm and appears to be infrequently recognized or diagnosed. Differential diagnosis of traumatic radial head subluxation from traumatic radial head dislocation, congenital radial head dislocation, brachial plexus palsy and "invisible" elbow fractures are discussed. It is postulated here that there are two types of traumatic rotary radial head subluxation in pronation, the simple type and the lateral type. Careful analysis of anteroposterior view of elbow reveals the change of the shape and position of the radial tuberosity indicating the simple type, or concommitant with lateral displacement of the radial head on the ulna indicating the lateral type. The lateral type and its reposition are demonstrated when premanipulative roentgenograms are compared with postmanipulative roentgenograms in one of the eight illustrative cases. Details of the supination manipulative reduction are described and demonstrated. PMID- 3655568 TI - Portrait of the healer as an artist. PMID- 3655569 TI - Peer review in the JMPT. PMID- 3655570 TI - A critical study of the student interns' practice activities in a chiropractic college teaching clinic. PMID- 3655571 TI - Analysis of the joint crack by simultaneous recording of sound and tension. PMID- 3655572 TI - The future role of the chiropractor in the health care system. PMID- 3655573 TI - American Hospital Association recommendations on AIDS management. PMID- 3655574 TI - Overview of a hospital. PMID- 3655575 TI - Hospital-physician relations: are we headed for a divorce? PMID- 3655576 TI - The year 2000: a look into the future of hospitals and medical staffs. PMID- 3655577 TI - The challenge of a new financial perspective. How it affects the hospital/physician relationship. PMID- 3655578 TI - The Georgia Hospital Association. What it is, what it does. PMID- 3655579 TI - PRO Georgia 1987. PMID- 3655580 TI - Reflections of tomorrow or the night of the cactus by Doctor Charlie and Ray. PMID- 3655581 TI - The PRO wants you! PMID- 3655582 TI - Incidence of melanoma. PMID- 3655583 TI - Plague situation in Thailand (1985). PMID- 3655584 TI - The weight of Thai infants exclusively breast-fed and formula-fed from birth to four months. PMID- 3655585 TI - Heating of amniotic fluid: a technique for detection of rupture membranes. PMID- 3655586 TI - Evaluation of halothane effect on blood coagulation and bleeding time: a study of 129 cases with elective operations. PMID- 3655587 TI - Oxidative stress and antioxidants in beta-thalassaemia/haemoglobin E. PMID- 3655588 TI - Serum vitamin E in Thai cancer patients. PMID- 3655589 TI - A large inflammatory pseudotumor of colon simulating carcinoma: a case report. PMID- 3655590 TI - Electrophysiologic properties differ in the ventricular endocardium and epicardium of the Japanese monkey. AB - We measured action potential duration (APD) from the endocardium (Endo) and epicardium (Epi) of the left ventricular free wall in Japanese monkey hearts and found that the APD of Endo is significantly longer than that of Epi at a stimulus cycle length of 1500 msec in normal Tyrode solution (control condition). We then hypothesized that shorter APD of Epi results from greater outward pump current and that the difference in the current may be due to a difference in membrane Na,K-ATPase activity between Endo and Epi. If this were the case, interventions which alter the Na,K-pump activity should alter electrophysiologic characteristics in the endocardium and the epicardium to different degrees. An application of ouabain (10(-6) M), an inhibitor of Na,K-ATPase, produced greater shortening of APD and greater depolarization of the resting potential in Endo as compared with Epi. Shortening of stimulus cycle length shortened the APD more markedly in Endo than Epi, resulting in a significantly longer APD in Epi than Endo at a stimulus cycle length of 200 msec. The hyperpolarization and the APD shortening produced when the tissues were returned to 5.4 mM K+ Tyrode solution from K+-free medium were also more marked in Endo than in Epi. Such findings suggest that endocardial cells are more liable to accumulate Na ions intracellularly and K ions extracellularly when the Na, K-pump is suppressed by ouabain or K+-free perfusion, presumably due to lower activity of Na, K-ATPase in Endo compared to Epi.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655591 TI - Body surface maps and the conventional 12-lead ECG compared by studying their performances in classification of old myocardial infarction. AB - The performance of body surface potential maps and the 12-lead ECG in the detection of old myocardial infarction has been compared in a two-group (54 normals; 52 infarctions) classification procedure (linear discriminant analysis). Three methods for data reduction of body surface maps were compared: 1) time integration, 2) one-step reduction in eigenvectors and 3) two-step reduction in spatial and temporal eigenvectors. Features were taken from the reduction variables by a stepwise selection procedure. From 90% to 93% correct classifications could be obtained using three features from the map data over the initial 30 ms (Q interval) of the QRS wave for all three methods considered. Using the 100 ms (QRS) interval 86% correct classifications were obtained using method 1, and up to 90% and 87% for methods 2 and 3, respectively. In a further analysis the classification based on body surface maps was compared to the one based on the 12-lead ECG. The 12-lead ECG was treated as a restricted set of the body surface mapping leads, so the same methods of data reduction, feature extraction and classification could be applied to both sets of data. Applying method 1 (time integration) 89% correct classifications were obtained using data taken from the 30 ms interval of the 12-lead ECG and a subsequent reduction to three features. When using the 100 ms interval the result was 79% also using three features. The results of method 2 applied to the 12-lead ECG were 89% (30 ms interval, three features) and 78% (100 ms interval, three features). PMID- 3655592 TI - Myocardial infarction size and location: a comparative study of epicardial isopotential mapping, thallium-201 scintigraphy, electrocardiography and vectorcardiography. AB - Based on epicardial isopotential mapping (the Ep Map), which was calculated from body surface isopotential mapping (the Body Map) with Yamashita's method, using the finite element technique, we predicted the location and size of the abnormal depolarized area (the infarcted area) in 19 clinical cases of anterior and 18 cases of inferoposterior infarction. The prediction was done using Toyama's diagnostic method, previously reported. The accuracy of the prediction by the Ep Map was assessed by comparing it with findings from thallium-201 scintigraphy (SCG), electrocardiography (ECG) and vectorcardiography (VCG). In all cases of anterior infarction, the location of the abnormal depolarized areas determined on the Ep Map, which was localized at the anterior wall along the anterior intraventricular septum, agreed with the location of the abnormal findings obtained by SCG, ECG and VCG. For all inferoposterior infarction cases, the abnormal depolarized areas were localized at the posterior wall and the location also coincided with that of the abnormal findings obtained by SCG, ECG and VCG. Furthermore, we ranked and ordered the size of the abnormal depolarized areas, which were predicted by the Ep Map for both anterior and inferoposterior infarction cases. In the cases of anterior infarction, the order of the size of the abnormal depolarized area by the Ep Map was correlated to the size of the abnormal findings by SCG, as well as to the results from Selvester's QRS scoring system in ECG and to the angle of the maximum QRS vector in the horizontal plane in VCG.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655593 TI - Temporal changes in body surface peak R isochrone maps and left ventricular function in patients with myocardial infarction. AB - Body surface peak R isochrone mapping and radionuclide ventriculography were performed twice in 22 patients with myocardial infarction. Eighty-seven unipolar electrocardiograms distributed over the anterior chest and the back were recorded simultaneously. For each lead, the time from the onset of QRS to the peak of the R wave was measured. From this data for 87 leads an isochrone map was constructed. The lead points where R waves were not observed were designated the no R-wave area (No-R area), which was postulated to correspond to the unexcited regional myocardium. Other abnormal findings, i.e., delay of peak R time near the No-R area (peri-No-R area delay), crowding of isochrone lines, and an island-like zone of delayed peak R times were postulated to indicate slow conduction in the partially excited regional myocardium. In three patients, abnormal patterns in the peak R isochrone maps during the acute phase (within a month from the onset of myocardial infarction) improved in the chronic phase with a significant increase in left ventricular ejection fraction. In two patients, the No-R area decreased after the left ventricular aneurysmectomy. In other patients, abnormal patterns of the isochrone maps and the ejection fraction remained unchanged during the chronic phase of myocardial infarction. We conclude that the comparison of peak R isochrone map patterns between the acute and chronic phase may be useful in evaluating the balance of reversible and irreversible regional damage in myocardial infarction. PMID- 3655594 TI - Prominent anterior QRS forces: clinical, electrocardiographic and prospective study. AB - Recent data suggest that the prominent anterior QRS forces (R greater than or equal to S in V1 and/or V2 leads), in the absence of posterior myocardial infarction, right ventricular hypertrophy, or WPW syndrome, are related to an intraventricular conduction disturbance, at times rate-dependent. We followed 240 subjects with prominent anterior QRS forces and without the above mentioned diseases (study group), (mean age: 44.6 +/- 16 years, mean follow-up: 8 +/- 2 years) and 240 subjects without the anterior displacement (control group), (mean age: 44.4 +/- 14 years, mean follow-up: 7.9 +/- 1.9 years). The age distribution, sex, prevalence of organic heart disease, and follow-up period did not show significant differences between the two groups. QRS duration, prevalence of left ventricular hypertrophy pattern, S1 S2 S3 morphology, terminal r wave in AVR and s wave in V6 were similar in the two groups. During the follow-up period the incidence of right and left bundle branch block and fascicular block was very similar in the two groups of patients. These data suggest that prominent anterior QRS forces do not appear to be related to an initial involvement of the main bundle branches and fascicles and do not increase the likelihood of appearance of an intraventricular block of more advanced degree. The clinical, ECG and prospective data are not helpful in localizing either the ventricle or the area of the ventricle affected by conduction disturbance responsible for the anterior displacement. Our data suggest that the prominent anterior QRS forces express a normal variant of ventricular depolarization and that this finding does not have, per se, any unfavourable clinical implication. PMID- 3655595 TI - Lack of superiority of the vectorcardiogram over the electrocardiogram in detecting inferior wall myocardial infarction regardless of time since infarction. AB - Using more recent VCG and ECG criteria, the relative accuracy of these two tests in detecting inferior wall MI over time was evaluated in 38 of 236 patients undergoing elective left ventriculographic and coronary angiographic studies who had clinical plus angiographic evidence of inferior wall myocardial infarction. The overall sensitivity and specificity of the ECG criteria of the New York Heart Association and Warner did not differ from that of the VCG criteria of Starr and Takatsu. There was a trend toward decreased sensitivity in both VCG criteria and the ECG criterion of Warner in detecting inferior wall myocardial infarction greater than or equal to 18 months, although the difference did not reach statistical significance. Changing the age of infarction to greater than or equal to 3, greater than or equal to 6, greater than or equal to 12, or greater than or equal to 24 months did not yield a different result. It is concluded that VCG is not superior to ECG in the diagnosis of inferior wall MI regardless of time since occurrence of infarction. PMID- 3655596 TI - Real-time analysis ambulatory electrocardiography--clinical evaluation of cardiac arrhythmias by the Aegis system. AB - To evaluate the technical reliability, clinical applicability, and arrhythmia accuracy of one manufacturer's real-time analysis ambulatory ECG instrument (Aegis Medical Systems), 164 patients were simultaneously examined through a "Y" cable by both a real-time analyzer and a conventional Holter recorder. Technical failure was similar for both recorders (2% in each), and the real-time analyzer was applicable to all patients encountered. Using a randomly selected hand counted database of 799 hours as the standard of truth, accuracy of the real-time analyzer for hourly mean heart rate, isolated ventricular ectopic beats, ventricular couplets, ventricular tachycardia, isolated supraventricular ectopic beats and supraventricular tachycardia was determined. Mean heart rate showed 96% agreement and a high correlation (r = .986) to hand-counted values. Real-time analysis overall sensitivity, positive predictive accuracy, and false positive rate for the Aegis Medical System were (a) for isolated ventricular ectopic beats -92%, 92%, and 8%, (b) for ventricular couplets--80%, 97%, and 3%, (c) ventricular tachycardia--81%, 92%, and 8%, (d) supraventricular ectopic beats- 81%, 82%, and 18%, and (e) for supraventricular tachycardia--75%, 89%, and 11%. Arrhythmia analysis was valid for mean heart rate and ventricular arrhythmias, but showed lower sensitivities in detection of low prevalence (1-60 b/Hr) ventricular couplets (72%) and ventricular tachycardia (43%). Significant inaccuracies for some densities of supraventricular arrhythmia were also found. This study found the real-time analysis ambulatory ECG similar to conventional Holter recording for technical reliability and patient applicability. Given the limitations of currently available real-time analysis ambulatory ECG systems, it is a promising technology. PMID- 3655597 TI - Ventricular fibrillation during coronary angiography: the precatheterization QT interval. AB - Ventricular fibrillation during coronary angiography is associated with contrast induced changes in repolarization and thus pre-catheterization abnormalities could predispose to this event. We retrospectively examined angiograms, pre catheterization electrocardiograms and records of 26 consecutive patients who had ventricular fibrillation during coronary angiography, and compared these patients to controls matched for age, sex, and left ventricular function. Diatrizoate meglumine was used as the angiographic contrast agent in all instances. Catheterization findings and the prevalence of prior myocardial infarction were similar in both groups. However, pre-catheterization QT intervals in the ventricular fibrillation group (0.43 +/- 0.05 sec) were significantly longer than in control patients (0.39 +/- 0.04 sec, P less than 0.005) as were their QT intervals corrected for heart rate (QTc) (0.47 +/- 0.04 vs 0.42 +/- 0.03 sec; P less than 0.001). Only seven of the 16 patients (44%) with ventricular fibrillation who had a precatheterization QTc greater than 0.44 sec had the arrhythmia during angiography of a critically stenosed (greater than 75%) coronary artery, whereas VF followed injection of critically stenosed vessels in eight of 10 (80%) of those with a normal QTc (p NS). After a follow-up period of 24 to 54 months (mean 39), two ventricular fibrillation patients have died (one suddenly), as compared to five in the control group (two suddenly) (p NS). Therefore, pre-catheterization QT prolongation was associated with ventricular fibrillation during coronary angiography, but ventricular fibrillation did not necessarily portend a worse long-term prognosis. PMID- 3655598 TI - R-wave amplitude changes during exercise stress testing: patients with dilative cardiomyopathy compared to patients with coronary artery disease. AB - R-wave amplitude (RWA) depends to a large extent on the left ventricular filling volume. Changes of RWA are attributed to the Brody-effect. Exercise has been shown to induce a decrease of RWA in a healthy population and an increase in patients with coronary artery disease (CAD). No clear data exist for cardiomyopathy (CMP). Controls (n = 12), patients with CMP (n = 32) and CAD (n = 58) were compared. Alterations of RWA (Wilson lead V5) were correlated with parameters of a bicycle exercise test including resting and exercise hemodynamics and parameters of LV-function including EF, LVEDV and LVEDP. CMP compared to CAD had smaller RWA at rest (0.78 +/- 0.47 vs 1.32 +/- 0.72 mV, P less than 0.01). During comparable levels of exercise CMP (EF 35 +/- 14%) showed no significant changes of RWA. CAD (EF 57 +/- 16%) presented an increase of RWA by +0.11 +/- 0.23 mV (P less than 0.01), while controls showed a straight decline of RWA ( 0.31 +/- 0.24 mV). In patients with CAD delta RWA (RWA max exercise - RWA rest) was a more sensitive parameter for detection of disease (assuming delta RWA greater than or equal to +0.1 mV, 36/58 patients) than maximal ST-segment changes (ST-segment-depression in lead V5 greater than or equal to 0.2 mV at 0.08 sec after J-point, 22/58 patients). Precordial leads V2, V4, V5 and V6 showed similar changes. This paper supports the theory that changes of wall thickness or changes in the amount of air respective to the amount of fluid in the lungs are responsible for RWA changes. These changes are clearly dependent on the severity of the disease and on left ventricular function. Therefore measurement of RWA changes during exercise may offer additional information in patients with CAD as well as in patients with CMP. PMID- 3655599 TI - Atrioventricular Wenckebach periodicity in athletes: influence of increased vagal tone on the occurrence of atypical periods. AB - In 37 athletes with atrioventricular (AV) Wenckebach periodicity, the relationship between PP and RR intervals was investigated. In most athletes, when PP intervals gradually lengthened, RR as well as PR intervals usually also gradually lengthened until a blocked P wave occurred, resulting in the occurrence of an atypical Wenckebach period with prolongation of the last RR interval (variant I). In 20 athletes, sudden marked prolongation of a PR interval occasionally occurred, which was usually followed by a blocked P wave (variant II). In five athletes, once sudden marked prolongation of a PR interval occurred, markedly long PR intervals were maintained for some time, and then a PR interval suddenly shortened without a blocked P wave (variant III). It appeared that the above findings were caused by spontaneous variations in vagal tone. It was suggested that longitudinal dissociation and concealed reentry in the AV node occurred in atypical Wenckebach periods of variants II and III, but not in the other periods. PMID- 3655600 TI - Barium-induced LH release from chicken pituitary cells: synergism with phorbol ester. AB - Barium is known to elicit secretion in a number of cell systems. The mechanism of Ba2+ stimulation of LH release in cultured chicken pituitary cells was investigated in the present study. Barium-stimulated LH release was inhibited by extracellular Ca2+, indicating that Ba2+ does not act by stimulating Ca2+ entry. Simultaneous stimulation of the cells with Ba2+ and phorbol ester produced a synergistic response, similar to the synergism obtained with phorbol ester and treatments which increase cytosolic Ca2+. Both Ba2+-stimulated LH release and the synergism of Ba2+ with phorbol ester were inhibited by calcium channel blockers (Co2+, methoxyverapamil and nifedipine) and by calmodulin antagonists (trifluoperazine and chlorpromazine). These results indicate that the actions of Ba2+ are dependent on its entry through Ca2+ channels, and suggest that calmodulin activation is necessary for the synergism between Ba2+ and phorbol ester. Thus, synergism does not result from a direct effect of divalent cations on C-kinase. PMID- 3655602 TI - Change of mosaic pattern by androgens during prostatic bud formation in XTfm/X+ heterozygous female mice. AB - The testicular feminization (Tfm) gene, which is characterized by a deficiency in androgen receptors, is located on the X-chromosome. Using steroid autoradiography, the mosaicism of the Tfm gene has been demonstrated in the androgen target tissues of XTfm/X+ heterozygous female mouse fetuses and the effects of androgens on the mosaic pattern analysed. In the mesenchyme of urogenital sinuses of wild-type female fetuses (X+/X+), more than 95% of the cells were androgen-receptor positive (labelled with [3H]testosterone) while in that of heterozygous fetuses (XTfm/X+), only half of the cells were receptor positive (Tfm gene inactive), and receptor-positive cells and -negative cells formed small irregular patches. When the heterozygous sinuses were cultured in vitro in the presence of androgens, the sinuses underwent male sexual development and formed epithelial buds (prostate gland rudiments) projecting into the surrounding mesenchyme. Autoradiographic analysis revealed that the mosaicism of the mesenchyme disappeared around the developing epithelial buds: almost all the mesenchymal cells in close vicinity to the buds were receptor positive while in the outer layers receptor-positive and -negative cells coexisted. The proportion of receptor-positive cells was greatly increased in the mesenchyme beneath the non-budding area of the sinus epithelium. This androgen-induced increase was observed before the onset of bud formation. The results obtained in the thymidine incorporation experiments suggest that the increase of receptor-positive cells beneath the sinus epithelium might be explained by the migratory behaviour of the androgen-incorporating cells rather than by their selective proliferation. PMID- 3655601 TI - Visualization of X-chromosome inactivation mosaicism of Tfm gene in XTfm/X+ heterozygous female mice. AB - The testicular feminization (Tfm) locus, which produces a deficiency in androgen receptors, is located on the X-chromosome. Steroid autoradiographic techniques were used to demonstrate the mosaicism of the X-chromosome inactivation in two androgen target tissues of XTfm/X+ heterozygous female mice. In the mesenchyme of urogenital sinuses of wild-type female fetuses (X+/X+), more than 95% of the cells were androgen-receptor positive (labelled with [3H]testosterone) while in that of heterozygous fetuses (XTfm/X+), about half of the cells were receptor positive (Tfm gene inactive). Statistical analysis of coherent clone size was applied to the heterozygous mesenchyme of the urogenital sinus and the coherent clone size of receptor-positive cells was estimated to be two or three cells per clone. This small clone size suggests that considerable cell mixing occurred in the tissue during embryonic development. Androgen binding in the mammary gland rudiments was restricted to the mesenchymal cells only in close vicinity to the epithelial mammary bud. In the wild-type rudiments most of the mesenchymal cells beneath the epithelium were receptor positive, while in heterozygous rudiments, receptor-positive and -negative cells intermingled. This observation suggests that in the wild-type mammary gland rudiments the epithelial bud may induce the formation of androgen receptors in adjacent mesenchymal cells rather than attract pre-existing receptor-rich mesenchymal cells. PMID- 3655603 TI - Effect of prolactin, progesterone, pregnancy and lactation on DNA synthesis and DNA polymerase activities in rabbit mammary gland. AB - DNA synthesis and DNA polymerase-alpha, -beta and -gamma activities in the rabbit mammary gland were studied during hormone-directed cellular growth. It was found that during pregnancy, early lactation and after injection of prolactin, changes in the activity of DNA polymerase-alpha paralleled the rate of mammary gland DNA synthesis. It was also found that the amount of polymerase-alpha activity bound to isolated chromatin depended on the physiological state of the animal. During pregnancy and early lactation changes in the activity of chromatin-bound enzyme correlated directly with the rate of DNA synthesis (r = 0.83). Moreover, in virgin rabbits treated with prolactin the activity of chromatin-bound DNA polymerase-alpha increased markedly at the same time as the DNA-synthetic rate increased. No correlation of the DNA-synthetic rate was found with the activity of soluble (cytosolic) DNA polymerase-alpha or with the activity of soluble or chromatin-bound DNA polymerases-beta and -gamma. On the basis of these results it is suggested that in the developing mammary gland both the activity and cellular distribution of DNA polymerase-alpha might be subject to hormonal regulation. PMID- 3655604 TI - Effects of injecting growth hormone or thyroxine on milk production and blood plasma concentrations of insulin-like growth factors I and II in dairy cows. AB - Three cows received injections of thyroxine (T4; 20 mg/day), four cows GH (40 mg/day) and three cows saline (control; 10 ml/day) on days 5-8 of a 16-day experimental period during peak lactation. Milk yield increased 13% in cows given GH (from 14.6 to 16.5 kg/day) and 15% in cows given T4 (from 15.8 to 18.2 kg/day) but did not change in control cows. Injection of T4 increased milkfat and lactose content but reduced milk protein content. Injection of GH was without effect on milk composition during the injection period but milk protein rose after injections ceased. Injection of T4 increased plasma concentrations of T4 and tri iodothyronine six- to sevenfold, with maxima occurring on day 9. Injection of GH increased the plasma concentration of GH five- to tenfold 5 h after injection. The plasma concentration of insulin-like growth factor I (IGF-I) was increased in cows given GH in both morning (08.30 h) and afternoon (14.30 h) blood samples, the difference being greatest in afternoon samples in which plasma IGF-I content increased from 3.3 to 6.8 nmol/l. Injection of T4 reduced the plasma concentration of IGF-I in morning samples but the concentration in afternoon samples remained relatively constant throughout the 16-day experimental period. The plasma concentration of IGF-II rose in morning samples in all treatment groups to reach a maximum of 200-250 nmol/l by day 9. The galactopoietic response to injection of GH but not T4 was associated with an increase in plasma concentration of IGF-I. Changes in plasma concentration of IGF-II were not associated with changes in milk yield. PMID- 3655605 TI - Noradrenergic stimulation of serotonin release from rat pineal glands in vitro. AB - The pharmacodynamics of serotonin (5-hydroxytryptamine; 5-HT) uptake and release were studied in rat pineal glands. Initially, uptake was tested by incubating pineals with several concentrations of [3H]5-HT. The incubation media also contained [14C]mannitol to which cells are impermeable. Since [14C]mannitol accumulates only in extracellular spaces, the radio-labelled sugar was used to determine the differential distribution of [3H]5-HT in pineal compartments. Intracellular accumulation of 3H in pineal glands increased linearly as a function of time for [3H]5-HT concentrations ranging from 1 to 10 mumol/l. The ratio of 3H to 14C also increased for the same time-interval, indicating that the glands accumulated [3H]5-HT preferentially in non-extracellular spaces. [3H]5-HT accumulated in pineal glands which were denervated for more than 7 days before testing, suggesting that uptake is not restricted to adrenergic terminals but also occurs in pinealocytes. In addition to uptake, spontaneous and noradrenaline stimulated release of [3H]5-HT was tested in perifusion and/or step-transfer systems. Spontaneous release of [3H]5-HT was biphasic consisting of rapid and slower efflux phases. In contrast, release of [14C]mannitol was monophasic, characterized exclusively by rapid efflux. Since [14C]mannitol does not enter cells, the rapid and slower phases of [3H]5-HT efflux may represent release from pineal extracellular and intracellular compartments respectively. The identity of [3H]5-HT in pineal glands and perifusion media was confirmed by thin-layer chromatography. When L-noradrenaline was added to the perifusion media, [3H]5-HT efflux during the slower phase of release was significantly increased above the non-stimulated state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655606 TI - Diurnal variations in plasma concentrations of cortisol, prolactin, growth hormone and glucose in the fetal sheep and pregnant ewe during late gestation. AB - We have measured fetal and maternal plasma concentrations of cortisol, prolactin, GH and glucose in samples collected during a 24-h period in 14 animals between 127 and 142 days of gestation. There was a significant increase in both the mean daily plasma cortisol concentration and mean daily coefficient of variation (C.V.) of plasma cortisol concentrations after 135 days of gestation. There was also a significant variation in the fetal plasma cortisol concentrations with a peak occurring at 19.00 h. There was a significant sinusoidal diurnal rhythm in the plasma prolactin concentrations in both the fetal sheep and pregnant ewe and the maximal prolactin concentrations occurred between 19.00 and 23.00 h (fetal) and 21.00 and 01.00 h (maternal). Although no significant diurnal variation was detected in fetal plasma GH concentrations, there was a significant sinusoidal diurnal rhythm in the plasma GH concentrations of the pregnant ewe and the maximal maternal GH concentrations occurred between 21.00 and 01.00 h. Both the fetal and maternal plasma glucose concentrations showed a significant sinusoidal diurnal rhythm. The maximal maternal and fetal glucose concentrations were measured between 21.00 and 01.00 h and between 23.00 and 03.00 h respectively. We have therefore established that diurnal variations in plasma cortisol and prolactin concentrations exist prenatally. Whether the presence of such hormonal rhythms reflects the activity of an endogenous fetal circadian pacemaker remains to be established. PMID- 3655607 TI - Immunization against an inhibin subunit produced by recombinant DNA techniques results in increased ovulation rate in sheep. AB - Seven Merino-Border Leicester cross-bred ewes were immunized with a purified fusion protein, produced by recombinant DNA methods, of the alpha subunit of bovine inhibin. Four animals were immunized with the fusion protein alone and three with a conjugate made by coupling the fusion protein to keyhole limpet haemocyanin (KLH) using glutaraldehyde. Each animal received four injections of the fusion protein over 93 days. The animals were synchronized using progestagen sponges and subjected to laparoscopy for the determination of ovulation rates in two consecutive cycles (days 115 and 135). The immunized animals had overall mean ovulation rates for each cycle of 3.4 and 3.4 which was significantly (P less than 0.001) above the rates of 1.1 and 1.4 determined for the controls, which had either received no treatment (n = 5) or had been immunized with 300 micrograms KLH (n = 4). Analysis of antisera taken on day 115 showed significant fusion protein antibodies and iodinated inhibin-binding capacity in the test but not control groups. Furthermore, antisera to the fusion protein in four out of seven ewes neutralized the inhibin bioactivity of ovine follicular fluid in an in-vitro bioassay. These data demonstrate that neutralization of inhibin can be effected by immunization with bovine inhibin alpha subunit and that such immunization results in increased ovulation rates as predicted from the biological role of inhibin as a suppressor of FSH. PMID- 3655608 TI - Improvements in the determination of the turnover rate of plasma thyroxine in avian species: application to the Japanese quail. AB - The disappearance of the thyroid hormone thyroxine (T4) from plasma in fully grown male Japanese quail can be described as a first order process with a rate constant of 0.178 +/- 0.013/h (mean +/- S.E.M., n = 8), which represents a half life of 3.90 h. A small amount of [125I]T4 in relation to total circulating T4 was injected i.v. into Japanese quail and plasma samples were taken at appropriate time-intervals for the determination of residual plasma radioactivity. The rate of disappearance of [125I]T4 was subsequently equated to the turnover rate of the endogenous hormone. Previous methods were modified to overcome problems arising from possible disturbance of plasma T4 metabolism, recirculation of radiolabelled iodide, and to purify the [125I]T4 from the plasma samples. By using labelled T4 of very high specific activity, the amount of [125I]T4 administered was kept much smaller than has been used in previous studies on Japanese quail, thus limiting any interference with plasma T4 dynamics. To minimize any disturbance of plasma T4 metabolism, only four blood samples were taken, at three-hourly intervals after the injection of [125I]T4. The rapid turnover of T4 produced a large amount of labelled inorganic iodide, the re-entry of which into the plasma T4 pool was inhibited by s.c. administration of sodium thiocyanate 1 h before injection of [125I]T4. Assay of the true [125I]T4 turnover was significantly improved over that used in previous studies by purifying the [125I]T4 from the plasma samples chromatographically. The samples were applied to small Sephadex G-25 columns with sodium hydroxide (0.1 mol/l) as the eluant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655609 TI - Release of big and small molecular forms of prolactin: dependence upon dynamic state of the lactotroph. AB - Secretion of different molecular forms of prolactin was studied from a multidisciplinary standpoint in three different experimental rat models which covered the broadest range of lactotrophic activity. The results obtained allowed the recognition of common secretory patterns in stimulated, inhibited and hyperstimulated lactotrophic activity. Polymeric (big) prolactin is stored exclusively in membrane-bound secretory granules and appears to be a convenient biochemical marker with which to quantify the pool of hormone stored in the cell cytoplasm, while monomeric (small) prolactin represents a pool of newly synthesized hormone which is loosely coupled to organelles involved in its intracellular processing. Most of the prolactin in stimulated lactotrophs is processed through a regulated pathway and the hormone released by exocytosis of secretory granules. Interruption of stimulation resulted in accumulation of secretory granules and polymeric prolactin. In hyperstimulated lactotrophs the polymerization and aggregation of prolactin into secretory granules was bypassed and most of the hormone released directly after its synthesis. The pattern of prolactin secretion could be closely correlated with the dynamic state of the lactotroph. PMID- 3655610 TI - Effect of asymmetrical reductions of photoperiod on pineal melatonin, locomotor activity and gonadal condition of male Syrian hamsters. AB - This study investigated the relationship of two overt circadian rhythms, locomotor activity and melatonin synthesis in the pineal gland, by comparing their responses to asymmetrical reductions in photoperiod. Transfer of male Syrian hamsters from long to short daylengths led to an increase in the duration of both locomotor activity and the period of melatonin synthesis. Over the course of re-entrainment, the two rhythms were held in a stable phase relationship, and the direction of the switch did not influence the rate of decompression or the final phase relationships established after 8 weeks in short daylengths. Decompression of the activity rhythm was not influenced by pinealectomy. Exposure to short photoperiods caused gonadal regression and a consequent decline in serum testosterone levels from 10 to less than 1 nmol/l. The direction of the photoperiodic switch did not affect the time-course of gonadal regression. These data demonstrate the important influence of photoperiod upon the duration of the nocturnal peak of melatonin production by the pineal and also demonstrate that this effect is one example of a more widespread response of the circadian system. A qualitatively similar signal controls both locomotor activity and melatonin synthesis, although the neural basis of this common mechanism is unclear. PMID- 3655611 TI - Effects of chronic infusion of porcine relaxin on oxytocin release in lactating rats. AB - The effects of chronic infusion of porcine relaxin on oxytocin release were studied in lactating rats. Infusion of relaxin (4.2 micrograms/h for either 4 or 6 days) suppressed reflex milk ejection and reduced litter weight gain for 48 h compared with saline-infused controls. After 2 days, neither the rate of growth nor the frequency of milk ejection were significantly different from controls. For 24 h after the infusion of relaxin ended, litters gained weight more quickly than controls but there was no difference seen in the frequency of milk ejection. The effects on oxytocin release of stopping an infusion of relaxin after 3 days were investigated. There was a significant (P less than 0.01) rise in plasma oxytocin (up to 90 pmol/l) 30 min after the infusion was stopped, followed by a sustained rise in intramammary pressure. Treatment of relaxin-infused rats with naloxone (0.1 mg/kg) when the infusion was halted caused a more rapid release of oxytocin (within 2 min), a greater release of oxytocin (up to 140 pmol/l) and a prolonged rise in intramammary pressure. PMID- 3655612 TI - Stress-induced disruption of parturition in the rat may be mediated by endogenous opioids. AB - Plasma samples were obtained before and during parturition from conscious rats implanted chronically with a jugular cannula. Rats were either allowed to remain in their nesting cage throughout parturition, or were moved immediately following the birth of the second or third pup into an empty glass chamber. The time-course of parturition was prolonged for mother rats which were moved in mid-parturition to this unfamiliar environment. However, in rats given an i.v. injection of the opioid antagonist naloxone at the time of transfer, parturition followed a normal time-course, and plasma oxytocin levels were significantly higher than in animals injected with saline. Thus our hypothesis is that stress activates opioid pathways which delay parturition by inhibiting oxytocin release. Opioid-mediated mechanisms may similarly be responsible for some problems in human parturition. PMID- 3655613 TI - Control of magnocellular oxytocin neurones by the region anterior and ventral to the third ventricle (AV3V region) in rats. AB - The involvement of the region anterior and ventral to the third ventricle (AV3V region) in the control of oxytocin release was investigated using electrical stimulation and electrolytic lesioning techniques in the rat. Electrical stimulation (0.5 mA, 50 Hz, 15-25 s) of the AV3V region of lactating rats evoked a reproducible rise in intramammary pressure equivalent to that induced by 0.25 0.5 mu. oxytocin (i.v.). Increases in circulating concentrations of oxytocin, as determined by specific radioimmunoassay, confirmed that AV3V stimulation released oxytocin in both lactating and non-lactating rats. The increases in plasma oxytocin concentration evoked by electrical stimulation of the AV3V region were dependent upon intensity and frequency of stimulation, and electrode position. A significant (P less than 0.05) increase followed stimulation at 25 Hz and 0.1 mA, and a maximal response was obtained with 50 Hz and 1.0 mA. Stimulation of the area in and around the nucleus medianus produced the greatest rise in oxytocin secretion. The milk-ejection reflex was not abolished after acute electrolytic ablation of the AV3V region in urethane-anaesthetized lactating rats, but electrolytic lesion of the AV3V region prevented the increase in plasma oxytocin concentration which normally followed an osmotic stimulus (1 ml 1.5 mol NaCl/l, i.p.). These studies provide evidence that the AV3V region is a major source of excitatory afferents to oxytocin neurones; this input is essential for the osmoresponsiveness of these neurones but plays little role in the control of such neurones during reflex milk ejection. PMID- 3655614 TI - Relationship between oxytocin release and amplitude of oxytocin cell neurosecretory bursts during suckling in the rat. AB - Plasma concentrations of oxytocin and vasopressin were measured in relationship to oxytocin cell firing during suckling in urethane-anaesthetized rats. Preliminary experiments showed that plasma concentrations of oxytocin and vasopressin, which were increased immediately after anaesthesia, reverted to basal concentrations 3 h later. Moreover, it was found that exogenous oxytocin had entirely disappeared 5 min after i.v. bolus injections of known doses of oxytocin. Suckling did not modify the basal plasma concentration of oxytocin (14.6 +/- 2.9 compared with 14.6 +/- 1.5 pmol/l before suckling) except during a brief period immediately after neurosecretory bursts on oxytocin cells (37.8 +/- 5.2 pmol/l; P less than 0.001, n = 11). The plasma concentration of oxytocin did not differ significantly from the basal concentration 1.5 min later. The plasma concentration of vasopressin never varied. After two neurosecretory bursts of similar amplitude (total number of spikes during the burst) recorded on the same oxytocin cell, the variations in plasma concentration of oxytocin were also similar. When, for a given cell, the amplitude of neurosecretory bursts increased or decreased, the amount of oxytocin released changed in the same way. These data demonstrate (1) that suckling induces pulsatile release of oxytocin without vasopressin, and (2) a direct relationship between the amounts of oxytocin released and the amplitude of oxytocin cell neurosecretory bursts which argue in favour of simultaneous increases or decreases in the neurosecretory burst amplitudes on all oxytocin cells. PMID- 3655615 TI - Role of prolactin in a pheromone-like sexual inhibition in the male lesser mouse lemur. AB - Sexual activity of the male lesser mouse lemur can be induced by a long photoperiod, and plasma testosterone concentrations increase from 20 to 220 nmol/l within 3 weeks of photoperiodic stimulation. When isolated males were exposed to the volatile compounds from the urine of an active dominant male for 4 weeks at the beginning of the long daylight period, they demonstrated a significant decrease in testosterone concentrations (134 +/- 11 nmol/l) compared with controls (210 +/- 26 nmol/l) within 2 weeks. Lowering concentrations of prolactin by daily injections of bromocriptine prevented the decrease in testosterone in males simultaneously exposed to the odorant stimulation. Increasing concentrations of prolactin by daily injections of sulpiride mimicked the effect of the odorant stimulation in males receiving only fresh non-odorized air. The decrease in testosterone was strengthened when sulpiride was administered concurrently with exposure to urine. These results support the conclusion that variations in the concentration of prolactin are involved in the neuroendocrinological process mediating the pheromone-like sexual inhibition in the male lesser mouse lemur. However, daily injections of bromocriptine in males which were photoperiodically stimulated but not exposed to dominant male urine odour, also induced a significant decrease in testosterone concentrations. This finding suggests that two different systems involving prolactin and leading to opposite effects might be implicated in the regulation by environmental factors of sexual activity in the male lesser mouse lemur. PMID- 3655616 TI - Plasma concentrations of ovarian steroids in the freshwater European silver eel (Anguilla anguilla L.): effects of hypophysectomy and transfer to sea water. AB - Intact and hypophysectomized freshwater (FW) silver eels were transferred to tanks of FW or artificial sea water (SW; salinity = 0.60 osmol/l) which were simultaneously renewed twice a week. Fish were killed 2 months after transfer and plasma was assayed for ovarian steroids. In all fish, 5 alpha-androstane-3 beta,17 beta-diol was present, while 5 alpha-dihydrotestosterone and 5 alpha androstane-3 alpha,17 beta-diol were undetectable. In intact FW eels, plasma levels of testosterone, 5 alpha-androstane-3 beta,17 beta-diol and oestradiol-17 beta were approximately 0.15 nmol/l. In intact SW eels, no change in plasma levels of testosterone and 5 alpha-androstane-3 beta,17 beta-diol was found, whereas the concentration of oestradiol-17 beta was increased significantly (P less than 0.01), indicating stimulation of aromatase activity. In hypophysectomized compared with intact FW fish, plasma levels of testosterone and 5 alpha-androstane-3 beta,17 beta-diol were decreased (P less than 0.05) and there was a slight but significant (P less than 0.01) augmentation of the plasma concentration of oestradiol-17 beta which may have involved the removal of pituitary-dependent inhibition of aromatase activity, possibly by 5 alpha-reduced compounds. In hypophysectomized compared with intact SW fish, plasma levels of testosterone, 5 alpha-androstane-3 beta,17 beta-diol and oestradiol-17 beta were decreased (P less than 0.05); in the case of oestradiol-17 beta, this may have reflected the diminished ovarian synthesis of testosterone, its precursor. The plasma level of oestradiol-17 beta was, however, higher in SW than in FW fish, even in hypophysectomized eels. This suggests that extra-pituitary mechanisms mediate, at least partly, the effects of transfer to SW on aromatase activity. PMID- 3655618 TI - Health and disease: two philosophical perspectives. PMID- 3655617 TI - Effect of different photoperiods on concentrations of 5-methoxytryptophol and melatonin in the pineal gland of the Syrian hamster. AB - Specific, sensitive and direct radioimmunoassays have been used to determine the daily patterns of 5-methoxytryptophol (ML) and melatonin in the pineal glands of Syrian hamsters kept in different photoperiods: 8 h light: 16 h darkness (8L:16D), 14L:10D and 16L:8D. A rhythm in pineal ML was evident in animals in all the photoperiods, with high daytime levels (641 +/- 35 (S.E.M.) fmol/gland; n = 162) which dropped to 119 +/- 16 fmol/gland (n = 44) 7.1-7.5 h after lights out. The duration of low night-time ML levels was proportional to the length of the dark phase (1.2 h in 16L:8D, 5.4 h in 14L:10D and 8.4 h in 8L:16D). A marked daily rhythm in melatonin was also present in hamsters in the different photoperiods, with daytime levels of 323 +/- 34 fmol/gland (n = 129) and night time peak concentrations of 3676 +/- 336 fmol/gland (n = 22). The duration of high nocturnal melatonin levels was dependent upon the length of the dark phase (4.1 h in 16L:8D, 4.5 h in 14L:10D and 12.5 h in 8L:16D). Linear regression analysis revealed a statistically significant inverse relationship between pineal ML and melatonin levels in 8L:16D (P less than 0.001), 14L:10D normal (P less than 0.05) and 14L:10D shifted (P less than 0.001) photoperiods. After advancing the lighting schedule by 10 h (14L:10D, lights off at 04.00 h), pineal ML and melatonin rhythms became entrained to the new lighting regimen. The daily rhythms in pineal ML and melatonin in the Syrian hamster thus depend on the prevailing photoperiod, a reciprocal relationship existing between pineal ML and melatonin concentrations. PMID- 3655619 TI - Is there seasonal variation in the prescribing of antidepressants in the community? AB - The prescribing of antidepressants by general practitioners might be expected to reflect the incidence of depression in the community. In a two-year study of the prescriptions issued by English general practitioners to a population of 40,000 people, the rates of initiating treatment with antidepressants were analysed by month. There was seasonal variation in new antidepressant prescribing for men (p less than 0.025), with peaks in early June and early December, but no significant seasonality for women. The bimodal pattern in men was similar to a recently reported seasonal variation in general practice consultations for depression. PMID- 3655620 TI - Early oral contraceptive use and breast cancer: theoretical effects of latency. AB - Many cancers and other chronic diseases are associated with a long delay between exposure to a putative risk factor and subsequent diagnosis. This presents well recognised problems in the elucidation of suspected risk factors by epidemiological methods. In this paper we discuss the interpretation in epidemiological studies of the effect of a possible risk factor when population exposure is recent and rapidly changing. An important contemporary example concerns the study of early oral contraceptive (OC) use in relation to the subsequent risk of breast cancer. Computer simulations reported here indicate that plausible delays in the manifestation of any effect on breast cancer incidence make it difficult to exclude early OC use as a risk factor for breast cancer, even when large well conducted epidemiological studies show no apparent increased risk. Methods for detecting a 'latent' effect are discussed. PMID- 3655621 TI - The nature of mycobacterial disease in south east England, 1977-84. AB - The nature and incidence of bacteriologically confirmed mycobacterial disease in south east England over the eight year period 1977-84 has been determined by a study of cultures received by the PHLS Regional Centre for Tuberculosis Bacteriology at Dulwich. The number of cases of tuberculosis in the ethnic European population has shown a decline, more so among males than females, but there has not been a significant decline in cases among ethnic Asians. Most tuberculosis is due to the classical human tubercle bacillus but cases due to the Asian human type, the bovine type (M. bovis), and the African types (M. africanum) also occur. The number of cases of disease due to 'atypical' mycobacteria has doubled over the eight year period, and these now account for about 5% of bacteriologically diagnosed mycobacterial disease in this region. The continuing role of reference facilities for the surveillance of tuberculosis and the diagnosis and management of the growing numbers of other mycobacterial infections is stressed. PMID- 3655622 TI - Perinatal outcomes and related factors: social class differences within and between geographical areas. AB - This paper makes use of the opportunity provided by comparable obstetric data bases to examine area and social class variations in perinatal outcome and associated factors in areas smaller than those usually reported. Analyses are based on singleton births to primiparous residents in the catchment areas of the Aberdeen Maternity and Neonatal Database (n = 4948) and the Cardiff Births Survey (n = 11893) between 1976 and 1981. The factors considered relate to the obstetric population (height, age, and smoking), obstetric practice (induction and assisted delivery), and perinatal outcome (curtailed gestation, low birthweight, and perinatal death). Our analysis confirms the existence of both area and social class differences and suggests that, except in the case of teenage pregnancy and smoking, the association observed between those factors and area and social class are largely independent of each other. PMID- 3655623 TI - Breast feeding and smoking hygiene: major influences on cotinine in urine of smokers' infants. AB - The determinants of urine cotinine levels were studied in a group of 101 infants aged 3 months, including 79 infants whose mothers were current smokers. At a pre arranged home visit the infants' mothers completed an interviewer-administered questionnaire, and samples of maternal urine and breast milk and infants' urine were collected. Cotinine and nicotine levels were determined by gas-liquid chromatography. Infant urine cotinine levels ranged from 0 to 140 micrograms/l (0 1120 ng cotinine/mg creatinine). A linear dose response relation between mother's smoking rate and infant urine cotinine level was observed among breast-fed infants (r = 0.79, p less than 0.001). The relation was weaker among infants fed by both breast and bottle (r = 0.56, p = 0.01) and was not apparent among bottle fed infants (r = 0.15, p = 0.16). In addition to mode of feeding and mother's smoking rate, mother's smoking "hygiene" (assessed by the reported frequency of smoking while feeding and with infant in same room) was independently associated with infant urine cotinine level. Father's smoking pattern and exposure to smoke outside the household did not relate significantly to infant cotinine levels. We conclude that when mothers smoke, breast feeding is the principal determinant of cotinine in infants' urine. It is likely that most of this cotinine comes from cotinine in mothers' breast milk, but further research is needed to establish how much nicotine is ingested by breast-fed infants of mothers who smoke, and to investigate possible health effects. PMID- 3655624 TI - Distribution of body weight and height: comparison of estimates based on self reported and observed measures. AB - The distribution of weight in the adult population aged 20-69 years was examined by comparison of estimates obtained from the 1985 Health Promotion Survey and the 1981 Canada Fitness Survey. The Health Promotion Survey obtained information on self-reported weight and height, and the Canada Fitness Survey utilised measured weight and height. The classification of respondents into weight categories followed the recommendations of the 1973 Fogarty Conference on Obesity. Values of the Quetelet index defined as W/H2, where W = kilograms and H = metres, were used to define four weight categories: underweight, acceptable weight, overweight, and obese. The comparisons of prevalence estimates of the various weight categories indicate that self-reported weight and height leads to a systematic weight misclassification bias. The implications of this bias for epidemiological studies are discussed and suggestions are offered to handle the bias. PMID- 3655625 TI - Association of serum lipids with coffee, tea, and egg consumption in free-living subjects. AB - The associations of serum lipids with coffee, tea, and egg consumption were examined in a survey of 658 men in Israel. A significant, positive association was found between coffee consumption and serum total cholesterol (TC), mainly reflecting a difference in the low density lipoprotein cholesterol (LDL-C). Among the subjects aged 20-39, the difference in TC between the lowest and highest consumption categories was 13.2 mg/dl, and among those aged 40-69 the difference was 7.4 mg/dl. An even stronger, negative association between tea intake and TC was present; the difference between the lowest and highest consumption categories was 28.7 mg/dl for the younger subjects and 18.4 mg/dl for the older group. On the other hand, serum TC levels were not elevated at higher levels of whole egg consumption. Thus, allowing for the bias inherent in dietary recall, coffee and tea consumption appear to be associated more strongly with serum lipid and lipoprotein levels than egg consumption. PMID- 3655626 TI - Edinburgh breast education campaign on breast cancer and breast self-examination: was it worth while? AB - A health education campaign was carried out at the start of a large trial of screening for breast cancer in Edinburgh. After preliminary studies the campaign concentrated on talks to small groups of women by specially trained health visitors. Over a year, 12,000 women attended. Systematic evaluation after 12 months showed that selected women who heard the talks were more knowledgeable about breast cancer, and a random sample of women in Edinburgh had a small but significant improvement in knowledge compared with women in Aberdeen. However, the random sample did not report an increase in the practice of breast self examination (BSE) and there was no increase in workload for general practitioners. It is suggested that BSE is more likely to be accepted if combined with a physical examination. PMID- 3655627 TI - Motor neurone disease in the Lothian Region of Scotland 1961-81. AB - One hundred and sixty one patients with motor neurone disease (MND), from the Lothian Region of Scotland, were studied in an attempt to identify factors important in disease aetiology. Onset of the disease was between 1961 and 1981 and the incidence was highest between 1968 and 1975. The probability of developing MND was greatest between the ages of 65 and 69, and a greater proportion of female patients than of males had onset in the bulbar muscles. Some 5% of patients had a positive family history of MND. There was no evidence that infective agents were important in the aetiology of the disease. There was a suggestion that the patient group contained a greater number of electrical workers, food, drink and tobacco workers, and rubber workers than would have been expected. However, a larger series of patients would be needed to confirm an increased susceptibility to MND in individuals engaged in these occupations. PMID- 3655628 TI - Epidemiology in Antarctica? PMID- 3655629 TI - Changes in annual tuberculosis notification rates between 1978/79 and 1983 for the population of Indian subcontinent ethnic origin resident in England. AB - In two national surveys of tuberculosis notifications in England conducted in 1978/79 and 1983 the estimated annual notification rates for the Indian subcontinent (Indian, Pakistani, and Bangladeshi) ethnic groups were considerably higher than the rate for the white ethnic group. The mean annual decline in rates between the surveys appeared to be greater for the Indian and the Pakistani and Bangladeshi ethnic groups, 15% and 16% respectively, than for the white ethnic group (7%). Data from two small sample population surveys, the National Dwelling and Housing Survey in 1978 and the Labour Force Survey in 1983, were used to calculate the rates. However, comparison of the estimates for the population of Indian subcontinent ethnic origin in England from these surveys revealed discrepancies between them. Additional information from the Labour Force Survey on the year of first entry to the United Kingdom (UK) permitted the calculation of new estimates for the 1978 population, and based on these estimates the annual notification rates for 1978/79 were 287 per 100,000 for the Indian and 286 per 100,000 for the Pakistani and Bangladeshi ethnic groups. The rates for 1983 were 178 and 169 respectively, and the mean annual decline between the surveys was 11% for the Indian and 12% for the Pakistani and Bangladeshi ethnic groups. There were important changes in the characteristics of the population of Indian subcontinent ethnic origin in England between 1978 and 1983, and therefore the rates for both surveys have been standardised by the method of direct standardisation to a common reference population. Standardizing for year of entry to the UK, place of birth (UK or abroad), age, and sex reduced the mean annual decline in the notification rate to 4% for the Indian and 9% for the Pakistani and Bangladeshi ethnic groups. The much greater reduction in the rate of decline in the Indian ethnic group is due to the substantial decline between the surveys in the proportion of recent immigrants, the group with the highest annual notification rate, in that population. Future trends will continue to be influenced by immigration patterns, but it will also be important to monitor the rates among the increasing proportion of the population born in the UK or resident in England for more than five years. PMID- 3655630 TI - Unemployment and mortality: a small area analysis. AB - It has been claimed that unemployment affects the health and thus the mortality of the unemployed, their families, and other members of their communities. This paper examines the relation between mortality and the unemployment experiences of small areas which vary in the extent to which their unemployment levels have changed in recent years. Quarterly numbers of unemployed, classified by age, sex, duration of unemployment, and unemployment office for 1977-81, have been aggregated to correspond to Family Practitioner Committee areas (FPCs), for which population and mortality data had been collected for a different study. There was little variation in long term (greater than 6 months) unemployment trends prior to July 1980, but subsequently there were large variations between FPCs in the rate of increase in unemployment rates. Mortality data for suicide, ischaemic heart disease, cerebrovascular disease, and all causes were examined for the period 1975-83. When the mortality trends of FPCs with different unemployment experiences were compared, no statistically significant differences in trends were found, although areas with greater increases in unemployment appeared to have slightly worse mortality trends for suicide, ischaemic heart disease, cerebrovascular disease, and total mortality for men in the younger age groups. If changes in the level of unemployment do have an effect on changes in trends in mortality levels, this effect is not of sufficient magnitude to be statistically significant with the sample available, in spite of the fact that it included the whole of England and Wales. PMID- 3655631 TI - Birthday and date of death. AB - The relation between birthday and date of death has so far been studied from two different perspectives: birthdays were either conceived of as emotionally invested deadlines motivating people to ward off their death which causes a 'dip' in death rates before their birthday, or they were considered as stressful events leading to an increase of mortality on or after their birthday. Using a collection of biographies of famous people from the whole world and another of well-known Swiss citizens we tested hypotheses derived from these assumptions. Neither the 'death-dip' hypotheses nor the 'birthday stress' hypothesis was supported by our results. PMID- 3655632 TI - Case-control study of occupation and cancer of the prostate in New Zealand. AB - A New Zealand Cancer Registry based case-control study involved 617 male patients with prostate cancer registered during 1979 and aged 20 years or more at the time of registration. Controls were also males chosen from the Cancer Registry with two controls per case, matched on age and year of registration. There was an elevated risk in the upper social class groupings. The data did not support the findings, from other countries, of elevated risks in agricultural workers (odds ratio = 1.08, 90% confidence limits 0.86-1.36). The only occupational groups showing elevated risks were sales and service workers (odds ratio = 1.29, 90% confidence limits 0.99-1.69) and teachers (odds ratio = 2.44, 90% confidence limits 1.05-5.70). The New Zealand data do not in general suggest that occupational factors--or lifestyle factors associated with occupation--are of major direct importance in the aetiology of prostate cancer. PMID- 3655633 TI - Why is chest disease so common in South Wales? Smoking, social class, and lung function: a survey of elderly men in two areas. AB - A respiratory survey was conducted in two British towns, one with a high mortality (Caerphilly) and one with a low mortality (Bath) from respiratory disease. A total of 513 men aged 65-74 years were seen. The Caerphilly men had poorer lung function than the Bath men; the overall difference in FEV1 and FVC for men aged 70 and 1.68m tall was 0.16 1 and 0.17 1 respectively. These differences appeared to be largely due to the greater tendency of the Caerphilly men to smoke and to an effect related to social class. Respiratory symptoms were also more common in Caerphilly, principally because of the effects of smoking and occupational group, although when these factors were allowed for there was still a significantly greater prevalence of breathless wheezing in Caerphilly. PMID- 3655635 TI - Blood pressure and migration: a study of Bengali immigrants in East London. AB - The role of blood pressure in explaining the increased risk of ischaemic heart disease (IHD) in Bengali immigrants living in the East End of London was studied in a comparative population study. In addition the effect on blood pressure of age, body mass, and duration of stay in the UK was evaluated. The Bengalis had significantly lower mean systolic and diastolic blood pressures though these differences disappeared after adjustment for age and body mass. Both groups, however, showed similar rises of blood pressure with increasing age and body mass. The effect on blood pressure of duration of time spent in the UK by the Bengalis could not be separated from that due to age, given the association between them. It seems unlikely that increasing duration of stay in inner London per se has a hypertensive effect on Bengali immigrants coming from a rural community. Further, the increased IHD risk in this group is not explained, even in part, by an increase in blood pressure. PMID- 3655634 TI - Changes in blood pressure and body weight over ten years in men selected for glucose intolerance. AB - Relative changes in body weight and blood pressure over ten years of observation are reported in men recruited for a trial of therapy in relation to the natural history of glucose intolerance. Half were recommended a diet restricting carbohydrate to 120 g daily (diet group) and half were recommended to 'limit use of table sugar' (no diet). In both groups average weight and blood pressure fell over the 12 to 18 months after treatment allocation, the decline being proportionately greater for both variables in the diet group. Subsequently, average weight remained constant up to the end of the ten year study, but blood pressure levels rose, though remaining below baseline levels in the diet group. Statistical analysis of changes in blood pressure and weight between initial (pre treatment) and third follow-up visit measurement indicated that the proportional change in blood pressure was related principally to change in weight, with little relation to initial level of blood pressure. Although a reduction in weight results in a fall in blood pressure, it does not necessarily prevent a subsequent age related increase in blood pressure. PMID- 3655636 TI - Certification and coding of two underlying causes of death in The Netherlands and other countries of the European Community. AB - Differences in certification and coding of causes of death between countries of the European Community were studied by sending sets of case histories to samples of certifying physicians. Completed certificates were coded by national coding offices and by by a WHO reference centre. Detection fractions ranged from 60% to 92% in a first study (concerning cases of chronic obstructive pulmonary disease) and from 80% to 94% in a second study (concerning cases of cancer). A detailed analysis of the findings for the Netherlands, which performed very well in both studies, reveals a substantial frequency of errors in certification (as opposed to errors in diagnosis). Comparison of national and reference centre coding suggests that the Dutch coding process is to a certain extent adapted to the frequency of these certification errors, leading to deviations from WHO coding rules. It is concluded that certification and coding practices should be studied together and that further international standardisation of coding practices will not necessarily improve the validity of national cause of death statistics. PMID- 3655637 TI - Education, prevalence of disease, and frequency of health care utilisation. The 1983 Italian National Health Survey. AB - The relation between education, prevalence of 17 chronic diseases or groups of diseases, and pattern of health care utilisation was evaluated from data from the 1983 Italian National Health Survey, based on 58 462 individuals aged 25 or over randomly selected within strata of geographical area, size of place of residence, and size of household, in order to be representative of the whole Italian population. Most of the diseases considered, including diabetes, hypertension, myocardial infarction and other heart disease, haemorrhoids or varices, chronic respiratory disease, anaemias, gastroduodenal ulcer, cholelithiasis and liver cirrhosis, kidney and urological diseases, arthritis, and psychiatric and neurological disturbances, were consistently less prevalent among more educated individuals. The age and sex adjusted risk estimates for individuals educated in high school or university compared with those with only a primary school education or less ranged between 0.21 for liver cirrhosis and 0.80 for anaemias. The sole exception was allergy, which was more prevalent among the more educated individuals (relative risk = 1.42). General practitioner visits and hospital admissions were reported less frequently by the more educated individuals, but specialist consultations of potential preventive value were less frequent among the less well educated. The results were similar when occupation was utilised as an indicator of social class. Thus, the findings of this national survey provide confirmation and quantitative assessment of considerable differences in health and health service utilisation according to indicators of social class. PMID- 3655638 TI - Mortality in relation to cigarette and pipe smoking: 16 years' observation of 25,000 Swedish men. AB - In a random sample of 25,129 Swedish men who responded to a questionnaire on smoking habits in 1963 the cause specific mortality was followed through 1979. In the cohort, 32% smoked cigarettes, 27% a pipe, and 5% cigars. There were clear covariations (p less than 0.001) between the amount of tobacco smoked and the risk of death due to cancer of the oral cavity and larynx, oesophagus, liver, pancreas, lung, and bladder as well as due to bronchitis and emphysema, ischaemic heart disease, aortic aneurysm, and peptic ulcer. Pipe smokers showed similar risk levels to cigarette smokers. There was a close to linear increase in lung cancer risk in relation to the amount of tobacco smoked for cigarette, pipe, and cigar smokers, respectively. An increasing risk of ischaemic heart disease with amount smoked was seen among both cigarette and pipe smokers. A similar fraction of inhalers in Swedish cigarette and pipe smokers may explain the similarity in risks. PMID- 3655639 TI - Troop-related multiple sclerosis outbreak in the Orkneys? PMID- 3655640 TI - Maternal blood lead. PMID- 3655641 TI - Transformation of a polygonal cellular pattern during sexual maturation of the avian oviduct epithelium: computer simulation. AB - A peculiar cellular pattern resembling a checkerboard has been observed on the luminal surface of the oviduct epithelium of an adult Japanese quail. The epithelium is a monolayer cell sheet and consists of two types of columnar cells, ciliated cells (C-cells) and gland cells (G-cells) assembled in alternating blocks. The pattern develops, during sexual maturation, from a kagome-like pattern (in which large C-cells are surrounded by small G-cells) characteristic of the immature oviduct. In the present paper, computer simulations of the pattern transformation from kagome to checkerboard were performed assuming a few properties of individual cells. The adult checkerboard-like pattern is not strictly rectangular, but is deformed toward a honeycomb pattern. In theoretical considerations the assumption that adhesion is stronger between unlike cells than between like cells formed an ideal checkerboard pattern, because all cell boundaries in it are edges along which unlike cells meet. On the other hand, a honeycomb pattern formed after assuming that the boundary length of the cellular pattern is minimized (caused by contraction of bundles of microfilaments running along lateral boundaries of the columnar epithelial cell while keeping contact between neighbouring cells). The actual checkerboard-like pattern was considered to be in a balanced state between the effects of (1) the strong adhesion between unlike cells, and (2) the boundary contraction. Using a computational analysis, this consideration enabled us to obtain a quantitative parameter value for the difference between cell adhesions of unlike cells and of like cells. C-cells divided once during the kagome-checkerboard transformation, while G-cells did not divide. We performed computer simulations starting with the kagome pattern in which all C-cells divided once. The computer program of the boundary shortening procedure we used involved the quantitative parameter value for differential cell adhesion obtained as described above. A checkerboard pattern was successfully generated in the simulation. It is concluded that the strong adhesion between unlike cells and the boundary shortening have important roles in formation and maintenance of the kagome and checkerboard patterns of the avian oviduct epithelium. PMID- 3655642 TI - Development and degeneration of retina in rds mutant mice: observations in chimaeras of heterozygous mutant and normal genotype. AB - In homozygous rds mutant mice the photoreceptor cells lack outer segment discs and slowly degenerate. In the heterozygotes the receptor cells develop abnormal outer segments and show altered disc shedding properties as revealed by the pigment epithelial phagosome content. The receptor cells also degenerate at a slower rate than in the homozygotes. The nature of the interaction resulting in dilution of the retinal lesion in the heterozygous retina was analysed in a series of chimaeras consisting of rds/+ and +/+ genotypes, which also differed in colour genes. In 64% of the chimaeras (18 out of 28) presence of both rds/+ and +/+ types of photoreceptors could be detected by electron microscopy. The relative proportion and patch size of the two components varied greatly between individuals but the location of the two types of photoreceptors was not related to the genotypes of the overlying pigment epithelial cells. Frequent occurrence of abnormally large phagosomes, resembling the rds/+ phenotype, was noted regularly in both rds/+ and +/+ types of pigment epithelial cells located above rds/+ types of receptors, but not in the cells of either genotype located above normal receptors. In the eyes examined at 12-18 months, localized and partial depletion of the perikaryal population in the outer nuclear layer was observed, and the location of such areas was also unrelated to the genotypes of the pigment epithelial cells. These findings confirm that the rds gene acts within the neural retina and possibly within the receptor cells and further show that the genetic interaction between the rds gene and its normal allele in the retina of the heterozygous mice takes place within the receptor cells. PMID- 3655643 TI - The phenotypic interdependence of the musculoskeletal characters of the mandibular arch in mice. AB - Evidence from studies of craniofacial anomalies and the evolutionary transition from reptiles to mammals suggests that the temporomandibular joint (TMJ), bony zygomatic arch, middle ear ossicles and mandibular muscle pattern may form a correlated suite of characters. To test the degree of phenotypic interdependence among these features, mandibular arch defects were analysed in prenatal mice. Retinoic palmitate was administered to pregnant mice on day 8.7 to produce test foetuses with malformations of the mandibular arch. A rating scale was developed for each of the four characters so that numerical values could be assigned to each phenotype encountered. Control animals were used to establish normal phenotypes for each character which were assigned a value of 1. Data from each test age, 16, 18 and 19 days postconception, were pooled and Spearmann rank correlation coefficients between each of the traits were calculated. Coefficients (R) range from a high of 0.87, between the TMJ and zygomatic arch, to a low of 0.67 between the zygomatic arch and the mandibular musculature showing highly significant correlations (P less than 0.0001) among all characters. Therefore, the data suggest that the musculoskeletal features of the mandibular arch are phenotypically interdependent during development. PMID- 3655644 TI - Regeneration in the anterior-posterior axis of the insect thoracic segment. AB - After removal of a transverse strip of ventral thorax from the beetle, Tenebrio molitor, interaction occurred between epidermis posterior to the mesothoracic leg and that anterior to the metathoracic leg. Depending on the size and position of the excision, this interaction resulted in either the regeneration of the extirpated tissue or its replacement by an A/P reversed pattern of sclerites and supernumerary leg. By either route, local pattern continuity was restored between the normal meso- and metathoracic legs. Similarly, when a leg plus adjacent tissue was extirpated, continuity was restored by leg regeneration or by formation of an A/P reversed duplication of sclerites. The results of these strip excisions can be understood in terms of two current models of the ventral thorax (the Boundary Model and the Polar Coordinate Model), each of which postulates a distinct compartment or region intervening between the epidermis surrounding the bases of successive legs. However, the models do not explain the large differences in the frequency of formation of the duplication/deletion pattern after excisions of different widths. The results are also compatible with a different model, involving an A-P sequence of positional values similar to that proposed for the abdominal segment. Regeneration would restore continuity within the sequence by the shortest route, forming either the midsegment (including the leg) or the intersegmental region. The meso- and metathorax differ in the structure of the ventral sclerites and in the segmentation of the tarsus of the leg. The structures regenerated after the various excisions show that the segment border is not crossed during regeneration and indicate that an A/P compartment border running through the leg is usually also respected. There is no sign, however, of a third line of lineage restriction that would indicate a subdivision of the segment into three compartments (as proposed in the Boundary Model). PMID- 3655645 TI - Chromosome analysis of single-pronuclear haploid parthenogenetic blastocysts and their inner cell mass derivatives. AB - Single-pronuclear haploid parthenogenetically activated mouse embryos were transferred to the oviducts of suitable recipients. One group of embryos was isolated at the morula stage and subsequently allowed to develop to the expanded blastocyst stage in vitro. Intact embryos were either analysed by the air-drying technique at that stage to determine their total cell number and ploidy, or treated by immunosurgery to isolate their inner cell mass. These were either analysed to establish their total cell number and ploidy, or retained in culture for an additional 24h or 72h. The inner cell mass derivatives were then analysed to establish the total cell number and ploidy. A second group of recipients was ovariectomized on the 4th day of pseudopregnancy, treated with Depo-Provera and blastocysts recovered 5 or 6 days later. The 'delayed' blastocysts recovered were treated by immunosurgery, and the inner cell masses isolated and either analysed at this time or transferred to culture for 72h, 96h or 144h. As in the previous groups, the inner cell mass derivatives were analysed to establish the total cell population present and their ploidy. The analysis of this material was found to be technically particularly difficult, though in general the non-'delayed' embryos and their inner cell mass derivatives yielded higher success rates than the 'delayed' inner cell mass derivatives. The 'delayed' inner cell masses initially contained on average about twice the number of cells compared to the number present in those isolated from the non-'delayed' expanded blastocysts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655646 TI - Level of histone H4 mRNA in Xenopus laevis embryonic cells cultured in the absence of cell adhesion. AB - The amount of histone H4 mRNA per embryo was followed during early development of Xenopus laevis by Northern blot analyses using a cloned histone H4 cDNA as the probe. The H4 mRNA content was nearly constant until the blastula stage, increased greatly at the gastrula stage and then decreased at the neurula stage. Experiments with actinomycin D suggested that most H4 mRNA molecules detected at the late gastrula and neurula stages were maintained depending on new transcription of H4 genes during these stages. To see if the H4 mRNA level is affected by cell adhesion, we prepared dissociated cells and measured H4 mRNA content under conditions that inhibit cellular reaggregation. It was found that the amount of H4 mRNA per embryo in dissociated and reaggregation-inhibited cells was nearly equal to that of the control embryo at the neurula stage. Therefore, we conclude that the synthetic activity of histone H4 mRNA is not dependent on the cellular adhesion during development. PMID- 3655647 TI - Effect of alterations in follicular steroidogenesis on the nuclear and cytoplasmic maturation of ovine oocytes. AB - The effects of inhibitors of follicular steroidogenesis on biochemical changes occurring in oocytes maturing in vitro were studied using radiolabelling and polyacrylamide gel electrophoresis. These effects were correlated with previously investigated developmental abnormalities induced by the same inhibitors. The most severe effects were generated by inhibition of 17 alpha-hydroxylase with the drug SU10603 which resulted in a greatly increased ratio of progesterone to testosterone and oestrogen. Such treatment halved the rate of meiotic maturation. Treated oocytes were analysed individually on SDS-PAGE gels and quantitative analysis showed that the drug had induced synthetic abnormalities even in those oocytes that resumed meiosis. This conclusion was confirmed by separation of oocyte proteins on two-dimensional gels. The effects of SU were reduced by delaying addition of the drug until 6h after the beginning of maturation but were not alleviated by the addition of exogenous oestrogen to the culture medium. When oocytes from SU-treated follicles were transferred to inseminated, recipient ewes and recovered 24h later, two-dimensional electrophoresis again revealed abnormalities in their protein synthetic patterns. Almost total abolition of steroid secretion by aminoglutethimide (AG) had much less effect on oocyte protein synthesis, although the proportion of oocytes maturing was reduced from 65% to 46%. The aromatase inhibitor, androstatriendione (AST) although eliminating follicular oestrogen secretion, had no effect on the rate of maturation and very little effect on protein synthesis. These results correlate well with the effects of steroid inhibitors on fertilization and early cleavage. PMID- 3655648 TI - Size regulation in the mouse embryo. II. The development of half embryos. AB - The study describes an analysis of the development of mouse embryos halved at the 2-cell stage by the destruction of one blastomere, in comparison with control embryos of parallel derivation, at 2.5-13.5 days post coitum. The results showed that: (1) half embryos achieve size regulation some time between 7.5 and 10.5 days; (2) there is an indication that by 13.5 days half embryos may have again dropped back significantly in size relative to controls; (3) preregulation half embryos are slightly retarded developmentally, but this does not wholly account for their smaller size: morphogenesis is not size-dependent; (4) early postimplantation half embryos contain a significantly decreased proportion of inner cell mass derivatives and increased proportion of trophectoderm derivatives when compared with controls. A comparison is also made between the up-regulation of half embryos and the down-regulation of aggregate embryos, and it is suggested that size regulation may occur by delaying a change in the normal growth rate. PMID- 3655649 TI - Analysis of cranial neural crest cell migration and early fates in postimplantation rat chimaeras. AB - Rat embryos were grown in vitro during the period of cranial neural crest cell migration. In order to study the pathways and positional fates of cells from different regions of the neural crest, labelled premigratory crest cells from donor embryos were microinjected orthotopically into host embryos of the same developmental stage except for area 1 (forebrain) grafts which were, for technical reasons, injected into area 2. After various periods of time in whole embryo culture, the embryos were examined by immunohistochemical staining in order to determine the new positions of the labelled cells, and a map of their migration pathways was constructed. The observed patterns of migration were consistent with predictions from morphological studies in mammals and with extrapolations from transplantation studies in birds. However, crest cell migratory behaviour in rat and chick embryos was not identical; possible reasons for this are discussed. PMID- 3655650 TI - Development of neural tube basal lamina during neurulation and neural crest cell emigration in the trunk of the mouse embryo. AB - In the trunk of higher vertebrates, the neural crest (NC) cells remain temporarily within the dorsal portion of the neural tube after fusion of the neural folds; shortly thereafter they emigrate, invading surrounding spaces and tissues. One of the factors postulated to be important in the initiation of migration of NC cells is the disruption of the basal lamina (BL) over the dorsal portion of the neural tube. It has been assumed by many that the BL must be discontinuous in order that the NC cells can leave the neural tube; and indeed, experiments performed in our laboratory, and by others, have shown that NC cells cannot penetrate an intact BL. Therefore, we have undertaken a systematic ultrastructural study to evaluate the condition of the BL during neural fold elevation and NC cell emigration. Our results show that: (i) BL surrounding the neural epithelium (NE) becomes progressively more extensive from neural fold to migratory stages. It first forms on the lateral portion of the neuroepithelium of the neural folds and then extends ventrally into the region adjacent to the notochord; (ii) BL becomes continuous beneath the epidermal ectoderm (EE) that overlies the NC cell region only during the terminal stages of NC cell emigration; (iii) BL does not form over the dorsal portion of the neural tube until NC emigration is terminated; and (iv) the morphology of the BL changes as development proceeds. We conclude that absence of a BL over the premigratory NC cell population in the trunk of mouse embryos is a necessary but not a sufficient condition for emigration to take place. PMID- 3655651 TI - Gonadal development of the chick embryo following microsurgically caused agenesis of the mesonephros and using interspecific quail-chick chimaeras. AB - Mesonephric agenesis was achieved by microsurgical excision of the left Wolffian duct and the underlying intermediate mesoderm of different regions between somites 16 and 23 in chickens after 50-52 h of incubation (stage 14 HH). Quail chick chimaeras were produced by transplantation of corresponding quail tissue in the region of somites 18-21. A morphometrical analysis of the mesonephric and gonadal area in cross sections shows that the intermediate mesoderm from somites 16 to 23 develops into the mesonephros. A partial agenesis of the mesonephros brought about by removal of the intermediate mesoderm at the level of somites 18 to 21 at stage 14 leads to a mean reduction of the gonadal volume of 37.8% compared to the volume of the untreated side at stage 30. Transplantation of quail intermediate mesoderm in this region of the excision results in development of a hybrid mesonephros. Consequently, the gonads are invaded and colonized by quail cells mobilized from mesonephric corpuscles examined at stage 30, 35 and 36. These results are discussed in terms of the origin of the gonadal stroma during this developmental period; they show that in the region from the third to the sixth segment the ventromedial part of the differentiating mesonephros participates in the contribution of stromal cells to the gonad. PMID- 3655652 TI - The effects of Streptomyces hyaluronidase on tissue organization and cell cycle time in rat embryos. AB - Day 9 rat embryos (late presomite stage with cranial neural plate or very early neural folds) were cultured for various periods of time from 6-48 h in medium containing 20 TRU ml-1 Streptomyces hyaluronidase. Exposure to the enzyme resulted in considerable reduction of mesenchymal extracellular matrix. Access of the enzyme to the embryo was confirmed by alcian blue staining which indicated considerable reduction of extracellular and cell surface hyaluronate. Cranial neurulation was retarded, but not inhibited, and migration of both neural crest and primary mesenchyme cells occurred. In general, morphology was normal at 48 h. The major effect was on growth: embryos were smaller, with slightly reduced neuroepithelial cell number and greatly reduced mesenchymal cell number. Neuroepithelial cell cycle time was slightly prolonged, and that of the mesenchyme more than doubled. This differential effect on the growth rates of these two tissues reflects the normal distribution of hyaluronate, which is particularly abundant in the mesenchymal extracellular matrix. PMID- 3655653 TI - Stimulatory effects of insulin-like growth factors on DNA synthesis in the human embryonic cornea. AB - 10- to 12-week-old human embryonic eye globes were microdissected so that a passage was opened between the outer environment and the anterior chamber which rendered free access of tissue culture medium to the endothelial cell monolayer. The dissected eye globes were maintained in organ culture for 24 h in the continuous presence of tritiated thymidine. Cross sections were cut through the whole eye globes and subjected to autoradiographic analysis in order to estimate the mitogenic response of human embryonic corneal endothelial cells to externally supplied growth factors and hormones. It was found that the corneal endothelial cells could be stimulated to initiate DNA synthesis by exposure to insulin-like growth factor I (IGF-I). The thymidine-labelling index doubled after IGF-I supplementation. Northern blot analysis revealed the abundant presence of IGF-II transcripts in the posterior eye. In contrast, the anterior portion of the eye, including the cornea, contains barely detectable levels of IGF-II transcripts. IGF-I transcripts were detected in both parts of the eye at much lower concentrations than those for IGF-II. No insulin transcripts were found. These results demonstrate that mRNA for both IGF-I and IGF-II is present in the late first trimester eye. The observed stimulatory effects of IGF-I in organ culture suggest that local production of IGF-I and IGF-II may stimulate cell proliferation in vivo. PMID- 3655654 TI - The effect of retinoic acid pretreatment on the ability of murine embryonal carcinoma and inner cell mass cells to participate in chimaera development. AB - Certain embryonal carcinoma (EC) cell lines can colonize the embryo following blastocyst injection or embryo aggregation, giving rise to EC-embryo chimaeras. However, such chimaeras often develop abnormally. For example, diploid P19 cells colonize the embryo readily but resulting chimaeras are usually abnormal, with persistence of tumour cells. Retinoic acid (RA) induces differentiation of EC cells to a variety of cell types in vitro but, in this study, it was shown that pretreatment of P19 cells with RA did not result in more normal development of P19-embryo chimaeras. The only significant effect of RA was to reduce the ability of P19 cells to participate in embryonic development at all after blastocyst injection. RA did not have a direct toxic or teratogenic effect on preimplantation mouse embryos and did not affect the ability of pluripotent embryo cells to colonize chimaeras. Therefore, RA may not be the normal inducer of differentiation in early embryogenesis. PMID- 3655655 TI - High endothelial venule binding as a predictor of the dissemination of passaged murine lymphomas. AB - It has long been postulated that normal lymphocyte homing mechanisms help determine the metastatic spread of lymphoid neoplasms. The traffic of normal lymphocytes is controlled in part by the regulated expression of surface receptors for high endothelial venules (HEV), specialized venules that mediate the extravasation of circulating lymphocytes from the blood into lymphoid organs and sites of chronic inflammation. Here we have compared the in vivo growth patterns of HEV-binding vs. nonbinding murine lymphomas passaged intramuscularly into syngeneic recipients. We report that lymphomas that bind well to HEV (as assessed in a quantitative in vitro assay) disseminate widely via the blood, involving all lymph node groups symmetrically. Although both HEV-binding and nonbinding lymphomas gain access to the blood, gross involvement of lymph nodes by nonbinding lymphomas is limited to nodes draining local tumor at the site of injection, a prominent feature of these lymphomas; distant lymph nodes are not enlarged. The results suggest that the expression of functional receptors for HEV either controls the hematogenous dissemination of malignant lymphocyte populations to HEV-bearing organs, or is coregulated with factors determining this metastatic behavior. The findings support the concept that normal lymphocyte homing mechanisms are important to the spread of leukemias and lymphomas. PMID- 3655656 TI - Interferon beta 1, an intermediate in the tumor necrosis factor alpha-induced increased MHC class I expression and an autocrine regulator of the constitutive MHC class I expression. AB - In conclusion, our observations indicate that the constitutive MHC class I expression is regulated by autocrine production of IFN-beta 1. TNF-alpha acts as an enhancer of the autocrine production of IFN-beta 1, and consequently as an enhancer of the MHC class I expression and viral protection. PMID- 3655658 TI - Macrophages as origin of factor increasing monocytopoiesis. AB - Earlier investigations had indicated that the factor increasing monocytopoiesis (FIM), present in the serum of mice and rabbits during the onset of an inflammatory response, is released by cells of the inflammatory exudate. The present study was performed to determine which cells produce and secrete this factor and to establish the kinetics of its production and secretion. FIM was assayed in vivo by intravenous injection of samples into untreated mice and monitoring the course of the number of blood monocytes in the recipients. FIM was assayed in vitro by adding samples to cultures of the macrophage cell line PU5 and determining the rate of proliferation of the cells. The results show that only macrophages contain and synthesize FIM. This factor is secreted upon exposure to a phagocytic stimulus, and after the release of preformed FIM, macrophages secrete newly synthesized FIM. Granulocytes and lymphocytes neither contain nor secrete FIM. The characteristics of FIM derived from macrophages are in all aspects similar to those of FIM in serum. Macrophage-derived FIM is a protein with a molecular weight between 10 and 25 X 10(3), its activity is cell lineage specific and dose dependent, and it stimulates monocyte production in the bone marrow. Macrophage-derived FIM is not identical to either CSF-1 or IL-1, and has no chemotactic activity. Taken together, the present results show that FIM occurring in serum during an inflammatory response originates from macrophages at the site of the inflammation. In this way the macrophages themselves regulate the supply of circulating blood monocytes that can migrate to the site of injury when needed. PMID- 3655657 TI - Cloning and sequencing of murine T3 gamma cDNA from a subtractive cDNA library. AB - The coding sequences of the murine and human T3 gamma chains are of identical length (182 amino acids) and contain a remarkable conservation of residues. The most striking observation is the high degree of homology between the murine and human cytosolic domains (89%), suggesting that the effector function of the T3 complex may be extremely similar or identical within human and murine lymphocytes. Both murine and human T lymphocytes can express two T3 gamma mRNA transcripts, suggesting that a second polyadenylation signal is present downstream. A poly(A) tail is not found in the 3' untranslated region of the murine gamma presented here, indicating that the murine clones analyzed represent mRNA generated by reading through the overlapping poly(A) signals at position 850 860 and possibly terminating at a position that would produce the 1.0 kb transcript. PMID- 3655659 TI - Inhibition of antibody-dependent lymphocyte cytotoxicity by homologous restriction factor incorporated into target cell membranes. AB - The 65 kD homologous restriction factor (HRF) was isolated from normal human erythrocytes (E) by immunoadsorption using rabbit anti-human HRF. The protein was radiolabeled and incorporated into the membrane of sheep erythrocytes (Es). Es bearing HRF exhibited a markedly reduced susceptibility to reactive lysis by C5b 9. Es-HRF with 1,000-3,000 HRF molecules per cell and sensitized with rabbit IgG anti-Es also were less susceptible to lysis by human large granular lymphocytes (LGL) than untreated Es sensitized with IgG antibody. Similarly, human E of a patient with paroxysmal nocturnal hemoglobinuria (PNH), lacking HRF and sensitized with IgG antibody underwent lysis by human LGL. Lysis was abrogated by incorporation of isolated human HRF. Incorporation of human decay-accelerating factor (DAF) into sensitized Es had no effect on antibody-dependent, cell mediated cytotoxicity. Furthermore, lysis of Es by the isolated cytolytic C9 related protein (C9RP) of human cytotoxic lymphocytes could be inhibited by cell bound human HRF. These results suggest that HRF inhibits channel formation not only by C5b-9, but also by cytotoxic lymphocytes. PMID- 3655661 TI - Selenium concentrations in the blood and urine of a healthy Polish sub population. AB - Selenium (Se) levels in whole blood, red blood cells, and plasma taken from 199 healthy subjects were investigated and found to be 101.1 micrograms/1 (whole blood), 133.1 micrograms/1 (packed red blood cells), and 78.0 micrograms/1 (plasma). In 62 samples of urine, the selenium level, expressed as micrograms/g creatinine, was 11.4. The mean whole blood selenium concentration was significantly higher in men than women: 104.5 +/- 23.2 vs. 96.9 +/- 21.2 micrograms/1. No differences were found in red blood cells, plasma and urine between male and female subjects. A strong linear correlation was observed between red blood cell and whole blood selenium levels (r = 0.879; p less than 0.001) as well as between selenium levels in whole blood and plasma (r = 0.806; p less than 0.001). A weaker but still significant linear correlation was found between urine and whole blood as well as between urine and plasma selenium concentrations. The relatively low levels of the element in the blood and urine are probably due to its deficiency in the diet. PMID- 3655660 TI - Renal ammonia production from the nitrogens of glutamine in intact acidotic dogs before and after bicarbonate infusions. AB - Renal ammonia is produced from the amide nitrogen of glutamine, approximately 33 50%. The remainder derives from the amino nitrogen of glutamine and other non amide sources, probably the amino nitrogens of other amino acids. We investigated the acute effects of acid-base perturbations on ammonia production from amide and non amide nitrogen sources to determine how they interrelate. Infusions of glutamine were given to some intact dogs to vary the renal load. Following an acute alkali challenge to dogs in metabolic acidosis, ammoniagenesis from the amide nitrogens decreased significantly when the presentation of glutamine to the kidney was normal or relatively low, but changed less or even increased when the glutamine load was relatively high. In contrast, ammonia from the non amide sources consistently decreased during acute alkalotic challenge at any glutamine load-high or low. Since decreased glutamine deamination leading to glutamate accumulation is generally associated with decreased deamidation in dogs with normal plasma glutamine concentrations, we explain the discrepancy of deamidation at high glutamine loads to an unmasking of a separate effect on the glutaminase (phosphate-dependent) pathway by the acute acid-base changes. Accordingly, our results indicate more than one influence from acute acid-base changes in vivo on renal ammonia formation, one stimulatory and other inhibitory. Nevertheless, the influence of glutamate removal predominates over the other effect on the phosphate-dependent glutaminase pathway at physiological concentrations of glutamine in the intact dog. PMID- 3655662 TI - Cholestasis in late metabolic acidosis of prematurely born infants. AB - Serum concentrations of bile acids and tyrosine were determined in 14 premature infants with late metabolic acidosis and in 13 comparable controls without acidosis (protein intake 2 g/kg X d). At the same time the bile acids and the catalytic activity concentrations of lipase and trypsin were estimated in the duodenal juice. The daily faecal excretion and the percentage of fat eliminated were measured. In 8 patients with late metabolic acidosis the duodenal studies were repeated one week after late metabolic acidosis. Infants with late metabolic acidosis showed significantly higher concentrations of bile acids and tyrosine in the serum than the controls (p less than 0.0005). In the duodenal juice the activities of lipase and trypsin and the concentration of bile acids--especially of dihydroxy bile acids--were decreased (p less than 0.001). The faecal excretion during late metabolic acidosis was significantly increased, with high percentage of fat. Eight days after late metabolic acidosis all duodenal parameters equalled the range of the control group. The relations between acidosis, cholestasis, and amino acid transport to the liver are discussed. PMID- 3655663 TI - [The clinical significance of sialic acid in the serum in benign and malignant disease]. AB - The concentrations of sialic acid in the serum of patients with benign and malignant diseases were determined and the criteria of diagnostic validity (sensitivity, specificity, efficiency, likelihood ratio, predictive values) were calculated. The concentrations of sialic acid in sera of patients with benign diseases (median 0.826 g/l, 5. percentile 0.62 g/l, 95. percentile 1.27 g/l, p less than 0.001) and malignant diseases (median 0.90 g/l, 5. percentile 0.67 g/l, 95. percentile 1.48 g/l, p less than 0.001) were significantly higher than those in a population of healthy persons (median 0.62 g/l, 5. percentile 0.52 g/l, 95. percentile 0.78 g/l). In malignant diseases, the serum sialic acid concentrations are significantly higher (p less than 0.005) than those in benign diseases. In the group of benign diseases marked increases were seen in patients with rheumatoid arthritis and collagenoses (median 1.03 g/l) and infectious inflammatory diseases (median 0.97 g/l). In the group of malignant diseases increases were seen in cases of gastrointestinal carcinomas (median 1.1 g/l), bladder tumours (n = 2, 1.12 g/l, 1.08 g/l) and carcinoma of the uterus (median 1.0 g/l). The sensitivity at a decision limit of 0.78 g/l for benign diseases is 0.68, for malignant diseases 0.83 and for both categories 0.71. The specificity for benign diseases is 0.94, for malignant diseases 0.32, for both categories 0.94. For benign diseases, the positive predictive values at a decision limit of 0.78 g/l are 0.55 and 0.72 (given prevalences 0.1 and 0.2, respectively); for malignant diseases, 0.11 and 0.23 (prevalences 0.1 and 0.2); for both categories 0.77 and 0.88 (prevalences of 0.1 and 0.2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655664 TI - The effect of pH and temperature on the stability and enzymatic activity of prostatic acid phosphatase. Studies on the optimization of a continuous monitored determination of acid phosphatase, II. AB - The catalytic activity and the stability of prostatic acid phosphatase were studied with respect to pH and temperature: 1. Enzymatic activity in serum decreases with time, and the rate of decrease depends on pH and temperature. Half life times were estimated. 2. To preserve at least 90% of its original activity, serum must be cooled as soon as possible below room temperature and/or the pH must be lowered to 6. 3. Considering the effect of pH on side reactions and kinetic parameters, a pH of 5.2 is recommended for the assay. 4. Between 25 and 37 degrees C, the value for Km app, in the absence of alcohols, is constant within the limits of error. In the presence of alcohols there is a significant increase of Km app at lower temperatures, and higher substrate concentrations are needed to avoid nonsaturation of the enzyme. vmax increases with temperature. Inactivation is observed above 45 degrees C, especially in the presenc of alcohols. 5. The Arrhenius plot shows a strict linear regression between 20 degrees C and 40 degrees C, in the presence or absence of 1,4-butanediol, 1,5 pentanediol or 1,6-hexanediol. 6. Temperature conversion factors for catalytic activity were calculated to be: 1.33 (25 to 30 degrees C), 1.96 (25 to 37 degrees C) and 1.47 (30 to 37 degrees C). PMID- 3655665 TI - Ethylene glycol-stabilized haemolysates for glycated haemoglobin assay. Further analytical investigations and applications to quality control programmes. AB - The direct effect of the ethylene glycol on the quantitation of glycated haemoglobins by ion-exchange minicolumn chromatography, affinity chromatography and high performance liquid chromatography was investigated. No evident effect was found for ethylene glycol concentrations between 0.0 and 0.5 (volume fraction). The ethylene glycol-stabilised haemolysates were also analysed by HPLC: the elution profiles were similar to those of haemolysates fresly prepared from whole blood, and they remained unchanged, even after 18 months of storage at -20 degrees C. A preliminary inter-laboratory trial among 15 Italian laboratories was organized, using these ethylene glycol-stabilised haemolysates and, for comparison, a lyophilized commercial preparation. From the data obtained in this trial we confirmed the validity of using ethylene glycol-stabilized haemolysates as control materials, both for intra- and inter-laboratory standardization of glycated haemoglobin measurements. PMID- 3655667 TI - Health care in Nicaragua. PMID- 3655666 TI - [Recommendation of the Deutsche Forschungsgemeinschaft. Senate Commission for Clinical-Toxicological Analysis. Working group for Analytical and Technical Developments. Recommendations on high performance liquid chromatography. 9 March 1987]. PMID- 3655668 TI - Initial prescription filling. PMID- 3655669 TI - Results of reminding family physicians about administration of flu vaccine. PMID- 3655670 TI - Painless sigmoidoscopy. PMID- 3655671 TI - Women's adjustment to marital separation. PMID- 3655672 TI - The gay-lesbian patient and the family physician. PMID- 3655673 TI - Reduction of adverse drug reactions by computerized drug interaction screening. AB - Computerized drug-interaction screening systems (CDISS) have been developed as a tool to help decrease the enormous morbidity and expense related to adverse drug interactions. In previous studies the CDISS was used primarily by pharmacists in hospital settings to screen for interactions after the prescription had been written. This study tests the feasibility of family physicians using CDISS before writing the prescription to allow for changes in the prescription while the patient is still in the office. In a 30-day period, 103 patients were screened by family physicians for potential drug-drug, drug-alcohol, and drug-food interactions. Potential drug interactions of varying clinical significance were detected for 71 patients (68.9 percent). The prescription plan was changed for 16 patients (15.5 percent) as a result of using the CDISS. Participating physicians reported that they gained new information in 45.8 percent of the patient encounters, that their awareness of the potential for drug interactions was heightened by participation in this study, and that their exposure to the CDISS was worthwhile as an educational tool. While a few problems, mainly logistic, were noted with the CDISS as used in this study, the authors conclude that with modifications a CDISS can be of great educational and clinical value to the family physician and his or her patients. PMID- 3655674 TI - Characteristics of mother-infant interactions in nonorganic failure to thrive. AB - Nonorganic failure to thrive (NOFTT) is characterized by physical and developmental retardation and a disturbed mother-infant relationship. This study sought to quantify differences in interactions between mother-NOFTT infant pairs and control mother-thriving infant pairs. Eleven mother-NOFTT infant dyads and 11 control mother-infant dyads were videotaped for 30 minutes through a one-way mirror. Mother and infant behaviors were evaluated for 21 behavioral categories: 12 maternal, 7 infant, and 2 mutual. Statistically significant differences were noted in five (24 percent) categories. The quantity of maternal and infant vocalizations and the responsiveness of the mother to the infant's vocal cues were strikingly reduced in the NOFTT dyads. PMID- 3655675 TI - Family physicians' activities in nursing homes: the Minnesota experience. AB - The Minnesota Academy of Family Physicians surveyed its members to determine their nursing home activities. The response rate was 66 percent. Eighty-three percent of members who responded had made at least one nursing home visit in the previous month. Nearly one half (48.1 percent) of physicians not currently caring for nursing home patients would continue to treat their own patient if that person were admitted to a nursing home. As the number of years in medical practice increased, statistically significant increases occurred in (1) the percentage of a practice composed of geriatric patients, (2) the number of visits made to nursing home patients, and (3) the number of hours and days spent in nursing homes. Physicians caring for nursing home patients (1) live in smaller communities, (2) spend more days each week in the office, (3) are not residency trained, (4) are board certified, and (5) have a greater percentage of patients in the geriatric age group. Physician nonparticipation in nursing homes was due to (1) too few nursing home patients in the practice, (2) inconvenience, and (3) excessive paperwork. PMID- 3655676 TI - Venomous snakebites in the United States. AB - Venomous snakebite treatment is controversial. Venomous snakebites are known to occur in all but a few states. Approximately 10 to 15 individuals die from snakebites each year, with bites from diamondback rattlesnakes accounting for 95 percent of fatalities. The identification of the two endogenous classes of venomous snakes are discussed in detail to aid in determining the proper treatment for each class. Approximately 25 percent of all pit viper bites are "dry" and result in no envenomation. The best first aid is a set of car keys to get the victim to a facility where antivenin is obtainable. Incision and suction should be limited to very special situations; cryotherapy and use of tourniquets applied by laymen should be avoided. Proper medical management at a health care facility requires establishing whether envenomation has occurred and to what extent, followed by appropriate dosing of antivenin. The use of corticosteroids and antibiotics is controversial. Tetanus immunization should be updated, if necessary. Although research in developing a more purified antivenin is under way, the best treatment for snakebite is prevention. PMID- 3655677 TI - The baseline screening electrocardiogram: is it worthwhile? An affirmative view. PMID- 3655678 TI - The baseline screening electrocardiogram: is it worthwhile? An opposing view. PMID- 3655679 TI - Bilateral ectopic pregnancy: a case report. PMID- 3655681 TI - The histogenesis of the rat adrenal cortex: a study based on histologic analysis of mosaic pattern in chimeras. AB - A series of chimeric rats was used to investigate the histogenesis of the adrenal cortex. These animals were produced by amalgamating preimplantation embryos of two congenic strains which express different alloantigens of the major histocompatibility system. The manner in which cells assort themselves during embryogenesis and organ renewal is amenable to analysis by using radiolabeled antibodies directed to the class I antigens. Mosaic pattern analysis of the adrenal cortex of these rats revealed that a clonal pattern of division was maintained across all three histogenic zones of the organ, even in highly unbalanced chimeric combinations. No apparent relationship existed between the proportion of cell types and the area of contiguously similar lineage (patch size). In the series examined, the percentage of cells derived from the PVG-RT1a lineage varied from 5 to 85%. The number of parallel cords varied from 6 to 28. The pattern analysis of informative corners of cross sections of the gland supports the thesis that organ maintenance is the result of cell division from the outside of the cortex toward the inside medullary surface. PMID- 3655680 TI - Hashimoto's thyroiditis: an unusual sequela. PMID- 3655682 TI - Influence of chromatographic fractions of extracts derived from bovine neural retina on newt (Notophthalmus viridescens) lens regeneration in vitro. AB - Removal of the ocular lens in adult newts (Notophthalmus viridescens) is followed by a series of cellular events leading to regeneration of a new lens by cell type conversion of pigmented iris epithelial cells at the dorsal pupillary margin (Yamada, Curr. Top. Dev. Biol. 2:247-283, 1967). Following depigmentation and five to seven cell divisions, iris epithelial cells redifferentiate into lens fiber cells and synthesize crystallin proteins (Yamada, Curr. Top. Dev. Biol. 2:247-283, 1967). This process is dependent upon neural retina in vivo (Stone, Anat. Rec. 131:151-172, 1958; Reyer, Dev. Biol. 14:214-225, 1966) and in vitro (Yamada et al., Differentiation 1:65-82, 1973). Acting on the hypothesis that the role of the neural retina is to promote passage of iris epithelial cells through the requisite number of cell cycles which will then allow them to redifferentiate as lens fiber cells (Yamada, in: Cell Biology of the Eye. Academic Press, New York, 1982), we undertook testing of the effects of eye-derived mitogenic substances, as well as other mitogens, on regeneration of lens from iris in organ culture. We have previously defined a critical period for the retinal influence in vivo and in vitro, and have shown that crude extracts of retina can enhance regeneration of lenses in culture (Connelly et al., J. Exp. Zool., 240:343-351, 1986). In this paper, we report on the lens regeneration enhancing activity (LRA) of more highly purified fractions of the retinal extracts. Heparin-sepharose chromatography of the crude retinal extract yields three fractions (Courty et al., Biochemie 67:265-269, 1985) called EDGF I, II, and III. EDGF I and II have affinity for heparin, while EDGF III does not. In our bioassay, LRA appears only in the EDGF III fraction. Dialysis of EDGF III against 0.1 N acetic acid yields a fraction which has affinity for cibacron blue sepharose (eluting at 2.15 M salt) and also has significant LRA. Because insulin at high doses has a marginal effect on lens regeneration in culture (Williams and McGlinn, Am. Zool. 19:923, 1979; Connelly, Differentiation 16:85-91, 1980), we tested IGF-I. Because of the putative neurotrophic effects of transferrin (Tf) (Mescher and Munaim, J. Exp. Zool., 230:485-490, 1986), we tested Tf for its ability to enhance regeneration of the lens in culture. IGF-I seems to have an enhancing effect on lens regeneration; Tf does not. PMID- 3655683 TI - Effects of calcium antagonists, calmodulin antagonists, and methylated xanthines on polar lobe formation and cytokinesis in fertilized eggs of Ilyanassa obsoleta. AB - We have studied the ability of fertilized eggs of Ilyanassa obsoleta to undergo polar lobe formation and cytokinesis in the presence of Ca2+ antagonists (Ca2+ channel blockers, Ca2+ uptake inhibitors). Earlier work had suggested little need for exogenous Ca2+ during these cellular shape changes. Again it appears that exogenous Ca2+ probably is not required, based on cell ability to undergo the shape changes with no, or only minor, delay in the presence of 50 mM La3+ at pH 6.5, 10 mM concentrations of Ni2+ or Co2+, 1 mM Cd2+, and 100 microM concentrations of Mn2+, papaverine, verapamil, D600, or diltiazem. In nominally Ca2+-free seawater (containing approximately 10 microM Ca2+) (CFSW), there still is no effect of Cd2+ (up to 100 microM), Ni2+, Co2+, Mn2+, or diltiazem; however, papaverine, verapamil, and D600 in CFSW cause longer delays in the shape changes than they do in the presence of normal levels of Ca2+ (SW). In 10-50 microM nifedipine, shape changes are progressively delayed to the same extent in both SW and CFSW, but more so in CFSW at concentrations above 50 microM nifedipine. Among calmodulin antagonists, trifluoperazine up to 100 microM was without effect, but chlorpromazine at 25-100 microM and calmidazolium at 50-100 microM caused substantial, concentration-dependent delays in the starting times for the shape changes. Methylxanthines caused a substantial speed-up in the starting times for both polar lobe formation and cytokinesis. The most effective of these, caffeine, at optimal concentrations of 0.7-10 mM in SW or CFSW caused shape changes to occur 12-15 min earlier than in controls undergoing a normal 50-min cycle. Caffeine is known to cause release of Ca2+ from muscle sarcoplasmic reticulum. A putative antagonist of intracellular Ca2+ mobilization, TMB-8, significantly inhibited the shape changes of the Ilyanassa cells, whereas a variety of inhibitors of exogenous Ca2+ uptake noted above did not inhibit. We conclude that Ca2+ may be necessary for polar lobe formation and cytokinesis in Ilyanassa cells, but that it may be released from intracellular, sequestered stores rather than derived from exogenous sources. PMID- 3655684 TI - Scanning electron microscope studies of sperm incorporation into the zebrafish (Brachydanio) egg. AB - Morphological studies on the gametes and entry of the spermatozoan into the egg of the zebra danio, Brachydanio rerio, were conducted primarily with scanning electron microscopy. The spermatozoan showed a spherical head, which lacked an acrosome, a midpiece containing several mitochondria, and a flagellum. Observations of the unfertilized egg confirmed and extended prior studies showing a distinct cluster of microvilli on the plasma membrane, identified as the sperm entry site, beneath the inner micropylar aperture (Hart and Donovan, '83). The fertilizing spermatozoan attached to the sperm entry site within 5 seconds of the mixing of a gamete suspension. Binding to the egg microvilli appeared restricted to the equatorial surface of the spermatozoan. Fusion between the plasma membranes of the interacting gametes was followed by the formation of a distinct, nipple-shaped fertilization cone. The sperm head was partially incorporated into the fertilization cone cytoplasm by 60 seconds postinsemination. The incorporation of the entire sperm head, midpiece, and a portion of the flagellum occurred between 1 and 2 minutes. During this time, the fertilization cone shortened and was transformed into a massive, blister-like cytoplasmic swelling. Concurrently, upward movements of the ooplasm resulted in the gradual disappearance of the original depression in the egg surface containing the sperm entry site. The second polar body, fully developed by 10 minutes postinsemination, formed approximately 10-15 microns from the site of sperm penetration. Development of the fertilization cone, formation of the second polar body and exocytosis of cortical granules at the sperm entry site readily occurred in parthenogenetically activated eggs, indicating that these surface rearrangements do not require sperm binding and/or fusion. PMID- 3655685 TI - Involvement of thiol-disulfide groups in the sensitivity of fully grown mouse oocytes to calcium-free medium. AB - The lethality caused by calcium-free medium (CFM) to fully grown mouse oocytes significantly decreases if a disulfide reducing agent (dithiothreitol, reduced glutathione, or L-cysteine) is added to the medium. In this condition, most of the surviving oocytes do not spontaneously resume meiosis. We also show that the sulfhydryl content of fully grown oocytes, estimated by monobromobimane labeling, rapidly decreases during culture in CFM. The hypothesis is discussed that lethality of oocytes cultured in CFM may be a consequence of an alteration of thiol-disulfide balance. PMID- 3655686 TI - Rates of male pronuclear enlargement in sea urchin zygotes. AB - Rates of male pronuclear enlargement were determined using synchronous populations of fertilized sea urchin eggs (Arbacia punctulata and Lytechinus variegatus), fixed at regular intervals following insemination and stained with Hoechst 33342. The rate of male pronuclear expansion in both Arbacia and Lytechinus zygotes was linear and significantly affected by polyspermy, temperature, metabolic inhibitors (dinitrophenol, potassium cyanide, sodium azide, antimycin A, and oligomycin), and blockage of cytoplasmic alkalinization. Inhibitors of protein synthesis (emetine and puromycin) and disrupters of cytoskeletal elements (colchicine, nocodazole and cytochalasin B) had no effect on the rate of male pronuclear enlargement. PMID- 3655687 TI - Actin-plasma membrane associations in mouse eggs and oocytes. AB - Using rhodamine-phalloidin stained preparations and extracted specimens labeled with heavy meromyosin or run on polyacrylamide gels, actin-plasma membrane associations in mouse mature eggs at the second metaphase of meiosis and oocytes at meiotic prophase have been examined. Cortices of extracted oocytes possessed numerous actin filaments that emanated from the plasma membrane delimiting regions between microvilli and from microvillar apices. The membrane anchorage sites of actin filaments were marked by an electron dense material on the inner leaflet of the plasma membrane. The free ends of filaments emanating from the plasma membrane of oocytes intermeshed to form a dense, cortical layer. With meiotic maturation, changes in the organization of cortical actin were first noted approximately 3 hr after the chromosomes had become localized at the oocyte's periphery. Fewer and shorter actin filaments, which did not form a well defined layer as in oocytes, were connected with electron-dense material to the inner leaflet of the plasma membrane of extracted egg cortices in regions other than that associated with the meiotic spindle. Cortical actin adjacent to the meiotic spindle, however, was organized into a dense, cresentic aggregation in which clusters of filaments emanated from electron-dense regions associated with both the inner and outer leaflets of the plasma membrane. These observations indicate that mouse oocyte maturation not only involves changes in the distribution of cortical actin but also local alterations in the association of actin with the plasma membrane. PMID- 3655688 TI - The Chaetopterus vitelline envelope is not necessary for the gamete interactions that lead to fertilization. AB - It has been recently shown that, in several genera of annelids, including Chaetopterus, fertilizing sperm attach to and fuse with egg microvilli which penetrate the vitelline envelope. This suggests that the annelid vitelline envelope may have no direct or obligatory role in normal fertilization. The present study was undertaken to investigate the involvement of the vitelline envelope in fertilization in Chaetopterus experimentally, by examining the fertilization of vitelline envelope-free eggs quantitatively and qualitatively. Brief exposure of the eggs to isotonic sucrose-EDTA removed the vitelline envelope as determined by both phase-contrast and electron microscopy, rendered the eggs more sensitive to polyspermy and substantially reduced the binding of supernumerary sperm to eggs but did not decrease fertilizability as determined by sperm dilution assay and did not make the eggs more sensitive to cross fertilization. The events of fertilization were examined by electron microscopy and found to be very similar in vitelline envelope-free eggs to those in intact eggs. We conclude that the vitelline envelope in Chaetopterus has binding sites for sperm but that it has no obligatory role in fertilization and is primarily involved in the prevention of polyspermy. PMID- 3655690 TI - The task force report on tort reform: a bugle call for drastic changes. PMID- 3655689 TI - Characterization of human sperm plasma membrane: glycolipids and polypeptides. AB - The plasma membranes from ejaculated human spermatozoa were removed by nitrogen cavitation (600 PSI for 10 min) and isolated by centrifugation followed by a discontinuous sucrose density gradient centrifugation. Glycolipid analysis of the plasma membrane revealed a three-fold enrichment in gangliosides: GM3 and GD1a/GD1b and neutral glycolipids: globoside and sulfatide as compared to that of whole human sperm. Two dimensional electrophoresis of human sperm plasma membranes revealed about 75 polypeptides. Several of these polypeptides were similar in migration and in display of shape and color to that found in boar sperm plasma membranes. PMID- 3655691 TI - Ethical concerns in medicine. PMID- 3655692 TI - Telling stories as a way of doing ethics. PMID- 3655694 TI - Medical ethics and the medical entrepreneur: are they compatible? PMID- 3655695 TI - The pale blue eyes of Jeffy Glick. PMID- 3655696 TI - Metaphors in medicine: a concept of physicianhood. PMID- 3655693 TI - The challenge of the ethical life in medicine. PMID- 3655697 TI - Withdrawing medical treatments: the difficult case of withdrawing nutrition. PMID- 3655698 TI - The Florida Medical Examiners Commission Ethical Advisory Committee. PMID- 3655699 TI - Ethics in medicine: the President's Special Committee on Ethics of the Board of Governors. PMID- 3655700 TI - Forensic science and the justice system in the late twentieth century. PMID- 3655701 TI - Medical technology: a viable source of criminalists. PMID- 3655702 TI - Mode of contracture inducing action of sodium selenite on the mouse diaphragm. PMID- 3655703 TI - Estrogen and progesterone receptors in decidualized uterus of pseudopregnant hamsters. PMID- 3655704 TI - Effect of human albumin on the assay of the serum free thyroxine levels by T4 analog radioimmunoassay. PMID- 3655705 TI - Comparison of serum hepatitis B virus DNA with other serological viral markers in liver diseases. PMID- 3655706 TI - Subcutaneous tumor of mice treated with hematoporphyrin derivative and laser radiation. PMID- 3655707 TI - Treatment of refractory acute leukemia with high-dose cytosine arabinoside. PMID- 3655708 TI - Penetration of moxalactam into the cerebrospinal fluid and its application in therapy of bacterial meningitis. PMID- 3655709 TI - Pharmacokinetics of theophylline in Chinese asthmatics. PMID- 3655710 TI - Analysis of body weight gain and estimation of additional energy costs during normal pregnancy in Taiwan and Japan. PMID- 3655711 TI - [Comparison of glucose reflectance meters for self-monitoring of blood glucose in diabetics]. PMID- 3655712 TI - [Survival of patients with malignant pleural effusion]. PMID- 3655713 TI - [Tuberculous aortitis complicated with rupture of aorta: report of a case]. PMID- 3655714 TI - Multiple oral cancers: report of 2 cases. PMID- 3655715 TI - A case of persistent positional vertigo treated by microvascular decompression. PMID- 3655716 TI - The control of Na+/H+ exchange by molecular oxygen in trout erythrocytes. A possible role of hemoglobin as a transducer. AB - It has previously been shown that addition of catecholamines to a suspension of trout erythrocytes induces an enlargement of the cells owing to an uptake of NaCl mediated by a cAMP-dependent, amiloride-sensitive Na+/H+ exchange. In this article, we show that the change in cell volume induced by catecholamines is much greater when the erythrocytes are incubated in N2 than when they are in O2. This difference is explained by an inhibition of the cAMP-dependent Na+/H+ exchange by O2. The inhibition is not reversed in cells incubated in O2 but poisoned with cyanide. It cannot be explained by a difference in the content of cAMP in O2 and in N2. In a CO atmosphere, in which the cells are anoxic, swelling and Na permeability are not increased as they are in N2: in CO, the cells behave as they do in O2. Moreover, cells previously exposed to CO and then put in an N2 atmosphere do not show the expected increase in Na+/H+ exchange. This strongly indicates that the binding of CO to hemoglobin, which persists during the subsequent exposure to N2, is the primary event responsible for the inhibition. As CO substitutes for O2 in binding to hemoglobin, the effect of O2 in the control of Na+/H+ exchange is probably explained by this interaction with heme. (Allen and McManus [1968. Biophysical Journal. 8:125a] previously described a similar effect of CO on passive Na permeability in duck red cells.) It is proposed that the hemoglobin, by interacting differently, according to its degree of oxygenation, with the cytoplasmic segment of band 3 protein, may influence some transport function, such as Na+/H+ exchange. The physiological significance of a control of Na+/H+ exchange by molecular O2 is discussed. PMID- 3655717 TI - Activation of electroneutral K flux in Amphiuma red blood cells by N ethylmaleimide. Distinction between K/H exchange and KCl cotransport. AB - Exposure of Amphiuma red blood cells to millimolar concentrations of N ethylmaleimide (NEM) resulted in net K loss. In order to determine whether net K loss was conductive or was by electroneutral K/H exchange or KCl cotransport, studies were performed evaluating K flux in terms of the thermodynamic forces to which K flux by the above pathways should couple. The direction and magnitude of the NEM-induced net K flux did not correspond with the direction and magnitude of the forces relevant to K conductance or electroneutral KCl cotransport. Both the magnitude and direction of the NEM-activated K flux responded to the driving force for K/H exchange. We therefore conclude that NEM-induced K loss, like that by osmotically swollen Amphiuma red blood cells, is by an electroneutral K/H exchanger. In addition to the above studies, we evaluated the kinetic behavior of the volume- and NEM-induced K/H exchange flux pathways in media where Cl was replaced by SCN, NO3, para-aminohippurate (PAH), or gluconate. The anion replacement studies did not permit a distinction between K/H exchange and KCl cotransport, since, depending upon the anion used as a Cl replacement, partial inhibition or stimulation of volume-activated K/H exchange fluxes was observed. In contrast, all anions used were stimulatory to the NEM-induced K loss. Since, on the basis of force-flow analysis, both volume-and NEM-induced K loss are K/H exchange, it was necessary to reevaluate assumptions (i.e., anions serve as substrates and therefore probe the translocation step) associated with the use of anion replacement as a means of flux route identification. When viewed together with the force-flow studies, the Cl replacement studies suggest that anion effects upon K/H exchange are indirect. The different anions appear to alter mechanisms that couple NEM exposure and cell swelling to the activation of K/H exchange, as opposed to exerting direct effects upon K and H translocation. PMID- 3655718 TI - Extra calcium on shortening in barnacle muscle. Is the decrease in calcium binding related to decreased cross-bridge attachment, force, or length? AB - Barnacle single muscle fibers were microinjected with the calcium-specific photoprotein aequorin. We have previously shown (Ridgway, E. B., and A. M. Gordon, 1984, Journal of General Physiology, 83:75-104) that when barnacle fibers are stimulated under voltage clamp and length control and allowed to shorten during the declining phase of the calcium transient, extra myoplasmic calcium is observed. The time course of the extra calcium for shortening steps at different times during the calcium transient is intermediate between those of free calcium and muscle force. Furthermore, the amplitude increases with an increased stimulus, calcium transient, and force. Therefore, the extra calcium probably comes from the activating sites on the myofilaments, possibly as a result of changes in calcium binding by the activating sites. The change in calcium binding may be due, in turn, to the change in muscle length and/or muscle force and/or cross-bridge attachment per se. In the present article, we show that the amount of the extra calcium depends on the initial muscle length, declining at shorter lengths. This suggests length-dependent calcium binding. The relation between initial length and extra calcium, however, parallels that between initial length and peak active force. The ratio of extra calcium to active force is therefore virtually independent of initial length. These data do not distinguish between a direct effect of length on calcium binding and an indirect effect owing to changes in cross-bridge attachment and force through some geometrical factor. The amount of extra calcium increases with the size of the shortening step, tending toward saturation for steps of greater than or equal to 10%. This experiment suggests that calcium binding depends on muscle force or cross-bridge attachment, not just length (if at all). There is much less extra calcium seen with shortening steps at high force when the high force results from stretch of the active muscle than when it results from increased stimulation of muscle.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655719 TI - Surface localization of sialic acid on Actinomyces viscosus. AB - This study reports the presence of sialic acid in Actinomyces viscosus strains T14V and T14AV. Mild acid hydrolysis of whole organisms released a compound which reacted positively in the periodate-thiobarbituric acid, direct Ehrlich's and resorcinol assays, and which co-chromatographed on paper with authentic N acetylneuraminic acid. Strain T14V contained 10-fold greater concentrations of sialic acid than did strain T14AV. Sialic acid content was dependent upon the stage of growth of the culture, reaching a maximum in early stationary phase. Epifluorescence microscopy of fluorescein isothiocyanate (FITC)-conjugated Limulus polyphemus agglutinin (LPA), a lectin specific for sialic acid, revealed a uniform distribution of bound lectin on the surfaces of strains T14V and T14AV. Additional evidence for surface localization was obtained by demonstration of whole-cell agglutination of both strains with LPA. All LPA interactions with A. viscosus were inhibited by the presence of 0.1 M-N-acetylneuraminic acid. Neuraminidases from Clostridium perfringens, Arthrobacter ureafaciens and Vibrio cholerae did not release detectable amounts of sialic acid, but the extracellular enzyme from A. viscosus cleaved amounts equivalent to those obtained by acid hydrolysis. Other laboratory strains (W1053, M100, W859, 5-5S, RC45, ATCC 19246, and 'binder') as well as recent clinical isolates of A. viscosus were agglutinated by LPA and released sialic acid upon mild acid hydrolysis. Surface available sialic acid has been implicated in the inhibition of alternative complement pathway activation and subsequent opsonophagocytosis. Thus the occurrence of surface sialic acid in A. viscosus may represent a mechanism of pathogenesis for this oral bacterium. PMID- 3655720 TI - Acid phosphatases of Sporothrix schenckii. AB - Sporothrix schenckii cells were grown on a medium containing yeast extract, neopeptone and glucose at 20 degrees C to obtain a mixture of mycelia and conidia, and at 35 degrees C to obtain yeast-like cells. The organism was maintained in the mycelial form, and its transformation to yeast at the higher temperature proceeded via conidia and 'intermediate cells' that then gave rise to yeast by a blastic mechanism. Cell-free extracts were analysed by PAGE at pH 8.0 and acid phosphatases (EC 3.1.3.2) were revealed by a sensitive detection reagent at pH 5.0. Mycelial, conidial and yeast extracts all had some acid phosphatase activity (M-I, C-I and Y-I) at the origin, although the proportion was highest for the yeast extracts. All of the bands that penetrated the gels had different electrophoretic mobilities. Mycelial and conidial extracts each had one other isoenzyme (M-II and C-II), while the yeast extracts had a total of five electrophoretically distinct acid phosphatases. Isoenzyme Y-II was further resolved into five closely related bands (Y-IIa to Y-IIe), the relative intensities of which varied with the phosphate nutrition of the yeast cells and the history of the extracts. The acid phosphatase isoenzymes were inhibited to various extents by sodium fluoride, L(+)-tartrate and phosphate, and showed interactions with citrate as opposed to acetate as the background buffer at pH 5.0. PMID- 3655721 TI - Regulation of gene expression during aerobic germination of Mucor racemosus sporangiospores. AB - The pool of mRNA stored in dormant sporangiospores of Mucor racemosus and expressed during early germination in air has been investigated. Total RNA was extracted from dormant and germinating spores and translated in a cell-free rabbit reticulocyte system containing L-[35S]methionine. Isotopically labelled in vitro translation products were analysed by PAGE and autoradiography and were compared with labelled proteins synthesized in vivo at the same stages of development. This comparison revealed several significant findings about the fates of individual mRNA populations as templates in translation: (i) a pool of mRNA, presumably represented entirely or in part by a recoverable polyadenylated RNA fraction, can be extracted from dormant spores in a translatable form; (ii) most of the differential gene expression displayed at the level of protein synthesis during germination results from concomitant changes in functional mRNA levels; (iii) some of the stored mRNA species may be activated and others inactivated by post-transcriptional processing mechanisms; and (iv) a small population of gene products may be regulated at the level of selective translation of pre-existing messages. PMID- 3655722 TI - Uptake of galactose and lactose by Kluyveromyces lactis: biochemical characteristics and attempted genetical analysis. AB - Study of the lactose and galactose transport systems in Kluyveromyces lactis has shown that lactose uptake is by active transport. The transport system is under monogenic control and is inducible. Galactose uptake is also by active transport but the system is controlled by two genes which, in the four strains we studied, are present only in K. lactis CBS 2359. Galactose uptake in the other K. lactis strains is by a simple diffusion process. PMID- 3655723 TI - Determination of genome size and DNA homology between an unclassified Mycobacterium species isolated from patients with Crohn's disease and other mycobacteria. AB - The genome size of an unclassified Mycobacterium species, isolated from a patient with Crohn's disease, was determined by measurement of DNA renaturation kinetics as 3.1 X 10(9) Da. The percentage of DNA homology of this organism to DNA of related mycobacteria was evaluated by measurement of DNA renaturation with heterologous DNA. These studies supported the classification of this organism as Mycobacterium paratuberculosis but failed to distinguish between M. paratuberculosis and organisms of the Mycobacterium avium-intracellulare groups. PMID- 3655724 TI - Systematic analysis of the long-chain components of Eubacterium lentum. AB - The cellular long-chain component patterns of 33 strains of Eubacterium lentum were determined by gas chromatography. Two main types of long-chain component patterns were distinguished. The first (26 strains) was characterized by saturated branched-chain fatty acids (br14:0, br15:0, br16:0 and br17:0). The second (7 strains) did not contain branched-chain fatty acids and was characterized by saturated straight-chain fatty acids (11:0, 12:0, 14:0 and 16:0). Both types contained fatty aldehydes and their respective dimethyl acetals (14ald and 14dma, 16ald and 16dma). br16dma was only found in the first type. The G + C content of the DNA (Tm) of the 33 strains varied between 63.7 and 69.1 mol %. Canonical correlation analysis distinguished three subtypes within the first main type. PMID- 3655725 TI - Presence of several plasmids in the fungus Ascobolus immersus, and homologies with the linear plasmid pA1. AB - DNA analysis of several genetically unstable strains of the fungus Ascobolus immersus revealed the presence of at least seven different plasmids. These plasmids ranged from 2 to 20 kb in size, and showed homology to one of them, pA1. In 18 stocks directly isolated from nature, two-thirds harboured plasmids ranging from 3 to 17 kb. Plasmids with homology to pA1 had similar molecular masses (about 8.5 kb). A possible mechanism of plasmid formation from chromosomal DNA is discussed. PMID- 3655726 TI - Antitumour activity of purified arabinogalactan-peptidoglycan complex of the cell wall skeleton of Rhodococcus lentifragmentus. AB - Antitumour activity of arabinogalactan peptidoglycan (AP) complex (peptidoglycan and arabinogalactan liberated by an acid or alkaline treatment from Rhodococcus lentifragmentus AN-115 cell wall skeleton) was examined in mice and compared with that of the cell wall skeleton. The growth of syngeneic fibrosarcoma Meth A cells after implantation in BALB/c mice was significantly suppressed by AP complex, and also regressed after intratumoral injection of AP complex on days 1, 4 and 7 after tumour implantation. Although the activity of peptidoglycan was less than that of AP complex, peptidoglycan also showed both tumour-suppressive and regressive activities. Arabinogalactan did not show antitumour activity. It is interesting that peptidoglycan has an important role in the effect against tumours. PMID- 3655727 TI - Immunological characterization of an exopolysaccharide from the Staphylococcus aureus strain Smith diffuse. AB - Exopolysaccharides (EXPs) of Staphylococcus aureus are associated with virulence in animal models. An EXP from the S. aureus strain Smith diffuse was previously detected in 64.3% of S. aureus clinical isolates. EXP was isolated from culture supernatants of this strain after DNAase, RNAase, phosphodiesterase I and lysostaphin treatment, and was further purified by cation-exchange and molecular sieve chromatography. Isoelectric focusing revealed a pI of 3.6 for the EXP while the pI of teichoic acid was less than 2.7. Crossed immunoelectrophoresis with homologous Smith diffuse antisera indicated that the EXP contained two immunological components. A major precipitin line persisted after the antisera had been absorbed with the non-EXP-producing variant strain, Smith compact, while the second component was removed. Tandem immunoelectrophoresis also demonstrated that the EXP was distinct from teichoic acid. The EXP contained 2-amino-2 deoxyglucuronic acid, glucose, mannose and galactose. No fatty acids or nucleic acids were present and total protein content was less than 2%. Teichoic acid could not be demonstrated in the EXP, thus further substantiating the immunological studies. S. aureus EXP isolated by the present method can be used for further serological and virulence studies. PMID- 3655728 TI - Animal models in Q fever: pathological responses of inbred mice to phase I Coxiella burnetii. AB - The susceptibility of inbred strains of mice to infection by phase I Coxiella burnetii, the aetiological agent of Q fever, was investigated by evaluating morbidity, mortality, antibody production and in vitro proliferative responses of splenic lymphocytes. Among the 47 strains of mice tested for morbidity and mortality to C. burnetii infection, 33 were resistant, 10 were of intermediate sensitivity, and four were sensitive. A/J mice exhibited the highest mortality, and surviving mice of this strain yielded high concentrations of viable rickettsiae from essentially all organs for more than 3 weeks after inoculation. However, A/J mice developed a protective immune response after vaccination with inactivated C. burnetii cells. Induction of gross pathological responses and antibody production were similar in sensitive mice (strain A/J) and resistant mice (strain C57BL/6J). The LD50 of phase I C. burnetii for A/J mice was about 1000-fold lower than that for the more resistant C57BL/6J mice. Mice of both strains developed antibody titres against phase I cells, phase II cells, and phase I lipopolysaccharide after the injection of one or more viable phase I organisms of C. burnetii; five or more rickettsiae caused splenomegaly that was almost proportional to the infecting dose. Suppression of in vitro proliferative responses of splenic lymphocytes to concanavalin A, a T-cell mitogen, was apparent after infection of sensitive A/J mice with as few as one to five phase I micro-organisms. However, suppression of proliferation of splenic lymphocytes from resistant C57BL/6J mice required 10(7) phase I C. burnetii. PMID- 3655729 TI - Regulation of Chlamydia psittaci (strain guinea pig inclusion conjunctivitis) growth in McCoy cells by amino acid antagonism. AB - Chlamydiae have amino acid requirements for growth in tissue culture as defined by those amino acids whose individual omission from the growth medium prevents chlamydial multiplication. We have tested the hypothesis that this inhibition of growth arises as a result of antagonism between particular amino acids such that inhibition occurs when the concentration of one amino acid is reduced in the presence of the antagonist amino acid at high concentration. Using the Chlamydia psittaci strain guinea pig inclusion conjunctivitis (GPIC), in the presence of cycloheximide, the requirement for valine was abrogated by the simultaneous omission of isoleucine, that for phenylalanine by simultaneous omission of tryptophan and that for leucine by simultaneous omission of isoleucine plus valine. The antagonism shown between leucine and isoleucine plus valine appears to be unique among bacteria. In the absence of cycloheximide, GPIC had an additional need for tryptophan, tyrosine and isoleucine; these amino acid requirements were shown for both infected McCoy, HeLa and BHK cells. The results are consistent with a mechanism for regulation of parasite growth which depends on the balance of amino acid concentrations in the extracellular environment. PMID- 3655730 TI - DNA:DNA hybridization studies on the pink-pigmented facultative methylotrophs. AB - The genomic relatedness among 36 strains of pink-pigmented facultatively methylotrophic bacteria (PPFMs) was estimated by determination of DNA base composition and by DNA:DNA hybridization studies. A reproducible hybridization system was developed for the rapid analysis of multiple DNA samples. Results indicated that the PPFMs comprise four major and several minor homology groups, and that they should remain grouped in a single genus, Methylobacterium. PMID- 3655731 TI - Biochemical characteristics and fatty acid compositions of some armadillo-derived mycobacteria and their relation to Mycobacterium gordonae. AB - The long-chain components of 75 strains of mycobacteria, cultivated from Mycobacterium leprae-infected or non-infected armadillos, and of eight clinical and 15 environmental isolates of M. gordonae, were compared. Four major groups could be distinguished based on the presence of 10-methyloctadecanoic (tuberculostearic) and 2-methyl 3-hydroxyeicosanoic acids and secondary alcohols (2-octadecanol and 2-eicosanol). Some heterogeneity was found in strains assigned to M. gordonae: the characteristic absence of tuberculostearic acid and secondary alcohols and the presence of the branched C14 and the hydroxylated C20 acids were seen in only 34 of the 49 strains studied. Three strains were identified as M. malmoense, one as M. kansasii, ten as belonging to the M. avium-M. intracellulare M. scrofulaceum complex and eight as belonging to new groups of armadillo-derived mycobacteria (ADM 1, ADM 2 and ADM 3) by conventional bacteriological tests and fatty acid compositions, though M. malmoense was heterogeneous in its fatty acids composition. Four strains, identified as M. avium by conventional tests, differed from this species by their fatty acid compositions. Thirteen strains showed some similarity to M. simiae and ten strains differed from all other known mycobacteria. PMID- 3655732 TI - Correlation between the rate of exoprotein synthesis and the amount of the multiprotein complex on membrane-bound ribosomes (MBRP-complex) in Staphylococcus aureus. AB - The membrane-bound ribosome protein (MBRP)-complex of Staphylococcus aureus was studied using antibodies to its individual components. The four polypeptides of the complex were firmly held together, and none were present in large excess. The membrane-bound fraction of the MBRP-complex was accessible to trypsin only after removal of the membrane-bound ribosomes; it also remained associated with the membrane-bound ribosomes even after solubilization of the membranes with Triton X 100. Furthermore, the amount of MBRP-complex in the membrane was proportional to the rate of exoprotein synthesis. These results strongly suggest a role for the MBRP-complex in protein secretion. PMID- 3655733 TI - Chemical composition and immunobiological activities of sodium dodecyl sulphate extracts from the cell envelopes of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Fusobacterium nucleatum. AB - The chemical composition and immunobiological activities in vivo and in vitro of sodium dodecyl sulphate extracts (SDS-SE) derived from periodontopathic bacteria (three strains of Actinobacillus actinomycetemcomitans, two strains of Bacteroides gingivalis, and one strain of Fusobacterium nucleatum) were investigated. The main components of SDS-SE were protein and lipid, with negligible amounts of peptidoglycan and lipopolysaccharide. Immunopotentiating activity was detected in both delayed-type hypersensitivity and antibody formation against the elicitation of a protein antigen with the SDS-SE preparations of A. actinomycetemcomitans ATCC 29524 and B. gingivalis 381 and 1021. On the other hand the SDS-SE of A. actinomycetemcomitans ATCC 29522 enhanced only the induction of a delayed-type hypersensitivity response. All the SDS-SE preparations had mitogenic activity to splenocytes from BALB/c nu/nu, C3H/HeN and C3H/HeJ mice. Migration-stimulating activity for human peripheral blood monocytes was detected especially in the SDS-SE preparations of A. actinomycetemcomitans ATCC 29524 and Y4. All of the SDS-SE samples inhibited [3H]thymidine uptake in human gingival fibroblasts and caused degradation of the cells. The results suggest that the cell membrane components extractable with sodium dodecyl sulphate from periodontopathic bacteria are involved in the pathogenesis of periodontal disease. PMID- 3655734 TI - Transport, nutritional and metabolic studies of taurine in staphylococci. AB - A specific, Na+-dependent, energy-requiring transport system for taurine has been reported recently in the Staphylococcus aureus M strain. Taurine was taken up vigorously by all S. aureus strains tested. The system was Na+-dependent, and Na+ decreased the Km but had no effect on the Vmax of the transport system. Among coagulase-negative staphylococci, the Staphylococcus epidermidis group (a taxonomically related group of species associated with humans or other primates) and the free-living, wide-ranging species Staphylococcus sciuri showed vigorous taurine uptake. Somewhat lower rates were found in the Staphylococcus saprophyticus group. Low or barely detectable uptake rates were noted in other staphylococcal species that were primarily of animal origin. No taurine uptake was detected in a variety of other bacterial species tested. Taurine uptake, which was not Na+-dependent, occurred in a Pseudomonas aeruginosa strain grown on taurine as sole energy, carbon, nitrogen, and sulphur source, but not when it was grown in a gluconate/salts medium. In nutritional studies we were unable to demonstrate a role for taurine as a sulphur source for S. aureus. [1,2-14C]- and [35S]taurine were taken up during overnight growth of cells, and radioactivity was distributed similarly among cellular fractions, indicating that the carbon and sulphur atoms of taurine were not cleaved and had the same fate. We were unable to demonstrate any catabolism of taurine in radiorespirometric experiments to detect evolution of 14CO2 by cells incubated with [1,2-14C]taurine. Thus, we found no evidence for a role of taurine in the energy, carbon and sulphur metabolism of S. aureus. PMID- 3655735 TI - Chlamydia trachomatis (L2 serovar) can be bound, ingested and destroyed by differentiated but not by undifferentiated human promyelocyte cell line HL-60. AB - As a model system for analysing interactions between chlamydiae and myeloid cells and their precursors, we have studied binding, ingestion and destruction of Chlamydia trachomatis (L2 serovar) by the human promyelocytic cell line HL-60. HL 60 cells were induced by phorbol myristate acetate (PMA) and dimethyl sulphoxide (DMSO) to differentiate along either the macrophage or the granulocyte pathway, respectively. Using an immunofluorescence assay and electron microscopy, we have shown that induced (differentiated) HL-60 cells, but not uninduced (undifferentiated) HL-60 or other cell lines treated with PMA or DMSO, exhibit increased binding, ingestion and elimination of C. trachomatis; these activities are associated with specific histochemical and antigenic markers of myeloid differentiation. These results suggest that myeloid cells acquire the ability to interact with and kill chlamydiae during cell development. PMID- 3655736 TI - Detection of Leptospira interrogans in clinical specimens by in situ hybridization using biotin-labelled DNA probes. AB - In situ DNA hybridization using biotin-labelled leptospiral DNA was performed on clinical specimens to investigate its usefulness as a technique for the identification of Leptospira interrogans. The applicability of this test in blood, urine and liver smears was demonstrated. In situ DNA hybridization can be completed in only 4 h and it combines the advantage of visualization of the leptospiral morphology with the specificity of the hybridization reaction. No cross-hybridization was observed with other bacteria. This study shows that hybridization in situ can be simple to perform and may contribute to a rapid diagnosis. PMID- 3655737 TI - Cloning of aminoglycoside-resistance determinants from Streptomyces tenebrarius and comparison with related genes from other actinomycetes. AB - At least two aminoglycoside-resistance determinants from Streptomyces tenebrarius have been cloned separately in Streptomyces lividans. In each case, resistance (to kanamycin plus apramycin or to kanamycin plus gentamicin) was expressed at the level of the ribosome and involved specific methylation of 16S ribosomal RNA. Hybridization and restriction analysis revealed that related genes were present in other aminoglycoside-producing actinomycetes. PMID- 3655738 TI - Induction of autolysis in Streptococcus faecium. AB - Autolysis of exponential-phase Streptococcus faecium cells was promoted by pretreating the bacteria (freezing-thawing; -70 degrees C) in Tris buffer, followed by incubation at 37 degrees C in the same buffer. The effect was dependent on Tris concentration. The pretreatment provoked ultrastructurally visible damage with extensive loss of K+ and leakage of UV-absorbing components. No autolysis was observed when the bacteria frozen-thawed in Tris were incubated in the presence of the autolysin inhibitor N-bromosuccinimide nor when they had been grown in the presence of chloramphenicol or tetracycline. Furthermore, two autolytic-defective mutants, EC31 and EC78, isolated from S. faecium, did not autolyse when frozen-thawed and incubated in Tris. Freezing-thawing in Tris, however, imparted extensive cell damage to the mutants and to the antibiotic treated bacteria as well as considerable leakage of K+ and UV-absorbing materials. These observations indicate that the lysis of S. faecium reported above is due to the activity of the endogenous bacterial autolysin. Induction of autolysis of S. faecium by freezing-thawing was also observed, although to a lesser extent, when Tris was replaced by imidazole. PMID- 3655739 TI - Investigation of variation in phenotype and DNA content between single-conidium isolates of single Penicillium strains. AB - Variation in phenotypic properties was examined in three strains of closely related fasciculate species of Penicillium using 114 morphological, physiological, and biochemical characters. Thirty-six of these characters showed variation within single-conidium isolates of the same strain. Conidial sizes and nuclear DNA contents were compared using flow microfluorimetry; these results suggested that significant differences in conidial DNA content are associated with phenotypic variation. The taxonomic significance of the results is discussed. PMID- 3655740 TI - Heterogeneity of Escherichia coli phages encoding Vero cytotoxins: comparison of cloned sequences determining VT1 and VT2 and development of specific gene probes. AB - Phages coding for production of Vero cytotoxins VT1 or VT2 in strains of Escherichia coli serotype O157.H7 or O157.H- were morphologically indistinguishable. Their genome size and restriction enzyme digests of the phage DNA were similar. These phages were clearly different in these respects from a VT1-encoding phage isolated from a strain of E. coli O26.H11 (H19). However the VT1 region cloned from the phage originating in the E. coli O157.H7 strain was identical to the VT1 region previously cloned from the phage carried by H19. Sequences encoding VT2 that were cloned from the phage in E. coli O157.H- have been mapped and the VT2 region identified by transposon insertion. The cloned regions coding for VT1 or VT2 production had no similarities in the presence of restriction enzyme sites over a distance of about 2 kb, and two VT1-specific probes spanning a region of about 1.4 kb did not hybridize under stringent conditions with cloned VT2 DNA. A 2 kb HincII fragment contained the VT2 genes but hybridized to VT1-encoding phages and recombinant plasmids via flanking phage DNA. A 0.85 kb AvaI-PstI fragment was a specific probe for VT2 sequences and did not hybridize under stringent conditions to phages or plasmid recombinants encoding VT1. PMID- 3655741 TI - Purification, characterization and serological properties of a glycolipid antigen reactive with a serovar-specific monoclonal antibody against Leptospira interrogans serovar canicola. AB - A glycolipid antigen possessing a serovar-specific antigenic determinant of Leptospira interrogans serovar canicola was purified from a chloroform/methanol extract of the organism. The purification procedures included silicic acid column chromatography and preparative thin-layer chromatography (TLC). Antigenic activity was detected by a TLC-enzyme immunostaining technique using monoclonal antibody CT3, which specifically agglutinates serovar canicola and only weakly serovar sumneri but no other serovars of Leptospira. The purified glycolipid reacted with CT3 antibody, indicating that the glycolipid possessed a serovar specific antigenic determinant. Infrared spectrum and proton nuclear magnetic resonance analyses showed that the glycolipid contained sugar and lipid moieties, which possessed amide linkages and an acetyl group. Gas-liquid chromatography mass spectrometry analysis showed that the glycolipid contained two unknown sugars, one of which (unknown sugar II) appeared to be associated with the antigenic determinant specific for canicola. The serovar-specific antigenic determinant was destroyed by mild alkali treatment of the glycolipid. These findings suggested that the antigenic determinant was an alkali-labile moiety which may be related to the unknown sugar II. PMID- 3655742 TI - Isolation and characterization of the facultative methylotroph Mycobacterium ID Y. AB - A facultatively methylotrophic Mycobacterium was isolated from Cleveland Harbor, Ohio, USA. The isolate, designated ID-Y, used a wide range of carbon and energy sources including methane and several other hydrocarbons. It displayed a growth cycle from rod-shaped exponential-phase cells, with many cell pairs exhibiting V formation, to cocco-bacillary stationary-phase cells. A fixation technique involving glutaraldehyde/alcian blue resulted in the observation of a three layered cell wall. Isolate ID-Y has an ultrastructure similar to that of other mycobacteria, particularly Mycobacterium phlei and Mycobacterium flavum, which is presently classified as a Xanthobacter species. PMID- 3655743 TI - In vivo reassortment of Thogoto virus (a tick-borne influenza-like virus) following oral infection of Rhipicephalus appendiculatus ticks. AB - Arboviruses with segmented genomes have the potential to reassort in both their vertebrate hosts and arthropod vectors. Reassortment of Thogoto virus, a tick borne orthomyxo-like virus, has been demonstrated following dual infection of hamsters by temperature-sensitive mutants. To investigate whether similar events can occur in ticks, Rhipicephalus appendiculatus larvae and nymphs were dually infected by interrupted feeding on viraemic hamsters. Wild-type reassortant virus was isolated from the ticks 12 to 15 days after engorgement. Following moulting, nymphs and adults transmitted reassortant virus to uninfected hamsters. This is the first reported evidence that a tick-borne arbovirus can reassort in vivo in a naturally infected arthropod vector. The relative roles of vector and vertebrate host in generating and perpetuating reassortant viruses in nature are discussed. PMID- 3655744 TI - Nucleotide sequence of the genes coding for the membrane glycoproteins E1 and E2 of rubella virus. AB - The complete nucleotide sequence of the genes coding for the two membrane glycoproteins E1 and E2 of rubella virus has been determined from cloned cDNA derived from the 40S genomic RNA. A sequence of 2451 nucleotides extending from the poly(A) tract towards the 5' end is presented. Within one continuous open reading frame E2 is located amino-terminally followed by E1 and a 58 residue long untranslated 3' region preceding the poly(A) tract. The coding regions of E2 and E1 are unusually G/C rich, 71.4% and 66.4% respectively. At the carboxy-terminal end of the coding region of E1, there is an inverted complementary nucleotide sequence, which could form a 13 base pair hairpin structure. Mature E2 and E1 are both preceded by a stretch of uncharged mainly non-polar amino acids, 21 and 20 residues in length, respectively. These could serve as signal peptides that mediate the membrane translocation of the proteins. At the carboxy termini of both proteins there are stretches of hydrophobic amino acids, 19 and 27 residues in length, which probably represent the transmembrane anchors of the proteins. The size of mature E1 is 481 amino acids (mol. wt. 51,502), whereas the exact size of mature E2 could not be established as its carboxy-terminal end could not be located in the sequence. A maximum size of 262 amino acids (mol. wt. 28,277) is, however, suggested. Between the E2 and E1 genes, there is a stretch of seven amino acids, five of which are arginines, which may serve as cleavage sites for a trypsin-like protease. E1 contains three and E2 four potential sites for asparagine-linked glycosylation. Both proteins are cysteine-rich (5%). Comparison of the rubella virus amino acid sequence to those of several alphaviruses indicated no sequence homology. PMID- 3655745 TI - Mumps virus-induced alterations in cellular excitability during persistent infections. AB - Persistent mumps virus infections were established in rat pheochromocytoma (PC 12) and human medulloblastoma (TE-671) continuous cell lines. Significant amounts of infectious virus were produced by the PC-12 cells; infectious virus production by the TE-671 cells was limited. This restricted replication may be due to decreased production of viral envelope glycoproteins by TE-671 cells. The presence of virus changed the distribution of stimulus-evoked electrical responsiveness of both cell lines from responsiveness composed primarily of normal, rapidly rising, all-or-nothing action potentials to one dominated by abnormal, slowly rising, graded responses or by no response at all. Such changes have the potential to disrupt neural integration within the nervous system, and suggest a new mechanism by which persistent virus infections might play a role in chronic neurological and/or mental disease. PMID- 3655746 TI - Demonstration that glycoprotein G is the attachment protein of respiratory syncytial virus. AB - Two monospecific rabbit antisera to the G glycoprotein, one induced with purified G and the second with a recombinant vaccinia virus containing the gene for G, inhibit the attachment of purified [35S]methionine-labelled Long strain of respiratory syncytial virus to monolayers of HeLa cells. Attachment was not inhibited by monospecific rabbit antisera to glycoprotein F induced with either purified F or with a recombinant vaccinia virus containing the gene for F. PMID- 3655747 TI - Population surveillance of multimalformed infants--experience with the Swedish Registry of Congenital Malformations. First Part. AB - The paper discusses the principles of an analysis of infants with multiple malformations, recorded in a birth defect registry. It is illustrated with 973 multimalformed infants recorded in the Swedish Registry of Congenital Malformations, 1965-1984. The detection and delineation of patterns of associated malformations is described and exemplified with the VATER association pattern. There is no time trend for the rate of infants with this association; they represent about 4% of all registered multimalformed infants; and their prevalence at birth is 2.7 per 100,000 births. The rate of infants probably representing unidentified trisomy 13 shows a decrease after 1977 indicating an increased access to cytogenetic services. A similar decrease is seen in infants probably representing unidentified Meckel's syndrome. Using 28 multimalformed infants registered in 1985, the technique for surveillance of multimalformed infants in a population is discussed. PMID- 3655749 TI - [Value of muscle studies in the early diagnosis of Schwartz-Jampel syndrome]. AB - The authors report a case of Schwartz-Jampel syndrome (osteo-chondro muscular dystrophy with myotonia). The diagnosis was made when the child was 3 1/2 year old. Then, there were no clinical symptoms; however, the electromyographic and histologic patterns of the disease were found. Two years later, the clinical status provided confirmation of the diagnosis. The discussion focuses on the difficulty of the diagnosis and the relevance of electrophysiological studies and muscular biopsy in order to distinguish this disease from others with similar clinical pattern (as Freeman-Sheldon, or Marden Walker syndromes). PMID- 3655748 TI - [Systematic neonatal detection of Duchenne's muscular dystrophy. Results after 10 years' of experience in Lyons (France)]. AB - Neonatal screening of Duchenne Muscular Dystrophy using serum CK level measurement has been performed for 10 years in a part of the Rhone-Alpes area (40,000 newborns per year). This test avoids consecutive cases in an affected family by mean of an early genetic counselling. So, 10 potential DMD boys have been avoided (i.e. one out of five of the D.M.D., as a whole which would be born during this same ten year study). Details on familial structures and efficiency of genetic counselling are given, and this efficiency will be increased by the DNA study of the concerned families. PMID- 3655750 TI - The Opitz hypertelorism-hypospadias syndrome. Further delineation of the spectrum of clinical findings. AB - In this paper we report three male patients with the Opitz hypertelorism hypospadias syndrome. In addition to the typical morphological findings, signs of cerebral palsy related to dysmaturity and perinatal adaptation problems were present in two of them. This illustrates that this syndrome is a true multiple congenital anomaly/mental retardation MCA/MR syndrome with great variability in expression of clinical symptoms. PMID- 3655751 TI - A pedigree with bilateral preaxial polydactyly from India. AB - Preaxial polydactyly in 15 males and 5 females of 6 generations display a bilateral duplication of the big toe in a pedigree from Andhra Pradesh, India, with reduced penetrance and variable expressivity. PMID- 3655752 TI - [Hydrocephalus and the Goldenhar syndrome]. AB - Two female babies with Goldenhar syndrome have, the first an aqueductal stenosis, the second repetitive spells of pain and strain of the anterior fontanel. Aqueductal stenosis, hydrocephalus or intracranial hypertension are not previously described in this syndrome. PMID- 3655753 TI - Cytogenetic evaluation of 163 azoospermics. AB - A constitutional chromosomal aberration was diagnosed in 38/163 (23.3%) azoospermic patients. Whereas the 47,XXY complement was the commonest (31/38 cases), the following abnormal karyotypes were also found: 46,XX; 46,X,del(Y) (q11); 46,X,r(Y); 46,XY,inv(1) (p3500q21.3)mat; and 46,Y,t(X;3) (q26;q13.2)mat (both the deleted and the annular Y were observed twice). Pooled data from the literature showed that the frequency of chromosomal abnormalities is higher in azoospermic (150.4/1000) than in infertile (55.3/1000) males, which in turn is higher than in newborns (less than 6/1000). The observed different frequency between azoospermic and infertile individuals is given by several types of chromosomal abnormalities, mainly by the complement 47,XXY. The analysis also showed that the male infertility secondary to rob translocations and supernumerary marker chromosomes is usually not related to azoospermia. The contrary occurs in certain rcp and gonosome;autosome translocations and in autosome inversions. PMID- 3655754 TI - Familial trisomy 3q25----qter. Report of two cases. AB - Two girls with the trisomy 3q2 clinical syndrome are presented. Their fathers were twins and carried a t(3;8)(q25;p23). Case 1, aged 8 months, had a 46,XX,der(8) complement. Case 2, died at 5 months of age before cytogenetic study, was considered to have the same karyotype. Both cases combined showed the majority of phenotypical features of trisomy 3q2 syndrome, including facial appearance, glaucoma, and visceral malformations. This observation suggests that the trisomy 3q25----qter is sufficient to produce the syndrome which shows variable expression in these cases. PMID- 3655755 TI - inv(5)(p13q13) in a four generation pedigree. AB - A 4 1/2 years old boy was found to have hypoplasia of the pectoralis major right muscle and a karyotype 46,XY,inv(5)(p13q13)mat. This inversion, probably independent of the boy's malformation, was present in at least four generations and it seems neither to impair fertility nor to yield viable recombinants. PMID- 3655756 TI - Development of time concepts: differentiating clock and calendar from apparent durations. AB - To investigate the role of perception and stress on time concepts, the real-time and apparent durations of common events varying in length from 30 s to 4 years were rated by kindergarten through 12th-grade pupils, college students, professors, and stress-impaired adults (N = 1,788). The events were pleasant, neutral or unpleasant; either directly perceptible and of specific duration or perceptually vague; and happened either to oneself or to someone else. Second graders differentiated apparent from real-time durations and, therefore, already had an abstract concept of time. As predicted from differentiation theory (Gibson, E. J., 1969; Gibson, J. J., 1966, 1983), longer durations were acquired later than shorter ones; perceptually-vague durations were acquired later than clearly perceptible ones of similar length; and, as Neisser (1976) also suggested, stress did not lead to regression, nor did the personal-impersonal dimension make a difference during childhood. PMID- 3655757 TI - The relationship between physical and social reasoning in adolescents. AB - The relationship between physical reasoning and interpersonal reasoning was examined by devising group-administered written measures of interpersonal reasoning tasks (social guessing games) and giving these and standard physical reasoning tasks to 11-year-old children (N = 106). A factor analysis revealed two factors: Physical reasoning accounted for 42% of the variance, and social reasoning accounted for 17% of the variance. This supports the proposition that social reasoning is distinct from physical reasoning, but performance on all reasoning tasks may depend upon structures of both types. PMID- 3655758 TI - Violent delinquency: an examination of psychopathic typologies. AB - This study sought to determine the combined effects of psychopathy, low intellectual functioning, and love deprivation on violent delinquency. Low intellectual-functioning psychopaths were significantly more violent than were low or high-intellectual-functioning nonpsychopaths or high-intellectual functioning psychopaths. Love deprivation was more strongly related to violence than was psychopathy/intellectual functioning, and severely love-deprived, low intellectual-functioning psychopaths were the most violent. PMID- 3655759 TI - Measurement of psychological hardiness in adolescents. PMID- 3655760 TI - Innocent bystander. Wide QRS tachycardia. PMID- 3655761 TI - Complications of tracheostomy. PMID- 3655762 TI - Successful child abuse program educates children and adults. PMID- 3655763 TI - Solar retinopathy from sungazing in Medjugorje. PMID- 3655764 TI - Magnetic resonance imaging of the female pelvis. PMID- 3655765 TI - Blood-ordering for otolaryngology. PMID- 3655766 TI - Psychiatry and its scientific relatives: "a little more than kin and less than kind". PMID- 3655767 TI - A follow-up of two panic disorder-agoraphobic study populations. The role of recruitment biases. AB - A self-referred and recruited panic disorder-agoraphobic study population are compared in terms of their symptomatic presentation and treatment outcome. The recruited group was found to be more symptomatically severe, more phobic, less character disordered, and more likely to stay in treatment. Implications for the potential methodological biases in recruiting study populations are explored. PMID- 3655768 TI - Physiological responses of college students to a pet. AB - The effect of a pet on cardiovascular responses of college students was examined under three test conditions (i.e., reading aloud, reading quietly, and interacting with an unknown dog). A repeated-measures analysis with three covariates was used to examine the effect of the treatment on each of six dependent variables (systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and State and Trait Anxiety). Reading aloud differed from baseline measures under all treatment conditions (p less than .001) Reading quietly and interacting with a pet were slightly below baseline for all dependent variables with a slightly greater effect by reading quietly than interacting with a pet. Examination of interactions between variables revealed no significant differences. Effects on State anxiety level mirrored cardiovascular responses (p less than .001). Trait anxiety levels remained relatively constant throughout the treatments. Results indicated that interacting with a pet does affect physiological and psychological responses by lowering response levels. A parallel effect was also demonstrated by reading quietly. Given the effect of pet interaction upon selected indicators of health in well college students, these data suggest the relevance of examining this treatment with an "at-risk" group. PMID- 3655769 TI - Impact of mental illness in families of mental health professionals. AB - Family burden and coping strategies were investigated in 84 experienced mental health professionals with family members suffering from chronic major mental illnesses. The sample was nationally recruited from ads in professional journals. Personal reactions of respondents involved cognitive and attitudinal changes in conceptions of psychotic disorders and guarded relations with colleagues with respect to self-disclosure and case involvement. Financial and emotional burdens were substantial, with ongoing stressful life events, aversive patient behaviors, and poor treatment histories. In rating family coping strategies, mental health professionals showed a high degree of concordance with nonprofessional family members in assigning priority to education on symptoms, medications, and patient management techniques. Involvement with self-help groups and physical separation from patients were rated higher than individual or family therapy as aids in coping for families of the mentally ill. PMID- 3655770 TI - Eating disorder and socioeconomic class. Anorexia nervosa and bulimia in nine communities. AB - To compare the prevalence of eating disorders in lower income vs. upper income communities, we administered a previously validated questionnaire to 394 women at nine state-regulated bingo tournaments. Surprisingly, eating disorders were more commonly reported by lower income respondents. PMID- 3655771 TI - Suicide attempts in antisocial alcoholics. AB - The dual diagnoses of alcoholism and antisocial personality are frequently associated with suicide attempts. A group of 94 alcoholics with antisocial personality were divided on the basis of a previous suicide attempt. A variety of symptoms, including depression, alcohol and drug abuse, conduct disorder, and violence were found more frequently in the suicide attempter group as reported on the structured interview. These emotional problems were additionally found to have an earlier onset. The results were consistent with the concept of secondary sociopathy and indicated that higher psychopathology may be associated with suicide behavior. PMID- 3655772 TI - "Panic disorder" in schizophrenia. AB - A patient is described with operationally diagnosed chronic schizophrenia who simultaneously experienced repeated "attacks" during which times he had intense apprehension and autonomic hyperactivity entirely similar to that usually described under the rubric of "panic attacks" in nonschizophrenic patients. Delusional and hallucinatory symptoms were also transiently exacerbated during these episodes. Alprazolam, as an adjunct to fluphenazine decanoate, was effective in ameliorating these symptoms. Diagnostic and treatment implications are discussed. PMID- 3655773 TI - Anorexia nervosa complicated by Mycobacterium xenopi pulmonary infection. AB - Pulmonary infection with a rare atypical mycobacterium, Mycobacterium xenopi, was discovered during the treatment of anorexia nervosa in a 21-year-old woman without preexisting pulmonary disease. Psychiatric treatment resulted in restoration of premorbid weight in the presence of active pulmonary disease and treatment with isoniazid and rifampin. Ethambutol was added for the final 12 months of the 18-month treatment course. Thirty-two-month follow-up indicated continued remission of both illnesses. Concurrence of M. xenopi infection and anorexia nervosa has not been previously reported. PMID- 3655774 TI - Investigating mental disorders in their natural settings. AB - This issue of The Journal of Nervous and Mental Disease reports fundamental research into the nature of mental disorders, using both new and traditional time sampling approaches. The studies present convincing findings gathered in a variety of patient populations and demonstrate the utility of using quantitative and replicable methods in psychiatric research and clinical care. Research that adequately describes the person in context as well as the influence of situations on mental state has proved difficult. Methods such as the diary and Experience Sampling Method that explore experiences in daily life overcome some of the shortcomings of previous psychiatric research strategies, such as reliance on retrospective recall and the failure to take the variability of mental state more fully into account. The studies in this issue introduce techniques for creating a data base for psychiatric research and clinical practice that is anchored in patient experience and behavior. PMID- 3655775 TI - Mental disorders in their natural settings. The application of time allocation and experience-sampling techniques in psychiatry. PMID- 3655776 TI - Microbehavioral approaches to monitoring human experience. AB - Microbehavioral approaches to social science research minimize the complexities of general activity reporting by limiting questions to elementary activity experience in the context of daily life. Time diaries and sampling studies of activity at random moments during the day are two examples of this approach. PMID- 3655777 TI - Infrequently occurring activities and contexts in time use data. AB - In this paper we describe an approach to the study of time use data that focuses on relatively infrequent activities as well as the contexts in which the activities take place. To illustrate the method, we present several examples from a secondary analysis of the Multinational Comparative Time-Budget data, based on over 25,000, 24-hour, time use diaries collected in 12 countries during 1965 through 1966. Activities that represent a small fraction of the overall time budget of a population may nevertheless yield valuable insights into a culture or group. Analyses of such mundane events as doing the laundry, transporting children, and taking a walk indicate marked differences among the countries surveyed in terms of frequencies, durations, by whom, and with whom these activities were typically performed. In the future, time use studies can be expected to contribute to the understanding of mental disorders in natural contexts. In contrasting specific diagnostic groups with normal subjects, analyses of specific activities (e.g., personal care, social interaction) or contexts (e.g., alone vs. with others, at home vs. away) may be particularly relevant. Strategies that combine continuous recording (diary) with repeated, instantaneous experience-sampling methods are likely to be the most useful in such studies of mental disorders. PMID- 3655778 TI - Validity and reliability of the Experience-Sampling Method. AB - To understand the dynamics of mental health, it is essential to develop measures for the frequency and the patterning of mental processes in every-day-life situations. The Experience-Sampling Method (ESM) is an attempt to provide a valid instrument to describe variations in self-reports of mental processes. It can be used to obtain empirical data on the following types of variables: a) frequency and patterning of daily activity, social interaction, and changes in location; b) frequency, intensity, and patterning of psychological states, i.e., emotional, cognitive, and conative dimensions of experience; c) frequency and patterning of thoughts, including quality and intensity of thought disturbance. The article reviews practical and methodological issues of the ESM and presents evidence for its short- and long-term reliability when used as an instrument for assessing the variables outlined above. It also presents evidence for validity by showing correlation between ESM measures on the one hand and physiological measures, one time psychological tests, and behavioral indices on the other. A number of studies with normal and clinical populations that have used the ESM are reviewed to demonstrate the range of issues to which the technique can be usefully applied. PMID- 3655779 TI - The daily life of ambulatory chronic mental patients. AB - The purpose of this research is to describe in greater detail than is typically done the daily life experiences of 11 ambulatory chronic mental patients and 11 nonpsychiatric controls. The subjects, although diagnostically heterogeneous, were representative of Dutch chronic mental patients. The Experience-Sampling Method was used to signal subjects randomly 10 times a day for 6 consecutive days to fill out self-rating forms assessing mental state and contextual information at the moment of the signal. Compliance was good. In time-allocation comparisons with nonpsychiatric subjects the patients were found to live relatively "normal" lives. As expected, their psychopathology was influenced by social environments such as being alone, at home, or in society at large. Contrary to other studies that stress the social isolation of such individuals, the chronic subjects reported feeling better away from home and among people than normal subjects. When alone, chronic patients reported daydreaming more and noted a tendency to drift away from thoughts about current activities. Mental state fluctuations and daily interactions, characteristic of this group, are examined in relation to theories of vulnerability and coping style of chronic mental patients, with an eye to individualized treatment applications. PMID- 3655780 TI - The monitoring of optimal experience. A tool for psychiatric rehabilitation. AB - This article illustrates the use of quantitative time-sampling data in developing a psychology of "optimal experience" to help in the psychiatric development of adequate rehabilitation approaches. The Experience-Sampling Method was used on a sample of 47 Italian adolescent students to measure fluctuations in their experience. We found that the ratio of subjectively experienced challenges and skills was a fundamental parameter that predicted optimal experience as well as boredom and anxiety. In contrast, "low" experience in daily life was viewed as a risk factor that could be minimized to increase the quality of life. Monitoring fluctuations in optimal and low experience may therefore be an important tool in developing personalized psychiatric rehabilitation plans. PMID- 3655781 TI - The social ecology of anxiety. Theoretical and quantitative perspectives. AB - Experience sampling is a relatively new research approach that captures relevant variations in experience and symptoms in the course of everyday life. In this paper, a socioecological frame of reference that integrates psychological, historical, cultural, and developmental theories about anxiety phenomena will be illustrated using quantitative descriptions of anxiety and avoidance behaviors gathered with the Experience-Sampling Method. The interaction between anxiety symptoms and the environment in which they occurred is explored in a case study that points to possibilities for future research and the establishment of therapeutic approaches that are optimally suited to the individual patient. PMID- 3655782 TI - Panic attacks in the natural environment. AB - Despite much recent research, there is still little systematic information about the phenomenology of panic attacks, and their possible causes remain obscure. We investigated panic attacks in the natural environment using an event sampling approach. Twenty-seven panic attack patients and 19 matched normal controls kept panic attack and self-exposure diaries for 6 days and wore an ambulatory heart rate/physical activity recorder for 3 days. Patients reported 175 attacks, generally of moderate severity. The most frequent symptoms were palpitations, dizziness/lightheadedness, dyspnea, nausea, sweating, and chest pain/discomfort. The results did not support the classification of panic attacks recently proposed by Sheehan and Sheehan, which requires three symptoms as a cutoff for panic attacks. Panic attacks classified by the patients as situational (i.e., occurring in feared situations) were more severe and occurred in situational contexts different from spontaneous attacks, but were otherwise phenomenologically similar. Heart rates did not change during spontaneous attacks and were only mildly elevated during situational attacks or during the 15 minutes preceding these attacks. These heart rate changes were interpretable as effects of anxiety, although physical activity showed a similar pattern of changes. Some normal control subjects reported on the panic diary primarily situational anxiety episodes that were phenomenologically similar to, albeit less severe than, the patients' episodes. Panic patients may sometimes fail to perceive environmental triggers for their attacks because many attacks classified as spontaneous occurred in classical "phobic" situations. Furthermore, the comparison of concurrent diary and retrospective interview and questionnaire descriptions showed that panic patients have a tendency toward retrospective exaggeration. Implications for the assessment, definition, and classification of panic attacks are discussed. PMID- 3655783 TI - Temporal and social contexts of heroin-using populations. An illustration of the snowball sampling technique. AB - Snowball sampling is a method that has been used in the social sciences to study sensitive topics, rare traits, personal networks, and social relationships. The method involves the selection of samples utilizing "insider" knowledge and referral chains among subjects who possess common traits that are of research interest. It is especially useful in generating samples for which clinical sampling frames may be difficult to obtain or are biased in some way. In this paper, snowball samples of heroin users in two Dutch cities have been analyzed for the purpose of providing descriptions and limited inferences about the temporal and social contexts of their lifestyles. Two distinct heroin-using populations have been discovered who are distinguished by their life cycle stage. Significant contextual explanations have been found involving the passage from adolescent peer group to criminal occupation, the functioning of network "knots" and "outcroppings," and the frequency of social contact. It is suggested that the snowball sampling method may have utility in studying the temporal and social contexts of other populations of clinical interest. PMID- 3655784 TI - "Goofed-up" images: thought sampling with a schizophrenic woman. AB - A variant of the time-sampling method, experience sampling, was used to produce a narrative description of the inner experience of a schizophrenic young woman. In general, her inner experience was predominantly visual, and those images were frequently "goofed up", i.e., tilted, obliterated, or inaccurate in detail. The case has methodological significance in that it demonstrates that the descriptive time-sampling method can provide useful information about individuals, and also has significance in our understanding of schizophrenia, in that it exemplifies in detail the everyday distortions of inner experience in schizophrenia. PMID- 3655785 TI - Evidence for differential DNA endoreplication during the development of a molluscan brain. AB - The DNA content of neurons in the cerebral ganglion of Achatina fulica was determined by the two-wavelength method of microspectrophotometry using Feulgen stained sections. DNA measurements of mouse hepatocytes were used as a control of the methods. All sampled neurons with a nuclear diameter greater than 7 microns were polyploid. The shape of the frequency histogram of DNA contents is not compatible with an interpretation that assumes one or more simple duplications of the genome. It is suggested, instead, that the results are due to either the underreplication of some DNA sequences or the selective amplification of genes. Additional experiments using [3H]-thymidine autoradiography showed that the incidence of neuronal DNA synthesis is highest during the period of the animal's greatest growth and then declines rapidly near the onset of sexual maturity. The mesocerebrum incorporated greater amounts of [3H]-thymidine than the rest of the brain, whereas the procerebrum remained diploid throughout the course of the study. PMID- 3655786 TI - Differences in surface molecules of motor axon terminals correlated with cell cell recognition. AB - The cell-cell interactions leading to the formation of synaptic connections among cells in the nervous system may be mediated by cell surface macromolecules. In the cockroach the specific reformation of the original innervation pattern of a set of leg muscles during axonal regeneration indicates a significant contribution from cell-cell recognition. Macromolecules mediating such a process would be expected to be distributed differentially among the axon terminals of the various motor neurons. Monoclonal antibodies have been isolated that selectively bind to the surfaces of axon terminals of some motor neurons and not others. Preliminary biochemical characterization indicates that these antigens are glycoproteins and are good candidates for consideration as recognition macromolecules. PMID- 3655787 TI - FMRF-amide-like immunoreactive efferent fibers and FMRF-amide suppression of pacemaker neurons in eyes of Bulla. AB - The eyes of certain marine gastropods including Aplysia and Bulla, contain circadian pacemakers, which produce a circadian rhythm of autogenous compound action potential (CAP) activity. The CAPs are generated by the synchronous spike discharge of a distinctive population of retinal pacemaker neurons whose axons convey the CAP activity to the CNS. When CAP activity is recorded from a preparation with eyes attached to the CNS, the CAP activity is modulated by efferent activity. In this study we have identified FMRF-amide-like immunoreactive efferent axons in the optic nerves of Bulla. These axons arborize in the basal retinal neuropil adjacent to the pacemaker neurons and are in a position to make synaptic contacts with their dendrites. Similar immunoreactive fibers are not observed in Aplysia eyes. Exogenous FMRF-amide at micromolar concentrations suppresses ongoing CAP activity in isolated eyes but does not suppress the ERG or phase shift the circadian rhythm of CAP activity. Intracellular recordings from the retinal pacemaker neurons reveal that FMRF amide hyperpolarizes the membrane potential, suppresses spike discharge, and decreases the input resistance, suggesting that a K conductance is increased. Electrical stimulation of the region of the cerebral ganglion that contains FMRF amide immunoreactive neurons suppresses ongoing CAP activity. All these results are consistent with the idea that the FMRF-amide immunoreactive central neurons and their axons provide a pathway for efferent modulation of the CAP rhythm generated by the retinal pacemaker neurons. PMID- 3655788 TI - Thiol competition for Et3PAuS-albumin: a nonenzymatic mechanism for Et3PO formation. AB - Thiols (RSH = 2,3,4,6-tetra-O-acetyl-beta-1-D-thioglucose, beta-1-D-thioglucose, and glutathione) can displace either the albumin or the triethylphosphine from the protein-gold complex, AlbSAuPEt3. The albumin is displaced in preference to triethylphosphine, but irreversible oxidation of the latter eventually shifts the equilibria toward Et3PO and AlbSAuSR. Albumin disulfide bonds are the probable oxidants. Neither O2 nor oxidized glutathione substantially enhanced the rate or extent of Et3PO formation. The labilization of the phosphine in AlbSAuPEt3 is attributed to a strong trans effect of the albumin thiolate, Cys-34. The 31P NMR chemical shifts of various thiolato(triethylphosphine)gold(I) complexes are correlated directly with the affinity of the thiols for gold and inversely with their pKSH values. Deacetylated auranofin (1-thio-beta-D-glucopyranosato-S) (triethylphosphine)gold(I) reacts with the mercaptalbumin and oxidized mercaptalbumin (putatively AlbSOH) forms of bovine serum albumin to form AlbSAuPEt3 with displacement of the thioglucose ligand. PMID- 3655789 TI - New xanthones from Psorospermum febrifugum. AB - The isolation and structural determination of two new xanthone derivatives, 1,2,4 trimethoxy-3,8-dihydroxyxanthone, 1,2,4-trimethoxy-3-hydroxyxanthone and a known 2-methoxy-3-hydroxyxanthone from Psorospermum febrifugum var. ferrugineum are reported. The structures were elucidated by extensive analysis of 1H and 13C nmr, ms, and chemical correlations. PMID- 3655790 TI - Insect antifeedant activity and hot taste for humans of selected natural and synthetic 1,4-dialdehydes. AB - The antifeedant activity towards larvae of Leptinotarsa decemlineata and Spodoptera littoralis and the hot taste for the human tongue have been determined for natural and synthetic 1,4-dialdehydes. Among the bicyclic dialdehydes the biological activity has been found to be dependent on the distance between the two aldehyde groups; tricyclic and pentacyclic dialdehydes are inactive in both tests. A short synthetic route to (-)- and (+)-polygodial is reported. PMID- 3655791 TI - Isolation and bioactivity of new tanshinones. AB - Two new diterpenoids, designated neocryptotanshinone and isotanshinone IIB, have been isolated from "Tan-Shen," the root of Salvia miltiorrhiza, together with a known compound, danshexinkun A. Their structures are established by spectral and physical data. Isotanshinone IIB exhibits significant inhibitory activity in vitro on ADP- and collagen-induced aggregation. PMID- 3655792 TI - Improved field tests for toxic pyrrolizidine alkaloids. AB - Two new qualitative field tests for unsaturated pyrrolizidine alkaloids (PAs) and their N-oxides are described. The tests are sensitive and able to detect all the potentially hepatotoxic PAs, except otonecine-based alkaloids. They do not respond to most saturated PAs. The first test, primarily for PA N-oxides, is particularly easy to perform in the field and can be extended to detect basic PAs with lower sensitivity. The second test is an improvement on an earlier N-oxide test and now detects both N-oxides and basic PAs. Practical details are given for testing both fresh and dried leaves, roots, woody material, seeds, and plant based foodstuffs such as flour. The sensitivity of the tests has been assessed using pure PAs and N-oxides, and a range of fresh and dried plant samples has been tested. A simple test for PA N-oxides only has proved adequate to identify the majority of plants containing 0.005% or more of PAs using samples of 0.1-0.5 g. High levels of PA N-oxides were found to persist for more than 20 years in dried plant materials. PMID- 3655793 TI - Irisones A and B: two new isoflavones from Iris missouriensis. AB - Two new isoflavones, irisones A and B, together with the known compound, 5,7 dihydroxy-2',6-dimethoxy isoflavone, were isolated from the roots of Iris missouriensis. With the help of 2D-homonuclear-J-correlation and 2D-nOe experiments the structure of irisone A was deduced to be 5-hydroxy-2'-methoxy-6,7 methylenedioxy isoflavone. The structure of irisone B was elucidated by spectral analyses as 2',5-dihydroxy-6,7-methylenedioxy isoflavone and was confirmed by chemical conversion to irisone A. PMID- 3655794 TI - Isolation and hypoglycemic activity of quinquefolans A, B, and C, glycans of Panax quinquefolium roots. AB - An H2O extract of the American crude drug "Amerika-ninjin" (American ginseng), Panax quinquefolium roots, exhibited significant hypoglycemic activity in mice. Activity-guided fractionation of the extract led to isolation of three glycans, quinquefolans A, B, and C, which displayed hypoglycemic effects in normal and alloxan-induced hyperglycemic mice. PMID- 3655795 TI - Cytotoxic steroids of Gelsemium sempervirens. AB - A new pregnane derivative, 12 beta-hydroxy-5 alpha-pregn-16-ene-3,20-dione, along with the known derivative 12 beta-hydroxy-pregna-4,16-diene-3,20-dione have been isolated from a MeOH extract of the stem of Gelsemium sempervirens and found to be the principal cytotoxic entities. The 13C-nmr spectra of both compounds were assigned by comparison with other pregnane analogs thereby allowing confirmation of the stereochemistry at C-5 in compound. Heteronuclear 2D correlation and selective INEPT experiments indicated the need to revise a number of 13C-nmr assignments of pregn-4,16-dien-3,20-dione. Nine indole alkaloids, gelsemine, gelsevirine, 21-oxogelsemine, gelsedine, 14 beta-hydroxygelsedine, gelsenicine, humantenidine, humantenirine, and koumidine were found to be inactive in the KB and P-388 cytotoxicity test systems. PMID- 3655796 TI - Maquiroside A, a new cytotoxic cardiac glycoside from Maquira calophylla. AB - Maquiroside A, a new cardiac glycoside, was isolated from the Peruvian plant Maquira calophylla. The structure was established using spectroscopic methods, and the aglycone was found to be cannogenol. The sugar portion was identified as D-cymarose. Maquiroside A demonstrated activity against the KB cell culture. PMID- 3655797 TI - A simplified isolation procedure for azadirachtin. PMID- 3655798 TI - Plant anticancer agents, XLIII. (E,E)-7, 12-dioxo-octadeca-8, 10-dien-1-oic acid (ostopanic acid), a cytotoxic fatty acid from Ostodes Paniculata. PMID- 3655799 TI - Bioactive stilbenes of Scirpus maritimus. PMID- 3655800 TI - Identification of antiinflammatory agents from Sideritis species growing in Spain. PMID- 3655801 TI - Chemical studies on Mexican plants used in traditional medicine II: Cucurbitacins from Hintonia Latiflora. PMID- 3655802 TI - Puupehenone, a cytotoxic metabolite from a deep water marine sponge, Stronglyophora hartmani. PMID- 3655803 TI - Cytotoxic flavonols from Gutierrezia microcephala. PMID- 3655804 TI - A reappraisal of the relationship between arachnoid cysts of the middle fossa and chronic subdural haematoma. AB - It has been increasingly recognised that patients with arachnoid cysts of the middle fossa appear more susceptible to the development of subdural haematomas. Seven patients with arachnoid cysts of the middle fossa and associated subdural haematomas are presented. Intra-cystic haemorrhage, masking the presence of an arachnoid cyst on computed tomography (CT) is highlighted. Repeat of CT scanning in young patients with subdural haematomas in the absence of severe trauma is recommended. Two theories are proposed to account for the observed susceptibility to the development of subdural haematomas in these patients. PMID- 3655805 TI - Syringomyelia: cyst measurement by magnetic resonance imaging and comparison with symptoms, signs and disability. AB - The severity and distribution of symptoms and signs in patients with syringomyelia is considered to be dependent on the longitudinal and transverse dimensions of the syrinx and it is thought that clinical examination can identify the extent of the cyst. Magnetic resonance imaging has made the anatomical localisation of intramedullary spinal lesions more exact and probably more specific than previous methods of investigation. Syrinx length, diameters, cyst:cord and cord:canal ratios have been studied in 12 patients with syringomyelia to assess whether the dimensions of the syrinx relate to the clinical findings. The length of syrinx appeared to be related to cyst diameter, cyst:cord and cord:canal ratios. Patients with a small syrinx tended to have a small cyst diameter, and small cyst:cord and cord:canal ratios. No significant relationship was found between muscle wasting or weakness, distribution of sensory loss, degree of disability or distress and the dimensions of the syrinx. These findings should be borne in mind when surgical management is being considered. PMID- 3655806 TI - Evoked skin sympathetic nerve responses in man. AB - Activity in human unmyelinated efferent nerve fibres was recorded from seven upper limb cutaneous nerve fascicles. The activity induced by contralateral nerve trunk stimulation or tone burst was averaged and could be compared providing the stimuli were delivered at random times and in a random sequence. The average evoked sympathetic nerve responses to nerve trunk stimulation and tone burst were identical in latency and duration. PMID- 3655807 TI - Testing the vestibular-ocular reflexes: abnormalities of the otolith contribution in patients with neuro-otological disease. AB - Conventional vestibular rotation testing with the head centered on the axis stimulates the semicircular canals evoking compensatory eye movements. If the head is placed forwards of the axis in an eccentric position the otoliths are also stimulated by a tangential linear acceleration acting laterally to the skull. In normal subjects the additional otolithic stimulus evokes compensatory eye movements with a higher gain than with head centred, particularly for high frequency (greater than 0.1 Hz) stimuli. The responses with head centred and eccentric in various patients with known/suspected neuro-otological abnormalities have been compared. Patients with vestibular neurinectomies who have asymmetrical head centred responses showed greater asymmetry with head eccentric at higher stimulus frequencies. Some patients with cerebellar lesions showed abnormally enhanced or depressed and asymmetrical responses with head eccentric in comparison with head centred responses, which could be normal. The enhancing effects could be specific to low frequency stimuli. All patients who showed abnormal responses with head eccentric also had positional nystagmus provoked by the gravity acceleration vector when the head was tilted laterally. The direction of the positional nystagmus with respect to the gravity vector was not necessarily the same as the direction of the effect on eye movements of lateral acceleration during eccentric oscillation. Patients with benign paroxysmal vertigo or chronic linear vertigo in whom otolithic abnormalities are suspected were not found to have abnormal responses with head eccentric. We conclude that this method of testing may be useful in elucidating pathophysiology but is not a decisive clinical test for the presence of disordered otolith function. PMID- 3655808 TI - Muscle fibre type composition, motoneuron firing properties, axonal conduction velocity and refractory period for foot extensor motor units in dystrophia myotonica. AB - Seven patients with dystrophia myotonica were investigated using neurophysiological combined with histochemical techniques to elucidate motor unit properties in foot extensor muscles, which are often involved in the early stages of this disorder. For the 25 extensor digitorum brevis motor units studied the axonal conduction velocity, the axonal refractory period and the voluntary firing properties were within normal limits. However, high threshold motor units were not observed and the mean value of the axonal conduction velocities was lower (p less than 0.02) for the dystrophia myotonica motor units when compared with corresponding data from healthy subjects. There were also signs of impaired impulse propagation in the terminal part of the motor unit. In muscle biopsy specimens from the anterior tibial muscle, fibre type composition and structure were demonstrated using enzyme histochemical techniques for adenosine triphosphate and immunohistochemical techniques for identification of the types of myosin isoform present. The histochemical findings indicated a type I fibre dominance, which was most obvious in the more seriously affected muscles. Neonatal myosin was observed preferentially in small but also in some normal sized fibres. Furthermore, some ring fibres were present and these showed staining with antineonatal myosin in their superficial portion. This indicates that an abnormal regeneration is one cause of the myopathic appearance of the muscle fibres in dystrophia myotonica. These investigations show that there is a reduced proportion of type II motor units in foot extensor muscles involved in the myopathy in dystrophia myotonica although it cannot definitely be established whether this is due to a loss of high threshold type II motor units or type II to type I transformation. PMID- 3655809 TI - Interobserver agreement in assessment of vestibulo-ocular responses. AB - In 30 comatose head injured patients vestibulo-ocular responses were elicited by caloric stimulation. Inter- and intra-observer agreement of these responses was studied. The responses were shown in the form of a film to ten doctors who classified them into four categories: no reaction, tonic reaction, paradoxical nystagmus and nystagmus. The level of the coefficient Kappa (a chance-corrected measure of interobserver agreement) was 0.50; this is within the range of levels for most components of clinical examination reported in the literature. PMID- 3655810 TI - Primary intracerebral Hodgkin's lymphoma. AB - The case is reported of a 51 year old man with primary intracerebral Hodgkin's lymphoma treated by surgical excision, intrathecal chemotherapy and whole-brain irradiation. One year later the patient had no evidence of Hodgkin's lymphoma intracranially or elsewhere. The possible histogenesis of this rare condition is discussed and a brief review of the literature is presented. PMID- 3655811 TI - Third nerve palsy due to posterior communicating artery aneurysm: the importance of early surgery. AB - The value of early, direct aneurysm clipping in restoring third-nerve function after palsy associated with a posterior communicating artery aneurysm is assessed. PMID- 3655812 TI - Craniopharyngioma in the third ventricle: necropsy findings and histogenesis. AB - A case of craniopharyngioma confined within the third ventricle with necropsy is reported. A stalk-like structure in this tumour was present in the wall of the third ventricle at its base. It is suggested that this tumour might have arisen from the remnants of Rathke's pouch persisting in the tuber cinereum. PMID- 3655813 TI - Intracranial angiolipoma. AB - Fat containing tumours within the central nervous system are rare. The second reported case of intracranial angiolipoma is described. PMID- 3655814 TI - Carnitine palmitoyl transferase deficiency with an atypical presentation and ultrastructural mitochondrial abnormalities. AB - A case of carnitine palmitoyl transferase deficiency presenting in a 72 year old woman with the clinical picture of ophthalmoplegia plus other muscle weakness is reported. Histological and ultrastructural examination showed the features of a mitochondrial myopathy. PMID- 3655816 TI - Syrinx associated with intramedullary metastasis. AB - Two cases are reported of syrinx associated with an intramedullary metastasis. The first presented with hyperaesthesia in the right arm and bilateral pyramidal leg weakness, the second with a partial right sided Brown Sequard syndrome with a sensory level at D6. A possible pathological mechanism for the development of such syrinxes is discussed. PMID- 3655815 TI - Neck tumour with syncope due to paroxysmal sympathetic withdrawal. AB - A patient with recurrent squamous carcinoma metastatic to the neck after radical neck dissection and high dose radiation therapy developed paroxysmal hypotensive episodes that were severe, spontaneous and characterised by suppressed sympathetic but not enhanced parasympathetic activity. Intravenous pressors were successful in treating acute episodes but neither drug therapy nor surgical neck exploration reliably prevented syncopal attacks. Glossopharyngeal and/or vagal nerve infiltration by tumour with episodic activation of the afferent limb of the baroreflex arc producing vasodilatation primarily due to sympathetic withdrawal is the likely mechanism of life threatening syncope in this patient. PMID- 3655817 TI - Contraindications to lumbar puncture as defined by computed cranial tomography. AB - Papilloedema is not always an adequate predictor of potential complications from lumbar puncture, and many clinicians are using computed tomography (CT) before lumbar puncture in an effort to identify more accurately the "at risk" patient. This paper identifies the following anatomical criteria defined by CT scanning that correlate with unequal pressures between intracranial compartments and predispose a patient to herniation following decompression of the spinal compartment: lateral shift of midline structures, loss of the suprachiasmatic and basilar cisterns, obliteration of the fourth ventricle, or obliteration of the superior cerebellar and quadrigeminal plate cisterns with sparing of the ambient cisterns. These criteria should be considered to be contraindications to lumbar puncture. PMID- 3655818 TI - Giant middle cerebral aneurysm presenting as hemiparkinsonism. PMID- 3655819 TI - The fluid-blood level in intracranial haematoma due to anticoagulant medication. PMID- 3655820 TI - Reversible movement disorder in a patient with post traumatic basal ganglia haematoma. PMID- 3655821 TI - Anaplastic astrocytoma associated with human growth hormone administration. PMID- 3655822 TI - Skull base chondroma presenting in pregnancy. PMID- 3655823 TI - Recurrence of Cushing's disease due to corticotrophe hyperplasia following transphenoidal hypophysectomy. PMID- 3655824 TI - Cysticercosis in the UK. PMID- 3655825 TI - Purulent meningitis after percutaneous radiofrequency trigeminal rhizotomy. PMID- 3655826 TI - Oblique pectoral crease and "scapular hump" in shoulder contour are signs of trapezius muscle weakness. PMID- 3655827 TI - Apraxia in subcortical lesions. PMID- 3655828 TI - On the mystery of multiple sclerosis. PMID- 3655829 TI - Thoracic cord compression from metastatic prostate carcinoma with Lhermitte's "sign". PMID- 3655831 TI - Changes in cerebral blood flow during anaesthesia and surgery in the sitting position. AB - Serial measurements of global cerebral blood flow (CBF) were made in 15 patients undergoing elective neurosurgical procedures in the sitting position, using a modified intravenous 133Xenon technique. The mean supine CBF rose from 43 (+/-3) ml/100g/min to 62 (+/-6) ml/100g/min in the sitting position and remained elevated at the end of surgery at 62 (+/-5) ml/100g/min. Both increases in CBF were statistically significant with respect to baseline supine values. PMID- 3655830 TI - Differences in the management of ruptured intracranial aneurysms: a survey of practice amongst British neurosurgeons. AB - British consultant neurosurgeons in post for at least one year were sent a postal questionnaire about the way in which they managed patients with ruptured aneurysms; 87% replied. Wide differences were evident in almost all aspects of treatment, before, during and after surgery. A consensus of opinion appeared in only a few areas: the employment of magnification during surgery, the use of clipping as the preferred method of surgical treatment, and a general reluctance to operate on patients with a depressed conscious level within a week of haemorrhage. PMID- 3655832 TI - Intracerebral haemorrhage: a model for the prediction of outcome. AB - The hospital charts and CT scans of 112 patients with spontaneous supratentorial haemorrhage were retrospectively reviewed to evaluate factors important to prognosis. A low Glasgow Coma Scale score, coma, ataxic respiration, abnormal pupils, acute hypertension, large haemorrhage size and intraventricular extension of blood were associated with a poor outcome. Multivariate analysis using the technique of logistic regression identified three variables, the Glasgow Coma Scale score, haemorrhage size and intraventricular extension of blood, which were most predictive of outcome. A model was developed from this analysis which accurately estimates the probability of good outcome and the risk of poor outcome based on data available on presentation. With additional validation, this model may be useful in choosing patients for surgical evacuation of haematomas. PMID- 3655833 TI - Do cerebral arteriovenous malformations increase in size? AB - Six patients are reported with cerebral arteriovenous malformations which have enlarged over follow up periods of from 4 to 20 years. The frequency of spontaneous enlargement is estimated to range from 0.2% to 2.8% per annum. This rate of enlargement should be considered when treatment options are reviewed in individual patients, and should be added to the risk of haemorrhage. PMID- 3655834 TI - A neuropsychological study of active amateur boxers. AB - Neuropsychological examinations were carried out on 29 amateur boxers and 19 controls matched for age, ethnicity, and education. There was no evidence of significantly impaired performance in the boxers. Within the boxing group, a variety of features of boxing history were examined as possible predictors of cognitive performance (such as number of knockouts, duration of boxing). No feature was a significant predictor of lower cognitive performance. PMID- 3655835 TI - Distribution of type VI collagen in human gliomas: comparison with fibronectin and glioma-mesenchymal matrix glycoprotein. AB - The distribution of type VI collagen was examined immunohistochemically in normal tissues and in 24 human gliomas and six medulloblastomas. Its localization in the neoplasms was compared with that of fibronectin and glioma-mesenchymal extracellular matrix (GMEM) glycoprotein. In normal non-neural tissues type VI collagen was demonstrated in the interstitial connective tissue and in some basement membranes. In normal brain it was localized to the vasculature, leptomeninges, and pial-glial membrane. In neoplasms type VI collagen and fibronectin codistributed in the vasculature and stromal connective tissue. The GMEM glycoprotein, as identified by monoclonal antibody (MAb) 81C6, and a related glioma-mesenchymal matrix antigen identified by MAb 2A6, were expressed not only in the tumor vasculature and connective tissue, but also within the tumor parenchyma in association with glioma cells. The staining intensity was variable in 20 malignant gliomas and weak to absent in two pilocytic astrocytomas and six medulloblastomas. An oligodendroglioma and ependymoma both expressed the 2A6 epitope, but staining with MAb 81C6 was weak to absent. The antigens identified by MAb 81C6 and MAb 2A6 represent the only recognized extracellular matrix components, other than proteoglycans, that are associated with glioma cells in vivo. As prominent constituents of the pericellular matrix, they may be involved in recognized matrix functions such as the modulation of cell adhesion and migration. PMID- 3655836 TI - Multiple neural cell types are infected in vitro by border disease virus. AB - Border disease (BD) of sheep results from a congenitally acquired nonarbotogavirus infection which causes a highly selective central nervous system (CNS) pathological lesion consisting of diffuse decreased myelination without inflammation or neuronal destruction. Thus, a selective disruption of oligodendroglial function appears to occur. In order to investigate the in vitro cell tropism of BD virus, primary cultures derived from fetal and adult ovine CNS and peripheral nervous system were inoculated with BD virus. Infected cell types were determined by dual immunofluorescent labeling for viral and cell type specific antigens. Infection of all the major cell types represented in these cultures, including oligodendrocytes, astrocytes, fibroblasts, dorsal root ganglion neurons and Schwann cells was found. Oligodendrocytes were only infected earlier and appeared to remain infected longer than astrocytes and fibroblasts. Infectious virus was produced by all cultures and continued to be produced even after the disappearance of nearly all immunocytochemically detectable viral antigen within cells. These studies suggest that the selective dysfunction of the oligodendrocyte in BD is not based on a selective viral tropism. PMID- 3655837 TI - Morphological responses to local CNS trauma: sprouting and synaptogenesis within membranes implanted into mature cerebral cortex of the rat. AB - The purpose of this study was to document in vivo neuronal sprouting in response to local trauma of the mature cerebral neocortex. The experimental approach enabled direct and unequivocal ultrastructural identification of newly sprouted neuronal processes and their synaptic relationships. Morphologically detectable factors that influence neuronal sprouting were also assessed. Tiny fragments of porous, synthetic membrane were implanted into the mature neocortex of the rat. After one week, axons, dendrites, growth cone-like structures, synapses, and processes from astrocytes and microglia were present deep within the interstices of the implant. Morphometric analysis of synapses within the implant, support the qualitative impression of active neuronal ingrowth and de novo synaptogenesis by these sprouted elements. Astrocytic processes appear to comprise the major barrier to neuronal invasion of the implant. Several observations suggested that glia sometimes may facilitate neuronal ingrowth. These findings provide direct morphological documentation of axonal and dendritic plasticity in the mature rat neocortex. The work demonstrates a strategy that could be useful for further evaluating the cellular mechanism of in vivo neuronal regeneration. PMID- 3655838 TI - The role of new vessels and macrophages in the development and resolution of edema following a cortical freeze lesion in the mouse. AB - The role of an influx of macrophages and neovascularity in the resolution of vasogenic edema is not well defined. The inhibition of these processes with x irradiation or parenteral corticosteroid administration was used to evaluate their contribution to the resolution of edema around a cortical freeze lesion in mice. The resorption of Evans blue, a marker of protein extravasation, was delayed in x-irradiated mice on the second day following a freeze lesion (p = 0.0075), which correlates with a delay in macrophage infiltration around the lesion. The specific gravity of the lesion and its border regions was significantly less in x-irradiated animals on day 7 than in controls (p = 0.00062), which correlates with a delay in new vessel formation around the lesion. Administration of corticosteroids from the time of production of the freeze lesion resulted in a specific gravity significantly less than control when measured eight days after the lesion (p = 0.01). Macrophages may participate by inhibiting the development of the macromolecular portion of vasogenic edema. The development of neovascularity correlates with the resorption of the aqueous portion of vasogenic edema. As with x-irradiation, corticosteroids administered from the time of freeze lesion inhibited the resorption of the aqueous portion of vasogenic edema, but they may suppress the spread of edema in this experimental model. PMID- 3655839 TI - Changes in number and size of Clarke's column neurons after cord transection. AB - The number of large neurons in Clarke's column of the L-1 segment of the spinal cord of the rat decreases five or more weeks after a T-9 spinal cord transection. Analysis of cells at 1, 2, 3, 5, 7, 9, 12, and 15 weeks (wk) postoperatively demonstrates a loss of large neurons at each time interval beyond five wk postoperatively. Comparison of cell sizes found in the anatomic region of Clarke's column at two or three wk postoperatively with the cells found at 15 wk after transection and their respective control groups, shows a decrease in total cells found in operated rats 15 wk postoperative with a profound decrease in larger neurons in these rats. We did not detect a significant offsetting increase in smaller neurons. We believe the observed changes are due to death of large neurons and can find no evidence to support the contention that axotomized cells persist in a shrunken, atrophic state. PMID- 3655840 TI - Cerebral amyloid angiopathy in the aged. AB - Cerebral amyloid angiopathy (CAA) was found in 57% of 123 autopsy brains removed from patients aged 59-101 years. The incidence of CAA increased with age. CAA was seen most frequently in the occipital cortex. Immunohistochemically, amyloid of CAA was positive for amyloid P component and negative for human AA protein and human prealbumin. The presence and severity of CAA were significantly correlated with the number of senile plaques and neurofibrillary tangles. The incidence of CAA in 17 patients with dementia of Alzheimer type (DAT) was estimated to be 88% and was significantly higher than that in 26 patients with dementia of non Alzheimer type. CAA had a pathogenetic relationship with both brain ageing and DAT. Lobar cerebral haemorrhage was found in 3 patients with CAA of marked or moderate degree. Lobar cerebral haemorrhage in the aged and in patients with DAT suggest the presence of CAA. PMID- 3655841 TI - Myoadenylate deaminase deficiency: absence of correlation with exercise intolerance in 452 muscle biopsies. AB - A histochemical assay was routinely performed of myoadenylate deaminase (MAD) in muscle biopsy specimens. MAD was absent in 13 cases, i.e. 2.9% of the specimens. In 10 cases the deficiency was confirmed biochemically. The diagnoses in the 13 patients were: polyneuropathy (n = 5), infantile spinal muscular atrophy (n = 3), congenital myopathy with type 2 fibre atrophy, facioscapulohumeral myopathy, polymyositis, myotonic dystrophy and hyperornithinaemia with gyrate atrophy of the retina. In contrast, 35 unrelated patients presenting with exercise-related muscle cramps or pains showed normal histochemical MAD activity. The biopsy specimens in all of these patients were essentially normal and in none of them was the diagnosis of a neuromuscular disease made. The results failed to confirm the association of MAD deficiency with aches, cramps and pains or exertional myalgia. PMID- 3655842 TI - Evaluation by MRI of paraparesis and tetraparesis of undiagnosed aetiology. AB - The clinical, neuroradiological, electrophysiological and CSF findings of seven patients with slowly progressive paraparesis or tetraparesis are presented. In all patients, the results of the tests performed, including evoked potentials, CT scanning, oligoclonal bands in the CSF and myelography, were normal or inconclusive and did not lead to the correct diagnosis of the aetiology. In contrast, magnetic resonance imaging (MRI) provided the diagnosis of the causative process: multiple sclerosis in four cases, meningioma of the craniocervical junction or upper thoracic spinal cord in two cases, and upper cervical cord low-grade astrocytoma in one case. The patients with tumour could be treated effectively. Without MRI, however, the correct diagnosis would have been delayed. T2-weighted spin-echo scans provided maximal sensitivity for the detection of MS plaques, although they lacked specificity for a special disease. Several morphological criteria during MRI were helpful in differentiating Binswanger's disease, leucodystrophy and adrenoleucodystrophy from MS. It is concluded that at present MRI is the only non-invasive test with which to screen reliably the craniocervical junction and the upper cervical level, both of which are diagnostically difficult regions. The case histories also demonstrate that MRI is essential in all patients where a full clinical evaluation of the suspected spinal segment is not possible. "Pure spinal MS" is a misleading diagnosis and should not be accepted without confirmation by MRI. MRI has to be performed early enough to permit timely treatment of spinal and brain-stem disorders. PMID- 3655843 TI - Inflammatory changes in affected muscles of facioscapulohumeral dystrophy. AB - A 34-year-old man developed slowly progressive muscular wasting of facioscapulohumeral (FSH) distribution with marked asymmetry. Clinical features, family history and laboratory findings were consistent with the diagnosis of FSH dystrophy. However, muscle biopsy revealed an inflammatory reaction with perivascular and endomysial infiltrate, myophagocytosis and invasion of the fibres by mononuclear cells. Monoclonal antibody analysis of the phenotypes of cells in the biopsy specimen suggested that cell-mediated immune response may occur during muscle fibre injury in FSH dystrophy. PMID- 3655844 TI - The subcortical generated somatosensory evoked potentials in non-cephalic, cephalic, and anterior neck referenced recordings in a patient with a cervico medullary lesion: a clue to the identification of the P14/N14 and N13 generators. AB - Median nerve somatosensory evoked potentials (SEPs) were studied in a patient before and after the development of a cervico-medullary lesion. The first examination demonstrated normal subcortical generated potentials N13 and N14. The second examination, following a subarachnoid haemorrhage at the cervico-medullary junction, displayed a delayed and reduced amplitude P14/N14 peak on both sides. P14/N14 showed the same latency in all montages, using non-cephalic, cephalic and anterior neck references. The N13 component was not significantly changed in latency compared with the first examination. The latencies of the N13 peak were variable in the different montages. They increased from the lower (C7) to the upper (C2) neck, whereas the latency of the N13 onset was identical in all montages. This alteration might be caused by a delayed near-field activity at C2 overlapping the N13 component. These results fit the hypothesis of two major generators responsible for subcortical SEPs; a near-field N13 component at the level of the lower neck and a far-field P14 component arising from the level of the cervico-medullary junction. An additional minor near-field activity generated by the cuneate nucleus is suspected. PMID- 3655845 TI - Degenerescence systematisee optico-cochleo-dentelee. AB - During the first year of life a girl, the first child of non-consanguineous parents, developed a progressive neurological disease characterized by blindness, severe hypotonia, impaired motor development, microcephaly and mental retardation. Later she became unresponsive to auditory stimuli. She died at the age of 13 months. Post-mortem examination revealed atrophy of the optic nerves and chiasm, lateral geniculate nuclei and superior colliculi, degeneration of the cochlear nerve roots, dorsal and ventral cochlear nuclei, superior olives, lateral lemnisci, medial geniculate nuclei and inferior colliculi and atrophy of the dentate nuclei, hilus and superior cerebellar peduncles. These were consistent with degenerescence systematisee optico-cochleeo-dentelee. Additional abnormalities included degeneration of the posterior columns in the spinal cord, gracilis and cuneate nuclei and medial lemnisci, atrophy of the spinocerebellar tracts and Clarke's columns, cerebral cortex, cerebellum, chiefly involving the rostral vermis, inferior olivary nuclei and demyelination of the sural nerves. PMID- 3655846 TI - A case of "myopathy with tubular aggregates" with increased muscle fibre sensitivity to caffeine. AB - A 23-year-old man with "myopathy with tubular aggregates" had suffered from exercise-induced muscle cramps for 1 year. His general and neurological findings were normal. Laboratory investigations were within normal limits except for a slightly elevated serum creatine kinase level. Muscle biopsy showed some small angular fibres and scattered type 2B fibres with prominent tubular aggregates originating from the sarcoplasmic reticulum. Since the muscle fibres contracted at a lower concentration of caffeine, increased muscle fibre sensitivity to caffeine is probably related to muscle cramps in this disorder. Tubular aggregates are then secondarily formed in the muscle fibres. PMID- 3655847 TI - Progressive multifocal leucoencephalopathy with magnetic resonance imaging verification and therapeutic trials with interferon. AB - Progressive multifocal leucoencephalopathy was diagnosed by magnetic resonance imaging (MRI) and brain biopsy in a 44-year-old woman, for whom therapeutic trials with various antiviral agents were made. Despite early diagnosis and treatment, her neurological deterioration and extension of MRI-detectable lesions were not halted for a period of about 8 months. After the introduction of intrathecal beta-interferon therapy, her neurological status and MRI findings became stable and showed minimal improvement. Early diagnosis of this fatal disorder is important and intrathecal interferon therapy should be considered. PMID- 3655848 TI - Becker and limb-girdle muscular dystrophy associated with pituitary dwarfism. AB - In 1981 a report appeared of a patient with Duchenne muscular dystrophy associated with dwarfism caused by growth hormone deficiency, in whom the muscular disease was unusually benign. The authors suggested that the benign course might be related to the growth hormone deficiency and dwarfism. Other authors later supported this idea, having observed that in dystrophic mice and hamsters with congenital and experimentally induced pituitary dwarfism, respectively, pathological expressions of the dystrophy were markedly reduced. In this paper one case of Becker and one of limb-girdle dystrophy, each associated with short stature and growth hormone deficiency are described. In these cases the disease did not have a particularly benign course. It is concluded that caution is necessary, at least in certain cases, before an association between reduced muscular growth and the dystrophic process can be assumed. PMID- 3655849 TI - Neuromuscular, autonomic and central cholinergic hyperactivity associated with thymoma and acetylcholine receptor-binding antibody. AB - Two cases of a neuromuscular hyperactivity syndrome associated with a proliferative thymoma and high serum titres of acetylcholine receptor (AChR) antibody with no signs of myasthenia are reported. The clinical and electrodiagnostic findings indicated generalized cholinergic hyperactivity at the neuromuscular junction and in the autonomic and central nervous system, resulting in generalized myokymia, excessive sweating and intermittent psychotic behaviour. The association with thymoma and raised AChR antibody suggests that this syndrome represents a unique type of autoimmune disease, in which antibodies against the AChR facilitate rather than inhibit cholinergic action. This conclusion is supported by the remission of symptoms after thymectomy and with immunosuppressive therapy in one case. PMID- 3655850 TI - Juvenile-onset bulbospinal muscular atrophy with deafness: Vialetta-van Laere syndrome or Madras-type motor neuron disease? AB - A girl with rapid-onset, bulbospinal muscular atrophy and deafness is described. The patient's mother and brother showed EMG features consistent with subclinical involvement. T is bulbospinal form of spinal muscular atrophy associated with deafness described by Vialetto and van Laere closely resembles the Madras type of motor neuron disease, also associated with deafness, described by Jagganathan and colleagues. PMID- 3655851 TI - Three cases of amyotrophic lateral sclerosis in a common occupational environment. AB - Three unrelated school teachers taught in the same school classroom for 2-5 years and subsequently developed amyotrophic lateral sclerosis (ALS) over an 18-year period. This clustering was not accompanied by an increased death rate for ALS in the county where the teachers lived and worked. Statistical analysis revealed that ALS as the cause of death for three teachers from the same school would be highly improbable as a random event. These findings suggest that the patient's shared school environment may have been a source of exposure to an agent pathogenetically significant in the development of their disease. PMID- 3655852 TI - Gliomatosis cerebri: report of a case presenting as a focal cerebral mass. AB - Gliomatosis cerebri (syn. astrocytomatosis cerebri) is a rare diffuse neoplastic condition affecting all parts of the brain. The clinical and pathological features of an unusually diffuse and histologically uniform case of gliomatosis cerebri are presented. Many tumour cells stained positively for glial fibrillary acid protein, confirming the astrocytic derivation of this neoplasm. Differing views on the nature of gliomatosis cerebri are briefly discussed. PMID- 3655853 TI - Computed tomography and magnetic resonance imaging in a young patient with Wernicke's encephalopathy. PMID- 3655854 TI - Adjuvant irradiation following mastectomy: where are we? PMID- 3655855 TI - Chemotherapy versus chemoimmunotherapy (CAF v CAFVP v CMF each +/- MER) for metastatic carcinoma of the breast: a CALGB study. Cancer and Leukemia Group B. AB - Three combination chemotherapy regimens each with or without the methanol extracted residue of bacillus Calmette-Guerin (BCG) (MER) were compared for efficacy. After stratification for disease-free interval and dominant sites of disease, patients were randomized to either CMF (cyclophosphamide [CYC], 100 mg/m2 orally, days 1 through 14; methotrexate [MTX], 40 mg intravenously [IV], days 1 and 8; 5-fluorouracil [5-FU], 500 mg/m2 IV, days 1 and 8), or CAF (CYC, 100 mg/m2 orally, days 1 through 14; doxorubicin [DOX], 25 mg/m2 IV, days 1 and 8; 5-FU, 500 mg/m2 IV, days 1 and 8), or CAFVP (CAF as above plus vincristine [VCR], 1.0 mg/m2 IV, days 1 and 8; and prednisone [PRED], 40 mg/m2 orally, days 1 through 14). Nonspecific immunotherapy with MER was administered in five sites at 100 micrograms or at the lowest tenfold dilution that produced a 1-cm indurated lesion. A total of 432 patients were entered, but 37 were disqualified, leaving 395 evaluable for treatment results and toxicities. One hundred thirty-five evaluable patients were randomized to chemoimmunotherapy until October 28, 1978. One hundred twenty-six evaluable patients were randomized to chemotherapy alone in the same time period. For the entire study, a total of 260 evaluable patients were randomized to chemotherapy. Chemoimmunotherapy patients were compared with the initial 126 chemotherapy patients. Chemotherapy regimens were compared among all 260 patients. Patient characteristics were similar between regimens and between chemotherapy and chemoimmunotherapy treatment groups. For patients on chemotherapy plus MER, there was no significant differences between the regimens for response frequencies: 43%, 41%, and 32%, respectively for CMF, CAF, and CAFVP. The comparable chemotherapy alone group had 36%, 58%, and 63% response, respectively. The response rates, adjusted for chemotherapy regimen, were 52% and 38% (P = .02) for chemotherapy and chemoimmunotherapy, respectively. MER was associated with painful ulcers and fevers. Thus, MER produced toxicity without response or survival benefit and further randomization after October 28, 1978 was to chemotherapy alone. For 260 evaluable patients on chemotherapy alone, the complete (CR) and partial responses (PR) were 37%, 55%, and 58%, respectively for CMF, CAF, and CAFVP. These response rates for CAF and CAFVP were significantly better than CMF (P = .01 and P less than .01, respectively). These comparisons were consistent within subgroupings such as dominant sites of disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655856 TI - Chemohormonal therapy in advanced carcinoma of the breast: Cancer and Leukemia Group B protocol 8081. AB - In a prospective, randomized trial Cancer and Leukemia Group B (CALGB) evaluated CAF chemotherapy (cyclophosphamide + doxorubicin + 5-fluorouracil [5-FU]) v CAF plus tamoxifen (TCAF) in advanced breast cancer. Patients were stratified by estrogen receptor (ER) status, dominant site of metastatic disease, menopausal status, and prior adjuvant therapy. Regardless of ER status or menopausal status, the addition of tamoxifen conferred no significant advantage in response rate, response duration, time to treatment failure (TTF) or survival over CAF alone. A secondary objective was to compare the response to CAF of ER positive (ER+) and ER negative (ER-) patients to determine if there was a differential response to cytotoxic chemotherapy. Response rates of ER+ and ER- patients to CAF were identical (56%), but the response duration, time to treatment failure, and survival of ER+ patients were significantly longer than ER- patients. This lack of differential response implies that chemotherapy and hormonal therapy may compete for the same pool of ER+ cells. It also suggests that chemotherapy kills breast cancer cells indiscriminately, regardless of ER status. PMID- 3655857 TI - Tamoxifen rechallenge: response to tamoxifen following relapse after adjuvant chemohormonal therapy for breast cancer. AB - Two-hundred seventy-three node-positive primary breast cancer patients with positive estrogen or progesterone receptors were placed on a short-term chemohormonal adjuvant program that included tamoxifen. At present, 64 have relapsed, 19 of whom have been rechallenged with tamoxifen after disease-free intervals (DFI) ranging from 0.4 to 4.4 years. Most patients had only one site of disease recurrence. Two patients have achieved complete remission (CR) and three partial remission (PR) for a CR and PR rate of 26% (95% confidence interval for CR and PR is 9% to 51%). Duration of response has ranged from 3 to 17+ months. Patients who receive short-term adjuvant therapy with tamoxifen and who relapse may respond to tamoxifen rechallenge. In this series, the response rate to tamoxifen rechallenge was similar to the response rate for patients unselected for estrogen receptor status receiving first-line endocrine therapy for breast cancer relapse. PMID- 3655858 TI - Pharmacokinetics and toxicity of intraperitoneal cisplatin combined with regional hyperthermia. AB - Hyperthermia (HT) potentiates in vitro cytotoxicity of cisplatin, providing a rationale for HT enhancement of cisplatin effect in vivo. In this study, regional abdominal HT was combined with intraperitoneal (IP) cisplatin in canines to characterize temperature distributions, as well as pharmacokinetics and toxicity of IP cisplatin with and without HT. Cisplatin (65 mg/m2) in normal saline was administered IP with a two-hour dwell time in ten Beagle dogs. Five of the ten dogs were randomly selected to receive concurrent regional microwave-producing HT at approximately 41.5 degrees C (IP) for a 60-minute period. Systemic temperatures in heated animals ranged from 37 degrees C to 40 degrees C; IP temperatures ranged from 39 degrees C to 44 degrees C. Initial IP temperatures ranged from 39 degrees C to 44 degrees C. Initial IP cisplatin concentrations were ten to 22 times greater than serum levels; the IP drug half-lives were 133 +/- 9 minutes and 68 +/- 15 minutes in heated and unheated dogs, respectively (P less than .001). Total concentrations of serum and urine cisplatin did not differ between the heated and unheated controls. The area under the concentration v time curve for free, ultrafilterable cisplatin in serum in units of percent minutes was 40 +/- 8 in heated and 60 +/- 7 in unheated controls (P = .006). Except for transient nausea and vomiting, no evidence of serious toxicity was observed in serum chemistries or histopathologic sections at 21 days post-treatment. Experiments involving in vitro incubation of cisplatin in normal saline were performed as a function of saline temperature; these showed that the amount of reactive cisplatin metabolites formed increased linearly with temperature by approximately 30% from 38 degrees C to 44 degrees C. This study supports the hypothesis that, with IP temperature elevation, there is an increased rate of generation and retention of reactive metabolites of cisplatin in the peritoneal cavity relative to unheated controls. In spite of these differences in pharmacokinetics, no significant toxicity was encountered. This study provides a model for treatment of IP malignancy such as ovarian carcinoma with IP cisplatin and regional HT. PMID- 3655859 TI - Combination chemotherapy for metastatic or recurrent adenocarcinoma of the cervix. AB - Twenty-four patients with recurrent or widespread adenocarcinoma of the cervix were treated with combination chemotherapy. The drugs used were 5-fluorouracil (5 FU) (500 to 800 mg/m2), doxorubicin (40 to 50 mg/m2), and cisplatin (50 to 60 mg/m2). The chemotherapy was administered as a 76-hour continuous infusion via a silastic central venous catheter and repeated every 28 days. The total response rate was 42% (25% complete and 17% partial). Median duration of response was 7 months. Areas of response were usually lung and lymph node metastases. Toxicity, mainly neutropenia, was acceptable. All patients relapsed. This combination chemotherapy results in a modest response rate for a malignancy about which there is little information regarding the treatment of disseminated disease. Future studies should determine the activity of this combination administered in a bolus fashion. PMID- 3655860 TI - Major complications and causes of death in patients treated for Hodgkin's disease. AB - A total of 340 patients with Hodgkin's disease were evaluated for the occurrence of intercurrent fatalities after treatment with radiotherapy, chemotherapy, combined modality therapy, and salvage chemotherapy. Mean follow-up time was 76.6 months. Causes of death were compared with the expected risk, calculated from mortality statistics of the Netherlands' population. Sixty-seven patients died of progressive Hodgkin's disease, whereas 37 patients died of causes unrelated to advanced disease. Patients showed an increased risk of dying of leukemia and solid tumors (P less than .001), whereas the risk of dying of cardiovascular complications was not increased. The 10-year actuarial risk of dying of leukemia varied between 0% for patients treated with radiotherapy only and 5.7% for those needing salvage chemotherapy. The 10-year risk of dying of solid tumors was 0% for patients treated with chemotherapy and 6.5% for those receiving radiotherapy. Treatment-related fatalities were highest after combined modality therapy (P less than .025); the corresponding 10-year risk was 6.1%. Compared with younger ones, patients greater than or equal to 40 years had an increased risk of dying of causes unrelated to progressive Hodgkin's diseases. The actuarial risk of developing intercurrent fatalities at 10 years was 4.9% in patients less than 40 years, and 34.7% in those greater than or equal to 40 years (P less than .001). Compared with population based statistics, patients successfully treated for Hodgkin's disease still showed an increased risk of dying (P less than .001). Treatment modality, stage, and histologic subtype were not predictors of intercurrent death. PMID- 3655861 TI - Modification of Kiel and working formulation classifications for improved survival prediction in non-Hodgkin's lymphoma. AB - The total survival of 203 patients with non-Hodgkin's lymphoma (NHL) was analyzed according to the working formulation (WF) and "expanded" Kiel classifications. The original Kiel classification consisting of low grade (LG) and high grade (HG) forms corresponded well to the LG and HG forms of the WF. When an expanded Kiel containing an intermediate grade (IG) composed of the original LG diffuse group was devised, this gave a much better separation of survival of the three grades as compared with the WF where the survival of IG and HG forms were nonsignificantly different. The main reason for this difference was the inclusion of the so-called centroblastic diffuse form in the HG Kiel, but in the IG according to the WF. In a "modified" WF analysis where this histologic entity was placed in the HG subgroup, the three survival curves then gave excellent separation like the expanded Kiel classification. Since the centroblastic diffuse form (and its analogous forms according to other classifications) has a poor prognosis, it is important that it be so recognized and treated accordingly with aggressive therapy. We propose either our expanded Kiel or modified WF classification of the three grade forms as an excellent predictor of survival. PMID- 3655862 TI - The effects of distance from primary treatment centers on survival among patients with multiple myeloma. AB - Twenty-one comprehensive cancer centers participated in a national reporting system of common data items, recording information on all patients seen between 1977 and 1982. There were 240,531 patients who had data abstracted. This report describes 1,479 patients with multiple myeloma. Parameters that may effect the type of treatment given during the initial episode of therapy in the center and the effect of these characteristics on survival were studied. In the univariate analysis, age, treatment, and distance traveled to the center were statistically associated with survival. In a multivariate analysis adjusting for potentially confounding covariates, blacks survive better than whites and the effects of sex and socioeconomic status (SES) on survival approach significance. Survival consistently improved with increasing distance traveled to treatment centers. This may be a serious confounding variable in assessing the results by both single and multiinstitution clinical trials. PMID- 3655863 TI - Comparison of spinal magnetic resonance imaging and myelography in cancer patients. AB - Spinal involvement by systemic malignancy is common, and often leads to extradural compression of the spinal cord and/or nerve roots by metastases. Rapid, anatomically accurate diagnosis is essential to the successful management of these patients. We compared spinal magnetic resonance imaging (MRI) with conventional myelography in a series of 31 cancer patients being evaluated for myelopathy (N = 10), or back/radicular pain (N = 21). All patients were evaluated between April 1985 and July 1986, and underwent both studies within ten days of each other (median, two days). MRI was performed on a 0.5 Tesla Technicare unit with a body surface coil, and results compared with standard contrast myelography. All studies were reviewed separately and in a "blinded" fashion. MRI and myelography were comparable in detecting large lesions that produced complete subarachnoid block (five of ten patients with myelopathy, three of twenty-one patients with back/radicular pain). In 19 of 31 patients, smaller but clinically significant extradural lesions were found. In nine of 19 cases, these lesions were demonstrated equally well by both modalities; in nine of 19 cases, these lesions were demonstrated by myelography alone; in one of 19, a lesion was demonstrated by MRI alone. Given our current technology, myelography appeared superior to MRI as a single imaging modality. However, MRI may be an alternative in patients where total myelography is technically impossible or unusually hazardous. PMID- 3655864 TI - Reporting outcomes in Hodgkin's disease and lymphoma. PMID- 3655865 TI - Red hair and hyperpigmentation in a black man after chemotherapy. PMID- 3655866 TI - Linear mechanism of orientation tuning in the retina and lateral geniculate nucleus of the cat. AB - 1. The orientation tuning of lateral geniculate nucleus (LGN) neurons and retinal ganglion cells (recorded as S potentials in the LGN) was investigated with drifting grating stimuli. 2. Results were compared with a quantitative model, in which receptive fields were constructed from linear, elliptical Gaussian center and surround subunits, and responses could be predicted to gratings of any spatial frequency at any orientation. 3. The orientation tuning of X and Y retinal ganglion cells and LGN neurons was shown to result from the linear mechanism of receptive-field elongation, as data from these cells could be well fit with this model. 4. The responses of LGN neurons and their input retinal ganglion cells were compared. The orientation tuning of LGN neurons was found to be a reflection of the tuning of their retinal inputs, showing that neither intrageniculate neural interactions nor the corticogeniculate projection play any role in LGN orientation selectivity. PMID- 3655867 TI - Retrograde effects of target atrophy on submandibular ganglion neurons. AB - 1. To study the retrograde effects of changes in target tissue upon the innervating nerve supply, we have examined the parasympathetic submandibular ganglion of the adult rat. Neurons of this ganglion innervate the submandibular and sublingual salivary glands. 2. Ligating the salivary ducts leads to rapid and prolonged salivary gland cell atrophy. 3. Duct ligations, without direct injury to the glandular nerve supply, initially produced few alterations in the ganglion. After 8 wk, however, neuron number was reduced by 50%. The numbers of presynaptic inputs/neuron and synapses/neuron perimeter were not affected by the cell loss. 4. After 1 wk of duct ligation in which the glandular nerve supply was intentionally damaged, some ganglionic neurons have lost all presynaptic inputs, suggesting synaptic disjunction. This is followed at 3 wk by a 40% decrease in neuron number and an increase in the number of inputs per (remaining) ganglion cell. However, the number of synapses/neuronal profile was unchanged. 5. Thus axotomy plus target atrophy causes synaptic disjunction, neuron cell death, and input rearrangement, presumably due to a combination of direct injury effects and an abrupt loss of peripheral trophic supplies. 6. In contrast, target atrophy alone produced more gradual changes in submandibular ganglion neurons. Only prolonged target atrophy leads to a decrease in the number of ganglionic neurons, perhaps due to the gradual loss of peripheral trophic supplies. However, other features, such as the number of inputs/cell and the number of synapses/neuron perimeter, remain unaltered. Evidently, the gradual loss of trophic support does not result in synaptic disjunction to the degree needed to produce presynaptic input rearrangement. PMID- 3655868 TI - Neonatal synapse elimination in the rat submandibular ganglion: effect of retarded target growth. AB - 1. We have studied synapse elimination in the submandibular ganglion of neonatal rats to determine the effects of retarded target growth on synaptic development. Neurons of this ganglion provide parasympathetic innervation to the submandibular and sublingual salivary glands. 2. Ligating the main salivary ducts 2-4 days after birth at a point where nerve fibers were not damaged reduces gland weight by 55% during the 2nd wk after birth and 80% by adulthood. 3. In control animals, the average number of preganglionic inputs/neuron normally declines steadily during the first few weeks after birth, before stabilizing during the 5th wk at the control adult level. Between birth and adulthood, the number of ganglionic neurons increases by 150%. 4. Ganglia from duct-ligated animals showed an acceleration in the process of synapse elimination. Input number in experimental ganglia reached the control adult level during the 3rd wk after birth. This acceleration is confined solely to ganglia that innervate the underdeveloped glands. 5. The loss of inputs was not further enhanced by prolonged target atrophy. Thus average input numbers to neurons of 5th wk or adult experimental ganglia were not different from age-matched control values. 6. No differences from control values were seen in most cases for resting potentials, input resistances, or cell size. However, the increase in neuron number was retarded in experimental animals, and the number of synapses/neuronal profile was reduced in the adult animals. 7. Thus subnormal target growth leads to an acceleration in the process of synaptic elimination in neonatal rats. This acceleration may be mediated by alterations in the level of trophic factors emanating from the target. PMID- 3655869 TI - Eye movements induced by pontine stimulation: interaction with visually triggered saccades. AB - 1. Rhesus monkeys were trained to look to brief visual targets presented in an otherwise darkened room. On some trials, after the visual target was extinguished but before a saccade to it could be initiated, the eyes were driven to another orbital position by microstimulation of the paramedian pontine reticular formation. If, as current models of the saccadic system suggest, a copy of the motor command is used as a feedback signal of eye position, failure to compensate for stimulation-induced movements would indicate that stimulation occurred at a site beyond the point from which the eye position signal was derived. 2. Animals compensated for perturbations of eye position induced by stimulation of most pontine sites by making saccades that directed gaze to the position of the visual target. With stimulation at other pontine sites, compensatory saccades did not occur. 3. Pontine stimulation sometimes triggered, prematurely, impending visually directed saccades. The direction and amplitude of the premature movement depended upon the location of the briefly presented visual target. The amplitude of the premature movement was also a function of the interval between the stimulation train and the impending saccade. These data suggest that input signals for the horizontal and vertical pulse/step generators develop gradually during the presaccadic interval. Saccade trigger signals need to be delayed until the formation of these signals is completed. 4. The implications of these findings for models of the saccadic system are discussed. Robinson's local feedback model of the saccadic system can explain compensation for pontine stimulation-induced changes in eye position but cannot easily account for the failure to compensate for perturbations in eye position produced by stimulation at other sites. Modified versions of Robinson's model, which assume that the input signal to the pulse/step generator is the desired displacement of the eye, can account for both compensation and the failure to compensate since two separate neural integrators are employed. However, these models ignore kinematic arguments that commands to the extraocular muscles must specify the absolute position of the eye in the orbit rather than a relative movement from a previous position. PMID- 3655870 TI - Effect of a spider toxin (JSTX) on excitatory postsynaptic current at neuromuscular synapse of spiny lobster. AB - 1. We studied the blocking properties of a spider (Nephila clavata) toxin (JSTX) purified from venom on the spiny lobster neuromuscular junction. 2. When a small amount of JSTX was applied to the neuromuscular junction, the excitatory postsynaptic potential (EPSP) was partially suppressed. The amplitude of EPSPs remained at a steady level for several hours during the washing of the preparation, showing that the action of JSTX is irreversible. 3. We recorded the excitatory postsynaptic current (EPSC) from synaptic site using a macro-patch electrode. The amplitude of EPSC increased linearly with hyperpolarization of the membrane potential in the presence and absence of JSTX. 4. The decay phase time constant of EPSC and spontaneous EPSC was decreased by hyperpolarizing the membrane potential both in the absence and in the presence of JSTX. The relationship between the decay time constant and the membrane potential was not modified by JSTX. 5. It is suggested that JSTX irreversibly blocks EPSC by acting on the site that is apart from the ionic channel of the glutamate receptor molecule. PMID- 3655871 TI - Spinal pathways mediating tonic or stimulation-produced descending inhibition from the periaqueductal gray or nucleus raphe magnus are separate in the cat. AB - 1. The spinal pathways for tonic and stimulation-produced descending inhibition of spinal nociceptive neurons were investigated in anesthetized paralyzed cats. Reversible circumscribed blocks were produced at various depths in the lateral funiculi (LF) at L1-L2 using the microinjection of the local anesthetic lidocaine. The total amount of tonic descending inhibition in the absence of LF blocks was evaluated by monitoring the spinal neuronal activity during reversible spinalization by cold block and compared with the activity of the same neuron during LF blocks. Stimulation-induced descending inhibition of neuronal responses to noxious skin heating was produced by bipolar focal electrical stimulation in the periaqueductal gray (PAG) or nucleus raphe magnus (NRM) and compared with the inhibition of the same neurons during LF blocks. The relative significance of ipsi- and contralateral pathways in the dorsal, medial, or ventral aspects of the lateral funiculi for these types of descending inhibition are quantitatively described. 2. All 35 lumbar spinal dorsal horn neurons studied responded to noxious and innocuous mechanical and noxious thermal stimuli applied within the receptive fields on the glabrous skin of the hindlimb. Responses to noxious skin stimuli (50 degrees C, 10 s at 3-min intervals) were constant over time and served as a parameter to evaluate tonic and stimulation-produced descending inhibition. All neurons also responded to electrical stimulation of hindlimb cutaneous nerves supramaximal for the activation of A-beta-, delta-, and C fibers. Neurons were located in laminae I-VI of the dorsal horn at L5-L7 levels. LF blocks were produced by the microinjection of 1 microliter lidocaine at each of one to six sites in the ipsilateral and/or contralateral LF 500, 1,500, and/or 2,500 microns below cord surface. 3. LF blocks ipsilateral to the recording sites in the cord significantly reduced tonic inhibition, with blocks in the dorsal part of the LF [i.e., the dorsolateral funiculus (DLF)] being equally effective to complete LF blocks. Stimulation-produced inhibition from PAG or NRM was, however, not significantly affected by ipsilateral LF blocks. 4. Contralateral LF blocks significantly reduced stimulation-produced descending inhibition and failed to affect tonic descending inhibition. Ventral LF blocks attenuated inhibition from the PAG but not from NRM, whereas DLF blocks were more effective on inhibition from the NRM. 5. Bilateral LF blocks significantly reduced tonic as well as stimulation-produced descending inhibition.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655872 TI - Evidence that periodontal pressoreceptors provide positive feedback to jaw closing muscles during mastication. AB - 1. Mastication was produced by stimulation of the right motor-sensory cortex of urethan-anesthetized rabbits with 15-s trains of shocks (1-ms duration) at 50 Hz. Movements of the lower jaw and jaw muscle electromyograms (EMGs) were recorded on magnetic tape for later computer analysis. 2. The stimulus site was chosen, and stimulus intensity adjusted, so that stereotyped movements were produced that included a wide swing of the mandible to the left side during jaw closure. 3. Control trials were alternated with trials in which a steel ball (2 mm diam) was thrust between the anterior molar teeth on the left side and left in place for several seconds. 4. When the obstruction was first introduced, a jaw opening reflex was sometimes evoked if the ball struck the buccal surface of the advancing mandibular molar teeth. Thereafter, when the ball was crushed between the occlusal surfaces of the teeth, no jaw opening reflex was seen. 5. Instead, the amplitude and duration of all the jaw closing EMGs increased, beginning at least 12 ms after contact with the ball. This caused a prolongation of the slow closing (SC) phase of the cycle that, coupled with a delay in the start of activity in the digastric muscle (jaw opener), prolonged the cycle by more than 60 ms. 6. During the SC phase of the obstructed trials, the medially directed grinding stroke was exaggerated because of an increase in the contraction of the contralateral zygomaticomandibular and anterior temporal muscles. 7. After collecting data, the sensory nerves to the maxillary and mandibular anterior molar teeth were cut to eliminate feedback from the periodontal pressoreceptors. Control and obstructed trials were repeated. 8. Following denervation, the obstructed cycles were of shorter duration. The mandible still moved to the right during SC in some animals, but the increase in closer muscle EMG activity was much reduced. 9. We conclude that periodontal receptors provide positive feedback to the jaw closing muscles during mastication. This is supplemented by input from other receptors, probably muscle spindles. In addition, an increase in periodontal feedback prolongs the SC phase and the early phases of the opening stroke. PMID- 3655873 TI - Topography of the oculomotor area of the cerebellar vermis in macaques as determined by microstimulation. AB - 1. Oculomotor responses to microstimulation of the cerebellar vermis of macaque monkeys were investigated by using a magnetic search-coil method. 2. The oculomotor responses were conjugate eye movements with an ipsilateral horizontal component. Analyses of amplitude-velocity and amplitude-duration relationships revealed that the peak eye velocities and the durations of the responses were comparable to those of saccadic eye movements. 3. Systematic mapping with microstimulation disclosed that the region in the cerebellar vermis that yielded saccades with weak stimulus currents was confined to lobule VII in five monkeys but included a part of folium VIc in the other four monkeys. This region coincided with the distribution of the saccade-related neural activity observed in the present study and also corresponded to the vermal folia from which we recorded the burst mossy-fiber units and the oculomotor Purkinje cell activity. 4. The oculomotor vermis was defined as that region of the cerebellar vermis that met the following criteria: 1) saccades were evoked with low-intensity microstimulation (with currents less than 10 microA); 2) vigorous saccade-related neural activity was present; and 3) Purkinje cell discharges were modulated with eye movements. The oculomotor vermis was more circumscribed and located more posteriorly than the vermal cortex explored in previous microstimulation experiments on monkeys. 5. Microstimulation of the oculomotor vermis evoked more or less curved saccades in oblique directions. The horizontal and vertical components were not simultaneous in some saccades: the shorter component started later or ended earlier than the other component and their peak velocities were not always synchronous. 6. The amplitude of the saccade depended on stimulus parameters; microstimulation with 10-12 pulses within a period of approximately 20 ms (500-600 Hz) was shown to be optimal. When the pulses were applied to the white matter or to the granular layer, a stimulus current of 10 microA was sufficient to evoke saccades. When the molecular layer was stimulated, evoked saccades were smaller and frequently curved, and an increase in the stimulus current changed either the initial direction or the trajectory of the saccade. 7. When the stimulus current was carefully controlled and maintained near the threshold, the direction of the saccade evoked from the oculomotor vermis was topographically organized.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655874 TI - Timing of spike initiation in cochlear afferents: dependence on site of innervation. AB - 1. The phase of excitation of inner hair cells (IHCs) relative to basilar membrane motion has been estimated as a function of best frequency (BF) (or, equivalently, cochlear location) by recording responses to tones (100-1,000 Hz) from chinchilla cochlear afferent axons at their central exit from the internal auditory meatus. 2. The time of IHC excitation (i.e., the time of chemical transmitter release) was derived from the neural recordings at near-threshold levels by applying a correction for the latency of synaptic processes and the propagation time of action potentials. 3. The phase of basilar membrane motion at the appropriate innervation site was estimated on the basis of previously measured basilar membrane responses at a location close to the basal end of the cochlea and estimates of mechanical travel time from the basal end to the innervation site, derived from the neural latencies to intense rarefaction clicks, as a function of BF. 4. The derived near-threshold excitation of basal IHCs leads basilar membrane displacement toward scala tympani by approximately 40 60 degrees. 5. At BFs corresponding to midcochlear locations (2-6 kHz) there is an abrupt phase transition. The derived excitation for IHCs located at more apical locations (BFs large in relation to stimulus frequency) corresponds approximately to peak velocity of the basilar membrane toward scala vestibuli. 6. Although the derived response phases of apically located IHCs are consistent with intracellular recordings from IHCs, the derived near-threshold response phases of basal IHCs may be inconsistent with intracellular IHC recordings. 7. The foregoing results, based on responses of nearly 1,000 cochlear afferents to tones 100-1,000 Hz at near-threshold stimulus levels, amply confirm our previous conclusions that were based on a smaller sample of responses to very low frequency tones (less than or equal to 100 Hz): there is a spatial transition at midcochlear regions in the mode of excitation of IHCs, which does not seem to simply reflect the macromechanics of the basilar membrane. 8. It has been proposed that both the paradoxical response phases of high-BF afferents and the spatial phase transition arise from an influence of cochlear microphonics on the transmembrane potential of IHCs. The present results, which show that the spatial phase transition occurs for frequencies at least as high as 400 Hz, would appear to make such an electrical influence of outer hair cells on IHCs less likely. An alternative explanation might be that the phase transition has a mechanical basis, perhaps localized to micromechanical events in the subtectorial regio PMID- 3655875 TI - Activity-evoked increases in extracellular potassium modulate presynaptic excitability in the CA1 region of the hippocampus. AB - 1. The effects of stimulus-evoked potassium release on the excitability of presynaptic axons were studied in the rat hippocampal slice preparation. Extracellular stimulation and recording in the stratum radiatum of CA1 yielded a characteristic field potential corresponding to the compound action potential of nonmyelinated afferents and subsequent postsynaptic activation of pyramidal cells. 2. Repetitive stimulation (1 s; 2-100 Hz) produced biphasic changes in the excitability of the afferents. Initial responses showed increased conduction velocity and variably increased amplitude; subsequent responses showed progressively decreasing conduction velocity and amplitude tending toward conduction block. Decreases in excitability were maximal at the end of stimulation and were more pronounced with higher stimulation frequencies. 3. When synaptic transmission was abolished with superfusate containing elevated [Mg2+] (6 mM) and decreased [Ca2+] (0.25 mM), kynurenic acid (1 mM), or adenosine (100 microM), the ability of the fibers to follow repetitive stimulation was enhanced, as indicated by a reduction in amplitude decrement of the presynaptic volley. The decrease in conduction velocity at the end of stimulation was less than half that obtained with intact postsynaptic activity. 4. Concomitant with changes in the excitability of CA1 afferents, the concentration of extracellular potassium ( [K+]o) increased up to 7 mM, as recorded in the stratum radiatum with potassium ion-sensitive microelectrodes. When postsynaptic activity was blocked, activity evoked rises in [K+]o were reduced to less than 25% of their former value. This suggests that activity-evoked increases in [K+]o derive predominantly from postsynaptic elements. 5. Superfusion of solutions containing elevated [K+] produced biphasic changes in the excitability of CA1 afferents that were qualitatively similar to those produced by repetitive stimulation. Elevated [K+]o below 6 mM produced increased excitability, whereas [K+]o above 6 mM yielded decreased excitability. 6. These results demonstrate that in the CA1 region of the hippocampus, significant rises in [K+]o occur with activity and derive predominantly from postsynaptic elements. The conduction properties of CA1 afferents are sensitive to the level of [K+]o, whether altered artificially or by activity. These effects may constitute a mechanism of postsynaptic modulation of presynaptic conduction operating within a broad range of afferent firing frequencies in the hippocampus. PMID- 3655876 TI - Gaze control in humans: eye-head coordination during orienting movements to targets within and beyond the oculomotor range. AB - Gaze, the direction of the visual axis in space, is the sum of the eye position relative to the head (E) plus head position relative to space (H). In the old explanation, which we call the oculocentric motor strategy, of how a rapid orienting gaze shift is controlled, it is assumed that 1) a saccadic eye movement is programmed with an amplitude equal to the target's offset angle, 2) this eye movement is programmed without reference to whether a head movement is planned, 3) if the head turns simultaneously the saccade is reduced in size by an amount equal to the head's contribution, and 4) the saccade is attenuated by the vestibuloocular reflex (VOR) slow phase. Humans have an oculomotor range (OMR) of about +/- 55 degrees. The use of the oculocentric motor strategy to acquire targets lying beyond the OMR requires programming saccades that cannot be made physically. We have studied in normal human subjects rapid horizontal gaze shifts to visible and remembered targets situated within and beyond the OMR at offsets ranging from 30 to 160 degrees. Heads were attached to an apparatus that permitted short unexpected perturbations of the head trajectory. The acceleration and deceleration phases of the head perturbation could be timed to occur at different points in the eye movement. 4. Single-step rapid gaze shifts of all sizes up to at least 160 degrees (the limit studied) could be accomplished with the classic single-eye saccade and an accompanying saccadelike head movement. In gaze shifts less than approximately 45 degrees, when head motion was prevented totally by the brake, the eye attained the target. For larger target eccentricities the gaze shift was interrupted by the brake and the average eye saccade amplitude was approximately 45 degrees, well short of the OMR. Thus saccadic eye movement amplitude was neurally, not mechanically, limited. When the head's motion was not perturbed by the brake, the eye saccade amplitude was a function of head velocity: for a given target offset, the faster the head the smaller the saccade. For gaze shifts to targets beyond the OMR and when head velocity was low, the eye frequently attained the 45 degrees position limit and remained there, immobile, until gaze attained the target.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655877 TI - Physiology and morphology of multireceptive neurons with C-afferent fiber inputs in the deep dorsal horn of the rat lumbar spinal cord. AB - Intracellular recording techniques have been used to study neurons that respond to low- and to high-intensity mechanical stimulation of the skin of the hindpaw (wide dynamic range or multireceptive cells) in the deep dorsal horn of the fourth lumbar segment of the spinal cord, in decerebrate-spinal rats. Electrical stimulation of the A-fibers in the sciatic nerve produced a short-latency response in all 32 neurons studied. A long-latency prolonged excitation was produced in 28 of the 32 neurons when the unmyelinated afferents in the sciatic nerve were activated. This paper describes the physiological properties of 12 multireceptive cells with A- and C-fiber inputs, whose cell body location was established by horseradish peroxidase ionophoresis and the morphology of six neurons in this group whose cell bodies lay within lamina V. Single stimuli to the sciatic nerve at an intensity high enough to activate unmyelinated afferent fibers (C-fiber strength) produced two patterns of response in the neurons. In five neurons a number of long-latency postsynaptic potentials (PSPs) clearly separated from the short-latency A-fiber evoked PSPs were produced, resulting in an early discharge, a silent period, and a late discharge. The second pattern, found in seven neurons, was a long-lasting depolarization, only generated by C strength stimuli, which continued from the early A-fiber evoked PSPs, peaked at 100-200 ms, and lasted for 300-500 ms, producing in six cases a continuous burst of action potentials with a maximal frequency at the expected latency of the C afferent fiber input but with no clear A- and C-fiber evoked banding of the action potentials. This postsynaptic depolarization was large enough to inactivate action potentials in one cell. Repeated stimuli to the sciatic nerve (1 Hz for 10 s) at C-fiber strength produced five different types of response in the neurons. In three neurons a progressive increase in the size and duration of the C-fiber PSPs occurred, resulting in an increase in the number of action potentials (windup), whereas in two, the repeated stimulation resulted in a progressive moderate depolarization of the neurons and an increase in the total number of action potentials evoked at both early and late latencies. Large depolarizations, sufficient to partially inactivate action potentials, developed during the repeated stimulation in two cells, effectively reducing the number of spikes evoked per stimulus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655878 TI - Characteristics of spinoreticular and spinothalamic neurons with renal input. AB - Spinoreticular (SRT) and spinothalamic (STT) neurons were studied for responses to renal and somatic stimuli in 34 cats that were anesthetized with alpha chloralose. SRT cells were antidromically activated from the medial medullary reticular formation near the gigantocellular tegmental field contralateral (35 cells), ipsilateral (15 cells), or both contralateral and ipsilateral (11 cells) to the recording site. Collision tests showed that activation from two electrodes resulted from stimulation of separate axonal branches and not from current spread. Twenty STT cells were activated from the spinothalamic tract just medial to the medial geniculate nucleus. SRT cells were located in laminae I, V, VII, and VIII of the T12-L2 segments. Most cells were located in lamina VII. STT cells were found in laminae I, V, and VII. The axons of 12 SRT cells were located in the ventrolateral or ventral quadrants of the upper cervical spinal cord. Antidromic conduction velocities of SRT cells averaged 48.7 +/- 3.7 m/s. No differences in conduction velocity were found between cells projecting to different reticular sites. In addition conduction velocity did not vary with the type of somatic or renal input. Antidromic conduction velocities of STT cells averaged 46.4 +/- 4.7 m/s. Renal nerve stimulation excited 58 and inhibited 3 SRT cells. All 20 STT cells were excited. Thirty SRT cells were excited only by A delta input, 26 received both A-delta- and C-fiber inputs, and 2 cells received only C-fiber input. Ten STT cells received A-delta input only and 10 received both A-delta- and C-fiber inputs. All cells with renal input also received somatic input. Thirty-six SRT cells (59%) were classified as high threshold, 12 (20%) as wide dynamic range, and 10 (16%) as deep. Ten STT cells were classified as high threshold and 10 as wide dynamic range. Somatic receptive fields of STT cells were usually simple and invariably included the left flank region, although many of the fields extended to the left hindlimb or abdomen. Eighteen of the 20 were restricted to the ipsilateral side. In contrast, somatic receptive fields of SRT cells were primarily bilateral (71%). While all but two receptive fields included the left flank area, most extended to one or both hindlimbs, the abdomen, or the right flank. Inhibitory receptive fields were found for 33% of the SRT cells and 20% of the STT cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655879 TI - The organization and activity patterns of the anterior and posterior heads of the guinea pig digastric muscle. AB - The structure and activity patterns of the anterior and posterior heads of the guinea pig digastric muscle (DG) were studied in ketamine-anesthetized guinea pigs. Collagen staining of longitudinal and transverse sections of the muscle revealed that the guinea pig DG is comprised of a unicompartmental anterior head (ADG) and a multicompartmental posterior head (PDG). The two heads are separated by a thin tendinous inscription that, unlike the intermediate tendon of the DG in humans, is not attached to the hyoid bone. The motor nuclei of the guinea pig DG were reconstructed using retrograde labeling with horseradish peroxidase. The motoneurons of the ADG were clustered in a longitudinal column within the trigeminal motor nucleus. The motoneurons of the PDG were segregated into two clusters within the facial motor nucleus. The cross-sectional areas of the ADG and PDG motoneuron somata exhibited unimodal frequency distributions and the average soma area was larger for ADG than PDG motoneurons. Histochemical characterization of ADG and PDG revealed that the two muscle heads contained the three main histochemical types of muscle fibers identified in limb muscles. The frequency distribution of fiber types in ADG and PDG were not significantly different. Both muscle heads were predominantly fast with slow oxidative fibers accounting for only 1.1 and 0.3% of the fibers in narrow dorsal regions of ADG and PDG, respectively, and 13.6 and 12.9% in the more ventral regions of ADG and PDG, respectively. Simultaneous recordings of EMGs from the ADG and PDG were carried out during spontaneously occurring rhythmical jaw movements. These recordings revealed a high degree of synchrony between the activities of the two heads, although differences were observed in the onset and duration of the EMG bursts. Activity in the PDG preceded activity in the ADG in most of the rhythmical cycles and persisted longer. The differences in latencies of time locked EMGs evoked in the ADG and PDG by four-pulse cortical stimulation were much smaller than those observed between the activity bursts of the two heads during rhythmical jaw movements. It is suggested that the early activity in the PDG is accounted for by shorter central conduction times in the pathways onto it and/or by higher recruitability of its motor units. The early activity in PDG may serve to optimize the location of ADG on its length-tension curve prior to and during the active state. PMID- 3655880 TI - Postnatal development of electrical activity in the locus ceruleus. AB - 1. A method for adapting a standard stereotaxic frame for use with neonatal rats as young as postnatal day 1 (PD 1) was devised, and single-unit extracellular recordings were obtained from neurons in the locus ceruleus (LC) in urethan anesthetized rats during different stages in development from PD 1 to PD 34. 2. The spontaneous firing pattern of neonatal LC neurons was characterized by long silent periods punctuated by brief epochs of sporadic firing. At PD 7-14, LC neurons exhibited periodic occurrences of irregular firing that lasted for 20-30 s. By PD 20, the pattern and rate of spontaneous activity were virtually indistinguishable from that of adults. 3. Conditioning stimulation of the dorsal noradrenergic bundle (DNB), given 10-200 ms prior to a test stimulus to the DNB, markedly reduced the amplitude of the antidromic action potentials to the test stimulus and sometimes resulted in spike decomposition. This refractoriness of the soma-dendritic membrane of LC cells was significantly attenuated with development and approached adult levels after PD 18. 4. Antidromic responses elicited by DNB stimulation were followed by a phase of inhibition or inhibition excitation. Postactivation excitation was most prominent in cells that were not spontaneously active, and decreased steadily throughout development, probably because of the steady increase in spontaneous firing rate seen during maturation. 5. Although the conduction velocity of LC axons increased steadily from birth through PD 26, conduction time remained unchanged. 6. Neonatal LC neurons were equally sensitive to noxious and nonnoxious somatosensory stimuli. As development proceeded, LC neurons became less sensitive to innocuous somatosensory stimuli such as air puffs and tactile stimuli while simultaneously becoming more sensitive to noxious stimuli. Auditory and visual stimuli became effective for the first time at PD 14 and PD 12, respectively. 7. These results indicate that the electrical activity of LC neurons in the developing brain is intimately related to input from peripheral sensory sources. Therefore, the influence of the LC on the developing brain may occur predominantly through sensory input. PMID- 3655881 TI - Voluntary control of motor units in human antagonist muscles: coactivation and reciprocal activation. AB - 1. Myoelectric (ME) activity of several motor units was detected simultaneously from the human flexor pollicis longus and extensor pollicis longus muscles, the only two muscles that control the interphalangeal joint of the thumb. The ME signals were detected while the subjects produced isometric force outputs to track three different paradigms: triangular trajectories, random-force trajectories requiring both flexion and extension contractions, and net zero force resulting from stiffening the joint by voluntarily coactivating both muscles. 2. The ME signals were decomposed into their constituent motor-unit action potential trains. The firing rate behavior of the concurrently active motor units was studied using cross-correlation techniques. 3. During isometric contractions, the firing rates of motor units within a muscle were greatly cross correlated with essentially zero time shift with respect to each other. This observation confirms our previous report of this behavior, which has been called common drive. Common drive was also found among the motor units of the agonist and antagonist muscles during voluntary coactivation to stiffen the interphalangeal joint. This observation suggests two interesting points: 1) that the common drive mechanism has a component of central origin, and 2) that the central nervous system may control the motoneuron pools of an agonist-antagonist muscle pair as if they were one pool when both are performing the same task. 4. During force reversals, the firing rates of motor units reverse in an orderly manner: earlier recruited motor units decrease their firing rate before later recruited motor units. This orderly reversal of firing rates is consistent with the concept of orderly recruitment and derecruitment. 5. A control scheme is suggested to explain the behavior of the motor units in both muscles during force reversal. It consists of centrally mediated reciprocally organized flexion and extension commands along with a common coactivation command to both muscles. This control scheme allows for coactivation and reciprocal activation of an agonist antagonist set. 6. The agonist-antagonist pair was observed to generate a net force in two control modalities: proportional activation and reciprocal activation. In proportional activation, the agonist-antagonist set is coactivated during either of two states: when uncertainty exists in the required task or when a compensatory force contraction is perceived to be required.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655882 TI - Effects of interaural time delays of noise stimuli on low-frequency cells in the cat's inferior colliculus. II. Responses to band-pass filtered noises. AB - 1. We studied cells in the central nucleus of the inferior colliculus of the cat that were sensitive to interaural time delays (ITDs) in order to evaluate the influence of the stimulus spectrum of noise signals. Stimuli were sharply filtered low-, high-, and band-pass noise signals whose cutoff frequencies and bandwidths were systematically varied. The responses to ITDs of these noise signals were compared with responses obtained to ITDs of broadband noise and pure tones. 2. The discharge rate in response to band-pass noise as a function of ITD was usually a cyclic function with decreasing peak amplitudes at longer ITDs. The reciprocal of the mean interval between adjacent peaks indicated how rapidly the response rate varied with ITD and was termed the response frequency (RF). This RF was approximately equal to the median frequency of the stimulus spectrum filtered by the cell's sync-rate curve, which was the product of the synchronization to interaural phase and the discharge rate plotted against frequency. This suggests that the RF was determined by all the spectral components in the stimulus that fell within the frequency range in which the cell's response was synchronized. The contribution of each component was proportional to the sync-rate for that frequency. 3. The central peak of the ITD function usually fell within the physiological range of ITDs (+/- 400 microseconds). The location of this peak did not vary significantly with changes in stimulus spectrum by comparison with responses to tones of different frequency. Its shape also remained constant, except for a decrease in width when high-frequency components within the range of the sync-rate curve were added to the stimulus. A few cells responded with a minimal discharge instead of a maximal near-zero ITD, and this central minimum had similar properties as the central peak. The amplitude of the secondary peaks of the ITD function decreased as the stimulus bandwidth that overlapped the sync rate curve broadened. 4. The sum of the ITD functions to two band-pass signals was similar to that of a broadband signal whose spectrum was composed of the sum of the band-pass spectra. 5. From these binaural responses we could make inferences about the response characteristics of the monaural inputs to binaural neurons. We then verified these predictions by studying responses of low frequency trapezoid body fibers to band-pass noises. PMID- 3655883 TI - Effects of interaural time delays of noise stimuli on low-frequency cells in the cat's inferior colliculus. III. Evidence for cross-correlation. AB - 1. We tested the coincidence, or cross-correlation, model of Jeffress, which proposes a neuronal mechanism for sensitivity to interaural time differences (ITDs) in low-frequency cells in the central nucleus of the inferior colliculus (ICC) of the cat. Different tokens of Gaussian noise stimuli were delivered to the two ears. We studied the neural responses to changes in ITDs of these stimuli and examined the manner in which the binaural cells responded to them. All of our results support the idea that the central binaural neurons perform an operation very similar to cross-correlation on the inputs arriving from each side. These inputs are transformed from the actual acoustic signal by the peripheral auditory system, and these transformations are reflected in the properties of the cross correlations. 2. The responses to ITDs of identical broadband noise stimuli to the two ears varies cyclically as a function of ITD at a frequency close to the best frequency of the neuron. This cyclic response is a consequence of the narrowband filtering of the wideband acoustic signal by the auditory nerve fibers. To examine the effects of using stimuli to the two ears that were correlated to each other to different degrees, we generated pairs of noises. Each pair consisted of one standard noise, which was delivered to one ear, and a linear sum of two standard uncorrelated noises, which was delivered to the other ear. The responses of 34 neurons in the ICC to ITDs of noises with variable interaural coherence were examined. When partially correlated noises were delivered, there was a positive and approximately linear relationship between the degree of modulation of the response as a function of ITD and interaural coherence. The degree of modulation was measured by the synchronization coefficient, or vector strength, over one period of the ITD curve. 3. We examined the effects of altering the interaural phase relationships of the input noise stimuli. The phase of the noise stimuli was changed by digitally filtering the standard noise so that only a phase delay was imposed. The responses to ITDs with differing interaural phase relationships were then studied by delivering a phase shifted noise to one ear and the standard noise to the other. The ITD curves in response to phase-shifted noise were shifted by about the same amount as the shift of the stimulus; the shift of the response was measured with respect to the case with identical noises to the two ears.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655884 TI - Effects of physiological amounts of high- and low-rate chronic stimulation on fast-twitch muscle of the cat hindlimb. I. Speed- and force-related properties. AB - 1. Long-term electrical stimulation was given during 4 or 8 wk to the peroneal nerve of deafferented hindlimbs in hemispinalized adult cats. Four different stimulation patterns were compared: 100-Hz bursts covering 5% of daily time (F1), 10-Hz bursts covering 5% of daily time (S1), pattern S1 plus added 100-Hz bursts during 0.5% of daily time (S1F2), and, finally, only the latter 100-Hz bursts (F2), again during 0.5% of daily time. 2. During the course of chronic stimulation, frequent noninvasive measurements were made of the twitch of the ankle dorsiflexors. In a terminal acute experiment under general anesthesia, performed after 4 or 8 wk of treatment, measurements were made of isometric contractile properties (speed, force) for one of the stimulated peroneal muscles, m. peroneus longus (PerL). Thereafter, the PerL muscle was removed for further histochemical/histological analysis. 3. Findings from chronically stimulated PerL muscles were compared with three kinds of control PerL muscles: 1) those from the contralateral (control) hindlimb of chronically treated animals, 2) those from the operated side of animals that had been deafferented and hemispinalized but not subjected to chronic stimulation, 3) those from normal animals that had not been subjected to chronic treatment. With respect to the presently studied parameters, the three kinds of control muscles rendered very similar results. 4. All the presently used patterns of chronic stimulation made the PerL muscles slower with respect to twitch contraction time, half-relaxation time, and tension frequency relation. Patterns covering 5-5.5% of daily time (F1, S1, S1F2) also caused an increase in the percentage of fibers classified as 'slow' (type I) on basis of their staining for myosin adenosine triphosphatase (ATPase). 5. Among patterns covering 5% of daily time, the change in ATPase histochemistry and the degree of physiological slowing was at least as pronounced after chronic stimulation at 100 Hz (F1) as after treatment at 10 Hz (S1). The slowing produced by pattern S1 was not more pronounced than that caused by this pattern (10 Hz) plus an equal number of pulses at 100 Hz (S1F2). 6. The slowing produced by the presently used patterns of chronic stimulation took place within the initial 2-3 wk. 7. Patterns F1 and S1 caused a decrease in maximum tetanic force as well as in mean fiber diameter.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3655885 TI - Effects of physiological amounts of high- and low-rate chronic stimulation on fast-twitch muscle of the cat hindlimb. II. Endurance-related properties. AB - 1. Long-term electrical stimulation was given to the peroneal nerve of deafferented hindlimbs in hemispinalized adult cats. The amount of stimulation covered 0.5-5.5% of total time per day, different in different animals. For some aspects of the present study, use was also made of cats subjected to "tonic" patterns of chronic stimulation (typically covering 50% of total time; 10, 16). 2. In a terminal acute experiment under general anesthesia, performed after 4 or 8 wk of long-term stimulation, one of the treated peroneal muscles (m. peroneus longus, PerL) was used for measurements of the resistance to contractile fatigue. The fatigue test consisted of 0.33-s bursts of motor-nerve stimulation at 40 Hz, repeated once a second for 4 min (6, 7). During this fatigue test, the evoked compound spikes of the muscle were recorded by electromyographic (EMG) techniques. Following the physiological procedures, PerL was removed for further histochemical analysis. In transverse sections, measurements of optical density were made in central regions of single fibers after staining for the activity of an oxidative enzyme, succinate dehydrogenase (core SDH). 3. Findings from chronically stimulated PerL muscles were compared with three kinds of control PerL muscles: 1) those contralateral to the stimulated ones, 2) those from the operated side of animals that had been deafferented and hemispinalized but not subjected to chronic stimulation, and 3) those from untreated normal animals. 4. Stimulation patterns covering both greater than or equal to 50% and 5-5.5% of daily time gave a marked improvement of fatigue resistance. Pulse rate seemed of little importance for these effects. The pattern covering only 0.5% of total daily time caused no increase of contractile endurance beyond that of normal muscles. 5. During the fatigue test of a control muscle (see above), the amplitude of the compound EMG spikes typically showed a marked decline. This "EMG depression" was effectively counteracted by all the present patterns of chronic stimulation, including the 0.5% pattern. 6. Fibers of chronically stimulated muscles became more similar to each other with respect to their density of core SDH staining. However, among muscles treated during 0.5-5.5% of total daily time, the degree and pattern of change in core SDH staining was not related to the amount and pattern of chronic stimulation or to the resulting degree of contractile endurance. PMID- 3655886 TI - Subtemporal-preauricular infratemporal fossa approach to large lateral and posterior cranial base neoplasms. AB - A subtemporal-preauricular infratemporal fossa approach to remove 22 large neoplasms involving the lateral and posterior cranial base is detailed. The areas from which a neoplasm could be removed by this approach included the sphenoid and clival bone; the medial half of the petrous temporal bone; the infratemporal fossa; the nasopharynx; the retro- and parapharyngeal area; the ethmoid, sphenoid, and maxillary sinuses; and the intradural clivus-foramen magnum area. The pathology of the neoplasms included benign tumors such as meningioma, malignant cartilaginous neoplasms such as chordoma, and other malignant lesions such as nasopharyngeal carcinoma. This approach offers many advantages over other anterior and lateral approaches to the lateral and posterior cranial base: these include minimal brain retraction; direct access to the ipsilateral petrous and upper cervical internal carotid artery; reconstruction of extensive cranial base defects, often with the use of a vascularized rectus abdominus flap; preservation of the hearing conduction mechanism when it is not involved by tumor; and the maintenance of excellent facial nerve function postoperatively. The use of an anterior extradural approach (transethmoidal) and of an intradural approach (frontotemporal or retromastoid), either concurrently or separately, is necessary in some patients to effect total tumor removal. The most serious complication in this series was the death of a patient due to postoperative infection and bilateral carotid artery rupture, which may have been avoided by the use of a rectus abdominis muscle flap for reconstruction. Among the 21 surviving patients, 18 had a good outcome, two had a fair outcome, and one with preexisting neurological deficits had a poor outcome. One of the surviving patients with a chordoma died of pulmonary metastases 1 year later, without evidence of local recurrence. The length of postoperative follow-up evaluation in these patients is insufficient to make any judgment about the effectiveness of this surgical approach in achieving a cure or long-term control of the tumors described. PMID- 3655887 TI - Adjuvant high-dose photoradiation therapy in the treatment of cerebral glioma: a phase 1-2 study. AB - A Phase 1-2 study of high-dose photoradiation therapy was performed in 23 patients with cerebral tumors. Twenty-two patients had high-grade gliomas (13 glioblastomas, six recurrent glioblastomas, two anaplastic astrocytomas, and one recurrent anaplastic astrocytoma) and one had a right frontal metastasis from a carcinoma of the lung. Hematoporphyrin derivative was administered to these patients in a dose of 5 mg/kg and, 24 hours later, they all underwent a craniotomy with radical excision of the tumor. The tumor bed was then irradiated with 630 nm of laser light from either an argon dye laser or a gold metal vapor laser for between 43 and 94 minutes, receiving total doses of 70 to 120 J/sq cm (six cases) or 120 to 230 J/sq cm (17 cases). The temperature of the tumor bed was kept below 37 degrees C by irrigation. Fifteen patients who developed new tumors underwent postoperative radiotherapy (45 Gy in 20 divided doses). There was no evidence of increased cerebral edema and no other toxicity from the therapy. All patients were discharged from the hospital within 18 days of surgery. Four of seven patients with gliomas have suffered a further recurrence at 12 to 16 weeks, and two of 15 patients with primarily treated gliomas experienced recurrence at 3 and 13 months following therapy. Fifteen patients have had no recurrence of their tumor and are alive and well at a median follow up period of 7 months (range 1 to 16 months). It is concluded that photoradiation therapy using 5 mg/kg of hematoporphyrin derivative and 630 nm light at doses of up to 230 J/sq cm can be used as an adjuvant to surgery and radiotherapy with no additional complications. PMID- 3655888 TI - Surgical approaches to trigonal arteriovenous malformations. AB - Only about 5% of intracranial arteriovenous malformations (AVM's) are located predominantly within the ventricular system. Between July, 1981, and February, 1986, 15 patients were treated at the authors' institution for AVM's within the ventricular trigone. The mean age of this patient population was 24 years, and two-thirds were female. Intracranial hemorrhage was by far the most frequent presenting symptom and intraventricular hemorrhage occurred in 11 cases, with multiple episodes being documented in five. Arterial supply of the malformations was quite uniform, with the lateral posterior choroidal or posterior temporal branch of the posterior cerebral artery (PCA) being the most frequent source. Venous drainage was similarly stereotypic, with predominant outflow into the galenic system in all but one patient. An interhemispheric surgical approach was used in eight patients, a middle or inferior temporal gyrus incision was performed in six, and a subtemporal route was chosen in a single patient. Operative results suggest that these lesions can be removed with reasonable safety. An interhemispheric approach is recommended if the nidus projects medially from the trigone and is observed medial to the P2-P3 junction of the PCA on angiography. A middle temporal gyrus approach is suggested if the nidus is lateral to the P2-P3 junction, even when the lesion is located in the dominant hemisphere. A subtemporal approach should be reserved for inferiorly projecting AVM's with cortical representation on the fusiform or parahippocampal gyrus in the nondominant hemisphere. PMID- 3655889 TI - The MRI appearance of cavernous malformations (angiomas). AB - The angiographic, computerized tomography (CT), and magnetic resonance imaging (MRI) findings were compared in 10 patients with a total of 16 pathologically verified cavernous angiomas. Only three lesions had abnormal vasculature in the form of venous pooling or a capillary blush. The CT scans were positive in seven patients and detected 14 lesions, while high-field strength (1.5 Tesla) MRI was positive in each case and demonstrated 27 distinct lesions. On T2-weighted MRI, the combination of a reticulated core of mixed signal intensity (SI) with a surrounding rim of decreased SI strongly suggests the diagnosis of a cavernous malformation. Smaller lesions appear as areas of decreased SI (black dots). The sensitivity of MRI is based on magnetic susceptibility and possibly diffusion effects related to field heterogeneity that is more conspicuous on high-field imaging and caused by the presence of excessive iron (hemosiderin). PMID- 3655890 TI - The rCBF response to Diamox in normal subjects and cerebrovascular disease patients. AB - Age-related norms for the regional cerebral blood flow (rCBF) response to Diamox (acetazolamide) were based on studies of 55 normal subjects at rest and on studies of 33 of these 55 normal subjects following an intravenous injection of Diamox (22 mg/kg). After the Diamox injection, rCBF increased at all locations measured in all subjects. On average, rCBF increased 1.7 times. The following were found for rCBF in both resting and Diamox-treated subjects: 1) rCBF decreased significantly with increasing age; 2) slope and intercept for the regression of rCBF on age were largest for frontal detectors, intermediate for parietal detectors, and smallest for occipital detectors; 3) rCBF hyperfrontality was most noticeable in younger subjects; 4) in subjects of any age, 95% confidence intervals for rCBF were relatively large (expected value +/- 30%) and lower 95% confidence intervals for Diamox rCBF tended to overlap the upper 95% confidence intervals for resting rCBF; and 5) side-to-side percentage difference in rCBF did not have a significant regression on age and tended to be less than 10% to 20%. Diamox did not have an important effect on blood pressure, pulse rate, or respiratory rate. The normative data for the rCBF response to Diamox was used in evaluating 20 patients with cerebrovascular disease. Forty percent of these patients, all of whom exhibited angiographic evidence of potentially hemodynamically significant lesions, had normal rCBF at rest and after Diamox injection. Twenty percent had normal resting flows with abnormal Diamox-activated flows. Asymmetry in rCBF was the most sensitive indicator of a potential abnormality in cerebral perfusion. Thirty percent of the abnormal studies showed only significant asymmetry. It is suggested that rCBF studies at rest and after Diamox treatment, with age-related norms, may be useful in the management of patients with cerebrovascular disease. PMID- 3655891 TI - Relationships between intracranial pressure, ventricular size, and resistance to CSF outflow. AB - In 230 patients with normal-pressure hydrocephalus, high-pressure hydrocephalus, or benign intracranial hypertension, measurements of the intracranial pressure (ICP), ventricular size, and cerebrospinal fluid (CSF) outflow resistance (Ro) have revealed a linear relationship between ICP and Ro. It is shown that on average the CSF formation rate tends to decrease with increasing ICP. It is also shown that the size of the ventricles increases as the ICP levels off toward normal values. The clinical implication of this is that a small or normal ventricular size in acute or subacute phases does not preclude defective CSF resorption. PMID- 3655892 TI - A prospective analysis of 142 carotid endarterectomies for occlusive vascular disease, 1979-1985. AB - Carotid endarterectomy may carry a substantial risk of morbidity and mortality from major stroke, thus offsetting any statistical benefit in reduction of future stroke. Because of the disturbing ranges in the incidence of stroke morbidity and mortality reported from the several institutional series studying carotid endarterectomy, the authors undertook a prospective review of 142 consecutive carotid endarterectomies performed for symptomatic atherosclerotic occlusive vascular disease on the neurosurgical service. The University of Alabama Hospital. Preoperative risk assessment was performed in each case according to the Mayo Clinic classification system. The overall mortality rate was 1.4% and the major stroke morbidity rate was 0.7%, for a combined major morbidity and mortality rate of 2.1%. The incidence of minor neurological morbidity was 1.4%. There was no morbidity or mortality in the Grade I and II (low-risk) patient groups. This low combined major morbidity and mortality rate of 2.1% for carotid endarterectomy causes the surgical stroke-free survival curve to intersect the medical stroke-free survival curve at an earlier point in time, and thus demonstrates the greater reduction in risk of stroke which accrues over time for the surgically treated patient. PMID- 3655893 TI - Primary cerebellar hemorrhage. Quadrigeminal cistern obliteration on CT scans as a predictor of outcome. AB - The authors studied a consecutive series of 75 patients with cerebellar hemorrhage diagnosed by computerized tomography (CT) scanning, and assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades: normal (Grade I), compressed (Grade II), or absent (Grade III). There were 43 patients with Grade I, 16 with Grade II, and 16 with Grade III cisterns. Of the 75 patients, 38 (88.4%) of those with Grade I, 11 (68.8%) of those with Grade II, and none of those with Grade III cisterns returned to their previous activities at 6 months or more after onset. A Grade I cistern predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cistern invariably predicted an unfavorable outcome. It is concluded that the CT grade of quadrigeminal cistern obliteration is an accurate indicator of outcome and is highly useful in selecting appropriate treatment for patients with cerebellar hemorrhage. PMID- 3655894 TI - The effect of timing of clot removal on chronic vasospasm in a primate model. AB - The effect of complete clot removal at times from 48 to 96 hours after subarachnoid hemorrhage (SAH) on the development of chronic cerebral vasospasm was evaluated to determine whether there is a critical point after which clot removal is ineffective in preventing vasospasm. Thirty cynomolgus monkeys were randomized to one of five groups: sham-operated group, clot removal at 48 hours after SAH (48-hour group), clot removal at 72 hours after SAH (72-hour group), clot removal at 96 hours after SAH (96-hour group), and clot placement only (clot group). Standard microsurgical techniques were used to dissect bilaterally the major cerebral arteries free of arachnoid. An autologous blood clot averaging 4.2 gm was placed around the vessels in the subarachnoid space of the monkeys in the 48-hour, 72-hour, 96-hour, and clot groups. Physiological saline was instilled into the subarachnoid space of the sham-operated animals. Animals in the clot removal groups underwent surgical clot removal at the determined times for each group. Two animals in each of the sham-operated and clot groups were subjected to reoperation at each of 48, 72, and 96 hours after SAH. The incisions were reopened and then simply reclosed. Neurological status, angiographic cerebral vessel caliber, and physiological status were evaluated before and 7 days after SAH induction. There were no significant neurological deficits in the sham operated, 48-hour, or 72-hour groups. Two animals in each of the 96-hour and clot groups showed deterioration in level of consciousness developing on Day 4 or 5 after SAH induction. All the major cerebral arteries of the animals in the clot and 96-hour groups showed significant vasospasm (p less than 0.01) on Day 7. Animals in the 72-hour group had significant vasospasm (p less than 0.05) of the internal carotid and middle cerebral arteries but not the anterior cerebral arteries. There was no significant vasospasm (p greater than 0.05) in any of the cerebral arteries in the 48-hour group. Severity of vasospasm paralleled the duration of contact between the blood clot and the cerebral vessels. Evacuation of the subarachnoid hematoma later than 48 hours after SAH resulted in no significant reduction in the degree of chronic cerebral vasospasm. It is suggested that clot removal at early operation is likely to be useful only if it is performed within 48 hours of SAH. PMID- 3655895 TI - The effect of craniectomy on the biomechanics of normal brain. AB - Does an open skull alter the fundamental biomechanical properties of normal brain tissue? This question was studied in 32 anesthetized cats, 16 of which underwent a standard craniectomy (2.5 X 2.0 cm) in the left frontoparietal region. Brain tissue pressure, regional cerebral blood flow (rCBF), and brain water content were measured from the same area of cortical gray and white matter, and intracranial pressure (ICP) was recorded from the cisterna magna. Brain tissue resistance, tissue compliance, and the pressure-volume index were analyzed in response to a bolus injection of saline into brain tissue or the cisterna magna. Cerebrovascular resistance was also calculated. In craniectomized animals 2 hours after surgery, ICP had fallen to 3.75 +/- 0.39 mm Hg, and cortical gray and white matter tissue pressure had fallen to 3.19 +/- 0.47 and 4.69 +/- 0.54 mm Hg, respectively (mean +/- standard error of the mean); these variables did not fall further over 4 hours. The pressure-volume index in the same animals increased significantly from 0.67 +/- 0.01 to 0.86 +/- 0.04 ml. Tissue compliance rose in the cortical gray matter but tissue resistance fell, approximating that found in subjacent white matter. There was no significant difference between animals with and without craniectomy in rCBF, cerebrovascular resistance, or brain water content in either gray or white matter. These findings indicate that in the cat craniectomy causes an increase in the compensatory capacity of the intracranial cavity to increased volume. The data also indicate that cortical tissue has high hydraulic conductivity and compliance when the skull is opened. PMID- 3655896 TI - Nonsuture microvascular anastomosis using an Nd-YAG laser and a water-soluble polyvinyl alcohol splint. AB - Anastomosis of rat common carotid artery was performed without sutures, using a neodymium (Nd)-YAG laser at 20 W for 100 msec; this power and exposure had been found optimal in preliminary experiments. An intraluminal intervascular splint made of water-soluble polyvinyl alcohol, which dissolved and disappeared within a few minutes after recirculation of blood, was used for precise "intima-to-intima" coaptation. No stay sutures or glue were required during the procedure. There was a 92% patency rate 24 hours after surgery, and the anastomosed vessels were still patent on the 7th and 30th postoperative days. Complications such as aneurysm formation or stenotic change were negligible. The fusion of the muscle layer and collagen fibers of the media in the anastomosis was confirmed histologically. A tensile strength test immediately following operation and 1 week later showed that this anastomosis was significantly better than that achieved with the usual manual suture method. The major advantages of this technique, combined with use of a water-soluble polyvinyl alcohol splint, are rapidity, consistency of results, and firm fusion with no residual foreign body. PMID- 3655897 TI - Mineralization and biodegradation of CSF shunting systems. AB - The mineralization and biodegradation of cerebrospinal fluid shunting systems were studied using material from 25 shunts that had been implanted for between 6 days and 10 years. New unused materials were also examined for comparison. Surface changes in six systems could be observed under an operating microscope. Substantial quantities of a white deposit had adhered to the tubing in four of the shunts. These changes were most advanced in the galeal penetrative portion of the shunts and are believed to have been caused by mechanical stress. Scanning electron microscopic analysis revealed surface wrinkles, microscopic holes, and tiny particles, suggesting deterioration of the material itself. An energy dispersive analysis using x-rays demonstrated that the surface deposits were due to mineralization of calcium phosphate and that the tiny particle growth was aluminum. These changes may be a consequence of the degradation of silicone rubber. A discriminant analysis of the mineralization was carried out; thus, the age of the host and the duration of system implantation could be correlated with the incidence of mineralization (p less than 0.1). A measurement of the physical properties showed progressive change with a remarkable deterioration in systems implanted for more than 5 years. PMID- 3655898 TI - Arteriovenous malformation in moyamoya syndrome. Report of three cases. AB - Three patients are reported with the rare combination of moyamoya disease and features of an associated arteriovenous malformation. Two of the patients developed ischemic symptoms, and the third patient presented with an intracerebral hemorrhage. All three patients fit the criteria of a stage III moyamoya syndrome on the basis of the angiographic classification described by Suzuki and Takaku. The patients were referred to this medical center following angiography with the presumptive diagnosis of arteriovenous malformation. PMID- 3655899 TI - Stump embolization from an occluded internal carotid artery. Case report. AB - A patient with known internal carotid artery occlusion developed transient ischemic attacks in the distribution of the occluded vessel. Arteriography demonstrated a thrombus clearly originating from the internal carotid artery stump, which was unassociated with significantly stenotic atherosclerotic disease of the ipsilateral common or external carotid arteries. Stump angioplasty and endarterectomy led to complete and sustained cessation of further symptoms. PMID- 3655900 TI - Lymphomatoid granulomatosis apparently confined to one temporal lobe. Case report. AB - Lymphomatoid granulomatosis is of uncertain etiology and poses problems with diagnosis and treatment. A case with involvement of the right temporal lobe, but associated with cystoid macular edema of the retina, is described. The unusual mode of presentation, the radiographic, operative, and pathological findings, the response to surgery and radiotherapy, and the possible etiology are discussed. PMID- 3655902 TI - Management of simple depressed skull fractures in children. PMID- 3655901 TI - Further modifications for the Frazier suction device. Technical note. AB - Two modifications of the Frazier suction device are described: a removable distal retractor that is clipped to a modified suction tip and a coupling device that decreases counter-rotational torque. PMID- 3655903 TI - Management of severely impaired SAH patients. PMID- 3655904 TI - Courtesy in medical and scientific writing. PMID- 3655905 TI - Obliteration of high-flow carotid-cavernous fistulas. PMID- 3655906 TI - Correlates of lung/heart ratio of thallium-201 in coronary artery disease. AB - We studied 306 patients with chest pain (262 with coronary artery disease and 44 with no coronary artery disease) to determine which of 23 clinical, exercise, thallium, and angiographic variables best discriminate between patients with increased lung/heart ratios of thallium versus those with normal ratios. Normal lung/heart ratio values were defined using an additional 45 subjects with less than 1% probability of coronary artery disease. The number of diseased vessels was the best discriminator between patients with increased ratios versus those with normal ratios. Double product at peak exercise, number of segments with abnormal wall motion, patient gender, and duration of exercise were also significant discriminators. Using discriminant function analysis these variables could correctly identify 81% of cases with increased lung/heart ratios and 72% of cases with normal ratios. These results indicate that an increased lung/heart ratio of thallium reflects exercise-induced left ventricular dysfunction and affords a better understanding of why this thallium parameter is a powerful prognostic indicator in patients with chest pain. PMID- 3655907 TI - Rotational artifact in phase imaging of cardiac scans: potential pitfalls in diagnosis. AB - In the past few years, we have occasionally observed linear bands in the phase images of gated cardiac blood-pool scans along the interventricular septum region among patients with normal septal motions. Our retrospective study investigated the cause of out-of-phase bands of 12 patients. We documented through review of cines, computer analysis of gated cardiac blood-pool scintigraphy data, and correlation with echocardiograms that this phenomenon was artifact introduced by rotational movements of the heart. It is important for nuclear physicians to recognize this rotational artifact on the phase analysis image in order to avoid the erroneous misdiagnosis of wall motion abnormalities of the septum. PMID- 3655908 TI - Radiophosphate uptake in asymptomatic knee arthroplasty. AB - The utility of radiophosphate bone scanning in the detection of complications following total knee replacement (TKR) is not yet fully established. A difficulty associated with the use of bone scanning is the persistent increased uptake seen around the prosthetic joint long after surgery, despite the absence of symptoms. In order to better characterize the time course of radiophosphate uptake, bone scans obtained 1 mo-12 yr after surgery were analyzed in 30 asymptomatic patients with 37 TKR. Uptake was graded 0-4+ in the femoral and tibial components. Scans of 18 implants were obtained 1 yr or less after surgery (Group 1), and 19 were obtained greater than 1 yr after surgery (Group 2). Mean uptake scores were as follows: femoral component Group 1 = 3.0 +/- 1.1; Group 2 = 1.8 +/- 0.9 (p less than 0.05); tibial component Group 1 = 3.2 +/- 0.8; Group 2 = 2.6 +/- 1.1 (not significant). Persistent increased uptake, particularly in the tibial component, reflects mechanical stresses peculiar to knee prostheses, and tends to undermine confidence in diagnosing loosening on the basis of a single study. PMID- 3655909 TI - Postprandial blush in multiphase bone scanning. AB - The presence of transient soft-tissue activity in the left side and the lower midportion of the abdomen on the early phases of the multiphase bone scan represents postprandial physiologic hyperemia of the small intestine. The bowel uptake was present in all 33 patients ingesting food between 15 min and 3.5 hr before scanning. In those patients who had not eaten within 4 hr of the study, only 25% demonstrated bowel activity. The observation of bowel uptake is important in differentiating a physiologic phenomenon from pathologic accumulations of activity. Pathology should be ruled out when bowel activity is not located in the usual left flank and lower mid-abdomen, or is present in a fasting individual. PMID- 3655910 TI - An osmium-191/iridium-191m radionuclide generator using an oxalato osmate parent complex. AB - A new osmium-191/iridium-191m (191Os/191mIr) radionuclide generator has been developed that offers high 191mIr yield (greater than 20%/ml) and low 191Os breakthrough (less than 5 X 10(-4)%/ml) when eluted with a solution of 0.001 M oxalic acid and 0.9% (normal) saline. This is the first 191Os/191mIr generator that combines the advantages of high 191mIr yield, extremely low 191Os breakthrough, and an eluate that does not require buffering prior to injection. These improvements in performance were accomplished through use of the chelate transdioxobisoxalatoosmate(VI) as the parent complex on the generator. The clinical result of the combination of higher yield and lower breakthrough is a 100-fold decrease in the estimated patient radiation dose compared with the same study performed with technetium-99m (99mTc), and the injectable eluate makes the generator easier to use. Acute and subacute toxicity studies performed on this generator eluate have shown no adverse effects attributable to the eluate. PMID- 3655911 TI - Targeting of ganglioside GD2 monoclonal antibody to neuroblastoma. AB - The biodistribution of 3F8, and IgG3 murine monoclonal antibody (MoAb) specific for the disialoganglioside GD2, was studied in nude mice xenografted with human neuroblastoma (NB). 3F8 conjugated to radioactive iodine and injected intravenously localized selectively to seven human NB when compared with Ewing's sarcoma and Hela cell xenograft controls. Uptake in NB was shown to be specific for MoAb 3F8 when contrasted with pooled mouse IgG or irrelevant IgG3 MoAb controls. Both small (50 mg) and large tumors greater than 2 g) showed radiolocalization. The percent injected dose uptake per gram tumor ranged from 8 to 50% and was inversely correlated with tumor size. Optimal tumor to normal tissue ratios were reached by 24-48 hr. There was no abnormal uptake in the reticuloendothelial system and the MoAb did not cross the blood-brain barrier. Based on the kinetics of the amount of radioactivity deposited in tissues, the relative radiation dose to normal organs was estimated to be 1% to 20% of the tumor dose. The MoAb 3F8 is useful for targeting radioactivity to human NB in vivo and the nude mice xenograft model may allow optimization of parameters that influence such biodistribution. PMID- 3655912 TI - Routine synthesis of carbon-11-carboxyl-labeled L-dopa. AB - Carbon-11-carboxyl-labeled L-dopa has been synthesized by the modified Bucherer Strecker method. The reaction mixture was first purified by chiral HPLC followed by deprotection using hydriodic acid. The entire procedure was performed in a remotely operated system which gave the product in 28% radiochemical yield (decay corrected) in an overall synthesis time of 55-60 min. PMID- 3655913 TI - Three cases demonstrating the role of gallium scanning in relapsing Hodgkin's disease and non-Hodgkin lymphoma. AB - Restaging of Hodgkin's disease and non-Hodgkin lymphoma for chemotherapy traditionally requires chest radiograph and abdominal computerized tomogram (CT) for routine follow-up examination. Although gallium scanning has had a poor record in the past, recent studies suggest that improved techniques have given this method high sensitivity. We present three cases in which gallium correctly staged lymphoma that had been missed or misinterpreted by chest radiographs and abdominal CT. Gallium imaging is useful in follow-up of lymphoma patients especially when the CT scan is difficult to interpret. PMID- 3655914 TI - Metaiodobenzylguanidine as an index of the adrenergic nervous system integrity and function. AB - The radiopharmaceutical, metaiodobenzylguanidine (MIBG) acts as an analog of norepinephrine (NE). Experiments in rats were carried out to determine how closely the movements of [125I]MIBG in the heart mimicked those of [3H]NE, and if the changes [125I] MIBG concentrations would reflect injury to, and function of, adrenergic neurons in the heart. Injury to adrenergic neurons by 6 hydroxydopamine substantially reduced the uptake of [125I] MIBG into the left ventricle, but the effect was less than that on uptake of [3H]NE uptake and concentration of endogenous NE. Similarly, when desmethylimipramine was given to inhibit the uptake-1 pathway of neurons, the reduction in uptake of [125I]MIBG was statistically significant but less than that of [3H]NE; part of this difference may be attributable to partial uptake of [125I]MIBG into neurons by a diffusion pathway. Substantial fractions of [125I]MIBG and [3H]NE were displaced from the heart by the sympathomimetic drug, phenylpropanolamine. When adrenergic neurons of the heart were stimulated by feeding of rats, the disappearance rates of [3H]NE and [125I]MIBG from the heart were significantly increased. Although not a perfect analog of [3H]NE, [125I]MIBG appears to enter and leave the heart in patterns similar to those of [3H]NE. Thus, movements of [125I]MIBG give indices of adrenergic neuron injury and function in the heart. PMID- 3655916 TI - Detecting bone marrow metastases at the time of examining the liver with radiocolloid. PMID- 3655915 TI - Metaiodobenzylguanidine to map scintigraphically the adrenergic nervous system in man. AB - Metaiodobenzylguanidine (MIBG) localizes in adrenergic neurons; MIBG labeled with 123I then serves as an analog of norepinephrine, and concentrations of [123I]MIBG reflect sites of adrenergic neurons in organs. Movements of [123I]MIBG into and out of organs were measured by quantitative scintigraphy in man. We perturbed adrenergic neuron function in several ways, and [123I]MIBG concentrations in the heart were subsequently altered in patterns consistent with the concept that [123I]MIBG resides mostly in adrenergic neurons. Uptake of [123I]MIBG into the heart was inhibited by the tricyclic drug, imipramine, and this agent also accelerated the rate of loss of [123I]MIBG. Phenylpropanolamine, a sympathomimetic drug that acts by displacing norepinephrine from neurons, increased the rates of loss of [123I]MIBG from the heart. Exercise was followed by a movement of [123I]MIBG into blood and urine. Generalized autonomic neuropathies were associated with marked diminutions of [123I]MIBG uptake into the heart. We conclude that quantitative scintigraphy in patients will enable determinations of regional disturbances in integrity (by measuring uptake of [123I]MIBG) and function (by measuring rates of loss of [123I]MIBG) of the adrenergic nervous system in the heart. PMID- 3655917 TI - Choosing the hospital information system: a nursing perspective. AB - If computerization of patient care information is to be successful, nurses must be involved in the process from the beginning. This article describes the process used by a committee in choosing a hospital information system and the roles of the nurses who served on the committee. PMID- 3655918 TI - Implementing a computer software system. AB - A great deal of time and energy goes into deciding what software computer system to purchase for the nursing department. Too often following purchase, we think our work is over, when in reality, the most critical phase is starting- installing the system. This article discusses critical responsibilities of both nurse administrators and installers during implementation of the system. PMID- 3655919 TI - Conceptual models: an assessment framework. AB - What criteria would you use to assess the conceptual model you choose to guide your nursing department's practice? Whether you are assessing a model for your own use or critiquing someone else's, there are several considerations relating to the model's utility that should be kept in mind. To avoid choices based primarily on intuition or what "seems right," the author presents a framework for assessing the adequacy, completeness, and appropriateness of nursing models before their adoption for use in practice. PMID- 3655920 TI - Clinical nurse researchers: strategies for success. AB - One response to nursing's growing commitment to grounding practice in a research base has been the development of clinical nurse researcher positions in hospitals throughout the country. Drawing on data from a nationwide survey, the authors describe goals and strategies that clinical nurse researchers and their chief nurse executives identify as contributing to successfully carrying out the clinical nurse researcher role. PMID- 3655921 TI - Ethics committees. PMID- 3655922 TI - Copyright law: how it affects your hospital and you. AB - Nurse administrators, inservice educators, and other nursing supervisors need to be aware of how copyright law affects the use of educational materials in hospitals, medical centers, and nursing homes. The United States' Copyright Act of 1976, along with Congressional guidelines and federal rulings, have a great deal to say regarding photocopying, off-air videotaping, and use of materials borrowed from lending libraries. Examples of copyright infringement are given, with suggestions for avoiding them. PMID- 3655923 TI - A suicide precautions policy for the general hospital. AB - Nursing administrators cannot ignore the need for suicide precautions in the general hospital. Though the incidence of suicide might be low, the number of patients at risk remains high. Legal liability for the institution that fails to provide reasonable care can be considerable. The authors offer a model suicide precautions policy, specifically tailored to the general hospital, and describe procedures for its implementation. PMID- 3655924 TI - Characteristics of nurse managers: defining a model for management selection. PMID- 3655925 TI - Absenteeism among nursing personnel. PMID- 3655926 TI - When individual rights conflict, who prevails? PMID- 3655927 TI - Issues that should alarm nurse executives. PMID- 3655928 TI - Systematic downsizing: an experience. AB - Many top level nurse administrators are experiencing major organizational downsizing/expense reduction programs. The authors recounts one institution's actual stepped process, and shares specific numbers and ratios targeted and achieved. The author shares lessons learned through experiences that are applicable not only to other downsizing projects, but also to major reorganizations, market shifts, and times of significant change. PMID- 3655929 TI - Chemically dependent nurses: implications for nurse executives. AB - The number of nurses with chemical dependencies is rapidly escalating. Nurse executives recognize the problems that can occur for chemically dependent nurses and the people for whom they care. As a result, nurse executives must create policies and procedures to deal with the problem of impaired nurses. The author presents qualitative field research describing the process nurses go through as they become addicted to chemicals. The data will help nurse executives gain a greater understanding of chemical dependency so that they can better plan management interventions. PMID- 3655930 TI - The impact of utilization review on nursing. AB - At first glance, nursing's role in UR appears to be of strategic significance to the profession. But there are several issues that nurse executives need to consider. First, since UR departments are seldom part of the nursing department, UR nurses are practicing outside the realm of nursing. What responsibility, if any, does the nursing department have to nurses practicing in the hospital, yet not in the nursing department? What can the nursing department do to help UR nurses maintain their identification with the profession and appreciate the strategic importance of their role, with its legal and financial ramifications? Second, UR is changing the established role of the primary care nurse. In your institution UR may already have taken the staff nurses' discharge planning function. It appears that several factors are contributing to this role change. Patient acuity has increased the time needed to administer physical care. The nursing shortage means more patients are assigned to each professional nurse and paraprofessionals are doing more patient care. There is less and less time left for the primary nurse to practice the professional attributes of nursing, primarily discharge planning. This function is shifting to the UR Department. Is discharge planning a function nurse executives wish to relinquish? Finally, we are entering another period of severe nurse shortages, where recruitment and retention of staff are paramount. Actively competing for our staff are the UR departments. Forty professional nurses work in three regional centers of the American Health Network, American Group Insurance Company (Dallas, Texas). In one hospital of 450 beds, nine nurses are employed by the UR department.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655931 TI - Indirect costs of research. PMID- 3655932 TI - Participative management: a contingency approach. AB - The participative management trend has been misinterpreted by staff to mean that they make all the decisions. To decrease the discrepancy between the management philosophy of participation and the subordinate interpretation of the system, the selection of appropriate decision participation procedures is essential. When the leaders communicate the degree of influence that subordinates will have, the staff learn to trust and support the participative management system. PMID- 3655933 TI - Effects of casein or soybean protein on plasma cholesterol level in jejunectomized or ileectomized rats. AB - The contribution of enterohepatic circulation of cholesterol and bile acids in the hypocholesterolemic activity of soybean protein isolate (SPI) was compared with the activity of casein. Intact, sham-operated, jejunectomized or ileectomized adult rats were fed a cholesterol-free, purified diet containing either 20% casein or 20% SPI for 7 or 10 d. For the subsequent 7 d the diets were reversed. In intact rats the plasma cholesterol concentration (p-chol) was significantly higher when the casein diet was fed than when the SPI diet was fed. Within 3 d after the diet crossover, p-chol in each group of intact rats reached rapidly the same level as that in its previous counterpart. These rapid inherent responses of p-chol to the casein and SPI diets remained unchanged even when the jejunum or the ileum was resected, and p-chol in jejunectomized or ileectomized rats was similar to that found in sham-operated rats. The extent of the change in p-chol induced by exchanging dietary proteins was almost the same among intact, sham-operated, jejunectomized and ileectomized rats. These findings indicate that the interruption of enterohepatic circulation of cholesterol and bile acids is not the major factor involved in the differential effects of dietary proteins on p-chol. PMID- 3655934 TI - Thyroid function, energy balance, body composition and organ growth in protein deficient chicks. AB - Protein-deficient diets (17, 10, 6.5 or 3% protein) and a 24% control diet were fed to growing chicks. A control group was pair-fed daily with each deficient group. Energy intake was lower in the 6.5 and 3% protein groups than in the other groups. However, weight gain, bone growth and feed conversion efficiency were lower with 10% protein or less. Relative thyroid weights were unaffected by dietary protein. Plasma T3 (3,5,3'-triiodothyronine) levels were significantly higher in all deficient groups, whereas plasma T4 (thyroxine) was lower. Plasma rT3 (reverse T3) was unaffected by the protein deficiencies, suggesting that enhanced conversion of T4 to T3 rather than to rT3 had occurred. Hepatic alpha glycerol-3-phosphate dehydrogenase (alpha-GP) shuttle activity increased markedly in protein-deficient chicks. Efficiency of energy utilization was unaltered in chicks fed 17 or 10% protein but was higher in chicks fed 6.5 and 3% protein than in controls. All deficient chicks had more fat and less protein and water in the tissues. The lower feed conversion efficiency therefore represents almost entirely a shift in body composition toward fat and does not reflect a loss of energy as heat. We conclude that elevations in plasma T3 and in thyroid controlled alpha-GP shuttle activity, although sensitive indicators of protein deficiencies, are not good predictors of altered thermogenic activity in protein deficient chicks. PMID- 3655935 TI - Metabolism of methionine and methionine hydroxy analogue by porcine kidney fibroblasts. AB - Porcine kidney fibroblasts in culture are able to utilize the 2-hydroxy analog of methionine (MHA) as the sole methionine source, but higher concentrations of MHA than methionine are required. The optimal concentration for growth with L methionine ranges from 0.02 to 1.0 mM, whereas that for DL-MHA is 7.5 mM. At concentrations above 1.0 mM, L-methionine exhibits a toxic effect. Supplementing 1.0 mM L-methionine with DL-MHA allows greater growth than that provided by an equimolar concentration of L-methionine alone, and no toxic effect is seen at methionine source (DL-MHA) concentrations up to 7.5 mM. Early in the growth phase of cells where DL-MHA is the sole source of methionine, a 48-h lag period is observed over that seen in cells grown in the presence of 1.0 mM L-methionine. After the lag period, the MHA-supplemented cells double at the same rate as the methionine-supplemented cells. Studies with the purified isomers of D- and L-MHA indicate that only the D-isomer is utilized by these fibroblasts. PMID- 3655936 TI - Mechanisms of absorption, transport and tissue uptake of RRR-alpha-tocopherol and d-gamma-tocopherol in the white rat. AB - The metabolism of alpha- and gamma-tocopherol was studied in three groups of rats that were fed a modified AIN-76 diet containing normal (NE, 0.2 g alpha tocopherol/kg), high (HE, 1.0 g alpha-tocopherol/kg) or low (LE, less than 0.02 alpha-tocopherol/kg) vitamin E for 3 mo. After 1, 2 and 3 d of an oral dose of 20 mg of alpha-tocopherol, gamma-tocopherol or both, the levels of the two vitamers were measured in plasma and tissues and in some cases in isolated microsomal and mitochondrial fractions from liver. Twenty-four hours after an oral dose of 20 mg gamma-tocopherol the levels of alpha-tocopherol in plasma and tissues remained constant and higher levels of gamma-tocopherol were found in tissues in which low alpha-tocopherol levels could be found such as in the LE group. In spite of this, it was enabled to remain there, after 2 and 3 d gamma-tocopherol had decreased levels in all tissues. When given in combination with alpha-tocopherol, the levels of gamma-tocopherol were lower than when gamma-tocopherol was given alone. Microsomes and mitochondria from livers of LE group bound five and nine times more alpha-tocopherol than gamma-tocopherol in rats dosed with equal amount of alpha- or gamma-tocopherol, respectively. These data indicate that the mechanisms that regulate the metabolism of vitamin E are highly specific for alpha tocopherol. Moreover, the relative amount of alpha-tocopherol determined the levels of gamma-tocopherol in tissues. However, the retention of gamma-tocopherol in tissues did not depend on the presence of alpha-tocopherol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3655937 TI - Effect of cimetidine on tissue distribution of some trace elements and minerals in the rat. AB - Cimetidine is a histamine H2-receptor antagonist that is used in the treatment of patients with gastric and duodenal ulcers and other hypersecretory conditions. This drug has a structure that suggests that it could act as a chelating agent. To examine its effects on trace metal and mineral metabolism, 38 weanling male Sprague-Dawley rats were assigned to one of five treatment groups. These were a high dose [(HD) 1750 mg/(kg X d)] group, HD pair-fed control (HDPF) group, intermediate dose [(ID) 875 mg/(kg X d)] group, ID pair-fed (IDPF) group and low dose [(LD) 87.5 mg/kg X d)] group. In a separate experiment, 20 female Sprague Dawley rats were assigned to one of two treatment groups: a high dose cimetidine group [(HDFem) 1750 mg/kg X d)] and a pair-fed control group (PFFem). Cimetidine was administered intragastrically four times per week for 5 wk. Significant differences (P less than 0.05) found among groups for the male rats studied included higher plasma copper in the HD and the ID groups, higher plasma sodium, liver copper, heart calcium and heart zinc in the HD group and a lower percentage of fecal excretion of all the divalent metals studied in the HD and the ID groups than in their pair-fed controls. Pathologic examination of the liver revealed extensive fatty infiltration of liver cells, liver cell necrosis and disrupture of liver lobular architecture in the HD group. Cimetidine-dosed females had higher zinc in heart and plasma, higher copper in heart, kidney, liver, jejunum, ileum and uterus, higher manganese in stomach and ileum, lower iron in kidney and liver, lower kidney calcium and higher stomach calcium and lower liver magnesium compared with their pair-fed controls. Levels of liver and kidney metallothionein in the two groups were comparable. Male and female rats receiving high dose cimetidine experienced significant changes in tissue concentrations of some of the trace metals and minerals studied. PMID- 3655938 TI - Effect of maternal zinc supply on blood and tissue metallothionein I concentrations in suckling rats. AB - Changes in metallothionein I (MT-I) levels were measured in blood and tissues of rat pups from dams given diets containing 6, 9 or 40 mg zinc/kg from wk 1 or gestation and throughout lactation. After 1, 2 and 3 wk of lactation, litters from each group were killed and tissues analyzed for MT-I. The relatively mild degree of zinc deficiency, which had no effect on fetal viability or litter size and caused only slightly lower pup weight, caused significantly lower MT-I concentrations in pup liver, thymus, plasma and red cells, particularly in pups from dams receiving 6 mg zinc/kg. Maternal zinc supply is therefore a major determinant of MT-I concentrations in neonatal tissues, and assay of this protein in blood plasma and red cells may give a useful indication of zinc status. PMID- 3655939 TI - Dose-response relations in urinary excretion of trimethylselenonium in the rat. AB - 75Se-labeled selenite was administered to fasting rats by orogastric intubation (1.5-3000 micrograms/kg body wt). Urine was collected and characterized for total radioactivity as well as for radiolabeled trimethylselenonium (TMSe). At lower doses of selenite (up to 500 micrograms/kg body wt), 30% of the administered dose was excreted. At higher doses of selenite, fractional urine excretion decreased as a function of the dose. The observed decrease in fractional urine excretion was not caused by changes in the absorption of the administered radiolabel. There was a direct relationship between the amount of the administered dose of selenite (up to 1500 micrograms/kg body wt) and the proportion of urinary [75Se] excreted as TMSe. Pretreatment with seleno compounds (10 or 100 micrograms Se/kg body wt as selenite, or selenomethionine) for 35 d before a challenge dose of [75Se]selenite did not influence the excretion of total [75Se] or of [75Se]TMSe in urine. Ingestion of a choline-deficient diet, which should deplete the availability of methyl groups, did not have any effect on excretion of total [75Se] or of [75Se]TMSe in urine after a challenge dose of [75Se]selenite (500 micrograms/kg body wt). The data presented here permit the following conclusions: 1) Production of TMSe is dose dependent, 2) production of TMSe from a single acute dose does not depend on the history of selenium intake and 3) rats fed a methyl-deficient diet are able to eliminate Se via formation of TMSe. PMID- 3655940 TI - Induction of ceruloplasmin synthesis by retinoic acid in rats: influence of dietary copper and vitamin A status. AB - Ceruloplasmin, a copper-containing acute phase plasma protein, has been shown to be regulated by 13-cis retinoic acid in rats. Ceruloplasmin activity was significantly increased within 24 h and remained elevated for at least 72 h after a single injection of 13-cis retinoic acid. With daily injections of retinoic acid, the ceruloplasmin activity continued to increase for at least 4 d. After 4 d, the activity was four times control levels. In copper-deficient rats, the ceruloplasmin activity did not increase in response to retinoic acid unless copper was also given to these rats 8 h after retinoic acid. Actinomycin D blocked the retinoic acid-induced stimulation of ceruloplasmin activity in copper sufficient rats, but in copper-deficient rats only about half of the increase was blocked when the rats were given copper or copper and retinoic acid. By use of pulse-labeling techniques, ceruloplasmin synthesis was shown to increase 1.5-fold after retinoic acid and this increase was blocked by actinomycin D. When vitamin A-deficient rats were repleted with 13-cis retinoic acid for 3 or 5 d, both the ceruloplasmin activity and synthesis were significantly stimulated when compared to the nonrepleted, deficient rats. Therefore, the dietary components, copper and vitamin A, play an important role in the regulation of plasma ceruloplasmin levels. PMID- 3655941 TI - Sodium deprivation growth failure in the rat: alterations in tissue composition and fluid spaces. AB - Dietary control of sodium intake was utilized in weanling rats to study the relationships among body growth, tissue composition and extracellular fluid volume (ECFV). Forty 3-wk-old rats were divided into groups receiving 30, 150, 300, 600 or 900 mu eq sodium/d for 5 wk. The minimal daily requirement for normal growth was 300 mu eq Na, or about 60 mu eq/g of new growth. Lower doses caused dose-related growth failure associated with a reduced ECFV. Analyses of carcass, muscle and bone composition were carried out. In sodium-deprived animals there was retarded growth of protoplasm, fat and bone; the mineral composition of muscle was not altered, whereas in bone calcium concentration was reduced. Plasma concentrations of sodium, potassium and chloride remained normal. Pair-feeding indicated that sodium-deficiency growth retardation could not be attributed to starvation. Sodium-deficient animals ingested a greater amount of food per gram of weight gain, possibly reflecting an increased energy expenditure. Sodium deprivation initially permitted protoplasmic growth to proceed at a rate disproportionate to that of the ECFV. Subsequently, both continued to grow at a reduced but similar rate, suggesting that ECFV may be a controller of protoplasmic growth. PMID- 3655942 TI - Number of days of food intake records required to estimate individual and group nutrient intakes with defined confidence. AB - The number of days of food intake data needed to estimate the intake of 29 male (n = 13) and female (n = 16) adult subjects, individually and as a group, was determined for food energy and 18 nutrients. The food intake records were collected in a year-long study conducted by the U.S. Department of Agriculture's Beltsville Human Nutrition Research Center. Each individual's average intake of nutrients and standard deviation over the year were assumed to reflect his or her "usual" intake and day-to-day variability. Confidence intervals (P less than 0.05) for each individual's usual intake were constructed, and from these the number of days of dietary records needed for estimated individual and group intake to be within 10% of usual intake was calculated. The results indicated that the number of days of food intake records needed to predict the usual nutrient intake of an individual varied substantially among individuals for the same nutrient and within individuals for different nutrients; e.g., food energy required the fewest days (averaging 31) and vitamin A the most (averaging 433). This was considerably higher than the number of days needed to estimate mean nutrient intake for this group, which ranged from 3 for food energy to 41 for vitamin A. Fewer days would be needed for larger groups. PMID- 3655944 TI - Tobacco smoke and air quality. PMID- 3655943 TI - Comments on measurement of iron bioavailability in rats. PMID- 3655945 TI - Garments for heat stress. PMID- 3655946 TI - Severe keratoconjunctivitis in plasma flame-spraying workers. PMID- 3655947 TI - Pleural plaques and asbestos-associated malignancy. PMID- 3655948 TI - The prospective impact of psychosocial variables on rates of illness and injury in professional employees. AB - From a prospective study of health changes in air traffic controllers, it was determined that high scores on self-report measures of work-related life change distress, other life changes outside the work setting, the type A behavior pattern, and dissatisfaction with management were positively related to future rates of injuries and physician-diagnosed acute illness episodes. Depending on the risk factor involved, high scorers on these psychosocial risk predictors incurred from 80% to 252% more future accidental injuries and from 38% to 69% more future total morbidity over a 27-month follow-up period than the men in the low scoring groups. Moreover, coworker-rated amicability, probably an indication of the amount of social support available to an individual, was significantly protective against these outcome variables, with the rarely or never chosen group experiencing 60% more total morbidity and 174% more injuries than the often chosen group. A multiple-regression equation revealed that stress, amicability, type A, and satisfaction with management had an additive effect on the outcome variables. Work- and non-work-related life change distress subscales were similar in their ability to predict later morbidity. Prediction was stronger for 27-month follow-up than for only the first 9-month period. The findings, if replicated, raise the possibility of screening programs to identify employees at high risk of future illness and injury. PMID- 3655949 TI - The effect of time in a new job on hospitalization rates for accidents and injuries in the U.S. Navy, 1977 through 1983. AB - The incidence of accidental injury hospitalizations among Navy enlisted men during the period 1977 through 1983 was analyzed by paygrade, type of duty station, and external cause of accident to determine whether time in a new job affected an individual's risk of injury and subsequent hospitalization. For personnel assigned to shore duty, the highest incidence of injury occurred during the first few weeks at a new job, then decreased sharply, eventually leveling off after several months. This trend was not present for sea-based personnel. Shore based personnel had significantly elevated risks of hospitalization from athletic , fall-, automobile-, motorcycle-, and machinery-related accidents during the first few weeks in a new job compared with sea-based personnel. The leading external causes of injury (motorcycles, automobiles, and athletics) did not change appreciably over time among E2 through E9 personnel. PMID- 3655950 TI - Characteristics of the frequent visitor to the industrial medical department and implications for health promotion. AB - The number of visits to an in-house industrial medical clinic, of absences in three categories, and of late arrivals found in 1,505 employees of an automobile assembly plant were compared with respect to the age, sex, race, department, and shift characteristics of the employees. Less than 16% of the work force was found to account for over 50% of the medical visits. Those 235 frequent visitors were found to have significantly more absences and more tardiness compared with the rest of the plant population. The frequent visitors who completed a health risk appraisal had significantly greater health risks compared with a responding sample of nonfrequent visitors. PMID- 3655951 TI - Mortality of workers in styrene-butadiene polymer production. AB - A total of 13,920 males who had worked in eight styrene-butadiene rubber polymer manufacturing plants in the US and Canada for at least 1 year were followed for deaths from 1943 when the industry began to 1979. Mortality ratios standardized for age, race, and calendar time using US male rates as a comparison revealed no excess mortality in this population for any cause of death. The overall standardized mortality ratio (SMR) for all causes was 0.81. Only the SMR for arteriosclerotic heart disease among black males showed a significant excess (SMR = 1.28). Examination of risks by major work areas such as production, utilities, maintenance, and other jobs, as well as by salaried and hourly pay grade, revealed no significant differences in cancer mortality by specific sites. Because the ratios for selected digestive cancers were above the all-cause SMR, this group of neoplasms is under further investigation as is the exposure profile of specific jobs within the industry. PMID- 3655952 TI - Prevalence of hepatitis B markers in occupational health nurses. AB - A seroprevalence study was undertaken at the 14th Annual Conference of the Occupational Health Nurses Association of Ontario. A total of 151 self-selected registrants (33%) provided demographic, health, and occupational information. Blood was drawn for hepatitis B serology (hepatitis B surface antigen, core antibody, and surface antibody). Vaccine-induced seropositivity was found in 11 persons (7.3%) while naturally occurring markers were present in 13 nurses (8.6%). This exceeds the natural prevalence of markers in Canada (4% to 6%) but is less than that seen in emergency and renal dialysis nurses. It implies that occupational health nurses are at less risk for hepatitis B virus infection than their acute care hospital colleagues. PMID- 3655953 TI - Physician-based surveillance of occupational disease: developing a methodology. AB - Because of the inadequacies of surveillance data for occupational disease in the United States, this study was undertaken to determine the feasibility of using physicians' and hospital records for occupational disease surveillance. The study was based on Rutstein's sentinel health event (occupational) classification and the use of sentinel physicians. Data were gathered on nonmalignant dermatologic and respiratory diagnoses prospectively at five sites and retrospectively at four of these sites. The combined approaches identified 49 patients whose illnesses were probably work-related. Because the prospective approach took less than 10% of the time for each case identified compared with the time required for the retrospective approach, and prospective data are more timely and easier to access, the prospective approach appears to be better. PMID- 3655954 TI - Febrile inpatients: house officers' use of blood cultures. AB - The so-called "fever work-up" is time-consuming and costly. The authors examined the practices of medical house officers in obtaining blood cultures, an important part of this evaluation, as well as the ability of these physicians to predict bacteremia in febrile patients. They studied all 344 medical inpatients who experienced episodes of fever during two 30-day periods, as well as all 50 cases of bacteremia detected during these and two additional 30-day periods. House officers drew blood for culture within one day after the onset of fever in 52% of fever episodes. In 20% of these episodes only one set of cultures (representing one venipuncture) was obtained. House officers estimated the likelihood of bacteremia to be 20% or less in 15 of 40 bacteremic patients. They failed to obtain blood cultures promptly in 10% of bacteremic episodes and in 27% of episodes where the cause of fever was a nonbacteremic bacterial infection. They obtained prompt blood cultures in only a bare majority of febrile episodes, frequently underestimated the likelihood of bacteremia, and inadequately sampled blood for bacteremia. In this study, clinical judgment was not an adequate substitute for routinely obtaining blood cultures for febrile medical inpatients. PMID- 3655955 TI - The effect of medication compliance on the control of hypertension. AB - The effect of medication-taking patterns on blood pressure was investigated in 24 hypertensive outpatients being treated with once-daily doses of hydrochlorothiazide or chlorthalidone. Medication-taking patterns were measured with a small pill dispenser that electronically records the time of medication removal. Blood pressure reduction was found to correlate better with the total number of doses the patient removed from the pill pack during a month than with any of four other compliance measures that were based on the timing of dose removal. Analysis also suggested that blood pressure is improved if patients ingest omitted doses to "catch up" to the prescribed regimen. It is concluded that a simple pill count may be the most clinically relevant definition of compliance for patients with hypertension being treated with only hydrochlorothiazide or chlorthalidone, and that such patients should ingest all prescribed doses, regardless of the time interval between doses. PMID- 3655956 TI - The effects of a cost-education program on hospital charges. AB - An educational intervention designed to change physicians' use of inpatient services was implemented on two general medical services for a year. The intervention consisted of a brief orientation to cost containment issues, a pamphlet that outlined practical cost containment strategies and listed the charges for commonly ordered tests and services, and access to detailed interim patients' bills generated during the hospitalization. Two concurrent control services received no intervention. Over 1,600 admissions were evaluated. The geometric mean length of stay was 0.61 days shorter on intervention services compared with control (5.15 vs. 5.76 days, p less than 0.01). The geometric mean hospital charges were $388 less for intervention patients ($3,199 vs. $3,587, p less than 0.005). Neither patients' demographic characteristics nor case mix could explain the reductions. The authors conclude that a simple program utilizing information already in existence in most hospitals can result in a significant and meaningful reduction in length of stay and charges. PMID- 3655957 TI - Six-month outcomes for medical patients with major depressive disorders. AB - The courses of depressive disorders and factors affecting recovery rates among patients treated in primary medical care facilities have rarely been studied. The authors investigated the clinical status of 274 patients initially and six months after they sought care at one of three primary care sites. Through use of the highly structured Diagnostic Interview Schedule, they found that physicians assigned a depressive diagnosis to only a fourth of the patients so assessed by the structured interview. Nevertheless, the rates of persisting major depressive disorders at follow-up were found to be very similar for patients whom both the structured interview and the physician initially considered depressed and those so diagnosed by structured interview but not by the physician (25% and 31%, respectively). An analysis of factors associated with course of illness suggests that psychiatric status at the initial assessment and the number of assigned medical diagnoses rather than the physician's recognition and treatment of depression strongly predict continued affective disorder. PMID- 3655958 TI - Physician's interviewing styles and medical information obtained from patients. AB - This paper investigates the association between physicians' interviewing styles and medical information obtained during simulated patient encounters. The sources of data are audiotapes and transcripts of two standardized patient cases presented by trained patient simulators to 43 primary care practitioners. Transcripts were scored for physician proficiency using expert-generated criteria and were content-analyzed to assess the process of communication and information content. Relevant patient disclosure was also scored from the transcripts based on expert-generated criteria. Findings were: 1) On the whole, physicians elicited only slightly more than 50% of the medical information considered important according to expert consensus, with a range from 9% to 85%. 2) Both open and closed questions were substantially related to patient disclosure of medical information to the physician, but open questions were substantially more so (Pearson correlations of 0.37 and 0.72, respectively). 3) Patient education, particularly information regarding prognosis, cause, and prevention, was substantially related to patient disclosure of medical information to the physician (Pearson correlations of 0.44, 0.36, and 0.34, respectively). 5) Finally, clinical expertise was only weakly associated with patient disclosure of medical information to the physician (Pearson correlation of 0.16). PMID- 3655959 TI - The relationship between features of residency training and ABIM certifying examination performance. AB - The purpose of this study was to provide data concerning the relationship between features of residency training and a test of cognitive achievement gathered at the end of residency. To accomplish this, data collected in the late 1970s by three national organizations were joined and analyzed with the aid of experts in internal medicine. Although graduate medical education has evolved since this information was gathered, it does provide a baseline for assessing the impact of changes on the cognitive skills of residents. The findings suggest that better program performance on the examination is associated with attracting more knowledgeable residents to begin with and that programs are able to maintain the advantage of their residents throughout training. Moreover, program characteristics have an impact on the cognitive skills of residents over and above what would be predicted by test scores at the end of medical school. Programs with better examination performance tend to provide residents an extensive, well-supervised educational experience stressing ambulatory care. PMID- 3655960 TI - The relationship of patient characteristics to physician delivery of advice to stop smoking. AB - To investigate the frequency of physician delivery of advice to stop smoking and patient characteristics affecting whether physicians deliver such advice, the authors surveyed 97 current cigarette smokers seen in two specialty and one general medicine clinic at a university medical center. Approximately two thirds of the smokers reported ever having been advised to stop smoking by their current physicians. In univariate and multivariate analyses, the presence of a smoking related illness, the number of prior attempts to quit, and the duration of cigarette smoking were significantly related to delivery of smoking cessation advice by physicians. Knowledge of factors that affect the provision of advice to stop smoking can be used to enhance the physician's role in smoking intervention. PMID- 3655961 TI - Managerial model of the attending physician. PMID- 3655962 TI - Doctors as "healers": striving to reach our potential. PMID- 3655963 TI - Studies of prognosis: progress and pitfalls. PMID- 3655964 TI - Liberal education and medical school admission. PMID- 3655965 TI - The medical interview as core clinical skill: the problem and the opportunity. PMID- 3655966 TI - Inexpensive tests of limited value: sometimes you get what you pay for. PMID- 3655967 TI - Psychiatric symptoms vs. psychiatric disorders. PMID- 3655968 TI - Allopurinol in prevention of reperfusion injury of hypoxically stored rat hearts. AB - We have studied the effect of the xanthine-oxidase inhibitor allopurinol on the performance of hypoxically stored rat hearts to evaluate the drugs' potential value in heart transplantation. Hearts were stored for 2 hours at 15 degrees C after potassium chloride cardioplegia. Hemodynamics were measured before hypoxia and after reperfusion. Hearts were treated with allopurinol in the cardioplegia, at the time of reperfusion, or with superoxide dismutase (SOD) and catalase (CAT) and compared with control hearts that received no treatment. Hemodynamic performance after hypoxia was significantly improved in the SOD/CAT group compared with the control group. Allopurinol-treated hearts were also significantly improved, especially when the drug was given in the reperfusion phase. Our results demonstrate the importance of free radicals during reperfusion of hypoxically stored hearts. Allopurinol and SOD/CAT may be of value in reducing such damage after heart transplantation. PMID- 3655969 TI - Locus of spatial-frequency discrimination. AB - In standard frequency-discrimination experiments either the retinal spatial frequencies (cycles per degree) or the object spatial frequencies (real world) could be compared, because the retinal and object frequency differences are the same. Current models of spatial-frequency discrimination assume that observers compare the retinal frequencies. I test this assumption by presenting gratings at different viewing distances (with strong depth cues). The object frequencies of the gratings bear the same relationship that they do in a standard frequency discrimination experiment, but the retinal frequency of the more distant grating is always markedly higher than that of the near grating. The observer's task is to compare the object spatial frequencies. This change from one depth to two (with no change in the stimulus object) has a negligible effect on the observer's performance, suggesting that observers compare object frequencies even in standard spatial-frequency-discrimination experiments. This conclusion is supported by the findings that (1) observers appear unable to learn to compare retinal frequencies and (2) the interstimulus interval has no effect (over the range 0-1020 msec), implying long-term storage of the visual information. Suggests are made about why these results are consistent with good system design. PMID- 3655970 TI - Hysteresis in human binocular fusion: temporalward and nasalward ranges. AB - Fender and Julesz [J. Opt. Soc. Am. 57, 819 (1967)] moved pairs of retinally stabilized images across the temporalward visual fields and found significant differences between the disparities that elicited fusion and the disparities at which fusion was lost. They recognized this phenomenon as an example of hysteresis. In the work reported in this paper, binocular retinally stabilized images of vertical dark bars on white backgrounds were moved into horizontal disparity in both the nasalward and the temporalward directions. The limits of Panum's fusional area and the hysteresis demonstrated by these limits were measured for two observers. The following results were obtained: (1) the nasalward limits of Panum's fusional area and the hysteresis demonstrated by the nasalward limits do not differ significantly from the temporalward limits and the hysteresis demonstrated by the temporalward limits; (2) the limits of Panum's fusional area and the hysteresis demonstrated by these limits are not significantly different if one stimulus moves across each retina or if one stimulus is held still on one retina and the other stimulus is moved across the other retina; (3) the use of nonstabilized cross hairs for fixation decreases the hysteresis; and (4) the full hysteresis effect can be elicited with a rate of change of disparity of 2 arcmin/sec. PMID- 3655971 TI - Reading fields of magnifying loupes. AB - For the purpose of understanding the influence of the use of magnifying loupes on the reading process, the reading field is a relevant concept. Three possible reading fields are distinguished: the monocular reading field, the binocular reading field, and the composite reading field. Theoretical expressions for the widths of reading fields are derived as a function of the physical parameters of the loupe and the geometry of the reading situation. Variation of reading-field width as a function of magnification is illustrated. For verification, experimentally determined reading-field widths were compared with the theoretical ones. There were small systematic deviations, probably caused by achromatic aberrations. In order to learn about the strategies that subjects use when reading with the aid of a loupe, loupe displacement was measured while subjects read text under conditions that provided a variety of reading-field widths. It was found that individual subjects use different strategies (i.e., they use different reading-field widths). PMID- 3655972 TI - Intracorneal correction of aphakia: paraxial approach at null incidence. AB - The technique of intracorneal implantation, recently proposed by de Laage de Meux and Cinquin [Implants, 2, 26 (1984)] for the correction of aphakia, is analyzed in terms of geometrical optics. The analysis is done by using matrix optics and by assuming a null incidence. The characteristics (diameter, radii of curvature, axial thickness) of the hard or soft lens to be implanted are determined and given. The aniseikonia of such lenses is shown to be nearly the same as that of contact lenses. PMID- 3655973 TI - St John Breast Cancer Screening Clinic: a twelve-year review. PMID- 3655974 TI - Legionella pneumophila infections in Oklahoma: prevalence among VA hospital patients prior to the 1976 Philadelphia outbreak. PMID- 3655975 TI - Dare to be intimate. PMID- 3655976 TI - Epithelial-cell architecture during involution of the human thymus. AB - One hundred thymus glands were assessed histologically as to their degree of involution. Epithelial cells were demonstrated by an immunoperoxidase method using a monoclonal antibody against cytokeratin. The distribution of these cells was studied in the medulla, the cortico-medullary junction, the cortical parenchyma and the subcapsular cortex. As involution proceeds, the loss of cells from the thymus is almost totally confined to the lymphoid-cell elements. The architecture of the epithelial-cell network remains largely intact although there is extensive collapse of the structure due to the loss of the intervening lymphocytes. Even when involution is apparently complete; sheets of epithelial cells can be demonstrated in the thymic remnant. PMID- 3655978 TI - Pathological Society of Great Britain and Ireland. 155th meeting. 8-10 July 1987, Southampton. Joint meeting with the British Society for Neuropathology and the British Society for Mycopathology. Synopses of papers. PMID- 3655977 TI - Pulmonary vascular disease in ventricular septal defect: structural and functional correlations in lung biopsies from 85 patients, with outcome of intracardiac repair. AB - Pulmonary vascular structure was analysed using morphometric techniques, and arterial wall abnormalities in lung biopsy specimens taken from 85 cases of ventricular septal defect, aged 3 weeks to 30 years were described. The defect was closed in 53 patients, 12 died at operation and 11 survivors were recatheterized. Structural examination revealed a characteristic pathological picture which appeared to precede classical grade IV pulmonary vascular disease. This predilatation phase was identified by finding pre-acinar obstructive intimal proliferation or fibrosis, associated with only a slight increase in intra-acinar arterial muscularity, in the absence of stigmata of grade IV disease in patients with a pulmonary resistance greater than 6 units m2. Predilatation features occurred in 62 per cent of patients who either died at repair or who had post operative pulmonary hypertension. These findings help identify a high risk group in whom resistance is higher than expected in the absence of classical grade IV changes. In addition, a marked increase in muscularity without intimal obstruction can also be associated with a pre-operative resistance of more than 6 units m2. The presence of medial hypertrophy only does not ensure either survival or a normal post-operative pulmonary arterial pressure. Early intra-cardiac repair is recommended before obstructive intimal fibrosis develops during the second year. PMID- 3655979 TI - Energy expenditure of patients with cystic fibrosis. AB - Resting energy expenditure was measured by open-circuit indirect calorimetry in 71 patients, aged 8.9 to 35.5 years, with cystic fibrosis who had no recent history of acute lung infection. Pulmonary function and nutritional status were studied simultaneously. In most patients, resting energy expenditure was above normal (range 95% to 153% of predicted values for age, sex, and weight as derived from the Harris Benedict equations), and was negatively correlated with pulmonary function (P less than 0.01) and nutritional status (P less than 0.01) when expressed as a percentage of body fat. Pulmonary status was positively correlated with nutritional status (P less than 0.01). We conclude that resting energy expenditure in patients with cystic fibrosis exceeds normal values and that the increase correlates with a deterioration in lung function and nutritional status. PMID- 3655980 TI - Severe hypervitaminosis A in siblings: evidence of variable tolerance to retinol intake. AB - A 2-year-old boy had signs and symptoms of chronic hypervitaminosis A. A course of increasing severity led to eventual death. A younger brother later had similar clinical features. Chicken liver spread containing up to 420 IU/g vitamin A was the likely source of intoxication. Markedly elevated circulating retinyl ester levels have persisted in the surviving sibling for 3 subsequent years despite severe restriction of vitamin A intake. A therapeutic trial of the carbohydrate derived complexing agent 2-hydroxypropyl-beta-cyclodextrin was initiated. Circulating retinyl esters transiently increased during the infusion (from 407 to 4791 micrograms/dL), and urinary total vitamin A excretion, undetectable before infusion, increased to 23 micrograms/dL after infusion. The frequency of hypervitaminotic episodes has decreased somewhat in the 2 years since the infusion, probably related to dietary vitamin A restriction. The occurrence of this syndrome in two brothers, while a sister ingesting the same diet remains completely healthy, suggests an inherited variance in tolerance to vitamin A intake. PMID- 3655981 TI - Five years' experience with continuous ambulatory or continuous cycling peritoneal dialysis in children. AB - In 93 children, end-stage renal disease was treated with the new dialytic methods of continuous ambulatory peritoneal dialysis (CAPD) or continuous cycling peritoneal dialysis (CCPD) over 5 years. Modality survival rates at 36 months with CAPD, CCPD, or both were 20%, 93%, and 87%, respectively. Use of CCPD as the primary dilaytic method increased during the study period. The peritonitis rate was one episode per 11.8 patient treatment months and was similar with both CAPD and CCPD. Gram-positive organisms were cultured in 34% of these episodes of peritonitis. Staphylococcus aureus peritonitis was associated with a recurrence rate of 40% and led to catheter replacement in 45% of the episodes. Peritoneal membrane failure necessitating switching to hemodialysis was related to peritonitis in three patients. Of the 74 peritoneal catheters that required replacement, 70% were infected. Serial serum levels of urea nitrogen, potassium, calcium, phosphorus, albumin, and alkaline phosphatase remained stable, whereas serum creatinine level rose slightly over time. Episodes of hyperkalemia, hypercalcemia, and hyperphosphatemia were observed at a frequency of one episode per 12.2, 4.6, and 2.5 treatment months, respectively. Blood transfusions were required in once per 1.5 and 3.3 treatment months in seven anephric patients and in 35 patients with their own kidneys, respectively (P = 0.05). In prepubertal patients who received CAPD or CCPD for greater than 1 year, little or no improvement in growth occurred in relationship to either chronologic or bone age. PMID- 3655983 TI - Pulmonary function in thalassemia major. AB - Pulmonary function tests were evaluated in 28 Chinese patients with beta thalassemia major receiving regular transfusions and desferoxamine, and in 34 height-matched normal Chinese children. Comparison of lung function using analysis of covariance with reference to standing height showed that patients with thalassemia had a proportional decrease in forced vital capacity and forced expiratory flow volume in 1 second, whereas their expiratory flow rates, residual volume, and total lung capacity were comparable to those in normal children. The single-breath carbon monoxide diffusion capacity was normal. Our findings suggest that children with thalassemia major have mild restrictive lung disease. The previous controversy regarding the presence of restrictive or obstructive lung disease in patients with thalassemia may be related to the use of inappropriate control values. PMID- 3655982 TI - Nonfamilial hematuria associated with glomerular basement membrane alterations characteristic of hereditary nephritis: comparison with hereditary nephritis. AB - Characteristic ultrastructural alterations of the glomerular basement membrane (GBM) have been reported in hereditary nephritis and in children without a family history of renal disease. The clinical features, renal biopsy findings, and subsequent course were studied retrospectively in 48 children with such GBM changes to compare findings in those with and without a family history of nephritis and to determine the significance of the GBM changes in patients with nonfamilial disease. All 48 patients had hematuria. For 30, there was hematuria in at least one other member of the family (familial hematuria group); for 18, there was no familial incidence. There were no differences between the two groups with regard to clinical and pathologic findings. At the latest follow-up six boys with familial hematuria and three boys with nonfamilial hematuria had reduced renal function, and nine boys with familial hematuria and four boys and one girl with nonfamilial hematuria had neurosensory deafness. Our study results show that children with these GBM changes, with or without a family history of hematuria, tend to have a progressive course, with frequent occurrence of neurosensory deafness, and that the prognosis is more severe in boys. These observations suggest that such GBM changes in patients with nonfamilial hematuria may represent new mutations for hereditary nephritis. PMID- 3655984 TI - Autosomal dominant ectrodactyly and absence of long bones of upper or lower limbs: further clinical delineation. AB - The association of ectrodactyly and absence of long bones of the upper or lower extremities has been recognized previously in nine families. We report 24 additional individuals in four families who are similarly affected. Two of these families manifest the unusual feature of unilateral preaxial polydactyly of a lower extremity. Data from these four families plus the nine previously reported suggest that ectrodactyly associated with absence of long bones of the upper or lower limbs is a genetically determined disorder, inherited as an autosomal dominant trait with widely variable expression or nonpenetrance. PMID- 3655985 TI - Analysis of covariance in medical research. PMID- 3655986 TI - Myofascial trigger point pain in children. PMID- 3655987 TI - Thermography in childhood reflex sympathetic dystrophy. PMID- 3655988 TI - Neutropenia and defective chemotaxis associated with binuclear, tetraploid myeloid-monocytic leukocytes. PMID- 3655989 TI - Perinatal cocaine and methamphetamine exposure: maternal and neonatal correlates. AB - Maternal and neonatal growth, behavior, and physiologic organization were evaluated in 104 mother-infant pairs with positive results of urine toxicology screens. ANOVA comparison of cocaine, methamphetamine, and cocaine plus methamphetamine groups revealed no significant differences in perinatal variables. The Finnegan withdrawal scoring scheme demonstrated that all three groups of infants had altered neonatal behavioral patterns, characterized by abnormal sleep patterns, poor feeding, tremors, and hypertonia. Infants exposed to cocaine or methamphetamine or both were combined and compared with both narcotic-exposed and drug-free mother-infant pairs matched for known maternal risk factors. All drug-exposed groups had significantly higher rates of prematurity and intrauterine growth retardation and smaller head circumferences than did the drug-free comparison group. A significantly higher rate of placental hemorrhage occurred in the cocaine plus methamphetamine group. Stepwise multiple regression analysis assessed the independent contribution of maternal factors; cocaine or methamphetamine was adversely, negatively associated with gestational age, birth weight, length, and occipitofrontal circumference. The increased rate of prematurity, intrauterine growth retardation, and perinatal complications associated with perinatal exposure to cocaine or methamphetamine was greater than that predicted by coexisting risk factors and was consistent with the pharmacologic properties of these drugs. PMID- 3655990 TI - Cardiovascular effects of patent ductus arteriosus in preterm lambs with respiratory distress. AB - We created a model for studying the cardiovascular and pulmonary effects of patent ductus arteriosus (PDA) in premature lambs with respiratory distress. In 47 fetal lambs at 129 to 133 days gestation (term, 145 days), we infiltrated the ductus arteriosus with formalin and placed a mechanical occluder about it so that its patency could be regulated. Two days later the lambs were delivered, given sheep surfactant, paralyzed, and their lungs mechanically ventilated. These premature lambs could more than double their left ventricular output when challenged with increasing degrees of left-to-right shunts through the PDA. This was accomplished by an increase in stroke volume, not by an increase in heart rate. During the 40-minute observation period, there was no change in dynamic compliance or functional residual capacity while the ductus was patent. When the ductus was patent, there was a significant increase in arterial PaO2 (even with small left-to-right shunts) and a decrease in PaCO2 (with large shunts). Despite the heart's ability to handle the increased volume load of a PDA, there were significant alterations in individual organ blood flows, resulting from a combination of decreased perfusion pressure and localized vasoconstriction. The abdominal organs had significant reductions in blood flow even with small PDA shunts. This decrease in organ blood flow may explain some of the pathophysiologic manifestations of PDA in preterm infants. PMID- 3655992 TI - Car seats and gastroesophageal reflux. PMID- 3655991 TI - Effect of theophylline on insulin-like growth factor I in children with asthma. PMID- 3655993 TI - Bioavailability of iron in cereals. PMID- 3655994 TI - Use of corticosteroids for acute asthma. PMID- 3655995 TI - Prognosis in IgA nephropathy. PMID- 3655996 TI - Familial lymphoid interstitial pneumonitis. PMID- 3655997 TI - Electron microscopical studies of Strongyloides ratti infective larvae: loss of the surface coat during skin penetration. AB - Previous indications using radiolabelled larvae that Strongyloides ratti free living infective larvae lose a surface coat during penetration of the skin were further investigated by transmission electron microscopy of the cuticle of S. ratti infective larvae in the free-living stage, after penetration of mouse skin, and after migration to the lungs. These studies demonstrated the presence of a faint electron-dense surface coat external to the epicuticle on free-living worms which was absent from larvae recovered from the skin and lungs. When free-living infective larvae were incubated in 10% CO2 at 37 C and then examined with phase contrast microscopy, worms were observed in the process of losing this coat. These observations confirm the hypothesis that S. ratti infective larvae lose a surface coat during penetration of the skin. PMID- 3655998 TI - An ultrastructural study of Dirofilaria immitis infection in the Malpighian tubules of Anopheles quadrimaculatus. AB - An ultrastructural study was conducted of the Malpighian tubules of Anopheles quadrimaculatus, both uninfected and following infection with Dirofilaria immitis. The Malpighian tubules in Anopheles are composed of primary and stellate cells. The primary cells are the predominant cell type and are characterized by the presence of membrane-bound, intracellular, mineralized concretions and large apical microvilli containing mitochondria. Following the infective blood meal, the microfilariae enter the primary cells of the Malpighian tubules and reside in the cytoplasm in a clear zone without a delimiting membrane. Cells in infected tubules differ from those in uninfected tubules in that the membranes of the vacuoles surrounding the concretions are disrupted in many specimens. The apical and basal cell membranes and the mitochondria associated with these are not disrupted during the first 6-8 days of infection. These observations differ sharply from those previously described in Aedes taeniorhynchus infected with D. immitis. The observations are consistent with the hypothesis that the extended transport capacity observed in previous physiological studies of An. quadrimaculatus infected with D. immitis are dependent on the prolonged normal ultrastructure of the apical microvilli, mitochondria, and basal membranes. PMID- 3655999 TI - In defense of frozen carcasses. PMID- 3656000 TI - Infectivity of Echinostoma revolutum miracidia for laboratory-raised pulmonate snails. PMID- 3656001 TI - Procoagulant activity of Babesia bovis-infected erythrocytes. PMID- 3656002 TI - Lethal synergism between benzimidazoles and Bacillus thuringiensis israelensis toxin for Trichostrongylus colubriformis eggs. PMID- 3656003 TI - Efficacy of bovine transfer factor to protect neonatal calves against experimentally induced clinical cryptosporidiosis. PMID- 3656005 TI - Development of Hammondia heydorni in the chorioallantoic membrane of chicken embryos. PMID- 3656004 TI - An evaluation of Locusta migratoria as a model for the study of pathophysiology of Hymenolepis diminuta metacestodes in insects. PMID- 3656006 TI - First reported case of human aural myiasis caused by the flesh fly Parasarcophaga crassipalpis (Diptera: Sarcophagidae). PMID- 3656008 TI - Discovery of Atoxoplasma in Hawaii. PMID- 3656007 TI - Trichinella spiralis: host immunity against newborn larvae during a primary infection in rats. PMID- 3656009 TI - The suprapopulation dynamics of Bothriocephalus acheilognathi in a North Carolina reservoir: abundance, dispersion, and prevalence. AB - A 2 1/2-year study (September 1980-March 1983) of abundance, dispersion, and prevalence of the pseudophyllidean cestode, Bothriocephalus acheilognathi, in 3 species of fish (Gambusia affinis, Notropis lutrensis, and Pimephales promelas) was conducted in 3 ecologically distinct areas of a North Carolina cooling pond. Mean infrapopulation density and prevalence differed by site, season, and species and size of hosts. Degree of aggregation and abundance and prevalence of gravid worms differed by species of host. Abundance of gravid worms was significantly lower in metapopulations from localities that received power plant effluents. The differences in infrapopulation density, prevalence, and aggregation appeared to be related to predator-prey interactions, which varied with season and local community structure. Differences in abundance of gravid worms, on the other hand, were probably caused by differential suitability of hosts and by local variation in selenium concentration in the water column. Thus, it appears that both biotic and abiotic components of the host community determined the suprapopulation dynamics of B. acheilognathi in Belews Lake. PMID- 3656011 TI - Attempts to culture the parasitic stage of Dermatobia hominis (L. Jr.) in vitro (Diptera: Cuterebridae). AB - Dermatobia hominis larvae were cultured in a semidefined liquid medium. First instar larvae (L1) grew well up to 44 days; 29.1% molted in a mean period of 8.62 days. Two larvae reached the third instar but lived only 1 and 18 days, respectively, after the second molt. The increase in size, measured in 4 larvae, was about 10-fold. Second- and third-instar larvae, obtained from the skin of cattle, survived and grew in the medium for up to 2 mo; 39.0% of the L2 molted while 77.3% of the L3 pupated, and some produced flies when transferred to sand after 14.84 +/- 10.08 days in the culture medium. Some maturation factor, obtained from the skin, may be necessary for the larvae to grow satisfactorily and to complete the full parasitic cycle in vitro. PMID- 3656010 TI - The growth, biomass, and fecundity of Bothriocephalus acheilognathi in a North Carolina cooling reservoir. AB - An investigation of differences in growth, maturation, biomass, and fecundity of Bothriocephalus acheilognathi in 3 host species was conducted on metapopulations from 3 distinct communities in Belews Lake, North Carolina. The results indicated that host-specific differences in growth and biomass were additive among metapopulations from different localities. However, species-specific differences in maturation and fecundity exhibited differential variation between the sites. These site X host interactions were related to host-specific differences in bioaccumulation of selenium at sites that were exposed to effluent from a coal fired power plant. Significant (alpha = 0.001) statistical associations were observed between selenium concentration in tapeworm tissue and fecundity measures. The results of this study demonstrate that host suitability is determined by morphological, physiological, and behavioral differences in the host species which affect transmission dynamics and the quality and stability of the enteric environment. PMID- 3656012 TI - Propagation of the marine dinoflagellate Amyloodinium ocellatum under germ-free conditions. AB - Germ-free infections of Amyloodinium ocellatum were produced on both living fish and in organ cultures. Exposing gnotobiotic guppies (Poecilia reticulata) to 125 dinospores in multiwell tissue culture plates produced nonlethal infections that could be serially propagated. Exposure to 250 or more parasites killed the fish during the first infection cycle, but if the dead fish were incubated in a cell culture medium/seawater mixture, the parasites could survive and reproduce for up to 2 wk in these organ cultures. Organ cultures containing only seawater or those containing bacteria did not support the prolonged survival of Amyloodinium. PMID- 3656013 TI - A new record of parasitism in the fantail darter, Etheostoma flabellare rafinesque (Percidae: Etheostomatini). PMID- 3656015 TI - The endogenous development of virulent strains and attenuated precocious lines of Eimeria tenella and E. necatrix. AB - Studies were made of the endogenous development of the H strains of E. tenella and E. necatrix, and precocious lines derived from them. Second-generation meronts of both precocious lines matured at a faster rate than those of the parent strains. The first- and second-generation meronts of the precocious line of E. necatrix and the second-generation meronts of the precocious line of E. tenella were significantly smaller and contained fewer merozoites than the corresponding stages of the parent strains. These observations provide reasons for the precocity, and a partial explanation for the attenuation, of these lines. PMID- 3656014 TI - Chromosomes of Heterobilharzia americana (Digenea: Schistosomatidae), with ZWA sex determination, from Louisiana. AB - Mitotic chromosomes of Heterobilharzia americana from Louisiana are described from parasite material that was dissected from snails, air-dried on slides, and stained with conventional Giemsa and C-band methods. As in other schistosomes, the female is the heterogametic sex. This Louisiana strain, however, differs from a Texas strain and other schistosome species in that the male and female have different diploid numbers of chromosomes (male, 20; female, 19), and the strain has a ZZ male/ZWA female sex-determining mechanism. The chromosomes of the male resemble those of the Texas strain in number and morphology with the Z chromosomes being metacentric and the largest elements in the karyotype. The others form a series decreasing in size to very small number 10's. Chromosomes 2,3, and 4 are subtelocentric; 5 is subtelocentric to acrocentric and is satellited; 6 is submetacentric to subtelocentric; 7 is submetacentric; 8 is subtelocentric to submetacentric; 9 is metacentric to submetacentric; and 10 is metacentric. The female complement differs from the male of this strain in having only 1 normal chromosome 5. The other number 5 and most of the original W apparently have fused tandemly to form the WA chromosome (a "neo-W"). PMID- 3656016 TI - Effects of cholinergic drugs on muscle contraction in Moniliformis moniliformis (Acanthocephala). AB - In whole Moniliformis moniliformis spontaneous muscle contractions were rhythmic; longitudinal contractions were measured with a force transducer. The cholinergic agonists levamisole and nicotine significantly increased muscle tension in whole worms; these contractions were tonic and were antagonised by the ganglionic blocker pentolinium and by piperazine. In addition, levamisole-induced contractions were inhibited by gallamine, hexamethonium, and norepinephrine. In worm segments, where drugs in solution were injected through the worms, acetylcholine (ACh) and nicotinic agonists were effective in causing contractions, whereas muscarinic agonists in concentrations up to 1 mM had no effect. Although muscle contraction in M. moniliformis was induced by nicotinic agonists, these contractions were effectively antagonised by a range of chemicals that block ganglionic, skeletal, and muscarinic sites in vertebrates. The presence of ACh in M. moniliformis and the effects of nicotinic agonists on muscle contraction suggest that ACh is a putative excitatory neurotransmitter. PMID- 3656017 TI - Anorectal incontinence: diagnosis and treatment. AB - In correcting anorectal incontinence, the analysis of all known factors responsible for a lack of function is mandatory. Besides anamnestic and clinical data, manometric investigation is especially helpful. Continence may be improved by conservative measures (biofeedback training, muscle training, and drugs). The indication for surgical procedures depends on clinical and manometric findings: missed portions of the sphincteric muscle complex are reintegrated with a repull through procedure. In some cases, Kottmeier's levatorplasty or a modification of it has led to some improvement of continence. Whenever a call to stool was present, gracilis transposition has markedly improved anorectal function in 22 of 27 operated patients. Free transplantation of palmaris longus muscle has not proven to be of functional advantage. Doubling the circular colonic musculature and an S-shaped anoplasty at the time of the primary pull-through procedure may lead to continence in the future. PMID- 3656018 TI - Papers presented at the 18th annual meeting of the Canadian Association of Paediatric Surgeons. Halifax, Nova Scotia, August 28-30, 1986. Part 1. PMID- 3656019 TI - Central venous catheters for children with malignant disease: surgical issues. AB - The use of long-term central venous catheters has eliminated the fear and pain of repeated venopunctures for children with malignant disease, but problems still exist for the surgeon. Issues include choice of catheter, site and technique of placement, prevention of infection and accidental displacement, and removal. Five years' experience with 102 catheter placements in 81 children with leukemia or malignant tumors has been reviewed. These catheters remained in place an average of 318 days (32,481 patient days), maintained at home under close nursing supervision. Six months after the last entry in this series, 14 catheters are functioning and 35 patients have died with catheters intact. Fifty-three catheters have been removed because of completion of treatment (29), infection (10), dislodgement (11), and other reasons (3). In these immunocompromised patients, infectious episodes were common (186 episodes) but only ten episodes required removal of the catheter for control (1/3,248 days of use). Central venous catheters are of great help in treatment of children with malignant disease, and with careful attention to detail complications can be minimized. The advantages of central venous catheters are so great that almost all parents now agree to their use from the time the diagnosis is made, despite the possible problems with maintenance, dislodgement, and infection. PMID- 3656020 TI - Familial coarctation of the aortic arch with bilateral ptosis: a new syndrome? AB - A Newfoundland family with the apparently unique syndrome of complex coarctation of the aortic arch, bilateral stenoses of the subclavian arteries, bilateral ptosis, sensorineural deafness, and bronchial asthma is reported. This syndrome appears to have affected at least four generations, and has the characteristics of autosomal dominant inheritance. PMID- 3656021 TI - Is hemisplenectomy a satisfactory option to total splenectomy in abdominal staging of Hodgkin's disease? AB - The spleens removed in 76 consecutive staging laparotomies for Hodgkin's disease were studied. The spleens were divided from superior to inferior pole into anterior and posterior halves and each half further divided into superior, mid, and inferior sectors. Sectors were studied grossly and microscopically and involvement by Hodgkin's recorded. Of the 23 positive spleens, all sectors were positive in 12, 5 sectors positive in 1, 4 sectors in 3, 3 sectors in 3, 2 sectors in 1, and 1 sector in 2. In one spleen, four sectors were involved but were not marked properly to allow identification of which four, and one spleen with fairly diffuse disease was not handled according to protocol, remaining an "indeterminate" positive. From the anatomic distribution, a lower pole hemisplenectomy would have removed disease in 22 of 23 spleens and likely would have shown disease in the diffusely involved "indeterminate" spleen. An upper pole hemisplenectomy would have missed disease in one spleen and possibly in the "indeterminate" spleen. Either approach would have missed disease in around 1% of the 76 cases. The addition of a biopsy of the opposite pole that remains is technically feasible and would reduce this small incidence of undetected abdominal disease. With the increasing appreciation of the importance of the immunologic functions of the spleen, alternative techniques for determining splenic involvement have been proposed. From this study, hemisplenectomy appears to be an attractive alternate that preserves the vital functions of the spleen with a minute risk of overlooking the presence of Hodgkin's disease. PMID- 3656022 TI - Management of thyroid nodules in children: a 20-year experience. AB - The medical records and surgical slides of 58 patients with the diagnosis of thyroid nodules (solitary nodule in 50 patients) are reviewed. The most common cause of thyroid nodules in this series is follicular adenoma (27 patients or 46%). A nuclear scan (technetium or radioactive iodine) was performed in 55 patients, of which 40 showed a cold nodule. Twelve of the 40 cold nodules were malignant (30%). However, for solitary nodules the incidence of cancer is 27%. This last figure is significantly greater than the one recently reported by Hung et al (18.5%). Available diagnostic methods are reviewed and the clinical management as derived from our experience is presented. PMID- 3656023 TI - Anterior cricoid split for subglottic stenosis. AB - Subglottic stenosis is a common problem that often results from ventilatory support necessary in the premature infant. Previous methods of treatment include tracheostomy with dilatation of the stenosis, steroid injections, and procedures to stent the trachea. Results of these methods have been unsatisfactory because of the multiple procedures needed to obtain an adequate airway as well as the high mortality from long-term tracheostomy in infants. In the past 2 years, seven infants have undergone an anterior cricoid split for tight subglottic stenosis and airway obstruction. Of the seven patients, six were premature, five of whom required ventilatory support ranging from 4 to 30+ days. Each child presented in respiratory distress with symptoms present in five children from 1 to 11 months (mean 3.8) after birth. Bronchoscopy identified the site of obstruction in each case as subglottic, with a narrow lumen, usually less than 2.5 mm in diameter. Anterior cricoid split was performed at ages ranging from 2 to 11 months (mean 5.0). All children were extubated at 10 to 14 days and subsequently discharged home asymptomatic; none required postoperative tracheostomy. Complications developed in five children, including atelectasis, otitis media, phlebitis, and tracheocutaneous fistula in two, one of whom required operative closure. One child was rebronchoscoped at 3 weeks postoperatively for bronchospasm, which resolved on aminophylline. The subglottic trachea was normal. At follow-up ranging from 2 to 21 months (mean 8.3), no child has symptoms referrable to the subglottic region. In one patient, a brief period of respiratory distress recurred 3 months postoperatively due to tracheomalacia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656024 TI - The emerging pattern of pediatric day-care surgery. AB - The utilization of short stay surgical facilities is increasing and indications for day-care surgery for children are becoming more diverse. These trends were observed in a review of day-care surgery performed at British Columbia Children's Hospital during the years 1982 to 1986. During 1984 and 1985, 688 hernia repairs were undertaken, as were 76 anorectal procedures such as anal fistulotomy, drainage of abscesses, etc. In addition, 127 orchidopexies were performed, which indicated a 40% increase when compared with earlier years. Further procedures included the excision of 38 branchial cleft anomalies and 17 salivary gland lesions, as well as the performance of 95 tracheobronchial endoscopies including the removal of 25 foreign bodies. Head and neck and endoscopic procedures now represent 21% of all general surgery day care cases, and have increased by 50% since 1982. Thirty-six children (1.6%) initially brought in for day care surgery required actual admission to the hospital for such reasons as (1) the procedure being more complex than initially anticipated (15 patients); (2) hemorrhage (5 patients); or (3) postanesthetic concern (11 patients). Two thirds of the anesthetic complications were in infants less than 3 months of age. A special subgroup of high-risk infants were identified--the previous premature less than 52 weeks conceptual age. In our opinion, infants who are less than 3 months of age, especially if born prematurely, should be admitted to the hospital for surgery. PMID- 3656025 TI - The pediatric general surgery undergraduate medical curriculum: what should medical students learn? AB - Pediatric general surgery should be included in the undergraduate medical curriculum for reasons of improving the total surgical care of infants and children, to enable teachers to serve as role models to students considering a career in pediatric surgery and to ensure survival of pediatric surgery in the medical school curriculum. A survey of recent medical literature and surgical textbooks revealed little or no discussion concerning the aims, objectives, content, and design of the pediatric surgical curriculum. A survey of 15 Canadian medical schools showed that students are assigned very little didactic time for pediatric surgery (average total seven hours) and only 25% of graduates proceed to a clerkship in pediatric surgery, usually as an elective. The Association hereby proposes an undergraduate medical education curriculum in pediatric surgery for Canadian medical schools in order to stimulate discussion and achieve uniform input of pediatric surgery in the undergraduate medical program. PMID- 3656026 TI - Pulmonary sequestration. AB - A review of 41 patients over a 15-year period with a diagnosis of pulmonary sequestration was undertaken. The most common presenting complaint was repeated infections of the sequestrated segment. Two of our patients were symptomatic since the neonatal period. On an average, each patient was admitted three times to the hospital before undergoing surgery. All our patients had abnormal chest x rays. Two patients had severe purulent infection needing emergency resection of the sequestrated lobe. In our experience, almost all cases of pulmonary sequestration require surgery in the long-term. PMID- 3656027 TI - Focal ectasia of the terminal bowel accompanying low anal deformities. AB - Three patients were treated at birth for low anal deformities and developed intractable constipation, not imputable to usual causes of rectal inertia. Barium enema, done the first time at ten days of age in one case, revealed focal ectasia of the terminal bowel, with a peculiar "balloon-like" aspect of the rectum. Optimal treatment includes resection of the terminal bowel down to the dentate line. Incidence of this anomaly in association with low anal deformities has been 5% in our series. PMID- 3656028 TI - Reoperation by anterior perineal approach for missed puborectalis. AB - Poor postoperative continence in patients operated for high imperforate anus may result from an inadequate bowel pull-through behind the puborectal muscle. Between 1979 and 1983, we used the anterior perineal approach for reoperations in five such cases (3 males, 2 females). In all of them, preoperative continence was socially unacceptable. Each time it was possible to identify a partially or totally missed puborectal muscle. Although some complications occurred postoperatively, all patients acquired a socially acceptable level of continence with a mean follow-up of 4.5 years. Preoperative and postoperative rectal manometries are presented. The anterior perineal approach not only provides adequate exposure of the urethra and puborectal muscle, but also has the advantage of operating through an area that has not been previously dissected. PMID- 3656029 TI - A ten-year experience with the pediatric Kock pouch. AB - In 1981, a five-year experience with the pediatric Kock pouch was reported. This series has now increased to 20 patients with an overall experience of 10 years. There were 12 females and eight males ranging in age from 13 to 19 years. These pouches were all elective: 18 were converted from standard ileostomies, (six with proctectomy or Hartmann procedure), and two had a total proctocolectomy. Three of these conversions were for failed Swenson, Soave, and Duhamel procedures. Sixteen children had ulcerative colitis, three Hirschsprung's disease (one with colon atresia and imperforate anus with rectovaginal fistula), and one colonic polyposis (Gardner's syndrome). None had Crohn's disease. The 100% follow-up shows that 19 of the 20 teenagers have been followed for more than 1 year. The most important conclusions from this 10-year review of 20 teenage Kock pouch patients are (1) this continues to be a difficult operation with a significant potential for complications. (2) After 15 months, there is a very small incidence of nipple valve and outflow tract problems, but the possibility of pouchitis remains between 15 months and 5 years. (3) After 5 years, the chances of any kind of a problem with the Kock pouch are minimal. These children are all well, continent, happy, and back to a virtually normal life that includes marriage and pregnancy. The pediatric Kock pouch continues to be a reasonable alternative for the appropriate teenager, when a standard ileostomy is not desired and/or a pelvic pouch is impossible. It must be done by a surgeon with the necessary interest and experience. Long-term follow-up is essential. PMID- 3656030 TI - Experiences with the use of the Port-a-Cath in children. AB - Over a period of 18 months, we have inserted 20 Port-a-Caths in 19 children between the ages of 8 1/2 months and 18 years. The smallest child weighed 7 k. Three others weighed less than 12 k. The indication in all cases except two was the administration of cancer chemotherapy. The devices have been in use for periods ranging from 2 to 70 weeks (total of 517 patient weeks, average 27 weeks). Four patients had the device removed electively at termination of chemotherapy. Five patients died with the device in place and functioning well. Three patients required removal for complications. The eight others still have functioning catheters. The only significant "nuisance" problem is the occasional inability to withdraw blood. Patient tolerance and parent acceptance is good. In particular, we are impressed with the fact that ease of insertion and of use, as well as durability, do not seem to be limited by patient size or age, as long as a vessel large enough to accommodate the catheter can be found. PMID- 3656031 TI - Neonatal pharyngoesophageal perforation mimicking esophageal atresia: clues to diagnosis. AB - Perforation of the newborn child's esophagus or pharynx can mimic esophageal atresia clinically. Fourteen cases of newborn hypopharyngeal or esophageal perforation are presented. In nine cases, esophageal atresia was the initial diagnosis entertained; seven of these on the first day of life. In four others, the diagnosis of a perforated pharynx or esophagus was evident on plain x-ray. Six patients had esophagograms. Two newborns underwent thoracotomies for repair of their initially diagnosed esophageal atresia. Subsequently, esophageal perforation was diagnosed intraoperatively on each and suture repair was undertaken. The 12 remaining neonates were treated nonoperatively. There were four deaths, all in the nonoperative group and three weighing less than 1,000 g. None of the deaths were directly attributable to the perforations. In retrospect, each child presented with one or more early clues to the diagnosis of pharyngoesophageal perforation, which included a history of difficult tracheal or nasogastric intubation, blood in the nasogastric tube, length and course of nasogastric tube inserted, and subtle chest x-ray changes. In these cases, nonoperative treatment is usually successful. PMID- 3656032 TI - Esophageal function following Livaditis repair of long gap esophageal atresia. AB - Proximal pouch esophagomyotomy (Livaditis) allows for repair of long gap esophageal atresia (EA). Postoperative esophageal functional studies in these patients are lacking. Six such infants were followed for up to 42 months. Esophageal function was assessed clinically and by barium swallow, manometry, 24 hr pH monitoring, esophagoscopy, and biopsy. Operative complications included two minor anastomotic leaks and two asymptomatic diverticula at the myotomy site. All patients had dysmotility on barium swallow. Gastroesophageal reflux (GER) was seen in four. Manometry showed a variable aperistaltic segment in each infant but lower esophageal sphincter pressures and relaxation were retained. Twenty-four hour pH monitoring showed an increase in frequency and duration of GER. All four patients biopsied had esophagitis. Five of the six patients showed normal growth velocity. Livaditis modified repair of EA was not associated with significant surgical complications. Esophageal motility showed abnormalities similar to those reported after the standard repair of EA. Myotomy did not adversely affect the esophageal function. PMID- 3656034 TI - Congenital endodermal sinus tumor of the penis. AB - Congenitally occurring endodermal sinus tumors are very rare and frequently occur in association with teratomatous growths. The most common location for these tumors in infancy is the gonads. Tumors of the penis are rare in any age group. As far as we know, this tumor has never been reported in the penis. A 17-month old baby boy was noted to have a pimple-like lesion at the corona of the glans penis. This was stationary and ignored for a year. At this point, the lump began increasing in size. A further delay of 6 months elapsed before a definitive diagnosis was made. This case emphasizes that any nodule in this area in the neonate is ignored with jeopardy. PMID- 3656033 TI - Esophageal perforation in the neonate: an emerging problem in the newborn nursery. AB - We report 11 cases of esophageal perforation in the neonate, in whom no surgery was performed for repair of the perforation, nor was any cervical or mediastinal drainage carried out. The perforation was in the cervical esophagus in all cases where an esophagram was performed. Nine were in premature babies (580 to 1,350 g), and two were full-term babies. There were two deaths in small prematures (580 and 935 g), from extreme prematurity and intraventricular hemorrhage, with no morbidity or mortality related to the esophageal perforation. The babies presented as esophageal atresia, or pneumothorax with the feeding tube in the right chest, or an abnormal right upper extrapleural air collection with infiltrate. Barium esophagram showed a classic "double esophagus" configuration. Two babies were mistakenly operated on, one with a diagnosis of esophageal duplication, and one had a gastrostomy for a diagnosis of esophageal atresia. Esophageal perforation in the neonate is an iatrogenic disease that may mimic esophageal atresia, and may be managed without surgical intervention. PMID- 3656035 TI - Pediatric trauma. PMID- 3656036 TI - Staphylococcus epidermidis bacteremia and enterocolitis. PMID- 3656037 TI - Nurse practitioners: the new victims of the malpractice crisis. PMID- 3656038 TI - Gastroesophageal reflux: problem or nuisance? PMID- 3656039 TI - Evaluating communicative behaviors in infancy. PMID- 3656040 TI - Young adolescents' contraceptive knowledge and attitudes: implications for anticipatory guidance. PMID- 3656041 TI - Home apnea monitoring in the Intermountain West. PMID- 3656042 TI - Speech characteristics of children after otitis media. PMID- 3656043 TI - The McCarran-Ferguson Act and professional liability insurance. PMID- 3656044 TI - Nocturnal enuresis. PMID- 3656045 TI - A randomized study of two cups for vacuum extraction. AB - O'Neil designed a set of suction cups which, because of more efficient lateral pull and greater maneuverability, were claimed to be more efficient and perinatally safer than the Malmstrom model. These claims were checked by comparing the two instruments in a randomized controlled trial comprising 410 attempted elective extractions. The two instrument groups were comparable at entry and the operators had a similar degree of experience, the sole inter-group difference being the 0.5 cm larger diameter of the O'Neil cups. No significant differences were found between the two types of instrument as to failure rate, incidence of correct cup positioning, and capacity of eliciting internal rotation nor was there a significant divergence in neonatal safety. In a few cases the perineum was lacerated by the traction cord affixed to the O'Neil instrument. The results of this study indicate that the relative advantages and disadvantages of the two cup models are unremarkable. PMID- 3656046 TI - Heterogeneity of congenital primary hypothyroidism: the importance of thyroid scintigraphy. AB - Current newborn screening programs in California and most of the U.S. depend for diagnosis of congenital primary hypothyroidism on demonstrating an elevated thyrotropin (TSH) level in infants with the lowest 5% to 10% of thyroxine (T4) levels by filter-paper bloodspot test. The diagnosis of primary congenital hypothyroidism based on low T4 with high TSH fails to distinguish between transient hypothyroidism, ectopic or hypoplastic thyroid, athyrosis, dyshormonogenesis, and transient hyperthyrotropinemia. We screened 166,300 newborn infants for primary congenital hypothyroidism for 6.5 years and confirmed the diagnosis in 46 cases; none of these patients had a goiter. Thyroid scintigraphy was performed in 40 with technetium-99m (Tc-99m) in the first eight cases tested and iodine-123 (I-123) in 29 of the last 32 cases. Fifteen infants were athyroid and seven had ectopic or hypoplastic glands; in 18 the thyroid gland appeared normal (present, normal location). Congenital hypothyroidism represents a spectrum of diseases from transient underactivity to complete absence of the thyroid gland. We recommend that, before starting treatment, a specific anatomic and functional diagnosis be confirmed by thyroid scintigraphy and other thyroid function tests. PMID- 3656047 TI - Low Apgar score as a risk factor for respiratory disturbances in the newborn infant. AB - The value of the Apgar score as a risk factor for all neonatal respiratory disturbances (RD) was evaluated in a prospective study of an unselected population. All liveborn infants (n = 4656) of mothers living in Gothenburg were screened over one year for signs of respiratory disease. This unselected population could be obtained since virtually all infants in Gothenburg are born in two maternity hospitals, with similar treatment principles, the same equipment standard and neonatal care. A low one minute Apgar score (less than 7) was found to be a powerful risk factor for RD in full term newborns and infants of 33-36 weeks gestation provided that the delivery had been vaginal. In these infants a low Apgar score at five minutes further increased the risk of RD. In immature infants less than 32 weeks and after cesarean section in all gestational ages a low Apgar score did not mean any additional risk of RD. The respiratory component in the Apgar score was not more predictive of RD than any of the others. In most infants with RD, irrespective of Apgar score, there was a few hours interval free from respiratory signs after birth. It has been well shown in other studies that Apgar score is not a reliable index of intrauterine or birth asphyxia. Nevertheless the one-minute score is a powerful predictor of neonatal respiratory difficulties. One explanation might be that Apgar score is correlated with sympathoadrenal activity at birth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656048 TI - Preconceptional diabetes control in insulin-dependent diabetes mellitus patients with continuous subcutaneous insulin infusion therapy. AB - Preconceptional diabetes management is an important prerequisite for pregnancy planning and its value has been well-documented. Glucose control and the outcome of pregnancy, managed in the preconceptional period, with continuous subcutaneous insulin infusion therapy to those receiving insulin injections are compared. Fifty-two juvenile onset insulin dependent diabetic women contemplating pregnancy were regularly consulted by a diabetology team starting at least two months before conception. Glucose control was achieved by continuous subcutaneous insulin infusion pumps (CSIIP) in 18 patients, and 34 women received intensive insulin therapy (IIT). In both groups, normal glucose levels and normal HbA1 were achieved at conception, maintained during the period of organogenesis and throughout pregnancy. In view of the fact that perinatal results, such as the occurrence of malformations, mean gestational age, mean birth weight and neonatal complications were not significantly different in both groups, we believe that both methods are equally effective. Consequently, the less costly and yet effective IIT may be the method of choice, while the more expensive pump should be used mainly in selected cases. PMID- 3656049 TI - The effect of placenta previa localization upon maternal and fetal-neonatal outcome. AB - The present study evaluated the association between maternal and fetal-neonatal outcome in women with placenta previa (PP) and the site of PP, i.e. low lying, marginal, partial or total. The study group was composed of 154 women (159 newborns) and the control group of 300 woman (305 newborns). Of the various parameters examined, the following 3 were associated with PP localization: advanced maternal age was associated with major types of PP, while focal accretion of the placenta and neonatal mortality in cases of vaginal delivery were associated with minor types of PP. No connection was found between antepartum, intrapartum or postpartum blood loss and any specific type of PP. A review of the literature and the results of the present study revealed that the use of the modern aggressive (conservative-active) management protocol in women with PP has resulted in a significant reduction in the maternal and perinatal complication rates, as well as a relative decrease in the importance of major types of PP and a relative increase of that of the minor types. PMID- 3656050 TI - Neonatal manifestations of maternal phencyclidine exposure. AB - The purpose of this study was to determine the effects of maternal phencyclidine use on the fetus. Ninety-four neonates with maternal phencyclidine exposure were compared with 94 controls. Maternal phencyclidine use was assessed by questionnaire and repeated urine testing. Mothers of study and control patients were matched for demographic characteristics. Infants were assessed between 24-72 hours postnatally by a single examiner blind to the maternal history. The results showed that study infants had a mean of 5.02 +/- 2.93 abnormalities while controls had a mean of 4.13 +/- 2.65 abnormalities (p less than 0.01). Furthermore, study infants were more likely than controls to have poor attention, hypertonia, and depressed neonatal reflexes (p less than 0.05). The contribution of seven drug classes to the total number of abnormalities was assessed using stepwise multiple regression. Only phencyclidine accounted for a significant proportion of the variance (f = 4.38; p less than 0.05). The results of this study suggest that maternal phencyclidine use may lead to abnormal neonatal neurologic findings and behavior. PMID- 3656051 TI - Morphometric investigations of terminal villi of diabetic placentas in relation to the White classification of diabetes mellitus. AB - In this morphometric study, terminal villi of 22 placentas of maternal diabetes mellitus were compared with the results in terminal villi of 22 normal placentas. The results demonstrate that there is a distinct retardation in maturation, statistically significant with bigger cross sectional surfaces of the terminal villi, particularly, when classified in 3000 mu2-steps, the number of the villous vessels and number of epithelial plates. Only slightly decreased in diabetic placentas is the villous vessels cross sectional surface as well as the degree of vascularization. The correlation between the degree of histometric changes and the severity and duration of the disease was separately investigated (classification was done according to White). It could be shown, that the degree of morphologic changes in the terminal villi does not run strictly parallel to the severity and duration of diabetes. The retardation in maturation of the terminal villi increases from White group A to C. In White group D, which is the most severe stage of diabetes mellitus which we investigated, the values of measured parameters are close to the normal placentas. This observation is interpreted as a compensatory reaction of the fetal organ placenta to the reduction in utero placental blood flow in diabetes caused by the diabetic angiopathy. PMID- 3656052 TI - Neuron specific enolase in amniotic fluid--a possible indicator for fetal distress and brain implication. AB - It can be suggested that a NSE concentration in body fluids above the normal range may indicate brain damage, because NSE is found in neurons and neuroendocrine cells only. In this paper the concentration of the neuron specific enolase (NSE) in the amniotic fluid of normal and high risk pregnancies was investigated. Sixty-three samples of amniotic fluid were collected from 55 pregnant women and women in labor between the 19th and the 42nd gestational week. In 24 normal pregnancies 1.02 +/- 0.31 microgram NSE/L (mean +/- SD) were found. A relationship of NSE concentration was not found for gestational age, uterine contractions, age and parity of the mother, infant's birth weight or 1 min Apgar score. Maternal diseases such as diabetes mellitus, hypertension and others do not result in any increase of NSE concentration in the amniotic fluid (N = 20; 1.06 +/- 0.24 microgram NSE/L). Fetal and birth related high risk factors such as meconium stained amniotic fluid, cord around the neck, severe decelerations of the fetal heart rate or combinations of these factors caused the NSE concentration to exceed significantly normal values (N = 17; 2.22 +/- 0.87 microgram NSE/L). Due to its high organ and cell specificity, NSE may be a possible parameter for brain damage due to hypoxia in the fetus and newborn; however, only subsequent neurological and psychological examinations of these children can indicate the prognostic value of an elevation of NSE concentration in amniotic fluid. PMID- 3656053 TI - Seat belts: a potential hazard to the fetus. AB - The widespread introduction of seat belts for front seat passengers has undoubtedly reduced injury and death during impact but the effects on the fetus of belt restraint has been little reported. We report here a fetus whose mother was involved in a low speed head-on collision and who rapidly developed abdominal tenderness. The fetus was bradycardic and emergency cesarean section delivered an infant who was shocked due to placental abruption and who required immediate resuscitation. The baby subsequently developed renal failure and convulsions but on follow-up is entirely normal. We draw attention to the fact that maternal seat belt trauma may cause placental abruption with severe fetal compromise. Careful assessment of fetal cardiotocography should be performed in all pregnancies where a deceleration collision in the presence of a maternal seat belt restraint makes fetal injury a possibility. PMID- 3656054 TI - The rorschach assessment of borderline defenses: a concurrent validity study. AB - This study assesses the concurrent validity of two Rorschach defense scales designed to identify borderline defensive structure. A Rorschach scale designed by Cooper and his colleagues was systematically compared to a defense scale constructed by Lerner and Lerner. Despite considerable overlap on a conceptual and operational level, the scales are based on divergent theoretical models (developmental arrest and fixation) and Rorschach units of analysis (all responses and human responses). Our results are based on the capacity of each scale to discriminate between independently diagnosed samples (neurotic, outpatient borderline, inpatient borderline, schizophrenic) and the relative discriminatory power of particular defenses within each scale to differentiate between groups. PMID- 3656055 TI - Gender differences in the relationship between hostility and the type A behavior pattern. AB - A group of 97 male and 111 female undergraduates completed the Jenkins Activity Survey, the Framingham Type A Scale, the Adjective Checklist Type A Scale, the Spielberger State-Trait Anxiety Inventory, and the Buss-Durkee Hostility Inventory. A factor analysis revealed three dimensions: Anger-Emotionality, Anger Aggression, and Residual Pattern A. All Type A measures loaded highly on the Type A factor, with the Jenkins Activity Survey loading the highest. The Framingham Type A Scale was related to Anger-Emotionality, the Adjective Checklist Type A Scale was related to Anger-Aggression, and the Jenkins Activity Survey was related to neither of the anger dimensions. Women scored higher than men on Anger Emotionality and the Guilt, Resentment, and Irritability subscales and lower than men on the Assaultiveness subscale. Women showed higher correlations between Type A and the Guilt subscale, and men between Type A and the Suspiciousness subscale. We conclude that Type A is a multidimensional construct that manifests itself differently in men and women. PMID- 3656056 TI - Refining personality assessments by combining MCMI high-point profiles and MMPI codes, Part V: MMPI code 78/87. AB - The present investigation shows that the addition of Millon Clinical Multiaxial Inventory (MCMI) high-point code data to the Minnesota Multiphasic Personality Inventory (MMPI) 78/87 code type may be used to clarify contradictory MMPI descriptors and produces three distinct clusters. These MMPI/MCMI clusters were designated as an interpersonally acting-in group, an emotionally acting-out group, and an emotionally acting-in group. In addition to the identification and elaboration of these three subgroups, we outline several clinical uses of this objective test battery approach. The results of this study support the efficacy of combining two objective assessment inventories for the purpose of multiaxial diagnosis as prescribed by the DSM-III. PMID- 3656057 TI - Comparison of the MCMI and MMPI-168 as psychiatric inpatient screening inventories. AB - The Millon Clinical Multiaxial Inventory (MCMI) has been recently developed as an alternative to the Minnesota Multiphasic Personality Inventory (MMPI) and shares some of its psychometric advantages and disadvantages with the MMPI-168, a short form of the MMPI. The current study compared the structure and utility of the MCMI and MMPI-168 for a general hospital inpatient psychiatric population. Overall, the two instruments were highly correlated and found to have conceptually similar factor structures. Empirical comparison of the factor structures indicated that construct validity is greatest for neurotic traits. Both instruments demonstrated a similar utility in predicting discharge diagnosis. PMID- 3656058 TI - Validation studies of a multifactor cognitive-behavioral Anger Control Inventory. AB - Two studies are reported on a new Anger Control Inventory based on a cognitive behavioral person-situation interaction model. In Study 1, the inventory responses of 118 clinical subjects and 190 normal subjects were correlated with an anger problem criterion based on observable signs. Factor analyses were conducted to clarify the construct base of the inventory. In Study 2, comparisons were made between the inventory responses of 100 spouse batterers and 96 normal subjects. Significant differences between the pretreatment and posttreatment scores of 65 batterers given treatment in anger control were obtained on the inventory scales, which were found to be correlated with the problem criterion and discriminating between the clinical and normal groups. The construct validity and clinical utility of the Anger Control Inventory are discussed. PMID- 3656060 TI - [Documentation on drugs: sources of information; the pharmacist's library]. PMID- 3656059 TI - Death anxiety in cancer survival: a preliminary cross-validation study. AB - In an attempt to cross-validate the results with cancer survivors and to test its sensitivity to illness-related variables, the Death Anxiety Questionnaire (DAQ) was administered with measures of general anxiety, depression, somatization, and global psychological distress to 90 young adult men (60 Hodgkin's disease survivors, 30 testicular cancer survivors). There were no differences between groups on any of the dependent measures. Significant but weak to moderate intercorrelations confirmed that death anxiety is separate but related to general anxiety, depression, somatic distress, and global psychological distress. The DAQ was the most highly correlated with time elapsed since diagnosis, but no measure was significantly associated with extent of the disease at diagnosis (i.e., prognosis). Factor analysis of the DAQ provided confirmation of its multidimensionality and lent partial support to the presence of previously reported specific dimensions. The factor structure of the DAQ in cancer survivors may be different from that in the general population. Further study is needed to examine this aspect. PMID- 3656061 TI - Proceedings of the 18th Symposium on Drug Metabolism and Action. Toyama. PMID- 3656062 TI - The intestinal dialysis of intravenously administered phenytoin by oral activated charcoal in rats. AB - The effect of oral administration of activated charcoal on total body clearance of phenytoin following intravenous administration was studied in rats. In situ single-pass perfusion study showed that phenytoin was exsorbed into the small intestinal lumen. The exsorption of the drug from blood into the intestinal lumen was increased in a dose-dependent manner. The exsorption rate of the drug at the dose of 10 mg/kg was 1.1% in 120 min, while that at 50 mg/kg was 2.5% in 120 min. The excretion of the conjugate of 5-(p-hydroxyphenyl)-5-phenylhydantoin (p-HPPH) into the bile was greater than phenytoin and unconjugated p-HPPH and the total percentage of excretion of p-HPPH was significantly decreased by increasing the dose. Oral activated charcoal had little effect on the serum phenytoin levels after the 10 mg/kg dose. On the other hand, charcoal reduced the serum phenytoin levels after the 50 mg/kg dose as compared with the corresponding controls. Oral administration of activated charcoal decreased the serum half-life to 77% and the area under the serum concentration-time curve to 75% after the 50 mg/kg dose of phenytoin. The apparent volume of distribution was not significantly different between rats with activated charcoal treatment and rats without charcoal treatment. Based on these results, a mechanism of the enhanced clearance of phenytoin at a high dose (50 mg/kg) may be due to the adsorption of the drug and its metabolites transported into the gastrointestinal tract by the charcoal. PMID- 3656063 TI - Age-dependent changes in phenytoin tissue distribution in rats. AB - Age-dependent changes of phenytoin disposition in rats were studied following intravenous administration of 5,5-[4-14C]-diphenylhydantoin to 1-d, 1-, 3- and 8 week-old rats. The distribution volumes changed similarly to those of warfarin in the growth process of rats. The lower clearances in infant and young rats were considered to be caused by the undeveloped liver function to metabolize phenytoin. The changes of distribution volumes in the growth process of rats were assumed to be based upon not only the changes in blood free fractions but also other factors. In any aged rats, the muscle largely contributed to the distribution of phenytoin in the body and the Kp values in the muscle decreased in the growth process of rats. This change of phenytoin transfer to the muscle affected the decrease of distribution volumes of phenytoin in 8-week-old rats and the distribution volumes of brain, lung and liver in infants and young rats were greater than those in adult rats. The Kp value in the lung in 8-week-old rats was smaller than the values in 1-d, 1- and 3-week-old rats and there was no significant difference in the Kp values in the liver among the 4 ages. These results were different from those in warfarin reported previously and suggested that warfarin and phenytoin bind different macromolecules in the liver and the lung. PMID- 3656064 TI - Biopharmaceutical characteristics of a suppository base containing poly (oxyethylene)-poly (oxypropylene) copolymer, Unilube. I. Effects of a suppository base containing Unilube 70DP-950B on release and rectal absorption of aminopyrine in rabbit. AB - The rectal absorption of aminopyrine (AP) from a three-component-system suppository base (TCS), which is a mixture of oleaginous base, water-soluble base and the poly-(oxyethylene) poly-(oxypropylene) block copolymer, Unilube, was investigated. Albino rabbits were used as the animal model. The bioavailability of oleaginous base and water-soluble base (polyethylene glycol 4000) were 44.3% and 82.6%, respectively. The time to reach maximum plasma concentration (Tmax) of the oleaginous and the water-soluble bases were 21.0 +/- 8.2 min and 33.0 +/- 16.4 min, respectively. When TCS was used, its Tmax was 30 min and increasing the amount of Unilube in the base from 5% (w/w) to 20% (w/w) decreased the bioavailability from 100.4% to 47.2%. The softening temperature of TCS was 55-57 degrees C. Collectively, TCS containing 5% of Unilube gave significantly higher bioavailability than the other bases without softening until 57 degrees C. Also, the results of the two different release tests were compared with the results of an animal experiment in this paper. PMID- 3656065 TI - Studies on drug absorption from oral cavity. II. Influence of the unstirred water layer on absorption from hamster cheek pouch in vitro and in vivo. AB - The influence of the unstirred water layer (UWL) adjacent to the membrane surface of the hamster cheek pouch on absorption was studied in vitro and in vivo. The tissue uptake rate of 14C-laurylalcohol was determined in vitro and the value of the effective resistance of UWL (RW) was calculated. RW values were reduced by increasing the stirring rate of the mucosal solution. In vitro permeation of 14C benzoic acid into the serosal compartment was also increased in the well-stirred condition. Thus, the existence of UWL as an effective diffusion barrier for drug absorption from the hamster cheek pouch was suggested. To clarify the influence of the existence of UWL on the absorption in vivo, the apparatus for luminal stirring was newly devised. When the luminal solution was well-stirred, the absorption of benzoic acid in the lower pH region significantly increased, resulting in the disappearance of the shift of pH-absorption curve for benzoic acid. Furthermore, the luminal stirring increased the absorption rate constant for salicylic acid. From these experimental results, it is suggested that UWL plays a part of barriers against drug permeation in the hamster cheek pouch. PMID- 3656066 TI - Food and nutrient intake of institutionalized and noninstitutionalized elderly in the Philippines. PMID- 3656067 TI - Peer support and nutrition education for older adults with diabetes. PMID- 3656068 TI - Developing a continuum of community nutrition services: Massachusetts elderly nutrition programs. PMID- 3656069 TI - Editor's choice. Where are the standards? PMID- 3656070 TI - Getting standards off the shelf and into practice. PMID- 3656071 TI - Testing child health standards in a clinical setting. PMID- 3656072 TI - Kawasaki disease: application of the Roy adaptation model to determine interventions. PMID- 3656073 TI - Assessing stress in children: research and clinical implications. PMID- 3656074 TI - Parents' waiting: is it an inevitable part of the hospital experience? PMID- 3656075 TI - The relationship between self-care behaviors and selected psychosocial variables in children with asthma. PMID- 3656076 TI - Succession planning in nursing administration. PMID- 3656077 TI - Wanting life. PMID- 3656078 TI - Teaching discharge management. PMID- 3656079 TI - Car safety and kids. PMID- 3656080 TI - Motivational influences on impression formation: outcome dependency, accuracy driven attention, and individuating processes. AB - How might being outcome dependent on another person influence the processes that one uses to form impressions of that person? We designed three experiments to investigate this question with respect to short-term, task-oriented outcome dependency. In all three experiments, subjects expected to interact with a young man formerly hospitalized as a schizophrenic, and they received information about the person's attributes in either written profiles or videotapes. In Experiment 1, short-term, task-oriented outcome dependency led subjects to use relatively individuating processes (i.e., to base their impressions of the patient on his particular attributes), even under conditions that typically lead subjects to use relatively category-based processes (i.e., to base their impressions on the patient's schizophrenic label). Moreover, in the conditions that elicited individuating processes, subjects spent more time attending to the patient's particular attribute information. Experiment 2 demonstrated that the attention effects in Experiment 1 were not merely a function of impression positivity and that outcome dependency did not influence the impression formation process when attribute information in addition to category-level information was unavailable. Finally, Experiment 3 manipulated not outcome dependency but the attentional goal of forming an accurate impression. We found that accuracy-driven attention to attribute information also led to individuating processes. The results of the three experiments indicate that there are important influences of outcome dependency on impression formation. These results are consistent with a model in which the tendency for short-term, task-oriented outcome dependency to facilitate individuating impression formation processes is mediated by an increase in accuracy-driven attention to attribute information. PMID- 3656081 TI - The role of attributions in the development of dating relationships. AB - In this study, we examine the role of attributions in the context of dating relationships. A large sample completed a questionnaire comprising structured ratings and a free-response relationship description. As expected, cognitive or attributional activity was more frequent within relationships when they were in the early stages, when important choice points or changes were occurring, and when the relationships were perceived as unstable. Also as predicted, subjects who reported higher relationship happiness, commitment, and love for their partners tended to describe the relationship in more interpersonal terms, to rate the causal inputs of the partners as equal, and to attribute lower external attributions for relationship maintenance. Finally, some evidence was obtained that attributions for relationship maintenance are causally related to relationship happiness over a 2-month period. The results are discussed in terms of the relationship between cognitive processing and the development of dating relationships. PMID- 3656082 TI - The impact of attributions in marriage: a longitudinal analysis. AB - In this study, we investigate the longitudinal relation between attributions for relationship events and marital satisfaction. Thirty-four couples were assessed at two points separated by approximately 12 months. Causal and responsibility attributions for marital difficulties and negative spouse behaviors were strongly related to concurrent marital satisfaction. For wives, later marital satisfaction was predicted by both causal and responsibility attributions after the effects of earlier satisfaction were removed. For husbands, attributions did not predict later marital satisfaction. Marital satisfaction did not predict later attributions for either husbands or wives. Marital satisfaction and the two types of attributions were related to concurrent unrealistic relationship expectations, but these expectations did not predict later marital satisfaction. The results are discussed in terms of a possible causal relation between attributions and marital satisfaction. PMID- 3656083 TI - Hardiness and health: a critique and alternative approach. AB - Recent research has suggested that individual differences in the personality variable of hardiness are related to health and illness. Despite some success at predicting health outcomes, there are several theoretical and empirical problems that must be addressed before research on this topic can proceed. Most critical are (a) how hardiness is to be measured; (b) whether hardiness should be treated as a unitary phenomenon or as three separate phenomena associated with commitment, control, and challenge; and (c) whether hardiness has direct effects on health or indirect effects by virtue of buffering the impact of stressful life events. After reviewing the literature and presenting our own study of the psychometric properties of the Hardiness Scale and its subcomponents, we draw the following conclusions: (a) Hardiness is not a unitary phenomenon, but should be treated as involving three separate phenomena; (b) of the three subcomponents of hardiness, only commitment and control have adequate psychometric properties and are systematically related to health outcomes; (c) lack of control and lack of commitment have direct effects on health because they are psychologically stressful; and (d) if there are buffering effects of commitment and control, they are in addition to these direct effects and are situation specific. Such a systematic consideration of the problems and prospects of the hardiness literature should facilitate research on this important topic. PMID- 3656084 TI - Two conceptions of maturity examined in the findings of a longitudinal study. AB - The third vector score (competence) of the revised California Psychological Inventory (CPI) and ego level as assessed by the Loevinger Sentence Completion Test (SCT) are measures of alternative ways of conceptualizing maturity: as the ability of the individual to function effectively in society or as the degree of intrapsychic differentiation and autonomy. A longitudinal study of women (for the CPI, N = 107; for the SCT, N = 90) provides these two measures of maturity at age 43. Competence and ego level were correlated with antecedent and concurrent measures selected from inventories and life history material concerning work, marriage, relations with parents, and so forth, to assess aspects of maturity adapted from Allport: self-extension in significant endeavors, reality orientation in perception of self and others and in the conduct of one's activities, capacity for intimacy, emotional security, and individuality of personal integration. Results from the age-21 data indicate that competence and ego level are enduring trait complexes. Despite considerable overlap, they differ conspicuously in the greater emphasis of competence on emotional security and of ego level on individuality of personal integration. Analysis of the patterning of competence and ego level in the whole sample and in homogeneous groups high on one or both measures suggests psychological reasons why the two types of maturity diverge and why the relation of ego level to adjustment seems to be curvilinear. PMID- 3656085 TI - Videotape reconstruction of emotions and cognitions related to shyness. AB - This study tested predictions of the self-presentational approach to situational and dispositional shyness within a broader perspective. Forty subjects who were high in self-rated dispositional shyness and 30 subjects who were low in self rated dispositional shyness watched videotapes of their interaction with a confederate of the experimenter in various situations, including apprehension of evaluation and positive feedback provided by the confederate. The subjects' free verbal responses to particular events during these situations were content analyzed. Compared with the group lower in shyness, the shy subjects (a) recalled more fear of social evaluation (including fear of positive evaluation) but did not more often report other kinds of fear, (b) had more negatively biased thoughts about the impression made on their partner but not more impression related thoughts in general, and (c) showed more negatively biased reactions to the positive feedback of their partner. These results support the self presentational view that fear of being socially evaluated is pivotal to dispositional shyness. However, some unexpected findings suggest that social evaluative situations also arouse fears of having to evaluate others; this would limit self-presentational explanations of situational shyness in these situations. PMID- 3656086 TI - Critical self-reflection and self-perceived altruism: when self-reward fails. AB - Social learning theory has produced a three-step model of prosocial development: In the young child, prosocial behavior is elicited by material rewards; in the older child, it is elicited also by social rewards; and in the morally mature adult, it is elicited by self-rewards based on an internalized perception of oneself as a kind, caring, altruistic individual. Self-perception theory has complicated this social learning model by demonstrating that once the third step is reached, the continued presence of material and social rewards may undermine intrinsic prosocial motivation based on self-rewards, producing moral regression. We propose a further complication. Critical self-reflection--the desire to know thyself, warts and all--may introduce a self-deprecating attributional bias that can undermine self-perceived altruism, even following helping for which one receives only intrinsic self-rewards. Two experiments are reported in which we manipulated critical self-reflection on one's reasons for helping. Results indicated that self-reflection undermined self-perceived altruism, especially when the salience of the self-rewards for helping was high. Experiment 2 also provided evidence that, as predicted, this self-reflection effect was most apparent for individuals who valued self-knowledge more highly than concern for others. Moral consequences of critical self-reflection are discussed. PMID- 3656087 TI - [Studies on antiallergy agent. II. Synthesis of 3-benzoylacrylic acids and the related compounds]. PMID- 3656088 TI - [Studies on the Chinese crude drug "forsythiae fructus". VIII. On isolation of phenylpropanoid glycosides from fruits of Forsythia koreana and their antibacterial activity]. PMID- 3656089 TI - [Studies on the constituents of Pinus densiflora Sieb. et Zucc. leaves. On the ethanol-extractable amino acids]. PMID- 3656090 TI - [Formation of lipid peroxides in adjuvant arthritis]. PMID- 3656091 TI - [Antiviral compounds. XVI. Antiviral activity of 1,2,4-triazines]. PMID- 3656092 TI - [Dissolution behaviour of indomethacin polymorphs in disk-state]. PMID- 3656093 TI - [The behavior of 1,4-benzodiazepine drugs in acidic media. VII. Carbon-13 nuclear magnetic resonance spectra of flurazepam in acidic aqueous solution]. PMID- 3656094 TI - [Studies on color and chemical structure in the solid state of riboflavin tetrabutyrate]. PMID- 3656095 TI - Use of salicylate to estimate the "threshold" inducer level for de novo synthesis of the phenol-degrading enzymes in Pseudomonas putida strain H. AB - A special approach was used to elucidate the "threshold" inducer concentration for coordinative de novo synthesis of phenol hydroxylase(s), catechol 2,3 dioxygenase and the 2-hydroxymuconic semialdehyde-metabolizing enzymes which initiate phenol catabolism in Pseudomonas putida strain H. It is based on cell precultivation with glucose (as the carbon and energy source) in the presence of different concentrations of sodium salicylate which proved to be a potent non metabolizable inducer in strain H of these enzymes. Subsequent estimation of the activity status of resting cell suspensions and cell-free extracts, respectively, prepared from those strain H cultures clearly revealed failing de novo synthesis of the mentioned phenol-degrading enzymes at salicylate concentrations lower than 0.2 mg/l. PMID- 3656096 TI - Improvement of the oral bioavailability of naltrexone in dogs: a prodrug approach. AB - In an effort to improve the oral bioavailability of naltrexone [17 (cyclopropylmethyl)-4,5 alpha-epoxy-3,14-dihydroxymorphinan-6-one;1], a number of prodrug esters on the 3-hydroxyl group were prepared: the anthranilate (2), acetylsalicylate (3), benzoate (4), and pivalate (5). The oral bioavailability of these prodrugs was determined in dogs. Compounds 2 and 3 exhibited the greatest enhancement of naltrexone bioavailability (45 and 28 times greater than 1, respectively). No correlation was found between the rates of plasma hydrolysis and bioavailability. Naltrexone-3-acetylsalicylate hydrolyzed in human and dog plasma with a fast deacetylation step to naltrexone salicylate followed by a slower hydrolysis step to naltrexone. PMID- 3656097 TI - Hypolipidemic activity of trimethylamine-carbomethoxyborane and related derivatives in rodents. AB - A number of substituted amine-carboxyborane esters were examined for their hypolipidemic activity in rodents. Trimethylamine-carbomethoxyborane, Me3NBH2C(O)OMe, was observed to be the most effective hypolipidemic agent in the rodent at the low dose of 8 mg/kg/d. This agent effectively increased the high density lipoprotein (HDL) cholesterol content and lowered the low density lipoprotein (LDL) cholesterol and triglyceride contents of rat lipoproteins. Furthermore, the agent accelerated cholesterol excretion from the body of the rat and reduced the activity of the rate-limiting enzyme involved in the de novo synthesis of lipids in the liver. The agent has a safe therapeutic index, and appeared to have more promise as a therapeutic agent than other borane esters. PMID- 3656098 TI - Effects of glucose on neuroblastoma in vitro and in vivo. AB - Because neuroblastoma cells in vitro are sensitive to changes in glucose levels in growth media, the effects of glucose levels and dietary carbohydrate on the sensitivity of neuroblastoma cells to chemotherapy were studied. In vitro, 20 microM bromoacetylcholine, 3mM 1,3-diaminopropane, and 5 mM 5-fluorouracil were added to the growth medium of strain N2a neuroblastoma cells cultured in Dulbecco's modified Eagle medium with high glucose (4.5 g/L, HG), normal glucose (1.0 g/L, NG), or low glucose (0.1 g/L, LG). Diaminopropane and 5-fluorouracil had some cytotoxic effect on cells in all media. Bromoacetylcholine killed cells in all media, but at a concentration of 20 microM was most effective in LG medium. Mice (A/Jax) were inoculated with neuroblastoma cells for in vivo studies. Mice could not tolerate a carbohydrate-free diet, while a high carbohydrate diet caused no change in survival time. When mice on a high carbohydrate diet were treated with cyclophosphamide (100 mg/kg, ip) or 5 fluorouracil (125 mg/kg, ip) they died faster than drug-treated mice on a normal diet. Oral chlorpropamide or cimetidine did not prolong survival time. Analysis of blood glucose levels showed neuroblastoma significantly lowered blood glucose levels (p less than 0.05), while chlorpropamide had no significant effect. It is proposed that manipulation of plasma glucose to lower levels will not be effective in enhancing the chemotherapy of neuroblastoma. PMID- 3656099 TI - Ion-exchange resins as potential phosphate-binding agents for renal failure patients: effect of the physicochemical properties of resins on phosphate and bile salt binding. AB - The effect of resin type, degree of cross-linking, bead size, and surface area on the phosphate and bile salt binding characteristics of five strongly basic Dowex anion-exchange resins in the chloride form was studied. The maximum uptake of phosphate (expressed as uptake of phosphorus) from sodium phosphate solutions was 137, 82, 86, 138, and 76 mg of phosphorus per gram of dry Dowex resins XF 43311, XY 40013, XF 43254, XY 40011, and XY 40012, respectively. The presence of simulated gastric or intestinal fluids resulted in small but insignificant alterations in phosphorus uptake by the resins. The resins all bound similar amounts of phosphorus and taurocholate (80-100% of the total phosphorus and taurocholate in solution) at physiological concentrations of phosphate and bile salt. Dowex resins XY 40013 and XF 43254, with identical physicochemical properties, but different bead sizes and surface areas, bound similar amounts of the bile salt sodium taurocholate at all taurocholate concentrations, indicating that binding was not restricted to the surface sites on the resin bead. The 2% cross-linked resins bound 3-4 times more taurocholate than the 8% cross-linked resins (at high taurocholate concentrations); the smaller pore size of the latter resins probably presents a greater mechanical exclusion barrier than the larger pore size of the 2% cross-linked resins. PMID- 3656100 TI - Fluorescence energy transfer study of the relationship between the lone tryptophan residue and drug binding sites in human serum albumin. AB - The relationship between the lone tryptophan residue at position 214 and drug binding sites (Sites I and II) in human serum albumin (HSA) was studied by fluorescence energy transfer. The distance between the lone tryptophan residue and ligands bound to HSA was estimated by Forster's equation, taking into consideration the degree of ligand binding at these sites, as determined from binding parameters (binding constant, k, and the number of binding sites, n). For all ligands investigated, the distance in each case appeared to asymptotically decrease when the occupation ratio of the binding sites increased with ligand concentration. When the primary binding site of each ligand in HSA was almost saturated, the distance attained a constant value, making possible a somewhat more exact determination of the distance. The distance ranged from approximately 22 to 23 A for ligands typical of Site I (warfarin, dansylamide, dansylglutamine), and approximately 16.1 to 17.5 A for ligands typical of Site II (dansylsarcosine, dansylproline, dansylglycine, diazepam, flufenamic acid). PMID- 3656101 TI - Solution stability of ciclosidomine. AB - The stability of N-cyclohexanecarbonyl-3-(4-morpholino)-sydnone imine hydrochloride (ciclosidomine) in solution was studied as a function of pH, temperature, ionic strength, and buffer species. The rate of hydrolysis in the absence of light was found to be apparent first order in drug and general acid- and base-catalyzed reactions. The pH rate profile at an ionic strength of 0.1 M at 60 degrees C had a minimum value near pH 6. Change in ionic strength in the range of 0.05 to 0.2 M did not affect the rate of degradation at pH 7 (carbonate buffer) or pH 2 (phosphate buffer) at 60 degrees C. Similar degradation rates were noticed in air or nitrogen in the dark at pH 3, 5, and 6. However, degradation in light was very rapid in either case at pH 3, 5, and 6, and, therefore, the protection of solutions from light was required during all studies. The time for 10% loss of drug in solution at pH 6 in dilute phosphate or citrate buffer at an ionic strength of 0.154 M was projected to be 9 months at 20 degrees C and 2.6 months at 30 degrees C. PMID- 3656102 TI - A simple and sensitive determination of histamine and N tau-methylhistamine in biological fluids by high-performance liquid chromatography with electrochemical detection. AB - The determination of picomolar levels of histamine and its major metabolite, N tau-methylhistamine, in biological fluids was achieved using reversed-phase liquid chromatography coupled with electrochemical detection. A simple sample purification procedure for blood and urine samples was carried out prior to analysis using an Amberlite CG-50 cation-exchange resin, which afforded an excellent recovery of both compounds. PMID- 3656103 TI - Determination of partial and total cohesion parameters of caffeine, theophylline, and methyl p-hydroxybenzoate by gas-solid chromatography. AB - For the first time, the total and partial solubility parameters, delta t, delta d, and delta s, of caffeine, theophylline, and methyl p-hydroxybenzoate were obtained by gas-solid chromatography (from the adsorption internal energy), by using the Keller, Karger, and Snyder equation. In comparison with the solubilization techniques, this method has the advantage of giving single solubility parameter values. The experimental work has been reduced to a minimum by the optimization of the matrix of experiments, according to the D-criterion, without any diminution in the quality of the results. PMID- 3656104 TI - Synthesis of 7a-substituted benzoylaminoalkyl-hexahydro-1H-pyrrolizines and evaluation of their antiarrhythmic activity. AB - Several 7a-substituted benzoylaminoalkyl-hexahydro-1 H-pyrrolizines were synthesized by acylations of 7a-aminoalkyl-hexahydro-1 H-pyrrolizines. All compounds synthesized were evaluated for their antiarrhythmic activities using the chloroform-mouse method, and some of them were found to have significant antiarrhythmic activities, comparable to that of procainamide. PMID- 3656105 TI - Use of fluidized bed in proliposome manufacturing. PMID- 3656106 TI - Differential effects of phenobarbital on ester and ether glucuronidation of diflunisal in rats. AB - The relative contribution of ether and ester glucuronidation to diflunisal metabolism was assessed by studying the effects of enzyme inducers, phenobarbital (PB), 3-methylcholanthrene (3-MC) and beta-naphthoflavone (BNF). Treatment with either PB, 3-MC or BNF increased markedly the unbound intrinsic clearance of diflunisal. Saline-treated control rats showed a greater unbound intrinsic clearance of diflunisal than oil-treated controls indicating that repetitive treatment with oil had an effect on enzyme activity. Treatment with 3-MC and BNF appeared to cause a decrease in the biliary clearance of ether and ester glucuronide, but PB had little effect on the biliary clearance of glucuronides. Rats pretreated with PB showed a 3-fold increase in the fractional metabolite formation clearance of ether glucuronide and a 2-fold increase in the fractional metabolite formation clearance of ester glucuronide, suggesting differential effects of PB on ester and ether glucuronidation. A similar trend, but to a smaller extent, was also observed for 3-MC- and BNF-treated rats. These results suggest the possibility of selective induction of multiple forms of UDP glucuronyltransferase involved in metabolism of diflunisal. PMID- 3656107 TI - Diuretic effect induced by intrarenal infusion of pinacidil in anesthetized dogs. AB - The diuretic action of pinacidil, a new vasodilating antihypertensive agent, was studied using anesthetized dogs. Intrarenally administered pinacidil (0.4, 2.0 and 10 micrograms/kg/min) produced a dose-related increase of renal blood flow, without altering mean arterial pressure. The glomerular filtration rate significantly increased only with the highest dosage. Pinacidil caused a dose related augmentation of urine formation and, when given at 10 micrograms/kg/min, increased urine flow and urinary excretion of electrolytes to about 10 times and 3 to 9 times over the respective control value. In comparison, hydralazine (4.0 and 20 micrograms/kg/min) produced no significant diuretic action and bradykinin, given at a dose (0.02 micrograms/kg/min) equipotent to pinacidil (10 micrograms/kg/min) with respect to increasing renal blood flow, was less effective. Pinacidil administration significantly increased the fractional excretion of phosphate. Thus, pinacidil-induced diuresis seems to be due mainly to the vasodilating effect on renal vessels, with some contribution from an inhibitory effect on sodium reabsorption in the proximal tubules. PMID- 3656108 TI - Impairment of the extraneuronal O-methylating system of isoproterenol by stop flow ischemia in the perfused rat heart. AB - Effects of ischemia on the extraneuronal O-methylating system were investigated in the perfused rat heart. Ischemia was produced by stopping of the perfusion for 30 min. Isoproterenol (ISO) was used as a model substrate for the extraneuronal uptake of catecholamines. The accumulation of ISO when catechol-O methyltransferase (COMT) (EC 2.1.1.6) was inhibited by 3',4'-dihydroxy-2 methylpropiophenone (U-0521) was decreased by ischemia to about 50% of the control value. Ischemia decreased the formation of 3-O-methyl-ISO, a major metabolite of ISO formed by COMT, to about 30% of that in the control hearts. The efflux of extraneuronally accumulated ISO in the heart with and without ischemia was measured. The diffusion constant calculated by the slope of the efflux rate of ISO or by the efflux rate divided by the amount of ISO remaining in the heart after ischemia was about 50% of the control. The experiments showed that ischemia suppressed the extraneuronal O-methylating system (extraneuronal uptake, COMT and diffusional flux) in the rat heart. Such suppression may lead to higher concentrations of local catecholamines in myocardial infarction. PMID- 3656109 TI - Effects of (-)-desmethoxyverapamil on heart and vascular smooth muscle. AB - (-)-Desmethoxyverapamil [also known as (-)-devapamil or (-)-D888] has been developed as a verapamil type radioligand for the study of calcium channels. In the present investigation, the effects of (-)-desmethoxyverapamil on action potential (AP) and force of contraction in heart muscle preparations and on tension and 45Ca influx in vascular smooth muscle are described. In part, the effects were compared with the (+)-isomer of desmethoxyverapamil and the isomers of both verapamil and methoxyverapamil. In atrial and/or ventricular heart muscle preparations from guinea pigs, cats and man, (-)-desmethoxyverapamil decreased the force of contraction and shortened the AP duration. Slow response APs were depressed, whereas dV/dtmax of phase 0 of the AP remained unchanged. The rank order of potency of the (-)-isomers was as follows: desmethoxyverapamil greater than methoxyverapamil greater than verapamil. Potassium-induced contractures and 45Ca influx were depressed by the (-)-isomers of desmethoxyverapamil, methoxyverapamil and verapamil in the same potency rank order as observed in heart muscle. The (+)-isomers exerted qualitatively similar effects at about 10 to 200 times higher concentrations. Correspondingly, the increase in potency of the racemic mixtures of the drugs was accompanied by increases in stereoselectivity. It is concluded that (-)-desmethoxyverapamil is the most potent stereoselective calcium antagonist of the verapamil type with respect to its effects on heart and vascular smooth muscle. PMID- 3656110 TI - Inhibition of ischemia-induced subcellular redistribution of lysosomal enzymes in the perfused rat heart by the calcium entry blocker, diltiazem. AB - Effect of diltiazem on subcellular distribution of lysosomal enzymes, high-energy phosphate metabolism and mechanical function in the ischemic heart was studied. Ischemia was induced by lowering the afterload pressure of the perfused working rat heart. The activities of cathepsin D, beta,N-acetylglucosaminidase and acid phosphatase were determined in the nonsedimentable and sedimentable fractions after centrifugation of the tissue extract to assess the subcellular distribution of lysosomal enzymes. After ischemia, decreases in the mechanical function and the tissue level of high-energy phosphates were observed. In addition, ischemia caused subcellular redistribution of lysosomal enzymes from the lysosomes to the cytoplasm. Reperfusion of the ischemic heart did not restore the mechanical function and the level of high-energy phosphates completely. Diltiazem (2.21 X 10(-6), 1.11 X 10(-5) and 2.21 X 10(-5) M) was provided for the heart 5 min before the onset of ischemia. Diltiazem preserved high-energy phosphates in the ischemic heart, and inhibited the subcellular redistribution of lysosomal enzymes being caused by ischemia, depending on its concentration. Reperfusion after ischemia with diltiazem recovered the mechanical function that had been decreased by ischemia. These results may indicate that diltiazem can protect the myocardium against ischemic damage. PMID- 3656111 TI - Effect of lidocaine on the myocardial acidosis induced by coronary artery occlusion in dogs. AB - The effect of lidocaine on ischemic myocardial acidosis was investigated in the dog heart, in which the left anterior descending coronary artery was occluded to reduce to about one-third (partial occlusion). Myocardial pH (MpH) was measured by means of a micro glass pH electrode. MpH before partial occlusion was 7.52 to 7.66. Partial occlusion decreased the left anterior descending coronary artery flow by 49 to 68%, MpH by 0.58 to 0.76 and myocardial contractile force by 26 to 43%, and increased ST segment (surface electrocardiogram) by 3.2 to 11.7 mV. Lidocaine (injected i.v. 30 min after partial occlusion) decreased heart rate, blood pressure and myocardial contractile force, and attenuated the decrease in MpH during ischemia. Lidocaine in doses of 2, 5 and 10 mg/kg restored the myocardial [H+], that had been increased by partial occlusion, by 23, 38 and 50%, respectively. Even in the paced heart, lidocaine (10 mg/kg) attenuated the myocardial acidosis, although the degree of attenuation was smaller (36%). Partial occlusion elevated the ST segment even in the presence of 5 or 10 mg/kg of lidocaine. In the nonischemic heart, however, lidocaine (2, 5 or 10 mg/kg) did not change in MpH. It is concluded that lidocaine attenuates the myocardial acidosis during ischemia, and the primarily important mechanism of pH attenuation is not a decrease in heart rate. PMID- 3656112 TI - Reinforcing and subjective effects of several anorectics in normal human volunteers. AB - A discrete-trial choice procedure was used to examine the reinforcing and subjective effects of four anorectic drugs (mazindol, benzphetamine, phenylpropanolamine and phenmetrazine) in groups of normal healthy adults. For each experiment, subjects first sampled placebo and a dose of one of the drugs (mazindol: 0.5, 1.0 and 2.0 mg; benzphetamine: 25 and 50 mg; phenylpropanolamine: 12.5, 25 and 50 mg; phenmetrazine: 25 and 50 mg; all p.o.). Subjects were then allowed to choose between drug and placebo on five separate occasions. The relative frequency with which active drug was chosen over placebo was used as an index of the drug's reinforcing efficacy. Subjective effects were measured with an experimental version of the Profile of Mood States, a short form of the Addiction Research Center Inventory and a series of visual analog scales. The rank order for reinforcing efficacy was benzphetamine approximately phenmetrazine greater than placebo greater than phenylpropanolamine much greater than mazindol. Ratings of drug liking were positively correlated with number of drug choices for each drug. Benzphetamine and phenmetrazine produced subjective effects characteristic of amphetamine-like drugs and increased ratings of drug liking. Mazindol produced only dysphoric subjective effects and decreased ratings of drug liking. Phenylpropanolamine had no significant effects on subjective measures or drug-liking ratings. These findings are consistent with the presumed dependence potential of these compounds, and demonstrate the validity of this experimental paradigm for assessing the reinforcing effects of anorectics in normal human volunteers. PMID- 3656113 TI - Pharmacological characterization of CGS 15943A: a novel nonxanthine adenosine antagonist. AB - CGS 15943A is a potent adenosine receptor antagonist with a novel nonxanthine heterocyclic ring structure. In vitro, CGS 15943A competitively inhibited the 2 chloroadenosine-induced A2 receptor-mediated relaxation of dog coronary artery strips contracted with KCl (25 mM). Similarly, CGS 15943A blocked 2 chloroadenosine- and N-ethylcarboxamideadenosine-induced A2 receptor-mediated relaxation of histamine-contracted guinea pig tracheal strips. Schild analysis of these results yielded pA2 values of 10.8 and 10.1 for the coronary arteries and the tracheal smooth muscle strips, respectively. In comparison, 8 phenyltheophylline blocked 2-chloroadenosine-induced tracheal response with a pA2 value of 7.0. CGS 15943A was devoid of intrinsic activity, and did not affect either histamine- or KCl-induced contractions of the smooth muscle strips. In the electrically stimulated guinea pig left atrial preparation, CGS 15943A antagonized the A1 receptor-mediated negative inotropic effects of R phenylisopropyladenosine with a pA2 value of 7.4. In vivo, i.v. administration of CGS 15943A blocked the vasodepressor response to 2-chloradenosine in anesthetized normotensive rats with an ID50 of 0.024 mg/kg. In addition, p.o. administration of CGS 15943A (4.0 mg/kg) to conscious rats inhibited 2-chloroadenosine-induced decreases in diastolic blood pressure; maximal effects were observed 30 min after dosing, with a T1/2 of approximately 103 min. Therefore suggesting that CGS 15943A is an orally active antagonist of adenosine receptors. These results indicate that CGS 15943A antagonized both A1 and A2 receptor-mediated responses with a greater affinity toward the A2 than the A1 receptor subtype. PMID- 3656114 TI - Adenosine mediates the negative chronotropic action of adenosine 5'-triphosphate in the canine sinus node. AB - ATP exerts pronounced electrophysiologic effects in the mammalian heart. The present study tested the hypothesis that the negative chronotropic action of ATP in the canine sinus node is dependent on its degradation to adenosine. Increasing doses of the following compounds were administered in the sinus nodal artery of 12 open chest dogs (either sex, 30-35 kg) anesthetized with pentobarbital (30 mg/kg i.v.): adenosine, ATP, alpha,beta methylene-ATP (AMPCPP) and beta,gamma methylene-ATP (AMPPCP). Right atrial, His bundle and right ventricular electrograms as well as Lead II ECG and systemic arterial blood pressure were monitored continuously and recorded. The depressant effects of test compounds on the sinus node were assessed from the prolongation of sinus cycle length and the duration of junctional escape rhythm which they induced. Data were used to plot dose-response curves for the four test compounds. The order of potency was adenosine greater than or equal to ATP greater than or equal to AMPPCP much greater than AMPCPP = 0. In 3 of 12 dogs the emergence of junctional escape rhythm was observed after the highest dose of either adenosine, ATP or AMPPCP. In addition, aminophylline, a selective competitive inhibitor of adenosine at P1 purinoceptor site, reduced the effects of maximal doses of adenosine, ATP and AMPPCP by 52 +/- 7, 67 +/- 8 and 72 +/- 6%, respectively (each, P less than .05; AMPPCP vs. adenosine, P less than .05). The present data indicate that the negative chronotropic action of ATP is due to its rapid catabolism to adenosine and the action of adenosine at P1-purinoceptor sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656115 TI - Diltiazem and autoregulation of canine cerebral blood flow. AB - Recent in vitro evidence suggests the existence of stretch-activated calcium channels in cerebrovascular smooth muscle. These channels, which may play a role in cerebral autoregulation, also appear resistant to antagonism by the benzothiazepine calcium antagonist diltiazem, an agent known to block potential sensitive and receptor-operated calcium channels. If cerebral autoregulation involves stretch-sensitive diltiazem-resistant calcium channels, then autoregulation should remain intact during vasodilatation produced by diltiazem. The present study was conducted to test this hypothesis. Using a canine cerebral venous outflow preparation, experiments were first performed to determine the optimum dose and route of administration for diltiazem. Although continuous i.v. diltiazem (1-100 micrograms/kg/min) did not increase cerebral perfusion at any normotensive dose, i.a. (lingual artery) diltiazem at 10.0 micrograms/kg/min increased cerebral blood flow by 36% and decreased cerebrovascular resistance by 31% without significant effects on blood gas levels, cerebral oxygen uptake, cardiac output or mean arterial pressure. In autoregulation experiments, 10.0 micrograms/kg/min of diltiazem significantly attenuated but did not eliminate autoregulatory responses to increases (inflation of an aortic balloon) and decreases (hemorrhage) in cerebral perfusion pressure. Autoregulatory responses to increases and decreases in perfusion pressure were equally affected by diltiazem, but both were unaffected by i.a. saline. These data support the view that cerebral autoregulation involves both diltiazem-sensitive and diltiazem resistant mechanisms. The diltiazem-resistant mechanisms, which may include the proposed population of stretch-sensitive calcium channels appear to account for up to one-half of the autoregulatory capacity in the cerebral circulation. PMID- 3656116 TI - Cytotoxicity of oxidative metabolites of procainamide. AB - Indirect evidence suggests that metabolism of procainamide (PA) may be necessary for generation of its autoimmunity-inducing capacity. Reactive metabolites of PA produced by hepatic mixed function oxidases have been identified by their capacity to bind proteins covalently. The present study extends these findings by comparing the toxicity of various chemically synthesized metabolites of PA to a variety of cell lines and primary cultures. PA and its N-acetyl- and N-acetyl-N oxide-derivatives were nontoxic to S49.1 cells at concentrations up to 5 mM, whereas nitro-Pa (4-nitro-N-(diethylaminoethyl)benzamide hydrochloride) and azoxy PA (bis-N,N'-(diethylaminoethyl)-4,4'-azoxydibenzamide) displayed partial cytotoxicity at 1 and 0.1 mM, respectively. (The therapeutic range of PA is 0.02 0.05 mM.). In contrast, hydroxylamine-PA (4-hydroxylamino-N (diethylaminoethyl)benzamide hydrochloride) was highly cytotoxic, producing a TD50 between 0.002 and 0.045 mM among the eight cell lines tested. Hydroxylamine PA sensitivity correlated with cell reducing capacity, suggesting that redox cycling contributes to cytotoxicity. The hydroxylamine metabolite of PA undergoes spontaneous air oxidation to the nitroso-derivative (nitroso-PA). When this oxidation was minimized by rapid manipulations or inhibited by ascorbic acid, cytotoxicity was reduced or eliminated, suggesting that the nitroso-derivative may be the toxic metabolite. Quiescent peripheral blood lymphocytes, especially T cells, were relatively insensitive to hydroxylamine-PA when evaluated by dye exclusion 1 day after drug exposure. However, massive DNA strand breaks were detectable in these cells immediately after drug exposure, and resting lymphocytes treated with 0.01 mM hydroxylamine-PA died slowly during the subsequent week.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656117 TI - A1- and A2-selective adenosine antagonists: in vivo characterization of cardiovascular effects. AB - Caffeine, a nonselective adenosine receptor antagonist, 7-methyl-1,3 dipropylxanthine, a purported A2 selective antagonist and a 1,3-dipropyl-8 phenylxanthine amine congener (XAC), an A1 selective antagonist, were evaluated for their in vivo selectivity at A1 vs. A2 adenosine receptors. Blockade of the negative chronotropic effect of bolus i.v. injections of 2-chloroadenosine, R phenylisopropyladenosine and N-ethylcarboxamidoadenosine was utilized as an index of antagonism at A1 receptors; blockade of the hypotensive effect of the same series of adenosine agonists was used as an index of activity at A2 receptors. In addition, blockade of the potentiating effect of adenosine on the hypertensive and chronotropic effects of nicotine was studied to assess further the role of A1 and A2 adenosine receptors in this response. The potent antagonist XAC displayed considerable A1 selectivity as demonstrated by blockade of adenosine receptor mediated bradycardia at doses 5- to 10-fold lower than those antagonizing adenosine receptor-mediated hypotension. XAC also selectively blocked potentiation by adenosine of the positive chronotropic effect of nicotine, at doses which had minimal effects on the enhancement of the hypertensive effect of nicotine. The caffeine homolog 7-methyl-1,3-dipropylxanthine exhibited A2 selectivity as demonstrated by prevention of adenosine receptor-mediated hypotension at doses which only minimally attenuated the bradycardiac effect of adenosine analogs. Caffeine displayed no selectivity for A1 vs. A2 adenosine receptors. The results indicate that selective analogs such as XAC and F-methyl 1,3-dipropylxanthine will be useful probes for investigation of receptors involved in the physiological functions of adenosine. PMID- 3656118 TI - Identification of A1 and A2 adenosine receptors in the rat spinal cord. AB - The adenosine receptors in membranes prepared from rat ventral and dorsal lumbar spinal cord were characterized by comparing the binding characteristics of [3H]5' N-ethylcarboxamide adenosine ([3H]NECA), an agonist with nearly equal affinities at the A1 and A2 adenosine receptor subtypes, with those of [3H]N6-[(R)-1-methyl 2-phenylethyl]adenosine ([3H]R-PIA), an A1-selective agonist. Saturation isotherms of the ventral and dorsal spinal cord yielded Kd values 1.9 to 2.3 nM for [3H]R-PIA and 18.1 to 19.5 nM for [3H]NECA. The Bmax for [3H]NeCA was approximately twice the Bmax for [3H]R-PIA in ventral and dorsal halves (267 vs. 128 fmol/mg of protein and 402 vs. 206 fmol/mg of protein, respectively). Displacement of specific [3H]NECA binding by the A2-selective agonist, 2 (phenylamino)adenosine, the relatively nonselective antagonist, theophylline and six A1-selective agonists, R-PIA, S-PIA, N6-(cyclohexyl)adenosine, N6 (cyclopentyl)adenosine, N6-(m-aminophenyl)adenosine and N6-(m iodophenyl)adenosine, revealed two [3H]NECA binding components with the characteristics of A1 and A2 receptors. All curves best fit a two-site model when analyzed by the computer program LIGAND. R-PIA, N6-(cyclohexyl)adenosine and N6 (cyclopentyl)adenosine were the most potent displacers at the first site (Ki = 0.6-1.4 nM). All A1-selective agonists were poor displacers of [3H]NECA at the second site (Ki = 0.6-18.6 microM). The A2-selective agonist, 2 (phenylamino)adenosine, was as potent as R-PIA in displacing [3H]NECA from this site with a Ki value 0.57 microM. Finally, the A1 and A2 adenosine receptor mediated inhibition and stimulation of adenylate cyclase were demonstrated directly in synaptic membranes prepared from the spinal cord. PMID- 3656119 TI - Individual differences in responsiveness to single and repeated amphetamine administration: behavioral characteristics and neurochemical correlates. AB - The administration of amphetamine to rats results in a relatively wide range of individual differences in responsiveness, both in the initial behavioral patterns as well as in the augmentation response to repeated administration. Therefore we examined the possibility that such differences might reflect intrinsic variation in neurochemical mechanisms regulating responsiveness to amphetamine. Animals were administered a transitional dose (1.75 mg/kg) of amphetamine with regard to the induction of locomotion and continuous stereotypy. On the basis of individual response profiles animals could be separated into two markedly different subgroups, one displaying continuous locomotion (S1), characteristic of lower amphetamine doses, and the other exhibiting a multiphasic pattern, including a prolonged focused stereotypy phase (S2), typically associated with higher amphetamine doses. Examination of regional brain monoamine and metabolite levels revealed distinguishing patterns between the subgroups only in the mesolimbic and mesocortical dopamine systems. With repeated amphetamine administration, the two prominent factors of the augmentation, the emergence of stereotypy and the enhancement of locomotion during the last half of the response, were dissociable between the subgroups. The emergence of stereotypy was confined to S1 animals, whereas only the S2 subgroup displayed the progressive increase in locomotion. Differences in the responsiveness of neurochemical systems to amphetamine rather than pharmacokinetic factors appear to underly the distinct behavioral profiles associated with the two subgroups. The results indicate that characterization of individual responses may be required to determine accurately the neurochemical mechanisms involved in the behavioral effects of amphetamine. PMID- 3656120 TI - Binding, degradation and pressor activity of angiotensins II and III after aminopeptidase inhibition with amastatin and bestatin. AB - In the metabolism of angiotensin peptides by tissue angiotensinases, aminopeptidases A, B, M and leucine aminopeptidase have been identified as being particularly effective. Because the inhibitory actions of amastatin (AM) and bestatin (BE) are relatively specific for these aminopeptidases, we have examined the effects of these inhibitors on the binding, degradation and pressor activity of angiotensin II (AII) and angiotensin III (AIII). Within 30 min at 37 degrees C, significant metabolism of 125I-AII and 125I-AIII by homogenates of a block of tissue containing hypothalamus, thalamus, septum and anteroventral third ventricle regions of the brain was observed. A majority of 125I-AIII metabolism was due to soluble peptidases, whereas that of 125I-AII primarily resulted from membrane-bound peptidases. AM, BE and reduced incubation temperatures significantly decreased the metabolism of 125I-AII and 125I-AIII. After appropriate adjustments to reflect the proportion of intact radioligand bound, temperature- or inhibitor-induced decreases in metabolism were matched by corresponding increases in specific binding. Heat-treated bovine serum albumin, as a nonspecific peptidase inhibitor, had no effect on either the metabolism or binding of the ligands used. In accordance with their actions in vitro, i.c.v. administration of AM and BE prolonged the pressor activity of subsequently applied AII and AIII. Unexpectedly, the amplitude of the pressor response to AIII was increased by BE, whereas that to AII was decreased by AM. The results of this study indicate that the metabolism of AII and AIII by aminopeptidases is relatively specific and acts to modulate the actions of these peptides.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656121 TI - Thermodynamic analyses of pirenzepine binding to membrane-bound and solubilized muscarinic receptors from rat forebrain and heart. AB - The thermodynamic properties of pirenzepine (PZ) binding to membrane-bound and digitonin-solubilized muscarinic receptors (mAChR) from the rat forebrain and heart were evaluated. Apparent dissociation constants (Kd) of PZ were measured from saturation studies using [3H]PZ for forebrain membrane-bound mAChR and from inhibition studies of (-)-[3H]quinuclidinyl benzilate binding using unlabeled PZ, at five different temperatures from 4 degrees C to 37 degrees C. The Kd values of PZ binding to both membrane-bound and solubilized mAChR decreased with decreasing temperature whereas the maximum receptor density was unchanged. The heterogeneity of membrane-bound mAChR characterized by PZ binding to mAChR from both tissues disappeared upon digitonin-solubilization of the mAChR. The magnitude of changes of the Kd values with temperature was greater in the solubilized mAChR, suggesting that some constituents in the membrane constrained the affinity changes. The Gibbs free energy of PZ binding to membrane-bound and solubilized mAChR were both negative. The Gibbs free energy for membrane-bound receptors decreased (more negative) whereas those for solubilized receptors increased (less negative) with increasing temperature. The change in entropy was the apparent major driving force for PZ binding to membrane-bound receptors with the change in enthalpy also being favorable. The change in enthalpy was the apparent major driving force for PZ binding to solubilized receptors at all temperatures with the change in entropy being unfavorable above 17 degrees C in the rat forebrain mAChR and above 10 degrees C in the heart mAChR. Our results suggest an important role for the biomembrane microenvironment and possible topographical differences in the binding sites which may contribute to the mechanism of muscarinic subtypes. PMID- 3656122 TI - Intracellular pH in sheep Purkinje fibres and ferret papillary muscles during hypoxia and recovery. AB - 1. The changes of intracellular pH (pHi) of papillary muscles from ferret and Purkinje fibres from sheep heart during hypoxia and recovery from hypoxia were recorded with pH-sensitive micro-electrodes filled with neutral H+ carrier. 2. Hypoxia was produced by replacement of O2 with N2 in the superfusing solutions. When oxidative phosphorylation was prevented, developed tension fell within 20 min to about 16 and 21% of its control value for papillary muscle and Purkinje fibres respectively. On restoration of O2, recovery of developed tension in ferret papillary muscle is preceded by a transient additional decrease. 3. In ferret papillary muscle, the pHi first increased by a mean value of 0.11 pH units after 3 min hypoxia, then decreased by about 0.24 pH units after 20 min. In sheep Purkinje fibres, the initial alkalosis was small or absent, and after 5-9 min, the pHi started to fall reaching 0.17 pH units after 20 min of hypoxia. On return to oxygenated solution, a transient additional intracellular acidification occurred. This acidification reached its peak of 0.31 pH units in papillary muscle and of 0.13 pH units in Purkinje fibres. In both preparations hypoxia was accompanied by a depolarization of a few millivolts. 4. The presence of cyanide (1-2 mM) or fluorodinitrobenzene (20-40 microM) prevented the additional intracellular acidification occurring on return to oxygenated solution. Removal of cyanide itself produced a transient but smaller and slower acidification. 5. On both preparations, exposure to a Tyrode solution containing 10 mM-L-lactate produced a transient intracellular acidification. After recovery from this acidification the acidification produced by hypoxia was increased without affecting the extra acidification on reintroduction of O2. 6. After reduction of the rate of glycolysis by removal of glucose and application of 2-deoxyglucose, the transient intracellular acidification, occurring on return to oxygenated solution after hypoxia, was inhibited in both preparations. In ferret papillary muscle, insulin (100 mU/ml) potentiated the changes of pHi occurring during hypoxia. 7. Using Na+-sensitive glass micro-electrodes it was found that the intracellular Na+ activity rose slightly during the later stages of hypoxia and rose transiently on readdition of O2. These results are consistent with a Na+-H+ exchange being stimulated by acidosis. 8. The origins of the pH changes during and after hypoxia are discussed as are the differences between the responses of sheep Purkinje fibres and ferret papillary muscle. PMID- 3656123 TI - Dendritic activities of spinal motoneurones in pigs and rabbits enhanced through chronic stimulation of a dorsal root. AB - 1. The L6 or L7 dorsal root in 7-10-day-old pigs was chronically stimulated for 3 or 4 h a day for 4 days/week. The stimuli were 50 or 500 Hz pulse trains delivered at 0.5/s. The induced movements were limited to the hip and hind leg on the stimulated side without any sign of pain. There was evidence that not only the monosynaptic, but also polysynaptic pathways to the motoneurones were chronically stimulated. After 2-6 days of chronic stimulation, all pigs were studied in acute experiments either under pentobarbitone (Nembutal) anaesthesia or in the decerebrated state. Normal (unstimulated) 15-28-day-old pigs were also studied in acute experiments under similar conditions, as the controls. 2. In thirty-three out of fifty-six motoneurones of normal pigs there were all-or-none potentials of 2-6 ms duration and 1-5 mV amplitude. These have been named D spikes. They occurred in response to tibial nerve and/or dorsal root stimulation and/or spontaneously. They could be abolished by injection of a hyperpolarizing current. These results show that D-spikes are different from any of the well established all-or-none events of the motoneurone, i.e. the spikes of the axon, initial segment, soma and unitary excitatory post-synaptic potentials. Several kinds of D-spikes could exist in the same motoneurone, as judged from their wave forms and thresholds. This argues for the dendrites as the sites of origin for D spikes, because only the dendrites can have multiple sites for spike generation. D-spikes were shown to summate to form a larger depolarization. 3. In pigs chronically stimulated with 500 Hz pulses seventy-five motoneurones were studied in acute experiments. In sixty-one motoneurones D-spikes were observed. This indicated that D-spike occurrence was enhanced in the chronically stimulated motoneurones as compared with controls. 4. Characteristic of the chronically stimulated motoneurone was the presence of a depolarization of all-or-none nature which was more than 10 ms in duration and 2-12 mV in amplitude. The depolarization is referred to as the D-wave. The D-wave was similar in properties to the D-spike described above, except that it was of longer duration. Consequently, it is assumed that the D-wave is summed D-spikes. D-waves were observed in nineteen motoneurones.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656124 TI - Triggered activity in atrial fibres of canine coronary sinus: role of extracellular potassium accumulation and depletion. AB - 1. Bursts of triggered activity can be induced in atrial fibres of the canine coronary sinus exposed to catecholamines. During a triggered burst there is an initial acceleration of rate accompanied by depolarization of the maximum diastolic potential (m.d.p.) followed by slowing of the rate and termination accompanied by hyperpolarization. 2. We have used extracellular K+-sensitive micro-electrodes (potassium ISE) to monitor extracellular K+ concentration ([K+]o) during and following triggered activity, while simultaneously measuring membrane potential with conventional intracellular micro-electrodes. 3. We found that the initial increase in rate during triggered activity is accompanied by increased [K+]o and depolarization. Later rate slowing and m.d.p. hyperpolarization is accompanied by decline of extracellular K+ accumulation. Following termination of triggered activity, extracellular K+ depletion occurred. 4. The decline of [K+]o and slowing of rate are known responses to enhanced Na+ K+ pump activation, as is the post-triggering depletion of extracellular K+. 5. Strophanthidin, which blocks the Na+-K+ pump, also blocks the [K+]o decline, the slowing of rate seen towards the end of the triggered episode, and the post triggering depletion of extracellular K+. 6. Separate experiments studying the effects of elevated bath K+ and depolarizing current on triggering rate and delayed after-depolarization amplitude support our hypothesis that the rate profile of the triggered episode is to a large extent controlled by variations in m.d.p. subsequent to extracellular K+ accumulation and Na+-K+ pump activation. PMID- 3656125 TI - Recurrent inhibitory connexions among neck motoneurones in the cat. AB - 1. Intracellular recordings were made from motoneurones innervating neck muscles in the cat. Dorsal roots were cut and muscle nerves electrically stimulated to activate alpha motor axons. 2. Recurrent inhibitory post-synaptic potentials (i.p.s.p.s) evoked by antidromic volleys in homonymous or heteronymous nerves were found in the majority of motoneurones studied, including those to dorsal neck muscles (biventer cervicis, splenius and complexus) as well as to occipitoscapularis and levator scapulae ventralis. 3. Central latencies of the recurrent i.p.s.p.s indicate disynaptic transmission. Amplitudes ranged from 100 microV (criterion level) to 2.2 mV. Average amplitudes were less than 0.6 mV. 4. The recurrent i.p.s.p.s were distributed to non-synergistic as well as to synergistic motoneurones. Analysis of relative strength of recurrent inhibition indicates influence of proximity of motoneurone pools, functional relatedness of muscles, as well as other factors. Variation in intrinsic motoneuronal properties probably underlies positive correlations (independent of variation in resting potential) between recurrent i.p.s.p.s evoked from different sources in motoneurones of a single pool. 5. Recordings (mainly extracellular) were also made from interneurones (Renshaw cells), located in the C3 and C4 segments of the spinal cord, that were excited by antidromic volleys in muscle nerves. The response varied from a single action potential to a burst of up to nineteen action potentials. Central latencies to the first response indicate monosynaptic transmission. Many Renshaw cells were excited by antidromic volleys in several muscle nerves, though this was restricted to nerves of the same segmental level as the Renshaw cell. All the muscle nerves studied were effective in activating Renshaw cells. 6. The results indicate that in many ways the recurrent i.p.s.p.s and the responses of Renshaw cells recorded in the neck segments resemble those in the hind-limb segments. Thus, the basic organization of recurrent inhibition in the neck segments resembles that occurring elsewhere in the spinal cord. A difference is the tendency for recurrent i.p.s.p.s in neck motoneurones to be relatively small in amplitude and Renshaw cell responses to be less strong than those recorded in the hind-limb segments. It is suggested that this is related to the segmentation of neck muscles and their motoneurone pools. 7. It is concluded that recurrent inhibition is a prominent feature of spinal organization governing neck muscles. It can therefore be expected to participate in control of head movements. PMID- 3656126 TI - Asymmetric charge movement in polarized and depolarized muscle fibres of the rabbit. AB - 1. The Vaseline-gap technique was used to record asymmetric charge movement in single white sternomastoid fibres of the rabbit, both when the fibres were normally polarized (holding potential, -90 mV) and when they were subjected to prolonged depolarization (holding potential, 0 mV). 2. In normally polarized fibres, 10 microM-nifedipine suppressed substantial charge movement (charge 1) without any prior depolarization, showing that the asymmetric charge does not have to be activated for the drug to exert its action. 3. Examination of the charge moved over a potential range from -140 to +10 mV confirmed that nifedipine affects only that charge generated at potentials more positive than -60 mV. 4. It was shown that there was charge movement in fibres subjected to prolonged depolarization (charge 2), with the greatest movement of charge occurring at about -71 mV, and that this charge was unaffected by nifedipine. 5. The total capacitive charge, that is, the sum of 'linear' capacitive and asymmetric charges, moved between -90 and -80 mV, was the same in polarized and depolarized fibres. Furthermore, the amount of asymmetric charge moved between potentials in the range -140 to -70 mV was the same in polarized and depolarized fibres. These observations indicate that the asymmetric charge moved between -140 and -70 mV in polarized fibres (charge 1) and depolarized fibres (charge 2) are in fact the same charge movement. 6. These results are inconsistent with the hypothesis that prolonged depolarization or nifedipine can cause a transition between charge 1 and charge 2. The results also suggest that the charge movement involved in calcium release may be quite different from that usually assumed. PMID- 3656127 TI - Spinal cord influences on the colonic myoelectrical activity of fed and fasted rats. AB - 1. The myoelectrical activity of the large intestine of fed and fasted rats was recorded with chronically implanted nichrome wire electrodes after destruction of the spinal cord, after spinal cord transection, and after spinal anaesthesia. 2. After spinal cord ablation, the cyclical organization of the colonic electrical spiking activity, as well as the gastrocolic reflex and accompanying postprandial enhancement of the cyclical pattern of activity, persisted on the proximal and distal colon. On the transverse colon, however, the spiking activity was considerably increased. This latter effect obliterated the gastrocolic response due to feeding but not the subsequent postprandial enhancement of the cyclical pattern of activity. 3. After spinal cord transection, the level of spiking activity also increased on both the transverse and distal colon, but no major changes in cyclical activity or in postprandial responses were recorded. 4. Spinal anaesthesia produced by intrathecal lidocaine increased the motility of the transverse colon to a level which masked the gastrocolic reflex. 5. These results suggest a prevertebral ganglia and/or a local control mechanism for the cyclical organization of the spiking activity of the colon. The central control mechanisms involve mostly spinal inhibitory influences on the transverse colon and supraspinal inhibitory influences on the distal colon. PMID- 3656128 TI - Changes in the length of the human biceps brachii muscle during elbow movements. AB - 1. Needles inserted into the biceps move with the muscle as the elbow flexes or extends. Pairs of needles were used to indicate changes in length of the muscle fibres. 2. During low-frequency flexion-extension movements the biceps lengthened as the joint extended. 3. When, however, joint movements at greater than 2.2 Hz were maintained by external electrical stimulation of triceps and the long head of biceps, or of biceps alone, the biceps lengthened and shortened in antiphase to the joint movement. The elastic properties of the biceps tendons then combined with the mass of the forearm as a spring-mass system whose natural frequency was about 2.2 Hz. 4. No such phase reversal appeared during voluntary elbow movements at frequencies up to 5 Hz. It was concluded that the combined tendons of biceps, brachialis and brachioradialis made a much less compliant muscle-to-bone coupling. 5. The results are discussed in relation to possible tremor mechanisms. PMID- 3656129 TI - The control of potassium concentration in the cerebrospinal fluid and brain interstitial fluid of developing rats. AB - 1. In situ measurements of plasma, cerebrospinal fluid (CSF) and brain interstitial fluid (ISF) K+ concentrations have been made in anaesthetized rats aged between 19 days gestation and 30 days after birth using K+-selective micro electrodes. 2. Under control conditions, plasma, CSF and ISF [K+] did not vary significantly with age, the over-all mean concentrations being 3.8, 3.1 and 3.2 mM respectively. The CSF and ISF [K+] were significantly lower than plasma [K+] at all ages. 3. It is concluded that young rats, from the age of 19 days gestation, can normally maintain plasma-to-CSF and plasma-to-ISF gradients similar to those in the adult, presumably by action of the blood-CSF and blood brain barriers. 4. During acute plasma hyperkalaemia there was very little regulation of CSF [K+] at 21 days gestation, but after birth there was a gradual improvement in CSF K+ homeostasis until by 30 days after birth a normal CSF [K+] could be maintained. 4. There was no regulation of ISF [K+] during hyperkalaemia at 21 days gestation, although after birth there was a rapid improvement in ISF K+ homeostasis. 1-day-old neonates were able to maintain a normal forebrain ISF [K+] during hyperkalaemia. 6. It is concluded that the onset of both CSF and ISF K+ homeostasis takes place at around birth in rats. However, K+ homeostasis matures more rapidly in the ISF than in the CSF. This suggests that, at least in the neonatal period, the CSF is not essential for ISF [K+] regulation. PMID- 3656130 TI - The relationship between ventilation and oxygen consumption in man is the same during both moderate exercise and shivering. AB - 1. Four naive subjects clothed in protective suits were immersed up to the neck in water on twenty-two occasions, the minimum skin temperature was 20 degrees C and the average skin temperature 26 degrees C. Subjects at first rested, initially demonstrating an increase in thermal muscular tone which did not lead to perceptible limb movements. Later, while resting, visible shivering with small unco-ordinated limb movements supervened. The subjects then exercised while still immersed by stationary cycling. 2. Steady-state minute oxygen consumption (VO2) and minute ventilation (VE) were measured on 152 occasions by timed collection of expired air. 3. The first collection was made at least 5 min after initial immersion. Hyperventilation due to recent immersion in cold water was not demonstrated. 4. The same linear relationship between VE and VO2 was demonstrated whether the increased oxygen consumption was due to shivering alone or to a combination of shivering and exercise. 5. VE was matched to VO2 in spite of an increase in the work of breathing as well as any ventilation-perfusion mismatching as a consequence of head-out water immersion. 6. Minute ventilation was not influenced by the large co-ordinated limb movements which only occurred during exercise. These results reinforce previous findings which have shown that in conscious man VE can be closely matched to VO2 below the anaerobic threshold despite large variations in the type and intensity of limb movements. 7. When VO2 is increased by thermal muscular tone VE is increased in direct proportion in a situation when the limbs are not perceptibly moving at all. PMID- 3656131 TI - Release of 5-hydroxytryptamine by pentagastrin and its role in the 'fade' of stimulated gastric secretion in cats. AB - 1. The release of 5-hydroxytryptamine (5-HT) by pentagastrin and the 'fade' phenomenon seen in acid gastric secretion during a continuous intravenous infusion of pentagastrin have been studied in anaesthetized cats. 2. During an intravenous infusion of pentagastrin, acid secretion rose steeply to a maximum at 45 min. It was maintained at this rate for only 15-30 min, after which it decreased gradually. Meanwhile there was a marked increase in the 5-HT content of the plasma which reached a peak at 120 min and remained just below the peak concentration for the rest of the experiment. 3. Acid secretion due to an intravenous infusion of histamine on the other hand, steadily increased over the 3 h collection period. Meanwhile there was only a gradual small increase in the 5 HT content of the plasma. 4. Whereas there was a continuous steady increase in acid secretion in response to an intravenous infusion of pentagastrin in cats pre treated with reserpine, acid secretion rose to a sharp peak and then decreased gradually when reserpinized cats were given a simultaneous infusion of 5-HT along with the pentagastrin. 5. It is concluded that 5-HT is released by pentagastrin and that it is responsible for the 'fade' phenomenon seen in acid secretion during infusions of pentagastrin, first of all augmenting acid secretion and then inhibiting it. PMID- 3656132 TI - Thresholds of action potentials evoked by synapses on the dendrites of pyramidal cells in the rat hippocampus in vitro. AB - 1. In this study we have measured the thresholds of action potentials and some properties of e.p.s.p.s (excitatory post-synaptic potentials) produced by activation of distal and proximal dendritic synapses in CA1 pyramidal cells in rat hippocampal slices. 2. Simultaneous intracellular and extracellular electrophysiological recordings were made from pyramidal cells. The two recording electrodes were positioned very close together to provide an accurate measurement of the transmembrane potential by subtraction of the extracellular field from the intracellular potential. 3. Two pairs of stimulating electrodes were placed in the stratum radiatum of area CA1. The proximal and distal afferents were stimulated alternately within a 15 s cycle and at an intensity to produce action potentials in about 50% of the trials. 4. At this stimulus intensity there was a slight difference in the mean 10-90% rise times of the e.p.s.p.s produced by stimulation of proximal and distal afferents. The ratio of the distal: proximal rise time was 1.27. 5. In those trials where the action potential failed there was also a significant difference in the time-to-peak of the e.p.s.p.s evoked from proximal or distal sites. The times-to-peak of the e.p.s.p.s from proximal stimulation were between 1.5 and 3.8 ms, whilst the times-to-peak from distal stimulation were longer (2.1-7.2 ms). 6. In 16/18 cells included in this study the thresholds for action potentials evoked by distal stimulation were significantly lower than those following proximal activation. The mean threshold for distal activation was 12 mV compared with 16 mV for proximal activation. 7. The threshold of action potentials activated by depolarizing current pulses appeared to be close to that for action potentials evoked from proximal synapses. 8. Whilst the shape indices of the e.p.s.p.s were slightly different when comparing transmembrane with conventional intracellular recordings, the thresholds of the action potentials were not affected by this procedure. 9. Possible explanations for the low threshold for action potentials evoked from distal synapses are discussed, including an active dendritic membrane and differences in inhibition. PMID- 3656133 TI - Peripheral lymphatic responses to outflow pressure in anaesthetized sheep. AB - 1. Lymph flow and pressure fluctuations were measured by cannulating popliteal efferent and distal hind-limb afferent lymphatic vessels in anaesthetized sheep. The cannula outflow height was raised above the vessels to increase lymphatic outflow pressure. 2. Lymph flow decreased non-linearly as the outflow was raised. The rate of decrease increased with increasing outflow height. 3. Lymphatic contraction frequency rose and stroke volume fell with increasing outflow height. 4. The calculated power necessary to move lymph along the cannula initially increased with outflow height but it reached a peak and was reduced again by raising the outflow further. Calculated lymphatic stroke work followed a very similar pattern. 5. Lymph flow was maintained up to a greater outflow height in afferent than in efferent vessels. Curves relating frequency, power and stroke work to outflow height were shifted to the right in the afferent lymphatics. 6. These results are consistent with an intrinsic lymphatic pump which can be stimulated by increasing pressure. At high pressures, however, the pump fails. PMID- 3656134 TI - The cardiovascular responses elicited from the posterior cerebellar cortex in the anaesthetized and decerebrate rabbit. AB - 1. In this study the posterior cerebellar cortex has been electrically stimulated and changes in heart rate, arterial blood pressure, regional blood flows and renal sympathetic nerve discharge have been recorded in both the anaesthetized and the decerebrate unanaesthetized rabbit. 2. Specifically, lobules VII, VIII, IX and X of the posterior cerebellar vermis were stimulated but the only region which elicited cardiovascular changes was lobule IX (the uvula). The responsive area of the uvula was localized to the medial regions of sublobules a, b and c and was identical in both anaesthetized and decerebrate animals. 3. Under urethane anaesthesia, uvula stimulation evoked a small bradycardia, a fall in arterial pressure, a transient inhibition of renal sympathetic nerve activity, with no change in renal vascular conductance, and an increase in femoral vascular conductance. 4. Stimulation of an identical area in the decerebrate rabbit evoked a marked tachycardia, an increase in blood pressure, maintained increase in renal sympathetic nerve discharge, and decreases in both renal and femoral conductances. 5. The response evoked from the decerebrate rabbit could be reversed by a small dose of anaesthetic to a pattern of response which was essentially identical to that seen in the urethane-anaesthetized rabbit. 6. This influence of anaesthetics on the pattern of cardiovascular responses that may be elicited from the cerebellar cortex indicates that caution should be exercised when making physiological inferences on the basis of stimulation experiments in anaesthetized preparations. 7. In the light of the cardiovascular changes that may be evoked from the uvula, and recent neuroanatomical and neurophysiological data concerning afferent and efferent connexions of this cerebellar region, we discuss the possibility that the uvula plays a role in the alerting reaction of the rabbit. PMID- 3656135 TI - The response of hair cells in the basal turn of the guinea-pig cochlea to tones. AB - 1. Intracellular recordings were made from inner and outer hair cells in the basal turn of the guinea-pig cochlea. The resting membrane potentials of the inner hair cells are more positive than -50 mV while those of outer hair cells are usually more negative than -70 mV. 2. At low frequencies the receptor potentials of inner hair cells are predominantly depolarizing while those from outer hair cells are hyperpolarizing at low and moderate sound pressure (e.g. less than 90 dB re 2 X 10(-5) Pa at 600 Hz). The potentials then become predominantly depolarizing at high sound pressure. 3. The asymmetry of the inner and outer hair cell receptor potentials are manifested instantaneously except at high stimulus levels when the depolarizing responses of outer hair cells take several cycles to develop. 4. At the offset of intense tones outer hair cell membrane potentials remain depolarized by 1-2 mV above their resting value and return to normal over a period depending on the level and duration of the tone. 5. In response to tones above about 2 kHz and at levels below about 90 dB the wave forms of outer hair cell receptor potentials are virtually symmetrical without measurable d.c. components. In response to tones close to their best frequencies (16-21 kHz), inner hair cells in the basal turn generate large depolarizing (d.c.) receptor potentials while outer hair cells from this region of the cochlea do not generate significant voltage responses. 6. Frequency tuning curves were derived for inner and outer hair cells from the amplitude-intensity relationships of their d.c. and phasic (a.c.) receptor potentials respectively. When the latter were compensated for the low-pass characteristics of the recording system and the hair cell time constant, the frequency selectivity of inner and outer hair cells are similar. 7. The response properties of inner and outer hair cells in the basal turn of the guinea-pig cochlea are discussed in relation to their proposed roles in mechano-electric transduction. PMID- 3656136 TI - Pulmonary stretch receptor relay neurones of the cat: location and contralateral medullary projections. AB - 1. The activity of pump (p.) cells, second-order neurones in the pulmonary stretch receptor pathway, was recorded extracellularly in the nucleus of the tractus solitarius (n.t.s.) of the decerebrate cat. Their firing was proportional to changes in lung volume but unrelated to the centrally determined respiratory rhythm. A systematic search of the n.t.s. for the location of p. cells was made and an assessment of their efferent projection to the contralateral n.t.s. was determined electrophysiologically by the antidromic mapping technique. 2. P. cells were located around, and in close proximity to, the solitary tract. The two sites of greatest density were ventromedial and dorsolateral to the tract, with lower concentrations found laterally and ventrolaterally. 3. For twelve of the thirty p. cells tested, evidence of a projection to the contralateral n.t.s. was obtained; in seven of these cells, axonal arborizations within the projection area were identified. Almost all the cells that sent axons to the contralateral n.t.s. were located dorsolateral to the tract; there was no evidence that cells in the ventromedial region had contralateral projections. 4. No evidence that R beta neurones project to the contralateral commissural and ventrolateral subnuclei was found. 5. No p. cells projected to the contralateral ventrolateral n.t.s. The site of projection and branching was consistently localized just caudal to the obex and medial to the solitary tract, in the caudal medial, and commissural subnuclei of the n.t.s. This same region has been shown to receive a dense, direct projection from pulmonary rapidly adapting receptors. PMID- 3656137 TI - Non-cholinergic component of rat splanchnic nerves predominates at low neuronal activity and is eliminated by naloxone. AB - 1. Effects of nicotinic (mecamylamine) and muscarinic (atropine) receptor antagonists were investigated on the secretion of catecholamines evoked by stimulation of splanchnic nerve terminals and acetylcholine in the isolated perfused adrenal gland of the rat to determine whether non-cholinergic substances released from nerve terminals participate in the secretion of catecholamines. 2. Increasing the frequency of stimulation from 0.5 to 10 Hz (300 pulses) caused enhanced secretion of catecholamines (26-110 ng/collection period). After blockade of nicotinic and muscarinic receptors with mecamylamine and atropine, the secretion was reduced by 40, 65 and 80% at 0.5, 1 and 10 Hz, respectively. Acetylcholine-evoked secretion of catecholamines, which was roughly equivalent to that produced by stimulation at 10 Hz, was blocked by over 90% by the cholinergic antagonists. 3. Naloxone (3-300 microM) caused a concentration-dependent inhibition of catecholamine secretion evoked by stimulation of splanchnic nerves (1 Hz); acetylcholine-evoked secretion was much less affected by naloxone. 4. The secretion of catecholamines that remained after blockade of cholinergic receptors at different frequencies of stimulation (see 2 above) was almost completely inhibited by inclusion of 30 microM-naloxone in the medium. The inhibitory effect of naloxone was concentration dependent (3-30 microM) and reversible. 5. Splanchnic nerve-evoked secretion of catecholamines was facilitated by 400% in the presence of tetraethylammonium or tetraethylammonium plus mecamylamine and atropine. The facilitatory effect of tetraethylammonium was inversely related to the frequency of stimulation. 6. The residual secretion of catecholamines obtained after blockade of cholinergic receptors was facilitated by increasing concentrations of tetraethylammonium (1-5 mM). 30 microM-naloxone antagonized the facilitatory effects of tetraethylammonium at 1 and 3 mM by 60% and 25%, respectively, but failed at 5 mM-tetraethylammonium; higher concentrations of naloxone (100 microM) were also ineffective. 7. It is concluded that neurally evoked secretion of catecholamines is mediated by acetylcholine and a non cholinergic substance(s); the contribution of non-cholinergic substance(s) predominates at low neuronal activity, whereas that of acetylcholine is maximum at high neuronal activity. Blockade of the non-cholinergic component by naloxone suggests that an opioid peptide may be involved in the secretion of catecholamines in the rat adrenal medulla. PMID- 3656138 TI - In vitro effects of dexamethasone on sodium transport across rat colon. AB - 1. The in vitro effects of dexamethasone on Na+ transport across the colon descendens from normal rats was investigated. Amiloride was used at two concentrations, 10 microM and 1 mM, to differentially inhibit the transport of Na+ across the colon. The colon descendens from each rat was divided into four segments and Na+ unidirectional fluxes before and 7 h after the addition of dexamethasone (10(-6) M) were determined under short-circuit conditions. 2. Base line JnetNa (net flux of Na+) was twice as high in the proximal segment as in the distal segment. The two middle segments had intermediate rates of Na+ transport. JnetNa in control tissue was unaffected by 10 microM-amiloride but was completely inhibited by 1 mM-amiloride. In control tissue, amiloride at either 10 microM or 1 mM had no effect on the transmural potential difference (p.d.), the transmural conductance (Gt) or the short-circuit current (Isc). 3. Dexamethasone caused a time-dependent increase in the p.d. and in the Isc in all four segments of the colon. The increase in the p.d. and Isc was greatest in the most distal segment and less in each of the successive more proximal segments. This segmental difference along the colon was observed in tissue from all animals studied (n greater than 30). 4. The increase in p.d. and Isc caused by dexamethasone was accompanied by an increase in JnetNa to the same maximum rate of 14 mu equiv cm-2 h-1 in each segment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656139 TI - Acetylcholine metabolism and choline availability at the neuromuscular junction of mature adult and aged rats. AB - 1. The balance between acetylcholine (ACh) synthesis and degradation and the availability of choline were studied in the neuromuscular junction of rats aged 10 (mature adult) and 28 (aged) months. Endogenous and 2H4-labelled variants of ACh and choline were assayed during steady-state stimulated and resting conditions using gas chromatography-mass spectrometry. 2. Endogenous ACh levels were 34% less per nerve terminal in the older rats; in non-innervated tissue, the levels were 12-14% as large as in innervated tissue. Endogenous choline levels in innervated and non-innervated tissue were similar and were 28% higher in the older animals. 3. Accumulation of 2H4-labelled choline was significantly greater in the 28-month animals; the specific activity at equilibrium was 60% higher in the older rats. 4. Incorporation of [2H4]choline into [2H4]ACh was significantly faster in the aged rats; times to half-maximal values were 2.0 and 0.6 min in the 10- and the 28-month animals, respectively. There was no measurable synthesis of ACh in the non-innervated tissue. 5. There were no major age-related differences in the amount of ACh released during stimulation between 1 and 20 Hz. In contrast, choline efflux during stimulation was significantly greater in the aged animals; flux values (+/- S.E. of mean) were 0.48 (+/- 0.014) and 0.66 (+/- 0.038) nmol/min for the 10- and the 28-month rats, respectively. 6. Under resting conditions, endogenous ACh efflux was significantly greater in the older rats; the rates (+/- S.E. of mean) were 2.00 (+/- 0.21) and 3.05 (+/- 0.43) pmol/min for the younger and the older animals, respectively; similarly, choline efflux was greater in the aged tissue. 7. These results indicated that lower intracellular ACh levels can be attributed to enhanced leakage rather than to decreased synthesis. Greater ACh efflux is accompanied by correspondingly greater choline uptake in the 28-month rats; this is associated with greater choline efflux and higher steady-state choline levels in the aged tissue. PMID- 3656140 TI - Mapping of early development of electrical activity in the embryonic chick heart using multiple-site optical recording. AB - 1. Using a multiple-site optical recording method with a 100-element photodiode array and a voltage-sensitive merocyanine-rhodanine dye, we have been able to monitor, for the first time, spontaneous electrical activity in pre-fused cardiac primordia in the 6- and 7-somite chick embryos. 2. To study the regional development of spontaneous electrical activity in the early embryonic pre contractile chick heart at the later 7-9-somite stages, we have also recorded optically action potentials simultaneously from the entire heart, and constructed maps of the early development of electrical activity. 3. The data show that during the 6-9-somite stages, the size of the active area gradually increases, and that the development of electrical activity was spatially non-uniform: two peaks of activity were found in the right and left sides of the cono-ventricular region at the 7-8-somite stages. As development proceeded to the 9-somite stage, several peak areas of activity appeared. 4. The results are discussed in relation to the spatial pattern of proliferation of electrically active cells in the early phases of cardiogenesis. PMID- 3656141 TI - Post-natal development of the retinal and cerebellar projections onto the lateral suprasylvian area in the cat. AB - 1. Post-natal development of the retinal and cerebellar projections onto the medial bank of the lateral suprasylvian visual area was examined by using the field potential method and, additionally, by the orthograde horseradish peroxidase method. 2. Optic nerve stimulation elicited a surface-positive, depth negative field potential in the medial bank of the lateral suprasylvian area of adult cats. By contrast, in kittens younger than 3 weeks old, a surface-negative, depth-positive field potential was evoked. The response grew adult-like by 1 month of age. Corticocortical response, activated by stimulation of cortical areas 17 and 18, underwent a similar developmental change. 3. Cerebellar stimulation evoked a surface-negative, depth-positive wave from birth up to adulthood. Thalamocortical afferents from the ventroanterior and ventrolateral nuclei of the thalamus to the medial bank of the lateral suprasylvian area, which is presumed to be responsible for this cerebellar response, terminate mostly in layer I in both new-born kittens and adult cats. 4. The present results, and our previous morphological findings on the projections from the extrageniculate visual thalamus and visual cortical areas 17 and 18 onto the medial bank of the lateral suprasylvian area, were correlated with reference to the maturation of the neuronal circuit in the cortex. PMID- 3656142 TI - An investigation into the neural regulation of calcium excretion by the rat kidney. AB - 1. An investigation was undertaken to examine the action of the renal nerves on the reabsorption of calcium ions from the left kidney of sodium pentobarbitone anaesthetized rats. 2. Renal denervation had no effect on renal haemodynamics but increased urine flow, calcium excretion, absolute and fractional sodium excretions by 26% (P less than 0.02), 73% (P less than 0.02), 90% (P less than 0.001) and 82% (P less than 0.01), respectively, without affecting the calcium to sodium excretion ratio. In a group of animals which were similarly prepared but the renal nerves were not sectioned, neither renal blood flow, nor the excretion of water, calcium or sodium changed during the time course of the experiment although glomerular filtration rate increased significantly (P less than 0.05) by 19%. 3. Low rates (0.8-1.5 Hz at 15 V, 0.2 ms) of renal nerve stimulation did not change renal haemodynamics but reduced urine flow by 31% (P less than 0.001), calcium excretion by 32% (P less than 0.001), sodium excretion by 32% (P less than 0.001) and fractional sodium excretion by 32% (P less than 0.01) while the calcium to sodium excretion ratio was unaffected. Renal nerve stimulation at 3-5 Hz reduced renal blood flow by 15% (P less than 0.02), did not change glomerular filtration rate and reduced urine flow, calcium excretion, absolute and fractional sodium excretions by 35% (P less than 0.01), 30% (P less than 0.01), 32% (P less than 0.01) and 32% (P less than 0.05), respectively, while the calcium to sodium excretion ratio remained unchanged. 4. These data show that the renal nerves can modulate the excretion of calcium by a mechanism which is independent of renal haemodynamics and which may represent a direct action of the nerves on the calcium reabsorptive processes of the tubular cells. It remains to be determined whether this neural control of calcium reabsorption is a direct one or indirect via changes in sodium reabsorption. PMID- 3656143 TI - Cutaneous primary afferent properties in the hind limb of the neonatal rat. AB - 1. Single cutaneous primary afferent units innervating the hind limb were recorded from the L4 dorsal root ganglion in neonatal rats aged 0-14 days. 2. Conduction velocities were less than 1.0 m s-1 on day 0 but by day 1 had clearly divided into a faster conducting group whose velocities markedly increased with age, reaching 15 m s-1 on day 14, and a slower conducting group that increased only slightly to 1.5 m s-1 on day 14. 3. All major cutaneous receptor types could be identified from day 0. Slowly adapting and rapidly adapting touch and hair mechanoreceptors had the same response patterns and thresholds described for such receptors in the adult, but peak firing frequency and ability to follow high frequency electrical stimulation was low. At birth, these afferents could only follow 20 Hz stimuli but by day 14 this had increased to 200 Hz. 4. Nociceptors were also present from birth. Polymodal nociceptors responding to intense mechanical, thermal and chemical skin stimulation were completely mature in their firing frequencies and response patterns from day 0. High threshold mechanoreceptors responded at somewhat lower frequencies than the adult but otherwise were comparable. 5. A prominent group of receptors responding to firm pressure on the skin were observed in the first post-natal week but not on day 14. It is proposed that these may represent maturing touch or hair receptors or alternatively a group of temporary receptors that are lost during development. 6. On the first post-natal days, there was no relation between conduction velocity and receptor type. After this time, however, afferents which have A beta fibres in the adult tended to conduct faster in the neonate than those with A delta and C fibres. There were exceptions however demonstrating that receptor properties and afferent axons do not always mature in parallel. 7. These results show that considerable maturation of cutaneous receptors must occur before birth. They suggest that central rather than peripheral maturation is responsible for the post-natal changes in dorsal horn physiology and cutaneous sensory reflexes. Furthermore since C polymodal nociceptors are fully functional at birth, the delayed development of neurogenic oedema and of certain specific C-evoked reflexes could be due to slow maturation of critical chemical factors in C fibres. PMID- 3656144 TI - Activation of the human diaphragm from the motor cortex. AB - 1. Rapidly conducting corticofugal pathways were activated by percutaneous electrical stimulation of the motor cortex in normal subjects. The electromyographic response produced in the diaphragm was assessed with recordings via a gastro-oesophageal catheter and the mechanical response was measured as a change in transdiaphragmatic pressure. 2. The mean latency from the cortical stimulus to the muscle action potential in the diaphragm was 12.3 ms. The latency to the diaphragm from stimulation of the cervical spinal cord at the C4 level was 8.0 ms. The mean 'central conduction time' to the phrenic motor nucleus of 4.3 ms (range 4.0-4.6 ms) was similar to that for the deltoid (mean 4.4 ms; range 4.0 4.8 ms) recorded in the same subjects. 3. The largest twitch contractions of the diaphragm were evoked by cortical stimuli near the vertex during inspiration. The amplitude and duration of the electromyographic and mechanical responses often exceeded those produced by a supramaximal stimulus to both phrenic nerves simultaneously. 4. These results provide the first direct evidence that there is a rapidly conducting oligosynaptic pathway from the motor cortex to the human diaphragm. PMID- 3656145 TI - Blockade of prostaglandin E1 hyperthermia by sodium salicylate given into the ventral septal area of the rat brain. AB - 1. Sodium salicylate (30.0 micrograms microliter-1) or artificial cerebrospinal fluid (ACSF) was infused bilaterally into the ventral septal area (v.s.a.) of the unrestrained rat for 1 h before and 1 h after the injection of prostaglandin E1 at a concentration of 20.0 ng microliter-1 into a lateral cerebral ventricle. 2. During control (ACSF) infusions, 200.0 ng of prostaglandin E1 evoked a hyperthermic response (0.95 +/- 0.16 degrees C). During sodium salicylate infusions, the prostaglandin E1-evoked hyperthermia was significantly reduced (P less than 0.025) to 0.31 +/- 0.16 degrees C. 3. The fever index (degrees C h for 1.0 h) during the infusion of sodium salicylate was reduced 66% below that of control infusions (P less than 0.01). 4. These data indicate that sodium salicylate infused in the v.s.a. of rats can antagonize a prostaglandin E-evoked hyperthermia. This suggests that there may be an additional mechanism of action for sodium salicylate antipyresis other than inhibition of prostaglandin E synthesis. PMID- 3656146 TI - Two types of synaptic selectivity and their interrelation during sprouting in the guinea-pig superior cervical ganglion. AB - 1. The synaptic connexions of the guinea-pig superior cervical ganglion were examined after collateral sprouting provoked by cutting the preganglionic nerve supply from spinal segments T3-T7. The selective properties of the connexions made by the remaining segments C8, T1 and T2 were explored both with respect to the segmental origin of the preganglionic axons (Nja & Purves, 1977 a) and with respect to their conduction velocity (Wigston, 1983). 2. After sprouting, the ventral root T1 elicited strong sympathetic effects on both the eye and the ear, while the normal response is largely confined to the region of the eye. This effect on the expressed selectivity was confirmed by intracellular recording in vitro, which showed that virtually all the ganglion cells were now innervated by T1. 3. However, neurones that received dominant innervation from T1 were more frequently innervated by sprouted axons from C8 than were neurones whose dominant innervation derived from T2. This indicates that basic mechanisms promoting segmental selectivity were still functioning. 4. The selective innervation of ganglion cells with respect to the conduction velocity of the preganglionic axons was well maintained after sprouting. 5. These results show that during sprouting from a restricted set of preganglionic axons the synaptic partners are still matched according to both types of selectivity. This suggests that the recognition mechanisms which guide neural development are preserved in adult life, but that the differences in the available sets of preganglionic axons lead to different competitive interactions and different resulting patterns of innervation. PMID- 3656147 TI - Voltage-clamp analysis of somatic gamma-aminobutyric acid responses in adult rat hippocampal CA1 neurones in vitro. AB - 1. The response of CA1 pyramidal neurones to somatic application of gamma aminobutyric acid (GABA) was studied in adult hippocampal slices using single electrode voltage-clamp techniques. 2. Small ionophoretic applications of GABA produced a pure outward current at the cell resting potential when recording with potassium-acetate-filled microelectrodes. This response reversed at a membrane potential of -69 +/- 5 mV (mean +/- 1 S.D.; n = 20). In recordings made with caesium-chloride-filled electrodes the GABA response reversed at -24 +/- 12 mV (n = 9). 3. The effect of different holding potentials on the size of the GABA response was examined in the range of -100 to -40 mV in twenty neurones using potassium-acetate-filled electrodes. In every case outward rectification of the response was observed. For twelve neurones the mean ratio (+/- 1 S.D. of the mean) of the conductance increase produced by GABA at -55 mV compared to -85 mV was 1.9 +/- 0.5. 4. Step changes in holding potential resulted in shifts in chloride equilibrium potential (ECl), as determined by time-dependent changes in the size of GABA-induced currents. The new value of ECl was generally reached within a few seconds of altering the membrane potential. Shifts in ECl did not appear to affect the extent of rectification but would cause underestimates of conductance measurements unless these were 'instantaneous'. The mean ratio (+/- 1 S.D. of the mean) of the 'instantaneous' conductance increase produced by GABA at 13 mV positive to that at 13 mV negative to ECl was 1.8 +/- 0.3. 5. The outward rectification was greater than that predicted by the constant-field equation. Possible factors that might contribute towards the rectification and its physiological significance are discussed. PMID- 3656148 TI - Effects of dark-rearing on the development of area 18 of the cat's visual cortex. AB - 1. We recorded extracellularly from 420 single units in area 18 in visually inexperienced kittens aged 7 days and dark-reared kittens aged between 3 and 12 weeks and from 60 single units in area 17 in dark-reared kittens aged 5 and 11 weeks. 2. Visual deprivation generally depressed the maturation of area 18, although some features were affected more than others and certain developmental improvements still occurred. The percentage of visually responsive units in area 18 increased from 40% in 7-day-old kittens to about 75% in dark-reared animals 10 12 weeks. At each age a proportion of cells was orientation biased (between 15 and 45%) and these neurones appeared to be arranged in a crude columnar fashion. However, dark-rearing, from birth, prevented the development of a significant proportion of orientation-selective cells in area 18; no more than 5% of neurones were orientation-selective at any age. We found no major bias in the over-all distribution of preferred orientations of cells in area 18 in dark-reared kittens. 3. Simple cells, which are found in area 18 even in very young, visually inexperienced kittens, persisted after dark-rearing, although most retained immature properties. Relatively few complex cells were found in area 18 in visually deprived animals. 4. The majority of neurones in area 18 of dark-reared kittens were binocularly driven, many equally well by either eye; evidence for regional variation in ocular dominance (indicative of a columnar pattern) was found in these deprived animals. 5. A laminar analysis in area 18 showed that percentages of non-oriented and orientation-biased cells changed little, if at all, in lower laminae (IV, V, and VI) but increased substantially in upper layers (above layer IV) in the absence of visual stimulation, over the first 12 post natal weeks. 6. A comparison of the effects of dark-rearing on areas 17 and 18 indicates that the normal development of visual responsiveness and specific receptive field properties is suppressed in both areas during the first 12 post natal weeks. It is possible that area 17 has a greater degree of orientation selectivity than area 18 in young visually deprived kittens and this may reflect a difference in the type of afferent inputs. PMID- 3656149 TI - Significance of active ion transport in transalveolar water absorption: a study on isolated rat lung. AB - 1. Experiments were performed on isolated rat lungs perfused with Ringer solutions containing red cells. The goal was to clarify the role of active transport of Na+ for the absorption of fluid across the alveolar membrane, and to characterize active and passive pathways. 2. Partially degassed lungs were filled with 5 ml of an isotonic Ringer solution containing 125I-labelled albumin in order to calculate the fluid movement, and 22Na+ or 36Cl- for measurement of ion fluxes. Passive non-electrolyte permeability was determined in all experiments using [3H]mannitol. 3. The average rate of fluid absorption in phosphate-buffered instillates was 134 nl/s (S.E., 18.5; n = 14). With ouabain (10(-4) M) in the perfusate the fluid absorption rate fell to 57 nl/s (S.E., 8.2; n = 18). Amiloride (10(-3)-10(-4) M) in the instillate reduced the absorption to 75 nl/s (S.E., 8.6; n = 16). These results show that fluid absorption depends on transcellular transport of Na+ and that alveolar epithelial cells have a Na+ entry system in the luminal membrane and a Na+-K+ pump in the abluminal membrane. 4. The transcellular ion transport operates in parallel with a paracellular, passive leak that allows mannitol to pass with a permeability surface area product of 1.2 X 10(-4) ml/s, corresponding to a permeability coefficient of 2.4 X 10(-8) cm/s, assuming an alveolar surface area of 5000 cm2. 5. The passive fluxes of Na+ were 9.4 pmol/(cm2s) (S.E., 1.3; n = 25) in the direction from alveoli to perfusate and 8.0 pmol/(cm2s) (S.E., 0.86; n = 6) from perfusate to plasma. The passive fluxes of Cl- in the two directions were not significantly different either. Thus the transalveolar electrical potential difference is too small to affect ion movements measurably. 6. The passive permeability to Na+ was 6.7 X 10(-8) cm/s and to Cl- was 10.2 X 10(-8) cm/s (alveolar surface area assumed to be 5000 cm2). The ratio of the permeabilities is close to the ratio of the diffusion coefficients in free solution, suggesting a neutral or weakly charged paracellular channel. 7. We conclude that the alveolar epithelium performs solute-coupled fluid transport from alveoli to plasma, and that it shows many features that are common to other fluid-transporting epithelia; with an approximate surface area of 100 m2 in humans it constitutes one of the largest epithelial surfaces in the body.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656150 TI - Cardiovascular responses at the onset of exercise with partial neuromuscular blockade in cat and man. AB - 1. In decerebrated cats the cardiovascular, heart rate and blood pressure responses to static muscle contractions were followed from the onset of stimulation of the cut L7-S1 ventral roots. Heart rate and blood pressure were also followed during maximal voluntary and electrically induced static muscle contractions in man using one leg. In both cat and man contractions were performed under control conditions and tubocurarine-induced neuromuscular blockade. 2. In the cat, heart rate and blood pressure increased 1.7 s after the onset of the contraction. No cardiovascular responses were seen when the muscle contraction was blocked by tubocurarine. 3. In man, both heart rate and blood pressure increased at the onset of voluntary contractions. Partial curarization reduced strength to 39% of control. The heart rate response was unaffected by tubocurarine while the blood pressure response was reduced from 61 to 32 mmHg. 4. Electrical stimulation of the muscles resulted in 75% of voluntary strength in man. The heart rate response was delayed one R-R interval in the electrocardiogram but was as large as during voluntary contractions. During partial curarization the heart rate response was significantly smaller and the blood pressure response was reduced from 11 to 8 mmHg. 5. In conclusion, processes in active muscles elicit an increase in heart rate and blood pressure which depends on the intensity of the muscle contraction developed. However, the immediate cardiovascular responses at the onset of voluntary muscle contractions cannot be accounted for by reflexes generated in the working muscles alone. PMID- 3656151 TI - The role of the sarcoplasmic reticulum in the response of ferret and rat heart muscle to acidosis. AB - 1. The photoprotein aequorin was micro-injected into papillary muscles from the right ventricle of ferrets and rats. Tension and aequorin light (a function of intracellular [Ca2+]) were monitored. 2. In stimulated ferret papillary muscles, increasing the [CO2] of the bicarbonate-buffered superfusate from 5% (pH 7.35) to 20% (pH 6.8) led to a rapid decrease of developed tension, with no significant change in the size of the intracellular Ca2+ transient which accompanies contraction. There was then a small brief recovery of tension which was accompanied by a large brief increase in the size of the Ca2+ transient. Tension then declined again before recovering more slowly, with no significant change in the size of the Ca2+ transient. 3. The time course of the Ca2+ transient was prolonged on exposure to the acid solution, but shortened on continued exposure to the acid solution. Relaxation of twitch tension became faster on exposure to the acid solution, but slowed again on continued exposure to the acid solution. 4. In the presence of 10 mM-caffeine the size of the Ca2+ transient increased during the initial decline of developed tension, the short-lived recovery of tension was abolished, and the Ca2+ transient became smaller during the slower recovery of developed tension. 2 microM-ryanodine had similar effects on developed tension. 5. Addition of 10 mM-lactic acid to the superfusate produced changes similar to those described in 2 and 3 above. 6. An intracellular acidosis, produced by the addition and subsequent withdrawal of 20 mM-NH4Cl from the superfusate also caused changes similar to those described above. In the presence of caffeine, withdrawal of NH4Cl produced changes similar to those described in 4 above. 7. In unstimulated ferret papillary muscles, increasing superfusate [CO2] produced an increase of aequorin light when the bathing [Ca2+] was increased or in the presence of ouabain (10 microM). This increase was not inhibited by verapamil (5 microM), carbonyl cyanide p trifluoromethoxyphenylhydrazone (1 microM) and oligomycin (2.5 microM), but was reduced by ryanodine (2 microM). 8. Rat papillary muscles showed responses which were quantitatively different from those observed in ferret papillary muscles: the initial recovery of tension developed more slowly, and sarcoplasmic reticulum (s.r.) inhibitors had a greater inhibitory effect on the recovery of tension. 9. It is concluded that the early decline of developed tension observed during acidosis is due to a decrease in Ca2+ release by the s.r. and a decrease in Ca2+ binding by the myofilaments.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656152 TI - Endogenous bursting by rat supraoptic neuroendocrine cells is calcium dependent. AB - 1. Phasic bursting by magnocellular neuroendocrine cells (m.n.c.s) in vivo causes increased vasopressin release from axon terminals in the neurohypophysis. In the supraoptic nucleus of the coronal hypothalamic slice thirty-two of sixty-five m.n.c.s recorded intracellularly displayed repetitive bursting, either spontaneously or during a low level of tonic current injection. 2. Of the thirty two repetitive bursters, twenty-four received no apparent patterned synaptic input and the phasic burst behaviour was voltage dependent. The evidence for these cells being bursting pace-makers and the underlying mechanism driving bursting were further investigated. 3. Phasic bursting by m.n.c.s is usually contingent upon two depolarizing events: a slow depolarization (s.d.) between bursts that brings the membrane potential to burst threshold, and the spike depolarizing after-potential (d.a.p.). One or several d.a.p.s can initiate a burst by summing to form a plateau potential which sustains firing. 4. Of eight phasic cells exposed to tetrodotoxin (TTX) and tonically depolarized with current injection, two cells retained the phasic burst pattern and underlying plateau potentials. Of the remaining six cells in TTX, three of four cells tested regained phasic firing with plateau potentials following the addition of Sr2+, a Ca2+ agonist. Evoked post-synaptic potentials were demonstrably blocked throughout TTX exposure, firmly establishing that some m.n.c.s are bursting pace makers. 5. The s.d., d.a.p. and plateau potential were retained in TTX or low-Na+ saline, augmented in Sr2+ and blocked in low-Ca2+ saline. All three events were activated at membrane potentials depolarized from -70 mV but steadily inactivated with increasing hyperpolarization to -90 mV. The s.d. and d.a.p. apparently represented partial activation of the same process that drives a burst, the plateau potential. 6. Hyperpolarizing pulses of constant current revealed an apparent decrease in cell conductance underlying the s.d., d.a.p. and plateau potential which was not due to membrane rectification. The plateau potential was reduced in low Na+ and eliminated in low Ca2+. However, it remained relatively unaffected by altering the external K+ concentration and it did not reverse below -90 mV, suggesting a less important role for K+ movement relative to Ca2+ or Na+. A hyperpolarizing pulse during the s.d., d.a.p. or plateau potential probably momentarily inactivated inward Ca2+ current, causing the apparent conductance decrease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656153 TI - Isoperiodic bursting by magnocellular neuroendocrine cells in the rat hypothalamic slice. AB - 1. Recruitment of magnocellular neuroendocrine cells (m.n.c.s) to a repetitive burst pattern (phasic firing) is associated with increased vasopressin secretion from neurohypophysial terminals in the intact animal. Based on invertebrate studies, bursts of action potentials can arise in two distinct ways: as an intrinsic property of the recorded cell or as an emergent property of synaptic interactions. 2. The majority of phasic m.n.c.s in the hypothalamic slice preparation display an endogenous pace-maker mechanism underlying bursting. It is voltage dependent and varies considerably in periodicity and time course as described in the accompanying paper (Andrew, 1987). 3. In contrast to this intrinsic mechanism, the present study examined if cells might be driven by periodic synaptic input. Intracellular recordings from six of thirty-two phasic m.n.c.s in the supraoptic nucleus revealed an isoperiodic oscillation of the membrane potential, where each depolarizing phase could support a burst. 4. The oscillation had a smooth trajectory and fixed period (range, 5-17 s). The oscillatory frequency was not voltage dependent, i.e. periodicity was unaffected by steady current injection through the recording electrode. 5. The frequency and amplitude of the oscillation remained unaltered by action potential firing. The isoperiodic oscillation could abate spontaneously, leaving intact the endogenous ability to fire a triggered burst driven by an underlying plateau potential. 6. Perfusion with either 10 mM-Mg2+-0.05 mM-Ca2+ or 0.5-2.0 microM-tetrodotoxin blocked both the oscillation and evoked post-synaptic potentials, indicating that the oscillation was synaptically generated. Given that both treatments could also block the intrinsic burst process and that the oscillation could spontaneously abate, the synaptic nature of the oscillation remains a tentative but reasonable conclusion. 7. In total, the evidence suggests that the isoperiodic oscillation has a synaptic origin independent of intrinsic mechanisms. It probably results from synaptic input generated within the slice but the source is not yet identified. This input could support phasic bursting in those m.n.c.s lacking a pace-maker ability and so promote the release of vasopressin in the intact animal. PMID- 3656154 TI - The receptive-field spatial structure of cat retinal Y cells. AB - 1. Y-type ganglion cells in the cat's retina were stimulated with bars of light and grating patterns at photopic luminances. Stimuli were stationary, and luminance at each point was varied sinusoidally in time at 2 Hz. Impulse rates were recorded from single cells. 2. When the stimulus was a narrow bar of light, the impulse rate approached a sinusoidal function of time as contrast was reduced. The linear behaviour of each cell was therefore characterized by taking the limit of response parameters as contrast approached zero. 3. The ratio of surround strength to centre strength varied widely between cells but the two strengths were approximately equal on average. The difference between surround phase and centre phase averaged 168 deg. 4. As contrast increased, responses became rectified. Rectifier output was well described by a power law of stimulus amplitude, where the power was usually 1.4 or 1.5. 5. Response phase advanced with increasing contrast, and at high response amplitudes grew less than proportionally with contrast. These effects were assumed due to the contrast gain control described by Shapley & Victor (1978). 6. Gratings in which luminance varied sinusoidally with distance were used to determine Y cell spatial resolution. The second-harmonic amplitude of the response diminished rapidly with increasing spatial frequency: the radius of the best-fitting Gaussian mechanism was about 0.25 deg for a cell at 10 deg eccentricity. 7. This spatial resolution is close to the linear resolution of X cells as determined by Linsenmeier, Frishman, Jakiela & Enroth-Cugell (1982). 8. A receptive field model incorporating both linear and non-linear elements is described. The model consists of an array of subunit pathways, each of which has a centre-surround organization followed by a rectifier; a pool weights and sums subunit outputs, and signals are then passed through a contrast gain control. 9. The model accounts qualitatively for the over-all centre-surround organization of Y cell linear responses, the dependence of frequency-doubled responses on spatial frequency, and impulse rate as a function of time for a variety of bar and grating stimuli. PMID- 3656155 TI - Autonomic control of penile erection in the dog. AB - 1. In anaesthetized dogs, resting mean penile artery pressure (p.a.p.) and corpus cavernosum pressure (c.c.p.) were 70-100% and 10-15% of mean systemic blood pressure, respectively. 2. Stimulation of the pelvic nerve at 10 Hz produced an immediate drop in p.a.p. and c.c.p., followed 10-30 s later by a rise in c.c.p. to the level of p.a.p. This level was 60-90% of systemic pressure, and was maintained throughout stimulation. 3. The threshold for a rise in c.c.p. was 3-5 Hz. Atropine (1 mg/kg), phentolamine (200 micrograms kg-1) and propranolol (200 micrograms kg-1) had no effect on the response to pelvic nerve stimulation. 4. C.c.p., p.a.p. and their changes in response to pelvic nerve stimulation were not significantly altered by either stimulation or section of the hypogastric nerves. 5. Cutting the sympathetic chain on both sides at L5, or administration of phentolamine, had no effect on resting c.c.p. or p.a.p. However, subsequent responses to pelvic nerve stimulation were enhanced. 6. When the pelvic nerve was stimulated during excitation of the sympathetic chain, there was still an initial drop in p.a.p. and c.c.p. but the subsequent increase in c.c.p. was delayed or abolished. These effects were mimicked by close arterial injection of phenylephrine and blocked by alpha-adrenergic antagonists. 7. This study suggests that erections in response to pelvic nerve stimulation result from an initial increase in volume of the corpus spongiosum, followed 20 s later by a stiffening of the corpus cavernosum as its pressure increases. Only the latter process is inhibited by activity of the sympathetic fibres. PMID- 3656156 TI - The transfer of visual information across the corpus callosum: spatial and temporal properties in the cat. AB - 1. The spatial and temporal characteristics of the visual information transmitted across the corpus callosum have been studied in normal cats by recording directly from the corpus callosum and in split-chiasm cats by means of visual evoked potentials (v.e.p.s) and single-unit recordings at the 17/18 border. 2. The modulation transfer functions (m.t.f.s) obtained by recording from the corpus callosum are comparable to the m.t.f.s evaluated by various techniques for the whole visual system of the cat. The spatial and temporal acuities, however, do not reach the values obtained behaviourally or estimated with cortical evoked potentials. 3. In split-chiasm cats, both v.e.p.s and single-unit recordings indicate that the contrast gain of the callosal pathway is considerably lower than the gain of the direct, geniculo-cortical system. Spatial and temporal acuities are lower for the callosal than for the direct system. 4. The same differences in contrast gain between the spatial m.t.f. obtained for the callosal and the direct system have been found in alert split-chiasm cats. 5. Our data suggest that the cross-talk between the hemispheres taking place across the corpus callosum is nearly abolished at low contrasts and high spatial and temporal frequencies. PMID- 3656157 TI - Interhemispheric transfer of visual information in humans: spatial characteristics. AB - 1. The problem of the interhemispheric transfer of visual information in humans has been approached psychophysically, making use of a visual discrimination task that shows a clear left field advantage and is subject to the phenomenon of perceptual learning. 2. For this task (discrimination of complex gratings differing only by the relative spatial phase of their harmonic components) there is a left field advantage and a lack of interhemispheric transfer of learning effects at all spatial frequencies tested for stimuli removed at least 5 deg from either side of the vertical meridian. 3. For stimuli close to the vertical meridian, the left field advantage disappears and there is a complete transfer of learning effects, provided the fundamental spatial frequency is 2 cycles/deg or lower. 4. At higher spatial frequencies the left field advantage is maintained and the learning effects do not transfer from one visual hemifield to the other, even at +/- 0.5 deg from the vertical meridian, unless the contrast is very high. 5. The transfer of learning effects obtained for spatial frequencies of 2 cycles/deg or lower is peculiar to regions placed close to the vertical meridian and symmetrically located on either side of it. No transfer is obtained between non-overlapping regions on the same side of the vertical meridian. 6. These findings are consistent with an interhemispheric transfer of visual information, preferential for low spatial frequencies and high contrasts, in agreement with that found for callosal transfer in the cat (Berardi, Bisti & Maffei, 1987). PMID- 3656158 TI - Analysis of gated membrane currents and mechanisms of firing control in the rapidly adapting lobster stretch receptor neurone. AB - 1. The gated membrane currents (a tetrodotoxin-sensitive Na+ current and a tetraethylammonium- and 4-aminopyridine-sensitive K+ current) of the rapidly adapting stretch receptor neurone of lobster were investigated with respect to their kinetic properties using electrophysiological, pharmacological, and mathematical techniques. 2. The currents were found to be controlled by slow inactivations as well as by fast Hodgkin-Huxley (1952) gating processes. They could be described by kinetic expressions which differed from those inferred for the slowly adapting receptor (Gestrelius & Grampp, 1983a; Gestrelius, Grampp & Sjolin, 1983) only with respect to some of the parameter values. 3. With these expressions, and additional equations for the cell's pump and leak current components (Edman, Gestrelius & Grampp, 1986), a mathematical receptor model was formulated which accurately predicts the impulse activity of the living preparation in different functional circumstances and which, therefore, was adopted as an appropriate theory of firing regulation. 4. From a model analysis it appeared (a) that the 'rapid' adaptation of the receptor's impulse activity is mainly an effect of slow Na+ current inactivation starting a regenerative process of accommodation which, basically, is due to a small ratio of subthreshold Na+ to K+ currents; (b) that, because of the transmembrane Na+ influx being limited by accommodation, impulse firing is only little affected by a Na+-dependent pump current activation; and (c) that the phenomenon of increased firing frequency initially during prolonged stimulation ('negative adaptation') is an effect of the slow K+ current inactivation being faster than the slow Na+ current inactivation at comparable degrees of membrane polarization. 5. From further model studies it also appeared that, during depolarizations between successive action potentials evoked by constant stimulation, the membrane behaves like a high-resistance constant-current generator feeding into a short-circuiting capacitor. In consequence, the cell's stimulus sensitivity (change in firing frequency with stimulation strength) is, at functionally relevant stimulation intensities, mainly determined by the membrane capacitance and by the amplitude of the interspike membrane depolarization while, at higher stimulation intensities and firing frequencies, it becomes more and more a function of the spike duration itself. PMID- 3656159 TI - Respiratory sinus arrhythmia in new-born infants. AB - 1. Ventilation was measured in eleven healthy term infants during both quiet and active sleep, using the trunk plethysmograph, and instantaneous heart rate was derived from the electrocardiogram. Variations in individual respiratory and cardiac cycles were compared in each sleep state, and cross-correlations between ventilation and heart rate were used in the analysis of the data. 2. It was found that heart rate and respiratory rate were higher and more variable during active than during quiet sleep, with a small reduction in tidal volume. 3. Cross correlations showed that respiratory sinus arrhythmia was present in both sleep states, but was more marked during quiet sleep. 4. Running cross-correlations using a 5 s window showed that phase relationships between ventilation and heart rate, were, on the whole, stable during quiet sleep, but markedly unstable during active sleep. 5. It is concluded that in the investigation of respiratory sinus arrhythmia in the new-born, it is important to take account of sleep state, the methods of measuring ventilation and heart rate, and to use analytical techniques suited to the specific purpose of the study. 6. Respiratory sinus arrhythmia is considered to be due to an interaction between systems controlling breathing and those controlling the cardiovascular system, and that this interaction is affected by sleep state. PMID- 3656160 TI - Complex spikes in Purkinje cells in the lateral vermis (b zone) of the cat cerebellum during locomotion. AB - 1. Complex spikes (c.s.s) due to climbing fibre input were recorded from forty one Purkinje cells in the lateral part of the vermis (i.e. the b zone) of lobule V of the cerebellum in cats walking on a moving belt or a horizontal ladder. Most cells were near the tips of the folia making up the lobule and some were shown by antidromic invasion to project to the ipsilateral lateral vestibular nucleus. In all cells c.s.s. could be evoked through mechanical stimuli delivered manually to the neck and/or trunk and/or the limb girdles and/or the proximal parts of the limbs. 2. During walking c.s.s. occurred at rates which ranged in different cells from 0.8 to 2.55/s (i.e. ca. 0.8 to 2/step). When activity was averaged across many successive steps the probability of c.s. occurrence was never completely constant throughout the step cycle, but no tendency was detected for c.s.s to recur at any precisely fixed time during the cycle. 3. When ladder locomotion was perturbed because a rung underwent an unexpected 2 cm descent when stepped on, some cells generated a c.s. at short latency in a proportion of trials. Such responses were well time-locked to the onset of rung movement but not to its cessation (which they often preceded). 4. For perturbations of either forelimb the earliest displacement-related c.s. occurred in different cells between 40 and 64 ms after the onset of rung movement. In different cells c.s.s occurred in from one out of five to three out of four perturbed steps (mean ca. two out of five steps). Eight out of seventeen cells responded to perturbation of the forelimb ipsilateral to the cell and five out of ten responded to contralateral perturbations. 5. Perturbation of the ipsilateral hind limb was accompanied by c.s.s in four out of nine cells and latency was usually longer (by ca. 30-40 ms). One cell showed a decrease in the probability of c.s. occurrence. Insufficient data were obtained for a systematic study of responsiveness to perturbation of the contralateral hind limb. 6. Cells showed different patterns of limb specificity, responding to perturbation of one, two or all of the three limbs studied. In total, c.s.s accompanied perturbation of at least one limb in thirteen out of twenty cells studied (65%).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656161 TI - Contractile and electromyographic characteristics of rat plantaris motor unit types during fatigue in situ. AB - 1. The ventral root dissection technique was used to obtain contractile and electromyogram (e.m.g.) characteristics of ninety-five plantaris motor units in situ in pentobarbitone-anaesthetized rats (n = 20). 2. Motor units demonstrated a wide spectrum of sizes, contractile speeds, and fatigue indices, and were categorized in the same manner as cat hind-limb motor units. Fast-fatigable (f.f.) and fast-intermediate fatigue resistant (f.i.) motor units constituted 20.2 and 25.5% of the motor unit population but together generated over 75% of the cumulative tetanic force. Fast-fatigue resistant (f.r.) and slow motor units composed 43.6 and 10.6% of the population while producing less than 25% of the aggregate tetanic force. 3. Only f.f. and a portion of f.i. motor units demonstrated extensive e.m.g. amplitude reductions during a standard fatigue test. Mean percentage e.m.g. decrease (from the first spike of the first burst to the last spike of the last burst) was 74.0 +/- 27.7% for f.f. units and 28.3 +/- 31.0% (mean +/- S.D.) for f.i. motor units. Relationships between percentage e.m.g. decline and motor unit size (tetanic force) showed significant (P less than 0.01) positive correlations in f.f. (r = 0.71) and f.i. (r = 0.69) motor units. 4. Backward extrapolation of the time course of the force-e.m.g. relationship during the fatigue test revealed that declines in e.m.g. may explain 15, 21 and 66% of the force losses in f.r., f.i. and f.f. motor units. Slow motor units were fatigue resistant and demonstrated a mean e.m.g. decline of 4.3 +/- 6.2%. 5. Indirectly stimulated whole muscle was more fatigable than a composite constructed from motor unit data because of more severe e.m.g. amplitude reductions in the former. 6. The motor unit mechanical and electrical responses during the fatigue test do not summate linearly during whole muscle contractile activity. This is most likely due to the presence, during whole muscle activity, of metabolic changes during the fatigue regimen which influence neuromuscular propagation of excitation, which are not as severe during single motor unit activity. PMID- 3656162 TI - Electrical constants of arterially perfused rabbit papillary muscle. AB - 1. Right ventricular rabbit papillary muscles were arterially perfused with a mixture of Tyrode solution, bovine erythrocytes, dextran and albumin. In the recording chamber, they were surrounded by a H2O-saturated atmosphere of O2 and CO2 which served as an electrical insulator. 2. Conduction velocity and passive electrical properties were determined from intra- and extracellular potentials measured during excitation and during flow of subthreshold current. 3. The propagation of the action potential was linear along the muscle at a velocity of 55.6 cm/s. The extracellular wave-front voltage was 51.5 mV. 4. The following values for passive cable properties were obtained: (i) a ratio of extra- to intracellular longitudinal resistance of 1.2; (ii) an extracellular specific resistance (Ro) of 63 omega cm; (iii) an intracellular specific resistance (Ri) of 166 omega cm; (iv) a space constant lambda of 0.357 mm; (v) a membrane time constant tau of 2.57 ms. The space constant lambda* recalculated for zero extracellular resistance was 0.528 mm. 5. Arresting perfusion with drop of perfusion pressure was associated with an immediate increase of the extracellular longitudinal resistance by 35% and a decrease of conduction velocity by 13%. 6. The present results demonstrate the important contribution of the extracellular resistance to electrotonic interaction and propagation in densely packed myocardial tissue. Moreover, changes in perfusion pressure are associated with changes in extracellular resistance, probably as a consequence of changes in intravascular volume. PMID- 3656163 TI - Water deprivation: effects on fluid and electrolyte handling and plasma biochemistry in Long-Evans and Brattleboro rats. AB - 1. Intakes and urine outputs of fluid and electrolytes were measured before, during and after water deprivation in normal rats (Long-Evans strain) and in vasopressin-deficient rats (Brattleboro strain). 2. In a parallel experiment it was confirmed that the water-deprivation schedule used (Long-Evans rats 53 h, Brattleboro rats 14 h), and previously shown to cause similar percentage reductions in plasma volumes in the two strains, did produce more marked hypernatraemia and hyperosmolality and a greater percentage reduction in body weight in Brattleboro than in Long-Evans rats. 3. In Long-Evans rats, water deprivation caused a gradual reduction in urine output, a reduction in food intake and, during the first 24 h, increases in Na+ and K+ output. In Brattleboro rats, the reduction in urine output was more pronounced, but despite this total water losses were greater than from Long-Evans rats. Brattleboro rats showed a greater reduction in food intake. Their urinary Na+ and K+ losses were elevated during the first 9 h of water deprivation; thereafter these variables fell but remained above the level of intake. 4. The cumulative Na+ losses during water deprivation were similar in the two strains but the cumulative K+ losses in the Brattleboro rats were greater than in the Long-Evans rats. Thus the relative hypernatraemia and hyperkalaemia in water-deprived Brattleboro rats compared to water-deprived Long-Evans rats cannot be explained simply on the basis of differences in renal fluid and electrolyte handling. 5. There were significant increases in plasma angiotensin II and aldosterone levels at the end of the water deprivation periods in both strains of rat, and after the drinking water was returned there was a marked anti-natriuresis consistent with an expression of one of the renal actions of aldosterone. PMID- 3656164 TI - Field potentials generated by group II muscle afferents in the middle lumbar segments of the cat spinal cord. AB - 1. A powerful projection from group II muscle afferents of hind-limb muscles to the 3rd, 4th and 5th segments of the lumbar spinal cord has been demonstrated by focal synaptic field potential recording. 2. Field potentials were found at two locations: one in the dorsal horn (Rexed's laminae IV and V) and the other in the intermediate zone and ventral horn (Rexed's laminae VII and VIII). In the dorsal horn the field potentials were exceptionally large and were evoked only by group II afferents. At more ventral locations, they were smaller and were sometimes preceded by small field potentials evoked by group I afferents. 3. At both locations field potentials could be evoked by stimulation of a number of hind limb muscle nerves at strengths sufficient to activate group II afferents. However, some nerves consistently evoked more powerful effects than others and the largest potentials were from the nerves to quadriceps, sartorius and to the pretibial flexor muscles (tibialis anterior and extensor digitorum longus). Activation of articular afferents (from the knee joint nerve) or Pacinian corpuscle afferents (from the interosseous nerve) evoked small field potentials at some locations. 4. In the dorsal horn the latency of the field potentials was so short that they must have been generated monosynaptically. Field potentials in the ventral horn had longer latencies, by 0.5-1.0 ms, but they also appear to have been monosynaptically evoked by slowly conducting intraspinal collaterals. This conclusion is based primarily on the effects of intraspinal stimulation which was found to antidromically activate afferents with the appropriate latencies and thresholds. 5. Evidence is presented that the dorsal and ventral field potentials are generated by afferents whose receptors can be activated by small (less than 100 micron) muscle stretches. PMID- 3656165 TI - Anterior pretectal stimulation alters the responses of spinal dorsal horn neurones to cutaneous stimulation in the rat. AB - 1. The behavioural effects of stimulating sites in the anterior pretectal nucleus (a.p.t.n.) were studied in unanaesthetized rats; 1-2 weeks later these rats were anaesthetized with Fluothane and the effects of similar electrical stimulation determined on the responses of spinal neurones to cutaneous stimuli. 2. Stimulation of the a.p.t.n. for 15 s with 35 microA r.m.s. sine-wave current inhibited the tail-flick response to noxious heat of unanaesthetized animals for up to 1 h. 3. Stimulation of the same sites in anaesthetized rats inhibited the responses to noxious heat of forty-two multireceptive and two high-threshold neurones located deep in the spinal dorsal horn. 4. The high-threshold responses of seven cells were unaffected or slightly potentiated by pretectal stimulation. These seven cells were all recorded from the dorsal margin of the dorsal horn, were not multireceptive neurones and could be made to discharge only by water above 50 degrees C. 5. The responses of twelve multireceptive cells to low threshold stimulation were not affected by pretectal stimulation. All these cells were recorded from deep within the dorsal horn. 6. On ten occasions, cells deep in the dorsal horn were identified as projection neurones which were driven antidromically by high-frequency (300 Hz) stimulation of the contralateral anterolateral tract at cervical levels. The high-threshold responses of all these cells were reduced by pretectal stimulation. No cells were driven antidromically by pretectal stimulation. 7. Ipsilateral lesions of the dorsolateral funiculus abolished the inhibitory effects of prectectal stimulation. Lesions of the dorsal columns were without effect. 8. It is concluded that stimulation of the a.p.t.n. inhibits the tail-flick reflex of unanaesthetized rats and inhibits the high threshold discharge of deep dorsal horn cells to cutaneous stimuli in anaesthetized rats. Cells recorded from the dorsal margin of the dorsal horn are not affected. The inhibition is mediated via the dorsolateral funiculus and affects cells which project rostrally in the contralateral anterolateral funiculus. PMID- 3656166 TI - The influence of gastrointestinal infusion of fats on regulation of food intake in pigs. AB - 1. The influence of gastrointestinal infusions of fat on short-term and 24 h control of food intake were studied in twenty-four pigs fed twice per day and seventeen fed three times per day. The pigs were fitted with up to four catheters placed in the stomach, the duodenum, and at 2, 4 and 8 m from the ligament of Treitz. 2. Various infusions were given into the catheters beginning 30 min before the first meal (two feeds) or second meal (three feeds) of the day and continuing until the end of the feeding period or until the pigs stopped eating. 3. Infusions of a fat emulsion (Intralipid) into the stomach, of oleic acid or glycerol into the duodenum, or of glycerol into the ileum (8 m from the ligament of Treitz) inhibited food intake during the infusion according to the amount of energy infused. 4. Food intake was inhibited by more than the amount of energy infused with duodenal infusion of Intralipid or monoglyceride, or with infusion of Intralipid mixed with bile salts and lipase (but not with Intralipid alone) into 2 or 4 m from the ligament of Treitz. 5. Duodenal infusion of glycerol, and ileal (8 m from the ligament of Treitz) infusion of monoglyceride or glycerol inhibited food intake at the following meal according to the amount of energy infused. 6. It is concluded that fats can exert both pre- and post-absorptive control of food intake and that since Intralipid infusion to the stomach but not to the duodenum inhibits food intake according to the amount of energy infused, it is likely that control of food intake is related to control of stomach emptying. 7. The inhibition of food intake by more than the amount of energy infused during upper intestinal infusion of fat is likely to be a result of digestion of the fat to monoglycerides, and interaction of monoglycerides with receptors in the proximal 4 m of intestine. PMID- 3656167 TI - Restoration of lung liquid volume following its acute alteration in fetal sheep. AB - 1. The experiments were aimed at determining the means by which lung liquid volume is controlled in fetal sheep. Six unanaesthetized chronically catheterized fetuses between 121 and 144 days of gestation were used in experiments in which lung liquid volume was acutely reduced or increased. 2. The effects on lung liquid volume, secretion and flow in the trachea were continuously monitored until the original volume was restored. Tracheal pressure, breathing activity, electrocortical activity and laryngeal adductor muscle activity were also monitored. 3. Following a mean reduction in lung liquid volume of 54.1% (40.0 +/- 4.3 ml) there was a reduction in tracheal pressure of 1.91 +/- 0.26 mmHg. There was no change in the rate of lung liquid secretion and there was a near cessation in its rate of efflux from the trachea. Influx of liquid from the upper airway was rarely seen. 4. 5 h after its reduction, lung liquid volume had returned to control values. Tracheal pressure and the rate of liquid flow in the trachea returned to control values over 7-8 h. 5. In the hour following the reduction in lung liquid volume the incidence and amplitude of fetal inspiratory muscle electromyogram (e.m.g.) activity were reduced by 19% and 28% respectively. There was no change in laryngeal adductor muscle activity or in the duration of fetal sleep states. 6. When lung liquid volume was increased by 25.4 +/- 3.1 ml tracheal pressure increased by 2.01 +/- 0.17 mmHg. Although there was no change in the rate of liquid secretion there was a rapid efflux of liquid from the trachea principally during epochs of fetal breathing activity thus returning lung liquid volume to its control value. 7. Following the increase in lung liquid volume there were no changes in the incidence or amplitude of fetal inspiratory muscle activity, the activity of laryngeal adductor muscles or in the duration of sleep states. 8. It is concluded that following its alteration in fetal sheep lung liquid volume is restored by passive means. There was no evidence of volume receptive neural reflexes being activated in defence of lung liquid volume. PMID- 3656168 TI - Properties of the inspiration-related activity of sympathetic preganglionic neurones of the cervical trunk in the cat. AB - 1. The experiments reported here have examined some temporal characteristics of the inspiration-related sympathetic discharge of the cat in control conditions and during forcing of the respiratory oscillator into marked deviations from its natural frequency. The purpose of these experiments was to establish whether or not the relation of sympathetic to phrenic nerve activity shows properties consistent with the hypothesis that the inspiration-related sympathetic discharge is driven by a neural oscillator, independent of, but coupled and stably entrained to, the brain-stem respiratory oscillator. 2. The electrical activity of the whole cervical sympathetic trunk (n = 26) or of small strands of the cervical trunk containing single units (n = 20) and of the phrenic nerve was recorded in pentobarbitone-anaesthetized, paralysed, artificially ventilated, sino-aortic denervated cats. Most of the cats were bilaterally vagotomized. 3. The onset of the inspiratory burst of the sympathetic preganglionic neurones had a fixed delay from the onset of the phrenic nerve burst. The level of activity within the burst, in whole cervical trunk recording, reached a maximum in early inspiration and then was maintained at approximately this level for the rest of inspiration (twenty-two out of twenty-six cats). In four cats the activity level increased throughout the burst. Individual sympathetic preganglionic neurones displaying inspiration-related burst firing were characteristically recruited in early inspiration and thereafter maintained an approximately constant firing frequency for the rest of inspiration. 4. Electrical stimulation of afferents in the superior laryngeal nerve during various phases of the respiratory cycle caused equivalent, phase-dependent, resetting patterns of both phrenic nerve and inspiration-related sympathetic discharge. 5. In cats with intact vagus nerves, entrainment of the brain-stem respiratory oscillator to the frequency of the respiratory pump was used to change the frequency of the former, within limits, by changing the frequency of the latter. Over the range of frequencies tested, the pump-to-phrenic delay varied as a function of frequency, while the delay between phrenic and sympathetic burst onset was essentially independent of frequency. 6. In hyperthermic, hypocapnic cats phrenic nerve burst frequency increased up to about 300 bursts/min from a value of 15 bursts/min in normothermia-normocapnia. At all frequencies within this range the sympathetic burst maintained a delay, with respect to the phrenic burst, which was essentially independent of frequency.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656169 TI - Botulinum toxin inhibits quantal acetylcholine release and energy metabolism in the Torpedo electric organ. AB - 1. Type A Botulinum toxin (BoTX) blocked nerve-electroplaque transmission in small fragments of Torpedo marmorata electric organ incubated in vitro. The effect was observed either with the crystalline toxin complex (associated with haemagglutinin) or with the purified neurotoxin (molecular weight approximately 150,000). 2. The quantal content of the evoked post-synaptic response was reduced by BoTX but the quantum size remained unchanged till complete blockade of the evoked response. 3. Spontaneous electroplaque potentials were composed of two populations: one with a bell-shaped amplitude distribution (miniature potentials or quanta) and a population of small events with a skewed distribution (subminiatures). In BoTX-poisoned tissue, the bell-distributed miniatures progressively disappeared, but the subminiatures kept on occurring. Occasionally, larger spontaneous potentials with a slow time course were recorded; they were also BoTX resistant. 4. A biochemical assay showed that evoked acetylcholine (ACh) release was impaired by BoTX. During the period when evoked transmission was blocked, spontaneous ACh release transiently increased. 5. At the time of transmission blockade, there was no significant change of ACh content, of ACh turnover, of ACh repartition in the vesicle-bound and free compartments, or of the number of synaptic vesicles. 6. The amount of ATP was reduced to 50% by BoTX, and that of creatine phosphate (CrP) to less than 20%. The ATP-CrP-converting enzyme, creatine kinase, was inhibited in BoTX-poisoned tissue. 7. Thus, the electrophysiological effects of BoTX are very similar at the nerve-electroplaque and the neuromuscular junctions. The present work suggests in addition that suppression of quantal release by BoTX is related to marked alterations of the energy metabolism in the tissue. PMID- 3656170 TI - Paracellular ionic and transcellular water diffusions across rabbit corneal endothelium. AB - 1. Corneal endothelial cell membrane electrical resistance is estimated at about 400 M omega by using intracellular micro-electrodes. 2. If all ion diffusion across the endothelium were transcellular, electrical resistance of the endothelial monolayer would be about 1300 omega cm2, as there are about 3000 cells mm-2. 3. Measured endothelial monolayer resistance is 12.7 +/- 0.8 omega cm2 (mean +/- S.E., n = 6), which indicates that about 99% of ion diffusion does not cross the transcellular pathway, but must pass through the paracellular route. Arguments are presented which suggest that the proportion may be even higher. 4. Endothelial passive ion permeabilities are about the same as corneal stromal passive ion permeabilities. 5. Stromal water diffusional permeability is about the same as stromal ion permeability, after allowance is made for free diffusion coefficients. In contrast, endothelial water diffusional permeability is so high as to be unmeasurable. 6. It is concluded that ions diffuse across the corneal endothelium through the paracellular route, and that water diffuses across the endothelium mainly through the transcellular route. PMID- 3656171 TI - The apparent reflexion coefficient of the leaky corneal endothelium to sodium chloride is about one in the rabbit. AB - 1. Rabbit corneal thickness changes were measured after some of the NaCl in the bathing Ringer solution was substituted by a neutral sugar. 2. The response had three phases which could be closely modelled by three exponentials of different amplitudes and rate constants, originating from the time of the substitution. 3. The first, fastest, phase was interpreted as being driven by the pure osmotic pressure difference developed across the corneal endothelium by the difference between the removed NaCl and the added sugar in the bathing Ringer solution; the second was driven by the diffusion of NaCl out of the stroma; and the third, slowest, phase was driven by the diffusion of the added sugar into the stroma. 4. Consistent with the interpretation, only the third, slowest, phase had its rate constant dependent upon the nature of the substituting neutral sugar. 5. The amplitude of the pure osmotic phase was a linear function of the added sugar. Its amplitude was zero when an equal osmolarity of sugar was substituted for NaCl. 6. It was concluded that the reflexion coefficient of rabbit corneal endothelium to NaCl is the same as that to sucrose, raffinose and stachyose, i.e. about 1. 7. The calculated hydraulic conductivity of the endothelium plus stroma was about the same as that of stroma alone, and it was concluded that the hydraulic conductivity of corneal endothelium is large compared to corneal stroma. 8. It is proposed that most of the hydraulic flow in response to osmotic gradients passes through the cells, whereas salt diffuses through the paracellular route, resulting in an apparent reflexion coefficient of 1. 9. Thus, corneal endothelium is a 'leaky' (12 omega cm2) salt-permeable epithelium and, according to the present study, simultaneously a semi-permeable membrane. To resolve the terminology, we suggest the term 'bi-permeable' for such epithelia which have a high salt permeability but such a very high water permeability as to give apparent reflexion coefficients of 1. PMID- 3656172 TI - Vasoactive intestinal polypeptide regulation of rabbit renal adenylate cyclase activity in vitro. AB - 1. The effect of vasoactive intestinal polypeptide (VIP) upon adenylate cyclase activity was determined in purified cortical basolateral membranes and in glomeruli and tubular elements obtained from rabbit kidney. 2. In purified basolateral membranes prepared from cortex, 1 microM-VIP consistently stimulated adenylate cyclase activity above basal levels (1.55 +/- 0.09-fold (mean +/- S.E. of mean), n = 10 animals). Half-maximal stimulation was observed at 17 +/- 11 nM VIP (S.D., n = 9). 3. Related peptides, e.g. secretin, glucagon, gastric inhibitory peptide, human pancreatic growth hormone releasing factor, and peptide having N-terminal histidine and C-terminal isoleucine amide (PHI), were without effect or gave lower stimulations of adenylate cyclase activity when tested at 1 microM. 4. Significant VIP degradation was observed under the assay conditions used but this did not substantially alter the response or selectivity to VIP. 5. In separate preparations of isolated glomeruli and proximal tubules addition of 1 microM-VIP resulted in a 3.3 +/- 1.1-fold (S.D., n = 3) and 2.2 +/- 1.0-fold (S.D., n = 3) stimulation (respectively) of adenylate cyclase activity. 6. In isolated medullary tubule suspensions, isolated by collagenase-hyaluronidase digestion of outer (red) medulla, and in thick ascending-limb-enriched preparations prepared by Percoll density gradient fractionation, 1 microM-VIP significantly increased adenylate cyclase activity by 2.4 +/- 0.6-fold (S.D., n = 3) and 2.1 +/- 0.7-fold (S.D., n = 3) respectively. 7. A possible role for VIP in the regulation of renal function in the rabbit is discussed in relation to the occurrence of VIP stimulation of adenylate cyclase activity in several renal cellular elements. PMID- 3656173 TI - Synaptic activation of slow depolarization in rat supraoptic nucleus neurones in vitro. AB - 1. The effects of synaptic activation on rat supraoptic nucleus (s.o.n.) neurones were studied in the hypothalamic slice preparation. Intracellular recordings were obtained from forty-one probable magnocellular neuroendocrine cells using microelectrodes filled with 3 M-potassium acetate. Responses to single and repetitive stimulation of the area dorsolateral to the s.o.n., which would be expected to activate a cholinergic pathway (Hatton, Ho & Mason, 1983), were analysed. 2. In forty of forty-one cells, responses to single stimuli consisted of a short-latency excitatory post-synaptic potential (e.p.s.p.), which was often followed by a brief burst of fast depolarizing events which resembled spontaneous e.p.s.p.s. When the membrane was depolarized, single stimuli could consistently produce a burst of action potentials. 3. Brief trains of orthodromic stimuli produced three effects in most cells. Spontaneous fast depolarizing events, which appeared to be primarily e.p.s.p.s. significantly increased in frequency after the train. A slow membrane depolarization, which lasted up to 1-2 min, was observed in twenty-eight of forty-one cells. In several cells the slow depolarization was accompanied by an increase in input resistance (Ri). In some cells an after-discharge occurred during the slow depolarization. Slow depolarizations were observed in each of eleven phasic neurones, and in a smaller percentage of non-phasic and silent cells. 4. All components of the response to dorsolateral stimulation could be reduced or blocked in low-Ca2+, high-Mg2+ bathing medium. 5. Slow depolarizations were observed when action potentials were not elicited by the stimulus train. The slow depolarization was still present after manipulations that blocked discharge during the stimulus train, including injection of hyperpolarizing current and diffusion of the quaternary ammonium compound QX314. These data argue that the slow depolarization can occur independent of spike depolarizing after-potentials (d.a.p.s). 6. In some cells antidromic stimulation at an intensity just suprathreshold for the recorded cell did not produce comparable bursts of fast depolarizing events or slow depolarizations; similar periods of depolarizing current injection, which produced repetitive discharge, also did not mimic the effects of orthodromic stimulation. 7. The fast depolarizing events appear to reflect spontaneous e.p.s.p.s; increases in the frequency of these events may reflect the after discharge of nearby neurones that are presynaptic to the recorded neurone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656174 TI - In utero right ventricular output in the fetal lamb: the effect of heart rate. AB - 1. The effect of heart rate on right ventricular output was examined in six lambs during a period extending from 126 to 139 days of gestation. The fetuses had been surgically instrumented at least four days previously with a main pulmonary artery flow probe, right ventricular dimension transducers and left and right atrial pacing electrodes. 2. During spontaneous variations in heart rate, rate was correlated positively with right ventricular output (P less than 0.0001) and end-diastolic dimension (P less than 0.0001) among the lambs considered as a group, but no significant effect of rate on stroke volume was found. When individual responses were examined, output increased significantly with rate in sixteen out of seventeen observations. 3. With left atrial pacing, heart rate did not affect output. With right atrial pacing, rate correlated negatively with output (P less than 0.0001). With pacing from either site, rate correlated negatively with end-diastolic dimension (P less than 0.0001) and stroke volume (P less than 0.0001). 4. The introduction of a longer period interval during each pacing rate inhibited the rate-related decrease in dimension and allowed the ventricle to fill to the same end-diastolic dimension. The systole following these longer intervals had a greater stroke volume than did the preceding systoles with smaller end-diastolic dimension. The faster the preceding paced rate, the greater was the increase in stroke volume (P less than 0.001). 5. Right ventricular dimensions and volumes were measured in vitro, and the relationship was found to be linear using regression analysis. 6. This study demonstrates that experimentally induced variations in heart rate produce changes in end-diastolic volume and contractility which prominently affect right ventricular stroke volume. As a consequence, rate has, over a broad range, either no significant effect on output or a negative one. With spontaneous variations in rate, additional changes in contractility and venous return occur which affect stroke volume and end-diastolic volume and enhance right ventricular output. These relationships are similar to those in the adult heart, and demonstrate the absence of a maturational change in the effects of rate on ventricular function from the fetus to the adult. PMID- 3656175 TI - The dynamic response of cat gastrocnemius motor units investigated by ramp current injection into their motoneurones. AB - 1. The isometric force developed by single motor units in response to injection of ramp-and-hold currents into their motoneurones was recorded from the common tendon of the gastrocnemius muscles of the cat. The average rate of rise of the force (force-slope) produced by the ramp-evoked discharge, was found to grow almost linearly with the rate of current injection (current-slope) up to a saturation value (maximal force-slope). 2. The slope of the function which links the force slope to the current-slope is the gain (dF/dI) of the motor unit under dynamic conditions. The value of the dynamic gain, measured in the linear region of growth, displays a large variability, i.e. for each nanoampere of current injected, the force developed is as much as 40 times larger in the strongest than in the weakest motor units. Such large gain differences, however, are drastically reduced if the force is expressed as a percentage of the maximal tetanic tension, Ft: per nanoampere injected, most of the units deliver from 1.0 to 3.0% of Ft. 3. The maximal force-slope which each unit could reach exhibits a large variability, ranging from 0.06 to 4.0 g ms-1. Like the dynamic gain, the maximal force-slope is positively related to Ft. 4. It was found that the dynamic sensitivity of the motoneurone, i.e. the increase of the firing rate per unitary increase of the current-slope, governs the fractional growth of the force-slope, whereas the motor unit contraction time determines the firing rate at which maximal force slope is reached. Together, the two factors co-operate in defining, for each motor unit, the range of input-slopes within which the force-slope is regulated. 5. The motoneurones which supply the weak motor units, those with the lowest dynamic gain, have higher dynamic sensitivity and lower rheobase than those innervating the strong motor units. This suggests that weak motor units need less synaptic current both to be recruited and to reach the maximal speed of force development when their input is supraliminal. PMID- 3656176 TI - Purinergic inhibition in the small intestinal myenteric plexus of the guinea-pig. AB - 1. The actions of adenosine on electrical behaviour of myenteric neurones were investigated with intracellular recording methods in guinea-pig small intestine. 2. The actions of adenosine were: membrane hyperpolarization, decreased input resistance, enhancement of post-spike hyperpolarizing potentials and suppression of excitability. These effects were observed exclusively in AH/type 2 myenteric neurones. 3. The presence of adenosine in the micromolar range of concentrations prevented or suppressed excitatory responses to forskolin. It also aborted the effects of forskolin when added in combination with this activator of adenylate cyclase. 4. Adenosine (100 microM) did not affect the excitatory actions of intracellularly injected cyclic AMP, membrane-permeant analogues of cyclic AMP, inhibitors of cyclic nucleotide phosphodiesterase or elevation of Mg2+ and reduction of Ca2+ in the bathing medium. 5. The results suggest that the mechanism of the inhibitory action of adenosine is suppression of the catalytic activity of adenylate cyclase and consequent reduction of intraneuronal levels of cyclic AMP. PMID- 3656177 TI - Transduction of aminergic and peptidergic signals in enteric neurones of the guinea-pig. AB - 1. The biogenic amines 5-hydroxytryptamine (5-HT) and histamine, and the peptides bombesin, gastrin-releasing peptide (GRP), vasoactive intestinal peptide (VIP), cholecystokinin (CCK), substance P and calcitonin gene-related peptide (CGRP) each mimicked slow synaptic excitation (slow e.p.s.p.) when applied to myenteric neurones of the guinea-pig small intestine. 2. Stimulation of the catalytic activity of adenylate cyclase by forskolin and intraneuronal elevation of cyclic 3',5'-adenosine monophosphate (cyclic AMP) also mimicked the slow e.p.s.p. and the actions of the aminergic and peptidergic messengers. 3. Adenosine prevented stimulation of adenylate cyclase by forskolin and abolished the slow e.p.s.p. like actions of forskolin. 4. Exposure of the neurones to adenosine prior to or during application of bombesin, GRP, VIP, CCK or histamine blocked the actions of these substances. 5. Pre-treatment with adenosine did not suppress the slow e.p.s.p.-like actions of substance P, CGRP or 5-HT. 6. The results suggest that signal transduction for bombesin, GRP, VIP, CCK and histamine involves stimulation of adenylate cyclase and second messenger function of cyclic AMP. Transduction mechanisms for 5-HT, substance P and CGRP appear not to involve second messenger function of cyclic AMP. PMID- 3656178 TI - Activation of cat motor units by paired stimuli at short intervals. AB - 1. In adult cats, paired stimulations at short intervals were applied in ventral root filaments to single motor axons innervating the peroneus tertius muscle. Paired impulses were recorded from the muscle nerve simultaneously with the electrical and mechanical responses of the muscle portion of the motor unit (muscle unit). The interstimulus interval was gradually reduced in order to determine the minimum compatible with a full activation of the muscle unit by the second impulse. 2. For motor units of all physiological types, this minimum stimulus interval was the shortest interval allowing initiation and conduction of two impulses in the axon, that is, the absolute refractory period for conduction. Its duration ranged between 0.58 and 0.88 ms, displaying no correlation with the axonal conduction velocity. 3. The amount of tension enhancement produced by paired stimulations at the shortest interval varied with the type of the motor unit: it was largest for fast-fatigable units, intermediate for fast-resistant units and smallest for slow units. 4. Paired impulses elicited by paired stimulations at the shortest possible interval arrived near the muscle at a longer interval because the second impulse was conducted at a slower velocity. The minimum interval between arrival of impulses at the muscle depended on conduction velocity and on conduction distance. 5. In motor axons to peroneus tertius, paired impulses leaving the spinal cord at a mean interval of 0.78 ms arrived near the muscle separated by a mean interval of 1.90 ms. Since such an interval always allowed full activation of the muscle unit by the second impulse, this interval is longer than the refractory period of motor units in this muscle. PMID- 3656179 TI - Appearance of adenosine in venous blood from the contracting gracilis muscle and its role in vasodilatation in the dog. AB - 1. In dogs anaesthetized with sodium pentobarbitone and artificially ventilated, the gracilis muscles were vascularly isolated and perfused at a constant flow rate of 51.2 +/- 9.8 ml min-1 100 g-1 muscle tissue (183 +/- 17.8% of resting blood flow; mean +/- S.E.; n = 13). 2. Electrical stimulation of the cut peripheral end of the obturator nerve (6 V, 4 Hz) resulted in muscle contraction (658 +/- 118 g 100 g-1 force after 5 min), and an immediate decrease in arterial perfusion pressure from 179 +/- 15.7 mmHg to 87 +/- 10.0 mmHg (51.4 +/- 4.5% decrease in vascular resistance after 2 min of contraction). Venous oxygen tension decreased from 69.2 +/- 5.1 mmHg to 18.5 +/- 1.4 mmHg (n = 6). These values did not significantly alter during the remaining period of stimulation (10 20 min). 3. The concentration of adenosine in arterial plasma did not change significantly during muscle contraction (137 +/- 23 nM; n = 10). However, the adenosine concentrations in venous plasma showed a significant (P less than 0.01) increase from a control value of 164 +/- 55 nM to 455 +/- 77 nM (n = 9) after 5 min of muscle contraction and remained high during the rest of the 20 min contraction. In six of the dogs adenosine concentrations were determined after 1 and 3 min of contraction and showed a smaller but statistically significant (P less than 0.05) rise in venous concentration. 4. During infusion of adenosine into the artery to give plasma concentrations between 0.3 microM and 1 mM, 72.6 +/- 2.1% (n = 29) of the infused adenosine was taken up by the tissues before it reached the vein. Comparison of vasodilatation and venous adenosine concentrations during adenosine infusion and muscle contractions showed that the released adenosine could contribute about 15% to the total vasodilatation after 1 min and about 40% between 5 and 20 min of contractions. Released adenosine could contribute about 80% to the vasodilatation that remained 5 min after the withdrawal of stimulation. Arterial perfusion pressure took 22 min to return to control, whereas adenosine release had fallen to zero within 10 min. 5. These data suggest that the released adenosine could contribute to exercise hyperaemia, but is unlikely to be the main factor, particularly in the initial stage. PMID- 3656180 TI - Co-operative action of calcium ions in dopamine release from rat brain synaptosomes. AB - 1. The release of [3H]dopamine from isolated presynaptic nerve terminals (synaptosomes) prepared from rat striata was measured as a function of the external Ca2+ concentration ([Ca2+]o). 2. In synaptosomes depolarized by the addition of 50 mM-K+, release of [3H]dopamine increased in a highly non-linear manner with [Ca2+]o. The release could be described as a third power function of [Ca2+]o. 3. Both 45Ca2+ influx and the change in the free cytosolic Ca2+ concentration ([Ca2+]i, measured with the fluorescent Ca2+ indicator fura-2) that were evoked by depolarization increased in a linear manner with [Ca2+]o. 4. These results suggest that non-linearity in the [Ca2+]o dependence of transmitter release originates in a co-operative relation between [Ca2+]i and exocytosis. PMID- 3656182 TI - Lung and cardiac reflex actions on the tracheal vasculature in anaesthetized dogs. AB - 1. With pentobarbitone-anaesthetized dogs, the cranial tracheal arteries have been independently perfused on both sides, to measure vascular resistance. Blood pressure and contractions of tracheal muscle were also measured. 2. Capsaicin was injected intravenously to stimulate lung C-fibre receptors. In breathing and in paralysed artificially ventilated dogs it decreased tracheal vascular resistance and blood pressure, and contracted tracheal muscle. The effects were abolished or far smaller after bilateral cervical vagosympathectomy. 3. Veratrine was injected intravenously to stimulate slowly adapting pulmonary stretch receptors and cardiac receptors. In breathing and in artificially ventilated dogs it lowered tracheal vascular resistance and blood pressure, and had variable effects on tracheal muscle tone. The vascular effects were prevented by vagotomy. 4. Veratrine injected into the left atrium caused similar vascular changes to intravenous administration. The changes were prevented by vagotomy. Veratrine causes a tracheal vasodilatation by action on cardiac receptors. 5. Inflation of the lungs in artificially ventilated dogs, to stimulate slowly adapting pulmonary stretch receptors, had no effect on tracheal vascular resistance but decreased blood pressure and tracheal muscle tone, the latter being prevented by vagotomy. 6. Bilateral carotid arterial occlusion, to decrease the discharge in carotid sinus baroreceptors, had no effect on tracheal vascular resistance but increased blood pressure and contracted tracheal muscle, the last two responses being greatly reduced by cutting the sinus nerves. 7. It is concluded that stimulation of lung C-fibre and cardiac receptors causes a reflex tracheal vasodilatation, but that no changes in the tracheal vascular bed occur with stimulation of slowly adapting pulmonary stretch receptors or inhibition of carotid sinus baroreceptors. PMID- 3656181 TI - Contractile effects of perivascularly applied vasopressin on the pial artery of the cat brain. AB - 1. The effects of perivascularly applied vasopressin on the diameter of pial arteries (control 298 +/- 14 S.E. micron) of the brain were examined after chronic implantation of a cranial window in fifteen anaesthetized cats. 2. Application of vasopressin resulted in a dose-dependent contraction. The threshold concentration for contraction was 3 X 10(-10) M, the half-maximal effective concentration (ED50) (1.6 +/- 0.2) X 10(-9) M, and the maximum reduction in artery diameter 37 +/- 2%. 3. The contraction was powerfully inhibited by perivascular application of a 10(-7) M solution of the vasopressin antagonist, [1-(beta-mercapto-beta,beta-cyclopentamethylenepropionic acid),2-(O methyl)tyrosine]arginine vasopressin. 4. Perivascular application of noradrenaline induced a dose-dependent contraction of the pial artery. The ED50 was (8.9 +/- 2.5) X 10(-7) M, and the maximum reduction in artery diameter was 33 +/- 2%. 5. Such noradrenaline-induced contraction was not modified at all in the presence of a subthreshold dose (2 X 10(-10) M) of vasopressin (P greater than 0.05, for the over-all difference in size of the contraction, ED50 and maximum contraction). 6. In another experimental setting it was also found that neither the subthreshold nor a suprathreshold (10(-9) M) dose of vasopressin modified the contraction induced by 10(-6) M-noradrenaline (P greater than 0.05, compared to the contraction in the absence of vasopressin). 7. Thus a powerful and sensitive contractile response of the pial arteries to perivascularly applied vasopressin was demonstrated. However, the modifying effect of vasopressin on the contraction induced by perivascularly applied noradrenaline was minimal. PMID- 3656183 TI - Gating properties of the mechano-electrical transducer channel in the dissociated vestibular hair cell of the chick. AB - 1. The gating property of a mechano-electrical transduction (m-e.t.) was studied in dissociated chick vestibular hair cells having hair bundles of varying length (from 7 to more than 30 microns long). The whole-cell recording voltage-clamp technique was used to record m-e.t. currents, and mechanical stimuli were applied to the hair bundle with a rigid glass rod. 2. Displacements of the glass rod and the hair bundle were measured with a resolution of 0.1 micron from contrast enhanced television images. The motion of the hair bundle was tightly coupled to the motion of the stimulating glass rod, and displacements were not detected in the circumference of the cell body. Thus, all the displacement applied to the hair bundle resulted in bending about the insertion into the cuticle and relative to the cell body. 3. Displacements of the hair bundle towards the taller stereocilia generated inward-going m-e.t. currents at negative membrane potentials, while displacements of the hair bundle towards the shorter stereocilia generated outward-going m-e.t. currents. These outward going m-e.t. currents reflect closing of the m-e.t. channels which are open at the resting position of the hair bundle. The fraction of these channels open at the resting position was 0.12 +/- 0.04 (n = 7). 4. The displacement-response relationship measured both at -50 mV and at +38 mV were superimposable after scaling. Thus, no voltage dependence was observed in gating of the m-e.t. conductance. 5. When a hair bundle of a shorter length (less than 7.5 microns long) was stimulated at 5 micron form the insertion to the cuticle, the minimum hair-bundle displacement which could generate a detectable amount of m-e.t. current was 0.01 micron. The transduction current was linearly related to the hair-bundle displacement for values of up to 0.6 micron towards the taller stereocilia, and showed saturation with larger displacements. 6. When a hair bundle of a longer length (more than 12.5 microns long) was stimulated (towards the taller stereocilia) at 10 micron from the insertion to the cuticle the m-e.t. current generated was linear for displacements of up to 1.5 micron, and saturated with larger displacements. 7. The above two points suggest that the range of linear transduction becomes wider as the length of the hair bundle becomes longer under in situ conditions where the displacement is likely to be applied at the tip of the hair bundle.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656184 TI - Responses of Purkinje cells and mossy fibres in the flocculus of the monkey during sinusoidal movements of a visual pattern. AB - 1. Discharges of Purkinje cells (P cells) and mossy fibres were recorded from the cerebellar flocculus of monkeys trained to fixate a stationary visual target. The units were tested with a sinusoidally moving random dot pattern (background) which was projected on an entire screen or on part of it. The receptive field organization of the units was tested by changing the area of stimulus presentation on the screen and by changing the direction of visual fixation. 2. When stimulated with sinusoidal movements of the background in the horizontal plane, ninety-two of 684 Purkinje cells (13.5%) responded to the retinal-slip velocity. Seventy-eight of the ninety-two visually responsive Purkinje cells (84.8%) also showed cyclic modulations in activity during horizontal smooth pursuit eye movements (these were so-called horizontal gaze-velocity Purkinje cells). 3. In response to the sinusoidal retinal-slip velocity, the visual Purkinje cells showed six types of discharge patterns. Type 1 Purkinje cells (28/92 or 30.4%) were directionally selective: they showed a peak activity during background movement in one direction and a trough in the other. Both peaks and troughs were related to stimulus velocities. Their receptive fields were relatively large (greater than 45 deg) and included the fovea. 4. Type 2 (8/92 or 8.7%) and type 3 (5/92 or 5.4%) Purkinje cells showed sinusoidal responses similar to those of type 1 Purkinje cells, but the visual inputs were primarily excitatory in type 2 Purkinje cells and inhibitory in type 3 Purkinje cells. Only the peaks in type 2 and troughs in type 3 were related to stimulus velocities. 5. Type 4 (4/92 or 4.3%) and type 5 (11/92 or 12.0%) Purkinje cells showed responses to stimulus movements in both directions (bidirectional). When the moving background was projected with 10 deg of fixation, type 4 Purkinje cells were excited bidirectionally in relation to retinal-slip velocities. When the periphery of either hemiretina was stimulated, type 5 Purkinje cells were inhibited and the trough activity was stimulus-velocity dependent. Receptive fields were found in the ipsilateral hemiretinae in seven type 5 Purkinje cells and in the contralateral hemiretinae in the remaining four type 5 Purkinje cells. 6. Type 6 (36/92 or 39.1% Purkinje cells received an excitatory input from the central retina and an inhibitory input from the periphery. The peripheral receptive fields were either in the ipsilateral (69.4%) or contralateral (30.6%) hemiretinae of both eyes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656185 TI - Actions of gamma-aminobutyric acid on rat supraoptic nucleus neurosecretory neurones in vitro. AB - 1. Intracellular recordings were obtained from thirty-eight rat supraoptic nucleus (s.o.n.) neurosecretory neurones in perfused hypothalamic explants. Changes in membrane potential and conductance were monitored following application of gamma-aminobutyric acid (GABA), and related agonists and antagonists. 2. GABA depressed action potential discharge of all of thirty-five s.o.n. neurones tested and induced either membrane hyperpolarization or depolarization. Neurones that displayed membrane hyperpolarization in response to lower GABA concentrations (30-300 microM) demonstrated a biphasic membrane voltage change with a later depolarizing phase as a response to higher concentrations (up to 3000 microM). 3. GABA (10-3000 microM) induced a prominent concentration-dependent increase in membrane conductance in all neurones. The critical slope for the log-log plot of [GABA] vs. GABA-induced membrane conductance was 1.7, indicating co-operativity in the GABA receptor-induced conductance change. 4. Muscimol (0.3-30 microM) potently mimicked all the effects of GABA. Bicuculline (1-100 microM) antagonized the effects of GABA and muscimol in a competitive manner. 5. Glycine and taurine (1-10 mM) had weak effects, although comparatively similar to those of GABA. These actions were blocked both by bicuculline (100 microM) and by strychnine (1 microM). At higher concentrations (greater than 10 microM), strychnine also antagonized the actions of GABA. 6. In recordings with potassium-acetate-filled micropipettes, the reversal potential of hyperpolarizing membrane voltage responses to GABA was 72.5 +/- 1.5 mV in close agreement (+/- 5 mV) with the reversal potential of inhibitory post-synaptic potentials (i.p.s.p.s) recorded in the same neurones. Depolarizing responses to GABA reversed polarity at -50 +/- 1.6 mV. In recordings with KCl-filled micropipettes, voltage responses to GABA were always depolarizing and reversed near -40.0 +/- 4.3 mV. Similarly, reduction of the concentration of chloride ions in the perfusion medium from 134 to 10.4 mM induced a positive shift of the GABA reversal potential by 40-50 mV. 7. From measurements of input resistance (Rin) and cell time constant (tau O), input capacitance (Cin; representing total membrane capacitance) was calculated as 78.9 +/- 2.1 pF. During responses to GABA or muscimol, decreased Rin was accompanied by a linearly related decrease in tau o indicating that these substances had no effect on the membrane capacitance of s.o.n. neurones.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656186 TI - The role of external compression and movement in lymph propulsion in the sheep hind limb. AB - 1. Pressure fluctuations and lymph flow were measured in metatarsal lymphatics in anaesthetized sheep. 2. Intermittent compression significantly increased lymph flow when this was applied over the hoof but did not increase flow significantly when applied over the metatarsal region. 3. In a second preparation a 15 cm length of metatarsal lymphatic was cannulated at both ends and measurements were made of the ability of the duct to pump saline from an inflow reservoir through an outflow at the same height. 4. In the absence of external forces fluid was propelled by the lymphatic's intrinsic contractions but when intermittent compression was applied over the metatarsal region flow increased almost fourfold. 5. When animals with the doubly cannulated duct were allowed to recover, the effect of normal limb movements on fluid propulsion was examined. Under these conditions flow only occurred in response to intrinsic lymphatic contractions and appeared to be unaffected by the animal moving round the cage. 6. These results suggest that the effects of external forces on lymph flow are more dependent on compression of tissues in the lymphatic drainage area than on compression of the main lymphatic ducts. External compression can increase fluid propulsion by these vessels but, since forces of adequate magnitude appear not to be encountered in normal hind-limb movements, lymph propulsion in this region must depend on intrinsic lymphatic pumping. PMID- 3656187 TI - The velocity dependence of direction selectivity of visual cortical neurones in the cat. AB - 1. The range of velocities, yielding direction-selective responses, was investigated in a total of 167 direction-selective cells from areas 17 and 18 of the cat, using a high-contrast light bar moving at velocities ranging from 0.6 to 900 deg s-1. 2. 11% of the cells were direction selective over the full range of velocities tested. Most cells (66%) gave only responses at low velocities and thus were not direction selective at high velocities. The remaining cells gave responses over a broad range of velocities but the direction selectivity was limited to either high or intermediate velocities (18 and 5% of the cells, respectively). Cells with direction selectivity at high but not at low velocities had large receptive fields with non-overlapping 'on' and 'off' subregions and they responded quickly and phasically to stationary flashes. This suggests that the latter cells relied on fast and brief interactions over large distances. 3. In thirty cells the spatial and temporal limits of direction selectivity were investigated using a stroboscopically illuminated moving light bar. In all cells direction selectivity depended both on the interflash distance and the interflash time interval. Area 17 cells with large receptive field at high eccentricity tolerated much larger interflash spacings than area 17 cells with small receptive fields near the area centralis. For eleven of the thirty cells the effective interflash distance could be larger than the width of the receptive field. The largest effective interflash time interval varied between 35 and 250 ms. 4. Eight of the thirty cells were direction selective at high but not at low velocities. These eight cells all remained direction selective over large interflash distances and they required brief interflash intervals (less than or equal to 65 ms). 5. Responses to single stroboscopic flashes within the sequence were observed in ten cells, which all responded well at high apparent velocities. While most cells (eight out of ten) showed both response increments in the preferred direction and response decrements in the non-preferred, the decrements constituted the dominant element in the direction selectivity of six out of ten cells while the remaining four cells relied mainly on response increments. 6. It is concluded that the range of direction-selective velocities of some cat visual cortical cells can be predicted from a knowledge of the spatial extent and the time course of the direction-selective interactions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656188 TI - Characterization of metachronal wave of beating cilia on frog's palate epithelium in tissue culture. AB - 1. A method is suggested to measure phase versus distance between beating cilia by means of a photoelectric device. A statistical method interpreting the results thus obtained is discussed. 2. It was found that: (a) an average phase exists between beating cilia, (b) despite strong fluctuations in phase on a short time scale, the average phase was kept constant over periods of 8 h, (c) the ciliary frequency and the length of the metachronal wave can be measured simultaneously. 3. The average phase differences are linearly dependent on distance. 4. The effective range of synchronization between cilia is of the order of 10 micron indicating that it occurs within one cell. 5. During the cycle of ciliary beating there are periods where coupling is stronger. PMID- 3656189 TI - Effects of morphine on electrical activity of the rectum in man. AB - 1. The effects of morphine on the electrical activity of the human rectum were investigated. 2. In healthy volunteers, morphine (0.04-0.16 mg/kg, i.v.) induced spike activity that could become cyclical. 3. All the effects of morphine were antagonized by naloxone (0.03-0.2 mg/kg, i.v.), but not blocked by atropine (0.007-0.014 mg/kg, i.v.). 4. In patients with spinal cord injury, morphine was observed to have similar excitatory effects. Spinal cord transection was complete in all patients, so that participation of supraspinal nervous structures in these effects could be ruled out. The sacral parasympathetic nervous centres could not have been involved in two patients in whom the medullary cone was also destroyed. The thoracolumbar sympathetic nervous centres were not completely destroyed in any of the patients, however, so that the possibility that these centres may have been involved cannot be entirely ruled out. 5. Morphine failed to activate an aganglionic rectum in a patient with Hirschsprung's disease, indicating that it had no direct effect on smooth muscle cells. It is therefore probable that morphine may have an effect on the intrinsic innervation. PMID- 3656190 TI - Specificity of synaptic regeneration in the spinal cord of the larval sea lamprey. AB - 1. Pairs of central neurones in large larval sea lampreys were impaled with micro electrodes and studied for synaptic connexions in both unoperated control animals and animals which had recovered from complete spinal transection. Two identified classes of neurones served as post-synaptic targets: giant interneurones (g.i.s) and lateral cells (l.c.s). Several identified neurone types were tested as potential sources of presynaptic input. 2. When synaptic potentials had short, fixed latencies they also persisted during activation of the presynaptic cell at 3.3-33.3 Hz and were not eliminated after addition of lamprey saline containing high (20 mM) Ca2+. These presumably represented monosynaptic connexions. Variable latency responses were eliminated by faster rates of stimulation of the presynaptic cell and were mediated via polysynaptic pathways. 3. In control animals, g.i.s received monosynaptic input from more caudal g.i.s in fourteen of thirty-two tested cell pairs. These excitatory post-synaptic potentials (e.p.s.p.s) were composite electrochemical responses. The amplitudes of the earlier electrical component averaged 1.66 +/- 0.24 mV (mean +/- S.E. of mean) and the amplitude of the later chemical component averaged 0.79 +/- 0.05 mV. 4. In operated larvae, eight of forty-seven g.i.-g.i. pairs separated by the transection scar were connected by monosynaptic composite e.p.s.p.s. In these pairs the electrical component averaged 0.84 +/- 0.17 mV (P less than 0.05 vs. control) and the chemical component averaged 1.56 +/- 0.40 mV. The average conduction velocity between these cells was less than that in control g.i.-g.i. pairs (0.93 +/- 0.11 vs. 1.61 +/- 0.25 m/s; P less than 0.01). 5. The l.c.s showed monosynaptic e.p.s.p.s after activation of a subset of the bulbar Muller neurones (B2-4) in seven of twelve pairs. In behaviourally recovered larvae three of twenty-two similar pairs separated by the transection scar were also connected via monosynaptic e.p.s.p.s. The average conduction velocity between these experimental neurones was also less than that in control bulbar-l.c. pairs (1.03 +/- 0.03 vs. 1.58 +/- 0.09 m/s; P less than 0.001). 6. Several types of neurones were either infrequently linked or never connected to g.i.s or to l.c.s in control larvae. In animals which had recovered from a spinal transection, no synaptic connexions were found from such neurones on to g.i.s or l.c.s respectively, in 124 tested cell pairs. In addition, dorsal cells (intraspinal primary sensory neurones) received no synaptic input upon stimulation of the spinal cord before or after transection.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656191 TI - Push-pull effect of surround illumination on excitatory and inhibitory inputs to mudpuppy retinal ganglion cells. AB - 1. Changes in membrane potential and conductance were measured in on-centre and off-centre ganglion cells during the responses to illumination of different portions of the receptive field. 2. In on-centre ganglion cells the sustained depolarizing response to steady illumination of the receptive field centre was associated with a net increase in conductance. In the presence of centre illumination, stimulation of the surround with an annulus of light caused a hyperpolarization and a net decrease in conductance, and the reversal potential of the light-evoked response was shifted in a negative direction. In the absence of centre illumination the same annular stimulus caused a hyperpolarization and a net increase in conductance. 3. In off-centre ganglion cells the sustained hyperpolarizing response to centre illumination was associated with a net increase in conductance. In the presence of centre illumination, stimulation of the surround with an annulus caused a depolarization and a net decrease in conductance, and the reversal potential of the light-evoked response was shifted in a positive direction. In the absence of centre illumination the same annulus caused a depolarization and a net increase in conductance. 4. The results indicate that illumination of the receptive field surround can affect both the excitatory and inhibitory sustained inputs to a given ganglion cell in a 'push pull' manner, by decreasing the synaptic input that was increased by centre illumination and increasing the synaptic input of opposite sign. The relative effect of a given surround illumination on these two inputs, and hence the sign and magnitude of the net conductance change, varied with the amount of centre illumination. PMID- 3656192 TI - Calcium-stimulated sodium efflux from rabbit vascular smooth muscle. AB - 1. The effects of the addition of Ca2+ on ouabain-resistant 22Na+ efflux from Na+ loaded strips of rabbit portal anterior mesenteric vein in Ca2+-free media have been studied. 2. Na+ efflux into Li+ media containing 5 mM-KCl is rapidly and transiently stimulated some 4- to 5-fold on the addition of Ca2+ (1.2 mM). No stimulation is observed if the Li+ medium is K+ free or if Na+ replaces Li+ ions. This Ca2+-activated Na+ efflux is not obligatorily coupled to Na+ influx. 3. The stimulation of Na+ efflux could also be triggered by the addition of 5 mM-K+ to a Ca2+-containing K+-free medium. The Ca2+-activated increase in Na+ efflux also occurred when K+ was the sole monovalent extracellular cation. Rb+ could substitute for the K+ requirement. Thus the Na+ efflux is not mediated by a system which has a specific requirement for counter-transport of Li+ or one in which Li+ but not K+ are counter-transported such as the familiar Na+-H+ exchange system. Acidification of the external medium reduced the Ca2+-stimulated Na+ efflux, in keeping with the conclusion that this efflux was not due to Na+-H+ exchange. 4. Progressive reduction of external [Ca2+] increased the time-lag to peak activation of Na+ efflux, suggesting that the effects of added Ca2+ were mediated by a rise in intracellular Ca2+. Under experimental conditions which did not result in activation of the Na+ efflux by the addition of extracellular Ca2+ alone (e.g. in Na+ media), addition of Ca2+ plus the Ca2+ ionophore, ionomycin, stimulated Na+ efflux. This further confirms that intracellular sites for Ca2+ are critical for the activation of Na+ efflux. In the absence of ionophore, in Na+ media, intracellular Ca2+ is not sufficiently increased when extracellular Ca2+ is added. A partial (40%) block of Ca2+-activated Na+ efflux by amiloride (2 X 10(-3) M) could also be overcome by the addition of ionomycin. 5. The lack of effect of a variety of inhibitors suggests that the Ca2+-stimulated Na+ efflux mechanism is not mediated via a Na+-K+-Cl- co-transport system or a Na+-H+ counter-transport system, or Na+-Ca2+ exchange. 6. The activation of Na+ efflux in smooth muscle by Ca2+ ions seems to involve Ca2+ entry partially via an extracellular Ca2+-intracellular Na+ exchange and also through other parallel pathway(s), followed by a rise in intracellular Ca2+ that activates Na+ efflux through a Ca2+-sensitive Na+ channel or other transport pathway. PMID- 3656193 TI - Modulation of the vagal drive to the intramural cholinergic and non-cholinergic neurones in the ferret stomach by baclofen. AB - 1. In the urethane-anaesthetized ferret vagotomy (cervical and abdominal) and hexamethonium both produced an increase in gastric corpus pressure after treatment with atropine and guanethidine, section of the greater splanchnic nerves and adrenalectomy. 2. The pressure increase was due to an interruption of a tonic vagal drive to the intramural non-adrenergic, non-cholinergic inhibitory neurones. 3. The GABAB receptor agonist baclofen (8 mg/kg s.c.) produced an increase in gastric pressure and enhanced the amplitude of the rhythmic contractions. Baclofen was without effect in vagotomized animals. 4. In the presence of atropine, guanethidine, adrenalectomy and section of the greater splanchnic nerves, baclofen produced only a slight enhancement of rhythmic contractions but the large increase in gastric pressure was still present. Under the above conditions the effects of baclofen on the whole stomach were virtually identical to those observed in the corpus region alone. 5. Baclofen was without effect on the magnitude of the corpus relaxation produced by the submaximal vagal efferent stimulation in the presence of atropine. 6. These results demonstrate that the GABAB agonist baclofen, probably acting at a central site, enhanced rhythmic gastric activity by increasing the vagal drive to the intramural cholinergic neurones. Simultaneously gastric pressure was increased primarily by a reduction in the tonic vagal drive to the intramural non-adrenergic, non cholinergic inhibitory neurones in the corpus region. The results of both the baclofen and vagotomy studies further demonstrate the importance of the vagal innervation of the non-adrenergic, non-cholinergic inhibitory neurones in the regulation of gastric pressure. PMID- 3656194 TI - Vasoactive intestinal polypeptide stimulates the secretion of catecholamines from the rat adrenal gland. AB - 1. Our previous studies have indicated that splanchnic nerves release a substance(s), other than acetylcholine, that induces the secretion of catecholamines from the rat adrenal medulla. To identify the nature of the non cholinergic substance, the effects of met-enkephalin and vasoactive intestinal polypeptide (VIP) were investigated in the perfused adrenal gland of the rat. 2. The secretion of catecholamines increased from a basal level of 8 ng to a maximum value of 18 ng during perfusion with 100 microM-met-enkephalin. The secretion evoked by 10 micrograms acetylcholine increased from 118 to 143 ng in the presence of 10 microM-met-enkephalin. Higher concentrations of met-enkephalin (100 microM) had no additional effect. Secretion of catecholamines evoked by stimulation of splanchnic nerves (10 Hz for 30 s) was even less (8%) affected by met-enkephalin. 3. 0.3 microM-VIP caused a significant increase in the secretion of catecholamines, and the effect increased with an increase in the concentration of VIP. About 115 ng of catecholamines were secreted during 15 min perfusion with 3 microM-VIP. 4. VIP-evoked secretion was not affected by antagonists of nicotinic and muscarinic receptors, nor by chronic splanchnicotomy. However, removal of calcium ions from, and inclusion of 1 mM-EGTA in, the perfusion medium completely inhibited the secretion evoked by VIP. 5. VIP-evoked secretion was reduced (20-75%) in a concentration-dependent manner by 3-30 microM-naloxone. 6. It is suggested that VIP may be the non-cholinergic excitatory substance present in the splanchnic nerves and released along with acetylcholine during simulation of the nerves to evoke secretion of catecholamine from the rat chromaffin cells. PMID- 3656195 TI - A fast motile response in guinea-pig outer hair cells: the cellular basis of the cochlear amplifier. AB - 1. Outer hair cells from the cochlea of the guinea-pig were isolated and their motile properties studied in short-term culture by the whole-cell variant of the patch recording technique. 2. Cells elongated and shortened when subjected to voltage steps. Cells from both high- and low-frequency regions of the cochlea responded with an elongation when hyperpolarized and a shortening when depolarized. The longitudinal motion of the cell was measured by a differential photosensor capable of responding to motion frequencies 0-40 kHz. 3. Under voltage clamp the length change of the cell was graded with command voltage over a range +/- 2 microns (approximately 4% of the length) for cells from the apical turns of the cochlea. The mean sensitivity of the movement was 2.11 nm/pA injected current, or 19.8 nm/mV membrane polarization. 4. The kinetics of the cell length change during a voltage step were measured. Stimulated at their basal end, cells from the apical (low-frequency) cochlear turns responded with a latency of between 120 and 255 microseconds. The cells thereafter elongated exponentially by a process which could be characterized by three time constants, one with value 240 microseconds, and a second in the range 1.3-2.8 ms. A third time constant with a value 20-40 ms characterized a slower component which may represent osmotic changes. 5. Consistent with the linearity shown to voltage steps, sinusoidal stimulation of the cell generated movements which could be measured at frequencies above 1 kHz. The phase of the movement relative to the stimulus continued to grow with frequency, suggesting the presence of an absolute delay in the response of about 200 microseconds. 6. The electrically stimulated movements were insensitive to the ionic composition of the cell, manipulated by dialysis from the patch pipette. The responses occurred when the major cation was K+ or Na+ in the pipette. Loading the cell with ATP-free solutions or calcium buffers did not inhibit the response. 7. It is concluded that interaction between actin and myosin, although present in the cell, is unlikely to account for the cell motility. Instead, it is proposed that outer hair cell motility is associated with structures in the cell cortex. The implications for cochlear mechanics of such force generation in outer hair cells are discussed. PMID- 3656196 TI - Intracellular studies of the electrophysiological properties of cultured intracardiac neurones of the guinea-pig. AB - 1. The electrophysiological properties of intracardiac neurones cultured from ganglia within the atria and interatrial septum of the new-born guinea-pig heart were studied using intracellular micro-electrodes. 2. Three types of neurones with resting membrane potentials in the range -45 to -76 mV were detected. The first type, AHs cells, had high (15-28 mV) firing thresholds, pronounced slow post-spike after-hyperpolarizations and fired only once to prolonged intrasomal current injection. The second type, AHm cells, were similar to AHs cells, except that they could fire short bursts of spikes (100-400 ms) at the onset of current injection. The third type, M cells, had low firing thresholds (10-15 mV), no slow after-hyperpolarizations and produced non-adapting trains of action potentials in response to depolarizing current injection. 3. The generation of action potentials in M cells was prevented by tetrodotoxin (TTX; 0.3 microM), whereas in AHs and AHm cells action potentials displayed a channel blockade using solutions containing the divalent cations cadmium, cobalt or manganese (0.02-1 mM). 4. The post-spike after-hyperpolarization in AHs and AHm cells was abolished by the removal of extracellular calcium, shortened in solutions containing the calcium entry blockers CdCl2, MnSO4 and CoCl2 (0.02-1 mM) and prolonged by the addition of calcium (5.0 mM), tetraethylammonium (1-3 mM), 4-aminopyridine (1-3 mM), cyanide (10 microM) or caffeine (100 microM) to the perfusate. 5. The reversal potential of the post-spike after-hyperpolarization was -89.1 mV. This value changed by 62.9 mV for a 10-fold increase in extracellular potassium concentration. 6. The peak conductance change during the post-spike after hyperpolarization (gK,Ca), was largely independent of membrane potential between 50 and -110 mV. The peak increase in gK,Ca and the duration of the after hyperpolarization increased with the number of spikes preceding it. 7. It is concluded that calcium entry during the action potential is responsible for the activation of an outward potassium current in the two types of AH cells; the roles played by intracellular calcium extrusion as well as sequestration mechanisms in the generation of the response are discussed. PMID- 3656198 TI - Absence of a relationship between arterial pH and pancreatic bicarbonate secretion in the isolated perfused cat pancreas. AB - 1. The secretion rate of bicarbonate by the isolated saline-perfused cat pancreas was linearly related to the bicarbonate concentration of the arterial inflow at constant PCO2 and at high volume rates of secretion. 2. Pancreatic bicarbonate secretion was independent of arterial inflow pH at constant bicarbonate concentrations when the pH was manipulated by alterations in the PCO2 at high volume rates of secretion. 3. A small but statistically significant linear relationship existed between the pH of the arterial inflow and bicarbonate secretion at constant PCO2 after inhibition of carbonic anhydrase by acetazolamide. Under the same conditions no relationship was found between bicarbonate secretion and arterial inflow pH when the perfusate bicarbonate concentration was kept constant and the PCO2 varied. 4. When the volume rate of secretion was reduced by about 60-70% of maximum no relationship was found to exist between arterial inflow pH and bicarbonate secretion at constant bicarbonate concentration in the perfusate. There was also no relationship between inflow pH and bicarbonate secretion at constant PCO2 down to a pH of 7.3 until the bicarbonate concentration of the perfusate was reduced below 10 mM, when the secretion rate fell off rapidly. 5. A linear relationship was found to exist between the volume rate of secretion and the PCO2 of the pancreatic juice and the output of lactate both in the isolated saline-perfused gland and the blood-perfused pancreas in situ. 6. At high rates of secretion the PCO2 of the pancreatic juice was always higher than that of either the arterial inflow or the venous outflow. There is therefore no gradient for the passive movement of carbon dioxide between the arterial inflow and the pancreatic juice. 7. Inhibition of secretion with acetazolamide caused a fall in the PCO2 of pancreatic juice and increased the output of lactate. The secretion of lactate was not due to hypoxia as it also occurred in the blood-perfused gland in situ which had normal haemoglobin concentrations and oxygen saturation. 8. It is concluded that the secretion of bicarbonate is independent of arterial pH but critically dependent upon the arterial concentration of the bicarbonate ion. These experiments do not support the concept that the secretion of protons over the basolateral membrane is the major primary event in pancreatic secretion of bicarbonate. PMID- 3656197 TI - Quantitative analysis of laryngeal mechanosensitivity in the cat and rabbit. AB - 1. Single afferent fibres in the internal branch of the superior laryngeal nerve which responded to light touch or gentle probing of discrete areas of the exposed epithelium of the opened larynx were identified in anaesthetized, paralysed cats (148 fibres) and rabbits (58 fibres). 2. A quantitative examination of the sensitivity of these laryngeal mechanoreceptors to both static (step indentations) and dynamic (vibratory) forms of mechanical stimulation was undertaken using a servo-controlled mechanical stimulator. 3. In both species two predominant classes of mechanoreceptors were observed (Boushey, Richardson, Widdicombe & Wise, 1974). One class was distinguished by a regular and continuous pattern of activity at a frequency of 10-70 Hz (tonic fibres, sixty-six in cat, thirty-five in rabbit). The other class was silent or (more rarely) irregularly active at a very low frequency (silent fibres, eighty-two in cat, twenty-three in rabbit). 4. The location of the receptive fields was determined by manual probing. Inter-species and regional variations in receptive field location were observed for the two fibre groups. 5. Conduction velocity was measured for twenty one tonic and seven silent fibres in the rabbit by a pre-triggered averaging technique. The results obtained (tonic: range 10.8-30.0, mean +/- S.E. of mean 21.4 +/- 1.2 m/s; silent: 14.8-28.6, 20.4 +/- 1.8 m/s) were characteristic of group III afferent fibres but were not significantly different for the two classes. 6. Both classes of receptor showed a response at the onset of a step indentation of the region of the mucosa that corresponded to their receptive field. Subsequent to this brief initial response the behaviour of the two classes diverged markedly. Tonic fibres were invariably slowly adapting whereas most (forty-four out of fifty-five in cat; twenty-two out of twenty-three in rabbit) silent fibres were rapidly adapting, at least for smaller indentation amplitudes. 7. Receptors of both classes were readily entrained to discharge at the same frequency as the probe stimulator (1:1 entrainment) when this was made to vibrate upon the receptive area for test periods of 0.5 or 1.0 s. Tuning curves were constructed of the minimum amplitudes required to elicit 1:1 entrainment throughout an entire test period at various frequencies. 8. Individual fibres in the two classes could be entrained at frequencies up to 400 Hz or more at sensitive (e.g. less than 100 microns) vibratory amplitudes. However, all fibres were less sensitive at these higher frequencies than at some lower point on the frequency scale.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656199 TI - The effects of direction and acceleration of movement of the knee joint of the dog on medial articular nerve discharge. AB - 1. The normal activity of the medial articular nerve of the knee joint of nine dogs was measured in response to continuous passive movement. Whole nerve recordings were made simultaneously with joint position and angular velocity. 2. When the knee was moved the medial articular nerve discharged at all joint angles with maximum activity at flexion in some animals, and at extension in others. For an individual animal the discharge pattern was reproducible over several cycles of movement. 3. The discharge was direction sensitive, responding with a lesser activity whenever the joint was moved away from the extremes of movement range. 4. With higher velocities of movement, the discharge activity of the nerve increased at the ends of joint movement. 5. The results indicate that the discharge activity of the whole medial articular nerve is influenced not only by joint position but also by the velocity and acceleration of movement. This may reflect changes in the tension of capsular and extra-capsular tissues. PMID- 3656200 TI - Inhibitory control of local excitatory circuits in the guinea-pig hippocampus. AB - 1. Exposure to the gamma-aminobutyric acid antagonist, picrotoxin, causes the discharge of hippocampal pyramidal cells to become synchronized. Synaptic mechanisms underlying the development of synchrony were investigated by recording from pairs of cells in the CA3 region of guinea-pig hippocampal slices. 2. Picrotoxin suppressed unitary inhibitory synaptic events. It appeared not to affect monosynaptic excitatory connections. Picrotoxin revealed latent excitatory connections in seven out of twenty-one dual recordings from burst-firing cells. 3. Post-synaptic events revealed by picrotoxin were elicited rarely by single action potentials. They were evoked with mean latencies of at least 8 ms and with more than 30% failures of transmission by bursts of three or more action potentials. They were suppressed by increasing extracellular Ca2+. They were considered to be mediated by polysynaptic excitatory pathways. 4. Polysynaptic excitatory post-synaptic potentials (e.p.s.p.s) had a smooth rising phase with time-to-peak of 15-40 ms and a falling phase of similar duration. Their amplitude was 2-3 mV at membrane potentials close to -70 mV. This shape was similar to that of summed e.p.s.p.s evoked by a burst of three to six action potentials at monosynaptic connections between CA3 cells. 5. One cell could evoke excitatory synaptic events in more than one follower cell, suggesting that axon collaterals mediating recurrent excitation were divergent. More than one polysynaptic excitatory pathway could exist between two cells. 6. We examined the role of recurrent excitatory synapses in the development of synchrony. As inhibition was suppressed by picrotoxin, simultaneous excitatory synaptic events appeared in recordings from pairs of cells. They occurred rhythmically at intervals of 0.5-3 s and grew in amplitude with time. Synchronous neuronal discharges were observed when the threshold for action potential generation was exceeded. 7. Firing induced in one cell could sometimes evoke a sequence of post-synaptic events in another cell as inhibition was suppressed. Initially, no connection was detected. On adding picrotoxin, a polysynaptic e.p.s.p. was revealed and with time longer latency components were recruited to the synaptic event. The amplitude of later components grew until firing threshold was reached. 8. We suggest that synchronous firing develops due to the loss of inhibitory control over the spread of firing between CA3 pyramidal cells via divergent, polysynaptic, recurrent excitatory pathways. PMID- 3656201 TI - The measurement of single motor-axon recurrent inhibitory post-synaptic potentials in the cat. AB - 1. Signal averaging was used in forty experiments on low-spinal cats to measure and characterize the oligosynaptic responses of seventy-six motoneurons supplying the medial gastrocnemius muscle to the single impulses of antidromically stimulated single motor axons supplying the same muscle. 2. In thirteen experiments on chloralose-urethane anaesthetized preparations, twelve (43%) of the tested twenty-eight motoneurones exhibited a single-axon recurrent inhibitory post-synaptic potential (recurrent i.p.s.p.), as compared to sixty-four (62%) of the 103 motoneurones tested in twenty-seven animals in the absence of anaesthetic after ischaemic decapitation. 3. Single-axon recurrent i.p.s.p.s most often consisted of a single, long-lasting hyperpolarization. Ten of the recurrent i.p.s.p.s contained a second late peak of hyperpolarization. In another eight of the i.p.s.p.s, a small late depolarization was evident. 4. The distinct profiles of the recurrent i.p.s.p.s were readily distinguished from the relatively flat profiles with low noise levels in the averages of the fifty-five 'no-response' cells. The transmembrane and post-synaptic nature of the i.p.s.p.s was confirmed by extracellular control recordings taken immediately outside seven of the cells with positive responses. In addition, ten cells with positive responses were subjected to current passage during the averaging procedure. In all cases, depolarization increased and hyperpolarization reduced the amplitude of their single-axon recurrent i.p.s.p.s. 5. The mean amplitude of the responses was 12.0 microV in chloralose-urethane preparations as compared to a peak-to-peak noise level less than 6.0 microV in the no-response averages. Corresponding values in ischaemic-decapitate preparations were 46.2 microV and less than 7.5 microV, respectively. 6. Latency, rise-time and half-width (i.e. duration at half amplitude) values of the i.p.s.p.s were similar for chloralose-urethane and ischaemic-decapitate preparations. The average values in both preparations were 2.5, 5.6 and 19.3 ms, respectively. The latency values indicated both disynaptic and, perhaps, longer components in the recurrent i.p.s.p.s. The rise-time and half-width values were relatively similar to those reported or measured from published records for analogous composite recurrent i.p.s.p.s (i.e. responses to antidromic stimulation of the whole muscle nerve rather than single motor axons). A weak, but significant, correlation between rise-time and half-width was observed for the sixty-six single-axon recurrent i.p.s.p.s with a single negative going peak.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656202 TI - Distribution of single-axon recurrent inhibitory post-synaptic potentials in a single spinal motor nucleus in the cat. AB - 1. The distribution of recurrent Renshaw inhibition was examined in the medial gastrocnemius motor nucleus of the cat by measurement of single-axon recurrent inhibitory post-synaptic potentials (recurrent i.p.s.p.s) in motoneurones supplying medial gastrocnemius produced by single impulses of antidromically stimulated single motor axons supplying the same muscle. 2. Stimulated motor-axon recorded-motoneurone pairs were classified as 'close' if both contributed their axons to the same portion of the ventral roots (L7 rostral, L7 caudal or S1). Alternatively, they were classified as 'distant' if their axons were in different portions of these ventral roots. 3. Both the incidence and amplitude of 'close pair' recurrent i.p.s.p.s were shown to be significantly larger than the corresponding values for 'distant-pair' recurrent i.p.s.p.s. 4. The results provided evidence of a strong topographic effect on the distribution of recurrent Renshaw inhibition within a single spinal motor nucleus. This finding is discussed in relation to the roles of topographic and species specificity in determining the organization of recurrent inhibition and to the partitioned distribution of monosynaptic Ia excitation in single motor nuclei. PMID- 3656203 TI - Presynaptic actions of curare and atropine on quantal acetylcholine release at a central synapse of Aplysia. AB - 1. In a cholinergic synaptic couple in the buccal ganglion of Aplysia california, where the synaptic areas are situated close to the somata (500 micron), we were able to control transmitter release by stimulating the cell body of the presynaptic neurone with long depolarizing pulses in the presence of tetrodotoxin (TTX). 2. Statistical analysis of noise occurring at the peak of the long depolarization-induced post-synaptic current (p.s.c.) responses allowed us to calculate the amplitude and the decay time of the miniature post-synaptic currents (m.p.s.c.s). These data were used to calculate the quantal content of the responses. 3. Bath-applied tubocurarine reduced the amplitude of the long depolarization-induced p.s.c. more than that of the m.p.s.c.s, indicating that tubocurarine exerts a depressive presynaptic action on the quantal content of the post-synaptic responses. 4. Tubocurarine injected into the presynaptic neurone blocked synaptic transmission without decreasing the size of the m.p.s.c.s probably by acting on the mechanism of transmitter release. 5. Bath-applied atropine (10(-6) and 10(-5) M) caused a slight decrease of the m.p.s.c.s but the long-depolarization-induced p.s.c.s increased, as did the quantal content. Higher concentrations of atropine depressed strongly both the m.p.s.c. and the quantal content. 6. Injection of atropine into the presynaptic neurone had the same effect as its bath application, probably due to the leakage of the drug into the synaptic cleft; the effect depended on the concentration reached in the cleft, i.e. on the quantity of injected drug. The synapses of the neighbouring cholinergic neurone were also affected by this leak of atropine. 7. The presence of nicotinic presynaptic receptors blocked by tubocurarine, and muscarinic presynaptic receptors blocked by atropine, which regulate synaptic transmission by facilitating and depressing the ACh release respectively, is discussed. PMID- 3656204 TI - Responses of spinothalamic tract cells in the superficial dorsal horn of the primate lumbar spinal cord. AB - 1. The responses of thirty-five spinothalamic tract (s.t.t.) cells in or near lamina I of the dorsal horn were examined in chloralose- and barbiturate anaesthetized monkeys (Macaca fascicularis). Many of the cells could be classified on the basis of receptive field properties as either wide dynamic range (w.d.r.) cells or as high-threshold (h.t.) cells. 2. Thalamic stimulation sites for antidromic activation of the s.t.t. cells were in or around the ventral posterior lateral nucleus. Axons of the s.t.t. cells had a mean conduction velocity of 17 m/s (33 and 14 m/s for w.d.r. and h.t. cells, respectively). Mean minimum afferent conduction velocity averaged 37 m/s (52 and 23 m/s for w.d.r. and h.t. cells, respectively). Background activity was low (mean of 2.3 impulses/s). 3. An alternative classification of the cells was based on a kappa means cluster analysis of the responses to a series of mechanical stimuli. The response profiles for a given cell were normalized, and those of the s.t.t. cells in or near lamina I were analysed along with the responses of a population of s.t.t. cells, largely in laminae IV-VI, that had been described previously. S.t.t. cells in or near lamina I were distributed amongst three of the four groups of cells determined by the cluster analysis (types 2-4). 4. Vibratory stimuli excited most of the w.d.r. but none of the h.t. cells tested. Best frequencies were 5-10 Hz (at 100 and 500 microns indentations). 5. Most w.d.r. but few h.t. cells responded to cutaneous cooling. All of the cells responded to noxious heating, but w.d.r. cells had steeper stimulus-response curves. 6. After a series of noxious heat stimuli, the thresholds for noxious heat were lowered and responses to lower-intensity noxious heat stimuli were enhanced (sensitization). However, responses to more intense stimuli were reduced (inactivation). Similar changes were seen in the responses to graded mechanical stimuli. 7. It is concluded that s.t.t. cells in or near lamina I can signal noxious cutaneous stimuli but have poor coding abilities for innocuous mechanical stimuli. Some of these cells respond to innocuous thermal stimuli, but their role in thermoreception is unclear. The small receptive fields suggest that these cells could contribute to stimulus localization. PMID- 3656205 TI - Inhibitory connections of ipsilateral semicircular canal afferents onto Renshaw cells in the lumbar spinal cord of the cat. AB - 1. In intercollicularly decerebrate cats, the excitability of lumbar spinal Renshaw cells (tested by single shocks to ventral roots and deafferented muscle nerves) decreased for 600-1000 ms after conditioning electrical stimulation of ipsilateral semicircular canal nerves. 2. Conditioning stimulation of posterior canal afferents and combined stimulation of anterior and lateral canal afferents were equally effective in causing inhibition of Renshaw cells. No significant differences were observed for Renshaw cells excitable from hind-limb flexor or extensor nerves. 3. Inhibition appeared when one to five stimuli were applied to the canal afferents and arrived at the spinal segmental level 11-15 ms after the onset of conditioning stimulation. 4. Evidence is adduced to suggest that the inhibitory effects on Renshaw cells following stimulation of semicircular canal afferents were mediated directly, i.e. they were not caused by alterations of motoneurone activity. 5. Excitation of Renshaw cells due to stimulation of the canal afferents was rarely observed; it could not be excluded that it was secondary to motoneurone discharges. 6. It is suggested that vestibular inhibition of Renshaw cells ensure a high gain of hind-limb alpha-motoneurones during postural adjustments following a massive disturbance of body equilibrium. PMID- 3656206 TI - Selective responsiveness of polymodal nociceptors of the rabbit ear to capsaicin, bradykinin and ultra-violet irradiation. AB - 1. The activity of single C- and A-fibre cutaneous sensory units was recorded from the great auricular nerve of anaesthetized rabbits to compare the effects of chemical with other forms of stimulation under several experimental conditions. Chemical agents were delivered by close arterial injection. 2. Small intra arterial injections of bradykinin (0.2 microgram) and a substantial range of capsaicin doses (2-200 micrograms) consistently activated C polymodal nociceptors without exciting other types of C- or A-fibre cutaneous sense organs. 3. Topical application of xylene to the receptive field of polymodal nociceptors evoked a strong excitation which lasted several minutes. 4. The responses of polymodal nociceptors to mechanical, chemical (bradykinin, xylene) and noxious thermal stimuli were suppressed or abolished after large intra-arterial doses of capsaicin. Capsaicin desensitization of polymodal nociceptors to one kind of stimulation often was not paralleled by similar changes in responsiveness to other stimuli. However, on the average, capsaicin desensitization altered responses to thermal, chemical and mechanical stimuli without afferent selectivity. 5. Background discharge developed in C polymodal nociceptors of the rabbit ear following ultra-violet irradiation sufficient to produce evidence of delayed inflammation. Noxious heat and bradykinin injection (0.2 micrograms) evoked more activity from C polymodal nociceptors in the irradiated ears than from control units. PMID- 3656207 TI - [Evaluation of residues of fenthion in the millet-eater (Quelea quelea L.)]. PMID- 3656208 TI - [Acute chlormezanone poisoning: 204 cases at the Poison Control Center in Paris]. PMID- 3656209 TI - A preliminary study of the mechanisms of cadmium teratogenicity in chick embryo after direct action. PMID- 3656210 TI - [Precision of blood alcohol calculated by extrapolation]. PMID- 3656211 TI - [Monitoring the risk of exposure to styrene by determination of the hydrocarbon in the alveolar air and by determination of its metabolites in the urine]. PMID- 3656212 TI - Hydroxocobalamine in cyanide poisoning. PMID- 3656214 TI - [Poison control centers--statistics]. PMID- 3656213 TI - [Plasma and erythrocyte toxico-kinetics of lithium following a single ingestion]. PMID- 3656215 TI - Experimental vaccination of chicks with Plasmodium gallinaceum sporozoites. I. Circumsporozoite proteins are expressed by sporozoites recovered from both salivary glands and midguts of mosquitoes. AB - Immunogenicity of Plasmodium gallinaceum sporozoites for chicks and their in vitro reactivity with normal and specific immune sera were studied. Two sporozoite populations recovered from experimentally infected Aedes fluviatilis were used: sporozoites from salivary glands and sporozoites from midgut oocysts. Populations seven to nine days old of sporozoites recovered from salivary glands were infective for all chicks until the chicks were three weeks old; however, sporozoites recovered from midguts containing oocysts infected these chicks only if isolated on days 8-9, but not on day 7 after the mosquitoes' infective blood meal. Infectivity of the sporozoites was lost after exposure to ultraviolet (UV) light (30 min) or X-rays (13 krad). Inactivated sporozoites from both sources proved highly immunogenic to chicks that were immunized by several intravenous or intramuscular injections. These parasites elicited a strong humoral immune response in the chicks, as measured by the circumsporozoite precipitation (CSP) reaction. The levels of the CSP antibodies were similar with sporozoites from both sources, there being no detectable differences in the percentage of reactive sporozoites or the intensity of the CSP reaction with sera containing antibodies to either sporozoites from salivary glands or sporozoites from oocysts. These results provide the first evidence that avian malaria sporozoites express the circumsporozoite protein that has been extensively characterized in mammalian malaria (rodent, simian, human sporozoites). Furthermore, we observed that the yields of sporozoites obtained from mosquito midguts, on days 8 and 9 of the P. gallinaceum infection, were at least twice as great as those obtained by salivary gland dissection, even 20 days after a blood meal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656216 TI - Polyamine metabolism in Acanthamoeba: polyamine content and synthesis of ornithine, putrescine, and diaminopropane. AB - Five polyamines which could be separated by high performance liquid chromatography were found in Acanthamoeba castellanii (strain Neff). These included in order of decreasing abundance: 1,3-diaminopropane, spermidine, spermine, norspermidine, and putrescine. Only diaminopropane and norspermidine had been found previously. Spermine was present in cultures grown in broth, but not in defined medium. Radioactive substrates were used to establish that putrescine was synthesized by decarboxylation of ornithine, ornithine was synthesized from arginine or citrulline, and diaminopropane was synthesized from spermidine. The presence of ornithine decarboxylase (EC 4.1.1.17), arginase (EC 3.5.3.1), and urease (EC 3.5.1.5) and the absence of arginine decarboxylase (EC 4.1.1.19) were established. A scheme for polyamine biosynthesis in A. castellanii is proposed. PMID- 3656217 TI - Effects of extracellular potassium on acid release and motility initiation in Toxoplasma gondii. AB - The internal pH (pHi) of Toxoplasma gondii was estimated by measuring the accumulation of the weak base 9-aminoacridine in buffers with various ionic compositions. The pHi of the metabolizing parasite increased when the extracellular K+ was elevated in alkaline medium or when the external pH (pHe) was substantially increased in medium employing high external K+ (90 mM). The parasite in mouse peritoneal fluid, or in potassium sulfate buffer (pH 8.2), where the pHi was demonstrated to be increased to 7.9, became motile when acidic buffer was substituted for the original suspension medium. This acid-induced independent movement subsided within 5 min but was repeatedly induced if the pHe was serially lowered to 6.0. Basic buffers, on the other hand, abolished motility when applied to the moving parasites. Nigericin, which is known to collapse pH gradients across the membrane, also abolished motility. PMID- 3656218 TI - Factors affecting motility and morphology of Cryptosporidium sporozoites in vitro. AB - In vitro motility and morphology of Cryptosporidium sporozoites were examined in the presence of various solutions. Crude preparations of the bile salt, taurocholic acid, maintained both motility and morphology in a dose-dependent manner. These effects appeared to be due to the taurocholic acid itself, and not simply due to pH variations, osmotic factors, or contaminants. Lysis of sporozoites was also observed and was found to be dependent on pH, with acidic conditions (pH less than 6.2) triggering the lysis. PMID- 3656219 TI - Further characterization of carbohydrate-containing fractions from Trypanosoma mega. AB - Epimastigotes of Trypanosoma mega were submitted to phenol extraction after lipid extraction, providing an extract whose carbohydrate portion (30%) contained fucose, ribose, xylose, mannose, galactose, and glucose. The purified fraction recovered in the void volume of Bio Gel P-150 gave on SDS-PAGE a band of Mr approximately equal to 55,000 positive for protein and carbohydrate and a diffuse band strongly positive for carbohydrate and lipids (Mr approximately equal to 22,000). The structural analysis of the carbohydrate moiety of this fraction by GLC-MS indicated the presence of nonreducing end groups of fucopyranose, mannopyranose, and galactopyranose, 3-O- and 4-O-substituted and 2,3- and 2,4-di O-substituted galactopyranosyl units. Extraction of this fraction with chloroform/methanol/water provided a soluble fraction that on SDS-PAGE gave rise to a carbohydrate and lipid-positive band (Mr approximately equal to 22,000). This fraction contained fucose, mannose, and galactose (1:1:1). As main branch points, 2,3-di-O-substituted galactopyranosyl units were present according to methylation data. Similar proportions of fucopyranosyl, mannopyranosyl, galactopyranosyl end units were present. The presence of lipids in this fraction was confirmed by methanolysis following isolation and characterization of the corresponding fatty acid methyl esters. Palmitic acid (16:0) and an 18:1 fatty acid were the predominant fatty acids. PMID- 3656220 TI - Trypanosoma humboldti n. sp. from the Chilean catshark, Schroederichthys chilensis (Guichenot, 1848). AB - The morphology of Trypanosoma humboldti n. sp. is described from living and stained specimens obtained from the blood of a catshark, Schroederichthys chilensis. This represents the first report of a trypanosome in fish from the eastern Pacific Ocean. It is distinguished by its size and apparent lack of pleomorphism. The presence of a leech, Branchellion ravenellii, attached to the catshark, raises the possibility that it can act as a vector. Additionally, this leech is recorded for the first time from the Pacific Ocean. PMID- 3656221 TI - Room restriction: a therapeutic prescription. PMID- 3656222 TI - Using play in psychiatric rehabilitation. PMID- 3656223 TI - Death & dying. Emotional, spiritual, and ethical support for patients and families. PMID- 3656224 TI - Sexual needs of psychiatric clients. PMID- 3656225 TI - Incest trauma. PMID- 3656226 TI - The birth of the American Psychiatric Nurses' Association. PMID- 3656227 TI - Clinicians' fallacies in psychiatric practice. AB - Eleven common clinicians' fallacies have been briefly described. Based on experience, the authors of this article believe these are the most common and pernicious ones in interdisciplinary psychiatric treatment. These patterns may lead to erroneous interdisciplinary treatment decisions for many patients. In order to protect the well-being of psychiatric patients, their families, and the integrity of interdisciplinary treatment teams, it behooves each and every team member to become knowledgeable about clinicians' fallacies. Those aware of clinician's fallacies will reason more soundly basing judgments on empirical evidence, careful observation, measurement, and a determination not to be influenced by emotional appeals. PMID- 3656228 TI - Clinical supervision as a learning tool for the therapist in milieu settings. PMID- 3656229 TI - Assertive training. PMID- 3656230 TI - Does the family make a difference? PMID- 3656231 TI - Per-operative cholangiography: an assessment of the criteria for duct exploration. PMID- 3656232 TI - Menetrier's disease and gastric carcinoma. PMID- 3656233 TI - Diverticular disease in the West Indies: a Trinidad study. PMID- 3656234 TI - Penetrating wounds of the heart: the aftermath. PMID- 3656235 TI - The patient history: a source of prognostic data in breast cancer. PMID- 3656236 TI - Spectrum of breast diseases seen in a hospital breast clinic in Riyadh. PMID- 3656237 TI - Branchiogenic carcinoma. PMID- 3656238 TI - Tuberculosis of the spine: results of management of 300 patients. PMID- 3656239 TI - Division of the C5 nerve root to control intractable pain following a pathological fracture of the humerus. PMID- 3656240 TI - Toe fusion using Kirschner wire. A study of the postoperative infection rate and related problems. PMID- 3656241 TI - The importance of orthotic treatment in the management of fibrous dysplasia of the lower limb. PMID- 3656242 TI - Gastric cancer bezoar. PMID- 3656243 TI - Sarcoid aortic aneurysm: surgical difficulties. PMID- 3656244 TI - Heterotopic pancreas: a rare cause of obstructive jaundice. PMID- 3656245 TI - A cyst of the second part of the duodenum. PMID- 3656246 TI - Mandibular metastasis from gastro-intestinal carcinoma. PMID- 3656247 TI - Spinal extradural tumour mimicking a lumbar disc protrusion. PMID- 3656248 TI - Fournier's gangrene of the scrotum following traumatic urethral catheterisation. PMID- 3656249 TI - Splenorrhaphy instead of splenectomy in paediatric splenic injuries. PMID- 3656250 TI - A simple technique for closed suction drainage. The Unical drain. PMID- 3656252 TI - Tracheostomy in childhood. PMID- 3656251 TI - Silastic foam dressing as a focus of abscess formation. PMID- 3656253 TI - Digital replantations distal to the distal interphalangeal joint. AB - Microvascular replantations of digits distal to the distal interphalangeal (DIP) joint were reviewed in 33 digits of 29 patients. Twenty-five digits were completely amputated and eight were incompletely amputated. Ten of 33 replants failed and 23 digits survived. Even without venous reconstruction, good results were obtained in Zone I. Of eight completely amputated digits in Zone 1 in which venous reconstruction was not performed, seven digits survived. Of four completely amputated digits in Zone 2 without venous reconstruction, all became necrotic. In digits followed for six months or more after surgery, 11 of 13 replantations showed good functional recovery. Two digits that developed paresthesia after replantation were functionally useless. Seven digits without bilateral digital nerve reconstruction were reviewed six months or more after surgery. Sensory recovery was good in the digital phalanx; the factor impeding functional recovery was the development of paresthesia. Replanted digits distal to the DIP joint are thus satisfactory in both function and cosmesis, even if digital nerves have not been reconstructed. The replantation of such digits should be considered. PMID- 3656254 TI - Free compound transfer of the distal interphalangeal joint. A case report. AB - The first case of free vascularized transfer of a distal interphalangeal (DIP) joint, used to replace a severely damaged proximal one, is presented. The case is interesting not only for the procedure used, but it also illustrates the principle by which useful components of nonsalvageable digits are used to reconstruct other damaged, but still salvageable, parts of the hand. PMID- 3656255 TI - Lower leg replantation in children: railroad amputation. AB - Replantation in the lower leg, although technically feasible, still remains a complicated clinical issue in terms of the decision-making process. In children, a limb salvage or replant procedure would seem preferable; however, in crush amputations from railroad injury, a very severe trauma, difficulties in treatment should be thoroughly weighed against prosthetic possibilities: for example, only a fair or good functional outcome would justify an attempt to replant a severed shin. Unfortunately, the outcome in most cases is unpredictable at the time of initial evaluation, and even during the replantation procedure itself. To facilitate prognosis, the authors determine four typical variants of replantation course and outcome, based on local patient conditions, although they stress that no clear indications for replantation vs. prosthesis can be derived from the variants listed. Rather, general guidelines for the surgeon's decision at a very early stage of treatment are presented. Choice of procedure and tactics cannot be determined once and for all, because the prognosis for functional outcome can change during the course of treatment. Among a few well-defined situations are clean amputations (replantation is indicated) and traumas with very extensive crushing of the whole lower leg (replantation is contraindicated). In the majority of cases, replantation is a worthwhile attempt, but this does not imply that a replanted extremity must be preserved at any cost. The surgeon must consider the possibility of re-amputation, in case of an unfavorable variant in the postoperative course. A successful case of replantation, involving two lower leg railroad amputations in a child, is presented. PMID- 3656256 TI - Importance of vessel tension in end-to-end and end-in-end anastomoses. AB - Arterial end-in-end and end-to-end microanastomoses were done experimentally under natural tension and without tension. Intraluminal plastic casts were made at different postoperative time intervals, and the resulting stenosis at the site of anastomosis compared by lumen area measurements. Both anastomotic techniques revealed marked stenosis at the first hour postoperative, even when there was no tension applied to the vessels. The end-in-end technique (EIE) showed a luminal area decrease with increasing longitudinal tension. The end-to-end (ETE) did not, however, show any significant difference in stenosis, either in the nontension or the normal tension groups. No occluded anastomosis was found in either the EIE or ETE technique groups. This was remarkable, because it is during the first postoperative hour that residual luminal areas were as low as 23 percent in the successful EIE anastomoses. PMID- 3656257 TI - Evaluation of different microsurgical techniques for arterial anastomosis of vessels of diameter less than one millimeter. AB - The purpose of this study was to compare four different methods of microsurgical arterial anastomosis. One hundred and sixty rabbit popliteal artery anastomoses were performed. The following techniques were employed in each of four equal groups. Group 1: end-to-end technique with asymmetrical sleeving of the adventitia; Group 2: end-to-end technique with symmetrical sleeving of the adventitia and wrapping of the suture site with a collagen cuff; Group 3: end-to end technique with symmetrical trimming of the adventitia; Group 4: end-in-end (sleeve) technique. A fifth group served as the control and omitted the division and anastomosis of the vessel. At one hour, 24 hr, three days, seven days, two weeks, six weeks, three months, and six months, the anastomosis was re-examined, and arterial segments were excised and prepared for evaluation. Long-term patency rates for the above techniques were found within the range of 87.5 to 92.5 percent. The healing process of anastomosed arteries occurred within three to seven days. A different pattern of arterial wall healing was found in the end-in end, compared to the end-to-end, techniques. The study showed that the end-in-end technique is comparable in long-term patency rates to the conventional end-to-end technique, with significant reduction of the time needed to perform the anastomosis. PMID- 3656258 TI - The age of the computer? PMID- 3656259 TI - Regional patterns of AIDS and HIV infection. PMID- 3656260 TI - Children and divorce. PMID- 3656261 TI - Course organizers in general practice. PMID- 3656262 TI - Smoking in pregnancy: is the message getting through? AB - In order to determine the current smoking habits of pregnant women and the success of anti-smoking advice, inpatient postpartum mothers were invited to complete a questionnaire on their smoking habits, their knowledge of the ill effects of smoking .in pregnancy and their recollections and reactions to anti smoking advice.Over a third of the smokers replied that smoking in pregnancy had no harmful effects, compared with 1% of the non-smokers. Only 37% of the smokers said they knew of the risk of having a smaller baby as a result of smoking, compared with 63% of the non-smokers. A high proportion of both smokers and non smokers did not recall receiving anti-smoking advice during pregnancy, 55% and 54% respectively. However, 48% of the smokers felt that anti-smoking advice was over-cautious, compared with 7% of the non-smokers.It is concluded that many smokers are ;blocking' the smoking advice given to them, and it is therefore ineffective. A different approach by health professionals is recommended and the emphasis of the advice given should be changed. PMID- 3656263 TI - A survey of paramenstrual complaints by covert and by overt methods. AB - A covert method of assessing perception of health in relation to menstruation was applied prospectively to a group of women aged 20 to 40 years. Of the 1386 randomly selected women contacted, 838 (60%) provided information for the full study period of six weeks and 608 of these respondents menstruated during that time. A clear excess of women demonstrated premenstrual deterioration in perceived health. This rose to a peak at the onset of menstruation and subsided rapidly during menstruation, thus reflecting the conventionally defined pattern of the premenstrual syndrome.When, on completion of prospective recording, the same women were asked to return an overt and retrospective assessment of paramenstrual symptoms, the overall pattern of results was similar but, for individual women, there was little correspondence between similar data obtained by the two different methods. PMID- 3656264 TI - An investigation into private sector nursing and residential home care for the elderly in north Wales. AB - In January 1984 two questionnaires were sent to private homes for the elderly in an area of north Wales with a high concentration of private beds. The first questionnaire was completed by eight nursing homes and 13 residential homes for the elderly and the second questionnaire for each of 321 residents - 154 in the former and 167 in the latter.The two types of homes were compared for staffing levels, facilities available and the degree of dependency of residents. As expected the degree of dependency of the residents in nursing homes was higher than in residential homes but even so the degree of dependency in residential homes was found to be high. The isolation of many residents was evident. Twenty three per cent of residents had come directly to the homes on moving into the area. The problems arising for general practitioners visiting a number of different homes and for homes having many different doctors visiting are highlighted.The need for adequate consultation and assessment prior to admission and periodic reassessment is demonstrated in the light of the recent changes to the supplementary benefit regulations. It was found that at least 20% of the residents had their fees supplemented by the Department of Health and Social Security. The need for greater collaboration between the two different registration authorities under the new legislation (Registration of Homes Act 1984) and with the general practitioners providing general medical services is demonstrated. PMID- 3656265 TI - Patients' opinions on the services provided by a general practice: a community health council survey. AB - A survey of 105 patients selected from a single general practice was undertaken by the local community health council to determine patients' opinions on the services provided. Although it had not originally been designed for studying individual practices the questionnaire produced much valuable information and complemented the ;What sort of doctor?' assessment. PMID- 3656266 TI - Feasibility and usefulness of family record cards in general practice. AB - In order to determine the feasibility of family record cards in general practice a research secretary created cards for 1825 households from a practice of 10 600 patients. The capital cost was pound108 and the time taken by the secretary was 1638 hours, which is equivalent to a wage of pound1330 for a maximum grade secretary, assuming a 70% rebate paid by the family practitioner committee. Approximately six and a half hours of receptionist/secretarial time are needed each week to maintain the system. The doctors spent a mean of three minutes checking and completing the initial update of each card.Before the cards were introduced, most information about families was held in the doctors' heads, and little was written in the records even though the doctors considered family information relevant in 33% of consultations. After the introduction of family record cards the doctors had access to reasonably complete information about the family at 98% of consultations and the cards were used at 95% of consultations. The doctors believed the information was useful for establishing rapport, identifying patients' concerns, obtaining relevant history, forming diagnostic hypotheses and managing the present complaint. Trainees and locums found the cards more useful than principals. PMID- 3656267 TI - Variation in peak expiratory flow in children with asthma. AB - Twice daily peak expiratory flow measurements were obtained at home from 65 asthmatic children and 34 non-asthmatic controls, and a measure of the daily variation in peak expiratory flow was calculated for each child (mean daily variation). Children aged less than 7.5 years appeared unable to provide reproducable peak expiratory flows, but above that age the mean of the mean daily variations was significantly higher for the asthmatics than the controls. This was true even on days when the asthmatics exhibited no wheeze or took no medication. The significance of the findings is discussed, and it is suggested that calculation of the mean daily variation might assist in the assessment of children presenting with atypical respiratory symptoms. PMID- 3656268 TI - Improved health care delivery in an inner-city well-baby clinic run by general practitioners. AB - The delivery of health care has been improved in an inner-city well-baby clinic by staffing the clinic with members of a primary health care team and by offering a therapeutic service together with a preventive service. Over a three-year period attendance at the clinic has doubled and the uptake of immunization has increased. Of children registered with the practice supplying the health care team, 95% are up to date with diphtheria, tetanus and polio immunizations and 93% have been immunized against measles. It is suggested that general practitioners should have greater involvement in the running of well-baby clinics. PMID- 3656269 TI - Medical aspects of drug misuse during one year in a rehabilitation unit. AB - The medical work in a voluntary drug rehabilitation unit near Glasgow was examined. During one year 174 residents were admitted of whom 103 (59%) developed illnesses which required medical treatment. The need for drug misusers to receive general medical services during and after drug misuse was confirmed. Although withdrawal from barbiturate misuse required the prescription of controlled drugs, opiate and other withdrawals were satisfactorily managed with psychological support and general care; substances which could be abused were not prescribed. Blood testing of 129 residents showed that 114 (88%) had evidence of previous hepatitis B infection, while only two had human immunodeficiency virus (HIV) antibody. The low prevalence of HIV antibody compared with the high prevalence that has been reported in Edinburgh suggests that the opportunity exists at the moment to limit the spread of acquired immune deficiency syndrome among Glasgow drug misusers. PMID- 3656270 TI - 'Epidemic' of polymyalgia and temporal arteritis. PMID- 3656271 TI - The influence of immobilization stress on cardiac protein synthesis. A possible regulatory role for glucocorticoids. AB - High serum corticosterone levels and transient depletion of cytosolic glucocorticoid receptor binding capacity were observed in rat cardiac muscle following immobilization stress. To evaluate the effect of this treatment on the protein synthetic capacity, biologically active polyribosomes were used to direct the in vitro synthesis of polypeptides in the rabbit reticulocyte lysate. The results of these experiments indicate that the template activity of several messenger RNAs coding for major myofibrillar proteins was increased. This change in protein synthetic activity was not observed in adrenalectomized animals. Collectively, these results suggest that glucocorticoids are involved in the regulation of cardiac protein biosynthesis. PMID- 3656272 TI - Demonstration and characterization of two classes of cardiac glycoside binding sites to rat heart membrane preparations using quantitative computer modeling. AB - Cardiac glycoside binding to rat heart membrane preparations was measured by rapid filtration technique. The binding data were analyzed using quantitative computer analysis. The experimental results using [3H]-ouabain as the labeled ligand were consistent with a model in which cardiac glycoside specific binding occurs at two independent classes of sites. The high affinity sites were characterized by a dissociation constants of 40 nM, 50 nM, and 61 nM for ouabain, digoxin and digitoxin, respectively, with a binding capacity of 1.3 pmoles/mg protein. The lower affinity sites for ouabain were characterized by dissociation constants of 2.3 microM, 67 nM and 71 nM for ouabain, digoxin and digitoxin, respectively, with a binding capacity of 3 pmoles/mg protein. Potassium ions inhibit [3H]-ouabain binding in a dose dependent manner with an IC50 of 500 microM. Quantitative computer modelling indicated that potassium inhibits ouabain binding at both binding sites. PMID- 3656273 TI - Reversible inhibition of cytosolic glucocorticoid receptors by mercurial agents. Application in the measurement of total and unoccupied receptors. AB - Recently developed "exchange assays" have been used to measure total cytosolic glucocorticoid receptor (GR) binding activity as compared to standard GR assays which measure unoccupied receptor. In the current study we modified these methods and extended the applications of such assays. Experiments defined the conditions whereby two sulfhydryl-binding agents, p-hydroxymercuribenzoate (PHMB) and mersalyl, completely inhibited binding of the glucocorticoid receptor to ligand in mouse renal cytosol. Reactivation of steroid-binding activity was restored by addition of dithiothreitol. The present study demonstrates 12% higher GR binding activity when this exchange assay is performed using saturated glucocorticoid receptor complex, rather than standard cytosol. Combining the data from the standard and exchange mouse renal cytosolic GR assays, it was determined that, at physiologic tissue corticosterone levels, the respective mean concentrations of unoccupied, occupied, and total GR were 467, 89, and 556 fmol/mg cytosol protein. Measurement of receptor concentrations by the use of these methods permits precise experimental differentiation of factors which affect total, as well as unoccupied GR. PMID- 3656274 TI - Changes in oviducal vascularity during the reproductive cycle of three oviparous lizards (Eumeces obsoletus, Sceloporus undulatus and Crotaphytus collaris). AB - Histologically derived estimates and ink suspension vascular casts were used to examine oviducal vascular changes. Vascularity peaked during gravidity and was correlated with maximal plasma progesterone concentrations. The vascular increase in the oviducal tissue was attributed exclusively to increased capillary densities. The greatest change occurred in the anterior uterus where incubation and egg shell secretion occur. Similar patterns of change in vascularity occurred in the infundibulum, although not as extreme as that seen in the anterior uterus, whereas no significant alterations were noted in the posterior uterus. These modifications mimic the pattern of vascular change occurring in viviparous lizards during simple placentation. We suggest that major changes in uterine vascularity may not be required for the evolution of simple chorioallantoic placentae in lizards. PMID- 3656275 TI - Serum oestradiol, progesterone, chorionic gonadotrophin and prolactin concentrations during pregnancy in the Bolivian squirrel monkey (Saimiri sciureus). AB - Concentrations of chorionic gonadotrophin gradually increased during early pregnancy, reached maximum values at mid-gestation, then declined to low levels. Oestradiol-17 beta concentrations were relatively low (300-600 pg/ml) during early pregnancy, increased thereafter to high levels (10-35 ng/ml), and then appeared to decline towards term. Concentrations of progesterone were constant (100-200 ng/ml) for the first 15 weeks of gestation, suggesting that sequential measurements of progesterone could be used to diagnose early pregnancy. Prolactin concentrations rose during pregnancy, reaching maximum values at term. PMID- 3656276 TI - The influence of male contact on plasma cortisol concentrations in the prepubertal gilt. AB - Large White X (Large White X Landrace) prepubertal gilts, 165 days of age, were fitted with indwelling venous catheters and housed in modified metabolism crates. After a period of acclimatization, frequent blood samples were taken at regular intervals before, during and after the 7 gilts were exposed to various degrees of contact with male pigs. The plasma samples were assayed for cortisol concentration using a competitive protein-binding radioassay. Significantly elevated concentrations of plasma cortisol (P less than 0.001) occurred only when full physical contact between the boar and the gilts was allowed. Boar exposure without full physical contact induced only minor changes in plasma cortisol concentrations of gilts. Plasma cortisol concentrations have been shown to constitute a reliable indicator of a stress response in pigs, and so the results of this study suggest that tactile stimulation from a male pig induces a stress response in the recipient prepubertal gilt. This stress response in the gilt may be involved in the stimulation of puberty onset by contact with a mature boar (i.e. the 'boar effect'). PMID- 3656277 TI - Antifertility mechanisms of gossypol acetic acid in female rats. AB - Gossypol acetic acid was administered orally (30, 60, 90 and 120 mg/kg/day) on Days 1-5 post coitum to mature female rats. At autopsy on Day 10, pregnancy in most treated animals (6/7 and 6/8) was blocked at high doses (90 and 120 mg/kg/day respectively). As the daily dose decreased to 60 mg/kg/day half (4/8) were not pregnant. However, at a lower dose (30 mg/kg/day), or at a single dose of 200 mg/kg at Day 1 p.c., pregnancy was not blocked. The concentrations of progesterone in the serum of these females were significantly decreased except at the low dose. The numbers of implantation sites in the treated females that did remain pregnant were similar to those in control females except at the dose of 120 mg/kg/day. Gossypol did not retard the development of the preimplantation embryo or cavitation. The Pontamine Blue test revealed that the drug did not interfere with the initiation of implantation. We suggest that gossypol has an antifertility effect in the female rat because it is luteolytic and disrupts post implantation development. PMID- 3656278 TI - Anatomy of the reproductive tract of the female muskox (Ovibos moschatus). AB - Reproductive tracts from 23 female muskoxen were collected from the Canadian high arctic during annual native muskox hunts. Twenty tracts were collected during the late breeding season and the last third of pregnancy or anoestrus, with 3 additional specimens taken just before the breeding season in August. The non gravid muskox uterus was very similar to that of sheep and goats except for two features found in parous muskoxen. The first was endometrial pigmentation found only in the caruncles and associated with a dense collection of lipofuscin granules in the endometrial stroma. The second was a prominent 5 mm deep band of muscular tissue protruding from the antimesometrial border of the uterine horns throughout most of their length. The pregnant uterus and the fetal membranes of the muskox resembled homologous structures in domestic ruminants. However, there was no morphological evidence of a corpus luteum during late pregnancy, apart from a luteal scar in the ovary ipsilateral to the pregnant horn. Of the 4 females collected at the end of the breeding season, 2 lactating females were apparently not cyclic while 2 others had more than one CL, suggesting that they had undergone at least 2 cycles without conceiving or remaining pregnant. PMID- 3656279 TI - Sperm-epithelium relationships in relation to the time of insemination in little brown bats (Myotis lucifugus). AB - Copulation lasted for up to 46 min in little brown bats. Spermatozoa were stored in both the uterus and the utero-tubal junction, although intimate relationships between spermatozoa and the epithelium were particularly evident in the utero tubal junction, and were established at the beginning of the period of sperm storage. Polymorphonuclear leucocytes were present in all uteri irrespective of whether or not they had been inseminated but were not generally present in the utero-tubal junction or oviduct. Engulfment of spermatozoa by the epithelial cells of the utero-tubal junction and by polymorphonuclear leucocytes in the uterine glands was evident soon after copulation. It is suggested that this may effect the removal of defective spermatozoa and allow luminal spermatozoa access to the spatially restricted storage sites. Uninseminated female bats attempted to elicit copulation from torpid males, and were also observed adjacent to copulating pairs. Female bats also uttered copulation calls. PMID- 3656280 TI - Inhibition of egg development and implantation in rats after post-coital administration of the progesterone antagonist RU 486. AB - RU 486 was administered to rats on Day 1 or Days 1 + 2 of pregnancy. Endometrial sensitivity (i.e. decidualization in response to oil instillation) was delayed by 2.5 mg/kg injected s.c. on Day 1, and almost half of the animals also exhibited a delay in implantation of 1-2 days. Higher doses (5 or 10 mg/kg) administered on Days 1 + 2 reduced the number of implantations to zero in all animals. Apparently normal morulae were found up to the evening of Day 4 in the oviduct and/or the uterus of most animals. However, on the morning of Day 5, ova were detected in only 25% of the animals and all were in the uterus: none was at the blastocyst stage and they appeared to be degenerated or compacted morulae. Egg survival and rate of egg recovery from the uterus was not improved by early ovariectomy, showing that this antiprogestagen acts on these events independently of the presence of circulating oestrogens. PMID- 3656281 TI - Regulation of the length of the fertile period in the domestic fowl by numbers of oviducal spermatozoa, as reflected by those trapped in laid eggs. AB - The numbers of spermatozoa trapped in the vitelline membrane of laid eggs were counted after staining with the fluorochrome 2,4-diamidino-2-phenylindole. In a group of 24 hens inseminated with different numbers of spermatozoa to produce different lengths of fertile periods, the numbers of spermatozoa in successive eggs from each hen decreased logarithmically with respect to days following insemination. A relationship could be described between the numbers of spermatozoa per unit area of membrane of an egg and the probability of that egg being fertile. After insemination the number of spermatozoa on successively-laid eggs appears to become reduced until a critical value is reached, after which the hen will lay infertile eggs. By estimating the day on which the critical value was achieved, the actual length of the fertile period could be predicted. It is suggested that the numbers of spermatozoa trapped in the vitelline membrane of laid eggs represent those which surround the ovum at the time of fertilization. PMID- 3656282 TI - Development of mouse embryos cryopreserved by vitrification. AB - Eight-cell mouse embryos were cryopreserved by vitrification in a concentrated solution of dimethylsulphoxide, acetamide, propylene glycol and polyethylene glycol. This solution (designated VS1) does not crystallize when cooled to subzero temperatures but instead forms a glassy transparent solid. Embryos were exposed in three steps to a stock VS1 solution or a saline solution containing 90% of the cryoprotectants in the stock VS1 (90% VS1) and then the suspensions were vitrified by rapid cooling in liquid nitrogen. Of 568 embryos vitrified in 90% VS1, 80% developed in vitro and 98 normal fetuses or young (17% of the total) were produced after transfer to pseudopregnant recipients. By contrast, 22% of 153 embryos vitrified in the stock VS1 developed in vitro, but only one normal fetus was obtained after transfer. These results demonstrate that normal fetuses and young can be produced from embryos cryopreserved by the simple and rapid method of vitrification. PMID- 3656283 TI - Biogenic amine regulation of bovine luteal progesterone production in vivo. AB - Biogenic amines were administered using osmotic pumps placed subcutaneously in the neck region of regularly cycling, non-lactating dairy cows on Days 9-11 (oestrus = Day 0) of the oestrous cycle. Blood samples were collected using indwelling jugular catheters and the plasma progesterone concentrations were measured. Samples were collected at 4-h intervals for the first 12 h of treatment and thereafter at 12-h intervals for the remainder of the 72-h treatment period. After administration of various doses of noradrenaline, adrenaline and serotonin (0.5-2.0 micrograms/kg/h) significant elevation of plasma progesterone was achieved at a dosage of 2.0 micrograms/kg/h (P less than 0.01). The response to adrenaline was greater than that observed for noradrenaline and serotonin (P less than 0.05). Within-treatment comparison to pretreatment samples showed plasma progesterone concentrations to increase within 4 h after the administration of noradrenaline, adrenaline and serotonin (P less than 0.05) and this enhancement was maintained throughout the treatment period (P less than 0.05). The elevation in plasma progesterone concentrations induced by noradrenaline, adrenaline and serotonin was independent of changes in circulating concentrations of luteinizing hormone. These results support a physiological role for endogenous biogenic amines in the control of bovine luteal progesterone production. PMID- 3656284 TI - Photoperiodic modification of negative and positive feedback effects of oestradiol on LH secretion in ovariectomized goats. AB - Ovariectomized Shiba goats carrying an oestradiol implant (4-10 pg/ml) were kept under a short-day light regimen (10L:14D; Group 1, N = 4) or a long-day regimen (16L:8D; Group 2, N = 4). Plasma LH concentrations were lower (P less than 0.05) in Group 2 than in Group 1 between Days 40 and 200, suggesting an enhanced negative feedback effect of oestradiol on LH secretion under a long-day regimen. On Days 30, 60, 100, 149 and 279, an LH surge was induced by i.v. infusion of oestradiol for 48 h; the infusion rate was gradually increased from 0.5 (0 h) to 4.1 (48 h) micrograms/h, thereby mimicking the preovulatory increase of oestradiol secretion. The duration and magnitude of the induced LH surge were indistinguishable between the groups. The latency from the onset of oestradiol infusion to the LH surge was relatively constant in Group 1, 41.1 +/- 0.9 h (mean +/- s.e.m., n = 17) but was shorter in Group 2 (19.7 +/- 3.7 h, P less than 0.05) on Day 149; less oestradiol was therefore required for induction of the LH surge (27.4 vs 89.7 micrograms, P less than 0.01), suggesting an increased sensitivity to the oestradiol positive feedback under a long-day regimen. These results might be interpreted to indicate that the hypothalamic-pituitary axis of the goat becomes hypersensitive to the positive as well as the negative feedback effect of oestradiol under long-day conditions. PMID- 3656285 TI - Time of parturition in rats after melatonin administration or change of photoperiod. AB - Two experiments were carried out with rats isolated at mating (Day 1 of gestation) and kept in a standard light regimen of 14 h light (14L:10D). All treatments started on Day 8 of gestation; periodicities of 23:45 h, 24:00 h and 24:15 h were applied to the light phase (14L) in Exp. I and to daily treatment with melatonin (0.3 mg/rat) or its vehicle in Exp. II. In Exp. II, the animals were placed in a continuous dim light regimen and injections were given at a time corresponding to lights off. In all groups, rats delivered on the afternoon of Day 22 and on the morning of Day 23 after a cessation of parturitions. The rates of births during these two times depended on the periodicities of the light phase or those of melatonin administration. With a periodicity of 24:15 h, 85.7% of rats in Exp. I and 85.7% of rats in Exp. II delivered on Day 22. With a periodicity of 23:45 h, 83.0% of births occurred on Day 23 in Exp. I and 57.7% in Exp. II with melatonin instead of 25.9% in the corresponding vehicle controls. These results suggest that melatonin secretion may be a mechanism whereby photoperiod regulates the time of parturition in the rat. PMID- 3656287 TI - Seasonal changes in testicular contents and plasma concentrations of androgens in the desert gerbil (Gerbillus gerbillus). AB - Gerbils were caught in the Beni-Abbes area (Algeria). Testicular endocrine activity was highest in spring (testicular wt 298 +/- 10 mg; seminal vesicle wt 603 +/- 62 mg; testicular testosterone and androstenedione content 9.2 +/- 1.7 and 0.5 +/- 0.1 ng/testis; plasma testosterone 832 +/- 200 pg/ml). Values decreased in summer, were lowest in late summer and in autumn (84 +/- 17 mg; 40 +/- 14 mg; 0.20 +/- 0.06 and 0.02 +/- 0.01 ng/testis; 228 +/- 54 pg/ml, respectively) and increased again in winter (December-January). The onset of testicular endocrine activity was concomitant with the lowest temperatures and the shortest photoperiod; it increased when temperatures and daylength were increasing and began to decline when temperatures and photoperiod were still maximal. These seasonal changes in the endocrine activity of the testis of the gerbil differ from those of the sand rat inhabiting the same area. PMID- 3656286 TI - In-vitro synthesis of a low molecular weight lipid-soluble luteotrophic factor by conceptuses of cows at day 13-18 of pregnancy. AB - Two culture systems for maintenance of Day 13-18 conceptus tissue were developed. Harvested culture media were assayed for luteotrophic activity by determining their ability to stimulate progesterone synthesis by dispersed bovine luteal cells. Significant luteotrophic activity was found in 80% of the 31 tissue culture media studied. A series of experiments carried out to determine the nature of the luteotrophic activity indicate that it is a small (Mr less than 10,000), heat-labile, lipid-soluble substance that is adsorbed by dextran-coated charcoal. The nature and activity of this factor, together with its synthesis by the early bovine conceptus, suggest that it may have a significant role in stimulating progesterone synthesis by the corpus luteum during early pregnancy. PMID- 3656288 TI - Rate of gonadotrophin-induced abnormalities in mouse ova is related to the site of hormone administration. AB - Adult female mice, regardless of the stage of the oestrous cycle, were superovulated with PMSG and hCG. Ovulated oocytes were recovered 20-22 h after hCG and fertilized ova 72-74 h after hCG. Compared with the controls, the gonadotrophin treatment increased the mating rate of the females, and the incidence of abnormal ova. Regardless of the site of gonadotrophin injections, the numbers of ova were equal, but the proportion of abnormal eggs in mice injected intraperitoneally was significantly higher than in mice injected subcutaneously. PMID- 3656289 TI - Visualization of pig sperm chromosomes by in-vitro penetration of zona-free hamster ova. AB - Zona-free hamster eggs were penetrated by pig spermatozoa capacitated using bovine follicular fluid and Percoll gradients. A mean penetration rate of 80.1% was obtained from 5 ejaculates from 2 boars. Penetrated eggs were cultured and analysable metaphase chromosome spreads were obtained from 16.8%. The analysis of 20 pig sperm complements indicated that 9 were 19, Y, 10 were 19, X and 1 appeared to have an XY sex chromosome constitution. PMID- 3656290 TI - Terbutaline treatment inhibits the hCG-induced increase in venular permeability in the rat testis. AB - Treatment with hCG results in an increase in venular permeability in the rat testis. This change in vascular permeability can be detected by the carbon labelling technique, by measurement of the volume of interstitial fluid and by quantification of the leucocyte migration into the interstitial space. Carbon labelling, interstitial fluid volume and leucocyte migration were all reduced in rats treated with hCG+ terbutaline compared to the values in animals given hCG only. However, terbutaline treatment did not influence the hCG-induced increase in testosterone secretion. These observations suggest that the hCG-induced increase in vascular permeability in the testis can be reduced by a beta adrenergic agonist. PMID- 3656291 TI - Role of LH pulse amplitude and the rate of LH increase on oestradiol-17 beta secretion by immature rat ovaries in perfusion culture. AB - Immature rat ovaries were placed in perifusion culture and exposed to LH in a variety of patterns, while tonic levels of FSH (200 ng/ml) were maintained. Perifusate was collected every 5 min and assayed for oestradiol-17 beta. In Exp. I, LH was delivered at 50 ng/ml for 30 min then reduced to 0 ng/ml for an additional 30 min (50 ng/ml LH step) or as linear increasing concentrations reaching 50 ng/ml by 30 min of culture then linear decreasing concentrations reaching 0 ng/ml by 30 min of culture (50 ng/ml LH ramp). Although both delivery systems exposed the tissue to 250 ng LH over the 1-h culture period, only the 50 ng/ml step significantly increased oestradiol-17 beta secretion rates (P less than 0.05). In Exp. II, ovaries were not exposed to LH for the first 30 min of culture but then LH was administered at a concentration of 25 or 50 ng/ml for 30 min. The LH concentration was reduced to 0 ng/ml for an additional 30 min of culture. Oestradiol-17 beta secretion rates were increased 50% by both treatments. These results suggest that the mechanism by which an LH pulse stimulates the immature ovary to secrete oestradiol-17 beta is, in part (1) 'threshold'-dependent and not solely dependent on the amount of LH administered, and (2) dependent on the time required to achieve a 'threshold' level. PMID- 3656292 TI - Long-term study of the immuno-pathological consequences of sympathetic orchiopathia in the rat. AB - Unilateral testicular ischaemia was induced in Wistar rats by ligation and division of the testicular and deferential vessels. Damage (as assessed by a Johnsen count) to the contralateral testis caused significant spermatogenic suppression only at the equator of the testis at 28 days after operation. Cytotoxic antisperm antibody production increased progressively from 7 to 14 days and became maximal at 28 days after infarction, but after 3 and 6 months antibody production was decreasing. The presence of agglutinating antisperm antibody was noted at 28 days, 3 months and 6 months after infarction. Serum immunoglobulin estimations revealed an increase in IgG and IgM levels at 7 days and IgM levels at 14 days, supporting the contention that an immunological reaction had occurred. It is suggested that unilateral testicular ischaemia in the rat, an animal model intended to mimic torsion of the testis in the human, causes a transient immunological phenomenon (sympathetic orchiopathia) which recovers over the course of time. Caution should be exercised before regarding this relatively common surgical emergency as an aetiology of oligospermia or asthenospermia. PMID- 3656293 TI - 2-Fluoro-oestradiol does not cause uterine refractoriness but inhibits oestradiol induced implantation in rats. AB - An intravenous injection of 2-fluoro-oestradiol simultaneously with an implantation-inducing dose of oestradiol reduced the number of implantation sites in delayed implanting hypophysectomized rats maintained with progesterone. Administration of 2-fluoro-oestradiol 1 h before or after oestradiol had no effect. Furthermore, injection of as much as 500 ng 2-fluoro-oestradiol 48 h before administration of oestradiol failed to have any effect upon implantation, i.e. failure to block implantation was correlated with failure to induce the uterine refractory state. These results suggest that conversion of primary oestrogens to catechol oestrogens could be important for implantation as well as for the induction of the oestrogen refractory state in the uterus. PMID- 3656294 TI - Reaction of monoclonal H-Y antibody in the ELISA. AB - Monoclonal H-Y antibody of demonstrated specificity was reacted with soluble H-Y antigen in a newly-developed enzyme-linked immunosorbent assay (ELISA). Typing of cell lines was accomplished by qualitative and quantitative absorption. In one case, the antibody was subdivided into equal portions, each of which was absorbed with 1, 3, 6 or 12 X 10(6) cells from male or female; after absorption, the cells were discarded and the antibody was titrated for residual activity in the ELISA. With increasing cell numbers, optical density scores for male-absorbed antibody approached baseline levels. Although male-female differences were pronounced and highly significant, there was also a fall in reactivity after absorption with female cells. PMID- 3656295 TI - Lectin-binding characteristics of mouse oviduct and uterus associated with pregnancy block by autologous antiprogesterone monoclonal antibody. AB - Oviducts and uteri were removed from BALB/cJ and F1 (CBA/Ca X BALB/cJ) mice at known stages post coitum and following treatment with an antiprogesterone monoclonal antibody (DB3) or a non-specific immunoglobulin (DNP). Thin sections of tissue were prepared and reacted with fluorescent conjugates of a wide range of lectins to determine if saccharide alterations were associated with the pregnancy-inhibiting effect of the DB3 antibody in BALB/c, but not F1, individuals. The ampullary region of the DB3-treated BALB/c mice showed the most marked changes, with an almost total inhibition of lectin binding, particularly for N-acetylglucosamine residues. There was also a reduced affinity for a lectin reactive with N-acetylgalactosamine in the uteri of DB3-treated BALB/c mice, associated with an extended expression during gestation of this saccharide in the proximal region of the oviduct in such mice. These are the first biochemical alterations in reproductive tract epithelia to be associated with the efficacy of the DB3 antibody in preventing pregnancy. PMID- 3656296 TI - Environmental influences on immunologically associated spontaneous abortion in CBA/J mice. AB - CBA/J female mice mated to DBA/2 male mice have a high level of fetal resorption. The rate of resorption can be influenced by the environment in which the animals are maintained. PMID- 3656297 TI - Hysteroscopy in perimenopausal and postmenopausal women with abnormal uterine bleeding. AB - From February 1983 to January 1985, we performed outpatient microhysteroscopic examinations on 618 women 45 years of age or older with abnormal uterine bleeding (AUB). Three hundred thirty-four (54%) had normal and functional or hypoatrophic endometrium, 78 (12.6%) had low-risk hyperplasia, 8 (1.3%) had high-risk hyperplasia, and 66 (10.6%) had adenocarcinoma. Correlation with histologic findings revealed the considerable diagnostic accuracy of the technique: its reliability approaches 100% when one deals with endometrial neoplasia, 87.5% with high-risk hyperplasia and 65.2% with low-risk hyperplasia. The diagnosis cannot rely on hysteroscopic examination only. A biopsy can be performed during the examination or immediately thereafter. In 54.1% of AUB patients, no endometrial changes could be detected on hysteroscopy and biopsy. Curettage, therefore, would have resulted in overtreatment of these patients. Moreover, the usefulness of dilatation and curettage in about half of AUB patients over 45 should be questioned seriously. PMID- 3656298 TI - Perinatal morbidity and mortality in a regional perinatal network. AB - A study of pregnancy outcome was performed using a 1982-1985 regional network database of 60,456 infants. The perinatal mortality rate was 15.6 deaths per 1,000 births (total, 942), while the antepartum, intrapartum and neonatal mortality rates were 5.3, 1.6 and 8.7, respectively. Seven hundred forty-three multiple gestation pregnancies (1.2%) and 1,632 major congenital anomalies (2.7%) were identified. The corrected perinatal mortality rate was 13.8 deaths per 1,000 births. This study revealed that prematurity, postdatism, congenital anomalies, low Apgar scores and neonatal complications, including respiratory distress syndrome, pneumothorax, persistent fetal circulation, intracerebral hemorrhage and seizure activity, were major factors contributing to mortality. This analysis suggests that a further reduction in mortality should follow a reduction in preterm deliveries and their sequelae and the early identification and management of maternal and fetal antenatal complications. PMID- 3656300 TI - Nocturnal prolactin levels in infertile women with endometriosis. AB - Both hyperprolactinemia and endometriosis are associated with infertility. A study was performed to ascertain whether sleep-related prolactin (PRL) hypersecretion was present in endometriosis. Fifty-five consecutive infertile women with regular menstrual cycles and admitted for diagnostic laparoscopy were studied. Blood samples were drawn throughout the night preceding surgery. Serum PRL, estradiol and progesterone levels were measured with radioimmunoassays. Nocturnal patterns of PRL secretion may be altered in infertile women with endometriosis, with an exaggerated and prolonged nocturnal peak. This alteration in PRL dynamics may contribute to infertility in women with endometriosis and may be a part of the pathophysiology of this disease. PMID- 3656299 TI - Planned Parenthood experience with triphasil. AB - Triphasil, a low-dose combination oral contraceptive containing levonorgestrel and ethinyl estradiol, was tested in four Planned Parenthood clinics on 317 women between 18 and 34 years of age (mean, 23) for a total of 4,692 cycles, or 361 woman-years of usage. Approximately half these volunteers (165) were nulligravidas, and 309 (97.5%) were white. Despite instructions on proper tablet usage, there were 416 cycles (8.9%) in which one or more tablets were missed. Only one pregnancy occurred, in a cycle in which a total of four tablets was missed, for an uncorrected Pearl index of 0.28 pregnancies per 100 woman-years of usage. No pregnancy resulted from method failure, indicating a 100% efficacy rate for Triphasil when taken properly. The mean length of the menstrual cycle with Triphasil was 27.9 days; the mean length of menses, 4.4 days; and the mean latency period, 2.1 days. Menstrual flow was average in 64.1% of the subjects, light in 34.1%, heavy in 1.3% and variable in 0.5%. Amenorrhea during the tablet free interval occurred in only 0.6% of the 4,692 cycles in which Triphasil was used. Breakthrough bleeding occurred in 6.9% of first cycles and 3.2% of total cycles; spotting, in 10.7% of first cycles and 4.4% of total cycles. Other symptoms that occurred with an incidence of greater than or equal to 1% were acne (1.0%), appetite increase (1.2%), breast discomfort (2.8%), breast enlargement (1.3%), gastrointestinal symptoms (1.7%), simple headache (1.4%) and nausea (1.1%). A total of 44 women (13.9%) discontinued treatment for medical reasons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656301 TI - Hyperbaric oxygen therapy for the treatment of acute carbon monoxide poisoning in pregnancy. A case report. AB - Acute carbon monoxide poisoning occurred in pregnancy. An acute treatment plan involving hyperbaric oxygen administration was employed in place of the more traditional passive approaches usually used during pregnancy. This treatment plan may help circumvent the potentially lethal effect of this gas. PMID- 3656302 TI - Vulvar hematoma secondary to a human bite. A case report. AB - A case of vulvar hematoma resulting from cunnilingus occurred in an alcoholic woman. Incision and drainage with debridement of devitalized tissues, systemic antibiotics covering both anaerobes and aerobes, and counseling are usually required for the optimal result in such cases. PMID- 3656303 TI - Traditional approaches to functional assessment in arthritis. AB - Both clinical rheumatology and medical rehabilitation have traditional functional assessment approaches to patients with arthritis. Drawing from both, a suggested "universe of function" for rheumatic disease patients is presented. The variables included begin with components of the physical examination and continue to maneuvers performed by the patient, mobility, activities of daily living (ADL), upper extremity function, extended living functions, and global assessment instruments. The development of standardized methodologic techniques is greater for some variables, especially ADL. In all, there is a need for a consensus approach so that aggregate data generated in different studies and programs will be more comparable. PMID- 3656304 TI - The Functional Status Index: reliability and validity of a self-report functional disability measure. AB - Practical, reliable and valid functional assessment instruments are needed to assist health providers in planning a patient's discharge from hospital and determining the need for rehabilitation or longterm care. In addition, such instruments can be used in clinical and epidemiological research. Several methods of assessing functional performance are available. Patient self-report offers many advantages: cost, speed of obtaining assessments and the potential for assessing a wide range of complex functional dimensions. Criticisms of this approach center around the degree to which the data are a reliable and valid reflection of patient function. We developed a Functional Status Index (FSI) and assessed its validity in 47 patients with hip fracture by comparing it to the results of objective functional performance tests. Our results indicate that patient self-report of function, if conducted with a structured, standardized format, yields data with considerable reliability and validity. PMID- 3656306 TI - The role of the biomechanics laboratory in the analysis of the gait of individuals with arthritis. AB - The function of a biomechanics laboratory is to measure those aspects of an individual patient's performance that cannot be quantitatively assessed in the clinical setting. Essential equipment provides the ability to measure gait events, ground reactive forces, kinematics (movement of the body and its segments in 3 dimensions), electromyographic activity, and oxygen consumption. A minicomputer with video screen is required to process the data and allow visual checks of the functioning of the system. Such things as moments around joints and deforming forces may be calculated from the measured variables. Illustrations are given of a schematic laboratory system, computer generated stick diagrams, real time changes in forces, moment-arms, moments, and excursions, in addition to the alteration of these variables in tibial nerve paralysis and degenerative arthritis of the knee. PMID- 3656305 TI - Efficacy of psychoeducational interventions on pain, depression, and disability in people with arthritis: a meta-analysis. AB - Meta-analysis is a technique which combines data from several properly and similarly designed controlled studies so as to increase the power of the relevant statistical analysis. Fifteen studies on the effects of psychoeducational interventions on disability, pain and depression in individuals with chronic rheumatoid arthritis or osteoarthritis were analyzed by this method. The results indicate that patient education can indeed contribute to improving the health status of such patients. PMID- 3656307 TI - Rehabilitation engineering technology and the arthritis patient. AB - Patients with arthritis and related disorders experience major limitations in their abilities to do work in the environment. The selective and appropriate use of technical aids and new forms of advanced technology can resolve dysfunctions of mobility, self-care, and manipulation of objects in the environment. This paper reviews the state of the art of various technologies for the disabled and points out specific applications and limitations to the patient with arthritis. PMID- 3656308 TI - Creating opportunities in rehabilitation research training. AB - To address a serious manpower shortage in rehabilitation research, the National Institute on Disability and Rehabilitation Research in 1986 created the Rehabilitation Research Career Award. This award is intended to support individuals with advanced clinical training for research careers in fields related to rehabilitation, including arthritis. The paper describes the 7 ingredients considered necessary for a qualified research training program in rehabilitation. PMID- 3656309 TI - The role of the Arthritis Foundation in training of rehabilitation research manpower. AB - In 1973 the Arthritis Foundation established a research training program for nonphysician health professionals in fields related to nonmedicinal care such as physical therapy, occupational therapy, psychology and health education. This program is primarily designed for individuals performing the research involved in a predoctoral program. For trained investigators in this field the Foundation offers a research grants program as well. PMID- 3656310 TI - Provision of health care for cystic fibrosis. PMID- 3656311 TI - Needs and opportunities for innovation in psychopharmacology. PMID- 3656312 TI - Adrenal suppression following low-dose topical clobetasol propionate. AB - The use of topical steroids is associated with adverse systemic effects such as suppression of the hypothalamic-pituitary-adrenal (HPA) axis, and application of more than 50 g per week of clobetasol propionate cream has been shown to cause secondary adrenal failure. We describe 4 patients who used clobetasol propionate cream over a prolonged period; 3 patients used less than 50 g per week (7.5, 25 and 30 g per week) and yet all developed secondary adrenal failure for up to 4 months after cessation of therapy. Adrenal insufficiency following prolonged use of clobetasol propionate in moderate dosages may therefore be more common than previously recognized. It is suggested that the metyrapone test, which conveniently examines the entire HPA axis, should be employed in patients receiving long-term topical clobetasol propionate cream and that glucocorticoid supplementation should be given during episodes of stress, such as infections and surgery, for up to 4 months after cessation of therapy. PMID- 3656313 TI - Anticonvulsant drugs and bone disease in the elderly. AB - Elderly psychiatric inpatients were studied to find the prevalence of osteomalacia in those taking anticonvulsant medication (n = 19) and a comparison group not taking these drugs (n = 37). Only one biopsy-proven case was discovered among the anticonvulsant group, and none in the comparison group. This was an unexpectedly low rate. The clinical and biochemical data (including alkaline and acid phosphatase isoenzymes) were further analysed to detect subclinical osteomalacia, but none was found. A difference between the two subgroups was found for total and liver alkaline phosphatase only. The possible explanations for these unexpected findings are discussed. The effect of anticonvulsants on vitamin D and bone metabolism is reviewed and the hypothesis that drug-induced changes in vitamin D metabolism are responsible for the bone changes described in earlier series is questioned. PMID- 3656314 TI - Association between azathioprine therapy and lymphoma in rheumatoid disease. AB - Three out of 41 patients treated with azathioprine and low-dose corticosteroids from 1976 to 1983 developed non-Hodgkin's lymphoma. This strikingly high incidence of lymphoma may be a reflection of long-term use of azathioprine. PMID- 3656315 TI - Effects of sperm protamine on human cervical epithelial cells and BHK 21 cells in vitro. AB - The addition of protamine, of both human and animal origin, to cultures of epithelial and fibroblastic cells has demonstrated that this component of sperm proteins may be capable of bringing about neoplastic transformation in vitro. PMID- 3656316 TI - Clinical pharmacology in criminal cases: discussion paper. PMID- 3656317 TI - Brain transplantation--still fantasy? Discussion paper. PMID- 3656319 TI - Pseudomonas stutzeri causing late prosthetic valve endocarditis. PMID- 3656318 TI - Bilateral unipapillary kidneys and haematuria. PMID- 3656320 TI - Primary aortoenteric fistula. PMID- 3656321 TI - Pulmonary embolism masquerading as Stokes-Adams attacks. PMID- 3656322 TI - Drug safety and the CSM. PMID- 3656323 TI - Myocardial infarction and mental illness. PMID- 3656324 TI - Communication in surgical practice. PMID- 3656325 TI - Abdominal tuberculosis. PMID- 3656326 TI - Deaths from choking on food in infancy. PMID- 3656327 TI - Acute appendicitis and carcinoma of the colon. PMID- 3656328 TI - Pasteurella multocida meningitis. PMID- 3656329 TI - Intra-abdominal sepsis. PMID- 3656330 TI - Motor neuron disease and ethics: a neurologist's point of view. PMID- 3656331 TI - Possible origin of synovial lining cell hyperplasia in rheumatoid arthritis. AB - A perplexing feature of rheumatoid arthritis is the increase in the number of synovial lining cells with no mitotic activity. This feature has been investigated in the rabbit model. Rabbits with the established condition were injected into the affected joint with tritiated thymidine and killed either up to 24 hours later, or at 3 or 7 days. The location of labelled cells, detected by autoradiography, showed the label predominantly in the stroma in the former, and mainly in the lining cells in the latter, indicating that the lining cells were derived by recruitment from active cells deep in the stroma. PMID- 3656332 TI - Alcohol consumption of patients attending two accident and emergency departments in north-west England. AB - The impact of alcohol use on the workload of two accident & emergency departments in north-west England was assessed by blood alcohol concentration (BAC) measurement, inspection of clinical records and interview of all patients aged 16 and over attending throughout a two-week period. The frequency of intoxication was similar to the previous reported rate in Scotland: 13.2% of all patients had a positive BAC. Inebriated injured patients arrived at all times of the day- varying in frequency from 2.5% of midday attenders to 78% of those presenting after midnight. The incidence of alcohol-related industrial accidents was low, but 60% of all assaulted patients were inebriated, many having sustained head injuries. Of patients attending within 2 hours of an accident at home, 19% also had a positive BAC, but 92% of those with ankle sprains were sober. Patients in lower social classes reported higher rates of alcohol consumption. The popularity of beer in comparison to wines and spirits was inversely related to age and unrelated to social class. Alcohol abuse is commonly associated with injuries sustained at home and with assaults occurring in public places. Prevention campaigns directed at the reduction of these types of incidents should be as concerned with the inebriation of the patient as with the architectural, environmental and legal framework within which the 'accident' occurs. PMID- 3656333 TI - Pericardial effusion complicating breast cancer. AB - Thirty-five patients with metastatic breast cancer and pericardial effusions are described. They were treated with specific endocrine or chemotherapy. Twenty-two (63%) had presented in cardiac tamponade and were rapidly relieved by pericardiocentesis. Eighteen (82%) of these required no further local treatment, 2 obtained relief from a second aspiration and 2 needed additional treatment (intrapericardial bleomycin instillation and surgical pleuropericardial window). The median survival was 13.2 months. No patient relapsed again in the pericardium, suggesting that their prognosis was that of the underlying disease. Cardiac tamponade should be considered in any breathless patient with malignancy. In breast cancer, periocardiocentesis is lifesaving and systemic treatment can usefully prolong life. PMID- 3656334 TI - Fulminant ulcerative colitis in late pregnancy and the puerperium. AB - Four patients underwent emergency colectomy during pregnancy or the puerperium for complications of ulcerative proctocolitis. Three had inactive colitis at conception, while in the fourth the disease started during pregnancy. Three patients required subtotal colectomy and ileostomy for toxic dilatation during the third trimester or within 5 days of delivery, and the fourth underwent proctocolectomy postpartum for intractable colitis. There were no maternal deaths but 2 of 4 infants died. One child weighing 1.4 kg survived vaginal delivery during the 33rd week of pregnancy, 2 weeks after his mother had undergone emergency colectomy. PMID- 3656335 TI - Intracellular metabolites in rat muscle following trauma: a 31P and 1H nuclear magnetic resonance study. AB - Hind limb skeletal muscle was studied in vivo in a rat trauma model using nuclear magnetic resonance (NMR) spectroscopy. The model used was a 25% body surface area, full-thickness burn administered under anaesthesia. Two groups of six rats were studied. Weight loss was observed in the experimental group whilst the control group continued to gain weight. Concentration ratios involving intramyocellular phosphocreatine (PCr), creatine (Cr), adenosine triphosphate (ATP), inorganic phosphate (Pi), anserine (Ans) and taurine (Tau) were measured. No change in the ratios of PCr/Pi, PCr/ATP, Ans/PCr + Cr and Tau/PCr + Cr were seen between the two groups. Intracellular pH was the same in the two groups. NMR spectroscopy in vivo gives values of Pi and PCr that differ from those obtained by conventional techniques. NMR values are probably more accurate as no degradation occurs during measurement, the measurements being repeatable and noninvasive. PMID- 3656336 TI - Hormones and behaviour: discussion paper. PMID- 3656337 TI - Promoting prevention and patient autonomy: discussion paper. PMID- 3656338 TI - Late recurrence of an abdominal haemangiopericytoma. PMID- 3656339 TI - The cause of death: blood hyperviscosity? PMID- 3656340 TI - Sociotherapy and psychotherapy in the treatment of personality disorder. PMID- 3656341 TI - Recent advances in management of cystic fibrosis. PMID- 3656342 TI - The treatment of our son with cystic fibrosis. PMID- 3656343 TI - Our experiences of cystic fibrosis and what we expect from the paediatrician. PMID- 3656344 TI - The case for cystic fibrosis centres. PMID- 3656345 TI - The experience and expectations of parents of a child with cystic fibrosis. PMID- 3656346 TI - Inactivation of thymidylate synthase at an alternate high-affinity binding site. PMID- 3656347 TI - Diketopiperazines as a new class of platelet-activating factor inhibitors. PMID- 3656348 TI - Synthesis of angiotensin II antagonists with variations in position 5. AB - Six angiotensin II antagonists containing cyclohexylglycine (Chg) or cyclopentylglycine (Cpg) in position 5 were synthesized by stepwise elongation in solution, using the pentafluorophenyl ester method. The influence of substitution on the inhibitory properties of the analogues was studied in four different bioassays. [Sar1,Chg5,Lac8]AII proved to be the most potent antagonist with low intrinsic activity in both the in vitro and in vivo tests. PMID- 3656349 TI - Cardiotonic agents. 6. Synthesis and inotropic activity of 2,4-dihydro-5-[4-(1H imidazol-1-yl)phenyl]-3H-pyrazol-3-ones: ring-contracted analogues of imazodan (CI-914). AB - A series of 2,4-dihydro-5-[4-(1H-imidazol-1-yl)phenyl]-3H-pyrazol-3-ones was synthesized and evaluated for positive inotropic activity. Only compounds with two small alkyl groups at C-4 showed significant activity. The structure-activity relationships for optimal inotropic activity are presented and compared with those of the 4,5-dihydro-3(2H)-pyridazinone series. The phosphodiesterase inhibitory activity is also reported and correlated with the substitution pattern at C-4 in the pyrazolone ring. PMID- 3656350 TI - Discovery and anticonvulsant activity of the potent metabolic inhibitor 4-amino-N (2,6-dimethylphenyl)-3,5-dimethylbenzamide. AB - Compound 2 [4-amino-N-(2,6-dimethylphenyl)benzamide] is an effective anticonvulsant in several animal models. For example, following oral administration to mice, it antagonized maximal electroshock (MES) induced seizures with an ED50 of 1.7 mg/kg. During drug disposition studies with 2, we found that it was rapidly metabolized by N-acetylation. Thirty minutes after oral administration of 1.7 mg/kg of 2 to mice, plasma concentrations of parent drug and the N-acetyl metabolite 5 were 1.09 and 0.41 microgram/mL, respectively. Six hours postadministration the concentrations were 0.23 and 0.22 microgram/mL, respectively. In order to sterically preclude or diminish the rate of metabolic N acetylation, we synthesized analogues of 2 possessing either one (3) or two (4) methyl groups ortho to the 4-amino substituent. Both compounds antagonized MES induced seizures after administration to mice; oral ED50 values for 3 and 4 were 3.5 and 5.6 mg/kg, respectively. Compound 3 was rapidly metabolized by N acetylation. However, 4 provided exceptionally high and long-lived plasma concentrations of parent drug; no N-acetyl metabolite could be detected. While 2 and 3 had no pharmacologically relevant effects on hexobarbital-induced sleeping time in mice, 4 was a potent, dose-dependent potentiator of sleeping time. Oral administration of 375 micrograms/kg led to a 61% increase in sleeping time relative to control values. Thus, 4 represents one of the most potent potentiators of hexobarbital-induced sleeping time described to date. PMID- 3656351 TI - Synthesis of potential anticancer agents: imidazo[4,5-c]pyridines and imidazo[4,5 b]pyridines. AB - The 1,2-dihydropyrido[3,4-b]pyrazines (1) are mitotic inhibitors with significant antitumor activity in mice. Also, the active imidazo[4,5-b]pyridine 3 was shown to cause the accumulation of cells at mitosis. Routes were developed for the synthesis of congeners of 3 by cyclization of 4-(substituted amino)-5,6 diaminopyridines with ethyl orthoformate. Oxidative cyclization of either 4,5- or 5,6-diaminopyridines with aryl aldehydes produced the [4,5-c] and [4,5-b] imidazopyridine ring systems, respectively. The latter reaction with 6 (substituted amino)-4,5-diaminopyridines gave imidazo[4,5-c]pyridine ring analogues of 1. Biological studies indicated that the target compounds were less active than 1 and 3. PMID- 3656352 TI - Synthesis, conformational considerations, and estrogen receptor binding of diastereoisomers and enantiomers of 1-[4-[2-(dimethylamino)ethoxy]phenyl]-1,2 diphenylbutane (dihydrotamoxifen). AB - As part of a study into nonisomerizable antiestrogens, the diastereoisomeric dihydrotamoxifens 7 and 8 were prepared by catalytic transfer hydrogenation of (Z)- and (E)-tamoxifen and were shown by NMR spectrometry to exist in preferred conformations with hydrogen atoms in an antiperiplanar relationship. The corresponding 4-hydroxy derivatives 9 and 10 were prepared from hydrogenated precursors of (Z)- and (E)-4-hydroxytamoxifen. The relative binding affinities (RBA) of the compounds to estrogen receptors are consistent with the assigned conformations and parallel reported data on derivatives of the nonsteroidal estrogen hexestrol. The growth-inhibitory activity against the MCF-7 human breast cancer cell line in vitro was for 10 comparable to that of 4-hydroxytamoxifen, although increasing the concentration from 10(-8) to 10(-6) M did not significantly improve the growth inhibition. The derivative 9 analogous to (E)-4 hydroxytamoxifen antagonized the growth-stimulating effect of added estradiol and is therefore also an antiestrogen but at low concentration (10(-8) M) in the absence of estradiol, MCF-7 cell growth was stimulated, indicating an estrogenic influence. The enantiomers of the dihydrotamoxifen 8 were individually prepared from the resolved enantiomers of 2-phenylbutanoic acid, the key reaction step being a lithium-ammonia reduction of the 1-(4-methoxyphenyl)-1,2-diphenyl-1 butanol to generate the triphenylbutane. The enantiomers of 8 gave identical RBA values in cytosol. PMID- 3656353 TI - Plant antitumor agents. 25. Total synthesis and antileukemic activity of ring A substituted camptothecin analogues. Structure-activity correlations. AB - Nineteen racemic ring A substituted analogues of the antitumor agent 20(S) camptothecin were prepared by total synthesis and evaluated for in vitro cytotoxic activity against KB cell culture and in vivo antileukemic activity against L1210. These compounds bore a wide variety of substituents at C11 designed to confer upon the ring system a broad range of combinations of electronic, steric, and lipophilic effects. A few C10-substituted derivatives as well as C10,C11-disubstituted analogues prepared as part of a concurrent study have also been included for general comparison. With the notable exception of the cyano derivative, the 11-substituted compounds displayed only modest in vitro and in vivo activities, and there was a remarkable insensitivity toward the nature of the substituent. In contrast, the 9- and 10-substituted compounds exhibited a considerably higher level of dose potency and activity both in vitro and in vivo. PMID- 3656354 TI - Synthesis and structure-activity relationships of 1-substituted 4-(1,2 diphenylethyl)piperazine derivatives having narcotic agonist and antagonist activity. AB - Racemates and enantiomers of 1-substituted 4-[2-(3-hydroxyphenyl)-1 phenylethyl]piperazine derivatives (3-18) were synthesized, and their analgesic and other pharmacological activities and structure-activity relationships were investigated. The S-(+) enantiomers of 2a, 5, 7, 9, 10, and 15-18 had a stronger analgesic activity than their R-(-) enantiomers; analgesic activity of the strongest one [(S)-(+)-10] was 105 times as potent as that of morphine. The S-(+) enantiomers of these compounds had the opposite configuration to that of morphine with respect to its (C-9) asymmetric center but the same configuration to that of the tyrosine residue of Met5-enkephalin. The R-(-) enantiomers of 16 and 18 showed narcotic antagonist activity, but the S-(+) enantiomers did not. (R)-(-) 18 had analgesic and narcotic antagonist activities comparable to pentazocine but showed no significant physical dependence liability. From these results, it is suggested that these compounds show an uncommon enantioselectivity in comparison with morphine and its surrogates, and belong to a new series of compounds having a potent analgesic activity. PMID- 3656355 TI - Effects of [(N-alkyl-1,3-dioxo-1H,3H-isoindolin-5-yl)oxy]alkanoic acids, [(N alkyl-1-oxo-1H,3H-isoindolin-5-yl)oxy]butanoic acids, and related derivatives on chloride influx in primary astroglial cultures. AB - It has been shown that agents that inhibit chloride influx and therefore lower intracellular chloride levels in a major cell type in cerebral gray matter, the astrocyte, inhibit astrocytic swelling in vitro and in vivo. In our laboratories, 4-[(N-alkyl-1,3-dioxo-1H,3H-isoindolin-5-yl)oxy]alkanoic acids and related derivatives have been synthesized and tested for ability to lower intracellular astrocytic chloride levels in an established in vitro cultured rat astrocyte model. In general, derivatives with nitrogen substituents such as relatively small alkyl groups are active at 0.1 mM and/or 0.5 mM levels whereas larger substituents such as cyclopentyl and cyclohexyl are less active. Halogen substitution on the aromatic ring did not enhance activity. Derivatives with acid side chains of four carbons demonstrated superior activity to those of two carbons. PMID- 3656356 TI - Thromboxane synthase inhibitors. Synthesis and pharmacological activity of (R)-, (S)-, and (+/-)-2,2-dimethyl-6-[2-(1H-imidazol-1-yl)-1-[[(4-methoxyphenyl)- methoxy]methyl]ethoxy]hexanoic acids. AB - A series of substituted omega-[2-(1H-imidazol-1-yl)ethoxy]alkanoic acid derivatives were synthesized and evaluated for their ability to inhibit thromboxane synthase both in vitro and in vivo. Compound 13 was identified as a potent and selective competitive inhibitor of human platelet thromboxane synthase having a Ki value of 9.6 X 10(-8) M. In collagen-treated human whole blood, 13 potentiated levels of 6-keto PGF1 alpha. Enantiospecific syntheses afforded the R and S enantiomers of 13, of which the S enantiomer 13b was the more potent. Compounds 13 and 13b were potent in vivo inhibitors of thromboxane synthase with good oral activity and duration of action. PMID- 3656357 TI - 6-Methylergoline-8-carboxylic acid esters as serotonin antagonists: N1 substituent effects on 5HT2 receptor affinity. AB - Three series of 6-methylergoline-8-carboxylic acid esters with various alkyl substituents in the N1-position were prepared and their 5HT2 receptor affinities measured. Some overlap occurred in the 5HT2 receptor affinities of the different ester series, indicating that both the ester side chain and the indole substituent influenced 5HT2 receptor affinity. While 5HT2 receptor affinity was affected by the structure of the ester side chain, the N1-substituent played a more crucial role in determining 5HT2 receptor affinity. When the ester side chain was held constant, maximal 5HT2 receptor affinity for that series of esters was obtained when the N1-substituent was isopropyl. Smaller substituents in the N1-position resulted in reduced 5HT2 receptor affinity. Groups C4 or larger in the N1-position resulted in a further decline in 5HT2 receptor affinity. The importance of the N1-substituent in determining 5HT2 receptor affinity was further substantiated when several 2-methyl-3-ethyl-5-(dimethylamino)indoles with various N1-substituents were tested. Again, maximal 5HT2 receptor affinity was obtained when the N1-substituent was isopropyl. PMID- 3656358 TI - C1- and C3-methyl-substituted derivatives of 7-hydroxy-2-(di-n propylamino)tetralin: activities at central dopamine receptors. AB - C1- and C3-methyl-substituted derivatives of the potent dopamine (DA) receptor agonist 7-hydroxy-2-(di-n-propylamino)tetralin (7-OH-DPAT) have been synthesized, and their conformational preferences have been studied by use of NMR spectroscopy, X-ray crystallography, and molecular mechanics (MMP2) calculations. The compounds were tested for activity at central DA receptors, by use of biochemical and behavioral tests in rats. (1S,2R)-7-Hydroxy-1-methyl-2-(di-n propylamino)tetralin [(+)-10] was demonstrated to be sevenfold less potent than (2R)-7-OH-DPAT as a DA receptor agonist. The other new compounds were of lower potency or inactive. PMID- 3656359 TI - Total synthesis and biological evaluation of structural analogues of compactin and dihydromevinolin. AB - The full experimental details for the total synthesis of (+)-compactin and 19 structural analogues are reported. We have evaluated three classes of analogues as inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A reductase: (1) functional and stereoisomeric analogues that possess the full carbon skeleton of compactin or dihydromevinolin, (2) functional analogues in which one carbon of the skeleton has been replaced by oxygen, and (3) analogues in which all of the 3,5 dihydroxyvaleric acid moiety has been omitted. Our most potent inhibitors belong to the first class of analogues. Compounds 42 (5-ketocompactin) and 69 (5 ketodihydromevinolin) are as active as the natural products compactin and dihydromevinolin, respectively (I50 = 1-20 nM). The corresponding enones 37 and 68 are less active, having I50 values 20-30 times larger. Inverting the stereochemistry at C-3 or C-5 or about the hexahydronaphthalene ring of compactin results in the elevation of the I50 to values in the micromolar range, comparable to the KM of the natural substrate 3-hydroxy-3-methylglutaryl coenzyme A. Class 2 analogues are active in this concentration range also. The synthetic sequence developed for compactin and its analogues includes a new method that permits the selective preparation of either the R or the S epimer at C-3 of the 3,5 dihydroxyvaleric acid moiety. This entails the reaction of anhydride 9 with either (R)- or (S)-1-phenylethanol in the presence of 4-(N,N dimethylamino)pyridine and triethylamine. The prochiral recognition is surprisingly high; under optimum conditions, the reaction of 9 with (R)-1 phenylethanol leads to a 15:1 ratio of diesters 17 and 18. PMID- 3656361 TI - Synthesis of some [N-(2-haloalkyl)amino]tetralin derivatives as potential irreversible labels for bovine anterior pituitary D2 dopamine receptors. AB - A series of hydroxylated 2-aminotetralins were prepared in the search for irreversible labels for D2 dopamine receptors. N-2-Haloacetyl and N-2-haloalkyl substituents were chosen as potential receptor alkylating groups. Titrimetric studies were carried out on [N-(chloroethyl)-N-methylamino]tetralins 10, 10a, 24, and 26 to demonstrate that aziridinium ions were formed as reactive intermediates from these compounds. This observation was confirmed by 1H NMR studies on compound 10. The majority of the aminotetralins prepared showed reasonably high affinity binding to anterior pituitary D2 dopamine receptors and exhibited agonist properties. Structure-activity results are presented together with preliminary studies designed to identify irreversible receptor binding agents. [N (2-Chloroethyl)-N-propylamino]-6,7-dihydroxytetralin hydrobromide (18) proved most promising in these studies. PMID- 3656362 TI - Evaluation of isomeric 4-(chlorohydroxyphenyl)-1,2,3,4-tetrahydroisoquinolines as dopamine D-1 antagonists. AB - The isomeric 4-(3-chloro-4-hydroxyphenyl)- and 4-(4-chloro-3-hydroxyphenyl) 1,2,3,4-tetrahydroisoquinolines, the N-methyl derivative of the 4-(4-chloro-3 hydroxyphenyl) isomer, and 4-(3-hydroxyphenyl)-1,2,3,4-tetrahydroisoquinoline were synthesized and evaluated for dopamine D-1 antagonist activity. The 4-(3 chloro-4-hydroxyphenyl) and the 4-(3-hydroxyphenyl) isomer possessed similar potencies as D-1 antagonists. Introduction of the N-methyl group enhanced potency about twofold. The "pharmacophore" for selective dopamine D-1 antagonist activity appears to be a tertiary 2-(3-hydroxyphenyl)-2-phenethylamine. PMID- 3656360 TI - Quantitative structure-activity relationships of the bitter thresholds of amino acids, peptides, and their derivatives. AB - Bitter thresholds of a total of 93 amino acids, peptides, and their derivatives were analyzed quantitatively by use of hydrophobicity parameters reported for amino acid side chains and those for the whole molecules estimated from partition coefficients obtained experimentally. We also explored the steric parameters that best explained the variation in the intensity of bitterness attributable to the molecular shape. The results showed that the total length along the zigzag peptide backbone chain of the molecule is an important factor. The bitterness of nonzwitterionic N-acyl and ester derivatives and that of neutral N-acyl ester derivatives were expressed by a single, common equation together with those of zwitterionic amino acids and peptides. Thus the interaction via the charge with the receptor site was probably not an indispensible factor for triggering of the bitter sensation. This study, together with earlier ones, may serve as a prototype of approaches toward unraveling structure-activity relationships of complex molecules like amino acids, peptides, and their derivatives that are of medicinal or agricultural importance. PMID- 3656363 TI - Prodrugs of L-cysteine as protective agents against acetaminophen-induced hepatotoxicity. 2-(Polyhydroxyalkyl)- and 2-(polyacetoxyalkyl)thiazolidine-4(R) carboxylic acids. AB - Eight prodrugs of L-cysteine (1a-h) were synthesized by the condensation of the sulfhydryl amino acid with naturally occurring aldose monosaccharides containing three, five, and six carbon atoms. The resulting 2-(polyhydroxyalkyl)thiazolidine 4(R)-carboxylic acids (TCAs) are capable of releasing L-cysteine and the sugars by nonenzymatic ring opening and hydrolysis. Thus, when added to rat hepatocyte preparations in vitro, these TCAs (1.0 mM) raised cellular glutathione (GSH) levels 1.2-2.1-fold relative to controls. On the basis of this finding, the cysteine prodrugs were tested as protective agents against acetaminophen-induced hepatotoxicity in a mouse model. The TCA derived from D-ribose and L-cysteine (RibCys, 1d) showed the greatest therapeutic promise of the series, with a 100% (12/12) survival profile compared to 17% without treatment. However, the degree of stimulation of GSH production in rat hepatocytes by these prodrugs did not correlate with the extent of protection afforded in mice, suggesting that pharmacokinetic parameters must supervene in vivo. To evaluate the effect of increased lipid solubility, we prepared prodrugs 2a-c by using peracetylated aldehydic sugars in the condensation reaction. These compounds, however, displayed acute toxicity to mice, possibly due to liberation of the acetylated sugars themselves. Nevertheless, the efficacy of the unacetylated TCAs, and RibCys (1d) in particular, suggests that the prodrug approach for the delivery of L-cysteine to the liver represents a viable means of augmenting existing detoxication mechanisms in protecting cells against xenobiotic substances that are bioactivated to toxic, reactive metabolites. PMID- 3656364 TI - Streptonigrin and lavendamycin partial structures. Probes for the minimum, potent pharmacophore of streptonigrin, lavendamycin, and synthetic quinoline-5,8-diones. AB - The preparation and evaluation of 7-amino-5,8-dioxo-2-(2'-pyridyl)quinoline-6' carboxylic acid (5a) and 7-amino-2-(2'-aminophenyl)-5,8-dioxoquinoline-5' carboxylic acid (6a) constituting potential minimum, potent pharmacophores of streptonigrin (1a) and lavendamycin (2a), two structurally related naturally occurring antitumor antibiotics, are detailed. In contrast to observations associated with streptonigrin and lavendamycin in which the C-ring C-6' carboxylic acid potentiates the antitumor, antimicrobial, and cytotoxic properties of the naturally occurring, substituted 7-aminoquinoline-5,8-dione AB ring systems, the C-6'/C-5' carboxylic acid of 5a/6a diminishes the observed antimicrobial and cytotoxic properties of the 2-(2'-pyridyl)- and 2-(2' aminophenyl)-7-aminoquinoline-5,8-diones. A direct comparison of the antimicrobial and cytotoxic properties of a complete set of streptonigrin and lavendamycin partial structures is detailed in efforts to define the role peripheral substituents play in potentiating the biological properties of the naturally occurring and synthetic agents bearing the 7-aminoquinoline-5,8-dione AB ring system and in efforts to define the minimum, potent pharmacophore of the naturally occurring antitumor antibiotics. The relationship of these observations to a chemical mechanism of cellular toxicity is discussed. PMID- 3656365 TI - The dopaminergic moiety of the ergots: a controversial topic studied with molecular mechanics. AB - Conformational analyses of the side chain of model compounds of the in vivo active dopamine receptor agonist 4-[2-(di-n-propylamino)ethyl]indole (DPAI) were performed with molecular mechanics calculations. The results from these calculations, together with the possibility of meta hydroxylation of indoles in vivo, led to the proposal of fitting 6-hydroxy-4-[2-(di-n propylamino)ethyl]indole (6-OH-DPAI), (S)-5-hydroxy-N,N-dialkyl-6,7,8,9 tetrahydro-3H-benzo[e]indol-8-ylami nes and (S)-5-hydroxy-2 (dialkylamino)tetralins in a common concept, considering both stereochemistry and hydrogen-bond function in such an overlap. This study emphasizes the importance of considering both conformational analysis and the possibilities of metabolic activation when performing structure-activity studies based on flexible compounds and in vivo data. The answer to the question as to which part of the ergot molecule is responsible for its dopaminergic effect is thus ambiguous. It is possible that the pyrrolylethylamine moiety of the ergots contributes to both in vitro and in vivo effects, and that their 13-OH metabolites contribute, possibly significantly, to their in vivo effects. PMID- 3656366 TI - Resolution, absolute configuration, and cholinergic enantioselectivity of (-)- and (+)-c-2-methyl-r-5-[(dimethylamino)methyl]-1,3-oxathiolane t-3-oxide methiodide and related sulfones. AB - As a continuation of previous studies on chiral cholinergic agonists carrying a 1,3-oxathiolane nucleus, the enantiomers of c-2-methyl-r-5 [(dimethylamino)methyl]-1,3-oxathiolane t-3-oxide methiodide ((+)- and (-)-1) and of cis-2-methyl-5-[(dimethylamino)methyl]-1,3-oxathiolane 3,3-dioxide ((+)- and ( )-2) were obtained and their absolute configurations established by synthesis. The cholinergic potency of the four isomers was evaluated in vitro on guinea pig ileum and frog rectus abdominis models, and the results show that (-)-1, which has the same absolute configuration as L-(+)-muscarine, is a selective and potent muscarinic agent. The (+)-1 enantiomer is some hundred times less potent than (-) 1 on the muscarinic guinea pig ileum while, on the same tissue, the corresponding sulfone derivatives ((+)- and (-)-2) show no enantioselectivity. PMID- 3656367 TI - Molecular biology and medicinal chemistry. PMID- 3656368 TI - Adult polycystic kidney disease. PMID- 3656369 TI - Polycystic kidney disease in children: a genetic and epidemiological study of 82 Finnish patients. AB - Information of 82 children in Finland, treated during the years 1974 to 1983 for polycystic kidney disease, was collected retrospectively. The occurrence was of the order of 1:8000 births. Fifty-one of the children had early lethal disease and 31 survived for over 28 days. These children came from 69 families. They were divided by family studies into three groups: autosomal dominant polycystic kidney disease (DPKD) in 11 families, autosomal recessive polycystic kidney disease (RPKD) in 14 families, and sporadic cases in 44 families. In three of the DPKD families there were two or more sibs with DPKD which manifested neonatally. The majority of the grandparents of the children with RPKD and sporadic polycystic kidney disease were born in the same sparsely populated areas in northern, central, and eastern Finland, which suggests that most of the sporadic cases are also actually RPKD. The purpose of this study was to find patients with polycystic kidney disease manifesting in childhood and to categorise them using genetic criteria. The observed series of cases genetically classified as DPKD and RPKD will serve as a basis for the further aim of defining clinical criteria for the differential diagnosis of these two entities. PMID- 3656370 TI - Trends in pyloric stenosis incidence, Atlanta, 1968 to 1982. AB - Four studies reported an increasing incidence of pyloric stenosis during the late 1970s from geographically diverse areas of the United Kingdom. It was suggested that the increased incidence might be related to changes in infant feeding practices. We used data from the Metropolitan Atlanta Congenital Defects Program, a population based birth defects registry, to examine the secular trends and descriptive epidemiology of pyloric stenosis in a North American city. For the period 1968 to 1982, the incidence of pyloric stenosis was 1.33 per 1000 live births; there was no evidence of an increasing trend for either race or sex specific rates of pyloric stenosis. The descriptive epidemiology of the pyloric stenosis cases showed higher rates for males, whites, and infants of higher birth weight. We found no increasing trend in pyloric stenosis incidence in Atlanta, despite well documented changes in US infant feeding practices (an increased prevalence of breast feeding) during the 1970s. PMID- 3656371 TI - Intrafamilial variation in Cohen syndrome. AB - Three sibs with Cohen syndrome are presented. Abnormalities present in all three children include mental retardation, hypotonia, and short philtrum with open mouth and prominent lips. The older two sibs have a similar facies and an engaging personality. The youngest child shows a different facial appearance and marked behavioural problems, thereby illustrating the intrafamilial variability which may occur in this disorder. PMID- 3656372 TI - Congenital scalp defects with distal limb reduction anomalies. PMID- 3656373 TI - A chromosome supplement to the London Dysmorphology Database. AB - A supplement to the computerised database for the diagnosis of rare dysmorphic syndromes described by Winter et al is presented, which includes a list of syndromes occurring in patients with unbalanced chromosome aberrations. The extension of the original programme is based on Schinzel's Catalogue of unbalanced chromosome aberrations in man. PMID- 3656374 TI - Trisomy 13 in monozygotic twins discordant for major congenital anomalies. AB - The occurrence of trisomy 13 in twins is very rare. We report a pair of genotypically identical twins with trisomy 13 discordant for major anomalies. This case contributes to the already published data on the contribution of non genetic factors to the aetiology of congenital malformations in monozygotic twins. PMID- 3656375 TI - Partial trisomy 17q and a generalised bone dysplasia in a 12 week fetus. AB - A fetus, which was spontaneously aborted at 12 weeks' gestation, was found to have a generalised bone dysplasia and an unbalanced karyotype with trisomy for 17q23.1----qter due to a maternal translocation: 46,XX,t(5;17)(p15.3;q23.1)mat. PMID- 3656376 TI - The London Dysmorphology Database. PMID- 3656377 TI - Pericentric inversion and sterility. PMID- 3656378 TI - The craniocardioskeletal syndrome and the Noonan-like short stature syndrome are possibly the same entity. PMID- 3656379 TI - Mental retardation with blepharophimosis. PMID- 3656380 TI - What faculty members value in practice plans. AB - Faculty practice plans are under scrutiny at many academic medical centers as teaching hospitals seek ways to encourage their physicians to increase their clinical activities. Discussions with physicians at two medical schools yielded insights into the faculty members' perspective on faculty practice plans. Interviews disclosed that the physicians were satisfied with a practice plan if they felt their professional goals were in balance with the institution's goals. Changes in the plan can either sustain institutional values or introduce new priorities. In view of physicians' loyalty to a particular plan and their anxiety in the face of change, the authors suggest that it may be better to modify an established plan than to impose a new system. The physicians interviewed agreed that strong chairmen can work within any plan to reward faculty members for research, clinical, or administrative contributions and thus to determine a department's directions and character. In considering changes in a practice plan, chairmen, deans, and administrators need to weigh the faculty's values and commitments. PMID- 3656381 TI - A comprehensive performance-based assessment of fourth-year students' clinical skills. AB - Written examinations are widely used for assessment in clinical clerkships and for licensure and specialty board certification, as opposed to assessment based on actual performance with patients. This reliance on written examinations is due to their ease of use and perceived objectivity and occurs despite the fact that the examinations assess few components of clinical competence. Simulated patients can standardize the presentation of a patient problem; and, if the patients are employed in an assessment in a manner parallel to the design of written test items, the assessment can have an objectivity similar to that enjoyed by written tests. Such an assessment allows the major components of clinical competence to be tested. The results and feasibility of using simulated patients in a multiple station assessment of an entire senior class in January 1986 are described. A second assessment was administered to a different senior class in December 1986. This latter assessment was designed in collaboration with another medical school that administered the same assessment to its senior students in March 1987. PMID- 3656382 TI - Geographic and specialty distributions of WAMI Program participants and nonparticipants. AB - In an effort to make the geographic distribution of physicians closer to the distribution of the population as a whole, in 1971 the states of Washington, Alaska, Montana, and Idaho established the WAMI Program. In a departure from the Flexnerian model of medical education, the WAMI Program was organized to distribute the components of medical education throughout the region, both at the medical center at the University of Washington School of Medicine and at remote sites. In the present article, the authors describe the results of the first seven years of the program (1975-1981) in terms of the geographic and specialty distribution of the school's graduates before and after the establishment of the program. At the time of the study, 23 percent of the graduates with WAMI Program experience practiced in nonmetropolitan areas as defined by the U.S. Bureau of the Census. Only 13 percent of all U.S. physicians practiced in such areas in 1981, while 24 percent of the U.S. population lived there. In addition, 61 percent of the graduates with program experience were in primary care practice in contrast to 35 percent of all U.S. physicians. If all U.S. physicians behaved as these graduates do, the distribution of U.S. physicians would be reversed, with the proportion of physicians practicing primary care in nonmetropolitan areas being larger than the proportion of the population living in those areas. PMID- 3656383 TI - Processing of critical information by physicians and medical students. AB - In the study reported here, differences between physicians and medical students in their recall of information from clinical problems were investigated. The focus of the study was on the recognition and recall of critical cues within cases as a function of problem difficulty and the organization of clinical information. Two clinical cases in two structural forms (typical and random) were designed, and the participants' written recall of the cases was analyzed using the techniques of discourse analysis. The results show that the physicians recalled significantly more critical cues than the medical students. However, when the case had a temporally ordered, underlying disease process, the random structure of the text disrupted both the physicians' ability to recall critical cues and the accuracy of their diagnoses. The medical students were unaffected by problem type or structural form in the amount of information they recalled. The results show that the physicians and medical students formulate the information from clinical problems differently, and this difference is due to the fact that the physicians recognize patterns of familiar problems with respect to critical cues but the students do not. PMID- 3656384 TI - Effects of curriculum and format changes in a medical pharmacology course, 1983 to 1987. AB - During the past five years, the medical pharmacology course at the University of Arkansas College of Medicine has changed from a poorly attended course in which students depended on "canned notes" (from a note-taking and note-distribution system organized among themselves) and had bad rapport with faculty members to a course in which attendance is high, the canned-notes system has been abandoned, and faculty-student interactions are generally pleasant. These changes in student behavior occurred during a period in which the pharmacology faculty implemented changes that anticipated the recommendations of the Panel on the General Professional Education of the Physician and College Preparation for Medicine of the Association of American Medical Colleges. These changes included encouraging independent learning, reduced lecture time, and increased problem-solving. The students' performance on the Part I examination of the National Board of Medical Examiners did not change during this period of curriculum revision. PMID- 3656385 TI - Nurses as evaluators of the humanistic behavior of internal medicine residents. AB - The reliability of a 13-item questionnaire designed to assess the humanistic behaviors of internal medicine residents and the reliability of nurses as raters of those behaviors were examined. Twenty-five residents were evaluated by 10 or 11 nurses on two general medicine services and on cardiology and hematology oncology services in a large, highly specialized department of internal medicine. Using an application of generalizability theory, which extends beyond classical test theory to establish estimates of multiple-error sources, the investigators calculated reliability-like coefficients for each of the services. The coefficients were .95 and .85 for the two general medicine services, .67 for cardiology, and .88 for hematology-oncology. These findings indicate that the questionnaire is a reliable instrument for assessing humanistic behavior and identifying reliable raters in groups of nurses. PMID- 3656386 TI - Academic qualifications and nonacademic characteristics of science and nonscience majors applying to medical school. PMID- 3656387 TI - Use of psychoactive substances by residents. PMID- 3656388 TI - Teaching affective skills to residents in decreased instruction time. PMID- 3656389 TI - Second-year students' score improvement during an objective structured clinical examination. PMID- 3656390 TI - The effect of number of cases on performance on a standardized multiple-station clinical examination. PMID- 3656391 TI - To inform or not to inform patients about students. PMID- 3656392 TI - Geriatrics as a career. PMID- 3656393 TI - Typing of Aeromonas species by polyacrylamide-gel electrophoresis of radiolabelled cell proteins. AB - A method for typing species of Aeromonas by 35S-labelling and sodium-dodecyl sulphate polyacrylamide-gel electrophoresis (SDS-PAGE) of total soluble proteins is described. Radiolabelled-protein profiles from different strains were compared by use of the Dice coefficient. Typability was 100% and discrimination of pairs of differing strains was satisfactory with acceptable reproducibility. The results also yielded information on subgroups of phenotypic species. PMID- 3656394 TI - Identification of Bacteroides species from adult periodontal disease. AB - Samples from deep (4-7 mm) periodontal pockets were collected from 17 patients with adult-type periodontal disease and one with the juvenile form of the disease. They were streaked immediately on selective and non-selective media and incubated anaerobically for 96 h. There was a heavy growth of Bacteroides spp. from most samples and 10 representative colonies from each sample were sub cultured for identification. In a total of 149 isolates from patients with adult type disease, the commonest species were B. oralis (40), B. asaccharolyticus (35), B. intermedius (31), B. fragilis (12) and B. ureolyticus (10); B. gingivalis was not detected. The distribution of species was not distorted by multiple identical isolates from individual patients. There was a heavy growth of a single species, B. ureolyticus, from the patient with juvenile-type disease. PMID- 3656395 TI - Primary malignant tumors of the small bowel. PMID- 3656396 TI - Current concepts: care and habilitation of the child with myelomeningocele--a multidisciplinary approach. II. Neurosurgical treatment. PMID- 3656397 TI - Prevention of bacterial endocarditis: current recommendations. PMID- 3656398 TI - Urologic management of the child with myelomeningocele. PMID- 3656399 TI - Public/private partnership works. PMID- 3656400 TI - Medical care for the indigent. PMID- 3656401 TI - Relationship between helix-coil transition and gene organization of ColE1 plasmid DNA. Differential scanning calorimetric and theoretical studies. AB - Differential scanning calorimetry (DSC) was carried out to analyze the transition of helix to coil state of DNA, using ColE1 DNA molecules digested with EcoRI. The DSC curves showed multimodal transition, consisting of nine to 11 peaks over a temperature range, depending on the ionic strength of the DNA solution. These DSC curves were essentially in good agreement with the optical melting curves of ColE1 DNA. The theoretical melting profiles of ColE1 DNA were predicted from calculations based on the helix-coil transition theory and the nucleotide sequence of the DNA. These profiles resembled the DSC curves and made it possible to assign the peaks seen in the DSC curves to the helix-coil transition of particular regions of the nucleotide sequence of ColE1. The helix-coil transition of each of the small genes gave rise to a single peak in the DSC curve, while the helix-coil transition of large genes contributed to two or more peaks in the DSC curve. This multimodal transition within a single coding region might correspond to the melting of individual segments encoding the different domains of the proteins. The helix-coil transition at the specific sites including ori, the origin of replication of ColE1, was also found to occur in a particular temperature range. DSC, a simple method, is thus useful for analyzing the multimodal helix-coil transition of DNA, and for providing information on the genetic organization of DNA. PMID- 3656402 TI - Attenuated strains of tobacco mosaic virus. Reduced synthesis of a viral protein with a cell-to-cell movement function. AB - Attenuated strains of tobacco mosaic virus (TMV) have been used to protect crops against virulent strains. The synthesis of viral proteins and RNAs was investigated in protoplasts that had been infected separately with three tomato strains of TMV, virulent type L, and attenuated strains L11 and L11A. It was revealed that the mutations, which are responsible for the viral attenuation and have been mapped in the p126 (p184) gene, caused a reduction of the synthesis of the viral-coded p30 protein with a cell-to-cell movement function and its mRNA, but it had no significant effect on the synthesis of other viral proteins and RNAs in virus-infected protoplasts. Thus, it was shown that the attenuated strains can multiply as efficiently as the virulent strain in initially inoculated cells, but they can not spread efficiently outside the infected cells. In addition, it is suggested that a non-structural protein, p126 or p184, of TMV is involved in the synthesis of viral subgenomic p30 mRNA. PMID- 3656403 TI - Multiple heavy-atom reagents for macromolecular X-ray structure determination. Application to the nucleosome core particle. AB - The X-ray structure of the nucleosome core particle was solved at 7 A resolution using the method of multiple isomorphous replacement based on two isomorphous derivatives, each containing a different multiple heavy-atom compound. The preparation of these heavy-atom compounds and their application to this macromolecular structure determination are described. The first of these reagents, TAMM (tetrakis(acetoxymercuri)methane), was solubilized by the addition of an excess of glycylglycine and, when added to crystals of the nucleosome core particle, produced a derivative with a single major site. Despite the large mass of 206,000 daltons per asymmetric unit, the position of the TAMM molecule was found in these crystals using the difference Patterson technique. This compound was sufficiently electron-dense to produce a unique solution, whereas the mono mercurial, methylmercury nitrate had been inadequate. The second reagent, PIP (di mu-iodobis(ethylenediamine)diplatinum(II) nitrate), is freely soluble in aqueous solution and, on addition to the crystals, labelled the histone proteins at several sites. The locations of the PIP groups were determined from difference Fourier and Patterson maps. The X-ray structure and solution characterization of this compound are reported. These multiple heavy-atom compounds appear to be generally applicable to X-ray structure determination, and are particularly useful in conjunction with crystals having asymmetric units of large volume but lacking non-crystallographic symmetry elements. PMID- 3656404 TI - A three-dimensional model of an anti-lysozyme antibody. AB - The primary amino acid structure of the lysozyme-binding antibody, HyHEL-10, as determined by amino acid and nucleotide sequencing was utilized to construct a scale model of the Fv (variable region domain of immunoglobulin) using energy minimized torsional angles of the McPC603 Fv as a prototype template. This model was in turn used as a template for generating a computer-built set of co ordinates, which were subjected to a total of 600 steps of Adopted Basis Newton Raphson energy minimizations using the program CHARMM. Only minimal shifts of the backbone (root-mean-square 0.76 A) were required to give an energetically stable structure with a favorable van der Waals' energy. Several notable features were evident from both the scale model and the energy-minimized computer model: (1) the shape of the antibody combining region is that of a very shallow concavity approximately 20 A X 25 A; (2) the concavity is acidic and non-hydrophobic and is bordered by hydrophobic segments; (3) the lower portion of the combining site is dominated by a cluster of tyrosine residues over the L3 and H2 areas; (4) a somatic mutation encoded by the J region of the heavy chain (JH) may contribute significantly to the complementarity of heavy chain H3 to the epitope on hen egg white lysozyme. In addition, the space-filling energy-minimized model revealed that residue 49L, a framework residue, was prominently exposed and accessible in the center of the combining-site concavity. The model suggests that variation in length of complementarity-determining regions may function not only to change directly the shape of the antibody combining site, but may also influence indirectly the nature of the antibody surface by changing the accessibility of residues not usually involved in antigen binding. PMID- 3656405 TI - Refinement of the C222(1) crystal form of oxidized uteroglobin at 1.34 A resolution. AB - The structure of uteroglobin, a progesterone binding protein from rabbit uterine fluid, was determined and refined at 1.34 A resolution to a conventional R-factor of 0.229. The accuracy of the co-ordinates is estimated to be 0.15 A. The isotropic temperature factor of individual atoms was refined and its average value is 11.9 A2 for the 548 non-hydrogen atoms of the protein monomer. A total of 83 water molecules was located in difference electron density maps and refined, first using a constant occupancy factor of 1 and then variable occupancy, the final (Q) being 0.63. The mean temperature factor of the water oxygen atoms is 26.4 A2. Uteroglobin is a dimer and its secondary structure consists of four alpha-helices per monomer that align in an anti-parallel fashion. There is one beta-turn between helix 2 and helix 3 (Lys26 to Glu29); 76% of the residues are part of the alpha-helices. In the core of the dimeric protein molecule, between the two monomers that are held together by two disulfide bridges, we have observed a closed cavity. Its length is 15.6 A and its width is 9 A; 14 water molecules could be positioned inside. In the "bottom" part of the protein, near the C terminus, we have observed a smaller cavity, occupied by two water molecules. The calculation of the molecular surface revealed four surface pockets whose possible functional implications are discussed below. PMID- 3656406 TI - H3 phosphorylation-dependent structural changes in chromatin. Implications for the role of very lysine-rich histones. AB - Contrary to native H1/H5-containing chromatin where phosphorylation induces local structural changes affecting chromatin condensation, in stripped fibers phosphorylation of the totality of H3 molecules does not affect significantly chromatin conformation and DNA-protein interactions. Modification of H3 causes only a slight increase of flexibility of nucleosomal chains, despite important changes in histone topography revealed by immunochemical reactivity studies. We suggest that phosphorylation may only induce into the system the potential for dynamic change by modulating histone-histone interactions within and between nucleosomes, probably as a result of conformational change in the H3 protein. The signal for structural change would come from one or other factors (very lysine rich histones, non-histones) that influence internucleosomal interactions at very specific locations in the chromatin, probably through protein-protein contacts. So, phosphorylation may modify a direct interaction between the N-terminal basic tail of H3 and very lysine-rich histones. PMID- 3656407 TI - Crystallization and preliminary X-ray diffraction study of a xylanase from Trichoderma harzianum. AB - A 20,000 Mr xylanase from Trichoderma harzianum has been purified and crystallized from 20% (w/v) saturated ammonium sulphate solutions. The unit cell is orthorhombic, space group P2(1)2(1)2(1), with unit cell lengths a = 44.2 A, b = 94.1 A, c = 51.6 A. Data from native crystals and several potential heavy-atom derivatives have been collected. An X-ray analysis to at least 2.8 A resolution appears to be feasible. PMID- 3656409 TI - Environmental influences on DNA superhelicity. The effect of ionic strength on superhelix conformation in solution. AB - The techniques of small-angle X-ray scattering and analysis that have been developed by the authors are used to investigate the influence of ionic strength on the superhelical conformation of native COP608 plasmid DNA in solution. For salt concentrations below 0.1 M, the superhelicity is partitioned between twisting (Tw) and writhing (Wr) in the ratio delta Tw/Wr = 2. Near the physiological salt concentration, [Na+] = 0.2 M, a co-operative transition is observed in which the pitch angle of the toroidal superhelix is drastically decreased. This results in an almost complete relaxation of writhe. At salt concentrations in excess of the threshold for this transition, the superhelical partitioning occurs in the ratio delta Tw/Wr greater than 25. Energetic considerations support the suggestion that this transition results from co operative, superhelical B to Z transconformation reactions at susceptible sites. A method is discussed that will enable the direct measurement of this secondary structural transition by means of X-ray scattering. PMID- 3656408 TI - Sequence-specific positioning of core histones on an 860 base-pair DNA. Experiment and theory. AB - Previous experiments have shown that the locations of the histone octamer on DNA molecules of 140 to 240 base-pairs (bp) are influenced strongly by the nucleotide sequence. Here we have studied the locations of the histone octamer on a relatively long DNA molecule of 860 bp, using two different nucleases, micrococcal and DNAase I. Data were obtained from both the protein--DNA complexes and from the naked DNA at single-bond resolution, and then were analyzed by densitometry to yield plots of differential cleavage, which show clearly the changes in cutting due to the addition of protein. Our results show that the placement of core histones on the 860 bp molecule is definitely non-random. The digestion data provide evidence for five nucleosome cores, the centers of which lie in defined locations. In all but one of these protein--DNA complexes, the DNA adopts a unique, highly preferred rotational setting with respect to the protein surface. Another protein--DNA complex is unusual in that it protects 200 bp from digestion, yet is cut in its very center as if it were split into two parts. The apparent average twist of the DNA within all of these protein--DNA complexes is 10.2(+/- 0.1) bp, as measured by the periodicity of DNAase I digestion. This value is in excellent agreement with the twist of 10.21(+/- 0.05) bp deduced from the periodicity of sequence content in chicken nucleosome core DNA. In addition, we observe a discontinuity in the periodic cutting by DNAase I of about -1 to -3 bonds in going from any nucleosome core to the next. The most plausible interpretation of this discontinuity is that it reflects the angle by which adjacent protein--DNA complexes are aligned. Thus, any nucleosome may be related to its neighbor by a left-handed rotation in space of -1/10.2 to -3/10.2 helix turns, or -35 degrees to -105 degrees. Repeated many times, this operation would build a long, left-handed helix of nucleosomes similar to that described by many workers for the packing of nucleosomes in chromatin. In order to look for any long-range influences on the positioning of the histone octamer in the 860 bp molecule (as would be expected if the nucleosomes have to fit into some higher order structure), we have examined the locations of the histone octamer on five different isolated short fragments of the 860-mer, all of nucleosomal length.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656410 TI - Superhelical DNA with local substructures. A generalization of the topological constraint in terms of the intersection number and the ladder-like correspondence surface. AB - The presence of certain local structural elements in superhelical DNA, such as cruciforms and denatured loops, complicates the topological and geometric analysis of these molecules. In particular, the duplex axis is often difficult to define. In consequence, the usual conservation condition, Lk = Tw + Wr, is often inapplicable as formulated in terms of the winding of either strand of the DNA about the duplex axis. We present here a more general formulation of the topological conservation condition in terms of a model in which the two strands of DNA are regarded as twisting about one another, and in which one of the two strands is considered to writhe. We define a ladder-like correspondence surface, which connects the two strands nd is independent of whether or not a unique duplex axis is locally available. These considerations lead to the definition of a new topological property of superhelical DNA, the intersection number, In. This quantity describes the complexity of a local structural element; in the case of a cruciform, for example, the intersection number is a measure of the number of duplex turns removed from the major segment of the DNA by the cruciform formation. In more general terms, the topological constraint applicable to closed circular DNA is given by Lk(W,C) + In(S,C) = Tw(W,C) + Wr (C), where W and C represent the two strands of the DNA and S is the ladder-like correspondence surface that connects the two strands. PMID- 3656411 TI - A new crystal form of tropomyosin. Preliminary X-ray diffraction analysis. AB - A new crystalline form of tropomyosin has been produced that diffracts to about 4 A resolution. The crystals are grown at room temperature by slowly lowering the concentration of spermine. This polyamine apparently neutralizes the acidic amino acid side-chains of tropomyosin and allows close side-by-side packing of molecules. The space group is C2, with unit cell dimensions a = 259.7 A, b = 55.3 A, c = 135.6 A, and beta = 97.2 degrees. The tropomyosin molecules appear to be bonded head-to-tail to form straight filaments that run along the crystallographic (332) direction in an arrangement closely related to thin crystalline sheets previously described. PMID- 3656412 TI - A novel arrangement of sequence elements surrounding the rDNA promoter and its spacer duplications in tsetse species. AB - Variation in organization and sequence of the rDNA of six species of tsetse fly (Glossina) has been investigated. Several novel tsetse-specific features have been uncovered. Like many other species the spacer is composed of subrepeats, which in some species contain duplications of the true promoter at the spacer-ETS boundary. In tsetse, however, the first 90 base-pairs of the external transcribed spacer (ETS) (that is, +1 to +90 after transcription initiation) is the 3' end of the last subrepeat. The absence of a "unique" region between the last subrepeat and the ETS suggests that the tsetse rDNA unit may consist of multiple true promoters, that is there is no single ETS boundary. Furthermore, interspecific comparisons show that the 90 base-pair region is part of a conserved 202 base pair region, consisting of 72 base-pairs upstream from the initiation site and a further 40 base-pairs downstream, which is shared by all promoters other than the last. In genera other than tsetse, subrepeat lengths between species are generally similar; in tsetse they differ due to (1) variation in copy-number of the subsubrepeat motif A9T6CAG, and (2) the presence of large regions flanked by direct simple repeats such as GA5 or TGGTCTC. Slippage-like mechanisms are probably responsible for (1), and recombination and subsequent excision involving the direct repeats for (2). Different structural and sequence variants are seen to be homogenized in the family and fixed in each species, reflecting continual unequal crossing-over. However, notwithstanding this process of differentiation, the available comparisons also reveal that there are two small conserved regions between Glossina and Drosophila: one is part of the promoter and the other is an ETS processing site. Such intergeneric and interspecific differences are discussed in relation to the problem of the maintenance of several essential functions within the rDNA repeating unit despite the continual differentiation of the unit into novel arrangements. PMID- 3656413 TI - Signals for the selection of a splice site in pre-mRNA. Computer analysis of splice junction sequences and like sequences. AB - To evaluate the importance of the surrounding nucleotide sequence in the selection of a splice site for mRNA, we have carried out computer studies of eukaryotic protein genes whose entire nucleotide sequences were available. A splice site-like sequence that has a significant homology to the consensus splice junction sequences is frequently found within an intron and exon. It is found that the higher the homology of a candidate donor site sequence to the nine nucleotide consensus sequence, the higher is its probability of being a donor site. For most of the donors, the stability of presumed base-pairing with U1-RNA is higher than that of donor-like sequences, if any, in the adjacent exon and intron. However, homology of a candidate acceptor sequence to the 15-nucleotide consensus is a poor criterion of an acceptor site. The presence of a sequence that could serve as a branch-point 18 to 37 nucleotides before an acceptor does not seem to be critical in distinguishing it from an acceptor-like sequence. For genes of human, rat, mouse and chicken, respectively, nucleotide frequencies around splice junctions of many genes have been calculated. They seem to be different at some positions around a donor site from species to species. The acceptors for these vertebrates have longer pyrimidine-rich regions than the previous consensus sequence. The newly derived nucleotide frequencies were used as the standard to calculate the weighted homology score of a candidate splice site sequence in a gene of the four species. This weighted homology score of the 40 to 60-nucleotide intron-exon sequence is a much better criterion of an acceptor. These results suggest that the most important signal in the selection of a splice resides in the surrounding nucleotide sequence. It is also suggested that the surrounding nucleotide sequence alone is not generally sufficient for the selection. PMID- 3656414 TI - Bacteriophage P22 Mnt repressor. DNA binding and effects on transcription in vitro. AB - We have examined the binding of Mnt repressor to operator DNA in vitro and have determined how this binding affects the level of transcription from two nearby promoters, Pant and Pmnt. Mnt binds to a region of DNA that overlaps the startpoint of transcription of Pant and the -35 region of Pmnt. Mnt represses transcription in vitro from Pant and enhances transcription from Pmnt. Protection and interference experiments show that Mnt binds to a single, 17 base-pair operator site. The operator sequence and the protein-DNA contacts are symmetric. Mnt makes major groove contacts on both faces of the operator DNA. At pH 7.5, 200 mM-KCl, 22 degrees C, the Mnt tetramer binds operator with high affinity (Kd = 2.2 X 10(-11M) and the protein-DNA complex is quite stable (t1/2 = 48 min). Operator binding shows large dependencies on pH, salt concentration, and temperature. PMID- 3656415 TI - Interaction of the bacteriophage P22 Arc repressor with operator DNA. AB - Are repressor binds to a single, partially symmetric, 21 base-pair operator site that is centered between the -10 and -35 regions of the Pant promoter. Protection and interference experiments show that Arc makes contacts with the operator on one side of the DNA helix. Although Arc is a small protein (53 residues/subunit), it makes contacts that are farther from the center of the operator than those made by many larger repressors. These extended contacts include the phosphate groups at the ends of the 21 base-pair site. Under standard conditions (pH 7.5, 100 mM-KCl, 3 mM-MgCl2, 22 degrees C) half-maximal operator binding is observed at an Arc concentration of 2.5 X 10(-9) M and the protein-DNA complex is very stable (t1/2 approximately equal to 80 min). PMID- 3656416 TI - Signal formation in the halobacterial photophobic response mediated by a fourth retinal protein (P480). AB - Halobacterial cells swim forward by clockwise, and backward by counterclockwise, rotation of their flagella. The changes of direction of rotation occur statistically and can be quantitatively described by a four-state model of the motor. Stimulation of the cells with blue light induces the formation of a signal that causes the motor to switch the direction of rotation. The results of step-up and flash experiments led to a kinetic equation that describes the signal formation as a photocatalytic process. The stimulating blue light is sensed either by sensory rhodopsin in the presence of green background light or by protein P480, which has a maximum in the action spectrum around 480 nm. P480, but not sensory rhodopsin, is synthesized by the cells constitutively, and both pigments together allow the cells to find optimal conditions during aerobic and phototrophic growth. The work presented here was reported at the U.S.-Israel Binational Science Foundation Meeting in Jerusalem, March 1986. PMID- 3656417 TI - Bundling of myosin subfragment-1-decorated actin filaments. AB - We have reported previously that rabbit skeletal myosin subfragment-1 (S-1) assembles actin filaments into bundles. The rate of this reaction can be estimated roughly from the initial rate (Vo) of the accompanying turbidity increase ("super-opalescence") of the acto-S-1 solution. Vo is a function of the molar ratio (r) of S-1 to actin, with a peak at r = 1/6 to 1/7 and minimum around r = 1. In the present paper we report a different type of opalescence (we call it "hyper-opalescence") of acto-S-1 solutions, which also resulted from bundle formation. Adjacent filaments in the bundles had a distance of approximately 180 A. Hyper-opalescence occurred at r approximately equal to 1 when KCOOCH3 was used instead of KCl. By comparing the effects of ADP, epsilon-ADP, tropomyosin or ionic strength upon the super- and hyper-opalescence, we concluded that the two types of S-1-induced actin bundling had different molecular mechanisms. The hyper opalescence type of bundling seemed to be induced by S-1, which was not complexed with actin in the manner of conventional rigor binding. The presence of the regulatory light chain did not affect hyper-opalescence (or super-opalescence), since there were no significant differences between papain S-1 and chymotryptic S 1 with respect to these phenomena. PMID- 3656419 TI - Crystallization, crystal structure analysis and preliminary molecular model of the bilin binding protein from the insect Pieris brassicae. AB - The bilin binding protein of the butterfly Pieris brassicae has been prepared, crystallized and its crystal structure determined at high resolution using film and FAST area detector intensity data. The crystallographic asymmetric unit contains a tetramer of identical subunits with a molecular weight of about 90,000. The crystal structure was determined by isomorphous replacement. Use was made of the molecular symmetry to improve phases. A molecular interpretation of the electron density distribution and partial tracing of the polypeptide chain was possible without amino acid sequence information, as the fold is very similar to retinol binding protein. It is characterized by a beta-barrel formed by two orthogonal beta-sheets and an alpha-helix. The bilin pigment seems to be bound within the beta-barrel analogously to retinol in retinol binding protein. The tetramer in the crystal has C2 symmetry and is a dimer of dimers of quasi equivalent subunits. PMID- 3656418 TI - Organization of the Sindbis virus nucleocapsid as revealed by bifunctional cross linking agents. AB - Purified Sindbis virus nucleocapsids were reacted with a variety of bifunctional protein-specific cross-linking agents. The products were analyzed in concentration-gradient polyacrylamide gels and amounts of various products determined. These studies indicated that available lysine residues within adjacent capsid proteins in purified intact nucleocapsids are separated by 6 A. The capsid proteins in intact nucleocapsids are cross-linked in a pattern predicted for discrete monomeric entities, rather than in dimeric or trimeric aggregates. Purified, soluble capsid protein exists in a conformation that differs from the arrangement of protein within nucleocapsids. These conformational differences suggest that topological changes may occur in the capsid protein during virus maturation. Cross-linked nucleocapsids that were treated with RNases resulted in the generation of RNA-free protein shells that retained hexagonal morphology, indicating that, together, the RNA and protein form the outer surface of the nucleocapsid. These data are used to produce a model of the Sindbis virus nucleocapsid in which the proteins are arranged quasi equivalently in a T = 4 icosahedral shell. PMID- 3656420 TI - C1 complex of human complement. Genesis of a model. PMID- 3656421 TI - Functional models of the C1 complex. Consensus and disagreement. PMID- 3656422 TI - Sequences and studies of bacteriophage T4 rII mutants. AB - We have sequenced more than 80 mutants of the bacteriophage T4 rIIA and rIIB genes. These include deletions about whose origin we have speculated, mutations affecting the rIIB promoters, various pseudo-revertants of the rII- phenotype, including mutations that bring about the reinitiation of translation following termination, mutations that affect regulation of rIIB translation by regA, the toxic minute plaquing mutants FC237 and FC238 and their detoxifiers, and many more of the classic frameshifts from the Cambridge collection. These mutants have been sequenced using dideoxy-mediated chain termination by either Escherichia coli DNA polymerase using single-stranded DNA as a template or by avian retroviral reverse transcriptase using mRNA or DNA as the template molecule. We list the sequence changes of the mutants with pertinent historic and phenotypic data. The mutants that facilitate translation reinitiation are discussed, and we discuss a model that could account for the generation of many of the mutations. PMID- 3656423 TI - Determination of the RNA secondary structure that regulates lysis gene expression in bacteriophage MS2. AB - The lysis gene of the RNA bacteriophage MS2 is not expressed unless translation of the overlapping coat gene takes place. To understand the molecular basis for this translational coupling the RNA secondary structure around the lysis gene start was analyzed with structure-specific enzymes and chemicals. The existence of a hairpin between nucleotides 1636 and 1707 is in agreement with the structural mapping data and also with the conservation of base-pairing in the related M12 phage. In this hairpin, the G residues in the Shine and Dalgarno region and start codon are inaccessible to RNase T1, which is consistent with the fact that ribosomal access to the lysis gene is blocked when there is no coat gene translation. Deletions or point mutations that are predicted to destabilize the hairpin give rise to lysis protein synthesis that is independent of coat gene translation. Base substitutions that are not expected to weaken the helix do not lead to independent lysis gene expression. Finally, nucleotide changes that strengthen the hairpin lead neither to uncoupled nor to coupled synthesis of the lysis protein. Structural analysis of mutant MS2 RNA shows that small changes in the stability of the secondary structure lead to substantial differences in translation initiation. The function of the hairpin structure in coupling lysis gene to coat gene translation requires that its stability is kept within narrow limits. PMID- 3656424 TI - Lysis gene of bacteriophage MS2 is activated by translation termination at the overlapping coat gene. AB - The 3' boundary of the coat gene of the RNA bacteriophage MS2 lies 46 nucleotides downstream from the beginning of the lysis (L) cistron. The translation of both reading frames is coupled; the synthesis of the lysis protein does not occur unless translation of the overlapping coat gene takes place. In the preceding paper we showed that de novo initiation at the L gene is prevented by a hairpin structure that sequesters the ribosomal binding site. Here we examine how translation of the coat gene activates the L gene start site. The experiments show that the movement of ribosomes through the hairpin is in itself not sufficient to expose the lysis gene. Rather, the endpoint of translation is important. Termination at the natural end of the coat gene triggers the lysis response, but further downstream terminations do not. Activation of the L gene is suppressed when the stability of the lysis initiator hairpin is increased by mutations that create additional base-pairs. We assume that the ribosome, terminating at the coat reading frame, covers part of the lysis hairpin, thereby destabilizing the secondary structure. This may be sufficient to promote the binding of a vacant ribosome to the L gene start. Alternatively, the terminated but not yet released ribosome may reach the L gene start by random lateral movements along the mRNA and reinitiate there. The present findings are also discussed in relation to an earlier proposal for L gene activation. PMID- 3656425 TI - Surface-induced aggregation of type I procollagen. AB - We have examined the state of aggregation of type I procollagen in the concentration range 5 to 800 micrograms/ml. Electron microscopy typically indicates a high proportion of aggregated material (greater than 50%), when a range of preparative techniques are used. Aggregates of in-register molecules (segment-long-spacing-like aggregates) are frequently observed, often with units of in-register molecules connected via the C-terminal propeptides. In contrast, studies using gel-filtration chromatography and density-gradient ultracentrifugation demonstrate only limited aggregation in solution (less than 5%) even at 800 micrograms/ml. The aggregated material is mainly dimeric and probably not segment-long-spacing-like. We conclude that aggregation of procollagen is strongly favoured by adsorption to a surface when samples are prepared for electron microscopy. The possible relevance of these observations to the fate of procollagen secreted by cells in vivo is discussed. PMID- 3656426 TI - Three-dimensional structure of the complex flagellar filament of Rhizobium lupini and its relation to the structure of the plain filament. AB - Electron micrographs of negatively stained preparations were used to obtain a three-dimensional reconstruction of the complex flagellar filament of Rhizobium lupini H13-3. The complex filament has an organization similar to that of the more common plain filament, but the subunits are perturbed in a pairwise fashion to generate a very distinctive set of three continuous ridges of density along the outer surface of the filament. In the three-dimensional map, the design of the complex filament is similar to that of the plain filament described in the accompanying paper. The structures consist of 11 segmented rods of density lying at a radius of 65 to 70 A. The exterior surfaces of both kinds of filaments consist of features that protrude from the segmented rods. The interiors of both consist of arms that extend inwards from the rods. In the case of the complex filament, but not of the plain filament, the inner arms interact to generate three tubular features, which, together with the three outer ridges, may account for the more brittle and, by implication, stiffer nature of the complex filament. PMID- 3656427 TI - Hydrophobicity scales and computational techniques for detecting amphipathic structures in proteins. AB - Protein segments that form amphipathic alpha-helices in their native state have periodic variation in the hydrophobicity values of the residues along the segment, with a 3.6 residue per cycle period characteristic of the alpha-helix. The assignment of hydrophobicity values to amino acids (hydrophobicity scale) affects the display of periodicity. Thirty-eight published hydrophobicity scales are compared for their ability to identify the characteristic period of alpha helices, and an optimum scale for this purpose is computed using a new eigenvector method. Two of the published scales are also characterized by eigenvectors. We compare the usual method for detecting periodicity based on the discrete Fourier transform with a method based on a least-squares fit of a harmonic sequence to a sequence of hydrophobicity values. The two become equivalent for very long sequences, but, for shorter sequences with lengths commonly found in alpha-helices, the least-squares procedure gives a more reliable estimate of the period. The analog to the usual Fourier transform power spectrum is the "least-squares power spectrum", the sum of squares accounted for in fitting a sinusoid of given frequency to a sequence of hydrophobicity values. The sum of the spectra of the alpha-helices in our data base peaks at 97.5 degrees, and approximately 50% of the helices can account for this peak. Thus, approximately 50% of the alpha-helices appear to be amphipathic, and, of those that are, the dominant frequency at 97.5 degrees rather than 100 degrees indicates that the helix is slightly more open than previously thought, with the number of residues per turn closer to 3.7 than 3.6. The extra openness is examined in crystallographic data, and is shown to be associated with the C terminus of the helix. The alpha amphipathic index, the key quantity in our analysis, measures the fraction of the total spectral area that is under the 97.5 degrees peak, and is a characteristic of hydrophobicity scales that is consistent for different sets of helices. Our optimized scale maximizes the amphipathic index and has a correlation of 0.85 or higher with nine previously published scales. The most surprising feature of the optimized scale is that arginine tends to behave as if it were hydrophobic; i.e. in the crystallographic data base it has a tendency to be on the hydrophobic face of teh amphipathic helix. Although the scale is optimal only for predicting alpha-amphipathicity, it also ranks high in identifying beta-amphipathicity and in distinguishing interior from exterior residues in a protein.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656428 TI - High-resolution crystal structure of cytochrome P450cam. AB - The crystal structure of Pseudomonas putida cytochrome P450cam with its substrate, camphor, bound has been refined to R = 0.19 at a normal resolution of 1.63 A. While the 1.63 A model confirms our initial analysis based on the 2.6 A model, the higher resolution structure has revealed important new details. These include a more precise assignment of sequence to secondary structure, the identification of three cis-proline residues, and a more detailed picture of substrate-protein interactions. In addition, 204 ordered solvent molecules have been found, one of which appears to be a cation. The cation stabilizes an unfavorable polypeptide conformation involved in forming part of the active site pocket, suggesting that the cation may be the metal ion binding site associated with the well-known ability of metal ions to enhance formation of the enzyme substrate complex. Another unusual polypeptide conformation forms the proposed oxygen-binding pocket. A localized distortion and widening of the distal helix provides a pocket for molecular oxygen. An intricate system of side-chain to backbone hydrogen bonds aids in stabilizing the required local disruption in helical geometry. Sequence homologies strongly suggest a common oxygen-binding pocket in all P450 species. Further sequence comparisons between P450 species indicate common three-dimensional structures with changes focused in a region of the molecule postulated to be associated with the control of substrate specificity. PMID- 3656429 TI - Refined structure of glutathione reductase at 1.54 A resolution. AB - The crystal structure of human glutathione reductase has been established at 1.54 A resolution using a restrained least-squares refinement method. Based on 77,690 independent reflections of better than 10 A resolution, a final R-factor of 18.6% was obtained with a model obeying standard geometry within 0.025 A in bond lengths and 2.4 degrees in bond angles. The final 2Fo-Fc electron density map allows for the distinction of carbon, nitrogen and oxygen atoms with temperature factors below about 25 A2. Apart from 461 amino acid residues and the prosthetic group FAD, the model contains 524 solvent molecules, about 118 of which can be considered an integral part of the enzyme. The largest solvent cluster is at the dimer interface and contains 104 interconnected solvent molecules, part of which are organized in a warped sheet-like structure. The main-chain dihedral angles are well-concentrated in the allowed regions of the Ramachandran plot. The spread of dihedral angles in beta-pleated sheets is much larger than in alpha-helices and especially in alpha-helix cores, indicating the higher plasticity of beta structures. The analysis revealed a large amount of 3(10)-helix. The side-chain conformations cluster at the staggered positions, and show well-defined preferences. Also, a mobility gradient is observed for side-chains. Non-polar and polar side-chains show average temperature factor increases per bond of 10% and 25%, respectively. A number of alternative conformations of internal side-chains, in particular serines and methionines, have been detected. The extended FAD molecule also shows a mobility gradient between the very rigid flavin (mean value of B) = 8.7 A2) and the more mobile adenine (mean value of B = 16.2 A2). The entire active center is particularly well ordered, with temperature factors around 10 A2. The dimer interface consists of a rigid contact area, which is well conserved in the Escherichia coli enzyme, and a flexible area that is not. Altogether, the buried surfaces at the crystal contacts are half as large as at the dimer interface, but less specific. The refined structure shows clearly that there are no buried cations compensating the charge of the pyrophosphate moiety of FAD. The flavin deviates slightly from standard geometry, which is possibly caused by the polypeptide environment. In contrast to an earlier interpretation, atom N5 of the flavin can accommodate a proton, and it is conceivable that this proton proceeds to the redox-active disulfide.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656430 TI - Equilibrium DNA-binding of AraC protein. Compensation for displaced ions. AB - Experiments on the AraC regulatory protein of Escherichia coli suggest a mechanism that DNA-binding proteins can use to reduce potentially drastic alterations in their affinity for DNA resulting from changes in salt concentration. Measurement of the net number of ions apparently displaced as AraC protein binds DNA and of fluorescence changes in the protein lead to the following picture. About 14 ions are displaced from the DNA as the protein binds the araI site. As the protein binds the DNA, however, it undergoes a conformational change and binds about ten ions. Consequently, the net order of the reaction is reduced from 15th to about fourth order in salt concentration. PMID- 3656431 TI - Preliminary X-ray data of NADH-cytochrome b5 reductase from human erythrocytes. PMID- 3656432 TI - Some observations of a correlation between the symmetry of large heavy-atom complexes and their binding sites on proteins. AB - Two large, electron dense heavy-metal complexes were found to bind to crystals of heavy riboflavin synthase. The crystallographic analysis by difference Fourier methods shows that the tungsten cluster compound [(W3O2(O2CCH3)6]2+, which has trigonal symmetry, binds to a site on the 3-fold axis of the protein. The heteropolytungstate compound [NaP5W30O110]14-, which has pentagonal symmetry, binds to a site on the 5-fold axis of the protein. PMID- 3656433 TI - Preliminary X-ray diffraction analysis of crystals of Bacillus thuringiensis toxin, a cell membrane disrupting protein. AB - Crystals suitable for high resolution X-ray diffraction analysis have been reproducibly grown of the 24,000 Mr protein insect toxin from Bacillus thuringiensis. This protein, which demonstrates substantial insecticidal activity by inserting into phospholipid membranes, crystallizes as long square needles from polyethylene glycol 4000 at neutral pH. The crystals are of space group P4(1) and have cell dimensions of a = b = 33 A and c = 235 A, which suggests to us a predominantly helical motif for the protein's structure. PMID- 3656434 TI - Properties of a new crystal form of the complex of concanavalin A with methyl alpha-D-glucopyranoside. AB - The complex of concanavalin A with methyl alpha-D-glucopyranoside crystallizes as regular rhombic dodecahedra containing 35% protein by weight. The crystal is of space group I23 with a = 167.8 A (1 A = 0.1 nm) and contains one concanavalin A dimer per asymmetric unit. It diffracts to a resolution of 1.9 A and is suitable for crystallographic investigation of the structure of the saccharide-binding site. PMID- 3656435 TI - A mutational analysis of the bacteriophage P1 recombinase Cre. AB - Bacteriophage P1 encodes a 38,600 Mr site-specific recombinase, Cre, that is responsible for reciprocal recombination between sites on the P1 DNA called loxP. Using in vitro mutagenesis 67 cre mutants representing a total of 37 unique changes have been characterized. The mutations result in a wide variety of phenotypes as judged by the varying ability of each mutant Cre protein to excise a lacZ gene located between two loxP sites in vivo. Although the mutations are found throughout the entire cre gene, almost half are located near the carboxyl terminus of the protein, suggesting a region critical for recombinase function. DNA binding assays using partially purified mutant proteins indicate that mutations in two widely separated regions of the protein each result in loss of heparin-resistant complexes between Cre and a loxP site. These results suggest that Cre may contain two separate domains, both of which are involved in binding to loxP. PMID- 3656436 TI - Trypanosoma brucei repeated element with unusual structural and transcriptional properties. AB - The genome of Trypanosoma brucei contains up to 400 copies of a conserved sequence (TRS, trypanosome repeated sequence). The majority of TRS copies (TRS1) are 5.2 X 10(3) base-pairs (kb) and are flanked by different separate halves of the previously described transposable element RIME (ribosomal mobile element), although a variant copy (TRS2) contains only the central 1.45 kb portion and lacks RIME. TRS1 elements can probably undergo transposition, since they are dispersed in all chromosome size classes and are bordered by direct repeats of about four base-pairs. Some TRS1 elements may contain an open reading frame over almost their entire length (1651 codons), encoding a protein showing homology with reverse transcriptase. TRS probes detect poly(A)+ transcripts of 5 to 9 kb, generated by a polymerase moderately sensitive to alpha-amanitin. Transcription is developmentally regulated. Both TRS and RIME sense transcripts are preferentially synthesized compared to anti-sense transcripts, and are much more abundant in bloodstream forms than in cultured procyclics. PMID- 3656437 TI - Co-operative interactions between troponin-tropomyosin units extend the length of the thin filament in skeletal muscle. AB - Ca2+ binding to troponin C (TnC), a subunit of the thin filament regulatory strand, activates vertebrate skeletal muscle contraction. Tension, however, increases with Ca2+ too abruptly to be the result of binding to sites on individual TnCs. Because extraction of one TnC on average per regulatory strand dramatically reduces the slope of the tension/Ca2+ relationship, we proposed that all 26 troponin-tropomyosin complexes of the regulatory strand form a co operative system. This study of permeabilized (chemically skinned) rabbit psoas fibers analyzes the extraction time-course, the distribution of extraction sites on regulatory strands and the effects of extraction on the co-operativity of the tension/Ca2+ relationship. Two components of TnC are resolved in the time-course of extraction: a "rapidly extracting" component that can be selectively removed without affecting tension or co-operativity, and a "slow extracting" component whose loss reduces tension and co-operativity. Extraction of [14C]TnC shows that the slowly extracting component is lost randomly, so that, after removal of 5% of the TnC, most extracted strands have lost one TnC. Extraction interrupts the transmission of co-operativity by dividing the regulatory strand into smaller, independent co-operative systems; it reduces tension by preventing Ca2+ activation of TnC-depleted regulatory units. Co-operativity of the tension/Ca2+ relationship is modeled with the concerted-transition formalism for intact systems of 26 regulatory units, and for the smaller systems in extracted fibers. PMID- 3656438 TI - Electron microscopic visualization of the N terminus of the myosin heavy chain using a site-directed antibody. AB - We determined the spatial location of the N terminus of the heavy chain of rabbit skeletal muscle myosin by electron microscopy, using a site-directed antibody raised against its N-terminal eight residues as an electron microscopic probe. By examining rotary-shadowed images of the heavy meromyosin-antibody complex, we measured distances between the head-rod junction and the attachment site of the antibody bound on the head. The average distance was estimated to be about 12 nm. The result indicates that the N terminus of the heavy chain is located at the middle region of the head. PMID- 3656439 TI - Prediction of protein secondary structure and active sites using the alignment of homologous sequences. AB - The prediction of protein secondary structure (alpha-helices, beta-sheets and coil) is improved by 9% to 66% using the information available from a family of homologous sequences. The approach is based both on averaging the Garnier et al. (1978) secondary structure propensities for aligned residues and on the observation that insertions and high sequence variability tend to occur in loop regions between secondary structures. Accordingly, an algorithm first aligns a family of sequences and a value for the extent of sequence conservation at each position is obtained. This value modifies a Garnier et al. prediction on the averaged sequence to yield the improved prediction. In addition, from the sequence conservation and the predicted secondary structure, many active site regions of enzymes can be located (26 out of 43) with limited over-prediction (8 extra). The entire algorithm is fully automatic and is applicable to all structural classes of globular proteins. PMID- 3656440 TI - Crystallization of a DNA duplex 15-mer containing unpaired bases: d(CGCGAAATTTACGCG). AB - Crystals of an almost self-complementary DNA 15-mer d(CGCGAAATTTACGCG) have been grown by the vapor diffusion technique at 4 degrees C. The space group is I222 with a = 37.3 A, b = 54.6 A and c = 104.8 A. Solution studies showed that the 15 mer forms a duplex with the extra adenine residue unpaired: (sequence; see text) Crystals are stable at 4 degrees C and are suitable for medium-resolution structural studies. PMID- 3656441 TI - DNA supercoiling promotes formation of a bent repression loop in lac DNA. AB - Titration experiments on supercoiled lac DNA show that one repressor tetramer can bind simultaneously to the primary lac operator and to the very weak lac pseudo operator, located 93 base-pairs apart. The formation of this complex is accompanied by the appearance of an extreme hypersensitive site in a five base pair sequence located approximately midway between the operators. This remote sequence is hypersensitive to attack by two different chemical probes, dimethyl sulfate and potassium permanganate, the latter of which is a new probe for distorted DNA. We interpret these results in terms of a complex in which lac repressor holds two remote operators together in a DNA loop. The formation of this bent DNA loop requires negative DNA supercoiling. In vivo, both lac operators bind repressor even though the presence of multiple operator copies has forced the two operators to compete for a limited amount of repressor. This suggests that the operator and pseudo-operator have similar affinities for repressor in vivo. Such similar affinities were observed in vitro only when DNA supercoiling forced formation of a repression loop. PMID- 3656442 TI - Precise identification of cleavage sites involved in the unusual processing of trypanosome ribosomal RNA. AB - The large subunit ribosomal RNA (LSRNA) of Trypanosoma brucei is unusual in being cleaved at multiple sites to yield six stable fragments of RNA. We report here the complete nucleotide sequence of two regions of the ribosomal DNA repeat unit. The first sequence includes all of the processing sites involved in the generation of one of the small LSRNA fragments. The second region encodes the trypanosome 5.8 S RNA. By RNA sequencing and S1 nuclease mapping, we have identified the processing sites involved in the generation of both of these small RNAs. On the basis of predicted secondary structure models, we infer that all the cleavages apparently occur near the junction of single- and double-stranded regions. The sites involved in the novel LSRNA processing show a clear symmetry with respect to a conserved region of ten base-pairs. No such signals are evident for the processing sites that generate the 5.8 S RNA. PMID- 3656443 TI - X-ray refinement study on the binding of cytidylic acid (2'-CMP) to ribonuclease A. AB - The X-ray structure of the inhibitor complex of bovine ribonuclease A with cytidylic acid (2'-CMP) has been determined at 2.3 A (1 A = 0.1 nm) resolution and refined by restrained least-squares refinement to R = 0.132 for 5650 reflections. Incorporation of the inhibitor molecule has occurred with little disturbance of the protein main-chain atoms, although significant displacement of some side-chain atoms has occurred, particularly in the region of the active site. The binding of 2'-CMP to ribonuclease A is different from that of the related cytidine-N(3)-oxide 2'-phosphate, which has an extra oxygen on N(3) of the cytidine base. The PO4(2-) group is held by hydrogen bond interactions to the side-groups of His 12, Glu 11 and His119. Thr45 is involved in stabilizing the enzyme-ligand complex by forming hydrogen bond interactions between O(gamma) and the pyrimidine base N(3) atom and between the main-chain N(45) and O(2) of the base. Phe120 is much closer to the inhibitor than in the cytidine N(3)-oxide 2' phosphate structure. PMID- 3656444 TI - Determinants of a protein fold. Unique features of the globin amino acid sequences. AB - The three-dimensional structures of globins are known, from crystallographic analyses, to be very similar. Their amino acid sequences, however, differ greatly. Only two residues are absolutely conserved in all sequences, and the residue identities of some pairs of sequences are only 16%. We have determined the nature and exact extent of the sequence variations and the extent to which the conserved features of the globin sequences are unique to this family. The 226 globin sequences now known were aligned and analysed. Because distantly related protein sequences cannot be aligned correctly without the use of structural data, we developed a method that incorporated structural information into the alignment procedure. Analysis of the aligned sequences show that: (1) Although individual chains vary in size between 132 and 157 residues, deletions and insertions result in there being only 102 residue sites common to all globins. These sites form six separate regions. Insertions and deletions between these regions means that their separations can vary in different sequences. (2) Within the conserved regions there are 32 sites that almost always contain hydrophobic residues. In the known structures, these sites are in the protein interior. We measured the variations in the size of the residues that occur in the 226 sequences at these sites. At six sites the residues differ in size by less than 40 A3, at 11 sites they differ by 40 to 100 A3, and at 15 sites they differ by more than 100 A3. There are two other conserved buried sites: one contains the His linked to the haem iron and the other usually contains a His involved with the haem ligand. (3) Within the conserved regions there are another 32 sites that are almost always occupied by charged, polar or small non-polar (Gly or Ala) residues. In the known structures, these sites are on the protein surface. To determine the extent to which the conserved features found for the globin sequences are unique to that protein family, the following procedure was used. The six conserved regions, and the residue restrictions that occur at the 66 sites within these regions, were encoded into two "templates". One was based only on the sequences so far determined; the other was extended to include as yet unobserved substitutions that seemed plausible on the basis of size, hydrophobicity and polarity. Each of the 3286 non-globin sequences in the data bank was then examined by a computer program to see how closely it could be matched to these templates.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656445 TI - Origin of the phosphate at the ligation junction produced by self-splicing of Tetrahymena thermophila pre-ribosomal RNA. AB - The exons of the self-splicing pre-ribosomal RNA of Tetrahymena thermophila are joined accurately in vitro, even when only 33 nucleotides of the natural 5' exon and 38 nucleotides of the natural 3' exon remain. RNA fingerprint analysis was used to identify the unique ribonuclease T1 oligonucleotide generated by exon ligation. Secondary digests of the ligation junction oligonucleotide with ribonuclease A confirmed the identity of the fragment and demonstrated that the phosphate group that forms the phosphodiester bond at the ligation junction is derived from the 5' position of a uridine nucleotide in the RNA. This observation supports the prediction that the splice junction phosphate is derived from the 3' splice site. These results emphasize the mechanistic similarities of RNA splicing reactions of the group I introns, group II introns and nuclear pre-mRNA introns. PMID- 3656446 TI - Molecular characterization of the histone gene family of Caenorhabditis elegans. AB - The core histone genes (H2A, H2B, H3 and H4) of Caenorhabditis elegans are arranged in approximately 11 dispersed clusters and are not tandemly arrayed in the genome. Three well-characterized genomic clones, which contain histone genes, have one copy of each core histone gene per cluster. One of the clones (lambda Ceh-1) carries one histone cluster surrounded by several thousand base-pairs of non-histone DNA, and another clone (lambda Ceh-3) contains a histone cluster duplication surrounded by non-histone DNA. A third clone (lambda Ceh-2) carries a cluster of core histone genes flanked on one side (12,000 base-pairs away) by a single H2B gene and on the other by non-histone DNA. A fourth cluster (clone BE9) has one copy each of H3 and H4 and two copies each of H2A and H2B. This cluster is also flanked by non-histone DNA. Analysis of cosmid clones which overlap three of the clusters shows that no other histone clusters are closer than 8000 to 60,000 base-pairs, although unidentified non-histone transcription units are present on the flanking regions. Gene order within the histone clusters varies, and histone mRNAs are transcribed from both DNA strands. No H1 sequences are found on these core histone clones. Restriction fragment length polymorphisms between two related nematode strains (Bristol and Bergerac) were used as phenotypic markers in genetic crosses to map one histone cluster to linkage group V and another to linkage group IV. Hybridization of gene-specific probes from sea urchin to C. elegans RNA identifies C. elegans core histone messenger RNAs of sizes similar to sea urchin early stage histone mRNAs (H2A, H2B, H3 and H4). The organization of histone genes in C. elegans resembles the clustering found in most vertebrate organisms and does not resemble the tandem patterns of the early stage histone gene family of sea urchins or the major histone locus of Drosophila. PMID- 3656447 TI - CpG islands in vertebrate genomes. AB - Although vertebrate DNA is generally depleted in the dinucleotide CpG, it has recently been shown that some vertebrate genes contain CpG islands, regions of DNA with a high G+C content and a high frequency of CpG dinucleotides relative to the bulk genome. In this study, a large number of sequences of vertebrate genes were screened for the presence of CpG islands. Each CpG island was then analysed in terms of length, nucleotide composition, frequency of CpG dinucleotides, and location relative to the transcription unit of the associated gene. CpG islands were associated with the 5' ends of all housekeeping genes and many tissue specific genes, and with the 3' ends of some tissue-specific genes. A few genes contained both 5' and 3' CpG islands, separated by several thousand base-pairs of CpG-depleted DNA. The 5' CpG islands extended through 5'-flanking DNA, exons and introns, whereas most of the 3' CpG islands appeared to be associated with exons. CpG islands were generally found in the same position relative to the transcription unit of equivalent genes in different species, with some notable exceptions. The locations of G/C boxes, composed of the sequence GGGCGG or its reverse complement CCGCCC, were investigated relative to the location of CpG islands. G/C boxes were found to be rare in CpG-depleted DNA and plentiful in CpG islands, where they occurred in 3' CpG islands, as well as in 5' CpG islands associated with tissue-specific and housekeeping genes. G/C boxes were located both upstream and downstream from the transcription start site of genes with 5' CpG islands. Thus, G/C boxes appeared to be a feature of CpG islands in general, rather than a feature of the promoter region of housekeeping genes. Two theories for the maintenance of a high frequency of CpG dinucleotides in CpG islands were tested: that CpG islands in methylated genomes are maintained, despite a tendency for 5mCpG to mutate by deamination to TpG+CpA, by the structural stability of a high G+C content alone, and that CpG islands associated with exons result from some selective importance of the arginine codon CGX. Neither of these theories could account for the distribution of CpG dinucleotides in the sequences analysed. Possible functions of CpG islands in transcriptional and post transcriptional regulation of gene expression were discussed, and were related to theories for the maintenance of CpG islands as "methylation-free zones" in germline DNA. PMID- 3656448 TI - Identification of intrinsic termination sites in vitro for RNA polymerase II within eukaryotic gene sequences. AB - We have identified and mapped several DNA sequences within a human histone gene (H3.3) at which in-vitro transcription by highly purified RNA polymerase II is efficiently terminated. Since transcription in our system involves only RNA polymerase II acting on a linear DNA template, these sequences contain "intrinsic" termination signals recognized by the polymerase protein itself. The existence of such signals within a gene suggests that efficient antitermination systems probably exist for mammalian transcription units. Alternatively, there could be a high frequency of premature transcription termination, or "polarity" for genes such as H3.3. Intrinsic transcription termination sites in H3.3 are located in sequences of consecutive thymidylate residues (5 to 8 nucleotides) on the non-transcribed DNA strand (T-runs), from which it is likely that such T-runs are elements of the intrinsic termination signal for RNA polymerase II. However, transcription proceeds without significant termination through many similar T runs, from which it follows that these intrinsic termination signals include other elements. Since transcription is also terminated efficiently at these sites when the transcript remains bound along its full length as a DNA-RNA hybrid, it is unlikely that formation of specific RNA secondary structures in the transcript is a general element of the intrinsic termination signal. Although DNA sequences downstream from the coding portion of the mouse beta-globin gene have been implicated as sites of transcription termination in vivo, these regions do not contain strong intrinsic termination signals, and transcription in vitro proceeds through these regions almost undiminished. Transcriptional termination in this region in vivo may depend on the presence of termination factors or other intracellular elements, and there may be multiple classes of DNA signals that control eukaryotic termination. PMID- 3656449 TI - Affinity chromatographic purification of nucleosomes containing transcriptionally active DNA sequences. AB - The unfolding of nucleosome cores in transcriptionally active chromatin uncovers the sulfhydryl groups of histone H3, making them accessible to SH-reagents. This has suggested that nucleosomes from active genes could be retained selectively on organomercurial/agarose columns. When nucleosomes released from rat liver nuclei by limited digestion with micrococcal nuclease were passed through an Hg affinity column, a run-off fraction of compact, beaded nucleosomes was separated from a retained nucleosome fraction. Although both contained monomer-length DNA and a full complement of core histones, histones in the retained fraction were hyperacetylated. Dot blot hybridizations showed the Hg-bound nucleosome fraction to be enriched in DNA sequences transcribed by hepatocytes (serum albumin and transferrin genes), while a brain-specific gene (preproenkephalin) was not retained, but appeared in the nucleosomes of the run-off fraction. The results are discussed in light of other evidence linking hyperacetylation of histones H3 and H4 to conformational changes at the middle of the nucleosome core. PMID- 3656450 TI - Spectroscopic studies on histone-DNA interactions. I. The interaction of histone (H2A, H2B) dimer with DNA: DNA sequence dependence. AB - Binding of the histone (H2A, H2B) dimer with chicken erythrocyte DNA has been studied by salt-titration spectroscopy in equilibrium conditions. The circular dichroism of DNA near 275 nm is depressed by the interaction with (H2A, H2B) at low concentrations of salt. The depression increases with increasing amounts of (H2A, H2B), and reaches a plateau at an (H2A, H2B) to DNA ratio of 1.5 (w/w), at which one (H2A, H2B) dimer occupies 28 base-pairs of DNA. The fluorescence emission intensity of the tyrosine residues in (H2A, H2B) is depressed by the H2A, H2B)-DNA interaction. When the DNA-(H2A, H2B) complex is titrated with NaCl, these two signals show transitions with increasing ionic strength of the buffer, whose normalized transition curves agree well. The midpoint of the transition is about 0.42 M-NaCl for a sample with a DNA concentration of 0.05 mg/ml and an (H2A, H2B) to DNA ratio of 0.4 (w/w). The fluorescence titration curves have been analyzed to obtain the binding constant for the (H2A, H2B) dimer with DNA. The sample concentration dependence of the titration profiles is consistent with the model of non-cooperative binding of (H2A, H2B) dimer to DNA. The titration profiles are reversible. The obtained binding constant for the (H2A, H2B) dimer with chicken erythrocyte DNA at 20 degrees C (pH 7.6), as a function of the ionic strength, I, is as follows: log10K = -14.9 log10(I)-1.2. The change of enthalpy delta H accompanied by the binding of the (H2A, H2B) dimer is nearly equal to zero, within an error of +/- 1.4 kcal/mol (1 cal = 4.184 J). DNA sequence dependence of the stability of DNA-(H2A, H2B) interactions is observed using reconstituted materials of synthetic DNAs. A decreasing stability of the interaction is observed following the order: the duplex of poly[(dA)-(dT)] greater than chicken erythrocyte DNA or the copolymer duplex of poly(dA).poly(dT) greater than the duplex of poly[(dG)-(dC)]. The difference in free energy of the association of the (H2A,H2B) dimer between the two copolymers is 0.8 kcal/mol. PMID- 3656451 TI - Spectroscopic studies on histone-DNA interactions. II. Three transitions in nucleosomes resolved by salt-titration. AB - The multiple-step transitions in DNA-histone interactions in chicken erythrocyte nucleosomes with increasing ionic strength are resolved by salt-titration spectroscopy. Both the circular dichroism of the DNA and the fluorescence of the histones in nucleosomes change during the titration process with concentrations of NaCl from 0.1 M to 2.5 M. By differentiating the titration curves, three distinct peaks corresponding to three structural transitions are observed. The two peaks near 0.95 M and 1.45 M-NaCl are common to the circular dichroism and fluorescence curves. The circular dichroism curve has another peak near 0.55 M NaCl. Because the derivative of the fluorescence titration curve for the DNA-(H3, H4) complex has only one peak near 1.45 M-NaCl, that peak is attributed to the dissociation of the histone dimer (H3, H4). The peak near 0.95 M-NaCl corresponds to the dissociation of the dimer (H2A, H2B) from the DNA-(H3, H4) complex, as shown by binding experiments of (H2A, H2B) to the DNA-(H3, H4) complex at the salt concentration near this peak. The peak near 0.55 M-NaCl reflects some inner core structural change. As the change of the circular dichroism signal is reversible, salt-titration spectroscopy is applicable to equilibrium studies of the physical chemical properties of DNA-histone interactions. By the assumption of a non-co-operative model, the binding constant for the chicken erythrocyte (H2A, H2B) dimer to the DNA-(H3, H4) complex is calculated as 2.8 X 10(6) M-1 at 1.0 M-NaCl (20 degrees C, pH 7.6). The DNA sequence dependence of the stability of the DNA-(H3, H4) interaction is observed in the salt-titration profiles of reconstituted material. Decreasing stability of the interaction of (H3, H4) is observed following the order: poly[(dG)-(dC)] much greater than chicken erythrocyte DNA greater than poly[(dA)-(dT)]. It is concluded that histones (H3, H4) have a different DNA sequence dependence from histones (H2A, H2B). PMID- 3656452 TI - The tertiary structure of azurin from Pseudomonas denitrificans as determined by Cu resonant diffraction using synchrotron radiation. AB - The structure of Pseudomonas denitrificans azurin has been solved at 3.0 A resolution by film data collection methods using synchrotron radiation. Bijvoet pairs of reflections were collected using 8.98 keV radiation where both delta f' and delta f", the real and imaginary corrections to azurin's Cu prosthetic group scattering, respectively, are large, and using 8.00 keV radiation where these corrections are smaller. The Cu atom was located by difference Patterson syntheses and used to phase the observed protein structure-factor moduli of selected reflections. An atomic model of the protein was built using a restricted data set and phases for all observed reflections to 3.0 A resolution were subsequently calculated from the initial model. The atomic model was subsequently rebuilt using all observed data. The results of this work are presented here and illustrate the utility of synchrotron radiation phasing techniques in solving the structures of metalloproteins without recourse to multiple isomorphous replacement. PMID- 3656453 TI - Rheologic behavior of deoxyhemoglobin S gels. AB - The physical properties of deoxyhemoglobin S gels formed from solutions at concentrations and temperatures approaching those in vivo have been characterized by stress relaxation using a rotational rheometer. Gels were annealed in the rheometer and then subjected to a constant shear strain; thereafter the stress sustained was followed with time. Gels with solid-like behavior held stress indefinitely, and were characterized by yield temperature (the temperature at which stress decreased). Gels with less solid behavior were unable to hold target stress, and were characterized by yield stress (maximum stress attained) and equilibrium stress (final stress held). The samples were ultracentrifuged to calculate pellet and polymer masses. The solidity of the gels, as measured by yield temperature or yield stress, was related to the initial hemoglobin concentration, pellet and polymer masses, shear history, temperature, and the temperature and time of annealing. Solidity increased significantly with time when gels were annealed at 37 degrees C, whereas, when annealed at 25 degrees C, no or minimal increases in solidity were noted. Studies suggest that polymerization occurs rapidly and is completed early in or before the gel annealing period and that the increase in solidity with time of annealing is mainly due to factors other than polymer mass, i.e. alignment, increasing bond strength, water loss. The chemical activity of deoxyhemoglobin S did not affect the solidity of the formed gels. When the resultant polymer masses were comparable, gels formed from samples with albumin present (higher initial total protein concentration, but lower initial deoxyhemoglobin S concentration), had the same behavior as gels formed from solutions with higher initial hemoglobin S concentration. These findings demonstrate that gel annealing conditions must be standardized when comparing the rheologic behaviors of deoxyhemoglobin S gels and indicate that the gel's physical properties (influenced by polymer mass, shear history, annealing time) must be considered in understanding pathophysiology of sickling disorders. PMID- 3656454 TI - Limited nucleosome migration can completely randomize DNA repair patches in intact human cells. AB - Following irradiation of human cells with ultraviolet light, DNA repair patches are initially inserted near the 5' and 3' ends of nucleosome core DNA leaving a "gap" in repair synthesis (of approximately 50 bases) near the center of the core DNA. With time, however, these same repair patches become randomized, apparently by nucleosome migration. We have developed both an analytical expression and a computer algorithm (which simulates nucleosome migration along DNA) to determine the average distance nucleosomes must migrate to change the initial, non-uniform distribution of repair patches in nucleosomes to a random distribution. Both of these methods yielded the same result: nucleosomes must migrate an average of about 50 base-pairs in either direction to produce the randomization observed. PMID- 3656455 TI - Stable DNA-protein complexes in eukaryotic chromatin. AB - Demembranized sperm and somatic nuclei of mammalian origin were extracted with high salt/urea/2-mercaptoethanol, treated with detergents and purified in CsCl density gradients to isolate DNA. Under these conditions a protein component still remained bound to DNA. This stable DNA-protein complex could be reduced to an oligodeoxynucleotide-peptide complex by extensive sequential digestions with DNase I and Pronase E. Chemical and enzymatic treatments of this complex indicated the presence of a phosphoester bond between DNA and a hydroxyamino acid. Two-dimensional tryptic peptide mapping revealed a remarkable similarity among the covalently linked protein components in all types of chromatin studied. These maps differed from the maps of mammalian topoisomerases I and II. PMID- 3656456 TI - Preliminary X-ray data for a D-amino acid amino-transferase from a novel thermophilic Bacillus. AB - Crystals of the D-amino acid aminotransferase (D-ATA) from a novel thermophilic Bacillus species (Escherichia coli pICT113 cloned gene product) have been examined by X-ray analysis. The crystals grow as hexagonal prisms, with the symmetry of space group P61 or P65 (indistinguishable crystallographically). The cell dimensions are a = b = 135 A, c = 53 A, alpha = beta = 90 degrees, and gamma = 120 degrees. The unit cell has a volume of 850,000 A3 with six asymmetric units per unit cell. There is one dimer of molecular weight 62,000 per asymmetric unit, and the crystals diffract to 2.7 A. PMID- 3656457 TI - The structure and function of the eye and its adnexa. PMID- 3656458 TI - Basic optical principles for the practice of refractometry. PMID- 3656459 TI - Advanced tonometry. Ophthalmic technician review. PMID- 3656460 TI - Pharmacology of ophthalmic drugs: Part II. Anti-inflammatory and anti-infective agents. PMID- 3656461 TI - Tonography. PMID- 3656462 TI - Correlation of cerebral perfusion pressure and Glasgow Coma Scale to outcome. AB - Cerebral Perfusion Pressures (CPP) and Glasgow Coma Scale (GCS) scores were monitored to guide the management of severely head-injured patients. These measures were correlated to outcome (Glasgow Outcome Scale-GOS) in 136 consecutive patients at least 1 year after injury. The GOS showed highly significant positive correlations to either CPP or GCS assessments (p less than 0.001). Two parameters that are correlated with subsequent death in most patients include 1) highest (h) GCS = 3 or 4 (Day 1: 31 of 32 patients died, and Day 2: 19 of 19 patients died), and 2) CPP less than or equal to 60 mm Hg more than 33% of the hourly measures during Day 2 (36% of all subsequent deaths; 11% overlap with the highest Glasgow Coma Scale). The Day 2 measures identifying two groups that have a greater than 75% incidence of "good outcome" or GOS = 4 or 5 include 1) hGCS greater than or equal to 6 (N = 45) and 2) the average (a) CPP greater than or equal to 90 mm Hg (N = 26). Of the 45 patients with a GOS = 4 or 5 who had both CPP and GCS recorded on the third day, 44 were identified by these "good outcome" parameters. PMID- 3656463 TI - Incidence and effect of hypothermia in seriously injured patients. AB - Hypothermia is a well recognized consequence of severe injury, even in temperate climates, and the physiologic consequences of hypothermia are known to be detrimental. To analyze the frequency and risk factors for hypothermia and its effect on patient outcome, we prospectively studied 94 intubated injured patients at a regional trauma center during a 16-month period. Esophageal temperature probes were placed in the field or ER and core temperatures (T) were followed for 24 hours or until rewarming. Patients were designated as normothermic (greater than 36 degrees C), mildly hypothermic (34 degrees C-36 degrees C) or severely hypothermic (less than 34 degrees C) based on initial T. The risk factors for hypothermia evaluated included age, severity and location of injuries, blood alcohol level, blood transfusion requirements, and time spent in the field, ER, or OR. The average initial T was 35 degrees C, with no seasonal variation. Injury severity and survival correlated with severe hypothermia. Normothermic patients had an average ISS of 28 with a 78% survival. Severely hypothermic patients had an average ISS of 36 with a 41% survival (p less than 0.05). Patient age strongly correlated with outcome although there was no relationship between age and initial temperature. Sixty-two per cent of patients tested were positive for blood alcohol, and one half were legally intoxicated (BAC greater than 100 mg%). However, no consistent correlation was found between alcohol intoxication and initial temperature or patient survival. Blood transfusion requirements paralleled injury severity and patients receiving greater than 10 unit transfusions had significantly lower core temperature (p less than 0.05). The average temperature change was positive in the ER, OR, and ICU with time to rewarming correlating with the aggressiveness of warming measures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656464 TI - Hypothermia in trauma victims: an ominous predictor of survival. AB - Hypothermia in trauma patients is generally considered an ominous sign, although the actual temperature at which hypothermia affects survival is ill defined. In this study, the impact of body core hypothermia on outcome in 71 adult trauma patients with Injury Severity Scores (ISS) greater than or equal to 25 was analyzed. Forty-two per cent of the patients had a core temperature (Tc) below 34 degrees C, 23% below 33 degrees C, and 13% below 32 degrees C. The mortality of hypothermia patients was consistently greater than those who remained warm, regardless of index core temperature. Mortality if Tc less than 34 degrees C = 40%, less than 33 degrees C = 69%, less than 32 degrees C = 100%, whereas mortality if Tc greater than or equal to 34 degrees C = 7%, and greater than or equal to 32 degrees C = 10%. Mortality and the incidence of hypothermia increased with higher ISS, massive fluid resuscitation, and the presence of shock. Within each subgroup (i.e., greater ISS, massive fluid administration, shock) the mortality of hypothermic patients was significantly higher than those who remained warm. No patient whose core temperature fell below 32 degrees C survived. PMID- 3656465 TI - Regional blood flow in sciatic nerve, biceps femoris muscle, and truncal skin in response to hemorrhagic hypotension. AB - Regional blood flow was measured simultaneously in rat sciatic nerves (NBF), truncal skin (SBF), and biceps femoris muscles (MBF) after graded hemorrhages. A modified 14C-butanol "indicator-fractionation" technique was used. In controls NBF was 11.4 +/- 1.38 ml X min-1 X 100 gm-1 and did not differ significantly between limbs. After hypotension, NBF was: 101 mm Hg, 7.7 +/- 1.3; 83 mm Hg, 5.3 +/- 0.6; 62 mm Hg, 4.1 +/- 0.6; 38 mm Hg, 3.1 +/- 0.3. The relationship between NBF and MAP was linear: (r = 0.56; p less than 0.001). SBF also declined linearly in hypotension (r = 0.54; p less than 0.01), but MBF did not change significantly. No significant change in nerve vascular resistance occurred with hypotension but muscle vascular resistance declined progressively. The data indicate a striking absence of autoregulation of NBF, but MBF, as expected, displayed close autoregulation. The vascular mechanisms which regulate resting NBF following hemorrhage differ from those in both muscle and skin: during hypotension, the calculated neurovascular resistance was unchanged, while the resistance in muscle fell and that in the skin increased. PMID- 3656466 TI - Essential fatty acid status in isolated closed head injury. AB - Abnormal profiles of polyunsaturated fatty acids in the plasma phospholipid fraction were observed in 14 patients with hypermetabolism due to severe isolated closed head injury. Depressed linoleic acid levels were observed within 24 hours along with elevation of oleic acid levels. By one week postinjury, subnormal levels of arachidonic acid were also observed. These data indicate that the metabolic response to injury encompasses changes in the metabolism of polyunsaturated fatty acids which are rapid in onset and qualitatively similar to those seen in mild essential fatty acid deficiency. PMID- 3656467 TI - The epidemiology of logging injuries in the northwest. AB - Logging is among the most hazardous forms of employment. However, a comprehensive review of severe logging injuries and their outcome has apparently not been previously undertaken. In the present study we review 51 consecutive injured loggers requiring transfer to a regional Level I trauma center. The average age was 34 years and the mode of injury in 67% was being struck by a falling or rolling log. Orthopedic intervention was required most frequently (49%), with neurologic injury in 43%. Two patients died (4%), both secondary to severe head injury, and both survived less than 24 hours. Importantly, while most severely injured patients survived, they required long hospitalizations and had a 58% permanent disability, with more than half of these being brain or spinal cord related. Although the overall number of workers involved in logging is small, the young average age, the work years lost, and the high risk of permanent disability support continued strong efforts to improve overall safety. Particularly, the high incidence of head injury argues strongly for improved and increased use of safety helmets, which may significantly impact the mortality and morbidity of logging accidents. PMID- 3656468 TI - Influence of internal fixation on wound infections. AB - With increasing frequency trauma surgeons are advocating early internal fixation in open fractures. The effect of the fixation devices on the infection rate in contaminated wounds remains a concern as our clinical experience in this area has been mixed. To study the effects of internal fixation on bone infections a 3.5-mm stainless steel screw was inserted into rabbit femurs and the wounds contaminated with Staphylococcus aureus. The controls had the screw hole drilled and taped but the screw was not inserted. Thirty of 49 rabbits receiving the screw subsequently became infected whereas 19 of 56 control animals developed an infection. The difference was significant at the 0.05 confidence level. PMID- 3656469 TI - Resistance of rapidly expanded random skin flaps to bacterial invasion. AB - This study tested the hypothesis that rapidly expanded random pattern skin flaps demonstrate enhanced resistance to bacterial invasion from intradermal injection of Staphylococcus aureus in a porcine model. Sites for a 6 X 12 cm expanded, a 6 X 9 cm sham-expanded, and a 6 X 6 cm acute random pattern skin flap were outlined, but not elevated, on the backs of 14 white pigs. A 450-cc tissue expander inserted beneath the panniculus carnosus at the site for expansion was sequentially filled to the limits of skin viability each day for 5 days. At the sham site a tissue expander was similarly inserted but left unexpanded; the acute flap site was left undisturbed. On day 8, flaps were elevated, immediately sutured in place, and 0.1 ml of saline solution containing 10(7) Staphylococcus aureus inoculated intradermally at four corresponding sites in each flap and at three sites in normal skin. In seven animals these sites were at the proximal base of the flaps; in seven others the sites were distal. The resulting areas of erythema and skin ulceration were measured on each of the next 3 days and the measurements compared. At corresponding proximal sites, the mean area of erythema and ulceration measured over the next 3 days in expanded flaps (31.2 mm2) and in sham-expanded flaps (33.8 mm2) was significantly less than in acute flaps and control skin (47.5 mm2, 43.4 mm2, p less than 0.05). Measurements in the rapidly expanded flaps were not significantly different than those in the sham-operated expanded flaps.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656470 TI - Penetrating thoracic injuries: in-field stabilization vs. prompt transport. AB - One hundred patients who were in extremis and required Emergency Room Thoracotomy (ERT) after sustaining penetrating thoracic injuries were analyzed to compare the results of attempted stabilization in the field (n = 51) with those who had immediate transportation (n = 49). The clinical status of the patients in the field and in the E.R. was quantified by Trauma Score (TS) as well as Physiologic Index (PI), ranging in severity from 20 (clinically dead) to 5 (stable). The anatomic injury severity was expressed by Penetrating Trauma Index (PTI). Survival was analyzed according to the type of injuries: noncardiac and cardiac. The overall survival was 10%. There was only one survivor with noncardiac injuries. Sixty-nine patients had cardiac penetration, 33 in Group I (stabilization) and 36 in Group II (immediate transport). Despite attempts at stabilization, none of the patients in Group I showed an improvement in clinical status from the scene to the emergency room. There were a higher number of patients arriving at the E.R. with signs of life in Group II compared to Group I. In Group II patients, survival was significantly improved overall (p = 0.01), in patients with signs of life on arrival at the hospital (p = 0.02) and in patients with isolated right ventricular wounds (p = 0.01) compared with Group I. The anatomic injury severity (PTI) as well as the mode of injury in the two groups was similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656472 TI - Tension pneumopericardium in blunt chest trauma. AB - Tension pneumopericardium is a rare complication of blunt chest trauma. We present two case reports of tension pneumopericardium, with clinical, hemodynamic, and radiographic evidence supporting the diagnosis. Although tension pneumopericardium is uncommon in blunt chest trauma, it should be considered in patients with pneumopericardium and hemodynamic instability. PMID- 3656471 TI - Steroid administration potentiates urinary nitrogen losses in head-injured children. AB - Exogenous steroid administration has been shown to increase post-traumatic nitrogen excretion in adults. Children sustaining head injuries and treated with steroids have previously been shown to have markedly increased total urinary nitrogen levels; the amount of nitrogen excreted is also directly related to the degree of injury, as evidenced by the Modified Injury Severity Score (MISS). It is unclear whether the increased protein breakdown in these patients is a result of the head injury or a result of the catabolic effects of steroids. Nineteen children aged 4-14 years, suffering head injuries, were prospectively studied. In ten children, management included steroid administration (1-1.5 mg/kg/day dexamethasone X 3-5 days); the remaining nine were similarly managed; however, without steroids. The groups were matched for age, weight, MISS, and Glasgow Coma Scale Score. The steroid-treated group showed a significantly higher urinary nitrogen excretion (mean, 256 +/- 24 mg/kg/day) than the nonsteroid-treated group (mean, 172 +/- 29 mg/kg/day) (p less than 0.02). These data suggest that steroids potentiate an already accelerated post-traumatic catabolic response seen in children with head injuries. Our data suggest that steroid use, which is common, mandates aggressive nutritional support in the management of children with head injuries. PMID- 3656473 TI - Posterior fracture dislocation of the shoulder with biceps tendon interposition. AB - Posterior dislocation of the shoulder, a rare injury, results from direct trauma, indirect trauma, or via a seizure or electrical shock. We present a case with a posterior fracture dislocation of the shoulder secondary to a seizure in which interposition of the biceps tendon precluded closed reduction. The fractured lesser tuberosity fragment included the bicipital groove, allowing the biceps tendon to sublux posteriorly preventing closed reduction, thus requiring a subsequent open reduction. PMID- 3656474 TI - Ventricular septal defect due to nonpenetrating chest trauma: use of the intra aortic balloon pump. AB - Nonpenetrating traumatic ventricular septal defect is rare. A triad of blunt chest trauma, holosystolic precordial murmur, and ECG abnormalities should suggest the diagnosis. Surgical repair, when indicated by progressive failure, rising pulmonary artery pressures, or significant (2:1 or larger) left-to-right shunt, has been shown to be very effective. Optimally, a period of several weeks from the injury should elapse before operative intervention is undertaken. Intra aortic balloon pump may be helpful to stabilize patients acutely, and, in selected instances, allow delay of surgical repair so that the tissue around the defect may hold sutures more securely. PMID- 3656475 TI - Percutaneous transcatheter steel-coil embolization of a large proximal post traumatic superior mesenteric arteriovenous fistula. AB - Arteriovenous fistulae affecting the proximal portions of the superior mesenteric vessels are extremely rare. We are reporting one such fistula which occurred in a young male as a sequel to a stab in the epigastrium. The arteriovenous fistula was successfully treated by percutaneous steel coil embolization. PMID- 3656476 TI - The use of Military Antishock Trousers (MAST) in the management of trauma patients. PMID- 3656477 TI - Blunt liver trauma at Sunnybrook Medical Centre. AB - Between 1 June 1976 and 30 June 1985 Sunnybrook Medical Centre Regional Trauma Unit admitted 2,016 patients of whom 220 (11%) sustained liver injury. Of these 220 patients, 211 (96%) sustained blunt liver trauma; 175 of 176 patients who underwent open peritoneal lavage had a true positive lavage. Resuscitation was successful in 212 patients, of whom 209 underwent laparotomy and three were treated nonoperatively: 129 of 209 patients (62%) required only minor surgical treatment; the remaining 80 patients (38%) required major surgical procedures. The overall mortality was 29% (64/220). Eight patients died during resuscitation, one of them of liver hemorrhage. Of the 56 patients who died after admission, the cause of death was head injury in 31, liver hemorrhage in 11 (five intraoperatively) and 14 died of other causes. Overall, liver hemorrhage was the cause of death in 12 of 64 deaths (19%). In other words, 12 of the total of 220 patients (6%) died from liver-related mortality. PMID- 3656478 TI - Mortality and morbidity related to severe intrapulmonary shunting in multiple trauma patients. AB - Of 210 multiple trauma patients admitted to our Intensive Care Unit (ICU), 12 (5%) presented with severe hypoxemic respiratory failure needing mechanical ventilation with an FIO2 of 1.0 because of severe intrapulmonary shunting (IS). Five (42%) of these patients survived and two (17%) died because of their underlying respiratory failure. We found a mean of three etiologic factors in each patient to account for their IS. Nonsurvivors had a lower cardiac index than survivors when they first needed FIO2 of 1.0 and ARDS was more frequent among this group. All patients who survived were in severe hypoxemic respiratory failure in the first 5 days post-trauma; all patients who needed FIO2 of 1.0 later than 5 days post-trauma died. Data collected for patients with similar degree of respiratory failure in coronary care ICU (n = 18), in medical ICU (n = 19), and surgical ICU (n = 21) demonstrated that multiple trauma patients with severe hypoxemic respiratory failure were younger and were hospitalized and ventilated for longer periods of time. In multiple trauma patients, as for patients with cardiogenic pulmonary edema, death was seldom related to respiratory failure itself. We concluded that severe hypoxemic respiratory failure in trauma patients is usually of mixed etiologies. It is a serious cause of morbidity in these patients; however, mortality is seldom directly related to this condition. Severe IS occurring shortly after trauma is of better prognosis than late IS. PMID- 3656479 TI - The pediatric passenger: trends in seatbelt use and injury patterns. AB - Injury patterns and use of passenger restraints were studied in 91 children injured while riding in motor vehicles and admitted to The Hospital for Sick Children, Toronto, from June 1984 through December 1985. Of theses, 44 had used restraints and 38 had not. Nine were excluded from the study because restraint use could not be determined. Age and sex distributions were closely matched in both study groups. The no-restraint group had more massive head injuries, thoracic injuries, and liver and spleen injuries than the restraint group. Classic "seatbelt syndrome" injuries were seen in the seatbelt group. The overall Injury Severity Scores were not significantly different between the groups. Despite mandatory legislation, many children do not use restraints, and many who do still suffer severe or fatal injuries. We conclude that better compliance with existing passenger restraint laws and more effective restraint systems are needed. PMID- 3656480 TI - The management of blunt splenic trauma. AB - Seventy cases of blunt splenic trauma were retrospectively reviewed for the period 1979-1984. There were 57 adults and 13 children. Motor vehicle accidents were implicated in 62%. Forty-five splenectomies and eight splenorrhaphies were performed. The patients fell into two groups. Group A, numbering 48 patients, were those operated upon within 24 hours of injury. The mortality rate was 16%, and no deaths were attributable to splenic injury. Indications for surgery were hemodynamic instability in 46% and positive peritoneal lavage in 40%. Group B included 22 patients, 17 of whom were managed nonoperatively with no deaths. Five patients eventually went to laparotomy. Fifty per cent of all patients had associated intra-abdominal injury but only 17% needed repair; 31% of patients were initially managed conservatively with a 77% success rate and no mortality. It is concluded that conservative management is safe in stable patients with blunt splenic trauma. PMID- 3656481 TI - Etiology and clinical course of missed spine fractures. AB - A prospective study was designed to document course and outcome. Two hundred fifty-three patients with 274 spinal injuries were reviewed at the time of injury and discharge from hospital, as well as at 1, 2, and 5 years postinjury. Thirty eight of these patients were identified who had been misdiagnosed at the initial assessment. Fracture location, cause of injury, neurologic deficit, and delay in diagnosis were all documented: 22.9% of cervical injuries, and 4.9% of the thoracolumbar injuries had a delayed diagnosis ranging from less than 1 day to 36 days. The causes of delayed diagnosis were: 1) failure to take X-rays, 2) fractures missed on X-ray, and 3) failure of patients to seek medical attention. Associated factors such as intoxication of the patient, multiple injuries, level of consciousness, or two levels of spinal injury contributed to the delayed diagnosis of these injuries. Certain "at-risk" populations for missed spinal injuries have been identified. In spite of delays in diagnosis, progression of an established neurologic deficit did not appear to occur in our study. However, the development of secondary deficits was significant in the delayed diagnosis group. PMID- 3656482 TI - Diaphragmatic trauma in southern Saskatchewan--an 11-year review. AB - An 11-year retrospective review of 51 patients with diaphragmatic injuries revealed 33 blunt and 18 penetrating injuries. In the blunt trauma group 24 were left-sided and nine were on the right side. Preoperative diagnosis was made in 24 patients. Delayed diagnosis (greater than 24 hours) during life occurred in four patients and two injuries were found at autopsy. Chest X-ray was diagnostic or highly suggestive in 23 patients. All patients in this group had associated extra abdominal injuries; 23 patients had concomitant intraabdominal injuries. Transabdominal repair was performed in 24 patients. Four deaths occurred in the blunt injury group. The penetrating diaphragmatic wounds consisted of 14 left sided, three right-sided, and one pericardial wound. Preoperative diagnosis occurred in only three patients. The penetrating wound, hypotension, or peritoneal signs dictated operation in the remaining 15 patients. One death occurred from peritonitis and septic shock. Blunt and penetrating diaphragmatic injuries remain a diagnostic challenge and associated injuries determine the outcome. PMID- 3656483 TI - Penetrating chest trauma: a 20-year experience. AB - From 1965 to 1985, 76 patients were admitted to Sacre-Coeur Hospital, Montreal, with a diagnosis of penetrating chest trauma (PCT). The majority were under the age of 30 years and almost two thirds suffered gunshot wounds. Sixty-seven (88.1%) sustained a lateral or thoracic (T) injury and in nine (11.8%) the lesion was central or mediastinal (M). In the first group (T), 53.7% were treated surgically with thoracotomy, laparotomy, and chest tube (CT) insertion or both; 46.2% were managed conservatively. In the second group (M) the pericardium or the heart was involved, eight patients (88.8%) were managed surgically without the use of extracorporeal circulation and one patient was observed only. Eight (11.9%) died in the thoracic group; all survived in the mediastinal group, for an overall mortality of 10.5%. Shock was associated with increased morbidity and mortality in the thoracic group (T) and infection was the most frequent complication for the entire group of patients under study. There has been a steady increase in the total number of PCT at our hospital during the last two decades suggesting an increase in crime and violence in our urban surroundings. PMID- 3656484 TI - Delayed posterior internal fixation of unstable pelvic fractures. AB - Fifteen patients with unstable pelvic fractures were treated with immediate anterior external fixation followed by delayed posterior fixation, including five sacroiliac lag screws, six transiliac rods, and four iliac plates. Initial anterior external fixation aided in resuscitation of hemodynamically unstable patients and allowed early mobilization. Delayed posterior internal fixation avoided infection and hemorrhage but failed to achieve anatomic reduction of disrupted sacroiliac joints and sacral fractures. Followup examination confirmed maintenance of fixation and fracture healing but pain and persistent neurologic deficits were common findings. Lumbosacral nerve plexus injuries occurred in patients with fractures through the sacral foramina. Fixation of these fractures with sacroiliac screws and transiliac rods caused overcompression and the resulting foraminal encroachment may be a factor in the lack of neurologic recovery. In this study, delayed posterior internal fixation was not associated with perioperative morbidity and achieved better reductions than those obtained with external fixation alone. Delaying the fixation, however, increased the difficulty of obtaining anatomic reduction of certain posterior arch disruptions. PMID- 3656485 TI - Studies on blood pressure and hypertension in children of 13 minority nationalities in China. PMID- 3656486 TI - Effects of phosphoramidothiolate pesticides on rat erythrocyte membrane acetylcholinesterase. PMID- 3656487 TI - Effects of LDL and HDL on morphology of and prostacyclin synthesis in cultured vascular endothelial cells. PMID- 3656488 TI - Effects of anti-inflammatory Agent No.6 for injection on the oxidative burst of rat peritoneal macrophages. PMID- 3656489 TI - Studies on the calcium antagonistic action of tetrandrine: XIV. Influence of tetrandrine and verapamil on hemodynamic action of ouabain in guinea pigs. PMID- 3656490 TI - Effect of naloxone injected into the lateral cerebral ventricle on the arterial baroreflex sensitivity during heat stress-induced hyperthermia in rabbits. PMID- 3656491 TI - [Morphological studies of norethisterone oxime effect on ovary in rabbits and rats]. PMID- 3656492 TI - A paediatric report on Bhutan. AB - These data from Thimphu General Hospital constitute the first published report of child health in the Kingdom of Bhutan. The unique geopolitical, social and health situation of the children of Bhutan is little known to the West. Hospital data from 1980 to 1982 provided the descriptive setting for the establishment of a paediatric referral service in 1983. Western medical care is gradually being introduced to the people, who live in stable traditional social structures and patterns. An understanding of the pre-existing health care systems and practices is essential to planning appropriate integration of acute medical care into the rich culture with minimal social dislocation and maximal medical efficacy. PMID- 3656493 TI - Management of febrile seizures in a developing country. AB - In the analysis of 128 patients with febrile convulsions, we identified hazards not encountered in the western world, which could alter the ultimate management of the child. These include administration of home remedies during the seizures, detrimental cultural beliefs and poor socio-economic conditions. All complex seizures in our series were initial seizures. Recurrent benign febrile seizures did not predispose to a complex seizure. Behaviour disorders were the most prominent side effect following long term phenobarbitone administration. PMID- 3656494 TI - Increased frequency of induced sister chromatid exchanges in kwashiorkor. AB - The study included 16 infants with advanced manifestations of kwashiorkor and 16 unrelated age-matched normals as controls. Whole blood samples, at room temperature, were exposed to gamma-rays in increasing dosages. Lymphocytes were cultured; phytohaemagglutinin and bromodeoxyuridine (10 microM) were added, at initiation of culture, and harvesting was performed after 64 to 68 h. Slides were coded and sister chromatid exchanges (SCE) counted. In controls, no significant increase in the frequency of SCE was found. For kwashiorkor infants the SCE frequencies showed significant increase as irradiation dosages rose. It is concluded that the changes observed are probably due to alteration in: the cell cycle length; activities of enzymes responsible for DNA repair; DNA growing points; and protection of cells from chromosome breakage. PMID- 3656495 TI - Cancer in southern Ethiopia. AB - A retrospective study of biopsies taken at three hospitals in Southern Ethiopia has been carried out to describe the cancer pattern in the Sidamo and Gamu Gofa regions. A histologically verified cancer diagnosis was recorded in 1154 patients. The bias that appear in the data are discussed. This includes aspects of hospital coverage, age and sex distribution and bias that arise from a lack of diagnostic facilities, especially to diagnose deep seated tumours. Taking these bias into consideration, the cancer pattern in Southern Ethiopia is outlined. Among men, hepatic carcinoma, lymphomas and superficial malignancies (skin cancers including melanomas and superficial soft tissue sarcomas) are the most common malignancies while among women, cervical, breast and ovarian cancers predominate. It is noted that most of the Kaposi's sarcomas recorded are from the Sidamo area. Hodgkin's disease and Burkitt's lymphoma are most common among childhood lymphomas, whereas non-Hodgkin lymphomas of other types dominate among adults. Cancer of the stomach is the second most common internal malignancy among both men and women. PMID- 3656496 TI - Isolation of Clostridium difficile from diarrhoea patients in Bangladesh. AB - An attempt was made to detect Clostridium difficile and its toxin from the stools of 20 patients with antibiotic-associated diarrhoea (AAD), 35 with colitis, six with chronic diarrhoea and 300 with watery diarrhoea. Two toxigenic and three non toxigenic strains were isolated from patients associated with antimicrobial therapy. All 300 stools from watery diarrhoea patients, not associated with antibiotics, were negative for Cl. difficile and its toxin. We conclude that Cl. difficile might be a cause of AAD in Bangladesh. PMID- 3656497 TI - Preliminary evaluation of some wild and cultivated plants for snail control in Machakos District, Kenya. AB - Fifty local medicinal, agricultural and wild growing deciduous plants, representing 49 species, 46 genera and 22 families, were screened as water extracts at 1:1000 concentration for molluscicidal activity against Biomphalaria pfeifferi in Machakos District, Kenya. Forty-seven of the 50 (94%) plants and 106 of the 134 (79%) plant materials (roots, stems, leaves, fruits, flowers and seeds) were molluscicidal. The leaves of Pappea capensis (Sapindaceae), Steganotaenia araliacea (Umbelliferae), Zornia setosa subsp. obvata (Papilionaceae) and Terminalia kilimandscharica (Combretaceae), the flower pods of Hyptis pectinata (Labiatae), the seeds of Acacia nilotica (Mimosaceae) and the fruits and roots of Solanum nigrum (Solanaceae) gave 100% kill. Another 15 species produced mortality rates between 53% and 87%. Plants were evaluated for possible use in local snail control programmes by considering their growing characteristics, habitat requirements, toxicity in non-target organisms, abundance in the study area and competing uses. PMID- 3656498 TI - Onchocerciasis in Ecuador: absence of microfilaraemia. AB - Blood samples from 497 people positive for onchocerciasis in the hyperendemic onchocercal focus in Ecuador were analysed for the presence of microfilaraemia using the Knott technique. No evidence of Onchocerca volvulus microfilaraemia was found, nor that of any other microfilaria. PMID- 3656499 TI - Acute epiglottitis: decade of change--a 10-year experience with 242 children. AB - Acute epiglottitis is a life threatening infection of the supraglottic structures. It more commonly occurs in early childhood but affects all age groups. Haemophilus influenzae type B is the usual pathogenic organism. The disease may progress so rapidly that sudden upper airway obstruction will occur, resulting in hypoxic brain damage or death. A retrospective study was completed on all patients (242) admitted to the Hospital for Sick Children in Toronto with a diagnosis of acute epiglottitis from January 1976 to December 1985. Prior to 1976, tracheotomy was the more common form of airway control but during the 10 year period reviewed endotracheal intubation was utilized almost universally in the 85% of patients having airway control and was associated with equally low morbidity. Airway obstruction prior to admission to the Hospital for Sick Children resulted in the subsequent deaths of five patients and persistent neurological deficits in four other surviving patients. The emergence of resistant strains of Haemophilus B organisms has altered antimicrobial management. PMID- 3656501 TI - Other health problems of children with acute otitis media. AB - To help clarify whether acute otitis media is associated with a different frequency of other health problems compared to other acute illnesses, 77 acute otitis patients (average age two years, three months) seen in a university affiliated pediatric primary care facility were studied. Each was paired with a patient of the same age and sex who presented at the same time with another acute health problem. No differences were detected between the two sets of patients in the frequency of neonatal or prior health problems, except that the patients with acute otitis media had had more previous episodes of this condition than the other patients. At the time of presentation both sets had similar growth and socioeconomic status, and during the year after presentation no differences were noted in the type or number of health problems. PMID- 3656500 TI - Airway management in craniofacial surgery: experience in 542 patients. AB - Five hundred and forty-two patients undergoing 579 craniofacial surgical procedures were admitted to the Intensive Care Unit of the Hospital for Sick Children, Toronto, during the 13-year period of 1972 to 1984. Ninety-eight of these patients underwent tracheotomies; 12 significant complications were documented. Two hundred and seventy-eight patients were managed with nasal endotracheal intubation for greater than 24 hours postoperatively; 42 related complications were documented. Good communication among the craniofacial surgeon, otolaryngologist, anesthetist and intensivist is crucial for the safe management of the various airway problems observed in patients with major craniofacial anomalies undergoing corrective surgery. PMID- 3656502 TI - The effect of swimming in chlorinated water on middle ear pressure. AB - This study evaluated whether an important fall in middle ear pressure (MEP) was recordable several hours after swimming. MEPs were measured in 52 normal school children on an average of four occasions immediately before swimming and "control" exercise sessions, and were repeated four hours after the activity. Twenty-nine children swam in a high chlorine concentration, with a mean free chlorine level of 2.3 parts per million, and 23 children swam in a low chlorine environment, with a mean concentration of 0.4 parts per million. For the former there was an average decrease of 0.5 daPa after swimming and an increase of 34.7 daPa after exercise; for the latter there were increases of 13.3 and 15.6 daPa after swimming and exercise respectively. It is concluded that swimming does not adversely affect middle ear function. Exercise induces an increase in MEP, and exposure to high chlorine levels appears to cause a small reduction in middle ear pressure. PMID- 3656503 TI - Cryptic otalgia: a case of Munchausen syndrome in a pediatric patient. AB - This paper reports a case of Munchausen syndrome in a pediatric patient. The patient, a 13-year-old boy, presented with a complaint of persistent otalgia. As a result of the patient's deception of his physicians, he underwent numerous unnecessary investigations and two unnecessary operative procedures. The patient's deception included the simulation of a cerebrospinal fluid leak. The literature with respect to Munchausen syndrome in the pediatric patient is reviewed. Emphasis is placed on the fact that physicians, by their investigations and treatments, inflict most of the morbidity on this group of patients. Specific warning signals as well as an approach for management of these patients are also reviewed. PMID- 3656504 TI - Sinusitis in children. AB - Sixty-eight children with the primary diagnosis of sinusitis have been admitted to the B.C. Children's Hospital since its opening in 1982 until July of 1986. Sinusitis in children under six years differs in presentation and course from sinusitis in older children. Children under six years seem to respond well to antibiotics while some children over six need surgery. Underlying diseases were present in half the cases and should be searched for in children who present with recurrent sinusitis. PMID- 3656505 TI - First branchial cleft fistula: case reports and literature review. AB - The 1st branchial cleft accounts for about 5% of branchial arch anomalies. The necessity for wide surgical exposure to delineate the anatomy between the facial nerve and tract is stressed; migrating mesenchyme, which brings with it the facial nerve, can orientate medically, laterally or both sides of the tract. Three cases and a literature review are presented. PMID- 3656506 TI - Otoplasty: an update. AB - Otoplasty is a common cosmetic surgical procedure. Various techniques have been described through the years, many of these addressing only specific aspects of the deformity rather than overall correction of the multiple defects that often occur. To achieve optimal results, an understanding of the embryology of the external ear and an appreciation of the development of otoplasty techniques are useful. Current surgical concepts are emphasized and the authors' graduated approach to otoplasty is presented. Thirty-five cases over a four-year period are reviewed. All achieved a satisfactory cosmetic result; there were 5 complications, 3 being due to Mustarde suture pull-away. Two of these required revision, and revision was also required in another patient who developed a hypertrophic scar. The remaining complication was a minor suture granuloma. PMID- 3656507 TI - Dipsogenic-like and behavioural effects of bombesin administered intracerebroventricularly to sheep. AB - Bombesin administered intracerebroventricularly both by bolus injection (3.0, 6.0, 12.5, 25.0 and 50.0 ng kg-1) and slow infusion (0.4, 0.8 and 1.6 ng kg-1 min 1 for 30 min) potently and promptly stimulated water intake in sheep. This effect was dose dependent and bombesin was slightly more potent than angiotensin II (on a molar basis); both caused behavioural alterations (scratching and licking) in treated animals. Intravenous bolus injections of bombesin at doses up to 2500 ng kg-1 did not elicit either dipsogenic-like or behavioural effects, unlike angiotensin II. The receptor antagonist of angiotensin II, saralasin, provoked drinking in sheep at doses of 18.7, 37.5 and 75.0 ng kg-1 by intracerebroventricular bolus injection. These results surprisingly revealed that bombesin, a potent inhibitor of water intake in other mammals (rats and pigs), exerted in sheep dipsogenic-like effects similar to those in pigeons and ducks. PMID- 3656508 TI - Pharmacokinetics of dantrolene sodium in horses. AB - The pharmacokinetics of dantrolene sodium were investigated in horses following both intravenous (2 mg/kg) and intragastric (4 mg/kg) administration. Two ponies also received dantrolene sodium intravenously (2 mg/kg) in a pilot study to obtain preliminary kinetic data and to determine urinary and biliary excretion of the intact drug. Distribution and elimination of dantrolene was rapid, resulting in an elimination half-life of 129 +/- 8 (SEM) min and a whole body clearance of 4.16 +/- 0.52 ml/min/kg. Following intragastric administration, dantrolene rapidly acheived peak concentrations within 1.5 h, but was incompletely absorbed, with a bioavailability of 39 +/- 10%. Small amounts of intact drug were recovered in urine and bile. Based upon disposition kinetics of dantrolene in these studies, intravenous and intragastric dosage regimens were determined which would maintain blood dantrolene concentrations within the predicted clinically effective range. PMID- 3656509 TI - Comparison of the effects of etomidate and its fluoro analogue, R 8110, on plasma cortisol, 11 beta-deoxycortisol, 17 alpha-hydroxyprogesterone and testosterone concentrations in dogs. AB - R 8110, an imidazole derivative, was shown to be clinically superior to etomidate for induction and maintenance of anaesthesia in dogs. The present study compared the effects of intravenous (i.v.) R 8110, etomidate and Ringer solution on cortisol biosynthesis by the adrenal gland in seven male labradors. A tetracosactide challenge was carried out 30 min after the i.v. injection of 3 mg/kg of both drugs and after i.v. Ringer solution (1 ml/kg). Etomidate and R 8110 both suppressed the cortisol response to tetracosactide almost completely and increased the plasma 11 beta-deoxycortisol levels more than 20 fold. Maximal 11 beta-deoxycortisol values were reached 120 min after R 8110, and not less than 300 min after etomidate. Plasma 17 alpha-hydroxyprogesterone and testosterone concentrations did not differ between placebo and R 8110 treatment, but they decreased after etomidate. These results indicate that the effects of R 8110 on steroid biosynthesis in dogs are less pronounced than those of etomidate and are largely limited to a temporary inhibition of the 11 beta-hydroxylase in the adrenal gland. PMID- 3656510 TI - Florfenicol in non-lactating dairy cows: pharmacokinetics, binding to plasma proteins, and effects on phagocytosis by blood neutrophils. AB - Serial blood samples were collected and plasma concentrations of florfenicol (FLO) were measured following the administration of an intravenous bolus of 50 mg/kg FLO to five healthy non-lactating dairy cows. A triexponential equation provided the best fit of the data for four of the five cows. The mean value for beta corresponded to a half-life of 3.2 h. The mean apparent volume of distribution was 0.67 l/kg, and the mean body clearance was 0.15 l/kg/h. The extent of binding of FLO to bovine plasma proteins was determined in vitro at concentrations of 5 micrograms/ml and 50 micrograms/ml by equilibrium dialysis and ultrafiltration. The drug was 18% and 19% bound by equilibrium dialysis, and 23% and 19% bound by ultrafiltration, at 5 micrograms/ml and 50 micrograms/ml, respectively. Phagocytosis of 32phosphorus-labelled Staphylococcus aureus by bovine blood neutrophils was compared in vitro between neutrophils incubated in phosphate-buffered saline alone or in combination with 5, 125, or 1000 micrograms/ml chloramphenicol or FLO. There was no significant effect of chloramphenicol at any concentration. Florfenicol significantly inhibited phagocytosis at all concentrations, but the percentage inhibition was small. The clinical significance, if any, of this effect of FLO remains to be demonstrated. PMID- 3656511 TI - Distribution of cephapirin into a tissue chamber implanted subcutaneously in horses. AB - The pharmacokinetics of cephapirin sodium and its distribution into a tissue chamber implanted subcutaneously in the neck of mature horses are described. Cephapirin was administered as an intravenous bolus dose of 20 mg/kg. The serum concentration vs time curve was best described by a two-compartment open model. Cephapirin disappeared from serum rapidly (t1/2 beta = 18.8 min), and had only a modest volume of distribution (Vd(area) approximately equal to 346 mg/kg, Vd(ss) approximately equal to 204 ml/kg). Total clearance was also rapid (approximately equal to 13 ml/min.kg). Concentrations of the antibiotic in tissue chamber fluid, however, were quite constant from 30 min to 3 h post-injection, and did not decay in parallel with either the concentration of the drug in serum or the estimated concentration of drug in the peripheral compartment. The ratio of area under the curve (AUC0-3 h) for serum: chamber fluid was 13.8 : 1, while that for peripheral compartment : chamber fluid was 11 : 1. The slow rate of cephapirin transport into, and out of, the chamber may be related to its hydrophilic nature. The lack of parallelism between the chamber fluid decay curve and that of serum is characteristic of drugs with a very short half-life. PMID- 3656512 TI - Effect of some vehicles used in intramammary mastitis preparations on inflammation indicators in milk. AB - The irritant effect of some vehicles used in intramammary mastitis preparations was assessed by indirect mastitis indicators in milk. Mineral oil, soybean oil, peanut oil, a combination of aluminium monostearate, stearic acid and mineral oil as well as isotonic saline were infused intracisternally in cows during mid lactation. These vehicles induced a selective increase in the number of somatic cells without any notable effects on the permeability marker antitrypsin or the lysosomal enzyme N-acetyl-beta-D-glucosaminidase (NAGase). PMID- 3656513 TI - Pharmacokinetics of ibuprofen in the dog. PMID- 3656514 TI - Inhibition of gastric acid secretion in dogs by detomidine. PMID- 3656515 TI - Percutaneous renal calculus removal in an extracorporeal shock wave lithotripsy practice. AB - The introduction of extracorporeal shock wave lithotripsy and transurethral ureteroscopy have altered markedly the incidence of standard surgical and percutaneous stone removal procedures. To help define the present role of percutaneous procedures in our practice we evaluated our indications, results and the clinical course of 143 patients who were treated primarily with percutaneous methods during 1 year in which extracorporeal shock wave lithotripsy also was available. The complexity of these residual percutaneous cases necessitated repeat endoscopic or fluoroscopic stone removal procedures in 20 per cent and ancillary extracorporeal shock wave lithotripsy in 22 per cent, and led to a slightly higher complication rate than in our previous percutaneous series. Despite the effectiveness of extracorporeal shock wave lithotripsy, percutaneous methods still are necessary for comprehensive therapy of upper tract urolithiasis. PMID- 3656516 TI - Patient exposure and radiation environment of an extracorporeal shock wave lithotriptor system. AB - Radiation exposures to the patient undergoing extracorporeal shock wave lithotripsy were assessed along with the scattered radiation levels around the lithotriptor systems. The data gathered from 2 Dornier lithotriptor systems suggest that the lead shieldings required for this particular make and model are minimal. Owing to the physical size of the lithotriptor system, the treatment room housing it may not require additional lead shielding when the walls are constructed with appropriate materials. Typical radiation exposures to the patient have been assessed from the experimental data. The total amount of radiation exposures a patient is likely to receive has been estimated to be approximately 26 roentgens, for example 21 roentgens from 3 to 4 minutes of fluoroscopic exposure and 5 roentgens from 8 frames of video spot filming. The scattered radiation has been found to be approximately 0.5 mR. per hour at 3 feet or 91 cm. from the center of the lithotriptor water tank. PMID- 3656517 TI - Radiation dose to patient and personnel during extracorporeal shock wave lithotripsy. AB - Radiation dose to the patient and personnel was determined during extracorporeal shock wave lithotripsy treatment of 60 patients. Surface radiation dose to the patient's back from the fluoroscopy unit on the side with the kidney stone averaged 10 rem (100 mSv.) per case, although the range was wide (1 to 30 rem). The surface dose from the opposing biplane x-ray unit was less, averaging 5.5 rem (55 mSv.) per case but again with a wide range (0.1 to 21 rem). Exit dose at the lower abdomen averaged 13 mrem. (0.13 mSv.) per case and estimated female gonad dose averaged 100 mrem. (1.2 mSv.). Radiation dose to personnel working in the extracorporeal shock wave lithotripsy suite averaged less than 2 mrem. (0.02 mSv.) per case, making it a procedure that is safe in regard to radiation exposure. PMID- 3656518 TI - Management of upper ureteral calculi with extracorporeal shock wave lithotripsy. AB - The results of 471 extracorporeal shock wave lithotripsy treatments in 465 patients with solitary ureteral stones managed by several different techniques are reported. In situ treatment was performed in 123 cases without instrumentation and in 47 after placement of a ureteral catheter. Retrograde stone manipulation was performed in 245 cases immediately before extracorporeal shock wave lithotripsy and an additional 56 were manipulated with ureteral stent placement at least 1 week before extracorporeal shock wave lithotripsy. The success rate was significantly greater if the stone was manipulated into the kidney before extracorporeal shock wave lithotripsy. Significantly less energy (p less than 0.0001) was required for complete disintegration if the stone was free floating in the kidney. The need for subsequent procedures was significantly less (p less than 0.0001) for stones manipulated successfully into the kidney. Complications were infrequent, with the most common being ureteral perforation in 5.1 per cent of the cases, all of which were managed conservatively. Extracorporeal shock wave lithotripsy is the treatment of choice for proximal ureteral calculi because it is less morbid than percutaneous approaches and provides significantly better results than ureteroscopy. An attempt at manipulation of proximal ureteral calculi back into the kidney should be made before extracorporeal shock wave lithotripsy. PMID- 3656519 TI - Percutaneous ureteral fulguration: a nonsurgical technique for ureteral occlusion. AB - Three patients with lower urinary tract fistulas after multiple operations and radiation therapy for pelvic cancer were treated with percutaneous ureteral fulguration and nephrostomy tube drainage. This technique occluded the ureter and allowed for maintenance of a dry fistula site in all 3 patients. There were no complications. The longest followup in these patients was 21 months. The procedure is simple technically and it can be performed with the patient under local anesthesia. The technique of percutaneous ureteral fulguration is described and other techniques for nonoperative occlusion of the ureter are discussed. PMID- 3656520 TI - The occurrence of vasculitis in perianeurysmal fibrosis. AB - The histological findings of retroperitoneal fibrosis in 17 operated patients are described. Of these patients 6 showed a simultaneous aneurysm of the abdominal aorta verified either by computerized tomography, ultrasound, arteriography or during an operation. Of the patients 14 were operated on primarily because of ureteral obstruction, 2 because of aortic aneurysm and 1 because of rupture of the abdominal aorta. Advanced fibrosis with varying amounts of inflammation was detected in all 17 patients. The same histological pattern was present in patients with aneurysm of the abdominal aorta and in those without aneurysm. Accompanying vasculitis with destruction of the vascular wall was noted in 8 patients, including 6 with an abdominal aortic aneurysm. In 3 patients who underwent aneurysm resection as well as in 1 patient with aortic rupture the process extended into the aortic wall. The only patient with vasculitis and no aortic process suffers from severe rheumatoid arthritis. On the basis of the different histological findings we suggest that retroperitoneal fibrosis with vasculitis and aneurysm may represent a distinct pathological entity. PMID- 3656521 TI - Remodeled right colon: an alternative urinary reservoir. AB - A total of 11 patients underwent bladder substitution or continent supravesical diversion with a remodeled right colonic segment as a urinary reservoir. Of the patients 1 woman and 2 men had bladder substitution: in 2 the bladder neck and urethra were preserved, and in 1 man radical cystoprostatectomy with preservation of the distal sphincteric mechanism was performed. All 3 patients currently are continent. In the 8 diversion patients an anti-incontinence mechanism was reconstructed with a segment of plicated ileum sutured to the abdominal wall. Six patients are completely dry between catheterizations every 4 to 6 hours, 1 man requires more frequent catheterizations, and the woman has refused self catheterization and wears an external appliance. There were 18 ureterointestinal reimplantations performed successfully for upper tract protection, and 1 ureterocolonic reimplantation became partially obstructed and required percutaneous dilation. Reflux did not occur. This remodeled right colonic segment, reconstructed with interruption of the intestinal circular fibers, allows for storage of large urine volumes at reasonable pressures and it is a suitable alternative bladder substitution procedure. Plicated ileum has allowed for easy catheterization and it has been an adequate anti-incontinence mechanism when associated with this colonic reservoir. PMID- 3656522 TI - Effect of liquid diphenoxylate hydrochloride and atropine sulfate (Lomotil) instillations on dynamics and function of continent cecal urinary reservoirs. AB - We assessed the impact of twice daily instillations of 10 ml. liquid diphenoxylate hydrochloride and atropine sulfate (Lomotil) on the dynamics and function of continent urinary reservoirs constructed from intact cecum and ascending colon. Six patients were treated for 1 to 3 weeks at 3 to 8 months postoperatively. The treatments reduced the frequency of spontaneous reservoir contractions, as well as the basal and contraction pressures of the reservoirs. The reservoir capacities were increased modestly. These alterations in reservoir dynamics were accompanied by a decrease in the cramping characteristically associated with reservoir distension and increased intervals between reservoir catheterization. Two patients who had incontinence after initially successful operations regained continence during treatment. No systemic side effects were observed, although dilution of the drug may be required to prevent reservoir irritability. Diphenoxylate hydrochloride and atropine sulfate instillations may prevent acute and possibly long-term pressure-related complications of continent urinary reservoirs constructed from intact cecum and ascending colon. PMID- 3656523 TI - Functional characteristics of the Camey ileal bladder. AB - We studied postoperatively 14 men who underwent urinary diversion with a Camey ileal bladder in association with radical cystoprostatectomy. Clinical and urodynamic evaluations revealed that the ileal bladder provides a moderate pressure reservoir (mean pressure at capacity 37 cm. water) and offers the patient reliable daytime continence. The mean capacity of 362 ml. allows for a voiding interval of 2.2 hours but it is not adequate for storage of urine produced through the night, so that nocturnal enuresis results universally. Even after 2 years of followup the tubular-shaped ileal reservoir maintained physiological contraction waves of segmentation and peristalsis typical of human ileum. Voiding is accomplished by abdominal straining and an intraluminal pressure of more than 50 cm. water is required to maintain the urine flow. Mean peak flow rate was 19 ml. per second. Reflux was prevented successfully in 86 per cent of the renal units. Metabolic acidosis was seen in 43 per cent of the patients. While the ileal bladder falls short of being the ideal form of continent urinary diversion, it offers a psychologically attractive technique to selected and highly motivated male patients faced with the need for urinary diversion. PMID- 3656524 TI - Features of 164 bladder ruptures. AB - We reviewed 164 cases of bladder rupture from external trauma. Of these patients 145 (88 per cent) suffered blunt trauma, and 59 (35.5 per cent) suffered intraperitoneal, 93 (57.5 per cent) extraperitoneal and 12 (7 per cent) both types of rupture. Bladder rupture owing to blunt trauma was caused by a compression (burst) type of injury in all patients with intraperitoneal rupture and in 24 per cent of those with extraperitoneal rupture. In the remaining instances of extraperitoneal rupture pelvic bone fragments corresponded to the site of the injury. Although surgical repair has been the traditional method of management of all bladder ruptures, nonoperative (catheter) management of extraperitoneal rupture was successful in most cases. PMID- 3656525 TI - Correlation of histopathological, cytological and flow cytometric findings in neoplastic and nonneoplastic lesions of the bladder. AB - Biopsy diagnosis, urine cytology and flow cytometry features of urine and bladder washings were compared in 81 cases of benign and malignant bladder disease. Some patients were followed by urine cytology and flow cytometry during treatment of tumors. There was a good correlation of the 3 parameters in relatively high grade tumors (II and III) but an inconsistent appearance of cells in the urine diagnosable by either urine cytology or flow cytometry for low grade lesions. High grade flat neoplasms may be detectable by urine cytology and flow cytometry before they are visible on endoscopy. Flow cytometry may indicate urothelial proliferation before it is apparent on urine cytology. Exfoliative benign lesions are diagnosed readily by the combination of urine cytology and flow cytometry. In benign and malignant lesions shedding of viable cells and, therefore, accessibility to urine cytology and flow cytometry are inconsistent. The need for repeated examinations in the case of low grade lesions suggests that the method is not reliable for single test screening programs but it is a valuable means of followup in cases of suspected or diagnosed disease. PMID- 3656526 TI - Influence of blood group type on the natural history of superficial bladder cancer. AB - The blood group was correlated with the grade and stage at diagnosis, and with the subsequent clinical course in 494 patients with bladder cancer treated at our institution from 1977 to 1986 who were followed for a mean of 5.5 years (range 2 to 9 years). The distribution of blood groups was similar to that reported for the general population and to that of 100 consecutive patients with urolithiasis used as controls, and the distribution was not different among patients with superficial cancer (stages O and A) than in those with advanced disease (stage B or higher). However, among patients with superficial disease high grade (III or IV) lesions were more frequent in those with blood group O (36 per cent) than in those with other blood groups (13 to 18 per cent) (p less than 0.001). In addition, in patients with superficial cancer of all grades progression to advanced disease was significantly greater among those with blood group O (37 per cent) than in those with other groups (12 to 16 per cent) (p less than 0.05). More importantly, in patients with low grade (I or II) superficial cancer development of advanced disease was significantly more frequent among those with blood group O (24 per cent) than in those with other blood groups (0 to 7 per cent) (p less than 0.004). Our findings suggest that individual genetic factors influence the natural history of superficial bladder cancer. The molecular basis of this phenomenon remains to be elucidated. PMID- 3656527 TI - Monitoring endoscopic treatment of superficial bladder carcinoma by postoperative urinary cytology. AB - Transurethral resection was the only modality of treatment in 39 patients with long-standing, recurrent, superficial bladder carcinoma. Postoperative urinary cytology was performed within 3 days of each endoscopy. Tumor recurrence was defined by the presence of a positive biopsy or visible papillary tumors on followup cystoscopic examination. Tumor recurred in 38 patients (97.4 per cent) and 1 patient (2.6 per cent) has remained free of disease 74 months following transient positive postoperative cytology. Among the 38 recurrences 15 (39.5 per cent) were positive, 3 (7.9 per cent) suspicious and 20 (52.6 per cent) negative at the postoperative cytological examination. The interval to recurrence did not differ significantly among the 3 groups. The failure of a negative postoperative cytology study to predict a durable response to treatment by transurethral resection reflects the polychronotopic nature of superficial bladder tumors in this select patient population and suggests the need for adjuvant therapy. PMID- 3656528 TI - Monitoring intravesical bacillus Calmette-Guerin treatment of superficial bladder carcinoma by postoperative urinary cytology. AB - We studied 51 patients with superficial bladder carcinoma who had been treated with transurethral resection of all gross tumor followed by intravesical bacillus Calmette-Guerin weekly for 6 weeks. Within 72 hours of either the first or second quarterly cystoscopic surveillance examination after bacillus Calmette-Guerin therapy, a conventional cytology study was obtained. Of these patients 8 (15.7 per cent) had positive, 9 (17.6 per cent) suspicious and 34 (66.7 per cent) negative postoperative cytology studies. Subsequent tumor recurrence was defined as a positive biopsy or visible papillary tumors on cystoscopic examination. All 8 patients with a positive postoperative cytology study had tumor recurrence at a median interval of 4 months. Of the 9 patients with a suspicious study 7 (77.8 per cent) had recurrent tumor at a median interval of 7 months and 2 (22.2 per cent) had no evidence of disease at 16 and 19 months, respectively. Of the 34 patients with a negative postoperative cytology study 13 (38.2 per cent) had tumor recurrence after a median interval of 4 months and 21 (67.8 per cent) had no evidence of disease after a median of 25 months. The tumor recurrence rate in patients with a positive or suspicious postoperative cytology study was significantly greater than that of patients with a negative study (p equals 0.001, Fisher's exact test). Postoperative cytology appears to be a significant prognostic indicator following transurethral resection and intravesical bacillus Calmette-Guerin treatment of superficial bladder carcinoma. PMID- 3656529 TI - The outcome of conservative treatment of carcinoma in situ of the bladder. AB - We treated 52 patients with carcinoma in situ by transurethral resection, thiotepa and other intravesical chemotherapeutic agents. All patients underwent standard initial and subsequent evaluative procedures and the average followup was 62 months. Half of the patients had a history of stage Ta and/or T1 transitional cell carcinoma. The remainder had carcinoma in situ when first diagnosed (10 had carcinoma in situ only). Of 12 patients treated by transurethral resection alone 1 reached 60 months without radical cystectomy or disease progression. There were 18 patients who had a complete response following chemotherapy, 11 had a partial response (positive cytology) and 11 failed (persistent carcinoma in situ). Patients with a history of transitional cell carcinoma had a statistically significantly greater probability of achieving a complete response. Despite other types of treatments only 2 of 22 patients (partial response and failure) achieved a lasting complete response. Persistent partial response and failure resulted in progressive transitional cell carcinoma (stage T2 or greater, prostatic involvement and metastases) and only 1 of these survived for more than 5 years without cystectomy. None of our patients received bacillus Calmette-Guerin because it was not available during the time most of the patients were treated. While the lives and bladders in some patients may be spared by its use, failure to achieve a complete response indicates impending disaster and cystectomy should be considered seriously. PMID- 3656530 TI - Transcystoscopic intracavitary irradiation for carcinoma of the bladder: technique and preliminary clinical results. AB - A remote controlled transcystoscopic intracavitary after-loading unit is introduced for irradiation therapy of bladder carcinoma. With intense radiation therapy a significant dose can be delivered to the tumor during a short interval. We treated 12 patients with transitional cell carcinoma of the bladder using transcystoscopic intracavitary irradiation. Of the patients 9 initially had a complete response, although within several months 3 subsequently had recurrence in a different part of the bladder. Technical difficulties and severe complications were not encountered. The preliminary results and technique of transcystoscopic intracavitary irradiation are reported. PMID- 3656531 TI - The epithelium in the female urethra: a quantitative study. AB - Histological sections were prepared from 8 regions along the length of the urethra in 16 women 19 to 82 years old. The epithelium was examined under the light microscope at 4 points in each region and the type of epithelium was classified. Our results indicate that the human female urethra is lined by stratified squamous, pseudostratified columnar and, occasionally, transitional epithelium. There is a gradual change from squamous to columnar epithelium with advancing age. More squamous epithelium is present at the distal end of the urethra. PMID- 3656532 TI - Artificial urinary sphincter for recurrent female urinary incontinence: indications and results. AB - A retrospective review of our experience with the artificial urinary sphincter in 32 women is presented. All patients had a history of recurrent urinary incontinence after failed bladder suspension procedures. Of 32 devices 31 were functioning, with an average followup of 2.5 years, and 91 per cent of the patients were dry without pads. Mechanical complications requiring surgical repair occurred in 21 per cent of the patients. Indications for artificial urinary sphincter implantation in the female patient and technical aspects of the procedure are discussed. The artificial urinary sphincter appears to be an acceptable treatment modality for urethral sphincter deficiency resulting in recurrent urinary stress incontinence in female patients. PMID- 3656533 TI - Psychometric differentiation of psychogenic and organic erectile disorders. AB - A study was conducted to assess the discriminant validity of patient responses to a questionnaire in distinguishing between organic and psychogenic erectile dysfunction. A total of 56 urologist-referred veterans slept for 3 nights in a sleep laboratory for nocturnal penile tumescence recording. Based on nocturnal penile tumescence results 48 patients were assigned to an organic group and the remaining 8 were assigned to a psychogenic group. A discriminant function analysis of questionnaire responses yielded a highly significant discriminant function [chi-square (19) equals 63.88, p less than 10(-6)], and all 56 patients were classified correctly into the nocturnal penile tumescence-defined organic and psychogenic groups. It was concluded that verbally reported data contain diagnostically meaningful information and that such information can compare favorably with information collected through standard laboratory-based nocturnal penile tumescence techniques. PMID- 3656534 TI - Spongiosolysis: a new surgical treatment of impotence caused by distal venous leakage. AB - Until recently ligation of the dorsal veins of the penis had been the only effective surgical treatment in cases of erectile dysfunction caused by venous insufficiency of the corpora cavernosa. Failure of this operation can be owing to persistent distal venous leakage consisting of venous shunts between the distal corpora cavernosa and corpus spongiosum, which can be demonstrated by cavernosography. These shunts can be closed successfully by spongiosolysis, that is by dissecting the distal half of the corpus spongiosum and by isolating the tips of the corpora cavernosa. Of 5 patients who underwent spongiosolysis after previous ligation of the dorsal vein of the penis 4 regained erectile ability with the help of intracavernous injection of a vasoactive drug mixture (15 mg. per ml. papaverine hydrochloride plus 0.5 mg. per ml. phentolamine mesylate, 0.5 to 2 ml. per injection), which was necessary because of concomitant arterial lesions demonstrated by arteriography. The only failure proved to be persistent venous insufficiency of the deep dorsal vein of the penis. Since none of the patients had any serious complication spongiosolysis seems to be a safe procedure in the treatment of distal venous leakage. PMID- 3656535 TI - Cyclophosphamide and sequential cisplatin for advanced seminoma: long-term followup in 52 patients. AB - Fifty-two patients with advanced seminoma were treated with primary chemotherapy: 44 received cyclophosphamide and weekly cisplatin, and 8 received sequential weekly cisplatin alone. Of the patients treated with chemotherapy alone only 44 achieved a complete remission and 4 were salvaged with further therapy (1 chemotherapy and 3 radiation therapy). These 48 patients (92 per cent) remained free of disease at a followup of 30 to 471 weeks. Six prognostic factors were tested by univariate analysis (chi-square) and only the use of previous chemotherapy predicted for a lower complete remission rate (p equals 0.02). Renal toxicity (greater than 0.4 mg. per dl. increase in serum creatinine) occurred in 2 patients (4 per cent). Neurotoxicity occurred in 16 patients (31 per cent). No fatal toxicity occurred. Cyclophosphamide and weekly cisplatin were well tolerated in patients previously treated with radiation therapy and is the treatment of choice for patients with disseminated seminoma. PMID- 3656536 TI - Cytological grading of prostatic aspiration biopsy: a comparison with the Gleason grading system. AB - Cytological grade determined by fine needle aspiration of the prostate was compared to histological grade in 30 patients undergoing subsequent radical prostatectomy. The degree of cytological pleomorphism determined by the consensus grade of 3 observers predicted correctly the Gleason grade sum range in 80 per cent of the cases. The cytological grade was reasonably reproducible with agreement among all 3 observers in 50 per cent of the cases and between 2 of 3 observers in the remainder. The accuracy of predicting the Gleason grade sum of the radical prostatectomy specimen by cytological examination compared favorably with that achieved by histological examination of cutting needle biopsy and transurethral resection specimens reported in the literature. PMID- 3656537 TI - Surgical treatment of locally advanced (T3) prostatic carcinoma: early results. AB - The fate of 48 patients with clinical stage T3 prostatic carcinoma after attempted curative surgical management was studied. In 23 of these patients positive frozen sections of the lymph nodes were found at pelvic lymphadenectomy and orchiectomy was performed. The median interval to progression was 61 months. Radical prostatectomy was performed in the remaining 25 patients. In 4 of these patients positive lymph nodes were found on paraffin sections but no additional treatment was given. Over-all, total tumor removal as defined by negative lymph nodes and negative margins of resection could be achieved in 14 of the 48 patients (29 per cent). During the same period 34 patients with clinical state T less than 3 prostatic carcinoma were treated in a similar manner. Orchiectomy was done in 4 patients because of positive frozen sections of the lymph nodes and radical prostatectomy was done in 30, including 1 in whom positive paraffin sections of the lymph nodes were found but no additional treatment was given. An attempt was made to study the impact of several prognostic factors by comparing the probability of progression between patients with stage pT3 disease with (T3pT3N0) or without (T less than 3pT3N0) extracapsular tumor growth as determined by preoperative rectal examination (36 versus 27 per cent progression at 3 years), with or without positive margins of resection (45 versus 20 per cent progression at 3 years) and with or without involvement of the seminal vesicles (47 versus 18 per cent progression at 3 years). Our results suggest that a certain proportion of patients with clinical stage T3 disease will benefit from radical prostatectomy. This is to be expected especially in patients with stage T3pT3N0 cancer and negative margins. PMID- 3656538 TI - Potency following radical prostatectomy with wide unilateral excision of the neurovascular bundle. AB - Delineation of the neurovascular bundles has made it possible to identify the branches of the pelvic plexus to the corpora cavernosa intraoperatively and to decide whether the bundles can be preserved or resected widely with the specimen. In the course of performing 312 radical retropubic prostatectomies the neurovascular bundle was widely excised unilaterally in 49 men with advanced clinical disease in whom, based on preoperative or intraoperative assessment, the bundle appeared to be involved by tumor. Because of this selection criterion these patients had higher clinical stage (52 per cent had clinical stage B2) and pathological stage (35 per cent had microscopic involvement of pelvic lymph nodes) disease than our previously reported series. In 38 patients the margins of resection were negative for tumor. In 11 patients despite attempts at wide excision of the lesion the surgical margins of resection were positive. In all 11 men with positive surgical margins there was extensive periprostatic extension of tumor and 8 had involvement of the pelvic lymph nodes. However, in none of the 11 patients with positive surgical margins were the margins positive only at the site where the bundle was spared, which shows that unilateral sparing of the neurovascular bundle did not compromise removal of tumor. Of the 29 men who were potent preoperatively and who have been followed for 1 year or longer postoperatively 20 (69 per cent) are potent. The return of sexual function correlated with age: 5 of 5 men (100 per cent) 40 to 49 years old were potent postoperatively compared to 8 of 10 (80 per cent) 50 to 59 years old and 7 of 14 (50 per cent) 60 to 69 years old. Histological evaluation of the resected specimens revealed that some of the men who were potent postoperatively had soft tissue and nerves resected in the region of the contralateral spared neurovascular bundle. By measuring nerves in the spared region of the neurovascular bundle we found that the role of the neurovascular bundles in potency is not owing to large nerves but to many nerves of varying size. In conclusion, potency can be maintained after radical prostatectomy in most patients in whom it is necessary to excise 1 neurovascular bundle widely without compromising the removal of tumor. PMID- 3656539 TI - A technique for stenting tortuous ureters. AB - A technique is described that has proved repeatedly to be successful in stenting tortuous ureters, such as those found in chronic distal ureteral obstruction in patients with prostatic carcinoma or long-standing obstruction in those with ureteral stone disease. Common endourological instruments are used and the procedure is performed under fluoroscopic control. PMID- 3656540 TI - Urodynamic evaluation of patients after the Camey operation. AB - Ten patients were evaluated urodynamically 3 to 18 months after they underwent the Camey operation. Of these patients 2 had total diurnal and nocturnal continence, 1 was totally incontinent and 6 were incontinent to various degrees that necessitated the use of 1 to 3 pads or diapers per day. All but 2 of the Camey neobladders had cystoplasty contractions at a capacity of 50 to 200 ml. The 2 totally continent patients had no cystoplasty contractions. The bladder in the totally incontinent patient had good capacity, good compliance and low pressure contractions up to a volume of 400 ml. The condition in this patient may be attributed to sphincteric incontinence. Urinary flow is achieved by abdominal straining and is interrupted. Vesicoureteral reflux occurred in 3 of 20 renal units. PMID- 3656541 TI - Urodynamic findings in Parkinson's disease. AB - Neurological evaluation was performed in 24 men and 5 women with Parkinson's disease who had persistent bladder symptoms. Detrusor hyperreflexia was found in 26 (90 per cent) of the patients. Sporadic involuntary electromyography activity of the external sphincter during involuntary detrusor contractions was encountered in 61 per cent but in none did this cause obstruction. Coordinated striated sphincter relaxation during voluntary detrusor contraction was found in 13 patients (45 per cent). Among 22 men who were in the prostatic disease age group only 4 (18 per cent) had definite prostatic obstruction. Moreover, none of 8 men with persistent symptoms after prostatectomy had evidence of bladder outlet obstruction. PMID- 3656542 TI - Initial experience with extracorporeal shock wave lithotripsy in children. AB - The clinical experience is presented of 4 United States centers at which extracorporeal shock wave lithotripsy was used for the treatment of renal calculi in 38 children 12 months to 16 years old. Patient characteristics, treatment specifics and followup data are detailed. Complete fragmentation of calculi was obtained in 97 per cent of those treated, with a 5 per cent complication rate. This experience demonstrates that with proper safeguards, extracorporeal shock wave lithotripsy can be performed safely and effectively in the pediatric population. PMID- 3656543 TI - Radionuclide renography to evaluate urodynamically expected upper tract obstruction in patients with meningomyelocele. AB - Radionuclide renography showed an obstructed pattern in 6 patients with meningomyelocele without dilatation of the upper urinary tract or reflux when the bladder was filled to the volume that during previous urodynamic testing had resulted in an intravesical pressure of 40 cm. water but not when these patients were studied with an empty bladder. Therefore, this study indicates that treatment should be directed at avoiding long-standing intravesical pressure exceeding 40 cm. water in patients with meningomyelocele. PMID- 3656544 TI - Rehabilitation of the dysfunctional bladder in children: method and 3-year followup. AB - A rehabilitation program has been developed for children with functional, nonneurogenic bladder disturbance. The basis for the program is a bladder regimen supplemented by biofeedback training if needed. Results in the first 70 children (64 girls and 6 boys) are presented. After 1 and 3 years 36 and 53 children, respectively, had completely normalized voiding patterns, that is they were continent, had no urgency, voided 3 to 6 times a day and emptied the bladder completely in 1 portion with a normal flow rate. The training program is applicable in children with varying urodynamic diagnoses and it has been used in children as young as 4 years old. PMID- 3656545 TI - Radiation exposure and extracorporeal shock wave lithotripsy. PMID- 3656546 TI - Bladder replacement. PMID- 3656547 TI - Renal capsular leiomyoma. AB - An exophytic renal mass was diagnosed preoperatively as renal cell carcinoma by ultrasound, computerized tomography and arteriography. Intraoperative recognition of the proper diagnosis of leiomyoma of the renal capsule permitted renal-sparing excision. Renal capsular leiomyoma should always be considered in the differential diagnosis of an apparent exophytic renal cell carcinoma. PMID- 3656548 TI - Adenocarcinoma in an ileal conduit: a late recurrence of urethral adenocarcinoma. AB - We report a case of recurrent adenocarcinoma in an ileal loop 13 years after cystectomy for adenocarcinoma of the urethra. The method of diagnosis is discussed. PMID- 3656549 TI - Squamous cell carcinoma in a young circumcised man. AB - A 34-year-old white man is described with multifocal invasive squamous cell carcinoma of the penis. Adequate circumcision had been performed at birth. PMID- 3656550 TI - Neuropeptide Y- and vasoactive intestinal polypeptide-containing nerves in the intrinsic external urethral sphincter in the areflexic bladder compared to detrusor-sphincter dyssynergia in patients with spinal cord injury. AB - Specimens of urethra were obtained from patients with cervical and thoracic spinal cord lesion with detrusor-sphincter dyssynergia and from patients with lower motor neurone lesion with detrusor areflexia, undergoing transurethral sphincterotomy. Neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP) in nerves associated with both the smooth and striated muscle components of the urethral sphincter were studied immunohistochemically and by immunoassay. In patients with detrusor-sphincter dyssynergia following cervical and thoracic spinal cord injury, NPY- and VIP-immunoreactive varicose nerve fibres were seen in both the smooth and striated muscle components of the urethral sphincter. In the smooth muscle, NPY- and VIP-immunoreactive nerves did not appear to have any particular orientation, but in the striated muscle region they were found to run along the length of individual muscle fibres. In patients with detrusor areflexia following lower motor neurone lesion, while the pattern, density and fluorescence intensity of NPY- and VIP-immunoreactive nerves in the smooth muscle of the sphincter mechanism appeared the same as seen in patients with detrusor-sphincter dyssynergia, there was a marked increase in the density of these nerves in the striated muscle region of the sphincter mechanism. Quantitation of the peptides by immunoassay was consistent with the histochemical findings, with significantly higher levels of both NPY and VIP in the striated muscle of patients with lower motor neurone lesion, compared to those with cervical and thoracic spinal cord lesion, p = 0.04. NPY and VIP levels in urethral smooth muscle were in the same range in lower motor neurone lesion patients and cervical and thoracic spinal cord lesion patients. We conclude that there are increased NPY- and VIP containing fibres in striated muscle of the intrinsic external urethral sphincter in patients with areflexic bladder compared with those with detrusor-sphincter dyssynergia. PMID- 3656551 TI - Formation of encrustations on indwelling urinary catheters in the elderly: a comparison of different types of catheter materials in "blockers" and "nonblockers". AB - In order to determine the effect of catheter materials on formation of encrustations in long-term indwelling urinary catheters in the elderly we performed a crossover study utilizing commercially available silicone, silicone coated, teflon-coated and latex catheters that were left in place for 14 days. The study was conducted with #18 french catheters fitted with a 30 ml. balloon since smaller size catheters frequently fell out spontaneously. The distinction between patients who were "blockers" and "nonblockers" was found to be clinically useful since "nonblockers", who constituted about half the population, did well regardless of type of catheter material used. Formation of encrustations and blockage was significantly less in "blockers" with silicone than with teflon coated or latex catheters. The more rapid flow-time through silicone catheters appears to be related to a larger bore. Although this study supports the use of silicone catheters for "blockers" on long-term drainage the results should not be interpreted to imply that they are preferable to other types of catheters for short-term use or to changing less expensive catheters more frequently when needed. PMID- 3656552 TI - Proteins of the rat prostate. II. Synthesis of new proteins in the ventral lobe during castration-induced regression. AB - Ventral prostates from adult Sprague-Dawley rats at different days postcastration were cut into one to two mm.3 pieces and incubated in medium containing S35 methionine (100 uCi/ml.) at 37C under 95% oxygen and 5% carbon dioxide for four hours. The incubated tissues were subjected to two-dimensional electrophoresis and radiofluorography. Over 100 spots were developed in the fluorograms. Three groups of spots, representing cytoskeletal proteins, androgen-dependent proteins and castration-induced proteins, were further evaluated by a computer-based densitometer. The level of densitometry absorption is proportional to the amount of radioactivity in each spot. The synthesis of cytoskeletal proteins, such as actin and tropomyosin, were relatively constant throughout the course of prostatic regression. The rate of synthesis of androgen-dependent proteins declined rapidly from a high level of synthesis before castration to a non detectable level by Day 3 postcastration. However, three proteins, which were either not synthesized (spot G and spot H) or synthesized at a very low level (spot I) before castration, were the major proteins synthesized by the prostate during early stages of its regression. The rate of synthesis of these proteins reached a peak by Day 4 postcastration, declined rapidly and remained at a low level thereafter. The respective molecular weights and isoelectric points for these three proteins were 33 Kd and 7.2 for spot G, 38 Kd and 5.3 for spot H and 64 Kd and 6.0 for spot I. Previous findings showed that prostatic regression in rats was associated with a surge of activities in proteolytic enzymes which peaked five to six days postcastration. The peak of synthesis of three proteins noted in the present study, therefore, preceded the peak of activities of proteolytic enzymes in the regressing prostate by one to two days. Testosterone replacement to animals at the time of castration prevented the synthesis of these proteins in the prostate. Since the synthesis of these three proteins in the ventral prostate is induced by androgen-depletion resulted from castration, they are considered as the castration-induced proteins. PMID- 3656553 TI - Experiences with bladder reconstruction in children. AB - The results in 56 children (28 with neurogenic bladder dysfunction) undergoing enterocystoplasty between 1981 and 1985 are presented. Ileal, ileocecal, right colon and sigmoid segments were used in tubular and opened configurations. Our experience leads us to recommend opened ileal segment reconstruction in neurogenic bladder patients and those with weak anal sphincters generally, and open ileocecal or open right colon segments in patients with other etiologies. Continence was achieved in 53 patients, although secondary procedures, particularly at the bladder outlet, were required in 13. When ureteral reimplantation was required we achieved excellent success with normal-sized or mildly dilated ureters regardless of the operative technique used. Initial failures to prevent reflux in the face of marked ureterectasis using the ileocecal valve have been resolved by a modified technique of intussusception and fixation. An over-all favorable experience is reported, which we believe permits us to formulate certain rules that will improve the acceptability and success of bladder reconstruction in general. PMID- 3656554 TI - Cystometric properties of ileum and right colon after bladder augmentation, substitution or replacement. AB - Cystometric studies were performed on 38 patients who had undergone augmentation, substitution or replacement enterocystoplasty. These studies were done to determine the choice of bowel segment to augment or replace the detrusor and the shape in which the bowel segment should be reconstructed. Eleven patients underwent tubular and 10 detubularized right colon cystoplasty, while 10 underwent tubular (Camey bladder) and 7 detubularized ileocystoplasty. Compliance curves were normal in nearly all patients except those who underwent tubular ileocystoplasty. Cystoplasty contractions were more common with tubular cystoplasty. These contractions appeared at a lower bladder capacity and were higher in amplitude in tubular cystoplasty patients. Detubularizing the bowel for bladder reconstruction appears to create a better low pressure capacitor with better compliance and fewer high pressure cystoplasty contractions. PMID- 3656555 TI - Gastrocystoplasty and colocystoplasty in canines: the metabolic consequences of acute saline and acid loading. AB - An experimental canine model was developed to quantitate the net transmural ion flux of colon and gastric segments used for augmentation cystoplasty. Gastrocystoplasty (4) or colocystoplasty (4) was constructed in 8 female mongrels. Acute intravenous saline and acid loading experiments were performed 2 to 4 weeks after cystoplasty. The mean solute excretion rates for sodium, chloride, phosphorus and ammonia exhibited opposite trends during acute saline and acid loading in this experimental model. The net flux of chloride, ammonia, phosphorus and sodium ions in the colocystoplasty animals was from the mucosa/urine surface to the serum (reabsorption). The opposite trend was true for the gastrocystoplasty. By not reabsorbing ammonium chloride, the gastrocystoplasty preserved an important renal mechanism for systemic acid elimination. This may help to prevent the hyperchloremic metabolic acidosis that can develop when urine comes in contact with small or large bowel segments. PMID- 3656556 TI - Small bowel augmentation in children with neurogenic bladder: an initial report of urodynamic findings. AB - Augmentation cystoplasty is a useful adjunct in the treatment of the neurogenic bladder. After preoperative urodynamic and clinical assessment, 10 children with neurogenic bladders underwent small bowel augmentation. Presenting clinical problems included incontinence and hydronephrosis. Urodynamic studies after small bowel augmentation demonstrated that bladder capacity increased an average of 184 per cent. Maximum intravesical pressures diminished considerably compared to preoperative values and no patient suffered significant uninhibited contractions. Nine children are totally dry and 1 has stress incontinence. Our initial findings demonstrate the efficacy of small bowel augmentation in the treatment of lower urinary tract neurogenic dysfunction owing primarily to alterations in detrusor function. PMID- 3656557 TI - Diagnosis and surgical correction of the pediatric varicocele. AB - We reviewed our experience with the diagnosis and management of varicoceles in 40 patients 9 to 18 years old. Of the patients 29 underwent varicocelectomy and 11 are being managed conservatively with periodic followup. The results of therapy and criteria for surgical intervention are discussed. PMID- 3656558 TI - Use of venography as an aid in varicocelectomy. AB - Venography has been proposed as an aid in preventing persistent varicoceles after internal spermatic vein ligation. Since 1984, 10 patients between 4 and 18 years old underwent successful outpatient varicocelectomy with high ligation and intraoperative internal spermatic venography to assure that all appropriate veins and collaterals had been isolated before ligation. PMID- 3656559 TI - Use of the anterior detrusor tube in managing urogenital sinus anomalies. AB - An anterior detrusor tube bladder neck reconstruction was performed in 8 girls with urogenital sinus anomalies during a 15-year period. A good or excellent result was achieved in 63 per cent of the patients. The surgical technique entails the creation of a long anteriorly based detrusor tube (6 to 7 cm.) tunneled subsymphyseal to the introitus, which provides access for clean intermittent catheterization. Augmentation cystoplasty, which was incorporated into the reconstruction in 1 case, may enhance further the success rates with this approach. PMID- 3656560 TI - Cloacal exstrophy: a report of 34 cases. AB - A clinical review is presented on 34 patients with cloacal exstrophy who were seen between 1963 and 1986. The patients were separated into 2 main groups: classical cloacal exstrophy (type I) and variant cloacal exstrophy (type II). In the classical cases 3 surface patterns were recognized: A-hemibladders confluent cranial to the bowel, B-hemibladders lateral to the bowel and C-hemibladders confluent caudal to the bowel. Surgical reconstruction was performed in 24 patients, with a 50 per cent survival rate. However, there was marked improvement in survival from 22 per cent between 1963 and 1978 to 90 per cent between 1979 and 1986. PMID- 3656561 TI - Cloacal exstrophy and cloacal exstrophy variants: a proposed system of classification. AB - A coding system that documents the abnormalities within the cloacal exstrophy complex is presented. Analysis allows the classification of these abnormalities into classical and variant series in a logical manner. The application of the coding system to selected reported material is described and it demonstrates the similarities between apparently divergent cases. PMID- 3656562 TI - Transverse island flap and double flap procedure in the treatment of congenital epispadias in 32 patients. AB - According to major reports in the literature satisfactory cosmetic and genital results after correction of male epispadias have been achieved in only 50 per cent of the patients. Since 1976 we have been using the Duckett transverse island flap principle adapted to epispadiac anatomical conditions. The original technique was used in our initial 18 patients and the Asopa double flap technique was performed in the subsequent 14. Excellent results were obtained in both series. However, there was a high percentage of fistulas that required secondary repair. The techniques and results are described. PMID- 3656563 TI - Outpatient catheterless modified Mathieu hypospadias repair. AB - Distal penile hypospadias was repaired in 59 boys with a modification of the Mathieu technique. Since a watertight urethroplasty is performed without overlying suture lines, catheter drainage and urinary diversion may not be necessary and they were not used in any patient. Penile nerve block and a small dressing allowed for postoperative mobilization. An excellent cosmetic and functional result was achieved with few complications, even in boys who had had prior unsatisfactory repairs. Because the children are ambulatory postoperatively and tolerate voiding through the repair, this procedure often is performed on an outpatient basis. PMID- 3656564 TI - The use of parenteral testosterone therapy in genital reconstructive surgery. AB - Previously, testosterone cream has been used for penile enlargement before genital surgery. The results not only were inconsistent but the absorption was variable. Therefore, we elected to study the use of parenteral testosterone as an adjunct before reconstructive surgery. In 44 patients with hypospadias (36), epispadias (5) or urethral fistulas (3) 2 mg. per kg. testosterone enanthate were given intramuscularly 5 and 2 weeks before reconstructive surgery. Testosterone caused a mean increase in penile length of 2.7 cm. and in circumference of 2.3 cm. as well as local vascularity in all patients. In addition to surgical results the potential side effects of testosterone treatment were monitored 3 months to 1 year postoperatively. Basal testosterone levels were obtained in patients before and during therapy, and postoperatively. In addition, side effects, such as increased bone age and excessive pubic hair, were not a problem. The use of preoperative testosterone significantly contributed to the successful reconstruction of these patients, particularly those with a paucity of penile skin and those who had undergone previous repairs. Temporary penile stimulation by testosterone enanthate allows for an earlier penile operation as well as provides negligible side effects. PMID- 3656565 TI - A unified approach to early reconstructive surgery of the child with ambiguous genitalia. AB - Gender assignment in the newborn with ambiguous genitalia poses a dilemma for the parents and physician, even if the infant has a normal 46XX or 46XY karyotype. In general, female pseudohermaphrodites are reared as female subjects, since they can undergo reconstruction to appear as phenotypic female subjects and they may even be able to bear children. Male pseudohermaphrodites, patients with mixed gonadal dysgenesis and male patients with a micropenis may not be so straightforward, and proper gender assignment in these infants may be difficult. A unified surgical approach to early reconstruction of the external genitalia in these patients, who are to be reared as female subjects, has been developed. Essential to this perineal reconstruction are phallic reduction and recession in which erectile tissue is removed with preservation of the neurovascular bundles and glans, creation of labia minora from flaps of phallic skin and foreskin, a labioscrotal Y-V plasty to produce normal-appearing labia majora and construction of a neovagina with a perineal flap. If the patient is a male pseudohermaphrodite or an infant with a micropenis creation of the vagina is deferred until late adolescence or young adulthood. In other patients in whom the vagina enters the urethra or urogenital sinus proximal to the external sphincter a pullthrough vaginoplasty is performed when the child is 2 to 3 years old. If the vaginal entry is distal to the external urinary sphincter a flap vaginoplasty is performed at the same time as the phallic reduction, and creation of the labia minora and labia majora during infancy. Ten patients (4 with the adrenogenital syndrome, 2 male pseudohermaphrodites, 2 genetic male patients with a micropenis, 1 with mixed gonadal dysgenesis and 1 true hermaphrodite) have undergone reconstruction with this composite procedure. All 10 patients have had a successful cosmetic and early functional result. PMID- 3656566 TI - The bladder mucosal graft for urethral reconstruction. AB - Single stage repairs of a variety of congenital and acquired urethral anomalies were performed in 16 male patients with free grafts of bladder mucosa. Of the patients 10 previously had undergone unsuccessful attempts at urethral reconstruction, including 9 boys with hypospadias. Grafts ranged between 2 and 8.5 cm. long. A fistula occurred postoperatively in 1 patient and it responded to prolonged suprapubic drainage. Meatal stenosis necessitated a further operation in 1 patient. The bladder mucosal graft technique should be considered for urethral reconstruction when prior attempts at repair have failed or when the disorder is primary, and local penile or preputial skin is deficient. PMID- 3656567 TI - Localization of bacteriuria in patients with enterocystoplasty and nonrefluxing conduits. AB - Urine cultures were obtained by percutaneous aspiration of renal pelvic urine in an attempt to localize the source of chronic asymptomatic bacteriuria in 10 patients with intestinal segments incorporated into the urinary tract. One child with a nonrefluxing colonic conduit and 6 of 8 patients with nonrefluxing enterocystoplasties had upper tract bacteriuria. One patient with a ureterosigmoidostomy and a history of pyelonephritis had negative cultures while on prophylactic antibacterials. The significance of upper tract bacteriuria in these patients is unknown but lifelong followup of renal function is necessary. PMID- 3656568 TI - Extracorporeal shock wave lithotripsy in childhood. AB - Extracorporeal shock wave lithotripsy is the treatment of choice for the majority of upper urinary calculi in adults. Technical limitations, including patient size and concerns over post-treatment stone fragment passage, have made the application of extracorporeal shock wave lithotripsy in children less clearly defined. We report the successful application of the Dornier lithotriptor in the management of 18 children (22 kidneys) with upper urinary calculi. PMID- 3656569 TI - Urodynamic assessment of children with cerebral palsy. AB - More than a third of the children with cerebral palsy present with dysfunctional voiding symptoms. Clinical evaluation and urodynamic study of cerebral palsy patients were performed to characterize the symptoms, to define the type of neurological deficit and to document its effect on voiding dynamics. We evaluated flow rate, and cystometrographic and external sphincter electromyographic findings in 57 children with cerebral palsy. Upper and lower motor neuron lesions were defined by standard criteria. Of the children 86 per cent had evidence of a pure upper motor neuron injury and 11 per cent manifested electromyographic findings suggestive of incomplete lower motor neuron sphincteric injury. The latter deficit could not be predicted on the basis of clinical neurological findings but it was suggested by a history of neonatal cyanosis. Treatment protocols achieved continence in more than 75 per cent of the children. The voiding dynamics in children with cerebral palsy have not been assessed previously. We have defined the lower urinary tract dysfunction in these patients, and provide a rational and effective plan of management. PMID- 3656570 TI - Biofeedback training for children with bladder sphincter incoordination. AB - We studied 35 children with voiding dysfunction and detrusor-sphincter incoordination. More than 90 per cent of these patients had a history of repeat urinary tract infections, and medication and surgical treatment of the voiding dysfunction had failed. Of the patients 22 (63 per cent) experienced significant improvement or resolution of the voiding dysfunction when biofeedback was used to teach normal bladder sphincter coordination as part of the over-all treatment regimen. A review of our experience with these patients indicates that with proper patient selection an even higher rate of success may be possible. PMID- 3656571 TI - Biological response of bladders rendered continent by insertion of artificial sphincter. AB - Artificial sphincters were inserted in 44 children for intractable urinary incontinence. Of the patients 70 per cent achieved satisfactory continence (minimum followup 18 months) with no revisions, and 10 per cent were rendered continent with 1 revision and 10 per cent with multiple revisions. The procedure failed in 10 per cent of the patients primarily because of infection. Extensive urodynamic studies were performed at reoperation and postoperatively. Long-term urodynamic followup was available in 36 continent children. Hydronephrosis occurred in 2 per cent of the upper tracts assessed and 18 per cent of the patients had significant residual urine. Mean bladder capacity tended to increase progressively postoperatively. Mean bladder compliance also was well maintained. PMID- 3656572 TI - Comparison of artificial sphincter implantation and bladder neck reconstruction in patients with neurogenic urinary incontinence. AB - The results of artificial urinary sphincter implantation and Young-Dees Leadbetter bladder neck reconstruction were compared in 27 patients with neurogenic urinary incontinence. Although an equal degree of continence was achieved with both procedures the reoperation rate was significantly higher in patients who underwent artificial sphincter implantation. The advantages and disadvantages of each procedure are discussed. PMID- 3656573 TI - Complications of artificial urinary sphincter around intestinal segments in reconstructed exstrophy patients. AB - Nine patients 15 to 28 years old underwent placement of the artificial urinary sphincter around an internal intestinal urinary reservoir. A total of 15 complications was experienced in 8 patients and 13 secondary procedures were necessary. Eight patients are completely continent and 1 has nighttime enuresis. The most common complication encountered was reduction in bowel luminal circumference underlying the sphincter cuff. PMID- 3656574 TI - Papers presented at the annual meeting of the Section of Urology, American Academy of Pediatrics. Washington, D.C., October 31-November 3, 1986. PMID- 3656575 TI - A nonsurgical approach to the management of primary vesicoureteral reflux. AB - We performed a retrospective review to evaluate the results of a nonsurgical approach to the management of primary vesicoureteral reflux during a 10-year period (1976 to 1986). During that interval patients with reflux were studied initially with a standard voiding cystourethrogram and either an excretory urogram or a renal scan with glomerular filtration rate and/or differential renal function determination. Height, weight, blood pressure, urine cultures and serum creatinine measurements also were obtained. Isotope cystography was used for followup examinations. A single, negative isotope cystogram was the radiological criterion for cessation of reflux. The charts of 545 children (55 per cent had bilateral reflux) with 844 refluxing ureters were reviewed. Based upon the international classification vesicoureteral reflux was grade I in 6.6 per cent of the cases, grade II in 54.2 per cent, grade III in 31.6 per cent, grade IV in 5.7 per cent and grade V in 1.9 per cent. All children were kept on long-term continuous prophylactic antibiotics and they were re-evaluated annually with isotope cystography. The followup rate for the entire group was 88 per cent. During the observation period spontaneous resolution of reflux was noted in 36 per cent of the patients and 39 per cent of the total refluxing ureters. Only 13 per cent of the entire group underwent surgical correction of reflux. Presently, 39 per cent (215) of the patients continue to be followed with reflux. Of the total group 66 patients (12 per cent) were lost to followup. In the 194 patients with spontaneous resolution of reflux the mean duration of reflux was 1.69 years, with 30 to 35 per cent resolving each year. Based on Student's t test there was a significant difference in duration of reflux in patients with grade II compared to grade III reflux (1.56 versus 1.97 years, p less than 0.04). When age at presentation was compared with duration of reflux there was a significantly shorter duration of reflux only in those patients presenting from age 0 to 12 months, compared to those 13 months and older (1.44 versus 1.85 years, p less than 0.02). Renal function was evaluated by serum creatinine, calculated glomerular filtration rate or differential diethylenetriaminepentaacetic acid scan results.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3656576 TI - Detrusorrhaphy: extravesical ureteral advancement to correct vesicoureteral reflux in children. AB - We used a modified extravesical technique, coined detrusorrhaphy, to correct surgically vesicoureteral reflux. By detrusorrhaphy the submucosal ureteral tunnel is opened, the ureteral meatus is advanced and anchored onto the trigone, and the detrusor buttress of the ureter is closed (-rrhaphy). The operation is performed extravesically. The procedure was used in the last 5 years in 79 children, or 120 renal units. Reflux resolved in 93 per cent of the renal units. Postoperative morbidity related to bladder spasms and hematuria was minimal compared to conventional transvesical surgical procedures. Detrusorrhaphy is an effective method to correct vesicoureteral reflux and to minimize postoperative morbidity. PMID- 3656577 TI - Endoscopic treatment of vesicoureteral reflux in children. AB - We treated 35 children with different grades of vesicoureteral reflux with endoscopic injection of polytetrafluoroethylene (Teflon) behind the intravesical ureter. A total of 51 refluxing ureters was treated. In all cases absence of reflux was noted on a cystogram performed immediately after the procedure. At 3 to 12-month followup reflux was absent in 32 ureters and it recurred in 4, including 3 ureters with low grade reflux. A second injection of polytetrafluoroethylene in 3 ureters resulted in its absence, while in 1 case reimplantation was performed. The procedure is simple and reliable. An operation is avoided, hospital stay is reduced and no complications have occurred. PMID- 3656578 TI - The endoscopic correction of reflux by polytetrafluoroethylene injection. AB - Endoscopic subureteral injection of polytetrafluoroethylene (Teflon) was done in 38 patients (55 ureters) to correct vesicoureteral reflux. Followup excretory urograms and nuclear cystograms were available in 28 patients (40 ureters) 2 to 11 months after injection. Nearly 50 per cent of the patients had a neurogenic bladder. Injection was done for all grades of reflux, although the majority of cases had at least grade III reflux. After injection reflux either was eliminated or decreased in 76 per cent of the patients with neurogenic disease and in 87 per cent of those with a normally innervated bladder. This outpatient procedure is simple and brief to perform, and it is associated with minimal morbidity. As with any new antireflux technique longer followup is indicated. PMID- 3656579 TI - Neodymium:YAG laser ablation of posterior urethral valves. AB - We report successful neodymium:YAG laser ablation of posterior urethral valves in 6 boys. No strictures or incontinence resulted. PMID- 3656580 TI - The dorsal lumbotomy incision in pediatric urological surgery. AB - Between January 1, 1983 and September 30, 1985, 42 upper urinary tract operations were performed using the dorsal lumbotomy incision, representing 28 per cent of all upper tract procedures performed. Operations included pyeloplasty, partial and total nephroureterectomy, pyelolithotomy, ureterolithotomy and renal exploration with cyst marsupialization. The major contraindications to lumbotomy were malignancy and malrotated or malpositioned kidneys. Patient age ranged from 1 month to 20 years. A modification of the Gil-Vernet vertical lumbotomy incision was used in all cases. This approach involves successive incisions through the layers of the lumbodorsal fascia to gain access to the kidney and ureter, and emphasizes a muscle-retracting technique. Incision of the costovertebral ligament allows 12th rib elevation and improves the exposure obtained. There were no postoperative complications related to the lumbotomy incision itself. Decreased surgical morbidity is suggested by our results. By 3 days postoperatively 64 per cent of our patients required no analgesic medication, 93 per cent were tolerating a regular diet and 83 per cent were evaluated as having a good appetite. Mean hospital length of stay for all lumbotomy patients was 5.6 days. We conclude that the dorsal lumbotomy incision can be used to perform a wide variety of upper tract operations in children, resulting in minimal morbidity and short hospital stays. PMID- 3656581 TI - Effect of cyclosporine A on male reproduction in rats. AB - We examined the effects of the immunosuppressive drug cyclosporine A on male reproduction in sexually mature rats. The drug was administered subcutaneously in 3 doses (10, 20 and 40 mg. per kg. daily) for 14 days. Cyclosporine A administration resulted in a dose-dependent decline in body and reproductive organ weights, histology of the testis showed definite degenerative changes, and sperm counts and motility decreased. Spermatozoa from treated rats retained the cytoplasmic droplet and they were decapitated. Consequently, sterility occurred in rats treated with high doses of cyclosporine A. A reduction in circulating testosterone and an increase in gonadotropins were noted. The possibility existed that the cyclosporine A-induced alterations in the male reproductive system were secondary to the hepatic or nephrotoxic effects of the drug. Therefore, we assessed liver and kidney function by assay of the serum levels of bilirubin, alkaline phosphatase, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase and creatinine. Except for an increase in bilirubin, none of the other liver function studies was altered, thereby eliminating hepatocellular damage as the etiology of impaired reproductive function in cyclosporine A treated rats. We observed an increase in creatinine levels in animals treated with higher doses of cyclosporine A, consistent with mild renal failure. However, the fact that a decline in reproductive function was seen even in the group treated with 10 mg. per kg. cyclosporine A daily, which had normal serum creatinine levels, suggests that the alterations in male reproduction seen with this therapy are not entirely the result of nephrotoxicity. PMID- 3656582 TI - Late results after carotid endarterectomy for amaurosis fugax. AB - Amaurosis fugax is considered an ocular transient ischemic attack with an ominous prognosis. One hundred twenty-eight patients with amaurosis fugax as the presenting symptom underwent carotid endarterectomy at the University of California, San Diego (UCSD) and Scripps Clinic between 1970 and 1985 with one death (0.8%) and one postoperative permanent stroke (0.8%). Subsequently, these patients were followed up for 6 to 160 months (mean 45.3 months). Only two subsequent late strokes were documented (at 2 and 5 years after operation). These results were significantly better (p less than 0.01) by life-table analysis than the late stroke rate after carotid endarterectomy performed to treat anterior motor transient ischemic attacks at both UCSD and Scripps Clinic, as well as the reported late follow-up for all transient ischemic attacks after carotid endarterectomy in the literature (1.8% per year, 17 publications, 1980 operations). Thus amaurosis fugax appears to be a particularly favorable indication for carotid endarterectomy. Left untreated, this event carries a high risk of stroke; after carotid endarterectomy, which has a low operative risk, there is a very low postoperative stroke rate (two strokes in 448 patient-years of follow-up). PMID- 3656583 TI - Long-term results of in situ and extracorporeal surgery for renovascular hypertension caused by fibrodysplasia. AB - In this study the early and late results of surgical reconstruction for renovascular hypertension caused by fibrodysplasia are evaluated in 53 patients treated between 1962 and 1983. There were 40 female and 13 male patients. The mean blood pressure was 208/126 mm Hg before medical therapy and 171/109 mm Hg thereafter. Bilateral renal artery stenoses were present in 12 patients. In situ revascularization was used in 26 patients and extracorporeal surgery to repair branch artery lesions was performed in 27 patients. Surgical therapy reduced the blood pressure to normal levels with minimal antihypertensive medications. This effect was already apparent 6 to 12 months after operation (mean blood pressure level of 140/90 mm Hg) and it was maintained during a mean follow-up period of 8.4 years (range 1 to 20 years) (mean blood pressure level of 134/85 mm Hg). At 6 to 12 months after operation, 79% of the patients were classified as either cured or improved. At this time the results did not appear to have been influenced by the preoperative duration of hypertension, nor by manifestations of extrarenal arteriosclerosis (ERA) as found in 10 patients, or by the surgical technique applied. But at the end of the long-term follow-up period (mean 8.3 years) the beneficial response rate of 87% appeared to have been adversely influenced by the presence of preoperative ERA, since beneficial response rates were 93% for those without and 67% for those with ERA (p = 0.17). We conclude that renal revascularization is effective both early and late for the treatment of renovascular hypertension caused by fibrodysplasia and that complex renovascular obstruction can be treated effectively with extracorporeal repair. PMID- 3656584 TI - A metropolitan experience with infrainguinal revascularization. Operative risk and late results in northeastern Ohio. AB - Despite being of fundamental importance, the late results of major arterial reconstruction rarely have been documented throughout a large metropolitan area. In this study of 932 patients entered into the computer registry of the Cleveland Vascular Society, 19 surgeons representing 13 community hospitals and referral centers in Cleveland and Akron report the intermediate-term outcome during a mean interval of 35 months after infrainguinal lower extremity revascularization performed in northeastern Ohio from 1978 through 1982. Operative risk (5%), the early amputation rate (7%), and actuarial 5-year survival (48% to 55%) for patients with rest pain or tissue necrosis were significantly worse (p less than 0.05) than comparable figures (0.6%, 0%, and 77%, respectively) for others who underwent procedures for disabling claudication. Although both materials had similar success above the knee, the cumulative 3-year patency rate of autogenous vein bypass to the distal popliteal (69% to 88%; p less than 0.05) and tibioperoneal arteries (43%; 0.05 less than p less than 0.1) was superior to the results of polytetrafluoroethylene grafts (32% to 50% and 19%, respectively). Moreover, polytetrafluoroethylene grafts required reoperations at three times the rate of vein grafts to maintain limb salvage. PMID- 3656585 TI - Local thrombolysis in peripheral arteries and bypass grafts. AB - Sixty-two patients hospitalized for recent angiographically documented arterial occlusion in the legs (46 femoropopliteal arteries and 16 grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a No. 4F or No. 5F catheter. This therapy combined a continuous urokinase (UK) infusion of 1000 U/kg/hr and a lysyl plasminogen (LYS-PLG) infusion of 15 mukat every 30 minutes. Angiographically confirmed lysis was obtained in 77% of the cases. Five percent of the patients had major and 8% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK and LYS-PLG is as effective as streptokinase but produces lower systemic fibrinolysis. However, local fibrinolysis remains a potentially hazardous procedure (10% suffered major complications) and must only be applied to patients with severe ischemia and little or no possibility of surgical intervention. PMID- 3656586 TI - Paraplegia in the rat induced by aortic cross-clamping: model characterization and glucose exacerbation of neurologic deficit. AB - Spinal cord damage caused by ischemia is a serious, underappreciated, and relatively refractory problem in clinical practice. Research is hampered by a lack of experimental models that appropriately mimic clinical situations. A new model of paraplegia in the rat is presented and evaluated by standard neurologic deficit scoring (1, 4, 18, and 24 hours after occlusion) and by computerized activity monitoring (1 and 18 hours after occlusion). Rats underwent temporary occlusion of the thoracic aorta for 10, 15, or 20 minutes. Experimental groups received glucose (2 gm/kg) and demonstrated a significant elevation in blood glucose (p = 0.001) and were significantly more neurologically impaired at all four time periods (p less than or equal to 0.005) than the ischemic control group, which received equivalent volumes of normal saline solution. Significant differences in neurologic deficit were noted with direct clinical examination and computerized activity monitoring. With the use of the latter system, statistical differences were detected in total distance traveled and number of vertical movements. We conclude the following: (1) Paraplegia is reliably and reproducibly achieved in this rat model; (2) because of the rat's more extensive behavioral repertoire when compared with other models of spinal ischemia (e.g., rabbit), more end points can be monitored and more subtle behavioral deficits discerned; (3) computerized activity monitoring can distinguish varying degrees of neurologic deficit and correlates with clinical neurologic deficit scoring; and (4) glucose exacerbates paraplegia in this model. PMID- 3656587 TI - Carotid endarterectomy, siphon stenosis, collateral hemispheric pressure, and perioperative cerebral infarction. AB - To determine whether moderate stenosis (50% to 80%) of the intracranial segment of the internal carotid artery increases the risk of cerebral infarction after carotid endarterectomy, the arteriograms, ocular pneumoplethysmograms, internal carotid back pressure, and clinical outcome after 169 operations were reviewed. Siphon stenoses less than 50% were not included because of their doubtful anatomic and hemodynamic significance. No patients with stenosis greater than 80% underwent operation. Moderate siphon stenosis affected 37 vessels, 24 (14.2%) ipsilateral and 13 (7.6%) contralateral to the side of operation. Eight patients had bilateral siphon stenosis. Three patients had stroke after operation; none of these cases had siphon stenosis. Moderate siphon stenosis did not increase the risk of perioperative cerebral infarction. Stroke only occurred in those patients in whom there was arteriographic or functional evidence that the affected hemisphere was isolated from effective collateral vessels. PMID- 3656588 TI - Tuberculous aneurysm of the descending thoracic aorta. AB - Tuberculous aneurysm of the descending thoracic aorta is a rare entity. To our knowledge the present case is the sixth on record to have been successfully treated surgically. These aneurysms present the usual difficulties of surgical therapy of the thoracic aorta: spinal cord and renal circulatory protection and the choice between distant or in situ revascularization. This case is of particular interest for its evolution and its treatment: resection of the aneurysm without shunting and insertion of a graft in situ covered by a flap of omentum. PMID- 3656589 TI - Misdiagnosed localized arteriovenous malformation. AB - We report a case of an 11-year-old girl with a pulsatile mass in the thigh diagnosed by angiography as localized arteriovenous malformation. Recent increase in tenderness and size of the lesion brought the patient to hospital and excision was performed at the parents' request. Subsequent histologic examination revealed that this lesion was an alveolar soft-part sarcoma in disguise. The angiographic and pathologic results are presented. Other investigators should be aware of this uncommon and highly vascular sarcoma, which might be misdiagnosed as a localized arteriovenous malformation and thus treated only conservatively. PMID- 3656590 TI - Improved operative exposure of infrapopliteal vessels in combined vascular and orthopedic injuries. AB - In a series of six patients, a single-bar anterior external fixator was used to treat combined vascular and orthopedic injuries of the leg. This method of external fixation facilitated operative vascular exposure without sacrificing bony stability or alignment. It may be the preferred method of external fixation for these complex injuries. PMID- 3656591 TI - Leads from the MMWR. Progress in chronic disease prevention: cigarette smoking in the United States, 1986. PMID- 3656592 TI - Fraudulent AIDS: a variant of Munchausen's syndrome. PMID- 3656593 TI - Adolescent pregnancy: incidence and cost. PMID- 3656594 TI - Roentgenograms in pericardial effusion. PMID- 3656595 TI - Adrenal-to-brain transplants and Parkinson's disease. PMID- 3656596 TI - Diltiazem and hyperkalemia. PMID- 3656597 TI - Cimetidine treatment in hyper-IgM hypogammaglobulinemia. PMID- 3656598 TI - Children and guns. PMID- 3656599 TI - A policeman's lot is not a happy one: flak jacket radiculopathy. PMID- 3656600 TI - Assuring the quality of health care for older persons. An expert panel's priorities. AB - To select topics for quality assurance activities focusing on older patients, we convened a 14-member panel of physicians and experts in quality assurance. In two rounds of ratings, panelists rated 42 medical conditions (eg, pneumonia) in terms of their effects on patient outcomes, the availability of beneficial interventions, and the health benefits from improving current quality. They rated 27 health services (eg, adult day-care) on similar dimensions. The feasibility of doing quality assurance work on each condition and service also was rated. Using the ratings, the conditions selected for quality assurance work were congestive heart failure, hypertension, pneumonia, breast cancer, adverse effects of drugs, incontinence, and depression. Health care services selected were hospital discharge planning, acute inpatient care for the frail elderly, long-term-care facilities (intermediate-care facilities and skilled nursing facilities), home health care services, and case management. PMID- 3656601 TI - Yield of routine annual laboratory tests in a skilled nursing home population. AB - The yield of routinely performed annual panels of laboratory tests was examined among patients in the skilled nursing facility section of a large, multilevel, long-term-care institution. Of 9270 tests done as part of 336 annual panels in 121 patients over an eight-year period, 17% of the tests yielded abnormal results, and in 36% of the tests, abnormal results were new. Among the 336 panels, 56 (16.7%) had at least one abnormality that was believed to have resulted in some benefit to 30 (24.7%) of the patients. Many of the abnormalities that led to patient benefit could have been detected by periodic monitoring of chronic conditions and their treatment as opposed to true screening tests, and all such abnormalities could have been identified by a complete blood cell count, electrolyte determinations, renal and thyroid function tests, and a urinalysis. The results suggest that a modest panel of annual laboratory tests could limit the potential costs of screening and not result in the loss of potential benefits to patients in skilled nursing facilities. PMID- 3656602 TI - Coagulopathy caused by vitamin K deficiency in critically ill, hospitalized patients. AB - A coagulopathy due to vitamin K deficiency was discovered in 42 hospitalized patients, most of whom had been misdiagnosed as having disseminated intravascular coagulation. Factors contributing to vitamin deficiency included inadequate diet, malabsorption, failure of physicians to prescribe vitamin K supplements, antibiotic therapy, renal insufficiency, hepatic dysfunction, recent major surgery, and possibly pregnancy. Sixteen patients (34%) bled sufficiently to need red blood cell transfusions and ten patients (24%) ultimately died. Of 18 patients who also had thrombocytopenia, three did have disseminated intravascular coagulation. The deficiency, a contributor to morbidity and mortality, can be prevented by prophylactic administration of vitamin K to severely ill patients who are eating inadequately and receiving antibiotics. PMID- 3656603 TI - Physician referrals in a competitive environment. An estimate of the economic impact of a referral. AB - Beyond offering optimum care for individual patients, physician referrals have a cumulative economic impact on many components of the broader medical care system. This article offers an approximation of the magnitude of that impact. By retrospectively reviewing financial records associated with 225 referrals from fee-for-service, rural family practice sites to university-based specialist colleagues, we found that the average referral generated $2944 in combined hospital charges and professional fees within a six-month period after referral. Almost half (110/225, or 49%) of those referrals resulted in a hospital admission and 72% of all revenue associated with referral accrued to the hospital. A second and more detailed study of 97 referrals showed that only 18% of total revenue resulting from referrals accrued to the physician to which the patient was initially referred. We argue that control over volume and destination of referrals, historically the referring physician's prerogative, is susceptible to change in our rapidly restructuring medical care system. In the future, no economic entity that benefits from physician referrals should take for granted those referrals or their impact. PMID- 3656604 TI - Dipstick leukocyte esterase activity in first-catch urine specimens. A useful screening test for detecting sexually transmitted disease in the adolescent male. AB - Although sexually active female adolescents are often routinely screened for sexually transmitted diseases, indications for culturing adolescent males for sexually transmitted urethral infections are controversial. A study of 54 sexually active males (14 to 22 years old) was undertaken to assess the reliability of using dipstick leukocyte esterase activity in first-catch urine specimens to detect urethritis caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Eighteen males had sexually transmitted diseases: N gonorrhoeae (nine patients), C trachomatis (eight patients), and N gonorrhoeae and C trachomatis (one patient). First-catch urine specimens with a 1+ (mild) or 2+ (moderate) reaction on dipstick testing had a leukocyte (WBC) count of 10 WBCs per high-power field or greater on microscopic analysis, with an 83% sensitivity, 100% specificity, a 100% positive predictive value, and a 92% negative predictive value for the presence of N gonorrhoeae, C trachomatis, or both. Clinical criteria for screening (urethral discharge, dysuria, or exposure to a sexually transmitted infection) plus a dipstick-positive first-catch urine specimen had a 94% sensitivity, 89% specificity, an 81% positive predictive value, and a 97% negative predictive value. PMID- 3656605 TI - Cholesterol embolization syndrome. Occurrence after intravenous streptokinase therapy for myocardial infarction. AB - Two patients developed the cholesterol embolization syndrome after coronary angiography and intravenous streptokinase therapy for acute myocardial infarction. Clinical manifestations included cyanosis, ulcers, gangrene of the hands and feet, myalgias, intestinal infarction, eosinophilia, and renal failure. One patient died; one has survived with chronic renal failure. Streptokinase therapy may expose atheromatous plaques to the circulation by lysing platelet fibrin thrombi. PMID- 3656606 TI - Cardiac rehabilitation. PMID- 3656607 TI - Altruism, self-interest, and medical ethics. PMID- 3656608 TI - Patients without physicians: the new risk of AIDS. PMID- 3656609 TI - Screening tests for nursing home patients. PMID- 3656610 TI - President's AIDS commission to report in December, again by middle of next year. PMID- 3656611 TI - 'Ticking clocks' and changing mores. PMID- 3656612 TI - Smoking prevention/cessation drive can parallel continuing tobacco-effects research, NCI says. PMID- 3656613 TI - Leads from the MMWR. Fatalities resulting from sulfuryl fluoride exposure after home fumigation--Virginia. PMID- 3656614 TI - Alcoholic women. PMID- 3656615 TI - Smoking drivers: standard or optional? PMID- 3656616 TI - AIDS wrongly diagnosed. PMID- 3656617 TI - Malignant lymphoma related to HIV infection in Italy: a report of 46 cases. PMID- 3656618 TI - Competition and the cost of hospital care. PMID- 3656620 TI - The relation between vaginal spermicides and congenital disorders. PMID- 3656619 TI - Snake oil. PMID- 3656621 TI - Pregnancy and birth rates among sexually experienced US teenagers--1974, 1980, and 1983. AB - We examined pregnancy rates and birth rates among United States teenagers aged 15 to 19 years in 1974, 1980, and 1983. Pregnancy rate refers to live births plus induced abortions per 1000 women; birth rate refers to live births per 1000 women. We present these rates for all teens aged 15 to 19 years and for teens aged 15 to 19 years who were sexually experienced. Data sources included National Center for Health Statistics birth records, Centers for Disease Control abortion surveillance reports, and Bureau of the Census population estimates. Sexual experience estimates came from national surveys of adolescent sexual behavior. Between 1974 and 1980, the pregnancy rate among all teens increased; the pregnancy rate among sexually experienced teens declined. From 1980 to 1983, the pregnancy rate declined among all teens and among sexually experienced teens. Birth rates among US teenagers (all teens and sexually experienced teens) declined between 1974 and 1983. Whereas the decline in the birth rate from 1974 to 1980 was primarily due to increased use of abortion, the decline from 1980 to 1983 related to the decrease in teenage pregnancies. PMID- 3656622 TI - Perspectives on adolescent substance use. A defined population study. AB - We asked 1447 tenth graders to complete a survey on physical activity, nutrition, stress, and substance use and to undergo basic physical assessments. In a multiple regression analysis, increased level of substance use by both boys and girls was most strongly predicted by friends' marijuana use. For boys, this was followed by perceived safety of cigarette smoking; poor school performance; parents' education; and use of diet pills, laxatives, or diuretics for weight control, accounting for 44% of the overall variation in substance use. For girls, friends' marijuana use was followed by poor school performance; self-induced vomiting for weight control; perceived safety of cigarette smoking; use of diet pills, laxatives, or diuretics for weight control; parents' education; perceived adult attitudes about cigarettes; and nonuse of seat belts, accounting for 53% of the overall variance. Separate multiple regression analyses for each substance produced similar results. The homogeneity of the study population precluded ethnic comparisons. These findings suggest that for many purposes substance use may be considered a single behavior regardless of the specific substance(s) used and that substance use may exist as part of a syndrome of adolescent problem behaviors. In addition, the potent influence of perceived social environment suggests that a social influence resistance model may represent the most successful preventive strategy. PMID- 3656623 TI - The effect of alcohol on nocturnal gastroesophageal reflux. AB - The effect of 120 mL (4 oz) of scotch whiskey (40% alcohol) on nocturnal gastroesophageal reflux was studied by ambulatory esophageal pH monitoring. Seventeen healthy volunteers were studied on two occasions, using a computerized radiotelemetric esophageal pH monitoring system. The subjects were given the alcohol during the second session, three hours after the evening meal, and went to bed at their usual time. Seven of the 17 subjects had prolonged supine reflux episodes on the night of alcohol ingestion. These lasted an average of 47.1 minutes (23.2 to 91.8 minutes) and occurred on an average of 3 1/2 hours after ingestion of whiskey and 1.4 hours after lying down. None of the subjects had these episodes on the control night. There was also a significant acidic shift in the cumulative percentage of data points below a pH of 3 and a pH of 4 in the supine position on the night of alcohol ingestion compared with the control night. This study has shown that there was a significant exposure of the distal esophagus to acid and that the normal acid clearance of the esophagus in the supine position was impaired after only moderate amounts of alcohol. PMID- 3656624 TI - Health and economic implications of a tobacco-free society. AB - Cigarette smoking causes more premature deaths than do all the following together: acquired immunodeficiency syndrome, cocaine, heroin, alcohol, fire, automobile accidents, homicide, and suicide. Attainment of a tobacco-free society ultimately would produce a national life-expectancy gain comparable with that that would accompany the complete elimination of all cancers not caused by tobacco use. In particular, each year 350,000 individuals who would have experienced tobacco-related deaths would realize a life-expectancy gain of 15 years. Reflecting their higher smoking prevalence and rates of smoking-related diseases, blacks would benefit more than whites. By altering the mix of morbid conditions and fatal diseases, the end of tobacco-related diseases would shift the need for particular medical specialties and health care facilities. The tobacco industry implies that the demise of tobacco consumption would wreak havoc with the economy. By contrast, some antitobacco activists suggest that the end of tobacco use would yield a multibillion dollar fiscal dividend. Each argument is fundamentally flawed. The economic impacts of a tobacco-free society would be modest and of far less consequence than the principal implication: a significantly enriched quality and quantity of life. PMID- 3656625 TI - Pain in the chest in a user of cocaine. PMID- 3656626 TI - Cerebral vasculitis associated with cocaine abuse. AB - A case of cerebral vasculitis in a previously healthy 22-year-old man with a history of cocaine abuse is described. Cerebral angiograms showed evidence of vasculitis. A search for possible causes other than cocaine produced no results. We now include cocaine with methamphetamines, heroin, and ephedrine as illicit drugs that can cause cerebral vasculitis. PMID- 3656627 TI - Risk-taking behaviors in adolescence. PMID- 3656628 TI - Physician leadership in preventing AIDS. PMID- 3656629 TI - Contempo '87. PMID- 3656630 TI - Assessing nutritional assessment. PMID- 3656631 TI - Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. AB - We studied 202 patients admitted to two major teaching hospitals for planned gastrointestinal surgery to assess the ability of several techniques of nutritional assessment to predict major postoperative complications (infection and/or wound problems). Subjective global assessment (SGA) and albumin were both of predictive value, and combinations of these variables were useful in differentiating low-risk from high-risk patients. Transferrin, creatinine-height index, percent ideal weight, percent body fat, and total lymphocyte count were not useful in predicting complications. We conclude that SGA and albumin are useful "nutritional assessment techniques" for patients undergoing major gastrointestinal surgery if the purpose of such an assessment is to predict postoperative "nutrition-associated complications." The second major finding of this study was the unexpectedly low rate of complications (10%) which was found in both hospitals. We suggest that these low complication rates may be more generalizable to patient populations derived from a wide community base, rather than those described in other studies in which veterans or patients of lower socioeconomic status comprised the sample. PMID- 3656632 TI - Hickman catheter dislodgement due to pendulous breasts. AB - Dislodgement of Hickman, Broviac, and Mediport catheters is a rare but recognized complication. To date, no specific etiology for this has been cited. We present five cases of dislodgement due to positional changes in large-breasted women and one man with gynecomastia. Apparently, motion in the subcutaneous tissue secondary to gravitational forces on large breasts causes downward and outward traction on the subcutaneous portion of the catheter. Variations in placement technique to help avoid this complication are described. PMID- 3656633 TI - Subclavian vein puncture under ultrasonic guidance. AB - Ultrasonically guided subclavian venipuncture is described. Since this method permits direct tapping of the subclavian vein and control of the insertion to the innominate vein under ultrasonic guidance, complications such as pneumothorax, accidental subclavian artery puncture, and malposition of the catheter, which often accompany the conventional method, can be avoided. As a result, this technique produces no radiation damage. PMID- 3656634 TI - [Effect of progesterone on respiratory depression by halothane]. PMID- 3656635 TI - [A comparison of arterial oxygen pressures before and after ligating the pulmonary artery during pneumonectomy]. PMID- 3656636 TI - [Effects of prostaglandins on hypoxic pulmonary vasoconstriction during one-lung ventilation]. PMID- 3656637 TI - [Postoperative hypoxemia after thoracotomy in children]. PMID- 3656638 TI - [Effects of age, smoking, and posture on respiratory functions]. PMID- 3656639 TI - [Renal handling of catecholamines during hemorrhagic hypotension]. PMID- 3656640 TI - [Clinical study of peripheral vascular changes during anesthesia; evaluation with the venous occlusion plethysmograph]. PMID- 3656641 TI - [Changes in erythrocyte fragility and plasma hemoglobin concentration during administration of high dose fentanyl]. PMID- 3656642 TI - [Anesthetic management of patients with DIC]. PMID- 3656644 TI - [The effect of local anesthetics on protein kinase C activation system]. PMID- 3656643 TI - [Effect of isoflurane anesthesia on glucose metabolism]. PMID- 3656645 TI - [Electrically elicited blink reflexes for the prognostic assessment of Bell's palsy]. PMID- 3656647 TI - [Evaluation of anesthetic vaporizers: application of the Normac infrared anesthetic agent monitor AA 102]. PMID- 3656648 TI - [Transdermal scopolamine as an anesthetic premedication]. PMID- 3656646 TI - [The electroencephalography (EEG), somatosensory evoked potential (SEP), and multiple unit activity (MUA) during etomidate and althesin anesthesia in cats]. PMID- 3656649 TI - [Anesthetic management of cervical perivascular sympathectomy in a patient with moya-moya disease; significance of internal jugular venous oxygen saturation]. PMID- 3656650 TI - [Anesthesia for patients with spondyloepiphyseal dysplasia congenita]. PMID- 3656651 TI - [Present status of anesthesia and therapy by acupuncture in pain clinics- questionnaires]. PMID- 3656652 TI - [Regional analgesic effect of epidural morphine--its evaluation using pain sensation produced by electrical stimulation]. PMID- 3656653 TI - [Cholecystokinin antagonist (proglumide) potentiates the inhibitory effect of morphine on micturition reflex]. PMID- 3656654 TI - [Enkephalin degrading enzyme activity in cerebrospinal fluid]. PMID- 3656655 TI - [Effect of sevoflurane on intracranial pressure in dogs]. PMID- 3656656 TI - [Effects of locally inhaled halothane on hypoxic pulmonary vasoconstriction]. PMID- 3656657 TI - [Effect of posture on the respiratory functions in surgical patients]. PMID- 3656658 TI - [Extracorporeal lung assist on premature sheep and goat delivered by cesarean section used as an experimental model of infant respiratory failure]. PMID- 3656659 TI - [Variation of oxygen consumption (VO2) and hemodynamics before and after awakening from anesthesia]. PMID- 3656660 TI - [The effects of portal vein occlusion on cardiovascular and respiratory system in dogs]. PMID- 3656661 TI - [Effect of dantrolene on the increased discharge of the muscle spindle induced by succinylcholine]. PMID- 3656662 TI - [Influence of acetylcholine released from denervated muscle on its twitch tension]. PMID- 3656663 TI - [Treatment with total spinal block of severe herpetic neuralgia accompanying median and ulnar nerve palsy]. PMID- 3656664 TI - [Severe hepatitis following halothane anesthesia in a child]. PMID- 3656665 TI - [Spiral tube obstruction due to progressive inflation of the intraluminal bubble during nitrous oxide-oxygen anesthesia]. PMID- 3656666 TI - [Continuing medical education material, "anesthesia-file"]. PMID- 3656667 TI - [Cerebral venous angiomas]. PMID- 3656668 TI - [Combined treatment of local hyperthermia and irradiation for radioresistant head and neck cancers]. PMID- 3656669 TI - [CT, angiographic and 67Ga scintigraphic findings of neurogenic tumors in the extremities]. PMID- 3656670 TI - [Extrahepatic extension of liver cancer to the rear of the right kidney]. PMID- 3656671 TI - [Brown tumor originating in the bladder wall and not accumulating 123I-MIBG]. PMID- 3656672 TI - [Arteriovenous malformations. Report of two rare and interesting cases]. PMID- 3656673 TI - [Two cases of nodular pulmonary pseudolymphoma]. PMID- 3656674 TI - [A case of capillary hemangioma of the right atrium]. PMID- 3656675 TI - [A case of transverse folds of the esophagus in early esophageal carcinoma]. PMID- 3656676 TI - [Two cases of so-called carcinosarcoma of the esophagus]. PMID- 3656677 TI - [A case of alcoholic focal fatty liver with mass effect]. PMID- 3656678 TI - [A case of xanthogranulomatous cholecystitis]. PMID- 3656679 TI - [A case of retroperitoneal inflammation: diagnostic usefulness of MRI]. PMID- 3656680 TI - [A case of multilocular cystic nephroma]. PMID- 3656681 TI - [CADO-EII model applicator for use in the brachytherapy of uterine cancer]. PMID- 3656682 TI - [Use of 5 French catheters in angiography and interventional angiography]. PMID- 3656683 TI - [Psychology of the mothers of infants kept at the NICU (newborn intensive care units) and family dynamics]. PMID- 3656684 TI - [Nursing assistance extended to infants in the NICU and their families--for the development of parent-child relationship and a health family structure]. PMID- 3656685 TI - [Enhancement of the mutual actions between parents and children--a nursing guideline at our NICU]. PMID- 3656686 TI - [Nursing of infants with cleft lips and palates under a system of mothers and infants sharing the hospital room]. PMID- 3656688 TI - [Weekly records of a practicing midwife. 5. A thought after practice of two months]. PMID- 3656687 TI - [Extended stays at the NICU and battered child syndrome]. PMID- 3656689 TI - [For more effective professional education. 5. Methods in human understanding]. PMID- 3656690 TI - [For the love of the midwifery profession. 5. What is an ideal mother?]. PMID- 3656691 TI - [Establishment of early mother-child relationship with extremely small premature infants]. PMID- 3656692 TI - [Introduction of personal computers to perinatology. 5. Data bases for personal computers (2)]. PMID- 3656693 TI - [Questions and answers on breast feeding. Safety of using another mother's milk]. PMID- 3656694 TI - [Threatened abortion and vaginal irrigation]. PMID- 3656695 TI - [Suppressive effect of mizoribine on progression of bovine serum albumin nephritis in mice]. PMID- 3656696 TI - [Aggravation and amelioration of glomerular injury in the rats fed with chaw containing various amount of protein and salt]. PMID- 3656697 TI - [Re-pregnancy in patients with pre-eclamptic focal glomerular sclerosis]. PMID- 3656698 TI - [Clinicopathological study of renal lesions in Wegener's granulomatosis]. PMID- 3656699 TI - [Clinicopathological study on 80 children with IgA nephropathy]. PMID- 3656700 TI - [Clinicopathological study of serially biopsied 23 children with IgA nephropathy]. PMID- 3656701 TI - [Evaluation of prognostic features in patients with IgA nephropathy]. PMID- 3656702 TI - [Inhibitory effects of uremic toxins on the compensatory renal growth]. PMID- 3656703 TI - [Mechanism of hypotensive action of a diuretic, mefruside, based on the pressure natriuresis relationship]. PMID- 3656704 TI - [Relation of platelet-derived growth factor with vascular involvements in diabetes mellitus]. PMID- 3656705 TI - [Three cases of rheumatoid arthritis developing glomerulonephritis with crescent formation]. PMID- 3656706 TI - [Comparative studies of plasma and urine levels between uremic peak 2a and guanidino compounds]. PMID- 3656707 TI - [Complement activating factors in hypocomplementemic membranoproliferative glomerulonephritis (MPGN) patients' sera--comparison with C3NeF positive and negative cases]. PMID- 3656708 TI - Membranoproliferative glomerulonephritis type I associated with immunodeficiency. PMID- 3656709 TI - Urinary Tamm-Horsfall glycoprotein in normal subjects. PMID- 3656710 TI - Urinary Tamm-Horsfall glycoprotein in patients with various renal diseases. PMID- 3656711 TI - PTH activity as determined by canine renal cortical adenylate cyclase assay in chronic renal failure. PMID- 3656712 TI - Diabetic glomerulosclerosis with nephrotic syndrome in early pregnancy. PMID- 3656713 TI - Urinary kallikrein excretion and renal interstitial damage in mesangial proliferative glomerulonephritis. PMID- 3656714 TI - A case of hypocomplementemic mesangiocapillary glomerulonephritis: appearance of C3 NeF and another factor. PMID- 3656716 TI - Proceedings of the 26th annual meeting of the Japanese Society of Nuclear Medicine. November 19, 20, 21, 1986, Kamogawa. Abstracts. PMID- 3656715 TI - The importance of vagal afferents for the expression of exaggerated natriuresis in spontaneous hypertension. PMID- 3656717 TI - [Coded aperture imaging using a rotating multi-slit aperture]. PMID- 3656718 TI - [Evaluation of right ventricular stress test using ultrashort-lived 81mKr and a gamma-camera]. PMID- 3656719 TI - [Hepatobiliary scintigraphy in chronic intrahepatic cholestasis--diagnosis of primary sclerosing cholangitis]. PMID- 3656720 TI - [Assessment of cardiac function by an ambulatory ventricular function monitor (VEST)--(2). Application in coronary artery disease]. PMID- 3656721 TI - [Profile of a nurse. Mrs. Yumiko Uto, a clinical nurse participating in the designing of the Kagoshima University hospital information system]. PMID- 3656722 TI - [A diary of a physician stationed at a hospital]. PMID- 3656723 TI - [Welfare and medical care in the aging society. 14. On problem behavior and selfishness of the aged]. PMID- 3656724 TI - [A recollection by a wife on her late husband: an encounter with another cancer patient who benefited from her husband's writing]. PMID- 3656725 TI - [Nursing report from overseas. From Scotland, a fantasy land. 1]. PMID- 3656726 TI - [Motor paralysis (1). The mechanism of the action of the pyramidal tracts]. PMID- 3656727 TI - [Home nursing. 7. Instructions to be given to family members]. PMID- 3656728 TI - [Nursing theory. 21. On "Humanistic Nursing" by J. Paterson and L. Zderad (2)]. PMID- 3656729 TI - [Partnership in nursing: for more efficient work in the hospital]. PMID- 3656730 TI - [Rehabilitation and interprofessional communication: the nurse, PT (physical therapist), OT (occupational therapist), and ST (speech therapist)]. PMID- 3656731 TI - [The nurse and clinical pharmacist: respect for the professional practice of each and joint effort for improved patient care]. PMID- 3656732 TI - [Partnership in the hospital supply management system: the nurse and the messenger]. PMID- 3656733 TI - [Volunteers at a hospital: give and take in learning and sharing love]. PMID- 3656734 TI - [Volunteers at a hospital: pleasure in serving from one's free will]. PMID- 3656735 TI - [Partnership in a hospital: for better cooperation with physicians]. PMID- 3656736 TI - [Partnership in a hospital. Members of a workshop: medical students learning from nurses' experiences]. PMID- 3656737 TI - [Partnership in a hospital. Activities at a workshop: the importance of knowing each profession]. PMID- 3656738 TI - [Nursing and education of a patient undergoing CAPD]. PMID- 3656739 TI - [A visit to West Germany after 20 years of absence and an observation on its homes for the aged]. PMID- 3656740 TI - [Home nursing. 5. A failure in nursing: a difference between institutional nursing and home nursing]. PMID- 3656741 TI - [Nursing theory 19. Orem's nursing theory. 4: From theories to practice]. PMID- 3656742 TI - [Lessons in clinical training in nursing]. PMID- 3656743 TI - [Hesitation of nursing students at the early stage of clinical training and their guidance]. PMID- 3656744 TI - [My recollection of clinical training]. PMID- 3656745 TI - [An observation on interpersonal relationship with patients: reflection on the involvement of the self]. PMID- 3656746 TI - [On the psychological aspect of nursing of a dying patient]. PMID- 3656747 TI - [Profile of a nurse: Ms. Kieko Nakajima, a former assistant professor at Chiba University School of Nursing who assumed a position of professorship at the Japanese College of Social Services]. PMID- 3656748 TI - [A diary by a physician at a hospital: the importance of listening to patients]. PMID- 3656749 TI - [Social welfare and medical care of the aging society. 12. On the "bedridden aged patients" (4): The relationship among the three parties involved in nursing]. PMID- 3656750 TI - [A record of a wife of a cancer patient. Cyclicity]. PMID- 3656751 TI - [Learning from the self-help group. 14. Self-help and voluntarism in England]. PMID- 3656752 TI - [Dilemma in home nursing in England]. PMID- 3656753 TI - [On teaching a course on hygienic regulations]. PMID- 3656754 TI - [Interview: Establishment of nursing ethics and bioethics, experiences in the United States]. PMID- 3656755 TI - [Bioethics in nursing: ethical problems associated with prenatal diagnosis]. PMID- 3656756 TI - [Attitudes toward the problems of bioethics--a survey among nurses, midwives, and medical students]. PMID- 3656757 TI - [Status of nursing education overseas. 1. Current status and future prospects for nursing education in South Korea]. PMID- 3656759 TI - [A trial in training of body motions--conclusion]. PMID- 3656758 TI - [Status of nursing education overseas. 2. Development of nursing studies and the nursing profession in China]. PMID- 3656760 TI - [Systematization of nursing education. 11. Educational evaluation in nursing studies]. PMID- 3656761 TI - [Volunteer activities by nursing students]. PMID- 3656763 TI - [Latent benefits of extracurricular activities]. PMID- 3656762 TI - [The concept and effective use of extracurricular activities]. PMID- 3656764 TI - [Extracurricular activities and personality development]. PMID- 3656765 TI - [Report on planning a "cultural festival" at a nursing school: "life, death, and nursing" as its theme]. PMID- 3656766 TI - [Extracurricular activities to give latitude in learning]. PMID- 3656767 TI - [Extracurricular activities in nursing education. Nurturing leadership through discussion]. PMID- 3656768 TI - [Extracurricular activities in nursing education. Goal of the activities and their planning: faculty actions for creative and organized group activities]. PMID- 3656769 TI - [Status of training of nursing instructors in Fukuoka Prefecture: for the improvement in nursing research]. PMID- 3656770 TI - [Systematization of the study of nursing education. 12. Nursing education as a research entity in the field of education]. PMID- 3656771 TI - Effect of cibenzoline, a class I antiarrhythmic drug, on action potential in canine ventricular muscle. AB - Effect of cibenzoline, a class I (local anesthetic-type) antiarrhythmic drug, was investigated upon canine ventricular muscle using a conventional micro-electrode method. In the presence of cibenzoline at the concentration of 3 X 10(-6) M or higher, the maximum rate of rise of the action potential was inhibited and the action potential duration was lengthened significantly in a concentration dependent manner. The effective refractory period was also prolonged. From its effect on the action potential duration, cibenzoline should belong to Ia, according to the Vaughan Williams classification of antiarrhythmic agents. On the other hand, cibenzoline inhibition of the maximum rate of depolarization was greater with an increase in stimulation frequency (a use-dependent block). In the presence of cibenzoline concentrations of 3 X 10(-6) M and 8 X 10(-6) M, which blocked the maximum rate of depolarization by 36% and 67% at 180 beats/min, the rates of onset of inhibition of the maximum rate of depolarization were 0.109 +/- 0.027 and 0.146 +/- 0.070 AP-1 (mean +/- S.D.), respectively. From the kinetics of inhibition of the maximum rate of depolarization, these results suggest that cibenzoline should be classified as an intermediate drug with the prolongation of the action potential duration. PMID- 3656772 TI - Comparative effects of two forms of gamma-oryzanol in different sterol compositions on hyperlipidemia induced by cholesterol diet in rats. AB - Hypolipidemic effects of the usual gamma-oryzanol (gamma-OZ) and a new gamma-OZ (N-gamma-OZ) with a different sterol composition from gamma-OZ were investigated on the hyperlipidemia induced by ingestion of a high cholesterol diet (HCD) containing 1% cholesterol for 12 days in male Sprague-Dawley rats. Treatment with gamma-OZ for 6 days significantly inhibited the increase in serum total cholesterol (TC) and phospholipids (PL) induced by HCD, while the treatment with gamma-OZ for 12 days did not inhibit the increase of TC and PL. Treatment with N gamma-OZ at 100 or 1000 mg/kg for 6 days slightly inhibited the increase of TC by HCD. The decrease of TC in high density lipoprotein (HDL-TC) was markedly inhibited by treatment with N-gamma-OZ for 12 days, but N-gamma-OZ for 6 days and gamma-OZ for 6 and 12 days did not inhibit the decrease of HDL-TC. Treatment with N-gamma-OZ for 12 days significantly inhibited the increase of PL and free cholesterol (FC) by HCD. gamma-OZ at 1000 mg/kg for 12 days also inhibited the increase of FC. N-gamma-OZ significantly reduced the atherogenic index using TC and HDL-TC by affecting the HDL-TC increase. gamma-OZ at 100 mg/kg and N-gamma-OZ at 100 mg/kg for 6 days reduced the atherogenic index using TC and HDL-TC by the inhibition of TC increase. The atherogenic index using PL and HDL-PL was only reduced by the treatment with N-gamma-OZ at 1000 mg/g for 12 days. The increase of triglyceride (TG) by HCD was inhibited by the treatment of N-gamma-OZ for 6 days (all doses) and 12 days (500, 1000 mg/kg), and gamma-OZ at 500 mg/kg for 6 and 12 days also inhibited the increase of TG by HCD. gamma-OZ and N-gamma-OZ had no effects on liver lipid contents. The hypolipidemic effect of N-gamma-OZ was slightly more potent than that of gamma-OZ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656773 TI - Antiarrhythmic effects of a new drug, E-0747, on canine ventricular arrhythmia models. AB - Antiarrhythmic effects of a new antiarrhythmic drug, E-0747, were examined using four canine ventricular arrhythmia models: digitalis-, adrenaline- and two-stage coronary ligation-induced arrhythmias and a newly developed locally-induced digitalis arrhythmia. The minimum effective plasma concentration of E-0747 was determined for the first three arrhythmia models. E-0747 suppressed those arrhythmias, and the minimum effective plasma concentrations for arrhythmias induced by digitalis, adrenaline, 24 hr coronary ligation, and 48 hr coronary ligation were 1.4 +/- 0.6, 1.8 +/- 0.4, 1.6 +/- 0.4 and 2.2 +/- 0.2 micrograms/ml, respectively (mean +/- S.D., n = 5-10). The aforementioned minimum effective plasma concentrations of E-0747 for these arrhythmias were almost equal to the reported concentration in vitro to suppress the Na channels of isolated canine ventricular tissues. The class 1 property of E-0747 was also shown in a newly developed locally-induced digitalis arrhythmia. Thus E-0747 suppresses arrhythmia by inhibiting Na channels of cardiac cells and is expected to become a clinically useful antiarrhythmic drug. PMID- 3656774 TI - Impairment of acid-neutralizing capacity and lesion formation in the rat duodenum during hemorrhagic shock: comparative study with indomethacin. AB - The effects of hemorrhagic shock (HE) on duodenal pH, acid-neutralizing capacity and mucosal tolerance to acid were investigated in anesthetized rats, and they were compared with those of indomethacin. HE was performed by bleeding from the carotid artery to reduce arterial blood pressure to about 55 mmHg (3 ml of bleeding per 200 g of body weight), and indomethacin was given s.c. in a dose of 5 mg/kg. Duodenal pH was determined in the outflow from the proximal duodenum (1.7 cm) which was perfused with 10(-4) M HCl, and acid-neutralizing capacity was measured by back-titration of the perfusate to pH 4.0 with 10 mM HCl. Under these conditions, duodenal pH was kept at around 6.0 as the result of neutralization in the loop (approximately 8 microEq/hr). Both HE and indomethacin significantly decreased the pH and acid-neutralizing capacity. Administration of 16,16-dimethyl prostaglandin E2 (16-dmPGE2: 30 micrograms/kg, s.c.) significantly increased both pH and acid-neutralizing capacity in normal and indomethacin-treated rats, but failed to affect these parameters in rats under HE conditions. When the duodenal loop was perfused with 50 mM HCl for 1.5 hr, both HE and indomethacin induced extensive damage in the mucosa. Pretreatment with 16-dmPGE2 significantly reduced the formation of duodenal lesions induced by indomethacin but not by HE. These results suggest that HE as well as indomethacin impaired duodenal acid neutralizing capacity to reduce the tolerance to acid of the mucosa. The deleterious effects of HE on the mucosa may be mainly due to a decreased mucosal blood flow, but not due to a deficiency of endogenous prostaglandins. PMID- 3656775 TI - Inhibitory effect of TJN-101 ((+)-(6S,7S,R-biar)-5,6,7,8-tetrahydro-1,2,3,12 tetramethoxy -6,7-dimethyl-10,11- methylenedioxy-6-dibenzo[a,c]cyclooctenol) on immunologically induced liver injuries. AB - TJN-101, which is a lignan component isolated from schisandra fruits, inhibits hepatotoxic chemicals-induced liver injuries. In this study, effects of TJN-101 on immunologically induced liver injuries were investigated in vivo and in vitro. When a small dose of lipopolysaccharide was injected into mice previously injected with heat-killed Propionibacterium acnes, most of the animals died with acute hepatic failure which was produced by cytotoxic factors from activated adherent cells, and liver cells were injured by antibody-dependent cell-mediated cytotoxic (ADCC) reaction or activated macrophages in vitro. TJN-101 reduced the mortality of the mice with acute hepatic failure dose-dependently. Histologically, necrosis was suppressed by the treatment of TJN-101, but infiltration of non-specific inflammatory cells was not. TJN-101 inhibited the isolated liver cell injuries induced by ADCC reaction or activated macrophages in vitro. These results suggest that TJN-101 can be markedly protective against immunological liver injuries. PMID- 3656776 TI - Central sympathoinhibitory action of a direct-acting vasodilator, budralazine, in anesthetized rats. AB - Previous data on budralazine, 1-[2-(1,3-dimethyl-2-butenylidene)-hydrazino] phthalazine, has indicated that it is a direct-acting vasodilating agent that does not produce marked tachycardia. The present study was undertaken to elucidate what effects may be seen on the central sympathetic nerve activity when budralazine is given systemically to rats. Budralazine (0.5, 1.0 and 5.0 mg/kg, i.v.) produced a dose-dependent reduction of mean arterial pressure. At doses of 0.5 and 1.0 mg/kg, budralazine induced bradycardia accompanied with a decrease in cardiac sympathetic nerve activity. Preganglionic adrenal sympathetic nerve activity was also reduced by budralazine (1.0 mg/kg, i.v.). A dose of 0.5 mg/kg of budralazine neither influenced carotid sinus nerve activity nor augmented aortic depressor nerve activity. On the contrary, a high dose of budralazine (5.0 mg/kg) produced simultaneous increases in the heart rate and cardiac sympathetic nerve activity along with a marked suppression of aortic depressor nerve activity. Plasma norepinephrine and epinephrine concentrations were also increased at a dose of 5.0 mg/kg. These findings suggest that budralazine doses of 0.5 and 1.0 mg/kg may reduce the sympathetic outflow that is mediated via central sympathoinhibitory action. Baroreceptor-mediated tachycardia occurred after high dose budralazine (5.0 mg/kg) administration in anesthetized rats. PMID- 3656777 TI - A regional difference in endothelium-dependent relaxation responses to acetylcholine in the canine venous system. AB - Endothelium-dependent relaxations of canine veins isolated from 15 different sites were examined. Acetylcholine (ACh, 10(-10)-10(-6) M) caused marked endothelium-dependent relaxations in the external jugular vein, superior vena cava, brachiocephalic vein, segment A (supradiaphragmatic portion) and D (infrarenal portion) of the inferior vena cava. However, only contractile responses were induced by ACh in the portal, mesenteric veins and the segment C of the inferior vena cava (between liver and renal veins) with or without endothelium. The other 7 veins showed only small endothelium-dependent relaxations (10-20%). These results indicated that the endothelium-dependent responses of canine veins to ACh are regionally different. PMID- 3656778 TI - Effects of antibiotics on fibrinolytic activity in vivo. AB - The effects of latamoxef, cefamandole, carbenicillin and cefotaxime on fibrinolytic system in rats were examined under feeding of an ordinary diet or a vitamin K-deficient diet for eight days. No obvious change was observed in UK induced plasma clot lysis time, euglobulin lysis time and antiplasmin level in plasma. These findings of the in vitro and ex vivo studies suggest that these antibiotics cause no enhancement of fibrinolytic activity. PMID- 3656779 TI - Studies on the affinity and selectivity of tiquizium bromide (HSR-902), a novel spasmolytic agent, for muscarinic receptors. AB - The affinity and selectivity of a novel spasmolytic agent, tiquizium bromide (HSR 902), for muscarinic receptors were studied by the radioligand binding technique using 3H-quinuclidinyl benzilate. The parameters (Ki, nH) of HSR-902 obtained from competition experiments in cerebral cortex and heart muscarinic receptors showed that HSR-902 was an atropine-type, nonselective muscarinic antagonist. The affinity of HSR-902 toward the stomach and ileal muscarinic receptors was about 3 4 times more potent than atropine. PMID- 3656780 TI - The use of beta-cyclodextrin-containing culture medium for in vitro evaluation of immunomodulating agents. AB - We have devised a new culture medium that is made of RPMI-1640 medium, 500 micrograms/ml beta-cyclodextrin (beta-CD) and 1% fetal calf serum (FCS) (beta-CD medium). Murine lymphocytes stimulated with sheep erythrocytes in vitro developed antibody-forming cells in beta-CD medium as efficiently as in 10% FCS-containing RPMI-1640 medium (10F medium). Immunostimulating agents (SA96 and levamisole) and immunosuppressive agents (hydrocortisone and D-penicillamine) showed similar immunomodulating effects on the antibody responses in both media. In addition, the enhancing effect of levamisole varied drastically depending on the lot of FCS used in 10F medium, but a clear enhancement was always observed in beta-CD medium containing any lot of FCS tested. PMID- 3656781 TI - Endothelium-dependent vasocontraction in response to noradrenaline in the canine cerebral artery. AB - In the canine basilar artery, noradrenaline-induced contraction was markedly decreased by intimal rubbing. Scanning electron microscopic studies showed that the rubbing procedure had scrapped away the endothelial cells from the intimal surface of the artery. Prazosin (10(-7) M) reduced the noradrenaline-induced contraction in intact arteries, but did not significantly affect the contraction in the scrapped arteries. Yohimbine (10(-7) M) strongly inhibited the contraction in both intact and scrapped arteries. The endothelium-dependent vasocontraction produced by noradrenaline was inhibited by aspirin (5 X 10(-5) M), OKY-046 (10( 5) M) and ONO-3708 (5 X 10(-9) M). The present experiments provided evidence for endothelium-dependence of the vasocontraction produced by noradrenaline in canine basilar arteries, and they suggested that the endothelium-derived contracting factors might be arachidonic acid metabolites such as TXA2; they also suggested that alpha 1 adrenoceptors might be preferentially distributed on the endothelium, while alpha 2 adrenoceptors are preferentially located in smooth muscle. PMID- 3656782 TI - Contribution of isosorbide-5-mononitrate, a major metabolite of isosorbide dinitrate (ISDN), to the hemodynamic effect of ISDN administered orally in conscious dogs. AB - This study was designed to determine the extent, to which isosorbide-5 mononitrate (5-ISMN) contributes to the hemodynamic effect of isosorbide dinitrate (ISDN) in conscious dogs. Test drugs (ISDN or 5-ISMN) were given orally. Either ISDN or 5-ISMN produced a decrease in blood pressure dose dependently, the decrease in pulse pressure being specific; the pattern of blood pressure change induced by ISDN or 5-ISMN was different from that induced by nifedipine or prazosin. The effect of ISDN (2 mg/kg) was almost equivalent to that of 5-ISMN (4 mg/kg) and the effect of ISDN (4 mg/kg) to that of 5-ISMN (8 mg/kg). After administration of ISDN, both ISDN and 5-ISMN appeared in the plasma, and the effect of ISDN well-correlated with the increase in the plasma concentration of 5-ISMN. Contribution of 5-ISMN to the effect of ISDN was estimated to be about 30% from the value of the plasma concentration of 5-ISMN at 3 to 4 hr after administration, when the maximal response to ISDN occurred. Based on the data of the area under the plasma concentration curve of 5-ISMN (from 0 to 10 hr after administration), the fraction of biotransformation to 5-ISMN from ISDN was calculated to be 73.6 to 76.6% (based on moles). Because the ability of 5-ISMN to decrease pulse pressure was about 1/2 (or 41% based on moles) of that of ISDN, the contribution of 5-ISMN to the effect of ISDN was estimated to be about 30% in total, the value being similar with that estimated at 3 to 4 hr after administration. PMID- 3656783 TI - Roles of gastric motility changes in cytoprotection induced by acetazolamide and cysteamine in rats. AB - The present study was undertaken using acetazolamide (AZ) and cysteamine (Cys) to investigate the relationship between gastric motor activity and the phenomenon of "cytoprotection" in rats. Both AZ (10-100 mg/kg) and Cys (10-100 mg/kg), given either p.o. or s.c., significantly reduced the formation of gastric mucosal injury caused by HCl-ethanol (1 ml of 60% ethanol in 150 mM HCl, p.o.). The protective effect of Cys appeared within 10 min, reached the maximal levels 30 min later, while that of AZ appeared from 30 min after administration and became potent with a latency period after treatment. Neither indomethacin (IM: 5 mg/kg, s.c.) nor N-ethylmaleimide (NEM: 5 mg/kg, s.c.) significantly affected the protective effect of Cys, whereas that of AZ was almost totally antagonized by IM. Both AZ and Cys, given either intragastrically or s.c., significantly inhibited gastric motor activity measured as intraluminal pressure recordings, but had minimal effect on acid and alkaline secretion. IM significantly attenuated the inhibitory effect of AZ on the motor activity, while NEM did not affect the inhibited motor responses caused by AZ and Cys. A significant relationship was found between the inhibitory effects of these two drugs on gastric motor activity and HCl-ethanol-induced mucosal injury, the correlation coefficient being 0.819 (P less than 0.01). When the mucosal folds were visualized with Gentian Violet (1 ml of 0.5% v/v, p.o.), both AZ and Cys significantly prevented the localized staining along the mucosal folds, suggesting dissolution of the folds. These results suggest that both AZ and Cys protect the gastric mucosa against injury caused by HCl-ethanol, probably through a dissolution of mucosal folds due to inhibition of gastric motor activity. PMID- 3656784 TI - Effect of several d-morphinans on ascites tumors in mice. AB - Dextromethorphan and its analogues (DM 16, DM 34, DM 72, DM 75 and DM 96) were examined for their effect on Ehrlich ascites carcinoma or ascites sarcoma-180 in female mice of the ddY strain. The suspension of Ehrlich carcinoma cells or sarcoma-180 cells was prepared from mice at 10 days after i.p. inoculation of the cells, using Hanks' balanced salt solution, and the cell suspension was inoculated i.p. into mice (2 X 10(6) viable cells/mouse). The chemicals dissolved in physiological saline containing 5% HCO-60 were then injected i.p. into the mice once daily for 5 successive days (5-40 mg/kg/day). In addition, mice given the tumor cells were treated with the saline containing 5% HCO-60 alone for 5 days (untreated mice). In groups of mice bearing Ehrlich ascites carcinoma or ascites sarcoma-180, the mean survival time of mice treated with 20-40 mg/kg/day of DM 96 was more than twice that of the corresponding untreated mice. The mean survival time of mice treated with 20 mg/kg/day of DM 96 was also longer than that of mice treated with 40 mg/kg/day of the other chemicals, irrespective of the ascites tumors. Concerning these survival times, the LD50 (i.p.) of DM 96 in mice differed slightly from that of other chemicals (88 mg/kg and 77-106 mg/kg). These results indicate that DM 96 is more active than the other chemicals against the ascites tumors in mice. PMID- 3656785 TI - Studies of chlorpromazine-induced enhancement of the potentials evoked by peripheral stimulation of the cat cerebellum. AB - 1) In the experiments reported here, we investigated effects of CPZ on the amplitude of cerebellar potentials using decerebrated or spinal cat; furthermore, we also examined the effects of microinjecting CPZ, DA or NE into the precerebellar nuclei on the amplitude of the cerebellar potentials. 2) Purkinje cell spontaneous discharge was either hardly changed or was depressed by CPZ. 3) CPZ did not change the potentials evoked by peripheral stimulation on the dorsal surface of the spinal cord. 4) CPZ depressed significantly the cerebellar potentials evoked by stimulation of the nucleus reticularis lateralis (LRN) or nucleus olivaris inferior (ION) in intact, decerebrated and spinal cats. 5) The cerebellar potentials evoked by the peripheral nerve stimulation were increased by microinjection of CPZ into the bilateral LRN but not into the bilateral ION. Microinjection of NE or CPZ into the contralateral LRN hardly influenced the cerebellar evoked potentials. 6) Although electrical stimulation at high frequencies of the ipsilateral LRN depressed significantly the cerebellar evoked potentials; similar stimulation after i.v. pretreatment of CPZ failed to affect them. Microinjection of CPZ into the ipsilateral LRN enhanced the cerebellar evoked potentials, and microinjection of NE or DA depressed them significantly. Furthermore, after pretreatment with CPZ, microinjection of DA failed to depress the potentials. 7) We suggest that intravenous CPZ-induced enhancement of the cerebellar potentials may be due to depression of the descending inhibitory mechanism, resulting from CPZ-induced blockage of the catecholamine receptors of the ipsilateral LRN and of the spinal level. PMID- 3656786 TI - Cytoprotective action of histamine against 0.6 N HCl-induced gastric mucosal injury in rats; comparative study with adaptive cytoprotection induced by exogenous acid. AB - We examined the effects of histamine 2HCl (a stimulator of endogenous acid production) and exogenous acid on transmucosal potential difference (PD) and pH of anesthetized rat stomachs, in order to investigate the mechanism underlying the protective action of histamine against 0.6 N HCl-induced gastric mucosal injury in conscious rats. Subcutaneously administered histamine (3-20 mg/kg) dose dependently produced a decrease in the PD and pH, and it reduced the severity of gastric mucosal injury caused by 0.6 N HCl. Both indomethacin (5 mg/kg, s.c.) and cimetidine (100 mg/kg, s.c.) completely reversed the protection afforded by histamine (20 mg/kg), although the decreased PD and pH responses were unaffected or inhibited, respectively, by indomethacin or cimetidine. Protective action of histamine was also partially mitigated by omeprazole (30 mg/kg, s.c.) which completely abolished histamine-induced acid secretion. On the other hand, exposure of the stomach for 10 min to exogenous acid (0.1-0.35 N HCl) caused a PD reduction and an increase of pH, in a concentration-related manner. The injury caused by 0.6 N HCl was prevented by prior exposure to these low concentrations of HCl, and the degrees of inhibition were associated with the concentration of HCl and the magnitude of PD reduction caused by HCl. The pretreatment with indomethacin, but not cimetidine or omeprazole, significantly antagonized the increased pH and mucosal protection induced by 0.35 N HCl. These results suggest that histamine protected the gastric mucosa against 0.6 N HCl-induced injury by two different ways, mediated with endogenous prostaglandins, (a) mainly through stimulation of H2-receptors and (b) partly through adaptive cytoprotection induced by acid. PMID- 3656787 TI - Effects of ifenprodil glucuronide derivative on platelet aggregation and vasocontraction. AB - It has been supposed that ifenprodil glucuronide derivative, detectable in large amount in rabbit plasma, is related to the pharmacological actions by ifenprodil tartrate. However, a synthesized ifenprodil glucuronide derivative was found to have no effect on platelet aggregation and vasocontraction in vitro. These results indicate that ifenprodil itself rather than its glucuronide derivative manifested the pharmacological actions. PMID- 3656788 TI - Vascular responsiveness of isolated and perfused simian metacarpal veins to several vasoconstrictor substances. AB - Using the cannula inserting method, vascular responses to 7 vasoconstrictor substances were investigated on isolated, perfused simian metacarpal veins. The vein was markedly constricted by an intraluminal administration of norepinephrine, phenylephrine and 5-hydroxytryptamine with a maximal increase in perfusion pressure of over 100 mmHg. Clonidine and xylazine induced only a slight vasoconstriction, but tyramine produced no significant constriction. A large dose of KCl induced a strong vasoconstriction. In this study, it was demonstrated that the simian metacarpal vein has a specific characteristic of vascular reactivity. PMID- 3656789 TI - L-methionine enhances the contractile response to norepinephrine of rat vas deferens. AB - Under Ca-depleted conditions, the contractile responses of rat vas deferens in the presence of norepinephrine were not elicited until the addition of CaCl2. L Methionine enhanced the contractile response of vas deferens in the presence of methylation blockers under these conditions. The enhancing effect of L-methionine on some other smooth muscles could not be determined because under Ca-depleted conditions, these muscles showed 60-80% of the maximal contractile response on addition of CaCl2 alone. These findings suggested that L-methionine has an enhancing effect on contraction of the rat vas deferens as it does on rat uterine muscle. PMID- 3656791 TI - [Public health nursing activities at Matsue-shi]. PMID- 3656792 TI - [The effect of the 2-department-system (creation of preventive medicine and health promotion sections within a public health clinic) on public health nurses]. PMID- 3656790 TI - Antinephritic effect of prostaglandin E1 on serum sickness nephritis in rats (4). Enhanced clearance of macromolecules by the reticulo-endothelial system with prostaglandin E1. AB - Function of the reticulo-endothelial system (RES) was determined by the carbon clearance technique in rats. Rats in the previous phase of nephritis showed reduced function of the RES with circulating immune complexes compared with normal rats. Prostaglandin E1 (PGE1) at 1.0 mg/kg, s.c., resulted in significant recovery in the impaired RES activity of the rats in the previous state of nephritis. Dipyridamole, 400 mg/kg, p.o., slightly enhanced function of the RES, but 20 mg/kg azathioprine, p.o., did not. Thus, the enhanced RES activity with PGE1 can explain part of the antinephritic effect of PGE1. PMID- 3656794 TI - [The heavy demands on public health nurses of Ishikawa Prefecture]. PMID- 3656793 TI - [Public health regional administration in Ishikawa Prefecture]. PMID- 3656795 TI - [The future of public health and public health clinics]. PMID- 3656796 TI - [Discussion: public health activities to support the lives of the citizens: with special reference to maternal and child health services]. PMID- 3656797 TI - [To eat and to feed (6): Problems of the patient and the caregiver]. PMID- 3656798 TI - [Public health nursing with special focus on certain areas with public health needs. 11. Planning of activities: steps in planning and implementation and description of associated problems]. PMID- 3656799 TI - [Public health nursing of an aged demented patient and her family and organization of a day care center for the aged. An example at Soka-shi, Saltama Prefecture]. PMID- 3656800 TI - [Nursing roots in public health nursing activities at a land reclamation project in the wilderness of Hokkaido: emergency nursing risking violations of the Medical Act]. PMID- 3656801 TI - [Attitude to health and public health actions of public health nurses: their own health problems and health education for the aged]. PMID- 3656802 TI - [The study of lung sounds in the future]. PMID- 3656803 TI - [Mechanism of bronchial smooth muscle contraction]. PMID- 3656804 TI - [Multiple systems organ failure in respiratory failure]. PMID- 3656805 TI - [Multiple-organ failure in respiratory failure--mental disease and neurologic lesions]. PMID- 3656806 TI - [Respiratory multiple systems organ failure. Cardiovascular system--right-sided heart]. PMID- 3656807 TI - [Left ventricular function in respiratory failure]. PMID- 3656808 TI - [Hepatic and renal disorders in patients with respiratory failure]. PMID- 3656809 TI - [Respiratory failure and coagulation-fibrinolytic disorders]. PMID- 3656810 TI - [Pathology of multiple organ failure in respiratory failure]. PMID- 3656811 TI - [Effects of hydrocortisone in severe Mycoplasma pneumoniae pneumonia]. PMID- 3656812 TI - [Background characteristics of patients with idiopathic interstitial pneumonia associated with lung cancer]. PMID- 3656813 TI - [Beat-to-beat variation of the heart rate in children with allergic disorders- relationship between nocturnal asthma and cholinergic function]. PMID- 3656814 TI - [Clinical and therapeutic studies in eleven cases of primary pulmonary cryptococcosis]. PMID- 3656815 TI - [A case of severe hypoxemia due to a shunt-like effect accompanied with liver cirrhosis]. PMID- 3656816 TI - [A case of alveolar hemorrhage in systemic lupus erythematosus diagnosed by bronchoalveolar lavage]. PMID- 3656817 TI - [Infection, inflammation and immunity]. PMID- 3656818 TI - [Primary care in the hyperventilation syndrome]. PMID- 3656819 TI - [Evaluation of psychologic factors in chronic bronchial asthma]. PMID- 3656820 TI - [Psychosomatic approach to chronic pulmonary emphysema]. PMID- 3656821 TI - [Terminal care in patients with lung cancer]. PMID- 3656822 TI - [Clinical application of airway collapsibility measurements by abrupt interruption of airflow during forced expiration]. PMID- 3656823 TI - [Effect of acetazolamide on blood gas, ventilatory control and sleep in patients with chronic respiratory disease and sleep apnea syndrome]. PMID- 3656824 TI - [Usefulness of bronchoalveolar lavage in the diagnosis of diffuse pulmonary hemorrhage]. PMID- 3656825 TI - [Analysis of HLA-DR antigens and complement polymorphism in diffuse panbronchiolitis]. PMID- 3656826 TI - [A case report of lung cancer with sarcoid-like reaction in the primary tumor and regional lymph nodes]. PMID- 3656827 TI - [A case of fulminant psittacosis with severe respiratory failure, muscle weakness and DIC]. PMID- 3656828 TI - [Influence of crystalloid cardioplegia against immature myocardium. A water content study]. PMID- 3656829 TI - [Difference of responses to a cardioplegic solution between the immature and the mature myocardium]. PMID- 3656830 TI - [The effectiveness of cardioplegia with the modified Krebs solution for the open heart surgery in neonates and infants]. PMID- 3656831 TI - [Myocardial protection in open heart surgery in infants less than 18 months of age]. PMID- 3656832 TI - [Intracardiac surgery in infants under 3 months: technic of cardiopulmonary bypass and myocardial protection]. PMID- 3656833 TI - [Clinical experience using albumin-containing crystalloid cardioplegia in open heart surgery in infancy]. PMID- 3656834 TI - [A study of postoperative chylothorax in children]. PMID- 3656835 TI - [Two cases of dehiscence between stent and leaflets in porcine xenograft]. PMID- 3656836 TI - [Successful surgical treatment of thoracoabdominal aortic aneurysm--a case report]. PMID- 3656837 TI - [Two cases of malignant thymoma complicated with cardiac tamponade]. PMID- 3656838 TI - [Surgical experience of a case of common atrium associated with persistent left superior vena cava draining into left atrium--surgical consideration of simple ligation of the left superior vena cava]. PMID- 3656839 TI - [A successfully operated case of complete interruption of the aortic arch without patent ductus arteriosus]. PMID- 3656841 TI - [The 31P nuclear magnetic resonance (NMR) study of the preserved kidneys. III. Renal viability evaluated with intracellular pH]. PMID- 3656840 TI - [A case report of pulmonary blastoma without sarcomatous features]. PMID- 3656842 TI - [The 31P nuclear magnetic resonance (NMR) study of the preserved kidneys. IV. 31P topical magnetic resonance study of ischemic rabbit kidneys in vivo]. PMID- 3656843 TI - [Recovery of bladder function and sparing of sacral sensation in patients with spinal cord injury. A clinical study in patients with spinal cord injury]. PMID- 3656844 TI - [The effect of autonomic drugs on ureteral peristalsis and urine bolus volume in an in vivo canine model]. PMID- 3656845 TI - [Viability of the perfused dog kidney and enzymes in the perfusate]. PMID- 3656846 TI - [Clinical studies on urinary tract Candida infection with special reference to the diagnosis and treatment]. PMID- 3656847 TI - [Non-specific immune response in patients on continuous ambulatory peritoneal dialysis]. PMID- 3656848 TI - [Study on the motor innervation of the sphincteric urethra by means of the stereographic urethral pressure profile (stereo-UPP)--the effect of transection and stimulation of the hypogastric and pudendal nerve on the canine stereo-UPP]. PMID- 3656849 TI - [A retrospective clinical study of stage A prostatic cancer]. PMID- 3656850 TI - [A study on a human genital skin androgen receptor in patients with intersexuality]. PMID- 3656851 TI - [Clinical result of percutaneous nephrolithotripsy]. PMID- 3656852 TI - [Postoperative adjuvant chemotherapy of bladder cancer. The effects of cisplatin administration on cases with vascular invasion]. PMID- 3656853 TI - [Clinical study of testicular seminoma--analysis of anaplastic seminoma]. PMID- 3656854 TI - [Significance of selective renal biopsy for chance hematuria]. PMID- 3656855 TI - [Effects of postoperative adjuvant therapies in renal cell carcinoma]. PMID- 3656856 TI - [Experience with combined cisplatin and radiation therapy for advanced urinary tract transitional cell carcinoma]. PMID- 3656857 TI - [The clinical study of optical internal urethrotomy for urethral strictures: a review of 74 cases]. PMID- 3656858 TI - [Studies on the nontuberculous lung mycobacteriosis in Japan (report of the study year 1985 of the Mycobacteriosis Research Group of the Japanese National Chest Hospitals). Incidence rate of lung disease caused by Mycobacterium kansasii is still increasing which elevates the incidence rate of nontuberculous lung mycobacteriosis]. PMID- 3656860 TI - [Lung sounds in patients with pulmonary tuberculosis]. PMID- 3656859 TI - [Long-term results of short-course chemotherapy of pulmonary tuberculosis (second study--A). Results up to 6 years after the end of treatment with 4-6 month chemotherapy of pulmonary tuberculosis]. PMID- 3656861 TI - [A resected case with massive hemoptysis due to Mycobacterium scrofulaceum lung infection]. PMID- 3656862 TI - [A case of endobronchial tuberculosis of the middle lobe bronchus resembling submucosal lung carcinoma]. PMID- 3656863 TI - Fine art and nursing are natural allies. PMID- 3656864 TI - A time for reflections and dreams. PMID- 3656865 TI - [Glycosaminoglycans of the arterial wall: their role in atherosclerosis]. PMID- 3656866 TI - [Effect of treatment of patients with acute myocardial infarction with a lytic mixture (morphine-chlorpromazine-promethazine) on catecholamine excretion]. PMID- 3656867 TI - [Usefulness of nifedipine for myocardial protection in the surgical treatment of heart valve defects]. PMID- 3656869 TI - [Usefulness of the transesophageal cardiac stimulation test and post-exercise polycardiography for qualifying patients for rehabilitation after myocardial infarction]. PMID- 3656868 TI - [Plasma lipids in healthy men with types A and B personality patterns]. PMID- 3656870 TI - [Recurrent cardiac tamponade in pancreatic cancer]. PMID- 3656871 TI - [Echocardiographic diagnosis of ventricular septal defects]. PMID- 3656872 TI - [Function of the lymphatic system]. PMID- 3656873 TI - [Autoimmune response]. PMID- 3656874 TI - [Role of immune complexes in the development of inflammatory vascular diseases]. PMID- 3656875 TI - [Circulating immune complexes in peripheral vascular diseases]. PMID- 3656876 TI - [Various immunological aspects of chronic ischemia of the extremities]. PMID- 3656877 TI - [Experimental autoimmune myocardial damage. IV. Ultrastructural studies]. PMID- 3656878 TI - [Hypertension--the look into the future]. PMID- 3656879 TI - [Remote observations of patients with multivalvular heart defects not treated surgically (a group of patients examined at the Clinic for Heart Defects at the Institute of Cardiology 1981-1984)]. PMID- 3656880 TI - [Effectiveness of superficial cooling of the heart and St. Thomas cardioplegia in the light of ultrastructural studies in patients with mitral valve disease]. PMID- 3656881 TI - [Effect of long-term reperfusion on cardiac activity in patients after temporary exclusion of coronary circulation during multivalve surgery]. PMID- 3656882 TI - [Diagnosis of abnormal function of the Bjork-Shiley mitral valve and indications for reoperation]. PMID- 3656883 TI - [Protective effect of trifluoperazine on the ischemic myocardium]. PMID- 3656884 TI - [Preliminary evaluation fo diurnal measurements of blood pressure by automatic magnetic tape recording]. PMID- 3656885 TI - [Clinico-hemodynamic and x-ray parallels in patients with an artificial pacemaker]. PMID- 3656886 TI - [Changes in atrioventricular conductivity in the late period following transvenous destruction of the atrioventricular junction]. PMID- 3656887 TI - [Clinical angiographic dynamics of coronary atherosclerosis in ischemic heart disease patients (a 10-year observation)]. PMID- 3656888 TI - [Surgical treatment of children with ectopic atrial tachycardia]. AB - Up-to-date electrophysiologic investigations of the heart, carried out in 212 children with arrhythmias, demonstrated a focus of ectopic atrial tachycardia in 21 (9.9%); 17 of those underwent long-term treatment (up to 10 years) with antiarrhythmic drugs. Kordaron produced a positive effect (discontinuation of the attacks) in 1 case only. Combined use of several antiarrhythmic drugs controlled the frequency of tachycardia in 4 patients. Signs of dilatation cardiomyopathy were in evidence in 60% of children with permanent ectopic tachycardia. Seven of 12 patients who failed to respond to medication were eventually subjected to radical surgery. All but one were discharged from hospital without additional medication and with normal heart rhythm. One child developed groups of extrasystoles generated by the lower right-atrial portion during the 2nd week after surgery. They diminished and eventually disappeared after a supportive digoxin treatment. Surgery is therefore regarded as an effective and radical treatment for ectopic atrial tachycardia in children. PMID- 3656889 TI - [Possibilities for cardiac defibrillation using intravascular electrodes]. AB - The efficiency of electric defibrillation of the heart was assessed in 17 experiments where the position of action electrodes varied. It is suggested that intravascular application of one electrode plus extravascular application of the other gives the optimum effect. The duration of unassisted reversible fibrillation averaged 3 minutes. PMID- 3656890 TI - [Treatment of ventricular arrhythmias in patients with manifestations of heart failure]. AB - A comparative study of the efficiency of digoxin and "pure" antiarrhythmic agents was carried out in 56 patients with ventricular arrhythmias and signs of circulatory insufficiency (CI). Digoxin had arrhythmogenic effect in 20% of the patients, which was twice as frequent in the marked CI group. "Pure" anti arrhythmic agents were effective in 47% (ritmilen) to 71% (cordaron), and etmozin, in 63% of the patients, while adverse myocardial inotropic effect was only produced by ritmilen. Combined use of etmozin, ritmilen or cordaron with digoxin increases their antiarrhythmic efficiency. PMID- 3656891 TI - [Function of the heart conduction system in patients with progressive muscular dystrophy]. AB - Intracardiac electrophysiologic studies were carried out in 9 patients with progressive muscular dystrophy. Diagnostic stimulation of the heart demonstrated no sinus mode dysfunction. The intra-atrial conduction time increased to 72 +/- 7.1 ms (p less than 0.05), and the interatrial conduction time, to 97 +/- 12.5 ms (p greater than 0.05) in response to shortened testing stimulus delay in 3 patients. All 9 patients showed great variation in the duration of effective refractory atrial and atrioventricular periods (97.0 +/- 12.5 ms). The H-V interval increased from 43.9 +/- 4.3 to 73.9 +/- 7.6 ms (p less than 0.01) in response to shortened delay in 7 of 9 patients. Atrial pre-excitation resulted in a block of the right and left limbs of the His bundle in 5 of 7 patients. Third degree atrioventricular block was recorded by continuous ECG monitoring in 7 patient. It is suggested that an apparent or latent intraventricular conductivity disorder may be present in most cases of progressive muscular dystrophy. PMID- 3656892 TI - [Differential psychopharmacotherapy of heart rhythm disorders]. AB - Antiarrhythmic activity of psychotropic agents, such as phenibut, eglonyl, azaphen, grandaxin, fali-lepsin, is demonstrated for the first time ever in patients with paroxysmal supraventricular tachycardia, atrial fibrillation and ventricular extrasystole. It is dependent on the nature of the underlying heart disease, the psychopathologic syndrome and vegetative cardiac rhythm regulation type. Different trends of cardiac and hemodynamic change are produced by different psychopharmacologic agents. Differential long-term intermittent psychopharmacotherapy is proposed for the control of heart rhythm disorders. PMID- 3656893 TI - [Experience with the clinical use and the outlook for the development of the cardiac micromonitor]. PMID- 3656894 TI - [Disorders of the hemodynamics and myocardial structure in patients with infectious-allergic myocarditis complicated by heart failure]. AB - A study of 30 patients with infectious-allergic myocarditis, accompanied with chronic heart failure made use of echocardiography, hemodynamic assessment by cardiac catheterization, endomyocardial biopsy. A relationship is demonstrated between hemodynamic changes and the lesion of cellular ultrastructural apparatus, mitochondria, in particular. Patients with first-stage heart failure associated with infectious-allergic myocarditis showed incomplete diastole, while systolic changes were found in patients with severe manifestation of circulatory insufficiency. PMID- 3656895 TI - [Cholinesterase activity of blood monocytes in healthy subjects and ischemic heart disease patients]. AB - Cholesterolesterase activity was assayed in monocytes of coronary patients and normal controls matched for age and showing no evidence of coronary disease. Cholesterolesterase level of coronary patients was significantly lower than that of the controls this two-fold difference in activity being particularly significant in patients with stable angina of effort, functional class 3-4, and progressive angina pectoris. Control subjects tended to have higher cholesterolesterase values than would appear normal for their age. PMID- 3656896 TI - [The appearance and development of ventricular rhythm disorders in the 1st 24 hours after the start of experimental myocardial infarct in dogs]. AB - The emergence of ventricular tachycardia (VT), its temporal progress and response to high-frequency stimulation were studied in 10 dogs subjected to two-step occlusion of the left descending coronary artery (LDA). Within two hours after the LDA ligation under atrioventricular block all animals developed an atrioventricular nodal rhythm of 37 +/- 9 pulses per minute that could be suppressed by high-frequency ventricular stimulation, i.e. the so-called overdrive suppression (OS) phenomenon was occurring. Three or four hours after LDA ligation, atrioventricular block brought out VT in 8 dogs. The onset of VT was always abrupt, its episodes being short-lived at first and growing progressively longer with time. Once VT was established, its rate increased gradually to reach the peak that exceed the base line VT rate by 21 +/- 9% 2 or 3 hours later. As the VT rate increased, the OS phenomenon grew less pronounced and disappeared altogether as the VT peak was reached. The results suggest that the abrupt emergence of VT 3 or 4 hours after the onset of myocardial infarction can be a result of ectopic pacemaker activity of partially depolarized fibres that in some cases may be due to the effects of a trigger mechanism. PMID- 3656897 TI - [3-dimensional reentry in paroxysmal ventricular tachycardias: the results of electrophysiological mapping]. AB - The mechanism of sustained ventricular tachycardias with a focal type of activation initiated by an extrastimulus was studied in isolated rabbit heart ventricle preparations by endocardial and epicardial mapping. Sixty-four electrograms were simultaneously recorded using unipolar electrodes (32 on each side of the preparation). The electrodes were spaced 3 mm apart. Data recording and processing were computerized. Sustained (greater than 0.5 min) tachycardias of a focal type were registered in 6 of 17 experiments. In each case, the three dimensional macro-reentry mechanisms was involved. The closed circuit was around the intramural ischemic zone resulting from impairment of coronary circulation. Endocardial and epicardial points of early activation occurred at the sites where the wave passed from one surface to another. PMID- 3656898 TI - [A method of determining the location of the pacemaker in the canine right atrium]. AB - Theoretical calculations and experiments on hearts of open-chest dogs have demonstrated a possibility of localizing a spontaneous excitation focus by recording 2 intra-atrial delays representing differences in activation moments at 3 sites of the right atrium. Assuming myocardial homogeneity with respect to excitation spread velocity, it has been shown that the pacemaker can be localized by intersection of two hyperbola-like intra-atrial delay isochronisms with recording electrodes at their foci. In natural, i.e. nonhomogeneous myocardium, experiments have been conducted to simulate pacemakers with known co-ordinates by electrical stimulation of various sites within the right atrium. Comparison of experimental and theoretical data showed the present method to be able to localize the pacemaker with an error of +/- 3 mm, provided the pacemaker is between the recording electrodes where the intra-atrial delays do not exceed 60% of their maximum values. PMID- 3656899 TI - [Protective action of an antioxidant of the 3-hydroxypyridine class on the contractility and electrogenesis of the heart muscle in hypoxia and reoxygenation]. AB - The effect of SD-6, a 3-hydroxypyridine antioxidant, on the pattern of variation in contraction intensity, contracture and membrane potentials were assessed in experimental studies on isolated left ventricular papillary muscles of rats, exposed to hypoxia and reoxygenation. The antioxidant considerably limited hypoxic and reperfusion contracture, its efficiency increasing with a concentration reduced to 10(-7) g/ml. Contraction intensity and duration of action potentials, diminished by hypoxia, were only recovered by reoxygenation, if the antioxidant was present. It is assumed that the recovery of action potentials by reoxygenation in the presence of SD-6 may result from normalization of ATP-dependent outgoing current through the kappa channels, activated by ATP deficiency. The antioxidant capacity for levelling diverse durations of action potentials between normal and ischemic areas is evidence of an important contribution of free-radical mechanisms to the development of reoxidation-induced recirculation arrhythmias. PMID- 3656900 TI - [Methods and results of catheter electrodestruction in treating tachyarrhythmias]. AB - Catheter electrodestruction (fulguration) was used in 56 patients with supraventricular and ventricular tachycardias resistant to conservative treatment. Its procedure and results are described. Transvenous electrodestruction of the His bundle and proximal portions of the atrioventricular junction was performed in 40 patients. Complete atrioventricular block and pacemaker implantation were used in 39 patients. In 3 cases with first- or second-degree atrioventricular block, tachycardiac paroxysms were absent in the presence of an antiarrhythmic therapy. In 1 case, tachyarrhythmia recurred after 6 months, so that repeated catheter electrodestruction of the His bundle was required. Radical surgery was performed in 16 patients: electrodestruction of atrial arrhythmogenic zones in 5, that of complementary atrioventricular junctions in 9, and that of left-ventricular arrhythmogenic zones in 2. The results were successful (tachyarrhythmias resistant to conservative treatment disappeared altogether at 6 months to 3.5 years follow-up) in 52 patients. PMID- 3656901 TI - [Local ventricular fibrillation in an experiment]. PMID- 3656902 TI - [Complications of temporary transvenous cardiac electrostimulation]. PMID- 3656903 TI - [Treatment of paroxysmal forms of supraventricular tachycardia with falikard]. PMID- 3656905 TI - [Anti-arrhythmic effect of adenosine in experimental myocardial infarction]. PMID- 3656904 TI - [Use of Benzonal in patients with heart rhythm disorders]. PMID- 3656906 TI - [Absence of endothelium-dependent relaxation of isolated segments of the human coronary artery in coronary arteriosclerosis]. PMID- 3656907 TI - [Electrophysiological localization of heart block in patients with disorders of atrioventricular conductivity]. PMID- 3656908 TI - [Effect of corinfar on serum digoxin levels in patients with chronic cardiac insufficiency]. PMID- 3656910 TI - [Regional functions of the lungs after correction of hypervolemic congenital heart defects]. PMID- 3656909 TI - [Serum alcohol dehydrogenase activity in patients with cardiovascular pathology]. PMID- 3656911 TI - [25-year observation of a patient with early ventricular repolarization syndrome simulating recurrent myocardial infarction]. PMID- 3656912 TI - [Heparin therapy]. PMID- 3656913 TI - [Ventricular tachycardia: classification and clinical spectrum]. PMID- 3656914 TI - [Hypertrophic cardiomyopathy]. PMID- 3656915 TI - [Electrocardiographic mapping of the body surface]. AB - Body surface electrocardiographic mapping may permit a regionally selective examination of the electrophysiologic state of the heart. Evidence of regional sensitivity has been obtained from experimental studies in animals and observations in patients. Appropriate technology including multiplexing circuitry for simultaneous acquisition of multiple leads has been developed. Clinically practical lead systems consisting of 32 leads from which total thoracic potential distribution can be accurately estimated have been designed. Quantitative map analyses based on statistical representation of maps by coefficients and common basis functions have been developed. Clinical studies include definitions of normal map features and limited studies suggesting medical utility of body surface maps in the recognition of coronary arterial disease, prediction of ventricular arrhythmias and evaluation of patients with prolonged QT interval syndrome. PMID- 3656916 TI - [Use of the electric stimulation of the heart in sick sinus syndrome (achievements and disputable problems)]. AB - Experience with cardiac electrostimulation for the weak sinus node syndrome is presented. Between 1982 and 1985, 296 primary pacemaker implantations were performed, or 21.44% of all primary implantations performed over that period. The weak sinus node syndrome was diagnosed on the basis of ECG, Holter's monitoring and the atrial stimulation test. Initial atrioventricular conductivity disorders were recorded in 22.1%. Atrioventricular conductivity deteriorated in 16.1% of patients after 2 to 8 years of follow-up. The right ventricle was the principal stimulus application site in 267 patients, right-atrial stimulation was performed in 9, and double stimulation (radio-frequency right-atrial stimulation plus right ventricular or right-atrial stimulation on demand), in 20. Permanent atrial fibrillation developed in 25% of 144 patients, followed up for 2 to 8 years, and the implant was removed in 5 (14%) patients. PMID- 3656917 TI - [Arrhythmogenic effect of anti-arrhythmia agents in patients with paroxysmal supraventricular reciprocal tachycardia]. AB - A retrospective study of the results of consecutive testing of antiarrhythmic agents was carried out in 82 patients with paroxysmal reciprocal supraventricular tachycardia. Arrhythmogenic effects of anti-arrhythmic drugs were detected in 22 (6.1%) of 359 pharmacologic tests. The electrophysiologic basis of arrhythmogenic effect is delayed impulse conduction at some point of the blood flow pathway, conducive to the emergence or maintenance of the re-entry phenomenon. PMID- 3656918 TI - [Disorders of the regulation of cardiac rhythm in various sleep phases and cycles in organic and functional pathology of the heart]. AB - The purpose of the study was to examine the correlation between individual stages, phases and cycles of sleep, and the heart rate (HR) in patients with organic and functional cardiac disorders. Twenty normal subjects and 103 cardiologic patients were investigated. During sleep, tonic HR increases and dynamic changes decrease in coronary patients. During stage 4 of slow-wave sleep (SWS), HR increases in postmyocardial-infarction patients. The circadian decrease of HR disappears with every sleep cycle. Anginal patients have a disturbed HR pattern in the second SWS stage, the circadian rhythm is weak. In sleeping patients with functional disorders associated with paroxysmal atrial arrhythmias, HR changes are dependent on basal rhythm regulation type. In bradycardia, a HR slow-down is observed during paradoxical sleep, while the circadian rhythm pattern is weaker. In tachycardia, there is no typical HR slow-down during the first cycles of SWS. The circadian HR changes are clearly marked. PMID- 3656919 TI - [Effect of clonidine on the basic mechanisms of hemostasis, secretory activity of the stomach and the regulation of cardiac rhythm]. AB - A study of 31 individuals (8 normal subjects and 23 patients with peptic ulcer) demonstrated that a single therapeutic dose (0.002 mg/kg) of clonidine, administered to individuals with normal hemodynamic parameters, slightly reduced their heart rate (by 7-8%), and arterial blood pressure (by 12-19%), had a modulating effect on blood aggregation, unaffected blood sugar and depressed dramatically basal gastric secretion of acid and pepsin, and, to a lesser extent, that of bicarbonates. This range of clonidine effects suggests that it may be useful in combined cases of arterial hypertension and gastric hypersecretion, yet the treatment should be relatively short-term and low-dose, because of a risk of gastric vasoconstriction. PMID- 3656920 TI - [Stress-limiting systems and the problem of the prevention of arrhythmia]. AB - Marked systemic resistance to damaging effects of stress develops as a result of repeated short-term stress exposures. This kind of adaptation is ensured by the activation of stress-limiting systems, namely, the opioidergic, GABA-ergic, serotoninergic, as well as antioxidant and prostaglandin ones. Proceeding from the stress-limiting system concept, adaptation to repeated stress exposure, as well as metabolites, synthetic analogues and activators of stress-limiting systems were successfully used to prevent and eliminate cardiac arrhythmias and fibrillations associated with acute ischemia, myocardial infarction and postinfarction cardiosclerosis. Prospects of further studies of stress-limiting systems' metabolites and activators as antiarrhythmic agents are considered. PMID- 3656921 TI - [Recent angina pectoris: the first experience using programmed stimulation of the heart for the detection of the electrical instability of the heart ventricles]. AB - Programmed ventricular stimulation was performed in 41 patients with recent angina pectoris (RAP, defined as less than 3 months old), 14 patients after large focal myocardial infarction (MI) and 9 patients without organic heart disease (WHD). The prevalence and number of repetitive ventricular responses (RVR) after programmed stimulation with one to three extra stimuli (2 ms, 2 MDS) from 2 right ventricular sites at sinus rhythm and three basic pacing cycle lengths (600, 500 and 400 ms) were compared in RAP, MI and WHD patients. In 56% of WHD patients, 32% of RAP patients, and 22% of MI patients, RVRs were absent. Five or more RVR were provoked in MI patients only (43%). The incidence of ventricular fibrillation during programmed stimulation was 2.5% in RAP patients and 22% in MI patients. Differences in incidence are not significant, but show the influence of the severity or organic coronary arterial and left-ventricular damage on the prevalence of RVRs. Programmed stimulation seems to have no diagnostic value for the detection of electrical instability in RAP patients without a history of MI. PMID- 3656922 TI - [Prevention of myocardial damage during reperfusion of the coronary artery in dogs using dibunol combined with verapamil]. AB - An experimental study in 69 dogs examined the effect of isolated and combined use of dibunol and verapamil (isoptin) on the course of reperfusion of ischemized myocardium after 180 minutes' coronary occlusion. Verapamil alone had no protective effect on reperfused myocardium, whereas dibunol, and particularly its combination with verapamil, essentially limited the size of necrosis, reduced plasma CPK activity and animal mortality rate and maintained ultrastructural integrity of cardiomyocytes, which was accompanied by a decrease of plasma lipid peroxidation products and a stabilization of cardiomyocyte sarcolemma. The significance of membrane damage and uncontrolled calcium entrance into cardiomyocytes for the mechanism of myocardial damage at the recovery of coronary circulation is discussed. PMID- 3656923 TI - [Energy-related disorders of myocardial contractility in calcium overload of the cardiomyocytes]. AB - Langendorff perfusion of euthyroid rat heart with 10 mM phosphocreatine (PCr) in Krebs-Henseleit solution in conditions of Ca2+-paradox significantly potentiated the development of contracture and produced a 4-fold increase in perfusion pressure as compared to heart contractility in PCr-free, but otherwise similar conditions. Similarly, in case of hyperthyroid myocardium, addition of PCr into hypoxic perfusate (glucose omitted) in the presence of supranormal extracellular Ca2+ (5.0 mM) irreversibly inhibited the restitution of resting tension and developed tension during aerobic reperfusion. In the same conditions, PCr did not modulate contractility of euthyroid myocardium. These results are consistent with Ruigrok's hypothesis (1978) that intracellular Ca2+ redistribution is energy dependent, provided PCr can penetrate into cardiomyocytes and stimulate ATP dependent accumulation of Ca2+ in mitochondria, leading to an impairment of energy production. It is concluded that PCr exerts its cardioprotective effect only in case of a reversible (acute) phase of ischemia. PMID- 3656924 TI - [Role of disorders of calcium homeostasis in the development of ischemic contracture of the heart]. AB - The development of ischemic contracture in rat was evaluated in relation to glycolytic production of ATP and Ca2+ homeostasis. When the rate of glycolysis was reduced by glycogen depletion (swimming at 33 degrees C for 2 h, administration of isoprenaline or heart perfusion with it), the rate of ischemic contracture development increased. Isoprenaline increased the development of contracture in a dose-dependent manner, and dexamethasone potentiated the effect of isoprenaline. The decrease in the intensity of ATP/P1 exchange, probably reflecting the intensity of glycolytic phosphorylation of ADP, which, in our conditions, arose from ATP hydrolyzed mostly by Ca2+-ATPase and Na, K-ATPase, correlated with the development of ischemic contracture. Experiments with the rapid equilibration of the extracellular compartment with Ca2+ in various concentrations in the presence or absence of verapamil suggest that the development of ischemic contracture depends on the rate of Ca2+ accumulation in myoplasm. This rate of Ca2+ accumulation correlates with the rate of glycogenolysis and glycolysis which seems to produce ATP for active transport of cations. PMID- 3656925 TI - [Contractile function of the isolated heart in chronic adriamycin-induced myocardial lesions]. AB - Adriamycin, administered to rats for 4 weeks, caused insufficiency of isolated heart contractility with a twofold reduction of cardiac output in surviving animals. The same cumulative dose of adriamycin, administered to rats over 10 weeks, was not associated with any significant reduction of the heart's pumping function. However, heart rate increase by atrial electrostimulation that shortened the diastolic pause to a control level, also reduced the minute and stroke volumes by 38%, as compared to the controls. All animals showed increased diastolic stiffness of the left ventricle that must have interfered with its filling, particularly so in case of low inflow pressure, and disturbed atrial automaticity, as reflected in bradicardia in rats and supraventricular arrhythmia in guinea pigs. PMID- 3656926 TI - [Prevention of ischemic myocardial damage by reducing the intracellular free carnitine level]. AB - 3-(2, 2, 2-trimethylhydrazinium) propionate (THP) inhibits gamma-butyrobetaine hydroxylase, which is accompanied by a drop in myocardial free carnitin content. In rabbits, 200 mg/kg THP, administered intraperitoneally for 10 days, decreases free carnitin and long-chain acylcarnitin by 59.8 and 59.2%, respectively. In a carnitin-depressing dose, THP helps to recover contractility of isolated atria after hypoxic exposure. THP prevents isoproterenol-induced accumulation of long chain acylcarnitin and ATR fall in the rat myocardium. The protective effect of THP is realized in the presence of considerably reduced (by an average of 77.8%) myocardial free carnitin levels. Inhibition of carnitin-dependent fatty acids metabolism by reducing intracellular carnitin concentration is a pathogenetically justified method of myocardial protection against ischemic damage. PMID- 3656927 TI - [Characteristics of afferent innervation of the ischemic heart and the development of the pain syndrome]. AB - Pain excitation during myocardial ischemia and its electrostimulation were investigated by recording evoked potential and iris movement in cats. It has been demonstrated that pain perception of the heart declines at an early stage of ischemia, but increases noticeably after prolonged and repeated ischemia. PMID- 3656928 TI - [Chronotropic vago-sympathetic interactions during electric stimulation of cardiac nerves in the cat]. AB - It is demonstrated that sympathetic nerves may strengthen or depress the synchronizing or tonic components of vagal chronotropic effect, but the former was absent if extracardiac nerves were cut bilaterally. PMID- 3656929 TI - [Depression of fibrinolysis in long-term stress in the rat]. AB - A study of fibrinolytic and hemostatic effects of emotional/painful stress induced by Dosiderato's technique in white Wistar rats demonstrated, 4 hours after discontinuation of 6-hour stress exposure, a thrombophilic condition that is characterized by heavily depressed fibrinolysis in combination with increased blood antiplasmin and coagulation activities. It is suggested that depressed fibrinolysis is a result of depletion of fibrinolytic elements, plasminogen activator in particular. PMID- 3656930 TI - [Oxygen requirements of the arterial and venous walls after cholesterol administration to animals]. AB - An experimental study in rabbits examined the intensity of oxygen consumption by strips of thoracic and abdominal aortas, pulmonary and common carotid arteries, posterior caval and portal veins after 5, 15, 30, 60 and 120 days of cholesterol feeding. A biphasic pattern of changes was demonstrated in oxygen consumption by the vascular wall under experimental atherosclerosis. An increase in Qo2 was followed by a decrease of the intensity of oxygen consumption. The duration and magnitude of each phase was dependent on baseline oxygen consumption by the vascular wall, on total duration of cholesterol feeding and the doses administered. PMID- 3656931 TI - Chronic renal failure after nephrotoxic nephritis in rats: contributions to progression. AB - In rats dietary protein restriction decreases the rate of progressive glomerulosclerosis and the development of renal failure after subtotal nephrectomies. The present experiments were designed to see whether dietary protein had similar effects on renal failure after nephrotoxic nephritis (NTN). Groups of rats were fed isocaloric diets containing 8%, 18% and 78% casein. Irrespective of whether the diets were introduced 7 days or 30 days after induction of nephritis by a single injection of rabbit anti-rat nephrotoxic globulin, rats on 8% casein and 78% casein had significantly lower plasma creatinines than rats fed with 18% casein. Semiquantitative scoring systems were used to assess glomerular sclerosis, tubular atrophy and tubular calcification. Rats on 8% protein had significantly lower glomerular sclerosis scores than the other two groups. Tubular atrophy scores were similar in rats on 8% and 78% casein and significantly lower than those of rats on 18% casein. All rats on 8% and 18% casein diets had tubular calcification whereas rats on 78% casein did not. This suggested that the normal relation between glomerular sclerosis and tubular atrophy after NTN was altered by a 78% casein diet. This was confirmed by the slopes of the regression equation for glomerular sclerosis on tubular atrophy (0.54 +/- 0.07) for rats on 78% casein compared to the slopes of the regression equations for the other two groups which were 1.12 +/- 0.10 and 1.00 +/- 0.12, respectively. This difference is highly significant statistically, P less than 0.1 X 10(-5) (one-way analysis of variance). These results show that dietary protein has a variable effect on the development of renal failure after nephrotoxic nephritis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656932 TI - Viscoelastic properties of tubule basement membranes in experimental renal cystic disease. AB - Hereditary and acquired renal cysts develop from tubule segments that enlarge progressively. We measured the deformability of basement membranes surrounding individual normal tubules and cysts to determine if cysts might develop by simple extension of abnormally-deformable basement membrane in response to normal or increased transtubule hydrostatic pressures. Deformability (cm/dyne) was measured in individual tubules and cysts in vitro by a micropipet aspiration technique that related negative pressures within the pipet to the distance the tubule or cyst wall was aspirated into the pipet. Viscoelastic creep was determined from the time-dependent effect of pipet aspiration on membrane deformation. Proximal and collecting tubules, glomerular capsules and cysts were microdissected from controls and animals with acquired (Diphenylthiazole [rats]. Nordihydroguaiaretic acid [rats]), hereditary (C57 BL/6J [cpk/cpk] mice) and spontaneous (CFWw mice) renal cystic diseases. The major resistance to deformation was localized to the basement membrane since collagenase destroyed the elasticity of tubule and cyst walls. Tubule basement membranes adjacent to cysts appeared abnormal by electron microscopy in the animals fed DPT, but measurements of deformability and viscoelastic creep showed no differences between normal and cystic tubules in any animal model. Deformability values of cysts (7.7 +/- 1.1, 10.9 +/- 1.1, 11.2 +/- 0.6, 9.4 +/- 0.8 X 10(-3) cm/dyne in DPT, NDGA, C57 BL/6J and CFWw, respectively) are consistent with the interpretation that high transtubule pressures ranging from 39 to 134 cm H2O would be required if cysts form by simple stretching of the basement membrane secondary to a transepithelial hydrostatic pressure-gradient. Since in vivo measurements of hydrostatic pressures across cyst walls are not high enough we conclude that cysts do not enlarge due to increased deformability of tubule basement membranes. PMID- 3656933 TI - Mechanism of furosemide resistance in analbuminemic rats and hypoalbuminemic patients. AB - To elucidate the mechanism of resistance of hypoalbuminemic patients to furosemide, the effect of this diuretic on urine volume of normal and analbuminemic rats (NAR) and of hypoalbuminemic patients was studied. Intravenous administration of furosemide rapidly enhanced sodium diuresis in normal rats but not in NAR. Total plasma clearance and distribution volume of furosemide were much larger in NAR than in normal rats, while no significant difference in these pharmacokinetic parameters was observed for the unbound fraction of the diuretic between the two animal groups. In contrast, urinary secretion of furosemide was significantly lower in NAR than in normal rats. Injected furosemide bound to albumin markedly promoted diuresis in NAR, while the same dose of albumin alone had no effect, indicating that binding to albumin is essential for the delivery of furosemide to the kidney, the site for its action. Injection of the complex rapidly increased the urine volume of hypoalbuminemic patients who showed a marked resistance to this diuretic. Thus, the resistance to furosemide in both NAR and hypoalbuminemic patients may be explained on the same basis. PMID- 3656934 TI - Tubuloglomerular feedback in animals with unilateral, partial ureteral occlusion. AB - Previous experiments have shown that the sensitivity of the tubuloglomerular feedback system (TGF) is reduced by volume expansion in normal rats. This reduction in sensitivity is probably mediated by changes in the renal interstitial pressure. The present study was designed to investigate the TGF control system during volume expansion in rats with chronic, partial ureteral occlusion--hydronephrosis. Hydronephrosis was induced on the left or right side according to the method described by Ulm and Miller, in weanling Sprague-Dawley rats three weeks old. Three to six weeks later the rats were prepared for whole kidney and micropuncture experiments. Sham-operated animals were used as controls. Net interstitial pressure (that is, interstitial hydrostatic pressure minus interstitial oncotic pressure) was higher in the hydronephrotic, volume expanded animals than in the volume expanded controls. From findings in earlier investigations this increase in interstitial pressure would have been expected to reduce TGF sensitivity but this sensitivity was increased in the hydronephrotic kidneys, as indicated by a reduction in the turning point, the tubular flow rate at which 50% of the maximal stop-flow pressure response was observed (14.4 nl/min, sham-operated control 33.4 nl/min). Strong activity of the TGF mechanism was also indicated by a large proximal-distal difference in the single-nephron glomerular filtration rate (11.9 nl/min versus 3.3 nl/min in sham-operated controls) in the hydronephrotic kidney during volume expansion. Thus, in hydronephrotic kidneys in the latter condition the TGF mechanism was highly sensitive and activated to reduce the glomerular filtration rate. This mechanism may protect the diseased kidney from high intrapelvic pressures which otherwise could damage the kidney during saline volume expansion. PMID- 3656935 TI - The kinetics of ultrafiltration during peritoneal dialysis: the role of lymphatics. AB - Net ultrafiltration was measured directly during hypertonic peritoneal dialysis exchanges in rats. Simultaneously, lymphatic absorption was measured by monitoring the disappearance of albumin in the instilled dialysis solution from the peritoneal cavity. The albumin method for measuring lymphatic absorption was also tested in rats absorbing Lactated Ringer's solution from the peritoneal cavity where absorption rate could also be measured directly. The findings suggest the following: 1.) lymphatic absorption rate is similar with both hypertonic dialysis solutions and Lactated Ringer's solution; 2.) lymphatic absorption is substantial and net ultrafiltration is well below true transcapillary ultrafiltration; and 3.) in our model, lymphatic absorption occurs at a relatively constant rate over six hours of dwell time. PMID- 3656936 TI - Glomerular filtration effects of acute volume expansion: importance of chloride. AB - The present studies were done to determine the effect on GFR of acute volume expansion (AVE) using solutions of various sodium salts and to explore if degree of tubuloglomerular feedback (TGF) activation plays a role in any GFR differences. Free-flow micropuncture and inulin clearance studies were combined to investigate anesthetized Munich-Wistar rats expanded to 10% body weight with isotonic solutions of NaCl, Ringers bicarbonate (RB), NaHCO3, Na acetate (NaAc) and Na2SO4 as well as euvolemic controls. In the clearance studies, AVE yielded per gram kidney weight GFR's greater than control (1009 +/- 51 microliter/min) in the NaCl and RB (chloride expanded) groups (1397 +/- 89 and 1389 +/- 64) microliter/min, respectively, P less than 0.05 vs. control) but not in the NaHCO3, NaAc, and Na2SO4 (non-chloride expanded) groups. Proximal minus distal single nephron GFR determinations (P-D), an estimate of the degree of TGF, were less than control 13.2 +/- 2.1 nl/min) in the NaCl and RB groups (4.1 +/- 0.7 and 5.3 +/- 1.9 nl/min, respectively, P less than 0.05 vs. control) but were not significantly different from control in any of the non-chloride expanded groups. Early distal (ED) fluid flow correlated positively with P-D in all groups. ED chloride concentration but not TCO2 nor osmolality correlated with P-D for all groups. The correlation was negative for control and chloride expanded groups and positive for non-chloride expanded groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656937 TI - Glomerular hemodynamics in mercury-induced acute renal failure. AB - As manifest by tubular collapse and the virtual absence of flow into the glomerulotubular junction (GTJ), filtration in most nephrons (SNGFR) of rats poisoned with 9 mg/kg body wt HgCl2 16 to 28 hours earlier was virtually absent. Arterial colloid osmotic pressure (COPA) and Bowman's space pressure (PBS) were modestly depressed (P less than 0.05 or below), and mean blood pressure was reduced from 115 +/- 2 mm Hg (SEM) to 97 +/- 1 mm Hg (P less than 0.001). Glomerular capillary hydraulic pressure (Pg), 25.6 +/- 1.3 mm Hg was some 24 mm Hg lower than control (P less than 0.001) and yielded a net afferent effective filtration pressure (Pnet) of 4.1 +/- 1.2 mm Hg. Excluding three rats with values greater than 10 mm Hg, Pnet averaged 2.0 +/- 0.9 mm Hg (N = 17 rats) versus 20.0 +/- 1.8 mm Hg in controls (N = 10, P less than 0.001), the former being statistically almost indistinguishable from 0 mm Hg and barely able to support any filtration. This decrease in Pg was caused by a major increase in preglomerular resistance (RA) and a reciprocal fall in efferent arteriolar resistance (RE), the RA/RE ratio of 7.2 +/- 0.8 being fourfold higher than control (P less than 0.001). Renocortical blood flow was not different from control (P greater than 0.2). A wide spread of Pg values in individual glomeruli and the absence of tubular flow despite the appearance of i.v. injected lissamine green in a quadrant of surface glomeruli suggested the possibility of a greatly increased, glomerular capillary resistance. It is concluded that reciprocal changes in RA and RE are the immediate cause of filtration failure in this form of ARF and that, in the virtual absence of filtration, tubular leakage can play no important role. Since PBS was depressed in both the developmental and established phases of ARF, tubular obstruction appears to play no direct role in the pathogenesis of this particular model of murine acute renal failure. PMID- 3656938 TI - Morphometric aspects of reflux nephropathy. AB - We have studied the relationships between renal size, glomerular hypertrophy and sclerosis and renal function in adults with reflux nephropathy. A digitizer was used to measure the renal surface areas in intravenous pyelogram films. This was then corrected for patient size by dividing by the area of the first three lumbar vertebrae. In renal biopsies, glomerular surface area and the proportion of segmentally and globally sclerosed glomeruli were measured and compared with a control group of 17 renal donors. Of 57 patients studied, 45 had intravenous pyelogram films and 32 had renal biopsy tissue available from the time of presentation, 20 had both. Thirty-one were followed for two years or more (median 6 years, range 2 to 11 years). There were positive correlations between corrected renal size and renal function, and inverse correlations between these and maximum glomerular size, the proportion of sclerosed glomeruli and vascular wall thickness. Proteinuria correlated best with the proportion of segmentally sclerosed glomeruli. As a prognostic guide, the strongest correlations were between rate of functional decline and percent segmental sclerosis, urine protein excretion and creatinine clearance at presentation. These studies confirm expected relationships between renal size, glomerular size and renal function and suggest that the severity of segmental sclerosis is a major factor in eventual decline into renal failure. PMID- 3656939 TI - Effect of dialysate composition on intercompartmental fluid shift. AB - Effect of dialysate composition on intercompartmental fluid shift and hemodynamics was studied in 12 patients during 1.5 or 2 hours of hemodialysis without net ultrafiltration, using high (H;Na 154 mmol/liter), normal (N;Na 140 mmol/liter) or low (L:Na 126 mmol/liter) concentration dialysate. H dialysate was associated with a small (0.9%) increase in blood volume, a larger increase in plasma volume and a decrease in erythrocyte volume. L dialysate resulted in a 2.3% decrease in blood volume, a larger decrease in plasma volume and an increase in erythrocyte volume. N dialysate gave results which were intermediately between the other two dialysis conditions. There was no difference in the post-dialysis mean arterial pressure between the groups, although heart rate increased more during H dialysis than during the other two conditions. Change in blood and erythrocyte volume correlated significantly with change in plasma Na concentration and osmolality, but not with change in plasma urea concentration. We conclude that dialysate composition affects the movement of water into and out of the plasma and erythrocytes in a manner that can be accounted for by altered plasma concentrations of osmotically active substances. PMID- 3656940 TI - The prognosis of segmental glomerulonephritis in systemic lupus erythematosus. AB - Severe segmental glomerulonephritis (Seg GN) (greater than or equal to 50% involvement) in systemic lupus erythematosus (SLE) is classified as diffuse GN (DPGN) in the WHO classification. We tested the validity of the assumption that severe Seg GN and DPGN have the same prognosis by determining the proportion of glomeruli involved by active segmental inflammation in a series of 127 patients and by comparing the prognosis in various categories of Seg GN with patients with DPGN. In Seg GN we found mild involvement (1 to 19%) in 19 patients, moderate involvement (20 to 49%) in 9 patients and severe involvement (greater than or equal to 50%) in 17 patients. There were 28 cases of DPGN. The actuarial five year survival of patients with mild and moderate Seg GN was 82%. The survival of patients with severe Seg GN and DPGN were 59 and 53%, respectively. The incidence of adverse outcomes, including death, end-stage kidney disease, and deterioration of renal function was similar in patients with severe Seg GN and DPGN, and greater than in patients with mild and moderate Seg GN. Although there was a trend associating increasing glomerular involvement with elevated urinary protein excretion and serum creatinine and decreased serum C3 and C4, the differences were not significant. Cumulative prednisone dose and prednisone given in the first and second years following biopsy were not different in the various categories of Seg GN and DPGN, suggesting that differences in outcome were not related to the amount of prednisone therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3656941 TI - Cellular and non-cellular compositions of crescents in human glomerulonephritis. AB - The composition of glomerular crescents was examined on the frozen kidney sections obtained from 10 patients (5 patients with IgA nephropathy, two with Henoch-Schonlein purpura nephritis and three with glomerulonephritis due to undetermined etiology) using well-defined monoclonal and polyclonal antibodies to coagulation proteins, extracellular matrices, intermediate filament proteins and immune cells. Fibrinogen/fibrin related antigens (FRA), which were stained with anti-fibrinogen serum, were positive in the crescents of all the patients, but monoclonal antibody to crosslinked fibrin or von Willebrand factor (factor VIII related) antigen did not bind to the crescents. This suggests that the FRA deposited in the crescents is fibrinogen or its degradation products rather than fibrin. Staining for intrinsic components of renal basement membrane, including type IV and V collagens, laminin and fibronectin, were consistently positive in all stages of the crescents. Cytokeratin, showing cytoplasmic staining of the glomerular parietal epithelium and tubular epithelium in the normal kidney, was demonstrated in three patients with cellular crescents. Vimentin, which is normally distributed in parietal and visceral epithelial cells in the glomeruli and interstitial cells, was found at all stages of the crescents. These findings suggest that in the early stage of crescent formation, glomerular epithelial cells play an important role, and that the accumulation of intrinsic basement membrane constituents is associated with the formation and progression of the crescents. None of the crescent cells reacted with either of two monoclonal antibodies (Mo2 and FMC 32) to monocytes/macrophages or with nonspecific esterase staining. It seems that, at least in our patients, monocytes are a minor factor contributing to the formation of glomerular crescents. PMID- 3656942 TI - [Necrotizing enterocolitis of the newborn infant. 4. Prevention, detection of early signs]. PMID- 3656943 TI - [Personal experiences with Catergen treatment in the neonatal period, infancy and childhood]. PMID- 3656944 TI - [Experience with micro-erythrocyte sedimentation rate in ambulatory pediatrics]. PMID- 3656945 TI - [Significance of risk factors in cerebral movement disorders]. PMID- 3656946 TI - [Degree of prepuce looseness and ability to independently retract the prepuce in preschool boys: 2 main prerequisites in teaching good personal hygiene to the male sex]. PMID- 3656947 TI - [Surgical treatment of neurovascular compressive thoracic outlet syndrome]. PMID- 3656948 TI - [Prognosis of the results and individual approach to the conservative treatment of patients with arteriosclerotic occlusion of the major arteries of the extremities]. PMID- 3656949 TI - [Complications and mortality after amputation of the extremity in arteriosclerotic gangrene]. PMID- 3656950 TI - [Status of muscle blood flow in the lower extremities in arteriosclerosis obliterans in middle-aged and elderly patients]. PMID- 3656952 TI - [Functional state of regional hemodynamics in patients with diabetes mellitus and arteriosclerosis obliterans of the lower extremities]. PMID- 3656951 TI - [The hemostasis system in patients with arteriosclerotic and autoimmune lesions of the peripheral arteries]. PMID- 3656953 TI - [Serratus anterior muscle as an autotransplant for plastic microsurgery]. PMID- 3656954 TI - [Current aspects of reconstructive-restorative operations in the postphlebitic syndrome]. PMID- 3656955 TI - [Changes in peripheral arterial hemodynamics of the lower extremities in varicose veins]. PMID- 3656956 TI - [Creation of arteriovenous anastomoses for the prevention of thrombosis in reconstructive operations on the arteries]. PMID- 3656957 TI - [Lymphatic system of the extremities in thrombophlebitis]. PMID- 3656958 TI - [Anatomical-surgical substantiation of obtaining an inguinal cutaneous flap on a vascular pedicle]. PMID- 3656959 TI - [Surgical treatment of endarteritis obliterans]. PMID- 3656960 TI - [Reconstructive operations on major arteries of the lower extremities in middle aged and elderly patients]. PMID- 3656961 TI - [Analysis of complications and mortality after interventions on the aorta and major arteries in acute ischemia]. PMID- 3656962 TI - [Reoperations in acute thrombosis and embolism of major arteries of the extremities]. PMID- 3656963 TI - [Selection of a method of treating diabetic angiopathy of the lower extremities complicated by a suppurative-necrotic process]. PMID- 3656964 TI - [Treatment of patients with occlusion of the peripheral arteries of the lower extremities]. PMID- 3656965 TI - [Treatment of venous insufficiency after replantation of the fingers]. PMID- 3656966 TI - [Simultaneous surgical treatment of varicose veins of the lower extremities and uterine fibromyoma]. PMID- 3656967 TI - [Ways of increasing the effectiveness of the complex treatment of non-healing trophic varicose ulcers]. PMID- 3656968 TI - [Various problems of surgical services in relation to the organization of rehabilitation of patients with arteriosclerosis obliterans of the lower extremities]. PMID- 3656969 TI - [Aneurysm of the left common iliac artery simulating an intestinal tumor]. PMID- 3656970 TI - [Injury of the iliac vessels during appendectomy]. PMID- 3656971 TI - [Surgical treatment of patients with cervical rib syndrome]. PMID- 3656972 TI - [Changes in the cervical spine in Raynaud's disease and syndrome]. PMID- 3656973 TI - [Profundaplasty as a method of improving the blood supply of the lower extremities in occlusive vascular diseases]. PMID- 3656974 TI - [Effect of correction of rheological indicators of the blood on the results of treatment of patients with occlusive arterial diseases of the extremities]. PMID- 3656975 TI - [Aneurysms of anastomoses after revascularization of the lower extremities]. PMID- 3656976 TI - [Multiple thromboembolic complications in a patient with endarteritis obliterans of the lower extremities]. PMID- 3656978 TI - [Pulmonary thromboembolism after emergency surgical interventions]. PMID- 3656977 TI - [Treatment of suppurative-septic and gangrenous lesions of the lower extremities in diabetes mellitus]. PMID- 3656979 TI - [Isolated damage of the abdominal aorta in a stab injury of the abdomen]. PMID- 3656980 TI - [A case of postural crush syndrome]. PMID- 3656981 TI - [Characteristics of active closed drainage of infected wounds after reconstructive operations on the blood vessels]. PMID- 3656982 TI - [Surgical treatment of valvular insufficiency of the lymphatic vessels of the lower extremities and external genital organs]. PMID- 3656983 TI - [A rare case of coarctation of the abdominal aorta]. PMID- 3656984 TI - [Surgical correction of vertebrobasilar insufficiency]. PMID- 3656985 TI - [A device for the prevention of subcutaneous hemorrhages during phlebectomy]. PMID- 3656986 TI - [Reconstructive surgery in arteriosclerosis obliterans of the lower extremities]. PMID- 3656987 TI - [Acral melanoma]. PMID- 3656988 TI - [Problems in diagnosis and surgical and orthopedic treatment of patients with osteomyelitis of the pelvic bones]. PMID- 3656989 TI - [Recurrent hematogenic osteomyelitis of tubular bones]. PMID- 3656990 TI - [Prognosis and prevention of postoperative suppuration]. PMID- 3656991 TI - [Relaparotomy after operations on the abdominal cavity]. PMID- 3656992 TI - [Superior median laparotomy in operations on the biliary tract]. PMID- 3656993 TI - [Gastric stasis and its prevention in the early postoperative period after vagotomy with concomitant stomach drainage]. PMID- 3656994 TI - [Disorders of lymph drainage and their surgical correction]. PMID- 3656995 TI - [Prevention and treatment of surgical infection]. PMID- 3656996 TI - [Use of laser irradiation in the treatment of suppurative wounds]. PMID- 3656997 TI - [Bacteremia in diffuse peritonitis]. PMID- 3656998 TI - [Endoscopic papillotomy at a surgical clinic]. PMID- 3656999 TI - [Comparative evaluation of various methods of hemostasis in operations on the liver and spleen]. PMID- 3657000 TI - [Surgical treatment of cholelithiasis]. PMID- 3657001 TI - [Experiences in anatomical and atypical resection of the liver]. PMID- 3657002 TI - [Endoprosthesis--a new trend in vascular surgery]. PMID- 3657003 TI - [Treatment of acute peptic ulcer hemorrhage]. PMID- 3657004 TI - [Use of the laser in combined surgical treatment of patients with stomach cancer]. PMID- 3657005 TI - [Surgical treatment of patients with cancer of the rectum complicated by inflammation]. PMID- 3657006 TI - [Changes in hemodynamics during preparation of proctologic patients for surgery using the intestinal lavage method]. PMID- 3657007 TI - [Principles of infusion-transfusion therapy in operations on the lungs]. PMID- 3657008 TI - [Value of assessing the autonomic nervous system in bronchial asthma in selecting the surgical treatment method]. PMID- 3657009 TI - [Extraorganic cysts of the retroperitoneal space]. PMID- 3657010 TI - [Pneumocompression in preoperative management of patients with postoperative ventral hernia]. PMID- 3657011 TI - [Disorders of function in pitting of the optic disk]. AB - Using 44 eyes with optic disk pits as reference material, these pits are described with particular attention to the functional disturbances which accompany them. Visual acuity is reduced in about 50% of eyes thus affected. In two-thirds of the cases the deterioration in visual acuity occurs suddenly and without warning, prompting the patient to see an ophthalmologist. The cause of the sudden disturbance of vision is the formation of subretinal fluid, which presumably originates in the vitreous and then passes through the pit into the subretinal space. In the present study it was demonstrated that pits in the optic disk are also accompanied by a defect in the nerve fiber layer. Under meticulous examination these scotomas can be identified both in static perimetry by their steep scotoma rims and ophthalmoscopically by the absence of the nerve fiber layer and of subretinal fluid. The nerve fiber defects often cause only small scotomas which go unnoticed by the patient. In some cases, when they affect the center, they can also result in reduced visual acuity and strabismus. PMID- 3657012 TI - [Argon laser trabeculoplasty in special forms of open-angle glaucoma]. AB - Argon laser trabeculoplasty was performed in 71 eyes with complicated forms of open-angle glaucoma and insufficiently regulated intraocular pressure. The follow up time was 18 +/- 6 months. The success rate was 35% in the group with secondary forms of glaucoma (37 treated eyes). Depending on the special indication a great difference in the subgroups was noted: the ALT failed in 4 cases of glaucoma after trauma, but was successful in 45% of all cases of aphakic glaucoma. Thirty four eyes were treated by ALT after trabeculectomy had failed. The success rate in this group was 71%. PMID- 3657013 TI - [Fluctuations and stable elements in the visual field in glaucoma]. AB - In glaucomatous visual fields there are more fluctuations than stable elements. High-amplitude fluctuations of stimulus threshold values are characteristic of glaucoma. The correlation between sensitivity and the mean loss can be demonstrated by the ABC test. The structure of scotomas is explained. There is a stable, relatively small nucleus (a) of individual defects which stay in the same location for three years and mainly have the most severe loss (greater than or equal to 2.0 logE). However, accompanying and border fluctuations (b and c) predominate. They are detected by recording individual defects. The results of a study lasting several years are communicated, in which 1124 visual field examinations were performed in 146 patients using the Peritest computer controlled perimeter. PMID- 3657014 TI - [Iris claw lens]. AB - The iris claw lens does not have some of the disadvantages of lenses fixed in the anterior chamber angle. It is clipped to the iris from the front and does not touch the structures of the angle. It is useful as a stand-by lens and for secondary implantations, as well as for certain other indications, such as a traumatized eye with anterior synechiae. It is conceivable that in the future this lens type may gain in importance as a carrier of a concave optic for use in myopic eyes. PMID- 3657015 TI - [Study of early glaucomatous visual field defects with the automatic perimeter Topcon SBP-1000. Comparative study with the Octopus 201 perimeter]. AB - The automatic perimeter TOPCON SBP-1000 uses light emitting diodes (LED's) for stimulus generation and thus completely differs from the projection type perimeter OCTOPUS 201. In order to get some first idea about the capabilities of the TOPCON SBP-1000 22 eyes of 18 patients with early glaucomatous visual field defects were examined both with the glaucoma program/TOPCON SBP-1000 and program 31/OCTOPUS 201. Field defects were divided into three groups according to the total loss (program DELTA/OCTOPUS 201): group I with a total loss of 0 dB, group II with a total loss of 1-200 dB, group III with a total loss greater than 200 dB. Evaluation and comparison of visual field results is done after discussing the most important technical parameters and fundamental aspects of methods and strategies using the total percentage of "normal" test points, "small relative defects", "deep relative defects" and "absolute defects". We could show that specificity and sensitivity for the detection of earliest field defects are quite equal both in the TOPCON SBP-1000 and in the OCTOPUS 201. Concerning the detection of more pronounced visual field defects the TOPCON-perimeter has a somewhat smaller sensitivity as a result of the different definition of the category "normal"; at the same time there is a tendency for showing up more "absolute defects" instead of "deep relative defects". Technical parameters and strategies are discussed critically taking into consideration the practical experience obtained during this first routine testing. PMID- 3657016 TI - [Candida retinitis following gastrectomy]. AB - The authors report on a 68-year-old patient who developed disseminated retinochoroiditis and vitritis following extensive gastrectomy for a cardial carcinoma. The clinical diagnosis of an endogenous Candida infection was confirmed by positive identification of Blastomyces from the subclavian catheter tip and the antibody titer. Resolution was achieved with orally administered ketoconazole and intravenously administered miconazole therapy. PMID- 3657017 TI - [Determining visual acuity]. AB - Ophthalmologists today need to be able to determine visual acuity accurately more and more frequently. The result depends not only on the optotypes but also on the investigation methods used. Possible errors are discussed. PMID- 3657018 TI - [Centering of eyeglasses with special reference to aspheric single-power lenses]. AB - In the positive power range, aspheric single-power lenses have clear advantages for the spectacle wearer over highly curved spherical lenses in terms of cosmetic appearance and comfort in wear. Correspondingly flat spherical lenses would not be acceptable, due to their dramatically poorer image reproduction properties. Only with an aspheric surface design is it possible to combine a flat lens with optimum image reproduction properties. In order to realize these advantages of aspheric surfaces, the lenses have to be centered in accordance with the ocular pivot point. Several examples are given to illustrate the effects of incorrect centering on the image reproduction properties of both spherical and aspheric single-power lenses. The negative effect of incorrect centering in accordance with the ocular pivot point is clearly far greater with the mathematically much more complex aspheric surfaces than with highly curved spherical lenses. Although the image reproduction quality of the aspheric lens is superior--at least on paper--when it is correctly centered, it is equally true that in practice these lenses quickly prove inferior if incorrectly fitted. PMID- 3657019 TI - [Possibilities and limits of marking the visual axis of the cornea using the surgical microscope]. AB - In procedures involving refractive corneal surgery, as in the fitting of conventional optical devices for visual correction, the question of correct centering arises, i.e., the surgeon has to determine and mark the point of intersection of the visual axis on the cornea. The operating microscope, which is in any case used for the surgical procedure, provides the simple means of performing this task. The practical application of this procedure, the theory behind it, and suggestions as to possible instrumentation are the subject of this paper. PMID- 3657020 TI - [Light phenomena in the dislocation of artificial lenses in a model trial]. AB - Light phenomena evoked by a Kratz elliptical posterior chamber lens, a Mark Choyce IX anterior chamber lens, and a four-loop Binkhorst anterior chamber lens were investigated in a model with pupils of various sizes. Besides monocular diplopia, the edge of the lens produces scattered light phenomena which vary according to the type of lens as well as the size of the pupil. It makes little difference whether the beam of light strikes the surface of the lens perpendicularly or at an angle of 30 degrees. Of the three lenses tested, the four-loop Binkhorst lens caused the most intense scattered light, due to the fixation of its haptic near its center. PMID- 3657021 TI - [Refraction of the dog eye]. AB - The refraction of 50 eyes of nonsedated dogs was measured by retinoscopy. The slightly hyperopic to middle-grade myopic refraction found in earlier studies was seen in individual cases; however the mean value of 0.5 D is close to emmetropy. The differences in the results of measurements made under non-influenced accommodation and cycloplegia were not significant. Keratometry with the Javal ophthalmometer showed a mean cornea radius of 8.77 mm. A average axial length of 20.9 mm was determined by sonography. In some instances the parameters examined varied considerably. PMID- 3657022 TI - [Pars plana vitrectomy in chronic uveitis]. AB - Sixty-eight patients (74 eyes) with chronic endogenous uveitis underwent pars plana vitrectomy. An increase in visual acuity was observed in 70% postoperatively. Visual results basically depended on the extent of previous damage to the macula. A lensectomy-vitrectomy was done in 23 eyes, while 51 eyes underwent merely a pars plana vitrectomy. The frequency and severity of uveitic relapses were diminished in virtually all cases. PMID- 3657023 TI - [Treatment of retinopathy of prematurity in the light of experimental studies]. PMID- 3657024 TI - [Evaluation of the effectiveness of ultrasonic therapy of selected diseases of the visual system]. PMID- 3657025 TI - [Experimental studies of retinal ultrastructure after using polyester implants]. PMID- 3657026 TI - [Experimental studies of the ultrastructure of the sclera and choroid after using polyester implants]. PMID- 3657027 TI - [Vitrectomy and intraocular tamponade in the treatment of extensive penetrating wounds of the eye. Preliminary report]. PMID- 3657028 TI - [Vitrectomy in surgery of the anterior and posterior segments of the eye. Personal experiences]. PMID- 3657029 TI - [Surgical treatment of retinal detachment using the microscope]. PMID- 3657030 TI - [Fate of residual subretinal fluid after surgical treatment of retinal detachment]. PMID- 3657031 TI - [Use of Hyalcon in the treatment of retinal detachment]. PMID- 3657032 TI - [Role of intravitreal injections of silicone oil in the surgery of the vitreous body and retina]. PMID- 3657033 TI - [Proceedings of the 15th Retinology Symposium. Poznan, 22-23 May 1986. I]. PMID- 3657034 TI - [Effect of tolazoline and papaverine on retinal blood vessels]. PMID- 3657035 TI - [Accidental saline poisoning in newborn infants. Morphologic findings and pathogenetic discussion]. AB - In the nursery of an Austrian hospital, five newborns accidentally received 10% natrium chloride solution by infusion or oral feeding. Because of wrong labelling by the hospital pharmacy the solution was taken for 10% glucose. In all five newborns, bradycardia, edemas, cyanosis and cramps occurred. In all cases, autopsy revealed a fatal haemorrhagic encephalopathy and more or less extended haemorrhages of the lungs, the kidneys and the liver. There was no suppurative pneumonia and no arteritis. The intracerebral bleedings, thromboses and necroses may be provoked by tissue shrinking caused by hypernatraemic dehydration. The cerebral lesions again cause hyperosmolarity leading to death in most cases. Peritoneal dialysis which may be life-saving in some cases, unfortunately has not been performed in the present cases. PMID- 3657036 TI - [Use of continuous arteriovenous hemofiltration in diuretic-resistant hypervolemia and electrolyte disorders]. AB - CAVH was carried out in 10 olig/anuric children with diuretic resistant hypervolemia. In addition, three children had hypercalcemia and one child hypernatremia. All but one needed artificial ventilation for pulmonary edema and positive inotropic cardiac support. Mean duration of CAVH for correction of fluid and electrolyte imbalance was 51.5 hours (range 20-144 hours). The mean fluid removal of 1715 +/- 1479 (SD) ml decreased mean body weight from 21.4 +/- 18.9 (SD) kg to 19.2 +/- 17.0 (SD) kg. The electrolyte disorders were corrected within 18-24 hours. After correction of fluid overload and electrolyte imbalance 7 children could be extubated and cardiac support could be stopped. Two children died because of multiple organ system failure. CAVH was well tolerated by all children, no hemofiltration related complications occurred. CAVH is an effective and safe extracorporal renal replacement therapy system to correct fluid- and electrolyte imbalances in critically ill children. It can be installed easily and quickly, can be performed in every pediatric intensive care unit and is well tolerated even by small children. PMID- 3657037 TI - [Administration of creatine and creatinine with breast milk and infant milk preparations]. AB - Creatine and creatinine intake can cause increased urinary creatinine excretion. To estimate the contribution of diet to creatinine excretion in infants, creatine and creatinine were determined in human milk, pasteurized cow's milk and formulas for preterm and term infants. Soy-based formulas did not contain creatine and creatinine. Average concentrations in human milk (creatine 77 [60-100] mumol/l, creatinine 52 [41-65] mumol/l) were markedly lower than in pasteurized cow's milk which contained 598 (476-640) mumol/l creatine and 105 (79-122) mumol/l creatinine. Creatine and creatinine concentrations differed widely in formulas for both preterm and term infants, from 155-559 and 33-174 mumol/l, respectively. The influence of ingested creatine on creatinine excretion should theoretically be negligible. On the other hand, based on known absorption data, creatinine from the diet should increase creatinine excretion in a 3-month-old infant up to an amount in the range of 5.3-28.4% of the endogenous production. Therefore creatinine ingestion should be taken into account when interpreting creatinine excretion in infants. PMID- 3657038 TI - [Lymphangiomum cysticum congenitum of the left half of the face in a newborn infant]. AB - In a mature dystrophic newborn a huge tumor of the face was evident. The left eye could not be seen, the left choana was obstructed, the left angle of the mouth was pushed caudally. Sonographically cystic and solid areas could be found. The cranial computer tomography showed normal intracerebral structures but some evidence of infiltration into the frontal brain. The left ocula was widened and the left eye was found within the tumor mass. Angiographically an abnormal vascularisation of the tumor could not be seen. In spite of corticoid therapy a rapid growth led to life-threatening obstruction of the airways. At the age of 6 weeks the tumor was totally extirpated. A small piece of dura mater was replaced by periost. The wound could not be closed. Histologically the diagnosis of lymphangioma cysticum congenitum was made and increased growth tendency were found. Four weeks postoperatively the baby was discharged. Several cosmetic operations with unpredictable results will be necessary. A close psychologic guidance is recommended. Localisation, size, and life-threatening growth of a benign lymphangiomum are very uncommon. PMID- 3657039 TI - [Rett syndrome--case report]. AB - We report on a 13 years old girl with Rett syndrome (autism, dementia, ataxia and loss of purposeful hand use in girls). The Rett syndrome is unexpectedly frequent (1:15,000 in 1-14 years old girls). The diagnosis is based solely upon clinical development observation. Typical false diagnoses are: autism, some types of epilepsia, deprivation, cerebral palsy, degenerative encephalopathy, infantile psychosis and types of ataxia. The etiology is unknown, genetic factors, possibly an X-linked dominant new mutation, explain many, but not all findings. The empiric recurrence-risk is apparently low. PMID- 3657040 TI - [Non-immunologic hydrops fetalis (NIHF)--case report of double partial trisomy 15q and 17q resulting from familial translocation 15/17 and cytogenetic findings in 50 cases with hydrops fetalis]. AB - We report the first case of non-immune hydrops fetalis (NIHF) with trisomy 15q11/17q22.5 resulting from a familial translocation 15/17. Furthermore the cytogenetic findings of 50 cases with hydrops fetalis are presented. Of the 30 cytogenetic analyzable cases 7 showed chromosomal abnormalities (4x45,X; 2x47,XY,+21; 1x47,XY,+13). In every case of NIHF a chromosomal analysis should be performed if possible from different tissues. PMID- 3657041 TI - Altered calcium metabolism in red blood cells of hypertensives: persistent marker or sequel of essential hypertension? AB - The characteristics of the increased calcium (Ca) influx observed in metabolically depleted red blood cells (RBCs) of hypertensive patients were investigated. Twenty-four normotensives, 16 untreated essential hypertensives, and 10 essential hypertensives under sufficient blood pressure control by 50-100 mg/day atenolol were studied. Free intracellular concentrations of Ca, sodium (Na), and potassium (K) were assessed using ion-selective electrodes in freeze thawed RBCs, which were metabolically depleted by 30 mM desoxy-glucose at 37 degrees C for 48 h. In the treated hypertensives values for Ca and K at 24 and 48 h were not different from values for the normotensives, whereas elevated Ca was found in RBCs of untreated hypertensives. Na in treated hypertensives was significantly increased at 0 and 48 h, thus, being similar to values for untreated hypertensives. Additionally, RBCs of six normals were stressed in a glass/teflon potter. Before metabolic depletion electrolytes were not affected by this procedure, while Ca at 24 and 48 h of metabolic depletion increased to significantly higher values for the hypertensive patients as compared to the controls. These results suggest that the altered Ca metabolism in the RBCs of hypertensives may reflect a secondary phenomenon due to the mechanical damage to RBCs by the elevated blood pressure. PMID- 3657043 TI - [Hypercalcemias in chronic lymphatic leukemias and other non-Hodgkin's lymphomas]. AB - Three years after diagnosis of chronic lymphocytic leukaemia in a 57 year old man developed a hypercalcaemia with multiple bone fractures, concomitant an increase of activity of the leukaemia. There was no hyperparathyroidism, nor in serum, nor inside the lymphocytes. The osteopenia was caused by leukaemic infiltrations. An additional activation of osteoclasts was caused by an osteoclasts activating factor (OAF), produced by the leukaemic cells. 2 (= 2.25%) of 89 Non-Hodgkin Lymphomas except chronic lymphatic leukaemia had a moderate hypercalcaemia with concomitant activation of the underlying disease. 9 (= 7.7%) of 116 chronic lymphocytic leukaemias had hypercalcaemia, 2 thereof with increased activity of the leukaemia. Hypercalcaemia is thus very rarely found in other Non-Hodgkin Lymphomas, in chronic lymphocytic leukaemia some what more often, and only here a concomitant increase in the activity of the underlying disease could be observed in some cases. PMID- 3657042 TI - [Intracranial and intraspinal hemorrhages in treatment with coumarin derivatives. Catamnesis of 63 cases between 1978 and 1986]. AB - From 1978-1986, 63 patients (48-79 years) under coumarin derivatives had to be hospitalized neurosurgically because of intracranial or intraspinal bleedings. This corresponds to a twelvefold increased risk compared to the untreated people. The male/female ratio was 1.5. At the time of the bleeding there was no true indication for anticoagulation in at least 60% of the patients. 80% with coma on admission died. Only for 2/7 with an intraspinal hemorrhage the outcome was better than paraplegic. Women proved to have a better chance of survival. There is a need for more concise indications for chronic anticoagulation. PMID- 3657044 TI - Bromocriptine in pregnancy: safety aspects. AB - Since Bromocriptine is used to restore fertility in hyperprolactinemic women, its safety in pregnancy and the offspring was investigated in a stepwise approach: (i) the first survey in pregnancy was based on spontaneous reporting, (ii) the second investigation was conducted at 33 clinics as an intensive monitoring project and, (iii) the third study consisted in a full examination of children up to the age of 9 years who had been exposed to Bromocriptine in utero. The data collated in this program includes information on 2587 pregnancies in 2437 women treated with Bromocriptine during some stage of gestation, and follow-up examinations for 988 infants. The results show that the use of Bromocriptine in the treatment of infertility in women is not associated with an increased risk of spontaneous abortion, multiple pregnancy or the occurrence of congenital malformation in their progeny. Moreover, exposure to this drug in utero has no adverse influence on the postnatal development. PMID- 3657046 TI - [Clinical nursing concepts. I. Nursing intervention to promote comfort]. PMID- 3657047 TI - [Seminar on nursing administration. The function of control in organization]. PMID- 3657045 TI - [Secondary gout and pseudo-Bartter syndrome in females with laxative abuse]. AB - Four females (27-54 y), presenting with a history of long-term laxative abuse, were admitted to the Medizinische Poliklinik for evaluation of generalized weakness. Laboratory findings revealed signs of Bartter's syndrome, including hypokalemia, systemic alkalosis and normal blood pressure. Three of the four females showed impaired renal function and elevated serum uric acid levels, two of them suffered from recurrent gouty attacks. In our patients the incidence of hyperuricemia and impaired renal function, as a consequence of chronic hypokalemia, was much higher than known from patients with Bartter's syndrome. Hyperuricemia is related to some pathophysiological features of Pseudo-Bartter's syndrome, (e.g. systemic alkalosis, elevated angiotensin) and combined with additional factors (e.g. catabolism, reduced plasma volume) may lead to gouty attacks. Gallstones were found in two of the four females. Long term surreptitious laxative ingestion frequently is observed in females. Hypokalemia, induced by the laxatives, causes reduced intestinal motility and leads to augmented laxative intake. These patients are prone to develop Pseudo-Bartter's syndrome, causing eventually a hyperuricemia and gouty attacks. PMID- 3657049 TI - [Seminar on nursing administration. Quality assurance in nursing: structure aspect]. PMID- 3657048 TI - [Seminar on nursing administration. Nursing standard]. PMID- 3657050 TI - [Seminar on nursing administration. Quality assurance in nursing: process aspect]. PMID- 3657051 TI - [Seminar on nursing administration. Quality assurance in nursing: outcome aspect]. PMID- 3657052 TI - [Seminar on nursing administration. Hospital standardization]. PMID- 3657053 TI - [Seminar on nursing administration. Developing tool for nursing quality assurance]. PMID- 3657054 TI - [Case study for nursing diagnosis]. PMID- 3657055 TI - [Case study of adjustment disorder patient using nursing diagnosis]. PMID- 3657057 TI - [Cardiopulmonary assessment]. PMID- 3657056 TI - [Clinical report for nursing diagnosis of schizophrenia with depressive mood]. PMID- 3657058 TI - [Clinical nursing concepts. I. Principle of comfort]. PMID- 3657059 TI - [A study on the analysis of activities of the community health practitioners--CHP in Choon Chung Nam Do]. PMID- 3657060 TI - [Morphogenesis of the brain of rats developing under conditions of weightlessness]. AB - Macroscopic and light microscopic examinations of the brain of 18-day fetuses, and neonate 15-, 30- and 100- day rats whose embryonic development from day 13 to day 18 occurred in space flight on Cosmos-1514 did not reveal any changes in the brain structures of the fetuses or pups of the three ages. However, the brain of the 18-day fetuses that developed in flight showed signs of insufficient tissue oxygenation, trends toward delayed cell migration in the cortex and delayed differentiation of neurosecretory cells of the hypothalamic supraoptic nuclei. The cell differentiation rate returned to normal during continued embryogenesis after flight at 1 g. PMID- 3657062 TI - [Morphometric analysis of the aortic endothelium of rats exposed to prolonged hypokinesia]. AB - Twenty-four white rats were exposed to 30-, 60- and 100-day hypokinesia. Using the stereological technique, film preparations of their aortic endothelium were examined for the mean area of endothelial cells, nuclei and cytoplasm. Also, the content of endothelial cells showing karyopyknosis, karyolysis or binuclear structures was measured morphometrically. As compared to the matched controls, the number of cells with karyopyknosis, karyolysis and two nuclei increased significantly at every time interval studied. On hypokinesia day 30, the area of endothelial cells, nuclei and cytoplasm was greater than that in the controls. On hypokinesia days 60 and 100, the cell size was within the normal limits and the nuclear size was smaller. This lead to a decrease of the nucleus-plasma ratios. Together with other factors responsible for hypercholesterinemia, the above changes in the endothelial layer may facilitate atherosclerotic lesions of the vascular wall during prolonged hypokinesia. PMID- 3657061 TI - [Reaction of blood circulation to antiorthostatic hypokinesia in men aged 45-52]. AB - Regional and central circulation reactions to 30-day antiorthostatic hypokinesia were investigated in 15 men, aged 45 to 52 years, with early signs of cerebrovascular and aortic atherosclerosis, neurocirculatory dystonia of the hypertensive type, and hypertensive disease of stage I. Regional and central hemodynamics of the subjects of the three groups during and immediately after exposure developed in a different manner. PMID- 3657064 TI - [Changes in regional and central hemodynamics during a 7-day immersion in water]. AB - Regional and central hemodynamics were assessed at bi- and tetrapolar rheography and tacho-oscillography during 7-day "dry" immersion and 8-day -8 degrees head down tilt. Blood redistribution evident from enhanced pulse filing of the brain, lungs and arms was most pronounced on day 3-5. The onset of the blood outflow to the liver was observed on immersion day 5 due to compensatory and adaptive reactions. Lack of exercise tolerance of cardiovascular system through its insufficient training was similar in the immersion and head-down tilt for all the 6 healthy males studied (aged 41-49) despite more obvious changes in regional hemodynamics during the immersion, which recovered on its fifth day. PMID- 3657063 TI - [Combined effect of microwave and ionizing radiation]. AB - The response of different physiological systems to ionizing radiation as modified by UHF irradiation of nonthermal intensity was investigated. The experimental rats were exposed to electromagnetic irradiation of the power flux density (PFD) 200 microW/cm2 30 min daily for 8 days and the next day they were exposed to single total-body gamma-irradiation at a dose of 5.5 Gy. Pre-exposure to UHF irradiation reduced 1.5 times the mortality rate of the test animals as compared to the controls. Immunobiological examinations revealed a significant increase of the stimulation index in the mitogen (PHA) induced lymphocyte blast transformation reaction and a decrease of the autopatch count. The motor activity of the rats exposed for 20 min to gamma-irradiation at a dose of 0.34 Gy and the next day to UHF irradiation (PFD = 40 microW/cm2) for 1 and 5 min remained essentially unchanged. The imprinting of the chicks irradiated in early embryogenesis for 5 min with UHF (PFD = 40 microW/cm2) and then with gamma-rays at a dose of 0.36 Gy was disrupted. PMID- 3657065 TI - [Specific organic compounds in the human waste products]. AB - It is for the first time that chromato-mass-spectrometry has been used to examine human wastes. The data on the excretion rate of specific organic compounds can be employed to predict the content of toxic metabolites in the enclosed environment, to give their biomedical characterization, and to diagnose unfavorable changes in the body. PMID- 3657066 TI - [Change in the functional indices of animals during prolonged inhalation of acetic acid]. AB - Laboratory animals inhaled acetic acid vapors at a concentration of 86 to 27 mg/m3 for 3 to 35 days. It was found that the dose 36 mg/m3 inhaled for as long as 22 days constituted the minimal acting dose. The most sensitive parameters to be used in detecting the toxic effect of acetic acid were: treadmill run duration, open field activity, and ethylene, acetaldehyde and acetone concentrations in the exhaled air. PMID- 3657067 TI - [Effect of piracetam on the resistance of mice to hypoxic hypoxia 2 to 3 months following x-ray irradiation]. AB - The resistance of mice to hypoxic hypoxia 3 months after their X-irradiation was evaluated with respect to such parameters as survival rate during the "ascent" to 11,000 m, life time at that altitude and brain succinic dehydrogenase (SDH) and lactate dehydrogenase (LDH) activities at an altitude of 7,000 m. Irradiated mice proved to be less resistant to hypoxic hypoxia. SDH activity increased to a greater extent in nonirradiated than in irradiated animals. Piracetam increased significantly the resistance to hypoxia of both irradiated and nonirradiated mice. SDH activity was stimulated by hypoxia in a greater degree in the piracetam treated mice. The resistance to hypoxic hypoxia and SDH activation at an altitude of 7,000 m were found to be closely correlated. LDH activity remained essentially unchanged in any of the animal groups. PMID- 3657068 TI - [Diagnostic value of load tests in the evaluation of nonspecific changes in the electrocardiogram]. AB - The paper describes the examinations of 353 patients with various cardiovascular pathologies and changes in the end-portion of the ECG ventricular complex. For that purpose potassium chloride, obsidan, orthostatic and hyperventilation tests were used. The examinations demonstrated that the ECG changes were of functional nature in 178 patients, of organic nature in 155 patients and of mixed nature in 20 patients which was important for reliable diagnostic and expertise conclusions. PMID- 3657069 TI - [Use of bifidumbacterin for the correction of intestinal dysbacteriosis]. PMID- 3657070 TI - [Regulation of energy metabolism during parachute jumping]. PMID- 3657071 TI - [Modeling the effect of the shock wave from the track of a heavy charged particle on biological matter]. PMID- 3657072 TI - [Effect of steroid hormones on the level of biogenic amines in the lungs during the development of pulmonary hypertension in rats exposed to chronic hypobaric hypoxia]. PMID- 3657073 TI - [Effect of intermittent hypercapnia on the functional status of the visual analyzer]. PMID- 3657074 TI - [Mononuclear phagocytes during the adaptation of essentially healthy persons to high mountain conditions]. PMID- 3657075 TI - Proceedings of the ASEAN Paediatric Federation Conference 1986 on Patterns of Mortality and Morbidity in Infancy and Childhood. November 28-29, 1986. Association of South-East Asia Nations. PMID- 3657076 TI - Risk approach strategy in maternal and child health service research at Bang Pa In. PMID- 3657077 TI - Iron status of Hong Kong babies at 18 months. PMID- 3657078 TI - Glucose-6-phosphate-dehydrogenase deficiency and thalassaemia traits in some South-East Asian populations. PMID- 3657079 TI - Acute nephritis in children in Hong Kong. PMID- 3657080 TI - Cot death in Hong Kong: an unexplained rarity. PMID- 3657081 TI - The significance of some metabolic aberrations in viral infections. PMID- 3657082 TI - Pattern of child morbidity and mortality in Indonesia. PMID- 3657083 TI - A seven year study of childhood encephalopathies. PMID- 3657084 TI - Diarrhoeal problems in Indonesia past, present and future. PMID- 3657085 TI - Current management of acute diarrheas in the Philippines. PMID- 3657086 TI - Patients of acute gastroenteritis in Singapore. PMID- 3657087 TI - Prevalence and clinical aspects of Campylobacter associated diarrhoea (a preliminary report). PMID- 3657088 TI - Hydrogen breath test with physiological dose of lactose in children and adolescents. PMID- 3657089 TI - Fluid therapy in sick low birthweight infants. PMID- 3657090 TI - Symptomatic patent ductus arteriosus in premature neonates: a 5 year study in Toa Payoh Hospital. PMID- 3657091 TI - Growth retardation in children with congenital heart disease. PMID- 3657092 TI - Morbidity and mortality patterns in Malaysian children. PMID- 3657093 TI - Infant and child morbidity and mortality patterns: a report from the Philippines. PMID- 3657094 TI - Pattern of infant and childhood mortality in Singapore. PMID- 3657095 TI - Pattern of mortality and morbidity in infancy and morbidity--country report from Thailand. PMID- 3657096 TI - An analysis of perinatal mortality statistics of Hong Kong and China. PMID- 3657097 TI - Genetic disorders as major infant mortality factors in the future in developing countries. PMID- 3657098 TI - Perinatal mortality and morbidity at Dr Pirngadi Hospital Medan, Indonesia. PMID- 3657099 TI - Morbidity and mortality of tetanus, diphtheria and morbilli (measles) cases (a 1982-1985 study at the Child Health Department, Dr. Pirngadi Hospital, Medan). PMID- 3657100 TI - A 20-year review (1966-1985) of hospital mortality in the University Department of Paediatrics, Singapore. PMID- 3657101 TI - A community-based infant mortality study in South Thailand. PMID- 3657102 TI - Nutritional status of children of various aboriginal communities in Peninsular Malaysia. PMID- 3657103 TI - Correlates of psychological hardiness in Canadian adolescents. PMID- 3657104 TI - Attitudes of rapists and other violent offenders toward women. PMID- 3657105 TI - A constitutive description of contracting papillary muscle and its implications to the dynamics of the intact heart. AB - A simple mathematical model capable of simulating the major biomechanical attributes of contracting cardiac muscle is presented. This model is based on the phenomenological observations on heart muscle. The form of the equation can be readily extended to describe the pressure-volume-time-velocity of the intact heart as well, thus allowing a direct bridge between the dynamics of papillary muscle and the dynamics of intact heart. Parameters that are sensitive to inotropic state of the muscle can be obtained directly from the isometric tension time record of the muscle or the isovolumic pressure-time record of the ventricle. These parameters have the potential to serve as quantitative measures of cardiac health. PMID- 3657106 TI - Direct comparison of muscle force predictions using linear and nonlinear programming. AB - Estimating forces in muscles and joints during locomotion requires formulations consistent with available methods of solving the indeterminate problem. Direct comparisons of results between differing optimization methods proposed in the literature have been difficult owing to widely varying model formulations, algorithms, input data, and other factors. We present an application of a new optimization program which includes linear and nonlinear techniques allowing a variety of cost functions and greater flexibility in problem formulation. Unified solution methods such as the one demonstrated here, offer direct evaluations of such factors as optimization criteria and constraints. This unified method demonstrates that nonlinear formulations (of the sort reported) allow more synergistic activity and in contrast to linear formulations, allow antagonistic activity. Concurrence of EMG activity and predicted forces is better with nonlinear predictions than linear predictions. The prediction of synergistic and antagonistic activity expectedly leads to higher joint force predictions. Relaxation of the requirement that muscles resolve the entire intersegmental moment maintains muscle synergism in the nonlinear formulation while relieving muscle antagonism and reducing the predicted joint contact force. Such unified methods allow more possibilities for exploring new optimization formulations, and in comparing the solutions to previously reported formulations. PMID- 3657107 TI - A three-dimensional nonlinear finite element model of lumbar intervertebral joint in torsion. AB - Torsion as a cause of failure in the lumbar intervertebral joint was studied using a three-dimensional nonlinear finite element model. The role of facets and ligaments as well as the stress distributions in the posterior elements, the disk, the ligaments, and the vertebral body were examined. For physiological range of torsion, the facets carried 10 to 40 percent of the torque. The fiber stresses in the disk were the highest at the lateral margin of the outer layer of the annulus. Therefore, torsion itself is unlikely to cause posterior or posterolateral disk prolapse. PMID- 3657108 TI - Modeling of human reactions to whole-body vibration. AB - A computer-automated approach for studying the human body vibration is presented. This includes vertical, horizontal, and torsional vibration. The procedure used is based on Finite Segment Modeling (FSM) of the human body, thus treating it as a mechanical structure. Kane's equations as developed by Huston et al. are used to formulate the governing equations of motion. The connective tissues are modeled by springs and dampers. In addition, the paper presents the transient response of different parts of the body due to a sinusoidal forcing function as well as an impulse function applied to the lower torso in the vertical direction. PMID- 3657110 TI - Comments on the new bioheat equation proposed by Weinbaum and Jiji. PMID- 3657109 TI - A comparative analysis of thermal blood perfusion measurement techniques. AB - The object of this study was to devise a unified method for comparing different thermal techniques for the estimation of blood perfusion rates and to perform a comparison for several common techniques. The approach used was to develop analytical models for the temperature response for all combinations of five power deposition geometries (spherical, one- and two-dimensional cylindrical, and one- and two-dimensional Gaussian) and three transient heating techniques (temperature pulse-decay, temperature step function, and constant-power heat-up) plus one steady-state heating technique. The transient models were used to determine the range of times (the time window) when a significant portion of the transient temperature response was due to blood perfusion. This time window was defined to begin when the difference between the conduction-only and the conduction-plus blood flow transient temperature (or power) responses exceeded a specified value, and to end when the conduction-plus-blood flow transient temperature (or power) reached a specified fraction of its steady-state value. The results are summarized in dimensionless plots showing the size of the time windows for each of the transient perfusion estimation techniques. Several conclusions were drawn, in particular: (a) low perfusions are difficult to estimate because of the dominance of conduction, (b) large heated regions are better suited for estimation of low perfusions, (c) noninvasive heating techniques are superior because they have the potential to minimize conduction effects, and (d) none of the transient techniques appears to be clearly superior to the others. PMID- 3657111 TI - Discussion of papers by Wissler and Baish et al. concerning the Weinbaum-Jiji bioheat equation. PMID- 3657112 TI - Least-squares matrix correlations between stump stresses and prosthesis loads for below-knee amputees. AB - Stump stresses were correlated to prosthesis loads for two unilateral, below-knee amputees over a range of flexion-extension angular adjustments. Normal stresses on the patellar tendon and gastrocnemius were related to the axial force and flexion-extension moment of the prosthesis via a matrix equation. Elements of this matrix, influence factors calculated by least-squares algorithms, identified the contributions of each time-dependent load component acting to produce the time-dependent normal stresses. The flexion-extension angular sensitivity of the way these sagittal plane loads combined to produce normal stresses was included in the matrix equation via a first-order Maclaurin series. Highly favorable correlation coefficients between empirically measured and theoretically predicted stump stresses were calculated. This demonstrated that, in future studies, using an influence-factor matrix holds promise for quantifying sensitivities of normal stresses of the stump to multiple adjustments in prostheses. PMID- 3657113 TI - A simple unconstrained dynamic knee simulator. AB - The design of a simple dynamic knee simulator is described. In the simulator the joint dynamics are reproduced in-vitro in a knee specimen by controlling the time histories of the tensions in two flexible cables acting as lumped muscle group equivalents, without constraining the natural conjunct and passive motions of the specimen. The two cable tensions acting individually are used to control the active flexion/extension motion, while their simultaneous action is used to control joint compressive force. The characteristics of the electrohydraulic servo system acting under real-time microprocessor control are described. The system performance during simulation of an idealized level-walking function is evaluated. PMID- 3657114 TI - Strain energy descriptions of biological swelling. I: Single fluid compartment models. AB - Strain energy functions are derived from biphasic soft tissue models in order to describe large-deformation, large-swelling, elastic behavior of nonlinear materials. The resulting analysis leads to calculations of stress-extension relations and tissue fluid pressure. Also explored are the elastic stability of the biphasic tissue models and the manner in which tissue pressure is altered by material deformation. PMID- 3657115 TI - Strain energy descriptions of biological swelling. II: Multiple fluid compartment models. AB - A series of multicompartmental, biphasic elastic tissue models is developed. In its most general form, the models consist of multiple tubular networks, each with an internal spring network. In addition, another spring network occupies the extratubular compartment. Strain energy functions are derived for the models, as well as expressions for the fluid pressures in each compartment arising from volume expansion or swelling. Calculations also show that the distribution of fluid among compartments is a significant determinant of tissue elasticity. PMID- 3657116 TI - Orthogonal bone cutting: saw design and operating characteristics. AB - The cutting process of orthopaedic bone saws was considered as orthogonal (two dimensional) cutting for determination of the horizontal and vertical force components of single edge cutting tools with rake angles of 0 to -30 degrees. The Merchant analysis for orthogonal cutting was used to determine the resultant force and other force and work relationships. The effect of an imposed lateral vibration on the cutting tool was also investigated. The results of the tests indicated a strong interaction between the measured and derived forces with the rake angle and feed velocity. It was concluded that to reduce the cutting forces and work expenditure, a negative rake angle between 0 and -10 degrees, high feed velocity, and an imposed lateral vibration provided the greatest reduction in force and energy expenditure. PMID- 3657117 TI - A compact centrifugal blood pump for extracorporeal circulation: design and performance. AB - A new compact centrifugal blood pump driven by a miniature DC servomotor has been designed for use for short-term extra corporeal and cardiac-assisted circulation. The impeller of the pump was connected directly to the motor by using a simple gear coupling. The shaft for the impeller was sealed from blood by both a V-ring and a seal bearing. Either pulsatile or nonpusatile flow was produced by controlling the current supply to the motor. The pump characteristics and the degree of hemolysis were evaluated with regard to the configuration of the impeller with a 38-mm outer diameter in vitro tests; the impeller having the blade angles at the inlet of 20 deg and at the outlet of 50 deg was the most appropriate as a blood pump. The performance in an operation, hemolysis and thrombus formation in the pump were assessed by a left ventricular bypass experiment in dogs. It was suggested by this study that this prototype pump appears promising for use not only in animal experiments but also in clinical application. PMID- 3657118 TI - The physiological response to exercise with special reference to age. PMID- 3657119 TI - Supine rest and lactic acid removal following maximal exercise. PMID- 3657120 TI - The contribution of selected variables to middle and long distance run performance. PMID- 3657121 TI - The effect of mitochondrial energetics inhibitors on spontaneous rosette formation of lymphocytes from athletes. PMID- 3657122 TI - Effect of strenuous exercise on platelet. PMID- 3657123 TI - Effects of repeated endurance exercise on some metabolic parameters in cross country skiers. PMID- 3657124 TI - An anthropometric prototype of female power lifters. PMID- 3657126 TI - Heart rate, maximal heart rate and pedal rate. PMID- 3657125 TI - Physical fitness of young Belgian swimmers. PMID- 3657127 TI - Three methods of assessing per cent body fat in elite cyclists. PMID- 3657128 TI - The current problems of physical fitness in Japanese children. In comparison with European and North American children. PMID- 3657129 TI - The influence of exercise on stress states using psychophysiological indices. PMID- 3657130 TI - Histological, morphometrical and biochemical muscle findings in ten Mediterranean runners. PMID- 3657131 TI - Body composition and anthropometric characteristics of elite male basketball and volleyball players. PMID- 3657132 TI - Aerobic, anaerobic, assistant exercise and weightlifting performance capacities in elite weightlifters. PMID- 3657133 TI - Changes in somatotype and body composition of college football players over a season. PMID- 3657134 TI - Effects of the acute ingestion of small amounts of alcohol upon 5-mile run times. PMID- 3657135 TI - The Haglund syndrome (H.s.): clinical and radiological features and sports medicine aspects. PMID- 3657136 TI - Pulmonary microembolism: a cause of lung injury. AB - Microthrombi found in the pulmonary capillaries in patients dying with post traumatic pulmonary insufficiency suggests that pulmonary microembolism (PME) may be etiologically important, but a temporal relationship has not been demonstrated. We used a modified Lim-Blaisdell model of PME to cause a severe ischemic soft tissue injury in dogs. The appearance of microaggregates (MA) in the venous circulation was measured using a laser optical scanning technique. The effect of MA on pulmonary physiologic and histologic parameters was measured and compared to control animals. In the ischemic soft tissue injury group, following restoration of local circulation, the platelet count dropped by 72% (P less than 0.00002), the number of MA increased by 800% (P less than 0.00002), the mean pulmonary artery pressure (PA) increased from 15.6 to 32 mm Hg (P less than 0.00002), and electron micrographs of lung obtained at 4 hr after ischemic insult revealed PM with severe lung injury that was consistent with a capillary membrane leak. The control group never demonstrated a significant change in platelets, MA, PA, or histologic lung injury. These findings imply that MA found in the pulmonary microcirculation are temporally related to the development of physiologic and anatomic lung abnormalities. PMID- 3657137 TI - Protein synthesis in skeletal muscle of rats following starvation and refeeding. AB - Determination of protein synthesis in individual tissues is important to understand the changes in protein metabolism during catabolic states. Three methods based on different underlying assumptions were compared in assessing muscle protein synthesis during nutritional manipulation. Rats were nonstarved, starved for 1 or 3 days, or refed for 2 days after 3 days of starvation. The extensor digitorum longus (EDL) muscles from the two hindlegs were used for analysis. In one EDL muscle the concentration and size distribution of ribosomes as well as the incorporation of [14C]leucine into protein in a cell-free system were determined. The other EDL muscle was incubated as such and the incorporation of [14C]phenylalanine into protein was measured. The total ribosome concentration per milligram of DNA decreased to 65% on the third day of starvation and remained low after refeeding. The amount of polyribosomes in the percentage of total ribosomes fell to 90% on the first day of starvation, regained the initial level on the third day, and reached 110% upon refeeding. During refeeding amino acid incorporation into protein in a cell-free system decreased to 40% and that in intact muscle to 64% of the prestarvation level. Upon refeeding, the activity increased to or above the original values. The use of several different techniques in parallel to assess protein synthesis in skeletal muscle is recommended since it gives information about the factors involved in regulation of the translational process in intact mammalian tissues. PMID- 3657138 TI - Sciatic nerve function following hindlimb thermal injury. AB - Peripheral neuropathy occurs in approximately 20% of patients with major burns and seriously impairs rehabilitation. We describe an experimental model which permits elevation of the tissue temperature in the region of the distal sciatic nerve trunk of rats at a reproducible rate to a predetermined level without inflicting concomitant major cutaneous injury. Radiofrequency current is delivered through parallel copper electrodes mounted in a chamber into which the limb has been inserted. In the present experiments, tissue temperature was arbitrarily elevated to 47 degrees C for 30 sec in 62 rats. There were 43 normal controls. The posterior tibial branch was the most intensively studied, as some of its conduction characteristics can be serially assessed percutaneously. Conduction block, which was apparently irreversible, was present in 67% of posterior tibials by 24 hr postinjury. In branches which were still excitable, prolongation of the absolute refractory period was the most consistent abnormality noted. Slowing of conduction, as evidenced by prolongation of inflection velocity or peak velocity, was never observed. However, this injury resulted in selective conduction failure of sural--but not of peroneal--fibers which conducted at 40 m/sec or greater. Fiber modality is an important determinant of the vulnerability to direct thermal injury of peripheral nerve in vivo. PMID- 3657139 TI - Transvascular protein movement in the intact ischemic hindlimb. AB - Postischemic limb swelling following reperfusion may be related to microvascular changes associated with ischemia. We used lymph-to-plasma total protein concentration ratios (L/P) and lymph flow (QL) as an index of transvascular exchange in the intact dog hindlimb during steady state (C) (1 hr), ischemia (I) (6 hr), and reperfusion (R) (3 hr). Central pressures, femoral arterial and venous pressures (PA, PV) and QL were recorded every 15 min. Lymph was collected from a femoral lymphatic in the passively flexed leg (50 cycles/min). Three groups of animals were studied: GI, sham-operated (N = 5); GII, moderate ischemia (N = 7, PA = 30-45% C); and GIII, severe ischemia (N = 7, PA = 5-20% C). In GI, QL gradually increased over 10 hr without change in L/P. Moderate ischemia produced a decrease in QL, 3.55 +/- 2.02 mg/hr to 0.92 +/- 0.53 mg/hr (P less than 0.0001), and QL remained below baseline during R with no change in L/P over the 10 hr. Severe ischemia produced a similar decrease in QL, 1.91 +/- 2.05 mg/hr to 0.15 +/- 0.1 mg/hr (P less than 0.01); however, an increase to 2.56 +/- 2.14 mg/hr occurred during R. Severe ischemia increased L/P 0.42 +/- 0.08 to 0.64 +/- 0.23 (P less than 0.001) and remained elevated during R at 0.63 +/- 0.18 (P less than 0.001). An increase in the wet-to-dry weight ratio of ischemic to nonischemic muscle after reperfusion was noted only in GIII, 3.82 +/- 1.17 vs 2.60 +/- 0.45 (P less than 0.04). Severe ischemia produces changes in vascular integrity which augment protein flow. Prevention of these vascular changes may help to minimize the muscle swelling of reperfusion. PMID- 3657140 TI - Maternal death due to the HELLP syndrome. PMID- 3657141 TI - Cocaine-related deaths in Memphis and Shelby County. PMID- 3657142 TI - Isolated blunt disruption of the common bile duct. PMID- 3657143 TI - Indoor radon. PMID- 3657144 TI - Too good to be true! PMID- 3657145 TI - Liability loss prevention. PMID- 3657146 TI - Desmethylnafoxidine aziridine: an electrophilic affinity label for the estrogen receptor with high efficiency and selectivity. AB - Desmethylnafoxidine aziridine (Naf-Az), an affinity label for the estrogen receptor based structurally on the antiestrogen nafoxidine, has been prepared in unlabeled and in high specific activity, tritium-labeled form and has been evaluated for its apparent competitive binding, and time-dependent irreversible, covalent attachment to the estrogen receptor. Naf-Az was synthesized through a key 1,2-diaryl-3,4-dihydronaphthalene intermediate that was prepared from 6 methoxy-1-tetralone by two routes involving alternate strategies for arylation. Conversion of the diaryldihydronaphthalene to Naf-Az through a series of deprotection-activation reactions culminated in ethyleneimine displacement of a methanesulfonate. The tritium-labeled material was prepared by tritium-iodine exchange on an iodinated methanesulfonate precursor, followed by ethyleneimine displacement. Compared to our previously-prepared reagent tamoxifen aziridine (Tam-Az), Naf-Az has a higher apparent competitive binding affinity, and it reacts with the estrogen receptor in cytosol preparations and in intact MCF-7 breast cancer cells rapidly and with at least comparable efficiency and selectivity. SDS-polyacrylamide gel electrophoretic analysis confirms its selective labeling of the Mr 66,000 estrogen receptor. Naf-Az should prove to be useful in studies aimed at characterizing the properties and structure of estrogen receptors. PMID- 3657147 TI - Testosterone stimulation of mitochondrial aspartate aminotransferase levels and biosynthesis in rat ventral prostate. AB - The effects of testosterone on mitochondrial aspartate aminotransferase (mAAT) synthesis in rat ventral prostate was investigated. Procedures for the isolation, purification and characterization of AAT isozymes were developed and described. Purified mAAT preparations contained no demonstrable contaminating proteins. Prostatic mAAT was characterized as a cationic protein with an estimated mol. wt of 120,000. Cytoplasmic AAT (cAAT) isozyme was identified as an anionic protein with an estimated mol. wt of 132,000. A cytosolic cationic isozyme, similar to mAAT, was also identified as pre-mAAT. Testosterone administration to castrated rats resulted in significant increases in leucine incorporation into mAAT, in the level of mAAT, and in mAAT activity. These effects of testosterone were observed within 2 h of administration. Conversely, testosterone administration had none of these effects on cAAT or on non-AAT protein pool. Testosterone treatment did appear to increase leucine incorporation into pre-mAAT. Testosterone treatment in organ cultures and in prostate epithelial cell cultures resulted in the same stimulatory effects on mAAT as observed in the in vivo studies. The hormone was effective at the physiological concentration of 2 X 10(-9) M. These results indicated that testosterone has a rapid and specific effect on the biosynthesis of mAAT. This continues to support our proposal that testosterone regulates prostate citrate production via a stimulatory effect on mAAT which results in increased mitochondrial synthesis of citrate from aspartate. PMID- 3657148 TI - Leupeptin inhibits the transformation of glucocorticoid receptor. AB - The effect of leupeptin upon the transformation of the glucocorticoid receptor was tested. When the labeled receptor was treated with heat or high salt in the presence of leupeptin, the binding to DNA-cellulose decreased in a dose-dependent manner. We observed 50% inhibition with about 40 mM leupeptin. The addition of leupeptin after the transformation procedures did not inhibit the binding to DNA cellulose. In gradient centrifugation, 40 mM leupeptin retained approximately 10S, untransformed form. Elution profiles from DEAE-cellulose showed the preservation of the peak eluted with 0.2 M KCl, corresponding to the untransformed form. These results indicate that leupeptin might have the similar effects to molybdate in regard to blocking the transformation of rat liver glucocorticoid receptor, though the effects with leupeptin were not as great as those seen with molybdate. PMID- 3657149 TI - Extracellular correction of the androgen-receptor transformation defect in two families with complete androgen resistance. AB - We have characterized the cellular and extracellular phenotype of the mutant androgen receptor (AR) from two families who have complete androgen resistance despite a normal androgen-binding capacity (Bmax) in their genital skin fibroblasts (GSF). The cellular receptors fail to up-regulate their basal AR activity in response to prolonged incubation with 5 alpha-dihydrotestosterone (DHT), or with two synthetic androgens, methyltrienolone (MT) and mibolerone (MB), and form A-R complexes with increased equilibrium (Kd) and non-equilibrium (k) dissociation constants. In addition, they are thermolabile when recently dissociated, but not in their native state. A-R complexes made in normal or mutant cytosol at 4 degrees C elute from DEAE-Sephacel at approximately 0.25 M KCl (untransformed), with or without prior passage through Sephadex G-25; when made in cells at 37 degrees C, extracted with 0.4 M KCl in a buffer containing 10 mM Na2MoO4, and desalted by G-25, they elute at less than or equal to 0.1 M KCl. Normal KCl-extracted DHT- and MB-R complexes dissociate (37 degrees C) at the same slow, linear rate as their in-cell counterparts (transformed); the mutant ones dissociated more slowly than their rapidly-dissociating in-cell counterparts and, to a variable extent, nonlinearly-an early faster phase, a later slower (transformed). Thus, as judged by two conventional criteria of steroid-R complex transformation, the mutant A-R complexes can transform, possibly in two steps, under certain cell-free conditions. This behavior differentiates a class of structural AR mutations whose molecular definition awaits application of recombinant DNA techniques to the X-linked AR locus. PMID- 3657150 TI - Progesterone in vitro stimulates secretion of a specific protein by ovine epithelial endometrial cells. AB - Cultured ovine epithelial endometrial cells from oestrogen-treated ovariectomized ewes were treated in vitro with combinations of oestradiol-17 beta (E), progesterone (P) and the P-receptor antagonist RU486 (each 10(-6) to 10(-9) M), in the presence of [35S]methionine. Neither DNA content of dishes nor total protein were increased in treatment compared with control dishes. Incorporation of [35S] into secreted protein was lower from cells treated in vitro with P or E + P (10(-9) M) than from those treated with E (10(-9) M, P less than 0.01). Incorporation of [35S] into cellular protein was decreased by P (10(-9) M, P less than 0.025). SDS-PAGE analysis of secreted proteins enabled measurement of levels of a 46K protein which is secreted maximally following E + P administration in vivo. In vitro, P either alone or with E (each 10(-7) M) increased the abundance of the 46K protein in cell secretions by a factor of 1.5 +/- 0.1 (N = 9) or 1.8 +/- 0.3 (N = 10) respectively (P less than 0.01) compared with controls. The administration of E (10(-7) M) or either or both steroids at 10(-9) M, was without effect. RU486 alone (10(-6) to 10(-8) M) was also without effect but in the presence of E + P or P, blocked the increase in the 46K protein, suggesting this effect is mediated via binding of P to its receptor. PMID- 3657151 TI - Analysis of tamoxifen and 4-hydroxytamoxifen levels in immature rat uterine cytoplasm and KCl-nuclear extracts by gas chromatography-mass spectrometry (GC MS) using selected ion monitoring (SIM). AB - A GC-MS (SIM) method has been developed which allows the measurement of tamoxifen and its metabolites in uterine cytosol and 0.5 M KCl-extracts of uterine nuclei from groups of immature rats. The method was shown to be specific, precise and accurate. Using this procedure tamoxifen and 4-hydroxytamoxifen were tentatively identified and measured in uterine extracts after tamoxifen administration. When tamoxifen and 4-hydroxytamoxifen levels in uterine cytosol and 0.5 M KCl nuclear extracts were compared a relative enrichment in the nuclear fraction of 4 hydroxytamoxifen (relative to tamoxifen) was consistently seen. These observations are supportive of a role for 4-hydroxytamoxifen in mediating the antiestrogenic actions of tamoxifen in the immature rat uterus. In some of the uterine cytosolic fractions desmethyltamoxifen and metabolite Y could also be detected. PMID- 3657152 TI - Oestrogen synthesis by the foetal rat testis in organ culture. AB - Testes from 19- to 21-day old rat foetuses were bisected and cultured in the presence of tritiated testosterone, androstenedione or dehydroepiandrosterone as precursors for oestrogen biosynthesis. Oestrone and oestradiol formed were identified by recrystallization to constant specific activity, and their conversion rate was determined after isotopic dilution. Both oestrogens formed from either precursor, their conversion rate being about 0.05% for oestradiol and 0.015% for oestrone. PMID- 3657153 TI - Pregnenolone metabolism in Y-1 mouse adrenal cells: HPLC analysis and identification of metabolites by gas chromatography-mass spectrometry. AB - The Y-1 mouse adrenocortical tumor cells secrete into the culture medium some metabolites of pregnenolone. The long term basic steroid secretion was studied for 24 h by high performance liquid chromatography (HPLC). After 6 h incubation, only one chromatographic peak was shown to be quantitatively important. When the cells were incubated with tritium labeled pregnenolone and carrier, the analysis of radioactivity of each HPLC fraction indicated a rapid incorporation of the exogenous precursor and successive secretion/reabsorption kinetics of the metabolites. The final product, accumulated in the medium, was characterized by gas chromatography-mass spectrometry as 11 beta,20 alpha-dihydroxy-4-pregnen-3 one. PMID- 3657154 TI - Characterization of progesterone 11 alpha-hydroxylase of Aspergillus ochraceus TS: a cytochrome P-450 linked monooxygenase. AB - The monooxygenase of Aspergillus ochraceus TS capable of 11 alpha-hydroxylation of progesterone has been resolved into three components and characterized as (i) cytochrome P450, (ii) NADPH-cytochrome P450-reductase and (iii) phosphatidyl choline. The 11 alpha-hydroxylase was observed to be NADPH dependent, and hydroxylation was enhanced by a NADPH regenerating system. This fungal monooxygenase has many features in common with that of mammalian liver microsomes. The role of mammalian cytochrome P450 inducers were tested for induction of 11 alpha-hydroxylase in Aspergillus ochraceus TS. The reductase has been partially purified. PMID- 3657155 TI - Effect of ketoconazole, etomidate and other inhibitors of steroidogenesis on cytochrome P-450sccII-catalyzed reactions. AB - The effects of a variety of certain inhibitors of adrenal steroidogenesis have been studied on the reconstituted C21-steroid 17 alpha-hydroxylase-17,20-lyase system, whose protein components, the enzyme 17 alpha-hydroxylase-17,20-lyase(P 450sccII) and its reductase, are extensively purified from pig testis microsomes. We found: (1) Ketoconazole (cis-1-acetyl-4-[4-((2-(2,4-dichlorophenyl)-2-(1H imidazole-1- ylmethyl-1,3-dioxalan-4-ol)methoxy)phenyl] piperazine and Etomidate(R-(+)-ethyl-[1-(a-methyl-benzyl)-indol-5-carboxylatel), inhibited cleavage of 17 alpha-hydroxy progesterone at the 17,20-bond to give androstenedione in a dose-dependent fashion. (2) Some other inhibitors of steroidogenesis, Metyrapone (2-methyl-1.2di-3-pyridyl-1-propanone), Trilostane (4,5-epoxy-17-hydroxy-3-oxo androstane-2-carbonitrile),o,p'DDD (1-(O chlorophenyl)-1-(p-chlorophenyl)2,2-dichloroethane) and Aminoglutethimide (p (alpha-aminopheny)-alpha-ethylglutaramide) did not inhibit the same 17,20-lyase system. (3) All of the above listed inhibitors, over a wide variety of concentration ranges, had no significant effect on the 17 alpha-hydroxylation of 11 beta-hydroxyprogesterone, which had been shown to be catalyzed by the same P 450sccII. (4) NADPH:P-450 reductase was not inhibited by all of the above listed inhibitors. PMID- 3657156 TI - Studies on aromatase inhibition with 4-androstene-3,6,17-trione: its 3 beta reduction and time-dependent irreversible binding to aromatase with human placental microsomes. AB - The metabolism of 4-androstene-3,6,17-trione (AT), previously described as a suicide substrate for aromatase, and its irreversible binding to aromatase were studied by using human placental microsomes. AT was rapidly converted into 3 beta reduced metabolite (3-OHAT) with an enzyme other than aromatase in the microsomes in the presence of NADPH under either aerobic or anaerobic conditions. The conversion was efficiently prevented by a steroid 5 alpha-reductase inhibitor. 3 OHAT was characterized as a competitive (Ki = 6.5 microM) and irreversible inhibitor of aromatase. Both 14C-labeled AT and 3-OHAT were demonstrated to be irreversibly bound to aromatase probably through a sulfur atom of the enzyme in time-dependent manners in the presence of NADPH, being accompanied with time dependent losses of the enzyme activity. It was shown that the process of an apparent time-dependent loss of aromatase activity caused by AT even under conditions allowing its 3 beta-reduction should principally depend on the action of the parent inhibitor AT itself and not on that of the metabolite 3-OHAT. PMID- 3657157 TI - Glucocorticoids increase the length of the G2 and M phases of the HeLa S3 cell cycle. AB - Glucocorticoids increase the size and content of RNA and protein in randomly growing HeLa S3 cells; however, the rates of growth and macromolecule synthesis are not effected. In synchronized populations of HeLa S3 cells, addition of 10( 7) M dexamethasone at the G1/S border causes a 1 h delay in cell division. The length of the S phase, determined in synchronized cells by incorporation of [3H] thymidine into acid precipitable material, is unaffected by glucocorticoids. Thus, the 1 h prolongation occurs during the G2/M phases, when the cells are largest, and accounts for the increase in the size and content of RNA and protein. As with the induction of specific proteins, the events producing the G2 effects are initiated during the S phase of the cell cycle. Thus, the HeLa S3 cells contain a G2 regulatory point, which is influenced by glucocorticoids. PMID- 3657158 TI - Trifluoperazine inhibits ovarian mitochondrial side-chain cleavage enzyme activity in the absence of calcium. AB - In a previous report we described the inhibitory effect of trifluoperazine (TFP) on steroidogenesis in avian granulosa cells. To clarify the possible site of action of TFP we measured the cholesterol side-chain cleavage enzyme (CSCC) activity in a mitochondrial preparation of granulosa cells isolated from mature and developing ovarian follicles. Using a calcium free medium, TFP inhibited CSCC in a dose related manner with an IC50 of 50 microM. Kinetic parameters (apparent Km and Vmax) obtained in the presence of TFP are indicative of uncompetitive inhibition of CSCC. Moreover, enzyme activity increased during follicular maturation while the efficacy of TFP was similar in both young and mature follicles. Because the inhibitory effects of TFP were manifest in medium from which calcium was omitted, it is suggested that the drug acts independently of the calcium-calmodulin system to suppress CSCC activity. PMID- 3657159 TI - Childhood problem behavior and neuropsychological functioning in persons at risk for alcoholism. AB - The relationship of childhood hyperkinetic and minimal brain dysfunction (Hk-MBD) to neuropsychological functioning was examined in three groups of young adults. Nonalcoholic offspring of an alcoholic parent (N = 21) and of nonalcoholic parents (N = 21) were examined. A comparison group of similar age alcoholic patients (N = 21) was also studied. Each subject completed a battery of neuropsychological test measures and was administered a checklist on the presence of Hk-MBD symptoms in childhood. Offspring of an alcoholic parent and offspring of nonalcoholic parents could not be distinguished on the basis of their cognitive abilities or their frequency of reported Hk-MBD symptoms in childhood. Alcoholic subjects performed more poorly on measures of verbal and performance intelligence and reported a higher frequency of childhood Hk-MBD symptoms. Further, it was found that the frequency of childhood Hk-MBD symptoms was related to poor performance on certain types of cognitive tasks, regardless of group membership. These findings do not support the suggestion that certain cognitive deficits distinguish persons with a family history for alcoholism. However, poor neuropsychological performance in adulthood, at least on certain types of tasks, appears to be associated with the presence of childhood Hk-MBD. PMID- 3657160 TI - Relationship between sex-role behaviors and alcohol consumption in undergraduate men and women. AB - The relationship between sex-typed behaviors and alcohol consumption is examined in a questionnaire study involving male and female undergraduates. A multiple regression analysis indicated that for women, feminine behavior was significantly negatively correlated with total alcohol, beer and distilled spirits consumption. Weight was positively correlated with total alcohol and wine consumption. For men, feminine behavior was negatively correlated with total alcohol, wine and beer consumption. Masculine behavior was positively correlated with total alcohol, wine and beer consumption; weight was negatively correlated with wine consumption. Except in the case of wine, sex-role variables were found to account for more of the variance in alcohol consumption than did biological gender. Feminine behavior was negatively associated with alcohol consumption for both men and women. Masculine behavior was positively associated with alcohol consumption for men. PMID- 3657161 TI - Validity of the MacAndrew scale in a general medical population. AB - The Minnesota Multiphasic Personality Inventory (MMPI) was scored for the MacAndrew (MAC) Scale in a series of samples totaling 14,789 subjects. These samples included 1077 substance-dependent patients (739 men), 7090 selected medical outpatients (2853 men), 5000 unselected medical outpatients (2500 men), 214 psychiatric inpatients (92 men) and 1408 contemporary normal (646 men). Overall, the MAC Scale correctly classified only 70.7% of the men and 37.9% of the women alcoholics. However, when samples of men and women alcoholics were broken down into four age groups, the MAC Scale correctly identified 90% of men alcoholics in the 18- to 24-year age group but only 41% of women alcoholics in the same age group. In addition, the predicted rate of alcoholism in the samples that were not substance-dependent, using the MAC Scale, was approximately 1.5 to 4 times the estimated lifetime prevalence rate (this was also true in the 18- to 24-year age group). MMPI item 215 ("I have used alcohol excessively") correctly identified 95% of the men and 94% of the women alcoholics. It was concluded that, except for men less than 24 years old, the MAC Scale is not an appropriate screening test for substance dependence in a predominantly middle-class medical population. PMID- 3657162 TI - Self-report validity issues. AB - Two possible sources of the substantial gap usually found between survey self reported alcohol consumption estimates for a population and estimates based on official alcohol sales records are investigated. A measure of atypical heavy drinking is added to ordinary consumption commonly measured in surveys, and consumption by an adolescent (age 14-17) sample is added to that of the adult sample. The relationship between respondents' purchases and consumption during a 30-day period is also investigated. Personal interviews were completed with a random sample of 997 adults and 182 adolescents in Iowa during February-April 1985. Adding atypical drinking to ordinary drinking narrowed the sales-self report gap more than did adding adolescent drinking, but a considerable gap remained. Self-reported purchases were closer to sales than was self-reported consumption. However, not all purchasers were drinkers and not all drinkers were purchasers, and the two were not highly correlated. The self-report validity issue, which remains unresolved, is apparently affected by many factors. Self reports appear to be accurate enough for some purposes but not for others. Official alcohol sales (or purchase) records are not necessarily valid measures of alcohol consumption. PMID- 3657163 TI - A comparison of black and white women entering alcoholism treatment. AB - Similarities and differences between Black and White women in the early stages of alcoholism treatment were investigated. Characteristics relevant to treatment and to the risk of early treatment discontinuance were examined including health related attitudes and beliefs, personality characteristics, alcoholism history, and social and situational factors. Data were obtained through interviews with 25 Black and 67 White women who had recently entered an alcoholism treatment facility. Black women had a significantly lower income and were on average 5 years younger than White women. After controlling for income and age, discriminant function coefficients indicated that ethnic differences also existed in women's perceptions about the role of health professionals in the maintenance of health, consequences of drinking, social isolation, self-esteem, access to alcoholism insurance, contact with important others and degree of opposition to treatment from others. Implications of the results for treatment continuance and service delivery are discussed. PMID- 3657164 TI - Predictors of attrition from an outpatient alcoholism treatment program for couples. AB - Applicants (N = 105, 22 women) to an outpatient alcoholism treatment research program for married couples were categorized into three classifications: (1) treatment refusers (N = 37), (2) treatment dropouts (N = 23) and (3) treated subjects (N = 45). Discriminant analyses were performed to determine the best predictors of eventual category from baseline data. Compared with those who consented to treatment, refusers were found to be younger, have shorter drinking histories and were less likely to have personally initiated contact with the treatment program. Dropouts were less likely than treated subjects to have made their own initial contact with the program, more likely to have depressive symptoms not associated with alcohol use and were not employed full time. Remaining in treatment was most strongly associated with marital factors- assignment of the couple to a marital therapy condition versus a treatment in which the spouse was not fully involved and the spouse's initial satisfaction with the marriage. Results are discussed in terms of the treatment implications for spouse involvement in treatment. PMID- 3657165 TI - Effect of a change in drinking pattern on the cognitive function of female social drinkers. AB - The relationship between social drinking patterns and sober cognitive performance was evaluated, and the effects of a change in alcohol consumption on cognitive function were measured. Sixty female drinkers were randomly assigned either to abstain for 3 weeks or to continue to drink as usual; 25 female abstainers served as a comparison group. Subjects' drinking patterns during the last 6 months were assessed, and a battery of cognitive tests was administered both before and after the 3-week interval. Results indicated that cognitive performance at baseline was not inversely correlated with either the quantity or the frequency of drinking over the last 6 months. Furthermore, the abstinence manipulation did not result in differential improvement on any of the tests between the subjects who abstained and the subjects who continued to drink. Thus, recent drinking practices were not related to cognitive test performance in this sample of female social drinkers. PMID- 3657166 TI - Alcoholic beverage preference as a public statement: self-concept and social image of college drinkers. AB - Several studies have indicated that drinking-driving violation rates differ significantly across beverage preference groups. In an effort to assess beverage specific alcohol expectancies, surveys of 120 college students probed self concept, drinker stereotypes, beverage preference and quantity-frequency of alcohol consumption. The results revealed sharply differentiated social stereotypes for hypothetical drinkers of various alcoholic and nonalcoholic beverages. Beverage preference groups differed little in self-concept except that men who preferred beer or mixed drinks rated themselves as more drunk than did men who preferred wine or nonalcoholic beverages. Combining all beverage preference groups, heavier drinkers rated themselves more positively and they rated male nondrinkers more negatively on most dimensions than did lighter drinkers. Support was found for some, but not all, extrapolations from consistency theory and enhancement theory in predicting beverage choice. PMID- 3657167 TI - Tavern going in Canada: a national survey of regulars at public drinking establishments. AB - The results of a national survey of tavern going are reported; special attention is paid to the drinking patterns, reasons for attending, types of places frequented and social characteristics of the "regular" (i.e., the person who usually attends the same establishment and with some frequency). Most Canadians make some use of pubs, but only a few are regulars. Regulars are young, unmarried and heavier than average drinkers. Persons going to taverns, lounges, nightclubs and private clubs differ in social characteristics and these attributes are related to the activities and social functions associated with the various types of public drinking establishments. PMID- 3657168 TI - Influence of tryptophan availability on selection of alcohol and water by men. AB - To study the effects of tryptophan on alcohol selection the tryptophan levels in subjects were altered through the administration of amino acid mixtures. Male social drinkers (N = 45) with no psychiatric or medical problems were divided into three groups and consumed a drink that contained, respectively, a nutritionally balanced amino acid mixture, a tryptophan-supplemented mixture, or a tryptophan-free mixture. After a waiting period of 5 hours, blood samples were taken and subjects participated in an ad-lib taste rating of six--one nonalcoholic and five alcoholic--beverages. Water was also made available to subjects. Although there was a marked effect on total and free plasma tryptophan levels showing a dramatic increase in the case of the tryptophan-supplemented group and a decrease in the tryptophan-free group, altered tryptophan levels did not influence the amount of alcohol subjects ingested. Tryptophan supplementation was found to decrease water intake significantly by an unknown mechanism without affecting alcohol selection. PMID- 3657169 TI - Alcohol-related problems of children of heavy-drinking parents. AB - Alcohol-related problems that are experienced by sons and daughters of heavy drinking parents (either father or mother) are examined using data from a 1978 household sample of employed adults in metropolitan Detroit. Adult children with heavy-drinking parents were found to have a higher percentage of dependent problem drinking than those without heavy-drinking parents. Also, adult children with low status (blue-collar) occupations were found to have a higher percentage of dependent problem drinking than those with high status (white-collar) occupations. Although it was not possible to disentangle the genetic processes from the social processes in this study, the results support the hypothesis that having both heavy-drinking parents and low occupational status places sons and daughters at elevated risk for alcohol-related problems. Implications for future epidemiological studies are discussed. PMID- 3657170 TI - Passive and assertive student interventions in public and private drunken driving situations. AB - The types and frequency of interventions used to prevent drunken driving across four different locations is examined. A drinking survey of 247 students provided 97 subjects who indicated that someone had attempted to prevent them from driving under the influence (DUI). Results suggest that the location of the drinking modestly influences the type of intervention, that the more assertive intervention has a higher success rate and that private or more intimate gatherings promote less assertive interventions. Given the failure of deterrence, further understanding of how, why, when and who does and does not intervene, and what, when and who is and is not successful are promising research directions. Most importantly, however, is the need to conceptualize drunken drivers and the reactions to their potential DUI. It is suggested that the social support-stress literature may be useful in that it provides us with a social psychology of both effective and ineffective crises management. Status and age characteristics are the sociological parameters that must be included if we are to clarify and improve our understanding and move toward an informed policy. PMID- 3657171 TI - Extroversion, anxiety and the perceived effects of alcohol. AB - To test the hypothesis that personality characteristics are related to alcohol effect expectancies, 256 (115 men) college students were divided into groups on the basis of self-reported alcohol consumption and anxiety and introversion scores on the Sixteen Personality Factor Questionnaire. Three-way multivariate analyses of variance were conducted to determine expectancy differences by drinking behavior, personality characteristics and sex. Alcohol expectancy scores were found to vary with drinking behavior and personality measures. Elevated expectancy scores were associated with higher quantity-frequency measures of drinking; however, no significant sex differences were obtained. Extroverted students expected more social and physical pleasure, more relaxation and less arousal with drinking. Students with higher levels of trait anxiety expected more global positive changes, sexual enhancement, social assertion and arousal. The association of drinking behavior and personality with expectancies appears to be independent and additive. PMID- 3657172 TI - Depressive symptoms and persistence in treatment for alcohol dependence. AB - The relationship between alcoholics' depressive symptoms during their preadmission evaluations and persistence in treatment for alcohol dependence is evaluated. Hierarchical multiple regression was used to determine the contribution of Beck Depression Inventory (BDI) scores to the prediction of the criterion: number of continuous days in treatment (up to 120). After several sources of variance were removed (age, race, age X race interaction, number of previous treatments and referral source), BDI score explained 10.8% of the criterion's variance. The full model explained 28.2%. Early withdrawal occurred in association with freedom from measurable affective distress during preadmission evaluation. A model for the prediction of number of continuous days in treatment is presented. PMID- 3657173 TI - Two-stage operation for poor-risk patients with carcinoma of the esophagus. AB - We have devised a two-stage operation for poor-risk patients with carcinoma of the thoracic esophagus. The first-stage operation consists of a right thoracotomy, subtotal esophagectomy, and lymph node dissection. Two to three weeks later, the second-stage operation of esophageal reconstruction with gastric tube is performed under laparotomy. During this 3-week period of no esophagus, the nutritional status can be adequately maintained by intravenous hyperalimentation. We describe herein the technique, postoperative complications, and mortality of our two-stage operation as compared with events during an ordinary one-stage operation for carcinoma of the thoracic esophagus. PMID- 3657174 TI - Proximal gastrectomy as the surgical procedure of choice for upper gastric carcinoma. AB - To assess the efficacy of proximal gastrectomy in the treatment of upper gastric carcinoma, we analyzed clinical data from patients with lesions confined to the upper third of the stomach (group 1) and from patients with lesions which, while primarily located in the upper portion of the stomach, showed spread to the body of the stomach (group 2). Patients in group 2 showed more metastatic lymph node involvement, particularly of the infrapyloric lymph nodes, which were not included in lymphadenectomy accompanying proximal gastrectomy. None of the group 1 patients demonstrated metastasis to the infrapyloric lymph nodes. The postoperative 5-year survival rate in curatively operated group 1 patients was not significantly different between those treated by proximal gastrectomy and those subjected to total gastrectomy. We conclude that proximal gastrectomy is indicated in patients with upper gastric carcinoma when it is confined to the upper third of the stomach. PMID- 3657175 TI - Management of endoscopically removed malignant colon polyps. AB - The medical records of 87 patients with 89 malignant colorectal polyps removed endoscopically between 1971 and 1983 were reviewed retrospectively. Fifty-five polyps contained carcinoma-in-situ. Four polyps had "pseudo-invasion" by displaced mucosal glands. Thirty polyps contained invasive carcinoma. No patients with carcinoma-in-situ or "pseudo-invasion" had either local residual disease or metastatic disease at the time of colectomy or which was detected during subsequent follow-up. Four patients (14%) with invasive cancer would have been inadequately treated by polypectomy alone, since one had residual disease at the polypectomy site, one had nodal metastases, one had liver metastases at the time of colectomy, and one subsequently developed liver metastases. Three histologic criteria correctly predicted all four cases where residual or recurrent disease was present: involvement of the polypectomy resection margin, lymphatic invasion within the polyp, and poorly differentiated histology. Polyp size, histology (villous adenoma, adenomatous polyp, or villo-adenomatous polyp), or anatomic location did not identify those patients who warranted further therapy. We conclude that polypectomy alone is adequate treatment for polyps containing carcinoma-in-situ. Polypectomy alone is also adequate treatment for most polyps containing invasive carcinoma. However, patients with lymphatic involvement within the polyp, poorly differentiated cancer, or resection margin involvement should probably undergo colectomy. PMID- 3657176 TI - Epithelial ovarian tumor in a phenotypic male. AB - Laparotomy in a 41-year-old married man with non-treated left cryptorchidism revealed female internal genitals on the left side, and an epithelial ovarian tumor of intermediate malignancy. Germinal malignancies are frequent in intersexes, but non-germinal gonadal neoplasms are rare. This is the second reported case of epithelial ovarian tumor in intersexes, and the first case of epithelial ovarian tumor in an intersex registered as male. PMID- 3657177 TI - Verrucous pseudonevoid melanoma. AB - A case of an unusual variant of malignant melanoma resembling a papillomatous dermal nevus is presented here. The lesion was initially diagnosed as a Spitz nevus, and recurred locally five months after excision. The features which distinguish this lesion from the more common types of benign dermal nevi include the architectural atypia of the melanocytes, with a tendency for continuous proliferation of single cells along the dermoepidermal junction, as well as the presence of cytologic atypia with large hyperchromatic nuclei and mitoses. Despite its seemingly innocent appearance, distinction of this low-grade variant of melanoma from its benign counterparts is of importance in order to avert the possibility of recurrence and potential metastases. PMID- 3657178 TI - Advanced gastric cancer successfully resected following cisplatin therapy: report of a case. AB - A case of unresectable advanced gastric cancer was treated with cis dichlorodiammine platinum (CDDP) at a dosage of 30 mg/day for 5 days every month after operation. After three courses of administration, examinations revealed that the tumor had disappeared, and an evaluation of complete response was made. Four months later, a second-look operation was performed; and it was found that the cancer was smaller than a thumb and could be resected radically. No significant side effects were observed during CDDP therapy. PMID- 3657179 TI - In vivo ethane production in vitamin E-deficient rats with DMH-induced colon cancer. AB - The effect of both a vitamin E-deficient and a high polyunsaturated fat (PUFA) diet was tested on rats injected with the colon carcinogen 1,2-dimethylhydrazine (DMH). In vivo lipid peroxidation was monitored by measuring exhaled ethane from the animals. Higher mean weights were found in animals fed high PUFA and vitamin E-sufficient diets. There was no difference in ethane exhalation between DMH treated and control animals regardless of diet. Mean ethane exhalation was highest in animals fed either vitamin E-deficient or high PUFA diets. There was no difference in tumor formation between the vitamin E-deficient and the vitamin E-sufficient groups. The high PUFA groups had more tumors than the low PUFA groups. Diet was shown to be the major factor affecting ethane exhalation. There was no evidence that vitamin E-deficiency promoted DMH-induced tumors or that DMH caused increased lipid peroxidation. PMID- 3657180 TI - Survival of operated bronchus carcinoma patients: a prospective study. AB - Maximum diameter, tumour volume, and inflammatory response of host tissue in 282 surgical specimens with primary carcinoma of the bronchus were measured. Cell type, pT- and pN-stage, maximum diameter and volume of the primaries, and inflammatory response of host tissue were analyzed in respect to survival of the patients. Date of death was evaluated by quarterly communications with the house physicians. Survival rates were computed by use of Kaplan-Meier estimation. Mean survival of all patients was calculated at 480 days. Lymph node involvement and tumour volume were found to have a major influence on survival. In accordance with the weak contribution of maximum diameter of the tumour to survival, no major differences in survival between pT1- and pT2-stage were found. If severe inflammatory response at the tumour boundary was noted, patients showed slightly increased survival in all tumour stages. Cell type and tumour grading were found to be of minor influence in respect to survival. PMID- 3657181 TI - Surgical treatment of intestinal radiation injury. AB - A review of 43 consecutive patients requiring operation for serious intestinal radiation injury was undertaken to elucidate the efficacy of surgical treatment. The most common site of radiation injury was the rectum (19 cases), followed by the small bowel (13 cases), the colon (7 cases), and the combination of these (4 cases). The overall operative mortality was 14%; morbidity, 47%; and the postoperative symptom-free period, 18 +/- 30 months. Colostomy (N = 20) carried the lowest risk of mortality, 0%, as compared with resection (N = 17) and bypass procedure (N = 6), which were accompanied by the mortalities of 24% and 33%, respectively. During the follow-up (3-13 years) 12 patients (28%) died of recurrent cancer and 9 patients (21%) of persistent radiation injury, which yielded an overall mortality of 65% after resection and 50% and 65% after bypass and colostomy procedures, respectively. Continuing radiation damage led to 15 late reoperations. Ten of these were performed after colostomy, four after resection, and one after bypass. We conclude that colostomy cannot be regarded as a preferred operative method, because it does not prevent the progression of radiation injury and because it is, for this reason, associated with a higher late-complication rate. A more radical surgery is recommended but with the limitation that the operative method must be adapted to the operative finding. PMID- 3657182 TI - Imaging of colon carcinoma with 111-indium-labeled anti-CEA monoclonal antibodies (Indacea) prior to surgery. AB - Patients with primary and/or metastatic colorectal cancer who had been scheduled for operative intervention were injected intravenously with 200 micrograms of a high-affinity anti-carcinoembryonic antigen (CEA) monoclonal antibody labeled with 2 mCi of 111-indium (Indacea). Patients were imaged by gamma camera at 24 and 48 hours. Primary tumors were identified in 3/10 cases and were not visualized in 3/10 cases. Four scans were considered equivocal. Hepatic metastases were identified as image defects in 5/13 cases and were not visualized in 8/13 cases. All tumors contained CEA by immunoperoxidase staining. In all cases, the primary tumor uptake (5.44 +/- 1.07% ID/kg) was much higher than the uptake of the adjacent fat (0.18 +/- 0.04% ID/kg). There was a direct correlation between tumor CEA content, tumor radioactivity, and the imaging of primary tumor by Indacea. High liver uptake (30.3 +/- 3.0% ID/kg), seen when scanning all patients, was the main limitation of imaging and led to photopenic visualization of hepatic metastases. These results suggest that selection of patients with colorectal carcinoma on the basis of tumor CEA content will lead to improved rates of tumor imaging by Indacea in post-surgical scanning. PMID- 3657183 TI - A possible explanation for the symbolic nature of language. PMID- 3657184 TI - ESS equations sometimes do not specify an ESS. AB - The equations used to find an evolutionarily stable strategy in the basic game theory model (Maynard Smith, 1974, 1982; Maynard Smith & Price, 1973), and in sexual conflict models (Maynard Smith, 1977; Parker, 1979) do not, in fact, specify an ESS when the expected number of contests entered is not the same for each strategy. This means that the conclusions of many game theory models may be incorrect. This is particularly likely to be true when the mean durations of contests for different strategies are not the same, or when the probability that an individual enters a contest is not the same for all strategies. New ESS equations are developed which incorporate the expected number of contests entered. PMID- 3657185 TI - A relationship between diffusional transport in lipid membranes and a lipophilic eutectic parameter. AB - A theoretical model has been developed to relate passive diffusional transport with a parameter termed the lipophilic-eutectic coefficient, Le. Based on this parameter it is proposed that the lipophilicity of a substance can be estimated. The method is based on the melting point lowering of a pure substance in the presence of an impurity of similar structure. Cholesterol was chosen as a model biological lipid because it is a neutral lipid that is found in relatively high concentrations in a variety of membranes. Transdermal absorption in humans and intestinal absorption in the rat both show a high degree of correlation with respect to Le. For our studies, Le appears to be as satisfactory as the partition coefficient for estimating lipophilicity and its determination is less demanding analytically. PMID- 3657186 TI - Design of experiments for the precise estimation of dose-response parameters: the Hill equation. AB - Optimal experimental designs were evaluated for the precise estimation of parameters of the Hill model. The optimally effective designs were obtained by using the criterion of D-optimization. For the Hill model, optimal designs replicate 3 sampling points. These points were shown to be quite sensitive to the behavior of the experimental error. Since an investigator is often uncertain about error conditions in biological studies, a practical approach would use the sampling scheme calculated for an intermediate error condition. Thus, if the behavior of error variances is not known, precise parameters of the Hill model are obtained by choosing concentrations which yield fractional responses (responses divided by their asymptotic, maximum value) of 0.086, 0.581 and 1.0. When experimental constraints limit the maximum attainable concentration and response, all design points are lowered. Appropriate designs can be constructed based on the design which is optimal when constraints result in a maximum attainable fractional response of 0.5. The optimal designs were found to be robust when the parameter values assumed by the investigator did not equal their true values. The estimating efficiencies obtained by using two frequently applied designs were assessed. Uniformly spaced concentrations yielded imprecise parameters. Six-point, geometrically spaced designs gave generally good results. However, their estimating efficiency was generally exceeded by the recommended sampling schemes even in the presence of uncertainty about error conditions. The method exemplified in this paper can be used for other models. PMID- 3657187 TI - Catalytic efficiency, kinetic co-operativity of oligomeric enzymes and evolution. AB - The catalytic performance of an enzyme, whether it is monomeric or oligomeric, depends on extra costs of energy in passing from the initial ground state to the various transition states, along the reaction co-ordinate. The improvement, during evolution, of the catalytic performance of individual subunits implies that three structural requirements are met in the course of an enzyme reaction: the unstrained enzyme subunits exist in the ground states under two conformations, one corresponding to the non-liganded state and the other to the liganded state; the inter-subunit strain is relieved in the various transition states; the subunits bound to the various transition states S not equal to, X not equal to and P not equal to have the same conformation. These structural requirements are precisely those which have been used to derive structural rate equations for polymeric enzymes. When subunits are loosely coupled, their arrangement controls the various rate constants, but not the extra costs of energy required to reach the various transition states. Moreover, one cannot expect the rate curve to display any sigmoidicity under these conditions. If subunits are tightly coupled and if the strained non-liganded and half-liganded states are destabilized with respect to the corresponding unstrained states, that is if they contain more conformational energy, the oligomeric enzyme is more catalytically efficient than the ideally isolated subunits. Moreover, if the available conformational energy of the half-liganded state is more than twice that of the non-liganded state, kinetic co-operativity is positive and the rate curve is sigmoidal. It is therefore the extent of inter-subunit strain in the half-liganded state which controls the appearance of sigmoidal kinetic behaviour. If subunits are tightly coupled but if inter-subunit strain is relieved in both the non-liganded and fully-liganded states, the half-liganded state controls both the catalytic efficiency of the enzyme and the sigmoidicity of the rate curve. Sigmoidicity and high catalytic efficiency are to be observed when this half liganded state is destabilized relative to the corresponding unstrained state.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3657188 TI - Kinetic meaning of I0.5 and A0.5 values in allosteric enzymes. PMID- 3657189 TI - Sequence deduced physical properties in the D-loop region common to five vertebrate mitochondrial DNAs. AB - Some sequence-induced physical properties of the region of the replication origin in human, mouse, rat, ox and xenopus mitochondrial DNA have been studied: characteristic profiles of stability can be observed, a consensus pattern of hydrogen bond donor/acceptor associated to a symmetrical distribution of base roll angles variation is found upstream of the 5' ends of the D-loop strand. In spite of diversity, evolution has conserved the collective physical properties in parts of the origin of replication region suggesting specific functions for these non-coding sequences. PMID- 3657190 TI - Codon usage in Homo sapiens: evidence for a coding pattern on the non-coding strand and evolutionary implications of dinucleotide discrimination. AB - This study reports the analysis of codon usage in 35 complete Homo sapiens genes. Both codon frequency and inter-codon interference exhibit patterns of evolutionary interest. There is a significant positive correlation between the frequency with which a given codon is used and the frequency with which its complement is used. Since the frequency of appearance of the complementary codon on the coding strand is equal to the frequency of appearance of the original codon on the non-coding strand, in the same phase, the non-coding strand is found to resemble the coding strand in triplet composition. The same effect has been observed in Escherichia coli. This preference for the use of certain complementary triplets as codons suggests that the evolution of the use of the genetic code depended to some extent upon the double-stranded nature of the coding material. In addition, the effect of discrimination against the use of two dinucleotides, CpG and UpA, is observed in codon usage and also in adjacent codon interference. Codons beginning with G, or A, are unlikely to be preceded by codons ending in C, or U, respectively. Consideration of codon assignment in the genetic code together with the observed CpG infrequency suggests that the evolution of the code may have been influenced by conditions in which the use of CpG dinucleotides was unfavorable. The infrequent use of UpA dinucleotides can be explained as the result of frameshift mutation during gene evolution. PMID- 3657191 TI - Energetics of enzyme catalysis. I. Isotopic experiments, enzyme interconversion, and oversaturation. AB - An enzyme-catalyzed interconversion of one substrate, S, and one product P, by an enzyme that exists in two forms E1 and E2 where E1 binds S and E2 binds P, is considered S + E1 in equilibrium E1S in equilibrium E2P in equilibrium E2 + P. Under reversible conditions (where the concentrations of S and P are not far removed from their equilibrium values) it is shown that, in addition to the usual unsaturated and saturated behaviour there exists a third regime at high substrate concentration: the oversaturated region. In this region, the rate-limiting transition state is the interconversion of the unliganded forms of the enzyme: E1 and E2. Expressions for six different experiments involving deuterium, tritium and 14C labels are presented. By considering the results from these experiments, the nature and importance of the enzyme interconversion steps can be elucidated. PMID- 3657192 TI - Energetics of enzyme catalysis. II. Oversaturation, case diagrams, reversible and irreversible behaviour. AB - Most enzymes react in vivo under reversible conditions where the substrate and product concentrations are not far removed from equilibrium values. Under these conditions when the concentration of substrate is increased, in addition to the usual unsaturated and saturated behaviour we find a third type of kinetic regime at high substrate concentration-oversaturation. In this regime the rate limiting transition state involves interconversion of free enzyme forms. For a one substrate/one product enzyme, case diagrams can be constructed which depict the kinetic behaviour as a function of substrate and product concentrations. Six different cases are found and are discussed with the relevant free energy profiles. A systematic procedure is described for the investigation and construction of the case diagram. PMID- 3657193 TI - A model of evolution for accumulating genetic information. AB - By taking into account recent knowledge of multigene families and other repetitive DNA sequences, a model of evolution by gene duplication for accumulating genetic information is studied. Genetic information is defined as the sum of distinct functions that the gene family can perform. A coefficient, "genetic diversity" is defined and used in this study, that is highly correlated with genetic information. Initially, a multigene family with a few gene copies is assumed, and natural selection starts to work on this gene family to increase genetic diversity contained in the gene family. As an important mechanism, unequal crossing-over is incorporated. Together with mutation, it is responsible for supplying genetic variability among individuals for selection to work. A specific model, in which individuals with less genetic diversity are selectively disadvantageous, has been studied in detail. Through approximate theoretical analysis and extensive Monte Carlo studies, it has been shown that the system is an extremely efficient way to accumulate genetic information. For attaining one gene, the genetic load is much smaller under this model than under the traditional model of natural selection. The model may be applied to the process of origin of multigene families with diverse copy members such as those of immunoglobulin or cytochrome P450. In general, the process of creating new genes by duplication might be somewhere between the present and the traditional models. PMID- 3657194 TI - Computational complexity of inferring phylogenies from chromosome inversion data. AB - In systematics, parsimony methods construct phylogenies, or evolutionary trees, in which characters evolve with the least evolutionary change. The chromosome inversion, or polymorphism, parsimony criterion is used when each character of a population may exhibit homozygous or heterozygous states, but when the heterozygous state must evolve uniquely. Variations of the criterion concern whether or not the ancestral states of characters are specified. We establish that problems of inferring phylogenies by these criteria are NP-complete and thus are so difficult computationally that efficient optimal algorithms for them are unlikely to exist. PMID- 3657195 TI - From simple to complex oscillatory behaviour: analysis of bursting in a multiply regulated biochemical system. AB - We analyze the transition from simple to complex oscillatory behaviour in a three variable biochemical system that consists of the coupling in series of two autocatalytic enzyme reactions. Complex periodic behaviour occurs in the form of bursting in which clusters of spikes are separated by phases of relative quiescence. The generation of such temporal patterns is investigated by a series of complementary approaches. The dynamics of the system is first cast into two different time-scales, and one of the variables is taken as a slowly-varying parameter influencing the behaviour of the two remaining variables. This analysis shows how complex oscillations develop from simple periodic behaviour and accounts for the existence of various modes of bursting as well as for the dependence of the number of spikes per period on key parameters of the model. We further reduce the number of variables by analyzing bursting by means of one dimensional return maps obtained from the time evolution of the three-dimensional system. The analysis of a related piecewise linear map allows for a detailed understanding of the complex sequence leading from a bursting pattern with p spikes to a pattern with p + 1 spikes per period. We show that this transition possesses properties of self-similarity associated with the occurrence of more and more complex patterns of bursting. In addition to bursting, period-doubling bifurcations leading to chaos are observed, as in the differential system, when the piecewise-linear map becomes nonlinear. PMID- 3657196 TI - A model for the three-dimensional structure of peptidoglycan in staphylococci. AB - Although the monomeric units of peptidoglycan in Staphylococcus aureus and other staphylococci are well known, the complete structure of the peptidoglycan has not been elucidated. The peptidoglycan monomeric unit may be divided into three parts: (1) glycan chain piece, consisting of N-acetylglucosaminyl-N-acetylmuramic acid; (2) connecting peptide extending from L-alanine to the alpha-amino group of L-lysine; (3) peptide chain piece, consisting of D-alanine, the remainder of L lysine not included in the connecting peptide, and pentaglycine (S. aureus) or mixed glycine and serine residues (other staphylococci) attached to the epsilon amino group of lysine. The deformation of cross wall into hemisphere in the course of cell division, the distensibility of peptidoglycan, and the appearance of circular (? spiral) lines in the cross wall and on the surface of the newly formed hemisphere are clues to the structure of peptidoglycan. In the proposed model, cross wall is formed as a linear spiral with 20 turns extending in a plane from periphery to center of the cell. During cell division, the cross wall is bisected. The cross wall spiral becomes a spiral forming the peripheral wall of a new hemisphere. The width of the spiral on the cell surface is maintained by rigid glycan chains and by covalent bonds linking turns of the spiral. The length of the spiral is about 30 times the diameter of the cell. Flexible polypeptide sheets consisting of parallel polypeptide chains run along the length of the spiral. Individual polypeptides contain an average of ten peptide chain pieces. The glycan chain is a helix with two disaccharide residues per turn; consequently consecutive connecting peptides project in opposite directions and are perpendicular both to the glycan chain and to the peptide chain. In cross wall, hydrogen bonding between polypeptide chains enables the polypeptide sheet to transmit changes in tension. The deformation of cross wall into peripheral wall requires doubling of the external surface area of the peptidoglycan. A change in the angle of the glycan chain with respect to the peptide chain results in an increase of the distance between peptide chains, causing the doubling of surface area. Implications of the model include explanations for the initiation of cell division and for the existence of osmotically growth-dependent staphylococci. PMID- 3657197 TI - Number of ways of joining SH groups to form multi-peptide chain proteins. AB - The expression for the total number of isomeric structures formed upon oxidation of SH groups has previously been correctly obtained for single chain proteins only. Expressions have now been obtained for molecules consisting of 2 and 4 peptide chains of the types A2 and A2B2. The latter type is particularly important as exemplified by the immunoglobulins and the insulin receptor. For the oxidation of insulin A chain with 4 SH groups, the total number of isomeric A2 structures is 59--this is different to all the values previously reported. Lack of consideration of symmetry problems probably accounts for the erroneous results obtained by earlier workers for the number of ways of randomly joining two identical chains. The total number of isomeric structures formed from the oxidation of two light and two heavy chains with 5 and 11 SH groups respectively of the human immunoglobulin GI has been found to be 4.8 X 10(16). PMID- 3657198 TI - The case for stochastic models of digesta flow. PMID- 3657199 TI - Cortical activity in vertebrate eggs. I: The activation waves. AB - We present a physical model for the propagation of chemical and mechanical waves on the surface of vertebrate eggs. As a first step we analyzed the propagation of the calcium wave observed to sweep over the surface of the Medaka egg (Gilkey et al., 1978). It has been assumed that this wave is driven by a mechanism of calcium-stimulated-calcium-release. By formulating this hypothesis mathematically we can use the observed wavefront data to obtain a map of cortical reactivity. This map indicates a gradient of reactivity along the egg: highest in the animal hemisphere and tapering off towards the vegetal hemisphere. The cortex of Xenopus eggs is also capable of propagating a calcium wave (Busa & Nuccitelli, 1985). At about the same time a wave of expansion followed by a wave of contraction sweeps across the egg surface (Takeichi et al., 1984). We have proposed a mechanism for this wave pair based on the physical chemistry of actomyosin gels. The calcium wave activates solation factors which sever some of the actin chains which leads to an osmotic swelling of the gel. Calcium also activates the contractile machinery of the actomyosin system which causes the gel to contract. The contraction lags the swelling because of the nature of the kinetics: solation and swelling is a more rapid process than contraction. By writing the equations for gel expansion and contraction we can mimic the mechanical and chemical wave propagation by a computer simulation. If the model is correct this provides a method for using the waves as a diagnostic of the mechanochemical properties of the egg cortex. PMID- 3657200 TI - Kinetics of bacterial adhesion--a stochastic analysis. AB - In a previous work (Hsu & Wang, 1986), a birth-death type of stochastic model was proposed to analyze bacterial adhesion onto the substrate surface. The model is based upon the assumption that the number of available active sites on the substrate surface is relatively large compared to that of the cells in the system. This assumption is relaxed in the present study, and thus, the problem is considered in a more rigorous manner. The transient behavior of bacterial adhesion is examined through simulation studies. It is found that the present stochastic model should be employed when the number of available active sites is less than or on the same order of magnitude as that of the cells. PMID- 3657201 TI - Absorbent Markov chains as a model for the study of the evolution of proteins. AB - The formalism of absorbent Markov chains, previously developed by Kemeny & Snell (1960) is used as a model for the study of the evolution of proteins. Within the limits of statistical analysis used, the amino acid substitution frequencies of McLachlan (1972) are explained by the numerical values derived from the model used. In addition, the amino acid composition of proteins is partially explained and the relative mutability of amino acids receives a new interpretation in the light of the above mentioned stochastic model. The results show that some basic aspect of protein evolution can be predicted by a stochastic model and therefore a significant component of protein evolution is driven by a random element. PMID- 3657202 TI - Stochastic modeling of bacterial adhesion: a two-step mechanism with linear adhesion rate. AB - Stochastic analysis of bacterial adhesion onto the surface of solid substrate is presented. Bacterial adhesion is assumed to occur in two steps: (i) a reversible adhesion between bacteria and solid surface; bacteria on the surface are weakly bound during this period, followed by (ii) an irreversible surface reaction which results in a strong binding force between bacteria and the surface; bacteria are considered to be in adhered form at this stage. The stochastic representation provides both the macroscopic and fluctuating information about the transient behavior of the phenomenon under consideration. PMID- 3657203 TI - On the vibrational mode of an eukaryotic cell during the cell cycle. PMID- 3657204 TI - Evolutionary conflict over the control of offspring sex ratio. AB - There are many theories which predict how animals should control the sex ratio of their offspring. In diploids, however, such control is rarely seen. Two explanations have been suggested for this. One is that parents are simply unable to control the sex ratio of their offspring. The other is that sperm actively oppose such control. This paper examines the possibilities and consequences of parent-gamete conflict over the sex ratio. Such conflict may occur between any of the parties concerned--sperm, ova, fathers, mothers, offspring. It is concluded that gametes are indeed almost always opposed to any parental manipulation of the sex ratio. However, it is probable that the rarity of adaptive parental control of progeny sex ratio in diploids is because parents are physiologically incapable of altering the sex ratio. PMID- 3657205 TI - Theoretical model for the post-transcriptional regulation of the human c-myc gene expression, involving double-stranded RNA processing. AB - We propose that the human c-myc gene expression is regulated by a post transcriptional mechanism based on the formation of a hairpin structure between c myc mRNA exons 1 and 2. This structure could be rapidly processed by a hypothetical double stranded RNAse, removing the 5' end segment of the c-myc mRNA having the cap site. Removal of cap should propitiate exonucleolytic degradation of transcript. PMID- 3657206 TI - Spatio-temporal characterization of intercostal activity during breathing in the cat. AB - It is envisaged that the motor control of the intercostal musculature--an assembly of mobile structures--can be characterized in terms of a conceptual spatially continuous control function, that underlies the discretely distributed muscular activity and reflects an inferred global dynamic control of the thoracic cage during breathing. The global control function is estimated by the spatio temporal pattern obtained by averaging in time and space and interpolation of multichannel simultaneous intercostal EMG recording in the anaesthetized cat. Different examples of the experimental preparation in the presence of stimuli of different kinds are analysed. The resultant signal patterns are found to be self consistent and capable of exhibiting systematically differing features in systematically differing experimental conditions, thus supporting the validity of the analysis and the choice of the estimator. It is concluded that a more detailed analysis of the requirements of this approach is then warranted. Such requirements are discussed, and, specifically, results that bear on the adequacy of spatial sampling rate are presented. It is suggested that such methods offer a promising approach in the study of motor control strategies of the respiratory apparatus. PMID- 3657207 TI - Ecological compensation--a complication for testing life-history theory. AB - Mortality, growth and birth rates cannot vary independently in stable populations, environmental change of one variable must be accompanied by compensatory variation of another. Ecological compensation is recognized if the stable populations are genetically identical. Ecological compensation, if it operates, constrains the direction of evolutionary change, and predictions that ignore it may be in error. PMID- 3657208 TI - The effect of ohmic return currents on biomagnetic fields. AB - To illustrate the calculation methods used for biomagnetic fields we present a detailed calculation of the B-field from a spherical cell in an infinite ohmic bath. The calculation is done from three approaches and the results are used to clarify some misinterpretations that may seem to be biophysical problems but are, in fact, creatures of the formalism used. PMID- 3657209 TI - Variation among the human T-cell lymphotropic virus type III (HTLV-III/LAV) strains. PMID- 3657210 TI - Theoretical molecular biology: prospectives and perspectives. AB - I briefly discuss some aspects of theoretical molecular biology. Specifically, I include the issues of searches for homologies via string matchings, for patterns of specific nucleotide groupings and of sequence-structure relationship. The various approaches developed in order to achieve this end are described, attempting to convey some of the excitement in this quickly growing field. PMID- 3657211 TI - On the difficulties of fitting the double Michaelis-Menten equation to kinetic data. AB - The double Michaelis-Menten equation describes the reaction kinetics of two independent, saturable uptake mechanisms. The use of this equation to describe drug uptake has been reported several times in the literature, and several methods have been published to fit the equation to data. So far, however, confidence intervals on the fitted kinetic parameters have not been provided. We present a grid-search method for fitting the double Michaelis-Menten equation to kinetic uptake data, and a Monte-Carlo procedure for estimating confidence intervals on the fitted parameters. We show that the fitting problem is extremely ill-conditioned, and that very accurate data are required before any confidence can be placed in the fitted parameters. PMID- 3657212 TI - Point mutations as an optimal search process in biological evolution. AB - Point mutations are pictured as jumps in a phase space representing the sequences of amino acids or nucleotides as discrete points. It is shown that this space can be given a natural metric by quantifying common physical and chemical properties of amino acid constituents in terms of a natural measure. Evolution through point mutations is simulated by the search for points in the phase space representing amino acid sequences of high survival fitness. Due to the local compactness of the distribution of these functionally allowed points in phase space any successful search procedure has characteristics qualitatively different from those in the case of a random distribution. This is demonstrated by model calculations. A specified distribution of allowed points is generated with subsequent evaluation of the success of the retrieval process as a function of the jump probabilities between lattice sites. The results of such simulations are compared with data obtained from the analysis of the DNA or mRNA sequences coding related proteins. By counting silent and expressed nucleotide replacement frequencies one can draw conclusions as to the efficacy of the natural evolutionary search processes in the phase space of amino acid sequences. There are cases, where the highest possible information gain of one bit per accepted point mutation is achieved. In general the information gain is found to be somewhat sub-maximal due to functional requirements. PMID- 3657213 TI - Minimal spanning tree analysis of biological structures. AB - A new approach to study order and disorder in biological membranes and more generally in biological structures is developed. It is based on a graph constructed on the set points representing the position of particles. From this graph, which is called the minimal spanning tree, it is possible to deduce two parameters, namely the average length m and the standard deviation sigma which are characteristic of the repartition to be studied. The use of a diagram involving both m and sigma makes it possible to determine the degree of order by taking a simple reading in the (m, sigma) plane. PMID- 3657214 TI - Dominance is not inevitable. AB - In a diploid organism, a mutant gene that results in elimination of an enzyme activity in the homozygote is almost universally found to be recessive, so that the heterozygote phenotype is virtually indistinguishable from the wild type. It has been argued (H. Kacser & J. A. Burns, Genetics 97, 639-666 (1981)) that there is no need to look to evolution for an explanation of this phenomenon, as it is an inevitable consequence of the low control coefficients for metabolic flux possessed by nearly all enzymes. However, it is possible to envisage pathways in which every enzyme is more than half-saturated, so that moderate changes in the concentration of any enzyme result in substantial changes in metabolic flux. Such behaviour can occur, for example, if the limiting rates of the enzymes decrease as one proceeds along the pathway and the precursor concentration is large compared with the Michaelis constants of all the enzymes. Consequently one does require an explanation in terms of natural selection of why such pathways are apparently not observed in nature. PMID- 3657215 TI - Ways to approximate current-distance relations for electrically stimulated fibers. AB - The behaviour of myelinated and unmyelinated fibers is simulated by a model for extracellular stimulation in order to confirm current-distance phenomena known from experiments. Lower and upper limits for cells stimulated with cathode current are calculated for unmyelinated fibers. In the case of myelinated fibers the threshold depends on the distance from the axon and from the nodes. PMID- 3657216 TI - Mathematical analysis of separation-induced vocalizations in squirrel monkeys. PMID- 3657217 TI - Surface potential of an ion-penetrable charged membrane. PMID- 3657218 TI - Memory and the efficient use of information. AB - We consider the problem of how an animal's memory should be designed in order to cope with a stochastic and changing environment. In particular we consider the problem of forming the best estimate of an unknown and possibly changing environmental parameter. Under the simple model we consider, the effect of an observation is to update this estimate using a linear operator. Two models of a changing environment are analysed. For each model we show how estimates change as a function of time elapsed and observations taken. The effect of a regular sequence of observations is also considered, and it is shown that an exponential weighting of past observations is a sufficient statistic on which to base decisions. The weighting factors are different in the two model environments considered, but each is shown to be a function of the rate at which the environment is changing. PMID- 3657219 TI - The frequency of shifts between alternative equilibria. AB - We derive a formula giving the frequency with which random drift shifts a population between alternative equilibria. This formula is valid when such shifts are rare (Ns much greater than 1), and applies over a wide range of mutation rates. When the number of mutations entering the population is low (4 N mu much less than 1), the rate of stochastic shifts reduces to the product of the mutation rate and the probability of fixation of a single mutation. However, when many mutations enter the population in each generation (4 N mu much greater than 1), the rate is higher than would be expected if mutations were established independently, and converges to that given by a gaussian approximation. We apply recent results on bistable systems to extend this formula to the general multidimensional case. This gives an explicit expression for the frequency of stochastic shifts, which depends only on the equilibrium probability distribution near the saddle point separating the alternative stable states. The plausibility of theories of speciation through random drift are discussed in the light of these results. PMID- 3657220 TI - Discrete systems, cell-cell interactions and color pattern of animals. I. Conflicting dynamics and pattern formation. AB - The morphogenesis of the color pattern of animals is modeled within the framework of a clonal model. The model takes into account the, sometimes conflicting, cell cell and cell-background interactions. The color patterns of some reptiles and mammals are found to be consistent with the predictions of the model. PMID- 3657221 TI - Discrete systems, cell-cell interactions and color pattern of animals. II. Clonal theory and cellular automata. AB - The morphogenesis of the color pattern of animals is modeled with cellular automata. The cell-cell near neighbor interactions are taken into account and impose restrictions on the model. The allowed patterns are observed in reptiles, felines and fishes. PMID- 3657222 TI - The conceptual framework of monitoring mutagens/carcinogens: a critical appraisal. AB - The main theme of this paper is an analysis of the present knowledge and conceptual framework in the field of monitoring for carcinogenic and mutagenic agents. The conclusions of the International Symposium on "Monitoring human exposure to carcinogenic and mutagenic agents" (Helsinki, 1983) were taken as a starting point for a series of considerations; methods suitable for the quantitative treatment of the information were applied to evidence the profile of current research in this area. The analysis indicated that the major underlying paradigms were related to technical considerations, such as chemical specificity, precision, reproducibility or ease of execution, as well as to the concept of mechanism of action of genotoxic agents. On the other hand, the lack of reliable information about the operational relevance of the systems for assessing health effects was dramatically evidenced. As a conclusion, the dangers of relying on a scientific background derived only from the basic research, without a critical re examination in terms of real, operational performances of the systems, are emphasized. PMID- 3657223 TI - A multivariate phenetic approach to neuronal nuclei resemblances across species, with examples from three regions of cerebral cortex of a mammal, a bird and a reptile. AB - In order to test the assumed homology between three examples of cortical cerebral architecture corresponding to three species of mammals, birds and reptiles respectively, a method arising from the quantitative standpoint of the concept of homology has been utilized. For this purpose, data corresponding to randomly selected neurons were analysed by means of multivariate techniques such as principal component, principal co-ordinates and hierarchical cluster analyses since on each neuron a set of nineteen variables, chosen as a definition of its dendritic morphology, was measured. This method has made it possible both to discern the neuron forms which are responsible for the discrimination between the three cortical nuclei studied and to show by setting up a discriminant index, the degree of overall similarity between such nuclei. These two findings provide evidence against both the fibrous connection criterion with which some modern neurobiologists ascertain homologs and the categorical concept of homology. PMID- 3657224 TI - Contrasting sex ratios in siblings of male and female left-handed persons. PMID- 3657225 TI - Antibacterial immunity and its modeling in experimental tumor tetanus and wound tetanus of the mouse. AB - The experimental and theoretical analysis of the tumor-tetanus phenomenon has provided us with new insights into the pathogenesis of tetanus infection. Our theoretical model of clostridial propagation in the proliferating tissue is based upon the principle of mitosis-controlled rod division (hit and cloning model). It has lent itself to the description of early growth stages of the clostridial rod population in our experiments of tumor tetanus and of wound tetanus of the mouse. However, the later course of the tetanus lethality curves under antitoxin protection, about a week following injection of the tumor cell-spore or CaCl2 spore suspensions, reveals a pronounced delay in clostridial propagation. Based on our model we can explain this process by a humoral immune reaction directed against the clostridial rods taking into account the variability of elimination of the heterologous tetanus antitoxin applied. The experimental results are in good agreement with those obtained by computer simulation. The theoretical knowledge resulting from these studies can be used for the interpretation of the serodiagnostic tumor test with apathogenic clostridia as well as for the quantitative assessment of the malignancy of neoplastic growth. PMID- 3657226 TI - Relationship between hydropathic variability and functional properties of alpha lactalbumins and type c lysozymes. AB - Hydropathic profiles obtained from the amino acid sequences of 8 alpha lactalbumins were averaged and compared to the average profile deduced from the primary structure of 21 type c lysozymes. This analysis was performed in order to detect differences between both types of molecules, since it could explain their different functional properties. The application of the method herein described reveals the existence of very significative differences (P less than 0.001) between the amino acid residues located at positions 31-32, 34-35, 37-45, 47-48, 80-85 and 108-113 of alpha-lactalbumins and their homologous in type c lysozymes. These differences are in agreement with the chemical data about the interaction sites of both galactosyltransferase and calcium ions with alpha-lactalbumin, which are not required for the lysozyme function. PMID- 3657227 TI - Towards a collective biology of the gene. AB - Two features of heterochromatin: heteropycnosis (high values of chromatin condensation), and repressed genetic expression, force upon us the use of cooperative variables, rather than molecular ones. In particular a "repressor" hypothesis is formulated, in which a useful parameter is clearly identified. This enables us to discuss the synchronized repression of a large number, n, of genes (as in the case of the Barr body, in which n is larger than 100). The hypothesis is documented with phenomena known to occur in active chromatin. Possible tests are suggested. PMID- 3657228 TI - The impact of symbolism on immunogenetics: an application to HLA. AB - The genes coding for the class I human lymphocyte antigens (HLA) are located on chromosome 6. These antigens are involved with the immunological interaction between cells. In some immunogenetic systems, such as HLA in humans, genes are defined by antibody/antigen reaction and are denoted by single symbolic identifiers. This symbolization assumes a one-to-one correspondence between antibodies, antigens and genes. Recent molecular studies, however, suggest that HLA antibody/antigen reaction is complex and most HLA class I specific antibodies may not uniquely identify a single allelic product. Where cross-reactivity is present in an immunogenetic system it is important to label each reagent with symbols corresponding to all genes coding for antigens with which the reagent will react. The problems of cross-reactive groups and unexplained linkage relations may be elucidated by the redefinition and clarification of certain HLA antigens. A computer program can suggest such labelling schemes using input given by phenotype reaction patterns with a panel of reagents. When this program was applied to data on the class I HLA antigens a genetic model was suggested that differs somewhat from the currently accepted model. The new model is able to predict what would appear as linkage relations in the accepted model. Our methodology can provide alternate models to guide in typing cloned genes in terms of the HLA locus and alleles. PMID- 3657229 TI - The population dynamics of acquired immunity to helminth infection: experimental and natural transmission. AB - Recently we described a mathematical model of the role of acquired immunity in host-helminth interactions. The model gives a good quantitative description of the results of experiments involving the nematode Heligmosomoides polygyrus in laboratory mice. Here we apply the model to the results of two further laboratory studies of the same parasite-host interaction: (i) the repeated experimental infection of a genetically heterogeneous host population, and (ii) the natural transmission of the parasite within mouse populations under different dietary conditions. Numerical simulation again reveals good quantitative agreement between the model predictions and laboratory data. Finally, the model is extended to give a preliminary description of the dynamics of helminth-host interactions of medical and ecological significance in the real world. PMID- 3657230 TI - The use of non-linear regression analysis and the F test for model discrimination with dose-response curves and ligand binding data. AB - Computer fitting of binding data is discussed and it is concluded that the main problem is the choice of starting estimates and internal scaling parameters, not the optimization software. Solving linear overdetermined systems of equations for starting estimates is investigated. A function, Q, is introduced to study model discrimination with binding isotherms and the behaviour of Q as a function of model parameters is calculated for the case of 2 and 3 sites. The power function of the F test is estimated for models with 2 to 5 binding sites and necessary constraints on parameters for correct model discrimination are given. The sampling distribution of F test statistics is compared to an exact F distribution using the Chi-squared and Kolmogorov-Smirnov tests. For low order modes (n less than 3) the F test statistics are approximately F distributed but for higher order models the test statistics are skewed to the left of the F distribution. The parameter covariance matrix obtained by inverting the Hessian matrix of the objective function is shown to be a good approximation to the estimate obtained by Monte Carlo sampling for low order models (n less than 3). It is concluded that analysis of up to 2 or 3 binding sites presents few problems and linear, normal statistical results are valid. To identify correctly 4 sites is much more difficult, requiring very precise data and extreme parameter values. Discrimination of 5 from 4 sites is an upper limit to the usefulness of the F test. PMID- 3657231 TI - Thermal interaction between animal and microclimate: a comprehensive model. AB - An equation based on heat transfer theory is developed to predict the rate of heat loss from a homeothermic vertebrate to the environment, specified by the air temperature, humidity, windspeed and radiation receipt. The analysis incorporates the animal's thermoregulatory responses--sweating ability, vasomotor action, and regulation of body-core temperature, metabolic and respiratory rate. The loss of heat and water vapour from cattle is used as an illustration, and particular attention is given to their heat balance in hot environments. The predicted rates of heat loss from cattle indoors at various air temperatures and humidities are consistent with experiments. Outdoors, intercepted solar radiation can reduce substantially heat loss through the body tissue when the air temperature is low. In contrast, at high air temperatures the heat dissipation may not be sensitive to the radiation load, although body-core temperature is. Increased rates of air movement can aggravate strain at low air temperatures, but mitigate strain in a hot environment. PMID- 3657232 TI - Quantum mechanical coherence in red blood cells: no experimental evidence. PMID- 3657233 TI - Extending the quasi-steady state concept to analysis of metabolic networks. AB - A means is proposed for evaluating enzyme effectiveness in vivo via a simplified dynamic description of the metabolic reaction network within which the enzyme operates. The basis of the method is application of sensitivity analysis to a quasi-steady approximation of a complete dynamic model, and its implementation centers on interpreting the transient relations of selected intermediates following a perturbation to the system of interest: for many important situations such relations can be simply interpreted to give a useful global measure of enzyme effectiveness. This method is found to be successful for estimating phosphofructokinase and pyruvate kinase activity in the human red cell, and it appears promising as a basis for developing a means for detecting enzyme abnormalities caused by environmental or genetic factors. This method may also prove useful for comparative studies of glycolysis in different types of cells. The analysis presented is based on available models of red cell glycolysis, but the results are not highly sensitive to ambiguities in the system model. The approach suggested appears to provide an effective means for describing system dynamics and determining the behavior of an individual enzyme in an intact system by making a first-order allowance for interaction with the system as a whole. Requirements for success of this approach remain to be identified in detail, but effective time-scale separation is probably the key. PMID- 3657234 TI - Simulation analysis of conduction of excitation in the atrioventricular node. AB - The excitation conduction in the atrioventricular node was simulated based on the spatially discrete model of the heart proposed in an earlier paper (Kawato et al., 1986). We constructed a model system composed of the atrium, the atrioventricular node and the Purkinje fiber. Coupling coefficients between these tissues were quantitatively estimated from experimental data on size and membrane capacitance of the three kinds of cardiac cells. We found the following three important features in the simulated excitation conduction along the atrioventricular node. First, shape of action potential was found to be different at different locations of the atrioventricular node although the membrane properties were assumed uniform through the atrioventricular node. Our analysis suggests that the difference in the action potential waveforms observed by Paes de Carvalho & De Almedia (1960) can be ascribed to the electrical influences of the atrium and the His bundle on the atrioventricular node. Second, when the excitation wavefront invaded the atrioventricular node from the atrium, a step was observed in the depolarization phase of the action potential at the atrioventricular node neighboring with the atrium. Janse found a similar step in the real experiment (1969). It is revealed that this step is caused by termination of the junctional current which flows from the atrium to the atrioventricular node. Finally, we found that the conduction velocity measured near the boundary between the atrium and the atrioventricular node was lower than that in the middle part of the atrioventricular node, which is in accordance with the experimental observation by Scher et al. (1959). PMID- 3657235 TI - Constancy of genomic instability in tumor progression. PMID- 3657236 TI - On Nussinov's compilation of eukaryotic transcription initiation sites. PMID- 3657237 TI - Does variation in the testosterone level of the seminal plasma affect the primary sex ratio? PMID- 3657238 TI - Semi-meiosis and evolution: a response. PMID- 3657239 TI - Size control of cell division. PMID- 3657240 TI - A model for oxygen storage by hemoglobin. AB - An oxygen store based on the reversible combination of oxygen with hemoglobin or related hemoproteins could be of considerable value to organisms or tissues faced with intermittent hypoxia or anoxia. It would be of interest, therefore, to know the physical and chemical requirements and limitations of useful storage. A model is presented which predicts storage time from physical, chemical, and geometric properties of the store. Storage time is arbitrarily defined as the time for 50% of the stored O2 to diffuse from a fully-loaded store when the store is exposed to a zero O2 environment. Results are presented in the form of simple approximate equations and in graphical form and indicate that: (1) a wide range of storage times can be obtained with reasonable biological parameters; (2) storage times approaching 1,000 s can be achieved even with stores of microscopic dimension; (3) biological O2 storage is predominantly diffusion-limited, although reaction limited behavior is not impossible; and (4) the major effect of co-operativity appears to be on the form of O2 release: hemoglobins without co-operativity release O2 at a constantly declining rate, whereas those with high co-operativity release O2 at a constant rate. The model is applicable not only to hemoglobin based O2 storage, but also to any reaction-diffusion system in which one substance can be "stored" by reversible combination with some other substance which acts as the store. PMID- 3657241 TI - On the relation between extended forms of the sinusoidal perfusion and of the convection-dispersion models of hepatic elimination. AB - Two models of hepatic elimination, the distributed sinusoidal perfusion model, and the convection-dispersion model, are extended and then compared for first order kinetics in the steady-state. The sinusoidal perfusion model is extended by the inclusion of intrahepatic sites of mixing between sinusoids. The degree of such mixing is estimated for taurocholate elimination by isolated perfused rat livers by a comparison of anatomical and kinetic estimates of uptake heterogeneity, using previously published data. The dispersion model is generalized by the inclusion of distributions of enzyme activity along the flow. Direct comparison of the two models in the limit in which the degree of dispersion is small, allows the flow-dependence of the dispersion coefficient to be determined, thereby greatly extending the explanatory power of the convection dispersion model. Finally, the effect of intrahepatic mixing sites on uptake by Michaelis-Menten kinetics is quantified in terms of the distributed sinusoidal perfusion model, with results which may be applicable to capillary beds in general. PMID- 3657242 TI - An efficient string matching algorithm with K substitutions for nucleotide and amino acid sequences. AB - Given a text of length n, a pattern of length m and an integer k, we present an algorithm for finding all occurrences of the pattern in the text, each with at most k substitutions. The algorithm runs in O(k(m log m + n)) time, and requires O(nk) space. This algorithm has direct implications for nucleotide and amino acid sequence comparisons. PMID- 3657243 TI - Dominance not inevitable but very likely. PMID- 3657244 TI - Vasodilator effects of cepharanthine, a biscoclaurine alkaloid, on cutaneous microcirculation in the rabbit. AB - Cutaneous microcirculatory responses to intravenous administration of cepharanthine (CT), a biscoclaurine alkaloid, isolated from Stephania cepharantha, were studied in a transparent round chamber installed in a rabbit ear, under conscious conditions. Vital-microscopic observations were made visually with a microscope-closed TV system and microphotoelectric plethysmography. Following the CT administration in doses of 1.0 and 3.0 mg/kg, an enhancement of rhythmic perfusion of microvascular blood due to vasomotion was developed for a period of 1 h or longer, although no appreciable change was observed following CT administration at 10.0 mg/kg. The microvascular dilator effect of CT appeared to have no direct association with systemic hemodynamics, based on the additional measurements of heart rate, blood pressure, carotid blood flow and auricular arterial blood flow. PMID- 3657245 TI - Natural constituents of Ilex species. AB - A literature survey on chemical constituents of Ilex species is given. General and medicinal uses of the plant are also described. PMID- 3657246 TI - Ethnobotanical inventory of medicinal plants used by the Guaymi Indians in western Panama. Part I. AB - Plants used by Guaymi "Curanderos" in Western Panama (Bocas del Toro and Chiriqui) are listed. Results of a literature survey are also reported, including medical use, known constituents and pharmacological effects. PMID- 3657247 TI - On the ethnomedical significance of the Arjun tree, Terminalia arjuna (Roxb.) Wight & Arnot. AB - Terminalia arjuna is an important cardiotonic plant described in the Ayurveda, the ancient Indian medical science. It is also believed to have the ability to cure hepatic, urogenital, venereal and viral diseases. An attempt is made here to analyse the available drug recipes using this plant from Sanskrit literature in the light of modern scientific knowledge. The chemistry and pharmacology of T. arjuna are also discussed, and areas of future investigations are identified. PMID- 3657248 TI - Ichthyotoxic activities of Ateleia glazioviana Baill. and Thinouia coriacea Britt. AB - Ethanolic extracts from leaves and roots of Ateleia glazioviana (Leguminosae Papilionoideae) and the saponin containing fraction from Thinouia coriacea (Sapindaceae) have been studied for ichthyotoxic activity on Phallocerus caudimaculatus and Geophagus brasiliensis. The ethanolic extracts were used in doses ranging from 50 to 100 ppm, based on the dry residue. The saponin fraction was used at doses of 1-10 ppm. The two plant extracts and saponin fractions were found to be ichthyotoxic, justifying their traditional role as an aid in fishing. PMID- 3657249 TI - Comparison of the skeletal muscle relaxant properties of Portulaca oleracea extracts with dantrolene sodium and methoxyverapamil. AB - The effects of aqueous (AEE), dialysable (DIF) and methanol (MEE) extracts of Portulaca oleracea stems and leaves were compared with those of dantrolene sodium and methoxyverapamil (D-600) with respect to inhibition of twitch tension on the rat phrenic nerve-hemidiaphragm and with respect to contracture induced by nicotinic agonists on the frog rectus abdominis preparations. The extracts, dantrolene and D-600 inhibited twitch tension due to indirect electrical stimulation via the phrenic nerve (NS) on hemidiaphragm muscle, whereas the extracts and dantrolene inhibited, in addition, twitch amplitude due to direct muscle stimulation (MS). The extracts, dantrolene and D-600 also attenuated K+- and caffeine-induced contractures with the extracts and D-600 also reducing the time taken for the K+-induced contracture to fall to basal tension. In addition, the tetanic tension due to NS and MS was attenuated with only the extracts and dantrolene reducing the twitch/tetanus ratio (MS). There was a non-significant but consistent tendency for mutual potentiation between the extracts and dantrolene with respect to their inhibitory effect on twitch amplitude (MS) resulting in a shift to the left of the concentration-response curves to the extracts or dantrolene. This was not evident with the extracts and D-600 or dantrolene and D-600. Simultaneous addition of the extracts and dantrolene resulted in an increase in the rate of twitch tension inhibition and a decrease in the time to maximum relaxation of twitch amplitude (MS). The extracts and D 600 proved more effective in attenuating nicotinic agonist (acetylcholine, carbachol and nicotine)-induced contractures on the rectus abdominis muscle than dantrolene. From these observations, it appears that the Portulaca oleracea extracts mimic, in part, the effect of D-600 and dantrolene on the rat hemidiaphragm and frog rectus abdominis muscles; therefore, the muscle relaxant properties of the extracts may be due, in part, to inhibition of trans-membrane Ca influx, interference with the Ca-induced Ca release process and/or inhibition of the release of intracellular Ca from stores in the sarcoplasmic reticulum. PMID- 3657250 TI - Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. I. Prevalence, diagnosis, and comparison of preoperative clinical and hemodynamic features in patients with and without tricuspid regurgitation. AB - Most reports of clinical experiences with palliation of acquired tricuspid regurgitation have failed to address the issue of coexisting disease of the mitral or aortic valve, or both. To accurately determine the natural history and the effect of operative interventions, we studied patients with chronic, pure mitral regurgitation who had surgical treatment at the National Heart, Lung, and Blood Institute from 1968 to 1984. Forty-seven patients fulfilled the criteria of a documented history of mitral regurgitation for more than 1.5 years, minimal mitral diastolic gradient, severe mitral regurgitation by angiography, and no prior mitral or tricuspid operative procedure. Twenty-five of the 47 patients (53%) had evidence of tricuspid regurgitation. No statistical differences in age, sex, mean duration of symptoms of congestive heart failure, or functional class were found between those patients with and those without tricuspid regurgitation. However, patients with symptoms of congestive heart failure for more than 6 years were more likely to have tricuspid regurgitation. This increased prevalence also correlated with higher elevations of left ventricular end-diastolic, systolic pulmonary artery, and mean right atrial pressures. The severity of tricuspid regurgitation estimated preoperatively did not correlate statistically with that determined by digital palpation, although the presence of tricuspid regurgitation was reliably confirmed. These data demonstrate that tricuspid regurgitation is frequently present in patients with chronic, pure mitral regurgitation and is associated with prolonged symptoms of congestive heart failure and significant alterations in right heart dynamics. PMID- 3657251 TI - Tricuspid regurgitation in patients with acquired, chronic, pure mitral regurgitation. II. Nonoperative management, tricuspid valve annuloplasty, and tricuspid valve replacement. AB - The incidence, preoperative and intraoperative diagnosis, methods, and the clinical and hemodynamic features of patients with and without tricuspid regurgitation associated with chronic mitral regurgitation were presented in Part I. This study (Part II) compares the early and late results in patients with chronic, pure mitral regurgitation undergoing isolated mitral valve replacement, mitral replacement and tricuspid valve annuloplasty, and mitral and tricuspid valve replacement. The mean follow-up interval was 6 years. Those with the longest duration of symptoms (18 years) required tricuspid and mitral valve replacement (11 patients), whereas those with the shortest duration (8.1 years) had only mitral replacement (22 patients). Eight patients had minimal tricuspid regurgitation by digital palpitation, with no procedure performed, and six had tricuspid valve annuloplasty, only one of whom received a ring support. Operative mortality rate was similar in all groups (13% to 18%). All but two of the surviving patients improved by at least one New York Heart Association functional class, and no statistically significant differences were found between preoperative and postoperative hemodynamic data. There were no statistically significant differences in survival at 1, 5, or 8 years (85%, 70%, and 60%, respectively) for patients with or without TR. Only two of the surviving five patients who underwent tricuspid valve annuloplasty were alive 3 years after operation, whereas 70% to 80% of those with mitral replacement or mitral and tricuspid replacement were alive after the same time interval. It is not clear whether or not the pathogenesis of tricuspid regurgitation resulting from mitral regurgitation is different from that of tricuspid regurgitation resulting from mitral stenosis. It is our contention that whether tricuspid regurgitation arises because of anatomic destruction of the tricuspid valve or because of right ventricular dilatation with tricuspid annular enlargement, the underlying mitral valve lesion may determine the preoperative and postoperative courses of these patients. Therefore, when tricuspid valve disease is being evaluated, we urge that patients be categorized by the nature of their underlying mitral or aortic valve lesions. PMID- 3657252 TI - Structural composition of central pulmonary arteries. Growth potential after surgical shunts. AB - Failure to achieve adequate pulmonary artery growth in patients with cyanotic congenital heart disease is a major obstacle to surgical correction. To assess whether differences in structural composition of central pulmonary arteries influence their growth potential after surgically created shunts, we obtained full-thickness biopsy specimens from the hilar pulmonary arteries of eight patients with pulmonary atresia or tetralogy of Fallot undergoing modified Blalock-Taussig shunts under 1 year of age. Tissue was processed for electron microscopic studies and a morphometric assessment was made of the volume proportions of smooth muscle, collagen, ground substance, and elastin. Initial pulmonary artery size was determined angiographically during the diagnostic cardiac catheterization. Pulmonary artery size was determined by cross-sectional echocardiograms 7 to 27 months later (mean 19 months). Pulmonary artery growth did not correlate with the interval between examinations but did correlate with the volume proportion of elastin (r = 0.73, standard error of the estimate = 1.45, p less than 0.05). Thus the structural composition of pulmonary arteries may influence their potential for growth after surgical shunts. In particular, an inadequate proportion of elastin may be a hindrance to growth. PMID- 3657253 TI - Critical aortic stenosis. Survival and management. AB - The factors associated with survival in 40 neonates (age less than 28 days) with critical aortic stenosis undergoing either open (22 patients) or closed (18 patients) transventricular aortic valvotomy were reviewed. Significant adverse correlates with survival included evidence of poor perfusion preoperatively (low pH, greater than Grade 2/6 soft ejection systolic murmur) and marked congestive heart failure (hepatomegaly, cardiomegaly, elevated left atrial pressure). Congenital mitral stenosis (anulus less than 11 mm), a small aortic anulus (less than 6.5 mm), and failure to achieve an adequate aortic orifice (greater than 6 mm), at operation were identified as factors associated with increased mortality. Initial perioperative survival was better with closed aortic valvotomy. However, there was no significant difference in overall operative survival between closed (9/18, 50%) and open (8/22, 36%) aortic valvotomy (p = 0.26). The incidence of early reoperation (less than 1 year of age) was greater in perioperative survivors undergoing closed valvotomy (7/13, 54%) rather than open valvotomy (1/10, 10%) (p less than 0.05). In conclusion, long-term survival among patients with critical neonatal aortic valve stenosis remains disturbingly low (13/40, 32%) and has not significantly improved over the past 20 years. PMID- 3657254 TI - Patterns of pulmonary arterial anatomy and blood supply in complex congenital heart disease with pulmonary atresia. AB - To identify the pattern of pulmonary anatomy and pulmonary blood supply, we analyzed the angiocardiograms of 40 patients with pulmonary atresia and complex congenital heart disease. All patients but two (95%) had confluent pulmonary arteries supplied by a patent ductus arteriosus. These two patients (5%) had nonconfluent pulmonary arteries, one with major systemic-pulmonary collateral arteries and absent patent ductus arteriosus and the other with a patent ductus arteriosus supplying the right lung and small collateral arteries supplying the left. The low incidence of pulmonary arterial abnormalities and the uniform pattern of pulmonary blood supply make the patients with pulmonary atresia and complex congenital heart disease potential candidates for palliative operation without cardiac catheterization in the neonatal period. PMID- 3657255 TI - Radionuclide transit in patients with colon interposition. AB - To assess radionuclide transit in interposed segments of the colon, we examined 25 patients with colon interposition for benign esophageal disease. No such assessment has been reported previously. The most common indications for operation were esophageal strictures that developed after lye ingestion and reflux strictures not responding to other treatment. The operations were performed without thoracotomy by blunt esophageal dissection in 80% of the patients. There were 18 antiperistaltic and seven isoperistaltic colon grafts. A large-field gamma camera and computer system were used. Data were collected at time intervals of 0.5 second during the first 30 seconds and at intervals of 30 seconds up to 20 minutes. The 5% and 90% stomach filling times, times to 50% and 25% activity levels, and residual activity levels as a percentage of the maxima were calculated in the upper, middle, and lower thirds of the colon grafts and of the normal esophagus of 10 healthy control subjects. The examinations were performed with the subject in a sitting position. All parameters showed that emptying of the colon graft was markedly slower than that of the normal esophagus. The intra-abdominal third of the graft had a residual activity of 50.5% +/- 15.7% after 20 minutes' observation. No differences between antiperistaltic and isoperistaltic grafts were observed. Reconstruction with proximal cologastric anastomosis and a short intra-abdominal colon graft segments is suggested. PMID- 3657256 TI - Age-related differences in the response to myocardial ischemic stress. AB - Clinical experience indicates that the risk of reparative cardiac operations is increased in the neonatal period relative to that in older infants and children. Age-related differences in the susceptibility to myocardial ischemic dysfunction were evaluated by comparison of left ventricular function and metabolism in neonatal (mean age = 7 days) and weanling (mean age = 96 days) piglets. Six animals in each group supported on cardiopulmonary bypass were subjected to (1) 120 minutes of hypothermic crystalloid cardioplegic arrest (CP-120) and (2) 15 minutes of normothermic ischemic arrest (NA-15) after a 60 minute interval of reperfusion. Left ventricular systolic and diastolic function was measured after each intervention via endocardially implanted ultrasonic dimension crystals in a septolateral minor-axis position. In both groups, systolic dysfunction was evidenced by an increase in the dimension-axis intercept (p = 0.001), but not the slope of the end-systolic pressure-dimension relation. Left ventricular end diastolic stiffness, expressed as left ventricular end-diastolic pressure versus Lagrangian strain, increased to a similar degree in both groups (p = 0.001). Adenosine triphosphate levels declined significantly (p = 0.001) in both groups in response to the ischemic interventions with no evident intergroup differences. Lactate levels increased significantly during the course of the experiment (p = 0.04); however, the increases were greater (p = 0.009) at all intervals in the neonatal group. This study demonstrates age-related metabolic differences in response to ischemia consistent with a greater dependence on glycolysis in neonatal myocardia. However, the fact that discriminating age-related differences in left ventricular function were not evident suggests that factors other than young age per se account for the increased surgical mortality in the neonatal period. PMID- 3657257 TI - The necessity for tricuspid valve repair can be determined intraoperatively by two-dimensional echocardiography. AB - Residual significant tricuspid regurgitation after mitral valve operations may significantly increase postoperative morbidity and mortality. However, routine techniques to detect tricuspid regurgitation preoperatively and intraoperatively are inaccurate. Two-dimensional echocardiography was performed intraoperatively to assess its ability to evaluate and quantify the severity of tricuspid regurgitation. In 50 patients who underwent cardiac operations, 5 ml of dextrose or saline was injected into the right ventricle to generate echogenic "contrast." In patients with tricuspid regurgitation, there was systolic reflux of contrast into the right atrium, which could be semiquantified on a scale of 0 to 4+. Besides correlating well with preoperative Doppler studies for the presence or absence of tricuspid regurgitation in 18 patients (sensitivity = 0.90, specificity = 1.00), the intraoperative contrast method could quantify the severity of reflux. The 50 patients were divided into two groups on the basis of severity of tricuspid regurgitation as assessed by intraoperative two-dimensional contrast echocardiography. Group I (36 patients) had no or mild (0-2+) regurgitation, and Group II (14 patients) had moderate to severe (3-4+) tricuspid regurgitation. Patients with significant tricuspid regurgitation (Group II) had greater intraoperative preprocedure and postprocedure systolic and diastolic pulmonary pressures. Additionally, the systolic tricuspid anulus length, as measured in the intraoperative right ventricular inflow view, correlated better with severity of tricuspid regurgitation (r = 0.76, p = 0.005) than mean pulmonary pressure (r = 0.52, p less than 0.01). Therefore, intraoperative contrast two-dimensional echocardiography can accurately assess the relative severity of tricuspid regurgitation. Importantly, intraoperative measurement of tricuspid anulus diameter could predict the presence of significant echocardiographic tricuspid regurgitation before as well as immediately after the operation. Two-dimensional echocardiography may be an important intraoperative method both for evaluating the presence and severity of residual tricuspid regurgitation immediately after left heart operations as well as for determining which patients should undergo tricuspid valve repair. PMID- 3657258 TI - Changes in myocardial oxygen consumption and coronary sinus blood flow before and after resection of left ventricular aneurysm after myocardial infarction. AB - The patients in this study consisted of eight men who underwent resection of left ventricular aneurysm. Right and left heart catheterization at rest and measurement of coronary sinus blood flow by continuous thermodilution were performed preoperatively and an average of 6 months after the operation. Coronary sinus blood flow decreased significantly from 161 to 118 ml/min and myocardial oxygen consumption decreased significantly from 17.2 to 10.5 ml/min postoperatively. Cardiac index increased postoperatively. Ejection fraction increased from 0.31 to 0.49 and mean velocity of circumferential fiber shortening significantly increased from 0.53 to 1.0 circ/sec postoperatively. Left ventricular end-diastolic volume decreased significantly from 166 to 120 ml/m2 postoperatively. The mean systolic circumferential tension significantly decreased postoperatively. We believe that the decrease in wall tension postoperatively brought about the reduction in myocardial oxygen consumption. Thus the high wall tension and myocardial oxygen demand, present preoperatively, were improved postoperatively, with a resultant lowering of oxygen consumption and equivalent or better left ventricular function. PMID- 3657259 TI - Left ventricular aneurysm with predominating congestive heart failure. A comparative study of medical and surgical treatment. AB - From 1979 to 1985, 109 patients were treated for congestive heart failure caused by postinfarction left ventricular aneurysm. Congestive heart failure was predominant in all patients at the time of diagnosis, 73% of whom were in Functional Class III or IV. Left ventricular end-diastolic pressure averaged 23.8 +/- 0.8 mm Hg (mean +/- standard error of the mean), total ejection fraction 29.7% +/- 1.0%, and telediastolic volume of the aneurysm 76.2 +/- 5.8 ml. Aneurysmectomy was performed in 49 patients (45%), whereas the remaining 60 patients were treated medically. The two groups did not differ in regard to clinical and hemodynamic data on admission, except for a more extensive coronary artery disease in the surgical group. Follow-up was obtained for all patients (100%) and averaged 48 +/- 3 months. Actuarial survival curves were similar, and the 5-year survival rates for surgical and medical groups were 70 +/- 7% and 64% +/- 7%, respectively (not significant). However, the 5-year complication-free rate was significantly (p = 0.05) higher among surgical patients (52% +/- 8%) than among the medical group (31% +/- 7%). Multivariate analysis showed the following variables to influence survival independently (p less than 0.05): contractile segment ejection fraction, right ventricular failure, antecedents of cardiac arrest or cardiogenic shock, and corrected contractile score. Independent variables decreasing the risk of cardiac-related complications and death (p less than 0.05) were as follows: surgical treatment, shorter interval between initial infarction and diagnosis of aneurysm, and absence of right ventricular failure. Functional improvement was directly related to surgical treatment and to residual segment contractile score (p less than 0.05). Thus, in patients with congestive heart failure caused by left ventricular aneurysm, surgical treatment improved the quality of life and prognosis for cardiac-related complications, but did not increase overall survival, compared to medical management of similar patients. PMID- 3657260 TI - Actuarial survival, freedom from reoperation, and other events after repair of atrioventricular septal defects. AB - Repair of an atrioventricular septal defect was performed in 134 patients from 1973 to 1985. Interventricular communication was present in 54 (40%) and none was present in 80 (60%). There were 12 hospital deaths (9%; 70% confidence limits 6% 12%). Earlier date of operation (p = 0.03) and younger age at repair (p = 0.005) were incremental risk factors for hospital death after repair of partial atrioventricular septal defect. Smaller size (p = 0.003) and longer cross-clamp time (p = 0.002) were risk factors for hospital death in those patients with complete atrioventricular septal defect. Higher preoperative pulmonary vascular resistance was a risk factor for death in both groups (p = 0.007). The 10 year actuarial survival rate was 82% overall. Increasing preoperative severity of left atrioventricular valve incompetence was not a risk factor for early (p = 0.001) or late (p = 0.002) death. The 10 year actuarial freedom from reoperation after repair of partial atrioventricular defects was 85%, and it was 68% for complete atrioventricular defects (p = 0.06). We conclude that the intermediate term results after repair of atrioventricular septal defects are good. Incompetence of the left atrioventricular valve has apparently been neutralized as a risk factor for hospital death in this series. However, the durability of the repair has been disappointing. A policy of earlier repair has been adopted and should improve hospital mortality and permit better preservation of the atrioventricular valve structures with resultant improved late term functional status. PMID- 3657261 TI - Vascular ring in interruption of the aortic arch with bilateral patent ductus arteriosi. AB - The previously unreported occurrence of a true vascular ring in association with interruption of the aortic arch resulting from bilateral persistence of the ductus arteriosi is described. Division of both ductus is necessary to minimize the potential for tracheobronchial compression. This should be accomplished either during definitive (one-stage) repair of the interrupted aortic arch and associated anomalies or at the initial procedure of a staged repair. PMID- 3657263 TI - Accuracy of sizers for aortic valve prostheses. AB - Accurate sizing of the aortic anulus is a prerequisite of prosthetic valve implantation, because it is usually desirable to insert the largest possible prosthesis. Although it is generally assumed that commercial valve sizers are accurately labeled, our measurements reveal that the sizers for the St. Jude Medical, Bjork-Shiley, and Ionescu-Shiley prostheses are larger than their nominal sizes. These findings are relevant to the selection of prosthetic valves. PMID- 3657262 TI - Calcium-induced ventricular contraction during cardioplegic arrest. AB - Cardiac arrest induced by hyperkalemic perfusion is generally considered to represent a state of complete electromechanical arrest. However, high-energy phosphate concentrations and ventricular function decrease with increasing cardioplegic calcium concentrations, possibly because of elevated resting muscle tone produced by calcium influx. We examined isolated rat hearts containing an isovolumic intraventricular balloon for the presence of contractile activity during the administration at 10 degrees C of a cardioplegic solution containing potassium, 20 mEq/L. Significant left ventricular pressure was developed (35.6% +/- 4.3% of prearrest systolic pressure) during administration of a solution containing a calcium concentration of 1.0 mmol/L and far less (9.7% +/- 1.6% of prearrest systolic pressure) with a calcium-free cardioplegic solution. The muscle contraction diminished with repeated doses, was increased by increasing cardioplegic calcium content, and was inhibited by magnesium. Adenosine triphosphate and creatine phosphate concentrations were 9.0 +/- 1.4 and 7.0 +/- 0.9 nmol/mg dry weight immediately after infusion of 15 ml of a hypoxic cardioplegic solution containing calcium, versus 13.3 +/- 1.3 (p less than 0.02) and 31.9 +/- 3.5 nmol/mg dry weight (p less than 0.0001) after a hypoxic acalcemic solution was given. When repeated doses of a hypoxic cardioplegic solution containing calcium in a concentration of 1.0 mmol/L were given at 15 minute intervals at 10 degrees C, ischemic contracture (a sustained development of ventricular pressure, mean 51% +/- 4% of prearrest systolic pressure) resulted within 1 hour. Coronary vascular resistance was increased during the muscle contractions induced by calcium-containing solutions, markedly so during contracture. Calcium-related mechanical activity was also observed during hypothermic cardioplegic arrest in five of six isolated isovolumic canine hearts. We conclude that hearts remain potentially active mechanically during cold hyperkalemic arrest and undergo energetically wasteful contraction when stimulated with calcium-containing hyperkalemic cardioplegic solutions. PMID- 3657264 TI - The modified polytetrafluoroethylene Blalock-Taussig shunt: case report of an unusual complication. AB - A case of excessive serous leak through a modified polytetrafluoroethylene Blalock-Taussig shunt is presented. This relatively rare complication was treated successfully with fibrin glue and collagen fleece. PMID- 3657265 TI - Aortic valve replacement in the presence of sternal metastases from prostatic carcinoma: a case report. AB - A 65-year-old man was admitted with New York Heart Association Class IV heart failure, refractory to maximal medical therapy. High-grade aortic insufficiency and severe left ventricular dysfunction were demonstrated by cardiac catheterization. The patient had known prostatic carcinoma with extensive metastatic involvement of the sternum. Aortic valve replacement was performed successfully through a median sternotomy incision and the patient returned to full activities. PMID- 3657266 TI - Left ventricular-coronary sinus fistula after mitral valve replacement. AB - One of the more rare complications after mitral valve replacement is the development of a left ventricular-coronary sinus fistula, which has been reported only twice before. In the reported cases a common feature has been multiple valve replacements. Our case was one of the late development (8 years) of a fistula in a patient who had only one previous replacement but in whom a murmur was detected 3 months after the operation. PMID- 3657267 TI - Postischemic ventricular performance and oxygen metabolism: corroboration or quandary? PMID- 3657268 TI - Modified ascending aorta-right pulmonary artery shunt. PMID- 3657269 TI - Cardioplegia. PMID- 3657270 TI - Further studies on the use of the fluorescent tracers fast blue and diamidino yellow: effective uptake area and cellular storage sites. AB - Some basic methodological issues concerning the use of the fluorescent tracers Fast blue (FB) and Diamidino yellow (DY) were studied using the projections of the red nucleus to the nucleus interpositus anterior (NIA) of the cerebellum of the cat. On standard Nissl-stained sections, it was possible to delineate 4 distinct zones at the FB and DY injection sites. Correlative studies of injection sites in the NIA and retrograde labeling of cell bodies in the contralateral red nucleus showed that effective uptake occurred only from the zone mechanically damaged by the injection needle (termed zone 0). The tracer remains in this zone during the post-injection survival. The limited uptake area for both tracers is a valuable feature for studies of restricted neuronal projections. However, the tracers are not suitable for use in quantitative studies, especially those concerning axonal collateralization. Perfusion with water-soluble fixatives did not alter the cellular storage site. In double-labeling experiments using horseradish peroxidase and DY, the HRP histochemistry induced an important "washing out" of DY and consequently, an underestimation of the number of labeled neurons. PMID- 3657271 TI - Wire electrodes for chronic single unit recording of dopamine cells in substantia nigra pars compacta of awake rats. AB - Stainless steel wire electrodes of varying sizes and coated with different insulating materials were tested in order to find a flexible fine wire which would allow the recording of small cells in deep structures of the brain in unrestrained, awake rats. Our main interest is to record from cells of substantia nigra pars compacta during locomotion. We found that stress relieved 18 micron stainless steel wire doubly insulated with lacquer and Parylene C provided the impedance, physical size, and flexibility needed to record single units during intense motor behavior. PMID- 3657272 TI - Linear response curves from an ELISA assay: measurement of anti-myelin IgG and IgM during experimental allergic neuritis. AB - An ELISA method for generating linear dose-response curves for measuring anti myelin IgG and IgM is described. Linearity is achieved without logarithmic transformations. This test is used to measure plasma levels of anti-myelin antibodies in rabbits with EAN. Results are expressed as relative concentrations of antibody in arbitary mass units with 95% confidence limits fitted by inverse prediction. In the 8 animals studied, appearance of anti-myelin antibody always preceded onset of clinical signs and neither anti-myelin IgG nor IgM could be detected in any animal pre-inoculation. Five out of 8 animals displayed steady and progressive increases in anti-myelin IgG with the remaining 3 animals showing plateaus in IgG levels 21-30 days post-inoculation. Increases in anti-myelin IgG were generally parallelled by increases in disease severity. However, 2 animals showed recovery and relapse from EAN with no change in plasma levels of anti myelin IgG. Patterns of production of anti-myelin IgM varied with some animals displaying early peaks while others showed gradual increases. PMID- 3657273 TI - [Recording the EMG activity in the uterus during labor]. PMID- 3657274 TI - [The effect of ecologic and socio-medical factors on premature labor]. PMID- 3657275 TI - [Microsurgical tubocornual anastomosis in the treatment of sterility due to obstruction in the proximal part of the ovarian duct]. PMID- 3657276 TI - [1-year results in the detection of precanceroses and carcinoma of the uterine cervix in Baranja]. PMID- 3657277 TI - [A new sign of placental separation in the 3d stage of labor]. PMID- 3657278 TI - [[Coagulopathy due to prolonged retention of a dead fetus in the uterus]. PMID- 3657279 TI - [Characteristics of sexual behavior of secondary schoolgirls in Novi Sad in relation to menarche]. PMID- 3657280 TI - [Levels of estrogen, progesterone, prolactin and sex hormone-binding globulin in the blood and breast cysts]. PMID- 3657281 TI - [Nursing of a patient following transurethral prostatectomy]. PMID- 3657282 TI - [Nursing of a patient with fracture of the right femoral neck and Colles' fracture of the same side]. PMID- 3657283 TI - [Establishment of communication of an autistic, non-communicative schizophrenic patient with other patients]. PMID- 3657284 TI - [Nursing of an aged primigravida with SLE during pregnancy, delivery, and puerperium]. PMID- 3657285 TI - [Nursing of patients with diseases of female reproductive organs]. PMID- 3657286 TI - [Errors in your nursing]. PMID- 3657287 TI - [Basic nursing technics. 1. Urination. 2]. PMID- 3657289 TI - [Definition of mental support in nursing]. PMID- 3657288 TI - [Introduction to medical electronics. 2. Equipment for drainage]. PMID- 3657290 TI - [Pitfalls in the psychological support in nursing]. PMID- 3657291 TI - [Nursing conference: our interpretation of psychological support of patients]. PMID- 3657292 TI - [Sexually transmitted diseases]. PMID- 3657293 TI - [The quality of life in pediatric nursing]. PMID- 3657294 TI - [The fifth sense to detect abnormalities in patients]. PMID- 3657295 TI - Ovarian lymphatics--a possible role in reproduction. PMID- 3657296 TI - Fine structure and morphometric analysis of lymphatic capillaries in the developing corpus luteum of the rabbit. AB - The fine distribution and ultrastructural changes in the intraovarian lymphatics were studied in the developing corpus luteum of rabbits. Three days after human chorionic gonadotropin (HCG) injection, lymphatic capillaries were observed among theca lutein but not granulosa cells. This distribution persisted even on day 14. Edema appeared around the lymphatic capillaries, corresponding to dilatation of blood capillaries surrounding the membrana granulosa. The diameter and perimeter of the latter vessels were about 5 times greater than before HCG injection. Lymphatic capillaries were slightly dilated and about 2 times their original diameter and perimeter. Flocculent material migrated into the lumen of the lymphatics through the open junctions. Lysosomes and rough endoplasmic reticulum were increased in number in the lymphatic endothelial cells. Five and 7 days after HCG injection macrophages and sometimes loose, degenerated lutein cells were observed in the lymphatic capillaries. Fourteen days after HCG injection, the dilatation of blood capillaries disappeared, although lymphatic capillaries remained slightly dilated after day 3. Some lymphatic but not blood vascular endothelial cells began to degenerate. The results suggest that lymphatic capillaries function to absorb and transport excess fluid and "hormones" in association with changes in ultrastructure. PMID- 3657297 TI - Lymphatic and blood vasculature of the forming corpus luteum. AB - The process of lymphatic vascularization of the corpus luteum was examined during luteinization following the first and second ovulations in young rats. In the corpus luteum formed after the first ovulation, blood vessels permeate the luteal parenchyma which at this stage shows laminar organization. Thereafter, a nest of connective tissue appears in the central portion of the corpus luteum. At this time lymphatics are not found. Luteinization following the second ovulation is similar to that of the first generation until the later stages when lymphatic vessels start to appear initially in the peripheral zone of the corpus luteum and subsequently in the central connective tissue nest. These lymphatic vessels are lined with endothelial cells that stain darkly with toluidine dye. PMID- 3657298 TI - Lymphocyte and erythrocyte turnover in thoracic duct lymph in patients with schistosomal hepatosplenomegaly and portal hypertension. AB - In 60 patients with hepatosplenic schistosomiasis and portal hypertension and in 20 control subjects, the turnover of erythrocytes and lymphocytes circulating in thoracic duct lymph was compared. Despite slight anemia in most patients with schistosomiasis, there was a greatly accelerated extravascular splanchnic circulation rate of erythrocytes. Lymphocytes also circulated more rapidly, but in contrast to erythrocytes, the peripheral blood lymphocyte count was elevated in schistosomal patients. Although thoracic duct lymph flow was increased at all stages of schistosomiasis, it was less rapid in "ascitic" and "varix bleeders" and thus the extravascular circulation turnover of erythrocytes and lymphocytes appeared to decline with chronicity of disease. The more rapid lymphocyte and erythrocyte "turnover," however, was almost entirely due to increased formation of interstitial fluid (greater lymph flow) suggesting that a prime regulator of splanchnic cellular migration was "solvent drag." These findings may derive from deranged portal microvascular dynamics (e.g., increased microvascular pressure, collagen deposition in Disse's space, capillarization of hepatic sinusoids, presinusoidal obstruction) as well as generalized host immunoresponsiveness to schistosomal infection. PMID- 3657299 TI - Nuclear magnetic resonance imaging of human lymph nodes. AB - MR-imaging of surgically excised enlarged and non-enlarged human lymph nodes was studied in patients with and without malignant metastatic lymphadenopathy. NMR tomograms were performed at frequency of 200 MHz using the CPMG sequence. Space resolution was up to 0.1 mm. "In vitro" NMR-tomograms of both non-enlarged and enlarged lymph nodes disclosed tiny foci of metastatic deposits. It is proposed that use of T2 differences for localization of a pathologic focus is an effective mode of visualization during NMR tomography at high frequency. PMID- 3657300 TI - Use of lymphscintigraphy in traumatic chylous ascites. AB - This report describes the use of lymphscintigraphy in a patient with traumatic chylous ascites. Radioactivity "leakage" near the origin of the thoracic duct and accumulation into the peritoneal cavity were delineated. PMID- 3657301 TI - Isotopic lymphangiography to evaluate lymphedema before and after operative treatment. PMID- 3657302 TI - Intraarticular lymphoscintigraphy of the human knee joint: a preliminary study. AB - Intraarticular (knee) lymphoscintigraphy using 99mTc-nanocoll was performed in five patients with chronic synovitis. Scintigrams from the anterior and lateral view of the knee and of the iliac region were taken 1, 2, 4, and 22 hours after injection. The inguinal and iliac lymph nodes uniformly visualized in about 2 hours. Based on radioactivity in regional lymph nodes measured at prescribed time intervals, we were able to quantify lymph drainage from the knee joint. Lymphoscintigraphy is without complication and discomfort and is potentially useful to study synovial fluid reabsorption in joint diseases. PMID- 3657303 TI - Tracking and prediction of blood pressure in children. AB - A significant but weak correlation between an initial and a subsequent blood pressure measurement in the same patient has been found in several previous longitudinal studies of blood pressure in children. In the current study, single determinations of blood pressure, weight, and height were recorded in 142 children at 5.9 to 9.5 years of age and again 9 years later. Both examinations were performed in a schoolroom. Body size at the first examination was associated with body size 9 years later. A significant correlation was noted between initial and subsequent raw systolic blood pressures (r = 0.36 in boys and in girls; P less than 0.01). Correlations of systolic blood pressure based on percentiles for age and for height and weight were smaller but also statistically significant. Correlations involving diastolic blood pressure, with use of raw blood pressure measurements, were significant only for boys (r = 0.24, P less than 0.05). Correlations were not improved when indices of body size were used. Single blood pressure measurements obtained under the usual conditions in a schoolroom had only slightly weaker correlations with subsequent blood pressure determinations than those obtained in studies in which considerable care was taken to achieve more "basal" measurements. This degree of blood pressure correlation is insufficient to allow accurate prediction of subsequent blood pressure levels on the basis of a single casual blood pressure measurement in an individual child. This result was indicated by a wide 95% confidence interval for the predicted subsequent systolic blood pressure, even when sex, initial diastolic blood pressure, weight, and change in weight were considered. PMID- 3657304 TI - Noninvasive conversion of a fixed-rate demand pacemaker to activity mode: a method for assessing the clinical effect of rate-responsiveness. AB - Some patients with fixed-rate demand pacemakers may benefit from conversion to a rate-responsive pacing system. In this report, we describe a technique by which the effect of rate-responsive pacing can be assessed before replacing the pacemaker system. An externally positioned activity-mode physiologic pulse generator was used to drive a previously implanted ventricular demand pacemaker programmed to the triggered mode. Comparison of exercise capacity under both conditions suggested a substantial benefit from rate-responsiveness. PMID- 3657305 TI - Imaging of cranial chordomas. AB - The clinical, pathologic, and imaging characteristics of clival chordomas in 14 patients who underwent magnetic resonance examinations were evaluated. Magnetic resonance imaging (MRI) was compared with skull series, tomography, computed tomography (CT), and magnification angiography in the diagnosis of clival chordomas. Although all examinations were highly sensitive for the detection of clival chordomas, MRI was the best single study because of its ability to image in orthogonal planes, its excellent soft-tissue contrast, and its demonstration of the relationship between the neoplasm and regional vital structures, particularly the brainstem, cavernous sinus, cranial nerves, and neighboring vessels. The deficiencies of MRI are poor visualization of tumoral calcification and osseous destruction--findings that are better identified on CT. In all 14 cases, MRI revealed the neoplasms to be black on inversion-recovery, gray on partial-saturation, and white on T2-weighted pulse sequences. Three chordomas had a speckled signal void pattern, typical of tumor calcification. PMID- 3657306 TI - Heterophilic serum antibodies: a cause for falsely elevated serum thyrotropin levels. AB - We report two cases of euthyroid patients with inappropriately elevated serum levels of thyrotropin (TSH) in whom investigation led to the detection of heterophilic antibodies. In addition, we compare the performance of two TSH immunometric assay systems in this setting. Even when monoclonal assay systems are used, TSH results must be critically interpreted when they are at variance with clinical and other biochemical findings. PMID- 3657307 TI - Vancomycin. AB - Vancomycin is a narrow-spectrum bactericidal antibiotic used primarily for treatment of serious staphylococcal infections. It is the alternative therapy of choice when the penicillins and cephalosporins cannot be used. Vancomycin is also used in (1) methicillin-resistant Staphylococcus aureus infections; (2) streptococcal endocarditis in conjunction with an aminoglycoside in patients intolerant of penicillin or ampicillin; (3) infections, including those involving prosthetic devices, caused by gram-positive organisms with multiple antibiotic resistance; (4) antibiotic-induced enterocolitis caused by Clostridium difficile; and (5) prophylaxis for endocarditis in patients who are at risk and cannot tolerate a penicillin, cephalosporin, or erythromycin. The major toxic effect associated with the use of vancomycin is ototoxicity, which may develop when serum levels exceed 30 micrograms/ml. PMID- 3657308 TI - Tetracyclines, chloramphenicol, erythromycin, and clindamycin. AB - The tetracyclines are effective in the treatment of Chlamydia, Mycoplasma pneumoniae, and rickettsial infections and may also be used for gonococcal infections in patients unable to tolerate penicillins. These drugs may cause gastrointestinal irritation, photo-toxic dermatitis, diarrhea, vestibular damage, and hepatotoxicity in pregnant women. Chloramphenicol is used primarily for anaerobic infections, Haemophilus influenzae meningitis, and typhoid fever. The most important toxic effect of chloramphenicol is bone marrow suppression, which can be dose related or idiosyncratic. Erythromycin is the drug of choice for the treatment of infections caused by M. pneumoniae, Legionella species, group A beta hemolytic streptococci, and Streptococcus pneumoniae. The frequency of serious untoward effects associated with the use of erythromycin is low; epigastric distress may occur. Clindamycin is active against Bacteroides fragilis and other anaerobic microorganisms. Pseudomembranous enterocolitis has developed in as many as 10% of patients taking this drug. The use of clindamycin should be discontinued promptly if diarrhea occurs. PMID- 3657309 TI - The aminoglycosides: streptomycin, kanamycin, gentamicin, tobramycin, amikacin, netilmicin, and sisomicin. AB - Despite the introduction of newer, less toxic antimicrobial agents, the aminoglycosides remain useful in the treatment of serious, hospital-acquired, gram-negative bacillary infections, especially those caused by Pseudomonas aeruginosa. Formidable nephrotoxicity and ototoxicity have limited the use of neomycin to topical or oral administration. Widespread antimicrobial resistance among Enterobacteriaceae has restricted the use of streptomycin and kanamycin to a few specific clinical situations. Gentamicin, tobramycin, and amikacin are active against a wide range of Enterobacteriaceae and many P. aeruginosa organisms. In medical centers where gentamicin resistance is prevalent, amikacin is the aminoglycoside of choice. Fortunately, amikacin resistance has not seemed to increase substantially, even in institutions where usage has been extensive for a long period. No new aminoglycoside has proved to be superior to amikacin. PMID- 3657310 TI - Endoscopic therapy for gastrointestinal neoplasms: from science fiction to science. PMID- 3657311 TI - Serial blood pressure measurements in children. PMID- 3657312 TI - Neuroanatomy of morphine-modulating peptides. AB - Antisera against two mammalian peptides related to the molluscan cardioexcitatory peptide Phe-Met-Arg-Phe-NH2 were used to locate immunoreactive neurons in the rat brain, nerve fibres and terminals in the spinal cord, sympathetic ganglion cells and adrenal chromaffin cells. Immunoreactivity for the newly characterised octa- and octadecapeptide was detected in nerve cell bodies in the hypothalamic area, including parts of the dorsomedial, periventricular and paraventricular nuclei, and in the nucleus tractus solitarii. Nerve terminals in the superficial laminae of the spinal cord were also immunoreactive for these peptides, while the sensory ganglia were nonreactive. Some principal ganglion cells in the superior cervical ganglia exhibited bright immunofluorescence for the peptides, and a few adrenal medullary cells were immunoreactive. The presence of these peptides in the substantia gelatinosa of the spinal cord suggests that they may be involved in sensory neurotransmission, especially in the mechanisms mediating pain. In the hypothalamo-hypophysial system these peptides may be involved in the regulation of hormonal systems. They may also act as co-transmitters in the sympathetic nervous system. PMID- 3657313 TI - Rib response and breakage due to anteroposterior loads. PMID- 3657314 TI - Noninvasive method for estimating the mean capillary pressure and pre- and postcapillary resistance ratio in human fingers. PMID- 3657315 TI - Noninvasive automatic measurement of arterial elasticity in human fingers and rabbit forelegs using photoelectric plethysmography. PMID- 3657316 TI - Theoretical analysis of the transient thermal clearance method for regional blood flow measurement. PMID- 3657317 TI - Accuracy and choice of procedures in 24-hour oesophageal pH monitoring with monocrystalline antimony electrodes. PMID- 3657318 TI - Robust computer algorithm for detecting breaths in noisy ventilatory waveforms from infants. PMID- 3657319 TI - Concept of local resolution in the design of lead-off electrode systems. PMID- 3657320 TI - Measurement and spectral analysis of fibrillation in the normothermic and hypothermic myocardium. PMID- 3657321 TI - Frequency analysis of Ionescu-Shiley prosthetic closing sounds in patients with normally functioning prostheses. PMID- 3657322 TI - Photoplethysmography: selecting optoelectronic components. PMID- 3657323 TI - Perception of dot matrix characters through skin sensation by electrical stimulation. PMID- 3657324 TI - Biofeedback system with interchangeable modules for applied research and clinical practice in underdeveloped countries. PMID- 3657325 TI - Addition to an RF-coupled phrenic nerve stimulator implant to provide outward transmission of body temperature. PMID- 3657326 TI - Simple circuit for linear measurement of temperature. PMID- 3657327 TI - [Characteristics of Acinetobacter strains isolated from a hospital environment. I. Presence of Acinetobacter in diagnostic specimens]. PMID- 3657328 TI - [Characteristics of Acinetobacter strains isolated from a hospital environment. II. Drug resistance of Acinetobacter strains isolated from a hospital environment]. PMID- 3657329 TI - [Sensitivity to antibiotics and chemotherapeutic agents of anaerobic bacteria isolated from clinical specimens 1981-1985]. PMID- 3657330 TI - [Sanitary evaluation of sewage sediments intended for agricultural use]. PMID- 3657331 TI - [Various aspects of the specific immunological effect of staphylococcal vaccine favoring the use of autologous vaccines. I. Evaluation of phagocytosis and intracellular destruction of Staphylococci by rabbit granulocytes]. PMID- 3657332 TI - [Various aspects of the specific immunological effect of staphylococcal vaccine favoring the use of autovaccines. II. Effect of control and immune rabbit sera on staphylococcal growth]. PMID- 3657333 TI - [Changes in the susceptibility of Staphylococcus aureus to phagocytosis in relation to the presence of R plasmids]. PMID- 3657334 TI - Comparative light and electron microscopic observations of the lesive effects of two non-steroid anti-inflammatory drugs plus stress on rat gastric mucosa. AB - In this histological study it has been demonstrated that a single-dose administration of piroxicam, at the same dosage (4 mg/kg) as droxicam, has a greater erosive potential on the gastric mucosa of rats later exposed to cold stress. For this purpose the depth of all lesions found was evaluated by light microscopy and results showed that piroxicam produces lesions deeper and more numerous than those of droxicam. The transmission and scanning electron microscopic studies showed that the lesive mechanism was very similar for both drugs and that both local and general factors induced by these drugs and stress come into play. Absorption or penetration and uptake by the cells of the mucosa have been considered among the most important local factors in the development of erosive gastric lesions caused by non-steroid anti-inflammtaory drugs. As this absorption is in direct relation to the depth of the lesions, it can be considered from the results of this study that the lesser lesive effect of droxicam on the gastric mucosa when compared to that of piroxicam is due to the fact that, owing to its hydrolysis to piroxicam the absorption rate is slower. PMID- 3657335 TI - Topographic brain mapping of EEG in neuropsychopharmacology--Part I. Methodological aspects. AB - Topographic brain mapping of the electroencephalogram (EEG) is a promising new method in neuropsychiatry and neuropsychopharmacology. Rapid advances in computer technology allow on-line analysis by means of micro-computers. This paper describes an acquisition and signal analysis system for studying neurophysiological and neuropsychopharmacological aspects of human brain function. It consists of a server micro-computer functioning as an acquisition unit which is connected to a workstation micro-computer for statistical analysis and subsequent documentation of data on a printer and color plotter. According to the recommendations for standardization of data acquisition and signal analysis in pharmaco-electroencephalography, the paper mediates detailed information concerning recording and analysis equipment with special emphasis on the treatment of artifacts. Since up to now there is no normative consensus on the choice of reference conventions and interpolation algorithms, the system is designed for high flexibility to enable empirical comparisons between different methods. PMID- 3657336 TI - [The Uppsala study. Every sixth 4-year-old child has a speech disorder which motivate check-up and treatment]. PMID- 3657338 TI - [Chronic polymorphous photo-exanthema--a more common disease than realized]. PMID- 3657337 TI - [Increased level of competence of physicians on duty should lower the number of hospitalizations in cases of suspected appendicitis]. PMID- 3657339 TI - [Hypokalemic paralysis in Sjogren's syndrome]. PMID- 3657340 TI - [Fever as the first or only symptom of colorectal cancer]. PMID- 3657341 TI - [Stagnation of weight in infants caused by caffeine in breast milk?]. PMID- 3657342 TI - [Agenesis cordis in multiple pregnancy--a serious threat to the healthy fetus]. PMID- 3657343 TI - [Arteriovenous fistula--an unusual complication in resection of the small bowel]. PMID- 3657344 TI - [BCG vaccination delay the diagnosis of tuberculous lymph nodes of the neck]. PMID- 3657345 TI - Limits of later-occurring rate information for phonetic perception. PMID- 3657346 TI - "Voicing" in English: a catalogue of acoustic features signaling /b/ versus /p/ in trochees. PMID- 3657347 TI - Evidence of talker-independent information for vowels. PMID- 3657349 TI - Parameters of speech rate perception in German words and sentences: duration, F0 movement, and F0 level. PMID- 3657348 TI - Intonation problems of hearing-impaired Hebrew-speaking children. PMID- 3657350 TI - Some word-order effects in Serbo-Croat. PMID- 3657351 TI - On word-initial voicing: converging sources of evidence in phonologically disordered speech. PMID- 3657352 TI - [Long-term follow-up of tympanoplasty using a ceravital prosthesis for the middle ear]. AB - An 8-year follow-up of Ceravital middle ear prostheses showed an extremely good tolerance in the middle ear space. Incompatibility phenomena were not observed. Inflammatory reactions were neither caused nor supported by the implants. The implantation was always performed without interposition of cartilage. Extrusions were not observed. Long-lasting inflammatory processes destroy implants in the same way as they affect ossicles. Transient inflammatory periods (e.g. in the early postoperative period, POM) do not lead to any remarkable changes of the implant surface. In healthy middle ears, the hearing results are stable. PMID- 3657353 TI - [Immunology and deafness. Manifestations of relapsing polychondritis in the ENT area. A case report]. AB - Relapsing polychondritis is a rare episodic systemic disorder characterised by recurrent, widespread, and potentially destructive inflammatory lesions involving cartilaginous structures, the cardiovascular system, and organs of special sense, such as the eyes and ears. Although the aetiology is unknown and its pathogenesis is incompletely understood, experimental evidence strongly suggests that immunological mediated mechanisms are operative. The following case report adds some considerations to the discussion about the immunopathology of the inner ear. PMID- 3657354 TI - [Complementary acoustic EEG control while recording early acoustically evoked potentials]. AB - An easily performed method for the additional acoustical assessment of the EEG quality by the investigator during recording of human brainstem potentials is presented. By means of feedback of the audibly transposed "noiselike" EEG voltage to the opposite ear of the examined subject (instead of the usual masking noise) the subject can perceive self-produced disturbances (muscle activities) and minimize them for the period of examination. An example shows how this additional rejection of artifacts via "biofeedback" can effectively support methods that are already in use. PMID- 3657355 TI - [Assessment of a hearing test procedure, the MIRA (Multichannel Infant Reflex Audiometry) and biofeedback. 2. Influences on threshold determination]. AB - Four years of experience with the hearing tests for babies MIRA (electrical registration of sucking, breathing and localisation reactions, respectively, due to acoustic stimuli with following evaluation of the curves) and biofeedback (1 1/2 years of experience, frequency modulation of the stimulus by the sucking activity and thus examination of the interaction between articulation and hearing) show different kinds of influence on the threshold determination. These are, in the first year of life, influences of a physical nature (room acoustics, audiometric apparatus and activity transducers) and of organisation and action (taking care of the babies, problems arising from simultaneous action and observation), as well as of different weighting of the number of reactions. These are compared with each other in respect of the reactions they provoke, rated individually, and discussed. PMID- 3657357 TI - [Hearing disorders in childhood: screening, early diagnosis, early therapy]. PMID- 3657356 TI - [Glomus caroticum tumor--diagnostic possibilities based on a case report]. AB - Tumours of the glomus caroticum are the most common paragangliomas of the neck. In the present study we report on a glomus caroticum tumour of extraordinary size. Adequate diagnostic procedures - such as digital subtraction angiography and magnetic resonance - are presented. PMID- 3657358 TI - Petrous apex and subarcuate fossa maturation. AB - During the first year of life, the bone of the petrous apex grows rapidly. At birth, only 5 mm of bone separates the cochlea from Dorello's canal as compared to 2 cm in the adult. More than half this growth occurs during the first year of life. The subarcuate fossa is a cavity within the superior semicircular canal which reaches from the posterior fossa to the future mastoid in fetuses and nearly to the mastoid antrum in newborns. During the second year of left it is nearly obliterated to form a shallow depression or slit on the posterior aspect of the temporal bone and the variable petromastoid canal which contains the subarcuate artery and vein. Clinical petrositis of infants less that 1 year of age is rare, and provides a challenge for surgery. A case is reported and discussed. PMID- 3657360 TI - Permanent middle ear aeration: long-term follow-up of transosseous ventilating tubes. AB - A technique for achieving permanent middle ear aeration by inserting a flanged silicone tube (SPAT) through a hole drilled in the external auditory canal was introduced in 1970. Since 1970, we have used the transosseous procedure in 36 patients (11%) of cases that required middle ear ventilation. The average length of time the transosseous SPAT functioned was 51 months (range 0-138). Best results were obtained in patients over 16 years of age, when chronic ear surgery was not performed simultaneously. Transient otorrhea occurred in 23% of cases. Forty-four percent of tubes became blocked and required removal or were extruded. No patient developed facial weakness, middle ear cholesteatoma, or persistent tympanic membrane perforation. In selected cases, the transosseous SPAT provides long-term middle ear aeration without the risk of permanent tympanic membrane perforation. PMID- 3657359 TI - Unusual head and neck manifestations of non-Hodgkin's lymphomas in children and adults. AB - Certain patterns of "lymphoma masquerade" are examined, where the diagnosis is very difficult to establish. The presence of prolonged symptoms prior to the acute event or indolent slow healing wounds should alert clinicians to the possibility that lymphoma may be involved. Localizing tumors in order to make a tissue diagnosis is one potential problem encountered even with computerized tomography, but magnetic resonance imaging has been helpful in demonstrating the presence of tumor mass. Included in this report is an unusual series of non Hodgkin's lymphoma cases in which there was not an obvious tumor. Three patients presented with symptoms and findings of deep neck abscess, two of which were associated with an esophageal perforation or tracheoesophageal fistula. The other cases involved chronic sinusitis and an apparent viral polyneuropathy affecting multiple cranial nerves. Treatment of these non-Hodgkin's lymphomas and techniques for establishing the pathological diagnosis are discussed. PMID- 3657361 TI - Reconstructing the absent lenticular process. AB - When a surgeon encounters an absent lenticular process of the incus, he must either reposition the incus or attempt to bridge the small gap between the remaining incus long process and the stapes capitulum. Our solution to this problem is to place a Lippy modified Robinson stapes prosthesis on the stapes footplate and attach it to the remaining long process, thus bypassing the stapes superstructure. This modified Robinson prosthesis has a portion of the well removed allowing the eroded long process to enter from the side. The hearing results of 63 cases at 6 months (two-thirds of which had a concurrent tympanoplasty) are 67% within 10 dB and 91% within 20 dB of the preoperative bone hearing level. The use of an existing and proven prosthesis provides both stability and, to date, the most successful hearing results for reconstructing the absent lenticular process. PMID- 3657362 TI - The changing characteristics of acoustic neuroma patients over the last 10 years. AB - The first 100 patients in a series of 616 cerebellopontine angle tumors were compared to the most recent 100 patients. All of the first 100 patients were evaluated prior to the common use of CT or ABR. Recently, improved diagnostic studies have resulted in the discovery of significantly smaller tumors. The later group of patients was also found to have their symptoms for a shorter period of time and had better overall hearing at the time of diagnosis. Reductions in the rates of various complications were also observed. These trends are felt to be the direct result of improved audiologic and radiologic diagnostic studies. A heightened awareness of all otolaryngologists to seek the diagnosis of acoustic neuroma also improved early diagnosis. PMID- 3657363 TI - Residual and recurrent acoustic neuromas. AB - A retrospective study was conducted on all 23 patients who underwent operation for residual or recurrent acoustic neuromas during the 10-year period January 1976 through December 1985. The most common symptoms at the time of reoperation were ataxia (16 patients), facial paresthesias (13 patients), and headaches (9 patients). Primary procedures had consisted of suboccipital posterior fossa approaches in 22 patients and a middle fossa approach in one. Reoperation for recurrent or residual tumor consisted of a retrosigmoid approach in 17 patients and a translabyrinthine or translabyrinthine/retrosigmoid approach in six patients. This study confirms that residual or recurrent acoustic tumors are not common. It also suggests that long-term follow-up, for at least 7 to 8 years, is indicated. PMID- 3657364 TI - Brain herniation and space-occupying lesions eroding the tegmen tympani. AB - Technological advances in neuroradiology and the development of skull base surgery in neurotology have improved diagnosis and management of lesions eroding the tegmen tympani. The diagnosis of brain hernia is to be suspected in patients with a history of complicated chronic ear surgery and a slowly developing pulsatile mass with CSF leak. Patients are best evaluated in the upright position, with an otomicroscope and by magnetic resonance imaging (MRI). Over 6 years, our group has treated seven patients with eight space-occupying lesions eroding the tegmen. Five of the lesions were repaired with a temporalis muscle flap, 2 with fascia and bone, and 1 with Marlex. A review of new technology in the diagnosis of brain hernia and a modification of previous techniques is given. PMID- 3657366 TI - Detection and quantification of laryngotracheopulmonary aspiration with scintigraphy. AB - Aspiration is analyzed by a new scintigraphic technique and standard videofluoroscopy in 78 patients with head and neck pathology and neurologic disorders. When both methods are compared to clinical aspiration and a positive x ray film of pneumonia, they appear to complement each other and provide a very accurate evaluation. Scintigraphy is a more sensitive method for detecting aspiration below the vocal cords and also provides for flow dynamics and a method of quantifying the amount of aspirated material. Videofluoroscopy shows more clearly the mechanism of the swallowing disorder and how the bolus enters the tracheobronchial tree. Studies in patients following head and neck surgery demonstrate a high incidence of dysphagia, aspiration, and pneumonia. PMID- 3657365 TI - The effect of glutathione and vitamins A, C, and E on acute skin flap survival. AB - Vitamins A, C, and E act as antioxidants and as free radical scavengers in biological systems. Glutathione is involved in several reactions in vitamin metabolism and also plays an important role in cell membrane protection against lipid peroxidation by free radicals. We sought to use these natural defense mechanisms against oxygen free radicals formed during reperfusion of ischemic skin flaps. An acute axial random skin flap model was utilized in the rat. Vitamins or glutathione were administered by oral gastric tube or intravenously in the perioperative period, and survival of the flap was measured at 1 week. Glutathione, beta-carotene, ascorbic acid and alpha-D-tocopherol showed mean flap survival of 84% to 89%, each of which was significantly improved over saline controls (67% p less than .0005). The mechanisms and biochemistry of these vitamins, and their interactions with other vitamins and with glutathione, are discussed, along with clinical implications of free radical scavenging and skin flap survival. PMID- 3657367 TI - Corrosive esophageal injuries. II. An investigation of treatment methods and histochemical analysis of esophageal strictures in a new animal model. AB - The unique clinical experience of having to treat simultaneously nine young adults who had ingested the same corrosive substance prompted this investigation in rabbits of the pathophysiology of corrosive esophageal injury and of drugs that might prevent formation of stricture. Treatment of experimental corrosive esophageal injury in these animals consisted of antegrade dilatation and administration of two lathyrogenic drugs, colchicine and penicillamine, in various combinations. This study demonstrated that the rabbit can serve as a suitable animal model for study of corrosive injury of the esophagus, that penicillamine given alone affected wound healing with less severe stricture after such an injury, and that colchicine was associated with delayed wound healing and severe stricture. PMID- 3657368 TI - Bilateral sensorineural hearing loss associated with Mycoplasma pneumoniae infection. AB - Three cases of persistent bilateral sensorineural hearing loss following Mycoplasma pneumoniae (MP) infection are reported. These cases were characterized by highly elevated MP complement fixation titer and cold hemagglutinin titer. All the patients had bilateral acute otitis media with a moderate to high degree of mixed hearing loss in the early stage following primary atypical pneumonia (PAP). PMID- 3657369 TI - Some observations concerning 200 stapedectomies: fifteen years postoperatively. AB - In this study, a statistical evaluation of the hearing improvement, the incidence of postoperative tinnitus and vertigo, and the permanency of the surgically restored hearing of 120 women and 80 men operated on for otosclerosis between 1970 and 1971 was undertaken. The standardized operating procedure in all of these cases involved the use of a Gelfoam and wire prosthesis (Schuknecht 3). All patients underwent normal audiological examinations, including determination of bone and air conduction values. Pure tone thresholds were determined by averaging the values for 500, 1,000, 2,000 and 4,000 Hz. The incidence (10%) of severe sensorineural loss in regard to age, preoperative bone conduction, and oval window pathology was examined. Severe sensorineural losses had occurred immediately postoperatively in 14 of the ears. In the remaining ears, losses were gradual in the course of 15 years. Hearing thresholds in ears not subjected to operation were also determined. PMID- 3657370 TI - Early visualization of the incus during mastoid surgery. PMID- 3657371 TI - [Evaluation of postgraduate studies at the Medical School in Zagreb. II. Student evaluation 1981-84]. PMID- 3657372 TI - [Critical value of psychological measurement instruments for evaluation of work disability in older alcoholics]. PMID- 3657373 TI - [Longitudinal study of the psychological development of children with a very low birth weight during the first 8 years of life]. PMID- 3657374 TI - [Cytogenetic findings in superficial tumors of the urinary bladder]. PMID- 3657375 TI - [Acute hepatitis B in the Zagreb region]. PMID- 3657376 TI - [Paraquat poisoning treated with hemoperfusion]. PMID- 3657377 TI - [Case report of a patient with an indistinct tumor mass in the posterior mediastinum]. PMID- 3657378 TI - [Surgical treatment of neglected ruptures of the achilles tendon]. PMID- 3657379 TI - Oxytocin acts as an antidepressant in two animal models of depression. AB - In the behavioral despair test in mice, oxytocin, i.p. injected 60 min before testing, significantly reduced the duration of immobility at doses of 0.250-1.0 mg/Kg; the effect being similar to that of imipramine (7.5-30 mg/Kg i.p.). A more powerful effect was obtained with a 10-day treatment schedule. In the learned helplessness test, oxytocin (0.500 mg/Kg/day i.p. for 8 days) significantly reduced the escape failures and the latency to escape, the effect being even more intense than that of imipramine (20 mg/Kg/day i.p. for 8 days). These results show a new behavioral effect of oxytocin, and further support its role of CNS regulatory peptide. PMID- 3657380 TI - The effects of L-tryptophan on haloperidol-induced movement disorder in the rat. AB - An animal model of haloperidol-induced tardive dyskinesia was studied in relation to the dietary manipulation of tryptophan and its effect on the movement disorder. This study showed a significant negative behavioral response to the neuroleptic drug, haloperidol. Increased dietary tryptophan (1.0 vs. 0.3%) significantly reduced the frequency of drug-induced head movements. Brain serotonin levels were elevated by the drug treatment. Brain serotonin levels correlated significantly with the behavioral response. Contrary to expectation, brain dopamine levels did not correlate with the behavioral response. These findings suggest a possible serotonergic involvement in neuroleptic-induced tardive dyskinesia and an amelioration of the disorder through tryptophan supplementation. PMID- 3657381 TI - Postnatal disappearance of the pregnancy-associated reduced sensitivity of plasma cortisol to feedback inhibition. AB - We recently observed that the characteristic insensitivity of the pituitary adrenal system in women to feedback inhibition during pregnancy persists for at least four days postnatally. We therefore examined women during the first five weeks after delivery to assess when the sensitivity of plasma cortisol to glucocorticoid inhibition returns to normal. Dexamethasone (DEXA, 1 mg) was ingested at 11 pm by normal healthy women, once between the 3rd and 27th postnatal days, and again on day 35. Blood plasma was collected at 4 pm on the following day for cortisol assay. Plasma cortisol levels (nmol/L, mean +/- sem [n]) after DEXA in the first two weeks (216 +/- 28, [47]) were higher (p less than 0.001) than in nonmedicated nonpregnant women (47.4 +/- 8.9 [12]) and were normal by the 35th day after delivery (41.7 +/- 4.8 [74]). A negative association was found between post-DEXA cortisol and time after delivery in the first 4 post partum weeks (r = -0.46, p less than 0.001). The study confirms that insensitivity of plasma cortisol to feedback inhibition persists beyond normal pregnancy in a significant proportion of healthy women for two to three weeks, and is absent by the 5th postnatal week. PMID- 3657382 TI - [3H]AF-DX 116 labels subsets of muscarinic cholinergic receptors in rat brain and heart. AB - The in vitro binding properties of the novel muscarinic antagonist [3H]AF-DX 116 were studied using a rapid filtration technique. Association and dissociation rates of [3H]AF-DX 116 binding were rapid at 25 degrees C (2.74 and 2.70 X 10(7) min-1 M-1 for K+1; 0.87 and 0.93 min-1 for k-1) but 20-40 times slower at 0-4 degrees C (0.13 and 0.096 X 10(7) min-1 M-1 for k+1; 0.031 and 0.022 min-1 for k 1 in cerebral cortical and cardiac membranes, respectively). Kinetic dissociation constants (Kds) were estimated to be 31.8 nM and 30.9 nM at 25 degrees C; 23.1 nM and 0-4 degrees C for the cerebral cortex and heart, respectively. In saturation studies, [3H]AF-DX 116 labeled 29 percent of the total [3H](-)QNB binding sites in the cerebral cortical membranes and 87 percent in the cardiac membranes, with Kd values of 28.9 nM and 17.9 nM, respectively. Muscarinic antagonists inhibited [3H]AF-DX 116 binding in a rank order of potency of atropine greater than dexetimide greater than AF-DX 116 greater than PZ greater than levetimide in both tissues. Except for PZ/[3H]AF-DX 116 and AF-DX 116/[3H]AF-DX 116 in the cerebral cortex, all the antagonist competition curves had Hill coefficients close to one. Carbachol and oxotremorine produced shallow inhibition curves against [3H]AF-DX 116 binding in both tissues. Regional distribution studies with [3H](-)QNB, [3H]PZ and [3H]AF-DX 116 showed that most of the muscarinic receptors in the cerebral cortex, hippocampus, nucleus accumbens and corpus striatum are of the M1 subtype while those in the brainstem, cerebellum and other lower brain regions are of the M2 subtype. These results indicate that [3H]AF-DX 116 is a useful probe for the study of heterogeneity of muscarinic cholinergic receptors. PMID- 3657383 TI - Steady-state model for plasma free and platelet serotonin in man. AB - A steady-state physiological flow model has been developed for predicting plasma free serotonin (5-HT), and platelet 5-HT, concentrations in man. The basic assumptions of the model are that 5-HT is produced in the wall of the intestine, enters the portal circulation at a constant rate, and is cleared by the lung, liver, kidney, and capillary bed. When a priori best estimates of the 5-HT production rate and organ extraction efficiencies were substituted into formulae describing the model, a predicted value for plasma free 5-HT of 304 pg/ml was obtained, in good agreement with a previously observed mean (+/- SE) of 387 +/- 84 pg/ml. The effects of varying production rate and extraction efficiency parameters on predicted levels of plasma free 5-HT are examined. The practical implications of the model and its possible utility in elucidating the causes of altered plasma free or platelet 5-HT seen in certain conditions are discussed. PMID- 3657384 TI - The anti-emetic properties of 1-sulpiride in a ground-based model of space motion sickness. AB - L-sulpiride, at a dose of 4 mg/kg, essentially abolished motion-induced emesis in a group of 6 squirrel monkeys undergoing horizontal rotation at 25 rpm, a terrestrial model of space motion sickness (SMS). Extrapyramidal side effects were not observed. In the absence of the drug, the usual emetic response returned. In comparison while typical neuroleptics were also strongly anti emetic, they produced a considerable degree of rigidity and akinesia. PMID- 3657385 TI - Changes in the secretion of inhibin and steroid hormones during induced follicular atresia after hypophysectomy in the rat. AB - Sequential changes in the function of antral follicles during the period of follicular atresia were investigated after hypophysectomy (Hypox) at 1100 hr on proestrus. Within 6 hours after Hypox, concentrations of progesterone (P), testosterone (T) and estradiol-17 beta (E) decreased abruptly in ovarian venous plasma (OVP) and follicles showed a reduced ability to ovulate. Six hours after Hypox, ovulation was still induced by human chorionic gonadotropin (hCG) in all animals but with significantly fewer number of oocytes compared to the group given hCG at 1100 hr on the day of proestrus. Nine hours after Hypox, several granulosa cells of all large follicles (greater than 400 microns in diameter) exhibited morphological signs of atresia. Twelve hours after Hypox, all large and medium sized (200-400 microns in diameter) follicles showed advanced stages of atresia and almost all follicles failed to ovulate in response to hCG. Inhibin activity in OVP declined more slowly compared to the profiles of steroid hormones and 53% of the initial inhibin activity was still maintained at 18 hours after the operation. Inhibin activity further decreased to 7% of the initial level at 24 hours and was undetectable by 48 hours after Hypox. These results suggest that fully developed Graafian follicles gradually lose their ability to secrete inhibin in contrast to the rapid decrease in secretion of steroid hormone during the process of atresia. PMID- 3657386 TI - Effects of alismol isolated from Alismatis Rhizoma on calcium-induced contraction in the rabbit thoracic aorta. AB - We examined the inhibitory effects of alismol, a sesquiterpenoid isolated from Alismatis Rhizoma, on vascular contractions induced by high concentrations of K+ and Ca2+, and on 45Ca2+ retention in normal and in high K+-containing medium. Alismol affected neither the resting tension nor the 45Ca2+ retention in normal medium, but it inhibited sustained contraction and increased 45Ca2+ retention induced by high K+ concentrations. Alismol did not affect norepinephrine-induced contractions in normal medium, nor phasic contractions in Ca2+-free medium. These results suggested that alismol inhibited mainly Ca2+ influx through a voltage dependent Ca2+ channel. PMID- 3657387 TI - Molecular form of human lymphocyte membrane-bound acetylcholinesterase. AB - The membrane-bound acetylcholinesterase (AchE) from human peripheral blood lymphocyte gives only one symmetrical peak on sucrose density gradient centrifugation in the presence of Triton X-100 detergent, with the calculated sedimentation coefficient of 6.5 S. However, this dimeric form of AchE was converted to a monomeric 3.8 S form when treated with 2-mercaptoethanol and iodoacetic acid. The results are consistent with studies which have shown by sodium dodecyl sulfate gel electrophoresis that the enzyme is built up of two identical monomers inter-linked by disulfide bond(s). Under reducing conditions, revealed a single species of 70,000 molecular weight, whereas under non-reducing conditions, another species of 140,000 molecular weight of the AchE was found. Polyacrylamide gel electrophoresis indicated a single band with AchE activity in the presence of Triton X-100. In contrast, in the absence of the same detergent multiple band pattern could be observed. These results suggest that membrane bound AchE enzyme is present in homogenous dimeric form on human lymphocyte membrane. PMID- 3657388 TI - Conditioned response to apomorphine in nigro-striatal system-lesioned rats: the origin of undrugged rotational response. AB - Development and time-course characteristics of Early rotational response (ER) to apomorphine in 6-hydroxydopamine-lesioned rats is explored. We show here how this ER can be considered a conditioned response that arises when the drug is repeatedly administered, according to a classical conditioning paradigm. In this way, the ER to apomorphine can be considered a non-pharmacological, conditioned, placebo response, the drug action being the unconditioned stimulus (UCS). In our model, the undrugged rotational response elicited by saline injections two weeks after drug treatment can be considered as the conditioned response (CR) to the conditioned stimulus, the CS being the environment associated with the drug treatment. This CR had not previously been identified during the drug treatment. Thus, we studied the acquisition of the ER, nonexistent after the first injection of apomorphine. Furthermore, we distinguish between this ER and the later, strictly pharmacological rotational response (LR) to apomorphine. Finally, we related this ER to the undrugged, paradoxical response to saline. In conclusion, we demonstrate the paradigm of pharmacological conditioning using this animal model of Parkinson's disease, supported by our own results and those of Silverman and Ho (1981). PMID- 3657389 TI - The effects of mannose on rat embryos grown in vitro. AB - Rat embryos have been cultured in vitro from 9.5 days of gestation for different times in serum containing mannose, and the embryos have been observed by scanning electron microscopy. Embryos cultured in 3 mg/ml (1.7 X 10(-2) M) or 6 mg/ml (3.3 X 10(-2) M) mannose for 48 h showed inhibition of the expansion of the yolk sac and were smaller than the control embryos. Mannose-treated embryos also showed delayed development according to morphological criteria, and a range of abnormalities including abnormalities of the neural tube. Embryos cultured in 6 mg/ml mannose for 24 h also showed significant inhibition of yolk-sac expansion and were smaller and less advanced than the control embryos. Abnormalities were seen, including a delay in the closure of the neural folds. Abnormalities were also observed in embryos cultured in mannose for 10 h; embryos at the neural groove stage showed irregularities in the neural groove. Mannose did not inhibit the re-elevation of neural folds which had been caused to collapse by exposure to medium containing low calcium. These results are compatible with the idea that mannose retards development and thereby perturbs the morphogenesis of the neural tube. PMID- 3657390 TI - Mode of action of antiprotozoan agents. Electron transfer and oxy radicals. AB - Cyclic voltammetry data were obtained for most of the main classes of antiprotozoan agents, specifically, nitroheterocycles, quinones, metal complexes and derivatives, iminium-type ions, and azo compounds. The reductions were generally reversible in the range of -0.3 to -0.9 V. Catalytic production of oxidative pressure from redox cycling involving oxygen is believed to be an important mode of action by the medicinal agents. Literature data contribute support. PMID- 3657391 TI - Plasma cholecystokinin-octapeptide like immunoreactivity in patients with hepatic cirrhosis. AB - Molecular forms of cholecystokinin (CCK) in the peripheral circulation were studied in normal subjects and cirrhotic patients. Fractionation of plasma extract collected 20 min after intraduodenal infusion of fat revealed four major peaks by Sephadex G-50 column chromatography in normal subjects. Peak I eluted at a position similar to CCK-33, peaks II and III eluted between CCK-33 and CCK-14, and peak IV eluted between CCK-14 and CCK-8. In cirrhotic patients, there was a prominent peak (peak V) eluted at a position similar to CCK-8, in addition to those four peaks. These findings are consistent with the previous observations of hepatic elimination of CCK-8, and suggest that smaller forms of CCK similar in size to CCK-8 are not major forms of CCK in plasma in normal subjects but circulate substantially in cirrhotic patients. PMID- 3657392 TI - Relative selectivity of some conformationally constrained tryptamine analogs at 5 HT1, 5-HT1A and 5-HT2 recognition sites. AB - In an attempt to define pharmacophoric differences between 5-HT1, 5-HT1A and 5 HT2 recognition sites, a number of rigid analogs were studied and compared to analogous free chain tryptamines. Racemic partial ergolines RU 27849 and RU 28306 showed reduced potency at all 5-HT1 sites, but were at least equipotent to analogous tryptamines at the 5-HT2 site. A nonergoline-like constrained analog of tryptamine was similar in potency to RU 27849 at all 5-HT1 sites, but showed a 4 fold enhancement in potency over RU 27849 and tryptamine at the 5-HT2 site. At all 3 sites, 3-(tetrahydropyridyl) indoles (unless substituted at the indole 2 position) were the most potent rigid analogs studied and represent the most promising class for the development of selective compounds. PMID- 3657393 TI - In vivo incorporation of labeled fatty acids in rat liver lipids after oral administration. AB - Striking differences were found in the compartmentalization of fatty acids into liver lipid fractions. The saturated fatty acids--lauric, myristic, palmitic and stearic--were incorporated into phosphoglycerides at faster rates with increasing chain lengths, while triglyceride incorporation was almost uniform. The degree of incorporation of the unsaturated fatty acids into phosphoglycerides (structural) compared to triglyceride (storage and energy) was the converse of their oxidation rates. The incorporation of oleic, linoleic and alpha-linolenic acids was mainly into triglyceride, whereas dihomo-gamma-linolenic acid and arachidonic acid were preferentially incorporated into phosphoglycerides. The data suggest that distribution of each fatty acid is different depending on its destination for structural or energy function. PMID- 3657396 TI - Effect of cold environment on hepatic microsomal delta 6 and delta 9 desaturase activity of male rats. AB - Male rats maintained at 24 C and then shifted to 5 C for 5 days increased food intake and decreased in growth rate and food conversion. No modification was observed in delta 6 desaturase activity, while delta 9 desaturase activity decreased after this period of time. These results were confirmed by liver microsomal and mitochondrial fatty acid composition. The phospholipid composition of liver microsomes was unaltered, whereas in mitochondria, phosphatidylcholine and sphingomyelin decreased and phosphatidylethanolamine increased due to the cold environment. The influence of food intake and weight changes on fatty acid metabolism was studied using (i) rats maintained at 5 C with restricted food intake to match the food intake of those kept at 24 C with food ad libitum and (ii) rats maintained at 24 C whose food intake was also restricted so that their growth rate would be the same as that of rats maintained at 5 C with food ad libitum, respectively. These results indicate that the negative metabolic balance state of these cold conditions is not an active factor modifier of delta 6 desaturase activity, whereas it decreases delta 9 desaturase activity, reflecting the lipogenic characteristics of the latter enzyme. PMID- 3657394 TI - Effects of Triton WR 1339 and orotic acid on lipid metabolism in rats. AB - In order to investigate the effect of hepatic cholesterol flux on biliary bile acids, Triton WR 1339 and orotic acid were administered to rats, and the biliary cholesterol, phospholipids and bile acids were analyzed together with serum lipoproteins and hepatic lipids. Triton, which raised serum very low density lipoprotein and lipid levels and decreased serum high density lipoprotein liver lipid levels, increase the biliary cholic acid group/chenodeoxycholic acid group ratio (CA/CDCA) in the bile without affecting the total amount of bile acids and the other biliary lipids. Orotic acid, which decreased serum lipid and lipoprotein concentrations and increased liver lipid levels, increased the biliary excretion of cholesterol and phospholipids, but produced no significant change in the total amount of bile acids and in the CA/CDCA ratio in bile. PMID- 3657395 TI - Alteration of hepatic phospholipids in rats and mice by feeding di-(2 ethylhexyl)adipate and di-(2-ethylhexyl)phthalate. AB - Effects of di-(2-ethylhexyl)adipate (DOA) and di-(2-ethylhexyl)phthalate (DEHP), plasticizers for polyvinylchloride products, on concentrations and compositions of hepatic phospholipids were studied in rats. When administered to rats at a 2% level for 2 wk, both DOA and DEHP caused a hepatomegaly, an increase in hepatic phospholipids and a decrease an increase in hepatic phospholipids and a decrease in the ratio of phosphatidylcholine (PC) to phosphatidylethanolamine (PE). In the comparable study with mice, the alkyl moiety of DOA was found to be responsible for these alterations. DOA and DEHP specifically altered fatty acid compositions of PC and PE: there was an increase in oleic and palmitic acids and a decrease in stearic and docosahexaenoic acids in PC and an increase in arachidonic acid at the expense of docosahexaenoic acid in PE. In addition, DOA caused an increase in the trienoic and tetraenoic molecular species in PC and an increase in the 1 palmitoyl-2-arachidonyl (16:0@20:4) species in PE. Thus, the effects of DOA on the lipid dynamics resembled those observed with DEHP, although the magnitude was slightly moderated. PMID- 3657397 TI - Formation of diacyl and alkylacyl glycerophosphocholine in rabbit alveolar macrophages. AB - The incorporation of various labeled precursors into alkenylacyl, alkylacyl and diacyl phospholipids in rabbit alveolar macrophages was studied. The incorporation rates of the individual precursors were shown to be quite different among the three subclasses of phospholipids. [3H]Glycerol, [14C]16:0, [14C]18:1, [14C]18:2 and [32P]-orthophosphate were preferentially incorporated into choline glycerophospholipids (CGP), especially into diacyl glycerophosphocholine (GPC), indicating that the de novo synthesis of diacyl GPC is extremely high. Considerable portions of the radioactivities of [14C]16:0, [14C]18:1, [14C]18:2 and [32P]orthophosphate were also found in alkylacyl GPC, the incorporation being higher than or comparable to that in the case of diacyl glycerophosphoethanolamine (GPE). We then examined the activities of cholinephosphotransferase and ethanol-aminephosphotransferase, and found that the activity of cholinephosphotransferase was remarkably high in macrophage microsomes compared with that in microsomes from several other tissues. This suggests that diradylglycerols were preferentially utilized by choline phosphotransferase, which is consistent with the results obtained for intact cells. We confirmed that a considerably higher amount of diacyl GPC as well as alkylacyl GPC was formed through this enzyme reaction with macrophage microsomes than with brain microsomes. The high formation of alkylacyl GPC could be responsible, at least in part, for the accumulation of this unique ether phospholipid, a stored precursor form of platelet-activating factor in macrophages. PMID- 3657398 TI - Rapid separations of diacyl- and dialkylglycerol enantiomers by high performance liquid chromatography on a chiral stationary phase. AB - Rapid and practical separations of 1,2- and 2,3-diacyl- and dialkyl-sn-glycerol enantiomers as their 3,5-dinitrophenyl-urethane derivatives were carried out by normal-phase high performance liquid chromatography on a chiral stationary phase, N-(R)-1-(alpha-naphthyl)ethylaminocarbonyl-(S)-valine chemically bonded to gamma aminopropyl silanized silica. Complete separations of the racemates into enantiomers were achieved for both of the diacyl- and dialkylglycerols within 10 min using a stainless steel column (25 cm long) packed with the 5-mu particles, an isocratic elution with a mixture of hexane/ethylene dichloride/ethanol as a mobile phase and a UV detector. The sn-1,2-enantiomers were eluted ahead of the corresponding sn-2,3-enantiomers. Satisfactory separation of the sn-1,3 diacylglycerols from the corresponding enantiomers and the separation of the homologues differing in acyl and alkyl groups were also observed. The formations of hydrogen bonding and charge transfer complex between the urethane derivatives and the stationary phase may contribute to the enantiomer separations. PMID- 3657399 TI - Water phases in rat striated muscles as determined by T2 proton NMR relaxation times. AB - The spin echo decay curve of NMR protons in in-vitro rat muscle is two or three exponential as Hazlewood demonstrated in 1974. This author hypothesized that the longer T2 component is extracellular water and that the medium T2 is intracellular water. Our purpose was to test the histological significance of these two T2. Variations of water contents in two types of rat muscles were induced by electrical stimulation and osmotic diuresis and their incidence on the decomposition of the proton spin echo signal analysed. Decomposition of signal in resting muscles revealed two phases with T2 values similar to the Hazlewood's: a short phase, S, with T2 of 40 ms (20 MHz, 276 degrees K) representing 90-97% of the total signal and a long one, L, with T2 of 100-120 ms representing 3-10% of the signal. Increasing vascular volume appeared to increase the percentage of phase (L) in the total signal. Osmotic diuresis decreased the volume of the phase (S) and increased the volume of the phase (L). The use of Gd-DTPA allowed to differentiate the vascular compartment: Gd DTPA decreased in a great extent the T2 values of phase (L) and in low extent the T2 values of phases (S). From these results, it appears that phase (L) could correspond to vascular volume and that phase (S) would be interstitial and intracellular water. Elements of comparison with classical methods for determination of water compartmentation in tissues are given. PMID- 3657401 TI - Operational safety issues in MRI. AB - The clinical usefulness of a diagnostic modality is weighed by considering its potential diagnostic benefit against its potential risk for a patient in question. Magnetic resonance imagining appears to offer both high efficacy and safety under most circumstances. Our understanding of the conditions under which MRI is safe and effective has undergone continual refinement with technological advances and clinical experience. The early emphasis on safety issues of MR focussed on consideration of bioeffects of RF and magnetic fields. More recently, hundreds of operating clinical MR sites, performing hundreds of thousands of clinical examinations to date, have provided a greater awareness of operational safety issues. Much of this experience is summarized in device labeling provided by manufacturers of MR devices, summaries prepared by regulatory agencies, and case reports in the medical literature. The purpose of this article is to review a broad range of safety considerations involved in the operation of MR imagers. The discussion is in two parts: (1) a short update of reported incidents and (2) an analysis of safety issues. PMID- 3657400 TI - Oxygen-sensitive 19F NMR imaging of the vascular system in vivo. AB - The fluorine nuclear magnetic resonance spin-lattice relaxation rate (1/T1) of the perfluorochemical blood substitute perfluorotripropylamine (FTPA) is very sensitive to oxygen tension. This presents the possibility of measuring blood oxygen tension by 19F MR imaging. We obtained oxygen-sensitive 19F NMR images of the circulatory system of rats infused with emulsified FTPA. Blood oxygenation was assessed under conditions of both air- and 100% O2-breathing. T1 relaxation times were derived from MR images using a partial saturation pulse sequence. The T1 times were compared with a phantom calibration curve to calculate average blood pO2 values in the lung, liver, and spleen. The results showed marked, organ specific increases in blood oxygen tension when the rat breathed 100% O2 instead of air. PMID- 3657402 TI - Magnetic field mapping in NMR imaging. AB - The Hahn spin preparation sequence provides a practical means for rapid and sensitive mapping of magnetic field inhomogeneity in NMR imaging applications. Choice of the rf pulse delay times tau 1 and tau 2 as well as conditions and limitations on the proposed use of this sequence for chemical shift imaging are discussed. PMID- 3657403 TI - MRI of peroneal nerve entrapment due to a ganglion cyst. AB - Ganglion cysts are relatively common entities, but impingement upon the peripheral nerves is rare. We describe a case in which peroneal nerve palsy was caused by a ganglion cyst demonstrated by MRI. PMID- 3657404 TI - Baby Jane Doe's right of privacy from cradle to grave: infirmities of the 1984 Child Abuse Amendment. PMID- 3657405 TI - Product liability. Breach of warranty/strict product liability. PMID- 3657407 TI - U.S. physicians' perceptions of malpractice liability factors in aggressive treatment of dying patients. PMID- 3657406 TI - The Infant Doe Amendments and parental privacy. Who makes the treatment decisions? PMID- 3657410 TI - Leon E. Kassel MD, President 1987-88. Interview by Ann Wintriss. PMID- 3657408 TI - Legal functions of psychiatric emergency services in Israel. PMID- 3657409 TI - Sexual molestation of children. PMID- 3657411 TI - Unity and diversity in medical laboratory science. PMID- 3657412 TI - Medical laboratory sciences: a look forward. PMID- 3657413 TI - The influence of substrate and initial cell number on the expression of anchorage independence by two malignant epithelial cell lines. PMID- 3657414 TI - Selection and evaluation of laboratory instrumentation in clinical chemistry: I. Survey of major analysers in the United Kingdom. PMID- 3657415 TI - Fluorometric determination of micro-amounts of selenium in human blood, using 2,3 diaminonaphthalene. PMID- 3657416 TI - Detection of Toxoplasma specific IgM by a solid-phase haemadsorption assay. PMID- 3657417 TI - The manual low-ionic strength polybrene technique for detection of red cell antibodies. PMID- 3657418 TI - Quality assurance of physiological saline used for blood grouping. PMID- 3657419 TI - Quality assurance. I. Philosophy and basic principles. PMID- 3657420 TI - Typing of red cells on microplates by the low-ionic polybrene technique. PMID- 3657421 TI - Topical anti-infective eye preparations. PMID- 3657422 TI - IMLS 86. 18th triennial conference of the Institute of Medical Laboratory Sciences. Southampton, 18-22 August 1986. Abstracts. PMID- 3657423 TI - The place of the review article. PMID- 3657424 TI - Pre-albumin and C-reactive protein after acute myocardial infarction. PMID- 3657425 TI - Measurement of low serum and red cell folate levels: a comparison of analytical methods. PMID- 3657426 TI - Selection and evaluation of laboratory instrumentation in clinical chemistry: II. Guidelines for selection and evaluation. PMID- 3657427 TI - Quality assurance. 2. Internal quality control. PMID- 3657428 TI - Transthoracic fine needle aspiration cytology: a report of five years' experience. PMID- 3657429 TI - Chromogenic Limulus amoebocyte lysate assay for endotoxin: comparison of three commercial products. PMID- 3657430 TI - Computerised generation of numbers for labelling blocks of resin-embedded tissue for transmission electron microscopy. PMID- 3657431 TI - Anti-Csb: the finding of the antibody antithetical to anti-Csa. PMID- 3657432 TI - [Method of radionuclide determination of coronary blood flow: experimental verification and clinical testing]. AB - For quantitative assessment of the coronary blood flow in diagnostic examination of CHD patients the authors have proposed a new method for determination of absolute values of the coronary blood flow by intragastric administration of 99m Tc-labeled human serum albumin microspheres with subsequent whole body scintigraphy and comparison of scintillation count intensity over the heart area and the whole body. The results of experiments on 13 rabbits for verification of the method and the results of clinical testing in 20 patients were presented. The proposed method was shown to ensure adequate assessment of the coronary blood flow in ml/min. the patient's safety without interfering in routine coronary angiographic investigation, providing very important additional diagnostic information. The method was recommended for clinical diagnostic practice in x-ray departments of cardiological hospitals. PMID- 3657433 TI - [Scintigraphy in cancer of the esophagus]. AB - Esophagoscintigraphy with labeled liquid and solid food was performed in 34 patients without subjective complaints and signs of disease of the esophagus in the patient history permitting the determination of quantitative and qualitative characteristics of normal motor-evacuatory function of the esophagus and lower esophageal sphincter (LES) under the most physiological conditions using mixtures of labeled natural food ingredients as compared to routine methods. In esophageal transit time (ETT) over 5 sec., a clearance value below 87.2% and passage rate below 21.6% for liquids, and ETT over 9 sec., a clearance value of 86.6% and passage rate less than 11.39% respectively for solid food disorders of esophageal and/or LES motor function were noted. Normal oropharyngeal time was 1.5-2 sec. A total of 46 patients with esophageal cancer and stomach cancer with the involvement of the esophagus before treatment were examined. In cancer of the esophagus its function depended on a tumor site and stage. In order to raise diagnostic sensitivity dynamic esophagoscintigraphy should be performed using liquid and solid food because during liquid passage a study with a hard bolus of patients with severe esophageal dysfunction showed that in 36.9% of the patients the quantitative and qualitative indices were within normal. Radionuclide methods permit the determination of the level of a pathological focus, a degree of esophageal permeability, quantitative characterization of a degree of disorder of esophageal function in order to raise the functional diagnosis of the esophagus and LES, and the determination of motor disorders at the earliest stages of tumor development. PMID- 3657434 TI - [Radioimmunologic analysis of ferritin, carcinoembryonic antigen and prolactin for evaluating the prognosis and effectiveness of treating breast cancer]. AB - The levels of tumor markers--CEA, ferritin and prolactin (the hormone of the anterior pituitary gland) were studied in the blood serum of 178 breast cancer patients in the menopause during combined therapy using a radioimmunoassay. This combination was shown to be informative for assessment of prognosis of disease and efficacy of antitumor therapy which was confirmed by clinical and x-ray findings and observation of a tumor process in breast cancer patients over a 5 year period. PMID- 3657435 TI - [Roentgenography of the skin and subcutaneous tissue in postmastectomy edema of the upper extremities]. AB - The results of radiography of the forearm and shoulder soft tissues in 47 patients with postmastectomy syndrome before and after conservative treatment and in 6 controls made it possible to determine differences in x-ray imaging of a skin and subcutaneous fat layer in limb edema. These differences were determined by lymph flow disorders and the formation of a connective tissue component in subcutaneous fat and could be used for objective assessment of a degree of edema, determination of tactics of rehabilitation activities and assessment of their effectiveness. PMID- 3657436 TI - [Dosimetric planning of combined radiation therapy (tele- and interstitial gamma therapy) of tumors originating in the mouth mucosa]. AB - The authors proposed a new model of dosimetric design of combined gamma-therapy of patients with oral mucosa tumors on the basis of F. Ellis' modified model with account of a therapeutic volume of tissues to be irradiated, and Henschke's model describing a focal dose optimum value in interstitial gamma-therapy as a function of its volume. The proposed model is based on the concept of relative (partial) tolerance which is equal to a ratio of values of a dose delivered to a therapeutic volume to a tolerance dose and differs from the formula of partial tolerance described by Orton and Ellis. PMID- 3657437 TI - [Proliferative activity of laryngeal cancer and possible morphologic prognostic factors]. AB - Altogether 70 patients with histologically verified laryngeal cancer were studied. An analysis of the data obtained showed that tumor proliferative activity expressed by a labeling index (LI) correlated, to a certain extent, with various structural and functional properties of a tumor, e. g. LI showed correlation with a degree of differentiation of squamous cell carcinoma: in a nonkeratinizing type the mean LI was 8.2, in a keratinizing type 5.5. A noticeable immune response to a tumor was observed in most of the patients. However a stable tendency (p = 0.95) to a decrease in LI in marked lymphoid infiltration was revealed in nonkeratinizing squamous cell carcinoma only. There was no correlation between LI and a degree of vascularization. The preponderance of weak vascularization was noted in keratinizing squamous cell carcinoma. A decrease in LI in weak vascularization was also observed in this cancer type taking into account a degree of lymphoid infiltration. In clinical practice while designing a therapy one should bear in mind a variety of clinical, structural and biological features of a tumor. PMID- 3657438 TI - [Distribution of heat production in the tissues of the lower extremities during capacitative heating by a UHF field]. AB - The authors described methods developed by them for measuring heat production in autopsy sections by taking pulse thermograms during local capacitative healing of tissues using special electrode devices filled in with liquid dielectric. Thermograms of heat production distribution on limb sections were shown. Qualitative peculiarities of heat production distribution determined by tissue topological structure, were analysed. PMID- 3657439 TI - [Immune status during the combined use of microwave hyperthermia and prospidin in animals with transplantable tumors]. AB - Experiments were conducted to study the time course of changes of some immunological indices in animals after a combined use of local hyperthermia and course use of prospidin. Local microwave hyperthermia used at the beginning of a course of prospidin caused a decrease in some indices of immunity which was much lower than in case of the use of only prospidin or hyperthermia. PMID- 3657440 TI - [Contrast and quantitative characteristics of biological tissues in experimental neoplastic processes based on biexponential relaxation analysis of NMR tomograms]. AB - A method of contrast enhancement and quantification of experimental tumors in vivo by estimation of tissue proton transverse magnetic relaxation nonexponentiality is proposed. Relaxation time and percentage of a rapidly descending magnetization component due to intracellular water protons are followed for tumor and uninvolved tissues in a course of subcutaneously transplanted solid mouse melanoma B16 development. The exponential approximation of a relaxation curve within the 6-90 ms time range is shown to fit melanoma B16 tissue characterization. Contrast-enhanced calculated MR-images are presented. PMID- 3657441 TI - [Dosimetric planning of intracavitary irradiation with the Selectron equipment]. PMID- 3657442 TI - [Color decoding of roentgenograms in periodontitis]. PMID- 3657443 TI - [Quantitative analysis of perfusion scintigrams of the myocardium using 201Tl in ischemic heart disease]. AB - Altogether 111 patients with coronary heart disease (CHD) were examined using loading perfusion scintigraphy testing of the myocardium with 201Tl. Quantitative assessment of scintigrams was based on a computer-assisted method proposed by the authors which was used for determination of indices characterizing a degree of perfusion disorder in each segment of the left ventricular myocardium: the M/B ratio (the ratio of a mean level of radioactivity of a myocardial segment to a mean level of background radioactivity) and the TAI (the thallium accumulation index--a quantitative value of segmental perfusion). The method permits the detection of a zone of disturbed perfusion (ischemia, scar changes and left ventricular aneurysm) and quantitative assessment of the depth of scar lesion of the left ventricular myocardium. PMID- 3657444 TI - [Achievements and trends in the development of basic research in the field of radiobiology]. PMID- 3657445 TI - [Effect of hemostasis on homeostasis during irradiation of the body and tumors]. PMID- 3657446 TI - [The results of research on the biological effects of neutrons]. AB - A study was made of the peculiarities of the biological effect of neutrons as compared to gamma-radiation. A number of biological models were proposed for interpretation of the phenomenon: a biophysical model of mutations and cell inactivation, a model for interpretation of the formation of a radioresistant and radiosensitive fraction. PMID- 3657447 TI - [Comparative effectiveness of different types of radiation in the induction of gene mutations: basic and applied aspects]. AB - Large-scale radiation-genetic studies on bacterial cells (E. coli) and Drosophila (D. melanogaster) using methods like an analysis of mutations of some structural genes and assessment of the frequency of mutations with relation to survival have shown for the first time that the efficacy of neutrons (E = 0.85 MeV) in the induction of gene mutations in Pro- and Eukaryotae is much lower than that of weak ionizing radiation with the same survival. Some features of radiation mutagenesis in a Drosophila mutant c(3)G defective in genetic recombination were described. A low level of the frequency of radiation-induced mutations typical of this mutant was also characteristic for some E. coli rec--mutants. A fact earlier reported for bacteria consisting in a higher (than one could expect extrapolation of lethal-sublethal irradiation doses to small ones) frequency of gene mutations in the range of relatively small absorbed doses of gamma-irradiation (the survival rate being not lower than 80%) was also first established for Drosophila. The importance of these entirely new facts for the theory of mutations in radiation genetics are briefly discussed. PMID- 3657448 TI - [Interphase death of lymphoid cells: role in the genesis of radiation sickness and molecular mechanisms]. AB - An analysis of the data on the effect of lymphoid cells on the proliferation and differentiation of hemopoietic stem cells has led to a conclusion that radiation injury of lymphocytes plays an important role in the pathogenesis of the cerebrospinal syndrome. The molecular mechanisms of lymphocyte interphase death were considered. It was shown that due to some peculiarities in the energy supply of these cells the appearance of breaks in DNA causes the development of biochemical processes resulting in a decrease in NAD, an increase in the activity of nucleases, a decrease in ATP, and the accumulation of active metabolites of glycolysis. These reactions result in an increase in the disintegration of DNA, chromatin and pyknosis of lymphocyte nuclei. PMID- 3657449 TI - [Protective and repair processes in the small intestine during radiation exposure]. AB - The small intestine as a complex heterostructural organ possesses morphofunctional defence-regenerative mechanisms. All elements of this mechanism suffer in irradiation of the organ especially at ionizing radiation doses causing the acute intestinal syndrome. Regenerative processes in the small intestine are suppressed not only by ionizing radiation but also by the toxic products of exo- and endogenous origin resulting from irradiation of the body. PMID- 3657450 TI - [Results of studies on radionuclide diagnosis at the Research Institute of Medical Radiology of the USSR Academy of Medical Sciences]. PMID- 3657451 TI - [Achievements and prospects for research at the X-Ray Department of the Research Institute of Medical Radiology of the USSR Academy of Medical Sciences]. PMID- 3657452 TI - [Development and application of activation and roentgenofluorescent methods of analysis of chemical elements in the human body]. PMID- 3657453 TI - [Results and prospects of preoperative irradiation of tumors]. AB - An analysis of the results of combined therapy of patients with cancer of different sites has shown a high efficacy of the method. The use of radiation therapy in combination with known surgical ablation methods results in a decrease in the number of local recurrences and distant tumor metastases as well as in an increase in the proportion of operable patients with locally spread tumors. These methods contribute to the prolongation of cancer patients' life. PMID- 3657454 TI - [Mathematical models in clinical radiobiology and optimization of the radiotherapy of tumors]. AB - A mathematical model was developed in the system of tumor-normal tissues. It reflected the main radiobiological factors and regularities of tumor growth kinetics: heterogeneity of cell populations with relation to radiosensitivity and a tendency to proliferation, the effects of reoxygenation. Using a package of RADON applied programs optimum irradiation regimens were obtained simultaneously for single doses and intervals of interfractional recovery. Optimum irradiation regimens were shown to be dynamic fractionation of a total dose and the entire period of treatment. PMID- 3657455 TI - [Application and prospects for development of a system of dosimetric planning of radiotherapy]. AB - A model of a system of dosimetric design of radiotherapy on the basis of SM-4 and ES-1033 computers has been developed and is being tested. Radiotherapy for over 600 patients with tumors of different sites was designed within 1 year. The simplicity of the system allowed a radiologist to take an active part in the choice of a favourable radiotherapy design. Four variants of dose distributions on an average were computed for each patient. A study of the time characteristics of the system has shown that the time of input of the data on a patient and beam parameters does not practically depend on the computer speed and lasts for an average of 15 min. Dose field computation and optimization of inputs vary from 0.4 to 6 min. depending on a volume of computation and computer type. A one-task computer system with one working place and memory is able to meet the requirements in dosimetric design for 2-3 radiotherapeutic units. More units will require multitask and all-purpose computers with 2 and more working places. Minimum standards of computer memory and speed are the same as in the first case. PMID- 3657456 TI - [Major trends of research at the Research Institute of Medical Radiology of the USSR Academy of Medical Sciences under the 12th 5-Year Plan]. PMID- 3657457 TI - [Contact neutron therapy of tumors with 252Cf irradiation]. AB - Clinical experience gained from a combined study of 252Cf brachytherapy by the staff-members of the Research Institute of Medical Radiology, USSR AMS, was generalized. To provide neutron beam therapy they employed contact apparatuses and flexible assemblies of 252Cf sources and the ANET-B neutron therapeutic unit. The immediate, short- and long-term results of therapy of 571 patients with malignant tumors of different sites, spread and histogenesis were assessed. Contact neutron beam therapy was shown to be a new effective method for local therapy of various neoplasms. Further progress in 252Cf brachytherapy necessitates a search for optimum schemes of 252Cf radiation in combination with gamma-beam therapy, radiomodifying agents, antineoplastic drugs and surgical interventions in order to influence primary, regional and distant tumor growth foci. PMID- 3657458 TI - [Clinical studies of the diagnosis and treatment of Hodgkin's disease (1967 1986)]. PMID- 3657459 TI - [Experimental basis and clinical results of the use of short-term hyperglycemia in combined therapy of malignant tumors]. AB - Proceeding from an analysis of the literature and their own data on radio- and thermodifying properties of hyperglycemia the authors have proposed a scheme of polyfactor therapy of malignant tumors including the following succession of exposures under clinical conditions: irradiation (the 1st fraction)--a chemotherapeutic drug--hyperglycemia--hyperthermia--irradiation (the 2nd fraction). The interval between exposures should be the least, best of all exposures should follow one another in a quick succession. Using the experimental data for determination of methods of therapy of transition and metastatic tumors of the upper respiratory tracts, satisfactory clinical results were obtained with regard to survival and the absence of local radiation reactions. PMID- 3657460 TI - [The morphologist and the radiotherapy of tumors]. PMID- 3657461 TI - [Local radiation injuries]. AB - The author has summed up the results of therapy and a clinical course of radiation injuries developing mostly after radiotherapy of different tumors in 3870 patients. PMID- 3657463 TI - Information holds medicine together. PMID- 3657462 TI - File structures for database management systems. PMID- 3657464 TI - The AI purists and the engineers. PMID- 3657465 TI - Theophylline dose calculation by microcomputer. PMID- 3657466 TI - Using the computer to end animal experiments. PMID- 3657467 TI - [Primary prevention of ischemic heart disease]. PMID- 3657468 TI - [Treatment characteristics of alcoholism at a general hospital]. PMID- 3657469 TI - [Participation of the nurse in rehabilitating aged patients in a psychiatric hospital]. PMID- 3657470 TI - [Ruptures of the heart]. PMID- 3657471 TI - [Use of radon baths in hypertension]. PMID- 3657472 TI - [Psychotherapy in modern clinical medicine]. PMID- 3657473 TI - [Treatment of diabetic neuropathy in children]. PMID- 3657474 TI - [Treatment and prevention of occupational diseases of the arms and shoulder girdle related to physical overexertion]. PMID- 3657475 TI - [Work characteristics of paramedical personnel in cancer institutions]. PMID- 3657476 TI - [Blood donation (an aid for propagandizers of blood donation)]. PMID- 3657477 TI - [Social hygiene aspects of the turnover in paramedical personnel]. PMID- 3657478 TI - [Radiation safety of the nurse in working in a department with open sources of volatile substances]. PMID- 3657479 TI - [Role of the orthoptics nurse in treating amblyopia in special preschool institutions for children with ocular pathology]. PMID- 3657480 TI - The influence of body mass in cross-country skiing. AB - The influence of body weight on the performance in cross-country skiing has been studied by: dimensional analysis of the ratio (R) between the factors of importance to power production (VO2max, acceleration of gravity) and the braking powers, e.g., friction and air resistance; measuring the energy cost of level skiing (N = 6); comparing male world class skiers (N = 5) with less successful ones (N = 34) and female winners of the National Championships (N = 9) with non winners (N = 9) in regard to the relationship between body weight and VO2max. The dimensional analysis revealed that R was less than unity for rather steep uphills. For level, downhill, and less steep uphill skiing, R was greater than unity. Thus, skiers who are light will be favored in steep uphill slopes, whereas heavier skiers have advantages in the other parts of the track. Energy cost per kilogram for level skiing was inversely related to the transported mass. Per unit of distance, this cost was positively related to velocity. The world class skiers displayed significantly greater VO2max than the less successful ones, regardless of the unit used. The lowest standard deviation among the world class skiers was attained when expressing VO2max as ml X min-1 X kg-2/3. The present results indicate that R will be quite close to unity and therefore the performance capability would theoretically be independent of body mass. Furthermore, VO2max is preferably expressed as ml X min-1 X kg-2/3 for cross-country skiers. PMID- 3657481 TI - Drop jumping. I. The influence of jumping technique on the biomechanics of jumping. AB - In the literature, drop jumping is advocated as an effective exercise for athletes who prepare themselves for explosive activities. When executing drop jumps, different jumping techniques can be used. In this study, the influence of jumping technique on the biomechanics of jumping is investigated. Ten subjects executed drop jumps from a height of 20 cm and counter-movement jumps. For the execution of the drop jumps, two different techniques were adopted. The first technique, referred to as bounce drop jump, required the subjects to reverse the downward velocity into an upward one as soon as possible after landing. The second technique, referred to as counter-movement drop jump, required them to do this more gradually by making a larger downward movement. During jumping, the subjects were filmed, ground reaction forces were registered, and electromyograms were recorded. The results of a biomechanical analysis show that moments and power output about knee and ankle joints reach larger values during the drop jumps than during counter-movement jumps. The largest values were attained during bounce drop jumps. Based on this finding, it was hypothesized that bounce drop jump is better suited than counter-movement drop jump for athletes who seek to improve the mechanical output of knee extensors and plantar flexors. Researchers are, therefore, advised to control jumping technique when investigating training effects of executing drop jumps. PMID- 3657482 TI - Drop jumping. II. The influence of dropping height on the biomechanics of drop jumping. AB - In the literature, athletes preparing for explosive activities are recommended to include drop jumping in their training programs. For the execution of drop jumps, different techniques and different dropping heights can be used. This study was designed to investigate for the performance of bounce drop jumps the influence of dropping height on the biomechanics of the jumps. Six subjects executed bounce drop jumps from heights of 20 cm (designated here as DJ20), 40 cm (designated here as DJ40), and 60 cm (designated here as DJ60). During jumping, they were filmed, and ground reaction forces were recorded. The results of a biomechanical analysis show no difference between DJ20 and DJ40 in mechanical output about the joints during the push-off phase. Peak values of moment and power output about the ankles during the push-off phase were found to be smaller in DJ60 than in DJ40 (DJ20 = DJ60). The amplitude of joint reaction forces increased with dropping height. During DJ60, the net joint reaction forces showed a sharp peak on the instant that the heels came down on the ground. Based on the results, researchers are advised to limit dropping height to 20 or 40 cm when investigating training effects of the execution of bounce drop jumps. PMID- 3657483 TI - Enkephalins, catecholamines, and psychological mood alterations: effects of prolonged exercise. AB - Seven healthy trained men were studied to determine if running at various relative intensities [percent maximal oxygen consumption (VO2max)] alters peripheral venous levels of leucine enkephalin-like material. Enkephalins were measured using a radio-receptor assay (Leu-Enk RRA). Subjects ran for 80 min at 40 and 60% VO2max and for 40 min at 80% VO2max. Each session was separated by at least 1 wk. Heart rate, blood pressure, lactic acid, and rectal temperature responses increased in an intensity-dependent manner. Epinephrine increased from resting values of 38.2 +/- 6.8 pg X ml-1, mean +/- SE to 75.0 +/- 13.3 pg X ml-1 during the 40% VO2max run, from 60.2 +/- 15 to 186 +/- 45 pg X ml-1 during the 60% run, and from 33.4 +/- 7.6 to 311 +/- 52 pg X ml-1 at the 40th min of the highest workload (80% VO2max). These increases were significant (P less than 0.05). Plasma Leu-Enk RRA was between 3.8 and 6.2 pmol X ml-1 prior to each run and did not change significantly as a result of exercise. Levels of Leu-Enk RRA also did not change during 30 min of supine recovery. Perception of effort increased (P less than 0.05) with increases in exercise intensity, and effort sense was unrelated to plasma Leu-Enk RRA. Psychological tension decreased significantly (P less than 0.05) following exercise at 60 and 80% of VO2max, but the decrease following the 40% run was not significant (P greater than 0.05). Reduced tension following exercise was not related to Leu-Enk RRA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657484 TI - Ratings of perceived exertion at the lactate threshold in trained and untrained men and women. AB - The purpose of this study was to investigate the effects of state of training and gender on ratings of perceived exertion (RPE) at the lactate threshold (LT), and to determine whether RPE during moderate to heavy sub-maximal exercise is more closely associated with LT or %VO2max. RPE at the LT (RPELT) and at various percentages of VO2max were compared in 10 male and 10 female trained distance runners, and 10 male and 10 female untrained subjects, 18 to 35 yr of age. Mean (+/- SD) VO2max [ml X kg FFW-1 (fat-free weight) X min-1] of the trained men and women (72.3 +/- 1.4 and 73.1 +/- 1.6) was significantly higher (P less than 0.05) than for the untrained men and women (60.2 +/- 1.4 and 53.2 +/- 1.8), confirming their higher cardiorespiratory capacity. Similarly, the mean LTs (%VO2max) of the trained men and women (79.2 +/- 1.7% and 73.3 +/- 1.8%) were significantly higher (P less than 0.05) than for the untrained men and women (66.5 +/- 3.3% and 58.9 +/- 3.3%), and mean values for the men were significantly higher (P less than 0.05) than for the women. The means for RPELT for the four groups, 13.6 +/- 2.1, 13.5 +/- 1.6, 13.5 +/- 1.5, and 12.9 +/- 1.3, respectively, were not significantly different (P greater than 0.05), even though the ratings were given at markedly different levels of VE, VO2 (1 X min-1), heart rate, and %VO2max.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657485 TI - Metabolic responses during hydraulic resistance exercise. AB - Thirteen college-age men under-went a treadmill (TM)-graded VO2max exercise test on 1 d and a 24.5-min hydraulic resistive exercise circuit on a following day. Seven exercises were performed in the following order: leg extension, bent-over row, bicep curl, squat, upright row, bench press, and behind-neck press. Each exercise was performed three times with the following work-to-rest timing: 30 s exercise, 30 s rest; 30 s exercise; 30 s rest; and 30 s exercise, 60 s rest (to allow for machine switch-over to the next exercise). Thus, each exercise took a total of 120 s, of which work was for 90 s and rest 120 s. During the circuit, heart rate averaged 153.8 b X min-1 (81.2% of TM max) and VO2 averaged 1.93 l X min-1 (41.4% of TM max). Oxygen uptake for the individual exercises ranged from 1.52 l X min-1 (32.6% of TM max) for the behind-neck-press exercise to 2.43 l X min-1 (52.1% of TM max) for the squat exercise. Heart rate ranged from 135.9 b X min-1 (71.8% of TM max) for the leg extension exercise to 163.4 b X min-1 (86.3% of TM max) for the squat exercise. Hydraulic circuit resistance exercise results in an average caloric expenditure of 40.8 kJ X min-1 (9.75 kcal X min-1). PMID- 3657486 TI - Physical fitness and hemodynamic response of women to lower body negative pressure. AB - Aerobic fitness as assessed by maximal aerobic capacity (VO2max) has been shown to be associated with an attenuated baroreflex function during lower body negative pressure (LBNP) in men. Sixteen women (mean age = 24.7 yrs) were evaluated during progressive LBNP to -50 torr. Each subject's VO2max was determined using indirect calorimetry during the Bruce protocol exercise test. Eight subjects [mean VO2max = 56.8 (ml O2 X min-1) X kg-1] were designated as trained, and eight subjects [mean VO2max = 39.4 (ml O2 X min-1) X kg-1] were designated as untrained. During LBNP, heart rate, blood pressure, cardiac index, forearm blood flow, and leg circumference were measured. All subjects completed the LBNP protocol without clinical symptoms of pre-syncope. The over-all hemodynamic responses of both groups to LBNP were qualitatively similar to previous findings reported for males. However, no significant differences in response of hemodynamic variables were observed between trained and untrained subjects during LBNP to -50 torr (P greater than 0.05) except for vascular resistance and diastolic blood pressure at -50 torr where the untrained value was greater than the trained value. This would suggest that a fitness-related difference may have been present at higher levels of LBNP. Furthermore, in contrast to previous reports in males, the index of baroreflex responsiveness (delta heart rate/delta systolic blood pressure) was similar for both groups (P greater than 0.05). When these data were compared with a similar subject pool of males, the females displayed a significantly greater (P less than 0.05) tolerance of LBNP to -50 torr regardless of fitness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657487 TI - The effects of resistance training on aerobic and anaerobic power of young boys. AB - A 4-wk interval-type training program incorporating omni-kinetic equipment and stationary cycling elicited an increase in the absolute and relative VO2max of an active group of young boys. The improvement in aerobic function was independent of the training protocols of high velocity-low resistance and low velocity-high resistance. However, the training programs failed to increase anaerobic function as measured by an "all-out" cycle test in which power output was calculated in watts and watts per kilogram for 0- to 15-s and 15- to 30-s work periods. Changes in aerobic and anaerobic functions were independent of physiological maturity as determined by serum testosterone level (ng X dl-1). PMID- 3657488 TI - Post-exercise echocardiography in pre-pubertal boys. AB - Echocardiography offers many advantages for non-invasively assessing cardiac function during exercise, but the use of this technique is hampered by interference created by respirations and body motion. The persistence of alterations in ventricular dimensions in the immediate post-recovery period, however, provides an artifact-free opportunity for evaluating recovery from the inotropic response of exercise stress. To determine the feasibility of this technique for children and to examine typical values in the pre-pubertal population, 20 boys had two-dimensional directed left ventricular M-mode echocardiograms performed before and after maximal treadmill exercise. Acceptable measurements were possible by 2 min of recovery in all subjects. Mean left ventricular shortening fraction at this time was increased 10% from resting values as a result of decreased end-systolic dimension. This study demonstrated the feasibility of post-exercise echocardiography in evaluating recovery left ventricular dimensions, but further examination of specificity, validity, variability, and reproducibility of this technique will be important in assessing its clinical usefulness. PMID- 3657489 TI - Exhaustive running: inappropriate as a stimulus of muscle glycogen super compensation. AB - Muscle glycogen super-compensation, as demonstrated after exhaustive cycling, may be affected by mode of exercise and state of training. Hence, we studied the effect of exhaustive running on post-exercise changes in muscle glycogen concentration in untrained subjects and compared the effect of tapered running with an exhaustive bout of running in well-trained runners. Six trained runners (T), 6 untrained subjects (UT), and 6 physically active subjects participated. Four hundred grams of carbohydrate were given for 2 d (PX2 and PX1) before exercise and 600 g for 3 d (R1, R2, and R3) with rest afterwards. Before exercise, T and UT were restricted in physical activity. Biopsies were obtained from the gastrocnemius muscle on PX2 and PX1 in T, and before (PX0), immediately after exercise (R0), and on R1, R2, and R3 in all groups. Muscle glycogen increased from 110 (+/-14) on PX2 to 180 (+/-11) mmol X kg-1 on PX0 in T (P less than 0.001). This PX0 value was higher than the PX0 value for UT, which was 102 (+/-8) mmol X kg-1 (P less than 0.005). R0 values were 57 (+/-14) and 26 (+/-4) mmol X kg-1, respectively. On R1, the glycogen concentration had increased to 127 (+/-10) and 87 (+/-3) mmol X kg-1 (P less than 0.001). No changes occurred during R2 and R3. In a supplementary study, physically active subjects rested (series I) or ran lightly for 40 min (series II) on PX2 and PX1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657490 TI - Women athletes with menstrual irregularity. PMID- 3657491 TI - 31P magnetization transfer studies of creatine kinase kinetics in living rabbit brain. AB - The kinetics of the CK reaction in the living rabbit brain was studied by three 31P magnetization transfer methods: inversion recovery (IR), inversion transfer (IT), and steady-state saturation transfer (SSST). Longitudinal relaxation rates (tau -1) were determined from IR and IT experiments. The values were 0.88 +/- 0.08 s-1 for PCr and 2.45 +/- 0.39 s-1 for gamma-ATP. Analysis of the results of SSST experiments in which gamma-ATP was saturated yielded a forward rate constant kF of 0.53 +/- 0.07 s-1. Upon saturation of PCr no change in the gamma-ATP signal could be detected in SSST. An average reverse rate constant (kR +/- S.D.) of 0.52 +/- 0.04 s-1 was estimated by analyzing IT data from three experiments with selective inversion of gamma-ATP. The standard error of kR was 50%. The average [PCr]/[ATP] of 1.21 +/- 0.16 together with the values of kF and kR yielded a forward-to-reverse flux ratio of 1.23. Within our limits of accuracy this ratio was not significantly different from 1.0, thus suggesting that in the brain the forward and reverse CK fluxes are equal. PMID- 3657492 TI - The contrast-to-noise in relaxation time, synthetic, and weighted-sum MR images. AB - The contrast-to-noise ratio (CNR) in three types of computed MR images is compared in a computer simulation. The original data consist of two spin-echo or two saturation-recovery images. Each pair of images is used to generate a relaxation time image, a synthetic image at arbitrary echo or repetition time, and an image which is a weighted sum of the original images. The CNR produced by these three methods is compared for signals spanning a wide range of relaxation times. In every comparison an optimally weighted sum produces the highest CNR that is statistically attainable. The CNR in the optimum synthetic image equals this bound only if contrast reversal does not occur in the original images. The CNR in relaxation time images is always less than the statistical bound and can be less than the CNR in the original images. PMID- 3657494 TI - Multiecho magnetic resonance angiography. AB - Several pulse sequences which generate projected MR angiograms are presented. These pulse sequences exploit multiple-gradient refocused echoes to obtain several independent angiograms, which can be combined or separately analyzed to provide more information than an individual angiogram. For example, a series of angiograms, each with a different projection axis, can be obtained in the time required to obtain a single angiogram using a single-echo method. If the view angle of each echo is the same, then the acquired angiograms can be added to enhance the signal-to-noise ratio. Another pulse sequence simultaneously obtains two or more angiograms, sensitive to orthogonal flow components of the overall blood flow. These angiograms are then added to give an angiogram which is sensitive to flow in all directions. PMID- 3657493 TI - Proton NMR spectroscopy in myocardial ischemic insult. AB - Proton NMR methods can monitor mobile lipids (e.g., fatty acids and glycerides) in intact tissue. Lipids play a major role in cardiac energy production, and elevated levels of myocardial lipids have been reported following an ischemic insult. The present study examines the potential of high-resolution 1H NMR spectroscopy to monitor lipid alterations 24 h following coronary occlusion in dogs, and to correlate these finds with regional myocardial blood flow (RMBF) measured by radiolabeled microspheres. The dogs were killed, and samples of excised myocardium were studied by high-resolution 1H NMR spectroscopic analysis using solvent suppression in combination with the Hahn spin-echo pulse sequence. Mobile lipids levels in myocardium with moderate blood flow reduction (28.6 +/- 7, integral values, arbitrary units; flow 5-50% of control) were significantly elevated compared to the mobile lipid levels in control myocardium (5.3 +/- 8, P less than 0.001) and in myocardium with severe flow reduction (7.2 +/- 10, P less than 0.001; flow less than 5% of control). The mobile lipids in myocardium with severe flow reduction were not elevated significantly relative to control tissue. As anticipated, depression in the level of creatine paralleled the microsphere determined degree of ischemia, i.e., compared to control (9.0 +/- 3); creatine levels were moderately decreased with flows 5-50% of control (5.5 +/- 4, P less than 0.001) and markedly decreased with flows less than 5% of control (1.0 +/- 2, P less than 0.001). This study suggests that high-resolution 1H NMR spectroscopy may be used to evaluate alterations in myocardial lipid levels following an ischemic insult.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657495 TI - Lipid and water suppression by selective 1H homonuclear polarization transfer. AB - A pulse sequence is presented which uses Polarization Transfer by a Selective Homonuclear Technique (POTSHOT) to retain all resonances, in phase, from a selected coupled spin system while suppressing all other peaks, from both coupled and noncoupled spins. This technique, which is a selective form of Homonuclear Polarization Transfer (HPT), has been used in a 1.5-T whole-body system to generate edited 1H lactate spectra from lactate/oil phantoms and from excised dog hearts. PMID- 3657496 TI - Metabolic fate in the dog of the nitroxide moiety in a compound with potential utility as a contrast agent in MRI. AB - Nitroxides, paramagnetic compounds with demonstrated effectiveness as contrast agents in proton magnetic resonance imaging, shorten the relaxation times of protons and therefore cause an increase in image intensity in tissues into which they distribute. In this study, the metabolic fate of the nitroxide moiety was examined in the dog using a pyrrolidine nitroxide derivative, 2,2,5,5 tetramethylpyrrolidine-1-oxyl-3-carboxylic acid, for which contrast-enhancing properties have been previously studied in animals. After radiolabeling by microwave discharge in the presence of tritium gas, the compound was administered intravenously to a dog. Ninety-four percent of the radioactivity injected was recovered in urine within 3 days; the majority (90%) was excreted during the first 6 h. The radioactivity in the urine was identified as either the unchanged nitroxide or its corresponding hydroxylamine. Neither complete reduction of the nitroxide moiety to the amine nor any other metabolic transformation was observed. PMID- 3657497 TI - Effects of age on apparent 31P spin-lattice relaxation times of rat brain phosphates. AB - Apparent 31P spin-lattice relaxation times have been measured in vivo for brain phosphates in young adult, mature adult, and aged rats at 4.7 T and 35 degrees C. Statistically significant differences were found for most phosphate species, except PCr and gamma-ATP, among the three age groups, particularly between the young and mature adults. Age-related changes in tissue composition and exchange reactions are discussed as possible contributors to these results. PMID- 3657498 TI - Spin echo imaging of multiple chemical shifts. AB - A method to obtain separate cross-sectional NMR images of chemically different species on the basis of their difference in chemical shift is presented. The total experiment time is no longer than that required for a conventional image and the method retains the full sensitivity of a spin-echo 2DFT imaging experiment. Simple addition of the chemical-shift selective images produces an image free from chemical-shift artifacts. Results of an in vivo experiment on a human subject are presented. PMID- 3657499 TI - Random noise selective excitation pulses. AB - Several methods for the spatial localization of NMR signals from well-defined regions of tissue within extended specimens have been proposed. Most of these techniques are prone to signal error which can arise from large volumes of sample that surround the region of interest. These errors can theoretically be reduced by several orders of magnitude by the application of a radiofrequency prepulse. The pulse acts to randomize the unwanted spin magnetization prior to the application of a spatial localization technique. PMID- 3657500 TI - NMR changes in experimental allergic encephalomyelitis: NMR changes precede clinical and pathological events. AB - In guinea pigs immunized with myelin basic protein (MBP) in complete Freund's adjuvant, experimental allergic encephalomyelitis (EAE) shows a characteristic clinical and pathological course. This study characterized the proton nuclear magnetic resonance (NMR) properties of the central nervous system prior to the onset of clinical signs of EAE. At this time (Days 7-9), the blood brain barrier is disrupted. The effects of the injection of paramagnetic contrast agents gadolinium-DTPA and gadolinium-deferoxamine on the tissue NMR relaxation times were examined. Both proton T1 and T2 relaxation times were prolonged in the spinal cord and the brain prior to the onset of clinical and pathological changes. The largest change was in the thoracolumbar spinal cord where T2 prolongation was 22.9%. Gadolinium-DTPA produced a moderate (5-11%) or marked (9 19%) decrease in control and MBP-treated animals, respectively. Gadolinium deferoxamine also decreased proton relaxation times but was toxic to all animals, producing respiratory arrest. Changes in proton T2 relaxation times in cord and cerebellum were sufficiently large (greater than 10%) to suggest that they might be visualized by magnetic resonance imaging techniques. We have previously described the changes in proton relaxation times during the acute phase of EAE (S.J. Karlik, G. Strejan, J.J. Gilbert, and J.H. Noseworthy, Neurology 36, 1112 (1986]. This study indicates that proton relaxation times are significantly altered at a time when blood brain barrier disruption occurs prior to the onset of clinical or pathological signs. PMID- 3657501 TI - Magnetic resonance imaging of midline brain tumors using inversion recovery sequences at 0.08 T (3.4 MHz). AB - The use of inversion recovery sequences to highlight intracranial tumors in children is illustrated. The effect of changing the inversion time (TI) to produce the best spatial resolution and to highlight the contrast resolution between different tumors and normal brain is analyzed. The normal appearances and clinical examples in the central nervous system are used to illustrate the options that are available using IR sequences. Variation of TI for providing a means of differentiating short T1 lesions from long T1 lesions is discussed, short TI sequences being best for demonstrating gliomas and astrocytomas whilst medium/long TI sequences are best for demonstrating vascular abnormalities and short T1 tumors. Inversion recovery imaging is considered to be an accurate alternative to spin-echo imaging as currently applied. PMID- 3657502 TI - The fate of inorganic phosphate and pH in regional myocardial ischemia and infarction: a noninvasive 31P NMR study. AB - To determine the characteristic appearance of phosphorus (31P) nuclear magnetic resonance spectra in acute and chronic myocardial infarction in situ, cardiac gated depth-resolved surface coil spectroscopy (DRESS) at 1.5 T was used to monitor 31P NMR spectra from localized volumes in the left anterior canine myocardium for up to 5 days following permanent occlusion of the left anterior descending coronary artery. Coronary occlusion initially produced regional ischemia manifested as significant reductions in the phosphocreatine (PCr) to inorganic phosphate (Pi) ratios and intracellular pH (P less than 0.05, Student's t test) in endocardially displaced spectra acquired in periods as short as 50 to 150 s postocclusion. Spectra acquired subsequently revealed either (i) restoration of near-normal phosphate metabolism sometime between 10 and about 50 min postocclusion or (ii) advancing ischemic phosphate metabolism at about an hour postocclusion, and/or (iii) maintenance of depressed PCr/Pi ratios for up to 5 days postocclusion with a return of the apparent pH to near normal values between 6 and 15 h postocclusion. Postmortem examination of animals exhibiting the first type of behavior revealed the existence of coronary collateral vessels. The last type of behavior indicates that Pi remains substantially localized in damaged myocardium for days following infarction. The location and size of infarctions were determined postmortem by staining excised hearts. The smallest infarctions detected by 31P DRESS weighed 4.9 and 7.5 g. The most acidic pH measured in vivo was 5.9 +/- 0.2. Infarctions aged 1/2 day to 5 days were characterized by elevated but broad Pi resonances at 5.1 +/- 0.2 ppm relative to PCr and significantly depressed PCr/Pi ratios (P less than 0.002, Student's t test) relative to preocclusion values. Contamination of Pi resonances by phosphomonoester (PM) components is a significant problem for preocclusion Pi and pH measurements. These results should be applicable to the detection and identification of human myocardial infarction using 31P NMR and DRESS. PMID- 3657503 TI - An optimized head coil design for MR imaging at 0.15 T. AB - Receive-only head coils employing a modified solenoid design were developed for a 0.15-T imager with horizontal main static and radiofrequency transmit fields. This coil design uses three or five identical horseshoe-shaped elements, constructed of 1/2-in. outside diameter copper tubing, lying one above the other in equally spaced horizontal planes. Coils of this design were compared to the half-saddle coil supplied with our imager and to the Hammersmith Hospital spherical coil (G.M. Bydder et al., J. Comput. Assist. Tomogr. 9, 987 (1985]. Compared to the half-saddle coil, one of our new head coils has the same field of view while improving the signal-to-noise ratio (S/N) by 80% in the upper brain and 20% in the cervical vertebrae; compared to the spherical coil the S/N was up to 60% lower but the field of view was larger and patient comfort was better. PMID- 3657504 TI - MR in renal disease: importance of cortical-medullary distinction. AB - The diagnostic value of MR contrast between renal cortex and medulla (CMC) as an indicator of renal disease was retrospectively studied in 51 patients (9 patients with obstructive disease, 7 with inflammatory disease, 12 with various noninfectious parenchymal medical disease, 5 with vascular disease, 2 with diffuse neoplastic disease, 7 with hemosiderosis, and 10 with renal trauma [blunt trauma and 9 postlithotripsy]). Additionally, normal kidneys from 20 control subjects were studied. On T1-weighted spin-echo images (SE 500/30), CMC was visible in all the normal kidneys (19% contrast +/- 2% SD). A decrease in or an absence of CMC on T1-weighted images (SE 500/28) was found to be a sensitive but nonspecific sign in most of the renal diseases studied. CMC was visibly preserved at normal levels in 7 of the 9 kidneys traumatized by lithotripsy and in all 4 kidneys with acute renal obstruction; CMC was above normal in kidneys with hemosiderosis. In conclusion, alteration in CMC is a sensitive but nonspecific indicator of renal disease. Furthermore, normal CMC can be seen in the presence of renal pathology. PMID- 3657505 TI - Noise reduction in wide-bore magnets using a patient cage. AB - Significant rf noise reduction is demonstrated by enclosing the patient in a conducting cage grounded to the magnet bore in a 22-cm-bore spectrometer system capable of examining magnetic images and spectroscopy of human limbs. This method of noise reduction was found to be reliable, simple, and efficient for dealing with ambient rf noise in an unshielded room. PMID- 3657506 TI - Surface coil holder for Signa. AB - A surface coil holder is described for the General Electric Signa spectrometer. This allows for accurate positioning of the 31P coil relative to that of the 1H coil used for tissue slice localization. PMID- 3657507 TI - Slice-shape artifact changes with precession angle in rapid MR imaging. AB - One possible method of measuring T1 in rapidly acquired magnetic resonance images using variants of the FLASH technique is by the manipulation of the magnetization precession angle. It is suggested here that this method is as prone to slice shape artifacts as many other approaches. PMID- 3657508 TI - 31P NMR studies on recovery from hypoxia of human tumor cells. AB - We describe the use of 31P NMR spectroscopy in the study of metabolic changes related to hypoxia in cultured human tumor cells in vitro. The 31P NMR spectrum can easily distinguish between metabolically active cells, metabolically inactive "dormant" cells, and necrotic cells. A crucial observation was that of the ability of the "dormant" cells to resume active metabolism on incubation with oxygen after long periods of hypoxia. PMID- 3657509 TI - Spectral resolution in clinical magnetic resonance spectroscopy. AB - We observe linewidths of 0.1-0.4 ppm in 31P spectra of human muscle, liver, and brain. T2 measurements of muscle phosphocreatine, together with previous brain studies, indicate that further improvements in linewidth to 0.02-0.05 ppm might often be achieved, but in some lesions magnetic susceptibility variations may limit spectral resolution. PMID- 3657510 TI - RAPID--a new method for fast imaging using a single slice of Z-magnetization. AB - A single slice of z-magnetization is used to generate high-speed images. The slice selection step is achieved using two sin-sinc pulses. This procedure eliminates the need for continual slice gradient reversal, a requirement for the FLASH technique. The RAPID imaging method has less inherent T1 and/or T2 dependence than current fast imaging methods and is more sensitive. PMID- 3657511 TI - Modified stimulated echo sequence for elimination of signals from stationary spins in MRI. AB - Simple modification of the basic stimulated echo sequence (MSTE), including bipolar gradient modulation, permits one to generate relative motion phase modulations between the two STE magnetization components. It is shown how this self-referencing process can provide flow enhancement without combination of separated images. PMID- 3657512 TI - The design of a multiple inversion recovery sequence for T1 measurement. AB - Inversion recovery has the potential to be a powerful method of determining the values of T1 in in vivo studies. However, because of its relative slowness it is not practical to undertake several experiments with different values of the interval between the magnetization inverting 180 degree pulse and the interrogating 90 degree one. The multiple inversion recovery method described here uses a series of sampling pulses, most much less than 90 degrees, to produce a series of images. It is shown that slice shape is relatively reproducible from one sample to another and that, largely as a result, the accuracy of the sequence in measuring T1 is encouraging. PMID- 3657513 TI - Triiodothyronine effects on RNA polymerase activities in isolated neuronal and glial nuclei of the mature rat brain cortex. AB - Our previous study demonstrated that a high level of nuclear triiodothyronine receptors (NT3R), which are identical to the hepatic NT3R, exists in neuronal nuclei of the cerebral cortex from an adult rat brain. To investigate whether thyroid hormone acts through binding to nuclear receptors, we measured RNA polymerase activities in isolated neuronal and glial nuclei of cerebral cortices prepared from three groups of rats with different T3 levels: T3 (20 micrograms/100 g BW/d, for three days)-injected hyperthyroid rats, control normal rats, and thyroidectomized rats. The enzyme activities in both nuclear fractions were assayed under the condition of dose-response linearity. When RNA polymerase I activity in neuronal nuclei from control rats was expressed as 100%, the activities from T3-injected and hypothyroid rats were 112.3 +/- 3.4% (n = 5, P less than .05) and 86.9 +/- 3.5% (n = 5, P less than .05), respectively. The increase in the enzyme activities were parallel to the increase in T3 content in neuronal nuclei among the groups. Glial nuclear RNA polymerase I showed the same tendency in response to T3, although the enzyme activity was smaller than from neuronal nuclei. RNA polymerase II, however, showed no significant change in response to altered T3 levels. The existence of numerous receptors and an induction of increased RNA polymerase I activity by T3 in neuronal nuclei raise the possibility that thyroid hormone through a NT3R pathway in the cerebral cortex of even the mature rat brain. PMID- 3657514 TI - The dyslipoproteinemia of anabolic steroid therapy: increase in hepatic triglyceride lipase precedes the decrease in high density lipoprotein2 cholesterol. AB - Administration of the androgenic anabolic steroid, stanozolol, is associated with decreased high density lipoprotein (HDL) cholesterol (primarily due to decreased HDL2 cholesterol) and increased levels of postheparin plasma hepatic triglyceride lipase (HTGL) activity. Since HTGL appears to play a role in HDL metabolism, we examined the temporal relationship between these changes. HDL cholesterol remained stable during the first two days of stanozolol administration, but decreased 14% (P less than .01) by the third day and 39% (P less than .01) by the seventh day of stanozolol. HDL2 cholesterol paralleled the total HDL cholesterol level and remained stable for the first two days, but decreased 22% (P less than .01) after three days and 71% (P less than .01) after seven days of stanozolol. In contrast, HTGL increased 62% (P less than .001) during the first day, 161% (P less than .001) with two days, 230% (P less than .001) with three days of stanozolol administration, and remained elevated thereafter. Thus, during stanozolol administration HTGL increased dramatically and clearly before any change in HDL or HDL2 cholesterol. PMID- 3657515 TI - Whole body lipid and energy metabolism in the cancer patient. AB - The relationship between whole-body energy and lipid kinetics in eight cancer patients was investigated after an overnight fast. Respiratory gas exchange and indirect calorimetry were used to obtain resting energy expenditure (REE) and net substrate oxidation rates. Free fatty acid (FFA) turnover, oxidation, and clearance rates were obtained after a primed-constant infusion of albumin bound 1 14C-Na palmitate. This was followed by a primed-constant, two-stage infusion of unlabeled glycerol to measure plasma glycerol turnover and clearance. The REE was 1.3 times the predicted (by the Harris-Benedict equation) basal energy expenditure. FFA and glycerol, plasma concentrations, and turnover rates were higher in these depleted but hypermetabolic cancer patients, compared to reported values for healthy normals. The ratio of FFA turnover to glycerol turnover was 3.14 +/- 0.38, which is close to the theoretical value of 3, suggesting complete hydrolysis of triglycerides and the absence of any extensive reesterification of FFA in adipose tissue. The net fat oxidation accounts for 53 +/- 5% of fat mobilized and 29 +/- 3% of the FFA turnover was converted to CO2 in the process of supplying energy in cancer patients. The results suggest that fat is efficiently mobilized and utilized as a fuel source in hypermetabolic cancer patients in the postabsorptive state. PMID- 3657516 TI - The effects of exercise on lipogenic enzyme activity and glyceride synthesis by liver homogenates of diabetic rats. AB - The purpose of this study was to determine if exercise ameliorates the elevated levels of triglycerides in diabetic rats and also to determine if the capacity of liver to synthesize glycerides correlates with changes in plasma triglyceride levels. Forty female rats were divided into four groups: sedentary control, sedentary diabetic, exercised control, and exercised diabetic. Diabetes was induced by intravenous injection of alloxan (40 mg/kg), and control rats were sham-dosed with physiologic saline. All rats remained sedentary in their cages for the first week after the injections. The exercised groups were exercised for seven consecutive days for 2 h/d at 20 m/min (0 grade). All rats were killed 24 hours after the last exercise bout. Blood glucose levels were significantly higher in the diabetic group than the nondiabetic counterparts, but exercise did not affect glucose levels in either the diabetic or nondiabetic groups. Exercise, however, significantly lowered plasma triglyceride and free fatty acid levels in both diabetic and nondiabetic rats. The activities of the five enzymes involved in fatty acid synthesis were all depressed in the diabetic rats compared to controls, and exercise had no effect on the activities of the enzymes. The capacity of liver to synthesize total lipids, diglycerides, or triglycerides was not different in the diabetic rats from that of nondiabetic rats, and exercise did not change that. Only phospholipid synthesis from glycerol-3-phosphate was affected by diabetes. It is concluded that exercise ameliorates the elevations in plasma triglyceride levels that result from diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657517 TI - Glycoconjugates as noninvasive probes of intrahepatic metabolism: I. Kinetics of label incorporation with evidence of a common precursor UDP-glucose pool for secreted glycoconjugates. AB - Conditions are described under which hepatic metabolism of administered labeled sugars can be monitored in the intact rat by measuring output of label from the liver in two secreted glycoconjugates derived from intracellular UDP-glucose, namely glucuronic acid linked to an administered drug (acetaminophen), and galactose secreted in glycoproteins. Rats with indwelling intrajugular catheters were given constant infusions of acetaminophen at nontoxic doses, and acetaminophen-glucuronide was isolated from rat urine by HPLC. When an unprimed continuous infusion of [U-14C]glucose or [1-3H]galactose is begun during acetaminophen infusion, labeling of urinary acetaminophen-glucuronide attains a plateau with an apparent half-life of 2.1 h from labeled glucose as the 14C donor, and 1.2 h from labeled galactose. The times required to attain steady state are attributable either to formation or to hepatic secretion of the glucuronyl conjugate rather than to mixing in extracellular pools or to delays in renal excretion since the half-time of urinary excretion of intravenously injected acetaminophen-glucuronide is only 21 minutes. Consequently, the excreted glucuronide provides noninvasive evidence of the recent specific activity in the precursor pool of hepatic UDP-glucose feeding glucuronic acid. The second glycoconjugate used for comparison was galactose, isolated from the acute-phase plasma protein alpha 1-acid glycoprotein. This represents hepatic UDP-galactose labeling. Comparison of the labeling patterns of secreted galactose and glucuronic acid demonstrates that they are derived from the same intracellular pool of UDP-glucose. This is in contrast to the patterns of labeling of hepatic glycogen from (1-3H) and [U-14C]glucose which have been shown to diverge from those of secreted glucuronic acid. PMID- 3657518 TI - Glycoconjugates as noninvasive probes of intrahepatic metabolism: II. Application to measurement of plasma alpha 1-acid glycoprotein turnover during inflammation. AB - We describe a new method for measuring plasma glycoprotein turnover in vivo using carbohydrate-moiety labeling compared with precursor UDP-sugar monitoring, which allows estimation of the specific activity of the precursor at the biosynthetic site of the glycoprotein. This method has been applied to plasma alpha 1-acid glycoprotein (AGP) kinetics, and has allowed direct quantitation of absolute synthesis rates of AGP in a non-steady state. Following turpentine-induced acute inflammation, AGP was found to undergo a maximum increase in plasma level of eight-fold with a 20- to 25-fold induction in absolute synthesis rate peaking at 25 to 50 h, and a concurrent 2.0 to 2.5-fold increase in fractional degradation rate. The changes in absolute synthesis rates were quite comparable both temporally and quantitatively to changes in hepatic AGP mRNA levels and gene transcription rates reported by others following turpentine inflammation, thus suggesting that AGP synthesis in vivo is predominantly regulated by the level of its mRNA. The carbohydrate moiety labeling method can be applied to other plasma glycoproteins to measure their kinetic parameters in the intact animal or human subject. PMID- 3657519 TI - Sulfur and sulfur amino acids. PMID- 3657520 TI - High-performance liquid chromatography of thiols and disulfides: dinitrophenol derivatives. PMID- 3657521 TI - Sulfite determination: sulfite oxidase. PMID- 3657522 TI - High-performance liquid chromatography of hepatic thiols with electrochemical detection. PMID- 3657523 TI - Analysis for disulfide bonds in peptides and proteins. PMID- 3657524 TI - Cellular protein-mixed disulfides. PMID- 3657525 TI - Measurement of thiol-disulfide interchange reactions and thiol pKa values. PMID- 3657526 TI - Cysteine and cystine: high-performance liquid chromatography of o-phthalaldehyde derivatives. PMID- 3657527 TI - Cysteamine and cystamine. PMID- 3657528 TI - Sulfite determination: fuchsin method. PMID- 3657529 TI - Cysteinesulfinic acid, hypotaurine, and taurine: reversed-phase high-performance liquid chromatography. PMID- 3657530 TI - Cysteinesulfinic acid: fuchsin method. PMID- 3657531 TI - Cysteinesulfinic acid and cysteic acid: high-performance liquid chromatography. PMID- 3657532 TI - Resolution of cysteine and methionine enantiomers. PMID- 3657533 TI - Sulfite and thiosulfate: using S-(2-amino-2-carboxyethylsulfonyl)-L-cysteine. PMID- 3657534 TI - 3-Mercaptopyruvate, 3-mercaptolactate and mercaptoacetate. PMID- 3657535 TI - Penicillamine. PMID- 3657536 TI - Arylsulfatases: colorimetric and fluorometric assays. PMID- 3657537 TI - Thiocyanate and thiosulfate. PMID- 3657538 TI - beta-Sulfopyruvate. PMID- 3657539 TI - Alanine sulfodisulfane. PMID- 3657540 TI - Selenodjenkolic acid. PMID- 3657541 TI - Chemical reduction of disulfides. PMID- 3657542 TI - Sulfane sulfur. PMID- 3657543 TI - Formation of disulfides with diamide. PMID- 3657544 TI - Amino acid sulfones: S-benzyl-DL-alpha-methylcysteine sulfone. PMID- 3657545 TI - Sulfonic acids: L-homocysteinesulfonic acid. PMID- 3657546 TI - Sulfoxides. PMID- 3657547 TI - Amino acid sulfoximines: alpha-ethylmethionine sulfoximine. PMID- 3657548 TI - Sulfide determination: ion-specific electrode. PMID- 3657549 TI - Preparation of sulfur and selenium amino acids with microbial pyridoxal phosphate enzymes. PMID- 3657550 TI - Construction of assay diets for sulfur-containing amino acids. PMID- 3657551 TI - Sulfate: turbidimetric and nephelometric methods. PMID- 3657552 TI - Production of selenium deficiency in the rat. PMID- 3657553 TI - Hydrogen selenide and methylselenol. PMID- 3657554 TI - Sulfatases from Helix pomatia. PMID- 3657555 TI - Adenosylhomocysteinase (bovine). PMID- 3657556 TI - Polarography of sulfur compounds. PMID- 3657557 TI - Betaine-homocysteine S-methyltransferase (human). PMID- 3657558 TI - Cysteamine dioxygenase. PMID- 3657559 TI - Spectrophotometric assay of thiols. PMID- 3657560 TI - L-methionine gamma-lyase from Pseudomonas putida and Aeromonas. PMID- 3657561 TI - Taurine dehydrogenase. PMID- 3657563 TI - Sulfate determination: ion chromatography. PMID- 3657562 TI - Sulfhydryl oxidase from rat skin. PMID- 3657564 TI - Thiol labeling with bromobimanes. PMID- 3657565 TI - Determination of low-molecular-weight thiols using monobromobimane fluorescent labeling and high-performance liquid chromatography. PMID- 3657566 TI - Purification of thiols from biological samples. PMID- 3657567 TI - Guide to molecular cloning techniques. PMID- 3657568 TI - Isolation of genomic DNA. PMID- 3657569 TI - Digestion of DNA: size fractionation. PMID- 3657570 TI - Isolation of messenger RNA from membrane-bound polysomes. PMID- 3657571 TI - Use of antibodies to obtain specific polysomes. PMID- 3657572 TI - Safety with 32P- and 35S-labeled compounds. PMID- 3657573 TI - Translation in cell-free systems. PMID- 3657574 TI - Translation of messenger RNA in injected frog oocytes. PMID- 3657575 TI - Characterization of in vitro translation products. PMID- 3657576 TI - Equipping the laboratory. PMID- 3657577 TI - Preparation of cDNA and the generation of cDNA libraries: overview. PMID- 3657578 TI - Second-strand cDNA synthesis: classical method. PMID- 3657579 TI - Purification of large double-stranded cDNA fragments. PMID- 3657580 TI - Full-length cDNA clones: vector-primed cDNA synthesis. PMID- 3657581 TI - Isolation of differentially expressed genes. PMID- 3657582 TI - Gene cloning based on long oligonucleotide probes. PMID- 3657583 TI - Hybridization of genomic DNA to oligonucleotide probes in the presence of tetramethylammonium chloride. PMID- 3657584 TI - Use of antibodies to screen cDNA expression libraries prepared in plasmid vectors. PMID- 3657585 TI - Identification and characterization of specific clones: strategy for confirming the validity of presumptive clones. AB - It should now be apparent that establishing the identity of a particular recombinant is not a simple procedure. In the absence of unambiguous and internally consistent DNA and protein sequence information, analyses become dependent on a series of characteristics which, together, may be unique to a specific gene and/or gene product. The process of identification is, thus, often more a corroboration of predicted characteristics than absolute proof. It is critical that the process of identification is not simply reduced to the circular arguments generated by reconfirming characteristics used during the initial selection scheme. PMID- 3657586 TI - Subcloning. PMID- 3657587 TI - DNA sequencing: chemical methods. PMID- 3657588 TI - Sequencing DNA with dideoxyribonucleotides as chain terminators: hints and strategies for big projects. PMID- 3657589 TI - Autoradiograms: 35S and 32P. PMID- 3657590 TI - Hybrid selection of mRNA and hybrid arrest of translation. PMID- 3657591 TI - Identification of genomic sequences corresponding to cDNA clones. PMID- 3657592 TI - Demonstration of tissue-specific gene expression by in situ hybridization. PMID- 3657593 TI - Use of eukaryotic expression technology in the functional analysis of cloned genes. PMID- 3657594 TI - Nick translation. PMID- 3657595 TI - The breast. Proceedings of a workshop. Fourth International Congress on the Menopause. Orlando, Florida. PMID- 3657596 TI - Xeromammography. AB - Early detection of breast malignancy can insure more effective treatment and a more likely cure. The early detection of cancer of the breast has become the most vital factor in determining successful treatment, arresting the malignancy before it spreads to other organs. Women do not die from breast cancer--it is the cancer's invasion throughout the body and its affect on vital organ systems which ultimately kills the patient. It is, therefore, understandable why the earliest possible detection offers any woman the most favorable prognosis. Evaluation of the female breast using xeromammography techniques provides us with the technical capability of detecting breast cancer at the earliest and, in the majority of women, the most favorable stage. Using today's reduced dose techniques, any proposed risk, hypothetical or real, becomes insignificant. PMID- 3657597 TI - Gross cystic disease of the breast. AB - The aetiology of fibrocystic disease of the human breast remains problematical. While oestrogens may cause cystic lesions and epithelial proliferation in the mammary glands of experimental animals and certain progestogens (chlormadinone acetate and medroxyprogesterone acetate) may induce severe myoepithelial hyperplasia in beagles, the classical oral contraceptives (oestrogens and progestogens) reduce the incidence of fibrocystic breast disease in women. The role of prolactin in human breast disease is far from clear despite the fact that in rodents mammary tumors fail to develop following oestrogen administration in the absence of prolactin. Because women with gross cystic disease of the breast are at four times greater risk of developing malignant breast disease, it is felt that the administration of courses of danazol, an impeded androgen derived from the progestin, 17 alpha-ethinyl testosterone, has proved effective in lessening fibrocystic disease of the breast, frequently obviating the need for breast biopsy. The study of the hormonal content of fluid aspirated from gross breast cysts should help elucidate the pathophysiology of breast disease. Breast cyst fluid is rich in androgens, particularly dehydroepiandrosterone sulfate; concentrations of polypeptide hormones like FSH, LH, TSH, PRL, and calcitonin are invariably present sometimes in less and at other times in greater amounts than that found in plasma. Of particular interest is the finding of measurable levels of beta-hCG in cyst fluid but not in the serum. The question arises whether the beta-hCG is biologically active or are the assay values merely the expression of radioimmunoassayable components? Preliminary (as yet unpublished) studies reveal excellent bioactivity as measured by testosterone production in Leydig cell cultures. Time will tell whether elevated levels of bioactive beta-hCG portend neoplastic potential. PMID- 3657598 TI - The surgical treatment of breast cancer. AB - Controversy regarding the efficacy of surgical treatment of breast cancer has persisted since the earliest descriptions of this disease in the first and second centuries AD. It has been acknowledged for many years that patients with untreated breast cancer survive for a surprisingly predictable period of 5 yr. Hence, in recommending extensive surgical procedures, the surgeon must recognize the unique biology of breast cancer and the need for long-term follow-up. In spite of a voluminous body of literature concerning the treatment of breast cancer, the distention and contention still continue. However, there is now increasing support for conservative treatment, including the less radical modified mastectomy, and in selected cases, wide local excision, axillary dissection and radiotherapy. As knowledge accumulates, it is clear that the treatment of breast cancer requires a multidisciplinary approach reflecting our understanding of the biology of this disease. PMID- 3657599 TI - Microcalorimetric investigation into the metabolic activity of rat caecal flora in the presence of different sugars and sugar substitutes. AB - When adapting young rats to different sugar substitutes (sorbitol, PolydextroseR and PalatinitR), effects were seen in the caecal morphology and caecal content e.g. bacterial concentration, which did not occur when adapting rats to sugars (glucose, sucrose). For in vitro studies, anaerobic growth of caecal flora in thioglycollate medium with and without the respective substances was monitored by continuous measurement of heat production, optical density and pH. Additionally, biochemical analyses and light microscopic observations were performed in order to detect differences between adapted and non-adapted flora. In particular the microcalorimetric data furnished valuable information about alterations in bacterial metabolic activity after adaptation to sugars and sugar substitutes, and clearly indicated that all the substances tested influenced the metabolism of caecal flora. PMID- 3657600 TI - Aggregation of Streptococcus sanguis biotypes I and II by parotid saliva: a comparison between peritrichously fibrillar and tufted strains. AB - Twelve strains of Streptococcus sanguis biotype I and seven strains of Streptococcus sanguis biotype II carrying either peritrichous fibrils or tufts of fibrils, were examined for their susceptibility to aggregation by parotid saliva. Salivary aggregation was evaluated using a spectrophotometric measurement of sedimentation to assess clump size. A clear distinction emerged between structural sub-groups. Irrespective of biotype, strains carrying peritrichous fibrils aggregated strongly whilst tufted strains were little affected. The one strain with peritrichous fimbriae as well as fibrils, was not aggregated by saliva. Pre-treatment of two peritrichously fibrillar strains with parotid saliva reduced their ability to adhere to parotid saliva-coated hydroxyapatite, whereas adhesion of two tufted strains was not inhibited. Inhibition of adhesion may have been due to steric hindrance, but blocking of bacterial adhesins by saliva components could not be discounted. PMID- 3657601 TI - An inapparent infection with a probable picornavirus in several stocks of laboratory reared and naturally occurring populations of Dacus oleae Gmel. pupae in Greece. AB - Pupae from several stocks of wild and laboratory reared olive fruit fly, Dacus oleae, were fractionated by a series of steps designed to identify occluded and nonoccluded viruses. Two different size of particles were isolated, the smaller of which contained a single-stranded RNA molecule of about 2.8 x 10(6). This small RNA virus was found to inapparently infect a Ceratitis capitata continuous cell line. PMID- 3657602 TI - Intracellular bioaccumulation of zinc by an Enterobacter species. AB - Bacterial strains tolerant to the presence of 100 mg/l zinc ions were isolated from a water reclamation system. Each of the organisms were screened for their ability to accumulate zinc at the above mentioned concentration. The organism capable of maximum zinc accumulation was identified as an Enterobacter species and intracellular zinc deposition by this micro-organism was determined using energy dispersive X-ray analysis, transmission electron microscopy and a metal staining technique at the light microscopy level. Further studies revealed that growth and glucose utilization by this isolate were inhibited in the presence of zinc, compared to a control culture grown in the absence of zinc. PMID- 3657603 TI - Responses of sequentially branching macro- and microvessels during reactive hyperemia in skeletal muscle. AB - Small artery and microvascular responses during reactive hyperemia were compared to determine which resistance-bearing vessels played a role in controlling blood flow and resistance for the cremaster skeletal muscle. Using an intravital video microscopy system, measurements of microvessel pressure, flow velocity, and diameter were obtained from cremaster muscles in anesthetized rats. These were compared with measurements of diameter that were obtained from the small arteries feeding the cremaster muscle. After a 60-sec occlusion of the sacral aorta, total cremaster blood flow increased approximately 28% and calculated microvascular resistance for the cremaster muscle fell 50%. During the period of occlusion, diameters of small arteries (159-292 micron) decreased despite the presence of smooth muscle tone. Likewise, the diameters of large arterioles (65-117 micron) decreased whereas small arterioles (16-30 micron) dilated. The decrease in diameter of the small arteries and large arterioles was accompanied by a significant fall in intravascular pressure, suggesting that the behavior of these vessels was largely passive. Immediately following the release of occlusion, small arteries and large arterioles returned to their control diameters while small arterioles remained in a dilated state for approximately 2 min. These results indicate that for the cremaster muscle, vascular responses vary along the length of the arterial tree during reactive hyperemia, small but not large arterioles are primarily responsible for the decrease in network resistance and subsequent hyperemia following occlusion, and the small feeder arteries did not dilate during reactive hyperemia but instead acted to set a limit on the decrease in network resistance and the increase in blood flow. PMID- 3657604 TI - Flow-dependent rheological properties of blood in capillaries. AB - Velocity-dependent flow of human red blood cells in capillaries with inside diameters of 4 to 8 micron is described theoretically. Cells are assumed to flow in single file, with axisymmetric shapes. Plasma flow in the gaps between cells and vessel walls is described by lubrication theory. The model takes into account the elastic properties of red cell membrane, including its responses to shear and bending. Cell shape is computed numerically as a function of tube diameter and cell velocity over the range 0.001 to 10 cm/sec. Relative apparent viscosity and dynamic hematocrit reduction (Fahraeus effect) are also computed. Since effects of interactions between cells are neglected, the Fahraeus effect is independent of hematocrit, while viscosity varies linearly with hematocrit. At moderate or high cell velocities, about 0.1 cm/sec or more, cell shapes and rheological parameters approach flow-independent limits. At lower velocities, cells broaden as a result of membrane shear and bending resistance and approach the walls more closely. Consequently, apparent viscosity increases with decreasing flow rate. Predicted values are in agreement with in vitro experimental determinations. Flow cessation is not predicted to occur in uniform tubes at positive driving pressures. Elastic deformational energies associated with red cell shapes are computed, leading to estimates of the pressure difference required to drive red cells past typical irregularities in capillary lumen cross sections. The hindrance to flow resulting from such structural irregularities represents a potential rheological mechanism for cessation of capillary flow at very low driving pressures. PMID- 3657605 TI - Effect of blood coagulation and platelet aggregation on perfusable capillaries and arterioles in ischemic and nonischemic myocardium. AB - The aim of this study was to determine the effect of blood coagulation and platelet aggregation on the perfusability of arterioles (19-50 micron) and capillaries in subepicardial and subendocardial ischemic and nonischemic myocardium of anesthetized open-chest rabbits. Fluorescein isothiocynate-dextran (MW 150,000) was injected intravenously to label perfusable myocardial microvessels of rabbits that were subjected to 60 min of coronary artery occlusion. Fluorescent microscopy was used to identify the perfusable vessels and an alkaline phosphatase stain was employed to locate the total microvasculature of the heart. Stereological principles were utilized to determine various morphometric parameters. About 25% of the capillaries were incapable of being perfused but virtually all arterioles were perfusable in occluded myocardium of the control group. Essentially all capillaries and arterioles were perfusable in nonoccluded myocardium. Collagen infusion produced a perfusion defect in 14% of the capillaries and arterioles in nonoccluded myocardium and in 33% of the capillaries and arterioles in occluded myocardium. Heparin, prostaglandin E1 (PGE1), or PGE1 + heparin did not prevent the perfusion defect in capillaries of occluded myocardium. It is concluded that while promotion of blood coagulation and platelet aggregation was able to produce microvessel obstruction, these hemostatic mechanisms were not primarily responsible for the capillary obstruction observed during myocardial ischemia in the rabbit heart. PMID- 3657606 TI - Effect of naloxone on microcirculatory behavior during irreversible hemorrhagic shock. AB - Thirty-six male Sprague-Dawley rats were divided into three groups (n = 12): simple hemorrhagic shock group, saline-treated group, and naloxone-treated group. Synchronous videotape recording with two cameras was used to observe the relationship between the change of blood pressure and that of microcirculation of cremaster muscle. It has been suggested that the temporary plugging of capillaries by WBC may be the explanation for no reflow in microvessels after transfusion and infusion during the irreversible stage of shock. Administration of naloxone (2 mg/kg iv) followed by reinfusion of the shed blood is associated with an increase in blood pressure and pulse pressure. Coincidentally, a pulsatile movement of the blood, impacted on the stationary blood cells in capillaries, eventually dislodges them and leads to reperfusion of capillaries. Thereafter systemic blood pressure and carotid artery red blood cell velocity were increased and remained stable. The 24-hr survival rate was significantly increased in the naloxone-treated group (10/12), as compared with that in the saline-treated group (1/12). The mechanism of naloxone treatment is discussed. The suggestion is advanced that the effects on cardiac and microcirculatory performance may influence each other, and that both contribute to the pathogenesis of irreversible hemorrhagic shock. PMID- 3657607 TI - A model of the lung interstitial-lymphatic system. AB - Our model of the pulmonary interstitial-lymphatic system is based on the assumption that the lung interstitial space can be divided into two compartments. The first compartment (C1) contains the terminal lymph vessels. Increases in the fluid pressure within this compartment, along with increased pressure generated by lymph vessel pumping, cause the lymph flow rate to increase. The lymph vessels run through the second compartment (C2) which we believe represents the perivascular spaces. Increases in the fluid volume of C2 cause the lymph vessels to dilate and this causes lymph vessel resistance to decrease. Normally the lymph flow rate equals the microvascular filtration rate so that lung fluid volume is constant. According to our model, increases in filtration rate cause fluid to collect in C1 and C2. The resulting increase in fluid pressure in C1, increased lymph vessel pumping, and the decrease in lymph vessel resistance in C2 cause lymph flow to increase. Eventually, the lymph flow rises to equal the filtration rate and lung fluid volume becomes constant again. The results of simulations with our model indicate that decreases in lymph vessel resistance are essential for lymph flow to increase substantially as edema develops. PMID- 3657609 TI - Parenthood education for adoptive parents. PMID- 3657608 TI - Characterization of mesosomes of Micrococcus luteus: isolation and properties of mesosomal ribosomes, and localization of penicillin-binding proteins in mesosomal membranes. AB - Mesosomes were isolated and purified from Micrococcus luteus under hypertonic conditions throughout preparation processes. The purified mesosomal preparation was composed of closed tubules and vesicles. Electron-dense ribosome-like particles were observed within the isolated mesosomal vesicles by electron microscopy. The ribosome-like particles were isolated from the purified mesosomes by a procedure involving solubilization of the membranes with detergents followed by centrifugation on a linear density gradient of sucrose. The isolated particles have a sedimentation coefficient of 70S in the presence of 10 mM Mg2+, when Mg2+ concentration was lowered to 0.1 mM, the particles were dissociated into two sub particles of 30S and 50S. The 70S particles had the same appearance as cytoplasmic 70S ribosome particles upon observations of negatively stained preparations. These findings indicate that mesosomal tubules contain ribosomes. The isolated mesosomal ribosomes had the ability for protein synthesis when polyuridylic acid-directed polyphenylalanine synthesis was assayed. The sensitivity of mesosomal ribosomes to inhibitors, chloramphenicol and streptomycin, for protein synthesis was significantly lower than that of both cytoplasmic and cytoplasmic membrane-bound ribosomes. In addition, three penicillin-binding proteins were detected in the mesosomal membranes. One of these was localized predominantly in the mesosomal membranes and the other two were distributed almost equally in both mesosomal and cytoplasmic membranes. PMID- 3657610 TI - Thoughts on a child rejected at birth. PMID- 3657611 TI - Discussing sexuality with teenagers. PMID- 3657612 TI - Sexual counselling for midwives. PMID- 3657613 TI - Waiting time in the antenatal booking clinic. PMID- 3657614 TI - Prenatal classes-California style. PMID- 3657615 TI - [Effect of antioxidants, pro-oxidants, respiration inhibitors and substrates on the formation of autonomic secondary colonies of Fusarium bulbigenum var. blasticola]. AB - Autonomous secondary colonies are formed on the primary colonies of Fusarium bulbigenum var. blasticola grown in a synthetic Rieder medium. The secondary colonies are similar to genuine neoplasia in the following characteristics: dedifferentiation of the mycelium filamentous structure to yield single yeast like cells, selective growth, faulty differentiation. Just as antioxidants and respiration substrates inhibit tumour formation and growth in higher organisms, they either prevent or inhibit the formation of secondary colonies in microorganisms. In contrast, their formation is stimulated when prooxidants and respiration inhibitors are added to the growth medium. PMID- 3657616 TI - [Hydrocarbon-oxidizing microflora from the water of the Baltic sea and Kurshsky bay polluted after a fuel oil spill]. AB - Microbiological studies were conducted in the water of the Baltic sea and the Kurshsky bay polluted with mazut as the result of a tanker wreck in November 1981 as well as in the water of nonpolluted regions. Within the summer of 1982 and 1983, 755 bacterial strains were isolated from water samples taken at three different depths. Bacteria belonging to the genera Pseudomonas, Rhodococcus + Mycobacterium and Arthrobacter predominated in the hydrocarbon-oxidizing cenoses of the Baltic sea and the Kurshsky bay. The central part of the Baltic sea pure from mazut did not differ from the polluted regions in the qualitative composition of the hydrocarbon-oxidizing bacterial flora. Rhodococci and mycobacteria prevailed in the water near harbours, and pseudomonades, in the open waters. The greatest variety of species was found at a depth of 1 m. The proportion between the predominating genera of hydrocarbon-oxidizing bacteria was not stable. The state of studies conducted with the hydrocarbon-oxidizing microflora is analysed and the factors causing discrepancies are discussed. One must keep in mind that it is necessary to use a strictly elective medium and to examine cultures with a microscope many times throughout their growth in the isolation and identification of hydrocarbon-oxidizing bacteria. The interrelationship is analysed between the predominant genera of hydrocarbon oxidizing bacteria. PMID- 3657617 TI - [Anaerobic bacteria in various infections and their antibiotic susceptibility patterns]. AB - In this study we have examined antibiotic susceptibility of anaerobic bacteria isolated from various samples of 75 patients. Anaerobic bacteria from 22 (29.3%) patients, and only aerobic bacteria from 29 (38.7%) patients have been isolated; there has been no growth in cultures from 24 (32%) patients. Of 75 isolates from 51 patients 38 (50.6%) are anaerobic and 37 (49.4%) are aerobic bacteria. Following anaerobic bacteria have been isolated: Peptostreptococcus (13), Peptococcus (5), microaerophilic streptococci (2), Veillonella (1), Bacteroides (9), Fusobacterium (4) and non spore forming anaerobic gram positive bacilli (4). Among the 38 anaerobic bacteria the highest resistance has been shown against tetracycline (65.8%). Resistance rates for cephalothin, erythromycin and penicillin G are 28.9%, 15.8% and 7.8%. In our investigation we have shown no resistance against carbenicillin, clindamycin and chloramphenicol. PMID- 3657618 TI - [Immunoglobulin and complement levels in migraine]. AB - There is circumstantial evidence to suggest that immune mechanisms are involved in the pathogenesis of migraine. Several workers have noted an increased incidence of allergy in patients with migraine and the disease has also been explained on an allergic basis. In this study the serum levels of IgG, IgA, IgM and C3 of 50 migraineurs are determined and the results were found to be increased realistically when compared by the control group. The results are compared by the literature. PMID- 3657619 TI - [Eggs of Enterobius vermicularis in vaginal smears]. AB - The technique of exfoliative cytology is used especially for early cancer diagnosis with cervical and vaginal smears. In these smears, some parasites eggs can be seen together with some kind of cells. One of these parasites is Enterobius vermicularis. Normally, this is intestinal parasite. But sometimes, especially in children, this parasite eggs can migrate in vagina by itching, and can cause vaginal discharge. The shape of egg is, one border is flat but the other is convex, and it may contain larva inside. We also observed the egg of Enterobius vermicularis which contains larva inside with squamous epithelial cells and polymorphonuclear leucocytes in a vaginal smear. As is seen, routine Papanicolaou smears are very useful to see unusual eggs of parasites during cancer detection. PMID- 3657620 TI - The effects of the delayed type immune response upon the host. AB - A consistent accumulation of experimental evidence, most of it published long ago, clearly shows that a constant consequence of the immune response elicited by the Koch bacillus is that the individual becomes susceptible to be injured or killed by the tuberculous antigen, which is totally innocuous to the virgin subject. This fact led Rich to conclude that throughout the natural history of tuberculosis, as soon as the immune reaction is activated, the tuberculo-protein poured out by the germ mass will exert its detrimental capabilities manifested as the constitutional symptoms of the disease. The pathogenicity of the specific antigen in the tuberculous-type immune reaction may be extrapolated to other states that elicit the same response, including cancer and tissue transplantation. Unexplained phenomena such as the general symptoms of many neoplasias, as well as the systemic manifestations of graft rejection, may then be attributed to the shedding of antigen from the foreign cell mass into the sensitized host. PMID- 3657621 TI - Ischaemic heart disease, and vehicle travel. AB - Mathematical data are presented supporting a relationship between road accident deaths (RAD), male and female, and ischaemic heart disease (IHD) deaths, male and female, in Australia. It is suggested that RAD on a national scale are a function of vehicle usage, for both males and females, and in turn, vehicle usage creates stress on bodily function resulting in IHD. PMID- 3657622 TI - The function of dreams (REM sleep): roles for the hippocampus, melatonin, monoamines, and vasotocin. AB - Rapid eye movement (REM) sleep is suggested to play a role in the storage of memory, resolution of emotional experiences, and erasure of memory (forgetting). Plasticity of hippocampal physiology, morphology, and chemistry seems to be evidence for new memory formation. REM sleep, melatonin, and monoamines may be involved in the transfer of memory from the intermediate-term high-capacity buffer in the hippocampus into long-term memory storage in the neocortex. Vasotocin, which is released by melatonin, could be an amnestic agent that erases recent memory from the hippocampal-entorhinal complex during dreams. PMID- 3657623 TI - Antilung cancer activities of selenium. AB - Selenium is considered an essential trace element in most animal and plant species, although still reported in many texts as a highly toxic material. Epidemiological investigations have reported an inverse relationship between selenium and lung cancer. Explanations of reported observations have resulted in numerous mechanistic theories. Only recently have selenium metabolites involved in excretion been considered potential agents for antilung cancer activity. Anticancer properties have been shown in occupationally exposed copper smelter workers, dietary investigations and experimental studies. Supplementation with selenium of public water supplies, as is currently done with fluoride, is a potential method for increasing the blood concentration. This may permit development of a population prevention strategy against lung cancer and other diseases. PMID- 3657624 TI - Asbestos blues. PMID- 3657625 TI - The effective use of rehabilitation. PMID- 3657626 TI - Is suicidal behaviour increasing among Australian youth? AB - The rate of suicide of 15- to 19-year-old Australian boys appears to have doubled since 1965. Some of this rise might be due to a trend by coroners to reach a verdict of suicide more frequently than previously. One in seven deaths of teenage boys is now termed suicide. Hospital admissions of boys and girls in Western Australia for attempted suicide doubled in the past decade. These figures indicate that suicidal behaviour among the young constitutes a serious problem for health and welfare services. PMID- 3657627 TI - The Australian Mesothelioma Surveillance Program 1979-1985. AB - The Australian Mesothelioma Surveillance Program was planned in 1977 in order to improve diagnostic criteria, to monitor the incidence of the disease, to develop methods of counting lung fibres, and to explore occupational and other associations of mesothelioma. This paper presents a preliminary analysis of data that were collected between January 1, 1980 and December 31, 1985 on the pathological findings and the work and environmental history of 858 cases of mesothelioma. The annual incidence rate of mesothelioma in Australia was 15 per million population who were aged 20 years and over. This is more than the incidence rate of mesothelioma in any other country for which data are available. However, uncertainty over diagnostic criteria and the degree of ascertainment of cases places doubt on the validity of such comparisons. In 69% of cases, a history of work with or other exposure to asbestos was obtained. Due to the long interval between the first exposure to asbestos and the provisional diagnosis of a mesothelioma (up to 60 years), more than three-quarters of the 456 exposed cases first contacted asbestos in the years of its heavy use between 1930 and 1959. This article analyses cases by the industry and the occupation in which exposure to asbestos first occurred. PMID- 3657629 TI - Human infection with Cryptosporidium spp.: results of a 24-month survey. AB - We report the findings of a two-year survey of faecal specimens for the protozoal pathogen, Cryptosporidium. Of the 2248 patients who were tested, 55 (2.5%) patients were found to have cryptosporidial infection. Transmission of the parasite appeared mainly to occur from person to person. In immunocompetent patients it caused an acute and sometimes severe gastroenteritis. Immunoincompetent patients experienced a variable illness that ranged from asymptomatic carriage to severe diarrhoea, causing malabsorption and ultimately death. Cryptosporidium is an important cause of gastroenteritis and may be the presenting feature of the acquired immunodeficiency syndrome. Therefore, it is pertinent to screen for this pathogen in all patients with acute diarrhoea. PMID- 3657628 TI - Slow-stream rehabilitation: is it effective? AB - Fifty-two patients, who were not considered to be suitable for traditional therapy, were evaluated on their admission (53 admissions) to the Slow Stream Rehabilitation Unit at Greenwich Hospital, and on and after their discharge from hospital, with a minimum follow-up period after discharge from hospital of 13 months. Mobility and the capacity to perform basic self-care activities were assessed by means of a set protocol while traditional rehabilitation therapies were employed. Of the 53 admissions to hospital, there were eight inpatient deaths and 45 discharges from the Unit: 19 discharges to home and 26 discharges to institutional care. This represents a considerable improvement over the initial assessment that all patients would need nursing home accommodation or prolonged hospitalization. At the second follow-up examination, seven of the 19 patients who were discharged home originally, still resided at home. There were 15 patients in nursing care while 23 patients had died. Most patients had maintained their discharge levels of mobility and self-care, unless a further disability had supervened. The majority of carers and patients expressed gratitude for the opportunity that the patients had had to undergo therapy, with the possibility of an eventual return to their own homes, rather than to have proceeded directly to a nursing home. PMID- 3657630 TI - Hearing loss attributed to desferrioxamine in patients with beta-thalassaemia major. AB - Sensorineural hearing loss was detected in nine (33%) of 27 patients with beta thalassaemia major. All were receiving regular hypertransfusion and nightly subcutaneous infusions of desferrioxamine. A retrospective analysis of these patients was undertaken to determine the risk factors for the development of deafness. No statistically significant differences were found between the affected and unaffected groups with respect to age, ferritin levels or lengths of time that they had received desferrioxamine, but the trends were similar to those reported by other authors. However, the desferrioxamine dosage was similar in both our groups (less than 60 mg/kg a day), and lower in the affected group than other authors have reported. Two patients experienced some resolution of their deafness when their dosage of desferrioxamine was lowered. These results suggest that the ototoxic effect of desferrioxamine is dose-related and can occur at relatively low doses of the drug. PMID- 3657631 TI - Mycetoma associated with Acremonium falciforme infection. AB - A patient from Vanuatu with a mycetoma of the foot of 25 years' duration is described. Culture of a biopsy specimen from the foot grew a fungus which was identified as Acremonium falciforme. This agent has not been described previously in association with mycetomas in the Pacific region. PMID- 3657632 TI - Five cases of sudden hearing loss of presumed vascular origin. AB - Sudden hearing loss is an important symptom which demands immediate evaluation. Although it may be attributed to a number of disorders, relatively few clinicopathological correlations have been described. The role of vascular disease in the aetiology of sudden hearing loss has been acknowledged in several case reports, but remains unclear and perhaps underemphasized, given the prevalence of vascular disease in other organ systems in Western communities. Five cases of sudden hearing loss due to presumed vascular disease are reported. It is postulated that vascular disease is an important factor in the pathogenesis, and one which may be overlooked in the management of sudden hearing loss. PMID- 3657634 TI - The practice of radiology. PMID- 3657635 TI - Epileptic persons in Australian society. PMID- 3657633 TI - Merkel-cell tumour of the skin. AB - The case histories of four patients with a Merkel-cell tumour of the skin are presented and the findings are compared with other reports in the literature. An association with other skin tumours is noted and ultraviolet light may be implicated in the causation of Merkel-cell tumours. The Merkel-cell tumours in this series occurred initially on the face. The difficulty of diagnosis is stressed. It is recommended that wide excision of the tumour be followed by radiotherapy to the excision site plus a large margin, in an attempt to prevent local recurrences that are brought about by lymphatic permeation. PMID- 3657636 TI - A case of mammary sarcoidosis. PMID- 3657637 TI - Epidemiology of AIDS. PMID- 3657638 TI - AIDS and the ethics of disclosure. PMID- 3657640 TI - Screening for hepatitis B in antenatal patients. PMID- 3657639 TI - Cephalexin-induced haemolytic anaemia. PMID- 3657642 TI - Clinical impact of in-vitro fertilization. PMID- 3657641 TI - Campylobacter pyloridis in patients with gastric carcinoma. PMID- 3657643 TI - Growth velocity indexes. PMID- 3657644 TI - Lens implantation in cataract surgery. PMID- 3657645 TI - Persons with intellectual disability. PMID- 3657647 TI - Heed Yul Brynner. PMID- 3657646 TI - The tyranny of technology. PMID- 3657648 TI - Breast-feeding of infants. PMID- 3657649 TI - Childhood asthma. PMID- 3657650 TI - Does Australia need a General Medical Council? PMID- 3657651 TI - Doctors and boxing contests. PMID- 3657652 TI - Ownership of clinical images. PMID- 3657653 TI - Quality assurance of therapeutic products and practice. PMID- 3657654 TI - Breast cancer--fiction, facts and fashion. PMID- 3657655 TI - Problems in the assessment and the overcoming of nutritional deficiencies in Australian aborigines. PMID- 3657656 TI - The process and content of general-practice consultations that involve prescription of antibiotic agents. AB - We devised a reliable coding system in order to analyse interactional events between general practitioners and patients that were observed on the videotapes of 201 consultations in which an antibiotic agent was prescribed. Of total consultation events, doctors contributed 14% on the collection of information about the presenting condition for which antibiotic agents were prescribed; 22% on the giving of such information; 17% on social exchanges; and 21% of events were devoted to other problems that emerged during the consultation. Patient questions made up 2% of events and were encouraged specifically by 1% of events. Whereas 75% of patients were told the dose and length of the course, only 46% of patients were told the name of the antibiotic agent, only 10% of patients were told of side-effects, and no patient was told what to do if he or she forgot a dose. Not surprisingly, with the exception of the justification of the treatment that was chosen, practitioners seldom used techniques which have been shown to be effective in the improvement of patient compliance or recall of information. Given that antibiotic agents are prescribed commonly, and compliance is frequently poor, our findings have implications for undergraduate, vocational and continuing education. PMID- 3657657 TI - The profile of breast cancer in Western Australia. AB - Information concerning all 435 women who presented with primary breast cancer in Western Australia during 1984 was obtained by a review of the WA Cancer Registry, hospital, histopathological laboratory, and medical practitioner records. The age standardized and cumulative incidence rates were 55.7 per 100,000 women and 6.4%, respectively. The probability that a woman would develop breast cancer during her lifetime (to the age of 74 years) was one in 15.6. There was a significant seasonal variation in the incidence of breast cancer, with a peak in spring (November) and a low in winter (July). The highest incidence rates occurred in women who had never had any children, those of professional status and those who lived in better socioeconomic areas. Stage-I disease accounted for only 22% of all breast cancers. A younger age was associated with a greater proportion of oestrogen-receptor-negative tumours and a longer symptom interval correlated with larger primary tumours. The findings support the concept that the characteristics of Australian women with breast cancer are similar to those that have been described in British and North American women. PMID- 3657658 TI - Food costs and nutrition of aborigines in remote areas of northern Australia. AB - A locally-relevant "market basket" has been devised to help to assess the cost of usual food purchases for Aborigines who live in the Kimberley region. The range of foods in the market basket is relatively restricted, especially for fresh vegetables. In some communities, basic food items cost over 40% more than they would in the Perth metropolitan area. Price differentials and other difficulties encourage unsatisfactory dietary patterns for Aborigines in the region. A food voucher system is proposed as one possible way to help to overcome serious nutritional imbalances for pregnant women and their infants and young children who are especially vulnerable to nutritional deficiencies. This proposal is likely to be politically unpopular, so other ways should be sought to help to improve the health of Aboriginal mothers and their children. PMID- 3657659 TI - Breast cancer and pregnancy. AB - Although breast cancer is a rare event in pregnancy, the consequences of a delay in its detection and of late-stage disease are tragic for the young woman who presents in her childbearing years. Therefore, all pregnant women with breast problems should undergo a careful assessment. Pregnancy is not a contraindication to orthodox investigations for breast cancer, provided that special care is taken to reduce the risk to the developing fetus. Management is also orthodox, and breast cancer in pregnant or lactating women is thought to behave no differently from breast cancer in non-pregnant women, when age, stage and histological type are similar. For women who have developed early breast cancer during pregnancy, termination of the pregnancy does not appear to have a beneficial influence on the disease. There is no convincing evidence that a subsequent pregnancy has any effect on the outcome of a breast cancer that has been managed successfully previously. The prevention of subsequent pregnancy is not an indication for a prophylactic oophorectomy. A decision for further pregnancies must be made by the patient and the family after sound advice is given as to the prognosis and consideration of the social, economic and spiritual factors. There is no evidence that the termination of a subsequent pregnancy will affect beneficially or adversely the prognosis of a patient with breast cancer. PMID- 3657660 TI - An initiative for teaching about alcohol and other drugs in Australian medical schools. AB - Education in Australian medical schools is presently under review, including teaching about alcohol and other drugs. In August 1986, the Alcohol and Drug Foundation, Australia (ADFA) presented to the Deans of Australasian medical faculties (including those of Fiji, Papua New Guinea, and New Zealand) a number of options to develop the alcohol and other drugs content of medical courses. It was proposed that a coordinator of education in alcohol and other drugs be appointed in medical faculties; this proposal had been modelled on the US Career Teacher Training Program in Alcohol and Drug Abuse. The Deans expressed interest in ADFA's proposal. This paper discusses the role of undergraduate medical education in alcohol and other drugs, and the background to, and some guide-lines from, the ADFA proposal. PMID- 3657661 TI - A case of vagal palsy due to dissecting aneurysm of the carotid artery. AB - A case of unilateral vagus palsy due to spontaneous painless dissection of the left internal carotid artery is reported. The anatomy of the extracranial course of the vagus nerve and the differential diagnosis of unilateral vagal palsy are discussed. PMID- 3657662 TI - Drug advertising. PMID- 3657663 TI - Quinine poisoning in children. PMID- 3657665 TI - Hyperinfection with Strongyloides. PMID- 3657664 TI - Limb-reduction deformities and Debendox. PMID- 3657666 TI - Indirect haemagglutination test for melioidosis. PMID- 3657667 TI - Clonidine-induced myalgia. PMID- 3657668 TI - Inhaled corticosteroid agents and dysphonia. PMID- 3657669 TI - Monitoring superovulation by Dual Analyte. PMID- 3657670 TI - Spirometric tests. PMID- 3657671 TI - Breast-feeding of infants. PMID- 3657673 TI - The looming storm. PMID- 3657672 TI - Exertion-induced heatstroke. PMID- 3657674 TI - On comparing medical school graduates. PMID- 3657675 TI - Comparison of performance of final-year students from three Australian medical schools. AB - Between 1984 and 1986, 888 final-year medical students from The Universities of Sydney, Western Australia and Newcastle took part in trial examinations that comprised multiple-choice questions, modified essay questions and a patient management problem. Differences in student performance among the schools were small. In 1984 and 1985, Newcastle students performed less well than did Sydney students on multiple-choice questions that were prepared by The University of Sydney, but there was no difference between the schools in 1986. Sydney students performed better than did Newcastle students on the multiple-choice question paper that was prepared by The University of New South Wales in 1984, but in the last two years no differences have been detected between the schools in performance on this paper. The performance on modified essay questions in 1984 suggested that Newcastle students were stronger in behavioural sciences and weaker in pathological sciences than were Sydney students. Sydney students performed less well than did Newcastle students in the patient management problem in 1985, particularly in the area of the use of clinical investigations. On the one occasion of testing that involved students from The University of Western Australia (in 1985), these students performed best of the three schools in the patient management problem, and roughly equally with students from Sydney and Newcastle in the multiple-choice question papers. Differences among the schools usually amounted to less than 10% and might have been accounted for by differences in familiarity with test instruments. We conclude that medical students are likely to graduate from The University of Sydney, Western Australia and Newcastle with similar levels of knowledge of internal medicine. Possible differences in problem-solving ability require further study, particularly in the clinical setting. PMID- 3657676 TI - Mycobacterial disease in the musculoskeletal system. AB - Over a six-year period, 12 patients were admitted to a Melbourne teaching hospital with mycobacterial infections of the musculoskeletal system. Four of the infections involved soft tissue and these included three atypical mycobacterial infections. The average age at diagnosis was 60 years. Five patients were born outside Australia. The predisposing factors included a past or family history of tuberculosis, pre-existing arthritis, alcoholism, earlier trauma, and membership of certain occupations. The average delay in diagnosis was four months. Treatment involved a combination of appropriate medication and surgical procedures that ranged from diagnostic aspiration to amputation. Mycobacterial infection of the musculoskeletal system, although uncommon in Australia, remains an important problem that requires continued awareness for early diagnosis. PMID- 3657677 TI - Voluntary euthanasia in The Netherlands. PMID- 3657678 TI - Nothing quiet on the violent front. PMID- 3657679 TI - Enterobiasis in the suburbs. PMID- 3657681 TI - Septic discitis--a misnomer. PMID- 3657680 TI - Staphylococcal septicaemia after an injection of methylprednisolone. PMID- 3657682 TI - Perforation of the gastrointestinal tract by a toothpick. PMID- 3657683 TI - The law and in-vitro fertilization. PMID- 3657684 TI - Results of the Richmond Report. PMID- 3657685 TI - Slow stream rehabilitation: is it effective? PMID- 3657686 TI - Effectiveness and cost of antiulcer medications. PMID- 3657687 TI - Accidental ingestion of potassium permanganate. PMID- 3657688 TI - Professional courtesy. PMID- 3657689 TI - [Confounding effect of tobacco smoke in the determination of occupational oncogenic risks]. PMID- 3657690 TI - [A simple procedure for the determination of airborne dust: collection by using a mask device]. PMID- 3657691 TI - [Accumulation of organochlorine pesticides in human adipose tissue: data from the province of Turin]. PMID- 3657692 TI - [A case of interstitial lung disease caused by cobalt: pathogenetic and prognostic considerations]. PMID- 3657693 TI - [Aneurysm of the hand as an unusual complication of occupational injury]. PMID- 3657694 TI - [Urinary elimination of xylene in experimental and occupational exposure]. PMID- 3657695 TI - [Collection of data and approximation of measurements]. PMID- 3657696 TI - Statistical data 1986. Medical Examiner Division, Commonwealth of Virginia. PMID- 3657697 TI - [Delta sleep-inducing peptide. Effective in sleep disorders, stress, chronic pain and substance dependence?]. PMID- 3657698 TI - Suing the doctors--an inexorable spiral? PMID- 3657699 TI - Up in smoke--the psychology of arson. PMID- 3657700 TI - Antimicrobial prophylaxis in surgery. PMID- 3657701 TI - A direct enzyme-linked immunosorbent assay (ELISA) for antibodies to enterobacterial Re core glycolipid and lipid A. Results in healthy subjects and in patients infected by gram-negative bacteria. AB - We have developed an ELISA for IgM and IgG antibodies to the core glycolipid (CGL) of the Re mutant Salmonella minnesota R 595, and to lipid A. Anti-CGL antibodies have been detected in sera from 37% of healthy blood donors, whereas anti-lipid A activities were found in 13% of individuals only. The anti-CGL and anti-lipid A activities were examined in patients in a surgical intensive care unit, selected on the basis of a definite risk of infectious complications due to Gram-negative bacteria. Of the patients who developed such infections, the rate of favourable outcome was significantly higher in patients with either stable positive or increasing anti-CGL activities than in patients found to be negative. Our results provide clear evidence that anti-CGL antibodies contribute to host defence against various Gram-negative bacteria. PMID- 3657702 TI - International Society of Pediatric Oncology, Italian Society of Radiology and Nuclear Medicine, Italian Society of Biology and Nuclear Medicine, and Associazione Genitori Oncologia Pediatrica. IVth International Workshop in Pediatric Oncology: "The role of MIBG in therapy, diagnosis, and monitoring of neuroblastoma". Rome, Italy, September 22 and 23, 1986. Proceedings. PMID- 3657703 TI - The treatment of neuroblastoma with 131I-MIBG. PMID- 3657704 TI - Radioimmunodetection of neuroblastoma with antineuroblastoma monoclonal antibody. AB - The Antineuroblastoma monoclonal antibody CNM-5 was submitted to preclinical studies and then used for tumor imaging with following results. 1. CNM-5 is an antibody which belongs to the IgM fraction and has a molecular weight of 900 kilodaltons. Its protein concentration was found to be 17.99 mg/dl. 2. The 131I labeled antibody was injected into nude mice transplanted with human neuroblastoma, and imaging was performed by a gamma camera. Accumulation of 131I in the tumor was relatively clearly seen. Various organs were removed and examined for 131I uptake. Radioactivity was easily detected in the tumor, suggesting that CNM-5 is effective for use in imaging diagnosis of neuroblastoma. PMID- 3657705 TI - Treatment of neuroblastoma with 131I-MIBG: dosimetric problems and perspectives. AB - Between 7/3/80 and 5/7/86 we gave 32 of our neuroblastoma patients 62 diagnostic doses of metaiodobenzylguanidine (MIBG) and 12 patients 20 treatment doses. Our conclusion from our diagnostic dose studies is that MIBG should be used for staging the extent of neuroblastoma before therapy is started, because it may change the proposed staging and therapy. In MIBG therapy for neuroblastoma, our criteria for agreeing to treat a patient are based on calculations from a 4-day tracer dose study that assures that the patient will receive from his first therapy dose a tumor dose of at least 2,000 rads/100 mCi, with a total body dose of not greater than 200 rads. Under these circumstances in children, the blood dose has been about 50 rads. The platelet count falls routinely with a 150-rad whole-body dose but never to dangerous levels. We have delivered tumor doses of 7,000-34,600 rads on the first dose using 150-215 mCi. We have had objective regressions (as shown by before and after CAT scans) of 30-59% in volume of the principal tumor mass in 3 of the first 12 patients treated. All patients had Grade IV neuroblastoma with extensive previous surgery, radiation, and chemotherapy, with and without previous bone marrow transplants. MIBG therapy was most effective in patients with slower-growing tumors for whom initial treatment doses were 200 mCi or more. PMID- 3657707 TI - Treatment of neuroblastoma with 131I-metaiodobenzylguanidine: experience of the Munster/Kassel Group. AB - I-131-metaiodobenzylguanidine was used for treatment of neuroblastoma stage IV in three children after surgery and or chemotherapy had failed to be effective. In two of the children with multilocular lesions, after an impressive improvement of clinical symptoms tumor progression was observed. Because in about 25% of children with relapsing neuroblastoma complete remission may be achieved by combining surgery, chemotherapy, and I-131-MIBG treatment, this therapeutic modality should be included in the therapeutic strategy of stage III and IV neuroblastoma. PMID- 3657706 TI - Radionuclide therapy of neural crest tumors. AB - The potential concentration of I 131-Meta-iodo-benzylguanidine (MIBG) in pheochromocytoma, and the successful application in diagnosis and therapy of pheochromocytoma, has led to its use in therapy in other tumours derived from the neural crest. In neuroblastoma, the concentration of MIBG is as reliable as it is in pheochromocytoma. 18 patients with a neuroblastoma were treated, leading to two complete remissions, seven partial remissions, two no change, and two progressive disease; one patient was lost for follow-up. Six adults were treated, three with a carcinoid, two malignant pheochromocytoma and one medullary thyroid carcinoma. Although follow-up is still short, preliminary results of therapeutic use of I 131-MIBG indicate that this treatment modality may be effective. PMID- 3657708 TI - Treatment of neuroblastoma with 131I-metaiodobenzylguanidine: the experience of an Italian Study Group. AB - Eight patients affected by neuroblastoma were treated with 18 courses of 131I meta-iodobenzylguanidine (MIBG). They all had been judged as "nonresponders" to conventional treatments. Six had stage IV disease: of these, five, with massive marrow involvement, had poor results, mainly because of marrow depression; one, whose marrow had been previously purged by chemotherapy, showed a decrease in blood cell counts but not to critical levels, thus allowing repeated treatments and some improvement. Two other cases had stage III disease, without marrow involvement. Both could receive repeated treatments without adverse effects on marrow and circulating blood cells; both could have surgical procedures when a significant neoplastic mass reduction had been induced by MIBG treatments. Almost all patients experienced reduction or disappearing of pain. Treatments were well tolerated. PMID- 3657709 TI - Therapeutic use of 131I-metaiodobenzylguanidine (MIBG) in neuroblastoma: a phase II study in nine patients. AB - Effects of high activities of I 131 meta-iodobenzylguanidine (mIBG) were evaluated in nine children with advanced neuroblastoma. All patients had been previously heavily treated and had either primarily refractory disease or resistant relapse. Twenty-two doses of mIBG labeled with 1.3 to 4 GBq (35-108 mCi) of iodine 131 were administered. Three subjective effects, especially relief of pain, and two objective effects were observed. Transient blood pressure increase was observed once and did not recur after prolongation of the infusion time to 6 hours. A major side effect was bone marrow toxicity, essentially marked by thrombopenia, particularly severe in previously bone-marrow-transplanted patients. PMID- 3657710 TI - Considerations on 131I-metaiodobenzylguanidine therapy of six children with neuroblastoma. AB - Six children affected by neuroblastoma at stages III and IV were treated with high-specific-activity 131I-metaiodobenzylguanidine (MIBG). After 131I-MIBG treatment three patients died at 12, 10, and 12 weeks, respectively; the other three were still living at 21, 16, and 24 weeks, respectively. Although the assumptions for this therapy were propitious, the results obtained do not correspond to those expected. It is supposed that large tumor volume and previous chemotherapy and/or radiotherapy may impair the effectiveness of 131I-MIBG therapy. Consequently, 131I-MIBG therapy is recommended even if the spread of disease is not proved-only, however, when the tumor is small. PMID- 3657711 TI - 131I-metaiodobenzylguanidine treatment in neuroblastoma: report of two cases. AB - Poor results with 131I-meta-iodobenzylguanidine (MIBG) therapy have been obtained in two children with stage IV neuroblastoma treated after partial surgery and unsatisfactory combination chemotherapy. Both patients' response to treatment (four and three 1-month-spaced courses, respectively; cumulative administration of 11.9 and 9.2 GBq) has been characterized by a low isotope concentration in the primary tumor and in the multiple bone metastases and by bone marrow uptake with final severe hematological toxicity. A slight decrease in the primary tumor's volume was observed in one patient at a cumulative dose of 85 Gy; there was no change in the other's at 42 Gy. At an initial, greater isotope concentration delivering 103 Gy, some bone metastases displayed a sharp decrease in uptake that persisted in the successive courses. For both patients a progressive spreading of new tumor localisation in the bones and finally in the soft tissues was observed. PMID- 3657712 TI - Treatment of neuroblastoma with 131I-metaiodobenzylguanidine. AB - Seven patients with neuroblastoma (six children and one adult) were treated with therapeutic doses of high specific activity 131I-metaiodobenzylguanidine (131I MIBG). Six patients were in stage IV and unresponsive to conventional treatment. One patient, in stage III, was treated at diagnosis, an approach never previously reported. Single doses of 131I-MIBG varying from 70 to 184 mCi split into two parts were administered by slow i.v. infusion (4 to 8 hours) at 2- to 4-day intervals. The following results were obtained in the six evaluable patients: two patients showed transient stabilization of the disease; three had an objective response, with shrinking of the primary tumor and/or regression of the metastatic lesions. Of these three patients, two suffered relapses at 2 and 7 months, respectively, from the first course of MIBG. The third patient, in whom the residual disease almost completely disappeared following MIBG therapy, is still alive in complete remission after autologous bone marrow transplantation with a follow-up of 14 months. The single patient treated at diagnosis showed a dramatic response to a relatively low dosage of MIBG, with histologically proved disappearance of the tumor mass. Our data indicate that MIBG may be useful in the treatment of neuroblastoma unresponsive to conventional chemotherapy. The complete response observed in the patient treated at diagnosis suggests that the full potentiality of MIBG therapy should be explored in untreated patients. PMID- 3657713 TI - Long-term survival in patients with Ewing's sarcoma relapsing after completing therapy. AB - While the proportion of patients with Ewing's sarcoma attaining and maintaining long-term remission has markedly improved, a proportion of patients suffer relapse of the tumor. In our experience relapses may occur late in the course of the disease, approximately 20% of those at risk beyond 5 years having recurrence of tumor. Review of our data indicates that for patients relapsing after therapy has been discontinued, the probability of attaining second remission is high (0.84) and that a significant proportion of these patients attaining second complete remission will survive their disease (0.60). PMID- 3657714 TI - Retroperitoneal sarcomas: the role of diagnostic imaging and multimodal management. AB - Retroperitoneal sarcomas are a varied group of malignancies which have a high rate of recurrence following surgery alone. The majority of the initial recurrences are local in nature, and new therapeutic approaches are clearly needed. Diagnostic imaging and "interventional radiology" have important roles to play in the management of these malignancies, as well as in investigational approaches to therapy. Two cases are presented which illustrate some recent advances in diagnosis and staging of this group of tumors which can be attributed to new cross-sectional imaging techniques, when used in concert with "conventional" imaging methods. The latter include arteriography to guide the placement of intra-arterial catheters for local infusion chemotherapy. CT-guided needle biopsies can be performed to secure a preoperative diagnosis and also to obtain viable tissue for in vitro chemosensitivity assays. A judicious combination of local and systemic chemotherapy, radiation, and surgery may hold promise for better control of this malignancy, similar to the therapeutic advances which have already been obtained with limb sarcomas. PMID- 3657715 TI - Liver mass in a four-year old child: current considerations for diagnosis and treatment. AB - A case is presented of an embryonal sarcoma of the liver in a young child. The differential diagnosis of liver masses in children is reviewed, as well as the implications of diagnostic imaging studies for diagnosis, prognosis, staging, and the choice of treatment. The use of diagnostic imaging for guiding interventional diagnostic procedures and certain palliative approaches is also discussed. PMID- 3657716 TI - Leiomyosarcoma of the kidney: report of a patient with favorable response to doxorubicin and cisplatin suspended in a lipid contrast medium and cyclophosphamide. AB - A man who had unresectable leiomyosarcoma of the left kidney with skin and lung metastases was treated with intra-arterial infusion chemotherapy consisting of cisplatin and doxorubicin suspended in lipid contrast medium, lipiodol, and oral administration of cyclophosphamide. The tumor responded well to this treatment three times. He is alive and well in remission, the renal tumor decreased in size, and lung metastases became unclear more than 50 weeks after treatment was completed. PMID- 3657717 TI - [The importance of Lopion (molsidomine) in the therapy of myocardial ischemia and angina pectoris]. PMID- 3657718 TI - [Diagnostic value of esophagogastroduodenoscopy in cases of clinically unclear disorders in the upper abdomen]. PMID- 3657719 TI - [Anatomic variation in the relation between the ovarian and uterine arteries during the fetal period]. PMID- 3657720 TI - [Carcinoma of the colon and malignant gastrocolonic fistula]. PMID- 3657721 TI - [Hereditary metabolism disorders and central nervous system diseases]. PMID- 3657722 TI - [Study of staphylococcal carrier state in the nose in a group of medical students]. PMID- 3657723 TI - [Trends in modern urology]. PMID- 3657724 TI - [Protein glycolysation]. PMID- 3657725 TI - [Ovestin cream in the treatment of postmenopausal vulvovaginal atrophy and atrophic vaginitis]. PMID- 3657726 TI - [Observations on the psychiatric work of the Counseling Service of the Health Center at the University in Novi Sad]. PMID- 3657727 TI - [The proportion of breast neoplasms in the morbidity rate among women employed in the area of Novi Sad in 1984]. PMID- 3657728 TI - [Electron microscopy study of the surface structure of alabaster gypsum before and after the addition of 5% superplasticizer]. PMID- 3657729 TI - [Growth deficiency in school children in Montenegro]. PMID- 3657730 TI - [Effect of an alternating magnetic field on the development of carrageenan paw edema in the rat]. PMID- 3657731 TI - [Jaundice in AL-amyloidosis in a 54-year-old patient]. PMID- 3657732 TI - [Epidemiology and prevention of malignant pleural mesothelioma]. PMID- 3657733 TI - [Acute fluorine-induced kidney failure following isoflurane with fatal organ oxalosis]. PMID- 3657734 TI - [Inhalation oxalosis?]. PMID- 3657735 TI - [Type of nutrition and growth in the low weight newborn infant]. PMID- 3657736 TI - [Familial hypophosphatemic rickets. Effects of treatment with 1,25 dihydroxycholecalciferol at supraphysiologic doses]. PMID- 3657737 TI - [Congenital hypothyroidism: new psychological problems linked to early diagnosis]. PMID- 3657738 TI - [Chloride depletion syndrome. Description of a clinical case and etiopathogenetic hypothesis]. PMID- 3657739 TI - [Clinico-endocrinologic study of a case of Cornelia De Lange syndrome with associated adrenogenital syndrome (cryptic form)]. PMID- 3657740 TI - [True hermaphroditism. Presentation of a clinical case]. PMID- 3657741 TI - [Histopathology of the polycystic ovary]. PMID- 3657742 TI - [Plasma and salivary steroids in the differential diagnosis of hirsutism. Use of mathematical technics for individualizing the most useful parameters]. PMID- 3657743 TI - [Clinical data and assessment of ovarian morphology in the diagnosis of the polycystic ovary syndrome]. PMID- 3657744 TI - [Antiandrogen therapy in the polycystic ovary syndrome]. PMID- 3657745 TI - Differential effects of methylphenidate on the growth of neonatal and adolescent rats. AB - Methylphenidate (MPH), the drug of choice in the treatment of Attention Deficit Disorders with Hyperactivity (ADD/H), has raised concern regarding its suspected potential for reducing body stature in growing patients. In a previous study we demonstrated that neonatal rats treated with MPH (35 mg/kg, SC, twice daily) showed an acute growth impairment followed by a rapid growth-rebound phenomenon. This report confirms our earlier findings in neonatal rats and extends the investigation of the growth suppressing effects of MPH to the periadolescent period of development in rats. Specifically, neonatal groups of male and female rats treated with higher and lower doses of MPH than in the original study confirmed the growth impairment and growth rebound phenomena reported earlier. Unlike neonatal rats, rats treated during the periadolescent period of development failed to show any growth impairment. These data suggest that the growth suppressing effects of MPH are the result of an acute toxicity which is readily reversible on discontinuation of the drug. Further, it is concluded that there is a low probability of long term effects on human body stature when the minimal therapeutic dose is used in clinical practice. PMID- 3657746 TI - Amphetamine-induced activity after fetal alcohol exposure and undernutrition in rats. AB - Behavioral responses to amphetamine were examined in 28- and 42-day-old 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 chow (LC) dams were included as controls. Animals received 0.0, 0.5, 1.0, or 2.0 mg/kg/ml d amphetamine prior to single 2-hr tests in automated activity monitors. At 28 days of age, when there were no differences in activity after saline injection, 35% EDC males were more active (measured by distance traveled) than LC and 0% EDC males following treatment with 2.0 mg/kg amphetamine. Thirty-five percent EDC females exhibited brief reductions in activity relative to LC females but were not different from 0% EDC females at 28 days of age following 2.0 mg/kg amphetamine. When treated with 1.0 mg/kg amphetamine, 28-day-old 0% EDC males were less active than LC and 35% EDC males, who did not differ from each other at this dose. At 42 days of age, animals from both liquid diet groups were less active than LC controls following 2 mg/kg amphetamine. These results suggest that both prenatal alcohol exposure and undernutrition may influence the postnatal functional status of catecholamine systems but that the nature of those functional changes varies with type of prenatal insult, sex and age of the animal at testing. PMID- 3657747 TI - Sensorimotor maturation and alcohol responsiveness in rats prenatally exposed to alcohol during gestational day 8. AB - On gestational day 8, pregnant Sprague-Dawley derived rats received two intraperitoneal injections of 0.015 ml/g body weight of a 24% v/v ethanol solution representing an absolute alcohol dose of 2.82 g/kg per administration (ETOH Group). Control females were injected with similar volumes of saline (SAL Group) or did not receive any type of intraperitoneal administration of drugs (AC Group). In comparison with the control treatments, the ethanol treatment did not affect long-term maternal body weight gain during pregnancy, total length of gestation, probability of delivery, number of pups born per litter or the offsprings' preference of alcohol odor. Nevertheless, this ethanol insult was sufficient to significantly reduce body weights at birth and to retard the ontogeny of some sensorimotor patterns among offspring, as assessed through the Righting Reflex, Horizontal Screen Test and opening of the external auditory canals. The maturation of other reflexes (Cliff Aversion and Negative Geotaxis) appeared to be retarded indirectly as an outcome of the maternal injection procedure, with ETOH and SAL pups exhibiting similar developmental delays when compared with AC animals. During adulthood, rats prenatally exposed to alcohol exhibited a decreased hypothermic response to an intoxicating dose of alcohol as well as significant increases in voluntary alcohol consumption in comparison with both control conditions. Collectively, these results suggest that relatively acute alcohol exposure early in gestation may not only affect normal patterns of development but also later responsiveness to this pharmacological agent. PMID- 3657749 TI - Behavioral toxicology: new experimental approaches. The first joint International Union of Toxicology and Italian Society of Toxicology symposium on behavioral toxicology. Bari, Italy, October 3, 1986. Proceedings. PMID- 3657748 TI - Differential deficits in regional brain growth induced by postnatal alcohol. AB - Neonatal rats were exposed to alcohol during a period of brain development equivalent to part of the human third trimester. Rat pups were fed a milk formula containing either alcohol (9.8 g/kg/day) or isocaloric maltose/dextrin using artificial rearing techniques from postnatal days 4-10. Blood alcohol concentrations reached 345.8 +/- 15.6 mg/dl on postnatal day 6. All animals, including a group of normally reared suckle controls, were sacrificed on postnatal day 10, and the brains were perfused and processed for the Timm histochemical technique. Significant microencephaly (30% reduction in brain growth) was found in the alcohol-exposed animals. Growth deficits also were found in specific brain regions of the alcohol-exposed rats. The overall area of the hippocampus proper at a midtemporal level was reduced by 26.1% compared to controls. Sublaminae within the hippocampus were stunted as much as 40.5%. An overall reduction of 14.5% was found in the midsagittal (vermal) cerebellum. In contrast, growth of the dentate gyrus appeared much less affected (6.8% deficit) by the alcohol exposure. These data indicate that not all regions of the brain are affected equally by alcohol exposure during the third trimester equivalent. PMID- 3657750 TI - Correlation of behavior with brain damage after in utero exposure to toxic agents. AB - Early postnatal behaviors involving sensorimotor integration were measured along with thickness of the sensorimotor cortex in rats irradiated with 1.0 Gy on gestational day 11 or 17. Body weight and morphology of anterior pituitary cells were recorded. Irradiation on day 17 was more effective in reducing cortical thickness and body weight and performance on behavioral tests and less effective in altering pituitary cells than irradiation on day 11. Prediction of behavioral effects, using cortical layers, body weight and pituitary morphology as predictors in stepwise multiple regression, was measured in both irradiated and control rats. Cortical Layer V more than I more than IV and VI as significant predictors of behavior. The best predictions accounted for about half of the variance in the data. When behavioral data were used to predict brain damage, the best predictor was negative geotaxis. Significant association of behavior with Layers V and VI was found. These experiments show the difficulties in correlating complex behaviors with specific brain areas and, at the same time, implicate especially Layer V of the sensorimotor cortex in these behaviors. PMID- 3657751 TI - Complex maze performance during carbon monoxide exposure in rats. AB - Most human victims of residential fires die of smoke inhalation. The cause of death of the victims is attributed to high levels of carboxyhemoglobin, but it is not clear why the victims are unable to escape even from locations remote from flaming combustion. In an attempt to provide a model of escape from toxic gases using animals, a complex maze was built for rats with 8 choice points. The animals were 24 hr water deprived and trained to remain in the start box for 15 min. Following this period, a rat was released in the maze and had to learn to avoid blind alleys and reach the goal box for water reinforcement within 15 min. Total time to traverse and total distance in the maze were recorded. Each animal was given one trial per day. After stable running times were established, different groups of six rats were exposed to 2000, 3000, 3500, and 4000 ppm of carbon monoxide (CO) when placed in the maze. Each animal was exposed to CO only once. On the day after CO exposure the rats were implanted with an arterial cannula and on the next day each animal was exposed to the same CO concentration it had previously experienced for 30 min. Blood samples were taken every 5 min. The effect of increasing CO concentrations was to increase maze running times as well as to decrease the number of animals reaching the goal. At 3500 ppm no animal reached the goal. At 2000 ppm, the animals that failed to reach the goal moved a greater distance than animals that reached the goal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657752 TI - Methodological approaches to primate behavioral toxicological testing. AB - The monkey may often be the best model with which to characterize low-level effects of neurotoxicants, including those produced by developmental exposure. The nervous system of the monkey is very similar to the human and, like humans, monkeys have a long period of gestation, infancy, and sexual immaturity during which the nervous system continues to develop. The sensory systems of monkeys are very similar to humans, and intellectual capabilities may be tested that are not possible using other common laboratory species. The effects of low-level developmental exposure to neurotoxicants have been studied in the cynomolgus monkey using operant conditioning techniques to detect subtle defects. Intermittent schedules, a standard tool in behavioral pharmacology, have proved sensitive indicators of toxicity produced by developmental lead exposure. Such intellectual functions as learning, memory, adaptability, and distractibility have been explored by techniques including discrimination reversal, matching to sample, and delayed alternation. Such techniques have revealed impairment produced by lead similar to that observed in lead-exposed children. Visual deficits produced by methylmercury have been revealed by psychophysical techniques, in the absence of any obvious signs of toxicity. PMID- 3657753 TI - The effects of chronic trichloroethylene exposure on neurobehavioral functioning in the rat. AB - Groups of rats were exposed by inhalation to either clean air (Controls) or trichloroethylene at 500, 1000 or 1500 ppm TCE for 16 hr/day, 5 days/week for 18 weeks. At preselected intervals, animals were evaluated for changes in: spontaneous activity, gripstrength, coordinated hindlimb movement, performance of a discrete-trial operant two-choice visual discrimination task, and peripheral nerve conduction velocity. Compared to Controls, TCE-treated rats showed no significant differences in open field behavior, fore- and hindlimb gripstrength or coordinated movement throughout the exposure period. Peripheral nerve conduction time was also unaffected. In contrast, TCE produced progressively marked changes in the speed and patterning of responding in the two-choice visual discrimination task. Two-choice response latency, for example, demonstrated an approximately four-fold increase (p less than 0.001) in the highest dose group. In addition, a recurrent within-week functional tolerance developed for all TCE exposed groups. However, tolerance was lost in the TCE 1500 group as exposure became chronic. Finally, following the termination of exposure, there was no carry-over of TCE-related effects on any of the measures and performance quickly returned to baseline levels. This profile of effects argues for a primary involvement of the CNS with chronic TCE exposure and is quite unlike that seen with, e.g., n-hexane and carbon disulfide. Such findings underscore the differences in the effects which can be produced by long-term exposure to organic solvents and emphasize the need for a battery of tests in the evaluation of neurotoxicant-induced changes in nervous system functioning. PMID- 3657754 TI - Problems of test choice and data analysis in behavioral teratology: the case of prenatal benzodiazepines. AB - Higher-tier tests for the assessment of early treatment effects should be aimed at providing specific information on the behavior processes affected, rather than simply at extending the descriptive data base. The contrast between positive and negative results can be useful to point out possible mechanisms of action. For example, late prenatal oxazepam exposure of mice produced a reduction of the amphetamine hyperactivity at the end of the second postnatal week, but did not significantly affect the response to scopolamine at the end of the third week. An impairment of active locomotor avoidance was observed at the young adult stage, which contrasted with the absence or scarcity of changes in passive avoidance and extinction responding in the same go-no go tests. These changes in response activating mechanisms appear to be in agreement with the medium- and long-term effects on CNS monoamine metabolism described in the literature. As concerns statistical analysis, dichotomous or polytomous data obtained, e.g., by the Fox battery are not yet amenable to an adequate processing, due to the shortcomings of the available nonparametric tests. By contrast, mixed-model ANOVAs can cope with complex data obtained, e.g., in activity and learning tests. However, the available checks on various assumptions (normality, homogeneity of variance, sphericity) are not valid when nested factors, block factors and repeated measures coexist. Finally, the more usual cross-fostering procedures provide adequate information on some aspects (e.g., separation of main effects of prenatal treatments from postnatal maternal effects) but not on others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3657755 TI - Neurotoxicants: emerging issues and policy options. AB - Neurotoxicants are increasingly seen as significant public health hazards, the resolution of which is influenced by science as well as economics, politics, and emotions. Three topical issues are presented to illustrate the application or abuse of scientific data in the political arena and to suggest appropriate responsibilities of scientists beyond the generation of data. The examples include regulation of occupation-related neurotoxic exposure, transfer of neurotoxic pollutants among environmental media, and export of neurotoxic hazards to Third World countries. These examples illustrate the variety of ways in which neurotoxicants impinge on policy questions--from international trade, through ecosystem effects, to personal occupational health and safety. PMID- 3657756 TI - A comparison of the effects of prenatal exposure to tobacco, alcohol, cannabis and caffeine on birth size and subsequent growth. AB - Maternal use of cigarettes, alcohol, cannabis, and caffeine was established for four time periods; prepregnancy, first trimester, third trimester and average use over pregnancy. The relationship between such usage and growth parameters of offspring followed up from birth to 12 and 24 months of age were examined. Of the soft drugs used, nicotine had the most pronounced effect. After adjustment for other relevant variables, nicotine use prior to and during pregnancy was negatively related to weight and head circumference at birth. Furthermore, third trimester nicotine use was a stronger predictor of decreased weight and head circumference at birth than was first trimester use. The results obtained are consistent with ponderal index (PI) literature suggesting a recovery of growth retardation in infants with a lowered PI. Average consumption of greater than one ounce of absolute alcohol per day was negatively related to birth weight and length. Neither cannabis nor caffeine use had a significant negative effect on any growth parameter. PMID- 3657757 TI - The effects of prenatal exposure to methylmercury on aggressive behavior in the rat. AB - The sensitivity of isolation-induced aggressive behavior to prenatal treatment of 6.0 mg/kg methylmercuric chloride (MMCl) by gavage on gestation days 6-9 was assessed in a subset of animals from the Collaborative Behavioral Teratology Study (CBTS). CBTS behavioral measures consisted of negative geotaxis, olfactory discrimination, auditory startle habituation, 1-hr activity, 23-hr activity, activity following pharmacological challenge and visual discrimination learning. Auditory startle was the only CBTS behavioral measure that discriminated among prenatal treatment groups. MMCl animals also were reliably more aggressive than vehicle controls in dyadic encounters. The results suggest that tests of aggressive behavior, which rarely have been included in teratologic assessments, be considered in the formulation of behavioral screening paradigms. The advantages of including tests of aggression and the relationship between aggressive and startle responses are discussed. PMID- 3657759 TI - The ethics of fiscal responsibility in a medical setting. PMID- 3657758 TI - The effects of perinatal exposure to nicotine on plasma LH levels in prepubertal rats. AB - Adult female rats were chronically treated with nicotine administered via the drinking water during pregnancy and/or lactation. The approximate doses of nicotine consumed per day were 2.4 mg/kg and 4.5 mg/kg of body weight. The pups were weaned at 20 days of age. The pups were killed by decapitation on postnatal days 20, 30, or 40 and plasma from heparinized trunk blood was assayed for luteinizing hormone (LH). At 30 days of age untreated male and female offspring had the highest levels of plasma LH compared to 20 and 40 days of age. This level was not affected by any subsequent dose or treatment. Prepubertal females exposed to nicotine during pregnancy failed to exhibit the pattern of LH levels seen in control animals, whereas those exposed during lactation or throughout the perinatal period showed a distinctive pattern of plasma LH. Chronic exposure of female offspring to the low dose of nicotine during lactation tended to increase plasma LH levels at 20 and 40 days. Female offspring exposed to nicotine during pregnancy or to the low dose during lactation showed significant deficits in body weight at 40 days of age which appeared to correlate with a delay in vaginal opening. The results suggest that perinatal exposure to maternally administered nicotine may disrupt normal patterns of LH release in the offspring of both sexes and alter sexual development in female offspring. PMID- 3657760 TI - AMA guidelines: counseling of HIV-seropositive transfusion recipients. PMID- 3657761 TI - The use of lasers in general surgery. A preliminary assessment. PMID- 3657762 TI - Surgical correction of pectus excavatum and carinatum. PMID- 3657763 TI - Acute pseudo-obstruction of the colon: a dangerous form of ileus. Report of two cases. PMID- 3657764 TI - Risk management in practice. Maintaining defensible medical records. PMID- 3657765 TI - [Identification and characteristics of mRNA's showing increased levels during DNA replication]. AB - A library of double-stranded cDNA was prepared using poly (A) + RNA from regenerating rat liver 20 h after partial hepatectomy. Differential screening of 350 recombinant clones with cDNA-G0 and cDNA-S identified eleven cDNA clones (pRL), the sequences of which were preferentially expressed during the DNA replication period. Levels of mRNAs complementary to these clones were 2--10-fold higher in the S-period, than in G0. Using plasmid cDNAs to different mRNA, pRL we have investigated the changes in the levels of mRNA pRL during liver regeneration. The level of mRNA mRL2 and pRL79 was increased just before DNA replication. mRNA pRL35 accumulates after partial hepatectomy with the maximum at 6 h. The augment of two other mRNA concentrations was expressed to a lesser extent. Northern-blot analysis allowed to determine the individual dual mRNAs corresponding to each of the three clones with their sizes ranging from about 1650 to 3900 bases. Three mRNAs (pRL35, 67 and 79) were shown (by hybrid-selected translation) to code for proteins of about 100, 140 and 120 kDa, respectively. PMID- 3657766 TI - [Effect of temperature on the conformation of native DNA in aqueous solutions of various electrolytes]. AB - Effect of the temperature on the conformation of the native DNA molecule in solution of different electrolytes (LiCl, NaCl, KCl, CsCl, Gu-HCl) at ionic strengths mu = 5; 0.1; 0.01; 0.005 and temperatures ranging from 10 to 40 degrees C were studied by the methods of flow birefringence and viscometry. The experiments showed that the value of intrinsic viscosity [eta] of DNA increases at increase of temperatures in solutions of all the chlorides studied, excluding guanidine. The effect of temperature on the value of [eta] doesn't depend on the type of the cation at a fixed value of mu and is elevated when mu decreases. The observed alterations of the value of [eta] for DNA in water-salt solutions at different temperatures can be explained by an increase in the hydration of the alkaline ions at temperature increase. The experiments showed the specificity of the effect of different ions on the dimensions of the DNA molecule in solution. The data on optical anisotropy of the DNA molecule testify, that the thermodynamic rigidity of the latter doesn't depend on the temperature of solutions of different electrolytes in the temperature range studied. PMID- 3657767 TI - [Structural-dynamic properties of the tryptophan residue environment in melittin]. AB - The structural dynamics of the environment of the single tryptophan residue in melittin was studied by site-selective red-edge-excitation fluorescence spectroscopy. The dependence of the spectral shift on transition from excitation in a maximum (at 280 nm) to long-wavelength edge (305 nm) was studied as a function of temperature. It was shown, that for melittin at high ionic strength (tetramer), the three regions of temperature dependence of the red-edge effect are observed: retarded relaxation (up to +30 degrees C), relaxational changes of spectra (from +30 to +50 degrees C) and thermal changes of structure (above +50 degrees C). The dipolar-re-orientational relaxation time and activation energy of orientation motions in the environment of indolic ring in the tetrameric melittin structure were estimated. Extrapolation from relaxational region to room temperature results in relaxation time 40 ns. In monomeric melittin (at low ionic strength) the red-edge shift of spectra is absent. The distinct differences in character of thermal quenching of fluorescence between monomeric and tetrameric forms of melittin are observed. It follows, that the short-wave-length fluorescence shift on monomer-tetramer transition is due to both the reduction of polarity, and the increase in rigidity of tryptophan environment, the absence of relaxation motions at nanosecond times. PMID- 3657768 TI - [Computer programs for the analysis of nucleotide sequences (MALK)]. AB - A system for the computer analysis of nucleic acid and protein sequences ("Helix") is described. Format of the DNA sequences is EMBL--compatible and may be easily commented with the help of convenient menus. "Helix" has also following possibilities: an effective alignment of gele reading data and formation of the final sequence; simple making of recombined molecules "in calcular"; calculations of nucleotide and dinucleotide distribution along the sequence; looking for coding frames; calculations percentage of codons and amino acids in coding frames; searching for direct and inverted repeats; sequences alignment; protein secondary structure prediction; restriction mapping; DNA--protein translation. "Helix" also contain programs for RNA-structure prediction, looking for homologies throughover the EMAL bank, choosing optimal sequence for probes and searching promoters. All the programs are written at FORTRAN-77 and automatically translated into FORTRAN-4. "Helix" require only 64 kbite. PMID- 3657769 TI - [The loss of CpG dinucleotides from DNA. III. Methylation and evolution of histone genes]. AB - From nucleotide sequences of more than 70 histones genes in 15 species of eucaryotes the probable frequency was determined for CpG----TpG + CpA substitutions, occurring as a result of deamination of 5-methylcytosine residues in DNA. It was found that histone genes differ in the character of CpG methylation with respect to the species studied and may be divided into three groups differing in the value of CpG suppression. In one of them, M-, CpG dinucleotides must have not been methylated throughout the existence of these genes; in another, M+, nearly every other CpG has undergone transition. In the third group, M +/-, no more than 20% of CpG have steadily undergone methylation (and mutation). The CpG deficiency in M+ and M +/- histone genes is in general proportional to the level of methylation of total DNA in different species. It has been noted that the genes of different core histones in the same organism are characterized, as a rule, by the same type of CpG methylation and belong to the same group. Genes H1 and H5 show a higher level of CpG suppression and thus have a higher degree of methylation than the genes of core histones from the same organism. The most conserved among the histone genes, those for H3 and H4 in particular, must have not been methylated in the majority of the species studied. The distribution of methylated and non-methylated spacers and coding sequences of histone genes of man, mouse, hen and yeast reveals a mosaic pattern. It has been found that 5'-flanked regions in most cases are methylated more than respective genes, while the G + C content in them is significantly lower, compared with the coding gene sequences. The absence of methylation in the 5'-regulatory regions does not appear to be mandatory for histone genes. It has been established that the genes of the same histones may differ in the level of methylation even in more or less closely related species. Group M- comprises genes of core histones of man, hen, sea urchin, Drosophila, Neurospora and wheat; group M +/- includes analogous genes of mouse, Xenopus, trout and sea urchins. The results obtained testify against the possible universal involvement of methylation in the regulation of histone gene expression. PMID- 3657770 TI - [Chromatin on a membrane: accessibility of histone H5 for antibodies in the supernucleosomal structure]. AB - Histone H5 accessibility for the antibodies in chromatin was studied. Chromatin was immobilised on the nitrocellulose membrane in conditions which provide different levels of its compactization. Antiserum specific to the globular domain of histone H5 was used. It was shown, that for establishing real protection of histone H5 in the supernucleosomal structure it is necessary to use long fibers of chromatin. Their linking to the membrane must occur by a minimum quantity of points. It was established, that histone H5 is 5 times more accessive in the preparations of dispersed chromatin (low ionic strength) then in chromatin with the supernucleosomal organization (physiological ionic strength). We suppose that the small level of accessibility of histone H5 for the antibodies in the compact chromatin can be explained by some disruptions in the supernucleosomal organization. On the contrary, the long equable solenoid of nucleosomes provides complete protection of histone H5. In accordance with the results obtained, the model of ordered packaging of nucleosomes in the solenoid is discussed. In this model the point of entrance and exit of DNA on the nucleosomes, fixed by globular region of histone H5, is localized inside the solenoid. PMID- 3657771 TI - [Interaction of nucleic acid bases with water molecules and formation of mismatched nucleotide pairs]. AB - The possibility of the inclusion of water molecules in the formation of mismatched nucleotide pairs was considered in relation to the mechanisms of point errors in template directed biosynthesis. Calculations of the intermolecular interaction energy for systems containing two bases and one water molecule were carried out by the method of atom-atom potential functions. There exist energy minima for each base pair, corresponding to a single N--H...O or N--H...N H-bond between the bases and H-bonding of the water molecule with both bases. The relative positions of glycosyl bonds in some of these minima are closer to those for Watson--Crick pairs, than the positions of minima for these pairs without water. For other minima, the H-bond formation between the water molecule and the two bases additionally stabilizes the relative base position in wobble-pairs with two H-bonds between the bases. The base and water positions in energy minima are compared with the positions in some pairs proposed on the basis of NMR and X-ray data for double helical oligonucleotides. PMID- 3657772 TI - [Theoretical study of structural transition in a nucleosome at low ionic strength]. AB - The theoretical analysis of nucleosome stability at low ionic strength has been performed on the basis of consideration of different contributions to the free energy of compact state of the nucleosome DNA terminal regions. The proposed model explains: the fact of low-salt structural change; the transition point (approximately 1.7 mM NaCl) and width (approximately 1 mM); the shift of the transition to the higher salt concentrations in the case of histones tails removal by trypsin. According to the model the increase of electrostatic repulsion between neighbouring turns of DNA superhelix is the main cause of the unwinding of nucleosomal DNA terminal regions in the course of low-salt structural change. The interactions between histone (H2A-H2B) dimer and (H3-H4)2 tetramer provide the compact state of the nucleosomal DNA terminal regions. The existence of electrostatic interactions of nucleosomal DNA terminal regions with tetramer was suggested. These interactions can provide the compact state of nucleosomal DNA at physiological ionic strength even in the absence of (H2A-H2B) dimer. PMID- 3657773 TI - [The nature of forces stabilizing nucleosome structure. Dissociation of histone octamers from DNA]. AB - We have used the measurements of the histone fluorescence parameters to study the influence of the ionic strength on histone-DNA and histone-histone interactions in reconstructed nucleosomes. The ionic strength increase lead to the two-stage nucleosome dissociation. The dimer H2A-H2B dissociates at the first stage and the tetramer (H3-H4)2 at the second one. The dimer H2A-H2B dissociation from nucleosome is a two-stage process also. The ionic bonds between (H2A-H2B) histone dimer and DNA break at first and then the dissociation of dimer from histone tetramer (H3-H4)2 occurs. According to the proposed model the dissociation accompanying a nucleosome "swelling" and an increase of DNA curvature radius. It was shown that the energy of electrostatic interactions between histone dimer and DNA is sufficiently less than the energy of dimer-tetramer interaction. We propose that the nucleosome DNA ends interact with the dimer and tetramer simultaneously. The calculated number (approximately 30 divided by 40) of ionic bonds between DNA and histone octamer globular part practically coincides with the number of exposed cationic groups on the surface of octamer globular head. On this basis we have assumed that the spatial distribution of these groups is precisely determined, which explains the high evolutionary conservatism of the histone primary structure. PMID- 3657774 TI - [Stability of the alpha-helix structure of oligopeptides]. AB - The problem of stabilization of oligopeptide alpha-helix conformation is discussed. The stabilizing role of intramolecular H-bonds and coulombic interactions for single molecules was shown. The influence of media results in the competition for formation of inter and intramolecular H-bonds and for coulombic interactions. High competitive media, eg. water, diminishes alpha-helix stability. PMID- 3657775 TI - [Pyruvate dehydrogenase from pigeon breast muscle. Chemical modification of the enzyme associated with conformation changes in the protein molecule]. AB - The two-phase character of essential histidine residues modification of pyruvate dehydrogenase component of pyruvate dehydrogenase complex from pigeon breast muscle by diethylpyrocarbonate has been demonstrated. The relative amplitude of the fast phase increases with increasing the modificator concentration. The model of chemical modification of dimeric enzyme where the modification of the residue in one subunit leads to the change of reactivity of corresponding residue in the other subunit is used for the description of inactivation kinetics. The expression for the diminishing of enzyme activity in the course of chemical modification and the methods of kinetic parameters estimation have been proposed. The following values of kinetic parameters for the modification of pyruvate dehydrogenase component by diethylpyrocarbonate were obtained (pH 6.0; 20 degrees C): k1 = 6400 +/- 400 M-1 min-1 (the microscopic rate constant for the modification of histidine residue in the intact dimer), k2 = 890 +/- 200 M-1 min 1 (the rate constant for the modification of histidine residue in the intact subunit in the dimer which contains one modified subunit) and kt = 0.9 +/- 0.2 min-1 (the rate constant for conformational transition of the dimer induced by modification of histidine residue in one of the subunits in the dimeric molecule). PMID- 3657776 TI - [Autoadenylation of tryptophanyl-tRNA synthetase]. AB - Incubation of bovine tryptophanyl-tRNA synthetase (EC 6.1.1.2) deprived of endogenous tryptophan, with [14C]ATP and without [gamma-32P]ATP, causes an appearance of radioactivity in protein due to formation of adenylated enzyme, [14C]AMP-E. Examination of the properties of the [14C]AMP-E thus obtained led to the conclusion that AMP is linked to the protein molecule via a macroergetic phosphoanhydride bond. ATP is formed when AMP-E is incubated with PPi. However, no tryptophanyl adenylate formation was observed when AMP-E was treated with tryptophan. The functional role of AMP-E remains obscure. PMID- 3657777 TI - [Effective method for physical mapping the DNA molecule]. AB - The method of DNA molecules physical mapping based on the algorithms of discrete optimization and graph theory was proposed. The input information consisted of the sizes of single and double restrictions fragments and the level of their measurement errors. The method presents possibilities for optimal planning of experiments and step by step construction of physical maps. Efficiency of the method and examples of its application are discussed. PMID- 3657778 TI - [Conformation oscillations of DNA]. AB - A conformational mobility model is proposed to describe the low-frequency DNA structure dynamics. The transverse oscillations of structure elements in a double stranded chain are studied. The frequency of DNA long-wave conformational oscillations are estimated and the theory is shown to agree with experiment. DNA low-frequency Raman spectra are interpreted. PMID- 3657779 TI - [Kinetics of dissociation of parvalbumin complexes with calcium and magnesium ions]. AB - Dissociation kinetics of parvalbumin complexes with calcium and magnesium ions were studied by means of stopped-flow method employing intrinsic protein fluorescence registration. In the temperature range from 10 to 30 degrees C the kinetic curves of Ca2+ and Mg2+ dissociation are best fitted with a sum of two exponential terms, each term is ascribed to a dissociation process in one of two bindings sites of parvalbumin. Dissociation rate constants in this temperature range increase from 0.03 to 0.8 s-1 and from 0.18 to 5 s-1 for Ca2+, and from 0.9 to 4.5 s-1 and from 4 to 33 s-1 for Mg2+. Parvalbumin equilibrium binding constants of Ca2+ and Mg2+ were also measured in the same temperature range. It makes possible to estimate the rate constants of association of Ca2+ and Mg2+. In the case of Ca2+ the rate of association approaches the diffusion controlled limit. PMID- 3657780 TI - [Effectiveness of complex-formation of nucleotides with human DNA polymerase alpha from data of enzyme modification by reactive nucleotide analogs]. AB - The modification of the human placenta DNA polymerase alpha by the imidazolides of dNMP was investigated. The modification was shown to occur only in the simultaneous presence of the template and the primer. This process, however, doesn't depend on the complementary interaction of the nucleotide base with the template. The Kd values of the complexes between the different nucleotides and DNA polymerase alpha were estimated. The affinity of Im-dTMP was determined from the dependence of the Kapp of the enzyme inactivation rate on the reagent concentration. The Kd values for dNMP, dNDP, dNTP were estimated using the protective effect of these nucleotides under the enzyme modification by Im-dTMP. The comparison of the interaction efficiency between the polymerase and dNMP, dNDP, dNTP (complementary or non-complementary to the template) allow to conclude that the nucleotide discrimination occurs on the dNTP level, i. e. dNMP and dNDP upon forming the complex with the enzyme, don't interact complementarily with the template. The additional contacts between the enzyme and the nucleotide terminal phosphate were supposed to form only for the complementary dNTP. The studies allowed to put forward a hypothetical model of the template complementary dNTP binding to the polymerases. The role of the hydrophobic interaction of the nucleotides with the enzyme as well as the possible influence of the nucleotide gamma-phosphate group on the template--dNTP complement formation. The Watson Crick bound formation of the nucleotide with the template was supposed to be followed by the additional conformational rearrangement of the nucleotide triphosphate chain. The latter process leads to the formation of additional contacts between the enzyme and the nucleotide gamma-phosphate. PMID- 3657781 TI - [The loss of dinucleotides CpG from DNA. IV. Methylation and divergence of genes and pseudogenes of small nuclear RNA]. AB - The frequency of neighboring base pairs in nucleotide sequences of over 80 genes and pseudogenes of low molecular weight RNAs U1-U8, 4.5S and 7S in different eukaryotes was determined. The probable frequency of CpG----TpG + CpA substitutions, caused as a result of the deamination of 5-methylcytosine residues in DNA, was determined. It was found that the genes of small RNAs do not reveal a single level of CpG methylation for all the species studied. In most cases CpG in the genes of U1, 4.5S and 7S RNA are methylated, whereas in the genes of U2-U6 RNA these sites must have never been subjected to methylation. Nearly all the investigated pseudogenes of different small RNAs are strongly methylated due to a considerable lack of CpG. It was established that CpG----TpG + CpA transitions may amount to as much third of all the mutations accumulated in the genes of the same RNAs in different species. Such transitions in pseudogenes may account for 40% of all the nucleotide substitutions. This disproportionately high level of mutations in CpG dinucleotides (3-5-fold higher than in other DNA dupletes) must be the direct result of the methylation of these sites. Consequently, CpG methylation causes a dramatic acceleration of the divergence rate of DNA sequences. It has been concluded that protection of most vital genes against methylation is one of the essential conditions for sustaining the high level of stability of the macromolecular structure and for the reliability of macromolecular functioning in a cell. PMID- 3657782 TI - [Detection of a perforin-like protein from the soluble cytotoxic factor of natural killer cells]. AB - The protein composition of the cytolytic factor (NKCF) secreted by natural killer cells was analyzed. Natural killer cells were isolated from spleens of nude rats and purified in the Percole gradient. SDS-PAAG analysis of NKCF revealed the presence of major proteins with an approximate molecular weight of 62-67 kDa. Biochemical properties of these proteins such as fractionation on a TSK-3000 SW gel filtration column, electrophoretical mobility in reduced conditions, enhanced cytolytical activity in the presence of Ca2+ demonstrate the similarity with the pore-forming protein--perforin. Apart from the major component, proteins with m. w. 42 kDa, 31-28 kDa, 17 kDa and 12-14 kDa were also found. It is possible that the Ca2+-independent cytolytical activity is bound to one of these minor protein components of NKCF. PMID- 3657783 TI - [Localization of active sites in human ceruloplasmin from data of intra- and intermolecular homology]. AB - The identification of possible copper ligands in human ceruloplasmin was carried out by the computer similarity analysis for sequences of ceruloplasmin and several other copper oxidases: azurin, plastocyanin, superoxide dismutase, tyrosinase and hemocyanin. It follows from the analysis of inter- and intramolecular homology that copper active sites of different types appeared to be in close contacts within the ceruloplasmin molecule. PMID- 3657784 TI - [The length of DNA determines the degree of regularity of crystals of the cro repressor complex]. AB - The DNA-cro-repressor complex crystals have been obtained, five DNA fragments of the same nucleotide sequence and different length being used. The rotation function for crystals of complexes with hexamer (pGpT)3 . (pApC)3 and with octamer (pGpT)3 . (pApC)3 have been calculated. The order of cro-DNA complex crystals is shown to vary with DNA length, the crystal of the complex with octamer being the most perfect among all investigated complexes. PMID- 3657785 TI - [Specific acid-soluble chromatin protein synthesized in the rat liver after cortisone administration]. AB - After cortisone injection, the content of the specific chromatin acid-soluble non histone protein alpha is markedly increased in rat liver cells. The alpha-protein has been isolated in preparative amounts, its amino acid composition and some properties have been studied. It has been shown that the amino acid composition of protein alpha differs markedly from that of the HMG proteins, semi-histone A24, and of other non-histone proteins studied so far. Cortisone has been shown to induce the de novo synthesis of protein alpha. The alpha-protein is observed in transcriptionally active chromatin. The 3H-labeled hydrocortisone and dexamethasone bind mainly to this protein. The suggestion, that this protein participates in the regulation of transcriptional activity of liver cells in response to the hormonal stimulus is put forward. PMID- 3657786 TI - Combining site specificity of monoclonal antibodies to the organophosphate hapten soman. AB - The combining site specificities of eight monoclonal antibodies raised against the organophosphorous-containing hapten Soman are compared to monoclonal antibodies specific for a naturally occurring organophosphorous compound, phosphocholine (PC). Although these haptens share some structural and spatial features, differences in their chemical structures, most notably the presence or absence of a positive charge, appear to prevent significant cross-reactivity between antibodies specific for each. The murine memory response to PC-KLH has been shown previously to be characterized by the presence of two major groups of antibodies differentiated on the basis of their specificity for free PC and for the nitrophenyl derivative of PC, nitrophenylphosphocholine (NPPC). Interestingly, two groups of hybridoma antibodies were detected in the immune response to Soma-KLH which possess differential specificity for Soman and for a nitrophenyl derivative of Soman. PMID- 3657787 TI - Antibody response to haptenic sugar antigen: immunodominancy of protein-bound lactose formed by amino-carbonyl reaction. AB - Several reducing sugars with structural analogy (glucose, galactose, lactose, melibiose, maltose and cellobiose) were bound to a carrier protein ovalbumin by amino-carbonyl reaction, and the non-enzymatically glycosylated proteins were injected into mice (BALB/c, C57BL/6, DBA/2 and C3H/He strains) with Freund's adjuvant. Antibody responses to the haptenic sugar antigens were analyzed quantitatively by enzyme-linked immunosorbent-assay using each sugar-bovine serum albumin complex. The haptenic sugar antigen from lactose induced a markedly higher response of specific antibody as compared with the haptenic sugar antigens from the other sugars. The antibody raised against the lactose adduct reacted well with lactulose (4-o-beta-D-galactopyranosyl-D-fructose) or alpha-N-acetyl epsilon-N-deoxylactulosyl-L-lysine. The results suggested that immunogenicity of haptenic sugar antigens was remarkably different in sugar chemical structure, and that the lactose adduct formed by lactose-protein amino-carbonyl reaction could be an immunodominant antigenic determinant. PMID- 3657788 TI - Characterization of the binding of and the immune response to pneumococcal group 9 capsular polysaccharides. AB - The binding of Streptococcus pneumoniae 14C-9N and 14C-9V polysaccharides (PSs) to lymphocytes and polymorphonuclear leukocytes of human blood were studied. The quantity of 14C-9N and 14C-9V PSs bound to leukocytes was proportional to the number of leukocytes and the incubation time; the binding was temperature dependent. The binding activity appeared to be specific, since the binding was inhibited by prior treatment with homologous group 9 PSs. The binding was also inhibited by prior treatment with cross-reactive group 9 PSs. The binding of 14C 9V PS to leukocytes was greater than that of 14C-9N PS. Reciprocal plot analysis revealed 6.4 X 10(4) binding sites for 9N PS on each lymphocyte and 9.5 X 10(4) binding sites for 9V PS on each lymphocyte, while the affinity constant for 9N PS was 3.7 X 10(9) M-1 and that for 9V PS was 9.4 X 10(8) M-1. Furthermore, there were 7.8 X 10(4) binding sites for 9N PS on each polymorphonuclear leukocyte and 1.2 X 10(5) binding sites for 9 V PS on each polymorphonuclear leukocyte, while the affinity constant for 9N PS was 1.6 X 10(9) M-1 and that for 9V PS was 8.5 X 10(8) M-1. There was a high degree of inhibition of the binding of 14C-9N PS to leukocytes by prior treatment with 9V PS, and a low degree of inhibition of the binding of 14C-9V PS to leukocytes by prior treatment with 9N PS. The high degree of inhibition of binding of 9V PS to leukocytes was not directly related to the production of cross-reactive antibodies to 9N PS. The serum antibody and the plaque-forming cell responses in mice immunized with 9V PS were significantly greater than responses in mice immunized with 9N PS. PMID- 3657789 TI - Partial amino acid sequence analysis of rabbit MHC class II molecules isolated from two-dimensional polyacrylamide gels. AB - Partial N-terminal amino acid sequence analyses were performed on rabbit MHC class II molecules eluted from 2-D electrophoretic gels. Rabbit spleen cells were biosynthetically labelled with 3H-phenylalanine, 3H-tyrosine and 35S-methionine and class II molecules were immunoprecipitated with a monoclonal antibody, 2C4. The immunoprecipitates were electrophoresed on 2-D gels and as many as 15 spots were observed. Individual spots corresponding to alpha and beta chains were eluted from unfixed gels following visualization of the spots by autoradiography of 35S-Met labelled polypeptides. Ten eluted polypeptides were subjected to amino acid sequence analysis to locate Phe and Tyr residues. Comparison of these partial sequences with sequences of human class II molecules indicated that each of six beta chains and three of four alpha chains were homologous to human DQ molecules; one of the alpha chains appeared homologous to DR alpha or DP alpha. The assignment of alpha or beta chain to the polypeptides was confirmed by radiosequence of molecules labelled with 35S-Cys residues. Thus, by a relatively simple procedure, individual MHC class II polypeptides in spleen cell lysates have been separated from each other and partial amino acid sequences have been obtained. PMID- 3657790 TI - A monoclonal antibody directed against a synthetic peptide reacts with a cell surface rabbit class I MHC molecule. AB - Monoclonal antibodies were prepared against synthetic peptides synthetized on the basis of nucleotide sequence from cDNA and genomic clones encoding a class I antigen expressed by the rabbit RL-5 cell line. Using a peptide corresponding to positions 61-73 of the N domain, we were able to obtain an hybridoma producing monoclonal antibody which recognized the peptide as well as the native class I antigen. This hybridoma, designated anti-61, reacted with cell surface molecules on RL-5 cells and on human HeLa cells transfected with the 19-1 gene encoding RL 5 class I antigen. No reactivity with HeLa cells prior to transfection could be detected by radioimmunoassay or by fluorescent activated cell sorter analyses, although these cells were strongly positive in both assays with anti-human class I reagents. Antibody reaction to positive cells could be inhibited by the homologous peptide but not by unrelated peptides. Anti-61 antibody precipitated a 41,000 mol. wt molecule from RL-5 cells with an N-terminal amino acid sequence corresponding to the RL-5 class I antigen. PMID- 3657792 TI - Thermal properties of human IgG. AB - Dynamic light scattering experiments have been performed to study the aggregation kinetics of human immunoglobulin G (IgG). Aggregation and irreversible cluster growth results when IgG solutions (2-15 mg/ml) are heated above 50 degrees C. The measured scattering intensity I and effective hydrodynamic radius (R) can be described consistently by a Smoluchowski aggregation process. The number of clusters ni(t) containing i monomers at time t are computed. The radius of an i cluster is assumed to be Ri = R0 i beta, where beta is the cluster exponent. This kinetic process results in the following characteristic power law behavior: (R)/R0 = (1 + gamma R (T, C, c)t) alpha R and (I)/I0 = (1 + gamma 1 (T, C, c)t) alpha I. Here R0 = 5.51 nm, is the monomer hydrodynamic radius, and I0 the scattered intensity from the monomer solution at temperature T and concn C. A fraction, c approximately 0.48 of the IgG monomers are heat stable up to 63 degrees C and do not participate in the aggregation process. The power-law behavior of mean value of R/R0 and mean value of I/I0 indicates scaling, and indeed a very satisfactory data collapse results from our data. The best non linear fit of the power-law forms gives alpha R = 0.48 +/- 0.05, alpha I = 1.00 +/- 0.01 and beta = 0.39 +/- 0.04. We also find that the heat aggregation of IgG is an activated process. Fits of the experimental data Gibbs free energy for the activated complex delta G* = 13.8 +/- 0.1 kcal/mole at 56 degrees C. The temp dependence of the growth rates exhibits an Arrhenius behavior with an enthalpy of activation delta H* = 120 +/- 5 kcal/mole. PMID- 3657791 TI - Functional polymorphisms among HLA-DR4+ DR beta chains associated with limited peptide diversity. AB - Tryptic peptide map analysis by high-pressure liquid chromatography of DR4- associated DR beta chains revealed limited structural variation within DR beta polypeptides. Comparison of 3H-leucine-labelled tryptic peptide maps of Dw4 and Dw14 homozygous cells identified distinct peaks corresponding to Dw4 and Dw14 associated DR beta polypeptides. HPLC analysis of cell line 256, heterozygous for two DR4-related specificities, Dw4 and Dw14, displayed both peptides, corresponding to the variable Dw4 and Dw14 chromatograms. This observation was confirmed using a deletion mutant cell line derived from 256 lacking Dw4 associated class II genes. The observed peptide variation correlated precisely with predicted nucleotide-derived amino acid sequences implicating amino acids 66 71 of the DR beta chain as contributing to HLA-D structural and functional polymorphisms. PMID- 3657793 TI - Characterization of jacalin, the human IgA and IgD binding lectin from jackfruit. AB - The lectin jacalin from the jackfruit Artocarpus heterophyllus reacts by precipitation and western blotting with human IgA1 and IgD but not with IgA2 (nor IgG and IgM). However, it weakly binds IgA2 as shown by affinity chromatography and competitive ELISA. Predominantly reactive carbohydrates are D-galactose and N acetyl D-galactosamine. Jacalin has an apparent Mr of about 54,000 and is probably made up of three non-glycosylated and one glycosylated non-covalently linked subunits. Its electrophoretic properties and amino acid and carbohydrate composition are indicated. PMID- 3657794 TI - A synthetic peptide coded for by the pre-S2 region of hepatitis B virus for adding immunogenicity to small spherical particles made of the product of the S gene. AB - Small spherical particles produced in the non-permissive phase of hepatitis B virus infection, when the viral genome is integrated into the chromosome of hosts, are rich in the product of the S gene, but poor in the product of the pre S2 region. For the purpose of adding immunogenicity to spherical particles deficient in the pre-S2 region product, they were conjugated with a synthetic peptide of 19 amino acid residues. The peptide reproduced a hydrophilic area of the pre-S2 region product encoded by viral genomes of subtypes adr, ayw and ayr. The spherical particles supplemented with the pre-S2 peptide raised antibody to the pre-S2 region product in mice, in addition to antibody to the product of the S gene. Antibody to pre-S2 region product, prepared from sera of immunized mice by absorption with the S gene product, bound to spherical particles bearing pre S2 region product, irrespective of adr, adw, ayw or ayr subtype, and agglutinated hepatitis B virions in immune electron microscopy. Based on the results obtained, the synthetic peptide may prove useful in adding protective efficacy to small spherical particles poor in pre-S2 region product. PMID- 3657795 TI - IgA-induced chemokinesis of human polymorphonuclear neutrophils: requirement of their Fc-alpha receptor. AB - The influence of purified human immunoglobulins on the migration of human neutrophils (PMN) was measured in a 48-well micro chemotaxis chamber, with results expressed as percentages of maximal formyl-methionyl-leucyl-phenylalanine (FMLP)-stimulated chemotaxis. Both monomeric and polymeric IgA, of both subclasses, in monoclonal and polyclonal form, as well as secretory IgA and Fc alpha, but not Fab-alpha fragments, enhanced PMN migration when present either in the lower or in both compartments of the chamber (chemokinesis) at concns as low as 0.1 mg/ml. IgM and IgE had no such effect. In contrast, IgG was chemotactic at low concn (0.1 mg/ml). Both monomeric and polymeric IgA decreased the maximally induced FMLP-chemotaxis, but IgA increased chemotaxis induced by suboptimal levels of FMLP. Binding of 3[H]-FMLP to PMN was not affected. Cytofluorographic analysis revealed that, under the conditions of the assay, IgA did bind to 93% of PMN. Thus, the various forms of IgA have a dual effect on human PMN mobility: (1) increase PMN random migration (chemokinesis); and (2) decrease the maximal FMLP induced chemotaxis. Our data support the requirement of binding of IgA to the Fc alpha receptor of PMN for expression of these activities. This effect of IgA on PMN mobility may be relevant in IgA deficiency states. PMID- 3657796 TI - Immunological cross-reactivity between preS2 sequences of the hepatitis B virus envelope proteins corresponding to serological subtypes adw2 and ayw. AB - An immune response to epitopes localized on the preS region of the hepatitis B virus (HBV) envelope (env) is elicited during recovery from HBV infection and appears to play a role in virus clearance. Anti-preS antibodies (Ab) are expected to be protective against HBV infection as indicated by the virus-neutralizing capacity of Ab to a preS2-specific synthetic peptide preS(120-145). However, there is considerable amino acid variability between preS regions corresponding to distinct serological subtypes of HBV, raising the question whether the preS sequences are sufficiently related immunologically to have the potential of inducing cross-protective immunity. To answer this question concerning the preS2 region, antisera to synthetic peptides preS(120-153) and preS(128-153) corresponding to subtypes adw2 and ayw, as well as to the native env [ayw] protein were raised. Using the resulting polyclonal Ab, an immunological relatedness between preS2 sequences of subtypes adw2 and ayw was demonstrated. On the other hand, Ab selected by affinity chromatography or by cloning hybridoma cells may recognize with strong preference subtype-specific determinants within the preS2 region when the compared antigens are in solution rather than on the solid phase. These findings have implication for the design of: (1) preS2 specific immunogens and (2) immunoassays for quantitation of preS2 sequences in HBV env proteins. PMID- 3657797 TI - Determination of intrinsic affinity constants of monoclonal antibodies against carcinoembryonic antigen. AB - A 2-phase method is described for the determination of the intrinsic affinity constants (K-values) for the interaction between monoclonal antibodies (MAbs) against carcinoembryonic antigen (CEA) and CEA. The Mabs were coupled covalently to CNBr-activated paper discs. MAb coupled discs and a 2-fold dilution series of 125I-CEA were incubated at 20 degrees C until equilibrium was reached. Nonlinear curve-fitting was used for estimation of K-values and different calculation models were thereby tested. The K-values for 12 different anti-CEA MAbs were determined to be 0.3-52 X 10(6) M-1, which is 1-2 orders of magnitude lower than the values obtained in a previous study with some of these MAbs using the ammonium sulphate method to separate free from bound antigen. The K-values obtained by the paper disc method are probably better estimates of the intrinsic association constant than those obtained previously. There are two main reasons for this: (1) free and bound antigen are separated from each other under physiological conditions and (2) the opportunity for multipoint interaction between MAb and CEA is minimized when the MAb is coupled to a rigid carrier substance. Thus, even when the MAb reacts with greater than or equal to 2 epitopes in CEA, as seems to be the case with several of our anti-CEA MAbs, the intrinsic K-value should be obtained. The fundamental validity of 2-phase assays, sometimes questioned in the literature, is demonstrated. PMID- 3657798 TI - Antibody heterogeneity: theoretical and experimental evaluation of a simple procedure to describe differing affinities in hapten binding reactions. AB - Heterogeneity in antibody binding affinity for hapten is easily and comprehensibly described by plotting the histogram of delta r, the change in the fraction of occupied active sites, vs the logarithm of the concn of free ligand. Computer simulations of binding reactions revealed that multimodal histograms occur only if differences in affinity are greater than 10-fold. Otherwise, the delta r histogram closely approximates a normal distribution, the variance of which increases with increasing heterogeneity. In biochemical experiments delta r histograms successfully detected mixtures of anti-DNP antibodies of varying affinities as well as changes between early and late anti-DNP immune responses in rabbits immunized with or without Freund's complete adjuvant. PMID- 3657799 TI - The regulation of membrane-bound and secreted immunoglobulins in the human lymphoid cell line LICR-LON and human hybridomas. AB - The synthesis of membrane-bound and secreted immunoglobulin was investigated in the human line LICR-LON-HMy2, a cell line often used for the derivation of human hybridomas. PAGE-SDS analysis of immunoprecipitates obtained from 35S-methionine labelled cell lysates shows that LICR-LON synthesize a hitherto undetected membrane form of IgG (with a heavy chain of mol. wt 62,000) in addition to the secretor form of IgG already described (55,000 heavy chain). Tunicamycin treatment, pulse-chase experiments and Western blot analysis showed that both chains are synthesized as independent proteins. Hybridomas obtained after fusion of LICR-LON and human peripheral blood lymphocytes retained the ability of the parental cell line to synthesize gamma m and gamma s. Some of these hybrids synthesize and secrete IgM which presumably originates from the parental B lymphocytes. Precipitation and PAGE-SDS analysis of membrane proteins after iodination of intact cells revealed only one heavy chain band, corresponding in size to that of the gamma m. No indication of the synthesis of the membrane form of IgM was found in the hybrids. These data show that the parental (lymphoid) phenotype (m and s-IgG) is codominant with the more differentiated phenotype (s IgM) of the fusion partner cell (plasma cell). These observations are compatible with a class-specific m-s regulation operating on a different chromatin structure at the expressed Ig loci of each parental chromosome. PMID- 3657800 TI - The immune response towards beta-adrenergic ligands and their receptors--VII. Equilibrium and kinetic binding studies of l-alprenolol to a monoclonal anti alprenolol antibody. AB - Binding of the catecholamine beta-adrenergic antagonist, l-alprenolol, by the IgGl anti-alprenolol monoclonal antibody 37A4 was examined using the radioligand 3H-dihydroalprenolol as an extrinsic signal and the increase in antibody fluorescence upon l-alprenolol binding as intrinsic signal. Equilibrium binding studies based on both signals indicated that the binding process was exothermic with a positive entropy change. The difference in the affinity constants obtained by radioligand binding studies and by fluorescence analysis could be ascribed to the higher affinity of the hydrogenated tritiated l-dihydroalprenolol compared to the unsaturated l-alprenolol. The association rate constants determined by both signals were 10(4)-10(5)/M/sec and showed a high activation enthalpy (8-10 kcal/mol), thus excluding a diffusion controlled reaction. At low temp (7 degrees C), the fluorescence stopped-flow studies showed non-linear pseudo first order kinetics, indicating the existence of a fast pre-equilibrium of low affinity, followed by a conformational change leading to the tight binding of the ligand. The dissociation rate constants determined using both signals were very similar. Thus, the differences in affinity between the hydrogenated and non-saturated l alprenolol could be ascribed to the association rate constants. Affinity constants and thermodynamic parameters calculated from the kinetic data were in close agreement with those determined by equilibrium binding. The mechanisms of ligand binding are discussed in terms of the interactions of idiotypes and anti idiotypes in the anti-catecholamine immune response. PMID- 3657801 TI - Inhibition of cytolysin activity in large granular lymphocyte granules by lipids: evidence for a membrane insertion mechanism of lysis. AB - The ability of various compounds to inhibit the lytic activity of purified cytoplasmic granules from LGL tumors was tested. The lytic activity of granule cytolysin was modestly inhibited by inorganic phosphate, and various monophosphoesters, with I50 values in the range of 8-20 mM. Among monophosphoesters, choline phosphate was exceptionally potent, with an I50 of 1.4 mM. In contrast to the inhibition by phosphate esters, the parent compounds such as neutral sugars, glycerol, and choline, showed no detectable inhibition at 50 mM. A lysolipid bearing a short aliphatic chain and some detergents were inhibitory with I50 values in the range of 1 mM. Lysolipids with longer aliphatic chains, phospholipids as liposomes, and related lipid compounds were found to display potent inhibition of the hemolytic activity of LGL granule cytolysin, with I50 values in the range of 0.2-30 microM. Soluble globular proteins inhibited LGL granule cytolysin hemolytic activity with I50 of 0.07-0.4 mg/ml. However, lipoproteins were 2-3 orders of magnitude more potent inhibitors, with L50 values of less than 1 microgram/ml. The observed potent inhibition by lipid compounds lends support to a model of the lytic action of granule cytolysin in which soluble cytolysin molecules insert into the membrane lipid bilayer during the course of the lytic event. PMID- 3657802 TI - Regulation of the activation of C1 in serum. AB - C1 has been partially purified from serum and its ability to activate has been studied. The activation status of C1 was measured using a sensitive hemolytic assay which allowed the activation status of C1 in serum to be monitored. C1 did not activate in serum but would spontaneously activate when separated from certain other serum proteins, in particular, the C1-inhibitor protein. The activation of C1 was time and concn dependent, but addition of fully activated C1 did not affect either the rate or extent of activation. The activation of C1 could be inhibited reversibly by C1-inhibitor. This action of the C1-inhibitor was over and above its ability to regulate fully activated C1 by covalent bond formation with either the serine esterase of C1s or C1r. The results presented suggest that the C1-inhibitor plays a dual role in the regulation of C1 activation. The regulatory actions of C1-inhibitor would account for the presence of C1 in a zymogen form and for the episodic nature of complement consumption observed in individuals with genetic deficiencies of the C1-inhibitor protein. PMID- 3657803 TI - Concentration dependence of the binding constant of antibodies. AB - By simultaneous dilution of the antigen (AG) and the antibody (AB) used in an immune precipitation reaction, at the equivalence AG/AB ratio, it was found that the association constant, Ka, increased from 1.7 X 10(7) 1/M at the highest concn of AG and AB, to 6.5 X 10(11) 1/M at 100-fold dilution of both. An important (but not the only) reason for this increase is taken to be the fact that the AB solution was polyclonal. PMID- 3657804 TI - Biochemical characterization of a T-lymphoma-specific 90,000 molecular weight disulfide linked dimeric glycoprotein. AB - The biochemical features of a membrane antigen detected by a mouse monoclonal antibody (A1) raised against the murine thymoma cell line EL4 are described. This reagent detected a novel disulfide-linked 90,000 mol. wt dimeric membrane glycoprotein composed of two chains of approx 45,000 mol. wt. Endo-beta-N acetylglucosaminidase F digestion generated a single 28,000 polypeptide, thus suggesting that the A1 molecule is a homodimer. No structural homology between the A1 molecule and the human T 90/44 protein (9.3 antigen) could be revealed by peptide mapping analysis. In view of the fact that three polypeptides of mol. wts 28,000-30,000, 21,000 and 15,000 respectively co-precipitated with the A1 antigen, the possible relationship of the A1 molecular complex to other known T cell surface antigens including the antigen receptor is discussed. PMID- 3657805 TI - Regulation of human natural cytotoxicity by IgG--I. Characterization of the structural site on monomeric IgG responsible for inhibiting natural killer cell activity. AB - Inhibition of human natural killer (NK) cell activity upon exposure of peripheral blood lymphocytes (PBL) to IgG in monomeric form (mIgG) was found to be dose-, time- and temp-dependent. PBL incubated for 2 hr at 37 degrees C in the presence of myeloma protein of a certain class or subclass had a significant reduction of their NK activity when exposed to IgG, but not to IgM or IgD, and the IgG-induced inhibition of NK cells was observed only when IgG1 or IgG3 paraproteins were used. IgG3 isolated from normal serum had a higher inhibitory property than that of total mIgG. The cytophilic activity of the IgG molecules was confined entirely to the Fc region and seemed to be localized in the CH3 domain, since human and rabbit Facb fragments had a reduced ability to inhibit NK activity. When synthetic peptides representing various sequences of the human gamma-chain were tested for inhibition of NK activity, only treatment of effector cells with a peptide comprising the sequence Tyr407-Arg416 of the CH3 domain showed a reduction of NK cell function comparable to the inhibition obtained following incubation of cells in the presence of mIgG. However, on a molar basis, this peptide was 20 times less active than mIgG. In contrast, peptides derived from sequences in the CH2 domain lacked this inhibitory capacity. Our data indicate that the structural site responsible for inhibiting NK cell activity is located in the C-terminal domain of the IgG molecule. PMID- 3657806 TI - Hapten-induced enhancement of monoclonal antibody binding in ELISA. AB - We have recently reported [Hall T. J., Stenzel-Poore M. and Rittenburg M. B., Sixth International Congress of Immunology, Toronto. Abstract 2.15.27, p. 108 (1986)] on the fine specificity analysis of six monoclonal antibodies (MAbs) which utilize lambda 1 (lambda 1) light chains, produced from BALB/c mice immunized with PC-KLH. Binding of these MAbs to PC-histone in ELISA was inhibited by the PC analogue nitrophenylphosphocholine (NPPC) but not by PC itself, thus distinguishing these group II antibodies from the group I PC binding myeloma proteins such as TEPC 15 and MOPC 603 [Leon and Young, (1971) Biochemistry 10, 1424-1429]. Three of these lambda MAbs showed a reproducible 2-4 fold increase in binding in ELISA at certain concns (10-100 microM) of NPPC and one of them (PCG2b 3) was chosen to examine this observation further. PMID- 3657807 TI - Evaluation of equilibrium constants for antigen-antibody interactions by solid phase immunoassay: the binding of paraquat to its elicited mouse monoclonal antibody. AB - A procedure is devised for simple graphical evaluation of the association constant for antibody-antigen interactions from data obtained by conventional solid-phase immunoassay for antigen. Application of the method to situations involving a univalent antigen is illustrated by means of ELISA data for the interactions of paraquat with its elicited murine monoclonal antibody, and the Fab fragment derived therefrom. Although the completely general situation with both antibody and antigen multivalent is not amenable to study by the present procedure, the quantitative expression is readily modified to accommodate antigen multivalency provided that the univalent Fab fragment may be substituted for the multivalent antibody (IgG or IgM) as partitioning species in the solid-phase immunoassay. PMID- 3657808 TI - The solution conformations of the subclasses of human IgG deduced from sedimentation and small angle X-ray scattering studies. AB - The solution conformations of human immunoglobulin G subclass molecules have been investigated by sedimentation and small-angle X-ray scattering techniques. Both methods qualitatively indicate IgG3 to be an extended molecule relative to IgG1. Sedimentation data have been collected for a number of paraproteins of all four subclasses and the hinge-deleted IgG1Dob protein. The known crystal structure of Dob allows the use of this protein as a basis for the proposal of models of the average conformations of IgG subclasses which are consistent with experimental s(0)20,w values. IgG1 is suggested to have a hinge length of 0-15 A and non coplanar Fab arms; IgG2 to be effectively hingeless with folded-back Fab arms; IgG3 to have an extended hinge of the order of 100 A and IgG4 to be effectively hingeless and T-shaped. The possible correlation of these conformations with subclass function is discussed. PMID- 3657809 TI - Immunochemical observations of antigen 5, a major venom allergen of hornets, yellowjackets and wasps. AB - Antigen 5 is a venom protein of hornets, yellowjackets and wasps, and it is an important allergen for insect-sensitive patients. Antigen 5s from these insects are found to have similar amino-terminal sequences for their first 20 residues, and to have similar cyanogen bromide cleavage patterns. A partial sequence homology of antigen 5s and scorpion neurotoxins is observed. Antigen 5s from these insects show varying extents of cross reactivity when tested with mouse polyclonal antibodies by enzyme immunoassay and they show limited or no cross reactivity with mouse monoclonal antibodies. Chemically modified antigen 5s shown greatly decreased binding of antigen 5-specific mouse polyclonal antibodies. The modified antigen 5s include its reduced and carboxymethylated PMID- 3657810 TI - Kinetics of the precipitation of cryoimmunoglobulins. AB - The kinetics of the cryoprecipitation of two monoclonal IgG and two monoclonal IgM cryoimmunoglobulins, two IgM/IgG mixed cryoglobulins and a series of cold soluble monoclonal IgG and IgM immunoglobulins in the presence of polyethylene glycol have been compared by time dependent turbidity measurements. The effects of temp and ionic strength on kinetic processes are described in detail. The monoclonal cryoimmunoglobulins display lag times which are not seen with the other proteins, suggesting a critical nucleation event. The protein concn dependence of the lag times indicate that these nucleation centers contain only a few immunoglobulin molecules. Direct evidence for the existence of precipitation nuclei was obtained from dynamic light scattering studies of two of the monoclonal proteins during their lag periods. Both proteins manifested an approx. 20% decrease in their mean diffusion coefficients (corresponding to a 25% increase in Stokes' radius) prior to detectable precipitation. This suggests the formation of nuclei between 2 and 8 times the size of the monomeric proteins. It is postulated that the increasing size of mixed cryoglobulin complexes with decreasing temp provides analogous nucleation sites. The latter stages of precipitation appear to be kinetically similar for all proteins examined, although the size and shape of the aggregates are quite variable. PMID- 3657811 TI - Antibodies to synthetic peptides from the pre-S1 and pre-S2 regions of one subtype of the hepatitis B virus (HBV) envelope protein recognize all HBV subtypes. AB - Immunodominant B and T cell epitopes have been demonstrated recently on the preS1 and PreS2 regions of the hepatitis B virus (HBV) envelope protein. Synthetic peptide analogs corresponding to the preS2 region elicit virus-neutralizing antibodies and protect chimpanzees against HBV infection. Antibodies raised by immunization with peptides derived from the preS1 sequence block the site involved in HBV attachment to cell receptors, and are expected to be virus neutralizing. Results presented here show that antisera raised against synthetic peptide analogs carrying the immunodominant epitope of the preS1 and preS2 sequence, respectively, and corresponding to two HBV subtypes, adw2 and ayw, each recognized preS1 and preS2 specific epitopes on all serological subtypes of the HBV envelope protein. Thus, the sequence variability within the preS1 and preS2 regions does not represent an impediment to the development of synthetic peptide or genetically engineered hepatitis B preS immunogens for worldwide immunization. PMID- 3657812 TI - [Pediatric gynecology: tasks and development]. AB - The modern development of pediatric gynecology is outlined. The special requirements of children in this respect and the education of doctors for the subspecialty are discussed. Aims and organisation of the German working group are presented. Some data and experiences of an outpatient clinic are given. PMID- 3657813 TI - [Personal hygiene and sex education of young girls]. AB - Sexual education of girls and guidance for their personal hygiene are closely related. In preventive checkups as well as in the course of each and every consultation, the physician has an opportunity to discuss reproductive health issues first with the mother and then with the daughter. As far as the hygiene of the reproductive organs is concerned, the doctor will find that his initiative is necessary and useful. It contributes to the prevention of diseases and simultaneously to sexual education, because it teaches the girls that these organs are as important and worth to be taken care of as every other part of their body. The physician should provide a model in giving advice on a comfortably uninhibited, yet considerate approach to the own body and, more specifically, to reproductive health care. PMID- 3657814 TI - [Somatic puberty development in girls]. AB - In 142 Swiss girls of the First Zurich Longitudinal Study. The somatic pubertal development between 9 and 18 years is described. The mean chronological age at the onset of the pubertal growth spurt was 9.6 years (standard deviation 1.2 years). The peak of the pubertal growth spurt (peak height velocity: PHV) was reached at a mean age of 12.2 years (SD 1.0). The development of pubic hair started at a mean age of 10.4 years (SD 1.2), breast development at 10.9 years (SD 1.2) and the development of axillary hair at 12.0 years (SD 1.1). Menarche occurred 2.7 years (SA 1.1) after the initiation of pubic hair development and 2.2 years (SD 1.1) after the breast development had started. Menarche was noted at a mean age of 13.4 years (SA 1.1). At menarche the mean height was 156.9 cm (SD 6.3), the mean weight 45.5 kg (SD 6.8) and the mean bone age (according to Greulich and Pyle) 12.6 years (SD 0.8). With the onset of menarche 95.3% (SD 1.7) of adult height were reached; the corresponding remaining height gain was 7.8 cm (SD 2.8). Acne was observed in 81% and striae in 41% of the girls by 18 years. PMID- 3657815 TI - [Midazolam (Dormicum) for sedation of children in painful interventions]. AB - In children painful diagnostic and therapeutic investigations require sedation and sometimes local anaesthesia. We tested Midazolam, a new benzodiazepine, for its sedative effect. Midazolam is the first derivate of imidabenzodiazepine and is remarkable for its rapid effect and a short half-life. It has good hypnotic, anxiolytic and amnesic properties. Sleep sets in immediately after intravenous application of Midazolam, and all patients reported anterograde amnesia afterwards. Over 24 months we observed 266 children who had been given Midazolam as a basic sedative before painful investigations. For sleep induction Midazolam was given in a dose of 0.3 mg/kg in children older than 6 years and 0.4 mg/kg in children younger than 6 years. The maximal dose was 15 mg. All patients fell asleep and did not remember anything about the procedure. In 30 patients pulse, blood pressure and respiration rate were measured before and after application of Midazolam. The quality of sleep was determined by the Glasgow-Coma-Scale. We did not observe any side effects. PMID- 3657816 TI - [Pediatric psychosomatic medicine: where did we come from? What is our status? Where are we going?]. AB - Historical development of pediatric psychosomatics from psychodiagnostics to individual-centered psychotherapy and recently to family oriented and systemic therapy is outlined in the example of our own development and that of our department. In classical psychosomatics dualism in medicine is kept alive by considering only so-called "psychosomatic diseases". At present, there is need for a new and more complex model in medicine: The bio-psycho-social model in medicine puts emphasis on diagnosis and treatment of psychological and social factors in the genesis, course and outcome of every disease. Especially in pediatrics this model should be favored. Some consequences for treatment, research and medical education are proposed. Finally we touch on the new potentials of systemic family therapy. PMID- 3657817 TI - [Group therapy with parents of premature infants]. AB - The birth of a premature infant means a heavy emotional burden on the parents which can considerably disturb the attachment process. Between October 1985 and March 1987 31 parents of very small premature infants participated in a parent support group under a pediatrician's guidance. This group has proved useful to help these parents to overcome their emotional crisis. The efficiency of this kind of group is described but also its limitations. Positive results of the parent-support group on the later development of the infants are to be expected but have still to be verified by means of a prospective study. PMID- 3657818 TI - [Neonatal emergency: bupivacaine poisoning following maternal caudal anesthesia]. AB - After maternal caudal anesthesia with bupivacaine life-threatening symptoms of bupivacaine intoxication occurred in the newborn. The local anesthetic had been injected directly into the fetal scalp. Cardiac shock caused by sinus bradycardia and impaired intracardial conduction (wide QRS-complex) was treated successfully. Seizures were absent. The bupivacain plasma level 90 min post partum was 3.6 mg/l, the elimination half-life 14 h. The symptoms presented in the newborn- especially the cardiovascular changes--coincide well with the results of animal experiments reported in the literature. PMID- 3657819 TI - [Effectiveness of a pediatric video learning program for students]. PMID- 3657820 TI - [83d meeting of the German Society for Pediatrics, 13-16 September 1987, Wolfsburg, together with the 25th annual meeting of the German Society for Pediatric Surgery, 12-15 September 1987 and the 39th annual meeting of the German Society for Social Pediatrics, 14-15 September 1987. Abstracts]. PMID- 3657821 TI - Chromosomal responses to ionizing radiation reminiscent of an adaptive response in cultured Chinese hamster cells. AB - When Chinese hamster V79 cells were internally exposed to low level chronic beta rays from incorporated tritiated thymidine (3H-dThd), they showed an "adaptive" response to the induction of chromosomal damage by subsequent higher acute doses of gamma-rays. The yield of sister-chromatid exchanges (SCEs) in the 3H-dThd pretreated cells was less than the yield induced by gamma-rays alone (protective effects), and the micronucleus frequency was less than the sum of the induced frequencies by 3H-dThd and gamma-rays separately (below-additivity effects). No adaptation to the micronucleus induction by gamma-rays was observed after the 3H adapted cells had divided once and when 3-aminobenzamide (3AB) was given before the challenge doses. The cross-resistance study revealed that the 3H-adapted cells were resistant to SCE induction but not to the micronucleus inductions by the challenge doses of reactor radiations. The results suggest that the SCE adaptation and the micronucleus adaptation or clastogenic adaptation are probably caused by different, inducible adaptive repair pathways. PMID- 3657822 TI - The induction of DNA strand breaks at specific sites by N-nitroso-N-ethylurea depends on the phases of the cell cycle. AB - Synchronized root meristems of Pisum sativum were treated at each phase of the cell cycle with 6.25 mM N-nitroso-N-ethylurea. DNA extracted from treated cells and run in agarose gel electrophoresis exhibits a series of discrete fragments with length below 2500 bp and a significant number of unspecific single-stranded breaks (or alkali-labile sites). Experiments with micrococcal nuclease indicated that the nucleosomal organization of the chromatin is not responsible for the generation of the discrete fragments: it seems that their appearance is associated with a preferable attack of the mutagen at specific sites, characteristic for the plant genome. Moreover, a cell cycle dependent release of the discrete fragments was found with maximum at G1-S and minimum at mitosis. The model experiments designed to clarify this observation suggest that it might be determined from the cell cycle dependent fluctuation in the accessibility of the chromatin DNA and/or the process of excision-repair. PMID- 3657823 TI - Indirect evidence for the induction of a prooxidant state by cadmium chloride in cultured mammalian cells and a possible mechanism for the induction. AB - The effects of scavengers of active oxygen species on cadmium chloride (CdCl2) induced inhibition of cell growth and DNA synthesis and on the metal-induced clastogenesis were investigated to evaluate whether cadmium could induce a prooxidant state in cultured Chinese hamster V79 cells. Inhibition by CdCl2 of cell growth and [3H]thymidine incorporation into the acid-insoluble fraction of cells and the metal-induced clastogenesis were suppressed in part by the presence of the diffusible radical scavenger, butylated hydroxytoluene (BHT). The action of BHT was concentration-dependent and did not affect the intracellular level of cadmium. D-Mannitol, a hydroxyl radical scavenger, also significantly suppressed Cd-induced inhibition of cell growth and [3H]thymidine incorporation. Catalase was marginally suppressive on Cd-induced inhibition of cell growth. These results suggest that cadmium can induce a prooxidant state in cultured mammalian cells. The mechanism by which cadmium induces a prooxidant state was investigated by measuring the effect of cadmium on those enzymes which constitute a cellular defense against active oxygen and on the level of the intracellular antioxidant, glutathione (GSH). 2-h treatments with CdCl2 over a concentration range of 2-10 X 10(-5) M did not influence superoxide dismutase, catalase, GSH peroxidase or GSSG reductase. In contrast, the level of glutathione was decreased to approximately 40% by treatment with 2 X 10(-5) M cadmium. The decrease in glutathione level may be responsible for a role by active oxygen in Cd-induced inhibition of cell growth and DNA synthesis and the metal-induced clastogenesis. PMID- 3657824 TI - Gesellschaft fur Umwelt-Mutationforschung e.V. (GUM). A German- speaking section of the European Environmental Mutagen Society (EEMS). Abstracts of papers and posters presented at the 10th meeting. 25-27 March 1987, Erlangen (F.R.G.). PMID- 3657825 TI - Variation of Mouse Spot Test. PMID- 3657826 TI - Guidelines for the conduct of micronucleus assays in mammalian bone marrow erythrocytes. PMID- 3657827 TI - A protocol and guide for the in vitro rat hepatocyte DNA-repair assay. AB - The in vitro rat-hepatocyte DNA-repair assay is a valuable tool in assessing the genotoxic activity of chemical agents. An advantage of the assay is that the target cells themselves are metabolically competent, so that the patterns of metabolic activation and detoxification closely reflect those in the whole animal. This article provides a typical procedure and guidelines for conducting the rat in vitro hepatocyte DNA-repair assay. PMID- 3657828 TI - A protocol and guide for the in vivo rat hepatocyte DNA-repair assay. AB - The in vivo rat hepatocyte DNA-repair assay is a valuable tool in assessing the genotoxic activity of chemical agents. An advantage of the system is that it reflects the complex patterns of uptake, distribution, metabolism, detoxification and excretion that actually occur in the whole animal. This article provides a typical procedure and guidelines for conducting the rat in vivo hepatocyte DNA repair assay. PMID- 3657829 TI - A guide for the performance of the Chinese hamster ovary cell/hypoxanthine guanine phosphoribosyl transferase gene mutation assay. PMID- 3657830 TI - Guide for performing the mouse lymphoma assay for mammalian cell mutagenicity. PMID- 3657831 TI - Mammalian in vivo cytogenetic assays. Analysis of chromosome aberrations in bone marrow cells. PMID- 3657832 TI - A guide for mutagenicity testing using the dominant lethal assay. AB - The dominant lethal assay has been used and continues to be used to provide information about the effects of chemicals on the gonadal cells of male animals. Guidelines for conducting this test are useful but as with any guideline scientists should avoid interpreting them as protocols. Thus this document is a general approach to dominant lethal testing and should be used in conjunction with other available protocols and procedures. PMID- 3657833 TI - The in vitro human lymphocyte assay for assessing the clastogenicity of chemical agents. PMID- 3657834 TI - Guidelines for minimal criteria of acceptability for selected short-term assays for genotoxicity. PMID- 3657835 TI - The organic solvents acetone, ethanol and dimethylformamide potentiate the mutagenic activity of N-methyl-N'-nitro-N-nitrosoguanidine, but have no effect on the mutagenic potential of N-methyl-N-nitrosourea. AB - The frequency of recessive chlorophyll and embryonic lethals included by N-methyl N'-nitro-N-nitrosoguanidine (MNNG) in Arabidopsis thaliana was markedly increased when exposure of the seeds to MNNG (3 h) was carried out in the presence of 4-12% acetone, 4-16% ethanol or 8-32% dimethylformamide. The enhancement of MNNG mutagenicity was proportional to the concentrations of these organic solvents. In contrast, neither of them, applied at the same conditions and doses, influenced the mutagenic activity of N-methyl-N-nitrosourea. The solvents without mutagens did not influence the spontaneous rate of mutations and revealed no or very weak toxic effect as measured by the seed germination. PMID- 3657836 TI - The possible mutagenic effect of the occupation of TV announcer. AB - In a group of TV announcers, a significant increase in the number of classical aberrations was detected in peripheral blood: 7.5 +/- 3.477% in comparison with 3 control groups (A - 7 healthy women matched for sex, age and place of residence, B - 9 members of TV technical staff, C - 9 actors and actresses) with a mean aberration level of 2.96 +/- 1.136. SCE numbers were not increased in the TV announcers compared to controls. An increased frequency of reproduction failure has also been noticed in TV announcers (females). A decrease in the level of aberrant cells was noticed when the announcer had been on holiday, although this was not statistically significant. The possible mutagens in the working environment of TV announcers are discussed; there is a suspicion that azodyes, present in cosmetics or other chemicals, may be the mutagenic factor. PMID- 3657837 TI - Mutagenicity of hydrogen peroxide in V79 Chinese hamster cells. AB - Hydrogen peroxide (H2O2) was investigated for its potential to induce gene mutations in V79 Chinese hamster cells. Exposure of 2-3 X 10(6) cells/100-mm dish to 0.5-4.0 mM H2O2 for 1 h resulted in a concentration-dependent increase in the frequency of 6-thioguanine-resistant clones. At 4 mM H2O2 the mutation frequency was increased about 6-fold above that in controls and survival of the cells was reduced by 50%. Cytotoxicity was markedly increased at lower cell densities. When only 100-200 cells/100-mm dish were exposed to H2O2 for 1 h, 50% were killed at an H2O2 concentration as low as 60 microM. The results show that mutagenicity of H2O2 in mammalian cells in vitro has escaped attention previously because the concentrations tested were too low, presumably because the likely toxicity of H2O2 to V79 cells treated at high cell densities was overestimated. PMID- 3657838 TI - The probability with which EMS-initiated mutagenic lesions generate mutations in CHO cells. AB - In this note we distinguish between multiple mutations affecting a given locus which are generated at separate error-prone lesions and multiple independent mutations generated at a single error-prone lesion. We describe a basis for determining the probability with which the latter class of mutations occurs based on the mutant fraction in the progeny and determine an average probability of 0.6 mutations/replication/mutagenic site for those EMS-modified sites which are mutagenic for G6PDH activity in CHO cells. PMID- 3657839 TI - A comparison between short-term evolution of micronuclei induced by X-rays and colchicine in root tips of Vicia faba. AB - The short-term evolution of micronuclei derived from acentric fragments and whole chromosomes was studied in root tips of Vicia faba. Micronuclei were induced by X rays (30 cGy and 120 cGy) and colchicine (10(-5) M and 3 X 10(-4) M). Frequencies of chromosome breakage or loss of micronuclei in interphase and mitotic cells were studied. The DNA content of micronuclei in interphase cells was also measured. Micronuclei derived from whole chromosome showed a higher probability to survive and to undergo mitotic condensation in synchrony with main nuclei than micronuclei derived from an acentric fragment. PCC (Premature Chromosome Condensation) was not observed for both types of micronuclei in Vicia faba, in contrast to the ones reported in mammalian cells in culture. PMID- 3657840 TI - Induction of sister-chromatid exchanges and exchange aberrations by UV light and quinacrine mustard in relation to chiasma formation in a standard line and two oligochiasmatic mutants of Vicia faba L. AB - The frequencies of sister-chromatid exchanges (SCE) and exchange aberrations (EA) in root tip cells were compared to chiasma formation in pollen mother cells of a standard line and two oligochiasmatic lines of Vicia faba L. SCE and EA were induced by UV light and quinacrine mustard. Between the lines SCE frequencies were not different. The background level of SCE was doubled after UV irradiation and 4 times higher after exposure to quinacrine mustard in all Vicia lines analysed. However, the induced frequencies of EA were found to be different under the same treatment conditions for the standard line and the oligochiasmatic mutants. Between the frequencies of induced EA and the frequencies of chiasmata a correlation could be shown. The relationship between the formation of SCE and EA due to the reduced ability of meiotic recombination in the mutants of Vicia faba is discussed. PMID- 3657841 TI - Factors affecting the production of SCEs by maleic hydrazide in root-tip chromosomes of Allium cepa. AB - We have investigated the influence of pH on the induction of chromatid-type aberrations and sister-chromatid exchanges (SCEs) by maleic hydrazide (MH) in root-tip cells of Allium cepa. For both cytogenetic endpoints, the lower the pH of the treatment solution, the higher were the frequencies of chromosome alterations detected at metaphase. We have further studied the persistence of lesions giving rise to SCEs during successive cell cycles, as well as the influence of BrdU concentration in the post-treatment medium on the yield of MH induced SCEs. Our results suggest that the cytogenetic action of MH in many respects resembles that of bifunctional alkylating agents. PMID- 3657842 TI - Spontaneous and cyclophosphamide-induced sister-chromatid exchanges in diploid and endoreduplicated tetraploid metaphases of preimplantation mouse embryos. AB - Endoreduplicated tetraploid metaphases could for the first time be induced in preimplantation mouse embryos by culture in the suboptimum medium MEM. In such endomitoses sister-chromatid exchange (SCE) frequency was approximately the same during the first and the second cell cycle. However, when morulae and blastocysts were cultured in the presence of cyclophosphamide metabolites SCE frequency was increased predominantly during the second cell cycle. Compared to diploid metaphases a decreased SCE frequency was found under both conditions of endomitoses induction, which may be related to DNA-repair processes. PMID- 3657843 TI - Induction of micronucleated erythrocytes by primary thioamides and their metabolites in the mouse. PMID- 3657844 TI - Mutagenicity of actinomycin D in mammalian cells due to clastogenic effects. AB - Actinomycin D was clastogenic and mutagenic in L5178Y/TK +/- -3.7.2C mouse lymphoma cells. The majority of the mutants were small colonies, indicating that actinomycin D acts primarily by a clastogenic mechanism. PMID- 3657845 TI - Variations of SCE frequencies in peripheral lymphocytes of ex-smokers. AB - We measured SCE frequencies over a period of 8 months in 14 smokers who stopped smoking at the start of the study. In a first group of 10 subjects, who did not resume smoking during the period of cytogenetic follow-up, a lowering of SCE frequencies was already evident after 18 days and this became statistically significant after 78 days. SCE decrease was related to the logarithm of the period (in days) for which smoking was interrupted (r = 0.98; p less than 0.001). In a second group of 4 subjects, who at various times resumed smoking, the decrease of SCE followed the same pattern as in the first group during the period of nonsmoking, but SCE frequencies rose even higher once smoking was resumed. Our study indicates that the decrease of SCE in ex-smokers is rather rapid during the first 78 days after stopping smoking, and much slower from the 78th to the 233rd day. PMID- 3657846 TI - An ab initio molecular orbital study on the characteristics of 8-hydroxyguanine. AB - To investigate the mechanism by which the 8-hydroxyguanine residue in DNA affects the fidelity of DNA replication, the intrinsic properties of this modified base were investigated using an ab initio molecular orbital method. The most stable 8 hydroxyguanine form was revealed to be 6,8-diketo. The addition of an oxygen atom to the 8 position of a guanine base was shown to change the electrostatic potential of the molecule entirely and to give it a negative character. This effect may influence the local structure of 8-hydroxyguanine-containing DNA and the interaction with DNA polymerase, thereby resulting in infidelity of DNA replication. PMID- 3657847 TI - Enhanced release of ammonia and hypoxanthine from exercising muscles in patients with idiopathic hypoparathyroidism. AB - Semiischemic forearm exercise tests were carried out in two patients with idiopathic hypoparathyroidism who had muscle cramps and high serum levels of creatine kinase. Although cubital venous lactate levels increased normally after forearm exercise, venous ammonia and hypoxanthine were greatly increased. The abnormal responses of ammonia and hypoxanthine were normalized 3 months after treatment with 1 alpha-hydroxyvitamin D3. These findings suggest that excess purine degradation occurred in exercising muscles of patients with idiopathic hypoparathyroidism. PMID- 3657848 TI - Decreased plasmalogen ratios in cultured skin fibroblasts from myotonic dystrophy. AB - It has become known that hypolipidemic agents, which can induce experimental myotonia in humans and animals, may alter the lipid metabolisms of intracellular organelles, peroxisomes. However, there has been no reported study on peroxisomal lipid metabolisms in myotonic dystrophy showing myotonia as well as experimental myotonia. We investigated one of the peroxisomal lipid metabolisms, i.e., plasmalogen metabolism in cultured skin fibroblasts from myotonic dystrophy, and found plasmalogen ratios to be significantly reduced. PMID- 3657850 TI - Abstracts of free communications: the thirty-fourth annual meeting of the American Association of Electromyography and Electrodiagnosis. San Antonio, Texas, October 16-17, 1987. PMID- 3657849 TI - Membrane defects in paramyotonia congenita (Eulenburg). AB - Membrane potentials, current-voltage relationships, and component conductances were determined in resting excised external intercostal muscle fibers from five patients with paramyotonia congenita. At 37 degrees C all investigated parameters were normal. At 27 degrees C the resting potentials decreased to about -40 mV, and the fibers were inexcitable. At this stage the membrane currents were much larger than in normal fibers owing to increases in the membrane conductances for Na and Cl ions. The earlier finding that in the cold the Na permeability is abnormally large was confirmed. The Cl permeability was shown to be normal even in the cold. The decrease of the resting potential and the changes in the current voltage relationship at 27 degrees C could be prevented by the use of the Na channel blocker tetrodotoxin (TTX) or by bathing the fibers in a Na-free solution. Our previous conclusion that the Cl conductance at 27 degrees C was also increased when TTX was present was not confirmed. Exposure of a muscle bundle to 7 mmol/l potassium did not lead to excessive depolarization and paralysis. PMID- 3657851 TI - AAEE glossary of terms in clinical electromyography. PMID- 3657852 TI - Microsporum gypseum infection in a gray wolf (Canis lupus) and a camel (Camelus bactrianus) in a zoological garden. PMID- 3657853 TI - [Multicenter study of the standardization of sensitivity testing of fungi to 5 fluorocytosine and amphotericin B]. PMID- 3657854 TI - Local hyperthermia in the treatment of sporotrichosis. PMID- 3657855 TI - [The effective epidermal inhibition depth of ciclopiroxolamine and naftifin in relation to a galenic preparation]. PMID- 3657856 TI - Laboratory techniques alternative to in vivo experiments for studying the liberation, penetration and fungicidal action of topical antimycotic agents in the skin, including ciclopiroxolamine. PMID- 3657857 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 42-1987. A 15-year-old boy from the Dominican Republic with a progressive, destructive cutaneous disorder. PMID- 3657858 TI - Genetic diagnosis by DNA analysis: progress through amplification. PMID- 3657859 TI - Calcium supplementation and postmenopausal bone loss. PMID- 3657861 TI - AIDS and renal failure. PMID- 3657860 TI - Long-term survival after advanced neuroblastoma. PMID- 3657862 TI - Benzene and leukemia. PMID- 3657863 TI - The EC-IC bypass study. PMID- 3657864 TI - Funding subspecialty training for clinical investigators. PMID- 3657865 TI - An improved method for prenatal diagnosis of genetic diseases by analysis of amplified DNA sequences. Application to hemophilia A. AB - We report the development of a rapid nonradioactive technique for the genetic prediction of human disease and its diagnostic application to hemophilia A. This method is based on enzymatic amplification of short segments of human genes associated with inherited disorders. A novel feature of the procedure is the use of a heat-stable DNA polymerase, which allows the repeated rounds of DNA synthesis to proceed at 63 degrees C. The high sequence specificity of the amplification reaction at this elevated temperature permits restriction-site polymorphisms, contained in the amplified samples, to be analyzed by visual inspection of their digestion products on polyacrylamide gels. By means of this method, we have performed carrier detection and prenatal diagnosis of hemophilia in two families with use of the factor VIII intragenic polymorphisms identified by the restriction enzymes BclI and XbaI. Predictions can be made directly from chorionic villi, without previous DNA extraction, and fetal sex can be determined by amplification of sequences specific for the Y chromosome. Specific amplification of genomic sequences with heat-stable DNA polymerase is applicable to the diagnosis of a wide variety of inherited disorders. These include diseases diagnosed by restriction-site variation, such as Duchenne's muscular dystrophy and sickle cell anemia, those due to a collection of known mutations, such as beta-thalassemia, and those due to gene deletion, such as alpha-thalassemia. PMID- 3657866 TI - Absence of thrombosis in subjects with heterozygous protein C deficiency. AB - Protein C deficiency has been thought to be associated with an increased risk of venous thrombosis. To establish a normal range of values, we used a two-site monoclonal-antibody assay to measure protein C levels in 699 healthy adults. The distribution was log normal; 95 percent of the values ranged from 70 to 140 percent of the overall mean (4.03 micrograms per milliliter). Two subjects had levels more than 3.5 SD below the mean (34 and 50 percent), consistent with heterozygous deficiency. We also screened 4723 other blood donors and found 8 additional unrelated subjects with levels from 33 to 51 percent of normal. Autosomal inheritance of heterozygous protein C deficiency was confirmed in them by a detailed study of four families. Levels from 55 to 65 percent of normal are consistent with either heterozygous deficiency or the lower end of the distribution of normal values, and were found in 79 of 5422 subjects when the two groups were combined. None of the subjects had any history of venous thrombosis. We conclude that heterozygous deficiency of protein C has a prevalence of 1 in 200 to 300, a figure consistent with the known number of homozygous infants recently identified, and that levels consistent with heterozygous deficiency are found in 1 in 60 healthy adults but are not detectably associated with a risk of thrombosis. PMID- 3657867 TI - Plasma glycocalicin. An aid in the classification of thrombocytopenic disorders. AB - In some patients with thrombocytopenia, it is difficult to determine whether the condition is caused by underproduction of platelets (reduced numbers of megakaryocytes) or an increase in the rate of their destruction (normal or increased numbers of megakaryocytes). A non-invasive test to help distinguish between these two categories of thrombocytopenia would be useful. We related the plasma concentration of glycocalicin, a fragment of the platelet-membrane glycoprotein Ib, to the mechanism of thrombocytopenia by evaluating bone marrow megakaryocyte content and measuring platelet life span. Plasma glycocalicin was measured with a monoclonal antibody to the glycocalicin component of platelet glycoprotein Ib. The mean (+/- SD) plasma concentration of glycocalicin in 34 healthy controls was 87 +/- 20 percent of the level in pooled normal plasma (range, 52 to 127 percent). All of eight patients with aplastic anemia or amegakaryocytic thrombocytopenia confirmed by examining bone marrow (in all patients) and by determining the life span of autologous platelets (in six patients) had glycocalicin levels significantly below the normal range (5 to 27 percent). In contrast, each of 25 patients with thrombocytopenia thought to be caused by a reduction in platelet life span, whose bone marrow contained normal or increased numbers of megakaryocytes, had glycocalicin levels that fell within or above the normal range (48 to 261 percent). There was no overlap of values between the two patient populations. These studies indicate that the measurement of plasma glycocalicin may be a useful adjunct in classifying thrombocytopenic disorders. PMID- 3657868 TI - Intermittent coronary occlusion in acute myocardial infarction. Value of combined thrombolytic and vasodilator therapy. AB - We performed continuous electrocardiographic ST-segment monitoring and serial coronary arteriography in 45 consecutive patients presenting in the early stages of acute myocardial infarction. During cardiac catheterization, 28 episodes of arteriographically confirmed coronary reopening and subsequent reocclusion were observed in 16 patients before (3 episodes) and during (25 episodes) continuous intracoronary infusion of streptokinase. In addition, ST-segment monitoring demonstrated 12 episodes of spontaneous transient return of the ST segment to the base line in eight patients between the time of admission and the performance of coronary arteriography. During arteriographically documented reocclusion, intracoronary isosorbide dinitrate (2 mg) reestablished the patency of the coronary artery within one to two minutes in 14 of 28 episodes that occurred in 11 of 16 patients. After streptokinase infusion, intracoronary administration of isosorbide dinitrate was followed by dilatation of the infarct-related stenosis from a mean value (+/- SD) of 1.12 +/- 0.3 mm (58.1 +/- 12.1 percent) to 1.33 +/- 0.4 mm (51.6 +/- 12.9 percent; P = 0.004). Spontaneous intermittent coronary recanalization and reocclusion resulting from a variable combination of thrombosis and vasoconstriction are frequent during the early phase of acute myocardial infarction. We propose that the combination of intracoronary streptokinase and isosorbide dinitrate may increase the rate of stable coronary recanalization. PMID- 3657869 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1987. A 61-year-old man with abdominal pain and a mass in the right side of the abdomen. PMID- 3657870 TI - Sodium chloride and blood pressure. PMID- 3657871 TI - An end to patchwork reform of health care. PMID- 3657872 TI - The medical clerkship. PMID- 3657873 TI - Adrenal grafts for Parkinson's disease. PMID- 3657874 TI - Human immunodeficiency virus viremia as a prognostic indicator in homosexual men with lymphadenopathy syndrome. PMID- 3657876 TI - Simplified calculation of body-surface area. PMID- 3657875 TI - Menopause and the risk of coronary heart disease in women. PMID- 3657877 TI - Prevention of typhoid fever in Nepal with the Vi capsular polysaccharide of Salmonella typhi. A preliminary report. AB - We conducted a pilot study followed by a large clinical trial in Nepal of the use of the capsular polysaccharide of Salmonella typhi (Vi) as a vaccine to prevent typhoid fever. In the pilot study, involving 274 Nepalese, there were no significant side effects of the Vi vaccine; about 75 percent responded with a rise in serum antibodies of fourfold or more. In the clinical trial, residents of five villages were given intramuscular injections of either Vi or, as a control, pneumococcus vaccine dispensed in coded, randomly arranged, single-dose syringes. There were 6907 participants, of whom 6438 were members of the target population (5 to 44 years of age); each was visited every two days. Those with temperatures of 37.8 degrees C or higher for three consecutive days were examined and asked to give blood for culture. Typhoid was diagnosed as either blood culture-positive or clinically suspected on the basis of bradycardia, splenomegaly, and fever, with a negative blood culture. Seventeen months after vaccination, the codes were broken for the 71 patients meeting the criteria for either culture-positive or clinically suspected typhoid. The attack rate of typhoid was 16.2 per 1000 among the controls and 4.1 per 1000 among those immunized with Vi (P less than 0.00001). The efficacy of Vi was 72 percent in the culture-positive cases, 80 percent in the clinically suspected cases, and 75 percent in the two groups combined. These data provide evidence that Vi antibodies confer protection against typhoid. Surveillance continues to determine the duration of Vi-induced immunity. PMID- 3657878 TI - Primary cutaneous aspergillosis associated with Hickman intravenous catheters. AB - We describe nine patients with underlying hematologic cancer in whom primary cutaneous aspergillosis developed at the sites of Hickman intravenous catheters. Our patients, 17 to 74 years of age, were all immunocompromised either from their primary disease or from chemotherapy, and the Hickman catheters had been placed to provide venous access for chemotherapy or hyperalimentation or both. Clinical signs of infection included erythema, induration, and cutaneous or subcutaneous necrosis at the point of entry into the subclavian vein, in the subcutaneous tunnel, or at the exit site from the skin. Diagnosis was confirmed by positive wound culture for Aspergillus flavus in all but one patient. Treatment consisted of intravenous amphotericin B, oral flucytosine, and local wound care. Three patients recovered completely without operative debridement; three others recovered after operative debridement and delayed grafting. Two patients died of disseminated aspergillosis, and one died of unrelated causes while recovering from primary cutaneous aspergillosis. Successful treatment required resolution of aplasia or leukopenia, catheter removal, systemic treatment with amphotericin B, and local wound care. We conclude that primary cutaneous aspergillosis, a rare infection, may occur at the sites of Hickman catheters in immunocompromised patients, and that it is a serious complication requiring prompt diagnosis and treatment. PMID- 3657879 TI - Respiratory distress syndrome in second-born versus first-born twins. A matched case-control analysis. AB - The well-known increased risk of the respiratory distress syndrome in a twin born second as compared with the twin born first is usually attributed to the second twin's predisposition to depression at birth ("asphyxia"). We analyzed the etiologic roles of birth order, presentation, and depression at birth in the development of the respiratory distress syndrome in matched case-control populations drawn from 221 preterm twin pairs. Among the 39 twin pairs discordant for respiratory distress syndrome, the second twin was the affected member in 31 pairs. Second birth order was the only independent risk factor, but only in vaginal deliveries (matched odds ratio, 14.2; 95 percent confidence interval, 2.5 to 81.1). Second twins delivered abdominally did not have an increased risk relative to first twins (odds ratio, 0.9; confidence interval, 0 to 17.8). When depression at birth was evaluated as an outcome variable, malpresentation, rather than birth order, was the major risk factor (independent matched odds ratios of 2.7 [confidence interval, 1.0 to 7.5] and 1.3 [0.7 to 2.5], respectively). Thus, second twins' increased risk of respiratory distress syndrome cannot be explained by a predisposition to depression at birth; a more important factor may be that second twins do not benefit from the salutary effects of labor to the same extent as first twins. PMID- 3657880 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 44-1987. A 69-year-old man with a right axillary mass. PMID- 3657881 TI - The compromised host as sentinel chicken. PMID- 3657882 TI - Acquired factor X deficiency and amyloidosis treated with melphalan and prednisone. PMID- 3657883 TI - Immunoglobulin-gene rearrangement in benign lymphoepithelial lesions. PMID- 3657884 TI - Safety of placental biopsy in the second and third trimesters. PMID- 3657885 TI - Rapid chromosome analysis and prenatal diagnosis using fluid from cystic hygromas. PMID- 3657886 TI - Journal advertising unrelated to medicine. PMID- 3657887 TI - Apartheid and the academic boycott of South Africa. PMID- 3657888 TI - Hip fracture and the use of estrogens in postmenopausal women. The Framingham Study. AB - To assess the effect of postmenopausal use of estrogens on the subsequent risk of hip fracture, we performed a retrospective cohort study of 2873 women in the Framingham Heart Study. Information obtained at routine biennial examinations about the use of estrogens, body weight, age at menopause, smoking, and alcohol consumption was used to evaluate the risk of hip fracture among postmenopausal women who received estrogens. Hip fractures occurred in 179 postmenopausal women, at a rate that increased exponentially after the age of 50. The risk of fracture was inversely related to weight at all ages. The relative risk of hip fracture in subjects who had taken estrogens at any time was 0.65 after adjustment for age and weight (95 percent confidence interval, 0.44 to 0.98). The adjusted relative risk in women who had taken estrogens within the previous two years was further reduced, to 0.34 (95 percent confidence interval, 0.12 to 0.98). Taking estrogens within four years of menopause also protected against fracture. The number of women in each age group who took estrogens was insufficient for a definitive evaluation of risk, but recent use of estrogens appeared to be protective in women under the age of 65 (no fractures among those who took estrogens) and those 65 to 74. We cannot exclude some degree of selection bias among the women who received estrogen-replacement therapy. Nevertheless, this large cohort study supports the hypothesis that postmenopausal use of estrogens protects against subsequent hip fracture in women. PMID- 3657889 TI - Aspartame and susceptibility to headache. AB - We performed a double-blind crossover trial of challenges with 30 mg of aspartame per kilogram of body weight or placebo in 40 subjects who reported having headaches repeatedly after consuming products containing aspartame. The incidence rate of headache after aspartame (35 percent) was not significantly different from that after placebo (45 percent) (P less than 0.50). No serious reactions were observed, and the incidence of symptoms other than headache following aspartame was also equivalent to that after placebo. No treatment-related effects were detected in vital signs, blood pressure, or plasma concentrations of cortisol, insulin, glucagon, histamine, epinephrine, or norepinephrine. Most of the subjects were well educated and overweight and had a family or personal history of allergic reactions. The subjects who had headaches had lower plasma concentrations of norepinephrine (P less than 0.0002) and epinephrine (P less than 0.02) just before the development of headache. We conclude that in this population, aspartame is no more likely to produce headache than placebo. PMID- 3657890 TI - Molecular analysis of the t(14;18) chromosomal translocation in malignant lymphomas. AB - One of the most common karyotypic abnormalities is the t(14;18) translocation, which is found in many lymphomas that have a characteristic follicular morphology. Recent molecular studies have shown that this chromosomal translocation results in the juxtaposition of the candidate proto-oncogene bcl-2 (B-cell leukemia-lymphoma) on chromosome 18 with the immunoglobulin heavy-chain locus on chromosome 14. However, because performing accurate cytogenetic studies in solid hematolymphoid neoplasms is difficult, knowledge of the prevalence of the t(14;18) translocation and, by association, the extent of bcl-2 involvement in human lymphomas is limited. We used a number of chromosome-18 DNA probes to analyze various subtypes of Hodgkin's and non-Hodgkin's lymphomas and test for structural abnormalities near or within the bcl-2 gene. Molecular features of the t(14;18) translocation were found in virtually all follicular neoplasms and about 28 percent of diffuse large-cell lymphomas. No changes in bcl-2 were found in several other subtypes of Hodgkin's and non-Hodgkin's lymphomas, including those previously suggested to originate from follicular-center cells and those about which cytogenetic data have been difficult to obtain. Our findings suggest a close pathogenetic relation between bcl-2 and a large group of non-Hodgkin's lymphomas, both with and without a follicular morphology. The methods employed in this study may be useful in improving the accuracy of diagnosis and subclassification of malignant lymphomas. PMID- 3657891 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 45-1987. A 16-year-old girl with hepatic and pulmonary masses after a sojourn in Bolivia. PMID- 3657892 TI - The febrile child and occult bacteremia. PMID- 3657893 TI - Medical practice a la mode. How medical fashions determine medical care. PMID- 3657895 TI - Thyroiditis and "chronic infectious mononucleosis". PMID- 3657894 TI - Court-ordered obstetrical interventions. PMID- 3657896 TI - Case 18-1987. PMID- 3657898 TI - Diffusing capacity as a predictor of gas exchange during exercise. PMID- 3657897 TI - Acute nose-blow palsy: a pneumatic variant of sudden facial paralysis. PMID- 3657899 TI - Americans whose forebears were Japanese. PMID- 3657900 TI - Hazards of smokeless tobacco. PMID- 3657901 TI - Keratinophilic fungi from Nigerian soil. AB - During a survey of keratinophilic fungi in Nigerian soil samples, twelve species of fungi were isolated. These included Chrysosporium keratinophilum, C. tropicum, Curvularia lunata, Microsporum audouinii, M. canis, M. fulvum, M. gypseum, M. vanbreuseghemii, Trichophyton ajelloi, T. mentagrophytes, T. soudanense and T. yaoundei. These keratinophilic fungi had a higher incidence by occurrence of individual species during the rainy season (May-October) than the dry season (November-April). PMID- 3657902 TI - Growth curves, morphology and ultrastructure of ten Paracoccidioides brasiliensis isolates. AB - The yeast phase of ten P. brasiliensis isolates were studied to characterize their growth pattern, morphology and ultrastructure. Growth curves were determined after counts of total and viable fungi units (FU) during 20 days. Three growth patterns were observed: slow, reaching approximately 10-30 X 10(6) FU/tube (Pb 18, Pb 265 and PB 2); intermediate, reaching 60-150 X 10(6) FU/tube (IVIC Pb 9, IVIC Pb 267, Pb SN, Pb Vitor and Pb Campo Grande) and fast, reaching 180-370 X 10(6) FU/tube (Pb 2052 and Pb 192). The highest percentage of viable cells occurred on the 6th day of culture for Pb 192, Pb Campo Grande, Pb 2052 and IVIC Pb 9; on the 8th day for Pb Vitor, Pb SN, Pb 18 and IVIC Pb 267; on the 10th day for Pb 265 and on the 12th day of culture for Pb 2. Mean generation times varied from approximately 21.2 (Pb 2052) to 102.6 hours (Pb 265). The isolates showed similar morphology, except IVIC Pb 267 which did not present a typical yeast-phase at 35 degrees C and the two fast-growing isolates (Pb 2052 and Pb 192) that presented smaller cell sizes and less tendency to clump. The ultrastructure of the isolates was similar: the cell walls presented a width of 0.1 to 0.2 mu; the mitochondria presented few cristae and had equivalent patterns of distribution and morphology; the endoplasmic reticulum was scanty, presenting narrow cisternae; the vacuoles, empty or filled with electron-dense material, were numerous and two to five nuclei with pores were constantly observed. PMID- 3657903 TI - Studies on the isolation, growth and maintenance of Malassezia pachydermatis. AB - Results related to the isolation, cultivation, culture and maintenance of the opportunistic pathogen Malassezia pachydermatis are reported. A dextrose nutrient medium with 1.5% yeast extract turned out to be the most favourable medium for its development. It permitted identification in 24 hours and maintenance of isolates for three months without subculturing. Addition of Tween 80 (1%) significantly enhanced the isolation of this yeast from clinical materials. PMID- 3657904 TI - Production of patulin and griseofulvin by a strain of Penicillium griseofulvum in three different media. AB - Production of patulin and griseofulvin by a strain of Penicillium griseofulvum is described. Mycelial dry weight, pH and production of patulin and griseofulvin were assayed in a minimal and a complete medium; patulin or griseofulvin production was assayed in apple juice. PMID- 3657905 TI - Aflatoxins in sunflower seeds: effect of zinc in aflatoxin production by two strains of Aspergillus parasiticus. AB - Growth and aflatoxin production by Aspergillus parasiticus NRRL 2999 and Aspergillus parasiticus RC 12 were studied both in sunflower seed and a synthetic culture medium (with and without zinc enrichment). On a synthetic culture medium the strains behaved in different ways according to the zinc concentration. In sunflower seed medium the influence of zinc was not so evident. Thus the results show that the influence of zinc is not the same for different strains and substrates. PMID- 3657906 TI - Compatibility of Metarhizium anisopliae var. anisopliae with chemical pesticides. AB - The effects of various insecticides on the mycelial growth, sporulation and conidial germination of Metarhizium anisopliae var. anisopliae isolate E9 were studied in the laboratory. Chlorpyrifos was the most toxic organophosphate to mycelial growth and sporulation at all concentrations. Temephos, malathion and leptophos were highly toxic to sporulation while malathion was the most inhibitory to germination. The carbamates, carbofuran, methomyl and oxamyl were moderately toxic to mycelial growth and sporulation while oxamyl had an adverse effect on germination. The pyrethroids (pyrethrin, permethrin and resmethrin) and the insect growth regulators (diflubenzuron and methoprene) were not inhibitory to the various developmental stages of isolate E9. The chlorinated hydrocarbons (chlordane, lindane and toxaphene) were more deleterious than all other insecticide groups tested. Among the fungicides, benomyl and maneb produced the greatest inhibition. PMID- 3657907 TI - The incidence of candidiasis amongst the asymptomatic female students of the University of Jos, Nigeria. AB - A survey was carried out on the incidence of candidiasis amongst the asymptomatic female students of University of Jos. One hundred and three students were selected at guided random. Their first stream urine samples were collected with the aid of sterile McCarthney bottles. The deposits of the centrifuged urine samples were plated out on sabouraud's dextrose agar (SDA) fortified with antibiotics (penicillin G and streptomycin). A total number of 42 positive Candida cases were obtained. This represented 40.78% of the total samples (103) examined. The Candida species isolated included C. albicans, C. glabrata, C. guilliermondi, C. parapsilosis, C. pseudotropicalis, C. stellatoidea, C. tropicalis and C. viswanathii. C. albicans and C. tropicalis were more predominant than the other species. C. albicans had 38.10% frequency of occurrence while C. tropicalis had 21.43% occurrence. The least percentage occurrence was recorded for C. viswanathii which had 2.38%. There were significant relationships between the incidence of candidiasis and the predisposing factors like drug administration (antibiotics and contraceptive pills), cases of pregnancy and previous cases of urinogenital tract infection. Neither the marital status nor the age groups of the test female students had significant effects on the incidence of this disease. The pH values of the infected urine samples had a significant effect on the incidence of the disease. PMID- 3657908 TI - Exoantigens: their value in mycology. PMID- 3657910 TI - Symposium: Status and perspectives in gastro-intestinal microecology. Potsdam, GDR, 24-26 April 1984. Proceedings. PMID- 3657909 TI - In vitro sensitivity of environmental isolates of pathogenic dematiaceous fungi to azole compounds and a phenylpropyl-morpholine derivative. AB - The in vitro sensitivity (minimum inhibitory concentrations; MICs) of 42 environmental isolates of pathogenic dematiaceous fungi to 7 azole compounds, viz. thiabendazole, ketoconazole, miconazole, econazole bifonazole, Bay n 7133, Bay 1 9139 and phenylpropyl-morpholine derivative, Ro14-4767/002 was studied by an agar dilution method using Emmon's Sabouraud dextrose agar (ESDA) as the culture medium. The isolates of Fonsecaea pedrosoi, Cladosporium carrionii, Exophiala jeanselmei and Ramichloridium subulatum were most sensitive to bifonazole with mean MICs of 0.06 microgram/ml or less; Phialophora verrucosa had an MIC of 0.05 microgram/ml to ketoconazole and Ro14-4767/002, respectively. Ochroconis sp had an MIC of 0.025 microgram/ml to Ro14-4767/002 and Cladosporium tennuisimum 0.39 microgram/ml to ketoconazole. Econazole and thiabendazole also showed good antifungal activity. The fungi were relatively resistant to the more recently developed azoles, viz. Bay n 7133 and Bay 1 9139, the later failing to inhibit C. tennuisimum at a concentration of 100 micrograms/ml. The minimum fungicidal concentrations (MFC) of the drugs were mostly within 2 to 8 fold of the MICs. PMID- 3657911 TI - [Gastrointestinal microecology in internal medicine]. AB - Gastrointestinal microecology is a field with highest integrative pretension. Its clinical actuality is reflected in numerous diseases. Colonization anomalies may become relevant particularly in the case of microbial overgrowth-syndrome. Due to recent experimental results, intestinal microbes are gaining a certain importance with respect of the utilization of hard- or non-absorbable carbohydrates. With regard to a further thinking over the conception of selective decontamination gastrointestinal microecology is challenged, too. Hitherto, the various microbial alterations of drugs and contaminants got little consideration. A microbial participation in the genesis of chronic inflammatory intestinal diseases as well as of carcinoma of the colon becomes subject of discussion, increasingly. PMID- 3657912 TI - [Gastrointestinal microecology from the viewpoint of the pediatrician]. AB - Under unfavourable circumstances a weakened resistance status within the newborn period may lead to acute or chronic diseases later on, too. In the early childhood, coli-infections connected to enterotoxin release are the most frequent reason for bacterial diarrhoeas. For some time cases of colitis and salmonellosis are increasing, whereas such of campylobacter enteritis became more seldom. Cases of shigellosis are decreasing. Also Yersinia infections and cases of mycosis can be found rather frequently. The knowledge about rotavirus infection led to a better understanding of many a disease. Anomalies of the intestinal flora should be determined more carefully in order to recognize and to attend acute and chronic diseases as soon as possible. Breast-feeding remains the best prophylaxis in early infancy. PMID- 3657913 TI - [Microecological regulative principles of human gastrointestinal flora]. AB - In the course of coevolution of man and microorganisms the macroorganism must have developed mechanisms which allow a qualitative and quantitative regulation in his microbial colonization. On the several places, microbial growth is limited by various factors. Adherence ability of microorganisms belongs to the special colonization events. An uninhibited colonization begins if regulative factors are omitted. Factors of the host are only partially able to kill the microorganisms. Microbes possess signal receptors managing adaptation to environmental changes. If a strategy of growth and multiplication is not realizable such factors change to a strategy of survival. Very likely, these common microbiological principles are valid to the gastrointestinal tract, too. PMID- 3657914 TI - [Immunoglobulin A and its significance for mucosa immunity--a contribution to the understanding of microbial interactions]. AB - The secretory immunoglobulin A is still dominating with regard to knowledges and further investigations of the causes of mucosal immunity. Origin, formation, structure and mode of action of s-IgA are extensively explored. In the clinical range results of researches on symptoms and consequences of selective IgA deficiency are gaining importance, increasingly. Patients with IgA defect suffer up to 40 times more frequently from allergies and autoimmunopathies. In the induction of the immune response cellular components of mucosa immunity attaining the Lamina propria and the epithelium with the effector cells of Peyer's patches play a particular role. PMID- 3657915 TI - [The defense function of the digestive tract lactoflora]. AB - Lactobacilli can belong to the gut flora or to the flora associating with gastrointestinal epithelial surfaces. They play an important role within the microbial defense mechanisms taking part in the colonization resistance and in the decontamination of the host. Lactobacilli affect the immune response. They accelerate the revival of the small intestinal epithelial cells. Those strains of lactobacilli with distinct antagonistic properties with lysozyme activity and resistance against lysozyme often develop a compact glycocalyx. They are endowed with a high adhesion capacity. The intestinal lactoflora consists of several species with different defense properties. PMID- 3657916 TI - [The microecological effect of human milk]. AB - With mother's milk, in the colon a buffer system round pH 5 is dominating which consists of short chain organic acids and the corresponding anions. Thus, the activity of the microbial metabolism is retarded. The degradation of lactose remains maintained down to the faeces. With cow's milk, a neutral buffer system on the basis of phosphate, bicarbonate, and protein degradation products causes a rapid lactose degradation already in the upper colon. Putrefactive metabolites thereby released and absorbed burden the infant's still immature detoxifying capacity. PMID- 3657917 TI - Effect of fructo-oligosaccharides on intestinal microflora. AB - Fructo-oligosaccharides are widely distributed in plants such as onions, asparagus, wheat etc., and obtained from sucrose by the action of fructosyltransferase. They are not hydrolyzed by human digestive enzymes, but are utilized by intestinal bacteria such as bifidobacteria. Bacteroides fragilis group, peptostreptococci and klebsiellae. In the experiment with 23 patients (73 +/- 9 years old), improvement of fecal microflora was observed by oral administration of fructo-oligosaccharides 8 g per day for two weeks: the population of bifidobacteria in feces increased about 10 times compared before the administration; average pH of stool showed 0.3 lower than that before administration. PMID- 3657918 TI - [Ballast matter from a microecological viewpoint]. AB - In a traditional sense, ballast matter means food constituents not attacked by digestion enzymes of macro-organism. Thus, they get to the hind-gut chemically unchanged. There they can be metabolised by microbes. Intestinal bacteria also utilize substances that are usually digestible and have escaped digestion within the small intestine, for various reasons. Such substances reveal the same effects as undigestible "classic" ballast matter. Therefore, from microecological physiological aspects it is suggested to expand the term ballast matter by so called "optional" or "potential" ballast matter (in the small intestine usually digestible but incompletely degraded nutriments) in addition to "obligatory" ballast matter (nutriments not digestible by indigene enzymes). In experiments with rats, microecological effects caused by the "optimal" ballast matter lactose are evidenced. PMID- 3657919 TI - Stress and intestinal microflora. AB - In this overview the actual international knowledge regarding phenomenons and their proven or speculated mechanisms of adaptative microecological, hormonal and immunological responses to neuroemotional stress conditions including space flights is represented. In most cases a decreased stability of the intestinal microflora provokes further reactions of the body. The necessity to predict the various possible disorders and to find optimal measures for their prophylaxis and elimination is emphasized. PMID- 3657920 TI - Interrelations between mucosal and luminal microflora of gastrointestine. AB - The quantitative relations of various groups of microbes, the biological properties of lactobacilli in the luminal and mucosal microfloras of the gastrointestine of rats after having received kanamycin and after starvation, of conventional and germfree mice after irradiation and of piglets of different ages were compared. It was revealed that there exists a positive correlation between the mucosal and the lumenal microfloras which remains considerably stable under different conditions. Nevertheless, in case of irradiation or starvation influencing the gastrointestine microflora, the mucosal microflora gets more changed and the translocation of microbes through the mucosa into blood circulation takes place. The mucosal lactoflora of piglets is formed during the first (1-5) days of life on account of microbes with well-expressed antagonistic activity and lysozyme resistance. PMID- 3657921 TI - Microecology and local immune and nonspecific defensive proteins depending on different nutrition. AB - Breast-feeding is of high importance for the development of intestinal eubiosis. Before beginning with breast-feeding the coprofiltrates of newborns lack of IgA. Following the first feeding IgA concentration in the faeces sharply increases (up to 200 mg/100 g faeces). Comparable high values can be found in the coprofiltrates of breast-fed sick prematures. In the coprofiltrates of artificially fed healthy newborns and sick prematures no IgA is provable, within the first two weeks of age. Afterwards both the frequency of its evidence and its concentration gradually rise. This can be regarded as a sign of an increasing local production of immune proteins. Starting with the second year of life, only, the values of all the immunoglobulins fall again. It happens a microbial degradation. Increased concentrations of immunoglobulins in the coprofiltrates of children over 3 years must be evaluated as a sign of subclinical dysbacteriosis. PMID- 3657922 TI - [Importance of stable gastrointestinal microflora in growing animals]. AB - A zysbiosis can be caused by food constituents. Food portions with 40% rye for chickens release a destabilisation of the gut flora. This can be prevented by effective stabilizers. Early weaned piglets harbour high numbers of E. coli in their ileum and jejunum content. These become decreased by about three tens powers by affective gut flora stabilizers. Simultaneously the body mass rises considerably without an increase of the food consumption with reference to the living mass. Partially, the ergotropic effect of the gut flora stabilizers is attributed to the smaller expense for the immune defence. Therefore, a new hypothesis for the growth stimulating effect of ergotropics for early weaned piglets is created. PMID- 3657923 TI - [Effect of metronidazole on the gastrointestinal flora of swine]. AB - In veterinary medicine since the beginning of the seventieth several derivatives of imidazole are mainly and successfully used for therapy of pig dysentery. Daily metronidazole doses of 25-100 mg/kg body mass resulted in no provable effect on the normal quantitative composition of the germ flora of healthy porkers. Even in such high doses of 100 mg/kg body mass per day that substance revealed well tolerant. A singular occurrence of colienterotoxemia was disconnected with the metronidazole application. PMID- 3657924 TI - Output of bacterial metabolites as a diagnostic means. AB - Output of bacterial metabolites reflects not only the number but the metabolic activity of certain microorganisms. In case of excess of a substrate one can observe the increased output of metabolite(s) without the overgrowth of intestinal bacteria. This matter is used for detection of malabsorption of some carbohydrates (lactose, glucose) by increased excretion of hydrogen in expired air. Another group of so-called breath tests (14C-cholylglycine, 14C-xylose) is designed to detect the bacterial overgrowth in the small intestine by measuring the rise of the concentration of 14CO2 in alveolar air. All the tests basing on the decomposition of the test substance by intestinal bacteria, have some limitations. Little is known about the microorganisms decomposing the different test substances. Significant correlations between the urinary phenols (p-cresol, phenol) and certain groups of mucosal flora (staphylococci, bacteroides) of the small intestine of rats could be found. Therefore one suggests that elucidating the origin of a bacterial metabolite is still possible in some instances, although very complicated. In conclusion, the authors refer to several reasons for failure to obtain correlations between the output of the metabolite(s) and data of bacteriological investigation. PMID- 3657925 TI - [Continuous flow cultures for simulation of intestinal biocenosis]. PMID- 3657926 TI - [Scanning electron microscopy of microbes and their mechanism of attachment to human small intestinal mucosa]. AB - In connection with the electron-microscopy of bioptic material from the upper small intestine of children with intestinal diseases and diarrhea (10 months to 8 years) we found some cases of fungus infection (26%) besides many cases of bacterial attachment to the intestinal epithelium (72%). On the intestinal wall normal yeasts, pseudomycelium and common mycelium are visible. Partly the epithelium was entirely covered with mycelium. In some cases the hyphae invaded in the intestinal wall. The epithelium and the villi are not or only slightly altered. This gives the reason to believe that the fungi participate in inducing diarrhea. After medicamentous treatment with nystatine-preparations in some cases the health state of these children was improved. PMID- 3657927 TI - [A mathematical description of microecologic correlations]. AB - Due to the diversity of microbiological interrelations results of animal experiments concerning the effect of nutrition factors on the microecological system in the intestinal tract are often difficulty to interpret. In order to reveal deeper correlations multivariate statistical methods particularly the non linear multiple regression analysis are tried to use. First results show that correlations between nutrition factors and microecological signs of the colon content can be depict by quadratic polynoms, whereas for biochemical signs also a linear dependence appears possible. PMID- 3657928 TI - Colonization resistance of the digestive tract--mechanism and clinical consequences. AB - Potentially pathogenic bacteria and yeasts meet a number of resistance factors. These colonization resistance (CR) determining factors control the growth density of potentially pathogenic microorganisms in the various parts of the alimentary canal. The CR of the digestive tract is to be seen partially of host origin but to a greater extent due to direct and indirect activity of the (anaerobic) indigenous microflora. This implies that the CR mechanism is vulnerable to antibiotics which affect the indigenous flora during treatment. A decreased CR enhances colonization by microorganisms that are resistant to the antibiotic(s) used for therapy. Increased population densities of potentially pathogenic bacteria ("overgrowth") may correlate with invasion of the mucosal tissues often followed by translocation to remote lymphatic organs. Overgrowth also may correlate with development or acquisition of resistance to the antibiotic applied. By screening in experimental animals antibiotics have been selected which do not affect the CR. Such antimicrobial drugs have successfully been used to selectively eliminate potentially pathogenic bacteria and yeast in neutropenic patients. PMID- 3657929 TI - [Significance of clinically used gnotobiotechnics in the prophylaxis and during therapy of granulocytopenic infections]. AB - Besides a literature survey own results by using the method of selective decontamination in the induction attendance of patients suffering from acute leucaemia are represented. These patients had an extreme infection disposition. The infection rate, the fever days, and the amount of systemic prescribed antibiotics could be decreased statistically significant. The results of selective decontamination, of granulocytes transfusion, and of isolation of patients in the life island achieved in our clinic are confronted. The selective decontamination is of central importance for prophylaxis in the same way as in the attendance of hospital infected defense diminished patients. Additionally, in the case of infections combinations of bactericidic antibiotics are indicated. On the other hand, granulocytes transfusion are not necessary. The effectivity of selective decontamination of the gastrointestinal tract underlines the significance of gnotobiotic methods within clinical practice. PMID- 3657930 TI - [Correlations between germ content and tumor incidence in laboratory animals]. AB - SPF-Status and hysterectomy is of high importance with respect of the spectrum of spontaneous tumours in mice. Obviously, the germ content of the gastrointestinal tract plays a decisive role in the inducibility of tumours in certain organs caused by chemical noxes. The specific changes of susceptibility are presented and its possible reasons are discussed. PMID- 3657931 TI - Nitrate-reducing microorganisms in the gastric juice of patients with stomach cancer--experimental data and considerations upon the role of these microorganisms in gastrocarcinogenesis. AB - During recent years evidence has been accumulated supporting the hypothesis according to which nitroso compounds are involved in the generation of stomach cancer in humans. The present report deals with the occurrence and content of nitrite, nitrate and nitrosamines in the gastric juice of stomach cancer patients with special reference to nitrate-reducing microorganisms. Microorganisms were found to be present in gastric juice in all cases of cancer, mean total count being (5.6 +/- 2.4) log/ml (mean +/- standard deviation) and with limit values 1.4-8.0 log/ml. Nitrate-reducing microorganisms were found in 9 cases from 10. Their mean counts were (5.2 +/- 2.5) log/ml and limit values less than 0.5-8.0 log/ml. The role of nitrate-reducing microorganisms in the formation of nitrite and carcinogenic nitroso compounds is discussed. Some practical measures to control the count of nitrate-reducing microorganisms in stomach are presented. PMID- 3657932 TI - Role of microorganisms in improving nutritional status of the poor. AB - The intestinal microflora as well as bacteria involved in fermentation of foods ordinarily consumed in India may contribute substantially for the improvement of nutritional status of poor Indians. PMID- 3657933 TI - Proteus dysbioses in patients with ulcerative colitis. AB - In patients with ulcerative colitis Proteus could be isolated from all the gastrointestinal portions studied: mouth cavity, stomach, small intestine, small intestinal mucous membrane, and mostly from faeces. In some patients with ulcerative colitis a decrease in membraneous hydrolysis of polysaccharides was noted. Severe Proteus dysbiosis was associated with a sharp decrease in absorption processes at the small intestinal mucous membrane. The Proteus strains obtained from the patients belonged mostly to 3 serogroups: OA, OB, OC. Studies in virulent properties of Proteus in experiments with white mice gave positive results in 96% cases. Enterotoxin could be found in no case. As the result of vaccinal therapy in most patients disappearance or decrease of signs of malabsorption, increase in weight, stool normalization, and better hematological indices was manifested. PMID- 3657934 TI - Problems of space gastroenterology and microenvironment. AB - Numerous studies have revealed changes in gastrointestinal secretion, motility, evacuation, and absorption in humans and animals after actual space missions and under hypokinesia of various duration as well. It is found that short-term space missions produce transient changes in the activity of digestive enzymes, instability of bifido- and lactoflora peculiar to stress reaction, and an enhanced evacuation of the stomach. Extended space missions result in more pronounced but transient changes which characterize mainly two states: development of a hypersecretory syndrome of the stomach and decrease in the functional capacity of the pancreas. As a rule, the changes of membranous enzymes are of compensatory-and-adaptive character. Concurrent with this, there occur disbiotic changes of various degree in the intestinal microflora. PMID- 3657935 TI - [Effect of Manasan on fecal pH, fecal microflora and acid-base homeostasis in young infants]. AB - Manasan is an adapted formula for infants on the basis of cow's milk simulating the mode of action of human milk on faeces-pH and faeces microflora. In two temporally separated tests the effect of Manasan-feeding on faeces-pH, faeces flora, and acid-base-homeostasis was controlled and compared with the effect of human milk and Ki-Na-formula. With Manasan fed up from birth or following breast feeding faeces-pH was to be found in an acid range, clearly. With Ki-Na the faeces-pH was situated in the neutral range. With Manasan the bacteria flora revealed a noteworthy decrease in the number of Bacteroides germs achieving a non putrefactive milieu. Concerning the acid-base-homeostasis as with human milk so with Manasan late metabolic acidosis were to meet rarely. The experiments revealed that in important parameters, particularly with microecological signs, Manasan is comparable with human milk. PMID- 3657936 TI - [15N-tracer kinetic studies on the utilization of urea in protein metabolism of infants]. AB - The virtual importance of the urea circuit is not clear. After a 3 to 21 day application of 100 mg [15N]-urea/l in 15 infants a [15N]-excess value of 0.06 in serum protein could be proven. Taking as a basis a protein content of 11.4% of the body mass and a regular distribution of the [15N] within the body one can calculate a retention of the urea nitrogen in the protein pool of 40.4% of the intake. Taking in account an amount of 11.4% urea nitrogen from the total nitrogen in mother's milk then the amount of urea nitrogen from the net protein accumulation comes to 6.5 (3.1-11.8)%. PMID- 3657937 TI - [Microflora in a controlled caries model study in rats]. AB - Changes of dental plaque were investigated in Osborne-Mendel-rats under the influence of a sucrose-containing diet as well as the inhibition of it by antibiotics (streptomycin, erythromycin, penicillin) in order to find out the optimal conditions of animal association with Str. mutans (OMZ 176). The cariogenic diet did not alter the isolated total germ numbers, but modified the flora to a streptococcal one. The application of an erythromycin/penicillin mixture caused a 100 fold decrease of the germ number and streptococcal elimination so that an association of the germ Str. mutans detectable by microbiological methods could take place at this moment. The obtained caries scores differed from the non-contaminated group. Mono-associated gnotobiotic Wistar rats developed more carious lesions than conventional animals of the same strain; therefore Str. mutans OMZ 176 was classified as high cariogenic. PMID- 3657938 TI - Gnotobiotes in nutritional studies. AB - Studies with gnotobiotic animals have demonstrated extensive synthesis of vitamins, involvement in the metabolism of nitrogenous compounds and modification of lipids among the activities of the conventional microflora. The extent to which they affect the host depends on factors such as the structure of the gut, the position of the sites of bacterial proliferation and the host's nutritional status. Thus the findings in experimental animals may not always be applicable to man. Results so far indicate that in circumstances of dietary inadequacy bacterial activity may be detrimental or beneficial. However, these effects are small, and it seems reasonable to conclude that the influence of the indigenous microflora on the host's nutrition is of relatively minor importance compared with its role as a barrier against invasion by undesirable organisms. PMID- 3657939 TI - The use of gnotobiological models for the studies of immune mechanisms. AB - Germfree (GF) animals are widely used for discrimination of natural mechanisms (genetically determined) from adaptive mechanisms of immunity induced by external antigens. GF rats fed at least for first 5 days after birth with artificial diet LNa, deficient in unsaturated fatty acids, were in contrast to those fed with K 50 diet deeply suppressed in humoral and cellular immune reactivities during their life. GF piglets, deprived from maternal colostrum (CF) as a source of passively transferred maternal antibody, immunized with preformed Ag/Ab complexes (HSA anti HSA) responded according to the composition of complexes (Ab excess, equivalence, Ag excess) by low or high dose tolerance or by secondary response. Similar pictures of response were obtained in groups of presensitized GF-CF piglets by immunization with different doses of antigen. It is concluded that 3 different types of response are the result of Ag/Ab complexes acting or formed on the lymphocyte membrane and exerting stimulatory or down-regulatory signals. PMID- 3657940 TI - Gnotobiological research of the host-microflora interaction. AB - The last two decades indicate that one of the main features of modern gnotobiology are comparative experiments on germfree and conventional counterparts to study the significance of normal (or dysbiotic) microflora (or individual species) in various physiological and pathological processes of the host organism. There are some immunological consequences of absence of normal microflora. Interactions between some indigenous and pathogenic bacteria in the intestine of gnotobiotic and conventional rats are discussed. PMID- 3657941 TI - Germ-free newborn baby. AB - Long term experience with germ-free animal experiments and technology encouraged us to apply the know-how in the field of the care of human neonates with presumed immunodeficiency. The program was carried out at the Faculty of Pediatrics of Charles University in Prague. The sterile caesarean section was performed within the plastic surgical isolator overlying the pregnant mother. A new type of this isolator adapted for the use in human medicine was designed and constructed. For the care of the neonate another special isolator was used. The whole isolator system included two rigid supply isolators, too. The newborn was sterile up to the age of 1 month. During this time, the newborns immunological capacity was investigated and found to be almost normal. Afterwards, the infant was gradually colonized with selected strains of bacteria and thus prepared for conventionalization. PMID- 3657942 TI - Lead and cadmium content in cocoa beans (short communication). AB - The choice of cocoa beans as the experimental and sample material for study of the contamination with lead and cadmium was inspired by high Pb and Cd limits in foods made on its basis (cocoa powder, chocolate) as well as by the relatively high proportion of these foods in human nutrition. For Cd, the limits in food products are within the range of 0.01 mg X kg-1 (milk) to 1.0 mg X kg-1 (kidneys) whereas the limits for lead range between 0.1 mg X kg-1 (e.g. milk) and 10.0 mg X kg-1 (e.g. tea, yeast, crustaceans, molluscs). Limits for Pb and Cd in foods made on cocoa bean basis are given in Table 1. PMID- 3657943 TI - Terrorist bombs and the emergency department nurse. PMID- 3657944 TI - [Disaster planning and civil defense]. PMID- 3657945 TI - [Nurses--direct victims of disasters?]. PMID- 3657946 TI - Disaster planning for a provincial hospital. PMID- 3657947 TI - Objective: social continence. Training the pelvic floor. PMID- 3657948 TI - [The Omega experience]. PMID- 3657949 TI - Wound complications. PMID- 3657950 TI - Psychological effects of disasters and guidelines for their management. PMID- 3657951 TI - Consent in practice--a nurse's view. PMID- 3657952 TI - [Job description. 2]. PMID- 3657953 TI - The management of patients with head injuries. PMID- 3657954 TI - Disaster preparedness and the nurse. PMID- 3657955 TI - Getting to grips with fraud. PMID- 3657956 TI - Genentech lose Protropin case. PMID- 3657957 TI - Human embryo. PMID- 3657958 TI - Hungary as neurosciences audit. PMID- 3657959 TI - Function of a new globin gene. PMID- 3657960 TI - Endstopped neurons in the visual cortex as a substrate for calculating curvature. AB - Neurons in the visual cortex typically respond selectively to the orientation, and velocity and direction of movement, of moving-bar stimuli. These responses are generally thought to provide information about the orientation and position of lines and edges in the visual field. Some cells are also endstopped, that is selective for bars of specific lengths. Hubel and Wiesel first observed that endstopped hypercomplex cells could respond to curved stimuli and suggested they might be involved in detection of curvature, but the exact relationship between endstopping and curvature has never been determined. We present here a mathematical model relating endstopping to curvature in which the difference in response of two simple cells gives rise to endstopping and varies in proportion to curvature. We also provide physiological evidence that endstopped cells in area 17 of the cat visual cortex are selective for curvature, whereas non endstopped cells are not, and that some are selective for the sign of curvature. The prevailing view of edge and curve determination is that orientations are selected locally by the class of simple cortical cells and then integrated to form global curves. We have developed a computational theory of orientation selection which shows that measurements of orientation obtained by simple cells are not sufficient because there will be strong, incorrect responses from cells whose receptive fields (RFs) span distinct curves (Fig. 1). If estimates of curvature are available, however, these inappropriate responses can be eliminated. Curvature provides the key to structuring the network that underlies our theory and distinguishes it from previous lateral inhibition schemes. PMID- 3657961 TI - The 5S gene internal control region is B-form both free in solution and in a complex with TFIIIA. AB - Rhodes and Klug have recently proposed that the internal control region of the Xenopus 5S RNA gene adopts an A-type DNA structure in solution. This suggestion was based on a Fourier analysis of both the spacing of DNase I cutting sites and on the distribution of G residues in the DNA sequence. Both revealed a approximately 5.6-5.7-base periodicity which the authors interpreted as a structural repeat every half helical turn of A-type DNA. This contention was strengthened by the finding that a 9-base-pair (bp) double-stranded deoxyoligonucleotide corresponding to residues +81 to +89 of the 5S gene exhibits an A' RNA-like crystal structure. This region of DNA is of special interest as it forms the binding site for the 5S gene-specific transcription factor IIIA (TFIIIA). TFIIIA is a Zn2+-binding protein which interacts with both the internal control region of the gene and the 5S transcript. As base-paired regions of RNA are of the A type, it was reasonable to postulate that 5S DNA might also adopt this conformation. We report here that the circular dichroism (CD) spectrum of a synthetic 54-bp deoxyoligonucleotide corresponding to the TFIIIA binding site is similar to the CD spectrum of B-form DNA in solution. Further, DNA-TFIIIA complexes show an unaltered DNA CD component indicating no gross alteration in DNA structure on protein binding. PMID- 3657962 TI - Can the product of the theta gene be a real globin? AB - A new member (theta 1, or psi alpha) of the alpha-globin gene family has recently been identified in a number of species. In higher primates the theta 1 gene has all the structural features apparently necessary for expression, and it appears to have long been under strong selective constraints which suggests that it could still be, or recently have been, a functional gene. No corresponding 'globin' has yet been identified, however. In some other species, galago and rabbit for example, the theta 1 and psi alpha genes have accumulated enough inactivating mutations for them to be considered genuine pseudogenes. Horses also have an alpha-like gene (psi alpha), in a 3' position identical to the other species in relation to the functional alpha genes, and this also appears to have the elements required for a functional gene. The predicted amino-acid sequence, however, suggests that any 'globin' product is likely to be non-viable because it has a number of seriously deleterious amino-acid replacements. Some of these amino-acid changes are shared with the rabbit and primate sequences, indicating that they predate the mammalian radiation, and that if indeed any of these genes are still functional, they are unlikely to be making haemoglobin. PMID- 3657963 TI - What medium for the message? PMID- 3657964 TI - IVF rules under pressure to change. PMID- 3657965 TI - French suspect information on radiation levels. PMID- 3657966 TI - California decides to speed up testing of new AIDS drugs. PMID- 3657968 TI - Clinical research on the move. PMID- 3657967 TI - Stanford animal-research facility expansion hit by local protests. PMID- 3657969 TI - But whose genome? PMID- 3657970 TI - Germ of an idea. PMID- 3657971 TI - Causes of death before birth. PMID- 3657972 TI - Antimicrobial peptides. PMID- 3657973 TI - Processing or inactivation of antimicrobial peptides. PMID- 3657974 TI - Cancer near nuclear installations. AB - The OPCS report on cancer incidence and mortality in the vicinity of nuclear installations in England and Wales provides a mass of information that is so large that it should be possible to detect quite small changes in disease levels with considerable confidence. The data on cancer mortality are less subject to selective bias than the registration data on which incidence rates are based, and they provide the firmest grounds on which evidence of any effect can be obtained. These data show conclusively that there has been no general increase in cancer mortality in the vicinity of nuclear installations in a 22-year period beginning several years after the opening of the installations that have released the largest amounts of radionuclides to the environment. On the contrary, the mortality from cancer has tended to be lower in the LAAs in the vicinity of nuclear installations than in control LAAs selected for their presumed comparability with the former. This is unlikely to be due to a protective effect of ionizing radiation and suggests that, despite the efforts that were made to choose comparable control areas, there were non-installation differences between the populations relevant to the risk of dying from one or other type of cancer. Detailed examination of the few types of cancer that were relatively more common in the installation areas suggest that several of the differences were most likely to be due to chance, diagnostic artefacts or social factors rather than to any hazard specifically related to the installations. One disease provides a possible exception: namely, leukaemia in the age group 0-24 years. Two other diseases need further investigation, multiple myeloma and Hodgkin's disease in the older age group 25-74 years. The excess mortality rates recorded from these cancers were not large, and it has yet to be established that they are not due to general confounding by other environmental or socio-economic factors. PMID- 3657975 TI - Evidence for a genetic aetiology in reading disability of twins. AB - Reading disability (dyslexia) is a major social, educational, and mental health problem. Although estimates of prevalence vary, up to 10-15% of school-age children have severe reading deficits in spite of average intelligence and adequate educational opportunity. That reading disability may have a constitutional basis has long been recognized, and results of twin and family studies suggest that one or more of its forms may be heritable; however, definitive evidence for a genetic aetiology has not been reported. Establishing a heritable basis for reading disability could suggest possible causes, give improved risk estimates, facilitate early diagnosis, and provide validity tests for ostensible subtypes. In this report, we apply a recently developed multiple regression analysis to data collected from a sample of 64 pairs of identical twins and 55 pairs of fraternal twins, in which at least one member of the pairs is reading disabled, and present evidence for a significant genetic aetiology. PMID- 3657976 TI - The gene for theta-globin is transcribed in human fetal erythroid tissues. AB - A new gene like the alpha-globin gene has been identified in higher primates at the 3' end of the alpha-globin gene cluster. There is some controversy as to whether this gene, theta, is a functional globin gene or a non-functional pseudogene. The high degree of sequence conservation displayed by theta between primates and various mammals, such as horse and rabbit, suggests that this gene is functional in some species. Furthermore, theta encodes a 141-amino-acid polypeptide in sequence similar to alpha-globin and appears to possess functional RNA-processing signals. But the promoter region of theta is unlike the other globin genes because its CCAAT and ATA box sequences are displaced from the coding sequence by the insertion of a 200-base-pair GC-rich sequence. We demonstrate here the presence of theta-globin messenger RNA in human fetal erythroid tissue, but not in adult erythroid or other non-erythroid tissues. Furthermore, theta-globin mRNA is detectable in significant amounts in a human erythroleukaemic cell line. These results predict that theta-globin protein will be found in the early stages of human fetal development. Surprisingly, the promoter sequence of theta-globin does not correspond to the CCAAT and ATA box sequences of the gene but rather lies within the adjacent GC-rich sequence, resulting in a heterogeneous series of mRNA 5' ends 50-10 base pairs to 5' of the initiation codon. This type of promoter is reminiscent of that found in housekeeping genes such as adenine deaminase and hypoxanthine-guanine phosphoribosyl-transferase. PMID- 3657977 TI - Stabilization of charges on isolated ionic groups sequestered in proteins by polarized peptide units. AB - Electrostatic interactions are of considerable importance in protein structure and function, and in a variety of cellular and biochemical processes. Here we report three similar findings from highly refined atomic structures of periplasmic binding proteins. Hydrogen bonds, acting primarily through backbone peptide units, are mainly responsible for the involvement of the positively charged arginine 151 residue in the ligand site of the arabinose-binding protein, for the association between teh sulphate-binding protein and the completely buried sulphate dianion, and for the formation of the complex of the leucine/isoleucine/valine-binding protein with the leucine zwitterion. We propose a general mechanism in which the isolated charges on the various buried, desolvated ionic groups are stabilized by the polarized peptide units. This mechanism also has broad application to processes requiring binding of uncompensated ions and charged ligands and stabilization of enzyme reaction charged intermediates, as well as activation of catalytic residues. PMID- 3657978 TI - President's new AIDS commission in turmoil. PMID- 3657979 TI - AIDS virus infects another lab worker. PMID- 3657980 TI - Training of operators needed for nuclear power station safety. PMID- 3657981 TI - Pasteur Institute celebrates centenary--and so do NIH. PMID- 3657982 TI - Hughes Institute gives US science education a boost. PMID- 3657983 TI - West German ructions over US surrogacy company. PMID- 3657985 TI - Vascular system of the giraffe. PMID- 3657984 TI - Polymorphic regulation of membrane lipid composition. PMID- 3657986 TI - How many Chernobyl fatalities? PMID- 3657987 TI - The retinoblastoma susceptibility gene encodes a nuclear phosphoprotein associated with DNA binding activity. AB - The human gene (RB) that determines susceptibility to hereditary retinoblastoma has been identified recently by molecular genetic techniques. Previous results indicate that complete inactivation of the RB gene is required for tumour formation. As a 'cancer suppressor' gene, RB thus functions in a manner opposite to that of most other oncogenes. Sequence analysis of RB complementary DNA clones demonstrated a long open reading frame encoding a hypothetical protein with features suggestive of a DNA-binding function. To further substantiate and identify the RB protein, we have prepared rabbit antisera against a trypE-RB fusion protein. The purified anti-RB IgG immunoprecipitates a protein doublet with apparent relative molecular mass (Mr) of 110,000-114,000. The specific protein(s) are present in all cell lines expressing normal RB mRNA, but are not detected in five retinoblastoma cell lines examined. The RB protein can be metabolically labelled with 32P-phosphoric acid, indicating that it is a phosphoprotein. Biochemical fractionation and immunofluorescence studies demonstrate that the majority of the protein is located within the nucleus. Furthermore, the protein can be retained by and eluted from DNA-cellulose columns, suggesting that it is associated with DNA binding activity. Taken together, these results imply that the RB gene product may function in regulating other genes within the cell. PMID- 3657988 TI - Chromosomal localization of the human rhabdomyosarcoma locus by mitotic recombination mapping. AB - A genetic description of the human genome requires maps of three types. The first shows the frequency of chromosomal interchange during meiosis, relying on many equally spaced markers, and is limited to interchanges that do not unmask defects lethal to the conceptus, whose every cell will contain such abnormalities. The second is the physical description of genomic regions defined by karyotypic rearrangements, DNA segments, genes, or their products. A third description of somatic chromosomal interchanges at mitosis is also required. Because mitotic exchanges occur in a single postembryonic somatic progenitor cell, lethal effects on the organism are reduced. These events have been important in genetic mapping in Drosophila melanogaster and fungi, but they have rarely been detected in mammals. Here we report a significant frequency of mitotic recombination in human tumours and the first application of this information in localizing their predisposing locus. PMID- 3657989 TI - [Why two eyes?]. AB - Having two eyes instead of just one is advantageous in at least six respects: the danger of blindness is decreased, the visual field is enlarged, stereoscopic depth perception is possible on the basis of binocular disparities, the position of the eyes relative to the head can be computed from the images of both eyes, visual obstacles in front of the horopter perceptually shrink, and the signal-to noise ratio is increased. PMID- 3657990 TI - The phorbolester TPA dramatically accelerates oligodendroglial process regeneration. PMID- 3657991 TI - Bud-like structures of mycoplasma-like organisms (MLO) demonstrated by freeze fracturing. PMID- 3657992 TI - On Capitol Hill with Edward H. Kennedy. Interview by Hurdis Griffith. PMID- 3657993 TI - The Robert Wood Johnson Health Policy Fellowship: a rewarding experience. PMID- 3657994 TI - A reexamination of uncompensated hospital care. PMID- 3657995 TI - Reimbursement for nursing services revisited. PMID- 3657996 TI - Automated information systems in quality assurance. PMID- 3657997 TI - [Frey's syndrome]. PMID- 3657998 TI - [Risk of sterilization using ethylene oxide]. PMID- 3657999 TI - [Early diagnosis of psychiatric disorders in children]. PMID- 3658000 TI - [Phlebography in deep venous thrombosis; indications and method]. PMID- 3658001 TI - [The role of external version in current obstetrics]. PMID- 3658002 TI - [Surgical treatment of acute appendicitis in elderly patients]. PMID- 3658003 TI - [Appendicitis; appendectomies]. PMID- 3658004 TI - [Antidiarrheal agents]. PMID- 3658005 TI - [Oral or vaginal yoghurt? The effect of yoghurt in the treatment of vaginal candidiasis]. PMID- 3658006 TI - [The terminally ill patient as seen through the eyes of a clinician]. PMID- 3658007 TI - [Blood sugar-lowering agents]. PMID- 3658008 TI - [Wegener's disease]. PMID- 3658009 TI - [Anthelmintics]. PMID- 3658010 TI - [Hearing during anesthesia]. PMID- 3658011 TI - [Vasculitis: a spectrum of divergent disease aspects with a common immunopathogenesis?]. PMID- 3658012 TI - [Analysis of symptoms preceding the diagnosis of Wegener's disease]. PMID- 3658013 TI - [Kidney injury and hypertension]. PMID- 3658014 TI - [The prognostic significance of alkaline and acid phosphatase levels in the hormonal treatment of patients with prostatic carcinoma]. PMID- 3658015 TI - [Age-specific decrease in mortality in cervix carcinoma]. PMID- 3658016 TI - [The significance of selenium in nutrition]. PMID- 3658017 TI - [2d-generation antidepressive agents]. PMID- 3658018 TI - [The acute scrotum in children]. PMID- 3658020 TI - [The role of plasmapheresis in the treatment of neuro-immunologic disorders]. PMID- 3658019 TI - [Quinolones]. PMID- 3658021 TI - [Minor complaints in family medicine: hordeolum]. PMID- 3658022 TI - [Hyponatremia caused by psychogenic polydipsia: a severe pathological condition]. PMID- 3658023 TI - [The kangaroo method]. PMID- 3658024 TI - [Early results of the Souter-Strathclyde total elbow prosthesis in patients with rheumatoid arthritis]. PMID- 3658025 TI - [Promotion of lactation by pharmacologic agents]. PMID- 3658026 TI - [Prevalence, case finding and treatment of hypertension in Lelystad (1982-1984); is the 'rule of halves' still applicable?]. PMID- 3658027 TI - [Prospective study of risk factors in cerebrovascular accidents in women]. PMID- 3658028 TI - [Euthanasia; comparison of the current discussion in The Netherlands with discussion in Germany prior to 1933]. PMID- 3658029 TI - Electroconvulsive therapy: a survey of use in Nebraska. PMID- 3658030 TI - Coagulase-negative staphylococcal bacteremia in neonates. PMID- 3658031 TI - Cough induced avulsion of the lesser trochanter. PMID- 3658032 TI - Bumming it over Christmas. PMID- 3658033 TI - Teratoma. PMID- 3658034 TI - Alternative birth centers: a four year experience at the University of Nebraska Medical Center. PMID- 3658035 TI - "Erroneous elevation of creatinine caused by 5-fluorocytosine". PMID- 3658036 TI - [Restructuring of the efferent activity of the scratching generator due to cyclic shifting of the position of the hindlimb in the decerebrate immobilized cat]. AB - The influence of the afferent inflow conditioned by passive cyclic movement of the ipsilateral hindlimb tip along a trajectory near to that of real scratching on the scratching generator activity was studied in decerebrated immobilized cat. This inflow caused significant rebuilding of the scratching generator efferent activity aimed to bring efferent activity into a definite phase correlation with the afferent inflow. Synchronization of fictitious scratching with passive moving occurred at the first movement cycle, the phase correlation between them being contrary to that of real scratching. PMID- 3658037 TI - [Efferent activity in the phrenic nerve during the startle reflex in chloralose anesthetized cats]. AB - Reflex activity in the phrenic nerve was studied in chloralose anesthetized cats during development of somatic startle reflexes in limb and lower intercostal nerves. It was shown that the main component of this activity during low threshold reflexes evoked by acoustic, tactile and low-threshold somatic afferent stimulation was depression of phrenic inspiratory activity. The following reflex discharges were prevalent components of phrenic responses to high-threshold afferent stimulation: early, propriospinal (intercostal-to-phrenic reflex) and late, suprasegmental ones. The latter were of two types: inspiratory (observed mainly during inspiration in about 75% of experiments) and expiratory (observed during expiration in 25% of experiments) which could be classified as "phrenic startle reflexes". Modulation of all responses during the respiratory cycle was described. Structural characteristics of reflex responses evoked in the phrenic nerve by stimulation of various respiratory and nonrespiratory bulbar sites as well as their respiratory modulation have been analyzed. Organization of possible neurophysiological mechanisms of phrenic responses during startle reflexes is discussed. PMID- 3658038 TI - [Comparative study of sympathetic and parasympathetic discharges in the autonomic nerves during stimulation of different structures of the cat hypothalamus]. AB - Simultaneous recordings of hypothalamo-parasympathetic and hypothalamo sympathetic evoked discharges in anesthetized cats demonstrated that both parasympathetic discharges in the pelvic nerve and sympathetic discharges in the splanchnic nerve of the lowest threshold and shortest latency could be obtained from stimulation of the posterior hypothalamus. The focus of the maximal neuronal activated elicited by stimulation of afferent fibres of visceral nerves and the focus evoking maximal efferent reactions of parasympathetic and sympathetic nerves were located in the same region of the postero-lateral hypothalamus. It is supposed (as a working hypothesis) that convergent polysensory neurons of the hypothalamus are also polyeffector divergent elements of the hypothalamo-visceral reflex system. PMID- 3658039 TI - [Electrophysiological indices of the degree of functional integration of a cortical transplant with the brain of the recipient]. AB - Pieces of the embryonal rat neocortex were grafted into the cavity at the place of the barrel-field of adult rats. Neuronal discharges and slow activity were recorded in 11 grafts 3-8 months after the grafting. Neurons of nine grafts responded to vibrissae deflection, their background activity consisted of randomly distributed discharges as in the normal cortex. The similar slow activity was observed in the responding grafts and in the host's intact contralateral barrel-field. Neurons of two grafts did not respond to vibrissae deflection. Hypersynchronous discharges prevailed in their background activity as well as slow delta-waves and epileptiform sharp spikes and waves. Complexes predominated in slow activity of these grafts. Histology revealed a close contact between responding grafts and host brain tissue. Nonresponding grafts were separated from the host brain by a thick glial scar which apparently prevented the axonal exchange between them. PMID- 3658040 TI - [Kinematic analysis of the different types of locomotor movement in rats after deafferentation]. AB - Comparative analysis of kinematics of rat hindlimb movements during different kind of locomotion (swimming, walking, hindlimb swimming but forelimb walking) was performed. After deafferentation an increase of the locomotor rhythm frequency and a decrease of the movement amplitude of hindlimb joints were common features for all kinds of the locomotion. This indicates that the above parameters of locomotor movements were formed by afferent influences. A decrease of the movement amplitude and of the EMG activity which were evoked after deafferentation were minimal for swimming and maximal for walking. The role of afferent influences in formation of different locomotion patterns is discussed. PMID- 3658041 TI - [Interrelation of the kinematics of hindlimb movement and efferent activity in the decerebrate cat during scratching]. AB - Statistical dependence between parameters of hindlimb scratching movements and muscle electrical activity was studied in decerebrated cat during real scratching. Power of electrical signal to scratching and aiming muscles and duration of aiming muscle activity are determining factors of movement parameters (amplitude, velocity and phase duration). Experiments with limb deafferentation had shown that statistical dependences between movement parameters and muscle electrical activity reflect the peculiarities of the scratch generator functioning. Some investigated statistical dependences change under the afferent signal influence. PMID- 3658042 TI - [Neuronal correlates of the functional reorganization of the dorsomedial thalamic nucleus in the rat after damage to the amygdala]. AB - Activity of the thalamic dorso-medial nucleus (DMN) cells evoked by stimulation of the periamygdaloid cortex was recorded in anesthetized rats in various periods of time after the baso-lateral amygdala destruction. It was found that changes in functional characteristics of cells observed at the early postoperative period intensified and reached the highest expression 10-30 days after such a destruction. Both the number of responding cells and percentage rate of neurons with excitatory and inhibitory responses restored along with the prolongation of the postoperative period. The structure of evoked excitation differed from the normal in predominant long-lasting tonic activation. Some peculiar features of functional reorganization of the DMN neuronal network involved in processing of incoming afferentation are discussed. PMID- 3658043 TI - [Inhibitory effects of taurine on spinal cord motoneurons of the lamprey]. AB - The influence of bath application of taurine (1-10 X 10(-4) mol/l) on the activity of motoneurons was studied in the isolated lamprey spinal cord. EPSPs evoked by stimulation of the descending tract as well as unitary EPSPs evoked by intracellular depolarization of the individual Muller axons were depressed, whereas conduction of action potentials in the Muller axons and antidromic action potentials of motoneurons were practically unchanged. A deep depression of electrical, in addition to chemical, components of EPSPs and comparison of the obtained results with the available morphological data on the structure of reticulomotor synapses in lamprey, allow concluding that the inhibitory synapses can be located near the excitatory ones on the motoneuron dendrites. PMID- 3658044 TI - [Rhythmic electrical activity of the isolated spinal cord of the chick embryo]. AB - Experiments on the isolated spinal cord have shown that even in early chicken embryogenesis, when first signs of the locomotor activity appeared, modulation of the presynaptic inhibition by the locomotor generator was present. Only few spinal cord segments are able to generate the locomotor rhythm. PMID- 3658045 TI - Modification by caffeine of acute cytotoxic response of cultured L5178Y cells to hydroxyurea treatment. AB - The effect of caffeine (CAF) on acute cytotoxic response of L5178Y lymphoblasts to hydroxyurea (HU) treatment was studied. The following events were examined: abnormal cell enlargement (giant cell formation), the rate of recovery of cell reproduction and DNA synthesis after releasing the cells from the HU blockage, parental DNA breakage and cell death. The presence of CAF at nontoxic concentration prevented giant cell formation, enhanced cell growth inhibition and cell killing. The effect of CAF was variable, dependent on the duration of exposure to HU and the time of exposure to CAF. To obtain maximal effect, the continuous presence of CAF during HU treatment and posttreatment time was necessary. Hydroxyapatite chromatography assay of single strand (ss) and double strand (ds) fractions in parental DNA and the measurement of the rate of post treatment recovery of DNA synthesis indicated that CAF enhanced HU-induced DNA lesions. It is concluded that the results give further evidence that even short HU treatment can damage not only newly formed but also parental DNA. The lesions are normally, at least partly repaired and can be expressed under the conditions of DNA repair inhibition. PMID- 3658046 TI - Further characterization of the leukemogenic activity of haloperidol in mice. AB - Haloperidol, a butyrophenon, is widely used for the treatment of psychotic disorders in man. Recently we reported that this drug causes, with high incidence, the development of monocytic-myeloid leukemias in male NMRI mice upon 5 X 5 mg/kg i.p. administration. Here we present evidence for the leukemogenic effect of haloperidol in two other strains of mice (XVII AKF1 hybrids, and the low leukemic BALB/c/BOM). The strain-dependent incidence of leukemias ranged both in males and females between 34% (AKR) and 69% (XVII AKF1) with average latencies between approximately 200 (AKR) and 600 (BALB/c) days. On the basis of cytological and cytochemical criteria the predominating type of leukemias was classified as monocytic-myeloid. These leukemic were serially transplantable. Cell-free extracts of leukemic tissues did not induce the disease indicating that no virus was activated by haloperidol. However, when the drug was administered to AKR mice after a suboptimal dose of nitrosomethylurea (NMU), a higher incidence of mixed-type leukemias was observed as with haloperidol alone. NMU alone induced lymphatic leukemias with proven viral involvement. The tumor promoter 12-0 tetradecanoylphorbol-13-acetate did not influence haloperidol-induced leukemogenesis. PMID- 3658047 TI - Protective immunity by chemically modified tumor cell antigens extracted by 3 M KCl. AB - Tumor antigens from Sarcoma-180 ascites tumor cells were extracted by 3 M KCl before and after treatment with acriflavine. Following dialysis of the extracts against distilled water to remove KCl, the soluble material (antigen) and the precipitate formed during dialysis were collected from the dialysate. Protective immunity of the soluble antigen and the precipitate was evaluated by immunizing mice and subsequent challenge with native tumor cells. It was noted that the soluble antigen and the precipitate of the dialysate obtained from acriflavine treated tumor cells induced significant protective immunity. The precipitate part appeared to be more effective. Interestingly, similar materials from untreated tumor cells did not show any such protective immunizing efficacy. Antigens extracted by 3 M KCl from chemically modified tumor cells assumed significance in respect to their antitumor immunity. PMID- 3658048 TI - N-acetyltransferase phenotype of patients with cancer of the larynx. AB - In the present paper N-acetyltransferase phenotype has been evaluated in 128 patients with cancer of the larynx. Out of 128 patients, 86.7% were smokers. The corresponding control group consisted of 106 men who did not suffer from neoplastic diseases. 83.6% of the patients were slow acetylators. This is significantly different from the frequency of 60.3% of slow acetylators observed in the control group. The slow acetylators exhibited a greater susceptibility to the cancer of the larynx. PMID- 3658049 TI - Combined chemotherapy and radiotherapy in the treatment of advanced head and neck cancer using cisplatin. AB - Between the years 1981-1984, 30 patients with advanced head and neck cancer (Stages III and IV) were treated by combined chemoradiotherapy. Chemotherapy with cisplatin was given before radiotherapy and three times after radiotherapy at the same dose (3 mg/kg body weight) monthly. Radiotherapy was administered with 60Co beam three times weekly in 17 fractions, at a total dose of 51 Gy. The results were summarized after completion of the combined therapy. Of the 30 patients 8 had complete remission (27%) and 13 patients had partial remission (43%). Adverse effects in this type of therapy were moderate and no serious complication occurred. The results were compared with a group of patients previously treated with methotrexate and radiotherapy. Optimal dosage of radiotherapy in combination with antineoplastic drugs is discussed. PMID- 3658050 TI - Relationship of some biosocial factors to colon cancer in Belgrade (Yugoslavia). AB - Eighty-eight patients with histologically confirmed colon cancer and two control groups individually matched by age, sex and place of residence, were interviewed about demographic, biosocial and medical variables. The use of laxatives, past history of large bowel disease and coffee consumption for 20 or more years were significantly more frequent among colon cancer than in their controls. No significant differences were found between cases and controls with respect to education level, job activity, smoking habits, alcohol consumption and cholecystectomy. PMID- 3658051 TI - [Cognitive versus interaction-oriented therapy. Comparison of 2 psychotherapy methods for the prevention of recurrence in schizophrenic patients]. PMID- 3658052 TI - [Schizophrenia specificity of negative and basic symptoms]. PMID- 3658053 TI - [Love and sexuality of manic patients]. PMID- 3658054 TI - [Case studies of so-called late mania]. PMID- 3658055 TI - [Electroconvulsive therapy in West Germany]. PMID- 3658056 TI - Coffee: an unknown risk factor? PMID- 3658057 TI - Diagnostic value of intact parathyroid hormone measurement. PMID- 3658058 TI - Left atrial ball thrombus during treatment with oral anticoagulants for more than one year. PMID- 3658059 TI - Primary sclerosing cholangitis, a vanishing bile duct disease. PMID- 3658060 TI - Early systemic heparinization prevents left ventricular thrombus formation in acute anterior myocardial infarction. PMID- 3658061 TI - Foreign particles contaminating hemodialyzers and methods of removing them by rinsing. AB - Foreign particles contaminating hemodialyzers constitute a risk of microembolism and allergic reactions in hemodialysis patients. We investigated the size distribution of particles, and the effects of striking headers of dialyzers and flow rates of rinsing saline on the elimination of foreign particles from dialyzers. Saline used for rinsing was filtered through a Millipore filter, and the particles thus removed were observed microscopically. We also checked changes in particle counts in a closed circuit consisting of a dialyzer and blood lines during 5 h of continuous circulation with a blood pump. The number of contaminating particles increased exponentially as their size decreased. For the sake of reproducibility we counted particles having diameters larger than 3.0 micron to monitor the rinsing efficiency. During rinsing, particles in the dialyzer were effectively eliminated by striking the headers of the dialyzer. We found that striking should be started immediately after the blood line is filled with saline, and that variation in saline flow rates in the range of 350-700 ml/min of saline does not affect the rinsing efficiency. By filtration of saline used for rinsing, particles, mostly ranging from 5 to 200 micron in length, of many shapes and colors were found. Among them were fibers having a length of as much as a few millimeters. Once dialyzers were rinsed effectively, there was almost no change in particle counts in a closed circuit consisting of a dialyzer and blood lines. To rinse dialyzers effectively, at least 1,000 ml of saline are necessary, and striking the headers of dialyzers throughout the rinsing procedure is important. PMID- 3658062 TI - Pancreatic pathology in chronic dialysis patients--an autopsy study of 78 cases. AB - Autopsy data from 78 patients with end-stage renal disease (ESRD) treated with long-term hemodialysis were examined. Various pancreatic abnormalities were found in 47 (60%) patients. The most prevalent abnormality was pancreatitis which was seen in 22 patients (28%). Other lesions found with considerable frequency included fibrosis, hemosiderin deposits, calcification, cystic changes, amyloidosis and abscess formation. In addition hyalinization, atrophy or absence of islands of Langerhans and necrosis of peripancreatic fat were seen in several cases and inspissated secretions, focal ductular epithelial metaplasia and dilatation were noted in some patients. Comparison of the present data with those of a large survey of ESRD patients conducted prior to dialysis era indicates a considerable increase in the prevalence of pancreatic pathology in ESRD patients sustained by long-term hemodialysis treatment. PMID- 3658063 TI - Delayed traumatic arteriovenous fistula following hemodialysis vascular catheterization. AB - Arteriovenous fistula formation is a rare complication of percutaneous femoral vein cannulation for hemodialysis. Symptoms and physical findings may be elusive and the lesion can proceed unnoticed for extended periods of time. This complication is easily managed with surgical repair following rapid clinical and angiographic diagnosis. It is the purpose of this paper to report a case of delayed arteriovenous fistula formation 7 months following percutaneous insertion of an acute hemodialysis catheter into the femoral vein. PMID- 3658064 TI - Effect of aluminum on porphyrin metabolism in hemodialyzed patients. AB - In patients with renal failure and on chronic hemodialysis, serum aluminum, serum delta-aminolevulinic acid, serum porphobilinogen and erythrocyte zinc protoporphyrin (ZPP) are significantly elevated, whereas erythrocyte delta aminolevulinic acid dehydratase activity (ALAD, values in percent) is significantly reduced. The last two parameters (ZPP and ALAD) are statistically related to serum aluminum concentration (Al-S), but only the correlation between Al-S and ALAD remains statistically significant after standardization for the degree of renal insufficiency (expressed in terms of urea level). This study does not support the hypothesis that the retention of aluminum is responsible for the increase of ZPP in uremic patients on dialysis. The disturbances of porphyrin metabolism found in patients with renal failure and on chronic dialysis are not similar to those observed in porphyria cutanea tarda. PMID- 3658065 TI - Reversible submandibular gland calcifications in a hemodialyzed woman with systemic lupus erythematosus. AB - Isolated submandibular gland calcifications were found in a young woman with systemic lupus erythematosus (SLE) undergoing intermittent hemodialysis for 2 years. The calcifications appeared to be due to multiple factors including high calcium-phosphorus product and possibly local inflammation due to SLE. PMID- 3658066 TI - Nodular cortical nephrocalcinosis: a benign and hitherto undescribed form of renal calcification. AB - Two unrelated adult patients were discovered by chance to have a diffuse form of renal cortical nephrocalcinosis, consisting of small nodules of radiologically visible calcification, most marked immediately under the renal capsule. The condition is not associated with urinary abnormalities or renal impairment, and appears to have an excellent prognosis. PMID- 3658067 TI - Rapidly progressive glomerulonephritis associated with rifampicin therapy for pulmonary tuberculosis. AB - Two months after commencing continuous treatment with rifampicin, isoniazid, streptomycin and pyrazinamide for pulmonary tuberculosis a patient developed a nephrotic syndrome, acute nonoliguric renal failure and evidence of intravascular hemolysis. Renal biopsy revealed a severe crescentic nephritis with mild interstitial changes. The use of rifampicin has been associated with various renal abnormalities and this report documents the occurrence of a rapidly progressive crescentic glomerulonephritis presenting as nephrotic syndrome in a patient receiving continuous treatment with rifampicin. PMID- 3658068 TI - Hypercalcemia and elevated 1,25(OH)2D3 levels in a dialysis patient with disseminated tuberculosis. AB - A 37-year-old diabetic patient with end-stage renal disease on maintenance dialysis developed widely disseminated tuberculosis. Tuberculosis was associated with hypercalcemia, inappropriately elevated serum levels of 1,25(OH)2D3, and consistently suppressed serum levels of iPTH. This case provides additional evidence that in granulomatous diseases extrarenal synthesis of 1,25(OH)2D3 may occur. PMID- 3658069 TI - Effect of hemodialysis on protein C levels. AB - The immunological functions of antithrombin III and protein C were studied in 8 patients before, during and after hemodialysis. After dialysis a significant decrease in protein C and antithrombin III levels was seen. The changes observed in both proteins after hemodialysis should be considered as a component in the genesis of the hypercoagulation state in these patients. PMID- 3658070 TI - Brucella endocarditis causing acute renal failure. PMID- 3658071 TI - Thoracic duct injury: an unusual complication following subclavian catheterization for hemodialysis. PMID- 3658072 TI - Non-bacterial thrombotic endocarditis in a CAPD patient. PMID- 3658073 TI - Digital angiography and hemodialysis vascular access. PMID- 3658074 TI - Dialysate concentrate: a potential source for lethal complications. PMID- 3658075 TI - Fish oils and nephritis or hypertension. PMID- 3658076 TI - Alterations of circulating thyroid hormone levels in dialysis patients: another piece to solve the puzzle. PMID- 3658078 TI - Transplantation therapeutics. Monoclonal antibody symposium and workshop. February 6-7, 1986, Miami, Fla. Proceedings. PMID- 3658077 TI - Treatment of idiopathic membranous nephropathy. PMID- 3658079 TI - Improvements to a simple Markov model of the natural history of multiple sclerosis. I. Short-term prognosis. AB - Follow-up data from a prognostic study done at L'Hopital Neurologique de Lyon have been reanalyzed using a new methodologic approach. A stochastic survival model which allows the course of the disease to be described through the movement of patients from one disease state to another is presented. This approach extends previous modelling work by enabling the risk of transition between pairs of states to be written as a function of any number of discrete or continuous prognostic variables. Length of the first remission, sex, and mode of onset (mono vs. polysymptomatic) were found to be significant prognostic indicators. PMID- 3658080 TI - Geographic and climatic factors and multiple sclerosis in some districts of Bulgaria. AB - The multiple sclerosis (MS) prevalence rates in five districts of Bulgaria were compared with some geographic and climatic factors. In Bulgaria the latitude seems not to be a factor influencing the MS distribution. As to the climatic factors, a negative correlation was obtained between MS prevalence and mean annual sunshine hours as well as between MS prevalence and mean annual temperature. When comparing MS prevalence and mean annual precipitation, the correlation was positive. PMID- 3658081 TI - Prevalence studies of multiple sclerosis, myasthenia gravis, and myopathies in Kumamoto district, Japan. AB - The prevalence ratio per 100,000 population of each disease was multiple sclerosis (MS) 1.3, myasthenia gravis (MG) 6.7, and polymyositis (PM) 5.0 in Kumamoto city, Japan (population 0.56 million, and the survey date on June 30, 1982). The prevalence ratio of MS was similar to that of 25 years ago in Kumamoto city. The incidence of MS had been stable despite Westernization of life-style in Japan. The prevalence ratio of MG and PM had increased moderately, possibly due to prolongation of life with recent progress in therapy. The prevalence ratio of all types of myopathies in Kumamoto prefecture (population: 1.8 million) on July 31, 1983, was estimated as approximately 17.4 per 100,000, for progressive muscular dystrophy (PMD) 4.1 per 100,000 population, compared to 3.9 for MG, and 2.4 for PM. The relative frequency of PMD, MG and PM was 23.3, 22.0 and 13.9%, respectively. The data shows that the prevalence ratio of various myopathies has not changed over the last 20 years in selected cities of Japan but the relative frequency of the diseases have changed due to recognition of the disease and prolongation of long life due to developments in diagnosis and treatment. PMID- 3658082 TI - Decreased incidence of Duchenne muscular dystrophy in western Japan 1956-1980. AB - In 50 patients from 41 families of Duchenne muscular dystrophy (DMD) born between 1956 and 1980 in the San-in area of Japan, the changes in DMD incidence rate were analyzed through five periods of time: 1956-1960, 1961-1965, 1966-1970, 1971-1975 and 1976-1980. The overall incidence decreased from 22.31 X 10(-5) live male births in the first period to 14.51 X 10(-5) in the last. This decrease was mainly related to the group of mothers who were definite carriers (p less than 0.005), and was probably due to genetic counselling of definite carrier families. For a further decrease in the incidence of DMD, the newborn male screening system for creatine phosphokinase (CPK) and appropriate genetic counselling might be effective. From an analysis of 28 families without previous family history, the expected proportion of maternal carriers was 0.57. PMID- 3658084 TI - Multivariate analysis of Hachinski's Scale for discriminating senile dementia of the Alzheimer's Type from multiinfarct dementia. AB - The need for an accurate clinical scale to aid in the diagnosis of senile dementia of the Alzheimer's type (SDAT) is clear in terms of both patient care and research. The ischemic scale of Hachinski, which differentiates multiinfarct dementia from primary degenerative dementia, has been criticized as lacking in validity. This study is a cluster by case analysis of the data from Hachinski's original report. The multivariate analysis provides support for those clinicopathologic studies that have found Hachinski's ischemic score of value. PMID- 3658083 TI - Studies on an isolated West Indies population. III. Epidemiologic study of sensorineural hearing loss. AB - An epidemiologic study of hearing loss was undertaken on a small Caribbean island and revealed a high frequency of abnormal audiograms among the population of French origin. Since there is no clear-cut discrimination between hypoacusis and normal hearing, but rather a continuous spectrum, the degree of hearing loss was quantified by an audiometric index, using the results of audiograms performed on 70% of the inhabitants. No environmental factors could be identified, although the effect of such factors is highly suggested by several observations of deafness aggravated by, or appearing after, a small dose of ototoxic antibiotics, and also by a strong residual age effect after correction for physiological presbyacusis. Hearing loss was found to be sparsed all over the island. Familial aggregation was noticed for several severe cases. PMID- 3658085 TI - Survey of specialised hospital services for adults with epilepsy in the North East Thames Region of the United Kingdom. AB - A Government (Department of Health and Social Security) (DHSS) Working Group has recently publish a report concerning the services for epilepsy in the UK, in which a number of recommendations for improvements were made, including the setting up of epilepsy clinics. In view of the lack of information concerning the specialised services currently available on a regional basis, we have undertaken a survey of hospital services for adults in the North East Thames Region. In this paper, we report the findings, noting the developments which have already taken place, the deficiencies that have been identified, and possible improvements in line with the Working Group's report. PMID- 3658086 TI - [[Cyclosporin forever?]. AB - The author presents a summarized review concerning the use of cyclosporine in the control of graft rejection. He insists on the need to reduce as far as possible the cyclosporine dosage applied. This can be achieved in association with other drugs, such as azathioprine and/or steroids. The mechanism of action due to cyclosporine seems to be linked both with some modifications in the graft's antigenicity, mainly the disappearance of MHC class II bearing cells, but above all with profound modifications in lymphokine secretion resulting in the inhibition of DTH responses and with the selective activation of suppressor cells. The author insists finally on the importance of cyclosporine not only for the medical treatment of rejection, but also for its significance as a research tool in immunology. PMID- 3658087 TI - [Plasma levels of cyclosporin 6 hours after its oral administration, T6: key to the surveillance of the treatment]. AB - Clinical evolution and CsA monitoring of 65 transplanted patients (55 kidneys and 10 kidneys and pancreas) treated with CsA were analysed, retrospectively (45 patients) and prospectively (34 patients). The aim of the study was: To show that nephrotoxicity is not uncommon with low trough plasma levels of CsA, and to indicate the value of CsA pharmacokinetic studies in individual cases. To suggest that the T6 value of a CsA pharmacokinetic plasma curve (6 hours after oral drug administration) is a valid expression of a full pharmacokinetics study. To show the results in a prospective study utilizing the T6 as a monitoring tool and with dose adjustments disregarding concomitant serum creatinine levels, with the aim of maintaining a therapeutic T6 (range 150-250 ng/ml). Patients with permanent Therapeutic T6 during the follow-up period (without dose adjustments) showed a creatinine serum level of 144 +/- 6 mumol/l. Serum creatinine levels decreased when CsA dose adjustments were made related to the presence of Toxic (greater than 350 ng/ml) or under-therapeutic (less than 100 ng/ml) T6 (p less than 0.01). Kidney and pancreas patients showed a tendency to under-therapeutic T6 and required a dose of 14 +/- 0.7 mg/kg to maintain a therapeutic T6. The CsA dose of kidney grafted patients through the T6 therapeutic period was 7.03 +/- 0.5 mg/kg. During the T6 toxic period, kidney patients received 8.85 +/- 0.3 mg/kg of CsA (p less than 0.02). Kidneys and graft survival is 97.6% at 6 months follow up in the prospective study. Current serum creatinine of all patients is 180.2 +/- 8 mumol/l. No patient was switched to conventional treatment. T6 is more useful than trough plasma levels for CsA monitoring. Nephrotoxicity and CsA under treatment can be avoided. This new monitoring tool may allow the utilization of lower doses of CsA and thus contribute to improved graft function at long term follow-up. PMID- 3658088 TI - [In vitro effects of 3 immunosuppressive drugs. Comparison of the effect of cyclosporin A, methylprednisolone and 6-mercaptopurine]. AB - Several tests of cellular immunity representing in vitro correlates of early lymphocytes activation have been studied with 3 immunosuppressive drugs currently used in organ transplantation, 6-mercaptopurine, cyclosporin A and methylprednisolone. Despite its significant antiproliferative action, 6 mercaptopurine does not affect interleukin 2 production nor Ia antigen induction on lymphocytes after stimulation with phytohemagglutinin. In contrast, cyclosporin A and methylprednisolone strongly block this reaction. Both immuno suppressive drugs disclose equivalent blocking action on all proliferative reactions with the exception of proliferation induced by phorbol myristate acetate which is resistant to cyclosporin A but inhibited by methylprednisolone. PMID- 3658090 TI - Brief review of the morphology of cyclosporin A nephropathy. PMID- 3658089 TI - [Pharmacokinetics and metabolism of cyclosporin; drug interactions]. AB - The pharmacokinetic properties of cyclosporine and mainly its absorption and hepatic elimination can vary in each patient in relation to the subject's individual characteristics (inter-subject variability), as well as in an individual patient during his treatment because of clinical episodes or drug interactions (intra-subject variabilities). Therefore, it appears compulsory to follow regularly cyclosporine blood levels or even to characterise each subject following a dose-test during the initiation of treatment, in order to adapt an individual posology aiming to minimise as far as possible the risk of nephrotoxicity. PMID- 3658091 TI - In vivo and in vitro immune responses of CBA/N (Xid) mice against allogeneic cells. AB - CBA/N (Xid) mice classically present a genetically determined immune deficiency. This is characterized by the absence of certain B lymphocyte subpopulations (Lyb 3, 5, 7) and a hyporeactivity towards class II T independent antigens. These mice were examined in comparison with conventional CBA/Ca (H-2k) histocompatible controls for their immune reactivity, using different systems linked to allogenic transplantation: the local graft-versus-host reaction (LGVHR), allogeneic tumor (Sa 1 A/J) rejection, mixed lymphocyte reaction (MLR) and cell mediated lymphocytotoxicity (CML). It is concluded that a difference in reactivity is also present in some responses to classically T dependent antigens. This difference can result either in an increased reaction in the case of a primary LGVHR or a decrease in the same but late secondary reaction. The rejection of a tumor allograft (Sa 1 A/J - H-2a) is delayed in the CBA/N (H-2k) substrain with respect to conventional CBA mice. Cell mediated lymphocytotoxicity (CML) does not seem to be affected by the Xid defect in immunized cell donors. On the contrary, MLR responses are strikingly increased. It is suggested that the poor seeding of B cells into peripheral lymphoid organs alters the T/B ratio, favoring either T effector cells or T suppressors (Ts) according to the models used. Antibody responses to allogeneic H-2 antigens are not significantly modified. PMID- 3658092 TI - [Clinical symptoms of stenosis and occlusion of the carotid arteries]. AB - In 174 patients with carotid artery changes confirmed by angiography or autopsy the syndromes of clinical manifestations characteristic of stenosis or occlusion of the internal carotid artery, common carotid artery, external carotid artery were analyzed. Particular attention was given to prodromal symptoms and signs of the disease and non-invasive auxiliary-investigations such as ophthalmodynamometry, ultrasound examination of arteries based on Doppler's phenomenon, and EEG. The role of the effect of its stenosis or occlusion on the condition of patients with associated occlusion of one internal carotid artery are discussed. PMID- 3658093 TI - [Effect of glucose load on blood cortisol levels in patients with stroke in the earliest period of the illness]. AB - The studied group comprised 32 healthy subjects, 30 patients with ischaemic stroke and 11 with cerebral haemorrhage. Serum glucose and cortisol levels were determined before and after intravenous administration of 40% glucose in a bolus injection. In cases of severe stroke significant hyperglycaemia and hypercortisolaemia were demonstrated. The degree of hypercortisolaemia was higher in cases with more severe course and was associated usually with disturbances in the circadian rhythm of cortisol secretion. Administration of hypertonic glucose solution caused no changes in the serum cortisol level in the studied patients. PMID- 3658094 TI - [Role of the parathyroid glands in the pathogenesis of intracerebral calcifications]. AB - Investigations of calcium-phosphate metabolism were carried out in a group of 11 children and adults with intracerebral calcifications. It was possible to isolate three different pathogenetic types of calcifications in the striatum and dentate nuclei in the cerebellum. The authors suggest restriction of the term "Fahr's syndrome" to cases without true of false hypoparathyroidism. The assessment of the calcium-phosphate metabolism, and particularly, the test with parathyroid hormone, seem to be an indispensable element in the differential diagnosis of this type of intracerebral calcifications. PMID- 3658095 TI - [Monotherapy of epileptic children with monitoring of the serum levels of anticonvulsive drugs]. AB - In 46 children with partial and primarily generalized seizures monotherapy was started with amizepine, luminal, mysodin or phenytoin. The treatment was monitored determining serum concentrations of the drugs. Monotherapy was effective in 74% of cases. In 89% of them the duration of treatment was one year, at least. In some children the values of amizepine, luminal and mysodin concentrations below the therapeutic level were effective. The evolution of electroencephalographic changes failed to correspond strictly to the clinical results of the treatment. PMID- 3658096 TI - [Hydrocephalus following subarachnoid hemorrhage]. AB - The authors present 56 patients with subarachnoid haemorrhages in whom CT of the head demonstrated internal hydrocephalus. This complication was observed most frequently in the age group 51-60 years. In 39% of cases hydrocephalus was low grade, in 36% it was moderately severe, and in 25% high grade. In 33 patients (59%) a syndrome of clinical symptoms and signs was observed which could be related, in part at least, to hydrocephalus. In 11% of cases. Pudenz valve had to be implanted. No significant differences were found in the frequency of hydrocephalus in late period after subarachnoid haemorrhage in relation to sex, number of haemorrhages, clinical state, vasospasm, treatment with epsilon aminocaproic acid and dexamethasone. PMID- 3658097 TI - [Vascular complications associated with cervical rib syndrome]. AB - Two cases are reported of vascular complications in the cervical rib syndrome. In one case thrombosis developed in the distal part of the brachial artery, and in both cases compression of the subclavian artery could be demonstrated clinically and during arteriography. Attention is called to the necessity of surgical treatment of patients with evidence of vascular compression in view of the possibility of thrombotic complications. Coexistence of several causes of compression and the relationship of good therapeutic result to removal of all causes is stressed. PMID- 3658098 TI - [Neuropsychological catamnesis in cases of intracranial aneurysm]. AB - The authors analyzed the results of neuropsychological examinations in 30 cases in which a single intracranial aneurysm had been excluded from circulation. The neuropsychological assessment of the higher mental functions was carried out using a set of tests of A. R. Luria in all cases and repeated thrice, comparing the results with those of neurological examination and EEG. The condition of the patients was evaluated using a three-grade scale. In the group of cases with aneurysms of the anterior communicating artery a divergence was observed between the results of neuropsychological examination and neurological examination. The patients achieved not infrequently, very good and good Grades in neurological examination and unsatisfactory in neuropsychological examination and unsatisfactory in neuropsychological examination. A similar divergence was observed also when the aneurysm was situated in other cerebral arteries. On the other hand, considerable similarities were found between the neuropsychological assessment and the result of EEG (with regard to the location, of disturbances and their intensity). Neuropsychological examination made possible detection and determination of the dynamic development of defects in the functions of higher psychic activities inaccessible for routine neurological examination, but having a very important effect on the everyday functions of the patient. PMID- 3658099 TI - ["Cluster-tic syndrome" with a report of our case]. AB - The author describes a case with elements of trigeminal neuralgia coexistent with Horton's headaches, with predominance of the latter ones. For this syndrome the author proposes the name "cluster-tic". In the pathogenesis of headache attacks of Horton's type and neuralgia of the V nerve the mediation of neurotransmitters and the nosological position of the described syndrome are discussed. PMID- 3658100 TI - [General muscular rigidity syndrome (stiff man syndrome) in multiple sclerosis]. AB - In a 57-year-old woman with a long history of multiple sclerosis a syndrome corresponding to the stiff-man syndrome was observed. PMID- 3658101 TI - [Acute tension pneumocephalus as a complication of surgical procedures of the posterior cranial fossa in prone position]. AB - The authors describe a case of acute tension pneumocephalus (TP) developing as a complication of an operation in the posterior cranial fossa, in a boy aged 3 years with a large cystic tumour of the vermis, operated on in prone position with flexed head. The authors discuss the circumstances leading to development of tension pneumocephalus. PMID- 3658102 TI - [Meningocele in the cervical segment of the spine associated with vertebral fusion]. AB - The authors describe a patient aged 22 years in whom a developmental anomaly was found with fusion of the vertebral bodies C4 through C6, posterior spina bifida from C5 through Th1 and meningocele at the level C4 through C7. The meningocele was removed surgically. The case illustrates an integral connection between this set of anomalies and the malformations from the group of dysraphism. PMID- 3658103 TI - [Cerebrospinal rhinorrhea 8 years after cranial injury]. AB - The authors present a case of posttraumatic cerebrospinal fluid rhinorrhoea developing 8 years after skull trauma. The rarity is discussed of the development of remote traumatic rhinorrhoea without previous symptoms of cerebrospinal fluid fistula, and the diagnostic difficulties are stressed in cases of such late rhinorrhoea. A new preparation used for plastic operation on the anterior cranial fossa floor is described. PMID- 3658104 TI - [Genetic characteristics of spinal muscular atrophy]. PMID- 3658105 TI - Lectin binding in meningiomas. AB - Forty-two meningiomas of different morphological sub-type were examined to determine their pattern of binding to 11 different lectins which characterize cell surface components such as carbohydrate residues. Histiocytic and xanthoma cells within meningiomas could be demonstrated with six different lectins: wheat germ agglutinin (WGA), peanut agglutinin (PNA) Bauhinia purpurea agglutinin (BPA), Helix pomatia agglutinin (HPA), Vicia fava agglutinin (VFA) and Soyabean agglutinin (SBA). Vascular elements including endothelial cells and intimal cells, bound Ulex europaeus agglutinin type 1 (UEA 1), WGA and HPA. The fibrous stroma in fibrous and fibroblastic meningiomas bound PNA, Laburnum alpinum agglutinin (LAA) and SBA. Tumour cells in meningotheliomatous meningiomas and some areas of anaplastic meningiomas bound Concanavalin A, PNA, LAA and VFA whereas tumour cells in fibrous and fibroblastic meningiomas bound BPA, LAA and VFA. Lectin binding has proved to be of value in detecting histiocytic and xanthoma cells together with vascular elements within meningiomas. In addition, the different lectin binding patterns allow different histological sub-types of meningioma to be distinguished although the biological significance of the binding patterns is unclear. PMID- 3658106 TI - Studies on the neurobiology of vitamin E (alpha-tocopherol) and some other antioxidant systems in the rat. AB - To understand why nervous tissue should be particularly affected by severe deficiency of vitamin E, the distribution of vitamin E (alpha-tocopherol) and some other antioxidant systems was investigated. The concentration of vitamin E and the activities of glutathione peroxidase and superoxide dismutase were determined in different regions of the nervous system in male Wistar rats. The cerebral cortex had the highest, and the cerebellum the lowest concentration of alpha-tocopherol (P less than 0.02). Activity of glutathione peroxidase tended to show an inverse relationship to the alpha-tocopherol concentration, whereas superoxide dismutase activity was evenly distributed through the nervous tissue. Vitamin E concentrations were also determined in spinal cord, sciatic and tibial nerves and in epineurial, myelin and non-myelin fractions of the sciatic nerve. Uptake of intravenously injected tritiated alpha-tocopherol was studied after 6 h and found to be greater in brain and peripheral nerve than cervical and thoracic regions of the spinal cord. Uptake of tocopherol varied along the sciatic and tibial nerve, being greatest where the sciatic nerve divided into tibial, sural and common peroneal nerves. This corresponded to an area of increased vasculature which was visualized by an angiographic technique using barium sulphate. PMID- 3658107 TI - The morphology and morphometry of the normal human tibialis anterior muscle. AB - The light microscopic appearance of the human tibialis anterior muscle is described based on conchotome biopsy specimens from seven healthy volunteers and 20 patients who presented with myalgia but who had no evidence of neuromuscular disease. The morphometric characteristics of these normal muscles are documented and the similarities and differences between the appearances of the tibialis anterior and other muscles discussed. PMID- 3658108 TI - 'Expanding cerebral lacunae' in a hypertensive patient with normal pressure hydrocephalus. AB - A hypertensive patient who had been treated successfully for normal pressure hydrocephalus (NPH), died from a left thalamic haemorrhage. Neuropathological examination showed recent and old thalamic haematomas and numerous parenchymal cavities or 'cerebral lacunae'. Two lacunae bulged into the lateral ventricles, and had all the characteristics of so called 'expanding lacunae'. They were surrounded by a single layer of epithelial-like cells, contained a normal, patent, arteriole, and presented as space occupying lesions. Only two similar cases have been reported previously. The complexity of the neuropathological features of 'cerebral lacunae' is emphasized and the relationships between cerebral hypertensive disease, NPH, and expanding lacunae are discussed. PMID- 3658109 TI - Immunocytochemical distribution of luteinizing hormone in rat central nervous system. AB - This paper presents the first detailed localization of luteinizing hormone (LH) containing cells and fibers in the rat central nervous system. These immunoreactive elements were identified by four LH antisera, two directed against the intact LH molecule and two against LHb. Cell bodies, immunoreactive for LH were found throughout the rostral-caudal extent of the hypothalamic arcuate and ventromedial nuclei, the periarcuate area ventral to the ventromedial nucleus, and the retrochiasmatic area. Immunopositive fibers were traced to numerous structures within the brain including discrete regions of the hypothalamus, septal area, nucleus of the diagonal band, bed nucleus of stria terminalis, amygdala, thalamus, periaqueductal gray, raphe nuclei, brainstem reticular nuclei, locus ceruleus, parabrachial nucleus, dorsal motor nucleus of vagus, and the nucleus of the solitary tract, with a few fibers extending into spinal cord central gray. This pattern of fiber distribution corresponds closely with those described for fibers containing several other anterior pituitary hormones. The extensive projection for LH may provide neuroanatomical substrate mediating reproductive events as it does in the pituitary, or it may serve some modulatory function in brain which is independent of its role in reproduction. PMID- 3658110 TI - Role of hypothermia in the pentobarbital-induced blockade of luteinizing hormone secretion in female rats. AB - Studies were conducted to determine if the hypothermic effects of barbiturates were responsible for their ability to suppress luteinizing hormone (LH) secretion in rats following ovariectomy or treatment with gonadal steroids. In both ovariectomized rats and rats treated with estradiol and progesterone, pentobarbital caused a marked hypothermia and blocked LH hypersecretion. In ovariectomized rats, the LH-suppressing effects of pentobarbital could be prevented by maintaining normal core body temperature. However, in steroid treated rats, the maintenance of normal core body temperature did not prevent the pentobarbital-induced blockade of the steroid-induced LH surge. These data indicate that the pentobarbital-induced reduction of LH secretion in ovariectomized rats is temperature-dependent, while its blockade of the steroid induced LH surge is not. Additionally, this study provides further evidence for the differential neuronal regulation of LH secretion following ovariectomy and during the steroid-induced surge in LH. PMID- 3658111 TI - Vasoactive intestinal polypeptide and dopamine: effect on prolactin secretion in normal women and patients with microprolactinomas. AB - In order to investigate the influence of dopamine (DA) in modulating prolactin (PRL) response to vasoactive intestinal polypeptide (VIP), VIP (75 micrograms i.v. over 12 min) was administered to normal women and patients with microprolactinomas during saline or DA (0.06 micrograms/kg BW/min) infusion. In 8 normal women VIP caused PRL to rise from 7.9 +/- 0.8 (mean +/- SE) to 33.4 +/- 17.1 ng/ml (p less than 0.01), the peak occurring at 15 min, while it did not elicit any significant modification in serum PRL levels in 18 patients with microprolactinomas. DA infusion lowered serum PRL by 67 and 58.2% at 120 min in normal women and in patients with microprolactinomas, respectively, and abolished VIP-induced PRL response in normal women without influencing PRL response in patients with microprolactinomas. PRL responsiveness to VIP was not restored by dopaminergic disinhibition (domperidone 10 mg i.v.) in 4 patients tested. Two previously unresponsive patients showed a VIP-induced PRL increase, superimposable on that recorded in normal women, after successful selective adenomectomy. These data suggest that DA, although able to suppress VIP-induced PRL response in normals, does not play any major role in causing unresponsiveness to VIP in prolactinomas. The lack of PRL responsiveness to VIP might be intrinsic to the adenoma or due to alterations of PRL secretion regulatory mechanisms other than DA secondary to the presence of the tumor, or to a depletion of the readily releasable pool of PRL. PMID- 3658112 TI - Epoxy derivatives of arachidonic acid are potent stimulators of prolactin secretion. AB - Arachidonic acid is metabolized to three distinct classes of metabolites: cyclooxygenase produces prostaglandins, prostacyclins, and thromboxanes; lipoxygenase produces hydroperoxyeicosatetraenoic acids and, epoxygenase, a NADPH dependent cytochrome P-450 enzyme, produces epoxyeicosatrienoic acids. Addition of 5,6-epoxyeicosatrienoic acid (5,6-EET) to GH3 cells, a rat anterior pituitary cell line, produces a rapid, dose-dependent stimulation of prolactin (PRL) release. Incubation with arachidonic acid (AA) was ineffective at increasing PRL release. The lipoxygenase metabolite 5-hydroxyeicosatetraenoic acid (5-HETE), however, increased PRL release from GH3 cells but with a much lower maximal response than 5,6-EET. We examined the role of metabolism inhibitors in 5,6-EET mediated PRL release. Microsomal and cytosolic epoxide hydrolase (EH) inhibitors do not alter 5,6-EET-induced PRL release, suggesting that EH does not play a significant role in 5,6-EET mediated PRL release from GH3 cells. A chemical analog of 5,6-EET wherein the epoxide oxygen is replaced with a sulfur to afford 5,6-thioepoxyeicosatrienoic acid was also tested and found to stimulate the release of PRL, although not to the same extent as 5,6-EET. Although 5-HETE tends to increase PRL release from GH3 cells, 5,6-EET is significantly more potent at the stimulation of PRL release from GH3 cells. PMID- 3658114 TI - Proceedings of the 25th anniversary symposium: Frontiers in Neuropharmacology. Tarpon Springs, Florida, U.S.A., 15-17 November 1986. PMID- 3658115 TI - Pharmacokinetics and pharmacodynamics of physostigmine after intravenous administration in beagle dogs. AB - The time course of physostigmine (Phy), its metabolites and activity of cholinesterase (ChE) in plasma were studied after intravenous bolus administration of [3H]Phy (100 micrograms/kg) to beagle dogs. The maximal inhibition of ChE (78%) in plasma at 2 min correlated with the largest concentration of physostigmine (124 ng/ml). The concentration of physostigmine decreased by 88% to 16 ng/ml at 45 min when the activity of ChE was still 59% inhibited. Acetylcholinesterase activity in four regions of the brain (medulla, striatum, cerebellum and cortex) was not significantly different from controls at 70 +/- 5 min after administration of physostigmine. Concentrations of physostigmine and its metabolites determined by HPLC were not significantly different in different regions. In plasma, physostigmine was found, together with eseroline and two other metabolites M1 and M2. At 45 min, only 18% of total radioactivity was due to physostigmine and 52% was due to the major metabolite M1. On the contrary, in regions of the brain, metabolite M1 represented only 1.9 3.37% of total radioactivity at 70 +/- 5 min. Pharmacokinetic parameters, obtained in the dog, were compared to previously published data in rat and man. The elimination half-life (beta) was 30.7 min in the dog as compared to 15 min in rat and and 21.7 min in man. The Vd (ml/kg) was higher than total body water volume in all three species: dog (1832), rat (1352) and man (664), indicating sequestration of the drug in body compartments. Clearance (ml/min/kg) was found to be 41.2 in dog, which compares to 62 in rat and 22 in man.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658113 TI - Subtypes of muscarinic receptors in cultured explants of the hippocampus of the rat. AB - Using the tritiated, muscarinic antagonist quinuclidinyl benzilate ([3H]QNB) as a ligand, muscarinic receptors have been identified and characterized in intact, cultured explants of the hippocampus of the rat. Competition studies with scopolamine and oxotremorine indicated a certain heterogeneity in the population of muscarinic receptors, whereas atropine and pirenzepine competed with [3H]QNB in a manner consistent with only one binding site for these substances. Thus, the observed heterogenity does not fit in with the M1/M2 receptor concept. Extended studies, with the aim of determining to what extent these putative subtypes of receptors are functional, would be of interest. PMID- 3658116 TI - Apomorphine-induced behaviour during the oestrous cycle of the rat. AB - The effect of various doses of apomorphine (APO) (25, 250, 400 and 750 micrograms/kg, s.c.) on open field behaviour, stereotyped behaviour, body temperature and concentrations of serum oestradiol was studied in cycling females and in ovariectomized rats. With the exception of grooming, the hormonal variations during the cycle, or the ovariectomy, did not have an effect on behaviour related to stimulation of presynaptic dopamine (DA) receptors. The endocrine status on proestrus (PE), characterized by an increase in serum oestradiol, did influence hyperlocomotion and hypothermia induced by apomorphine; the former being attenuated and the latter increased, as compared to the other phases of the cycle. Ovariectomy resulted in an increase in the stimulatory effect of apomorphine on locomotion. Stereotypy induced by apomorphine was unaltered by hormonal variations during the cycle and it was slightly attenuated by removal of the ovaries. During phases of low levels of oestrogen (oestrus, metestrus) apomorphine significantly increased the levels of serum oestradiol, determined 30 min after the administration of drug. It is concluded that the various DAergic mechanisms in brain are differentially affected by hormonal variations during the cycle and by ovariectomy. PMID- 3658117 TI - Dopamine neurons projecting to the medial prefrontal cortex possess release modulating autoreceptors. AB - The ability of dopamine (DA) agonists and antagonists to modulate the K+-evoked overflow of radioactivity from superfused slices of prefrontal cortex of the rat, preincubated with [3H]DA in the presence of 1 microM desipramine, was examined. Apomorphine and the putative autoreceptor-selective DA agonist EMD 23 448 inhibited the K+-evoked overflow of radioactivity, while the DA antagonist sulpiride enhanced the evoked overflow in a dose-dependent and stereoselective manner. The latter effect was partially reversed by EMD 23 448. More than 95% of the radioactivity retained by the slices chromatographed with DA, while deaminated metabolites represented the majority of both the basal efflux (84% metabolites, 4-5% DA) and evoked overflow (84% metabolites, 14% DA) of radioactivity. These findings indicate that mesoprefrontal DA neurons possess release-modulating nerve terminal autoreceptors. Previous studies have shown that these neurons lack synthesis-modulating autoreceptors. Thus, autoreceptors on prefrontal DA terminals appear to be coupled to regulation of the release but not the synthesis of DA. PMID- 3658118 TI - Effects of naloxone and diprenorphine on amphetamine-stimulated behavior in guinea pigs and rats. AB - Amphetamine (0.1-10 mg/kg), naloxone (0.1-10 mg/kg) and diprenorphine (0.03-10 mg/kg) were studied for their ability to modulate locomotor behavior in the guinea pig. Naloxone, administered alone, caused a non-significant decrease in locomotor activity and had a similar non-significant effect on amphetamine stimulated activity. Diprenorphine induced a significant suppression of locomotor activity, the magnitude of which was inversely related to dose: smaller doses of diprenorphine caused a greater suppression of locomotor activity than larger doses. Two doses of diprenorphine (0.1 and 1.0 mg/kg) were tested in combination with amphetamine in the guinea pig. They significantly reduced amphetamine stimulated behavior and were equipotent in this regard. In contrast, diprenorphine had no effect on amphetamine-stimulated activity in rats. However, in keeping with other reports, naloxone (10 mg/kg) significantly reduced amphetamine-stimulated behavior. The differences in the actions of diprenorphine and naloxone on the behavior of guinea pigs and rats may reflect a different underlying distribution of subtypes of opioid receptor in the two species. PMID- 3658119 TI - Test-dependent changes in nociception after administration of the putative serotonin antagonist metitepin in mice. AB - Intraperitoneal administration of the putative serotonin receptor antagonist metitepin (0.06-1.0 mg/kg) in mice induced dose-dependent antinociception in the increasing temperature hot-plate test and the formalin test, but elicited hyperalgesia in the tail-flick test. Reduced motor activity was observed after injection of the largest dose of metitepin, but did not influence the behavioural responses in the tests. Selective lesions of ascending serotonergic pathways induced by administration of the neurotoxin p-chloroamphetamine 5 and 6 days before testing (40 mg/kg each day) did not directly affect the responsiveness in any of the tests but enhanced the metitepin-induced antinociception in the hot plate and formalin tests. The hyperalgesia in the tail-flick test was not affected by the lesions. The results suggest that metitepin may alter nociception in mice by exhibiting both agonist and antagonist properties on central serotonergic receptors. PMID- 3658120 TI - Concentrations of histamine in the hypothalamus of the rat: effect of extraction volume and interpretation of the effects of acutely-administered morphine. AB - The effect of varying the ratio of extraction volume to tissue weight (EVR) on the apparent concentration of histamine (HA) in the hypothalamus of the rat was examined. Increasing the weight of tissue (by pooling 1, 2 or 3 hypothalami), in a constant extraction volume, resulted in progressive decreases in apparent concentration of histamine in the hypothalamus. These concentrations were 642, 450 and 282 ng/g, respectively. Morphine (10 mg/kg, i.p.) significantly reduced the concentration of histamine in the hypothalamus. Expressed as percentages of the saline-control values (obtained for the extraction volume to tissue weight of 35.7, 57.2 and 118.4 ml/g), treatment with morphine resulted in 24, 17 and 11% reductions in the concentration of histamine in the hypothalamus, respectively. However, expressed in terms of ng/g, the reductions in histamine induced by morphine were 68, 75 and 69 ng/g, respectively. It is concluded that morphine may consistently affect a single pool of histamine. The possibility that de novo histamine is formed in the homogenate during the extraction process is discussed. PMID- 3658121 TI - Theophylline-induced upregulation of A1-adenosine receptors associated with reduced sensitivity to convulsants. AB - Chronic administration of theophylline (50 mg/kg twice daily for 14 consecutive days) significantly increased the specific binding of [3H]CHA in membranes of the cerebral cortex and cerebellum of the rat, but not in membranes derived from the hippocampus or diencephalon. To characterize further the upregulation of A1 = adenosine receptors induced by theophylline, saturation analysis with [3H]CHA was performed in membranes of the cerebral cortex and cerebellum. In both saline- and theophylline-treated cortical membranes the binding isotherms for [3H]CHA could be resolved into receptor affinity states having respectively high (KH) and low (KL) affinity for [3H]CHA. The high and low affinity dissociation constants obtained from theophylline-exposed membranes of the cerebral cortex were 1.14 nM and 25.2 nM and did not differ significantly from the corresponding values in saline-treated animals. Chronic exposure to theophylline did, however, produce significant increases in the densities of both the high and low affinity forms of A1-adenosine receptors in the cerebral cortex. Qualitatively and quantitatively similar results were observed in cerebellar membranes. These results suggest that chronic exposure to theophylline increases the density of A1-receptor in the cerebral cortex and cerebellum with no concomitant changes in the ability of [3H]CHA to distinguish separate agonist affinity states of the receptor. The physiological significance of theophylline-induced upregulation was assessed by determining seizure thresholds for convulsants in rats treated chronically with saline or theophylline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658122 TI - Injection of baclofen into the ventromedial hypothalamus stimulates gastric motility in the rat. AB - Injection of 2 micrograms (+/-)-baclofen into the ventromedial hypothalamus (VMH) of urethane-anaesthetized rats resulted in an increase in gastric tone and amplitude of contractions. This effect was curtailed by administration of atropine methyl nitrate (20 mg/kg i.p.) or bilateral cervical vagotomy. These results provide evidence for a hypothalamic modulation of gastric motility by the vagus. Baclofen, possibly acting on receptors insensitive to gamma-aminobutyric acid (GABA), may be mimicking a vagal activation system, located within the ventro-medial hypothalamus. PMID- 3658123 TI - An analysis of cholecystokinin-induced increase in acetylcholine output from cerebral cortex of the rat. AB - The effect of colecystokinin (CCK-8) on the release of ACh from the cerebral cortex was studied in urethane-anaesthetized rats with the cortical cup technique. The increase in output of ACh brought about by the administration of CCK-8 1.5 micrograms/kg (i.p.) was prevented by pretreatment with haloperidol (1 mg/kg i.p.) and by lesions of the nucleus basalis magnocellularis and substantia nigra but it was reduced only slightly by bilateral vagotomy. Conversely, none of the treatments abolished the decrease in output of ACh brought about by CCK-8 at a dose of 10 micrograms/kg (i.p.). Local injection of CCK-8 into the nucleus basalis had no effect. Therefore, CCK-8 appears to increase cortical cholinergic activity by indirectly stimulating the cholinergic neurones of the nucleus basalis through dopaminergic neurones. PMID- 3658124 TI - Characteristics of bombesin-induced inhibition of intake of ethanol. AB - The temporal and neural dependencies of the inhibitory effect of the administration of bombesin tetradecapeptide (BBS) on the intake of ethanol were assessed in the water-deprived rat. Variation of the intraperitoneal (i.p.) injection of neuropeptide--5% ethanol access interval (0-20 min), revealed that suppression induced by bombesin (0.5-4.0 micrograms/kg) was significantly greater and more potent at shorter intervals. The intake of ethanol was less in rats with subdiaphragmatic vagotomies, but bombesin equivalently suppressed the intake. Intracerebroventricular injection of bombesin more potently and completely inhibited the intake of ethanol but bombesin injected intraventricularly, unlike that given intraperitoneally, elicited excessive grooming and scratching behavior. The suppressant effect of bombesin, given intraperitoneally, requires close temporal contiguity of administration and caloric solution access, which is consistent with a satiety action of a neuropeptide. This satiation effect to ethanol of peripherally administered bombesin appears to reflect a non-vagal, extra-ventricular neural action. PMID- 3658125 TI - The effect of ethanol and haloperidol on dopamine receptor (D2) density. AB - The study was performed to investigate the influence of ethanol on haloperidol induced changes of the dopamine (D2) receptors in rat striatal membrane preparations. Subchronic administration of the neuroleptic in the drinking water resulted in an increase of the number of binding sites in a dose-dependent manner. Simultaneous treatment with both haloperidol and ethanol prevented the rise of D2 receptors. PMID- 3658126 TI - Preliminary report: effects of high dose methylprednisolone on delayed cerebral ischemia in patients at high risk for vasospasm after aneurysmal subarachnoid hemorrhage. AB - Mounting evidence suggests that chronic cerebral vasospasm may be linked to the inflammatory response that follows subarachnoid hemorrhage. Twenty-one patients judged to be at high risk for vasospasm because of either poor admitting grade or a large amount of subarachnoid blood shown by computed tomography were treated with a course of high dose methylprednisolone, and management results were compared to those of a cohort of contemporary control patients matched for grade, number of hemorrhages, time from hemorrhage to admission, time from hemorrhage to operation, aneurysm location, age, and sex. Patients treated with high dose methylprednisolone were twice as likely to have an excellent result and half as likely to die as those who were not treated. The incidence and severity of delayed cerebral ischemia were reduced in treated patients when compared to control patients. None of the treated patients developed a serious side effect that could be attributed to steroid treatment. These findings are consistent with the conclusion that chronic vasospasm is an inflammatory vasculopathy and suggest that early treatment with high dose methylprednisolone may benefit this high risk group of patients. PMID- 3658127 TI - Mechanism of vascular responsiveness to barbiturates in isolated and perfused canine basilar arteries. AB - We inserted stainless steel cannulae to compare vascular responses to five kinds of barbiturates and to investigate the mechanism of vascular responsiveness to thiopental in isolated and perfused canine basilar arteries. Intraluminal thiopental (10 to 3000 micrograms) usually caused a distinctly biphasic vascular response, i.e., initial vasoconstriction followed by vasodilatation. The vasoconstriction was always greater than the vasodilatation in percentage of change. Thiamylal (10 to 3000 micrograms) evoked similar vascular responses. Pentobarbital, phenobarbital, and amobarbital (100 to 3000 micrograms) induced slight monophasic vasodilatation in lower doses and a weak biphasic response in higher doses. Pretreatment with phentolamine and ketanserin, an alpha adrenoceptor antagonist and a 5-hydroxytryptamine2 inhibitor, did not alter vasoconstriction to thiopental. Increasing doses of pretreatment with diltiazem, a potent calcium antagonist, depressed the vasoconstriction induced by potassium chloride in a dose-related manner, but thiopental-induced constriction was only slightly suppressed by diltiazem treatment. Endothelial removal produced by intraluminal saponin treatment significantly enhanced vasoconstriction to potassium chloride, but thiopental-induced constriction was not enhanced significantly after saponin treatment. These findings suggest that thiopental induced vasoconstriction does not involve adrenergic and serotonergic mechanisms and is due to intracellular movement of calcium ions in canine basilar arteries. PMID- 3658128 TI - Computed tomographic evaluation of extracranial carotid artery disease. AB - Axial computed tomographic (CT) scans after intravenous contrast infusion were used to image the cervical carotid arteries of patients with cerebral ischemic symptoms. Standard transfemoral cervical carotid and cerebral angiography was the principal diagnostic modality used in all patients studied. The angiographic results were compared to the CT images and to the gross and microscopic endarterectomy pathological specimens, when available. Examples of the various types of abnormalities that can be visualized using CT scans are presented. The CT scan was useful for determining the presence of degenerative atheromatous changes including carotid artery calcification, subintimal hemorrhage, carotid occlusion, carotid segmental occlusion, and carotid pseudoocclusion, as well as carotid artery dissection. The scans were particularly useful for identification of atheromatous carotid artery disease when the carotid angiogram appeared nearly normal and for identifying the cause of postoperative carotid stenosis. CT scanning allows visualization of the carotid artery wall and lumen rather than just the lumen and, consequently, can sometimes add helpful information about the pathological processes affecting this artery. PMID- 3658129 TI - Effects of intraventricularly injected isoosmolar glycerol on brain water and electrolytes in the rat. AB - The infusion of isoosmolar glycerol (0.35 mol/dm-3) into the ventricles of laboratory rats for 120 minutes led to an increase in the serum osmolality by 11 mosm/kg and to hypernatremia. The brain water content of the cerebral hemispheres decreased by 0.9% (P less than 0.05). A corresponding intraventricular infusion of saline or d-glucose did not cause significant changes in these parameters. These findings support the view that glycerol, even in a dose incapable of creating a major osmotic gradient between plasma and brain, could have a beneficial effect in the control of intracranial volume-pressure perturbations. It is hypothesized that, besides acting as an osmotic dehydrating agent in certain concentrations, glycerol influences the central neuroendocrine system responsible for brain ion and volume homeostasis. By its presumed reduction of central and peripheral vasopressin release through lowering the cerebrospinal fluid sodium concentration, it may help in decreasing the brain water content. PMID- 3658130 TI - Three-dimensional computed tomography in the diagnosis of vertebral column pathological conditions. AB - Three-dimensional computed tomographic scanning is a valuable adjunct in the diagnosis and treatment of disease processes involving the spine. We present our experience with this noninvasive radiological diagnostic technique in 32 patients with vertebral column abnormalities ranging from craniovertebral junction disorders to fractures of lumbar vertebrae. The three-dimensional CT images often demonstrate pathological conditions and occult lesions that are not adequately defined by conventional radiographic means. PMID- 3658131 TI - Pulmonary complications of acute spinal cord injuries. AB - The records of 123 consecutive patients admitted with spinal cord injury were examined for the presence of pulmonary complications. Forty-nine had tetraplegia and 23 had paraplegia; the remainder suffered a variety of neurological deficits. Multiple injuries were encountered in 36 patients. Fifty-three pulmonary complications were noted in 44 (35.7%) patients. The most common problems were atelectasis and pneumonia. There were 22 (18%) deaths. Fourteen deaths were related to pulmonary complications. The mean age of patients who died was 52 +/- 13 (SE) compared to 28 +/- 12 for survivors. A mean forced vital capacity (FVC) of 1127 +/- 410 cc in patients suffering respiratory difficulties compared to a FVC of 1865 +/- 85 cc in patients without complications (P less than 0.001). Oxygenation (PaO2 90 +/- 19 torr) was normal in patients without respiratory problems and was abnormal in patients developing problems (PaO2 76 +/- 30 torr; P less than 0.05). Twenty patients were treated with a rotating bed. The complication rate of patients on the bed was only 10%. In conclusion, respiratory problems remain a significant cause of morbidity and mortality in spinal cord injury. The forced vital capacity, blood oxygen tension, and age are predictors of pulmonary complications. The use of a multidisciplinary approach and a rotating bed may minimize these problems. PMID- 3658132 TI - Hearing preservation after acoustic neurinoma operation. AB - Between 1981 and 1984, 44 patients underwent acoustic neurinoma removal by a posterior cranial fossa approach with an attempt to preserve hearing. Seven tumors were small (less than 20 mm), 28 were medium (20 to 40 mm), and 9 were large (greater than 40 mm). Preoperatively, 4 patients had normal hearing, 15 had serviceable hearing, 10 had poor hearing, and 15 had no hearing. Postoperative hearing was preserved in 11 cases. Of the 19 patients with normal or serviceable hearing, 8 (42%) had serviceable hearing preserved postoperatively. Hearing preservation was achieved in 43% of the patients with small tumors, 25% of those with medium tumors, and 11% of those with large tumors. This study confirms the value of the suboccipital approach, which can be used in an attempt to preserve hearing whenever the patient has serviceable hearing preoperatively and whenever the tumor size makes it feasible. PMID- 3658133 TI - Fascicular ligation in the prevention and treatment of painful terminal neuroma: an experimental study in the rat. AB - The role of microfascicular double ligation and interligature coagulation in the prevention of painful neuroma was studied in an experimental model of section of the sciatic nerve in the rat. The experimental parameters used were the onset of autotomy and the weekly autotomy score. The autotomy of the denervated limb is a behavioral pattern that occurs in the experimental animal after the severing of peripheral nerves and has been related to anomalous electrical activity originating from the neuroma. Microfascicular ligation was performed immediately after section of the sciatic nerve or 10 days later. The results were compared to those of control groups treated with simple nerve section or simple neuroma resection 10 days after nerve section. The results show that immediate or delayed microfascicular ligation has no effect on pain as measured by the development of autotomy. PMID- 3658134 TI - Spinal cord decompression for Gaucher's disease. AB - We report an individual with Type I nonneuronopathic Gaucher's disease who experienced the rare complication of spinal cord compression secondary to a sclerotic vertebral fracture. He successfully underwent anterolateral spinal cord decompression and spinal fusion despite the severity of his generalized skeletal disease. PMID- 3658135 TI - Magnetic resonance imaging of syringomyelia associated with an extramedullary spinal cord tumor: case report. AB - The association of syringomyelia and extramedullary spinal cord tumors is rare. We present the case of a patient with this association documented by magnetic resonance imaging and discuss the unusual features of the syrinx. PMID- 3658136 TI - "Caval-septal" hematoma: does it exist? AB - A "caval-septal" hematoma shown by computed tomography has been described in cases of ruptured aneurysms arising from the anterior communicating artery. This term seems to imply that the hematoma is confined to the cavum septi pellucidi. This common findings almost always represents a hematoma in the anterior interhemispheric fissure. PMID- 3658137 TI - Demyelinating disease of corpus callosum presenting as glioma on magnetic resonance scan: a case documented with pathological findings. AB - Magnetic resonance imaging (MRI) has improved the diagnosis of several pathological entities of the brain. MRI especially has been credited with distinguishing demyelinating diseases of the central nervous system from other diseases. The presence of a mass effect in a demyelinating disorder, however, makes difficult the distinction between tumor and a demyelinating disease. We report a case of a demyelinating disorder simulating an infiltrating glioma of the corpus callosum on MRI scan, resulting in surgical intervention. To our knowledge, this is the first case to be reported with MRI and documented pathological findings. PMID- 3658138 TI - Coincidence of an arachnoid cyst of the middle fossa and a pituitary adenoma. PMID- 3658139 TI - Multiple chronically implanted catheters. PMID- 3658140 TI - Cisternal drainage after aneurysm operation. PMID- 3658142 TI - Nitrous oxide and pneumocephalus. PMID- 3658141 TI - Intracarotid BCNU for glioma. PMID- 3658143 TI - Interhemispheric communication of visual learning: a developmental study in 3-6 month old infants. AB - Infants aged 12-26 weeks (3-6 months) were presented with a visual category discrimination learning task (normal vs scrambled faces) in the right or left visual field. Once they had reached the learning criterion, they were tested for transfer to the untrained visual field in order to establish whether visual experience can be communicated to the opposite hemisphere. Transfer of learning was found to occur in infants aged 19-26 weeks but not in younger ones. Neural pathways possibly forming the channels for this communication are discussed. PMID- 3658144 TI - Interference and priming within and across visual fields in a lexical decision task. AB - A lower-case target word or non-word was laterally presented by itself or simultaneously with an upper-case distractor word in the same or in the opposite visual field. The distractor words were either semantically associated or unrelated to the target. Subjects performed a lexical decision task on the target. Two kinds of selection within and across visual fields were investigated. Selection of an external target relevant for the response (filtering) and selection of an internal target by automatic priming. No lateral asymmetry was found for automatic priming. Filtering was equally efficient within hemispheres, but strongly asymmetrical across hemispheres. Unrelated distractor words presented to the right hemisphere interfered less with target processing in the left hemisphere than vice versa. Thus, all distractor words received equivalent semantic processing; those presented to the right hemisphere, however, were least costly to exclude from task-relevant processing in the left hemisphere. PMID- 3658145 TI - Visual hemispace differences reflect hemisphere asymmetries. AB - The relationship between the representation of the extracorporeal visual hemispace and the contralateral hemisphere has been investigated by presenting visual stimuli foveally either in the right or in the left hemispace. In a lexical decision task (Exp. 1) and a face-familiarity decision task (Exp. 2) lateral asymmetries very similar to those obtained using the divided visual field technique have been found. These results suggest that under particular circumstances the hemispace representation in the contralateral hemisphere overrides the retinal representation. Finally, it was found that in a lexical decision task performance with stimuli in the right hemispace was very similar to that with stimuli in a central position. The physiological and adaptive meaning of this phenomenon is discussed. PMID- 3658146 TI - Scanning the visual field without eye movements--a sex difference. AB - Subjects identified the location of a briefly exposed target pattern in the presence of five other patterns. Right-handed females, but not males, exhibited a significantly higher error rate in correctly localizing the target pattern when it was in the left visual field, particularly for the left parafoveal region. This unexpected distribution of errors as a function of target location can be accounted for by a sequential (serial) mechanism which scans the visual field. Since the exposure time was too brief for eye movements to have occurred, the results must reflect an internal scan of the neural representation of the information retained in the visual system following the brief stimulus presentation. PMID- 3658147 TI - Analytic processing in the classification of melodies as same or different. AB - Two groups of non-musicians were required to classify pairs of melodies as "same" or "different". The experimental group was instructed to respond as fast as possible, while the control group did not receive such a speed requirement. Contrary to the control subjects, the experimental subjects exhibited a right-ear advantage in accuracy for "different" responses. Thus, time pressure was instrumental in inducing subjects to rely mainly on left-hemisphere processing. The fact that "different" responses were both faster than "same" ones and quicker than melody offset indicates the use of a self-terminating search process. The features searched for were, in all likelihood, local. Indeed, contrary to control subjects, experimental subjects performed equally well with (1) melodies differing in both contour and local pitches and with (2) melodies differing in local pitches only. PMID- 3658148 TI - Dissociation of item and order spatial memory in rats following medial prefrontal cortex lesions. AB - In order to test whether there is a correspondence in function of prefrontal cortex in rats and humans, rats with medial prefrontal cortex lesions were tested for item and order memory for a list of items (spatial locations in a maze). Results indicate that for order memory rats with medial prefrontal cortex lesions cannot remember the order of presentation of four or eight specific spatial locations. This inability to remember order information can be seen even when animals with lesions have to remember only two spatial locations, can self-order the sequence of four or eight spatial locations, or have been presented with the same study phase on every trial. In contrast, for item memory animals with medial prefrontal cortex lesions retain the first item of the list in the variable study phase situation and remember all the items of the list in a constant study phase situation. However, there are also deficits for the last items within a list in the variable study phase situation for both win-stay and win-shift procedures. This deficit might be a function of an impairment in the utilization of appropriate temporal strategies, which normally would facilitate recognition memory in the win-stay and win-shift tasks. In general, the data suggest a partial, but not complete, dissociation of item-order memory. Furthermore, the data suggest that the medial prefrontal cortex is involved in temporal structuring of information. PMID- 3658149 TI - Left-handedness: its association with allergic disease. AB - It has been postulated that anomalous cerebral dominance is associated with disorders of the immune system and increased incidence of autoimmune diseases has been reported in left-handed individuals. In this study, 313 patients attending an allergy clinic were assessed for left- and right-handedness, using the Edinburgh Handedness Inventory. The results were compared to those in 350 age- and sex-matched control individuals. It was found that significantly more (P less than 0.02) left-handers than right-handers attended the clinic. Among atopic patients in general, patients with IgE-mediated symptoms, patients with urticaria and patients with eczema, there was a highly significant increase in left-handers (P less than 0.005). The results are discussed in terms of dominance. PMID- 3658150 TI - Eye-fixation patterns in homonymous hemianopia and unilateral spatial neglect. AB - Eye-fixation patterns while viewing simple patterns were quantitatively analysed in homonymous hemianopic subjects with or without unilateral spatial neglect (USN), using an eye camera. Hemianopic subjects without USN used the strategy to look at the hemianopic side of the patterns longer in order to compensate for their visual field defect. However, those with USN lacked this compensatory eye fixation pattern. PMID- 3658151 TI - Expressive and perceptual asymmetries of the resting face. AB - Lateral facial composites reveal the asymmetry of the resting face. In the current research, we created lateral composites of 30 resting faces, then had subjects compare the two composites of a face with a depiction of the whole face in either normal- or mirror-image. Results indicate that the side of the face in a subject's left visual hemi-space dominates facial recognition. The magnitude of this bias can be altered by priming tasks. It is a bias in facial perception, not memory. PMID- 3658152 TI - Hand movement asymmetry during speech: no effect of speaking topic. AB - Right-handed subjects were videotaped as they spoke on verbal, spatial and neutral topics and the frequencies of their spontaneous hand movements were analyzed. Although subjects made more free movement gestures during the spatial topics than during the other topics, there was a consistent level of right hand preference for free movements across topics. Self-touching movements showed no hand preference in any topic. The results suggest that free movements are generated by a left-hemisphere motor control system which exerts consistently greater influence over the right than the left hand regardless of the source of processing preceding activation of this system. PMID- 3658153 TI - Hand preference and performance effects on line bisection. AB - Right- and left-handed subjects performed a visual line bisection task with each hand. When bisecting horizontal lines, both groups bisected left of true center regardless of hand used. Regardless of hand preference, bisections were significantly left of center only when subjects performed with their left hand. Left-handed subjects using their left hand deviated significantly further left than right-handed subjects using their left hand. Regardless of hand used, right handers bisected vertical lines significantly above veridical center. Left-handed subjects were not significantly above center with either hand. The results require both hemispheric advantage and lateralized activation effects for a complete explanation. PMID- 3658154 TI - Anomia in cerebral diseases. AB - Naming performance was studied in demented patients, age-matched controls, left hemisphere stroke patients with aphasia and right-hemisphere stroke patients. The experimental naming test compared four levels of perceptual difficulty and two language variables: word frequency and word length. Naming accuracy and error types were compared among subject groups. Perceptual difficulty influenced naming in the demented and right-hemisphere stroke patients, but not in aphasics and controls. Visual errors, likewise, characterized the former two groups. Semantically-related errors and circumlocutions characterized the naming of aphasic and demented patients, while phonemic errors were common only in aphasics. The results suggested differing patterns of anomia in different patient groups. PMID- 3658155 TI - A dissociation of conscious visual imagery and visual short-term memory. AB - Two people who reported an impaired ability to form conscious visual images were tested. Compared to a control group of college students, these impaired visualizers were not impaired on two tests of visual short-term memory. Furthermore, they retained more digits in visual short-term memory than they could visualize. These results suggests that deficits in the ability to form conscious visual images can arise without visual short-term memory being impaired, and conscious visual imagery should not be equated with visual short term memory. PMID- 3658156 TI - Sex differences in visual information processing following right cerebrovascular accidents. AB - This study examined whether males and females who had sustained right CVA's but did not show gross asymmetries in processing left- and right-sided visual information would demonstrate visual hemiimperception when tested with more demanding evaluation procedures. Testing involved tasks of reaction time, oral reading and searching for embedded words and figures. Males and females differed in their response patterns for tasks involving searching for embedded target stimuli; specifically, males required greater lengths of time to locate stimuli in left hemispace, while females showed no such pattern of results. This suggests that closer attention must be paid to screening procedures used to detect hemispatial visual imperceptions, particularly among males. PMID- 3658157 TI - An alternative to interference indexes in neuropsychological time-sharing research. AB - Interference indexes are used as criterion measures in a significant proportion of time-sharing paradigms in order to control for the initial discrepancy between left- and right-handed tapping rates. Problems associated with these indexes include low reliability, low statistical power, and especially correlations with baseline tapping rates. An analysis of covariance procedure using raw-score concurrent tapping rates as criterion measures, and baseline tapping rates as covariates, can effectively address these problems as demonstrated through a reanalysis of data. PMID- 3658158 TI - The design and application of a data- and methodbase system for the Aachen Aphasia Test. AB - The basic components of a data- and methodbase system useful for both individual diagnosis and (group-study) research in neuropsychology are described. Such a system enables one to organize, access and evaluate large data-sets of behavioural, neuroradiological and neurological information. The most important component of the system, the data- and methodbase management system, is described in some detail. It operates on databases comprised of Aachen Aphasia Test examinations and standardized CT evaluations as well as on methodbases containing various sets of analysis routines for the psychometric evaluation of (individual) aphasia test results and the evaluation and (graphical) presentation of standardized (individual) CT lesions. Although exemplified for AAT scores the techniques and principles employed are applicable to data- and methodbase systems in general. PMID- 3658159 TI - Why is there a left side underestimation in rod bisection? AB - Subjects set the extremities of a horizontal rod to appear equidistant from a central reference point, with or without central fixation. On either side, the contrast (salience) of the rod against the background was high or low. Extents to the left were set smaller than those to the right, an effect (LSU) which was stronger with central fixation, indicating that both hemispatial and anatomical pathway factors contribute. Reduced salience on the left increased rather than decreased the LSU, indicating the importance of attentional factors. PMID- 3658160 TI - The sensitivity and specificity of MRI in stroke. AB - We compared MRI and CT in a study of 175 patients; 87 infarcts within a week, 40 from 1 to 40 weeks, 25 a year after onset, and 23 hemorrhages, 18 within 2 weeks and 5 in 4 to 8 weeks. Fifty-nine infarcts and eight hemorrhages had sequential scanning. MRI is more sensitive than CT in the early detection of cerebral infarcts. CT is the method of choice to rule out intracerebral bleeding, but MRI is more specific in later stages of hemorrhage. Periventricular hyperintensity is seen more frequently with diabetes than without. Hyperintense white matter patches are often unrelated to clinical events. MRI is useful in following the evolution of strokes and distinguishing acute and chronic infarcts without contrast agents. PMID- 3658161 TI - Predicting cerebral ischemia after aneurysmal subarachnoid hemorrhage: influences of clinical condition, CT results, and antifibrinolytic therapy. A report of the Cooperative Aneurysm Study. AB - Cerebral ischemia from vasospasm is a major cause of death and disability following aneurysmal subarachnoid hemorrhage (SAH). This study examines and compares the relative utility of the initial neurologic examination and early CT in predicting cerebral ischemia after SAH. The influence of antifibrinolytic drugs (AFD) in the development of cerebral ischemia was also studied. AFD increased the risk of cerebral ischemia regardless of the admitting neurologic condition or the findings of CT. Among patients given AFD, impaired orientation or alertness was associated with a higher risk of ischemia. Other neurologic signs were not predictive of ischemia. Clinical features were not predictive of ischemia among patients not given AFD. Focal, thick collections of blood on CT were highly predictive of ischemia, whether or not patients received AFD. Admitting CT is the best prognostic indicator for the development of cerebral ischemia after SAH. It should be used to supplement the clinical examination in selecting patients best suited for therapy to prevent vasospasm. PMID- 3658162 TI - Cerebral blood flow in systemic lupus erythematosus with or without cerebral complications. AB - We measured mean cerebral blood flow (CBF) in 25 lupus patients using the xenon 133 method. The CBF was normal in lupus patients without cerebral disease and also in CNS lupus patients in remission. The CBF was lower than normal during bouts of cerebral lupus (p less than 0.001). Repeat studies showed a stereotyped pattern consisting of depressed CBF during exacerbation of CNS disease and normalization of CBF during remission (p less than 0.01). These results show that CBF is a sensitive indicator of activity of CNS disease and that the direction of change in CBF reflects the clinical course of CNS lupus. PMID- 3658163 TI - Cerebellar glucose metabolism in chronic aphasia. AB - (18F)-Fluorodeoxyglucose PET was used to compare left/right cerebellar hemispheric glucose metabolism in 37 aphasic patients with left hemisphere lesions and 22 age-matched controls. Sixteen aphasic subjects showed cerebellar symmetry. Twenty-one aphasic subjects were found to have cerebellar metabolic asymmetry, which (1) resulted from an absolute reduction in local cerebral metabolic rates of glucose in the right cerebellar hemisphere; (2) was associated with left less than right glucose metabolic asymmetry in the frontal, parietal, caudate, and thalamic regions; (3) was associated with Broca's region and deep hemisphere structural damage to the internal capsule and basal ganglia; (4) related to reduced functional motor performance, spontaneous speech, naming, reading, and writing; and (5) included all Broca's aphasia subjects. PMID- 3658164 TI - Controlled-release levodopa/carbidopa. II. Sinemet CR4 treatment of response fluctuations in Parkinson's disease. AB - Sixteen patients with Parkinson's disease and therapeutic response fluctuations entered an open-label trial of a controlled-release carbidopa/levodopa preparation, Sinemet CR4. Sinemet CR4 behaved as a slow release preparation. At the end of 6 weeks CR4 treatment, there was an increase in percent "on" time and mean interdose interval; the number of daily doses and "off" periods were diminished and a slight reduction in the variability of plasma levodopa levels was observed. Overall benefit waned over the next 6 months, despite addition of standard levodopa or Sinemet to overcome the delayed onset of antiparkinsonian effect of CR4 which resulted from prolongation in the Tmax for levodopa. The major benefits of CR4 were reduction in off time and in the number of daily off periods, with fewer levodopa doses per day and prolongation of the interdose interval. PMID- 3658165 TI - The risk of automobile accidents with seizures occurring while driving: relation to seizure type. AB - Automobile accidents occurred with 55% of seizures in epileptic drivers with both well-described seizures at the wheel and a well-classified epilepsy diagnosis. A further 38% of seizures would have led to accidents in less fortunate settings. Complex partial seizures occurred in 81% of patients and were responsible for 88% of accidents. Immediate alterations of consciousness were significantly more likely to lead to accidents than were seizures beginning with an aura. Motor activity during simple partial seizures was also responsible for some accidents. Differences in seizure frequency may account for different crude accident rates among studies of epileptic drivers. We suggest guidelines for licensing restrictions that seem safe and reasonable. PMID- 3658166 TI - The significance of head and eye turning in seizures. AB - We evaluated the history of ictal versive movement in determining the site of the seizure focus. The focus was in the hemisphere opposite the direction of head or eye turning in more than 90% of patients. Ipsiversive movements were more likely to occur with temporal foci and were never found with occipital foci. Maintenance of awareness during versive movements indicated a contralateral focus in 100% and origin from the frontal lobe in 93%; a temporal focus was more likely if awareness was not maintained. Ictal versive movements, if unequivocal, consistent, and forced, are of reliable lateralizing and localizing value. PMID- 3658167 TI - Causes of treatment failure with antiepileptic drugs vary over time. AB - The V.A. Epilepsy Cooperative Study Group evaluated monotherapy with carbamazepine, phenobarbital, phenytoin, and primidone in a total of 622 patients with previously untreated partial seizures. In the 24 months following onset of treatment, 223 patients failed treatment. Analysis of these failures reveals that the majority occurred during the first 6 months with equal contributions to failure from systemic toxicity, neurotoxicity, and seizures. The contribution of systemic toxicity to failure was significantly less in the next 18 months. An increase in the contribution of seizures to failure was seen in this latter period. PMID- 3658168 TI - ECG abnormalities in patients with epilepsy. AB - Some investigators believe that patients with epilepsy are at increased risk of sudden death, perhaps because of cardiac arrhythmias. We studied 338 patients with epilepsy referred for simultaneous ambulatory EEG/ECG monitoring. High-risk cardiac arrhythmias were detected in 18 (5.3%) patients while low-risk arrhythmias or negative studies were found in the others. Fifty-six electrographic seizures were seen in 17 patients, but no associated ventricular arrhythmias or conduction defects were identified. We conclude that the incidence of serious cardiac arrhythmias predisposing to sudden death is not increased in patients with epilepsy. PMID- 3658169 TI - Multiple sclerosis in a nationwide series of twins. AB - A nation wide Finnish Twin Cohort was linked with sickness insurance and hospital discharge registers on the basis of the unique identification number assigned to each Finnish citizen. The study series consisted of 4,063 monozygotic (MZ) and 9,001 dizygotic (DZ) same-sexed twin pairs born before 1958 and alive in 1981. Altogether, 22 subjects representing 11 MZ pairs and 10 DZ pairs showed clinically definite multiple sclerosis (MS). In one MZ pair both members had the disease. The frequency of MS among DZ twins corresponded to the figure in the Finnish population, but the prevalence was higher in MZ twins than in DZ twins. PMID- 3658170 TI - Risk factors for Alzheimer's disease: a case-control study. AB - A case-control study was conducted to assess personal and family medical history and the appearance of Alzheimer's disease. We compared 98 men with clinically diagnosed Alzheimer's disease and 162 controls, matched by sex, year of birth, and town of residence. Family history of dementia and personal history of depression were more frequent in patients. The number of cigarettes smoked was greater in cases. PMID- 3658171 TI - Clinical outcome after complete or partial cortical resection for intractable epilepsy. AB - This is the first epilepsy surgery series to analyze the definition of "completeness" of resection, based solely on results of chronic scalp and subdural EEG recording. When patients had complete removal of all cortical areas with ictal and interictal epileptiform discharges, the clinical outcome was usually good. When areas with epileptiform discharges were left behind, good outcome was significantly less frequent. This correlation between complete resection and good outcome was independent of the presence or absence of CT detected structural lesions or sharp waves on post-resection electrocorticography. These results support completeness of resection, defined by prolonged extraoperative EEG, as an important factor in seizure surgery. PMID- 3658172 TI - Looking but not seeing: attention, perception, and eye movements in simultanagnosia. AB - We studied three subjects who reported the apparent "disappearance" of stationary objects from direct view. They had simultanagnosia caused by CT-verified bilateral superior occipital lobe lesions. They had no abnormalities of visual acuity or fields to explain their defect. EOG with computer analysis showed intact motility and scanning. Most important, the subjects reported intermittent disappearance of a light target during EOG-verified fixation--ie, they were looking but not seeing. Results indicate that attention mechanisms that permit sustained awareness of visual targets depend on the superior visual association cortices and are relatively separate from mechanisms that shift gaze and drive visual search. PMID- 3658173 TI - Predictors of disease course in patients with probable Alzheimer's disease. AB - The presence of extrapyramidal signs or psychosis may indicate greater disability in patients with probable Alzheimer's disease. We evaluated the ability of these signs, noted at a patient's first visit, to predict one of two specific clinical endpoints: (1) a preselected score on the modified Mini-Mental State examination (cognitive endpoint), and (2) a preselected score on the Blessed Dementia Rating Scale (functional endpoint). Sixty-five patients were followed either until they reached the endpoints or to the end of the study period. Survivorship curves were drawn to predict the distribution of time to onset of an endpoint in patients with and without the clinical signs. Time to reach the cognitive endpoint was shorter for patients with extrapyramidal signs or psychosis compared with those without these signs and symptoms. These clinical signs did not predict the functional endpoint. We conclude that extrapyramidal signs and psychosis may be useful predictors of intellectual decline in Alzheimer's disease. PMID- 3658174 TI - Glutaric aciduria type I: clinical heterogeneity and neuroradiologic features. AB - We present four patients, two pairs of siblings, with glutaric aciduria type I (GA I). All four had undetectable glutaryl-CoA dehydrogenase activity on fibroblast culture and massive urinary excretion of glutaric acid. All had serum carnitine deficiency at time of diagnosis except one patient who was diagnosed neonatally. All had a unique pattern of frontotemporal atrophy on CT. Remarkably, in both sibling pairs, one child was asymptomatic. This suggests that the biochemical markers hitherto identified with GA I do not encompass the entire scope of the metabolic or enzymatic abnormalities. Alternatively, as yet unidentified mechanisms might spare or delay the destructive process. PMID- 3658177 TI - Brainstem auditory hallucinosis. PMID- 3658175 TI - Multiple sclerosis and the workplace: report of an industry-based cluster. AB - Eleven cases of MS occurred within a 10-year period in a zinc-related manufacturing plant. The observed disease incidence was greater than expected from population data, using multiple approaches to statistical analysis (p less than or equal to 0.01). A case-control study, performed to examine several zinc parameters in blood, failed to indicate specific abnormalities among the MS patients, but all subjects (both MS and controls) working in the plant demonstrated higher serum zinc levels than all subjects (MS and controls) not working there. PMID- 3658176 TI - Prevalence of Parkinson's disease in the Republic of San Marino. AB - A prevalence survey on Parkinson's disease (PD) was performed in the Republic of San Marino, which is the smallest independent state in the world, and is located near the Adriatic coast, within Italy. On April 30, 1986, it had a population of 22,322. We found 34 cases of PD (17 men, 17 women). Crude prevalence ratio per 100,000 population was 152 (154 for men, 150 for women) with an age-adjusted ratio of 185 (both sexes). This study shows that the prevalence of PD in the Mediterranean area of South Europe is similar to that in North Europe and the United States. PMID- 3658178 TI - Acute "upside down" reversal of vision in transient vertebrobasilar ischemia. PMID- 3658179 TI - Postpartum intracranial hemorrhage and phenylpropanolamine use. PMID- 3658180 TI - Phenytoin effect on BAEP. PMID- 3658181 TI - Progressive bulbar palsy and gammopathy. PMID- 3658182 TI - Global aphasia without hemiparesis. PMID- 3658183 TI - Allopurinol and epilepsy. PMID- 3658184 TI - MRI, myelopathy, and MS. PMID- 3658186 TI - Phenomenon of tumor regression in the central nervous system. PMID- 3658185 TI - Correction: Clinical and biochemical correlates of bradyphrenia in Parkinson's disease. PMID- 3658187 TI - [GABA synthesis in the central nervous system of rats with extrapyramidal syndrome after acute cobalt acetate poisoning in cerebral ischemia]. PMID- 3658188 TI - [Changes in ECoG and ECG in acute triethyltin poisoning in rats]. PMID- 3658189 TI - Effect of hyperthermia on the structural and enzymatic properties of rat cerebellum cultured in vitro. PMID- 3658190 TI - [A case of chronic polyradiculoneuritis with especially severe clinical course and extensive neuropathological changes]. PMID- 3658191 TI - [Cardio-inhibitory reflex induced by massage of the carotid sinus in acute myocardial infarct]. PMID- 3658192 TI - [Reversible pathologic Q wave in transient myocardial ischemia induced by hyperventilation. Description of 2 clinical cases]. PMID- 3658193 TI - [A case of cranio-cerebral injury associated with a pericoronary lesion caused by closed chest injury]. PMID- 3658194 TI - [Combined aortic and pulmonary valve stenosis, changes in primary hemostasis and partial deficiency of factor XII in Noonan's syndrome]. PMID- 3658195 TI - [Cardiac function in sclerodermic myocardiopathy]. PMID- 3658196 TI - [Effectiveness of antibiotic prevention of bacterial endocarditis in patients with valve prostheses. Prospective study]. PMID- 3658198 TI - [Echocardiographic evaluation of the cardiac function in Cooley's disease]. PMID- 3658197 TI - [Echocardiographic observations of 2 false chordae tendineae of the left ventricle. Clinical case and review of the literature]. PMID- 3658200 TI - [Acute dissection of the thoracic aorta]. PMID- 3658199 TI - [Supraventricular tachycardia induced by deglutition. Description of a clinical case]. PMID- 3658201 TI - [Our experience in the treatment of spontaneous pneumothorax. 1981-1986]. PMID- 3658202 TI - [Recurrent ventricular tachycardia, torsade de pointes type, in a subject under chronic treatment with tricyclic drugs. Clinical and therapeutic considerations]. PMID- 3658203 TI - [Biochemical changes in the liver and blood of rats treated with high doses of enflurane]. PMID- 3658204 TI - [Hypotension and spinal anesthesia. Clinical study toward an optimal dose of anesthetic]. PMID- 3658205 TI - [Surgical anesthesia and phenylalanine]. PMID- 3658207 TI - [The Swan-Ganz catheter. Its usefulness in improving the prognosis and increasing surgical indications in cases of aneurysm of the abdominal aorta]. PMID- 3658206 TI - [The buprenorphine-droperidol combination in general anesthesia]. PMID- 3658208 TI - [Comparative study of intramuscular and sublingual administration in buprenorphine therapy of acute postoperative pain]. PMID- 3658209 TI - [Right ventricular infarct and atrioventricular blocks]. AB - Right ventricular infarction in inferior left ventricular infarction is very common. We have examined, by means of equilibrium gated radionuclide angiography, the relationship existing between right ventricular infarction and atrioventricular block. Seventy-two patients with inferior wall myocardial infarction were studied. Thirty-nine of them had ventriculographic evidence of right ventricular infarction. Fifteen of them (38%) had a-v block in the acute phase. Only 3 patients without right ventricular involvement (9%) had a-v block. The occurrence of a-v block is usually explained by the fact that the blood supply to the a-v node depends on the right coronary artery. In the patients with right ventricular involvement, the incidence of a-v block is high just because occlusion of the right coronary artery is proximal to the branch to the a-v node. However, the presence of collateral blood supply to the a-v node makes the occurrence of a-v node not so high as expected. PMID- 3658210 TI - [Penbutolol and arterial hypertension]. AB - Penbutolol has proved particularly effective and suitable for the treatment, even on a long-term basis, of recently developed hypertension, especially in its hyperkinetic forms. The drug produces minimal side effects, is well tolerated and gives an early therapeutic response. In addition penbutolol does not cause any significant alterations in the biohumoral parameters of the patients treated and is ideal for combination with dihydralazine, reserpine and dihydrochlorotiazide in the treatment of more stubborn cases, making it possible to reduce the doses of the other drugs without causing bradycardia. PMID- 3658211 TI - [Housedust mites: their importance in the pathogenesis of respiratory allergic diseases in Piedmont]. AB - In this study we have considered the importance of house dust mites (Dermatophagoides farinae and pteronyssinus) in the pathogenesis of respiratory allergic diseases in Piedmont. We have identified, from 1980 to 1986, 1530 subjects with sensitization to at least one of the tested allergens; 479 of these (31.3%) were allergic to both or to one of the tested mites. Particularly 97 subjects (6.3%) were sensitized to Dermatophagoides farinae, 73 (4.8%) to Dermatophagoides pteronyssinus and 309 (20.2%) to both of them. This group included 258 males (53.9%) and 221 females (46.1%). Most of the examined subjects had shown the clinical symptoms before the 35th year of age (366 subjects, 76.4%). The mean age of beginning of clinical picture has come out to be of 27.377 +/- 11.527 SD year old. This result shows no significant differences with the mean age come out in allergic subjects to other allergens (26.939 +/- 10.755 SD); 196 subjects (40.9%) presented rhinitis-conjunctivitis, while 102 subjects presented bronchial asthma-rhinitis-conjunctivitis. We have found that bronchial asthma (alone or with other symptoms) was present in 186 subjects (38.8%), while in the allergic subjects sensitized to other allergens was present only in 299 out of 1051 (28.4%); 277 subjects had continuous symptoms (57.8%) while 202 subjects (42.2%) had symptoms only in some periods of the year. PMID- 3658212 TI - [Angiosarcoma of the breast]. AB - Two cases of angiosarcoma of the breast observed in 1981 and 1982 are reported; one of these is still living, but with local recurrence. The pathogenesis, classification, prognosis and therapy of this malignant tumor are analysed. The review of the literature and personal experience seem to suggest that the treatment of choice should be surgical with complementary radiotherapy. PMID- 3658213 TI - [Subacute cerebellar degeneration in cystadenopapillary carcinoma of the ovaries]. AB - A subacute cerebellar degeneration-like paraneoplastic syndrome is reported in a woman with cystoadenopapillar carcinoma involving both ovaries. This syndrome, characterized by remarkable cerebellar ataxia, is an exceptional disorder which pathogenesis is still unknown although there is a hypothesis of a viral infection and autoimmunitary unchaining. PMID- 3658214 TI - [Personality profile of cancer patients under ambulatory chemotherapeutic treatment]. AB - The MMPI questionnaire was used as a personality test on 20 painfree cancer patients, otherwise in good health and undergoing outpatient chemotherapy. Analysis of the data shows that even in an early stage cancer can produce significant alterations in personality. 85% of the patients studied had emotional disorders with hypochondria and depression being the psychopathological profiles most commonly observed. PMID- 3658215 TI - Import of multiresistant bacteria from the Middle East to Norway. PMID- 3658216 TI - Horseradish peroxidase study of the localization of motoneurons in the accessory nucleus (XI) of the Japanese toad. AB - It has been conventionally accepted that the anuran accessory nerve (nXI) only innervates the musculus cucullaris (C). However, we have found that the nXI of the Japanese toad innervated the musculus interscapularis (IS) in addition to the C. The motoneurons innervating these muscles were labelled by the intramuscular injection of horseradish peroxidase (HRP). In the accessory nucleus (XI), the motoneurons were somatotopically organized: the C motoneurons were localized more rostrally, while the IS motoneurons more caudally. PMID- 3658217 TI - In situ hybridization to rat brain and pituitary gland of growth hormone cDNA. AB - Using in situ hybridization, we have investigated the presence of mRNA coding for growth hormone (GH) in the rat brain. Using 32P-labeled GH cDNA as a probe, the pituitary gland showed hybridization in unfixed sections. Using 3H-labeled GH cDNA hybridized to fixed sections, only cells in the anterior pituitary were labeled in good agreement with the localization of somatotropes. In the brain, wide zones were labeled with 32P-GH cDNA: the caudate putamen, the striatum, the ventral thalamus, the formatio reticularis and the basal cortex. With the 3H GH cDNA probe, more discrete regions of the brain showed hybridization: the basal cortex, the outside part of the hippocampus and the caudate putamen. PMID- 3658218 TI - A direct projection from the tuberomammillary nucleus to the spinal cord in the rat. AB - After injections of retrograde fluorescent tracers (True blue (TB), Diamidino yellow (DY) and Fluorogold) into the upper cervical segments of the rat spinal cord, a group of labeled neurons were consistently found bilaterally in the tuberomammillary nucleus (TM) of the hypothalamus with an ipsilateral predominance. The data from injections of two different tracers (TB and DY) in the same animal suggest that the vast majority of TM cells projecting to the spinal cord rarely give off divergent axon collaterals to the frontal/prefrontal cortices, striatum, amygdala and superior colliculus. PMID- 3658219 TI - In vitro autoradiography of [3H]acetylcholine binding in rat hind limb muscles. AB - The morphological distribution of acetylcholine receptors in normal and denervated rat tibialis anterior and soleus muscles was studied by in vitro quantitative autoradiography with [3H]acetylcholine (ACh). In normal muscles [3H]ACh binding was restricted to the neuromuscular junction, while denervated muscles showed binding also in extrajunctional areas. After denervation there was also an increase in the junctional binding. PMID- 3658220 TI - Species differences in the localization of 'peripheral' type cholecystokinin receptors in rodent brain. AB - A comparison of cholecystokinin (CCK) receptor binding to sections of rat, mouse and guinea pig brain has been performed using 125I-Bolton Hunter CCK and the selective peripheral CCK receptor antagonist L-365,031. In both rat and mouse, 125I-Bolton Hunter CCK binding in the region of the interpeduncular nucleus (IPN) was inhibited by L-365,031 indicating that these receptors resemble CCK receptors found in peripheral tissues. In the mouse especially, dense regions of peripheral CCK receptors were detected either side of the IPN. By contrast, in the guinea pig IPN no evidence of L-365,031-sensitive binding could be found. The present reports shows that in different species, regional variations in brain CCK receptor binding occur not only in the case of classical 'brain' receptors, but also for the more discretely localised 'peripheral' type CCK receptors. PMID- 3658221 TI - Impairment of learning by cueing during postlearning slow-wave sleep in rats. AB - Rats were trained in a two-way shuttle avoidance task, 20 trials per day for 3 consecutive days. The conditioned stimulus preceding a footshock was an ear shock in expt. 1, it was a tone in expt. 2. In both experiments, experimental animals received non-awakening ear shocks during 6 periods of slow-wave sleep (SWS) following each conditioning session. Control animals received no ear shock during SWS. Results showed that ear shocks delivered during SWS impaired subsequent learning performances only in expt. 1, i.e. when they were relevant to the learning task and could act as a reminder treatment. PMID- 3658222 TI - Excitatory actions of tetrahydro-9-aminoacridine (THA) on hippocampal pyramidal neurons. AB - The action of tetrahydro-9-aminoacridine (THA) on guinea pig pyramidal neurons was examined using intracellular recording in an in vitro hippocampal slice preparation. THA had a powerful excitatory action on pyramidal neurons, causing depolarization, increased firing, and an increase in input resistance. This excitatory action of THA persisted in atropine and in tetrodotoxin. The estimated reversal potential of this THA effect was near -90 mV. These results indicate that THA has a direct excitatory action on pyramidal neurons independent of its anticholinesterase activity, resulting from blockade of a conductance carried predominantly by potassium ions. PMID- 3658223 TI - A proteolytic 140-kDa fragment of neurite outgrowth factor and its cell-binding activity. AB - A neurite outgrowth factor (NOF) from chicken gizzard was treated with elastase, and a protease-resistant fragment of 140 kDa (F-140) with heparin-binding activity, was isolated from the digested mixture. Although F-140 showed no neurite outgrowth activity, it could bind dissociated cells from the dorsal root ganglia of chick embryos. The antiserum to F-140 inhibited the cell binding activity of native NOF in a dose-dependent manner, but not the neurite outgrowth activity. When membrane proteins from whole chick embryos were incubated with NOF or F-140, a protein band of 41 kDa was detected as a major NOF-binding component. PMID- 3658224 TI - Inhibition of sexual behavior in female rats by intracerebral injections of Met enkephalin in combination with an inhibitor of enkephalin degrading enzymes. AB - Injection of Met-enkephalin, either subcutaneously (10 or 100 microgram, s.c.), intracerebroventricularly (100 ng or 1 microgram, i.c.v.) or into the mesencephalic central gray (100 ng), had no inhibitory effect on sexual behavior in female rats. If combined with [(R)-3-(N-hydroxy)-carboxamido-2 benzylpropanoyl]-L-alanine (kelatorphan, 5 micrograms i.c.v.; 1.5 micrograms in the central gray; 200 micrograms s.c.), an inhibitor of enkephalin degrading enzymes, however, i.c.v. or central gray (100 ng), but not s.c. (100 micrograms), injection of Met-enkephalin suppressed the behavior. Injection of Leu-enkephalin, s.c. or i.c.v. alone or in combination with kelatorphan, had no inhibitory effect. Peptidases may rapidly inactivate Met-enkephalin after intracerebral injection and prevent the behavioral effect. Inhibition of sexual behavior by Met enkephalin may occur during lactation, a physiological state when the behavior is suppressed by an opioid peptide. PMID- 3658225 TI - Acquisition of a brief behavioural experience in the rat is inhibited by the brain-specific monoclonal antibody, F3-87-8. AB - Intraventricular infusion of the brain-specific monoclonal antibody F3-87-8 is demonstrated to inhibit the acquisition of a passive-avoidance paradigm in a rat model. Antibody was infused prior to, and following, training of a step-down task and recall was assessed after 24 and 48 h. The antibody only inhibited recall when infused prior to training and no effect was seen when administered 6 h after acquisition of the task. No effect was found with absorbed antibody or in sham operated animals and open field studies showed no alterations in locomotor activity. Results are discussed considering available information on the antigen and current memory/learning theories. PMID- 3658226 TI - Dextrorphan and dextromethorphan attenuate hypoxic injury in neuronal culture. AB - The dextrorotatory opioid derivatives, dextrorphan and dextromethorphan, can attenuate hypoxic injury in cortical cell cultures. This effect is concentration dependent in the micromolar range, and not strongly stereospecific, as it can also be demonstrated with the levorotatory enantiomer of dextrorphan, levorphanol. The possibility that these clinically available compounds may have therapeutic utility in hypoxic or ischemic encephalopathy warrants further investigation. PMID- 3658227 TI - Dendritic maturation in cat retinal ganglion cells: a Lucifer yellow study. AB - The dendritic morphology of developing cat alpha- and beta-retinal ganglion cells was investigated by intracellular injection of Lucifer yellow. In both cell classes the basic pattern of adult morphology was present at birth. However, the presence of transient small spiny protrusions along the dendrites was characteristic of early postnatal cells. Many alpha-cells were further distinguished by a small degree of dendritic bi-stratification which disappeared within the first 5 postnatal days. Therefore during the period before the eyes opened (P7-P10) there was a considerable degree of modification and maturation in dendritic morphology in both classes of retinal ganglion cells. alpha- and beta cells exhibited differing temporal patterns of dendritic growth, which argues against a 'passive-stretching' hypothesis that explains dendritic field enlargement solely as an effect of retinal areal growth. PMID- 3658228 TI - Peripheral pathways for neuropeptide Y- and cholecystokinin-8-immunoreactive nerves innervating the rat ovary. AB - The superior ovarian nerve (SON) or plexus nerve (PN) innervating the rat ovary was transected separately or in combination and the effects of these nerve lesions on intra-ovarian NPY- or CCK-8-immunoreactive nerve fibers was evaluated. Transection of the SON did not affect NPY or CCK-8-immunoreactive nerve fibers. In contrast, section of the PN eliminated nerve fibers immunoreactive for these neuropeptides. This study demonstrates that both NPY- and CCK-8-immunoreactive nerve fibers reach the ovary via the PN. PMID- 3658229 TI - The relationship of terminals containing neuropeptide Y-like immunoreactivity to lumbar sympathetic vasoconstrictor neurones in the rabbit. AB - The distributions of preganglionic neurones retrogradely labelled with horseradish peroxidase and of immunohistochemically identified varicose axons reactive for neuropeptide Y (NPY-IR) in the intermediate zone of rabbit lumbar spinal segments have been compared. Neurones projecting in the caudal lumbar sympathetic chain (LSC), which are mainly vasoconstrictor, were located laterally, associated with dense accumulations of NPY-IR terminals in mid L3 to caudal L4. In all other regions of the lumbar intermediate zone, there was relatively little correlation between the location of either LSC neurones, or those projecting to the pelvic viscera, and aggregations of NPY-IR axons. Most of these axons probably arise in the C1 nucleus, but it seems possible that this nucleus innervates only some groups of lumbar vasoconstrictor neurones. PMID- 3658231 TI - Single channel currents of different amplitude activated by glutamate in a tonic (slow) crayfish muscle. AB - Single channel currents were recorded by means of the patch-clamp technique from a tonic (slow) crayfish muscle in the presence of 5 mM glutamate. The experiments were carried out with 'Gigaohm-seals' in the 'cell-attached' mode at 15-17 degrees C. Five classes of single channel currents with different mean amplitudes were resolved: i1 = -0.75 +/- 0.43 (S.D.) pA, i2 = -1.4 +/- 0.4 pA, i3 = -3.5 +/- 0.63 pA, i4 = -8.5 +/- 0.92 pA and i5 approximately equal to 2 X i4, i2, i3 and i4 were recorded at resting membrane potential, Eo approximately equal to -80 mV (pipette potential Vp = 0), while i1 and i5 were recorded at 40 mV hyperpolarized to Eo (Vp = +40 mV). The current most frequently seen was i4 which is the excitatory glutamate-activated single channel current recorded previously by Franke et al. The membrane reversal potentials and channel conductances for i2 and i4 were estimated to be +60 mV (Eo + 140 mV), 13 pS for i2 and +40 mV (Eo + 120 mV), 80 pS for i4. It was assumed that up to 40 i1 currents could superpose in a single patch to generate a DC current of up to -30 pA with current fluctuations the intensity of which increased with the DC current amplitude. Often variable combinations of i1 to i4 currents could be recorded simultaneously in a single patch. In particular, simultaneous activity of i1, i4; i2, i4 and i3, i4 currents was observed in different single patches. PMID- 3658230 TI - Chronic exposure to random restraint stress retards the development of estrogen induced pituitary prolactinoma in rats. AB - The effects of stress on carcinogenesis have been equivocal. The present work examined the influence of an unpredictable pattern of chronic restraint stress on estradiol-induced pituitary hyperplasia in male Fischer 344 rats. The animals were grouped as follows: (1) control, (2) stressed, (3) estradiol (31 mg), subcutaneous implant for 40 days and (4) estradiol with stress, 1 h daily, randomly, for 40 days. The pituitaries increased markedly in mass in groups 3 and 4 compared to the first two groups. However, the gland weight in rats exposed to estradiol plus stress was significantly (P less than 0.04) reduced as compared to estradiol per se. Prolactin levels increased due to estradiol treatment and decreased following exposure to stress. Weights of adrenal glands increased as a result of estradiol treatment when compared to those in stressed or untreated animals. This adrenal hypertrophy correlated well with plasma corticosterone levels. The data demonstrate that chronic immobilization stress retarded estradiol-induced pituitary prolactinoma. Modulation of the immune response by stress-related factors may play a role in the inhibition of tumorigenesis. PMID- 3658232 TI - Multisensory convergence in the thalamus of the pigeon (Columba livia). AB - Neuronal activity was extracellularly recorded from the nucleus dorsolateralis posterior thalami (DLP) of anesthetized pigeons. The sensitivity of individual cells to stimuli of different sensory modalities: somatosensory, visual and auditory was investigated. A substantial population of the DLP neurons responded to mechanical stimulation of large, often bilateral areas of the animal's body surface. No somatotopic organization could be detected. The functional properties of these neurons resembled those described for mammalian nucleus posterior thalami neurons. The visually responsive cells could be driven from large areas of the visual field. Auditory sensitive neurons were optimally activated by wideband noise. Twenty-nine percent of the DLP recorded neurons showed polysensory properties responding either to somatosensory and visual or to somatosensory and auditory stimuli. PMID- 3658233 TI - Effects of acetylcholine on internal intercostal muscle activity in the rabbit. AB - In pentobarbitone-anesthetized rabbits, intracarotid injections of acetylcholine (ACh, 3-30 micrograms) during inspiration led to an inhibition of internal intercostal muscle activity (IIMA). After the section of the carotid sinus nerve (CSN), ACh-induced inhibitory responses in IIMA were abolished. In addition, changes of the rabbit carotid chemoreceptor activity were studied by ACh (3-30 micrograms) given into the carotid body region during inspiration. Spontaneous chemoreceptor activity was inhibited in a dose-dependent manner by ACh. These results suggest that the inhibitory responses of IIMA to ACh are probably mediated through the carotid chemoreceptor reflexes. PMID- 3658234 TI - Effect of copper sulphate on the rate of afferent discharge in the gastric branch of the vagus nerve in the rat. AB - The afferent nerve activity was recorded from a nerve filament isolated from the peripheral cut end of the gastric branch of the vagus nerve. The gastric perfusion of 4 ml of two different concentrations (0.04% and 0.08%) of CuSO4 solution provoked an increase in afferent activity. The stimulating effect of the 0.08% solution was stronger than that of the 0.04% solution, and lasted for a longer period of time. The observations suggest a possible mechanism by which CuSO4 elicits emesis. PMID- 3658235 TI - Neural plasticity of basal forebrain cholinergic neurons: effects of gangliosides. AB - Nucleus basalis magnocellularis (NBM) cholinergic neurons, furnishing the major portion of the extrinsic cholinergic innervation of the rat cortex, undergo specific retrograde changes in cell somata and choline acetyltransferase (ChAT) activity after cortical lesions. These are prevented in young and mature animals, but not in aged rats, by the chronic administration of exogenous ganglioside GM1 after lesioning. However, a delay of 10 days (in young animals) in the commencement of treatment averted the responses to GM1 in lesioned animals. It is suggested that the effects of exogenous gangliosides on retrograde biochemical and morphological alteration of cholinergic neurons may vary with circumstances permissive of plastic changes of central nervous system neurons at the time of administration. PMID- 3658236 TI - Effects of corticosterone on neurones of the locus coeruleus, in the rat. AB - The effects of microelectrophoretic application of corticosterone (CS) on single neurones of the locus coeruleus (LC) were investigated in rats under urethane anaesthesia. Ejecting currents generally ranged from 10 to 60 nA. CS produced an excitatory effect in 73% of the neurones and no effect in 27%. The prevailingly excitatory effects induced by CS on LC neurones may be related to the regulation of those complex events, which constitute the 'stress response'. PMID- 3658237 TI - Metals, trace elements and mammalian development. Proceedings of the symposium. December 10-12, 1986, Sydney NSW, Australia. PMID- 3658238 TI - Effect of chronic lead treatment on the development of neuromuscular connections in the rat. PMID- 3658239 TI - Reproductive effects of occupational exposures to lead: policy considerations. PMID- 3658240 TI - Manganese, malformations and motor disorders: findings in a manganese-exposed population. PMID- 3658241 TI - The use of scalp hair to monitor manganese in aborigines from Groote Eylandt. PMID- 3658242 TI - Reproductive toxicology of manganese in rodents, including exposure during the postnatal period. PMID- 3658243 TI - Retention and distribution of cadmium in the mouse brain: an autoradiographic and gamma counting study. PMID- 3658244 TI - Federal funding for nursing education: competition for federal dollars. PMID- 3658245 TI - Chorionic villus sampling: counseling your patient. AB - Chorionic villus sampling is a technique for prenatal genetic screening that has been widely publicized by the print and television media. Although not yet commonly available, women may seek additional information about the procedure from nurse practitioners. This article discusses the women for whom this procedure is most appropriate, the procedure's accuracy, sampling techniques, safety records and the procedure's accessibility and cost. The NP's role in counseling and anticipatory guidance is also discussed. PMID- 3658247 TI - Continuing education: how to choose the best course for you. PMID- 3658246 TI - Parental attitudes toward adolescent sexuality: transcultural perspectives. AB - The problem of teenage pregnancy continues to impact private and public resources, affecting all socioeconomic and cultural groups. A key factor for nurse practitioners to consider when planning sex education programs is the differing parental attitudes toward teenage sexuality. These attitudes are especially important to keep in mind when dealing with parents from minority cultural groups, as these groups are often highly influential in determining the nature of adolescent sexual behavior and attitudes toward reproduction. A study of Cuban and Haitian child-rearing practices clearly demonstrates two divergent parental views of adolescent sexuality. Nurse practitioners must recognize these differing views, and individualize their approach, in order to develop culturally sensitive sex education programs for adolescents and their parents. Suggestions are provided for development of such programs for Cuban and Haitian parents and children. PMID- 3658248 TI - A healing game. PMID- 3658249 TI - Myths & facts about diabetes. PMID- 3658251 TI - Managing the patient with upper airway obstruction (continuing education credit). PMID- 3658250 TI - Ruptured arteriovenous shunt. PMID- 3658252 TI - The risks of not following orders. PMID- 3658253 TI - Helping families in crisis hold on. PMID- 3658254 TI - Nurses can change things. PMID- 3658255 TI - How to repair cracks, holes, and tears in central venous catheters. PMID- 3658256 TI - A checklist for better discharge planning. PMID- 3658257 TI - Meet the "chronologically gifted". PMID- 3658258 TI - Update on cardiac drugs: inotropic and chronotropic agents. PMID- 3658259 TI - Mr. Tanner knew what he wanted. PMID- 3658260 TI - Nursing and A.I.D.S.: is it worth the risk? PMID- 3658261 TI - When the patient's blood pressure falls: what does it mean? What should you do? PMID- 3658262 TI - How nurses feel about A.I.D.S. PMID- 3658263 TI - How to deal with apnea. PMID- 3658264 TI - Feeling at home. PMID- 3658265 TI - [Encountering a novel type of health problems]. PMID- 3658266 TI - [Chemotherapy: prevention of alopecia]. PMID- 3658267 TI - [Silence: rape is taking place]. PMID- 3658268 TI - [To the aid of elderly people]. PMID- 3658269 TI - A strategic course of action--intensifying multidisciplinary teamwork. PMID- 3658271 TI - [Detection of foot problems]. PMID- 3658272 TI - [Helping relationship in the laboratory]. PMID- 3658270 TI - [The administration of a drug--no room for error]. PMID- 3658273 TI - [Self assessment: personal and professional growth]. PMID- 3658274 TI - Nuchal cords and neonatal outcome. AB - To assess the significance of nuchal cords, 110 affected woman-infant pairs at term gestation were compared with 110 control pairs. Newborns with a nuchal cord had an increased prevalence of umbilical artery acidemia (22 of 110 versus 13 of 110; P less than .05) and more variable fetal heart rate (FHR) decelerations in the first stage of labor (mild = 41 versus 20; P less than .0001; moderate-severe = 21 versus 5; P less than .0001) and the second stage of labor (moderate-severe = 46 versus 21; P less than .0001). In newborns with a nuchal cord, the umbilical artery acidemia was usually mixed (68%) or respiratory (23%) in origin, and pure metabolic acidemia was infrequent (9%). We conclude that nuchal cords are associated with an increased prevalence of variable FHR decelerations in the first and second stages of labor and with an increased incidence of umbilical artery acidemia. PMID- 3658275 TI - Persistent pulmonary hypertension: assessment of perinatal risk factors. AB - Persistent pulmonary hypertension of the neonate, a disease of unknown etiology, is associated with a mortality rate as high as 50%. We conducted a retrospective study (1979-1983) to identify antenatal events that may be associated with this disease. Thirty-seven mothers of neonates with this disorder were compared with 150 randomly selected control patients. Logistic regression analysis revealed that meconium, maternal fever (caused by urinary tract infection, upper respiratory infection, chorioamnionitis, and unknown causes), maternal anemia (caused by abruptio placentae, placenta previa, and unknown causes), and maternal pulmonary disease (caused by asthma and/or pneumonia) were associated with persistent pulmonary hypertension of the neonate. The computed odds ratios for the variables associated with this disease were increased significantly above the controls. In addition, cesarean section, nonvertex presentation, fetal distress, and vaginal bleeding were found to be significant on univariate analyses. The cesarean section rate in the study group was 59%, with the primary indications of fetal distress and/or third-trimester bleeding in 77.3% of instances. These data suggest that antenatal risk factors and the computed odds ratio may help identify pregnancies likely to produce infants at high risk for persistent pulmonary hypertension of the neonate. PMID- 3658276 TI - Antepartum ambulatory tocodynamometry: the significance of low-amplitude, high frequency contractions. AB - The clinical significance of low-amplitude, high-frequency contractions was examined during pregnancy in 142 women who underwent daily ambulatory tocodynamometry between 23-36 weeks' gestation. The results indicate that patients destined to develop preterm labor had this contractility pattern significantly more often than did their counterparts who delivered at term (13.5 versus 9.2%; P less than .01). Parity and gestational age had no effect on the occurrence of low-amplitude, high-frequency contractility, but this pattern was also significantly more prevalent in the presence of multifetal gestations, independent of the occurrence of preterm labor. The institution of tocolytic therapy was accompanied by a 50% decrease in the proportion of time occupied by low-amplitude, high-frequency contractions. Although this contraction pattern occurred significantly more often among patients who later developed preterm labor, calculations of its predictive values, specificity, and sensitivity indicate that its presence has relatively limited clinical significance. PMID- 3658277 TI - Trial of labor in previous cesarean section patients, excluding classical cesarean sections. AB - The American College of Obstetricians and Gynecologists has supported the concept of a trial of labor in patients with a previous lower uterine transverse cesarean section, and its safety is generally accepted. The purpose of this report was to present the results of a year-long, prospective study in which the indications for trial of labor were liberalized. Only patients with a previous classical incision or "T" incision on the uterus were excluded. Two hundred seventy-two patients elected to undergo a trial of labor. Vaginal delivery occurred in 216 patients (76.5%). Oxytocin was used as needed, and epidural anesthesia was used in all patients who requested it. One uterine rupture occurred in a patient with a single lower transverse scar. The results of this study suggest that a trial of labor is a safe alternative for patients with a previous single or multiple lower uterine transverse incision or a lower uterine vertical incision. In addition, the use of epidural anesthesia and oxytocin appears safe in patients undergoing a trial of labor. PMID- 3658278 TI - Single-dose cefazolin versus cefonicid for antibiotic prophylaxis in cesarean delivery. AB - The purpose of this prospective investigation was to compare a single intravenous dose of cefazolin to a single dose of cefonicid as prophylaxis for women having unscheduled cesarean delivery. In a double-blind, randomized design, 96 patients were assigned to receive a 1-g dose of cefazolin and 103 patients were designated to receive a 1-g dose of cefonicid. The antibiotics were administered after delivery of the infant. The two groups were comparable with respect to recognized risk factors for postcesarean infection. There were no statistically significant differences between the groups in the incidence of standard febrile morbidity, endomyometritis, urinary tract infection, wound infection, and bacteremia. There were also no significant differences between the groups in the fever index or the duration of hospitalization. We conclude that cefazolin and cefonicid provide a similar degree of prophylaxis against infection in patients having unscheduled cesarean delivery. PMID- 3658279 TI - Maternal and fetal factors affecting success of antepartum external cephalic version. AB - We studied 172 patients who were considered for external cephalic version with tocolysis at term. Before a single attempt at version, a variety of maternal and fetal factors considered likely to affect success were coded for each patient. Maternal age, height, and Quetelet index did not affect success. However, successful version was more likely in parous women than in nulliparous women, and less likely with cornual than with other placentations. Amniotic fluid volume, fetal abdominal circumference, type of breech, and the specific nature of the maternal-fetal spatial relation were also important determinants of success. Fetal biparietal diameter, gestational age, and estimated fetal weight were not. All of these factors can be evaluated before attempting version and can be used when counseling candidates for version. PMID- 3658280 TI - Single-probe spectrophotometry in the assessment of fetal oxygenation. AB - Six sheep fetuses were monitored with a single-probe tissue spectrophotometer. This spectrophotometer provides continuous digital output of the index of hemoglobin that is saturated with oxygen. To vary the fetal pO2, each maternal ewe was given room air, 100% oxygen, 12% oxygen, and 100% nitrogen via rebreathing bag. Fetal venous (N = 4) or arterial (N = 2) blood was analyzed for pO2. There was excellent correlation between the index of hemoglobin saturated with oxygen and the fetal pO2. The single-probe spectrophotometer overcomes two of the technical problems encountered when a double-probe spectrophotometer is used. PMID- 3658282 TI - The screening Papanicolaou smear: contribution of the endocervical brush. AB - Between September 1984 and February 1985, cervical cytologic smears were collected from 510 patients using a spatula and an endocervical swab. These smears were compared with those collected from 510 patients between September 1985 and February 1986 using a spatula and an endocervical brush. The use of the endocervical brush increased the number of smears that contained endocervical cells, for both reproductive-age and postmenopausal women. In women without previous radiation therapy, the rate of suboptimal smears (those without endocervical cells) fell from 12.0 to 1.7% when the endocervical brush was used. This modified smear collection technique improved the quality of the cytologic material. PMID- 3658281 TI - A critical evaluation of the endocervical curettage. AB - A prospective study was undertaken to critically evaluate the endocervical curettage. The study group consisted of 261 patients with colposcopically identifiable cervical lesions that had not been previously biopsied and were not macroscopically suspicious for invasive cancer. In 210 patients, the entire lesion, transformation zone, and squamocolumnar junction were visible (satisfactory colposcopy), and in 51 patients, the full extent of the lesion was not visualized colposcopically (unsatisfactory colposcopy). We used a method of examination not previously described. Colposcopy was performed before and after the endocervical curettage, but before the ectocervical biopsy. This method of examination allowed us to identify potentially contaminated endocervical curettages and to test the null hypothesis that a positive endocervical curettage in patients with satisfactory colposcopy is not the result of contamination. Twenty of 210 endocervical curettages in patients with satisfactory colposcopy were potentially contaminated, as suggested by an ectocervical lesion disrupted by the endocervical curettage. No patient with a positive endocervical curettage had an intact ectocervical lesion. Therefore, the null hypothesis was rejected (P less than .005). Of the 51 patients with unsatisfactory colposcopy, 39 (76%) underwent cone biopsy. Invasive cancer was diagnosed by cone biopsy in two patients when both ectocervical biopsy and endocervical curettage demonstrated only dysplasia. We also confirmed that patients with unsatisfactory colposcopy occasionally benefit from having an endocervical curettage. However, basing the treatment plan for any lesion short of invasive cancer solely on the results of colposcopy, ectocervical biopsy, and/or endocervical curettage could lead to significant undertreatment of some patients. PMID- 3658283 TI - Fluid loss quantitation test in women with urinary incontinence: a test-retest analysis. AB - A modified perineal pad-weighing method for objective quantitation of fluid loss is presented. The bladder was filled by retrograde flow, a sequence of provocative maneuvers was performed under direct supervision, and fluid loss was determined by pad weights. An analysis of immediate test-retest correlation and variability was done in patients with either sphincteric incompetence alone (N = 46) or detrusor instability with or without concomitant sphincteric incompetence (N = 21). Test-retest correlations were high in both groups, suggesting that the method could be applied as an index of severity of urinary incontinence in women. Test-retest within-patient variability was considerable, and limits its usefulness in the analysis of treatment outcome. PMID- 3658284 TI - Factors influencing women's decision to undergo mammography. AB - Despite the consensus that mammography is a valuable screening tool for the detection of early breast cancer, it is underused by physicians, and most women remain unconvinced of its efficacy. We studied consecutively 735 women who underwent mammography at two rural midwestern hospitals to determine the factors that influence the decision to undergo mammography. Those who underwent mammography had significantly more education and higher household incomes than the general population. The decision to have mammography was influenced by many factors, the most important of which were encouragement by the doctor, influence of the media, and the cost of the mammogram. Women of higher socioeconomic status were most likely to be influenced by the media, particularly printed material, but were much less likely than women of lower socioeconomic status to report physician influence as an important factor. These data have implications for the methods physicians use in recommending mammography to individual patients. PMID- 3658285 TI - Metabolic and hormonal effects of 25-mg and 50-mg 17 beta-estradiol implants in surgically menopausal women. AB - A prospective study involving 12 surgically menopausal women was undertaken to determine whether 17 beta-estradiol pellets could maintain bone mineral content without inducing adverse cardiovascular side effects. Surgically menopausal women were randomly selected to have either 25-mg or 50-mg pellets implanted subcutaneously. The bone mineral content of the midshaft of the nondominant radius in the combined group--measured by single photon absorptiometry--increased by 1.8% over the two-year period of observation (P less than .03); the distal bone mineral content of the radius was maintained at 0.8% per annum. No adverse effects were noted in the coagulation profiles or in the coagulation inhibition and fibrinolysis assays of both groups. Serum high-density lipoprotein cholesterol and triglycerides were unaltered, but serum cholesterol values decreased during the six-month period of observation by 14 mg/dL (P less than .05) and 11 mg/dL in the 25- and 50-mg groups, respectively. Carbohydrate and insulin metabolism was unaffected, as was the systolic and diastolic blood pressure. There were no significant intergroup differences in any of the parameters measured. The serum estradiol/estrone ratios of 1.45 and 1.59 reflected a physiologic estrogen milieu at the 25- and 50-mg dosages. Subcutaneous 17 beta-estradiol pellets can effectively maintain the bone mineral content of surgically menopausal women without inducing adverse cardiovascular side effects. PMID- 3658286 TI - The prophylactic effect of doxycycline on postoperative infection rate after first-trimester abortion. AB - A prospective double-blind study was performed to evaluate the effect of prophylactic antibiotic treatment before induced abortion. Eight hundred consecutive women admitted for first-trimester abortion, without signs of genital infection or antibiotic use in the last three weeks, were included in the study. Doxycycline 400 mg or placebo was given as a single oral dose ten to 12 hours before vacuum aspiration. Ninety-one women (11.8%) returned to the hospital with suspected complications. Thirty-two of these women were diagnosed as having pelvic inflammatory disease, eight of whom (2.1%) had received doxycycline before the abortion and 24 of whom (6.2%) had received placebo, a statistically significant difference (P less than .01). A history of pelvic inflammatory disease increased the risk of developing it again after an abortion. PMID- 3658287 TI - Intraperitoneal cis-platinum as salvage therapy for refractory epithelial ovarian cancer. AB - Eighteen patients with residual epithelial ovarian cancer at second-look laparotomy were treated with a combined total of 210 cycles of intraperitoneal cis-platinum. Sixteen patients had previously received cis-platinum containing combination chemotherapy systemically. Seven patients had microscopic residual disease at the start of intraperitoneal therapy, eight had macroscopic disease of 5 mm in diameter or less, and three had disease of 6-10 mm in diameter. The drug was administered weekly in 2 L of Ringer's lactate solution via an indwelling Tenckhoff catheter, and the dose ranged from 30-270 mg per cycle (median 120 mg). The dwell time was 20 minutes. After 12 cycles, response was assessed by open laparoscopy (six patients), laparotomy (eight patients), or peritoneal cytology (three patients). One patient developed distant metastases. Local and systemic toxicity was mild. Delays of therapy were necessary for eight of the 210 cycles because of hematologic toxicity. Of the 15 patients available for pathologic evaluation, four (26.6%) had a complete response and two (13.3%) had a partial response. Results of this pilot study suggest a possible role for intraperitoneal cis-platinum in the management of carefully selected patients with epithelial ovarian cancer. PMID- 3658288 TI - Treatment of metastatic stromal tumors of the ovary with cisplatin, doxorubicin, and cyclophosphamide. AB - From September 1981 until June 1986, eight patients with metastatic ovarian stromal tumors were entered into a prospective phase II study to determine the efficacy of a chemotherapy regimen combining cisplatin, doxorubicin, and cyclophosphamide. Patients received cisplatin 40-50 mg/m2 intravenously (IV), doxorubicin 40-50 mg/m2 IV, and cyclophosphamide 400-500 mg/m2 IV, all on day 1 every 28 days. The median age was 43 years (range 24-65 years). Two patients had stage II disease, one had stage III, and five had recurrent disease (original stage: four stage I and one stage III). The median number of chemotherapy cycles was six (range four to 14). Three patients (38%) had a complete response to therapy (two confirmed by second-look laparotomy), and two patients (25%) achieved a partial response (one verified by second-look laparotomy). The overall response rate was 63%. Toxicity was minimal. Four patients are disease-free at 13+ to 48+ months, one patient is alive with disease at six+ months, and three patients are dead of tumor at four, 17, and 36 months from the start of chemotherapy. These results indicate that the combination of cisplatin, doxorubicin, and cyclophosphamide has modest activity in the treatment of metastatic ovarian stromal tumor. PMID- 3658289 TI - Results of second-look laparotomy in patients with early-stage ovarian carcinoma. AB - One hundred twelve patients with early (FIGO stage I and II) ovarian carcinoma had a second-look laparotomy performed after comprehensive surgical staging and randomization into clinical protocols. Of the 95 patients who were asymptomatic before second-look laparotomy, only 5% had positive findings. In contrast, 53% of the 17 patients with findings that suggested recurrence or bowel obstruction had disease at second-look laparotomy. Overall, only 13% of the entire group of 112 patients had recurrent disease at second-look laparotomy. Asymptomatic patients with early ovarian carcinoma who have undergone careful initial surgical staging followed by appropriate adjuvant therapy can be spared a routine second-look operation. PMID- 3658291 TI - A simplified method for determining individual growth curve standards. AB - To simplify the procedure for obtaining individual growth curve standards, we investigated the use of models derived from the slopes of growth curves determined before 26 weeks' menstrual age. In serial examinations of 33 normal fetuses between 15-38 weeks, we obtained measurements of the biparietal diameter (BPD), head circumference, abdominal circumference, femur diaphysis length, head profile area, abdominal profile area, head cube, and abdominal cube. Rossavik models fitted to these data provided estimates of the coefficients c and s, and fitting linear models to the data before 26 weeks gave estimates of growth curve slopes. Slopes were also estimated from two data points at approximately 16 and 25 weeks. Regression analysis demonstrated a strong linear relationship between loge c and loge SLOPE1 (R2 = 87.3-98.4%), and between s and c (R2 = 64.9-90.3%). Using these relationships, growth models were determined from the slope values. Comparisons between observed measurements and those predicted by these models for the period after 26 weeks indicated that the methods of slope calculation were equally accurate in predicting future growth, and that this accuracy was very similar to that obtained with models based on regression analysis. These results demonstrate that individual growth curve standards for at least eight anatomic parameters during the last 14 weeks of pregnancy can be determined from the data obtained in two examinations before 26 weeks' menstrual age. PMID- 3658290 TI - Histologic prognosticators in stage I squamous cell carcinoma of the vulva. AB - Sixty-four cases of stage I vulvar squamous cell carcinoma were analyzed histologically to define a patient subset at minimum risk for recurrence or nodal metastases. Three patterns of invasion were predefined: carcinoma in situ with early stromal invasion (33%), pushing (8%), and infiltrative (59%). Infiltrative pattern and invasion deeper than 1.5 mm equally predicted nodal metastases (P = .045), although depth measurement in biopsy specimens was subject to sampling error. Confluence and absence of carcinoma in situ each predicted extranodal recurrence (P = .011). Local recurrence appeared more related to inadequate surgical margins than failure to perform radical vulvectomy. Carcinoma in situ with early stromal invasion represents a group at zero risk for nodal metastases. We recommend wide local excision for all stage I lesions. In general, omission of lymphadenectomy should be reserved for cases of carcinoma in situ with early stromal invasion. PMID- 3658292 TI - Bipolar systems--do they perform? PMID- 3658294 TI - Effect of type of anesthesia on blood loss at cesarean section. PMID- 3658293 TI - How often does maternal preeclampsia-eclampsia incite thrombocytopenia in the fetus? PMID- 3658295 TI - The effect of epidural analgesia on the frequency of instrumental delivery. PMID- 3658296 TI - Worksite consumer education programs can influence health care demands. PMID- 3658297 TI - Smoke-free work environments require proper ventilation adjustments. PMID- 3658298 TI - Preventing slip and fall injuries requires environmental controls. PMID- 3658299 TI - Revised ANSI labeling standard includes more OSHA requirements. PMID- 3658300 TI - Hearing conservation program adequacy can be measured before damage occurs. PMID- 3658301 TI - Successful loss control programs require management's time, money. PMID- 3658302 TI - OSHA's shifting responsibilities include controversial new hazards. PMID- 3658303 TI - Promoting nursing diagnosis: keeping your care plans short and simple. PMID- 3658304 TI - Prevention of illness and injury from household products. PMID- 3658305 TI - The necessity of cataract surgery. PMID- 3658306 TI - Let the debate begin... PMID- 3658307 TI - [Ultrastructure of the centrosome in L cells]. AB - Three types of microtubule-organizing centers are present in the interphase L cells: centriolar matrix, pericentriolar satellites, and electron-dense bodies that are not attached to the centrioles. Different types of microtubule organizing centers may be present simultaneously in the same centrosome. In most of the cells some microtubules have their proximal ends free, rather than attached to the microtubule-organizing center. A network of intermediate filaments is condensed around the centrosome. The intermediate filaments run from the centrosome parallel to the microtubules. Although the filaments are often in close proximity to the centrioles and microtubules, direct contacts between them are rare. The intermediate filaments have convergence foci of their own in the centrosome. PMID- 3658309 TI - [Rate of gluconeogenesis in the hepatocytes of the developing chick embryo]. AB - The rate of glucose formation from lactate was determined in the hepatocytes isolated from the liver of developing chick embryos and one day old chickens. The maximum rate of gluconeogenesis is observed in the hepatocytes of 16-17 day old chick embryos. A sharp fall in the rate of gluconeogenesis is noted in the hepatocytes of the embryos before hatching. It decreases still further in one day old chickens. The patterns of the gluconeogenesis rate are similar both for endogenous precursors and lactate. PMID- 3658308 TI - [Ultrastructure of nervous tissue developing in the anterior chamber of the eye. 1. Perikaryons and dendrites]. AB - Embryonic tissues of septum and hippocampus were transplanted into the anterior eye chamber (AEC) of adult rats. The morphology of initial embryonic tissues and of transplants within 3 to 4 months of cultivation in AEC was studied. The transplanted tissue consists of neuroblasts and immature neurones: no synaptic contacts are observed. Within 3 to 4 months, highly differentiated neurones establishing synaptic contacts can be seen in the transplants. At the same time the fine structure of perikaryons and dendrites undergoes some changes: increased vacuolization, transformation of ergastoplasm into lamellar bodies. These can be due to an elevated functional activity of some neurones. Another group of morphological abnormalities (increased number of dendrite processes and microphyllopodia, somatic spines, dendrite cones of growth, tight junctions between perikaryons) suggests incomplete tissue maturation. These might be due to the absence of normal afferent and trophic influences in AEC. PMID- 3658310 TI - [Nonsurgical embryo transplantation in mice]. AB - Nonsurgical transplantation of the mouse embryos at the blastocyst stage into the uterus was performed using a device of original construction. The use of this device made it possible to exclude the loss of embryos, to reduce the amount of culture medium introduced together with the embryos, to lessen the damage of genital tract and ensured guaranteed "ejection" of embryos into the uterus. The females of the third day of pregnancy were used of recipients. Transplantation was performed between the mice of strains CBA/Lac, C57BL/6 and tetrahybrid CBWA. The level of newborn attained 65% of the number of transplanted blastocysts. PMID- 3658311 TI - The effect of a collagen bandage lens on corneal wound healing: a preliminary report. AB - Collagen bandage lenses were inserted in 24 eyes of white New Zealand rabbits following 8-incision radial keratotomy. Specimens were examined at eight and 24 hours by light and electron microscopy. Treated eyes demonstrated more complete epithelial healing, as evidenced by surface microvilli and differentiation into multi-layers. In the treated eyes there was reduced stromal edema at the wound site, and reactive keratocytes were limited to the wound margins. Collagen bandage lenses therefore may be useful in the treatment of a variety of ocular surface problems. PMID- 3658312 TI - Removal of lens epithelial cells by ultrasound in endocapsular cataract surgery. AB - A new method was developed to remove lens epithelial cells during endocapsular cataract surgery using a device with a tip that resembles the irrigating aspirating tip for cortex removal by extracapsular cataract extraction. The tip has an opening on the side and end, both 0.20 mm in diameter, for aspiration. The opening at the end serves to remove the cells at the equator. The top of the tip is sandblasted to provide an abrasive surface. This tip is connected to a phacoemulsifier handle. After nucleus delivery and cortex removal, the tip is inserted beneath the inner surface of the anterior capsule. The cells are detached by the abrasive tip, which vibrates by ultrasound, and then aspirated. Histologic examination revealed that the cells can be removed completely, and that this method is more effective than vacuum cleaning. PMID- 3658313 TI - Perforation of the globe during the injection of local anesthesia. AB - Perforation of the globe occurred during injection of local anesthetic into the eyelids. No such occurrence has been reported, although there have been reports of perforation of the globe during retrobulbar injection (five cases), while injecting anesthetic around the superior rectus muscle (one case), and when placing the superior rectus bridle suture (four cases). The prognosis is good if the perforation is recognized and treated immediately. New methods of local anesthesia should greatly reduce the incidence of this complication. PMID- 3658314 TI - Panretinal photocoagulation for radiation-induced ocular ischemia. AB - We present preliminary findings on the effectiveness of panretinal photocoagulation in preventing neovascular glaucoma in eyes with radiation induced ocular ischemia. Our study group consisted of 20 patients who developed radiation-induced ocular ischemia following cobalt-60 plaque radiotherapy for a choroidal or ciliary body melanoma. Eleven of the 20 patients were treated by panretinal photocoagulation shortly after the diagnosis of ocular ischemia, but nine patients were left untreated. In this non-randomized study, the rate of development of neovascular glaucoma was significantly lower (p = 0.024) for the 11 photocoagulated patients than for the nine who were left untreated. PMID- 3658315 TI - Unilateral blepharochalasis. AB - We present two unique cases of unilateral blepharochalasis. Blepharochalasis is an idiopathic disorder of young adults manifested by intermittent, recurrent episodes of eyelid edema. After repeated episodes of swelling, the periorbital tissue develops premature aging with thinned, redundant skin and stretching of the eyelid tendons. Blepharochalasis is considered bilateral; unilateral cases are extremely rare. Ptosis surgery in these cases may be unpredictable due to alterations in the levator aponeurosis. Simple reattachment of the apparent edge of the disinserted levator aponeurosis may cause significant overcorrection and variations in postoperative eyelid heights. Our two unilateral cases demonstrated proptosis on the affected side, and prominent vessels in the levator aponeurosis and suborbicularis muscle planes, plus vascular changes in orbital fat in one case. Blepharochalasis therefore may be an orbital rather than a periorbital disease, as suggested previously. Proptosis is probably overlooked in the usual bilateral cases. When all other causes of unilateral swelling have been ruled out and the findings are consistent with blepharochalasis, this diagnosis should be considered. PMID- 3658317 TI - Idiopathic central serous retinopathy in China: a report of 600 cases (624 eyes) treated by acupuncture. AB - Six hundred Chinese patients (624 eyes) with clinically diagnosed central serous retinopathy were treated by consecutive courses of acupuncture. Eighty-six percent of patients had resolution of their subretinal fluid within 3 months of treatment, a result similar to the natural history of the disease as reported by others in non-Chinese patients. Central serous retinopathy was most common in the 30 to 50 year age group, occurred in males seven times more frequently than in females, and was bilateral in 4% of patients. PMID- 3658316 TI - Oncocytic carcinoma of the plica semilunaris with orbital extension. AB - A 76-year-old male had orbital extension and regional lymph node involvement from an oncocytic carcinoma thought to have arisen in the plica semilunaris of the left eye. Declining early orbital exenteration and radical neck dissection, the patient received radiation therapy. Although initial palliation was achieved, the lesion recurred 1 year later, with massive orbital involvement. Despite exenteration and chemotherapy, the patient expired within 6 months. Oncocytomas arise from transformed epithelial cells, generally in the medial canthal region. Oncocytic carcinoma of the ocular adnexa is extremely rare and no such lesion of the plica semilunaris has been reported. PMID- 3658318 TI - Implantation growth of an iris melanocytic lesion simulating a ciliary body melanoma. AB - A 59-year-old woman had a sectorial pigmented iris tumor in her right eye and was found to have secondary glaucoma unresponsive to medical therapy. Gonioscopy revealed a satellite tumor in the inferior chamber angle, which we suspected to be a ciliary body melanoma. Subsequently, both lesions were removed completely by superior total and inferior partial iridocyclectomy. Histologic examination disclosed a spindle cell nevus with surface plaque associated with a borderline epithelioid cell nevus. This case is an example of unexpected clinical findings that may be encountered in any iris melanocytic lesion, benign or malignant, and the consequent problems of diagnosis and management. PMID- 3658319 TI - A new infusion-aspiration system for extracapsular cataract surgery. AB - This new unit has the advantages of motorized aspiration with greater control and far less cost than a console unit. The instrument is small and light enough to fit comfortably in the surgeon's hand. For those who prefer a small light handpiece, the unit is available in two parts. It is simply designed like a manual aspiration system without the disadvantage of two-handed operation. PMID- 3658320 TI - Specialized needle for laser sclerostomy. PMID- 3658321 TI - Whitnall's sling. PMID- 3658322 TI - Treatment of iris melanoma by photocoagulation. PMID- 3658323 TI - Histochemical studies on the conjunctival goblet cells. I. (Alcian-blue) AB (periodic acid-Schiff) PAS staining and PAS-AB staining. AB - The difference in the histochemical results between AB-PAS and PAS-AB sequence was studied in the conjunctival goblet cells of monkeys and rats by light microscopy. These sequences demonstrated the presence of different staining patterns of goblet cells in the conjunctiva. In the monkey conjunctiva, the results revealed at least two staining patterns by PAS-AB staining. The goblet cells, which were observed at troughs, showed magenta. The goblet cells, which were observed in the pits of the conjunctiva, showed alcianophilia. In the rats, the goblet cells which showed magenta and the goblet cells which showed alcianophilia were located together in the same gland bud. From the results obtained by the present experiments, it was concluded that the goblet cells of the conjunctiva of the monkey and the rat were grouped into at least two types by histochemical examination. PMID- 3658324 TI - Disulfide-linked membrane proteins in X-ray-induced cataract. AB - The formation of membrane protein disulfide was investigated at various stages of development of X-ray-induced cataract in the rabbit. Intermolecular disulfide bonding of lens membrane proteins was detected not only in the mature cataract (occurring 8-9 weeks after the X-ray dose) but also at 1 week prior to maturation, in which no significant increase in lens hydration occurs and where opacification is confined mainly to the posterior subcapsular region. Two dimensional diagonal electrophoresis revealed that polypeptides with apparent molecular weights of 21, 23, 25, 31, 35, 46 and 53 kilodaltons were involved in cross-linking. The MP26 membrane polypeptide was not significantly involved in the disulfide bonding. The oxidation of membrane proteins in stages other than mature was evident only in the lens nucleus (which remained clear) and not in the cortex. The results of this study indicate that an intermolecular disulfide linkage of cytosolic proteins to membranes occurs prior to formation of mature cataract, and may be a precursor to protein aggregation and insolubilization in the mature nuclear cataract. PMID- 3658325 TI - Water-soluble and insoluble crystallins of the developing human fetal lens, analyzed by agarose/polyacrylamide thin-layer isoelectric focusing. AB - Eight human fetal lenses, selected on basis of normality, of a gestational age of 119 to 231 days were analyzed by thin-layer isoelectric focusing (IEF) in agarose/polyacrylamide gels. This method was adapted for the separation of lens crystallins into HM-, alpha-, beta- and gamma-crystallins. It is especially suitable for analysis under non-denaturing conditions of high-molecular-weight crystallins and of insoluble crystallins (WI) solubilized in formamide. The latter could be separated into HM-, alpha- and gamma-crystallins. During fetal development, a considerable increase of gamma-crystallin proportion was observed due to new synthesis. This increase was balanced by a decrease of alpha crystallin proportion. PMID- 3658326 TI - Changes of lens crystallins photosensitized with tryptophan metabolites. AB - The effect of UV irradiation on bovine lens soluble proteins (crystallins) in the presence of tryptophan metabolites was investigated in vitro. The cross-linking of crystallins by UV irradiation was accelerated by kynurenine, 3 hydroxykynurenine, anthranilic acid and 3-hydroxyanthranilic acid. On denaturation of crystallins by photooxidation, alpha-crystallin was characterized by the formation of water-soluble HMW (high molecular weight) protein, while water-insoluble HMW protein was produced from beta- and gamma-crystallin. These HMW aggregates showed cross-linking by non-disulfide covalent bonds. LMW (low molecular weight) peptides were formed by degradation of alpha- and beta crystallin. PMID- 3658327 TI - Fibrinogen-induced vitreous membranes. AB - Fibrinogen was injected in the vitreous cavity of 29 rabbits with follow-up for 75 days. Vitreous membrane formation was detected by indirect ophthalmoscopy and confirmed by histopathological study. Membrane formation was significantly more common in the fibrinogen group than in the control group. Fifteen days after injection, the membranes decreased in size and gave place to vitreous liquefaction in the majority of eyes in the fibrinogen group. Histochemical stains for fibrinogen were positive in half of the vitreous membranes. Fibrinogen is thought to be transformed into a long fibrin polymer forming a matrix for surrounding cells to proliferate in the vitreous. An effective fibrinolytic system in the vitreous explains the ultimate resolution of most of the fibrinogen induced membranes. Simple fibrinogen injections do not provide a good model for long-term vitreous band formation, yet they add more evidence to the role of fibrin in the pathogenesis of vitreoproliferative diseases. The spontaneous resolution of some proliferative vitreoretinopathies parallels the reversibility of most of the fibrinogen-induced vitreous membranes. PMID- 3658328 TI - Proteoglycans from pterygium tissues. AB - The proteoglycans of pterygium tissues were isolated and characterized by using biochemical methods. The existence of 2 kinds of proteoglycans was shown by agarose-polyacrylamide gel electrophoresis; their molecular weights were estimated based on the mobility on agarose-polyacrylamide gel electrophoresis and on Kav values on gel chromatography. One proteoglycan was protein-rich with a molecular weight of 1.15 X 10(6), while the other was free from protein or contained a little protein, and had a molecular weight of 4.9 X 10(5). PMID- 3658329 TI - Is ocular melatonin regulated by the adrenergic system? AB - There is evidence supporting a role for melatonin as an endogenous agent regulating intraocular pressure, but little is known about whether ocular levels of melatonin are regulated by the sympathetic nervous system, as they are in the rat pineal gland. The effects of topically applied L-timolol, norepinephrine, forskolin, domperidone and pilocarpine on levels of melatonin in regions of rabbit and chicken eyes were determined. None of these drugs altered levels of melatonin in the rabbit iris-ciliary body or in the chicken iris or ciliary body, suggesting that the actions of these drugs were not mediated through an action on melatonin. Topical forskolin did not alter N-acetyltransferase activities in rabbit iris-ciliary body. Chemical sympathectomy with 6-hydroxydopamine had no effect on nighttime levels of melatonin in rabbit iris-ciliary body or on daytime levels in chicken eyes. These results suggest that melatonin in the eyes does not appear to be under the solitary control of the adrenergic sympathetic nervous system. The data suggested a transmitter other than norepinephrine regulates N acetyltransferase activities and melatonin levels. PMID- 3658330 TI - Long-term complications of toxic epidermal necrolysis (Lyell's disease). Clinical and histopathologic study. AB - A case of toxic epidermal necrolysis had been observed in a 4-year-old child. This patient has been reexamined by us 21 years later. At that time a biopsy of conjunctival material and a histopathologic and ultrastructural study were done. The long-term ocular complications of the disease caused severe visual impairment with a remarkable sicca syndrome due to extensive scarring and keratinization, as confirmed also by light- and electron-microscopic features. These findings, concerning a particularly long follow-up, suggest that the ocular sequelae of this disease require continuous ophthalmological supervision many years after the acute stage of the disease. PMID- 3658331 TI - An epithelioma of the ciliary body. AB - A 57-year-old woman developed a ciliary body mass which compressed the anterior side of the lens with focal cataract causing the iris to protrude into the anterior chamber. The lesion was removed by a large iridocyclectomy. The mass was classified as an epithelioma of the ciliary body, which was consistent with a benign epithelioma, i.e. an adenoma of the nonpigmented ciliary epithelium. Light and electron microscopic examinations revealed that the tumor cells had characteristics of both the ciliary and iris epithelium, which originated from the neuroectoderm, including abundant cytoplasmic filaments, and pheomelanosomes, and that the gland-like lumen was the pseudoacinous lumen, i.e. invaginated stroma containing the vitreous. PMID- 3658332 TI - [Treatment of severe uveitis with cyclosporin A]. AB - The results of a treatment with ciclosporin A in 4 patients with severe uveitis (2 cases with Behcet's disease, 2 cases Vogt-Koyanagi-Harada disease) are presented. Ciclosporin A produced a rapid regression of exudates in the ocular fundus and of the inflammatory signs at the anterior segment in the 4 cases. However, at the same time, side effects including the deterioration of the hepatorenal function developed. Interruption of the treatment with ciclosporin A led to the development of inflammation at the anterior and posterior segments in cases 2 and 4. PMID- 3658333 TI - Retroequatorial red retinal lesions in sickle cell anemia. AB - We report 2 patients with sickle cell anemia who showed retroequatorial localized red retinal lesions. In 1 patient these lesions were associated with closure of the retinal precapillary arteriole and capillary bed. In both patients these lesions receded during the course of therapy with a selective arteriolar vasodilator, nifedipine. These observations are discussed in relation to the possible pathogenesis of the retinopathy seen in patients with sickle cell anemia. PMID- 3658334 TI - Retinal manifestations of Mediterranean spotted fever. AB - The authors studied the incidence, type and systemic relationship of the retinal findings observed by ophthalmoscopy in Mediterranean spotted fever (MSF) in a consecutive series of 34 cases. It is found that retinal vasculitis either arterial and/or, more frequently, venous is present in 55.9% of the cases. Branch vein retinal thrombosis appeared as complication of such small vessel vasculitis in 1 case. Although frequent, the retinal findings were asymptomatic in all cases but the retinal vein thrombosis one, and were not significatively related to or were predicted by other systemic parameters of severity of the disease. Because of its frequency, retinal vasculitis might be considered as an important clinical sign of MSF in endemic areas. PMID- 3658335 TI - Cytological and immunological study of the aqueous humor in acute retinal necrosis syndrome. AB - We experienced 4 cases of acute retinal necrosis syndrome, and performed anterior chamber paracentesis as a diagnostic aid in their acute and convalescent phases. The aqueous humor obtained by it was used for measuring antibody titers to herpes group virus and electron microscopic observation. One case showed elevated titer to herpes simplex virus type 1 in the convalescent phase, while the other to varicella-zoster virus, suggesting that these 2 viruses could cause this disease. Electron microscopy showed persistent lymphocytes and macrophages throughout the course, while plasma cells appeared at the height of the inflammation corresponding to the locally elevated antibody titers. There was no electron microscopic evidence of viral infection in the aqueous cells examined. PMID- 3658336 TI - Effect of resection of lateral rectus muscle in undercorrected esotropia. AB - Bilateral lateral rectus resection was performed on both previously recessed medial rectus muscles in 23 patients with residual esotropia. The operation reduced the deviation in all patients, but successful treatment was achieved only in 52%. The advantages and disadvantages of this surgical approach are discussed. PMID- 3658337 TI - Orbital computed tomography. Does it help in diagnosing the infiltration of choroid, sclera and/or optic nerve in retinoblastoma? AB - High-resolution computerized tomography of the orbit was performed in patients with histologically proven retinoblastoma to assess the efficacy of CT in delineating the retro-orbital extent of the tumor and determining if the optical nerve was involved. High-resolution CT proved able to accurately delineate tumor size, tumor localization, tumor calcification, retro-orbital and intracranial tumor growth. Microscopical tumor spread past the lamina cribrosa of the optic nerve, however, could not be detected by CT. PMID- 3658338 TI - Autosomal recessive juvenile cataract in Hutterites. AB - Autosomal recessive inheritance of juvenile cataract is described amongst several related sibships of Lehrerleut Hutterites. The main features of the cataract include onset between three and seven years of age; rapid progression to maturity within one to three months; normal intelligence; no systemic associations, and no urinary reducing substances and normal erythrocyte galactokinase activity. Genetic analysis demonstrates the close relationship between parents of affected sibships with a coefficient of inbreeding of affected sibships of 0.0512. Estimates of heterozygote frequency within Lehrerleut Hutterites at 0.128 indicate that if current inbreeding practice continues additional cases can be expected. PMID- 3658339 TI - Ocular aspects in biotinidase deficiency. Clinical and genetic original studies. AB - There are two distinct forms of multiple carboxylase deficiency. A neonatal onset form is due to deficiency of holocarboxylase-synthetase. A later onset form in which neurological abnormalities are seen as well as those of the skin and hair is due to biotinidase deficiency. It is the purpose of this report to describe a patient with biotinidase deficiency who presents bilateral optic atrophy. The dosage of biotinidase enzyme in the patient's serum and in other members of his family confirms the autosomal recessive transmission of this condition. PMID- 3658340 TI - Ocular changes in long-term evolution of infantile cystinosis. AB - Infantile cystinosis is an autosomal recessive lysosomal disorder of aminoacid metabolism leading to a storage of cystine crystals in the cells of many tissues, but mainly in the kidney and the eye. The ocular symptoms and long term evolution were studied in a series of 25 patients at the Enfants Malades Hospital. The follow-up over 26 years demonstrated that infantile cystinosis affected mainly corneal and retinal epithelium just as it affected the kidney epithelium. Corneal involvement was a constant finding after one year of age. It induced photophobia, which appeared between three and four years when a superficial punctate keratopathy appeared. A characteristic retinopathy was observed as early as three years of age. It was constantly present at seven years of age and caused loss of vision. When ERG results were compared to the most recent measurement of visual acuity, a correlation was observed between retinopathy and visual defect. For this reason, no corneal grafts were performed. The use of topic cysteamine appeared promising but no definitive conclusions could be made. PMID- 3658341 TI - The prognosis of retinoblastoma in terms of globe saving treatment. A computer assisted study. Part I. AB - At present there is no satisfactory classification or staging system. In order to compare the Reese classification (Reese & Ellsworth, 1963), the Essen classification (Hopping, 1983) and a new classification, a method of evaluating different parameters was created to get an optimal classification of globe saving treatment. A computer score table for the Essen eye clinic was established and this table could be valuable for all clinics using modern methods of treatment. PMID- 3658342 TI - The prognosis of retinoblastoma in terms of survival. A computer assisted study. Part II. AB - At present there is no satisfactory classification or staging system. In order to compare the Reese classification (Reese, 1963), the Essen classification (Hopping, 1983) and a new classification, a method of evaluating different parameters was created in order to get an optimal classification of survival. PMID- 3658343 TI - The use of iodine-125 plaques in the treatment of retinoblastoma. AB - 125I has an energy of 27-35 keV which permits highly effective screening and makes it eminently suitable for treating ophthalmic tumours. It was first used for this in 1974 (Sealy et al., 1976), and since then a flexible system has been developed to treat a variety of such tumours including localized retinoblastoma. A gold foil backed plaque is custom built to cover the tumour(s). The turned edges reduce the dose and thus protect vital adjacent structures such as the optic nerve and lens. The iodine seeds are sealed in the plaque in a predetermined position to give the required dose. A range of doses and times have been used but the authors now aim to give a TDF of 100 to the apex of the tumour in two to three days. Ten tumours in the remaining eye of seven patients with bilateral retinoblastoma were treated. The size ranged from 3 X 3 X 2 to 10 X 10 X 6 mm. There were nine complete responses from 17-90 months and a partial response in one patient who died of metastases at ten months. Vision was maintained in all. Eight recurrent tumours in seven patients were also treated together with a subsequent new tumour in one of the patients. There were three complete responses at 28-39 months and six tumours persisted. Vision was maintained in three of seven patients. The only complication was a vitreous haemorrhage which was mild in two patients, moderate in one patient and severe in three previously treated patients. These latter three patients subsequently had the eye enucleated and were found to have recurrent tumour. PMID- 3658345 TI - Symposium: Diabetic retinopathy: ten years after the Diabetic Retinopathy Study. Presented at the American Academy of Ophthalmology annual meeting. New Orleans, November 1986. PMID- 3658344 TI - Improved cosmesis in retinoblastoma patients treated with iodine-125 orbital irradiation. AB - Patients who are at risk for developing an orbital recurrence after enucleation of the eye for retinoblastoma are those with full thickness choroidal invasion or further extension into the sclera or extension into the optic nerve beyond the lamina cribrosa. The authors have treated these patients routinely with external irradiation to the orbit but this usually resulted in a dry contracted socket that often would not accept a prosthesis. An orbital implant was designed with 125I seeds in an attempt to improve the cosmetic result. It consisted of seven rows of 125I seeds, six of which were partially screened and implanted around the periphery of the orbit so that the contents were irradiated whilst reducing the dose to the bony orbit. The seventh central row was unscreened. A metal disc, with 125I seeds sealed to the posterior surface, was sutured beneath the eyelids thus protecting them and the accessory lacrimal glands. A TDF of 90-100 over two to three days was given. Thirteen patients have been treated, nine prophylactically and four therapeutically. Three of the latter patients have died of metastases but no local recurrences have been seen. All 13 patients were left with a moist socket that accepted a prosthesis. PMID- 3658346 TI - The Wisconsin Epidemiologic Study of Diabetic Retinopathy. VI. Retinal photocoagulation. AB - The prevalence of focal and panretinal photocoagulation and its relationship to demographic and other characteristics were examined in a population-based study in southern Wisconsin. For participants whose age at diagnosis was less than 30 years and who were taking insulin (996 persons) the prevalence rate of panretinal photocoagulation (13.9%) was higher than that of focal photocoagulation (3.6%). For those whose age at diagnosis was 30 years or older (1370 persons), the prevalence rate for panretinal photocoagulation (3.6%) was slightly higher than that of focal photocoagulation (3.0%). Seventy-two percent of eyes of younger onset and 45% of eyes of older onset persons that had received panretinal photocoagulation treatment were found to have incomplete regression of retinal new vessels, and in approximately half of these eyes severe proliferative retinopathy (Diabetic Retinopathy Study High Risk Characteristics [DRS-HRC]) was present. Among eyes with DRS-HRC, 55% were found to be untreated. PMID- 3658347 TI - Macular edema in Diabetic Retinopathy Study patients. Diabetic Retinopathy Study Report Number 12. AB - Results from the Diabetic Retinopathy Study (DRS) demonstrate that scatter photocoagulation is associated with some loss of visual acuity soon after treatment. This visual loss is especially prominent in eyes with preexisting macular edema. It is also associated with the intensity of treatment. Reducing macular edema by focal photocoagulation before initiating scatter treatment and dividing scatter treatment into multiple sessions with less intense burns may decrease the risk of the visual loss associated with photocoagulation. PMID- 3658348 TI - Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Early Treatment Diabetic Retinopathy Study Report Number 2. Early Treatment Diabetic Retinopathy Study Research Group. AB - The Early Treatment Diabetic Retinopathy Study (ETDRS) has recently shown that argon laser photocoagulation treatment is beneficial in reducing the risk of visual loss from clinically significant diabetic macular edema. The ETDRS treatment consisted of a combination of focal treatment to individual-leaking microaneurysms and grid treatment to areas of diffuse leakage and capillary nonperfusion. These techniques are described in detail, and the concepts of "clinically significant macular edema" and "treatable lesions" are defined. Guidelines for the application of ETDRS findings to clinical practice are discussed. PMID- 3658349 TI - Pseudophakic and aphakic retinal detachment mimicking cystoid macular edema. AB - Seventeen eyes of patients who were being followed by their ophthalmologists for aphakic (8 eyes) or pseudophakic (9 eyes) cystoid macular edema (CME) were examined on referral. All eyes showed retinal detachment (RD), and eight eyes had CME with RD. Most RDs were inferior and shallow. Proliferative vitreoretinopathy (PVR) was noted in 15 eyes (88.2%). There was history of vitreous loss during the last intraocular surgery in 88.2% eyes. Visual acuity ranged from 20/40 to hand movements. Fundus view was hazy in most eyes, and indirect ophthalmoscopy was most useful in detecting RD. Retinal reattachment with scleral buckling and/or vitrectomy was achieved in 16 eyes (94.1%). Postoperative visual recovery was jeopardized due to longstanding macular detachment of greater than 1 month in 11 eyes (64.7%). Eight eyes (47%) achieved 20/50 vision whereas 25% did not improve to better than 20/400. Factors leading to failure in making the correct diagnosis and their prevention are discussed. PMID- 3658350 TI - Prealbumin. A major constituent of vitreous amyloid. AB - Vitreous amyloid may be the presenting clinical manifestation of types 1 and 2 familial amyloidotic polyneuropathy or complicate the course of these syndromes. Recent studies have shown that the major subunit protein composing amyloid fibrils in these conditions is a variant or abnormal prealbumin molecule and that affected individuals have low levels of this protein in their blood. The authors studied material obtained at vitrectomy from two cases of vitreous amyloid. One of these was nonfamilial and the other familial. Two-dimensional gels of solubilized protein from pelleted and washed vitreous amyloid in both cases were found to consist of material with the molecular weight and isofocusing coordinates of prealbumin monomer. Reactivity of fibrils with a monospecific antiserum to prealbumin was confirmed by colloidal gold immunoelectron microscopy. Non-familial as well as familial vitreous amyloid may in fact be systemic forms of amyloidosis due to deposition of prealbumin which can be characterized by biochemical or immunohistologic studies of material obtained at vitrectomy. PMID- 3658351 TI - Visual acuity loss in patients with Stargardt's macular dystrophy. AB - Ninety-five patients with Stargardt's macular dystrophy were appraised for visual loss with age by both life-table analyses and cross-sectional procedures. The probability of maintaining a visual acuity of 20/40 or better in at least one eye was 52% by age 19, 32% by age 29, and 22% by age 39. In the population studied, once a patient's visual acuity dropped below 20/40, it tended to decrease rapidly and stabilize at 20/200. Fluorescein angiograms obtained on 64 of the 95 patients showed a "dark choroid" in 55 (85.9%). This finding, therefore was present in the majority of the patients, although its absence does not rule out Stargardt's macular dystrophy. PMID- 3658352 TI - Prevalence and mechanisms of secondary intraocular pressure elevation in eyes with intraocular tumors. AB - A survey of 2704 eyes with intraocular tumors in patients who were evaluated on the Oncology Service at Wills Eye Hospital showed that 126 of the tumor containing eyes (5%) had tumor-induced elevated intraocular pressure (IOP) at the time of diagnosis of the tumor. Of the 2111 eyes with uveal melanomas, secondary IOP elevation was present in 55 (3%). Secondary IOP elevation was present in 7% of eyes with iris melanoma, 17% with ciliary body melanoma, and 2% with choroidal melanoma. The most common mechanism of elevated IOP was tumor invasion of the angle in the case of iris melanomas, pigment dispersion and tumor invasion of the angle in the case of ciliary body melanomas, and iris neovascularization in the case of choroidal melanomas. Of the 256 eyes with uveal metastases, secondary IOP elevation was found in 12 eyes (5%). Secondary IOP elevation was present in 64% of eyes with iris metastases, 67% with ciliary body metastases, and 1% with choroidal metastases. The most common mechanism of elevated IOP was tumor invasion of the angle in the case of iris and ciliary body metastases, and angle closure in the case of choroidal metastases. There were 303 eyes with retinoblastoma, 17% of which had elevated IOP which was secondary to iris neovascularization in 70% of cases and to an angle closure without neovascularization in 27%. Several other intraocular tumors including lymphoma, leukemia, medulloepithelioma, melanocytoma, and adenoma of the iris pigment epithelium were occasionally associated with secondary elevated IOP. PMID- 3658353 TI - Improving the therapeutic index of topical phenylephrine by reducing drop volume. AB - This study examined the effect of reducing eyedrop volume on the efficacy and systemic absorption of a given quantity of phenylephrine hydrochloride. Aqueous phenylephrine hydrochloride (2.5%) given in the commercially available drop volume of 32 microliters was compared with 10% aqueous phenylephrine given in an 8-microliters volume. Both preparations contained the same total amount of phenylephrine per drop. Ten subjects had both eyes dilated with each of the phenylephrine solutions according to a randomized, double-crossover sequence. The mean final pupillary diameter was nearly 1.0 mm larger for the 8-microliters drop (P = 0.0033). Nine of ten subjects achieved a larger pupillary diameter with the 8-microliters drop. Systemic absorption, as measured by plasma phenylephrine level, was similar for the two drop volumes. Thus, the 8-microliters drop achieved a significantly larger pupillary dilation without an increase in systemic absorption. Phenylephrine may have the most favorable risk-benefit ratio when administered as a high concentration in a small volume. PMID- 3658354 TI - Three-year efficacy of argon laser trabeculoplasty. AB - The authors report on the effect of argon laser trabeculoplasty on intraocular pressure (IOP) over a 3-year period with a mean follow-up period of 1.8 years in patients with uncontrolled primary open-angle glaucoma who had not undergone prior surgery. An analysis of the effect of laser trabeculoplasty using the criteria for success of an IOP of 22 mmHg or less with no further laser trabeculoplasty or glaucoma surgery, showed a cumulative success of 79% (112 eyes) at 1 year, 69% (85 eyes) at 2 years, and 59% (58 eyes) at 3 years. Similar results are presented for 22 eyes from patients with pseudoexfoliation glaucoma. The authors conclude that although the initial success rate of laser trabeculoplasty is high, it diminishes progressively over time. PMID- 3658355 TI - Long-term follow-up of lens changes with Scheimpflug photography in diabetics. AB - This study was designed to document and quantify changes in lens clarity over 24 months in a group of diabetic patients. One hundred thirty-four type I and type II diabetics of 3 months' to 45 years' duration with an average age of 53.5 +/- 7 years volunteered to participate in this prospective study. Patients were evaluated upon entry and at 6-month intervals. Scheimpflug lens photographs (Topcon SL45) were taken at each visit. All photographs were evaluated by densitometry which allowed quantification of the light scattering in the various lens layers. A significant and progressive (4-7% every 6 months) increase in light scattering was observed in the lens anterior superficial lens cortex over 24 months. The rate of change in lens clarity was similar in all patients regardless of the clinically observable lens change type (nuclear, cortical, posterior subcapsular, or mixed). Patients who were younger at enrollment, having diabetes of shorter duration and higher glycosylated hemoglobin values (a measure of long-term glucose control), were identified to be at greater risk of having increased densitometry values in the anterior superficial lens cortex. Only a few patients had significant changes in visual acuity during 24 months, and the correlation of superficial cortical lens clarity changes to clinical cataract formation and visual impairment remains to be established. PMID- 3658356 TI - The Jackson cross cylinder: a reappraisal. PMID- 3658357 TI - Systemic tetracycline therapy for epithelial defects. PMID- 3658358 TI - Progressive hyperopia in radial keratotomy. PMID- 3658359 TI - Thyroid carcinoma metastatic to the orbit. AB - Metastatic thyroid carcinoma rarely involves the orbit. A 35-year-old woman with a history of thyroid lobectomy for a "benign" goiter 6 years earlier presented with a right superotemporal mass causing bony erosion of the lateral orbital wall shown by clinical examination and computed tomographic (CT) scanning. Orbital exploration with biopsy showed metastatic thyroid carcinoma. This represents the youngest patient reported with this rare condition. PMID- 3658360 TI - Eosinophilic granuloma of the orbit with spontaneous healing. AB - A 13-year-old boy presented with a 2-month history of swelling of the right upper eyelid and displacement of the right eye. Computed tomography (CT) showed a tumor in the right orbit and a large osteolytic defect of the orbital frontal bone. At surgery a yellowish-tan mass was found replacing the orbital roof and abutting the dura. Incisional biopsy established the diagnosis of eosinophilic granuloma. In the absence of further therapy, the mass resolved, and the bony defect completely reossified within 14 months. During more than 2 years of follow-up, there has been no evidence of local recurrence or systemic disease. This case demonstrates that eosinophilic granuloma may resolve spontaneously with healing of bony defects, thus eliminating the need for adjunctive resection or radiation therapy in selected patients. PMID- 3658361 TI - Ophthalmic manifestations of maxillary sinus mucoceles. AB - Mucoceles involving any of the paranasal sinuses may present with ophthalmic disturbances. Maxillary antral mucoceles can encroach on the inferior orbit with ocular displacement and compression, proptosis or enophthalmos, lower lid distortion, tethering of extraocular muscles, and ptosis. Periocular pain, erosion of the inferior orbital rim, infraorbital nerve compression, epiphora, and inner canthal swellings are other important presentations. Postoperative mucoceles may involve only a portion of the antrum. Five illustrative cases are presented. PMID- 3658362 TI - Anterior ischemic optic neuropathy. VII. Incidence of bilaterality and various influencing factors. AB - A prospective study was conducted in 438 patients with anterior ischemic optic neuropathy (AION). There were 388 patients with nonarteritic AION and 50 with arteritic AION. The risk of bilaterality in patients with arteritic AION was found to be 1.9 times the risk in patients with nonarteritic AION (P = 0.0118). The cumulative incidence curve, considering the time taken to develop bilateral AION for nonarteritic cases was significantly (P = 0.0103) different from that for arteritic cases. The estimated 25th-percentile time to development of bilateral AION was much shorter in patients with arteritic AION (0.4 month) than in those with nonarteritic AION (32.4 months). In arteritic AION, unilateral as well as bilateral AION had almost invariably developed before systemic steroid therapy was started and not after, indicating that this therapy is effective in preventing the development of AION in giant cell arteritis. In nonarteritic AION, the risk of bilaterality was significantly greater in men (P = 0.0113) and in young (less than 45 years old) patients with diabetes (P = 0.0245), with no significant difference attributable to the other age groups or other associated systemic diseases. In this study, it was found that young diabetic men have a risk of AION developing in the second eye that is 1.56 times the risk in young diabetic women, 2.56 times the risk in women who either are nondiabetic or are not young, and 1.64 times the risk in both older men and nondiabetic men. PMID- 3658363 TI - Deficits in visual function after resolution of optic neuritis. AB - A study was done to systematically characterize visual function in eyes with recovered optic neuritis. Thirty-five eyes from 27 patients, all of whom had recovered at least 20/30 Snellen acuity after resolution of the neuritis, were included. Minimum recovery period was 6 months. Abnormalities were found in color vision (57%), contrast sensitivity (72%), perimetry (26%), stereoacuity (80%), light brightness (89%), pupillary reaction (89%), and optic disc appearance (77%). Eighty-five percent of patients complained of at least some subjective disturbance in vision. Subjective visual complaints correlated better with deficits in contrast sensitivity than they did with the other measures. The results of the study indicate that deficits in visual function are common after resolution of optic neuritis. PMID- 3658364 TI - Two-flash photorefraction in screening of amblyogenic refractive errors. AB - A selection of amblyopic (n = 14) and nonamblyopic (n = 18) children with different ametropias, anisometropias, and astigmatisms was photorefracted without cycloplegia by two-flash photorefraction (T-FP) in which refractions in both horizontal and vertical meridians of both eyes are measured simultaneously. The results were compared to conventional cycloplegic retinoscopy in a blind study. Significant amblyogenic conditions, such as hyperopic anisometropias of more than 1.0 diopter (D), high ametropias, or astigmatism and strabismus cases of 2 degrees to 3 degrees or more are detectable. The technique provides a simple and useful tool for mass screening of infants. The sensitivity of the method for detecting amblyopia seems to be at least as high as in visual checking. Media opacities are recordable, and a permanent document is obtained. PMID- 3658365 TI - Simultaneous superior oblique tenotomy and inferior oblique recession in Brown's syndrome. AB - The technique and results of simultaneous superior oblique tenotomy and 14-mm inferior oblique recession for true Brown's syndrome are presented for 16 eyes of 13 patients. A good or excellent result was achieved in 15 of 16 eyes (94%). Reoperation for overcorrection was not necessary; however, repeat tenotomy was required in two cases. Inferior oblique underaction was present in 12 of 16 eyes (75%) in the early postoperative period; however, elevation in adduction improved over time. At most recent examination, 92% of eyes demonstrated greater than 25 degrees elevation in adduction. Underaction of the superior oblique occurred in 3 of 16 eyes (19%). A simultaneous superior oblique tenotomy and inferior oblique recession is recommended in all patients selected to undergo surgery for true Brown's syndrome to prevent reoperation for iatrogenic superior oblique palsy. PMID- 3658366 TI - Congenital unilateral adduction deficit with simultaneous abduction. A variant of Duane's retraction syndrome. AB - Congenital adduction deficit not associated with other signs of oculomotor nerve weakness occurs infrequently. Type 2 Duane's retraction syndrome accounts for some of these cases. The authors identified three children with unilateral adduction deficits and simultaneous abduction of the eyes on attempted lateral gaze into the field of action of the apparently paretic medial rectus muscle. This is the first report of a series of patients with this condition previously termed simultaneous or synergistic divergence. All patients had a large exotropia, and two had a horizontal face turn away from the involved eye. A large (14 mm) lateral rectus muscle recession done on one of these children reduced the face turn but did not eliminate the simultaneous abduction. Clinical, intraoperative, and electromyographic data suggest that this condition is an unusual variant of type 2 Duane's syndrome. PMID- 3658367 TI - Ocular pathologic findings in neonatal adrenoleukodystrophy. AB - Ocular pathology in a case of neonatal adrenoleukodystrophy (ALD) showed marked degeneration of photoreceptor cells throughout the retina including the macula. Macroscopically visible white opacities in the cortical vitreous of the posterior fundus were shown immunohistochemically and ultrastructurally to be macrophages containing bileaflet inclusions, a finding previously unreported. Additional findings included extensive loss of the retinal nerve fiber and ganglion cell layers, optic nerve degeneration, and bileaflet inclusions in retinal pigment epithelial cells and macrophages of the retina and optic nerve. Focal retinal pigmentary changes were observed that histologically were different from retinitis pigmentosa. PMID- 3658368 TI - Contact lenses in the treatment of patients with overcorrected radial keratotomy. AB - Thirty-two eyes of 28 patients who underwent radial keratotomy had a hyperopic overcorrection after the surgical procedure. Anisometropia, with associated aniseikonia and depth perception problems were present in many of these patients. The patients were subsequently fit with contact lenses. Conventional methods of fitting contact lenses in these patients were unsuccessful. A trial lens technique is used with the initial lens having a base curve equal to the preoperative keratometry measurements and the power equal to the preoperative spherical equivalent. Superficial neovascularization developed within the radial incisions in 33% of the eyes fitted with soft contact lenses. Gas permeable contact lenses offered patients the best-corrected visual acuity as well as minimal complications. In addition, the anisometropia was minimized, and fluctuating vision was eliminated in cases in which it was a problem. PMID- 3658369 TI - Free enterprise and health care. Should the buyer beware? PMID- 3658371 TI - Ligneous conjunctivitis. A clinicopathologic study of 17 cases. AB - Seventeen cases of ligneous conjunctivitis were studied. Most of the patients were children; however, two elderly individuals were involved (range, birth to 85 years). The most common site was the tarsal conjunctiva, where firm sessile or pedunculated membranous lesions were seen. However, corneal involvement, as well as similar and recurrent lesions, were also present in the larynx, vocal cords, trachea, nose, vagina, cervix, and gingiva. Many recurrences (up to 10 times) rapidly followed simple surgical excision in all patients. Histopathologically, the lesions were characterized by subepithelial, eosinophilic, amorphous material admixed with acute and chronic inflammatory cells. The finding of amorphous material containing fibrin, immunoglobulins, and albumin suggested leakage from hyperpermeable blood vessels. Electron microscopic studies of the lesions disclosed few abnormal blood vessels with wide gaps between endothelial cells that were surrounded by a thick multilaminar basement membrane. The duration of the disease ranged from 4 months to 44 years. After several recurrences, spontaneous resolution occurred in six patients. PMID- 3658370 TI - Synthetic keratophakia for the correction of aphakia. AB - Although the majority of aphakic patients will have intraocular lens implants (IOLs), there are several groups of patients for whom IOLs are not indicated. Synthetic keratophakia for the correction of aphakia has several inherent advantages over alternative forms of refractive surgery which use lathed corneal tissue. For example, the ability to produce a synthetic lens to precise specifications before surgery is a dramatic advantage over the use of lathed tissue lenses whose refractive properties cannot be determined until weeks or months after the lens is in place on the recipient cornea. Synthetic materials appear to behave in a predictable manner and are biocompatible. Both polysulfones and hydrogel materials can be used to correct aphakia in clinical situations where other modalities are less appropriate. PMID- 3658372 TI - Large congenital melanocytic nevus. Light and electron microscopic findings. AB - The family of a 10-month-old black girl with a large periocular congenital melanocytic nevus (CMN) was given markedly differing advice from experienced physicians regarding how the lesion should be managed. The nevus was eventually removed surgically because of concern about the risk of malignant transformation and because of its cosmetic appearance. Histologically, the lesion was a dermal nevus, but extended deeply into subcutaneous tissue and had neuroid features. The ultrastructural characteristics of melanocytes varied according to the depth at which they resided, but cells did not differ basically from melanocytes found in smaller acquired nevi. Given the limited understanding of the biologic basis for malignant transformation, large size remains the most important risk factor in CMN. PMID- 3658373 TI - Lumbosacral chordoma metastatic to the eyelid. AB - The authors report a patient treated with radiation therapy for a lumbosacral chordoma. The first and only evidence of metastatic disease was an eyelid cyst. This case is unusual for several reasons. First, eyelid metastases are rare; they are much more uncommon than metastases to the uvea or orbit. Second, metastatic tumors to the eyelid are usually manifestations of widespread disease and seldom occur as a solitary focus of dissemination. Third, the clinical presentation of our patient's lesion as an eyelid cyst is uncommon for a metastasis to the eyelid. Finally, to the best of our knowledge, all previously reported tumors metastatic to the eyelid have been carcinomas; this is the first report of a metastatic soft-tissue tumor to the eyelid. PMID- 3658374 TI - Effectiveness of botulinum toxin therapy for essential blepharospasm. AB - The effectiveness of Botulinum toxin (Oculinum) therapy in 76 patients with the diagnosis of essential blepharospasm was analyzed. Botulinum offers relief to almost all patients suffering from essential blepharospasm, however, this relief is usually temporary. The response time for repeated treatments tended to be longer than the first treatment. Patients with mild blepharospasm responded significantly longer to Botulinum injection, than those with severe spasms. The response to Botulinum was not significantly different in patients with Meige syndrome than in patients with only essential blepharospasm. Patients previously treated surgically for essential blepharospasm did not respond differently than those patients with no previous surgical therapy. The authors believe that Botulinum toxin injection is an effective, although temporary, mode of therapy for the signs and symptoms of this focal dystonia. The authors recognize that there may be psychologic factors affecting the response. PMID- 3658375 TI - Use of botulinum toxin in the treatment of one hundred patients with facial dyskinesias. AB - One hundred patients with involuntary eyelid and facial spasms resulting from essential blepharospasm, Meige syndrome, and hemifacial spasm continued to respond to repeated injections of botulinum toxin at expected time intervals during a 30-month period. This series of more than 372 injections done by one of us (JAM) supports the finding of earlier, smaller series that tolerance to the toxin does not develop. The drug had a greater duration of effect in patients with hemifacial spasm than in patients with blepharospasm; the duration of effect was 17.25 weeks in the former group and 12.6 weeks in the latter. Eighteen percent of patients required a higher than standard dose for a therapeutic response. Fourteen of 15 patients with lower facial spasms and one patient with torticollis had significant relief. Dry eye may be managed by titrating the lower lid dose. PMID- 3658376 TI - Genotypic monoclonality in immunophenotypically polyclonal orbital lymphoid tumors. A model of tumor progression in the lymphoid system. The 1986 Wendell Hughes lecture. AB - Molecular genetic (genotypic) analysis elucidates gene rearrangements within lymphocytes that are responsible for either immunoglobulin production in B lymphocytes or the expression of cell-surface antigen recognition receptors in T lymphocytes. Molecular genetic analysis is far more sensitive than immunophenotypic methods for the detection of small clones of lymphocytes because as few as 2 to 5% of cells in an infiltrate can be discovered to possess the same rearranged DNA sequences with genetic probes. In truly polyclonal proliferations, each lymphocyte reorganizes its immunoglobulin or T-antigen receptor genes in a unique manner, resulting in an almost infinite number of combinations of genetic rearrangement and the absence of any new hybridizing bands upon Southern blotting. In monoclonal proliferations, a new, homogeneous, nongermline band is identified on Southern blotting because a sufficiently large number of lymphocytes exhibit an identical genetic rearrangement. In a group of five orbital lymphoid tumors that appeared to be benign reactive hyperplasias by light microscopy and that were polyclonal by immunophenotypic methods, three were found by molecular genetic analysis to harbor small clones of B-lymphocytes with new rearrangement bands on Southern blotting. No clonal abnormalities of T lymphocytes were found in these five lesions, despite the fact that they were the preponderant cells in the tumors. These observations suggest that "reactive lymphoid hyperplasia" of the orbit may be an unstable lesion, owing to a T-cell immunoregulatory imbalance, with the potential for developing clonal expansions of B-lymphocytes that nonetheless usually remain localized to the orbit. PMID- 3658377 TI - Orbital manifestations of plasmacytic lymphoproliferations. AB - Orbital involvement by plasmacytic lymphoproliferative disorders is rare. Presented are four cases, with different clinical onsets and courses, demonstrating the diversity of expression of lymphoproliferative plasma cell lesions of the orbit. The first patient presented with a slowly developing palpable mass in the upper and anterior orbit. This localized lesion proved to be a reactive plasma cell proliferation. The second case had a 3-month history of proptosis, diplopia, and droopy eyelid and a pulsatile temporal mass with bone destruction. Results of biopsy and systemic investigations showed a solitary plasmacytoma of bone. In the third case, a patient with a known multiple myeloma for 2 years presented with a progressive osteolytic mass which proved on biopsy to be a plasmacytoma. At the time, she also had other active bone lesions. The fourth case presented as a possible orbital cellulitis in a man with known multiple myeloma for 2 years. He proved to have disseminated myeloma, the orbital infiltrate being secondary to sinus involvement. The differential diagnosis for each case can be quite involved. Each case required a biopsy for an accurate diagnosis in addition to a complete clinical, radiographic, and laboratory workup. The pathologic features of each tumor can be misleading. These will be discussed as well as the use of ancillary diagnostic methods such as electron microscopy and immunohistochemistry to further characterize each lesion. The clinical course and treatment modalities will be discussed. PMID- 3658378 TI - [Dysplasia of the joints--dysplastic arthrosis (a conceptual model of its etiology and pathogenesis)]. PMID- 3658379 TI - [Intertrochanteric osteotomy of the femur in the treatment plan for coxarthrosis deformans]. PMID- 3658380 TI - [Surgical treatment of injuries of the sciatic nerve in fractures of the pelvic bones and proximal femur]. PMID- 3658381 TI - [Clinical picture and treatment of posttraumatic tunnel syndromes]. PMID- 3658382 TI - [Current methods of treating the neurodystrophic syndrome in Colles' fractures]. PMID- 3658383 TI - [Treatment results in open fractures and their sequelae in injuries of the bones of the hand]. PMID- 3658384 TI - [Peripheral circulatory function of patients with sequelae of hand injuries]. PMID- 3658385 TI - [Surgical treatment of dislocations of the acromial end of the clavicle]. PMID- 3658386 TI - [Characteristics of rotatory medial dislocations of the shoulder]. PMID- 3658387 TI - [A circular bandage for fixation of the elbow joint]. PMID- 3658388 TI - [Fibrolipoma of the median nerve in children]. PMID- 3658389 TI - [A method of treating closed injuries of the extensor tendons of the 2d to 5th fingers]. PMID- 3658390 TI - [Treatment of deep frostbite of the fingers and toes]. PMID- 3658391 TI - [Lavsan plastic repair in treating dislocations of the acromial end of the clavicle]. PMID- 3658392 TI - [Use of combined osteosynthesis in diaphyseal fractures of the bones of the forearm]. PMID- 3658393 TI - [Pediatric transportation splint for the upper extremity]. PMID- 3658394 TI - [An appliance for developing movement in the shoulder joint]. PMID- 3658395 TI - [A splint for the hand]. PMID- 3658396 TI - [A device for training the upper extremity]. PMID- 3658397 TI - [A multifunctional splint for the hand]. PMID- 3658398 TI - [Drunkenness as a cause of trauma]. PMID- 3658399 TI - [Organizational problems of medical care for trauma patients in vehicular road accidents]. PMID- 3658400 TI - [Surgical reconstruction of the dysplastic hip joint in adolescents]. PMID- 3658401 TI - [Insulin dependent diabetes mellitus of autoimmune origin]. PMID- 3658402 TI - [Immunoglobulin-containing cells in the mucosa of the small intestine in children with celiac disease]. PMID- 3658403 TI - [Villous adenoma of the duodenum showing signs of malignant degeneration]. PMID- 3658404 TI - [AIDS screening for milk donors]. PMID- 3658405 TI - [Prenatal diagnosis of toxoplasmosis]. PMID- 3658407 TI - [Continent colostomy created by transplantation of a pedicled colon muscle]. PMID- 3658406 TI - [Cytosol receptor levels in malignant and benign ovarian tumors]. PMID- 3658408 TI - [The Ars Poetica of the physician-pedagogue]. PMID- 3658409 TI - [Retreat and rescue operations]. PMID- 3658410 TI - [Procedure in extensive or complete loss of bone substance of the femur following shaft loosening]. AB - We reviewed our present method of treatment in cases of femoral bone loss. Our clinical experience with the method is based on 800 exchange operations performed at the Endo-Klinik per year. The review showed that in cases of proximal bone deficiency, custom-made protheses are increasingly required. Cemented implants are used in septic and aseptic cases but we also have had experience with a small number of cases in which reconstructive surgery was carried out using allografts and cementless shaft components. In 1.4% of revision cases total femoral replacement is required. We have had more than 12 years experience with this type of prostheses, which is available as a modular system. So far there has been no disarticulation as a result of implant failures but in some instances failure occurred due to persistent deep infections. PMID- 3658411 TI - [Girdlestone's hip resection. Clinical and electromyocinesigraphic study]. AB - Forty-five patients with unilateral excision of the femoral head and neck and 2 patients with bilateral excision were studied with a follow-up of 6 months to 6 years. In 36 cases the hip excision was performed after a total hip prosthesis. We have personally monitored 22 patients. The others either died or suffered from other general diseases not related to the operation, making it impossible to check their locomotor apparatus. Two criteria were studied in particular: walking and pain. Fifty-five percent of the patients can walk well with one cane, 31% with two canes, and 14% require assistance to walk. Thirty-one can stand and walk without pain, 55% have some discomfort when fatigued, and 14% have constant pain. Electromyocinesigraphic examination was performed in 6 patients in order to study the automatic function of the muscles when the patient was standing and walking. We found the following: (1) no innervation of the hip abducters with high activity of the rectus anterior during the standing phase of the leg operated upon; (2) abnormal symmetrical and permanent activity of the erectores trunci during the usual standing posture and during walking; (3) increased activity of the hip abductors of the nonoperated leg when standing and walking. PMID- 3658412 TI - [Revision prosthesis for the hip joint in severe bone loss]. AB - When total hip prostheses loosen after initial implantation and subsequent prosthesis replacement, increasing bone resorption occurs in the bed of the prosthesis. Finally, a very thin cortex remains in the bed of the prosthesis, which no longer provides sufficient mechanical stability. The replacement prosthesis described, which is anchored in the distal medullary canal without cement, provides a bridge over the damaged prosthesis bed and results in a condition of relative mechanical stability. After implantation of the replacement prosthesis, lively proliferation of the bone tissue occurs in the old prosthesis bed, which again replaces the bone loss that had taken place previously. The late results that would permit a final assessment of the procedure are not yet available. PMID- 3658413 TI - [Arthrodesis following knee arthroplasty]. AB - In 44 failed total arthroplasties of the knee joint, arthrodesis was attempted (1970-1986). The interval between implantation of the total knee arthroplasty and diagnosis of infection was more than 2 years on average. Removal of the arthroplasty and arthrodesis was performed about 1 year later. In 80% of the knees, compression arthrodesis using an AO plate was used 34 times, with solid fusion occurring after 6 months. External fixation was used in 10 patients; rate of solid fusion was only 60%. The reasons for delayed union or failure had to do with reduced bone stock in the metaphysis with poor bone quality, inadequate fixation, and uncontrolled infections. PMID- 3658414 TI - [Secondary correction on the forefoot]. AB - If the results after operation on the forefoot are insufficient, in our opinion this is due to: (1) indications that are not strict enough (cosmetic of semicosmetic indication); (2) inadequate technique: insufficient consideration of the length of the toes and the metatarsus or correction of individual toe deformities instead of homogeneous treatment of the whole forefoot. As our results show, when considering all of these points, we obtain a substantial improvement in these feet. The metatarsal length was corrected by the Helal osteotomy or by resection of the head of the metatarsal bone. When the differences were extreme, the forefoot was corrected following the Lelievre procedure. Full capacity, however, is reached in only one-third of the cases. From this fact, it must be concluded that first operations should be carried out only when there are functional limitations. If the foot is initially free of pain and there is pain after an operation, however slight it might be, the result is always considered poor. PMID- 3658415 TI - [Compound fractures of the proximal humerus]. AB - This paper stresses the importance of considering reconstructive measures when dealing with complex fractures, including fracture dislocations of the proximal humerus. Mainly, we try to use "biological" techniques with minimal exploration and internal fixation for stabilization. Indications for internal fixation are compared with prosthetic replacement and primary fusion. PMID- 3658416 TI - [Replacement of the head of the humerus as a rescue operation following dislocated compound fractures of the shoulder joint]. AB - Results after conservative or surgical treatment of comminuted fractures of the head of the humerus are often unsatisfactory and complicated by pain and a severely decreased range of motion. In these patients good results have been obtained by replacement of the humeral head with the Isoelastic Humeral Head Prosthesis. Fourteen cases are reported and their results discussed. PMID- 3658417 TI - [Reconstructive plastic surgery of the humeral condyles following removal of endoprostheses of the elbow versus arthrodesis]. AB - The condyles of the elbow are of utmost importance for the stability of this joint. This is particularly evident in cases where elbow prostheses had to be removed because of loosening or infection and where the condyles had been deliberately resected at the primary operation. In order to obtain a functional elbow with sufficient stability and mobility after removal of the prostheses, we can reconstruct the condyles by means of a large autologous bone graft, which we take from the midpart of the illiac bone. The fixation is done with a specially adapted plate rather than with screws. A few case examples with a longer follow up are presented for whom the result was very gratifying. We also insist on the great importance of solid fixation of fractured condyles, particularly in cases of resection arthroplasty. Elbow arthrodeses should only be used where there is no chance of obtaining a sufficiently satisfactory result by means of an arthroplasty. In these rare cases, we have been using internal fixation with an adapted AO plate and the interposition of an autologous bone graft. In the future replantation of prostheses, possibly on neocondyles will become more important. PMID- 3658418 TI - [Reinterventions in postoperative instability of the lumbar spine]. AB - Among the many reasons for reinterventions in the lumbar spine, postoperative instability was chosen as the subject for investigation. Abnormal mobility can be described more precisely in terms of pathological, segmental movement than in terms of instability, as such movement not only represents a greater range of motion of one vertebra towards the adjacent one, but also movement with a restricted (or normal) amplitude of a pathological pattern. Three conditions create pathological postoperative movement: (1) nonunion after attempted fusion; (2) pathologically increased movement because of removal of important weight bearing structures; (3) compensatory movement of the segment next to a fusion. At the Wilhelm Schulthess Clinic in Zurich, 26 patients underwent one or more operations on the lumbar spine because of persisting pain as a result of postoperative pathological movement. In accordance with the results reported in the literature, good results were rare in reoperations on the lumbar spine (only 8 patients were completely free of pain); 14 patients had intermittent or continuous lumbar pain and 4 patients became worse. The indications for several interventions are carefully analyzed. Better results could probably have been obtained by more stable fixation techniques (transpedicular fixation, combined ventral and dorsal fusions), but the best means of avoiding reoperation is to observe the following guidelines: first, in disectomy cases, the osseous, weight bearing structures (lamina, facet joint) should remain untouched. If even partial removal seems to be inevitable, fusion should be added done as well.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658419 TI - Interocular equality of tonic accommodation and consensuality of accommodative hysteresis. AB - Interocular differences in tonic accommodation were assessed before and after a 10 minute period of sustained monocular fixation. The fixation task was carried out once for each eye using a high-contrast target at near, and once for each eye using an empty illuminated field. Tonic accommodation increased significantly as a result of fixating the high contrast target at near, but remained stable when viewing the empty field. Close correspondence was found between the two eyes with respect to both prefixation tonic level and magnitude of tonic after-effect. Absence of interocular differences clearly demonstrates the consensuality of accommodative hysteresis. PMID- 3658420 TI - A quantitative investigation into the effects of pupil diameter and defocus on contrast sensitivity for an extended range of spatial frequencies in natural and homatropinized eyes. AB - Contrast sensitivity was measured in 12 subjects for different spatial frequencies of sinusoidal grating patterns, generated by oscilloscope, for pupil diameters 2-8 mm and for defocus of +1-4 D, following homatropine eyedrops. Changes in pupil diameter, without correction for the change in retinal illumination, had no significant effect on contrast sensitivity, except at 0.5 and 1 c deg-1 when a significant reduction occurred with the 2 mm pupil. Defocus caused a large reduction in contrast sensitivity at spatial frequencies higher than the peak of the contrast sensitivity function (3 c deg-1) and a smaller reduction below the peak. In both individual and group results, there was no significant effect of defocus in causing a disproportionately greater reduction in contrast sensitivity at higher spatial frequencies nor were the zero mimina predicted by optical theory observed. The results were confirmed in eight subjects viewing with the natural eye, though the reduction in contrast sensitivity caused by +1 D defocus was not significant: this was attributed to the relaxation of accommodation in response to defocus. To predict the performance of the visual system, multiple regression equations were derived to incorporate terms for pupil diameter, defocus and spatial frequency. These equations reflected the lack of effect of pupil diameter, while defocus caused a 51% loss in contrast sensitivity per dioptre at higher spatial frequencies (3-38 c deg-1) and a 19% reduction at low spatial frequencies. PMID- 3658421 TI - Excursion tests of ocular motility. AB - Three alternative excursion tests of ocular motility have been compared. A computer model of the mechanics of the extraocular muscles has been used to estimate the tensions developed by the muscles in these tests. On the basis of these calculations we recommend the transverse test in which the positions of the eyes are observed as they track a target moving from the right to the left with a fixed elevation and a fixed depression. PMID- 3658422 TI - Fixation disparity in binocular stress. AB - Fixation disparity has been taken as a sign of stress on binocular vision because it is established that prism stress creates fixation disparity. This paper looks at the effect on fixation disparity of the stress caused by requiring subjects to read in inadequate illumination. It is found that the reduction in illumination does not in itself immediately change the magnitude of the fixation disparity. There is, however, an increase in the mean slope of the central part of the fixation disparity curve which suggests that when the effect of reduced illumination is added to prism stress, fixation disparity is increased. The stress created by asking subjects to read in reduced illumination for half an hour resulted in the mean associated heterophoria being increased, and over half the subjects reported symptoms of stress. It is concluded that fixation disparity is changed by this type of visual stress in some subjects, and in near vision is increased to a more marked degree of exo-disparity. Most of this increase occurs in the first ten minutes. PMID- 3658423 TI - The use of computerized contrast sensitivity, Arden gratings and low contrast letter charts in the assessment of amblyopia. AB - Contrast sensitivity measured with an electronic display was compared with Arden gratings and low contrast letter charts in normal and amblyopic children and adults. The low contrast letter charts and the Arden gratings used in the conventional manner revealed no additional information over that obtained by conventional Snellen acuity. However, the interocular differences found with each plate of the Arden gratings compared favourably with the computerized CSF. With the addition of an extra plate to test at a higher spatial frequency, the Arden gratings would be a useful technique for monitoring amblyopia therapy. PMID- 3658424 TI - The influence of temporal frequency and wavelength on beta movement. AB - The maximum displacement threshold for beta (apparent) movement was determined using small near-monochromatic stimuli subtending 2 min arc, over the frequency range 1.67-6.67 Hz. Displacement thresholds for the apparently oscillating spot were dependent upon both temporal frequency (F(9,903) = 1413) and wavelength (F(12,903) = 19.6), the stimuli having been equated for luminance. Significant interaction effects (F(108,903) = 3.32) demonstrated that the influence of colour varied with temporal frequency. It is suggested that short-range apparent movement over this frequency range may be mediated by a mechanism which is colour dependent. PMID- 3658425 TI - Reliability of the wetting value of tears. AB - The wetting value is the length of a Schirmer strip wetted in millimetres for a 5 min test period plus the length of time in seconds for dry spots to appear and has been suggested as a better prognostic test than its components in isolation (Fanti and Holly, 1980). Parameters of these procedures are examined and important shortcomings in the derivation of wetting value discussed. Reliability figures are presented for the Schirmer, tear break-up and wetting value tests. The norms obtained for the tear break-up test are substantially different from those usually assumed and we recommend that practitioners should therefore rely on their own norms rather than published values. PMID- 3658426 TI - A survey of visual defects on Tristan da Cunha, 1984. AB - This paper gives data, obtained during 1984, on the incidence of refractive error and ocular disease in the small, isolated island community of Tristan da Cunha in the South Atlantic. In general, despite inevitable consanguinity among the population of less than 300, ocular health is good. PMID- 3658427 TI - Generalization of the Tscherning theory: optimization of aspheric ophthalmic lenses. AB - The perfect single vision ophthalmic lens should be free from oblique astigmatism, mean oblique error, distortion and chromatism. At the same time, it should be aesthetic and comfortable. By means of third-order theory, we show that T scherning ellipses can be considered to correspond merely to the particular case in which the lens surface is spherical in the three-dimensional space defined by the conic constant epsilon, the power of the first surface D1, and the back vertex power D. Consideration is given to the best way of building a merit function for final optimization with a classical ray tracing optimization program on a computer. PMID- 3658428 TI - Three South African studies on the relation between road accidents and drivers' vision. AB - This report describes three studies of drivers' vision which have recently been carried out in South Africa. In the first, it was found that younger myopes constituted a substantial fraction of those drivers who failed to reach the acuity standards required for a South African driving licence: the acuity of almost all these drivers could be raised to an adequate standard by a proper refractive correction. In the second study, a comparison of the visual characteristics of a group of drivers who had been involved in accidents with those of a control group of accident-free drivers suggested that the former had mean acuities and depth perception which were worse than those of the accident free group by small but statistically significant amounts. A third study, comparing the visual acuities of a group of randomly selected drivers with those of a group who had been involved in road accidents, showed that a higher proportion of the accident group had acuities which were below that required by the licensing authority. PMID- 3658430 TI - Target direction effects in visual field plots in a retinitis pigmentosa family. PMID- 3658429 TI - Structure of the tear film during the blinking process. AB - The structure of the tear film was photographed immediately prior and subsequent to lid closure with a magnification factor of 140 X. Deformations of the tear film were observed in the form of "creasing", "wave motion" and also "fairly rough graininess" which point to a remarkably stable consistency of the lipid layer. PMID- 3658431 TI - The effect of stimulus contrast on the accommodation response. AB - Accommodation responses to stimuli of various contrasts at a vergence of -5.0 dioptres were measured with an objective infra-red optometer. Both an edge and sinusoidal gratings were employed. The sinusoidal gratings were 1.67, 5.0 and 15.0 c deg-1. The accommodation responses changed little as object contrast was reduced, until an accommodation response contrast threshold (ARCT) was reached; below this ARCT considerable accommodative error occurred. Intersubject variation in the ARCT was also noted. The ARCT for the 15.0 c deg-1 grating was significantly higher than for the other two gratings. On two subjects accommodation responses to the 5.0 c deg-1 grating were measured over a stimulus range of +0.5 to -0.5 dioptres with three grating modulations of 2.7, 8.0 and 25%. The results indicated that no contrast dependence occurs in the near range but that contrast may be important as the system approaches the far-point. The data further indicate the importance of intermediate spatial frequencies as accommodative stimuli. PMID- 3658432 TI - Abstracts of papers presented at the meeting of the Society for Experimental Optometry. Birmingham, 21-22 July 1986. PMID- 3658433 TI - Oscillatory movement displacement thresholds: resistance to optical image degradation. AB - Vernier acuity, under optimal conditions, appears remarkably resistant to image degradation. This characteristic has been used to assess neural function in cataract patients who exhibit poor spatial resolution. Conventional resolution tests fail to differentiate between neural and optical causes of visual loss. The oscillatory movement displacement threshold--the smallest amplitude of oscillation which gives rise to the perception of movement--provides an alternative hyperacuity test. This may offer advantages over vernier acuity. The effect of image defocus upon displacement thresholds for a sinusoidal contrast grating of spatial frequency 2 c deg-1 was investigated for high (15 Hz) and low (2 Hz) oscillation frequencies. With visible stationary references, subjects were more sensitive to oscillation frequencies of 2 Hz than to 15 Hz (F 1,9 = 33.34, p less than 0.005) whilst blur of up to 2 dioptres had no significant effect (F3,27 = 1.73, p greater than 0.1). Simulating media opacities by spatial degradation affected both grating acuity and contrast sensitivity functions, whilst displacement thresholds remained largely unaffected. Results suggest that oscillatory movement displacement thresholds may be of value in assessing ocular neural dysfunction in the presence of media opacities. PMID- 3658434 TI - Oculomotor consequences of beta-adrenoceptor antagonism during sustained near vision. AB - The effect of a topical non-selective beta-adrenergic antagonist, timolol maleate (0.5%) on the response accommodative convergence/accommodation (AC/A) ratio was monitored during a 16 min near-vision task. A double-blind protocol was adopted between timolol and a saline control for 17 emmetropic subjects. Timolol produced a significant reduction in AC/A during the first 4 min of the task with respect to saline. This reduction was mediated via accommodative convergence and it is proposed that this demonstrates direct involvement of sympathetic innervation to the ciliary muscle during the initial stages of a near-vision task. PMID- 3658435 TI - Time course and decay of effects of near work on tonic accommodation and tonic vergence. AB - Changes in tonic accommodation and tonic vergence were monitored before, during and immediately after a 45 min period of reading adult level text displayed on either a computer monitor or hard copy at 20 cm under binocular viewing conditions. Both tonic accommodation and tonic vergence gradually increased during the reading period, with changes in tonic accommodation occurring more rapidly. The average increases in tonic accommodation and tonic vergence following reading were 0.35 dioptres and 0.38 metre angles, respectively. Decay of both tonic components to the baseline in either light or total darkness occurred within the first 3 min. These results suggest that a moderate period of interrupted reading at a close distance can produce a transient increase in the tonic oculomotor levels. PMID- 3658436 TI - Effect of target content at higher spatial frequencies on the accuracy of the accommodation response. AB - The accommodation responses to sinusoidal and square-wave gratings at the same vergence (-5.0 dioptres) are compared as a function of the modulation of the fundamental of both waveforms. At low spatial frequencies (less than or equal to 2 c deg-1), responses to square-wave gratings are found to be more accurate than those to sine-waves. At higher frequencies the responses become very similar. An explanation is offered in terms of the contribution of higher harmonics to the square-wave response. PMID- 3658437 TI - Variation of dark focus of accommodation with laser speckle exposure duration. AB - Dark focus of accommodation (DFA) was measured in 10 subjects using a computer aided He-Ne Badal laser optometer having high temporal and amplitude resolution. Accommodative responses were tracked during 5 min sessions for 10 speckle exposure durations ranging from 100 to 1000 ms. DFA-speckle exposure functions fell into four distinct groups. This identifies the laser speckle exposure time as a possible contaminant in measures of DFA made by laser optometers if individual variability across exposure times is ignored. Group averaging of accommodative responses for laser exposure times obfuscates the reported individual variability. PMID- 3658438 TI - A method for raytracing through schematic eyes with off-axis components. AB - A linear algebraic method for tracing skew rays through aspheric surfaces is described. The advantage of this method is that the refracting surfaces can be translated and rotated with respect to each other. The method is used to investigate the optical factors affecting the location of Purkinje images. PMID- 3658440 TI - A model for retinal shape changes in ametropia. AB - Modeling ametropic retinal shape changes with an ellipsoid of constant equatorial radius has been found to produce types of peripheral astigmatism which are in good agreement with experimental findings. PMID- 3658441 TI - The physiological basis for the sensation of gloom: quantitative and qualitative aspects. AB - As our ambient lighting is gradually reduced from a high level, subjects use the following words - bright, gloomy, dim and dark. On six subjects the light level at which these decisions are given has been measured. It has been found that the word gloomy is used when the rods begin to take over from the colour-sensitive daylight cones. PMID- 3658439 TI - A schematic eye model for the effects of translation and rotation of ocular components on peripheral astigmatism. AB - The relative contributions of translation and rotation of the cornea and lens to peripheral astigmatic asymmetry have been investigated using a linear algebraic ray tracing method. It is believed that lenticular rotation is responsible for angle alpha, so bringing about peripheral astigmatic asymmetry, as normally occurs in human eyes over the temporal and nasal retina. Rotation of the cornea may be responsible for the small numbers of eyes which exhibit large amounts of peripheral astigmatic asymmetry. The effects of corneal rotation and translation on the dimensions of the entrance pupil are illustrated. PMID- 3658442 TI - Bad lights stops play. AB - The visual performance of cricket batsmen is simulated over a wide range of ambient illumination. When illumination falls to the level at which they usually stop batting (the gloom level) a rapid increase in reaction time commences. It is also the level at which office and car sidelights are turned on and the sensation of "gloom" occurs. PMID- 3658443 TI - The orthophorization of heterophoria. AB - The distribution of heterophoria within the general population is significantly non-normal and a high incidence of approximate orthophoria is observed. This observation has been named the orthophorization of heterophoria. It has been suggested that prism adaptation is the mechanism underlying orthophorization. A prolonged occlusion experiment has been used to investigate this possibility and further supports this theory. PMID- 3658444 TI - A longitudinal study of the age dependence of human ocular refraction--III. The mediation of changes from direct to inverse astigmatism examined by means of matrices of transition probabilities. AB - This study enquires into the manner in which the axis of astigmatism changes in the course of individual refractive histories. Specifically, two related problems are addressed: (1) how is the change from direct to inverse astigmatism mediated, and (2) what is the range of relative proportions of each of four variables (spherical ametropia, direct, inverse and oblique astigmatism) that occur in a sample population so that it can be considered randomly sampled and well distributed? Solutions to both problems are obtained by calculation of the probabilities with which transitions between such variables occur. A moderately sized longitudinal sample is used to demonstrate the new method. One of the conclusions is that the biological strategy for the mutation of the astigmatic axis is multi-faceted and that there is unlikely to be a single cause which can explain the process by which inverse astigmatism is achieved. PMID- 3658445 TI - On the use of small artificial pupils to open-loop the accommodation system. AB - Monocular accommodation responses to stimuli at vergences from 0 to -4.5 D (i.e. effective object-eye distances from infinity to 22 cm) were measured objectively using artificial pupils of 0.5, 0.75, 1.0 and 3.0 mm diameters and a constant retinal illuminance of 7000 td. The slopes of the response/stimulus curves for the 0.75, 1.0 and 3.0 mm pupils agree with those reported previously. The 0.5 mm pupil produced open-loop accommodation, no systematic change in accommodation being observed as the stimulus vergence was varied. However, the response drifted considerably with this pupil diameter. PMID- 3658446 TI - Cessation age of childhood myopia progression. PMID- 3658447 TI - [Results of surgical treatment of laryngeal cancer at the Otolaryngology Clinic, Medical Academy, in Poznan 1946-1985]. PMID- 3658448 TI - [Cytologic studies of precancerous conditions and cancer of the larynx]. PMID- 3658449 TI - [The directions of spread of laryngeal cancer and their clinical significance]. PMID- 3658450 TI - [Various complications of chronic otitis media]. PMID- 3658451 TI - [Changes in serum iron levels in patients surgically treated at the ORL clinic and ways of correcting]. PMID- 3658452 TI - [Serum amino acid levels in patients with cancer of the larynx treated by roentgen rays and Co-60 radioisotope]. PMID- 3658453 TI - [Embolization of the internal carotid artery with a pedunculated flap of the sternocleidomastoid muscle in injury of the siphon]. PMID- 3658454 TI - [Effect of surgical factors, status of progression and the site of the neoplastic process on voice and speech rehabilitation after laryngectomy]. PMID- 3658455 TI - [Clinical studies of the capacity for selectivity in hearing by the human ear]. PMID- 3658456 TI - [Terminology and use of a Polish-produced recorder in impedance audiometry]. PMID- 3658457 TI - [Changes in the clinical picture of acute and chronic suppurative otitis media in the last 40 years]. PMID- 3658458 TI - [Stapedotomy with preservation of the tendon of the stapedius muscle]. PMID- 3658459 TI - [Stapedotomy in otosclerosis]. PMID- 3658460 TI - [Morphometric evaluation of the epithelium of the endolymphatic sac in persons with normal hearing]. PMID- 3658461 TI - [Extended atticoantromastoidectomy in the treatment of various forms of chronic otitis media]. PMID- 3658462 TI - [Chronic granulomatous otitis media]. PMID- 3658463 TI - [Atopic rhinitis]. PMID- 3658464 TI - [Changes in nasal patency in relation to posture]. PMID- 3658465 TI - [Changes in the upper respiratory tract in ceramic plant workers]. PMID- 3658466 TI - [Our experiences in the treatment of choanal atresia in children]. PMID- 3658467 TI - [Rhabdomyosarcoma in children]. PMID- 3658468 TI - [Cysts and fistulas of the thyroglossal duct (data of the Otolaryngology Clinic, Medical Academy, in Gdansk)]. PMID- 3658469 TI - Godspeed House struggles for quality of life. PMID- 3658470 TI - Chlamydia trachomatis: the neglected epidemic. PMID- 3658471 TI - Neonatal intensive care: technology vs. quality of life. PMID- 3658472 TI - Medico-legal issues associated with organ donation and transplantation: cadaver donors; living donors. PMID- 3658473 TI - [Fanconi's hypoplastic anemia]. PMID- 3658474 TI - [Perforated appendicitis in childhood]. PMID- 3658475 TI - [Basilar impression in childhood. Correlation of radiologic and clinical findings]. PMID- 3658476 TI - [Presentation of a complex monitoring and therapy program in neuromuscular diseases, exemplified by X chromosomal muscular dystrophies. 1: Etiology, development, clinical and paraclinical findings]. PMID- 3658477 TI - [Presentation of a complex monitoring and therapy program in neuromuscular diseases, exemplified by X chromosomal muscular dystrophies. 2: Complex treatment concept]. PMID- 3658478 TI - [Intestinal mucosa as the site of biologic integration]. PMID- 3658479 TI - [The role of the initial life patterns of species in the evolution of parasitic systems]. PMID- 3658480 TI - [Microsporidiosis of Sakhalin Salmonidae: the incidence and dynamics of the infection]. AB - Four-year summer observations have shown that G. takedai distribution in Salmonidae of Sakhalin is limited by the rivers entering the Aniva Bay. Maximum infection of pink salmon (Oncorhynchus gorbuscha) amounts to 70-100%, that of masu salmon (Oncorhynchus masou) to 9.0-45.6% and was recorded in September. Dynamics and possible ways of infection are discussed. PMID- 3658481 TI - [Susceptibility of Bithynia inflata mollusks from discrete populations for Opisthorchis felineus infestation from different foci of opisthorchiasis]. AB - Experiments were conducted on crossed infection of the specific intermediate host of Opisthorchis, molluscs of Bithynia inflata from different and remote populations, with eggs of O. felineus from different nidi of the disease. The strains of the agent were found to be heterogeneous that is expressed in different degree of compatibility with the intermediate host. PMID- 3658482 TI - [Apoptosis--cell death]. PMID- 3658483 TI - [Primary non-epithelial malignant lung neoplasms]. PMID- 3658484 TI - [Malignant ectomesenchymoma]. PMID- 3658485 TI - The neuropathological pattern of the intramural ganglia of the digestive tract in routine biopsy material. PMID- 3658486 TI - [Histoenzymatic reactions in the liver of castrated female rats after administration of thyroxine and estradiol]. PMID- 3658487 TI - [Angioimmunoblastic lymphadenopathy--clinical and morphologic evaluation of 6 cases]. PMID- 3658488 TI - [Monoclonal antibodies in the histologic diagnosis of neoplasms]. PMID- 3658489 TI - [Diagnostic and prognostic value of morphologic analysis in myelodysplastic syndromes]. PMID- 3658490 TI - [Plexiform neurofibroma of the larynx. A case report]. PMID- 3658491 TI - Sex differences, activation level, and bilateral electrodermal activity. AB - The effects of the activation level and subject's sex on bilateral skin conductance measures were studied. Thirty right-handed subjects (15 males and 15 females) were exposed to three types of stimulus conditions: rest-period, verbal task and spatial task. Results showed that no relationship was observed between EDA asymmetry and the increase in the activation level induced by the verbal and the spatial tasks. Males showed both higher SCRs and greater frequency of responses on the left than on the right hand. The direction of electrodermal asymmetry remained constant regardless of the stimulus conditions. It was concluded that sex differences are important in the study of EDA asymmetry and that this asymmetry appeared to depend on peripheral variations. PMID- 3658492 TI - Incubation of conditional suppression is an associatively-based phenomenon. AB - Ten rats were deprived of water and trained to lick a tube for saccharin reinforcement. In each of the two sessions that followed, the rats received six contiguous pairings of a 30-second illumination of the houselight and a 0.75 second, 0.10 mA electric shock while licking. No sign of conditioning was observed during the first experimental session, but profound conditioning was observed on the first and subsequent trials of the second conditioning session. No comparable change in the rate of licking was observed in groups of rats that received only presentations of the visual stimulus, only presentations of the electric shock, or random presentation of the visual stimulus and electric shock during the first conditioning session. These data establish that the incubation of conditional suppression is an associative phenomenon. PMID- 3658493 TI - Pediatric echocardiography 1987. AB - Echocardiography and Doppler have revolutionized diagnosis and management in pediatric cardiology. The information generated by these noninvasive studies on appropriate patients permits the pediatric cardiologist to make more accurate diagnostic assessments than previously possible. In turn, the pediatrician and the family are better informed regarding the management and care of the patient. PMID- 3658494 TI - Diagnosing precordial catch. PMID- 3658495 TI - Adolescent learning disabilities overlooked. PMID- 3658496 TI - Pulmonary function testing in children with cardiac disease. AB - These cases illustrate the clinical importance of pulmonary function testing in children. The first case demonstrated a significant restrictive defect in a child with pulmonic stenosis and scoliosis. Although this child had no respiratory symptoms, it was important to document the degree of functional impairment to plan for her postoperative course. The second case demonstrated the way in which pulmonary function tests can lead to a specific diagnosis and provide important information about response to therapy. This patient had distressing symptoms which limited her ability to participate in sports. Her chest x-ray revealed no significant abnormality and she had no auscultatory finding. Pulmonary function tests defined both the nature and severity of her problems and provided objective information about her response to therapy. In the third case, one might have anticipated decreases in flow rates and lung volumes because of neuromuscular weakness. That was not evident on testing and the patient had an uneventful postoperative recovery. Pulmonary function testing provides invaluable information about the nature and severity of functional impairment in children with known or suspected pulmonary disease. New equipment and individuals specifically trained to work with children now permit the evaluation of even young children. Pulmonary function testing can expand our knowledge of disease processes and improve our therapeutic strategies. PMID- 3658497 TI - Cardiac surgery without preoperative cardiac catheterization. PMID- 3658498 TI - Percutaneous balloon valvuloplasty for the treatment of valvular pulmonic stenosis. PMID- 3658499 TI - Detection and management of cardiac involvement in the Kawasaki syndrome. PMID- 3658501 TI - Psychosocial aspects of diabetes in childhood and adolescence. PMID- 3658500 TI - Respiratory syncytial virus infection and cardiopulmonary disease. PMID- 3658503 TI - Management principles in pediatric urology. PMID- 3658502 TI - Pediatric urinary tract infection. Diagnosis, classification, and significance. AB - The initial task is to establish the diagnosis of a urinary tract infection. The clinical setting, method of specimen collection, bacterial colony count, and species are all important considerations. Next, the infection is classified as complicated or uncomplicated. Complicated infections require hospitalization and parenteral antibiotic therapy. Appropriate imaging studies are imperative to determine whether urologic intervention is necessary. All children with well documented urinary tract infections deserve diagnostic evaluation, regardless of sex or presence of systemic symptoms. PMID- 3658504 TI - Neurogenic bladder dysfunction. AB - The neurophysiology of lower urinary tract function is followed by a discussion of the causes, evaluation, and management of neurogenic bladder dysfunction in children. All forms of injured bladders require early assessment and proper treatment, the basis for which is provided. Clues to what the pediatrician can look for and care for are presented. PMID- 3658505 TI - The artificial urinary sphincter. AB - Urinary incontinence has many etiologies and a similarly varied and wide-ranging spectrum of therapeutic alternatives. The AMS artificial sphincter represents one of these options that has a distinct, albeit limited, place in certain patients. The authors outline the mechanical details of these devices and present their own clinical experience in a large pediatric population. PMID- 3658506 TI - Surgical considerations in childhood end-stage renal disease. AB - This article provides a conceptual framework that is useful to the pediatrician who provides children with renal failure with care. Operative and perioperative consideration are emphasized. PMID- 3658507 TI - Hypospadias. AB - This article outlines the basic etiologic, anatomic, and reconstructive considerations needed for screening, evaluating, counseling, and following patients with hypospadias. PMID- 3658508 TI - Ureteral duplication, ectopy and ureteroceles. AB - These entities pose some of the most challenging diagnostic and therapeutic objectives involving the urinary system. The clinical presentations are varied, and involve children from prenatal to adolescent age groups. The diagnostic and therapeutic alternatives are presented, along with a classification for the more complex clinical settings. PMID- 3658509 TI - Pediatric urinary diversion and undiversion. AB - Many things have changed in our management of the urinary tract of children and young adults. Important contributions from many sources have resulted in the refinement of therapy and the progression from diversion to undiversion and reconstruction. Primary urinary diversion is now uncommon. Patients with exstrophy, for example, are treated with primary bladder closure as newborns, and newborns with valves often are treated with primary valve ablation. Children with neurogenic bladder dysfunction resulting from myelodysplasia are rarely diverted, but are started at an early age with ICC. It is hoped that in future the contents of this article on diversion techniques and undiversion will be of historical interest, however. Note: The editors also have found the use of the Mitrofanoff procedure, utilizing a nonrefluxing tunnel and a catheterizable stoma made out of the ureter or appendix, to be a very valuable addition to the reconstructive surgeon's armamentarium. We also feel that use of detubularized bowel for either bladder augmentation or replacement provides more efficient storage capability. Occasional reports of extremely significant diarrhea after removal of the ileocecal segment from the intestinal tract have been reported in children with myelodysplasia. PMID- 3658510 TI - Obtaining the adolescent sexual history. PMID- 3658511 TI - Health concerns of adolescents. PMID- 3658512 TI - Influence of parents, peers, and problem-solving on contraceptive use. PMID- 3658513 TI - Assessing parenting potential for child abuse risk. PMID- 3658514 TI - False allegations of child abuse: the other side of the tragedy. PMID- 3658515 TI - Chronicle of a pediatric nurse practitioner program. PMID- 3658516 TI - Weaning from the breast: influences on maternal decisions. PMID- 3658517 TI - Temperament and cognitive style in early childhood. PMID- 3658518 TI - Discharged from neonatal intensive care: how satisfied are parents? PMID- 3658519 TI - Pediatric organ donation: responsibilities of the critical care nurse. PMID- 3658520 TI - The meaning of FDA approval. PMID- 3658521 TI - Acquiring foundation funds for health-related projects. PMID- 3658522 TI - Pediatric management problems (airway obstruction--foreign body). PMID- 3658523 TI - North American Cystic Fibrosis Conference. Toronto, Ontario, Canada. October 14 17, 1987. Abstracts. PMID- 3658524 TI - Gastroesophageal reflux and unexplained chronic respiratory disease in infants and children. AB - Thirty-eight children, aged from a few weeks to 7 years, with severe chronic pulmonary disease and without gastrointestinal symptoms, were investigated for gastroesophageal reflux (GER), using prolonged pH probe monitoring and gastroesophageal scintiscanning. All treatments were discontinued before testing. GER was found in 24 patients (63%) (group I) and it was not observed in 14 patients (group II). All patients of group I received antireflux treatment, consisting of cisapride; in 22 of 24 patients, GER was controlled, as indicated by improvement of either pH monitoring or scintiscanning, or both. Eighteen of these 22 (82%) had remission of their pulmonary disease, and only two patients of group II (14%) had spontaneous remission of the respiratory symptoms. We concluded that GER was probably the cause of the respiratory disease in 63% of our patients, since treatment of GER was followed by disappearance of the respiratory complaints in most of them. The combination of gastroesophageal scintiscanning and pH probe study improved the diagnostic accuracy. PMID- 3658525 TI - Compliance of the total respiratory system in healthy preterm and full-term newborns. AB - The compliance of the total respiratory system (CRS) was determined by the occlusion technique during expiration in 19 preterm newborns (NB) over 31 weeks of gestational age (mean, 34 +/- 1.5 SD) and in 20 full-term NB. Postnatal age ranged from 1 to 28 days. No sedation was used during the test. In absolute terms, CRS was significantly greater (P less than 0.01) in full-term than in preterm NB (3.17 +/- 0.71 ml/cm H2O vs 2.37 +/- 0.81 ml/cm H2O). When normalized for body weight, length cubed, [corrected] body surface area, and the Quetelet index (body weight/length squared) [corrected], CRS was similar in preterm and full-term NB. These results suggest that, normalized for biometric data, passive elastic properties of the total respiratory system are similar in full-term and preterm NB, at least in the gestation age range studied. PMID- 3658526 TI - Effect of early furosemide administration in neonates with respiratory distress syndrome. AB - The effect of early furosemide-induced diuresis was prospectively evaluated in 39 neonates less than 24 hr of age with clinical respiratory distress syndrome (RDS) who received either four doses of furosemide (1 mg/kg) or no diuretic. Measurements of FiO2 alveolar-arterial oxygen gradient (P[A-a]O2), peak inspiratory pressure (PIP), and urine output as a fraction of intake (O/I) were averaged for every 8 hr. The furosemide group overall showed a significant decrease (P less than 0.01) in FiO2, P[A-a]O2, and PIP with an earlier (32 hr vs 52 hr) and more pronounced diuresis (35% greater O/I) when compared to the controls. This effect was accentuated in the subgroup with 1,000-1,500 g birth weight (significantly lower FiO2 and P(A-a)O2 from 16 to 48 hours), while no increase in urine output was observed for the infants weighing less than 1,000 g. A significant reduction in supplemental oxygen and need for ventilatory support at 96 hr of age was observed in the furosemide-treated, less than 1,500-g infants. The incidence of patent ductus arteriosus was not increased following furosemide therapy, and no significant difference in echocardiographic parameters was observed in 21 infants from both groups, who were followed daily during the first week of life. This study suggests that early furosemide-induced diuresis, particularly in infants weighing 1,000-1,500 g at birth, promotes improvement in pulmonary functions in RDS and leads to faster reduction in oxygen and ventilatory support. PMID- 3658527 TI - Hypercarbic ventilatory responses of infants at risk for SIDS. AB - We examined the hypercarbic ventilatory responses (HVR) of 143 infants at risk for sudden infant death syndrome (SIDS) and 34 normal control infants. Sixty-five of the at-risk infants had experienced apparent life-threatening events (ALTE), and 78 were siblings of SIDS victims. Twenty-three (35%) of the ALTE infants experienced subsequent apnea; one died of SIDS. Seven (9%) of the SIDS siblings experienced subsequent apnea; two ultimately died of SIDS. In the HVR studies, we measured tidal volume (VT), minute ventilation (VE), frequency of breathing (f), and end-tidal PCO2 (PETCO2) at rest and while breathing 2% and 4% CO2. Mean HVR vales for the ALTE, sibling, and control groups were all similar. The mean HVR values for those at-risk infants who experienced subsequent apnea were not different from those who did not experience subsequent apnea. However, those infants experiencing subsequent apnea had higher mean VT/kg values (P less than 0.01) and lower mean PETCO2 values (P less than 0.001) than those who did not. The SIDS siblings had significantly lower resting VT/kg values than either the near-miss infants or normal controls (P less than 0.01). We did not find depressed HVR values in infants at risk for SIDS. On the contrary, those infants who experienced subsequent apnea had evidence suggesting relative hyperventilation. SIDS siblings had evidence suggesting relative hypoventilation. These findings are interesting and thought-provoking. However, HVR studies do not appear to be sensitive, specific, or appropriate for the general screening of infants at risk for SIDS. PMID- 3658528 TI - Changing patterns in neonatal respiratory diseases. AB - Using the current Nottingham Health District, England, as a geographically defined population we have investigated the changing patterns of neonatal respiratory diseases. We have categorized all newborns who developed a respiratory problem during either 1977 or between April 1, 1983, and March 31, 1984 using a system based on that of Hjalmarson (Acta Paediatr Scand 1981; 70:773 783). There has been no change in the incidence of any of the disease types. However, the gestation of babies in two groups, idiopathic respiratory distress syndrome (IRDS) and minimal respiratory disturbance (requiring added oxygen for less than 6 hours), has shown a significant reduction. Overall, mortality for infants developing IRDS has shown a slight decrease, and for infants between 29 and 32 weeks gestation, mortality has shown a significant reduction. Overall, requirements for oxygen therapy and ventilation have shown a threefold increase, while hours in receipt of continuous positive airways pressure (CPAP) have increased sevenfold. PMID- 3658529 TI - Pulmonary function at 1 year of age in survivors of neonatal respiratory distress: a multivariate analysis of factors associated with sequelae. AB - We studied pulmonary function 1 year after neonatal respiratory distress (RD) in 54 infants who had been treated at birth in the same neonatal intensive care unit. RD was related to hyaline membrane disease in 36 cases (group I) and to other causes in 18 cases (group II). Compared with predicted values, dynamic lung compliance (CL) was lower (less than -2 SD) and total pulmonary resistance (RL) was higher (+2 SD) in 18 (33%) and 12 (22%) infants, respectively. The relationships between these functional abnormalities at 1 year of age and the characteristics of the neonatal respiratory disease were assessed using a multifactorial analysis (multiple correspondences analysis). We found that elevated RL (greater than +2 SD) at 1 year of age was very significantly related with hyaline membrane disease, involving both high rate of positive pressure ventilation and prolonged intubation, and with the presence of both tachypnea and abnormal chest X rays at the time of discharge. Compared with elevated RL, the relationships between low CL (less than -2 SD) and the same neonatal characteristics were less significant; in particular, there was no strong link between low CL and hyaline membrane disease. Finally, birth before 30 weeks gestation was an index of severity. PMID- 3658530 TI - Cold air challenge in children with asthma. AB - A study was designed to determine the sensitivity and specificity of a cold air bronchial provocation test. A total of 18 children with asthma (mean age 12 years) and 18 normal children (mean age 14 years) were studied. The cold air challenge consisted of a 4 min period of isocapnic hyperventilation of subfreezing air (mean temperature -15 degrees C). In-Induced response in forced expiratory volume in 1 sec (FEV1) expressed as a percentage of predicted normal values was obtained at 4, 6, and 8 min post-challenge. The average response to the cold air was a 27% decrease of FEV1 in asthmatics, which was significantly different from that of the normal children, who showed no statistically significant drop. In both the asthmatic and normal groups, the maximal drop in FEV1 had occurred by the time measurements 4 min post-challenge had been made. At that time, the smallest overlap was observed between normal and asthmatic children. This suggests that the fourth minute post-challenge can be chosen as a cut-off time to distinguish normal from asthmatic children. Considering a decrease of FEV1 greater than 10% as a positive test, the sensitivity of the cold air challenge was 95% and the specificity was 89%. PMID- 3658531 TI - Normal values of maximal inspiratory and expiratory pressures with a portable apparatus in children, adolescents, and young adults. AB - Maximal inspiratory and expiratory mouth pressures (Plmax and PEmax) were measured over a wide age range using a cylindrical mouthpiece and a multiple trial procedure. Two hundred forty-three students and 30 adults were studied. In addition, a comparison of a cylindrical and a scuba-type mouthpiece was made in 16 subjects. Fifty percent of the subjects required five or more trials to achieve their maximal mouth pressures. Higher PEmax values were obtained using a cylindrical mouthpiece than with a scuba-type mouthpiece in 15 of the 16 subjects tested. Plmax was not affected by mouthpiece type. Males had higher Plmax and PEmax values than females except in the 8-10 years age group. Maximal mouth pressures correlated with age in boys only. Technical considerations, such as the number of trials and the type of mouthpiece used, are important determinants of maximal mouth pressure values. PMID- 3658532 TI - Effect of sleep state on chest wall movements and gas exchange in infants with resolving bronchopulmonary dysplasia. AB - During active sleep, neonates exhibit asynchronous chest wall movements, which have been associated with a small but significant decrease in oxygenation. To determine the effects of maturation and residual chronic lung disease on both these phenomena, we studied 11 preterm infants with resolving bronchopulmonary dysplasia (BPD) and compared these infants to ten healthy preterm infants all at time of discharge. Synchrony of chest wall (upper rib cage and abdominal) movements, sleep state, O2 saturation, and transcutaneous CO2 (TcPCO2) were recorded during both active (AS) and quiet sleep (QS). Sleep state was determined by electroencephalographic and behavioral criteria. Normal preterm infants displayed asynchronous chest wall movements only in AS, whereas, in infants with BPD, asynchrony predominated in both sleep states, although O2 saturation and TcPCO2 did not differ between sleep states in either group. The O2 saturation during AS was lower in the BPD group than in the group of normal infants (92% vs 96%; P less than 0.02), whereas TcPCO2 was higher in the BPD group unrelated to sleep state. We conclude that infants with resolving BPD exhibit asynchronous chest wall movements in both AS and QS, and that change in sleep state from QS to AS is not associated with a detrimental fall in oxygenation in these infants. PMID- 3658533 TI - Clinical Candida supraglottitis in an infant with AIDS-related complex. PMID- 3658534 TI - On follicular bronchitis/bronchiolitis without bronchiectasis. PMID- 3658535 TI - Persistently circulating C3 nephritic factor (C3 NeF)-stabilized alternative pathway C3 convertase (C3 CoF) in serum of an 11-year-old girl with meningococcal septicemia--simultaneous occurrence with free C3 NeF. AB - Hemolytic complement was found to be absent in the serum of an 11-yr-old girl (R.N.) with meningococcal septicemia. C1, C4, and C2 were slightly decreased, C3 was absent, C5-C9 within the normal range. B levels immunochemically and electrophoretic mobility of B were normal. C3d was greater than 1000% of a pooled EDTA-plasma standard indicating hypercatabolism of C3. On incubation of the patient's serum with normal human serum activation of C3 occurred even in the presence of 0.04 M EDTA. The amount of C3b generated was, however, greater without any chelating agent or in Mg-EGTA. On gel filtration of the serum two protein containing peaks were found to be responsible for activation of C3: the IgG containing peak was able to activate C3 in normal human serum without chelating agents and in Mg-EGTA but not in the presence of EDTA. The IgM containing peak activated the third component of complement even in the presence of EDTA. The factor responsible for this phenomenon was termed C3 converting factor (C3 CoF). The IgG fraction of the patients serum caused activation of C3 in Mg-EGTA. However, in the presence of EDTA no activation of C3 could be induced even if physiological concentrations of the patients IgG were added to normal human EDTA-plasma. Thus the activity of the patient's IgG did not differ from typical C3 nephritic factor. The decay of C2 in EAC42 intermediates in the presence of the patient's IgG was uninfluenced indicating that it did not carry autoantibody activity against the classical pathway convertase C4b,2a, an activity recently termed NFc.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658536 TI - The in vivo effect of bilirubin and sulfisoxazole on cerebral oxygen, glucose, and lactate metabolism in newborn piglets. AB - Bilirubin inhibits in vitro oxidative phosphorylation and glycolysis. This study investigated the in vivo effect of bilirubin on cerebral oxygen, glucose, and lactate uptake in newborn piglets. Seventeen 2- to 4-day-old piglets were divided into three groups and examined as follows: group 1 = control (C); group 2 = control with sulfisoxazole; and group 3 = experimental, given bilirubin with sulfisoxazole. In the experimental group, bilirubin was infused for 4 h. The cerebral bilirubin content in the bilirubin-infused group was 11.0 +/- 1.4 nmol/g of cerebral cortex (mean +/- SEM), consistent with levels found in infants with kernicterus. However, this level of brain bilirubin had no major, acute effects on cerebral uptake of oxygen, glucose, or lactate despite producing lethargy and ataxia which were consistent with bilirubin intoxication. This suggests that mitochondrial changes may not be involved in vivo in acute bilirubin encephalopathy. PMID- 3658537 TI - Changes of membrane fluidity in erythrocytes of obese children: a spin label study. AB - Red blood cells depend on circulating lipoproteins for the turnover of membrane phospholipids. Thus abnormalities in lipid and lipoprotein metabolism are frequently associated with changes in composition and fluidity of erythrocyte membranes. Using the electron spin resonance technique we studied the physical state of erythrocyte membranes from 15 obese children with a body mass index ranging from 22.8 to 34 kg . m-2 and slight alterations of plasma lipids. The spin labels used, 5-doxylstearate and 16-doxylstearate, have shown an increase of the order parameter and of the correlation time, respectively. These observations indicate a decrease of fluidity at the surface and in the hydrophobic core of erythrocyte membranes from obese subjects. The results are statistically significant and they are discussed in relation to clinical aspects of childhood obesity. Studies on erythrocyte membrane molecular organization could represent a sensitive way to find out small metabolic alterations hardly detectable with compositional studies. PMID- 3658538 TI - Failure to detect a stimulatory effect of estradiol-17 beta on ovine fetal lung maturation. AB - It has been reported that estradiol-17 beta (E2) stimulates rat and rabbit fetal lung maturation; however, E2 was not directly administered to the fetus in these experiments. Therefore, we used the chronically instrumented fetal sheep to study the effects of 14 days of continuous E2 infusion on fetal lung maturation. Animals were instrumented on days 104-106 of gestation, then infused with either saline or E2 (100 micrograms/day) from 111 to 127 days of gestation. Fetal plasma concentrations of E2, estrone, and cortisol, and tracheal fluid phosphatidylcholine:sphingomyelin ratios and phosphatidylcholine flux were measured daily in E2-infused (n = 8) and saline-infused (n = 6) control animals. At 127 days of gestation, fetuses were sacrificed and lung tissue samples obtained for biochemical and morphological analyses. Plasma E2 levels rose from 0.045 +/- 0.001 (mean +/- SE) to 7.45 +/- 5.31 ng/ml (p less than 0.05) in E2 infused animals whereas levels remained less than 0.06 ng/ml in saline-infused animals. Plasma estrone concentrations also were significantly elevated by E2 infusion. Plasma cortisol concentrations increased from 0.58 +/- 0.08 to 0.88 +/- 0.40 microgram/dl in E2-treated fetuses during the last week of infusion whereas values in control animals were unchanged. The ratio of acetone-precipitated phosphatidylcholine to sphingomyelin and the flux of acetone-precipitated phosphatidylcholine in tracheal fluid were not affected by E2 infusion. Fetal lung tissue phospholipid content was also unaffected by E2 infusion. Furthermore, there was no consistent effect of E2 infusion on the histological structure of the fetal lung tissue as determined by morphometric methods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658539 TI - The effect of betamethasone on neonatal neutrophil chemotaxis. AB - Antenatal maternal glucocorticoid administration has been widely used to accelerate fetal lung maturation. Glucocorticoids have also been used postnatally in selected neonates as antiinflammatory agents. Numerous studies have shown that glucocorticoids inhibit multiple components of the immune system including neutrophil (PMN) function in children and adults. Since PMNs are of critical importance in host defense against bacterial infection, impaired PMN function in newborn infants is thought to be an important cause of their increased morbidity and mortality from bacterial infection. Further compromise of neonatal PMN function by exogenous factors such as glucocorticoids may therefore be of significant clinical importance. A micropore filter chemotactic assay was used to determine the in vitro effect of betamethasone on the random migration and directed migration (chemotaxis) of PMNs from 18 neonates. The addition of a concentration of betamethasone (0.01 microgram/ml) similar to that found in cord blood following a standard dose administered to the mother resulted in a significant (p less than 0.01) inhibition in mean neonatal PMN random migration ( 15.0 +/- 0.8%) and chemotaxis (-23.5 +/- 3.0%). A similar inhibition was not found when PMNs from 14 adults were exposed to the same concentrations of betamethasone. Betamethasone administration to pregnant women or their newborn infants may further impair PMN motility and lead to an increased morbidity and mortality from bacterial infection in neonates. PMID- 3658540 TI - Lecithin/sphingomyelin ratios in tracheal aspirates from newborn infants. AB - A sensitive and rapid high-performance liquid chromatography method for determining lecithin/sphingomyelin (L/S) ratios in small volume tracheal aspirates has been evaluated in 115 infants sampled within 3 h of delivery. Respiratory distress syndrome was present in 41 infants and all had L/S ratios of less than or equal to 15 (sensitivity 100%). Respiratory distress syndrome was absent in 74 infants, 67 of whom had L/S ratios of greater than 15 (specificity 91%). Serial tracheal aspirates (n = 68) in 27 infants showed little change in nine respiratory distress syndrome infants with L/S ratio less than or equal to 15 over 3 h while 18 nonrespiratory distress syndrome infants with L/S greater than 15 were more variable. In two infants initial immature ratios rose to maturity rapidly after birth. Comparison of amniotic fluid L/S ratios obtained within 2 h of delivery correlated with the corresponding tracheal aspirate L/S in 24 infants (r = 0.81, p less than 0.001) although the latter were three times higher. This method may have potential routine application in the assessment of surfactant replacement and mechanical ventilator therapies. PMID- 3658541 TI - Increased respiratory frequency and variability in high risk babies who die of sudden infant death syndrome. AB - We have tested the hypothesis that autonomic instability, reflected in increased variability of heart rate and respiratory frequency, characterized high risk babies who died of sudden infant death syndrome. Using computer-based methods, we compared the power spectra of instantaneous heart rate and respiration on coded tape recordings from seven asymptomatic siblings and 10 babies with symptomatic apnea who died of sudden infant death syndrome to 34 age- and sex-matched controls. We confirmed our previous observation of increased respiratory bandwidth, an index of variability in respiratory frequency (p = 0.009) but failed to confirm our finding of increased low frequency fluctuations in heart rate (p = 0.18). In addition, we found an increase in mean respiratory frequency during quiet breathing (p = 0.001) and a significant relationship between respiratory bandwidth and mean respiratory frequency (r = 0.604, p = 0.0002). These variables along with those from a previous analysis of the same data base yield a discriminant function with 82% sensitivity and 100% specificity. These results confirm previous suggestions that high risk babies who die of sudden infant death syndrome exhibit autonomic instability. PMID- 3658542 TI - Developmental aspects of renal beta-amino acid transport. VI. The role of membrane fluidity and phospholipid composition in the renal adaptive response in nursing animals. AB - Accumulation of the beta-amino acid taurine is higher in adult rat renal brush border membrane vesicles than in nursing animals, which relates to a higher initial rate Vmax. A low sulfur amino acid diet increases and a 3% taurine diet reduces the Vmax of Na+-taurine cotransport in brush border membrane vesicles at all ages after 7 days as compared to values on a normal diet. To determine if changes in membrane fluidity account for these developmental and adaptive events, the fluorescent probe 1,6-diphenyl-1,3,5-hexatriene was used to measure fluorescence anisotropy. A two-component, single break curve fit the data over the range 4 to 56 degrees C. Values for the break temperature centered around 23 degrees C, not different than a break temperature determined in adult membranes. The values for membrane polarization range from 0.311 to 0.329 in membranes from 7-, 14-, and 21-day-old pups exposed to each of the three diets, significantly lower than the value in adult membranes (p less than 0.02). The slopes of each component, equivalent to the apparent energy of activation, did not differ in relation to diet. The ontogenic changes in taurine uptake by brush border membrane vesicles related to the exposure to different dietary sulfur amino acid levels are not related to changes in membrane fluidity using 1,6-diphenyl-1,3,5 hexatriene as a probe. However, there is a decrease in fluidity with age. Total phospholipid content falls postweaning, and the percent of total content of phosphatidyl choline and glycerol phosphate fall, and phosphatidyl serine and ethanolamine rise as the rat ages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658543 TI - Oxygen transport and metabolism in the conscious lamb: the effects of hypoxemia. AB - We studied the response of O2 consumption, systemic O2 transport, arterial blood lactate concentration, base deficit, and respiratory exchange ratio (CO2 production/O2 consumption) to graded alveolar hypoxia (fractional concentration of inspired oxygen 0.21, 0.16, 0.12, and 0.08) in seven intact, conscious chronically catheterized lambs at less than 1 wk after birth, at 25-40 days and at greater than 40 days. To test whether there was an age related difference in the metabolic response to a decline in O2 transport due to hypoxemia, we related the changes in blood lactate and base deficit to the systemic O2 transport and to the fractional change in O2 consumption. Systemic O2 transport and O2 consumption decreased with severe hypoxemia, while lactate concentration and respiratory exchange ratio increased in all age groups. The changes in base deficit were not significant. When the hypoxemia-induced reduction in O2 consumption was less than 15% of the baseline value (at fractional concentration of inspired oxygen 0.21) there was no elevation in lactate concentration; however, when O2 consumption was reduced by more than 15%, lactate concentration consistently increased by more than 1 mmol/liter. There were no apparent differences amongst the age groups in this response. Therefore, the newborn lamb does show metabolic consequences of a fall in O2 consumption with hypoxemia which is similar to the older sheep, however, there is a "buffer zone" in which O2 consumption may decrease before evidence of tissue hypoxia can be found. The mechanism by which O2 consumption can decrease without accumulation of lactate remains speculative. PMID- 3658545 TI - Developmental changes in thickness, contractility, and hypoxic sensitivity of newborn lamb cerebral arteries. AB - The present studies were conducted to examine the possibility that the increased vulnerability of the newborn brain to hypoxia may be due to age-related differences in vascular thickness and contractility. Segments of rostral choroidal (RC), posterior communicating (PC), basilar (B), and common carotid (CC) arteries were taken from 3- to 7-day-old lambs (n = 11) and adult sheep (n = 8) and studied using standard in vitro techniques. In lamb cerebral arteries, maturation was associated with significant increases in vessel thickness and tension generation. Because the increases in tension generation (77, 90, and 135% in PC, B, and RC segments) were proportionately greater than the corresponding increases in thickness (45, 75, and 34% in PC, B, and RC), force per unit area increased with maturation in the cerebral arteries. In the CC segments, the age related increases in thickness (117%) were greater than the increases in tension generation (30%), such that average force per unit area was actually greater in the lamb than in the sheep. In response to hypoxia (PO2 less than 15 torr), all vessels exhibited significant relaxation relative to normoxic controls, although the rates and magnitudes of relaxation varied considerably. In the sheep, the carotid exhibited rapid relaxation of small magnitude (21%), whereas the cerebral arteries relaxed more slowly and more completely (56, 52, and 45% in PC, B, and RC). In contrast, the lamb carotid segments relaxed more slowly than the cerebral arteries.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658544 TI - Inhibition of mitochondrial functions by margosa oil: possible implications in the pathogenesis of Reye's syndrome. AB - Margosa oil (MO), a fatty acid-rich extract of the seeds of the neem tree and a reported cause of Reye's syndrome, has been used in the induction of an experimental model of Reye's syndrome in rats. It has been reported that MO causes a decrease in in vivo mitochondrial enzyme activity similar to that seen in Reye's syndrome. We have attempted to uncover some of the biochemical mechanisms of MO's toxicity by examining its effect in vitro on isolated rat liver mitochondria. Male rat liver mitochondria were isolated by centrifugation; oxygen uptake, reduced forms of cytochrome b, c + c1, a + a3, and flavoprotein, intramitochondrial concentrations of acetyl coA, acid-soluble coA, acid-insoluble coA, and ATP content were measured after incubation with and without MO. Our results reveal that MO is a mitochondrial uncoupler. State 4 respiration was increased while the respiratory control ratio was decreased. The intramitochondrial content of ATP was also decreased. There were substantial changes in the reduction of the respiratory chain components after incubation of mitochondria with MO. This decelerative effect on mitochondrial electron transport was alleviated by the addition of coenzyme Q and/or carnitine. These effects of MO on mitochondrial respiration may be due to changes in fatty acid metabolism caused by MO as MO caused a shift in the proportion of acid-soluble or acid-insoluble coA esters. Supplementary therapy with L-carnitine and coenzyme Q may be useful in the management of MO-induced Reye's syndrome. PMID- 3658546 TI - Inhibition of lipoprotein lipase by plasma from children with the steroid responsive nephrotic syndrome. AB - The study was designed to investigate the hyperlipidaemia associated with the steroid responsive nephrotic syndrome in children and in particular to examine the mechanism for the delayed clearance of the circulating triglyceride-rich lipoproteins. The possibility that plasma from patients with steroid responsive nephrotic syndrome may contain an inhibitor of lipoprotein lipase activity was studied by examining the effect of the addition of plasma from patients, on normal postheparin lipoprotein lipase activity. Plasma from children with steroid responsive nephrotic syndrome significantly inhibited lipoprotein lipase activity (p less than 0.001), whereas that from patients with familial hypercholesterolaemia and normal children had no significant effect. The inhibition of lipoprotein lipase activity by plasma from patients with steroid responsive nephrotic syndrome correlated significantly with their increased plasma cholesterol and reduced plasma albumin concentrations (p less than 0.001 and less than 0.02, respectively), but there was no significant correlation with plasma triglyceride concentrations. Thus, the degree of inhibition probably reflected the severity of the condition at the time of study. Neither the cholesterol, albumin nor triglyceride concentrations appeared to directly influence the lipoprotein lipase activity of postheparin plasma. PMID- 3658548 TI - Transfer of tuberculin immunity from mother to infant. AB - The purpose of our study was to investigate transfer of tuberculin immunity from mother to infant via breast milk by studying newborn lymphocyte blastogenesis induced by purified protein derivative antigen at 1-5 days of age, 4-6 wk of age, and 3 months of age. Our study consisted of four mother-infant groups: breast feeding and bottle-feeding infants of tuberculin-positive and tuberculin-negative mothers. A difference in the groups was found only at 4-6 wk of age where 17% (4/23) of breast-feeding infants and 13% (2/15) of bottle-feeding infants of tuberculin positive mothers had lymphocyte blastogenesis to purified protein derivative. None of the infants of tuberculin negative mothers had purified protein derivative-induced blastogenesis. Analysis of covariance with tests for equality of slopes showed that the responses of tuberculin-positive mothers were significantly different from the responses of tuberculin-negative mothers (p less than 0.05). These studies suggest transplacental transfer of tuberculin immunity evident at 4-6 wk of age which wanes by 3 months of age. We could not find evidence of transfer via human milk. PMID- 3658547 TI - Development of myocardial contractile system in the fetal rabbit. AB - Developmental changes in the myocardial contractile system were evaluated in the fetus at 18, 21, and 28 days of gestation (full term 31 days) and in 3- to 5-day old newborn rabbits. Mechanical function was studied using the isolated arterially perfused heart. Perfusion with ryanodine (10(-5) M), an inhibitor of Ca release from the sarcoplasmic reticulum, decreased contractile force and increased the time to peak tension in the 28-day fetus and newborn but these changes were minimal in the 18- and 21-day fetus. Postextrasystolic potentiation, which is thought to be caused by Ca release from the sarcoplasmic reticulum, was observed in the 28-day fetus and the newborn, but was not significant in the 18- and 21-day fetus. An ultrastructural study showed poorly developed sarcoplasmic reticulum and myofibrils in the 18- and 21-day fetus. Although the maximum developed tension observed at high extracellular calcium increased with development, the relative value of developed tension at various extracellular calcium was similar in the three fetal groups and only in the newborn the extracellular calcium-developed tension curve shifted to the right. Myofibrillar yield increased with development but sensitivity of myofibrillar ATPase activity to Ca was similar in the fetus and newborn. These data suggest that 1) the sarcoplasmic reticulum does not function significantly in the 18- and 21-day fetus, 2) although sarcoplasmic reticulum starts to function at late gestation, it does not cause significant changes in intracellular calcium in the fetal period, 3) myocardial contractility remains similar in the fetus from the 18th to 28th day of gestation and major changes in contractility occur after birth. PMID- 3658549 TI - Effects of variable oxygenation and gradual withdrawal of oxygen during the recovery phase in oxygen-induced retinopathy: kitten model. AB - The effects of two types of prolonged oxygen supplementation were tested in the kitten model of oxygen induced retinopathy. Thirty-one litters were placed in 80% oxygen for 65 h starting the 3rd day after birth to initiate a moderately severe retinopathy. One-half of each litter thereafter served as controls, remaining in room air during the development of the retinopathy. In the remaining half, the retinopathy was allowed to develop in either a variably hyperoxic/hypoxic environment (one-half of each of 16 litters) or in an oxygen environment that was gradually reduced to room air by 4 wk (one-half of each of 15 litters). The retinopathy scores in the controls were comparable in both studies and the same as in previous experience with this model. Kittens exposed to the variable oxygen recovery environment had significantly less severe retinopathy than their room air recovery littermates (p less than 0.05). The retinopathy scores in the group with gradually withdrawn oxygen did not differ from the littermate controls (power greater than 80%). These data support the hypothesis that conditions of oxygenation during the recovery process from an acute oxygen-induced vascular injury have a significant effect on the healing process. PMID- 3658550 TI - Brain oxidative phosphorylation following alteration in head position in preterm and term neonates. AB - An alteration in head position, which effects cerebral blood flow, may increase the risk for intraventricular hemorrhage in the critically ill infant. The purpose of this study was to evaluate in vivo cerebral oxidative metabolism as an index of tissue oxygen delivery reflecting brain blood flow, in healthy preterm and term infants following a change in head position. Cerebral phosphoenergetics using 31 phosphorus nuclear magnetic resonance spectroscopy were measured in 10 preterm and eight term infants following three different head positions: neutral, prone, and supine. All infants were clinically stable at the time of study. The phosphocreatine to inorganic phosphate ratio, an indicator of bioenergetic reserve, was determined. The mean +/- SD for phosphocreatine to inorganic phosphate ratio in the neutral position in preterm and term infants was 1.08 +/- 0.15 and 1.12 +/- 0.21, respectively, and did not change significantly following head turning. These data suggest that any alteration in cerebral blood flow as a result of a change in head position in the healthy neonate may be compensated by physiological and biochemical regulations so that no changes in brain oxidative phosphorylation are measurable. PMID- 3658551 TI - Heart rate variability during respiratory pauses in puppies and dogs. AB - We studied the time course and change in heart rate during respiratory pauses in puppies (3-4 wk) and young adult dogs. We measured ventilation and ventilatory pattern using barometric plethysmography and recorded the respiratory rate (RR) interval using a pre-processor with an accuracy of 0.2 ms. During tidal breathing, the fluctuations in RR interval were an order of magnitude smaller in the puppy than in the dog. During respiratory pauses in dogs, the RR interval increased sharply, stabilized around the level of expiration of previous breaths, and dropped immediately with the subsequent inspiratory effort. The time course of the change in heart rate was different in the puppy: there was a gradual increase in the RR interval during the entire course of the pause and the maximum RR interval reached was substantially higher than during expiration of previous breaths. Our results suggest that 1) the change in heart rate at the outset of respiratory pauses is too fast to be related to blood gas changes in both puppies and dogs and 2) the mechanisms responsible for the vagal gating of heart rate during tidal breathing and during respiratory pauses are not well developed in early life in the puppy. PMID- 3658552 TI - The role of magnesium in neonatal calcium homeostasis: effects of magnesium infusion on calciotropic hormones and calcium. AB - Magnesium (Mg) deficiency is a possible etiologic factor contributing to neonatal hypocalcemia. In adults, parathyroid hormone (PTH) secretion is negatively feedback regulated by acute changes in serum Mg concentration, but paradoxically Mg deficiency may lead to functional hypoparathyroidism and hypocalcemia. We hypothesized that in neonates, Mg administration will cause changes in PTH secretion and serum Ca concentration that will be inversely related to serum Mg status. We also hypothesized that Mg administration will result in increased calcitonin (CT) secretion. Thirty-nine newborn infants with birth weights greater than 1500 g were studied on day 3 of life. Ten received placebo, and 29 intravenous magnesium sulfate (MgSO4), 6 mg elemental Mg/kg body weight, over 1 h. Serum Mg, Ca, PTH, and CT were measured at time 0 (baseline, preinfusion) and 1, 2, 6, 12, 24, and 48 h postinfusion. In both groups combined, baseline PTH correlated with baseline Mg (r = 0.72, p less than 0.005), and with baseline Ca (r = 0.68, p less than 0.005). In the control group there was no change in serum Mg, Ca, PTH, and CT during the study period. In magnesium sulfate-infused infants: 1) serum Mg concentration rose from 1.80 +/- 0.06 to 2.82 +/- 0.07 mg/dl (mean +/- SEM, p less than 0.001); 2) the change from baseline in serum PTH at 1, 6, and 12 h postinfusion correlated inversely with baseline Mg (p less than 0.05); 3) the change from baseline in serum Ca at 1, 2, and 24 h postinfusion correlated inversely with baseline Mg (p less than 0.005); 4) serum CT remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658553 TI - Elastin and collagen in the fetal sheep lung. I. Ontogenesis. AB - The ontogenesis of elastin (desmosine), collagen (hydroxyproline), and DNA concentrations and their rates of increase were studied in fetal sheep lungs from day 60 until term. Elastin increased 13-, 17-, 63- and 11- fold in nondissected parenchyma, dissected (free of tubular structures of greater than 0.1 mm diameter) parenchyma, pleura, and trachea, respectively. Collagen increased 2.1-, 1.8-, 5- and 3-fold, respectively, in the four tissues. A sharp rise in elastin occurred after day 100. The rate of increase in elastin was greater in dissected than in nondissected parenchyma while the reverse was true for collagen. The steepest rise of elastin concentration occurred in the pleura after day 125. DNA concentration peaked on day 125 and was lowest at term. These findings are consistent with 1) the onset of a steep rise in elastin accumulation during the canalicular period, 2) the development of a rigid, mainly collagenous structure of the central airways and blood vessels and a distensible peripheral "gas exchange tissue," rich in elastin, 3) an important role of elastin in the function of the visceral pleura, and 4) a peak of mitotic activity during the early alveolar period. PMID- 3658554 TI - Elastin and collagen in the fetal sheep lung. II. Relationship to mechanical properties of the lung. AB - The relationship between elastin and collagen concentration and indices of lung maturation was studied in the lungs of fetal sheep. Fetal sheep of 124 days gestation were infused for 84 h with cortisol, triiodothyronine, prolactin, or epidermal growth factor alone or in combination. Pressure-volume curves with air were performed on the lungs and saturated phosphatidylcholine was measured in lung washes. Desmosine and hydroxyproline were determined in lung tissue in seven hormone-treated fetuses that displayed distensible and stable lungs similar to term lungs [volume of air at 40 cm H2O (V40) greater than 1.5 ml/g wet weight and at 5 cm H2O (V5) greater than 0.8 ml/g] and in seven fetuses whose lungs remained nondistensible and unstable (V40 less than 0.6 ml/g and V5 less than 0.4 ml/g). Alveolar saturated phosphatidylcholine was five times higher (p less than 0.001) in distensible than in nondistensible lungs, but attained less than 20% of term values. Desmonsine and hydroxyproline concentrations in parenchyma, pleura, and trachea of nondistensible, unstable lungs were similar to intact controls of 125 days gestation and those in distensible, stable lungs were similar to controls of 137 days gestation. Desmosine (p less than 0.0001) and hydroxyproline (p less than 0.001) concentrations in parenchyma of distensible, stable lungs were higher than those of nondistensible, unstable lungs. We speculate that increased distensibility of the fetal lung in response to treatment with hormones is attributable in part to changes in the composition of connective tissue. PMID- 3658555 TI - A developmental study on types and frequency distribution of short apneas (3 to 15 seconds) in term and preterm infants. AB - We measured the frequency distribution and the ventilatory correlates of the various types of apneas 3 to 15 s long during sleep in eight term infants (birth weight 3.65 +/- 0.16 kg; gestational age 39.5 +/- 0.3 wk) and eight preterm infants (birth weight 2.07 +/- 0.18 kg; gestational age 34.3 +/- 0.4 wk). Each infant was studied on five to seven occasions from birth to 56 wk of postconceptual age using a modified flow-through system. Sixty-six paired epochs of quiet sleep (1163 min) and rapid eye movement sleep (829 min) were analyzed in term infants and 85 paired epochs of quiet sleep (1553 min) and rapid eye movement sleep (1328 min) in preterm infants. Of the 783 apneas recorded in term infants 82% were central, 1.5% obstructive, 0.5% mixed, and 16% were of the breath-holding type; the corresponding figures for the 4086 apneas recorded in preterm infants were 93, 0.5, 1.0, and 5.5%. This distribution was similar in the two sleep states but term infants had a higher percentage of breath-holding apneas than preterm infants (p less than 0.01). In preterm infants the rate of central apneas decreased with postnatal age (p less than 0.01); in term infants the rate did not change significantly. The duration of apneas showed a modal distribution for central apneas at about 8 s for both groups during the 1st month of life (p less than 0.05). The findings suggest: 1) apneas in the newborn and early infancy are primarily central and are more frequent in preterm than in term infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658556 TI - The effect of maternal hyperglycemia on acid base balance and lung liquid production in the fetal sheep. AB - In 10 chronically catheterized fetal sheep, the effects of 100 g of glucose infused (intravenous) to the pregnant ewe on lung liquid production and acid-base status were investigated. Maternal and fetal hyperglycemia occurred within 15 min of the infusion of glucose. There was a significant increase in fetal PCO2 from 41.67 +/- 1.00 to 46.89 +/- 1.83 mm Hg and a decrease in fetal arterial pH from 7.42 +/- 0.016 to 7.33 +/- 0.026 (n = 7). This acidosis was probably the result of fetal lactacidemia. There was also a decrease in fetal PO2 (p less than 0.001) following the infusion of glucose to the ewe. This, along with the acidosis, might account for the increased risk of unexplained fetal death in the diabetic pregnancy especially near term. Following the infusion of glucose to the ewe there was an increase in maternal plasma osmolality by 16 +/- 3.35 mosmol/kg (n = 9) and in fetal plasma osmolality by 14 +/- 2.64 mosmol/kg (n = 9; p less than 0.001). Fetal lung liquid production fell from 0.195 +/- 0.04 to 0.093 +/- 0.02 ml/min (n = 6; p less than 0.001). There was no change in the excretion of osmol by the lungs. The decreased lung liquid production was probably due to a decrease in the net movement of fluid across the pulmonary epithelium. PMID- 3658557 TI - The clinical pharmacology of vancomycin in seriously ill preterm infants. AB - The first dose and steady state pharmacokinetics of vancomycin were studied in 16 seriously ill preterm infants (less than or equal to 34 wk gestational age) with documented Staphylococcus epidermidis infections. One infant was dropped from the study due to peripheral flushing occurring during administration of the first dose. Individual vancomycin doses ranged from 9.8 to 17.8 mg/kg and were infused intravenously over 15-37 min. Fifteen infants were studied after the first dose of vancomycin, whereas only 12 of these 15 were able to be studied under steady state conditions. Vancomycin half-life, steady-state volume of distribution, and body clearance averaged 6.0 h, 0.53 liter/kg, and 1.22 ml/min after the first dose and only slight differences were observed in these parameter estimates under steady state conditions. However, substantial accumulation of vancomycin in serum was observed with multiple dosing. Complete 8-h urine collections were possible in 12 of 15 premature infants after the first dose of vancomycin. Overall, 44.6% of the dose was recovered in the urine with a corresponding vancomycin renal ClR averaging 0.88 ml/min. Vancomycin body Cl correlated directly with renal ClR (r = 0.88, p less than 0.001) and body weight (r = 0.8, p less than 0.001). Vancomycin pharmacokinetic parameter estimates Vdss and Cl correlated directly with body weight, surface area, and postconceptional age. No significant relationships were observed between these parameter estimates and gestational age or postnatal age. Fourteen of 15 infants were treated successfully for their underlying infectious process. These data support the use of lower doses of vancomycin than previously recommended for the treatment of preterm infants. PMID- 3658558 TI - [Genetic studies of children with neural tube defects. I. Empirical and relative risks]. PMID- 3658559 TI - [Genetic studies of children with neural tube defects. II. Complex segregation analysis]. PMID- 3658560 TI - [Evaluation of registries of congenital anomalies in 9 selected provinces]. PMID- 3658561 TI - [Clefts of the primary palate and secondary palate. I. Empirical and relative risks of the development of the defects]. PMID- 3658562 TI - [Clefts of the primary palate and secondary palate. II. Evaluation of the mode of inheritance]. PMID- 3658563 TI - [Chondroangiopathia calcarea in a 2-month-old infant]. PMID- 3658564 TI - [A case of congenital anophthalmos in a newborn infant of a mother receiving ethambutol in the first trimester of pregnancy]. PMID- 3658565 TI - [Idiopathic juvenile osteoporosis (Dent-Friedman syndrome) in an 8-year-old girl]. PMID- 3658566 TI - [Prader-Willi syndrome with chromosome 15 abnormality]. PMID- 3658567 TI - Sustained release and standard methylphenidate effects on cognitive and social behavior in children with attention deficit disorder. AB - Two studies were conducted to investigate the relative effects of sustained release methylphenidate (Ritalin [SR-20]) and standard methylphenidate (Ritalin, 10 mg, administered twice daily). In the first study, 13 boys with attention deficit disorder participating in a summer treatment program went through a double-blind, within-subject trial of each form of methylphenidate and placebo. Measures of social and cognitive behavior were gathered in classroom and play settings. Although group analyses of the data showed that both drugs were effective and there were few differences between them, standard methylphenidate was superior to SR-20 on several important measures of disruptive behavior. Furthermore, analyses of individual responsivity showed clearly that most boys responded more positively to standard methylphenidate than to SR-20. The second study involved a partially overlapping group of nine boys with attention deficit disorder participating in the same summer treatment program. Also double-blind, within-subject, and placebo controlled, this study tracked the time courses of the two forms of methylphenidate. Both were shown to have similar time courses on the Abbreviated Conners Rating Scale and other measures, but SR-20 had a slower onset than did the standard drug form on a continuous performance task. Effects of SR-20 were still evident eight hours after ingestion. PMID- 3658568 TI - Intrauterine growth and gestational duration determinants. AB - Despite the general recognition that low birth weight can be caused by many factors, confusion and controversy remain about which factors have independent causal effects, as well as the quantitative importance of those effects. Previous research findings have often been conflicting because of a failure to distinguish intrauterine growth retardation from prematurity, differences in focus (means v rates), inadequate control for confounding variables, and insufficient statistical power. This review of the English and French language medical literature published between 1970 and 1984 is based on a critical assessment and meta-analysis of 895 studies concerning 43 potential determinants of intrauterine growth or gestational duration. Based on methodologic standards established a priori for each candidate determinant, the best studies were used to assess the existence and magnitude of an independent causal effect on birth weight, gestational age, prematurity, and intrauterine growth retardation. Factors with well-established direct causal impacts are identified, and their relative importance is indicated for "typical" developing and developed country settings. Modifiable factors with large effects are targeted for public health intervention in the two settings. Finally, factors of potential quantitative importance, but for which data are either unavailable or inconclusive, are highlighted as priorities for future research. PMID- 3658569 TI - More on human immunodeficiency virus embryopathy. AB - Eight patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex, ranging in age from 4 to 33 months, were evaluated for the presence of dysmorphic features recently described as human immunodeficiency virus embryopathy. Birth data and growth charts were available. Growth failure, a prominent box-like head, large wide eyes, and a well-formed philtrum were seen in the majority of patients. The significance of hypertelorism, obliquity of eyes, long palpebral fissures, blue scleras, depressed bridge of nose, and prominent upper vermilion border is discussed. PMID- 3658571 TI - Perilymph fistula: an important cause of deafness and dizziness in children. AB - This study underscores the importance of considering a perilymph fistula, an abnormal communication between the inner and middle ear, in any child with a progressive sensorineural hearing loss. A concomitant complaint of intermittent dizziness or observed spells of imbalance (56%) is another indication of the disease. Six of 16 patients (37.5%) with proven fistulas were less than 2 years of age at the onset of symptoms. Unless the fistula is identified and repaired by grafting, the ear may become totally deaf. This would be disastrous in the presence of bilateral fistulas, which occur commonly in children (56% of patients had symptoms of bilateral disease). Our experience in recognizing and treating fistulas and thereby saving and restoring hearing is described. PMID- 3658570 TI - Taurine improves the absorption of a fat meal in patients with cystic fibrosis. AB - The effect of taurine supplementation on the absorption of a fat meal was evaluated in patients with cystic fibrosis. In a cross-over design study, five patients with cystic fibrosis (12.1 +/- 2.6 years of age) and three control subjects received either placebo or taurine (30 mg/kg/d) for two 1-week periods, a month apart, followed by a fat meal test. Blood samples were drawn 0, 1, 2, 3, 5, 8 hours after the meal. Four patients with cystic fibrosis and severe steatorrhea despite appropriate enzyme therapy showed a significant (P less than .05) improvement in the absorption of triglycerides, total fatty acids, and linoleic acid while receiving taurine supplements. Three control subjects and one child with cystic fibrosis and mild steatorrhea receiving enzyme therapy did not experience such an effect. The difference in triglyceride absorption, when calculated as the area under the curve, receiving and not receiving taurine was significantly (P less than .05) correlated with the degree of steatorrhea. Furthermore, in contrast to control subjects, the fatty acid composition of chylomicrons in these four study patients showed important discrepancies with that of the fat meal and was corrected, in part, by taurine supplementation. These results suggest that taurine supplementation could be a useful adjunct in the management of patients with cystic fibrosis with ongoing fat malabsorption and essential fatty acid deficiency. PMID- 3658572 TI - Developmental outcome prediction from acoustic cry analysis in term and preterm infants. AB - It has been suggested that the cry may reflect the neurophysiologic integrity of the infant and relate to later developmental outcome. In this study, the cry was recorded at term conceptional age in 18 preterm and 13 term infants using a standardized procedure and analyzed by high-speed computer. At 18 months of age, a significant number of infants were correctly classified as scoring high or low on the Bayley Scales of Infant Development based on the mean and variability in the fundamental frequency, variability in the first formant, and the amplitude of the cry. At 5 years of age, a significant number of infants were correctly classified on the McCarthy General Cognitive Index and on the verbal, perceptual performance, and quantitative subscales based on the variability of the fundamental frequency, variability of the first formant, and amplitude and duration of the cry. Although preliminary, this study supports the potential use of the cry as a noninvasive measure to detect developmental outcome in the infant at risk. PMID- 3658573 TI - Percutaneous central venous catheter colonization with Malassezia furfur: incidence and clinical significance. AB - Malassezia furfur colonization of central venous catheters has been implicated in the pathogenesis of systemic infections with this lipid-dependent yeast. To determine the incidence of catheter colonization in our neonatal intensive care unit (NICU), 25 consecutively removed percutaneous central venous catheters were examined by rinsing the lumen with saline and plating the rinse fluid on Sabouraud dextrose agar overlaid with olive oil. M furfur grew from the lumina of eight catheters (32%). Surveillance skin cultures were performed in the NICU on two occasions to determine the prevalence of skin colonization with M furfur. M furfur was found on the skin of 64% of the infants. In contrast, only 3% (1/33) of healthy, nonhospitalized infants 2 to 8 weeks of age had skin colonized with M furfur. During the 5-month study period, two NICU infants had evidence of systemic infection with M furfur. We conclude that M furfur frequently colonizes both the skin and percutaneous central venous catheters in NICU infants. Further studies are needed to determine the relationship between skin colonization and catheter colonization, and the factors contributing to systemic disease with this organism. PMID- 3658575 TI - Gonorrhea and syphilis in incarcerated urban adolescents: prevalence and physical signs. AB - During a 1-year period from July 1983 to June 1984, 285 adolescent girls and 2,236 adolescent boys, ranging in age from 9 to 18 years (89% were 14 to 16 years of age), were screened for gonorrhea and syphilis on entry into a detention facility in New York City. The prevalence rate for gonorrhea was 3% for boys and 18.3% for girls, and the prevalence rate for syphilis was 0.63% for boys and 2.5% for girls. The rates of gonorrhea without penile or cervical discharge on physical examination were 2.1% for boys and 10.9% for girls. This high prevalence of syphilis and gonorrhea and the high frequency of disease without physical signs of illness indicate the desirability of screening high-risk adolescents for these and other sexually transmitted diseases. Our data support the need for programs in detention facilities and, we believe, schools, to encourage use of barrier contraceptives to control gonorrhea, syphilis, Chlamydia, human papillomavirus, human immunodeficiency virus, and unwanted pregnancy. PMID- 3658574 TI - Primary hemochromatosis in childhood. AB - Primary hemochromatosis is a genetic disorder rarely recognized in childhood; its long-term consequences include cirrhosis and liver cancer. We report a family with primary hemochromatosis affecting three generations, including a 7-year-old child and a 29-month-old child; these are the youngest children with primary hemochromatosis yet reported. The pathophysiology, genetics, and clinical findings of this disorder are reviewed. Serum ferritin and transferrin saturation are useful screening tests; definitive diagnosis, however, depends on determination of hepatic iron content. A plan for evaluating and treating affected patients is proposed. Physicians caring for children must learn to recognize this potentially treatable disorder. PMID- 3658576 TI - Temporomandibular joint dysfunction and facial pain in children: an approach to diagnosis and treatment. AB - A model for the diagnosis and treatment of temporomandibular joint dysfunction and facial pain in children is presented. Emphasis is placed on systematic assessment of physical, psychologic, and behavioral factors when conservative medical therapy is inadequate for symptom relief. The model represents a multidisciplinary approach to patient care which is described through case presentations. The results of research on the incidence of primary psychopathology in 53 children and 322 adults evaluated during a 3-year period for temporomandibular joint dysfunction and facial pain are also presented. It was found that children were more likely to be psychiatrically impaired (25%) than adults (7%). Children had a variety of psychiatric diagnoses including depression, conversion and adjustment disorders, overanxious behavior, and anorexia nervosa. The benefits of a multidisciplinary approach are discussed in terms of the efficacy of this coordinated treatment effort in ameliorating symptoms. PMID- 3658577 TI - Native American postneonatal mortality. AB - Although dramatic gains have been realized in lowering the incidence of neonatal deaths among native American infants to a level lower than the white race, postneonatal death rates for this population remain twice as high as in the white race. The limited data available reveal that excessive postneonatal deaths among native American infants largely result from preventable accidents and treatable acute medical conditions, such as pneumonia and gastroenteritis. This suggests that native American infants leave the hospital healthy but go to unsafe environments, which decrease their chances of survival past 1 year. In particular, the poorer socioeconomic conditions that native American families experience and the related problems of alcoholism, unemployment, and family disorganization contribute to the high rate of postneonatal mortality. Intervention programs to lower native American postneonatal mortality should focus on promoting prompt recognition of and health seeking for treatable medical conditions and prevention of accidents and other postneonatal health problems. The roots of the problem of native American postneonatal mortality lie in the socioeconomic conditions of many Indian communities and cannot be addressed without recognition of how these factors combine with the health care delivery system to diminish life expectancy for native American infants. PMID- 3658578 TI - Poor prediction of positive computed tomographic scans by clinical criteria in symptomatic pediatric head trauma. AB - A retrospective study of 98 children who received CT scanning for head trauma was conducted to determine whether clinical signs would accurately identify patients needing CT scans. The clinical findings of Glasgow Coma Scale score of 12 or less, altered consciousness on admission, and focal abnormalities on neurologic examination were each significantly associated with abnormal findings on CT scans (P less than .01). However, 31% of the 51 patients with Glasgow Coma Scale scores greater than 12 had abnormal CT scan findings. No clinical findings, alone or in combination, accurately identified all patients with abnormal findings on CT scans. PMID- 3658579 TI - Phototherapy and patent ductus arteriosus. PMID- 3658580 TI - Diagonal fontanel measurements. PMID- 3658581 TI - Cerebral edema and galactosemia. PMID- 3658582 TI - Day care for sick children. PMID- 3658583 TI - Inborn errors of metabolism. PMID- 3658584 TI - Septic arthritis. PMID- 3658585 TI - [Morphology of diabetic fetopathy in children in the perinatal period]. PMID- 3658586 TI - [Clinical characteristics of intestinal yersiniosis in children under 1 year of age]. PMID- 3658587 TI - [Characteristics of lipid peroxidation in children with various forms of hypotrophy]. PMID- 3658589 TI - [Changes in blood levels of lipids and vitamin A, E and carotene in children with glomerulonephritis]. PMID- 3658588 TI - [Status of carbohydrate and lipid metabolism in children with kidney diseases]. PMID- 3658590 TI - [Prostaglandins in congenital heart defects of the pale type in young children]. PMID- 3658591 TI - [Use of thermography in the diagnosis of chronic gastroenterological diseases in children]. PMID- 3658592 TI - [Inactive gallbladder in children with chronic cholecystitis]. PMID- 3658593 TI - [Morphometric evaluation of infiltration of the portal tract in children with chronic hepatitis and liver cirrhosis]. PMID- 3658594 TI - [Therapeutic use of laser irradiation in gastroduodenal ulcers in children]. PMID- 3658595 TI - [Arterial blood pressure determination in infants]. PMID- 3658596 TI - [Impedance measurement in the evaluation of breast milk infection in lactation mastitis]. PMID- 3658597 TI - [A simple and economical method of screening diagnosis of cystic fibrosis]. PMID- 3658598 TI - [Various indicators of the functional status of 6-year-old children during the process of adaptation to school conditions]. PMID- 3658599 TI - [Common respiratory diseases in children]. PMID- 3658600 TI - [Present-day clinical pattern of whooping cough]. PMID- 3658601 TI - [Characteristics of the course of pneumococcal meningitis in children]. PMID- 3658602 TI - [International Children's Day]. PMID- 3658603 TI - [Treatment of infectious-toxic shock in generalized forms of meningococcal infection in children]. PMID- 3658604 TI - [Resuscitation of newborn infants with severe asphyxia neonatorum]. PMID- 3658605 TI - [Complex treatment of true eczema in young children]. PMID- 3658606 TI - [Experience with the treatment of peptic ulcer in children]. PMID- 3658607 TI - [Substantiation of diet therapy of young children with food allergy]. PMID- 3658608 TI - [Characteristics of toxemia in acute respiratory pathology in young children]. PMID- 3658609 TI - [Pathogenetic aspects of disorders of hormonal balance in children with gastroduodenitis]. PMID- 3658610 TI - [Simpson's syndrome and Golabi-Rosen syndrome: the same disease or 2 different but close forms?]. PMID- 3658611 TI - [Use of Falimint in the preparation of children for fibrogastroduodenoscopy]. PMID- 3658612 TI - [Treatment of viral hepatitis in children with human concentrated interferon by the electrophoresis method]. PMID- 3658613 TI - [Effectiveness of iodine-bromine baths and electrosleep in the treatment of primary arterial hypertension in children]. PMID- 3658614 TI - [Cyclosporin: precise and limited indications]. PMID- 3658615 TI - [Cyclosporin in organ transplantation in children]. AB - The authors review the biochemical, immunological and pharmacological properties of cyclosporine and give an account of the current place of cyclosporine in the treatment of children with organ transplants. PMID- 3658616 TI - [Acute chorea, systemic lupus erythematosus and antiphospholipid antibodies. Apropos of a case]. AB - A case of acute chorea in a 10 years old girl complicating a systemic lupus erythematosus associated with antiphospholipid antibodies is reported. The lupus anticoagulant was detected with a coagulation assay and the false serological reaction for syphilis by the RPR test. The child recovered with Prednisone therapy. The place of chorea in the context of neurological complications of SLE and the particularity of its association with anti-phospholipid antibodies are discussed. PMID- 3658617 TI - [Hydranencephaly and congenital toxoplasmosis. Apropos of 4 cases]. AB - Four cases of congenital toxoplasmosis with hydranencephaly are reported. The anatomic lesions are the consequence of ischemic necrosis and foetal hydrocephalus. The risk of such lesions is highest during the second trimester of pregnancy. The preventive steps against congenital toxoplasmosis are recalled. PMID- 3658618 TI - [Aneurysm of the vein of Galen with neonatal cardiac insufficiency. Success of early neurosurgical treatment]. AB - The vein of Galen malformation is a rarely recognized cause of congestive heart failure in the newborn. This report describes a newborn who developed severe cardiac failure in the second week of life. An aneurysm of the vein of Galen was noted on the computerized tomography scan, confirming the clinical diagnosis of cerebral arteriovenous fistula. The vascular abnormality was well shown by cerebral arteriography. At the age of four weeks, surgery was carried out by clipping the afferent arteries. The patient is non a three years old infant with moderate developmental delay and hypotonia. PMID- 3658619 TI - [Thymus surgical pathology in children]. AB - The object of this paper is to briefly review the surgical aspects of the thymic pathology. Thymic cysts and thymic ectopy are usually asymptomatic and are one of the multiple etiologies of cervical masses. Thymic tumors are very rare and may sometimes be difficult to differentiate from simple thymic hyperplasia; being almost always separated from the normal thymic tissue by a dense capsule, they do not tend to extend rapidly. Thymectomy may be indicated in severe myasthenia. PMID- 3658621 TI - [Tonsillitis]. PMID- 3658620 TI - [Medical violence toward young children]. AB - The author describes the many circumstances during which infants and young children are submitted to violence by doctors or medical assistants when given medical care. This violence starts at birth in the newborn ward. Later it is found in all forms of care dispensed to young children in ambulatory as well as hospital practice. The author shows that most of this violence can be avoided provided that doctors act in full consciousness of its consequences. PMID- 3658622 TI - [A single daily injection of ceftriaxone for treating suppurated meningitis in infants and children. Apropos of 31 cases]. AB - Thirty-one infants and children aged 1 month to 15 years 3 months were treated with ceftriaxone once a day for the treatment of a meningitis related to Neisseria meningitidis (19 cases), haemophilus influenzae (7 cases), streptococcus pneumoniae (1 case), not identified bacteria (4 cases). All identified bacteria were sensitive to ceftriaxone. Twenty children were treated with 100 mg/kg/day, 11 with 50 mg/kg/day. CSF was sterile at the first control generally performed 30 h after the onset of treatment-in all cases. Despite a great number of severe forms (fulminans purpura and septic shock; 11 cases; severe neurologic disturbances: 6 cases), all patients survived and recovered after a treatment of 9 to 22 days. Two infants exhibited neurologic sequelae: deafness, delayed development and hydrocephalus. Tolerance to ceftriaxone appeared to be good. With a 100 mg/kg/day dosage, mean CSF level at 6 h was 3.3 mg/l (0.8-7.7), on the first day of treatment. At the end of treatment, mean CSF level at 24h was 0.47 (0.15-2.5). With a 50 mg/kg/day dosage, mean CSF level at 6 h was 2,1 mg/l (1.1-3.9) in the first day of treatment. At the end of the treatment, mean CSF level at 24h was 0.22 mg/l (0.08-0.5). Once a day administration of ceftriaxone is adequate for the treatment of meningitis in infants and children. Though a 50 mg/kg/day dosage is probably sufficient in most cases, it seems to be more secure to use a 100 mg/kg/day dosage. PMID- 3658623 TI - The colour-matching functions and visual research. AB - The following points are examined: the problem of how to define the colour of a stimulus used in visual research; the limited relation of the colour-matching functions to the spectral sensitivity curves of the individual colour receptors in the retina; and the case for abandoning luminance as a colorimetric variable and lightness as a colour appearance variable. PMID- 3658624 TI - Interindividual receptor variability of normal colour observers: analysis of the 2-deg Stiles and Burch data. AB - Examination of the interobserver variability among the ten observers of the 2-deg Stiles and Burch colorimetric study reveals an interesting pattern: the chromaticities of the matches made by different normal subjects fall approximately on straight lines and these lines appear to converge. Because of a geometric relationship that holds between the normal, anomalous, and dichromatic colour spaces, it can be argued that part of the variability must be due to actual differences in the shape or spectral position of the receptor sensitivities of different normal observers. PMID- 3658625 TI - The equivalent background of bleaching. AB - Stiles and Crawford proposed that a retinal region bleached by preexposure to intense light behaves as if it were illuminated by some steady veiling or background luminance. We test this notion by comparing the afterimage of a bleaching light with a steady (and retinally stabilized) light of adjustable intensity, in the manner of Barlow and Sparrock. With their matching procedure, and also with a new procedure, we find as they did that during the rod phase of recovery the afterimage does look like a stabilized field of an intensity which, presented as a background, brings visual sensitivity to the same level. It is as if the two conditions produce equal signals at some stage of the visual pathway. Liked Barlow and Sparrock we observe a rod-cone break in the afterimage matches. However, we argue that the appearance of the rod-cone break presents a paradox and we show a way to resolve it. PMID- 3658626 TI - The spectral sensitivities of the middle- and long-wavelength cones: an extension of the two-colour threshold technique of W S Stiles. AB - When a tiny centred test flash is presented on a small concentric background, the threshold rises with background radiance more quickly than Weber's law would predict. It is argued that under such conditions it is possible, by means of a test sensitivity method, to isolate either the M-cone or the L-cone types throughout the visible spectrum. As predicted, double-branched M- and L-cone tyr functions are found when the test flash and the field are of the same wavelength. From the independent vertical displacements of the two branches as test wavelength is varied, it is possible to derive spectral sensitivities that agree well with dichromatic sensitivities and Konig fundamentals. The test sensitivities deviate from pi 4 at longer wavelengths and from pi 5 at shorter wavelengths. PMID- 3658627 TI - Similarity of normalized discrimination ellipses in the constant-luminance chromaticity plane. AB - Discrimination steps were measured for three subjects, along oblique axes passing through nine points in a 25 td constant-luminance chromaticity plane. When plotted in a normalized cone-excitation chromaticity diagram, the best-fitting discrimination ellipses for a given subject have approximately the same shape and orientation regardless of the reference chromaticity. Their orientation is consistent with the hypothesis that excitation of B-cones affects the red-green opponent balance, otherwise determined by R- and G-cone excitations, in a manner independent of initial cone-excitation levels. The CIELAB formula predicts an orientation for normalized ellipses in agreement with the data, but it also predicts systematic changes in the ratio of minor to major axes which are not observed experimentally. PMID- 3658628 TI - The Stiles summation index applied to heterochromatic brightness matching. AB - The summation index technique introduced by Stiles has been applied to heterochromatic brightness matching in order to explain individual differences in luminous efficiency functions for brightness. Such functions were obtained for 2 deg and 10-deg fields from twelve subjects, and the difference between the two fields was compared with the macular pigment density tabulated in Wyszecki and Stiles's book. A summation index was obtained for red and green stimuli combinations and the results are expressed in the form of an equation with nonlinear coefficients. The same equation is applied to the brightness luminous efficiency functions and the individual differences in the efficiency function are interpreted as the result of different contributions of opponent chromatic channels to the perception of brightness. PMID- 3658629 TI - The Stiles-Crawford effect of the first kind (SCE I): studies of SCE I in an aniridic observer. AB - The Stiles-Crawford effect of the first kind (SCE I), discovered in 1933, represented a major breakthrough in our understanding of retinal physiology and the modern beginning of the science of photoreceptor optics. The current status of knowledge in this area is briefly reviewed. A study is presented of a white adult female observer with aniridia, clear media, only traces of nystagmus, rather good visual acuity, and good fixation. It is shown that this individual exhibits approximate alignment of her photoreceptors with the center of the retinal sphere, clear evidence of side lobes on functions, and surprisingly steep SCE I functions. The implications of these findings are considered. PMID- 3658630 TI - The Stiles-Crawford effect of the second kind (SCII): a review. AB - The background which led Stiles to the discovery that the color of a monochromatic ray of light varied with its angle of incidence on the retina, and the developments in the subject since 1937 when this discovery was reported are summarized. Stiles's original measurements of the 'hue shift' did not successfully quantify SCII in every part of the spectrum, since it provided only two degrees of freedom while the color changes sometimes require three. Nevertheless, they were the paradigm for most subsequent work for the next quarter of a century. Full quantification of the effect was first obtained by trichromatic matching on Stiles's NPL trichromator almost 25 years after the initial discovery. The phenomena were then also fully described quantitatively with an elaboration of Stiles's original theory ('self-screening' theory), on the assumption that the ordinary laws of additivity are valid for color matches of three primaries striking the retina at one angle of obliquity to a test incident at a different angle. More recent experiments suggest that this initial assumption may not be generally true and that 'self-screening' theory may not generally provide a satisfactory description of the color changes throughout the visible spectrum, even for measurements of the effect obtained under conditions in which the additivity assumption seems to be valid. However, the available data strongly imply that absorptions of photons obliquely incident on foveal cones depend upon spectra clearly different from those upon which absorptions of normally incident photons depend. PMID- 3658631 TI - Auditory attention and the representation of spatial information. PMID- 3658632 TI - Age differences in place-of-articulation phoneme boundary. PMID- 3658633 TI - The Bourdon illusion in subjective contours. PMID- 3658634 TI - Influence of maintained ocular deviation on the spatial displacement component of the oculogyral illusion. PMID- 3658635 TI - Dependence of target redundancy effects on noise conditions and number of targets. PMID- 3658636 TI - Selective adaptation with reversible figures: don't change that channel. PMID- 3658637 TI - Visual discrimination of abstract mirror-reflected three-dimensional objects at many orientations. PMID- 3658638 TI - Visual system responds to rotational and size-change components of complex proximal motion patterns. PMID- 3658639 TI - Lightness models, gradient illusions, and curl. PMID- 3658640 TI - The effects of different attentional loads on feature integration in the cerebral hemispheres. PMID- 3658641 TI - Letter processing during eye fixations in visual search. PMID- 3658642 TI - Bile, magnetism, and dopamine: simple answers to difficult problems. PMID- 3658643 TI - The intellectual crisis in clinical science: medaled models and muddled mettle. PMID- 3658644 TI - Ethical issues in modern medical autobiographies. PMID- 3658645 TI - My brother, my keeper, my self? PMID- 3658646 TI - Polarographic determination of extraction constants. AB - The extraction constant of three organic compounds containing nitrogen as a picrate ion pair in a water-chloroform system were determined by following polarographically the picrate concentration in the aqueous phase as a function of the added amount of reagent. The extraction constants were also determined spectrophotometrically (via batch extraction). The obtained results are in good agreement. The proposed method is applicable for extraction constants with values between 10(3) and 10(9). PMID- 3658648 TI - 35th annual congress of the Gesellschaft fur Arzneipflanzenforschung (Society for Medicinal Plant Research). Noordwijkerhout (The Netherlands), September 20-24, 1987. Abstracts. PMID- 3658647 TI - Analytical studies on illicit heroin. V. Efficacy of volatilization during heroin smoking. AB - The recovery of heroin in fumes was investigated. In the Netherlands the common mode of heroin smoking is the 'chasing the dragon' procedure: heroin is heated on an aluminium foil by a lighter and the fumes are inhaled. The efficiency of the volatilization of heroin using this procedure was studied under laboratory conditions using thin layer chromatography, gas chromatography and high pressure liquid chromatography. A considerable influence of the form (salt or base) of the heroin was found as well as strong influences of other substances that may be present in illicit heroin samples as diluents. The danger of the inhalation of fumes containing unknown pyrolysis products is mentioned and a hypothesis is given for the phenomenon of 'heroin'-leucoencephalopathy that was observed in heroin smokers in Amsterdam in 1981. The types of heroin encountered in the Netherlands are discussed with regard to their suitability for smoking. PMID- 3658649 TI - Repeatability of kinetic and kinematic measurements in gait studies of the lower limb amputee. AB - During the last few years considerable attention has been given to the use of gait analysis as a tool for clinical use. The instrumentation for measurement of the kinetics and kinematics of human locomotion was originally designed for research use. Extension of its use into the clinical field calls for simplified methodology and clearly defined protocols with precise identification of the relevant parameters for the analysis. Force platforms, TV-computer and pylon transducer systems were used for collection of kinetic and kinematic data of five normal subjects, 10 below-knee, 10 above-knee and one hip disarticulation amputee. The repeatability tests showed significant differences in the measured parameters. These variations are attributed to the methodology of the analysis and the step to step variation of the subjects' gait. Differences in the degree of step to step variation between various amputee and normal subjects are quantified. In this presentation the capability of present day systems to perform repeatable gait measurements is discussed. A computational method for determination of representative measurements for the purposes of biomechanical evaluation and comparison as well as quantification of the degree of repeatability is described. PMID- 3658650 TI - Bondgraph modelling and simulation of the dynamic behaviour of above-knee prostheses. AB - A mathematical model was used to investigate the dynamic behaviour of an above knee (AK) prosthesis in the swing phase and to analyse the influence of mass and mass distribution on the maximal stump load and the required energy. The model consists of a bondgraph model of the prosthesis and a "walking" model which predicts the walking velocity, step length and the femoral trajectory. Equipment was developed to measure the inertial properties of the components of the prosthesis. Through computer simulation, stickdiagrams of the swing phase and graphs of the variation with time of the hip and stump forces were obtained. It was found that for a normal AK prosthesis with a knee-lock mechanism the axial stump load is greatest at the beginning and at the end of the swing phase. At a walking velocity of 5 km/hr the maximum axial stump load amounts to 2.1 times the static weight of the prosthesis. The maximum axial stump force appeared to be almost directly proportional to the total mass of the prosthesis but independent of the mass distribution. The required energy also increased with the mass of the prosthesis but is dependent on mass distribution. Because of their comparable weights the influence of the shoe is almost equal to the influence of the prosthetic foot. Thus lightweight shoes should be used with lightweight prosthetic feet in order to add to their advantages. PMID- 3658651 TI - Effect of anaerobic and aerobic exercise promoted by computer regulated functional electrical stimulation (FES) on muscle size, strength and histology in paraplegic males. AB - The influence of anaerobic and aerobic exercise, promoted by computer regulated functional electrical stimulation (FES) was evaluated in four paraplegic males. Quadriceps muscle bulk was monitored by serial computerised axial tomography (CT) scanning and histology by muscle biopsies from the vastus intermedius. Anaerobic exercise consisted of 60 degree straight leg raising against increasing weights (range 1.4-11.4 kg) over a period of ten weeks. Aerobic exercise consisted of pedalling a modified Monark bicycle ergometer at 50 rpm against a fixed load ranging from 0-3/8 kilopond (0-18.75 watts) over a period of eight months. In both exercise studies the same work was not achieved by each paraplegic. FES was regulated by a closed loop system which is not presently commercially available, the frequency of the sequential muscle stimulator was 40 Hz with a pulse width of 300 microseconds. Quadriceps muscle area of both legs increased 62.7% (p less than 0.01) after anaerobic exercise; similar but less pronounced effects followed aerobic exercise. Histologically two distinct patterns were noted from the outset, one had normal fibre type distribution the remainder had marked Type 1 loss. Both exercise regimens failed to change these although the number of internal nuclei per 100 fibres steadily increased (from 7.0% to 13.8% to 26.0%) as did the % of fibres with internal nuclei (5.4% to 10.5% to 25.7%) throughout the exercise periods. The significance of these observations is not immediately apparent but may signify continuing damage which may be due to the eccentric rather than the concentric nature of FES promoted muscular contraction. PMID- 3658652 TI - Mobility after major limb amputation for arterial occlusive disease. AB - This study is concerned with the degree of mobility achieved by patients following major amputation for arterial occlusive disease of the legs and its relationship to the level of amputation. Eighty-four out of a possible 85 consecutive amputees form the basis of the study and the degree of mobility was assessed and graded in survivors six months after amputation. Of the 69 survivors 74% were mobile to some degree and 57% walked daily with a prosthesis. Sixty-five per cent of all the amputations were below-knee. Seventeen per cent of below-knee stumps in patients surviving two weeks failed to heal. In amputees who attained a unilateral mobile healed stump 78% with below-knee amputations and 50% with above knee amputations walked daily with a prosthesis. To obtain maximum mobility the knee should be retained whenever practical even though this results in some unhealed stumps requiring revision. PMID- 3658653 TI - An alternative design of extension prosthesis. AB - Some patients with a congenitally shortened lower limb can be fitted with a total contact socket of one piece construction, dispensing with the need for removable panels or split socket construction. This gives advantages in weight, strength and cosmesis. The technique is described and compared with those conventionally used. PMID- 3658654 TI - An economic cushioned seat of variable easily adaptable configuration for cerebral palsied children. AB - This paper describes a low cost cushioned seat of variable configuration for cerebral palsied children in the 5 to 10 year age bracket. Economic considerations are presented and the manufacturing process is described. It is believed that the system has advantages specially related to socio-economic conditions prevailing in a developing country. PMID- 3658655 TI - Tangential goniometry--Angulator. AB - Tangential goniometry based on the principle of mechanical strain measurement is proposed for evaluating human body deformities or mobility. This features continuous body contour matching; defined measuring plane P2 due to rigidity in measured surface P1 (Fig. 1); stable physical characteristics; simple mechanical structure; ease of transformation of the measured angle into electric signal for CAD contour and shape reconstruction; can be integrated into orthopaedic appliances for monitoring activity. The novel design of ANGULATOR--flexible polycentric goniometer is presented. PMID- 3658656 TI - Splinting for CDH--initial impressions of a 'user-friendly' alternative. AB - A lightweight, washable, and easily adjusted splint for the congenitally dislocated hip, designed to improve maternal compliance, is described. Observations are currently scientifically uncontrolled, though initial impressions are favourable. PMID- 3658657 TI - [Magnetic resonance imaging (MRI) of avascular necrosis of the femoral head]. PMID- 3658658 TI - [Magnetic resonance imaging of the spine--differentiation by T1 and T2 relaxation times]. PMID- 3658659 TI - [Comparative study of findings by tomography with a compensation filter and those by bronchofiberscopy in the hilar and mediastinal region]. PMID- 3658660 TI - [Effect of an ionic low-osmolality contrast medium (ioxaglate) on the erythrocyte membrane]. PMID- 3658661 TI - [Significance of measurement of serum thyroglobulin in patients with differentiated thyroid carcinoma after total thyroidectomy--a marker of metastases]. PMID- 3658662 TI - [Hemodynamic changes in femoral and dorsalis pedis arteries following injections of glucose solutions and contrast media into femoral artery in the dog]. PMID- 3658663 TI - [Evaluation of pineal calcification in children--using both CT and plain radiographs]. PMID- 3658664 TI - [Development of an advanced brachytherapy planning system with a personal computer. I. Evaluations of the system from accuracy of calculations]. PMID- 3658665 TI - [Results of radiation therapy for brain metastases]. PMID- 3658666 TI - [Radioiodide therapy in pulmonary metastasis of differentiated thyroid cancer- factors affecting the success of I-131 therapy]. PMID- 3658667 TI - [Estimation of frequency, population doses and stochastic risks in stomach mass screening examinations in Japan, 1980]. PMID- 3658668 TI - OVEC, a versatile system to study transcription in mammalian cells and cell-free extracts. AB - We have developed a vector, OVEC ("oligonucleotide vector") to study DNA sequences involved in the regulation of transcription in mammalian cells. This vector is equally suitable for studying expression in vivo after transfection into cells, or for transcription studies in vitro with cell-free extracts. Putative cis-acting DNA segments from enhancers or promoters can be inserted at a position immediately upstream of the TATA box and coding sequence of the rabbit beta-globin gene. A regulatory DNA segment can be tested by itself or in conjunction with an enhancer located either in an adjacent upstream position, or downstream of the beta-globin gene. S1 nuclease mapping can be used to study transcription from circular and linear templates and run-off transcription in vitro is also feasible. Transcripts from a reference globin gene with a small deletion around the transcription initiation site can be measured with the same S1 nuclease probe and thus serve as an internal standard. We demonstrate the usefulness of OVEC by inserting either short oligonucleotides comprising a metal responsive enhancer element, or the SV40 enhancer, directly upstream of the TATA box. Both constructs yield high levels of correctly initiated transcripts in a transient expression assay in HeLa cells. In a HeLa cell nuclear extract the SV40 enhancer stimulates transcription 40-fold. PMID- 3658669 TI - Structure of tobacco genes encoding pathogenesis-related proteins from the PR-1 group. AB - Infection of Samsun NN tobacco with tobacco mosaic virus (TMV) was found to induce the synthesis of mRNA encoding a basic protein with a 67% amino acid sequence homology to the known acidic pathogenesis-related (PR) proteins 1a, 1b and 1c. By Southern blot hybridization it was shown that the tobacco genome contains at least eight genes for acidic PR-1 proteins and a similar number of genes encoding the basic homologues. Clones corresponding to three of the genes for acidic PR-1 proteins were isolated from a genomic library of Samsun NN tobacco. The nucleotide sequence of these genes and their flanking sequences were determined. One clone was found to correspond to the PR-1a gene; the two other clones do not correspond to known TMV-induced PR-1 mRNA's and may represent silent genes. Compared to the PR-1a gene, these genes contain an insertion or deletion in the putative promoter region and mutations affecting the PR-1 reading frame. PMID- 3658670 TI - Human DNA (cytosine-5)methyltransferase selectively methylates duplex DNA containing mispairs. AB - The presence of the C.C mispair in a defined duplex oligodeoxynucleotide enhanced its capacity to serve as a substrate for highly purified human DNA methyltransferase. Analysis of tritiated reaction products showed that the C.C mispair acted as a "methylation acceptor" in that it was itself rapidly methylated. The m5C.G base pair also enhanced the capacity of the oligodeoxynucleotide to serve as a substrate for the enzyme. However, this complementary base pair was found to act as a "methylation director". That is, the presence of the m5C in one strand induced the enzyme to rapidly methylate at the cytosine residue on the opposite strand in an adjacent C.G base pair. PMID- 3658671 TI - In vitro processing of the human growth hormone primary transcript. AB - To study the sequence of events during processing of primary RNA transcripts and to gain more insight into the mechanism of splice site selection, the in vitro processing of a 2.5 kb human growth hormone (hGH) pre-mRNA containing four introns and an alternative 3' splice site for intron B was analysed. In order to process the hGH pre-mRNA the preparation of the HeLa cell nuclear extract had to be modified, indicating differences in factor requirement for processing this pre mRNA. After an unusual long lag phase of one hour splicing intermediates begin to accumulate. Intron A and D are removed with correct ligation of exons 1/2 and 4/5. Most splice sites are used--albeit with variable efficiencies--except the splice sites surrounding exon 3 and the 3' alternative splice site within exon 3; as a consequence "exon skipping" events take place. Using a pre-mRNA containing only intron B neither the 5' nor the 3' splice site is cleaved, indicating that the 3' splice site of intron B is not recognized. The results show that splice sites can differ considerably in their requirement for splicing factors. PMID- 3658672 TI - alpha-DNA-V. Parallel annealing, handedness and conformation of the duplex of the unnatural alpha-hexadeoxyribonucleotide alpha-[d(CpApTpGpCpG)] with its beta complement beta-[d(GpTpApCpGpC)] deduced from high field 1H-NMR. AB - The beta-complementary hexamer, beta-d[GTACGC], to the alpha-sequence, alpha d[CATGCG], was synthesized by the phosphotriester method. The non-exchangeable proton assignments were obtained using 1D- and 2D-NMR techniques, including NOE, COSY and NOESY. The beta-strand exists as a random coil at 21 degrees C; however, at 4 degrees C, it forms an antiparallel self-recognition duplex annealing at positions 1-4. The beta-strand was annealed to the alpha-strand, and confirmation of complete annealing was obtained by detection and assignment of the six base pair imino protons in H2O/D2O solution at 21 degrees C. 1D-NOE experiments of the alpha, beta duplex d[alpha-(CATGCG) X beta-(GTACGC)] reveal that (i) it exists in aqueous solution in a conformation that belongs to the B family, (ii) it is 70 +/ 10% right-handed, (iii) the sugar-base orientations of the beta-strand are anti, and the deoxyribose units exist predominantly in the 2'-endo-3'-exo conformation. NOE measurements of the imino proton signals in the alpha, beta duplex reveal that the duplex exhibits parallel polarity. PMID- 3658673 TI - Nucleotide sequence and secondary structure of apple scar skin viroid. AB - The complete nucleotide sequence of apple scar skin viroid(ASSV) has been established, and a probable secondary structure is proposed. A single-stranded circular ASSV RNA consists of 330 nucleotides and can assume the rodlike conformation with extensive base-pairing characteristic of all the known viroids. ASSV shows low sequence homologies with other viroids and lacks the central conserved region. These indicate that ASSV should be allocated to a separate viroid group. However, homologous sequences with potato spindle tuber viroid(PSTV) in ASSV occur in limited and scattered regions of both viroids. These homologous regions fall within the particular domains in the viroid domain model which has been previously proposed by Keese and Symons(Proc. Natl. Acad. Sci. USA. 82, 4582-4586, 1985). PMID- 3658674 TI - Circular dichroism of poly(dG-dC) modified by the carcinogens N-methyl-4 aminoazobenzene or 4-aminobiphenyl. AB - Poly(dG-dC) was modified to different extents by the carcinogens 4-aminobiphenyl (ABP) or N-methyl-4-aminoazobenzene (MAB). HPLC analysis of the enzymatically hydrolyzed modified polymers indicates that more than 90% of the ABP and 81% of the MAB modification occurs at the C8 position of guanine. The conformational changes of the unmodified and modified polymers were studied as a function of ethanol and magnesium ion concentrations by the use of circular dichroism (CD). The modified polymers show a CD inversion pattern similar to that of the salt induced B to Z transition of poly(dG-dC). Both of the modified polymers require less salt or ethanol than the unmodified polymer for the inversion of the spectra. The amount of ethanol or magnesium needed to induce the inverted CD spectrum is inversely proportional to the percentage of bound ABP or MAB. These data indicate that ABP and MAB can enhance conversion from B to Z conformation in alternating purine-pyrimidine sequences. PMID- 3658675 TI - RNA splice junctions of different classes of eukaryotes: sequence statistics and functional implications in gene expression. AB - A systematic analysis of the RNA splice junction sequences of eukaryotic protein coding genes was carried out using the GENBANK databank. Nucleotide frequencies obtained for the highly conserved regions around the splice sites for different categories of organisms closely agree with each other. A striking similarity among the rare splice junctions which do not contain AG at the 3' splice site or GT at the 5' splice site indicates the existence of special mechanisms to recognize them, and that these unique signals may be involved in crucial gene regulation events and in differentiation. A method was developed to predict potential exons in a bare sequence, using a scoring and ranking scheme based on nucleotide weight tables. This method was used to find a majority of the exons in selected known genes, and also predicted potential new exons which may be used in alternative splicing situations. PMID- 3658676 TI - The nucleotide sequence of a 16S rRNA gene from Streptomyces coelicolor A3(2) PMID- 3658677 TI - cDNA sequence coding for human glutathione peroxidase. PMID- 3658678 TI - Nucleotide sequence of the 3' portion of a human gene for protein kinase C beta I/beta II. PMID- 3658679 TI - Nucleotide sequence of a gene encoding sunflower ribulose-1,5-bisphosphate carboxylase/oxygenase small subunit (rbcs). PMID- 3658680 TI - Nucleotide sequence of a gene encoding an insecticidal protein of Bacillus thuringiensis var. tenebrionis toxic against Coleoptera. PMID- 3658681 TI - The complete nucleotide and deduced amino acid sequence of mouse serum amyloid P component. PMID- 3658682 TI - Sequence of a 3.18 kb tandem repeat of Xenopus laevis DNA containing 8 tRNA genes. PMID- 3658683 TI - DNA fingerprinting in man using a mouse probe related to part of the Drosophila 'Per' gene. PMID- 3658684 TI - Sequence of two rat insulin-like growth factor I mRNAs differing within the 5' untranslated region. PMID- 3658685 TI - The nucleotide sequence of a cDNA clone encoding acyl carrier protein (ACP) from Brassica campestris seeds. PMID- 3658686 TI - Centrifugal transfer and sandwich hybridisation permit 12-hour Southern blot analyses. PMID- 3658687 TI - An improved iodine/water oxidation reagent for automated oligonucleotide synthesis. PMID- 3658688 TI - 2'-Deoxy-3,7-dideazaadenosine--synthesis and NMR assignment. PMID- 3658689 TI - Nucleotide sequence of the protein G gene from Streptococcus GX7805, and comparison to previously reported sequences. PMID- 3658690 TI - Rat uroporphyrinogen decarboxylase cDNA: nucleotide sequence and comparison to human uroporphyrinogen decarboxylase. PMID- 3658691 TI - Structural conventions for group I introns. AB - Conventions for nomenclature of structural elements and a standard secondary structure representation for group I introns have been established by workers in the field. These conventions are designed to facilitate effective communication of information concerning the structure and function of these self-splicing introns. PMID- 3658692 TI - Incorporation of 5-bromodeoxycytidine in the adenovirus 2 replication origin interferes with nuclear factor 1 binding. AB - We have studied the binding of nuclear factor 1 (NFI), a human sequence-specific DNA-binding protein, to a DNA fragment substituted in vitro with 5 bromodeoxycytidine (5-BrdC). Even at low substitution grades binding of NFI to its recognition sequence was considerably lower than with the unsubstituted control fragment. We developed a procedure to cleave substituted DNA specifically at a BrdC residue and searched for contacts between NFI and 5-BrdC residues by an interference assay. Surprisingly, no specific contacts were found in or near the recognition sequence. It appeared instead that interference was inversely related to the distance of a 5-BrdC residue from the NFI binding site. Models to explain these results, including a possible sliding mechanism, are discussed. PMID- 3658693 TI - Solid phase synthesis of oligoribonucleotides using the o-nitrobenzyl group for 2'-hydroxyl protection and H-phosphonate chemistry. AB - Oligoribonucleotides with chain length of 7, 11, 15, 17, 24 and 34 were synthesized on long chain alkylamine controlled pore glass beads (LCA-CPG) using o-nitrobenzyl protection of 2'-hydroxyls via a H-phosphonate approach either manually or by using an automatic synthesizer. The oligoribonucleotides were obtained in yields of 0.6 0.6-20%, based on initial nucleoside bound to the LCA CPG support. PMID- 3658694 TI - Mapping the testis determinants by an analysis of Y-specific sequences in males with apparent XX and XO karyotypes and females with XY karyotypes. AB - A number of patients with paradoxical sex chromosome complements (so-called XY females, XX and XO males) have been investigated with a series of 19 Yp and 4 Yq DNA probes to establish which region of the Y is essential for male sexual differentiation. Of the 23 XX males, 18 possessed one or more Yp probe sequences with only 5 lacking such sequences. Of 9 XY females examined, only one showed evidence of a deletion in Yp occurring either as a result of X-Y interchange or interstitial deletion. This suggests that the majority of XY females are not commonly deleted for those Y sequences which are found to be transferred to the X in XX males. The DNA of two XO males both contained different portions of the Y. From a comparison of the patterns of Yp sequences in these patients, it has been possible to elaborate a model of Yp in terms of the order of probe sequences and to suggest a location for the testis determining region in distal Yp. PMID- 3658695 TI - Structure of the gene for human uroporphyrinogen decarboxylase. AB - Uroporphyrinogen decarboxylase, the fifth enzyme of the heme biosynthetic pathway, is an housekeeping enzyme whose activity is enhanced during erythropoietic differentiation. We have previously shown that this increased activity was in part accounted for by an enhanced transcription of the gene in erythropoietic tissues. To elucidate further the tissue specific regulation of an housekeeping gene we have isolated the human URO-D gene and determined its organization. The cloned gene comprises 10 exons spread over 3 Kb. Two transcriptional start sites were determined and analysis of 900 bp of the 5' flanking region suggests a very simple structural organization for the URO-D gene promoter. We also show that this gene is functional when transfected into mouse fibroblasts, and that its promoter is sensitive to a viral enhancer. PMID- 3658696 TI - Transcription of the intergenic regions of the tubulin gene cluster of Trypanosoma brucei: evidence for a polycistronic transcription unit in a eukaryote. AB - The tubulin genes of T. brucei are clustered in a tightly packed array of alternating alpha- and beta-genes. The steady state mRNA contains one abundant mRNA species each for alpha- and beta-tubulin, both carrying the identical 35 nt mini-exon sequence at their 5'-ends. We have used in vitro run-on transcription assays to investigate the mechanism of tubulin gene transcription in T. brucei. Our results show that the regions between the individual tubulin genes are transcribed at the same rate as are the genes themselves. On the other hand, transcripts containing the intergenic regions could not be detected by Northern analysis or in vivo labelling experiments. We conclude that putative transcripts from the intergenic regions have a half-life of less than one minute. These results suggest that the tubulin gene cluster is transcribed as a single contiguous transcription unit yielding a primary transcript which is rapidly processed into individual mRNAs by the polyadenylation and mini-exon trans splicing machineries. PMID- 3658697 TI - The relationships between the 5' end repeats and the largest members of the L1 interspersed repeated family in the mouse genome. AB - Analysis of a few large L1 elements has revealed two types of tandem repeats at the 5' end: A and F. In this study, the relationships between these repeats and a series of large L1 elements has been analysed. Most of cloned L1 repeats were shown to lack either A or F sequences at their 5' ends. F sequences are found less frequently associated than A sequences to the 5' ends of L1 and an evolutionary comparison shows that the A type was introduced more recently during the evolution of the mouse genome than the F type. PMID- 3658698 TI - Linker scanner mutagenesis of the Xenopus laevis ribosomal gene promoter. AB - We have assayed a series of linker scanner mutants which cover the Xenopus laevis ribosomal gene promoter at approximately ten base pair intervals. All of these mutations adversely affect promoter activity with the exception of one mutation which stimulates activity. Thus, none are neutral. We show that most of the mutations can be partially rescued by ligating a block of enhancer elements upstream of the promoter. In addition, we have made extracts from liver nuclei which produce DNaseI protection footprints over the promoter. Analysis of both strands reveals a prominent footprinting domain from about -5 to -30. However, lesser changes in the digestion pattern are detected over most of the promoter. Previously published analyses have suggested that this promoter might be composed of three functional domains. The experiments presented here suggest that either 1) the three putative domains are so closely arranged that the boundaries are difficult to discern, or 2) the situation is more complex. PMID- 3658699 TI - Synthesis and properties of oligodeoxynucleotides with an AP site at a preselected position. AB - A general synthesis of a deoxyoligonucleotide with an AP site at a preselected sequence is described. Deoxyuridine is introduced during routine oligonucleotide syntheses of d(TTTUTTTT) and d(AAAAGTTUAAAACAT). Treatment with uracil DNA glycosylase produces d(TTTrTTTT), where r = deoxyribose, and d(AAAAGTTprpAAAACAT). KM and Vmax are: d(TTTUTTTT), 7.3 X 10(-9)M and 2.0 X 10( 9) mumol/min; d(AAAAGTTUAAAACAT), 1.5 X 10(-8) M and 6.4 X 10(-9) mumol/min. Both d(AAAAGTTprpAAAACAT) and d(TTTprpTTTT) undergo rapid beta-elimination in 1 M piperidine at 25 degrees giving two oligonucleotide fragments, d(AAAAGTTpr') and d(pAAAACAT), where r' = -O-CH2-CHOH-CH=CH-CHO (or its hemiacetal form). The fragment, d(AAAAGTTpr'), which can be isolated by reverse phase chromatography, is resistant to the 3'----5' exonuclease activity of snake venom phosphodiesterase. Endonucleolytic hydrolysis of the penultimate phosphodiester occurs removing pTpr' and generating a normal 3'-OH end. In 1 M piperidine at 90 degrees two beta-eliminations occur producing the oligonucleotides d(AAAAGTTp) and d(pAAAACAT) from d(AAAAGTTprpAAAACAT); d(TTTp) and d(pTTTT) from d(TTTprpTTTT). PMID- 3658700 TI - Structural and functional characterization of a Dictyostelium gene encoding a DIF inducible, prestalk-enriched mRNA sequence. AB - The pDd56 mRNA sequence is highly enriched in prestalk over prespore cells and is inducible by DIF, the putative Dictyostelium stalk-specific morphogen. We show that the pDd56 gene is composed of forty one copies of a twenty four amino acid, cysteine rich repeat. This is highly homologus to a repeat which we have previously shown to compose the major fraction of the pDd63 mRNA, another DIF inducible, prestalk-enriched sequence. The predicted pDd56 protein contains a putative signal peptide but does not appear to contain a transmembrane segment. In combination these features suggest it to be an extrinsic protein and we confirm this elsewhere by showing that the pDd56 gene encodes a known, extracellular protein of the stalk. The pDd56 mRNA is dependent upon exogenous DIF for its accumulation. We show that this control is exerted at the transcriptional level and that a restriction fragment containing 1.7Kb of upstream sequence directs temporally-regulated expression of the gene. PMID- 3658702 TI - 2D-NMR studies of the unnatural duplex alpha-d(TCTAAAC)-beta-d(AGATTTG). AB - The unnatural oligonucleotide alpha-d(TCTAAAC) was synthesized and was found more resistant towards endonucleases than its beta-analog. 2D-NMR experiments allowed the assignment of all non-exchangeable aromatic and sugar protons except for the overlapping 5' -5" resonances, as well as the exchangeable imino protons of the parallel hybrid duplex alpha-d (TCTAAAC)-beta-d(AGATTTG). NMR studies show that the strength of the association between the alpha-strand and the beta parallel strand is equivalent to that between their anti-parallel complementary beta analogs beta-d(CAAATCT) and beta-d(AGATTTG). NOE data provide evidence that both duplexes form stable right-helical duplexes with an anti-conformation on the glycosyl linkages and a Watson-Crick pairing. NOESY and COSY spectra allowed us to determine that alpha and beta deoxyriboses adopt a 3' -exo conformation. PMID- 3658701 TI - Molecular characterization of the virD operon from Agrobacterium tumefaciens. AB - The Agrobacterium tumefaciens Ti plasmid virulence (vir) region contains at least six transcriptional units required for the efficient transfer of T-DNA to the plant genome (virA, B, C, D, E, and G). We have reported that two proteins encoded by the 5'portion of the virD operon are required for a site-specific endonuclease activity that nicks the direct repeats which flank the T-DNA. We have presented the nucleotide sequence for this portion of the operon. The nucleotide sequence of the remainder of the virD operon essential for virulence has now been determined. Two additional open reading frames encode proteins of 21.3 and 75.8 kilodaltons (kd). Translational fusions between virD2, virD3, and virD4 proteins and trpE produced fusion proteins of the size predicted from the nucleotide sequence data. We have used antisera directed against the trpE-virD2 fusion protein to detect both native virD2 protein and a virD2-lacZ fusion protein in crude extracts from Agrobacterium. PMID- 3658703 TI - Nucleotide sequence heterogeneity of alpha satellite repetitive DNA: a survey of alphoid sequences from different human chromosomes. AB - The human alpha satellite DNA family is composed of diverse, tandemly reiterated monomer units of approximately 171 basepairs localized to the centromeric region of each chromosome. These sequences are organized in a highly chromosome-specific manner with many, if not all human chromosomes being characterized by individually distinct alphoid subsets. Here, we compare the nucleotide sequences of 153 monomer units, representing alphoid components of at least 12 different human chromosomes. Based on the analysis of sequence variation at each position within the 171 basepair monomer, we have derived a consensus sequence for the monomer unit of human alpha satellite DNA which we suggest may reflect the monomer sequence from which different chromosomal subsets have evolved. Sequence heterogeneity is evident at each position within the consensus monomer unit and there are no positions of strict nucleotide sequence conservation, although some regions are more variable than others. A substantial proportion of the overall sequence variation may be accounted for by nucleotide changes which are characteristic of monomer components of individual chromosomal subsets or groups of subsets which have a common evolutionary history. PMID- 3658704 TI - Periodicities in introns. AB - The sequence information for the splicing process of introns is found in the consensus sequences at the two splice sites. For long introns, of 300 or more nucleotides, the middle regions may provide additional specificity for splicing which can be investigated by defining an adequate quantitative parameter. This methodology permits to retrieve the coding periodicity in the viral and mitochondrial introns and to identify with a statistical significance, a surprising alternating purine-pyrimidine base sequence -i.e. a modulo 2 periodicity- in the eukaryotic introns, and particularly in the vertebrate introns. This alternating structure suggests that the vertebrate introns do not have the genetic information to code for proteins, they carry structural and regulatory functions. PMID- 3658705 TI - A Raman scattering study of the helix-destabilizing gene-5 protein with adenine containing nucleotides. AB - Raman spectra of gp5 and complexes of gp5 with poly(rA) and poly(dA) have been determined and analysed. From a fit of the amide I-band with model spectra it follows that the secondary structure of gp5 contains 52% beta-sheet, 28% undefined conformation and 19% alpha-helix. The band at 1032 cm-1 due to phenylalanine has an anomalous intensity both in the spectra of the complexes and the free protein. This possibly indicates a stacked structure present in the protein. Binding of gp5 to poly(rA) and poly(dA) influences the intensity of bands near 1338 and 1480 cm-1 which are considered to be marker-bands for the phosphate-sugar-base conformer. A change in conformation of the nucleotides is also reflected by vibrations originating in the phosphate- and sugar-residues of the backbone. In the spectrum of complexed poly(rA) the intensity of the conformation sensitive band at 813 cm-1, which is due to the phosphodiester group, is zero. It seems that gp5 forces poly(rA) and poly(dA) to a similar conformation. A marker band for stacking interaction in poly(rA) indicates that stacking interactions in the complex have increased. PMID- 3658706 TI - Vacuum UV circular dichroism is diagnostic for the left-handed Z form of poly [d(A-C).d(G-T)] and other polydeoxynucleotides. AB - Circular dichroism spectra are extended into the vacuum UV to about 178 nm for four polydeoxynucleotides of various sequences capable of assuming the left handed Z form. It is found that each of these polymers, including those with brominated bases and those with the four different bases, have a characteristic negative feature at short wavelengths when in the Z form. In contrast, the B form only has a positive band between 180 and 200 nm. Furthermore, a blue shift of the short wavelength crossover is diagnostic of the B- to Z-form transition for all polymers studied so far. These results confirm that poly[d(A-C).d(G-T)] can assume the Z form in solution at low concentration. PMID- 3658707 TI - The nucleotide sequence of a human protamine 1 cDNA. PMID- 3658708 TI - Sequence of the seed lectin gene from pea (Pisum sativum L.). PMID- 3658709 TI - Sequence of the chicken ovotransferrin gene. PMID- 3658710 TI - Amplification of acidic endothelial cell growth factor (ECGF) gene sequences in hamster DDT1-MF2 tumor cells. PMID- 3658711 TI - Psychiatric care: out of MIND. PMID- 3658712 TI - Students: declaration of independence. PMID- 3658713 TI - Consideration costs nothing. PMID- 3658714 TI - Just when you thought you were safe. PMID- 3658715 TI - Pressure sores. Are you in the dark? PMID- 3658716 TI - Pressure sores. Pointers to good care. PMID- 3658718 TI - Animal experiments: the case for; the case against. PMID- 3658717 TI - The nurse advocate: speaking up for advocacy. PMID- 3658719 TI - New treatments for impotence. PMID- 3658720 TI - Nursing Aid. Fertility control. PMID- 3658721 TI - A suitable job for a man? PMID- 3658722 TI - Computers in nursing news. PMID- 3658723 TI - Computers in nursing news. A flexible friend. PMID- 3658724 TI - Computers in nursing news. The tale of two systems. PMID- 3658725 TI - Behind bars. Interview by Lawrence Dopson. PMID- 3658726 TI - Down at St Jimmy's. PMID- 3658727 TI - Elderly care: closure can be fatal. PMID- 3658728 TI - Why shouldn't we be clever? PMID- 3658729 TI - Caring for Kathleen. PMID- 3658730 TI - Home truths. PMID- 3658731 TI - From Edinburgh to Berlin. PMID- 3658732 TI - Not a case of abuse. PMID- 3658733 TI - The nurse as advocate. Professionalism revisited. PMID- 3658734 TI - Pressure sores. Keeping up-to-date on treatments. PMID- 3658735 TI - Subacute sclerosing panencephalitis. PMID- 3658736 TI - Death of Edmond. PMID- 3658737 TI - Hidden assets. PMID- 3658738 TI - Systems of life. No 153. Senior systems. 18. PMID- 3658739 TI - Stress in nursing. 3. Managing stress. PMID- 3658740 TI - Beating a hasty retreat. PMID- 3658741 TI - Hungerford's aftermath. PMID- 3658742 TI - Brent's big brother. PMID- 3658743 TI - A midwife's nightmare. PMID- 3658744 TI - The staff nurse. Are you prepared to be a staff nurse? PMID- 3658745 TI - The staff nurse. Unreasonable expectations? PMID- 3658746 TI - The staff nurse. Limited opportunities. PMID- 3658747 TI - Managing paediatric pain. PMID- 3658748 TI - The relationship of clothing to self-esteem in elderly patients. PMID- 3658749 TI - 'My life's not worth living, nurse'. PMID- 3658750 TI - A special baby. PMID- 3658752 TI - Wound care. Conducting a fair trial. PMID- 3658751 TI - Wound care: packing wound cavities. PMID- 3658753 TI - No patients please, we're students. PMID- 3658754 TI - Band aid or real aid?. Interview by Niall Dickson. PMID- 3658755 TI - A case of overload? PMID- 3658756 TI - Relatives. Sour grapes. PMID- 3658757 TI - Relatives. Familiar faces. PMID- 3658758 TI - Relatives. Just visiting. PMID- 3658759 TI - Mothers' lament. PMID- 3658760 TI - Who inspects the inspectors? PMID- 3658761 TI - Nursing Aid. Fighting fit. PMID- 3658762 TI - Care to talk? PMID- 3658763 TI - The staff nurse. Prepared transition. PMID- 3658764 TI - Mental health. The journal for psychiatric nurses. PMID- 3658765 TI - Mental health. Breaking the silence. PMID- 3658767 TI - Mental health. Hitting out. PMID- 3658766 TI - Mental health. In someone else's shoes. PMID- 3658768 TI - The Journal of Infection Control Nursing. PMID- 3658769 TI - The Journal of Infection Control Nursing. Penny wise, pound foolish? PMID- 3658771 TI - The Journal of Infection Control Nursing. All in a week's work. PMID- 3658770 TI - The Journal of Infection Control Nursing. Hand-drying methods. PMID- 3658772 TI - The Journal of Infection Control Nursing. All the better to treat you with. PMID- 3658773 TI - If the glove fits. PMID- 3658774 TI - The process of preparing a grant. Part II. PMID- 3658775 TI - Antibiotic therapy in the cancer patient: focus on third generation cephalosporins. PMID- 3658776 TI - A home care transfusion program. PMID- 3658777 TI - Development of a scale to measure undergraduate students' attitudes about caring for patients with cancer. PMID- 3658778 TI - Developing continuing education programs in cancer nursing. PMID- 3658779 TI - Developing continuing education programs in cancer nursing. Learning needs assessment. PMID- 3658780 TI - Developing continuing education programs in cancer nursing. Developing educational objectives. PMID- 3658781 TI - Developing continuing education programs in cancer nursing. Defining content and methods. PMID- 3658782 TI - Developing continuing education programs in cancer nursing. Program evaluation. PMID- 3658783 TI - Ethical principles in the nursing care of the terminally ill adult. PMID- 3658785 TI - [Neuroregulation of respiration]. PMID- 3658784 TI - Standardized teaching plans for management of chemotherapy and radiation therapy side effects. PMID- 3658786 TI - [Nonspecific bronchial hyperreactivity and the degree of allergic sensitization to occupational factors in carpet factory workers]. PMID- 3658787 TI - [Value of spirometric and gasometric studies in the diagnosis of chronic cor pulmonale in coal miners with pneumoconiosis]. PMID- 3658788 TI - [Effect of hydrocortisone, methylprednisolone and dexamethasone on the chemiluminescence of peripheral blood neutrophils]. PMID- 3658789 TI - [Cellular infiltrates in lung cancer. I. Evaluation of the composition of cellular infiltrates in squamous cell carcinoma]. PMID- 3658790 TI - [A case of primary pulmonary hypertension]. PMID- 3658791 TI - [Immotile cilia syndrome]. PMID- 3658792 TI - [Preliminary evaluation of the diagnostic usefulness of bronchoalveolar lavage. Preliminary report]. PMID- 3658793 TI - [Effect of cachexia and intravenously administered lidocaine on the hemodynamic reaction during bronchoscopy]. PMID- 3658794 TI - [Changes in blood pressure and heart rate during bronchoscopy under topical and general anesthesia]. PMID- 3658795 TI - [The leukocyte migration inhibition test and skin tests using bacterial suspensions in patients with infectious bronchial asthma]. PMID- 3658796 TI - [Late diagnosis of a foreign body in the bronchus]. PMID- 3658797 TI - [Jejunal biopsy]. AB - Considering many years' experience in various centres, the authors evidence indications, contraindications, and possible technical inconveniences relative to jejunum biopsy. They analyze various aspects concerning the rightest methods of performance particularly concerning the patient's sedation and immobilization, the local anaesthesia of the back pharynx, techniques facilitating the placement of the capsule the sampling of the mucosa (mucous membrane) and the recovery of the capsule. Then the authors examine the criteria of evaluation of the biopsy sample through both stereomicroscopical and traditional microscopical examinations. They analyze the main parameters in the histological evaluation of biopsy and the basic conditions to observe in order to evaluate histological aspects correctly. Finally they propose a score of histological evaluation, for quick, easy routine use; its results can be reproduced in accordance with traditional histological reading which allows examiners from different centres to confirm their judgements about the atrophy of the mucosa and enables more significant comparisons in case of biopsy repeated on the same subject. PMID- 3658798 TI - Allergic and disergic children rhinopathy. AB - Authors studied 42 children affected with obstructive rhinopathy. They complained nose obstruction with mono or bilateral difficult nasal breathing, permanent (rarely seasonal) symptoms, hypertrophic adenoids, nasal hypersecretion, hearing loss and recurrent otitis media. Two groups of tests were performed: 1) to document the entity of nasal stenosis and the correlated otologic diseases: rhinomanometry by Mercury NR1 rhinomanometer; tympanogram, classified according to Jerger; tubotympanogram, according to Honjo, Morimitsu and Cocchini. 2) To formulate etiologic hypothesis: Prick skin tests; immunoenzymatic specific and total IgE assay; nasal smear; secretory IgA assay. In 8 children anamnesis showed an environmental allergy while familiar anamnesis was positive in 26 cases. Skin tests and/or IgE assay were positive in 14. Neutrophilia in nasal smear was noted in 30, lymphocytosis in 2 and eosinophilia in 5. Secretory IgA were decreased in 39. Children were divided into three classes: A: no documented atopic component; B: disergic children; C: allergic children. PMID- 3658799 TI - [Allergy caused by Alternaria in children]. AB - For many years molds have considered to be important causes of rhinitis and asthma but since they have been poorly studied many questions remain unanswered. Allergological and epidemiological considerations have been made by the authors concerning the role of the Alternaria tenuis in respiratory diseases in children. 253 subjects were skin tested, 9.48 percent had an immediate reaction, 3.55 were also positive to the fungus only. Good correlation was observed between positive skin tests and RAST (66%). This study confirmed that probably Alternaria tenuis has an important role as immunopathogen for rhinitis and asthma in children. The authors discuss epidemiological considerations and related problems. PMID- 3658800 TI - [Disorders of acid-base equilibrium in neonatal physiologic jaundice]. AB - 38 healthy term jaundiced infants were tested. On 3rd day of life we obtained a blood sample from a peripheric vein to determine red blood cells and reticulocytes count, serum albumin, total, conjugated and unconjugate bilirubin. On 3rd, 4th, 5th, 6th day of life 4 standard heparinized microtubes were filled after lancing the heel: 2 microtubes to estimate the mean value of total bilirubin, 2 for the mean value of pH. The urine pH was evaluated every morning. The results of total bilirubin (T.B.), pH, pCO2 and Base Deficit were analyzed using T-test. All tested infants were free-bilirubin jaundiced. Infants treated with phototherapy had a T.B. ranging from 15.2 mg/dl on 3rd day of life to 10.5 mg/dl on 6th, while in controlled infants T.B. never exceeded 10 mg/dl. In treated infants the pH was higher than in controlled ones: p was less than 0.001 on 4th day, less than 0.005 on 5th day and less than 0.001 on 6th day. In both groups the urine pH ranged from 5 to 6.5 every day. The marked increase in respiratory rate during phototherapy is a well known side effect. But a significant decrease in pCO2 was present before starting phototherapy. A mixed disturbance of acid-base balance could be suspected: an already existing mild metabolic acidosis in phototherapy group with respiratory alkalosis due to anion gap variety, with unknown determining causes. We relate the initial metabolic acidosis to the depressed oxidative phosphorylation (with lactic acidosis) in the neonatal liver.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658801 TI - [Intracranial hemorrhage caused by vitamin K deficiency in early infancy. Still a problem?]. AB - A case of intracranial hemorrhage in a one month old infant is reported. A review of the prodromal symptoms presented by this infant seems useful to delineate a clinical picture that should allow a timely recognition of this problem in the population at risk. Furthermore, the relative frequency of this entity, due to vitamin K deficiency, in the first months of life in exclusively breast-fed infants, confirms the advisability of vitamin K supplementation at birth. PMID- 3658802 TI - [Photoprevention or phototherapy in newborn infants born prematurely?]. AB - The authors studied the effects of different kinds of phototherapy in 186 newborns with a gestational age less than 33 weeks and weighing less than 2500 g. A control group of 60 infants was compared with a group of 31 infants submitted to photoprophylaxis, a group of 54 infants treated with day light, and a group of 41 infants treated with day light + special blue light. As far as the serum bilirubin variations in the first week, the maximum levels attained and the number of exchange transfusions are concerned, phototherapy always proved effective in reducing potentially neurotoxic serum bilirubin concentrations. Among the infants subjected to treatment, those treated with the day light showed a significant smaller decrease of serum bilirubin compared to those treated with the day light + special blue light, even if levels above 15 mg/dl were found in a similar percentage. Only 3.2% of the babies treated with photoprophylaxis showed serum bilirubin values above 15 mg/dl. The authors conclude that prophylaxis seems to be preferable to other phototherapeutic schedules used in the treatment of hyperbilirubinemia in low gestational age infants. PMID- 3658803 TI - [Ureteral ectopy. The residual stump syndrome]. AB - Anatomy and symptoms of ureteral ectopy in childhood can greatly vary. In most cases the site of ectopies in the urethral tract, so that a complete excision of the distal ureter is difficult and may cause damage to the sphincteric structures. When lower ureterectomy is performed below iliac vessels, symptoms secondary to residual ectopic ureter are rare. In our experience, residual ureteral stumps were symptomatic in two cases, with continence and micturation disturbances, which were codified as "residual ureteral stump syndrome". Clinical features and treatment are herein reported. PMID- 3658804 TI - [Surgical strategy in the treatment of infantile ureterocele]. AB - The authors describe their experience on the surgical treatment of ureterocele in the pediatric age. The anatomic and clinical features which condition the choice between various therapeutic solutions are presented. All problems concerning any kind of different surgical approach are discussed, stressing the importance of the endovesical radical treatment. PMID- 3658805 TI - [Valves of the anterior urethra without diverticulum. Description of 3 cases]. AB - Anterior urethral valves are rare entities, especially in case they are not associated to urethral diverticulum. Because of their obstructive effects on the urinary tract, they must be searched in case of clinical evidence of lower obstructive uropathy. Three cases of anterior urethral valves without urethral diverticulum are herein reported. Differential diagnosis with urethral diverticula, endoscopic features and treatment are discussed and emphasized. PMID- 3658806 TI - [When and why a celiac patient could be subjected to surgical intervention]. AB - The authors report the case of a three year old patient who presented with coeliac disease simulating an Hirschsprung's (constipation and megacolon). She underwent surgery many times and this was due to an initial diagnosis of aganglionic megacolon. Moreover the relationship between constipation and megacolon is discussed and some pathogenetic interpretations of megacolon, a common observation in patient with coeliac disease, are presented. PMID- 3658807 TI - [Coffin-Lowry syndrome. Description of 2 cases associated with cardiovascular anomalies]. AB - In this work the authors describe two cases of Coffin-Lowry syndrome, diagnosed in two brothers of different age and with a different degree of evolution of the illness. The brothers present the mitral prolapse association. The clinic and instrumental examination have been executed. The various pathogenetic hypothesis have been discussed and the authors propose the most recent that considers the fibroblast incapable to produce the substances of connective matrix. This hypothesis explain also the evolution and the progression of the lesion at the interested organs (skin, joints, bones, heart). The illness is genetic, with a X linked, semidominant transmission. PMID- 3658808 TI - [Home-coming diarrhea. Presentation of a clinical case]. AB - The Homing Diarrhea, described by Duhamel and Rey in 1980, represents a gastrointestinal disease which affects children of emigrants coming back from a trip to their country of origin and may become so serious to cause death secondary to dehydration or septicemia. The poor nutritional conditions at the beginning of the trip (secondary to low socioeconomic situation) and the onset of acute enteritis during the travel, caused by Salmonella or Shigella, E. Coli, Campylobacter, Myceti, Giardia Lamblia, Rotavirus, are considered the main and triggering factors of the homing diarrhea. Intensive care can be necessary to interrupt the sequence constituted by diarrhea-malnutrition-dehydration. Therefore prophylaxis, including good basal nutritional conditions and the use of p.o. glucose-electrolyte solutions at the beginning of the acute enteric episode appears to be the most effective measure to prevent the onset of the disease. A case of homing diarrhea is reported. PMID- 3658809 TI - [A rare cause of urologic emergency in childhood: obstruction of the urinary tract caused by Candida]. AB - AA. report a case history about a 3 month old female baby affected by bilateral pyelo-ureteric obstruction by fungus ball, presented as urine ascites because of fissure in renal pelvis and successfully treated by surgery. In spite of disobstruction and subsequent medical treatment, the obstruction relapsed and a second operation was necessary. This time a bilateral nephrostomy was done allowing irrigation with anti-candida drugs. This case has to be considered unusual because of the age of the patient, the clinical presentation as ascites, the bilateral affection, the tendency to relapse after disobstruction, and the successful treatment after the second operation. PMID- 3658810 TI - Increased levels of vasoactive intestinal peptide (VIP) and oxytocin during suckling in lactating dogs. AB - The aim of the present study was to investigate how suckling influences the plasma levels of oxytocin and vasoactive intestinal peptide in lactating dogs. Blood-samples were drawn from ten lactating beagles during suckling, in week one and week three of the five week long lactation period and the levels of vasoactive intestinal peptide and oxytocin were determined by radioimmunoassay. The immunoreactive levels of vasoactive intestinal peptide and oxytocin (below referred to VIP and oxytocin) increased rapidly in response to the suckling stimulus. The rise of both peptides was significant at both suckling experiments. The origin and role of suckling-released oxytocin is well established. The origin of and function of the VIP released in response to suckling remains unknown. PMID- 3658811 TI - The effect of enkephalin dimers on body temperature in mice. AB - Short-lasting decrease in rectal temperature in mice after intraperitoneal administration of an enkephalin dimer, the so called double-enkephalin--(Tyr-D Ala-Gly-Phe-NH)2 (D-ENK-O)--at dose 0.1, 0.5, 1, 2.5, 5, 10 and 20 mg/kg of body weight was observed. Another double-enkephalin--Tyr-D-Ala-Gly-Phe-NH-(CH2)3-HN Phe-Gly-D-Ala-Tyr-- fai led to produce this effect. The hypothermic effect of D ENK-O was almost completely reduced by naloxone which suggests an involvement of opiate receptors in the D-ENK-O produced hypothermia in mice. PMID- 3658812 TI - In vivo arteriolar dilation in response to parathyroid hormone fragments. AB - The in vivo responsiveness of small arterioles to the topical administration of two parathyroid hormone fragments was investigated using television microscopy. Male Sprague-Dawley rats were anesthetized with sodium pentobarbital (50 mg/kg) and second- and third-order arterioles in the cremaster muscle were exposed to increasing concentrations (2 X 10(-5) to 6 X 10(-4) mg/ml) of either hPTH (1-34) or bPTH-(3-34). Second- and third-order arterioles within the cremaster dilated (183% and 281% of control, respectively) following exposure to PTH-(1-34) in bath concentration of 10(-4) mg/ml and above. The dilation associated with PTH administration was abolished in second-order and greatly attenuated for third order arterioles when the first two amino acid residues of the PTH molecule were removed (PTH (3-34) fragment). Inhibition of endogenous prostaglandins synthesis with mefenamic acid did not attenuate the vasodilator response to PTH. However, exposure to the muscarinic blocking agent atropine (10(-7) g/ml) totally inhibited the dilator response to PTH-(1-34). These data suggest that PTH induces arteriolar dilation by stimulation of muscarinic receptors in the vasculature possibly by causing the release of endogenous acetylcholine. PMID- 3658813 TI - Prenatal administration of arginine vasopressin impairs memory retrieval in adult rats. AB - Eight pregnant female rats were chronically treated via an osmotic pump with arginine vasopressin or placebo during days 13 to 19 gestation. All offspring were tested as adults in either a discrimination task or a 25 day retention of a passive avoidance response. The results revealed that rats whose mother had been treated with vasopressin did not differ from controls on the acquisition or reversal of a brightness discrimination; however, they did require more trials to reach criterion during the ten day memory test of discrimination reversal. Further, treatment resulted in impaired memory retrieval in male rats on the 25 day memory test, while female rats were not affected. Treatment did not influence body weight. The results indicated that vasopressin administered during the prenatal period of development may have had a teratogenic effect on memory retrieval. PMID- 3658814 TI - The brain of Lymnaea contains a family of FMRFamide-like peptides. AB - Authentic FMRFamide and two FMRFamide-related heptapeptides were purified from the central nervous system of the fresh water snail Lymnaea stagnalis. The sequences of the heptapeptides were determined as: Ser-Asp-Pro-Phe-Leu-Arg-Phe NH2 (SDPFLRFamide) and Gly-Asp-Pro-Phe-Leu-Arg-Phe-NH2 (GDPFLRFamide) by modified Edman degradation and enzymatic digestion. Relatively high quantities of the deamidated and therefore non-immunoreactive analogs of these two peptides (SDPFLRF and GDPFLRF) were also found. SDPFLRFamide and GDPFLRFamide were synthesized and were found to be chromatographically and biologically indistinguishable from the natural peptides, confirming the sequences. The log dose-response curves for the chronotropic action of either synthetic peptide on the heart of Lymnaea was very similar to that of FMRFamide. These data indicate that Lymnaea contains a family of FMRFamide-like peptides. PMID- 3658815 TI - Evidence for a novel FMRFamide-related heptapeptide in the pulmonate snail Siphonaria pectinata. AB - Extracts of whole false limpets (Siphonaria pectinata) were analysed to determine their complement of FMRFamide-related peptides. As in other pulmonates, FMRFamide itself was found to account for only a portion of the immunoreactivity; the largest immunoreactive peptide peak eluted during HPLC under acidic conditions at the same position as a peak also found in other pulmonates. This major peak was resolved into two components by HPLC at neutral pH, and one component was identified as the heptapeptide amide, GDPFLRFamide, previously described from Lymnaea. The amino acid composition of the second component indicates that it is also a heptapeptide, but that it has two Asx (aspartic acid or asparaginyl) residues instead of the one found in the previously identified pulmonate heptapeptides. PMID- 3658816 TI - A presynaptic locus of the action of Met-enkephalin demonstrated in mouse spinal cord cultures. AB - Monosynaptic excitatory post-synaptic potentials (EPSPs) evoked in spinal cord (SC) neurons by stimulation of dorsal root ganglion (DRG) neurons in cell cultures were reduced by perfusion application of the opiate peptide, Met enkephalin (2-4 microM). In about 2/3 of cases examined, EPSPs evoked by stimulation of spinal cord cells were also reduced by Met-enkephalin. The effects were antagonized by concomitant perfusion with naloxone (1-2 microM) and recovered when perfusion with Met-enkephalin was stopped. Statistical analysis of synaptic responses indicated that the reduction of EPSP amplitude was due, at least to a major extent, to a decrease in presynaptic transmitter release. PMID- 3658817 TI - Localization of neuropeptide Y-like immunoreactivity in the cat hypothalamus. AB - The distribution pattern of neuropeptide Y-like immunoreactivity (NPY-Li) in cat hypothalamus was studied using avidin-biotin modification of immunocytochemical method. This study showed cell bodies containing NPY-Li in the periventricular and the infundibular nuclei and also a moderate number of neurons with NPY-Li in the ventromedial nucleus, an observation not reported in earlier studies. Fibers with NPY-Li were noted throughout the hypothalamus, but most prominently within the periventricular regions. The location of NPY cells within the hypothalamus suggests the possibility of an interaction with dopaminergic and other proopiomelanocortinergic neurons. PMID- 3658818 TI - Photo-patch testing and patch testing with silver sulfadiazine cream. PMID- 3658819 TI - Photosensitivity associated with triflusal (Disgren). PMID- 3658820 TI - Treatment of light-sensitive mycosis fungoides with PUVA and prednisolone. PMID- 3658821 TI - Treatment of polymorphous light eruption with PUVA and prednisolone. PMID- 3658822 TI - Photodermatoses--diagnostic procedures and their interpretation. PMID- 3658823 TI - Dissecting human DNA repair. PMID- 3658824 TI - Cytochemistry and biochemistry of acid phosphatases VII: Immunohistochemistry of canine prostatic acid phosphatase. AB - Acid phosphatase (E.C. 3.1.3.2.) has been isolated from canine prostatic gland homogenates by gel permeation chromatography (AcA34 or G150), by affinity chromatography (con A-Sepharose), or by using fluid phase liquid chromatography (FPLC) using Superose 12 and Mono P columns. Acid phosphatase-enriched fractions were submitted to analytical SDS-PAGE or to analytical isoelectric focusing. A protein with a molecular weight of 30 kD (on SDS gels) was used for immunization of rabbits. The antiserum produced was cross-reactive with prostatic acid phosphatase (canine and human) as shown by immunoblotting. When applied to paraffin or plastic sections of normal canine prostate, a positive immunoreaction was found exclusively in the secretory cells. In experimentally altered glands (castration and/or hormone treatment), a varying pattern of immunoreactive cells was found. In canine prostatic carcinomas, intensively reacting cell clusters were found along with nonreactive cells. The antiserum was also slightly cross reactive with the respective human antigen, but the cross-reactivity of an antiserum prepared against human prostatic secretory acid phosphatase with canine prostatic acid phosphatase was far more pronounced. PMID- 3658825 TI - Relationship of testosterone, sex hormone binding globulin, and calculated free testosterone to subsequent clinical progress in patients with carcinoma of the prostate treated with bilateral orchidectomy or estrogens. AB - The concentration in serum of testosterone, sex hormone binding globulin (SHBG), and albumin has been measured, and from these measurements free testosterone has been calculated in 75 patients with carcinoma of the prostate treated with either bilateral orchidectomy, stilbestrol, or estramustine phosphate (Estracyt). After exclusion of 3 noncompliant patients, total testosterone did not differ significantly between treatments, but free testosterone was lower in estrogen treated patients (5.9 +/- 0.9 (SEM) pmol/l, n = 28) compared with the orchidectomized patients (23 +/- 1.4 pmol/l, n = 44) (P less than 0.001); all of the estrogen-treated patients falling in the lower third of the range of the orchidectomized patients. Free testosterone did not change systematically during several years of treatment and there was no evidence of a rise with clinical deterioration. In the 33 patients with metastatic cancer treated with orchidectomy, the third with the lowest free testosterone or total testosterone showed a better survival over 2 years than the two-thirds with higher free or total testosterone; thereafter, the advantage was lost. PMID- 3658826 TI - Interaction of sex steroids and prolactin on phosphatases, transaminases, and citric acid in the ventral prostate of male albino rats. AB - The interaction of androgens, testosterone propionate (TP), and dihydrotestosterone (DHT) with prolactin (PRL) and estradiol-17 beta (E2) on phosphatases, transaminases, and citric acid were studied in the ventral prostate of prepubertal and adult intact and castrated rats. None of the secretory products studied were affected by androgens or their combinations with E2/PRL in prepubertal rats except for the increase observed in organ weight and DNA content. However, in adults the hormonal combinations produced some significant changes. Among the secretory products, phosphatases, glutamate oxaloacetic transaminase (GOT), and citric acid increased significantly in adult rats after the administration of TP/DHT. Glutamate pyruvic transaminase (GPT) required PRL along with TP/DHT to show an appreciable increment in intact adult rats. The synergistic effect of PRL with androgens was observed in the adult ventral prostatic secretory acid phosphatase and citric acid. Unlike PRL, E2 in combination with androgens produced an antagonistic effect in intact adult rats, which was well pronounced in the case of prostatic weight, DNA content secretory acid phosphatase, and citric acid. None of the androgens or their combination with PRL produced any significant change in DNA content compared to intact controls. PMID- 3658827 TI - Quantal relationship between prostatic dihydrotestosterone and prostatic cell content: critical threshold concept. AB - The shape of the prostatic dihydrotestosterone (DHT) dose vs prostatic cell number response curve can be used to determine if the androgen-induced increase in prostatic cell number occurs as a continuous graded process increasing with all levels of prostatic DHT, or whether the process is quantal, beginning to occur only when a critical threshold of prostatic DHT is reached. To make this determination, castrated-adrenalectomized rats, castrated rats given no treatment, and castrated rats given testosterone-filled silastic implants of varying lengths were used to construct such a prostatic DHT dose/prostatic cell number response curve ranging from undetectable to pharmacologically high levels of prostatic DHT. The shape of this dose-response curve was found not to be continuously hyperbolic, but instead, to be discontinuously sigmoidal. This demonstrates that, in the rat, androgen-induced increase in prostatic cell number occurs as a quantal process which can only begin when the concentration of prostatic DHT is above a critical threshold value (ie, 0.4 ng/10(8) cells for the rat ventral prostate). Thus, in order to completely prevent this androgenic stimulation of prostatic cell number, the prostatic DHT level has to be lowered to below this critical threshold but does not have to be completely eliminated. PMID- 3658828 TI - Percutaneous transperineal placement of gold 198 seeds for treatment of carcinoma of the prostate. AB - Thirty-one patients have been treated for carcinoma of the prostate with 198Au seeds placed transperineally using transrectal ultrasonic guidance. Twenty patients have been followed postoperatively for periods ranging from 3 to 31 months, with an average follow-up time of 12 months. Cumulative dose of radiation to the prostate calculated by dosimetry was either 9,000 rads or 15,000 rads. Serial transrectal ultrasound examinations performed on these patients showed a decrease in prostate size in all patients within 6 months of treatment, with a statistically significant decrease observed between the third and sixth months. No significant difference in amount or rate of tumor regression was noted when tumor stage and grade were correlated to volume decrease after treatment. Patients who received the larger doses of radiation (15,000 rads) showed a significantly greater rate of decline in prostatic volume than those who received 9,000 rads. Seven patients underwent prostate biopsy between 12 and 18 months after treatment; six biopsies showed residual tumor. Complications after treatment included urinary retention because of prostatic edema (three), radiation urethritis (three), and rectal ulceration (one). Transperineal placement of 198Au is well tolerated and offers an alternative to external beam radiation for treatment of carcinoma of the prostate. PMID- 3658829 TI - Stress stimuli-induced histopathological changes in the prostate: an experimental study in the rat. AB - To elucidate a suggested relationship between stress stimuli and prostatis, a histological study on the genital organs of seven rats was performed. The specimens were histopathologically examined after a 10-day period, during which the rats had been submitted to standardized stress stimuli, and compared with corresponding organs from a control group of seven male rats. Inflammatory histopathological changes and large numbers of inflammatory cells were seen in the prostatic glands of all rats submitted to the long-term stress stimuli. The findings agreed with those from the prostatic glands of human males with prostatis. No corresponding changes were observed in the control group. There was no evidence indicating a bacterial origin. The results indicate a connection between stress stimuli and prostatitis. PMID- 3658830 TI - Definitive radiotherapy of prostatic cancer: the Norwegian Radium Hospital's experience (1976-1982). AB - During the years 1976 to 1982 definitive curatively aimed radiotherapy to the primary tumor was given to 53 patients with prostatic cancer confined to the true pelvis (T0, 2; T1-2, 19; T3, 24; T4, 8; N0, 18; N+, 2; Nx, 33); all patients were of the Mo-category. The pelvic lymph nodes received a total dose of 2 Gy X 25 by means of an anterior and posterior radiation field. The prostatic gland was irradiated by an additional booster dose of 2 Gy X 10 given to a perineal field. Twenty-four patients have relapsed after their prostatic radiotherapy, only three of them within the irradiated area. For the patients with T0-T2 tumors, the 5 year crude survival was 69%, whereas it was only 37% for patients with T3 tumors. Thirty-five patients developed intestinal (26 patients) and/or urogenital (23 patients) radiation side effects. In three patients a colostomy had to be performed owing to rectal stricture or fistula. The poor survival after radiotherapy in the present series is probably due to a high incidence of unrecognized pelvic lymph node metastases. In the future only prostatic cancer patients without pelvic lymph node spread will be considered candidates for definitive radiotherapy. An optimal radiation technique is mandatory in order to avoid major radiotherapy-induced toxicity. PMID- 3658831 TI - Immunization, abrasion, and sunburn as localizing factors in chicken pox. AB - Three children had striking localization of varicella lesions to skin overlying a diphtheria-pertussis-tetanus toxoid (DPT) immunization injection site, a facial abrasion, and a sunburn of the trunk, respectively. Presumably, during the viremic stage of varicella, the virus passed from damaged blood vessels into the skin. A disabling myalgia in the thigh at the DPT site in one child may also have been the result of localization of the varicella virus in the muscle during the inapparent viremic stage. This suggests that an injection given during an occult viremia could trigger an unexpected reaction at the site. PMID- 3658832 TI - Recurrent cutaneous vasculitis in cystic fibrosis. AB - We treated a patient with cystic fibrosis who experienced recurrent episodes of palpable purpura and arthralgias associated with exacerbations of her pulmonary disease. Skin biopsy demonstrated the classic findings of leukocytoclastic vasculitis, and C3 deposits were detected in the dermal blood vessels. Chronic bacterial infection and antibiotics are possible sources of antigen involved in immune complex formation in patients with chronic lung diseases. PMID- 3658833 TI - Sucking pads (sucking calluses) of the lips in neonates: a manifestation of transient leukoedema. AB - The clinical and histologic features of sucking pads in neonates are clearly different from sucking blisters and leukoedema, both of which may also be present in neonates. We propose that the condition is due to a combination of intracellular edema and hyperkeratosis. Perhaps the alternative term of sucking calluses is more appropriate. The intracellular edema is ascribed to passive diffusion of fluid, presumably saliva, into the cells, while the hyperkeratosis is regarded as an adaptive phenomenon to friction during sucking. PMID- 3658834 TI - Kawasaki disease: new etiologic clues and advances in therapy. PMID- 3658835 TI - Alopecia areata symposium. PMID- 3658836 TI - Diaper dermatitis and superabsorbant diapers. PMID- 3658837 TI - Treatment of pediculosis capitus and scabies. PMID- 3658838 TI - Folliculitis ulerythematosus reticulata: a report of four cases and brief review of the literature. AB - Folliculitis ulerythematosus reticulata (FUR) is an uncommon genodermatosis best classified as one of the keratosis pilaris atrophicans group of disorders. It is characterized by erythema and follicular plugging of the cheeks that evolves into honeycomb atrophy. Associated cutaneous and visceral abnormalities can occur. This report describes four patients with FUR, one with an unaffected twin, a finding not previously reported. The significance of an early and accurate diagnosis is emphasized. PMID- 3658839 TI - The yellow nail syndrome in an 8-year-old girl. AB - Yellow nail syndrome is characterized by the triad of abnormally shaped, slow growing, yellow nails, lymphedema, and chronic respiratory tract disease. Nail changes may precede the other features by several years. The syndrome is most often seen in middle-aged individuals and has not been documented in children under age 11 years. We cared for an 8-year-old girl with this disorder. PMID- 3658840 TI - Acute laryngeal obstruction in junctional epidermolysis bullosa. AB - A boy with junctional epidermolysis bullosa died from acute laryngeal obstruction at the age of 29 months, having been hoarse since early infancy. Post mortem studies showed gross narrowing of the laryngeal airway by cystic dilatations of the ducts of the seromucinous glands, and replacement of the laryngeal epithelium by oedematous granulation tissue. Laryngeal involvement appears to occur not infrequently in junctional epidermolysis bullosa, and contributes to its considerable mortality. PMID- 3658841 TI - Pulmonary vascular changes associated with prolonged prostaglandin E1 treatment. AB - Prostaglandin E's (PGEs) are used therapeutically in newborn infants to maintain an open ductus arteriosus when there is obstruction to systemic or pulmonary arterial blood flow. These prostaglandins have been shown to have other systemic physiologic effects, such as vasodilation, inhibition of platelet aggregation, and enhancement of chemotactic-factor-mediated polymorphonuclear leukocyte infiltration, with resultant loss of lysosomal granules and possibly the generation of free radicals. We have recently seen previously unreported vascular lesions in 3 infants with hypoplastic left heart syndrome treated with usual therapeutic doses of PGE1 for prolonged periods. At autopsy, pulmonary vascular changes reflecting increased flow were present in each infant. One infant had a necrotizing vasculitis, sometimes associated with infarcts, in the lungs and in small muscular arteries in other organs. The form and severity of the vascular changes appear to be related to the duration of PGE1 administration. PMID- 3658842 TI - Liver fibrosis in carbamoylphosphate synthetase deficiency. AB - Structural sequelae of inherited defects of the urea cycle in general, and their liver pathology in particular, are still not well understood. This holds true especially for the possible late effects in involved organs of patients now surviving longer because of more effective therapy. Some urea cycle defects may result in chronic and progressive liver damage, as has been reported. A peculiar type of liver fibrosis was observed in a girl with carbamoylphosphate synthetase deficiency, who survived for 1 year and 7 months. Hepatic fibrosis, or even cirrhosis, has been observed in argininosuccinic aciduria. Long-term survivors with urea cycle disorders may form a group at risk for the development of chronic fibrosing liver disease. PMID- 3658843 TI - Infantile fibrosarcoma of femur. AB - We describe the clinical presentation and pathological features of an infantile fibrosarcoma of the femur that occurred in a 3 1/2-month-old male infant. The tumor grew rapidly, reaching large size within a few months, finally requiring amputation. The tumor was poorly circumscribed, infiltrating the adjacent soft tissue extensively. Microscopically, it was a highly cellular tumor composed of immature-appearing spindle-shaped cells. Ultrastructural study revealed mesenchymal cells with fibroblastic and histiocytic differentiation. PMID- 3658844 TI - Gonadoblastoma: unusual presentation in a patient lacking persistent mullerian ducts. AB - We report a patient with a disorder of sexual differentiation who presented with a 46,XY karyotype, absent internal Mullerian ducts, a vaginal pouch, hypospadias, and bilateral cryptorchidism with a gonadoblastoma in one testis. A human chorionic gonadotropin stimulation test and tissue 5-alpha-reductase and androgen receptor assays were normal. Except for the absence of internal Mullerian ducts, this patient most closely resembles the disorder of dysgenetic male pseudohermaphroditism (DMP). On this basis, we hypothesize that the internal Mullerian ducts in DMP may manifest anywhere along a spectrum that extends from normal to complete absence of structures depending on the degree of gonadal dysgenesis. This case also illustrates the importance of testicular biopsy in patients with dysgenetic testes because of the high likelihood of germ cell neoplasms in these gonads. PMID- 3658845 TI - Propranolol pharmacokinetics during the menstrual cycle. AB - The pharmacokinetics of propranolol during menstruation and in the mid menstrual cycle have been studied in nine young women taking a single 80 mg tablet on each occasion. There were wide between-individual differences in the serum concentration at any given time (4-5 fold at peak concentrations) but the serum concentration time curves within individuals showed only mild variations. The differences between the average pharmacokinetic parameter estimates for the group did not differ significantly between the two periods of study. PMID- 3658846 TI - Fatal intraperitoneal haemorrhage of hepatic origin. AB - Eight cases of fatal haemoperitoneum due to liver bleeding are reported. Two followed trauma (liver biopsy and cholecystectomy). The remaining six were spontaneous, 5 being due to malignant liver disease. The sixth case due to polycystic liver disease appears to be unique. The aetiology and importance of spontaneous hepatic bleeding is discussed. PMID- 3658847 TI - Blood eosinophilia and ulcerative colitis--influence of ethnic origin. AB - Blood eosinophilia is an alleged manifestation of ulcerative colitis. To investigate this association and to determine the effect of race, the occurrence of eosinophilia in all 44 Asians presenting between 1968-84 was compared to that in an age- and sex-matched group of indigenous white Caucasian patients presenting over the same period. Nineteen (43%) of the Asians presented with an eosinophilia compared to only 3 Caucasians (P less than 0.0001); similar numbers (14 and 13) in both groups demonstrating transient eosinophilia on occasions during maintenance treatment although not related to clinical relapse. A control group of Asians with other disorders not known to be associated with eosinophilia did not manifest this abnormality on presentation although 3 patients did so transiently during out-patient observation. Eosinophilia is a feature of ulcerative colitis in many Asians possibly due either to an unusual racial response to ulcerative colitis or as a reflection of the underlying pathogenesis of their disease. We have not confirmed earlier suggestions of such a feature in white Caucasians. Eosinophilia occurring during maintenance treatment in both groups may be drug-related. PMID- 3658848 TI - Aluminium phosphide poisoning: a prospective study of 16 cases in one year. AB - Sixteen patients suffering from aluminium phosphide poisoning were treated during the year from January 1985 to December 1985. These accounted for approximately half the total number of cases of acute poisoning. Profuse vomiting, pain in the upper abdomen and shock were the most common presenting features. Six patients succumbed to their illness. Analysis of various prognostic factors revealed that ingestion of 'unexposed' tablets of aluminium phosphide taken from a freshly opened bottle was associated with a greater risk of fatal outcome. Aluminium phosphide poisoning has become an important matter of public health in parts of India. PMID- 3658849 TI - Internal carotid artery occlusion in a young female with mitral valve prolapse. AB - A healthy 28 year old housewife presented with sudden right hemiplegia and aphasia. No predisposing factors could be ascertained apart from posterior cusp mitral value prolapse on two dimensional echocardiography. Extensive investigations confirmed the presence of cerebral infarction and persistent occlusion of the left internal carotid artery near its origin. PMID- 3658850 TI - Transient atrial fibrillation in hypertensive patients with thiazide induced hypokalaemia. AB - During the previous 34 months, 3 hypertensive patients on long-term thiazide therapy were admitted to the medical department, Mubarak Hospital, Kuwait, with atrial fibrillation (AF) and hypokalaemia. They received potassium chloride by intravenous infusion, followed by oral therapy with reversion to sinus rhythm. There were no clinical, electrocardiographic, radiological, or echocardiographic signs of cardiac or pericardial disease, and the other usual cases of AF were also excluded. The contribution of thiazide-induced hypokalaemia to the occurrence of AF in our patients is discussed. PMID- 3658851 TI - A combination of cranial and peripheral nerve palsies in infectious mononucleosis. AB - A 44 year old woman presented with bilateral brachial neuritis and an isolated Bell's palsy. Subsequently she was found to have infectious mononucleosis. The association of cranial and brachial neuropathy has not previously been reported. Without any specific drug therapy she recovered completely within 5 months. PMID- 3658852 TI - Pericarditis with pericardial effusion complicating chickenpox. AB - A girl with chickenpox is presented. She developed arthritis, pericarditis with pericardial effusion and meningism during the course of her illness. Pericarditis is an unusual complication of this disease, and in this instance was associated with characteristic electrocardiographic changes. Aspects of her case history are discussed. PMID- 3658853 TI - Intussusception in intestinal lymphoma: the role of colonoscopy. AB - Intussusception is a well known complication and sometimes the presenting symptom of intestinal lymphoma. The final diagnosis in most patients is made by surgery. We report a 12 year old boy with intussusception in whom the diagnosis was established by colonoscopy and surgery was avoided. PMID- 3658854 TI - Sarcoidosis presenting as multiple pulmonary nodules and nephrotic syndrome. AB - A 56 year old man presented with thrombophlebitis, nephrotic range proteinuria and multiple pulmonary nodules. A renal biopsy showed membranous glomerulonephritis, and after a thoracotomy a diagnosis of sarcoidosis was established. A pulmonary nodular pattern is unusual in sarcoidosis and is often mistaken for malignant disease. The association of this type of pulmonary involvement and membranous glomerulonephritis as the presenting form of sarcoidosis has not previously been described. PMID- 3658855 TI - Anorexia nervosa and pancreatic ascites. AB - Acute alcoholic pancreatitis was undiagnosed in a patient with anorexia nervosa who subsequently developed pancreatic ascites and oedema, wrongly attributed to protein malnutrition alone. She became hyperphagic in an attempt to reverse the malnutrition and hence the abdominal swelling, indicating that the goal of attaining a thin shape was the major determinant of the eating disorder in this patient. Measurement of ascitic fluid amylase concentration should be carried out in all patients with unexplained ascites. PMID- 3658856 TI - Achieving a balance. PMID- 3658857 TI - Acute crescentic glomerulonephritis developing during warfarin therapy. PMID- 3658858 TI - Asymptomatic Graves' disease during lithium therapy. PMID- 3658859 TI - OTC medicines--are they 'open to criticism'? PMID- 3658860 TI - Scrotal pain. PMID- 3658861 TI - Abdominal tuberculosis in East Birmingham--a 16 year study. AB - Abdominal tuberculosis, although rare, occurs mainly in immigrants from the Indian subcontinent. Such people comprise 13.5% of our local population and contributed 90% of a series of 72 patients presenting in the last 16 years; a local disease incidence of 1:6000 for Asian immigrants. Men and women were equally affected, but on average women were much younger. Diagnosis was made from one month to 10 years after immigration. No clinical feature was diagnostic, but abdominal pain, night sweats and weight loss occurred in more than half the patients. The erythrocyte sedimentation rate (ESR) was elevated in 95% and no patient tested had a negative Mantoux test. In 20 patients diagnosis was by clinical suspicion and response to therapeutic trial. In 52, including 39 who had a laparotomy, histological and culture material was obtained but these patients fared no better. Only one organism was resistant (to streptomycin) and rapid response to chemotherapy was the rule. Successful outcome was not related to the type of presentation, operative findings or specific chemotherapeutic agents. We would suggest that in Asians presenting with difficult-to-diagnose abdominal symptoms accompanied by malaise, raised ESR and a positive Mantoux test, a therapeutic trial of anti-tuberculous therapy should precede diagnostic laparotomy. PMID- 3658862 TI - Gastritis and gastric campylobacter-like organisms in patients without peptic ulcer. AB - Gastric biopsy specimens were obtained from 83 patients without peptic ulcer disease and analysed histologically. Culture and serological studies were done on the last 64 patients. The patients were divided into two age groups (young and old groups.) In 34 patients with chronic superficial gastritis, gastric campylobacter-like organisms (GLCO) were identified histologically in 91% and grown on culture in 88%: antibody to GCLO was detected in 81%. No age-related difference in the prevalence of the organism was demonstrated. In the 23 patients with atrophic gastritis (all elderly), presence of the organisms appeared to be related to the presence of an inflammatory cell infiltrate into the gastric mucosa. These figures for the prevalence of the organism in this selected group of patients are similar to those reported in previous studies of unselected patients which included those with peptic ulcer. This suggests that GCLO is unlikely to be causally related to peptic ulcer. PMID- 3658863 TI - The breast pain clinic: a rational approach to classification and treatment of breast pain. AB - Three hundred and fifty women complaining of breast pain symptoms of sufficient severity to interfere with their normal lifestyle were reviewed in a special breast pain clinic over a 5 year period. Seventy-two patients (21%) had spontaneous resolution of breast pain and they required reassurance only before discharge. Of the remaining 278 patients, accurate classification of breast pain syndromes was achieved in 89%, the commonest syndrome being cyclical breast pain which accounted for 54% of the women followed up. The remaining womens' breast pain was classified as trigger zone (14%), continuous (8%), Tietze's disease (5%), spinal root (4%), duct ectasia (4%) and psychological depression (2%). In the remaining 25 patients (9%) the breast pain could not be classified. The experience from this clinic is that a majority of women complaining of severe breast pain symptoms can be accurately classified and appropriate therapy instituted. PMID- 3658864 TI - Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur. AB - We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics. PMID- 3658865 TI - Colobomata associated with Noonan's syndrome. AB - A patient with Noonan's syndrome and fundal colobomata in both eyes is described. To our knowledge, this is the first report of the association of colobomata with Noonan's syndrome. Although the patient had poor sight since early childhood and dyspnea on exertion as a teenager, the diagnosis of Noonan's syndrome was not made until early adulthood. We hope this report will encourage recognition of this syndrome and its implications at an earlier stage. PMID- 3658866 TI - Systemic lupus erythematosus presenting with cardiac tamponade due to a haemorrhagic pericardial effusion. AB - A 14 year old girl presented with cardiac tamponade due to a haemorrhagic pericardial effusion. Systemic lupus erythematosus was diagnosed. Pericardial stripping was performed due to recurrence of the effusion despite pericardiocentesis and steroid therapy. PMID- 3658867 TI - A giant thyroid cyst. AB - The case report describes a female of 82 who presented with a very large goitre caused by a solitary thyroid cyst that was successfully treated by aspiration. PMID- 3658868 TI - Successful termination of combined rapid atrial flutter/fibrillation and ventricular tachycardia by intravenous sotalol. AB - Combined rapid atrial flutter/fibrillation and recurrent ventricular tachycardia occurred in an 82 year old man with acute myocardial infarction. Both arrhythmias were promptly terminated by intravenous sotalol, suggesting another use for this unique drug in the absence of hypotension, heart block or cardiac failure. PMID- 3658869 TI - Granulomatous mastitis--a rare cause of erythema nodosum. AB - Granulomatous mastitis is a recently described, rare condition of unknown aetiology. It occurs in young, parous women as a tender extra-areolar breast lump and therefore needs to be differentiated from carcinoma. Histologically, a discrete granulomatous lobulitis is seen and because of morphological similarities to granulomatous thyroiditis it has been suggested it may be immunologically mediated. We present a patient in whom granulomatous mastitis presented with periarthritis and erythema nodosum, an association not previously described. PMID- 3658870 TI - Staphylococcus aureus endocarditis presenting as acute scrotal pain. AB - A previously healthy 17 year old boy had Staphylococcus aureus endocarditis presenting as acute scrotal pain. There was no trauma or evidence of scrotal or epididymal infection. The pain subsided after therapy for endocarditis was started. PMID- 3658871 TI - Benylin dependence, metabolic acidosis and hyperglycaemia. AB - We describe a patient who had consumed large quantities of a proprietary cough mixture containing diphenhydramine, ammonium chloride and sodium citrate (Benylin expectorant) daily for several months and subsequently presented with confusion, marked metabolic acidosis and non-ketotic hyperglycaemia. PMID- 3658872 TI - Severe hypokalaemia from kaolin and morphine abuse. AB - A 34 year old man, registered disabled as a result of muscle weakness, was admitted to hospital because of increasing weakness. He had profound hypokalaemia and admitted to taking up to 1400 ml of kaolin and morphine mixture daily. After considerable potassium replacement muscle power recovered completely. The hypokalaemia is likely to have been caused by the combination of liquorice extract and sodium bicarbonate in kaolin and morphine. PMID- 3658873 TI - Technology and the doctor/patient relationship. PMID- 3658874 TI - Bilateral ballism induced by ibuprofen in a schizophrenic patient. PMID- 3658875 TI - Liquid methionine as a drinking water supplement for broiler chicks. AB - Three experiments were conducted to study the effect of a liquid methionine source supplied through the water on chick performance. Methionine at .025, .05, and .075% (Experiment 3, only) from the liquid source were added to the drinking water and compared with .05 and .075% (Experiment 2 and 3) dry methionine supplementation in a methionine-deficient basal. A dry DL-methionine was used for diet supplementation in Experiments 1 and 2, and both liquid and dry sources were used in Experiment 3. Day-old (Cobb) feather-sexed broiler chicks received these treatments for 3-week periods. Mortality was not significantly altered by any of the treatments. In two of the three experiments neither feed nor water intake was significantly affected by treatment. In Experiment 2, control birds consumed significantly less feed than other groups, and daily water intake of birds that received .05% supplemental feed methionine was elevated above that of other regimens. Fecal moisture and fecal sodium levels were not elevated above those measured from the unsupplemented basal. In all three studies comparable levels of methionine from feed or water supported equivalent body weights. Within the limits of these tests, liquid DL-methionine provided in the drinking water was effectively assimilated by broiler chicks and increased total methionine intake, which increased growth. PMID- 3658876 TI - Performance and physiological profiles of high dietary zinc and fasting as methods of inducing a forced rest: a direct comparison. AB - Equal periods of fasting or high zinc feeding as a means of inducing a forced rest were examined. Single Comb White Leghorn hens (60 weeks of age) were fasted (F) or fed a layer diet containing 20,000 ppm zinc (Zn) for either 4 or 10 days in a 2 X 2 factorial arrangement of treatments. Feed intake was markedly depressed in the first day of high zinc feeding and averaged 10.7 and 6.1 g/hen day during the 4 or 10 days of Zn feeding. Body weight losses of hens fasted or fed high dietary zinc were not significantly different. Egg production rate was highest for hens treated 10 days (both F and Zn) in the immediate weeks following the rest. However, over the entire 6-month experimental period, there were no significant differences among the four treatments. Ovary and oviduct regressed similarly in F and Zn hens. Tissue zinc concentration greatly increased during zinc feeding, especially in the pancreas, and rapidly returned to normal upon refeeding a normal layer diet. Fasting also caused a substantial increase in tissue zinc. The results show that the effectiveness of zinc as a forced-resting agent for hens is related to changes in feed intake. PMID- 3658877 TI - Effect of antibiotics on tissue trace mineral concentration and intestinal tract weight of broiler chicks. AB - Two experiments were conducted with broiler-type chicks to determine the effect of antibiotics on intestinal weight and kidney, bone, and liver trace mineral concentrations. All antibiotics were in diets at the manufacturers' recommendations. Feed intake of experimental diets (antibiotics or non-treated control) was restricted to 90% of that of an additional group fed the control diet ad libitum. Feed intake, weight gain, and feed efficiency were not affected (P greater than .10) by dietary treatments. Virginiamycin decreased intestinal weight an average of 19% as compared with 14% for bambermycins and oxytetracycline, 6% for Zn bacitracin, and 18% for lincomycin. Except for Zn bacitracin, all antibiotics produced intestinal weights which were lower (P less than .01) than those of controls. Only virginiamycin increased (P less than .01) kidney Mn concentration. Bone Mn concentration was greater (P less than .01) for virginiamycin than bambermycins or oxytetracycline in Experiment 2, and greater (P less than .05) for lincomycin than virginiamycin or Zn bacitracin in Experiment 2. Feeding Zn bacitracin increased (P less than .01) bone Zn concentration whereas feeding virginiamycin caused a decline (P less than .05) in bone Zn concentration in Experiment 1. There were no differences in Cu, Zn, or Fe concentrations in liver or kidney. PMID- 3658878 TI - Effect of ammonium chloride ingestion on Eimeria acervulina-infected chicks fed excess copper. AB - Four experiments were conducted with broiler chicks to investigate the effect of dietary NH4Cl on gain, feed efficiency, duodenal pH, and liver Cu concentration of Eimeria acervulina-infected chicks. Experimental coccidial infection reduced chick gain, feed efficiency, and duodenal pH, but it increased liver Cu concentration in chicks fed excess Cu. Ammonium chloride had no effect on gain, feed efficiency, liver Cu concentration, or on duodenal pH. PMID- 3658879 TI - Amelioration of ethionine toxicity in the chick. AB - Several chick bioassays were conducted to evaluate means of ameliorating ethionine toxicity. Supplementing a corn-soy diet marginally deficient in sulfur amino acids (methionine + cystine) with .075% D,L-ethionine reduced weight gain in 8-day-old chicks by 70% compared to gains of unsupplemented controls. Dietary addition of .50% DL-methionine prevented reduction in weight gain and feed intake resulting from ethionine supplementation whereas feeding supplemental L-cystine was without effect. Supplementation of the ethionine-containing diet with either choline or betaine ameliorated the growth depression, although neither compound was able to completely overcome the toxic effects of ethionine. Dietary ethionine did not affect plasma levels of free methionine or cystine but did increase plasma free glycine 6-fold. Dietary addition of .50% DL-methionine caused normalization of plasma glycine levels whereas it elevated plasma methionine concentration. Although results suggested the possibility of ethionine-induced serine or threonine deficiency, dietary additions of .75% L-serine or .75% L threonine failed to improve chick weight gain. These studies suggest that ethionine, in addition to affecting transsulfuration and transmethylation activity may exert specific effects on certain amino acids in tissue pools. PMID- 3658880 TI - Histological evaluation of the vascular system for the severity of atherosclerosis in hyper and hypotensive male and female turkeys: comparison between young and aged turkeys. AB - Relationships among age, blood pressure, and atherosclerosis were studied in turkeys genetically selected for high and low systolic blood pressure ranging in age from 2 days to 104 weeks. Relationships between sex and atherosclerosis were studied only at 104 weeks of age. Abdominal aortas were examined in all birds in each age group. The left and right internal, external, and common carotid arteries, cranial and caudal thoracic aortas, area of coeliac orifice, sciatic junction, left and right sciatic arteries, left and right coronary arteries, and left and right deep branches of the coronary arteries were examined in the 104 week-old group. Mean abdominal aortic plaque scores for the different age groups increased linearly to the age of 12 weeks; after this time scores reached a plateau. Except for the first and last time period, the hypertensive group of males showed a significantly greater abdominal aortic plaque score than the hypotensive group. The right sciatic artery was the only other blood vessel in the 104-week-old group that had a significantly greater plaque score in the hypertensive line when compared with the hypotensive line. In the 104-week period, only the left and right sciatic arteries showed significantly higher plaque scores in the males than in the females. Also, only the male turkeys showed an increase in plaque scores with a concomitant rise in systolic pressure. In 104-week-old females there was no evidence of intimal change in either the left and right internal carotids, left and right common carotids, cranial thoracic aorta, or the right coronary artery. The hypertensive line had significantly greater blood pressure and greater ventricular weight, length, and sagittal width than the hypotensive line. The 104-week-old turkeys had more lipid staining material within the plaque than the younger birds, and calcification was evident in two of the older turkeys. PMID- 3658881 TI - Influence of 12 hours of sound stimuli on gonad development and plasma luteinizing hormone in Japanese quail (Coturnix coturnix japonica) exposed to 6 hours of daily light. AB - Two experiments were conducted to determine the effects of sound stimulation on gonadal growth in male and female Japanese quail (Coturnix coturnix japonica) maintained under a photoperiod of 6 hr light and 18 hr dark (6L:18D) from 1 to 12 weeks of age (Experiment 1) or 1 to 14 weeks of age (Experiment 2). The quail were split into three sound environments as follows: 1) 12 hr of radio music (RS) beginning 1 hr before lights off; 2) 12 hr of vocalization from a breeding colony of quail (QV) beginning 1 hr before lights off; 3) no sound stimulation (NS). In Experiment 1, birds were killed at 8, 10, and 12 weeks of age and in Experiment 2, they were killed at 8, 10, 12, and 14 weeks of age. There were no significant differences in tests weights of the three groups at 8 and 10 wk of age (Experiment 1), but those of the RS and QV groups were larger (P less than or equal to .05) than those of the NS group at 12 weeks. Tests in the NS group appeared to grow between 8 and 10 weeks, then regress. There were no differences in testis weights at 8 and 10 weeks of age in Experiment 2. At 12 weeks, testes in the RS group were larger (P less than or equal to .05) than those of the other two groups and by 14 weeks testes of both sound stimulated groups were larger than the NS group and were also different from each other.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658882 TI - Influence of corticosterone infusion on plasma levels of catecholamines, thyroid hormones, and certain metabolites in laying hens. AB - Corticosterone was infused continuously through subcutaneously implanted mini osmotic pumps into laying White Leghorn hens at the rate of 30 micrograms/hr for 14 or 28 days. In both groups receiving corticosterone, plasma levels of glucose and triglycerides were not altered significantly. Circulating levels of cholesterol and free fatty acids increased significantly following both 14 and 28 day infusions of the hormone. Corticosterone treatment for 28 days produced significant increases in plasma levels of thyroxine (T4) and triiodothyronine (T3). However, following the 14-day corticosterone infusion, only T3 showed significant increase. The T3:T4 ratio in both groups of corticosterone-infused hens was significantly higher than in control hens. The concentration of plasma epinephrine showed no significant response to corticosterone treatment, while norepinephrine increased significantly following both periods of treatment. PMID- 3658883 TI - Research note: differences in major histocompatibility complex gene frequencies associated with feed efficiency and laying performance. AB - Associations between egg production and feed efficiency and the genes of the major histocompatibility complex (MHC) of the chicken were investigated. Breeders were selected on the basis of indexes incorporating information on body weight and egg mass, with or without feed consumption information. Over 1,000 progeny were serotyped for the erythrocyte antigen B (Ea-B) after the 6th generation of selection. The B2 and B13 haplotypes accounted for over 75% of the Ea-B gene pool in all lines. Comparing each index-selected line with the control B2 significantly increased in frequency at the expense of B13. This study further implicates MHC-linked genes as important in the physiology of growth and reproduction in the chicken. PMID- 3658884 TI - Research note: nutritive value of poultry by-product meal. 3. Incorporation into practical diets. AB - Studies were conducted to investigate the value of poultry by-product meal (PBPM) when incorporated into practical diets at low levels (5 to 10%). Samples from one plant, a Monday morning sample (fresh broiler waste) and a Friday afternoon sample (broiler and hatchery waste and dissolved air flotation sludge) were compared to a sample from another plant (fresh broiler waste). When the samples were incorporated at the 5% level into isocaloric, isonitrogenous corn-soy meal based practical diets, no differences in 20-day gain or feed efficiency could be detected between the samples or in comparison with the effects of feeding an all plant-based control diet in two experiments. Chick growth and feed efficiency were significantly depressed when PBPM was incorporated into the diet at the 10% level. PMID- 3658885 TI - Selection for body weight at eight weeks of age. 19. Influences of heterozygosity and dwarfism on early egg production and associated traits. AB - Body weight, body components, and reproductive traits were compared during the first 60 days after onset of lay in pullets from lines of White Plymouth Rocks selected for high or low juvenile body weight, their reciprocal F1 crosses, an F2 cross, and dwarfs from the parental lines. Absolute and relative body weight gains were less for dwarf than for nondwarf pullets in the high weight line. In the low weight line, there were differences in absolute but not relative weight gains. Among nondwarfs, both relative and absolute changes in body weight during the first 60 days of lay were similar for crosses and the high weight parental line, and considerably less for the low weight parental line. Numbers of ovulation were the same for the crosses and the high weight parental line, however, more normal eggs were produced by F1 crosses than either parental line. Rate of production was influenced mainly by variation in body weight at onset of lay in the high weight nondwarfs and low weight dwarfs, and by age at first egg in low weight nondwarf pullets. None of the independent variables had a significant association with normal egg production in crosses and high weight dwarf populations. PMID- 3658886 TI - Effect of ionophorous anticoccidials on invasion and development of Eimeria: comparison of sensitive and resistant isolates and correlation with drug uptake. AB - Prophylactic levels of three ionophorous antibiotics, monensin, salinomycin, and lasalocid, were administered to groups of chickens and turkeys. All three ionophores markedly inhibited invasion of cecal tissues by sporozoites of ionophore-sensitive (IS) Eimeria tenella. Monensin and salinomycin also reduced invasion in turkeys by sporozoites of E. adenoeides, but lasalocid only minimally inhibited invasion. Invasion of ceca of monensin-medicated chickens was significantly greater by sporozoites of ionophore-resistant (IR) E. tenella than of the IS isolate. Concomitant experiments showed significant differences in [14C]monensin accumulation among IS and IR isolates of E. tenella. The decreased uptake of monensin by the IR isolates appeared to be accompanied by a decrease in responsiveness to the activity of monensin as well as to two other ionophores, salinomycin and narasin in cell culture. The amount of monensin, salinomycin or narasin required to inhibit development of E. tenella by 50% was 20 to 40 times higher for the IR isolates than for the IS ones. Collectively, the data suggest that differences in ionophore accumulation by IS and IR isolates of E. tenella might reflect differences in membrane chemistry and that these differences are responsible for the expressions of resistance that were observed in these studies. This expression of resistance appears to be common to all ionophores tested. PMID- 3658887 TI - Citrinin toxicity in young chicks. AB - Two experiments were conducted to demonstrate the capacity of citrinin to cause dose-related increases in water consumption and urine excretion. In Experiment 1, chicks 24 days old were fed mixtures of untreated and inoculated corn containing citrinin to provide 0, 50, 100, 150, 200, and 250 micrograms of the toxin per gram of blended corn. The corn was fed for 4 hr, and water intake and urine excretion were measured. Chicks consumed 0, 1.23, 2.37, 3.68, 4.26 and 5.44 mg citrinin from the respective treatments. Compared with chicks consuming no citrinin, water intake and urine excretion of treated chicks increased (P less than .05) when chicks consumed 3.68 mg or more citrinin. Measures of the difference between water intake and urine excretion were similar for all treatments except for chicks consuming 3.68 mg citrinin; for those chicks the difference was significantly greater (P less than .05) than for chicks consuming 1.23 mg citrinin. In Experiment 2, inoculated corn was heated in a microwave oven for 1, 2, 8, and 16 min. Temperatures of the heated corn samples, when removed from the oven, were 76 C, 100 C and 105 C, respectively. Chicks that were 28 days old were fed these various samples of corn for 4 hr. Heating corn for 2 min to a temperature of 76 C caused no apparent loss of citrinin activity based on water intake and urine excretion measures. Heating the corn for 8 min to a temperature of 100 C destroyed some of the citrinin activity. Heating citrinin-contaminated corn to 105 C for 16 min destroyed the diuretic effect of the mycotoxin. PMID- 3658888 TI - Interaction of dietary protein level on dose response relationships during aflatoxicosis in young chickens. AB - It is well known that the effect of aflatoxin is enhanced by a low protein diet, but whether this is associated with a lower apparent minimum effective dose, increased slope of response curves, or both has not been investigated previously. Aflatoxin at 12 dosages ranging from 0 to 2.34 micrograms/g of feed was fed to eight groups of 10 young chickens per treatment consuming a 10.00 or 12.75% protein diet for 3 weeks. The body weights, liver weights relative to body weights, and total lipid content of the livers were determined. Mathematical models were fitted to the data and from the appropriate equations the dose response curves were predicted as continuous functions of aflatoxin concentration. A quadratic polynomial fit body weight data on the 12.75% protein diet whereas a plateau-linear model fit body weight data on the 10.00% protein diet. This implies that in a low protein diet aflatoxin affects only one of the factors controlling growth. Plateau-linear models fit liver relative weight and liver lipid content data on both 10.00 and 12.75% diets. For both variables the lower protein diet decreased the apparent minimum effective dose and increased the positive slope of the linear response. The apparent minimum effective doses (micrograms of aflatoxin per gram of feed) in this experimental system were calculated from the modeling approach to be 1.21 and 2.00 for body weight, 1.08 and 1.65 for liver lipids, and 1.45 and 2.34 for liver relative weight in 10.00 and 12.75% protein diets, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658889 TI - Impact of high dietary vomitoxin on yolk yield and embryonic mortality. AB - Single Comb White Leghorn hens at 58 weeks of age were given control (C) and vomitoxin (V)-contaminated feed for 4 weeks; then the V treatment was changed to C for 2 subsequent weeks. Fusarium graminearum-infected corn was substituted for sound corn to attain a practical extreme of 38 ppm V. Hen-day production, feed consumption, body weight, and gross pathology were the same between treatments. Egg weight, internal quality, and shell strength were not adversely affected; however, dietary V led to a small reduction in the percentage of yolk while albumen increased. Solids content of both egg components remained unchanged, and no V as such could be detected (less than .2 ppm). Presence of toxic V metabolites in the egg were indicated by increased (although still low) embryonic mortality upon incubation. Improvement in yolk yield and relief from germ losses occurred 1 week after the change from V to C feed. Overall responses to present extreme circumstances were no greater than variation occurring between weeks, and problems in practice seem remote. PMID- 3658890 TI - Cholesterol content of broiler breast fillets heated with and without the skin in convection and conventional ovens. AB - Six treatment combinations for the heating of broiler breast fillets were investigated: three skin variables (heated and analyzed with skin, heated with and analyzed without skin, and heated and analyzed without skin) and two heating systems (convection broiling and conventional roasting). Matched broiler breast fillets were analyzed raw or breaded and heated to 82 C. Raw and cooked samples of meat, skin, and meat with skin were analyzed for moisture, fat, and cholesterol contents. In the raw state, samples of meat with skin contained greater moisture and fat contents, but similar cholesterol contents, when compared with samples of meat alone. Fillets heated by convection broiling had greater cooking losses but shorter heating times compared with conventionally roasted samples. Fillets with the skin removed before or after heating contained more moisture, less fat, and less cholesterol than samples cooked and analyzed with the skin present. PMID- 3658891 TI - Soft cervical collars for vertebrobasilar symptoms in the elderly. PMID- 3658892 TI - AIDS--how much have we learned? PMID- 3658894 TI - General practice--a technological future. PMID- 3658893 TI - The general practitioner's role in the prevention of coronary heart disease. PMID- 3658895 TI - Extracorporeal shock wave lithotripsy. PMID- 3658896 TI - The current status of discolysis. PMID- 3658897 TI - Progress in terminal care. PMID- 3658898 TI - Over-the-counter hydrocortisone. PMID- 3658899 TI - The erythrocyte sedimentation rate--its use in general practice. PMID- 3658900 TI - Minor surgery in general practice. PMID- 3658901 TI - The management of erectile impotence. PMID- 3658902 TI - Profile and nurses' attitudes: membership in a professional organization. PMID- 3658903 TI - Nursing caught in liability insurance crunch. PMID- 3658904 TI - Nursing shortage symptomatic of changes in health care. PMID- 3658905 TI - [German Society for Pneumology and Tuberculosis. Guidelines for quality assurance in bronchology]. PMID- 3658906 TI - [A nomogram for detecting alveolar-arterial differences in oxygen pressure (AaDO2) in relation to the alveolar air formula]. PMID- 3658907 TI - [Nocturnal polygraphic measurements--transcutaneous blood gases, pulmonary artery pressure, sleep stages--in oxygen therapy in chronic obstructive respiratory disorders]. PMID- 3658908 TI - [Stomach involvement in sarcoidosis]. PMID- 3658909 TI - [School problems in Japan]. PMID- 3658910 TI - [Understanding instead of judging]. PMID- 3658911 TI - A simple method for preparing prometaphase chromosomes from amniotic fluid cell cultures. AB - A simple method for preparing prometaphase chromosomes from amniotic fluid cell cultures is described. The technique is based upon several key steps including: (1) reduced colcemid concentration, (2) reduced exposure to trypsin-EDTA, and (3) maintaining cells in single suspension by adjusting cell concentration appropriately. Chromosomes with banding resolution up to 800 bands per haploid set can be routinely produced. The described methodology is particularly useful in defining and establishing the clinical significance of subtle structural aberrations. PMID- 3658912 TI - Chorionic villus sampling: improved method for preparation of karyotypes after short-term incubation. AB - A method for the isolation and trypsin-Giemsa banding of metaphases obtained after short-term incubation (48 h) of cytotrophoblast cells from chorionic villus sample is described. A new slide-making instrument, developed expressly to enhance the spreading of chromosomes from metaphases released from small tissue pieces, is responsible for the increase yield of analysable metaphases in this protocol. PMID- 3658913 TI - Pseudomosaicism for trisomy 13. Three case reports. AB - Pseudomosaicism is of particular concern in prenatal diagnosis when it involves mosaicism for a cytogenetic abnormality associated with a clinical syndrome which is compatible with postnatal life, such as trisomies for chromosomes 13, 18, and 21. The lack of data regarding the outcome of pregnancies involving these specific kinds of pseudomosaicism makes genetic counselling difficult. Three cases of prenatal diagnosis of pseudomosaicism for trisomy 13, each of which had a normal outcome, will be presented (Tables 1 and 2). The three main areas for consideration are: (1) the genetic counselling issues, (2) the additional prenatal diagnostic options available to evaluate the status of the fetus in an attempt to identify some of the clinical features of trisomy 13, and (3) the outcome of the pregnancies. PMID- 3658914 TI - Prenatal diagnosis of tuberous sclerosis: the use of fetal echocardiography. AB - Fetal echocardiography was used to identify a cardiac rhabdomyoma in the second trimester. The combination of this finding with a maternal history of Tuberous Sclerosis allowed the patient and her family to make a more educated decision regarding termination of the pregnancy. Post mortem examination of the fetus confirmed the prenatal findings. This case report demonstrates the importance of ultrasound evaluation of the fetus at risk of recurrence of a genetic syndrome in which one or more anatomical defects might be seen. PMID- 3658915 TI - Comparison of maternal and fetal chromosome heteromorphisms to monitor maternal cell contamination in chorionic villus samples. AB - Maternal cell contamination (MCC) presents a potential problem in the analysis of chorionic villus sampling (CVS) preparations for early prenatal diagnosis by chromosomal, biochemical and molecular methods. Through the comparison of fluorescent chromosome variants from CVS and maternal cells, we found three out of 50 samples to have MCC. One of these was observed on a direct preparation. Routine chromosome heteromorphism analysis is suggested as a reliable method for monitoring MCC in CVS specimens. PMID- 3658916 TI - The concurrence of fetal supraventricular tachycardia and obstruction of the foramen ovale. AB - Fetal supraventricular tachycardia (FSVT) is a cardiac arrhythmia that bears a high mortality rate. In the majority of cases no morphological anomalies are found and death is caused by congestive heart failure. This report presents two cases of FSVT in which cross sectional echocardiography revealed obstruction of the foramen ovale with dilatation of the right heart without structural cardiac anomalies. After birth sinus rhythm re-established under digitalis medication in both cases. The association between premature obstruction of the foramen ovale and unexplained intrauterine death in the third trimester of gestation is suggested. PMID- 3658917 TI - Neonatal lung function following mid-trimester amniocentesis. AB - Three hundred and fifty-four women who underwent midtrimester genetic amniocentesis were matched for age, parity, indication, and smoking history, with an equivalent number of women who had declined the procedure, for the purpose of comparing the neonatal respiratory status of their offspring. There was no evidence that the infants exposed to genetic amniocentesis were compromised. PMID- 3658918 TI - Psychological impact of amniocentesis on low-risk women. AB - The study comprised 85 young (25-34 years old) women who underwent genetic amniocentesis, 80 comparable young women who had an ultrasoundscan at the same gestational age and 74 women (35-40 years old) who had amniocentesis. The State Trait Anxiety Inventory and Visual Analogue Scales concerning anxiety and worry were used on four occasions to evaluate psychological changes during pregnancy. The anxiety level in the younger women decreased after amniocentesis and a further decrease was observed after the results were communicated to them. However, similar changes were seen in the group of younger women after ultrasonography, and there was no difference in anxiety level between the two groups of younger women in the 16th or in the 35th week of pregnancy. Thus, in younger women at low genetic risk amniocentesis was neither anxiety-relieving, nor anxiety-creating. The level of anxiety before amniocentesis was not higher in the older than in the younger women having amniocentesis. However, in the younger women a significant decrease in anxiety was seen as soon as amniocentesis had been performed, while in the older women this decrease was delayed until after the results were known. PMID- 3658919 TI - Chromosomal mosaicism confined to chorionic tissue. AB - Chorionic villus samples from two healthy pregnant females were obtained for first trimester fetal diagnosis. The karyotypes were 46,XX/47,XX,+3 and 46,XX/47,XX,+15, respectively. In both cases fibroblast cultures after termination of pregnancy were shown to have normal karyotypes. PMID- 3658920 TI - Cross-sectional features and three-dimensional structure of human placental villi. AB - Human placental villi from both normal and complicated pregnancies were examined by both light and scanning electron microscopy. The findings provide evidence that histological features such as syncytial sprouts, bridges, and a net-like arrangement of villi represent tangential sections of irregularly shaped villi rather than proliferative activity of the villous surface. Hence the two dimensional appearance of paraffin and semithin sections has to be interpreted three-dimensionally in comparison with the respective scanning electron micrographs. In the light of these findings the various types of villous maldevelopment are summarized in a diagram which may be used as an aid for pathological diagnosis. PMID- 3658921 TI - Flow cytometry used to distinguish between complete and partial hydatidiform moles. AB - Cells prepared from fresh tissue from a normal conception, and three complete hydatidiform moles (CHMs), were shown to be diploid by flow cytometry, while triploid populations were identified in tissue from two partial hydatidiform moles (PHMs). Similar results were found in cells from formalin-fixed, paraffin embedded material. In nine cases where cytogenetic analysis was carried out this correlated with the results from flow cytometry. Using flow cytometry we were able to show that two cases which were pathologically complete were in fact diploid, despite the finding of trisomy at one locus in the molar tissue using biochemical markers. The most likely explanation of apparent trisomy of the enzymes in the molar tissue was contamination by maternal tissue. PMID- 3658922 TI - Extraction of radioactive rubidium and D-glucose from the artificially perfused intervillous space of the human placenta. AB - Extraction (Et) of 86Rb and [14C]D-glucose from the artificially perfused intervillous space of the human placenta was measured using [3H]L-glucose as a reference tracer. E. of 86Rb increased slowly from initial values near zero to a late maximum, which indicates that Et was greatly influenced by heterogeneity of indicator transit times through the intervillous space. The ascending part of the plot of -1n(I-Et) against time (t) of 86Rb was approximately linear. In each experiment the time corresponding to zero extraction was estimated by linear extrapolation of the plot. The mean of the times obtained in the individual experiments corresponded to the most frequent transit time of the indicators through the system outside the placenta. These observations suggest that 86Rb is taken up by the trophoblast from the entire space perfused. Under such conditions the rate of the trophoblast uptake can be estimated from the slope of the above plot. Unlike that of 86Rb, Et of [14C]D-glucose increased rapidly to a relatively steady level. This time course of Et may result from combined effects of transit time heterogeneity and rapid back-flux of the tracer. PMID- 3658923 TI - Expression of HLA-DR molecules in human gestational choriocarcinoma cell lines and malignant cell lines. AB - In order to determine whether trophoblast (or gestational choriocarcinoma) expresses the HLA-DR antigen or not, it was analysed using human gestational choriocarcinoma cell lines (GCH-1, GCH-1(m) and TAK-N) by the Northern hybridization method. TYK-nu (human undifferentiated ovarian carcinoma cell line), M-14 (human malignant melanoma cell line), L-14 (human B lymphocyte cell line), and KKNS-1, KKNS-2 and KKNS-3 (three human endometrial carcinoma cell lines) were also examined. Messenger ribonucleic acids (mRNAs) were prepared from 2 X 10(7) cells in each cell line and hybridized by HLA-DR alpha-chain complementary deoxyribonucleic acid (cDNA) probe (pDR alpha-1) and beta-chain cDNA probe (DK-10). Northern hybridization analysis revealed that GCH-1 transcribed at least two kinds of alpha-chain (16s and 23s) and beta-chain mRNA (15s and 23s). TYK-nu transcribed alpha- and beta-chain mRNA, L-14 transcribed only alpha-chain mRNA, and TAK-N appeared to transcribe only a little alpha-chain mRNA. The HLA-DR molecules were not, however, expressed in the other cell lines (GCH-1(m), M-14, KKNS-1, -2 and -3). These results are compared with those obtained by immunocytochemical methods in our laboratory. PMID- 3658924 TI - Secretion of a gonadotrophin-releasing hormone- (GnRH-)like factor by the rabbit fetal placenta in vitro. AB - Previous studies have shown that the rabbit fetal placenta contains both biological and immunological gonadotrophin-releasing hormone- (GnRH-) like activity. The purposes of this study were to determine whether (1) the fetal placenta secretes a GnRH-like factor, and (2) this GnRH-like factor is secreted into the uterine vein. In experiment 1, fetal placentae were collected from day 18 pregnant rabbits. The placentae were divided in half, and one-half was used for measurement of GnRH; the other half was cut into small pieces and placed into a perifusion system. Following a 2-h stabilization period, tissue was challenged with two 60 mM K+ injections spaced 90 min apart. Six replicates were run with either liver (n = 4) or spleen (n = 2) as control tissues. Basal levels of GnRH secreted (nmol/g protein/30 min) were 1.2 +/- 0.3 for placental tissue, 0.3 +/- 0.1 for liver tissue and non-detectable for spleen tissue. Following the first K+ injection there was no response from liver or spleen tissue, while placental tissue showed a 78 per cent increase after 90 min. There was no response to the second injection. The concentration of GnRH in the placenta was 6.8 +/- 0.5 nmol/g protein. In experiment 2, plasma samples were obtained from the marginal ear vein of five oestrous does and five day-7 pseudopregnant does, and from the marginal ear vein and uterine vein of six day-18 pregnant does.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658925 TI - Structural relationships between the isoenzymes of human placental alkaline phosphatase: a serum factor converts M-PLAP to A- and B-PLAP. AB - A protein factor has been found in serum which converts the M form of placental alkaline phosphatase (PLAP) to the A and B forms. The identity of the conversion products has been confirmed by analysis of their dimers and polypeptides. Proteolysis is not implicated in this phenomenon. This report establishes microvillous M-PLAP as the precursor of the A and B forms. PMID- 3658926 TI - Placental-ovarian relationship in the control of testosterone secretion in the rat. AB - Both ovaries and placentae of rats produce androgen in the second half of pregnancy. The objectives of this investigation were to determine whether the pituitary controls both ovarian and placental secretion of testosterone, to find out whether ovarian secretion of testosterone is maintained by the placenta, and to examine whether levels of testosterone produced by the ovaries and placentae depend upon the number of placentae present. Pregnant rats were hypophysectomized with or without hysterectomy in one experiment, and hypophysectomized with or without partial hysterectomy leaving one placenta in situ in another experiment. Testosterone output by the placenta(e) or the ovary was quantified. The results suggest that placental secretion of testosterone is independent of the pituitary between days 12 and 18 of pregnancy, reduction in placental number causes the remaining placenta to compensate by increasing its testosterone output, and ovarian secretion of testosterone may be under placental control between days 12 and 18 of pregnancy. PMID- 3658927 TI - [Isolation of cathepsin D from fish muscle tissue]. AB - A preparation of cathepsin D was isolated with a 20% yield from the Pacific herring muscles using thermal and acid-alkaline treatment as well as salting out with ammonium sulfate and gel chromatography on Sephadex G-75. Cathepsin D isolated from the Pacific sardine muscles was purified 200-400-fold by means of affinity chromatography on immobilized hemoglobin, the yield being about 5%. PMID- 3658928 TI - [A method of quantitative determination of delta 5,7-sterols in unsaponifiable lipid fractions]. AB - The technique is offer for rapid quantitative definition of sterols having a system of delta 5,7-conjugated double bonds which conditions biological activity of D vitamin--the result of photoisomerisation of the sterols. The technique bases on the analysis of UV absorption spectra of unsaponifiable lipid fraction of several kinds of mutant yeast strains and the model mixtures of sterols. The results obtained concerning the estimation of delta 5,7-sterols containing in total fraction are confirmed by gas-liquid-chromatography and mass-spectrometry data. PMID- 3658929 TI - [A method of purifying a Soviet preparation of sodium dodecyl sulfate]. PMID- 3658930 TI - [Hormone content of the blood in juvenile osteoporosis]. AB - Juvenile osteoporosis should be regarded as a polyetiological disease developing against the background of constitutional osteopathy in which endocrine disorders play a certain role. A tendency to a decrease in the levels of calcitonin and parathyroid hormone was found in juvenile osteoporosis; mild signs of hypogonadism (secondary) and a relative decrease in hypophyseal somatotropic activity promoted its detection. Two groups of patients were defined: I--with raised AP activity and a normal or lowered level of serum inorganic phosphorus without hormonal disorders; II--with lowered or normal AP activity and a normal level of phosphorus, mild hormonal disorders. Prolonged multimodality therapy with calcitonin, anabolic steroids, active forms of Vitamin D3, calcium agents, physiotherapy and exercise therapy was found effective in juvenile osteoporosis. PMID- 3658931 TI - [Glucocorticoid receptors of the blood lymphocytes in Itsenko-Cushing disease]. AB - 45 patients with Itsenko-Cushing disease received combined therapy (unilateral adrenalectomy with subsequent therapy with mitotane, bromocriptine or their combination). The level of cortisol, the amount of blood lymphocytes and glucocorticoid receptors (GR) were determined over time, before adrenalectomy and on the 7th-10th day after it. Ten healthy donors were entered into the control group. A sharp decrease in the GR amount in blood lymphocytes was detected at the active stage of Itsenko-Cushing disease. After unilateral adrenalectomy the amount rose, in recurrence decreased. A significant increase in the GR amount was noted in remission. Therapeutic results were better in the patients with an increase in the GR amount in blood lymphocytes in the early postoperative period. The determination of GR in blood lymphocytes permits more objective assessment of therapeutic results and prognosis of a course of disease. PMID- 3658932 TI - [Use of combined radionuclide tests in the differential diagnosis of different forms of thyroid cancer]. AB - The levels of TSH, T4, T3, calcitonin (CT), PTH, TGA and TG were determined in 96 persons (87 patients and 9 healthy persons) before and after operation; 46 patients had papillary carcinoma, 15 follicular cancer, 24 medullary carcinoma, 2 undifferentiated cancer. There was no common clinicomorphological approach to the studied problem therefore it was impossible to compare the data of different researchers. Radionuclide tests were employed to specify the importance of different methods in clinical practice. Elevated levels of TG, TSH, PTH, T4 and a lowered level of CT were revealed in differentiated thyroid carcinomas; elevated levels of CT, TSH, PTH, T4 and a lowered level of TG were revealed in medullary carcinoma. A decrease in T4 and T3 levels was noted after operations in patients with differentiated thyroid cancers necessitating the use of substitution therapy and thyroid hormones. PMID- 3658933 TI - [Sensitivity of the hypothalamo-hypophyseal system to dexamethasone administered at different times of the day in obesity]. AB - The paper is concerned with the results of a study of the circadian rhythm of cortisol secretion and sensitivity of the hypothalamohypophyseal system to small doses of dexamethasone administered in different time of a day to patients with obesity. Disturbance of the circadian rhythm of cortisol secretion resulting in change of the nature of cortisol discharge in the second half of a day, was revealed. Three groups of patients were defined with relation to the type of response of the hypothalamohypophyseal system to dexamethasone administration: with normal, paradoxical and hypersensitive reactions. The results of the study of the circadian rhythm and response of the hypothalamohypophyseal system to dexamethasone were indicative of hypothalamic disturbances in obesity. The authors emphasized the relationship between the nature of sensitivity of the hypothalamohypophyseal system to dexamethasone and age at which the disease developed. PMID- 3658934 TI - [Combination of Wolfram and de Lawtor syndromes and bladder and urethral anomalies]. PMID- 3658935 TI - [Retrograde ejaculation syndrome in a patient with diabetes mellitus]. PMID- 3658936 TI - [The disseminated intravascular coagulation syndrome in diabetes mellitus]. PMID- 3658937 TI - [Renal and central hemodynamics in diabetics suffering from suppurative pyelonephritis]. PMID- 3658938 TI - [Recurrent spontaneous pneumothorax in bullous emphysema in a female patient with Shereshevskii-Turner syndrome]. PMID- 3658939 TI - [Changes in the duration of the Achilles reflex in euthyroid goiter in children]. AB - Changes in the duration of the Achilles reflex were studied in subclinical disturbances of thyroid function. For this purpose the duration of the Achilles reflex, the levels of T4, T3, iodine protein bound TSH and cholesterol were investigated in children admitted to hospital with the general diagnosis of the "euthyroid goiter". Clinical and laboratory findings revealed subclinical types of the diffuse toxic goiter, hypothyrosis, chronic thyroiditis, endemic goiter, nodular goiter, pubertal struma and sporadic euthyroid goiter. The aim of the study was to define the diagnostic importance of reflexometry in subclinical disorders of thyroid function and to assess the relationships between metabolic derangements and the duration of the Achilles reflex. Changes in the duration were shown to correspond to disorder of thyroid function. In 76% of the cases reflexometry brought about the correct assessment of the patient's thyroid status. A significant conformity of the levels of TSH, T3, T4 to the duration of the Achilles reflex was shown. PMID- 3658940 TI - [Action of 5 alpha-reduced diols on the uterus of sexually immature rats]. AB - The effect of testosterone (T), 5 alpha-androstane-3 alpha, 17 beta-diol (3 alpha diol) and 5 alpha-and-rostane-3 beta, 17 beta-diol (3 beta-diol) on the uterus of immature rats was studied in combined with estradiol-17 beta (E2) and separate intraperitoneal administration. Repeated administration of T (100 micrograms per 100 g of body mass) caused no changes in the uterine mass whereas a similar dose of 3 alpha-diol resulted in a noticeable effect (0.05 greater than greater than p less than 0.1). 3 beta-diol administered repeatedly at a dose of 1.00 microgram per 100 g of body mass, produced the same uterotropic effect like E2. In combined administration of the above androgens (100 micrograms) and E2 (10 micrograms) 3 alpha-diol only inhibited the uterotropic effect of E2. PMID- 3658942 TI - [Androgen-protein interactions in the cytosol of the liver and prostate in aging]. AB - The androgen-protein interactions in liver and ventral prostate cytosol of immature (1.5 months), young (6 months), mature (12 months) and old (24 months) male rats were studied. The minimum content and maximum values of association constant of testosterone-binding proteins in liver cytosol were observed in immature rats. Maximum concentration of testosterone-binding sites was in young and mature rats and decreased in old animals, thus correlating with synthesis of alpha 2u-globulin in ontogenesis. The binding affinity of testosterone-binding proteins in rats aged 6, 12 and 24 months were approximately equal. As for ventral prostate, the maximum content of 5 alpha-dihydrotestosterone-binding proteins was revealed in immature rats. In young mature rats the ventral prostate concentration of binding sites for 5 alpha-dihydrotestosterone decreased three fold in comparison with the rats aged 1.5 months. Minimum content of 5 alpha dihydrotestosterone-binding sites was found in the old rats. Binding affinity of 5 alpha-dihydrotestosterone-binding proteins was approximately the same in rats aged 1, 5, 6, and 12 months and increased in old animals. The age-dependent reduction of androgen-binding sites in rat ventral prostate cytosol was followed by a marked decrease in the weight of the ventral prostate. PMID- 3658941 TI - [Effect of a new peptide morphogen on androgen metabolism in the gonads during sexual maturation in the rat]. AB - After chronic administration of a new neuropeptide (hydra growth activator--HGA) to male and female Wistar rats from the 29th to 43rd day of life at a dose of 30 micrograms X kg-1 of body mass a study was made of [3H] testosterone, [3H] 5 alpha-dehydrotestosterone [( 3H] DHT) and [3H] 5 alpha-androstane-3 beta, 17 beta diol metabolism in gonadal homogenates of the animals. In testis homogenates HGA administration was shown to influence the production of [3H] 3 beta-diol from [3H] DHT only. In female rats HGA administration made an effect on the majority of enzymes of androgen metabolism in the ovaries of animals with the closed and open vagina. Basing on changes in enzymatic activity of androgen metabolism in the gonads of rats in chronic HGA administration in the period of male pubescence a conclusion was made that it acted as a pubescence accelerating factor. PMID- 3658943 TI - [Indicators of lipid metabolism and their relation to disorders of microcirculation in diabetes mellitus]. AB - The levels of cholesterol, triglycerides, lipoproteins (LP), lipid peroxidation products (LPP), and tissue antioxidants were determined in 49 patients with diabetes mellitus (DM), types I and II, at the stage of subcompensation. The study groups were composed of patients with stages II and III capillaroscopic changes with corresponding changes in the fundus of the eye in the form of common and proliferating stages of retinopathy. Patients with DM of both types revealed significant changes in lipid metabolism expressed in the accumulation of highly atherogenic LP, an increase in the content of cholesterol and LPP in VLDLP and LDLP against a background of a decrease in the activity of the antioxidant system. An analysis of the data obtained made it possible to assume the involvement of LPP processes in the formation of diabetic angiopathies in patients with DM of both types. PMID- 3658944 TI - [Immunoglobulin levels in the blood of persons with diabetes mellitus risk factors]. AB - Persons with risk factors of diabetes mellitus are prone to certain changes in the content of the main classes of immunoglobulins. These changes are aggravated during progression of disease and reflect immunological readjustment of the body playing a certain role in the pathogenesis of diabetes mellitus. PMID- 3658945 TI - [Lipid composition of thrombocytes in diabetes mellitus depending on the degree of microangiopathy]. AB - The paper is concerned with the results of a study of the content of platelet lipid fractions in 115 patients with type I and II diabetes mellitus with a different degree of vascular complications. The results showed that the development of vascular lesions caused the appearance of specific disorders of platelet lipid composition characteristic for type I and II diabetes mellitus. In type I disorders of neutral phospholipids and free fatty acids were noted whereas in type II the above changes were noted in parallel with changes in the levels of cholesterol and acid phospholipids. With an increase in vascular lesions in type II there was a significant increase in phospholipase A2 activity, in type I under the same conditions the activity of this enzyme was absent. These facts suggest correlation between the development of vascular complications of diabetes mellitus and disorders in platelet membrane lipid structure. PMID- 3658946 TI - [The number and ultrastructure of large granule-containing lymphocytes (natural killer cells) in the blood of patients with diabetes mellitus type 1]. AB - The content and ultrastructure of blood large granule containing lymphocytes (LGL) associated with the system of natural killer cells (NKC) were investigated in primary untreated patients with type I diabetes mellitus using light and electron microscopy. A marked decrease in the content of LGL and change in their submicroscopic structure indicating disorder of their function, were noted in the blood of patients with type I diabetes mellitus as compared to those in the blood of healthy subjects. LGL cytoplasm revealed a decrease in the number and size of specific electron dense granules (azurophil granules), their destruction and vacuolization were noted; the number of peculiar submicroscopic formations (parallel tubular structures) was on an increase. A conclusion has been made that in type I diabetes mellitus the activity of the system of natural killer cells playing an important role in nonspecific protection of the body is lowered and therefore can be regarded as a cause of more frequent development of inflammatory processes in this disease. PMID- 3658947 TI - [The metoclopramide test in the differential diagnosis of various forms of galactorrhea-amenorrhea syndrome]. AB - The results of the metoclopramide test in 24 patients with the lactorrhea amenorrhea syndrome were presented. It was shown that the metoclopramide test could be used for differential diagnosis of various types of disease. The blood prolactin concentration was raised only in the patients with the functional type of the lactorrhea-amenorrhea syndrome and changed insignificantly in the patients with pituitary microadenoma as well as in the patients with a noticeable increase in the prolactin basal level but without x-ray signs of a pituitary tumor. The presence of pituitary microadenoma could be suspected in the patients of the 3rd group. PMID- 3658948 TI - [Pituitary apoplexy]. AB - Ten patients with pituitary apoplexy were treated at the Institute of Endocrinology, Gerontology and Geriatrics in Sofia over the last 5 years. They represented 5.06% of the total number of patients with pituitary adenomas treated at the Institute during the same period. The highest frequency of pituitary apoplexy was noted among patients with Nelson's syndrome. In 5 patients of this group pituitary apoplexy was the first sign of a tumor. Headaches combined with nausea and vomiting were the earliest symptoms of pituitary apoplexy, and ptosis and ophthalmoplegy were the most common symptoms in the patients. The disease was not correctly diagnosed in 7 patients who immediately after apoplexy were treated in neurological and ophthalmological departments. PMID- 3658949 TI - [Aseptic femur head necrosis in endogenous hypercorticism]. PMID- 3658950 TI - [Disorders of sexual function associated with chronic alcoholic intoxication (psychoendocrinologic aspects: a lecture]. PMID- 3658951 TI - [Role of gamma-aminobutyric acid in activating the hypophyseo-testicular complex in male mice in the presence of females]. AB - Experiments on male mice of 3 inbred strains (CBA/Lac, A/He, and BALB) have shown that an increase in the level of testosterone in the peripheral blood induced by the presence of a recipient female mouse, is blocked under the conditions of gamma-aminobutyric acid (GABA) accumulation in the body. A GABA inhibitory effect depends on a genotype. Neither the blockade of receptors to GABA, nor a decrease in its content have produced any effect on an increase in the blood level of testosterone in sexual excitement. It has been assumed that the GABAergic mechanism inhibits sexual excitement of a male mouse during its meeting with a recipient female mouse under stress conditions only. PMID- 3658952 TI - [Characteristics of the levels of various nucleic acid precursors in the tissues of rabbits with various thyroid conditions]. AB - The content of the precursors and metabolites of nucleic acids in the brain and liver of normal rabbits, rabbits with hypothyrosis (thyroidectomy) and hyperthyrosis (100-150 Mg of L-thyroxine per 1 kg of body mass daily for 10-12 days) was determined by liquid chromatography with a high resolution. A decrease in the content of deoxyguanosine, thymine, hypoxanthine, cytosine, thymidine and an increase in the content of inosine, adenine and adenosine in the liver of animals with hypothyrosis were shown. In the brain of these rabbits the level of cytidine was lowered, and the levels of deoxyguanosine, thymine, inosine, hypoxanthine, adenine and uracil were on an increase. An increase in the levels of deoxyguanosine, thymine, adenine, thymidine and a decrease in the levels of cytidine, hypoxanthine, cytosine, adenine and uracil in the liver were noted in hyperthyrosis. In the brain of rabbits with hyperthyrosis an increase in the levels of deoxyguanosine, cytidine, inosine and adenine was combined with a decrease in the levels of thymine and hypoxanthine. These thyroid-dependent changes in the content of registered metabolites and precursors of nucleic acids in tissues suggest that the observed shifts illustrate one of many mechanisms of the regulation of cell metabolism by thyroid hormones. PMID- 3658953 TI - [Quantitative evaluation of the sensitivity of experimental animals to the diabetogenic effect of alloxan]. AB - A study was made of the time course of development of alloxan diabetes in mature male Wistar and random bred rats for a quantitative analysis of responses to the administration of a diabetogenic dose of the drug. Proceeding from the animals' death, a decrease in body mass, water consumption, the blood level of glucose and GTT results in the animals were divided into 3 groups depending on the gravity of alloxan diabetes. In Wistar rats acute, obvious and latent types of diabetes developed in 35, 35, and 30% respectively. Rats with obvious diabetes were characterized by a significant decrease in the IRI level in the plasma 3-8 weeks after drug administration. In rats with latent diabetes the IRI level in the plasma on the 3rd week showed a tendency to a decrease and exceeded control values in 8 weeks. In random bred rats acute, obvious and latent types of diabetes were noted in 76, 12, and 12% respectively. The results have shown that the division of animals into the groups with a different degree of gravity of alloxan diabetes can express quantitative assessment of the sensitivity of a population in question to the diabetogenic action of alloxan. PMID- 3658954 TI - [Effect of diets with easily assimilated carbohydrates on the lipid composition of tissues of young rats with alloxan diabetes]. AB - The blood serum, liver, cerebral and pancreatic tissues of 250 rats aged 1 to 1.5 mos. were investigated. Alloxan diabetes caused profound changes in the lipid composition of various tissues, the most noticeable ones in the pancreas. Of all easily assimilable carbohydrates used as admixtures to a common ration fructose followed by xylite and sorbitol produced the most unfavorable effect on lipid metabolism. The best results were obtained by adding up glucose. PMID- 3658955 TI - [Antiandrogenic effects of hydroxyniftolide in male rats]. AB - Experiments on intact mature male Wistar rats showed the ability of hydroxyniftolide (4'-nitro-3'-trifluoromethyl-2-hydroxy-2 methylpropionylanilide), a hydroxylated antiandrogen derivative of niftolide, to inhibit the effects of male sex hormones in androgen target organs. At doses of 10 mg/kg and upwards administered intravenously or intramuscularly for 10 days, it stimulated the hypothalamohypophy-seogonadal system expressed in an increase in the activity of delta 5-steroid-3 beta-ol-dehydrogenase in the testicles and blood plasma testosterone concentration. Comparative studies on antiandrogenic properties of niftolide and hydroxyniftolide made it possible to show that the effect of the first agent was more noticeable with relation to the hypothalamic centers of gonadotropin secretion regulation whereas the effect of the second one was more noticeable in the accessory sex glands. PMID- 3658956 TI - [Antitoxic function of the liver and the effect of zixorin in patients with diabetes mellitus]. AB - A study of 79 patients with insulin dependent and insulin independent types of diabetes mellitus showed a significant decrease in antitoxic liver function according to the criteria of the antipyrine test. A 10-day course with zixorin (an inductor of the oxidase enzymatic system of the hepatocytic microsomal fraction improved considerably antitoxic liver function indices in the patients with both types of diabetes mellitus. PMID- 3658957 TI - [Outcome of idiopathic fibrosing alveolitis and its relation to indicators of pulmonary hemodynamics and respiration]. PMID- 3658958 TI - [Medico-biological aspects of chronic alcoholism and problems of phthisiology]. PMID- 3658960 TI - [Primary tuberculosis and nonspecific pneumonia in children and adolescents]. PMID- 3658959 TI - [Informative value of various laboratory tests in evaluating the activity of siderosilico tuberculosis]. PMID- 3658961 TI - [The mucociliary system in patients with dust-induced bronchitis]. PMID- 3658962 TI - [Diagnosis of disseminated diffuse lesions of the lungs]. PMID- 3658963 TI - [Correction of liver function in patients with tuberculosis by enterosorption]. PMID- 3658964 TI - [Comparative evaluation of the effectiveness of treatment with rifampicin and isoniazid administered at various intervals]. PMID- 3658965 TI - [Changes in the ultrastructure of formed elements of the peripheral blood after hemosorption]. PMID- 3658966 TI - [Effectiveness of the treatment of experimental tuberculosis with BCG vaccine and tuberculin]. PMID- 3658967 TI - [Dependence of the level of anti-tuberculosis antibodies on HLA-DR genotype in patients with tuberculosis]. PMID- 3658968 TI - [Functional status of the liver and volumetric hepatic blood flow in patients with tuberculosis of the respiratory organs]. PMID- 3658969 TI - [Periradicular changes in the lungs of children in tuberculin sensitivity]. PMID- 3658970 TI - [A jet method of administering BCG vaccine]. PMID- 3658971 TI - [Condition of the bronchi in patients with pulmonary tuberculosis and chronic opisthorchiasis]. PMID- 3658972 TI - [Problems of improving the control of tuberculosis in adolescents]. PMID- 3658973 TI - Transmission of Trypanosoma theileri to cattle by Tabanidae. AB - Tabanids were collected in an area in northern Germany, where pastured cattle were abundant. Trypanosomatidae were identified in 14% of tabanids examined. Twelve cattle became infected with Trypanosoma theileri after applying usually 2 5 infected tabanids, to the intact oral mucosa. Haematopota pluvialis, Haematopota italica, Hybomitra micans and Tabanus bromius were identified as vectors. Infective stages of Trypanosoma theileri were identified in the gut and in the faeces of tabanids by transmission experiments. The minimum prepatent period was less than 4 days. No apparent signs of disease were observed in the infected cattle. PMID- 3658974 TI - Improved immunodiagnosis of human cysticercosis with scolex protein antigens. AB - Crude antigenic extract (CAE) and a scolex protein antigen (SPA) of Taenia solium cysticerci were used in indirect haemagglutination (IH) and enzyme-linked immunosorbent assay (ELISA) to detect serum antibodies in cysticercosis patients. Complement fixation (CF) was used for comparison with antigens obtained as an alcoholic extract of CAE (ACAE) and SPA (ASPA). For each test, a dilution was chosen which showed no cross-reactivity with sera from patients with other parasitic diseases such as taeniasis, schistosomiasis, ancylostomiasis, ascaridiasis, strongyloidiasis, Chagas' disease and syphilis. For the CF, 1:4 was the discriminative dilution determined; for IH, 1:16 and for ELISA, 1:256. The CF could detect serum antibodies to cysticerci in 45% of patients when ACAE antigen was used and 73% using ASPA. In the IH, serum antibody was detected in 73% of patients when CAE was used and 86% using SPA. In ELISA 63% of patients were positive when CAE was used and 91% using SPA. The use of SPA improved the serological distinction between infected and uninfected patients in all tests and the ELISA showed a significantly higher capacity to detect infected patients. PMID- 3658975 TI - Pathogenic factors in the later pulmonary phase of Angiostrongylus cantonensis infected rats. AB - In rats infected with different worm burdens of Angiostrongylus cantonensis, the loss of body weight was proportional to the increasing dose of infection. Body weight was correlated inversely with female worm burden (r = -0.669), the sum of mean numbers of larvae per gram of faeces (LPG) (r = -0.527) and lung weight (r = -0.761). Lung weight was positively correlated with female worm burden (r = 0.785) and the sum of mean numbers of LPG (r = 0.685). On the other hand, in rats infected with larvae developed from gamma-irradiated first-stage larvae (Experiment B) or infected rats treated with the drug ivermectin (Experiment C), body weight was inversely correlated with the sum of mean numbers of LPG (r = 0.798, Experiment B; r = -0.670, Experiment C) and lung weight (r = -0.862, Experiment B; r = -0.812, Experiment C), but not with female worm burden. Furthermore, lung weight was positively correlated with the sum of mean numbers of LPG (r = -0.783, Experiment B; r = 0.899, Experiment C), but not with the female worm burden. From these results, it is concluded that in the later pulmonary phase of infection in rats the pathogenic effects may be closely related to the increasing number of first-stage larvae produced by female worms. PMID- 3658976 TI - Important parasites of dover sole (Solea solea L.) kept under mariculture conditions. AB - Dover sole (Solea solea L.) were examined for parasites at the White Fish Authority (WFA) fish farm at Hunterston, Ayrshire, Scotland. The most important parasites appeared to be the two blood-feeding ectoparasites Lernaeocera sp., a copepod, and Hemibdella soleae, an ichthyobdellid leech, and the haematoprotozoan Haemogregarina simondi. The anaemia and general malaise of the sole investigated was attributed partly to general stress and the debilitating effects of transfer from the wild into an aquaculture system and partly to the impact of the parasites observed. PMID- 3658977 TI - The occurrence of Trypanosoma (Nannomonas) simiae in the cerebrospinal fluid of domestic pigs. PMID- 3658978 TI - A picture of psychiatric/mental health nursing. PMID- 3658979 TI - Comparable worth vs. civil rights. PMID- 3658980 TI - Nursing manpower shortage. PMID- 3658981 TI - Current concepts and approaches to the study of prostate cancer. Proceedings of a meeting. Prouts Neck, Maine, October 18-20, 1985. PMID- 3658982 TI - Mitogenic activity of prostatic extracts. PMID- 3658983 TI - Assessment of the effect of androgen and estrogen on the development of prostatic adenocarcinoma and urinary bladder calculi in Nb rats. PMID- 3658984 TI - Inflammation-proliferation: possible relationships in the prostate. PMID- 3658985 TI - Gross dissection of three lobes of the rat prostate. PMID- 3658987 TI - Clinical and pathological evaluation carcinoma of the prostate. PMID- 3658986 TI - Heterogeneity of structure and function in the mouse prostate. PMID- 3658988 TI - Clinical imaging of prostatic carcinoma. PMID- 3658989 TI - Assessment of tumor control following definitive radiotherapy in carcinoma of the prostate--a continuing dilemma. AB - Following completion of radiotherapy, clinically detectable (palpable) and histologically identifiable prostate carcinoma may persist for an extended period before it undergoes complete resolution. Although in most patients treated with adequate radiotherapy tumor resolution by both clinical and histological criteria occurs in the first 2 years, in a proportion of patients complete resolution may occur during the third year or even later. Since the proportion of patients with late resolution appears to be quite small, it seems reasonable to use the histologically identifiable tumor in the biopsy specimen beyond the second postirradiation year as a criterion for the diagnosis of treatment failure. The available data are insufficient to establish, by histological evaluation, the true pattern of tumor resolution. To achieve such a goal one would need to assess a substantial population of patients, adequately irradiated in a standardized manner, by systemic periodic biopsies over several years. To avoid selection biases, all patients, regardless of the clinical findings, would need to undergo biopsies. To avoid sampling errors, particularly in patients without palpable abnormalities, multiple specimens would need to be obtained from several quadrants of the prostate. The studied population should not receive hormonal management in conjunction with radiotherapy. Only completion of this ideal, hypothetical study and correlation of the biopsy results with long-term follow-up data on local failure, the incidence of distant metastases, and survival would make possible meaningful interpretation of the biopsy results in the future. Only then would it become possible to assign a statistical probability of local and/or distal failure as a function of the biopsy status at a certain point in time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3658990 TI - Pathology paradigms. PMID- 3658991 TI - Characterization of premalignant changes in the prostate. PMID- 3658992 TI - Fine needle aspiration of the prostate. PMID- 3658993 TI - Morphologic indices of progression in prostatic carcinoma. PMID- 3658994 TI - Incidence, mortality, and survival statistics for prostatic cancer. PMID- 3658995 TI - Issues on mortality from prostate cancer: role of clinical trials. PMID- 3658996 TI - Prostate cancer. Part A: Research, endocrine treatment, and histopathology. Proceedings of the Second International Symposium on Prostate Cancer. Paris, France, June 16-18, 1986. PMID- 3658997 TI - Punch biopsy tissue: enzyme and receptor analyses as criteria for hormone responsiveness in the treatment of prostatic cancer--limitations. PMID- 3658998 TI - Biochemical markers in human prostate. PMID- 3658999 TI - Aminoglutethimide in the treatment of advanced prostatic cancer. PMID- 3659000 TI - Aminoglutethimide in metastatic adenocarcinoma of the prostate. PMID- 3659001 TI - The endocrine effect of ketoconazole high doses (KHD). PMID- 3659002 TI - Side effects of ketoconazole therapy in advanced cancer of the prostate. A case report. PMID- 3659003 TI - Ketoconazole high dose (H.D.) in the management of hormonally pretreated patients with progressive metastatic prostate cancer. AB - Ketoconazole high dose (H.D.) reduces effectively the testosterone production in both adrenals and testes. Its use in the management of (metastatic) prostate cancer has been advocated. Even in relapsing patients after previous hormonal therapy Ketoconazole H.D. could be of value. 28 Relapsing patients, of whom 15 were evaluable at 3 months, have been treated with Ketoconazole H.D. As could be expected, objective response was seen in only a small number of patients followed up till 9 months. Subjective improvement was however noticed in the majority of symptomatic patients. The side effects and toxicity of the therapy remains however a major limitation for the use of Ketoconazole, be it as first line treatment or as therapy for relapsing patients. PMID- 3659004 TI - Plasma hormone levels before and after orchiectomy in prostate cancer patients. PMID- 3659005 TI - Clinical pharmacokinetics of a new antiandrogen Anandron (RU 23908). PMID- 3659006 TI - Hormonal consequences of orchidectomy for carcinoma of the prostate. With special reference to the measurement of free testosterone in the saliva. AB - 22 patients with metastatic carcinoma of the prostate were treated by subcapsular orchidectomy and followed by regular determinations of plasma T, DHT, D4A Dione, SDHEA, and TeBG as well as salivary T which measures the free Testosterone. Subcapsular orchidectomy constantly induced a dramatic and stable decrease of testicular androgens or TeBG. Free Testosterone levels vary widely for a given value of plasma T, probably due to individual variations of TeBG. Therefore salivary T should be used preferably to plasma T to monitor hormonal therapy of metastatic carcinoma of the prostate. PMID- 3659008 TI - Effects of oestrogen on growth and morphology of the Dunning R3327H prostatic carcinoma. PMID- 3659007 TI - Anti-human prostatic acid phosphatase (P.A.P.) monoclonal antibodies: characterisation and practical application. PMID- 3659009 TI - The prognostic value of pathological factors in carcinoma of the prostate. PMID- 3659010 TI - Are nuclear shape factors good predictors of the disease course in patients with carcinoma of the prostate. PMID- 3659011 TI - Is cytology a definitive diagnostic procedure of prostatic cancer? PMID- 3659012 TI - Role of cytology in the follow-up of prostate cancer. PMID- 3659013 TI - The effects of suppressing of androgen action on the normal prostate. PMID- 3659014 TI - Sclerotic bone metastases of prostatic origin and osteomalacia. Importance of a histomorphometry study. PMID- 3659015 TI - Prostate cancer. Part B: Imaging techniques, radiotherapy, chemotherapy, and management issues. Proceedings of the Second International Symposium on Prostate Cancer. Paris, France, June 16-18, 1986. PMID- 3659016 TI - Prostate cancer: results of radiotherapy in French cancer institutes. PMID- 3659017 TI - Curative treatment of carcinoma of the prostate with an association of external irradiation, iridium implant and lymphadenectomy. PMID- 3659018 TI - Interstitial irradiation using I-125 seeds. PMID- 3659019 TI - Interstitial radiotherapy with I-125 seeds for intracapsular prostatic cancer. PMID- 3659020 TI - The success of radiation therapy in controlling prostatic cancer within the treated field. AB - An important question is the ultimate (i.e. with "infinite" time of follow-up) local tumor regrowth rate for patients treated for specified stages of clinically localized prostatic cancer. Using combined data from patients irradiated at Stanford University from 1956 through 1983, and patients irradiated at the Massachusetts General Hospital from 1973 through 1979, we approached this question by an evaluation of the cumulative frequency of local tumor regrowth. These curves, relating cumulative incidence of local regrowth against time, approached an asymptote. These results indicate that following 6,800 to 7,500 cGy external beam irradiation, permanent local control of cancer of the prostate occurs in 85% to 90% of patients with stage T2 (B) tumors and in 60% to 70% of patients with stage T3 and T4 (C) tumors. Further analysis of the patients with T3 and T4 tumors may identify subgroups in whom more aggressive initial therapy is indicated. PMID- 3659021 TI - Treatment of cancer of the prostate by use of physiotherapy: long term results. PMID- 3659022 TI - Phase II trial of the association of doxorubicin, 5 FU and cis platinum in hormonally unresponsive metastatic carcinoma of the prostate. PMID- 3659023 TI - Staging of prostatic carcinoma: is the classification into A, B, C, D (I, II, III, IV) still valid? PMID- 3659025 TI - How to stage prostatic cancer in 1986. PMID- 3659024 TI - Identification and therapy of stage B prostate carcinoma. AB - We identify Stage B1 lesions using a combination of clinical and pathologic criteria. Only patients with normal acid phosphatase, chest x-ray and radioisotope bone scan are considered surgical candidates. Patients with a palpable nodule confined to the prostate gland undergo biopsy of the nodule and the contralateral lobe. Our preference is to use the fine needle aspiration which is as accurate as the large needle biopsy, and is associated with less morbidity. Furthermore, local reaction and scarring is less following the fine needle aspiration, making the surgical procedure less difficult. According to the pathologic findings, the tumor is assigned either Stage B1 or B2. The delineation of the size and extent of the tumor is best determined by the digital rectal examination, though the inaccuracy, as shown above, will be directly related to the size of the tumor, the grade of the tumor, and prior therapy. Examination of the prostate under anesthesia has not improved our staging accuracy. CT scan is relied upon mainly to assess the status of the pelvic lymph nodes, and enlarged, suspicious lymph nodes are biopsied by fine needle aspiration. Obviously, only patients with normal acid phosphatase and normal bone scans are considered for surgical therapy. In spite of the inaccuracy of the current staging methods, the probability of tumor-free survival of patients with clinical Stage B tumors is extremely high after radical prostatectomy. Many patients with capsular and seminal vesicle extension remain free of tumor after long-term follow-up (Zincke et al., 1982). Therefore, even within the limitations of our current staging methods, the results of radical prostatectomy for Stage B carcinoma remain excellent, and staging inaccuracy should not deter an attempt at surgical cure. PMID- 3659026 TI - Role of the transurethral resection in the cancer of the prostate. PMID- 3659027 TI - Natural history of prostatic cancer. PMID- 3659028 TI - Prostatic cancer in patients 80 years of age. AB - Thirty patients with adenocarcinoma of the prostate, Grade III-V, Stage IV, 80 years of age or more have been studied. Survival rate at 12 months was 19/30 (63.3%). Survival rate at 3 years was 18/30 (60%). The results of this study show that in spite of being a selected group of patients with high grade, high stage tumors, the survival rate at three years was even better when compared to a heterogeneous group of patients ten years younger (57.75%). PMID- 3659029 TI - Adenocarcinoma of the prostate: stage A1. PMID- 3659030 TI - Prostatic carcinoma: stage A. PMID- 3659031 TI - Evaluation of continence after radical prostatectomy. PMID- 3659032 TI - Radiotherapy of stage B2 lesions of the prostate. PMID- 3659033 TI - Wait and see: experience with B1 lesions. PMID- 3659034 TI - Reconstruction of the urethra by a tube from a bladder flap during radical retropubic prostatectomy. AB - Extirpation of a carcinoma-bearing prostate with requisite radicality is occasionally beset by problems with the reconstruction. On the basis of 56 cases, we have found it possible to use a tube from a bladder flap for the reconstruction of the urethra. When cases of neurogenic disorders and thin bladder musculature are excluded before the operation, one can expect normal urodynamic findings postoperatively and a good prognosis. PMID- 3659035 TI - Current therapeutic approach to prostatic cancer confined to the prostate gland (stage B). PMID- 3659036 TI - Oestrogens: are they really dangerous? Groupe Cooperatif d'etude sur le Cancer de la Prostate. PMID- 3659037 TI - Deferred hormone treatment in prostate cancer. PMID- 3659038 TI - Delayed hormonal therapy in advanced prostatic cancer. PMID- 3659039 TI - The case for early combined hormonal and cytostatic treatment for metastatic prostatic carcinoma. PMID- 3659040 TI - Primary treatment of stage C and D prostatic cancer: conclusions. PMID- 3659041 TI - Salvage prostatectomy. PMID- 3659042 TI - Urinary diversion in cancer of the prostate. PMID- 3659043 TI - The role of radiotherapy in the treatment of hormone-resistant stage C lesions. PMID- 3659044 TI - Non-specific treatment of persistent pain in advanced prostatic cancer. PMID- 3659045 TI - Extraperitoneal pelvioscopy in the evaluation of lymph node extension of prostatic cancer. PMID- 3659046 TI - The role of neurosurgery in the non-specific treatment of prostatic cancer pain. PMID- 3659047 TI - Pain treatment in metastatic prostatic carcinoma by radiofrequency thermolesion on the pituitary gland. Preliminary report. AB - Radiofrequency thermolesion on the pituitary gland is a simple and safe procedure to reduce pain in metastatic prostatic carcinoma. The method is indicated in patients with multiple and bilateral painful areas due to bone metastases, which are resistant to hormonal therapy and Estracyt. A good pain relief is achieved in over 60% of patients. Only one infectious complication has been encountered in a series of 17 patients treated this way. PMID- 3659048 TI - Prospects for the future: quality of life evaluation in prostatic cancer protocols. PMID- 3659049 TI - Management of hormone resistant stage C and D prostatic cancer. PMID- 3659050 TI - Evaluation of endocrine therapy of prostate cancer by assessing tumor markers and hormone parameters. Hormonal "cross-over" treatment of false endocrine independent tumors. PMID- 3659051 TI - Place of the computed tomography in the staging of prostatic cancer. PMID- 3659052 TI - Quantitative computerized tomography for staging and follow up of patients with prostatic cancer. PMID- 3659053 TI - Magnetic resonance imaging (MRI) in staging of the prostatic cancer. AB - In a prospective study, the role of MRI in the staging of prostatic cancer has been assessed in 32 patients. The results of MRI has been compared with those conventional staging modalities for prostatic cancer including pelvic CT, cystoscopy, bimanual examination and biopsy of the prostate. The final clinical and/or pathologic staging was obtained. The results of CT were compared with those of MRI in a blind fashion. In 22 of Stage A and B neither MRI nor CT were able to define the extension of the disease. In no cases were results of CT superior to the MRI. However, in 10 cases, the seminal vesicles were involved and these cases were interpreted as stage C. In exploration 2 out of 10 cases had metastases shown by MRI. It is concluded that MRI is more sensitive in revealing the detail of the seminal vesicles thereby detecting the bulk of the tumor and the extension of cancer into the soft tissue of the lymphadenopathy of this organ. The role of MRI in the detection of and the utilization of paramagnetic media remains to be studied. PMID- 3659054 TI - Cellular immunotherapy of cancer. Proceedings of an international symposium. Racine, Wisconsin, October 30-November 1, 1986. PMID- 3659055 TI - Molecular structure of the avian and mammalian ets genes. AB - The ets gene was originally identified as a second cell derived sequence transduced by the avian transforming retrovirus, E26. E26 induces erythroblastosis and myeloblastosis in chickens and transforms erythroblasts and myeloid cells in culture. From sequence analysis of the cloned provirus, the p135 transforming protein was found to be tripartite, with gag, myb and ets sequences. We have determined the nucleotide sequence of the v-ets homologous regions contained in chicken genomic clones which define nine domains. Two of these domains are not transcribed and thus do not represent functional exons. To further explore the function of the ets gene, we have begun characterization of the mammalian ets genes. Unlike the chicken gene, the mammalian ets genes are present on two chromosomes. The mammalian homologs of the 5' v-ets domain, ets-1, were mapped to chromosome 11 in man, to chromosome 9 in mouse, and to chromosome D1 in cat. The homologs of the 3' v-ets domain, ets-2, were mapped to human chromosome 21, to mouse chromosome 16, and to feline chromosome C2. The assignment of the ets-2 gene to the Down syndrome associated chromosome 21 may have interesting implications. This oncogene, ets has been connected with leukemias in chickens, and therefore might have a role in the increased frequency of leukemias in Down patients. PMID- 3659056 TI - Interferon alpha and beta induce increases of diacylglycerol in multiple cell types. PMID- 3659057 TI - [Simple qualitative determination of the active substances of drugs and/or their metabolites in urine--compliance test and drug screening]. PMID- 3659058 TI - Interaction between salicylic acid and repeatedly administered pyridinolcarbamate in rabbits. PMID- 3659059 TI - Determination of phenytoin in tablets by second-order derivative ultraviolet spectroscopy. PMID- 3659060 TI - [Microcapsules prepared by interfacial crosslinking with milk proteins]. PMID- 3659061 TI - Lupus catatonia: a case report. AB - A 19-year old female with catatonia associated with multi-system involvement with systemic lupus erythematosus is described. There was no evidence of CNS involvement (negative CT scan, normal EEG, normal ice-caloric response, and normal CSF findings). The patient improved on large doses of steroids. It is suggested that cerebral lupus should be considered in the differential diagnosis of catatonia even in the absence of radiological and focal neurological signs when the active disease is present. PMID- 3659062 TI - The use of sustained-release morphine in a hospice setting. AB - Thirty-seven patients with advanced cancer requiring oral administration of strong narcotics for pain control have been treated with one or other of two commercially-available, sustained-release morphine preparations. Patients were followed up primarily at home, supervised by a local hospice care team, and received daily dosage ranging from 60 mg to 420 mg morphine administered as 30 mg sustained-release tablets delivered at intervals from 6 to 10 hours for 'Roxanol SR' and from 8 to 14 hours for 'MS Contin'. Duration of treatment ranged from 2 to 80 days, and 17 of 19 patients who received sustained-release morphine for 20 or more days achieved a stable dosage schedule. Thirty-five of the 37 patients obtained good to excellent analgesia and only 2 of them required intermittent 'rescue' doses of standard morphine between doses of the sustained-release preparation. From experience with the use of the two preparations it was considered that 'MS Contin' was preferable because of the smaller size of the tablets and because of the longer duration of analgesia provided. It is concluded that sustained-release morphine preparations offer a safe and efficacious alternative to immediate-release analgesics and can help to improve the quality of life for the patient and care-givers. PMID- 3659064 TI - Urinary cortisol excretion and mood ratings in aircraft cabin crew during a tour of duty involving a disruption in circadian rhythm. AB - A psychophysiological study was carried out on 28 cabin crew, comprising two teams, who were to travel from Sydney to Los Angeles and return, with stopovers in Los Angeles of 58 and 82 hr respectively. Every urine sample for a period of nine days, commencing 2 days before the flight, was collected. The volume and time the sample was passed were recorded so that urinary cortisol secretion rates could be calculated. Mood was also rated on a scale scored 0-9 at the same time the urine sample was collected. A control group matched for age, sex ratio, and degree of manual labour involved in their occupation, but not involved with the flights, was included in the study for comparison. On the basis of urinary cortisol excretion rates, the crews in Sydney before the flight and in Los Angeles were more highly stressed than the control group. The urinary cortisol excretion rates were significantly greater than those of the control group in Sydney before the flight, in Los Angeles, and during the return flight, but not on the flight out. The high excretion rates before the flight were attributed to an apprehension factor, whereas the elevated values in Los Angeles and during the flight back were attributed to a disruption in circadian rhythm. A factor analysis of mood ratings showed three major factors assessing vitality, distress, and relaxation. Analysis of variance of the mood ratings showed significant changes over the tour of duty for 13 of the 14 moods. PMID- 3659063 TI - Long-term behavioral changes in rats following organophosphonate exposure. AB - The organophosphorus compound soman irreversibly inhibits cholinesterase in both the central and peripheral nervous systems. High doses of this compound produce seizures and death in animals. Surviving animals exhibit neural lesions and behavioral abnormalities. The behavioral effects of a single exposure to soman were evaluated in rats injected with 50 micrograms/kg or 85 micrograms/kg soman or with saline. Each rat was tested for either activity in an open field or performance in a 14 choice point multiple T-maze. All rats were then tested for reactivity to tactile stimuli. Some rats exposed to soman showed increased activity in the open field, learning deficits in the Stone maze, and increased reactivity to tactile stimuli, while others showed behavior similar to that of controls. An increase in reactivity was correlated with increased open field activity and with poor performance in the Stone maze. Rats which had received soman and were abnormal in behavioral tests were more likely to have abnormal brain pathology than rats which had received soman and were normal in behavioral tests. PMID- 3659065 TI - Stimulatory effects of ethanol in C57BL/6 mice. AB - Although ethanol stimulation is well documented in several species including humans, there is some controversy about whether the stimulation occurs in the highly inbred mouse strain, C57BL/6. Since inbred mouse strains are frequently used to elucidate mechanisms for individual differences in reaction to alcohol, the present study was undertaken to more completely characterize the behavioral effects of ethanol and to help resolve some of the controversy regarding the drug's stimulatory effect on C57 mice. Activity of female C57BL/6cr mice was assessed in either a lighted or dark environment for 20 min after injections of water or ethanol at doses of 0.5, 1.0, 2.0, 4.0 g/kg. Elevated activity (stimulation) was observed in mice injected with relatively low ethanol doses and tested in the light. The 2.0 g/kg dose produced a transient elevation in activity which declined rapidly across time. Animals tested under the dark condition were not stimulated by the drug but had activity reductions to high doses of ethanol. The detection of ethanol-induced stimulation appears to be related to the performance of control mice rather than a light-related difference in ethanol sensitivity. PMID- 3659066 TI - Effects of d-amphetamine on behavioral and autonomic thermoregulation in mice. AB - d-Amphetamine has well-known behavioral and sympathomimetic effects in rodents, but its effects on thermoregulation are not well characterized. d-Amphetamine was administered IP to mice at doses of 0.1 to 10.0 mg/kg. Locomotor activity and preferred ambient temperature (Ta) were measured for 60 min after injection in a linear temperature gradient, and metabolic rate (MR) and evaporative water loss (EWL) were measured in a metabolic chamber at ambient temperatures of either 20 degrees C or 30 degrees C. Colonic temperatures (Tc) were obtained 60 min after injection in all cases. Doses of d-amphetamine at 0.3 mg/kg and above reduced preferred Ta from the control value of 30 degrees C to about 25 degrees C. Locomotor activity was reduced briefly by 0.3 mg/kg, and increased after 3.0 mg/kg d-amphetamine. Metabolic rate was suppressed by 0.3 mg/kg of the drug at both 20 and 30 degrees C. At 20 degrees C Ta, 10.0 mg/kg d-amphetamine increased MR but not EWL. At 30 degrees C, MR and EWL were both increased by doses of 3.0 and 10.0 mg/kg. Body temperatures varied both as a function of d-amphetamine dose and of apparatus, with pronounced hyperthermia (Tc greater than 38.5 degrees C) evident only after 10 mg/kg in the metabolic chamber. Thus, the behavioral and autonomic heat loss responses induced in mice by d-amphetamine suggest that its thermogenic action is detected by the animal at doses below those producing measurable thermogenesis and that appropriate effectors, from selection of a cool Ta to increasing EWL, are engaged in an orderly progression to maintain normothermia under all but the most challenging conditions. PMID- 3659067 TI - Dietary calcium and phosphorus and seizure susceptibility of magnesium deficient rats. AB - Convulsions are characteristic of magnesium deficiency and hypocalcemia. In this study, weanling rats were fed magnesium deficient diets with varying concentrations of calcium and phosphorus. Diets were either normal (Mg =) or low (Mg-) in magnesium and were either low (Ca- or P-), normal (Ca = or P =) or high (Ca+ or P+) in calcium or phosphorus. After consuming the diets for 17 days, the rats were tested for audiogenic seizures and blood was then drawn for serum mineral analyses. Rats fed Mg-Ca = P =, Mg-Ca = P-, Mg-Ca+P = or Mg-Ca+P+ diets had high incidences of seizures. Those fed Mg-Ca-P =, Mg-Ca-P-, Mg-Ca = P+, Mg-Ca P+ or Mg-Ca+P- diets had low incidences of seizures. In general, animals with low serum magnesium and calcium levels and high serum potassium levels were susceptible to audiogenic seizures. In this model, serum magnesium level is the most important determinant of seizure susceptibility, followed by calcium and potassium. PMID- 3659068 TI - Influences of electrical lesions of the dopaminergic system on morphine- and U 50,488H-induced analgesia in rats. AB - The effects of electrical lesions of brain areas containing dopamine cell bodies and terminals on morphine analgesia were investigated and compared with those of a selective kappa-opioid agonist, U-50,488H. The analgesic effect of morphine 10 mg/kg IP was potentiated significantly in substantia nigra (SN)- or caudate putamen-lesioned rats, but not by ventral tegmental area (VTA) or nucleus accumbens lesions. However, electrical lesions of neither SN nor VTA affected the analgesic activity of U-50,488H 32 mg/kg IP. Although the tolerance to morphine analgesia developed in all four of the lesioned groups as well as in sham lesioned rats, a significant analgesic effect in the SN-lesioned group prevailed during chronic treatment for 14 days as compared with that of sham-lesioned rats. From these results, it is suggested that morphine analgesia is potentiated by dysfunction of the nigro-striatal dopaminergic system, but not by that of the mesolimbic dopaminergic system, the central dopaminergic system is not involved in the appearance of U-50,488H analgesia and is not basically related to the development of tolerance to morphine analgesia. PMID- 3659069 TI - Effect of dopamine agents on schedule- and deprivation-induced drinking in rats. AB - The dopamine agonist, apomorphine, or its antagonist, haloperidol, was administered to rats whose drinking was induced by fixed-interval schedules of pellet delivery or by water deprivation. The first study revealed that both drugs produced dose-dependent decreases in bar-pressing and schedule-induced polydipsia (SIP). At higher doses, haloperidol also depressed the rate of pellet delivery. The second study demonstrated that the suppression in SIP obtained in the first study was primarily due to the direct effect of the drugs and not to changes they produced on the underlying food reinforcement schedule. The third study showed that both drugs suppressed water deprivation-induced drinking during a ten-minute session. Apomorphine delayed the onset of drinking, while haloperidol accelerated the cessation of drinking. The results indicated that apomorphine produced motor deficits that interfered with consummatory behavior, and that haloperidol interfered with the sensory feedback necessary to sustain consummatory behavior. PMID- 3659070 TI - Sex and day-night differences in opiate-induced responses of insular wild deer mice, Peromyscus maniculatus triangularis. AB - We examined the effects of mu and kappa opiate agonists on the day- and night time nociceptive, locomotory and ingestive behaviors of an island population of wild male and female deer mice, Peromyscus maniculatus triangularis. The prototypical mu opiate agonist, morphine, had significant analgesic and locomotory effects, which were blocked by naloxone, and the specific delta opiate antagonist, ICI 154,129, respectively. The specific kappa opiate agonist, U 50,488, had significant analgesic actions and inhibitory effects on locomotor activity, as well as stimulating feeding. Significant day-night variations occurred in the analgesic and activity responses, with the mu and kappa opiate agonists having significantly greater effects at night. There were also prominent sex differences in responses; male deer mice displaying significantly greater levels of mu and kappa opiate-induced analgesia and alterations in activity than female animals. These sex differences in opiate-induced effects were most pronounced at night, female deer mice displaying reduced day-night rhythms of responsiveness. These results demonstrate the existence of significant day-night rhythms and sex differences in the mu and kappa opiate behavioral responses of a wild population of rodents. PMID- 3659071 TI - Differences in the acquisition process and the effect of scopolamine on radial maze performance in three strains of rats. AB - The acquisition process and the effect of scopolamine (SCOP) on the radial maze task were studied in 3 strains of male rats, Fischer 344 (F344), Sprague-Dawley (SD) and Wistar. The pretraining level of locomotor activity was measured and performance was quantitatively and qualitatively evaluated. The highest pretraining locomotor activity was observed in Wistar rats. In this experiment, rats were allowed to select each arm successively. The changes in the number of correct choices during the first eight selections, error choice in a trial and the total duration of a trial differed with the strain in the first 5 training sessions. Acquisition curve for F344 rats gradually rose. Wistar rats made many error choices. However, during the final 5 sessions, only the total duration of a trial differed with the strain. Wistar rats took the shortest time to finish a trial, but the number of sessions taken to acquire this task was the fewest with F344 rats, and the most with Wistar rats. The effect of SCOP differed among strains in all the above 3 indexes. Generally, the Wistar rat was the most affected by the injection of SCOP. Moreover, the change of the choice accuracy and the spatial strategy by the administration of SCOP were investigated. SD and Wistar rats showed a dose-dependent decrease in choice accuracy in the earlier selection. The spatial strategy was changed in every strain by the injection of SCOP. These findings do not support the previous finding that a high level of locomotor activity yields fast acquisition of this task or that Wistar rats are better in learning than SD, but indicates that SCOP affects not only the working memory but also the motivational factor. PMID- 3659072 TI - Interactions between oxiracetam, aniracetam and scopolamine on behavior and brain acetylcholine. AB - The effect of cognition-enhancing agents oxiracetam and aniracetam on scopolamine induced amnesia and brain acetylcholine decrease was investigated in the rat. Acetylcholine levels were measured by means of a gas-chromatographic method. Scopolamine (0.63 mg/kg IP 60 min before training) prevented the acquisition of a passive avoidance conditioned response ("step through": retest 30 min after training) and brought about a 64, 56 and 42% decrease in acetylcholine level in the cortex, hippocampus and striatum respectively. Oxiracetam (50 and 100 mg/kg IP) administered 30 min before scopolamine reduced the scopolamine-induced amnesic effect and decrease in acetylcholine level in the cortex and hippocampus, but not in the striatum. Lower and higher doses of oxiracetam were ineffective. Aniracetam (100 mg/kg PO) also prevented scopolamine-induced amnesia but attenuated acetylcholine decrease in the hippocampus only. Aniracetam (300 mg PO) reduced acetylcholine decrease in the hippocampus but did not prevent scopolamine amnesia. In conclusion, oxiracetam and aniracetam exert a stimulatory effect on specific central cholinergic pathways. However, a direct relationship between cognition-enhancing properties and cholinergic activation needs further confirmation. PMID- 3659073 TI - Effects of methylphenidate and d-amphetamine on timing in the rat. AB - Rats were trained to press a lever for food pellets provided according to a fixed interval 60-sec schedule of reinforcement. Probe trials (peak trials) assessed responding over two-min periods with no pellet delivered. The low rates of responding found early and late in probe trials were increased by methylphenidate and 1.0 mg/kg d-amphetamine (rate-dependent effect). Further, the mean time of responding (peak time) was shortened for both drugs (timing effect). PMID- 3659074 TI - Oral ethanol reinforcement in the rat: effect of the partial inverse benzodiazepine agonist RO15-4513. AB - The partial inverse benzodiazepine agonist RO15-4513 has been found to reverse the sedating and anti-conflict effects of acute ethanol administration. In non food or fluid-deprived rats, orally self-administering 10% ethanol in an operant situation, RO15-4513 resulted in a dose-dependent suppression on ethanol intake. Doses of 0.3, 1.0 and 3.0 mg/kg suppressed responding from approximately 25% to 60% respectively. A dose of 0.1 mg/kg had no significant effect upon responding. These findings were discussed in terms of the potential independence of brain mechanisms related to ethanol reinforcement and sedation. PMID- 3659075 TI - Effect of dopamine-receptor blockade on stimulation-induced feeding. AB - The effect of pimozide on stimulation-induced feeding was tested in food satiated rats. Pimozide produced a dose-dependent decrease in the number of animals eating during electrical stimulation of the lateral hypothalamus. A quantal dose response analysis yielded an ED50 of 0.323 mg/kg for pimozide. Because this dose is within the range of pimozide doses found to be effective in disrupting feeding in other tests, it seems likely that the neural substrate mediating stimulation induced feeding is similar to that involved in deprivation-induced feeding. PMID- 3659076 TI - One injection of cocaine produces a long-lasting increase in [3H]-dopamine release. AB - A single cocaine exposure has been reported to sensitize animals to the behavioral effect of subsequent cocaine administration for up to one week. We now report that a single injection of cocaine results in an augmentation in amphetamine-induced release of tritium from rat striatal slices preloaded with [3H]-dopamine. The augmentation appears within 24 hr and persists for at least 2 weeks after injection. This increase in release may result in increased synaptic concentrations of dopamine possibly caused by a change in the membrane transporter for dopamine. Increased dopaminergic synaptic transmission could explain behavioral sensitization. PMID- 3659077 TI - Increase of paradoxical sleep (PS) by intraperitoneal injection of brain extract from PS-deprived rats. AB - Intraperitoneal injection of a brain extract obtained from paradoxical sleep-(PS) deprived donor rats resulted in a small but significant increase of PS in normal recipient rats. Brain extract of non-deprived control rats was without effect. The results provide further evidence for the existence of a PS-inducing factor accumulating in the brain during PS deprivation. PMID- 3659078 TI - Locomotor behavior: numbers, numbers, numbers! Proceedings of a satellite symposium to the sixteenth annual meeting of the Society for Neuroscience. Washington, DC, November 9, 1986. PMID- 3659079 TI - Age differences in locomotor behavior of C57BL/6NNia mice: a data management approach. AB - Separate age groups of C57BL/6NNia mice were tested for within- and between session habituation of locomotor behavior using a Digiscan System for simultaneous automated gathering of 23 locomotor variables. A computer program, Raw Data Input Program (RDIP) was developed for the reformatting and transfer of raw data samples to a spreadsheet/database management system, and a method for summarization, analysis and presentation of the multivariate data is described. It is concluded that large samples of multivariate locomotor activity data can be effectively managed using a single microcomputer and commercially available software packages. PMID- 3659080 TI - Pattern recognition of rat behavior. AB - Analysis of animal behavior has been an arduous task requiring a human observer to record and classify individual motor acts. A computer pattern recognition system is introduced which simplifies this task by minimizing the need for human intervention. This system uses two video cameras with horizontal and vertical views of the behavior of a control and an experimental rat as they explore a simple environment for 15 minutes. Their behavior is sampled at a rate of one frame/second. Data from the video cameras are then converted into a form acceptable to Micro Vax I and VAX 11/750 computers. Each video picture is reduced to a 256 by 256 array, and ultimately each 15 minute observation session generates 28,800 blocks of information at 512 bytes each. Using a mathematically complete set of moments to the fourth order and the associated scalar invariants, the computer is programmed to identify the five major body positions of the rat including standing, sitting, rearing, walking and lying down. The computer also is programmed to identify the behaviors of grooming, head turning, whole body turning, looking, smelling, sniffing and washing face. This computer pattern recognition system not only speeds up behavioral classification, it alleviates the much criticized subjectivity introduced by human observers. PMID- 3659081 TI - Automated multivariate measurement of spontaneous motor activity in mice: time course and reliabilities of the behavioral measures. AB - A variety of automated procedures have been developed to measure certain aspects of spontaneous motor activity in small animals. The present study used a Digiscan Animal Activity Monitor to measure six different aspects of spontaneous motor behavior in male CF-1 mice. The Digiscan system uses infrared beams and computer analysis to quantify various behavioral variables. The mice were tested for 1 hour on 2 different days of the week for 3 consecutive weeks. Both the temporal changes in the measured variables and the test-retest reliabilities were examined in a group of 30 mice. Statistical analysis of the data revealed significantly higher mean values for total movement time, average distance travelled, and horizontal activity on the first test session relative to the second session (p less than 0.01). The other 3 measures, total distance travelled, number of movements, and average speed, did not vary significantly across test sessions. All 6 behavioral variables showed good test-retest reliabilities and these could be increased by aggregating the data on a weekly basis. The present results indicate that the measures obtained from the Digiscan system are reliable and that the animals should first be habituated to the test apparatus in order to obtain stable baseline activity values. PMID- 3659082 TI - Digiscan activity: automated measurement of thigmotactic and stereotypic behavior in rats. AB - Visual measures of stereotypy, margin time (thigmotaxis or wall-hugging), and center time were correlated with automated measures using a revised 16 beam version of the Digiscan Animal Activity Monitor System. Rats were injected with d amphetamine (1.25, 2.5, 5.0 and 10.0 mg/kg), scopolamine (1.25 and 2.5 mg/kg) or saline and drugs were found to increase center time and decrease margin time in a dose-dependent manner, with the maximum effect occurring with 1.25 and 2.5 mg/kg, respectively. At higher doses, an opposite effect was observed. Extremely high correlations between visual and automated recordings of both margin time and center time were found. Since thigmotaxic or wall-hugging behavior has been used as an indicator of emotionality in rats, the results of the present study suggest that these two locomotor variables may be useful additions to the Digiscan multivariate analysis of locomotor behavior. It was also found that a redefinition of stereotypic behavior improved its correlation with visual measurements compared to earlier studies. PMID- 3659083 TI - Mice genetically selected for differences in open-field activity after ethanol. AB - Starting from a population of genetically heterogeneous mice, selective breeding is being used to develop lines differing in sensitivity to ethanol-induced open field activity. Mice are tested twice for 4 min in an open field. The first test is between min 2-6 after injection of saline. Twenty-four hr later, a similar test is performed after injection of ethanol (1.5 g/kg). Two independent FAST lines are being selected for ethanol-induced increases in activity, and two independent SLOW lines are being selected for ethanol-induced decreases. After four generations of selection, the lines have diverged significantly. These lines should be useful for exploring the neuropharmacological basis for the activating and rewarding properties of ethanol. PMID- 3659084 TI - Locomotor behavior changes induced by E-17 striatal transplants in normal rats. AB - It is well established that embryonic tissue transplantation into an abnormal or lesioned brain can ameliorate some of the accompanying symptomatology. Specifically, transplants placed into kainic acid (KA) or ibotenic acid lesioned striatal rats promote behavioral recovery in various ambulatory measures. In the KA animal model, when the transplant encroached on normal host tissue, the behavioral recovery was diminished. However, little has been done to reveal what effect tissue transplants have on normal host brain. The present study placed E 17 striatal tissue into a normal adult striatum. Digiscan locomotor testing revealed that ten weeks after surgery, the implanted animals demonstrated pervasive nocturnal hyperactivity. Ambulatory, vertical and stereotypic measures were significantly increased when compared to controls. Rats with ten week implants showed lower increases in body gain yet increased food consumption when compared to controls. The transplants survived and contained normal looking AChE positively stained neurons. Evidence for fiber passage through the host-graft interface was also seen. When comparing three and ten week implants, there was a decrease in transplant size in the latter group accompanied by enlarged ventricles giving the brain a lesioned-like appearance. From these results, it is suggested that the placement of E-17 striatal tissue into adult striatum results in lesion-like behavior which may be attributed to the physical disruption of striatal systems. PMID- 3659085 TI - Ninety-fifth annual convention of the American Psychological Association. Division 28 (Psychopharmacology). August 28-September 1, 1987, New York, NY. Abstracts. PMID- 3659086 TI - Estrogen treatment to ovariectomized rats modifies morphine-induced behavior. AB - Two weeks after surgery, ovariectomized (OVX) rats were treated for 3 days with either 17 beta-estradiol (10 or 100 micrograms/kg, SC, per day) or the oil vehicle. They were then tested for morphine-induced hyperactivity (4 mg/kg, IP), analgesia and catalepsy (15 and 20 mg/kg, IP) 24 or 72 hr after the last steroid or oil injection. Estradiol treatment did not affect the locomotion or the sensitivity to nociceptive stimuli of OVX rats and did not induce a cataleptic state in animals. Estradiol- (100 micrograms/kg) treated OVX rats exhibited attenuated morphine-induced hyperlocomotion regardless of the time that had elapsed after estradiol treatment cessation, attenuated morphine-induced catalepsy at 24 hr after estradiol treatment and unaltered morphine-induced analgesia. OVX rats treated with a lower estradiol dose (10 micrograms/kg) exhibited significantly increased morphine-induced analgesia and slightly increased catalepsy. The results show that the sensitivity of brain opiate systems controlling some of the behavioral effects of morphine is modified following estradiol treatment to OVX rats. PMID- 3659087 TI - Influence of hypophysectomy on dopamine receptors and dopaminergic behaviors. AB - Hypophysectomy (Hypox) has been proposed to alter the behavioral and biochemical indices of striatal dopamine (DA) function. Since the regulation of striatal DA receptors by hormones may involve the pituitary, it was relevant to reevaluate the effects of Hypox in male and female rats. Behaviorally, dopaminergic agonists exerted enhanced activity in Hypox male and female rats. It has been suggested that these changes are due to altered metabolism since no increase in the DA receptor populations was observed. Dopaminergic antagonists showed equivalent behavioral actions in male and female rats, whether intact or Hypox. Biochemically, neither the density nor the affinity of the striatal DA receptors is altered by Hypox in female rats for 1-2 weeks or male rats for 5-6 weeks. However, in female rats at 5-6 weeks after Hypox there is a significant decrease in receptor number. This decrease in density is not reflected in behavioral changes to either DA receptor agonists or antagonists. Therefore, all dopaminergic behavioral changes do not result from alterations in DA receptors and changes in DA receptors do not necessarily dictate altered behavioral responses to dopaminergic agents. PMID- 3659088 TI - Effects of low-level microwave irradiation on hippocampal and frontal cortical choline uptake are classically conditionable. AB - In previous research, we found that sodium-dependent high-affinity choline uptake in the hippocampus and frontal cortex of the rat was lowered after acute (45 min) exposure to low-level 2450-MHz pulsed microwaves (power density 1 mW/cm2; average whole body specific absorption rate, 0.6 W/kg; 2 mu sec pulses, 500 pps). In the present experiment, we investigated developments of tolerance and classical conditioning to these effects of microwaves. Rats were exposed to microwaves in cylindrical waveguides in 10 daily sessions (45 min per session). In an 11th session, we subjected the rats to either microwave (study of tolerance) or sham exposure (study of conditioned effect) for 45 min, and immediately measured choline uptake in the hippocampus and frontal cortex. We found that tolerance, a decrease in response to microwaves, developed to the effect of microwaves on choline uptake in the hippocampus, but not in the frontal cortex. Conditioned effects were also observed: an increase in choline uptake in the hippocampus and a decrease in uptake in the frontal cortex. These data suggest that the effects of microwaves on choline uptake in the hippocampus and frontal cortex are classically conditionable, probably to cues in the exposure environment. PMID- 3659089 TI - Ethanol effects on aggression of rats selected for different levels of aggressiveness. AB - Male rats confronting strange male intruders into their home cages were divided into nonaggressive, low-to-intermediate aggressive, and highly aggressive groups. In tests with low (0.3 and 0.6 g/kg) doses of ethanol the nonaggressive rats did not become aggressive; low-intermediate animals showed a significant increase in frequency and duration of attack behaviors; but highly aggressive rats displayed a slight (nonsignificant) decline. A higher ethanol dose (1.2 g/kg) consistently led to decreased aggression. This rate-dependency of the enhancement of aggression by low doses of ethanol is concordant with a view that the mechanism of this enhancement involves ethanol interference with some mechanism which normally acts to limit or inhibit attack. PMID- 3659090 TI - Ethanol effects on female aggression vary with opponent size and time within session. AB - Female rats displayed different patterns of attack to large and small male intruders into their home cages, as a function of ethanol dose levels. In confrontations with small male intruders, female attack increased significantly at 0.3 g/kg ethanol, declining to saline levels with higher doses (0.6 and 1.2 g/kg). Attack toward large intruders was (nonsignificantly) higher at 0.3 g/kg ethanol, and declined to significantly lower than saline levels with the higher ethanol doses. The attack increases seen with low ethanol doses came in the initial 5-min block of the 30 min test session, and did not persist. These findings suggest that low ethanol doses may especially increase overt aggression in situations in which the tendency to attack is only moderately inhibited by factors such as opponent size or the potential danger of retaliatory attack. PMID- 3659091 TI - Effects of d- and l-amphetamine on food intake: evidence for a dopaminergic substrate. AB - The present experiment examined the effects of d- and l-amphetamine on the intake of sugar, sweetened rat chow and unsweetened rat chow in free feeding rats. Rats were injected IP with 4 doses of d- or l-amphetamine (0.0, 0.125, 0.50 and 2.00 mg/kg). Regardless of drug condition, animals were found to prefer sugar over sweetened or unsweetened chow. d-Amphetamine significantly increased food intake at 0.125 and 0.50 mg/kg doses but not at 2.00 mg/kg. l-Amphetamine had no significant effects at any dose. Further, d-amphetamine significantly increased sugar intake but not sweetened or unsweetened chow. Since d- and l-amphetamine are equipotent at releasing noradrenaline, while d-amphetamine is 2 to 5 times more potent at releasing dopamine, the results suggest that d-amphetamine-induced feeding is associated with activation of a dopaminergic substrate. PMID- 3659092 TI - Effect of xylene inhalation on fixed-ratio responding in rats. AB - The effect of xylene inhalation was studied on operant behavior under a fixed ratio (FR24) schedule in rats. Experiments were performed while rats were being exposed to xylene vapor in an inhalational (flow-through) behavioral chamber. Rats were exposed successively to three graded concentrations (113, 216 and 430 ppm) of xylene vapor each for 2 hr in range-finding studies during 6 1/4-hr sessions. The reinforcement rate which is correlated with FR responding was shown to be decreased at hr 1, hr 3 and hr 5. However at hr 2, hr 4 and hr 6 the reinforcement rate in rats increased approaching the control levels, thereby indicating development of tolerance. When rats were exposed to one of the three graded concentrations of xylene for 2 hr on separate days, they also showed a decrease in the reinforcement rate at hr 1; development of acute tolerance was also noted in this schedule. Exposure to the lowest (98.5 ppm) level of xylene used during 5-hr sessions caused no significant decrease in the reinforcement rate. This study thus attempts to identify a minimum effective concentration of xylene and indicates the development of acute tolerance to behavioral effect of xylene. PMID- 3659093 TI - Heroin self-administration: effects of antagonist treatment in lateral hypothalamus. AB - The involvement of the lateral hypothalamus and medial prefrontal cortex in mediating heroin self-administration was examined by means of intracranial microinjections of the quaternary opiate antagonist methyl naltrexone over a dose range of 0-3.0 micrograms. In animals trained to respond on a continuous reinforcement schedule for intravenous heroin (0.03 mg/kg/infusion), microinfusions of antagonist into the lateral hypothalamus prior to a self administration session produced significant dose-related increases in responding on the drug manipulandum, similar to increases in responding observed after treatment with naltrexone systemically. Microinfusions of quaternary antagonist into the medial prefrontal cortex over the same dose range effective in the lateral hypothalamus did not produce response increases. These data suggest that opiate action in the lateral hypothalamus, but not in the medial prefrontal cortex, is salient in maintenance of intravenous self-administration. PMID- 3659094 TI - Similarity of 5-HT2 receptor sites in dominant and subordinate vervet monkeys. AB - Pharmacological studies using serotonergic agents have revealed status-linked behavioral effects in dominant and subordinate vervet monkeys. A possible explanation for the greater drug response observed in dominant animals is that there is a CNS difference between dominant and subordinate animals. Such differences could exist at the level of serotonin receptor sites, membrane responsiveness, or interaction with other neurotransmitters. We have examined the specific 3H-ketanserin binding in various regions of vervet monkey brain to evaluate the hypothesis that dominant and subordinate vervet monkeys differ in CNS 5-HT2 receptor sites. No differences were found in the number or affinity of 3H-ketanserin binding sites between dominant and subordinate animals. Further, no differences were found in the displacement of 3H-ketanserin binding by the serotonin agonist quipazine. These results suggest the conclusion that differences at 5-HT2 binding sites do not account for status-linked differences in behavioral drug response in vervet monkeys and that other or additional mechanisms must underlie status-related drug response differences. PMID- 3659095 TI - The effects of d-amphetamine on food competition in male rats. AB - Male Wistar rats were tested in 3 competitive situations to determine the effects of d-amphetamine (AMP) on competitive behavior. Subjects were initially tested in a fixed-pair food competition paradigm. Based on the percentage of pellets obtained, a winner and loser were defined for each pair. AMP (2.0 and 4.0 mg/kg) was then administered to one or both members of pair, and the effects of the drug on the defined winners and losers were determined. AMP did not significantly alter the percentage of pellets obtained by losers except when only the winners were administered AMP (4.0 mg/kg). Subjects were then tested in a round-robin competition paradigm in which each subject was paired with every other subject. The animals were ranked according to the percentage of pellets obtained out of a possible 450 pellets. AMP (2.0 mg/kg) decreased pellet acquisition in higher ranking subjects, whereas pellet acquisition was increased in lower ranking subjects. The effects of AMP were also evaluated in a "worker-parasite" paradigm. Subjects were individually conditioned to press a lever using an FI schedule for presentation of a food pellet. When the lever was located on the wall opposite the food hopper, a worker and parasite were defined for each pair. The worker was the subject that made the most responses on the lever while obtaining fewer reinforcements. Subjects that were defined as winners in the fixed pair food competition emerged as the workers in this situation. AMP (0.8 mg/kg) given concurrently to both subjects resulted in a reversal of roles; the parasites now emitted the majority of responses and obtained less pellets. The data indicate that AMP has a differential effect on participants in competitive situations when all subjects in the situation are treated. PMID- 3659096 TI - Genetic influences on tolerance development with chronic oxotremorine infusion. AB - Mice of four inbred strains (BALB, C57BL, DBA and C3H) were administered either saline or oxotremorine, a muscarinic agonist, at a dose of 0.5 mg/kg/hr by constant infusion through cannulas implanted in the right jugular veins. Chronic treatment resulted in the development of tolerance to the effects of oxotremorine both on rotarod performance and on body temperature. For drug-treated BALB mice, the dose-response curves for both measures were parallel to those for saline treated mice, while for DBA and C3H mice the slopes of the dose-response curves were significantly less for treated mice than they were for controls. The equi effective doses for the drug-treated animals were at least 8-fold greater than those for saline-treated mice. Drug treatment resulted in a significant decrease in the total number of muscarinic receptors in cortex as measured by the binding of [3H]quinuclidinyl benzilate (QNB) without effect on the KD for this ligand. Similarly, drug treatment did not affect the affinity of carbamylcholine as an inhibitor of QNB binding, but did significantly decrease the levels of both the high- and low-affinity agonist binding sites in cortex. The number of M1 muscarinic receptors measured by high affinity [3H]pirenzepine (PZ) binding was also significantly decreased in cortex without effect on the KD. The experiments were extended to five other brain regions. Full saturation curves were not constructed, however. Oxotremorine treatment significantly reduced QNB binding in every brain region. While the binding to agonist affinity states measured by carbamylcholine inhibition of QNB binding and M1 receptor levels measured by high affinity PZ binding tended to decrease with oxotremorine treatment not all changes were statistically significant. The changes in muscarinic receptor subtype levels induced by oxotremorine infusion did not differ among the strains. The results demonstrate that chronic treatment with a muscarinic agonist results in substantial tolerance to the effects of the drug in all four mouse strains. Although some differences in tolerance development exist, these differences are not readily explained by differences in the number or affinity states of brain muscarinic receptors. PMID- 3659097 TI - Effect of muscimol on ethanol-induced central nervous system depression. AB - In male Sprague-Dawley rats acute ethanol (1.0 and 2.0 g/kg) produced impairment of motor coordination and induced hypnosis (4.0 g/kg). Muscimol (1.25 mg/kg, IP) prior to ethanol administration enhanced motor impairment as measured by the aerial righting reflex. The rate of ethanol disappearance from the blood was unaltered by muscimol. Functional tolerance to the effect of ethanol on sleep time was produced by a 24 hr ethanol inhalation procedure. Animals tested 48 hr after ethanol inhalation exhibited a reduced sleep time from ethanol (4.0 g/kg). Muscimol (1.75 mg/kg) was administered along with ethanol 48 hr following 1 day of ethanol inhalation. Although the animals exhibited tolerance to ethanol induced hypnosis, they did not manifest tolerance to the effect of muscimol. PMID- 3659098 TI - Action of fenfluramine, phenylpropanolamine, phentermine and diethylpropion on acoustic startle in rats. AB - Four commonly used anorectics which are amphetamine analogues were tested for their action on responsiveness in an acoustic startle test when rats were given daily IP injections adequate to produce a change in body weight. Drugs were given for 22 days. None of these drugs increased startle responsiveness as does the amphetamine parent compound. Instead, fenfluramine and phenylpropanolamine decreased startle responsiveness and phentermine and diethylpropion produced no change. There was no relationship between drug action and body weight. Partial tolerance was found for the fenfluramine action on startle and complete tolerance was found for its action on body weight gain. The fenfluramine action is compatible with the extensive literature on humans and animals indicating sedative properties. PMID- 3659099 TI - Tetrahydro-beta-carboline may produce its stimulus effects via 5HT1B receptors. AB - To further clarify the role of 5-hydroxytryptamine (5HT) in the behavioral effects of tetrahydro-beta-carboline, male rats were trained to discriminate either 20 mg/kg THBC from its vehicle (n = 10) or 2.0 mg/kg fenfluramine from saline (n = 5). THBC was observed to produce fenfluramine-like effects in the fenfluramine-trained rats while fenfluramine produced THBC-like effects in the THBC-discriminating rats. To investigate which of the serotonergic receptors may mediate the THBC-induced discriminative stimulus, various putatively specific 5HT agonists were administered to THBC-trained rats. Results indicate that the 5HT1B receptor agonists TFMPP and m-CPP substitute for THBC in a dose-response manner whereas 5HT1A agonists do not generalize to the THBC-induced discriminative stimulus. These observations support a role for the 5HT1B receptor site in the discriminative stimulus properties of THBC. PMID- 3659100 TI - The involvement of neuropeptide Y in the antimuricide action of noradrenaline injected into the medial amygdala of olfactory bulbectomized rats. AB - The present study was designed to clarify the functional role of neuropeptide Y (NPY) in the regulation of muricide induced by olfactory bulbectomy (OB) in relation to that of noradrenaline (NA) in the medial amygdala (AME). NA injected into AME inhibited muricide dose-dependently in OB rats. NPY at doses of 5 and 10 micrograms/microliter injected alone into AME failed to suppress muricide. When NPY 10 micrograms was injected into AME in combination with the maximal non effective dose of NA, which was determined in each rat, muricide was suppressed in 80% of OB rats. The present study has provided the first evidence suggesting that NPY may be involved in the regulation of OB-induced muricide. PMID- 3659101 TI - Persistence of tolerance to a single dose of ethanol in the selectively-bred alcohol-preferring P rat. AB - The persistence of tolerance to a single dose of ethanol was examined in the selectively-bred alcohol-preferring P line of rats. Tolerance was measured by a test that required trained rats to jump onto a descending platform to avoid footshock. On day 0, each trained rat received a single IP injection of 2.5 g ethanol/kg body weight and was tested every 15 minutes for recovery to a criterion of 75% of pre-alcohol training performance. The second ethanol injection of 2.5 g/kg and testing were carried out seven days later for one group (n = 12), and 14 days later for another group (n = 12). Tolerance was assessed by the differences in time required to recover to criterion performance and blood alcohol concentrations (BACs) at time of recovery on day 0 vs. day 7 and day 14. The mean recovery times and BACs on day 0 were 156 +/- 5 minutes and 222 +/- 6 mg%, respectively. The group injected on day 7 exhibited shorter recovery times of 113 +/- 4 minutes and higher BACs at recovery of 261 +/- 4 mg%, while the group injected on day 14 did not show any significant differences from the values obtained on day 0. In a second experiment, the persistence of tolerance in P rats was compared with that of rats from the alcohol-nonpreferring NP line and of stock Wistar rats (n = 6/group). All rats were trained and tested for recovery to criterion after 2.5 g ethanol/kg on day 0 as described for the first experiment. The rats were then injected with ethanol and tested for tolerance on three subsequent occasions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659102 TI - Chronic ethanol tolerance through free-choice drinking in the P line of alcohol preferring rats. AB - The objective of this study was to determine if the selectively bred P line of alcohol-preferring rats would develop behavioral (neuronal) tolerance with free choice drinking of ethanol. Adult, male P rats were divided into four groups. One group (FCE) received food, water and a 10% (v/v) ethanol solution ad lib, while the control group (C) had only food and water. The other two groups received either a liquid diet containing 5% (v/v) ethanol (LDE) or a control liquid diet (LDC). All groups were kept on their respective feeding regimens for 14 days. The mean (+/- SEM) ethanol intakes for the FCE and LDE groups were 6.8 +/- 0.5 and 9.9 +/- 0.4 g ethanol/kg body wt./day, respectively. A shock-motivated jumping task was used to test for tolerance. Each rat received an IP injection of 2.5 g ethanol/kg and was tested every 15 minutes for recovery to a criterion of 75% of the performance level achieved with training. All rats were tested twice, once on the day before beginning their feeding regimens (day 0) and again 14 days later. Tolerance was assessed from differences in time of recovery to criterion performance and in blood alcohol concentrations (BACs) at recovery on day 0 vs. day 14. The mean recovery times for the C, FCE, LDC, and LDE groups on day 0 were 177 +/- 6, 170 +/- 6, 143 +/- 10 and 153 +/- 13 minutes, respectively, and the BACs were 219 +/- 6, 222 +/- 5, 220 +/- 19 and 214 +/- 6 mg%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659103 TI - Repeated low dose apomorphine induced subsensitivity of presynaptic dopamine receptors. AB - The influence of repeated administration of a low dose of apomorphine on presynaptic dopamine (DA) receptors was examined. (1) Male ddY mice were given a low dose of apomorphine (0.2 mg/kg) for 7 days. Following 2 drug-free days they were given apomorphine (0.2 mg/kg, IP), after which cage climbing behavior and the level of 3-methoxytyramine (3MT) in striatum was measured. Mice became tolerant to apomorphine's activity-depressing effect and 3MT-decreasing effect. (2) Mice were given haloperidol (1 mg/kg) for 7 days. Then after 2 drug-free days they were given 0.2 or 1.0 mg/kg of apomorphine, after which cage climbing behavior was measured. One mg/kg of apomorphine significantly increased cage climbing behavior, indicating that supersensitivity of postsynaptic DA receptors was induced by haloperidol, but the activity-depressing effect of 0.2 mg/kg of apomorphine was not modified. The results suggest that subsensitivity of presynaptic DA receptors participates in the tolerance to the activity-depressing effect of a low dose of apomorphine. PMID- 3659104 TI - Effect of taste aversion learning on ethanol self-administration. AB - Ethanol (EtOH) oral self-administration studies using rats have had inconsistent outcomes: studies in which rats are fluid deprived report decreasing EtOH intake over trials, whereas studies not employing fluid deprivation report increasing intake over trials. The present study supports the hypothesis that differential taste aversion learning may account for some of this discrepancy. This study indicates that taste aversion learning is maximized under fluid deprivation conditions and that "latent inhibition," i.e., exposure to non-intoxicating amounts of the EtOH solution prior to conditioning, reduces taste aversion learning. It is suggested that the effect of fluid deprivation on taste aversion resulting from EtOH self-administration may be at least in part due to the development of latent inhibition in non-deprived animals during initial exposure to the EtOH solution. PMID- 3659105 TI - Rat strain differences in ethanol self-administration and taste aversion learning. AB - Taste aversion learning was investigated in two inbred strains of rats known to differ in amount of ethanol (EtOH) they will self-administer orally. The "low EtOH preference" strain, WKYs, acquired an aversion to an EtOH solution during self-administration; but a "high preference" strain, M520s, did not. It was shown that a lower dose of EtOH will condition saccharin aversion in WKYs than in M520s, suggesting EtOH is a more effective US in the low preference strain. Analysis of patterns of EtOH self-administration indicates the pattern of the low preference strain is more likely to result in taste aversion learning. The implications of these results for the presumed relation between EtOH preference and other EtOH-related phenotypes is discussed. PMID- 3659106 TI - Effects of intrathecal capsaicin on autonomic and behavioral heat loss responses in the rat. AB - Capsaicin and Tween 80 were injected into the lumbar subarachnoid space of rats via a chronic cannula, and the thermoregulatory effects compared. The rats were placed in a climatic chamber at an ambient temperature (Ta) of 20 and 30 degrees C. In the first series of experiments the rats had no access to the fan lever. Intrathecal (IT) capsaicin injection produced a fall in rectal temperature, with a rise in cutaneous temperatures due to vasodilation. On the contrary, IT or the intraperitoneal (IP) Tween 80 injection route had no effect on body temperature. In addition capsaicin-administered IP induced a fall in spinal cord temperature (Tsp). In the second series of experiments the rats had access to a lever activating a fan that drew cool outside air into the climatic chamber. After IT capsaicin injection, the rats increased bar-pressing behavior for fresh air. This was significant at both Ta 20 and 30 degrees C. The results tend to support the hypothesis of capsaicin action somewhere on the thermal afferent pathways. Furthermore, it is possible that the action of capsaicin on thermoregulatory behavior is mediated by the release of substance P from primary afferent terminals. PMID- 3659107 TI - Effects of a subanesthetic concentration of nitrous oxide on establishment, elicitation, and semantic and phonemic generalization of classically conditioned skin conductance responses. AB - Classical conditioning of skin conductance responses was studied in 16 men and 16 women breathing 30% nitrous oxide or 100% oxygen to see how nitrous oxide affected establishment, elicitation, and generalization of conditioned responses (CRs). For CRs that had been established before gas inhalation, nitrous oxide blocked elicitation of "anticipatory" (long latency) but not "orienting" (short latency) CRs. Nitrous oxide appeared to prevent new CRs from being established during its inhalation, but learning evidently took place since anticipatory CRs could be elicited after nitrous oxide inhalation had ceased. Words were used as the conditioned stimuli and nitrous oxide altered generalization of CRs to other words related in meaning or sound, though generalization effects were limited. Nitrous oxide also seemed to reduce the efficacy of the unconditioned stimulus. The results were interpreted in terms of Rescorla's theory of classical conditioning. PMID- 3659108 TI - Interactions of Ro 15-4513 with diazepam, sodium pentobarbital and ethanol in a holeboard test. AB - Ro 15-4513 (1.5 mg/kg) decreased the exploratory activity of mice in a holeboard test. This effect was reversed by diazepam (1 mg/kg), ethanol (1 g/kg) and sodium pentobarbital (15 mg/kg). Higher doses of these three agents reduced the number of exploratory head-dips, and Ro 15-4513 antagonised these effects. These observations are consistent with the suggestion that Ro 15-4513 is a partial inverse agonist at benzodiazepine receptors and acts by reducing the efficacy of GABA. Ro 15-4513's interaction with ethanol in the holeboard closely resembled its interaction with the barbiturate. PMID- 3659109 TI - Diazepam self-administration and resistance to extinction. AB - Self-administration behavior was maintained by a unit dose of 0.03 mg/kg diazepam in 4 of 5 monkeys trained to respond on a lever by successive approximation using diazepam or saline. A dose-response function was determined using diazepam doses ranging between 0.01 and 0.3 mg/kg/infusion. Peak rates of responding occurred at doses of 0.01 or 0.03 mg/kg/infusion and drug intake was directly related to dose. When saline was substituted for diazepam either before or again after the dose-response function was determined, levels of responding remained unexpectedly high, even after as many as 16 consecutive sessions. The rates of responding maintained under extinction conditions appeared to be directly related to the amount of diazepam previously self-administered. For instance, monkeys which did not initially have high rates of responding for saline showed increases in responding after additional exposure to diazepam. Furthermore, the one monkey with low diazepam self-administration rates also had low rates of responding for saline. However, following a period of cocaine self-administration, responding declined in all monkeys when saline was substituted for cocaine. The data suggest that diazepam self-administration affects responding under extinction conditions, an effect which makes the interpretation of diazepam's reinforcing properties difficult. PMID- 3659110 TI - Aspects of abstinence after morphine ingestion. AB - Sprague-Dawley male rats were intoxicated with morphine, using an ingestion method where exposed and control rats received equivalent amounts of calories and nutrients. The degree of physical dependence on morphine was demonstrated by studying and quantifying abstinence symptoms after withdrawal or after administration of opiate antagonists. The aims of the study were (1) to further enlighten the specificity and validity of the intoxication method concerning physical dependence, and (2) to determine whether some of the abstinence signs might be of value to facilitate quantitation of the degree of physical dependence on morphine, with diet and fluid intake being maintained under control. Withdrawn rats showed a decreased fluid diet intake and a body weight loss, the latter partly due to anorexia. Other mild abstinence signs were irritation, tremor and some motor excitation. The body weight loss during the first day of morphine withdrawal was proportional to the accumulated drug dose (between 25 and 300 mg morphine PO/kg b.wt.). However, prolonged morphine treatment on one dose (340 mg/kg b.wt.) did not reinforce the body weight changes caused by morphine withdrawal. The succeeding weight gain some days after morphine withdrawal was not entirely dependent on the amount of fluid diet intake. Methadone was shown to partially block the decrease in diet intake and the weight loss seen during morphine withdrawal. The naloxone-precipitated withdrawal symptoms were motor excitation, cholinergic signs, body weight loss, diarrhoea and decreased diet intake. The weight loss 2 hr after naloxone administration to long-term intoxicated rats was proportional to the naloxone dose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659111 TI - The role of endogenous opioids in footshock-induced hyperthermia. AB - Either opioid or nonopioid forms of stress-induced analgesia can be elicited depending on the intensity or duration of the stressor. Several forms of stress have also been shown to cause hyperthermia in the rat. The present study investigated whether opioid and nonopioid forms of such stress-induced hyperthermia can be elicited in the rat as a function of footshock current intensity. Rats were given footshock after pretreatment with saline or naltrexone, or chronic morphinization. Footshock produced hyperthermia, the degree of which was found to be a function of current intensity. While the peak rise in temperature was not affected by naltrexone or chronic morphine administration, the rate of return to baseline temperature was slowed by these treatments. Thus, the endogenous opioid system appears to be involved in the return to normal body temperature following footshock, but not in the footshock induced rise in temperature. PMID- 3659112 TI - Urinary 6-beta-OH-cortisol and paracetamol metabolites as a probe for assessing oxidation and conjugation of chemicals in humans. AB - The ratio between urinary 6-beta-OH-cortisol and 17-OH-corticosteroids was taken as an indirect estimate of monoxygenase activity in a population of controls and epileptic patients undergoing therapy with diphenylhydantoin and phenobarbital. Cortisol hydroxylation was increased in the group of epileptics with large inter individual variations notwithstanding a similar dosage of inducers. The levels of some phase II conjugating enzymes were followed by administering paracetamol and measuring the urinary excretion of its main metabolites. Paracetamol glucuronate was increased by levels of cysteine and mercapturic derivatives of paracetamol did not vary, whereas sulfate derivatives were decreased in epileptic patients. Plasma N-acetyl-transferase activity did not vary in either group. Hydroxylated cortisol and paracetamol glucuronide excretion were not correlated in the same individuals, and no correlation was found between the ratio of 6-beta-OH cortisol/17-OH-corticosteroids and the plasma levels of diphenylhydantoin or phenobarbital. Oxidation of cortisol and conjugation of paracetamol were controlled with different mechanisms, varied considerably between individuals and were not predictive of the pharmacokinetics of the inducers in treated patients. PMID- 3659113 TI - PEG superoxide dismutase derivatives: anti-inflammatory activity in carrageenan pelurisy in rats. AB - Two derivatives of superoxide dismutase (SOD) with monomethoxypolyethyleneglycol, having different molecular weights (46,000 and 121,000 D) and different plasma half-lives are tested in carrageenan pleurisy in rats after single i.v. injection. The compounds were prepared following an original method where the polymer is activated by trichlorophenylchloroformate to give a phenylcarbonate which is reactive towards the protein amino groups. The anti-inflammatory activity of derivatives results correlated to their kinetics, lasting longer for the derivative with the longest half-life (SOD-PEG 18). SOD activity, in plasma of rats treated with SOD-PEG 18, is still present 24 hour after carrageenan, in agreement with the prolonged anti-inflammatory activity. Moreover SOD-PEG 18 diffuses well in pleural exudate, as it is evidentiated from the increase with time of exudate/plasma concentration ratio. PMID- 3659114 TI - Cholinergic and non-cholinergic components of the inotropism evoked by electric field stimulation in the isolated rat urinary bladder. Influence of some eicosanoids. AB - The present study explores whether some arachidonic acid (AA) metabolites formed via cyclo-oxygenase or lipoxygenase pathways influence the inotropism of isolated rat urinary bladders evoked by electric field stimulation (EFS), both in presence of or in absence of atropine. The EFS consisted in square wave pulses of 5 Hz, 5 msec duration and supramaximal voltage, applied every 3 min for a period of 10 sec. Acetylsalicylic acid (ASA) at 10(-4) M, decreased around 30% the magnitude of inotropic responses to EFS and prostaglandin E2 (PGE2, partially at 10(-9) M and fully at 10(-8) M), restored control inotropic levels. PGI2 was also active but only at 10(-7) M; whereas PGF2 alpha, at all concentrations tested (10(-9) 10(-7) M), failed to counteract the diminishing effect of ASA. Moreover, dose response curves for added acetylcholine (ACh) were not modified by ASA. On the other hand, in presence of atropine (10(-5) M), a diminution of around 40% in the magnitude of control responses to EFS, was detected and when ASA (10(-4) M) was added to atropine-exposed preparations, the atropine resistant component of the EFS-evoked inotropism, was reduced around 30%. Although recovering effects of added PGs were again observed, they were not identical to those observed in absence of atropine. Indeed, PGE2 fully restored the magnitude of contractile responses but it did so only at concentrations 10 times higher than without the cholinergic receptor blocker. On the other hand, PGI2 as well as PGF2 alpha, even at 10(-7) M, were devoid of significant influence. In determining whether lipoxygenase products of AA were also able to modulate the EFS-evoked inotropism, tissue preparations were incubated with nordihydroguaiaretic acid (NDGA), an inhibitor of lipoxygenases, and tested for contractile responses to electric stimulation. NDGA (10(-7) M), failed to alter rat urinary bladder inotropic response to EFS, both in presence of or in absence of atropine. Results suggest that the cholinergic, as well as the non-cholinergic components of the EFS-evoked contractions in isolated rat urinary bladders, are modulated by some cyclo oxygenase formed AA metabolites, particularly certain PGs, like PGE2. PMID- 3659115 TI - Hemodynamics, prolactin and catecholamine levels during hemorrhagic shock in dogs pretreated with a prolactin inhibitor (bromocriptine). AB - Bromocriptin, a dopaminomimetic drug, causing inhibition of prolactin secretion, was used in experiments on haemorrhagic shock in dogs. 5 dogs were treated with bromocriptine (0.4 mg.day-1) for two days; a further 5 dogs were used as control animals. 30% of the blood volume was drawn from each dog. Mean arterial blood pressure, heart rate, central venous pressure, acid-base status, prolactin, GH and catecholamine levels were checked before blood letting and monitored until 1 hour after blood letting. Animals treated with bromocriptine showed a significant decrease of the mean arterial blood pressure and of the prolactin rate and a significant increase of catecholamine levels. Control animals, instead, showed a significant increase of the prolactine and catecholamine rates. The results obtained suggest that bromocriptine can constitute an additional hypotensive factor in subjects with acute haemorrhage. A considerable amount of research work previously carried out has shown a close correlation between stress and hyper prolactinemia. The increase of prolactinemia and the effects of bromocriptine on this hormone during surgical stress is particularly interesting due to its possible implications (Lanza V. et coll., 1983). In previous experiments involving animals it was found that Prolactin exerts positive chronotropic and hypertensive effects (Horrobin D.F., 1977) whilst bromocriptine is a potent agonist of D2 dopaminergic receptors (Thorner M.O. et coll., 1980). Dopamine was found to be particularly useful in the clinical treatment of shock thus suggesting an involvement of peripheral D2 receptors. On the basis of these observations we have considered it worthwhile to investigate the haemodynamic effects of bromocriptine in haemorrhagic shock. PMID- 3659116 TI - The genetic animal model of reflex epilepsy in the Mongolian gerbil: differential efficacy of new anticonvulsive drugs and prototype antiepileptics. AB - Four new anticonvulsive drugs were compared to four prototype antiepileptics regarding their differential efficacy, i.e. against tonic-clonic, myoclonic, and minor seizures, in reflex epilepsy in genetically epileptic gerbils. We distinguished at least three types of drugs: Phenytoin and ralitoline selectively prevented tonic-clonic seizures; the other drugs tested were active against all seizure types. However, carbamazepine and AHR-11748 were predominantly active against tonic-clonic seizures, whereas phenobarbital, valproate, gabapentin, and zonisamide equipotently suppressed both tonic-clonic and myoclonic seizures. PMID- 3659117 TI - Neurochemical and behavioural changes induced by ascorbic acid and d-amphetamine in the rat. AB - In male Wistar rats, ascorbic acid (AA) (1 gr/kg i.p.) significantly (P less than 0.05) decreased the rate of CAR in the shuttle box avoidance test and antagonized the d-amphetamine (d-A) (1 mg/kg s.c.)-induced increase of CAR. Shuttle box test reduced striatal dopamine (DA) levels by about 86% (with a consistent 2-3 fold increase of DOPAC levels). DA levels were greatly reduced also in hypothalamus (HYP) and in hippocampus (HIP). AA further decreased striatal DA but significantly antagonized the reduction of DA levels in HYP and HIP. d-A antagonized the reduction of DA levels in all the above brain regions. Shuttle box test reduced noradrenaline (NA) levels mainly in HIP (-52%) and again d-A showed a significant protective effect in all regions; AA did not interfere with NA level reduction in striatum (ST) and HYP, but antagonized it in HIP. It is concluded that striatal DA system plays an important role in rat operant active avoidance behaviour. AA seems to exert a negative modulatory activity which can be counteracted by d-A. PMID- 3659118 TI - Hemodynamic and pharmacokinetic aspects of the interactions between verapamil and pindolol. AB - Combined administration of verapamil, a phenylalkylamine calcium-entry antagonist, with a pure beta-adrenoceptor blocker, propranolol, produces profound cardiovascular depression associated with decreased hepatic clearance of both drugs. We have therefore studied the combination of verapamil and pindolol, a beta-adrenoceptor blocker with intrinsic sympathomimetic activity (ISA), to evaluate whether or not the property of ISA will confer protection from the usual toxic effects observed with verapamil and a beta-adrenoceptor blocking agent. In an anesthetized dog model, dosing regimens which produced stable plasma concentrations of either verapamil and/or pindolol resulted in drug effects which were closely related to the plasma levels of the individual agents. When pindolol was combined with verapamil, profound depression of cardiac pump function occurred, similar to that previously found with propranolol. Further, plasma concentrations of verapamil promptly increased into a toxic range during combined administration with pindolol. In summary, since the cardiovascular depression resulting from verapamil and pindolol in combination is similar to that which occurs with verapamil and propranolol, ISA does not appear to obviate the toxic effects of verapamil and a beta-adrenoceptor agent in combination. PMID- 3659119 TI - Development of tolerance to the inhibitory effects of ethanol in the isolated rat vas deferens. Effect of selective agonists and antagonists. AB - Our previous experiments demonstrated that chronic ethanol treatment of rats produces tolerance to the in vitro inhibitory effects of ethanol on norepinephrine-, KCl-, and electrically evoked contractions of the vas deferens. In the present study, ethanol dependence also resulted in subsensitivity of the vas to the effects induced by alpha 2-adrenoceptor agonist clonidine, the alpha receptor antagonists phentolamine and phenoxybenzamine, as well as to adenosine and naloxone. These results indicate that the biochemical mechanisms of ethanol express themselves at both the pre- and postjunctional level involved in the modulation of neurotransmission in the rat vas deferens. PMID- 3659120 TI - After fifteen years, what does M.D. really stand for? PMID- 3659121 TI - Casualties of the health care system: patients depressed by medicine's "moral dilemmas". PMID- 3659122 TI - Toenails and heart transplants: technology challenges humanistic medicine. PMID- 3659123 TI - The death penalty: dilemmas for physicians and society--a panel discussion. PMID- 3659124 TI - University hospitals: historical precedents. PMID- 3659125 TI - Publish (in the Yellow Pages)--or perish? PMID- 3659126 TI - Grant program development. PMID- 3659127 TI - Hand washing. PMID- 3659128 TI - Competence versus caring. PMID- 3659129 TI - Double degrees. PMID- 3659130 TI - The physician at the movies. PMID- 3659131 TI - Past and present. PMID- 3659132 TI - Influence of prior knowledge on automatic and voluntary postural adjustments in healthy and hemiplegic subjects. AB - The purpose of this study was to analyze the effects of prior instruction on automatic postural responses and voluntary postural sways measured about the ankle joint. Ten subjects with right hemiplegia resulting from a cerebrovascular accident (mean age = 56 +/- 14 years) and 5 healthy subjects (mean age = 47 +/- 6 years) stood symmetrically on a movable force platform. During platform-induced sway, the support surface was translated horizontally to induce antero-posterior body sway about the ankle joints. Surface electromyographs were obtained from the tibialis anterior, quadriceps femoris, gastrocnemius, and hamstring muscles bilaterally. Prior knowledge appeared to have no significant influence on healthy subjects' ability to execute postural adjustments more rapidly during AP displacements. Hemiplegic subjects exhibited longer and more variable latencies in the paretic limb than in the nonparetic limb during voluntary AP weight shifts. When hemiplegic subjects had prior knowledge of the platform's movement (time and direction), latencies were significantly shorter in the paretic limb and could be as brief as those seen in the nonparetic limb. The results showed that prior knowledge may be an important treatment consideration for patients with muscle timing disorders. PMID- 3659133 TI - Comparison of heart rate responses. Water walking versus treadmill walking. AB - The purpose of this study was to compare heart rate responses to water walking versus treadmill walking to determine whether the responses were of sufficient magnitude to elicit cardiorespiratory training effects. The heart rates of 12 healthy, female college students were measured immediately after walking in waist deep water and on a treadmill at the same distance, durations, and speeds (2.55, 2.77, 3.02, and 3.31 km/hr). A significant increase in heart rate with increased speeds resulted from water walking (p less than .05); from rest to the fastest speed, it was 135% (96 bpm). For treadmill walking, the increase of 19% (13 bpm) was not significant. The heart rates for the water condition were significantly higher (p less than .05) at each speed. These findings indicate that water walking could serve as an effective exercise mode, for example, for cardiorespiratory fitness for individuals who are unable to perform such weight bearing activities as jogging, fast walking, cycling, and dancing. PMID- 3659134 TI - Effects of recurrent lateral ankle sprains on active and passive judgements of joint position. AB - The purpose of this study was to examine the effects of recurrent lateral ankle sprains on subjects' active and passive judgments of joint position. Fourteen subjects with recurrent unilateral ankle sprains contributed data to two groups: 1) In Group 1, the subjects' 14 sprained ankles were tested and 2) in Group 2, the same 14 subjects' contralateral nonsprained ankles were tested. An additional seven subjects with no history of injury to either ankle comprised Group 3 with 14 nonsprained control ankles. The experimenter tested all blindfolded subjects with active and passive attempts at replicating predetermined ankle joint positions in the inversion-eversion range of motion. An isokinetic dynamometer measured joint position. A two-way analysis of variance indicated no significant effect caused by ankle injury or noninjury. Passive judgments were significantly better than active judgments of joint position (p less than .01) in the nonsprained control group. The results suggest that joint receptors play a dominant role in joint angle detection and that muscle receptors are more valuable in the perception of joint movement. PMID- 3659135 TI - Prosthetic use in elderly patients with dysvascular above-knee and through-knee amputations. AB - Fifty-five patients with vascular insufficiency resulting in above-knee (AK) and through-knee (TK) amputations were studied to determine factors related to prosthetic candidacy and functional outcome. Chart review showed that the only difference between patients who were fitted with prostheses and those who were not fitted with prostheses was their respective number of medical complications. Twenty-three of 31 patients with prostheses were evaluated 7 to 35 months after receiving the prostheses. Ten (44%) of these patients wore their prostheses all day every day and used wheelchairs minimally or not at all. Over half of the patients evaluated used their wheelchairs most of the time. Two (9%) of the 23 patients had stopped wearing their prostheses. Patients who demonstrated increased walking distances and velocities at follow-up used their prostheses more and their wheelchairs less than did the other patients. Neither gait factors nor hip range of motion at discharge was predictive of continued prosthetic use. Functional outcome and prosthetic use were limited in this group of elderly patients with dysvascular AK and TK amputations. The results of this study may serve as a basis for clinical determination of prosthetic candidacy and functional goals. PMID- 3659136 TI - Effects of prone spinal extension exercise on passive lumbar extension range of motion. AB - The purpose of this study was to determine the effectiveness of prone spinal extension exercises for increasing passive lumbar extension range of motion in healthy young adults. Eighteen healthy female and 18 healthy male volunteers were divided randomly into control groups (women, n = 10; men, n = 8) and experimental groups (women, n = 8; men, n = 10). The experimental groups performed 20 repetitions of a prone extension exercise each day for four weeks; the control groups did not. We used spondylometry to measure lumbar extension ROM. The exercises produced a significant difference (p less than .025) in the passive lumbar extension ROM between the male experimental and control groups preventing a loss of spinal mobility in the men who exercised. Analysis of the data revealed no significant difference between the female groups. The results are discussed in light of the clinical significance of lumbar extension ROM. We suggest further studies to examine the effects of lumbar extension exercises on patients with restricted ROM and low back pain. PMID- 3659137 TI - Interexaminer reliability of observations in physical examinations of the neck. AB - The purpose of this study was to collect data on interexaminer reliability of a set of tests representative of the clinical examination of a patient with neck and radicular pain. A conventional neurological examination, palpations, and tests for the provocation or relief of radicular symptoms were performed on 52 patients by two independent raters. Good reliability was obtained in the atrophy inspection of the small muscles of the hand, in the sensitivity tests for touch and pain, and in the neck compression and axial manual traction tests. Fair reliability was obtained in muscle strength testing and in the estimation of the range of motion, and poor reliability was obtained for many palpations. Poor standardization of examination procedures and changes in the patients' attention were considered the main factors affecting reliability. Better operational definitions and procedures, such as the standardization of palpation pressure and traction force, are suggested for future studies. PMID- 3659139 TI - Molded double-rocker plaster shoe for healing a diabetic plantar ulcer. A case report. AB - The purpose of this case report is to document the successful healing of a chronic neuropathic plantar ulcer with the molded double-rocker plaster shoe (MDRPS) in a lower extremity that also had stasis changes and poor blood flow. The patient was a 67-year-old woman with insulin-dependent diabetes mellitus, insensitive feet, a right ankle-arm index of 0.48, and an ulcer beneath the right cuneonavicular joint measuring 0.94 cm2 in area and 2 mm deep. Reported onset of the ulcer was 10 months before referral for physical therapy. The MDRPS was chosen as an alternative treatment to conventional below-knee total contact casting (TCC) because of the stasis changes and fragile skin in the patient's lower extremities. The ulcer healed in 39 days after initiating treatment with the MDRPS. We consider the MDRPS the preferred treatment with those patients with neuropathic plantar ulcers who cannot tolerate the below-knee TCC. PMID- 3659138 TI - Diagnostic value of knee extension torque tracings in suspected anterior cruciate ligament tears. AB - The purpose of this study was to determine the diagnostic accuracy of knee extensor muscle torque tracings in patients suspected of having damage to the anterior cruciate ligament of the knee joint. The knee extensor torque tracings of 30 patients suspected of having anterior instability of the knee joint were reviewed independently for abnormalities believed to be associated with anterior cruciate ligament damage. These results were compared blindly with an arthroscopic evaluation. The diagnostic accuracy of the torque tracing approach was determined by calculating the prevalence, sensitivity, specificity, and positive and negative predictive values. The sensitivity and specificity were calculated to be 25.0% and 85.7%, respectively. These results suggest that the curve patterns examined in this article have poor diagnostic accuracy and are of little benefit as a clinical diagnostic aid. PMID- 3659140 TI - Statistical analysis of productivity in one physical therapy department. AB - The purposes of this retrospective study were to document productivity-relevant measurements, describe the relationships between these measurements, and discuss the implications of the relationships in one physical therapy department. The department's inputs (clinician and staff hours worked), outputs (patient visits, patient procedures, hours charged, and dollars charged), and productivity (staff utilization, financially productive time, and dollars charged per staff hours worked) were monitored. Pearson product-moment correlations, partial correlations, and linear regression statistics were calculated to determine the relationships between the variables measured. During the 30-month period studied, average daily census of the institution decreased, clinician hours worked decreased, patient procedures and dollars charged increased, and the three productivity measures increased. The relationship between output measures and clinician hours worked was apparent only after the effects of increased productivity were controlled. Departmental outputs and productivity were independent of the institution's census. The findings provided no evidence that decisions regarding staffing should be based on institutional census. PMID- 3659141 TI - Role of injections. PMID- 3659142 TI - DRL performance in the weanling rat: a comparison with adult subjects. AB - Weanling (21-day) and adult (3-month-old) albino rats were reinforced for lever pressing on a Differential Reinforcement of Low rates 20 seconds schedule. After 2 sessions at DRL 5, 10, 15 and 20 seconds, 40 DRL 20 seconds sessions were performed, at a pace of 4 sessions a day. Adult rats emit lower response rates, higher median Inter-Response-Times (IRTs) and obtain more reinforcers than weanling rats. Furthermore, their coefficients of variation (ratio between semi interquartile range and median of the IRT distribution) are significantly lower than those of the young subjects. Age-related differences are discussed in relationship with general activity, food motivation and timing mechanisms. It is suggested that weanling and adult timing devices do not basically differ, but that age-related differences exist at the level of the translation of time estimates into overt behavior. PMID- 3659143 TI - Growth and activity but not maturation are affected by perinatal diet. AB - Growth, maturation and activity in Sprague-Dawley rat offspring were studied as a function of two diets which were offered both pre- and postnatally. Day 1 gravid rats were placed ad lib on either Purina chow or Ensure, a total liquid diet. Half of each group was switched to the other diet on day 21 of gestation and maintained on it through weaning. Offspring remained on the same diet until sacrificed on postnatal day 60. Seven developmental measures were assessed daily until all of the animals reached criterion. The type of diet significantly affected maternal weight gain during the second third of gestation, and neonatal weight gain as measured on days 7, 14, 21, 28 and 45. Females were affected more than were male littermates. Males were significantly heavier than female littermates at all postnatal weighings. Diet had little or no effect on the developmental measures. Male/female differences were found for voluntary activity in the wheel which was measured on day 45. The use of liquid diets in behavioral teratology studies and the wisdom of using pellet diets as a control are discussed. The possibility of substituting careful measures of growth as an alternative to developmental testing is discussed. PMID- 3659144 TI - Weight gain in postweaned rats as a function of predictable and unpredictable feeding schedules. AB - In two experiments rats given unpredictable feeding schedules gained less weight over a 24 or 30 day training period than rats which consumed an equivalent amount of food on a predictable schedule. These results suggest that irregular feeding schedules disrupt food utilization. PMID- 3659145 TI - The basolateral limbic circuit and self-stimulation of the medial prefrontal cortex in the rat. AB - The effects of lesions of the basolateral nucleus of the amygdala (ABL) and the mediodorsal nucleus of the thalamus (MD) on self-stimulation (SS) of the medial prefrontal cortex (MPC) were investigated. Spontaneous motor activity (SMA) was measured as a control for possible non-specific effects of the lesions. Bilateral electrolytic lesions of ABL or MD produced a parallel transient decrease of SS and SMA. However, combined lesion of ABL and MD produced clearly different effects on both parameters. SMA decreased during the 1st day post-lesion and recovered to control levels by the 3rd day post-lesion. SS, on the contrary, was significantly decreased during the first five days post-lesion and after that time SS rate recovered to control levels. These results suggest the involvement of the basolateral limbic circuit in the neural substate underlying SS behavior of the MPC. PMID- 3659146 TI - The impact of single versus repeated exposure of mice to Toxocara canis. AB - Infection with T. canis can alter dramatically the brain and behavior of the host. Previous results suggest that if the mammalian host is exposed either simultaneously to lead, or has a history of prior exposure to that toxic substance, the magnitude of the behavioral reaction to T. canis may be modified or even reduced. The present data suggest that the magnitude of both the behavioral and tissue/immune reactions may be less if the organism has multiple, instead of a single exposure, to T. canis. Lead, and perhaps other environmental toxicants may alter neurotropic products of the parasite, the behavior of the parasite, and/or reactivity of the host in the presence of the parasite. Such considerations may help explain, in part, the relative rarity of reported toxocariasis in humans, despite the fact that serological indices suggest that exposure to T. canis may be as high as 7% of the world population. PMID- 3659147 TI - Hormonal influences on the duration of postpartum maternal responsiveness in the rat. AB - These studies investigated the role of gestational hormones in controlling the duration of the postpartum period of elevated maternal responsiveness in rats. In the first study, females had pregnancies terminated by Caesarean section, and had ovaries removed on day 16 or 22 of pregnancy. Removal of the ovaries did not prevent the sustaining of an elevated maternal responsiveness for 7 days after pregnancy termination on either day. In the second study, changes in concentrations of estrogen and progesterone during pregnancy, and following parturition, were determined by radioimmunoassay. Levels of these hormones postpartum were found to decline to virgin levels by 7 days postpartum and could not therefore explain the elevated maternal behavior seen at this time. In the third study, ovariectomized virgins were given a pregnancy-mimicking schedule of estradiol and progesterone, with and without prolactin, and were tested for maternal behavior 2 and 7 days later. A 22-day estradiol-progesterone schedule induced rapid maternal behavior within 2 days, but did not sustain it for 7 days. Adding prolactin to the 22-day estradiol-progesterone schedule sustained some components of maternal behavior, notably nest-building and retrieval, but not maternal behavior as a whole. PMID- 3659148 TI - Daily variations in plasma noradrenaline, adrenaline and corticosterone concentrations in rats. AB - Plasma noradrenaline (NA), adrenaline (A) and corticosterone (CS) concentrations were determined in blood samples taken once every hour during a 12-hr light/12-hr dark period from freely moving rats with a permanent heart cannula. Before, during and shortly after each blood sampling, behavioral activity was recorded. All rats exhibited a very pronounced peak in CS concentrations at the end of the light period, indicating normal circadian rhythmicity. Plasma NA and A contents varied significantly over the 24-hr sampling period. During nighttime, the behaviorally active phase, mean levels of circulating A and NA were significantly higher than during daytime resting period. Significant correlations between the daily NA, A and behavioral activity patterns were found only when uncorrected data were considered. In contrast, no significant correlations were found for values corrected for circadian trends, indicating that circadian patterns of NA, A and behavioral activity rather than their short-term fluctuations are similar. It is concluded that the circadian variations in plasma NA and A reflect a common activation of both the neural and adrenomedullary parts of the sympathetic autonomic nervous system, most likely associated with the daily patterning of behavior activities. On short-term basis through the day however, a dissociation between these two parts can occur suggesting separate regulating mechanisms for the fine tuning of physiological processes. PMID- 3659149 TI - The anterior basal lobe and control of prey-capture in the cuttlefish (Sepia officinalis). AB - The predatory behaviour of the cuttlefish comprises several stages: prey detection, orientation, translation and prey-seizing. In this neuroethological study, lesions to the anterior basal lobe were made by an electrolytic method and the animals were allowed to attack their prey in an unrestricted way so that motor defects, functional recovery and the emergence of new adaptative behavioural strategies could be studied. Lesions to the central region of the anterior basal lobe suppress the orientating behaviour, thus only prey situated in the frontal visual field can be seized. Less extensive lesions in this region are associated with similar defects. Without head orientation, the cuttlefish still rotates with its fins. This rotation, however, is usually underestimated, tentacular ejection thus missing the prey. Dorsal lesions cause an underestimation of tentacular strike often associated with defects in maintaining ocular convergence. These results demonstrate the heterogenous function of the anterior basal lobe and its complex role in the control of predatory behaviour. PMID- 3659150 TI - Capsaicin and its effects upon meal patterns, and glucagon and epinephrine suppression of food intake. AB - The neurotoxin capsaicin has been shown to selectively interfere with unmyelinated sensory fibers, as well as leading to depletions of substance P and other peptides. Meal pattern analysis was performed both before and after treatment with capsaicin in twelve adult male Sprague-Dawley rats. Capsaicin treatment only briefly altered feeding patterns. No long term effect on body weight was noted. These same animals were then tested for the appetite suppressing effects of IP injections of glucagon (125 micrograms/kg) and epinephrine (30 micrograms/kg). Capsaicin treated rats decreased their intake of sweetened condensed milk during a 30 minute test in response to glucagon and epinephrine. Controls failed to suppress intake in response to glucagon, but drank less milk after epinephrine than did capsaicin treated rats. Efficacy of capsaicin treatment was obtained using similarly treated animals subject to histological evaluation within 2 days of capsaicin treatment. These results suggest that peripherally generated information relayed to the CNS via small diameter sensory neurons is not a necessary component of the normal hunger/satiety sequence, nor body weight regulation. PMID- 3659151 TI - A method to quantify aggressiveness in Japanese quail (Coturnix c. japonica). AB - Testing procedures which rely on paired fights are unsuitable for measuring individual aggressiveness because the outcome of initial encounters influences subsequent dominance status. In an effort to circumvent this problem, we developed a test system which quantifies aggressiveness in individual Japanese quail by measuring locomotor and pecking activity of test birds presented with the visual stimulus of a conspecific. Using this procedure, we demonstrate that aggression is specific to sexually mature males; however, the intensity of the behavior varies widely among individuals. Scores for each bird are constant with time, reproducible, independent of the gender or behavior of the stimulus bird and accurately predict the outcome of a subsequent paired fight. In addition, we show that fighting per se produces increases and decreases in aggressiveness of dominant and subordinate birds, respectively, and re-orders the rank of a group of birds. This test procedure, therefore, confirms earlier studies which indicate that dominance hierarchies are influenced by initial encounters. Finally, repeat testing is reliable and gives an absolute, not relative, measure of aggressiveness. We conclude that this behavioral test can be applied to future studies addressing the social, developmental and endocrine basis of aggressiveness and dominance in quail and other vertebrates. PMID- 3659152 TI - Change in salt appetite due to rehydration level in rats. AB - Thermally dehydrated rats were given a choice of tap water and saline (0.9% or 1.8% NaCl), and the change in the salinity of their choice during rehydration was measured up to 15 hr. The rats consumed more water than saline for about 2 hr after the start of fluid replacement (about 55 mEq/l), while they consumed more saline than tap water (about 120 mEq/l) thereafter. Urine output and urinary Na output were only about 20% of their intake during the initial 4 hr of rehydration, while after 4 hr the output became almost equal with the intake. The change in salt intake occurred when about 90% of Na loss and 60% of fluid loss was regained. The results indicate that rats choose dilute salt solution to lower plasma osmolality during the initial period of the rehydration and then regain body fluid isotonically. Urine volume and urinary Na output increased only after volume repletion. Thus, osmoregulation with salt appetite has priority over fluid volume regulation in restitution from thermal dehydration. PMID- 3659153 TI - Changes in water intake following pharyngolaryngeal deafferentation in the rat. AB - The role of afferent information arising from the pharyngolaryngeal region in the regulation of water intake was evaluated in rats. The animals received picric application to the mucosa of either the pharyngolaryngeal or the hard palate region. Water intake of the pharyngolaryngeal treated animals was reduced significantly, while no reduction in water intake was shown in the control and hard palate treated animals. PMID- 3659154 TI - Workshop on the Interaction of Ethanol and Stress. Helsinki, Finland, June 13, 1986. Proceedings. PMID- 3659155 TI - Stress and ethanol-induced hypothermia. AB - Three experiments examined the effects of three stressors on the hypothermic response to IP injection of ethanol in rats. Although all three stressors elicited hyperthermia in the absence of ethanol, only electric footshock reduced ethanol hypothermia. Handling/rectal-probing and bright, flashing light enhanced ethanol hypothermia. Type of cage floor (solid vs. grid) affected overall magnitude of ethanol hypothermia, but did not affect handling-induced enhancement of ethanol hypothermia. It is suggested that events which trigger release of endogenous opioids may enhance ethanol hypothermia. This kind of ethanol-stress interaction has important implications for studies of the acute and chronic effects of ethanol, including studies of learned tolerance. It may also have implications for understanding the impact of stress on voluntary consumption of ethanol. PMID- 3659156 TI - Ethanol prevents stress-induced increase in cortical DOPAC: reversal by RO 15 4513. AB - Electric foot-shock increased DOPAC and decreased DA levels by about 70 and 20% respectively in the medial prefrontal cortex in rats. Pretreatment with diazepam (5 mg/kg IP) or ethanol (1.2 g/kg orally) prevented these stress-induced changes. The protective effect of diazepam and ethanol was eliminated by RO 15-4513 (5 mg/kg IP) a partial inverse benzodiazepine agonist. PMID- 3659157 TI - Effects of early experience on responsiveness to ethanol: a preliminary report. AB - The present study examined the hypothesis that early experiences which alter an organism's response to novel or aversive stimuli and hence its ability to cope with stress might also alter sensitivity to and preference for alcohol. On day 1 of pregnancy, females were assigned to 1 of 5 groups: Handled (H), Nonhandled (NH), Malnourished (MAL), Prenatally stressed (PRE) or Control (CON). Offspring were tested in adulthood to measure their adrenocortical response to stress (ether plus cardiac puncture), adrenocortical response to IP ethanol injection and alcohol preference. Data indicate that early experience did alter responsiveness to stress in adulthood; early handling decreased later stress responsiveness and prenatal stress increased later stress responsiveness. In addition, although early experiences did not alter the corticosterone response to IP ethanol at 60 min post injection, both preweaning handling and perinatal malnutrition reduced alcohol preference in adulthood. PMID- 3659158 TI - Ethanol sensitivity in rats: effect of prenatal stress. AB - The present study examined whether sensitivity to ethanol could be altered by prenatal stress exposure. Pregnant female rats were handled during the third week of gestation and the offspring were tested for ethanol sensitivity as adults. Compared to control offspring, the following characteristic responses to acute ethanol were significantly attenuated in prenatally stress-exposed rats: the decreases in body temperature, motor coordination and startle amplitude, and the increases in circulating corticosterone and free fatty acids. Ethanol-induced impairment of swim performance, in contrast, was potentiated in these animals. Since no differences were found in blood or breath ethanol levels, the rate of ethanol metabolism was probably not affected by prenatal stress. Rather, the altered responses appear to result from long-term changes in central nervous system sensitivity to ethanol. PMID- 3659159 TI - Maxillary hypoplasia secondary to midfacial trauma in childhood. AB - Three normal children who suffered midfacial trauma and developed midfacial retrusion that would require Le Fort III advancements for correction of the deformity are described. The common denominator in these three cases seems to be an injury to the medial facial structure including the nasal septum. It is concluded that midfacial fractures in childhood may be a cause of subsequent midfacial hypoplasia. PMID- 3659160 TI - Frontal sinus fractures: guidelines to management. AB - The appropriate management of frontal sinus fractures is controversial. Experience with 78 frontal sinus fractures over a 9-year period was reviewed, and the fractures were classified into anterior wall, anterobasilar, and frontal skull fracture extensions. The presence of a concomitant CSF leak or an air-fluid level in the sinus was a diagnostic clue of posterior wall involvement. Ablation or obliteration of the fractured frontal sinus is not necessary. Primary reconstruction of the sinus and nasofrontal duct drainage constitute the preferred treatment. "Cranialization" of a severely damaged sinus is performed by excision of the posterior wall plugging of the nasofrontal duct and reconstruction of the anterior wall. Reconstruction of the anterior wall with primary bone grafting may be necessary in selected patients. PMID- 3659161 TI - Unilateral cleft lip repair. AB - The marking of the medial lip segment of the Millard rotation advancement procedure for repair of the unilateral cleft lip has been altered in the uppermost portion by utilizing tissue from the columellar base. Once adequate length has been obtained, cutback is utilized at approximately 90 degrees. With adequate full-thickness release of this medial lip segment and subsequent rotation into the proper position, the C flap is advanced into the donor defect of the columellar base and is also used to lengthen the shortened columella on the cleft side. This results in placement of a scar that will closely simulate the "mirror image" of the noninvolved philtral column. Fifty-seven patients with unilateral cleft lip have been repaired utilizing this technique during the past 14 years. Several of these children have required secondary surgeries because of mucosal irregularities or residual nasal deformities, but none has required additional surgery because of inadequate rotation of the medial lip segment or for correction of any donor-site defect at the base of the columella. PMID- 3659162 TI - Hemifacial microsomia: a multisystem classification. AB - Variability of deformities in hemifacial microsomia has precluded the general acceptance of any classification based on one reference organ. We present a review of hemifacial microsomia classifications and propose a TNM-style multisystem classification. This alphanumeric coding system, SAT, provides cohesion to existing hemifacial microsomia classifications. The acronym SAT is derived as follows: S = skeletal, A = auricle, and T = soft tissue. There are five levels of skeletal deformity (S1 through S5), four levels of auricular deformity (A0 through A3), and three levels of soft-tissue deformity (T1 through T3). Hence a patient with minimal deformity would be classified S1A0T1, whereas a patient with the most severe deformity would be S5A3T3. PMID- 3659163 TI - Prosthetic replacement of the condylar head for temporomandibular joint disease. AB - Temporomandibular joint replacement was performed in 8 adults who had intraarticular ankylosis, 6 who had end-stage osteoarthritis, and 12 who had rheumatoid arthritis. Three methods of replacement were used; an ulnar head prosthesis (8 patients), an interpositional implant (11 patients), and a Proplast coated metallic prosthesis (7 patients). The mean age of the 26 patients (19 women and 7 men) at surgery was 38 years (range 17 to 58 years), and the mean follow-up was 36 months (range 3 to 84 months). Relief of pain was experienced by 23 patients, and maintenance or improvement of incisal opening was experienced by 21. Prosthetic replacement of the condylar head for end-stage disease is highly successful in the patients for whom it is indicated. PMID- 3659164 TI - Lower eyelid reconstruction with a conchal cartilage graft. AB - A conchal cartilage graft without skin or mucosa was used as a posterior lining for lower eyelid reconstruction in seven patients. The raw surface of the graft was smooth enough to cause no corneal irritation and was epithelialized from the surrounding mucosa about 3 to 4 weeks after the operation. The lower eyelid reconstructed in this method produced a stable lid margin. PMID- 3659165 TI - Breast volume measurement of 248 women using biostereometric analysis. AB - A study of volumes of the right and left breasts of 248 subjects was undertaken using biostereometric analysis. This measurement technique uses close-range stereophotogrammetry to characterize the shape of the breast and is noncontact, noninvasive, accurate, and rapid with respect to the subject involvement time. Volumes and volumetric differences between breast pairs were compared, using chi square tests, with handedness, perception of breast size by each subject, age, and menstrual status. No significant relationship was found between the handedness of the subject and the larger breast volume. Several groups of subjects based on age and menstrual status were accurate in their perception of breast size difference. Analysis did not confirm the generally accepted clinical impression of left breast volume dominance. Although a size difference in breast pairs was documented, neither breast predominated. PMID- 3659166 TI - Immediate breast reconstruction with tissue expansion. AB - Between October of 1983 and June of 1985, 31 patients underwent primary breast reconstruction with tissue expansion. Tissue expansion was utilized for breast reconstruction when the remaining muscle and skin following modified radical mastectomy was insufficient to accommodate a prosthesis that matched in size and shape the opposite breast. All expanders were placed beneath an investing muscular pocket created by elevating the pectoralis major and serratus anterior. Postoperative expansion began within 1 week, and the breast was expanded to double the volume of the opposite breast. Twenty-two patients have completed their reconstruction with a mean follow-up in 7 months. There were nine complications, including five deflations and four infections. All patients have remained Baker I or Baker II. Creating ptosis to match the breast was accomplished by placing the expander below the rectus fascia and superiorly advancing this expanded tissue at the time of prosthesis placement. Primary breast reconstruction with tissue expansion following modified radical mastectomy is safe, simple, and produces a breast with excellent shape, size, texture, and patient satisfaction. PMID- 3659167 TI - Maximum overinflation of tissue expanders. AB - An ex vivo study was undertaken to document the maximum possible overinflation of tissue expanders with a comparison of all major manufacturers. Ten standard round implants from each vendor were expanded. Mean overinflation varied from 33 to 99 times stated capacity, with a range from 16 to 157 times this volume. The mechanism of failure in 93 percent of implants was envelope rupture. Overexpansion appears safe without risk of implant failure at least to 15 times vendors' stated maximum volume. PMID- 3659168 TI - Rapid elongation of arteries and veins in rats with a tissue expander. AB - The saphenous arteries and veins of 40 rats were elongated with 20-cc tissue expanders underlying the leg adductor muscles. The mean rate of successful elongation of the vessels was 84 +/- 47 percent SD, with a maximum gain of 140 percent. The fastest mean elongation velocity reached 45 percent per day. Thrombosis occurred only with stretching velocities of more than 10 percent per day, which seemed to be a safe margin. Distribution of the volume into many intervals was safer than infrequent high-volume injections. Histology showed no reduction in vessel wall diameter or loss intimal integrity. Subendothelial cellular proliferation was an indicator of this rapid regeneration. Microvascular anastomoses performed in elongated arteries and veins had the same patency rate (90 percent) as in controls. PMID- 3659169 TI - The ability of oxygenated fluorocarbon solution to minimize ischemic skeletal muscle injury. AB - The amputated canine limb was used to create a devascularized skeletal-muscle containing model. The extremity was perfused with one of several solutions or merely cooled as a preservative measure during the devascularized period and then replanted. Perfusion of the limb with oxygenated fluorocarbon solution minimized edema formation and leakage of skeletal muscle enzymes into the serum following revascularization as compared to the other perfusates or to mere cooling. Histopathologic changes within the revascularized muscle were also minimized by the oxygenated fluorocarbon perfusion. It is probable that these findings will correlate with improved function of replanted extremities or free muscle flaps. The applicability of these findings to human extremity replantation and free-flap transfer is postulated. However, long-term human studies will be necessary to assess the function of extremities and flaps perfused with this solution prior to its general use in extremity replantation and free-flap transfer. PMID- 3659170 TI - The role of perfusion washout in limb revascularization procedures. AB - Amputated rat hindlimbs were subjected to either normothermic (26 degrees C) or hypothermic (4 degrees C) ischemia. Experimental limbs had their microcirculation washed out (either before or after the ischemic insult) with a physiologic acellular plasma substitute previously reported to enhance flap survival following extended periods of warm ischemia. Control limbs were not washed out; i.e., stagnant blood remained in these limbs. Following the ischemic interval, amputated limbs were replanted. Monastral blue B, a colloidal pigment capable of labeling leaky blood vessels, was administered systemically to all rats just prior to vascular declamping. Limb biopsies of skin and muscle were harvested 30 minutes following revascularization in order to assess Monastral labeling and, therefore, the functional integrity of the microcirculation. Results confirm that stagnant blood under conditions of warm ischemia is detrimental to the functionality of the microcirculation in both skin (p less than 0.03) and muscle (p less than 0.007). Accordingly, perfusion washout, when performed prior to the ischemic period, enhances limb survival following 6 hours of warm ischemia (p less than 0.01). Hypothermia protects against the detrimental effects of stagnant blood; perfusion offers no benefit if hypothermic conditions prevail. Physiologic mechanisms responsible for these findings are discussed. PMID- 3659171 TI - Choosing sides for small animal research. PMID- 3659172 TI - A comprehensive classification of flaps: the atomic system. PMID- 3659173 TI - Acute management of dopamine infiltration injury with Regitine. AB - A case of subcutaneous infiltration of dopamine into the hand of a newborn is presented. Treatment consisted of administration of subcutaneous phentolamine into the area of ischemia approximately 6 hours after the injury occurred. Dramatic resolution of ischemic changes rapidly followed phentolamine injection with no untoward effects. PMID- 3659174 TI - Lionfish envenomation. AB - Correct and immediate care can significantly reduce the debilitating effects of Scorpaenidae evenomation. The lack of immediate heat application to the wound in our case report may have contributed to the complications and eventual loss of motion in the affected area, since the toxic ingredient, a nondialyzable protein, remained active. PMID- 3659175 TI - Primary Kaposi's sarcoma of an intraparotid lymph node with AIDS. AB - A case of Kaposi's sarcoma of an intraparotid lymph node in a patient with previously undiagnosed AIDS is presented. In patients at risk for AIDS who present with undiagnosed head and neck tumors, the diagnosis of epidemic Kaposi's sarcoma should be considered. Although transmission of AIDS to health care workers is exceedingly rare, proper precautions should be exercised when working with these patients. PMID- 3659176 TI - Split earlobes: a method of repair preserving the hole. AB - A method of repairing split earlobes preserving the hole is presented. It is simple, sound, has a good cosmetic appearance, and is more resistant to recurrence of the split than other methods. PMID- 3659177 TI - Implant injector for retropectoral augmentation. AB - The implant injector allows an augmentation of the breast through very small incisions with silicone gel implants without endangering them mechanically. This way the risk of damaging nerves in the axillary region is minimal, operation time is shortened, and the visible scar can be reduced considerably. Contamination of the prosthesis by the skin is avoided. Lubrication of the implant injector by peanut oil (arachis oil) is necessary. Tissue reaction induced by the oil had never been seen. None of the implants broke while using the implant injector. PMID- 3659178 TI - Systemic lidocaine absorption during liposuction. PMID- 3659179 TI - The stuck drain. PMID- 3659181 TI - Monitoring the completely "buried" muscle flap by temporary conversion to a myocutaneous unit. PMID- 3659182 TI - Autologous fat from liposuction for breast augmentation. PMID- 3659180 TI - Effective treatment of intraoperative breast prosthesis rupture: new use of the suction-assisted lipectomy machine. PMID- 3659183 TI - Physician, test thyself, or thoughts on reading an article about AIDS testing. PMID- 3659184 TI - Fat autografting. PMID- 3659185 TI - Incriminating photographs. PMID- 3659186 TI - Arm restraints for outpatient surgery. PMID- 3659187 TI - Syringe injection gun. PMID- 3659188 TI - [Structural differentiation of psychological performances in epilepsy patients]. AB - Investigating the specific of psychic performance disorders in epileptics structural aspects in addition to quantitative performance differences are considerable. We compared psychometrically obtained performance structures of epileptic children and adults and of parallelised healthy control persons. It became evident, that the performance differentiation hypothesis is to corroborate also in epileptic patients. The psychic performance structure of epileptics is characterized by a lower differentiation level of the basis functions underlining the performances. Our factor analytic investigations emphasize the importance of deceleration of psychic/psychomotoric speed in epileptics as primary basic disorder. PMID- 3659189 TI - [Diagnostic value of myelography as an expanded clinical study method]. AB - The paper investigates 54 myelograms and their influence on diagnostic thinking efficacy, on patient management efficacy, and on ultimate outcome efficacy, using statistical methods. Conventional myelography contributes to diagnostic thinking efficacy having a LLR- value of approximately 0.9. With an accuracy value of 0.95 it can be regarded as a reliable method of diagnosis. It alters diagnostic thinking efficacy in no less than 83% (94%) of the cases and patients management efficacy in 89%. Thus, by definition, myelography may be said to affect the state of health of the myelographed patients in 94.4%. PMID- 3659190 TI - [Neuro-otologic symptoms in a case of arteriography and autopsy-verified basilar artery thrombosis]. AB - A case report on a 26 years old woman, who was admitted for a pontobulbar vascular accident. She took oral anticoncipients since 10 years without any control. Vertebral angiography confirmed the basilar artery thrombosis. Otoneurologic investigation was three times performed. The cochleovestibular alterations were in accordance with the neurologic signs and demonstrated the level and extension of the pathologic process. The autopsy confirmed the clinical diagnosis. PMID- 3659191 TI - [The phenomenology of depression]. AB - Jakob Wassermann's story Die Gefangenen auf der Plassenburg (The prisoners of Plasenburg) is taken as a starting point for a discussion of experiences, coping with events, and estrangement, and their effect regarding depressive emotional deterioration and its description. The possibilities of succinct expression in the description of boredom, depressive emotional deterioration, melancholy, and dejection are indicated, with special reference to interactional psychopathology. PMID- 3659192 TI - [The square search test in connection with acoustic evoked brain stem potentials]. AB - A random sample of 15 patients suffering from multiple sclerosis without acute episodes and at least partially able to work, shows to a high degree of statistical certainty that reduction in amplitude of acoustically evoked brain stem potentials (BAEP) is closely linked with beta-weighted performance value of the square search test (QSP). PMID- 3659193 TI - [Loss of smell and taste within the scope of vitamin B 12 deficiency]. AB - The article deals with the case of a patient who had a partial gastrectomy and developed a vitamin B12 deficiency syndrome with anemia, myelopathy and complete loss of the senses of taste and smell. Regression of the symptoms followed liberal dosing with vitamin B12. PMID- 3659194 TI - [Course-oriented single-case studies in clinical practice--methodology and examples for use]. AB - Although the relevance of single-case methodology for clinical research is stressed frequently in the literature, clinicians do seldom use this approach. The present contribution is an attempt to stimulate and exemplify the realization of single-case designs clinical settings. In the first part of this paper single case designs and strategies of statistical analysis for practical use are discussed. In the second part three empirical studies are reported: (1) An A/B design for evaluation of a relaxation program for treatment of chronic headache; (2) an A/B/A/B-design to analyze the effect of cognitive-behavioral treatment in anxiety; and (3) an A/B/C/B/C-desing to test psychological treatment in rehabilitation of a schizophrenic patient. PMID- 3659195 TI - [Bipolarity, monopolarity and "dichotomous functional decay" as principles of differential diagnosis and "functional pathology" of endogenous psychoses]. AB - On the basis of Leonhard's Classification of the endogenous psychoses an attempt is made to trace the phenomenology of the monopolar and bipolar affective psychoses as well as Leonhard's "unsystematic schizophrenias" to three different functional anomalies. The differential diagnosis between the "cycloid psychoses" and the "unsystematic schizophrenias" as well as the problem of the so-called schizoaffective psychoses connected with them, is of particular interest. The arrangement to "functional areas" seems to be suitable. PMID- 3659196 TI - [Interpretation of paroxysmal slow activity--"subcortical signs"--in the electroencephalography of adults]. AB - Slow paroxysmal EEG activity, also referred to as "subcortical signs", offers an indication of impaired subcortico-cortical functional interaction that may be set off as a result of intracranial processes of a wide range of localisation. For this reason, the occurrence of this EEG pattern should not be taken to indicate a primary localisation in the range of the medical subcortical structures, nor does its absence imply any improbability of extensive lesions in the region. Taking into consideration the form and frequency of the waves during paroxysms and their local distribution, even this aspecific pattern yields more information for the clinical diagnosis. In particular, generalised paroxysms from monomorphic delta waves are usually associated with an existing primary or secondary brain illness, and would suggest the need for further diagnostic clarification. In interpreting the slow-wave groups restricted to the temporal regions, frequently counted among the "subcortical signs", the wave frequency and the patient's age must be taken into account. In the second half of life they frequently occur unaccompanied by any pathological process. PMID- 3659197 TI - [Use of automatic frequency analysis in the therapy of patients with acute ischemic insults]. AB - A series of EEG reading by automatic frequency analysis by means of Fast-Fourier transformation was taken, with a total of thirteen patients with acute ischemic infarction. Of the parameters under test, the total power-parameters, the relative performances of the delta and alpha wavebands, the delta/alpha index, and the alpha peak frequency variation proved their suitability in assessing clinical progress and in lateral localisation. Automatic frequency analysis adds to the range of tools available for EEG diagnosis, and can play its part in trend analysis during intensive therapy. PMID- 3659198 TI - [Computer-assisted implementation of the MMPI test]. AB - In a research programme lasting one year a computer-supported technique for the MMPI-Test has been developed in co-operation of the Clinical-Psychology and the Bio-Medical. Engineering Departments. The use of the microelectronically operated test apparatus has proved extremely economic. PMID- 3659199 TI - [External difficulties and their management in catamnestic studies (home visits)]. AB - It is reported on som difficulties arising an attempt to trace former children whom we wanted to follow-up. On the one hand there were individuals who had been treated in childhood in our hospital many years ago, on the other hand some individuals concerned had been cared in a long stay-nursery during their first years of life. Furthermore, we traced adult patients to follow-up them and also visited some of their relatives in their homes. It is described how much persistent and time-consuming efforts had to be made to trace the probands and their relatives, for they, frequently, had altered their names and their addresses. However, the visits to the individuals' homes were worth while. Only in this way we were enabled to satisfactorily carry out the tasks, we had set to ourselves. PMID- 3659200 TI - [An additional unit for the "Minicoma" electroconvulsator]. AB - Discussion of the necessity of unilateral ECT with discontinuous stimulation current and report on an add-on unit to the electroconvulsator "Minicoma" realizing the required stimulation parameters. PMID- 3659201 TI - [Microprocesses in early dialogue. Strategies of autonomy]. AB - The authors present a microanalytic study of holding and gaze interactions in 16 families (clinical and non-clinical), each including infant-mother, father and stranger dyads. They summarize the findings on holding and gaze engagement/disengagement of their structural study on the first two minutes of dialogue. They proceed to present the findings on the microevolution over the entire play: how dyadic engagement/disengagement stabilizes and terminates, or how it evolves to another organisation. They discuss the similarities of the clinical and microanalytic methods and suggest that microanalysis is a useful contribution to the clinical sciences. PMID- 3659202 TI - [Meeting with the child from an underprivileged milieu or ambiguity in the psychiatric attitude toward "those people"]. AB - This article is an effort to understand in depth what the experience of great poverty might be like. It is based on the personal and professional experience of the authors, as well as on recent social and militant literature. After describing the principal consequences of the precariousness of these sub proletariens life, we have analysed the repercussions on the development of the young child. This population frequently incites negative counter attitudes. An interpretation is proposed. Some practical implications for handling such cases in therapy are outlined. PMID- 3659203 TI - [Earthquakes in Mexico in 1985. Their psychological repercussions and intervention by psychoanalysts]. AB - Starting with a real event, the Mexican earthquake of 1985, this article describes a certain number of practices of Mexican psychoanalysts and their theoretical reflections which grew out of the experience of helping a disaster struck population during a crisis period. The result of this intervention was that it enhanced the elaboration of the emotional and traumatic conflict created by this kind of natural phenomenon. This work, a; though not constituting a generalized practice within psychoanalysis, corroborates certain processes in Freud's second theory of drives. PMID- 3659204 TI - [Interaction between psychological disorders and juvenile diabetes]. AB - This article describes the profound impact that diabetes and its treatment can have on the different aspects of the personality of the child. The succession of stages of development, their force, the nature of internalized conflicts, the kind of defenses and their equilibrium, the structuration of the super ego and object relations are at risk of being distorted as a result of psychological problems related to the treatment of the illness. The restrictions and the suffering resulting from the treatment can become charged with psychic meaning and become the object of fantasy elaboration. Poor management of the treatment can become a metaphor for the actualization of instinctual derivatives or of unacceptable feelings and at the same time serve as a defense against the consciousness of psychic conflict. Inversely, the defenses against drives can be utilized to avoid the awareness of the real dangers inherent in the disease. These defenses interfere with a clear understanding of the illness and can be inferred from the distortions in the distorted body images and the fantasies of these children. PMID- 3659205 TI - [Severe digestive disorders in infants: infants who let themselves die?]. AB - Do infants suffering of severe feeding problems let themselves die? From this question, the author attempts to describe some of the central elements of her psychodynamic understanding of merycist infants and of their treatment in an inpatient paediatric setting. Merycism appears as a vicissitude, within the parent-child relationship, of pathological mourning. Projective identifications allow the parents to avoid a melancholic fate but they hinder the development of the child's psychic and physical life. A clinical vignette illustrates the theoretical constructions as well as the therapeutic setting and approaches used by the author. The important role of a mother-child room and the central place of interpretations are discussed. PMID- 3659206 TI - [Wanting a child]. AB - To want a child and to want to have a child are notions receiving renewed interest ever since the generalization of contraception and even more recently, the new methods of procreation. These two notions are compared and tested against biological data across historical, psychoanalytic and sociological works. A brief resume of research done with mothers of newborns underlines the ambiguity and the complex and dynamic character of the question. The desire for a child and the desire to have a child are different notions and one should discriminate between them. PMID- 3659207 TI - [The beginnings of the kiss in infants during the first year]. AB - In the first year certain forms of "early beginnings of the kiss" can be recognized. Quite early on in this period various buccal activities are observed in response to kisses given to him. As for those kisses given by the baby, or so perceived by the adult, an important stage begins with progressive differentiations. One of these phases corresponds, when the pleasure of feeling and using the gums and teeth is felt, to an ambivalence of these preliminary shapes of kisses such as the "bite-kiss". The baby's early observed attraction to the adult's mouth can result, around the age of one year, in quick passing "mouth to mouth" observations which are not yet "kisses" but a kind of one to one correspondence. This new form combines with other modalities such as gaze and hugging which have already been tried as means of exchanging emotions and feelings. It is only several months later that it will have its definite diversified form and its own special meaning. PMID- 3659208 TI - Paternal care of infants during maternal separations: associations with father infant interaction at one year. AB - Observations of father-infant interaction in the home environment at age one year were compared for two groups of infants that in the months preceding the observations differed in the amount of experience they had with their fathers when the mother was outside the home. The sample consisted of 46 middle-class families, each with a first-born infant (23 males, 23 females). Estimates of the amount of experience the father had with the infant when the mother was outside the home were obtained from detailed maternal interviews that addressed all mother-infant separations. At one year, fathers who provided more extensive care in the absence of the mother showed a higher degree of breadth or variety in their patterns of engaging the infant and higher rates of behavior directed to the infant. These infants showed higher rates of responding to their fathers and more frequent instances of exploratory behavior. Distinctive patterns of differences were evident in the behavior of fathers and infants who had contrasting amounts of experience with each other in social contexts without the mother. PMID- 3659209 TI - The relation of essential hypertension to feelings of anxiety, depression and anger. AB - Franz Alexander (1939) offered the hypothesis a number of years ago that hypertension can result from the inhibition of feelings of anger. Although a great deal of research has been done to test this hypothesis, the results remain equivocal. Part of the difficulty is that usually only anger was examined, making it impossible to determine the extent to which the results were specific to anger and not general for other negative emotions. A second prevalent problem has been the failure to match hypertensive and control groups on demographic variables that may be relevant to the relationship of hypertension to anger and its expression, such as education, economic level, and age. A third problem is that most studies have investigated only male hypertensives, thereby limiting the generality of the findings. The present study compares male and female hypertensives with carefully matched controls on measures of anxiety, depression, and anger and its suppression. PMID- 3659210 TI - Cyclical psychodynamics and the triangle of insight: an integration. AB - This paper attempts to integrate a recent dynamic conceptualization of patients' problems known as "cyclical maladaptive pattern" (Strupp and Binder 1984) with a more traditional model, the "triangle of insight" (Menninger 1958). The integration is offered as an effort to illustrate the theoretical continuity of the two models. The integrated model also serves as a useful step toward improved specification of the principles and procedures implicit in the creation of a comprehensive psychodynamic formulation, potentially enhancing research, training, and the clinical practice of psychodynamic psychotherapy. An illustrative case is presented. PMID- 3659211 TI - Ethnocultural identification in psychotherapy. AB - Ethnoculturally translocated individuals, members of minority groups, and patients in cross-cultural psychotherapy frequently experience disturbances of their ethnocultural identities. During psychotherapy these patients often attribute ethnocultural qualities to their therapists in a process called ethnocultural identification. This process may be used to foster a therapeutic identification in which the therapist reflects pieces of the patient's conflicted ethnocultural identity. Cases are presented here illustrating the use of ethnocultural identification as an auxiliary therapeutic tool to facilitate coping with changing cultural values and transitional experiences, and to promote the integration of the ethnocultural self into a consolidated sense of identity. PMID- 3659212 TI - Family functioning and suicidal behavior in psychiatric inpatients with major depression. AB - Family functioning was compared between suicide-attempting and nonsuicidal depressed inpatients in order to further understand psychosocial determinants of suicidal behavior. Suicidal behavior was strongly associated with a discrepancy between the patient's perception of his/her family and the perception held by other family members. Suicide-attempting depressed inpatients perceived their family functioning to be worse than did their families. Suicidal patients also viewed their families more negatively than did depressed nonsuicidal inpatients, who actually viewed their family functioning more positively than did their family members. The clinical implications of these findings are discussed. PMID- 3659213 TI - "Entering the adult world": developmental issues in medical education. AB - Members of a medical school graduating class of 1985 were studied as freshmen and prior to graduation to assess the developmental issues of autonomy, intimacy and career choice. Results indicated that senior medical students were more likely to address and resolve these issues than were freshmen, that students who had resolved these issues were better able to cope with the stressors of medical education, and that senior men and women responded to these issues differently. Women were significantly more concerned about career choice, competency, intellectual challenge, socializing with peers and developing an intimate relationship. Individuals who were in committed relationships were better able to cope with the stressors of medical school than their noncommitted colleagues, as evidenced by their reporting fewer depressive episodes and lower use of alcohol and drugs. PMID- 3659214 TI - Personal identity and the schizophrenic process: an integration. AB - In this paper we explore the relation between theories of self, particularly identity theory, and the schizophrenic process. A fundamental assumption in identity theory is that a person's self includes a hierarchically organized set of identities. When an individual's set of identities is limited in range and/or diffusely organized he/she is thought to be at risk for schizophrenia. The onset and relapse of schizophrenic episodes are assumed to occur when important identities are negated. Implications of identity theory for integrating extant conceptions of schizophrenia are discussed. Also discussed are the effects of medication in establishing a patient identity and the role of the patient identity in preventing psychotic relapse. PMID- 3659215 TI - Mutual involvement and alienation in families of Holocaust survivors. AB - Clinical studies suggest that children of Holocaust survivors remain enmeshed with their families or alienated from them. To examine the applicability of these observations to a nonclinic population, questionnaire responses of a randomly selected community sample of adult children (ages 19-36) of Holocaust survivors (COS) were compared to those of children of other immigrants (COI), and of children of native-born parents (CON). The clinical findings were not supported in most of the wide range of possible manifestations of ties to or distance from the family. COS did, however, report more dissatisfaction with some aspects of the cross-sexed parents' disciplinary habits in the past. Male COS continued to feel that way in the present, wishing their mothers would be more permissive. Documented negative consequences of prolonged, severe victimization may affect only small segments of the second generation. PMID- 3659216 TI - No mood-altering effects found after treatment of normal subjects with bright light in the morning. AB - Studies have shown that depressed patients with seasonal affective disorder (SAD) respond to treatment with bright artificial light. In this study 2 hours of bright artificial light administered in the morning for 1 week did not alter mood in 11 normal subjects. This finding suggests that the mood-enhancing effect of light for SAD patients is not necessarily generalizable to other populations. PMID- 3659217 TI - Differential time course of antidepressant effects after sleep deprivation, ECT, and carbamazepine: clinical and theoretical implications. AB - The pattern and time course of antidepressant response to different treatment modalities provide important clinical information and hints about underlying neurobiological mechanisms. Depressed patients who responded to 1 night's sleep deprivation (11 of 33 patients) showed maximal improvement on day 1 and deterioration in mood thereafter. In contrast, slower onset and more sustained effects were observed following carbamazepine (12 of 37) or electroconvulsive therapy (ECT) (8 of 8). Nearly maximal improvement required about 2 weeks for ECT and 3 weeks for carbamazepine. Possible differential or common biological mechanisms with differential times of action are implied by these data, which are of importance to the neuroscientist attempting to uncover neural substrates of antidepressant response and the clinician attempting to find rapid onset, yet sustained antidepressant treatments. PMID- 3659218 TI - Serum phosphate and anxiety in major depression. AB - Serum inorganic phosphate was measured in 33 hospitalized patients with unipolar depression. As predicted, serum phosphate showed significant negative correlations with Minnesota Multiphasic Personality Inventory scales sensitive to anxiety (Psychasthenia: -0.33) and somatic concern (Hypochondriasis: -0.51). This is consistent with previous observations of relative hypophosphatemia in patients with panic disorder. Clinical consequences of relative hypophosphatemia and the possible roles of hyperventilation or elevated peripheral catecholamines as mediators of this effect are discussed. PMID- 3659219 TI - Platelet monoamine oxidase activity in panic disorder. AB - Platelet monoamine oxidase (MAO) activity was studied in 21 patients meeting Research Diagnostic Criteria for panic disorder and in 12 healthy controls. Platelet MAO activity in females in both patient and control groups tended to be higher than that in males, but the results did not reach statistical significance. Platelet MAO activity was significantly decreased in panic disorder patients compared to controls. PMID- 3659220 TI - Platelet serotonin uptake: methods and strain differences. AB - The pharmacokinetic properties of platelets make these vascular elements a potential and convenient model for serotoninergic neurons. Because we encountered several difficulties in preliminary platelet serotonin (5HT) uptake assays, we explored the influence of several assay factors on the parameters obtained. We found that a citrate-dextrose anticoagulant stabilized platelet 5HT uptake even at room temperature. More rapid wash rates during the filtration following the assay incubation gave higher apparent uptake affinities. Platelets from an inbred strain of rats exhibited less variability in Vmax than cells from outbred strains studied. These findings, in conjunction with a human twin study also suggesting that variance in platelet 5HT uptake increases with genetic diversification, demonstrate some additional confounding factors in platelet 5HT uptake studies. PMID- 3659221 TI - Cardiovascular response to speaking in schizophrenics. AB - Cardiovascular responses to speaking are compared in schizophrenic and nonschizophrenic psychiatric patients. Schizophrenics show a significantly smaller mean arterial pressure (MAP) response to speaking than nonschizophrenics, and a trend toward significantly smaller heart rate (HR) and diastolic blood pressure (DBP) responses. Previous studies found that normal individuals consistently increase MAP when they speak. Nonschizophrenic psychiatric patients resemble normals, but a significant number of schizophrenics do not increase MAP when they speak. This difference is not explained by baseline differences between the two groups (Law of Initial Value effects). Effects of neuroleptic use cannot be excluded entirely, but the pattern of response is not consistent with a neuroleptic-induced attenuation of response. PMID- 3659222 TI - MAOIs: impact on social behavior. PMID- 3659223 TI - Psychological effects of military service in Vietnam: a meta-analysis. PMID- 3659224 TI - Dyadic social interactions. PMID- 3659225 TI - Small-sample tests for homogeneity of response probabilities in 2 X 2 contingency tables. PMID- 3659226 TI - Neuroleptic drug treatment alters in vitro central neurotensin metabolism. AB - Neurotensin (NT) has been shown to possess pharmacological properties associated with neuroleptic drugs. To determine if chronic haloperidol (HL; 3.5 mg/kg/day) or chlorpromazine (CPZ; 4.2 mg/kg/day) treatment affects central NT metabolism, HL and CPZ were perfused via Alzet minipumps into male Sprague-Dawley rats for 8 days. Purified synaptosomal plasma membrane (pSPM) were isolated and time-course incubated with NT (100 microM; 30-120 min). All samples were analyzed by high resolution, reversed-phase high performance liquid chromatography. HL and CPZ caused an increase in NT metabolism at the pSPM. Although an increase in NT metabolism would result in a loss of biological activity, it does lead to a significant accumulation of the biologically active NT fragment NT-(9-13), which has been shown to bind to the NT receptor. Therefore, neuroleptic drug treatment alters NT metabolism at the pSPM, leading to the formation of a fragment with antinociceptive activity. PMID- 3659227 TI - Influence of the histaminergic system on opiate-induced neurosecretion and behaviour. AB - The influence of the histaminergic system on fentanyl (Fe)-induced growth hormone (GH) and prolactin (PRL) release as well as on Fe-induced increase of noradrenaline (NA) plasma levels has been studied in male volunteers. These volunteers received, according to a randomized block design, different pretreatments: the H1-antagonist dimethindene (Di) (0.1 mg/kg i.v.), or the H2 antagonist cimetidine (Ci)(5 mg/kg i.v.), or a combination of dimethindene and cimetidine (Di + Ci), or saline. The PRL increase caused by Fe (0.2 mg/70 kg) was not altered by pretreatment with the H1-antagonist Di, the H2-antagonist Ci, or the combination of both. The increase of NA plasma levels after Fe also was not modified by the histamine antagonists. In contrast, the maximum GH increase after Fe was blunted by the combination of Ci and Di, but not by either Ci or Di alone. These results suggest an involvement of the histaminergic system in opiate induced GH-release. PMID- 3659228 TI - The relationship of the dexamethasone suppression test (1 mg and 2 mg) to basal plasma cortisol levels in endogenous depression. AB - The 1 mg and 2 mg dexamethasone suppression tests (DST) were evaluated in two groups of endogenously depressed patients (n = 39 and n = 30, respectively) who also had a 1300-1600 hr basal cortisol assessment. Non-suppressors (on both DSTs) had significantly higher basal plasma cortisol levels and thus were significantly associated with relative cortisol hypersecretion. However, there was only a partial overlap between DST response and basal plasma cortisol, with a large variation of cortisol levels among non-suppressors. The 2 mg DST appears to be more specific for cortisol hypersecretion than the 1 mg DST. If cortisol hypersecretion is to be identified, neither the 1 mg or 2 mg DST is an adequate assessment nor a substitute for a basal cortisol assessment. PMID- 3659229 TI - Nocturnal prolactin and cortisol secretion and recovery from melancholia. AB - Spontaneous prolactin and cortisol patterns were determined at 20 min intervals over 3 hr during the night in eight patients with melancholia, both during illness and after treatment with amitriptyline. Mean plasma prolactin levels were greater after recovery in the seven patients who responded to treatment. Mean cortisol secretion decreased upon recovery from melancholia, and such changes in two patients paralleled normalization of dexamethasone suppression test responses. The influence of assumptions of lack of interaction on the statistical significance of the analysis of variance with repeated measures for prolactin and cortisol values was evaluated. PMID- 3659230 TI - [Psychological transformation of medicine--retrospective view to the year 2000]. PMID- 3659231 TI - [Clinical psychology and medical psychology--hostile brothers or Siamese twins?]. PMID- 3659232 TI - [Development of research in the specialty of medical psychology in the last 10 years]. PMID- 3659234 TI - [Curriculum in psychosocial medicine--a Swiss educational model in medical psychology and sociology]. PMID- 3659233 TI - [Medical psychology in the teaching and practice of psychology, medicine and dentistry in East Germany]. PMID- 3659235 TI - Planning teams revisited. PMID- 3659236 TI - Health visitor contribution to pre-school child prophylaxis. PMID- 3659237 TI - Neurotic illness as grounds for medical priority for rehousing. PMID- 3659238 TI - Prevalence, distribution and intensity of soil-transmitted helminthiases among Malaysian children. PMID- 3659239 TI - Computer-managed cervical cytology screening: a pilot study of non-attenders. PMID- 3659240 TI - A pilot study of urinary thioethers as biological indicators of the urban contamination. PMID- 3659241 TI - Health-related behaviour and smoking in young adolescents. PMID- 3659242 TI - Occupational hazards of domestic workers providing home care. PMID- 3659243 TI - Missionary doctors in the 1980's. PMID- 3659244 TI - A study of the cost of tuberculosis contact investigation related to non tuberculous mycobacterial isolation in Jefferson County, Alabama. PMID- 3659245 TI - Intramedullary spinal cord metastases: a clinical and pathological study of nine cases. AB - The clinical and pathological findings in nine cases of intramedullary spinal cord metastases are reported and are compared with those of previous studies. Intramedullary metastases are more common than is generally believed and the incidence is probably increasing with the more prolonged survival of cancer patients. A wide spectrum of symptoms and signs may be produced, frequently with attendant diagnostic difficulties. Most patients present with myelopathy as the first manifestation of cancer or of its recurrence. Symptoms may be present for several months, with few clinical signs, despite distortion and destruction of much of the spinal cord by tumour. The extent of metastatic disease remains limited in a significant proportion of patients. No neurological symptoms or signs differentiate intramedullary metastases clearly from the more common extradural deposits. However, the diagnosis should be considered when myelopathy evolves more slowly, where plain radiographic evidence of adjacent vertebral disease is absent, and particularly when myelography is normal. Early diagnosis and aggressive medical treatment may provide for a more favourable outcome. PMID- 3659246 TI - Fifty cases of primary hyperaldosteronism in Hong Kong Chinese with a high frequency of periodic paralysis. Evaluation of techniques for tumour localisation. AB - Fifty consecutive Chinese patients with primary hyperaldosteronism were studied. All were considered to have an adrenal cortical adenoma, this being proven by surgery in 46 cases. In contrast to other reports, periodic paralysis was a presenting feature in 42 per cent of patients. Other notable symptoms were palpitations (30 per cent) and syncope (12 per cent). Vascular complications were present in 20 per cent of cases. Mean serum potassium level at presentation was 2.1 +/- 0.1 (mean +/- SEM) and sodium 145.0 +/- 0.1 mmol/l. Serum potassium was significantly lower and plasma aldosterone higher in patients with periodic paralysis. Adrenal venography in order to localise the tumour was unreliable and was misleading in two cases. Adrenal venous sampling for steroid analysis was much more helpful, despite the difficulty of obtaining right adrenal venous blood. The side of the adenoma could be predicted in 97 per cent of cases from measurements of left adrenal venous and vena caval aldosterone levels. The use of high resolution CT gave 100 per cent accuracy in all 18 patients who underwent surgery, the smallest detected tumour being 0.8 cm in diameter. Surgery corrected hypokalaemia in all cases, and 37 of the 46 patients required no further antihypertensive treatment. PMID- 3659247 TI - The high morbidity of CAPD fungal peritonitis--description of 10 cases and review of treatment strategies. AB - Fungal infection is an uncommon cause of peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD). This report describes the clinical and microbiological features of 10 cases of fungal peritonitis. Although all patients survived, morbidity was high. Abscess and adhesion formation were particular problems. Only two patients were able to return to CAPD after microbiological cure. Currently available treatment strategies for fungal peritonitis are reviewed. PMID- 3659249 TI - Eightieth annual general meeting. The Association of Physicians of Great Britain and Ireland. London, 4 and 5 April 1986. Abstracts. PMID- 3659248 TI - Adult-onset Still's disease; clinical and laboratory features, treatment and progress of 45 cases. AB - The clinical and laboratory features, treatment, prognosis, complications and disability of 45 patients with adult-onset Still's disease were studied. Sixty per cent of the patients were female. Median age at onset was 25 years and median observation period after onset was 41 months. For 28 patients detailed data were available of the first month of illness. In only 43 per cent of these did the disease present with the classical triad of fever, arthritis and rash, although in the whole group eventually, fever with temperatures of 40 degrees C or more occurred in 84 per cent, arthritis in 98 per cent, and the typical rash in 82 per cent. In 32 per cent of the patients with rash, this was pruritic. Other features seen frequently were: lymphadenopathy (71 per cent), splenomegaly (36 per cent), pleuritis and/or pneumonitis (31 per cent), pericarditis (22 per cent), leucocytosis (98 per cent) and hepatic abnormalities (84 per cent). The high spiking fever was reduced to normal in six of 21 cases (29 per cent) by aspirin, in 19 of 27 cases (70 per cent) by indomethacin and in six of seven cases (86 per cent) by naproxen. In 16 of 21 cases (76 per cent) glucocorticoids reduced the systemic and/or joint symptoms. In three patients who remained febrile on glucocorticoids, indomethacin reduced temperature to normal. Eight patients whose joint disease improved on steroids later developed severe joint destructions. Thirteen patients received one or several slow-acting antirheumatic drugs. Only in eight of 18 trials (44 per cent) with one of these drugs did symptoms and signs improve. Fifty-one per cent of the 45 patients had self-limiting disease and 49 per cent had persistent disease with continuous activity for at least one year. At the time of evaluation 47 per cent of the 45 patients were in remission without medication, 33 per cent were in remission while on medication and 20 per cent had active disease. Three life-threatening complications occurred: two patients developed signs of cardiac tamponade and one almost died from diffuse intravascular coagulation. Disability was determined primarily by the course of the arthritis. At the time of review 43 per cent of the 45 patients had no joint destruction (Group 1), 24 per cent had destruction of at least one joint, but had no evidence of disease of the root joints (Group 2) and 33 per cent had destruction in at least one root joint (Group 3).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3659250 TI - Treatment of phenobarbitone poisoning with repeated oral administration of activated charcoal. AB - Six patients with moderate to severe phenobarbitone intoxication were treated with repeated oral doses (50 g) of activated charcoal following an initial dose of 50 to 100 g. All recovered more rapidly than would otherwise be expected with supportive care alone. The mean maximum rate of fall in plasma phenobarbitone concentrations corresponded to a half-life of only 6.2 +/- 2.5 h (normally three to five days); 62 to 93 per cent of the absorbed dose was eliminated within 24 h and the mean total body clearance of the drug during and for up to 12 h after administration of charcoal was 84 +/- 34 ml/min. Treatment with repeated oral doses of activated charcoal is simple and safe. It seems to be as effective as forced alkaline diuresis, haemodialysis and haemoperfusion for the removal of phenobarbitone following overdosage. PMID- 3659251 TI - The blood pressure response to unilateral adrenalectomy in primary aldosteronism. AB - The factors determining the outcome of blood pressure after removal of the aldosterone-secreting adenoma in primary aldosteronism are largely unknown. We have studied the results of surgery in 21 patients with this disorder, all of whom were investigated and treated in a single referral centre, and evaluated the contributions of clinical, biochemical and pathological factors to blood pressure outcome. Blood pressure before surgery was high (mean 210/121 mmHg), but after an average period of 5.4 years 12 patients (60 per cent) were considered by their primary physician not to require antihypertensive medication and a further seven had reduced drug requirements. In only two patients was arterial pressure unimproved by surgery. Blood pressure recordings within six months of surgery were not a good predictor of later levels. Of the clinical, electrolyte, hormone and pathological features assessed, only the systolic pressure before surgery, and abnormalities in the optic fundi, correlated statistically with final blood pressure ranking. There was no relationship between the severity of vascular changes in the adrenal or kidney biopsy tissue and final blood pressure. These results show that while the blood pressure response to the removal of a single adrenal adenoma is usually good, it is not possible to predict accurately the final blood pressure response using these criteria. PMID- 3659252 TI - Treatment of rheumatoid arthritis with desferrioxamine. AB - Desferrioxamine was used to treat six patients who had rheumatoid arthritis refractory to conventional treatment, on the basis that levels of intra-articular iron would be reduced and inflammation lessened. After a period of initial intensive treatment which was limited by side effects, five patients continued on once-weekly maintenance doses. Two patients had temporary improvement in their symptoms, but relapsed in spite of continuing treatment. The remaining three patients completed six months of treatment with no improvement in their rheumatoid disease. There were no significant changes in rheumatological parameters, immunological markers of disease activity nor radiological evidence of improvement. Treatment did lead to significant falls in haemoglobin concentration (p less than 0.01), mean corpuscular volume (p less than 0.05) and serum ferritin levels (p less than 0.02). Therefore, in spite of a reduction in iron available for haem synthesis and a fall in tissue storage iron the rheumatoid inflammatory process persisted. PMID- 3659253 TI - Life-threatening respiratory failure due to a previously undescribed myopathy. AB - The case of a young man with a previously undescribed myopathy associated with polydactyly is reported. Although both limb girdles were affected, the major effect of the disease was upon the respiratory muscles leading to his presentation with life-threatening respiratory failure. A further feature was pronounced stiffness of the vertebral column and limb girdles, similar in some respects to the 'rigid spine syndrome'. Muscle biopsy appearances were unique but showed some similarities to both nemaline myopathy and myotonic dystrophy. Ventilatory assistance at night using a rocking bed led to a marked improvement and has enabled the patient to return to full-time employment. PMID- 3659254 TI - Non-convulsive status epilepticus: a prospective study in an adult general hospital. AB - A prospective study of non-convulsive status epilepticus was undertaken in order to evaluate the occurrence and characteristics of this condition in adults. The diagnosis was established in 22 of 113 patients (19 per cent) presenting with status epilepticus over a 23-month period. Non-convulsive status was most prevalent in the over 60 age group. Its two subgroups, absence status (18 cases) and complex partial status (four cases) were both manifest clinically by a prolonged alteration of consciousness of variable extent. Absence status presented de novo (six cases) or against a background of epilepsy (12 cases), often with a long seizure-free interval before presentation. Precipitating factors included infection, inadequate anticonvulsant medication and benzodiazepine withdrawal. The clouding of consciousness was usually characterised by confusion, disorientation and partial responsiveness. Myoclonic or clonic movements of the eyes, face or jaw were evident in all but two patients. Automatisms, including ambulatory behaviour (three cases) were less common. Serious psychiatric disorders preceded the status in seven cases, and contributed to the difficulty in diagnosis. Complex partial status was associated with underlying cerebrovascular disease in three of four cases, and is characterised by a more severe and variable clouding of consciousness, less frequent facial clonic movements, episodic adversive head and eye movements, and a more gradual recovery after treatment. PMID- 3659255 TI - Psoriatic arthritis (PSA)--an analysis of 220 patients. AB - Since 1978, 220 patients with psoriatic arthritis have undergone detailed study at the Women's College Hospital in Toronto, Canada. Clinical, radiological and biochemical data were subjected to computer analysis in order to determine clinical-biochemical correlations within subsets of patients with psoriatic arthritis. Our findings indicate a spectrum of disease patterns and severity. Overall, we found a 40 per cent incidence of deforming, erosive arthropathy, with 17 per cent of patients having five or more deformed joints. ARA stage 3 and 4 radiological joint change occurred in 28 and 14 per cent respectively, and 11 per cent of patients had ARA Class III or IV functional impairment. The asymmetric oligoarthritis previously reported to account for the majority of cases of psoriatic arthritis was not a dominant pattern in our own experience, occurring in only 28 per cent of the series. Polyarthritis was the most common joint pattern, present in 61 per cent with symmetric and asymmetric patterns occurring equally. Our experience suggests that polyarthritis, symmetric or asymmetric, is a more common presentation of the disease than is generally acknowledged. Furthermore, the frequency of deforming destructive arthropathy challenges the concept of psoriatic arthritis as a benign arthropathy. PMID- 3659256 TI - Metastatic adeno or undifferentiated carcinoma from an unknown primary site- natural history and guidelines for identification of treatable subsets. AB - Two hundred and eighty-six patients presenting with metastatic adenocarcinoma or undifferentiated carcinoma whose primary site was not identified by clinical history, physical examination and chest radiograph have been studied. Median survival from presentation was 22 weeks. Factors independently predicting improved survival were lymph node presentations, good performance status and body weight loss of less than 10 per cent. In 88 (31 per cent) patients the primary tumour site was subsequently identified, in 58 (20 per cent) during life. Lung cancer was the most frequently identified primary tumour, and in only 32 (11 per cent) of the patients was a 'treatable' primary tumour (i.e. germ cell, breast, ovarian, prostate, thyroid cancer or lymphoma) identified. Among the treatable primary tumours were those in eight out of 16 female patients presenting with axillary metastases who were subsequently shown to have primary breast cancer and four of 13 females presenting with ascites who were found to have primary ovarian cancer. Prostatic cancer was confirmed in five out of 13 men with raised serum acid phosphatase. Of 22 patients with elevated serum alphafoetoprotein (AFP) or beta-human chorionic gonadotrophin levels (beta HCG) 18 had some features of the 'atypical teratoma syndrome'. Of the total of 32 patients with treatable tumour types, 29 (90 per cent) were identified during life. Median survival for patients with treatable tumour types identified during life was 104 weeks, compared with 22 weeks for the group as a whole. Retrospective immunocytochemical staining of the original biopsy showed that prostatic specific antigen and antibodies to beta HCG and AFP were diagnostically useful, but a series of organ site non-specific markers of histogenesis or cellular differentiation (carcinoembryonic antigen, secretory component for IgA, peanut lectin binding, epithelial membrane antigen and keratin) showed no significant correlations with identified primary sites, responsiveness to empirical chemotherapy or survival. Metastatic undifferentiated carcinoma or adenocarcinoma from an unknown primary site represents 6.5 per cent of all referrals to the medical oncology unit, Royal Prince Alfred Hospital, Sydney. We offer guidelines for the rapid identification of the limited number of primary sites for which effective and specific forms of systemic treatment are available. PMID- 3659257 TI - Lupus nephritis: clinical and pathological correlation. AB - The clinical course of 135 patients with lupus nephritis was examined long-term as part of a prospective study. Biopsies were classified according to modified WHO criteria and showed 17 per cent of patients had mild mesangial lesions, 10 per cent focal lesions, 21 per cent mild diffuse proliferative lesions, 37 per cent severe diffuse proliferative lesions and 15 per cent membranous lesions. Overall patient survival of 83 and 65 per cent at five and 10 years respectively from onset of nephritis was similar to other recently published series. In contrast to the latter, the severe proliferative group had a significantly worse outcome than the other proliferative groups (p less than 0.01) and only patients in this group progressed to end-stage renal failure. Haematuria was more common (p less than 0.05) in the severe group and there was a striking correlation between histologic activity assessed semiquantitatively (Table 1) and urinary red cell count (p less than 0.001). There was no correlation between serum creatinine, proteinuria or chronic lesions with urinary red cell count. In contrast to a previous study there was no correlation between the presence of hyaline thrombi on initial biopsy and subsequent development of glomerular sclerosis. Although the value of renal biopsy has been questioned, we suggest that it remains a most important investigation in the management of lupus nephritis. Determination of urinary red cell count provides a most useful monitor of disease activity and response to treatment. PMID- 3659258 TI - Treatment of tuberculous meningitis: role of short-course chemotherapy. AB - Twenty-eight adult patients admitted consecutively with tuberculous meningitis were treated with pyrazinamide, isoniazid, rifampicin and streptomycin daily during the first two months, followed by isoniazid and rifampicin daily for seven months with intensive management of the complications during the active stage of the meningitis. Twenty-two patients completed the course of treatment and recovered with minimal morbidity in three patients. Two patients died in a vegetative state from other causes seven and nine months after the start of treatment. No evidence of recurrence of meningitis was observed in the 21 patients who were regularly observed for 12 to 29 months after completing treatment. Four patients dropped out during the early stage of treatment. Intensive chemotherapy of tuberculous meningitis with this regimen before the development of serious neurological damage can shorten the duration of treatment to nine months with a favourable outcome. PMID- 3659259 TI - Psychiatric disorder in medical in-patients. AB - Four hundred and fifty-three general medical in-patients were screened for mood disorder (anxiety and depression), organic mental states and alcohol problems. Using the Present State Examination, affective disorder was identified in 14.6 per cent, being especially common in younger women. Organic psychiatric disorder was very common in the elderly, occurring in 31 per cent of those over 70 years, and 18 per cent of men and 4 per cent of women admitted to a drink problem. Mood disorder was not related to the type or severity of physical illness, but was significantly associated with previous psychiatric history and social problems. Two-thirds of those with mood disorder on admission who were still alive four months after discharge were improved. House officers and family doctors identified approximately half the cases of depression and anxiety, but house officers were no more likely to recognise the more severe cases than the milder ones. Organic psychiatric disorder was often missed, alcohol problems less so. PMID- 3659260 TI - The importance of limited exposure to ultraviolet radiation and dietary factors in the aetiology of Asian rickets: a risk-factor model. AB - Regional variation in the prevalence of Asian rickets was examined in Coventry, Bradford and Glasgow. Records of 152 weeks of daylight outdoor exposure were obtained from 104 Glasgow Asian children, 53 of whom had been treated for rickets. Records of seven-day weighed dietary intake were obtained from 84 Asian children, 43 of whom had been treated for rickets. There was a marked north-south gradient in the prevalence of Asian rickets. In all cases of severe rickets with deformity the child was vegetarian. Severe rickets was associated with lower intake of meat, higher intake of chapati and lower daylight outdoor exposure values than in normal children. Multivariate analysis employing a combination of these variables provided good separation between rachitic and normal groups. A risk-factor model is proposed which suggests that regional variation in the prevalence of rickets among Asian communities in Britain is mainly determined by the effects of latitude and the nature of the urban environment on available ultraviolet radiation. Where UV radiation is restricted, individual propensity to rickets within a given Asian community is mainly determined by dietary factors. PMID- 3659261 TI - Variation in mortality from ischaemic heart disease between England and Scotland. AB - A comparison of mortality from ischaemic heart disease under the age of 60 for 1980 to 1981 between the Grampian Health Board and the North Staffordshire Health Authority has been made. A total of 993 deaths was notified by death certificate from the two areas of similar population of which 434 were from Grampian and 559 from North Staffordshire. After examination of general practitioner and hospital case notes, autopsy reports and death certificates, nearly all (532) of the North Staffordshire deaths were accepted as being due to ischaemic heart disease but only three-fifths (263) of the Grampian deaths could be substantiated as there was inadequate information for the remainder. Deaths from ischaemic heart disease seem apparently to be twofold greater in North Staffordshire than Grampian but much of this discrepancy could be attributed to a widely different autopsy rate and to unavailability of case notes. Experience of this survey suggests that the results of other epidemiological investigations may be equally or even more unreliable. PMID- 3659262 TI - Symptomatic intracranial tuberculoma developing during treatment of tuberculosis: a report of 10 patients and review of the literature. AB - Ten patients with intracranial tuberculomata which developed during treatment for tuberculosis are described. The initial infection was meningeal in five, miliary in three and pulmonary in two and all improved after treatment was started. However 10 days to five months (mean two months) after the start of treatment, new neurological symptoms and/or signs occurred that led to the recognition of intracranial tuberculomata. CT brain scans suggested tuberculomata in all 10 patients; there were several lesions in five and histological confirmation was obtained in three cases. Earlier CT brain scans (six weeks to five months before) were carried out in five patients and in none was a tuberculoma seen. After treatment with anti-tuberculous drugs and control of raised intracranial pressure when present, five patients made a full recovery, three were left with mild neurological deficit and in two it is too early to assess the outcome. PMID- 3659263 TI - Human molecular pathology. PMID- 3659265 TI - Investigation of anterior pituitary function in elderly in-patients over the age of 75. AB - Dynamic pituitary function tests were carried out on 50 randomly selected in patients, (30 women and 20 men) over the age of 75 during early convalescence. Twenty-five subjects also had CT scans of the pituitary fossa. One male patient had hypogonadotrophic hypogonadism; another had a large prolactinoma and hypothyroidism; these were excluded from the analysis. Of the remaining 48 subjects, 14 (29 per cent) had reduced TSH responses to TRH and 28 (64 per cent) decreased GH responses to L-dopa compared with our laboratory's reference ranges. Fifteen women (51 per cent) had low basal gonadotrophin levels of which 10 (34 per cent) gave a poor LH response to LHRH and eight (27 per cent) a poor FSH response. Forty-three subjects (93 per cent) gave a good ACTH response to metyrapone. Only six subjects (24 per cent) had an apparently normal pituitary fossa; 16 (64 per cent) had partially or completely empty fossas. There was no significant correlation between the diminished pituitary responses. Only one patient had responses which suggested panhypopituitarism. There was also no significant correlation between the appearance on CT scan of the pituitary fossa and the results of the dynamic tests. It is suggested that laboratory reference range for pituitary function which have been derived from young ambulatory subjects are not appropriate for hospital in-patients over the age of 75. A series of reference ranges for such subjects is proposed. PMID- 3659264 TI - Tumoral calcinosis: clinical and metabolic response to phosphorus deprivation. AB - Two patients with extensive tumoral calcinosis were treated with aluminium hydroxide. Initial metabolic studies showed positive calcium and phosphorus balances which became negative with aluminium hydroxide treatment. One subject, who had renal impairment, developed transient hypercalcaemia, parathyroid suppression, low levels of 1,25-dihydroxyvitamin D and calcium malabsorption during treatment with aluminium hydroxide. The second patient developed calcium malabsorption due to vitamin D deficiency. When she was replete with vitamin D there were supranormal levels of 1,25-(OH)2D in the serum and enhanced calcium absorption during treatment with aluminium hydroxide. Both subjects developed hypercalciuria and there was dissolution of many of the calcific tumours. The patient with renal impairment accumulated aluminium in the bone. PMID- 3659266 TI - A prospective study of hepatic tuberculosis in 41 black patients. AB - Forty-one black patients aged 21 to 75 years with hepatic tuberculosis diagnosed at liver biopsy were studied prospectively. The liver varied in size and consistency and was tender in 44 per cent of patients. Abdominal symptoms, weight loss, pyrexia, hepatomegaly, splenomegaly and anaemia were absent in 54, 39, 37, 5, 68 and 27 per cent of patients respectively. Twenty-two per cent of chest radiographs were normal. Liver function tests were of little diagnostic value and hepatic imaging techniques often gave normal results. Acid-fast bacilli, caseation and coexistent liver disease were detected in 59, 51 and 37 per cent of patients respectively. Since there was no consistent clinical pattern a high index of suspicion is necessary if this disease is to be detected in communities in which tuberculosis is endemic. In patients with unexplained hepatomegaly or hepatosplenomegaly or pyrexia of unknown origin liver biopsy provides the only means of making this diagnosis. PMID- 3659267 TI - Bacteraemia in adults after splenectomy or splenic irradiation. AB - Between 1980 and 1985 eight patients who had had splenectomy or were hyposplenic were admitted to University Hospital, Nottingham with pyrexia and bacteraemia. Three of these patients died from fulminant sepsis, and one patient who had meningitis was left with serious neurological sequelae. All eight patients had had splenectomy or splenic irradiation for haematological disease. Str. pneumoniae was the commonest infecting organism. There were 1579 other bacteraemic episodes seen at University Hospital, Nottingham during the same period. PMID- 3659268 TI - Increased catabolism of muscle proteins as a manifestation of radiation myopathy. AB - Exposure of the hindquarter of the rat to 1000 rad of gamma-radiation caused a significant increase in the release of glutamine and alanine into the perfusion fluid at 4 h post-irradiation. The extent of the release of glutamine exceeded that of alanine. Furthermore, the exposure to gamma-radiation brought about a significant lowering of the intra-/extracellular concentration gradient with respect to glutamine and alanine. PMID- 3659269 TI - A microdosimetric interpretation of the radiobiological effectiveness of 125I and the problem of quality factor. AB - When considering the microdosimetric energy deposition in small biological targets the Auger electron emitter 125I behaves like a high-LET radiation. For a specific incorporation in sensitive biological volumes of 20 nm in diameter a mean lineal energy of gamma F approximately equal to 270 keV micron-1 has been evaluated. Experimental data on transformation, mutation and chromosome aberration from DNA-bound 125I are interpreted to yield RBE-values, relative to 200 kV X rays, of 32 to 38 (transformations), 1 to 16 (mutations) and 6 to 77 (chromosome aberrations). Thus the RBE for transformation and chromosome aberration tends to be larger than the ICRP recommended high-LET quality factor (Q = 20). The implications of these results for the function Q(L) applied in radiation protection will be discussed. PMID- 3659270 TI - 125Iodine decay in DNA: a discussion of its effectiveness for the breaking of DNA strands. AB - 125I incorporated in DNA is known to be exceptionally toxic. Values of D0 range from about 40 to about 90 decays for survival of mammalian cells. The effectiveness of 125I in DNA with respect to the induction of breaks of the DNA strands, however, appears to be comparatively low. The numbers of strand breaks per energy deposited in subnuclear cellular structures such as DNA is smaller for a disintegration of 125I than for gamma-rays. The difference in effectiveness diminishes with increasing mass of the considered sensitive volume. The apparent inefficiency of 125I-decay may, on one hand, result from a waste of local energy deposition. On the other hand, it may be caused by a multitude of local strand breaks (clusters) induced by 125I-decay which are measured as one break only by the conventionally applied techniques of strand break measurement. The apparent inefficiency of 125I may be evidence furthermore for the importance of considering not only the DNA as the sensitive target but with equal pertinence the gross sensitive volume, i.e. the whole cell nucleus. Further, for drawing meaningful comparisons, it may be necessary to take into consideration the microdosimetric event size distributions for the critical targets. PMID- 3659271 TI - Analytical techniques for boron and boron 10 analysis in a solid experimental tumor EO. 771. AB - If a tumor can be preferentially loaded with a suitable boron-10 compound and irradiated with thermal neutrons, malignant cells can be selectively destroyed via the alpha-particle + Li 7-nucleus from the reaction 10B(n, alpha)7Li. Neutron capture therapy with two boron-10 amino acid analogs of low toxicity has been tested in recent years: (a) trimethylamine-carboxyborane, (A3) and (b) amine carboxyborane, (A7). Now the boron-10 glycineamide analog (A8), amineboryl carboxamide has been synthesized; it contains 13.81% boron (90% Boron 10 + 10% Boron 11) and shows a very low toxicity in mice. The effects of this compound were tested on the syngeneic solid adenocarcinoma EO 771 on the right hind leg of male C57 BL/6J mice under standard conditions, by measuring tumor volume growth delay and cell cycle changes using flow cytometry. Boron distribution between tumor and muscle was analyzed by emission spectroscopy with inductively coupled plasma (ICP) following injection of a suspension of peanut oil emulsion. In addition, boron-10 concentration in the tumor were analyzed with prompt gamma activation analysis and neutron capture radiography (Kodak-Pathe LR 115) at the MRR reactor in Brookhaven after i.p. injection of 0.4 mg/g A8. Application of A8 alone (0.4 mg/g i.p.) or thermal neutron irradiation of the tumor EO. 771 produced a tumor growth delay of 1-2 days for tumor volume doubling. Application of the boron 10 glycine-amide analog A8 i.p. plus 5 X 10(12)n/cm2 resulted in a growth delay of 3-6 days. In contrast intratumoral application of A8 plus 4 X 10(12)n/cm2 neutrons gave a growth delay of 7-14 days; the fraction of (G2 + M) cells rose from 35% (neutrons alone) to 52%, as evaluated from flow cytometry. PMID- 3659272 TI - Low dose intraarterial cis-platinum/radiotherapy after local tumour preradiation. AB - The simultaneous use of intraarterial Cis-Platinum and Radiotherapy (CP/RT) was found to be a very effective and relatively little burdened treatment for a palliative treatment concept. This affects life quality as well as the remission- and survival times. The fast and continual remission with low CP/RT concentrations, even in extreme palliative cases, is surprising. CP/RT treatment shows additive and synergistic effects which are not explainable by the single effects of the cis-platinum dose used (60 mg/1.73 m2 in our case) or the total irradiation dose (e.g., 5 Gy TD) or the fractionation (e.g., 5 X 1 Gy), especially since the doses of each which were used are by themselves without therapeutic relevance. Only the combination of the modalities with a low dose two day preradiation program induced the described effects. PMID- 3659273 TI - Chromosome aberration frequency and radiation dose to lymphocytes by alpha particles from internal deposit of Thorotrast. AB - Frequencies of chromosome aberrations in peripheral blood lymphocytes from 63 Thorotrast patients were analysed basing on the age distribution of lymphocytes. The frequency and distribution of chromosome aberrations among lymphocytes are best explained if we assume that the lymphocytes are renewed as an exponential function of time and spend most of their lifetime in the distributive pool where, while exchange of lymphocytes is taking place, the lymphocytes are hit by alpha particles from Thorotrast aggregates resulting in the formation of chromosome aberrations and killing at specific rates per hit. The model predicts that the aberration frequency is rather insensitive to the fluence rate because of modulation by cell killing by hit. Fitting the observed data to the model showed that approximately 0.8 dicentrics and rings were produced by a single path of alpha-particle and average fluence rate to lymphocytes in a group of patients with the highest aberration frequency was estimated to be about 1.5 hits or 87 rad/lymphocyte/year. PMID- 3659274 TI - Comparative study on the therapeutic ultrasound effects on erythrocyte membrane bound and free acetylcholinesterase. AB - Kinetics of erythrocyte acetylcholinesterase activity alterations exposed to ultrasound of therapeutic intensities of 0.88 MHz and 0.05-1.5 W/cm2 was studied. The differences were studied between the mechanisms of the inactivation of membrane-bound and free enzyme: the diminution of active enzyme sites for membrane-bound acetylcholinesterase and the decrease of enzyme-substrate affinity for the free form during sonication. The combined mechanical stresses in the ultrasonic field did not produce inactivation of free enzyme, as compared to the membrane-bound enzyme. Exponential ultrasonic/acoustochemical inactivation curves were obtained for the soluted crystalline form of acetylcholinesterase. PMID- 3659275 TI - A quantitative comparison of potentially lethal damage repair and the rejoining of interphase chromosome breaks in low passage normal human fibroblasts. AB - After long postirradiation incubation periods, the residual frequency of prematurely condensed chromosome fragments following X-ray exposure of noncycling diploid human fibroblasts was found to be correlated with the frequency of chromosome aberrations observed under identical treatment conditions when the cells were subcultured and scored after they reached mitosis. Over a wide range of doses, the proportion of such cells without aberrations at their first metaphase was not significantly different from the proportion able to form macroscopic colonies. Further, the rate of rejoining of interphase chromosome breaks was the same as the rate of increase in survival due to the repair of potentially lethal damage (PLD). These results suggest that there is a one-to-one correspondence between the initial breakage and rejoining of G0 chromosomes and the induction and repair of PLD measured by delayed plating from plateau-phase cultures of these cells. PMID- 3659276 TI - Relationship between the recovery from sublethal X-ray damage and the rejoining of chromosome breaks in normal human fibroblasts. AB - Using plateau-phase cultures of AG1522 normal human fibroblasts, we examined relationships between the breakage and rejoining of chromosomes and the induction and repair of sublethal damage (SLD) following fractionated doses of X rays. The rate constant for the rejoining of breaks in prematurely condensed interphase chromosomes, measured previously, accurately predicts both the rate of change in survival due to potentially lethal damage (PLD) repair and the rate of change in survival for dose fractionation due to SLD repair. Further, changes in the frequency of chromosome-type deletions and asymmetrical exchange aberrations measured in the first postirradiation mitosis corresponded closely with changes in cell killing when doses were fractionated, and a dose-fractionation- or dose rate-independent alpha component of damage was similar for aberration and cell killing end points. These results substantiate the hypothesis that sublethal damage repair results from the rejoining of breaks in interphase chromatin produced by a first dose so they no longer are capable of interacting with those produced by a second dose. The fact that the repair of potentially lethal damage is also readily explained on the basis of chromosome break rejoining (M. N. Cornforth and J. S. Bedford, Radiat. Res. 111, 385-405 (1987)) strongly suggests that PLD and SLD repair are different manifestations of the same basic process operating on the same basic lesions. PMID- 3659277 TI - Radiosensitivity parameters for neoplastic transformations in C3H10T1/2 cells. AB - We have evaluated radiosensitivity parameters for cellular transformation from published experimental data on neoplastic transformations induced in C3H10T1/2 cells by BEVALAC ions. The measured RBE values are well reproduced by a track theory calculation using sets of m-target parameters with either m = 2 or m = 3, suggesting a quadratic or cubic extrapolation to low doses of gamma rays. Using track theory one is thus able to predict transformation frequencies in those cells after an arbitrary radiation field, under known or assumed conditions of exposure, in a manner shown earlier for cellular survival. Extension of these calculations to interpret cancer incidence in vivo is also discussed. PMID- 3659278 TI - Cytogenetic analysis of mouse metaphase II oocytes following exposure to tritiated water. AB - Female mice were given different dosages (0, 3.0, 7.5, 15.0, or 30 muCi/ml) of tritium in their drinking water continuously from 3 to 7 weeks of age to assess the effects on germ cell chromosomes. At 8-9 weeks of age, mice were superovulated and metaphase II oocytes were processed and C-banded for cytogenetic analyses. Chromatid acentric fragments were the only type of structural aberration detected, and their incidence was higher in controls than in any of the tritiated water (HTO) groups. Analysis of numerical chromosomal aberrations revealed that the incidence of hypoploid (N = 19) oocytes was higher in oocytes from mice who drank HTO as compared with controls. However, the effects of HTO upon aneuploidy induction was not definitive due to the increase the incidence of aberrations in mouse oocytes can be related to the low dose rate resulting from chronic HTO exposure and possibly death of tritium-damaged cells. PMID- 3659279 TI - Modification by cis-diamminedichloroplatinum (II) of the radiation dose-response curve for intestinal crypt cells in mice. AB - The effect of cis-diamminedichloroplatinum (II) (c-DDP) on the shape of the radiation dose-response curve for mouse duodenal crypt cells was investigated. A priming X-ray dose was followed 18 h later by graded test doses (single doses or five equal fractions at 3-h intervals) with or without c-DDP. Curves were fitted by a linear quadratic (LQ) relationship. The drug modified the dose-response curve by enhancing both the alpha and the beta terms. Repair kinetics were analyzed in split-dose experiments. c-DDP caused a minor, nonsignificant decrease in the rate of repair after irradiation. The survival ratio after split-dose irradiation, when the same X-ray doses were given, was actually slightly increased by the drug. This paradoxical effect can be explained by the fact that c-DDP mainly increased the beta term in the LQ relationship. There was no significant increase in crypt cell survival when split-drug doses were given alone at increasing intervals, suggesting no cellular repair after c-DDP treatment. The data are discussed in the light of the recently proposed "lethal and potentially lethal" (LPL) unified repair model of Curtis. PMID- 3659280 TI - Radiation-induced changes in liver and kidney alkaline phosphatase and esterase of mice. AB - Whole-body exposure of mice to 2 Gy gamma radiation results in an increase in the specific and total activities of esterase and alkaline phosphatase found in the supernatant of liver and kidney. This increase developed at 1 h, reached a maximum at 24 h, and then declined at 48 h after irradiation. The increase in the activity of these enzymes was not accompanied by an increase in protein content. Electrophoretic analysis on acrylamide gel confirmed the results obtained by the quantitative biochemical analysis. An increase in the level and/or number of bands was observed postirradiation. PMID- 3659281 TI - The effect on depigmentation after multifractionated irradiation of mouse resting hair follicles. AB - The function of melanocytes, i.e., pigmentation, was studied after doses of radiation given in one to eight fractions ranging from 0.9 to 4.0 Gy by quantifying depigmentation of particular (zig-zag) hairs in resting phase in the mouse. Considerable variability in response was noted, perhaps related to variations in growth status of the hair follicle. The slope of the single-dose survival curve is described by a D0 value of 1.47 Gy over a dose range 5 to 10 Gy. A weighted, nonlinear regression analysis of the multifraction data gave estimates of alpha/beta of 6.5 Gy for the linear quadratic model. The same analysis suggests that there are about four clonogenic melanocytes per hair follicle. There was a fluctuating pattern of recovery in the early hours after exposure to a dose of 4.0 Gy but no evidence of melanocyte regeneration up to 4 days. However, a characteristic of the data was its variability, suggesting that the radiation response of melanocytes over the dose range 0.9 to 10 Gy may be very variable, reflecting, perhaps, variability in the kinetic status of the melanocyte. PMID- 3659282 TI - Hypertension after bilateral kidney irradiation in young and adult rats. AB - The mechanism of a rise in blood pressure after kidney irradiation is unclear but most likely of renal origin. We have investigated the role of the renin angiotensin system and dietary salt restriction in the development of systolic hypertension after bilateral kidney irradiation in young and adult rats. Three to 12 months after a single X-ray dose of 7.5 or 12.5 Gy to both kidneys of young and adult rats, the systolic blood pressure (SBP) and plasma renin concentration (PRC) were measured regularly. A single X-ray dose of 12.5 Gy caused a moderate rise in SBP and a slight reduction in PRC in both young and adult rats. A dose of 7.5 Gy did not significantly alter the SBP or PRC during the follow-up period of 1 year. In a second experiment, the kidneys of young rats received an X-ray dose of 20 Gy. Subsequently, rats were kept on a standard diet (110 mmol sodium/kg) or a sodium-poor diet (10 mmol sodium/kg). On both diets, SBP started to rise rapidly 3 months after kidney irradiation. Sodium balance studies carried out at that time revealed an increased sodium retention in the irradiated rats compared to controls on the same diet. In rats on a low sodium intake, there was neither a delay nor an alleviation in the development of hypertension. Compared to controls, the PRC tended to be lower in irradiated rats up to 4 months after irradiation. Subsequently, malignant hypertension developed in all 20 Gy rats, resulting in pressure natriuresis, stimulating the renin-angiotensin system. Our findings indicated that hypertension after bilateral kidney irradiation was not primarily the result of an activation of the renin-angiotensin system. Although there were some indications that sodium retention played a role, dietary sodium restriction did not influence the development of hypertension. PMID- 3659283 TI - The effect of hyperglycemia on the tumor response to irradiation given alone or in combination with hyperthermia. AB - The effect of hyperglycemia (elevated blood glucose level) on the response of a murine tumor to irradiation given alone or in combination with hyperthermia was studied. Tumors were early generation isotransplants of a spontaneous C3H/Sed mouse fibrosarcoma, FSa-II. Single-cell suspensions were transplanted into the foot, and irradiation was given when each tumor reached an average diameter of 7 mm. Following irradiation, the tumor growth time to reach 1000 mm3 was studied and the dose-response curve between the tumor growth time and radiation dose was fitted. Preadministration of glucose increased the size of the hypoxic and chronically hypoxic cell fractions without altering the slope of the dose response curve where the chronically hypoxic cell fraction is determined as the fraction of cells which were not oxygenated under hyperbaric oxygen conditions. Hyperthermia given prior to irradiation enhanced the tumor response to irradiation, but simultaneously increased the size of the hypoxic and chronically hypoxic cell fractions. Similar results were observed following hyperthermia given after irradiation. When hyperthermia at 43.5 degrees C was given 24 h before irradiation, the size of the hypoxic cell fraction increased with increasing treatment time, while a substantial decrease in the chronically hypoxic cell fraction was observed. Administration of glucose 60 min before hyperthermia further increased the size of the hypoxic cell fraction. Possible mechanisms explaining why glucose administration increases the hypoxic cell fractions are discussed. PMID- 3659284 TI - Collagen metabolism in mouse lung after X irradiation. AB - Collagen and total protein synthesis rates have been determined in the lungs of CBA mice irradiated with single doses of X rays between 8 and 16 Gy. Mice were injected with [3H]proline accompanied by a large dose of unlabeled proline, and synthesis rates were measured at 2-month intervals from 8 to 31 weeks after irradiation. At 2 months after radiation treatment, collagen and total protein synthesis rates were significantly depressed but they had recovered by 4 months. By 6 months collagen synthesis rates had increased above control in a dose dependent manner, so that in the 14-Gy dose group the fractional synthesis rate for collagen was 4.6 times higher than in control mice as measured by incorporation of [3H]proline. However, a significant net accumulation of collagen was seen only in the lungs of the highest dose group at 31 weeks, as indicated by total hydroxyproline measurements. There was a slight increase in the ratio of types I and III collagen. Late radiation damage in the CBA mouse lung is characterized by increased collagen metabolism, which may or may not lead to a net accumulation of collagen. PMID- 3659285 TI - Characterization of the adaptive response to ionizing radiation induced by low doses of X rays to human lymphocytes. AB - In previous studies we have shown that low doses of radiation from incorporated tritiated thymidine can make human lymphocytes less susceptible to the genetic damage manifested as chromatid breakage induced by a subsequent high dose of X rays. We have also shown that this adaptive response to ionizing radiation can be induced by very low doses of X rays (0.01 Gy; i.e., 1 rad) delivered during S phase of the cell cycle. To see if a low dose of X rays could induce this response in cells at other phases of the cell cycle, human lymphocytes were irradiated with 0.01 or 0.05 Gy before stimulation by phytohemagglutinin (G0) or with 0.01 Gy at various times after stimulation (G1), followed by 1.5 Gy (150 rad) at G2 phase. Although G0 lymphocytes failed to exhibit an adaptive response, G1 cells irradiated as early as 4 h after stimulation did show the response. Experiments were also carried out to determine how long the adaptive response induced by 0.01 Gy could persist. A 0.01-Gy dose was delivered to lymphocytes in the first S phase, followed by 1.5 Gy in the same or subsequent cell cycles. Lymphocytes receiving a 1.5-Gy dose at 40, 48, or 66 h after stimulation exhibited an adaptive response, whereas those receiving a 1.5-Gy dose at 90 or 114 h did not. Duplicate cultures containing bromodeoxyuridine showed that at 40 h all the lymphocytes were in their first cell cycle after stimulation, at 48 h half of the lymphocytes were in their first cell cycle and half in their second, and at 66 h 80% of the lymphocytes were in their third cell cycle. Thus the adaptive response persists for at least three cell cycles after it is induced by 0.01 Gy of X rays. In other experiments, the time necessary for maximal expression of the adaptive response was determined by delivering 0.01 Gy at hourly intervals 1-6 h before the 1.5-Gy dose. While a 4-h interval was enough for expression of the adaptive response, shorter intervals were not. PMID- 3659286 TI - A Monte Carlo simulation of Auger cascades. AB - The energy imparted to biological tissue after the decay of incorporated Auger emitters stems from two sources: (a) energy deposition by the Auger and Coster Kronig electrons and (b) the charge potential which remains on the multiple ionized atom after the end of the cascade. For the numerical assessment of both the kinetic energy of the released electrons and the charge potential, a new and- for purposes of microdosimetry--precise method is presented. Based on relativistic Dirac-Fock calculations and a rigorous bookkeeping, this method provides a perfect energy balance of the considered atomic system when applied to Monte Carlo simulations of Auger cascades. By comparing the results for charge distribution for krypton and iodine with experimental data and the electron spectrum of 125I with theoretical data, it can be shown that the approach followed in this work is reasonable and appropriate for the determination of the energy deposited by incorporated Auger emitters in small volumes of condensed matter. The total energy deposited by 125I in a volume of 20-nm diameter is 2.03 keV which is made up by multiple ionization (1.07 keV) and energy deposition by the emitted Auger electrons (0.96 keV). PMID- 3659287 TI - Some consequences of the Auger effect: fluorescence yield, charge potential, and energy imparted. AB - The potential energy produced by the Auger cascade due to the charging of atoms is evaluated and incorporated into conventional treatment of energy deposition. A straightforward method for calculating this energy is presented. For the photoelectric interaction the potential energy is shown to be at least as important as L-shell fluorescence in calculating the electron kerma. For radioactive decay by electron capture or internal conversion, it is shown that, for small (less than 100 nm) targets containing the decay, the atomic charging can be the dominant contribution to the total energy deposited in the target. PMID- 3659288 TI - Human epidermal keratinocytes retain radiation resistance following in vitro immortalization and malignant transformation. AB - The radiobiology of human tumors suggests that multiple factors are involved in clinical radioresponsiveness. To date, no direct experimental evidence is available to correlate intrinsic cellular radiosensitivity with the steps of malignant transformation. We developed an in vitro multistage model of epithelial neoplasia using human epidermal keratinocytes to examine the effects of malignant transformation on radiation response. These cells were first immortalized as a result of infection with a hybrid virus (adenovirus 12 and simian virus 40) and subsequently transformed either by infection with a second virus (Kirsten murine sarcoma virus) or by treatment with a chemical carcinogen (N-methyl-N'-nitro-N nitrosoguanidine or 4-nitroquinoline-1-oxide). We demonstrate that primary human epidermal keratinocytes were radiation resistant (D0 = 2.24 Gy) as compared with human fibroblasts (D0 = 1.45 Gy) and that this resistance was retained in the immortalized as well as the transformed cell lines. These findings present direct experimental evidence that radiation sensitivity of malignant human keratinocytes is an intrinsic property of the precursor cell that may be conserved through the stages of neoplastic transformation. PMID- 3659289 TI - Cell survival and plating efficiency. AB - The question of whether cellular radiation sensitivity is independent or related to plating efficiency (PE) is addressed. Three different cell lines, one human and mortal (AG 1522), one rodent and immortal (CHO AA8), and one rodent and mortal (C3H 10T1/2), were investigated. The first two showed a strong correlation between radiation sensitivity and PE, even when, for the mortal cells, the effect of passage number was factored out. PMID- 3659290 TI - Estimation of interaction function gamma(x) with sparsely ionizing radiation. AB - The interaction function gamma(chi), which was introduced in the theory of dual radiation action as the probability that two energy transfers separated by distance chi combine with each other to produce a lesion, was estimated with sparsely ionizing radiation (60Co gamma rays and 40 kV X rays). Gamma(chi) was deduced on the assumption that the sensitive matrix is made up of small spherical flocculi distributed over the cell nucleus. The diameter of a flocculus was estimated at (4.0-11.2) X 10(-8) m when the diameter of the cell nucleus d was assumed to be 5 microns, and (4.0-11.4) X 10(-8) m when d was assumed to be 10 microns. It seems reasonable to hypothesize that the flocculus corresponds to the linker DNA in the chromatin structure of DNA, because the size of the linker DNA as a target (about 40 nm) is consistent with the diameter of flocculi obtained in this study. PMID- 3659291 TI - The radiation response of a human colon adenocarcinoma grown in monolayer, as spheroids, and in nude mice. AB - A human colon adenocarcinoma cell line, WiDr, has been grown in monolayer, as multicellular spheroids, and as xenografted tumors in immune-deprived mice. The growth and radiation responses of the cells under these different growth conditions were compared. The mean doubling time of monolayer cultures was 0.8 day and the initial volume doubling times of spheroids and xenografts averaged 1.2 and 6 days, respectively. The mean total viable cell plating efficiencies were 82, 63, and 7% for cells from monolayers, spheroids, and xenografted tumors, respectively. The radiation responses of single cell suspensions prepared from WiDr tumors (8-10 mm in diameter), exponentially growing monolayer cultures (5 days growth), and spheroids (1200 microns in diameter) irradiated in air at 4 degrees C were similar. Values for D0 were 1.5 Gy and for n between 3 and 5. Nitrogen curves were characterized by a D0 of 5 Gy and n between 3 and 6. Oxygen enhancement ratios were approximately 3.3. Both spheroids and tumors had radioresistant components to the 37 degrees C/air-breathing survival curves with estimated hypoxic fractions of 8 and 12%, respectively. The final portion of the survival curves for irradiations in nitrogen and under normal growth conditions were parallel for both tumors and spheroids. Thus WiDr spheroids appear to model accurately the radiation sensitivity of WiDr tumors. PMID- 3659292 TI - Effects of hyperthermia on spectrin expression patterns of murine lymphocytes. AB - In this study the influence of whole-body hyperthermia on the distribution of spectrin in murine lymphocytes isolated from various lymphoid tissues is examined. Lymphocytes normally vary in terms of the pattern of spectrin distribution within the cell. In certain populations of lymphocytes, spectrin is distributed into a dense submembranous aggregate that can be easily identified by immunofluorescence microscopy. In these lymphocytes, little or no spectrin is seen at the plasma membrane region in the rest of the cell. Other lymphocytes have no such cytoplasmic aggregates, and the protein is seen at the region of the plasma membrane. Following whole-body hyperthermia (40.5 degrees C for 90 min) there is a 100% increase in cells exhibiting polar spectrin aggregates in the spleen, while lymphocytes from the thymus show no alteration in the number of cells showing such aggregates. The increase in the percentage of splenic cells that express aggregated spectrin is a result of increases occurring in both T- and B-cell subsets. This increase gradually returns to control levels by 48 h post-heating. During recovery to control levels this phenomenon is resistant to additional changes when a second heat treatment is applied. The effects described above are not observed when the experiments are performed in vitro; therefore, it is likely that the in vivo heat-induced alteration in the splenic lymphocyte population reflects the physiological response of lymphocytes to stimuli during a natural fever. The role that spectrin may play in the modulation of lymphocyte membrane properties is discussed. PMID- 3659293 TI - Radiosensitization in multifraction schedules. I. Evidence for an extremely low oxygen enhancement ratio. AB - Stable monolayers of contact-inhibited C3H 10T1/2 cells were used in multifraction radiation experiments to measure the oxygen enhancement ratio (OER) at low doses/fraction under conditions where cell cycle effects (repopulation, redistribution) were minimal. Consistent with there being a dose-dependent reduction in the OER at low doses, an extremely low OER of 1.34 was measured after 20 fractions of 1.7 Gy every 12 h. The sparing effects of fractionating radiation doses were not apparent for cells irradiated under hypoxic conditions (i.e., multifraction survivals were lower than acute single-dose values) until doses exceeding 15 Gy were reached. This result suggested a deficiency in the recovery from sublethal and/or potentially lethal damage might exist after hypoxic irradiations, thereby reducing the OER. The capacity to repair potentially lethal damage was found to be nearly the same after hypoxic as compared to aerobic irradiations. However, there was an apparent absence of sublethal damage repair by 10T1/2 cells between two hypoxic irradiations which could be a major contributing factor to the extremely low OER value measured in this multifraction schedule. PMID- 3659294 TI - Radiosensitization in multifraction schedules. II. Greater sensitization by 2 nitroimidazoles than by oxygen. AB - The objective of this study was to characterize the extent of and mechanisms involved in radiosensitization by 2-nitroimidazoles in multifraction schedules using low doses per fraction. For this purpose, contact-inhibited monolayers of C3H 10T1/2 cells were given 1.7 Gy every 12 h and plated 12 h after the last dose received to allow full repair of potentially lethal damage (PLD). Severe hypoxia was obtained by a 1-h gassing procedure at room temperature immediately before each irradiation. No toxicity occurred as a consequence of multiple exposures to 5 mM misonidazole (MISO) or SR 2508 (2508) during the deoxygenation procedure. Experimental conditions during the pregassing and irradiation (presence of drug and gas mixture) were appropriately manipulated to test for the different mechanisms of radiosensitization demonstrated by nitroimidazoles. A very low oxygen enhancement ratio (OER) results under these conditions (1.34). Exposure to 5 mM MISO or 2508 during the deoxygenation and irradiation of hypoxic cells resulted in greater radiosensitization than could be accounted for by oxygen mimetic sensitization alone (MISO and 2508 enhancement ratios were greater than the OER). Pregassing cells with N2 in the presence of 5 mM drug sensitized cells which were subsequently irradiated under aerobic conditions (drug free), indicating the occurrence of the "preincubation effect" (which does not require hypoxia or the drug's presence during the irradiation). Thus, for the hypoxic irradiations, the preincubation effect could account for the greater sensitization by nitroimidazoles than by oxygen. The presence of 5 mM drug only during the irradiation of aerobic cells produced radiosensitization in both multifraction and single-dose experiments with delayed plating. This sensitization has been previously shown to involve reduced PLD repair. Finally, maximum radiosensitization occurred in the multifraction schedule when a transient period of hypoxia with drug preceded an aerobic irradiation with drug present, thus combining the benefits of both the preincubation effect and PLD repair inhibition. This work demonstrates the possibility that effects other than oxygen-mimetic radiosensitization could be largely responsible for the sensitization seen in multifraction schedules, particularly when the OER is already low and only transient periods of hypoxia occur. PMID- 3659295 TI - The repair of double-strand DNA breaks correlates with radiosensitivity of L5178Y S and L5178Y-R cells. AB - To better understand the basis for the difference in radiosensitivity between the variant murine leukemic lymphoblast cell lines L5178Y-R (resistant) and L5178Y-S (sensitive), the production and repair of DNA damage after X irradiation were measured by the DNA alkaline and neutral elution techniques. The initial yield of single-strand DNA breaks and the rates of their repair were found to be the same in both cell lines by the DNA alkaline elution technique. Using the technique of neutral DNA elution, L5178Y-S cells exhibited slightly increased double-strand breakage immediately after irradiation, most significantly at lower doses (i.e., less than 10 Gy). Nevertheless, even at doses that yielded equal initial double strand breakage of both cell lines, the survival of L5178Y-S cells was significantly less than that of L5178Y-R cells. When the technique of neutral DNA elution was employed to measure the kinetics of DNA double-strand break repair, both cell lines exhibited biphasic fast and slow components of repair. However, the double-strand repair rate was much lower in the radiosensitive L5178Y-S cells than in the L5178Y-R cells (T1/2 of 60 vs 16 min). This difference was more pronounced in the fast-repair component. These results suggest that the repair of double-strand DNA breaks is an important factor determining the radiosensitivity of L5178Y cells. PMID- 3659297 TI - Comparison of free radical damage in dinucleoside monophosphate via autoxidation processes and by ionizing radiation. PMID- 3659296 TI - Modification of radiation response in mice by fractionated extracts of Panax ginseng. AB - A water-soluble extract of the root of Panax ginseng, a plant native to northeastern China, was fractionated into three components: carbohydrate, protein, and saponin fractions. The fractions obtained were tested for their ability to protect against the lethal effects of 60Co gamma irradiation in C3H mice. The results were compared to the protective ability of the water-soluble fraction of whole ginseng. An experiment designed to test the optimum time of injection of whole ginseng showed that administration 24 h prior to irradiation was optimal. Ginseng extract or one of its three fractions was dose adjusted and injected intraperitoneally into mice that 24 h later were irradiated, whole body, with doses ranging from 7 to 11 Gy. The LD50 in 30 days was calculated using Probit analysis. The results indicated that the water soluble extract of whole ginseng gave the best protection against gamma radiation. The isolated protein and carbohydrate fractions gave less protection, while the saponin fraction did not protect. PMID- 3659298 TI - Supralinearity in thermoluminescence dose-response curves. PMID- 3659299 TI - Gastrointestinal absorption of americium-241 by orally exposed swine: comparison of experimental results with predictions of metabolic models. AB - Two groups of 11-week-old swine (40 miniature and 40 domestic swine) received a single oral administration of 1.9 X 10(8) Bq (5.2 mCi) of 241Am citrate, and groups of eight animals, four of each type, were killed and sampled at 1, 2, 4, 8, 16, 24, 48, 72, and 96 h and 30 days later. Uptake and excretion patterns of the radioactivity appeared to occur in three phases: rapid uptake, rapid excretion, and then a slower excretion. All animals were systematically dissected, and the eviscerated carcasses were autoclaved for separation of bone and muscle. The predominant site of deposition was bone, and autoclaving had little effect on releasing 241Am from either bone or muscle. The maximum fractional gastrointestinal absorption of 1.1 X 10(-3) occurred 8 h after radionuclide administration. The tissue distribution data suggest partitions of 50, 20, and 30%, for bone, liver, and other soft tissues, respectively. Two metabolic models were evaluated: a modified Mewhinney-Griffith model and the ICRP 30 model to compare the biological data with model predictions. All models underestimated the actual early time data, but the fits to the experimental results were better at later times. PMID- 3659300 TI - Comparative effects of X irradiation on the testes of adult Sprague-Dawley and Wistar rats. AB - The response of the testes of two strains of adult rats (Sprague-Dawley and Wistar) to graded single doses and split doses of 230 kVp X rays has been investigated. A marked difference was noted between the strains in the response of the clonogenic spermatogonia to irradiation, as measured histologically by the repopulation index. Single-dose response curves derived for these cells in the Sprague-Dawley strain had a much larger shoulder (up to about 4-5 Gy) than for the Wistar (less than 2 Gy). Split-dose studies revealed that this difference may partly be explained by a greater repair capacity in the cells of the Sprague Dawley strain. Changes in serum FSH concentrations mirrored the changes in clonogenic spermatogonial survival following split doses of radiation. PMID- 3659301 TI - [Nuclear medicine--brief scientific reports. 23d symposium of the Society for Nuclear Medicine of East Germany. Reinhardsbrunn, May 1986]. PMID- 3659302 TI - [Experience with 131I-MIBG scintigraphy of children with neuroblastoma]. PMID- 3659303 TI - [Results of puncture biopsy of the thyroid in relation to the comprehensive diagnosis of thyroid diseases]. PMID- 3659304 TI - [Discriminant analysis in nuclear medicine cancer diagnosis]. PMID- 3659306 TI - [Biokinetics of IDA derivatives]. PMID- 3659305 TI - [Present status and trends in radiopharmacology]. PMID- 3659307 TI - [Medullary carcinoma of the thyroid--epidemiologic, diagnostic and therapeutic aspects]. PMID- 3659308 TI - [Construction of a nuclear medicine data collecting and processing system by coupling 2 microcomputers]. PMID- 3659309 TI - [Respiration- and ECG-gated data collection in a data processing system controlled by a microcomputer]. PMID- 3659310 TI - [Data compression using a 16-bit computer module adapted to bone scintigraphy]. PMID- 3659311 TI - [RIA-DAT: a Dialog program for statistical evaluation of radioimmunologic and immunoradiometric data using a microcomputer]. PMID- 3659313 TI - [Present status and trends in probe technics in nuclear medicine--problems of methodology]. PMID- 3659312 TI - [Present status and trends in probe measurement technics in nuclear medicine. Technical status and development]. PMID- 3659314 TI - [Value of radiotherapy in the treatment of colorectal cancer]. PMID- 3659315 TI - [Effectiveness of radiotherapy in the treatment of malignant parotid tumors of different histological types]. PMID- 3659316 TI - [Radiation pneumopathy. I. Analysis of clinical and x-ray findings]. PMID- 3659317 TI - [Radiation pneumopathy. II. Informational value of spirometry in the diagnosis of radiation pneumopathy]. PMID- 3659318 TI - [Radiation pneumopathy. III. Importance of blood gas analysis and acid-base balance in the follow-up of radiation pneumopathy]. PMID- 3659319 TI - [Radiation pneumopathy. IV. Importance of CO-diffusion capacity in the early diagnosis of radiation pneumonitis]. PMID- 3659320 TI - [Radiation pneumopathy. V. Studies on the perfusion scintigraphy of the lungs in radiation pneumopathy]. PMID- 3659321 TI - [Detection of a TAA-specific sensitization in patients with metastatic breast cancer following breast removal and upper and lower half-body irradiation]. PMID- 3659322 TI - Radiosensitivity of lymphocyte of mice irradiated in utero and its modification as a function of exposure dose. PMID- 3659324 TI - Response of amphibian liver to external gamma irradiation. PMID- 3659323 TI - Radioprotective effect of neo-mercazole on the rats during starvation stress. PMID- 3659325 TI - [Mathematical and metrological determinations of the intensity distribution of cobalt-60 radiation behind block filters]. PMID- 3659326 TI - [60Cobalt gamma irradiation of the bilateral cervical lymph node system using opposing anterior-posterior fields]. PMID- 3659327 TI - [Spontaneous occlusion of intracerebral vascular malformations]. PMID- 3659328 TI - [Roentgen morphologic changes in the skeleton and soft tissues in adult patients with renal failure]. PMID- 3659329 TI - [Roentgen diagnosis of lung hypoplasia in children]. PMID- 3659331 TI - The roentgenmorphology of the femoro-patellar joint and its clinical significance. PMID- 3659330 TI - [Computerized tomography studies of ventricular size and cortex-medullary relations of the brain in a normal population]. PMID- 3659332 TI - [Radiologic study following knee-joint endoprosthesis surgery]. PMID- 3659333 TI - [Roentgen anatomy of foot veins and their changes in varicose veins of the lower extremities]. PMID- 3659334 TI - [Value of complex roentgen endoscopy diagnosis of cancer and ulcer of the greater curvature of the stomach]. PMID- 3659335 TI - [Positive tumor scintigraphy of oral and oropharyngeal tumors]. PMID- 3659336 TI - [Measurement of lipid digestion and lipid absorption with 3H-palmitic acid and 14C-tripalmitate]. PMID- 3659337 TI - [Comparative measurements of radiation dose between large and medium format technics in roentgen diagnosis of female urinary incontinence]. PMID- 3659338 TI - Advantages of a low-osmolality ionic contrast medium in intra-arterial applications. AB - Osmolality is recognized as a major contributing factor of contrast media related adverse reactions. The development of a new ionic contrast medium has made it possible to retain the ionic nature of contrast agents and have a lower osmolality than non-ionic and conventional ionic contrast media. Studies have indicated that low osmolality ionic contrast media is comparable to non-ionic agents and in some instances has proven to be superior to non-ionic contrast media. PMID- 3659339 TI - Exposure reduction and image quality for pantomographic radiography. AB - A laboratory study was undertaken in our institution to determine if radiation exposure could be reduced in pantomographic radiography without affecting image quality. Various types of rare earth filters were evaluated along with two radiographic screens and films. The results of our study indicate that exposure reductions of between 19 and 79% can be acheived without affecting image quality significantly. PMID- 3659340 TI - Certification and licensure of radiologic technologists: Part II. AB - This article focuses on the vast inconsistencies in radiologic technology credentialing within the United States. There is no Federal statute requiring licensure of medical radiologic technologists. Historically, professional self monitoring certifying agencies have provided the voluntary competency requirements that are used in some states. However, among these agencies varying standards prevail. Even though the majority of states do not license radiologic technologists, there are efforts underway to introduce licensure within the field. PMID- 3659341 TI - CT scanograms compared with conventional orthoroentgenograms in long bone measurement. AB - In this article the standard orthoroentgenograph is compared with computed tomography (CT) scanography in determining bone length discrepancies. Dried femur bones are studied by both methods. The CT scanogram method is found to be more accurate than the orthoroentgenography method. PMID- 3659342 TI - [Intracranial manifestation of lymphomatoid granulomatosis (Liebow's disease)]. AB - An intracranial manifestation of lymphomatoid granulomatosis occurs in 20% of patients. In the case of a 56-year-old patient it is shown that a relative long period can pass from the first neurological symptoms to histological diagnosis by stereotactic brain puncture. Over 15 months, follow-up studies were performed using computed tomography and magnetic resonance. PMID- 3659343 TI - CT-findings in ARDS. AB - The CT features of 28 patients with ARDS are described. Diffuse lung consolidation, multifocal patchy involvement and lobar or segmental disease were observed. Large lung cysts as well as small cysts producing a "swiss-cheese" appearance of the parenchyma, were detected. These findings were not regularly appreciated on chest radiographs. The overall mortality of our 28 patients was 72.7% (22 out of 28). Patients with lung cysts showed a trend toward higher mortality (87.5% or 13 out of 16). Other unexpected findings were basilar lung abscesses and an empyema. In 15 out of 28 patients, CT scans provided additional information, not obvious on bedside chest radiographs and led to a change in management in five patients. PMID- 3659344 TI - Pulmonary arterial hypertension as a manifestation of lupus erythematosus. AB - We present five patients with systemic lupus erythematosus (SLE) who developed pulmonary arterial hypertension and cor pulmonale in the course of their disease. The clinical features, as well as, the radiological manifestations of this rare manifestation of SLE are discussed. A vasculitic process is the most likely cause of this complication. Therapy is ineffective and the prognosis is poor. PMID- 3659345 TI - [Axial myopia--computed tomography and magnetic resonance tomography findings]. AB - The case of a 44-year-old women suffering from amblyopia of the left eye with unilateral proptosis caused by axial (progressive) myopia is presented. The clinical and radiological findings were discussed in reference to the literature. The diagnosis was established by ruling out neoplastic, inflammatory or endocrine causes for the exophthalmos. CT and MR scans revealed an enlarged left globe without evidence of orbital masses. The findings were regarded as typical for the diagnosis of axial myopia. PMID- 3659347 TI - On display. Technical innovations and innovators, imaging-related services and educational literature at RSNA '87. Radiological Society of North America. PMID- 3659346 TI - [Metallic middle-ear implants in magnetic resonance tomography: hearing impairment and other hazards]. AB - Concurrent with the expanding clinical applications of nuclear magnetic resonance (NMR) imaging, patients with metallic middle-ear implants will certainly be exposed to this strong magnetic field in the future. To determine potential hazards, associated with movements of steel- or Platinum stapes-prostheses, several tests were performed in a 0.5 tesla NMR unit and the induced forces were calculated. Although the commonly used paramagnetic steel-wire or platinum-alloys will not dislodge in vivo, ferromagnetic prostheses may present a risk. Prior to exposure to the magnetic field, information about the implanted material should therefore be obtained. A side-effect of the induced current flow is the attenuation of the sound-vibrations of the stapes prosthesis. This, 5-10 dB impairment of transmission develops only at a certain position of the patient's head, when the prosthesis vibrates perpendicularly to the magnetic field's Z axis. Patients with a metallic prosthesis should be informed about this purely physical, harmless phenomenon prior to entering the NMR-cylinder. PMID- 3659348 TI - Xeroradiography of the breast: overview of 21,057 consecutive cases. AB - Xeroradiography was performed on 21,057 new patients referred over a 5 1/2-year period. For purposes of analysis, mammograms reported as "benign" or "follow-up suggested" were considered negative and those reported as "suspicious" or "strongly suggestive of cancer" were considered positive. All patients were followed up for 12 months. After 6 months, 773 breast cancers were diagnosed. An additional 19 cancers were proved to exist during the 6-12-month period. The cancer rate increased progressively with age and ranged from 1.2% at age 30-39 years, to 4.5% at age 50-59 years, to 11.8% at age 70 years and over. Mammography had a sensitivity of 91.1%, a specificity of 89.9%, and a predictive value of 25.5%. Sensitivity increased with age, ranging from 78.5% at age 30-39 to 95.1% at age 70 and over. Predictive value increased dramatically with age, varying from 12.4% at age 30-39, to 28.4% at age 50-59, to 49.4% at age 70 years and over. PMID- 3659349 TI - A simple classification system for mammographic reporting. AB - A simple classification system for reporting mammograms is described, similar in format to a system formerly used for reporting Papanicolaou smears. Class 1 indicates an examination with normal findings. Class 2 indicates findings of a mass or masses that appear to be benign. Class 3 indicates findings of an indeterminate lesion, suggestive of possible malignancy. Class 4 indicates probable malignancy. Advantages of the classification system include effective triage of patients and easier computerized record keeping for long-term tracking. PMID- 3659350 TI - Nonpalpable breast lesions: accuracy of prebiopsy mammographic diagnosis. AB - Mammograms of 220 patients who underwent spot localization for removal of nonpalpable breast lesions were reviewed for accuracy of interpretation. Results of subsequent biopsy indicated malignancy in 77 cases. The interpretations of mammograms obtained before biopsy were incorrect in 71 cases (27 false-negative and 44 false-positive studies). Among the false-negative cases, 70% of the abnormalities were determined histologically to be noninfiltrative cancers. An aggressive screening program with preoperative localization and biopsy is needed in questionable cases, since mammographic signs of early or nonpalpable malignancy are often subtle and nonspecific. PMID- 3659351 TI - Disappearing breast masses caused by compression during mammography. AB - Two cases are described in which a palpable mass and a nonpalpable mass disappeared during the performance of mammography. The disappearance is presumed to be caused by cyst rupture, resulting from the firm compression used to perform the examination. This occurrence can create confusing clinical and radiographic situations, and radiologists should be aware that occasional cyst rupture may occur. PMID- 3659352 TI - Epipericardial fat pad: CT findings. AB - Epicardial and mediastinal fat around the apex of the heart may produce the classic appearance of a cardiac fat pad filling in the anterior cardiophrenic angle on a lateral chest radiograph. A review of 50 computed tomographic (CT) scans of the chest that were normal save for possible cardiomegaly, together with chest radiographs obtained within a 14-day interval, revealed a wide variation in the configuration of this fat pad in 16 patients (32%). Depending on geometric circumstances, the fat pad may produce a well-marginated region of increased density, a region of increased density with poor margination, or an area of reduced density lying anterior to the heart. In an additional four patients (8%), however, a simulation of a cardiac fat pad was produced by cardiomegaly alone or by relative levoposition of the heart. In these four patients, the left side of the heart contacted the chest wall on the left over a larger than normal area and thereby excluded lung from the vicinity, simulating the appearance of a fat pad where none existed. PMID- 3659353 TI - Preoperative chest radiography: value as a baseline examination for comparison. AB - An important use of the preoperative chest radiograph is as a baseline for comparison when complications occur after surgery. Many authors have commented on the value of preoperative chest radiography as a screening examination, but no statistics have been presented regarding its impact on postoperative management. In 369 consecutive general surgical patients, the need for a baseline chest radiograph was evaluated. In 65 patients undergoing chest radiography postoperatively, a preoperative baseline was essential in making an accurate interpretation in 33 (51%). The value of preoperative chest radiography proved to be twofold. Some minimal abnormalities on postoperative radiographs were demonstrated to be clearly new, necessitating treatment or further evaluation. Second, significant abnormalities detected on postoperative radiographs that may have otherwise been subjected to expensive evaluation were often shown to have been present preoperatively. In approximately 9% of patients the preoperative chest radiograph had a significant impact on postoperative management. PMID- 3659354 TI - Pulmonary angiography with iopamidol: patient comfort, image quality, and hemodynamics. AB - The choice of a contrast agent for pulmonary angiography has important implications for patient comfort, image quality, and perhaps the safety of the procedure, particularly for "high-risk" patients. In a prospective study the nonionic, low-osmolality agent iopamidol eliminated the problem of image degradation due to coughing, and patients showed excellent tolerance for it. However, pressure measurements obtained within 3-5 minutes of injection of iopamidol and diatrizoate sodium meglumine 76% showed no significant difference in the hemodynamic effects of the two contrast agents, either for normotensive or for pulmonary hypertensive patients. Contrary to a common presumption, pulmonary hypertension by itself did not appear to increase the risk of pulmonary angiography. The theoretic presumption of greater hemodynamic stability with low osmolality contrast agents was not clinically evident in this trial with iopamidol. At present, enhanced patient comfort and improved image quality remain the only confirmed bases for choosing this contrast agent for pulmonary angiography. PMID- 3659355 TI - Fatal systemic arterial air embolism following lung needle aspiration. AB - Fatal systemic arterial air embolism occurred as a complication of percutaneous fine-needle aspiration of the lung, immediately following cytologic sampling of a vasculitic lesion of Wegener granulomatosis. This complication is extremely rare, and it may have been caused by the biopsy of abnormal veins, in which transmural inflammation prevented the normal vasoconstrictive responses to injury. PMID- 3659357 TI - Improved interpretation of exercise Tl-201 myocardial perfusion scintigraphy in women: characterization of breast attenuation artifacts. AB - Thallium-201 myocardial perfusion scintigraphy is reported to be a less accurate diagnostic test for coronary artery disease in women than in men. We retrospectively analyzed 34 Tl-201 studies obtained in 28 symptomatic women and compared them with those obtained in 32 men during the same interval. Three criteria were tested: criterion 1 was defined as abnormal scans showing any defect; criterion 2, scans showing only transient (reversible) defects; and criterion 3, scans showing either transient or "significant" (i.e., not due to breast attenuation) fixed defects. The sensitivity in women was 1.00, 0.73, and 0.93, respectively; the specificity, 0.26, 0.84, and 0.85. The best values in men were a sensitivity of 1.00 and a specificity of 0.86. The three criteria were then prospectively tested in 33 scans of 29 additional women. The sensitivity was 0.90, 0.65, and 0.80, respectively, and the specificity, 0.18, 1.00, and 0.92. Defects (usually fixed) due to breast attenuation artifact were seen frequently (30%). Criterion 3 best differentiates such defects from those resulting from coronary artery disease, making Tl-201 myocardial perfusion scintigraphy as accurate in women as in men. PMID- 3659356 TI - Deep venous thrombophlebitis: detection with 4-hour versus 24-hour platelet scintigraphy. AB - Thirty-one nonheparinized patients with suspected deep venous thrombophlebitis (DVT) underwent contrast venography and indium-111 platelet scintigraphy (In-111 PS). Venography permitted identification of acute DVT in 12 of 31 cases (39%). One additional patient was considered to have acute DVT despite nonconclusive venography results. In-111 PS results were positive at 4 hours in nine of 13 cases (69%) and at 24 hours in 12 of 13 cases (92%). Two of four patients with false-negative 4-hour In-111 PS studies had received warfarin. Thus, the sensitivity of 4-hour In-111 PS in patients not receiving anticoagulants was 82%. Venography results were negative for acute DVT in 18 cases, and 4-hour In-111 PS studies were negative or equivocal in each. In-111 PS is an alternative to contrast venography for detecting acute DVT. If 4-hour In-111 PS results are positive, anticoagulation can be initiated. Delayed images are necessary if the 4 hour images are negative or equivocal. PMID- 3659358 TI - Aortic lacerations: fatal complications of thoracic aortography. AB - Traumatic aortic lacerations are life-threatening injuries that require a prompt diagnosis and surgery if patients are to survive. Most authors recommend transfemoral catheterization when performing thoracic aortography in patients with suspected aortic lacerations. The authors of this study describe two patients in whom transfemoral catheterization and contrast material injection were directly related to their deaths. These cases illustrate the need for cautious catheter manipulation in patients with aortic lacerations. PMID- 3659359 TI - Percutaneous transfemoral placement of the Kimray-Greenfield vena cava filter. AB - In 109 patients in whom inferior vena caval interruption was indicated to prevent pulmonary embolism, Kimray-Greenfield (K-G) filters were inserted from a percutaneous transfemoral approach, 94 from the right common femoral vein and 15 from the left common femoral vein. All attempts at transfemoral filter insertion were successful except in two patients in whom a left common femoral approach was used. No complications occurred during insertion. In four patients, clinical evidence of femoral vein thrombosis ensued within 48 hours of filter insertion. There were no complications related to filter migration, and in 97% of patients the alignment was satisfactory. The percutaneous transfemoral route is a rapid and effective method for inserting K-G filters. The most frequent postinsertion complication was femoral vein thrombosis (ten patients), but only two patients suffered permanent sequelae. PMID- 3659360 TI - Percutaneous insertion of the Kimray-Greenfield filter: technical considerations and problems. AB - Kimray-Greenfield filters were inserted percutaneously into the inferior vena cava (IVC) in 57 patients. Thirty-six were placed from the right femoral vein, 14 from the left femoral vein, and seven from the right internal jugular vein. There were no deaths or major complications and only six minor complications. Inferior vena cavography was done before filter insertion in all cases. Cavography is vital to determine feasibility of filter insertion, route of insertion, and filter location; pertinent findings include caval size, presence or absence of clot in the IVC or iliac veins, and position of the renal veins. The guide wire provided with the standard filter introduction set has a tendency to catch on the filter as the wire is withdrawn. A stiff wire with a straight, tapered, floppy tip was substituted. The femoral approach is preferred when it is feasible. Though there was only one known occurrence of femoral vein thrombosis at the filter insertion site, other cases may have occurred and may not have been detected. If the frequency of this complication proves to be significant, the preferred route for filter insertion may have to be reconsidered. PMID- 3659361 TI - Recurrent pulmonary embolism after Greenfield filter placement. AB - Three patients with documented recurrent pulmonary embolism with an inferior vena cava (IVC) Greenfield filter in place were examined with contrast-material enhanced cavography. Mechanisms for recurrent pulmonary embolism were found to be propagation of thrombus through the filter struts, occlusion of the IVC at the level of the filter, and loss of contact of the filter hooks with a portion of the caval wall. PMID- 3659362 TI - Superior vena caval placement of a Kimray-Greenfield filter. AB - Kimray-Greenfield filters placed in the inferior vena cava have been shown effective for prophylaxis against pulmonary embolism from lower extremity or pelvic thrombi. Percutaneous filter placement in the superior vena cava is described in a patient with pulmonary embolism and upper extremity thrombosis in whom anticoagulative therapy was contraindicated. PMID- 3659363 TI - Recanalization of obstructed arteries with a flexible, rotating tip catheter. AB - A flexible, rotating tip catheter (Kensey catheter) was used to recanalize 24 segments of diseased superficial femoral arteries (from cadavers) that were sewn as xenografts into the femoral, carotid, or aorticorenal arteries of 14 dogs. One perforation occurred; there were emboli in some brains and kidneys, the consequences of which remain unknown. No signs of gross neurologic deficits or limb ischemia were seen at 0-11 days. PMID- 3659364 TI - Transesophageal drainage of mediastinal abscesses. AB - Esophageal perforation with subsequent formation of a mediastinal abscess is a well-recognized clinical entity. Causes include perforation due to rigid and fiberoptic endoscopy, bouginage, breakdown of surgical anastomoses, and protracted vomiting. This disorder is associated with a high morbidity and, without intervention, a high mortality. In the past, surgery has been the treatment of choice. Although percutaneous drainage techniques have been used in some cases, they are frequently less attractive due to the location of the esophagus and its proximity to thoracic organs and vascular structures. In this study, eight abscesses caused by esophageal perforations were drained through a transesophageal route with minimal patient morbidity. These cases are presented with a discussion of the techniques and patient follow-up. PMID- 3659365 TI - Budd-Chiari syndrome: dynamic CT. AB - A retrospective multi-institutional study was carried out on a series of 38 patients with histologically proved Budd-Chiari syndrome: Five patients had acute disease, and 33 had subacute or chronic disease. All patients underwent dynamic CT scanning. Angiography was performed in 20 cases, inferior cavography in 22, and wedge-hepatic venography in 16. In all acute cases, CT showed global liver enlargement with diffuse hypodensity on plain scans and patchy enhancement after contrast material injection. Thrombosis of the three main hepatic veins was always demonstrated. In subacute or chronic disease, plain CT scans showed abnormalities of liver morphology and hypodensity either in atrophic areas (19 cases) or in the periphery of the liver (eight cases). With dynamic CT, patchy enhancement was present in 28 cases. Correlation with angiography in 15 cases revealed a normal portal blood flow in enhanced areas and an inversed portal blood flow in atrophic areas. Different morphologic and enhancement patterns on CT scans could be related to the direction of portal blood flow, which changes with different stages of Budd-Chiari syndrome. PMID- 3659366 TI - Antegrade ureteral stents: technical and catheter-related problems with polyethylene and polyurethane. AB - Antegrade placement of polyethylene and polyurethane stents was successfully achieved in 93 of 107 ureters (87 of 101 patients). These materials functioned adequately in 24 of 26 patients with indications for temporary stenting, including fistulas, strictures, and trauma caused by manipulation of calculi. Thirty of 61 patients with malignancy (49.2%) died within 6 months with their original stents in place; 12 survived to undergo elective cystoscopic stent replacement. Fifteen of the 61 patients had premature stent occlusions, which were treated by permanent nephrostomy in nine, replacement of the stent in five, and no further diversion in one patient with lymphoma. Encrustation and stent occlusion are problems during extended use of polyethylene and polyurethane stents. Long-term patency rates with newer stent materials remain to be documented and compared. PMID- 3659367 TI - Upper airway obstruction in infants and children: evaluation with ultrafast CT. AB - The diagnostic accuracy of ultrafast computed tomography (CT) was evaluated prospectively in 25 infants and children with suspected airway obstruction. All examinations were conducted in spontaneously breathing, nonsedated children. Scan acquisition times were 0.05 or 0.1 second. CT examinations, completed in an average of 10 minutes, routinely included localizing, contiguous sections through the trachea followed by serial images obtained at a rate of 17 per second through regions of interest. Imaging results were correct in 24 of 25 examinations as judged from clinical and surgical data. Ultrafast CT data permitted diagnosis of dynamic changes in airway caliber, small intraluminal polyps, focal tracheal atresia, compressive mediastinal masses, and foreign body obstructions of the major bronchi. Dose measurements showed a maximum skin exposure of 245 mR (0.06 mC/kg) per 0.05-second image. Ultrafast CT provides an accurate, minimally invasive method for dynamic imaging of the airway in nonsedated children. PMID- 3659368 TI - Orbital dermoids: features on CT. AB - The computed tomographic (CT) features of orbital dermoids were retrospectively reviewed in 17 patients; 15 of the lesions were proved histologically. On the basis of clinical and CT features, the tumors were classified as superficial or deep. All but one were extraconal in location. Seven lesions appeared cystic; only six showed typical fat density. The presence of a margin or rim, often partially calcified, was identified in ten lesions. Irregular scalloping of adjacent bone was a highly suggestive feature, occurring with 11 dermoids. Other bone changes, such as linear defects, thinning, or sclerosis, also occurred. Superficial dermoids showed less apparent bone changes. An extraconal orbital lesion associated with adjacent bone thinning or notching should raise the possibility of a dermoid, especially if a rim with calcification is seen. The appearance is pathognomonic if fat density is also present. PMID- 3659369 TI - Calcifications of the palatine tonsillary region: CT demonstration. AB - The scans of 100 consecutive patients referred for computed tomographic examinations that included the oropharynx were reviewed with regard to calcifications of the palatine tonsillary region. Calcifications were found in 20% of the female patients and 13% of the male patients. Ten patients had one calculus, and six had two or more. The sizes of the calculi ranged from 1 to 7 mm. Tonsillary calculi must be included among the diagnostic possibilities when survey radiographs of the neck show soft-tissue calcifications. PMID- 3659370 TI - Posterior pituitary gland: appearance on MR images in normal and pathologic states. AB - T1-weighted magnetic resonance (MR) images of the pituitary gland and sella turcica routinely demonstrate a region of high signal intensity in the neurohypophysis. High-resolution MR imaging studies of the sella turcica in 200 subjects with a normal or abnormal sella were analyzed. The hyperintensity was found in the images of about 90% of healthy subjects and patients with microadenoma, in only 43% of patients with macroadenoma, and in 12% of patients with empty sellae. The signal was absent in several patients with functional or anatomic abnormalities of the hypothalamic-hypophyseal axis. It is concluded that the high signal intensity in the posterior lobe of the pituitary gland is present in most healthy individuals and that its absence in many patients with large intrasellar masses and empty sellae is due to compression of posterior lobe tissue. Its absence in diabetes insipidus further suggests a relationship between hyperintensity and the functional status of the hypothalamic-hypophyseal axis. PMID- 3659371 TI - Transection of the pituitary stalk: development of an ectopic posterior lobe assessed with MR imaging. AB - Magnetic resonance (MR) imaging was performed in ten patients with pituitary stalk transection who had idiopathic pituitary dwarfism. Contiguous sagittal T1 weighted images were obtained in all cases, and, in some, axial or coronal images were taken for further evaluation. On MR images, normal anterior and posterior lobes of the pituitary gland can be clearly differentiated because the posterior lobe has a characteristic high intensity on T1-weighted images. In the ten patients, the high-intensity posterior lobe was not seen, but a similar high signal intensity was observed at the proximal stump in seven patients. This high intensity area is the newly formed ectopic posterior lobe, which secretes antidiuretic hormone just as the posterior lobe would. When the ectopic lobe completely compensates for the impaired posterior lobe, endocrinologic data indicate normal posterior lobe function. However, MR imaging can reveal the transection of the pituitary stalk and formation of the ectopic lobe. PMID- 3659372 TI - Rathke cleft cysts: CT, MR imaging, and pathologic features. AB - The authors retrospectively reviewed the clinical, computed tomography (CT), and magnetic resonance (MR) imaging findings in seven patients with pathologically proved Rathke cleft cysts. All the cysts were located in the anterior sella turcica or the anterior suprasellar cistern. Five cysts had both intra- and suprasellar components, one was entirely intrasellar, and the other was predominantly suprasellar in location. The size of the cysts ranged from 8 to 20 mm. CT scans demonstrated low-density homogeneous lesions in four cases. On MR images of three of these four cases, the cysts had the same intensity as cerebrospinal fluid on T1- and T2-weighted images, while in the fourth case, the cyst was hyperintense on the T1-weighted images. In the remaining three cases, CT showed slight hyperdensity relative to brain parenchyma, suggestive of contrast enhancement. MR showed signal heterogeneity of these lesions with focal components of diminished signal intensity of T2-weighted images. These same foci appeared iso- to slightly hyperintense on T1-weighted images. PMID- 3659373 TI - Adrenoleukodystrophy: correlating MR imaging with CT. AB - The effect on the brain of the sex-linked recessive form of adrenoleukodystrophy was studied in 40 boys, 4-18 years old. All underwent computed tomography (CT) scanning; six underwent magnetic resonance (MR) imaging. MR showed a high sensitivity in demonstrating white matter disease. Auditory pathway disease was characterized as involvement of the lateral lemniscus and medial geniculate body, and visual pathway disease was characterized by lateral geniculate body, Meyer loop, and optic radiation involvement. Contrast-enhanced CT still proved to have a greater capacity (at this time) to show the active, advancing form of the disease and concomitant calcifications. This large CT series also demonstrated the broad and variable expressions of adrenoleukodystrophy, which allowed the unification of previously described atypical forms of the disease. PMID- 3659374 TI - Cerebral sparganosis: CT characteristics. AB - Cerebral sparganosis is an extremely rare parasitic zoonosis caused by a migrating plerocercoid tapeworm larva, genus Spirometra. Nineteen computed tomography (CT) scans of 12 patients with cerebral sparganosis were retrospectively analyzed and correlated with clinical and pathologic data. On CT scans, the following characteristics were noted: (a) unilateral involvement; (b) extensive or multifocal areas of low density along white matter bundles, with ipsilateral ventricular dilatation and localized cortical atrophy; (c) nodular or irregular enhancement with spotty calcification; and (d) change in location of enhancing nodules on sequential scans. These pathognomonic features reflect a chronic inflammatory process with both active granulomatous lesions and widespread degeneration of brain tissue, especially in the white matter. Degeneration is probably caused by migration of the long-surviving larva along the fiber tracts of white matter. PMID- 3659375 TI - Thoracic disk herniation: MR imaging. AB - The authors undertook a retrospective study to assess the role of magnetic resonance (MR) imaging in thoracic disk herniation. The initial MR images were interpreted independently of other findings. These interpretations were compared with the findings of plain and computed tomography (CT) myelography and surgery, when available. Sixteen thoracic disk herniations were confirmed with plain and CT myelography and/or surgery. Plain myelography was performed on 14 patients and showed focal ventral filling defects in nine. Results of CT myelography were equivalent to those of MR imaging with three pulse sequences (sagittal T1 and T2 weighted, axial T1 weighted) in the identification of all the abnormal levels. In two patients, the signal from the herniated disk was so low on all sequences that thoracic disk herniation had to be inferred from the mass effect on the spinal cord. Precise location of the abnormal level with body coil MR images was achieved in six of 13 patients. PMID- 3659376 TI - Normal and degenerative posterior spinal structures: MR imaging. AB - A retrospective study of the magnetic resonance (MR) images of the lumbar spines of 13 healthy subjects and 30 patients with degenerative changes was done. In the healthy subjects, the vertebral facets, thickness of the cartilage and ligamentum flavum, signal characteristics of the bone marrow, and size of the spinal canal were studied. In the patients with degenerative changes in one of these structures, MR images in the sagittal plane were useful in demonstrating hypertrophy of the ligamentum flavum or the vertebral facets, in grading the degree of foraminal stenosis, and in measuring the sagittal diameter of the spinal cord. MR images in the axial plane facilitated detailed analysis of the facet joint and more accurate measurements of the thickness of the ligamentum flavum and spinal canal diameter. MR images were compared with computed tomography scans in 12 patients. PMID- 3659377 TI - Elbow joint: normal anatomy on MR images. AB - The normal anatomy of the elbow joint in axial, sagittal, and coronal planes was evaluated by comparing 30 magnetic resonance (MR) images of eight healthy volunteers with microtomed cryosections prepared from six cadaver elbows. MR images provided depiction of muscles and tendons, bone marrow, articular cartilage, and neurovascular structures. Cross-referencing of MR images from one plane to another was useful in the evaluation of complicated, obliquely oriented muscle bundles and other soft tissues. PMID- 3659378 TI - Osteoporosis with vertebral compression fractures, retropulsed fragments, and neurologic compromise. AB - Osteoporosis frequently affects the vertebral column and causes compression fractures, biconcave ("fish-mouth") vertebrae, kyphosis, and pain. The cases are reported of three postmenopausal osteoporotic women who had neurologic symptoms of the lower extremities because of vertebral body fractures with a retropulsed fragment narrowing the spinal canal. None of the women had experienced trauma. The fractures resembled burst-type fractures that result from axial loading with major trauma. The retropulsed fragments could be seen best on computed tomographic or magnetic resonance images and were very subtle on conventional radiographs, on which an abnormal posterior vertebral body line was the only abnormality detected. This complication of osteoporosis of the spine is important to recognize so that appropriate treatment can be instituted. PMID- 3659379 TI - Acetabular fractures: optimal imaging. AB - In 19 cases of acetabular fracture, computed tomography (CT) with volumetric three-dimensional (3D) reconstructions displayed as video loops about horizontal and vertical axes of rotation replaced the traditional imaging combination of CT and multiple plain radiographs, while offering significant advantages. Overlying bowel content or foreign matter obscured detail in 36 of 45 plain radiographic views, and positioning or radiographic technique was suboptimal in 21. Three dimensional reconstructions completely eliminated these problems. These 3D reconstructions accurately simulated oblique, inlet, and tangential views in all cases. In ten of 19 cases a nonconventional oblique view, and in 13 of 19 cases a cephalocaudal angulation other than the inlet, tangential, or anteroposterior view, best demonstrated the fracture. Elimination of five plain radiographs resulted in a skin radiation dose savings of 5 rad (50 mGy). No difficult or painful patient positioning was required beyond that necessary for the standard CT examination. PMID- 3659380 TI - Bone marrow diseases of the spine: differentiation with T1 and T2 relaxation times in MR imaging. AB - Forty-two patients underwent magnetic resonance (MR) imaging for a variety of lesions in the vertebral body. A 0.15-T MR system was employed. Twenty-six patients were found to have malignant metastatic lesions (group 1); 16 had nonneoplastic lesions (group 2). The ability to differentiate between the two groups with MR imaging was evaluated. With the longer spin-echo repetition time, the image was variable in both groups. All malignant metastatic lesions appeared as low-intensity areas on T1-weighted images, but 50% of the nonneoplastic lesions also appeared this way. The mean T1 for group 1 was longer than that for group 2, but not significantly so. However, there were significant differences in the ratios of T1 to T2 and of the T1 ratio to the T2 ratio (T1 ratio = T1 for affected vertebrae/T1 for normal vertebrae, T2 ratio = T2 for affected vertebrae/T2 for normal vertebrae). These ratios were therefore useful in distinguishing malignant metastatic from nonneoplastic lesions. PMID- 3659381 TI - Carpal alterations in adult-onset Still disease, juvenile chronic arthritis, and adult-onset rheumatoid arthritis: comparative study. AB - A specific pattern of pericapitate involvement of the wrist has been described in the rheumatologic literature as characteristic of adult-onset Still disease (AOSD), a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the potential diagnostic value of carpal radiography in suspected cases of AOSD, a retrospective blinded analysis of 48 patients (16 each with AOSD, juvenile chronic arthritis, and adult onset rheumatoid arthritis) was performed. Pericapitate articular alterations without radiocarpal involvement were found to be distinctly unusual among patients with rheumatoid arthritis but frequent in the setting of AOSD. In juvenile chronic arthritis severe pericapitate involvement also occurs frequently but is more likely to be associated with interosseous fusion and severe pancompartmental disease. PMID- 3659382 TI - Aneurysmal bone cyst arising in fibrous dysplasia during pregnancy. AB - A case of two secondary aneurysmal bone cysts arising in fibrous dysplasia during pregnancy is reported. Marked radiographic changes were seen in one lesion over a 3-week period. The development of these cysts during pregnancy strongly suggests that the hemodynamic and/or hormonal changes of pregnancy were responsible for their formation. PMID- 3659383 TI - Clinical trial of digital teleradiology in the practice of emergency room radiology. AB - The application of digital teleradiology (DTR) to radiologic examinations performed in the emergency room was evaluated. A total of 919 examinations (ten computed tomographic; the rest, radiographic) were transmitted to a radiology resident at another hospital emergency room. The 512 X 512 images were reviewed by an attending radiologist and compared with another attending radiologist's interpretation of the original films. Cases with discrepant interpretations were analyzed. Inadequate DTR image quality was responsible for clinically significant discrepancies in 14 of 897 cases (1.6%) available for follow up. Problem areas such as the detection of pneumothorax and abdominal calcifications were identified. Retransmission of optically zoomed images of areas of concern and repeat radiographs of overpenetrated films are suggested to improve DTR performance. PMID- 3659384 TI - Cervical cancer: intracavitary dose specification and prescription. AB - Dose and volume specifications for reporting intracavitary therapy were analyzed according to criteria recommended by the International Commission on Radiation Units and Measurements (ICRU). Ninety Fletcher-Suit radium applications were studied to examine the validity of the assumptions of the ICRU and the merit of their routine reporting. It was demonstrated that the reporting recommendations were inconsistent with clinical prescription systems and added little to dose specification. The distinction between dose specification and dose prescription was stressed. PMID- 3659385 TI - Inoperable adenocarcinoma of endometrium: radiation therapy. AB - Between 1960 and 1979, 41 patients with adenocarcinoma of the endometrium who were poor surgical risks were treated with radiation therapy at the University of Iowa. Local tumor control was achieved in 78% of the patients, 5% manifested complications, and 46% survived 5 years ("uncorrected" 5-year survival rate). Intercurrent disease was the major cause of death (54%), and intrauterine recurrence (22%) was the most frequent recurrence. Intraperitoneal spread (12%) occurred as commonly as hematogenous metastases (12%). Three of nine local failures occurred after 5 years. Local control rates correlated well with clinical stage, and the survival rates correlated well with the stage and grade of the tumor. Local tumor control was achieved in 95% of patients who received greater than 7,000 mg-h intracavitary radium, compared with 63% of patients treated with less than 7,000 mg-h. PMID- 3659386 TI - Radiation therapy of periaortic node metastases in cancer of the uterine cervix and endometrium. AB - Thirty-eight women with surgically confirmed periaortic lymph node metastases from cervical or endometrial carcinoma received radiation therapy. The 5-year observed actuarial survival and relapse-free rates were 42% and 41%, respectively. Concomitant peritoneal metastases conferred a bleak prognosis. There were no differences in survival as a function of site of origin, histologic characteristics, or bulk of periaortic metastases. Earlier stage disease tended to have a higher probability of cure. Morbidity was acceptable. The results confirmed the importance of radiation therapy in the management of lymph node metastases in uterine cancer. PMID- 3659387 TI - Blood-flow measurement in muscle with Xe-133. AB - An alternative method to the conventional miniature probe system for the measurement of blood flow in muscle has been developed. Xenon-133 was injected into the quadriceps muscles of ten subjects. A gamma camera and an online computer were then used to measure the half-clearance time of the Xe-133 while the subject was both at rest and exercising on an upright bicycle ergometer. The blood flow in the muscle was then calculated from the acquired data. PMID- 3659388 TI - A new torque guide wire. AB - A new guide wire that provides markedly improved torque control is described. It was compared with a conventional guide wire in two models, one simulating a drainage tube with numerous side holes and one, the biliary tree. The new wire was much more easily controlled than the conventional guide wire and passed through both models significantly faster (P less than .01 and P less than .005). Although some deterioration in control was noted when it was inserted through a catheter in vivo, the new torque-control wire still exhibited a definite improvement over conventional wires in directional control. PMID- 3659389 TI - Surface coil with variable geometry: a new tool for MR imaging of the spine. AB - A switchable-array surface coil for magnetic resonance (MR) imaging of the spine has been built that enables the user to change the working size of the coil depending on the volume of interest. The prototype has achieved similar image quality to that obtained with conventional coils of equal size. This type of antenna may reduce the number of individual coils necessary for a high-quality MR imaging study. PMID- 3659390 TI - Biplane stereoscopic magnification cerebral angiography. AB - An angiographic system capable of simultaneous biplane stereoscopic magnification cerebral angiography was evaluated. Stereoscopic imaging improved the morphologic depiction of aneurysms and of arteriovenous malformations. In a series of 357 patients, procedure time was reduced because the initial biplane stereoscopic series was nearly always diagnostic, obviating the need for additional angiographic views. PMID- 3659392 TI - The double-fissure sign: a motion artifact on thin-section CT scans. AB - A motion artifact has been observed that may affect the number of fine interstitial lines seen at thin-section (1.5-mm-collimation) computed tomography (CT) for the evaluation of interstitial lung disease. In 14 of 42 patients, one or both major fissures appeared as two parallel lines rather than as a single line. This was more common in the left lung base. Using a phantom, the authors were able to reproduce the phenomenon by simulating cardiac motion. Therefore, this motion may lead to an artifactual increase in the number of interstitial lines. PMID- 3659393 TI - Blood clot formation in angiographic syringes containing nonionic contrast media. PMID- 3659391 TI - Superficial peroneal nerve block for leg venography. AB - Insertion of a needle into the dorsum of the foot for lower-extremity venography is painful for many patients, and several attempts at puncture may be necessary. A regional anesthetic technique, superficial peroneal nerve block, has been devised to alleviate this pain. The nerve block is simple to perform, consisting of infiltration of lidocaine just above the ankle. Discomfort from performance of the block was minimal in all 20 cases in which it was performed. The block was effective in eliminating or significantly reducing pain in 17 of the 20. PMID- 3659394 TI - Blood cell aggregates with low-osmolality and nonionic contrast media. PMID- 3659395 TI - Greenfield filter placement with the extra-long sheath technique. PMID- 3659396 TI - Multiphasic examinations of the stomach. PMID- 3659397 TI - 73rd scientific assembly and annual meeting: the Radiological Society of North America. November 29-December 4, 1987, Chicago. Abstracts. PMID- 3659398 TI - IVP reaction and death: "late entry.". PMID- 3659399 TI - Negligent catheterization: hypotonic areflexic bladder. Case in point: Duerden v. Utah Valley Hospital (663 F. Wupp. 871-UT). PMID- 3659401 TI - [Construction and usage of the reference database by relational database management system]. PMID- 3659400 TI - Nurse-anesthetist negligence: vicarious liability. Case in point: Thomas v. Raleigh General Hospital (358 S.E. 2d 222-WV). PMID- 3659402 TI - [Differences in the effect of verapamil on pulmonary circulation in primary pulmonary hypertension]. PMID- 3659403 TI - [Increased urinary excretion of cotinine--the main nicotine metabolite--and increased level of lipid peroxides in the serum of newborn infants exposed in utero to tobacco smoke pollution]. PMID- 3659404 TI - [Changes in left-ventricular systolic and diastolic time intervals in hyperthyroidism]. PMID- 3659405 TI - [Large doses of methotrexate in the treatment of breast cancer resistant to other types of chemotherapy]. PMID- 3659407 TI - [Acid-base imbalance--simple or mixed?]. PMID- 3659406 TI - [Differential diagnosis of thirst changes]. PMID- 3659408 TI - [Effect of environment on the health status of pregnant women]. PMID- 3659409 TI - Bilateral venous infarctions of the thalamus: a case report. AB - This is a mini-report of a case of bilateral nonhemorrhagic venous infarctions of the thalamus, complicated by a dural arteriovenous malformation. PMID- 3659410 TI - CT retrograde pancreatography using an indwelling balloon catheter. AB - We report a new technique for computed tomography (CT) of the pancreas during retrograde injection of contrast material into the pancreatic duct via an in situ balloon catheter placed by duodenoscopy (CT-RP). The method resulted in more stable ductgrams at CT than were obtained with other methods. Our data suggest that CT-RP provides useful information in evaluating pancreatic lesions that produce subtle or insignificant abnormalities of the outline of the pancreas and the ductal system on conventional CT and ERP. PMID- 3659412 TI - Psychiatry and the mental health professionals. New roles for changing times. PMID- 3659411 TI - Scimitar syndrome associated with diaphragmatic herniation of the liver. AB - A rare case of scimitar syndrome associated with diaphragmatic herniation of the liver is reported. The upper lobe blood of this case drained abnormally to the inferior vena cava. Pulmonary angiography and radionuclide scintigraphy were useful in the diagnosis of the abnormal vessels and herniated liver. PMID- 3659413 TI - [Psychiatric consultation and liaison psychiatry]. PMID- 3659414 TI - [Disseminated histoplasmosis. Confirmed cases in the Metropolitan Hospital Complex of the Social Security Agency]. PMID- 3659415 TI - [Surgical emergencies during pregnancy]. PMID- 3659416 TI - [Disseminated mycobacteriosis and nocardiosis in a patient with acquired immunodeficiency syndrome]. PMID- 3659417 TI - [Insecticide residues in the milk of Panamanian mothers]. PMID- 3659418 TI - [Primary carcinoma of the gallbladder in the Metropolitan Hospital Complex of the Social Security Agency]. PMID- 3659419 TI - [Candida albicans endometritis as a cause of reproductive dysfunction. Report of a case]. PMID- 3659420 TI - [Intracranial aneurysms]. PMID- 3659421 TI - [Cryptosporidiosis. Report of a fatal case in an infant malnourished and with right basal pneumonia]. PMID- 3659422 TI - Abstracts. 1987 annual meeting of the Israeli Physiological and Pharmacological Society. PMID- 3659423 TI - [Radiological study of the temporomandibular joint]. PMID- 3659424 TI - [Quantitative computerized tomography of the vertebral spongiosa. Proposal of a method applicable to the study of postmenopausal osteoporosis]. AB - A Quantitative Computed Tomography (QCT) method, simplifying the well-known technique proposed by Genant (1982) and applied to a standard third generation whole body CT scanner is described. This technique was applied in the measurement of the trabecular bone which has high sensitivity for metabolic changes. The BMC (Bone Mineral Content) measured in different groups of subjects (healthy postmenopausal patients versus women with postmenopausal osteoporosis) showed a highly significant difference (p less than 0.001). The precision of repositioning (coefficient of variation 1.8% to 2.3%, obtained in healthy male patients) and the good, linear relationship computed from the phantom values, minimize measurement errors. Since this method is quickly applied and involves low-dose radiation-exposure, it could be introduced in the clinical study of metabolic bone diseases. PMID- 3659425 TI - [Oto-palato-digital syndrome. Clinico-radiological study]. AB - Oto-palato-digital (OPD) or Tyabi syndrome is a familiar, X-linked bone dysplasia with intermediate expression, in females or autosomal dominant with more severe manifestations in males. In the past both the clinical features (flat face with sunken and broad nasal bridge, antimongoloid slant of palpebral fissures, palatoschysis, conductive deafness, short and broad thumbs and big toes, nail dystrophy) and radiological findings (thick and dense base of the skull, prominence of supraorbital ridges, middle ear bone deformities with dense ossicles, large and broad vertebral bodies, posterior defects of neural arches of the vertebrae, carpal and tarsal bone fusions, short and broad nail phalanges) have been well described and established. The present report describes 7 patients (4 females and 3 males) all belonging to the same family (the first described in this country) and all presenting the clinical and radiological features of OPD syndrome. A cranial and spinal CT was performed on one patient, with peculiar findings. PMID- 3659426 TI - [Ambulatory radicular myelography with iopamidol]. AB - The appearance of side effects was monitored in 70 selected patients who underwent radiculography and myelography. After the examination, a rapid return to normal activity was recommended. In accordance with literature, no greater incidence of side effects was found in patients who were allowed to get up soon after myelography or radiculography, than in patients confined to bed for some hours. These results are essentially attributable to the low toxicity of the contrast medium used in this study (Iopamidol), and to an adequate hydratation of the patients after examination. PMID- 3659427 TI - [Role and possibilities of compensation filters in lateral decubitus radiographs in opaque enemas]. AB - A wedge-shaped plexiglass compensation filter for use in lateral decubitus radiographs of double contrast barium enema examinations has been designed. This filter, which has been used since February 1985, was compared with a second plexiglass filter, made by E-Z-EM. Voltage and amperage were kept contrast. Two different experiments were conducted in order to demonstrate the benefits of routine use of this compensation filter. First, the changes in skin dose were assessed using an ionization chamber on a phantom. Secondly, three radiologists examined a series of 80 consecutive barium enemas without knowing which had been performed using the new filter. Out of the 70 examinations they considered excellent, as many as 45 had been performed with the new filter. Personal experience and the studies described show that the use of a compensation filter improves the accuracy and thus the diagnostic quality of the examinations as it enhances the detail of the anatomic structure of the colon; moreover the filter reduces skin exposure by up to 73.1% (EZ-E-EM filter 47.3%) and, at the same time, less radiographic films are needed. Routine use of a plexiglass compensation filter in lateral decubitus radiographs while performing a double contrast barium enema examination, is strongly recommended especially in obese patients. PMID- 3659428 TI - [Usefulness of ultrasound and CT in the diagnosis of complications caused by surgical sponges left in the abdominal cavity]. AB - The identification of surgical sponges left in the abdomen and their complications (gossypiboma) creates difficult diagnostic problems in the absence of radio-opaque markers. The phlogistic septic or aseptic reaction to the presence of a foreign body produces nonspecific symptoms and may vary according to the site of the lesion and its relationship with contiguous viscera. Plain abdomen films and the barium meal give some information (mainly topographic), but are usually insufficient for correct diagnosis. As proved by the three case reports discussed, US images (strongly attenuating mass with intense acoustic shadows in a fluid collection) and especially the CT images (mass containing a striped, spotted and whirlike pattern) may be highly indicative, permitting correct preoperative diagnosis. PMID- 3659429 TI - [Staging of prostatic carcinoma. Accuracy of magnetic resonance]. AB - Twenty-nine prostatic cancer patients were evaluated for staging purpose by Magnetic Resonance (MR). MR findings were correlated with the pathologic examination in 18/29 patients who underwent radical prostatectomy. Four MR staging parameters were evaluated individually: periprostatic fat; periprostatic venous plexus; seminal vesicles and pelvic adenopathy. MR correctly staged 16/18 patients, with one case of overstaging and one case of understaging. The diagnostic accuracy of MR in differentiating intracapsular stage B from extracapsular stage C was 87%, with a sensitivity of 90% and a specificity of 87%. MR and CT results agreed in 4 of the 7 operated patients who were examined with both techniques; in 3 cases there was disagreement, and MR was correct. PMID- 3659430 TI - [Percutaneous transhepatic cholangioscopy with an 8.5 French endoscopic catheter. Technic and preliminary results]. AB - The authors describe their preliminary personal experience in bile duct endoscopy with a very small diameter catheter (8.5 F) much less traumatic than traditional choledochoscope (15 F). The CE can be reutilized after sterilization; an angiographic guide wire up to 0.042" can be introduced in the operating channel. The CE was used in 3 patients with uncertain cholangiographic diagnosis. Instrument introduction is facilitated when simple technical manoeuvres are followed; there were no difficulties in report interpretation. An experienced interventional radiologist and an endoscopist are needed to handle the instrument. Cytologic sample, biopsy and gallstone lithotomy instruments will increase diagnostic and therapeutic possibilities of the system: for this a wider CE use in the immediate future to complete interventional radiology manoeuvres can be expected. PMID- 3659431 TI - [Possibilities of CT typing of liposarcomas]. AB - Twenty-nine cases of liposarcomas were examined by CT; in 60% of them the CT finding was that of an ill defined, often large mass with content uniformly dishomogeneous and CT numbers ranging from -40 to +28 H.U. Diagnosis of liposarcoma is often possible when this finding is recognized in a mass of the thigh or retroperitoneum where these tumors frequently arise. Authors report differential diagnosis between liposarcomas and other lipomatous tumors such as angiomyolipoma of the kidney (when it is large and only attached to the kidney by an inconspicuous pedicle) and intramuscular lipomas (50% of them are located in the thigh). PMID- 3659432 TI - [The search for abdominal foreign bodies in the framework of the campaign against drug smuggling]. PMID- 3659433 TI - [Ectopic pheochromocytoma. Description of a clinical case]. PMID- 3659434 TI - [An "atraumatic" universal needle for single-shot regional anesthesia: clinical results and a 6 year trial in over 30,000 regional anesthesias]. AB - The so-called "atraumatic" needle was developed by modification of two essential features of the Whitacre Spinal needle. The new atraumatic needle tip is universally suitable for all single-shot techniques of regional anesthesia. This is the result of a 6-year test period with 34,950 applications of 24- and 22 Gauge needles in spinal anesthesia, diagnostic lumbar puncture, peridural anesthesia, plexus anesthesia, peripheral nerve blocks with a Teflon-coated version (unipolar electrostimulation), and lumbar sympathetic and celiac plexus blocks. Postspinal headache was observed following 0.02% of punctures for anesthetic or diagnostic purposes. Transient monosymptomatic nerve damage occurred in 1 case after axillary block (0.009%). No permanent neurological sequelae were observed due to vascular, neural, or dural lesions. In comparison, 10 cases of persistent traumatic nerve damage were reported to be caused by conventional needles during the last decade. An analysis of these cases reveals some reasons for underestimating the risk of neurological sequelae after regional anesthesia. The routine clinical use of this type of atraumatic needle revealed no disadvantages with regard to efficacy of nerve blocks or training of anesthetists. Due to the extremely low incidence of postspinal headache, this needle has been used for spinal therapy and diagnostic lumbar punctures in outpatient pain therapy for 2 years. As of this time, the overall risk of outpatient lumbar puncture cannot be estimated. Our experience should encourage further controlled studies to evaluate criteria for excluding those patients unsuited for outpatient spinal anesthesia and lumbar puncture. PMID- 3659435 TI - [Opinion of mothers on continuous peridural obstetrical anesthesia]. AB - The general opinion on epidural anesthesia in obstetrics may be adversely affected by recent public controversies about the mother's situation during childbirth in hospital, which nowadays is often considered to be a highly technological, impersonal, or "unnatural" procedure. This assumption led us to conduct an inquiry on maternal assessment of obstetric epidural anesthesia and its relation to the clinical and social history. The study included 113 parturients, who received epidural anesthesia (on-demand epidural injections of bupivacaine 0.25%) for vaginal delivery. Mothers were asked to answer certain questions about this regimen (e.g. analgetic efficacy; difficulties in deciding on this method; recommendations to other parturients; opinion of the role of epidural anesthesia in obstetrics; choice of analgesic regimen for future childbirth) 1 day after delivery and 2 months later. Additional social and historical factors (e.g. education; profession; family status; preceding pregnancy, childbirth or abortion; complications during pregnancy or childbirth; duration of parturition) were used to reveal relevant statistical correlations. Sixty-five percent of the patients considered pain relief by epidural anesthesia as "good" or even "very good" during the first inquiry immediately after childbirth. Women who had undergone prior interruptions of pregnancy were less satisfied, probably because of their rather ambiguous attitude towards motherhood. With regard to the choice of analgesic regimen for future childbirth (50% of the patients had made a definite decision to have epidural anesthesia under this condition), those women were especially reserved who had suffered from complications during pregnancy and disapproved of it in the future.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659436 TI - [Comparative study of circulatory and ECG-changes after supraclavicular plexus block with bupivacaine-HCl 0.5 per cent in patients with chronic kidney failure]. AB - The systemic effects of local anesthetic drugs, especially bupivacaine, on myocardial conduction and the increase of cardiotoxicity by hypoxemia, acidosis, and hyperkalemia has been proven in numerous animal experiments. In our department, supraclavicular brachial block with bupivacaine is the method of choice for patients with chronic renal failure requiring operations of the upper limb. The question may be raised whether or not these patients with their concomitant disease--electrolyte and acid-base imbalances, uremic cardiomyopathy- are especially endangered by the use of this drug. Supraclavicular brachial blockade (3 mg/kg bupivacaine 0.5% + 0.1 IU vasopressin/ml) was performed in 10 patients with chronic renal failure requiring hemodialysis. The control group consisted of 10 healthy patients who were admitted for minor hand surgery. Preoperative blood samples were taken for measurements of blood urea nitrogen, serum creatinine, serum electrolytes, and arterial blood gas analysis. Long-term ECG monitoring begun 20 min before injection of the block and continued over a total of 200 min. Serum concentrations of bupivacaine were determined at 10, 20, 30, 60, 120, and 180 min after injection. Comparing the two groups, no severe changes in electrolytes or acid-base status could be found despite some statistical significances. Even though bupivacaine serum concentrations proved to be 3 times higher in the study group than in the control group, no changes in cardiac conduction could be registered. We conclude that bupivacaine is as safe in dialyzed patients with chronic renal failure with regard to possible changes in circulatory parameters and myocardial conduction as in healthy patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659437 TI - [Treatment of frostbite of the extremities by combined axillary plexus and peridural anesthesia: a case report including blood levels of bupivacaine]. AB - To enhance peripheral perfusion after local frostbite, temporary or definitive interruption of the sympathetic activity in the region of injury is useful as an adjunct to systemic treatment. The common catheter techniques of axillary or epidural block provide the advantage of continued sympathicolysis without the risks of serial punctures or irreversible surgical alterations of the autonomic nervous system. bupivacaine into the three catheters (Fig. 2). A very satisfactory clinical result was observed. There was no loss of fingers PMID- 3659438 TI - [Effectiveness of sympathetic block using various technics]. AB - Blocking of sympathetic conduction aims at permanent or temporary elimination of those pain pathways conducted by the sympathetic nervous system. In order to provide an objective evaluation of sufficient blocking effect, earlier inquiries referred to parameters such as: (1) observation of clinical signs such as Horner's syndrome, Guttman's sign, anhidrosis, extended venous filling; (2) difference in skin temperature of at least 1.5 degrees C between blocked and unblocked side; (3) increase in amplitude of the pulse wave; and (4) depression of the psychogalvanic reflex (PGR) on the blocked side (Fig. 1). In clinical practice, these control parameters are effective because they are time-saving, technically simple, and highly evidential. Further parameters for evaluating sympathetic blockade are examination of hydrosis by means of color indicators such as bromocresol and ninhydrin, oscillometry, and plethysmography. The effectiveness of sympathetic blockade after stellate ganglion and sympathetic trunk blocks has been verified by various authors. In a clinical study, 16 patients were divided into four groups in order to test the effectiveness of sympathetic blockade after spinal anesthesia with 3 ml 0.75% bupivacaine (group I) and 4 ml 0.75% bupivacaine (group II) and after peridural anesthesia with 15 ml 0.75% bupivacaine (group III) and 20 ml 0.75% bupivacaine (group IV) by means of temperature difference, response of pulse wave amplitude and PGR between blocked lower and unblocked upper extremity, and sensory levels of block. The patients were classified as ASA I and II; their ages varied from 20 to 63 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659439 TI - The effectiveness of three sets of school-based instructional materials and community training on the acquisition and generalization of community laundry skills by students with severe handicaps. AB - This study examined the effectiveness of three sets of school-based instructional materials and community training on acquisition and generalization of a community laundry skill by nine students with severe handicaps. School-based instruction involved artificial materials (pictures), simulated materials (cardboard replica of a community washing machine), and natural materials (modified home model washing machine). Generalization assessments were conducted at two different community laundromats, on two machines represented fully by the school-based instructional materials and two machines not represented fully by these materials. After three phases of school-based instruction, the students were provided ten community training trials in one laundromat setting and a final assessment was conducted in both the trained and untrained community settings. A multiple probe design across students was used to evaluate the effectiveness of the three types of school instruction and community training. After systematic training, most of the students increased their laundry performance with all three sets of school-based materials; however, generalization of these acquired skills was limited in the two community settings. Direct training in one of the community settings resulted in more efficient acquisition of the laundry skills and enhanced generalization to the untrained laundromat setting for most of the students. Results of this study are discussed in regard to the issue of school versus community-based instruction and recommendations are made for future research in this area. PMID- 3659440 TI - Oddity performance in preschool children at risk for mental retardation: transfer and maintenance. AB - The oddity performance of five preschool children at risk for mental retardation was facilitated by increasing the number of nonodd elements in a visual array. A combination intrasubject reversal and multiple baseline across subjects design indicated the internal validity of interventions designed to enhance the perceptual salience and consequent stimulus control of the odd stimulus. Results demonstrate that transfer and maintenance of oddity learning can be obtained even with individuals for whom correct oddity responding is uncommon. The typically poor performance of young and developmentally delayed children as compared to nondelayed children on tasks such as the oddity task may be attributable to a lower sensitivity to relational information. PMID- 3659441 TI - Automated contingent reinforcement of correct posture. AB - This study evaluated the effectiveness of a mercury switch as a self-monitoring device to improve the sitting posture of an adult male. The participant in this study was a 31 year old man who was blind, nonambulatory, and who had been classified in the moderate range of intellectual functioning and in the severe range of adaptive functioning due to physical impairments. After determining that music practice and listening to a game show on the television channel of a radio were powerful reinforcers, a multiple baseline across the two reinforcing activities was implemented. The participant wore a mercury switch inside of a baseball cap which activated a Casio keyboard during music practice and a radio during the independent leisure activity of listening to a game show. During the treatment condition, the keyboard and radio were activated automatically by upright sitting posture. Results indicated that the participant's sitting posture increased from an average of almost 0% correct upright posture during baseline to an average of 52% during treatment. PMID- 3659442 TI - Leadership training in UAFs supported by the Division of Maternal and Child Health. AB - University Affiliated Facilities (UAFs) were established to promote improved care for mentally retarded and handicapped children and their families. Specifically, they are charged with the interdisciplinary training of professionals who provide leadership within their respective disciplines and, thus, impact a greater service delivery system. A definition of leadership training and two potential models for implementation within the UAF system are developed. Data available for FY 1983-1984 indicate the UAFs funded by the Division of Maternal and Child Health (DMCH) trained 3,450 graduate or post-graduate students. Preliminary estimates indicate that approximately 25% of long-term UAF trainees eventually fill positions of leadership within the service delivery system. More systematic assessment of the impact of UAF training is suggested. PMID- 3659444 TI - Self-recruited feedback: a cost-effective procedure for maintaining behavior. AB - The maintenance of learned behavior is a problem faced frequently by teachers of persons with severe disabilities. The present study examines the use of a self management procedure to improve and maintain work performance of young adults with severe disabilities in integrated job settings. Students were taught to self monitor work rate on job tasks, evaluate daily performance against a criterion, and recruit contingent feedback from supervisors. A multiple baseline design across subjects, and two within series reversals, indicate a functional relationship between self-recruited feedback and maintenance of improved work rate. Self-monitoring of work rate alone was not a consistently effective maintenance strategy. Results are discussed in terms of the need for a comprehensive technology of maintenance that requires a low response cost to apply over long periods of time. PMID- 3659443 TI - Teaching interactive signing in a dialogue situation to mentally retarded individuals. AB - Verbal prompts, modeling, physical guidance, positive reinforcement, fading, and chaining procedures were used to teach two nonverbal individuals, one severely and one moderately mentally retarded, an interactive signing dialogue in a naturalistic snack time setting. Both were required to initiate signed communication and to respond to signed communication with either action or manual signing. Using a multiple probe design across three dialogue situations, each client was successively taught his role in each dialogue with a staff member serving as his partner. After both trainees had mastered a dialogue role, signing competency was formally probed as they interacted with their staff partner in a maintenance situation and with the other trainee in a generalization situation. Results showed that clients could learn to use signed communication in each dialogue situation but that extensive training was required. Data also indicated that only partial generalization to the client-client situation occurred. PMID- 3659445 TI - [Clinical and experimental study of sealed surface arthroplasty of the hip after a minimum 5-year follow-up. Abstracts]. PMID- 3659446 TI - [Puncture and lavage after total hip arthroplasty]. AB - A hip arthroplasty which becomes painful without signs of loosening merits joint irrigation. Particulate debris of polyethylene, polyester, cement or contrast material may be responsible for inflammatory changes. Their removal by irrigation has led to lasting relief of pain in 24 out of 44 non-septic painful hips. Before it becomes loose, an infected arthroplasty can be treated successfully by repeated irrigation. In 10 out of 42 patients, the infection seemed to be controlled. The simplicity of this procedure recommends its application in an unexplained painful hip arthroplasty. PMID- 3659447 TI - [Septic arthritis of a posterior vertebral inter-apaphysial articulation. Apropos of a case]. AB - A report of a case of haematogenous infection of a lumbar zygapophysial joint. In spite of radiographic and bone scan findings that localised the lesion, the diagnosis was not made until an operative exploration was made, which also effected a cure. This is an unusual site for sepsis and the clinical picture can easily lead to confusion with spondylosis which is much more common. PMID- 3659448 TI - [Preoperative embolization of bone and muscle tumors excluding spinal lesions]. AB - The authors report 25 cases of pre-operative embolisation of tumours of bone or muscle. The aim of this technique is to improve surgical safety by diminishing hemorrhage at operation and to preserve vessels in the region of the tumour especially if secondary intra-arterial chemotherapy is required. PMID- 3659449 TI - [Corrections of limb deformities in children with Wagner's external fixator]. AB - The authors describe a method of correction of limb deformities whilst allowing the length of the limb segment to be maintained. The apparatus used was the Wagner external fixator which first allows distraction at the site of an osteotomy followed by correction of angulation with suppression of this temporary lengthening. PMID- 3659450 TI - [The articular cartilage of the patella in scanning electron microscopy]. AB - The authors have studied 50 samples of patellar cartilage, normal and pathological, obtained by biopsy, using a scanning electron-microscope. The normal cartilage shows characteristic regular wave-like undulations. The size of these waves varied between 5,000 and 7,000 nm and the undulations were linked by regularly-spaced fibrillary bridges. In a case with an osteochondral fracture, the fracture site was covered by peripheral cartilage, as had previously been shown by Ghadially. Eighteen cases of patellar chondropathy were divisible into three groups: group I (four cases) showed fibrillary chondropathy, of cerebriform appearance and without fibres. Group II (12 cases) showed a fibrillary chondropathy with loss of geometrical regularity and a staghorn appearance. Group III (two cases) showed an oedematous chondropathy with destruction of fibres. In group II, the presence of bundles of fibres with microfractures indicates a potential for progress to frank arthrosis. PMID- 3659451 TI - [The role of peripheral capsulo-ligamentoplasties in the treatment of chronic anterior instability of the knee. Apropos of a series of 104 cases]. AB - The authors have studied the results of 91 extra-articular ligamentoplasties amongst 104 knees treated surgically for chronic anterior laxity of the knee. The technique used in 40 cases was a Lemaire isolated lateral extra-articular ligamentoplasty using a strip of fascia lata and in 51 cases a double plasty, combining the same lateral plasty with a tightening of the posteromedial capsule and a forward transfer of the semimembranosus. The follow-up was from one to seven years, with a mean of four years. The results were assessed using the "ARPEGE" (Research Association for the Study of the Knee) scoring system, based on ability to undertake sports, functional stability, pain, resistance to fatigue, mobility and residual laxity. The overall results were excellent in 51 per cent, good in 10 per cent, fair in 10.5 per cent and bad in 28.5 per cent of cases. These results may seem to be unsatisfactory but a detailed study of the failures showed some errors in the indications for surgery which could have been avoided by a full appreciation of the type of laxity, the post-operative needs of the patient, his age and the level of sporting activity. Meniscectomy and lesions of the articular cartilage had a disturbing effect on the results. This study indicates a more precise place for extra-articular ligamentoplasties compared with in situ reconstructions of the anterior cruciate ligament. PMID- 3659452 TI - [Aneurysmal bone cysts in children. Study of 28 cases]. AB - Twenty-eight aneurysmal bone cysts in children aged between 3 and 16 years, with a mean follow-up of five years, have been reviewed. The diagnosis in these uncommon lesions was straightforward in 22 cases, based on the clinical, radiological and macroscopic features. The histological characteristics confirmed the diagnosis. Apart from these typical lesions, there were some cases in which the diagnosis remained doubtful in spite of a review of the sections and a re assessment of the radiological and clinical findings. For the surgeon, the diagnosis is primarily from a unicameral bone cyst, whose treatment is very different. For the pathologist, the diagnostic problem is not so much from benign dystrophies, which are often difficult to distinguish from them, but from rare lesions in children, such as telangiectatic sarcoma, which have a more serious prognosis. The high recurrence rate, in four cases out of eleven, after curettage led to a preference for more radical treatment whenever possible, such as excision or resection, which was performed in 14 cases and which limited the liability to recurrence. Aneurysmal bone cyst is a benign tumour whose severity depends on its site, especially in the spine, where there is a risk of neurological complications, on its size, which may render surgical removal difficult and on its proximity to the growth plate, which may result in disturbance to growth which not infrequently occurs. PMID- 3659453 TI - [Treatment of spinal deformities with the Hartshill frame]. AB - The Hartshill rectangle, a metal frame fixed to the laminae by sublaminar wires, has been used in 50 cases. Twenty idiopathic adolescent scolioses have been corrected from 49.3 degrees to 24.7 degrees with excellent stability of the curve at six and twelve months follow-up. Twelve paralytic scolioses were corrected from 71 degrees to 34.7 degrees but, in nine cases, the associated pelvic obliquity was not appreciably altered. Eleven adult scolioses, with an age range between 20 and 68 years, were corrected from 66.3 degrees to 38.7 degrees by a two-stage procedure of anterior release followed by posterior fixation with a Hartshill frame. In six patients with spinal metastases the Hartshill frame was used to provide spinal stability. The segmental fixation gave immediate post operative comfort and allowed the patient to mobilise early without bracing. There were transient neurological complications--three cases of cutaneous hyperaesthesiae and one of monoparesis of a lower limb. Failure of the apparatus was encountered in cases of severe deformity with bending of the metal of the rectangle in two cases, breakage of distal wires in three cases and slipping of wires on the frame in two cases. The Hartshill frame provides stable fixation of the spine. It produces a three-dimensional correction of the scoliosis with preservation of reformation of the normal physiological kyphosis and lordosis. It is indicated for the correction of sagittal deformities, particularly in older patients and adults with thoracolumbar or lumbar curves and for spinal instability, especially in cases of destruction of posterior bony and ligamentous elements of the spine. PMID- 3659454 TI - [Long-term results of the treatment of fractures of the patella]. AB - A series of 400 patellar fractures has been reviewed with a follow-up of three to 12 years. The continuity of the extensor apparatus had been interrupted in 73 per cent of cases and in 21 per cent the fracture was compound. The best results were obtained by conservative treatment with plaster, patellar suture or partial patellectomy. Total patellectomy, in contrast, only gave satisfactory results in one case out of two. PMID- 3659455 TI - [Chiari's osteotomy in the adult. Apropos of 70 cases]. AB - Seventy Chiari osteotomies have been performed between 1975 and 1986. Fifty-three cases have been reviewed with a follow-up greater than a year and with a mean of four years and eight months. In half of the cases, the operation was done for very dysplastic hips, usually at an advanced stage of osteoarthritis (stage two in 37.5 per cent and stage three in 25 per cent). Post-operative complications were very rare except for two cases of non-union. The functional results were very satisfactory, with 83 per cent of very good and good results, especially in respect of relief of pain which was remarkable. These results were sustained in the long-term follow-up; 21 hips had a follow-up of 5 to 11 years, with a mean of 6.8 years. Only two hips needed a total hip arthroplasty. Radiologically, the osteotomy produced normal antero-posterior and lateral hip measurements in almost all the cases, largely due to a considerable medial displacement of more than 20 mm in 87 per cent of cases. There was improvement in the osteoarthritic changes in 74 per cent of cases. The factors which affected the outcome favourably were the degree of dysplasia, a round femoral head and a technically correct operation, with bone division close to the femoral head and a sufficiently upward slope to the osteotomy. An advanced osteoarthritis is not a contra-indication if it is due to a very marked acetabular dysplasia. PMID- 3659456 TI - [Treatment of fractures of the clavicle by closed pinning inside-out without back and-forth]. AB - Pinning of fractures of the clavicle is easily and safely done by introducing the pin through the medial fragment. The pointed tip is embedded into the cortex of the lateral fragment and the inner end of the pin is bent at a right angle to fix it to the bone. Insertion is made with image intensification to avoid vascular damage and to guide the passage of the pin through the medial fragment without danger. Of 25 fractures treated in this way, only two, treated at the beginning of the series, required open reduction. No other immobilisation was necessary. All the fractures united uneventfully. PMID- 3659457 TI - [Total hip and knee arthroplasties in hemophilia. Apropos of 27 cases]. AB - Thirteen total hip and 14 total knee prostheses were performed in 21 haemophilic patients. Nineteen had severe factor deficiency. Their average age was 43 years. Pain was the only indication for hip prostheses. All the hip arthropathies were of Arnold stage IV or V. For the knees, the indication was permanent pain with patello-femoral involvement in nine cases. In other cases, stiffness and instability was the indication. Seven knees, one out of two, had a flexion deformity of more than 30 degrees and only in four knees, one in three, was the range of flexion greater than 90 degrees. The quadriceps was extremely atrophied in eight knees and was always fibrotic. The arthropathies were of stage IV in three cases and stage V in eleven cases. There was pre-operative valgus deformity, greater than 20 degrees in three cases. At the hip, all 13 total prostheses were cemented. The 11 patients had factor replacement for an average of 21 days. No inhibitor was present pre-operatively or developed after operation. Early complications were rare: two moderate hematomata of the hip and one haematoma of the homolateral psoas. The late complications were not unusual: two aseptic bipolar loosenings after eight and nine years. At long-term follow up, with a mean of four years and one month, 77 per cent of the hips were painless and stable with a good range of movement. Eight per cent were painless and stable but had some limitation of flexion. Fifteen per cent were failures. At the knee, a Guepar I knee was inserted in four cases, a Total Condylar knee in eight cases and a Kali knee in two cases. All the patients had factor replacement for 24 days. No post-operative inhibitor developed. The early complications were three superficial skin necroses, four deep hematomata and one transient common peroneal nerve palsy. The late complications were one permanent dislocation of the patella and one bipolar septic loosening with septic pyaemia which needed an arthrodesis and required 79,290 International Units of factor VIII, 72 units of packed cells and 28 bottles of fresh plasma. After a mean follow-up of two years and five months, five knee prostheses had a very good results, four a fair result and five a bad result. PMID- 3659458 TI - [Accidents caused by arteritis after fracture or tibial osteotomy]. AB - In five cases of fracture or osteotomy of the tibia complicated by delayed union, non-union or infection, a latent chronic vascular insufficiency was belatedly discovered, often after failure of local treatment. It was responsible for the complication, since, in all the cases, the restoration of arterial patency resulted in healing. A study of the arterial circulation should be made, especially in smokers, when there is delay in union. PMID- 3659459 TI - [Tuberculosis and parenteral drug addiction]. PMID- 3659460 TI - [Arterial pressure in childhood. The Torrejon de Ardoz study (Madrid)]. PMID- 3659461 TI - [Hypereosinophilia: present-day status and our experience with CFU-GM cultures and cytogenetics]. PMID- 3659462 TI - [Patients with transitional cell carcinoma of the bladder. Future perspectives]. PMID- 3659463 TI - [Plasma zinc levels, nutritional status and immune response in chronic renal insufficiency]. PMID- 3659464 TI - [Familial and sporadic Gilbert syndrome]. PMID- 3659465 TI - [Hematogenous pyomyositis caused by Staphylococcus aureus]. PMID- 3659466 TI - [Hepatitis B markers, in a study to detect sexually transmitted diseases, in the Central Provincial Penitentiary of Murcia]. PMID- 3659467 TI - [Thoracic mass in a child]. PMID- 3659468 TI - [Emergency medicine: a topic for debate]. PMID- 3659469 TI - [Acute psychiatric symptoms and multiple sclerosis]. PMID- 3659470 TI - [Tuberculous meningitis and normal glucose in the CSF]. PMID- 3659471 TI - [Medical treatment of splenic abscess. Apropos of a case]. PMID- 3659472 TI - [Sarcoidosis and hemochromatosis]. PMID- 3659473 TI - [Blepharoptosis and systemic lupus erythematosus]. PMID- 3659474 TI - [Hyporeninemic hypoaldosteronism: an ever more frequent cause of hyperpotassemia]. PMID- 3659476 TI - Clinical and epidemiological features of peste des petits ruminants in Sokoto Red goats. PMID- 3659475 TI - [Meningitis caused by pyogenic bacteria and bacteremia. Prospective study over a 12-month period]. PMID- 3659477 TI - Concurrent outbreaks of visceral gout and lymphoid leucosis in domestic fowls in Nigeria. PMID- 3659478 TI - [Epizootiology and incidence of cattle dermatophilosis in Madagascar]. PMID- 3659479 TI - Immune response to contagious bovine pleuropneumonia vaccine in dermatophilosis infected animals. PMID- 3659480 TI - [Incidence of bovine trypanosomiasis on the ranch at Madina-Diassa (Mali). Curative treatment of ill animals]. PMID- 3659481 TI - [Trypanosomiasis of dwarf Djallonke sheep and goats in southern Guinea areas in Togo]. PMID- 3659482 TI - Studies on the role of complement in the in vitro invasion of bovine erythrocytes by Babesia bovis. PMID- 3659483 TI - [Survival of larvae of Protostrongylidae in feces and directed infection of mollusks in Rabat (Morocco)]. PMID- 3659484 TI - [Results of experimentation with ivermectin (Ivomec) on parasites of camels in Niger]. PMID- 3659485 TI - [On the comparison of the molluscicidal properties of Ambrosia maritima (Egypt) and Ambrosia senegalensis (Senegal)]. PMID- 3659486 TI - [Attractive power of the odor of hosts for Glossina tachinoides in the Sudan Guinea zone (Burkina Faso)]. PMID- 3659487 TI - Sheep demodecosis (Demodex ovis Railliet, 1895) in Israel. PMID- 3659488 TI - [Seasonal dynamics of tick infestations (Ixodoidea) in cattle in the high plateaus of western Cameroon. Study of 3 sites around Bamenda over the period of a year]. PMID- 3659489 TI - Exclusion in Nigeria of chickens and guinea-fowls from the host range of Menacanthus stramineus (Mallophaga: Insecta). PMID- 3659490 TI - [Ticks and hemoparasitoses of livestock in Senegal. I. The Niayes region]. PMID- 3659491 TI - [Preliminary study of common blood parameters of the Mauritanian dromedary (Camelus dromedarius)]. PMID- 3659492 TI - [Hematological standards of the Gudali zebu in the high planes northwest Cameroon]. PMID- 3659493 TI - Interrelationships between thirteen parameters of blood in apparently healthy buffalo-calves (Pakistan). PMID- 3659494 TI - [Compensatory growth of zebus in Burkina. Comparative analysis under various degrees of malnutrition]. PMID- 3659495 TI - [Mineral composition of forage eaten by ruminants of the Sahelian zone]. PMID- 3659496 TI - [Mineral composition of forage of the subregion of Ituri (Zaire) and a proposal for mineral supplementation for cattle]. PMID- 3659497 TI - [Kapsiki: a breed of cow from the far north of Cameroon. I. Introduction and barymetry]. PMID- 3659498 TI - [Water behavior of 2 fodder plants cultivated in Senegal (Andropogon gayanus and Brachiaria brizantha) as a function of the constraints exerted by the environment]. PMID- 3659499 TI - [New analgesics (I). Nefopam as a postoperative analgesic: our experience]. PMID- 3659500 TI - [New analgesics (II). Buprenorphine as a postoperative analgesic: our experience]. PMID- 3659501 TI - [Chronic intrathecal administration of morphine for cancer pain]. PMID- 3659502 TI - [Pharmacological prevention of myoclonias during anesthesia induction with etomidate. Comparative study of fentanyl, flunitrazepam and pancuronium]. PMID- 3659503 TI - [Comparative study of epidural morphine and subcutaneous morphine in the treatment of post-thoracotomy pain]. PMID- 3659504 TI - [Respiratory depression in the newborn due to a congenital anomaly in plasma cholinesterase]. PMID- 3659505 TI - [The Tubolock safety connector: a critical view based on our experience]. PMID- 3659506 TI - [Osteogenesis imperfecta. Anesthetic considerations]. PMID- 3659507 TI - [Ectopic pheochromocytoma of the bladder]. PMID- 3659508 TI - [Detection of catheterization of an extradural vein]. PMID- 3659509 TI - [Endotracheal tubes once more]. PMID- 3659510 TI - [Percutaneous block of the celiac plexus by anterior approach]. PMID- 3659511 TI - [Selective prolonged anesthesia in the lower limb as a complication of "3 in 1" block of the crural nerve]. PMID- 3659512 TI - [Intraoperative anaphylactic shock in a case of hydatid cyst]. PMID- 3659513 TI - [Arterio-jugular difference in colloid osmotic pressure]. PMID- 3659514 TI - [Unstable angina at the crossroads]. PMID- 3659516 TI - [Acute and severe prosthesis disfunction]. PMID- 3659515 TI - [Evaluation of the diagnostic criteria in peroperative myocardial infarct in coronary surgery. Prospective study]. PMID- 3659517 TI - [Comparison of the anti-angina effect of the calcium antagonists diltiazem, nifedipine and verapamil with each other and with propranolol]. PMID- 3659518 TI - [Coronary surgery in patients over 70 years of age (experience with 40 cases)]. PMID- 3659519 TI - [Acute electrophysiologic effects of propafenone in patients with accessory pathways]. PMID- 3659520 TI - [Time changes in the QT interval in patients with fixed-frequency ventricular pacemakers]. PMID- 3659521 TI - [Changes in segmental perfusion and contractility in severe aortic valvulopathy with normal coronary vessels. Isotopic study]. PMID- 3659522 TI - [Usefulness of monitoring the pulmonary artery in the postoperative period in congenital cardiopathies]. PMID- 3659523 TI - [Male pseudohermaphroditism associated with post-ductal aortic coarctation, aneurysm of the ascending aorta and calcified pseudoaneurysm compressing the right cavities]. PMID- 3659524 TI - [Gonococcal endocarditis]. PMID- 3659525 TI - [Pneumopericardium and cardiac tamponade: a frequent association]. PMID- 3659526 TI - [Late sick sinus syndrome after surgery of an auricular myxoma. Apropos of a case]. PMID- 3659527 TI - [Adenocarcinoma of the pancreas. Cytologic bases of the diagnosis]. PMID- 3659528 TI - [Acute hepatitis caused by hepatitis B virus and hepatitis delta virus. Diagnosis and epidemiology. Clinical course]. PMID- 3659529 TI - [Treatment of hepatic encephalopathy with oral branched-chain amino acids: I. Acute hepatic encephalopathy]. PMID- 3659530 TI - [Recurrence in hepatic hydatidosis. Presentation of our cases]. PMID- 3659531 TI - [Foreign bodies in the digestive tract caused by voluntary ingestion. Study of 73 prisoners]. PMID- 3659533 TI - [Tumors of the smooth muscles of the small intestine: 10 cases]. PMID- 3659532 TI - [Natural history of gastric cancer]. PMID- 3659534 TI - [Image diagnosis and other advances in gastroenterologic diagnostic technics]. PMID- 3659535 TI - [Hypertransaminasemia, the first step toward active chronic hepatitis, or obsessive neurosis?]. PMID- 3659536 TI - [Bouverets syndrome: contribution of a new case and review of the literature]. PMID- 3659537 TI - [Emergency surgery: peritonitis caused by schwannosarcoma of the duodenojejunal angle]. PMID- 3659538 TI - [Pneumoperitoneum caused by mechanical ventilation. Apropos of a case]. PMID- 3659539 TI - [Heterotopia of the gastric mucosa in the duodenum]. PMID- 3659540 TI - [Hemorrhagic rectocolitis secondary to hypovolemic shock caused by percutaneous hepatic biopsy]. PMID- 3659541 TI - [Homologous radioimmunoanalysis of serum L-thyroxine and triiodo-L-thyronine in rats with hypo- and hyperthyroidism]. AB - Total L-thyroxine and triiodo-L-thyronine serum concentrations have been measured in 70-day-old male rats under normal conditions (controls) and in rats subjected to several experimental alterations of the thyroid function: hyperthyroidism, hypothyroidism and substitutive treatments. Since some problems appear when standard curves are performed with hormone serum, as consequence of differences in the affinity and inhibitory effects between heterologous proteins at the antigen-antibody reaction, RIA in this work has been carried out with standard curves performed with rat serum maintaining similar protein concentrations in standard and problems. This modification avoids errors by the use of extraction methods and shows a high degree of similarity between standard and problems. PMID- 3659542 TI - Ketose induced respiratory inhibition in isolated hepatocytes. AB - The addition of 10 mM fructose or 10 mM tagatose to a suspension of hepatocytes caused respiratory inhibition, whereas no change in oxygen uptake was observed following the addition of glucose. However, incubations in the presence of fructose showed a high, aerobic glycolytic activity. Tagatose is phosphorylated to tagatose 1-phosphate but is not further metabolized by cell free liver extract. Moreover, the addition of fructose to glucagon treated cells also caused the Crabtree-like effect. The concentration of adenine nucleotides and inorganic phosphate (Pi) in the mitochondrial and cytosolic compartments during incubation (time 30 min) was determined by the digitonin fractionation procedure. In the presence of 10 mM fructose or tagatose, the total adenine nucleotide pools decreased by 40%; however, glucose produced no change. The addition of ketoses diminished the asymmetric distribution of extramitochondrial (ATP/ADP)e ratio and intramitochondrial (ATP/ADP)i ratio. At the same time the total mitochondrial Pi fell from 17 mM to 6-7 mM. The mitochondrial membrane potential (-161 mV) in the presence of fructose showed no changes during the 30 min experimental period. An increase in the NADH/NAD+ ratio was observed. These results suggest that in hepatocytes the inhibition of respiration is not necessarily linked with the enhanced aerobic glycolysis, by competition for common substrates. PMID- 3659543 TI - Increased plasma volume in two models of portal hypertension in the rat: cirrhosis of the liver and partial portal vein ligation. AB - Portal hypertension has been studied in the rat to see if it is associated to altered blood volume composition, as it has been shown in other species. Plasma volume was measured by isotope dilution using 99mTc labelled albumin in three groups of male Sprague-Dawley rats: normal rats (controls), partially ligated portal vein rats and rats with Cl4C induced cirrhosis. Plasma volume was significantly higher in rats with portal hypertension due to partially ligated portal vein and cirrhosis than in control animals. Similarly, the calculated blood volume was also significantly higher in the portal hypertensive animals than in control group. Portal hypertension in the rat, therefore, has been demonstrated to be associated to a marked hypervolemia and this finding should be taken into consideration in haemodynamic and pharmacokinetic studies in portal hypertensive rat models. PMID- 3659544 TI - Commissural component of the stria terminalis: electrophysiological properties. AB - The commissural component of the stria terminalis (S. T.) was studied in Equi Thesin (92.7 mg/kg) anesthetized rats after their exposure in the caudothalamic surface of both hemispheres. Two types of connection between right and left S. T. across the anterior commissure are described: A "direct" connection set up by fibres that run through the S. T. and join the contralateral S. T., and another "indirect" component, formed by cell axons that receive excitatory synaptic contacts from fibres running in the S. T. PMID- 3659545 TI - Vagal influence on the adrenocortical function of the rat. AB - The vagal influence on the fasciculata's function was studied in 23 Wistar male rats. The corticoadrenal function was evaluated by means of karyometric and histological studies. After vagotomy, the fasciculata of the left adrenal (operated side) showed a significant increase of the nuclear area in comparison with the right (control) side. This side difference was maintained in the stressed rats. In these animals the nuclear area did not increase significantly in either of the two adrenals. These results lead to the following conclusions: the vagus nerve, in normal conditions, has an inhibitory influence on the adrenal cortex; the vagal participation in the corticoadrenal response to a neurogenic stressor is meagre; the inhibitory vagal action on the fasciculata must be direct since the corticoadrenal modifications were unilateral, whereas, if the vagal influence were exerted through the hypophysis, the adrenal reaction should be bilateral; and, finally, the participation of the vagus nerve in the adrenal vascular disorders, which appeared in the stressed rats, seems to be insignificant since both glands, vagotomized and non vagotomized, showed a similar appearance. PMID- 3659546 TI - [Proliferation kinetics of MCF-7 cell cultures. I. Relative influence of estrogens and antiestrogens on the growth of the cell population]. AB - The cellular hormone dependent cell line MCF-7 is a tumoral model of mammary cancer the growth kinetics of which operating under the influence of varied and opposed hormonal factors (estrogens and antiestrogens at precise concentration levels) has provided the means of knowing the action mechanisms of such agents. In this study, carried out with cultured MCF-7 cells under well defined experimental conditions, it has been shown that: 1) antiestrogens (OH-TAM) seem to be opposed to the growing process of the cellular population the elements of which, under the influence of OH-TAM, double the value of the parameter TD (Doubling Time); 2) estrogens (17-beta-E2) cancel out this effect and promote the growth of MCF-7 cells whether OH-TAM is previously or simultaneously added to the culture medium; 3) the observation of this estrogenic action needs accurate experimental conditions without which the effect may not be seen. PMID- 3659547 TI - [Proliferation kinetics of MCF-7 cell cultures. II. Synchronization and cell recruitment induced by hormones]. AB - The culture of MCF-7 cells in well known experimental conditions and the analysis of the cellular uptake of 3HTdR under the influence of estrogens (17-beta-E2) and antiestrogens (OH-TAM) at precise concentration levels (10(-6)/10(-9) M) have made possible the study of the growing kinetic process of the cellular cultured population and the determination of the action of such hormonal preparations on the same process. The main findings are as follows: the growing rate of the cultured cells appears to slow down in presence of OH-TAM; the reason for this slowing growth seems to be the "blockade" of the cultured cells in the last part of G1 phase, a phenomenon that has proved to be dose-dependent; by the stimulating effect of the 17-beta-E2, the MCF-7 cells, synchronized in G1, progress simultaneously in their vital cycle during, at least, three divisory cycles; and this "recruitment" effect seems to be characteristic of the estrogen since the synchronization process fades or disappears when the 17-beta-E2 is absent from the culture medium. PMID- 3659548 TI - Embryotoxic effects of sodium metavanadate administered to rats during organogenesis. AB - Pregnant Sprague-Dawley rats were given orally a daily dose of 0, 5, 10 or 20 mg NaVO3/kg from the sixth through the fourteenth day of pregnancy. Fetal examinations were performed on day 20 of gestation. Sodium metavanadate was neither embryolethal nor teratogenic in rats when administered orally at 20 mg/kg/day or lower. Nevertheless, this dose was embryotoxic. PMID- 3659549 TI - Lipid biosynthesis and composition in oil bodies and microsomes of olive fruit. AB - Both lipid synthesis and composition in oil bodies and microsomes of olive fruit at the first stage of development have been studied. The rate of fatty-acid synthesis in isolated oil bodies was saturated by 4.0 microM [2-14C]-malonyl-CoA. The fatty-acids synthesized of phospholipids and neutral lipids were saturated and monounsaturated. Neutral lipids, galactolipids and, above all, phospholipids were the major acyl-lipid components of microsomal fraction, oleic and palmitic being their principal fatty-acids. When the lipids of microsomes were labelled in vivo with [1-14C]-acetate, phospholipids and neutral lipids exhibited a higher biosynthesis rate relative to the galactolipids. The increase in saturated and monounsaturated fatty-acid synthesis in microsomes, was also accompanied by an important [1-14C]-acetate incorporation into polyunsaturated acids. The data presented here, in conjunction with our previous morphological results, suggest the possibility that olive fruit oil bodies could contain the necessary enzymes for the reserve lipid biosynthesis. PMID- 3659551 TI - A computer program for behavioral analysis. PMID- 3659550 TI - Effect of tannic acid on muscle protein composition of chickens fed a raw field bean (Vicia faba L.) diet. PMID- 3659552 TI - [Infectious diseases, AIDS...the return of the disease]. PMID- 3659553 TI - [Study of bronchoalveolar lavage in febrile patients with AIDS or AIDS-related syndrome]. PMID- 3659554 TI - [Bacteriuria associated with catheters. Natural history in long-term hospitalized patients]. PMID- 3659555 TI - [Posologic adaptation of antibiotics in patients with renal insufficiency]. PMID- 3659556 TI - [Treatment with ceftriaxone of infections of the lower respiratory tract. Results of an Italian multicenter study]. PMID- 3659557 TI - [Efficacy and tolerance of cefonicid in the treatment of respiratory infections]. PMID- 3659558 TI - [Cinoxacin reduces the diffusion of plasmid resistance to antibiotics]. PMID- 3659559 TI - [Intervertebral disk surgery and postoperative rehabilitation treatment: effect on health status]. AB - There is an increasing frequency of lumbar disc surgery in many countries. In the Federal Republic of Germany, many patients are admitted to in-patient rehabilitation immediately after surgery, which causes additional socioeconomic costs. In order to assess the efficiency of this therapy approach, we used the MOPO Scales, a thoroughly evaluated instrument describing patient health status in both its physical and psychosocial dimensions. In 79 patients who had been followed-up over six months post-discharge from in-patient rehabilitation, a significant increase in mobility, physical activity, activities of daily living, household activities, and social activities was found, as well as a significant decrease in pain, depression and anxiety. These results prove lumbar disc surgery combined with immediate post operative rehabilitation to be efficient. PMID- 3659560 TI - [Rehabilitation overseas. Help--but please not too much! Impressions and experiences of a blind person in America]. PMID- 3659561 TI - [Diet type, grinding size and anatomo-functional characteristics of the proximal digestive tract in the rabbit]. AB - Two diets containing either dehydrated lucerne (40%) or dehydrated beet pulp (50%) both being coarsely (4 mm) of finely (1 mm) ground before pelleting, were fed to 120 rabbits after weaning. Feed intake and weight gain were estimated. After 79 days, 11 rabbits in each group were slaughtered between 14.00 and 17.00 h. The parameters measured were stomach and ileal weights, dry matter, fibre and nitrogen contents, volatile fatty acid concentrations. Gastric emptying and intestinal transit time were estimated in each group. Rabbits fed the beet pulp diet had a better feed conversion ratio associated with a higher solid matter gastric retention and also a longer jejuno-ileal transit time. Finely ground diet further increased the transit time, particularly in the ileum, which was also associated with a higher concentration of fermentation by-products. PMID- 3659562 TI - Valorization of rapeseed meal. 4. Effects of iodine, copper and ferrous salt supplementation in growing rats. AB - Ten groups of 10 growing male rats (65 g) were fed ad libitum either a control diet or rapeseed diets (15 mM glucosinolates/kg DM) supplemented either with l- alone, l- and Cu++ (2 levels), l- + Cu++ and methionine or l- and Fe++ (2 levels) (table 1) for 35 days. When the rapeseed diets were given as powder or as mash, food intake decreased 24 and 32%, respectively; live weight gain was reduced by 36 and 46%, liver weight increased 20 and 33%, thyroid gland was 3 and 4 times as big, and a 30 and 50% decrease in the T4 plasma level was noted (table 2). l- supplementation did not prevent the deleterious effects of rapeseed meal feeding. l- and Fe++ supplementation had detrimental effects on food intake, live weight gain and kidney weight, but beneficial effects on liver and thyroid weights and on plasma thyroid hormone levels. The low level of l- and Cu++ supplementation suppressed the depressive effects of rapeseed meal on food intake and live weight gain and reduced the deleterious effects on kidney, liver and thyroid weights and on plasma thyroid hormone levels, whereas the higher level almost suppressed them. The results are discussed considering the likelihood of a bivalent cation effect on glucosinolates. PMID- 3659563 TI - [Triglyceride fatty acids of abdominal adipose tissue in two lines of chickens rendered lean or fat by selection]. AB - Newly-hatched chickens from two lines selected for high or low abdominal fat/live weight ratio, were fed on a stock low-lipid diet (2.9 wt % lipids) for nine weeks. Linoleic acid made up 54.3% of dietary fatty acids. Their abdominal adipose tissue and liver triglycerides were then isolated for fatty acid analysis. The linoleic acid content of abdominal fat triglycerides was higher in lean than in fat chickens (19.2 vs 16.4% of triglyceride fatty acids, respectively). This difference was highly significant. Conversely, the level of monounsaturated fatty acids in the abdominal fat triglycerides was significantly lower (especially palmitoleic acid) in lean than in fat chickens. The proportion of linoleic acid in liver triglycerides was also higher in lean than in fat chickens (12.2 vs 5.5% of triglyceride fatty acids). The higher dilution of dietary linoleic acid within the depot fat of the fat line chickens shows that the flux of endogenous fatty acids from the liver was larger in these animals than in the lean ones. Moreover, the elevated amounts of palmitoleic acid (virtually absent from the diet) in the depot and liver triglycerides of fat chickens, was most likely caused by a higher delta 9-desaturating activity in the liver of the latter animals. PMID- 3659564 TI - Body composition, metabolic rate and utilization of milk nutrients in suckling piglets. AB - The oxygen (O2) consumption, carbon dioxide (CO2) production, heat production (HP) and milk nutrient intake of 22 litters of suckling piglets were recorded every 4 days from the day after birth to weaning at 22 days of age. At weaning, 147 representative piglets of these litters were slaughtered to measure their chemical composition and to calculate the energy and nutrient balance of individual piglets and litters between birth and weaning. O2 consumption, CO2 production and HP were constant over the suckling period when expressed per kg of body weight0.68 (BW0.68); O2 consumption and HP averaged 34.4 liters and 168 kcal per kg of BW0.68 and per day, respectively. The respiratory quotient (RQ) (CO2/O2) was 0.84. Average daily gain between birth and weaning (ADG) ranged from 35 to 285 g (mean: 186 g). Dry matter, fat and energy contents of piglets at weaning were positively correlated with ADG while protein and ash contents were negatively correlated with ADG. The daily amounts of protein, fat, ash and energy deposited were linearly related to ADG, so that the chemical composition of additional gain was constant: 410, 141, 197 and 28 mg/g and 2,960 cal/g for dry matter, protein, fat, ash and energy, respectively. The deposition of 1 g of protein or fat was associated with 5.20 or 1.17 g of weight gain, respectively. Finally, 55% of the energy and 85% of the nitrogen supplied by milk were retained in piglet weight gain. PMID- 3659565 TI - [Postnatal development of zinc levels in the epididymis and testis in rats under normal and experimental conditions]. AB - Postnatal testicular and epididymal zinc concentration in the rat was investigated by means of differential pulse polarography. The zinc concentration increased gradually from birth to day 90 in the testis and up to day 60-90 in the epididymis with an abrupt increase on day 21. No marked variation in the zinc content was observed all along the epididymal duct. Experimental castration and efferent duct ligation were carried out in order to assess the influence of blood borne and luminal androgens on epididymal zinc content. In prepubertal rats, unilateral castration and efferent duct ligation did not affect the zinc content of the epididymis. Moreover, zinc concentration was not affected by bilateral castration which induced very low plasma testosterone levels. These results suggested that epididymal zinc content did not depend upon endocrine testicular secretions, especially androgens. On the other hand, in adult rats efferent duct ligation and cryptorchidism resulted in about 50 and 70% reduction, respectively of the testicular and epididymal zinc content. A correlation was found between the absence of testicular fluid and spermatozoa or the alteration of germ cells and the decrease in epididymal and testicular zinc content. PMID- 3659566 TI - An integrated model for intestinal development in the fetal sheep. AB - The interrelationships between 22 parameters relating to small intestinal morphology and enterocyte cell kinetics were investigated. It was found that all significant correlations could be related to changes in intestinal diameter. The area of accessory and mucosal coats in cross section was computed and a constancy of relative composition, independent of experimental perturbation, was noted. It appears likely that despite seemingly trophic responses in specific tissue components, an overall balance of these components is maintained in the developing intestine. The need to develop integrated models of gut structure and function to allow adequate interpretation of results is discussed. PMID- 3659567 TI - Chronic dihydroergotoxine administration increases muscarinic cholinergic receptor binding in aged-rat brain. AB - Changes in the distribution and densities of muscarinic cholinergic receptors (mCh-R) and the effects of dihydroergotoxine (DHET) administration on these changes were studied in the aged-rat brain by in vitro autoradiography. mCh-R binding in the brain was markedly reduced in aged rats as compared with young adult rats, but chronic administration of DHET specifically recovered mCh-R binding in the temporal cortex and hippocampus. PMID- 3659568 TI - Mechanism of N,N'-diallylpentobarbital potentiation of pentobarbital-induced sleep in mice. AB - Potentiation mechanism of pentobarbital (PB)-induced sleep by N,N' diallylpentobarbital (DAPB) was studied in mice. DAPB significantly prolonged the PB [40 mg/kg, intraperitoneal (i.p.)]-induced sleeping time by two routes of administration [intravenous (i.v.) and intracerebroventricular (i.c.v.)], nevertheless DAPB alone was devoid of hypnotic activity even by both routes of administration (i.v. and i.c.v.). In addition, DAPB (160 and 320 mg/kg, i.p.) significantly prolonged the sleeping time induced by i.c.v. injection of PB (200 micrograms/mouse). The brain PB half-life (T1/2) of DAPB (80 mg/kg, i.p.) treated group (9.0 h) was 13-fold longer than that of the control (0.7 h). The plasma PB half-life (T1/2) of DAPB treated group (15.2 h) was longer than that of the control (0.6 h). Moreover, DAPB significantly decreased the activities of ethylmorphine (EM) N-demethylase and aniline hydroxylase, and the content of cytochrome P-450 in mouse liver microsomes. The inhibitory effect of DAPB (40 mg/kg, i.p.) on the mouse hepatic drug-metabolizing enzymes was shown til 6 h after administration. DAPB exhibited non-competitive inhibition on the EM N demethylase activity in vitro. These results indicate that DAPB prolongs the PB induced sleeping time by both its depressant action to the central nervous system (CNS) and inhibitory effect on the hepatic drug-metabolizing enzymes. PMID- 3659569 TI - Involvement of membrane sulfhydryl groups in apomorphine-induced inhibition of neutrophil migration. AB - Apomorphine inhibits fMet-Leu-Phe stimulated migration of rabbit neutrophils, in the absence of albumin, in the concentration range of 1-20 microM. In the presence of albumin inhibition by apomorphine occurs at higher concentrations. Casein-stimulated migration, and non-stimulated migration are equally inhibited by apomorphine. The presence or absence of extracellular Ca2+ has no effect on the degree of inhibition by apomorphine. The ability of albumin to interfere with apomorphine inhibition of migration is diminished after treatment of albumin with the sulfhydryl reagent N-ethylmaleimide. Sulfhydryl compounds, such as glutathione and dithiothreitol, strongly interfere with apomorphine inhibition. The results suggest that the inhibiting effect of apomorphine is due to a reaction with sulfhydryl groups, the intactness of which is required for neutrophil migration, and which are probably located on the plasma membrane. PMID- 3659570 TI - Bromotrichloromethane-induced damage to bronchiolar Clara cells. AB - Administration of bromotrichloromethane (BrCCl3) to rats results in selective damage to bronchiolar non-ciliated Clara cells; ciliated bronchiolar cells and pneumocytes were unaffected. The cellular alterations begin very early (10 min) after poisoning. Lipid peroxidation, as measured by the malonic dialdehyde (MDA) content in the lung, is greatly increased 10 min after BrCCl3 administration. A histochemical technique to detect, in vitro, lipid peroxidation in frozen sections was used to demonstrate whether sufficient activation of BrCCl3 occurs in lung tissue. The positivity for the histochemical reaction was observed in bronchiolar epithelium in which cytochrome P450-dependent monooxygenase activity is predominantly located. The data obtained strongly support that BrCCl3 is highly metabolized in bronchiolar Clara cells. PMID- 3659571 TI - Plasma levels of (+)- and (-)-nilvadipine after oral dosing with racemic (+) nilvadipine in man. AB - The plasma levels of (+)- and (-)-nilvadipine 1 h after an oral dose of racemic (+)-nilvadipine 4 mg in sixteen healthy volunteers were studied to find the extent of variation between (+)- and (-)-nilvadipine plasma levels. Additionally the pharmacokinetic profiles of the enantiomers in the plasma up to 12 h after dosing were examined in three subjects. The plasma levels of the (+)- and (-) nilvadipine in the three subjects peaked at 0.5-1 h, and the maximum concentration and the area under the plasma concentration-time curve of the more potent (+)-enantiomer were 2.38-3.18 and 2.27-3.10 times, respectively, higher than those of its optical antipode. The half-lives of the enantiomers were mostly similar. In the sixteen subjects, the ratio between (+)- and (-)-nilvadipine levels 1 h after dosing with racemic (+)-nilvadipine were from 1.77 to 3.65. PMID- 3659572 TI - Effects of caffeine on biotransformation and elimination kinetics of acetaminophen in mice. AB - Coadministration of caffeine (CAF) with acetaminophen (ACM) to mice prolonged the blood half-life of ACM, increased moderately the fraction of ACM excreted as the glucuronide conjugate, and decreased slightly the fraction excreted as the sulfate conjugate. CAF exerted more profound effects on fractions of ACM metabolites which are formed as a consequence of biotransformation via cytochrome P-450-dependent pathway(s); urinary excretion of ACM-mercapturate was reduced ca. 44%, ACM-cysteine was reduced ca. 24%, and the methylthio metabolites were reduced ca. 30%. The apparent rate constants (K') for ACM metabolite formation were suppressed markedly by CAF. Following CAF coadministration with ACM, the K' values for the sulfate-, mercapturate-, cysteine-, and methylthio metabolites were decreased approximately 35%, 56%, 42%, and 47%, respectively. It was concluded that the protective action of CAF against ACM-induced hepatic injury in mice is mediated by a decrease in the rate of formation of N-acetyl-p benzoquinoneimine, the reactive metabolite of ACM. PMID- 3659573 TI - Inhibition of glycerolipid synthesis by gossypol acetate. AB - The activities of the initial enzymes of glycerolipid synthesis were inhibited by the antifertility drug gossypol acetate. Both the dihydroxyacetone phosphate acyltransferase and glycerol phosphate acyltransferase activities of microsomes isolated from liver were inhibited 60% or greater at a concentration of 60 uM. The activity of the peroxisomal dihydroxyacetone phosphate acyltransferase of liver was not greatly affected by gossypol until the peroxisomal activity was solubilized by detergent. It is suggested that gossypol can alter the capacity for glycerolipid synthesis within the microsomal and peroxisomal compartments. PMID- 3659574 TI - Effect of exogenous heme on sulfide-induced changes in rat heme metabolism. AB - Intraperitoneal heme treatment (5 mg/kg body wt) reversed the effects of a preceding (2 h) intraperitoneally injected Na2 S (150 mumol/kg body wt) dose on blood delta-amino levulinic acid synthase and heme synthase activities. The sulfide dosing caused decreased activity of both enzymes of which that of heme synthase was overcorrected above controls by the heme treatment 25 h after the sulfide dose. Heme alone caused a transient induction in the heme oxygenase activity in liver 23 h after the injection. The effects on heme synthesis in the sulphide-dosed rats support the role of the inactivation of the heme-controlled translational inhibitor of protein synthesis by the supply of exogenous heme. PMID- 3659575 TI - Sarcoidosis presenting with acute pleurisy, hemoptysis, pruritus and eosinophilia. AB - Sarcoidosis carries a low prevalence in Israel, and acute pleural involvement in sarcoidosis is uncommon throughout the world. We report a case of a young Israeli male of Yemenite origin who presented with atypical manifestations of sarcoidosis: pleuritic pain, hemoptysis, pruritus and alcohol-induced pain. The differential diagnosis from Hodgkin's disease was involved. Various aspects of diagnosis are discussed. PMID- 3659576 TI - Bronchoalveolar lavage during third-trimester pregnancy in patients with status asthmaticus: a case report. AB - Bronchial asthma is not uncommon among pregnant women. Especially, uncontrollable status asthmaticus may endanger both the lives of mother and fetus. We present a case of a late-phase pregnant woman in whom life-threatening status asthmaticus was relieved by repeated bronchoalveolar lavage (BAL) under controlled ventilation, followed by successful spontaneous vaginal delivery. This case may indicate that BAL should be considered as an option in status asthmaticus complicating pregnancy before terminating the pregnancy to save the lives of mother and fetus. PMID- 3659577 TI - High incidence of malignant pleural mesothelioma in neighbouring villages of Northwestern Greece. AB - Between 1981 and 1985 seven patients from three villages of the Metsovo area in Northwestern Greece (population 5000) developed malignant pleural mesothelioma (MPM). The diagnosis was made with pleural biopsy and pleural fluid cytology. Six of these patients have died 18-24 months after the first symptoms (usually dyspnea on exertion) and 1 is still alive after 24 months. Seven MPMs in 5,000 in five years is about 280 times the expected incidence of 1/1,000,000/year. In the same area, endemic pleural calcifications linked to nonoccupational asbestos exposure have recently been reported, but none of our patients with MPM had pleural calcifications. The combination of MPM and pleural plaques in such a high frequency in the same area strongly suggests asbestos fiber as a common etiologic agent. On the other hand, the fact that the combination of MPM and pleural plaques did not occur in the same individuals, suggests a different response to this common offending agent. PMID- 3659578 TI - Mycobacterium malmoense--report of a case in Switzerland. AB - Mycobacterium malmoense was isolated in four different sputum samples of a 45 year-old alcoholic smoker. The biochemical and culture characteristics of this species are described and compared with a reference strain (ATCC 29571). The isolated strain was sensitive in vitro to rifampicine, ethionamide, kanamycine and erythromycin. Therapy consisted of right-upper-lobe lobectomy and a two-year antimicrobial therapy. There was no sign of relapse at the end of the treatment period. PMID- 3659579 TI - Pharmacokinetics of ciprofloxacin in the elderly. AB - The pharmacokinetics of ciprofloxacin, administered orally as a 250-mg tablet were compared in 10 young (age 20-30 years) and 10 elderly (age 60-73 years) healthy volunteers. The time to peak serum concentrations was about 80 min in both age groups, although the maximum concentration attained was significantly greater in the old (1.7 mg/l) than the young (1.2 mg/l). Area under the plasma concentration-time curve, corrected for body weight, was on average 48% greater in the elderly, but the mean terminal elimination half-life was not significantly different, averaging 4.3 h in the old and 3.7 h in the young. Overall 24-hour urinary recovery in both age groups was comparable. The differences may be explained by a reduced volume of distribution of ciprofloxacin in old age and do not suggest a general need for significant dose alteration in the elderly. PMID- 3659580 TI - Multinuclear giant cells in bronchoalveolar lavage in interstitial lung diseases. AB - The presence of multinuclear giant cells (MGC) is a pathological feature of interstitial lung diseases produced either by some organic and inorganic dust or by granulomatous disorders. In order to assess the diagnostic significance of the presence of MGC in bronchoalveolar lavage (BAL), the percent of MGC in the BAL of 52 subjects exposed to asbestos (26 with asbestosis) as well as from 79 with several interstitial lung diseases (idiopathic pulmonary fibrosis, pulmonary fibrosis associated with collagen vascular disorders, hypersensitivity pneumonitis and sarcoidosis) was compared with that of a control group of 14 subjects with no evidence of diffuse pulmonary disease. The results of this study suggest that MGC are present in the BAL of subjects with no pulmonary disease, and the quantification of these cells does not aid in the diagnostic evaluation of interstitial lung diseases. PMID- 3659581 TI - Effect throughout the day of inhaled fenoterol on the bronchial responsiveness to histamine in asthmatic patients. AB - The effect throughout the day of inhaled fenoterol on the bronchial responsiveness to inhaled histamine was evaluated in 8 asthmatic patients. The airway response to increasing concentration of histamine aerosol was assessed by measurement of forced expiratory volume in one second (FEV1). The provocative dose of histamine needed to cause a 20% fall in starting FEV1 was calculated from the cumulative log dose response curves. Histamine challenges were performed in duplicate, on separate days, after premedication with placebo or fenoterol given by metered dose inhalers in the morning and in the afternoon. The mean starting FEV1 in the morning and in the afternoon did not change significantly after placebo inhaler, but fenoterol caused a mean increase in FEV1 of 11.11% in the morning and 4.92% in the afternoon. Geometric mean histamine PC20 was significantly higher after fenoterol than after placebo. After fenoterol there was no significant difference between morning and afternoon geometric mean histamine PC20. No relation was found between bronchodilatation achieved by fenoterol and increase in the geometric mean histamine PC20 (p greater than 0.05). There was instead a significant relationship between starting FEV1 and histamine PC20 in the morning and in the afternoon both after placebo and fenoterol. PMID- 3659582 TI - Relationship between different measurements of respiratory function in asthma. AB - Peak expirator flow rate (PEFR) and forced expiratory volume in 1 s (FEV1) were measured in 630 asthmatics at routine attendance (actual function). The highest potential PEFR and forced vital capacity (FVC) were established with corticosteroids if necessary (maximum function). Maximum function assesses the persistent component, and the ratio of actual maximum function is a measure of the potentially reversible component of obstruction relieved at attendance. Actual PEFR and FEV1 were closely related (r = 0.85), and maximum PEFR and FVC somewhat less so (r = 0.58). Mean values for actual/maximum function were similar in both sexes by both methods. Persistent obstruction and control of reversible wheeze were not closely related, particularly in long-standing asthma. In routine clinics, spirometry adds little to PEFR although in females it was more sensitive than PEFR in detecting persistent obstruction. Dissociation between control and persistent obstruction, particularly in long-standing asthma, suggests that poor control is not important in determining the development of persistent obstruction. PMID- 3659583 TI - Antitussive effect of dextromethorphan and dextromethorphan-salbutamol combination in healthy volunteers with artificially induced cough. AB - The antitussive effects of dextromethorphan (30 mg) + salbutamol (2 mg), dextromethorphan (30 mg) alone and placebo on artificial cough induced by citric acid were compared in 19 healthy non-smoking volunteers in a double-blind crossover study. The method using inhaled citric acid with increasing concentrations to establish the cough threshold level showed an acceptable reproducibility and proved to be suitable for comparison of antitussive drugs. The cough threshold level was assessed before as well as 90 and 180 min after each medication. After placebo the cough threshold level showed no statistically significant rise. However, significant rises were shown following dextromethorphan (p less than 0.001) and the dextromethorphan-salbutamol combination (p less than 0.001). Between the treatments significant differences were shown in favour of the dextromethorphan-salbutamol combination. The results indicate that salbutamol has antitussive action enhancing the effect of plain dextromethorphan. PMID- 3659584 TI - Massive pulmonary embolism complicating streptokinase treatment for deep vein thrombosis. AB - A fatal massive pulmonary embolus developed in a patient treated with streptokinase for acute deep vein thrombosis. This fatal complication occurred despite a careful selection of the patient and the presence of a lytic state. Embolization of a fragmented thrombus or/and attenuation of the lytic state leading to fresh embolization is/are the possible mechanism(s). Although rare, massive pulmonary embolus must be considered to be a major risk of thrombolytic therapy for deep venous thrombosis. PMID- 3659585 TI - [Acute effect of prostigmin on lung function and breathing of patients with myasthenia gravis at rest and following ergometric exercise]. AB - The acute effects of a single intravenous Prostigmin injection (0.5 mg) on lung function and gas exchange during rest and bicycle ergometry were measured in 26 patients with myasthenia gravis. The mean age of the patients was 44.6 +/- 17.6 years and the mean duration of myasthenia gravis 5.4 +/- 6.3 years. Lung function parameters obtained from 15 patients showed a normal total lung capacity with an increase in functional residual capacity and residual volume, while vital capacity was diminished. While the application of Prostigmin showed no acute effects on these lung volumes, there was a significant increase in airway resistance, even into the pathologic range. Data obtained during spiro-ergometry concerning gas exchange, circulation and muscle metabolism correspond to those expected from healthy individuals; application of Prostigmin did only influence the heart rate, which can be explained by parasympathomimetic activity. We conclude that dyspnoea in patients with myasthenia gravis need not necessarily be a symptom of the illness itself but can also be caused by therapy; in the latter case bronchodilatators are required. PMID- 3659586 TI - Primary ciliary dyskinesia and nasal mucociliary clearance. AB - In this study, nasal mucociliary clearance is investigated in patients with primary ciliary dyskinesia, patients with other respiratory tract infections and healthy persons. Mucociliary clearance is established with a drop of albumen labelled with 99m-Tc. From this study it appears that measurement of mucociliary clearance in the nose can serve as a reliable screening method. If a patient with respiratory tract infections shows a normal mucociliary clearance rate there is no primary ciliary dyskinesia, and a biopsy of ciliated epithelium is not necessary. If, after repeated examinations, a normal clearance rate cannot be demonstrated, a biopsy of ciliated epithelium should be taken for studying ciliary activity and ciliary ultrastructure. PMID- 3659587 TI - Measurement of anaerobic threshold in chronic airflow obstruction. AB - We compared determinations of anaerobic threshold (AT) made from measurements of arterial lactate concentration with AT determined from ventilatory response measurements of subjects with chronic airflow obstruction (CAO). Six untrained subjects with CAO performed incremental maximal cycle ergometer tests. Ventilation (VE); O2 uptake (VO2), CO2 output (VCO2); end-tidal CO2 fraction (FETCO2); and end-tidal O2 fraction (FETO2) were measured breath by breath. Arterial lactate concentration was sampled at rest and every 30 s during exercise from an indwelling arterial catheter. For three subjects with more severe airflow obstruction, plots of VE/VO2 and FETO2 failed to detect AT. In contrast, a systematic increase of the respiratory gas exchange ratio across the lung (R) accompanied increasing arterial lactate concentrations in all 6 subjects. We conclude that progressive increases of VE/VO2 and FETO2 cannot be relied upon for the measurement of AT in patients with severe CAO. Progressive increases of R unaccompanied by decreasing FETCO2 detect AT in CAO. PMID- 3659588 TI - Ventilatory dysfunction in palatal myoclonus. AB - A patient with palatal myoclonus and involvement of respiratory muscles is described. Partial characterization of the mechanism of ventilatory dysfunction was achieved using noninvasive tests. Ventilatory dysfunction in this disorder can be manifested in different patterns depending on which respiratory muscles are involved predominantly. PMID- 3659589 TI - [(Quantitative) diagnosis of myocardial infarction using colored areal mapping electro-cardiography]. PMID- 3659590 TI - [Effects of nifedipine on pulmonary circulation in patients with chronic cor pulmonale]. PMID- 3659591 TI - [Changes in QRS amplitudes and QRS loops of vectorcardiogram during coronary artery spasm provoked by ergonovine maleate]. PMID- 3659592 TI - [A case of secondary cardiomyopathy with pulmonary hypertension due to hyperthyroidism]. PMID- 3659593 TI - [Diagnosis of dissecting aortic aneurysm using MRI-CT]. PMID- 3659594 TI - [Electrophysiological studies in 2 patients with chronic persistent atrial tachycardia]. PMID- 3659595 TI - [Effective management of the long QT syndrome with verapamil]. PMID- 3659596 TI - [Surgical repair of congenital mitral stenosis]. PMID- 3659597 TI - [Two cases of prolonged QT interval and syncopal attacks treated with ventricular pacemaker]. PMID- 3659598 TI - The effect of non-isotonic solutions on human isolated airway smooth muscle. AB - In patients with asthma, bronchoconstriction can be provoked by the inhalation of aerosols of non-isotonic solutions. In order to determine if this bronchoconstriction results from a direct effect on airway smooth muscle we decided to examine the effects of non-isotonic solutions on the resting tone of human isolated bronchi and on responses to carbachol, histamine and field stimulation. Human bronchi were obtained from thoracotomy and dose-response relationships for each agonist were obtained for bronchial rings suspended in isotonic Krebs-Henseleit solution (290 mOsm). A second curve was then obtained with half the rings immersed in a solution made hypotonic (145 mOsm) or hypertonic (440 mOsm) by the addition of NaCl or salts and glucose. The other half remained in isotonic solutions as controls. In a separate series of experiments, field stimulation responses to a submaximal frequency (15 Hz) were measured before and after a change from isotonic to non-isotonic bathing solution. The resting tone of the preparations was transiently reduced by hypertonic solutions and increased by hypotonic solutions. Contractile responses to agonists were significantly diminished by non-isotonic solutions. Agonist potency was unaffected by hypertonic solutions but the potency of carbachol was reduced by hypotonic solutions. Responses to field stimulation were unaffected by the hypertonic solution but reduced by the hypotonic solution. We conclude that the bronchoconstrictor actions of non-isotonic solutions and their effects on airway reactivity are unlikely to be due to direct effects on airway smooth muscle. PMID- 3659599 TI - Relationship between maldistribution of ventilation and airways obstruction in children with asthma. AB - This study was designed to explore the relationship between ventilation non uniformity, as assessed by moment analysis of nitrogen washout, and airways obstruction, as assessed by spirometry, in children with asthma. Moment ratios derived from the multibreath washout curves in asthmatics were significantly higher than those obtained from healthy controls (P less than 0.001). Among patients with asthma, moment ratios showed a high degree of negative correlations with spirometric variables expressed as percent of predicted, i.e., increasing airways obstruction was associated with increasing ventilation non-uniformity. When the subjects were tested on multiple occasions during one test day the results demonstrated a strong quantitative relationship within subjects between spontaneous changes in moment ratios and spirometric variables (P less than 0.001), with the slope of the regressions showing a trend to vary from one patient to another. Chi squared analysis showed that significant changes in FEV1 were paralleled by corresponding significant changes in moment ratios with a sensitivity of approximately 81% and a specificity of 82%. Additionally, changes in FEV1 induced by an inhaled bronchodilator were associated with concomitant changes in moment ratios. We conclude that: (1) the majority of children with asthma have some degree of ventilation non-uniformity which is correlated with their degree of airways obstruction, and (2) spontaneous changes in airways obstruction in such subjects are paralleled by changes in ventilation non uniformity. PMID- 3659600 TI - Partitioning of upper airway resistance in Friesian and double-muscled calves. AB - Respiratory resistance in calves was partitioned in two components: upper airway resistance and pulmonary resistance. The former one was divided into naso pharyngeal and laryngeal resistance. A comparison between seven healthy unsedated double-muscled calves of the Belgian White and Blue breed (BWB) and five healthy unsedated Friesian (F) calves was performed. Respiratory resistance was significantly greater in the BWB calves, due to the significantly higher values of the naso-pharyngeal and the laryngeal resistances. This finding might be related to the higher prevalence of laryngitis in this breed. PMID- 3659601 TI - Inhibitory and excitatory effects on respiration by phrenic nerve afferent stimulation in cats. AB - Respiratory effects of electrical stimulation of phrenic nerve afferents were studied in anesthetized cats, either spontaneously breathing or paralyzed and ventilated. The type of phrenic afferent fibers activated was controlled by recording the evoked action potentials from dorsal root fibers. In both preparations, stimulation at a strength sufficient to activate small diameter myelinated phrenic nerve afferents induced a biphasic response. The first phase lasted a few respiratory cycles and was inhibitory and consisted of a decrease in tidal volume (VT) or phrenic activity (NA), inspiratory time (TI), respiratory duty cycle (TI/Ttot) and instantaneous ventilation (VE) or minute phrenic activity (NMA). Expiratory time (TE) increased and breathing frequency (f) and mean inspiratory flow (VT/TI) or mean inspiratory neural activity (NA/TI) did not change. This short-term response was suppressed in animals pretreated with bicuculline. The second phase was a long-term excitation in which VT or NA, f, VE or NMA and VT/TI increased whereas both TI and TI/Ttot decreased and TE did not change. Unlike published data, our results suggest that small-diameter myelinated phrenic nerve afferents are involved in these responses. These phrenic fibers, like afferents from other muscles, affect respiratory output and may play a role in the control of breathing. PMID- 3659602 TI - Cooling the intermediate area of the ventral medullary surface affects tracheal responses to hypoxia. AB - The intermediate area of the ventral medullary surface (VMS) influences changes in airway tone caused by hypercapnia and intrapulmonary irritant receptor activation. These studies evaluated the effects of cooling the intermediate area of the VMS on the reflex hypoxic responses of the trachealis smooth muscle and of the phrenic nerve. Anesthetized, paralyzed cats were hyperventilated with 100% oxygen to produce phrenic neural apnea. Tracheal tone was measured indirectly by evaluating pressure changes in an innervated tracheal segment and the phrenic electroneurogram was determined from the central end of a cut cervical root. Switching the inspired gas to 12% O2 increased tracheal pressure of 11 of 12 cats but caused phrenic activity to reappear in only 6 of the animals. Ventilation with 6% O2 significantly increased tracheal constriction prior to phrenic activity. After intravenous administration of atropine methyl nitrate tracheal responses to hypoxia were abolished but phrenic neural responses were unaltered. Neither the tracheal pressure nor the phasic phrenic electroneurogram responded to hypoxia after cutting the carotid sinus nerves. When the intermediate area of the VMS was cooled to 20 degrees C prior to ventilation with the hypoxic gases, both tracheal and phrenic responses were significantly diminished. While the cats were hyperventilated with 6% O2, cooling of the intermediate area significantly diminished tracheal pressure and phrenic nerve activity and both returned to the same levels after rewarming. Cooling of the intermediate area blunted tracheal and phrenic responses to carotid body stimulation by NaCN. However, the appearance of tracheal constriction prior to the onset of phasic phrenic activity may suggest that increased trachealis tone may occur independent of cyclical respiratory activity. PMID- 3659603 TI - Circadian rhythm of extracellular pH in crayfish at different levels of oxygenation. AB - The extracellular pH regulation was studied in the crayfish Astacus leptodactylus (a night animal) as a function of circadian rhythm. The venous acid-base balance (ABB) was determined in the morning (10 a.m.-12 a.m.) and in the evening (10 p.m. 12 p.m.) at PO2 ranging from 29 to 6 kPa and constant ABB in the water at 13 degrees C. In the morning the venous pH (pHv) was maintained constant by metabolic means independently of PO2 from 29 to 10 kPa. In the evening pHv again was constant and independent of PO2 but it was more alkaline by 0.1 unit corresponding to a shift along the in vitro buffer line. At that time, the ventilation required for providing a unit quantity of O2 (i.e. the ventilatory requirement) increased more than for simply providing O2. The related circadian changes of sensitivity of the ventilatory control system were assessed by comparing morning and evening ventilatory responses to 1-h periods of hypoxia and then hypercapnia. In the evening, the amplitude of the responses to both O2 and CO2 increased but the increase in CO2 sensitivity was proportionally more important. This is consistent with the increase of ventilatory requirement and the related decrease of hemolymph PCO2 during this period. It is concluded that in this animal there exists a circadian rhythm of extracellular pH that is achieved by controlling the CO2 partial pressure in the hemolymph. Results are discussed in terms of O2 transport processes and metabolic modulation through pH adjustments. PMID- 3659604 TI - Postinspiratory-ramp activity of diaphragm under inspiratory resistive load. AB - Inspiratory ramp activity, postramp activity (PRA) of diaphragm and respiratory flow were studied in anesthetized rabbits and conscious humans under inspiratory resistive load. Under load with chloralose-urethane anesthesia neural inspiration lasted 124 +/- 12 msec more than under control conditions and end of mechanical inspiration lagged behind that of neural inspiration by 114 +/- 4 msec. With pentobarbital-urethane anesthesia corresponding changes under load were 67 +/- 18 msec and 44 +/- 6 msec; after SO2 block of slowly adapting stretch receptors in bronchi corresponding changes under load were nil and 65 +/- 7 msec. In humans corresponding changes under load were about 192 and 127 msec. Both in rabbits and humans time course of PRA under load was essentially unchanged. Hence, under load a considerable part of PRA (or all of it under pentobarbital-urethane anesthesia without SO2 block) occurred during inspiration and that occurring during expiration was smaller than under control conditions. Consequently, under load braking of expiratory flow was smaller and peak expiratory flow occurred earlier than under control conditions. PMID- 3659605 TI - Heart rate in humans during underwater swimming with and without breath-hold. AB - Heart rate was monitored, by way of radiotelemetry, from 6 male subjects of mean age (+/- SE) 24 +/- 1 years and of mean mass 73.5 +/- 2.5 kg. Measurements were made in a 25 m pool at a water temperature of 28 degrees C. Resting heart rate was 67 +/- 3.7 beats X min-1 and when the subjects submerged themselves completely in the pool, but remained inactive, there was a prompt, gradual reduction in heart rate which reached 48 +/- 2.6 beats X min-1 within 30 sec and 40 +/- 2.6 beats X min-1 within 59 +/- 5.6 sec (maximum duration). When they propelled themselves under water for 33 sec by kicking their legs and breathed through a snorkel tube, heart rate increased progressively to a value of 118 +/- 4.1 beats X min-1 at 28 sec. However, when they performed the same manoeuvre while holding their breath, there was an initial increase in heart rate to 106 +/ 5.7 beats X min-1 within the first 10 sec. This was followed by a decline in heart rate which was more rapid than that recorded during inactive submersion and which eventually reached 48 +/- 4.4 beats X min-1 at mean underwater duration of 33 +/- 1.8 sec. It is concluded that during the first 10-15 sec of underwater breath-hold swimming in humans, the cardiovascular response (as indicated by heart rate) is similar to that seen during a similar level of exercise while breathing air. From then on there is a progressively more intense bradycardia which is probably indicative of an oxygen conserving response consisting of reduced perfusion of most of the body except the heart, CNS and active locomotory muscles. The degree and rate of onset of this proposed oxygen conserving response are influenced by the intensity of the exercise performed while under water and whether or not the period of underwater breath-hold swimming is preceded by exercise. PMID- 3659606 TI - Determination of lung capillary blood volume and membrane diffusing capacity in man by the measurements of NO and CO transfer. AB - NO and CO lung transfer values (TL) were measured separately in 14 healthy subjects (7 men, 7 women), using the single breath technique. Five repetitive maneuvers were performed by each subject for TLNO and TLCO determinations. The inspired mixture contained either 8 ppm NO or 0.25% CO, with 2% He, 21% O2 in N2. In order to measure an appreciable fraction of NO in the alveolar gas it was necessary to shorten the breath holding time to 3 sec. TLNO was about five times greater than TLCO. This result suggests that the specific conductance of blood (theta) for NO is very high and that the second term of the second member of the equation 1/TLNO = 1/DmNO + 1/(theta NO.Qc) is therefore negligible. DmCO and Qc values can thus be computed from TLNO and TLCO measurements. The results obtained with this method are very close to those reported in the literature; for men DmCO = 79.0 +/- 14.3 ml.min-1.Torr-1, Qc = 78.0 +/- 13.2 ml and for women DmCO = 59.0 +/- 10.1 ml.min-1.Torr-1, Qc = 59.5 +/- 11.6 ml. PMID- 3659607 TI - Respiratory drive during sudden cold water immersion. AB - Sudden decreases in cutaneous temperature induce an immediate ventilatory response, which has been termed the inspiratory or 'gasp' reflex. This respiratory response has been implicated as a contributing factor to cold water immersion drowning. In the present study, five subjects wearing either shorts or a variety of thermal protective apparel were immersed on separate occasions in 10 degrees C water. The observed peak mean skin temperature cooling rates (dTs/dt) for the different conditions varied from 6.9 +/- 2.1 degrees C/min for the shorts condition to 1.8 +/- 0.3 degrees C/min for a helicopter pilot suit made of cotton ventile material. During the immersion, recordings were made of respiratory drive, as indicated by the mouth occlusion pressure at 100 msec following the onset of inspiration (P0.1). The respiratory drive, an indicator of central inspiratory activity, correlated well with peak dTs/dt. The slope P0.1/(dTs/dt) was subject dependent and did not appear to be related to body composition. The substantial intersubject variability in the respiratory response is suggested to result from differences in the central integration of thermoafferent information. It is concluded that the inspiratory reflex is the result of cutaneous thermoreceptor activity. PMID- 3659608 TI - Phasic changes in upper airway impedance. AB - To identify within breath variations in the mechanical properties of the isolated upper airway, we examined changes in impedance spectra over the course of the respiratory cycle. Changes were evaluated with a modified forced oscillation technique applied to the isolated, sealed upper airways of nine anesthetized mongrel dogs. Upper airway impedance spectra were studied during sequential 350 msec epochs. We found spectral changes which were reproducible within the respiratory cycle. Impedance spectra revealed that during mid-inspiration at the point of peak upper airway muscle activity, the low frequency real part decreased and the imaginary part was less negative and less steep. During late inspiration and early expiration the impedance values returned to their end-expiratory values. The only significant change in parameter estimates from a three-parameter model indicated an increase in compliance. Since these changes correlated not only with tidal flow through the lower trachea and lung but also with upper airway muscle activation, we reasoned that changes in impedance could have resulted from an increase in upper airway size. Therefore, we used a sealed speaker system and, while the animal was apnoeic, evaluated impedance at two different airway pressures and the resultant volumes. The changes in impedance spectra with a volume increase were similar to those seen during spontaneous breathing efforts. We conclude that the mechanical properties of the upper airway change during the respiratory cycle and that these changes correlate with the respiratory activation of upper airway muscles. We suspect that these changes in input impedance could reflect a change in the size of the airway rather than a true increase in elasticity. PMID- 3659609 TI - Breathing pattern in rats with chronic section of the superior laryngeal nerves. AB - In a first set of experiments we registered the integrated afferent activity of the superior laryngeal nerve (SLN) in adult anaesthetized rats. The activity increased with positive upper airway pressure (Pua); with progressively more negative Pua, the SLN activity at first declined then increased again. A second set of adult rats underwent bilateral section of the SLN (SLN denervated) or a sham operation (controls). Both groups appeared to recover promptly from the operation and 6 days later their resting breathing pattern was recorded by the barometric method. SLN denervated rats had a shorter inspiratory time (80%), hence higher frequency and mean inspiratory flow, than controls. During hypoxia (10 min at 10% O2) both groups hyperventilated with an almost identical pattern. The rats were then again anaesthetized and the right vagus cut in an attempt to reduce the afferent component from the lower airways, which may have masked the SLN regulatory contribution. One week after this second operation both SLN denervated and controls breathed more deeply and slowly than before vagotomy, but the pattern was not significantly different between the two groups, either in normoxia or hypoxia. Finally, the rats were anaesthetized and integrated diaphragm activity recorded during spontaneous breathing and the first effort against closure of the nostrils. With both vagi cut, the duration of the occluded effort was slightly longer in SLN denervated than in controls. These results suggest that in adult awake rats laryngeal afferent activity tends to decrease mean inspiratory flow. However, this regulatory contribution is small during eupnea and insignificant during hypoxic hyperventilation. PMID- 3659610 TI - Hypoxic-hypercapnic ventilatory interaction at the carotid body of awake goats. AB - Neurophysiological studies have demonstrated that a positive interaction between hypoxic and hypercapnic stimuli occurs at the carotid body (CB). The present study was designed to confirm that this interaction at the CB was translated into a similar interaction in the ventilatory response. By utilizing an awake goat model in which the CB could be selectively perfused using an extracorporeal circuit we avoided confounding central effects. In six goats the CB was stimulated by progressively decreasing PcbO2 from 160 to 40 Torr at two constant levels of PcbCO2, 36 and 61 Torr. The animals breathed room air with supplemental CO2 to maintain systemic isocapnia. The response to CB hypoxia was significantly greater in CB hypercapnia than in CB normocapnia for minute ventilation, tidal volume, respiratory frequency, and mean inspiratory flow rate. We conclude that the hypercapnic-hypoxic interaction at the CB is reflected in the ventilatory responses of the animal. PMID- 3659611 TI - Allometry of red cell oxygen binding and hematology in larvae of the salamander, Ambystoma tigrinum. AB - Very few studies have attempted to relate blood characteristics to body mass within, rather than between, species. Thus, respiratory and hematological properties of the blood of larval tiger salamanders (Ambystoma tigrinum) have been measured in animals ranging in body mass from approximately 2 to 112 g. This amphibian species was chosen because larvae of very different body mass may be of similar developmental stage, minimizing interference from ontogenetic factors. Mean corpuscular volume, mean corpuscular Hb, hematocrit, blood Hb concentration, blood O2 capacity and Hill's n were all positively correlated with body mass (P less than 0.005). Blood O2 affinity (P50) and Bohr shift were not significantly correlated with body mass (P greater than 0.20). The findings are discussed in the context of the general effect of body mass upon metabolic rate in vertebrates, as well as environmental and biological factors specific to larvae of the tiger salamander. PMID- 3659612 TI - Respiration in heat stressed camels. AB - Respiration and heat exchange in relation to brain temperature (Th) and body temperature (Tb) were investigated in four heat stressed camels subjected daily to high temperature (47 degrees C) in a climate chamber while resting when hydrated and dehydrated by approximately 10%, 15% and 20% of initial weight. Diurnally Tb followed patterns described previously. Th was usually 0.2-0.5 degrees C greater than Tb: occasional reversals with brain cooling were observed. Minute ventilation increased with Tb: above 37.5 degrees C it was approximately half as much in dehydrated as in hydrated animals. Respiratory frequency increased with Tb up to 60/min. Tidal volume fell with increasing frequency; above 25 breaths/min, tidal volume approximated dead space volume. Exhaled air was almost always unsaturated with no systematic effect of dehydration. Metabolic rate fell on dehydration reducing ventilatory demand. Th and Tb were measured in two of the animals walking outdoors: then Th fell below Tb if exercise exceeded 30 min. The data indicate that heat stressed camels pant, but turbinate vasoconstriction in a hot environment prevents cooling of the brain by carotid rete heat exchange. PMID- 3659613 TI - Tuberculostearic acid in lymph nodes from patients with sarcoidosis. AB - It has earlier been suggested that mycobacteria may play an aetiological role in the development of sarcoidosis. To investigate this further we analyzed the presence of a characteristic mycobacterial constituent, tuberculostearic acid (TS, 10-methyloctadecanoic acid), in lymph nodes from 22 patients with sarcoidosis and in eleven children and three adult controls. To detect TS gas chromatography/mass spectrometry was used. These findings were compared with the results from conventional mycobacterial culture and radiometric respirometry. Although the latter techniques failed to detect mycobacteria in all the tested tissue samples, TS was found in various amounts. Thus, 0-3 micrograms TS/g freeze dried tissue was noted in eight sarcoid patients, 3-50 micrograms TS/g in eight and 51-400 micrograms TS/g in the remaining six patients. Among the controls only 1/14 had detectable TS. In one patient with lymph node tuberculosis TS was in the range 51-400 micrograms/g. We conclude that the findings could be explained by the presence of mycobacteria not cultivable with the studied techniques or with the presence of remnants after an earlier colonisation with mycobacteria, e.g. BCG-vaccination. Mycobacteria or mycobacterial cell-envelope in sarcoid tissue may possibly act as cofactors in the development of the disease, i.e. they might function as triggering agents (adjuvans) of the immune response. On the other hand the findings may be without any aetiological significance. In that latter case a hitherto unknown lack of wax decomposition during several decades has to be considered. PMID- 3659614 TI - Distribution of ventilation-perfusion ratios in pulmonary sarcoidosis. AB - In 14 patients with advanced stage pulmonary sarcoidosis the distribution of regional ventilation-perfusion ratios (V/Q) was obtained by quantitative analysis of ventilation-perfusion single photon emission computed tomography (SPECT) of the lungs. In 6 patients normal V/Q distributions were found with a decreased DLCO in only one of them. In 8 patients abnormal distributions of V/Q ratios were found. Six of these patients also had a decrease in diffusing capacity for CO (DLCO). It is suggested that the decrease in DLCO in these patients is partly a result of uneven distribution of V/Q ratios. PMID- 3659615 TI - Pulmonary function in patients with sarcoidosis. A three year follow-up. AB - During a 3 year period, 101 patients were consecutively diagnosed as having sarcoidosis. During the 3 year follow-up 9 patients died, 6 of them directly or indirectly due to their sarcoidosis. In 78 patients bronchoscopy and spirometry were performed at the primary investigation, and after 3 years a new spirometry was performed. A positive bronchial mucosal biopsy, bronchial sarcoidosis, was found in 31 (40%) of the 78 patients. Mean values of vital capacity, total lung capacity and forced expiratory volume in one second were normal in both patients with bronchial sarcoidosis and those without. Abnormal spirometry was found in 16 (21%) patients at the initial examination and in 11 (14%) at the follow-up. There were 10 (32%) patients with and 6 (13%) without bronchial sarcoidosis who had an abnormal spirometry. At follow-up a normalized lung function was found in 8 (50%) of the 16 patients with abnormal spirometry. Only 3 (4.8%) patients with initially normal lung function had abnormal lung function at follow-up. Our findings indicate a very little risk of developing abnormal lung function if there are normal findings at the primary investigation. Corticosteroids seem to have some effect, especially in patients with endobronchial sarcoidosis. PMID- 3659616 TI - Simultaneous presentation of IgA nephropathy and sarcoidosis. AB - Sarcoidosis and IgA nephropathy diagnosed simultaneously in a 23-year-old male patient is described. This association is most unusual. The possible inter relationship between the two conditions is discussed. PMID- 3659617 TI - Multimodality evoked response testing in sarcoidosis. AB - Neurosarcoidosis is suspected on clinical grounds. The diagnosis is confirmed radiographically or by spinal fluid examination or biopsy. Evoked response testing in sarcoidosis has been studied by three groups of investigators. Visual, somatosensory, or brainstem auditory evoked potentials were abnormal in some sarcoidosis patients with, and in others without clinical evidence of neurological involvement. Multimodality evoked response testing may be useful in further defining neurosarcoidosis and in detecting subclinical disease. PMID- 3659618 TI - Sarcoidosis and amyloidosis. Is the association causal or co-incidental? AB - During 1950-83, 52,371 autopsies were done at the Los Angeles County Hospital; 503 cases showing amyloidosis, seven of these also had sarcoidosis, and three also had rheumatoid arthritis. These associations could be coincidental or it is just possible that there is a causal aetiological relationship. It is hoped that other workers will review their material, and, in particular, to assess whether there is an increased incidence of amyloidosis in sarcoidosis. PMID- 3659619 TI - Apropos of the present level of epidemiologic knowledge on sarcoidosis. AB - Some particularities of the public health service in the GDR especially: 1) systematic unselected chest X-ray screening of the total population since 1954, 2) compulsory registration of sarcoidosis since 1961, 3) uniform, easily accessible and well developed medical care for all citizens represent the unique prerequisites for providing unbiased epidemiologic data in sarcoidosis. The author made use of the totally ascertained sarcoidosis population derived from the mass experiment as mentioned above and carried out an analytic study (cohort analysis of incident cases (n = 1575) adjusted for several variables. The incidence is the only parameter which is suitable for valuating the epidemiologic situation. The incidence/year ranged from 8.1 to 10.2/100,000 for a long period. Excessive ascertainment of the asymptomatic and transient forms does not contribute to the improvement of the medical care of the diseased persons. There is no reason to suppose an increase of the disease in the last 25 years. Recently the incidence curve is parallelly decreasing to the advanced restriction of the X ray screening. Further relevant results are reviewed and some conclusions were drawn. PMID- 3659620 TI - Sarcoidosis in north India: the clinical profile of 40 patients. AB - Sarcoidosis is being increasingly recognized in India. Over the last 7 years we studied 40 patients. Older males out numbered young females. Thoracic (98%), constitutional (50%) and ocular (40%) involvement dominated the clinical profile. In addition, erythema nodosum (20%), facial palsy (13%), parotid enlargement (8%), lymphadenopathy (42%), hepatomegaly (37%) and splenomegaly (17%) were also observed. Radiologically, 53%, 30% and 15% of patients were in Stage I, II and III respectively at presentation. Kveim test was positive in 45% of those tested. The diagnosis was histologically confirmed in 80% of patients. The remaining eight patients (20%) were relatively asymptomatic, all had bilateral hilar lymphadenopathy and either erythema nodosum or uveitis or both. 88% were tuberculin negative. Systemic steroids were used in 60% and topical steroid eye drops in a further 20%. Response to therapy was excellent except in Stage III disease where radiological and spirometric deterioration was observed in three patients. There were no fatalities. The overall clinical behaviour of north Indian patients with sarcoidosis was quite similar to that of patients in England but different from previously reported Indian patients. PMID- 3659621 TI - Necrotising sarcoidal granulomatosis: a problem of identity. A study of seven cases. AB - We report on a study of 6 cases of Necrotising Sarcoidal Granulomatosis (NSG) and details of another problem case illustrating the difficulties of classification. We have compared the clinical and pathological features with those of sarcoidosis, Wegener's Granulomatosis (WG), Churg Strauss Granulomatosis (CSG), Pulmonary Hyalinizing Granuloma (PHG) and various metal lung diseases. We distinguish NSG from sarcoidosis, in particular by the prominence of vasculitis, necrosis and the rarity of extrapulmonary manifestations, but accept that problem cases can occur. We see no difficulty in separating NSG from CSG, PHG and metal lung granulomatous diseases, but on occasion WG may cause considerable difficulty. For the present NSG is best regarded as a distinct entity. PMID- 3659622 TI - [Cholecystectomy as a risk factor in the development of colorectal carcinoma]. PMID- 3659623 TI - [Seroepidemiology of acute hemorrhagic conjunctivitis in communities along the border of Chiapas State]. PMID- 3659624 TI - Heterochromatin C sizes distribution of chromosomes 1, 9, 16 and Y in a sample of the Mexican population: comparison of two quantitative methods of measurement. PMID- 3659625 TI - [Selection of a reference standard for use in the epidemiologic surveillance of nutrition and growth]. PMID- 3659626 TI - Immunologic classification of the acute non-granular leukemias in the city of Puebla, Mexico: its value in the diagnosis and prognosis. PMID- 3659627 TI - [Dystrophia myotonica. Clinical and genetic study of 21 cases in 18 families]. PMID- 3659628 TI - [Restrictive cardiomyopathy secondary to cardiac amyloidosis as the unique manifestation of multiple myeloma]. PMID- 3659629 TI - [Primary lymphoma of the bone marrow]. PMID- 3659630 TI - [Photosensitization by piroxicam]. PMID- 3659631 TI - [Tomographic findings in the "locked-in" syndrome: report of 3 cases]. PMID- 3659632 TI - [Achalasia in 2 adult sisters]. PMID- 3659633 TI - [Anatomo-clinical case. 25-year-old woman with thrombocytopenic purpura, hemolytic anemia and neurological changes]. PMID- 3659634 TI - [Risk of infection transmission in the families of chronic HBAGs carriers]. PMID- 3659635 TI - [Clinical and morphological considerations on alcoholic cardiomyopathy]. PMID- 3659636 TI - [Correlations between hemoglobin A1C and several disorders of lipid metabolism in juvenile diabetes]. PMID- 3659638 TI - [Expert systems in medicine: achievements and perspectives]. PMID- 3659637 TI - [Neuro-capillary interrelations at the level of the sympathetic ganglia. Histogenetic aspects]. PMID- 3659639 TI - [Synthesis of new pyridazine products with physiologic activity]. PMID- 3659640 TI - [Synthesis of several new benzimidazolyl-2'-mercapto-methyl)-5-aryl-amino-1,3,4 thiadiazoles and tests of their cytostatic action]. PMID- 3659641 TI - [Treatment with Viskaldix in arterial hypertension]. PMID- 3659642 TI - [Man and night work. III. Ergonomic, familial and social implications]. PMID- 3659643 TI - Non operative lavage therapy in severe acute pancreatitis. PMID- 3659644 TI - [Hypophyseal nanism caused by craniopharyngioma]. PMID- 3659645 TI - [A rare observation: agenesis of the left hemidiaphragm]. PMID- 3659646 TI - [Hemorrhagic non-Hodgkin's lymphoma of a gastric stump]. PMID- 3659647 TI - [Trends, achievements and perspectives in the field of internal medicine]. PMID- 3659648 TI - [Antiandrogens in the therapy of various androgenic cutaneous syndromes]. PMID- 3659649 TI - [Global bone marrow insufficiency]. PMID- 3659651 TI - [Heart veins. I. General considerations]. PMID- 3659650 TI - [The nuclear family of students and the university instructional and educational process]. PMID- 3659652 TI - [128 cases of borderline arterial hypertension in children and adolescents]. PMID- 3659653 TI - [Psychological valences of the physician-patient relationship]. PMID- 3659654 TI - [Significance of hypertension risk factors standard values in workers employed at the ROM Research and Design Institute in Iasi, based on analysis of the information present in the socio-medical data bank of the unit]. PMID- 3659655 TI - [Practical use of bio- and immunochemical determinations in the nosological classification of borderline rheumatoid syndromes]. PMID- 3659656 TI - [Destructuralization of human behavior by disturbing its integrative relationships]. PMID- 3659657 TI - [Institutional and relational aspects in the family micro-group in schizophrenic psychoses]. PMID- 3659658 TI - [Localized post-traumatic meningo-cerebral dilaceration. Considerations on 499 cases]. PMID- 3659659 TI - [A new technic for the surgical treatment of old isolated dislocations of the lower end of the cubitus]. PMID- 3659660 TI - [Indications and limitations of femoral osteotomy in children with primary ischemic necrosis of the femoral head]. PMID- 3659661 TI - [Our approach in the treatment of fractures of the humerus in the adult (I)]. PMID- 3659662 TI - [Essential arterial hypertension at two industrial units: 5 years of multidisciplinary epidemiological research]. PMID- 3659663 TI - [Preventive implications of cancer multistaging]. PMID- 3659664 TI - The probability of inevitability: the inherent impossibility of validating criteria for brain death or 'irreversibility' through clinical studies. AB - A great need persists for diagnostic criteria for both brain death in young children and irreversible loss of consciousness at all ages. This article examines the inferences derived from a hypothetical confirmatory study in which all of the N patients who fulfilled the criterion did in fact experience brain death (irreversibility). A Bayesian methodology proves that, for N in the range of a large clinical study, estimations of prior probabilities are, for all practical purposes, irrelevant to the calculation of the posterior probabilities. The risk of a false positive diagnosis for the next patient who meets the criterion is approximately 1/(N + 2). The chance of at least one false positive diagnosis among the next (N + 1) patients who meet the criterion is around 50 per cent. Thus, achievement of the requisite moral certainty of a declaration of death (irreversibility) necessitates an impossibly large N for the study. This does not mean that one cannot diagnose death, but rather that the validity of the diagnostic criteria must be self-evident on a priori grounds, and that confirmatory studies are necessarily either inadequate or superfluous. PMID- 3659666 TI - Issues of efficiency in combining proportions of deaths from several clinical trials. AB - The Mantel-Haenszel test provides a straightforward method to combine results from several clinical trials when only summary information, such as the proportion of deaths, is available for each trial. More efficient tests, such as the stratified logrank test, should be used if the survival and censoring times are known for all individuals, but in practice, the cost and effort of obtaining this information may be prohibitive. The purpose of this paper is to derive a general expression for the asymptotic relative efficiency (ARE) of the Mantel Haenszel test with respect to the stratified logrank test, and to compute the ARE in situations which are likely to be of practical interest. The results show that under realistic assumptions about the survival distribution, losses to follow-up and duration of accrual, the ARE frequently exceeds 80 per cent. An example is given to show the usefulness of the approach when combining proportions of deaths from several cancer clinical trials. PMID- 3659665 TI - Modelling binary data from a three-period cross-over trial. AB - A new method of analysing binary data from a three-treatment, three-period cross over trial is described. This method is based on a log-linear model and mirrors the analysis of continuous data. It is an extension of the method we introduced recently for the analysis of binary data from a two-treatment, two-period cross over trial. We illustrate our method using data from a trial which compared two analgesics and a placebo for the relief of primary dysmenorrhea. PMID- 3659667 TI - A simple method of sample size calculation for unequal-sample-size designs that use the logrank or t-test. AB - This paper presents a simple method of calculating sample sizes for unequal sample-size designs with use of published tables applicable to equal-sample-size design. The method applies to both the logrank test and the t-test. For the power of logrank test, this paper compares the proposed method with existing methods and with the Monte Carlo simulation. PMID- 3659668 TI - The analysis of a titration study. AB - For analysis of data from a titration study, this paper adopts the idea of a life table analysis and utilizes a logistic linear dose-response model. The procedure uses iterated reweighted least-squares to provide parameter estimates. Computation of the asymptotic covariance of the life-table estimates of the response rates involves Greenwood's formula and a conditioning argument. A special case consists of examination of the covariance structure when no dropouts took place. Data from a titration study that investigated the efficacy of an anti hypertensive compound illustrate the procedure. PMID- 3659669 TI - Multiple comparisons for relative risk regression: extension of the kappa-ratio method. AB - We propose a kappa-ratio method for multiple comparisons among disjoint groups in survival analysis, specifically among relative risk estimates from a proportional hazards regression analysis. The new method relates the magnitude of critical values to an overall measure of group heterogeneity. That is, large critical values result from small values of a chi-square statistic for testing between groups homogeneity. Conversely, large values of the overall statistic lead to small critical values for individual comparisons, even if there are many groups. The adaptivity of the kappa-ratio method contrasts sharply with the conservatism of competing methods. PMID- 3659670 TI - Some considerations in the analysis of rates of change in longitudinal studies. AB - This paper discusses and compares several estimators of mean rate of change in unbalanced longitudinal data based on a model with randomly distributed regression coefficients across individuals. The estimators are unweighted and weighted means of these coefficients. The paper also evaluates commonly used variance estimates corresponding to the estimators. Results show that in situations of very slight imbalance, the choice of method is not critical. When imbalance is substantial, however, one should weight the regression coefficients by their estimated precision. An example using data from a nutritional study on premature neonates illustrates some issues encountered in the analysis of longitudinal clinical data sets. PMID- 3659671 TI - Monitoring maternity services by postal questionnaire: congruity between mothers' reports and their obstetric records. AB - The validity of information obtained from women about the medical aspects of their childbearing experiences has been assessed by comparing the responses of 223 mothers on a postal questionnaire with information extracted from their medical records. When discrepancies between the two sources were found, it was not assumed that the hospital records were correct. Instead, attempts were made to ascertain why the data might be inconsistent by re-checking the records and by contacting the mothers again. There appeared to be five main reasons for discrepancies: mothers' limited knowledge or understanding of certain procedures; problems of interpretation and definition; occasionally inaccurate or missing information in the medical records; under-reporting of sensitive information by mothers and, finally, questions which were misunderstood or misinterpreted by the mothers. For most items, however, good agreement between the mothers and hospitals was obtained, and the results indicate that valid information over a range of events can be obtained using postal surveys of mothers. PMID- 3659672 TI - Non-random sampling in human genetics: estimation of familial correlations, model testing, and interpretation. AB - By choice or necessity, human geneticists and genetic epidemiologists often design studies that involve non-random sampling of clusters of individuals, and yet address hypotheses appropriate to the population as a whole. Failure to adjust for the non-randomness of data often leads to biased parameter estimates and misspecification of predictive models that cause familial resemblance of traits. We develop an approach to adjust for common forms of non-randomness in the context of estimating familial correlation with minimal distributional assumptions and discuss its implications in connection with adjustments for concomitant variables. PMID- 3659673 TI - The ureter. PMID- 3659674 TI - Ureteral mechanics. PMID- 3659675 TI - Methods of diagnosing ureteral obstruction. PMID- 3659676 TI - Ureteral healing. PMID- 3659677 TI - Ureteroscopy: experience with 268 cases. PMID- 3659678 TI - The management of ureteral calculi. PMID- 3659679 TI - [Role of the clinical biology laboratory in the diagnosis of hyperlipemia]. PMID- 3659680 TI - [A case of Pancoast-Tobias syndrome]. PMID- 3659681 TI - [Indications for renal puncture biopsy in the child]. PMID- 3659682 TI - [Malignant teratomas of the ovary in children: apropos of 4 cases]. PMID- 3659683 TI - [Value of hemodynamic studies of the liver by supra-hepatic catheterization]. PMID- 3659684 TI - [Acute infectious diarrhea--meaningful clarification and therapy]. PMID- 3659685 TI - [Sleep disorders in infants and young children. Treatment by structured conditioning, i.e., by understanding and consistency]. PMID- 3659686 TI - [Recurrent tachycardia]. PMID- 3659687 TI - [A case from practice (85). Patient: T.W., born 1967 (Gilbert's syndrome)]. PMID- 3659688 TI - [Incontinence in elderly persons]. PMID- 3659689 TI - [Case from practice (86). Patient: Mr.F.F., born 3-3-1954]. PMID- 3659690 TI - [Local-regional anesthesia in hand surgery]. PMID- 3659691 TI - [Place of local-regional anesthesia in ophthalmology]. PMID- 3659692 TI - [Anesthesia in proctology]. PMID- 3659694 TI - [Local-regional anesthesia and arthroscopy]. PMID- 3659693 TI - [Peridural anesthesia in disk hernia]. PMID- 3659695 TI - [Morphine by peridural route]. PMID- 3659696 TI - [Repair of inguinal hernias under local anesthesia]. PMID- 3659697 TI - [Anesthesia in orthopedics and urology. Local-regional anesthesia]. PMID- 3659698 TI - [Psychological aspects of local-regional anesthesia]. PMID- 3659699 TI - [Forensic medicine aspects of clinical medicine and practice]. PMID- 3659700 TI - [Still's disease in adults--diagnosis by exclusion]. PMID- 3659701 TI - [Multidisciplinary approach to baker's asthma]. PMID- 3659703 TI - [Case from practice (87). Patient: Mr. A. D., born 1942, city registrar]. PMID- 3659702 TI - [Epigastric pain, a feeling of fullness and belching]. PMID- 3659704 TI - [Acute retrosternal pains]. PMID- 3659705 TI - [Appendicitis]. PMID- 3659706 TI - [Acute subdural hematoma due to anticoagulation]. PMID- 3659707 TI - [Considerations on psychiatric activity in intermediate facilities]. PMID- 3659708 TI - [A psychoanalytic look at the care-giving team in the work-place]. PMID- 3659709 TI - [Interdisciplinary collaboration and therapeutic perspectives among the treatment team at a center for psychiatric patients]. PMID- 3659710 TI - [How does one link personal dynamics and institutional dynamics at an intermediate facility?]. PMID- 3659711 TI - [Intermediate facilities and reflections on a psychiatric topic]. PMID- 3659712 TI - [Intermediate facilities: interludes or cures?]. PMID- 3659713 TI - [Attempt at evaluating the functioning and usefulness of a protected home for psychiatric patients]. PMID- 3659714 TI - [Protected homes. What role and of what use in the administration plan?]. PMID- 3659715 TI - [Possibilities for socio-professional rehabilitation and community psychiatry]. PMID- 3659716 TI - [The Mujon Home at Yverdon, creation of the institution and its description]. PMID- 3659717 TI - [Place of occupational workshops in social rehabilitation]. PMID- 3659718 TI - Anatomical considerations relevant to fecal continence. AB - A brief description is given of the anatomical operative findings considered relevant to fecal incontinence. The posterior sagittal approach and the importance of the electrical muscle stimulator in effecting meticulous repair are stressed. New viewpoints are presented with regard to the functions of the anatomical structures and their roles in fecal continence. PMID- 3659719 TI - Alterations in DNA methylation in human colon neoplasia. AB - A review of studies on DNA methylation in colonic neoplasia is presented. Hypomethylation of a wide variety of genes from throughout the genome was seen in all colon cancers studied. These changes preceded malignancy because benign adenomas were also affected. PMID- 3659720 TI - Tissue culture model of adenoma invasion. AB - Colon carcinoma cells cocultured with adenoma cells were examined under various experimental conditions. Carcinoma cells were shown to have a selective advantage over adenoma cells. This advantage is enhanced by exposure to a tumor promoter. PMID- 3659721 TI - [Clinical symptomatology of epileptic seizures of temporal origin]. AB - Many discrepancies still exist in the description of clinical symptoms and signs attributable to a paroxysmal disorganization of temporal structures. They result from various methodological appraisals of clinical, electrophysiological and neuroradiological data concerning partial epilepsies. However a study of anatomo electroclinical correlations in temporal seizures yield an easy pattern when the methods of elaboration, the criteria of validity and their meaning are strictly defined. An analysis of temporal seizures, recorded, filmed and described clinically in 300 patients having had a pre-surgical SEEG examination is the basis of a proposed classification of their main clinical features. The structures supposed to be ictally disorganized are, for each category, as follows: simple and complex visual and auditory hallucinations and illusions are due to a discharge beginning in the temporal-occipital or superior (posterior or anterior) temporal cortex. Memory troubles like dreamy-state are due to a simultaneous impairment of some neo-cortical areas and of Ammon's horn. Instinctive-affective troubles, like genital and sexual signs, or symptoms, emotional, mood, affective troubles seem to be linked to discharges in hippocampal and juxta-insular, internal perisylvian areas. Autonomous (cardiac, digestive, etc.) troubles are linked to a disorganization of basal limbic structures and especially of the perisylvian cortex. Motor and verbal automatisms have different meanings: only chewing is due to a discharge in the amygdalian area and in its hypothalamic efferents. Cognitive impairment is difficult to classify.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659722 TI - [Antiepileptic drugs and teratogenesis]. AB - The teratogenic risk of anticonvulsant drugs was established more than 15 years ago. Experimental and statistical studies, types of malformations, drugs incriminated, significance of epileptic seizures during pregnancy are reviewed. The percentage of congenital malformations among children from epileptic mothers is twice higher than in the general population. Such data, especially those about epidemiological investigations, can in fact be criticized. The origin of a congenital malformation is always multifactorial and genetic factors play a major role. A line of conduct may be proposed to women asking for advice before and during pregnancy. It is concluded that generally the teratogenic potential of an antiepileptic drug is low and does not contraindicate pregnancy in epileptic women. PMID- 3659723 TI - [Total or partial withdrawal of antiepileptic drugs]. AB - Total withdrawal of antiepileptic drugs leads to a mean relapse rate of approximately 50 p. 100 in adults and 25 p. 100 in children. The relapse rates are lowest in patients with benign epilepsies of childhood and epilepsies with absence seizures only and those with a short duration of epilepsy. Relapse rates are higher in patients with complex partial seizures, absences with generalized tonic-clonic seizures, juvenile myoclonic epilepsy, patients with several types of seizures, high seizure frequency prior to control, in patients with neurological, psychiatric or social handicaps and in those with emotional ambivalence towards the reduction. Guidelines for slow and safe withdrawal are given. Reduction should be actively encouraged only in patients with absence seizures or benign focal epilepsy and those with epilepsy of short duration. Slow partial withdrawal is recommended in uncontrolled epilepsy because in 80 p. 100 of the patients it results in a decrease in seizure frequency and side effects or both. PMID- 3659724 TI - [The "epileptogenic zone" in humans: representation of intercritical events by spatio-temporal maps]. AB - In the preoperative investigation of partial epilepsies, electrical characteristics of the so-called epileptogenic area are of critical interest to localize this area. We have always emphasized that the analysis of ictal events themselves, is more valuable than that of inter-ictal anomalis. One reason for this emphasis has been the absence of a reliable method to evaluate the relationship between the topography of ictal and interictal events. An technique for imaging an intracerebral potential field is reported. It allows to analyse the spatio-temporal distribution of interictal events recorded during the SEEG exploration. This technique applied to an illustrative patient shows that the temporo-spatial distribution of interictal spikes is related to that of the ictal discharge itself. A new hypothesis concerning the build up of an epileptogenic area in man is presented. PMID- 3659725 TI - [Organization of sleep in recent temporal lobe epilepsy before and after treatment with carbamazepine]. AB - Sleep in epileptic patients with complex partial seizures has been considered as being less well organized than in normal subjects. This study attempted to precise whether this disorganization could be related to the length of the disease and could be improved by carbamazepine treatment. The study was performed in 15 patients with recently diagnosed (less than 3 months) and untreated temporal lobe epilepsy. Neurologic examination and CT scan were normal. Patients did not present a generalized seizure in the preceding 48 hours and during the study. Nocturnal sleep polygraphic recordings were performed: 2 recordings before treatment and 2 others after one month of carbamazepine administration (800 mg/day). Before treatment sleep was characterized by a marked instability (increase in awakenings, shifts in sleep stages, waking after sleep onset, stage 1 duration) when compared to normal subjects. Carbamazepine treatment improved sleep stability. Our data support the hypothesis of another possible mechanism than the occurrence of seizures to explain the disorganization of sleep in temporal lobe epilepsy. On the other hand sleep instability could not be related to the length of the disease since it existed soon after its onset. Carbamazepine treatment improved sleep stability and this improvement could play a role in the therapeutic effect of the drug. PMID- 3659726 TI - [Occlusion of the vertebral artery (100 personal cases)]. AB - Occlusion of the vertebral artery is usually due to atherosclerosis. According to the site and extension of the arterial lesions 3 clinico-pathologico-angiographic situations can be encountered: segmental occlusion (proximal: V1 or distal: V3, V4), multisegmental (mainly V1-V2, sometimes V1-V2-V3) or extensive (V1 or V4). Subsequent infarctions are localized in ipsilateral cerebellar lobes and ipsilateral lateral part of the medulla oblongata; supra-medullary involvement is rare and indicates a propagation of the vertebral thrombus into the basilar artery. Cerebellar, vestibular or cerebello-vestibular strokes and Wallenberg's syndrome are the more frequent clinical disorders. They are often preceded by occipito-cervical headache. Contrary to a common belief, the vital risk in vertebral artery occlusion is not negligible. Among 160 cases, 100 of which are personal, mortality was 25%. In fact benign segmental and proximal occlusion adequately compensated, specially when isolated, must be opposed to segmental distal occlusion and extensive occlusion. Angiography and Doppler examinations localize arterial lesions and subsequent hemodynamic disorders. The treatment is often symptomatic only. Surgery of the proximal vertebral artery may in some cases be the only hope of preventing occlusion. PMID- 3659727 TI - [Amnesic ictus and cerebral blood flow]. AB - Cerebral blood flow determinations using the Xenon inhalation test in two patients with transient global amnesia showed overall decreases during the attack with a more marked fall in temporal-inferior frontal flow in one case and in temporal flow in the other. In the latter patient the temporal anomaly was reversible after naloxone injection but clinical improvement was lacking. Blood flow determinations in a further patient with transient global amnesia, after 2 mg of ergotamine tartrate plus caffeine, showed a global decline in flow without focal anomaly, with recovery after ten days. Values obtained in two other patients 24 and 38 hours respectively after typical transient global amnesia attacks were normal. The effect of naloxone appears related to a direct neuronal action although the role of endorphins in this affection is not conclusive. Comparison of these anomalies with those noted by Reichle with position emission tomography imaging suggests a primary neuronal mechanism. PMID- 3659728 TI - Excessive daytime somnolence in young men: prevalence and contributing factors. AB - To investigate the prevalence of excessive daytime somnolence and contributing factors, 58,162 draftees between 17 and 22 years of age, registered in two selection centers of the French army, were screened by means of a 17-item questionnaire. In response, 8,201 subjects (14.1%) reported occasional daytime sleep episodes, 2,210 (3.8%) one or two daily episodes, and 640 (1.1%) more than two daily episodes. Of the total sample, five percent or 2,933 considered these sleep episodes to affect their lives. Different possible factors of daytime sleep episodes were investigated, including hours of nocturnal sleep, sleep-wake schedule, sleep difficulties, use of hypnotics, snoring, and occurrence of cataplexy. A strong association was found between these factors and excessive daytime somnolence. A stepwise multivariate analysis was performed on five of these factors: hours of nocturnal sleep, sleep-wake schedule, sleep difficulties, use of hypnotics, and snoring. All five factors were shown to be independently related to excessive daytime somnolence and were ranked in the following descending order: use of hypnotics, sleep difficulties, irregular sleep-wake schedule, snoring, and hours of sleep. PMID- 3659729 TI - Ethanol and caffeine effects on daytime sleepiness/alertness. AB - Eighteen normal-sleeping young (mean age 25.6 years) volunteers received either ethanol (0.75 g/kg producing blood ethanol concentrations of 71.1 +/- 24.3 mg/100 ml on average) or caffeine (4.0 mg/kg dissolved in 300 ml of 97% caffeine-free instant coffee) at 0920-0950 h after spending 5, 8, or 11 h time in bed (TIB) the previous night. Latency to sleep onset was tested at 1000, 1200, 1400, and 1600 h. Mean sleep latency differed significantly between drugs on each day of testing, with subjects being sleepier after ethanol than caffeine. On day 2 the TIB manipulation produced significant differences in latency, with the 11-h condition differing from both the 8- and 5-h conditions. The significant interaction revealed that in fully rested subjects (11-h TIB), ethanol did not produce sleepiness to the degree it did after 5 or 8 h in bed. In this condition latencies were similar to those of the caffeine and 5- or 8-h TIBs. PMID- 3659730 TI - Temporal placement of a nap for alertness: contributions of circadian phase and prior wakefulness. AB - Napping can enhance alertness during sustained wakefulness, but the importance of the temporal placement of the nap between days and within the circadian cycle remains controversial. To resolve these issues, a between-groups study was conducted with 41 healthy, young adults permitted a 2-h nap at one of five times during a 56-h period otherwise devoid of sleep. Naps were placed 12 h apart, near the circadian peak (P) or trough (T), and were preceded by 6, 18, 30, 42, or 54 h of wakefulness. Visual reaction time (RT) performance, Stanford Sleepiness Scale (SSS) ratings, and sublingual temperature were assessed every few hours throughout the 56 h, which took place in an environment free of time cues. All groups displayed a circadian-modulated decline in RT measures and increases in SSS functions as sleep loss progressed. A nap placed at any time in the protocol improved RT performance, particularly in the lapse domain, but not SSS ratings. Comparisons within groups of circadian temperature cycles for the first versus second day of the protocol indicated that early naps (P6, T18, P30) tended to prevent the mean drop in temperature across days. The earlier naps (P6, T18) yielded more robust and longer lasting RT performance benefits, which extended beyond 24 h after the naps, despite the fact that they were comprised of lighter sleep than later naps. Circadian placement of naps (P vs. T) did not affect the results on any parameter. In terms of temporal placement, therefore, napping prior to a night of sleep loss is more important for meeting subsequent performance demands than is the circadian placement of the nap. SSS ratings suggest that the napper is not aware of these performance benefits. Because the longest lasting RT gains followed early naps, which were composed of less deep sleep than later naps, napping during prolonged sleep loss may serve to prevent sleepiness more readily than it permits recovery from it. PMID- 3659731 TI - Differences in sleep-wake habits and EEG sleep variables between active morning and evening subjects. AB - This article is a survey study, followed by an experimental study, examining the differences of sleep-wake habits and sleep electroencephalographic (EEG) variables between morning and evening type subjects (Ss). In the survey study, the Japanese version of the Horne and Ostberg Morningness-Eveningness Questionnaire and Life Habits Inventory (LHI) were administered to approximately 1,500 university students. The survey results showed that the two types were significantly different from each other in terms of retiring and arising time, sleep latency, mood on arising, nap, adequate amount of sleep, number of times of staying awake all night, and variability in bedtime, arising time, and sleep length. These results suggested that evening type Ss had more irregular and/or flexible sleep-wake habits than morning type Ss. In the experimental study, 10 morning and 11 evening type Ss were selected from the population included in the survey study, and polysomnograms were obtained. The results showed that only in rapid eye movement (REM) latency did morning type Ss significantly differ from evening type Ss. REM latency might be related to personality factors, particularly to neuroticism and anxiety. PMID- 3659732 TI - Subjective ratings of sleepiness--the underlying circadian mechanisms. AB - Previous field and laboratory studies have revealed that there is a diurnal variation in subjective sleepiness that is different in form to that of objective sleepiness and many measures of performance efficiency. The worst subjective sleepiness occurs at the trough in the circadian temperature rhythm, the least subjective sleepiness about 7 h before the peak in temperature. A series of forced desynchronization experiments, in which the endogenous circadian oscillator controlling the temperature rhythm ran at a different period to the sleep/wake cycle, revealed that these findings can be explained by postulating subjective sleepiness to be under the control of both factors, with minimum sleepiness occurring at the peak in temperature in terms of the temperature cycle and about 6 h after waking in terms of the sleep/wake cycle. PMID- 3659733 TI - Performance during frequent sleep disruption. AB - Performance on a simple addition task was measured during three schedules of frequent sleep disruption for 2 nights. Five young adults had their sleep briefly disturbed for 2 nights in 3 separate weeks either every 1 min, every 10 min, or at sleep onset after an undisrupted 2.5-h sleep period. Subjects were required to perform a two-number, two-digit addition problem as rapidly as possible on awakening. Main effects were found for sleep disruption condition and time of night, and a significant interaction between the two was also observed. Latency to response was longest for the 10-min condition on night 1, on night 2, however, response latencies were longest in the 1-min condition. Response latencies were fastest in the 2.5-h condition for both nights of disruption. Arousal thresholds were also gathered across both nights. Arousal thresholds were consistently the highest in the 1- and 10-min conditions for both nights of disruption, reaching maximum threshold levels at the end of night 1. Arousal threshold was significantly positively correlated with response latency. Sleep stages (slow wave sleep (SWS), SWS + REM (SWSR), and total sleep time minus stage 1 sleep) were poor predictors of performance changes across the 2 disruption nights. The data were best explained by sleep continuity theory, which posits that a period of at least 10 min of uninterrupted sleep is required for restoration to take place. PMID- 3659734 TI - Sleep restoration as a function of periodic awakening, movement, or electroencephalographic change. AB - Eleven young adults had their sleep briefly disturbed following each 2 min of accumulated sleep for 2 consecutive nights in 3 different weeks. During 1 week the disturbance was a brief awakening followed by a subjective response. During another week subjects were required to make a quarter-body turn response. During the final week, the disturbance was an ongoing electroencephalographic (EEG) change. As expected, the three disturbance conditions differentially impacted sleep, with the most sleep disturbance seen in the awakening condition and the least disturbance seen in the EEG change condition. Morning vigilance performance and nap latency were decreased and fatigue was increased as compared with baseline following all three disturbance conditions. However, no significant condition interaction was found for any performance variable or for morning nap latency. For the mood scales, significant condition interactions indicated that subjects reported being sleepier only after the awakening condition. The data were interpreted as providing evidence that the restorative function of sleep is equally impaired by any periodic change in ongoing EEG and that impairment does not require a return to waking consciousness. However, mood, as a subjective rating, is dependent upon conscious events that occur during the sleep period. PMID- 3659735 TI - Human sleep patterns in Antarctica. AB - Eight volunteers wintering in a French coastal station in Antarctica underwent 156 polysomnographic night recordings. The subjects, selected for their usual good sleeping habits, were recorded on 17-21 nights throughout the wintering in sessions of 2 to 3 consecutive nights. A two-way analysis of variance showed that most of the subjects' sleep characteristics were not similar, leading the authors to study the individual time course of sleep variables. As the subjects slept in their own comfortable quarters, there was no "polar insomnia," no first night effect, nor any relationship between sleep pattern variations and climatic changes. In all subjects, delta sleep tended to increase throughout the wintering, whereas stages 1 and 2 decreased. No significant variation was seen in paradoxical sleep (PS), neither between subjects nor with time. PS latency was also within normal range, but it was bimodally distributed in subjects S1, S2, and S8. Some other sleep variables also varied in certain subjects. Such was the case for sleeping time, which decreased throughout the wintering period in subject S8, the least adapted individual. However, due to the limited number of subjects, no statistical attempt could be made to link individual differences in sleep patterns and adaptation to life in Antarctica. PMID- 3659736 TI - Slow wave sleep elevations after body heating: proximity to sleep and effects of aspirin. AB - On three different occasions, six healthy young adult subjects ahd their body temperatures raised by an average of 2.0 degrees C for 30 min while sitting in baths of warm water. This was done once at 1700 h and on two occasions at 2100 h, once after the subjects had taken aspirin and once after a placebo. Nighttime sleep was recorded after each experimental condition and for baseline nights following nil heating. Records were scored both visually and by an automated sleep stager. Electroencephalographic (EEG) power was computed over the night. Results from the automated scoring were very similar to those of the visual method. While the early bath caused no changes in sleep, the late bath + placebo resulted in significant rises in stage 4 sleep and slow wave sleep (SWS) and significant falls in sleep onset and in REM sleep. Aspirin mostly counteracted these effects and, in particular, left stage 4 sleep and SWS at baseline levels. EEG power was significantly increased only after the late bath plus placebo, supporting the SWS outcome. These findings were assessed in light of other comparable results from our laboratory. It seems that as the time of the day of heating recedes from nighttime sleep, a larger "dose" of heating is required to produce the same effect. PMID- 3659737 TI - Periodic leg movement, L-dopa, 5-hydroxytryptophan, and L-tryptophan. PMID- 3659738 TI - Failure of clonidine to ameliorate the symptoms of restless legs syndrome. PMID- 3659739 TI - [Significance of intravenous immunoglobulins to the neonate born of a mother with idiopathic thrombopenic purpura]. AB - High dose gammaglobulin therapy for pregnant women with idiopathic thrombocytopenic purpura may be suitable for both mother and foetus during pregnancy. A newborn with severe thrombocytopenia secondary to maternal illness, was treated successfully by intravenous gammaglobulin, without toxicity. In such a case, we believe the platelet count is not the only criterion for starting immunoglobulin therapy. PMID- 3659740 TI - [Leukocyte depletion of labile blood products]. PMID- 3659741 TI - [Geographic distribution of hematologic elements in Central African countries: distribution of the ABO blood group system]. AB - 1,559 people of various ethnical and geographical origin from the Central African Republic (CAR) have been tested for A, B, O group determination. Genic repartition is analysed, historic implications in human migrations are discussed. PMID- 3659742 TI - [Immunogenetics of DNA polymorphism]. PMID- 3659743 TI - [Designated blood donors: an illusion not to be maintained]. PMID- 3659744 TI - [Direct collection of information during blood donation in blood mobiles]. AB - Direct data storage, in the presence of the donor, ensures a realistic reliability and erases any deferred interpretation of the essential information for a good donation identification. Computers can help relieve this restraint. Indeed the evolution of microcomputers (increased capacity and power, decreased weight and volume, and good performance in any use makes them more and more accurate. Associated use of barcodes and microcomputers gives a nonmanual non human line of words: donor-donation-analysis-blood products-patient. We found, working that way, the following advantages: Information secured. No deferred inputs. Instart comparison of the information on the donor's past history. Accurate donation-donor connection. Such a system represents one more step towards a continuous line of treatment from Donor to Patient in regard of Blood Transfusion Safety. PMID- 3659745 TI - [Equity in health and health care]. PMID- 3659746 TI - [A disease called obesity]. PMID- 3659747 TI - [The family unit. The basis of the mother-child health education program]. PMID- 3659748 TI - [Nursing dealing with injuries in the newborn infant (1)]. PMID- 3659749 TI - [From the custodial to the therapeutic]. PMID- 3659750 TI - [Basic principles of sterilization (1)]. PMID- 3659751 TI - [Pre- and postoperative nutrition]. PMID- 3659752 TI - [Continuing education. 17. Subject: the behavioral sciences. Topic: the psychological aspects of becoming ill]. PMID- 3659753 TI - [White skins, red skins]. PMID- 3659754 TI - Into the 21st Century: a scenario for nursing. PMID- 3659755 TI - A look ahead: what the future holds for nursing. PMID- 3659756 TI - If you have to ask for an organ donation. PMID- 3659757 TI - Does that patient need extra vitamins? PMID- 3659759 TI - Getting i.v. patients ready to go home. PMID- 3659758 TI - How to teach do-it-yourself i.v. therapy. PMID- 3659760 TI - Why our head nurses have lost their touch. PMID- 3659761 TI - We give every nurse the schedule she wants. PMID- 3659762 TI - How we won our war with Mr. Goodman. PMID- 3659763 TI - Nursing income: experience begins to pay off. PMID- 3659764 TI - What new parents need to know about CPR. PMID- 3659765 TI - Heading off depression in the chronically ill. PMID- 3659767 TI - When an addicted nurse comes back to work. PMID- 3659766 TI - The when and how of isolation (continuing education credit). PMID- 3659768 TI - Helping the patient who has lupus. PMID- 3659769 TI - [Exposure of the Warsaw population to traffic noise. II]. PMID- 3659770 TI - [Lead and cadmium intake with daily meals by children aged 1-3 years]. PMID- 3659771 TI - [Laboratory evaluation of the nutritive value of average daily diets of selected population groups in Poland. VII. Selenium and chromium levels]. PMID- 3659773 TI - [Preparation and evaluation of foods made with modified seeds of beans and peas]. PMID- 3659772 TI - [Metals and organochlorine compounds in eels from the Gdansk Bay and adjacent waters. III. Eels from Puck Bay]. PMID- 3659774 TI - [Nitrates and nitrites in the saliva]. PMID- 3659775 TI - [Effect of the amount and quality of dietary proteins on the levels of free amino acids in selected tissues of experimental animals]. PMID- 3659776 TI - [Mutagenic effect of lead chloride in the presence of ethyl alcohol]. PMID- 3659777 TI - [Survival of Yersinia enterocolitica in water]. PMID- 3659778 TI - [Combined effects of vibration and temperature on the survival of Staphylococcus aureus in milk]. PMID- 3659779 TI - [Nematoda and their use in the control of insects of sanitary and medical significance and insects destructive to plant crops]. PMID- 3659780 TI - [Effectiveness of insect control preparations used in hospitals in relation to humidity and temperature]. PMID- 3659781 TI - [Sanitary conditions in elementary schools in Poland 1985]. PMID- 3659782 TI - [Scholastic progress and behavior of 14-year-old students with various degrees of sex maturation]. PMID- 3659783 TI - [Advanced pulmonary alveolar microlithiasis]. AB - A severe course of microlithiasis alveolaris pulmonum in a 28-year old patient is described. The disease, which had progressed to a very advanced stage at the time of examination, produced in the plain radiograph of the thorax an extensive, homogeneous, ground-glass like shadow of practically all organs of the thorax. The typical miliary (spot-like) shadow ("sandstorm lung") is visible only in the lateral and apical parts of the lung. CT revealed massive calcareous deposits which increased in craniocaudal and ventrodorsal direction. Bullous metaplasia of the lung was particularly striking in the apical region. No effective therapy is known so far. A combined heart and lung transplantation might be the only therapy that could prolong the patient's life. PMID- 3659784 TI - [MR imaging of the knee joint plain, following intra-articular administration of gadolinium DTPA, saline and air]. AB - Noninvasive MRI of the knee joint yields a great deal of information on soft parts (ligaments, capsule, free fluid, menisci, cartilage) and bones. The image is changed by intraarticular administration of air and of small quantities of fluids supply many signals, such as gadolinium DTPA solution. The results and possibilities of application are discussed. PMID- 3659785 TI - Beer as colon lavage preparation. AB - Six patients received beer preparation prior to double contrast barium enema. The beer group scored slightly better (though not statistically significantly) both in the cleanliness and in the mucosal coating of the bowel than the control group with standard preparation. The fluid balance was unaltered. The patients in the beer group felt surprisingly well, likely due to the good fluid and energy balance provided by the beer. The beer preparation could be used in cases, when the patients are ready to intake beer and want to maintain a good nutritional status. PMID- 3659786 TI - [Misinterpreted expansive process of the middle lobe of the lung caused by unnoticed aspiration of a tooth]. AB - In a patient of 78 years of age a diagnosis of a suspected expansive process of the middle lobe was made on the basis of the clinical findings and a plain radiography of the thorax. Fibre bronchoscopy revealed a subtotal stenosis of the middle lobe bronchus on the right side. The tissue sample revealed a chronically inflamed granulated tissue. Subsequent tomography of the hilus region in two planes showed a foreign body situated in the bronchus intermedius and extending into the middle lobe bronchus. Bronchoscopy was then repeated and an incisor tooth with two mental clamps was removed. A remarkable fact in this case was that the patient was unable to remember the aspiration incident, and it was also remarkable that the shape of the shadow that showed up in the middle lobe segment justified the suspicion of a tumour, although generally atelectasis or pneumonia show up on the x-ray film as sequels of an aspiration if an aspiration has taken place. PMID- 3659787 TI - [Fracture of the nasal bones and epistaxis]. PMID- 3659788 TI - [Fractures of the mandible]. PMID- 3659789 TI - [Fronto-orbital fractures]. PMID- 3659790 TI - [Soft tissue wounds of the face. Their cicatricial outcome]. PMID- 3659791 TI - [Facial injuries and plastic surgery]. PMID- 3659792 TI - [Non-hormonal methods of female contraception]. PMID- 3659793 TI - [Oral estroprogestational contraception in 1987 and its complications]. PMID- 3659794 TI - [Progestational contraception]. PMID- 3659795 TI - [Contragestion]. PMID- 3659797 TI - [Principles and evolution of progestational treatment methods of contraception]. PMID- 3659798 TI - [Evolution of the present place of surgery in therapy]. PMID- 3659796 TI - [Contraception at risk]. PMID- 3659799 TI - [Volvulus of the pelvic colon]. PMID- 3659800 TI - [Extra-uterine pregnancy today]. PMID- 3659801 TI - [Surgery of the adrenal glands]. PMID- 3659802 TI - [Benign tumors of the pancreas]. PMID- 3659803 TI - [Silent myocardial ischemia]. PMID- 3659804 TI - Leukemias and lymphomas--a common cellular basis? PMID- 3659805 TI - Study of the prognosis factors in liver cirrhosis. AB - In a prospective study carried out on a group of 1210 patients with liver cirrhosis (LC), the diagnosis was based on clinical, biological and histological criteria, as well as on the prognostic significance of 20 clinical, biochemical and histological parameters. The group, including 830 males (68.59%) and 380 females (31.41%), with an average age of 49.27 +/- 13.18 years, was studied during periods of 6 to 16 months, the initial investigations being periodically repeated. The statistical significance of the prognosis factors was studied by uni- and multivariative methods, according to the model of Cox, with the help of an IMB computer. The survival rate for the group studied ranged from 6 to 204 months, with an average period of survival of 38.29 months. The multivariative analysis demonstrated that the prognosis factor with a best correlation with the death power is ascites, which has additional predictive significance in association with encephalopathy and/or jaundice. The multivariative analysis selects as clinical factors of unfavourable prognosis the cholestasis, the hepatocytolytic syndrome, the syndrome of liver deficiency and the age over 50. The limits of the biochemical parameters with unfavourable significance were: bilirubinemia level greater than 3 mg%, ASAT/ALAT = 50.24/70.33 u.i., prothrombinemic index less than 50% and albuminemia greater than 3 g%. The multivariative method proved also superior in appreciating the interrelations of the prognostic factors, emphasizing the significance of the clinical parameters (ascites, encephalopathy, jaundice), while the multivariative analysis differentiated the biochemical prognosis factors (bilirubinemia, ASAT/ALAT, prothrombinemic index, albuminemia) and their level of significance. PMID- 3659806 TI - Biliary involvement in the evolution of gastric and duodenal ulcer. AB - The complex clinical, biological and radiologic study of 1000 patients with gastric ulcer (GU) and duodenal ulcer (DU) showed biliary involvement (BI) in 141 (14.10%) cases, more frequently in women (57.44%) in the 30 to 39 years age group (35.76%). With reference to the onset or the clinical form, the frequency of BI increases with the duration of the ulcer. After the development of biliary distress, the clinical picture changes rendering the diagnosis more difficult. Ulcer being the cause of BI by functional, inflammatory and adhesion factors, a pathogenetic treatment is obligate. PMID- 3659807 TI - Evaluation of pulmonary hypertension by echocardiographic right ventricular systolic time intervals. AB - Pulmonary valve echogram and right cardiac catheterization were simultaneously performed in 18 patients suffering from heart disease in whom pulmonary hypertension was suspected. Echocardiography was employed to measure right preejection period (RPEP), right ventricular ejection time (RVET) and RPEP/RVET ratio. Cardiac catheterization was used to determine pulmonary artery diastolic pressure (PADP), pulmonary artery systolic pressure (PASP), pulmonary artery mean pressure (PAMP) and right ventricular and diastolic pressure (RVDP). Each of these pressures was compared to each of the echo-date by means of regression analysis. The best correlation (r = 0.970; p less than 0.0005) was between PADP and RPEP/RVET ratio. We also found that RPEP/RVET ratio and RVET were each good predictors for the pulmonary artery pressures. PMID- 3659808 TI - Antiarrhythmic effects of verapamil given in sublingual way. AB - In order to eliminate the first pass through the liver where the drug is deactivated, 80 mgs verapamil was given in sublingual way in a) 10 patients with supraventricular tachycardias where in 7 instances sinus rhythm was obtained after 15-30 minutes, b) in 18 patients with atrial fibrillation and in 5 with atrial flutter with rapid ventricular rate, where a significant slowing down of ventricular rate was obtained after 20 minutes. The sublingual way of verapamil administration is a simple, effective and safe procedure in the treatment of tachyarrhythmias. PMID- 3659809 TI - High levels of plasma von Willebrand factor in hyperthyroidism. AB - Both von Willebrand factor antigen and activity tested as ristocetin cofactor, were found to be increased in the 20 patients with hyperthyroidism, while changes detected on the 10 hypothyroid patients did not significantly differ from the mean values recorded in 19 healthy control subjects. It is considered that the high levels of endothelia-derived plasma von Willebrand factor in hyperthyroidism is the result of a long-standing stimulation of vascular endothelial cells by either a direct effect of thyroid hormones or by an excessive adrenergic activity. The present findings represent an important limitation in interpreting raised levels of plasma von Willebrand factor as a marker of endothelial injury or in terms of a thrombotic tendency. PMID- 3659810 TI - [Simple calcergy: an experimental model for the study of heterotropic calcification in connective tissue]. PMID- 3659811 TI - Lasting effect of head down tilting on sympathetic tonus and blood pressure values in hypertensive subjects. PMID- 3659812 TI - Incidence of brain stem auditory evoked potential amplitude disorders in oto neurologic pathology. PMID- 3659813 TI - Aphasic symptoms and CT-determined cerebral lesions. PMID- 3659814 TI - Aspects of the relationship between depressive symptomatology and personality. PMID- 3659815 TI - Psychopathology in children aged 10-17 of bipolar parents: psychopathology rate and correlates of the severity of the psychopathology. PMID- 3659816 TI - Brief clinico-genetic report: the Coffin-Lowry syndrome. PMID- 3659817 TI - [The effect of indomethacin on the peripheral blood picture in laboratory rats irradiated with gamma rays]. PMID- 3659818 TI - [Radiation dosage in children during nuclear medicine examinations in Czechoslovakia]. PMID- 3659819 TI - [Incorporation of 125I-UdR into K2M polymorphocellular sarcoma in LEW/CUB rats- radiometry in situ and in vitro (1st report)]. PMID- 3659820 TI - Performance of direct equilibrium dialysis and analogue-type free thyroid hormone assays, and an immunoradiometric TSH method in patients with thyroid dysfunction. AB - Direct equilibrium dialysis and analogue-type radio-immunoassays for free triiodothyronine (FT3) and free thyroxine (FT4) in serum were compared in 168 subjects with various states of thyroid function. A good diagnostic efficacy for FT3 and FT4 by either type of assay was observed in hyperthyroidism. In hypothyroidism the free thyroid hormone assays, particularly the FT3 assays, performed diagnostically less well, partly because patients with mild disease were included in the study. No significant differences in the percentages of misclassifications of thyroid dysfunction patients by corresponding dialysis and analogue assays were found. We observed a good linear correlation between dialysis and analogue methods for FT3 (r = 0.98) and FT4 (r = 0.97) in this study comprising out-patients not suffering from severe non-thyroidal disease, known from earlier studies in this and other laboratories to interfere in these assays. It is concluded that analogue assays may be used on out-patients in whom severe systemic diseases are less frequent than in hospitalized patients. There are, however, other limitations to the use of analogue assays than systemic diseases. We observed two euthyroid patients with thyroxine auto-antibodies causing very high FT4 concentrations as determined by analogue assay; their dialysable FT4 concentrations were normal. We also tested a recently developed immunoradiometric serum TSH assay, which was found to perform well in primary hypo- and hyperthyroidism. Serum TSH was elevated in one patient hyperthyroid because of a TSH-producing pituitary adenoma, and within the reference limits in a patient with secondary hypothyroidism. PMID- 3659821 TI - Influence of epidural blockade on postoperative plasma fibronectin concentrations. AB - To investigate the influence of neurogenic and hormonal stimuli during and after surgery on plasma fibronectin levels, 16 females undergoing cholecystectomy were studied. Eight patients received general anaesthesia, and eight also received a thoracic epidural block with local anaesthetic, which was maintained for 24 h postoperatively. The epidural group had significantly lower plasma levels of adrenaline and cortisol than the general anaesthesia group in the postoperative period. The previously well-documented early decrease in plasma fibronectin concentration following surgery was observed, and was essentially parallel with that of albumin, pre-albumin and thyroid hormones, with no differences between the groups. However, the restoration of the fibronectin level was slower in the epidural group, with significantly lower values as compared with controls at 48 and 72 h after surgery (p less than 0.01-0.001). It was concluded that the post traumatic plasma fibronectin decrease is not mediated by neurogenic or adrenal stimuli. Such stimuli may, however, influence the subsequent restoration of the plasma fibronectin concentration. PMID- 3659822 TI - Platelet aggregation and intraplatelet adenine nucleotides in diabetic retinopathy. AB - Twenty non-diabetic controls, 50 diabetics without retinopathy and 29 diabetics with retinopathy, all well-matched age groups, were studied in males and females, respectively. Moreover, diabetic patients with retinopathy were divided into the following two subgroups: mild retinopathy and severe retinopathy. Platelet aggregation was elevated in the male diabetics with mild or severe retinopathy. There was no difference in platelet volume between the groups. Intraplatelet ADP contents were significantly decreased in the female diabetics with severe retinopathy showing no high platelet aggregability. There was no significant difference in intraplatelet ATP contents between groups. These results indicated not only that platelet aggregation might be generally high in the diabetics with retinopathy, but also that dense granule release might occur readily in vivo in the female diabetics with severe retinopathy and therefore platelet aggregation was not elevated in the group. PMID- 3659823 TI - Oxidation of leucine in human lymphocytes. AB - Appropriate conditions for analysis of leucine oxidation in peripheral human lymphocytes were determined. Lymphocytes, isolated by Ficoll centrifugation, were washed in phosphate-buffered saline without additions, with 5 mmol/l ADP or with 5 mmol/l ADP plus 25 mmol/l NaF for determination of transaminase activity, and total and basal activity of branched chain keto acid dehydrogenase (BCKA-D), respectively. Cells were incubated for 20-60 min with [1-14C]-leucine, or [1-14C] alpha-ketoisocaproic acid (KIC) in the presence of various concentrations of the respective unlabelled substrates. Pyridoxal phosphate (0.1 mmol/l) augmented transaminase activity, coenzyme A, NAD and thiaminepyrophosphate (0.5 mmol/l each) enhanced BCKA-D activity. Apparent Km values for transamination and for BCKA-D were 40 and 17 microM, respectively. Total capacity for leucine transamination was about five times greater than for oxidation of KIC. The mean activity state of BCKA-D was 30%. Oxidation of KIC declined when 5.6 mmol/l glucose was added to the medium. It is concluded that: (1) BCKA-D is rate limiting for leucine catabolism in peripheral human lymphocytes, (2) the BCKA-D complex is normally only partially active, and (3) flux of leucine through BCKA-D is inhibited by physiological glucose concentrations. PMID- 3659824 TI - Determination of cardiac output by first passage radiocardiography: theoretical considerations and phantom studies. AB - Non-invasive determination of cardiac output by aid of precordial first passage radiocardiography may prove a useful tool in the management of cardiac disorders. The basic concepts of a method together with theoretical assumptions necessary for the clinical application of the method are described. The principle of the technique was tested in a cardiac phantom model with adjustable stroke volume and heart rate, in which background problems were avoided. First passage radiocardiography gave highly accurate cardiac output determinations compared with the 'true' phantom values, r = 0.998 (p less than 0.001). PMID- 3659825 TI - Primary sclerosing cholangitis. PMID- 3659826 TI - Metabolism of estrone sulfate by normal human pancreatic tissue in vitro. AB - Homogenates of normal pancreatic tissue obtained from five female and nine male subjects transformed (3H)estrone sulfate into (3H)estrone and (3H)estradiol-17 beta in vitro. No other unconjugated (3H)metabolites were found. The rates of transformation were comparable to those previously demonstrated in mammary carcinoma and greatly exceeded those found in endocrinologically unrelated pectoralis and abdominal muscle. The results may provide additional indications for a possible association between estrogens and pancreatic function. PMID- 3659827 TI - Chronic gastritis in cholecystectomized patients. AB - Duodenogastric reflux is considered to be a possible cause of chronic gastritis. This reflux, however, is reported to be common after cholecystectomy. In the present investigation we have studied the possible relation between chronic gastritis and prior cholecystectomy in 106 symptomatic outpatients with prior cholecystectomy and in 131 controls without cholecystectomy. We surveyed their endoscopic biopsy specimens from antral, body, and esophageal mucosa. We found that the mean score and prevalence of chronic antral and body gastritis in cholecystectomized patients was the same as or slightly lower than that in controls. The mean progression of gastritis, when compared with the progression of gastritis in the general population, was slightly slower than expected in the cholecystectomized patients. This slow progression was seen in body gastritis in cholecystectomized patients with a coexisting esophagitis. We conclude that there is no positive correlation between chronic gastritis and prior cholecystectomy. In contrast, this correlation may be negative, especially in patients with esophagitis, in whom an association of the postcholecystectomy state and a possible duodenogastric reflux with normal, nongastritic and nonatrophic body mucosa may facilitate mechanisms favoring the pathogenesis of esophagitis. PMID- 3659828 TI - Primary sclerosing cholangitis: a long-term follow-up study. AB - During the 10-year period from 1 January 1975 to 31 December 1984, primary sclerosing cholangitis (PSC) was diagnosed in 45 patients. Twelve of the patients have died (26.7%), 10 of them of causes related to PSC. Inflammatory bowel disease was found in all patients; ulcerative colitis was found in 37, Crohn's disease in 6, and unclassified colitis in 2 patients. Of the patients alive, 27 were submitted to a follow-up study in 1985. At the follow-up examination no general progression of the liver disease, as measured on the basis of clinical examination and levels of transaminases, alkaline phosphatases, and bilirubin, was found. Cholangiographic evaluation in 24 patients showed that the stage of ductal changes progressed from mild to moderate in 3 patients; in the other patients the stage was not altered. Morphologic examination of liver biopsy specimens in patients with a benign clinical course usually showed portal inflammation, fibrosis, and minor signs of piecemeal necrosis, whereas widespread piecemeal necrosis was found in patients who deteriorated and died. The 50% survival since diagnosis of liver disease was calculated to be 17 years in patients with PSC and 50 years in a comparable group among the general population. The estimated survival curve in PSC was displaced to the left, indicating a reduced life expectancy of about 30 years. PMID- 3659829 TI - Short-chain fatty acids and succinate in feces of healthy human volunteers and their correlation with anaerobe cultural counts. AB - Short-chain fatty acids (SCFA) and succinate in fresh feces from 10 healthy human volunteers were detected with gas-liquid chromatography and were correlated with their fecal cultural counts. The SCFA content of feces did not change significantly after freezing, but the cultural counts of total anaerobes and bifidobacteria showed significant changes (0.001 less than P less than 0.01). A significant negative correlation (r = -0.78; 0.01 less than P less than 0.02) was found between the bifidobacteria cultural counts and the succinic acid concentration in fresh feces, which disappeared after freezing of the samples. Because of the significant differences in cultural counts and the shift in significant correlations after freezing, it is important to use fresh fecal samples for these correlation studies. Lactic acid and i-caproic acid were not found in the fecal samples. The results show that SCFA and organic acid concentrations cannot replace (an)aerobe cultural counts in fecal flora studies of healthy human volunteers because of the low rate of significant correlations between these two. PMID- 3659830 TI - Initial mass screening for colorectal cancer with fecal occult blood test. A prospective randomized study at Funen in Denmark. AB - A Danish study allocated at random 30,970 persons to screening with Hemoccult-II and 30,968 as controls in a population of 140,000 between 45 and 74 years old. Persons with known colorectal cancer, adenoma, and distant spread from all types of cancer were excluded. The test was completed in 20,672 persons from August 1985 to September 1986, and 215 (1%) were found to be positive. Colonoscopy in 203 and double-contrast barium enema in 6 detected 37 persons with cancer and 86 with adenomas. Dukes A cancer was detected in 19 in the screening group, in contrast to 2 among controls. Synchronous adenomas were found in 23 with a positive test and 10 controls. Interval cancer was found in nine persons within 1 11 months after a negative test. Eighteen persons got cancer before invitation and six defectors as well. In all, colorectal cancer was detected in 70 persons in the screening group and in 38 controls; the figures for adenomas alone were 103 and 38, respectively. The study is designed to detect a possible reduction in mortality from colorectal cancer of 25% within 5 years after three screenings with intervals of 2 years. The second screening will begin in September 1987. It remains to be shown whether a reduction may be obtained both in mortality and in incidence of colorectal cancer. PMID- 3659831 TI - Cholecystokinin secretion in pregnancy. AB - The gallbladder volume is increased in pregnancy, and its contraction during a meal is impaired. This is of importance for the increased risk of gallstones in pregnancy, since it may cause retention of cholesterol crystals in the gallbladder lumen. Cholecystokinin (CCK) is responsible for the food-induced gallbladder contraction. We have consequently measured the plasma concentrations of CCK in the fasting and the stimulated state in pregnant women and in age matched non-pregnant controls. In a subset of pregnant women and controls the gallbladder volume was measured with ultrasound. The results show that whereas basal CCK concentrations were normal, the response to an oral preparation that contracts the gallbladder was increased in pregnancy. Moreover, the secretion of CCK correlated well with gallbladder emptying. We conclude that the behaviour of the gallbladder in pregnancy is not due to impaired secretion of CCK. PMID- 3659832 TI - Fecal bile acids related to small-bowel length before and after ileal exclusion. AB - We studied the relationship among the small-bowel length, the fecal excretion of bile acids and neutral steroids, and cholesterol synthesis in 16 patients with familial hypercholesterolemia before and 1 month after the ileal bypass operation. The mean small-bowel length measured during the operation was 6.3 +/- 0.3 (SEM) m before and 4.3 +/- 0.2 m after the bypass of the distal third of the small bowel. The preoperative fecal bile acid excretion was negatively correlated (r = 0.63, p less than 0.01) with the small-bowel length, whereas this correlation was insignificant for fecal neutral steroid excretion and cholesterol synthesis. Postoperative amounts of fecal bile acids and neutral steroids and cholesterol synthesis were negatively correlated with the length of the small bowel remaining in function (r = -0.52, -0.51, and -0.62, respectively). Our study suggests that fecal bile acid excretion and, hence, bile acid synthesis are related to the small-bowel length even under physiologic conditions. PMID- 3659833 TI - Paracetamol medication and alcohol abuse: a dangerous combination for the liver and the kidney. AB - The clinical pattern of paracetamol-induced acute liver damage was studied with regard to whether the intoxication was acute or due to continuous use. This condition was found to be caused almost as often by accidental chronic medication as by acute intoxication, with annual incidences per 100,000 of 0.8 and 1.2 cases, respectively. The liver damage found in 18% of the cases of acute intoxication was generally mild, probably due to an early antidote treatment. In contrast, in the chronic intoxicated cases the liver damage was more pronounced and often accompanied by a severe renal dysfunction. Since all these patients were alcohol abusers, and the reported paracetamol intake was not remarkably high, it seems reasonable to recommend that paracetamol should be prescribed with great caution to alcoholics, and absolutely not for continuous use. PMID- 3659834 TI - Symptoms and endoscopic findings in the diagnosis of gastroesophageal reflux disease. AB - Two hundred and twenty patients with symptoms suggestive of pathologic gastroesophageal reflux were investigated to elucidate the ability of symptoms and endoscopic findings in establishing a diagnosis of reflux disease as measured by ambulatory 24-h pH-monitoring. Daily occurrence of heartburn or acid regurgitation had positive predictive values of 59% and 66%, respectively. pH monitoring showed pathologic reflux in 75% of patients with esophageal mucosal erosions. Endoscopic erythema of the distal esophagus predicted reflux disease in only 53%. Symptom registration during ambulatory 24-h pH-monitoring showed that about half of the symptomatic events reported by patients with pathologic reflux occurred within 5 min of a reflux episode. The corresponding figure for patients with normal pH-monitoring was less than 20%. We conclude that it is difficult to establish a diagnosis of gastroesophageal reflux disease by patient history alone, that erythema at endoscopy correlates poorly with pathologic reflux, and that reflux disease may be present even with normal endoscopy findings. PMID- 3659835 TI - Esophageal collagen content and mechanical strength after endoscopic sclerotherapy of esophageal varices. An experimental study in rabbits. AB - Twenty-five rabbits with esophageal varices were randomized to no treatment (n = 10) or endoscopic paravenous sclerotherapy of the varices (n = 15). Five other rabbits served as sham-operated controls. When they were killed, the mechanical strength and collagen content of the esophagus were determined at proximal, middle, and distal levels. The esophagus was examined histologically at proximal and distal levels. Animals treated by sclerotherapy showed histologic edema and inflammation of the esophageal wall after 2 days. This was not accompanied by any decrease in collagen content or mechanical strength. Ten days after sclerotherapy a slight but non-significant increase in collagen content and mechanical strength at middle and distal levels was observed. After 30 days the increase in collagen content at middle and distal levels was significant, and the mechanical strength was significantly increased at the middle level. PMID- 3659836 TI - Flow cytometric DNA studies in normal human gastric mucosa, gastritis, and resected stomachs. AB - Flow cytometric measurements of cellular DNA have been performed on biopsy specimens obtained by gastroscopy in patients with normal gastric mucosa (controls), superficial and atrophic gastritis, and resected stomachs. Aneuploidy was found in two biopsy specimens from a patient with superficial gastritis and in one specimen from a resected stomach. The fractional number of cells with a DNA content corresponding to the DNA synthetic and (G2 + M) phases of the cell cycle was defined as the 'proliferative index' (PI). No difference between the antral and body part of the stomach was found for the PI in controls or between controls and superficial and atrophic gastritis. PI was weakly but significantly correlated to a selection of mucosal enzymes. In resected stomachs increased PI was found when compared with that in the body part of the stomach in controls (p less than 0.01). Biopsy specimens with intestinal metaplasia (p less than 0.01) or atrophy (p less than 0.05) in the resected stomach showed significantly higher PI when compared with specimens with such findings from the body part of the stomach in atrophic gastritis. PMID- 3659837 TI - Interdigestive motility pattern in subjects with duodenogastric bile reflux. AB - The role of antroduodenal motility in the pathogenesis of duodenogastric biliary reflux is widely accepted, but few and conflicting data are available on the possible motor abnormalities related to this phenomenon in the fed and in the fasting state. In an attempt to define the motility pattern of the antroduodenal region associated with bile reflux in the fasting state, 20 subjects with proven duodenogastric reflux and without disorders of the upper gastrointestinal tract have been studied, and the results have been compared with those observed in 6 control subjects without evidence of reflux. The interdigestive motility complex (IDMC) has been evaluated (mean duration of IDMC and frequency and site of onset of migrating motor complexes). In subjects with duodenogastric reflux a significant increase (p less than 0.01) in the mean duration of IDMCs (179 +/- 22.19 min) was observed, in comparison with controls (108.5 +/- 37 min). A considerable reduction in the frequency of migrating motor complexes (MMC) was also observed, while no differences in the site of onset and the propagation of MMCs and in the percentage of time recorded occupied by the single phases of IDMC were found. This evidence suggests a strict relationship between duodenogastric reflux and the occurrence of phase III of IDMC and supports the hypothesis that the IDMC abnormalities are the cause and not the consequence of biliary reflux. The reduced incidence of MMC may also account for the high incidence of chronic gastritis due to prolonged contact in the fasting state between the gastric mucosa and the duodenal content. PMID- 3659838 TI - Secretory state and acute gastric mucosal injury in sepsis. AB - Cats were subjected to a standardized 3-h septicemia by intravenous infusion of live Escherichia coli in an LD50 dose. The effect of pentagastrin stimulation on the development of gastric mucosal injury was studied. There was no hemodynamic difference between the series during septicemia. Thus, pentagastrin did not induce increased gastric blood flow during the period of E. coli infusion. Intraluminal gastric pH was lower in the series given pentagastrin during the last 2 h of septicemia. Nevertheless, the extent of gastric mucosal injury was similar in the two groups, whereas the depth of injury was, if anything, less pronounced in the pentagastrin-stimulated group. PMID- 3659839 TI - Human IgD and IgA1 compete for D-galactose-related binding sites on the lectin jacalin. AB - Lectin selectivity for human Ig classes is based on carbohydrate differences. Earlier reports that the lectin jacalin precipitated human IgA were confirmed and supplemented by the current study, which demonstrates that jacalin also binds human IgD as evaluated by micro-ELISA and SDS-PAGE. Experimental findings indicated that: (i) Monoclonal and polyclonal (sera) IgD, IgA1, but not IgA2, IgM, or IgG1-4 reacted with jacalin. (ii) Six tested monoclonal IgD proteins each bound approximately equally to jacalin when antigenicity rather than protein concentration was measured: the results weigh against the presence of jacalin detectable IgD subclasses or genetic variants. (iii) IgD and IgA1 both associated maximally in 4-8 h at 4 degrees C. There was no dissociation at 4 degrees C but limited dissociation occurred at 37 degrees C after 24 h. (iv) Both IgD and IgA1 were eluted from jacalin by galactose-related sugars. (v) IgD and IgA1 bind competitively to jacalin. The results suggested that jacalin reacts with O-linked oligosaccharide N-acetyl-galactosamine (GalN) residues found on the hinge region of both IgD and IgA1. Jacalin also interacted with one major and several minor unidentified sera proteins. The findings offer an approach to the isolation of serum polyclonal IgD and to the characterization of the unusual carbohydrates of the human delta heavy chain with respect to their function. PMID- 3659840 TI - The extracellular portion of HLA-DR alpha chain is composed of two compactly folded domains. AB - A truncated form of the class II antigen DR alpha chain of the human major histocompatibility complex was produced in bacteria. A cDNA clone encoding the intact chain was modified so that the segment encoding the signal sequence was replaced by an ATG codon and the 3' region downstream to the part corresponding to the third exon was replaced by a stop codon. The new construct was put under the control of the Tac promoter in a bacterial expression vector. The distance between the Shine-Delgarno sequence and the initiation codon was randomized so that clones with optimal expression of the truncated DR alpha chain could be obtained after induced expression and immunoscreening. The truncated DR alpha chain was subjected to limited proteolysis with chymotrypsin, and the resulting cleavage products were analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Two fragments were visualized by western blotting. Electrophoresis in the absence and presence of reducing agents suggested that one of the proteolytic fragments contained a disulphide bridge. It is concluded that the extracellular portion of the DR alpha chain is composed of two compactly folded domains connected by an extended stretch of the polypeptide chain. PMID- 3659841 TI - [Heavy metals in the environment. Environmental hygiene and health aspects]. PMID- 3659842 TI - [Results of field studies on the heavy metal burden of the population from industrial sources]. PMID- 3659843 TI - [Field studies of lead in the area around an accumulator factory]. PMID- 3659844 TI - [Cadmium burden of the population of West Germany]. PMID- 3659845 TI - [Ability of the neurotoxic effects of lead to regress]. PMID- 3659846 TI - [Blood cadmium levels in mother and child]. PMID- 3659847 TI - [Heavy metal emissions--deposits, suspended dust, particle sizes, trends]. PMID- 3659848 TI - [Heavy metal emissions]. PMID- 3659849 TI - [Heavy metals in foods]. PMID- 3659850 TI - [Assessment of the heavy metal content of soil and clarifying sludge]. PMID- 3659852 TI - [The cycle of heavy metals]. PMID- 3659851 TI - [Lead in drinking water and its remedies]. PMID- 3659853 TI - [Metal radioisotopes in the environment]. PMID- 3659854 TI - Occupation and risk of cancer in Denmark. An analysis of 93,810 cancer cases, 1970-1979. PMID- 3659855 TI - Enamel structure in odontocete whales. AB - With regard to the enamel structure of mammals, a large number of studies have been reported in the past. Of them, however, the enamel structure of odontocetes has not yet been sufficiently elucidated. The author therefore observed the enamel structure of 11 species in 7 families of living odontocetes. A clear prism structure in the enamel is noted in delphinids and Pontoporia blainvillei. Neophocaena phocaenoides has a very simple-structured prism, but even this structure is obvious only in the deep layer of the enamel, disappearing gradually from the mid layer to surface layer. The prism pattern of delphinids differs significantly depending on the site of the enamel; that of Pontoporia shows as a whole pattern 1. On the other hand, the enamel of Physeter catodon, Berardius bairdi, Phocoena phocoena, Phocoenoides dalli and Delphinapterus leucus is prismless. The enamel of Physeter and Phocoena shows pseudoprisms; that of Phocoenoides contains enamel tubuli. The enamel of Berardius and Delphinapterus is 3 to 8 micron thick, which is extremely thin for mammalian enamel. No enamel was noted in Monodon monoceros teeth. The enamel structure of living odontocetes is thus very variable. Several characteristic structures having been present during the evolutionary course of this tissue are still present in some of them. As the results of comparative histologic study, it is considered that the variable enamel structure of living odontocetes is a secondary phenomenon produced during the degenerative history of the enamel. PMID- 3659856 TI - Scanning electron microscope studies on the breakdown of passivity of a nickel chromium-molybdenum dental alloy. AB - The breakdown of passivity and localized corrosion of a Ni-20Cr-10Mo alloy was investigated. The methods employed were potentiodynamic polarization and SEM, and AES and EDX after potentiostatic polarization over a period of 20 hours in the passive and transpassive regions. The 1 micron finished as-cast specimens were polarized in aerated 0.1 M NaCl. The cyclic polarization curves revealed a critical pitting potential of 470 mV (SCE), while the protection potential was 300 mV (SCE). Using the potentiostatic polarization technique, nearly constant corrosion currents appeared, indicating that the whole surface was corroded uniformly. SEM pictures of samples, corroded at 650 mV, showed little pits under the oxide layer and a thinning down of the outer oxide layer. This lead to the opinion that the penetration as well as the adsorption mechanism determine the breakdown of passivity. EDX analysis and AES depth profiles showed an enrichment of Cr and Mo in the oxide. In contrast to oxidized samples, no second layer of Ni was found in the outer oxide region. In the transpassive region the relative amount of Cr and Mo in the oxide layer was higher than the one found in corresponding samples polarized in the passive region. The oxide thickness found was about 5 nm in the passive region (300 mV SCE) and about 250 nm in the transpassive region (650 mV SCE). PMID- 3659857 TI - Ultrastructural analysis of enamel formation during in vitro development using chemically-defined medium. AB - To test the hypothesis that enamel biomineralization is regulated by sequential expression of an intrinsic genetic program, we designed experiments to determine if a serumless, chemically-defined medium is permissive for position-dependent ameloblast differentiation and subsequent enamel tissue-specific biomineralization in vitro. In the absence of serum or other exogenous growth factors, Swiss Webster strain mouse embryonic (15- and 16-days gestation) mandibular first molar tooth organs (cap stage) developed within 21 days in vitro into well-defined molar tooth organs expressing dentine and enamel biomineralization. Analysis of data obtained from von Kossa histochemistry for calcium salt formation, as well as ultrastructural information obtained from x ray microanalysis, electron diffraction, transmission electron microscopy and scanning electron microscopy documented tissue-specific patterns of calcium hydroxyapatite formation in the absence of serum within organotypic cultures in vitro. An as yet unknown intrinsic genetic program regulates enamel formation in vitro. PMID- 3659858 TI - Tooth eruption: the regulation of a localized, bilaterally symmetrical metabolic event in alveolar bone. AB - Tooth eruption is a complicated process by which developing teeth are moved within the jaws to their functional position. The usual model chosen to study this process, the erupted rodent incisor, differs both structurally and functionally from the human dentition and conclusions drawn from these studies are not directly applicable to tooth eruption in human beings. We have studied the eruption of developing permanent premolars in dogs and present evidence by scanning electron microscopy for regional differences in metabolic activities on bone surfaces of the crypt during eruption. We review evidence that these polarization of alveolar bone metabolism are cell-mediated, dependent upon the dental follicle, independent of root formation or the tooth itself and that tooth eruption depends on coordination of these activities by the dental follicle. We conclude that tooth eruption is a localized, bilaterally symmetrical event in alveolar bone and that this is an excellent model system in which to study the regulation of alveolar bone metabolism. PMID- 3659859 TI - Interpretation of electron micrographs. AB - Courses in electron microscopical techniques should include training in the active reading of electron micrographs. The student should be made aware of the fact that every micrograph contains a wealth of information, evident and hidden, and that a careful inspection is required to retrieve the information. More time should normally be spent in scrutinizing the micrograph than in its manufacture. Active reading of the micrograph is aided by a curiosity in the functional significance of the various details of the picture; there has to be a dialogue between the mind and the eye concerning the structural elements and their significance. The investigator also has to be critical with respect to the possibility of technical flaws and should further be on guard against "seeing" such patterns that others may have seen and have described but which actually do not exist in the micrograph. Among examples given for an analysis in this paper are flaws in the metal shadowing technique and in ultrathin sections that have undergone deformation. PMID- 3659860 TI - The effects of hypoxia on sensory cells of the cochlea in chinchilla. AB - The effects of hypoxia on the sensory epithelium of the cochlea were investigated in the chinchilla. Systemic hypoxia was produced by increasing the dead space of the respiratory tidal volume. A disarrangement of hair-cell stereocilia, and cytoplasmic protrusions from sensory cells are the main findings in cochleas from hypoxic animals; these changes take place firstly at the inner hair-cells then, with the increase in degree of hypoxia, at the outer hair-cells. These degenerative changes of sensory cells correlate well with both respiratory suppression and with the elevation of auditory threshold to click stimulation as monitored using the compound action potential recording from the cochlear nerve. The latter measure appears to be a useful indicator of cochlear hypoxia. Our morphological findings are similar to other studies including those which have reported on post-mortem cochlear hair-cell degeneration. Our studies indicate the deleterious effects of long term hypoxia on cochlear mechanisms and point to the need for careful monitoring of cardiovascular and respiratory functions in animals under anaesthesia for physiological studies of the auditory system. PMID- 3659861 TI - Sperm nuclear zinc, chromatin stability, and male fertility. AB - Zinc excreted from the human prostate secures a high content of zinc in the sperm nucleus and contributes to the stability of the quaternary structure of the chromatin. After ejaculation, in vitro, a second type of stability, most probably involving disulfide-bridge crosslinks, supersedes the zinc-dependent stability. Normally, the nucleus of the ejaculated spermatozoon remains stable, i.e., it does not decondense when exposed to a detergent (e.g., sodium dodecyl sulfate - SDS), whereas a spermatozoon which has been exposed to a zinc-chelating medium becomes destabilized and decondenses in SDS. Spontaneous decondensation in SDS, i.e., without prior treatment with zinc-chelators, occurs among many spermatozoa from some infertile men, especially men with impaired secretory function of the prostate. This indicates that spontaneously decondensing spermatozoa have an inadequate content of zinc at ejaculation. Here, zinc in the sperm nucleus and chromatin stability was studied in semen samples from a group of men living in marriages with hitherto unexplained cause for infertility, and a group of fertile donors, who participated in an insemination program. Sperm nuclear zinc was studied with X-ray microanalysis and chromatin stability was assessed as percentage spermatozoa with stable sperm heads after exposure to SDS. Fertile donors had higher content of zinc in the sperm nuclei and had also higher proportions spermatozoa with a stabilized chromatin, than had the men living in infertile marriages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659862 TI - Anatomical basis of sperm-storage in the avian oviduct. AB - The anatomical basis of oviductal sperm-storage in the avian oviduct is the sperm storage tubule (SST). In the turkey this is composed of a simple columnar epithelium characterized by a supranuclear vacuole, which possibly contains lipid material, and appears to differentiate from the oviductal surface epithelium prior to full sexual maturation. Turkey SST epithelium was periodic-acid Schiff negative and failed to bind four of the five lectins examined. Only winged pea agglutinin, which has an affinity for fucose-containing glycosidic residues, bound to some individual SST epithelial cells. Short-term cultures of oviductal mucosae containing SST showed aggregates of sperm associated with the spaces between adjacent folds and in surface openings assumed to be SST. PMID- 3659863 TI - Cell polarity and water transport in thyroid epithelial cells in separated follicles in suspension culture. AB - Separated thyroid follicles maintained in suspension culture can be used to study the properties of thyroid epithelium in the virtual absence of other cell types and to study the effect of extracellular materials on the follicles. They can be prepared by enzymatic separation of thyroid into single cells followed by reaggregation of the epithelial cells and also by collagenase treatment of thyroids to release follicles and sheets of epithelia that can be separated from other materials by differential filtration. The follicles can exist with normal orientation or inverted (inside out). The follicles are inverted in the presence of high serum concentrations (5%) but can have normal orientation when embedded in a type I collagen gel, even at high serum concentrations. When normally oriented follicles invert, the polarity of the epithelial cells reverses while they are connected to neighbors. During inversion, bipolar cells are observed having microvilli-bearing surfaces at both lumen and medium. Inverted follicles can revert to normal orientation when embedded in collagen gel. Various functional properties of normally oriented follicles are similar to those of follicles in vitro. However, inverted follicles do not concentrate iodide, although they synthesize thyroglobulin and secrete it into the medium. Mutants are available in established cell lines. They have functional and organizational properties that differ from those of normal cells and demonstrate a lack of coupling between functional properties and organization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659864 TI - Identification of non-denuding endothelial injury by scanning electron microscopy. AB - Endothelial injury is important in the development of arterial disease. To examine the response to endothelial injury it is necessary to recognise if endothelium has been altered and how this relates to normal function. Of the several methods available to evaluate endothelial integrity, ultrastructural examination has certain advantages. In particular, scanning electron microscopy of the endothelium will permit large areas to be examined, and changes can be related to the overall anatomy of the vessel. There is good evidence that endothelial injury does not inevitably result in endothelial cell loss and denudation of the subendothelium, but that endothelial cells can be desquamated in a process of non-denuding injury. The morphological changes described in endothelial cells stimulated by a variety of agents suggest that the response varies according to the method of investigation, that there are some common features, but that each stimulus induces certain specific changes. The endothelial response to a range of agents was therefore examined in the same animal model, using carefully controlled preparation parameters. The observations indicate that the response to stimuli which induce an inflammatory type of reaction is characterised by fibrin formation and white cell adhesion. In contrast stimuli which result in vessel collapse show protruding cells and damage at vessel orifices. Certain features are seen irrespective of the stimulus. The significance of many of the observed changes remains to be elucidated. PMID- 3659865 TI - Scanning electron microscopy of vascular corrosion casts in comparative studies on renal vascular structure. AB - In comparative microcorrosion casting studies on renal vascular systems the following demands should be met: The preparation procedure (anaesthesia, operation, flushing of the blood vascular system, ...) should be in accord with the specific physiological properties of the animal under investigation and the casting procedure (injection, curing, maceration, ...) should be kept constant as far as possible. If these points are considered, comparative data, even of quantitative nature, can be obtained from corrosion casts. Examples of results at the organ, single vessel and intercellular level as well as correlation of the results with physiological data are given. PMID- 3659866 TI - Endotoxin: a twofold effect on bone marrow ultrastructure. AB - Ultrastructural studies of mouse bone marrow reveal that reduction of the marrow blood barrier precedes the two waves of leukocytosis which follow endotoxin administration. These ultrastructural changes include a decrease in adventitial cover of the marrow sinus wall, an increase in sinus circumference, and a decrease in endothelial cell overlap. The marrow-blood barrier changes which precede the first wave of leukocytosis are transient and are associated with depletion of marrow granulocytes. The changes that precede the second wave of leukocytosis 5 to 6 days later are more sustained and are associated with marked granulocyte hyperplasia. We suggest that endotoxin has two effects on marrow ultrastructure: (1) an early, direct effect on the sinus wall and (2) a later, indirect effect associated with granulocyte proliferation. The late effect may be mediated through endotoxin induced release of colony stimulating factor. Both effects diminish the normal marrow-blood barrier and appear to facilitate cell release from the marrow. PMID- 3659867 TI - Adherent platelets and surface microthrombi of the human aorta and left coronary artery: a scanning electron microscopy feasibility study. AB - As part of a feasibility phase of an investigator-initiated multicenter NIH supported study on the Pathobiological Determinants of Atherosclerosis in Youth (PDAY), we report observations on microthrombi and adherent platelets on the intima of the aorta and left anterior descending coronary artery. The long-term objective of this cooperative study is to define more precisely the pathogenesis of atherosclerosis during late childhood and early adulthood and to investigate the influence of selected risk factors known to be associated with clinically manifest disease in later life. Scanning electron microscopy (SEM) was utilized to survey broad areas of arterial intima. Of 109 specimens studied from 52 cases, microthrombi composed of a mixture of aggregated platelets and fibrin and measuring approximately 30-70 micron in size were observed in about 4% [corrected] of the specimens and in about 6% of the cases, while individually adherent platelets were observed in approximately 7% of the specimens and about 10% of the cases. Microthrombi and adherent platelets may be important in atherogenesis by stimulating proliferation of intimal smooth muscle cells through the release of a growth factor from platelets. This feasibility study has shown that SEM is a rapid and effective method for surveying large areas of arterial intima for the study of adherent platelets and microthrombi. PMID- 3659868 TI - Early cardiogenesis in the newt embryo. AB - The migration of cardiogenic cells and the formation of a tubular heart in newt embryos were examined mainly by scanning electron microscopy (SEM). Cardiogenic cells are known to localize at the border region of lateral mesoderm migrating in the space between the ectoderm and the endoderm. They initially (before stage 20 or mid-neurula) appeared to attach to the basal surface of the ectoderm, whereas later (after stage 22 or late neurula) they changed their scaffold to the endoderm. On the scaffold cell surface, very fine fibrils of extracellular matrix (ECM) were found. These fibrils were proved to be composed partly of fibronectin by the immunofluorescence method as well as by immunoSEM using latex bead-labeled antibody, suggesting their seemingly important role in migration of cardiogenic cells. At stage 26 or the early tail bud stage, when the tips of bilateral cardiogenic areas begin to fuse under the foregut, several free vasoformative cells are seen there and the mesodermal sheet itself splits into two layers to produce a coelomic cavity. The splanchnic wall of the coelomic or pericardial cavity was recognized to form a though consisting of cobblestone-like myocardial cells not yet covered with the epicardium. PMID- 3659869 TI - Myogenesis in vitro as seen with the scanning electron microscope. AB - In this paper, we review our recent observations by scanning electron microscopy (SEM) on the differentiation of the cell surface and cytoplasmic organelles in embryonic chick skeletal muscle cells in vitro. The changes of the surface structures of myoblasts during mitosis were essentially similar to those of other cell types, but the characteristic spindle shape of myoblasts did not change throughout most of this period. Cytoskeletal structures under the sarcolemma were examined by Triton extraction and metal coating. Cells in S, G2 and M possessed a dense, and those in G1 a loose filament network under the membrane. Myotubes possessed a dense network under the sarcolemma. In the fusion area between a myoblast and a myotube, the cytoskeletal domain of the former could be distinguished from the latter because of the mosaic appearance of the subsarcolemmal cytoskeletal network. This network was composed predominantly of 10-13 nm filaments; they were identified as actin filaments because of their decoration with myosin subfragment-1. Triton treatment and thiocarbohydrazide osmium staining allowed us to visualize myofibrils. They ran in the direction of inferred stress lines brought about by elongation and adhesion of the cells to substrate. Intracellular membranous organelles could be seen by the freeze polishing and osmium-maceration procedure. Mitochondria exhibited complex irregular branchings. T system tubules ran a tortuous course. Sarcoplasmic reticula with occasional dilatations were connected to each other. The results are of sufficient promise to encourage more extensive analysis of myogenesis by SEM. PMID- 3659870 TI - Surface studies of calcium oxalate dihydrate single crystals during dissolution in the presence of urine. AB - Single crystals of Calcium Oxalate Dihydrate (COD) were grown from solution under controlled release of the reacting ions. Dissolution of COD was studied at different pH levels and in different dilutions of urine. The descriptors of the contour were determined during dissolution of COD using a quantitative morphological technique. The shape parameters and surface ruggedness were determined from Fourier and fractal analysis. The results obtained give quantitative information on the dissolution kinetics and the surface geometry of COD crystals in normal and diluted urine. Dissolution inhibition and morphological changes of COD crystals during dissolution were attributed to selective adsorption of urine non-ionic macromolecules on the crystal stepped surface. Surface etching of COD was found to depend on urine dilution and time of incubation. The data obtained suggest that the geometric structure of the surface is likely to be a potential factor in understanding crystal aggregation in stone formation. PMID- 3659871 TI - Role of scanning electron microscopy and x-ray microanalysis in the identification of urinary crystals. AB - Urinary crystals can be identified by using analytical electron microscopic techniques of scanning electron microscopy and energy dispersive x-ray microanalysis. Crystal habit can be recognised by scanning electron microscopy and their chemical nature by elemental analysis. With a conventional detector the lightest element that can routinely be detected is sodium, but with a windowless or thin window detector even carbon can be detected. Thus almost all the commonly occurring urinary crystals including uric acid can be analysed by energy dispersive x-ray microanalysis. PMID- 3659873 TI - X-ray microscopy and X-ray imaging. AB - Within a framework of an overview of the current status and potential of X-ray microscopy, a description is given of the development of the King's College scanning instrument which produced its first images in September, 1986. The instrument was mounted on the newly-built undulator beam line at the UK Science and Engineering Research Council's SRS synchrotron. There are consequently three sites worldwide where high-resolution X-ray microscopes with zone-plate optics are in operation. The other sites are BESSY-Berlin and NSLS-Brookhaven. PMID- 3659872 TI - Immunogold localization of intra- and extra-cellular proteins and polysaccharides of plant cells. AB - This paper illustrates post-embedding immunogold labelling of protein and polysaccharide molecules of plant cells. For EM studies, one is restricted (for most plant cells) to the post-embedding approach because the surrounding cell wall prevents access of antibodies (and secondary gold-tagged markers) to internal sites. The large size of many plant cells also does not lend itself to diffusional entry of antibodies. The molecules localized include seed storage proteins that are large and present in major quantities, a smaller less abundant, water soluble albumin, an oxygen-binding protein, components of the photosynthetic electron transport chain, and complex sugars from the cell wall. A range of preparative procedures and embedding plastics are used. PMID- 3659874 TI - [Malformations (duplications) of the terminal ileum in adults. Report of 3 unusual cases]. AB - Three cases of rare malformations of the ileo-cecal region (duplications) are discussed and compared to 20 others of the same kind already published. The main characteristics are an inflammatory symptomatology, especially in the right hypogastrium, with periodic recurrences. Since the clinical, radiological, endoscopic and biopsy findings often simulate Crohn's disease, patients must frequently undergo years of unsuccessful medical treatment and innumerable follow up examinations. Nevertheless, when certain findings are taken into consideration they can lead to correct diagnosis of this rare disease, which is established through pathological anatomy. The special features of the disease are described in detail. It can be definitively cured through resection of the ileo-cecal segment. PMID- 3659875 TI - [Evaluation of specialist instructions at a hospital center based on compliance. A study of 47 patients with mild hemostatic disorders]. AB - Individual with so-called mild bleeding disorders (MBD) are being investigated with increasing frequency on an outpatient basis at the Central Hematology Laboratory of the Inselspital, Berne. Following diagnosis of a given disorder the patients are informed orally, and sometimes also in writing, concerning the nature of the disorder, prophylactic and therapeutic measures prior to elective surgery, and the role of certain drugs in promoting hemorrhage. In the present study we attempt to evaluate the quality of these specialized medical services catamnestically. As a first step 67 patients with well defined bleeding disorders, and who had had no further contact with this institution since the investigation, were invited for interview. The interviewer was unknown to the patients and the patients participating in the study remained anonymous. A total of 47 patients came for interview. The goal of the enquiry was to find out how far the advice given by the physicians of our laboratory had been actually taken, or what were the possible grounds for ignoring it. Since MBD causes few symptoms in everyday life and complications may arise only as a consequence of surgery, there were particular problems in properly informing patients and thereby motivating them to act on medical advice. On the basis of the criteria selected, two thirds of patients showed adequate, and one third inadequate, compliance. Compliant patients correlated significantly with understanding of diagnosis, carrying brief written information with them for emergencies, coping with disease in general, poor perception of their own body, a "positive memory for medical advice", and their position within the family.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3659876 TI - [Cryptococcoma of the adrenal gland]. AB - The case is described of a 49-year-old man who developed cryptococcal meningo encephalitis ten months before his death. Six months later complicating hydrocephalus occurred which required the implantation of a ventriculo-peritoneal shunt. A further four months later the patient, who was receiving anticoagulation therapy due to deep vein thrombosis, died from intraventricular cerebral haemorrhage. In a blood culture taken shortly before his death, growth of Cryptococcus neoformans was detected. At autopsy, which confirmed cerebral haemorrhage as the cause of death, a large cryptococcoma of the left adrenal gland was discovered as an incidental finding. We presume that this cryptococcoma was the source of the new haematogenous dissemination of the disease. We review the literature and discuss the increasing importance of cryptococcosis. PMID- 3659877 TI - [Control of diabetes management: daily profile of blood glucose? self-monitoring of blood glucose? HbA1/HbA1c?]. AB - The introduction of glucose oxidase strips has given blood glucose measurements a new dimension. Together with assessment of time-averaged blood glucose concentration by measurements of glycosylated hemoglobin, self-monitoring of blood glucose has proven of value in the management of diabetes mellitus in cases with intensified insulin therapy, at the beginning of insulin therapy, with frequent hyperglycemia, and a number of other management problems. The principles and information which are important for the interpretation of the two parameters are summarized. PMID- 3659878 TI - [Radiation proctocolitis following gynecologic radiotherapy: an endoscopic study]. AB - The prevalence of radiation injuries was assessed in 155 of 206 surviving patients who had had radiation therapy for carcinoma of the uterus or vagina. The patients were examined according to a standardized protocol. 51 (32.9%) exhibited endoscopic proctitis, and in 10 of them sigmoid colon was also affected. The prevalence of colitis was 31 of 66 (47%) in patients treated for carcinoma of cervix and 19 of 86 (47%) in those treated for carcinoma of corpus. 41 (80.4%) had clinical symptoms (bleeding and diarrhea in 53% each). The mean time lag between radiation therapy and beginning of symptoms was 9 months. Histology was positive in only 24 (47.1%) of 51 endoscopically documented cases of proctocolitis. There was no increase in the prevalence of radiation injury after previous surgery of any kind. Nor was higher risk found in patients with hypertension, diabetes, or congestive heart failure. However, patients with low body mass were at increased risk (p less than 0.01). There was a dose-response relationship between total dose and endoscopic proctitis (p less than 0.001). The incidence was 0% below 40 Gy, 20% at 60 Gy and 50% at 90 Gy. PMID- 3659879 TI - [Home treatment of cancer: experiences with ambulatory intra-arterial chemotherapy of liver metastases]. AB - We have attempted to determine how far it would be feasible to administer intraarterial chemotherapy in patients with colorectal liver metastases on a domiciliary basis. Care of the patients was in the hands of a permanent team consisting of a doctor, a nurse and a psychologist. So far 43 patients have been treated this way. An increased complication rate has not been found during the 225 chemotherapy cycles carried out to date. The median survival of the patients was 14 months, with enhanced quality of life through chemotherapy performed at home. PMID- 3659880 TI - [Ossification of the meta- and acropodium in the course of early fetal ontogenesis in sheep]. PMID- 3659881 TI - [Biopsy of the uterine mucosa in mares for the assessment of fitness for breeding]. PMID- 3659882 TI - [Topography of the fascia trunci superficialis in swine]. PMID- 3659883 TI - [Evaluation of adrenal cortex function in pre-ruminant fattening calves treated with dexamethasone ]. PMID- 3659884 TI - [Tennis elbow. An alternative etiologic and therapeutic concept]. PMID- 3659885 TI - [Arginine aspartate and muscular activity]. PMID- 3659886 TI - [Energy conversion and physiologic parameters of runners during a marathon with different types of nutrition]. PMID- 3659887 TI - [General medicine and sports medicine]. PMID- 3659888 TI - [Osseous tendon ruptures of the pelvis and leg in adolescents]. PMID- 3659889 TI - [Introduction to the problem of insertion tendinoses]. PMID- 3659890 TI - [Endurance training and psychological adjustment]. PMID- 3659891 TI - [Contusion of the forefoot--from the minor to the exceptional]. PMID- 3659892 TI - How children learn words. PMID- 3659893 TI - [Nonsurgical therapy of abdominal and retroperitoneal abscesses]. AB - From 1976 to March 1987 intraabdominal or retroperitoneal abscesses were confirmed by ultrasound in 40 patients. 13 patients had surgical drainage with zero-mortality. 3 of 27 patients were treated with antibiotics (only systemically). 24 patients were treated by percutaneous catheter drainage or needle aspiration. Elective cholecystectomy was performed later in 3 patients. Nonsurgical treatment was successful in 22/27 cases. 3 patients died despite percutaneous drainage. Failure of percutaneous drainage required surgical intervention in 3 patients. The considerably poorer primary condition of the patients receiving nonsurgical treatment allows no comparison with the surgical group. Advantages of percutaneous drainage and needle aspiration are a high success rate and low mortality. These techniques can be used even in critically ill persons. PMID- 3659894 TI - A computer-assisted study of quantitative morphological features of C type horizontal cells in retina. AB - Biphasic C type horizontal cells of the retina of crucian carp were intracellularly stained with horseradish peroxidase (HRP) and quantitatively studied with computer-aided three-dimensional reconstruction techniques. Several parameters characterizing their morphology were determined and compared among different subtypes of horizontal cells. The results show that both cell body area and horizontal extension are proper parameters by which different subtypes of biphasic horizontal cells can be clearly classified. PMID- 3659895 TI - The three-dimensional structure of trichosanthin molecule. AB - A model completed recently of two trichosanthin molecules in an asymmetric unit belonging to the monoclinic system is reported. It can be seen that the molecular structure consists of two domains, one large and one small, and that there are some features in the secondary structure. The dissimilarity between two molecules as well as their interactions in an independent unit correlated in a non symmetric way has been described, moreover, the binding sites of the heavyatom position in the derivatives are also discussed. PMID- 3659896 TI - X-ray microanalysis of calcium in ischemic skeletal muscle cells. AB - Tissue sections of both transiently and persistently ischemic musculus latissimus dorsi of rabbits show degenerated and necrotic cells in varying degrees. Degenerated mitochondria appearing in the cells contain moderate electron-dense fluffy intramatrical deposits. However, only in the transient ischemia sample can other two kinds of electron-dense granules be seen between myofibrils. According to their ultrastructure, size and distribution, the larger granules are considered the degenerated mitochondria, and the smaller ones the degenerated sarcoplasmic reticulum. X-ray microanalysis proves that these two kinds of granules contain high concentration of calcium, while the fluffy deposits contain little calcium. The findings suggest that the calcium deposits in the degenerated and necrotic cell seen under light microscope occur in mitochondria and sarcoplasmic reticulum of the transiently ischemic muscle cell. The conditions of calcium accumulation in ischemic muscle cells are discussed. PMID- 3659897 TI - Studies on monoclonal antibodies against human platelets--a monoclonal antibody to human platelet glycoprotein I--SZ-2. AB - A monoclonal antibody, SZ-2, reacts specifically on human platelets and megakaryocytes. The platelets from 10 normal donors are bound to 15,200 +/- 4,100 SZ-2 molecules/platelet. The antigen recognized by SZ-2 is chymotrypsin-sensitive but neuraminidase-insensitive, and has been identified as glycoprotein Ib (GPIb) by an affinity chromatography technique. SZ-2 is different from other monoclonal antibodies to GPIb. It inhibits not only platelet aggregation induced by ristocetin, but also platelet aggregation induced by collagen (type I) and by PAF. SZ-2 also inhibits platelet serotonin and beta-thromboglobulin release in response to these stimuli. PMID- 3659898 TI - Chernobyl public health effects. PMID- 3659899 TI - Indo-U.S. vaccine pact disputed. PMID- 3659900 TI - EPA's predicament over regulating pesticides. PMID- 3659901 TI - Injury litigation and liability insurance dynamics. AB - Prices for some lines of liability insurance have increased sharply in recent years, even while the real amount of coverage provided has declined. What accounts for these changes? The large financial inertia inherent in the insurance business, forecasting errors repeated across the industry, and herd-like reactions among many insurers have made the market adjustments exceptionally abrupt. But the most likely underlying cause for the current crisis in liability insurance is the inexorable expansion in liability law. PMID- 3659902 TI - Sequence analysis on microcomputers. AB - Overall, each of the program packages performed their tasks satisfactorily. For analyses where there was a well-defined answer, such as a search for a restriction site, there were few significant differences between the program sets. However, for tasks in which a degree of flexibility is desirable, such as homology or similarity determinations and database searches, DNASTAR consistently afforded the user more options in conducting the required analysis than did the other two packages. However, for laboratories where sequence analysis is not a major effort and the expense of a full sequence analysis workstation cannot be justified, MicroGenie and IBI-Pustell offer a satisfactory alternative. MicroGenie is a polished program system. Many may find that its user interface is more "user friendly" than the standard menu-driven interfaces. Its system of filing sequences under individual passwords facilitates use by more than one person. MicroGenie uses a hardware device for software protection that occupies a card slot in the computer on which it is used. Although I am sympathetic to the problem of software piracy, I feel that a less drastic solution is in order for a program likely to be sharing limited computer space with other software packages. The IBI-Pustell package performs the required analysis functions as accurately and quickly as MicroGenie but it lacks the clearness and ease of use. The menu system seems disjointed, and new or infrequent users often find themselves at apparent "dead-end menus" where the only clear alternative is to restart the entire program package. It is suggested from published accounts that the user interface is going to be upgraded and perhaps when that version is available, use of the system will be improved. The documentation accompanying each package was relatively clear as to how to run the programs, but all three packages assumed that the user was familiar with the computational techniques employed. MicroGenie and IBI-Pustell further complicated their documentation by mixing instructions for the version based on floppy disk operation with that for the hard disk version.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3659903 TI - TMI and Chernobyl. PMID- 3659905 TI - Science budgets get lift from Senate. PMID- 3659904 TI - NIH finally resolves 7-year dispute. PMID- 3659906 TI - Why do women live longer than men? PMID- 3659907 TI - Oncogene linked to fruit-fly development. PMID- 3659908 TI - The growth and composition of the U.S. labor force. AB - In sharp contrast with the experiences of all other industrialized nations, the size of the labor force of the United States is growing rapidly while, simultaneously, its age, gender, and ethnic composition are changing markedly. Consequently, human resource issues present an unprecedented challenge in the nation's quest to achieve a fully employed and equitable society. New public policies that focus on labor market adjustment policies will be required if these developments are to be a boon rather than a bane to the emerging postindustrial economy. PMID- 3659909 TI - Reduction to homozygosity of genes on chromosome 11 in human breast neoplasia. AB - The somatic loss of heterozygosity for normal alleles occurring in human tumors has suggested the presence of recessive oncogenes. The results presented here demonstrate a loss of heterozygosity of several genes on chromosome 11 in primary breast tumors. Restriction fragment length polymorphism analysis of these DNAs further suggests that the most frequent loss of sequences in breast tumors occurs between the beta-globin and parathyroid hormone loci on the short arm of chromosome 11. The loss of heterozygosity for chromosome 11 loci has a significant association with tumors that lack estrogen and progesterone receptors, grade III tumors, and distal metastasis. PMID- 3659910 TI - D-alanine in the frog skin peptide dermorphin is derived from L-alanine in the precursor. AB - A D-alanine-containing peptide termed dermorphin, with potent opiate-like activity, has been isolated from skin of the frog Phyllomedusa sauvagei. Complementary DNA (cDNA) libraries were constructed from frog skin messenger RNA and screened with a mixture of oligonucleotides that contained the codons complementary to five amino acids of dermorphin. Clones were detected with inserts coding for different dermorphin precursors. The predicted amino acid sequences of these precursors contained homologous repeats of 35 amino acids that included one copy of the heptapeptide dermorphin. In these cloned cDNAs, the alanine codon GCG occurred at the position where D-alanine is present in the end product. This suggests the existence of a novel post-translational reaction for the conversion of an L-amino acid to its D-isomer. PMID- 3659911 TI - Transformation by oncogenes encoding protein kinases induces the metastatic phenotype. AB - Oncogenes encoding serine/threonine or tyrosine kinases were introduced into the established rodent fibroblast cell line NIH 3T3 and tested for tumorigenic and metastatic behavior in T cell-deficient nude mice. Transforming oncogenes of the ras family were capable of converting fibroblast cell lines to fully metastatic tumors. Cell lines transformed by the kinase oncogenes mos, raf, src, fes, and fms formed experimental metastases and (in some cases) these genes were more efficient at metastatic conversion than a mutant ras gene. In contrast, cells transformed by either of two nuclear oncogenes, myc or p53, were tumorigenic when injected subcutaneously but were virtually nonmetastatic after intravenous injection. These data demonstrate that, in addition to ras, a structurally divergent group of kinase oncogenes can induce the metastatic phenotype. PMID- 3659912 TI - Instrumentation and equipment. PMID- 3659913 TI - Chemical carcinogenesis. PMID- 3659914 TI - Human control. PMID- 3659915 TI - President's AIDS panel in disarray. PMID- 3659916 TI - New sequencers to take on the genome. PMID- 3659917 TI - Conservation of the Duchenne muscular dystrophy gene in mice and humans. AB - A portion of the Duchenne muscular dystrophy (DMD) gene transcript from human fetal skeletal muscle and mouse adult heart was sequenced, representing approximately 25 percent of the total, 14-kb DMD transcript. The nucleic acid and predicted amino acid sequences from the two species are nearly 90 percent homologous. The amino acid sequence that is predicted from this portion of the DMD gene indicates that the protein product might serve a structural role in muscle, but the abundance and tissue distribution of the messenger RNA suggests that the DMD protein is not nebulin. PMID- 3659918 TI - Conduction velocity variations minimize conduction time differences among retinal ganglion cell axons. AB - The visual system is able to accurately represent the spatiotemporal relations among the elements of a changing visual scene as the image moves across the retinal surface. This precise spatiotemporal mapping occurs despite great variability in retinal position and conduction velocity even among retinal ganglion cells of the same physiological class-a variability that would seem to reduce the precision with which spatiotemporal information can be transmitted to central visual areas. There was a strong negative relation between the intraretinal and extraretinal conduction time for axons of individual ganglion cells of the X-cell class. The effect of this relation was to produce a nearly constant total transmission time between the soma of a retinal X cell and its central target site. Thus, the variation in the conduction velocities of retinal ganglion cell axons may ensure that, regardless of the constraints imposed by retinal topography, a precise spatiotemporal central representation of the retinal image is maintained. PMID- 3659920 TI - Behavioral recovery induced by applied electric fields after spinal cord hemisection in guinea pig. AB - Applied electric fields were used to promote axonal regeneration in spinal cords of adult guinea pigs. A propriospinal intersegmental reflex (the cutaneous trunci muscle reflex) was used to test lateral tract function after hemisection of the thoracic spinal cord. An electrical field (200 microvolts per millimeter, cathode rostral) applied across the lesion led to functional recovery of the cutaneous trunci muscle reflex in 25 percent of experimental animals, whereas the functional deficit remained in control animals, which were implanted with inactive stimulators. PMID- 3659919 TI - Apolipoprotein B-48 is the product of a messenger RNA with an organ-specific in frame stop codon. AB - The primary structure of human apolipoprotein (apo) B-48 has been deduced and shown by a combination of DNA excess hybridization, sequencing of tryptic peptides, cloned complementary DNAs, and intestinal messenger RNAs (mRNAs) to be the product of an intestinal mRNA with an in-frame UAA stop codon resulting from a C to U change in the codon CAA encoding Gln2153 in apoB-100 mRNA. The carboxyl terminal Ile2152 of apoB-48 purified from chylous ascites fluid has apparently been cleaved from the initial translation product, leaving Met2151 as the new carboxyl-terminus. These data indicate that approximately 85% of the intestinal mRNAs terminate within approximately 0.1 to 1.0 kilobase downstream from the stop codon. The other approximately 15% have lengths similar to hepatic apoB-100 mRNA even though they have the same in-frame stop codon. The organ-specific introduction of a stop codon to a mRNA appears unprecedented and might have implications for cryptic polyadenylation signal recognition and RNA processing. PMID- 3659921 TI - Linkage of functional and structural heterogeneity in proteins: dynamic hole burning in carboxymyoglobin. AB - Inhomogeneous broadening of the 760-nanometer photoproduct band of carboxymyoglobin at cryogenic temperatures has been demonstrated with a dynamic hole burning technique. Line-shape changes and frequency shifts in this spectral band are generated by ligand recombination and are shown not to be the result of structural relaxation below 60 K. The observation of dynamic hole burning exposes the relation between the structural disorder responsible for the inhomogeneous broadening and the well-known distributed ligand rebinding kinetics. The findings provide direct evidence for the functional relevance of conformational substrates in myoglobin rebinding. In addition, a general protocol for evaluating the relative contributions of structural relaxation and hole burning to the spectral changes accompanying rebinding in hemeproteins is presented. PMID- 3659922 TI - Alexander Bearn: new Hughes trustee. PMID- 3659923 TI - AIDS 101. PMID- 3659924 TI - Measuring cholesterol is as tricky as lowering it. PMID- 3659925 TI - X-ray holograms at improved resolution: a study of zymogen granules. AB - X-ray holography offers the possibility of three-dimensional microscopy with resolution higher than that of the light microscope and with contrast based on x ray edges. In principle, the method is especially advantageous for biological samples if x-rays in the wavelength region between the carbon and oxygen K edges are used. However, until now the achieved resolution has not exceeded that of the light microscope because of the poor coherence properties of the x-ray sources and the low resolution of the detectors that were available. With a recently developed x-ray source based on an undulator on an electron storage ring, and high resolution x-ray resist, a hologram has been recorded at about 400-angstrom resolution. The experiment utilized x-rays with wavelengths of 24.7 angstroms and required a 1-hour exposure of the pancreatic zymogen granules under study. PMID- 3659926 TI - Family study of platelet membrane fluidity in Alzheimer's disease. AB - The fluorescence anisotropy of 1,6-diphenyl-1,3,5-hexatriene in labeled platelet membranes, an index of membrane fluidity, identifies a prominent subgroup of patients with Alzheimer's disease who manifest distinct clinical features. In a family study, the prevalence of this platelet membrane abnormality was 3.2 to 11.5 times higher in asymptomatic, first-degree relatives of probands with Alzheimer's disease than in neurologically healthy control subjects chosen without regard to family history of dementia. The pattern of the platelet membrane abnormality within families was consistent with that of a fully penetrant autosomal dominant trait. Thus, this abnormality of platelet membranes may be an inherited factor that is related to the development of Alzheimer's disease. PMID- 3659927 TI - Quick-freeze lipid techniques: correction. PMID- 3659928 TI - [Indications and results of dorsal plate osteosynthesis of the tibial shaft]. PMID- 3659929 TI - [Functional anatomy and biomechanics of the long biceps tendon]. PMID- 3659930 TI - [Pathophysiologic principles of plastic surgery management of bone and soft tissue defects]. PMID- 3659931 TI - [Problems in the assessment of injuries of the cervical spine including cervicocephalic whiplash injuries]. PMID- 3659932 TI - Endoprosthesis. The best way to treat unstable intracapsular hip fractures in elderly patients. PMID- 3659933 TI - [Total prosthesis of the hip joint in patients over 100 years of age]. PMID- 3659934 TI - [Rupture of the pectoralis major muscle]. PMID- 3659935 TI - [Prevention of thromboembolic complications with intravenous heparin in polytrauma]. PMID- 3659936 TI - [Reflections on the treatment of massive hemorrhage following trauma]. PMID- 3659937 TI - [Mortality following Ender nailing of pertrochanteric fractures]. PMID- 3659938 TI - [Plastic surgery management of delayed surgically treated subcutaneous rupture of the Achilles tendon]. PMID- 3659939 TI - [Pathologic fractures as a complication of osteomyelitis. Report of experiences from the tropics of southeast Nigeria]. PMID- 3659940 TI - [Indications, one of the critical principles of trauma surgery]. PMID- 3659942 TI - [Injuries of the proximal tibial epiphysis]. PMID- 3659941 TI - [Intraoperative and early postoperative complications in the osteosynthesis of pertrochanteric femoral fractures with the dynamic hip screw]. PMID- 3659943 TI - [Motorized knee exercise splints. Remarks on construction]. PMID- 3659944 TI - [Assessment of prognosis in polytraumatized patients by determining cellular immunity using the intradermal puncture test]. PMID- 3659946 TI - Leukemia. III. PMID- 3659945 TI - [Deepening of the trochlea femoris and osteotomy of the patella as possible causal therapy of recurrent traumatic patellar dislocations. An experimental study]. PMID- 3659947 TI - Thrombotic microangiopathy. II. PMID- 3659948 TI - Deleterious effects of platelet transfusions and recovery thrombocytosis in patients with thrombotic microangiopathy. PMID- 3659949 TI - Leukemia. IV. PMID- 3659950 TI - Issues and answers: An open forum on recent advances in hematology. Proceedings of a symposium. December 5, 1986, San Francisco. PMID- 3659951 TI - AIDS: questions and controversies--a panel discussion. PMID- 3659952 TI - Humor in medicine. PMID- 3659954 TI - Sickle cell anemia. PMID- 3659953 TI - "Hair-on-end" pattern in the skull. PMID- 3659955 TI - The skull and spine. PMID- 3659956 TI - Bone changes in the extremities in sickle cell anemia. PMID- 3659957 TI - Uroradiological manifestations of S-hemoglobinopathy. PMID- 3659959 TI - Central nervous system. PMID- 3659958 TI - Radiology of the gastrointestinal tract in sickle cell anemia. PMID- 3659960 TI - Scintigraphic examination of bone and marrow infarcts in sickle cell disorders. PMID- 3659961 TI - [A preliminary observation on the hemopoietic inductive effect of marrow stroma]. PMID- 3659962 TI - [Effect of electrical stimulation of rostral ventrolateral medulla on unit discharges of sympathetic preganglionic neurons in the rat]. PMID- 3659963 TI - [Interaction between renal nerve afferent stimulation-produced depressor response and carotic sinus baroreflex]. PMID- 3659964 TI - [Effects of vagal stimulation on transmembrane potentials of in situ rabbit's cardiac ventricular fibers]. PMID- 3659965 TI - [The influence of intermittent exercise of human unilateral arm on set-point for sweating]. PMID- 3659966 TI - [Effect of progesterone and norethisterone oenanthate on dynamic distribution of progesterone receptor in target cell]. PMID- 3659967 TI - [Effect of fibroblasts on the early stage development of skeletal muscle cells in culture]. PMID- 3659968 TI - [Effects of lesion and stimulation of hypothalamic arcuate nucleus region on leu enkephalin, dopamine and norepinephrine contents in rat brain and spinal cord]. PMID- 3659969 TI - [Isolation and identification of C-12-h peptide from the skin of Bombina orientalis in China]. PMID- 3659970 TI - [A method for intracellular recording of resting and action potential from the isolated frog single myelinated nerve fiber]. PMID- 3659971 TI - Experiments on human beings. PMID- 3659972 TI - Planning for the future--the National Health Plan. PMID- 3659973 TI - Fine needle aspiration cytology: a personal experience with 800 cases. PMID- 3659974 TI - Adenosine deaminase in pleural fluid--an enzymatic test for tuberculous pleural effusion. PMID- 3659975 TI - Some aspects of sexual knowledge and sexual behaviour of local women--results of a survey: XI: Sex and pregnancy. PMID- 3659976 TI - Urodynamic investigations of the lower urinary tract--early experiences and observations in male patients. PMID- 3659977 TI - Risk factors for acute and recurrent vaginal candidiasis in Singapore. PMID- 3659978 TI - Preventable trauma death in Singapore. PMID- 3659979 TI - How benign are aural polyps? PMID- 3659980 TI - The SMA-APMPS cardiopulmonary resuscitation (CPR) training programme. PMID- 3659981 TI - Cardiopulmonary resuscitation. PMID- 3659982 TI - The undergraduate. PMID- 3659983 TI - Continuing medical education--the family physician. PMID- 3659984 TI - Recertification--the specialist. PMID- 3659985 TI - Health expectations of the aged. PMID- 3659986 TI - Schmidt's syndrome: a case report. PMID- 3659988 TI - Cutaneous secondary in carcinoma oesophagus. PMID- 3659987 TI - Radiculomyelopathy due to typhoid fever. PMID- 3659989 TI - Measurement and restoration of equality in length of the lower limbs in total hip replacement. AB - Alteration of the length of the lower limb was measured in 39 patients undergoing total hip replacement. Radiographs were taken in the erect posture prior to operation and 6 months postoperatively. The inequality of limb length was measured by the difference between the height of the vertices of the femoral heads and by the difference between the lowest points of the ischial tuberosities. The change of the length was measured intraoperatively as the difference observed between two reference points: one above the acetabulum and the other on the proximal femur. Good correlation was obtained between the change of the limb length made intraoperatively and the change in the limb length using the ischial tuberosities as reference points; no correlation was observed when the vertices of the femoral heads were the reference points. Inequality of limb length can be radiologically determined before and after total hip arthroplasty. Femoral and prosthetic heads are not good reference points for measurement. The difference in the height of the ischial tuberosities demonstrates inequality of limb functional length as it reflects the tilting of the pelvis. PMID- 3659990 TI - Ball-and-socket ankle joint. AB - The ball-and-socket ankle joint is a malformation of the ankle in which the articular surface of the talus is hemispherical in both the anteroposterior and lateral projections and has a congruent, concave tibial articular surface. Fourteen patients with this condition were identified retrospectively. Thirteen patients were thought to have the congenital type of ball-and-socket ankle joint which in many was associated with tarsal coalition, short limb, and ray fusion and deletion anomalies. One case of the acquired type, demonstrating less geometric rounding of the talar margins, was seen in a patient with myelomeningocele, probably resulting from sensory and motor deficits. Although the exact etiology of the congenital type is unknown, its association with other malformations suggests that the ball-and-socket ankle joint results from an overall maldevelopment of the ankle and foot. PMID- 3659991 TI - Bone loss in limbs with decreased or absent sensation: ten year follow-up of the hands in leprosy. AB - Three hundred and sixty-seven patients with insensitive hands have been studied by correlating radiologic findings with occupational and medical history in order to better define causal factors in bone resorption. This study indicates that nonspecific infection and trauma are the reasons for bone resorption in 98% of cases. The role of intermittent pressure seems to be in soft tissue breakdown, which then allows bone to become infected. Bone resorption can be arrested at any stage of the disease by appropriate therapy of splinting and control of infection. PMID- 3659992 TI - Pseudofractures due to Nec-Loc cervical immobilization collar. AB - The plastic rivets attached to the commonly used Nec-Loc cervical immobilization collar produce linear lucencies which often traverse the cervical vertebrae. Linear lucencies in this location often simulate a fracture. In most instances, the complete outline of the object causing the artifact may be identified. However, identification may not be possible in all cases. Radiologists should familiarize themselves with the appearance of the artifact produced by this particular immobilization device so as to avoid the erroneous diagnosis of a cervical fracture. Whenever the diagnosis is in doubt, the collar should be removed and a repeat radiograph should be obtained. PMID- 3659993 TI - Skeletal abnormalities of acrogeria, a progeroid syndrome. AB - We report the skeletal abnormalities in a 4 1/2-year-old boy with acrogeria, a progeroid syndrome of premature aging of the skin without the involvement of internal organs seen in Hutchinson-Gilford progeria syndrome. Acro-osteolysis of the distal phalanges, delayed cranial suture closure with wormian bones, linear lucent defects of the metaphyses, and antegonial notching of the mandible are the predominant skeletal features of the disorder. The skeletal features described in 21 other reported cases of acrogeria are summarized. PMID- 3659994 TI - Soft tissue pseudotumor following intramuscular injection of "DPT": a pitfall in magnetic resonance imaging. AB - We report the time-dependent magnetic resonance imaging (MRI) changes that resulted from an intramuscular injection of a commonly-used pediatric sedation regiment ("DPT"). These changes at the site of injection consist of a focal abnormality characterized by a slight increase in signal intensity on T1 weighted images and markedly increased signal intensity on T2 weighted images. Alterations in signal are detectable almost immediately after the injection and progress over the first 31 hours. This abnormality, which could be mistaken for real disease, persists up to 36 days following injection. PMID- 3659995 TI - Case report 428: Bizarre parosteal osteochondromatous proliferation (BPOP). PMID- 3659996 TI - Case report 435: Myxopapillary ependymoma of filum terminale with massive bone destruction of sacrum. PMID- 3659997 TI - Case report 437: Solitary (unicameral, simple) bone cyst of the scapula. PMID- 3659998 TI - Case report 438: Osteolytic phase of Paget disease affecting the ulna in case 1 and the humerus in case 2. PMID- 3660000 TI - Employment, economy and care in Sweden by the year 2000. AB - Within the context of the future study 'Care in Society' an analysis has been made concerning the relationships between employment, economy and care. The changed economic outlook for Sweden creates problems for employment as well as for the public care systems. Employment in the future will be influenced by: - the growing labour force; --the changing structure of the labour market; --the expansion of the public care systems; --working hours per week and life. It is argued that shorter working hours--besides positive effects on employment--also will create more favourable conditions for the informal care sector--care in the family and voluntary care. A conscription system for care might be a solution to the problems of care and employment in the future. PMID- 3659999 TI - Case report 439: Synovial chondromatosis (osteochondromatosis) of the right hip: "hidden" radiologic manifestations. PMID- 3660001 TI - The employed unemployed: the subterranean economy in Spain. AB - This paper discusses the relationship between the subterranean economy and unemployment. Clandestine economic activity provides jobs at low incomes, but also bad and dangerous working conditions and job insecurity. Governments and even trade unions tend to ignore the wider implications of the underground economy. Three main forms of submerged economy are identified. PMID- 3660002 TI - The choices to be made. AB - If we are to avoid unemployment when technology increases productivity, we have two choices. We must increase our level of material living (more private luxury gadgets or more public luxury services) and/or decrease our total working time. These choices reflect social power relations. Capital owners and leaders of labour unions normally endorse the standard increase solution. The unemployed are for the reduction in hours, hoping to get a share of the labour time. Studies reported here indicate that a solid majority of ordinary men and women also seem to prefer the reduction in working time solution. PMID- 3660003 TI - Economic change, alcohol consumption and heart disease mortality in nine industrialized countries. AB - This paper examines the question of whether economic changes--including economic growth, unemployment and business failures--and alcohol consumption by beverage type are independently related to heart disease mortality. Controls for cigarette and animal fat consumption are also employed in a multivariate time series analysis. Data for nine countries in the post World War II era are investigated: Australia, Canada, England and Wales, Denmark, Federal Republic of Germany, Finland, France, Sweden and the United States. In all nine countries unemployment and business failures are positively related to heart disease mortality, and in eight countries the trend of economic growth shows an inverse relationship. The relation of alcohol consumption to heart disease mortality depends on beverage type. When spirits or wine consumption shows a significant relation, occasionally requiring controls for other beverages, it is positive. On the other hand, beer consumption shows an inverse relation to heart disease mortality in all countries. The statistical significance of that relationship also occasionally must be based on controls for other beverages. PMID- 3660004 TI - Youth unemployment--individual and societal consequences, and new research approaches. AB - The social effects of youth unemployment must be described in connection with the special unemployment situations which this condition implies for youths. Periods of joblessness are in general short and alternate with job programmes or educational programmes, a situation which can be characterised as a 'permanent impermanence'. Unemployment must also be seen in light of its occurrence during a central stage of a youth's development. The social effects are primarily of three kinds: those limited to the individual welfare, those concerning the individual's connection to his group and those concerning the individual's relationship with society. The first mentioned is most commonly expressed psychosomatically or socio-medically, the second socio-psychologically and the third socio-culturally or societally. PMID- 3660005 TI - Long-term unemployment among women in Sweden. AB - Vulnerability at long-term unemployment is discussed and the results of a study of the effects of job loss and long-term unemployment among Swedish women are presented. Psychological and physiological data for the unemployed were sampled repeatedly over a two year period. Some of the unemployed were subject to an intervention programme aiming at buffering for the possibly negative effects of unemployment. Health data from matched control groups of employed were gathered over the same period. The results indicate a strong negative stress reaction at the job loss period, followed by a gradual adaptation to the conditions of unemployment as measured by biochemical and physiological health indicators. However, a substantial proportion of the unemployed compared to the employed showed a lower degree of psychological well-being and more severe depressive reactions. Recommendations are given concerning further research approaches on long-term unemployment. Policy implications to reduce vulnerability at long-term unemployment are discussed. PMID- 3660006 TI - Coping with unemployment--a contribution to the understanding of women's unemployment. AB - The aim of this paper was to contribute to the understanding of women's unemployment with emphasis on individual reactions in terms of their significance and context. The study was carried out within the methodological tradition of grounded theory. Thirty-six unemployed women were interviewed. The reactions to unemployment were seen in relation to two, systematically generated core variables: 'the relation to wage labour' and 'the relation to alternative activities'. Four different groups of unemployed were identified in light of their relations to these two core variables. They were called 'the give-uppers', 'the clenchers', 'the refocusers' and 'the ambivalents'. Serious effects of unemployment were found among the give-uppers and the clenchers. The refocusers on the other hand, enjoyed their lives and had replaced the loss of work with other meaningful activities. PMID- 3660007 TI - Prolonged unemployment and depression in older workers: a longitudinal study of intervening variables. AB - In this study, unemployed blue-collar workers over the age of 45 (N = 51) filled out a questionnaire in 1975 and in 1977. It was shown that prolonged unemployment or re-unemployment leads to depression, reduced hope, and financial problems, although none of these factors leads to prolonged unemployment. Being employed or retired leads to a reduction of depression and financial problems. Problems associated with the daily hassles of unemployment, such as financial problems and disappointed hope play a role in the development of depression with prolonged unemployment. Potential third variables that could cause both unemployment and depression--such as internal/external control, passivity, sickness, and age--do not affect the effect of unemployment on depression. PMID- 3660008 TI - The psychological meaning of job insecurity and job loss: results of a longitudinal study. AB - This paper presents some results from a longitudinal intensive study of 26 shipyard workers during a period of two years. Unemployment was found to comprise a process consisting of a series of psychological crisis due to loss of important factors contributing to identity. The anticipatory phase was found to be a very burdening phase of unemployment due to the prolonged uncertainty. Despite good economic compensation depressive reactions were noticed. Other psychological reactions were irrational job seeking behaviour. The attitudes towards work were investigated. The central concepts of meaning of work was found to be unconscious and mediated early during childhood and to change very slowly. The shipyard workers tried to maintain an old working identity but especially the old, single men had difficulties to stand firm to it. Some of them intensifies alternative to work, like fishing, hunting and other activities and, in a way, continue to work. The single, older unemployed men were found to be a risk group. PMID- 3660009 TI - Relation of economic change to Swedish health and social well-being, 1950-1980. AB - To what extent, and through what mechanisms, does the deterioration of economic conditions affect the health of the population at the national level? In this paper, the author presents the results of a study of Swedish data, analyzing the post-World War II changes in mortality rates in relation to deleterious economic changes, especially unemployment, business failure rates, and declines in real per capita income. The analysis uses a version of the 'Economic Change Model of Pathology' which includes the influence of health risks related to patterns of consumption and production. It is found that economic growth plays a principal role in reducing mortality at nearly all ages, and specifically mortality due to total cardiovascular disease, cerebrovascular disease, total heart disease, ischemic heart disease, total malignancies, disorders of infancy, and motor vehicle accidents. Economic recession, by contrast, is related to increases in total mortality for virtually all age groups, in both sexes, for major causes of death and causes due to psychopathological conditions. Per capita alcohol consumption, by specific beverage, is an important risk to mortality rates in cerebrovascular disease, malignancies, cirrhosis, motor vehicle accidents, suicide, homicide, and infant diseases. Cigarette consumption rates are positively related to mortality due to cardiovascular, malignant, and infant diseases; fat consumption rates are positively related to cardiovascular and cancer mortality. PMID- 3660010 TI - Unemployment and health--new approaches in research and social action. PMID- 3660011 TI - International social and health policies to prevent ill health in the unemployed: the World Health Organization perspective. PMID- 3660012 TI - Economic growth and industrial expansion and renewal as instruments to achieve full employment. AB - Institutional changes have weakened the capacity of market economies to adjust with sufficient speed to change in factor prices and in the available technology. As a consequence of this lower flexibility traditional economic policy instruments are no longer effective in creating growth and employment. This is the overall theme of the analysis presented in this paper concerning the reasons for our current long-term employment problems. PMID- 3660013 TI - Some experiences of Yugoslavia in solving of unemployment. AB - Unemployment in Yugoslavia represents one of the most serious economic, social and political problems. The causes are numerous: migration from rural to urban areas, discrepancies between education and market demands. The profile of the unemployed Yugoslav is a specific one: young, under 30 years of age, the graduate of a secondary or high school, and a somewhat larger number of females. Measures undertaken are numerous and extend from the Federation to each work organisation. Organised efforts made by young people themselves are of particular importance for the solving of the unemployment problem. PMID- 3660014 TI - Alleviating depression in the unemployed: adequate financial support, hope and early retirement. AB - Results of a longitudinal study on older blue-collar workers in the Federal Republic of Germany (Soc. Sci. Med. 25, 173-178, 1987) showed that people who retired out of unemployment improve in depression similar to those people who found a job. Furthermore, financial problems and disappointed hope were important in the development of depression in the unemployed. These results are relevant for measures to alleviate depression in the unemployed in three areas: early retirement and an increase of financial unemployment compensation are recommended. Furthermore, all those programs (like counseling or therapeutic programs) that increase hope to find a job without increasing the chances to find a job have to be viewed with skepticism because they might actually turn out to be dysfunctional. PMID- 3660015 TI - Unemployment causes ill health: the wrong track. AB - It is not unemployment per se that causes ill health. It can be a very desirable state. There are no diseases specific to unemployment. Contrast this with employment. Unemployment shares with all other socio-environmental situations risk of exposure to common physical, social and psychological stressors that predispose to disease. Focus for action and research should be on reducing such stressors and not on provision of full employment. The former is likely to be possible and beneficial. The latter is likely to be impossible and carries a risk of making matters worse. As an immediate first step, that will reduce 'cratogenic' disease, people in authority should stop misleading the public into believing that unemployment is the cause of ill health. PMID- 3660016 TI - An alternative model. AB - In present Western societies, we witness the growing power of the state over the citizens, with an ever-growing flow of freedom-encroaching regulations, legitimated by the wish to keep full employment for all, for all of life. It is suggested here that a major political challenge for the rest of this millenium is to find a limit for the state's material responsibility for, and claims on, its citizens. This can only be done if we divide society into one highly regulated basic needs sector and other free sectors, in which state influence is minimized. This is like dividing trains into smoking and non-smoking compartments. PMID- 3660017 TI - Some observations on 'unemployment and health' research. PMID- 3660018 TI - Unemployment and health. PMID- 3660019 TI - [Non-steroidal anti-inflammatory agents]. PMID- 3660020 TI - [Lumbar puncture]. PMID- 3660021 TI - [Intestinal parasitoses. Diseases caused by protozoa]. PMID- 3660023 TI - [Parasitoses of the reticuloendothelial system]. PMID- 3660022 TI - [Hepatic parasitoses]. PMID- 3660024 TI - [Toxoplasmosis]. PMID- 3660025 TI - [Ectoparasitoses]. PMID- 3660026 TI - [Intestinal parasitoses. Diseases caused by roundworms]. PMID- 3660027 TI - [Coheban, useful emergency bandages]. PMID- 3660028 TI - [Treatment of chronic cardiac insufficiency]. PMID- 3660029 TI - [Protection of the legally incompetent adult]. PMID- 3660030 TI - [Intestinal parasitoses. Diseases caused by flatworms]. PMID- 3660031 TI - [Use of scanning electron microscopy in forensic medicine]. PMID- 3660032 TI - [Sudden death in aortic aneurysm rupture]. PMID- 3660033 TI - [Biomechanical aspects in the relation between external and internal injuries in fatal accidents]. PMID- 3660034 TI - [Incidence and mechanism of development of central contusions in the corpus callosum]. PMID- 3660035 TI - Realistic expectations of a patient-physician encounter. PMID- 3660036 TI - Troublesome aspects of the patient-physician relationship: a study of human factors. AB - We investigated three onerous aspects of the patient-physician relationship using contemporary psychosocial research methods. A "hassle index" identified three dimensions of vexation in practice: problems with running a practice, medical conditions of patients, and social characteristics of patients. In general, hassle was found to be dependent on the type of practice, but physicians were equally annoyed by unlikeable patients irrespective of their practice site. Diagnostic errors made by resident physicians from various clinics were more related to an unlikeable medical disorder than to differences in the clinics. To clarify doctors' negative feelings toward patients, a questionnaire measuring antipathy toward specific patient types was administered to physicians. Responses indicated that physicians' antipathy was unrelated to the doctors' ethical beliefs and their medicopolitical orientation. Personality variables indicative of "extremeness" of opinion about patients included high needs for dominance, low needs for nurturance and "intraception" (the ability to analyze the behavior and motives of others), and low self-esteem. Personality profiles of physicians least vexed by medical practice reflected less psychopathology--less self-derogation, less need for emotional support, and more extroversion. Medical College Aptitude Test scores revealed that high science scores were associated with extremeness of opinion, and low scores on general information were indicative of increased susceptibility to the daily irritations of medical practice. PMID- 3660037 TI - Comparison of dietary intake of urban and rural elderly patients in family practice centers. AB - To compare dietary intake of urban and rural patients, we interviewed 50 patients over age 64 at each of two family practice centers, one urban and one rural, using the 24-hour dietary recall method for nutrient comparison. A deficiency of calcium was evident in the intake of both elderly populations, but other specific deficiencies were evident in the rural group. We discuss the need for dietary evaluation and intervention in the elderly, with emphasis on the rural population, and offer specific strategies for application by primary care physicians. PMID- 3660038 TI - Comparison of hypertension prevalence and control in 5,237 rural and urban Alabama residents. AB - Selected urban and rural Alabama populations were compared by age, sex, and race on the prevalence of hypertension and uncontrolled hypertension and the percentage of treated hypertensives with controlled blood pressure. We found the following results: (1) Rural women had a significantly higher prevalence of hypertension than urban women. (2) The prevalence of uncontrolled hypertension was significantly higher for urban white men than for their rural counterparts. (3) The prevalence of uncontrolled hypertension was significantly higher for rural black women aged 30 to 39 than for the same age group of urban black women. (4) Rural dwellers generally had much better blood pressure control than urban, though this was not manifested evenly across groups. Statistically significant differences were found for white men and women of all ages combined and in three of four age groups. Reasons for the rural-urban differences are unclear, but the rural area surveyed was served by nurse practitioner clinics that strongly emphasized patient education. PMID- 3660039 TI - Central venous cannulation done by house officers in the intensive care unit: a prospective study. AB - Central venous cannulation (CVC) is a procedure frequently performed by house staff in the intensive care units of teaching hospitals. In the medical ICUs of our two hospitals, CVC was successfully done by house officers in 172 cases requiring 231 attempts (one operator at one insertion site), for a success rate of 74%. There were 14 complications (6.1%), five requiring intervention, but none fatal. The overall success rate was higher for the internal jugular approach and lower for the external jugular approach than for other sites. The success rate for Swan-Ganz catheterization was higher for the internal jugular than for the subclavian approach. CVC during resuscitation was frequently unsuccessful (41%) and/or complicated (13.6%). Although success rates were comparable, complications were more common among experienced house officers than among interns, perhaps reflecting patient selection. There was a trend toward fewer and/or less severe complications during the course of the month and of the study. PMID- 3660040 TI - Superior vena cava syndrome: experience in a teaching hospital. AB - Between 1972 and 1985, 39 patients with superior vena cava syndrome were admitted to the Medical College of Georgia Hospitals. I have reviewed the hospital courses of these patients and compared clinical and laboratory findings with those reported in previous series. The syndrome was malignant in 34 patients (mean age of 50 years) and benign in five (mean age of 30 years). Duration of symptoms before diagnosis was 17 months in patients with benign disease and 18 days in those with malignant disease. Presence of symptoms for less than four weeks was associated with a high likelihood of malignancy. Invasive diagnostic procedures established a diagnosis in 33 patients, and no procedural complications occurred. Computerized tomography (CT) of the chest confirmed superior vena cava obstruction and localized the level of obstruction in all six patients in whom it was done. Information gained from venacavograms did not alter therapeutic decisions. In eight patients, establishment of a definitive histologic diagnosis altered the treatment. Treatment relieved the symptoms in 69% of the patients with malignant superior vena cava syndrome, and no patient had recurrent symptoms after therapy. PMID- 3660041 TI - Cause of death in systemic lupus erythematosus: a pattern based on age at onset. AB - We reviewed the causes of death in 50 patients treated for systemic lupus erythematosus at the University of Mississippi Medical Center between 1973 and 1985. Two groups of patients could be distinguished based on the age at onset but not on the duration of disease. Younger patients more often died of active renal disease an infectious complications, while older patients died of other organ involvement, inactive renal disease, and miscellaneous causes. Common causes of infection were gram-positive cocci and gram-negative bacilli. Atherosclerotic cardiovascular disease was an infrequent cause of death, and no patients died of malignancy. Patients who died had more multisystemic involvement, with serositis and renal, central nervous system, and hematologic manifestations than patients who were alive at last follow-up. PMID- 3660042 TI - Bile acids in radiation-induced diarrhea. AB - Radiation-induced bowel disease manifested by debilitating diarrhea is an unfortunate consequence of therapeutic irradiation for pelvic malignancies. Although the mechanism for this diarrhea is not well understood, many believe it is the result of damage to small bowel mucosa and subsequent bile acid malabsorption. Excess amounts of bile acids, especially the dihydroxy components, are known to induce water and electrolyte secretion and increase bowel motility. We have directly measured individual and total bile acids in the stool samples of 11 patients with radiation-induced diarrhea and have found bile acids elevated two to six times normal in eight of them. Our patients with diarrhea and increased bile acids in their stools had prompt improvement when given cholestyramine. They had fewer stools and returned to a more normal life-style. PMID- 3660043 TI - Continent intestinal reservoir. AB - In this series, 170 patients have received a continent intestinal reservoir, with follow-up of one to eight years. In 126 a conventional ileostomy was converted to a continent intestinal reservoir, 38 at the time of coloproctectomy. Six had an unsatisfactory ileoanal or ileorectal anastomosis initially, and 26 (15%) required revisional surgery for problems involving the reservoir or valve. The incidence of valve slippage was 3%. Eighty-five percent achieved a normally functioning small bowel reservoir with one operation, and 19 more patients were added with one additional operation, for an ultimate good result of 96% with two operations at most. The average reservoir capacity is 400 ml, and most patients empty the pouch two or three times per day. Under favorable circumstances, the continent intestinal reservoir is preferable for most patients after coloproctectomy. PMID- 3660044 TI - Bishop score and labor duration: a new look. AB - The Bishop score determined on admission was correlated with labor duration in this group of 770 patients delivered of infants in community hospitals. The total score correlated well with duration of latent-phase labor in primiparas and multiparas, but not with active phase in either parity group. We recommended the Bishop score as a useful predictor of latent-phase duration to facilitate decisions in management of labor. PMID- 3660046 TI - Renal injury associated with laxative abuse. AB - Surreptitious laxative abuse is a common cause of unexplained diarrhea, but has not been considered an important cause of irreversible electrolyte and renal functional abnormalities. We have described five patients with the laxative abuse syndrome associated with significant renal injury and electrolyte disorders. We conclude that laxative abuse, like analgesic abuse, is a cause of interstitial renal disease that is more common than generally recognized. PMID- 3660045 TI - Chronic granulomatous disease in an adult. AB - We have described a 49-year-old man with chronic granulomatous disease. The diagnosis was established by a deficiency of NBT dye reduction by neutrophils, in addition to impairment in 14C-1-glucose utilization, 125I-iodination of zymosan, chemiluminescence, superoxide radical generation, and bactericidal activity toward S aureus. This adult patient exhibits many characteristics of chronic granulomatous disease of childhood but of less severity, which may explain his unusually long survival. It is thus important to consider the diagnosis of chronic granulomatous disease not only in children but also in adult patients having the characteristic pattern of recurrent infections. PMID- 3660047 TI - Acute fracture of the proximal humerus superimposed on a chronic posterior dislocation of the humeral head. AB - We have reported the case of a 73-year-old woman with a posterior shoulder dislocation and comminuted fracture of the proximal humerus occurring during a seizure. Surgery disclosed an acute humeral fracture superimposed on a chronically dislocated humeral head. Endoprosthetic replacement yielded a satisfactory clinical result. We found no similar report in the literature. PMID- 3660048 TI - Familial fibromuscular dysplasia of the mesenteric arteries. AB - We have reported the case of a critically ill 17-year-old girl who had an evolving gastrointestinal infarction when she came to our institution 11 months before she died. After surgical revascularization, biopsy of the superior mesenteric artery showed FMD. We interviewed and examined all close consanguineous relatives and found abdominal bruits in the patient's younger sister and mother. Arteriograms showed total occlusion of the celiac and superior mesenteric arteries in the sister, and a subtotal celiac occlusion in the mother. Postprandial abdominal pain and constipation in the sister prompted elective mesenteric revascularization, and biopsy of the superior mesenteric artery confirmed FMD identical to that of her older sister. The mother, who is asymptomatic, has single vessel disease and has not required operative intervention. Our report strongly supports the hypothesis of a genetic basis for this arteriopathy. PMID- 3660049 TI - Resistance to the effects of thyroid hormone in children. AB - We have described three children with serum levels of TSH that are too high for the concomitant serum T4 level. Two of them meet the criteria for combined central and peripheral resistance to thyroid hormone. The third has long-standing central resistance to TSH suppression previously reported in congenital hypothyroidism. The recognition of this syndrome by physicians is important to avoid unnecessary and potentially dangerous treatment. PMID- 3660050 TI - Splenic abscess due to Clostridium septicum in a patient with multiple myeloma. AB - Solitary abscesses of the spleen may occur as a consequence of septicemia from various septic foci, particularly intra-abdominal sites. A variety of causative organisms, including the clostridia, have been isolated. We have described a patient with multiple myeloma who had a solitary splenic abscess due to Clostridium septicum and who failed to survive despite seemingly appropriate treatment. Clinicians should be alert to this complication, which demands immediate splenectomy and appropriate antibiotic therapy. PMID- 3660051 TI - Uterine leiomyomas with retroperitoneal lymph node involvement. AB - We have presented a case of benign metastasizing leiomyoma (BML) involving pelvic lymph nodes found at the time of hysterectomy for uterine leiomyomas. The patient received postoperative adjunctive therapy with methotrexate, actinomycin D, chlorambucil, and irradiation, and has no evidence of disease 11 years later. PMID- 3660052 TI - Neisseria mucosus septicemia after near-drowning. AB - Neisseria mucosus is a normal inhabitant of the upper respiratory tract which may rarely cause serious infection. A 21-year-old woman had N mucosus bacteremia and the adult respiratory distress syndrome (ARDS) after a near-drowning episode. Despite appropriate antibiotic therapy and intensive respiratory support, the patient died. Bacteremia with this organism is rare, and we believe it has not previously been reported in association with near-drowning. PMID- 3660053 TI - Bleeding duodenal ulcer after gastric bypass procedure for obesity. AB - A patient without previous history of peptic ulcer disease had gastrointestinal bleeding from a duodenal ulcer four years after having a gastric bypass procedure for obesity. The use of the technetium-labeled red blood cell scan helped localize the source of bleeding in this patient after routine endoscopy and barium studies failed to show any abnormality of the upper and lower gastrointestinal tracts. The patient has done well after subtotal gastrectomy for treatment of this disorder. PMID- 3660054 TI - Acute myocardial infarction associated with cocaine abuse. PMID- 3660055 TI - Traumatic cerebral edema relieved by stellate ganglion anesthesia. AB - Stellate ganglion neural blockade reverses within seconds anoxemia and edema by release of catecholamine vasoconstriction of the small arteries. The factor XII enzyme cascade is controlled by increased oxygenated arterial blood flow and a normal pH. My patient's rapid recovery reflects the effectiveness of this approach for treatment of traumatic cerebral edema. Continuing edema with its scar-forming process injures brain neuron function. A patient's level of recovery or survival requires such immediate and effective control of edema. PMID- 3660056 TI - Recurrent primary mesenteric venous thrombosis. AB - We have reported a case of recurrent primary mesenteric venous thrombosis resulting in small bowel infarction. Resection of necrotic bowel, anastomosis, and postoperative anticoagulation remain the cornerstone of management. Delay in diagnosis and treatment contributes to the high mortality. A history of peripheral thrombosis, antithrombin III deficiency, hypovolemia, or carcinoma in susceptible patients with abdominal pain should arouse suspicion of ischemic bowel. PMID- 3660057 TI - Osteoporosis fracture threshold. PMID- 3660058 TI - Cardiac tamponade. PMID- 3660059 TI - Scanning electron microscopy of helminth ova. PMID- 3660060 TI - Visceral leishmaniasis: a case report. AB - Visceral leishmaniasis is diagnosed in a Thai worker returning home from the Middle East. A 39-year-old Thai male who had abdominal swelling, weight loss, hepatosplenomegaly and hyperglobulinemia, was diagnosed by demonstration of organism in liver biopsy and bone marrow aspiration specimen. Amphotericin B was administered in this case. PMID- 3660061 TI - Acute human isosporiasis in Thailand: a case report. AB - A case of acute human isosporiasis in Thailand was reported. A 57-year-old man developed diarrhoea after prednisolone administration for the management of nephrotic syndrome. Stool examination revealed numerous Isospora oocysts. On the basis of parasite morphology and sporulation time, it was identified as Isospora belli Wenyon, 1923. The patient recovered for the diarrhoea without specific treatment. PMID- 3660062 TI - Observations on the D/V ratio of male genitalia of Culex pipiens complex in Amphur Muang Chiang Mai, Northern Thailand. AB - Mosquitoes belonging to the Culex pipiens complex were collected from various locations in Amphur Muang Chiang Mai, Northern Thailand, and identified by using D/V ratios of male genitalia. Most of the mosquitoes were Cx. pipiens quinquefasciatus, having D/V ratios of 0.46 +/- 0.09. Among these mosquitoes, 1.23% (6/490) had D/V ratios between 0.8-0.9 These forms were considered as Cx. p. quinquefasciatus which showed extreme variations from the generally acceptable criterion. PMID- 3660063 TI - Gnathostoma malaysiae Miyazaki and Dunn, 1965 from Rattus surifer in Thailand. AB - Gnathostoma malaysiae Miyazaki and Dunn, 1965 was found in the stomach wall of Rattus surifer, captured in Phuket Island and Khao Yai National Park of Thailand. This is the first to be recorded in Thailand and the second discovery after the first description of Miyazaki and Dunn (1965). Pathological findings of infected animals were also described. Some new morphological descriptions were added to the original. PMID- 3660064 TI - A note on laboratory colonization of Aedes (Muscidus) quasiferinus Mattingly 1961, Amphur Muang Chiang Mai, Northern Thailand. PMID- 3660065 TI - Scanning electron microscopic study of nocturnally subperiodic Brugia malayi (Filarioidea: Onchocercidae), Narathiwat, Southern Thailand. AB - Scanning Electron Microscopic (SEM) observations were made on the adult females and males of nocturnally subperiodic Brugia malayi (Narathiwat, Southern Thailand) from 8-month-old intra-peritoneally infected jirds (Meriones unguiculatus). Descriptions of the morphological surfaces of anterior end, vulva, body cuticle, anus, posterior end of females and anterior end, body cuticle, cloaca, caudal papillae, spicules, sheath, posterior end of males were demonstrated. The comparison among these and other filarial parasites were also investigated. PMID- 3660066 TI - Antibodies against Vibrio cholerae lipopolysaccharide, cell-bound haemagglutinin and toxin in the intestinal fluid during convalescence. AB - Specific antibodies to V. cholerae lipopolysaccharide (LPS), cell-bound haemagglutinin (CHA) and toxin (CT) in the intestinal lavages of healthy Thais and Thai cholera patients during the convalescence period were determined by enzyme-linked immunosorbent assay. Only IgM and IgA specific antibodies were detectable in the specimens. All of the persons who were just recovered from cholera had IgA anti-CT and IgA anti-LPS and 82.4% had IgA anti-CHA. The IgA anti CT, anti-LPS and anti-CHA were detected also in the gut fluids of 70.6%, 94.1% and 88.2%, respectively, of the healthy controls. The mean levels of the IgA antibodies of all specificities between the two groups of individuals were not different. However, the IgM anti-CT and IgM anti-LPS of the cholera patients increased during the convalescence period. The levels, therefore, were significantly higher than those of the controls. The ratios of IgA anti-CT: IgM anti-CT and IgA anti-LPS: IgM anti-LPS among the patients were 2.93:1 and 2.02:1, respectively while those of the controls were 10:1 and 34:1, respectively. IgA antibodies predominated in the lavages of both groups of the individuals. PMID- 3660067 TI - Persistence of hepatitis B viral antigens in Culex quinquefasciatus. AB - Culex quinquefasciatus mosquitoes were fed on or inoculated with blood or serum positive for hepatitis B viral antigens and pools of mosquitoes were tested by radioimmunoassay daily for 3 weeks after exposure to detect the viral antigens. Hepatitis B surface antigen (HBsAg) was detectable up to 3 weeks, while hepatitis B e antigen (HBeAg) persisted only for 3 days in mosquitoes after feeding on hepatitis B viral antigens-positive blood. Mosquitoes inoculated with serum were HBsAg-positive for 3 weeks and HBeAg positive for 4 days after inoculation. These results suggest that biological multiplication of hepatitis B virus did not occur in these mosquitoes. The possibility of mechanical transmission of hepatitis B antigens by mosquitoes is discussed. PMID- 3660068 TI - Neurovirulence effects of dengue-2 viruses on the rhesus (Macaca mulatta) brain and spinal cord. AB - Vaccines prepared from attenuated virus can cause symptomatic viral infection of the central nervous system. In the present study, dengue-2 parental and its live attenuated viruses were tested by intrathalamic and intraspinal injections in rhesus monkeys. The dengue-2 viruses were found to be only very weakly neurovirulent when injected directly into the brain or spinal cord of rhesus monkeys. PMID- 3660069 TI - Renal clearance, tubular reabsorption and urinary excretion of albumin in monkeys infected with Plasmodium knowlesi. AB - The glomerular filtration rate (GFR) and the glomerular clearance rate of albumin were determined in 6 rhesus monkeys infected with P. knowlesi as well as in 6 control monkeys by using 51Cr-EDTA and 125I-HSA respectively. The excreted albumin in the urine was also determined and used for calculating the renal clearance value. The amount and rate of albumin filtered in the glomeruli and reabsorbed by the tubules were then calculated from these parameters. The present study showed that the rate and amount of albumin filtered through the glomeruli, reabsorbed by tubules and excreted in the urine of normal monkeys, which were similar to results reported earlier in normal human, dogs and rats. In the monkeys infected with P. knowlesi the glomerular filtration rate was reduced while the glomerular clearance rate of albumin increased which resulted in the significantly elevated filtered albumin in the glomeruli. The tubular reabsorptive capacity to plasma albumin was also found to be significantly increased in parallel to the elevated filtered load of albumin. However, as this capacity was limited, the excess albumin was therefore excreted into the urine in the infected monkeys. All these findings indicated that the albuminuria in P. knowlesi-infected monkeys was due to the increased glomerular capillary permeability to plasma albumin, although the tubular reabsorptive capacity increased but could not cope with a very high filtered load, therefore, excess albumin was detected in the urine. PMID- 3660070 TI - Adherence of human eosinophils to infective filariform larvae of Necator americanus in vitro. AB - Eosinophilia is common in hookworm infection but the interaction between eosinophils and the larval stage of the parasite is poorly understood. The present study was conducted to test the ability of the eosinophils to adhere to infective filariform larvae of Necator americanus in vitro. Adherence of eosinophils to the larvae was found to be serum dependent. Antibody facilitated eosinophil adherence but this was maximal in the presence of complement. The adherence was greatly diminished by EGTA treated normal human serum (NHS) and was completely abolished when NHS was treated with either EDTA or heat-inactivation, suggesting that the process can be facilitated through complement activation via the alternative pathway. As with other nematodes, the surface of hookworm larvae appeared to be both antigenic and complement-activating. Although it is not known whether eosinophil adherence has any larvicidal effect, the present study demonstrated for the first time a definite interaction between human eosinophils and hookworm filariform larvae. PMID- 3660071 TI - Laboratory transmission of lymphatic filariasis by vector mosquitoes. AB - Aedes togoi and Ae. aegypti were used to examine the transmission potential of Brugia pahangi to one of its natural hosts, the domestic cat. Although a larger proportion of microfilariae taken in by Ae. togoi developed into infective larvae, the total number of B. pahangi larvae recovered from a cat exposed to Ae. aegypti was larger than from a cat exposed to Ae. togoi. Factors influencing the transmission dynamics included: development of microfilariae to infective larvae; survival of mosquitoes; willingness to take repeated blood meals; and proportion of infective larvae that egress from mosquitoes during the feeding process. From 19 to 25% of infective larvae were transferred to a susceptible host. The feasibility of using a Brugia-cat model to do comparative vector efficiency studies was demonstrated. PMID- 3660072 TI - Pneumococcal infection in hospitalized patients: a four-year study in Malaysia. AB - A total of 90 cases of pneumococcal infections were identified at a major referral hospital in Kuala Lumpur, Malaysia during a study period of four years. Pneumonia was the most common clinical presentation (41 cases) followed by meningitis (19 cases). Of 48 patients who were followed-up during the microbiology consultation round, 11 died, 9 were children below two years old. Capsular typing was carried out on 57 strains of Streptococcus pneumoniae isolated from blood and body fluids of 43 children and 14 adults. 38 strains isolated from pharyngeal specimens were also typed. Types 6A (11 strains), 6B (7 strains), 14 (8 strains) and 19A (8 strains) predominated in children. The strains from older patients comprised 3 isolates from cerebrospinal fluid (types 18B, 6B and 14), five from blood (4 strains, type 1 and 1 strain, type 4) and six from pus (1 strain, type 14, 3 strains type 23F and 2 strains type 34). The isolates from pharyngeal specimens belonged to capsular type similar to those implicated in infections. 90% of the types reported in this study are included in the 23 valent pneumococcal vaccines. Minimum inhibitory concentrations of penicillin, cefuroxime, chloramphenicol and rifampicin were determined for selected strains. 4.1% of isolates were resistant to penicillin (3/74), 4.5% to cefuroxime (2/44), 6.5% to chloramphenicol (3/46) and 14.6% to rifampicin (6/41). PMID- 3660073 TI - Intestinal parasitoses among the workers and their families at three electricity generating dams in Thailand. AB - During September 17, 1980 - May 29, 1981 a total of 986 single stool specimens were collected from workers and their families at three electricity generating dams under the administration of the Electricity Generating Authority of Thailand (EGAT). Parasitological surveys were carried out at the dam sites, namely the Khoa Laem Project, the Srinakarin Dam and the Ubolratana Dam. The overall prevalence at all three sites are moderately high (62.50%, 45.33% and 54.05% respectively). The Khoa Laem project had the highest prevalence of E. histolytica infection (16.16%) which may be the result of poorer sanitary standards for workers of the project under construction. The occurrence of opisthorchiasis at the first two sites situated in central Thailand (12.19% and 7.01%) is the result of influx of migrant northeastern workers. The prevalence of other parasites are not remarkable. However, because of the proximity of the people living close to the large bodies of fresh water, urgent measures should be taken to eradicate the parasitic infections among them in order to prevent the spread through the water. PMID- 3660074 TI - A case of black water fever treated with peritoneal dialysis and artemether (quinghaosu derivative). AB - A clinical case of Black Water Fever following Plasmodium falciparum infection is reported. The patient had no previous history of malaria and had not taken anti malarials as prophylasis. He was free from G-6-PD deficiency and abnormal haemoglobins. He had acute intravascular haemolysis, haemoglobinurea and renal failure after the third dose of quinine infusion. His life was saved by peritoneal dialysis and Artemether injection. In in vitro test, his blood haemolysed suddenly in 36 hours when incubated with quinine (10 mg per lit) at 37 degrees C in test tube while control blood took over a week for natural slow haemolysis. Thus quinine plays an important part in the cause of Black Water Fever. PMID- 3660075 TI - Some upper cervical spine norms. AB - Lateral cervical spine films from 175 normal examinations of adults performed in the emergency room of North Carolina Baptist Hospital were analyzed to establish some norms and relationships in the upper cervical spine. The predens angle was found to be between 0 degree-13 degrees (mean 5.57 degrees) in neutral position and 0-18 degrees (mean 9.27 degrees) in flexion in most persons. Ninety-two percent of persons have angles greater than 3 degrees in flexion. A V-shaped predens space is not indicative of injury to the cruciate ligament. Virtually every person has posterior slanting or tilting of the dens and the range of values is up to 35 degrees (mean 17.43 degrees). Ninety-eight percent of persons have an angle greater than 6 degrees. A tilted dens does not indicate acute or remote trauma. No relationship was identified between the predens angle and the dens tilt angle. The posterior arch of the atlas can be found at any position between the occiput and spinous process of C2 in all positions of the head and neck. Hence, fanning or widening of the C1-C2 interspinous distance is not a reliable index of ligamentous injury in the upper cervical spine. PMID- 3660076 TI - Progression of unsupported curves in adolescent idiopathic scoliosis. AB - Stability of three types of double scoliotic curves of 10-40 degrees was analyzed using a biomechanical model: double primary (Type I), primary thoracic with compensatory lumbar (Type II), and primary lumbar with compensatory thoracic (Type III). The load-carrying capacity of each curve was analyzed as a function of magnitude of the curve, its location and flexibility. Curve magnitude was found to be the most influential parameter governing the stability of a scoliotic curve up to 30 degrees. Results suggest that in evaluating curves of comparable magnitudes, Type I and II curves are more likely to progress and, therefore, should be braced at an earlier stage than Type III curves. PMID- 3660077 TI - Osteophytes of the spine compressing the sympathetic trunk and splanchnic nerves in the thorax. AB - The presence of osteophytes compressing the sympathetic structures in the thorax was found in 655 (65.5%) of 1,000 cadavers. In 60.4% of the affected cases, the compression was on the right side, and in 36.9% it was bilateral, although the right side was more severely affected. In 2%, the compression was on the left only. The highest frequency of compression was at the T8-10 level, the right greater splanchnic nerve being the structure most frequently involved. The sympathetic trunk itself (ganglia and cord) was affected only by osteophytes of vertebrae at the lowest thoracic levels; however, bony excrescences due to costovertebral joint arthritis were frequently found impinging on the sympathetic trunk and its rami communicantes at similar frequencies on both sides. The factors governing the characteristic compression of the sympathetic structures in the thorax are the typical development of the osteophytes and the special relations of the sympathetic structures to the vertebral column at the various levels. It is proposed that these observations are useful in understanding certain observed clinical conditions and act an anatomic baseline for research in the future. PMID- 3660078 TI - Detection of sacral sparing in acute spinal cord injury. AB - Sacral dermatomal-evoked responses (DEP) and posterior tibial nerve (PTN) somatosensory-evoked potentials (SSEP) were recorded 28 hours after gunshot injury to the 12th thoracic vertebra of a 17-year-old male. Repeatable responses were obtained from stimulation of the fourth sacral dermatome despite absence of repeatable PTN responses. This suggestion of "sacral sparing" was accompanied by clinical improvement of neural function during the hospital course and 10 months after discharge. This case suggests DEP can make valuable contributions in the diagnosis of sacral sparing in acute spinal cord injury. Considerations regarding the unusual ipsilateral scalp recording location for sacral DEP are discussed. PMID- 3660079 TI - Anterior spinal fusion complicated by paraplegia. A case report of a false negative somatosensory-evoked potential. AB - A case of an anterior spinal artery syndrome complicating an anterior spinal fusion is reported. Besides documenting a relatively rare complication of anterior spinal surgery, the level of the lesion (T6) and the association of spinal shock are relatively unusual. Intraoperative somatosensory-evoked potentials (SEP) deteriorated only transiently and failed to reflect adequately the neurologic injury either intraoperatively or postoperatively. The shortcomings of SEP monitoring are discussed, and the recommendation is made to use the combination of SEPs with the wake-up test when possible. PMID- 3660080 TI - Posterior spinal fusion complicated by posterior column injury. A case report of a false-negative wake-up test. AB - A case is reported of an isolated posterior column injury secondary to direct mechanical trauma complicating a posterior spinal fusion. This case documents a rare complication of posterior spinal surgery. Intraoperative somatosensory evoked potential (SEP) monitoring documented the injury whereas two intraoperative wake-up tests did not. This case demonstrates the value of intraoperative spinal cord monitoring in general. It also demonstrates the value of combining means to assess both anterior and posterior cord separately, intraoperatively. It is recommended that the wake-up test be used in conjunction with SEPs intraoperatively. PMID- 3660081 TI - Stabilization of the lower thoracic and lumbar spine with the internal spinal skeletal fixation system. Indications, techniques, and first results of treatment. AB - Since 1984, 30 patients with burst fractures of the lower thoracic and lumbar spine were treated with AO internal spinal skeletal fixation system. All patients in this series had a minimum follow-up of 12 months. This new instrumentation is a posterior intrapedicular system developed by Dick in 1982. It allows stable fixation that is limited only to adjacent spinal segments. The internal fixator permits reduction in all three planes. Independently, it is possible to add distraction or compression to the involved segments. It also is able to reduce effectively the "middle column" which is thought to be accomplished by "ligamentotaxis." In this series there were 16 neurologically intact patients and 14 with partial or complete neurologic injury. There were two minor instrumentation loosenings early in the series. Most patients in this series had a near-anatomic reduction of all three columns in the involved segment. It was also possible to re-establish the normal lordosis of the lumbar spine. The device provided sufficient rigid fixation for rapid postoperative mobilization in a light external orthosis. PMID- 3660082 TI - Body height changes from vibration. AB - A device for measuring body height is reported (SD, 1 mm). The change in body height before and after vibration and quiet sitting respectively was studied in eight men aged 22-44 years who were free of back pain. The vibration frequency was set at 5 Hz and the acceleration at 2 msec-2. Subjects were asked to report for testing within 2 hours after arising from bed. Body height was measured before and immediately after vibration or sitting exposure and the measurements were repeated at different intervals up to 2 hours after the experiment. Results show that exposure to vibration increases the overall creep response in most subjects. There is a great deal of variability in response between subjects, but most of them show a recovery to the average creep response within a 2-hour time interval. PMID- 3660083 TI - Biomechanical comparison of seven internal fixation devices for the lumbosacral junction. AB - For comparison purposes, seven different internal fixation systems were applied sequentially to each of six fresh-frozen cadaver spines at the lumbosacral junction. The spines were loaded to a maximum flexion bending moment of 12 Newton meters and an extension moment of 6 Nm. Resultant angular motion was recorded with an electrogoniometer. The Synthes and Kaneda devices provided the most rigid fixation in flexion and extension testing. The Luque internal fixation system was as effective as the Kaneda and Synthes systems at limiting extension but was slightly less successful at limiting flexion. The Knodt system was effective at limiting extension but less effective in limiting flexion. The interfacet screws were effective at limiting flexion but less effective at limiting extension. Harrington rods to the sacral alae were the least effective system in both directions. Sublaminar wires did little to improve their performance. PMID- 3660084 TI - Metrizamide myelography in patients with iodine allergy or previous adverse reactions to iodinated contrast media. AB - Twenty-seven metrizamide myelographies were performed in 26 patients who had a history of iodine allergy or adverse reactions to iodinated contrast media. Three of the patients had had adverse reactions from a previous myelography procedure. All patients received atropine, diazepam, and metoclopramide as premedication. In ten examinations corticosteroids were also given. No patient, during or after myelography, had any reaction that could be related to hypersensitivity to the contrast medium. The incidence of headache, the most frequent side effect, was almost the same in patients who had corticosteroids in their premedication (30%) as in patients without (35%). These observations indicate that metrizamide myelography may be performed despite previous adverse reactions to contrast media. PMID- 3660085 TI - Foraminal and extraforaminal lumbar disc herniation: diagnosis and treatment. AB - During a 1-year period from December 1, 1984, through November 30, 1985, a total of 174 patients underwent lumbar discectomy for herniated nucleus pulposus. Eighteen (10.3%) were diagnosed as having foraminal or extraforaminal disc herniations. Sixteen patients are included in this study. All patients were evaluated with computed tomography, metrizamide myelography, discography, and discography-enhanced computed tomography (disco-CT). Accurate diagnosis of foraminal or extraforaminal herniation was made with disco-CT in 15 of 16 cases (93.8%), compared with discography alone (37.5%), computed tomography alone, and/or myelography-enhanced computed tomography (50%) and myelography alone (12.5%). Surgical treatment with bilateral hemilaminectomy, partial medial facetectomy, and partial internal foraminotomy, if needed, followed by discectomy is very effective and the favored surgical management for nerve root decompression in most all cases. PMID- 3660086 TI - Extreme lateral lumbar disc herniations. Clinical syndrome and computed tomography recognition. AB - The clinical histories of four patients with extreme lateral lumbar disc herniations are presented to demonstrate the ineffectiveness of myelography and the value of computed tomography. PMID- 3660087 TI - A joint shadow in the cervical spine presenting as a vertebral body fracture. Case report. PMID- 3660088 TI - Osteoid osteoma in a vertebral body. Case report. PMID- 3660089 TI - Biodegradation phenomena observed in vivo and in vitro spinal instrumentation systems. PMID- 3660090 TI - Tuberculosis of the arch of the atlas. Case report. AB - This rare case of tuberculosis of the arch of atlas illustrates the potential difficulties in making a clinical diagnosis of tuberculosis of the upper cervical spine. Plain roentgenograms may not demonstrate an early lesion of the neural arch, and CT is a valuable adjunct. The use of a halo vest proved a successful alternative to operation in conferring stability to the spine during healing. PMID- 3660091 TI - Cushioned face rest for face-down operations. PMID- 3660092 TI - Advantages of topical marcaine during spinal surgery. Technical note. AB - Marcaine applied to irritated nerve roots during extradural spinal surgery may attenuate sympathetically mediated and somatosensory (pain)-related hypertensive and tachycardic crises. PMID- 3660093 TI - Malignant rhabdoid tumor of the thoracic spine. Case report. PMID- 3660094 TI - Spinal cord ischemia and paraplegia in the multiple-trauma patient with aortic arch injury. Case report. PMID- 3660095 TI - [Histoplasmosis]. PMID- 3660096 TI - [Non-hemolytic elliptocytosis in a Mexican family]. PMID- 3660098 TI - [Planning and public health. A focus centered on health problems]. PMID- 3660097 TI - [Typical epidemiologic principles of mortality from peptic ulcer in Mexico 1930 1980]. PMID- 3660100 TI - [Serendipity in medicine]. PMID- 3660099 TI - [Current status of the pharmaceutical industry in Mexico: advances and problems]. PMID- 3660101 TI - [Magnetic resonance anatomy of the male pelvis]. PMID- 3660102 TI - [Acute ischemia due to vasospasm following prevention of thrombosis with dihydroergotamine/heparin]. PMID- 3660104 TI - [Effect of static NMR magnetic fields on the processing of biological signals in man]. PMID- 3660103 TI - [Imaging of aortic dissection]. PMID- 3660105 TI - [31-P spectroscopy in radiotherapy]. PMID- 3660107 TI - [Pre-filtration of an x-ray radiation source in 2-pulse operation]. PMID- 3660106 TI - [Qualitative and quantitative determination of the extra-focal portion of the radiation from x-ray tubes]. PMID- 3660108 TI - [Division of competence in radiology]. PMID- 3660109 TI - [Surgical treatment of cardiovascular changes in Marfan's syndrome]. PMID- 3660110 TI - [Surgical treatment of myxoma of the heart atrium]. PMID- 3660111 TI - [Direct splenorenal arterial anastomosis in the treatment of vasorenal hypertension]. PMID- 3660112 TI - [Late occlusion of arterial prostheses in the aortofemoral area]. PMID- 3660113 TI - [Long-term clinical experience with the Arteknit vascular prostheses]. PMID- 3660114 TI - [C-reactive protein--a prognostic factor in the development of inflammation]. PMID- 3660115 TI - [Treatment of dissecting aneurysm of the ascending aorta using the Bentall operation]. PMID- 3660116 TI - [Aseptic meningitis during the course of mixed connective tissue disease (MCTD)- a case report]. PMID- 3660117 TI - [Methylprednisolone pulse therapy for a child with fulminant dermatomyositis]. PMID- 3660119 TI - Visual therapy and learning disability. PMID- 3660118 TI - [Case report of autopsy of ankylosing spondylitis]. PMID- 3660120 TI - Magnesium, calcium, sodium and potassium status in normotensive and hypertensive Johannesburg residents. AB - Serum magnesium, calcium, sodium and potassium, and erythrocyte magnesium, sodium and potassium levels were measured in a selected group of 296 urbanised black male labourers in Johannesburg. Of these, 214 subjects were normotensive and 82 were hypertensive. The aim of the study was to examine the relationship between serum and erythrocyte electrolytes, specifically magnesium and calcium, and blood pressure in this population sample. The results showed a significant decrease in serum magnesium, calcium and potassium in the hypertensive subjects. Red blood cell magnesium was significantly lowered and red blood cell sodium was significantly raised in this group. A significant inverse correlation was found between serum magnesium and blood pressure, erythrocyte magnesium and blood pressure, serum calcium and blood pressure, and serum potassium and blood pressure. A positive correlation was observed between erythrocyte sodium and blood pressure. Of all the electrolytes assessed, magnesium (serum and erythrocyte) correlated most closely with blood pressure. The data reported here suggest that body magnesium and its interactions with calcium, sodium and potassium may, in certain groups of individuals, play an important role in the development and maintenance of high blood pressure. PMID- 3660121 TI - Serum calcium ion concentrations in eclampsia. AB - Serum calcium levels were determined in black women with normal pregnancies, with severe hypertension of pregnancy and with eclampsia. Blood samples were taken before and 48 hours after delivery. Mean levels of serum calcium before and after delivery were found to be significantly lower in eclamptic patients than in those with normal pregnancies and in non-gravid controls. PMID- 3660122 TI - In vitro susceptibility of upper respiratory tract pathogens to 13 oral antimicrobial agents. AB - An in vitro comparison of the activities of 13 oral antimicrobial agents against clinical isolates of bacteria commonly responsible for causing upper respiratory tract infections was performed. With regard to Haemophilus influenzae, beta lactamase-negative strains were susceptible to amoxycillin, augmentin, cefaclor, erythromycin, trimethoprim, cotrimoxazole and tetracycline, with CL 284,635 being the most active agent. With the exception of amoxycillin these drugs were also active against beta-lactamase-producing strains. CL 284,635 was also very active against Branhamella catarrhalis isolates, including beta-lactamase-producing strains, but was less active against the Gram-positive bacteria tested. Cefadroxil, cephradine and cephalexin were mainly active against Gram-positive pathogens. Based on minimum inhibitory concentration determinations, cefaclor, augmentin and co-trimoxazole would be appropriate drugs for the treatment of those cases of otitis media and sinusitis where H. influenzae and Streptococcus pneumoniae are important pathogens provided they are susceptible to these agents. PMID- 3660123 TI - [Clinical experience with atracurium--a continuous infusion technic]. AB - A continuous infusion technique for atracurium was investigated. It provided a stable neuromuscular block, with a mean infusion rate of 0.008 mg/kg/min after an initial bolus of 0.5 mg/kg. A wide individual response was found and an arbitrary infusion rate based on mass alone is therefore not possible. The above rate is thus a starting point and should be adjusted according to individual requirements, preferably by using a peripheral nerve stimulator. The technique obviates the need for repeated increments of atracurium during lengthy surgical procedures. PMID- 3660124 TI - Stopayne for postoperative analgesia in plastic surgery patients. AB - A 2-day study to assess the safety and efficacy of a combination analgesic, Stopayne (Rio Ethicals), was conducted in 23 postoperative plastic surgery patients with pain of moderate to severe intensity. Statistically significant pain relief was attained, with 2 (9%) patients reporting complete relief 1 hour after taking the tablets and 19 (82%) reporting satisfactory relief (P less than 0.01). One patient recorded the pain relief as slight and another reported no relief. The average time taken for analgesia to occur was 37.7 min and it lasted an average of 3.8 h. On being woken by pain 18 (78%) patients reported that they were able to sleep again after taking the study drug; 19 patients reported that the tablets helped them to fall asleep. PMID- 3660125 TI - Continuous morphine infusion for postoperative pain in children. AB - Previous erratic use of intermittent intramuscular and intravenous morphine or pethidine for postoperative analgesia prompted a prospective trial of continuous intravenous morphine delivered by an infusion pump. The rate was adjusted to keep the patient free of pain--as assessed by observation in the infant and enquiry in the older child. Serum morphine levels were monitored for the first 36 hours. The results of a cohort of 20 patients (aged 3 months-12 years) are presented. Thanks to positive parental and nursing staff support, and absence of complications, administration of postoperative analgesia with continuous intravenous morphine infusion is now standard practice in this unit. PMID- 3660126 TI - Breast reconstruction after mastectomy. The Cape Town experience. AB - As methods have advanced, trends in breast reconstruction after mastectomy have changed considerably with more emphasis being placed on reconstruction by means of tissue expansion. Indications for using the various methods available are discussed and their advantages and disadvantages enumerated. By May 1987, 95 breasts in 88 patients had been reconstructed at Groote Schuur Hospital with few complications. The challenge remains one of improving the appearance of reconstructed breasts. PMID- 3660127 TI - Complications in the treatment of Hodgkin's disease. AB - Early Hodgkin's disease is curable with radiotherapy, while combination chemotherapy is curative for stages III and IV. The acute side-effects of treatment (haematological, infectious and neurological toxicity), as well as the late side-effects (sterility, cardiac and pulmonary damage and secondary neoplasms), are therefore of major concern. Data on 60 patients treated over a 12 year period in Bloemfontein were analysed. The acute and chronic complications encountered were in the range expected and 6 patients developed secondary neoplasms. The possible reduction of these complications is discussed. It is concluded that the oncologist should select the best treatment consistent with a good chance of a durable remission but must weigh this against not only short term but also long-term toxicity. PMID- 3660128 TI - Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part I. All causes. AB - Previous reports, based largely on the 1970 census and the 8th revision of the International Classification of Diseases, (ICD-8) have suggested that marked differences in mortality exist between population groups in the RSA. In this article the ICD-9 classification of causes of death and 1980 census are used to assess whether the trends have continued through to the present time. Total mortality data in the RSA for whites, coloureds and Asians for the 5-year period 1978-1982 are presented. The 1980 national census provided the denominator population data. Annual age- and sex-specific mortality rates were higher for coloureds than for whites or Asians, the differences being most marked in childhood. There appears to have been little change in total standardised mortality rates among whites over the 5-year period, while increases have occurred among coloureds of both sexes and among Asian males. Analysis of proportional mortality stresses the relatively large proportion of deaths accounted for by external causes and infections among coloureds and by cardiovascular diseases among whites and Asians. There is an urgent need for the health services to take note of these data in order to provide for the varied needs of the population. PMID- 3660129 TI - Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part II. Cerebrovascular disease. AB - An analysis was undertaken of mortality from cerebrovascular disease in the RSA between 1978 and 1982 in whites, coloureds and Asians. This article details the age-specific mortality rates for each group and also comparisons between groups based on age-standardised mortality rates. Marked differences are seen between the various population groups, the rates for Asians and coloureds (particularly females) far exceeding that for whites. Comparison of these data with those published previously by Wyndham suggest that while mortality from this cause may be falling among whites and Asians, the rate is remaining relatively static in the coloured population. PMID- 3660130 TI - Variations in mortality of the coloured white and Asian population groups in the RSA, 1978-1982. Part III. Rheumatic heart disease. AB - An analysis was undertaken of mortality from rheumatic heart disease in the RSA between 1978 and 1982 in whites, coloureds and Asians. This article details the age-specific mortality rates (MRs) for each group and also comparisons between groups based on age-standardised MRs. The rates for Asians and coloureds markedly exceed those for whites, particularly in the lower age groups (under 45 years). PMID- 3660131 TI - Medical psychology--its growth and development in South African medical schools. AB - New training models and programmes in the teaching of clinical psychology associated with medically applied psychology at medical schools are developing in South Africa. However, a recent survey showed that a minimum number of full-time clinical psychologists is employed by medical schools in South Africa. How the few who are so employed fare away from their 'home base' is also explored as well as what their contributions are in such settings and in providing medical psychological services in general hospitals. These findings are discussed with reference to a developing country such as South Africa. Methods are proposed to further enhance the development of medical psychology and the effective contribution of clinical psychology to medical and related education, and its functioning as a bridge across the body-mind dichotomy within promotive and preventive healing systems. PMID- 3660132 TI - Selection of medical students--are all matriculation examinations equivalent? AB - The marks achieved by students vary significantly with the type of matriculation examination written. In particular, students who write the examination set by the Transvaal Education Department score significantly higher matriculation marks than other students but score the same in the first year at medical school as other students. These students have an undeserved advantage in the selection process. PMID- 3660133 TI - 'Abnormal' eating attitudes and behaviours among women students. AB - A prevalence study of attitudes and behaviours associated with anorexia nervosa and bulimia was carried out among female undergraduate students at the University of Cape Town. Findings were similar to those found in surveys overseas. More than one-tenth of respondents (11.8%) scored in the 'anorexic range' on the Eating Attitudes Test (EAT); more than one-fifth (21.9%) are at present binge-eating, and 6.3% using self-induced vomiting as a means of weight control. Use of laxatives, diet pills, fasting, strict diets and exercise was common. The findings are discussed within the context of sociocultural pressures on women to conform to a slim ideal shape and size. Sensitive management of the problem is needed. PMID- 3660134 TI - Low-birth-weight infants in the Cape Peninsula. A follow-up study at the age of 3 years. AB - A sample of coloured children from the Cape Town City Council area who had been of low birth weight, although a weight appropriate for gestational age, was examined at the age of approximately 3 years. The children were compared with a control group of similar social background who had been of normal birth weight. Growth parameters were compared with the National Center for Health Statistics centiles. The low-birth-weight infants had compensated well. Although they were lighter, shorter in stature and had lower intelligence quotient scores than their normal-birth-weight contemporaries, when corrected for prematurity the growth parameters and IQ did not differ significantly from those of the controls. Six per cent of the preterm infants had major and 15% minor handicaps. Infants with very low birth weights (less than 1500 g) had no more handicaps than those with low birth weights. Iron deficiency was detected in 18% of the children overall but all those who were anaemic were from the low-birth-weight groups. Between 1 and 3 years of age the low-birth-weight infants had more illnesses but no more hospital admissions than the controls. PMID- 3660135 TI - Some aspects of household diet and family income problems in Transkei. AB - Apparent levels of household diet, perceptions of diet and food production, rural water supplies, attitudes to birth control, and household incomes and expenditure of families in rural areas in Transkei were studied. The results revealed problems of deficiencies in family energy intake and low incomes, such that at least 40% of rural families were living in a state of poverty. There is urgent need for an integrated development approach aimed at fulfilling basic needs. PMID- 3660136 TI - Sealed-off spontaneous perforation of the common bile duct. A case report. AB - A case of spontaneous perforation of the common bile duct is reported, in which there was no bile peritonitis or bile collection. The mechanism of sealed-off perforation of the duct is discussed. Cholecystectomy and T-tube decompression of the common bile duct were performed after exploration. PMID- 3660137 TI - Gilded cervico-uterine stem retained for 49 years. A case report. AB - Retention of a gilded 'wish-bone' cervico-uterine stem pessary inserted 49 years previously was the unusual cause of postmenopausal bleeding. This device, which is of historical and developmental interest, therefore still has clinical relevance. PMID- 3660138 TI - Diastematomyelia without a median septum in congenital scoliosis. A report of 2 cases. AB - Two unusual cases of congenital scoliosis with distematomyelia, without median septa and with single dural sacs, are described. Both cases were neurologically intact without any stigmata of diastematomyelia in the lower extremities. Computed tomographic myelography added valuable information to the radiological anatomy. PMID- 3660139 TI - Postpartum sterilisation with the Filshie clip and subsequent pregnancy. PMID- 3660140 TI - Complications of circumcision using the Plastibell device. PMID- 3660141 TI - Dosage schedules for tuberculosis patients. PMID- 3660142 TI - Detached ciliary tufts in semen. PMID- 3660143 TI - Haemorrhage from the maxillary artery. PMID- 3660144 TI - Occupational health legislation--progress since 1983. PMID- 3660146 TI - The academic vacuum. PMID- 3660145 TI - Cochlear implants. PMID- 3660147 TI - The contemporary romance of alternative medicine. PMID- 3660148 TI - Neonatal maintenance solution--is neonatalyte safe? AB - Newborns in the neonatal unit at Ga-Rankuwa Hospital who required intravenous fluids were randomly allocated, after 24 hours of life, to receive either Neonatalyte (Sabax) or a control solution. Biochemical monitoring was performed every 12 hours for a period of 5 days. Neonatalyte does not cause hyperkalaemia or hypocalcaemia in the early neonatal period. PMID- 3660149 TI - Therapeutic monitoring as an aid in rationalizing aminoglycoside dosage techniques in the neonate. AB - General pharmacokinetic parameters applicable to adults are not suitable in neonatal practice owing to wide interpatient variations in respect of fluid balance, renal clearance and metabolic rates. We attempted to determine whether acceptable blood levels of gentamicin or tobramycin are obtained with dosage regimens and dosage techniques which are generally recommended. Forty neonates receiving aminoglycosides were studied. After administration of the drug as a slow, constant intravenous infusion into the 'Y' connection of the infusion set, peak levels were found to be subtherapeutic. Trough levels were also very low. After administration of the same dose of gentamicin or tobramycin as a bolus into the butterfly connection of the infusion set, however, high therapeutic levels were obtained. We therefore recommend that gentamicin and tobramycin be administered as an intravenous bolus injection and that blood levels be monitored constantly in order to individualize therapy. PMID- 3660150 TI - Use of mitoxantrone-based combination chemotherapy regimens as first-line treatment for advanced breast cancer. AB - Three first-line combination chemotherapy regimens which included mitoxantrone were studied for the treatment of advanced breast cancer. The first combination, consisting of methotrexate, mitoxantrone (Novantrone) and 5-fluoro-uracil (MNF), gave a response rate of 17/48 (35%). Cyclophosphamide + mitoxantrone (CN) gave a response rate of 20/31 (64%) while cyclophosphamide + mitoxantrone + vincristine (CNV) gave a response rate of 28/39 (72%). The response durations for the three regimens were 6 months for MNF, 7.5 months for CN and 11.5 months for CNV. The regimens were well tolerated with an approximately equal frequency of side effects. Cardiotoxicity was infrequent, occurring in only 2 patients out of 118 studied. PMID- 3660151 TI - Osteopenia of the pelvis associated with Mseleni joint disease. Radiological aspects. AB - Mseleni joint disease, an endemic form of osteoarthritis (OA), is associated with osteopenia (OP). In a detailed investigation of the disorder, the degree of OP was assessed in 593 radiographs of the pelvis which were taken during surveys of four populations: rural blacks from Mseleni, rural blacks from Manguzi (a similar population to Mseleni), a black control group of rural Tswanas and a white control group from Johannesburg. Only females were included because the number of males in the rural populations was too small. The radiographic trabecular pattern was assessed at four sites: sacrum, ilium, pubis and ischium. Four grades were used: O = normal bone, 1 = minimal OP, 2 = definite OP, 3 = severe OP. The sum of the grades at the four sites made up the OP score for the individual. The OP scores increased with age in all groups, the age-specific mean OP scores did not differ in the non-OA subgroups of all four populations, and subgroups with OA had significantly higher age-specific mean OP scores than those without OA. PMID- 3660152 TI - Microbiology of secondary osteomyelitis. Value of bone biopsy. AB - Secondary osteomyelitis occurs as a direct infection of bone from a source outside the body or as progressive and continuous spread of infection from a contiguous focus. Twenty patients with secondary osteomyelitis were studied. Pathogens were identified by culture of biopsy material from infected bone. Staphylococcus aureus accounted for most cases in the upper limbs, while infection in the lower limbs was predominantly associated with Gram-negative bacilli. The essential value of bone biopsy in treatment is emphasised. PMID- 3660153 TI - The incidence of polyspermy during in vitro fertilisation. A study at the H. F. Verwoerd Hospital, Pretoria. AB - Results from 1249 in vitro-fertilised human oocytes were analysed to identify the incidence of polyspermy. In this study polyspermy occurred in 23 oocytes (1.8%). The effects of the various ovulation induction protocols employed, maturation of oocytes, incubation time before insemination and anaesthesia exposure were examined in order to identify a cause for polyspermy. Early diagnosis of polyspermy is important because the polyspermic embryo may appear morphologically normal at a later stage but should not be transferred since this nearly always results in a spontaneous abortion. PMID- 3660154 TI - Sex and infertility. Part I. Prevalence of psychosexual problems and subjacent factors. AB - Data on 514 couples with psychogenic factors affecting their sex lives and fertility showed that the most prevalent problems were lack of sex education, consequences of premarital sex and the problem of infertility per se. These factors contributed to psychosexual problems of which the general prevalence was 42% (10.5% women, 13.2% men and 18.3% both husband and wife). The high prevalence of psychosexual problems emphasises the importance of the inclusion of extensive training in sex counselling in the curricula of medical students and the urgent need for sex counselling facilities at training hospitals. PMID- 3660155 TI - Sex and infertility. Part II. Influence of psychogenic factors and psychosexual problems. AB - In a study of 514 couples ignorance about sex because of a complete lack of or inadequate sex education resulted in an unfavourable attitude towards sexual behaviour which adversely affected their fertility. Sexual activities which gave rise to feelings of guilt, fear or anguish had a dramatic effect on fertility; most important were premarital intercourse, criminal and therapeutic abortion, illegitimate children and prostitution. Psychosexual problems were found to have a direct influence on intercourse, as the results of post-coital tests showed. In 18.3% of cases severe psychosexual problems caused infertile couples to use lubricating substances to facilitate intercourse; this had a deleterious effect on penile penetration and on the migration of spermatozoa in the cervical mucus. PMID- 3660156 TI - [Artificial intrauterine insemination with washed prepared spermatozoa of the husband]. AB - Intra-uterine insemination with washed spermatozoa of the husband was evaluated in 42 infertile couples during 103 treatment cycles. A pregnancy rate of 47.3% was obtained after an average of 2 treatment cycles in a group of patients in whom hostile cervical mucus was the only known cause of infertility. A pregnancy rate of 21.7% was obtained after an average of 2.6 treatment cycles in a group of patients in whom low sperm morphology was the only known cause of infertility. The overall conception rate of 33.3% compares favourably with that in other published series. PMID- 3660157 TI - Reference values for serum copper, ceruloplasmin and zinc and haematological indices for healthy nulliparous females. AB - Reference serum copper, ceruloplasmin and zinc values were established for 100 healthy white nulliparous students aged 18-23 years resident in Cape Town who had been taking low-dosage triphasic contraceptives for a minimum period of 3 months, and in 100 female students not taking contraceptives. The mean serum copper values were 26.5 +/- 4.2 mumol/l and 16.9 +/- 2.7 mumol/l for those taking and not taking oral contraceptives respectively; corresponding values for ceruloplasmin were 181 +/- 43.9 IU/ml and 110 +/- 22.7 IU/ml respectively. Both differences were statistically significant. Serum zinc values for those on contraceptives were 14.1 +/- 2.1 mumol/l and for the others 14.7 +/- 2.0 mumol/l. There were no differences in the haematological parameters except for a significantly higher mean corpuscular volume in females taking oral contraceptives. Of possible clinical significance in this student population are prevalence rates of 2.2% for anaemia (haemoglobin value less than 11.5 g/dl), 7% for iron deficiency (serum ferritin less than 12 micrograms/l) and 6.6% for iron depletion (serum ferritin 12-20 micrograms/l). PMID- 3660158 TI - Carotid body tumours. A review of 52 cases. AB - During a 22-year period (1962-1984) 52 carotid body tumours were encountered in 50 patients. In addition, 2 of the patients had tumours of the glomus intravagale. One patient had a recurrent tumour, the first one having been removed 23 years previously. The ages ranged from 23 to 80 years, the female/male ratio was 2:1, and the right side was affected twice as often as the left. Four patients were treated non-surgically; 3 were too elderly and frail to undergo the operation and in the 4th case the tumour was considered inoperable. In 2 cases excision was attempted but abandoned for technical reasons. In the remaining 44 patients 46 tumours were excised, with grafting of the internal carotid artery in 6 cases. There were 2 deaths (4.5%), 1 after hemiplegia and 1 a pulmonary embolus. Eight patients were left with cranial nerve palsy, which had been present preoperatively in 5 cases. Of the tumours 7 (13.5%) were found to be malignant. The results of endocrine studies when undertaken were normal. Although ultrasonography and computed tomography were used in some cases, arteriography was the definitive mode of investigation. PMID- 3660159 TI - The effect of secretin on duodenogastric reflux in vagotomised dogs. AB - An experimental study investigated the effect of secretin on duodenogastric reflux in vagotomised dogs. The amount of reflux was estimated by measuring the concentrations of bile phospholipids in the gastric contents. Secretin infusion increased bile reflux into the stomach and promoted the production of lysolecithin from lecithin. PMID- 3660160 TI - Cholecystectomy with highly selective vagotomy--the effect on bile reflux. An experimental study. AB - An experimental study investigated the effect of highly selective vagotomy (HSV) alone and HSV combined with cholecystectomy on bile reflux into the stomach. The amount of reflux was estimated by measuring the concentration of bile phospholipids in the stomach. Neither HSV alone nor HSV combined with cholecystectomy was associated with increased reflux. In fact HSV seems to prevent reflux and inhibit the production of lysolecithin, which is injurious to the gastric mucosa. PMID- 3660161 TI - Successful coronary reperfusion with intracoronary streptokinase in a patient with coronary ectasia. AB - A case in which successful coronary artery reperfusion was achieved during an acute inferior wall myocardial infarction by means of infusion of streptokinase (Kabikinase; Adcock Ingram) into an ectatic right coronary artery is described. The pathogenic mechanisms resulting in occlusion of ectatic coronary arteries and the incidence of the condition are discussed and the importance of anticoagulation therapy in these patients is stressed. PMID- 3660162 TI - Metastases of prostate cancer to breast. A case report. AB - A case of carcinoma of the prostate metastasising to the breast and mimicking breast cancer in a male is presented. The possibility of this diagnosis should always be considered. The usefulness of cytochemical staining for prostate specific acid phosphatase is illustrated. PMID- 3660163 TI - Thoracic kidney. A report of 2 cases. AB - Thoracic kidney is extremely rare; there are two types--traumatic and congenital- which are illustrated. One patient had been in a motor vehicle accident and sustained injury to the diaphragm and the congenital representation was found in an asymptomatic patient with a hiatus hernia. Both displaced kidneys were left in situ. PMID- 3660164 TI - Measles in South Africa. PMID- 3660165 TI - The impoverishment of the medical profession. PMID- 3660167 TI - Widal testing for typhoid. PMID- 3660166 TI - Tibial and fibular shaft fractures. PMID- 3660168 TI - Pelvic inflammatory disease associated with Neisseria gonorrhoeae and Chlamydia trachomatis: clinical correlates. AB - The purpose of this study was to determine whether selected clinical features can distinguish salpingitis associated with endocervical Neisseria gonorrhoeae from that caused by Chlamydia trachomatis in black, inner-city adolescents. We reviewed retrospectively the charts of teenagers presenting to a university hospital outpatient department between January 1982 and January 1984 who were diagnosed as having salpingitis. We included all teenagers who presented with a history of low abdominal pain plus (1) either cervical motion tenderness (n = 15), adnexal tenderness (n = 13), or both (n = 57); and (2) either cervical cultures positive for N. gonorrhoeae and negative for C. trachomatis (n = 31) or cervical cultures negative for N. gonorrhoeae and positive for C. trachomatis (n = 54). Discriminant analysis indicated that the presence of breakthrough vaginal bleeding (standard regression coefficient [SRC] = 0.301; P = 0.023), current usage of oral contraception (SRC = 0.408; P = 0.009), and an elevated erythrocyte sedimentation rate (SRC = 0.522; P = 0.0002) were significantly more often related to the presence of endocervical C. trachomatis. However, we found no significant differences between the two groups for other variables that have been described as distinguishing features (i.e., duration of pain, fever, and leukocyte count). PMID- 3660169 TI - Topical self-treatment of penile warts with 0.5% podophyllotoxin in ethanol for four or five days. AB - Penile condylomata were eradicated from 26 (70%) of 37 and from 15 (63%) of 24 uncircumsized men with penile warts who performed one course of self-treatment with 0.5% podophyllotoxin in ethanol, which was applied twice daily for four and five days, respectively. In comparison with previous data on the efficacy for use of the same regimen for only three days, no major advantages were observed; instead, the frequency of local adverse effects was increased. However, because warts growing in a plaque-like fashion reacted favorably to the therapy, such lesions may be treated for four to five days if they are recalcitrant to the three-day regimen. The efficacy of application of 0.5% podophyllotoxin in ethanol only once daily was significantly lower than that resulting from application twice daily. PMID- 3660170 TI - Effect of prior sexually transmitted disease on the isolation of Chlamydia trachomatis. AB - In developed nations, Chlamydia trachomatis is the most common sexually transmitted pathogen. To determine whether prior disease affects the probability of subsequent chlamydial infection, we took culture specimens from 2,546 men and 1,998 women attending a sexually transmitted diseases clinic. The men had nongonococcal urethritis and the women were contacts of men who had a positive chlamydial culture or nongonococcal urethritis. Significantly lower isolation rates for those with a history of sexually transmitted diseases were found for both men (29% vs. 38%; P less than 0.0001) and women (27% vs. 36%; P less than 0.0001). In addition, both men and women with previously documented chlamydial infections had a lower isolation rate at the index visit, if the previous infection occurred less than, as opposed to more than, six months earlier (men: 20% vs. 41%; P = 0.0006; women: 14% vs. 35%; P = 0.003). These relationships were found to be independent of age. However, the effect of partial immunity due to prior infection could not be distinguished from that of prior antibiotic therapy, and if such immunity does confer protection against reinfection, that protection appears to be both partial and of relatively short duration. PMID- 3660171 TI - Illness behavior among patients attending a sexually transmitted disease clinic. AB - A questionnaire on illness behavior was administered to a consecutive sample of 90 men and 47 women attending a public clinic for sexually transmitted diseases. Abnormal illness behavior (particularly general hypochondriasis, degree of psychologic perception of illness, and denial of stresses apart from the illness) increased with the number of previous infections. Those with no previous infections saw sexually transmitted disease as an illness significantly less often than those with previous infections. First attenders have a higher risk of noncompliance with treatment, and illness behavior may develop by association with repeated infections and the increasingly apparent connection between behavior and illness. These findings applied to homosexual as well as to heterosexual men, although responses to the questionnaire showed that homosexual men were significantly less hypochondriacal. It is concluded that there is greater evidence of psychologic maladjustment among this clinic population than among that attending general practices and that illness behavior is related to established risk factors such as more partners and previous infections. PMID- 3660172 TI - Detection of leukocyte esterase in urine: a new screening test for nongonococcal urethritis compared with two microscopic methods. AB - First-catch urine samples of 130 men attending a clinic for genitourinary medicine were screened with the leukocyte esterase dipstick test. Conventional microscopy of centrifuged sediment and inverted microscopy of unspun urine samples were performed 2-4 hr later. The leukocyte esterase test had sensitivities of 100% and 96.6% and specificities of 55% and 52.8%, respectively, when compared with the two microscopic methods. The apparently low predictive value of the positive leukocyte esterase test was probably linked to its ability to detect lysed cells and the limitations of the microscopic methods, which were used as the absolute indicator of nongonococcal urethritis. Of the 42 patients with microscopic pyuria, 45.2% had positive cultures for Chlamydia trachomatis, and the leukocyte esterase test was positive in every case. Twenty-one per cent of the C. trachomatis-positive patients were asymptomatic, and 42% had fewer than five polymorphonuclear leukocytes per high-power field (X1000) of the gram stained urethral smear. The leukocyte esterase test appears to be a simple, practical, and sensitive test that is useful in screening for nongonococcal urethritis, especially asymptomatic nongonococcal urethritis. PMID- 3660173 TI - [Acute leukemia in pregnant women. Review of 20 cases]. PMID- 3660174 TI - [Morphophotometric study of 66 cases of non-Hodgkin's lymphoma classified according to the Working Formulation and comparison with their benign cell counterparts]. PMID- 3660175 TI - [Systemic mastocytosis: study of 5 cases]. PMID- 3660176 TI - [Treatment of non-Hodgkin's lymphoma in children in Costa Rica. Analysis of the long-term results of a study with multiple chemotherapy without radiotherapy]. PMID- 3660177 TI - [Hb C homozygosity and double Hb C/beta + thalassemia heterozygosity in a Spanish family]. PMID- 3660178 TI - [Hemoglobin Complutense (beta 127 (H5) Gln replaced by Glu) in a Spanish family]. PMID- 3660179 TI - [Blood cell counts in parenteral drug addicts]. PMID- 3660180 TI - [Neonatal icterus and erythrocyte glucose-6-phosphate dehydrogenase deficiency. Experience in Costa Rica]. PMID- 3660181 TI - [Myelodysplastic syndromes: characterization of a series of 56 patients classified according to FAB criteria]. PMID- 3660182 TI - [Role of the hematocrit and platelet count in the interaction of the platelets with the subendothelium]. PMID- 3660183 TI - [Haplotype in 3 patients homozygous for beta-thalassemia]. PMID- 3660184 TI - [Value of erythrocyte ferritin in heterozygous A2 and F thalassemias]. PMID- 3660185 TI - [Plasma fibronectin in normal subjects and in Hodgkin's disease]. PMID- 3660186 TI - [Effects of methyldopa on the humoral immune response to goat red cells in the rat]. PMID- 3660188 TI - [Type I congenital dyserythropoietic anemia presenting in the neonatal period]. PMID- 3660187 TI - [High-dose cytosine arabinoside and L-asparaginase in the treatment of refractory or recurrent acute non-lymphoblastic leukemia]. PMID- 3660189 TI - [Two-way dialysis catheters as prolonged vascular access in onco-hematologic patients]. PMID- 3660190 TI - [Myeloma without a monoclonal component with tumor and neurologic manifestations]. PMID- 3660192 TI - The future of Social Security. PMID- 3660191 TI - Social Security reforms in Japan. PMID- 3660193 TI - Money incomes of aged and nonaged family units, 1967-84. AB - This article provides a detailed examination of changes in the income of the aged and of other age groups from 1967 to 1984. Levels of income, income inequality, the relative importance of selected types of income, and the poverty rates of various age groups are also analyzed. The data are from the Bureau of the Census Current Population Survey and annual money income before taxes is the measure of income. The relative income gains of the aged, compared with the nonaged, in 1967 84 reversed an earlier pattern in the post-World-War-II period: From 1947 to 1967, the incomes of the nonaged rose at a faster pace than those of the aged. Differences in their income growth were greater in 1979-84 than in 1967-79. Despite the substantial difference in the rates of income growth for the aged and nonaged units in 1967-84, the relationship between age and median income was altered only slightly. In 1984, aged family units continued to have relatively low median income, especially compared with the incomes of those in middle age. PMID- 3660194 TI - Splenectomy performed upon thirty-seven patients with hairy cell leukemia. AB - Thirty-seven patients with hairy cell leukemia underwent splenectomy. The postoperative course was uneventful for 34 patients. Improvement of peripheral cytopenia was obtained in the majority of patients. Survival time of patients who underwent splenectomy was significantly longer than for patients who did not undergo this procedure. Splenectomy is a habitually effective form of treatment for hairy cell leukemia, although not completely free of risks. PMID- 3660195 TI - Update on clinical experience with different surgical techniques of the endorectal pull-through operation for colitis and polyposis. AB - During the past ten years, 145 patients (130 with ulcerative colitis and 15 with polyposis) have undergone colectomy and endorectal ileal pull-through operations at the UCLA Medical Center. The mean age of the patients at operation was 22.4 years (a range of seven to 56 years). All of the patients had a two stage operation with temporary ileostomy. Five had an S-shaped reservoir (SR), one patient had a J-shaped reservoir (JR), 12 patients had no reservoir (NR), 97 had a lateral reservoir with the reservoir constructed at the second operation (LR-2) and 30 had a lateral reservoir constructed at the first operation (LR-1). The most common complications were reservoir inflammation, obstruction of the reservoir outlet, stricture of the ileoanal anastomosis, superficial wound infection and sinus tracts extending upward between the rectal muscle cuff and the pull-through segment of ileum. Forty-four patients underwent reoperation for one or more of the complications. Reoperation was performed upon 60 per cent of the patients with SR, 36 per cent with LR-2, 10 per cent with LR-1 and 17 per cent with NR. Of the reoperations, 33 were performed upon the first 50 patients. Only 11 of the last 95 patients required a corrective operation. Of the last 95 patients, 97.5 per cent are currently functioning well. Important features of the operative technique include using a short rectal muscle cuff (5 centimeters or less), constructing a short reservoir (less than 15 centimeters) and having a short reservoir spout (less than 2 centimeters). Although a reservoir reduces fecal urgency and frequency in most instances, patients with obesity, anorectal muscle spasm, severe rectal disease and thick mesentery may be best treated with no reservoir. In our experience, the LR-1 procedure is technically easy to construct, has a low incidence of complications and is the preferred technique. PMID- 3660196 TI - Preservation of the parathyroid glands in total thyroidectomy. AB - A series of 183 patients who underwent total thyroidectomy is presented. The operative method, which emphasizes visualization and preservation of the parathyroid glands and their blood supply, as well as exposure of the recurrent laryngeal nerves, is discussed in detail. Permanent hypoparathyroidism was a complication in six patients (3.3 per cent). Permanent nerve injury occurred in one patient (0.55 per cent). Postoperatively, 78 patients had radioactive iodine uptake studies to evaluate the amount of residual thyroid tissue in the neck. Sixty-four (82 per cent) had 24 hour uptake studies of less than 2 per cent and 52 had an uptake of less than 1 per cent. Although a careful and consistent technique of total thyroidectomy substantially reduces the danger of permanent hypocalcemia, we experienced this complication sporadically. Since no operative technique completely removes the danger of permanent hypoparathyroidism, it is our opinion that total thyroidectomy should not be the standard management for carcinoma of the thyroid gland. It is best reserved for those patients in whom the extent of disease or the aggressiveness of the histologic cell type warrants the increased risk. PMID- 3660198 TI - A tool for transhepatic stenting. AB - A modified method for transhepatic tube stenting is presented. The use of a No. 25 gauge music wire (1.5 millimeters in diameter) allows for different surgical maneuvers to be performed without parenchymal splitting. This technique can also be used in a slightly dilated biliary tree. PMID- 3660197 TI - Comparison of nosocomial infections due to Staphylococcus aureus and enterococci in a general hospital. AB - Hospital acquired infections caused by enterococci are increasing in incidence. This increase has been attributed, in part, to widespread use of cephalosporin antibiotics which lack activity against enterococci. To test this hypothesis, we compared patients having nosocomial enterococcal pulmonary and wound infections with those patients having nosocomial staphylococcal infections for antecedant cephalosporin use. In a six month period, we found 14 instances of nosocomial enterococcal wound and respiratory infections; 13 were superinfections (occurring during or up to one week after administration of antimicrobials). Seven had coexisting pathogens noted. In the same six month period, 30 instances of Staphylococcus aureus nosocomial respiratory tract and wound infections were found and only 13 were superinfections (p less than 0.002 compared with enterococcal superinfections). Nine had coexisting pathogens noted. The mean age, gender distribution and underlying illnesses in the Staphylococcus aureus and enterococcal superinfection groups were comparable. Of the 14 instances of enterococcal nosocomial infections, 11 were associated with administration of a cephalosporin compared with seven of 30 for staphylococcal infections (p less than 0.002). Nosocomial enterococcal infections are commonly associated with antimicrobial therapy and the use of cephalosporins may selectively predispose patients to increased risk of enterococcal superinfections. PMID- 3660199 TI - A set of new angled, hand held retractors for use in abdominal and perineal operations. PMID- 3660200 TI - Partial gastric resection by surgical stapler. AB - This technique of gastric resection is easily applied and is useful for benign lesions or complicated lesions in poor risk patients. For lesions of the fundus, it may obviate an esophagogastric anastomosis. To our knowledge, the procedure has not been described in gastric resection. PMID- 3660201 TI - A new reflux-free surgical esophageal intubation technique. AB - Pull-through esophageal intubation with a composite, detachable prosthesis allows insertion of the tube only in the narrowing due to the tumor. Using this easy technique, which permits a convenient low, small 3 millimeter gastrotomy, the intra-abdominal contamination is reduced. The end of the tube does not pass across the cardia, so the patient is free from gastroesophageal reflux and its consequences. PMID- 3660202 TI - Direct vision valvulotomy in in situ venous bypass. AB - The autogenous saphenous venous bypass is accepted as an optimal procedure for distal arterial reconstruction. However, serious complications, including incomplete valvulotomy, laceration of the venous wall and persistent arteriovenous communications, are found in in situ bypasses. To avoid these complications, a new and simple technique using an angioscope in the in situ venous bypass has been developed. Angioscopy prevents tearing of the vein wall and avoids inaccurate incision of the valves. PMID- 3660203 TI - The omentum as an untapped reservoir for microvascular conduits. AB - The use of the omentum as a source for vessel grafts is recommended when long or multiple vessel conduits are needed and when a combination of vessel grafts and soft tissue are needed. It is particularly suitable in reconstructing the superficial palmar arch but may also provide an immense graft reserve for the imaginative and careful surgeon. PMID- 3660204 TI - Immunohistochemical, electron microscopic, and morphometric studies of human prolactinomas after short-term bromocriptine treatment. AB - Two cases of human prolactinomas after short-term treatment with bromocriptine were studied by means of immunohistochemistry for prolactin, electron microscopy, and morphometry at the ultrastructural level. The results obtained showed an abundance of immunoreactive secretory granules in the tumor cells, a paucity in the electron microscopic images suggesting exocytosis of secretory granules, and no significant changes in the volume density of rough endoplasmic reticulum when compared with untreated (control) tumor cells. These findings strongly suggest that the effects of short-term bromocriptine treatment for lowering serum prolactin levels did not inhibit protein and secretory granule synthesis but rather caused a disturbance in the secretion of prolactin granules. The present morphometrical data suggest the possibility that a reduction in the number of cytoplasmic microtubules might be related to the disturbance of prolactin secretion. PMID- 3660205 TI - Thoracic aortic occlusion: somatosensory evoked potential monitoring and neurologic outcome in a canine model. AB - Somatosensory evoked potentials (SEPs) were monitored in 17 canines during spinal cord ischemia induced by balloon occlusion of the thoracic aorta. Graded distal aortic hypotension to 40 mmHg in seven animals had no significant effect upon the evoked potential. A significant alteration in the SEP did result in 21 +/- 9.8 minutes when distal aortic pressures were reduced in a graded fashion below 30 mmHg. Acute occlusion of the thoracic aorta (10 animals, distal pressure 15-25 mmHg) was associated with a change in the SEP in 8.4 +/- 4.3 minutes. Continuation of aortic occlusion for 30 minutes beyond an evoked potential change resulted in a moderate to severe motor deficit in all cases. Somatosensory evoked potentials obtained 72-96 hours after the ischemic injury were closely correlated with sensory deficits, but were not predictive of motor examination. Histologic examination of the spinal cords demonstrated central gray necrosis of the lumbar region in all animals with a severe deficit, and a variable degree of neuronal loss in the intermediate and dorsal gray matter zones in animals with moderate deficits. This balloon occlusion method is relevant as a model of spinal cord injury during aortic occlusion, such as may occur during aortic surgery. PMID- 3660206 TI - Contributions of magnetic resonance imaging in the evaluation of optic gliomas. AB - Eleven patients with gliomas in the optic chiasm were studied using a 0.5 Tesla superconducting system and third generation computed tomography scanners. All tumors were identified with both modalities, but in the majority of cases, the posterior extension of the tumor and its relationship to adjacent brain, important to both prognosis and management, were shown better by magnetic resonance imaging. PMID- 3660207 TI - Incisional adenocarcinoma after intracranial metastasis resection. AB - Skin and subcutaneous secondary tumors are unusual, especially in cases of colonic adenocarcinoma. They usually signify disseminated metastases. A rare case of an isolated incisional tumor after resection of a metastasis to the cerebellum is presented. The pathophysiology and management of such an event is discussed. The clinical setting suggests that this occurrence represented the result of microscopic deposits of neoplastic cells in the wound rather than hematogenous spread. PMID- 3660208 TI - Meningeal chondrosarcomatous tumor associated with meningocytic differentiation. AB - Most meningeal chondrosarcomatous tumors have been regarded as identical to similar tumors occurring elsewhere in the body. The neoplasm reported here, however, clearly demonstrated transitions between usual meningiomas and chondrosarcomatous tumors. The present case thus provides evidence in support of Cushing's and Eisenhardt's proposal that some meningeal chondrosarcomatous tumors are derived from meningeal cells and are histogenetically related to meningiomas. PMID- 3660209 TI - Cervical vertebral erosion due to tortuous vertebral artery. AB - A case of cervical vertebral erosion due to tortuous vertebral artery is presented. This entity is rare and only 11 cases have been reported in the literature. The present case is the first to be demonstrated by magnetic resonance imaging. The importance of considering this vascular anomaly in the differential diagnosis of cervical spinal tumors is discussed. PMID- 3660210 TI - Pituitary enlargement with target organ deficiency: hypothyroidism and hypogonadism. AB - Three women with pituitary enlargements associated with preexisting target organ failures are reported. Two pituitary enlargements owing to primary hypothyroidism and one to primary hypogonadism were shown to be regressed on computed tomography after the replacement therapy. Clinically and pathologically, the differentiation of a pituitary hyperplasia from a pituitary adenoma is often very difficult. Moreover, the treatments for these conditions are quite different. Adequate medication can diminish a pituitary enlargement because of the feedback mechanism. Existence of the target organ deficiency should always be checked before the management of pituitary tumor. PMID- 3660212 TI - American Board of Neurological Surgery. PMID- 3660211 TI - Chiasmal syndrome caused by pituitary-sellar disproportion. AB - A patient with pituitary-sellar disproportion, a perichiasmal visual field defect, and no clinically demonstrable endocrinopathy is presented. Radiographic and pathologic studies suggested that the pituitary-sellar disproportion was secondary to sellar hypoplasia, a previously unrecognized cause of the chiasmal syndrome. It remains to be seen whether hormonal manipulation aimed at suppression of gonadotropin- and/or prolactin-secreting cells might obviate the need for exploration in patients similar to ours. PMID- 3660213 TI - Ependymal cell proliferation after spinal cord injury. PMID- 3660214 TI - Resection of arteriovenous malformation. PMID- 3660215 TI - A case report--valuable? PMID- 3660216 TI - Costs of prostatectomy: variations within the United States. PMID- 3660217 TI - Profile of the American husband. PMID- 3660218 TI - Trends in ectopic pregnancies: United States 1970 to 1985. PMID- 3660219 TI - New high for expectation of life. PMID- 3660220 TI - [Scientific bases of radiation protection--stages and turning points in 60 years' development]. PMID- 3660221 TI - [High-dose preoperative radiotherapy of primary inoperable oropharyngeal cancer]. AB - Despite the great progress made by tumor therapy in recent years, it has not yet been possible to obtain a decisive improvement in the five-year survival of about 20% and the five-year recurrence-free survival of about 30% of patients suffering from advanced T3 oropharynx carcinomas. A new way to improve the poor prognosis of these patients is only offered by the possibilities of modern radiotherapy with ultrahard X-radiation as well as by the progress of microsurgery. Up to now, the recurrence-free survival of our patient's group suffering from primarily inoperable T3 oropharynx carcinomas has reached 60% (increase of about 40%). This was achieved by preoperative high-dose irradiation and subsequent implantation of myocutaneous skin flaps with the vascular bundle supplying the flap with blood. As is shown by the communications of literature and our own experience, about 80% of all recurrences will appear within the first 24 months after the end of therapy. In our preoperatively high-dose irradiated group, the observation period is meanwhile 48 months, and the recurrence-free survival is still by 40% higher than that of the control groups. Although a new formation of local recurrences cannot be excluded for the further observation time and despite the small number of patients, the rate of recurrence-free patients suffering from tumors of stage T3N+ signifies a most promising therapeutic approach. PMID- 3660222 TI - Radical radiation therapy of the thoracic esophageal carcinoma supplemented with or without salvage surgery. AB - From September 1977 to June 1985, 63 patients received radical radiotherapy for squamous cell carcinoma of the thoracic esophagus at the Center for Adult Diseases, Osaka. Fourty-six of them received radiation therapy alone (RT) and 17 received surgical treatment after irradiation (RT-OP) due to local recurrence or residual tumor. In these groups, 38 of 46 in RT only group and twelve of 17 in RT OP group were selected for radiotherapy because of high risk for surgery or T3 lesion. For RT only group, tumor response after irradiation was the most important prognostic factor and a statistically significant difference of survival rates was detected between complete response (CR) group and non-CR group. Among RT-OP group, there were three five-year survivors in CR group (n = 8) after irradiation while no five-year survivor in non-CR group (n = 9). Tumor response after radical radiation therapy seems to show the indication for the salvage surgery in high risk or T3 patient. PMID- 3660223 TI - [Conservative treatment of anal cancer. Retrospective results--radiotherapy]. AB - The results of primary radiotherapy in anal carcinoma are reported in a retrospective study. Fourteen patients have been treated by primary radiotherapy between 1970 and 1982. The three-year survival rate is 11/14 (corrected: 11/12). Among eleven patients followed up, ten have a normal anal function. The importance of radio-oncology as a therapy of choice in conservative, function preserving treatment of the anal carcinoma is discussed regarding the retrospective results as well as possible combinations of radiotherapy and chemotherapy. PMID- 3660224 TI - [Interstitial brachytherapy using 192-iridium in locally recurring tumors]. AB - Between January 1983 and December 1985 49 patients with different malignancies underwent a palliative interstitial brachytherapy with 192Iridium. 25 patients with local recurrences without distant metastases were analysed retrospectively: 17 (68%) complete remissions and six (24%) partial remissions were achieved, two (8%) patients did not respond to therapy. Seven patients (28%) developed subsequent recurrence. PMID- 3660225 TI - [Equipment for rapid and reliable perineal implantation of I-125 seeds in prostatic cancer with reduced radiation exposure]. AB - The aim of an implantation of iodine seeds into the prostate controlled by ultrasound is reached by means of the equipment presented in this paper. The method, allowing to implant the seeds according to the therapy plan, has been developed above all in order to reduce the radiation exposure to the physicist, the radiotherapist and the surgeon. PMID- 3660226 TI - [The T category and metastasis in testicular tumors]. AB - On the background of the advantageous prognosis of patients with testicular tumors we define subgroups in which therapy can be reduced. Basing on the distribution of metastases, especially the localisation of solitary nodes, staging LA may be limited to certain regions in patients with non-seminomas. The modification of irradiation fields for seminomas is difficult as the predictive value of negative diagnoses (CT, sonography, lymphography) is only 77%. As the topography of metastases does not differ within the various T-categories, the necessary extent of irradiation cannot be related upon them. In clinical stage I contralateral iliacal fields have not to be included. In left-sided tumors no positive solitary nodes were found in the ipsilateral iliac region, subsequently we suppose that this area might be preserved. In right-sided tumors occasional solitary nodes in the ipsilateral field are not necessarily due to an infiltration of the epididymis; therefore we recommend in general a prophylactic irradiation of the ipsilateral iliac region. An inguinal irradiation should be reserved only for pre-operated patients and an involvement of the scrotal wall. PMID- 3660227 TI - [Computed tomography and MR tomography before and after radiotherapy of primary and secondary CNS lymphoma]. AB - CT scans were made prior to and following radiotherapy in eleven patients with primary or secondary malignant lymphomas of the CNS. Six patients were additionally submitted to MR tomography with calculated T1 and T2 images. Radiotherapy induced a very rapid regression of the lymphomas. A measurable quantitative influence of the irradiation could thus not be visualized in the MR scans. The survival curve of our patients was calculated, too. The median survival after radiotherapy is 17.4 months. PMID- 3660228 TI - [Cystic craniopharyngiomas: computed tomography in the pretherapeutic evaluation and control of treatment results following intracystic contact irradiation]. AB - A report is given on the treatment planning by computed tomography and monitoring in 37 cases of preponderantly cystic craniopharyngiomas with different solid tumor parts. Colloidal yttrium 90 silicate was used for the intracystic contact irradiation. Two pretherapeutic forms of the solid tumor parts were found in CT examination which correlated with different courses: 1. the polymorphic type and 2. the type with a smooth outline. A posttherapeutic decrease of the cystic volume was observed in 74% of type 1 cases (n = 19) and in 89% of type 2 cases (n = 18). An increase in volume was only found in type 1 (21%). An increase of the solid tumor part was also found exclusively in the polymorphic type (68%). An additional external irradiation should be considered for this CT manifestation of the tumor, as the solid tumor part is not exposed in intracystic contact irradiation. PMID- 3660229 TI - Radiation myelopathy of the mouse spinal cord--isoeffect correlations after fractionated radiation. AB - A one cm long segment of the lower thoracic upper lumbar spinal cord of mice was irradiated using one, two, three, five, seven, ten, 15, 20 and 25 daily fractions. The animals were checked for paraparesis of the hind legs over their entire life span up to two years. The ED 50-values for radiation myelopathy for intervals of 250 up to 550 days were calculated. The resulting isoeffect curves follow an upward bending course being flat for one to five fractions and then getting steeper up to 25 fractions with a slope of 0.27 to 0.30. For intervals between 250 and 550 days the isoeffect curves run a parallel course. Only ED 50 values for intervals of 550 days post radiation omitting data above 6 Gy/fraction fit the linear quadratic cell survival (LQ) model with an alpha/beta value of 6.5 Gy which is relatively high compared to alpha/beta-values for late damage of normal tissues. Incomplete repair between fractions or overlapping effects of the cell systems responsible for radiation myelopathy (oligodendrocytes and endothelial cells) might account for failure of the other isoeffect data to fit the LQ-model. There are important differences of the isoeffect correlations of rat and mouse radiation myelopathy probably due to different repair characteristics and kinetics between the involved cells. On the other hand similarities of isoeffect correlations of man, rat and mouse are observed. Therefore the model of mouse radiation myelopathy presented in this paper might be used to test new treatment strategies. PMID- 3660230 TI - Some legal decisions significant for ophthalmology. AB - The court decisions included in this article reflect judicial attitudes towards medicolegal cases in most states. The courts have defined and amplified issues of informed consent, the physician's duty to warn patients and protect third parties, the limitations of the "Good Samaritan" statute, the responsibility of the physician to prepare insurance reports, and the denial of coverage by third party payers. Several cases regarding these issues are reviewed and their implications for ophthalmologists are discussed. PMID- 3660231 TI - Retinitis pigmentosa. A mimic of neurologic disease. AB - Six patients with various forms of retinitis pigmentosa who were misdiagnosed as having neurologic disease are presented. In five of the patients, visual field defects were misinterpreted as being secondary to a neurologic rather than a retinal problem. In two patients, optic nerve drusen, which accompanied the retinal degeneration, were mistaken for papilledema. Since the diagnosis of retinitis pigmentosa is not always obvious on ophthalmoscopy, the clinician must be aware of the various manifestations of this disorder and be able to distinguish visual field defects on a retinal from a neurologic basis. PMID- 3660232 TI - Presidential address: the academic medical center--dynasty or dinosaur? PMID- 3660233 TI - Colon interposition for benign esophageal disease. AB - We reviewed 53 consecutive patients with benign disease who underwent esophageal resection followed by colon interposition to assess operative morbidity and long term results. Indications were gastroesophageal reflux in 32 patients, advanced motility disorders in eight, esophageal perforation in six, and strictures not related to reflux in seven. There were two operative deaths (3.8%). Fourteen other patients (26.4%) had 18 major complications including three graft infarcts, two graft perforations, and four anastomotic leaks, one of which required surgical treatment. Follow-up was complete in 83% of patients and averaged 5 years. Eight patients required dilations; and 15 underwent late reoperations for stricture, persistent symptoms, or anastomotic leak. Of the 20 patients who did not have pyloroplasty done at the initial resection, five (25%) required a subsequent gastric emptying procedure. Results were rated by patients (subjectively) and physicians (objectively, based on symptoms and the need for further therapy) as 1 = excellent, 2 = good, 3 = fair, and 4 = poor. The patients' ratings averaged 1.89, with 27 patients (75%) claiming good or excellent results despite symptoms of postprandial fullness in 78% and dysphagia in 42%. Objective ratings averaged 2.05, with 28 of 39 patients (72%) rating the results as excellent or good. Despite a 30% major complication rate and a 37% late reoperative rate, colon interposition for benign esophageal disease can be accomplished with low mortality and high patient acceptance and remains our preferred technique for reconstruction of benign esophageal disease. PMID- 3660234 TI - Specificity and sensitivity of objective diagnosis of gastroesophageal reflux disease. AB - To evaluate the diagnostic value of different tests for gastroesophageal reflux disease, a test population was constructed from 45 patients with symptoms of heartburn and regurgitation with or without esophagitis and 45 healthy subjects, who never experienced heartburn, regurgitation, or swallowing discomfort. The test population underwent esophagoscopy, standard acid reflux test, 24-hour pH monitoring, and manometry of the lower esophageal sphincter. Sensitivity, specificity, positive predictive value, negative predictive value, and the accuracy of the tests and test combinations were calculated. Esophagoscopy had a sensitivity of 62%, that is, only 62% of patients with the disease have evidence of mucosal damage on endoscopy. Manometric measurements of the lower esophageal sphincter had a sensitivity of 84%, a specificity of 89%, and an accuracy of 87%. Twenty-four hour esophageal pH monitoring had a sensitivity, specificity, and accuracy of 96%. The results show that 24-hour pH monitoring can detect gastroesophageal reflux disease with an accuracy of 96% by measuring an increase in esophageal acid exposure. Manometry of the lower esophageal sphincter can detect a mechanically deficient sphincter as a cause of the disease with an accuracy of 87%. The test combination of 24-hour monitoring and motility studies can select patients with an accuracy of 91% who have an increase in esophageal exposure to gastric juice because of a deficient cardia. Antireflux surgery is designed to reduce esophageal exposure to gastric juice in patients with a deficient sphincter by creating a mechanical antireflux mechanism at the cardia. Therefore it is necessary to determine the mechanical status of the sphincter with manometry before surgery in such patients. Thus the indications for antireflux surgery are (1) uncontrolled symptoms of increased esophageal exposure to gastric juice; (2) a documented increase in esophageal exposure to gastric juice by 24-hour pH monitoring; and (3) a mechanically defective sphincter on motility with a pressure of 6 mm Hg or less, an overall length of 2 cm or less, and an abdominal length of 1 cm or less. PMID- 3660235 TI - Diagnosis and treatment of genitofemoral and ilioinguinal entrapment neuralgia. AB - During the past 7 years 30 patients were diagnosed as having either ilioinguinal or genitofemoral entrapment neuralgia. A multidisciplinary approach (surgeon, neurologist, and anesthesiologist), as well as local blocks of the ilioinguinal nerve and/or paravertebral blocks of L-1 and L-2 (genitofemoral nerve), were essential to determine accurately which nerve was specifically involved. Fifteen of the 17 patients (88%) diagnosed as having ilioinguinal neuralgia after previous inguinal herniorrhaphy are pain free after resection of the entrapped portion of the nerve. Thirteen patients were diagnosed as having genitofemoral neuralgia after previous inguinal herniorrhaphy, blunt abdominal trauma, or other surgery. Neurectomy of the genitofemoral nerve proximal to the entrapment controlled the persistent pain in 10 of 13 (77%) of these patients. Ilioinguinal or genitofemoral nerve entrapment neuralgias are rare complications of surgery in the inguinal region. When accurately diagnosed, neurectomy of the specific nerve is highly successful in relieving severe pain and paresthesia without significant morbidity. PMID- 3660236 TI - The physiology of postvagotomy duodenal ulcer healing: a prostaglandin connection. AB - This study evaluated the type and mode of action exerted by truncal vagotomy on mucosal prostaglandin content in the rat. Ninety-six rats were equally divided into sham-operated, vagotomy, atropine-treated, and cimetidine-treated groups. Each group was subdivided into stressed (cold-restraint) and nonstressed cells. Gastric mucosal injury was graded, and duodenal mucosa was processed for determination of prostaglandin content. Results included: (1) significant increases in duodenal mucosal prostaglandins in all experimental groups compared with sham-operated controls, (2) decreases in duodenal mucosal prostaglandin content associated with stress in all groups, and (3) significantly less gastric mucosal injury in all stressed, experimentally treated rats compared with sham operated animals. These results demonstrate that attenuation of gastric acid secretion, achieved either surgically or pharmacologically and proved by decrease in stress gastric injury, is associated with an increase in the content of duodenal mucosal prostaglandins. Such augmentation of mucosal prostaglandins could account for, along with the direct acid-lowering effect of vagotomy, the success of truncal vagotomy in the surgical cure of duodenal ulcer disease. PMID- 3660237 TI - Assessment of portosystemic shunt patency and function with magnetic resonance imaging. AB - Magnetic resonance imaging (MRI) was performed in seven patients before and after portosystemic shunting to evaluate venous changes accompanying nonselective and selective shunt construction. The size and number of the intrahepatic portal and hepatic veins, left perirenal veins, and left upper quadrant varices were evaluated at MRI before and after shunt construction. MRI correctly diagnosed patent shunts in all seven patients. A marked decrease in the size of intrahepatic veins after a total or nonselective shunt suggests adequate portal vein and variceal decompression. Dilatation of left perirenal veins in the presence of a patent mesorenal or splenorenal shunt suggests hypertension of the left renal vein and possibly inadequate decompression of esophageal varices. PMID- 3660238 TI - Caval tumor thrombus complicating renal cell carcinoma: a surgical challenge. AB - The surgical challenge of resection of renal cell carcinoma with vena caval invasion may require close cooperation between the urologist and cardiovascular surgeon. From 1977 to 1986, 13 patients with renal cell carcinoma and tumor thrombus invading the inferior vena cava (IVC) underwent radical surgical resection. In three of 13 patients the thrombus extended into the heart (right atrium two patients and right ventricle one patient). The tumor originated in the right kidney in 10 patients and in the left kidney in three patients. There were 10 men and three women with a mean age of 64 years (range, 46 to 75 years). Surgical management included midline incision, seven, with median sternotomy, four, and thoracoabdominal, two. After exposure of the renal vessels and IVC, all patients underwent radical nephrectomy. Two patients had caval sleeve resection, one had a partial caval resection, and seven had a 1 cm caval cuff. Planned cardiopulmonary bypass was used in three patients. The tumor thrombus was extracted by simultaneous atrial and caval approaches. One patient underwent unplanned emergency cardiopulmonary bypass after intraoperative cardiac arrest caused by a large tumor embolus of the pulmonary artery. No operative deaths occurred. Postoperative morbidity was significant in five of 13 patients, caval thrombosis in one, lower limb swelling in two, renal failure in one, and pulmonary edema in one patient. Two patients required long-term anticoagulation therapy for confirmed pulmonary emboli within 1 month of surgery. These complications resolved. The follow-up period ranged from 7 to 64 months with a mean of 36 months. Two patients died of metastatic disease at 24 and 48 months after surgery. Three patients are alive with metastatic disease at 6 to 64 months while one patient had a solitary metastatic lesion removed from the frontal lobe 4 years after nephrectomy and has been disease free a subsequent 18 months. Eight of 11 patients are disease free at 7 to 64 months (four patients greater than 52 months). Our 83% survival rate at a mean follow-up of 36 months suggests that this group of patients should not be denied aggressive resection. Documentation of tumor source and caval extension are essential to plan operative procedures, including use of cardiopulmonary bypass. PMID- 3660239 TI - Prognostic significance of nuclear deoxyribonucleic acid ploidy patterns in resected hepatic metastases from colorectal carcinoma. AB - Nuclear deoxyribonucleic acid (DNA) ploidy studies of paraffin-embedded archival tumor specimen blocks were performed by flow cytometry on extracted nuclei from 101 surgically resected hepatic metastases from colorectal cancer. In 28 patients, the corresponding primary carcinoma of the metastases was also studied. Tumor clinicopathology and clinical course of the patients were reviewed. Preparation of paraffin-embedded tissue specimens was performed by the technique of Hedley et al. and stained with propidium iodide according to the method of Vindelov et al. Eighty-eight of 101 metastatic tumors and 26 of 28 primary tumors yielded evaluable DNA histograms. Twenty-six metastases showed a DNA diploid pattern, 25 showed a significantly increased 4C peak (DNA tetraploid/polyploid), and 37 had a DNA aneuploid peak. Ploidy pattern was constant between primary and metastases in 84.6% of tumors. No significant relationship between host and tumor characteristics and ploidy pattern was found except for a correlation between grade 3 metastases and DNA aneuploid. Survival of patients with DNA aneuploid metastases was significantly less than that of patients with DNA diploid metastases (p = 0.03). However, among DNA nondiploid metastases, survival was significantly less for low DNA index metastases (less than or equal to 1.5) than for high DNA index (greater than 1.5) metastases (p less than 0.05). Flow cytometric DNA ploidy measurements may have prognostic value for patients with resected hepatic metastases from colorectal carcinoma. PMID- 3660241 TI - Cardiopulmonary complications after major surgery: a role for epidural analgesia? AB - Improvement in postoperative pulmonary mechanics with epidural analgesia has been described. Data on the hemodynamic effects of this technique are absent from the surgical literature. To provide such data we have evaluated two groups of patients undergoing aortic reconstruction: group I (n = 25), general anesthesia and group II (n = 6), general anesthesia with adjunctive epidural analgesia. The groups were comparable preoperatively as judged by the incidence of cardiac history, preoperative ejection fraction, and measured hemodynamic parameters. Postoperatively there were no significant differences in the pressure-related parameters; however, rate-related factors including heart rate and double product were significantly decreased in group II with no reduction in cardiac index. Postoperative increases in total body oxygen consumption were also markedly attenuated by epidural analgesia. Epidural analgesia reduces the hemodynamic demands on the heart after major surgery and is a useful adjunct, especially in patients with coronary artery disease. PMID- 3660240 TI - Exenterative surgery for locally advanced rectosigmoid cancers. Is it worthwhile? AB - Among 1480 patients treated for cancers of the rectosigmoid over a 30-year period, 24 patients underwent total pelvic exenteration. These patients, 13 men and 11 women, had a median age of 64 years. Pathologic staging revealed 15 Dukes' B and nine Dukes' C lesions. For 17 patients, this operation was the only form of therapy. The operative mortality rate was 20.8%; however, the mortality rate has decreased to 13.3% during the past 20 years and to 9% in the past decade. Five complications occurred in the group surviving the procedure, resulting in a 26.3% morbidity rate. Three of the five complications occurred in patients who had previous radiation therapy or surgery. The overall 5-year survival rate was 41.6%. Those patients surviving the operation had 5- and 10-year survival rates of 52.6% and 31.5%, respectively. There were seven patients in whom the disease recurred at an average of 20.3 months after exenteration, and all died an average of 8 months later. The recurrence rate for patients with Dukes' B lesions was 27% compared with 57% for patients with Dukes' C lesions. The remaining 12 disease free patients had a mean survival of 11 years. At present, four patients are alive and well 6 to 30 years after exenteration. The best predictor of morbidity was treatment before exenteration (p less than .005). Age older than 65 years and the presence of nodal metastases may contribute to increased mortality rates and recurrence, respectively, but these relationships were not statistically significant for the group. Total pelvic exenteration is advocated for selected primary, locally advanced, rectosigmoid lesions in good-risk patients; it can be achieved now with acceptable morbidity and mortality rates and a survival rate in excess of 40% at 5 years. PMID- 3660242 TI - Meconium ileus: a fifteen-year experience with forty-two neonates. AB - From 1969 to 1984, 42 neonates were managed for meconium ileus caused by cystic fibrosis. Simple, uncomplicated meconium ileus occurred in 24 infants (57%) and complicated meconium ileus occurred in 18 (43%). Meglumine diatrizoate (Gastrografin) enema completely relieved the obstruction in 13 patients with simple meconium ileus (54%) and caused colonic and rectal perforations in three (13%). Six operative procedures were used in 29 patients: double enterostomy (seven), resection with primary anastomosis (seven), Bishop-Koop enterostomy (seven), intraluminal lavage (four), colostomy (three), and Mikulicz enterostomy (one). Postoperative complications included malabsorptive diarrhea (nine), pneumonia (three), intestinal obstruction (two), total parenteral nutrition catheter sepsis (two), and anastomotic leak (one). Infants managed nonoperatively by Gastrografin enema had a significantly shorter hospitalization (average, 15 days) than those undergoing operation for simple meconium ileus (54 days) and complicated meconium ileus (111 days). Postoperative survival rate was 100% with a late survival rate of 86%. PMID- 3660243 TI - Intussusception: current management in infants and children. AB - Intussusception remains a leading cause of bowel obstruction in early infancy and childhood. From 1970 to 1985, 83 patients with intussusception were treated. There were 51 boys and 32 girls ranging in age from 2 months to 22 years. Ten patients had a total of 14 separate recurrences; nine occurred during the initial hospitalization. Symptoms on presentation included abdominal pain (80%), palpable mass (60%), rectal bleeding (53%), and lethargy or sepsis (45%). Fifteen children underwent exploration without contrast studies based on duration of symptoms (greater than 5 days) and evidence of severe obstruction on plain abdominal x-ray films. In the remaining children, diagnosis was confirmed by barium enema and hydrostatic reduction was achieved in only 34 patients (42% success rate). Symptoms were present more than 48 hours in 55% of the reduction failures. At operation, five children had spontaneously reduced and an appendectomy was performed. Manual reduction was possible in 32 patients. The intussusception was irreducible in 26 patients, and 18 required temporary stomas. Pathologic lead points were found in 11 patients. Average length of hospitalization was 1.5 days after barium enema reduction, 9.6 days after manual reduction, and 13.8 days after bowel resection. There were no recurrences of intussusception after surgical reduction. A significant morbidity rate was observed with a delay in diagnosis. Adequate preoperative preparation and prompt surgical intervention are associated with 100% survival. PMID- 3660244 TI - Injuries to the abdominal vascular system: how much does aggressive resuscitation and prelaparotomy thoracotomy really help? AB - The records of 154 patients with 254 abdominal vascular injuries seen over 5 years (1980 to 1985) were reviewed. The overall mortality rate (MR) was 46%. This included 100% (5/5) for blunt injuries, 49% (59/119) for gunshot wounds, and 23% (7/30) for stab wounds. The most common venous injuries and the MRs were: inferior vena cava, 59% (33/56) and iliac veins, 65% (10/16). The most common arterial injuries and the MRs were: aorta, 68% (15/22), iliac artery, 57% (12/21), and superior mesenteric artery, 67% (8/12). Of 84 patients who presented to the emergency department (ED) with a blood pressure (BP) less than 70 mm Hg, 60 (71%) died, and of 64 patients with four or more associated injuries, 41 (64%) died. Failure to reduce the duration of shock, amount of bleeding, or severity of hypotension before surgery is highly lethal. Of the 42 patients who had shock for more than 30 minutes, 38 (90%) died. Of the 93 patients who received more than 10 U of blood in the ED and operating room (OR) 60 (64%) died. Of the 60 patients presenting to the OR with a systolic BP less than 70 mm Hg, 52 (87%) died. Prelaparotomy cross-clamping of the thoracic aorta for persistent shock is controversial. However, of the 26 patients with this procedure, 12 responded with a sustained increase in systolic BP greater than 90 with five (42%) survivors. Of the 14 no responders, none survived. Of 17 patients with persistent shock without a prelaparotomy thoracotomy, only one (6%) survived. In the high-risk group (admission systolic BP less than 70 mm Hg and four or more associated injuries), if shock was kept to less than 30 minutes and bleeding to 10 U of blood or less, the MR was reduced from 92% (24/26) to 0% (0/12). In patients presenting to the OR with a BP less than 70, a prelaparotomy cross-clamping of the aorta should be considered. In those patients not responding, prolonged surgical efforts are futile. PMID- 3660245 TI - Dextrose administration increases sensory/motor impairment and paraplegia after infrarenal aortic occlusion in the rabbit. AB - Spinal ischemia with resultant cord infarction is a catastrophic complication of surgical procedures involving the thoracoabdominal aorta. A rabbit spinal ischemia model was used to test if glucose administration would increase neurologic deficit of the lower extremity. Rabbits (2 to 3 kg), anesthesized with halothane, had a snare occluder placed around the aorta just below the left renal artery. After a 2-hour recovery, the aorta was occluded for 15 minutes. Before occlusion animals received an intraperitoneal injection of isotonic glucose (2 gm/kg; n = 11), isotonic mannitol (2 gm/kg; n = 3), or an equal volume of saline solution (n = 11). Four sham-operated animals received glucose and an identical surgical procedure, but the aorta was not occluded. Average blood glucose level at the time of occlusion for the glucose group was 249 +/- 15 versus 156 +/- 6 for the control group (p less than 0.01). At 1, 4, 18, and 24 hours, a neurologic impairment score (1 = normal, 2 = partial impairment, 3 = complete impairment) was assigned. At 4, 18, and 24 hours, the glucose group had significantly greater neurologic impairment than did control groups (p less than 0.02). Glucose administration had an adverse effect in a controlled and highly reproducible model of spinal cord ischemia. Exogenous glucose administration should potentially be avoided during complex aortic reconstruction. PMID- 3660246 TI - Optimal resources for carotid endarterectomy. AB - This review compares the results and costs of carotid endarterectomy (CE) done by a single surgeon over a 1-year period working at both a university hospital (UH) and a community hospital (CH). Hospital and financial records of 157 patients were reviewed, 78 at UH and 79 at CH. The patient populations were matched for age, associated illnesses, and presenting symptoms. The principles of patient management were identical at both hospitals except that shunting requirements were determined by electroencephalographic monitoring at UH. There were no differences in the complication rates, and the combined stroke/mortality rate was 0.6%. The cost of CE was 56% greater on a per patient basis at UH ($3918 versus $6126, p less than 0.001) and 23% greater on a per diem basis at UH ($611 versus $755, p less than 0.001). Patients stayed longer at UH (8.2 days versus 6.6 days at CH, p less than 0.03). These differences are largely explained by three types of delays at UH. First, patients with cardiovascular accidents at UH were kept in the hospital before surgery until maximum improvement occurred whereas patients at CH were allowed to convalesce at home before CE. Patients operated on after a cardiovascular accident spent an average of 17.6 days in UH while a similar group spent only 7.3 days in hospital at CH (p less than 0.03). Second, delays in obtaining angiograms of greater than 2 hospital days occurred in 28% of patients at UH compared with only 10% at CH (p less than 0.05). Third, delays in scheduling operating room time of greater than 2 hospital days occurred in 17% of patients at UH and in only 7% of patients at CH (p less than 0.05). When there were no delays, the cost of treating patients at each hospital was identical, $3483 at CH and $3520 at UH. UH must accept the fact that equally good results can be obtained at CH, and although the potential exists for equal costs at both types of hospitals, the CH provides the service at a lower cost. UH administrators must address these inefficiences if the UH is to compete effectively in the current marketplace. PMID- 3660247 TI - [Elderly have a need for nursing home places and comprehensive care]. PMID- 3660248 TI - [Children's health. 26. Good children's books catch the child in his own situation]. PMID- 3660249 TI - [AIDS status discussed in WHO General Assembly]. PMID- 3660250 TI - [Attitude modification through information]. PMID- 3660251 TI - [WHO. Economic values do not alone create public health]. PMID- 3660252 TI - [Terminal care. The first terminal nursing unit to be established beginning 1988]. PMID- 3660253 TI - [AIDS: you might do little yourself to become infected with AIDS. Interview by Allan Knoblauch]. PMID- 3660254 TI - [AIDS: unacceptable rudeness when health personnel fears AIDS patients. Interview by Helle Kastholm Hansen]. PMID- 3660255 TI - [Primary nursing and self care in the community hospital]. PMID- 3660257 TI - [Pension's provisions widely invested in Danish occupational life]. PMID- 3660256 TI - [Children's health. 27. Treatment of pregnant drug abusers and their infants]. PMID- 3660258 TI - [Equal Rights Council: many nurses benefit from equal rights]. PMID- 3660259 TI - Management of refractory SVT with an antitachycardia pacemaker. PMID- 3660260 TI - Update on thyroid function testing. PMID- 3660261 TI - Texas Medical Foundation at the crossroads. PMID- 3660262 TI - Statewide test of a new postmarketing drug surveillance system. PMID- 3660263 TI - Implications of allied health and nursing students' knowledge of cancer prevention. PMID- 3660264 TI - Saragosa: the medical response. PMID- 3660265 TI - Immigration Reform and Control Act of 1986. PMID- 3660267 TI - Myths and misconceptions about pain. PMID- 3660266 TI - AIDS: ethical considerations involved in AIDS/HIV care. PMID- 3660268 TI - AIDS: working with AIDS victims. PMID- 3660269 TI - AIDS: I am an AIDS victim. Interview by Myrna L Armstrong. PMID- 3660270 TI - Volunteer emergency response: the Advanced Disaster Nurse Cadre, American Red Cross. PMID- 3660271 TI - Prospective health planning: emergency medical services Texas-style. PMID- 3660272 TI - The "battle of the sexes": a genetic model with limit cycle behavior. AB - A two-locus genetic model, based on Dawkins "sex war" game, with the fitness of the genotypes at each locus depending on the gene frequencies at the other, is shown to give rise to a stable limit cycle. The mathematical analysis involves averaging techniques and elliptic integrals. PMID- 3660273 TI - Cycles in nonlinear age-structured models. I. Renewal equations. AB - A variety of density-dependent population models can be described by nonlinear renewal equations. This paper develops analytical tools for such models to study the sustained population cycles which arise by bifurcation. The results obtained describe explicitly the direction of bifurcation, and the period, form, and dynamic stability of sustained cycles. The results are illustrated by application to a cohort-controlled model of human populations which has been proposed as a formalization of the Easterlin effect. PMID- 3660274 TI - The average number of sites separating DNA sequences drawn from a subdivided population. AB - The "infinite sites" model in the absence of recombination is examined in a subdivided population in which there is arbitrary migration among demes. It is shown that, if the migration matrix is symmetric and irreducible, the average number of sites that differ in two alleles chosen from the same deme depends only on an effective size of the whole population and not on either the elements of the migration matrix or the size of each deme separately. If there are n demes all of size N, the average number of sites that differ in two alleles chosen from the same deme is 4nN mu, where mu is the average mutation rate per site. This is the same value as for two alleles drawn from a panmictic population of size nN. The average number of sites that differ in alleles drawn from the same and from different demes can provide some information about the degree of population subdivision, as is illustrated by using the data of Kreitman and Aquade (1986, Proc. Nat. Acad. Sci. U.S.A., 83, 3562) on Drosophila melanogaster. PMID- 3660275 TI - Genotypic distribution at the limits to natural and artificial selection with mutation. AB - A general procedure for analysing the change of genotypic distributions under stabilizing and truncation selection is described here and used to investigate the genotypic distribution at the limits to selection. For comparison, a simple approximate procedure using a normal distribution is also presented. It is clear that in the long term truncation introduces departures from normality mainly through gene frequency change, rather than through the generation of linkage disequilibrium under random mating. The Gaussian approximation performs reasonably well for additive gene effects unless the mean gene frequency is very extreme (say, outside the range of 0.05 to 0.95) and the number of loci is small (say, less then 50) regardless of the type of selection in operation. The genotypic distribution at the limits to selection largely depends on the type of limit reached. If a limit is obtained due to the action of natural selection before the exhaustion of existing variation, the distribution will normally not be very skew, but if a limit is reached at which mutation plays a central role in the maintenance of genetic variability, it could have high coefficients of skewness and kurtosis. The role of mutation on the long-term response is also discussed. PMID- 3660276 TI - Life and the scientific concept of life. PMID- 3660277 TI - Ontology and ethics in the foundation of medicine and the relevance of Levina's view. PMID- 3660279 TI - The judgment comes with healing in its wings: a call for rational detachment. PMID- 3660278 TI - The philosophical basis of medicine as a philosophical question. PMID- 3660280 TI - Toward a systematic philosophy of medicine. PMID- 3660281 TI - Medicine as a form of practical understanding. PMID- 3660282 TI - Challenges for a philosophy of medicine of the future: a response to fellow philosophers in the Netherlands. PMID- 3660283 TI - The physician-patient relationship: models and criticisms. PMID- 3660284 TI - Scientific uncertainty and medical responsibility. PMID- 3660285 TI - The philosophical foundations of medical practice. Proceedings of a conference on Research in the Foundations of Medicine. May, 1984. PMID- 3660287 TI - Response and acclimatisation of symptomless smokers on changing to a low tar, low nicotine cigarette. AB - Ten symptomless smokers were switched from their usual cigarette to a low tar, low nicotine test cigarette for two weeks to investigate their immediate response and subsequent acclimatisation to the test cigarette. The tar (T) and nicotine (N) yields of the test cigarettes were T = 3.8 mg, N = 0.6 mg; the median yields of the usual cigarettes were T = 16.4 mg, N = 1.4 mg. The subjects were monitored over a six week period comprising a control period (usual cigarette), a test period (test cigarette), and a return period (usual cigarette), each lasting two weeks. The inhaled smoke volume (smoke from the burning tip of the cigarette which is subsequently inhaled) was measured with a non-invasive radiotracer technique. Puffing indices were recorded using an electronic smoking analyser and flowhead cigarette holder. Measurements were made at the beginning of the control period, at the beginning and end of the test period, and at the end of the return period. Subjects kept records of their cigarette consumption during each of the three periods. Apart from a small change in puff duration, cigarettes were smoked in the same way during the control and return periods. Mean and total puff volumes increased with the low tar, low nicotine cigarette but did not change from the beginning to the end of the test period. There was no significant change between the control, test, and return periods for mean inhaled smoke volume, total inhaled smoke volume, or cigarette consumption. It is concluded that when smokers are switched to a low tar, low nicotine cigarette the puff volume increases but there is no change in the inhaled smoke volume or daily consumption. PMID- 3660286 TI - Serum C-reactive protein concentrations in patients with pulmonary sarcoidosis. AB - In a prospective study serum C-reactive protein concentrations were measured in nine patients with "active" pulmonary sarcoidosis (as assessed by bronchoalveolar lavage lymphocyte counts, gallium-67 lung scanning, and serial pulmonary function testing), and in five patients with "inactive" disease. Active pulmonary sarcoidosis was associated either with no rise or with only a modest rise in serum C-reactive protein concentrations. In contrast, serum C-reactive protein concentrations in 12 patients with sputum positive pulmonary tuberculosis were considerably raised. Serum C-reactive protein may thus provide a valuable test in the differentiation of sarcoidosis from conditions which it may mimic and which are known to induce an acute phase response. PMID- 3660288 TI - Importance of airflow obstruction after thoracoplasty. AB - Thirty six patients previously treated for pulmonary tuberculosis by thoracoplasty were studied to determine the prevalence and effect of airflow obstruction. The mean (SD) FEV1 was 1.3 (0.65) 1 and the mean forced expiratory ratio (FER) 64% (12%). FEV1 was less than predicted in every patient whereas FER was less than predicted in 30, being below the lower 98th percentile in 15 (42%). In the 18 patients who complained of breathlessness the means of the standardised residuals (SR) for FEV1, peak expiratory flow (PEF), and FER were significantly lower and that for residual volume/total lung capacity (RV/TLC) significantly higher than those for the 18 patients who were not breathless (all p less than 0.0001). There was no difference in the smoking history of the two groups. Only three of the 23 patients in whom reversibility of airflow obstruction was assessed showed a greater than 25% increase in PEF. None showed an increase in FEV1 of greater than 15%. The 18 who were breathless had significantly lower values of arterial oxygen tension (PaO2) and higher values of arterial carbon dioxide tension (PaCO2) (p less than 0.0001). Thirteen of these patients were in chronic respiratory failure (PaO2 less than 8.0 kPa or PaCO2 greater than 5.9 kPa, or both) compared with only one of the 18 who were not breathless. The indices correlating best with PaO2 and PaCO2 were SR FEV1 and SR PEF respectively. SR FEV1 accounted for 34% of the variance in PaO2 and SR PEF for 29% of the variance in PaCO2. Airflow obstruction has been found to be common in patients with a thoracoplasty and to be associated with hypoxia and hypercapnia. PMID- 3660289 TI - Oxygen desaturation during sleep and exercise in patients with interstitial lung disease. AB - The relations between mean and maximum fall in arterial oxygen saturation (SaO2) during sleep, hypoxaemia during moderate and maximum exercise, and lung mechanics were studied in 16 patients with interstitial lung disease. Mean and minimum SaO2 during sleep were significantly related to each other and to daytime oxygenation but not to lung mechanics. Although the maximum fall in SaO2 during sleep was similar to the fall during maximum exercise (a level seldom achieved during normal daily activities), profound hypoxaemic episodes during sleep were rare and brief and therefore contributed little to the mean SaO2. The fall in mean SaO2 during sleep was not significant and was considerably less than during moderate exercise (average 0.5 v an estimated 4.5%, p less than 0.05). It is therefore concluded that in patients with interstitial lung disease oxygen desaturation during sleep is mild and less severe than hypoxaemia during exercise. PMID- 3660290 TI - Prevalence of bronchial hyperresponsiveness and asthma in a rural adult population. AB - The prevalence of bronchial hyperresponsiveness in adult populations is not known. To document its prevalence and distribution and to determine the factors associated with it, a random sample of the adult population of Busselton, Western Australia, was studied. Spirometric function, bronchial responsiveness to histamine, and atopic responses to skin prick tests were measured. Respiratory symptoms were determined by questionnaire. Data were obtained from 916 subjects. Of these, 876 underwent a histamine inhalation test and bronchial hyperresponsiveness to histamine (defined as a dose of histamine provoking a 20% fall in FEV1 equal to or less than 3.9 mumol) was found in 10.5%. Another 40 subjects with poor lung function were tested with a bronchodilator and 12 were found to have bronchial hyperresponsiveness (defined as a greater than 15% increase in FEV1), making the total prevalence of bronchial hyperresponsiveness 11.4%. The prevalence of current asthma, defined as bronchial hyperresponsiveness plus symptoms consistent with asthma in the last 12 months, was 5.9%. The distribution of bronchial hyperresponsiveness in the studied population was continuous. There was a significant association between it and respiratory symptoms, atopy, smoking, and abnormal lung function (p less than 0.001 for all associations). There was no association with age, sex, or recent respiratory tract infection. PMID- 3660291 TI - Early and late results of surgical treatment of congenital coronary artery fistula. AB - The early and late results of surgical treatment in 23 patients with congenital coronary artery fistula (CCAF) are presented. One patient died for reasons unrelated to the fistula during corrective surgery for an associated complex cyanotic abnormality. The patients with isolated CCAF and preoperative symptoms improved significantly after surgical closure of the CCAF (p less than 0.05). We conclude that all symptomatic patients with CCAF should be treated with surgical closure of the fistula. PMID- 3660292 TI - Growth of the bronchial tree in man. AB - Bronchial tree casts were made from one or both lungs from nine children aged from five weeks to 17 years. The branches of the casts were ordered by the method of Strahler, and diameter ratio, length ratio, and branching ratio were determined. From five to 12 weeks the diameter ratio is about 1.35, but by 13 months it has risen to 1.45, indicating a faster rate of growth in the larger airways over the period; thereafter it stays at or above this level. The data show that the peripheral conducting airways are relatively large in diameter at 1 3 months, attaining their adult proportion after one year. In contrast, length ratio shows no trend with age. On the assumption of 25,000 terminal bronchioles, the mean number of orders between terminal bronchiole and trachea was estimated to be about 12. PMID- 3660293 TI - Paraffinoma confirmed by infrared spectrophotometry. PMID- 3660294 TI - Instrumental perforation of the oesophagus into the pericardial cavity. PMID- 3660295 TI - Aortopulmonary fistula: role of computed tomography. PMID- 3660296 TI - Extrinsic allergic alveolitis caused by a cold water humidifier. PMID- 3660297 TI - Pulmonary sequestration and related congenital bronchopulmonary-vascular malformations: nomenclature and classification based on anatomical and embryological considerations. AB - The pulmonary sequestration spectrum and related congenital lung anomalies present an extremely complex and varied group of bronchopulmonary-vascular malformations. Previous attempts at nomenclature and classification have proved inadequate. In this article we present a classification of the newly named pulmonary malinosculation spectrum, which includes all congenital lung anomalies where there is abnormal connection (that is, malinosculation) of one or more of the four major components of lung tissue--namely, tracheobronchial airway, lung parenchyma, arterial supply, and venous drainage, which in various combinations make up these lesions. We feel that this simple descriptive approach will improve our understanding and management of these complicated lesions and this is supported by the clinical experience we report in the next article. PMID- 3660298 TI - Congenital bronchopulmonary vascular malformations: clinical application of a simple anatomical approach in 25 cases. AB - Congenital malformations of the bronchopulmonary airway and related arterial blood supply are a complex group of lesions in which abnormalities of venous drainage and lung parenchyma may coexist. Twenty five cases have been analysed, by a method whereby each anatomical component is separately considered. All 25 patients had abnormalities of the tracheobronchial tree, with no connection to the abnormal segment in nine cases. The aberrant arterial blood supply was single in 16 cases and multiple in nine cases, one patient from the latter group having a mixed pulmonary and systemic arterial supply to a part of the abnormal segment. Seventeen patients had anomalous venous drainage. In nine of these the vein or veins (they were multiple in four cases) drained the major part or the whole of the lung, whereas the aberrant arterial supply was limited to the right lower zone--that is, mismatched anomalous venous drainage. Abnormalities of lung parenchyma included changes within the lesion (for example, cysts, foregut inclusions) and associated abnormalities of surrounding lung (for example, hypoplasia, abnormal lobation). This information, together with the clinical features and haemodynamic data, was found to be essential for decisions on appropriate management. Patients presenting in infancy with haemodynamic disturbance continue to present major management problems (50% mortality), particularly if there are associated congenital heart defects. The role of aberrant systemic artery occlusion or ligation as a first stage procedure is well established in patients with haemodynamic abnormalities. There may be a place for this procedure in selected patients who have no haemodynamic disturbance at presentation. PMID- 3660299 TI - The crossover lung segment: congenital malformation associated with a variant of scimitar syndrome. AB - Three cases of a congenitally misplaced segment of lung are described. In one case the abnormal segment was identified at thoracotomy; it extended from an origin in the right upper lobe across the midline into the left hemithorax. The remaining two patients, with identical radiographic features, were identified in a review of 24 cases of bronchovascular malformation. In all three patients the crossover segment was associated with a variant of the scimitar syndrome: right lung hypoplasia with dextrocardia, aberrant systemic arterial supply to the right lower lobe, and anomalous venous drainage of the whole of the right lung, and in two patients with eventration of the right diaphragm. PMID- 3660300 TI - Epidemiology of sarcoidosis in the Isle of Man--1: A case controlled study. AB - A case controlled study of 96 cases of sarcoidosis has been carried out in the Isle of Man. Age and sex matched controls were selected at random from the pathology and radiology records, which cover 85% of the resident population, and a second control group was drawn from a tuberculosis register. Special efforts were made to achieve a high level of ascertainment. In this study most cases occurred in young adults. It affected the sexes equally and occurred more frequently in the indigenous Manx population. Thirty eight cases (39.6%) had been in contact with the disease before diagnosis, compared with two (1.2%) of the combined controls. These contacts included members of the same household, colleagues at work, and close friends. A bias may have been introduced as patients would inevitably be more aware of the disease and be more likely to mention previous contact than the controls. Nevertheless, the evidence is considered to support the view that sarcoidosis is a communicable disease. PMID- 3660301 TI - Epidemiology of sarcoidosis in the Isle of Man--2: Evidence for space-time clustering. AB - The case-control test for space-time clustering developed by Pike and Smith was applied to 96 cases of sarcoidosis diagnosed in the Isle of Man from 1962 to 1983. There were significantly more links between cases separated by time intervals of less than 10 years and distances of less than 100 metres than between the others. Analysis of the type of links indicated that clusters consisted of pairs whose contact was by place of residence or work. More linked cases were diagnosed less than three years apart than would be expected by chance. These findings lend support to the idea that sarcoidosis is a communicable disease. PMID- 3660302 TI - Role of the neodymium YAG laser in the management of tracheal tumours. AB - Twenty one patients with tracheal tumours (10 primary and 11 secondary) have been treated with the neodymium YAG laser under general anaesthesia. Fourteen of these patients presented with impending asphyxia and in 11 cases this was dramatically relieved with emergency laser treatment. The improvements in peak expiratory flow (PEF) ranged from 26% to 512%. The three patients who did not respond were immediately given other treatments but died in hospital. The remaining seven patients were not in severe respiratory distress and were treated electively; all were thought to have benefited from their treatment, the mean increase in PEF being 36%. The improvement obtained in the 11 patients who responded to emergency laser treatment provided time in which to assess the disease carefully and plan the most appropriate longer term management with surgery, radiotherapy, tracheal stenting, or repeat laser treatment. The patients who were treated electively have either not required further treatment of have been managed with repeat laser treatments alone. Laser treatment provides an excellent method of resuscitating patients with life threatening tracheal obstruction and enables subsequent management to be carefully planned. In some cases this longer term management should be with further laser treatment alone. PMID- 3660303 TI - Late sequelae of pulmonary tuberculosis treated by thoracoplasty. AB - With the help of information provided by the Office of Population, Censuses and Surveys the survival up to 1 July 1985 of the 171 patients treated for pulmonary tuberculosis by thoracoplasty at Papworth from 1951 to 1953 was determined. Thirteen (8%) could not be traced, 65 (38%) had died, and 93 (54%) were alive. For those who were traced the survival at 10, 20, and 30 years from the date of operation was 93%, 79%, and 65%. This represents a significantly greater mortality rate than that predicted from the Registrar General's review of deaths in England and Wales (1841-1984). Nineteen patients died from cardiorespiratory failure. Eight of the survivors are known to have developed respiratory failure, five having enjoyed apparently good health before this was precipitated by intercurrent illness or drugs. A stepwise logistic regression analysis using information from the 124 patients for whom full details were available showed significant associations between the development of cardiorespiratory or respiratory failure and a preoperative contralateral artificial pneumothorax, older age at operation, the presence of cavities before operation, and male sex. In a questionnaire 50 of the survivors (57% of those who replied) reported cough, 45 (51%) breathlessness, 41 (47%) wheeze, and 24 (27%) ankle swelling. Nineteen (22%) smoke and the same number now attend a chest clinic. Many patients treated for tuberculosis by thoracoplasty have respiratory symptoms and some are at risk of respiratory failure. There are grounds for considering that they should be reviewed periodically by a chest physician. PMID- 3660304 TI - Peripheral blood eosinophil counts and bronchial responsiveness. AB - Bronchial responsiveness (histamine PC20) and peripheral blood eosinophil counts were measured in 23 asthmatic subjects, of whom 14 were atopic and nine non atopic. In the group as a whole there was an inverse correlation between baseline eosinophil count and histamine PC20 (r = -0.71; p less than 0.001). For atopic subjects a relationship between eosinophil count and histamine PC20 was observed (r = -0.74; p less than 0.01), but there was no correlation between eosinophil count and baseline FEV1 or baseline FEV1 and histamine PC20. For the non-atopic subjects a similar relationship between eosinophil count and histamine PC20 was seen (r = -0.68; p less than 0.05) and a less significant inverse correlation between baseline eosinophil count and baseline FEV1 (r = -0.65; p less than 0.05). These results show a relationship between eosinophil count and non specific bronchial responsiveness in both atopic and non-atopic asthma. PMID- 3660305 TI - Effect of particle size of bronchodilator aerosols on lung distribution and pulmonary function in patients with chronic asthma. AB - The particle size of bronchodilator aerosols may be important in determining the site of deposition in the lung and their therapeutic effect. The distribution of aerosols (labelled with technetium-99m diethylene triamine pentacetic acid) of two different particle sizes has been studied by gamma camera imaging. The particles had mass median aerodynamic diameters (geometric standard deviations) of 1.4 (1.4) and 5.5 (2.3) micron, and they were administered from a jet nebuliser to eight patients with chronic severe stable asthma. There was no significant difference in peripheral lung deposition with the two aerosols in any patient. The bronchodilator effect of the two aerosols was determined from cumulative dose-response studies. To avoid large doses that might mask possible differences in effect due to aerosol size, small, precisely determined incremental amounts of salbutamol (25-250 micrograms total lung dose) were used. The two doses were given via a nebuliser on separate occasions and the bronchodilator response was measured from FEV1, forced vital capacity, and peak expiratory flow 30 minutes after each dose. Bronchodilatation was similar with the two aerosols at each dose of salbutamol. There was therefore no difference in distribution within the lung or any difference in bronchodilator effect between an aerosol of small (1.4 micron) particle size and an aerosol of 5.5 microns in patients with severe but stable asthma. PMID- 3660306 TI - Ectopic right upper lobe bronchus as a cause of breathlessness. PMID- 3660308 TI - Pleural aspergillosis in a 14 year old boy. PMID- 3660307 TI - Non fatal pulmonary haemorrhage associated with nitrofurantoin. PMID- 3660309 TI - Effects of laser treatment on respiratory function in malignant narrowing of the central airways. AB - Twenty patients with inoperable carcinoma in the trachea or a main bronchus were investigated before and one and 10 days after treatment with a carbon dioxide laser. Patients were assessed by spirometry, maximum flow-volume loops, and a visual analogue score of breathlessness on a scale from 0 (not at all breathless) to 100 (very breathless). At day 10 mean FEV1 had improved from 51.9% to 62.6% of predicted (p less than 0.02) and mean peak expiratory flow (PEF) from 45.3% to 53.1% of the predicted value (p less than 0.05). Improvements in maximum inspiratory and expiratory flows at 50% vital capacity were not significant but the breathlessness score decreased from a mean of 49.1 to 35.3 (p less than 0.01). Improvements in breathlessness were significantly correlated with increases in FEV1 and PEF. Thirteen of the 20 patients had unilateral tumours with partial or complete occlusion of the main bronchus; in these perfusion and ventilation were assessed by radioisotope scans before and 10 days after treatment. Seven of the 13 patients showed an increase in perfusion of the affected lung after treatment but the improvement was small, with a mean increase in unilateral perfusion in the 13 patients of 2.4% of the total counts. Four patients with no perfusion of the affected side showed no significant improvement after laser treatment. Changes in ventilation scans were similar to those in perfusion. It is concluded that laser treatment improves airway function and dyspnoea in malignant narrowing of central airways and that in unilateral obstruction such treatment results, at best, in a small increase in the contribution of the affected lung to perfusion. PMID- 3660310 TI - Asbestos induced diffuse pleural fibrosis: pathology and mineralogy. AB - Lungs from seven cases of diffuse pleural fibrosis with known asbestos exposure were studied to determine the gross and microscopic pathological features and relate these to the analysed mineral fibre content of the lung. All seven individuals had had substantial exposure, ranging from two to 25 years, and chronic chest problems and at necropsy all cases met the criteria for compensatable disease. Macroscopically, all had extensive visceral pleural fibrosis and extensive areas of adhesions, and four also had discrete parietal pleural plaques. The histological features were similar in all the cases--most strikingly the basket weave pattern of the thickened pleura and a dense subpleural parenchymal interstitial fibrosis with fine honeycombing, extending up to 1 cm into the underlying lung. The similar histological appearances raise the possibility that diffuse pleural fibrosis and pleural plaques have a similar pathogenesis. Amphibole asbestos (crocidolite and amosite) counts were high in six of the seven cases and chrysotile counts in four; four cases had high mullite counts, but the importance of this is not known. It is concluded that diffuse pleural fibrosis is a specific asbestos associated entity, of uncertain pathogenesis, with mineral fibre counts falling between those found with plaques and those in minimal asbestosis. PMID- 3660311 TI - Pneumococcal serotypes in sputum isolates during acute respiratory illness in Edinburgh. AB - During the years 1978-83 serotyping was carried out on all sputum isolates of pneumococci obtained from patients in the chest wards of the City Hospital, Edinburgh. In 402 patients with acute respiratory illness the peak isolation rates occurred from January to April, and the serotype distribution was similar to that seen in previous UK studies, the commonest types being 3, 6, 9, 19, 23, and 8. The overall mortality rate was 8.7%, the serotype distribution in fatal cases reflecting the distribution of the whole group. The presence of mixed infection, predominantly with Haemophilus influenzae, was associated with a lower mortality rate of 3.5%. Nearly all patients (92%) were either elderly or had a chronic underlying disease and only one death occurred in a patient under 70 years who had no pre-existing disease. Of the pneumococcal serotypes isolated from the 292 patients with chronic chest disease, 82% are included in the new 23 valent pneumococcal vaccine and the efficacy of this needs to be assessed further in high risk patients. PMID- 3660312 TI - Mycobacterium malmoense infections in Scotland: an increasing problem. AB - During 1982-4 20 cases of Mycobacterium malmoense infection were identified in Scotland (13 male, seven female; age 34-82, median 62 years). Features of the disease were obtained from case notes and radiographs of 19 patients and were found to be indistinguishable from those of patients with pulmonary tuberculosis. Chronic chest disease, predominantly chronic airflow obstruction, was the most frequent associated disease. The organisms showed in vitro resistance in eight patients to rifampicin, in 19 patients to isoniazid, and in all patients to pyrazinamide and p-aminosalicylic acid. Nevertheless, all patients showed an early response to standard combination chemotherapy with rifampicin, isoniazid, and ethambutol, with or without pyrazinamide. Five have been cured and none had died of the infection, although four died of unrelated disease. Of nine patients still having treatment, five had relapsed after completing a course of antituberculosis drugs. All had received ethambutol for less than five months. The response to standard drugs was more satisfactory when the course included administration of ethambutol for at least nine months. Currently one new infection with M malmoense occurs in Scotland for every 40 with tuberculosis, and the incidence appears to be rising. In view of this, it is suggested that when tuberculosis is suspected the chemotherapeutic regimen should include ethambutol until the culture results are reported. If these then show M malmoense, ethambutol should be continued in the combination for at least nine months. PMID- 3660313 TI - Measurement of effective pulmonary blood flow by soluble gas uptake in patients with chronic airflow obstruction. AB - A study was designed to assess the accuracy and reproducibility of rebreathing and single breath soluble gas uptake measurements of effective pulmonary blood flow (Q) in patients with airways obstruction. Both rebreathing (RB) and single breath (SB) estimates of Q were compared with direct Fick and thermodilution (TD) measurements of cardiac output at rest and during exercise in eight patients with chronic, poorly reversible airflow obstruction with mean FEV1 65% predicted and mean FEV1/FVC 53%. The mean (SD) resting values obtained were QRB 3.47 (0.46), QSB 4.75 (1.15), QFick 4.77 (0.97), and QTD 5.15 (0.98). QRB was significantly lower than the other three estimates, which did not differ significantly from each other. Exercise produced significant increases in all four estimates for the group. The mean exercise values were QRB 6.23 (1.19), QSB 7.62 (1.97), QFick 8.97 (1.96), and QTD 9.09 (1.00), both QRB and QSB being significantly less than QFick and QTD. Analysis of variance of the rest, exercise, and combined data showed highly significant relationships with the TD and Fick measurements for both QRB and QSB over the range of values studied. In addition, the reproducibility of QRB and QSB was assessed in 15 other patients with chronic airflow obstruction (mean FEV1 42% predicted, FEV1/FVC 43%) and in 10 normal subjects. The coefficients of intrasubject variability for a single measurement for QRB were 8.7% in normal subjects and 10.2% in patients and for QSB were 11.7% in normal subjects and 16.1% in patients. The group differences from morning to afternoon, between days, and over a month were not significant in the normal subjects. In the patients QRB was slightly higher in the afternoon than in the morning of the same day, but the differences between days and over a month were not significant for either test. Although both tests detected the increase in pulmonary blood flow during exercise, the single breath test was more accurate at rest. Some underestimation was present for rebreathing at rest and for both tests during exercise, but this can be allowed for. In patients with mild airflow obstruction the reproducibility of the soluble gas uptake methods was similar to that of invasive catheter methods of cardiac output estimation. The single breath test in particular was, however, less reproducible in patients with more severe airflow obstruction, and the rebreathing method may be more useful for detecting increases in pulmonary blood flow in these patients. PMID- 3660314 TI - Atrophy of Leydig cells in the testes of men with longstanding chronic bronchitis and emphysema. AB - The total volume of Leydig cells in the testes of men coming to necropsy with a history of chronic bronchitis and emphysema of at least 15 years' duration, and with morphological evidence at necropsy of the cardiopulmonary effects of hypoxia, was significantly less than the volume in matched controls (0.98 (SD 0.39) and 0.93 (0.42) ml v 1.66 (0.54) and 1.72 (0.52) ml for left and right testes respectively; p less than 0.005). This atrophy may be a consequence of hypoxic inhibition of pituitary synthesis or release of luteinising hormone. PMID- 3660315 TI - Pulmonary vascular permeability to transferrin in the pulmonary oedema of renal failure. AB - Thirteen patients with renal failure and pulmonary oedema were assessed for evidence of increased pulmonary vascular permeability to protein by a double isotope technique. Comparison was made with 10 patients with cardiogenic pulmonary oedema, 11 healthy volunteers, and 10 patients with the adult respiratory distress syndrome. There was no significant difference in the accumulation of a radiolabelled plasma protein (transferrin) in patients with renal or cardiogenic pulmonary oedema and normal volunteers. Patients with adult respiratory distress syndrome showed significantly greater protein permeability (p less than 0.001). In pulmonary oedema associated with renal failure managed by current regimens there was no evidence of increased permeability to transferrin. PMID- 3660316 TI - Effect of head position on the efficacy of topical treatment of chronic mucopurulent rhinosinusitis. PMID- 3660317 TI - Adult intrapulmonary and mediastinal lymphangioma causing haemoptysis. PMID- 3660318 TI - Mortality in cases of asbestosis diagnosed by a pneumoconiosis medical panel. PMID- 3660319 TI - [Allometric relations in pharmacokinetics. Influence on pharmacodynamics (from mouse to elephant, without forgetting man)]. PMID- 3660320 TI - [Influence of a new macrolide, dirithromycine, on the clearance of antipyrine]. PMID- 3660321 TI - [Comparison of passage, in the vitreous body, of cefotaxime and cefoperazone]. PMID- 3660322 TI - [Good use of hypnotics]. PMID- 3660323 TI - [Chinese restaurant syndrome. Implication of drugs]. PMID- 3660324 TI - [Hepatic involvement due to nifedipine. Description of a case and review of the literature]. PMID- 3660325 TI - [Neonatal impact of benzodiazepine consumption in pregnancy]. PMID- 3660326 TI - [Iatrogenic Cushing's syndrome caused by an acute overdose of triamcinolone]. PMID- 3660327 TI - Testosterone effects on biosynthesis of coagulation proteins. AB - Studies were performed to assess the effects of testosterone on synthesis of selected coagulation proteins using the isolated rat liver perfused in vitro for 10 hours, as well as effects of testosterone on plasma levels of these same proteins. Pretreatment of castrated male rat liver donors for 14 days with pellets containing placebo or testosterone, 0.5 mg, 5.0 mg or 15.0 mg had no significant effects on cumulative biosynthesis of Factor II, Factor VII, antithrombin III, plasminogen or fibrinogen. Plasma concentrations of these proteins in liver donor animals were also unchanged by such hormonal manipulations. In contrast, biosynthesis of fibronectin was increased significantly by increasing doses of testosterone, and plasma concentrations of fibronectin in liver donor rats showed a similar effect. PMID- 3660328 TI - Antithrombin III and heparin cofactor II in patients with chronic renal failure undergoing regular hemodialysis. AB - Heparin enhances the inhibition rate of thrombin by both antithrombin III (AT III) and heparin cofactor II (HC II). We studied the activity of these two plasma proteins in patients with chronic renal failure (CRF) undergoing regular hemodialysis as their heparin requirements varied widely. In 77 normal blood donors, normal ranges (mean +/- 2 SD) were 82-122% for AT III and 65-145% for HC II. When compared with these controls 82 dialyzed CRF patients had a subnormal AT III activity and a significantly (p less than 0.001) lower HC II activity. To evaluate the effect of hemodialysis we compared AT III, HC II and total proteins in plasma before and after dialysis in 24 patients (12 with normal and 12 with low basal HC II activity). AT III and HC II activities significantly (p less than 0.001) increased in absolute value. When related to total plasma proteins, in order to suppress the influence of hemoconcentration induced by dialysis, AT III decreased significantly (p less than 0.01) whereas HC II increased slightly but significantly (p less than 0.01) in the 12 patients with low initial HC II activity. The decrease of AT III induced by heparin administrated during dialysis is likely to account for this relative decrease of AT III activity. A modification of the distribution of both HC II and heparin between the vascular wall and the circulating blood is evoked to explain the relative increase in HC II activity and the need for higher heparin dosage in patients with low HC II levels. PMID- 3660329 TI - Effect of omega-3 fatty acid supplementation on platelet aggregability and platelet produced thromboxane. AB - We investigated the sustained effect of 12-week supplementation of 2.880 g/day of omega-3 fatty acids on platelet aggregability, platelet produced thromboxane B2 concentration and serum fatty acid composition in a double-blind controlled trial in 44 healthy mildly overweight eastern Finnish men recruited from a representative population sample. The supplementation was discontinued seven days before the biochemical measurements. Body weight, alcohol consumption and dietary composition remained constant during the study. Even though the percentage of eicosapentaenoic acid (20:5 omega 3) in total serum lipids increased by 37% (p less than 0.01) and that of dihomo-gamma-linolenic acid (20:3 omega 6) decreased by 18% (p less than 0.01) more in the omega-3 supplemented than placebo group during supplementation, there were no significant differences in the changes in either the ADP induced platelet aggregation or in vitro platelet produced thromboxane B2 concentration between the groups. These data suggest that omega-3 fatty acids have no detectable sustained effect either on ADP induced platelet aggregation or on thromboxane produced by the platelets in vitro. PMID- 3660330 TI - The antithrombogenic in vivo effects of calcium channel blockers in experimental thrombosis in mice. AB - A new model of thrombotic challenge, well suited for screening agents and which acts primarily against platelet thromboembolism, has been used to test the in vivo anti-platelet effects of four calcium channel blockers (CCB). An i.v. injection of a mixture of collagen plus epinephrine (15 micrograms and 1.8 micrograms/mouse, respectively) was given to male mice. 94% control mice died or remained paralyzed for more than 15 minutes. The dihydropyridine agents, CRE-223 and Nifedipine, were highly protective against experimental thrombosis, whereas Verapamil had a weaker and much shorter effect and, on the other hand, Diltiazem had no protective effect over a range of doses. The activity on both dihydropyridines lasted for seven hours or even longer. PMID- 3660331 TI - Calcium and the Fc receptor on human platelets. AB - We have described the calcium dependence of the IgG Fc receptor (Fc-R) on human platelets by analyzing the direct binding of radiolabelled Fc fragments, monomers and dimers of IgG. Specific binding to platelets was undetectable at 37 degrees C in a calcium-free preparation but readily detected when calcium was restored. Scatchard analysis of the binding data for the calcium-restored platelets permitted calculation of the available Fc-R and the Ka of binding for the different IgG ligands. The mean Ka of binding for 12 normal subjects varied from 10(7) to 10(8) L/M, with an equal receptor number measured by Fc fragments and dimers of IgG, but a lesser amount for monomeric IgG. There was no apparent difference in Fc-R number for platelets from 6 normal male versus 6 normal female subjects. At 4 degrees C binding was detectable for dimers and polymers of IgG in a calcium-free preparation and this was markedly increased with recalcification. Thus, our data are consistent with an Fc receptor population on human platelets whose avidity for binding is significantly enhanced in a calcium-restored medium. PMID- 3660332 TI - Excessive deposition of fibrin, platelets and platelet thrombi on vascular subendothelium during contraceptive drug treatment. AB - We investigated the effect of oral contraceptives on thrombogenesis induced by subendothelium of rabbit aorta (SE), exposed to flowing non-anticoagulated blood in an annular flow chamber. Six healthy women on sequential contraceptive drugs (0.05 mg aethinylestradiol/day, 0.125 mg desogestrel/day) were compared with 6 women without hormonal contraception and 6 men. On contraceptive drug treatment, blood values were significantly increased for fibrinogen (2.6 +/- 0.2 vs 1.9 +/- 0.1 g/l) and fibrinopeptide A (3.9 +/- 0.9 vs 0.9 +/- 0.1 ng/ml), whereas antithrombin III was decreased (81 +/- 4 vs 97 +/- 6%). Fibrin deposition on vascular subendothelium was more than four-fold increased when measured morphologically (63.4 +/- 2.5 vs 14.6 +/- 6.8% coverage of SE surface with fibrin) as well as immunologically (29.3 +/- 2.2 vs 4.5 +/- 1.9 micrograms fibrin/cm2 of SE). Thrombus volumes were more than two-fold increased in women with contraceptives (9.0 +/- 1.4 vs 3.7 +/- 1.0 micron 3/micron 2). Our study shows that during contraceptive drug treatment the exposure of flowing blood to vascular subendothelium leads to excessive deposition of fibrin and platelet thrombi. Measurement of blood interactions with subendothelium might be of predictive value in hypercoagulable states such as contraceptive treatment. PMID- 3660333 TI - Antithrombin III in full-term and pre-term newborn infants: three cases of neonatal diagnosis of AT III congenital defect. AB - Antithrombin III (AT III) plasma levels were investigated in 18 full term neonates and 14 healthy preterm neonates. A control group of 20 healthy adults was also studied. AT III was measured as antigen concentration (Ag) and antithrombin or anti-factor Xa heparin cofactor (H.C.) activities. Crossed immunoelectrophoresis on heparin-agarose (H-CIE) was carried out on plasma samples; moreover the distribution of isoantithrombins was investigated on whole plasma by a technique of crossed immunoelectrofocusing (CIEF). AT III plasma levels in full term infants were significantly lower as compared to the adult values. The preterm newborns group showed a further significant decrease in AT III levels as compared to the full term neonates. In all infants AT III H-CIE runs displayed a single fast moving anodal peak, so that a normal binding to heparin was demonstrated. The CIEF AT III plasma pattern of the adults as well as of all neonates displayed three major peaks at pH range 5.2-4.9, a small amount of AT III at pH 4.9-4.8 and a minor peak at pH 4.8-4.6, so that it was concluded that the isoantithrombins plasma distribution in neonatal age is identical to that of the adult subjects. Four neonates whose mothers were affected by AT III congenital defect were also investigated: diagnosis of congenital deficiency was established in three cases. PMID- 3660334 TI - Inhibition of fibrin polymerization by serum amyloid P component and heparin. AB - The effects of serum amyloid P component (SAP) and heparin on the thrombin catalyzed formation of polymeric fibrin from purified fibrinogen were examined using a turbidometric method to quantify fibrin polymerization. SAP and heparin acted synergistically to inhibit the lateral aggregation of fibrin fibrils, resulting in the formation of fibrils with a smaller mass to length ratio. Heparin did not enhance the incorporation of SAP into fibrin clots, and the effect of heparin and SAP did not seem to be related to inhibition of thrombin or of fibrinopeptide release. The evidence suggests that a soluble complex of SAP and heparin inhibits fibrin polymerization. PMID- 3660335 TI - International Committee Communications. ICTH (International Committee on Thrombosis and Haemostasis). Subcommittee on Clinical Trials: Registry of Multicenter Clinical Trials. Eighth report 1986. PMID- 3660336 TI - Fibrinogens "Milano II"- and "Naples". PMID- 3660337 TI - Antithrombotic effect of indobufen in an experimental model of arterio-arterial microanastomosis in the rat. AB - Using an end-to-side microanastomosis of the left common carotid into the right common carotid of rats, implementing a potentially thrombogenic situation, we have investigated the possible antithrombotic effect of indobufen, a new antiplatelet drug. In eight of 15 untreated rats the anastomosis was totally obstructed by a single thrombus growing from the anastomotic wall. Indobufen treatment prevented thrombus formation completely in 14 of 15 rats (p less than 0.02). In treated animals indobufen also produced a statistically significant reduction of ADP-induced platelet aggregation relative to basal values. Platelet count were not influenced by drug treatment. Our experimental results suggest the potential usefulness of indobufen as an antithrombotic agent. PMID- 3660338 TI - Inhibitory effect of immobilized microsomal proteins on platelet aggregation. AB - Bovine aorta microsome was solubilized by 0.5% Triton X-100, and then immobilized on agarose gel (Sepharose 4B). Immobilized microsomal proteins (I-MP) inhibited platelet aggregations induced by ADP, arachidonic acid, collagen, and thrombin. The decrease of free platelet count in sheared whole blood was suppressed by I MP. The anti-aggregatory activity of I-MP on arachidonic acid-induced aggregation was inhibited by 15-HPETE. This result suggests that I-MP contains PGI2 synthetase activity. It is considered that immobilization of enzymatic systems in aorta microsome which limited platelet aggregation is effective to provide an antithrombogenicity to the artificial polymers for artificial organs, especially used under the conditions which frequently induced platelet aggregation. PMID- 3660339 TI - Spontaneous platelet aggregation: observations on potential mechanisms. AB - We identified SPA in three young apparently healthy women. SPA was associated with release of TXA2 and was only partially inhibited by ADP-inhibitor apyrase and alpha 2-adrenoceptor blocker yohimbine. In vitro incubation of aspirin (90 micrograms/ml) or selective TXA2 synthetase inhibitor OKY-046 (0.1 uM) with platelet rich plasma (PRP) did not abolish SPA, although platelet generation of TXA2 was markedly inhibited. In contrast, oral administration of large amounts of aspirin in one subject or in vitro incubation of PRP with TXA2 -endoperoxide receptor blocker SQ 29,548 (20-100 nM) significantly inhibited SPA. These studies suggest that SPA is associated with TXA2 release. Since TXA2 -endoperoxide receptor blocker completely abolishes the secondary wave, agents like this may be of therapeutic value in individuals with SPA and evidence of tissue ischemia. PMID- 3660340 TI - Comparison of fibrin networks in plasma and fibrinogen solution. AB - Mass-Length ratio of fibrin fibres (microT and microP) derived independently from turbidity and permeability respectively, in networks made in fibrinogen solution and plasma, have been compared under similar conditions of clotting. Amount of fibrinogen conversion to fibrin was similar in both systems when high thrombin concentrations were used. But networks in plasma had significantly thicker fibres (higher microT and microP) than those in fibrinogen solution. This difference arises from differing kinetics of fibrin assembly in the two systems. When lower thrombin concentration is used, fibrin fibre thickness (as indicated by microP and microT) is increased in fibrinogen solution but the fibrin content of the network remains unaltered. In plasma, on the other hand, the fibrin content of the network is decreased, microT remains relatively unchanged while microP increases. The thrombin concentration dependence of the fibrin content of the network in plasma and the bimodal distribution of fibrin fibre thickness explain the breakdown in correlation between microP and microT. PMID- 3660341 TI - Membrane potential of stored platelets and its effect on platelet functions. AB - Relationships among intracellular Ca2+ level, membrane potential in resting state and platelet functions were examined. Membrane potential of platelets was increased (hyperpolarized) during storage and decreased (depolarized) by 37 degrees C incubation with plasma after storage. The degree of depolarization was greater in fresh plasma than in stored plasma. Changes of platelet functions were reverse with the membrane potential change. Aggregation induced by ADP or collagen was enhanced by depolarization with increasing extracellular [K+]. Shrinkage ratio (hypotonic shock response) of stored platelet which were hyperpolarizing, exhibited optimal value when the membrane potential was slightly depolarized. Intracellular [Ca2+] was not affected by the extracellular [K+]. These results suggest that platelet sensitivity is controlled by the membrane potential in resting state. PMID- 3660342 TI - Thrombocytopenia and liver cirrhosis evidence for relationship between platelet count, spleen size and hepatic synthetic activity. PMID- 3660343 TI - Platelet count, mean platelet volume, and platelet dimensional width in runners during basal training. PMID- 3660344 TI - Experimental gram-negative septicemia: thromboplastin generation in mononuclear phagocytes from different anatomical sites. AB - Rats were subjected to gram-negative septicemia induced by cecal perforation or were sham-operated. Thromboplastin values increased in blood monocytes (40-fold), peritoneal macrophages (115-fold) pleural macrophages (5-fold), splenic macrophages (3-fold), and lung alveolar macrophages (1.4-fold) in septic animals as compared to controls. In septic animals disseminated intravascular coagulation was evidenced by a significant (p less than 0.05) fall in fibrinogen, factor VII, X and platelets. A simultaneous and significant (p less than 0.05) decrease in thromboplastin content of tissue-specimens from lung and spleen was observed in rats with septicemia, whereas increased thromboplastin values were demonstrated in tissue-samples from cecum - the infectious focus. This might reflect mobilization of mononuclear phagocytes in favour of the site of infection. PMID- 3660345 TI - Monocyte procoagulant activity in breast cancer. AB - Abnormalities of blood coagulation associated with neoplasia may be important in the pathogenesis of tumour spread. Most patients with advanced malignancy have evidence of activated coagulation, but the mechanisms underlying this are unclear. We have examined in vitro monocyte procoagulant activity and compared this to plasma levels of fibrinopeptide A, in 52 patients with clinically localised breast cancer. Patients with localised breast cancer and activated coagulation displayed a strong positive correlation between monocyte procoagulant activity and level of fibrinopeptide A(r = +0.86, p less than 0.001). No such relationship was demonstrated in a smaller number of patients with metastatic breast cancer. It is concluded that monocyte procoagulant activity plays an important role in coagulation activation in patients with localised breast cancer. The implications of this for adjuvant anticoagulant therapy in breast cancer are discussed. PMID- 3660346 TI - Effect of phosphorylation in vitro of human fibrinogen with protein kinase C on thrombin-induced gelation. AB - Thrombin-induced gel formation of fibrinogen phosphorylated by protein kinase C yielded a transparent gel, whereas unphosphorylated fibrinogen yielded a coarse gel. The mass-length ratio was found to be one order of magnitude higher for the unphosphorylated than for the phosphorylated fibrinogen. Since the phosphorylated sites are located near the cross-linking sites in the A alpha-chain of fibrinogen, it is likely that the introduction of charged phosphate groups in this region prevent the lateral growth of the fibrin fibres. PMID- 3660347 TI - Effect of different ratios of dietary N-6 and N-3 fatty acids on fatty acid composition, prostaglandin formation and platelet aggregation in the rat. AB - Five groups of male Sprague-Dawley rats (150 g) were fed a fat-free diet supplemented with 10% by weight of evening primrose oil (Efamol, rich in linoleic acid and gamma-linolenic acid) and/or marine oil (Polepa, rich in eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3) combined in several ratios (Efamol/Polepa; 10.0%/0%; 7.5%/2.5%; 5.0%/5.0%; 2.5%/7.5%; 0%/10.0%). The n-6 fatty acid levels in aortic, platelet and plasma phospholipids decreased in proportion as Efamol was replaced with Polepa. The exception in phospholipids was dihomo-gamma-linolenic acid (20:3n-6), which increased when marine oil was provided in the diet with Efamol. The ratio of 20:3n-6 to arachidonic acid (20:4n-6) was positively correlated with 20:5n-3, docosapentaenoic acid (22:5n-3) or 22:6n-3 in aortic, platelet and plasma phospholipids under these dietary conditions. In contrast, 20:3n-6 in plasma cholesterol esters, triglycerides and free fatty acids did not show any increase in the presence of Polepa. Aortic prostaglandin (PG) production (6-keto-PGF1 alpha, PGE2 and PGE1) was reduced as Efamol was progressively replaced with Polepa. Aortic PG production was positively correlated with 20:4n-6 content in aortic phospholipids. Thrombin-induced thromboxane B2 production in whole blood was related to 20:4n-6 content in platelet phospholipids. However, ADP-induced platelet aggregation was significantly decreased only in the 7.5% Efamol/2.5% Polepa group as compared to the other 4 groups. These results suggest that combined treatment with Efamol and Polepa increases the ratio of 20:3n-6 to 20:4n 6 in tissue and plasma phospholipids. An appropriate ratio of these oils favorably affects aortic PG production and platelet ADP aggregation. PMID- 3660348 TI - Uptake and inactivation of thrombin on the subendothelium: comparisons with endothelium. AB - One aspect of the non-thrombogenicity of endothelium is the property to bind and inhibit thrombin. Loss of the endothelial layer gives rise to a thrombogenic surface. The present study concerns uptake and inactivation of thrombin on endothelium as well as subendothelium. Both the immediate subendothelial layer and the media were investigated. Binding and inhibition of thrombin was assayed using both a synthetic chromogenic substrate and fibrinogen. In the latter case thrombin enzymatic activity was assessed by measuring liberation of fibrinopeptide A. There was a linear relationship between thrombin in the solution and thrombin enzymatic activity recovered on the surface on both endothelium and media. 30-50 per cent of the surface bound thrombin measured with the chromogenic substrate was also active towards fibrinogen. Preincubation of endothelium with plasma gave rise to an increased loss of thrombin from the solution at the same time as less thrombin was recovered on the surface. This indicates increased inactivation. Increased inactivation could also be obtained by pretreatment with antithrombin (AT) but not with AT-depleted plasma. The same general pattern was seen on the subendothelium but not on the media. It is concluded that inhibition of thrombin occurs on the endothelium and can be augmented by prior binding of AT to the surface. This effect although less pronounced can also be obtained on the subendothelium. The deeply injured vessel is much less capable of inhibiting thrombin. PMID- 3660349 TI - Continuous chromogenic tissue factor assay: comparison to clot-based assays and sensitivity established using pure tissue factor. AB - The continuous chromogenic tissue factor assay has been compared to one-stage and two-stage coagulation assays, and its sensitivity has been established using purified human placental tissue factor. Log-log plots of the clot-times versus A405/min2 are linear over the mutually useful ranges of tissue factor concentration. Using human placental tissue factor reconstituted into phosphatidylserine-phosphatidylcholine (30:70) vesicles, the chromogenic assay quantitatively detected tissue factor in dilutions containing from 3 femtomoles to less than 10 attomoles of protein. PMID- 3660350 TI - Studies on the anticoagulant action of Aspilia africana. AB - An anticoagulant activity was identified and isolated from the leaves of a West African plant, Aspilia africana by gel filtration on Sephadex G-100. The anticoagulant factor had an apparent molecular weight of approximately 60,000 d. Upon incubation with plasma, it prolonged the partial thromboplastin time, prothrombin time, thrombin and reptilase time. The factor decreased the fibrinogen content of plasma as well as the activity of coagulation factors V, VIII and IX but not factor VII, X or XI activities. After incubation with fibrinogen, the thrombin clotting time was prolonged and the quantity of clottable fibrinogen reduced. The action on fibrinogen was characterized by sequential lytic breakdown of the A-alpha-chain and B-beta-chain, the gamma-chain being lysed last, after prolonged incubation. Benzamidine, Epsilon aminocaproic acid or soybean trypsin inhibitor did not impede lysis. PMID- 3660352 TI - [Mortality in meningococcal disease. Relation to age, sex and clinical signs]. PMID- 3660351 TI - Ancrod enhances the thrombolytic effect of streptokinase and urokinase. AB - Since thrombi continue to incorporate fibrin during lysis we tested the effect of pretreatment with ancrod, a defibrinating agent from Malaysian pit viper venom, on thrombolysis with urokinase and streptokinase. Thrombi were induced by copper coils in the carotid arteries of the dogs, weighed after 1 hour and inserted into the femoral arteries of the same animals. They were then exposed for 15 min to iv boluses of streptokinase 10,000 U/kg, urokinase 10,000 U/kg and urokinase 25,000 U/kg with or without pretreatment with ancrod. Ancrod depleted fibrinogen within 5 min and enhanced the lytic effect of streptokinase from 25 +/- 8% to 59 +/- 13% (p less than .05), urokinase 10,000 U/kg from 16 +/- 11% to 66 +/- 18% (p less than .01) and urokinase 25,000 U/kg from 27 +/- 17% to 85 +/- 8% (p less than .001) of the initial thrombus weight. Ancrod itself did not activate plasminogen to plasmin. We conclude that ancrod enhances thrombolysis probably by depleting fibrinogen and preventing new fibrin incorporation into the thrombus during lysis. PMID- 3660353 TI - [Mortality in meningococcal disease. Relation to time of hospitalization]. PMID- 3660354 TI - [Diet and consumption of stimulants among 128 North Cape fishermen]. PMID- 3660355 TI - [Diabetes mellitus and pregnancy]. PMID- 3660356 TI - [Magnesium deficiency. Diagnosis and occurrence of different disease conditions]. PMID- 3660357 TI - [Cystic fibrosis and physical activity]. PMID- 3660358 TI - [Obesity. Treatment with intermaxillary fixation and diet]. PMID- 3660359 TI - [Maxillomandibular fixation as a method for weight reduction. A simple method with a good early results and few adverse effects]. PMID- 3660360 TI - [Serum uric acid in pregnancy]. PMID- 3660361 TI - [Trientin in Wilson's disease. Therapeutic possibilities in patients who cannot tolerate penicillamine]. PMID- 3660362 TI - [Metastatic calcification as a side effect of treatment with a vitamin D metabolite]. PMID- 3660363 TI - [The retina, visual pathways and visual cortex. Neurophysiological studies]. PMID- 3660364 TI - [The general practitioner and the family with a chronically ill child]. PMID- 3660365 TI - [Have you ever had cancer? A comparison between answers to this question given in connection with the Tromso cardiovascular study and Cancer Registry data]. PMID- 3660366 TI - [Patients' opinion on the services provided by physicians. A study of services in Ulstein County]. PMID- 3660367 TI - [Screening for cancer--a current health service? An updating of screening for breast cancer, cervix cancer and colorectal cancer]. PMID- 3660368 TI - [Urography in children. Indications and findings]. PMID- 3660369 TI - [Primary hyperparathyroidism]. PMID- 3660370 TI - [Extrahepatic bile duct carcinoma]. PMID- 3660371 TI - [Intrathoracic peptic ulcer perforation]. PMID- 3660372 TI - [Drusen of the optic nerve papilla. Diagnosis by orbital CT]. PMID- 3660373 TI - [Pneumothorax in severe asthma attacks]. PMID- 3660374 TI - [Miliary tuberculosis]. PMID- 3660375 TI - [Argon laser treatment of capillary hemangioma (nevus flammeus)]. PMID- 3660376 TI - [Arrhythmias caused by anti-arrhythmia agents--torsade de pointes]. PMID- 3660377 TI - [HIV transmission and occupational life]. PMID- 3660378 TI - [Prevention of AIDS in prisons]. PMID- 3660379 TI - [Radon and the risk of cancer]. PMID- 3660380 TI - [Drug-induced encephalopathy. Permanent brain damage caused by solvents?]. PMID- 3660381 TI - [Seasickness at Rost]. PMID- 3660382 TI - [Degenerative lumbar spinal stenosis]. PMID- 3660383 TI - [Degenerative lumbar spinal stenosis. A retrospective study of patients treated surgically]. PMID- 3660384 TI - [Does rooming-in increase the duration of breast feeding?]. PMID- 3660385 TI - [Musicians and herpes labialis]. PMID- 3660386 TI - [Foley catheter for preoperative cervix dilatation in induced abortion]. PMID- 3660387 TI - [Pulmonary echinococcosis. Has the disease been eradicated in North Norway?]. PMID- 3660388 TI - [Transient global amnesia]. PMID- 3660389 TI - [The os supratrochleare]. PMID- 3660390 TI - [Malignant melanoma. Unknown primary tumor and long survival--2 rare case reports]. PMID- 3660391 TI - [Endoscopic laser therapy of tracheobronchial tumors]. PMID- 3660392 TI - [Background variables related to death and to continued living at home a year after application for nursing-home care]. PMID- 3660393 TI - [Blood specimen collection in individual cattle or will one specimen suffice for all animals?]. PMID- 3660394 TI - [Central Veterinary Institute finds rabid bats also in the metropolitan area, Twente and the provinces of Groningen and Friesland]. PMID- 3660395 TI - [Preservation and storage of cleansing and disinfection agents]. PMID- 3660396 TI - [Automation, the (interim) status]. PMID- 3660397 TI - HLA-A,B,C and DR antigens in a sample of the Tunisian population. AB - The HLA-A, B and DR phenotypes of 109 unrelated Tunisian individuals have been determined. The HLA-A and B antigen frequencies were compared with data reported for European Caucasoids and various Arab populations. Most similarities in antigen frequencies were seen between Tunisians and Kabyles from North Africa. A high frequency of HLA-A23 and HLA-Bw50 was observed in Tunisians and all Arab populations. A very close similarity in HLA-DR antigen frequencies exists between Tunisians and European Caucasoids. Linkage disequilibria between alleles of HLA loci were examined; many instances of previously reported antigen associations were seen in Tunisians, together with a number of associations which have not been described elsewhere. Aw34B8 and A2DRw14 are suggested as being common haplotypes in Tunisians. PMID- 3660398 TI - The distribution of HLA-A,B, DR antigens in Chinese myasthenia gravis. AB - The association of HLA antigens with Myasthenia Gravis (MG) in many different races is well known. In this study, HLA-A, B and DR antigens were typed on 65 Chinese MG and 232 controls for HLA-A, B and 61 for DR antigens. A2 and DRw9 increased significantly in patients with MG (p less than 0.025 and p less than 0.05 respectively). DR2 and DR4 had the opposite influence (both p less than 0.005). Several alleles were shown to have relatively high values of P D/A and relative risk but low P A/D and E.F, which suggests the marker heterogeneity of MG. Comparisons of clinically different types of MG, variations of the age of onset and thymic pathology did not show any statistically significant difference in HLA distributions. The clinical implications were discussed. PMID- 3660399 TI - Hepatitis B and HIV testing of HLA reagents. PMID- 3660400 TI - Metastatic enhancement and growth inhibition by glucocorticoid and its receptors in mouse teratocarcinoma OTT6050 in vivo. AB - To elucidate the mechanism of glucocorticoid-induced metastases and growth inhibition of mouse teratocarcinoma OTT6050, syngeneic 129/Sv-CP+SlJ mice were subcutaneously (s.c.) injected with the tumor and treated with daily intraperitoneal (i.p.) injections of hydrocortisone in doses of 1.5 to 12.5 mg per mouse. The number of lymph-node and visceral metastases was greatly increased by the treatment with hydrocortisone unrelated to the doses and sexes. Tumor growth (the products of three principal diameters) of lymph-node metastases was dose-dependently inhibited by the treatment. Histologically, lymph-node metastatic tumors contained large masses of well-differentiated tissues compared with the s.c. transplanted tumor of the same size. The glucocorticoid receptors were measured using dextran-coated charcoal adsorption techniques with [3H] hydrocortisone. Glucocorticoid receptor contents were higher in lymph-node metastatic tumor (100 fmole/mg cytoplasmic protein, mean) than in s.c. transplanted tumors (74.5 fmole/mg, mean) respectively treated with 12.5 mg of hydrocortisone. The metastatic growth inhibition by hydrocortisone might be closely related to the receptor-mediated mechanisms and histological differentiation. PMID- 3660401 TI - Characteristics of anti-TSH receptor antibodies in two patients who developed spontaneous hypothyroidism after antithyroid drug therapy for hyperthyroid Graves' disease. AB - Spontaneous hypothyroidism was developed in two patients with Graves' hyperthyroidism 1.8 or 1 years after antithyroid drug therapy. In these patients anti-thyrotropin (TSH) receptor antibodies were detected. Thyrotropin receptor antibody (TRAb) index measured with TSH radioreceptor assay was 61.0% in case 1 and 68.0% in case 2 (normal value: -10 to 10%), and human thyroid adenylate cyclase stimulating activities (HTACS) were 154% in case 1 and 190% in case 2 (normal value: 70 to 130%). IgG from case 1 suppressed the stimulating activity of bovine TSH (bTSH) on thyroid adenylate cyclase in low concentrations in vitro. These results indicate that a blocking type of anti-TSH receptor antibodies as well as concomitant chronic thyroiditis might be a causative factor in patients who developed spontaneous hypothyroidism shortly after the cessation of antithyroid drugs. PMID- 3660402 TI - Detection of AB antigen in blood stain using enzyme-linked immunosorbent assay. AB - A new method for detection of AB antigen from blood stain using enzyme-linked immunosorbent assay (ELISA) is described. Flat-bottomed-wells of polystylen plate coated with human anti-B or rabbit anti-A were sensitized with AB antigen which was extracted from blood stain with 1% octyl-glucopyranoside in 0.1 M phosphate buffer pH 8.0. Mouse monoclonal anti-A or anti-B, and peroxidase conjugated anti mouse immunoglobulin were added to the wells, respectively. Subsequently, the substrate was dropped into the wells, and the absorbance of the solution was measured. By this method, we could distinguish AB group blood stain from the mixed stain of A and B group bloods. When rabbit antiserum was used as the first antibody, differentiation between these antigens was unsuccessful presumably because of non-specific adsorption. PMID- 3660403 TI - A family case with autosomal-dominantly inherited pituitary dwarfism. AB - Isolated growth hormone (GH) deficiency (IGHD) is detected in 1/10 of pituitary dwarfism, but there are only a few reports on IGHD as an autosomal-dominant trait. We found one family with autosomal-dominantly inherited IGHD and examined their pituitary functions and GH genomes. Brothers (9.5 year and 11 year) and their mother (37 year) were diagnosed as having IGHD and their grandmother and uncle also seemed to have IGHD. All of their heights were under "mean-4.0 S.D.". Cerebral tomography of brothers and their mother all showed "empty sella", and GH releasing hormone (GRH) tests showed no responses of GH not only to bolus intravenous injections but also after repeated intramuscular injections of GRH (100 micrograms/day) for 7 days. Although genetic analysis (Southern blotting method) could not detect any mutations in their GH genomes, the IGHD lesion of them seemed to be pituitary in origin. PMID- 3660404 TI - A simple method for quantification of biotinidase activity in dried blood spot and its application to screening of biotinidase deficiency. AB - A simple and reliable method for quantification of biotinidase (EC.3.5.1.12) activity in dried blood spot was devised by a modification of the colorimetric screening test developed by Heard et al. (1984). The enzyme reaction and hemoglobin denaturation were carried out in a U-bottomed microplate. An aliquot of the reaction solution was transferred to a flat-bottomed microplate. After the coupling reaction was started, the adsorbance was measured in situ by a microplate-reader. Both intra- and inter-assay coefficient of variation (CV) values were less than 10%. Biotinidase activity in dried blood spot showed a good correlation to that in serum (r = 0.912, n = 8). This method was applied in a pilot screening of 18,945 newborns in Sapporo City. No positive results have been obtained as yet. PMID- 3660406 TI - Mechanical production of pleural cysts in isolated rat lungs: an experimental model for pleural blebs. AB - In an effort to establish the pathogenesis and developmental mechanisms of pleural blebs, which are not well understood, I attempted to produce bleb-like lesions experimentally in isolated rat lungs, and observed them histologically and ultrastructurally. One to 2 ml of the Dulbecco's phosphate-buffered saline or a mixture of sodium citrate, citric acid and dextrose was injected in usual speed into the subpleural lung parenchyma while the hilum of the lung was lightly pinched with forceps. This treatment induced one of two kinds of pleural cysts near the site of injection; one, in which a space was produced between the pleural connective tissues and lung parenchyma, and the other, in which it was between mesothelial cell layer and the pleural connective tissues. These observations suggested that some of the blebs in humans may arise on mechanical stress, and that there may be two different types of blebs in humans, too. PMID- 3660405 TI - MC-838 (altiopril calcium): a novel orally active angiotensin converting enzyme inhibitor. AB - MC-838, calcium (-)-N-[(S)-3-(N-cyclohexylcarbonyl-D-alanyl) thio]-2 methylpropionyl]-L- prolinate, is a new orally active angiotensin converting enzyme (ACE) inhibitor in which the mercapto-group is taken up in a stable thiolester linkage. The linkage was relatively resistant against enzymatic hydrolysis by rat liver homogenates. The ACE prepared from rabbit lung was inhibited by MC-838 in a concentration-dependent manner. In isolated rat aortic ring and guinea-pig ileum preparations, MC-838 was highly specific in suppressing the contractile response to angiotensin-I (A-I) an in augmenting the contractile one to bradykinin. However, the ACE inhibitory activity of MC-838 was 30-100 times less potent than that of captopril. In conscious two-kidney (2 KG), renal hypertensive rats and spontaneously hypertensive rats (SHRs), MC-838 (3 and 10 mg/kg) given orally caused a long-lasting hypotensive effect with a slow onset. When compared on a weight basis (3 mg/kg), the antihypertensive effect of MC-838 was comparable to that of captopril in magnitude, but the duration of action of MC-838 was approximately 2 times longer than that of captopril. PMID- 3660407 TI - Effects of acute and chronic dimethylamine exposure on the nasal mucociliary apparatus of F-344 rats. AB - Dimethylamine (DMA) is a highly water soluble gas with many industrial applications. Male F-344 rats were exposed to 175 ppm DMA 6 hr per day for 1, 2, 4, or 9 days or 2 years. Gross changes in nasal structure were recorded, effects of DMA on the mucociliary apparatus were assessed using video analysis, and tissues were evaluated for histopathology. In vitro nasal mucociliary flow patterns, mucus flow rates, and ciliary activity were studied and recorded for video motion analysis. There were distinct and generally consistent differences in the shape of the naso-, maxillo-, and ethmoid turbinates between young and old animals. Acute and chronic DMA exposures resulted in erosion of the anterior margins of the naso- and maxilloturbinates and fenestration of the adjacent septum. Ciliastasis and mucostasis were observed only on the anteromedial aspect of the maxilloturbinate. In the chronically exposed rats, mucociliary activity was present in areas adjacent to erosions of the turbinates and septum. Abnormal mucus flow patterns, including altered or reversed direction of flow and "whirlpool-like" formation, were observed in all treated rats, but were more severe following chronic exposure. There was a good correlation between the distribution of responses as assessed by histopathology and abnormal mucociliary function at all time points. In conclusion, the mucociliary apparatus continues to function in the nasal passages of rats having localized destruction of nasal epithelium, induced by DMA exposure, and this clearance system responds to alterations of nasal structure by modification of mucus flow patterns. PMID- 3660408 TI - The mechanism of acute cytotoxicity of triethylphosphine gold(I) complexes. I. Characterization of triethylphosphine gold chloride-induced biochemical and morphological changes in isolated hepatocytes. AB - Triethylphosphine gold complexes are effective therapeutic agents used for the treatment of rheumatoid arthritis. Many of those molecules are also highly cytotoxic in vitro and can inhibit DNA and protein synthesis. Preliminary experiments have indicated that triethylphosphine gold chloride (TEPAu) may induce the peroxidative decomposition of cellular membrane lipids. The purpose of these investigations therefore was to evaluate the role of lipid peroxidation in the mechanism of acute cytotoxicity of a gold(I) coordination complex, TEPAu, and to examine the early morphological and biochemical changes induced by TEPAu in suspensions of freshly isolated rat hepatocytes. TEPAu caused a rapid loss of cell viability at concentrations above 25 microM which was significantly different from that of control by 60 min and complete by 180 min of incubation. TEPAu also depleted cells of reduced glutathione (GSH) and increased the formation of malondialdehyde (MDA) by 60 min. Incubation of cells with either of the antioxidants, N,N'-diphenyl-p-phenylenediamine (DPPD) or promethazine blocked the formation of MDA but did not alter the time course of cell death or GSH depletion induced by TEPAu. TEPAu also caused a decrease in cellular NADPH and NADH by 10 min. Electron microscopy of hepatocytes exposed to TEPAu revealed early (5 min) formation of flocculent electron-dense precipitates within condensed mitochondria. These changes characteristically preceded cell death. Energy-dispersive electron-probe microanalysis indicated that the electron-dense precipitates did not contain detectable amounts of gold. TEPAu also caused a concentration-dependent decrease in cellular ATP and oxygen consumption in isolated rat hepatocytes. These data suggest that lipid peroxidation, as indicated by the formation of MDA, is probably not a major mechanism by which triethylphosphine gold complexes lethally injure cells. These data, therefore, suggest that mitochondria may be target organelles in TEPAu-induced toxicity to isolated rat hepatocytes. PMID- 3660409 TI - The mechanism of acute cytotoxicity of triethylphosphine gold(I) complexes. II. Triethylphosphine gold chloride-induced alterations in mitochondrial function. AB - Triethylphosphine gold complexes have therapeutic activity in the treatment of rheumatoid arthritis. Many of these compounds are also highly cytotoxic in vitro to a variety of tumor and non-tumor cell lines. Triethylphosphine gold chloride (TEPAu) is highly cytotoxic to isolated rat hepatocytes at concentrations greater than 25 microM. The earliest changes that could be detected in hepatocytes included bleb formation in the plasma membrane, alterations in the morphology of mitochondria, and rapid decreases in cellular ATP and oxygen consumption. The degradation of ATP could be followed sequentially through ADP and AMP and was ultimately accounted for entirely as xanthine. The sum of adenine and xanthine derived nucleotides remained constant throughout the experiments. TEPAu (50 microM) caused a significant decrease in the hepatocyte ATP/ADP ratio and energy charge within 5 min. The antioxidant, N,N'-diphenyl-p-phenylenediamine (DPPD), which blocked TEPAu-induced malondialdehyde formation but not cell death, also had no effect on the decreases in oxygen consumption, ATP, ATP/ADP ratio, or energy charge. In isolated rat liver mitochondria, TEPAu (1 microM) caused significant reductions in carbonyl cyanide-4-trifluoromethoxyphenylhydrazone (FCCP) (uncoupled)-stimulated respiration. TEPAu (5 microM) inhibited state 3 respiration and the respiratory control ratio without affecting state 4 respiration and caused a rapid dissipation of the mitochondrial-membrane hydrogen ion gradient (membrane potential). Concentrations greater than 5 microM also inhibited state 4 respiration. TEPAu caused a concentration-dependent inhibition of FCCP-stimulated respiration with pyruvate/malate and succinate as substrates but had not effect on ascorbate/tetramethyl-p-phenylenediamine-supported respiration. The inhibition of state 4 respiration and FCCP-stimulated respiration by TEPAu (10 microM) could be reversed by the addition of 2 mM dithiothreitol. Dithiothreitol also partially protected cells from TEPAu-induced injury and reversed the TEPAu-induced depletion in cellular ATP. These data indicate that TEPAu may be acting functionally as a respiratory site II inhibitor, similar to antimycin. The reversal of TEPAu-induced inhibition of mitochondrial respiration and cell lethality by dithiothreitol suggests that mitochondrial thiols may be involved. PMID- 3660410 TI - Dantrolene and mepacrine antagonize the hemolysis of human red blood cells by halothane and bee venom phospholipase A2. AB - Dantrolene is an effective antagonist of anesthesia-induced malignant hyperthermia due to a poorly understood action on skeletal muscle. The present study examines whether the red blood cell can be used as a model to investigate the mechanism of dantrolene action. Halothane (4.7 mM) caused 9% hemolysis of red blood cells. Phospholipase A2 (1 microM) alone caused less than 2% hemolysis, despite high levels (54%) of phosphatidylcholine hydrolysis. Incubation of red blood cells with halothane and phospholipase A2 caused 72% hemolysis. Halothane addition caused 100% hydrolysis of all diacylphosphoglycerides by phospholipase A2, suggesting a mutual potentiation. The major products of phospholipase A2 activity, arachidonic acid and lysophosphatidylcholine, when exogenously added, also greatly increased hemolysis induced by halothane, with arachidonic acid most closely resembling the synergism observed with phospholipase A2. Dantrolene (10 microM) and mepacrine (10 microM) significantly antagonized hemolysis induced by halothane and phospholipase A2 or halothane and exogenously added arachidonic acid and lysophosphatidylcholine. Dantrolene and mepacrine did not antagonize phospholipid hydrolysis or free fatty acid levels. Dantrolene and mepacrine antagonized the synergism between halothane and phospholipase A2 most likely by reducing the lytic action of halothane in the presence of arachidonic acid. The red blood cell is a useful model for studying the antagonism of halothane and phospholipase A2 toxicity by dantrolene and mepacrine. PMID- 3660411 TI - Mitochondrial toxicity of 2-bromohydroquinone in rabbit renal proximal tubules. AB - 2-Bromohydroquinone (BHQ) is a nephrotoxic metabolite of bromobenzene and a model toxic hydroquinone. The primary goal of these studies was to determine whether BHQ produces toxicity in rabbit renal proximal tubules by inhibiting mitochondrial function. BHQ induces a specific sequence of cellular events. Initially there was decrease in tubular glutathione content followed by a decrease in nystatin-stimulated ouabain-sensitive respiration. A decrease in cell viability, as measured by a decrease in lactate dehydrogenase retention, was late event. Associated with the decrease in respiration was a decrease in intracellular ATP content. Probing of mitochondrial function in the tubule revealed that BHQ did inhibit mitochondrial function in a somewhat selective manner. State 3 respiration was inhibited prior to changes in the rate of electron flow through cytochrome c-cytochrome oxidase. It is postulated that BHQ may initially inhibit state 3 respiration by inhibiting the adenine nucleotide translocator and/or the F1-ATPase. PMID- 3660412 TI - A novel acute toxicity resulting from the administration of morphine and adriamycin to mice. AB - The toxic potential of the combination of morphine and Adriamycin (doxorubicin) has been evaluated in mice. Intravenous administration of 20 or 40 mg Adriamycin/kg resulted in a dose-related mortality beginning 4 days postdose. Increasing the dose of Adriamycin to 75 mg/kg caused a biphasic mortality pattern, with 30% of the animals dying within 30 min of drug treatment. Pretreatment with morphine (20 mg/kg) reduced by 80% the dose of Adriamycin required to induce a 30% mortality at 30 min post-Adriamycin administration. Morphine pretreatment also caused a dose-dependent increase in plasma Adriamycin, as measured by total plasma fluorescence. Morphine or Adriamycin administered alone resulted in a slight hematocrit increase. The combination of morphine and Adriamycin caused an increase in hematocrit to maximal levels of approximately 75% from basal levels of about 48%. The increase in hematocrit after morphine plus Adriamycin exceeded the rise caused by higher doses of Adriamycin which, without morphine, resulted in similar plasma Adriamycin levels. The temporal relationship between the elevated hematocrit and early (30 min) mortality suggest a cause/effect relationship between these two events following combined morphine plus Adriamycin treatment. PMID- 3660413 TI - Evidence for the involvement of presynaptic cholinergic functions in tolerance to diisopropylfluorophosphate. AB - Rats were treated with diisopropylfluorophosphate (DFP) acutely or daily for 14 days. The involvement of various presynaptic and postsynaptic functions of the cholinergic system in the development of tolerance to DFP was studied. Receptor density and affinity of both muscarinic and nicotinic receptors, high-affinity choline uptake, and [K+]-evoked release of acetylcholine (ACh) by atropine were not changed after acute administration of 2 mg/kg DFP. Both muscarinic and nicotinic receptors were down-regulated to the same extent (40-50%) after subacute administration of DFP (1 mg/kg) without changes in their affinities. Binding sites of muscarinic receptors were maximally decreased after 7 days of DFP administration. Thereafter, they remained constant throughout 14 days of administration. One hour after the last injection of 2 mg/kg DFP to subacutely treated rats, the maximum velocity of high-affinity choline uptake was significantly decreased in the striatum (33%) and hippocampus (53%) without changes in Km values. Twenty-four hours after the last injection of DFP, only a higher dose of DFP (2 mg/kg) significantly inhibited choline uptake. Potassium evoked release of ACh by slices of striatum was not different between acutely and subacutely treated rats. However, the release of ACh by slices of striatum and hippocampus was significantly increased by atropine in subacutely treated rats. It is suggested that along with the down-regulation of the postsynaptic receptors, subsensitivity of presynaptic functions of the cholinergic synapse also develops during subacute administration of DFP. PMID- 3660415 TI - Toxicokinetics of the four stereoisomers of the nerve agent soman in atropinized rats--influence of a soman simulator. AB - The toxicokinetics of the four stereoisomers of C(+/-)P(+/-)-soman were investigated in anesthetized, atropinized, and artificially ventilated rats at iv doses of 6 (495 micrograms/kg) and 3 LD50. By integration of a thermodesorption/cold trap injector into our GLC analysis, the soman stereoisomers could be followed in rat blood down to a minimum detectable concentration, i.e., 1.5 pg/ml (8.3 pM), 55-fold lower than that published previously. This new detection limit is probably near or below the minimum concentration relevant for survival. Whereas C(+)P(+)-soman disappears in vivo from rat blood within 0.25 min, the toxicokinetics of C(-)P(+)-soman could be described by a two-compartment model, with a biological half-life of 1-1.5 min. The extremely toxic C(+/-)P(-)-isomers could be followed in rat blood for greater than 4 and 2 hr at doses of 6 and 3 LD50, respectively. The toxicokinetics of the P(-)-isomers are best described with a three-compartment model, with terminal half-lives of 40-64 and 16-22 min at doses of 6 and 3 LD50, respectively. Administration of a 13.6-fold molar excess of the soman simulator 1,2,2 trimethylpropyl dimethylphosphinate (PDP) 10 min prior to administration of 6 LD50 of C(+/-)P(+/-)-soman reduces the terminal half-lives of the C(+/-)P(-) isomers to the values measured at the dose of 3 LD50 without PDP pretreatment. Previous investigations showed that, without PDP pretreatment, rats suffer from endogenous reintoxication 4-6 hr after initially successful therapy, at C(+/ )P(+/)-soman doses greater than or equal to 6 LD50. Both this reintoxication phenomenon due to the presence of toxicologically significant C(+/-)P(-)-soman levels up to 4 hr after intoxication and its antagonism via PDP pretreatment can be understood on the basis of our toxicokinetic measurements. This shows that such investigations can contribute to insight into the toxicology of C(+/-)P(+/-) soman and to a better treatment of intoxications with this agent. PMID- 3660414 TI - Changes in ACh levels in the rat brain during subacute administration of diisopropylfluorophosphate. AB - Rats were treated with diisopropylfluorophosphate (DFP) acutely and daily for 14 days. The total, free, and bound acetylcholine (ACh) levels were monitored in striatum, hippocampus, and frontal cortex after DFP administration. Thirty minutes after daily administration of DFP, the total and free ACh levels were significantly increased and remained constant after each successive dose. The bound ACh levels in striatum and frontal cortex were also significantly increased; however, they were comparable to control levels after the 14th injection of DFP. The total ACh levels 30 min after a challenge dose of 2 mg/kg DFP in saline and DFP subacutely treated rats were significantly increased in hippocampus (34 and 76%) and frontal cortex (49 and 64%) and were not significantly different between the two groups. However, the level of total ACh in striatum was increased less in the tolerant rats (10%) than in the acutely treated rats (36%). The levels of free and bound ACh after acute administration of 2 mg/kg DFP were markedly increased in three brain regions. After subacute administration, the levels of bound ACh were significantly increased in hippocampus (84%) and frontal cortex (40%); however, that in striatum did not change. The increase in the bound ACh level in the subacute treatment group was less than that in acutely treated rats in all three brain regions; however, the duration of the elevation of the free ACh in striatum was shorter in subacutely treated rats. These results suggest that the presynaptic cholinergic storage sites for ACh might be changed during subacute administration of DFP. PMID- 3660416 TI - A mechanism of S-(1,2,3,4,4-pentachloro-1,3-butadienyl)-L-cysteine toxicity to rabbit renal proximal tubules. AB - S-(1,2,3,4,4-Pentachloro-1,3-butadienyl)-L-cysteine (PCBC) has been identified as the penultimate compound responsible for hexachlorobutadiene-induced nephrotoxicity. The primary goal of these studies was to determine the mechanism of PCBC-induced toxicity in rabbit renal proximal tubules by examining the early changes in tubular physiology. PCBC (20-500 microM) induced a specific sequence of toxic events. Following 15 min of exposure, 200 microM PCBC increased basal (25%) and ouabain-insensitive (78%) respiration. This was followed by a decrease in basal (46%), nystatin-stimulated (54%), and ouabain-insensitive (21%) respiration and a decrease in glutathione content (79%). Finally, there was a decrease in cell viability as measured by a decrease in LDH retention at 60 min. Direct probing of mitochondrial function revealed that the initial increase in respiration resulted from the uncoupling of oxidative phosphorylation, while the late changes in respiration appeared to result from gross mitochondrial damage characterized by inhibited state 3 respiration, inhibited cytochrome c-cytochrome oxidase, and inhibited electron transport. Studies utilizing tubules with decreased glutathione content revealed that glutathione plays little if any role in the early events of PCBC-induced toxicity. These results suggest that PCBC induced mitochondrial dysfunction may initiate the renal proximal tubule injury. PMID- 3660417 TI - Effects of ozone on lung and somatic growth. Pair fed rats after ozone exposure and recovery periods. AB - Minor differences in lung growth and development during childhood have been considered as a potential cause of rapid decline in pulmonary function in adulthood. Inhalation of ozone commonly causes changes in both body weight and lung volumes, which complicates interpretation of any changes in lung growth. The effects of ozone on lung growth were studied in rats which were pair fed. This technique permitted comparison of ozone-exposed and filtered-air control rats of the same body weight and body size as well as age and sex. Exposure was to filtered air or to 0.64 or 0.96 ppm ozone (UV standard) 8 h/night for 42 nights. A second control group was fed ad libitum and exposed to only filtered air. Half the rats were studied at the end of the 42-night exposures, the rest after a 42 day post-exposure period during which all rats were fed ab libitum and breathed filtered air. Rats examined at the end of the exposure period had larger saline and fixed lung volumes. These larger lungs had greater volumes of parenchyma, alveoli and respiratory bronchioles. Some of these changes persisted throughout a 42-day post-exposure period. Ozone inhalation by young rats alters lung growth and development in ways likely to be detrimental and those changes persist after ozone inhalation stops. PMID- 3660419 TI - The choroid plexus and cerebral vasculature as target sites for cadmium following acute exposure in neonatal and adult mice: an autoradiographic and gamma counting study. AB - The relationship between postnatal age at time of cadmium (Cd) exposure, and the retention and distribution of Cd in the central nervous system (CNS) was studied using gamma counting and autoradiography. A single intraperitoneal dose of Cd2+ (84 micrograms/kg or 750 micrograms/kg) containing radioactive 109Cd, was administered on postnatal day 0, 7, 14, or 42. Animals were then killed at various times post exposure (1-115 days) and retention and distribution determined. Maximum retention of Cd in the brain (calculated as a percentage of administered dose) occurred 1-24 days after exposure. Following exposure on day 0, 7, 14, or 42, maximum retention was 1.2%, 1.6%, 0.4%, or 0.09%, respectively. Cd retention after 114 days was 0.3%, 1.0%, 0.1%, or 0.04% for the respective days of exposure. For the carrier-added group maximum retention was higher with corresponding figures of 2.3%, 1.6%, 1.4%, or 0.07% and retention after 114 days was also elevated 0.6%, 1.1%, 0.4%, or 0.04%. The autoradiographic studies indicated that the choroid plexus was the prime target for Cd uptake in the CNS for all age groups, with the blood vessels a target in the early postnatal period. PMID- 3660418 TI - Peroxidation of brain lipids following cyanide intoxication in mice. AB - Lipid peroxidation of brain lipids as determined by the conjugated diene method was observed in mice following administration of sublethal doses of potassium cyanide (KCN). Conjugated diene production was dose- and time-dependent; 10 mg/kg KCN produced detectable levels of conjugated dienes at 30 min post cyanide, whereas, 15 mg/kg produced marked levels of conjugated dienes over a 10-60-min period after KCN. Pretreatment of mice with either diltiazem (600 micrograms/kg, i.v.) or allopurinol (25 mg/kg, i.v.) blocked the generation of conjugated dienes. These results suggest lipid peroxidation of neuronal membranes play a role in cyanide intoxication and this action is related to altered regulation of neuronal calcium homeostasis and activation of xanthine oxidase. PMID- 3660420 TI - Selective pancreatic toxicity of palmitoylpentachlorophenol. AB - Palmitoylpentachlorophenol (PPCP), which is a lipid conjugate of a xenobiotic compound, has been found in human fat. To study the toxicity associated with PPCP, rats were given 100 mg/kg PPCP and sacrificed at 4, 8 and 12 days. The target organ identified was the exocrine pancreas; no other major organs examined showed any gross or histopathological abnormality. At 4 and 8 days after treatment, focal, spotty vacuolation, and loss of pancreatic acini was observed. Acute inflammatory infiltrate was also observed in parenchyma at all time points and the loss of acinar tissue was resolved through fibrous tissue formation by 12 days. The present study indicates that PPCP has a specific target organ toxicity. PMID- 3660421 TI - Alterations of lipid synthesis in the normal and dysmyelinating trembler mouse sciatic nerve by heavy metals (Hg, Pb, Mn, Cu, Ni). AB - Lipid synthesis from 14C-labeled acetate was dramatically reduced by inorganic mercury in the mouse sciatic nerve in vitro (IC50 was 10 microM). The dysmyelinating trembler mutant was less affected (IC50 was 40 microM). Under the same conditions, lipid synthesis was less inhibited by inorganic lead but was increased 3 times by manganese, copper and nickel at less than 2 mM. Although the synthesis of all lipids is dramatically reduced by inorganic mercury, their relative proportions vary in the presence of this metal:cholesterol synthesis was inhibited most strongly, phosphatidylcholine synthesis was also reduced, whereas synthesis of other lipids was relatively unchanged (phosphatidylserine, phosphatidyl inositol, sphingomyelin, cholesterol esters, cerebrosides). Incorporation of [14C]acetate into free fatty acids was enhanced by a factor of 4 in the presence of inorganic mercury. PMID- 3660422 TI - The effect of griseofulvin on the heme pathway. Studies on tissue explant cultures. AB - The effect of griseofulvin on porphyrin biosynthesis was studied in vitro and in vivo using liver and skin explants from mice. Neither porphyrin nor precursors accumulation was detected after in vitro treatment of explants with griseofulvin. Culture medium porphyrins formed from added delta-amino-laevulinic acid (ALA) were increased after oral chronic intoxication. Similar results were obtained by cutaneous and oral intoxication. Consequently griseofulvin topical application is proposed as an alternative method to produce experimental erythropoietic protoporphyria. Probable intoxication mechanisms are proposed to explain the porphyrinogenic action of griseofulvin. PMID- 3660424 TI - Metallothionein, cadmium, copper and zinc levels of human and rat tissues. AB - Metallothionein (MT), zinc (Zn), copper (Cu) and cadmium (Cd) were determined in 10 tissues (brain, heart, kidney cortex, liver, lung, muscle, pancreas, small intestine, spleen and stomach) from human autopsies (10 male individuals, mean age 43 +/- 9 years, all smokers) and Wistar rats. The mean tissue concentrations of MT in the human samples varied between 3.8 and 495 micrograms/g wet weight in spleen and kidney cortex, respectively. In most tissues human MT levels were high as compared to rats; particularly in liver and kidney cortex human MT levels exceeded those of rats about 25- and 10-fold, respectively. Positive linear relationships were observed between Zn or Cu and MT in human liver and between Cd and MT in human kidney cortex. PMID- 3660423 TI - Developmental toxicity of halogenated acetonitriles: drinking water by-products of chlorine disinfection. AB - The developmental toxicity of acetonitrile and 5 halogenated derivatives was examined with an in vivo teratology screen adapted for use in the Long-Evans rat. The screen was extended to an evaluation of growth till postnatal Days 41-42, and weight of several organs at sacrifice. Acetonitrile was without developmental effects even at doses toxic to the dam. Of the halogenated compounds, treatment with trichloroacetonitrile (TCAN) and dichloroacetonitrile (DCAN) resulted in reduced fertility and increased early implantation failure. There was no effect on litter size in females bearing live litters, but pup birth weight was reduced in all litters exposed to halogenated compounds. Perinatal survival of the pups was adversely impacted by DCAN and TCAN. Postnatal growth till Day 4 was reduced by DCAN and bromochloroacetonitrile (BCAN) while growth till Day 42 was consistently affected only by TCAN. Some general observations were made on the usefulness of the criteria used in the screen, and TCAN, the most toxic of the halogenated compounds, was selected for further in-depth evaluation. PMID- 3660425 TI - The effects of ozone on lung, heart, and liver superoxide dismutase and glutathione peroxidase activities in the protein-deficient rat. AB - The effects of protein deficiency or food restriction and ozone exposure on lung, heart and liver superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were studied in weanling and adult rats. Two groups of rats were fed diets containing 4 or 16% protein. A third group was fed the 16% protein diet, but at the level consumed by the rats fed the 4% protein diet. After 3 weeks (weanling) or 5 weeks (adult), one-half of the rats in each group were exposed continuously to 0.64 ppm ozone for 7 days. In adult rat lung, O3 exposure typically stimulated Cu,Zn-SOD and GPx activities in all groups, but in weanling rats only GPx activity was elevated and only in rats fed the 16% protein diet. Liver Cu,Zn-SOD activity was also influenced by diet; in adult rats, liver Mn-SOD and GPx activities were often depressed following O3 exposure. Heart SOD and GPx, however, were not affected by ozone or diet. The pulmonary and hepatic effects due to diet and O3 further illustrate the importance of nutritional status when assessing the health effects of O3 exposure. PMID- 3660426 TI - The effects of in vitro exposure to the neurotoxins sarin (GB) and soman (GD) on unscheduled DNA synthesis by rat hepatocytes. AB - Large amounts of the nerve agents, sarin (GB) and soman (GD), are part of the military chemical arsenal and small amounts are on hand in numerous U.S. research laboratories. Thus, there is a potential for accidental occupational exposure to these compounds. As part of a study of mutagenic, reproductive and subchronic effects of these agents, we measured unscheduled DNA repair synthesis in isolated rat hepatocytes after exposure to GBI (stabilized with tributylamine), GBII (stabilized with diisopropylcarbodiimide) or GD. This was done to determine whether these agents or their metabolites directly damage DNA or their related proteins. Each agent was assayed at least once over concentrations ranging from 3.0 X 10(-4) to 2.4 X 10(-3) M for GBI and GBII and 2.3 X 10(-4) to 1.8 X 10(-3) for GD and at least 3 times at 2.4 X 10(-3) M for GBI and GBII and 1.8 X 10(-3) M for GD, added as 20% of the culture medium. In all assays, no increase in the level of DNA synthesis was observed. On the contrary, significant decreases in repair synthesis were seen in hepatocytes exposed to GBI or GBII. The decreases in DNA synthesis seen in response to GD were less marked and not significant. These observations were not related to cell death, since 8 of 10 assays performed showed no significant decrease in the amount of DNA present in cultures exposed to the nerve agents compared to the negative controls. Our results suggest that the agents GBI, GBII and GD may either inhibit the repair of DNA or protect DNA from damage. PMID- 3660427 TI - Cytogenetic effects of vaginally administered gossypol in murine bone marrow cells. AB - The cytogenetic effects of gossypol were evaluated by determining the frequency of sister chromatid exchanges (SCEs), percentage of pulverized metaphases, mitotic indices and micronuclei in bone marrow cells of mice treated per vaginam. A dose-dependent increase in the frequency of SCEs was observed when gossypol suspended in corn oil was administered at dosages of 10, 20 or 40 micrograms/g. In comparison with controls, incidences of SCEs were significantly higher in mice given 20 and 40 micrograms/g gossypol, whereas the mitotic indices, percentages of pulverized metaphases and the frequency of interphase micronuclei in treated animals were not different from their control counterparts. The SCE data suggest that gossypol has a DNA-damaging potency in murine bone marrow cells. PMID- 3660429 TI - Effect of lead toxicity on the organ concentration of glutathione and glutathione related free amino acids in the chick. AB - Total non-protein sulfhydryl (NPSH) and glutathione (GSH) concentrations in liver and kidney and GSH-related free amino acid concentrations in liver, kidney and plasma were examined in the chick following intoxication with 2000 ppm dietary lead (Pb). After 3 weeks, NPSH content was significantly (P less than 0.05) increased by Pb in both liver and kidney while only liver GSH was increased by Pb treatment. The concentrations of glutamate, glycine and methionine were elevated in liver by Pb while glycine, cysteine and cystathionine concentrations were increased in the kidney. In plasma, Pb significantly decreased cysteine, taurine and cystathionine concentrations. PMID- 3660428 TI - Rat hepatic mitochondria are more sensitive to allyl alcohol than are those of mice. AB - The hepatotoxic effects of allyl alcohol with particular reference to mitochondrial morphology and function were compared in male CD1 mice and male CD rats 24 h after 0.05 ml/kg i.p. in corn oil. As already noted by others, allyl alcohol-treated rats usually showed histologic evidence of tissue necrosis when hematoxylin-eosin-stained tissue sections were examined whereas mouse tissue sections did not. The serum glutamic pyruvic transaminase (SGPT) activities were significantly elevated in both mice and rats but to a much greater extent in the latter. Pentobarbital sleeping time was significantly increased over that of corn oil control groups in rats but decreased in mice. In rats electron microscopy showed mitochondria which contained flocculent densities. State 4 respiration was not altered by allyl alcohol in rats, but state 3 respiration was significantly depressed indicating an absence of respiratory control and an inability to perform energy coupling. In allyl alcohol-treated mice the isolated mitochondria were found to be primarily in a condensed form. Except for the effect on pentobarbital sleeping time and SGPT, no other findings were different from those in control groups given only corn oil. When the dose of allyl alcohol in mice was increased to 0.15 ml/kg in an attempt to elicit more severe signs of hepatotoxicity, there was a high mortality in the first 24 h period without histologic evidence of liver necrosis. Thus, we confirm that at equivalent doses, male rats are more sensitive to the hepatotoxic effects of allyl alcohol than are male mice, and extend the generalization to the liver mitochondria of the 2 species. PMID- 3660430 TI - Protective effect of a PAF-acether antagonist, BN 52021, in trichothecene toxicosis. AB - Trichothecenes are mycotoxins which produce lethal toxicosis in humans and animals, yet no adequate therapeutic regimen has been developed. This study provides evidence that the selective platelet activating factor (PAF) antagonist, BN 52021 (5-15 mg/kg i.v.) can prolong the survival of conscious rats exposed to a highly lethal T-2 toxicosis. These data also suggest that PAF is an important mediator of this unique toxicosis. PMID- 3660431 TI - Hematological indices in copper-poisoned rats. AB - The effects of 30 days oral administration of a sublethal daily dose (0.1 g/kg body weight) of copper sulfate on the blood constituents of albino rats were studied. Percent hemoglobin, number of red blood corpuscles, plasma corpuscular volume and mean corpuscular volume were decreased significantly. No marked alteration was observed in the number of white blood corpuscles, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and alkaline phosphatase activity. The concentrations of blood glucose, cholesterol, bilirubin and urea were elevated in the copper-fed rats. The activities of glutamic oxaloacetic transaminase, glutamic pyruvic transaminase and lactate and glutamate dehydrogenases were increased significantly, but blood total protein and acid phosphatase activity were reduced. PMID- 3660432 TI - Effect of cisplatin on calcium uptake by rat kidney cortical mitochondria. AB - The effect of the nephrotoxic antineoplastic drug, cisplatin, on mitochondrial calcium uptake was examined in rat kidney cortical mitochondria. We treated rats with cisplatin (5 mg/kg, i.p.), and prepared and incubated the mitochondria. Uptake of calcium decreased after 24 h. The mitochondria contained platinum even 3 days after injection. Cisplatin (0.5 mM) added to incubation medium inhibited calcium uptake. Platinum accumulated in the mitochondria during incubation. Mitochondria accumulated less of another divalent cation, magnesium, in rats given cisplatin and in incubation medium with cisplatin added. The results suggest that cisplatin taken up into kidney cortical mitochondria inhibited divalent cation uptake there, which may contribute to cisplatin nephrotoxicity. PMID- 3660433 TI - Preliminary investigations into the involvement of the intestinal microflora in CNS toxicity induced by 1,3-dinitrobenzene in male F-344 rats. AB - Administration of a single oral dose of 20 mg/kg of 1,3-dinitrobenzene caused ataxia in germ-free male F-344 rats but not in conventional rats. Repeated oral dosing of 20 mg/kg, 1,3-DNB was required to cause ataxia in conventional rats. Considerable differences were observed between the uptake, tissue distribution and excretion of DNB in germ-free and conventional rats. PMID- 3660434 TI - Toxic actions of senaetnine, a new pyrrolizidine-type alkaloid, in rats. AB - Senaetnine is a new type of Senecio alkaloid with a dihydropyrrolizinone structure. A limited amount of the crude alkaloid was available for preliminary toxicity tests in weanling male rats via i.p., oral and i.v. routes. Single i.p. or p.o. doses up to 280 mg/kg were not acutely toxic, and showed no evidence of hepatotoxicity. The compound or its metabolites appeared to be eliminated rapidly via the kidneys. However, senaetnine had a direct irritant action on tissues near to the site of i.p. administration, and caused damage to pulmonary vascular tissue when given i.v. Senaetnine is closely related to, but less reactive than, dehydrosenecionine, a putative short-lived metabolite of the alkaloid senecionine. It possesses mild alkylating reactivity, and the evidence indicates that it can cause moderate tissue injury without the need for metabolic activation. This suggests the need for testing of this and related compounds for chronic toxicity and carcinogenicity. PMID- 3660435 TI - Pulmonary hydroxyproline content and production following treatment of mice with O,S,S-trimethyl phosphorodithioate. AB - The systemic administration of O,S,S-trimethyl phosphorodithioate (OSS), a contaminant of various organophosphorus insecticides, induces delayed damage to rat and mouse lung tissue. The lesion, particularly in the rat, closely resembles that produced by butylated hydroxytoluene (BHT) in mice. Although the time course of cell damage and repair has been studied in both species, it is not clear whether excess collagen, indicative of fibrosis, is deposited. Changes in pulmonary hydroxyproline content and synthesis, indices of collagen metabolism, were analysed in mice treated with 45 mg/kg OSS. A significant increase in total lung hydroxyproline was evident 21 days after treatment compared to both pair-fed and ad libitum controls. This increase was not augmented by subsequent treatment with 35 mg/kg 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) or exposure to 70% oxygen for 7 days. The rate at which lung tissue synthesized hydroxyproline was increased 7-14 days after treatment with OSS. These data demonstrate that treatment of mice with OSS results in changes indicative of pulmonary fibrosis. However, in contrast to some other lung-toxic chemicals, this lesion was not enhanced by subsequent treatment with BCNU or hyperoxia. PMID- 3660436 TI - Bile acid profiles in bile, urine, and feces of a patient with cerebrotendinous xanthomatosis. AB - Bile acid profiles of bile, urine, and feces obtained from a patient with cerebrotendinous xanthomatosis on the same day have been analyzed by gas-liquid chromatography-mass spectrometry after fractionation into groups by mode of conjugation by an ion-exchange chromatography. The predominant biliary bile acid was cholic acid conjugated with glycine and taurine. Lesser amounts of the amino acid conjugates of chenodeoxycholic acid, ursodeoxycholic acid, 7-ketodeoxycholic acid, allocholic acid, and deoxycholic acid, and of unconjugated norcholic acid and allonorcholic acid were also present in the bile. The major fecal bile acid was 7-epicholic acid. Relatively large amounts of bile acids were excreted in the urine. Unconjugated 7-epicholic acid, norcholic acid, allonorcholic acid, and cholic acid predominated. The bile acid profiles of the patient were different from those of normal subjects and should be useful for the diagnosis. PMID- 3660437 TI - The unoccupied estrogen receptor: some comments on localization. PMID- 3660438 TI - Development and use of a radioimmunoassay for D-(-)-norgestrel 17 beta cyclopentanecarboxylate. AB - The synthesis of the 6 alpha-carboxymethylmercapto BSA and homologous histamine conjugate of D-(-)-norgestrel 17 beta-cyclopentanecarboxylate is reported. Using the BSA conjugate as an immunogen for the development of antibody in the rabbit and the 125I-histamine conjugate as the radioligand, a radioimmunoassay (RIA) for the ester was developed. Serum profiles of the free alcohol and ester were determined following IV or IM injection in macaques. Peak values for the ester (about 12 ng/mL) were observed 2 min following an IV bolus of 0.5 mg in one rhesus monkey. Blood levels dropped rapidly within the first 30 min and were barely detectable at 24 h. Serum levels of the free alcohol rose to a peak at 30 min and then declined slowly to very low values by 24 h. Following IM injection of 20 mg in cynomolgus monkeys, peak levels of the ester were observed within a few days while the free alcohol reached a maximum about day 30. Serum concentrations of D-(-)-norgestrel had fallen to about 0.4 ng/mL 160 days post injection when levels of the ester fell below 0.2 ng/mL. PMID- 3660439 TI - Steroids and related products. LIV. The synthesis of 11-oxa steroids. VI. The synthesis of 11-oxatestosterone. AB - The synthesis of 11-oxatestosterone from 11-oxa-5 alpha-androstane-3,17-dione, which is available from hecogenin, is described. The product shows, in comparison with the natural hormone, diminished androgenic and anabolic activities. PMID- 3660440 TI - Fluoro-clomiphene and its synthetic precursors: synthesis and receptor binding. AB - In an attempt to synthesize compounds with selective estrogen-receptor binding, fluoro- and amino-clomiphene were totally synthesized from benzyl chloride, and their estrogenic/antiestrogenic activity as well as that of some of their chemical intermediates was evaluated. The triazene prepared from the amino clomiphene was converted into fluoro-clomiphene with 39% yield. In the uterotropic test, both amino- and fluoro-clomiphene exerted mild equipotent estrogenic activity, with minimal saturation doses being 50 and 100 micrograms/rat/day for three days. In the receptor binding test both derivatives demonstrated similar displacement, with an A50% value in the 10(-5) M range, as compared to 10(-6) M for clomiphene and 10(-9) M for diethyl-stilbestrol. This synthesis may be useful for the preparation of 18F-labeled clomiphene for biodistribution studies. PMID- 3660441 TI - The properties of cytochrome P-450 induced in the rat small intestine by estradiol. AB - The properties of cytochrome P-450 induced in the rat small intestine by estradiol were investigated. The interaction of substrates with intestinal microsomal cytochrome P-450 was compared to that of the enzyme induced in the rat liver by phenobarbital. The results obtained indicate that in the rat small intestine estradiol increases the concentration of the enzyme which differs from the liver type cytochrome P-450 but resembles the liver type cytochrome P-448. The difference spectroscopy data were supported by a parallel study on the action of specific inhibitors of the hydroxylation reaction. PMID- 3660443 TI - Mechanisms of hepatocyte necrosis in HBV hepatitis. PMID- 3660442 TI - Endoscopic sphincterotomy. PMID- 3660444 TI - Acute sporadic viral hepatitis in Nepal. PMID- 3660446 TI - Analysis of clinical case records from dairy co-operatives in Bangladesh. AB - Records of 28,266 clinical cases collected over a period of three years from a veterinary clinical service to small dairy farms in Bangladesh were analysed. The major clinical conditions encountered were those which adversely affect the performance of draught animals and those causing infertility. Gastrointestinal disorders and general debility were also of major significance. It was concluded that the most pressing constraint on cattle productivity in Bangladesh is inadequate nutrition. Although infectious diseases were of minor importance overall, annual epidemics of foot-and-mouth disease were associated with seasonal movement of cattle. Difficulties involved in the analysis of clinical case records are discussed. PMID- 3660445 TI - Repeatability, reproducibility and sequential use of condition scoring of Bos indicus cattle. AB - There is a scarcity in the literature of statistical analyses of condition score data. This paper assesses the repeatability and reproducibility of a condition scoring system in order to test whether it can be sufficiently reliable for widespread use and statistical treatment. Differences in cow condition resulting from an eight-month dry season, changes in lactational status and watering frequency were used to demonstrate how condition score data can be used sequentially in parallel with weight or heart girth data to monitor changes in body reserves over a prolonged period. The condition scoring system is based on a nine-point scale and its superiority over a six-point scale is demonstrated under the conditions encountered in Africa. An analysis of the trend in condition over time showed that cows watered daily lost condition linearly while cows watered every three days lost condition in a quadratic decline. PMID- 3660447 TI - Phosphorus supplementation of Nellore steers fed Yaragua/Stylo mixture in the Peruvian tropics. AB - Twenty-four yearling 11-month old Nellore steers initially weighing 180 kg were assigned to three treatments in a randomised complete block experiment lasting 392 days. Animals grazed continuously either Yaragua grass (Hyparrhenia rufa) or Yaragua/Stylo legume (Stylosanthes guianensis) and received the following treatments: A) Control, Yaragua plus common salt, B) Yaragua/Stylo plus common salt, and C) Yaragua/Stylo plus dicalcium phosphate/common salt (1:1). Mineral consumption in the three groups averaged 52 g per animal day-1. At 13 months daily liveweight gains/steer were 0.182, 0.409 and 0.483 kg for treatments of Yaragua, Yaragua/Stylo, and Yaragua/Stylo plus dicalcium phosphate/common salt mixture. Daily liveweight gains per ha were 0.488, 1.289, and 1.522 kg steer-1 for Yaragua, Yaragua/Stylo plus common salt and Yaragua/Stylo plus dicalcium phosphate/common salt. Steers receiving a legume (stylo) in the diet more than doubled weight gains (P less than 0.05) compared to controls with dicalcium phosphate further (P less than 0.05) increasing these gains. PMID- 3660448 TI - Dioxathion (Delnav) residues in milk in Kenya. AB - Dioxathion residues in milk (expressed as the sum of the cis and trans isomers) have been determined by gas liquid chromatography using the N-P thermionic detector. It was found that dioxathion residues of 0.06 to 2.29 ppm (fat basis) are present in milk and are associated with tick control procedures of spraying cows with 0.05% w/v dioxathion (Delnav) twice weekly. Average concentrations from bulked milk were 0.96 ppm after 10 hours, 0.54 ppm after 34 hours and 0.4 ppm after 58 hours following spraying. The levels of residues in the milk differed greatly in different animals. PMID- 3660449 TI - Comparative physiological responses of Bos taurus, Bos indicus and Bubalus bubalis animals: dissertation review II. PMID- 3660450 TI - Enzootic haematuria in Nepal. AB - Haematuria of cattle has been recognised in the Nepal hills for many years where it is of local economic importance. The aetiology has been thought to be babesiosis. The disease was investigated in East Nepal over a nine month period. Affected animals exhibited a chronic, intermittent haematuria and an associated polyuria and dysuria. The average age of onset of clinical signs was 7.3 years and duration 1.5 years. Investigation revealed that urine samples contained intact red blood cells, protein and white blood cells. Red blood cell counts, packed cell volume and haemoglobin concentration were not significantly reduced compared to unaffected cattle. Histopathological examination of abnormal bladder tissue revealed epithelial proliferation and mononuclear infiltration and large, blood filled cavities in the lamina propria. Pteridium aquilinum, bracken fern, is common in this area. Blood smears were negative for Babesia spp. These findings conform to the classical description of enzootic haematuria. This is the first recorded occurrence for Nepal. PMID- 3660452 TI - A recent outbreak of rinderpest in East Africa. AB - Rinderpest was brought under control in Kenya in 1976 but in April 1986 an outbreak of the disease occurred in cattle in Western Kenya, five kilometres from the Kenya-Uganda border. This was the first confirmed field outbreak of the disease in Kenya after a lull of over 10 years. Clinical disease was confined to unvaccinated zebu calves aged six to eight months from which rinderpest virus was isolated. High titres of antibodies to rinderpest virus were demonstrated in sera collected from sheep and goats that were grazing together with the affected cattle herds; there was, however, no evidence of clinical disease in these small ruminants and wildlife species in the affected area. The disease outbreak was rapidly stamped out by quarantine and vaccination. PMID- 3660451 TI - Bovine trypanosomiasis in southern Tanzania: parasitological and serological survey of prevalence. AB - In a survey for bovine trypanosomiasis blood smears from 1,617 cattle at 72 sites were examined. Trypanosomes were found in 93 cattle, representing 16% of the cattle in herds in which trypanosomiasis was confirmed. Of the positive cattle 56% had infections with T. congolense, 17% T. vivax and 2.2% T. brucei. Five cattle had mixed infections and in 18 cattle the species was not identified. Sera from 1,352 cattle were tested using microelisa. Ten out of 16 sites, at which no trypanosomes were found in blood smears and at which trypanocides were in use, had over 15% seropositive cattle compared with five of 19 sites at which trypanocides were not in use. It was concluded that the microelisa was a useful aid to the diagnosis of bovine trypanosomiasis and that there is a need for accurate records of drug use and livestock movements to be kept. The serious risk of drug resistant strains of trypanosomes emerging due to the uncontrolled use of trypanocides is emphasised. PMID- 3660453 TI - Modified method for taking suspected rabies material. PMID- 3660454 TI - Field control of bovine parasitic otitis. AB - Nicotine used at approximately 2 ppm in 0.25% toxaphene dip wash was found to be 95% effective in the treatment and control of bovine parasitic otitis after dipping clinically affected cattle twice weekly for twelve weeks. Only three of 64 clinically affected animals failed to recover completely following the above treatment regime. The viable nematodes, Rhabditis bovis, which were easily isolated from dip tanks prior to treatment, could no longer be isolated 48 hours following dip tank treatment with nicotine. The above results are very significant since the control of bovine parasitic otitis would greatly enhance the productivity of cattle. PMID- 3660455 TI - Seasonal changes in the prevalence of Haemonchus and Trichostrongylus hypobiotic larvae in tracer goats in Malaysia. AB - An investigation into the seasonal changes in the population structure of Haemonchus and Trichostrongylus in tracer goats was conducted over 12 months at Serdang, an area in southern West Malaysia with year-round tropical rainfall. Successive groups of parasite-free tracer goats were grazed for a month alongside naturally infected adult goats and necropsied for worm counts 14 days after their removal from pasture. No hypobiotic larvae of Trichostrongylus were recovered. Hypobiotic larvae of Haemonchus were evident during each month of the year but accounted for only a very small proportion of the total Haemonchus burden. Very low levels were encountered from December through to June. Comparatively higher levels of hypobiosis were observed thereafter with a peak of 7.4% in September. The factors responsible for hypobiosis were not clearly defined but the phenomenon was associated with increasing levels of soil moisture storage. Host resistance, adult worm population of tracers and population of ingested L3 were ruled out as possible inducing factors. PMID- 3660456 TI - Evaluation of the protective effect of BCG vaccination by a case-control study in Yaounde, Cameroon. AB - A case-control study carried out in Yaounde (Cameroon) shows that the protective effect of BCG against pulmonary tuberculosis in the young adult was 66% (relative risk 0.34). This result is not affected by taking into account various factors such as sex, age, socio-economic class and geographical origin. PMID- 3660458 TI - Spinal tuberculosis presenting with abdominal symptoms--a report of two cases. AB - We present two unusual cases of tuberculosis of the spine presenting with abdominal symptoms; both patients underwent exploratory laparotomy before the true nature of the diagnosis became known. The diagnosis of spinal tuberculosis was evident on the pre-operative abdominal radiographs but this was overlooked. PMID- 3660457 TI - Mycobacterium tuberculosis infection in the acquired immunodeficiency syndrome. A review of 14 patients. AB - The clinical findings in 13 drug abusers and one homosexual man with tuberculosis and the acquired immunodeficiency syndrome (AIDS) from New York City are described. Tuberculosis preceded the diagnosis of AIDS in nine of the 14 patients by a mean of 7 months and occurred within the same month in the remaining five. The presence of thrush, generalised lymphadenopathy, lymphopenia, cutaneous anergy and chest radiographs showing hilar adenopathy and/or lower lobe infiltrates was common among the patients in whom tuberculosis preceded AIDS. Eight of our patients had extra-pulmonary tuberculosis, six had disseminated tuberculosis and five had tuberculous lymphadenitis. Cultures of tissue biopsies may be positive for Mycobacterium tuberculosis despite the absence of acid fast bacilli or granulomas on microscopic examination. Tuberculosis generally responded to chemotherapy, but the majority of patients died from opportunist infections. PMID- 3660459 TI - Immune response to environmental mycobacteria. PMID- 3660460 TI - Tuberculin response of Sri Lankan children after BCG vaccination at birth. AB - A total of 740 healthy children aged between 3 months and 11 years who had received BCG vaccination in the first month of life were Mantoux tested in Sri Lanka. Despite 97% having a visible scar following vaccination, 80% showed Tuberculin anergy (0-1 mm). Those without a scar showed no response. There was no correlation between scar size and the Mantoux response. A low mean Mantoux reaction was seen at all ages: 3.5 mm at 3 months, 3.2 mm at 18 months, 1.8 mm at 5-7 years and 1.9 mm at 9-11 years. A significant waning of the Mantoux reaction occurred at 5-7 years but there was no significant change at 9-11 years. Children who had received routine revaccination at 10 years, having received the first at birth, had a significantly higher mean Mantoux reaction (9.6 mm) when tested 3 months after revaccination. In 90 bacteriologically proven tuberculous patients, there was a significantly increased Mantoux reaction compared to all other groups. 1 T.U. PPD RT 23 (with tween 80) was used in all instances for Mantoux testing. The present study shows that routine BCG vaccination at birth, using a reduced dose of 0.05 ml, is unlikely to interfere subsequently with the diagnostic value of the Mantoux test. However, revaccination at 10 years may do so. PMID- 3660461 TI - A prospective study of BCG given to young children in Agra, India--a region of high contact with environmental mycobacteria. AB - A multiple skin test survey of school children (aged 5-15 years) living in Agra, India showed very high levels of sensitisation to numerous species of mycobacteria and little difference in tuberculin positivity between those with and without BCG scars. A total of 136 children aged 3 months to 8 years, living in Agra, were skin tested with Tuberculin and Leprosin A and examined for scars of previous BCG vaccination. Of those who had not previously received BCG and who had responses to Tuberculin of zero or less than 5 mm induration, 109 were offered BCG vaccination: 107 accepted and as many of them as possible were followed up with repeat skin testing 1 and 2 years later. The results are discussed in relation to the background of environmental sensitisation. A comparison is made with the data obtained from other places, particularly the Lebanon, where there is little sensitisation from the environment. Although the high level of Tuberculin conversion achieved after BCG suggested that the vaccine might have an important protective effect, the large size of Tuberculin responses in comparison with those obtained in the UK was worrying. Evidence was obtained suggesting that sensitisation to mycobacteria may occur in very young children which is not detected by the Tuberculin test, but which influences responses to BCG vaccination. PMID- 3660462 TI - The relationship between natural killer cell activity and delayed-type hypersensitivity reaction to 2,4-dinitrochlorbenzene in the spectrum of chronic, intractable pulmonary tuberculosis. AB - We examined natural killer (NK) cell activity and delayed-type hypersensitivity reaction to 2,4-dinitrochlorbenzene (DNCB) in the spectrum of chronic, intractable pulmonary tuberculosis. A high reactive group as defined by high NK cell activity and positive reaction to DNCB were characterised by stable clinical courses assessed by radiographical and clinical changes. A low reactive group defined by non-augmented NK cell activity and negative reaction to DNCB were characterised by progressive clinical courses. Although far advanced radiographic lesions were observed more frequently in the low reactive group and moderately advanced lesions more frequently in the high reactive group, there was not a significant statistical trend. PMID- 3660463 TI - The acquired immune deficiency syndrome: with special reference to tuberculosis. PMID- 3660464 TI - Occupational exposure to Mycobacterium tuberculosis and cytology of response to skin testing with 'New Tuberculin'. PMID- 3660465 TI - Tuberculosis infection transmitted at autopsy. AB - Tuberculosis can be a risk to staff and students in the autopsy room. We report three medical students and one technician who were infected with tuberculosis during two autopsies. In both cases pulmonary tuberculosis had not been diagnosed before death. PMID- 3660466 TI - The diagnosis of tuberculosis in children. PMID- 3660467 TI - Dietary constituents and rifampicin absorption. PMID- 3660468 TI - Effectiveness of BCG vaccination in England and Wales in 1983. AB - The effectiveness of BCG vaccination, at about age 13 years, in the prevention of tuberculosis at ages 15-24 years in England and Wales in 1983, has been determined by the same method as in two previous surveys in 1973 and 1978. In 1983, the tuberculosis notification rate among those vaccinated in the schools' scheme was 3.30 per 100,000, compared with an estimated rate of 13.20 per 100,000 among those who were tuberculin negative and not vaccinated in the scheme. The protective effectiveness of BCG vaccination at ages 15-24 years in England and Wales in 1983 is thus estimated as 75%; the estimated efficacy in the white ethnic group is closely similar, namely 76%. The estimated efficacy of BCG at ages 15-19 and 20-24 years in the three surveys, both in the white ethnic group and in the entire cohort, has been compared with that found in the Medical Research Council's controlled trial of tuberculosis vaccines which began in 1950. There is no evidence of any decrease in the protective efficacy of BCG vaccination between the four cohorts of young adults, which span a total period of 29 years. However, there were steep decreases between the cohorts in the annual notification rates for the white ethnic group; these decreases occurred in the BCG vaccinated and in the tuberculin negative unvaccinated groups, as well as among those found tuberculin positive (and not vaccinated) in the schools' scheme. It is concluded that the level of protective efficacy of BCG vaccination at ages 15-24 years is high, and has remained unchanged since the start of the BCG in schools' scheme. However, as the tuberculosis notification rate in young adults has decreased steeply throughout this period, and is continuing to decrease, the benefits to be expected from the BCG in schools' scheme will decrease equally rapidly. PMID- 3660469 TI - Cancer mortality in Italy, 1981. PMID- 3660471 TI - High-dose cisplatin in the outpatient clinic: a feasibility study. AB - A clinical trial was undertaken to assess the feasibility of treatment with high dose cisplatin on an outpatient basis. Eleven patients entered the study: 9 patients with squamous cell carcinoma of the head and neck, 1 patient with malignant melanoma of the skin, and 1 patient with breast cancer. All patients were pretreated. The chemotherapy scheme consisted of cisplatin, 60 mg/m2 for 3 consecutive days, every 4 weeks. We observed 5 partial responses, 4 stable diseases, and 1 progression of disease; 1 patient failed due to toxicity. The overall response rate was 45.4%. This treatment was associated with severe toxicity including nausea and vomiting, myelosuppression, neurotoxicity, nephrotoxicity and electrolyte disorders. Two patients died and 2 discontinued the treatment due to toxicity. In light of the incidence and severity of toxicity, this treatment should not be used as routine practice. PMID- 3660470 TI - A preliminary clinical experience with reduced glutathione as protector against cisplatin-toxicity. AB - A total of 16 consecutive patients (15 with ovarian cancer and 1 with unknown adenocarcinoma) were treated with a standard regimen including cisplatin and cyclophosphamide or with the same regimen in combination with reduced glutathione as potential protective agent against cisplatin nephrotoxicity, in a non randomized study. Reduced glutathione (1500 mg/m2) was administered prior to each cisplatin administration (90 mg/m2) to seven patients for a maximum of five consecutive courses. A standard hydration protocol without diuretics was used. The patients received a total of 33 courses with glutathione. Glutathione was well tolerated, since it did not produce appreciable side effects. Cisplatin and glutathione combination did not produce unexpected toxicity. Two patients treated with standard regimen without glutathione developed a transient nephrotoxicity. The severity of myelosuppression was reduced following glutathione administration. Moreover, the therapeutic efficacy was not impaired by glutathione pretreatment. PMID- 3660472 TI - The role of combination cyclophosphamide, doxorubicin and cisplatin (CAP) chemotherapy in advanced non-small-cell lung cancer. AB - Thirty-one patients with non-small-cell lung cancer (NSCLC), stage III (T3 N2 M 0 1), were treated with cyclophosphamide (400 mg/m2), adriamycin (40 mg/m2) and cisplatin (60 mg/m2) (CAP) every 4 weeks for 8 cycles. Twenty-six patients were evaluable for response. Patients characteristics included: median age, 63 years; median performance status, 70% (range 60%-100%). One hundred and fifty-five cycles of chemotherapy were administered with a median of 5. There were 9 partial responses and 3 complete remissions, for an overall response rate of 46%. The median survival duration was 9 months, and 29% survived 1 year. CAP combination chemotherapy was well tolerated without nephrotoxicity, which can be imputed to the strong saline hydration given. Seventy percent of the patients did not experience emesis due to the antiemetic regimen used. PMID- 3660473 TI - Early-onset diagnosis of lung toxicity caused by cyclophosphamide, melphalan and procarbazine therapy. AB - Lung function studies were performed in 33 patients with lymphomyeloproliferative diseases (25 cases of multiple myeloma and 8 cases of Hodgkin's disease) who received cyclophosphamide, procarbazine, and melphalan therapy. Lung function was investigated by spirometric tests, indicative tests of small airways disease, and diffusing capacity of the lung for carbon monoxide (DUCO). Indicative tests of small airways disease and other lung function tests such as forced expiratory volume in 1 second (FEV1), vital capacity (VC), total lung capacity (TLC) etc. were markedly improved in 18 patients (55%), whereas 24 patients (73%) showed a decreased diffusing capacity of the lung for carbon monoxide. Furthermore, most of the patients (77%-83%) showed contemporaneous involvement of spirometric tests and DUCO. The DUCO was also found more constantly impaired than other function tests because it had decreased with and without other spirometric tests. Impaired lung function tests were found to be related to a cumulative dose of antineoplastic drugs. The absence of increased lung toxicity was found to be related to several drugs administered in combination. In view of the absence of previous bronchopathies, lung involvement signs in multiple myeloma (25, 26) or lymphoma, and concomitant bronchopneumonias, the impaired functional tests could be ascibed to drug-induced lung toxicity. In the absence of clinical symptoms, roentgenographic and pathologic features, impaired lung function tests may play a role as early-onset signs of drug-induced lung toxicity. PMID- 3660474 TI - Cardiotoxicity during chemotherapy for advanced gastroenteric tumors. AB - The authors report two cases of patients with advanced gastroenteric carcinoma, which developed different cardiotoxicity patterns after the administration of cytotoxic drugs. The first patient showed a picture of dilatative cardiomyopathy with associated symptoms of angina pectoris and congestive heart failure; the second patient presented a cardiac arrhythmia after several administrations of 5 fluorouracil. The possible mechanisms of these toxic effects, as well as the drug interactions are briefly discussed. Cardiotoxicity of cytotoxic drugs should be considered by oncologists even in patients with no previous history of cardiac disease. PMID- 3660475 TI - Aminoglutethimide in postmenopausal breast cancer refractory to multiple hormonal and cytostatic treatments. AB - Eighty-seven consecutive patients with metastatic breast cancer were treated with aminoglutethimide plus hydrocortisone. All patients were postmenopausal and had progressive disease following prior chemotherapy and endocrine therapy. Eighty five women were evaluable for drug response. One patient showed complete remission and 14 patients partial response, for an overall response rate of 17%. The median duration of response was 11+ months. The response rate was highest in the presence of soft tissue involvement (36%). The most common side effects were transient skin rash, lethargy, and dizziness. Two patients discontinued treatment because of cutaneous allergy. Aminoglutethimide can be considered a moderately active agent when utilized as second- or third-line hormonal therapy. PMID- 3660476 TI - Impact of hospitalization on the nutritional status of cancer patients. AB - This study was undertaken to examine the influence of hospitalization on the nutritional status of cancer patients. We examined 126 patients consecutively admitted to the Istituto Nazionale Tumori of Milan. At admission, all patients underwent standard evaluations, including actual weight, percentage weight loss, arm circumference, triceps skinfold, serum proteins, serum albumin, total iron binding capacity, cholinesterase and peripheral lymphocytes. Finally, from all patients a 24-h dietary recall was obtained, in order to calculate calorie and protein intake. All the patients underwent another evaluation after 1 week of hospitalization; after 2 weeks only 37 of them were evaluated again, since some were operated, some were treated with radio-chemotherapy, some were discharged or had died. Results showed that after one week of hospitalization some variables were significantly altered, such as arm circumference in male patients, serum proteins, cholinesterase, total iron binding capacity, peripheral lymphocytes, calorie and protein intake. A significant weight loss was seen after 2 weeks. The reduced calorie and protein assumption was correlated with depletion of some of the nutritional variables (body weight, arm circumference in males, total iron binding capacity, serum albumin, cholinesterase, lymphocytes). Our data show that hospitalization plays an important role in deterioration of nutritional status in our patient population, and this problem is generally overlooked by the clinicians primarily involved in the care of cancer patients. PMID- 3660477 TI - Ovarian cancer: ten-year experience in a community hospital. AB - We reviewed 187 patients with epithelial ovarian cancer treated, from 1975 to 1985, at the Division of Radiotherapy and Medical Oncology, Pordenone General Hospital, Italy. It seemed of interest to report an experience carried out in a community hospital in a consecutive unselected series of patients affected by ovarian cancer. Survival time was evaluated from the day of the primary surgical approach to the end of the study (March 1985). The aim of the study was to confirm in our patient population the importance of some already recognised prognostic factors that influence survival (age, stage, histology, grade, type of surgery and residuum). We also analyzed the effect of the treatment variables chemotherapy and radiotherapy on survival. The general pattern of prognostic factors appears to be in agreement with reports in the literature. In our experience, residual disease and stage were the main important prognostic factors; grade and histology had a secondary relevance, and age did not seem to be a prognostic factor in our population. New chemotherapy regimens and/or radiotherapy did not appear to improve survival. In fact, comparison of the results obtained from 1975-1979 and from 1980-1985 (when more aggressive surgery and cisplatin-containing regimens were employed) showed no statistically significant difference in survival rate. Our data suggest that patients at an early stage can receive a satisfactory quality of care in a general hospital with oncology facilities, provided the surgeon and the pathologist are experienced in ovarian cancer. Patients at stage III but completely surgically resected can also be adequately treated. Patients with advanced disease, considering the lack of established efficacious treatments, should be referred to specialized centers, where new drugs or experimental strategies can be tested. PMID- 3660478 TI - Case report of a Burkitt-like lymphoma in a bisexual HIV-positive man. AB - The clinical and pathologic features of a Burkitt-like lymphoma in a bisexual HIV sero-positive man are reported. Emphasis is placed on some histologic characteristics present in a hyperplastic lymph node removed 2 years before the development of the B-cell lymphoma. PMID- 3660479 TI - Anal squamous cell carcinoma arising on radio-dermatitis cured with chemotherapy alone: case report. AB - A squamous cell carcinoma of the anal canal appeared 10 years and 6 months after ionizing radiation therapy (58 Gy) for a previous squamous cell carcinoma in the same region. The patient was treated with chemotherapy alone, which produced a complete remission for 17+ months without relevant acute toxicity. PMID- 3660480 TI - [AIDS: acquired immune deficiency syndrome]. PMID- 3660481 TI - [Diarrhea and oral liquid therapy]. PMID- 3660482 TI - [A case of pulmonary thromboembolism]. PMID- 3660483 TI - [Depression in children: reasons and risks]. PMID- 3660484 TI - [Infusion thrombophlebitis]. PMID- 3660485 TI - [We don't deal with illnesses, we deal with patients]. PMID- 3660486 TI - [10 problems with nasogastric tubes and how to solve them]. PMID- 3660488 TI - [Practical applications in nursing]. PMID- 3660487 TI - [Commercial formulas in feeding babies 0-1 years old]. PMID- 3660489 TI - [Associate degree in nursing]. PMID- 3660490 TI - Difference Fourier analysis of "surface features" of bacteriorhodopsin using glucose-embedded and frozen-hydrated purple membrane. AB - A difference Fourier map of the projected structure of bacteriorhodopsin has been synthesized from electron diffraction amplitudes collected from membranes prepared in the glucose-embedded state and the frozen-hydrated state. Phases of a recently published data set for glucose-embedded specimens were used for the difference Fourier map. Moderate resolution (9 A) and high resolution (4.25 A) maps both indicate that glucose is exchangeable for water in the region of the map corresponding to the lipid regions. We interpret this as indicating that there is a small surface depression in this region of the structure. The depth of this feature is estimated to be 1/6 the thickness of the protein region in the membrane. The data obtained in this study rules out the existence of an aqueous transmembrane channel, the dimensions of which are large enough to allow free exchange of glucose for water. Several new features are also observed in the protein region of the membrane. These features are probably due to segments of the polypeptide at the aqueous interface that are well ordered in frozen-hydrated specimens but not in glucose-embedded specimens. Candidate structures for the origin of these features are extensions of the helices, or linker regions connecting the helices. PMID- 3660491 TI - A new resolution criterion based on spectral signal-to-noise ratios. AB - A new criterion for the "useful" resolution of electron micrographs of macromolecular particles is introduced. This criterion is based on estimation of the spatial frequency limit beyond which the spectral signal-to-noise ratio (SSNR) falls below an acceptable baseline. Applicable to both periodic and aperiodic specimens, this approach is particularly apposite for sets of correlation-averaged images. It represents a straightforward and intuitively appealing generalization of the traditional method of estimating the resolution of crystalline specimens from the spectral ranges of periodic reflections in their diffraction patterns. This method allows one to assess how closely the resolution of an averaged image based on N individual images approaches the ultimate resolution obtainable from an indefinitely large number of statistically equivalent images. Inter-relationships between the SSNR and two other measures of resolution, the differential phase residual and the Fourier ring correlation coefficient, are discussed, and their properties compared. PMID- 3660492 TI - High resolution cryo system designed for JEM 100CX electron microscope. AB - A high resolution (3.5 A) cold stage operated at 123 K and an improved anti contamination device have been constructed and operated in a top-entry JEM 100CX electron microscope. High resolution electron diffraction patterns and images of hydrated tobacco mosaic virus particles in vitrified ice have been recorded with the use of this cryo system. PMID- 3660493 TI - How to obtain a thickness-independent image in a STEM. AB - "Z" contrast is independent of thickness only for extremely thin specimens (3 nm of carbon). Following Egerton [Ultramicroscopy 10 (1983) 293], we propose a new method of imaging which is really independent of thickness and which provides absolute values. It consists of a mixing of the unscattered, the annular darkfield and the inelastic signal. Two-dimensional histograms are used to determine the relative efficiency factors of the different images. Thus, in addition to the obtaining of lambda i/lambda e images, the method allows the calculations of the ratios of the detection factors, of the primary beam intensity image and the production of image free of beam fluctuations. An example of such a treatment is given for a biological specimen with knife-marks. PMID- 3660494 TI - Noninvasive assessment of normal carotid bifurcation hemodynamics with color-flow ultrasound imaging. AB - The combination of a B-mode imaging system and a single range-gate pulsed Doppler flow velocity detector (duplex scanner) has become the standard noninvasive method for assessing the extracranial carotid artery. However, a significant limitation of this approach is the small area of vessel lumen that can be evaluated at any one time. This report describes a new duplex instrument that displays blood flow as colors superimposed on a real-time B-mode image. Returning echoes from a linear array of transducers are continuously processed for amplitude and phase. Changes in phase are produced by tissue motion and are used to calculate Doppler shift frequency. This results in a color assignment: red and blue indicate direction of flow with respect to the ultrasound beam, and lighter shades represent higher velocities. The carotid bifurcations of 10 normal subjects were studied. Changes in flow velocities across the arterial lumen were clearly visualized as varying shades of red or blue during the cardiac cycle. A region of flow separation was observed in all proximal internal carotids as a blue area located along the outer wall of the bulb. Thus, it is possible to detect the localized flow patterns that characterize normal carotid arteries. Other advantages of color-flow imaging include the ability to rapidly identify the carotid bifurcation branches and any associated anatomic variations. PMID- 3660495 TI - [Behavior of artificially produced defects in the epiphyseal plate of rabbits after transplantation of autologous and homologous rib cartilage]. AB - In the first part of this study one could demonstrate that a defined mechanical traumatization of the distal epiphyseal plate of femur produced a constant development of bone fossilization which united the epiphysis to the metaphysis as a histopathological substract. In the second part--a correspondingly set-up defect--on the opposite side of the distal epiphyseal plate femur was filled up either by an autogeneous or homogeneous cartilage from the rib of a rabbit. The autogeneous rib transplantations were in this connection in a good position to prevent a partial bone-bridge-development between the epiphysis and metaphysis. The homogeneous transplantations showed some bone fossilizations, on the whole though satisfactory results with regard to the prevention of a partial obstruction could be obtained. PMID- 3660496 TI - [Static stress of tibiofibular syndesmosis]. AB - The tension-patterns of the tibiofibular syndesmosis during stance and push-off phases of gait are still unknown. Therefore a strain-gauge study was done, using an anatomically prepared human leg with the syndesmosis removed and the gauges fixed on the bone, avoiding bending influences. Syndesmotic tension forces measured under sequential axial loading up to 500 N in neutral ankle position were 6.5 N for anterior and 10 N for posterior ligaments under maximum load. With 10 degrees ankle dorsiflexion and no load applied about 5 N of tension were measured in each of the anterior and posterior ligaments. Application of axial load under same conditions resulted in a decrease to negligible tension in the anterior ligament and an increase of tension in the posterior ligament. In evaluating the load tests, which were done in 10 degrees dorsiflexion and the so called neutral-zero-position of the ankle, we found that our data correlated well with the elasticity and tearing resistance, measured by Sauer. According to the pathomechanics of trauma exact measurements of these forces in the weightbearing ankle are of interest for postoperative treatment of ankle fractures. PMID- 3660497 TI - [Injuries and their causes in bicycle accidents]. AB - From April to September 1984 456 bicycle accidents were registered (73% adults, 27% children) and classified according to type and severity of injury and cause of accident. Of 594 injuries those of the upper extremities were predominant followed by mostly severe head injuries. The commonest injury was the fracture of clavicle and thereafter fractures of the radial head and distal radial fractures in children. 59% of accidents occurred without involvement of another person. 58% of accidents were caused by the bicycle riders themselves. PMID- 3660498 TI - [Conservative therapy of shoulder dislocation]. AB - There is no undivided agreement in how long a shoulder ought to be fixed after a luxation. Having made a distinction between the terms of habitual and posttraumatic recidivous luxation of the shoulder, the results of a retrospective analysis of 118 luxations of the shoulder are shown, with 75 outpatients after a primary luxation. In most cases the fixation in the Desault-dressing was maintained for three to four days and was followed by early-functional physiotherapeutical after-treatment. Ten patients = 14.9% developed posttraumatic recidivous, and eight patients = 10.4% habitual luxations. In comparison with other analyses, these results show that with a short time of fixation of three to four days there is no higher tendency to reluxation than with a longer time of fixation. If a habitual or a posttraumatic recidivous luxation occurs, operative treatment is required. PMID- 3660499 TI - [First results after the use of a Y-plate for the stabilization of supradiacondylar humeral fractures]. AB - A new implant for the stabilisation of supra- and diacondylar fractures of the humerus is assessed. If compared with other implants this y-shaped plate has a considerably better stability. Due to different diameters of the holes 4.5 mm screws may be used for the long part, 3.5 mm screws for the branches of the plate, which in most cases allow good stabilisation and early mobilisation of the limb. Out of twelve patients, operated since 1981, ten were reexamined for follow up after a mean of 34.1 months. All of the fractures stabilised with the y-plate were healed with normal osseous consolidation. According to the scheme of Cassebaum, the result was excellent in five, good in four and unsatisfactory in one patient. For each of the two available types of plates the dimensions proved to be sufficient with respect to the branches. However, for cases with fractures continuing into the humeral shaft, an additional type with a longer mainpart would seem desirable. PMID- 3660500 TI - [Results of the surgical treatment of distal femoral fractures]. AB - In a follow-up of 97 operated distal femoral fractures good and satisfactory results were found in 64% of the cases. 22% unsatisfactory and 14% poor findings attribute mainly to the comminuted supracondylar fracture types. More than half of the patients were multiple injured. In 83% of the cases the internal fixation was obtained by the use of the condyle buttress plate. PMID- 3660501 TI - [Arthrolysis of the knee joint]. AB - The surgical treatment of the extensor rigidity of the knee joint described by Payr was performed in fourteen cases at the Orthopedic University Hospital of Giessen. A flexion of more than 90 degrees was achieved in all patients. In case of correct indication, this method has still its value in orthopedia even regarding the changed patient categories. PMID- 3660502 TI - [Closure of soft tissue defects in bone infections using free and pedicled muscle flaps]. AB - Over the period of three years 33 free latissimus dorsi-flaps and 23 pedicled myoplasties of various types for the coverage of large tissue and bone defects are performed. The operative technique of the free muscle transfer with microvascular anastomosis are described in detail. The postoperative management is outlined. The results of the free and pedicled muscle flaps are reported. In free transplantations the success-rate was 88% and in pedicled flaps 65% There is good evidence that bone consolidation and healing of the chronic bone infection can be improved by healthy vital soft tissue coverage. The indications for both procedures and the advantages and disadvantages of free and pedicled flaps are discussed. PMID- 3660503 TI - [Blood supply and function of the scaphoid bone]. AB - The proximal row of carpal bones, including Os scaphoideum, Os lunatum and Os triquetrum, should be considered as a functional unit. The arterial supply stems from branches of the rete carpi dorsale et palmare, which pass through the Ligamentum radiocarpeum dorsale et palmare, respectively. In two-thirds of all cases, the scaphoid bone, the most frequently fractured of the wrist bones, is uniformly vascularized, so that by fracture both fragments retain their blood supply. In the remaining third of all cases, only one end of the scaphoid is supplied arterially. Thus the poorly vascularized fragment frequently becomes necrotic. PMID- 3660504 TI - Prevalence of sleep apnea syndrome--estimation by two stage sampling. AB - This article describes stepwise the methodological and statistical considerations made in the planning of an epidemiological survey of the prevalence of the sleep apnea syndrome (SAS) in the municipality of Uppsala in Sweden. The investigation had to be confined to 60 subjects, since all-night polysomnographic studies are required for an unequivocal diagnosis of SAS. It was decided to investigate men 30 to 69 years old. Initially, the possibility of taking a simple random sample (SRS) was considered, but statistical calculations showed that for prevalences between 1-3% this would lead to totally unacceptable results. A postal questionnaire, sent to the total population of 35,779 men in this age group, was then considered and, depending on their replies, they would be divided into low risk and high-risk stratums of SAS. Optimal numbers would then be called from each group for polysomnographic studies. This also proved impossible, as the lowest possible standard error was still too large and the samples would contain unacceptably few cases of SAS. We therefore decided to concentrate on the highrisk stratum, obtaining an estimated under limit of the prevalence. For economical reasons, we could not send a questionnaire to all the 35,779 individuals, but based the investigation on a SRS of 4,000 men, post-stratified in a high-risk and a low-risk group. From the high-risk group, 60 men were then selected for polysomnographic studies. PMID- 3660505 TI - [Blood and urinary middle molecules in the diagnosis of inflammatory urological diseases and chronic kidney failure and the evaluation of plasmapheresis effectiveness]. PMID- 3660506 TI - [Diagnostic value of middle molecule clearance in acute inflammatory organic diseases of the urogenital system]. PMID- 3660507 TI - [Medical gymnastics in chronic prostatitis]. PMID- 3660508 TI - [Electroureterography in the diagnosis of obstruction of the distal ureter in children]. PMID- 3660509 TI - [Structural characteristics of the bladder and the vesico-ureteral segment in children up to 4 years of age]. PMID- 3660510 TI - [Indications for the transfistular removal of kidney stones]. PMID- 3660511 TI - [Treatment of the complications of interureteral reflux in the bifid ureter]. PMID- 3660512 TI - [Comparative characteristics and choice of treatment method in hypospadias in children]. PMID- 3660514 TI - [Urethrorrhagia in children]. PMID- 3660513 TI - [Adrenal insufficiency in the removal of the left kidney in an experiment]. PMID- 3660515 TI - [Experience in treating urethral strictures]. PMID- 3660516 TI - [Ascorbic acid in the blood plasma in uremia]. PMID- 3660517 TI - [1-stage radical nephrectomy and left-sided hemicolectomy in tumors of the kidney and large intestine]. PMID- 3660518 TI - [Male sexual functions in hyperprolactinemia]. PMID- 3660519 TI - [Hemosorption in the treatment of acute pyelonephritis]. PMID- 3660520 TI - Treatment options for patients with stage D1 (T0-3,N1-2,M0) adenocarcinoma of prostate. AB - Three hundred six patients with adenocarcinoma of the prostate underwent pelvic lymphadenectomy and had Stage D1 (T0-3,N1-2,M0) disease; 171 patients underwent radical retropubic prostatectomy with or without immediate adjuvant therapy (hormonal or radiation or both) or conservative (hormonal or radiation or both) treatment alone (n = 135). Follow-up was one-half to eighteen and one-half years (mean, 5 yrs). Immediate adjuvant orchiectomy significantly (P = 0.01) improved survival (87.4% at 10 years) and nonprogression rates for patients who underwent radical prostatectomy, but not for those who had lymphadenectomy. Overall patient survival was significantly better (P = 0.005) after prostatectomy than lymphadenectomy. Residual disease (n = 43) in patients who underwent prostatectomy and received adjuvant treatment (orchiectomy or radiation or both) did not affect disease outcome. Bilateral pelvic lymphadenectomy and radical prostatectomy with immediate adjuvant orchiectomy provided survival comparable to the expected survival; conservative treatment alone was associated with rapid disease progression and poor survival and significantly (P = 0.02) higher local morbidity. PMID- 3660521 TI - Importance of acid phosphatase in response criteria for prostate cancer. AB - The role of acid phosphatase in the definition of response to treatment for prostate cancer is unclear. To better define its predictive value, especially regarding survival rate, we reviewed the clinical course of 76 men with Stage D2 prostate cancer who were treated with combination chemotherapy. PMID- 3660522 TI - Pitfalls in preoperative staging in prostate cancer. AB - Clinical staging in 60 patients with adenocarcinoma of the prostate was compared with pathologic staging to identify factors which may contribute to staging errors. Understaging was directly related to tumor stage and was documented in 0 per cent of A2, 26.5 per cent of B1, and 66.7 per cent of B2 patients. Capsular invasion was found in 11.8 per cent of B1 and 52.4 per cent of B2 patients, seminal vesicle extension in 17.7 per cent of B1 and 52.4 per cent of B2 patients, and lymph node metastases in 2.9 per cent of B1 and 28.6 per cent of B2 patients. The majority of patients who had unnoticed gross extension of the tumor beyond the prostate underwent transurethral resection of the prostate or failed irradiation therapy prior to radical prostatectomy. The results suggest that intraprostatic or periprostatic changes caused by previous treatment to the prostate may interfere with the preoperative staging. PMID- 3660523 TI - Progression of mild ureteropelvic junction obstruction in infancy. AB - Mild and clinically silent ureteropelvic junction obstruction was observed to progress in severity in 2 infants. Diuretic renography was useful in serial evaluation and documentation of progression. The possible mechanism for such progression of obstruction is proposed. Although mild obstruction in the older child and adult can be followed successfully without surgery, it appears that close follow-up of mild obstruction during the first year of life is necessary to detect and assure treatment of progressive obstruction at an optimum age. PMID- 3660524 TI - Combined hormone-chemotherapy for metastatic prostatic carcinoma. Eleven-year follow-up. AB - Thirty-six patients with histology-proved Stage D2 carcinoma of the prostate were treated with a combination of bilateral orchiectomy, diethylstilbestrol 3 mg/day, and chemotherapy (5-fluorouracil and cyclophosphamide) soon after diagnosis was established. The combined therapy was well tolerated by the patients, and complications were not severe and of a transient nature. The majority of patients showed a subjective and objective improvement: 75 per cent of patients had relief of bone pain, and 80 per cent reported relief in urinary symptoms. There was regression or stabilization of the primary tumor in 82.2 per cent. Disappearance or stabilization of osteoclastic lesions on bone scans was noted in 55.5 per cent of patients. The cumulative survival rate at eleven years is 55.5 per cent. PMID- 3660525 TI - Distal ureteral obstruction complicating percutaneous nephrolithotomy. AB - Endourologic techniques for the treatment of surgical stone disease have proved cost-effective and safe with results comparable to open surgical procedures. Because these are new procedures, unexpected complications are going to occur. We have had 3 cases of complete distal ureteral obstruction unrelated to a ureteral calculus following a percutaneous nephrolithotomy. The obstruction resolved after extended nephrostomy tube drainage. These 3 cases and their treatment and pathogenesis are presented. PMID- 3660526 TI - Postoperative complication from hemostatic clips. AB - Hemostatic clips were found in a patient's bladder four months after radical retropubic prostatectomy. A calculus, which had formed on one clip, caused acute urinary retention. Inadvertent enclosure of the hemoclips within the bladder intraoperatively and early intraurethral migration of the hemoclips are possible causes of this complication. Although this problem is rarely reported, hemoclips should be used sparingly, if at all, around the vesicourethral anastomosis. PMID- 3660527 TI - Urinary ascites: complication of umbilical artery catheterization. AB - In the newborn, intraperitoneal extravasation of urine from a urachal laceration may follow an attempt at umbilical artery catheterization. Clinical results of this injury are neonatal ascites, anuria, and azotemia. Herein, we describe a case of iatrogenic bladder injury with successful management following late detection. The anatomy of the urachus and bladder in the newborn are reviewed as well as clues to the diagnosis of neonatal urinary ascites. PMID- 3660528 TI - Vascular polyps of ureter associated with megacalycosis and nephrolithiasis. AB - Multiple benign vascular polyps of the ureter are rare, and the associated congenital megacalycosis and nephrolithiasis are very uncommon. Herein we report a case with vascular polyps of the right ureteropelvic junction dissociated with extensive hydronephrosis which was considered to be megacalycosis. Clinical features and treatment modalities are reviewed. PMID- 3660529 TI - Parathyroid adenoma in patient with prostatic carcinoma and hypercalcemia. AB - A sixty-seven-year-old white man with prostatic carcinoma was noted to be hypercalcemic and was subsequently found to have a parathyroid adenoma. Review of the literature revealed only 13 prior cases of hypercalcemia in patients with prostate malignancy. In none of those recorded cases was a parathyroid abnormality found, although a complete evaluation was not made in most of the patients. Because of the infrequent occurrence of hypercalcemia and prostatic carcinoma, it is suggested that patients with both disorders be evaluated for causes of hypercalcemia other than those generally associated with malignancy. PMID- 3660530 TI - Solving dilemma of optimal length for Small-Carrion prosthesis during surgery. PMID- 3660531 TI - New method for aseptic intermittent self-catheterization in females. PMID- 3660532 TI - Retrograde pyelography via ureteral stents. AB - Retrograde pyelography to establish ureteral patency prior to removal of ureteral stent can be done via the stent. A simple technique is described. PMID- 3660533 TI - Transitional cell carcinoma of fossa navicularis. Fourth reported case. AB - The fourth reported case of transitional cell carcinoma arising in the fossa navicularis is described. Failure of carbon dioxide laser treatment to eradicate an apparent condyloma of the urethra is an indication for biopsy. PMID- 3660534 TI - Loss of DNA sequences on chromosome 3 in renal cell carcinoma. PMID- 3660535 TI - Prostatic cancer nomenclature. PMID- 3660536 TI - Two cases of equine primary gastric impaction. AB - The clinical details of two cases of equine primary gastric impaction are described and the syndromes of gastric impaction and dilatation are discussed. Both cases of gastric impaction were successfully treated by gastrotomy and evacuation of the gastric contents. PMID- 3660537 TI - Ectopia cordis in two calves. PMID- 3660538 TI - Equine pleuropneumonia: the importance of anaerobic bacteria and the potential value of metronidazole in treatment. PMID- 3660539 TI - Control of cattle ticks using flumethrin in central Zambia. PMID- 3660540 TI - Keratoconjunctivitis in the dog. PMID- 3660541 TI - Flurbiprofen toxicity in a dog. PMID- 3660542 TI - Meteoric or power strike? PMID- 3660543 TI - Hip scoring scheme update. PMID- 3660544 TI - Employed or self-employed? PMID- 3660545 TI - Economic losses due to paratuberculosis in dairy cattle. AB - The results of a study of the economic losses caused by paratuberculosis in dairy cattle are reported. The losses in production and the determination of lost future income due to premature disposal are emphasised. A decrease in milk production of 19.5 per cent compared with the lactation two years before culling was recorded in animals showing clinical signs of paratuberculosis. The decrease in production in the last lactation but one compared with the previous lactation was 5 per cent. In animals with non-clinical forms of paratuberculosis these decreases in production were 16 per cent and 6 per cent, respectively. PMID- 3660546 TI - Inactive ovaries in high-yielding dairy cows before service: aetiology and effect on conception. AB - The overall rate of inactive ovaries diagnosed by two consecutive rectal examinations was 8.5 per cent for 7751 lactations. Inactive ovaries had an inverse association with increasing parity and were directly associated with twinning, retained placenta, primary metritis and high milk yield after calving in heifers. No independent associations were established with stillbirth, a low milk yield in the last 120 days before calving, a long dry period, ketonuria or a high serum glutamate oxaloacetate transaminase activity in the first week after calving. The presence of inactive ovaries in the previous lactation was a significant predictor of the trait. Cows with either metritis or inactive ovaries were at a greater independent risk of not conceiving within 150 days after calving and the combined risk associated with both factors was higher than their sum. It is concluded that while damage to the uterus repeatability and an energy shortage after calving are responsible for ovarian inactivity, this trait was not associated with fatty liver. Such an association could be due to an indirect causal relationship, the outcome of post parturient uterine diseases which are associated independently with overfeeding before calving and inactive ovaries. PMID- 3660548 TI - PML vaccines. PMID- 3660549 TI - Control scheme for familial nephropathy in cocker spaniels. PMID- 3660547 TI - Choanal cleft as an alternative site for the isolation of avian mycoplasmas. PMID- 3660550 TI - Cynomolgus monkey twins. PMID- 3660551 TI - Laryngeal chondritis in texel sheep. PMID- 3660552 TI - New serotype of Pasteurella haemolytica isolated in Hungary. PMID- 3660553 TI - Schistosomus reflexus--a cluster of cases. PMID- 3660554 TI - Trimethoprim-sulphonamide induced polyarthritis. PMID- 3660555 TI - Veterinary accomplices. PMID- 3660556 TI - Efficacy of sulbactam-ampicillin in the treatment of neonatal calf diarrhoea. AB - Sulbactam-ampicillin is a combination of sulbactam, a beta-lactamase inhibitor, and ampicillin, a broad spectrum beta-lactam antibiotic. The efficacy of sulbactam-ampicillin was evaluated in the treatment of neonatal calf diarrhoea under conditions where a major proportion of the calves were excreting enterobacteria which were resistant to beta-lactam antibiotics. In a series of six studies with a common experimental design, three treatments (sulbactam ampicillin, ampicillin alone and untreated control) were compared in over 300 Friesian and Ayrshire calves aged between three and 10 days and of known immunological status as determined by their zinc sulphate turbidity values. A mortality rate of 26.4 per cent in the negative control calves was reduced to 14.0 per cent with ampicillin alone and 9.5 per cent with sulbactam-ampicillin. The probability of diarrhoea subsequent to initiation of treatment was reduced from 0.50 in the negative control calves to 0.44 with ampicillin alone and 0.35 with sulbactam-ampicillin. The differences in mortality and diarrhoea observed between the calves treated with sulbactam-ampicillin and the calves in each of the other treatment groups were statistically significant. The superior efficacy of sulbactam-ampicillin is explained by the inhibitory effect of sulbactam on the beta-lactamases produced by resistant bacteria, thus rendering them susceptible to the ampicillin in the combination. PMID- 3660557 TI - Acute disease in lambs caused by a Mycoplasma species. PMID- 3660558 TI - X-trisomy in Friesian cow with continuous oestrus. PMID- 3660559 TI - Intratracheal treatment for kennel cough. PMID- 3660560 TI - Hip dysplasia--puppy assessment scheme. PMID- 3660561 TI - Judgement in meat inspection. PMID- 3660562 TI - Testing milk samples for quality and antibiotic residues. PMID- 3660564 TI - Aspects of animal welfare. PMID- 3660563 TI - Prolonged gestation in mare. PMID- 3660565 TI - Blowpipe permission. PMID- 3660566 TI - Control of cattle ticks. PMID- 3660567 TI - In Practice quiz: sweet-itch. PMID- 3660568 TI - Prostate problems increase. PMID- 3660569 TI - Statistics is semantics and common sense. PMID- 3660570 TI - A latex agglutination test for field diagnosis of contagious caprine pleuropneumonia. AB - Latex beads were sensitised with a polysaccharide isolated from a F38 culture supernatant and used in a slide agglutination test to detect serum antibodies in goats with contagious caprine pleuropneumonia. The latex agglutination test detected antibodies in the sera of goats by 22 +/- 2 (mean +/- 1 sd) days after contact exposure to contagious caprine pleuropneumonia, whereas the complement fixation test detected antibodies by 24 +/- 4 days after contact exposure. Both tests were negative with 181 sera from a farm which was free of the disease. When the same tests were done on 763 sera from two different farms with outbreaks of classical contagious caprine pleuropneumonia, 63 per cent were positive by the latex agglutination test and 23 per cent were positive by the complement-fixation test. Besides being more sensitive than complement fixation, the latex agglutination test can be performed in the field using undiluted serum or whole blood and a result obtained within two minutes. PMID- 3660571 TI - Role of magnesium in the aetiology of ovine urolithiasis in fattening store lambs and intensively fattened lambs. AB - High dietary levels of magnesium (greater than 2 g/kg drymatter [DM]) have been implicated as the main causal factor of urinary calculi in concentrate-fed lambs. Experiments were performed to try to reproduce this effect of high magnesium (from added calcined magnesite) on the incidence of urolithiasis in lambs. In the first, store lambs were given diets containing magnesium in the following concentrations: A,2.9; B,8.6 g/km DM. Twenty-four blackface lambs were each allocated to A and B and the control group of 160 lambs was fed a combined dried grass/sugar beet pulp pellet and hay ad libitum (diet C). The animals were housed and fed ad libitum until they were killed at an average liveweight of 35 kg. No animals showed clinical signs of urolithiasis and post mortem only a trace of calculous material was recovered from one lamb fed diet A. In the second experiment housed Suffolk and Suffolk cross lambs were fed a starter beginning at three to four weeks old and changed to a finisher at a liveweight of 23 kg. The feeds were either high magnesium starter (5.7) and finisher (6.0) or low magnesium starter (2.3) and finisher (2.8 g/kg DM). Twenty-two single lambs and 32 twins were assigned to both high and low magnesium diets. Lambs fed additional magnesium drank more water/kg DM intake and one of the single lambs showed clinical signs of urolithiasis and was killed. No others showed clinical signs and from the 62 killed there was no post mortem recovery of calculous material. PMID- 3660572 TI - Selection of sites for intramuscular injections in the neck of the horse. AB - A radio-opaque marker was injected intramuscularly at different levels and with needles of different lengths into the cervical musculature of a series of ponies and horses which were under profound anaesthesia prior to euthanasia. Subsequently the necks were sectioned and radiographed to determine the fate of the injected material. The results indicated that care was necessary in the selection of the level for injection in order to prevent deposition of material on to the periosteal surface of the cervical vertebrae or on to the ligamentum nuchae and fascial sheaths. The muscle mass over the third vertebra was relatively poor but increased in the more caudal cervical regions. The best site for intramuscular injection appeared to be at the level of the fifth cervical vertebra, ventral to the funicular part of the ligamentum nuchae but dorsal to the brachiocephalic muscle. Even at this position injection material sometimes entered intermuscular fascial sheaths. PMID- 3660574 TI - The veterinary surgeon as expert witness. PMID- 3660573 TI - Feline dysautonomia in Belgium. PMID- 3660575 TI - Supply of PML vaccines. PMID- 3660576 TI - Anaesthesia of guinea pigs. PMID- 3660577 TI - Peripheral neuropathy in diabetic bitch. PMID- 3660578 TI - The expression of capsule in serum-soft agar by Staphylococcus aureus isolated from bovine mastitis. AB - Strains of Staphylococcus aureus were isolated from bovine mastitis, subcultured and maintained in the laboratory for up to 3 years. Encapsulation was assessed by production of a diffuse colony in serum-soft agar. Eight (4%) of 200 strains were encapsulated. Three rapid passages of the remaining 192 strains through either brain-heart infusion broth containing 30% serum or modified 110 medium retrieved the capsule in 75%, but this was rapidly lost after subculture on blood agar. The stimulation of capsule production was studied in 18 of these strains by addition of various components to the passaging medium. Heat-labile factors in serum, milk and mastitic milk enhanced capsule production while bovine serum albumin, an extract of polymorphonuclear leucocytes, NaCl and immunoglobulins had minimal effect. The results indicate that encapsulation is common in bovine staphylococci and while it is lost on subculture, may be retrieved under appropriate conditions. PMID- 3660579 TI - Purification of a heat labile dermonecrotic toxin from culture fluid of Pasteurella multocida. AB - A highly pure heat-labile dermonecrotic toxin (DNT) of Pasteurella multocida was isolated from bacterium-free broth culture fluid. The protocol for the isolation included the following steps: ammonium sulphate precipitation, gel filtration, ion exchange chromatography and preparative polyacrylamide gel electrophoresis (PAGE). About 1 mg of purified DNT was recovered from 3 l of broth culture fluid. The final product was toxic for embryonic bovine lung (EBL) cells, lethal for mice, dermonecrotic in the guinea pig skin test and inactivated by heating at 56 degrees c. The recovery of biological activity was about 5% that of the original culture fluid and the specific activity had increased about 4000 times. After sodium dodecyl sulphate (SDS)-PAGE and silver staining a single band appeared, indicating that the purified DNT was free from contaminating proteins. The molecular weight of the toxin was approximately 125,000 daltons. The minimal toxic dose of DNT protein for embryonic bovine lung cells was about 2 ng, the minimal dermonecrotic dose in the guinea pig skin test was about 80 ng and the 50% lethal dose for mice about 300 ng. PMID- 3660580 TI - Analysis of caprine IgG1 and IgG2 subclass responses to Chlamydia psittaci infection and vaccination. AB - Enzyme-linked immunosorbent assays (ELISAs) specific for caprine IgG(H+L), IgG1 and IgG2 were developed and evaluated for serodiagnosis of Chlamydia psittaci infections in a Tunisian goat flock with currently occurring chlamydial abortions and a clinically inapparent goat flock of an animal research facility. Additionally, ELISAs were applied to record the IgG1 and IgG2 dynamics of four goats vaccinated with inactivated Chlamydia psittaci and Coxiella burnetii. For screening purposes, the IgG(H+L) ELISA proved to be superior to the complement fixation test because it detected a larger number of chlamydial abortions and was easier to perform and to interpret. Analysis of Chlamydia psittaci-specific IgG1 and IgG2 responses to naturally occurring infections by ELISA revealed high IgG1 levels associated with IgG2 in goats with current abortions, whereas clinically inapparent, but seropositive goats were characterized by significantly lower IgG1 levels only (P less than 0.001). Similarly, the four vaccinated goats responded initially with Chlamydia psittaci-specific IgG1, whereas second and third vaccinations induced (as in goats with chlamydial abortions) predominantly IgG1, but also IgG2. The results indicated that clinically inapparent chlamydial infection may be distinguished from overt disease by analysing specific IgG1 and IgG2 responses. Applying Coxiella burnetii- specific ELISAs on field samples, IgG1 alone could be detected in eight, IgG2 alone in one and IgG1 combined with IgG2 in nine goats. The coxiella-specific antibody response of the four vaccinated goats was--in contrast to the chlamydia-specific response- characterized by IgG2 dominance. PMID- 3660581 TI - Pathogenicity of Mycoplasma capricolum in sheep after experimental infection. AB - Mycoplasma (M.) capricolum has been frequently isolated from diseased as well as from healthy sheep in Morocco. In order to determine its pathogenicity for sheep, experiments were performed in three trials with the Moroccan isolate 012. The following results were obtained: Ewes inoculated intramammarily developed acute mastitis; the organism was transmitted to lambs suckling these ewes. Only a mild mastitis appeared after a second inoculum, performed 5 weeks after the first. Young lambs, 1 month of age, fed four times with M. capricolum broth culture, died during the septicemic phase, showing a generalized septicemia, polyarthritis and a diffuse interstitial pneumonia. Lambs, 2 and 3 months of age inoculated intrabronchially developed a disease, which appeared to be age and weight dependent. The more susceptible animals died within 1-2 weeks after infection. The older lambs recovered gradually from the disease, which was characterized by pneumonia, conjunctivitis and arthritis. A significant increase of antibodies against M. capricolum developed in the older animals in the complement fixation test. PMID- 3660582 TI - Cell-mediated and humoral immune response to non-viable Mycoplasma pulmonis in mice enhanced by cross-linked ricin. AB - The enhancing effect of cross-linked ricin (CL-ricin) on the cell-mediated and humoral immune response of mice to non-viable Mycoplasma pulmonis was studied. The cell-mediated immune response was evaluated by means of the delayed-type footpad swelling, and the humoral immune response by means of the indirect hemagglutination test. Mice pre-treated subcutaneously with non-viable M. pulmonis and CL-ricin showed significantly increased delayed-type footpad swelling when they were injected in the footpad with the same antigen 7 days later. Delayed-type footpad swelling was not detected in mice pre-treated only with non-viable M. pulmonis or CL-ricin followed by footpad injection with non viable M. pulmonis. Injection of non-viable M. pulmonis in the footpad on Days 3, 7, 14, 21, 28, 35 and 42 after pre-treatment with non-viable M. pulmonis and CL ricin resulted in significant footpad swelling. Delayed-type footpad swelling was transferred by intravenous injection of spleen cells from mice which had been pre treated 7 days previously with non-viable M. pulmonis and CL-ricin into non treated recipient mice. Intravenous injection of anti-mouse thymus cell serum into mice previously pre-treated with non-viable M. pulmonis and CL-ricin reduced the delayed-type footpad swelling significantly. Mice pre-treated subcutaneously with non-viable M. pulmonis and CL-ricin showed a marked increase in serum antibody titers compared with those that received non-viable M. pulmonis alone. PMID- 3660583 TI - The potential of the ovine udder as a model to determine the pathogenicity of bovine ureaplasmas. AB - Various methods of inducing mastitis in the ovine mammary gland with two bovine ureaplasma strains were investigated. The most successful method was by inoculation of fresh broth cultures on two successive days, 24 h apart. Eight more bovine strains were inoculated by this means and three successfully infected the glands. PMID- 3660584 TI - Epidemiologic particularities of influenza in 1986 in a large urban centre of Romania. AB - The study presents the evolutive peculiarities of the epidemiologic influenza process in 1986 in a large urban centre in Romania, inferrable from the active control by a complex methodology based on clinical, epidemiologic and laboratory investigations. The prevalent part of A (H1N1 and H3N2) and B influenza viruses in causing seasonal morbidity risings is being stressed. A (H3N2) and B influenza viruses determined an epidemic rising during the first trimester and A (H1N1) and A (H3N2) during the fourth trimester in 1986. The epidemiologic influenza impact in 1986 is discussed from the point of view of the complex relationships between the antigenic structure of circulating influenza viruses and the antiinfluenza immune structure of the population. PMID- 3660585 TI - Distribution of sequence differences in influenza N9 neuraminidase of tern and whale viruses and crystallization of the whale neuraminidase complexed with antibodies. AB - Neuraminidase genes from A/tern/Australia/G70C/75 (H11N9) and A/whale/Maine/1/84 (H13N9) influenza viruses have been sequenced. Seventy-two nucleotide changes were found, 17 of which result in changes in the amino acid sequence of the neuraminidase; 3 in the stalk region and 14 in the heads. To our surprise, all of the sequence changes in the head region are located on the base of the neuraminidase tetramer, resulting in conservation of antigenic sites on top of the neuraminidase which vary extensively in human influenza virus neuraminidase. Whale N9 neuraminidase, like tern N9 neuraminidase, possesses high levels of hemagglutinating activity but, unlike the tern neuraminidase, failed to form large well-ordered crystals. However, when the neuraminidase was complexed with Fab fragments of monoclonal antibodies, which were made against the tern N9 neuraminidase, large crystals of the complexes were obtained which diffract X rays to beyond 3 A. PMID- 3660586 TI - Identification of an amino terminal domain required for the transforming activity of the Rous sarcoma virus src protein. AB - Transformation of chicken cells by Rous sarcoma virus (RSV) requires the functional expression of the viral src protein, a tyrosine protein kinase, pp60src. Variants of RSV containing deletions within the amino terminal one-third of the src protein have been identified that exhibit either temperature-sensitive or transformation-defective phenotype when used to infect chicken embryo cells. To define the regions within the amino terminal portion of pp60src that influence morphological transformation, a series of overlapping deletion mutations in the src gene of Prague A RSV (Pr A RSV) were constructed and their biological and biochemical properties were analyzed. Deletions within the src gene which remove amino acid residues 38 to 142 had minimal effects on the ability of the mutant viruses to induce cellular transformation. However, deletions, which impinged upon the region of the src gene encoding residues 142 to 169, inhibited cellular transformation. A variant containing a deletion of amino acid residues 169 to 225, was temperature sensitive for transformation. Structurally altered src proteins recovered from cells infected with transformation-defective variants exhibited a somewhat reduced tyrosine protein kinase activities when assayed in the immune complex kinase assay. Analysis of the in vivo phosphorylation of a pp60src substrate, the 36-kDa protein, revealed virtually wild-type levels of phosphorylation in cells infected with the transformation-defective mutants. These studies suggest that the region of the Pr A RSV src protein delineated by amino acid residues 142 to 169 is essential for initiation and maintenance of morphological transformation of chicken cells in culture. PMID- 3660587 TI - Molecular analysis of the hemagglutinin genes of Australian H7N7 influenza viruses: role of passerine birds in maintenance or transmission? AB - In 1985 a fowl plague-like disease occurred in chickens in Lockwood, Victoria, Australia and caused high mortality. An H7N7 influenza virus was isolated from the chickens (A/Chicken/Victoria/1/85); additionally, an antigenically similar virus was isolated from starlings (A/Starling/Victoria/5156/85) and serological evidence of H7N7 virus infection was found in sparrows. Antigenic analysis with monoclonal antibodies to H7, oligonucleotide mapping of total vRNA, and sequence analysis of the HA genes established that the chicken and starling influenza viruses were closely related and probably came from the same source. There was high nucleotide sequence homology (95.3%) between the HA genes of A/Chick/Vic/85 and a fowl plague-like virus isolated from chickens in Victoria 9 years earlier [A/Fowl/Vic/76 (H7N7)]. The sequence homologies indicated that the A/Chick/Vic/85 and A/Fowl/Vic/76 were derived from a common recent ancestor, while another recent H7N7 virus, Seal/Mass/1/80 originated from a different evolutionary lineage. Experimental infection of chickens and starlings with A/Chick/Vic/1/85 (H7N7) was associated with high mortality (100%), transmission to contact birds of the same species, and virus in all organs. In sparrows one-third of the birds died after infection and virus was isolated from most organs; transmission to contact sparrows did not occur. In contrast, the H7N7 virus replicated in ducks and spread to contact ducks but caused no mortality. These studies establish that the host species plays a role in determining the virulence of avian influenza viruses, and provide the first evidence for transmission of virulent influenza viruses between domestic poultry and passerine birds. They support the hypothesis that potentially virulent H7N7 influenza viruses could be maintained in ducks where they cause no apparent disease and may sometimes spread to other wild birds and domestic poultry. PMID- 3660588 TI - The influenza C virus glycoprotein (HE) exhibits receptor-binding (hemagglutinin) and receptor-destroying (esterase) activities. AB - A cDNA copy of RNA segment 4 of influenza C/Cal/78 virus was cloned into an SV40 vector and expressed in CV-1 cells. The gene product expressed from the SV40 recombinant virus was immunoprecipitated by monoclonal antibodies directed against the influenza C virus glycoprotein. Cells infected with the recombinant virus also exhibited C virus-specific hemagglutinin and O-acetylesterase activity. This suggests that the same C virus protein is associated with receptor binding as well as receptor-destroying activity. The latter viral activity was measured using as substrates bovine submaxillary mucin or a low molecular weight compound p-nitrophenylacetate. In analogy to the parainfluenza virus HN protein, the influenza C virus glycoprotein was termed HE, because it possesses hemagglutinin and esterase (receptor-destroying) activity. PMID- 3660589 TI - Sequence of the bacteriophage P22 anti-recBCD (abc) genes and properties of P22 abc region deletion mutants. AB - The nucleotide sequence of a segment of the bacteriophage P22 chromosome to the left (downstream in the PL operon) of the erf gene was determined. Previous studies (A. C. Fenton and A. R. Poteete, 1984, Virology 134, 148-160) have shown that this region encodes a function that is required for efficient growth of P22 in wild-type, but not in recB- Salmonella. The gene or genes encoding this function were designated abc (anti-recBCD). The DNA sequence reveals three open reading frames that potentially encode polypeptides with molecular weights of 10,900, 11,600, and 6600 (in order of transcription). P22 deletion mutants lacking each of the open reading frames were constructed. In addition, plasmids were constructed placing each of the open reading frames under control of the lac UV5 promoter. The phenotypes of the deletion mutants, and the results of plasmid phage complementation tests, indicate that Abc activity depends primarily on sequences that encode the 11.6-kDa polypeptide; the 10.9-kDa polypeptide-encoding sequence makes a minor contribution to Abc activity as well. These sequences have been designated abc2 and abc1, respectively. The 6.6-kDa polypeptide is apparently uninvolved. PMID- 3660590 TI - Recognition of monovalent sialosides by influenza virus H3 hemagglutinin. AB - This report presents a procedure for evaluating the relative affinities of simple sialoside receptor determinants for their interaction with the receptor binding pocket of the influenza virus hemagglutinin. The virus examined was A/Memphis/102/72, previously shown to exhibit preferential binding specificity for enzymatically modified erythrocytes containing the NeuAc alpha 2,6Gal linkage. Sialosides examined included those with structures representative of terminal sequences found on carbohydrate groups of naturally occurring glycoproteins and glycolipids. Sialosides with the NeuAc alpha 2,6Gal and NeuAc alpha 2,6GlcNAc linkage were 5-30 times more potent inhibitors than those with the NeuAc alpha 2,3Gal linkage. The results provide evidence that the previously reported specificity of the A/Memphis/102/72 hemagglutinin for the NeuAc alpha 2,6Gal sequence on cell surface receptors was due to differential affinity of the receptor binding pocket for sialoside sequences, apart from contributions due to the protein or lipid portions of the cell surface receptors. A number of synthetic sialic acid glycosides were also evaluated as inhibitors of viral attachment. The differential inhibition observed with these receptor analogs may provide clues to the detailed molecular interaction of sialosides with the hemagglutinin binding pocket and aid in the design of small molecular weight inhibitors of viral adsorption to cells. PMID- 3660591 TI - Minute virus of mice (MVM) mRNAs predominantly polyadenylate at a single site. AB - The polyadenylation sites for MVM(p) and MVM(i) mRNAs were determined by a quantitative hybridization-S1 protection assay. mRNAs produced by MVM(p) both early and late in infection of mouse A9 fibroblasts, and by MVM(p) and MVM(i) late in infection of human NB324K cells, polyadenylate predominantly at a single site, at nucleotide 4908 +/- 2 for MVM(p) and 4843 +/- 2 for MVM(i), shortly downstream of the final AATAAA in each viral genome. These results demonstrate that although the right-hand end of MVM has multiple AATAAA signals, and MVM(p) and MVM(i) vary significantly within this region, 3' end processing of viral mRNAs is not a prevalent mechanism for the regulation of MVM gene expression. PMID- 3660592 TI - Identification of endogenous retroviral sequences as potential donors for recombinational repair of mutant retroviruses: positions of crossover points. AB - Mutants of Moloney murine leukemia virus carrying deletions in essential regions of the genome can revert after infection of mouse cells by recombination with endogenous retroviral sequences. We have identified cloned DNAs containing potential donor sequences for two such recombination events and determined the nucleotide sequences in the relevant regions. Comparison of these sequences with that of the original mutants and the revertant viruses allowed a determination of the crossover points that were used in formation of the revertants. Each crossover occurred in short stretches (17-24 bp) of perfect homology between the two parent sequences. PMID- 3660593 TI - Altered ratios of measles virus transcripts in diseased human brains. AB - In rare cases measles virus (MV) induces subacute sclerosing panencephalitis (SSPE) or measles inclusion body encephalitis (MIBE), two lethal diseases of the human central nervous system. MV transcripts present in the brains of two SSPE patients and one MIBE patient were analyzed by quantitative Northern blots. In all three cases the transcripts from the first MV gene were relatively abundant, amounting to about one-tenth of that in lytically infected cells. However, the quantity of transcripts decreased sharply for each subsequent MV gene, arriving at 200-fold lower levels for the fifth MV gene. In comparison gradients of transcript levels are more shallow in either lytically or persistently infected cultured cells, where the transcripts of the fifth MV gene are only about five times less abundant than those of the first. These altered ratios of mRNAs appear to be typical for persistent MV brain infections and most likely lead to reduced expression of the viral envelope proteins, encoded by distal MV genes, at the surface of brain cells. This could account for the lack of viral budding and allow persistent MV infections to elude immune surveillance. PMID- 3660594 TI - The responses of neurons in the cortex in the superior temporal sulcus of the monkey to band-pass spatial frequency filtered faces. AB - There are neurons in the cortex in the anterior part of the superior temporal sulcus of the macaque monkey with visual responses which would be useful for face recognition (Rolls, 1984; Baylis et al., 1985). To analyze further the information which leads them to respond, their responses were measured to parametrically filtered stimuli. The responses of 48 such single neurons were measured to faces which were digitized and were bandpass spatial frequency filtered. The octave width bands were 2-4, 4-8, 8-16, 16-32, 32-64 and 64-128 cycles per image. It was found that the neurons could respond well to single octaves of the spatial frequencies normally present in faces, that the most effective bands were 4-8, 8-16 and 16-32 cycles per face (cpf), and that the bands 2-4 and 32-64 cpf were partly effective. In investigations of whether the responses of the neurons to an unfiltered face, and to low-pass and high-pass filtered images could be predicted by linear addition of their responses to each of the octave bands shown separately, it was found that the majority of the neurons were non-linear, and responded much less than predicted. It was also shown that this occurred even when the contrast was reduced to 0.25 of that normally present in a face, so that the result was not due just to a ceiling effect of the maximum firing rate. These results help to define parametrically the aspects of the information normally present in a face which are sufficient to produce responses of these neurons to them, and show that linear operations cannot account for information processing in this part of the visual system. PMID- 3660595 TI - The ultrastructure of cones in the walleye retina. AB - The ultrastructure of single and twin cone photoreceptors in the retina of the walleye was analyzed by scanning and transmission electronmicroscopy. The outer segment disks resemble those of other vertebrates. An accessory outer segment arises from the inner segment, makes frequent contacts with the outer segment proper, and may thus provide a bridge for signal transmission from outer to inner segment. A palisade of some 30 calycal processes surrounds and may provide structural support for the outer segment. The region of apposition between the inner segments of twin cones consists of a space of some 28 nm with no indication of gap junctions. The proximal quarter of the inner segment displays a profusion of some 50 lateral fins which increase the inner segment surface by 3-4 X and do not contact fins of neighboring cones. The fins surround a profusion of Muller cell microvilli and probably promote metabolic exchange between cones and Muller cells. Apart from differences in size and the presence of apposed inner segments, twin and single cones appear to be morphologically similar. PMID- 3660596 TI - Visual receptive field properties in the posterior suprasylvian cortex of the cat: a comparison between the areas PMLS and PLLS. AB - Receptive field (RF) properties of single units were examined in two visual areas in the cat's postero-medial and postero-lateral suprasylvian cortex (PMLS/PLLS). Electrophysiological recordings were made in the paralyzed and anesthetized preparation in corresponding regions of the medial and lateral banks of the lateral suprasylvian sulcus (LS). In both areas, cell samples were obtained from within the same range of A/P co-ordinates. In both samples, cells responded best to moving stimuli, had large RF's, and did not differ with respect to the distributions of their ocular dominance. Binocularity was equally high, but units in PLLS showed significantly less binocular summation. Cells in both areas preferred high velocities, and a high percentage was direction selective, with directions up and away from the vertical meridian being most common. While in PMLS the preferred direction of a unit usually could be classified into a "radial" vs a "circular" category when RF position was taken into account, this was not possible in PLLS. Units in PLLS also had significantly higher spontaneous activity, higher optimal velocity, and larger RF sizes. In PLLS the investigation of background-foreground interactions revealed a large variety of phase-dependent responses. This is in contrast to the clear preponderance of in-phase inhibition and antiphase facilitation effects in PMLS. The results indicate important differences of RF properties for the two areas, but do not yet suggest a clear functional differentiation. These differences reflect in some respects the RF properties of cells in the structures that provide the main afferents to the two areas. PMID- 3660597 TI - Electrophysiological correlates of rod outer segment disc shedding in rabbit retina. AB - We hypothesize that the b-wave of the electroreginogram (ERG) can provide a precise, noninvasive measure of the morning rod disc shedding event. ERGs were recorded in the dark from photoentrained rabbits using a 500 nm test light. Histological examination of the pigment epithelium confirmed that an increase in large phagosome content occurred shortly after light onset. In albino rabbits the b-wave decreased in amplitude at about 30 min after the time of normal light onset. The corresponding decrease in sensitivity required to produce this change in amplitude was 0.11 log unit. No ERG effect was seen in pigmented rabbits. PMID- 3660598 TI - Facilitation and masking of briefly presented gratings: time-course and contrast dependence. AB - We measured two-alternative forced-choice contrast thresholds for briefly presented sinusoidal gratings in the presence of superimposed masking gratings of various contrasts, and at a range of onset asynchronies. Facilitation (lower thresholds) occurred when the mask was simultaneous, in-phase, and near threshold, but was abolished at asynchronies of 50 msec or more and by presenting the test grating as a brief contrast reversal instead of a pulse. We argue that facilitation requires temporal summation of responses within the same neural channels, but our results do not distinguish between transducer and uncertainty models. Masking (threshold elevation) occurred over a broader range of asynchronies, and was not abolished by test contrast reversal. Masking and facilitation probably depend on different processes with different time-courses. The occurrence of masking at asynchronies outside the range of temporal summation suggests that a static, compressive transducer does not, in general, account for masking. Brief masking and prolonged contrast adaptation are very similar in magnitude, and as a function of contrast and relative spatial frequency. Masking and adaptation may have a common origin, but differ in speed of recovery. PMID- 3660599 TI - Extraocular muscle sideslip and orbital geometry in monkeys. AB - The belly of each extraocular muscle is elastically coupled to both the globe and orbit. The dependence of muscle planes on gaze angle must be determined experimentally. In monkeys, radio-opaque markers were implanted along the upper and lower margins of a lateral rectus. A scleral search coil was implanted in the other eye. With the eye in various gaze positions, X-ray images were made to show the LR in the lateral view. We found that as the eye rotates vertically over 50 deg (+/- 25 deg), the point of tangency of the LR with the globe slips an average of 5.1 mm vertically with respect to the globe, allowing this point--and so the muscle plane--to remain approximately fixed relative to the orbit. The results of quantitative orbital dissections are presented in support of the sideslip calculations. PMID- 3660600 TI - Oculomotor and skeletal motor systems share one map of visual space. AB - Previous research has shown that cognitive and motor visual systems have separate maps of visual space because spatial values in them can be manipulated independently. Here we ask whether the motor map in turn can be divided into separate representations of space. Forty large saccadic eye movements in darkness resulted in significant ocular undershoot of a remembered eccentric target location, and a comparable amount of undershoot with manual pointing to the same remembered target. Saccadic and manual measures were also highly correlated within sessions as well as between sessions. Because pointing could be changed by manipulating only saccades, we conclude that the two systems share a single map of space. PMID- 3660601 TI - Effects of light and dark environments on macaque and human fixational eye movements. AB - Eye position of two macaques and two humans was recorded while they detected the unpredictable dimming of a fixation spot in a dark or a light environment. Fixational saccades often had complex waveforms that resulted from clustering of two or more saccadic displacements with no intervening drift periods. In the dark, all subjects had low frequencies of saccade clusters (0.15-0.61/sec). Three of the subjects increased the frequency of saccade clusters and decreased the magnitude of the displacements when the task was performed in the normally lighted laboratory. The higher saccade frequencies in the light did not automatically result in greater dispersion of eye position. One of the humans, who had the lowest saccade frequency, was relatively unaffected by the stimulus conditions. The change in stimulus conditions had a more pronounced effect on the fixational eye movements of the macaques than the humans. In the dark, the macaques made saccades mostly down and nasal, but in the light the saccadic displacements occurred over a wider range of angular directions. Mean eye position was higher in the dark than in the light. The humans altered the direction of their saccadic displacements very little and did not change their mean eye position when they switched from a dark to a lighted environment. The influence of a lighted environment is interpreted as an interaction between foveolar and peripheral retinal inputs. The results suggest that fixational saccades may have more than one role, perhaps including stimulation of pathways originating in the peripheral retina. These peripheral field inputs have a stronger effect on the fixational control system of macaques than of humans. PMID- 3660602 TI - Position and spatial frequency in large-scale localization judgments. AB - The frequency-channel model and the position, or "local-signs," model that have been proposed to account for hyperacuity (i.e. small-scale relative spatial localization) are examined in the context of large-scale relative spatial localization. As a basis for subsequent experiments, localization accuracy is measured over a large range of object separations, and previous findings that the "Weber fraction for localization" is constant are replicated. The effects on localization accuracy of both high- and low-spatial frequency components in the objects being localized are examined in some detail. Localization accuracy is found not to rely exclusively on either the high- or the low-frequency components. Neither the frequency-channel nor the position hypothesis as defined here is consistent with all of the observed results. However, with a slight modification, the position hypothesis can account qualitatively for all of the observed results, whereas no reasonable modification of the frequency-channel hypothesis appears able to do as well. PMID- 3660603 TI - A central binocular mechanism affects chromatic adaptation. AB - Two experiments explored the role of central binocular mechanisms in color perception. The first experiment examined the effect of adapting to simultaneous, binocularly fused fields. Each eye adapted to a slowly flickering (0.5 Hz) long wavelength light. The two eyes were adapted either inphase (both eyes stimulated at the same moment) or out-of-phase (only one eye stimulated at any given moment). Both adapting procedures shifted equilibrium yellow toward longer wavelengths, but a significantly greater shift was found when adapting light stimulated both eyes simultaneously. This reveals that a central binocular mechanism affects chromatic adaptation. The second experiment tested whether the binocular mechanism could shift equilibrium yellow measurements made with both eyes (identical, binocularly fused fields presented to each eye) outside of the range of measurements established by left-eye monocular viewing and right-eye monocular viewing. Differences were found between monocular left-eye and monocular right-eye color appearance under conditions of moderate chromatic adaptation, but binocularly fused measurements fell within the range established by the monocular results. This is consistent with the view that central mechanisms serve to keep the two eyes in balance, rather than systematically alter color appearance from colors perceived under monocular viewing. PMID- 3660604 TI - Scale invariant features of differential spatial displacement discrimination. AB - For a configuration of three blobs, with Gaussian spatial contrast profiles, at threshold luminance contrast, differential spatial displacement discrimination thresholds were determined. The blobs were arranged one above the other, at equal spatial intervals. Thresholds were determined for displacements of the middle blob both orthogonal to and along the axis joining the outer two blobs. Thresholds for both tasks were obtained as a function of both the resolution and the separation of the blobs. The thresholds for both tasks increased linearly with decreasing resolution (increasing blur), for a constant ratio of the resolution parameter and the separation of the outer two blobs. At all levels of resolution there are two blob-separation regimes, in which different strategies are used to compute differential spatial displacements. Independent of the level of resolution, transition between those regions occurs when the separation of the outer two blobs is a constant multiple (approx. 25) of their blur parameter. We interpret these results as further evidence for a scale-invariant mechanism for differential spatial displacement computation. PMID- 3660605 TI - Illusory contour orientation discrimination. AB - Just noticeable differences (JNDs) in orientation for real lines and illusory contours were compared. JNDs in orientation of an illusory contour and of a real line differ by less than a factor two. JNDs in orientation of an illusory contour showed meridional variations similar to those obtained for a real line. By scaling measurements illusory contours are equally visible at all orientations, so meridional variations in illusory orientation discrimination reflect an anisotropy in orientation processing mechanisms. JNDs in orientation measured at an oblique reference orientation improve with practice for an illusory contour as well as for a real line. However while the effect of practice transfers from an illusory to a real contour, the reverse is not true. These results suggest that there are two paths for processing orientation: one activated only by real lines, the other concerned with both real and illusory contours. PMID- 3660606 TI - Isolation of short-wavelength-sensitive cone photoreceptors in 4-6-week-old human infants. AB - Spectral sensitivity was measured for nine infants, 4-6 weeks of age, and three adults under conditions of chromatic adaptation chosen to reveal the presence of short-wavelength-sensitive cones. Monochromatic test stimuli (400-550 nm) were presented at 2 Hz superimposed on a broadband, yellow background. Following 4 min of adaptation to the background, test stimuli were presented while recording the steady-state, visually-evoked cortical potential (VECP). Response averages were obtained for several radiance levels at each test wavelength, and the amplitude of the fundamental frequency was extracted from the digitized response with a fast-Fourier transform. These data were used to construct response vs intensity functions for each wavelength. A fixed criterion response was chosen from the latter family of functions to generate individual spectral sensitivity curves. These VECP spectral sensitivity functions matched the psychophysically-determined functions of adults, measured by the method of adjustment and with the same stimulus configuration. Peak sensitivity for infants and adults under these conditions occurred at about 440 nm, and the main lobe of the curve (400-500 nm) was well fitted by the Vos-Walraven short-wavelength cone fundamental. The only major difference between the infant and adult data was in the relative sensitivity of the secondary mode of the curves (above 500 nm). These results demonstrate the presence of short-wavelength-sensitive cones and a functional pathway to the visual cortex by 4-6 weeks of age. PMID- 3660607 TI - Rod-cone interaction in monocular but not binocular pathways. AB - Photopic background stimulation elevates scotopic increment thresholds (rod-cone interaction) at moderate background levels when both test and concentric disk background stimuli enter the same eye (monocular condition) but not when they enter different eyes (dichoptic condition). Only when background levels are made extremely high is there any measurable dichoptic interaction, and this interaction does not resemble that observed monocularly. Rod-cone interaction, as usually studied, is a property of monocular pathways in human vision. PMID- 3660608 TI - Description of the length-tension curves of the extraocular muscles. PMID- 3660609 TI - The variation in the light responses of carp retinal ganglion cells is independent of response amplitude. AB - The variation of the response rate of carp retinal ganglion cells to photopic light stimulation was studied. It was found that the standard deviation was independent of the mean of the response rate, even when responses showed compression. This finding is in agreement with a late origin of retinal noise. Implications of the existence of intrinsic constant amplitude retinal noise and of the presence of a mean maintained activity are discussed. PMID- 3660610 TI - Pupillometric measures of retinal sensitivity in infants and adults with retinitis pigmentosa. AB - Steady-state pupil diameter was measured in darkness and over a 9 log unit range of Ganzfeld illumination in 20 normal adults, 28 normal infants, 59 adults with retinitis pigmentosa, and 30 children at risk for retinitis pigmentosa. Pupil threshold was defined as the retinal illuminance necessary to decrease pupil diameter by 1.0 mm relative to the diameter in darkness. Spectral measurements in normal adults confirmed that pupil threshold was determined primarily by rods with this procedure. Pupil thresholds of newborns and infants did not differ significantly from those of normal adults. In patients with retinitis pigmentosa, elevations in pupil threshold were related to rod loss as indexed by reductions in rod ERG amplitude. Electroretinographic follow-up of 13 of the children at risk for retinitis pigmentosa showed normal rod ERG function in 5 children who had pupil thresholds within the normal range and significant rod ERG loss in 8 children who had elevated pupil thresholds. PMID- 3660611 TI - Effect of monocular light exclusion on the Stiles-Crawford function. AB - Contrary to previously published studies, monocular light exclusion did not alter the shape of the Stiles-Crawford function in a substantial manner in four subjects who were patched in this laboratory for one full week. In order to rule out methodological differences, an experimenter from each of the two sets of experiments (current and prior) patched one eye for 1 week, then tested each other. For one subject, there was little effect of patching. For the other, patching had a measurable effect, but it was different from that originally reported. However, the much larger, symmetrical broadening of the Stiles-Crawford function reported in earlier studies was not replicated. A testable working hypothesis to explain the earlier results is discussed. PMID- 3660612 TI - An unusual optic fiber pattern in the retina of the primitive fish Pantodon buchholzi, Peters. AB - The organization of the fiber layer in the retinas of fishes belonging to the suborder Osteoglossoidei appears to be unique amongst bony fishes. The intraretinal pattern of ganglion cell axons is described for one of the species (Pantodon buchholzi). The pattern is unusually linear rather than radial and its organization conforms to a remarkable falciform process. PMID- 3660613 TI - Predictive eye saccades are different from visually triggered saccades. AB - The metrics of eye saccades in response to random and predictable target motion were determined in 8 normal young subjects. The peak velocity of predictive saccades (PS) was significantly reduced when compared with randomly elicited saccades (RS) of equal amplitude. Saccadic gain (initial saccadic amplitude/target amplitude) was also decreased in PS. Saccadic inaccuracy was extremely frequent in PS and, in contrast to RS, it was independent of target amplitude displacement. These stimulus-dependent changes in saccadic characteristics may reflect activation of the saccadic pontine generators by different supranuclear pathways. PMID- 3660615 TI - Motion aftereffects associated with pursuit eye movements. AB - Contrary to an earlier report [Anstis and Gregory, Q. Jl exp. Psychol. 17, 173 174 (1965)], we find that the sustained retinal motion caused by tracking a moving target over a stationary grating does not result in a motion aftereffect (MAE) which is equivalent to that resulting from comparable retinal motion caused by actual motion of a grating. The MAE associated with tracking generally occurs in elements falling on areas not previously exposed to retinal motion. It is in the same direction as the previous retinal motion in the display and is apparently an induced MAE caused by a weak, below threshold MAE in the elements stimulating areas that were previously exposed to retinal motion. Based on an analysis of eye movement records, we do not believe that the weakness of the tracking MAE is primarily a function of the poor quality of the tracking eye movements. Other possible reasons for the weakness of the MAE are suggested. PMID- 3660614 TI - Duration of visual afterimages on modulated backgrounds: postreceptoral processes. AB - A foveal afterimage produced by a small photoflash increases in duration when the luminance of a 5.8 degrees diameter background on which it is seen is temporally modulated. At a modulation frequency of 1 Hz and a depth of modulation of 52%, the duration of the afterimage is prolonged by 335% compared to the duration obtained on a steady background. This increase has been attributed to the functional border resulting from the difference in excitability between bleached and unbleached photoreceptors. Afterimage duration is also prolonged, although only by 20%, when the luminance of the background is kept constant, while the luminance of an annular surround is modulated. This finding suggests a weak effect of neural lateral interaction (via area contrast). If the background luminance is modulated only in the contralateral eye (dichoptic presentation), afterimage duration increases by as much as 54% compared to the unmodulated state. This result indicates that afterimages, in part, are sustained by processes mediated by the visual cortex. PMID- 3660616 TI - Effect of surround configuration on increment thresholds of a tiny violet flash. AB - Increment thresholds were measured for a 5', 435-nm test flash (50 or 200 msec) on background fields of various wavelengths and spatial configurations. As the field diameter was increased, the detection threshold for the 50-msec test decreased rapidly and leveled off when the field diameter exceeded 20'. For short to-middle wavelength fields (much less than or equal to 503 nm), the detection threshold for the 200-msec test varied with field diameter in a similar manner to those observed for the 50-msec tests, while for middle-to-long wavelength fields (much greater than or equal to 544 nm), the detection threshold continued to decrease even when the field diameter exceeded 20'. The temporal-integration properties and the threshold vs intensity curves were determined for 465-nm and 579-nm fields to specify the mechanisms responsible for the detection. It was shown that the detection thresholds of the test upon the large 579-nm field were characterized by the short-wavelength mechanism isolated by an intense yellow adapting field, whereas the detection thresholds of the test upon the small 579 nm or the 465-nm field showed an intrusion of a more sensitive alternate mechanism, presumably the middle-wavelength mechanism. It was suggested that the sensitivity of the S cone signals might be affected by spatially distributed signals from the longer-wavelength mechanisms. PMID- 3660617 TI - Perception of random-dot symmetry and apparent movement at and near isoluminance. AB - There have been conflicting reports on whether apparent movement in random-dot kinematograms is abolished at isoluminance. The present results suggest that it is, provided that dynamic (uncorrelated) surrounds are used, and the subject has to report the shape of the target rather than the presence of movement in an isolated portion of the target. On the other hand, perception of random-dot symmetry is still possible at isoluminance. The reason for this difference appears to be the need for exact-position information in movement but not symmetry perception. Control experiments suggest that the effects are not due to artefacts such as chromatic aberration in the eye. PMID- 3660618 TI - Dioptric and non-dioptric stimuli for accommodation: target size alone and with blur and chromatic aberration. AB - The frequency response of the accommodative system (0.05-1 Hz) was determined for various combinations of stimuli: changing target size was presented alone, together with defocus blur, and with both defocus blur and chromatic aberration. A high-speed infrared optometer monitored accommodation while the subject viewed the target in a Badal optometer. Target size was varied sinusoidally and blur was provided by moving the target towards and away from the subject at the same frequency. Chromatic aberration was controlled by using either monochromatic (590 nm) or white (3300 K) light. The target was presented under open-loop conditions when size was the only stimulus. We find that besides the conventional dioptric stimuli, changes in target size that result in changes in apparent distance can have substantial effects on accommodation. PMID- 3660619 TI - Global factors generate the McCollough effect. AB - It has recently been demonstrated that certain globally orthogonal pattern pairs derived from Hoffman's Lie Transformation Group Model of Neuropsychology (LTG/NP) are sufficient to generate McCollough effects (pattern-contingent colour aftereffects: PCCAES). We now provide evidence that the global factors postulated to generate these particular PCCAEs are also necessary. In Experiment 1 observers made controlled eye movements over the induction patterns and subsequently showed PCCAEs which were as strong as those obtained under central fixation. The induction process therefore did not depend on selectively adapting local oriented and colour-specific edge detectors. The global structure of the inducing patterns appears to be a necessary component of the generation of such aftereffects. In Experiment 2, a number of pattern pairs having various degrees of global organization were used as induction patterns, but in every case there was an equal degree of local orthogonality. Local orthogonality was shown not to be sufficient to induce PCCAEs, but global orthogonality was. These results lend strong support to the notion that McCollough-type PCCAEs are generated in a structure of the visual system somewhat above the level of strictly local operations, whether defined as edge and bar detectors or, equivalently, as units selectively tuned to different spatial frequencies and orientations. The global nature of the effects, and the particular pattern structures involved, lead us to suggest that Hoffman's LTG/NP provides a sound basis for explaining our findings. PMID- 3660620 TI - Positional uncertainty in peripheral and amblyopic vision. AB - Three experiments were performed to examine positional acuity and the role of spatial sampling in central, peripheral and amblyopic vision. In the first experiment, 3-line bisection acuity was compared to grating acuity. In normal foveal vision bisection acuity represents a hyperacuity. In anisometropic amblyopes, bisection acuity is reduced in rough proportion to their grating acuity. In strabismic amblyopes, and in the normal periphery, bisection acuity is reduced to a greater extent than grating acuity. This result implies that reduced contrast sensitivity of the spatial filters is not sufficient to account for the increased positional uncertainty found in peripheral vision and in strabismic amblyopia. In order to test the hypothesis that the high degree of positional uncertainty evident in these visual systems is a consequence of sparse spatial sampling, bisection thresholds and width discrimination thresholds were measured with stimuli comprised of discrete samples. The results showed that normal foveal vision and the vision of anisometropic amblyopes show little benefit from adding discrete samples to the stimulus. In contrast, the normal periphery, and the central field of strabismic amblyopes demonstrate marked positional uncertainty which can be efficiently reduced in proportion to the square root of the number of samples (up to about 10) comprising the stimulus in the direction orthogonal to the discrimination cue. In aggregate the results suggest that anisometropic and strabismic amblyopia are fundamentally different. The positional uncertainty in anisometropic amblyopia is consistent with the reduced sensitivity of the spatial filters. The data of the normal periphery and of the central field of strabismic amblyopes suggest that the cortical sampling grain imposes a fundamental limit upon their positional acuity. PMID- 3660621 TI - The optics of comparative ophthalmoscopy. AB - One factor peculiar to the practice of comparative ophthalmoscopy is the very large variation in ocular size of the animals examined, a factor which is ignored in current textbook treatments of the subject. We have computed values of lateral magnification, axial magnification, angular field of view and linear field of view for 19 species of terrestrial vertebrates. The dimensional value of a 1 diopter change in direct ophthalmoscopic focus was also determined. The anterior focal length of the eye in air and the vitreal refractive index were the intrinsic optical parameters of the animal's eye necessary for these calculations. Where these values were not available from the literature, the vitreal refractive index was assumed to be 1.336 and the anterior focal length was estimated as two-thirds of the axial length using a regression equation we derived from data in the literature. The angular field of view in ophthalmoscopy was shown to be invariant in the emmetropic eye and equal to the angular subtense of the ophthalmoscopic beam. The lateral field of view and retinal depth corresponding to a 1 diopter change in direct ophthalmoscopic focus varied directly with the anterior focal length of the eye. The remaining parameters of lateral and axial magnification varied inversely with the anterior focal length of the animal's eyes. These findings provide a basis for evaluating the relative size and significance of ophthalmoscopically viewed features in terrestrial vertebrate eyes. PMID- 3660622 TI - Influence of saccades on manual reactions--a reaction time and VEP study. AB - Experiments were performed to investigate the retardation of motor reactions, triggered immediately after saccadic eye movements, by comparing VEP latencies and manual reaction times. As visual stimuli grating patterns of different spatial frequencies were used. They were presented during continuous fixation ("resting eye" condition) as well as shortly after a saccade ("saccadic" condition) with different onset delays (25, 50, 100, 150 msec), in order to determine the influence of saccades on VEP latencies and on manual reaction times. Compared with the reaction times in the "resting eye" condition, the postsaccadic reaction times were much prolonged whereas the respective VEP latencies are almost unchanged. Thus an inhibitory interaction of different motor responses (i.e. saccadic eye movements and manual reactions in this study) at higher levels of the afferent system or at the motor control site is postulated. This result has been confirmed for stimuli of different spatial frequencies. PMID- 3660623 TI - Receptive field size of human motion detection units. AB - Receptive field sizes of motion detector units in the human visual system were determined using a summation technique. Contrast sensitivity was measured for detecting the direction of motion of a drifting (8 Hz) sinewave grating (0.01 30.0 c/deg) multiplied by a stationary Gaussian envelope, for various widths of the Gaussian envelope. For each test spatial frequency, sensitivity increased linearly with aperture width up to a certain limit, and thereafter at a rate consistent with a model incorporating probability summation over space and between channels. The limit of linear summation designates the limit of the receptive field. Results show that the receptive field size varies with spatial frequency, from 2' arc at high spatial frequencies to as large as 7 deg at low frequencies. The change in field size was progressive. The smallest aperture width (delta W) for directional discrimination was also measured. Results show delta W to vary from 0.03 cycles at low spatial frequencies to 0.30 cycles at high frequencies. PMID- 3660624 TI - Transient tritanopia of a second kind. AB - Using a psychophysical method that allows the tracking of very rapid changes in sensitivity, we demonstrate an anomaly in the time-course of light adaptation for the short-wave mechanism: after the onset of a yellow (581 nm) field of approximately 10(5.3) td the threshold for short-wave targets does not recover monotonically but continues to rise for several seconds before falling to its equilibrium value. The phenomenon is absent when the adapting field has a wavelength of 511 nm and has been adjusted to give a similar equilibrium value for the short-wave threshold. PMID- 3660625 TI - Shape recognition in amblyopia. AB - The results of recent investigations of supra-threshold spatial vision in amblyopia have indicated that the amblyopic eye may be more disadvantaged than acuity or contrast detection measurements have suggested. We report here on the sensitivity of the amblyopic eye when performing tasks requiring the recognition of small spatial differences in thin bright line stimuli displayed in a variety of 2-D configurations. Amblyopes were able to perform these tasks, but their amblyopic eye was generally poorer than their normal eye by a multiplicative factor. It is argued that this pattern of results indicates that spatial scrambling rather than blurring is an appropriate model for amblyopia. PMID- 3660626 TI - Spatial information and uncertainty in anisometropic amblyopia. AB - Anisometropic amblyopes were found to have a reduced sensitivity for shape discrimination. The introduction of positional jitter in the elements of the display had a profound effect on the performance of the normal eye, but not on that of the amblyopic eye. On the other hand the introduction of gaussian blur affects the performance of both eyes to the same degree. We conclude that raised spatial uncertainty due to metrical scrambling is a suitable model for anisometropic amblyopia. PMID- 3660627 TI - On plotting amplitude-transition functions for voluntary eye saccades. AB - The first of two oppositely directed saccades may be small if the time interval between the two saccades is short. We have examined the merits of plotting the amplitude of the first saccade against saccadic interval. This plot provides a useful supplement to other approaches in the literature, as it is insensitive to variation due to extraneous factors or to task. Reasons for this are discussed. PMID- 3660628 TI - A retinal smear technique for varying grating contrast. AB - We present here a technique for modulating contrast in gratings seen in Maxwellian-view or on a projection screen. The method can be used with achromatic or chromatic grating stimuli. It is based on a high frequency oscillatory displacement of the grating image, which in turn produces a smearing of the image on the observer's retina. The waveform of the displacement and its amplitude determine the appearance and contrast of the image produced on the retina. PMID- 3660629 TI - Light adaptation of red cones and L1-horizontal cells in the turtle retina: effect of the background spatial pattern. AB - Electrical coupling allow red cones and L1-horizontal cells to respond to light stimuli illuminating remote retinal loci. The contribution of the spatial pattern of background light to flash sensitivity of red cones and L1-horizontal cells was studied intracellularly in the turtle retina. Lateral spread of background adaptation was observed in the cones. The sensitivity of the cones was related to the steady hyperpolarization of the cells irrespective of the background's spatial pattern. Light sensitivity of L1-horizontal cells mainly depended upon the background illuminating their dendritic field. Unlike red cones, the horizontal cells responded differently to spot and annular backgrounds regardless of the steady hyperpolarization induced. PMID- 3660630 TI - The relationship of retinal sensitivity and rhodopsin in human infants. AB - During dark adaptation after full field, greater than or equal to 90% bleaches recovery of sensitivity and regeneration of rhodopsin were studied using electroretinographic and pupillographic techniques in both 10-week-old infants and adults. The courses of scotopic sensitivity recovery and rhodopsin regeneration of infants and adults were similar and were reasonably well fit by single exponentials having tau = 400 sec. For both infants and adults log scotopic sensitivity was linearly related to the proportion of rhodopsin present during dark adaptation. It is concluded that by age 10 weeks human distal retinal processes that occur after photolysis are equivalent to those of adults. PMID- 3660631 TI - Optical density of human macular pigment. AB - Foveal and parafoveal spectral sensitivities of the G cone mechanism were used to derive the difference spectrum for the macular pigment for 12 observers. Measurements of the peak density of the macular pigment were obtained with a shortened version of the same procedure for an additional 15 observers. The mean density for all 27 observers at 460 nm was 0.77 +/- 0.06 with a range of 0.21 1.22. The mean density is higher than that previously reported and, compared to the standard absorbance curve (Wyszecki and Stiles, 1967), the results indicate higher density values for wavelengths on the long wavelength side of the absorption maximum. PMID- 3660632 TI - Intracellular potassium activities of horizontal cells and extracellular potassium activity in isolated retinae of a cyprinid fish. AB - Extracellular and intracellular K+ activities of luminosity and biphasic chromaticity type horizontal cells were measured in non-superfused roach retinae using double-barrelled K+-sensitive micro-electrodes. The extracellular K+ activity in dark-adapted retinae was 3.4 mM on average. The intracellular K+ activities of the two types of horizontal cell in the dark were very similar (57 and 54 mM, respectively), and corresponding values of the K+ equilibrium potential were about 35 mV more negative than respective resting potentials. During light-evoked hyperpolarizations, the intracellular K+ activity decreased, and at saturation, resting potentials matched corresponding K+ equilibrium potentials. The results are discussed in relation to sub-synaptic and non synaptic membrane ionic mechanisms and further support the view that the non synaptic membrane is selectively permeable to K+. PMID- 3660633 TI - The duplex character of the corticofugal pathway from the striate cortex to the lateral geniculate complex of the cat. AB - From studies on signal conduction times in the corticofugal pathway from the striate cortex of the cat it has been proposed that S cells project to the LGN and C cells to the PGN. This concept has not received support from the histological examination of axons projecting to the two nuclei. The physiological experiments pointed to a clear segregation not apparent in the distribution of axonal diameters. A larger sample of signal conduction times, collected in the present study, is more consistent with the findings on the morphology of the pathway. PMID- 3660634 TI - The effect of grating spatial frequency on the early VEP-component CI. PMID- 3660635 TI - Skewness of saccadic velocity profiles: a unifying parameter for normal and slow saccades. AB - It has become customary to make use of so-called main sequence plots to characterize the dynamic properties of saccades. However, such a description does not account for the fact that the ratio between the accelerating and the decelerating fraction of the eye movement is not constant for all saccades. In this paper we introduce a new parameter, skewness, that characterizes this much neglected aspect of the saccade velocity profile. Human saccade data in this report demonstrate a clear relation between saccade duration (D) and skewness (S). When saccadic eye movements become extremely slow, due to fatigue or diazepam, the main sequence relation breaks down, while the S-D relation still holds. Despite large differences in amplitude, saccades of a fixed duration appear to have the same shape of velocity profile. A unifying equation relating the saccade parameters amplitude, maximum velocity and skewness, which is valid for both normal and slow saccades, is proposed. PMID- 3660636 TI - The role of eye movements in motion detection. AB - The roles of small eye movements of fixation, and of different kinds of background in motion detection were studied. Minimum detectable displacement for a luminous line oscillating either in a blank field or in the presence of three types of background was measured under two viewing conditions: normal, when eye movements generate normal movements of the image on the retina, and stabilized when these retinal image movements were nearly eliminated. It was demonstrated that eye movements enhance motion detection for a sinusoidally moving target when the target is superimposed on a patterned background; they are detrimental when there is no background. In addition, it was found that the function relating threshold amplitude to frequency of movement is band-pass when the image is stabilized or when the bar moves on a blank field, and is more low-pass when both the background and the test target are subject to the effects of eye movements. PMID- 3660637 TI - Visual inertia in apparent motion. AB - Four dots in an imaginary diamond were flashed in succession to give ambiguous apparent motion (AM). The top and bottom dots were flashed at time t1 and replaced by the left and right dots at time t2. If two priming dots were flashed beforehand at time t0 in line with two parallel sides of the diamond, AM was seen along those sides. We call this "visual inertia". The amount of visual inertia (measured by a null method) fell off with increasing angle between the priming dot and the side of the diamond. Visual inertia was still seen when the priming dots were presented to one eye and the test dots to the other, so the effect must be partly central. The timing and length of the priming path made little difference to visual inertia. However, static priming dots were ineffective. We conclude that the visual system was examining at least three successive time frames in deciding which items in one frame correspond with which items in succeeding frames. PMID- 3660638 TI - Temporal properties of spatial contrast vision. AB - The temporal characteristics of spatial contrast vision at and above threshold were assessed psychophysically using sinusoidal gratings and a contrast-matching method. Temporal frequency response curves became flatter as contrast level increased. An impulse response model was fitted to these flicker data, and used to make predictions about temporal integration and two-pulse summation. The predictions fitted the experimental data well, except under conditions where the Broca-Sulzer effect occurred. The latter was not predicted by the biphasic impulse response that otherwise worked well. Temporal filtering became moderately transient and operated over a shorter time-scale as contrast increased, and above threshold temporal properties varied little with spatial frequency. The data and modelling supported the idea that subjects exploited probability summation at threshold while using a peak detection criterion above threshold. Systematic visual field asymmetries in contrast perception are also described. Single- and multiple-channel models of temporal processing are discussed. PMID- 3660639 TI - Chronometric analysis supports fusion rather than suppression theory of binocular vision. AB - Suppression theory attributes the singleness of vision during binocular viewing to inconspicuous binocular rivalry. In two experiments, reaction time (RTs) for detection of a small molecular probe were measured while the eyes viewed identical ("fusion") or different (rivalry) stimuli. As expected, distributions of RTs obtained during binocular rivalry showed large positive skew, from trials in which detection was delayed because the probe was superimposed on the suppressed field. Opposite to the prediction of suppression theory, however, the RT distribution during fusion showed far less positive skew, implying that information is available from both eyes during binocular viewing, as held by fusion theory. These findings were confirmed and extended over a large range of probe luminances. During fusion, log mean RTs fell steeply as log probe luminance was increased up to a critical value, then less steeply for further increases. During rivalry, the same steep branch of the RT-luminance function appeared, but shifted as though the probe was about 0.25 log units dimmer. The second branch was also present, but steeper than for fusion, so that RTs for fusion and rivalry were the same at the highest values tested. PMID- 3660640 TI - Detecting the displacements of spatial beats: a monocular capability. AB - Sensitivity to the sudden displacement (phase shift) of a single monocularly presented sinusoidal grating is increased when a static grating of similar spatial frequency is presented to the same eye. If the static grating is presented to the other eye instead sensitivity is, at best, halved. This demonstration implies that monocular and binocular visual pathways differ in their sensitivity to spatial variations of contrast. In addition it provides another example in which the monocular visual pathways are more sensitive to spatial displacements than the binocular pathways. PMID- 3660641 TI - Moving contexts do affect the perceived direction of apparent motion in motion competition displays. AB - Three experiments were performed to test Ullman's [The Interpretation of Visual Motion. MIT Press, Cambridge, Mass. (1979)] independence hypothesis, used in the minimal mapping theory of motion correspondence. Subjects were required to detect the direction of motion (left vs right) of an element in a motion competition display. In control conditions, threshold interelement distances were obtained for this task in the absence of any moving context. In experimental conditions, context elements that moved either to the left or to the right were added to the display. This resulted in changes in thresholds (relative to the control condition) that indicated that a context moving in one direction increased the probability of seeing the competition element move in the same direction. The magnitude of the context effect was shown to be related to the proximity of the context to the competition display, as well as to the number of elements in the context. These results are in conflict with Ullman's independence hypothesis. An alternative model of the motion correspondence process, which uses information about interdependencies between element movements, is briefly discussed. PMID- 3660642 TI - Human gaze stability in the horizontal, vertical and torsional direction during voluntary head movements, evaluated with a three-dimensional scleral induction coil technique. AB - The stability of gaze in three dimensions (horizontal, vertical and torsion) was measured with a new type of scleral search coil in eight emmetropic observers. Subjects held the head still or oscillated it at 0.16-0.67 Hz (amplitude about 10 deg) in the horizontal, vertical or torsional plane while fixating a point target at optical infinity. Veridical gaze and head coordinates were calculated with full correction for non-linear goniometric relations and for cross-coupling artifacts due to misalignments of the coil on the eye. The amount of gaze instability in the horizontal and vertical direction was virtually identical. With the head still, in either of these directions the mean standard deviation of gaze position (inclusive saccades) was about 7 min arc; mean non-saccadic retinal image speeds were 20-30 min arc/sec. During head oscillation these values increased to about 16 min arc and 1 deg/sec; a mean of about 2.5% of the head motion remained uncorrected by the compensatory eye movements. These findings agree well with our earlier results for the horizontal plane; the effect of the corrections was relatively small because the adventitious cross-coupling of horizontal and vertical to torsional head movements proved to be usually smaller than 10%. However, the corrections were important when head torsion was deliberately produced. Gaze stability in the torsional plane was considerably inferior to that in the horizontal and vertical plane. With the head held still, the mean SD of torsional gaze position was about 17 min arc; mean torsional non saccadic retinal image speed was about 46 min arc/sec. Gain of the torsional compensatory eye movements was frequency dependent and rose from about 0.26 in static conditions (0 Hz) to about 0.42 at 0.16 Hz and 0.64 at 0.67 Hz. Accordingly, position instability and speed of the retinal image in torsion were about an order of magnitude larger than in the horizontal and vertical direction. PMID- 3660643 TI - Spatial influences on colour opponent contributions to pattern detection. AB - The contribution of colour opponent mechanisms to detection thresholds is investigated at different spatial frequencies by presenting monochromatic, sinusoidal gratings on a uniform white background. Colour opponent mechanisms, characterised by a triple peaked spectral sensitivity function, determine threshold at low spatial frequencies (below 1 c/deg) and their contribution flattens the Weber function. They display low pass spatial frequency characteristics, becoming relatively more sensitive than non-opponent mechanisms as spatial frequency decreases. Colour opponent contributions are not revealed when the test grating and background are presented dichoptically. PMID- 3660644 TI - Stereoscopic contours and optokinetic nystagmus in normal and stereoblind subjects. AB - Moving stereoscopic contours in a dynamic random-dot stereogram have been previously shown to induce optokinetic nystagmus in subjects with normal stereopsis. For this to be validated as an objective test of stereopsis, stereoblind subjects must also be shown not to develop OKN, especially since it has been shown that the optomotor system of stereoblind individuals retains sensitivity to some cyclopean stimuli. In this report we verify that stereoblind subjects do not have an optomotor response to stereoscopic contours--regardless of the alignment angle at which the stereo image pair is presented. PMID- 3660645 TI - Isolation of opponent-colour mechanisms at increment threshold. AB - An experimental examination was made of some paradigms designed to isolate the opponent-colour system at increment threshold. The effectiveness of a uniform white conditioning field spatially coincident with a 1.05-deg uniform test field was assessed by measuring intensity thresholds for simple detection and for colour discrimination. Values were obtained both by a method of adjustment and by a two-interval forced-choice procedure. For sufficiently high luminances of the conditioning field (3000 td or greater) little or no difference was found between simple-detection and colour-discrimination thresholds over the critical test flash spectral range 520-620 nm, implying that the paradigm produced almost complete isolation of the opponent-colour system at increment threshold. A control experiment in which thresholds were obtained for a conditioning field larger than the test field gave less satisfactory isolation; near 580 nm the luminance system was found to be at least 0.3 log unit more sensitive than the opponent-colour system. A comparison was also made of the spatially coincident field paradigm with a paradigm in which a modified test stimulus of low temporal and spatial frequency content was presented on a large conditioning field. Test spectral sensitivity curves for simple detection obtained by a method of adjustment showed little difference in effectiveness in opponent-colour isolation. PMID- 3660646 TI - Statistical efficiency for the detection of visual noise. AB - Visual detection thresholds were measured for one-dimensional static noise patterns centered at 2 c/deg on a logarithmic scale, for several widths and spatial frequency bandwidths in the presence and absence of a one-dimensional dynamic visual noise mask. Human performance was compared with the ideal observer's performance for the same task. The ideal's contrast thresholds increase with the fourth root of bandwidth. For thresholds measured in the presence and absence of noise, the fourth-root-law for bandwidth fitted the human observers' data from 1 to 6 octaves for a space constant of 2 degrees and from 2 to 6 octaves for a space constant of 0.25 degree. Detection efficiencies were quite high (30-60%) for patterns of 1- and 6-octave bandwidths. These results can be interpreted either in terms of a channel with an adjustable spatial frequency bandwidth or as very efficient combination of information between spatial frequency channels. PMID- 3660647 TI - Saturation of the tilt aftereffect. AB - The tilt aftereffect increases as a logarithmic function of adapting time, reaches saturation after approx 1 hr and decays on a symmetric, logarithmic time course. This is similar to the time-course of contrast threshold elevation, suggesting that threshold and suprathreshold aftereffects are based on similar type of adaptation processes. PMID- 3660648 TI - Visual resolution and sensitivity in a nocturnal primate (galago) measured with visual evoked potentials. AB - Visual resolution and contrast sensitivity were examined in anesthetized, paralyzed galagos using visual evoked potentials (VEPs) resulting from stimulation with phase-reversed sinewave gratings. Spatial frequency vs contrast response functions were band-pass with peak sensitivity at 0.2-0.4 c/deg and a high frequency cut-off between 1.6 and 3 c/deg. Peak contrast sensitivities (estimated from extrapolation of contrast response functions) varied across animals from 10 to 170. Variation of the stimulus modulation rate showed that best responses occurred at 1 Hz with an upper limit of 6-16 Hz. As in other primates, an oblique effect was seen in 6 of 8 animals. The contrast sensitivity function (CSF) determined from cortical VEPs agrees well with the CSFs of cells in the lateral geniculate nucleus, but peak sensitivity and spatial frequency are slightly lower than found for the behavioral CSF. Overall visual performance resembled closely that of another nocturnal species, the cat. PMID- 3660649 TI - Simulation of responses of spectrally-opponent neurones in the macaque lateral geniculate nucleus to chromatic and achromatic light stimuli. AB - The responses of spectrally opponent, parvocellular-layer cells in the lateral geniculate nucleus of the macaque vary with stimulation along all three dimensions of colour space (luminance, dominant wavelength and purity). Here, the responses of different cell types to light stimuli successively replacing a white adaptation field are simulated mathematically by a simple model using known cone spectral sensitivities. Hyperbolic response functions with two adjustable parameters relate cone excitation with the output signals of each cone mechanism. For the majority of cells, differences of outputs of two cone mechanisms, receiving inputs from L- and M-cones, describe responses to chromatic and achromatic stimuli. For each opponent combination of cone inputs, either L-M or M L, two cell types were found. Off-centre cells had lower maximum firing rates of their on-component, but were the more sensitive of the two groups, preferring dark colours, whereas on-centre cells showed better responsiveness to brighter stimuli. For all four cell types, the predictions of the equations replicated well the responses measured to stimuli varying along all three dimensions of colour space. The quantification of cell responses presented here provides possibilities for studying suprathreshold coding of colour and lightness, and the model can help to link physiology with the psychophysics of colour vision. PMID- 3660650 TI - Effect of pattern luminance profile on the pattern ERG in man and pigeon. AB - Pattern electroretinograms (PERGs) have been recorded in man and pigeon using phase reversing patterns. Studies were made in both species of the effect of grating spatial frequency, grating profile (sine or square) or the size of the squares of a checkerboard on the amplitude of the responses. The results obtained in the two species were similar. In general, the ratio of the amplitudes of the sine wave:square wave responses is that predicted by the Fourier fundamentals of the pattern, and is thus not determined by changes in local luminance or contrast as it is normally defined. Checks however gave larger responses than sine or square wave profile bars matched to the Fourier fundamental on the diagonal. The results are not explicable in terms of any single stimulus parameter and suggest that the PERG generator has a degree of center/surround organisation similar to retinal ganglion cells. It is however argued that, because of the known physiological properties, generators cannot be unequivocally localised by varying the stimulus or comparing retinal, cortical and perceptual response dynamics. PMID- 3660651 TI - The topography of scalp potentials evoked by pattern pulse stimuli. AB - Pattern pulse stimuli evoke activity in two distinct regions of the human visual cortex in temporal sequence. The earlier responding region (implicit time 93 msec) is localized to a relatively small region near Oz. Its topography is very sensitive to the position of the evoking stimulus in the visual field; it is dominated by a representation of the visual field near the vertical meridian. The later responding cortical region (implicit time 131 msec) is larger than the earlier one. Its medial border touches the lateral border of the earlier responding cortical region and it extends several cm laterally. Its topography is much less sensitive to the position of the evoking stimulus in the visual field. Stimuli presented to the ipsilateral field evoke either weak or no measurable activity in the earlier responding cortical region but often evoke measurable activity near the lateral boundary of the later responding cortical region. These results suggest that the earlier responding cortical region is striate cortex and that the later responding cortical region is composed of visual areas V2, V3, V3A, and V4. PMID- 3660652 TI - Changes in visual sensitivity with age in rats with heredity retinal degeneration. AB - Hereditary retinal degeneration in the Royal College of Surgeons (RCS) strain of rat has been shown to produce extensive loss of photoreceptors and a corresponding decline of the electroretinogram, ganglion cell sensitivity, and the sensitivity of the pupillary light reflex. The behaviorally measured thresholds of RCS rats, on the other hand, are reported to be comparable to those for age-matched controls. We report here, that our own behavioral measurements show a clear difference between RCS rats and age-matched controls between four to twelve months of age. The difference in thresholds between RCS and control rats is about three long units at four months of age, and this difference progressively increases until at twelve months, we measure threshold differences of over seven log units. PMID- 3660653 TI - On and off systems in human vision. AB - Three experiments examined the interaction of On and Off responses that were produced by sudden increments and decrements in luminance. All three experiments utilized a masking technique that required observers to detect a signal in a masking field. The mask was produced by brightening or dimming a field of dots, and the signal consisted of the addition or subtraction of a dot. Experiment 1 showed that detection of the signal-dot was more difficult when the luminance of the signal and the mask changed in the same direction (e.g. a new dot added to the field of dots that were being brightened) than when luminance changed in different directions. When the amplitude of signal and mask was varied parametrically (Experiments 2 and 3), accuracy increased with the ratio of amplitudes of signal and mask. But at any given ratio, the signal was more difficult to detect when signal and mask were of the same sign. The greater difficulty encountered in detecting a signal in the context of a "like" mask is ascribed to greater interference between signal and mask when they share the channel. PMID- 3660654 TI - A direct test of Listing's law--I. Human ocular torsion measured in static tertiary positions. AB - The validity of Listing's law was reinvestigated by means of a direct test. Horizontal, vertical and torsional eye movements were measured simultaneously with a recently developed scleral induction coil. Either eye of 4 subjects was measured monocularly. Eye position were measured in Fick coordinates and ocular torsion values were compared to the theoretical ones predicted by Listing's law. During consecutive measurements in the primary position torsion values were close to zero although considerable fluctuations of torsion were seen. Torsion values in the secondary positions were also close to zero. In the tertiary positions torsion in the direction as predicted by Listing's law and increasing with eccentricity was recorded. In the temporal quadrants mean torsion was quantitatively in agreement with Listing's law; torsion values in the nasal quadrants however showed systematically larger values and this discrepancy increased with eccentricity to more than 50%. Statistical support for this finding however, was seen only in 4 out of 8 eyes. Symmetry could be obtained by shifting the chosen horizontal primary position (gaze parallel to the midplane) in the temporal direction; as a consequence all measured torsion values would exceed the ones specified by Listing's law. Torsion values varied idiosyncratically among subjects and among the left and right eyes of any one subject. It is concluded that Listing's law specifies ocular torsion only approximately: physiological eye movements show considerable stochastical as well as systematical deviations from this law. PMID- 3660655 TI - A direct test of Listing's law--II. Human ocular torsion measured under dynamic conditions. AB - Ocular torsion was recorded with a scleral search coil technique in five normal subjects. The dynamic aspects of torsion were investigated during monocular fixation, blinking, smooth pursuit and saccades. Torsion near the primary position showed considerable short-term (SD about 0.25 deg) and a much larger long-term fluctuation (SD about 2.3 deg). During saccades between diagonally opposite tertiary positions torsion transiently reached values approximating those in the sustained primary position. During smooth pursuit across the primary position, the minimal values of torsion varied with the direction and the trajectory of pursuit, in violation of Donder's law. Changes in torsion associated with horizontal and vertical saccades and during the aftermath of blinks often had a sluggish, exponential time course. During eye movements around a circular or square trajectory torsion showed hysteresis. During clockwise pursuit the right eye showed relative intorsion compared to counterclockwise pursuit. It is proposed that central nervous control of torsion is usually imprecise, and that the eye follows Listing's and Donder's laws only approximately. PMID- 3660656 TI - Direction-specific improvement in motion discrimination. AB - With training, an observer's ability to discriminate similar directions of motion gradually improves. A series of studies reveals that this improvement, (1) is restricted to the trained direction and other, similar directions, (2) persists for at least several months, (4) shows appreciable, but not complete, transfer between the two eyes, and (5) is largely restricted to the stimulated region of the field. Moreover, the improvement in direction discrimination does not produce a concomitant change in detection thresholds. In all likelihood, most of the improvement in direction discrimination represents a change in visual function, rather than changes in nonsensory processes. PMID- 3660657 TI - Perceptual "blankout" of monocular homogeneous fields (Ganzfelder) is prevented with binocular viewing. AB - The loss of visual perception or "blankout" which occurs when a homogeneous field (Ganzfeld) is presented monocularly is prevented when the same field is viewed binocularly. Thus, blankout cannot be retinal; and contours or transients in time and space are unnecessary for the continuous maintenance of visual perception. Experiments are reported in which blankout ensues only if the two eyes receive luminance disparities ca 0.75 log I. Furthermore, blankout is only marginally affected by stimulus intensity, nor is it dependent on stimulus hue. However, equally luminant but disparate hues presented to the two eyes produce perceptions reminiscent of blankout, with the darkness of blankout replaced with that of color. It is hypothesized that the underlying mechanisms have a commonality in the phenomena of blankout and binocular rivalry but several noncongruent features require explanation. PMID- 3660658 TI - Sensitivity of smooth eye movement to small differences in target velocity. AB - The precision of smooth pursuit eye movements was described by means of a new dependent measure, the "oculomotor difference threshold" (analogous to the perceptual difference threshold) which represents the smallest difference in target velocity that produces statistically distinguishable differences in eye velocity. Oculomotor difference thresholds for constant velocity motions were largest (greater than 50% of target velocity) during the initial 200 msec of target motion, despite fairly high average gains (0.7-1.4) during the same period. Oculomotor difference thresholds declined over time. By about 600-700 msec after the onset of target motion they reached values as low as the perceptual difference thresholds measured psychophysically with the same target velocities. The similarity of the difference thresholds suggests that equally precise sensory representations of target velocity influenced perception and smooth eye movements. Nonsensory influences on smooth eye movement were also found. Smooth pursuit velocity: (1) depended on the velocity of targets in preceding trials; (2) was decreased during the initial 200 msec of target motion when the duration of motion was reduced from 1 sec to 200 msec, a result which shows that high initial pursuit velocity depends on the expectation that pursuit will continue. These effects of context and expected duration allowed the eye to achieve quickly a velocity close to that of the target it was most likely to encounter. Study of the precision of pursuit may be valuable for characterizing its sensory input, but study of the effects of the context in which a stimulus appears and the effects of expectations about future target motion may be more valuable for understanding how smooth eye movements guarantee retinal image velocities optimal for vision. PMID- 3660659 TI - A multichannel microspectrophotometer for visual pigment investigations. AB - The microspectrophotometer described replaces the photomultiplier of conventional scanning systems with a multichannel detector. By eliminating scanning-related artifacts, particularly those associated with mechanical vibrations, this system makes possible ship-based microspectrophotometric studies of visual pigments of marine organisms too fragile for live transport to shore-based laboratories. The performance of the multichannel microspectrophotometer is compared with that of conventional scanning systems and absorbance spectra taken at sea on isolated rhabdoms from Euphausia pacifica are presented. Difference spectra gave a lambda max for rhodopsin of 483 nm and a lambda max for metarhodopsin of 489 nm. PMID- 3660660 TI - Isolation and characterization of a retinal-binding protein from the squid retina. AB - A retinal-binding protein (RALBP) was isolated from the squid retina, and purified by anion-exchange and size-exclusion chromatography. The molecular weight was determined to be 51,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and by gel filtration. The purified sample showed absorption maxima at about 330 and 400 nm in addition to a protein band, indicating the occurrence of retinol and retinal, respectively. The relative heights of these two peaks varied from preparation to preparation, depending on retinoid ligands. Irradiation of RALBP caused no marked change in absorption, but the amount of 11 cis-retinal decreased to form a photosteady state mixture with all-trans- and 13 cis-retinals. RALBP was fairly stable even in the presence of hydroxylamine (100 mM), but was affected by sodium borohydride (30 mM) or borane dimethylamine (400 mM), with the retinal reduced to retinol. When incubated with metaretinochrome carrying membranes in the dark, RALBP specifically took up 11-cis-retinal and lost all-trans-retinol. Upon further incubation of this RALBP with opsin containing membranes, rhodopsin was progressively formed in the dark. Squid RALBP may act as a shuttle in transferring the 11-cis-retinal from metaretinochrome to opsin in the visual cells. PMID- 3660661 TI - Displaced amacrine cells in the ganglion cell layer of the hamster retina. AB - Neuronal populations were estimated in the ganglion cell layer (GCL) of the adult hamster retina. The total number of neurones averaged 128,000 in Nissl-stained whole-mounts. Following injections of horseradish peroxidase into the brain, an average of 72,000 cells were labeled (mostly above 8 micron in diameter), indicating that 56% of the neurones in the GCL are ganglion cells. Forty-one percent of the neurones (mostly below 8 micron diameter) of the GCL survived for 5 months after optic nerve transection at 12 days after birth. The results indicate that more than 40% of the neurones in the GCL of the hamster retina are displaced amacrine cells. PMID- 3660662 TI - Macular pigment and reduced foveal short-wavelength sensitivity in retinitis pigmentosa. AB - Some patients with retinitis pigmentosa (RP) show a reduced foveal short wavelength sensitivity that cannot be attributed to a reduction in the sensitivity of the short-wavelength cone system. To determine whether an increased amount of macular pigment (xanthophyll) might account for this finding, we derived estimates of the two-way optical density of the macular pigment of five such RP patients as well as of five normals. The spectral reflectance of the foveal region of each subject was obtained from digitized images of the bleached fundus provided by a television-based reflectometer. The density spectra of the macular pigment, melanin, and oxygenated hemoglobin were fit by a least-squares procedure to the log of the ratio of parafoveal to foveal spectral reflectance in order to obtain a quantitative estimate of the contribution of each of these ocular pigments to foveal short-wavelength reflectance. By this analysis, the two way densities of the macular pigment, melanin, and oxyhemoglobin of the RP patients were not significantly different from those of the normals. Therefore, the reduced foveal short-wavelength sensitivity of these patients was not due to an increased amount of macular pigment, but may result instead from morphological abnormalities in the foveal cones such that a normal amount of macular pigment screens the cones more effectively. PMID- 3660663 TI - Interactions between the rod and the cone pathways in the cat retina. AB - The receptive field centers of 21 on-center X retinal ganglion cells in cat were tested with stimuli designed to detect nonlinear interactions between the rod and the cone systems. One red and one green stimulus light were always present, at a level such that modulation of the red light essentially affected only cones, and that of the green light only rods. The two lights could be superimposed spatially (overlapped configuration) or fall on separate subareas of the receptive field center (nonoverlapped configuration). In most cases, there was less complete summation of the responses to modulation of the lights in the overlapped than in the nonoverlapped configuration, with a corresponding difference in the summation of sensitivities. In 1/6 of the experiments, there was more complete summation of the responses to the lights in the overlapped configuration, with a corresponding difference in the summation of sensitivities. The mean magnitude of the interaction for all experiments was equivalent to an antagonistic interaction between the rod and cone pathways such that the signal in each was diminished by a quantity slightly greater than 30% of the signal in the other. PMID- 3660664 TI - Dependence of cone b-wave implicit time on rod amplitude in retinitis pigmentosa. AB - Computer-averaged full-field rod and cone electroretinograms (ERGs) were evaluated in 63 patients with retinitis pigmentosa and 116 normal subjects. Cone b-wave implicit times to 30 Hz white flicker and to 1.0 Hz white flashes on a white background were both inversely proportional to the log amplitude of the dark-adapted rod b-wave, even when controlling for the log amplitude of the dark adapted cone b-wave. Cone ERGs were also obtained from a subset of 12 patients with retinitis pigmentosa in the presence of photopically-matched red and blue backgrounds that allowed direct assessment of the effect of rod function on cone b-wave implicit time in the patients. The effectiveness of the blue background in reducing cone b-wave implicit time relative to that obtained with the red background varied with the amplitude of the rod ERG. The results of both experiments suggest that delays in cone b-wave implicit time obtained with 30 Hz white flicker or with background adaptation in patients with retinitis pigmentosa are due, at least in part, to rod disease. PMID- 3660665 TI - Chromatic suppression of cone inputs to the luminance flicker mechanism. AB - Eisner and MacLeod [J. opt. Soc. Am. 71, 705-718 (1981)] showed that intense green and red chromatic adapting fields may suppress respectively the M and L cone input to the luminance mechanism by a factor considerably greater than Weber's law. We obtained evidence for such chromatic suppression by measuring complete detection contours for different ratios of red and green test lights presented in rapid flicker in the center of a uniform field. The detection contours represent thresholds as the quantal modulation of the M and L cones normalized by the quantal catch owing to the field. Luminance flicker mechanisms were identified by sections of the contours where detection was controlled by a linear sum of the M and L cone test signals. The slope of these sections indicated that intense red fields selectively suppressed the L cone input to the luminance mechanism by a factor greater than Weber's law; evidence was much less firm for an analogous suppression of the M cone input by intense green fields. The shape of the detection contours also suggests that intense red fields, which differentially light-adapt the M and L cones, may produce a moderate temporal phase-shift between the M and L cone signals. The shape of the temporal MTF of the M cone and the L cone input to the luminance mechanism may be determined at the cone stage, with the absolute sensitivity (vertical scaling) being partially dependent on selective chromatic suppression of the cone inputs owing to the intense chromatic field. Luminance and red-green chromatic temporal sensitivity functions are presented in terms of the M and L cone quantal modulations. Chromatic sensitivity progressively rises above luminance sensitivity as temporal frequency is gradually lowered below 15 Hz, with the consequence that 'contrast sensitivity' may be much higher for color than for luminance. PMID- 3660666 TI - Developmental aspects of experimental myopia in chicks: susceptibility, recovery and relation to emmetropization. AB - Chicks deprived of form-vision in the lateral part of their visual fields become severely myopic largely because of elongation of the vitreous chamber. The myopia mostly affects the visually deprived nasal retina; the nondeprived temporal retina is unaffected. These changes occur most rapidly early in life, being evident then after only 3 days of visual restriction. The susceptibility declines with age, being proportional to the rate of increase of axial length. Recovery from this myopia occurs if the visual restriction is removed during the first 6 weeks of life, as a result of the cessation of elongation of the vitreous chamber. The rate of recovery is directly related to the degree of myopia and inversely related to age. The pattern of changes in refractive status and variability argue for the probable existence of an active mechanism regulating eye growth in a manner dependent on refractive error, thereby producing emmetropization. PMID- 3660667 TI - Psychophysics of reading--V. The role of contrast in normal vision. AB - How does contrast affect reading rate? What is the role of contrast sensitivity? We measured reading rate as a function of the contrast and character size of text for subjects with normal vision. Reading rates were highest (about 350 words/min) for letters ranging in size from 0.25 degree to 2 degrees. Within this range, reading was very tolerant to contrast reduction--for 1 degree letters, reading rate decreased by less than a factor of two for a tenfold reduction in contrast. The results were very similar for white-on-black and black-on-white text. Reading rate declined more rapidly for very small (less than 0.25 degree) and very large (greater than 2 degrees) letters. People with low vision usually require large characters to read, so high contrast is particularly important for them. Taking 35 words/min to be a threshold for reading, we constructed a contrast-sensitivity function (CSF) for reading. We were able to relate the shape of this CSF to the shape of sine-wave grating CSFs. PMID- 3660668 TI - The effect of optical degradation on the contrast sensitivity function measured at the fovea and in the periphery. AB - Contrast sensitivity functions (CSF's) were measured for a zone of 0.5 degree angular radius at the fovea and for annular zones extending from 0.5 degrees eccentricity to 1 degree, from 1 to 2 degrees and from 2 to 4 degrees. The effect of optical degradation was taken into account by the application of a correction factor determined from the Modulation Transfer Function (MTF). Using the reciprocal of the peak of the CSF [1/SF (max)] as a parameter, the effect of applying the MTF correction on the CSF with eccentricity was determined. The effect of applying an MTF correction is significantly to increase the rate of change of 1/SF (max) with eccentricity. Since it has been reported that hyperacuity is relatively unaffected by optical degradation, it is proposed that the differing effects of optical degradation between grating acuity and hyperacuity may account, at least partially, for the different rates of decline of these thresholds with eccentricity. The implications of this proposal for M scaling theories and strategies are considered. PMID- 3660669 TI - Temporal integration in human vision and the opponent-color systems. AB - The present study demonstrated that the temporal integration time (t.i.t.) could be prolonged even if the background energy was increased, provided that the background consisted of the colors opponent to each other. This was found, more or less, irrespective of the test stimulus size. These results suggest that the t.i.t. is not determined solely at receptor sites in the visual system, but that the chromatically-opponent systems are heavily involved. Mechanisms based upon a two-sites adaptation with one detection pathway model were briefly discussed. PMID- 3660670 TI - Color-opponent characteristics revealed in temporal integration time. AB - The critical durations for temporal integration at threshold were obtained for lights of various wavelengths, presented both against darkness and against achromatic or chromatic backgrounds of different luminances. The critical duration (tc) was defined by a point of intersection of the two lines with the slopes of zero and unity in a log I.t-t plot, fitted by means of an algorithm implemented by computer program. tc was short for the lights of middle wavelengths, longer for the lights at the ends of the spectrum, and became shorter as the background luminance increased. tc also depended on the background wavelength, generally showing color-opponent characteristics when the difference was taken between tc's for the chromatic background and those for the achromatic one. The results were interpreted as the manifestation of chromatically-opponent system activities in temporal integration. PMID- 3660671 TI - Zero horizontal disparity in binocular depth mixture stimuli. PMID- 3660672 TI - Detailed diagnoses and procedures for patients discharged from short-stay hospitals. United States, 1985. PMID- 3660673 TI - [Hemodynamics in isolated pulmonary stenosis in adults]. PMID- 3660674 TI - [Depression of the ST segment in thoracic leads in acute inferoposterior myocardial infarct]. PMID- 3660675 TI - [Significance of ambulatory ECG monitoring in the evaluation of ectopic ventricular activity]. PMID- 3660676 TI - [Antithrombin III in patients with acute myocardial infarct in relation to fibrinolytic therapy]. PMID- 3660677 TI - [Biopsy diagnosis of the leukemization of malignant lymphomas]. PMID- 3660678 TI - [Combined chemotherapy in advanced stages of chronic lymphatic leukemia]. PMID- 3660679 TI - [Cardiac autonomic neuropathy in type I diabetics]. PMID- 3660680 TI - [Evaluation of the melliPHAN diagnostic strip for the visual determination of blood glucose]. PMID- 3660681 TI - [Acquired Pelger-Huet anomaly in a patient with malignant lymphogranuloma]. PMID- 3660682 TI - [Difficulties in the diagnosis of Crohn's disease with rectal involvement]. PMID- 3660683 TI - [Cor triatriatum]. PMID- 3660684 TI - [Gaucher's disease with paraproteinemia]. PMID- 3660685 TI - [Electrophysiology of cardiac rhythm disorders. V. ECG analysis in arrhythmia]. PMID- 3660686 TI - [Indicators of hemocoagulation in heparinized blood]. PMID- 3660687 TI - [Hypertension in the Slovak population--results and observations in the cardiovascular program]. PMID- 3660688 TI - [New findings about the etiopathogenesis of essential hypertension]. PMID- 3660689 TI - [Clinico-pharmacologic possibilities of theophylline therapy]. PMID- 3660690 TI - [Use of the post-loading systolic blood pressure response in the diagnosis of ischemic heart disease]. PMID- 3660691 TI - [Probability analysis of the results of a noninvasive examination of patients with suspected ischemic heart disease]. PMID- 3660692 TI - [Incidence of HBsAg carriers, anti-HTLV III and the AIDS problem in Malta 1985 86. Report of the experience of an expert from the transfusion service]. PMID- 3660693 TI - [The Rotterdamm Thoraxcenter--the epitome of modern cardiology. I]. PMID- 3660694 TI - [Changes in the contractility of the left ventricle in patients with dilated cardiomyopathy]. PMID- 3660695 TI - [Incidence and prognosis of pericardial effusion in patients with acute myocardial infarct--echocardiographic study]. PMID- 3660696 TI - [Long-term results of thrombolytic therapy in acute myocardial infarct]. PMID- 3660697 TI - [Electrophysiologic characteristics of refractory paroxysmal atrial flutter]. PMID- 3660698 TI - [Infectious complications of intravenous catheterization]. PMID- 3660699 TI - [The effect of dialysis on indicators of pulmonary function]. PMID- 3660700 TI - [The importance of determining iron in anemia in the aged]. PMID- 3660701 TI - [Infectious complications in malignant hematopoietic diseases under an incompletely protective regimen]. PMID- 3660702 TI - [Abnormal hemoglobins in foreign students]. PMID- 3660704 TI - [The Rotterdam Thoraxcentrum--the epitome of modern cardiology. II]. PMID- 3660703 TI - [Successful completion of pregnancy in a patient with the recurrent type of thrombotic thrombocytopenic purpura]. PMID- 3660705 TI - [The shaping of intelligent human needs: the sociomedical aspects]. PMID- 3660706 TI - [Increased effectiveness of the primary specialization of ship's physicians in surgery]. PMID- 3660707 TI - [The brigade form of organizing and encouraging work in a military district hospital]. PMID- 3660708 TI - [Biorhythmological principles for the long-range prediction of monthly fluctuations in the blood leukocyte count of healthy persons (2.)]. PMID- 3660709 TI - [Current problems in the development of laboratory studies in the Army and Navy]. PMID- 3660710 TI - [The late sequelae of battle wounds of the lungs]. PMID- 3660711 TI - [Antimicrobial linen as a means of preventing pyodermitis (a review of the literature)]. PMID- 3660712 TI - [Psychophysiological principles of setting work standards during flight instruction]. PMID- 3660713 TI - [Experience in rendering dental care to patients before and during a cruise]. PMID- 3660714 TI - [The anxiety level of patients with severe mechanical injuries]. PMID- 3660715 TI - [Modern possibilities in the x-ray diagnosis of foreign bodies]. PMID- 3660716 TI - [Prevention of prostatic diseases]. PMID- 3660717 TI - [Dispensary care of servicemen from distant garrisons in the dental polyclinic]. PMID- 3660718 TI - [Effectiveness of treating hypertension by dispensary observation]. PMID- 3660719 TI - [Drug-induced lesion of the liver]. PMID- 3660721 TI - [Alcoholism in adolescence and youth]. PMID- 3660720 TI - [Means for the rational use of disinfecting agents]. PMID- 3660722 TI - [Screw pin-based multiplanar compression-distraction apparatus]. PMID- 3660723 TI - [Soft immobilization bandage for the upper extremity]. PMID- 3660724 TI - [Modification of the otoscope, Politzer's bag and the electrovibromassage tube for the diagnosis and treatment of ear diseases]. PMID- 3660725 TI - [A method for the temporary closure of a small intestine fistula]. PMID- 3660726 TI - [Determination of circulating immune complexes using a chemical reagent kit]. PMID- 3660727 TI - [Pipette-siphon for standard sera]. PMID- 3660728 TI - [Scientific and medical creativity of young military physicians (1)]. PMID- 3660729 TI - [Complex-formation with hyaluronic acid as a cause of fibronectin heterogeneity in the synovial fluid]. AB - Heterogeneity of synovial fluid fibronectin was studied by means of Laurell cross immunoelectrophoresis in patients with rheumatoid arthritis, posttraumatic synovitis and other arthropathies. Prior to hyaluronidase treatment all the synovial fluid samples exhibited the fibronectin heterogeneity, which disappeared after the action of hyaluronidase. The data obtained suggest that complexes of fibronectin and hyaluronic acid are responsible for physico-chemical heterogeneity of fibronectin in synovial fluid. PMID- 3660730 TI - [Mechanism of activation of the kallikrein-kinin system in human plasma in stomach and duodenal ulcer]. AB - Activity of kallikrein and content of prekallikrein were studied in blood serum of patients with gastroduodenal ulcer accompanied (or not accompanied) by hemorrhage. The rate of the kallikrein-kinin system activation was higher under conditions of the disease complicated by hemorrhage. Extracts of bioptic samples obtained from ulcerous zones as well as the extracts of leukocytes were shown to activate prekallikrein and Hageman factor in human blood plasma. At the same time, the activating effect of these extracts was distinctly lowered in the ulcer accompanied by hemorrhage. The phenomenon observed might occur due to high intensity of polymorphonuclear leukocytes degranulation during hemorrhage in the ulcer area. PMID- 3660731 TI - [Membrane-stabilizing effect of alpha-tocopherol in acute stress]. PMID- 3660733 TI - [Effective method of isolating an acid-stable protease inhibitor from human urine]. AB - A modification is described of the previously developed procedure for isolation of acid stable proteinase inhibitor (ASI) from urine of patients with nephritis. The modified procedure enabled to increase the yield of the inhibitor and to obtain its highly purified preparations. These preparations possessed a property to inhibit effectively the activity of human granulocyte elastase (ki = 10(4) M-1 min-1). The modified procedure is based on affinity chromatography on chymotrypsin-Sepharose 4B, substitution of dialysis by gel filtration on Sephadex G-25, use of alternative methods for concentration of protein fractions instead of membrane ultrafiltration and chromatography on polyamide for ASI depigmentation. The inhibitor yield amounted up to 75% of the initial activity in urine. The possibilities of the human urine ASI use in medical practice are discussed. PMID- 3660732 TI - [Metabolic pool of purine and pyrimidine derivatives in the palatine tonsil of patients with chronic tonsillitis]. AB - Tonsils from 10 patients (18-40 years old), with chronic tonsillitis were studied by means of histological methods as well as by high pressure liquid chromatography. In 5 patients with decompensated forms of the disease, accompanied by heart impairments during 1-3 years, only slight alterations in epithelial and follicular parts of tonsils were observed, while pronounced destruction of tonsil cells was detected in other 5 patients suffering from repeated anginas. The following purine and pyrimidine derivatives were identified in faucial tonsil tissue of all the patients with chronic tonsillitis studied: adenine, guanine, adenosine, guanosine, inosine and uridine. Distinct increase in content of these derivatives as well as occurrence of xanthine and uric acid (non identified in the first group of patients with chronic tonsillitis) was noted in the patients with maximal destruction of faucial tonsil cells. PMID- 3660734 TI - [A method of isoelectric focusing in a borate-polyol system with pH gradient of 4.0 to 5.6 in a thin layer of polyacrylamide gel]. AB - A procedure is described for thin-layer polyacrylamide gel isoelectric focusing involving borate-polyol system with gradient pH 4.0-5.6, where 0.5 M H3BO3-Tris was used as an electrode buffer. Riboflavin, TEMED, Tris-borate buffer and glycerol were used in preparation of gradient pH, which was stable and did not alter during the electrophoresis. Blood serum proteins, particularly blood serum albumin, from patients with diabetes were studied using the isoelectric focusing procedure. After isoelectrofocusing of blood serum albumin from patients with diabetes additional minor acid fractions of the protein were detected at pH 4.3 4.6. The procedure of electrophoresis in gradient pH 4.0-5.6 was highly effective and might be used in biochemical laboratories. PMID- 3660736 TI - [Study of rat liver mitochondrial proteins by two-dimensional electrophoresis]. AB - About 50 protein fractions with molecular mass 15-158 kDa were detected in purified mitochondria isolated from rat liver homogenate after two-dimensional electrophoresis performed as described by O'Farrell. Individual spots, corresponding to proteins of inner mitochondrial membrane, disappeared from electrophoregrams as a result of incubation of the isolated mitochondria at 37 degrees and pH 7.5. Degradation of these proteins was augmented if ATP was added into incubation mixtures. Intrinsic proteolytic activity occurred in rat liver mitochondria as shown by these and previously obtained data. PMID- 3660735 TI - [The role of cell membrane damage in the development of hormone-resistant kidney diseases in children]. AB - Distinct increase in content of lysophosphatidyl choline, dehydrocholesterol, decrease in concentration of phosphatidyl ethanolamine simultaneously with high level of diene conjugates and Schiff bases were found in children with hormone resistant form of nephrotic glomerulonephritis as compared with children suffering from a hormone-dependent form of the disease. Peroxidation of membrane lipids appears to cause a destabilization of cell membranes, which is responsible for development of hormone-resistance. PMID- 3660737 TI - [The state of energy metabolism in the rat liver after a single acute hemorrhage]. AB - A system of adenine nucleotides and redox state of liver cells as well as activities of dehydrogenases of the tricarbonic acid cycle and of cytochrome oxidase in liver cell homogenates were not altered after an acute single hemorrhage in rats even though the process run into the step of circulation decompensation (AP 40 mm Hg). PMID- 3660738 TI - [Energy metabolism in skeletal muscles in experimental traumatic shock]. AB - Content of ATP and adenylate nucleotides was not markedly altered in rats during a traumatic shock induced by Cannon's procedure involving an impairment of skeletal muscles. Energy potential and content of creatine phosphate were only slightly decreased in these tissues, while the level of lactate and the lactate/pyruvate ratio were increased at the terminal phase. PMID- 3660739 TI - [Fucosylation of serum proteins in stomach cancer]. AB - Content of fucose and of fucosylated protein fractions was studied in blood serum of healthy donors as well as in blood serum of patients with chronic gastritis and with stomach cancer. Concentration of fucose was increased in blood serum under conditions of the tumor generalization. At the same time, content of fucosylated albumin was elevated within early steps of stomach cancer, while the content of fucosylated globulins was decreased. Estimation of albumin-bound fucose might be used in diagnosis of stomach cancer. PMID- 3660740 TI - [Amidation of blood proteins during hyperglycemia in experimental diabetes mellitus]. AB - Rates of amidation of blood serum albumin and hemoglobin was studied in hyperglycemia developed during alloxan diabetes mellitus. Content of glucose in blood of the animals with diabetes exceeded 5.2-fold its level in blood of controls; amount of glycosylated hemoglobin was increased by 41.7%. Concentration of total, readily and hardly hydrolyzed amide groups was decreased in hemoglobin of the impaired animals by 13.1%, 17.6% and 10.4%, respectively, as compared with control group. The degree of blood serum albumin amidation was not altered. Hyperglycemia, accompanied by glycosylation of proteins, was the most probable cause of accelerated deamidation of hemoglobin. Participation of the protein deamidation in pathogenesis of diabetes mellitus is discussed. PMID- 3660741 TI - [Oxidoreductase activity of peripheral blood lymphocytes of patients with herpetic keratitis]. AB - Activities of glutathione peroxidase, lactate-, malate- and glutamate dehydrogenases were decreased, while glucose-6-phosphate dehydrogenase was activated in peripheric blood lymphocytes of patients with herpetic keratitis within the acute period. Alterations in the enzymatic activity were especially distinct in herpetic ulcer of sclera as compared with other clinical forms of herpetic keratitis. As lymphocyte oxidoreductases responded distinctly to herpetic infection, estimation of their activity could be used for diagnosis, prognosis and monitoring of herpes treatment. PMID- 3660742 TI - [Biochemical indices of the differentiation of cold stress and adaptation]. AB - Monoamine oxidase, acid peptide-hydrolase activities, intensity of lipid peroxidation in brain and liver tissues, hemoglobin content in blood serum, total peroxidase activity and glucose-6-phosphate dehydrogenase activity were investigated during the cold acclimation within 1-45 days, 4 degrees. Cold stress within 1-3 days destabilized erythrocyte, lysosomal and mitochondrial membranes in the rat tissues studied. At the same time, cold adaptation within 45 days prevented the membrane labilization. PMID- 3660743 TI - [Effect of dibunol on lipid peroxidation and alpha-tocopherol levels in the rat liver in myocardial infarction]. AB - Lipid peroxidation in rat liver tissue homogenate was studied by evaluation of diene conjugates and Schiff bases content within 24 hrs after myocardium infarction. Tocopherol was estimated using spectrofluorimetric procedure. Ionol was administered intraperitoneally at a dose of 120 mg/kg within 15 min after the left coronary artery ligation. In the myocardium infarction content of diene conjugates was increased 2-fold and of Schiff bases--2.5-fold in liver tissue, while content of tocopherol was decreased 1.7-fold. Ionol prevented the increase of lipid peroxidation products and the tocopherol content decrease. This antioxidant proved to be effective drug at the initial steps of myocardium infarction as well as it exhibited the distinctly protective effect on liver tissue. The protective effect of ionol appears to occur not only due to its antioxidant properties and the ability to restrict stress reactions but also in response to rapid accumulation in liver tissue. The data obtained suggest that lipid peroxidation in liver tissue may be one of mechanisms responsible for metabolism impairment in myocardium infarction; treatment with the antioxidant ionol is the effective pathogenetic mean for correction of these disorders. PMID- 3660744 TI - [Characteristics of glycolytic enzymes during biostimulation of reparative osteogenesis]. AB - Content of hexokinase, pyruvate kinase and lactate dehydrogenase was studied in rat callus, formed in presence of commercially available preparations of placental and normal serum albumin. Total activity of all these enzymes was not similar at different stages of healing; the enzymatic activity was closely related to morpho-functional state of cellular structures in repairing zone and was dependent on their maturation. Especially pronounced changes in glycolytic enzymes activity occurred at the period of maximal proliferative activity of osteogenic cells. Placental albumin was shown to exhibit the greater stimulating effect on reparative osteogenesis as compared with the protein from blood serum. PMID- 3660745 TI - [The state of the monooxygenase enzymatic system of the rat liver in hypokinesia]. AB - Activities of amidopyrine N-demethylase, aniline hydroxylase, NADPH, cytochrome c reductase as well as content of cytochromes P-450 and b5 were studied in liver tissue of rats within 1, 3, 7, 10, 20 and 30 days of hypokinesia caused by maintaining of the animals in individual cell-cases. Both the hypokinesia and its combination with adrenalectomy were accompanied by inhibition of microsomal oxidation especially during the later steps of the experiment. At the same time, activity of microsomal enzymes was slightly increased within 1-3 days of the hypokinesia; this effect was not observed after combination of hypokinesia with adrenalectomy. Stress factor appears to be of importance within early periods of hypokinesia, whereas the hypokinesia itself acquires the major role in prolonged deprivation of free motions. PMID- 3660746 TI - [Effect of physical exercise on myoglobin and tropomyosin levels in skeletal muscles and myoglobin level in rat blood]. AB - Single intensive physical exercise caused phase alterations in content of myoglobin and tropomyosin in rat skeletal muscles. Within the first 2-4 hrs of rest concentration of myoglobin and tropomyosin was decreased in muscles by 40 50% (catabolic, urgent step of adaptation). Within the later period of rest (72 120 hrs) content of myoglobin and tropomyosin was increased by 25-30% (anabolic, later step of adaptation) as compared with the control level. Similar phase alterations of these proteins in skeletal muscles were detected in trained animals but they were less distinct. Training of the animals led to elevation in content of the proteins in musculus quadriceps. The content of myoglobin increased from 1.2 +/- 0.1 mg/kg up to 2.6 +/- 0.1 mg/kg and that of tropomyosin from 4.9 +/- 0.1 mg/kg up to 5.5 +/- 0.1 mg/kg as a result of an increase in protein biosynthesis. Incorporation of 14C-leucine into myoglobin was increased 1.7-fold. Concentration of myoglobin in blood of untrained rats was increased 3 fold immediately after physical exercises and--9-fold within 72 hrs of the rest. Content of muscular proteins in blood reflected the response of muscle system to physical exercises and may serve as a criterion in evaluation of various steps of adaptation to physical loading. PMID- 3660747 TI - [Effect of tuberculostatic agents and sodium succinate on the functional state of liver mitochondria in tuberculosis]. AB - Effects of isoniazide and of new tuberculostatic drug of long-term action on functions of guinea pig liver mitochondria were studied in experimental tuberculosis. Significant changes in oxidative phosphorylation were found. The combination of sodium succinate with tuberculostatic drugs improved the bioenergetic functions of liver mitochondria under the conditions of antibacterial therapy of experimental tuberculosis. PMID- 3660748 TI - [Comparative study of the RNA-polymerase activity of non-pathogenic and pathogenic influenza viruses A and B]. AB - Activity of RNA polymerase was studied in original non-pathogenic for mice viruses of influenza A and B (A/seal/Massachusetts 1/80, A/USSR 05/81, A/Philippines 2/82 and B/Singapore 227/79) and of their pathogenic derivatives. All the non-pathogenic viruses studied exhibited the low rate of transcriptase activity. Pathogenic derivatives of these strains exhibited higher activity of RNA polymerase, which was 1.5-3-fold higher as compared with the original strain. During passage of influenza viruses A and B in mice organism selection of the population appears to occur, which had the highest transcriptase activity. PMID- 3660750 TI - [Lecithin-cholesterol-acyltransferase activity in chronic liver diseases]. AB - Activity of lecithin-cholesterol-acyl transferase (LCAT) was distinctly decreased in chronic impairments of liver tissue, especially under conditions of liver cirrhosis and hepatocellular cancer. After treatment with "essentiale forte" the enzymatic activity was elevated only in the patients with chronic hepatitis. The LCAT activity correlated with content of albumins, gamma-globulins and the data of thymol test. Estimation of the LCAT activity might serve as a diagnostic test in chronic liver tissue diseases. PMID- 3660749 TI - [Incorporation of 1-6-14C-glucose into lipid fractions of the liver and brain of rats with different alcohol motivation]. AB - Specific radioactivity of total phospholipids, cholesterol and lysophosphatidyl choline was decreased in liver tissue of rats consuming ethanol as compared with the animals preferring water. In brain of rats with alcohol motivation incorporation of 1-6-14C-glucose into cardiolipin was decreased, while the label incorporated into triacylglycerols, sulfatides II and cerebrosides I at the increased rate. PMID- 3660751 TI - [Additions to the classification of edema of the upper extremity afer mastectomy]. PMID- 3660752 TI - [Hormonal function of the thymus gland in melanoma of the skin: relation to functional disorders of other endocrine glands]. AB - The analysis of correlations between levels of epiphyseal, hypophyseal, adrenocortical and gonadal hormones suggested functional disorders developing in these glands to be interdependent and account for dysfunction of the thymus and immune system in patients suffering malignant melanoma. The degree of relationship between pituitary-adrenal system and thymus function disorders increased with tumor size; it was more pronounced in males. The rationale for application of pineal gland preparations in melanoma patients aimed at combatting neuroendocrine disorders is discussed. PMID- 3660753 TI - [Ultrastructure of carcinoid of the lung]. AB - The paper deals with the electron microscopic analysis of samples of 40 lung tumors histologically diagnosed as carcinoid or malignant carcinoid. The study group was shown to include tumors differing in cell ultrastructure and histological patterns. Three basic tissue patterns formed by 3 specific cellular types were identified: epithelioid, sarcomatoid and symplastic one. Tumors usually showed a combination of the said types with the predominance of one of them. Tumors exhibiting only one morphologic pattern of neurosecretory granules were much more rare. All the neoplasms studied were of neuroendocrine nature. PMID- 3660754 TI - [Progesterone receptors in breast cancer]. AB - Levels of progesterone and estrogen receptors in tumor tissue were measured in 99 cases of stage I-IV breast cancer. 76.6% of tumors were found to be hormone dependent. A considerable number of estrogen receptor-positive tumors lacked progesterone receptors. Tumors showing only progesterone receptors were not rare, either. The significance of the data obtained is discussed. PMID- 3660755 TI - [Morphological criteria of the risk of stomach cancer in gastritis patients]. AB - A comparative evaluation of microscopic features of gastric mucosa in patients with stomach cancer and non-tumor controls showed the incidence of atrophic hyperplastic gastritis and degree III gastric mucosa cell dysplasia in the former group to be 24.8 and 7 times that in controls, respectively. The data obtained suggest the said non-tumor pathology to be factors of risk for stomach cancer development. PMID- 3660756 TI - [Prognostic value of the level of steroid hormone receptors in cancer of the large intestine]. AB - Clinical course of 77 surgical cases of cancer of the large bowel was evaluated versus levels of estrogen, androgen, progesterone and glucocorticoid hormone receptors. Within the follow-up period (range 6-41 months), 7 (9%) patients died of tumor progression, 16 (21%) developed recurrence or metastases, while the rest 54 (70%) cases continued in remission. Patients with steroid hormone receptor positive tumors revealed more favorable clinical course as well as longer disease free and overall survival than cases of receptor-negative cancer. Estrogen receptor status was found to be of the highest prognostic value in terms of clinical course and survival, as compared to all other hormone receptors studied. PMID- 3660757 TI - [Quantitative changes in the karyotype during hyperplastic processes in cancer of the endometrium]. AB - Cytogenetic examination of scrapings obtained from 42 patients with uterine bleeding was performed. A decrease in diploid cell level matched by a rise in that of aneuploid and aberrant cells was seen both in carcinoma and adenomatous hyperplasia of the uterine mucosa. A correlation was established between the level of aneuploid and aberrant cells, on the one hand, and degree of endometrial hyperplasia, on the other. Changes in karyotype in hyperplastic lesions of the endometrium are thought to be a factor predisposing to cancer development. PMID- 3660758 TI - [Secondary chondrosarcoma]. AB - A retrospective evaluation of 101 cases of secondary chondrosarcoma was performed. The results of the analysis of X-ray data showed chondrosarcoma to develop from osteocartilaginous exostosis or chondroma (53 and 47 cases, respectively). (One case lacked roentgenologic data). The former pattern of tumor development prevailed in patients under 40 years of age, while the latter one was more frequently observed in the older age group (68% of cases in each age bracket). Secondary chondrosarcoma was most frequently localized to long tubular and flat bones (48 and 34 patients, 47.53 and 33.66%, respectively). Roentgenologic diagnosis of early stage secondary chondrosarcoma was extremely difficult. Histologic examination showed degree I cell anaplasia in most cases. Surgery is the main procedure of treatment of secondary chondrosarcoma. Relapses were observed only in patients who had undergone sparing operations. The smaller the extent of surgery, the higher relapse rate was registered. Fifteen patients (14.87%) died of tumor progression. Sparing procedures were performed in 14 of them (93.3%). PMID- 3660759 TI - [Characteristics of the clinical course of breast cancer in patients with diabetes mellitus]. AB - Clinical course of breast cancer was studied in 119 patients suffering concomitant diabetes mellitus. Peculiarities of clinical course of breast cancer versus type of diabetes mellitus were analysed. Rapid growth and dissemination of tumor were observed in cases of insulin-dependent diabetes, whereas in patients with insulin-non-dependent disease long-term postoperative remissions were registered. PMID- 3660760 TI - [Quantitative evaluation of the degree of edema in edematous-infiltrative breast cancer]. AB - Water receptivity test after McClure-Aldrich was used to assess edema of the mammary gland affected by edematous-infiltrative carcinoma. Fifty-five patients with said pathology as well as 20 nodular carcinoma and 22 mastopathy patients in control were examined. Patients failing to respond to a combination of polychemo- hormono-therapy and irradiation showed the following pattern of test parameters: initial time of resolution of a blister produced by intradermal physiologic salt solution injection ranged 3-10 minutes. After treatment, it increased by less than 5 minutes or even decreased. An 81.8 +/- 8.2% remission rate was seen in patients in whom the said indexes were 11-50 minutes and a less than 5 minute increase, respectively. High predictive value of the test was confirmed mathematically. PMID- 3660761 TI - [Fibrocervicohysteroscopy in the diagnosis of cancer of the endometrium and cervical canal]. AB - Fibrocervicohysteroscopy was performed in 152 patients in whom cancer of the endometrium or cervical canal was suspected. The said pathology was detected in 33 cases (21.7%). The basic advantages of the procedure described are as follows: (I) atraumatic nature assured by flexible operating part of the fibroscope, (2) clear visualization of the uterine cavity areas which are difficult of access, even in cases of pronounced organic lesions and deformity of the uterus, and (3) possibility of repeated biopsy from any part of the uterine mucosa. PMID- 3660762 TI - [Treatment of the pain syndrome in cancer patients by peridural administration of low doses of opiates]. AB - Peridural injections of morphine were given to 180 incurable cancer patients suffering chronic pain. The effectiveness of the said procedure as well as its side-effects were assessed. A relationship between the external respiration parameters, on the one hand, and drug dosage and time postinjection, on the other, was studied. The data obtained point to the effectiveness of the said method and suggest that it be used as a universal procedure for the treatment of intractable pain in incurable patients. PMID- 3660763 TI - [Clinico-morphological characteristics of basal cell carcinoma of head and neck skin]. PMID- 3660764 TI - Heat stability of lyophilized C1 inactivator concentrates. AB - Heat stability of lyophilized C1 inactivator (C1-INA) concentrates of intermediate and high purity has been investigated under several heat treatment protocols that include heating for 96 and 192 h at 68 degrees C and for 10 h at 80, 90 and 100 degrees C. Both types of concentrate showed high stability in functional activity, with not more than 5% loss in any of the time-temperature combinations evaluated. However, the C1-INA antigen from both concentrates showed small but progressive changes in crossed immunoelectrophoretic pattern, in proportion to the intensity of heat treatment. High-pressure size-exclusion chromatography revealed only minimal signs of aggregation in the high-purity concentrate, but a significant and progressive aggregation of nonspecific protein contaminants present in the intermediate-purity concentrate, making the high purity concentrate preferable for heat treatment. PMID- 3660765 TI - Post-thaw storage at 4 degrees C of previously frozen red cells with retention of 2,3-DPG. AB - Fresh human blood was collected in CPD, frozen by either the Meryman or the Valeri high glycerol technique, and stored at -80 degrees C. Later the red cells were thawed, deglycerolized by the appropriate technique and resuspended in either saline-glucose wash solution or an additive solution containing ascorbate 2-phosphate, adenine, glucose (dextrose), mannitol and sodium phosphate. The cells were stored at 4-6 degrees C for 21 days and assayed weekly for ATP, 2,3 DPG, pH, P50, glucose utilization and lysis. The additive solution maintained red cell 2,3-DPG at fresh blood levels for 3 weeks and maintained ATP levels sufficiently well to suggest good red cell viability for 21 days. There was no difference in results between the Meryman or the Valeri freezing methods if sodium phosphate was used with the saline-glucose wash solution in the Valeri method. If this additive solution is coupled with sterile deglycerolization techniques, 3 weeks of post-thaw red cell preservation would be practical. Using this additive solution would make frozen blood a reasonable source of red cells for emergency needs in both military and civilian blood banking. PMID- 3660766 TI - Effects of plasticizers and plastic bags on granulocyte function during storage. AB - The influence of the plasticizers, di-(2-ethylhexyl)phthalate (DEHP) and tri-(2 ethylhexyl)trimellitate (TOTM), on granulocyte function was examined. Polyvinyl chloride (PVC) bags with DEHP (DEHP-PVC) leaked DEHP into plasma, but TOTM did not dissolve in plasma under the same conditions. Glow discharge treatment inhibited the leakage of DEHP from DEHP-PVC bags. Depending on the amount of DEHP added into granulocyte suspension, chemotaxis and bactericidal activity decreased, but cell counts and phagocytosis were not affected. During storage for 24 h at 22 degrees C, granulocyte function decreased greatly in DEHP-PVC, but was well maintained in the bags which did not leak plasticizers, TOTM-PVC and glow discharged DEHP-PVC. PMID- 3660767 TI - Monitoring of platelet contamination in filtered red blood cell concentrates. Use of a radioimmunoassay detecting the platelet glycoprotein IIb-IIIa complex. AB - Monitoring of contaminating platelets, granulocytes, and lymphocytes in leukocyte poor red blood cell concentrates is usually done by counting in an electronic particle counter. Sensitivity and specificity of this technique are compromised by the contamination of the preparations with other cell types and particles thereof. In this report we studied platelet contamination in filtered red blood cell concentrates by use of a radioimmunoassay for detection of the platelet glycoprotein complex IIb-IIIa. Our results indicate that platelets and/or fragments thereof, not detectable for particle counters, are present in blood cell concentrates. This finding might have important implications for the preparation of pure red blood cell concentrates to avoid unwanted immunization after transfusion. PMID- 3660768 TI - Comparison of three different methods used in the preparation of leukocyte-poor platelet concentrates. AB - We compared three methods for preparing leukocyte-poor platelet concentrates from random donors: the centrifugation procedure 400 g/6 min, the filtration by Immugard TFIG 500 Y and the Cutter Leukotrap platelet pooling system. The most efficient method with regard to removal of leukocytes and platelet yield could be obtained by filtration through the Immugard filter. Platelet loss was less than 10% and the residual leukocyte count was lower than 10 X 10(6). PMID- 3660769 TI - Identification of the Yukb allo-antigen on platelet glycoprotein IIIa. AB - The glycoprotein (GP) localization of a new platelet-specific allo-antigen Yukb is described. The antibody was isolated from serum of a patient with neonatal allo-immune thrombocytopenia. In immunoblot procedure, it bound exclusively to platelet GP IIIa, like anti-PlA1, while the known anti-Baka and anti-Leka reacted with GP IIb. Analysis of GP from chymotrypsin-treated platelets with anti-Yukb revealed no binding in the 68-kilodalton position while anti-PlA1 did. Thus, unlike the PlA1 antigen, the Yukb determinant either resides on the 30-kilodalton fragment of GP IIIa or it is destroyed by chymotrypsin treatment. PMID- 3660770 TI - Estimation of the number of binding sites for a murine monoclonal anti-Lub on human erythrocytes. AB - The number of Lub antigen sites on the human erythrocyte membrane, as recognised by the murine monoclonal antibody BRIC-108, has been determined. The number of antibody molecules bound per cell on one example of cells of the phenotype Lu(a-b ) with recessive inheritance was an average of around 200 in replicate determinations, which probably represents non-specific antibody binding. A similar number of antibody molecules to this bound to trypsin- or pronase-treated normal cells or cells of the Lu(a-b-) phenotype associated with the inheritance of the X-borne gene, XS2. The number of binding sites on three examples of cells of the phenotype Lu(a-b-) with dominant inheritance was from 440 to 690. A variation in the number of binding sites per cell from 1,640 to 4,070 was found in five individuals with the phenotype Lu(a-b+) and from 850 to 1,820 in four individuals with the phenotype Lu(a+b+). Four individuals with the Lu(a+b-) phenotype had an average of 480 binding sites per cell. The Lub antigen therefore appears to a have low-site density and a variable level of expression on the erythrocyte surface. PMID- 3660771 TI - Effects of partial and total isovolemic exchange transfusion in fully conscious rats using pyridoxylated polyhemoglobin solution as a colloidal oxygen-delivering blood replacement fluid. AB - Stroma-free hemoglobin (SFHb) treated with pyridoxal 5'-phosphate (PP) was intermolecularly cross-linked with glutaraldehyde to give pyridoxylated polyhemoglobin (PP-PolyHb) solution (14.0 g/dl) with colloid osmotic pressure = 25 torr and a P50 = 20 torr. To evaluate PP-PolyHb as a blood substitute, fully conscious rats with chronic cannulations were subjected to blood replacement (30 100%) by a new continuous isovolemic exchange transfusion set up. Crystalline SFHb, PP-SFHb, PP-PolyHb, bovine serum albumin (BSA) and Ringer's solution were tested. Respiration, pulse and arterial blood pressure were more stable following transfusion with PP-PolyHb or PP-SFHb compared to BSA. By 7-8 days post-exchange, hematological changes returned to normal. Plasma retention of PP-PolyHb was 10-15 times longer than either crystalline SFHb or PP-SFHb for major blood exchanges. A T1/2 of 30 h was obtained for PP-PolyHb after total replacement. Long-term survival rates of 80, 63 and 50%, following replacement of 70, 85 and 100%, respectively, were significantly higher (p less than 0.05) than survival obtained for all other solutions tested. Superiority of PP-PolyHb over other fluids was clearly demonstrated. PMID- 3660772 TI - Peripheral blood and bone marrow abnormalities in the acquired immunodeficiency syndrome. AB - In reviewing the peripheral hematologic manifestations, bone marrow changes and clinical course in 41 consecutive patients with acquired immunodeficiency syndrome (AIDS), frequent findings included anemia (95%), leukopenia (76%), bone marrow hypercellularity (73%) and pancytopenia (41%). These hematologic abnormalities were not clearly associated with specific clinical manifestations of AIDS, but support the conclusion that the hematopoietic system is a target organ in AIDS. The mechanisms of these abnormalities still need to be evaluated. Clinicians should be aware of these commonly encountered changes. PMID- 3660773 TI - The sexual history-taking and counseling practices of primary care physicians. AB - As part of a statewide survey of experiences related to the acquired immunodeficiency syndrome and competencies of a random sample of primary care physicians in California done in early 1986, we interviewed 1,000 internists, family and general practitioners about their sexual history-taking and counseling practices. Less than 4% have patients complete a history form that includes questions about sexual orientation or practices, and only 10% ask new patients questions specific enough to identify those at high risk of exposure to the human immunodeficiency virus. Internists, women and younger physicians and those expressing little discomfort in dealing with gay men more often took adequate sexual histories and gave appropriate advice. Among those physicians with patients at risk of becoming infected, only half recommended the use of condoms and 60% advised a reduction in the number of partners. More than 15% recommended abstention from sexual intercourse, and 8% suggested these patients should switch to a heterosexual life-style. PMID- 3660774 TI - The neurologic sequelae of cardiac arrest. AB - This discussion was selected from the weekly Grand Rounds in the Department of Medicine, University of Washington School of Medicine, Seattle. Taken from a transcription, it has been edited by Drs Paul G. Ramsey, Associate Professor of Medicine, and Philip J. Fialkow, Professor and Chair of the Department of Medicine. PMID- 3660775 TI - The health policy agenda for the American people. PMID- 3660776 TI - Coma after cardiac arrest--how much care is enough? PMID- 3660777 TI - The battlefield called sarcoidosis. PMID- 3660779 TI - Are we a violent nation? PMID- 3660778 TI - Sexual history-taking. PMID- 3660780 TI - Diabetic lipemia with fatty splenomegaly culminating in unnecessary splenectomy. PMID- 3660781 TI - Tuberculoma of the brain stem. PMID- 3660782 TI - Pasteurella multocida urinary tract infection. PMID- 3660784 TI - Causes of anosmia. PMID- 3660783 TI - Disseminated actinomycosis. PMID- 3660785 TI - The plight of public hospitals. PMID- 3660786 TI - Physicians and the death penalty. PMID- 3660787 TI - Opposing views on deaths from firearms. PMID- 3660788 TI - Soviet health care system. PMID- 3660789 TI - Consent and confidentiality laws for minors in the western United States. PMID- 3660791 TI - [Causes of neonatal mortality in Warsaw and Warsaw province]. PMID- 3660790 TI - [Peritoneal dialysis in the treatment of mushroom poisoning in children]. PMID- 3660792 TI - [Intra-articular fractures in the knee area with considerable displacement of bone fragments: methods of therapeutic management]. PMID- 3660793 TI - [Cancer of the rectum]. PMID- 3660794 TI - [Clinical evaluation of alcohol dependence]. PMID- 3660795 TI - [Genotoxicity of metal ions]. PMID- 3660796 TI - [A case of Wolff-Parkinson-White syndrome coexistent with sick sinus syndrome]. PMID- 3660797 TI - [3 cases of metastases of bronchial cancer to the heart]. PMID- 3660798 TI - [Chronic granulomatous disease as an example of congenital functional disorders of granulocytes]. PMID- 3660799 TI - [Successful open-chest resuscitation in a case of gunshot wound of the lung]. PMID- 3660800 TI - [Fibrosigmoidoscopy as a method of detecting cancer of the large intestine. Its comparison with proctoscopy]. PMID- 3660801 TI - [Problems of noninvasive diagnosis and therapy in patients with WPW syndrome]. PMID- 3660802 TI - [A case of intussusception of the small intestine in Schoenlein-Henoch syndrome]. PMID- 3660803 TI - [Intrauterine endometriosis--diagnostic and therapeutic difficulties]. PMID- 3660804 TI - [Tuberculous meningitis]. PMID- 3660805 TI - [A case of epileptic attacks produced by the closing of the eyes in a 9-year-old girl]. PMID- 3660806 TI - [Congenital arthrogryposis in a 2-year-old girl]. PMID- 3660808 TI - [Proceedings of the 5th Symposium on Medical and Veterinary Acaroentomology. Gdansk, 19-21 September 1985]. PMID- 3660807 TI - [An objective method of determining the range of movement in the shoulder joint in malingering]. PMID- 3660809 TI - The biology and epidemiological role of arthropods in the environments at various stages of anthropogenization. Stage of investigations on Ixodides, parasites of rodents and Nematocera. PMID- 3660810 TI - Occurrence of the tick Ixodes ricinus in a landscape strongly influenced by human activities. PMID- 3660811 TI - A comparison of factors influencing the distribution of Dermacentor reticulatus (Ixodidae) in Czechoslovakia and Poland. PMID- 3660812 TI - [Histopathological changes in the skin of rabbits caused by the tick Hyalomma dromedarii asiaticum Schulze et Schlottke 1929, and larvae of Rhipicephalus sp]. PMID- 3660813 TI - Pheromonal communication of wild and laboratory reared populations of Argas (Persicargas) persicus (Oken). PMID- 3660814 TI - Effect of large city conditions on the species composition of fleas parasitizing small mammals. PMID- 3660815 TI - The biology and epidemiological role of arthropods in biotopes at various stages of anthropogenization. Investigations of mites, lice, Brachycera and other arthropods which are parasitic or noxious to humans and domestic animals. PMID- 3660816 TI - [Synanthropic Calyptrata in selected habitats in Poland]. PMID- 3660817 TI - [Ear mite of cattle (Raillietia auris Leidy, 1872) in the annual cycle ]. PMID- 3660818 TI - [Allergenic acarofauna of house dust in selected cities in the Upper Silesia]. PMID- 3660819 TI - [Acari isolated from the dust of harbor buildings in Gdynia]. PMID- 3660820 TI - Wild bird and mammal ectoparasites. PMID- 3660821 TI - [Arthropods isolated from Sorex alpinus Schinz (Mammalia, Insectivora) in Poland]. PMID- 3660822 TI - [State of knowledge of mite fauna isolated from the mammals in Poland. Index of the families and genera of mites isolated from mammals up to 1984]. PMID- 3660823 TI - Parasitic Crustacea of marine fishes. PMID- 3660824 TI - Some fish species of the Northern Atlantic attacked by copepods of the genus Sphyrion and the pathological alterations in redfish fillets caused by Sphyrion infestation. PMID- 3660825 TI - [Dynamics of occurrence of Eubrachiella antarctica (Quidor, 1906) in Nototnenia gibberifrons Lonnberg 1905]. PMID- 3660826 TI - A review of methods of controlling arthropod pests of sanitary and veterinary importance. PMID- 3660827 TI - [Effectiveness of bromfenvinphos and photostable pyrethrin mixtures in the control of sanitary pests]. PMID- 3660828 TI - [Development of resistance and cross resistance in deltamethrin-select ed houseflies (Musca domestica L.)]. PMID- 3660829 TI - The use of Bacillus thuringiensis var. israelensis in the biological control of blackflies in Czechoslovakia. PMID- 3660830 TI - [Sensitivity of Blattella germanica (L.) from the Polish merchant navy ships to carbamate compounds]. PMID- 3660831 TI - [Control of ectoparasites in zoo animals with Butox]. PMID- 3660832 TI - [Treatment of gasterophilosis in horses]. PMID- 3660833 TI - [Treatment of chorioptosis in horses]. PMID- 3660834 TI - [Control of flies and cockroaches in the zoo with Alfacron]. PMID- 3660835 TI - [Demodecosis in cattle and its treatment]. PMID- 3660836 TI - [Economic effectiveness of housefly control in dairy cattle farms]. PMID- 3660837 TI - [Effectiveness of ivermectin in the treatment of demodecosis in dogs]. PMID- 3660838 TI - [Usefulness of ivermectin in the treatment of scabies in foxes]. PMID- 3660839 TI - [Wild silk-induced asthma. A contribution to the knowledge of inhalation allergies caused by wild and tussah silk-filled bed quilts]. AB - In the silk industry occupational IgE-mediated hypersensitivities to different allergens are well known. Since the use of silk waste for the filling of bed quilts a great number of patients suffering especially from silk-asthma could be observed. Immunological investigations showed clearly that in this context sericin and also antigens from an insect of the genus anthrenus in the silk material are of allergenic importance. On the basis of typical case histories from the occupational and private scene the diagnostic difficulties of silk allergy are discussed. PMID- 3660840 TI - [Panic attacks and cardiac phobia]. AB - In this study 36 patients with cardiac phobia were examined prior to hospitalisation and 29 of them were re-examined after 2.5 years. An analysis of the clinical pictures showed that all of the patients met the DSM III criteria for panic disorder. The follow-up results indicated that the anxiety attacks often recurred despite treatment; on the other hand, the patients felt significantly less threatened by the symptoms and consequently showed less help seeking behaviour. The attack symptomatology was characterized by a uniform picture and thus played, at best, a limited role in predicting the course of the illness. According to DSM III cardiac phobia is listed under the somatoform disorders as hypochondriasis; this seems to be an unfortunate decision and ought to be revised. PMID- 3660841 TI - [Some treatment effects of inpatient psychosomatic therapy]. AB - In an earlier study the authors found that patients of the psychosomatic ward of the Vienna Allgemeine Krankenhaus showed a high frequency of consultation with physicians for the time period prior to their admission to the ward. The present study asked--in comparison with untreated cases--whether a) this consultation frequency would be different in quantity and quality according to the experience of in-patient treatment and b) what the effect of in-patient treatment would have on medication consumption and a set of subjective parameters. This study comparing 37 psychosomatic patients with the control group of 18 individuals showed that psychosomatic in-patient treatment had a decisive influence on consultation frequencies and behaviour, on medication habits and on some subjective parameters. Individuals with in-patient treatment had a consultation frequency over 50% lower than diagnostically comparable cases without psychosomatic treatment. In their own estimation, patients were able to cope with their symptoms (insofar as these remained) significantly better than those without such treatment, and the majority expressed satisfaction with their stay in the psychosomatic ward even 5 years later. Their medication consumption rate showed a declining pattern und their positive responses to a number of personal and medical parameters had the same wide scope as the persons of the control group, while those patients who did not receive this specific treatment clearly manifested a more restricted pattern. PMID- 3660842 TI - [Disorders of micturition following intervertebral disk operations. Neurologic diagnosis and therapy]. AB - Urodynamic investigation was carried out in 33 patients (14 male, 19 female) who presented with micturition disorders after prolapsed disc operation. The predominant symptom was urinary incontinence in 16 cases and urinary retention or residual urine in 17 cases; faecal incontinence was encountered in 15 patients. The main nerve supply for detrusor and sphincter muscles stems from the S-3 segment. Of 25 patients with unilateral or bilateral loss of sensation in the S-3 dermatome, 21 patients demonstrated detrusor areflexia, 11 of those with urinary incontinence, 10 with urinary retention and 13 with faecal incontinence. 4 patients showed normoreflexia of the detrusor, although three of them had urinary incontinence, one urinary retention and two faecal incontinence. The success of medication or electrostimulation is demonstrated in 17 patients on follow-up over a period of 12 months postoperatively. Medication alone was successful only when no peripheral nerve lesion was present. Out of 9 patients with a nerve lesion located at S-1/S-3, transurethral electrostimulation according to Katona was successful in two cases, whilst functional electrostimulation successful in another two cases. PMID- 3660843 TI - [Metabolic changes in ischemic brain infarct]. AB - Serum and cerebrospinal fluid (CSF) from 17 patients less than 3 days after brain infarction (measurement 1) and during recovery 7 +/- 2 days after infarction (measurement 2) were analysed for organic acids (energy metabolites, keto acids and amino acids). Clinical parameters improved by 32% over the period of assessment. Only serum pyruvate levels were elevated at both measurement times. Acute infarction was characterized by significant correspondence of serum and CSF concentrations for pyruvate and alpha-oxo-beta-methyl valeric acid which was lost during the recovery period. Amino acids of the L-system were roughly doubled (phenylalanine 7-fold in the CSF); increased concentrations were recorded for amino acids of the basic transport system, while amino acids of the A-system stayed unchanged (with the exception of alpha-amino butyric acid--20-fold in CSF). Except in the case of taurine, serum and CSF amino acid concentrations remained unchanged between the two measurement times. Mutual dependence of CSF and serum amino acid concentrations, existing initially for glycine, valine, leucine, tyrosine, as well as ornithine, lysine and histidine was lost in the recovery phase. This is interpreted as indication of a normalization of the blood brain barrier. PMID- 3660844 TI - [So-called "ependymoma of the foramen of Monro" with differentiation of tissue toward the subfornical organ]. AB - A tumour was found in the left ventricle of a 25 year-old woman. Histology of this "ependymoma of Monro's foramen" shows characteristic structures of the subfornical organ. Whereas tumours of the pituitary or the pineal gland, which are also part of the circumventricular organs, are quite frequent, a tumour with differentiation characteristic of the subfornical organ is a rarity. PMID- 3660846 TI - Packaging of drugs and chemicals in child resistant containers. PMID- 3660847 TI - Health care for health workers--is nurses' health at risk? Health and safety legislation. PMID- 3660845 TI - Public health nurses section. Presidential address. PMID- 3660848 TI - Biotransformation of primary nicotine metabolites. II. Metabolism of [3H]-S-(-) cotinine in the guinea pig: determination of in vivo urinary metabolites by high performance liquid-radiochromatography. AB - 1. The metabolism of [3H]-S-(-)-cotinine in vivo has been investigated in the guinea pig. The quantitive determination of urinary metabolites has been carried out using a high-performance liquid radiochromagraphic procedure. Metabolite analysis of C- and N-oxidation products, and N-methylcotininium ion, were carried out on two chromatographic systems: (a) Partisil-10 SCX cation-exchange chromatography, and (b) Partisil-10 ODS reverse-phase chromatography. 2. 3 Hydroxycotinine was the major urinary metabolite of cotinine in the guinea pig, accounting for 57% of the total radioactivity in the urine. Cotinine-N-oxide constituted 18% of total metabolites in the urine, whereas neither nicotine nor the N-methylcotininium ion were detected as urinary metabolites of [3H]-S-( )cotinine. S-(-)-Cotinine was extensively metabolized in the guinea pig; total recovery of radioactivity in 24 h urine was very high (greater than 95%) and very little cotinine was detected (less than 1%) in the urine. 3. Two unidentified metabolites of [3H]-S-(-)-cotinine were detected which collectively constituted approximately 20% of total urinary tritium. PMID- 3660850 TI - The effects of general anaesthesia on tocainide clearance in the sheep. AB - The haemodynamic effects and regional clearances of tocainide were investigated in sheep with chronic intravascular cannulae to measure blood flow through, and drug extraction by, lungs, kidneys, liver and gut. 2. Tocainide, at arterial blood concentrations in the therapeutic range, caused no haemodynamic effects and was significantly extracted only by the liver. 3. In the presence of general anaesthesia with halothane, the mean hepatic blood flow and tocainide extraction ratio were each reduced by approximately 25% so that the mean hepatic clearance and intrinsic clearance of tocainide each were reduced by approximately 50%. Thus arterial blood tocainide concentrations were increased by 50%. 4. While the clinical implications of this interaction are unclear because of insufficient information about the margin of safety of tocainide, the pharmacological implications are plain. Because general anaesthesia may alter the relationship between dose and blood drug concentrations, pharmacokinetic and pharmacodynamic data should not be interchanged between awake and anaesthetized subjects. PMID- 3660849 TI - Inhibition of cytochrome P-450c-mediated benzo[a]pyrene hydroxylase and ethoxyresorufin O-deethylase by dihydrosafrole. AB - 1. Inhibitory activity of dihydrosafrole towards benzo[a]pyrene (BP) hydroxylase activity in hepatic microsomes from beta-naphthoflavone (BNF)-induced rats, and in reconstituted systems containing cytochrome P-450c, increased dramatically on preincubation of the inhibitor with NADPH; no inhibition occurred without preincubation. The level of BP hydroxylase inhibition was associated with the progressive formation of the 456 nm dihydrosafrole metabolite-cytochrome P-450c spectral complex during preincubation. 2. Inhibition of BP hydroxylase by dihydrosafrole in control microsomes, and inhibition of ethoxyresorufin O deethylase (EROD) in microsomes (control or BNF-induced) and in reconstituted systems with cytochrome P-450c, did not require preincubation and apparently was not dependent on prior formation of the dihydrosafrole metabolite-cytochrome P 450 complex. 3. Kinetic studies established that, following preincubation with NADPH, dihydrosafrole was a noncompetitive inhibitor of both BP hydroxylase and EROD activities. In the absence of preincubation, dihydrosafrole was an effective competitive inhibitor of EROD in BNF-induced microsomes and in reconstituted systems with cytochrome P-450c. 4. Both ethoxyresorufin and benzo[a]pyrene inhibited the development of the type I optical difference spectrum of dihydrosafrole in reconstituted systems containing cytochrome P-450c. Inhibition by ethoxyresorufin was competitive while that caused by benzo[a]pyrene was noncompetitive in nature. 5. The type II ligand phenylimidazole was an effective noncompetitive inhibitor of EROD activity but failed to exert any inhibitory effect on cytochrome P-450c-mediated BP hydroxylase activity. Phenylimidazole inhibited formation of the dihydrosafrole type I optical difference spectrum non competitively. 6. The results indicate that ethoxyresorufin and benzo[a]pyrene may occupy different binding sites on cytochrome P-450c and that dihydrosafrole binds primarily to the site utilized by ethoxyresorufin. PMID- 3660851 TI - Studies on the metabolism of arylacetic acids. 6. Comparative metabolic conjugation of 1- and 2-naphthylacetic acids in the guinea pig, mouse, hamster and gerbil. AB - The patterns of metabolic conjugation of the isomeric 1- and 2-naphthylacetic acids have been compared in guinea pig, mouse, hamster and gerbil. Equimolar doses of [carboxy-14C]1- and 2-naphthylacetic acids were given to these species by i.p. injection, their urine collected and urinary metabolites examined by t.l.c. before and after treatment with beta-glucuronidase or mild alkali. 2. Urinary excretion of 14C following administration of 14C-1-naphthylacetic acid was 76-93% of dose in 72 h, the bulk being eliminated in 24 h. Urinary metabolites comprised 1-naphthylacetic-glycine and -glucuronide together with the unchanged acid. 3. Following administration of 14C-2-naphthylacetic acid, some 68 94% of the 14C dose was recovered in the urine in 72 h, with the majority in the 0-24 h urine. All four species excreted 2-naphthylacetyl-glucuronide and glycine: additionally, 2-naphthylacetyl-taurine was excreted by mouse, gerbil and hamster and the glutamine conjugate was also present in hamster urine. PMID- 3660852 TI - Studies on the metabolism of arylacetic acids. 7. The influence of varying dose size upon the conjugation pattern of 2-naphthylacetic acid in the guinea pig, mouse and hamster. AB - 1. The influence of dose size upon the metabolic conjugation of 2-naphthylacetic acid with various amino acids and glucuronic acid has been studied in the guinea pig, mouse and hamster. 2. Guinea pigs conjugated 2-naphthylacetic acid with glycine and glucuronic acid. 3. Mice conjugated 2-naphthylacetic acid with glycine, taurine and glucuronic acid. Taurine conjugation had the highest capacity, and both this and the glycine mechanism were saturated at doses above 100 mg/kg. 4. Hamsters utilized glutamine, glycine, taurine and glucuronic acid for the conjugation of 2-naphthylacetic acid. No conjugation pathway was saturated by doses up to 200 mg/kg. 5. The thus-far unique ability of 2 naphthylacetic acid to evoke multiple amino acid conjugations, using the taurine and glutamine mechanisms hitherto unknown in these species, appears to be due to its affinity for previously unrecognized enzyme systems, rather than to saturation of 'normal' pathways revealing novel routes at high doses. PMID- 3660853 TI - The effect of nitrite on 14C-sulphathiazole (4-amino-N-2-thiazolyl[U 14C]benzenesulphonamide) metabolism in the rat. AB - 1. Rats given a meal containing 613 p.p.m. of 14C-sulphathiazole (4-amino-N-2 thiazolyl[14C]benzenesulphonamide) excreted less 14C-activity in urine and more 14C-activity in faeces as nitrite in the meal was increased (0, 10, 100 or 1000 p.p.m.). As nitrite in the meal was increased from 0 to 1000 p.p.m. the total 14C residues in the gastrointestinal tract six hours after dosing increased, but decreased in other tissues. 2. High nitrite in the meal resulted in increased methanol insoluble 14C-activity in the gastrointestinal tract but had little or no effect on the methanol-insoluble activity in liver and blood. 3. Conversion of 14C-sulphathiazole to 14C-desaminosulphathiazole (N-2-thiazolyl[U 14C]benzenesulphonamide) in the rat was greatly increased by nitrite in the meal. PMID- 3660854 TI - Biotransformation of ketamine, (Z)-6-hydroxyketamine, and (E)-6-hydroxyketamine by rat, rabbit, and human liver microsomal preparations. AB - 1. (Z)- and (E)-6-Hydroxyketamine have been synthesized and their metabolism by hepatic microsomal preparations studied to elucidate the metabolism of ketamine. 2. Both 6-hydroxyketamines are exclusively converted to 6-hydroxy-norketamines by N-demethylation. The g.l.c. retention properties and mass spectral characteristics of these 6-hydroxy-norketamines were used to confirm the structures of ketamine metabolites. 3. Ketamine is converted to norketamine, 4-, 5- and 6-hydroxynorketamines and possibly 4- and 6-hydroxyketamines in hepatic microsomal preparations from rats, rabbits and man. Norketamine is the major metabolite in all species tested. 4. 6-Hydroxynorketamine is the major hydroxylated metabolite and is found only in the (Z)-form in the species examined. 5. The metabolism of ketamine and the 6-hydroxy-ketamines is greatly increased after phenobarbital pretreatment of rats and rabbits. PMID- 3660855 TI - Metabolism of procyclidine in isolated rat hepatocytes. AB - 1. The biotransformation of procyclidine in isolated hepatocytes, prepared from untreated and from phenobarbital-pretreated rats, is described. 2. Major metabolic pathways are ketone formation on carbon-4 and monohydroxylation in cis 4, trans-4 and (1R*, 3R*, 7S* (or R*))-trans-3 positions of the cyclohexyl ring. 3. Minor pathways consist of monohydroxylation in (1R*, 3S*, 7R*)- and (1R*, 3S*, 7S*)-cis-3 and vicinal diol formation in (1R*, 3R*, 4S*, 7R* (or S*))-cis-3, cis 4 and (1R*, 3S*, 4R*, 7S* (or R*))-trans-3, trans-4 positions of the cyclohexyl part of the molecule. 4. After phenobarbital treatment monohydroxylation in cis 4, trans-4 and trans-3 and vicinal diol formation in trans-3, trans-4 positions are significantly increased and the cis-4 to trans-3 ratio is reversed. 5. The hypothesis is made that the monohydroxylations in cis-3 and trans-3 represent an intermediate step in the formation of the dihydroxycyclohexyl metabolites, since this pathway is not observed in vivo. The hypothesis is supported by incubation experiments of synthetic monohydroxycyclohexyl derivates of procyclidine with isolated rat hepatocytes. PMID- 3660856 TI - The effect of midazolam administration on the pharmacokinetics of antipyrine in the rat. AB - 1. The clearance and elimination half-lives for i.v. doses of antipyrine were determined in 6 groups of 6 male CD rats with no prior treatment, then again following 7 days treatment with graded oral doses of midazolam, and finally after 3 i.p. doses of phenobarbitone. 2. Substantial increases in clearance and decreases in half-lives were observed following phenobarbitone treatment, demonstrating that antipyrine provides a reliable index of enzyme induction. 3. After treatment with midazolam, maximal induction was seen in animals dosed at 27 or 80 mg/kg per day; an intermediate effect was found with 9 mg/kg per day and no effect at 0.2 and 1.0 mg/kg per day. 4. The results indicate that there is a substantial margin of safety between the proposed human therapeutic doses (7.5 to 15 mg/day) and the minimum effective dose that leads to enzyme induction in laboratory animals. PMID- 3660857 TI - The effect of midazolam (Hypnovel) administration on antipyrine pharmacokinetics in humans. AB - 1. Twelve healthy volunteers were given a standard regimen of oral midazolam (Hypnovel) (15 mg nightly) for 10 consecutive nights. 2. Antipyrine pharmacokinetics were studied immediately before midazolam administration was started, after the dosage schedule had been completed and one week after dosing had been discontinued. 3. No statistically significant changes were seen in the disposition of antipyrine as assessed by the plasma half-lives, areas under the curve and plasma clearances. Therefore, although previous studies have demonstrated that high doses of midazolam induced the drug-metabolising enzymes in laboratory animals, such effects are unlikely to occur in humans being treated with therapeutic doses. PMID- 3660858 TI - Metabolic fate of the thrombolytic agent benzarone in man: comparison with the rat and dog. AB - 1. The metabolic fate of 14C-benzarone in the rat and dog has been compared to that in human subjects. An oral dose was well-absorbed in all three species. However, the 14C excretion patterns differed: humans (100 mg) excreted means of 73 and 19% dose in the urine and faeces respectively, whereas the rat (2 mg/kg) and dog (0.5 mg/kg) excreted greater than 80% in the faeces, mostly during the first 48 h. 2. Much of the faecal 14C was attributable to 14C excreted in the bile which amounted to 59% in the 7 h bile collected from an intravenously dosed dog, and a mean of 72% in the 24 h bile of orally dosed rats. Enterohepatic circulation of 14C was demonstrated in rats. 3. Total 14C in human plasma reached peak concentrations between 1-2 h and declined relatively rapidly, to about 10% of this value within 24 h. Unchanged benzarone was not detected in plasma (less than 25 ng/ml), even after a 400 mg dose, but conjugated benzarone was- accounting for about 10% of the peak concentration of 14C. In the dog, by contrast, conjugated benzarone accounted for about 50% of the peak concentration of 14C of 0.96 microgram equiv./ml at 1 h. The extent of binding of benzarone to human plasma proteins (greater than 99%; in vitro was slightly greater than that (greater than 96%) of total 14C (ex vivo, representing metabolites). 4. Examination of metabolite profiles by h.p.l.c. suggested that in the rat and dog, at least 70% absorbed dose was eliminated by direct conjugation, whereas in humans at least 70% was hydroxylated before conjugation, mainly with glucuronic acid. Hydroxylation occurred in the benzofuran ring and/or the ethyl side-chain. The principal urinary metabolite in humans was the conjugate(s) of the 1 hydroxylated ethyl side-chain derivative (mean 26% dose). PMID- 3660859 TI - Hepatitis B vaccine: prospects for duration of immunity. AB - The duration of hepatitis B vaccine-induced immunity was studied in a group of 54 seronegative health professionals who received plasma-derived hepatitis B vaccine (Merck's Heptavax) in 1978 and 1979. Five to seven years later, 52 vaccinees received a booster dose of yeast recombinant hepatitis B vaccine (Merck's Recombivax). Of 54 vaccinees, 47 (87 percent) had a favorable anti-HBs response (greater than 10 S/N RIA units) and 7 (13 percent) had low (2.1-10 S/N) or undetectable levels (less than 2.1 S/N) one year after primary immunization. After five to seven years, the anti-HBs values had declined to undetectable levels in 25 percent and to low levels in 23 percent. A booster dose of vaccine induced an anamnestic response in 90 percent of vaccinees by two weeks. The results of this study indicate that persons who respond favorably to primary immunization may be protected for at least seven years. PMID- 3660860 TI - Current issues in perinatal epidemiology. AB - The main national data sources for perinatal epidemiology are birth and death certificates, yet routinely linked birth and death certificate data are still not available in the U.S. Completeness and quality of the reporting of perinatal events should be considered in examining trends over time and between jurisdictions. The U.S. has experienced a marked decline in its infant mortality rate, but only a very modest decline in the rate of low birth weight. Research must focus more on studies of pre-term labor, rather than low birth weight, which include children who are underground or who are born too early and who, therefore, may represent different etiologies. Sensitive hormonal tests may provide more precise estimates of the rate of very early fetal loss. Management of labor and delivery and of the high-risk newborn have undergone marked changes during the last 15 years, and yet clinical trials have not played a major role in the evaluation of these changes. The difference in reproductive outcomes between whites and blacks, especially in the rate of low birth weight, have persisted and are not understood. Data bases are becoming available for intergenerational studies to determine whether nature or nurture accounts for this difference. PMID- 3660861 TI - Relationship between acute and chronic disease epidemiology. AB - Epidemiology is the study of epidemics. The primary goal of epidemiological studies should be the identification of the determinants of disease in order to decrease morbidity and mortality. Epidemiological studies evolve through descriptive, analytical, and experimental approaches. The traditional infectious disease epidemiology studies were primarily concerned with identification of an agent, incubation period, mode of transmission, population at risk, and methods of disease control. Chronic disease epidemiology has tended to emphasize a more complex interaction of independent and dependent disease variables that resulted in a greater need for statistical methodology. There has been relatively little interest in chronic disease epidemiology either in modes of disease transmission or in incubation periods. Chronic disease epidemiology has also focused more on analytical epidemiology than on experimental, clinical trials. Many chronic diseases are probably caused by living organisms such as viruses. The fundamental difference in methodology may relate to length of incubation period. Chronic disease epidemiology should probably build more on successful methods of infectious disease epidemiology, especially modes of disease transmission, host susceptibility, incubation periods, and clinical trials. The concept of multifactorial etiology of many chronic diseases may be a measure of our ignorance of causality rather than a biological principle. PMID- 3660862 TI - [Vitamin A--deficiency and excess]. PMID- 3660863 TI - [Effect of choice of therapy on treatment results in Bell's palsy]. PMID- 3660864 TI - [Treatment of idiopathic facial paralysis]. PMID- 3660865 TI - [Diagnosis and therapy of traumatic facial paralyses with reference to childhood]. PMID- 3660866 TI - [Monitoring chronically hoarse patients in consultation in a state ENT practice]. PMID- 3660867 TI - [Effect of chronic alcohol abuse on fertility and sexual potency of the male]. PMID- 3660868 TI - [Calcinosis of intervertebral disks--relatively rare, heterogenous and mostly benign]. PMID- 3660869 TI - [Effect of changes in the demographic structure of the female population on reproduction statistics in the Rostock district]. PMID- 3660870 TI - [Disinfection and sterilization in gastroenterologic endoscopy]. PMID- 3660871 TI - [Hygienic approaches to maintaining asepsis in joint replacement operations]. PMID- 3660872 TI - [The bacterial genus Acinetobacter and its significance for hospital hygiene]. PMID- 3660873 TI - [Preventive rubella vaccination for risk groups]. PMID- 3660874 TI - [Public health study of the water at Varadero beach, Cuba]. PMID- 3660875 TI - [Residues of plant protective agents on plant surfaces as a source of poisoning and possibilities of standardizing exposure]. PMID- 3660876 TI - [Projection guidelines for incorporation of the disinfection technic into the total machinery system of seed preparation]. PMID- 3660877 TI - [Some problems of sex specificity in work disability]. PMID- 3660878 TI - [Combined effect of simultaneously occurring environmental industrial factors on the health status of exposed workers]. PMID- 3660879 TI - [Determination of control values of metabolite excretion in the use of biologic exposure tests for styrene, toluene and xylene in occupational medicine monitoring of exposed workers]. PMID- 3660880 TI - [Interaction of noise and sociorhythm in areas of new housing]. PMID- 3660881 TI - [Rare forms and aspects of human Chlamydia infection]. PMID- 3660882 TI - [Effect of body position on the ability to initiate paroxysmal supraventricular reentry tachycardias and on the conduction system properties of the reentry circuit]. AB - The obtainability as well as the maintenance and termination of paroxysmal supraventricular reentry tachycardias depend upon the interaction of the individual components of the reentry circle, in which cases the properties of the pathway are influenced by the changing preponderance of the sympathetic and parasympathetic tonus and thus also by the body position. In 29 investigations by means of highly frequent and programmed transoesophageal atrial stimulation the influence of the body position on the initiation possibility of the paroxysmal supraventricular tachycardia and on the pathway properties of the individual components of the reentry circle are analysed. The investigations were performed either in the standing position or in lying position, in 16 patients for the objectivation of anamnestically reported paroxysms of tachycardia and in 13 patients for the therapy control after medicamentous stabilisation. In 6 patients supraventricular reentry tachycardias could be initiated only in standing position, in lying position only a few echo systoles appeared. In 9 patients in whom we obtained a tachycardia both in standing position and in lying position in upright posture an in most cases clear increase of the frequency of tachycardia was found. The evocation mode of the tachycardia was partly alleviated in the standing position, but also rendered difficult in several cases. It seems to be indicated to repeat the investigation under orthostatic conditions, when an adequate anamnesis of the tachycardia is present and an initiation possibility in lying position is lacking, or when a great subjective impairment in a paroxysm of tachycardia is reported and there is a relatively low frequency of tachycardia in lying position. PMID- 3660883 TI - [Effect of the calcium antagonist nifedipine on blood pressure and its circadian rhythm in patients with hypertension]. AB - In 74 patients with hypertension with an average age of 60 years on the basis of 8 measuring values the behaviour of blood pressure and frequency was controlled between 6 a.m. and 11 p.m. during the administration of the calcium antagonist nifedipine. The average blood pressure decreased from 198/106 to 178/89 mm Hg during the nifedipine treatment. The scope of the decrease of blood pressure was significantly higher in the patients older than 60 years than in the younger patients. At the same time the blood pressure values very much decreased in patients with the higher values. The heart rate increased only in patients of older age under the administration of nifedipine. The circadian rhythm of the blood pressure, in particular the matutinal increase of blood pressure, could not be influenced. PMID- 3660884 TI - [Surgical therapy of bacterial endocarditis]. AB - On the basis of an own clinical material of 26 patients and in comparison to the literature indications and results of the operative therapy in bacterial endocarditis were discussed. The progressive, conservatively not controllable cardiac insufficiency is the most frequent indication for operation. Without valve replacement it causes death in 60-90% of the patients. In contrast to this there is a postoperative early lethality of 10-30%. Among our own patients the early mortality was 19%. Ill patients operated on were in an advanced stage of the disease, seven patients had to be operated on under emergency conditions. Postoperatively, an improvement of the clinical stages by on an average two degrees of severity (NYHA) could be established. For the purpose of a further improvement of the changes of survival in patients with bacterial endocarditis the demands for an early diagnosis, an adequate antibiotic therapy, a well-timed operation and a suitable operating technique have to be fulfilled. PMID- 3660885 TI - [Incidence, diagnosis and therapy of acute respiratory tract diseases caused by influenza viruses, Mycoplasma, Legionella and Chlamydia]. AB - Epidemiology, diagnostics and specific therapy of the infections of the respiratory organs by influenza viruses, mycoplasmas, legionellae and chlamydia are represented at the example of the so-called atypical pneumonias. Among our own hospitalized patients by means of bacteriological and serological methods the proportion of the pathogen agents mentioned in acute diseases of the respiratory tract was established. In more than 30% of the cases cared for, in pneumonias even in 50%, an etiologic clarification was possible. The results render probable that in adult patients who are hospitalized with acute infections of the respiratory system in the winter half-year in 25% is to be reckoned with an influenza virus infection, in 10% with an infection by mycoplasma pneumoniae and in 15% with a legionellosis. PMID- 3660886 TI - [Hypocholesterolemia ]. AB - In the present study 140 patients with serum cholesterol concentrations below 3.885 mmol/l (150 mg/dl) were examined. The most frequent diagnoses were diseases of the thyroid gland, of the intestines and the liver, malignant tumours, anaemias, pyelonephritis as well as bronchopneumonias. Hypocholesterolaemias sporadically occur also in cardio-vascular and venous diseases. Reductions of the serum cholesterol concentrations are in most cases of secondary nature and can reveal relations to the severity as well as to the prognosis of a disease. PMID- 3660887 TI - [Use of a caudal epidural sympathetic nerve block and a combination injection in chronic arterial circulatory disorders of the lower extremities]. AB - In 30 patients with organic disturbances of the arterial blood supply of the lower extremities the caudal epidural combination injection (one per cent procaine and radecol comp.) in comparison to the caudal epidural sympathetic blocking one per cent procaine) was performed. By means of experiments on corpses of adults the spreading of the anaesthetic drug (in form of a model imitated by one per cent methylene blue) into the thoracic epidural space could be proved. The method was objectified according to clinical and plethysmographic points of view. A particular indication is present in the ischaemic ulcer depending on arteriosclerosis. During the plethysmographic investigations clear differences appeared in favour of the caudal epidural combination injection. PMID- 3660888 TI - [Primary non-Hodgkin's lymphoma of the thyroid gland]. AB - It is reported on a patient with low-malignant primary non-Hodgkin lymphoma of the thyroid gland with hitherto 7-year absence of recidivity after exclusive operative therapy. The course is critically discussed in the light of the literature. Conclusions relate to the diagnostic and therapeutic regimen within clinical treatment, cytology, antibody diagnostics, operation and combined therapy in lymphomas of the thyroid gland and Hashimoto's thyroiditis. PMID- 3660889 TI - Ricinoleic acid and loperamide have opposite motor effects in the small and large intestine of the cat. AB - The actions of laxatives and antidiarrheal agents in the gut are incompletely understood. Therefore, the effects of Na ricinoleate 10(-4)-10(-2) g/kg b. w. and of loperamide 10(-4) g/kg b. w. on myoelectric activity and marker propulsion were studied in the small and large intestine of 7 unanesthetized cats. Intraduodenal application of ricinoleate briefly increased and then decreased spike activity in the small intestine; marker transit was delayed (92 +/- 18 min vs. 55 +/- 14 min in controls). Ricinoleate also initiated spike complexes of 10 215 sec duration. Transit from the right to the left colon was sometimes accelerated and sometimes delayed. The number of uncoupled slow waves was increased to 278% of control. Loperamide accelerated small intestinal transit to 17 +/- 6 min and markedly delayed it in the colon. At the same time it caused a strong and prolonged rise in colonic spike activity. When ricinoleate and loperamide were given together, their effects almost compensated for each other. The resulting net effect was similar to the data in the control experiments. It is concluded that laxatives and antidiarrheal agents alter not only transit, but also myoelectric activity in the small and large intestine. The effects are largely in opposite direction. Loperamide may, therefore, antagonize motor effects of ricinoleate in the gut. PMID- 3660890 TI - European Intestinal Transit Group. 7th meeting. May 4th-7th, 1986, Fiskebackskil, Sweden. Abstracts. PMID- 3660891 TI - [Topical aspects on the pathogenesis and therapy of peptic ulcers of the stomach and the duodenum]. PMID- 3660892 TI - [Ultrastructural aspects of active and healed duodenal ulcer]. AB - To characterize the fine structure of active and healed duodenal ulcers, tissue specimens of patients with active duodenal ulcer disease were examined under two different treatment schedules by various electron microscopic techniques. The striking histological feature of both, the active and healed duodenal ulcer, was the appearance of PAS-positive epithelial cells. Electron microscopy revealed similarity to a special type of mucus secreting cell of the antrum. The destroyed mucous structure during the ulcerative phase regains the normal net-like structure after treatment. The ultrastructural healing process shows constant features independent from the type of treatment and shows that the repair mechanisms are incomplete after a 4 week treatment. PMID- 3660893 TI - [Lattice structure antacids and antacid mixtures]. AB - In the last years the importance of the evaluation of antacid compounds according to their neutralizing capacity decreased. Clinical investigations have shown that antacid mixtures of aluminum-magnesium hydroxide healed gastric an duodenal ulcers (neutralizing capacity 100-150 mmol/day) as well as H2 receptor antagonists and better than a placebo. By this the necessary daily dosage could be reduced essentially. This paper presents studies showing that lattice like structured antacids (e.g. Magaldrate) healed gastric and duodenal ulcers (neutralizing capacity 100-350 mmol/day) as well as Ranitidine (150 mg b.d.). Maintenance therapy should be evaluated critically because sufficient data are not available and mineral metabolism is changed significantly by extremely small dosages of aluminium-magnesium hydroxide antacids even in patients with normal kidney function. PMID- 3660894 TI - Mucosa protectives: sucralfate and colloidal bismuth subcitrate in peptic ulcer disease. AB - Mucosa protective drugs are thought to have an important role in the treatment of both duodenal (DU) and gastric ulcer (GU) disease by means of correcting the disturbed defensive factors. Sucralfate as well as colloidal bismuth subcitrate (CBS) form a layer on the ulcer base and in this way protect the ulcer from acid, peptic activity and bile. In duodenal ulcer sucralfate and CBS have shown a significant difference in healing rate compared with placebo. The same holds true for gastric ulcer. When compared with H2-receptor antagonists the healing rates obtained with sucralfate are rather similar. The data obtained with CBS tend to be superior. Also the scores for symptomatic improvement are indistinguishable compared to that seen with H2-receptor antagonists. Especially after CBS the relapse rates of both DU and GU appear less and delayed. Mucosa protective agents are to be considered as valid alternatives to the H2-receptor antagonists. PMID- 3660895 TI - [Drugs modifying motility in ulcer therapy]. AB - The outstanding success of H2-blocking agents in ulcer therapy proves gastric acid as a dominating factor in the pathogenesis of ulcers. Motility disturbances can be demonstrated in ulcer patients but up to now in therapeutic terms played only a minor role. The therapeutic success of the antimuscarinic drug pirenzepine which inhibits only gastric secretory volume without influencing gastric pH but exerting a significant influence on interdigestive motility of the upper gastrointestinal tract reestablishes this factor to be of pathogenetic relevance. The pathophysiological factor of motility disturbances in the etiology of gastric ulcers is stressed also by the results of a recent therapeutic study comparing ranitidine and cisapride, where the motility-stimulating benzamide showed exactly the same rate of success as the H2-blocker; this holds true for both healing rate and symptomatic improvement. Therefore as far as chronic gastric ulcer is concerned a combination therapy should be preferred thus avoiding the side effects of a strong and long lasting suppression of gastric acid secretion. PMID- 3660896 TI - [Peptic ulcer: therapeutic principle of vagotomy]. AB - The selective proximal vagotomy (SPV) is the surgical procedure of choice today in patients with duodenal ulcer. The ulcer can be cured in 90-95% of all cases, if the indication for surgery is correct and the operation is performed by a technically experienced surgeon. The rate of complications and postoperative side effects is extremely low as compared to the risks in patients suffering from an ulcer complication. If the peptic ulcer is located in the prepyloric region or high in the stomach, the SPV cannot be generally recommended; its application in these cases has so far been justified only within the scope of clinical studies. PMID- 3660897 TI - [Peptic ulcer: status of resecting stomach surgery]. AB - In gastric ulcer disease the operative procedure of choice is still partial gastrectomy, mostly carried out as Billroth I reconstruction with preservation of the duodenal passage. Indications for gastric resection are as follows: suspicion of malignancy, non-healing ulcers under conservative therapy, recurrent ulcer following conservative treatment, multiple and giant ulcers and ulcer complications like penetration, perforation, or bleeding. In duodenal ulcer gastric resection represents the exception. The routine operation is selective proximal vagotomy. The indication for partial gastrectomy in duodenal ulcer disease is: Recurrent ulcer after selective vagotomy (refractory to drugs), gastrin cell hyperplasia (hyper-function) and in rare cases of technical problems during surgery. PMID- 3660898 TI - [Effect of various forms of therapy of peptic ulcer on calcium metabolism]. AB - Several studies have shown that 5-15 per cent of postgastrectomy patients develop osteomalacia, while 10-50% show reduced bone mineral density values with increased risk of fractures. The changes develop slowly over a period of 10-20 years. The high prevalence of metabolic bone disease in this group of patients demands regular controls over an extended period of time and in many cases substitution with calcium and vitamin D. In patients with a very high consumption of aluminium based antacids an increased risk of aluminium intoxication with pronounced osteomalacia has been demonstrated. In theory vagotomy and chronic treatment with H2-antagonists could lead to metabolic bone disease. The data available at the present show, however, that the risk is very low. PMID- 3660899 TI - [Is there a hepatogenic ulcer? Prospective study of the incidence of peptic ulcer in portal hypertension]. AB - During a 7 years study, the endoscopically determined prevalence and incidence of peptic gastroduodenal ulcer in 305 patients with portal hypertension (72% alcoholic cirrhosis, 21.3% non-alcoholic cirrhosis, 6.7% non-cirrhotic portal hypertension) were 4.3% and 3.9% per year, respectively. The yearly risk per patient of suffering from peptic ulcer was 7.4% if both, first and recurrent ulcers (total: 49) were considered. No association was disclosed of peptic ulcer with sex, age, etiology or severity of liver disease. Although an adequate control group was not yet available for comparison, the data do not support the previously postulated relationship between liver cirrhosis and peptic ulcer. PMID- 3660900 TI - [Gastrin in the pathogenesis of ulcer disease]. AB - The role of endogenous gastrin in the pathogenesis of "idiopathic" ulcer disease is difficult to determine; however, gastrin is probably only of limited importance besides various probable more important factors. In conditions associated with uncontrolled gastrin production by a gastrin secreting tumor or in cases in which the feedback regulation between gastrin release and intragastric pH is disturbed severe and recurrent ulcers may develop. Radioimmunological determination of serum gastrin levels enable to identify such cases of ulcer disease due to an excess of circulating gastrin. PMID- 3660901 TI - [Motility and peptic ulcer--possible pathogenetic relations]. AB - The most important causes of peptic ulcers are increased gastric acid secretion, impaired mucosal circulation and damages to the mucosa. In contrast, motility plays only a minor role. The following motility disturbances are discussed in peptic ulcers: 1. Impaired gastric emptying may favor the development of gastric ulceration, if it is grossly delayed, and that of duodenal ulceration, if it is inappropriately accelerated. 2. Disturbances of duodenal motility in the fasted state may disturb bicarbonate secretion and, thus, become theoretically ulcerogenic. 3. Duodenogastric reflux has been discussed as a cause of gastric ulceration for a long time; yet, the proof is still missing. 4. According to own studies gastric ulcer is frequently accompanied by morphological and functional changes in the antrum; the cause-effect relationship, however, has yet to be elucidated. PMID- 3660902 TI - [Effect of circadian rhythm on gastrointestinal motility]. AB - In western civilization, circadian rhythms of the gastrointestinal tract are dominated by a digestive-interdigestive rhythm: During the day interdigestive activity is rare because of frequent meal intakes prior to termination of preceding fed states: in contrast, nocturnal activity is largely interdigestive. Digestive and interdigestive functions are characterized by specific and interactive motor and secretory activity patterns. When exogenous influences via food intake are prevented, additional, underlying, endogenous, circadian rhythms are observed that modulate gastric and intestinal motility in a characteristic fashion, possibly with tight links to the central nervous system. It is likely that disturbances of physiologic circadian modulation of gastrointestinal function may have pathogenic importance. PMID- 3660903 TI - [Histomorphologic studies of the detection of disordered barrier function of the gastric mucosa]. AB - The gastric mucous barrier is characterized anatomically and by physicochemical processes ("double barrier"). Its main components, such as a mucus cover, foveolar epithelium and mucosal interstitium can be investigated by morphological methods. In the present light microscopical study an analysis of mucosal changes after peroral aspirin administration was performed. A significant difference was found between the reaction pattern of antral and corpus mucosa. The distribution of pathologic changes found in stromal microcirculation (ectasia and hyperemia of blood vessels, deformation and rouleaux-formation of red cells, beginning hemolysis) suggests an indirect action of aspirin through vasoactive mediators rather than a direct effect of the drug. The data are compatible with a significant role of a compromised microcirculation in the pathogenesis of epithelial defects. PMID- 3660904 TI - [Blood flow as a protective mechanism of the stomach and duodenum]. AB - Blood flow in the stomach and duodenum is not only important for the transport of O2, CO2 and substrates, but also a protective mechanism against luminal H+. Back diffusion of H+ stimulates blood flow in the stomach, thus preventing mucosal acidosis by removing H+. Another important function of blood flow is the transport of HCO3- for extra and intracellular buffering of H+. PMID- 3660905 TI - [Inhibition of uterine contractions by alpha adrenergic receptor blockaders]. AB - In order to further investigate the adrenergic system of the pregnant uterus, the alpha 2-adrenoblocker Yohimbine and the alpha 1-alpha 2-blocker Phentolamine were examined in regard to their tocolytic effect on myometrial strips and compared with the relaxant effect of Prazosin which was already detected by our group. For both substances a highly significant decrease of uterine activity was found which did not differ from that of the alpha 1-blocker Prazosin. PMID- 3660906 TI - [Premature cervical ripening--surgical or conservative therapy?]. AB - We studied the effect of the cerclage operation as treatment of premature ripening of the cervix in the 15.-35. week of gestation with a retrospective matched pair analysis (n = 142). For each patient in the group treated operatively (n = 71) a patient was selected, who was clinically comparable in parity, gestational age and cervix score at the time of diagnosis but was managed conservatively (n = 71). The study showed that the cerclage operation is not generally advantageous as treatment of premature cervical ripening. Because of the higher perinatal morbidity in the group treated by an operation, the unselected indication for a therapeutical cerclage is questioned. To define indications for cervical cerclage as operative treatment for premature cervical ripening we selected subgroups by history and clinical data treated either operatively or conservatively and evaluated their parameters of gestation, delivery and puerperium as well as the perinatal outcome. We found that the operative treatment was superior to the conservative therapy only in patients with premature cervical ripening before the 25th week of gestation and in patients with an "open cervix" and a history of miscarriage, abortion or premature delivery. The results of this study led to a proposal for the treatment of patients with premature ripening of the cervix, which has to be confirmed by prospective controlled studies. PMID- 3660907 TI - [Rapidly progressing thrombocytopenia as a threatening form of pre-eclampsia]. AB - Atypical courses of pregnancy-induced hypertension (PIH) have been reported quite frequently during the last time. They include prepartal coagulation disorders with slight or missing typical symptoms of PIH. In cases of quickly increasing thrombocytopenia during the last trimenon, in company with elevated liver enzymes, PIH must always be taken into account. We give a case report about a nearly asymptomatic secundigravid woman who developed low platelet counts (8,000 platelets/microliter) within a few hours, which later was confirmed to be severe preeclampsia. Transient and moderate thrombocytopenia down to 50,000 platelets/microliter caused by PIH may first be treated conservatively. Progredient symptoms should lead to an early delivery, as neonatal mortality in such cases is high. We give a review about current literature which reflects on differential diagnosis, pathogenesis and therapy of this disease. PMID- 3660908 TI - [Correlation between maternal hemoglobin levels and placental morphology and findings in newborn infants]. AB - According to the criteria formulated by the WHO a hemoglobin concentration of 11 g/% represents an anaemia requiring treatment. 28 placentas of patients with hemoglobin concentrations of 7.2 to 10.9 g/% were examined morphometrically to detect possible disturbances of placental development. The patients had all delivered between the 37th and 41st week. Weight, hematocrit and HbA content of the newborn were correlated with the maternal hemoglobin content. There was no influence of maternal hemoglobin concentration on weight and size of the placenta, degree of vascularization and epithelial plates of the terminal villi. In patients with severe anaemia villous areas were smaller and villous vascular areas appeared larger than usual. The ratio of weight of the newborn to weight of the placenta was more commonly decreased in patients with anaemia. In some cases of severe anaemia fetal HbA values were elevated. All newborns with a hematocrit of 50 or more were delivered of mothers with haemoglobin concentrations of 9.5 g/% or less. The weight of all newborns in this study were above the 10th percentile. 7 of 9 newborns with a weight of 3,200 g or less were delivered of patients with a hemoglobin concentration of 9.5 g/% or less. These results indicate that placenta and fetal organ systems are able to compensate for the maternal anaemia without any major complications. PMID- 3660909 TI - [Intrauterine growth--normal curves for gestational age]. AB - We calculated new birthweight, length and head circumference standards for caucasian boys and girls between 26 and 43 weeks gestation from 28,126 singleton live births at our hospital between 1980 and 1985. Only stillbirths and infants with serious congenital abnormalities were excluded, whereas babies born to mothers suffering from complications known to affect fetal size were considered part of the population to which standards will be applied and thus remained included. The standards were determined from centiles for each gestational week independent of the mode of distribution of the data. The centiles were then "smoothed" using a Hanningfilter. The descriptive analysis showed a skew to the left of all our data and a steep distribution pattern so that the assumption of a normal distribution is incorrect. Comparison with mean values and standard deviations computed from the same data revealed considerable deviations from our results. PMID- 3660910 TI - [Actocardiograph--an instrument for the diagnosis of fetal behavioral stages?]. AB - The investigation of fetal behaviour are an important clinical tool for assessing fetal well-being. However, they are time-consuming and at least 2 real-time scanners must be employed. The aim of this study was to find out if fetal behavioural states can be diagnosed by using only the "actocardiograph". Thus we compared tracings of the actocardiograph with simultaneously registered tracings from "polygraphic monitorings" including real-time observations of fetal eye, breathing and body movements. We could demonstrate that state 1F and 4F can be recognised in 93% resp. 82%. Periods without a definite state cannot be diagnosed from actocardiographic tracings. This suggested that the combined recording of fetal movements and fetal heart rate with the actocardiograph might be useful for the registration of fetal movements and for the overall diagnosis of fetal behavioural states. However polygraphic monitorings including real-time observations give the only precise picture of neuromotoric coordination. PMID- 3660911 TI - [Configural methods of assessment in psychotherapy research]. AB - The particularity of psychotherapy research implies the application of configural techniques, with respect to the developmental state of theory generation in psychotherapy especially inductive configurational approaches like GUHA or HYPAG/Search. Each variant of HYPAG (i. e. Search for non-disjunctive types, explanations of multiple relationships, elaboration of theory-related optimal suggestions for operationalization) are presented in detail and demonstrated with secondary analyses. The main problem of this approach is the requirement of large numbers of subjects. The application of this approach can hardly be recommended with less than 250 subjects. PMID- 3660912 TI - [An analysis of experimental studies of Schachter's theory of emotion]. AB - The present paper is concerned with Schachter's theory of emotion and with experiments evaluating its empirical significance. Three studies are examined, those by Schachter a. Singer (1962), Erdmann a. Janke (1978) and Marschall a. Zimbardo (1979). They differ considerably in their results. The view is taken, that the seemingly inconsistent findings could be related to a common denominator, with no immediate need of abandoning Schachter's basic ideas. In addressing this issue the concept of "cognitive-physiological incongruity" is introduced referring to altered relations between a person's bodily reactions and his cognitions. An attempt is made to show, that cognitive-physiological incongruity, assumed to be present in the experimental studies under consideration, accounts for most of their conflicting results. PMID- 3660913 TI - [Preventive activity: II]. AB - In this paper a construct called "Praventives Handeln" is outlined. This term is developed within the framework of a general term of "action". First the actualisation of preventive actions in concrete situations is analysed. The relation of this process to conflict, anxiety and self awareness is described. As a special problem the change from external, situational, to internal, structural reinforcers, that seems to be essential for this type of action, is discussed. Finally some consequences for practical applications are presented. PMID- 3660914 TI - [Use of the Kuchenhoff continuity correction of the Lehmacher CFA test in search of types of sociogenic behavior disorders]. AB - To avoid anticonservative rejections of CFA null hypotheses when using Lehmacher's test Kuchenhoff suggested to apply a continuity correction. This correction reduces the differences between observed and expected cell frequencies by a constant. The present paper discusses this variant of Lehmacher's test. Application of the correction for continuity in the search for types of sociogene neuropathology are presented. The discussion covers the effectivity of CFA tests in connection with Holm's method of alpha adjustment. PMID- 3660915 TI - ["Relations and gestalt" (Wyss)--autism and physiognomic gestalt change in malignant schizophrenias]. AB - Reality is what makes it possible to exist as a human being; every form of psychosis is characterized by a loss of reality. Human reality is the social reality of one's fellow-creatures. It is always rooted in the corporeal, the soma which is the manifestation within the individual of the unity of physis, bios, and mind. This complex manifestation (or gestalt in a broader sense) is unstable. It must be maintained by means of a constant supply of emotional stimuli, which is aesthetically mediated by communicative intercourse. Schizophrenia signifies the rupture of interpersonal relationships, a breakdown in the process of emotional refuelling. A marked diminution of clear contours in physiognomic manifestations also has somatically perceivable consequences in the case of the chronically ill. Not only does gestalt thus help form the basis of relationships; relationships, for their part, are instrumental in shaping gestalt. PMID- 3660916 TI - [Reflections on a theoretical psychopathology]. AB - One of the central tasks of theoretical psychopathology is the treatment of the question of in which sense one can speak of illness in the field of psychic mistakenness. A dynamic, an ontological and a relational illness conception are depicted. Of necessity, the conception of the illness determines the comprehension of the talk of an illness symptom. By differentiating between homologous and analogous symptoms, justice is done to the fact that psychopathologic description is based, on the one hand, on the description of subjective suffering and, on the other hand, in the service of a psychiatrically relevant diagnosis. PMID- 3660917 TI - [Interdisciplinary research strategies in geriatric psychiatry--studies and results in dementia and depressed patients]. AB - Eighty-one patients (mean age: 66 +/- 9 years) who had been in gerontopsychiatric in-patient care were included in the study. As well as physical, psychiatric and neurological examinations, EEG, brain CT scanning and the determination of the Ischemic Scale were performed, in order to confirm the clinical diagnosis of dementia of Alzheimer type (DAT), dementia of vascular type (DVT) or multi infarct dementia (MID), and depression in old age, as based on the DSM III criteria. A comprehensive psychological test battery was administered, to one section of the subjects. Our results indicate that EEG and Ischemic Score can differentiate patients with DAT and DVT to a satisfactory degree, whereas CT findings and psychometric assessment were apt to confirm the overall diagnosis of dementia (DAT/DVT) and depression. Patients with dementia showed memory impairment to a greater extent than depressive patients, as could be proved by a memory test (Syndrom-Kurztest). However, a dementia screening test (Information Memory-Concentration Test) could more accurately differentiate dementia and depression. The application of a comprehensive psychometric testing procedure did not prove to be an effective diagnostic tool in the assessment of various stages of dementia. Short dementia tests and rating scales seem to be appropriate to distinguish depression from dementia, especially in cases of mild to moderate dementia. In patients with very mild and insignificant organic brain disturbances these screening methods fall short of diagnostic validity. Beyond this, there is a current need for assessment instruments in the evaluation of alterations in personality and affectivity, such as are seen in depression. PMID- 3660918 TI - [Learned helplessness and depression in the aged. A study of the concept of Seligman's depression in the old age home]. AB - Seligman's concept of "learned helplessness" is examined with a sample of rest home residents. A semi-structured interview is used to assess attributions in the dimensions of internality, stability and generality for past, present, and future life-events. Interrelations of these attributions with depression and age-related self-esteem are investigated. According to Seligman's model elderly subjects with high scores in depression and age-related self-esteem tend to attribute negative life-events as internal, stable and global. Some other assumptions of the model of "learned helplessness" could not be confirmed. Methodological problems are discussed with respect to Seligman's theory of learned helplessness and depression in the elderly. PMID- 3660919 TI - [Abuse and dependence on alcohol and drugs in advanced age]. AB - The report is based on records of 117 in-patients over 60 years of age treated because of alcohol or drug dependence. Remarkably, the abuse of alcohol and particularly of drugs had frequently started at higher age. Situations of loss, loneliness, and isolation as well as mental and physical disease played a precipitation part. In the majority of patients the course of the dependence was severe. Prophylactic and diagnostic problems will be discussed and the necessity of improved therapeutic means will be pointed out. The avoidance of iatrogenically induced drug dependence appears to be particularly important. PMID- 3660920 TI - [Optical hallucinations in the aged with diseases of the eye]. AB - Two cases of Charles Bonnet Syndrome (CBS) showing an unusual history are reported. In a 67-year-old man visual hallucinations developed 38 years after bilateral optic nerve damage due to methyl alcohol poisoning. A 78-year-old woman suffering from bilateral advanced cataract experienced visual hallucinations which ceased after improvement of vision resulting from cataract extraction. Sensory deprivation and--possibly--central neurophysiological disturbance are to be regarded as important pathogenetic factors. Signs of cerebral dysfunction which could be relevant to the pathogenesis of CBS were revealed by the EEG. PMID- 3660922 TI - [Autogenic training in geriatric psychiatry patients]. AB - Autogenic training (a.t.) as an additional therapeutic method was applied to 20 psychogeriatric inpatients in daily exercises. The patients were suffering from major depression, dementia, psychoneurotic disorders and Parkinson's disease. By using only the basic exercises, supported by some learning helps, 14 out of the 20 patients were able to learn and practice a.t. with quite good success, especially in the treatment of sleep disorders and restless states. Involving the nursal staff proved to be of great importance. Finally special aspects of the application of a.t. in psychogeriatric inpatients are discussed. PMID- 3660921 TI - [Circadian-dependent changes in the EEG of vital elderly humans]. AB - The study was conducted with six women and four men, 70-84 years old, without any psychopathologic signs of organic brain syndrome. Every experiment ran for five days during which closed-eye-EEGs were registered at 8 a.m., at 12 noon, at 4 p.m., and at 8 p.m. of the alert but relaxed patients and recorded on tape for computer processing. Simultaneously with every EEG registration the body temperature was measured. RESULTS: As in younger persons the power of the alpha frequency band occipital exceeds the activity of the other frequency bands. But though the frequency of the dominant alpha rhythm comes with 9.5 Hz occipital on an average clearly under the normal range, there was a slight slowing down in sporadic cases. Probably old age leads to a decrease of alpha frequency, even in a state of unaffected sanity. The increase of peak frequency and body temperature during the day, well known from experiments with younger people, comes to the fore in the healthy aged as well. Of striking intensity, especially in the evening, is the beta power at the parietal and the central parts of the scalp, caused possibly by a transitory decline of vigilance. Circadian variations of the different band powers, ascertained in younger persons, are absent in the present collective. PMID- 3660923 TI - [Autogenic training in gerontology]. AB - Autogenic Training (AT) is the most common method of psychotherapy in use today. It is however rarely used with older people who are generally considered less responsive to this method. In this analysis we consider whether or not this scepticism is justified. Our control group consisted of 58 subjects who learnt AT in 7 one-and-a-half-hour sessions. The age of the subjects of two groups was between 18 and 54 years ("younger group") and that of the other two groups between 58 and 80 years ("older group"). 77% of all the subjects were able to get a sufficient grasp of AT over this period. There were no statistically significant differences between young and old in the level of success attained in the individual exercises. It can be proved that the more elderly are more strongly motivated to learn AT and to integrate it into their daily lives. The group situation also meets the greater need of the elderly for contact and mutual support. The results of this small random test should show the way ahead for future investigations necessary in this area. PMID- 3660924 TI - [The elderly patient with dementia in the family: principles of counseling relatives]. AB - For the majority of demented elderly persons the family is the most important resource of support. Living with a demented family member lays a heavy strain on the care-givers. Appropriate counselling may reduce the care-givers' burden and enable them to be more effective. In the present report, some general guidelines of family support are proposed, summarising two years of experience in a special outpatient clinic for the demented elderly. PMID- 3660925 TI - Drug-impaired physicians: identification, intervention, treatment. PMID- 3660926 TI - Chronic S aureus pneumonia presenting as mediastinal mass: case report. PMID- 3660928 TI - Perspectives on the prevention of nuclear war. PMID- 3660927 TI - In encephaloceles, autopsy holds key to genetic counseling: case reports. PMID- 3660929 TI - The responsibilities of a physician. PMID- 3660930 TI - [Schorsch (a case history of our time)]. PMID- 3660931 TI - Assessment of the venous pump function by simultaneous phlebodynamometry, light reflexion-rheography and infrared-photoplethysmography: a statistical comparison. PMID- 3660932 TI - [Plantar light reflection rheography]. PMID- 3660933 TI - [Angiography in acute arterial trauma of peripheral vessels and the aorta]. PMID- 3660934 TI - The accuracy of 125-I-radioactive uptake test for detection of deep venous thrombosis using different labelled proteins (fibrinogen, albumin) and compared to phlebography in hip surgery patients. PMID- 3660935 TI - [Adaptation of peripheral circulation to isolated calf muscle stress and its relation to blood gases and substrate concentrations in femoral and popliteal venous blood in patients with occlusive disease]. PMID- 3660936 TI - A multichannel electronical device for determination of digital blood pressure in peripheral occlusive and vasospastic disease. PMID- 3660937 TI - The importance of arterial compliance for the determination of ankle systolic pressure. PMID- 3660938 TI - The assessment of deep vein valve incompetence by ascending phlebography with a Valsalva manoeuvre: a comparison with descending phlebography. PMID- 3660939 TI - [Erdheim-Gsell cystic medionecrosis. Histomorphologic analysis of 3 clinically different cases]. PMID- 3660940 TI - [Prevalence of extracranial vascular processes and risk profile in patients with peripheral and coronary artery disease]. PMID- 3660941 TI - [Sarcoidosis of the coronary arteries]. PMID- 3660942 TI - The S segment of the Germiston virus RNA genome can code for three proteins. AB - The complete sequence of the S segment of Germiston bunyavirus has been determined from plasmids containing S cDNA inserts. The S segment is 980 nucleotides long with the first 15 bases at the 3' end complementary to the first 15 bases at the 5' end. Three overlapping open reading frames (ORF) were identified in the viral complementary RNA strand. The first ORF codes for a polypeptide of 233 amino acids (Mr 26,600) which is the nucleoprotein N. The second ORF codes for a polypeptide of 109 amino acids (Mr 11,800) which corresponds to the NSS protein, also called p12. Following this ORF, in the same frame, a third ORF which could encode a polypeptide of 75 amino acids was identified. Such a polypeptide has not yet been detected in infected cells. The N and NSS proteins of Germiston virus were compared with the corresponding proteins of La Crosse, snowshoe hare, and Aino viruses, and show a high extent of homology. PMID- 3660943 TI - Nucleotide sequences of the PA and PB1 genes of B/Ann Arbor/1/66 virus: comparison with genes of B/Lee/40 and type A influenza viruses. AB - The complete sequences of the PA and PB1 genome RNA segments of B/Ann Arbor/1/66 virus have been determined. The PA vRNA is 2308 bases long. Its complementary RNA has a single open reading frame of 2187 bases, capable of encoding a PA protein of 726 amino acids with a molecular weight of 83,175 Da. The predicted PA polypeptide has an overall net charge of -7.5 at pH 7.0. The PB1 vRNA is 2369 bases long. Its complementary RNA has a single open reading frame of 2277 bases, capable of encoding a PB1 protein of 752 amino acids with a molecular weight of 84,332 Da. The predicted PB1 polypeptide has an overall net charge of +18.5 at pH 7.0. Sequence homology comparisons of the PA and PB1 polypeptides from B/Ann Arbor/1/66 virus to the PA and PB1 polypeptides of type A influenza virus reveal respective homologies of approximately 38 and 60%. This high cross-type homology (61%) was previously reported for the PB1 protein of B/Lee/40 virus (Kemdirim et al., 1986). The cross-type homology for the PA protein is similar to that of other non-polymerase proteins, but is substantially lower than that seen for the PB1 protein. Thus, the high cross-type homology that exists for the PB1 gene does not appear to be a characteristic of all polymerase genes. PMID- 3660944 TI - Heat-regulated expression of the hepatitis B virus surface antigen in the human Wish cell line. AB - The DNA fragment coding for the hepatitis B virus surface antigen (HBsAg) was placed under the control of a human 70 kDa heat-shock protein (hsp70) promotor sequence. This plasmid construct has been used in transfection experiments to establish a stable amnion cell line of human origin (Wish), expressing an HBsAg in a heat-regulated fashion. Post-translational modifications, such as assembly, glycosylation, secretion and production of both major and middle S proteins appear to function normally. In addition, production of HBsAg under various protocols of heat induction is described. After inoculation into nude mice, development of tumours has been observed at the site of injection. Tumour cells, dispersed by means of collagenase or trypsin treatment from excised tumours, and subsequently seeded into Petri dishes, were able to secrete the same quantities of HBsAg after heat induction as were cells of the original cell line. PMID- 3660945 TI - [Parallelism in the hereditary variability and population concept of species in representative prokaryotes]. PMID- 3660946 TI - [Changes in the cell differentiation rate of a megakaryocytic line after cytotoxic exposure]. PMID- 3660947 TI - A comparison of the product formation induced by ultrasonic waves and gamma-rays in aqueous D-glucose solution. AB - The oxidation products obtained in aerated, aqueous alpha-D-glucose solutions after irradiation with ultrasonic waves and gamma-rays were compared. Separation and identification were performed by gas chromatography/mass spectrometry and three methods for the derivatization of the products were used: (1) trimethylsilylation of the OH groups; (2) methoximation of the carbonyl groups followed by trimethylsilylation of the OH groups; (3) reduction of the carbonyl and carboxyl groups to alcohols by sodium borodeuteride, followed by trimethylsilylation of the OH groups. When using ultrasound and gamma-irradiation identical products were observed: D-glucono-1,4-lactone, D-glucono-1,5-lactone, D arabino-hexos-2-ulose, D-ribo-hexos-3-ulose, D-xylo-hexos-4-ulose, D-xylo-hexos-5 ulose, D-glucohexodialdose and arabino-1,4-lactone. From the results it was concluded that in ultrasound and gamma-irradiation the same primary species and consecutive reactions are involved in product formation. PMID- 3660948 TI - [The quality of dried fruit, especially figs, based on results of food surveillance and our own research]. AB - The legal controls of dried fruits put forward by the state control laboratories show that contamination by insects, especially mites, is often a reason for complaints. This is evidently due to the rural conditions of production. Because hygiene is of great importance, a much stronger control should be achieved in the producing countries as well as in the importing countries. PMID- 3660949 TI - [Increased levels of cesium-137 and cesium-134 in 34 mushroom species following the reactor accident at Chernobyl]. AB - From September to December of 1986, 85 samples of 34 species of wild mushrooms were collected, mostly in northern Baden and occasionally in neighboring areas. Cs-137, Cs-134, and the natural nuclide K-40 were determined by gamma spectrometry. Samples from the Rhine Valley and the Kraichgau were generally much less contaminated than those from the Black Forest. With one exception, their radiocesium levels were below the Common Market limit of 600 Bq/kg. The exception was a sample of Laccaria amethystina with 1710 Bq/kg Cs-137 and 766 Bq/kg Cs-134. Relatively high levels were also found in Xerocomus badius, X. chrysenteron and Cantharellus tubaeformis. The hymenophore contained higher concentrations of radiocesium than the other parts of the body of the fruit. No correlation between the concentration of K-40 and that of the Cs nuclides was found. The ratio of Cs 137:Cs-134 was usually below 3 but reached the value of 11.8 in Piptoporus betulinus growing on birch wood. In this case, the substrate must have contained more radiocesium from the time before the Chernobyl reactor accident than from the time thereafter. PMID- 3660950 TI - Use of gas liquid chromatography/mass spectrometry for triazine herbicide residues analysis in forage and milk. AB - Residual s-triazines were isolated from forage and milk samples by methanol/chloroform extraction followed by column purification. The evaporated extracts were dissolved in acetone and analysed by gas chromatography with NPD detection and mass spectrometry. The detection limits for both methods were found to be about 5 approximately 10 ng of each s-triazine. The selective ions of the 10 s-triazines investigated (simazine, atrazine, propazine, terbuthylazine, cyanazine, desmetryne, ametryne, prometryne, terbutryne and methoprotryne) were chosen on the basis of an electron impact mass spectrometry study of the s triazine standards and the whole mass spectra are given. Special attention was paid to the fragmentation of cyanazine and the general cleavage pathways of the s triazines under investigation. PMID- 3660951 TI - Radioimmunological determination of cocaine in human hair. AB - A simple procedure for the determination of cocaine in human hair was described. After washing hair samples were crushed in 0.1 m HCl and incubated overnight at 45 degrees C. The acid extracts were neutralized with 1 m NaOH. Phosphate buffer (pH 7.4) was added to the extracts. The cocaine concentrations were measured by radioimmunoassay. Detection in hair was achieved in all hair samples obtained from cocaine users. This method appears to be suitable for the routine determination of cocaine. PMID- 3660952 TI - Determination of cocaine in human hair by gas chromatography/mass spectrometry. AB - A qualitative method for the determination of cocaine alone without its metabolites in human hair by gas chromatography/mass spectrometry (GC/MS) was developed. The assay used helium as carrier gas, a 30-m bonded phase fused silica OV-1 capillary column, and solid injection at 290 degrees C evaporator temperature. The cocaine concentrations in hair were determined also by radioimmunoassay (RIA). The values obtained are the sum of cocaine and its metabolites. Both GC/MS and RIA meet the requirements for the determination of drug abuse by two different methods in forensic science. PMID- 3660953 TI - [Double ricochet marks]. AB - When bullets are flying stably and ricochet on a surface, only one mark is produced. In contrast yawing bullets can produce a double mark if the angle of incidence is sufficiently small (less than or equal to 5 degrees). Distances up to 15 cm were seen between the two marks. PMID- 3660954 TI - [Liability in desensitization accidents]. AB - Deaths that occur during the course of desensitization treatment are regularly analyzed in penal or civil investigations. Abnormal activity of an allergenic extract may also be the cause of the incident, but it is difficult to prove. Today the burden of proof is being reversing in favor of the patient because the legal requirements for drug producers are more specific. Liability to injury and liability of the product are discussed with regard to the legal situation in the Federal Republic of Germany and in Austria. In any case, there is a considerable gray area regarding liability for incidents during desensitization treatment. Because safer medicines are required today, the author is proposing that the duty to notify be intensified by the requirement that mild systemic reactions also be reported to a central registry. PMID- 3660955 TI - [Computer-assisted identification of basic substances]. AB - The potential applications of a personal computer with integrated database software in toxicologic analysis are discussed. A toxicologic database including 370 basic compounds, is presented that was built up without knowledge of a higher programming language and was used as a base for drug identification in normal analysis by PC, DC and GC. PMID- 3660956 TI - [A new criminologic procedure: study of L-cystine-aminopeptidase activity for the detection of seminal stains]. AB - L-Cystine-aminopeptidase (CAP) enzyme cleaves L-cystine-di-beta-naphthylamide substrate to beta-naphthylamine. The final product of this process is a violet azostain. CAP enzyme determination was developed for criminological procedures. CAP shows almost 100 times greater activity in human semen than in other body fluids. Samples taken at different time intervals (1 week, 1-3-6 months, 1 year, and 5-10 years) were investigated; they were dried on cloth and filter paper and then stored at room temperature for various time periods. The enzyme was also shown to be specific in the comparative studies performed with other human secretions (nasal discharge, saliva, vaginal secretion, feces, urine, breast milk) and fruit juices (raspberry, strawberry, apple, pear, plum, tomato, etc.). PMID- 3660957 TI - Instrumental set-up as a factor influencing the variability of retention index values in high pressure liquid chromatography. AB - The influence of different laboratory set-ups on HPLC retention index values of selected acidic and basic drugs was investigated. The RI values of drugs were calculated using the alkyrarylketone scale. Two columns filled with different batches of the same Hypersil ODS phase were consecutively used in two laboratories under identical conditions, but using different instrumentation. The study showed that the different laboratory set-ups influence the precision of RI values, and the differences in column filling affect the accuracy. PMID- 3660958 TI - [On the work: Madea B, Henssge C, Lockhoven HB (1986) Priorities in multiple gunshot wounds of the skull]. PMID- 3660959 TI - [CO2 laser treatment of the Buschke-Lowenstein tumor]. AB - On the basis of two casuistics is reported on the laser treatment of Buschke Lowenstein tumours. Hereby the advantages of this method are emphasized and compared with the former treatment techniques. PMID- 3660961 TI - [Conservative treatment of staghorn calculi]. AB - On the basis of the examination of 24 patients with unilateral or bilateral staghorn calculus, who could not be operated for internal reasons, is reported on the course of the lithiasis. The observation time is between 2 and 9 years. In all patients an infection of the urinary tract was present. During the observation time in no patient a growth of the calculi could be stated. 6 patients who died of the lithiasis and uraemia already when the diagnosis was made had a functionless kidney greatly restricted global renal function. In the living patients no progression or exacerbation of the infection was revealed. The suggestion that a staghorn calculus necessarily leads to the loss of the renal function cannot be confirmed on the basis of the literature and the own results. Though there is no doubt about the advantage of the operation, in an increased risk an expectant attitude with conservative therapy seems to be justified. An infection of the urinary tract cannot be treated conservatively. PMID- 3660960 TI - [Resorption of oxalic acid in calcium oxalate nephrolithiasis]. AB - In 43 healthy reference persons and 54 patients with relapsing calcium oxalate nephrolithiasis the absorption of oxalic acid was measured by means of 14C-oxalic acid. In patients with oxalate calculi the absorption of oxalic acid is totally increased and also in such ones with Whewellite-calculi. It is decreased in carriers of Weddelite calculi. The increase of the absorption of oxalic acid in patients with mixed calculi is not significant. PMID- 3660962 TI - [Therapy of bladder calculi--trends and results of a mainly transurethral oriented clinic]. AB - From 1975 to 1985 519 patients with urinary calculi were treated in the Urologic Clinic of the Berlin-Buch Hospitals. 57.6% of them were treated by lithotripsy and TUR-P, 14.8% by lithotripsy alone, 11.8% by stone removal and transvesical adenomectomy and 15.8% by suprapubic cystotomy only. The diagnosis of the four forms of therapy is described. The trend in the conception of treatment goes to the treatment of calculi transurethrally in combination with the simultaneous removal of the obstruction of the outflow from the urinary bladder. Since October 1985 the electrohydraulic lithotripsy has been used. Up to 1985 in 218 patients urinary calculi were crushed by means of the device Urat-1. In 190 patients (87.3%) the lithotripsy was carried out in combination with other therapeutic measures, in 153 (70.2%) a transurethral resection of the prostate gland and in 28 patients (12.9%) other transurethral interventions were performed. Postoperatively, in 7 patients complications occurred (3.2%), perforations of the urinary bladder were not seen. Taking into consideration the whole number of patients, it is reported on the advantages of the use of the electrohydraulic lithotripsy by means of the apparatus Urat-1 as an uncomplicated technique easily to be learned, which excellently may be combined with simultaneous transurethral interventions. PMID- 3660963 TI - [Surgical therapy in colon perforations]. AB - Diagnosis of colon perforation is an absolute indication for surgery. Therapy should include removal of the perforated colon section. Continuity resection should be preceded by colostomy for higher safety. PMID- 3660964 TI - [Cervix and tocography screening in basic pregnancy monitoring]. AB - Report about a myometrial contractility-screening in 2462 asymptomatic pregnancies at 30 weeks of gestation. A cervical examination was performed in the 26th and 33th weeks of gestation. An increased uterine contraction frequency was obtained in 3% and a cervical opening in 5.6%. Uterine contractions with cervical opening are a high-risk factor of prematurity (52%-70%) whereas uterine contractions alone are of low-risk. The prevention of preterm birth is useful. We found a significant decrease of early neonatal mortality in 487 singleton preterm deliveries after treatment. A classification of unexplained preterm delivery, iatrogenic or elective preterm delivery and complicated preterm labor is recommended for controlled outpatient and clinical trials. PMID- 3660965 TI - [Lymphogranulomatosis and pregnancy]. AB - A long period of full remission after successfully treated Hodgkin's disease set more and more in our concern problems of pregnancy and parturition in these patients. There are no exact informations about an unfavourable influence of pregnancy on the course of Hodgkin's disease. Although in cases of severe disease the treatment of the mother goes first we will restrain from therapeutical activities in patients with favourable histology and missing B-symptoms. It is reported on 3 cases of Hodgkin's disease with succeeding pregnancy and delivery. The stage IV of Hodgkin's disease in one patient is apparently followed by an uncomplicated course of pregnancy and lack of recurrent disease. PMID- 3660966 TI - [Tobacco and pregnancy. Weight of the newborn infant and weight gain of the mother]. AB - 865 patients delivered at women's clinic "La Paz" have been examined, to prove the hypothesis, that the weight of the newborn may be influenced by smoking indirectly via nutrition. 276 of the 865 women did smoke. In this group the weight of the newborns was lower significantly. If we select both groups of smoking and nonsmoking patients appropriate to the weight increase during pregnancy above or below the average value, we can state that those fetuses had a intrauterine growth retardation whose mothers did smoke and had a lower weight increase than the average value of all pregnant women. PMID- 3660967 TI - [Culture of placental tissue by the modified roller tube method in vitro]. AB - Tissue cultures of the placenta are being performed with various methods. Tissue cultivation is currently used as a method and as a medium for various investigations. In the present study, the authors have found that the Modified Roller Tube Methods appearing to be of a practical and repetitive nature in securing in vitro of the placenta. PMID- 3660968 TI - [Intrapartum fetal death]. AB - Among the 18,394 children, who have been born at the Obstetric Department of the University of Innsbruck, Austria, from 1976 to 1984, 16 intrapartum deaths have been observed. Eight of these who have been vaginally delivered showed anomalies of presentation, three were anencephali, the others were singularities. There was an impressive improvement in the course of the years, but also in comparison with international results. In bur eyes, the consequence of this study is the avoiding of preterm births, an increased use of the caesarean in preterm infants with anomalies of presentation and the intensive observation intrapartum combined with a human background. PMID- 3660969 TI - [Incidence and potential factors in the genesis of birth injury-induced clavicular fractures]. AB - The incidence of clavicula fractures at the First Department of Obstetrics and Gynecology of the University of Vienna was 217/8383 (2,6%) deliveries in 1980 through 1984, whereas 248/5531 (4,44%) deliveries were noted at LKH Modling. Higher birth weight and larger children result in a greater incidence of clavicula fractures. The greater percentage of children weighing more than 4000 gm and being larger than 52 cm at the LKH Modling compared to that at the First Department of Obstetrics and Gynecology of the University of Vienna, i.e. 18,55% and 40,32% vs. 15,67% and 28,57%, resp. explains the higher incidence of clavicula fractures there. PMID- 3660970 TI - [Multifocal (chaotic) atrial tachycardia in a newborn infant]. AB - Description of multifocal (chaotic) atrial tachycardia in a newborn, which reverted to sinus rhythm after treatment with digitoxin. PMID- 3660971 TI - Lysophospholipase activity of Mycobacterium smegmatis. AB - Lysophospholipase (LPL) activity found in Mycobacterium smegmatis was characterized. LPL activity was found to exist in high levels in two-to-10-day old cultures. The enzyme assay was run using 1.4 X 10(9) viable bacteria at an incubation time of 24 h. Enzyme activity was detected between 1 degree C and 80 degrees C with maximal activity between 40 degrees C and 60 degrees C. LPL activity was maximal at pH 9.0, with activity ranging between pH 3.0 and 10.0. PMID- 3660972 TI - [Bacterial agglutination for antibody detection in patient serum (Widal reaction). Commission for the establishment of procedural guidelines for microbiologic diagnosis]. PMID- 3660973 TI - Proceedings of the Fifth Japanese-German Cooperative Symposium on Protozoan Diseases. September 25-28, 1985, Tokyo, Japan. PMID- 3660974 TI - Malaria situation in Asia with special reference to western Pacific region. PMID- 3660975 TI - Cecal filling and defecation of chickens infected with Eimeria tenella. AB - White Leghorn cockerels, 11 to 22 days old, were inoculated each with a single oral dose of 4-5 X 10(4) sporulated oocysts of Eimeria tenella. Radiographic study of urinary backflow in infected chickens injected with sodium iothalamate subcutaneously indicated that retrograde movement of ceca was impaired particularly 7, 10, and 14 days after infection. No inflow was noted 7 days after infection when barium sulfate was inoculated into cloaca. Weight of cecal contents examined 7 days after infection was significantly smaller than uninfected control. Number of cecal feces was counted every 24 h beginning 4 through 14 days after infection. The counts in infected birds were significantly fewer than uninfected control 8, 9, and 10 days after infection. Outflow of cecal contents was studied in chickens surgically injected with barium sulfate into cecum 7 days after infection. Radiographic study indicated that most of uninfected control ceca excreted or evacuated the medium between 10 and 24 h after injection, while a few infected birds cleared ceca during the same period. PMID- 3660976 TI - Experimental infection of chickens with Cryptosporidium. AB - To study the clinical and pathological manifestations of Cryptosporidium infections, 24 h-old chickens were inoculated via four routes: orally, nasally, cloacally and by contamination, using 10(5) oocysts of Cryptosporidium in each case. The chickens began to shed oocysts of Cryptosporidium on days 7 to 8 after inoculation. There was no difference in the clinical manifestations or histological damage with respect to the inoculation routes. Various developmental stages of Cryptosporidium were also demonstrated microscopically in the smears or sections of bursa of Fabricii, larynx, trachea and cecal tonsils of inoculated chickens. Although the intestinal mucosa and respiratory tract mucosa were scarcely infected with the parasites, the bursa Fabricii was heavily infected in association with hypertrophy and hyperplasia of the lining epithelial cells. PMID- 3660977 TI - Light-microscopical appearance and ultrastructure of Blastocystis hominis, an intestinal parasite of man. AB - A study on Blastocystis hominis was undertaken for the purpose of clarifying the morphology of the organism using the following techniques; Giemsa, Heidenhain Iron Hematoxylin, and DAPI stains, phase-contrast microscopy, and transmission- and scanning-electron microscopy. Microscopic examinations of the lumen fluids aspirated at the endoscopical examination revealed the habitation of B. hominis in the lower ileum and cecum of a patient. When examined light-microscopically, organisms from stool materials, cultures, and aspirated intestinal lumen contents of a patient showed morphological resemblances to each other except for variations in size. Vacuolated cells, which were spherical in shape and characteristically had a large central vacuole and a narrow rim of cytoplasm containing nuclei and some inclusions, were the only form of the organism observed in this study, although the contents of the vacuole notably varied. DAPI stains clearly revealed the nucleus and the possible mitochondrion in the narrow rim of cytoplasm. Phase-contrast microscopy of fresh material prepared with physiological saline was recommended for diagnosis. When examined electron microscopically, the organisms were coated with a capsule that was composed of fine filamentous materials. All the organisms contained a central vacuole although the contents of it varied considerably. The cytoplasm gave the organism a signet ring appearance and contained cristate mitochondria, a great number of ribosomes, Golgi's apparatuses, cytoplasmic microtubules, and nuclei with a nucleolus. Very few of the ultrastructures are those that would be expected of a yeast. Recent occurrences of B. hominis infection in Kyoto City, Japan, during a two-year period (June 1983 to August 1985) were also reported. PMID- 3660978 TI - Existence of a connecting system in the flagellar apparatus and the accessory structures of Trypanosoma evansi. AB - The three-dimensional architecture of a quartet of microtubules (QM) of Trypanosoma evansi and its related structures was examined with a transmission electron microscope (TEM). The initiation of the QM as a successive bundle of microtubules was confirmed at the juxtaposition of the second barren body (SBB). After connecting with the distal part of the basal body (BB), the QM ascended to the level of the terminal plate (TP) and gained access most closely to the inner membrane of the flagellar pocket (FP) and formed the special structure together with macula adherens (MA) and the electron dense linear substance (EDLS); then it follows its way around the FP from the posterior to the anterior and fills the subpellicular space at the underneath of the flagellum. This special structure disappeared when the associated-flagellum became the extracellular flagellum (EF), where the QM intervened into the row of the subpellicular microtubules (SM). This EDLS is suggested to represent a demarcating line (DL). In the deep cytoplasm of the flagellar root, connections via several microtubules between the BB and the SBB and via electron zonal substance (EDZS) between the BB and the mitochondrion (M) were observed. As a result, a connecting system among the flagellar apparatus and its accessory structures seems probable. PMID- 3660979 TI - In vivo interaction between Trypanosoma gambiense and leucocytes in mice. AB - Naturally occurring phagocytosis of Trypanosoma gambiense by mouse eosinophils and neutrophils was reported. In vivo and in vitro experiments using monoclonal antibodies confirmed that the phagocytosis is triggered by G1 class antibodies against variable surface antigen. Ultrastructural observation revealed the mode of entry and the intracellular fate of T. gambiense: initial attachment, pseudopodia formation and complete invagination. This phagocytosis resulted in the killing of T. gambiense by mouse eosinophils and neutrophils, suggesting that eosinophils and neutrophils give at least partial protection against infection with T. gambiense in combination with the specific antibodies. PMID- 3660980 TI - Present epidemiological situation of kala-azar in the Republic of Sudan. PMID- 3660982 TI - Modification of growth rate of Toxoplasma gondii by continuous passage in immune mice. AB - Growth of the RH strain of Toxoplasma gondii, is suppressed in mice immunized with Toxoplasma antigens. At the second passage, the growth of T. gondii harvested from immune mice is suppressed more strongly in immune mice than that of T. gondii from control mice. After 52 passages in immune mice, the growth of T. gondii was still suppressed in immune mice than in control mice. T. gondii did not possess ability of antigenic variation (Pfefferkorn et al., 1983). After vaccination with the S-273 strain of T. gondii, mice were challenged twice with the RH strain. Cysts in brains caused death of all mice by inoculation at the 1st, 2nd, 3rd, 4th and 8th week after the second challenge of the RH strain. But the cysts from mice at the 16th and 30th week have decreased virulence, causing death in only 2 out of 4 and 1 out of 4 mice, respectively. Virulence of cysts had no definite relationship to Toxoplasma antibodies by indirect latex agglutination test and the numbers of cysts per brain. Growth variation of T. gondii is proposed under unfavourable conditions as in mice immunized with Toxoplasma antigens or vaccinated with the S-273 strain. PMID- 3660981 TI - Correlation between release of reactive oxygen intermediates and inhibition of Toxoplasma multiplication in mouse peritoneal and alveolar macrophages and kidney cells after in vitro incubation with Obioactin, lonomycin A, muramyl dipeptide, lipopolysaccharide or Toxoplasma lysate antigen. AB - The inhibition of Toxoplasma multiplication inside cells does not correlate with an enhanced release of oxygen intermediates except in the case of peritoneal macrophages treated with Obioactin. The inhibition observed in alveolar macrophages treated with Obioactin, in kidney cells treated with Obioactin or lonomycin A and in peritoneal macrophages treated with lonomycin A was not accompanied by an increment of release of oxygen intermediates. Lipopolysaccharide (LPS) and muramyl dipeptide (MDP) enhanced the release of toxic oxygen intermediates in peritoneal macrophages, but did not have any toxoplasmacidal effect. Adenosine triphosphate (ATP) content increased during Obioactin, MDP or Toxoplasma lysate antigen (TLA) treatment. The actual oxygen consumption of the peritoneal macrophages treated with Obioactin increased dose dependently, but that of TLA-, lonomycin A- or MDP-treated cells did not change. These results suggest that the relationship between the intracellular killing of Toxoplasma protozoa and the release of oxygen intermediates differs according to the cells and/or the stimuli, and that the cellular mechanism of Toxoplasma killing in the peritoneal macrophages treated with Obioactin involves an energy dependent mechanism. PMID- 3660983 TI - Long-term in vitro suspension culture of Toxoplasma and HeLa cells. AB - To establish a method of mass and long-term propagation of Toxoplasma in suspension cultures and to find a technique for separating the organisms from host cells, basic investigations were carried out in a microcomputer controlled system. By using an arbitrary unit "the medium index" host HeLa cells were continuously supplied to Toxoplasma organisms for about 30 days, at cycles of 4 days. HeLa cells were well infected with Toxoplasma in the suspension cultures by leaving the medium unstirred for 15 min intervals. The separation of Toxoplasma organisms from cells was improved by treating toxoplasmas and HeLa cells mixtures with 0.4% trypsin. The total number of separated organisms obtained from 29 days cultivation period was 4.9 X 10(9). The mean generation time of Toxoplasma organisms on the 0, 10, 20 and 30 day's cultivation was calculated approximately 7.4, 9.4, 9.3 and 7.8 h, respectively. PMID- 3660984 TI - [The genotoxic effects of T-2 toxin, a trichothecene produced by fusarium fungi]. PMID- 3660985 TI - [N-methyl-N-nitro-nitrosoguanidine induced neoplastic transformation of fetal lung fibroblasts in vitro]. PMID- 3660986 TI - [The studies on chromatin structure and basic protein composition of mature sperm in Carassius auratus gibelio]. PMID- 3660987 TI - [The specific inhibitory effect of cancer serum on mouse lymphocyte SCM reaction]. PMID- 3660988 TI - [Analysis of DNA synthesis and DNA content in the proliferative lymphocyte]. PMID- 3660989 TI - [In vitro culture of canine circulating haemopoietic progenitors]. PMID- 3660990 TI - [Some biological characteristics and karyotype analysis of a mouse embryonic stem cell line-ES 8501 cells]. PMID- 3660991 TI - Resection in renal tumour patients. AB - Nine cases (two of them bilateral) of renal resections for renal tumour are reviewed. The survival results of patients with bilateral renal tumours are considered particularly favourable, one of them has survived for 72, the other for 37 months. Of the patients with solitary renal tumour, one was lost 25 months postoperatively, after the development of a distant metastasis. The other patient has been free of recurrence and metastases after 31 months. The above results have proved the outdatedness of the old concept, i.e. to remove the tumorous kidney. As supported by the authors' cases, their patients have had a high survival rate after resection for renal tumour. The clear-cell tumours are well demarcated by a fibrous capsule and they can easily be resected. The granular cell renal tumours are localized more centrally, they often infiltrate the kidney. In cases cautiously considered, the resection of the tumorous kidney can be performed under the present technical conditions by strict 6 monthly postoperative urographic, ultrasound, and angiographic examinations. PMID- 3660993 TI - The significance of early diagnosis in the management of testicular tumour patients. AB - Surveying the therapeutic results of 16 testicular tumour patients treated in the recent 5 years, the authors stress, beside the generally accepted and use complex treatment, the importance of recognizing the disease in its early stage. PMID- 3660992 TI - Surgical treatment of vesicoureteral reflux. AB - Based on the critical analysis of their own material, the authors evaluate the different antireflux operations. The problems of surgical indication are dealt with. The principles applied in selecting the type of operation are reviewed and the experiences of the control examinations are reported. PMID- 3660994 TI - Primary retroperitoneal tumours, in the material of our department. AB - After giving a brief survey of the literature, the authors discuss the symptomatology, diagnostics and management of retroperitoneal tumours. Four of their own cases treated between 1979 and 1985 summarized in tables are presented. All of them were operated and three of them received irradiation therapy. The fate of the first patient is unknown. The second patient survived for 24 months following the first operation, with additional three operations and irradiation on two occasions for recurrence of tumour. The third patient survived for 5 months. In the fourth, it could be revealed by ultrasound and angiography that the retroperitoneal tumour was independent of the kidney. Thus, the intact left kidney was preserved during operation. The patient died three months postoperatively at the department of pulmonology. The histological finding of the tumours of all patients was a malignant tumour of mesenchymal origin, a type of sarcoma. Based on their experiences, the authors stress the importance of the early recognition and removal of the tumour, since the patients have a poor chance of surviving these extremely malignant sarcomas in spite of the surgical and irradiation therapies. PMID- 3660995 TI - Procedures increasing the effectivity of percutaneous nephrolithotomy. AB - The advantages of percutaneous nephrolithotomy are reviewed and the difficulties are pointed out. During more than 100 successful nephrolithotomies it was found that stones or their fragments often drift away during manipulation into lateral or upper calices which cannot be visualized by a rigid nephroscope. Thus, removal of calculi was possible only by an auxiliary manipulation and so it took more time. To prevent this, an occlusive catheter was introduced, simultaneously with the ureteral catheter, into the renal cavital system and by blocking the balloon, the orifice of the calices was closed. In the case of multiple stones, two calices were simultaneously punctured and the two nephroscopes introduced were alternately applied during ultrasonic crushing of the stone, depending on which of the two instruments was closer. The modifications introduced by the author have significantly reduced the time of the operation and increased the effectivity of the procedure. PMID- 3660996 TI - Pre- and postoperative examinations in intestinal tumours of the pelvis. AB - Pre- and postoperative urological and lower urinary tract urodynamic studies were made in patients operated for intestinal tumours of the pelvis. It was established that urological complications often arise and they often escape detection during the examination or under the conventional surgical care. An examination and a control scheme is recommended for the early detection of the possible complications and for starting an adequate treatment in due time. PMID- 3660997 TI - Application of aluminium ammonium-sulphate solution in treating massive haemorrhage of bladder origin. AB - The effect of the 1% aluminium ammonium-sulphate solution has been studied. As revealed by animal experiments and clinical examination, the new method can effectively be used without side-effects in the symptomatic treatment of the massive vesical haemorrhages of different origin. PMID- 3660998 TI - Experiences on the surgical management of testicular torsion. AB - The authors performed operations in 9 patients at the Department of Urology of the Istvan Hospital during the past 5 years. In 7 cases, detorsion and saving of the testicle was successful in possession of an early diagnosis. Two patients had to be castrated. In view of their results, authors draw attention to the necessity of establishing a rapid diagnosis and to the importance of an early surgical intervention. PMID- 3660999 TI - [The surgical treatment of exogenous morbid obesity]. AB - 19 patients underwent a subtotal gastric bypass following Griffen as the treatment of their morbid obesity. All patients had a complete follow-up ranging from 18 to 36 months. All patients had a weight reduction, into the proposed norms, f.i. below 20 to 30% above the ideal body weight. The sequelae of the obesity disappeared progressively with the weight reduction. Two patients however developed an anastomotic ulcer more than one year after the intervention (11.2% 2/19 patients). 21 patients died of a leakage after Mason-plasty (1/40 patients 2.5%). A minimal morbidity and mortality can only be obtained by using a meticulous operative technique and a team approach of the patient by medical, nursing, dietary and physiotherapist staffs. PMID- 3661000 TI - Roux-en-Y gastrectomy: early and late results. AB - Results obtained in 16 patients by Roux-en-Y gastrectomy (Moskowicz procedure) are presented. According to Langhans a high gastrectomy ascending on the lesser curvature to 2 to 3 cm below the cardia and unaccompanied by a sectioning of the vagal branches was performed. The Roux-en-Y resection was used only in exceptional situations, being preferred to the standard Billroth II operation in order to avoid the biliopancreatic reflux into the gastric remnant. It was performed as a primary intervention in 13 cases (penetrating gastric or duodenal ulcers, gastritis due to biliar reflux) and as a revisional surgery in three patients with disturbances of the operated stomach. The best results were obtained in gastritis due to biliar reflux, in gastric ulcers Johnson I type, and when the method was used as a revisional surgery. When it was used as a primary operation in duodenal ulcers, the main risks depend of two things: the duodenal fistula and the ulcerous recurrence. Duodenal stump disruption has not specific causes and as well as in all the Billroth II resections may results from less than satisfactory duodenal closure. This complication was noted in one patient. Concerning the risk of the anastomotic ulcer, it is particularly increased in the Billroth II-Roux gastrectomy compared with the other types of gastric resections. When the operation is unaccompanied by vagotomy, the risk has maximum values. In this clinical material the ulcerous recurrence was noted in four patients. PMID- 3661001 TI - [Hydatid cyst of the pancreas. Apropos of 2 case reports]. AB - Hydatic cyst of pancreas is a rare disease, the symptomatology is polymorph and the diagnosis is rarely evocated before surgery. Epidemiological, clinical, biological (immunofluorescence) and echographic data should allow its better detection. Surgical treatment is function of the cyst localisation: exeresis for left lesions and conservative surgery for right lesions. PMID- 3661002 TI - Retroperitoneal leiomyosarcoma. AB - The clinical history, radiological investigations, pathologic findings and treatment of four patients affected by retroperitoneal leiomyosarcoma were compared with data of the literature. These tumors have a great tendency to develop local recurrences after excision, but metastases to lymph nodes and distant organs usually occur lately. CT examination of the retroperitoneal space is a sensitive tool in the diagnosis and follow-up. Complete excision of the tumor followed by radiotherapy improves significantly the prognosis. Chemotherapy is advisable only when disseminated metastases appear. No correlation was found between the histologic appearance and the clinical behaviour. PMID- 3661003 TI - [Adenocarcinoma in a cystic duplication of the ileum]. AB - A case of adenocarcinoma arising in a cystic duplication of the ileum of a 34 year old woman is described. Only one case of adenocarcinoma in ileal duplication has been recorded previously. The adenocarcinoma arose from gastric mucosa of a tubular duplication. In this case the adenocarcinoma arose from primitive type intestinal mucose in a cystic duplication. PMID- 3661004 TI - Internal fixation of femoral neck fractures. A follow-up study of 118 cases. AB - A retrospective study of 118 femoral neck fractures treated with multiple Knowles pins or with AO (ASIF) cancellous bone screws, and followed for at least 22 months, revealed nonunion in 1/33 undisplaced fractures and in 27/85 displaced fractures. Avascular necrosis was radiographically evident in respectively 2/32 and 19/58 united undisplaced and displaced fractures. Four factors were adversely associated with union: inaccurate reduction, mental confusion, age above 80 years and fixation with less than 6 Knowles pins. Late segmental collapse was not significantly related with any of the 9 analyzed factors. It was concluded that displaced femoral neck fractures in confused patients older than 80 years, or fractures one cannot adequately reduce, should be primarily treated with arthroplasty. Following accurate reduction, internal fixation with less than 6 Knowles pins cannot be recommended. PMID- 3661005 TI - [An unusual cause of subcutaneous postsacral swelling]. AB - A subcutaneous sacrococcygeal located myxopapillary ependymoma is a rare presentation of this malignancy. It has a tendency to metastasize, even after a long latent period. This is a report of such a case together with proposals for treatment and follow-up. PMID- 3661006 TI - [Adenocarcinoma of the thyroglossal duct]. AB - Carcinoma of the thyroglossal duct is a rare entity. In most cases, papillary carcinomas are reported. Follicular or squamous cell carcinomas are seldom. Insofar no capsular refraction exists, the best treatment seems to be the Sistrunk operation with postoperative thyroid suppression medication. PMID- 3661007 TI - [Surgical case report: diagnosis of associated abdominal lesions in penetrating injuries of the lower chest]. AB - We discuss the way to diagnose intra-abdominal lesions caused by penetrating objects in the lower thorax. Let us call these wounds penetrating wounds. Two kinds of penetrating wounds are considered: 1. shotwounds; 2. knifewounds. 1. In shotwounds of the lower thorax there is not any non-surgical method available to find the associated intra-abdominal lesions. In these cases the results of: 1. physical examination; 2. local wound exploration; 3. echography of the abdomen and 4. peritoneal lavage cannot be trusted. Only laparotomy can show us if any associated lesion in the abdomen exists. 2. For knifewounds we can make almost the same remarks: 1. physical examination; 2. local exploration of the lesion; 3. echography of the abdomen are not to be considered as good diagnostic tools to find the associated intra-abdominal wounds. However in this situation the results of peritoneal lavage are to be trusted. Without omitting a 24 h observation of the patient the most rational criteria for a positive peritoneal lavage are red blood cell greater than 100.000/mm3; white blood cell greater than 500/mm3. PMID- 3661008 TI - The management of bronchopleural fistulas. AB - Bronchopleural fistulas remain a severe complication of pulmonary surgery and pulmonary disease. Treatment often requires multiple surgical interventions. The etiology, the methods for diagnosis and the different possible therapeutic procedures are discussed. PMID- 3661009 TI - [Resection of the large intestine and anastomosis dehiscence]. PMID- 3661010 TI - [Therapy of complications of liver echinococcosis]. PMID- 3661011 TI - [Surgical therapy of intramural heart lipoma]. PMID- 3661012 TI - [Recurrent ulcer]. PMID- 3661013 TI - [Spontaneous perforation of the colon in fecal impaction (case report)]. PMID- 3661014 TI - [Use of the latissimus dorsi flap in the reconstruction of defects after mastectomy in advanced and ulcerative breast carcinoma]. PMID- 3661015 TI - [Problems with the early diagnosis of pancreatic carcinoma]. PMID- 3661016 TI - [The Olerud technic in the treatment of supra- and intracondylar femoral fractures]. PMID- 3661017 TI - [Splenic abscess (2 case reports)]. PMID- 3661018 TI - [The importance of liver biopsy for the diagnosis and therapy of liver diseases]. PMID- 3661019 TI - [Changes caused by AO compression plate cortical screws on the long bones and their healing]. PMID- 3661020 TI - [Results of the surgical treatment of Dupuytren's contracture in our department]. PMID- 3661021 TI - [Personal experience with the surgical treatment of traumatic osteomyelitis from 1970 to 1985]. PMID- 3661022 TI - [Resection of pelvic bone tumors]. PMID- 3661023 TI - [Energy expenditure after orthopedic operations determined by indirect calorimetry]. PMID- 3661024 TI - [The role of biomechanics in the development of hip joint prostheses]. PMID- 3661025 TI - [Long-term results of total hip joint prostheses at the Department of Orthopedics and Traumatology of the Motor System in Ostrava]. PMID- 3661026 TI - [HLA antigens in Perthes disease]. PMID- 3661027 TI - [2-step extirpation of L5 in spondyloptosis]. PMID- 3661028 TI - [Peroperative monitoring of the spinal cord using the arousal test]. PMID- 3661030 TI - [Results of computer tomography in the classification and therapy of thoracolumbar injuries]. PMID- 3661029 TI - [Results of the treatment of juvenile kyphosis]. PMID- 3661031 TI - [Results of the treatment of injuries of the thoracic and lumbar vertebrae]. PMID- 3661032 TI - [Use of a claw-shaped plate (Krallenplatte) in fractures of the outer ankle]. PMID- 3661033 TI - Long-term effects of surgery for normocalcaemic hyperparathyroidism. AB - A retrospective study of the long-term effects of surgery for normocalcaemic hyperparathyroidism in 82 patients is presented. The median postoperative follow up time was 96 months. In most of the patients recurrent renal calculi had been the main preoperative symptom, and intermittent peaks of hypercalcaemia were recognized in more than 50% of them. Of the 19 patients with severe tendency to calculus formation, 12 appeared to have been cured by parathyroidectomy. These cured patients were found at operation to have parathyroid adenoma or hyperplasia, or even normal glands. Preoperatively depressed renal function normalized in about 50% of cases, as assessed by the desmopressin test. No patient had paralysis of the recurrent laryngeal nerve, and all were normocalcaemic during follow-up. Parathyroid surgery should be considered for this category of patients, although it is very difficult to distinguish between those who stand to benefit and those who do not. PMID- 3661034 TI - Hemodynamic and biochemical changes in severe induced subtotal ischemia of the leg. Studies with a pig model. AB - To investigate hemodynamic and biochemical changes in acutely ischemic leg muscle, the arterial flow to one hind leg was reduced to 5% of resting flow in nine pigs. Blood sampled from the aortic arch and femoral vein before and during ischemia and during 2.5 hours of reperfusion was analyzed and blood flow was measured in the femoral artery. The flow increased to 140% of preischemic values after 10 min of reperfusion and thereafter normalized. Efflux of potassium, magnesium, CK, LDH and ASAT increased only slightly during ischemia, but responded immediately to reperfusion, with maxima at 2-10 min, and thereafter declined to around normal values. Venous pH in the leg fell in the first 2.5 hours of ischemia (7.32-7.11), then remained constant until reperfusion started, when a nadir of 6.99 was reached, and rose to 7.29 by the end of the study. O2 consumption in the leg increased 3.8 times from preischemia to 1 min after reperfusion. Control pigs did not show the mentioned changes. This standardized ischemic trauma resembles the situation in humans with severe unilateral leg ischemia and can facilitate investigations of response to medication. PMID- 3661035 TI - Muscle metabolic changes in induced subtotal ischemia of the leg in a pig model. AB - In nine pigs the arterial blood flow to one hind leg was reduced to 5% of resting values during 8 hours in order to study changes in muscle energy metabolism. Biopsy samples from the gastrocnemius muscle were analyzed for ATP, ADP, AMP, PC, Cr, lactate, pyruvate, glycogen and pH before ischemia, at the end of the ischemic period and during 2.5 hours of reperfusion. During ischemia ATP/TCr decreased to 25%, ECP to 80% and PC/TCr to 6% of preischemic values. Lactate increased eightfold and glycogen fell to 40%. In the reperfusion period, lactate decreased to 1/3 of the end-ischemic value, PC/TCr showed threefold rise and ATP/Cr doubled. TCr fell to 66% of preischemic value. Other changes were not significantly affected by reperfusion. The end-ischemic values indicated severe ischemia, but some improvement of metabolism occurred during early reperfusion. The pig model is suitable for further studies aiming to improve the energy state of the cells during ischemia. PMID- 3661036 TI - Extensive or partial microsurgical sympathectomy of the arm by supraclavicular route for primary or secondary Raynaud symptoms. AB - Surgery was performed in patients with Raynaud's disease (primary Raynaud symptoms) or with Raynaud symptoms as part of the cervical rib/scalenus-anticus syndrome (secondary Raynaud symptoms). In 13 arms with primary, and six with secondary Raynaud symptoms with trophic changes, the aim was extensive sympathectomy. Good results, without Horner's syndrome, were obtained with extensive postganglionic sympathectomy. When the grey ramus T1 could not be identified, T2 ganglionectomy and extirpation of the grey rami C7 and C8 were performed with the same result. Extirpation of the grey ramus C6 was not mandatory for a good result. Extirpation of unidentified T1 rami resulted in permanent Horner's syndrome in two of four patients. Cases of secondary Raynaud symptoms without trophic changes were divided into two equal groups, each of 18 arms. Combined neurovascular decompression and partial sympathectomy were performed in one group, and neurovascular decompression only in the other. Partial sympathectomy seemed to improve the results. PMID- 3661037 TI - Obturator hernia--clinical significance of radiologic diagnosis. AB - Obturator hernia was revealed in 15 of 850 patients undergoing herniography for investigation of groin pain of obscure cause. The 15 patients (4 men, 11 women) were retrospectively analyzed in regard to symptoms, treatment and clinical outcome. They were of normal physique and with median age 56 years. Surgical exploration was performed in five cases, but confirmed presence of hernial sac in only two. Even after hernial repair these two patients still had symptoms. Two of the three patients with negative surgical findings were asymptomatic postoperatively. Of the ten patients without surgery, six had only minor symptoms and in four the symptoms were in the contralateral groin. The study showed that herniography in patients with groin pain can reveal small obturator hernias, but these hernias are mostly without significance for the patient's symptoms. PMID- 3661038 TI - Fibre-endoscopic dilatation of peptic oesophageal strictures. AB - 51 patients with dysphagia caused by peptic oesophageal stricture due to primary or secondary reflux oesophagitis were treated by fibre-endoscope and Eder-Puestow dilatations under local anaesthesia and sedation, between 1976 and 1984. There was one death (2%) attributable to the procedure (perforation) and complications arose in three (6%) patients (perforation, pneumonia). The dilatation was successful in 96% but two patients (4%) had to be operated on because of undilatable stricture. Follow-up data was available for the other 44 patients for periods of one to eight (mean 2.8) years later. The stricture was cured by dilatation and antireflux treatment (conservative or operative) in all patients and 98% of them were able to eat solid food and improve their nutritional status. During follow-up 22 patients (50%) were asymptomatic and 22 (50%) had dysphagia or/and reflux symptoms. At endoscopy oesophagitis was healed with conservative or operative treatment in 25 patients (57%). It is concluded that fibre-endoscopic dilatation of peptic oesophageal strictures with the Eder-Puestow system combined with conservative or operative antireflux treatment, is a simple and safe procedure and gives good results in almost all patients. Surgical procedures aimed at total correction of the stricture are indicated only rarely in intractable cases. PMID- 3661039 TI - Decreased gastrointestinal absorption of peroral polyethyleneglycols (PEG 1000) in Crohn's disease. A sign of jejunal abnormality. AB - Gastrointestinal absorption of orally administered polyethyleneglycols in the 634 1294 dalton range (PEG 1000) was investigated in 44 patients with ileocaecal Crohn's disease and in 24 healthy controls. Absorption of PEG was inversely proportional to molecular weight in both groups. In the Crohn patients the absorption of all tested molecular weights of PEG was significantly less than in the controls. In Crohn's disease there was also less of selectivity of the mucosal barrier against the larger molecules. The state of the distal ileum- acutely inflamed, in remission or post-resection did not influence absorption. Decreased PEG absorption in ileocaecal Crohn's disease probably reflects an abnormality of jejunal mucosal permeability. The observations support the concept that Crohn's disease is a diffuse lesion, affecting the whole gastrointestinal tract. The nondependence of the abnormality on the severity of distal inflammatory changes or on previous resection suggests that abnormal jejunal permeability may be a primary expression of Crohn's disease. PMID- 3661040 TI - Congenital absence of the anatomic common bile duct. Case report. AB - In congenital absence of the anatomic common bile duct, all bile from the liver drains into the gallbladder and thence to the duodenum via the cystic duct. A likely consequence of cholecystectomy then is discontinuity of hepatic drainage, since the gallbladder and cystic duct appear normal, and the anomaly is so rare that it is not considered. PMID- 3661041 TI - Leiomyomas of the small intestine: a rare cause of abdominal emergency. Case report. AB - Two cases of spontaneous perforation of small bowel leiomyomas are discussed, one previously asymptomatic, the other with a single episode of hematemesis two years earlier. Perforation of these tumours is rarely seen. Selective visceral angiography seems to be the most sensitive radiologic examination. New types of enteroscopes are being developed. PMID- 3661042 TI - Reversed rotation of the midgut in an adult. Case report. AB - Management of a patient with a congenital anomaly of the midgut can be difficult for a surgeon since these abnormalities are extremely rare particularly in adults. However a thorough knowledge of embryology and anatomy will allow the complexity of a rotational anomaly to be resolved. A case of reversed rotation of the midgut is presented and the literature on this subject reviewed. PMID- 3661043 TI - The role of excess iron in the pathogenesis of disturbed neutrophil functions in cirrhotic patients (neutrophil functions in cirrhotic patients). PMID- 3661044 TI - Poliomyelitis in an airline pilot and the need for vaccination of travellers. PMID- 3661045 TI - [A case of septicemia caused by a group DF-2 gram-negative bacillus following a dog bite]. PMID- 3661046 TI - The POEMS-syndrome: an unusual form of plasma cell dyscrasia. PMID- 3661047 TI - Relapsing fever imported into Belgium: a case report. PMID- 3661048 TI - Opportunistic Rhodococcus equi infection in an African AIDS case (1976-1981) PMID- 3661049 TI - [Preoperative diagnosis of ganglioneuroma]. PMID- 3661050 TI - The influence of free fatty acids on the free fraction of thyroid hormones in serum as estimated by ultrafiltration. AB - Thyroid hormones are displaced from their binding proteins in serum during nonthyroidal somatic illness, and FFA have been claimed to contribute. It seems mandatory to evaluate this effect using techniques for the measurements of serum free thyroid hormones in which serum remains undiluted. We measured the effect of 7 common human FFA on the free fraction of T4, T3 and rT3 in serum from healthy subjects using an ultrafiltration technique by which serum is diluted only minimally. In addition we measured the effect of oleic acid on the free fractions of the iodothyronines in pooled serum from healthy subjects and in pooled serum from patients with nonthyroidal illness. All FFA tested were able to displace both T4, T3 and rT3, but to a varying degree, arachidonic and linoleic acid being the most potent ones. A 20% increase in the free fractions of T4, T3 and rT3, respectively, was obtained by adding between 1.7-3.3 mmol/l, 1.3-4.6 mmol/l and 1.0-2.4 mmol/l of the different FFA. A serum pool obtained from patients with nonthyroidal somatic illness was more sensitive to oleic acid than a serum pool obtained from healthy subjects, since 2-3 times less oleic acid was necessary to induce a 20% increase in the free fractions of thyroid hormones. It is concluded that FFA are able to displace both T4, T3 and rT3 from their serum binding proteins in healthy subjects as well as in patients with nonthyroidal illness. However, serum from patients with nonthyroidal illness was more sensitive to the displacing activity of oleic acid than serum from healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661051 TI - Circulating blood progesterone is pulsatile throughout the rat oestrous cycle. AB - In the present experiment, we determined circulating progesterone (P4) levels of intact cycling female rats. A cannula constructed from polyethylene 50 tubing containing heparinized saline was inserted into the jugular vein of the rat under light ether anaesthesia and after a 3-6 h recovery period sequential blood samples were withdrawn from unanaesthetized, freely-moving rats. Blood samples (80-100 microliter) were collected at 10-min intervals for 6 h and the volume was replaced with saline. Plasma P4 was determined using a specific P4 radioimmunoassay. Four rats in each of three phases of the rat oestrous cycle (E, D1, D2) were examined. In addition, rats in proestrus were divided into an early (EP, N = 4) and a late (LP, N = 4) proestrous conditions. Individual data were analyzed by PULSAR as adapted for an IBM-PC. P4 was found to fluctuate in a pulsatile mode throughout the rat oestrous cycle. Mean levels of circulating P4 were lowest (38.8 +/- 1.7 nmol/l plasma) in EP and highest (122.5 +/- 1.3) in D1. The frequency of P4 pulses was dramatically decreased in D1 (2.50 +/- 0.86 pulses/6 h), whereas no difference was found among the other days of the cycle (7.25 +/- 0.47 in E, 7.25 +/- 0.85 in D2, 5.75 +/- 1.31 in EP, and 6.50 +/- 1.04 in LP). Interestingly, the amplitude of P4 pulses was significantly lower in EP (14.0 +/- 2.91 pmol), whereas no difference was found among other groups. Another group of experimental animals were ovariectomized (N = 4; two with and two without an implant of a silastic capsule of P4) and similarly bled.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661052 TI - Differential effects of hydrocortisone, fluocortolone, and aldosterone on nocturnal sleep in humans. AB - Previous experiments have suggested that sleep processes are sensitive to influences of corticosteroids. The present experiment was designed to compare effects of three different corticosteroids on human sleep: fluocortolone (a synthetic pure glucocorticoid), cortisol which possesses glucocorticoid and mineralocorticoid activity, and aldosterone (the major mineralocorticoid). Ten male adult subjects were tested in four experimental nights according to a double blind latin-square design under conditions of either 1.0 mg of aldosterone, 20 mg of fluocortolone, 80 mg of hydrocortisone, or placebo. Substances were administered orally (fluocortolone, 23.00 h) or infused iv throughout the night (hydrocortisone, aldosterone) starting at 23.00 h. Hydrocortisone and fluocortolone induced a substantial reduction of rapid eye movement sleep. Hydrocortisone increased slow wave sleep activity. No such effect was observed after fluocortolone. Effects on sleep processes of aldosterone, in general, seemed to be neglegible. The results demonstrate differential effects of synthetic glucocorticoid, cortisol, and aldosterone on sleep in humans, which may be attributed to the heterogeneity of corticosteroid receptors in the brain. PMID- 3661053 TI - Antibodies to membrane antigens in autoimmune thyroid disease. AB - The possibility that sera from patients with autoimmune thyroid diseases contain autoantibodies to thyroid membrane proteins distinct from microsomal antigen and the TSH receptor has been investigated using (a) solid phase assay system based on human thyroid membranes and 125I-labelled protein A and (b) immunoprecipitation of detergent solubilized 125I-labelled thyroid membranes followed by gel electrophoresis and autoradiography. In the solid phase assay binding to membranes showed a highly significant correlation with binding to microsomes (r = 0.82; P less than 0.001; N = 82) indicating that the interaction between the serum and the membranes was due principally to microsomal antibody binding to microsomal antigen contaminating the membrane preparations. However, there were some discrepancies suggesting that an additional antigen-antibody system was involved. This possibility was then investigated using immunoprecipitation of 125I-labelled thyroid membranes. A labelled protein with mol wt 54 K was specifically immunoprecipitated (relative to normal pool serum) by 3 out of 4 sera from patients with Graves' disease who showed high binding to thyroid membranes. A further 4 sera from such patients with low membrane binding affinity failed to immunoprecipitate the 54 K protein. Sera from some patients with Hashimoto's disease and some patients with rheumatoid arthritis and one patient with Addison's disease also immunoprecipitated the 54 K protein from solubilized thyroid membranes. These studies suggested that antibodies interacting with the 54 K protein contributed to the discrepancies between thyroid membrane and microsome binding. However, the 54 K protein was also immunoprecipitated from detergent solubilized membranes prepared from human placenta, skeletal muscle and adrenal tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661054 TI - Urinary melatonin, LH, oestradiol, progesterone excretion during the menstrual cycle or in women taking oral contraceptives. AB - Nocturnal urinary excretion of melatonin, LH, progesterone and oestradiol was measured by radioimmunoassay in nine normal women during a complete cycle. In addition, these hormonal excretions were studied in two women taking an oral contraceptive. A high within-subject coefficient of variation was observed for melatonin excretion in the two groups. In the nine normal cycling women, melatonin excretion was not decreased at the time of ovulation, but was significantly increased during the luteal phase compared with that of the follicular phase (P less than 0.01). These data are consistent with a positive relationship between melatonin and progesterone during the luteal phase. In the two women under an oral contraceptive, melatonin excretion was found within the same range as for the other nine. The results are discussed in terms of pineal investigation in human. PMID- 3661055 TI - Vasoactive intestinal polypeptide and dopamine in the hypothalamus and pituitary of ageing rats with prolactinomas. AB - Vasoactive intestinal peptide (VIP), an dopamine have been measured in the hypothalamus and anterior pituitaries of female rats at three different ages. Rats aged 19 months had a high incidence (35%) of prolactin-secreting tumours of the pituitary and these animals had increased hypothalamic and pituitary VIP compared with three-month-old rats or rats without tumours. VIP in old animals without tumours was similar to that in young animals. The third group, with an even more advanced age of 22-28 months, had a lower incidence of PRL-secreting tumours, and pituitary and hypothalamic VIP concentrations similar to those in young animals. Dopamine was significantly increased in the pituitaries of 22-28 month-old nontumorous rats and slightly raised in 19-month-old rats. We conclude that the increased pituitary and hypothalamic VIP content of 19-month-old rats could be a factor in the development of tumours seen at this age, and the differences seen in the two groups of old rats may be related to changes in the steroid environment. PMID- 3661056 TI - Sleep-electroencephalography and the secretion of cortisol and growth hormone in normal controls. AB - Sleep-electroencephalography, and the nocturnal secretion of cortisol and GH were investigated simultaneously in a sample of 25 male normal controls (27.1 +/- 1.3 years) in order further to examine interaction between sleep structure and concurrent endocrine activity. Slow wave sleep activity was increased during the first part of the night, whereas cortisol concentration was low and GH output reached maximal levels. The second half of the night was characterized by a relative preponderance of REM-sleep, low GH-concentration, and an increase in cortisol. However, no distinct reciprocal interaction between cortisol and GH concentration was noted. In all subjects, a pronounced GH surge between 22.00 and 02.00 h was recorded which occurred independently of the presence of slow wave sleep. Six out of the 25 subjects showed nocturnal GH increases even before sleep onset. These data indicate that somatotropic cell activity during night is less dependent upon the sleeping state or specific conventially defined sleep stages than originally reported. PMID- 3661057 TI - Lowering of serum T3 and rise in reverse T3 induced by glucagon infusion in anaesthetized dogs. AB - We recently demonstrated that lowering of T3 and a rise in rT3 observed in non thyroidal illnesses could be induced by glucagon infusion in normal subjects without altering T4. Free T4 (FT4) and T3 resin uptake (T3RU) values suggesting that altered T4 metabolism may be mainly responsible for those changes. To further assess the role of altered T4 metabolism in these changes during induction of hyperglucagonaemia, we studied glucose, T4, FT4, T3RU, T3, and rT3 concentrations before and after iv glucagon injection (0.5 mg) for up to 3 h in 6 anaesthetized dogs, since thyroxine-binding globulin (TBG) concentration is known to be extremely low in dogs. A control study was conducted with iv normal saline (0.5 ml) injection. T4, FT4 and T3RU remained unchanged during both studies. A significant fall was noted in T3 with glucagon (delta T3, 0.23 +/- 0.06 nmol/l vs 0 +/- 0.03 nmol/l with normal saline; P less than 0.01). rT3 rose markedly following glucagon infusion (delta rT3, 0.04 +/- 0.011 nmol/l vs -0.017 +/- 0.006 nmol/l with normal saline; P less than 0.01). Moreover, areas under the curves for T3 and rT3 were markedly increased during glucagon infusion when compared to saline administration (P less than 0.01 for both comparisons). Therefore, this study suggests that changes in T3 and rT3 concentrations observed in non thyroidal illnesses may be attributed to hyperglucagonaemia and may be secondary to altered T4 metabolism as reflected by lowered T3/T4 and increased rT3/T4 ratio. PMID- 3661058 TI - Reversibility of deficient sleep entrained growth hormone secretion in a boy with achondroplasia and obstructive sleep apnea. AB - Obstructive sleep apnea may lead to disordered sleep architecture and impair the physiologic slow wave sleep related growth hormone release. Obstructive sleep apnea occurs with craniofacial syndromes and in children with airway narrowing, pharyngeal hypoplasia, tonsillar adenoidal hypertrophy, micrognathia and achondroplasia. To examine the relationship between disordered sleep and growth hormone release we studied a 9 year old male with achondroplasia, growth failure (3 cm/year) and obstructive sleep apnea. Polysomnography data and a 20 min sampling for sleep entrained growth hormone showed before therapeutic tracheostomy numerous apneic episodes, absent slow wave sleep and abnormal low growth hormone secretion during sleep. Normalized slow wave sleep entrained growth hormone secretion after tracheostomy led to a sustained increase in growth rate. Normal growth rate (greater than 5 cm/year) continues 2 years after tracheostomy. We conclude that obstructive sleep apnea may impair sleep related growth hormone release. Obstructive sleep apnea may be a useful model for other diseases in which growth failure and sleep disturbances are linked. PMID- 3661059 TI - Effect of prolactin on the diurnal changes in immune parameters and plasma corticosterone in white leghorn chickens. AB - The effect of PRL on the diurnal changes in peripheral lymphocyte and granulocyte number, anti-sheep red blood cells, and natural anti-rabbit red blood cells serum agglutinins titre as well as plasma corticosterone concentration was examined in White Leghorn cockerels, immunized twice with sheep red blood cells. PRL was administered for six consecutive days at 4 or 8 h after light onset. Control birds were treated at the same times with hormone solvent alone. Immunized non treated birds served as an additional control group. PRL injections influenced markedly the diurnal changes in all parameters examined. The effect of PRL administration on the diurnal changes in lymphocyte and granulocyte number and natural anti-rabbit red blood cells serum agglutinins consisted in elimination of the influence of solvent injections. In those cases where the solvent injections did not alter the pattern of the diurnal changes, i.e. in anti-sheep red blood cells serum agglutinins and in plasma corticosterone concentration, the pattern was modified by PRL injections. PRL administration affected also the correlations between the diurnal changes in plasma corticosterone concentration and those in lymphocyte number and anti-sheep red blood cells agglutinin titre. This suggests that the role of PRL in the regulation of the diurnal variations of immunity in chickens may be realized either directly, via its receptors in immune system or by its influence on plasma corticosterone concentration. PMID- 3661060 TI - Oestrogen dependent suppression of mitogen response in rat lymphocytes. AB - Female Fischer rats have a significantly (P less than 0.01) lower response to mitogens (phytohaemagglutinin and pokeweed mitogen) in whole blood cultures, than do male. In vitro cultures were carried out in 96-well micro-test plates with 5% blood over a period of 64 h, with a pulse of [3H]thymidine at 48 h. Ovariectomy resulted in a significant (P less than 0.01) increase in mitogen response, raising it to the level of normal males. Orchidectomy caused a small, but consistent rise in response. Injection of oestradiol valerate (at 0.5 mg/week, to yield physiological levels) suppressed the response of gonadectomized animals of both sexes to the level of normal female rats. Testosterone oenanthate had little effect unless administered in conjunction with oestradiol valerate, when a much greater depression of response was noted. Suppressor cells, or suppressive serum factors, could not be detected in the blood of normal females or oestrogen treated animals during in vitro mixing experiments. Although it required 3 weeks for the ovariectomized animals' response to rise to the level of normal males, only 3 days of oestradiol valerate treatment was necessary to suppress the response again. Whereas it seems clear that oestradiol is responsible for the suppressed response of female Fischer rats, its mechanism of action has not been revealed by our experiments. PMID- 3661061 TI - Ontogenesis of thyroid hormone receptor in foetal lambs. AB - Affinity and concentration of T3 receptor sites have been measured in nuclear extracts from the brain, lung, and liver of foetal lamb tissues at 50, 82 and 100 days of gestational age. Control experiments indicated that the concentration of sites was similar when nuclear extracts or purified nuclei were used, and that maximal binding capacity was obtained after 2 h of incubation at 22 degrees C. The pattern of receptor binding affinity when different thyroid hormone analogs were used in competition assays with [125I]T3 was T3 greater than 3,5,3' triiodothyroacetic acid (Triac) greater than T4 in the lung and brain. In the liver, Triac had the same affinity as T3. The sedimentation coefficient of the receptor was 3.6 S in lung. There were minor changes of receptor affinity in the brain, but not in the lung or liver, during development with the highest value at 82 days. Receptor concentration increased twice from 50 to 82 days. Since in the brain this is the period of neuroblast proliferation, the results suggest that thyroid hormone is required for proper foetal lamb development and, in particular, for neuroblast proliferation and/or differentiation. PMID- 3661062 TI - Pre-operative evaluation of the prognosis of hypertension in primary aldosteronism owing to adenoma. AB - The prognosis of hypertension was evaluated pre-operatively in 40 patients with primary aldosteronism owing to adenoma by examining the severity of hypertension, family history of hypertension, age of the patients, duration of hypertension, plasma renin activity, plasma aldosterone concentration, and efficacy of spironolactone (100 mg per day for 10 days) on blood pressure. In 30 of the 40 patients, the blood pressure was reduced to below 160/95 mmHg within a year after adrenalectomy (responders). In the other 10 patients, the blood pressure was not markedly reduced and remained above 160/95 mmHg (nonresponders). There were no significant differences in the age of the patients, family history of hypertension, plasma renin activity or plasma aldosterone concentration between these two groups. The severity of hypertension as judged by the WHO classification and the duration of hypertension prior to operation seemed to be of some use in assessing the postoperative prognosis of hypertension, but the efficacy of spironolactone was far more useful. That is to say, a reduction in mean blood pressure of more than 15 mmHg after administration of spironolactone was observed in 29 of the 30 responders. The remaining one patient showed an 11 mmHg reduction in mean blood pressure. On the other hand, none of the nonresponders revealed a reduction in mean blood pressure of more than 15 mmHg after spironolactone administration. From these results it is concluded that the pre-operative response of blood pressure to administration of 100 mg per day of spironolactone for 10 days represents a useful indicator of the postoperative prognosis of hypertension in patients with primary aldosteronism owing to adenoma. PMID- 3661063 TI - Gonadal function in male offspring of pinealectomized female rats. AB - Female rats were exposed to a short (6 L: 18 D) photoperiod from 21 days of age. On day 2 of gestation, animals were pinealectomized sham-operated. Lighting regimens were not changed during the course of the study. Male offspring of the 2 groups of rats were sacrificed on days 30, 42 and 49 after birth. Pinealectomy of the mother induced the following modifications: in 30-day-old offsprings, a decrease in prostatic weight and plasma dihydrotestosterone level; in 42-day-old rats, a decrease in prostatic weight, in testicular androstenedione and dihydrotestosterone content, and in plasma testosterone and dihydrotestosterone levels; in 49-day-old animals, decreased testicular and plasma testosterone and dihydrotestosterone levels. These results indicate that rat testicular function, after exposure to a short photoperiod beginning before conception, is decreased by maternal pinealectomy. The mother's pineal gland may play a part in the control of rat testicular function. PMID- 3661064 TI - The rapid diagnosis of sensitivity or resistance to dopamine agonists with depot bromocriptine. AB - Some patients with hyperprolactinaemia are unable to tolerate even low doses of oral bromocriptine. In such cases, it is difficult to predict whether serum prolactin might be normalized if higher doses could be tolerated, or whether true resistance to bromocriptine is present. We have investigated 8 such patients who were subjected to a dopamine infusion (4 micrograms/kg per min for 4 h), followed by an injection of 50 mg of depot bromocriptine on a separate occasion. Serum prolactin was normalized in 4 patients during dopamine, and in 6 patients 12-48 h following depot bromocriptine. The 2 patients who failed to respond to depot bromocriptine also failed to respond to high oral doses of bromocriptine, while the remaining 6 patients were successfully transferred to oral bromocriptine without adverse reactions after the depot preparation was administered, and with a normalization of serum prolactin. It is concluded that depot bromocriptine may represent a better predictor of true unresponsiveness to dopamine agonist therapy than a dopamine infusion, and may also allow for initiation onto oral therapy of previously intolerant patients. PMID- 3661065 TI - The effect of hypermagnesaemia on serum immunoreactive calcitonin levels in normal human subjects. AB - The effect of hypermagnesaemia on serum levels of immunoreactive calcitonin was studied in normal human subjects. After iv administration of magnesium sulphate over 120 min, the mean (+/- SEM) serum magnesium concentration rose from the baseline level of 0.9 +/- 0.1 to 2.6 +/- 0.3 mmol/l (P less than 0.01), and thereafter remained higher than the baseline level. The magnesium infusion caused a significant increase in serum immunoreactive calcitonin levels (P less than 0.01). The rise in serum magnesium concentration was accompanied by a significant decrease in the concentrations of corrected serum calcium and whole blood ionized calcium (P less than 0.01, P less than 0.01 respectively). Our results suggest that hypermagnesaemia causes an increase in serum immunoreactive calcitonin levels in normal human subjects despite a decrease in the concentrations of corrected serum calcium and whole blood ionized calcium. PMID- 3661066 TI - Effects of two novel dopaminergic drugs, CV 205-502 and CQP 201-403, on prolactin and growth hormone secretion by human pituitary tumours in vitro. AB - Two novel dopaminergic drugs, designated CV 205-502 and CQP 201-403 have recently been developed by Sandoz Pharmaceuticals Ltd (Basle, Switzerland). The effects of these drugs on PRL and GH secretion by normal rat and tumorous human pituitary cells in vitro have been investigated. Low doses of both CV 205-502 and CQP 201 403 immediately and profoundly suppressed PRL secretion, which failed to recover up to 7 h after removal of the drugs. Similarly, CQP 201-403 significantly suppressed basal GH secretion by human pituitary somatotropic tumours in culture, and both drugs significantly reduced the stimulatory effect of GHRH. These effects are more potent and longer acting than the previously described in vitro effects of bromocriptine. It is concluded that CV 205-502 and CQP 201-403 hold potential for the treatment of patients with hyperprolactinaemia and, possibly, also in patients with acromegaly. PMID- 3661067 TI - Evidence for a physiological reduction in brain dopamine but not norepinephrine metabolism during the preovulatory phase in normal women. AB - To investigate the role of brain catecholamine (CA) activity in the mechanisms related to physiological ovulatory function, we used high-performance liquid chromatography with electrochemical detector to measure the levels of urinary dopamine (DA), norepinephrine (NE), epinephrine (E), vanillylmandelic acid (VMA), homovanillic acid (HVA), 3,4-dihydroxyphenylacetic acid (DOPAC), and total 3 methoxy-4-hydroxy-phenylglycol (MHPG) in a group of 12 normal women during both the early follicular and pre-ovulatory phases of the menstrual cycle. The mean (+/- SEM) concentrations of HVA and DOPAC were significantly lower (P less than 0.001) during the pre-ovulatory phase than during the early follicular phase, whereas those of DA, NE, E, VMA and total MHPG were unaltered. A significant negative correlation between urinary HVA and plasma LH (r = -0.70, P less than 0.01) was also found during the pre-ovulatory period, whereas no significant negative correlations were found between urinary HVA and plasma PRL, progesterone and oestradiol. These data show: 1) reduced brain DA activity and 2) unchanged brain NE activity at the time of the midcycle surge in normal women, suggesting a physiological variation of the central DA metabolism in ovulatory function. PMID- 3661068 TI - Effects of oestrogen and human growth hormone on pregnancy-associated plasma proteins in the rat. AB - The serum concentrations of pregnancy-associated murine protein-1 (PAMP-1), acute phase alpha 2-macroglobulin, albumin, transferrin, and complement factor 3(C3) were followed in male rats during continuous infusions of oestradiol-17 beta and human growth hormone. Three different patterns of protein response could be distinguished. A distinct acute phase response without any additive influence of the given hormones was recorded for alpha 2-macroglobulin, whereas the levels of albumin, transferrin and C3 were virtually unaffected throughout the experiment. Growth hormone gave a rapid and pronounced increase of PAMP-1 levels, whereas the response to oestradiol of this 'steroid-sensitive' protein was significantly weaker and delayed. It is suggested that the apparent oestrogenic influence on certain pregnancy-associated plasma proteins is mediated via growth hormone. PMID- 3661069 TI - [Campylobacter pylori and gastroduodenal pathology]. PMID- 3661070 TI - [Preoperative evaluation and surgical treatment of epidermoid cancer of the esophagus. Apropos of 81 resections]. PMID- 3661071 TI - Endoscopic retrograde cholangiopancreatography (ERCP) in the elderly. PMID- 3661072 TI - [Gastric leiomyoblastoma. Apropos of 4 cases]. PMID- 3661073 TI - Cholecystoduodenocolic fistula and gallstone ileus. PMID- 3661074 TI - [Differential diagnosis of ulcerated gastric lesions]. AB - The semiological characteristics of the ulcerated gastric lesions, benign and malignant, are on study. Its frequency and location is analysed in 32,829 subjects of 40 or more years of age, apparently in good health, finding gastric ulcers in 2.98% been unique in 2.3% and multiple in 0.68%. A symptomatic group of 8,765 people of 40 or more years, showed gastric ulcer in 7.11% been unique in 5.18% and multiple in 1.93%. It is also reported the frequency of gastric cancer in both studied groups, which leads to permanently propose the differential diagnostic with benign lesions, underlying by its frequency those of ulcerated type. The value of the gastric biopsy in differential diagnosis represents finally an aid of major importance because its high yield. PMID- 3661075 TI - Colonoscopic polypectomy. AB - Colonoscopic polypectomy is well established as an outpatient procedure. In skilled hands it is essentially safe. The components of a satisfactory therapeutic outcome are good bowel preparation, adequate sedation analgesia, an experienced operator and the proper range of equipment. In this two year series of 71 patients (176 polyps) there were no fatalities, no perforations and only two minor bleeds. Eighty percent of the polyps were of the tubuloadenomatous or tubulovillus type. Carcinoma was present in 6% and their outcome is described in detail. The commonest presentation of colonic polyps was rectal bleeding or occult blood in the stools (56%). Two or more polyps were present in 60% of patients. Seventy percent were located distal to the splenic flexure and the rest proximally. Fifteen percent were over 2 cm in maximum diameter. Policies for the type and frequency of follow-up are a matter for ongoing discussion. PMID- 3661076 TI - [Training in digestive endoscopy. Considerations, experiences and methodological contributions]. AB - The bibliographical contributions on education in digestive endoscopy and the need of establishing in Argentina a curricular programming for its teaching learning are considered. The experience of the authors acquired during the giving of eight Basic or initiation Courses and eight Advanced or Improvement Courses is presented. They used in them six didactic simulators and endoscopic cinematography that completed the written simulations. Conceptual and methodological aspects are exposed to perform the curricular programming of training comprising the student from the student of Medicine to the gastroenterologist or surgeon more devoted or specialist in digestive endoscopy. PMID- 3661077 TI - [Elevated gastric lesions]. AB - Elevated gastric lesions, represent an important group among gastric pathology. To establish its incidence in our experience, we studied the endoscopic reports of two important hospitals in La Paz city: Instituto de Gastroenterologia Boliviano Japones and Hospital Obrero No. 1. In order to make a good endoscopic diagnosis among different elevated lesions we use some parameters like: location, shape, size, diameter, surface of the lesion and surrounding mucosa and characteristics of the falls. 10.472 endoscopic reports were reviewed, 497 elevated gastric lesions were found, 475 corresponded to mucosal lesions (352 benign lesions and 123 malignant lesions), 11 to submucosal and 11 extragastric lesions. PMID- 3661078 TI - [Proceedings of the XXXXIX general meeting of the Japan Hematological Society. Tokyo, April 7, 8 and 9, 1987. Abstracts]. PMID- 3661079 TI - Standard of care. PMID- 3661080 TI - The effect of an auditory distraction on anxiety in ambulatory surgical patients experiencing regional anesthesia. PMID- 3661081 TI - Pulmonary wedge pressure does not accurately reflect left atrial pressure in patients with severe left ventricular dysfunction. PMID- 3661082 TI - Evaluation of the effect of a pre-operative anesthesia videotape. PMID- 3661083 TI - AANA Journal course: advanced scientific concepts: update for nurse anesthetists- Part III. The respiratory system. PMID- 3661084 TI - Intrathecal and epidural narcotics. PMID- 3661085 TI - Health care reform: sketching the future. Part two. PMID- 3661086 TI - Poison-PAC. PMID- 3661087 TI - Families: change, coping and children's behavior problems. PMID- 3661088 TI - Unmet standards--what do we do with a poor audit result? PMID- 3661089 TI - Looking ahead to retirement. PMID- 3661090 TI - Discharge planning--we can't afford to be without it! PMID- 3661091 TI - Human orienting reaction: the role of genetic and environmental factors in the variability of evoked potentials and autonomic components. AB - The effect of genetic and environmental factors on interindividual differences in GSR, heart rate and EP components of orienting reaction to neutral acoustical stimulus and to the same stimulus at a very high intensity was analysed in 22 pairs of monozygotic and 21 pairs of dizygotic twins. Genetic factors appeared to be important for the variability of all GSR characteristics, N100 and P180 EP amplitudes, magnitude of the HR response to the strong stimulus and HR habituation to the weak stimulus. Environmental factors influenced greatly the variances of late EP components but only in response to the weak stimulus. Different role of genetic and environmental factors in motivation and cognitive components of orienting reaction points to the involvement of several relatively independent functional systems in it. PMID- 3661092 TI - The clinical picture of information neurosis. PMID- 3661093 TI - Improvement of impaired higher nervous activity in man and in the dog under information neurosis after treatment in the climate of a karstic cave. PMID- 3661094 TI - Animal model of depression: retention of motor depression not predictable from the threshold of reaction to the inescapable shock. PMID- 3661095 TI - Animal model of depression: drug induced changes independent of changes in exploratory activity. PMID- 3661096 TI - Animal model of depression: effect of nicotergoline and metergoline. PMID- 3661097 TI - A lower behavioural activity of nude mice on social encounters. PMID- 3661098 TI - Emotion induced by specific image--a method of diagnostics and evaluation of therapeutic effectiveness in neuroses. PMID- 3661099 TI - 22d Conference on Higher Nervous Functions. Hradec Kralove, Oct. 1986. Abstracts. PMID- 3661100 TI - Are sleep complaints predictive of future myocardial infarction? AB - In a prospective study of 3877 males, aged 39-65 years, the hypothesis was tested that sleep complaints are predictive of myocardial infarction. It was found that complaints about troubles in falling asleep and about feeling exhausted when one wakes up were predictive of myocardial infarction occurring in a 4.2 years follow up period. However, this predictive power was confounded by age, and especially by vital exhaustion. It is concluded that sleep complaints are long term determinants of myocardial infarction because they are part of the syndrome of vital exhaustion. PMID- 3661101 TI - Eye and head movements to visual and auditory targets. AB - Coordinated eye-head movements evoked by the presentation of visual, auditory and combined audio-visual targets were studied in 24 human subjects. At 60 deg located targets latencies of eye and head movements were shorter for auditory than for visual stimuli. Latencies were shorter for bisensory than for monosensory targets. The eye and head latencies were differently influenced by the modality of the stimulus when the eccentricity of the target was changed, but not by the variation of the stimulus duration. The different responses of the eye and the head depending on target modality and target eccentricity can be partially attributed to perceptual and central processing mechanisms, and are important to answer the question about the initial event in coordinated eye-head orientation. PMID- 3661102 TI - Spontaneous wheel running in laboratory rats genetically selected for activity level in a novel environment. AB - Wistar rats were genetically selected for either high (+A) or low (-A) locomotor activity level in a new environment. The response to the novelty was tested in all filial generations at the age between 75-80 days of life. Groups of 15 +A male rats selected from the 11th and 12th generations were placed in the individual cages connected with rotation wheels at the age 149 +/- 9 days. For a period of 32 days, the spontaneous wheel running activity was recorded for the time intervals 0.00-6.00 a.m., 6.00-12.00, 12.00-18.00, and 18.00-24.00 h. The -A group exhibited a generally low level of running activity over the entire experimental period, whereas the time of running in the +A tended to increase. Inside the +A group, homogeneous as to the short- term activity level, there gradually differentiated two sub-groups, one with relatively constant medium values and the other which showed an enormous prolongation of the time spent with running. The +A and -A groups differed also in their daily activity rhythm. Whereas the +A rats reached maximum of their activity between 18-24 h., followed by a rapid decrease in the morning hours, the -A animals showed a tendency to a later onset of night-type activity, and a higher level continued to morning hours. PMID- 3661103 TI - Effect of local ischemia on catecholamine and 5-hydroxytryptamine levels in the dog brain. AB - Sixty-minute partial ischemia (occlusion of a. cerebri media dextra) had no such marked effect on changes in monoamine levels as observed after longer intervals. In differentiated parts of area S II (area of direct damage) there was a significant increase of NE in g. sylvius ant. and g. coronarius in comparison to sham-operated controls, a significant elevation of 5-HT in g. sylvius ant. and lesser nonsignificant dopamine changes in area S II. An interesting finding was that in comparison with monoamine levels in sham-operated controls there were changes in their levels also in the contralateral hemisphere of animals with experimentally induced ischemia. In the other areas monitored there were no changes. These results from unilateral partial brain ischemia are corroborated by the findings of other authors at total brain ischemia and indicate that shorter intervals of ischemia produce only slight reversible changes in monoamines whereas longer intervals produce their reduction and impaired metabolism. PMID- 3661104 TI - Levels of norepinephrine and 5-hydroxytryptamine in the spinal cord of the dog following ischemia and recirculation. AB - Forty minutes of abdominal aorta ligature (partial ischemia in the lumbosacral segments of the spinal cord) did not change significantly levels of norepinephrine (NE) and 5-hydroxytryptamine (5-HT) in the spinal cord of the dog in comparison with sham-operated controls. After a 40-minute interval of recirculation NE levels dropped nonsignificantly below levels of the control group and 5-HT significantly in lumbar segments. It thus appears that even though in the stage of recirculation in the spinal cord energy metabolism is restored, the functional deficit of monoamines may persist. PMID- 3661105 TI - Pulse oximetry--principle and first experiences during anesthesia. AB - Oximetry is a photometric method for simple, non-invasive, and continuous measurement of the O2 saturation (SaO2). The addition of the word "pulse" indicates that, directed by a photo-electric plethysmogram, measurements are only performed during arterial pulsations. It appears from our first experiences with pulse oximetry during anesthesia that each decrease in SaO2 is indicated quickly and reliably. From a practical point of view it is important that the apparatus is connected quickly and easily, and that the O2 saturation is monitored continuously, also in those periods when normally no blood samples are taken. An additional advantage is that by means of the plethysmogram the circulation is also monitored. PMID- 3661106 TI - Atropine methylbromide and glycopyrrolate. A comparative study during reversal of neuromuscular block. AB - Two quaternary anticholinergics, atropine methylbromide (methylatropine bromide, MAB) and glycopyrrolate (ROBINUL) were compared as adjuncts to neostigmine for the reversal of residual nondepolarising neuromuscular block. MAB 0.75 mg in combination with neostigmine 2 mg produced a marked initial rise in heart rate. This was significantly greater than that produced by the administration of glycopyrrolate 0.4 mg with neostigmine. The antisialogogue effects of the two anticholinergics were identical and the central nervous system status of the patients was similar. It is concluded that, with the doses used in this study, glycopyrrolate is a superior alternative to MAB and is the drug of choice if a quaternary ammonium anticholinergic is required. PMID- 3661107 TI - The influence of ketanserin, droperidol and hydergine on postoperative hypertension during early recovery following major abdominal surgery. AB - Forty adult patients, who developed postoperative hypertension (greater than 160/90 mm Hg) following major abdominal surgery were given double-blind, randomized either ketanserin 10 mg i.v. (n = 10), droperidol 5 mg i.v. (n = 10), hydergine 0.9 mg i.v. (n = 10) or placebo solution (n = 10). Following the injection of ketanserin or droperidol systolic and diastolic blood pressure decreased significantly (p less than 0.001 and p less than 0.01), but were no longer significantly lowered 30 minutes following the injection in 5 out of 10 ketanserin treated and in 8 out of ten droperidol treated patients. Neither hydergine nor placebo had a significant effect on blood pressure. It is concluded, that both ketanserin and droperidol have a moderate and short acting antihypertensive effect. PMID- 3661108 TI - To a day care surgical hospital (III). Influence of two anesthetic techniques on some appraisal criteria of the Newman test. AB - Fourty four young male patients, anesthetised to undergo common peripheral surgery, performed the Newman test during pre-anesthetic consultation, then again 2 h. 30 and 3 h. 30 after induction of anesthesia and, if possible, 3 days later. Five different criteria of analysis were selected to rate the drawing. These criteria were compared either on an individual basis or altogether with the Student "t" test. The anesthetic and surgical modes were comparable, except for the anesthetic drug used, either a combination of fentanyl-Gamma hydroxybutyric acid (GHB) for 22 patients or a combination of fentanyl-diazepam for the remaining 22. There was no significant difference between any of the criteria used except for the time duration to perform the test which was less in the GHB group 2 h. 30 min. after induction. This result supports a comparative study of the Newman test after other anesthetic inductions. PMID- 3661109 TI - Ultrastructural observations on the gallbladder of Richardson's ground squirrel (Spermophilus richardsonii). AB - The gallbladder of Richardson's ground squirrel shares many structural similarities with numerous other species, including the mouse, rabbit and man. Dark cells exhibit a condensed cytoplasm but contain all the typical organelles of light cells, although their total complement appears reduced. Edematous cells extruded from the epithelial lining were replaced through mitosis or had their space occupied by adjacent cells. Specializations of the basal plasma membrane and underlying basal lamina form peg-and-socket interdigitations, and desmosomes were observed on the lateral cell boundaries down to the level of the basal lamina. The latter remain intact during active water resorption while the former disappear. Adrenergic nerve fibers were observed intramuscularly and beneath the basal lamina. Random interepithelial migration of leucocytes was also observed. Some of these observations help to elucidate controversial issues whereas others have been previously unreported and may be species-dependent. PMID- 3661110 TI - Morphometry and ultrastructure of the squirrel monkey (Saimiri sciureus) vestibular nerve. AB - Vestibular nerves of squirrel monkeys (Saimiri sciureus) embedded in plastics and epoxies were examined with light microscopy (LM) and transmission electron microscopy (TEM), and computerized measures were obtained and analyzed statistically. An average of 12,412 perikarya and 12,005 myelinated nerve fibers was obtained. Approximately 0.7% of the perikarya appeared unmyelinated under LM. About 500 unmyelinated fibers were counted. The cross-sectional area of 1,864 perikarya was 200-650 micron 2. The cross-sectional area of 1,346 nerve fibers was 3-11 micron 2 for the axoplasm and 11-12 micron 2 for the myelin sheath of the same fiber. Myelin thickness was directly proportional to the axoplasm cross sectional area of the nerve fibers. The cross-sectional area of central axons and peripheral dendrites differed significantly (p less than 0.001). The initial segments of peripheral dendrites were usually smaller, but longer than the initial segments of the central axons. Both initial segments increased in diameter after the first node of Ranvier. Schmidt-Lantermann incisures were more abundant in thick and heavily myelinated fibers than in thin and lightly myelinated fibers. Larger perikarya usually had larger fibers and vice versa, within the first 100-200 micron from the first node of Ranvier. No major ultrastructural differences were found between myelinated and unmyelinated perikarya, except at the hillock region. The Nissl substance was preferentially located in the peripheral cytoplasm. PMID- 3661111 TI - Quantitative ultrastructural study of somatotropic cells in malnourished weanling rats. AB - A quantitative ultrastructural study of somatotropic cells was carried out in 21 day-old malnourished rats after maternal food restriction during the nursing period. Changes represented mainly by a reduced cytoplasmic mass and diminished secretory material were found. A decrease in growth hormone secretion of malnourished weanling rats is suggested. PMID- 3661112 TI - Morphometry of eosinophils in human blood. AB - Ultrastructural characteristics of human blood eosinophils have been analysed by morphometric methods in 18 healthy adults. Data were obtained relating to whole cell, nucleus, mitochondria and specific granules. No significant differences were found between the eosinophils of the 9 male and 9 female subjects. The results provide normal values against which changes in eosinophils in disease states may be assessed. PMID- 3661114 TI - Morphology of the meniscotemporal part of the temporomandibular joint and its biomechanical implications. AB - The temporomandibular joint is a diarthrosis. It has classically been referred to as being a condylar, and functionally as a double condylar joint. We have used the moire topographical technique to study the morphology of the pars suprameniscalis or meniscotemporalis of the joint. The findings show that this pars suprameniscalis could be classified as a saddle joint. The biomechanical implications are also discussed. PMID- 3661115 TI - Cartilage calcification in the human thoracic column. AB - A histological and microradiological study of the cartilage calcification processes in the human thoracic column of an old man has been performed. Two different types of cartilage mineralization have been identified. The first corresponds to a calcification of the hyaline cartilage ground substance where chondrocytes are apparently intact. The second is a real mineralization of the chondrocyte lacunae in an uncalcified matrix, which we have called cartilaginous necrosis. PMID- 3661113 TI - A morphologic and histochemical study of the mesentery in the guinea pig. AB - The guinea pig mesentery is a uniform, continuous, thin (18 micron) sheet of connective tissue covered by a single layer of flattened mesothelial cells on both surfaces. Tight and gap junctions provide for cell-to-cell adhesion among mesothelial cells. These cells possess numerous micropinocytotic vesicles; a conspicuous basal lamina separates the mesothelium from the underlying connective tissue. Most of the material found between the two serous coverings consisted of a three-dimensional meshwork of abundant collagenous fibers intermingled with a sparse net of very thin (0.4 micron) elastic fibers. Two distinct populations of collagen fibrils are segregated into different compartments of the mesentery. One population is formed of thick (56 nm) fibrils which associate to form closely packed fibers. The second population, composed of loosely arranged thin (38 nm) fibrils which do not become assembled into fibers, is found underlying the basal lamina that separates the mesothelium from the connective tissue. These observations strongly suggest that the mesentery contains both collagens type I and type III. The guinea pig mesentery contains 6.8 mg of sulfated glycosaminoglycans/g dry weight. Most of these glycosaminoglycans (78%) were identified as dermatan sulfate, whilst the rest (22%) corresponded to heparan sulfate. PMID- 3661116 TI - [Comparative histology, histochemistry and innervation of striated muscle fibers of the greater pectoralis muscle and supracoracoid muscle in birds]. AB - The morphology of the pectoralis major muscle and the supracoracoideus muscle was compared in three Galliformes and five Passeriformes, in relation to partial behavioral characteristics. In all species, two fibres types are observed. The frequencies of these fibres are different, especially between Galliformes and Passeriformes, but also between Coturnix and other Galliformes. All fibres show phasic innervation. A relation of the extent between synaptic gutters and muscle activity is suggested. PMID- 3661117 TI - Effect of clomiphene citrate on the ovary of a wild rat, Bandicota bengalensis. AB - The effects of clomiphene citrate (0.3 or 3.0 mg/kg body weight/day) for 10 consecutive days on the ovary of a wild rat, Bandicota bengalensis, were studied. The low dose of clomiphene decreased the number of nonatretic follicles larger than 400 microns in diameter, increased atresia in follicles smaller than 200 microns, inhibited granulosal mitosis in follicles less than 200 microns and between 401 and 600 microns in diameter and inhibited thecal mitosis in follicles smaller than 400 microns and larger than 600 microns. The high dose of clomiphene increased the number of follicles between 201 and 400 microns, decreased the number of follicles larger than 600 microns, increased atresia in follicles of 51 400 microns and increased granulosal mitosis in follicles of 201-400 microns diameter. In both the doses, clomiphene inhibited the ovulation rate (p less than 0.005), with 25 and 35% of the rats being anovulatory in low and high doses, respectively. In addition, clomiphene caused irregularity in the estrous cycles associated with increased cycle length. These results suggest that the clomiphene induced partial inhibition of ovulation is possibly through its action on follicular growth and atresia mainly in nonantral (less than 200 microns) and mature follicles (401-600 microns). PMID- 3661118 TI - The effects of nerve transection on the endoneurial collagen fibril sheaths. AB - The connective tissue changes during Wallerian degeneration and subsequent regeneration were studied in the distal stump of transected sciatic nerves of Wistar rats. In half of the animals regeneration was prevented by suturing the distal stump to muscle and in the rest spontaneous regeneration was allowed. Intact contralateral nerves served as controls. By 4 weeks after transection the Schwann cell columns became surrounded by a layer of thin collagen fibrils that were, on average, 25-30 nm in diameter. This was only half of the fibril diameter observed elsewhere in the endoneurium or in control nerves. The layer of thin fibrils diminished in thickness when axonal regeneration reached the distal stump, especially as the axons became myelinated. At all stages of the experiment the fibril diameter distribution in the surrounding normal endoneurial stroma was comparable with that observed in control nerves. Segments of Schwann cell basement membrane were observed to be closely associated with collagen fibrils both in freely regenerating, as well as in non-regenerating, nerves. The diameter of these fibrils corresponded to that observed in the zone of thin fibrils surrounding the Schwann cell columns. Such areas were not found in control nerves. The data obtained show that deposition of thin collagen fibrils occurs around the Schwann cell columns as a reaction to transection. Our observations on the regenerating nerves indicate that this connective tissue reaction does not prevent regeneration in the early phases following injury and that its progression is limited concomitantly with axonal regeneration. PMID- 3661119 TI - Aluminum accumulation in tangle-bearing neurons of Alzheimer's disease with Balint's syndrome in a long-term aluminum refiner. AB - Progressive dementia had developed since the age of 55 in a male patient, who had worked as an aluminum refiner for 30 years. Balint's syndrome was observed from at 60 and he died of bronchopneumonia at 65. Neuropathological examination revealed characteristic features of Alzheimer's disease with marked atrophy of the occipito-temporal lobes and senile plaques of the cerebellum. Wavelength dispersive X-ray microanalysis disclosed focal aluminum accumulation within the nucleus and cytoplasm of the tangle-bearing neurons. Microanalysis by the same method failed to disclose aluminum accumulation in the tangle-bearing neurons in a case of senile dementia of Alzheimer's type who had no possible inhalation of aluminum. PMID- 3661120 TI - Subclinical entrapment neuropathy of the equine suprascapular nerve. AB - The suprascapular nerve from 14 horses, which had no clinical evidence of spinatus muscle atrophy, were obtained to determine whether the nerve was sub clinically compressed at the scapular edge. The nerves were divided into three portions, proximal and distal to the scapular edge and as it reflected around it. In nine horses there was evidence of a chronic neuropathy which varied in severity and which was most severe at the site of reflection, where the nerve appeared constricted by a tendinous band. At this site the predominant change was that of chronic demyelination and remyelination, with many scattered thinly myelinated fibres and occasionally profuse onion bulb formation. There were also occasional regenerating clusters, which were the only abnormalities seen in the distal nerve. Renaut bodies appeared to be more common and larger in nerves with chronic focal neuropathy. Teased fibres confirmed the chronic myelin sheath changes, and the presence of many paranodal swellings suggested a possible chronic compressive aetiology. This is the first reported spontaneous entrapment neuropathy in the domestic animals. PMID- 3661121 TI - Adaptation of the myelin sheath during axonal atrophy. AB - Distal axonal atrophy was produced by proximal constriction of the tibial nerve in the rabbit. Single fibres were teased from the distal tibial nerve, and a selected internode from each fibre was measured and then cut transversely for electron microscopy, so that axon area and perimeter, myelin lamellar number and periodicity, and myelin spiral length could be related to the length of the internode which had been sectioned. When sections from atrophic and control internodes of similar length were compared, there was no difference in the mean number of myelin lamellae or their periodicity in the two groups, in spite of a mean reduction in axon cross-sectional area of 60% in the atrophic group. Mean values for axon perimeter and myelin spiral length were reduced by 14%-15% in atrophic fibres, compared with controls. The reduction in mean myelin spiral length might seem to imply that myelin had been lost from the atrophic internodes. However, there was also an increase in the length of individual lamellae in the long axis of the internode, due to the irregular folding of the sheath, and it is uncertain whether any overall change in internodal myelin volume had occurred. PMID- 3661122 TI - Topochemical demonstration of zinc in meningiomas. AB - In agreement with the atomic absorption tests, histochemical demonstration of zinc in meningiomas using the dithizone method revealed a higher level of zinc in fibromatous meningiomas than in its meningiotheliomatous variant. Calcified psammoma bodies and vessels exhibited an intensely positive reaction on their surface. The metabolic function of zinc in the synthesis of fibre proteins, as well as in metallo-enzymes associated with mineralization, explains these findings. PMID- 3661123 TI - Peculiar pattern of glial fibrillary acidic protein production in extracranial metastatic tumor cells of malignant astrocytoma. AB - An 83-year-old woman suffered from malignant astrocytoma originating in the temporal lobe. Autopsy revealed its extracranial metastasis to the liver, lung and bone marrow. The tumor tissue at the primary site was composed of plump, process-forming cells and small cells with scanty cytoplasm, and showed dural invasion. In the metastatic areas, most of the tumor cells were small cells, although proliferation of the plump cells in contact with perivascular connective tissue was marked, particularly in the liver. These plump cells were positively stained with antiserum to glial fibrillary acidic protein (GFAP), showing that the collagenous tissue was able to induce increased production of GFAP by the glial tumor cells. PMID- 3661124 TI - Young adult-form of dementia with neurofibrillary changes and Lewy bodies. AB - Alzheimer's neurofibrillary tangles, Lewy bodies and chromatolytic neurons were found in the brain at autopsy of a 28-year-old male with pyramidal and extrapyramidal signs, and severe dementia of 7-year duration prior to his death. Review of histological material showed generalized changes involving both cortical and subcortical structures. These changes were characterized by the presence of neurofibrillary myelin in long tracts and in subcortical regions. The neurofibrillary tangles were mostly composed of Alzheimer's paired helical filaments (PHF), PHF were immunostained with both polyclonal and monoclonal antibodies to PHF and the microtubule-associated protein tau. Some Lewy bodies were immunolabelled with monoclonal antibodies to PHF. To the best of our knowledge it is the first reported case of a young adult-form of dementia with extensive formation of neurofibrillary changes and Lewy bodies. PMID- 3661125 TI - Conservative management of the abnormal smear during pregnancy. A long-term follow-up. AB - One hundred and thirty-two pregnant women who had a smear suggestive of cervical intra-epithelial neoplasia (CIN) II or more during the 10th to 12th gestational week, were followed with repeated smears and colposcopy every month and, when indicated, a colposcopically guided biopsy. Post-partum follow-up included cytology, colposcopy, portio biopsies and endocervical curettage. Seventy-nine women with normal findings post partum were checked once a year in a long-term study. A close correlation (71% of CINIII) was found between cytological and histological diagnoses in cases of persistent (three or more) abnormal smears. However, in women with regression of the cytological diagnosis, high frequencies of histologically verified CIN were found. Thus, 37.5% (18/48) of normal or CINI smears were histologically still CINIII. Histologically verified CIN during pregnancy, on the other hand, showed a post partum progression of two degrees or more of CIN in only two cases. Cytology seemed to be inappropriate post partum, with 23.3% smears which were normal or suggestive of CINI, when histology showed CINIII. In a long-term follow-up, 24% of women with a normal post partum follow up for at least one year had a subsequent recurrence of CIN. It is concluded that follow-up of abnormal smears during pregnancy with repeated smears is not a reliable method. Post-partum follow-up should include at least colposcopy and a biopsy when indicated by the colposcopical examination. Women with a normal post partum follow-up constitute a high risk group for future recurrence of CIN and should be carefully followed for at least 5 years. PMID- 3661126 TI - Early complications after induced first-trimester abortion. AB - Complications subsequent to 5,851 consecutively induced first-trimester abortions during the period 1980-85 were analysed. Three hundred and fifty-six abortions (6.1%) led to complications requiring hospital admission. According to bivariable analysis, women below 25 years of age, women with parity 0, women with no spontaneous and with no induced abortions, and women in gestational week 8 had significantly higher postabortal complication rates than women 25 years of age and older (p less than 0.001), women with previous births (p less than 0.0001), women with spontaneous abortions (p less than 0.005), women with induced abortions (p less than 0.005), and women in other gestational age groups (p less than 0.0005). The mean stay in hospital per complicated abortion was 5.3 days. It was discussed whether the administration of prophylactic antibiotics to women with a history of pelvic inflammatory disease and young women completing their first pregnancy could reduce the complication rate. PMID- 3661127 TI - Serum ferritin and iron status in mothers and newborn infants. AB - Iron status, including hemoglobin, S-ferritin, S-iron, S-transferrin, transferrin saturation and the erythrocyte zinc protoporphyrin/hemoglobin (ZPP:Hb) ratio, was evaluated in 85 healthy iron-supplemented mothers at parturition and in 74 of their term newborn infants. Of the mothers, 17% had a S-ferritin level less than 15 micrograms/l (i.e. depleted iron stores), 9.9% had S-ferritin less than 15 micrograms/l and transferrin saturation less than 15% (i.e. latent iron deficiency), and 2.4% had S-ferritin less than 15 micrograms/l, transferrin saturation less than 15% and Hb less than 120 g/l (i.e. iron deficiency anemia). Newborn infants had higher S-ferritin than mothers: median 128 micrograms/l versus 21 micrograms/l (p less than 0.0001), higher transferrin saturation: 48% vs. 21% (p less than 0.0001), and higher ZPP:Hb ratio: 74 mumol/mol Hb vs. 41 mumol/mol Hb (p less than 0.0001). During the first 5 post-natal days, median S ferritin rose from 128 to 236 micrograms/l (p less than 0.0001). S-ferritin appeared to be the best single indicator of maternal iron status. Ferritin levels in newborn infants were correlated to levels in mothers (rs = 0.36, p less than 0.01), indicating that fetal iron reserves are dependent on maternal iron stores. PMID- 3661128 TI - Placental proteins (PP 5, PP 12 and PP 14) in ovarian tumors. A preliminary report. AB - Using a specific radio-immunoassay, the placental proteins PP 12, PP 14 and PP 5 were studied in serum for 2 patients with ovarian cancer and 7 with benign ovarian tumor. Elevated levels of PP 14, found in one endometroid ovarian cancer, decreased during successful treatment. PP 14 could also be found in the blood of nude mice grafted with this tumor. One patient with serous kystadenocarcinoma had a slightly elevated level of PP 14 at diagnosis, increasing as the tumor progressed. PP 14 was demonstrated histochemically in both the original tumor and the grafted. Ascitic fluid was rich in PP 14. Elevated levels of the proteins PP 12 and PP 5 were not found in these patients, however. In seven benign ovarian tumours, low PP 14 serum levels were found. The conclusion drawn from this study is that PP 14 can constitute a tumor marker in ovarian cancer. PMID- 3661129 TI - Acute effects of maternal smoking on human fetal heart function. AB - M-mode echocardiography was used to evaluate fetal heart function following maternal smoking in 21 healthy smoking pregnant women between 24 and 39 weeks of uneventful gestation. Prior to smoking one cigarette (nicotine content 1.7 mg), a fetal M-mode echocardiographic examination was performed and repeated 5 and 10 min after maternal smoking. Maternal heart rate and systolic blood pressure increased 8.7% and 15.0%, respectively, immediately after smoking, while diastolic blood pressure remained unchanged. Fetal heart rate increased 4.3% and left ventricular diastolic and systolic diameters decreased 4.5% and 15.0%, respectively. No changes in right ventricular dimensions, ventricular ejection times, ventricular wall thickness or septal thickness were observed. Fractional shortening, mean velocity of fractional shortening, stroke volume and cardiac output of the left ventricle also remained unchanged subsequent to smoking. Thus, maternal smoking of one cigarette seems to elicit only a transitory acceleration in fetal heart rate without concomitant significant changes in fetal heart function. PMID- 3661130 TI - Carpal tunnel syndrome in pregnancy. A prospective study. AB - In this prospective study, 56 women (2.3%) of 2,358 (47% nulliparous and 53% multiparous) delivered during a 12-month period at the Department of Obstetrics and Gynecology, Malmo General Hospital, had symptoms of carpal tunnel syndrome during pregnancy. All (33 nulliparous and 23 multiparous women) were examined, at the outpatient's maternity care unit and within 4-5 weeks from the time of debut of symptoms, by a specialist in hand surgery. At that time the most common symptoms were paresthesia and nocturnal pain. Twenty-nine had signs of reduced sensibility and 14 of them had a positive two-point discrimination test. All had generalized edema. Conservative treatment with splinting of the wrist at night made 46 out of 56 symptom-free. Of the remaining 10 women, 3 had to be operated on, whereas 7 received only conservative treatment, as the expected time for parturition was very close. One of them had to be operated on after delivery. In conclusion, carpal tunnel syndrome during pregnancy is most common in primiparas with generalized edema. Conservative treatment is sufficient for symptom relief in most women (80%) but a few cases need operative intervention to abolish the severe pain and to avoid disturbances of hand function. PMID- 3661131 TI - The evaporation test for detecting rupture of the fetal membranes. AB - A method for detecting rupture of the fetal membranes, first described by Iannetta in 1984, has been tested. It is based on the heating of endocervical material on a glass slide to evaporate water, thus leaving a white residue if amniotic fluid is present and a brown residue if it is not. The method is simple, quick and inexpensive. The study showed the method to be reliable if the result is positive, but also to produce some false-negative results. Interpretation may in some cases be open to observer bias unless clearly positive. Positive results were seen as early as in week 26. This method may prove to be a valuable addition to other tests for detecting rupture of the fetal membranes. PMID- 3661132 TI - Sex hormone binding globulin in clinical perspective. AB - The plasma steroid-binding proteins play a fundamental role in the modification and delivery of the steroid "signal" to its target tissue. While their precise function requires further evaluation, the measurement of these proteins, particularly of SHBG, provides clinically useful information. This article reviews the current theories of sex steroid transport and uptake, and documents the changes in SHBG status relevant to health, disease and drug therapy. PMID- 3661133 TI - High maternal levels of hemoglobin A1c associated with delayed fetal lung maturation in insulin-dependent diabetic pregnancies. AB - Phosphatidylglycerol (PG) in 227 amniotic fluid specimens obtained by amniocentesis during the third trimester and hemoglobin A1c (Hb A1c) in 889 maternal blood specimens obtained between 6 and 39 gestational weeks were measured for 115 singleton insulin-dependent diabetic pregnancies without major fetal malformations or stillbirths. The fetuses of diabetics whose mean Hb A1c during pregnancy was 8.5% or more remained PG-negative more often than those in the pregnancies with the mean Hb A1c below 8.5% at 37 (4/7 vs. 8/68, chi 2 = 10.2, p less than 0.01) and 38 (2/7 vs. 2/84, chi 2 = 5.2, p less than 0.05) completed weeks of gestation. The fetuses of the patients with a mean Hb A1c 8.0% or more were more often PG-negative at 37 gestational weeks (7/15) than those in the pregnancies with a mean Hb A1c below 8.0% (5/60, chi 2 = 10.4, p less than 0.005). Because Hb A1c reflects long-term blood glucose levels, the results suggest that maternal hyperglycemia, or other metabolic disturbances associated with hyperglycemia, is the cause of delayed fetal lung maturation among insulin dependent diabetics. PMID- 3661134 TI - Two highly sensitive methods of HCG determination in women with subacute ectopic pregnancy. PMID- 3661136 TI - Depressed fracture of the skull in a child born by cesarean section. PMID- 3661135 TI - Profile of Danish women undergoing reversal of sterilization, 1978-1983. AB - To help identify those women who might regret undergoing sterilization, the Danish women refertilized from 1978 to 1983 were contacted by mailed questionnaire. Eighty-three percent (120/144) responded. These women were younger at the time of sterilization than Danish women sterilized in the same period (mean age 29 years versus 34 years). Furthermore, they had more children at the time of sterilization and had their first and last child at a younger age than Danish women generally, in the same age group. Their social and educational status was lower than the background population and fewer were in gainful employment. At sterilization, most of the women were in an emotionally stressful situation (e.g., marital disharmony (78% of the married women), single parenthood (28%), unwanted pregnancy (27%], or had chronic health problems in the family. Alternative contraceptive methods had not been fully explored. Thirty-eight percent complained of late secondary effects attributable to the sterilization, but the main reason for wanting reversal of sterilization was a new partner (75%). The study suggests that the psycho-social situation and contraceptive alternatives should be carefully evaluated in women requesting sterilization, especially in those below the age of 30. PMID- 3661137 TI - Uterus didelphys with a unilateral imperforate hemivagina and ipsilateral renal agenesis. PMID- 3661139 TI - Comparison between the conventional Malstrom extractor and a new extractor with silastic cup. PMID- 3661138 TI - Successful treatment with bromocriptine of hypertension associated with polycystic ovarian disease. AB - The use of bromocriptine, 5 mg per day, markedly improved the severe hypertension (up to 180/120 mmHg) of a patient suffering from polycystic ovarian disease (PCOD). The response was rapid, with decreasing concentrations of serum testosterone and 11-deoxycorticosterone (DOC). Bromocriptine induced further renewal of the ovulatory cycle. Bromocriptine may thus be of considerable value in the treatment hypertensive patients with PCOD. PMID- 3661140 TI - Lactoferrin and serum albumin in the conjunctival fluid of eyes operated for senile cataract. AB - The concentrations of serum albumin (SA) in the conjunctival fluid were measured in 25 patients before surgery and in the post-operative period following cataract extraction. We found a significant increase in mean tear fluid SA concentration on the first post-operative day. The SA concentration remained high during the first 3 pre-operative levels. No correlation between the post-operative concentration profile of tear fluid SA and earlier findings of the tear lactoferrin (LF) profile of the same group of patients (Jensen et al. 1985) could be shown, although a trend towards an inverse relationship was apparent from the graphs. Pre-operatively, we found a significant positive correlation between age and concentration of SA in the conjunctival fluid (P less than 0.05) which might be interpreted as an increase in leakage from conjunctival vessels with age. This would, at least partly, explain the decreasing LF concentration with age (Jensen et al. 1986; McGill et al. 1984). It is concluded that transudate/exudate from the conjunctival vessels, represented by the change in the SA concentration in the conjunctival fluid, might be responsible for an initial post-operatively reduced concentration of LF and possibly other lacrimal gland proteins. PMID- 3661141 TI - Effect of methyl cellulose on tear film break-up-time in health and disease. AB - Methyl cellulose instillation enhanced the values of BUT in healthy individuals, as well as in patients with trachoma stage III and chronic conjunctivitis, while no effect was observed in patients with squamous blepharitis. PMID- 3661142 TI - Effect of multiple applications of compound 48/80 on mast cells of rat conjunctiva. AB - We sought to determine the effect on rat conjunctival mast cells of chronic exposure to a degranulating agent. Compound 48/80 (250 micrograms in 10 microliter) was applied daily to the ocular surface of rats for a total of 13 treatments administered in 17 days. A single application of compound 48/80 was given to rats for comparison. Four groups of animals (6 in each group) were evaluated 1 or 48 h after the last application of compound 48/80 in both chronic exposure and single exposure studies. Although a single exposure to compound 48/80 induced significant degranulation of mast cells in animals observed 1 h after treatment, no significant degranulation of mast cells was observed 1 h after the last dose of compound 48/80 was given to rats whose conjunctiva had been chronically exposed to this degranulating agent. Thus, multiple applications of compound 48/80 attenuated the mast cell response to compound 48/80. This acquired tolerance to compound 48/80 was reflected in the lessened clinical signs in rats receiving repeated applications compared with those given a single application. PMID- 3661143 TI - An investigation of aetiology and heredity of pterygium. Report of 11 cases in a family. AB - A family with pterygium affecting 11 members of 3 generations was reported. Although the disease is not necessarily hereditary in most of the patients, the mode of transmission in this particular family was autosomal dominant. The relationship between individual predisposition and the external factors in pterygium formation is briefly discussed. PMID- 3661144 TI - Capsule thickness of cataractous lenses with and without exfoliation syndrome. AB - Lens capsule thickness was measured in 105 cataractous lenses with and without exfoliation syndrome. The lenses were removed by intracapsular cryoextraction. Forty lenses (38%) showed exfoliation, while 65 (62%) were exfoliation negative. Thickness values were measured by light microscopy from the central anterior capsule, central posterior capsule and from the equator. The mean thickness values were for the central anterior capsule 8.2 +/- 3.2 mu, for the central posterior capsule 3.2 +/- 1.4 and for the equator 3.9 +/- 1.3. There was no statistical difference between the exfoliation-positive and exfoliation-negative lenses. The capsule thickness varied greatly throughout the present material. The highest value, 22.4 mu, was measured from an exfoliation-negative central anterior lens capsule of a male patient aged 33 years. The lowest value, 0.6 mu, was measured from an exfoliation-positive central posterior capsule of a male patient aged 64 years. The central posterior capsule is the thinnest area of the lens capsule. The findings call for great caution in polishing the posterior capsule during extracapsular cataract surgery. The higher complication rate in eyes with exfoliation syndrome cannot be explained by thinner lens capsules but rather on the more friable zonules. PMID- 3661145 TI - A biometric investigation of late onset myopic eyes. AB - There is a paucity of biometric information on late onset myopia (onset after 15 years-old). The present investigation compared the ocular component dimensions of 30 late onset myopes and 30 emmetropes, who were both age and sex matched. Measurement techniques included A-scan ultrasonography and keratometry. The findings revealed that the ultimate cause of late onset myopia is vitreous chamber elongation. Late onset myopes were also found to have significantly deeper anterior chambers and thinner crystalline lenses, no differences being found in corneal curvature measures. Possible mechanisms leading to these observed biometric differences are discussed in the light of recent findings. PMID- 3661146 TI - The central light reflex of retinal arteries and veins in insulin-dependent diabetic subjects. AB - The width (Wr/Wo) and the intensity (Ir) of the central light reflex were studied on retinal arteries and veins in insulin-dependent diabetic patients. A diabetic group (n = 45) was compared to normal subjects (n = 57), and the groups were matched according to age and blood pressure levels. A computerized scanning microdensitometer was applied across various sites on vessels in fundus photographs. The Ir of the reflected light was significantly reduced in diabetic arteries and veins compared to the vessels in the control group (P less than 0.001). This may implicate abnormalities in blood rheology of the retinal circulation in diabetes. The Wr/Wo was found narrower in veins in diabetic patients (P less than 0.001). This probably indicates differences in haemodynamics of venous flow in diabetic and normal subjects. The intensity was correlated to the duration of diabetes (P less than 0.05), while neither the width nor the intensity were found related to sex, metabolic control, intraocular pressure or retinopathy. PMID- 3661147 TI - Natural history of diabetic retinopathy in insulin-dependent juvenile diabetics. A longitudinal study. AB - In 1975 a prospective longitudinal study of 63 non-pubescent children with insulin-dependent diabetes mellitus (IDDM) was started in order to study the development of retinopathy. This paper presents the results of a 5- and an 8-year follow-up examination concerning the individual development of retinopathy in the patients. At the last follow-up the mean age of the patients was 21.9 years (18 23 years) and the mean diabetes duration 13.2 years (8.1-21.2 years). In 1975 only 5% had developed retinopathy. In 1980 this incidence had risen to 63% and in 1983 to 93% (14% proliferative retinopathy and 79% background retinopathy). In most patients the retinopathy developed slowly, in some patients, however, it deteriorated severely within a few years. A slight regression in the number of microaneurysms and in the number of haemorrhages was observed in a few patients. Microaneurysms seemed in all but one case to be the first pathological element in diabetic retinopathy and developed as a rule several years before other diabetic fundus manifestations occurred. Development of retinopathy was correlated to the duration of diabetes. No correlation could be demonstrated between the progression of retinopathy and the status of regulation. Retinopathy occurred only in 5 patients (8%) before puberty. PMID- 3661148 TI - Predictive value of Lang two-pencil test, TNO stereotest, and Bagolini glasses. Orthoptic examination of an adult group. AB - In our comparative study of a Rodenstock sight-screener and a clinical eye examination, an orthoptic examination was included. The present study describes the orthoptic examination of 109 subjects and evaluates the predictive diagnostic value of Lang two-pencil test, TNO stereotest and Bagolini striated glasses. We found 14 orthoptic pathological cases most of which could be revealed by an accurate cover test. The TNO stereotest and the Bagolini glasses have high predictive diagnostic values of negative and even of positive tests. If one of these tests is used as a supplement to the ophthalmological examination and anamnesis, we find it to be a valuable hint of orthoptic normality or abnormality. If an orthoptic pathology is suggested, this must be followed by a complete orthoptic examination concerning diagnosis and treatment. PMID- 3661149 TI - Characterization of an intraocular retinoblastoma-like tumour. AB - A transplantable intraocular retinoblastoma-like tumour growing in F 344 rat eyes and tissue cultures suitable for therapeutic experiments is characterized. The tumours grew in the vitreous and infiltrated the internal layers of the retina. Feeder vessels from the retina supplied the tumours. Few and often incomplete rosettes were seen, and calcification was sparse in areas of necrosis. Stainings for glial fibrillary acidic protein, S-100 protein, neuron-specific enolase and desmin were negative. Ultrastructural analysis brought out a close correspondence between the tumour cell and the human retinoblastoma and other virus-induced retinoblastoma-like tumours. The experimental tumour cells lacked cilia, but had neurosecretory granules. Chromosome analysis showed a modal chromosome number in the triploid range, and 6 marker chromosomes were demonstrated. Flow-cytometric analysis showed a S-phase cell fraction of 42%, and chromosome stability was suggested by a tumour-cell DNA index which remained stable for more than 3 months. PMID- 3661150 TI - Regional ocular blood flow after chronic topical glaucoma drug treatment. AB - The effects of a chronic three times a day treatment over a 5 to 6 week period of rabbit eyes with 1 of 5 topically applied glaucoma drugs on ocular blood flow was determined using a radioactive microsphere technique. The drugs employed were timolol (0.5%), pilocarpine (4%), epinephrine (2%), norepinephrine (2%), and ecothiophate iodide 0.125%). The results showed that epinephrine statistically decreased blood flow to the iris and ciliary processes while not to the posterior uveal tissues or optic nerve head. Pilocarpine also showed this same trend, while the differences were not statistically significant. Other drugs were without effect on regional ocular blood flow. PMID- 3661151 TI - Eye movements induced by gravitational force and by angular acceleration: their relationship. AB - The relationship between putative 'canal' and 'otolith' function was studied by using both vertical axis and horizontal axis (barbecue spit) rotations. The vestibulo-ocular reflex (VOR) with eyes closed of 7 normal subjects during vertical axis rotation was characterized (0.02 to 1.67 Hz) using pseudorandom acceleration. Gain and phase points were calculated. The long time constant of the VOR was then estimated from the phase points using a simple linear systems model. The same subjects were also tested with eyes closed using earth horizontal axis rotations. Constant velocity rotation (60 degrees/sec) produced a periodic oscillation in the slope of the slow component of nystagmus known as the 'modulation component'. The amplitude of this component was averaged for clockwise and counterclockwise runs. For the 7 subjects, the amplitude of averaged modulation component correlated with the low-frequency phase values (r = 0.82 to 0.89) and VOR long time constant estimates (r = -0.95) obtained during vertical axis rotations. These data suggest a complementary relationship between responses to linear and to angular accelerations. Subjects having eye movement responses which are less sensitive to low-frequency angular acceleration also tend to have relatively greater responses to changing linear accelerations. PMID- 3661152 TI - X-ray diffraction analysis of the auditory ossicles in chronic otitis. AB - An X-ray diffraction analysis was carried out on 10 healthy mallei and incudes which were taken from cadavers and on 50 diseased mallei and incudes taken peroperatively from patients with atticoantral otitis. X-ray powder diagrams of normal ossicles were shown as a granular hydroxyapatite. In diseased ossicles, changes were found in the crystallinity of hydroxyapatite which can be divided into four groups: (i) with characteristics of a diagram of normal bones giving peaks of maximum intensity of a granular hydroxyapatite; (ii) with less hydroxyapatite crystallinity; (iii) characterized by the occurrence of an amorphous phase of bone; (iv) characterized by the absence of all types of crystallization. The occurrence of different phases of crystalline hydroxyapatite in various forms of atticoantral otitis does not depend on the type of pathological process, i.e., with or without cholesteatoma. PMID- 3661153 TI - Inhibition of vestibular nerve activity by efferent fibres in the cat. AB - Electrophysiological studies were performed in anesthetized cats to examine the role of the parvocellular reticular nucleus (PCRN) in vestibular afferent fibers originating in the horizontal semicircular canal. When the primary afferent fibres intra-axonally recorded in the brainstem were classified into regular, intermediate, and irregular types, repetitive stimuli over 100 Hz applied to the PCRN inhibited spontaneous firing and the increase in firing during horizontal rotation in irregular and intermediate type units, whereas in regular type units PCRN stimulation affected neither the spontaneous firing nor rotation-induced responses. These results strongly suggest that the PCRN stimulation inhibits the primary afferent terminals of irregular type units receiving impulses from type I hair cells of the ampullae. PMID- 3661154 TI - The effect of chronic middle ear inflammation on the pneumatization of the tympanic bulla in pigs. AB - The effect of chronic middle ear inflammation on the pneumatization of the tympanic bulla was investigated in piglets. The pig tympanic bulla has an air cell system which is divided by trabeculae and closely resembles the human mastoid air cell system. The tympanic bulla and its air cell system in normal ears were well developed because of the bone formation and the bone resorption inside the cortex, whereas the tympanic bulla affected by chronic otitis media in the early stages of life exhibited retardation of pneumatization arising from the disturbed bone resorption by inflammatory stimulus. It was concluded that affliction with chronic middle ear inflammation in the early stages of life causes inhibition of pneumatization by hindering the development of the air cell system. PMID- 3661155 TI - Incidence of acute otitis media up to the age of 1 1/2 years in urban infants. AB - The object of this prospective cohort investigation of 1,642 infants was to study the incidence of acute otitis media (AOM) in urban children during the first 18 months of life. The monthly incidence of AOM was greatest at the age of 10 months, and the largest proportion of children with AOM was also found in this 10 month age group. Before the age of 18 months, 56.7% of the infants had had at least one episode of AOM, while 26.9% had had one or two episodes and 29.8% three or more. The corresponding figures before the age of 12 months were: 45.3%; 26.8%; 18.5%, and before the age of 9 months: 30.5%; 22.1%; 8.4%. The AOM incidence, particularly as regards recurrent AOM, was rather higher in boys than in girls. PMID- 3661156 TI - Formation of junctional complexes in otocysts developed in vitro. A freeze fracture study. AB - The thirteenth gestational day inner ear anlage (otocyst) was explanted to an in vitro system and cultured for 8 days, i.e. to a time corresponding to birth. The freeze fracturing technique was used to evaluate morphological differentiation, particularly as regards cell membrane specializations. The epithelial cells were found fully differentiated, e.g. there were regularly arranged stereocilia on the hair cells. The development of tight junctions and gap junctions followed the same pattern as in vivo, but tight junctions did not reach the same degree of regularity and maturation as they did in vivo. There were very few gap junctions in our in vitro specimens. Several tight junctions had an odd appearance, with loss of the normally punctate structure of the strands and areas with considerable thickening. It is possible that this specific morphology can be explained by differentiation in the in vitro system. PMID- 3661157 TI - Argon laser in otosclerosis surgery. AB - Data are reported from 323 otosclerotic ears in which primary surgery was carried out by using a large fenestra stapedectomy technique with fascial sealing of the window. In 129 ears the footplate was perforated with an argon laser. In the whole series, one ear became deaf (0.3%) as a result of granulomatous reaction in the operated area. Results in the argon laser group were slightly better than those in the group with mechanical footplate perforation and reconstruction with wire and fascia. Use of argon laser facilitates stapes surgery and, when used judiciously, it is a very helpful tool in all types of ear surgery. PMID- 3661158 TI - Early development of the stato-acoustic and facial ganglia. AB - The early embryonic development of the stato-acoustic and geniculate ganglia was documented in CBA/CBA mice by light and transmission electron microscopy. The geniculate ganglion was identified at the 12-15 somite stage with its origin from the epibranchial placode as well as the neural crest. The VIII ganglion develops later at the 25-27 somite stage, having its origin both in the otic vesicle and in the neural crest cells. PMID- 3661159 TI - Comparison between different techniques for measuring nasal patency in a group of unselected patients. AB - Many techniques for measuring nasal patency have been developed in search for a reliable, easily performed and reproducible method. Rhinomanometry is easily performed in the clinic but daily records of nasal blocking cannot be obtained. In this study we examined the correlation between posterior rhinomanometry (PR), nasal peak flow (nPF), the ratio nasal patency index (NPI), and the opening interrupter method (Rtn) for measuring nasal patency. Twenty-eight subjects with no symptoms of rhinitis and 20 patients with diagnosed rhinitis were investigated. A significant (p less than 0.05) correlation was found between PR and nPF after stratification according to the diagnosis of rhinitis and between nPF, PR, and height. All other correlations tested proved non-significant. We conclude that PR is the method which ought to be used in the hospital, but nPF is an easy way to measure nasal patency and might even be used by the patient at home. PMID- 3661160 TI - Biological rhythmicity of nasal airway patency: a re-examination of the 'nasal cycle'. AB - Rhinomanometric observations of nasal airway patency were obtained for each nasal passage every 10 min throughout an uninterrupted 8-h session. The 49 airflow observations for each nasal passage were subjected to autocorrelation analysis, a statistical technique for quantifying periodicities in a temporal sequence of observations. No significant periodicities were found in any of the 16 subjects when the autocorrelation functions were interpreted by conventional statistical criteria. However, when less stringent criteria were applied, we found suggestive evidence for rhythmicity in one (7 subjects) or both nasal passages (2 subjects). The relationship in patency between the two sides of the nose was characterized with correlation coefficients. These correlations were significantly negative in 7 subjects, indicating bilateral reciprocity of patency. In addition, the correlations were significantly positive in one, and nonsignificant in 8 subjects. Only a minority of subjects (13%) displayed the classical nasal cycle, i.e., rhythmicity in both nasal passages as well as reciprocity of patency between passages. PMID- 3661161 TI - Immunoglobulin allotypes in head and neck cancer patients with multiple primary cancers. AB - Immunoglobulin allotypes G1m, G2m, G3m, A2m and Km were determined in patients with a single head and neck cancer and in head and neck cancer patients with multiple primary tumours. Frequencies were compared with those of healthy controls. In all 39 patients with multiple primary tumours studied, Km(1) was absent vs. 82% and 75% absence in healthy controls and patients with a single head and neck cancer, respectively. This difference is highly significant. We conclude that head and neck cancer patients lacking the Km(1) are susceptible to the development of new cancers, and therefore should be screened thoroughly for more tumours. PMID- 3661162 TI - The ultrastructure of spiral ganglion cells in the mouse. AB - In the adult mouse, three types of spiral ganglion cells can be distinguished on an ultrastructural basis. The first type, TI cells, corresponds to the most commonly encountered cells in the ganglion, which represents 92 to 94% of the whole population. This type of cell is characterized by numerous cytoplasmic organelles that give a dark and a granular appearance, while the nucleus is more lightly coloured. Moreover, the perikaryon is surrounded by a myelin sheath composed of several myelin lamellae that can be either loose or compact. The periodicity of compact myelin around the perikaryon is larger than that found in nerve fibres. The T II ganglion cells, corresponding to the second type, are less numerous and represent only 6 to 8% of the cell population. They present a clear perikaryon with few cytoplasmic organelles and large areas composed of filamentous structures. The perikaryon is not surrounded by a myelin sheath, although several Schwann cell processes can be observed. The third type is composed of few ganglion cells that are ultrastructurally very close to T I cells, but without a myelin sheath. Desmosome-like junctions have been observed between myelin lamellae and between myelin lamellae and the plasmalemma, but no synaptic contacts have been observed between auditory nerve fibres and ganglion cells. PMID- 3661163 TI - Macular suprastructure, stereociliary bonding and kinociliary/stereociliary coupling in rat utricular macula. AB - This report considers rat utricular macular suprastructure after chemical treatment with the sodium salt of N,N-Naphthaloylhydroxylamine (NHA), used alone or in combination with tannic acid (TA). NHA and TA preserve calcium and complex carbohydrate-protein molecules, respectively. Macromolecules of supramacular substance appear comparable morphologically to material of the external lamina of glycocalyx. Similar material crosslinks stereocilia with approximately equal to 58 nm periodicity and couples parts of kinocilia with specific stereocilia. Particles which occur within kinocilia at certain attachment sites connect to dynein arms of the kinocilia. Interstereociliary connections are aligned with internal linkers to actin. Thus, a basis for dynamic communication between kinocilia and stereociliary actin has been shown. The mechanism would appear to be calcium dependent. The findings support the concept that kinocilia are motile and lead to the stereociliary tuft in vestibular hair cells. PMID- 3661164 TI - The change in the electrical resistance of the scala media produced by vasopressin. AB - The electrical resistance of the scala media (Rm) in the basal turn of the guinea pig was measured during perilymphatic perfusion with vasopressin. As the endocochlear potential (EP) diminished under the influence of vasopressin (0.1 mM), so the Rm increased. The Rm decreased when the EP decreased by vasopressin recovered above the pre-asphyctic level after the termination of temporary asphyxia. The present study demonstrates that the EP decrease produced by vasopressin is associated with the increase in Rm. PMID- 3661165 TI - Glycine immunoreactivity in the brainstem auditory and vestibular nuclei of the guinea pig. AB - An immunohistochemical study was performed on the brainstem of the guinea pig, using a specific antibody against glycine. Glycine-like immunoreactivity was observed in stellate and multipolar neurons in the cochlear nucleus, in the medial and lateral nuclei of the trapezoid body and in the ventromedial periolivary cell group. No immunoreactive neurons were found in the vestibular nuclei. Positive fibre tracts were observed mainly in dorsal acoustic stria and lateral lemniscus. The results are consistent with electrophysiological and anatomical data from the literature concerning the response pattern in the fusiform layer of the dorsal cochlear nucleus and the phenomenon of binaural inhibition in the superior olivary complex. PMID- 3661166 TI - The effect of target tissues on survival and differentiation of mammalian statoacoustic ganglion neurons in organ culture. AB - This study explored the effect of peripheral and central target tissues on the survival and differentiation of murine statoacoustic ganglion neurons. Isolated ganglia, ganglia with otic sensory epithelia, ganglia with rhombencephalic tissue and ganglia with both otic sensory epithelia and rhombencephalic tissues were explanted from 12.5 gestation-day mouse embryos. All explants developed for 14 days in vitro on the surface of HEMA hydrogel substrata. There were significantly fewer differentiated statoacoustic ganglion neurons in isolated ganglion explants (18.5%) than in explants of ganglia with peripheral (97.2%) or central (87.5%) target tissues or in those explants that contained both targets (93.1%). Our results confirm in the developing mouse that both peripheral and central target tissues exert a trophic influence on the survival and cytodifferentiation of statoacoustic ganglion neurons. PMID- 3661167 TI - The effects of deferoxamine mesylate and hypoxia on the cochlea. AB - Deferoxamine mesylate (DF) is a chelating agent used for the treatment of iron overload. Recently audiological testing of patients on long-term treatment with this drug indicated the possibility of an ototoxic side effect (1). We administered DF to chinchillas with both acute and chronic regimes. Functional and histological damage to the cochlea was detected only in the acute experiment. This was assumed to come not from the direct effect of DF on the cochlea but from the hypoxia as a result of respiratory suppression due to DF toxicity. To confirm this, animals were exposed to hypoxia during the same time course as for the DF experiment. Histological and physiological consequences of this hypoxia alone revealed very similar results to that observed in the acute DF experiment. This implies that DF has little direct toxic effect on the cochlea and, more importantly that considerable attention to hypoxia should be paid when assessing the cochlear pathology of animals which have been subjected to general anesthesia for long periods. PMID- 3661168 TI - [Tumor markers of malignant head and neck neoplasms]. PMID- 3661169 TI - [Experimental course in clinical otorhinolaryngology for medical students. Considerations and results]. PMID- 3661170 TI - [Effect of ipsilateral competitive message on the identification of synthetic phrases in selective noise damage (3-4 KHz)]. PMID- 3661171 TI - Severe neonatal respiratory distress syndrome treated with the isolated phospholipid fraction of natural surfactant. AB - Ten newborn infants (795-1680 g) with severe respiratory distress syndrome (RDS) were treated with the isolated phospholipid fraction of bovine or porcine surfactant, which was administered via the airways (dose 200 mg/kg), at a median age of 10.5 h. Before receiving surfactant, all the infants were on artificial ventilation (FiO2 0.6-1.0). Within 2 h after surfactant replacement, the arterial to-alveolar PO2 ratio increased from 0.1 to 0.35. There was a concomitant improvement in lung aeration on the chest roentgenograms and a significant reduction in the right-to-left shunt. Four patients died of cerebral hemorrhage; two of them also had a patent ductus arteriosus. One surviving infant developed bronchopulmonary dysplasia, and another succumbed 8 months later to the sudden infant death syndrome. No antibodies against surfactant were detected in the sera of the survivors. Since our results show a significant improvement in lung function after replacement therapy, the efficacy of this new surfactant preparation should be further tested in randomized clinical trials. PMID- 3661172 TI - Risk factors for wheezing during infancy. A study of 5,953 infants. AB - Risk factors for the development of wheezing during infancy were studied in 5,953 children. The data for the study were collected from a large prospective investigation of children born in 1959-61, who had attended a one-year follow-up examination. Wheezing was diagnosed when the symptom had been observed at least once during the first year of life, not in conjunction with pneumonia, epiglottitis or acute laryngitis. Logit analysis was used for the purpose of assessing the causal effect of environmental and other factors on the risk of wheezing among infants. The assessment of a risk factor by means of regression technique, requires certain other variables to be included in the regression model. A general rule concerning inclusion of other variables has been formulated and applied to the above data. The study demonstrated that the risk of wheezing was affected by a number of factors--particularly environmental. Poor social environment increases the risk of wheezing, as does the mother's smoking, and placement of the baby in day-care. Boys experienced wheezing more often than girls. Premature infants are more liable to develop wheezing than mature children. Remarkably, children born in the period April through September develop wheezing, but not bronchitis, more often than children born in October through March. PMID- 3661173 TI - Early and late discharge after hospital birth: breastfeeding. AB - Breastfeeding was studied among women discharged early and late after normal delivery in a hospital. Early discharge was defined as leaving the hospital 24-48 h after delivery in combination with domiciliary visits, and late discharge as the regular hospital postpartum care (mean 6 days). 164 women interested in participating in the early discharge study were randomly allocated in late pregnancy to a group offered early discharge (Experimental group = EG) or a group offered the traditional later discharge (Control group = CG). After medical exclusions and non-medical withdrawals, 50 mother-infant couples remained in EG and 54 in CG. Regular breastfeeding at 6 months after birth was reported by 63% of the multiparae in EG and 41% in CG (p = 0.06). Thirty-three per cent of the primiparae in each group were still breastfeeding at 6 months. 2% of the infants in EG and 72% in CG received supplementary breastmilk at least once during their first week of life. Infants discharged early were breastfed more often on the 2nd (NS), 3rd (p less than 0.05) and 4th day (p less than 0.001) after birth, compared with infants who stayed longer in hospital. There were no statistically significant differences between EG and CG women in their experience of success in breastfeeding according to daily records from the first 14 days after the birth. PMID- 3661174 TI - Persistence of human milk proteins in the breast-fed infant. AB - Several proteins in human milk are postulated to have physiological functions in the breast-fed infant. Therefore, survival of human milk proteins after passage through the gastrointestinal tract of the breast-fed infant was investigated. Fecal samples were collected from exclusively breast-fed term infants and milk samples from their mothers. Soluble proteins in the feces were extracted and analyzed for total protein, nitrogen, lactoferrin, secretory IgA, serum albumin and lysozyme. Significant amounts of lactoferrin and secretory IgA were excreted by the infants and this excretion decreased throughout the study period in a trend similar to the decreasing milk concentrations of these proteins. Gel filtration demonstrated excreted lactoferrin and secretory IgA to be intact. No serum albumin or lysozyme was detected in the fecal extracts. Crossed immunoelectrophoresis showed three human milk proteins to be present in the feces -the third was identified as alpha 1-antitrypsin. Excretion of these proteins indicates the total protein content of human milk is an over-estimation of the protein nutritionally available to the infant. PMID- 3661175 TI - Evidence for colonic absorption of protein nitrogen in infants. AB - The absorption of protein nitrogen by the colon was assessed in 6 infants with colostomy by giving 15N yeast protein in a dosage of 5-20 mg 15N/kg (92.4 atom-% 15N). The absorption of 15N ranged between 87.1 and 98.1% of the administered dose, and the retention in the protein pool ranged between 79.0 and 94.2%. The incorporation of 15N in the plasma proteins was demonstrated by 15N excess values between 0.02 and 0.10 atom-%. The results suggest that the colon can assimilate proteins when insufficient absorption of protein nitrogen in the small intestine occurs. The breakdown of protein is thought to result from the action of colonic flora. PMID- 3661176 TI - Perinatal retinal haemorrhages and development. Follow-up in seven year olds. AB - Depending on methods of delivery, 7-50% of all children are born with retinal haemorrhages (RH). To assess the prognostic value of extensive RH for the future development of the child, the ophthalmological, neurological and psychological status of 52 children, 26 born with RH and 26 controls, were examined at the age of seven years. There were significant differences between the two groups using only psychological measures. Children with RH performed poorer than the control group, but the results did not point to any particular cerebral areas being affected. However, children with both RH and low socio-economic status were significantly less emotionally stable than the controls. Socio-economic factors also seem to be more highly correlated with later performance than do RH. PMID- 3661177 TI - Unexpected occurrence of retinopathy of prematurity: is there a need for custom made screening procedures? AB - Widely differing screening routines for retinopathy of prematurity (ROP) are encountered in the literature. Because no standard pattern in the development of retinopathy of prematurity has so far been recognized and substantial differences exist between patient-populations, none of these procedures seem generally applicable. Diverse manifestations of this entity cast doubt upon the usefulness of rigid screening procedures. As illustrated by two cases, some retinas seem to be at risk of developing ROP over a considerable period of time which may even extend beyond term. It is suggested that very low birthweight neonates, suffering serious illness or undergoing anesthesia after the initial "routine" ROP screening, should be reexamined for ROP thereafter. PMID- 3661178 TI - Acute gastroenteritis in children attending day-care centres with special reference to rotavirus infections. I. Aetiology and epidemiologic aspects. AB - Acute gastroenteritis (GE) among 214 children (aged 6 months-7 years) attending day-care centres (DDCs) in the Copenhagen County was studied during a 12-month period. A total of 197 cases of GE was observed in 109 children (i.e. 51% of the participants). The aetiology was as follows: rotavirus (n = 48) (24%), pathogenic bacteria (n = 11) (6%), Giardia lamblia (n = 3) (2%), while the aetiology of 68% remains unknown. The pathogenic bacteria included Yersinia enterocolitica, thermophilic Campylobacter, Clostridium difficile (+/- toxin) and enteropathogenic E. coli. In 4% of the GE the infections were multiple and Cryptosporidium was seen in one of these cases. The rate of GE declined with age from 1.35 GE per child per year (age group 1.0- less than 2.0 years) to 0.36 (6.0 less than 8.0 years). Serum sampled at the start of the study period showed that the frequency of detectable rotavirus IgG increased with age from 48% in the 6 months- less than 1.0 year group to 96% in the 4.0- less than 7.0 year group. The highest rates of rotavirus GE occurred from January to April (i.e. the rotavirus season). Moreover, rotavirus GE was almost absent after the age of 4. Hence, the rates of rotavirus GE per rotavirus season per child were 0.80 (age group 6 months-less than 1.0 year), 0.32 (1.0-less than 2.0), 0.14 (2.0-less than 3.0), 0.16 (3.0-less than 4.0), 0.06 (4.0-less than 5.0) and 0.04 (5.0-less than 6.0). Only 2 out of the 48 rotavirus GE were reinfections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661179 TI - Acute gastroenteritis in children attending day-care centres with special reference to rotavirus infections. II. Clinical manifestations. AB - In a prospective study of a cohort of 214 children (aged 6 months-7 years) attending day-care centres, a total of 197 episodes of acute gastroenteritis (GE) occurred in 109 children (i.e. 51% of the participants) during a 12-month observation period. Rotavirus, pathogenic bacteria and Giardia lamblia caused GE in 24%, 6% and 2% of the cases, respectively. The aetiology of the remaining 68% was not discovered. Generally, the symptoms of GE were light and only two episodes led to hospitalization. Thirty-two rotavirus infections were asymptomatic. Two rotavirus GE reinfections occurred. They showed less severe symptoms than the primary infections. The older children (greater than 1.5 years) with rotavirus GE had lighter symptoms than the younger ones (less than or equal to 1.5 years). Compared with children with non-rotavirus GE, those with rotavirus GE showed the following clinical features: (1) Age between 6 months and 2 years. (2) Occurrence of rotavirus GE almost exclusively during the rotavirus season, i.e. January to April (winter). (3) High frequency of vomiting, the onset of which often preceded that of diarrhoea. However, these signs did not form a safe basis for the clinical diagnosis of rotavirus GE. One or more upper respiratory manifestations (URM) were observed in 39% of the children with rotavirus GE and in 36% of those with non-rotavirus GE. The occurrence of URM was age-related being highest in children less than 2 years. Consequently, the existence of a rotavirus syndrome is questioned. It is argued that URM in children with rotavirus GE may be due to a co-infection of the upper respiratory tract by a different micro-organism. PMID- 3661180 TI - Effect of a modified fluid therapy on renal function during indomethacin therapy for persistent ductus arteriosus. AB - A rehydration with 7 ml/kg/h for six hours prior to indomethacin administration prevented the adverse effects of this drug on renal function in prematures with persistent ductus arteriosus. During the 36 hour observation period after indomethacin administration, no significant changes in serum creatinine, sodium, and potassium concentrations, or urinary flow, creatinine clearance, or filtered sodium could be detected. The only significant finding was a reduction in fractional sodium excretion. One can assume that this beneficial effect of the fluid load is due to a suppression of some parts of the vasoconstrictor mechanisms, which are responsible for the deterioration of renal function in newborns during indomethacin therapy. Using this modified fluid regimen, no cardiovascular side effects were noticed, a closure of the duct was achieved in 7 of 10 treatment courses. PMID- 3661181 TI - The prevalence of microalbuminuria in diabetic children and adolescents and its relation to puberty. AB - The albumin excretion rate (AER) was studied in two groups of diabetic children and adolescents. Twenty-four-hour AER was studied in 75 children with diabetes for 5 years, in 49 children with diabetes for 10 years, in 55 children with diabetes for 10-20 years and in 21 age matched healthy controls. Overnight AER was studied in 129 diabetic children and adolescents with a duration of diabetes varying from 1-14 years. Diabetics exhibited a wide range of AER-values and when expressed per body surface area, diabetic children had significantly higher AER compared to controls. Log transformed AER-values were significantly correlated to age and body surface area in diabetics but not in controls. In the diabetics, log AER was also correlated to systolic and diastolic blood pressure but not to HbA1c. 20% of the diabetics had AER values exceeding the upper value for healthy controls which was 18.5 micrograms/min. 31/35 of them were older than 12 years. In both groups of diabetics, 5% had AER-values exceeding those reported to be predictive for later development of overt nephropathy, the youngest being 16 years old. When comparing diabetic children 0-12 years (i.e. before the maximal growth spurt of puberty) to those older than 12 years, at the same duration of diabetes, the latter group had significantly higher AER-values. No sex difference was found in either age group. It is concluded that after puberty diabetic patients also show evidence of incipient diabetic nephropathy. Thus, routine screening for microalbuminuria is recommended also in pediatric diabetes care after 12 years of age. PMID- 3661182 TI - Dietary survey of Finnish adolescent diabetics and non-diabetic controls. AB - Food consumption data of 152 diabetic and 74 non-diabetic adolescents were collected by means of two 48 h recall interviews. The nutrient density of the diet was systematically higher for the diabetics than the controls. The energy intake from protein was higher for the diabetics (18% vs. 15%), and correspondingly the proportion of fat lower (33% vs. 36%). The ratio of polyunsaturated to saturated fatty acids was higher for the diabetics (0.49 vs. 0.39) and the share of energy from sucrose for the controls (14% vs. 4%). The intra-individual variation in nutrient intakes was higher for the controls. The diet of the diabetics met reasonably well the recommendations for diabetics and also the general recommendations for a healthy population. However, the differences between the diabetics and controls regarding food consumption, nutrient intake and intra-individual variation of nutrient intake decreased with age. PMID- 3661183 TI - Motor performance of neonatal risk and non-risk children at early school-age. AB - The motor skills of 382 children with neonatal risk factors and 107 children with no risk factors, in the age group 8-9 years, were studied using the Test of Motor Impairment (Stott-Moyes-Henderson). Neonatal disturbances, such as low birthweight and neurological symptoms were associated with marked clumsiness. The test performance was found, unexpectedly, to be significantly affected by age and sex in both the study and the control group. The test items were the same for an age range of one whole year, with no allowance for continuous development of skills. The need of normative data for each country is stressed. PMID- 3661184 TI - Sitting heights in Sheffield, 1985: have standards changed? AB - A community study was performed on 354 schoolchildren aged 4 to 13 years to assess whether the published UK standards for sitting height and leg length applied to the local population. The schoolchildren showed no significant difference from UK standards in standing height, but had significantly shorter sitting heights and significantly longer legs. When compared to children measured in several European studies, the Sheffield children had normal sitting: standing height ratios, whereas ratios from the published UK standards were significantly greater than those from the rest of Europe. PMID- 3661185 TI - Growth in head circumference from birth to fifteen years of age in Japan. AB - Growth charts for head circumference in Japanese children from birth to fifteen years of age are presented. The charts were compiled from the pooled data obtained in a prospective longitudinal study on development and growth in Nagoya city. An adolescent growth spurt in head circumference was found and this spurt occurred earlier in girls than in boys. Heads were smaller up to the age of 10 years and larger beyond that age than those in Nellhaus' composite charts. The heads of children of both sexes in our study are definitely smaller than those of children born in the United Kingdom in the same period, but they are considerably larger than those of children born in Japan more than 50 years ago. Therefore, the standards for head circumference will differ from country to country and from generation to generation. PMID- 3661186 TI - Psychosocial factors and physical health during the first year of life. Children in a new Stockholm suburb. A prospective longitudinal study. III. AB - The study is part of a longitudinal research project of a cohort of 501 children in a Stockholm suburb. The aim of the project is to clarify the relation between the children's health and development and their home environment. The present work deals with the children's physical health during their first year of life and comparisons were made between infants in families suffering or not suffering from psychosocial stress. Indications of psychosocial stress in the homes include reports of alcohol abuse, mental disease or criminality in one or both of the parents. Judging by reports from child welfare centres and hospital records, children from homes with psychosocial stress do not have a higher rate of somatic illnesses, retarded psychomotor development and psychosomatic problems than the control children. PMID- 3661187 TI - Computed tomography in the diagnosis of brain hydatidosis in children. PMID- 3661188 TI - Growth hormone deficiency in one of identical twins. PMID- 3661189 TI - Clomethiazole treatment in a child with status epilepticus. PMID- 3661190 TI - Primary adenocarcinoma of the small intestine with emphasis on microvillous differentiation. AB - A detailed ultrastructural study was made of 12 primary adenocarcinomas of the small intestine. A comparative analysis of microvilli identified three characteristic features in various proportions on the apical tumor cell surface. These were; 1) "long rootlets," which are long intravillous filamentous cores penetrating into the cytoplasm and identical to those observed in colonic adenocarcinoma; 2) a regular arrangement of uniform microvilli similar to the brush border of normal intestinal epithelium; and 3) sparse rudimentary microvillous structures. Because of the rarity of adenocarcinoma in the small intestine no previous study defined these ultrastructural characteristics. The results of the present study suggest that the diverse ultrastructural findings may be related to different stages of tumor cell maturation and that the neoplastic state may increase the variation and range of microvillous differentiation regardless of capacity of mucin secretion by the tumor cells. For diagnostic purposes, brush borders as well as two other microvillous features may serve to identify adenocarcinoma of mucosal origin of the small intestine, if an ultrastructural study discloses these three features. PMID- 3661191 TI - Follicle structure-dependency of thyroglobulin and thyroxin staining in the thyroid glands of Graves' disease. AB - H.E. morphology of the thyroid glands from 170 patients with Graves' disease was studied, and the thyroid follicles were classified into two main groups: (1) F pattern, in which the follicles show circle/ellipse on cut sections; (2) P pattern, in which the follicular epithelium protrudes into the lumen or a follicle, is accompanied by proliferation of tubular or microfollicular structures. Studies on three serial sections of 88 thyroid glands stained with hematoxylin and eosin, thyroglobulin (TG), and thyroxin (T4), respectively, revealed the followings: (i) TG/T4 staining is dependent on the follicle structure (i.e., F or P); while the epithelium and colloid including scalloped vesicles in F follicles generally exhibited a direct relationship between TG and T4 staining, those in P follicles often showed an intense TG, but negative T4 staining. (ii) The results of morphological and immunohistochemical studies of P follicles among the cases are consistent with the view that P follicles are in the process of proliferation of immature daughter follicles from a main follicle and of their maturation. (iii) P follicles of Graves' thyroid glands were evaluated as possible non-neoplastic counterparts of well-differentiated follicular and papillary tumors. PMID- 3661192 TI - Melanocytes in the nasal cavity and paranasal sinus. Incidence and distribution in Japan. AB - Random, nonselected tissue specimens from 99 Japanese-20 cylindrically cut nasal blocks removed during autopsy (A.C., Autopsy Cases) and 79 cases removed during surgery, consisting of 32 chronic sinusitis cases (C.S.) and 47 nasal polyp cases (N.P.)-were examined histopathologically and electronmicroscopically with respect to distribution and frequency of melanocytes in the nasal cavity and paranasal sinus. Malignant melanoma cases were excluded. The overall incidence of positive cases for melanocytes revealed 21.2% (21 of 99 cases), with an incidence ratio of male to female of 0.9:1.0. Melanocytes were found beginning in the under 19 age group with incidence increasing proportionately with age. Peak incidence was in the 50-year age group at 50%. Melanocytes and melanotic cell foci were distributed in the stroma of the propria mucosa beneath the pseudostratified columnar epithelium and focused around the nasal and paranasal glands and sinuses. In 2 of the 21 cases positive for stromal melanocytes, intraepithelial melanocytes with dendritic processes were found. The histogenesis of malignant melanoma arising from the nasal cavity and paranasal sinus are also discussed in this study. PMID- 3661193 TI - Ultrastructural study on the pulmonary parenchyma of the neonates following prolonged mechanical ventilation. AB - The ultrastructural alterations in the pulmonary parenchyma were studied in four premature babies with the respiratory distress syndrome who were treated by prolonged mechanical ventilation from 43 to 172 days. Macrophages and fibroblasts passed through a defect of the epithelial basement membrane to encompass the hyaline membrane. Thickening and reduplication of epithelial and capillary basement membrane, varying patterns of epithelial regeneration, i.e., hyperplasia of type II pneumocytes and cuboidal cells, and proliferation of fibroblasts and myofibroblasts were observed in the alveolar walls. In the emphysematous areas, elastic fibers were condensed and thickened, or fragmented. All these changes were more pronounced in premature babies, who underwent concentrations of more than 80% of oxygen and high positive end-expiratory pressures (greater than 30 cm H2O) for long periods. PMID- 3661194 TI - A study on the mechanism of acute hepatic necrosis following partial resection of the liver. AB - Endotoxin was injected intravenously into rats 48 hours after 70% hepatectomy. The remaining hepatic tissue demonstrated marked hemorrhagic necrosis in high frequency. However, hepatic lesions were slight in other groups such as the group in which heparin was administered simultaneously with injection of endotoxin 48 hours after 70% hepatectomy and the group in which endotoxin was injected 10 days after 70% hepatectomy. Defining of this marked necrosis to be a univisceral Shwartzman reaction in the liver may be justified from (i) conformity of experimental manipulations to those employed in the Shwartzman reaction, (ii) macroscopical as well as histological evidence, (iii) formation of microthrombi in hepatic lesions, (iv) inhibition of occurrence of the reaction by heparin, and (v) absence of any remarkable change in other organs. We concluded that the hepatic regenerative state might correspond theoretically to a state of preparedness for the Shwartzman reaction. PMID- 3661195 TI - Monoclonal antibodies against synthesized short peptides corresponding to human AA amyloid protein. AB - Monoclonal antibodies (McAbs) were raised against the synthesized short peptides corresponding to 37-47 residues in amino acid sequence of human AA protein. The McAbs reacted immunohistochemically to amyloid tissues from cow, mouse, swan, and human AA amyloidosis. We concluded that the McAbs were useful for identification of AA type amyloidosis of various species, and that the 37-47 residues were effective antigenic sites in AA protein. PMID- 3661196 TI - Anti-glucocorticoid effects of melatonin on adult rats. AB - To extend our previous experiment on anti-glucocorticoid effects of melatonin which was performed under a very special condition using young rats, we have carried out another experiment of long term administration of pineal hormone melatonin to adult female rats which were conditioned by overdose glucocorticoid. The results clearly demonstrated significant protection, by melatonin, from the injurious effects of a glucocorticoid, dexamethasone: decrease of body weight gain, atrophy of the thymus and adrenals, and elevation of the level of total cholesterol in blood. Thus, it has been clarified that anti-glucocorticoid effects of melatonin could be shown experimentally not only in young rats but also in adults, and also, could be really seen not only in short term experiment but also in longer ones. Anti-glucocorticoid effects of melatonin seem to be of considerably wide range, not being limited to occur under a special condition, including the age of animals, in experiments. PMID- 3661198 TI - Electron microscopic study of mucoepidermoid carcinoma in the pancreas. AB - An autopsy case of extremely rare mucoepidermoid carcinoma of the pancreas in a 58-year-old male was reported. The main tumor in the pancreatic tail associated with wide-spreading metastases, was histologically composed of squamous cancer cell nests intermingled with mucin-containing cells, but not true glandular structures except for metastatic foci in the liver. Electron microscopic findings of the main tumor revealed roughly three kinds of cancer cells, namely undifferentiated cells, squamous cells, and squamous cells with mucin-containing intracytoplasmic lumina, accompanied by variety of transitional forms. The mucin was similar to that of the intra-or interlobular duct epithelium of pancreas in mucin stains. Immunohistochemically, positive immune reaction of the cancer cells was observed by anti-keratin, -epithelial membrane antigen and -carcinoembryonic antigen sera. These findings suggested that the cancer cells originated from undifferentiated cells of pancreatic duct, which showed multipotency to differentiate predominantly into squamous cells, but also into mucin-producing cells. PMID- 3661197 TI - Malignant peritoneal mesothelioma as a pelvic mass. Application of athymic mice in clinical pathology. AB - We reported herein an unusual presentation of malignant peritoneal mesothelioma which appeared as a solid pelvic tumor in a 73-year-old man. The solid tumor was confined in the pelvic cavity, except for one tiny disseminated nodule on the mesocolon. The pelvic tumor was resected with whole pelvic organs en bloc. Histologically, the tumor consisted of tubular and sarcomatous structures, suggesting the biphasic malignant mesothelioma. One of the transplanted tumors in athymic mice was cystic and its histology had striking similarities to cystic mesothelioma. Transplantation of human neoplasms to athymic mice may be able to reproduce histological diversity of the tumor, even if it is not fully expressed in the original tumor. PMID- 3661199 TI - Minute carcinoid tumor of the uterine cervix associated with microinvasive adenocarcinoma, with reference to its histogenesis. AB - A rare case of carcinoid tumor of the uterine cervix associated with adenocarcinoma was reported. The carcinoid tumor was composed of round to polygonal cells showing solid or trabecular proliferation. Most of these cells and a small number of isolated cells wedged in neoplastic glands were positive with either Grimelius or Fontana-Masson stains, and also positive for serotonin by immunostain (PAP method). Positively stained cells were thus considered to have the same histochemical nature as enterochromaffin cell. The carcinoid tumor was minute, about 2 X 2 mm and the adenocarcinoma was a microinvasive one. In some parts, smooth transition between both tumor components was observed. From these findings, it is suggested that both the carcinoid tumor and the adenocarcinoma in the present case were derived from a primitive precursor cell of common mesodermal origin. PMID- 3661201 TI - [Effects of ginseng saponins on 14C-arachidonic acid metabolism in rabbit platelets]. PMID- 3661200 TI - Malignant Brenner tumor with peritoneal metastasis. AB - A case of malignant Brenner tumor with peritoneal metastasis in a 67-year-old woman was reported. The multilocular cystic tumor of right ovary was 420 g in weight, and their cystic walls were covered with multilayered tumor cells showing papillary pattern very frequently. The tumor was histologically transitional cell carcinoma with occasional glandular structures but no squamous differentiation corresponding to grade 2 or 3 urinary bladder carcinoma. The pattern of benign Brenner tumor was not identified, but there was some area of proliferating Brenner tumor. Immunohistochemically, carcinoembryonic antigen was detected in several tumor cells, especially in the intercellular spaces among them, and cytokeratin was detected only in some tumor cells. Ultrastructurally, the malignant Brenner tumor shared many common features with the benign one and also bladder tumor. Intercellular spaces with microvilli were frequently found and thought to be important for diagnosis. The morphologic criteria of this rare tumor are discussed. PMID- 3661202 TI - [Blocking action of berberine on various receptors in the rat anococcygeus muscle]. PMID- 3661203 TI - [Studies on metabolites and the structural modification of beta-caryophyllene]. PMID- 3661204 TI - [Syntheses of 1-(2-hydroxy-3-aryloxypropyl)-4-aroylpiperazines]. PMID- 3661205 TI - [Studies on the synthesis of 11 alpha-hydroxy-quinestrol, 11 alpha-methoxy quinestrol and their antifertility activity]. PMID- 3661206 TI - [Studies on the chemical constituents of Piper hancei Maxim (II)]. PMID- 3661207 TI - [The structures of two new flavonoid glycosides from bai-shui-cha, a kind of Camellia sinensis L]. PMID- 3661208 TI - [Differential pulse polarographic determination of flavonoids in Pueraria lobata]. PMID- 3661209 TI - [Study of the statistical characteristics of the USP XXI content uniformity sampling plan for tablets]. PMID- 3661210 TI - [Influence of pH on the Cu(II) catalyzed aerobic oxidation of ascorbic acid]. PMID- 3661211 TI - [The diagnostic value of the cuticle in the crude drugs from the genus Piper L]. PMID- 3661212 TI - [Effects of iodium-heterocycle compound on the thresholds of excitation and fibrillation of the ischemic rabbit myocardium]. PMID- 3661213 TI - [Determination of propranolol in human plasma by reversed phase high performance liquid chromatography]. PMID- 3661214 TI - 50th Jubilee Congress and IUPS sponsored symposia of the Hungarian Physiological Society. July 1-7, 1985, Budapest. Symposium 5. Capsaicin and the sensory system. Proceedings. PMID- 3661215 TI - The immediate and long-term effects of applying capsaicin to cutaneous nerves. AB - Capsaicin has now been shown to have a neurotoxic action on C-fibres in adult rodents and several other mammalian species. In the adult the effect is preferentially on nociceptive C-fibres. The hypoalgesia and loss of neurogenic inflammation that follow capsaicin treatment are likely to be a direct consequence of the C-fibre loss. In addition to its long-term toxic action, capsaicin also has an immediate effect on conduction in nociceptive C-fibres. This action probably produces the short-term hypoalgesia and loss of antidromic plasma extravasation that follow application of capsaicin to peripheral nerves. PMID- 3661216 TI - Capsaicin and nociception. AB - The antinociceptive effect of capsaicin to noxious chemical stimuli has been invariably verified. As to thermal or mechanical nociception, however, routine pharmacological methods resulted in conflicting findings. Therefore, using new techniques the nociceptive thresholds of different stimuli were determined on the hindpaw of the rat. After systemic (400 mg/kg s.c.), perineural (1% on the sciatic nerve) and local (5 micrograms into the hindpaw) application of capsaicin the threshold for noxious heat (47.4 +/- 0.08) was shifted upwards by 3.3 degrees C, 4.1 degrees C and 2.9 degrees C, respectively. The changes in mechanonociceptive threshold evoked by pin prick (186 +/- 9 mN force) were more variable. The response to percutaneous xylene application was abolished or markedly inhibited. After systemic application the responsiveness to noxious heat recovered faster than the effect of xylene. C-polymodal nociceptors and some A delta mechanoheat-sensitive nociceptors isolated from the saphenous nerve of the rat were activated by capsaicin in nanogram doses given close arterially. Five micrograms capsaicin excited few slowly adapting A mechanoreceptors after a long latency, but not A-delta mechanonociceptors or other cutaneous receptors. Proportion of C-polymodal nociceptors was decreased, that of the C mechanoreceptors was increased after systemic treatment. The role of polymodal type nociceptors, interaction of other nociceptors, as well as secondary dynamic changes are stressed to explain the antinociceptive effect of capsaicin. PMID- 3661217 TI - Nociceptor functions in intact skin and in neurogenic or non-neurogenic inflammation. AB - Acute neurogenic or non-neurogenic inflammation was elicited in skin patches innervated by the saphenous nerve of anaesthetized Sprague Dawley rats. Lambda carrageenan was used to induce non-neurogenic inflammation, mustard oil (allyl iso-thio-cyanate) or antidromic nerve stimulation to induce neurogenic inflammation. Antidromic nerve stimulation yielded plasma extravasation but no significant sensitization of unmyelinated nociceptor units. In contrast, mustard oil and carrageenan yielded plasma extravasation and sensitization of nociceptors, though carrageenan sensitized only part of them. Sensitization resulted in ongoing spike discharges and in a shift of response curves to lower temperatures when controlled radiant heat stimuli were applied to the receptive fields. Responses to mechanical stimuli with v. FREY hairs were not significantly altered. Effects of neurogenic and non-neurogenic inflammation on unmyelinated nociceptor units are compared. PMID- 3661218 TI - Responsiveness of microcirculation and local cold vasodilation to capsaicin in the intact and chronically denervated canine tongue. AB - Lingual blood flow and its distribution were determined at rest and in response to local cooling of the tongue (32 degrees C) in 6 anaesthetized, paralyzed and artificially ventilated dogs before and after two intraarterial (i.a.) injections of capsaicin (2.5 mg) at an interval of about 40 min. In 3 dogs, the same protocol was performed after degeneration of the chorda-lingual and glossopharyngeal nerves due to prior transection. In general the first i.a. injection of capsaicin resulted in a marked and the second injection in a smaller decrease of lingual blood flow. Local cooling of the tongue induced significant increases in lingual blood flow before as well as after capsaicin treatment, regardless of whether sensory innervation was intact or degenerated. In both the untreated and capsaicin treated dogs the increase in lingual blood flow during local cooling of the tongue was solely due to an increase in blood flow through the arteriovenous anastomoses, while blood flow through the capillaries of the mucosa and muscles even decreased. The findings suggest that capsaicin-induced vasoconstriction of the tongue vessels is due to a direct effect on vascular receptors. It is further suggested that cold vasodilatation of the canine tongue is not mediated by axon collaterals releasing substance P. Direct thermal effects on the intramural ganglia and the postganglionic vasomotor efferents innervating the AVAs, or on AVAs basal tone itself are suggested as the underlying mechanism. PMID- 3661219 TI - Spinal cord sensory systems after neonatal capsaicin. AB - Animals with a severe reduction in the number of afferent C-fibres as a consequence of neonatal administration of capsaicin, exhibit a number of neurological and behavioral deficits including increased nociceptive thresholds, altered somato-visceral and viscero-visceral reflexes, depressed cardiovascular and respiratory reflexes and changes in the organisation of spinal cord sensory systems. The reduction in the number of C-fibres produced by neonatal capsaicin does not cause a decrease of similar magnitude in the number of dorsal horn cells driven by the surviving C-fibres. Twenty-two per cent of dorsal horn neurones in capsaicin treated animals respond to electrical stimulation of the surviving afferent C-fibres: a reduction of only 50% from control values. Inhibitory controls on afferent C-fibre evoked responses of dorsal horn neurones are weaker in capsaicin treated rate than in control animals. The cutaneous receptive fields of some dorsal horn neurones can increase in size following stimulation of afferent C-fibres. Tonic descending inhibition on C-fibre evoked responses of dorsal horn neurones is reduced in capsaicin treated rats: fewer neurones show tonic descending inhibition in these animals and those that do are subjected to less powerful inhibitions than similar neurones from control animals. However, some central inhibitory mechanism are unchanged after neonatal capsaicin treatment, specially those that do not involve afferent C-fibres. We suggest that the nervous system develops central inhibition in response to and directed towards the excitations mediated by its afferent drives. Therefore reduced central inhibition in response to a decreased number of afferent C-fibres can compensate for the lost capacity in the signalling of peripheral noxious events. PMID- 3661220 TI - Differences in the mechanisms of the thermoregulatory impairment induced by capsaicin in newborn and adult rats. AB - The function of heat defence was compared in rats pretreated as adults (A-rats) and neonates (N-rats) with capsaicin. The thermoregulatory impairment as tested by whole body heating was similar in A-rats and N-rats. The thermosensitivity and chemosensitivity of the preoptic region (RPO) seemed to be normal in N-rats. A deficiency of RPO mechanisms could be demonstrated in A-rats. It is suggested that the preoptic effects of capsaicin have but a minor significance for the thermoregulatory impairment. It seems that the main cause of decreased heat tolerance is a reduction of peripheral warm sensation due to degeneration of unmyelinated C-fibre primary neurons in both A-rats and N-rats. The results do not support the primary importance of preoptic warm sensation in physiological thermoregulation. PMID- 3661221 TI - Intracellular and voltage clamp studies of capsaicin induced effects on a sensory neuron model. AB - The acute effects of capsaicin (CAP) were studied on membrane properties, the action potential (AP) and the membrane ionic currents in the giant serotoninergic neuron of the cerebral ganglion (MCC) in the snail of Helix pomatia L. CAP (30 300 microM) depolarized the MCC, decreased the amplitude, the rate of rise and the rate of fall of the action potential. CAP prolonged the AP-duration, increased the membrane slope resistance, decreased the hyperpolarizing afterpotential and the posttetanic hyperpolarization both in normal and Na-free media. All the effects were reversible and could be evoked repeatedly. CAP attenuated the outward membrane currents with decreasing potency in the sequence of the transient potassium (IA) voltage-dependent potassium (IK), Ca-dependent potassium (IC) and leakage currents (IL). CAP decreased or increased the peak amplitude of the Ca-current (ICa), depending on the extracellular Ca concentration. CAP increased the inactivation of the ICa, decreased the Ca conductance (GCa) in normal and high Ca solutions and shifted the Ca-equilibrium potential (VCa) to more positive voltage in 30 mM Ca-solution. CAP decreased the electrically activated Na-current and blocked the acetylcholine (ACh) activated increase in Na-K conductances. It is concluded that CAP profoundly affects the electrically and some transmitter-activated cationic conductances. Further studies are needed to clarify the significance of these changes with respect to the mechanism of the selective neurotoxic effects of CAP. PMID- 3661222 TI - [Change and conflict]. AB - Owing to the all-accelerating rhythm in present life changes, alienation is likely to be envisioned as the main feature of our time. To the traditional change factors handed down through centuries on, modern life patterns add fresh ones up, ss: 1) transformations at an accelerated pace, b) evolution of both scientific knowledge and technology, c) development of massive media, d) political challenges, e) crisis of both life and relationships models, f) crisis in ideologies and the scientific as well as the philosophical principles, and g) intense transculturation. These challenges are to be met by means of a permanent learning i.e. Man is to enterprise an educating process aiming at a body, character, and spirit forming up of every individual within the frame of his very culture. It is also suggested that the mourning process is essential to either success or failure in changes to be achieved. PMID- 3661223 TI - [Sleep characteristics in patients with anxiety crises]. AB - All night sleep EEG recordings were compared in patients with panic attacks, major depression, and normal controls. Total time asleep, total time awake and sleep efficiency were significantly different in normal controls as compared with the other groups. In contrast, REM latency and REM density were significantly different in depressed patients as compared with the other groups. Differences were also observed in stage I and DELTA sleep, but when age was considered as covariate these differences were no longer observed. These findings support the concept the patients with panic attacks have a sleep pattern that differs from normal subjects but that is also different from that of depressed patients. The implications of sleep recordings for psychiatric nosology are discussed. PMID- 3661224 TI - [The Diagnostic Interview Schedule in Spanish: its translation and adaptation in Puerto Rico]. AB - The process and results of the Puerto Rico's DIS Spanish translation and adaptation are described in this paper. The process is presented in the context of cross cultural research on psychiatric diagnoses and the translation and adaptation of diagnostic instruments for use across cultural boundaries. Several translation techniques were employed (bilingual committee, back-translation and instrument testing) to obtain an instrument in correct Spanish, comprehensible for most Spanish-speaking people as well as linguistically and culturally adapted to the Puerto Rican population. Its semantic, technical, contents and criterion equivalence with the English DIS were considered. The resulting instrument is not only a translation and adaptation of the original but it also presents some additional features which aim to enhance its diagnostic accuracy. A descriptive and quantitative comparison with the Karno et al's Spanish DIS version is also included as well as a discussion of its possible contribution to DIS transcultural use, specially in Hispanic cultures. PMID- 3661225 TI - [Psychiatric epidemiology]. AB - This paper presents a critical synthesis of models and methods in psychiatric epidemiology, with special reference to the developing world. Basic epidemiological concepts and their application to psychiatric epidemiology are reviewed. Lastly, the relevance of these developments for the Third World is described, underlining their role in General Health and Mental Health planning and policy. PMID- 3661226 TI - [In defense of egoism]. AB - Every being alive on earth is an offs ing of a form of centripetal force. Human behavior--from its most elementary states up to its most exquisite differentiae- is certainly determined by egoism. If we dare admit this fundamental egoism, then -some day--we may come to exercise a free and conscious influence upon our own evolution. PMID- 3661227 TI - [Medical anthropology]. AB - The title should be understood as a world play--since, obviously, Medicine is not bound to be considered a new branch of Anthropology. The author comments the different historical approaches which focused on the problem of disease as such. I.E., in times past, medical thinkers considered disease as a self-existing entity absolutely unrelated to the individual who, however, was suffering from it. Quite contrary, disease should be envisioned as the response the living system sets against physiological, psychological, and/or social stimuli which severely affect its equilibrium. So, 'feeling well' means more than being free of illness. It means Man ought to enjoy his vital gifts fully within a twofold relationship, with himself and the environment as well. Hence, in future, Medicine is to comprehend Man as a whole. In other words, healing is no longer to be the sole duty of Medicine to come. Aiming at bringing health up to perfection will be its major commitment. PMID- 3661228 TI - [Predictability of change]. AB - The present paper considers the predictability of behavioral changes as a pragmatic-epistemological criterium of empirical corroboration of theory. The predictability itself remits us to a broad spectrum of points of view, I.E. one related to Epistemology, another related to Psychological Theory, another which will consider the scientist himself as a psycho-social cognitive being, and, at last, one related to Ethics. It emphasizes the value of the statistical prediction and its value of semicertainty with which it allows us to work in the field of Social Psychology. However, the conditionability the epistemological behavior of the scientist is subject to is not to be superseded. The author points out the need for desisting from a scientific posture that switches the professional practice of Psychology into a mere diffusing of the Philosophy of Behavior--instead of resorting to technics aiming at modifying a behavior the patient feels as unpleasant or unadapted. PMID- 3661229 TI - [Trends in psychiatry]. PMID- 3661230 TI - [Contribution to the classification of endogenous psychoses]. AB - The authors intend to describe the main points in endogenous psychoses classification according to H.J. Bochnik's criteria. The chief aspect thereby is the prognosis in terms of orientation of a certain symptomatology--either "phasic" or "process"--forming course. On the other hand phasic schizo-affective psychoses are called atypic-phasic psychoses and are incorporated in the group of phasic psychoses. In all cases a separate consideration is recommended as far as psychiatric research is concerned. PMID- 3661231 TI - On the generality of logical recoding in spatial interference tasks. PMID- 3661232 TI - Representation of matrix patterns in long- and short-term visual memory. PMID- 3661233 TI - [The importance of the approach in external carotid artery surgery for the improvement of collateral cerebral circulation]. PMID- 3661234 TI - [Cellular immunity in patients with rheumatoid arthritis]. PMID- 3661235 TI - Cathepsin activity of blood serum and synovial fluid in patients with seropositive and seronegative rheumatoid arthritis. PMID- 3661236 TI - [Total anuria in the clinical syndrome of acute renal failure]. PMID- 3661237 TI - Renin-angiotensin-aldosterone system in patients on maintenance hemodialysis. PMID- 3661238 TI - [Thrombosis of the vein of Galen with a symmetrical paraventricular hemorrhagic infarct and internal hydrocephalus]. PMID- 3661239 TI - Concanavalin A-induced cap formation in rat ascites hepatoma cells (AH 7974) and the interaction of cytoplasmic proteins with plasma membranes. AB - Concanavalin A (Con A) induced cap formation in rat ascites hepatoma cells (AH7974). In these Con A-treated cells, the association of cytoplasmic proteins with cell membranes was suggested by observing their Triton shells. The transition from G-actin to F-actin occurred in these cells. The association of membrane lipid with cytoplasmic proteins extracted from AH cells was studied by the isolation of protein-bound liposomes and phase transition release. The analysis of isolated liposomes revealed that many cytoplasmic proteins which specifically associated with liposomes were cytoskeletal elements including F actins. The association of proteins with liposomes was affected by the lipid composition of the liposomal membrane and by the Ca2+ concentration of the incubation medium. The strong interaction of liposomal membrane with cytoplasmic proteins or isolated cytoskeletal proteins was demonstrated also by phase transition release using carboxy fluorescein-containing liposomes. These experiments showed that there was a strong affinity between lipid membrane and cytoskeletal elements including F-actins and that the amount of F-actin increased due to Con A treatment. The association of the submembranous microfilaments with the cell membrane may contribute to capping of the cells caused by Con A. PMID- 3661240 TI - Synergism between human tumor necrosis factor and human interferon-alpha: effects on cells in culture. AB - The cytostatic and cytotoxic effects of highly purified natural human tumor necrosis factor (HuTNF-alpha) and natural human interferon-alpha (HuIFN-alpha) on 23 cell lines were studied in vitro. Natural HuTNF-alpha showed cytostatic and cytotoxic effects on PC-9, KHG-2, HT-1197, KG-1 and L-929 cells, and HuIFN-alpha showed both effects on KHG-2 and Daudi cells. A mixture of HuTNF-alpha and HuIFN alpha (1:1, by unit) showed cytostatic and cytotoxic effects on HuTNF-alpha- or HuIFN-alpha-resistant cell lines such as KB, KATO-III, HEp-2, P-4788, as well as on HuTNF-alpha- or HuIFN-alpha-susceptible cells. Thus, the combined preparation of HuTNF-alpha and HuIFN-alpha expanded the spectrum of sensitive cells. The dosage of the mixed preparation required to produce 50% inhibition of cell growth was less than 20% of that of HuTNF-alpha or HuIFN-alpha alone. These results indicate that the cytostatic and cytotoxic effects of HuTNF-alpha and HuIFN-alpha are synergistically enhanced when they are administered together. PMID- 3661241 TI - Human kidney glomeruli, with special reference to those in the aged person: scanning electron microscopic study of microvascular corrosion casts. AB - Blood vascular beds of fetal, adult and aged human kidneys were reproduced with methyl methacrylate and observed with a scanning electron microscope. The kidney glomeruli, including those from the fetal kidneys, had anastomosing capillaries. The glomeruli in the kidneys of an aged person contained many more capillaries which were much more tortuous than those of the adult and fetal kidneys. Furthermore, it was observed that the glomeruli in the kidneys of the aged person usually received tortuous afferent vessels and frequently emitted multiple efferent arterioles. The glomeruli in the juxtamedullary layer of the kidneys of the aged person were rather small in size and contained degenerative capillary networks. This observation suggests that the medulla of the kidneys of the aged is poorly supplied with blood. PMID- 3661242 TI - Histological and morphological observations of the paravestibular canaliculus. AB - The paravestibular canaliculus was studied by light microscopy in serial sections of the temporal bones from otosclerotic patients who underwent fenestration or stapes surgery. In all examined 23 specimens (13 cases), the endolymphatic duct and sac were observed to be normally developed with no pathological findings. The paravestibular canaliculus was found in 14 of the specimens (60.9%). Its course was traced from the proximal to the distal area in 12 specimens, and it appeared to merge into the distal portion of the endolymphatic sac in 7 of them. Twelve of the paravestibular canaliculi contained one vein, and 3 contained several veins. No artery was found. The paravestibular canaliculus was observed to originate from small vascular channels around the vestibule in the otic capsule, lateral to and near the internal aperture of the vestibular aqueduct. PMID- 3661243 TI - [The trainee registry and post-graduate education in Portugal in the 1980s]. PMID- 3661244 TI - [The lower esophageal sphincter and gastroesophageal competence]. PMID- 3661245 TI - The role of intravenous cholangiography in predicting papillary stenosis. PMID- 3661246 TI - [Mauriac syndrome. Apropos of a clinical case]. PMID- 3661247 TI - [Renal cell carcinoma. Nephrectomy 7 years after diagnosis]. PMID- 3661248 TI - [Theoretical orientation of Spanish psychiatrists]. PMID- 3661249 TI - [Language in childhood and adolescent psychoses]. PMID- 3661250 TI - [Psychosocial factors and diagnostic categories of depression]. PMID- 3661251 TI - ["Crack": a new addictive drug]. PMID- 3661252 TI - [The Hamilton depression scale: Bech's short version or complete version?]. PMID- 3661253 TI - [Individual characteristics of each item of the Hamilton depression scale]. PMID- 3661254 TI - [Various aspects of the psychiatric treatment of Spanish immigrants in Holland]. PMID- 3661256 TI - [Radiotherapy and infiltrating bladder cancer]. PMID- 3661257 TI - [Current contribution of computerized tomography to the study of the pathology of the pelvic region: 1. Vesico-prostatic pathology]. PMID- 3661255 TI - [Depression and attempted suicide in a patient, a sporadic user of "crack"]. PMID- 3661258 TI - [Current contribution of computerized tomography to the study of the pathology of the pelvic region: 2. Non-vesico-prostatic pathology]. PMID- 3661259 TI - [Urologic tumors of double primary localization (apropos of 6 cases)]. PMID- 3661260 TI - [Infected calculi]. PMID- 3661261 TI - [Internal urethrotomy under direct vision]. PMID- 3661262 TI - [Role of the hyperactivity of the detrusor in the pathogenesis of so-called primary vesico-ureteral reflux]. PMID- 3661263 TI - [Penetrating renal injury]. PMID- 3661264 TI - [Eosinophilic cystitis]. PMID- 3661265 TI - [Ureteral polyp prolapsed through the urethra]. PMID- 3661266 TI - [Primary malignant lymphoma of the testicle]. PMID- 3661267 TI - [Analysis of ionic components, proteins and lipids in calculi containing porphyrins]. PMID- 3661268 TI - [Analysis by infrared spectrometry of renal calculi in whose composition there are porphyrins]. PMID- 3661269 TI - [Cholesteatoma of the renal pelvis. Apropos of a case]. PMID- 3661270 TI - [Enlargement gastrocystoplasty. Experimental study (I)]. PMID- 3661271 TI - [Enlargement gastrocystoplasty. Experimental study (II)]. PMID- 3661272 TI - [Changes in the prostate of Wistar rats induced by estradiol and trenbolone acetate]. PMID- 3661273 TI - Cigarette smoking cessation attempts by recovering alcoholics. AB - Survey data on the smoking cessation experiences of 77 recovering alcoholics are reported. A comparison of successful and unsuccessful quitters addressed questions about optimal timing of cessation efforts, relative severity of alcohol and tobacco abuse histories, and the impact of cessation efforts on the maintenance of sobriety. Findings suggest that recovering alcoholics can successfully quit smoking without jeopardizing sobriety but that individuals with more severe substance abuse histories may be less successful. Although successful quitters tended to wait longer before attempting cessation, a comparison of the two groups was not statistically significant. PMID- 3661274 TI - Beliefs about smoking and health: their measurement and relationship to smoking behavior. AB - A scale was constructed to measure four types of beliefs about smoking and health. According to Krietler and Krietler's (Cognitive Orientation and Behavior, New York, Springer, 1976) cognitive orientation model these four types of beliefs -general beliefs, goal beliefs, self beliefs, and norm beliefs--direct an individual's molar behavior. Four subscales, representing each of the four belief types were found to have moderately high levels of internal consistency and test retest reliability. Factor analysis indicated a relatively high independence for the two subscales measuring self and goal beliefs, but found some overlap between the two subscales measuring norm and general beliefs. Smokers, former smokers, and nonsmokers were found to differ in predictable ways on the four subscales and the combined scale. Also the length of time that former smokers had been abstinent as well as length of smoking habit and number of cigarettes smoked per day by smokers were found to be related to some of these beliefs. Implications of these findings for smoking cessation intervention programs are discussed. PMID- 3661276 TI - Correlates of alcohol consumption: sex, age, and expectancies relate differentially to quantity and frequency. AB - Expectations of the effects of alcohol have been related to drinking behaviors for both problem and nonproblem drinkers. The present investigation expanded on previous research by considering age, sex, and alcohol expectancies as differential predictors of frequency and quantity of drinking. Subjects, 157 males and 168 females, completed alcohol expectancy, drinking habits, and demographic questionnaires. Results showed significant sex differences in predictors of drinking frequency. Males who reported most frequent drinking tended to have stronger expectations of increased Social and Physical Pleasure, Global Positive Changes, and Sexual Enhancement. On the other hand, frequent consumption among females was best predicted by stronger expectations that alcohol would reduce tension. The amount consumed per drinking occasion was predicted by the same two expectancy factors for males and females: Social and Physical Pleasure and Social Assertion. Age was an important contributing predictor of quantity and frequency for females only. Results indicated the importance of investigating the mediating role of expectancies (a) within sex and (b) with respect to frequency versus quantity of drinking behavior. PMID- 3661275 TI - The measurement of substance use among adolescents: when is the 'bogus pipeline' method needed? AB - The use of objective measures to assess cigarette smoking among adolescents has become commonplace in research studies in recent years. This trend is based on evidence that this so called pipeline methodology can increase the disclosure of socially proscribed behaviors in a setting where adolescents might otherwise feel pressure to deny that they smoke. This paper examines the effects of the pipeline methodology alone and in combination with procedures designed to ensure anonymity on the disclosure of tobacco, alcohol, and marijuana use by young adolescents. The data indicate that the pipeline procedures significantly increase disclosure of tobacco and marijuana use when students are promised confidentiality but not anonymity. However, when anonymity was assured, disclosure of cigarette use was just as high without the pipeline; for marijuana use, disclosure was higher without the pipeline. No effects were observed for alcohol disclosure. These data are interpreted for their implications for prospective and cross sectional studies. PMID- 3661277 TI - The effect of alcohol consumption on risk-taking while driving. AB - Using a cover story of the effects of alcohol on perceptual and motor abilities, three levels of alcohol consumed (high, moderate, and none) were combined with three levels of alcohol expected (high, moderate, and none) to determine their effects on risk-taking while driving. Thirty-nine subjects were randomly assigned to six conditions. A driving simulation task was employed; dependent variables were cars passed and total time at high speed. Results indicated greatest risk taking, measured by cars passed and time spent at high speed, by subjects who believed they had consumed a moderate amount of alcohol. Actual amount of alcohol consumed produced no significant differences. PMID- 3661278 TI - Restraint, bulimia, and psychopathology. AB - This study investigated the similarities between bulimia and dietary restraint by examining how these variables related to each other as well as to two standardized measures of psychopathology. Female college students completed the restraint scale (which consists of a weight fluctuation (WF) and a concern with dieting (CD) factor), a bulimia scale (BULIT), a narcissism scale (NPDS), and a maldajustment scale (Mt). Bulimia was significantly correlated with restraint and each of its factors; however, it was most strongly related to the CD factor. When WF was controlled, bulimia and CD were significantly correlated, whereas when CD was controlled, bulimia and WF were not related. However, despite their strong relation with each other, bulimia and CD did not show similar patterns of relations with narcissism and maladjustment. Bulimia was significantly related to maladjustment when narcissism was controlled. In contrast, CD was significantly related to narcissism when maladjustment was controlled. In summary, bulimia and the CD factor of restraint appear to be overlapping constructs; however, they are associated with different types of psychopathology. PMID- 3661279 TI - Physician modeling influences on patient smokers. AB - Physicians may be considered important models of healthful behavior for their patients. This analogue study examined the behavioral impact of advice to quit given by a smoking and nonsmoking physician model on 27 light (less than 20 cigarettes per day) and 27 heavy (greater than 20 cigarettes per day) inpatient smokers in a V.A. Medical Center setting. Results indicated that heavy smokers smoked significantly more than light smokers on all measures across conditions. Interestingly, both heavy and light smokers tended to smoke more when the model advised quitting regardless of the presence or absence of model smoking. Post hoc analyses of locus of control revealed that patients with an internal locus of control tended to react to the physician's advice to quit by smoking significantly more during exposure, irrespective of model behavior. Patients with an external locus of control seemed to respond in a manner consistent with the behavior of the model. PMID- 3661280 TI - A utility analysis of drinking. AB - In a study applying a utility analysis to drinking behavior, a questionnaire on beliefs about the effects of alcohol and the desirability of those effects was administered to a sample of college students and a sample drawn from the population. Measures of the expected utility of drinking were calculated. Utility scores were positively related to drinking habits, due to heavier drinkers' increased expectations of positive consequences of drinking and more positive evaluation of all consequences. It is suggested that studies on expectancies about drinking should include not only measures of behavioral expectations but measures of the desirability of alcohol effects. PMID- 3661281 TI - Disordered eating and weight control behaviors among male and female university students. AB - The purposes of this study were to develop an instrument capable of assessing factors potentially related to disordered eating and weight control behaviors among university students and then to compare male and female students on these factors. A 90 item instrument was developed. Sixty-four items were written by these authors, such that eight items would assess each of eight identified factors related to disordered eating. Additionally, all 26 items from the Eating Attitudes Test (EAT-26) were included and interspersed within the instrument. The instrument was administered to 502 female university students and their responses were factor analyzed. Ten factors were identified. The instrument was then administered to 94 female and 76 male university students. Results indicate that compared to males, females report a greater desire to be thin, less tolerance for cold, more frequent use of laxatives, and a greater occurrence of eating in response to internal and external cues. There were no other sex differences. The students in this study appeared to be engaging in appropriate health practices. PMID- 3661282 TI - Effectiveness of impersonal versus interpersonal methods to recruit employees into a worksite quit smoking program. AB - One of the first salient issues a worksite quit smoking program must face is how to motivate employees to enroll and participate. The purpose of this study was to determine the effectiveness of impersonal versus interpersonal recruitment strategies used by an ongoing worksite quit smoking program. One hundred and nineteen smokers who stated on a questionnaire that they would be either "strongly yes" or "yes" interested in participating in a quit smoking program were randomized into two groups. One group was sent letters by employee mail from the director of the quit smoking program. This letter briefly described the program and invited employees to participate. The other group received a personal phone call from the staff health educator inviting them to participate. Results indicate that of the 46 individuals randomly assigned to Group 1 who were sent letters, none responded to the invitation; while 37 of the 44 employees who received a personal phone call, 19 scheduled an appointment, 7 kept their appointments. These results indicate the possible increased effectiveness of an impersonal versus interpersonal communications in recruiting full-time smoking employees. PMID- 3661283 TI - Breath-holding endurance as a predictor of success in smoking cessation. AB - A pretreatment test of breath-holding endurance predicted end-of-treatment outcome in 56 Smokers Clinic clients (r = .44; p less than .001). The cut off points derived by discriminant analysis were 32 seconds for men and 20 seconds for women, which correctly classified 78.6% of cases. The breath-holding test might sample the type of endurance necessary to withstand the discomfort associated with cigarette withdrawal and may also be relevant to success in quitting other addictive behaviours. However, alternative explanations are possible and more data are needed. PMID- 3661284 TI - The effect of increased cocaine use on drug treatment. AB - Trends in primary illicit drug use were monitored in an inpatient drug treatment program over a 10-year period, along with illicit drug used in a methadone maintenance program over a six-year period. The percentage of cocaine users admitted for inpatient treatment showed an increase for each six-month interval over the past three-year period. Cocaine was found to be the most frequently used illicit drug by methadone maintenance clients, and its continued use disrupted both inpatient and outpatient treatment. Implications for treatment are discussed. PMID- 3661286 TI - The scope of thromboembolism. PMID- 3661287 TI - The new dimensions of warfarin prophylaxis. Proceedings of an international symposium. October 16-18, 1986, New York City. PMID- 3661285 TI - Selective attrition causes overestimates of treatment effects in studies of weight loss. AB - Selective attrition causes serious threats to the validity of experimental trials. Experimental studies in behavior therapy typically include only data from those who complete an experiment. In this paper, we examine the probability of dropping out of a study contingent upon failure to achieve desired benefits. The data are derived from an experimental trial evaluating the effects of weight loss for patients with Diabetes Mellitus. Seventy-six percent of the original participants completed the intervention and the follow-up assessments. However, the probability of failing to appear for follow-ups over an 18 month period was examined. The chances of dropping out of the study were significantly higher for those who did not achieve a goal of weight reduction. This selective loss to follow-up results in an overestimate of treatment effectiveness. By failing to acknowledge drop-outs, treatment failures may be systematically eliminated from the analyses. PMID- 3661288 TI - What's the dose? PMID- 3661289 TI - Two-step warfarin therapy for the prophylaxis of venous thrombosis after elective surgery. PMID- 3661290 TI - Improving the benefit/risk ratio. PMID- 3661291 TI - Long-term anticoagulant treatment after acute myocardial infarction. PMID- 3661292 TI - Arterial thromboembolism: valvular heart disease and prosthetic heart valves. PMID- 3661293 TI - Clinical trial dilemmas and cerebrovascular disease. PMID- 3661294 TI - Atrial fibrillation and stroke: the view from cardiology. PMID- 3661295 TI - Atrial fibrillation and stroke: the view from neurology. AB - In summary NVAF is an important risk factor for stroke identifying a population at a six fold increased stroke risk. When stroke occurs it tends to be large and without a preceding TIA. These patients commonly have other cardiovascular disorders that must be considered as a potential cause of brain ischemia. The appropriate management of these patients to prevent cardioembolic stroke is unknown and must be individualized pending appropriate clinical trials. Following a cardioembolic stroke anticoagulation should be considered only in patients with small or moderate sized infarcts who have no evidence of hemorrhagic infarction on a CT scan and delayed until 36-48 hours post stroke onset. PMID- 3661296 TI - Human genes for factor IX and other vitamin K dependent blood proteins. PMID- 3661297 TI - INR--calibration of the therapeutic range. PMID- 3661298 TI - AIDS, alcohol and heroin: a particularly deadly combination. PMID- 3661299 TI - Risk-taking behavior, substance abuse disorders, and the acquired immune deficiency syndrome. AB - The Acquired Immune Deficiency Syndrome (AIDS) has rapidly emerged as a public health crisis of unusual proportion. Despite the attention given to the association of AIDS and parenteral substance use, the relationship between AIDS and other aspects of substance use disorders such as risk taking, disinhibition and lack of self care has not been emphasized. In vitro and in vivo evidence of immune suppression as a result of substance abuse, coupled with behavioral disinhibition and co-existent psychiatric problems make the relationship between these two public health problems a likely area of concern. Substance abuse, increased risk taking and self destructiveness are co-factors involved in the transmission of AIDS which need to be studied epidemiologically. The authors address the relationship between the addictions and disinhibition, suicidal behavior, and the clinical and therapeutic needs of patients, their families and staff. PMID- 3661300 TI - Cardiovascular effects of alcohol. PMID- 3661301 TI - AIDS, HTLV-III diseases, minorities and intravenous drug abuse. AB - Minorities and women who are engaging in activities which place them at high risk for infection with HTLV-III are developing HTLV-III related illnesses including AIDS. In Northeastern urban areas the relatively large number of minorities who use intravenous drugs are responsible for producing large numbers of patients with AIDS (PWAs). Eighty percent of heterosexual male and female PWAs are Black or Hispanic. The development and implementation of effective prevention and education programs for these individuals rests upon an understanding of the less traditional approaches which may be necessary to reach these groups. The general public must be made aware of the hazards of HTLV-III related diseases and that the risk of infection is restricted to very well defined high risk groups. Minorities must be made to understand that they are at increased risk for HTLV III related diseases only because of the high incidence of drug abuse in their community. PMID- 3661302 TI - Female to male mortality ratios for alcohol-related disorders: possible indicator of susceptibility in different sexes. AB - We investigated the possibility that organs other than liver in women were more susceptible to alcohol than in men. Female:male cirrhosis mortality ratio in different countries was used as an index of female susceptibility to alcohol. The F:M cirrhosis ratio correlated significantly with F:M ratios for cerebrovascular disease and cancers of the esophagus, liver and lung. This preliminary evidence suggests that other organs and/or disease processes in women may be affected more by alcohol than in men. PMID- 3661303 TI - [The health status of vocational students]. PMID- 3661304 TI - [Physical activity of adolescents]. PMID- 3661305 TI - [Blood pressure measurements within the scope of mass pediatric screening at the time of the 2d-school admission examination and in the 3d grade as a contribution to the assessment of health status]. PMID- 3661306 TI - [Studies of form vision deprivation amblyopia]. PMID- 3661307 TI - [Photocoagulation in simple diabetic retinopathies--follow-up study with respect to macular changes and vision]. PMID- 3661308 TI - [Quarter circumference argon laser trabeculoplasty]. PMID- 3661309 TI - [Effects of topical flurbiprofen in planned-extracapsular cataract extraction by a double-blind method]. PMID- 3661310 TI - [Magnification in aphakic patients wearing spectacle lenses, contact lenses and intraocular lenses]. PMID- 3661311 TI - [Peroxidase diffusion in the optic disc following acute elevation of intraocular pressure]. PMID- 3661312 TI - [Permeability of the blood-retinal barrier and oscillatory potential of ERG in diabetics without retinopathy]. PMID- 3661313 TI - [Changes of fluorescein diffusion across the blood-retinal barrier at different laser power in panretinal photocoagulation]. PMID- 3661314 TI - [Extracorporeal renal surgery. Current indications. 4 case reports]. PMID- 3661315 TI - [Treatment of renal calculi using extracorporeal shock waves. A new generation of lithotriptors]. PMID- 3661316 TI - [Posterior vertical lumbotomy. Its value for the surgical treatment of pelvic and proximal ureteral calculi]. PMID- 3661317 TI - [Lipoma of the renal hilus causing spontaneous hemorrhage in the renal space]. PMID- 3661318 TI - Bilateral adrenal metastasis from renal cell carcinoma. A case report. PMID- 3661319 TI - [Endoscopic cervicotomy. Vaporization using the contact Nd-YAG laser]. PMID- 3661320 TI - Urodynamic data in enuresis patients. PMID- 3661321 TI - [Urethral instability. Clinical and physiopathological observations]. PMID- 3661323 TI - [Urography in prostatic disorders. Statistical study of 1,000 cases]. PMID- 3661322 TI - [Neuro-anatomical correlations of high-compliance bladders in women]. PMID- 3661324 TI - [Foreign bodies of the urethra]. PMID- 3661325 TI - Malignant melanoma of the glans penis. PMID- 3661326 TI - [Paratesticular tumors in children]. PMID- 3661327 TI - Sclerosant therapy for hydroceles with injection of tetracycline. PMID- 3661328 TI - Short treatment regimen of lower urinary tract infections by pivmecillinam. PMID- 3661329 TI - Effectiveness and tolerability of aztreonam in urinary tract infection caused by multiresistant bacteria. PMID- 3661330 TI - [Detection of polyamines by an enzymatic assay. (6). Fundamental and clinical studies of a simple enzymatic method for determining total polyamines in blood]. AB - A simple enzymatic method for determining total polyamines in human blood was established. Polyamines in trichloroacetic acid extract from 1 ml of blood were isolated on an anion-exchange column and measured spectrophotometrically by the end point assay using polyamine oxidase and putrescine oxidase. The recovery was as high as 98.4% and within-run precision (coefficient of variance: 1.82%), and the values obtained by this method were in fair agreement with those obtained by high performance liquid chromatography and the enzymatic differential assay methods previously reported. The polyamine levels were not changed when the blood was stored at -20 degrees C. Blood polyamine levels were measured in 108 patients with genitourinary cancers, 29 patients with benign prostatic hypertrophy, 18 patients with benign urological diseases and 25 normal subjects. Although polyamines were not significantly elevated in the low stage of cancer, elevation was observed at a high stage of malignancy. These results indicate that the determination of total polyamines may be useful to determine biochemically the malignancy of cancers. PMID- 3661331 TI - [Observation on fungi within urinary stones]. AB - We examined the fungi within the urinary stones of two cases by light microscopy and scanning electron microscopy. In one case, fungal elements, hyphae and spores, were found in some layers within a bladder stone. This patient probably had a history of fungal urinary infection. In another case brown hyphae suggesting dematiaceous fungi were found in the surface and peripheral layers of a kidney stone. This maybe due to contamination of the fungi after removal of the stones. These fungi invaded into interstices of the apatite crystals within the stone as in the tissue. PMID- 3661332 TI - [Clinical experience with extracorporeal shock wave lithotripsy (ESWL) in renal and ureteral stones. The 3rd report: Treatment of 59 cases (64 renal stones) of complete staghorn calculi]. AB - This report describes the treatment of 64 cases of complete staghorn calculi using extracorporeal shock wave lithotripsy (ESWL). Thirty cases (46.8%) were successfully treated using ESWL monotherapy and the rest of the cases (53.2%) required ESWL combined with an auxiliary procedure. Forty-four of the cases (68.7%) had symptoms such as fever and pain after ESWL. These cases were treated with chemotherapeutic agents and an auxiliary procedure. X-ray examination showed that the result of ESWL treatment was satisfactory in 97.4% of the 34 cases followed up for more than 12 weeks after ESWL. Based on the results of this study, the following plan of treatment for complete staghorn calculi has been adopted in our hospital. ESWL monotherapy is performed in cases without a dilated collecting system or stricture. ESWL combined with an auxiliary procedure is performed in cases with a dilated collecting system, stricture, ileal conduit and solitary kidney. PMID- 3661333 TI - [Percutaneous nephrolithotripsy: a report of 50 cases]. AB - Fifty patients with renal (33 patients), renal and ureteral (4 patients) and ureteral (13 patients) stones were treated by percutaneous nephrolithotripsy (PNL) between November 15, 1984 and December 14, 1985. Complete stone removal was achieved in 39 cases (78%). Four of the 11 cases of incomplete stone removal were among the first 5 cases we treated. We have not experienced any severe complications in our 50 cases. The cause of the unsuccessful attempts, complications and other factors of PNL are briefly discussed. PMID- 3661334 TI - [Clinical treatment of renal and ureteral stones by extracorporeal shock wave lithotripsy (ESWL). IV: Treatment of distal ureteral stones with ESWL]. AB - ESWL has been used to treat distal ureteral stones in ten patients. All stones were broken up to sandy fragments. In six patients, all fragments were discharged completely within 3 days and in two patients within 20 days without any additional manipulation. The other two patients were lost to follow up regarding complete discharge. PMID- 3661335 TI - [Analgesic effect of calcitonin in patients with metastatic bone lesions from urogenital cancer]. AB - The analgesic effect of eel-calcitonin (Elcitonin) was evaluated in 10 patients with metastatic bone lesions from urogenital cancer. Five patients had renal cell carcinoma, while the remaining 5 patients had prostatic cancer. Eel-calcitonin was injected intravenously to each patient at a dose of 80 units every day. The drug was markedly effective for 3 patients, effective for 4 patients and ineffective for 3 patients. The effect was better for prostatic cancer than renal cell carcinoma. PMID- 3661336 TI - [Evaluation of preoperative bladder tumor staging]. AB - Twenty-eight out of 90 patients with bladder tumor seen from 1979 to 1982 were examined by CT, pelvic angiography, cystography and bimanual digital palpation for staging diagnosis preoperatively. Twenty-two patients underwent total cystectomy, and the other 6 patients underwent partial cystectomy. Preoperative staging (T) and postoperative histopathological staging (pT) were compared to define the diagnostic accuracy. The accuracy rate with CT was 20.0%, that with pelvic angiography, 29.4%, that with cystography 33.3%, and that with bimanual digital palpation 47.1%. Digital palpation had a better diagnostic accuracy rather than other examinations. PMID- 3661337 TI - [Cytodiagnosis of Chlamydia trachomatis by the immunoperoxidase technic]. AB - The PAP-immunocytochemistry using a monoclonal antibody against Chlamydia trachomatis was applied to male patients with clinically manifest urethritis and their female sex partners. In addition, serum levels of the antibody were determined by means of an ELISA system. Immunoperoxidase reactions were recognized on urethral scrapes in 53 (33%) out of 160 cases, and on endocervical specimens in 13 (59%) out of 22 sex partners of PAP-positive patients. In patients with gonococcal urethritis, an infection of C. trachomatis was revealed immunocytochemically in 11 (31%) out of 36 cases, and in 29 (46%) out of 62 cases with non-gonococcal urethritis. Following medication with 200 mg of minocycline or doxycycline per day, PAP staining became negative in 23 (66%) out of 35 cases. The levels of serum antibody against C. trachomatis were undetectable in 8 (26%) out of 29 PAP-positive cases, but positive in 7 (15%) out of 44 PAP-negative cases. PMID- 3661338 TI - [A case of adrenal ganglioneuroma]. AB - A 40-year-old female was admitted to the department of internal medicine of our hospital for evaluation of left sided diaphragm elevation, cardiomegaly and splenomegaly. CT scan incidentally revealed a 5 X 5 cm solid mass in the right adrenal and the patient was referred to our department of urology. Endocrinological studies and angiography indicated a non-functioning right adrenal tumor without any remarkable signs of malignancy. Right adrenalectomy was performed. The tumor was smooth-surfaced, measured 6 X 5 X 5 cm and weighted 50 g. The cut surface was yellow-white and demonstrated interlacing bundles of fibers. Histopathological examinations revealed a typical structure of ganglioneuroma. Ganglioneuroma is a very rare tumor most of which arise in the posterior mediastinum. To the best of our knowledge, this is the 17th case of adrenal ganglioneuroma in the Japanese literature. PMID- 3661339 TI - [A case of Cushing's syndrome caused by an adrenal black adenoma]. AB - A black adenoma of the adrenal cortex was surgically removed from an 18-year-old female who had clinical and laboratory findings characteristic of Cushing's syndrome. The electron microscopic study revealed typical features of steroid producing cells, including a prominent smooth and rough endoplasmic reticulum, and mitochondria. In addition, many of the adenoma cells contained numerous pigmented granules which were lipofuscin. Three months after the surgery, the hormone levels returned to the normal range. The Japanese literature of functional black adenoma is reviewed. PMID- 3661340 TI - [A case of bilateral synchronous renal cell carcinoma managed with radical nephrectomy and ex-vivo tumor enucleation]. AB - A 61-year-old female presented with gross hematuria and left flank pain. The arteriogram and CT scan revealed a large left renal tumor and multiple small right renal metastatic tumors. A chest X-ray and Ga scintigram showed no other metastatic lesions. A left radical nephrectomy and a right renal bench surgery were performed at the same time. The right multiple tumors were enucleated and the right kidney was autotransplanted into the right iliac fossa. The postoperative course was uneventful and the patient was free of tumor with good renal function. Renal preservation surgery was considered more beneficial for this patient than bilateral nephrectomy followed by hemodialysis. PMID- 3661342 TI - [Acute renal failure after renal trauma in a case of a functional solitary kidney]. AB - Herein we report a case of acute renal failure after renal trauma in a patient with contralateral hypoplastic kidney. The patient was treated conservatively including temporary hemodialysis successfully. In the case of renal trauma, the status and function of the contralateral kidney must be evaluated first, and in the case of a solitary kidney, treatment should be centered on the preservation of its function. PMID- 3661341 TI - [Report of a case of a renal arteriovenous malformation presenting an unusual computed tomographic finding]. AB - A fifty-three-year-old woman was admitted for gross hematuria and left lumbago. She was diagnosed as having left renal arteriovenous malformation (AVM) by renal angiography, but contrast enhanced CT of her left kidney demonstrated a low density area of renal parenchyma adjacent to AVM. Because a renal tumor could not be denied completely, we performed translumbar nephrectomy. No renal tumor was found in the removed kidney, and she was diagnosed as having cirsoid type AVM of the left kidney. The low density area in contrast enhanced CT was suspected to be indicating the ischemic renal parenchyma due to the steal phenomenon of renal AVM. This is the first report of a renal AVM with ischemic renal parenchyma demonstrated by CT. PMID- 3661343 TI - [Successful percutaneous drainage for infected cysts in polycystic kidney disease in a case of chronic hemodialysis]. AB - A 60-year-old woman, who had been receiving chronic hemodialysis for chronic renal failure due to polycystic disease for 7 years, was admitted to our hospital with the chief complaints of right flank pain and high-grade fever on February 3, 1986. She had a family history of polycystic kidney disease and her elder sister has been undergoing chronic hemodialysis. The patient has had repeated episodes of urinary tract infection. The right markedly distended kidney was palpated with severe tenderness, and the performance status was poor. Computerized tomography showed the right kidney enlarging beyond the median line, but localization of the infected cysts was not clear. The 7-day intensive antibiotic therapy had no beneficial effect. On the 8th hospital day, percutaneous drainage, which was carried out for a large cyst with low-level echoes using ultrasonic guidance, yielded 600 ml of hemopurulent fluid. Bacterial culture of the aspirated fluid was positive for Escherichia coli. As the clinical symptoms did not improve after the 8th day, 10 Fr. catheter placement, percutaneous drainage and catheter placement were added for other cysts containing hemopurulent fluid. Although hematopyuria persisted, the patient became afebrile and the right kidney became smaller and softer. Both catheters were removed on the 30th hospital day. Repeated computerized tomography or ultrasonography revealed a few hyperdense or hyperechoic cysts in the right kidney. However, no recurrence of high-grade fever or right flank pain has been seen for 3 months. Ultrasonic-guided percutaneous drainage has a great potential for patient care of infected cysts in polycystic kidney disease. PMID- 3661344 TI - [A case of distal ureteral atresia]. AB - A case of distal ureteral atresia with the chief complaint of a mass in the left lower quadrant is reported. On palpation of the abdominal region, a 3 X 4 cm mass, smooth-surfaced and movable, was palpable in the left lower quadrant, IVP failed to show the left kidney, while CT revealed an atrophic left kidney and dilated ureter. For the diagnosis of distal ureteral atresia, total left ureteronephrectomy was performed. The left kidney measured 4.5 X 3 X 3 cm and the ureter was dilated and ended blind. The pathohistological findings included dysplasia with normal nephrons here and there of the kidney. We examined the distal ureteral atresia from the renal tissue. PMID- 3661345 TI - [Clinical experience with cefbuperazone in complicated urinary tract infection]. AB - Cefbuperazone (CBPZ) was administered to inpatients with complicated urinary tract infections (UTI) at our department. Clinical efficacy and safety were evaluated in 22 chronic cases by the criteria for evaluation of clinical of antimicrobial agents on urinary tract infection. Overall clinical efficacy was excellent in 8 cases, moderate in 9 cases and poor in 5 cases with an effectiveness rate of 77%. Twenty-four of the 34 strains isolated from the patients were eradicated and eradication rate was 71%. Neither subjective nor objective adverse reactions were observed. Abnormal changes in laboratory tests were found in 9 patients, but were probably not related to CBPZ administration. Judging from these results, CBPZ is considered to be an effective and safe antibacterial for the treatment of complicated UTI. PMID- 3661346 TI - [Determination of urinary oxalate using a Sigma kit]. AB - Many methods for measuring urinary oxalate have been reported. However, most of them are unsuitable for clinical use because of complexity and difficulty. We tested the value of the Sigma kit for measuring urinary oxalate. In principle, after extraction from urine, oxalate is oxidized to hydrogen peroxide in the presence of oxalate oxidase and the hydrogen peroxide reacts with 3-methyl-2 benzothiozolinone hydrazone and 3-(dimethylamino) benzoic acid in the presence of peroxidase to yield an indamine dye with a maximum absorbance at 590 nm. The linearity of the standard curve and reproducibility of this method were measured and good results were obtained. (Linearity: r = 0.998, within assay: C.V. = 1.5 to 5.0%, between assays: C.V. = 4.0 to 11.6%). The correlation between this method and modified Hodgkinson and Williams' method or ion chromatographic method were 0.922 and 0.796, respectively. The overestimation effect of added ascorbic acid was completely inhibited by FeCl3 which had been added beforehand. PMID- 3661347 TI - [Study of clinical efficacy and safety of long-term cinoxacin therapy of chronic urogenital organ infection]. AB - Thirty-five patients with chronic simple and complicated urogenital organ infections were treated with 400 mg/day Cinoxacin for 60 to 284 days. The effects were judged according to improvements of subjective symptoms, bacteriuria and pyuria before and after the complete administration. Overall clinical efficacy in 35 cases with urogenital organ infections was estimated as excellent: 54%, good: 26%, poor: 17%, and effectiveness rate: 80%. The clinical effectiveness rate in 12 cases of chronic simple urinary tract infection was 100%, and in 14 cases of chronic complicated urinary tract infections was 64%, and in 6 cases of chronic prostatitis the rate of effectiveness was 83%. No recurrence was observed during the treatment. No side-effects or toxicity were seen. Accordingly long-term Cinoxacin therapy seems to be useful in preventing recurrence in chronic infections encountered in the department of urology. PMID- 3661349 TI - Education in the University of Veterinary Science. PMID- 3661348 TI - Structure of the present institution (University of Veterinary Science). PMID- 3661350 TI - Postgraduate (refresher and specialist) training in the University of Veterinary Science. PMID- 3661351 TI - Research activities in the University of Veterinary Science. PMID- 3661352 TI - National and international relations of the University of Veterinary Science. PMID- 3661353 TI - Effect of different fractions of dialyzable leukocyte extract--transfer factor- on the chemiluminescence of human phagocytes. AB - The chemiluminescence (CL) inducing effect of the fractions of dialyzable leukocyte extract (DLE)--transfer factor--from tonsil leukocytes was tested on the phagocytes of human whole blood. The fractionation of DLE by Sephadex G-25 results in three main fractions: I, II, III. We found only fraction II having a direct CL inducing effect on the non-stimulated cells. Fraction II increased further the CL of phagocytes which were stimulated by zymosan (Mannozym). Fractions I and III were ineffective. We suggest that in the complex "transfer factor" effects of DLE, the stimulation of the peripheral phagocytes of blood-by the oligopeptides of fraction II may have an important role. PMID- 3661354 TI - Complement and sepsis. AB - The present study is an evaluation of changes undergone in the serum of factors C3 and C4 of the complement, IgG, IgA, IgM and circulating immune complexes during the initial phase of sepsis and throughout its development in 53 patients, with the object of establishing their prognostic value. During the initial phase of sepsis the determination of the serum levels of immunoglobulins (IgG, IgA, IgM), C3 and C4 complement components and circulating immune complexes lack prognostic interest. Nevertheless, the disappearance of circulating immune complexes, together with an intensive reduction in concentration of IgG, IgM, and C3 and C4 complement components below the range of normality, during the evolutive course, is an indication of a bad prognosis. PMID- 3661355 TI - Cytologic study of food microaspiration in recurrent obstructive bronchopathy. AB - Sixty-four cases of infants ranging from 4 to 24 months of age (fed on milk) who suffered from Recurrent Obstructive Bronchopathy and a group of 10 healthy children were studied during 6 months (from May to October, 1984) in order to evaluate the incidence of the microaspiration phenomenon. This was done by means of a quick, easy and very cheap cytological method which etiologically diagnoses the microaspiration through fat elements phagocitized by the alveolar macrophages. They were evident in two different ways: 1) a new method of stained cellulae of a better morphological fidelity. 2) a larger quantity of exploratory smears from each patient which allowed an easier elimination of positive falses and a better individuation of negative falses. The data obtained by the technic were statistically processed using the significance of Chi or Khy square test, so as to make an exploratory-descriptive study of the method through the comparison of the averages obtained from the samples, smears and macrophages. PMID- 3661356 TI - Preliminary study on the concentration and species composition of bacteria, fungi and mites in samples of house dust from Silesia (Poland). AB - Twenty-one samples of house dust collected from dwellings situated in Upper Silesia (Poland) were subjected to bacteriological, mycological and acarological examination. Moreover, in two samples the concentration of bacterial endotoxin was estimated by the use of Limulus test. The mean concentration of bacteria in the examined samples was 2831.9 thousands cfu (colony forming units) per gram, that of fungi - 28.4 thousands cfu per gram, and that of mites - 51.5 specimens per gram. No significant correlation could be found between the numbers of these three components of house dust. Two examined samples of house dust contained high amounts of bacterial endotoxin which are comparable to the concentration of endotoxin in agricultural dusts, and could be of immunopathogenic significance. In the bacterial flora of the examined house dust samples, staphylococci prevailed in 45.9% of all isolates, streptococci (23.2%), corynebacteria (13.9%) and spore-forming bacilli (12.2%). Among fungi, the most numerous were strains of the genus Penicillium (39.4%), yeasts (29.5%) and strains of the genus Aspergillus (8.4%). Both bacteria and fungi comprise species that are known for their allergenic properties. The mite fauna of the examined samples was dominated by Dermatophagoides farinae (62.7% of all specimens) and Dermatophagoides pteronyssinus (30.4%); both species are known as important allergens of house dust. The results hitherto obtained indicate the potential significance of all the investigated components (bacteria, fungi and mites) in causing allergy to house dust. PMID- 3661358 TI - Controlling hypertension. PMID- 3661357 TI - [Cold urticaria associated with serologic markers of hepatitis B and cryoglobulinemia]. AB - The acquired form of cold induced urticarial syndrome can be found associated with serum cryoproteins, in idiopathic form (generally IgE mediated) and transitory forms associated with other factors. The viral infections, specially infectious mononucleosis and hepatitis B can cause urticaria, mostly chronic, although infrequently produces cold urticaria. We present a case of a 13 year old patient with history suggestive of cold urticaria wherein we have found the existence of a mixed polyclonal cryoglobulinemia, IgG-IgA (exceptionally associated) and serologic markers of hepatitis B, HBsAb and HBsAb (the last being suggestive of a recent infection) 3 months from the urticaria, without recent or past history of hepatitis B infection. We also observed an elevated total serum IgE and peripheral blood eosinophilia. The provocation test presented an evolution similar to the cryoglobulinemia and markers of hepatitis B (after 18 months were negative) but serum IgE and eosinophilia remain elevated until the present time. All of this make us think that the patient could have suffered a subclinical form of hepatitis B which triggered off a cryoglobulinemia, presenting as cold urticaria. PMID- 3661359 TI - Genesis of paranoia. PMID- 3661360 TI - AIDS in the age of anxiety. PMID- 3661361 TI - Superiority of intracoronary papaverine to radiographic contrast for measuring coronary flow reserve in patients with ischemic heart disease. AB - Measurement of coronary flow reserve has been suggested as an adjunct to anatomic assessment of coronary stenoses in patients with ischemic heart disease. We compared papaverine hydrochloride and radiographic contrast to determine which agent was superior for the determination of coronary flow reserve. Coronary flow reserve was determined during cardiac catheterization by means of digital coronary angiography and parametric imaging. Two groups of patients were studied. Among patients in group 1, coronary flow reserve was determined by means of both papaverine and contrast. In group 1 patients with normal coronary arteries, papaverine-induced flow reserve was greater than contrast-induced reserve in all but one vascular region (n = 9, 4.98 +/- 1.15 vs 3.56 +/- 0.89; p = 0.29). Group 1 patients with coronary disease also demonstrated significantly greater flow reserve with papaverine (n = 25, 2.57 +/- 0.20 vs 1.83 +/- 0.11, p less than 0.01). Group 2 included patients with single-vessel coronary artery stenoses. These patients were studied by means of either papaverine or contrast to determine coronary flow reserve for both the stenotic "ischemic" region and an adjacent nonstenotic, "nonischemic" region. Those patients in group 2 who were studied by means of contrast had a modest difference between flow reserve values in the nonischemic and those in the ischemic regions (n = 15, 1.78 +/- 0.10 vs 1.26 +/- 0.09; p less than .0001) with considerable overlap. Patients studied by means of papaverine had a much greater separation in flow reserve between nonischemic and ischemic regions (n = 22, 2.78 +/- 0.19 vs 1.46 +/- 0.14; p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661362 TI - The clinical significance of exercise-induced left ventricular wall motion abnormality occurring at a low heart rate. AB - We studied the relationship between the heart rate at the time of onset of exercise-induced wall motion abnormality and the severity of coronary artery disease in 89 patients who underwent exercise equilibrium radionuclide ventriculography as part of their evaluation for coronary artery disease. Segmental wall motion was scored with a five-point system (3 = normal; -1 = dyskinesis); a decrease of one score defined the onset of wall motion abnormality. The onset of wall motion abnormality at less than or equal to 70% of maximal predicted heart rate had 100% predictive accuracy for coronary artery disease and higher sensitivity than the onset of ischemic ST segment depression at similar heart rate during exercise: 36% (25 of 69 patients with coronary disease) vs 19% (13 of 69 patients), p = 0.01. Wall motion abnormality occurring at less than or equal to 70% of maximal predicted heart rate was present in 49% of patients (23 of 47) with critical stenosis (greater than or equal to 90% luminal diameter narrowing), and in only 5% of patients (2 of 42) without such severe stenosis, p less than 0.001. The sensitivity of exercise-induced wall motion abnormality occurring at a low heart rate for the presence of severe coronary artery disease was similar to that of a deterioration in wall motion by more than two scores during exercise (49% vs 53%) or an absolute decrease of greater than or equal to 5% in exercise left ventricular ejection fraction (49% vs 45%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661363 TI - Augmented preexcitation assessed by scintigraphic phase analysis during atrial pacing. AB - We sought to characterize the effect of augmented preexcitation on the phase image pattern associated with scintigraphic acquisition during conduction via accessory arteriovenous connections. For this reason we assessed phase image scintigraphy, acquired in sinus rhythm and during rapid atrial pacing in 12 patients with documented right (five patients) or left (seven patients) lateral accessory pathways. Augmented preexcitation during atrial pacing was documented at electrophysiologic study in all patients during atrial pacing at similar rates. Phase analysis was abnormal in only 8 patients during sinus rhythm but in all 12 patients during atrial pacing. Atrial pacing brought a significant delay in both mean left and right ventricular phase angles, LV phi and RV phi, respectively. With atrial pacing, the site of earliest phase angle, interpreted to indicate the site of earliest excitation, shifted to the site of the accessory pathway. There was increased relative "prematurity" of the mean phase angle of the ipsilateral ventricle and an absolute increase in the difference between mean and earliest left and right ventricular phase angles, delta phi (LV-RV) and delta phi 0 (LV-RV), respectively. In patients with right-sided pathways, delta phi (LV RV) increased from 9.5 +/- 12.6 degrees to 47.9 +/- 22.8 degrees, whereas delta phi 0 (LV-RV) increased from 28.1 +/- 18.0 degrees to 67.6 +/- 25.0 degrees (both p less than 0.05). Patients with left-sided pathways demonstrated similar changes in which delta phi (LV-RV) decreased from 2.9 +/- 10.8 degrees to -26.5 +/- 9.0 degrees and delta phi 0 (LV-RV) decreased from 3.4 +/- 14.2 degrees to -27.4 +/- 17.9 degrees (both p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661364 TI - The hemodynamic effects of ventricular pacing with and without atrioventricular synchrony in patients with normal and diminished left ventricular function. AB - The relative hemodynamic effects of heart rate, inotropic state, and atrioventricular (AV) synchrony during ventricular pacing were evaluated in 10 patients with normal left ventricular ejection fraction (LVEF) (0.66 +/- 0.07, mean S.D.) and in eight patients with a diminished LVEF (0.34 +/- 0.18). Hemodynamics were measured at AV intervals of 130, 0, and -130 msec during ventricular pacing at a baseline rate that was 10 pulses/min greater than the resting heart rate, at 130 pulses/min alone, and at 130 pulses/min during continuous intravenous infusion of dobutamine. During baseline ventricular pacing and during ventricular pacing at 130 pulses/min with and without dobutamine, both groups of patients had a significant decrease in cardiac index, stroke volume index, and stroke work index when the AV pacing interval was decreased from 130 to 0 msec. The observed decrease in these three hemodynamic variables was similar when patients with diminished LVEF were compared to patients with normal LVEF. No further significant decrease in cardiac index, stroke volume index, and stroke work index occurred in either group when the AV interval was changed from 0 to 130 msec during baseline ventricular pacing or during ventricular pacing at 130 with and without dobutamine. Beneficial hemodynamic effects occur during ventricular pacing when AV synchrony is maintained at resting heart rates and during increases in heart rate and inotropic state in patients with normal and diminished LVEF. PMID- 3661365 TI - Cephalic vein guide wire technique for implantation of permanent pacemakers. AB - This report describes a modified cephalic vein guide wire technique for the implantation of permanent pacemakers. The procedure was attempted in 11 patients only when pacing leads could not be passed directly into the exposed cephalic vein. Eight bipolar DDD (two leads), two unipolar DDD, and one bipolar VVI (one lead) pulse generators were implanted successfully, with only one relatively minor complication. The cephalic vein guide wire technique provides easy access to the subclavian vein and may allow implantation of most single- and dual chamber pacemakers with only a cephalic vein cutdown. PMID- 3661366 TI - Increased afferent vagal responses produced by epicardial application of nicotine on the canine posterior left ventricle. AB - Vagally mediated vasodepressor reflexes are observed in dogs and patients with acute myocardial ischemia or infarction and may be related to the Bezold-Jarisch reflex. To test whether nicotine and bradykinin produced site-specific vagal vasodepressor and sympathetic vasopressor responses, respectively, we compared blood pressure and heart rate responses to these drugs applied topically at six epicardial sites of the canine left ventricle: midanterior, apical anterior, midlateral, apical lateral, midposterior, and apical posterior left ventricle. In alpha-chloralose-anesthetized dogs with open chests a felt pad soaked in bradykinin (25 micrograms) or nicotine (50 micrograms) was applied to the test sites. Previous studies indicated that epicardial application of these drugs elicited a sympathetically mediated pressor response and a vagally mediated depressor response, respectively. Vasopressor response to bradykinin did not differ among six test sites in 10 dogs. However, vasodepressor response to nicotine was greater in the midposterior left ventricular epicardium than at other test sites in 16 dogs. A hypertensive response after the initial hypotensive response to nicotine was observed in the midanterior left ventricle and not in any other site. These data indicate that vagal vasodepressor responses to epicardial nicotine are greater in the canine midposterior left ventricle and are compatible with the higher incidence of bradycardia or hypotension during acute inferoposterior myocardial infarction in patients. Sympathetic vasopressor responses to epicardial bradykinin are not site specific. Half of the dogs showed no response to bradykinin or nicotine. PMID- 3661367 TI - Progressive attenuation of the carotid baroreflex control of blood pressure and heart rate during exercise. AB - With the use of a variable pressure neck chamber, the effect of supine bicycle exercise on the carotid baroreceptor reflex was investigated in 10 normal volunteers who were studied at rest and during moderate and severe exercise, i.e., at 33% and 66% of their previously determined maximal exercise capacity. Deactivation of the carotid baroreceptors by a decrease in carotid transmural pressure produced a greater (p less than 0.001) increase in mean intra-arterial pressure at rest (+11.2 +/- 0.2 [SE] mm Hg) than during moderate (+9.0 +/- 0.2 mm Hg) and severe (+6.1 +/- 0.1 mm Hg) exercise. Heart interval decreased less (p less than 0.005) at rest (-73 +/- 3.2 msec) than during exercise (-0.7 +/- 0.7 msec and -4.6 +/- 0.2 msec, respectively). Furthermore, activation of the carotid baroreceptors by an increase in carotid transmural pressure provoked a greater (p less than 0.005) reduction in mean intra-arterial pressure at rest (-11.5 +/- 0.2 mm Hg) than during exercise (-9.8 +/- 0.1 mm Hg and -7.5 +/- 0.1 mm Hg, respectively), while the lengthening of heart interval was also more (p less than 0.005) pronounced at rest (+97 +/- 4.3 msec) than during moderate (+44 +/- 1.2 msec) and severe (+7.6 +/- 0.3 msec) exercise. Finally, carotid baroreceptor sensitivity was defined as the slope of the changes in blood pressure and heart interval that occurred with increasing (baroreceptor deactivation) and decreasing (activation) neck tissue pressure. On average, baroreceptor sensitivity was consistently smaller (p less than 0.05) during exercise, as compared to rest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661368 TI - Influence of nifedipine on arterial baroreflex modulation of heart rate control during dynamic increases in arterial pressure: studies in normal man. AB - Studies in animals have demonstrated that calcium channel blocking agents exert important influences on autonomic mechanisms in addition to their direct vascular effects. Previous studies in our laboratory showed that clinical doses of nifedipine sensitized baroreceptor-mediated control of peripheral vascular resistance in normal human subjects. However, baroreflex control of vascular tone does not necessarily imply parallel control of heart rate. A series of experiments was therefore performed to test the hypothesis that therapeutic doses of nifedipine would potentiate arterial baroreflex modulation of heart rate during ramp increases of arterial pressure in normal volunteers. Arterial baroreflex control was assessed by measuring heart interval (HI) responses to dynamic ramp elevation of systolic arterial pressure (SAP) with bolus administration of phenylephrine (PE) before and after nifedipine or placebo in 19 normal subjects. Arterial baroreflex control was calculated from the slope of the regression of SAP on succeeding HI during the first 18 cardiac cycles following onset of rise of SAP after PE bolus. In 13 subjects, bolus PE produced an increase in SAP from 125 +/- 3 mm Hg to 152 +/- 5 mm Hg (p less than 0.01), with a resultant increase in HI from 1110 +/- 57 msec to 1541 +/- 87 msec (p less than 0.01). The baroreflex response was linear (r greater than 0.80, p less than 0.025) and = 17.8 +/- 3.3 msec/mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661369 TI - Merits and limitations of quantitative treadmill exercise score. AB - This study examined the ability of the treadmill exercise score (TES) in determining the presence and extent of coronary artery disease (CAD). The score was derived from the integrated area of ST segment depression and ST slope in two leads (V5 and a VF), corrected for R wave amplitude, exercise time, and percent of maximum predicted heart rate. The ST segment depression was measured at 80 msec after the J point. There were 34 patients with no significant CAD, 38 patients with one-vessel CAD (greater than or equal to 50% diameter stenosis), and 58 patients with multivessel CAD. The TES showed a considerable scatter in patients with and without CAD. A receiver operating characteristic curve showed different levels of sensitivity and specificity, depending on the cut-point. The TES was similar to ST segment depression in detecting CAD (predictive accuracy, 77% vs 78%, p = NS). A markedly abnormal score (less than -1.0) was seen in 41 patients, of whom 32 (78%) had multivessel CAD. On the other hand, a score greater than 0 was seen in 49 patients, of whom 40 (82%) had no or one-vessel CAD. In 40 patients with TES between -1.0 and 0, 17 (43%) had multivessel CAD and 23 (57%) had no or one-vessel CAD. In 51 patients with nondiagnostic ST changes, the TES correctly classified the extent of CAD in 20 patients (40%). Thus, the TES has a similar accuracy to the ST segment depression criteria in detecting CAD. The extent of CAD can, however, be ascertained in 80% of the patients with very high or very low TES. PMID- 3661370 TI - Syndrome cardiac myxoma: more than just a sporadic event. PMID- 3661371 TI - Doppler color flow mapping demonstration of diastolic mitral regurgitation in severe acute aortic regurgitation. PMID- 3661372 TI - Right and left coronary artery to left ventricle fistula detected by color Doppler flow mapping. PMID- 3661373 TI - Congenital mitral insufficiency secondary to anomalous mitral arcade in an adult. PMID- 3661374 TI - Thallium scintigraphic evidence of reversible myocardial ischemia caused by anomalous origin of the left main coronary artery from the anterior sinus of Valsalva. PMID- 3661375 TI - Cardiovascular findings in the Williams-Beuren syndrome. PMID- 3661376 TI - A new paraspinal window in the echocardiographic diagnosis of descending aortic dissection. PMID- 3661377 TI - Chest thump terminating atrioventricular nodal reentry tachycardia. PMID- 3661378 TI - Tuberculous pericarditis as the first manifestation of acquired immunodeficiency syndrome. PMID- 3661379 TI - Increased procainamide plasma concentrations caused by quinidine: a new drug interaction. PMID- 3661380 TI - Hypercoagulability: a conceptual and diagnostic approach. PMID- 3661381 TI - What are we trying to prevent by controlling hypertension? PMID- 3661382 TI - Problems with intervention trials in hypertension. PMID- 3661383 TI - Hypertension as a factor in the coronary risk profile. Proceedings of the symposium. September 13, 1986, Washington, D.C. PMID- 3661384 TI - Hypertension and other risk factors in coronary heart disease. AB - Whether systolic or diastolic, labile or fixed, at any age in either sex, hypertension is dangerous. Adiposity, heart rate, alcohol intake, hematocrit, blood sugar, serum cholesterol, and triglycerides are all related to the occurrence of hypertension in one or both sexes. These factors also contribute to the occurrence of the cardiovascular sequelae of hypertension. The influence of blood pressure on the incidence of cardiovascular disease is independent of other predisposing cofactors but is greatly affected by them. Elevated pressures are often accompanied by hyperlipidemia, hyperglycemia, elevated fibrinogen, and ECG abnormalities, all of which augment the risk. Coronary disease is now the most common sequela of hypertension, and the excess risk is concentrated in those with an increased low-density lipoprotein/high density lipoprotein ratio, impaired glucose tolerance, and ECG abnormalities, and in cigarette smokers. Hypertension is only a component of a multifactorial coronary risk profile which must be considered when implementing optimal therapy. Both the urgency for treatment and judgment of efficacy should be guided by the multivariate risk profile. PMID- 3661385 TI - Ambulatory monitoring of blood pressure as a predictor of cardiovascular risk. PMID- 3661386 TI - Structure and function of the arteries in hypertension. AB - Like tissues in other parts of the body, those of the heart and blood vessels can rapidly adapt their design. The principles of these differentiated structural changes in response to altered functional demands will be outlined in this report. With respect to arterial resistance vessels in hypertension, any sustained arterial pressure elevation leads to wall (w) hypertrophy, whereas the average inner radius (ri) decreases. The reverse occurs at sustained pressure reductions, and this process is aptly termed "structural autoregulation." By means of this structural autoregulation, wall tension per unit layer (T) remains largely constant when pressure (P) increases (decreases), according to Laplace's law: T = P X r/w. Furthermore, this structural w/ri increase, because it is a local vascular response although it is often considerably modified by neurohormonal "trophic" influences, results in a geometrically based vascular hyperreactivity affecting the systemic precapillary resistance vessels, whereas the structural ri reduction leads to an upward resetting of systemic resistance to flow which is present even at maximal vasodilation (Rmin). Because of this "structural amplifier" principle, an increased systemic resistance can be maintained even at normal vascular smooth muscle activity, and smooth muscle activations may then lead to exaggerated resistance elevations. Thus, a most important positive-feedback interaction is created between even mild functional "pressor" influences, if adequately sustained, and this normal process of structural adaptation. This positive-feedback interaction therefore gradually tends to accentuate the latter element until it entirely dominates the hemodynamics of established hypertension. As the process is induced early and established rapidly, and in primary hypertension often even seems to be genetically reinforced in various ways, it becomes of utmost pathogenetic significance. With respect to the aorta-large conduit arteries, their "Windkessel function" becomes reduced by the same process of adaptive wall thickening. This increases the pulse amplitude and thereby accentuates the systolic afterload of the left heart, the load of which is raised also because of the upward structural resetting of systemic precapillary resistance. Furthermore, the same type of structural adaptation also contributes to the upward resetting of the cardiac, arterial, and renal "barostat" mechanisms, as cardiac and arterial walls become thicker and stiffer, whereas renal preglomerular resistance vessels participate in the upward structural autoregulation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3661387 TI - The role of antihypertensive pharmacologic treatment in countering adverse pathophysiological profiles: influence on small arteries. AB - Usually, when antihypertensive therapy is considered in the hypertensive patient, structural cardiovascular changes are already well established and the structure of the cardiovascular system is redesigned to maintain higher than normal pressure. Left ventricular hypertrophy has been shown to be an independent risk factor for all manifestations of coronary heart disease. In hypertension, the increased pressure load over a long period of time induces degenerative changes in, for example, cerebral, renal, and coronary vessels, with well-known clinical consequences. Independent of the primary cause of hypertension, full reversal to normotension will probably occur only when the structurally reset cardiovascular system has been returned to normal dimensions by regression of structural vascular changes. In animal models several forms of antihypertensive treatment have prevented the development of or induced regression of left ventricular hypertrophy as well as medial hypertrophy of the vessels. These effects have been related both to the extent of blood pressure reduction and to the degree of inhibition of neurohormonal trophic influences. In humans the results have been somewhat contradictory. Plethysmography has demonstrated a reduction of resistance at maximal dilatation with either combination therapy or pindolol but not with mefruside or atenolol. There may be several explanations for the difficulties in showing regression of structural vascular changes in humans: (1) inadequate treatment of high blood pressure, (2) reflexogenic activation of neurohormonal trophic factors, (3) investigation of an unsuitable vascular bed, or (4) treatment started too late. The ultimate goal in the treatment of hypertension is, of course, reduction of cardiovascular morbidity and mortality, but normalization of structural cardiovascular changes is clearly the second most important therapeutic goal. PMID- 3661388 TI - The role of antihypertensive drugs in counteracting adverse influence on large arteries. AB - Studies in humans have shown that chronic elevation of blood pressure induces early alterations in the large arteries, consisting mainly of increased diameter, increased pulse wave velocity, and decreased arterial compliance. Acute reduction of blood pressure, per se, does not necessarily correct these alterations homogeneously. For instance, cadralazine reduced brachial artery diameter and urapidil decreased pulse wave velocity, without accompanying changes in forearm arterial compliance. In contrast, acebutolol, isosorbide dinitrate, nicardipine, and nitrendipine, for the same acute decrease in blood pressure, improved forearm arterial compliance by a concomitant decrease in pulse wave velocity and increase in arterial diameter. To determine whether or not these vascular effects persist with long-term acebutolol therapy, nine hypertensive patients were treated for a period of 3 months. Forearm hemodynamic and cytosolic free calcium concentrations in platelets were simultaneously assessed before and after treatment. Compared with placebo baseline values, chronic acebutolol therapy significantly decreased mean arterial pressure (p less than 0.01), pulse wave velocity (p less than 0.01), and platelet free calcium concentration (p less than 0.05); forearm arterial compliance was increased (p less than 0.01), but brachial artery diameter did not change. Platelet calcium concentration correlated closely with pulse wave velocity even at constant mean arterial pressure. These findings suggest a relaxant effect of acebutolol on the smooth musculature of large arteries, which is independent of changes in blood pressure and arterial diameter, and possibly mediated by changes in cytosolic calcium levels. PMID- 3661389 TI - Prognosis after cardiac arrest due to ventricular tachycardia or ventricular fibrillation associated with acute myocardial infarction (the MILIS Study). Multicenter Investigation of the Limitation of Infarct Size. AB - Previous studies have reached conflicting conclusions about whether cardiac arrest due to ventricular tachycardia (VT) or ventricular fibrillation (VF) in acute myocardial infarction (AMI) is of long-term prognostic significance. The mortality rate in 849 patients with confirmed AMI was analyzed. The mortality rate during the initial hospitalization was higher for patients in whom VT/VF occurred (27% vs 7%, p less than 0.001). The in-hospital mortality rate for patients with primary VT/VF, that is, VT/VF occurring in the absence of hypotension or heart failure, was similar to that of patients who did not have VT/VF (8% vs 7%, difference not significant), whereas the rate for patients with secondary VT/VF was significantly greater than that for patients with no VT/VF (51% vs 7%, p less than 0.001). The timing of occurrence of VT/VF also influenced mortality: Patients in whom VT/VF occurred more than 72 hours after admission had a higher in-hospital mortality rate than did patients in whom it occurred within 72 hours (57% vs 20%, p less than 0.05). All cases of primary VT/VF occurred within the first 72 hours of admission. The long-term mortality rate for hospital survivors was not significantly different for patients who had had VT/VF during acute infarction compared with those who had not (19% vs 21%) (mean follow-up 32 months). Thus, cardiac arrest due to ventricular tachyarrhythmia was associated with a higher in-hospital mortality rate but was not a prognostic factor among hospital survivors. Patients resuscitated from primary VT/VF, which characteristically occurs early after AMI, do not have an adverse prognosis. PMID- 3661390 TI - Outcome in suspected acute myocardial infarction with normal or minimally abnormal admission electrocardiographic findings. AB - Seven hundred seventy-five consecutive patients with symptoms suggestive of acute myocardial infarction (AMI) who were admitted to the cardiac care unit from the emergency room were studied; 107 had normal electrocardiographic findings and 73 had only minimal nonspecific changes. AMI subsequently evolved in 11 patients (10%) with normal electrocardiographic findings and in 6 (8%) with minimal changes, compared with 245 (41%) with frankly abnormal emergency room findings. Only 1 (1%; 95% confidence limits 0.02 to 5%) and 4 (6%; 95% confidence limits 2 to 15%) of those with normal and nonspecific initial electrocardiographic findings, respectively, had a complication for which they potentially benefited from intensive care unit intervention, although many patients received prophylactic therapy. Thus, the initial emergency room electrocardiogram can effectively separate patients into high- and low-risk groups for AMI and serious complications. Admission to a monitored intermediate care ward may be an acceptable practice in patients with chest pain and a normal or minimally changed initial electrocardiogram. PMID- 3661391 TI - Usefulness of sex steroid hormone levels in predicting coronary artery disease in men. AB - The relation between sex hormone levels and subsequent risk of a major coronary event was studied in a nested case-control study among 163 men in the Multiple Risk Factor Intervention Trial who later had a major coronary event and in 163 controls. Cases and controls were matched for age, serum cholesterol level, randomization group, randomization date and clinic. Blood samples were collected at baseline before randomization and frozen at -70 degrees C. Follow-up extended over 6 to 8 years. Sixty-one patients had a nonfatal acute myocardial infarction and 102 fatal infarction. Total and free testosterone, total and free estradiol, androstenedione and estrone concentrations were measured. There were no significant differences between cases and controls for any sex hormone level. There was also no difference in the ratio of testosterone to estradiol. Controlling for other cardiovascular risk factors did not change these results. These results do not support previous case-control studies of a relation between sex hormone levels and risk of heart attack among men. PMID- 3661392 TI - Prognostic implications of symptomatic versus asymptomatic (silent) myocardial ischemia induced by exercise in mildly symptomatic and in asymptomatic patients with angiographically documented coronary artery disease. AB - Patients with coronary artery disease (CAD) may undergo periods of reversible myocardial ischemia without experiencing angina. To study the prognostic implications of "silent" myocardial ischemia induced by exercise, exercise electrocardiography and radionuclide angiography were performed in 131 consecutive patients with CAD, preserved left ventricular (LV) function at rest and mild or no symptoms during medical therapy. All patients who died during medical therapy were in the subgroup of patients with 3-vessel CAD in whom exercise-induced ischemia developed, which was characterized by both a decrease in LV ejection fraction and ST-segment depression. Patients in whom angina pectoris developed during exercise (54% of all patients) had a greater prevalence of this combined ischemic response to exercise than patients without angina (61% vs 27%, p less than 0.001) and also a greater prevalence of left main or 3-vessel CAD (59% vs 25%, p less than 0.001). However, when inducible ischemia was demonstrated, risk stratification and prognosis were the same whether the ischemic episode was symptomatic or silent. Among patients having both a reduction in ejection fraction and a positive ST-segment response, the likelihood of significant left main narrowing (13% vs 26%), 3-vessel CAD (56% vs 51%) and death during subsequent medical therapy (16% vs 9%) was similar in patients with silent compared to those with symptomatic ischemia. These data indicate that patients in whom angina develops during exercise have a greater prevalence of high-risk coronary anatomy and of inducible ischemia than patients without angina. However, once inducible ischemia is documented, the symptomatic response to exercise appears irrelevant for prognostic or risk stratification considerations. PMID- 3661393 TI - Circadian variation in the incidence of sudden cardiac death in the Framingham Heart Study population. AB - To determine if sudden cardiac death shows circadian variation, the time of day of sudden cardiac deaths in the Framingham Heart Study was analyzed. Analysis was based on mortality data collected in a standardized manner for the past 38 years for each death among the 5,209 persons in the original cohort. The necessary assumptions about the cause and timing of unwitnessed deaths were made in a manner likely to diminish the possibility of detecting an increased incidence of sudden cardiac death during the morning. In the Framingham study, analyses using these assumptions reveal a significant circadian variation (p less than 0.01) in occurrence of sudden cardiac death (n = 429), with a peak incidence from 7 to 9 AM and a decreased incidence from 9 AM to 1 PM. Risk of sudden cardiac death was at least 70% higher during the peak period than was the average risk during other times of the day. Further studies are needed to confirm this finding in other populations, to collect data regarding medications and to determine activity immediately before sudden cardiac death. Investigation of physiologic changes occurring during the period of increased incidence of sudden cardiac death may provide increased insight into its causes and suggest possible means of prevention. PMID- 3661394 TI - Success of re-use of cardiac electrode catheters. AB - The feasibility of cardiac electrode catheter re-use was prospectively evaluated over a 5-year period (1981 to 1986), during which time 178 catheters were used 1,526 times for 847 electrophysiologic procedures. Detailed records of catheter testing and use were maintained. No complications were encountered during the study period. All re-used catheters functioned for cardiac pacing and electrographic recording. Surveillance cultures and biologic indicators revealed that adequate sterilization procedures were used. Thus, electrode catheters may be safely re-used provided a thorough cleaning, testing and record-keeping system is instituted. This may result in lower patient cost (approximately $30 per re use vs [200 per single use) for electrophysiologic catheterization. PMID- 3661395 TI - Efficacy and tolerance of spironolactone in essential hypertension. AB - The long-term efficacy and tolerance of spironolactone in essential hypertension was evaluated among 20,812 patients referred to the Broussais and St. Joseph systemic hypertension clinics between 1976 and 1985 by using information prospectively collected in the computerized ARTEMIS data bank. In 182 patients (51 men, 131 women) treated with spironolactone alone during a mean follow-up period of 23 months, a mean dose of 96.5 mg decreased systolic and diastolic blood pressure (BP) by 18 and 10 mm Hg, respectively, below pretherapeutic levels. The BP decrease was greater with doses of 75 to 100 mg (12.4% and 12.2%) than with doses of 25 to 50 mg (5.3 and 6.5%, p less than 0.001), but no additional decrease was found with doses above 150 mg. Plasma creatinine level increased modestly (8.3 mumol/liters), as did plasma potassium level (0.6 mmol/liters) (both p less than 0.001); uric acid level increased, but not significantly (10.5 mumol/liter). Fasting blood glucose and total cholesterol levels did not change, triglyceride levels increased slightly (0.1 mmol/liter, p less than 0.05). These changes were similar in both sexes and were not influenced by length of follow-up. Among the 699 men prescribed spironolactone alone or in association with another antihypertensive treatment, 91 cases of gynecomastia developed (13%). Gynecomastia was reversible and dose-related; at doses of 50 mg or less the incidence was 6.9%, but 52.2% for doses of 150 mg or higher. Despite limitations inherent in the interpretation of data banks, it is concluded that spironolactone administered in daily practice reduced BP without inducing adverse metabolic adverse effects and that in patients with essential hypertension, doses should be kept below 100 mg. PMID- 3661396 TI - Effects of diltiazem alone and combined with mefruside on cardiovascular response at rest and during exercise, carbohydrate metabolism and serum lipoproteins in patients with systemic hypertension. AB - The antihypertensive effects of the calcium antagonist diltiazem, both alone and combined with the diuretic mefruside, were assessed over 14 months in 36 patients with essential hypertension. Patients received 180 or 270 mg/day; those with inadequate response were given 270 mg/day plus mefruside, 20 mg/day. Both monotherapy and combination therapy significantly reduced blood pressure (BP) at rest and during exercise. However, adding mefruside did not significantly decrease BP below that achieved with diltiazem alone. After 14 months of therapy, the percentage of responders (patients with at least 10% reduction in diastolic BP at rest) was 64% for all patients, 100% (by definition) for those receiving diltiazem alone and 47% for those receiving the combination. Diltiazem decreased heart rate by 6% (4 beats/min at rest) (p less than 0.05). Combined therapy with mefruside did not further reduce heart rate. There were few adverse effects and no undesirable metabolic effects with either monotherapy or combined therapy. Plasma renin activity, aldosterone levels, carbohydrate metabolism, serum lipoprotein levels and routine laboratory test results were unchanged in both groups at the end of the study. Thus, diltiazem is an effective antihypertensive agent and apparently the combination of diltiazem and mefruside does not potentiate the antihypertensive effect of diltiazem alone during long-term therapy. PMID- 3661397 TI - Comparison of the acute hemodynamic response to intravenous nisoldipine (Bay k 5552) and intravenous nifedipine for left ventricular dysfunction secondary to myocardial infarction. AB - Dihydropyridine calcium blocking drugs exert potentially dangerous negative inotropic action in selected patients with severe left ventricular dysfunction. In 10 patients peripheral and central hemodynamic effects of nisoldipine were intraindividually compared with nifedipine using a sequential crossover protocol. The drugs were titrated to a similar steady-state reduction of mean arterial pressure by 15 +/- 3% and 15 +/- 2% and systemic vascular resistance by 25 +/- 5% and 17 +/- 2%, respectively. The equi-effective dosage was 0.17 +/- 0.06 microgram/min/kg for nisoldipine and 0.58 +/- 0.1 microgram/min/kg for nifedipine. In contrast to nifedipine, administration of nisoldipine was associated with increases in cardiac index of 0.45 +/- 0.33 liters/min/m2 (p less than 0.05), stroke volume index of 3.91 +/- 3.0 ml/m2 (p less than 0.05) and left ventricular ejection fraction of 4.6 +/- 2.8% (p less than 0.05). Mean pulmonary capillary wedge pressure decreased with nisoldipine from 11.8 +/- 3.4 to 8.0 +/- 3.4 mm Hg (p less than 0.005) and mean pulmonary arterial pressure from 20.4 +/- 4.06 to 16.1 +/- 3.2 mm Hg (p less than 0.005); these variables were unaffected by nifedipine. Thus, intraindividual comparison revealed no cardiodepressive action of nisoldipine, whereas with nifedipine the conceptually beneficial effect of afterload reduction appears to be offset by intrinsic negative inotropic action. Due to higher vasospecificity and more effective unloading, nisoldipine appears to be superior to nifedipine in patients with left ventricular dysfunction secondary to ischemic heart disease. PMID- 3661398 TI - Effect of oral milrinone on end-systolic relations in patients with severe congestive heart failure. AB - The new inotropic agent milrinone has both vasodilator and inotropic cardiovascular effects, but the importance of these effects in patients with severe congestive heart failure (CHF) is controversial. The left ventricular (LV) end-systolic pressure-diameter relation was used to determine the independent inotropic effect of milrinone. Seven patients with New York Heart Association class III CHF were invasively monitored with right-sided heart catheters and radial arterial lines. M-mode echocardiography was used to measure LV dimensions. The effect of a 10-mg oral dose of milrinone on hemodynamic, echocardiographic and end-systolic variables was determined. End-systolic pressure was measured at the dicrotic notch of the arterial pressure tracing and end-systolic LV dimensions at the time of aortic valve closure. Methoxamine (n = 6) or nitroprusside (n = 1) was used to alter afterload so that the end-systolic pressure-diameter relation could be determined. Arterial vasodilation from milrinone was evidenced by a decrease in mean arterial blood pressure (88 +/- 5 to 77 +/- 2 mm Hg, p less than 0.025) and an increase in cardiac index (from 2.7 +/- 0.2 to 3.2 +/- 0.2 liters/min/m2, p less than 0.025), with no change in heart rate (80 +/- 5 beats/min). Milrinone decreased preload as assessed by the pulmonary artery wedge pressure (from 17 +/- 2 to 10 +/- 2 mm Hg, p less than 0.01) and end-diastolic LV diameter (from 7.4 +/- 0.4 to 7.0 +/- 0.4 cm, p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661399 TI - Technical and biologic sources of variability in the mapping of aortic, mitral and tricuspid color flow jets. AB - The quantification of valvular regurgitation by 2-dimensional Doppler imaging depends on identifying and minimizing variability. Aortic, mitral and tricuspid regurgitant jet areas were measured in 50 patients with sinus rhythm or atrial fibrillation to analyze the variables of reading error, valve site, jet size, rhythm and frame rate. One technician recorded jet velocities at 1 frame/cycle at a triggered interval after the electrocardiographic R wave and at frame rates of 7.5 and 15 frames/s. Jet areas from 5 consecutive beats were measured by planimetry by 1 observer. Coefficients of variation between and among groups were compared by analysis of variance; mean values were 14 to 22%. Jets grouped less than 2.5, 2.5 to 5 and greater than 5 cm2 showed the variance of small jets exceeding that of medium and large jets. Aortic regurgitant jets were largest and had smaller variance than mitral tricuspid jets. Variability due to atrial fibrillation and the slower frame rate was marginal. Intraobserver error was 4.3% and interobserver 15.4%. Thus, reproducing jet areas carries a minimum variability of 15% or higher, depending on jet size. Valve site could not be excluded as a separate variable. Comparative quantification is best limited to 1 observer. PMID- 3661400 TI - Correlation of continuous-wave Doppler assessment of chronic aortic regurgitation with hemodynamics and angiography. AB - Fifteen patients with chronic aortic regurgitation (AR) were studied by cardiac catheterization and continuous-wave (CW) Doppler echocardiography. The slope of the AR CW Doppler signal was higher in patients with severe AR (5.7 +/- 2.1 m/s2) than in those with moderate (2.5 +/- 1.3 m/s2) or mild (1.8 +/- 0.7 m/s2) AR (p less than 0.05). The slopes in patients with mild (less than or equal to 18 mm Hg), moderate (19 to 24 mm Hg) and severe (greater than 24 mm Hg) elevation of left ventricular end-diastolic pressure were significantly different (1.9 +/- 0.6, 3.3 +/- 1.2 and 7.1 +/- 0.4 m/s2, respectively, p less than 0.05). Patients with severe AR had shorter pressure half-times than those with mild AR (283 +/- 141 vs 820 +/- 393 ms, p less than 0.05). There was a significant correlation between the slope and left ventricular end-diastolic pressure (r = 0.80, p less than 0.001) and a weaker inverse correlation between pressure half-time and left ventricular end-diastolic pressure (r = -0.59, p less than 0.05). The end diastolic pressure gradient estimated from CW Doppler using a simplified Bernoulli equation correlated poorly with the catheter measured gradient (r = 0.59, p less than 0.02). The slope of the CW Doppler signal is a better predictor of severity than pressure half-time and is affected by left ventricular end diastolic pressure in addition to angiographic severity of AR. PMID- 3661401 TI - Limited value of balloon dilatation in calcified aortic stenosis in adults: direct observations during open heart surgery. AB - Percutaneous balloon dilatation was recently recommended as a treatment for management of calcified aortic valvular stenosis. This procedure was initially reserved for patients who were not considered surgical candidates; it is now regarded by some as an acceptable alternative for valve replacement. To investigate the validity of this postulate, balloon valvuloplasty was performed under direct vision in the operating room in 16 patients just before excision and replacement of their ossified aortic valve. Changes after valvuloplasty were evaluated by inspection as well as by geometric measurements. The authors found that balloon valvuloplasty did not make a detectable impact on valvular anatomy in about two-thirds of the patients and induced enlargement of the functional aortic orifice judged as "minimal" or "moderate" in one-third of the cases. In no patient was there significant increase in the functional orifice size. Other investigators have shown that hemodynamic and clinical improvement may be induced in some patients by small increases in the aortic orifice; based on the observations herein, such an improvement, if it occurs at all, would be short lasting; the procedure should be offered only to those who present truly prohibitive risk by standards of modern surgery. PMID- 3661402 TI - Calcific valvular aortic stenosis with and without mitral anular calcium. AB - Seventy-six consecutive patients, mean age 66 +/- 9 years (+/- standard deviation), with isolated aortic valve replacement for calcific valvular aortic stenosis (AS) were studied. Mitral anular calcium (MAC) was detected by echocardiography in 45 patients (59%). Patients with MAC were older (p less than 0.01), had greater peak systolic aortic valve gradients (p less than 0.025), lower cardiac indexes (p less than 0.025) and smaller valve areas (p less than 0.05) than patients without MAC. Thirty-three percent of patients (15 of 45) with MAC required permanent pacemaker implantation after aortic valve replacement, compared with only 10% of patients (3 of 31) without MAC (p less than 0.025). During the follow-up of 7 years (mean 3.8 +/- 1.6), 27% of patients (12 of 45) with MAC died from cardiac causes, compared to only 7% (2 of 31) without MAC (p less than 0.025). Thus, patients with AS and MAC are older, have more severe AS, more frequently undergo permanent pacemaker implantation after aortic valve replacement and more frequently die of cardiac causes than patients with AS and no MAC during follow-up. PMID- 3661403 TI - Longitudinal changes in left ventricular architecture and function in peripartum cardiomyopathy. AB - Left ventricular (LV) function was quantitated in 14 patients with peripartum cardiomyopathy, in 10 using 2-dimensional (2-D) echocardiography and in 4 radionuclide ventriculography, and values were compared with those in 11 normal women in the immediate postpartum period. LV end-diastolic and end-systolic volume indexes, LV wall mass index and ejection fraction were calculated during the acute phase of the illness and serially through long-term follow-up (mean 24 months). During the acute phase of illness there was marked LV dilatation: mean end-diastolic volume index was 95 +/- 22 ml/m2, vs 67 +/- 9 ml/m2 in control subjects (p less than 0.005), and mean end-systolic volume index was 66 +/- 18 ml/m2, compared to 27 +/- 5 ml/m2 in control subjects (p less than 0.001). Mean heart rates and mean systolic pressures in the patients with peripartum cardiomyopathy and the control subjects were similar, 91 +/- 24 vs 79 +/- 14 beats/min and 120 +/- 14 vs 117 +/- 10 mm Hg, respectively. LV wall mass index was higher, 139 +/- 38 vs 96 +/- 8 g/m2 (p less than 0.005), and ejection fraction much lower, 29 +/- 5% vs 67 +/- 5% (p less than 0.001), in control subjects. Five patients underwent endomyocardial biopsy during the acute illness, which showed interstitial fibrosis but no evidence of active inflammation. There was rapid and early improvement in LV function in 13 of 14 patients. Changes in LV volume, mass and ejection fraction all followed an exponential time course during LV remodeling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661404 TI - Frequency and significance of mitral anular calcium in hypertrophic cardiomyopathy: analysis of 200 necropsy patients. AB - To determine the frequency and significance of mitral anular calcium (MAC) in hypertrophic cardiomyopathy (HC), 43 clinical and morphologic variables in 200 necropsy cases of HC were examined. Of 100 patients less than 40 years of age, none had MAC. Of the 100 necropsy patients greater than 40 years, 30 (30%) had MAC, 21 (70%) of whom were women. The mean age of the 30 MAC patients was older than that of the 70 non-MAC patients greater than 40 years of age (66 years vs 53 years). The frequency of MAC increased with age. MAC was present in 3 of 31 patients (10%) aged 41 to 50 years; in 6 of 34 patients (18%) aged 51 to 60 years; in 11 of 21 patients (52%) aged 61 to 70 years; and in 10 of 14 patients (71%) aged 71 to 90 years. Compared with the 70 patients greater than 40 years of age without MAC, the 30 patients greater than 40 years of age with MAC had higher average systemic arterial peak systolic pressure (133 mm Hg vs 113 mm Hg); a larger percentage of the MAC patients had calcific deposits in the epicardial coronary arteries (93% vs 41%) and in the aortic valve cusps (33% vs 6%); and a larger percentage of the MAC patients had severe narrowing by atherosclerotic plaques of 1 or more of the 4 major epicardial coronary arteries (47% vs 24%). The frequency of a history of systemic hypertension, diabetes mellitus and total serum cholesterol levels greater than 200 mg/dl in the patients with and without MAC was similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661405 TI - Long-term follow-up after aortic valvuloplasty and defect closure in ventricular septal defect with aortic regurgitation. AB - The clinical course was studied in 25 patients with ventricular septal defect (VSD) and aortic regurgitation (AR) who had undergone aortic valvuloplasty and VSD closure. Twelve patients had a doubly committed subarterial VSD and 13 had a perimembranous type of VSD. Preoperatively, progressive hemodynamic disturbance after the onset of AR occurred in 11 patients (44%). The follow-up period extended from 6 months to 23 years (mean 10 years). Four patients required prosthetic valve replacement after valvuloplasty. One of these had had initial improvement of the AR but required valve replacement 20 years later; the condition of the other 3 did not improve initially and their valves were replaced 1 month to 8.5 years later. Four other patients had no initial improvement as a result of valvular reconstructive surgery, but the AR did not progress and remained hemodynamically well tolerated. Hence, the overall success rate of the valvuloplasty, defined as improving or preventing progressive AR, was 21 of 25 (84%). Since initial and long-term improvement in aortic valve function can be expected in most patients after valvuloplasty and closure of the VSD, early surgical intervention is recommended in patients with a VSD and AR. PMID- 3661406 TI - Comparison of amplitude-modulated (direct) and frequency-modulated ambulatory techniques for recording ischemic electrocardiographic changes. AB - Continuous ambulatory electrocardiographic monitoring of ST-segment configuration has become a useful technique for evaluation of myocardial ischemia. Concern that direct or amplitude-modulated (AM) recording and playback systems have inherent limitations that cause inaccurate ST-segment recordings has led to preference for frequency-modulated (FM) devices. To determine the accuracy of AM and FM ambulatory electrocardiographic systems, the signal was compared from the same set of 2 bipolar leads simultaneously recorded by standard electrocardiography and AM and FM recorders in 14 patients during treadmill exercise. Also, simultaneous AM and FM recorders were compared in 9 ambulatory patients in 16 monitoring sessions. The AM recording system accurately reproduced ST segments recorded during treadmill exercise (range 4.0 mm of ST-segment depression to 2.0 mm of ST elevation) when measured at the J point (r = 0.91, p less than 0.0001), and 0.08 second after the J point (r = 0.95, p less than 0.0001). FM recording was equally accurate (r = 0.89 and 0.95, respectively, p less than 0.0001). Similarly, during ambulatory recording, the AM technique accurately recorded maximal ST depression in each episode as recorded by the FM device (28 episodes, range 0 to 3 mm of ST depression, r = 0.85, p less than 0.0001). Both AM and FM ambulatory electrocardiographic systems can accurately reproduce ST-segment deviation associated with ischemia and can be used to monitor transient ST segment changes in patients with coronary artery disease. PMID- 3661407 TI - The struggle for acceptance of mitral valve reconstruction. PMID- 3661408 TI - Usefulness of atrial fibrillation as a predictor of stroke after isolated coronary artery bypass grafting. PMID- 3661409 TI - Leaflet to left ventricular size disproportion and prolapse of a structurally normal mitral valve in anorexia nervosa. PMID- 3661410 TI - Late embolic phenomena associated with cloth-covered Star-Edwards aortic valve prostheses. PMID- 3661411 TI - Identification of textural differences of the mitral leaflets in subsets of patients with mitral valve prolapse. PMID- 3661412 TI - Emergency reoperation for primary tissue failure of porcine bioprostheses. PMID- 3661413 TI - Cross-sectional and pulsed Doppler echocardiographic features of anomalous origin of right pulmonary artery from the ascending aorta. PMID- 3661414 TI - Patent ductus arteriosus associated with rheumatic mitral regurgitation in the adult. PMID- 3661415 TI - Rest and exercise left ventricular ejection fraction before and after therapy in young adults with hyperthyroidism and hypothyroidism. PMID- 3661416 TI - Hydatid cyst of the right atrium diagnosed by echocardiography. PMID- 3661417 TI - Effect of diltiazem overdose. PMID- 3661418 TI - Low-frequency requirements for electrocardiographic recording of ST segments. PMID- 3661419 TI - Effects of amrinone. PMID- 3661420 TI - Exercise ventricular function in mitral valve prolapse. PMID- 3661421 TI - Neonatal hypothyroidism after treatment by amiodarone during pregnancy. PMID- 3661423 TI - Grading of pulmonary hypertension. PMID- 3661422 TI - AICD detection failure: perspectives of the detective. PMID- 3661424 TI - CASS and RA. PMID- 3661425 TI - Postexercise hypotension in apparently healthy subjects. PMID- 3661426 TI - Combination of mechanical and bioprosthetic valves in aortic and mitral valve replacement. PMID- 3661427 TI - Considerations of current methods for drug selection in treating malignant ventricular arrhythmias. AB - The current burgeoning interest in antiarrhythmic drugs derives in large measure from a growing concern with the enormous problem of sudden cardiac death. Until the latter half of the twentieth century, beyond a nodding acknowledgment of its massive prevalence, this syndrome received but scant attention from the medical profession. In the early 1960s a number of insights changed perceptions as well as practice. These related to 4 postulates: (1) sudden cardiac death, in the majority of victims, was due to ventricular tachyarrhythmias either initiated by or culminating rapidly in ventricular fibrillation; (2) the lethal arrhythmia was not the consequence of irreversible pathomorphologic impairment of the contractile apparatus, but rather the expression of an electrophysiologic derangement; (3) the triggering of ventricular fibrillation was the result of an electrical accident both reversible as well as preventable; (4) the potential victim was identifiable either by the presence of certain grades of ventricular ectopic activity or by exposure of repetitive ectopic activity or by exposure of repetitive ventricular arrhythmias by electrophysiologic techniques. The innovations that have led to these insights and their consequences have been numerous and continuous. Among these are direct current defibrillation, cardioversion, coronary care units, bystander-initiated cardiopulmonary resuscitation, ambulatory electrocardiographic monitoring and exercise stress testing for exposing ventricular arrhythmias, electrophysiologic provocative testing and mapping techniques, overdrive programmable pacemakers as well as implantable defibrillators and cardioverters, and surgical, electrical and laser techniques for ablating the nidus or interrupting the pathways of the arrhythmias. PMID- 3661428 TI - Abstracts. American Academy of Pediatrics, Section on Cardiology, 29th annual meeting, New Orleans, Louisiana, October 30-November 1, 1987. PMID- 3661429 TI - Combined hemodynamic and scintigraphic assessment of piroximone (MDL 19,205) and comparison with dobutamine and nitroprusside. AB - The acute hemodynamic responses to intravenous infusion of piroximone (MDL 19,205), a nonglycoside, noncatecholamine agent with positive inotropic activity in vitro, were compared with those of intravenous dobutamine and sodium nitroprusside, respectively, in 2 groups of patients with New York Heart Association class III or IV symptoms. Each drug was titrated to optimal dosage (dobutamine, 12.5 +/- 3.9 micrograms/kg/min; nitroprusside, 2.5 +/- 0.6 micrograms/kg/min; piroximone 1.4 +/- 0.6 mg/kg) and simultaneous hemodynamic and scintigraphic values were measured. In group 1, the increase in cardiac index was slightly greater with piroximone than with dobutamine (from 1.6 +/- 0.5 to 2.7 +/ 0.6 vs 2.4 +/- 0.6 liters/min/m2, p less than 0.025) and only piroximone significantly decreased left ventricular (LV) filling pressure (from 29 +/- 7 to 22 +/- 8 mm Hg, p less than 0.05). Both agents increased heart rate and systolic blood pressure. In group 2, cardiac index increased similarly with nitroprusside and piroximone (1.5 +/- 0.6 to 2.6 +/- 0.8 and 1.6 +/- 0.5 to 2.6 +/- 0.5 liters/min/m2, difference not significant), whereas LV filling pressure decreased slightly less with piroximone (29 +/- 7 to 24 +/- 10 vs 30 +/- 7 to 20 +/- 11 mm Hg, difference not significant). Only nitroprusside reduced mean arterial pressure (88 +/- 13 to 72 +/- 12 mm Hg, p less than 0.001 between drugs). In group 1, systolic blood pressure to end-systolic volume ratio increased in 9 of 10 patients taking both piroximone and dobutamine, whereas in group 2, this ratio increased in 7 of 8 patients taking piroximone and declined in 7 of 8 taking nitroprusside.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661430 TI - Effects of afterload reduction (diuretics and vasodilators) on left ventricular volume and mitral regurgitation in severe congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. AB - The mechanism by which afterload reduction increases left ventricular stroke volume while decreasing left ventricular filling pressure has not previously been established. In 15 patients with severe congestive heart failure due to ischemic or idiopathic dilated cardiomyopathy, absolute ventricular volume, ejection fraction and total stroke volume from radionuclide ventriculography were compared with thermodilution stroke volume before and after intensive afterload reduction with vasodilators and diuretics titrated to hemodynamic goals. After 48 to 72 hours, pulmonary artery wedge pressure decreased from 32 +/- 8 to 16 +/- 4 mm Hg and systemic vascular resistance from 1,960 +/- 700 to 1,200 +/- 400 dynes s cm 5. End-diastolic volume decreased from 390 +/- 138 to 301 +/- 126 ml (p less than 0.01) and end-systolic volume from 316 +/- 127 to 241 +/- 111 (p less than 0.01). Ejection fraction did not change and total stroke volume decreased from 74 +/- 22 to 59 +/- 20 ml (p less than 0.01). Simultaneous forward stroke volume by thermodilution increased from 37 +/- 14 to 52 +/- 14 ml (p less than 0.01), and forward fraction increased from 0.55 +/- 0.40 to 0.96 +/- 0.42. Intensive reduction of ventricular filling pressure and systemic vascular resistance decreased total ventricular stroke volume by 20% but increased forward stroke volume by 40%. The major effect of intensive afterload reduction for severe congestive heart failure may be the reduction of ventricular volume and mitral regurgitation. PMID- 3661431 TI - Comparison of hemodynamic results of anterograde versus retrograde percutaneous balloon aortic valvuloplasty. AB - Percutaneous balloon aortic valvuloplasty (PAV) has been reported in children and in selected adults with aortic stenosis using retrograde arterial catheterization. Some patients, however, cannot undergo retrograde catheterization because of atherosclerotic disease, previous vascular surgery or the presence of vessel tortuosity. Because PAV requires the use of large balloon dilating catheters, extreme bleeding and local arterial damage are potential complications. The results of PAV using the anterograde transseptal approach were compared with those using the retrograde arterial approach. Diminution in aortic gradient and increase in aortic valve area were similar in the 2 groups. Vascular complications were more common using the retrograde approach (4 vs 0). Thus, PAV can be performed successfully using anterograde transseptal catheterization. This technique of PAV could be particularly useful in patients who cannot undergo retrograde arterial catheterization. PMID- 3661433 TI - Spontaneous closure of uncomplicated ventricular septal defect. AB - The charts of 222 patients with a diagnosis of ventricular septal defect (VSD) were reviewed to determine the overall incidence, the prevalence of membranous and muscular defects and the rates of spontaneous VSD closure. VSD diagnosis and location were determined primarily from reports of 2-dimensional and pulsed Doppler echocardiograms. In a 5-year period, VSDs occurred in 3.85/1,000 live full-term births and 7.06/1,000 live premature births. The VSD closed spontaneously in 20 of 44 patients (45%) followed from birth (University Hospital group) during a mean follow-up of 12 months. Of 165 patients not followed from birth (referred group), the VSD closed spontaneously in 37 (22%). Overall, VSD location was determined in 101 of 209 patients (48%) and was distributed as follows: membranous 66 (65%), muscular 32 (32%) and subpulmonic 3 (3%). Rates of spontaneous closure for membranous and muscular VSDs were 37% and 50%, respectively, for the University Hospital group and 9% and 9%, respectively, for the referred group (no significant difference in either case). Surgical closure was required in 30 of 165 referred patients (18%) and only 1 of 44 University Hospital patients (2%). There was no significant difference in rate of closure for premature vs full-term infants or small vs larger defects. Data for patients followed from birth more likely reflect the true natural history of VSD. PMID- 3661432 TI - Mechanism of isoproterenol-induced angina pectoris in patients with obstructive hypertrophic cardiomyopathy and normal coronary arteries. AB - In 14 patients with obstructive hypertrophic cardiomyopathy and angiographically normal coronary arteries, 8 with angina (group B) and 6 without (group A), the effects of intravenous isoproterenol, 2 to 4 micrograms/min, followed by intravenous propranolol, 0.2 mg/kg, were studied. An intraventricular systolic gradient less than 50 mm Hg, high-quality echocardiograms and cineangiograms and high-fidelity pressure tracings were selection criteria. Hemodynamic and metabolic variables were assessed during basal conditions, after 5 minutes of isoproterenol infusion or at angina and ST-segment depression, and 5 and 10 minutes after intravenous propranolol infusion. Isoproterenol increased the intraventricular systolic gradient more significantly in group B than in group A (102.4 +/- 8.3 vs 52.2 +/- 8.2, p less than 0.0001). Group B also had higher left ventricular end-diastolic pressure (32.5 +/- 3.9 vs 20.2 +/- 5.7), lower mean arterial pressure (69.7 +/- 3.5 vs 84.7 +/- 4.8) and a smaller increase in coronary sinus flow (176.1 +/- 9.2 vs 261.5 +/- 33.9, all p less than 0.0001), concomitant with lactate release and ST-segment depression. Propranolol promptly reversed hemodynamic and metabolic changes caused by isoproterenol, except for a further coronary sinus flow increase (from 176.1 +/- 9.2 to 219 +/- 14.2 ml/min, p less than 0.001), and heart rate decrease below basal values (57.8 +/- 7.5 vs 79.9 +/- 9.8 beats/min, p less than 0.001) in group B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661434 TI - Acute complications of catheter therapy for congenital heart disease. AB - Although therapeutic catheter procedures for congenital heart disease are still developing, the number of procedures being performed allows statistically relevant review of the acute complications. Between January 1, 1984, and February 1, 1987, 417 such procedures were performed at The Children's Hospital, Boston; the age range of the patients was 1 day to 51 years (median 4 years, 6 months). Catheter procedures consisted predominantly of vascular dilations (peripheral pulmonic stenosis, 97; valvular pulmonic stenosis, 67; valvular aortic stenosis, 62; recurrent coarctation, 49) and embolizations (double umbrella device, 36; steel coils, 45). Overall, there were 50 acute complications (12%); 24 (6%) were major and 26 (6%) were minor. The mortality rate was 3 of 417 (0.7%). Complication rates varied between 4% for dilation of recurrent coarctation and 40% for dilation of aortic stenosis. The age of the patients was a factor in complications of vascular access (11 patients), 8 of which occurred in patients younger than 6 months (median 5), and in cardiac arrest and ventricular fibrillation (4 patients, 3 of whom were younger than 6 months [median 3]). No statistically significant trend toward diminishing overall complication rates was discerned over the 37 months of this study. PMID- 3661435 TI - Nonutility of cineurograms in children with congenital heart disease. AB - Cineurography is often performed after cineangiocardiography to look for occult congenital urinary tract disease. The accuracy of cineurography was investigated in 171 patients by comparing cineurograms with renal sonograms. One hundred fifteen cineurograms (67%) showed both kidneys well enough to allow assessment of renal structure and function and the results were confirmed in 112 by ultrasonography; 3 cineurograms yielded false-positive results. Limited or no information was obtained from cineurograms of 56 patients (33%) because of nonvisualization or poor visualization of 1 or both kidneys. Of the 11 patients (6%) with urinary tract disease, only 3 were correctly assessed by cineurography. Ultrasonography discovered all 11 renal abnormalities and produced only 1 false positive result. These data indicate that cineurography is a poor screening test and should be abandoned. When uroradiologic screening is necessary for high-risk patients, sonography is recommended. PMID- 3661436 TI - Detection of caval obstruction by magnetic resonance imaging after intraatrial repair of transposition of the great arteries. AB - Vena caval obstruction may cause significant morbidity after intraatrial repair of transposition of the great arteries (TGA). Two noninvasive methods of diagnosing vena caval obstruction were compared with cardiac catheterization. Echocardiographically gated magnetic resonance imaging (MRI) and echocardiographic evaluation (2-dimensional saline contrast echocardiography and pulsed Doppler flow measurement) were performed on 15 patients 0.7 to 13.5 years after intraatrial repair of TGA (8 Mustard, 7 Senning). At catheterization, complete superior vena cava or partial caval obstruction (gradient greater than 5 mm Hg from cava to systemic venous atrium) was present in 7 of 15 patients. Superior vena cava obstruction was directly visualized by MRI in both patients with catheterization-proved complete superior vena cava occlusion. A dilated azygous/hemiazygous venous complex (greater than or equal to 5 mm cross-sectional diameter) was seen by MRI in 5 of 7 patients with complex or partial vena caval obstruction and in no patient without vena caval obstruction. MRI showed superior vena caval dilatation (ratio of superior vena caval diameter to aortic diameter greater than 1.45) in 3 of 5 patients with partial vena caval obstruction and in 0 of 8 without vena caval obstruction. Direct visualization of narrowing within the atrium was unreliable for any MRI plane because of the 3-dimensional nature of the intraatrial baffle. Two-dimensional saline contrast echocardiography, successfully performed in 12 of 15 patients, detected complete superior vena caval obstruction only in the 2 patients with catheterization-proved complete superior vena cava occlusion. Contrast echocardiography failed to identify any of the 5 patients with partial vena caval obstruction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661437 TI - Electrophysiologic effects of intravenous verapamil in children after operations for congenital heart disease. AB - To assess the effect of verapamil in children with congenital heart disease after surgical correction, an electrophysiologic study was undertaken in 19 patients, 0.8 to 15 years old. Atrial pacing and programmed atrial extrastimulation were performed before and 5 mn after intravenous administration of verapamil. A significant increase in conduction time and refractory periods was observed at the atrioventricular node level. Dual or accessory atrioventricular pathways, present in 14 cases, appear to have been suppressed in 9. The effect on the sinus node was of particular interest: The corrected sinus node recovery time was strongly prolonged by verapamil in 6 patients, 5 of whom had undergone surgery with extensive atrial reconstruction (Senning 2, anomalous pulmonary venous return 3) and 1 of whom had undergone correction of tetralogy of Fallot. Additional effects of verapamil were the disappearance of a sinus node entrance block in 8 patients and emergence of an ectopic pacemaker in 6. Although verapamil has electrophysiologic properties that should make it a useful drug in the treatment of reentry tachycardia, caution is indicated after extensive atrial surgery because sinus node depression may occur. PMID- 3661438 TI - Comparison in young and elderly patients of pharmacodynamics and disposition of labetalol in systemic hypertension. AB - Pharmacodynamics and pharmacokinetics of labetalol, a combined alpha- and beta adrenoceptor antagonist drug, were studied in elderly and young hypertensive patients. After receiving intravenous labetalol, elderly patients had a greater maximal mean decrease in systolic blood pressure (BP) (39 +/- 8 vs 25 +/- 13 mm Hg, p less than 0.02); however, maximal decrease in diastolic BP was similar in elderly (18 +/- 10 mm Hg) and young (17 +/- 6 mm Hg) patients. After receiving oral labetalol, elderly patients had a greater maximal decrease in standing systolic BP (41 +/- 16 vs 16 +/- 14 mm Hg, p less than 0.001) and similar decreases in standing diastolic BP (21 +/- 7 vs 17 +/- 9 mm Hg). Sitting maximal BP decreases after oral labetalol treatment were similar in elderly and young patients (12 +/- 16 vs 17 +/- 7 mm Hg systolic and 24 +/- 6 vs 12 +/- 7 diastolic). The decrease in heart rate was greater in young patients after intravenous labetalol administration. To evaluate labetalol pharmacodynamics, a linear model was used. Slope of labetalol concentration vs systolic BP for elderly vs young patients was 0.928 +/- 1.05 vs 0.326 +/- 0.490 ng/ml X mm Hg-1 (difference not significant). The slope of labetalol concentration vs heart rate for elderly vs young patients was 0.176 +/- 0.063 vs 0.406 +/- 0.303 ng/ml X beats/min-1 (p less than 0.05), with 2 elderly patients showing no decrease in heart rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661439 TI - Monotherapy with the calcium channel antagonist nisoldipine for systemic hypertension and comparison with diuretic drugs. AB - A comparative, double-blind, placebo-controlled, double-dummy, randomized, crossover trial was performed in 32 hypertensive patients (initial blood pressure [BP] 165/105 +/- 3/2 mm Hg), most of them obese women, to evaluate the antihypertensive efficacy and tolerability of the new calcium channel blocking drug nisoldipine, 10 mg once or twice daily, over 6 weeks compared with the diuretic hydrochlorothiazide-amiloride (hydrochlorothiazide, 25 mg, in combination with amiloride, 2.5 mg once or twice daily). Adequate 24-hour control of BP (supine diastolic BP less than 90 mm Hg) was achieved in 15 of 32 patients (47%) with monotherapy by 1 agent and in 23 of 32 patients (72%) when including those who responded to either agent. Both nisoldipine and the diuretic had a flat dose-response curve. The larger dose of diuretic yielded lower systolic and exercise BP values (erect and supine) than high-dose nisoldipine (p less than 0.05), with less headache (p less than 0.05). In the other 9 patients who did not respond, the combination of nisoldipine 10 mg plus hydrochlorothiazide (25 mg) amiloride (2.5 mg) was administered and yielded a response in 8 patients (overall response including monotherapy 96%). Ten patients were given nisoldipine for an additional period of 6 months, and they required an average dose of 33 mg/day for BP control. In both the 6-week and 6-month studies, nisoldipine monotherapy caused frequent subjective adverse effects. In contrast, in the 6-week study the combination of low-dose nisoldipine and low-dose diuretic gave good BP control with no adverse effects. PMID- 3661440 TI - Cellular telephone transmission of 12-lead electrocardiograms from ambulance to hospital. AB - Currently, only single-lead, serial telemetry rhythm strips can be transmitted from ambulances. Triage of patients with chest pain and administration of thrombolytic therapy in ambulances is limited by the lack of specific electrocardiographic (ECG) diagnosis. A new technique is described using cellular telephone transmission of simultaneous 12-lead ECGs from ambulance to hospital to overcome this limitation. A portable 12-lead ECG installed in an ambulance was connected via modern link to a cellular telephone and digitized ECG information was transmitted to an ECG device in the hospital emergency room. Paramedics in the field placed adhesive patch electrodes and attached ECG wires. Field ECGs from 23 patients were compared with corresponding transmitted ECGs. There were no differences in heart rate, PR interval, QRS duration, QT interval or R- and T wave axes. Baseline and transmitted ECGs had identical morphologic characteristics. Differences in R-wave amplitude in 5 transmitted tracings compared with hospital-recorded ECGs resulted in computer diagnosis of left ventricular hypertrophy by voltage, possibly due to differences in patient position. Twelve-lead ECGs can be easily transmitted from a moving ambulance using cellular telephones. This allows diagnosis before hospital arrival, improves prehospital triage of patients and may facilitate prehospital therapy with lidocaine or streptokinase. In addition, the cellular telephone link can convey both verbal and digitized information and thus improve on current telemetry systems. PMID- 3661441 TI - Possible link between acute myocardial infarction-related coronary artery narrowing and presence of a previous coronary event. PMID- 3661442 TI - Fatal rupture of both left ventricular free wall and ventricular septum (double rupture) during acute myocardial infarction: analysis of seven patients studied at necropsy. PMID- 3661443 TI - Value of indium-111 monoclonal antimyosin antibody for imaging in acute myocardial infarction. PMID- 3661444 TI - Early precordial ST-segment depression due to isolated acute right or left circumflex coronary artery occlusion. PMID- 3661445 TI - Dissolution of angiographically detected intracoronary thrombus for unstable angina pectoris after aspirin therapy. PMID- 3661446 TI - Headache angina. PMID- 3661447 TI - Early experiences with the portable automatic external defibrillator in the home and public places. PMID- 3661448 TI - Fatal aortic rupture during percutaneous balloon valvuloplasty for valvular aortic stenosis. PMID- 3661449 TI - Balloon percutaneous valvuloplasty for stenotic bioprosthetic valves in the mitral position. PMID- 3661450 TI - Value of programmed electrical stimulation using a standardized ventricular stimulation protocol in hypertrophic cardiomyopathy. PMID- 3661451 TI - Usefulness of computed tomography in preoperative assessment of resternotomy after ascending aortic aneurysm resection or after cardiac ventricle to pulmonary conduit insertion. PMID- 3661452 TI - Number of cardiac cycles required to accurately determine mean velocity of blood flow in the ascending aorta and pulmonary trunk. PMID- 3661453 TI - A symposium: Hypertension--the preventable cardiovascular risk factor. June 23 27, 1986, Jakarta, Indonesia, and November 22-25, Seoul, Korea. Proceedings. PMID- 3661454 TI - Effects of antihypertensive drugs on plasma lipids. AB - Among the risk factors associated with atherosclerotic coronary artery diseases, systemic hypertension and disorders of plasma lipoproteins and apoproteins are very important. Blood lipid changes have been reported with a number of antihypertensive drugs and may conceivably reduce the coronary artery disease protective benefits of blood pressure reduction. The prevalence of various types of hyperlipoproteinemia among Japanese is discussed, with special reference to the frequency of atherosclerotic vascular diseases. Data concerning the effects of commonly prescribed antihypertensive drugs on blood lipids and apolipoproteins are reported. PMID- 3661456 TI - Luteal morphology, atresia, and plasma progesterone concentrations during the reproductive cycle of two oviparous lizards, Crotaphytus collaris and Eumeces obsoletus. AB - From ovulation to oviposition, the corpora lutea of the oviparous lizards Crotaphytus collaris and Eumeces obsoletus exhibit three stages of luteal development: 1) luteogenesis, 2) luteal maturity, and 3) luteal regression. Each stage exhibits distinct characteristics, involving changes in: 1) luteal volume, 2) nuclear diameter of cells within the luteal cell mass, and 3) thecal development. Plasma progesterone concentration is greatest during luteogenesis and is positively correlated with ovarian atresia, although atresia occurred throughout the period of gravidity. These data suggest that in these two species, the corpora lutea secrete high amounts of progesterone immediately following ovulation and exhibit morphologically distinct stages of growth and regression. PMID- 3661455 TI - Estrogen-induced tumors: changes in the vasculature in two strains of rat. AB - The influence of estrogen on the vasculature of the pars distalis has been studied in two strains of rat that differ in estrogen responsiveness. (Fischer 344 rats are highly estrogen-responsive in comparison to Sprague-Dawley rats.) Ovariectomized adults were implanted with silastic capsules containing 17 beta estradiol benzoate. Control and experimental animals were sacrificed 10 and 20 days after implantation of the silastic capsules. Pituitary weights and plasma prolactin were elevated dramatically in estrogen-treated Fischer rats in comparison to more moderate increases in Sprague-Dawley rats. Although both strains exhibited the hypertrophy of mammotrophs expected after estrogen stimulation, the vasculature in Fischer rats were dramatically altered from normal. The pars distalis of the 20-day, estrogen-treated Fischer rats contained well-formed arteries. In addition, capillaries frequently were disrupted, contributing to the formation of hemorrhagic lakes unlined by an endothelium. Even in intact capillaries, basal laminae delimiting the pericapillary spaces often were disrupted or absent. Perivascular connective tissue cells were prominent within the perivascular spaces and often contained numerous, large lysosomal dense bodies as well as clusters of small dumbbell-shaped bodies. These granule clusters also were apparent adjacent to the perivascular space within parenchymal cells, most frequently within follicular cells. The vasculature of Sprague-Dawley rats maintained a more normal appearance after estrogen treatment, although perivascular connective tissue cells did appear activated and basal laminae delimiting the pericapillary spaces were disrupted occasionally. However, no capillaries were disrupted, nor were any hemorrhagic lakes evident, and no arteries were present.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661457 TI - Effects of estradiol and progesterone on accumulation of relaxin- and carbohydrate-containing granules in endometrial gland cells of the guinea pig. AB - Guinea pigs were spayed and given various regimens of injections of estradiol and progesterone. The following were monitored in each animal: pubic separation (relaxin stimulation), resorption of the vaginal membrane (estrogen priming), and the presence of PAS-positive granules and/or relaxin in endometrial gland cells (EGC). Injections of estradiol alone resulted in resorption of the vaginal membrane, accumulation of PAS-positive granules in EGC of all animals, and accumulation of relaxin in EGC of two of four animals; but they did not cause pubic separation. Progesterone injections did not result in resorption of the vaginal membrane, separation of pubes, or accumulation of PAS-positive granules; however, one of three animals demonstrated a few EGC that contained relaxin. Animals that received both estradiol and progesterone exhibited PAS-positive granules and relaxin in EGC as well as separated pubes, but did not have resorbed vaginal membranes. Upon examination with the electron microscope, EGC from animals that received estradiol alone exhibited remarkable numbers of secretory granules that contained a carbohydrate-rich material. Secretory granules were not prominent in EGC from animals that received progesterone alone. Estradiol and progesterone injections resulted in accumulation of secretory granules in EGC that contained relaxin and a carbohydrate-rich material. The observations that estradiol and progesterone induce relaxin production in EGC support the hypothesis that uterine relaxin plays an important role in pregnancy and/or parturition in the guinea pig. PMID- 3661458 TI - Histological, histochemical, and fine structural observations on the spleen of seals. AB - Spleens of three species of Antarctic seals with different diving habits (Weddell seal, crabeater seal, and fur seal) have been studied with histological, histochemical, and electron microscopic methods. The spleens can be classified as nonsinusoidal, with capsule and trabeculae rich in innervated smooth muscle cells. The trabecular system is particularly well developed in the deep- and long diving Weddell seal. As in other mammals the pulp can be divided into white and red pulp. In the white pulp, periarteriolar lymphatic sheaths and secondary lymphatic nodules occur; both are surrounded by a marginal zone rich in macrophages and eosinophils. The nodules can be observed frequently, which is in accordance with abundance of plasma cells in the red pulp. Well-developed white pulp and numerous plasma cells and eosinophils obviously reflect a high load of nematodes, which have mainly been found in lung and stomach. Additionally, in the red pulp morphological evidence for the following functions has been found: destruction of erythrocytes, erythropoiesis, and thrombopoiesis. In respect to blood flow through the red pulp, we interpret our observations in the following way: terminal branches of arterioles open into the space between the fibroblastic reticulum cells; blood draining from here is collected into pulp veins, which are mainly found near the trabeculae. Thus, the seals have an open vascular compartment in their spleens, as also occurs in the cat. The red pulp is innervated by numerous nerve fibers that seem to include both cholinergic and adrenergic ones. The target cells of these fibers seem to be the fibroblastic reticulum cells, whose state of contraction may influence the direction of blood flow through the red pulp. PMID- 3661459 TI - Ultrastructure of complex carbohydrates of rodent and monkey ependymal glycocalyx and meninges. AB - The surfaces of the brain offer metabolic and mechanical support to the underlying parenchyma. Mouse, rat, and monkey brains were fixed by immersion in a glutaraldehyde fixative or glutaraldehyde with cetylpyridinium chloride, followed by block staining for complex carbohydrates using alcian blue with OsO4 postfixation, or OsO4 postfixative solution containing ruthenium red, or alcian blue and then ruthenium red-OsO4 treatment. The ependyma in these species had a glycocalyx extending into the ventricular fluid as a finely filamentous network when stained with alcian blue or with alcian blue followed by ruthenium red-OsO4. Mice in the middle age range had stained material in this glycocalyx resembling the hyaluronic acid reported in the ocular vitreous body. Similar material was seen in the arachnoidal space of these mice and in the inner connective tissue matrix of the dura mater. Both the mouse and monkey had a cell-free zone, termed the inner dural matrix zone, between the thick fibrous dura and its innermost cellular layer. This zone contained filamentous and globular alcian blue-stained material. The complex carbohydrates of the mouse ependymal glycocalyx and inner dural matrix zone underwent changes developmentally. Aged rats were injected intraventricularly with latex beads, which, along with extravasated erythrocytes, were seen to adhere to the ependymal glycocalyx. A similar adhesion of erythrocytes was seen in the mouse and monkey ependymal glycocalyx and in the filamentous network of the mouse and monkey inner dural matrix zone. The ependymal glycocalyx, formed in part of complex carbohydrates, is much thicker than previously demonstrated. Some activities related to the ependymal lining of the ventricles, including the movement of cells or particles, the penetration of metabolites or serum-protein fractions (e.g., immunoglobulins), and cell-surface hydration, probably depend in part on complex carbohydrates that provide a sticky, electrically negative, hydrophilic environment. The complex carbohydrates in the inner dural matrix zone might provide mechanical buffering. Complex carbohydrates in the arachnoidal space may help to maintain a loose tissue that needs not only to be hydrated, but also to be open enough to provide cerebrospinal fluid circulation. PMID- 3661460 TI - Postnatal development of the ovarian bursa of the golden hamster (Mesocricetus auratus): its complete closure and morphogenesis of lymphatic stomata. AB - The golden hamster ovarian bursa was studied by light and electron microscopy to clarify the process of its complete closure and the development of lymphatics that leads to morphogenesis of stomata. The results were as follows. 1) The bursa completely closed at 9 days of age primarily due to development of the mesotubarium superius. 2) With the closure, the ovary and bursa became closely apposed, and most of the original bursal cavity disappeared. 3) Between 9 and 12 days of age U-shaped folds of the bursal mesothelium began to invade the connective tissue of the bursa. 4) Widening of the internal angle of the U-shaped folds contributed to reappearance of the bursal cavity, and thus separation of the bursa from the ovary. It also contributed to future geometrical proximity of lymphatics to the cavity of the bursa. 5) The separation of the bursa from the ovary began as early as 12 days of age in the cephalic half of the bursa. It occurred remarkably late in the caudal half. Juxtaposition of the window portion of the bursa to the ovary remained in some adult animals. 6) Development of lymphatics in the cephalic half of the bursa was divided into two stages, before and after days 21-24 of life. In the first stage, lymphatics grew in the submesothelial connective tissue, and the framework of lymphatics was formed. In the second stage, lymphatics extended small branches to form the submesothelial plexus or lymphatic lacuna. 7) Intercellular junctions between contiguous lymphatic endothelial cells were mostly tight and desmosomelike. Open junctions were, if they occurred at all, rare. (8) A smooth-surfaced area lined with the lymphatic endothelium was found in the bursa on day 27 of life, before the initiation of ovulation. Valvelike stomal orifices were absent before the initiation of ovulation and extremely rare even after the first ovulation. They were commonly present in the bursae after the fourth ovulation, however. The process of complete closure of the ovarian bursa is very complex and may be related to the later development of the bursal mesothelium and lymphatics. Some liplike stomal orifices are of purely developmental origin. However, all valvelike stomal orifices are assumed to be formed as a result of damage to the bursal mesothelium, as well as to the submesothelial connective tissue and lymphatics, by repetition of ovulation. It is possible that liplike stomal orifices may be formed in the process of repairing the damage. PMID- 3661461 TI - A study of intercellular bridges during spermatogenesis in the rat. AB - A morphological evaluation of intercellular bridges was undertaken during rat spermatogenesis. The dimensions and relationships of the bridges were shown to vary during different phases of spermatogenesis. Cellular divisions of spermatogonia and spermatocytes resulted in the partitioning of pre-existing bridges by complex structures termed bridge partitioning complexes, which are described in detail, as is the process whereby new bridges are formed. The structure of premeiotic bridges was generally consistent; however, during spermiogenesis, the structure of bridges and bridge contents were modified at specific phases of their development. The plasma membrane density associated with the cytoplasmic aspect of early step 1 spermatids separated into multiple dense bands that encircled the peripheral aspect of late step 1 spermatid bridges. By step 2 of spermiogenesis, these dense bands became associated with several cisternae of endoplasmic reticulum, which later coalesced into a single saccule that completely encircled the bridge structure by step 4. At steps 10-13 of spermiogenesis, the single saccule of endoplasmic reticulum vesiculated into many smaller cisternae. Also, filament-bounded densities (measuring 10-12 nm in diameter) appeared within the bridge channel. At step 17 of spermiogenesis, the filament-bounded densities were no longer apparent, but an anastomosing network of endoplasmic reticulum, often in the configuration of a sphere, occupied the entire central region of the bridge. In step 19 spermatids, the smooth endoplasmic reticulum within the bridge channel and the multiple cisternae lining the bridge density were gradually displaced. The subsurface density of bridges gradually lost its prominence. Some cytoplasmic lobes were connected by extremely narrow (approximately 22 nm) cytoplasmic channels. Similar-appearing channels were seen on the surface zone of cytoplasmic lobes or residual bodies, this observation suggesting that channels were sites of severence of bridges. Just prior to the separation or disengagement of the spermatid from the cytoplasmic lobe, selected bridges appeared to open to form large masses. After spermiation, residual bodies were not found joined by bridges; but from the size of some of the residual bodies, it was suspected that they were formed by coalescence of more than one cytoplasmic lobe. Freeze-fracture demonstrated few intramembranous particles on either the P or E face of the plasma membrane forming the bridge; this finding suggested bridge structures restricted free lateral movement of membrane constituents across the bridge.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3661462 TI - Morphological study of sarcoplasmic reticulum in the atrioventricular node and bundle cells in guinea pig hearts. AB - The osmium-ferrocyanide method for staining of the sarcoplasmic reticulum (SR) was used for a morphological investigation of the various components of the SR in the atrioventricular node and bundle (AVNB) cells of guinea pig hearts. On the basis of light microscopic observations, the AVNB tissue in guinea pig hearts can be divided into five regions: atrionodal junction, midnode, proximal bundle, distal bundle, and bundle branches. Electron microscopic observations revealed two types of junctional SR (j-SR) saccules in the cells from all the regions of AVNB tissue. One is similar to that seen in the working cardiac cells, i.e., flattened saccules with junctional granules. The second type is dilated and contains electron-dense granular material throughout its lumen. The flattened type is seen more often than the dilated type in atrionodal junctional cells and midnode cells, whereas the dilated type occurs more often in distal bundle cells and bundle branch cells. In most cells from the atrionodal junction and midnode regions, the j-SR saccules are apposed more often to sarcolemmal areas associated with nonspecialized regions of intercellular junctions than to other sarcolemmal areas. This distribution was not found in the distal bundle and bundle branch cells. Free SR tubules around the myofilament bundles are poorly developed in the midnode cells, generally in accord with the extent of development of myofibrils. Z-tubules are found in cells from all regions but are poorly developed in midnode cells. Corbular SR vesicles are found in cells from all the regions of AVNB tissues but are rare in midnode cells. Thus, each of the regions in the AVNB tissue has a different, characteristic distribution of SR components. Because of their possible relationship to the regulation of the intracellular concentrations of calcium, these differences in SR morphology may contribute to the diverse physiological properties of the different regions of the AV node and bundle. PMID- 3661464 TI - Computer ranking of the sequence of appearance of 73 features of the brain and related structures in staged human embryos during the sixth week of development. AB - The sequence of events in the development of the brain in human embryos, already published for stages 8-15, is here continued for stages 16 and 17. With the aid of a computerized bubble-sort algorithm, 71 individual embryos were ranked in ascending order of the features present. Whereas these numbered 100 in the previous study, the increasing structural complexity gave 27 new features in the two stages now under investigation. The chief characteristics of stage 16 (approximately 37 postovulatory days) are protruding basal nuclei, the caudal olfactory elevation (olfactory tubercle), the tectobulbar tracts, and ascending fibers to the cerebellum. The main features of stage 17 (approximately 41 postovulatory days) are the cortical nucleus of the amygdaloid body, an intermediate layer in the tectum mesencephali, the posterior commissure, and the habenulo-interpeduncular tract. In addition, a typical feature at stage 17 is the crescentic shape of the lens cavity. PMID- 3661463 TI - Secretion of proteins and glycoproteins by perifused rabbit corpus epididymal tubules: effect of castration. AB - Protein synthesis in epididymal tissue of intact and castrated rabbits was studied after incubation of epididymal minces with [35S]-cysteine or [35S] methionine and protein separation by two-dimensional gel electrophoresis. Regional differences in the pattern of protein synthesized were observed. Castration did not change overall protein synthesis, but it reduced these regional differences. The presence of 5 alpha-DHT in the culture medium of the proximal corpus epididymidis perfused for 24 hr did not increase overall protein synthesis in tubules from intact or castrated rabbits and did not reinitiate synthesis of the proteins that had disappeared after castration. The kinetics of glycoprotein synthesis and secretion were studied by light and electron microscopy autoradiography at 0.5, 2, 6, and 24 hr after exposure to [3H] mannose, [3H]-fucose, and [3H]-glucosamine. Changes in the distribution of mannose- and glucosamine-labeled material indicated that the decline in grain density over the epithelium from 30 min to 24 hr coincided with an increasing reaction over the stereocilia border from 30 min to 2 hr and in the lumen from 2 to 24 hr. The distribution of fucose-labeled material indicated that the grain reaction over the epithelium declined more rapidly than with the mannose label. When the glucosamine-labeled sperm mass was released from the tubules, the labeled material was lost after the first washing, indicating that the glucosamine-labeled glycoproteins did not bind firmly to corpus spermatozoa within 24 hr. After castration, both mannose- and fucose-labeled materials migrated to the cell apex more rapidly than in the intact animal, but they were not released as readily into the lumen. The culture of epididymal tubules from castrated males with 5 alpha-DHT for 24 hr did not promote the release of either mannose- or fucose-labeled material into the lumen. However, testosterone given in vivo for 2 weeks restored secretion of mannose-labeled material into the lumen. PMID- 3661465 TI - Unrecognized biologic bases of behavioral symptoms in patients referred for hypnotherapy. PMID- 3661466 TI - Hypnotherapy in weight-loss treatment: case illustration. PMID- 3661467 TI - Attributions, involuntariness, and hypnotic rapport. PMID- 3661468 TI - An experimental investigation of the interaction between hypnotic responsiveness and type of esteem suggestion on self-concept. PMID- 3661469 TI - Personality characteristics of hypnotizability. PMID- 3661470 TI - Predicting hypnotic susceptibility via a self-report instrument: a replication. PMID- 3661471 TI - The Stanford Hypnotic Clinic Scale and a group of obstetrical patients. PMID- 3661472 TI - The withheld eye-roll sign. PMID- 3661473 TI - Leucine, glucose, and energy metabolism after 3 days of fasting in healthy human subjects. AB - Adaptations of leucine and glucose metabolism to 3 d of fasting were examined in six healthy young men by use of L-[1-13C]leucine and D[6,6-2H2]glucose as tracers. Leucine flux increased 31% and leucine oxidation increased 46% after 3 d of fasting compared with leucine flux and oxidation after an overnight fast. Glucose production rate declined 38% and resting metabolic rate decreased 8% during fasting. Plasma concentrations of testosterone, insulin, and triiodothyronine were reduced by fasting whereas plasma glucagon concentrations were increased. We conclude that there is increased proteolysis and oxidation of leucine on short-term fasting even though glucose production and energy expenditure decreased. PMID- 3661474 TI - Zinc, vitamin B-6, and other nutrients in pregnant women attending prenatal clinics in Mexico. AB - Biochemical measurements and 24-h dietary recalls were conducted early (18.9 +/- 5.9 wk) and late (35.1 +/- 2.0 wk) in pregnancy in women attending clinics in Montemorelos, Mexico. Mean weight gain per week (0.4 +/- 0.2 kg) and birth weight (3381 +/- 456 g) were normal. Intakes tended to decline during pregnancy and declined significantly for zinc (p less than 0.05) and vitamin B-6 (p less than 0.03). Mean Zn intake late in pregnancy was low (7.8 +/- 3.3 mg/d). Various supplements were taken but none contained Zn. During pregnancy mean plasma Zn levels fell (p less than 0.001) and late in pregnancy 57% of the women had values suggestive of poor Zn status (less than or equal to 8.1 mumol/L). These data indicate that Zn intakes of approximately 8 mg/d will not maintain plasma Zn levels in late pregnancy. Erythrocyte glutamic-pyruvic transaminase (EGPT) index and the index of diamine oxidase (DAO), a vitamin B-6-requiring enzyme of placental origin, were correlated suggesting that DAO index may be useful in evaluating vitamin B-6 status in pregnancy. PMID- 3661475 TI - Physical activity and plasma total- and HDL-cholesterol levels in Western Samoan men. AB - This study examines effects of physical activity on plasma total- and high density lipoprotein (HDL) cholesterol and derived variables in Western Samoan men who differ in rural/urban residence and occupation. Rural agriculturalists have significantly higher HDL cholesterol and HDL:total ratio than men employed in either physically active or physically sedentary occupations in an urban setting. Total cholesterol levels do not vary significantly, but when the differences in HDL cholesterol are accounted for, the means for agriculturalists and active workers are significantly lower than those for sedentary workers who do not play sports. These differences in HDL- and non-HDL-cholesterol levels are consistent with measures of physical activity among the groups. Variation in physical activity due to residence and occupation in Western Samoan men is related to lipoprotein cholesterol levels, but not to total cholesterol levels, and some effects may be secondary to differences in body composition. PMID- 3661476 TI - Protein nutriture of a group of free-living elderly. AB - The adequacy of the protein intakes of elderly people without overt debilitating diseases was investigated on 691 free-living men and women divided into those aged 60-75 y and those greater than 75 y. In both age groups men and women had average protein intakes of 1.02-1.06 g/kg body weight, values well above the safe level of 0.75 g/kg recommended in a WHO/FAO/UNU report. Although plasma concentrations of albumin, prealbumin, and transferrin declined with age, these were not related to low intakes of protein by individual elderly people. Similarly, upper-arm muscle mass was not less in those elderly people at the lower end of the range of protein intakes. Thus in this population of overtly healthy elderly men and women, there was no evidence of protein deficiency in contrast to other surveys where elderly people with chronic diseases were included. PMID- 3661477 TI - Protein metabolism in cystic fibrosis: responses to malnutrition and taurine supplementation. AB - Increased protein breakdown has been cited as an important cause of nutrient loss in cystic fibrosis (CF). Taurine deficiency, which is common in CF, may contribute to the increased breakdown. The occurrence of and the benefit of taurine supplementation to abnormal protein metabolism in apparently optimally treated CF were assessed using a 12-mo double-blind crossover technique in 14 well-nourished and seven mildly-moderately malnourished infection-free preadolescent CF children. Muscle protein breakdown (urinary 3-methylhistidine technique) was significantly decreased in well-nourished (1.35% degraded/24 h +/- 0.15, p less than 0.05) and malnourished (1.24 +/- 0.11, p less than 0.001) CF children compared with controls (1.50 +/- 0.17, n = 13). Whole-body protein flux, synthesis, and catabolism ([15N]-glycine technique) were similar in all groups. Net protein gain was greater in CF children, particularly those who were well nourished (0.55 g/(kg X 10 h) +/- 0.35, p less than 0.01) compared with controls (0.16 +/- 0.26). Taurine supplementation did not significantly affect any of the indices. In the absence of infection, protein metabolism in CF children responds appropriately to malnutrition. PMID- 3661478 TI - Serum protein concentrations and bone mineral content in aging normal men. AB - Low serum protein levels and low dietary protein intakes possibly influence bone metabolism. To evaluate the relationships among serum protein concentrations, protein intakes, and bone mineral content (BMC), we have examined two populations of normal men. BMC was measured at two radial sites and a vertebral site. Aging was associated with a fall in BMC at all sites. Serum albumin levels also fell with age and were related to BMC. Albumin concentrations were associated with BMC when other variables (calcium and protein intake, vitamin D levels, parathyroid hormone, and urinary calcium) also were considered. Thus, alterations in protein metabolism may affect BMC and may play a role in the genesis of senile osteopenia. PMID- 3661479 TI - Effects of exercise and food restriction on body composition and metabolic rate in obese women. AB - Obese women (140-180% of ideal body weight) were studied on a metabolic ward during 1 wk of maintenance feeding, followed by 5 wk of 800 kcal/d (liquid formula diet). Five subjects participated in a supervised program of daily aerobic exercise and three subjects remained sedentary. Total weight loss was not different between exercising and nonexercising subjects but significantly more of the weight loss came from fat and less from fat-free mass in the exercising subjects. Resting metabolic rate (RMR) declined similarly in both groups (approximately 20%), even though exercising subjects were in greater negative energy balance due to the added energy cost of exercise. In summary, results from this controlled inpatient study indicate that exercise is beneficial when coupled with food restriction because it favors loss of body fat and preserves fat-free mass. PMID- 3661480 TI - Fecal short-chain fatty acid (SCFA) analysis by capillary gas-liquid chromatography. AB - A new method is described for short-chain fatty acid (SCFA) analysis in stool samples. After sample purification by acid vacuum transfer and concentration by alkaline freeze-drying, SCFAs were measured by gas-liquid chromatography using a capillary column. Peak resolution and reproducibility were superior to SCFA analysis on a conventional glass column. With this new technique SCFA were quantitated in stool samples of six healthy volunteers on a basal diet with and without a fermentable dietary fiber preparation; fiber had no effect on fecal SCFA concentration. In two patients with a short-bowel syndrome, SCFA could be demonstrated in stool samples, indicating active fermentation. PMID- 3661481 TI - Comparison of dietary intakes and iron status of vitamin-mineral supplement users and nonusers, aged 1-19 years. AB - Despite widespread use of supplements, few studies have been conducted to determine if supplement users have better nutritional status. Using data from the second National Health and Nutrition Examination Survey (NHANES II), mean values of five iron status indicators (hemoglobin, mean corpuscular volume, transferrin saturation, erythrocyte protoporphyrin, and serum ferritin) and dietary intakes of several nutrients and food groups were compared between regular supplement users and nonusers aged 1-19 y. Users consumed more vitamin C and fruits and vegetables than nonusers in several age-sex groups. No significant differences in mean Fe status indicator values were observed except for hemoglobin for the 3-4-y olds and serum ferritin for the 5-10-y olds. In both cases, users had higher values than nonusers. In general, Fe status was not associated with supplement use but the reason cannot be identified from this survey. PMID- 3661482 TI - Interrelationships of diet, athletic activity, menstrual status, and bone density in collegiate women. AB - We undertook a case-control study to examine the effect of nutritional factors on menstrual function and bone density in collegiate athletes. Three groups, matched with respect to age, height, and weight, were studied: eumenorrheic collegiate athletes, oligomenorrheic collegiate athletes, and eumenorrheic sedentary collegiate control subjects. Menarche was delayed in the eumenorrheic (13.1 y) and oligomenorrheic (14.3 y) athletic groups compared with the sedentary control subjects (12.2 y) (p less than 0.05). Average bone density tended (p = 0.10) to be lower in the oligomenorrheic athletes (158 mg/mL) compared with the eumenorrheic athletes (184 mg/mL) or sedentary control subjects (173 mg/mL). Dietary fiber intake was significantly elevated (p less than 0.05) in the oligomenorrheic athletes (5.74 g/d) compared with the eumenorrheic athletes (3.62 g/d) or sedentary control subjects (2.97 g/d). We conclude that increased dietary fiber intake is associated with menstrual dysfunction of these collegiate athletes. These factors may contribute to decreased bone density. PMID- 3661483 TI - Dietary calcium intake and bone loss from the spine in healthy postmenopausal women. AB - Controversy exists over the relationship between calcium intake and axial bone loss. We measured bone density of the spine (L2-4) by dual photon absorptiometry (DPA) two times, 7 mo apart, in 76 healthy postmenopausal women aged 40-70 y. Ca intake was assessed by food-frequency questionnaire. Women with a Ca intake less than 405 mg/d lost spine density at a rate that was significantly greater than that of women with an intake greater than 777 mg/d, p = 0.026. There appears to be a threshold of Ca intake below which increased Ca in the diet is likely to be beneficial in reducing spine mineral loss. PMID- 3661484 TI - Ethanol metabolism in postmenopausal women fed a diet marginal in zinc. AB - Five postmenopausal women aged 50-63 y were fed a diet of mixed Western foods that supplied an average of 2.6 mg zinc/d for 6 mo. Plasma zinc did not change significantly during Zn depletion but increased slightly when Zn was fed. Zn content of blood cellular components and activities of Zn-containing enzymes were not affected by Zn intake. Ethanol tolerance tests performed at the end of control, middle of depletion, end of depletion, and end of repletion showed a change in ethanol metabolism at the end of the low-Zn intake period that was corrected within 1 mo with Zn supplementation. These data suggest that there are homeostatic mechanisms that maintain circulating levels of Zn. Zn and activity of Zn enzymes in tissues may be decreased before changes in circulating Zn levels are seen. Functional indices of Zn biochemistry, such as ethanol metabolism, may be more sensitive indicators of Zn stores and nutriture than circulating Zn. PMID- 3661485 TI - Dietary selenium intake and selenium concentrations of plasma, erythrocytes, and breast milk in pregnant and postpartum lactating and nonlactating women. AB - The selenium status of a group of 23 lactating and 13 nonlactating women was assessed from 37-wk gestation through 6-mo postpartum. The mean overall dietary Se intake of both groups of women was 80 +/- 37 micrograms/d. Plasma and erythrocyte Se levels were lower in the lactating than in the nonlactating mothers both before and after parturition. Breast-milk Se concentrations fell from 20 micrograms/L (0.25 mumol/L) at 1-mo postpartum to 15 micrograms/L (0.19 mumol/L) at 3- and 6-mo postpartum. A weak (r = 0.38) but statistically significant (p less than 0.025) relationship was observed between maternal plasma Se level and breast-milk Se concentration. The dietary Se intake of these lactating North American women appears sufficient to maintain satisfactory Se nutriture in their breast-fed infants during the first 6 mo of lactation. PMID- 3661486 TI - Effects of glucose and glucose polymers on calcium absorption in healthy subjects. AB - Glucose polymers have been shown to enhance intestinal calcium absorption in normal subjects as well as in patients with gastrointestinal disease. Glucose polymers are widely used as an energy source in enteral nutritional supplements and infant formulas. In this study, eight normal subjects underwent 47Ca absorption tests to compare the effect on calcium absorption of carbohydrate given orally as a simple carbohydrate (glucose) or a more complex carbohydrate (glucose polymers). Oral coadministration of glucose with calcium increased the efficiency of intestinal calcium absorption by 20% and coadministration of glucose with glucose polymers increased calcium absorption by 27%. This suggests that glucose, derived from glucose polymers by hydrolysis, may be responsible for the positive effect of polymers on calcium absorption. The potential positive effect of coadministration of carbohydrate on calcium bioavailability deserves considerations in the design of calcium supplementation strategies. PMID- 3661487 TI - Changes in mood after carbohydrate consumption. PMID- 3661489 TI - Aminothiadiazole (NSC #4728) in patients with advanced colon cancer. A phase II study of the Eastern Cooperative Oncology Group. AB - The Eastern Cooperative Oncology Group (ECOG) studied 29 patients with advanced measurable colon cancer who were treated with Aminothiadiazole (NSC #4728) 125 mg/m2 intravenously. Allopurinol 300 mg daily was taken by all patients during treatment. Three patients (12%) demonstrated partial responses on this regimen. Hematologic toxicity did not occur. Gastrointestinal toxicity was severe in 16% of patients and consisted primarily of vomiting and diarrhea. No life-threatening toxicity was encountered. A lack of appreciable toxicity together with the few responses seen suggest that further studies at higher dose may be indicated. PMID- 3661488 TI - Phase II trial of sequential chemotherapy and low-dose radiotherapy in advanced gastric adenocarcinoma. A Southwest Oncology Group Pilot Study. AB - Thirty-four patients with metastatic gastric adenocarcinoma were treated with the combination of chemotherapy and radiation therapy in a Phase II trial. Induction chemotherapy consisted of one cycle of 5-fluorouracil (5-FU), adriamycin, and BCNU (FAB), followed in 4 weeks by a cycle of 5-FU, adriamycin and mitomycin-C (FAM). In responding and stable patients, consolidation radiotherapy to major sites of disease, followed by maintenance FAM, was administered. Twelve of 30 (40%) patients with measurable disease responded (3 complete responses and 9 partial responses), with a median response duration of 6.0 months. Toxicity was moderate and consisted of nausea, vomiting, and myelosuppression. No additive effects for this combined modality approach could be demonstrated. PMID- 3661490 TI - Breast conservation treatment with perioperative interstitial irradiation. AB - Limited resection of the breast combined with radiation has proved to be as effective as more radical surgery in treating early breast cancer. At the University of Kansas Medical Center, the radiotherapy consists of an interstitial implant at the time of lumpectomy to deliver an interstitial boost dose to the tumor bed with iridium-192 immediately following the surgical procedure. An axillary node dissection is also performed at the time of lumpectomy. A dose of 2,000 cGy is delivered to the tumor bed between 40 and 60 h. Two to three weeks later, 4,500-5,000 cGy is delivered to the entire breast with external beam radiation over 5-5.5 weeks. One hundred breasts in 98 patients were so treated between June 1982 and February 1986, with 2 carcinomas in situ, 40 stage I, 51 stage II, and 7 stage III cancers, consisting of 2 TIS, 54 T1, 39 T2, and 5 T3 lesions. Locoregional control with a median follow-up of 31 months was 98%. One recurrence was in a different quadrant, and the other revealed predominantly the in situ component. Immediate implant did not compromise wound healing or cosmesis. The cosmetic result was graded as good to excellent in 88% of the breasts. Our preliminary results appear to suggest a better local control with immediate interstitial irradiation. PMID- 3661491 TI - A phase II study with danazol in metastatic breast cancer. AB - Danazol is a synthetic steroid that inhibits the gonadotropin secretion. Its efficacy was tested in 27 patients with metastatic breast cancer at the dose of 200 mg three times daily. Characteristics of patients were as follows. The median age was 57 years (range, 44-85). All patients were postmenopausal, and all had previously received a median of two (range, 1-3) endocrine therapies. Estrogen receptor status was known in 12 (positive in five of 12; negative in seven of 12). Dominant sites of metastases were lung in seven, bone in ten, liver in three, and soft tissue in seven. Six of 27 patients were unevaluable for response (early death, four; lost to follow-up, two). Three of 21 patients showed an objective response, eight of 21 obtained stabilization of disease, and eight progressed. The therapy was well tolerated in the majority: gastric pain was observed in three and nausea in two. Danazol could have a role in the treatment of metastatic breast cancer as an alternative regimen when other treatment has failed. PMID- 3661492 TI - Simultaneous radiation therapy and cisplatin chemotherapy in advanced cancer of the head and neck. A pilot study at Tygerberg Hospital, Parowvallei, South Africa. AB - Fifty patients with advanced carcinoma of the head and neck were treated in a nonrandomized pilot study utilizing simultaneous cisplatin and radiotherapy. Treatment was delivered in two segments. The initial partial course (PC) consisted of 75-100 mg/m2 of cisplatin and concomitant radio-therapy to 20.00 Gy in 1 week, with 4-week split. Patients who tolerated therapy and experienced at least a partial response (PR) went on to complete the full course of therapy (FC), with the second phase consisting of 120 mg/m2 of cisplatin and 38.40 Gy of radiation. Total cisplatin delivered ranged between 195 and 220 mg/m2, and the total radiation dose was 58.40 Gy. Of 38 evaluable patients, 31 (82%) had at least a partial response (PR). However, at time of analysis 20 months after study, 27 (71%) patients were alive with disease or dead. Mean disease-free survival (DFS) for patients receiving FC therapy (10.05 months) was greater than that for patients who received only PC therapy (2.65 months), but the difference in overall survival (OS) was not statistically significant (11.95 FC versus 10.29 PC). Response rates and the minimal toxicity are within the range of other reported studies. Randomized studies should seek optimal time-dose schedule and establish advantages in terms of crude survival and disease-free survival. PMID- 3661493 TI - Spinal metastases from pituitary hemangiopericytic meningioma. AB - A rare, previously irradiated, recurrent malignant angioblastic meningioma of the pituitary, hemangiopericytic type, was locally controlled by a new endocurietherapy technique that allows delivery of very high (10,000 cGy), sharply localized irradiation. Rather than succumbing to the local tumor recurrence, as would otherwise be expected, the patient developed distant spinal metastases several years later. PMID- 3661494 TI - A phase II trial of vinblastine in patients with advanced or recurrent endometrial carcinoma. A Southwest Oncology Group Study. AB - Forty-one patients with advanced or recurrent endometrial carcinoma no longer amenable to control with surgery and/or radiotherapy were entered into study. Five of these were ineligible for study. One eligible patient never received any treatment, another had no baseline information recorded; these were thus inevaluable. The remaining 34 patients received continuous infusion vinblastine (1.5 mg/m2) as a 24-h infusion daily for 5 days every 3 weeks. One complete and 3 partial responses were observed among these 34 patients, for an overall objective response rate of 12%. Two of these 4 responders are deceased, and 2 remain alive with disease at 18 and 22 months, respectively. The most common toxicity noted was leukopenia in 22 patients (65%); 12 (35%) of these had severe or life threatening leukopenia (less than 2,000 WBC/microliter). Fourteen of the 34 (41%) experienced nausea and vomiting. Other adverse effects were less common. Overall, 15 of the 34 patients (44%) experienced severe or life-threatening toxicity. In this trial, continuous infusion vinblastine was toxic and had minimal to moderate efficacy at best. These facts suggest that the drug at the dose and schedule tested has no role in the management of advanced or recurrent endometrial carcinoma. PMID- 3661495 TI - Estrogen receptor immunocytochemistry for preoperative determination of estrogen receptor status on fine-needle aspirates of breast cancer. AB - Fine-needle aspirates (FNAs) of 84 primary breast carcinomas were analyzed immunocytochemically for estrogen receptor (ER) using (ER-ICA) monoclonal antireceptor antibodies. ER-ICA in FNAs was concordant to ER-ICA in histologic biopsies in 87% (P less than 0.0001). In most of the carcinomas, biochemically determined ER status also correlated to ER-ICA. There was no false positive ER ICA in FNAs compared with ER-ICA in histologic biopsies. In 11 FNAs, ER-ICA was negative, whereas it showed positivity in histologic specimens. The most frequent contributing factors to false negative ER-ICAs of FNAs were ER-ICA-low results in histologic biopsies, a prominent stroma component in these tumors, and low cellularity of FNAs. The biochemical ER values in these cases never exceeded 90 fmol/mg protein. In a minority of cases, false negative results were inexplicable. PMID- 3661496 TI - A novel whole blood capillary technic for measuring the prothrombin time. AB - The prothrombin time (PT) is frequently performed to monitor anticoagulant therapy. Although relatively simple to perform, it requires venipuncture and laboratory resources for sample handling and analysis. A recently developed capillary whole blood device that uses fingerstick samples was evaluated. Paired capillary whole blood and reference plasma PTs were performed in 858 samples from 732 subjects. The PT for normal volunteers (n = 193) was 11.8 +/- 0.9 seconds with the use of the new instrument and 12.1 +/- 0.5 seconds with the use of the reference method. In samples from 539 patients receiving anticoagulants, the correlation coefficient between the two methods was 0.96. Venous whole blood without anticoagulant and capillary whole blood gave equivalent results, which suggests that the fingersticks do not effect the quality of the specimen. Variation in hematocrit between 23.4% (0.34) and 53.8% (0.538) did not alter the performance of the instrument. The new instrument is easy to use and may allow testing by nonlaboratory personnel and patients. It obviates the need for venipuncture, provides immediate results, and appears to be comparable in accuracy to current reference methods. PMID- 3661497 TI - Fluorescence intensity as a quality control parameter in clinical flow cytometry. AB - The fluorescence intensity (FI) and percentage of immunostained peripheral blood lymphocytes (PBLs) were tested as parameters for monitoring quality control of monoclonal antibodies (MoAbs) and the staining procedure. Several potential variables were addressed, including optimal dilutions of MoAbs, standardization of instrument functions with fluorescent microspheres, stability of day-to-day fluorescence detection with fluorescent fixed cells, and effects of separation method and storage conditions on FI and PBL antigens. Although some small (but statistically significant) changes were found in certain tests, in general the FI and percentages of MoAB-positive human PBLs provided information useful in a standardized flow cytometry quality control program. This type of standardization and quality control facilities early discovery of methodologic and reagent problems in the clinical laboratory, as well as the ability to routinely evaluate disease states associated with abnormal antigen density. PMID- 3661498 TI - A panel approach to the evaluation of the sensitivity and specificity of antibodies for the diagnosis of routinely processed histologically undifferentiated human neoplasms. AB - The evaluation of antibodies for diagnostic purposes on routinely processed sections of histologically undiagnosable neoplasms presents special problems. The authors have addressed this problem by constructing a panel of putatively mutually exclusive antibodies and testing it on sections of anaplastic neoplasms. Tissue sections of 120 routinely processed histologically undifferentiated large cell human neoplasms with a histologic differential diagnosis of carcinoma versus lymphoma and/or melanoma were stained with a panel of antibodies composed of monoclonal antikeratin AE1, monoclonal antileukocyte common antigens PD7/26 and 2B11, and rabbit anti-S-100 protein. Only cases not diagnosable by routine morphologic examination were included. PD7/26 and/or 2B11 were positive in 61 cases (supporting lymphoma), AE1 was positive in 17 cases (supporting carcinoma), and anti-S-100 was positive in 25 cases (supporting melanoma). Seventeen neoplasms failed to react with any of the panel antibodies. None of the neoplasms reacted with antibodies directed against two or more different antigens. These results indicate excellent specificity (100%) and good sensitivity (86%) of the panel antibodies on histologically undifferentiated neoplasms. These results are significant on two levels: first, as a test of the panel approach to evaluate antibodies on anaplastic neoplasms, and, second, as a demonstration of the diagnostic utility of the specific panel the authors have employed in such cases. PMID- 3661499 TI - The diagnostic value of acetylcholinesterase/butyrylcholinesterase ratio in Hirschsprung's disease. AB - Aganglionosis of large bowel (Hirschsprung's disease; HD) is associated with higher acetylcholinesterase activity (AChE activity). Occasionally, especially in the neonatal period, the AChE activity may not be of diagnostic value. The authors previously reported that simultaneous estimation of butyrylcholinesterase activity (BChE activity) and the determination of AChE/BChE ratio may have discriminatory diagnostic value. They extended this finding to 31 cases of HD, in 16 of which resected tissue was available for study. All cases had histologic confirmation of aganglionosis. The AChE/BChE ratio was found to be higher than 2.0, with the exception of a case in which the biopsy weight was low (i.e., less than 3 mg), even when the AChE activity was normal or borderline. The estimation of AChE/BChE ratio is easy, rapid, and, in the author's experience, of discriminatory diagnostic value. PMID- 3661500 TI - The effect of fibrin polymerization inhibitors on quantitative measurements of plasma fibrinogen. AB - A number of reports have highlighted discrepancies between the DuPont aca and fibrometer-based methods for quantitating plasma fibrinogen levels. Although many authors have suggested that the presence of fibrin(ogen) degradation products are in some way responsible for the discrepancies, no direct test of this hypothesis has been carried out. In this report, the authors demonstrate that inhibitors of fibrin monomer polymerization have different effects on the aca and fibrometer assays of fibrinogen. Fibrin polymerization inhibitors allow short soluble fibrin polymers to assemble that can scatter light and are therefore detected by the aca method. However, these short polymers do not gel and thus are not detected by the fibrometer. Therefore, the fibrometer method gives lower fibrinogen values than the aca in the presence of fibrin polymerization inhibitors. The authors also assayed plasma from a patient whose fibrinogen did not polymerize normally and therefore was not measurable by the fibrometer assay. The dysfibrinogenemic plasma assayed by the aca method recorded normal fibrinogen levels. In conclusion, the DuPont aca fibrinogen assay is insensitive to alterations of fibrin polymerization whether from inhibitors or a defective fibrinogen molecule. PMID- 3661501 TI - Evaluation of dipstick urine studies using a scoring system based on test performance characteristics. AB - A weighted scoring system based on the selection of four measures of the performance characteristics of a laboratory test--sensitivity, specificity, and false positive and false negative rates--was devised to provide a rationale basis for ranking and evaluating dipstick urine screening tests as a criterion for elimination of routine urine microscopic examination. Equal weight was assigned to each performance characteristic, and an arbitrarily chosen scoring scale of 100 was selected for simplicity. When a summation procedure was applied to urine studies available in the medical literature, three categories of author acceptability were found: accept: score greater than 80; conditional accept: score 70-80; reject: score less than 70. Studies incorporating leukocyte esterase (LE) were found to have the highest scores and the highest author acceptability, whereas studies lacking LE had the lowest scores and lowest author acceptability. This easy-to-use, weighted scoring system is proposed as a guide for deciding whether dipstick screening tests are acceptable as a way of eliminating routine microscopic examination. PMID- 3661502 TI - Hereditary lecithin-cholesterol acyltransferase deficiency. Case report of a German patient. AB - Lecithin-cholesterol acyltransferase (LCAT) deficiency was first described in a Norwegian family as an inborn error of metabolism. Altogether, 35 patients in 18 families have been identified. The authors report the first German patient, who presented with the characteristic clinical features of corneal opacity, proteinuria, and mild anemia. Renal biopsy revealed foam cells and an increased mesangial matrix in the glomeruli. Confirmation of the clinical diagnosis of LCAT deficiency was obtained by plasma enzyme and lipid analyses. Functional LCAT activity was not detected in incubated plasma by chemical or radiochemical methods, although rocket immunoelectrophoresis indicated that the patient had about one-third of normal LCAT mass. In keeping with other reports of LCAT deficiency, apoE-rich discoidal particles were seen in the patient's high-density lipoprotein fraction by electron microscopic examination. PMID- 3661503 TI - Native-valve endocarditis caused by coagulase-negative staphylococci. PMID- 3661504 TI - One ambiguity. PMID- 3661505 TI - Unlikely to improve accuracy of diagnosis. PMID- 3661506 TI - The 1986 American College of Gastroenterology membership survey. PMID- 3661507 TI - DNA content in Barrett's esophagus and esophageal malignancy. AB - Barrett's esophagus is a premalignant condition; endoscopic surveillance is often performed to search for early adenocarcinoma of the esophagus. In an attempt to detect early changes of malignancy, we have added the use of flow cytometry to routine endoscopic surveillance procedures. DNA histograms were generated from biopsy samples by utilizing a specific DNA fluorochrome (4',6-diamidino-2 phenylindole) and flow cytometry. Sixty-three samples from patients with esophagitis, Barrett's esophagus, and esophageal malignancy were analyzed. An abnormal DNA histogram (aneuploidy) was detected in 79% of esophageal malignancies. In addition, aneuploidy was detected in seven patients with Barrett's esophagus, two of whom had dysplasia. DNA quantification with flow cytometry may be a useful adjunct in screening patients with Barrett's esophagus for early malignant change. PMID- 3661508 TI - Malignant transformation of gastric hyperplastic polyps. AB - Four hundred and seventy-seven hyperplastic polyps, removed by endoscopic polypectomy, were reviewed with special reference to the appearance of dysplastic foci and their malignant transformation. Focal carcinomas were found in 10 hyperplastic polyps, which corresponded to 2.1% of the total of 477 hyperplastic polyps. The location of cancer was at the head or at the surface of the polyp, and was intramucosal. Dysplastic foci equivalent in the degree of histological atypia to adenoma were found adjacent to the cancerous foci in these 10 polyps. Dysplastic foci were also found in 19 hyperplastic polyps without cancerous foci, which corresponded to 4.0% of the total hyperplastic polyps. In connection with the histogenesis of malignant transformation of hyperplastic polyps, the results of clinicopathological examination and immunohistochemical stains strongly suggested that cancer cells arose from the dysplastic area in hyperplastic polyps, rather than directly from nondysplastic hyperplastic epithelium. PMID- 3661509 TI - Incidence of bacteremia after endoscopic laser treatment of stenosing processes in the upper gastrointestinal tract. AB - Bacteremia following endoscopic interventions has been repeatedly described. This prospective study was intended to establish the extent to which this condition can occur after endoscopic laser therapy. A total of 32 procedures to treat stenosing processes in the upper gastrointestinal tract had been performed on the 20 patients admitted to the study. The incidence of bacteremia was found to be 34%. Two patients developed sepsis that required antibiotic treatment, despite which, however, one of the patients died. Routine prophylactic antibiotic administration would, at present, appear to represent overtreatment. However, patients with cardiac diseases or artificial heart valves need antibiotic prophylaxis. Should a fever develop in patients undergoing laser therapy, immediate broad-band antibiotic cover is urgently recommended to prevent septic complications. PMID- 3661510 TI - Clinical experience with electronic video duodenoscopy in a community hospital. AB - Thirty consecutive endoscopic retrograde cholangiopancreatography examinations, including 14 cases of endoscopic sphincterotomy, were performed with either the Fujinon or Olympus electronic video duodenoscope. The clinical experience with these electronic instruments was similar to that occurring with fiberoptic duodenoscopes. These instruments complement the electronic upper gastrointestinal and colonoscopic endoscopes presently available. PMID- 3661511 TI - Effect of acute and chronic cimetidine administration on acetaminophen metabolism in humans. AB - In our study of the effect of acute cimetidine administration on acetaminophen metabolism, 10 healthy subjects were given an oral dose of acetaminophen (1 g) before and after administration of cimetidine (800 mg, po). In another experiment, 10 patients with duodenal ulcer received acetaminophen (1 g, po) before and after 2 months of cimetidine treatment (400 mg twice a day, po). Acetaminophen metabolism in blood and urine was studied for 9 h in each experiment. The half-life of acetaminophen was similar either in the absence or presence of both acute and chronic cimetidine administration. Although acute cimetidine ingestion did not affect acetaminophen urinary excretion, prolonged cimetidine treatment resulted in a slight but significant decrease of acetaminophen mercapturate urinary excretion. These findings suggest that, unlike acute cimetidine, prolonged histamine H2 antagonist therapy inhibits acetaminophen oxidation to its reactive metabolite. The clinical relevance of such an interaction remains to be explored. PMID- 3661512 TI - Immunoreactive neuromedin B and neuromedin C: distribution and molecular heterogeneity in rat and human tissue extracts. AB - Immunoreactive neuromedin B and neuromedin C were characterized and measured in rat and human tissue extracts, using radioimmunoassay combined with gel filtration and high performance liquid chromatography in order to clarify tissue distribution and molecular structure. There are two distinct systems of bombesin like peptide found in rat and human tissue. The neuromedin B family, including neuromedin B and big neuromedin B, is a major bombesin-like peptide in the brain; the neuromedin C gastrin-releasing peptide family is found mainly in the alimentary tract. Neuromedin B is the major and big neuromedin B the minor constituent of central nervous neuromedin B immunoreactivity. Gastrointestinal neuromedin C immunoreactivity is composed chiefly of neuromedin C in rats, and two N-terminally extended forms of neuromedin C including gastrin-releasing peptide in man. It is probable that molecular heterogeneity reflects species variation. PMID- 3661513 TI - Jejunal interposition hepaticoduodenostomy for choledochal cyst. AB - Four cases of choledochal cyst with interesting modes of presentation were managed by excision of the cyst and biliary drainage by a new physiological and antireflux technique of jejunal loop interposition hepaticoduodenostomy. The advantages of this new technique over earlier practiced procedures are discussed. PMID- 3661514 TI - Change in the extent of colonic involvement in ulcerative colitis: a colonoscopic study. AB - The change over time in the extent of colonic involvement in ulcerative colitis has, to date, been assessed only by radiological means. To study this issue further, we examined, with repeated colonoscopies, 31 patients with ulcerative colitis. Serial biopsies were taken every 5 cm from the most proximal area reached by the colonoscope down to rectum. The endoscopic and histological extents were evaluated, and the severity of the inflammatory process was graded. Clinical scoring also was performed at the time of both colonoscopies. A change of extent was found in 77% of the patients endoscopically, and in 58% histologically, during a mean follow-up period of 17 months. Extension and regression were demonstrated in the same number of patients. In 61% of 62 procedures, there was complete agreement between colonoscopic and histological extents. The histological extent exceeded the colonoscopic extent in 28% of the procedures. We have the impression that change in the disease extent is a frequent event, and may be a part of the natural history of ulcerative colitis, rather than the exception. PMID- 3661515 TI - Measurement of intrahepatic pressure as an index of hepatic sinusoidal pressure. AB - Intrahepatic pressure was measured in 148 patients with liver disease (32 outpatients, 116 inpatients) and 13 controls with almost normal liver histology (inpatients), with a 23-gauge needle (inner diameter 0.38 mm). Intrahepatic pressure was significantly elevated in the group order of chronic active hepatitis without bridging necrosis (n = 17, 9.2 +/- 3.0 mm Hg), chronic active hepatitis with bridging necrosis (n = 24, 12.3 +/- 5.7), and posthepatitic liver cirrhosis (n = 65, 18.8 +/- 4.2), compared with controls (n = 13, 6.8 +/- 2.7), whereas it was not elevated in the group of idiopathic portal hypertension (n = 9, 7.8 +/- 2.5 mm Hg), acute hepatitis (n = 10, 8.4 +/- 2.6 mm Hg), and chronic persistent hepatitis (n = 23, 7.9 +/- 2.7 mm Hg), compared with controls. As complications, four patients had abdominal discomfort continuing for more than a day; however, patients were allowed to walk after they had rested on their beds for 30 min. In 37 patients (27 with cirrhosis, seven idiopathic portal hypertension, and three others), portal vein and/or hepatic vein catheterization was performed during the same procedure of intrahepatic pressure measurement. Intrahepatic pressure showed significant correlations with corrected wedged hepatic vein pressure (r = 0.91), portohepatic gradient (r = 0.69), wedged hepatic vein pressure (r = 0.79), and portal vein pressure (r = 0.68). Slopes were 0.97, 0.83, 0.66, and 0.65, respectively. In conclusion, intrahepatic pressure reflects hepatic sinusoidal pressure (corrected wedged hepatic vein pressure), and intrahepatic pressure starts to elevate at the stage of chronic active hepatitis. PMID- 3661516 TI - The credentialing process: rational decisions of hospital committees for granting of privileges in gastrointestinal endoscopic procedures. PMID- 3661517 TI - Primary duodenal carcinoid. AB - Duodenal carcinoid tumors are rare. We report two patients with isolated duodenal carcinoid tumors diagnosed accidentally by endoscopy, who were not operated, and were followed for more than 2 yr without evidence of metastasis. Because duodenal carcinoid tumors are slow growing and have a relative benign course, a conservative approach is recommended in old patients with relative contraindications to surgery. PMID- 3661518 TI - Impacted foreign bodies in the duodenum. PMID- 3661519 TI - Endoscopic sphincterotomy in the management of biliary-cutaneous fistula. AB - Endoscopic sphincterotomy was performed on two patients who had biliary-cutaneous fistula after cholecystectomy. The outcome was favorable. The author recommends this procedure as a desirable alternative to laparotomy with secondary biliary surgery. PMID- 3661520 TI - Hemodialysis-associated hemorrhagic cholecystitis. AB - Hemorrhagic complications of hemodialysis have been recognized and described in many viscera and anatomic locations. In addition, hepatobiliary pathology is a frequent finding in hemodialysis patients. An adult male is reported as the first case of spontaneous intracholecystic hemorrhage treated by urgent cholecystectomy. PMID- 3661521 TI - Chylous ascites caused by constrictive pericarditis. AB - Chylous ascites is an uncommon clinical entity associated with lymphatic obstruction usually caused by underlying malignancy. The authors describe a patient with chylous ascites caused by constrictive pericarditis in the absence of mechanical lymphatic obstruction. Pathophysiological mechanisms for the development of chylous ascites in constrictive pericarditis include augmented lymph production and high impedance to lymph drainage caused by central venous hypertension. After pericardiectomy, the patient's ascites and edema resolved. Constrictive pericarditis should be considered a rare but potentially curable cause of chylous ascites. PMID- 3661522 TI - Nodular hyperplasia of the liver in primary biliary cirrhosis of early histological stages. PMID- 3661523 TI - Achalasia dilation under direct vision revisited. PMID- 3661524 TI - Vanishing tumor of the stomach. PMID- 3661525 TI - Gastric mucosal perforation by a Levin tube. PMID- 3661526 TI - Effects of passive smoking in the Multiple Risk Factor Intervention Trial. AB - The Multiple Risk Factor Intervention Trial (MRFIT), conducted in 1973-1982, provided a unique opportunity to study the effect of passive smoking on men whose wives smoke. MRFIT participants who reported at entry that they had never smoked tobacco products were classified according to the smoking status of their wives. Men with wives who smoked had similar mean levels of serum thiocyanate (54.3 vs. 53.9 mumol/liter, p = 0.83) but higher mean levels of expired carbon monoxide (7.7 vs. 7.1 ppm, p = 0.001). Lower levels of pulmonary function (by maximum forced expiratory volume in one second) were also observed in these men (3,493.1 vs. 3,591.9 ml, p = 0.04). The relative risks, for men whose wives smoked compared with men whose wives did not smoke, for the endpoints coronary heart disease death, fatal or nonfatal coronary heart disease event, and death from any cause were 2.11 (p = 0.19, 95% confidence interval (CI) 0.69-6.46), 1.48 (p = 0.13, 95% CI 0.89-2.47), and 1.96 (p = 0.08, 95% CI 0.93-4.11), respectively. When smokers who quit prior to entry were included in the analyses, the relative risks, for men whose wives smoked compared with men whose wives did not smoke, for the above endpoints were 1.45 (p = 0.25, 95% CI 0.77-2.73), 1.19 (p = 0.29, 95% CI 0.85-1.65), and 1.72 (p = 0.01, 95% CI 1.12-2.64), respectively. These relative risk estimates did not change appreciably after adjusting for other baseline risk factors. The results suggest that passive exposure to cigarette smoke may have a deleterious impact on the health of nonsmokers and that nonsmokers may be at an increased risk of death through passive exposure to cigarette smoke. PMID- 3661527 TI - Evaluation of two food frequency methods of measuring dietary calcium intake. AB - To assess the ability of food frequency methods to measure current dietary calcium intake in elderly women, the authors administered two types of food frequency instruments to 37 randomly selected women who attended two senior citizens centers in San Francisco, and they compared those responses to seven-day food records. A 34-item food frequency instrument (with portion sizes rated as small, medium, or large) correlated well (r = 0.76) with the estimated calcium intake from seven-day records. Limiting the instrument to the top 15, 10, or five foods that contribute to dietary calcium intake had little effect on this correlation (r = 076, 0.75, and 0.67, respectively). Rating all portions as "medium" reduced these correlations somewhat. An 18-item instrument, which asks respondents to rate portion sizes in ounces or cups, did not correlate as well with the seven-day records (r = 0.49). The authors conclude that brief food frequency instruments which rate portion sizes on a simple qualitative scale may be suitable for many clinical uses and adequate for some types of epidemiologic studies of calcium intake in elderly women. PMID- 3661528 TI - Coffee consumption and mortality in the Chicago Western Electric Company Study. AB - The relations between coffee consumption and 19-year mortality from all causes, coronary heart disease, and non-coronary causes were assessed in 1,910 white males aged 40-56 years in 1957-1958 from the Chicago Western Electric Company Study. Mortality rates, adjusted for age, serum cholesterol, diastolic blood pressure, and smoking status, were compared for those consuming 0-1, 2-3, 4-5, and 6+ cups of coffee per day; coffee intake, measured at the first anniversary examination, included both caffeinated and decaffeinated intake. Mortality from all causes was greatest in the highest and lowest intake groups. The increased mortality in the 6+ cups per day group was due to coronary heart disease, while the increased mortality in the lowest intake group was due to noncoronary causes. The adjusted relative risk of coronary heart disease death for those drinking 6+ cups of coffee per day compared with those drinking less was 1.71 (95 per cent confidence limits 1.27, 2.30). This increased risk of coronary heart disease death was present in both smokers and nonsmokers, with adjusted relative risks of 1.62 and 2.21, respectively (95 per cent confidence limits 1.17, 2.24 and 1.06, 4.62). The increased mortality from non-coronary causes in the lowest intake group was due primarily to increased mortality from cancer and cardiovascular diseases other than coronary heart disease. The results of this study support the hypothesis that those who drink 6+ cups of coffee per day may be at an increased risk of death from coronary heart disease. PMID- 3661529 TI - The association between low birth weight and caffeine consumption during pregnancy. AB - In a prospective study of 3,891 antenatal patients at Yale-New Haven Hospital between 1980 and 1982, 76.7% consumed caffeine from coffee, tea, colas, and drugs. A dose response of caffeine intake to increased risk for delivering low birth weight (less than 2,500 g) singleton newborns was observed. This relation was observed in deliveries after 36 weeks gestational age. When comparison was made with women who had no caffeine exposure, the relative risks of low birth weight after adjustment for confounding factors were 1.4 (95% confidence interval (CI) 0.7-3.0) for 1-150 mg of caffeine daily; 2.3 (95% CI 1.1-5.2) for 151-300 mg; and 4.6 (95% CI 2.0-10.5) for over 300 mg. Decreases in mean birth weight were 6, 31, and 105 g, respectively. Gestational age did not appear to be related to caffeine consumption in the crude or adjusted analysis. Maternal caffeine intake seems to exert an effect on birth weight through growth retardation in term newborns. PMID- 3661530 TI - Familial resemblance in the blood pressure response to sodium restriction. AB - Familial resemblance in the blood pressure response to sodium restriction in normotensive persons was investigated. Forty-four families of identical twin children participated in a sodium restriction (less than or equal to 75 meq/day) protocol for a period of 12 weeks. Subjects were residents of central Indiana, and the study was conducted over a three-year period. Parent-offspring and sibling-sibling resemblances for actual blood pressure were not different under conditions of ad lib sodium intake versus sodium restriction. Mother-offspring resemblance in blood pressure change with sodium restriction was significant for systolic (p less than 0.001), diastolic (p less than 0.05), and mean arterial (p less than 0.05) pressures. Sibling-sibling and twin-twin resemblances were also highly significant for the change in all three blood pressures. Father-offspring resemblances were marginal (p less than 0.10). This study is, to the author's knowledge, the first to demonstrate significant familial resemblances in blood pressure change with sodium restriction in normotensive persons. PMID- 3661531 TI - A prospective study of reproductive factors and breast cancer. I. Parity. AB - The relation between childbearing and breast cancer risk was investigated in a prospective study of 63,090 Norwegian women, among whom 1,565 breast cancer cases occurred in a follow-up from 1961 through 1980. The authors observed a strong and highly significant inverse association between the number of full-term pregnancies and the risk of breast cancer. The association was consistently found in all subgroups according to demographic variables and was obtained for all histologic subtypes except for cases classified as Paget's disease. The relation with parity could not be explained by confounding with age at first birth or other reproductive factors. The apparent protective effect of high parity was strongest in the groups with an early first birth, and no such effect could be established among women with their first birth at age 35 or later. The protective effect of multiparity was observed for cancers in all age groups. Uniparous women had, however, higher risk of developing breast cancer under age 60 than nulliparous women. Those who reported at least one abortion had somewhat lower risk than those who did not, but no trend according to the number of abortions was observed. PMID- 3661532 TI - A prospective study of reproductive factors and breast cancer. II. Age at first and last birth. AB - The relations between age at first and last full-term pregnancy and breast cancer risk were investigated after 20 years of follow-up of 63,090 Norwegian women, among whom 1,565 breast cancer cases occurred. An association seen in preliminary analyses between early age at first birth and low risk of breast cancer was removed after adjustment for parity and age at last birth. Age at last birth showed initially no association with breast cancer. After adjustment for parity, however, a significant positive association emerged. The authors' observations suggest that the relation between age when a pregnancy occurs and breast cancer risk may be more complex than previously believed. Despite the overall association between increasing parity and lower risk, the women with many late pregnancies and those with few, widely spaced pregnancies had higher risk than nulliparous women, indicating that both the age when pregnancy occurs and the length of intervals between successive births may modify the protective effect. The findings are consistent with a dual effect of a pregnancy, causing a transient increase followed by a subsequent strong and long-lasting decrease in risk of breast cancer. PMID- 3661533 TI - The influence of exogenous estrogen use on survival after diagnosis of endometrial cancer. AB - For examination of the effect of prior exogenous estrogen use on survival after diagnosis of endometrial cancer, 244 endometrial cancer cases newly diagnosed at North Carolina Memorial Hospital, Chapel Hill, North Carolina, between 1970 and 1976 were followed until 1982. Estrogen users (n = 46) were younger, had less advanced disease, and were more likely to be nonobese and white than were nonusers (n = 198). The estimated probability of surviving (Kaplan-Meier) five years after diagnosis was 0.89 for users and 0.53 for nonusers. When adjusted for age, grade, stage, obesity, race, and treatment (using the Cox proportional hazards regression model), the survival probabilities throughout the period of observation for estrogen users continued to be higher. The adjusted hazard rate for a nonuser was 2.05 (95% confidence interval (Cl) 0.96-4.39) times that for an estrogen user. The adjusted hazard rate from endometrial cancer only was 4.01 (95% Cl 1.22-13.21) times greater among estrogen nonusers. The more frequent occurrence of endometrial cancer in an earlier stage and grade among estrogen users may not be the sole cause of their lower hazard rate from this disease. PMID- 3661534 TI - A prospective study of age at menarche, parity, age at first birth, and coronary heart disease in women. AB - Reproductive events in women are associated with alterations in blood lipids and blood pressure and may therefore influence determinants of coronary heart disease. To investigate the risk of coronary heart disease in relation to age at menarche, parity, and age at first birth, the authors evaluated prospectively the experience of 119,963 US women aged 30-55 years who were free from coronary heart disease in 1976 and were followed through 1982. During 700,809 person-years of observation, 308 incident cases of nonfatal myocardial infarction or fatal coronary heart disease occurred. Younger age at menarche was weakly associated with coronary heart disease (age-adjusted rate ratio of 1.3 for menarche before age 11 years compared with menarche at age 13 years; chi, Mantel extension test for trend = -1.1, p = 0.2). Nulliparous women experienced only a slightly higher rate of coronary heart disease than parous women (rate ratio = 1.2, 95 per cent confidence interval 0.8-1.8). Among parous women, there was no alteration in risk with increasing number of births. Likewise, there was no significant association between age at first birth and coronary heart disease (chi, Mantel extension test for trend = -0.4, p = 0.4). Established risk factors for coronary heart disease nevertheless showed expected relations. These findings show no important association between reproductive experiences and risk of coronary heart disease. PMID- 3661535 TI - Trends in coronary heart disease in Queensland, 1971-1980. An interpretation. AB - Routine data on mortality and hospital activity were used to estimate changes in coronary heart disease mortality, case fatality, and hospitalizations in the Australian state of Queensland over the decade 1971-1980. Acute myocardial infarction (International Classification of Diseases (ICD) 410) and other ischemic heart disease (ICD 411-414) were considered separately. For acute myocardial infarction, age-adjusted total mortality declined by about one fourth in both men and women; in-hospital mortality decreased somewhat more and deaths out of hospital correspondingly less. The age-adjusted case fatality ratio fell by the same amount (29%), in both sexes. Similar trends occurred at all ages. Admission rates decreased 11% in men and 18% in women. Similar patterns were evident for other ischemic heart disease except for admissions, which rose 23% among men and remained at the same level in women. These findings suggest that both declining incidence, particularly in the form of fewer deaths out of hospital, and improvements in care may have contributed to the general decline in coronary heart disease mortality in this community. Without direct measures of incidence or changing disease severity, the relative contributions of each factor cannot be examined. PMID- 3661536 TI - Coronary heart disease risk factors in a random sample of Athenian adults. The Athens Study. AB - Risk factors for cardiovascular diseases not previously investigated in Greece were studied in a random sample of 4,097 Athenian adults. Mean systolic and diastolic blood pressures increased with age in both sexes. Similar findings were observed for mean serum total cholesterol up to age 50 years, but no significant changes were observed in older persons. Smoking was more common for men than for women and less common in those aged more than 50 years. Mean values of body mass index were higher for men than for women in those less than 45 years, but the opposite was observed for the older age groups. The age-adjusted prevalence rate of borderline hypertension was 10.1% for men and 9.1% for women and of stable hypertension (greater than 160/95 mmHg), 8.1% and 8.6%, respectively; the age adjusted prevalence rate of obesity was 23.5% for men and 23.2% for women and of hypercholesterolemia (total cholesterol greater than or equal to 260 mg/100 ml), 20.1% for men and 17.3% for women. The associations of age and systolic blood pressure and of age and diastolic blood pressure persisted even after controlling for body mass index, total cholesterol, and smoking. In the examined representative sample, the prevalence rates of risk factors for cardiovascular diseases are the same or greater than those in industrialized countries. PMID- 3661537 TI - US prevalence of occupational pleural thickening. A look at chest X-rays from the first National Health and Nutrition Examination Survey. AB - The prevalence of occupational pleural thickening in the United States in the mid 1970s was estimated; since asbestos often produces pleural thickening, this estimate in turn was used to estimate the prevalence of asbestos exposure. Chest x-rays obtained by the 1971-1975 National Health and Nutrition Examination Survey were reread by three readers using the International Labour Office criteria for diagnosis of pleural thickening consistent with dust exposure. All 289 x-rays showing any pleural abnormalities plus a 3-to-1 age-, sex-, and race-matched control series were reread. Using two of three readings as "positive," and extrapolating to the US population from this defined sample, the authors showed that 2.3% of males and 0.2% of females had occupational pleural thickening on x ray, with a strong increase with age in white males. This provides a US population estimate of 1.3 million people with occupational pleural thickening and approximately 8 million people with asbestos exposure in the mid-1970s. This cohort might make a substantial contribution to cancer mortality into the next century. PMID- 3661538 TI - Observer perception of skin color in a study of malignant melanoma. AB - Observer perceptions of skin color with a 15-step skin tone panel were evaluated during an as yet unpublished case-control study of malignant melanoma. Skin color is a risk factor for melanoma, and the skin tone panel was introduced in an effort to reduce its misclassification. Reflectances of the 15 artificial skin tones were measured at four wavelengths with a reflectance spectrophotometer. Six observers each evaluated the skin color of eight study subjects twice under three lighting conditions, and the results were transformed to reflectance values. Components of variance analysis demonstrated that between-subject variability contributed 63% or more of the variance at wave-lengths of 400-600 nm, while observers, light source, observation time, and error contributed 30% or less. At 700 nm, only 25.5% of the variance was due to subjects, indicating lower levels of reliability. Similarly, the correlation of visual and spectrophotometric assessment of skin reflectance was higher at 400-600 nm (r = 0.63-0.71) than at 700 nm (r = 0.41). Thus, the value of the skin tone panel-based assessments depends upon knowledge of which wavelengths most closely relate to the physiologic risk factor. For instance, reflectance at 650-700 nm is a better measure of skin melanin content than reflectance at lower wavelengths. Since the role of melanin as a risk factor remains in doubt, the utility of this technique has yet to be demonstrated. However, data from the case-control study and from this validity and reliability study will allow us to develop an analytic approach that minimizes misclassification of skin color as a confounder. PMID- 3661539 TI - Serum lipids in young women before, during, and after pregnancy. AB - The associations between pregnancy and serum lipids were investigated in a cohort of 831 Dutch women, initially aged 5-19 years. These women were examined yearly from 1975 to 1985 for an average period of six years, as part of a longitudinal survey of risk factors for coronary heart disease. During this period, 62 women became pregnant, and their serum total and high density lipoprotein (HDL) cholesterol levels were compared with those of an age-matched reference series of nonpregnant women, derived from the same cohort. Pregnant women showed higher total cholesterol levels (235 +/- 7.4 mg/100 ml) than nonpregnant women (205 +/- 2.7 mg/100 ml). Pregnant women also had higher levels of HDL cholesterol (66 +/- 2.1 mg/100 ml) than their referents (57 +/- 1.0 mg/100 ml). Total and HDL cholesterol increased with duration of pregnancy. When serum lipid levels of pregnant women were compared with the levels one year before and one year after pregnancy, it was observed that the year after pregnancy, HDL cholesterol levels dropped below pre-pregnancy concentrations. At the final examination, women who had ever been pregnant showed lower HDL cholesterol levels than those who had never been pregnant. The difference was most marked in users of oral contraceptives. These observations suggest that serum total and HDL cholesterol levels are elevated during pregnancy, probably because of hormonal changes. Furthermore, they point to a possibly lowering effect of parity on HDL cholesterol. These findings may help to explain the reported positive association between parity and the occurrence of cardiovascular diseases. PMID- 3661540 TI - Genetic variance of weight and length in infant twins. AB - A population-based cohort of 166 twin pairs (67 monozygotic and 99 dizygotic) born at the Jackson Memorial Hospital/University of Miami Medical Center, from July 1, 1976 to December 31, 1980 was identified. Body weight and length were measured at 14 days and at one, three, six, nine, and 12 months of age. Statistically significant genetic variance was found for both body weight and length at each data point. Heritability for body weight increased from 0.28 at 14 days to 0.64 at one year. Corresponding values for body length were 0.16 and 0.48. PMID- 3661541 TI - Injuries and deaths among elderly persons. AB - Injury related to a death may be recorded on the death certificate as the underlying cause of death or as a condition associated with death but not causing it. The present study uses the National Center for Health Statistics Multiple Cause of Death data for 1978 to determine the percentage of injury-related deaths for which injury was identified as the underlying cause of death and the variation of this percentage with age at death. Injury was identified as the underlying cause of death in 86% of all cases with injury recorded on the death certificate. The percentage with injury identified as the underlying cause varied with age: 93% for those in the first year of life, 97% for those aged 1-44 years, 87% for those aged 55-64, and 50% for those aged 75 or older. The percentage with injury identified as the underlying cause also varied by cause of injury. In all age groups, assault, suicide, and motor vehicle accidents were identified as the underlying cause of death in more than 90% of the cases in which they were mentioned. Causes other than motor vehicle accidents, assaults, and suicides, especially when occurring in the elderly, were less likely to be identified as the underlying cause of death. Cause of death tabulations based only on the underlying cause of death selectively underestimate the role of injury in the deaths of the elderly. PMID- 3661542 TI - General relative risk regression models for epidemiologic studies. AB - Three parametric families of relative risk functions for the analysis of case control data are discussed. A desirable feature for any general relative risk function is that inference based on it be independent of the coding of a binary covariate. Only one of the three families considered has this property. Additionally, when the relative risk is not multiplicative, methods of inference based on the asymptotic covariance matrix are likely to be seriously misleading unless the sample size is very large, as has been noted previously in other papers. This is illustrated by means of examples. Likelihood-based procedures should routinely be employed when nonmultiplicative relative risk functions are used for analysis of case-control data. PMID- 3661543 TI - A comparison of responses to mailed questionnaires and telephone interviews in a mixed mode health survey. AB - This paper compares respondents to mailed questionnaires with those nonrespondents subsequently interviewed by telephone in a survey of Massachusetts women aged 45-55 years conducted in 1981-1982. This mixed mode approach produced 8,050 responses, giving a response rate of 77%. This rate is similar to rates obtained in many surveys that employed in-person interviews, which are still widely used in health surveys but are increasingly expensive. Telephone respondents differed socioeconomically from mail respondents, suggesting that telephone follow-up of nonrespondents may have reduced nonresponse bias in this survey. Thus, a mixed mode approach may be superior to a mail-only approach with respect to this aspect of data quality. Women responding by mail were more likely to hold professional jobs, to have relatively high household incomes, and to have more years of education. Controlling for these socioeconomic differences did not, however, remove differences in reported health outcomes between mail and telephone respondents. These differences may be explained by less complete recall in the telephone interviews or they may arise from actual differences in health profiles between early (i.e., mail) and late (i.e., telephone) respondents. Although a mixed mode approach may reduce nonresponse bias, more research is required concerning the reasons for response differences between modes and to eliminate any differences caused by problems in data quality. PMID- 3661544 TI - Statistical methodology for paired cluster designs. AB - Recently developed methodology is applied to the analysis of data arising from a design in which an experimental intervention is assigned at random to one of two clusters in a matched pair. Standard statistical techniques do not apply to such data, since they do not take into account variation arising from differences among clusters as well as within clusters. The methodology presented provides a significance test over kappa pairs of clusters with respect to a dichotomous outcome variable while controlling for confounding. The investigation of interaction effects is also discussed. PMID- 3661545 TI - Re: "Total energy intake implications for epidemiologic analyses". PMID- 3661546 TI - Hemophiliac patient's knowledge and educational needs concerning acquired immunodeficiency syndrome. AB - The Patient Knowledge Assessment Study (PKAS) was conducted among 107 male hemophilic patients, aged 15 to 67 years, at 19 hemophilia treatment centers (HTC). Participants were given a 30-item questionnaire concerning the cause of acquired immunodeficiency syndrome (AIDS), the groups at risk, and modes of transmission. The questionnaire included questions on the participant's status in regard to antibody to human T-lymphotropic retrovirus, type III/lymphadenopathy associated virus (HTLV-III/LAV), and the meaning of this test result. HTC health care providers were asked to complete a separate questionnaire containing 17 questions about information given patients concerning their HTLV-III/LAV antibody status and its meaning. Overall, patients had a good base of knowledge about AIDS; however, there were gaps in this knowledge. Twenty-nine percent of patients did not know that spouses of AIDS patients were at risk for AIDS; 47% did not know that sexual partners of persons with hemophilia were at risk; and 32% did not know that hemophilic children were at risk. Further, only 69% understood that antibody-positive individuals had had contact with the AIDS virus. Identifying these and other areas of misunderstanding will provide the information needed to design educational strategies and psychosocial support programs appropriate for the hemophilic population, and which may serve as a model for other populations. PMID- 3661547 TI - Surgery in acute leukemia: a review of 167 operations in thrombocytopenic patients. AB - Of 435 consecutive patients with acute leukemia, 95 patients had 167 operations with a platelet count of less than 100 X 10(9)/L and 130 operations with platelet counts of less than 50 X 10(9)/L. Only 7% of operations had intraoperative blood loss of greater than 500 ml, and 7% required greater than 4 units of red cells transfused in the perioperative period. No patient died of bleeding attributable to surgery within 1 month of the operation. Granulocyte count was less than 0.5 X 10(9)/L in 66% of operations with 57% febrile preoperatively. However, no patient developed infection within the surgical field in the postoperative month. Logistic regression analyses were used to assess preoperative factors, which identified those operations at risk for excessive bleeding or postoperative surgical complications. Major (group 1) operations, preoperative fever, and preoperative coagulation abnormalities were associated with operations with an intraoperative blood loss greater than 500 ml and/or perioperative red blood cell RBC transfusions greater than 4 units (P less than .001). Surgery in cytopenic patients with acute leukemia is safe provided optimal supportive care is available. PMID- 3661548 TI - Effects of a magnesium-free dialysate on magnesium metabolism during continuous ambulatory peritoneal dialysis. AB - While the use of magnesium-containing compounds is usually contraindicated in dialysis patients, the risk of toxicity from hypermagnesemia can be reduced by lowering the magnesium concentration in dialysate. We examined the effects of a magnesium-free dialysate on both serum magnesium level and the peritoneal removal rate of magnesium over 12 weeks in 25 stable patients undergoing continuous ambulatory peritoneal dialysis (CAPD). After 2 weeks, the serum magnesium level decreased from 2.2 to 1.9 mg/dL (0.9 to 0.8 mmol/L) (P less than .02) and the peritoneal removal rate increased from 66 to 83 mg/d (2.8 to 3.5 mmol/d) (P less than .05), with both values remaining stable thereafter. There was a strong association between these parameters (r = -0.62, P less than .05), suggesting that the serum magnesium level decreased as a result of the initial increased peritoneal removal rate. For an additional 4-week period, a subgroup of nine patients received magnesium-containing, phosphate binding agents instead of those containing only aluminum. During this phase, serum inorganic phosphorus was well controlled. The serum magnesium level increased only from 1.8 to 2.5 mg/dL (0.7 to 1.0 mmol/L) (P less than .05), due in great part to the concomitant 41% rise in peritoneal magnesium removal from 91 to 128 mg/d (3.8 to 5.3 mmol/d) (P less than .05). No toxicity was noted during the entire 16-week study period, nor did serum calcium change. Thus, serum magnesium levels remained within an acceptable range as magnesium-containing phosphate binders were given through the use of magnesium-free peritoneal dialysate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661549 TI - A five-year study of the microbiologic results of exit site infections and peritonitis in continuous ambulatory peritoneal dialysis. AB - We studied the culture results from 321 continuous ambulatory peritoneal dialysis (CAPD) related infections (exit site, tunnel infections, and peritonitis) in 137 patients over a 5-year period to determine the contribution of exit site and tunnel infections to peritonitis and catheter loss. Seventeen percent of peritonitis episodes were associated temporally and by microbiologic results with exit site or tunnel infections. Twenty-one percent of exit site and tunnel infections and 20% of peritonitis episodes resulted in catheter loss. Peritonitis due to Staphylococcus aureus was more likely to be associated with an exit site or tunnel infection and was more likely to result in loss of the catheter than peritonitis due to Staphylococcus epidermidis. Peritonitis and exit site infections due to Pseudomonas sp also frequently resulted in catheter removal. We found that exit site infections cause significant morbidity in CAPD patients. Further studies in this area are needed. PMID- 3661550 TI - Iron overload and mobilization in long-term hemodialysis patients. AB - Iron overload from repeated transfusions of RBCs in long-term hemodialysis patients is a problem of increasing clinical significance. We report on the prevalence of and diagnostic criteria for identification of hemodialysis patients with iron overload. In 150 unselected hemodialysis patients, 62 (41%) had ferritin levels greater than 2,000 ng/mL (normal = 10 to 360 ng/mL). In 16 of these patients, accurate transfusion histories were obtained and ferritin levels correlated with calculated transfusional iron burden (r = 0.553, P less than .05). These patients could be divided into two distinct groups on the basis of their response to a single dose (2 g, IV) of deferoxamine: "high" responders had twice the level of feroxamine (the chelated product of deferoxamine and iron) of the "low" responders (P less than .001). High responders also had significantly higher prevalence of the "hemochromatosis" alleles A3, B7, and B14 than a large group of dialysis patients awaiting transplantation (71% v 37%, P less than .001). In two patients with iron overload and clinically significant bone disease, bone histology revealed prominent iron staining at the calcification front. We conclude that transfusional iron overload is a significant clinical problem in long-term hemodialysis patients, that may also be associated with bone pathology. PMID- 3661551 TI - Once weekly intraperitoneal therapy for gram-positive peritonitis. AB - The pharmacokinetics and clinical outcome following a 30 mg/kg/2 L intraperitoneal (IP) dose of vancomycin, which was administered once a week for 3 weeks, was studied in ten continuous ambulatory peritoneal dialysis patients with peritonitis. Vancomycin was 91% absorbed following the first dose and rapidly achieved therapeutic serum concentrations, 19 +/- 8 mcg/mL at 1 hour and a peak of 37 +/- 8 mcg/mL at 6 hours. Vancomycin was eliminated slowly with a mean total clearance of 7 +/- 3 mL/min/70 kg and a distribution volume of 1.2 +/- 0.3 L/kg. The resultant mean serum t1/2 over the first week was 184 hours and the mean serum concentration at 168 hours was 10 +/- 4 mcg/mL. Based on the positive clinical outcome (100% cure) among patients with uncomplicated gram-positive peritonitis, the potential use of this alternative vancomycin dosing regimen is proposed. PMID- 3661552 TI - Temporary loss of renal function: an unusual complication of perinephric hemorrhage after percutaneous renal biopsy. AB - Two cases of temporary loss of function following percutaneous renal biopsy are reported. The mechanism was probably restriction of renal perfusion brought about by the compression of the perirenal hematoma. PMID- 3661553 TI - Cat-bite peritonitis: Pasteurella multocida peritonitis following feline contamination of peritoneal dialysis tubing. AB - We report a case of a 55-year-old woman with end-stage renal disease undergoing intermittent peritoneal dialysis who developed peritonitis secondary to an infection with Pasteurella multocida resulting from a cat bite or cat scratch penetrating her peritoneal dialysis tubing. This case points out the potential importance of household pets as a source of peritoneal contamination. PMID- 3661555 TI - Looking upon the water. Sabbatical leaves. PMID- 3661554 TI - Sinusitis and glomerulonephritis in a middle-aged man. PMID- 3661556 TI - Effectiveness of clonidine in alleviating the symptoms of "restless legs". PMID- 3661557 TI - Oral baclofen may be effective in patients with spasticity due to spinal cord injury or disease. PMID- 3661558 TI - A genetical model for emergenesis: in memory of Laurence H. Snyder, 1901-86. AB - When a phenotype is determined by a specific gene combination of several loci, it is called an emergenic trait. Such a trait, although genetically controlled, does not usually run in families, since the specific gene combination can hardly be preserved in the process of reproduction. The present paper suggests a concrete genetical model to account for the phenomenon that there is little resemblance between siblings and parent-child pairs with respect to this trait. The genetical model is multiple homozygosis for all loci involved in the gene configuration. The properties of such a trait in a random mating population for all families, as well as for the segregating families only, are investigated. Some of the difficulties in estimating the genetical parameters on the basis of empirical data are also discussed. PMID- 3661559 TI - Isolation of a cDNA clone for the human laminin-B1 chain and its gene localization. AB - A cDNA clone encoding the B1 chain of human laminin has been isolated from a human endothelial cell cDNA library. With use of this probe and a panel of rodent/human somatic-cell hybrids and in situ hybridization, the gene for the human laminin-B1 chain has been localized to chromosome 7, band q31. PMID- 3661560 TI - The gene encoding human vimentin is located on the short arm of chromosome 10. AB - The gene for vimentin, an intermediate-filament protein, is growth regulated. We used Southern blot analysis and in situ chromosome hybridization to determine the location of the human vimentin gene. Our results show that there is only one copy of the vimentin gene and that it is located on the short arm of chromosome 10 (10pter-10q23) close to the interleukin-2 receptor gene, which is also growth regulated. In situ hybridization studies suggest that the most likely location of the vimentin gene is 10p13. Sequence similarities and homologies of human vimentin to other genes are presented. PMID- 3661561 TI - Genetic studies of low-abundance human plasma proteins. VI. Polymorphism of hemopexin. AB - An analytical isoelectric focusing method in 3 M urea followed by immunoblotting has been devised to detect genetic and biochemical variation in the glycoprotein hemopexin (HPX) in human plasma or serum. HPX reveals extensive microheterogeneity with multiple major and minor components that are susceptible to neuraminidase treatment, suggesting that the observed biochemical variation is due to differences in sialic acid content between HPX isoproteins. However, charge differences that persist in HPX isoproteins following neuraminidase treatment suggest the presence of genetically determined HPX variation, and this is confirmed by population and family studies. HPX was found to be monomorphic, with an invariant pattern, in U.S. whites; but it is polymorphic in U.S. blacks, with three alleles controlled by a single locus, a situation that demonstrates an autosomal codominant pattern of inheritance. The HPX 1, HPX 2, and HPX 3 allele frequencies in U.S. blacks are .941, .018, and .041, respectively. PMID- 3661562 TI - Rapid karyotyping of neonates on the basis of data from cord blood. AB - A method is described for karyotyping neonates on the basis of data from cord blood--by means of direct examination of dividing cells--that yields results within a few hours of birth. This method obviates the need for bone-marrow aspiration when chromosome studies are required urgently. PMID- 3661563 TI - The effects of genetic screening and assortative mating on lethal recessive allele frequencies and homozygote incidence. AB - The widespread use of genetic screening, along with mating and reproductive patterns reflecting that information, can significantly alter the genetic structure of populations. Both allele frequencies and mortality could be significantly reduced if carriers of lethal recessive alleles were withdrawn from the mating pool. But schemes to mask deleterious alleles in heterozygous condition could significantly increase the deleterious-allele frequencies while resulting in only a slight reduction in mortality. The immediate and equilibrium consequences of such mating strategies may be quite disparate. PMID- 3661564 TI - Prenatal studies in a family with transcobalamin II deficiency. PMID- 3661565 TI - Likelihoods in pedigree analysis under sequential sampling. PMID- 3661566 TI - Merging autosomal dominance and recessivity. PMID- 3661567 TI - Some investigations into the nature and cause of massive fibrosis (MF) in the lungs of South African gold, coal, and asbestos mine workers. AB - Samples from fibrotic lung lesions greater than 1 cm in diameter macroscopically (by definition, massive fibrosis; MF) were taken from the lungs of 9 randomly selected post-mortem cases of mine workers all showing a background of a pneumoconiosis. These samples were studied histologically, biochemically, and by X-ray diffraction and electron microscopy. As controls for the biochemical and X ray diffraction investigations, nonfibrosed lung tissue was taken from the same specimens. The findings suggest that the higher quartz content may be the primary cause responsible for the MF formation in this series of cases, while other factors such as tuberculosis may play a part according to some relevant literature on MF. Although an area of MF appears macroscopically to be a solid lesion, on microscopy this is not the case and the lesion is composed of dense and sparse collagen bundles and cellular elements. PMID- 3661568 TI - Comparison of occupational interview data to death certificate data in Utah. AB - Lifelong occupational histories obtained by interview prior to death were compared to death certificate data for 87 male bladder cancer patients in Utah. Agreement was defined as identical Bureau of Census codes, after predetermined groupings were made. Usual occupation, defined as that with the longest duration, agreed with the death certificate occupation for 54% of the individuals; usual industry agreed for 72%. Most recent occupation and industry agreed for 47% and 53%, respectively. For 69%, at least one interview occupation agreed with the death certificate occupation, and at least one industry agreed for 84%. Variables affecting agreement were duration of the job and education. Also examined were interview data about employment either during the last 15 years or prior to age 65 years, obtained from 112 male colon cancer patients. The Bureau of Census codes were in agreement for occupation in 63% and for industry in 65%. Duration of the job and education were related to percent agreement. We conclude that occupations and industries listed on death certificates reflect at least part of the work history of the majority of individuals. PMID- 3661569 TI - A behavioral evaluation of pest control workers with short-term, low-level exposure to the organophosphate diazinon. AB - Neurobehavioral effects of short-term, low-level exposure to diazinon were investigated among 99 pest control workers tested before and after their work shift with a computer-assisted neurobehavioral test battery. Each subject completed a brief neurological screening examination, a symptom questionnaire, and tests of concentration, eye-hand coordination, pattern recognition, visual memory, and finger tapping. The diazinon metabolite diethylthiophosphate (DETP) was measured in pre- and post-shift urine samples collected from 46 diazinon applicators applying granulated diazinon onto residential properties with lawn spreaders, and 56 non-applicators. Post-shift median DETP for applicators and non applicators was 24 and 3 ppb, respectively. Full shift, whole body exposure to diazinon was quantitated for 19 subjects using personal air monitoring and passive badges. Median diazinon exposure for applicators and non-applicators was 2.1 and 0.03 mg, respectively. Mean duration of pesticide application was 39 days (SD = 12 days) before testing. No adverse DETP-related changes in pre- or post shift neurobehavioral function were found with multiple linear regression models after adjusting for age, sex, education, and ethanol intake, although Symbol Digit pairing speed was slower among the applicators as a group. The prevalence of 18 symptoms possibly related to diazinon exposure was not elevated among applicators. The study failed to demonstrate diverse behavioral effects of short term, low-level diazinon exposure in a pest control program which emphasized personal protective equipment and direct supervision. PMID- 3661570 TI - Respiratory and nonrespiratory morbidity in a titanium oxide paint factory in Nigeria. AB - A study of 67 subjects in a small titanium oxide paint factory in Nigeria showed 50-54% frequency for airway symptoms, 20-40% for neurological symptoms, and 10 27% for other symptoms. The symptoms were well correlated with exposure (p less than .05) and pulmonary function tests (PFTs). The directly exposed subjects had likelihood odds ratios of 5 to 17 of presenting symptoms compared to controls. The PFT deficit, relative to the expected value, was significantly higher for those with airway symptoms than for those of other symptom categories (p less than .005). There were 28 (42%) cases of restrictive lung impairment. Exposure to cotton dust had confounding influence on the PFT of subjects previously exposed. Smoking rate was very low. These findings indicate the need for worker protection in a manufacturing plant in Nigeria. PMID- 3661571 TI - Historic cohort study in Montreal's fur industry. AB - A historic cohort mortality study was carried out among two groups of male workers in the Montreal fur industry: 263 dressers and dyers and 599 fur garment manufacturers. The first group is exposed to a very wide variety of chemicals used in tanning, cleaning, and dyeing fur, including substances considered to be carcinogenic and/or mutagenic. The second group is exposed to residue from the dressing and dyeing stage and to respirable fur dust. The cohorts consisted of all active members of two unions as of January 1, 1966. The mean age of the workers was 43.2 and the mean number of years since first employment 14.1. The follow-up period was from January 1, 1966, to December 31, 1981; 95% of the workers were successfully traced. Observed deaths were compared with those expected based on mortality rates of the population of metropolitan Montreal. Standardized mortality ratios (SMRs) for the manufacturers were significantly low, probably because of the ethnic composition of the cohort and a healthy worker effect. SMRs for the dressers and dyers were also low, but not as low as for the manufacturers. When attention was restricted to the French Canadians in the cohort, the observed deaths were close to the expected; there was a noteworthy excess of colorectal cancer (four observed, 0.8 expected) for dressers and dyers. Apart from this weak suggestive evidence, the results did not indicate any excess mortality risks in the fur industry. However, because of the relatively small number of expected and observed deaths in the cohort and especially among the heavily exposed dressers and dyers, the confidence intervals around SMR estimates were wide and excess risks cannot be ruled out. PMID- 3661572 TI - Assessing color vision loss among solvent-exposed workers. AB - Acquired color vision loss has been associated with exposure to organic solvents in the workplace. However, not all tests of chromatic discrimination loss are designed to detect acquired, as opposed to congenital, loss. The Lanthony D-15 desaturated panel (D-15-d), a simple 15 cap color arrangement test, designed to identify mild acquired dyschromatopsia, can be administered rapidly in the field, under standard conditions. The objective of the present study was to evaluate the D-15-d among 23 solvent-exposed workers of a paint manufacturing plant, by comparing the results obtained with the D-15-d to those obtained with the Farnsworth-Munsell 100 Hue (FM-100), a highly sensitive measure of color vision loss. The D-15-d revealed a significantly higher prevalence of dyschromatopsia among the ten highly exposed workers (80%) as compared to the 13 moderately exposed workers (30.8%); FM-100 results revealed one false positive. All dyschromatopic workers presented blue-yellow loss; the FM-100 detected eight complex patterns, while the D-15-d identified 5. Comparison of D-15-d and FM-100 scores were highly correlated (corr. coeff. 0.87; p less than 0.001). Multiple regression analyses showed both scores to be significantly related to age and exposure level. The findings of this study indicate that the D-15-d is an adequate instrument for field study batteries. However, the FM-100 should be used for more detailed assessment. PMID- 3661573 TI - Occupational asthma from inhaled egg protein. AB - We evaluated workers and performed an industrial hygiene assessment at a plant where raw eggs are processed into powdered egg yolk and whole egg. Egg dust levels in the packaging room straddled the American Conference of Governmental Industrial Hygienists' (ACGIH) exposure guideline of 10 mg/m3 for nuisance dust. We obtained medical histories from 25 workers, and performed physical examinations, spirometry, and serial determinations of peak expiratory flow rate (PEFR) by portable meter every 3 hrs (while awake) for 7 days. We defined symptomatic bronchial lability to be a decrement in PEFR on any one day of 20% or more of the day's maximum, with concurrent symptoms. Skin-prick tests and serum assays for specific IgE by the radioallergosorbent (RAST) method were performed to assess sensitivity to commercial egg proteins, egg protein fractions, and freshly prepared extracts of whole egg powder and yolk. We classified participants as definite cases of asthma if both the examining physician diagnosed asthma and symptomatic bronchial lability was demonstrated by serial PEFR determinations. Definite noncases of asthma were those participants in whom the physician did not diagnose asthma and in whom symptomatic bronchial lability was not demonstrated by PEFR. All five definite cases, compared to three of 16 definite noncases of asthma, had one or more positive skin-prick tests to egg proteins. Four of five cases, compared to 0 of 14 noncases, who had serum determinations, had an elevated RAST to one or more of the egg proteins. This study demonstrates that occupational asthma associated with IgE-mediated allergy to egg proteins occurs among workers exposed to inhaled egg proteins. PMID- 3661574 TI - Lung cancer risk among workers with silicosis: potential confounding by smoking habits. PMID- 3661575 TI - Prevalence of radiographic small opacities in vermiculite miners. PMID- 3661576 TI - The hazardous waste facility siting controversy: the Massachusetts experience. AB - Intense local opposition has frequently frustrated efforts to site hazardous waste facilities. This Note examines states' attempts to balance the increasing need for such facilities with growing community opposition. The Note focuses on the Massachusetts response to this problem, and argues that the Massachusetts program has failed to adequately preempt a locality's power to block facility siting. The Note proposes an alternative model, based on the National Environmental Policy Act, which addresses local concerns while achieving its purpose of siting safe containment facilities for toxic substances. PMID- 3661577 TI - Crisis and informed consent: analysis of a law-medicine malocclusion. AB - Many individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician. PMID- 3661578 TI - The case against compulsory casefinding in controlling AIDS--testing, screening and reporting. AB - The spread of acquired immune deficiency syndrome (AIDS) demands a comprehensive and effective public health response. Because no treatment or vaccine is currently available, traditional infection control measures are being considered. Proposals include compulsory testing and screening of selected high risk populations. The fairness and accuracy of compulsory screening programs depend upon the reliability of medical technology and the balancing of public health and individual confidentiality interests. This Article proposes criteria for evaluating compulsory testing and screening programs. It concludes that voluntary identification, education, and counselling of infected persons is the most effective means of encouraging the behavioral changes that are necessary to halt the spread of AIDS. PMID- 3661579 TI - Drunk driving and the alcoholic offender: a new approach to an old problem. AB - Health laws in every state recognize alcoholism as a treatable disease. State drunk driving laws, however, inadequately provide for alcoholic drunk drivers. Studies show that problem drinkers make up as much as two-thirds of the DWI offender class. Alcoholic drunk drivers cannot fully conform their drinking behavior to the dictates of the law as long as their alcoholism remains untreated. This Note argues that the law should consistently treat alcoholism as a disease. This Note suggests that the most appropriate way for the legal system to deal with alcoholic DWI offenders is to suspend the offender's license until he can show that he has successfully completed an initial alcohol detoxification/rehabilitation program. In addition, because alcoholism requires lifelong treatment, alcoholic drivers should be required to present periodic documentation that their condition is under supervised treatment. Epileptic drivers are handled in a similar manner in most states. PMID- 3661580 TI - Refractory symptomatic ventricular tachycardia and ventricular fibrillation in elderly patients. AB - The problem of refractory life-threatening ventricular tachyarrhythmias in elderly patients has not been previously studied. To determine if clinical, anatomic, or electrophysiologic variables and prognosis are significantly different in elderly subjects, 49 elderly (68 to 84 years) and 44 younger (44 to 53 years) survivors of refractory symptomatic ventricular tachycardia and/or ventricular fibrillation secondary to coronary artery disease were studied. Elderly patients displayed more extensive anatomic coronary artery disease, with 80 percent having three-vessel disease in comparison with 30 percent of the younger patients (p less than 0.001). Prior myocardial infarction, heart failure, and cardiomegaly were more common in the elderly group (p less than 0.01, p less than 0.001, and p less than 0.034, respectively), whereas angina was more common in the younger group (p less than 0.001). In 55 percent of the elderly patients and 58 percent of the younger patients, electrophysiologic testing demonstrated inducible sustained ventricular tachycardia that required treatment with an investigative antiarrhythmic drug and/or cardiac surgery, including implantation of an automatic defibrillator. Elderly patients tolerated aggressive evaluation as well as did younger patients, and despite the difference in clinical and anatomic findings, long-term survival curves were similar, although the probability of survival at 20 months was 62 percent in the elderly and 80 percent in the younger patients. This difference in early survival is explained by eight surgical deaths in the elderly group, compared with two in the younger group. PMID- 3661581 TI - Inefficacy of pneumococcal vaccine in a high-risk population. AB - Use of pneumococcal vaccine remains controversial. To further study this question, 89 patients hospitalized at the Denver Veterans Administration Medical Center with pneumococcal bacteremia were chosen as the case group for a case control study. The control group was made up of patients matched on the basis of age, date of admission, and comorbid conditions. Vaccination status in the bacteremic patients and control patients was determined, as were pneumococcal serotypes among the bacteremic patients. If the vaccine were protective, vaccination rates should be higher among the control patients, and serotype distribution should be different in vaccinated and nonvaccinated bacteremic patients. There were no differences between vaccination rates among bacteremic patients (29 percent) and control patients (24 percent). Furthermore, 65 percent of the blood isolates from nonvaccinated bacteremic patients were serotypes included in the vaccine, as compared with 69 percent of the isolates in vaccinated bacteremic patients. Pneumococcal vaccine did not appear to be protective in this high-risk population. PMID- 3661582 TI - High incidence of relapses in thrombotic thrombocytopenic purpura. Clinical study of 38 patients. AB - Described in this study are 38 patients who received treatment for thrombotic thrombocytopenic purpura in 15 hospitals in Israel and the New York City area since 1977, when plasma therapy was introduced. Thirty-seven patients received plasma therapy and 30 survived. In 12 patients (37 percent of survivors), relapsing thrombotic thrombocytopenic purpura developed, manifested by thrombocytopenia and microangiopathic hemolytic anemia, and less frequently by neurological or renal abnormalities. Six patients had a second relapse, and two had five relapses. To assess the severity of the disease, a scoring system was designed based on the four major manifestations of thrombotic thrombocytopenic purpura listed above. The patients who died had a significantly higher score than those who survived. The initial episodes and the relapses of patients with relapsing thrombotic thrombocytopenic purpura were milder than those in patients who only had a single episode and survived. Two relapses, however, were fatal, demonstrating that relapsing thrombotic thrombocytopenic purpura is not a benign disorder. Infections, pregnancy and surgery were frequently associated with the initial episodes and the relapses. Hence, patients who recover from thrombotic thrombocytopenic purpura should be alerted to the possibility of relapse in association with these conditions. PMID- 3661583 TI - Central nervous system involvement in acute nonlymphocytic leukemia. A prospective study of adults in remission. AB - To identify adults with acute nonlymphocytic leukemia at risk for the development of central nervous system involvement, we performed periodic cerebrospinal fluid examinations on patients in remission. Among 58 consecutive patients monitored during first remission, central nervous system leukemia developed in nine (16 percent). Four patients, including one who was symptomatic, had central nervous system leukemia detected simultaneously with marrow relapse. Five additional patients were asymptomatic and continue to have bone marrow remission. Following central nervous system and systemic treatment, two of these five patients have never had relapse, and three had relapse in the bone marrow five, 10, and 21 months later. Factors at diagnosis associated with the subsequent development of central nervous system leukemia were elevated leukocyte count, serum lysozyme and lactate dehydrogenase, extramedullary infiltration including splenomegaly, and monocytic (FAB M4 or M5a) morphology. In six of 17 patients (35 percent) with monocytic morphology, central nervous system leukemia developed compared with only three of 41 patients (7 percent) with other subtypes (p = 0.02). Discriminant analysis identified leukocyte count, splenomegaly, and M4 or M5a morphology as the most important risk factors and led to a mathematical formula that correctly identified 90 percent of the patients. Although the risk of central nervous system leukemia in adults with acute nonlymphocytic leukemia is too low to justify routine prophylaxis, those patients recognized to be at a greater risk should receive prophylaxis or be monitored closely with periodic lumbar punctures. PMID- 3661584 TI - Papillary and follicular thyroid cancer. Prognostic factors in 1,578 patients. AB - This report from the Canadian survey of thyroid cancer describes 1,074 patients with papillary thyroid cancer and 504 with follicular thyroid cancer followed for four to 24 years. The study groups included more patients with "advanced" disease and fewer with "early" disease than in the general population because these patients were referred to radiotherapy cancer centers, sometimes routinely, but often because referring physicians believed that certain clinical features indicated the need for additional treatment. Although this report is subject to all the problems of retrospective studies, a careful assessment of the pretreatment extent of disease combined with a long follow-up period has allowed an analysis of prognostic factors with considerable confidence. Univariate analysis of 12 possible prognostic factors (excluding treatment) demonstrated that nine of them were of statistical significance: postoperative status, age at diagnosis, extrathyroidal invasion, distant metastases, nodal involvement, differentiation, sex, tumor size, and pathologic type (in descending order of importance). Multivariate analysis was carried out using cause-specific survival rates. Independently important prognostic factors at initial treatment were age at diagnosis, extrathyroidal invasion, and degree of differentiation histologically for papillary cancers; and extrathyroidal invasion, distant metastases, primary tumor size, nodal involvement, age at diagnosis, and postoperative status for follicular cancers. The prognostic factors for tumor recurrence were quite different for the papillary and follicular cancers and ranked differently for the two groups. PMID- 3661585 TI - Fine needle aspiration of the thyroid. Use in an average health care facility. AB - Fine needle aspiration of the thyroid is suggested as an initial diagnostic procedure in the evaluation of thyroid nodules. Some proponents of the procedure, however, believe that fine needle aspiration should be restricted to centers in which each operator obtains at least 500 biopsy specimens annually. Reviewed were 155 biopsy specimens obtained over three and one-half years, and the sensitivity of fine needle aspiration was determined to be 100 percent, the specificity to be 47.4 percent, and the accuracy to be 73 percent. A review of the literature revealed the sensitivity in larger series to range between 92 and 98 percent, specificity to range between 52 and 99.5 percent, and accuracy to range between 56.1 and 91.3 percent. The surgical yield of carcinoma was 64 percent in patients evaluated with fine needle aspiration, whereas the yield was 26 percent in those who underwent surgery without fine needle aspiration. These results appear to justify the use of fine needle aspiration in the evaluation of nodular thyroid disease at average-sized health care centers. PMID- 3661586 TI - How to classify Raynaud's phenomenon. Long-term follow-up study of 73 cases. AB - Raynaud's phenomenon without an underlying cause was diagnosed in 96 consecutive patients in 1978 to 1979. Seventy-three patients were available for long-term follow-up. They were classified on initial evaluation as having primary Raynaud's phenomenon (49 patients) when no clinical, laboratory, or serologic abnormality was detected, and as having suspected secondary Raynaud's phenomenon when at least one finding was abnormal. Re-evaluation was performed in 1984 to 1985 after an average duration of Raynaud's phenomenon of 14.9 +/- 12 years. The average duration of the follow-up from initial to final evaluation was 4.7 +/- 1 years. On final evaluation, none of the 49 patients with an initial diagnosis of primary Raynaud's phenomenon had evidence of secondary Raynaud's phenomenon, whereas 14 of the 24 patients with suspected secondary Raynaud's phenomenon had a definite diagnosis. Among them, there were 13 connective tissue diseases. The study proved that Raynaud's phenomenon without an underlying cause must be followed up for more than two years, contrary to what was recommended previously, before it can be rightly diagnosed as primary Raynaud's phenomenon. Moreover, the results suggested that, in order to distinguish early primary Raynaud's phenomenon from suspected secondary Raynaud's phenomenon, a simple and noninvasive evaluation is sufficient. In this study, the evaluation included history and clinical examination, tests for antinuclear antibodies, radiography of hands, chest roentgenography, and nailfold capillary microscopy. PMID- 3661587 TI - Dyslipoproteinemia in systemic lupus erythematosus. Effect of corticosteroids. AB - The increased incidence of atherosclerotic coronary artery disease in patients with systemic lupus erythematosus (SLE) may be due to a dyslipoproteinemia caused by corticosteroid administration. To determine whether lipoprotein lipid levels are abnormal in SLE and the relation of lipoprotein levels to corticosteroid use, lipid and apolipoprotein levels were measured in 46 female patients with SLE and 30 matched control subjects. The patients with SLE had higher levels of plasma triglyceride (134 versus 73 mg/dl; p less than 0.001), cholesterol (201 versus 168 mg/dl; p less than 0.001), and low-density lipoprotein cholesterol (121 versus 94 mg/dl; p less than 0.001) than control subjects. The levels of high density lipoprotein cholesterol, high-density lipoprotein subfraction 3 cholesterol, and apolipoprotein Al were similar in the two groups, but high density lipoprotein subfraction 2 cholesterol was lower in the patients with SLE (10.2 versus 18.2 mg/dl; p less than 0.001). When patients with SLE treated with prednisone (n = 32) were compared to patients with SLE not treated with prednisone (n = 14), the former had higher triglyceride (158 versus 87 mg/dl; p less than 0.001), cholesterol (214 versus 170 mg/dl; p less than 0.001), and low density lipoprotein cholesterol (130 versus 103 mg/dl; p less than 0.001) levels. The patients with SLE not treated with prednisone had lipid levels similar to those in control subjects except that high-density lipoprotein cholesterol was lower (49.7 versus 59.0 mg/dl; p less than 0.05). The daily prednisone dosage in the treated patients with SLE correlated with levels of cholesterol (r = 0.38, p less than 0.02), high-density lipoprotein cholesterol (r = 0.40, p less than 0.02), and high-density lipoprotein subfraction 3 cholesterol (r = 0.47, p less than 0.01). Thus, female patients with SLE have a dyslipoproteinemia of the type that would place them at an increased risk for coronary artery disease. Corticosteroids, used in the treatment of SLE, seem to play a role in the pathogenesis of the observed lipoprotein abnormalities. PMID- 3661588 TI - Is our AIDS policy ethical? PMID- 3661589 TI - Impact of multiple comparisons in randomized clinical trials. AB - The randomized clinical trial is the preferred research design for evaluating competing diagnostic and therapeutic alternatives, but confidence in the conclusions from a randomized clinical trial depends on the authors' attention to acknowledged methodologic and statistical standards. This survey assessed the level of attention to the problem of multiple comparisons in the analyses of contemporary randomized clinical trials. Of the 67 trials surveyed, 66 (99 percent) performed multiple comparisons with a mean of 30 therapeutic comparisons per trial. When criteria for statistical impairment were applied, 50 trials (75 percent) had the statistical significance of at least one comparison impaired by the problem of multiple comparisons, and 15 (22 percent) had the statistical significance of all comparisons impaired by the problem of multiple comparisons. Although some statistical techniques are available, there still exists a great need for future work to clarify further the problem of multiple comparisons and determine how the impact of this problem can best be minimized in subsequent research. PMID- 3661590 TI - Role of clindamycin in the treatment of central nervous system toxoplasmosis. AB - Three patients with acquired immune deficiency syndrome (AIDS), central nervous system toxoplasmosis, and hypersensitivity to sulfadiazine were given treatment with clindamycin plus pyrimethamine. All three showed improvement clinically with resolution of symptoms. Two patients had computed tomographic evidence of improvement with reduction in size or clearing of cerebral lesions and the third had resolution of chorioretinitis. Another patient who had a relapse during administration of standard therapy (pyrimethamine plus sulfadiazine) had a clinical response when clindamycin was added to this regimen. Clindamycin in combination with pyrimethamine, or as an adjunct to standard therapy, may be useful in the treatment of central nervous system toxoplasmosis in patients with AIDS. PMID- 3661591 TI - Sterile splenic abscesses in systemic Weber-Christian disease. Unique source of abdominal pain. AB - A patient with Weber-Christian disease and relapsing abdominal pain due to sterile splenic abscesses is presented. Histologically, acute and chronic inflammation with focal suppurative infiltrates of phagocytosed fat was detected in the absence of vascular or embolic disease, infection, or other apparent cause. Abdominal discomfort, an uncommon manifestation of Weber-Christian disease, usually is related to mesenteric panniculitis. Sterile splenic abscesses represent a previously undescribed complication of Weber-Christian disease, and another source of abdominal pain in this disorder. Although the precise pathophysiology of sterile splenic abscess formation in Weber-Christian disease is unknown, splenectomy is an effective means of alleviating pain. PMID- 3661592 TI - Pseudosepsis after myocardial infarction. Unusual presentation of anterior wall rupture and left ventricular pseudoaneurysm. AB - Left ventricular pseudoaneurysm complicating myocardial infarction is extremely rare. A case of left ventricular anterolateral pseudoaneurysm with its initial presentation mimicking septic shock is reported. The need for urgent resection is stressed due to the high incidence of spontaneous rupture and death regardless of the age or the size of the pseudoaneurysm. PMID- 3661593 TI - Lack of myocardial necrosis despite clinical and electrocardiographic criteria of acute transmural infarction. AB - The development of "pathologic" Q waves with ST segment elevation is considered diagnostic of transmural myocardial infarction. Previous reports have suggested that myocardial ischemia without infarction can result in electrocardiographic abnormalities simulating those of acute infarction. However, lack of infarction has been poorly documented in these reports. If real, this phenomenon could have an impact on the management of patients with apparent acute infarction. This study describes a patient with documented severe myocardial ischemia and electrocardiographic evidence of acute transmural myocardial infarction, in whom significant myocardial necrosis has been excluded definitively. PMID- 3661594 TI - Premenopausal osteoporosis associated with vitamin D-responsive calcium malabsorption. A case report. AB - A premenopausal woman with severe osteoporosis was found to have impaired calcium absorption, without other evidence of intestinal malabsorption. Although circulating levels of 25-OH-vitamin D and 1,25-(OH)2-vitamin D were normal, calcium absorption improved markedly following two weeks of treatment with synthetic 1,25-(OH)2-vitamin D. This suggests that a partial intestinal resistance to the actions of 1,25-(OH)2-vitamin D contributed to the development of her osteoporosis. This case report demonstrates the feasibility of using the calciuric response to a standard oral calcium load to screen for impaired calcium absorption in osteoporotic patients. PMID- 3661595 TI - Cecal perforation following flexible sigmoidoscopy. PMID- 3661596 TI - Legionella micdadei pneumonia in the acquired immune deficiency syndrome. PMID- 3661597 TI - Chronic cocaine abuse and dilated cardiomyopathy. PMID- 3661598 TI - Prinzmetal's angina during 5-fluorouracil chemotherapy. PMID- 3661599 TI - Multinodular pneumonia caused by Legionella. PMID- 3661600 TI - Treatment of diabetic diarrhea with clonidine. PMID- 3661601 TI - Bacterial infections in adult patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related complex. PMID- 3661602 TI - Infective endocarditis due to Clostridium sordellii. PMID- 3661603 TI - New agenda for medicine. PMID- 3661604 TI - Metastasis in deep calf muscles as first manifestation of bronchus adenocarcinoma. PMID- 3661605 TI - Abused statistical language in journal articles. PMID- 3661607 TI - International Sucralfate Research Conference. Proceedings of a symposium. February 7 through February 12, 1987, Maui, Hawaii. PMID- 3661606 TI - Prolonged antiviral activity of D-penicillamine in human immunodeficiency virus infected homosexual men. PMID- 3661608 TI - Acid, cytoprotection, and peptic ulcer. Introduction. PMID- 3661609 TI - Efficacy of sucralfate and cimetidine in protection of the human gastric mucosa against alcohol injury. AB - In order to study whether sucralfate or cimetidine may protect human gastric mucosa against alcohol injury, 28 healthy volunteers were pretreated with either: (1) placebo 1 g; (2) cimetidine (Tagamet) 300 mg; or (3) sucralfate (Carafate) 1 g. One hour later, 100 ml of 40 percent ethanol was sprayed directly on the gastric mucosa of the greater curvature during an endoscopic examination. Gastric mucosal changes were assessed by endoscopic appearance (according to grading scale) and by histology. In placebo-pretreated subjects, alcohol produced prominent mucosal damage (endoscopic score, 3.9 +/- 0.3, histologic score, 4.0 +/ 1.1 at 30 minutes). Cimetidine alkalinized gastric pH but did not prevent alcohol-induced damage (endoscopic score, 4.0 +/- 0.6; histologic score, 3.8 +/- 1.1, at 30 minutes). Sucralfate reduced endoscopic and histologic features of alcohol injury (endoscopic score, 1.8 +/- 0.6; histologic score, 1.8 +/- 1.1, at 30 minutes) without affecting gastric luminal pH. Reduction of alcohol-induced injury of the human gastric mucosa by sucralfate but not cimetidine demonstrates that effective protection of the gastric mucosa can be achieved without neutralization or inhibition of gastric acid secretion and points out another clinical application for sucralfate. PMID- 3661610 TI - Clinical efficacy of sucralfate in reflux esophagitis. Comparison with cimetidine. AB - Sucralfate has been evaluated in reflux esophagitis, based on its protective adherence to denuded surfaces, its bile salt-binding properties, and its cytoprotective properties. Histamine (H2)-receptor blockers are currently considered the standard therapy. The goal of this study was to compare the potential efficacy of sucralfate with that of cimetidine. A single-blind, randomized, multicenter study was performed in 42 patients with endoscopically documented reflux esophagitis. Patients were randomly given 1 g of sucralfate suspension four times daily or 400 mg of cimetidine four times daily for eight weeks. Forty patients were evaluated after eight weeks. Symptomatic improvement was good and comparable in both groups. In two patients given sucralfate and one given cimetidine, side effects were noted but did not necessitate withdrawal from the study. Endoscopy showed improvement in 53 percent of patients and healing of esophagitis in 31 percent after sucralfate treatment. With cimetidine, improvement was seen in 67 percent and healing occurred in 14 percent. In one patient receiving cimetidine, distal esophageal stenosis developed, requiring dilatation therapy. It is concluded that treatment with sucralfate improves the symptomatology and severity of reflux esophagitis. The results obtained with sucralfate appear comparable to those with cimetidine. Sucralfate may therefore be considered as a valid alternative to H2-receptor antagonist therapy in treating reflux esophagitis. PMID- 3661611 TI - Comparison of potential cytoprotective action of sucralfate and cimetidine. Studies with experimental feline esophagitis. AB - The potential mucosal protective effects of a liquid sucralfate preparation and the histamine (H2)-antagonist cimetidine on acid-induced esophagitis were studied. Esophagitis was induced in adult cats using a constant infusion of 0.1 N hydrochloric acid at 1 ml/minute for 20 minutes. Mucosal lesions were evaluated by blinded investigators using both fiber-optic endoscopy and light microscopy. Histology was scored for basal cell hyperplasia, intraepithelial leukocytosis, and subepithelial leukocytosis. Liquid sucralfate given prior to acid infusion consistently prevented acid-induced lesions, demonstrated by quantitative histologic scoring. Although cimetidine did not show the same degree of protection as sucralfate, the results did show a trend towards a cytoprotective effect. PMID- 3661612 TI - Effects of concurrent sucralfate administration on pharmacokinetics of naproxen. AB - Sucralfate has been reported to protect the gastroduodenal mucosa against a variety of agents and is known to adsorb bile salts. Since gastrointestinal side effects can seriously compromise the efficacy of nonsteroidal anti-inflammatory drug therapy, and since it seems reasonable to assume that sucralfate may adsorb nonsteroidal anti-inflammatory drugs, the influence of sucralfate on the pharmacokinetic parameters of naproxen was assessed in 12 healthy volunteers. To do so, the pharmacokinetic profile of naproxen, administered alone or with sucralfate, singly or repeatedly (twice daily for five days), was compared. No significant difference was observed with any pharmacokinetic parameter between the single administration of naproxen alone or with sucralfate. However, a significantly lower maximum plasma concentration was attained with the repeated administration of naproxen in combination with sucralfate, compared with the repeated administration of naproxen alone. When single- and multiple-dose administration were compared, significant differences were observed in the maximum plasma concentration and the cumulative area under the curve. These results suggest an accumulation of naproxen after five days' administration. This accumulation, however, is not altered by the administration of sucralfate. The results of this study suggest that when naproxen is administered with sucralfate, only a delay in naproxen's absorption may occur, confirmed by a lower maximum plasma concentration, a longer time to reach the maximum plasma concentration, a similar elimination half-life, and equivalence in bioavailability. The clinical importance of such a delay has yet to be proved; however, it is unlikely that the clinical efficacy of naproxen will be altered, since the amount of drug absorbed remains the same. PMID- 3661613 TI - Protective effect of sucralfate against aspirin-induced damage to the human gastric mucosa. AB - Sucralfate, an agent that heals peptic ulcers in humans, has been shown to reduce aspirin-induced gastric mucosal damage in experimental animals. It has been suggested that the protective effect of sucralfate is due to stimulation of local prostaglandin production. The purpose of this study was to establish whether sucralfate was capable of reducing aspirin-induced gastric damage in humans. The effect of 1 g of sucralfate or identical placebo was studied in random order in eight healthy subjects. To determine if the effect of sucralfate was related to local prostaglandin synthesis, a second series of studies was performed in which prostaglandin production was inhibited with indomethacin 50 mg given orally eight hours before sucralfate. In each subject, all studies were performed at least one week apart. Following an overnight fast, upper gastrointestinal endoscopy was performed, with sucralfate or placebo given orally 30 minutes before ingestion of 1,200 mg of soluble aspirin in 50 ml of water. Both endoscopist and subject were unaware of the test agent. Ninety minutes after aspirin ingestion, endoscopy was again performed and gastric mucosal lesions were counted and graded to derive an erosion score. Results are expressed as mean +/- SEM. Aspirin produced endoscopic changes (score of 2.75 +/- 0.49) that were significantly (p less than 0.05) inhibited by sucralfate (score of 1.13 +/- 0.44). The protective effect of sucralfate was abolished by pretreatment with indomethacin (scores of 2.88 +/- 0.55 and 1.88 +/- 0.40, respectively). These results demonstrate that sucralfate significantly protects the human gastric mucosa against the acute damaging effects of aspirin. This effect is abolished by indomethacin, suggesting that the protective action of sucralfate on the gastric mucosa of humans may be related to stimulation of endogenous prostaglandins. PMID- 3661614 TI - Role of maintenance sucralfate in prevention of duodenal ulcer recurrence. AB - Fifty-nine patients who had duodenal ulcers that were healed following sucralfate administration in a dose of 1 g four times a day were randomly entered into a double-blind, placebo-controlled, 12-month maintenance study to determine whether sucralfate 1 g twice daily prevents recurrence of duodenal ulceration. Patients were assessed endoscopically at four, eight, and 12 months after healing or earlier if clinical relapse occurred. Of the original 59 patients, 53 showed healing with six weeks of therapy, and the remaining six patients required 10 weeks of treatment. Nine patients were subsequently lost to follow-up because of non-compliance, leaving 50 patients for the analysis, 24 who received sucralfate and 26 who received placebo. There were 10 ulcer recurrences in the sucralfate group and the ulcers in 14 (58 percent) patients remaining healed at the end of 12 months. In contrast, there were 21 recurrences in the placebo group with the ulcers in five patients (19 percent) remaining healed at 12 months. Patients who received placebo experienced recurrence more quickly than those who received sucralfate and there was no difference between the two groups in terms of symptomatic and asymptomatic recurrence. There was no alteration in serum aluminium and phosphate levels throughout the study. Smoking seemed to have no adverse effect on recurrence once initial healing had been achieved. Sucralfate is, therefore, an effective and safe maintenance treatment for duodenal ulcer disease. PMID- 3661616 TI - Prolonged volume depletion imitating end-stage renal failure. AB - Four patients with chronic renal insufficiency were erroneously diagnosed as reaching the "end stage" of their disease. All of them had had insidious salt and water depletion prolonged over a period of 5 to 8 weeks. The correct diagnosis was missed because the signs and symptoms of slowly developing volume depletion were indistinguishable from the clinical picture of terminal uremia. Correction of the salt and water depletion was followed by marked clinical improvement and return of renal function to baseline values. Postural hypotension and hyponatremia are important clues for the diagnosis of insidiously developing mild or moderate volume depletion super-imposed on chronic renal insufficiency. PMID- 3661615 TI - Reversible acute decrease in renal function by NSAIDs in cirrhosis. AB - The effects of sulindac were compared with those of ibuprofen or naproxen on creatinine clearance and urinary prostanoids in patients with severe alcoholic cirrhosis. Sulindac caused acute declines in all renal parameters in four of five patients. The effect occurred with serum concentrations of the active sulfide metabolite comparable to those in patients with no hepatic impairment. The patient who was not affected had less effects on urinary PGE2 and TxB2 and no effect on 6-keto PGF1 alpha. In this patient, dosing with ibuprofen caused pronounced declines in all urinary prostanoids and a decrease in creatinine clearance. Two other patients treated with ibuprofen and one treated with naproxen also suffered decrements in all parameters. In conclusion, sulindac had suppressant effects on renal prostanoids associated with declines in creatinine clearance in these patients with cirrhosis, indicating a need for similar cautions with its use as with other NSAIDs. PMID- 3661617 TI - Effects of serum from oral contraceptive users on the metabolism of low density lipoprotein. AB - The metabolism of radiolabeled 125I-low density lipoprotein (LDL) was studied in cultured human aortic smooth muscle cells (SMC) to investigate potential mechanisms contributing to heart attack and stroke in young women taking oral contraceptive (OC) preparations. No consistent difference was discerned in the capacity of these cells to bind and internalize LDL following 24-hour exposure to pooled lipoprotein-poor (d greater than 1.25 gm/ml) serum from nonsmoking OC users and controls. However, significantly (p greater than 0.01) less soluble radioactive material was released into the media from dishes containing SMC incubated with OC serum, indicating that their capacity to degrade LDL was impaired. Increased amounts of both cholesterol and cholesterol ester and electron microscopic evidence of lipid accumulation were found in SMC grown for 12 days under standard culture conditions with 10% OC serum. This combination of in vitro findings suggests that OC use may accelerate the development of cardiovascular disease in some women by modifying the metabolism of LDL by cells of the arterial wall. PMID- 3661618 TI - Metabolism in human endomyocardial biopsies and cardiac work. AB - The activities of the Krebs cycle (KC), glycolytic pathway (GP), and the hexose monophosphate shunt were studied in endomyocardial biopsies obtained from 25 patients and were related to left ventricular stroke work index (LVSWI). Unexpectedly, KC activity was greater in patients with a reduced LVSWI than in those with a normal or elevated LVSWI. When the cardiac work:KC ratio, defined as LVSWI divided by KC activity, was plotted against LVSWI, the correlation coefficient was 0.86. Cardiac work did not correlate with other metabolic pathways measured. Patients with a reduced LVSWI generated less cardiac work per unit of KC activity than those who had a normal or elevated LVSWI. These data indicate that a reduction in LVSWI below 40 gram-meters/square meter (gm-m/m2) may be associated with either inefficient energy production, inefficient energy utilization, or both. PMID- 3661619 TI - 5-Fluorouracil cardiotoxicity: left ventricular dysfunction and effect of coronary vasodilators. AB - Seven patients developed clinical features simulating myocardial ischemia less than 72 hours after 12 of 13 separate intravenous 5-fluorouracil administrations; 9 episodes were associated with chest pain, 3 with hypotension, 3 with ventricular tachycardia and 1 with cardiogenic shock. Left ventricular dysfunction was demonstrated by echocardiography in 5 separate episodes, 2 with interval improvement upon repeat echocardiograms. Pretreatment with nitrates and/or calcium channel blockers failed to prevent recurrence of cardiotoxicity during 5 of 6 repeat 5-fluorouracil administrations. Therapy with 5-fluorouracil is associated with cardiotoxicity simulating myocardial ischemia with left ventricular dysfunction. Pretreatment with coronary vasodilators may not prevent this phenomenon. PMID- 3661620 TI - Angioimmunoblastic lymphadenopathy following Kaposi's sarcoma. AB - The close relationship of Kaposi's sarcoma (KS) with other lymphoproliferative disorders is a poorly understood, but well documented, phenomenon. A case is presented of a 68-year-old woman with the classical form of cutaneous KS in whom disappearance of the lesions after treatment was shortly followed by the development of angioimmunoblastic lymphadenopathy, pursuing a fulminant course to death. Postmortem examination revealed diffuse involvement of the marrow, spleen, liver, and lymph nodes by the immunoblastic proliferation. The close association of these two conditions may represent more than a chance occurrence. The appearance of a constellation of nonspecific symptoms suggestive of a lymphoproliferative disorder in debilitated patients with KS should alert the physician to the possibility of the development of this rare complication. PMID- 3661621 TI - Vaso-occlusive crisis-associated neutrophil dysfunction in patients with sickle cell disease. AB - Polymorphonuclear leukocyte (PMN) aggregation and chemotaxis were studied in 27 patients with sickle cell disease (SCD). Pain-free patients with SCD had a significantly impaired aggregation response to stimulation with n-formylmethionyl leucyl-phenylalanine (FMLP) with or without cytochalasin B (CB), compared with normal volunteers (p less than 0.001). Patients with SCD in vaso-occlusive crisis had PMN aggregation induced by FMLP with or without CB that was significantly increased compared with the cohort of pain-free SCD patients (p less than 0.001). PMN from pain-free patients had normal chemotaxis, whereas patients in vaso occlusive crisis had a significant impairment in PMN chemotaxis. PMN chemotaxis was inversely related to the PMN aggregation response to FMLP with CB (r = 0.75). Thus, the PMN from pain-free patients with SCD appears to have normal or decreased "stickiness" and to develop increased stickiness during vaso-occlusive crisis. The mechanisms responsible for these changes need further elucidation. Alterations in PMN function may be responsible, in part, for the increased risk of infection noted in individuals with SCD and may play a role in the development of the acute chest syndrome. PMID- 3661622 TI - Malignant thymoma associated with progressive systemic sclerosis. AB - A 65-year-old man manifested certain features of scleroderma several years before discovery of malignant thymoma. Following tumor resection, the signs and symptoms of scleroderma did not improve, and the patient experienced the abrupt onset of renal failure with malignant hypertension 7 months after the operation. The scleroderma renal crisis caused terminal renal failure, which was treated by chronic hemodialysis. This is the second reported case of thymoma associated with progressive systemic sclerosis (PSS). The authors suggest that thymoma and various immunologic disorders have a common etiologic factor which has not yet been found. This case emphasizes that thymectomy frequently has little effect on the course of the immunologic disease. The implications of the association of thymoma and PSS are discussed. PMID- 3661623 TI - Heat stroke New Orleans style. AB - An in-depth discussion of Classic Heat Stroke (CHS) and Exertional Heat Stroke (EHS) Syndromes occurred during morning report at a large metropolitan teaching institution during a New Orleans heat wave. The opportunity arose to compare the syndromes via case reports of two patients admitted the same day to the same housestaff teams. The physiology of the hyperthermic state, maladaptions predisposing the hyperthermic syndrome and current heat stroke management updates are reviewed in detail. This report should compel the reader to remain attentive to the subtleties and differences presented in life-threatening high-heat and humidity-related illnesses and how to act rapidly and prudently in management of the illnesses. PMID- 3661624 TI - How do you measure transcutaneous oxygen? PMID- 3661625 TI - A strong defense. PMID- 3661626 TI - The "don't tell" mentality. PMID- 3661627 TI - When every day is Saturday: the shortage. PMID- 3661628 TI - The condom barrier. PMID- 3661629 TI - Getting extra mileage from your uniform. PMID- 3661630 TI - Screening children for common orthopaedic problems. PMID- 3661631 TI - Home care for psych problems. PMID- 3661632 TI - Chicago: an AJN Job Focus. PMID- 3661633 TI - Reducing death from translocation syndrome. PMID- 3661634 TI - Busting the blood gas blues. PMID- 3661635 TI - Reaching educationally disadvantaged students. PMID- 3661636 TI - If you're having another bad day. PMID- 3661637 TI - Hospitals cast new baits and lures for nurses; recruiters' ranks swelling as staffing thins. PMID- 3661638 TI - Going home--for all the wrong reasons. PMID- 3661639 TI - Microbial contamination of contact lens care systems. AB - We examined the contact lens care systems of 100 asymptomatic patients who used hard or soft contact lenses for correction of refractive errors for the presence of bacteria, fungi, Acanthamoeba, and endotoxin. Of 100 patients, 52 had contaminated contact lens care systems. Sixteen of 126 bottles (13%) of commercial contact lens care solutions were contaminated. Contaminated commercial solutions were opened and used for a longer period of time than uncontaminated solutions. Contamination was not found in bottles of preserved commercial solutions that were opened and used for less than 21 days. All 12 bottles of homemade saline were contaminated with bacteria, and Acanthamoeba was isolated from two of these bottles. Pseudomonas was found in the care systems of 12 patients. Bacillus species, which form spores resistant to heat, were found in the care systems of seven patients. Endotoxin, which is also resistant to heat, was detected in nine of 35 care systems (26%) tested. Potential pathogens were isolated from the conjunctiva of six patients. PMID- 3661640 TI - A controlled five-year follow-up study of laser trabeculoplasty as primary therapy for open-angle glaucoma. AB - We followed up 32 eyes of 32 patients with early glaucoma (22 with capsular glaucoma and ten with simple glaucoma) who received laser trabeculoplasty as a primary therapy. These eyes were compared with a matched control group of 32 eyes treated with medication initially. The success rate (intraocular pressure below 22 mm Hg with laser alone or medication alone) at five years was 50% (16 of 32 eyes) in the laser-treated group and 22% (seven of 32 eyes) in the control group (P less than .02). The control group required more modifications of their therapy to control intraocular pressure. The neuroretinal rim area in the control eyes decreased 2.5 times as much as in the laser group (P = .017). Changes in the Friedmann visual fields did not differ significantly between the two groups. PMID- 3661641 TI - Long-term results of low power, long duration laser trabeculoplasty. AB - We performed argon laser trabeculoplasty using 0.2-second duration on 15 patients with primary open-angle glaucoma. We then retrospectively compared the results to a similar group of 14 patients on whom a duration of 0.1 second was used. Power was titrated to achieve blanching or small bubble formation. All the other treatment variables were kept constant. Before treatment, the two groups did not differ in mean age, visual acuity, intraocular pressure, or number of drugs. After treatment, there was a 7 to 8 mm Hg decrease in intraocular pressure for both groups over a two-year follow-up period. No statistically significant difference between the two groups was observed for intraocular pressure, visual acuity, or drug score at the various follow-up periods. No patient required subsequent filtering surgery. PMID- 3661642 TI - The effect of twice daily nadolol on intraocular pressure. AB - The 12-hour control of intraocular pressure obtained with 10 and 20 mg of nadolol twice daily was studied in a placebo-controlled trial. In this ten-week study involving 17 patients a significant reduction in intraocular pressure was obtained with both doses. The effect of 20 mg of nadolol twice daily on intraocular pressure, resting pulse rate, and blood pressure was consistently slightly greater than 10 mg twice daily, but the difference was not significant. PMID- 3661643 TI - Chronic anterior and posterior uveitis and primary Sjogren's syndrome. AB - We examined eight patients with primary Sjogren's syndrome and uveitis. In all patients, the uveitis was bilateral, chronic, anterior and posterior, and not associated with active chorioretinitis. Seven of the eight patients were women. The diagnosis of primary Sjogren's syndrome was generally based on results of a Schirmer test, minor salivary gland biopsy, and serologic studies. Frequent findings included keratic precipitates, cataract, a pars plana exudate, an increased sedimentation rate, a positive test for antinuclear antibodies in a speckled pattern, and associated systemic disease compatible with the spectrum of Sjogren's syndrome. PMID- 3661644 TI - An analysis of the effect of intravitreal blood on visual acuity. AB - We investigated the effect of diffuse hemorrhage on Snellen visual acuity in a model of vitreous hemorrhage in phakic and aphakic eyes. Two cylindrical test chambers with optical paths of 17 mm and 23 mm were constructed to simulate the effect of vitreous hemorrhage in phakic and aphakic eyes. The visual acuity was measured in two subjects in a double-masked fashion for 17 dilutions of whole blood between 1/100 and 1/12,800. The visual acuity decreased approximately linearly between the 1/800 and 1/4,800 dilutions of blood. The visual acuity was 20/20 in all dilutions of blood higher than 1/4,800. The visual acuity was reduced to hand motions or worse with 12.5 microliter of blood in the 5-ml test chamber under all test conditions. The visual acuity was 20/20 in all tests with 1.04 microliter of blood in the test chamber. The visual acuity decreased from 20/20 to hand motions with only a twelve-fold change in concentration of blood in the test chamber. PMID- 3661645 TI - Visual recovery in combined central retinal artery and central retinal vein occlusion. AB - We observed two patients who had combined central retinal artery occlusion and central retinal vein occlusion with severely reduced visual acuity and characteristic retinal changes. Over the course of several months, visual acuity and ophthalmoscopic appearance returned to normal. Both patients had a transient visual loss before their occlusive events and a mild nonconcurrent central retinal vein occlusion in their fellow eye. There was no evidence of inflammatory, vascular, or myeloproliferative disease. PMID- 3661646 TI - Retinal detachment after choroidal ischemia. AB - Injection of a 15-micron microsphere suspension through one or two vortex veins of nine monkey eyes caused various degrees of sectorial choroidal ischemia, which were documented by fluorescein angiography and electron microscopy. The severity of the lesions to the fundus depended on the volume of microspheres injected (0.4 to 1.6 ml of a suspension of 600,000 microspheres/ml). Three hours after embolization white patches appeared in the retinal pigment epithelium as well as a posterior pole serous retinal detachment in five eyes. Delayed choroidal filling was noted in the quadrant involved, but a few choriocapillaris units slowly perfused, leading to fluorescein leakage in the serous retinal detachments. Histologic examination showed various types of damage to the retinal pigment epithelium, including vacuolization and cell membrane rupture. PMID- 3661647 TI - Nd:YAG laser photodisruption of the lens nucleus before phacoemulsification. AB - We studied the use of Q-switched Nd:YAG laser pulses to soften sclerotic lens nuclei before phacoemulsification. We obtained 105 lens nuclei from extracapsular cataract extractions, graded them for degree of sclerosis, and randomized them into laser treatment (53 lenses) or control groups (52 lenses). The treated lenses received laser pulses until confluent pits and clefts were visible. All lenses were phacoemulsified and the times recorded. Nd:YAG laser pretreatment decreased phacoemulsification time in all grades. In moderately sclerotic nuclei, average phacoemulsification time was reduced from 40.1 to 23.9 seconds (40.4%). The nuclei of ten lenses obtained from intracapsular cataract extractions were treated intracapsularly, and the posterior capsule was inadvertently ruptured in five. PMID- 3661648 TI - Compensatory mechanisms in congenital nystagmus. AB - Congenital nystagmus may occur in a manifest or latent form. Since most patients with latent nystagmus also have nystagmus with both eyes open (manifest latent nystagmus), differentiation between these two entities frequently requires electronystagmographic wave form analysis. Such analysis shows distinctive characteristics for manifest and latent or manifest latent congenital nystagmus, suggesting different origins. Several compensation mechanisms exist by which congenital nystagmus is decreased and visual acuity improved. For manifest nystagmus, these mechanisms include version or convergence innervation or a rest point between primary position and maximal lateroversion. In latent or manifest latent nystagmus, the nystagmus decreases when the fixating eye is adducted. Patients with manifest congenital nystagmus may use several of these compensation strategies. Because of the difficulties involved in distinguishing between manifest and manifest latent nystagmus without electronystagmography, confusion has arisen regarding the etiologic relationship between congenital nystagmus and infantile esotropia. Such relationship clearly exists in some patients with manifest nystagmus and convergence dampening. However, in most patients with infantile esotropia and congenital nystagmus, the nystagmus is latent or manifest latent and there is no evidence of a causal relationship between these two entities. PMID- 3661649 TI - Incidence of subcortical lesions not increased in nonarteritic ischemic optic neuropathy on magnetic resonance imaging. AB - We performed magnetic resonance imaging on nine patients with nonarteritic ischemic optic neuropathy and 11 control patients with sensorineural hearing loss and suspected acoustic neuroma. We then counted the number of subcortical lesions in each patient, which may represent an index of generalized cerebral vascular disease. Although patients in the ischemic optic neuropathy group had an average of 3.2 subcortical lesions and those in the control group had an average of 0.9 lesions, this difference was not significant. Based on the presence of subcortical lesions, patients with nonarteritic ischemic optic neuropathy do not appear to have an increased incidence of generalized cerebral vascular disease. PMID- 3661650 TI - Intracranial oculomotor nerve paresis with anisocoria and pupillary parasympathetic hypersensitivity. AB - Three patients developed anisocoria as a result of third nerve palsies caused by intracranial lesions: two in the cavernous sinus and one in the mesencephalon. Pharmacologic testing using low concentration pilocarpine showed apparent preganglionic parasympathetic supersensitivity of the abnormal pupil. These findings are compatible with the existence of a proposed direct pathway from the midbrain to the eye, without synapse at the ciliary ganglion. Cholinergic hypersensitivity can occur, not only with postciliary ganglionic but also with preciliary ganglionic parasympathetic lesions. PMID- 3661651 TI - Transient visual loss in ornithine transcarbamoylase deficiency. AB - We examined a 32-year-old, previously healthy man who developed episodic bilateral visual impairment and confusion. Coincident hyperammonemia led to the diagnosis of ornithine transcarbamoylase deficiency, which was established by enzymatic analysis of a liver biopsy specimen. The available data were insufficient to determine if the metabolic derangement impaired vision at the level of the optic nerves or at the cerebral level. PMID- 3661652 TI - Corneal sensitivity in nephropathic cystinosis. AB - We measured corneal sensitivity in 14 patients with infantile nephropathic cystinosis and in 13 age-matched controls. All patients with cystinosis had the pathognomonic anterior segment findings of crystal deposition within conjunctiva and cornea. Transcutaneous stimulation of the supraorbital nerve and surface electromyographic recording of the orbicularis oculi muscle performed on four patients showed a normal afferent limb to the blink reflex. The corneal sensitivity in patients with cystinosis was 3.18 g/mm2; in the control subjects it was 0.43 g/mm2. This difference was statistically significant (P less than .001). PMID- 3661653 TI - Human conjunctivitis caused by the bird parasite Philophthalmus. AB - We removed a trematode of the species Philophthalmus from under the left upper eyelid of a 66-year-old man who had follicular conjunctivitis for three weeks. After removal of the parasite, the conjunctivitis resolved. PMID- 3661654 TI - Persistent hemorrhage after extracapsular surgery associated with excessive aspirin ingestion. PMID- 3661655 TI - Intraocular foreign body from a Healon syringe. PMID- 3661656 TI - Hypopyon keratouveitis in acute angle-closure glaucoma. PMID- 3661657 TI - Sinus arrest associated with betaxolol ophthalmic drops. PMID- 3661658 TI - Scintillating scotomas relieved with topical timolol. PMID- 3661660 TI - Ischemic optic neuropathy after cardiac arrest. PMID- 3661659 TI - Isolated trochlear nerve palsy secondary to cavernous sinus meningioma. PMID- 3661661 TI - Unusual ocular findings in multicystic encephalomalacia. PMID- 3661662 TI - Giant papillary conjunctivitis associated with cyanoacrylate glue. PMID- 3661663 TI - Chiasmal neuropathy secondary to rheumatoid pachymeningitis. PMID- 3661664 TI - Bilateral avascular zones of the conjunctiva in a patient with juvenile dermatomyositis. PMID- 3661665 TI - Long-term results of scleral reinforcement surgery. PMID- 3661666 TI - Visual acuity and hyperacuity: resolution, localization, form. AB - The roles of optical resolution, of spatial localizing ability, and of form perception are assessed as they relate to visual acuity and hyperacuity and to the measurement of a patient's performance in these tasks. PMID- 3661667 TI - 1986 Carel C. Koch memorial lecture: the professional world view--making the togetherness factor happen. PMID- 3661668 TI - Normative data and control studies of flash VEP's for comparison to a clinical population. AB - The effects of aging, interocular comparisons, pupil dilation, iris pigmentation, and simulated cataracts on bright flash visual evoked potentials (VEP's) of normal observers were studied to assess the flash VEP as a potential predictor of postsurgical visual function in cataract patients. Seventy-six observers (from 20 to 80 years old) were tested for age differences in flash VEP's. Implicit time measures for transient responses increased significantly as a function of age, but neither transient nor steady-state response amplitudes were altered significantly. Moreover, no significant changes in VEP's occurred as a function of interocular comparisons, pupil dilation, or differences in iris pigmentation of normal observers. Simulation of cataracts with 14 observers did not affect implicit time measures, but did change response amplitudes significantly. Therefore, implicit time measures of cataract patients should be compared either to those of normal age-matched controls or, in the case of a unilateral problem, to the normal fellow eye. Delayed implicit time measures, after the appropriate comparison, suggest optic nerve/pathway dysfunction. However, comparisons of amplitude measures require compensation for opacity density. PMID- 3661669 TI - Relation among accommodative facility, lag, and amplitude in elementary school children. AB - Normative data for accommodative lag, facility, and amplitude of children have been presented in the literature for each of the parameters separately. This paper delineates the relation among accommodative amplitude, lag, and flexibility for grade school children. Approximately 200 children were screened. Those who wore corrective lenses, had uncorrected acuity worse than 6/9 (20/30) in either eye, had strabismus, had a refractive error outside the range from 0.00 to +0.75 D; or astigmatism greater than 0.50 D were excluded from the study. Of the 123 who remained, 53% had a deficit in accommodative facility, 26% had a deficit in lag, and 25% had a deficit in amplitude from that which would be expected from their age. Sixteen percent had deficits in both facility and lag. Eighteen percent had deficits in both amplitude and lag. Twenty-four percent had deficits in both facility and amplitude. Only 4% had deficits in all three of the accommodative functions considered--amplitude, lag, and facility. Clinically, these results indicate that when a patient's accommodative dysfunction is examined all facets of accommodation--lag, facility, and amplitude--need to be evaluated. PMID- 3661670 TI - Embryonic lens of the human eye as an optical structure. AB - The spherical aberration of the excised embryonic (18 to 22 weeks) human lens was determined by photographing the refractive effects of the lens on fine parallel laser beams. All lenses showed little evidence of focal variation with laser position although a slight tendency toward positive (undercorrected) spherical aberration was noted. One lens from the eye of a newborn showed slight negative (overcorrected) aberration. It is assumed that the continued growth of the lens, with central compression of old tissue, produces a refractive index distribution which contributes to lens optical quality, even in the uterine environment. Frozen sections of embryo eyes of the same period (18 to 22 weeks) indicate that a major part of the change from a spherical to an elliptical lens shape takes place between the fourth and fifth month of development. PMID- 3661671 TI - Use of photoretinoscopy as a screening technique in the assessment of anisometropia and significant refractive error in infants/toddlers/children and special populations. AB - The presence of significant refractive error and/or anisometropia can produce an irreversible decrease in visual function if not detected and treated at an early age. The general consensus is that the earlier a problem is detected, the easier the process of remediation. The authors have examined photoretinoscopy as a means of screening infant/toddlers and/or nonverbal persons for refractive anomalies. Fifty adults and fifty infants/toddlers/children were photographed and the estimated refractive error from review of the pictures was compared to the refractive error obtained from retinoscopy. The results indicate that photoretinoscopy is an effective screening procedure for the detection of significant refractive error and is extremely sensitive to anisometropia. PMID- 3661672 TI - Prevalence of glaucoma in an eye hospital in Nigeria. AB - A study of glaucoma prevalence in Nigeria was undertaken using data from the eye clinic records of 622 females aged between 4 and 80 years and 1055 males aged between 5 and 95 years who attended the Evangelical Churches of West Africa Eye Hospital, Kano, northern Nigeria, in January, 1985. Glaucoma occurred in 8.6% of the patients. Comparative analysis of glaucoma prevalence studies from different parts of the world and using different sampling techniques showed a marked variation. PMID- 3661673 TI - Comparison of two fast quantitative methods for evaluating the Stiles-Crawford function. AB - Stiles-Crawford (SCE) functions are determined using an increment threshold procedure. The customary technique requires considerable time to obtain a full SCE function and in many situations, both clinical and experimental, it is imperative that the SCE function be evaluated at many retinal loci in as short a time as possible. We have been using two different variants of the standard method, one requiring a very limited number of threshold settings at five fixed entry points in the entrance pupil (5-point method) and in the other, thresholds are determined at only three preselected entry points (3-point method). The time required to obtain a complete SCE function is the order of 5 to 8 min using either method. Comparison and statistical evaluation of the techniques are presented. PMID- 3661674 TI - Automatic infrared refractors--a comparative study. AB - In order to determine the performance of seven automatic infrared (IR) eye refractors, measurements have been conducted on a model eye as well as on normal subjects and patients under standardized conditions. Concerning the model eye, a range of measurement slightly smaller than specified and linearity errors have been detected on several instruments. Using a group of 55 normal ametropic subjects, the results of the automatic refraction were compared to the results of a conventional subjective examination. The spherical equivalent differed by less than 0.51 D in more than 80% of all cases on all instruments. The error of the cylinder power was smaller than 0.51 D in more than 90% of all cases. Larger errors were found on patients with intra ocular lenses, aphakic eyes, or scattering eye media. In each of these groups the automatic refraction was at times either impossible or yielded a wrong result. PMID- 3661675 TI - Retinal eccentricity and the accommodative response. PMID- 3661676 TI - Formation of mast-cell colonies in methylcellulose by mouse skin cells and development of mucosal-like mast cells from the cloned cells in the gastric mucosa of W/Wv mice. AB - Connective tissue-type mast cells, other than those located in the serosal cavity, are fixed in the tissues. For study of the differentiation processes of mast cells in connective tissue, an in vitro method for producing mast-cell colonies is required. The authors enzymatically dispersed the cells from the skin of either neonatal or adult mice and plated them in methylcellulose containing pokeweed mitogen-stimulated spleen cell-conditioned medium (PWM-SCM). More than 97% of the colonies that developed consisted of mast cells alone. The clonal nature of the mast-cell colonies was determined by using the giant granules of C57BL/6-bgJ/bgJ mice as a marker: even when a mixture of skin cells from C57BL/6 bgJ/bgJ and C57BL/6-+/+ mice was plated, most of the resulting colonies consisted of either bgJ/bgJ-type mast cells alone or +/+-type mast cells alone. In spite of depletion of T-cell-derived factors, concentrations of mast cells and mast cell colony-forming units (CFU-Mast) in the skin of nude athymic mice are normal. However, PWM-SCM was necessary for in vitro development of mast-cell colonies from the skin of nude mice. The concentration of CFU-Mast in the skin of genetically mast-cell-deficient WBB6F1-W/Wv mice was negligible when compared with the value observed in the skin of control WBB6F1-+/+ mice. Individual mast cell colonies derived from the skin of neonatal WBB6F1-+/+ mice were lifted from the methylcellulose, and cells from each colony were injected into the wall of the glandular stomach and the skin of WBB6F1-W/Wv mice. Most of the mast cell that appeared at the skin injection sites of the WBB6F1-W/Wv mice stained with berberine sulfate, indicating that they contained heparin. In contrast, the mast cells that appeared in the stomach mucosa of the recipient WBB6F1-W/Wv mice did not stain. This suggests that CFU-Mast located in the skin have not been committed to the connective tissue type. The present method may be useful for investigation of the mechanisms of mast-cell differentiation in connective tissue other than the serosal cavity. PMID- 3661677 TI - Immunohistochemical localization of metallothionein in human thyroid tumors. AB - High levels of metallothionein (MT) are present in the developing mammalian liver; however, a remarkable decrease is observed during postnatal life after weaning. This developmental profile is similar to that of certain oncofetal gene products such as alpha-fetoprotein, which is used as a tumor marker. This study deals with the reexpression of MT genes in thyroid tumors. With an immunohistochemical method, the presence of MT was investigated in tissue sections of normal and neoplastic human thyroid glands. Tissue sections of 34 thyroid tumors and 10 normal human thyroid glands were studied by means of the peroxidase-antiperoxidase method. MT was localized in 31 of the thyroid gland tumors. MT was also present in two of the normal thyroid glands. These findings indicate that although high levels of MT are mainly found in the fetal liver, it may also be expressed actively in certain human thyroid neoplastic tissues, and occasionally in normal thyroid tissue. PMID- 3661678 TI - Possible roles of tumor necrosis factor in the pathology of malaria. AB - The authors have earlier proposed that tumor necrosis factor (TNF) might contribute to the pathology of malaria. Here they report the outcome of injecting recombinant human TNF/cachectin into normal mice and others with low parasitemias (6-35%) of Plasmodium vinckei. The object was to see how precisely the pathologic features of the terminal stages of this infection could be produced, when parasitemias are 70-80%. Hypoglycemia, mid-zonal liver damage, and pulmonary accumulation of neutrophils in the pulmonary vasculature, all of which are seen in severe P vinckei infection, occurred within 4-12 hours after the mildly infected mice received TNF/cachectin. Uninfected mice were much less susceptible. TNF/cachectin also increases plasma lactate, a change seen in both the human and rodent diseases. From these findings and the recent literature on TNF/cachectin, including its detection in serum from malarial patients, it seems likely that excessive release of this monokine could account for certain of the unexplained pathologic features of human malaria. PMID- 3661679 TI - Activation of C5 by cobra venom factor is required in neutrophil-mediated lung injury in the rat. AB - Cobra venom factor (CVF)-induced systemic activation of the complement system in the rat has been shown to result in the development of acute lung microvascular injury and appearance in lungs and plasma of lipid peroxidation products. The pathogenesis of these events is dependent on complement and neutrophils and is sensitive to pretreatment of experimental animals with iron chelators or scavengers of hydroxyl radical. In order to further analyze the role of complement in the pathogenesis of acute lung injury in rats after systemic complement activation, two different CVFs have been employed in the present study. One was the previously used CVFn isolated from Naja n. naja venom, whereas the other factor, CVFh, was isolated from Naja h. haje venom. Both factors have been shown to activate the alternative complement pathway by forming a potent C3 convertase but differ with respect to their ability to bind and activate C5. CVFn but not CVFh activates C5 and distant complement components. When equal doses of C3-activating activity of CVFn or CVFh were injected intravenously into rats, CVFh-treated rats failed to develop acute lung injury, whereas CVFn-treated animals showed pronounced increases in lung vascular permeability. Similarly, in isolated blood perfused rat lungs neither the lung injury nor pulmonary hypertension caused by CVFn were found after injection of CVFh. In addition, CVFh treated animals failed to show transient neutropenia or appearance in plasma of C5-derived chemotactic activity, although the extent of C3 conversion in vivo was identical to that seen in CVFn-treated rats. Morphologic examination of the lungs of the experimental animals revealed no signs of injury in CVFh-treated rats, whereas the lungs from CVFn-treated animals revealed interstitial and alveolar edema, as well as plugging of pulmonary capillaries with neutrophils, blebbing and/or destruction of vascular endothelial cells, fibrin deposition, and hemorrhage. These studies provide evidence that activation of the complement system involving C3 but not extending further in the complement sequence is not sufficient to bring about acute injury of the lung microvasculature and that the activation sequence must at least also involve C5. PMID- 3661681 TI - Hemoglobin concentration of pastoral nomads permanently resident at 4,850-5,450 meters in Tibet. AB - This paper presents data on the hemoglobin concentration of a sample of 103 pastoral nomads who are lifelong residents of Phala, at 4,850-5,450 m, on the northern plateau of the Tibet Autonomous Region of the Peoples' Republic of China. This native population resides at the highest altitude of which we are aware and is thus exposed to the most extreme chronic hypoxic stress. However, they do not exhibit the most pronounced physiological adaptations, i.e., hemoglobin concentrations exceeding those found in all other high-altitude populations. Adult male and female mean hemoglobin concentrations of 18.2 and 16.7 gm/dl, respectively, were found. These data, in conjunction with earlier studies of ethnic Tibetans living at 3,400 m, demonstrate a pattern of increasing hemoglobin concentration (erythrocytosis) at increasing altitude of residence in the Himalayas and Tibet. At the same time, however, the hemoglobin concentration is lower than that found among Andean highlanders. These new data raise the possibility of quantitative population differences in hematological adaptation to high altitude hypoxia. PMID- 3661680 TI - The pathophysiology of protein-overload proteinuria. AB - Alterations in glomerular function and structure were studied in protein-overload nephrosis in the rat induced by intraperitoneal administration of bovine serum albumin (BSA). Fractional clearance (C/GFR) studies using inulin and tracer proteins of different molecular size and charge revealed in proteinuric rats 1) unchanged glomerular filtration rate and renal plasma flow; 2) a 34-fold increase in C/GFR of rat serum albumin, reaching values similar to BSA; 3) a 2-fold increase in C/GFR for anionic horse radish peroxidase (HRP), but normal values for neutral and cationic HRP, and 4) an 11- and 3-fold increase for heterologous IgG and IgM, respectively. Glomerular epithelial cells showed degenerative changes, but the distribution of anionic sites in the glomerular basement membrane was found to be unaltered, as determined by polyethyleneimine binding studies. In summary, an elevation of serum albumin concentration resulted in an increased transcapillary albumin transport. This was found to lead to degenerative changes of glomerular epithelial cells with development of large pore defects, which were completely reversible. PMID- 3661682 TI - Distribution of Gm and Km allotypes among ten populations of Assam, India. AB - Serum samples from ten endogamous populations of Assam, India-Brahmins, Kalitas, Kaibartas, Muslims, Ahoms, Karbis, Kacharis, Sonowals, Chutiyas, and Rajbanshis were typed for G1m (1, 2, 3, 17), G3m (5, 10, 11, 13, 14, 15, 16, 21, 26), and Km (1). Among Brahmins, Kalitas, Kaibartas, Muslims, Ahoms, Sonowals, Chutiyas, and Rajbanshis, five different Gm haplotypes were found: Gm1,17;21,26; Gm1,17;10,11,13,15,16; Gm1,2,17;21,26; Gm1,3;5,10,11,13,14,26; and Gm3;5,10,11,13,14,26. Kacharis and Karbis show only four of these haplotypes: Gm3;5,10,11,13,14,26 is absent among them. The intergroup variability in the distribution of these haplotypes is considerable, which can be explained by the ethnohistory of these populations. Genetic distance analysis, in which five Chinese population samples were included, revealed the existence of three main clusters: 1) North and Central Chinese; 2) Kalitas, Kaibartas, Chutiyas, Rajbanshis, Muslims, and Brahmins; and 3) Ahoms, Sonowals, Kacharis, South Chinese, and Karbis. The clusters suggest some genetic relation between these four Assamese populations and South Chinese, which is again understandable considering the ethnohistory of the populations of Northeast India. In the Km system, too, a remarkable variability is seen in distribution of phenotype and allele frequency. PMID- 3661683 TI - Standards of arm muscle by stature for the assessment of nutritional status of children. AB - This study is based on a sample of 9,134 children ranging in age from 2 to 17 years from which the excessively lean and fat children by skinfold thickness were excluded. This sample was derived from the combined data sets of the first and second National Health and Nutrition Examination Surveys (NHANES I and II) of 1971-1974 and 1976-1980. Means and percentiles of upper arm muscle area were calculated for 3 cm increments in stature from 84 to 184 cm for boys and from 84 to 176 cm for girls. Based on means, Z-score units, and percentile ranges of upper arm muscle area by stature, five operational categories of nutritional status have been established. It is recommended that these standards and this classification system be used to supplement current standards of weight for age and weight for height in order to obtain a more complete assessment of body composition and nutritional status. PMID- 3661684 TI - Variation in early neonatal mortality for different types of fetal growth retardation. AB - Birth and first-48-hr death records were analyzed for 10,024 liveborn infants in Mexico City and 12,786 liveborn infants in Santa Cruz, Bolivia. The objective of the analysis was to characterize the early postnatal mortality rates for different types of fetal growth retardation and prematurity. Infants who were delivered prior to 37 weeks of gestation had 23-100 times the mortality risk of infants born at full term and normal weight. Light-for-gestational-age infants (birth weight less than 2,900 g) were further divided into proportionately growth retarded with normal Rohrer's index (weight/height) and disproportionately growth retarded with low Rohrer's index. The proportionately growth-retarded infant had nearly twice the mortality of the full-term, appropriate-weight infants, whereas the disproportionately growth-retarded infants had 2.9-5.7 times the mortality rate of the full-term, appropriate-weight infants. There were some differences between samples in mortality rates and prevalence of the different classes of small infants, but the pattern of mortality within samples was consistent between samples. PMID- 3661685 TI - Short and plump physique of Mexican-American children. AB - Mexican-American children are shorter but relatively heavier than non-Hispanic whites and blacks. The objectives of this paper are to assess the extent to which this "short and plump" physique occurs in data collected in two national surveys (HANES I and II); to determine variations by age, sex, and socioeconomic status; and to investigate the anthropometric characteristics that may account for the overweight. Three groups, defined on the basis of reported ancestry and observed race, are studied: Mexican-Americans (MEXAME), non-Hispanic Whites, (EURAME), and blacks (BLACK). Short stature was clearly associated with the poverty index (PI) in all three groups. MEXAMEs with a PI greater than 1.6 were similar in stature to EURAMEs at the same income level at ages 1-11 years but not at 12-17 years. On the other hand, MEXAMEs were shorter than BLACKs at all ages and income levels. The body mass index (kg/cm2) and poverty were unrelated. With respect to the anthropometric characteristics examined that are related to the body mass index, MEXAMEs and EURAMEs were similar in sitting height as a proportion of total height, arm muscle and fat areas, and triceps skinfold but different in the following ways: MEXAMEs had narrower elbow but broader bitrochanteric breadths and larger chest circumferences and subscapular skinfolds. Greater upper body dimensions and fatfolds seem to best describe the physique of MEXAMEs. However, in multiple regressions, these anthropometric characteristics failed to account fully for the greater relative weight of MEXAMEs as compared to EURAMEs. PMID- 3661687 TI - Interaction of nutritional and socioeconomic status as determinants of cognitive development in disadvantaged urban Guatemalan children. AB - The relationship between nutritional status, measured by height for age, and cognition, measured by WISC full-scale IQ, was studied in a longitudinal sample of 459 urban Guatemalan children, aged 4-9 years, from a disadvantage community of the fringe of Guatemala City, examined annually over a 3 year period. Socioeconomic status (SES) was controlled by developing a composite index for each home. The mean IQ differed significantly from the lowest to the highest quartiles of stature, the difference between the two extreme quartiles being approximately 0.3 SD of IQ. There was a significant interaction between SES and stature in their effects on IQ. Whereas nutritional status and SES affected IQ in an additive fashion in the upper three SES quartiles, there was no difference in IQ attributible to stature among children from the most disadvantaged homes. This analysis indicates that the mild-to-moderate protein-energy malnutrition (defined by height for age) that is prevalent among children from disadvantaged environments in developing countries is significantly related to cognitive development. However, in the poorest homes, SES is seen as a more important determinant of cognitive development than stature. PMID- 3661686 TI - Adaptive significance of small body size: strength and motor performance of school children in Mexico and Papua New Guinea. AB - The postulated superior functional efficiency in association with reduced body size under conditions of chronic protein-energy undernutrition was considered in school children from rural Mexico and coastal Papua New Guinea. Grip strength and three measures of motor performance were measured in cross-sectional samples of children 6-16 years of age from a rural agricultural community in Oaxaca, Mexico, and from the coastal community Pere on Manus Island, Papua New Guinea. The strength and performance of a mixed-longitudinal sample of well nourished children from Philadelphia was used as a reference. The Oaxaca and Pere children are significantly shorter and lighter and are not as strong as the well nourished children. Motor performances of Pere children compare favorably to those of the better-nourished Philadelphia children, whereas those of the Oaxaca children are poorer. Throwing performance is more variable. When expressed relative to body size, strength is similar in the three samples, but the running and jumping performances of Pere children per unit body size are better than the relative performances of Oaxaca and Philadelphia children. Throwing performance per unit body size is better in the undernourished children. The influence of age, stature, and weight on the performance of Oaxaca and Pere children is generally similar to that for well nourished children. These results suggest that the hypothesized adaptive significance of small body size for the functional efficiency of populations living under conditions of chronic undernutrition varies between populations and with performance tasks. PMID- 3661688 TI - Growth status, age, and grade as predictors of school continuation for Guatemalan Indian children. AB - Schooling is considered by many researchers and agencies as an important contributor to individual and national development for populations living in the less developed countries. Accordingly, programs to increase school enrollment and continuation from grade to grade are being developed for many of these countries. This paper investigates the relationship of physical growth status (height, weight, and body composition), grade in school, and age to school continuation for a sample of Indian children living in a village near Guatemala City. It was found that physical growth status, a reflection of health and nutritional status, does not predict school continuation. A child's age and current grade in school do predict continuation. Most children leave school after reaching 9 years of age or after completing the second grade. It is suggested that children may learn enough to satisfy their parents' expectations by this age or grade. Also, the child's economic value to his or her family may be a significant reason for school drop-out. PMID- 3661689 TI - Variation in nutrient intake of infants and its implications for collecting reliable dietary intake data. AB - Sources of variance in dietary intake data for infants in the fourth to sixth months of life were examined. Twenty-eight mothers of infants in the Special Supplemental Food Program for Women, Infants, and Children gave 24-hr recall information on their infants' diets on 4 random days over approximately 1 month. ANOVA found no day of the week or sequence effects on nutrient variation. Variance was partitioned into between- and within-subject (residual) components. Interindividual variation exceeded intraindividual variation for all nutrients except vitamin C. Variance ratios ranged from 0.3 to 1.3. Calculations of 95% confidence limits for group and individual mean intakes indicated that, whereas a single recall would estimate the group mean within 20% for most nutrients, five recalls would be necessary for the same accuracy in individual means. Magnitude and patterning of variance components differ substantially from those found in studies of adults, suggesting that infant data collection strategies should be tailored to the unique nature of the infant diet. PMID- 3661690 TI - Cross-cultural correlations of childhood growth and adult breast cancer. AB - International differences in breast cancer incidence and mortality, and studies on Japanese migrants to the United States, point to the importance of environmental factors, including diet and nutrition, in the etiology of breast cancer. Some studies have suggested that dietary patterns in early life are important to the long-term risk of breast cancer. Given that human growth is partially a function of early dietary intake, cross-cultural correlations between breast cancer rates and anthropometric variables measured at different times in childhood provide additional information about the association of early nutrition and cancer. In this study, the associations between food consumption and anthropometric variables, and childhood growth patterns (attained size at age) and adult breast cancer rates, were considered. Data from cross-sectional growth studies conducted during the years 1956-1971 on children aged 6-18 years were obtained for age-specific stature, sitting height, weight, triceps skinfold thickness, arm and chest circumferences, and biacromial and biiliac diameters. National food consumption data were obtained from the United Nations Food and Agriculture Organization (FAO) and socioeconomic status indicators from the United Nations Children's Fund (UNICEF). Cancer incidence data for the years 1972 1977 were obtained from regional cancer registries reported by the International Agency for Research on Cancer (IARC), and mortality data for 1978 were obtained from national cancer registries around the world. Significant correlations were seen between national food consumption data and childhood growth (attained size at age); between cancer incidence and age-specific stature (r = 0.68), weight (r = 0.59), triceps skinfold thickness (r = 0.78), and biacromial width (r = 0.84); and between mortality and age-specific stature (r = 0.77), weight (r = 0.75), and biacromial width (r = 0.78). In general, the correlation coefficients of the observed anthropometric variables with breast cancer increase with increasing age and become highly significant at ages 13-14 years, reflecting cumulative childhood nutritional intake. PMID- 3661691 TI - Feeding low-fat milk during infancy. AB - Despite the widespread agreement that low-fat milk should not be used during infancy, there is a sizable portion of infants in the United States who were fed a diet that included low-fat milk (less than or equal to 2% fat). In 1985, 14% of infants 8 months old, 20% of infants 10 months old, and 32% of infants 12 months old were fed low-fat milk. The reasons given most often by mothers for low-fat milk use was their consideration that low-fat milk has less fat than whole cow's milk and that low-fat milk use was recommended/suggested by their physician. Nutrient intakes of infants fed low-fat milk are compared to those of infants fed whole cow's milk and infant formula. Except for fat, nutrient intakes of infants fed low-fat milk or whole cow's milk were similar. A majority of infants fed either low-fat milk or whole cow's milk received amounts of sodium, potassium, and chloride that exceeded the recommended safe and adequate ranges and amounts of iron below the RDA. These data are considered in relation to dietary requirements during infancy. PMID- 3661692 TI - Gentamicin enhanced production of hydrogen peroxide by renal cortical mitochondria. AB - Agents that affect mitochondrial respiration have been shown to enhance the generation of reactive oxygen metabolites. On the basis of the well-demonstrated ability of gentamicin to alter mitochondrial respiration (stimulation of state 4 and inhibition of state 3), it was postulated that gentamicin may enhance the generation of reactive oxygen metabolites by renal cortical mitochondria. The aim of this study was to examine the effect of gentamicin on the production of hydrogen peroxide (measured as the decrease in scopoletin fluorescence) in rat renal cortical mitochondria. The hydrogen peroxide generation by mitochondria was enhanced from 0.17 +/- 0.02 nmol . mg-1 . min-1 (n = 14) in the absence of gentamicin to 6.21 +/- 0.67 nmol . mg-1 . min-1 (n = 14) in the presence of 4 mM gentamicin. This response was dose dependent with a significant increase observed at even the lowest concentration of gentamicin tested, 0.01 mM. Production of hydrogen peroxide was not increased when gentamicin was added to incubation media in which mitochondria or substrate was omitted or heat-inactivated mitochondria were used. The gentamicin-induced change in fluorescence was completely inhibited by catalase (but not by heat-inactivated catalase), indicating that the decrease in fluorescence was due to hydrogen peroxide. Thus this study demonstrates that gentamicin enhances the production of hydrogen peroxide by mitochondria. Because of their well-documented cytotoxicity, reactive oxygen metabolites may play a critical role in gentamicin nephrotoxicity. PMID- 3661693 TI - Regulation of ribosome synthesis during compensatory renal hypertrophy in mice. AB - Ribosomal synthesis was studied at the transcriptional and translational levels to investigate the mechanisms of ribosome accretion during compensatory renal hypertrophy. As measured by in vitro transcriptional runoff comparisons 6-48 h after surgery, nuclei from the kidney remaining after contralateral nephrectomy show an increase of up to 150% in the rate of synthesis of ribosomal precursor RNA. The rate of rDNA transcription is 40-50% greater than control values as early as 6 h after nephrectomy; by 48 h, the rate returns to normal. In contrast to the stimulated transcription of rDNA and accretion of rRNA, the steady-state levels and the cytoplasmic distribution of ribosomal protein mRNAs S16 and L10 remain unchanged during induced renal growth. Thus coordinate production of adequate protein for increased assembly of ribosomes during induced renal growth appears to be accomplished by increasingly efficient translation of existing ribosomal protein mRNAs or by post-translational stabilization of ribosomal proteins. The rate of rDNA transcription may be regulated by accelerating the transcription of already functioning genes or, more likely, by recruiting transcription units that are transcriptionally inactive in the normal kidney. PMID- 3661694 TI - Histamine-induced calcium release and phorbol antagonism in cultured airway smooth muscle cells. AB - Primary cultures of airway smooth muscle cells were exposed to histamine, and intracellular free calcium transients were measured by the calcium-sensitive dye fura-2. Stimulation with 100 microM histamine resulted in a rise in intracellular calcium from an unstimulated level of 178 +/- 25 to 497 +/- 154 nM Ca2+ (SE; n = 14) and a return to base-line free calcium concentration within 1 min of stimulation. Pretreatment of cells with the H1 receptor blocker pyrilamine (2.5 microM) abolished the response; however, the calcium transient was not altered by pretreatment with the H2 blocker cimetidine (50 microM), by chelation of external calcium, or by pretreatment with 2 mM Co2+ or 5 microM nifedipine. Activation of protein kinase c by 200 nM phorbol 12-myristate 13-acetate (PMA) resulted in no detectable rise in cytosolic calcium but completely blocked the release of internal calcium by histamine. We conclude that 1) histamine causes a transient rise of cytosolic calcium in airway smooth muscle, 2) the rise in cytosolic calcium is mediated by H1 receptor coupling that triggers release of internal calcium stores, and 3) activation of protein kinase c blocks the histamine induced release of intracellular calcium. PMID- 3661695 TI - Platelet-derived growth factor stimulated mechanisms of glucosamine incorporation. AB - Platelet-derived growth factor (PDGF) treatment of density-arrested BALB/c-3T3 cells results in increased [3H]glucosamine (GlcN) incorporation into cellular material. The enhanced GlcN incorporation is not due to a preferential increase in proteoglycan synthesis as measured by [35S]H2SO4 incorporation. Approximately 50% of the GlcN incorporated in PDGF or platelet-poor plasma (PPP)-treated cultures enters N-linked glycoproteins. Addition of dolichol-phosphate (dolichol P), a required intermediate in N-linked glycosylation, did not alter [3H]GlcN incorporation in PDGF-treated cells but did increase incorporation in PPP-treated cultures to a level comparable to that observed for PDGF-treated cultures. PDGF treated cultures contained twofold greater quantities of [3H]GlcN dolichol intermediates and lipid-free glycoprotein. Over a 12-h time course 3-hydroxy-3 methylglutaryl coenzyme A reductase (HMG CoA reductase) activity was similar in cultures treated with PDGF or PPP. Results of these studies reveal that enhanced protein glycosylation in response to PDGF treatment is not the result of a direct effect on HMG CoA reductase. PMID- 3661696 TI - Effects of bradykinin and angiotensin II on intracellular Ca2+ dynamics in endothelial cells. AB - The purpose of this study was to investigate the effects of angiotensin II and bradykinin on intracellular Ca2+ dynamics in cultured endothelial cells. We used the "second-generation" fluorescent Ca2+ indicator fura-2, in conjunction with dual-wavelength fluorescence spectroscopy, in cultured adherent pulmonary arterial endothelial cells. Angiotensin II (up to 2 microM) had no consistent effect on intracellular Ca2+ levels. In contrast, bradykinin (10 nM) elicited a transient increase of cytosolic free Ca2+, from the resting value of 37 +/- 5 to 647 +/- 123 nM, followed by a decline to a steady-state value of 113 +/- 14 nM, which was significantly higher than the resting Ca2+ levels. Bradykinin's Ca stimulatory effect was dose dependent, having a half-maximally effective concentration of approximately 1 nM and a maximally effective concentration of 10 nM. A B1-receptor agonist, Des-Arg9-bradykinin, was much less effective than bradykinin as modulator of cytosolic Ca2+. Moreover, a B1-receptor antagonist, Des-Arg9, [Leu8]-bradykinin, did not significantly affect the increase of cytosolic Ca2+ elicited by bradykinin. On the other hand, the bradykinin-elicited increase of Ca2+ was almost completely inhibited by a novel B2-receptor antagonist, D-Arg-[Hyp3, Thi5,8, D-Phe7]-bradykinin. Bradykinin increased cytosolic free Ca2+ levels in cells maintained in Ca2+-deficient extracellular medium, suggesting that the peptide mobilized Ca2+ from intracellular stores. However, the absence of extra-cellular Ca2+ resulted in an 80-90% attenuation of the transient Ca2+ response, whereas the posttransient steady-state response was completely absent. These findings are consistent with the notion that the bradykinin-elicited transient Ca2+ response is dependent on both extra- and intracellular Ca2+ and that the posttransient steady-state response is entirely dependent on extracellular Ca2+. Endothelial cells were responsive to a second dose of bradykinin after a 10-min interim period of incubation in the absence of the peptide hormone. The absence of extracellular Ca2+ during the interim period, or the pretreatment of cells with ionomycin in the absence of extracellular Ca2+, prevented the response of the cells to a second dose of bradykinin. Bradykinin- or ionomycin-desensitized cells could be resensitized by a brief incubation period in Ca2+-replete medium. The results are consistent with the notions that cellular resensitization requires the replenishment of intracellular Ca2+ and that bradykinin, but not angiotensin II, modulates intracellular Ca2+ dynamics in endothelial cells by interacting with a B2-type receptor. PMID- 3661697 TI - Photobleaching of fura-2 and its effect on determination of calcium concentrations. AB - This study was performed to determine the effect of photobleaching on the spectral properties of the calcium-sensitive fluorescent dye fura-2. Fura-2, whether in cells or in calibrating solutions, was found to be bleached when exposed to excitation light. In contrast to the widely held belief, photobleaching altered the spectral properties of the dye. Decomposition of the excitation spectra of partially bleached fura-2 solutions revealed an intermediate that is still fluorescent and is not sensitive to calcium over the same range as fura-2, but which can bind calcium in the millimolar range. The presence of this intermediate violates one of the assumptions on which the ratio method of calibration is based; that is, that the only fluorescent species present are the calcium-bound and the free anion forms of fura-2. Thus, if photobleaching occurs, the ratio method will not give accurate calcium concentration values. We calculate that as little as an 8% loss of total fluorescence intensity is sufficient to produce a large error. Photobleaching of fura-2-loaded cells and fura-2 containing calibrating solutions can be minimized by reducing the oxygen concentration and by reducing the excitation light intensity. Strategies are presented to help maintain a high signal-to-noise ratio in fura-2 fluorescence detection systems, despite a lower excitation intensity so that photobleaching, and the resulting inaccuracies in calculated [Ca2+], can be largely avoided. PMID- 3661698 TI - Dynamic peripheral nerve metabolic and vascular responses to exsanguination. AB - We studied the dynamic effects of exsanguination of approximately one-third of rat blood volume over 3-12 min on energy metabolism and blood flow in rat sciatic nerves. Nerve high-energy phosphate compounds were relatively well maintained. There was a modest stimulation of anaerobic metabolism at slow rates of exsanguination, and glucose stores were slightly increased. These findings indicate that when stressed because of significant blood loss, compensatory mechanisms, presumably adrenosympathetic mediated, are effective in vivo. We recorded nerve blood flow (NBF), endoneurial oxygen tension, and mean arterial pressure simultaneously; NBF was linearly related to blood pressure (BP) over a wide range of BPs, confirming that NBF does not significantly autoregulate. Endoneurium underwent oxygen-exchange, indicating that peripheral nerve microvasculature is physiologically nutritive. NBF fell before and at a faster rate than BP, indicating that it is a capacitive system. Nerves also adapted to declining oxygen supplies, presumably by reducing their oxygen consumption. The physiological implications of such a system are discussed. PMID- 3661699 TI - Patterns of glycogen turnover in liver characterized by computer modeling. AB - We used a computer model of liver glycogen turnover to reexamine the data of Devos and Hers, who reported the time course of accumulation in and loss from glycogen of label originating in [1-14C]galactose injected at different times after the start of refeeding of 40-h fasted mice or rats. In the present study computer representation of individual glycogen molecules was utilized to account for growth and degradation of glycogen according to specific hypothetical patterns. Using this model we could predict the accumulation and localization within glycogen of labeled glucose residues and compare the predictions with the previously published data. We considered three specific hypotheses of glycogen accumulation during refeeding: 1) simultaneous, 2) sequential, and 3) accelerating growth. Hypothetical patterns of glycogen degradation were 1) ordered and 2) random degradation. The pattern of glycogen synthesis consistent with experimental data was a steadily increasing number of growing glycogen molecules, whereas during degradation glycogen molecules are exposed to degrading enzymes randomly, rather than in a specific reverse order of synthesis. These patterns predict the existence of a specific mechanism for the steadily increasing "seeding" of new glycogen molecules during synthesis. PMID- 3661700 TI - Absence of detectable phosphocreatine in rat luteal cells. AB - Previous studies from this laboratory showed that adenosine amplifies the action of luteinizing hormone (LH) severalfold in rat and human luteal cells by an intracellular, adenosine 5'-triphosphate (ATP)-linked process. The objective of this study was to evaluate the contribution of phosphocreatine (PCr) and creatine kinase (CK) to the dynamics of luteal ATP metabolism. Levels of PCr in luteinized rat ovaries were similar to those seen in liver but were approximately 1 and 7% of levels found in skeletal and heart muscle, respectively. In isolated rat luteal cells, little detectable PCr was seen after incubation in the presence or absence of adenosine, although cell ATP levels were increased twofold by adenosine treatment. The presence or absence of LH had no effect on either PCr or ATP levels in incubations of isolated luteal cells. Analysis of CK activity in tissue and cell homogenates showed that the specific activity of CK in luteal cells was in the same range as that seen in liver but less than 1/30 of that seen in skeletal muscle. From these studies we conclude that rat luteal cells contain little, if any, PCr and low levels of CK. Thus the rapid changes in ATP levels that are seen in rat luteal tissue and cells may occur because these cells have little capacity to buffer ATP levels with a reservoir of high-energy phosphate groups in the form of PCr. PMID- 3661701 TI - Maternal-fetal communication of circadian phase in a precocious rodent, the spiny mouse. AB - The development of circadian rhythms was examined in a precocious rodent species, the spiny mouse. Spiny mouse pups born and reared in constant darkness expressed robust circadian rhythms in locomotor activity as early as day 5 of life. Free running activity rhythms of pups born and reared in constant darkness were coordinated with the dam on the day of birth. Postnatal maternal influences on pup rhythmicity are minimal in this species, as pups fostered on the day of birth to dams whose circadian phases were opposite to the pups' original dams were coordinated with their original dams on the day of birth. Studies using 2-deoxy-D [1-14C]-glucose autoradiography showed that there were synchronous (coordinated) rhythms in metabolic activity in the maternal and fetal suprachiasmatic nuclei, directly demonstrating prenatal coordination of maternal and fetal rhythmicity. Maternal-fetal coordination of circadian phase was not the result of direct entrainment of the fetuses to the environmental light-dark cycle. These results demonstrate that there is prenatal communication of circadian phase in this precocious species, without demonstrable postnatal maternal influences on pup circadian rhythmicity. Spiny mice therefore represent an important animal model in which circadian rhythms in the postnatal period can be used to precisely assess prenatal influences on circadian phase. PMID- 3661702 TI - Metabolites of 2-deoxyglucose in rat brain at 12-24 h: bounds on kinetic constants. AB - Activities of 2-deoxy-D-glucose and its metabolites in rat brain were examined at 12, 16, 20, and 24 h after intraperitoneal injection of 14C-labeled 2-deoxy-D glucose. Plasma radioactivity was monitored for 2 h before each of these determinations. As proportion of total brain radioactivity, 2-deoxy-D-glucose decreased monotonically from the unexpectedly high value of 22% at 12 h to 11% at 24 h after injection, 2-deoxy-D-glucose 6-phosphate decreased monotonically from 69% at 12 h to 23% at 24 h, and unphosphorylated products (of high and low molecular weight) increased from 10% at 12 h to 64% at 24 h. The data were analyzed in terms of a four-compartment model. Secure lower and upper bounds on the rate constant, k4*, for the dephosphorylation of 2-deoxy-D-glucose 6 phosphate were established: k4* was at least 0.0158 +/- 0.0014 . min-1 and at most 0.0385 +/- 0.0037 . min-1. If k4* is constant in time, then appreciable dephosphorylation occurs within the 45-min experimental period commonly used in the standard 2-deoxy-D-glucose method for estimating local cerebral glucose utilization. The possibility that the effective k4* is lower at such early times is reviewed in the light of a reanalysis of previously published data. Implications of these results for the 2-deoxy-D-glucose method are discussed from the points of view of numerical analysis and capillary heterogeneity. PMID- 3661703 TI - Increased glucose dependence in resting, iron-deficient rats. AB - Rates of blood glucose and lactate turnover were assessed in resting iron deficient and iron-sufficient (control) rats to test the hypothesis that dependence on glucose metabolism is increased in iron deficiency. Male Sprague Dawley rats, 21 days old, were fed a diet containing either 6 mg iron/kg feed (iron-deficient group) or 50 mg iron/kg feed (iron-sufficient group) for 3-4 wk. The iron-deficient group became anemic, with hemoglobin levels of 6.4 +/- 0.2 compared with 13.8 +/- 0.3 g/dl for controls. Rats received a 90-min primed continuous infusion of D-[6-3H]glucose and sodium L-[U-14C]lactate via a jugular catheter. Serial samples were taken from a carotid catheter for concentration and specific activity determinations. Iron-deficient rats had significantly (P less than 0.05) higher blood glucose (7.1 +/- 0.3 vs. 6.1 +/- 0.2 mM) and lactate concentrations than controls (1.0 +/- 0.1 vs. 0.8 +/- 0.1 mM). The iron-deficient group had a significantly higher glucose turnover rate (67 +/- 2 vs. 58 +/- 4 mumol . kg-1 . min-1) than the control group. Significantly more metabolite recycling in iron-deficient rats was indicated by greater incorporation of 14C (from infused [14C]-lactate) into blood glucose. Assuming a carbon crossover correction factor of 2, half of blood glucose arose from lactate in deficient animals. By comparison, only 25% of glucose arose from lactate in controls. Lack of a difference in lactate turnover (irreversible disposal) rates between deficient rats and controls (191 +/- 26 vs. 163 +/- 15 mumol . kg-1 . min-1) was attributed to 14C recycling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661704 TI - Measuring lactate production. PMID- 3661705 TI - Short-chain fatty acids stimulate motility of the canine ileum. AB - Based on earlier observations that colonic contents stimulated ileal motility in the dog, our hypothesis is that the ileum would respond to physiological amounts of short-chain fatty acids (SCFA). Four dogs had isolated ileocolonic loops constructed surgically and boluses of test solutions (15 ml) were instilled into the distal ileum through a small catheter. Intraluminal pressure catheters were used to record motility. Concentrations of SCFA (also called volatile fatty acids) comparable to those found in dog stool (108 mM; 66% acetic, 24% propionic, and 10% butyric acids) regularly stimulated motility with a dose-related effect. The response was not due to the pH of the SCFA solutions and was independent of the pH at which SCFA were instilled. Ricinoleic acid (4 mM) also stimulated motility, as did chenodeoxycholic acid; the bile acid was active only at supraphysiological concentrations (approximately 7.6 mM). Instillates that simulated the composition of ileal chyme in malabsorptive states were without effect. The results suggest that the ileum can "sense" the presence of colonic contents in the lumen and that SCFA are the responsible mechanisms. Stimulation of ileal motility by SCFA could be a response to coloileal reflux. PMID- 3661706 TI - Receptor-mediated internalization and secretion of cholecystokinin into rat pancreatic duct fluid. AB - We measured cholecystokinin (CCK) in pancreatic duct secretions (PDS) after infusion of different amounts of CCK-8 (the C-terminal octapeptide of cholecystokinin) into rats. Injection of 23, 46, and 92 ng of CCK-8 increased immunoreactive cholecystokinin in PDS by 3-, 13-, and 28-fold above basal levels within 30 min. Continuous intravenous infusion of CCK-8 (50 ng/min) into rats for 30 min, followed by a 30-min rest period, and then a final infusion of peptide for another 30 min increased CCK in PDS only during the final period by 12-fold to 500 pg/30 min. Neither gastrin nor oxidized CCK-8 were detected in PDS after intravenous infusion of each peptide. Administration of proglumide (ip), a CCK receptor antagonist, during continuous CCK infusion significantly reduced immunoreactive CCK levels in PDS to 2% of the control group (P less than or equal to 0.01). CCK was also rapidly internalized into dispersed pancreatic acinar cells in a temperature-dependent fashion, and this process was inhibited by proglumide. The above data suggest that CCK in PDS reflects a peptide-specific process that is receptor mediated. We propose that circulating cholecystokinin binds to specific receptors on pancreatic acinar cells, is internalized, and is then secreted into pancreatic duct fluid. PMID- 3661707 TI - Interdigestive contractile patterns of the ileum in dogs. AB - The aim of this study is to elucidate the nature of ileal interdigestive contractile patterns by the computerized analysis of the contraction spread and by videofluoroscopy. Conscious dogs equipped with closely spaced strain-gauge force transducers were used. Two patterns of repetitive, phasic contractions were recorded, migrating clusters and phase IIIs; both patterns consisted of repetitive, propagated contractions. Both patterns migrated aborad by sequential movement of contraction waves down the bowel. Consequently, the rate of migration of either of the entire patterns was slower than the propagation velocity of constituent, individual contraction waves. Both patterns differed in several parameters, especially the propagated contractions of the clusters spread over shorter distances (1.47 +/- 0.4 cm) than those of phase III (4.65 +/- 0.99 cm). Compared with these complex patterns, propagating power contractions represented single contractions that propagated aborad at the same velocity as the contraction waves of the complex patterns. All three patterns propelled luminal contents distally. PMID- 3661708 TI - Bicarbonate sulfate exchange in canalicular rat liver plasma membrane vesicles. AB - The mechanism(s) and driving forces for biliary excretion of sulfate were investigated in canalicular rat liver plasma membrane vesicles (cLPM). Incubation of cLPM vesicles in the presence of an inside-to-outside (in, out) bicarbonate gradient (50 mM in, 5 mM out, pH 8.0 in and out), but not pH (pH 8.0 in, 6.0 out) or out-to-in sodium gradients, stimulated sulfate uptake 10-fold compared with the absence of bicarbonate and approximately 2-fold above sulfate equilibrium ("overshoot"). Initial rates of this bicarbonate gradient-driven sulfate uptake were saturable with increasing concentrations of sulfate (apparent Km, approximately 0.3 mM) and could be inhibited by probenecid, N-(4-azido-2 nitrophenyl)-2-aminoethylsulfonate, acetazolamide, furosemide,4-acetamido-4' isothiocyanostilbene-2,2'-disulfonic acid, and 4,4'-diisothiocyanostilbene-2,2' disulfonic acid (IC50, approximately 40 microM). Cisinhibition of initial bicarbonate gradient-stimulated sulfate uptake and transstimulation of sulfate uptake in the absence of bicarbonate were observed with sulfate, thiosulfate, and oxalate but not with chloride, nitrate, phosphate, acetate, lactate, glutamate, aspartate, cholate, taurocholate, dehydrocholate, taurodehydrocholate, and reduced or oxidized glutathione. These findings indicate the presence of a sulfate (oxalate)-bicarbonate anion exchange system in canalicular rat liver plasma membranes. In conjunction with the previously reported chloride bicarbonate exchanger (J. Clin. Invest. 75: 1256-1263, 1985), these findings support the concept that bicarbonate-sensitive transport system might play an important role in bile acid-independent canalicular bile formation. PMID- 3661709 TI - Detection of cholecystokinin-58 in human blood by inhibition of degradation. AB - Although cholecystokinin-58 (CCK-58) is a major molecular form stored in the intestine, it has not yet been shown to be released into the circulation. This report describes in vitro degradation of CCK-58 in human blood and plasma and the molecular forms detected when this degradation is inhibited. After incubation of CCK-58 for 150 min between 20 and 24 degrees C, approximately 60% of immunoreactivity recovered was degraded to smaller immunoreactive forms. Storage of the 150-min incubate at -20 degrees C for 3 days greatly increased the observed degradation to 85%. When CCK-58 was added in vitro to blood, similar degradation occurred. Degradation of CCK-58 could be inhibited by addition of acid. Blood was obtained 1 h after a test meal designed to stimulate CCK release. The pH was lowered during collection and processing of blood and plasma to inhibit in vitro degradation of cholecystokinin. This method permitted the detection of significant amounts of CCK-58 in circulation. PMID- 3661710 TI - Histamine H2-receptor of human and rabbit parietal cells. AB - The histamine H2-receptor on the human parietal cell has been characterized by using dose-response curves and the negative logarithm of the molar concentration of an antagonist (pA2) analyses of cimetidine antagonism of betazole, histamine, and impromidine stimulation in isolated human and rabbit gastric glands. To evaluate the in vitro results, betazole-stimulated gastric acid secretion with and without cimetidine was also studied in healthy subjects. In the in vivo model, individual dose-response curves were shifted to the right with increasing cimetidine concentrations, but this was counteracted by increasing betazole doses, indicating competitive, reversible antagonism. The pA2 values ranged from 6.1 to 6.3. In isolated human gastric glands, impromidine was shown to be eight times more potent than histamine, indicating higher receptor affinity, but the maximally stimulated aminopyrine accumulation was the same as for histamine, and the pA2 values for cimetidine antagonism did not differ significantly, i.e., 5.7 (histamine) and 6.1 (impromidine). In isolated rabbit gastric glands, cimetidine inhibited the histamine- and impromidine-stimulated response with pA2 values of 6.0 and 7.3, respectively. Impromidine was shown to be approximately 100 times more potent than in human gastric glands, whereas histamine had the same potency. This confirms the role of the histamine H2-receptor and suggests a difference between the species concerning receptor affinity. PMID- 3661711 TI - Intracellular transport of pancreatic zymogens during caerulein supramaximal stimulation. AB - Rats infused with a dose of the secretagogue caerulein that is in excess of that which stimulates a maximal rate of pancreatic digestive enzyme secretion develop acute edematous pancreatitis. We have previously noted that infusion of this dose of caerulein (5 micrograms . kg-1 . h-1) induces the appearance of large heterogeneous vacuoles in acinar cell, blockade of exocytosis, and intracellular accumulation of digestive zymogens [O. Watanabe et al. Am. J. Physiol. 246 (Gastrointest. Liver Physiol. 9): G457-G467, 1984 and A. Saluja et al. Am. J. Physiol. 249 (Gastrointest. Liver Physiol. 12): G702-G710, 1985]. The current studies were performed to further elucidate these phenomena at the electron microscopic level of resolution and employed the techniques of pulse labeling, radioautography, and immunolocalization. Rats were infused with caerulein (5 micrograms . kg-1 . h-1) for 1 h, given a pulse of [3H]phenylalanine, and killed at selected times during the subsequent 5- to 180-min postpulse period during which caerulein infusion was continued. Transport from the endoplasmic reticulum to the Golgi cisternae was not altered by supramaximal stimulation, but transport through post-Golgi elements was altered. In particular, the maturation of condensing vacuoles into zymogen granules was found to be impaired. This led to the accumulation of partially condensed vacuoles and to the development of the large vacuoles containing newly synthesized digestive zymogens as well as the lysosomal hydrolase cathepsin D. The source of the latter could be impaired sorting of lysosomal and digestive enzymes and/or fusion of vacuoles with lysosomes. At the later times after pulse labeling, mature zymogen granules were also found to fuse with these large cathepsin D-containing vacuoles by a process analogous to crinophagy. Thus these studies indicate that the large heterogeneous vacuoles that appear during supramaximal secretagogue stimulation and that contain admixed digestive zymogens and lysosomal hydrolases arise by at least two mechanisms, impaired condensing vacuole maturation and crinophagy. PMID- 3661712 TI - Variations in rat mesenteric tissue thickness due to microvasculature. AB - Studies of microvascular, tissue and lymphatic transport using microphotometric and microfluorometric techniques are potentially subject to artifact due to variations in tissue specimen thickness. Absorbance techniques utilize the Lambert-Beer law in which A = log I0/I = act, where A is absorbance, I0 is incident light intensity, I is transmitted intensity, a is an absorbance coefficient, c is concentration of substance, and t is path length. If differences in t are known to be present, then inferences of changes in c from changes in A become suspect. In microfluorometry the amount of light gathered is proportional to the number of fluorochromes in the effective cuvette, which is determined by the microscope's numerical aperture and the sample thickness. If variations in thickness are known to occur, the effective cuvette volume may be changing; therefore, inferences of changes in fluorochrome concentration from changes in intensity become suspect. Existing data suggest that rat mesentery is 15-30 microns thick, but variation over a tissue region is unknown. Our goals are to determine thickness variation in avascular, fat-free mesenteric tissue regions; thickness variation near blood vessels; and average tissue thickness. Sprague-Dawley rats were anesthetized with Inactin. Mesenteric tissue from a loop of small intestine was draped over a platform for observation; thickness was measured with an oblique microscope and a microgravimetric technique. The average variation in avascular fat-free tissue was 1.1 micron/100-microns distance, and average thickness was 17.4 microns. There was a significant increase in thickness over the microvasculature. PMID- 3661713 TI - Differential effects of [Gln4]neurotensin on circular and longitudinal muscle of dog ileum in vitro. AB - We studied the effects of neurotensin analogue [Gln4]-neurotensin on isolated dog ileal longitudinal and circular muscle strips. [Gln4]neurotensin stimulated the spontaneous contractile activity of the circular muscle but inhibited that of the longitudinal muscle in a dose-dependent fashion. Hexamethonium had no effect on the spontaneous longitudinal or circular muscle contractile activity. Atropine and tetrodotoxin (TTX) both inhibited the longitudinal muscle. Atropine had no effect on the circular muscle, but TTX stimulated it. The effects of [Gln4]neurotensin on the circular muscle were reduced but not completely abolished by atropine. The inhibition of the longitudinal muscle by [Gln4]neurotensin was not reduced by any of the above antagonists but was enhanced by atropine. Electrical field stimulation (10 Hz, 100 mA) stimulated the longitudinal muscle and inhibited or stimulated the circular muscle depending on the pulse width of the stimulus. These effects were unaffected by [Gln4]neurotensin. We conclude that [Gln4]neurotensin has differential effects on isolated muscle strips of the two muscle layers in the dog ileum. It stimulates the circular muscle partially through cholinergic nerves at preganglionic sites and partially through a direct myogenic effect. [Gln4]neurotensin inhibits the spontaneous activity of the longitudinal muscle presumably by reducing the excitability of cholinergic nerves at postganglionic sites. PMID- 3661714 TI - Hybrid blood flow probe for simultaneous H2 clearance and laser-Doppler velocimetry. AB - To perform two independent regional blood flow measurements in tissue volumes of similar dimensions, we designed a hybrid blood flow probe capable of measuring regional perfusion by both laser-Doppler velocimetry (LDV) and H2 clearance. The probe consisted of two fiber-optic light guides to conduct light between the surface of tissue of interest and a laser-Doppler blood flowmeter. Also contained within the probe were a platinum 25-microns H2-sensing electrode and a 125 microns H2-generating electrode. The probe can thus be used to measure local perfusion with H2 clearance. The H2 can either be inhaled or can be generated electrochemically at the locus of interest. Evaluation of the probe in the canine gastric mucosa indicated 1) that the relationship between mucosal flow measurements made simultaneously with H2 clearance and LDV was highly significant and linear and 2) that H2 clearance could potentially be used to calibrate the laser-Doppler blood flowmeter in absolute units. The methods of constructing the flow probes are discussed in detail. PMID- 3661715 TI - Potassium secretion by nonsensory region of gerbil utricle in vitro. AB - The isolated nonsensory region of the gerbil utricle in vitro produced a lumen positive transepithelial electrical potential difference (VT) of +5.7 mV and a luminal fluid containing 106 mM K when bathed in mammalian Ringer solution (5 mM K and 150 mM Na). The lumen of this region was perfused in vitro with K-free solution and the luminal [K], VT, and transepithelial resistance (RT) were measured before and following perfusion under control conditions and after addition of bumetanide (0.1 mM) or ouabain (1 mM) to the bath. The perfusate contained a reduced [Ca], since the average value of utricular endolymph in vivo (0.28 +/- 0.03 mM) measured with Ca-selective microelectrodes was 38% of that in perilymph. Under control conditions, the luminal [K] initially increased at a rate of 2.13 mumol X cm-2 X h-1 after perfusion; net secretion continued until the luminal [K] returned to its preperfusion level. This flux rate corresponds to 57 microA/cm2. The "equivalent short-circuit current" (Equiv. Isc; VT/RT) was found to average 61 microA/cm2. Both K secretion and VT were fully inhibited by bumetanide and by ouabain. Luminal application of Ba (5 mM) in K-free solution had no effect on the initial rate of K secretion, but did prevent full recovery of luminal [K] to the control level. These results are the first estimates of K secretion by the nonsensory cells of the utricle and are the first to directly demonstrate inhibition of K secretion in the inner ear by bumetanide and in the nonsensory tissue of the utricle by ouabain. PMID- 3661716 TI - Postnatal maturation of rabbit renal collecting duct: intercalated cell function. AB - Intercalated cells play a major role in renal regulation of acid-base balance. We used fluorescent dyes to characterize postnatal maturation of intercalated cells. We stained rabbit collecting ducts with the pH-sensitive dye 6-carboxyfluorescein diacetate and identified individual intercalated cells by their bright green fluorescence. Number of fluorescent cells per millimeter tubule doubled during maturation in midcortex (68 +/- 7 to 121 +/- 9; P less than 0.01) but did not change in outer stripe of outer medulla. Excitation-ratio (490/450 nm) fluorometry of individual cells in nonperfused tubules revealed an increase in pH of cortical intercalated cell from 7.28 +/- 0.03 in newborn to 7.43 +/- 0.03 in adult (P less than 0.005); principal cell pH did not change with age, averaging 7.10 +/- 0.05. The smaller difference in pH between intercalated and principal cells in neonates suggested a paucity of H+ pumps in immature intercalated cells. Indeed, few cortical intercalated cells trapped the weak base acridine orange in cytoplasmic vesicles that contained H+ pumps or demonstrated selective uptake of 3,3'-dipentyloxacarbocyanine, a fluorescent cation that probes for mitochondrial potential. Intercalated cells in neonatal medullary collecting ducts had a cell pH similar to that measured in the adult, as well as numerous acidic cytoplasmic vesicles and significant mitochondrial potentials. In conclusion, intercalated cells in cortical collecting duct underwent postnatal proliferation and maturation, whereas those cells present in outer medullary collecting duct, where proliferation was virtually complete by 1 wk of age, were nearly differentiated. Signals directing this centrifugal pattern of postnatal renal maturation are presently unknown. PMID- 3661717 TI - Load dependency of sodium chloride reabsorption by medullary collecting duct in rat. AB - During antidiuresis, the medullary collecting duct (MCD) reabsorbs sodium in load dependent fashion. However, attempts to characterize reabsorption when sodium delivery to the MCD is elevated have not led to clear results, largely due to interfering effects of the strategies employed to raise delivery. In the present study, microcatheterization was performed in rats undergoing water diuresis induced solely by infusion of 2.5% dextrose in water, and in rats where solute delivery to the MCD was markedly elevated by the combination of water diuresis with acute potassium chloride loading. The results show that delivery of sodium was elevated by the experimental maneuvers, averaging 7.01 +/- 0.83 mumol . min-1 . g kidney wt-1 compared with a normal antidiuretic value in the literature of 3.50 +/- 0.40 mumol . min-1 . g-1. Sodium and chloride reabsorptions were increased proportionally, indicating that the MCD has a large capacity to transport sodium chloride. Normalized sodium reabsorption remained high, varying in different series between 80 +/- 10 and 96 +/- 1% of the delivered load. Thus the MCD reabsorbed an average of 6.37 +/- 0.70 mumol . min-1 . g-1 of sodium while sodium excretion was 0.52 +/- 0.11 mumol . min-1 . g-1. The results emphasize the importance of MCD sodium chloride reabsorption for determination of final urinary salt excretion, and thus for regulation of body salt balance. PMID- 3661718 TI - Hepatic denervation alters first-phase urinary sodium excretion in dogs with cirrhosis. AB - Cirrhotic dogs without intrahepatic hypertension (IHH) never retain sodium or expand plasma volume. To test the hypothesis that IHH may cause urinary sodium retention early in cirrhosis, we prepared cirrhotic dogs (chronic biliary obstruction) who underwent simultaneous hepatic denervation with end-side portacaval anastomoses. Such animals, along with appropriate controls and unanesthetized were studied by balance techniques. In the experimental group, plasma volume never increased, and sodium retention did not occur until 2 days prior to the appearance of detectable ascites. In a sham-denervated group, plasma volume increased by 10% and sodium retention occurred on the average 8.4 days prior to ascites. When the portal veins were left intact, the sham-denervated group showed the usual magnitude of plasma volume expansion observed in cirrhotic dogs (18.3%) with a 7-day delay between sodium retention and ascites appearance. Those dogs with hepatic denervation demonstrated a 9.2-day delay with 12.6% expansion of plasma volume. When ascites was mobilized with a peritoneovenous valve, and dogs were subjected to a high salt diet (130 meq/day), denervated dogs excreted the load normally, whereas sham-denervated dogs retained sodium and developed anasarca. We conclude that in cirrhotic dogs with IHH, liver denervation prevents early non-volume-related sodium retention. PMID- 3661719 TI - Sodium excretion in dogs with low-grade caval constriction: role of hepatic nerves. AB - Low-grade thoracic caval constriction will raise intrahepatic pressure without driving fluid from the vascular space as ascites. In eight such dogs where venous pressure was increased by 6.6 cmH2O, sodium balance studies showed a positive cumulative balance of 85 meq and a weight gain of 480 g over a 6-day period in the absence of any change in renal perfusion, glomerular filtration rate, central venous pressure, blood pressure, cardiac output peripheral vascular resistance, or plasma levels of aldosterone. Liver function tests, including bromosulfophthalein disappearance curves, were also normal. In dogs with either sham surgery, or subjected to equivalent venous hypertension of the abdominal vena cava or portal veins, there was a cumulative positive sodium balance of only 21-28 meq over a 2-day period. When the liver was completely denervated prior to performing the thoracic caval constriction, the sodium handling profile reverted to the same pattern as observed in sham controls, i.e., 22 meq cumulative sodium over a 3-day period. When the thoracic caval constriction was tightened to produce ascites, a LeVeen valve was inserted and the ascites mobilized. In response to 130 meq/day sodium diet, denervated dogs excreted the sodium load normally, whereas dogs with intact hepatic nerves retained sodium and developed anasarca. We conclude that intrahepatic baroreceptors may modulate sodium excretion in the presence of intrahepatic hypertension. PMID- 3661720 TI - Evidence for the transport function of uricase, an oxidative enzyme. AB - [2-14C]urate uptake was examined in proteoliposomes prepared with phosphatidylcholine and either pig liver uricase or albumin, and in protein-free liposomes. Urate uptake was only evident in proteoliposomes that contained active uricase. Uptakes were indistinguishable in the presence and absence of inwardly directed gradients of sodium, potassium, or choline chloride or outwardly directed hydroxyl gradients. Both urate and allantoin accumulated within proteoliposomes during urate uptake; however, [2-14C]allantoin was not taken up by proteoliposomes. Urate uptake was accelerated in the presence of unlabeled urate in the trans position, saturable, and competitively inhibited by oxonate, findings consistent with carrier-mediated transport. Finally, the kinetics of urate uptake and oxidation were virtually identical, implying that the transporter is uricase. Thus, these studies provide evidence that uricase can function as a transport protein for urate when inserted in a lipid bilayer: transport via uricase is neither cation dependent (not a cotransporter) nor dependent on an exchangeable anion (not a urate/anion exchanger). Additionally, these studies demonstrate that neither urate nor allantoin cross lipid bilayers by simple or nonionic diffusion. PMID- 3661721 TI - Calcium and vitamin D metabolism in spontaneously hypertensive rats. AB - We have studied the effect of dietary vitamin D restriction on serum levels of vitamin D metabolites in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). Both WKY and SHR were fed a vitamin D-deficient or a vitamin D-supplemented diet beginning at 4 wk of age. In vitamin D-supplemented animals, the serum 1,25-dihydroxycholecalciferol [1,25(OH)2D3] concentration of WKY (55.4 +/- 6.6 pg/ml, n = 5) was similar to the level of SHR (46.3 +/- 5.9 pg/ml, n = 5). Plasma calcium concentration was not different between WKY and SHR. In animals fed a vitamin D-deficient diet, the serum concentration of 1,25 (OH)2D3 of SHR (23.0 +/- 1.3 pg/ml, n = 5) was significantly lower than that of WKY (67.6 +/- 4.6 pg/ml, n = 5, P less than 0.01). Plasma 25 hydroxycholecalciferol level was markedly decreased in both WKY (3.6 +/- 0.5 ng/ml, n = 7) and SHR (2.8 +/- 0.4 ng/ml). The SHR, but not the WKY, developed hypocalcemia (WKY, 9.68 mg/dl; SHR, 6.70 mg/dl). Despite hypocalcemia, fasting urinary Ca2+ excretion of SHR exceeded that of WKY. We conclude that the lower 1,25(OH)2D3 level in SHR fed a vitamin D-deficient diet may be due to a defect in the synthesis of 1,25(OH)2D3. The low level of 1,25(OH)2D3 is associated with renal wasting of calcium and hypocalcemia in SHR. PMID- 3661722 TI - Hypocalcemia-associated modulation of renal response to acute volume expansion in rats. AB - The present study used free-flow micropuncture and whole-kidney clearance studies to determine the renal response to normocalcemic vs. hypocalcemic acute volume expansion (AVE) in anesthetized Munich-Wistar rats. Animals received AVE with Ringer bicarbonate to 10% body weight; half of these animals were supplemented with calcium to maintain normocalcemia (VE + Ca2+) and half were allowed to become hypocalcemic (VE). Filtered load of chloride and total CO2 (TCO2) to the superficial proximal tubule and delivered load to the superficial loop segment were not different between groups. Superficial proximal tubule absolute Cl reabsorption was not different, but superficial loop segment absolute Cl reabsorption was less in the VE + Ca2+ animals (2,221 +/- 106 vs. 2,651 +/- 125 pmol/min, P less than 0.05) and whole-kidney fractional chloride excretion was greater (10.5 +/- 1.6 vs. 4.3 +/- 0.5%, P less than 0.05). When indomethacin (I) was administered to hypocalcemic (VE + I) and normocalcemic (VE + Ca2+ + I) AVE animals, both groups of animals had tubular and whole-kidney chloride reabsorption similar to VE animals. TCO2 reabsorption was not influenced by Ca2+ or I. The data indicate that normocalcemic vs. hypocalcemic AVE results in reduced superficial loop segment chloride reabsorption and greater whole-kidney fractional chloride excretion in the absence but not in the presence of prostaglandin inhibition. The data are compatible with an effect of hypocalcemia during AVE to limit superficial loop segment and whole-kidney chloride excretion by inhibiting renal prostaglandin synthesis. PMID- 3661723 TI - Effects of adrenalectomy on CCD: evidence for differential response of two cell types. AB - Electrophysiological and chemical methods were used to determine the Na and K transport properties of the isolated cortical collecting duct (CCD) of control and adrenalectomized (ADX) rabbits. Net fluxes of Na (JNa) and K (-JK) in controls were 5.7 and 3.2 pmol . mm-1 . min-1 and in ADX were 1.0 and 0.7 pmol . mm-1 . min-1, respectively, similar to electrically determined rates. In separate experiments, blind impalement of cells from adrenal intact (group 1), ADX (group 2), and ADX rabbits treated with deoxycorticosterone (group 3) allowed identification of two distinct cell types, majority cells (MA) and minority cells (MI). In all groups, MA were distinguished from MI by a relatively high basolateral membrane potential (-Vb), low apical membrane fractional resistance (FRa), and presence of apical and basolateral membrane K conductances. Vb of MA ( 82.4 mV) was significantly hyperpolarized in groups 1 and 3 combined, when compared with group 2 (-66.4 mV). However, there was no significant difference between Vb of MI in group 2 (-38.9 mV) and Vb of MI in groups 1 and 3 (-36.2 mV). In MA of group 1 equivalent circuit values of apical membrane Na and K conductances (GNaa, GKa) and maximum pump current (Ipmax) were 0.84 and 6.72 mS/cm2 and 46.7 microA/cm2, respectively. These values in group 2 were significantly lower (0.28 and 1.52 mS/cm2 and 8.7 microA/cm2, respectively). It is concluded that two cell types can be distinguished electrically in the CCD. MA have properties consistent with principal cells and MI have properties consistent with intercalated cells. ADX causes a decrease in GNaa, GKa, and Ipmax of PC that results in proportionate decreases in INaa and IKa. PMID- 3661724 TI - Na-dependent effects of DOCA on cellular transport properties of CCDs from ADX rabbits. AB - Microelectrode methods were used to assess the Na-dependent effects of mineralocorticoids on the conductive transport properties of cortical collecting ducts (CCD) from adrenalectomized (ADX) rabbits. Rabbits were divided into four groups: control, 3 h treatment with deoxycorticosterone (DOCA), 18 h DOCA treatment, and 18 h DOCA plus amiloride treatment. After only 3 h of DOCA treatment the transepithelial potential (VT) increased significantly from -1.4 to -8.7 mV, and after 18 h VT increased further to -19.3 mV. The basolateral membrane potential (Vb) significantly increased after 18 h (from -61.6 to -87.6 mV). However, compared with treatment with DOCA alone for 18 h, both -VT and -Vb were significantly attenuated with DOCA plus amiloride treatment to -8.3 and 72.9 mV, respectively. The apical membrane Na and K currents (INaa and IKa) and conductances (GNaa and GKa) were all increased after 3 h DOCA treatment. After 18 h of DOCA treatment, IKa, INaa, and GKa increased further, but GNaa remained unchanged. On simultaneous treatment with DOCA and amiloride, the maximum pump current (Ipmax), IKa, INaa, and GKa but not GNaa were all reduced significantly. These results support a mechanism whereby mineralocorticoids first increase GNaa. A rise in cell Na results then in the simultaneous increase in GKa and sodium transport, probably by insertion of new Na pumps. An additional direct effect of DOCA on GKa and Ipmax is not excluded. PMID- 3661725 TI - Ammonia entry along rat proximal tubule in vivo: effects of luminal pH and flow rate. AB - The roles of luminal pH and flow rate in determining ammonia entry along the rat proximal tubule were examined using in vivo microperfusion. With perfusion rate constant at 15 nl/min, perfusate bicarbonate concentration was varied. Collected fluid ammonia concentration correlated with collected fluid bicarbonate concentration, consistent with nonionic diffusion (r = 0.726; P less than 0.001). Hence ammonia entry was dependent on luminal pH. With perfusate bicarbonate constant at 5 or 25 mM, perfusion rate was varied. In all groups, there was little change in collected fluid ammonia concentration with flow rate. Thus ammonia entry was also highly dependent on flow rate. With paired collections using a 25 mM bicarbonate perfusate, collected fluid bicarbonate was higher at a 30 nl/min perfusion rate than at 15 nl/min (16.8 +/- 1.1 vs. 10.3 +/- 1.1 mM), whereas total ammonia concentrations were similar (0.54 +/- 0.1 and 0.55 +/- 0.1). Thus the NH3 concentration was higher at 30 than at 15 nl/min (6.1 +/- 1.2 vs. 3.4 +/- 0.5 microM; P less than 0.025), a result not predicted by simple nonionic diffusion. Thus these studies demonstrate the importance of nonionic diffusion in determining ammonia entry along the proximal tubule. However, the results also demonstrate that flow rate importantly determines ammonia entry in vivo in a manner not predicted by simple nonionic diffusion of NH3. This augmentation of ammonia entry with increasing flow rate may involve flow dependent alterations in ammonia synthesis or transport of NH+4. PMID- 3661726 TI - Regional ventricular segmental dynamics in normal conscious dogs. AB - Left ventricular (LV) subendocardial segmental behavior was analyzed during the whole cardiac cycle for different loading and inotropic conditions in six conscious dogs that were instrumented with ultrasonic crystals in the basal (B) and apical (A) LV regions, a LV micromanometer, and an aortic cuff occluder. There were large variations of A and B segmental behavior during isovolumic contraction and relaxation. In contrast, a linear relationship between A and B was observed during ejection but segmental shortening was larger during control in A than in B, whether it was expressed as a percentage of systolic shortening (34.6 +/- 1.1 and 25.0 +/- 1.2%, respectively; P less than 0.005), or whether segments were normalized for passive resting length. This linear relationship during ejection with a slope of 1.49 was not significantly modified by alterations of loading conditions or inotropic state. The larger A than B shortening, independent of the normalization procedure, is attributed to the regional stress distribution in the LV. The absence of regional and cycle invariance particularly during isovolumic phases prevents the inference of ventricular volume from a limited number of dimensions. PMID- 3661727 TI - Twitch contractions during low Na+-induced [Ca2+]i overload in rat ventricular muscle. AB - To elucidate the mechanisms of the negative inotropism induced by excessive intracellular Ca2+ ([Ca2+]i), we observed detailed characteristics of twitch contractions during low Na+-induced [Ca2+]i overload. Rat right ventricular trabecular muscles were superfused with a low-Na+ solution ([Na+]o:50, 25, 18, and 14 mM), obtained by substituting choline-Cl for NaCl at 30 degrees C on the stage of an inverted microscope and electrically stimulated at the rate of 12 pulses/min (n = 6). Each low-Na+ perfusion decreased developed tension with the increase in resting tension (Ca2+ overload). As [Na+]o decreased below 50 mM, peak contracture tension increased and developed tension at peak contracture decreased. The decrease in developed tension coincided with the appearance of the marked aftercontractions and with the increase in fluctuating intracellular contractile activities during the resting period, which have been ascribed to [Ca2+]i oscillations. Neither maximum rate of tension development nor minimum rate of relaxation showed significant changes during the phase of Ca2+ overload. These results suggest that the decrease in developed tension during Ca2+ overload is due to [Ca2+]i oscillations, rather than due to depressed contractility and relaxation. PMID- 3661728 TI - Left ventricular O2 consumption and pressure-volume area in puppies. AB - We studied the relation between O2 consumption (VO2) and systolic pressure-volume (PV) area (PVA) in the left ventricles of eight puppies (2-4 mo old). PVA is the area circumscribed by the end-systolic and end-diastolic PV curves and systolic PV trajectory. We assumed PVA to represent the total mechanical energy generated by ventricular contraction. We produced isovolumic contractions at different volumes in the left ventricles isolated and cross-circulated with adult dogs. VO2 closely correlated with PVA in each of control contractile state, an enhanced contractile state with epinephrine, and a depressed contractile state with propranolol in each heart. The slope of the regression line of VO2 on PVA was not significantly affected by epinephrine and propranolol. The regression line shifted upward with epinephrine and downward with propranolol. These characteristics of the puppy's VO2-PVA relation were comparable to those of the adult dog. These results suggest that similar relations hold between myocardial mechanics and energetics in both the puppy and adult dog despite the differences in the heart size and contractile properties. PMID- 3661729 TI - Depressor neurons in rabbit caudal medulla do not transmit the baroreceptor vasomotor reflex. AB - Experiments to determine whether depressor neurons in the caudal ventrolateral medulla form an integral part of the central pathway transmitting the baroreceptor-vasomotor reflex were performed on rabbits anesthetized with urethan. The function of the depressor neurons was altered by intramedullary injections of agents that stimulate or block receptors for gamma-aminobutyric acid and by electrolytic lesions in the caudal ventrolateral medulla. Muscimol abolished both the depressor response and the inhibition of renal nerve activity normally observed after stimulation of the aortic depressor nerve and caused a paradoxical reversal of the depressor response. However, muscimol only partially impaired the inhibition of renal nerve activity produced by experimental elevation of arterial pressure, and it did not affect the increase in renal nerve activity normally produced by decreasing arterial pressure. Bicuculline methiodide amplified the depressor response and the inhibition of renal nerve activity and also restored baroreceptor-vasomotor reflexes abolished by muscimol. Bilateral electrolytic lesions did not alter any component of the baroreceptor vasomotor reflex. Results indicate that the depressor neurons in the caudal ventrolateral medulla do not form an integral part of the central pathway mediating the baroreceptor-vasomotor reflex. However, output from the depressor neurons appears to inhibit sympathoexcitatory neurons, which also receive baroreceptor-derived inhibitory inputs. PMID- 3661730 TI - Carotid and aortic baroreceptor control of heart rate in conscious monkey. AB - This study looks at the difference between the aortic and the carotid baroreceptors in controlling the heart rate of conscious monkeys in the cage vs. the laboratory. Macaca mulatta and M. radiata underwent sequential baroreceptor denervation by first stripping the aortic arch, then one carotid sinus, and finally the second carotid sinus [sinoaortic denervation (SAD)]. Four monkeys had the carotid sinuses denervated before denervation of the aortic arch. Mean arterial blood pressure (MABP)-heart rate (HR) curves were determined by infusing nitroprusside and phenylephrine hydrochloride. The peak sensitivity (PS) was significantly less for all animals (control and denervated) in the laboratory than in the cage (P less than 0.05) with the exception of the SAD animals, which showed no difference. There was no significant difference in sensitivity between control and aortic-denervated animals in the cage. The PS decreased significantly after denervation of aortic arch and one carotid sinus. Monkeys with only the aortic baroreceptors intact had gains for the baroreflex curves that were similar to that of the SAD animals. After complete SAD the PS were essentially zero. We concluded that 1) the maximum slope of the MABP-HR reflex is greater when the monkey is in the cage than it is in the laboratory, probably resulting from an increase in the sympathetic tone; and 2) the carotid baroreceptors exert a greater influence on the HR component of the baroreflex in the conscious monkey than do the aortic baroreceptors. PMID- 3661731 TI - Subendocardial segment length shortening at lateral margins of ischemic myocardium in dogs. AB - The lateral borders of an infarcted area are sharply delineated in terms of perfusion, but functional impairment extends a limited distance into adjacent nonischemic myocardium. To determine the distribution of functional impairment we arrayed three ultrasonic dimension gauges to measure two subendocardial segment lengths in series. The center crystal, placed at the perfusion boundary (PB) between left anterior descending and circumflex arteries, radiated ultrasound to receiver crystals 7-17 mm to either side of the PB. The locations of the functional measurements relative to the PB were determined with myocardial blood flow (microsphere) "maps" constructed from multiple small tissue samples obtained circumferentially. On the nonischemic side of the PB, segment shortening (dL) increased from 2.00 +/- 0.37 mm during control conditions to 2.20 +/- 0.43 mm (P less than 0.05) after left circumflex coronary occlusion. Similar results were obtained in four conscious chronically instrumented dogs, supporting the conclusion that segment function adjacent to the ischemic margin is well preserved after coronary occlusion. On the ischemic side of the PB, dL decreased from 2.24 +/- 0.54 to 0.42 +/- 0.39 mm (P less than 0.01). By adding the data from the two segments in series, a combined measurement of dL across heterogeneously perfused myocardium was derived that decreased by 38% from control. The level of shortening represented an integral of normal and abnormal motion that was proportional to the mean reduction in blood flow (-44%) in all of the muscle spanned by the crystals. We conclude that subendocardial segment lengths "average" shortening in the muscle they subtend when arrayed across the perfusion boundary. PMID- 3661732 TI - Limited capacity for renal vasodilatation in anesthetized diabetic rats. AB - Studies were conducted to determine whether reduced renal blood flow (RBF) exhibited by rats with uncontrolled streptozotocin (STZ)-induced diabetes is attributable to diabetes-induced structural changes in the renal vasculature. Vehicle-treated control rats (CR) and rats that were injected with STZ (STZR) after pretreatment with 3-O-methylglucose (3-OMG), an agent that prevents STZ induced hyperglycemia, were also studied. Basal values of total RBF (ml.min-1.g kidney wt-1, electromagnetic flow probe), systemic arterial pressure (BP, mmHg), and renal vascular resistance (RVR, BP/RBF) in pentobarbital-anesthetized rats during a control period were 5.4 +/- 0.3 (P less than 0.01 vs. CR), 116 +/- 3, and 21.9 +/- 1.0 (P less than 0.01 vs. CR) in STZR (n = 12) and 8.2 +/- 0.4, 121 +/- 2, and 15.3 +/- 1.0 in CR (n = 11), respectively. Basal values of RBF, BP, and RVR in 3-OMG-pretreated STZR were identical to CR. The relative capacity of STZR and CR kidneys for vasodilatation in situ in response to intrarenal arterial infusions of acetylcholine (ACh) and bradykinin (BK) and systemically administered sodium nitroprusside (NP) was evaluated. The capacity of STZR to exhibit active renal vasodilatation in response to intrarenal arterial ACh and BK was significantly less than that of CR (P less than 0.01). The minimum level to which RVR was suppressed after 50 micrograms NP/kg iv was higher in STZR than in either CR or 3-OMG-pretreated STZR (14.8 +/- 1.5 vs. 9.0 +/- 0.7 and 9.3 +/- 1.5 mmHg.ml-1.min.g kidney wt, respectively; P less than 0.05). This dose of NP exerted effective functional antagonism of renal vasoconstriction induced by exogenous norepinephrine and angiotensin II. These in vivo studies suggest that the elevated RVR in STZR might be attributable in part to structural changes in the renal vasculature that are associated with the diabetic state and limit the capacity for renal vasodilatation. However, there was no difference in pressure flow relationships between the two groups in maximally dilated isolated kidneys perfused with Krebs buffer containing 5% albumin, and the RBF deficit in STZR kidneys was corrected by perfusion with blood from CR. Thus the decreased RBF exhibited by STRZ in vivo cannot be attributed solely to renal vascular structural changes associated with diabetes. These findings suggest that undefined humoral factors or abnormal interaction of formed blood elements with vessel walls may account for elevated RVR in STZR. PMID- 3661733 TI - Determination of pyridine nucleotide fluorescence from the perfused heart using an internal standard. AB - Mitochondrial reduced nicotinamide adenine dinucleotide (NADH) is a key intermediate in energy metabolism in the heart, which can be qualitatively monitored using nondestructive surface fluorescence techniques. However, this optical technique is subject to artifacts from alterations in tissue absorbance, motion of the heart, and variations in excitation intensity. In this study rapid scan fluorescence emission spectroscopy was used in conjunction with an internal fluorescence standard to compensate for these optical artifacts. The fluorescence spectra obtained from heart had a maximum at 460 nm and a shoulder at 415 nm. Dilution of heart homogenates resulted in a fluorescent spectrum characteristic of suspensions of mitochondria, indicating that absorption of fluorescence by tissue components produces an inner filter effect. This internal filter was characterized, and isobestic points with regard to O2 were found at 425 and 450 nm. Alterations in the inner filter effect due to changes in tissue oxygenation were eliminated by monitoring the NADH at 425 nm. Motion artifacts and excitation source fluctuations were corrected by loading heart cells with an internal fluorescent standard, 5(6)-carboxy-2',7'-dichlorofluorescein (ClCF). Motion of the heart and changes in excitation intensity altered the fluorescence detected from both NADH and ClCF. The use of the NADH-to-ClCF ratio detected at isobestic wavelengths (425 nm NADH and 520 nm ClCF) gives a relative measure of NADH fluorescence, which adequately compensates for both internal absorbance and motion artifacts. PMID- 3661734 TI - Acetylcholine release by a stimulus train lowers atrial fibrillation threshold. AB - This study was designed to evaluate the importance of local release of autonomic neuromediators when electrical stimuli are applied to the right atrium to measure the atrial fibrillation threshold (AFT). Experiments were performed in 16 open chest dogs anesthetized with alpha-chloralose. The dogs were denervated by bilateral transection of the stellates and cervical vagi. The AFT was determined in 11 dogs by delivering either a train of stimuli (14 pulses, 4 ms, 100 Hz) or a single stimulus (10 ms) to the right atrium during its vulnerable period. In eight dogs, beta-adrenergic blockade with timolol (0.1 mg/kg) had no effect on the AFT determined with either method. Atropine (0.2 mg/kg), given after timolol, significantly increased the train-of-pulses AFT from 4.7 +/- 0.4 to 32.3 +/- 4.6 mA (P less than 0.001). The single-pulse AFT increased from 16.5 +/- 1.5 to 17.8 +/- 1.5 mA (P less than 0.05). Atropine had a similar effect on the AFT when it was given in the absence of timolol (n = 3). In five additional dogs, a monophasic action potential was recorded while a 10-mA train was delivered to the atrium during its absolute refractory period. There was marked shortening of the monophasic action potential duration (55 +/- 6 ms) in the first beat after the train. The shortening was totally abolished by atropine (0.2 mg/kg). The results suggest that a train of stimuli liberates local stores of acetylcholine, which cause a shortening of atrial repolarization time and a profound decrease in the current necessary to evoke fibrillation. PMID- 3661735 TI - Hypothermia reduces cerebral metabolic rate and cerebral blood flow in newborn pigs. AB - We examined effects of hypothermia on cerebral metabolic rate and cerebral blood flow in anesthetized, newborn pigs (1-4 days old). Cerebral blood flow (CBF) was determined with 15-micronS radioactive microspheres. Regional CBF ranged from 44 to 66 ml . min-1.100 g-1, and cerebral metabolic rate was 1.94 +/- 0.23 ml O2.100 g-1 . min-1 during normothermia (39 degrees C). Reduction of rectal temperature to 34-35 degrees C decreased CBF and cerebral metabolic rate 40-50%. In another group of piglets, we examined responsiveness of the cerebral circulation to arterial hypercapnia during hypothermia. Although absolute values for normocapnic and hypercapnic CBF were reduced by hypothermia and absolute values for normocapnic and hypercapnic cerebrovascular resistance were increased, the percentage changes from control in these variables during hypercapnia were similar during normothermia and hypothermia. In another group of animals that were maintained normothermic and exposed to two episodes of hypercapnia, there was no attenuation of cerebrovascular dilatation during the second episode. We conclude that hypothermia reduces CBF secondarily to a decrease in cerebral metabolic rate and that percent dilator responsiveness to arterial hypercapnia is unaltered when body temperature is reduced. PMID- 3661736 TI - Aging of modulation of heart rate. AB - We postulated that measurements of autonomically mediated fluctuations in heart rate might provide a quantitative probe of biological aging. We used power spectrum analysis of instantaneous heart rate while 33 male subjects matched their breathing to a metronome at 15 breaths/min. Measurements were made in supine and standing position. Total power and its two major components, high- and low-frequency power, declined with age in both positions but at different rates. High-frequency power that represents parasympathetically mediated respiratory sinus arrhythmia declined linearly in supine position only in subjects 9-28 yr with a slope of -0.796, which was significantly different from zero at P = 0.0007. The absolute value of high-frequency power in standing position was approximately 60% of that in supine, a difference that was statistically significant (P = 0.01). Low-frequency power that represents beta-adrenergically mediated heart rate fluctuations, especially in standing position, declined linearly to 62 yr of age (P = 0.0001). Mean heart rate increased 17.2 beats/min, and diastolic blood pressure increased 8 mmHg in the entire group in the standing compared with supine position. There were no significant differences in these changes above and below 30 yr of age. We conclude that the influence of the two major mechanisms that modulate heart rate decline at significantly different rates with aging. PMID- 3661737 TI - Effect of ambient oxygen on cultured endothelial cells from different vascular beds. AB - By the use of production of neutrophil chemoattractant activity as a marker, we investigated the responsiveness of endothelial cells of four different anatomic origins to altered ambient oxygen tension to determine whether genetic or conditioned variation existed. The ability of bovine aortic, bovine pulmonary arterial, bovine coronary arterial, and human umbilical vein endothelial cells incubated in decreased oxygen concentrations to release neutrophil chemoattractant activity was assessed. Bovine aortic, human umbilical vein, and bovine coronary arterial endothelial cells produce neutrophil chemoattractant activity in response to 10 or 3% ambient oxygen in vitro. In contrast, 0% ambient oxygen is required for appearance of neutrophil chemoattractant activity from pulmonary artery endothelial cells. These studies suggest that there may be genetic or conditioned variations in the response of endothelium from different vascular beds to decreased oxygen tensions. Furthermore, endothelial cells may play a role in neutrophil-mediated tissue injury during ischemia. PMID- 3661738 TI - Interaction of hypoxia and hypercapnia on cerebral hemodynamics and brain electrical activity in dogs. AB - The interaction of hypoxic hypoxia, hypercapnia, and mean arterial blood pressure (MABP) was studied in 15 pentobarbital-anesthetized ventilated dogs. In one group of animals (n = 5) hypercapnia [arterial CO2 partial pressure (PaCO2) approximately 50 Torr] was added to both moderate hypoxia and severe hypoxia. Moderate hypoxia [arterial O2 partial pressure (PaO2) = 36 mmHg] increased MABP and cerebral blood flow (CBF) without changes in cerebral O2 uptake (CMRO2). Superimposed hypercapnia increased CBF and MABP further with no change in CMRO2. In another group of animals (n = 5), a MABP increase of approximately 40 mmHg during moderate hypoxia without hypercapnia did not further increase CBF, suggesting intact autoregulation. Thus, during moderate hypoxia, hypercapnia is capable of increasing CBF. Severe hypoxia (PaO2 = 22 mmHg) increased CBF, but MABP and CMRO2 declined. Superimposed hypercapnia further decreased MABP and decreased CBF from its elevated level and further decreased CMRO2. Raising MABP under these circumstances in another animal group (n = 5) increased CBF above the level present during severe hypoxia alone and increased CMRO2. The change in CBF and CMRO2 during severe hypoxia plus hypercapnia with MABP elevation were not different from that severe hypoxia alone. We conclude that, during hypoxia sufficiently severe to impair CMRO2, superimposed hypercapnia has a detrimental influence due to decreased MABP, which causes a decrease in CBF and cerebral O2 delivery. PMID- 3661739 TI - Influence of reduced red cell deformability on regional blood flow. AB - The effects of a reduction in red blood cell (RBC) deformability on regional blood flow and RBC distribution were studied in rats anesthetized with pentobarbital sodium. RBCs were subjected to minimum hardening by incubation in a very diluted solution of glutaraldehyde (0.025%). Normal and partially hardened RBCs, labeled with 51Cr or 111In, were injected into the femoral vein, while an equal volume of blood was simultaneously withdrawn from the femoral artery. Approximately 70% of the labeled, partially hardened RBCs disappeared from the circulating blood within 25 min after injection, compared with less than 2% of the labeled normal RBCs. The relative distribution of RBCs with reduced deformability to normal RBCs in tissues was determined from radioactivity counting; this ratio (mean +/- SD) was 7.95 +/- 0.85 in the spleen, 7.44 +/- 0.43 in the sternum, 7.10 +/- 1.09 in the lung, 4.54 +/- 0.31 in the liver, and 3.50 +/- 0.61 in the femur bone. The results indicate a significant degree of trapping of RBCs with reduced deformability in these regions. This ratio of relative distribution of RBCs with reduced deformability as compared with normal RBCs was 1.06 +/- 0.13 in the heart, indicating the absence of preferential trapping of RBCs with reduced deformability in this organ. Regional blood flows were determined with 15-microns microspheres in the control period and after infusion of RBCs with reduced deformability (experimental).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661740 TI - Rapidly recovered transient flow resistance: a newly discovered property of blood. AB - Although blood flows in a pulsatile fashion, little consideration has been given in past studies to its instantaneous resistance to motion when onset and cessation of flow occur abruptly. Hemorheological studies have documented three kinds of blood flow properties. 1) Shear thinning is a fall in viscolity as shear rate rises. 2) Viscoelasticity is a transient shear stress variation due to elastic deformation of erythrocytes. Dilatancy is a viscoelasticity-modifying property attributed to high shear rate erythrocyte rigidity; viscoelasticity is prominent only at low shear rate. 3) Thixotropy is an initial extra flow resistance linked to developing orientation and disaggregation of erythrocytes. Thixotropy returns fully to blood over a period longer than 1 min. Measurements utilizing a fast response Couette viscometer have revealed an extra 10% transient flow resistance after a flow cessation shorter than that between heart beats. The rapidly recovered transient flow resistance has a temporal pattern similar to thixotropy. Its peak and duration are directly related to total shear strain (shear rate x time) over the 8-30 s-1 shear rate range studied. Transient behavior was essentially identical in analyses carried out using three different viscometer gaps. Numerical simulation to test the effect of the newly observed transient behavior on sudden onset tube flow shows that the developing pattern of pulsatile arterial flow can be affected by its presence. PMID- 3661741 TI - Role of catecholamines in mediating fetal blood volume decrease during acute hypoxia. AB - Hypoxia was induced in chronically catheterized sheep fetuses at 133 days gestation (term = 145-150 days) by lowering the O2 content of air inspired by the ewe while supplementing with 1-3% CO2. Control fetal arterial oxygen tension (PO2) averaged 22.5 +/- 0.4 (SE) mmHg. During 30 min of mild hypoxia (PO2 decrease less than 6 mmHg) in normal fetuses, fetoplacental blood volume decreased by 4.7 +/- 0.4% and fetal PO2 by 4.3 +/- 0.7 mmHg. In fetuses with alpha- plus beta-receptor blockade, no change in blood volume occurred during mild hypoxia even though PO2 decreased by 3.4 +/- 0.5 mmHg. During severe hypoxia (PO2 decrease greater than or equal to 6 mmHg), fetal blood volume decreased by 9.2 +/- 1.4% and PO2 by 10.4 +/- 0.4 mmHg in normal fetuses. After adrenergic receptor blockade, blood volume decreased by 7.6 +/- 2.5% when PO2 decreased by 8.0 +/- 0.8 mmHg. Fetal arterial and venous pressure were unchanged during mild hypoxia. Vascular pressures increased significantly during severe hypoxia in normal and blocked fetuses, but these were significantly delayed following adrenergic blockade. Thus, although the catecholamines appear to mediate the decrease in fetal blood volume during mild hypoxia, they appear to have little effect on the blood volume decrease that occurs during severe hypoxia. In addition, the changes in blood volume are not directly correlated with the changes in arterial and venous pressures. PMID- 3661742 TI - Alterations in the microvasculature of one-kidney, one-clip hypertensive rats. AB - The microcirculation was studied in the cremaster muscle of one-kidney, one-clip (1K-1C) hypertensive rats and uninephrectomized controls under chloralose-urethan anesthesia 1-2, 4-5, or 8-9 wk following renal artery stenosis. With the use of television microscopy, inside and outside diameters of first (1A) through fourth order (4A) arterioles were measured before and after vasodilation with 10(-4) M adenosine. Mean arterial blood pressure was significantly elevated in the 1K-1C rats, rising to 170 +/- 6 mmHg by 8-9 wks vs. 93 +/- 2 mmHg in controls. Enhanced vasoconstriction, resulting in closure of arterioles, appeared only in the smaller arterioles of 1K-1C and diminished throughout the development of hypertension. Structural rarefaction appeared later and increased with the development of hypertension. Vasodilated inside diameters of control, but not 1K 1C, 1A, 2A, and 3As, increased with increasing age, leaving the hypertensive arterioles with structurally reduced lumens and increased wall-to-lumen ratios, but without increases in wall cross-sectional areas. Structural lumen reduction appeared first in the 1A and advanced downstream as hypertension developed. Thus vasoconstriction of the smallest arterioles is important initially in renal hypertension, but structural alterations become more important later. PMID- 3661743 TI - Role of hypotension in decreasing cerebral blood flow in porcine endotoxemia. AB - The role of reduced arterial blood pressure (MAP) in decreasing cerebral blood flow (CBF) during endotoxemia was studied in pentobarbital-anesthetized pigs. Microspheres (15 microns diam) were used to measure regional CBF changes during MAP manipulations in animals with and without endotoxin. Endotoxin (0.2 mg/kg iv) decreased MAP to 50 mmHg and decreased blood flow to the cortex and cerebellum without affecting cerebral cortical oxygen consumption (CMRO2). Elevating MAP from 50 to 70 mmHg during endotoxemia with norepinephrine (1.82 +/- 0.58 micrograms . kg-1 . min-1, iv) did not change cortical blood flow or CMRO2 but increased cerebellar blood flow. Brain stem blood flow was not affected by endotoxin or norepinephrine. When MAP was decreased to 50 mmHg by hemorrhage without endotoxin, no change in blood flow to cortex, cerebellum, or brain stem was observed from base-line levels. These results suggest that decreased MAP below a lower limit for cerebral autoregulation does not account for the decreased CBF observed after endotoxin. PMID- 3661744 TI - Double-barrel pipette system for microinjection. AB - A method for constructing double-barrel micropipettes is described. The pipettes are made from theta-tubing, which permits easy beveling of the tips. The two sides of the system operate independently and are suitable for simultaneous microinjection, microperfusion, or servo-null micropressure measurements. PMID- 3661745 TI - Canine AV nodal artery: anatomical variations and a detailed description of cannulation technique. AB - Cannulation of the atrioventricular (AV) nodal artery for selective perfusion of the AV node is a useful physiological method for evaluating the direct effects of pharmacological agents on the AV node. However, previous reports have not included a detailed description of the technique for AV nodal artery cannulation. Furthermore, successful cannulation is dependent on familiarity with the anatomical variations of the AV nodal artery [i.e., the most superior posterior septal artery (PSA)], which supplies blood to the AV nodal region and the posterior descending artery (PDA). The purpose of this report is to describe in detail the technique for cannulation of the AV nodal artery as well as the common anatomical variations of this artery. The anatomy of the PDA and PSA was studied at postmortem examination with ink injection in 30 dogs. Verification of the anatomical location of the AV nodal artery was aided by the induction of transient AV nodal conduction block following intracoronary administration of acetylcholine in the beating heart, as was done in previous studies. Two main variations and two subtypes of PDA anatomy and three main variations of AV nodal artery were found. Based on the present findings, an improved technique for cannulation of the AV nodal artery was established. Using this technique, we achieved a high rate of successful cannulation. PMID- 3661746 TI - Hypertension in SHR rats: contribution of maternal environment. AB - The role of the maternal environment in the development of hypertension in spontaneously hypertensive (SHR) rats was evaluated using the technique of reciprocal cross fostering. Litters of SHR and Wistar-Kyoto (WKY) normotensive pups were either reared by their natural mothers, in fostered to mothers of the same strain, or cross fostered to mothers of the opposite strain shortly after birth. Litters were weaned at 21 days of age, at which time all pups were weighed. At 18-20 wk of age, resting mean arterial blood pressures (MAP) and heart rates were determined for male subjects from the six groups (2 strains X 3 rearing conditions) via an indwelling tail artery catheter. At weaning, SHR animals weighed less than WKY animals. SHRs fostered to WKY mothers were significantly heavier than control SHRs, and WKYs fostered to SHR mothers were significantly lighter than WKY controls at weaning. These body weight differences were also evident in adulthood. Cross fostering SHR pups to normotensive WKY mothers resulted in a dramatic reduction in resting MAP measured in adulthood. Conversely, cross fostering WKY pups to SHR mothers had no measurable effect on adult resting MAP. We propose that an interaction between characteristics of the SHR maternal environment and a genetic susceptibility in SHR pups is essential in triggering the full expression of the hypertensive phenotype in this animal model of human essential hypertension. PMID- 3661747 TI - Chronic vascular access for repeated blood sampling in the unrestrained rat. PMID- 3661748 TI - Blood volume restitution after hemorrhage in adult sheep. AB - Indirect experimental evidence suggested the possibility that the restoration of blood volume to normal hemorrhage in adult sheep may occur more quickly than in other species that have been studied. To test this hypothesis, we studied unanesthetized chronically catheterized adult female sheep 1-2 wk after splenectomy. An average of 19.6 +/- 1.4% (SE) of their initial blood volume was removed over 10 min. Blood volume restitution at 0.5, 1, 3, 5, 7, 24, and 48 h posthemorrhage averaged 12 +/- 3, 34 +/- 3, 41 +/- 3, 50 +/- 4, 62 +/- 10, 79 +/- 10, and 124 +/- 25%, respectively. Arterial pressure decreased during the hemorrhage and returned to normal within 2 h, whereas venous pressure did not change significantly. No change in blood osmolality occurred. There was a highly significant correlation between blood volume and plasma protein mass (r = 0.98, P less than 10(-6)) during and after the hemorrhage. Thus it appears that the posthemorrhage restoration of blood volume in adult sheep occurs over essentially the same time course as in other species and this appears to be mediated by a restoration of plasma protein mass. PMID- 3661749 TI - Glomerular filtration, renal blood flow, and solute excretion in conscious aging rats. AB - Measurement of daily food and water intakes and of renal water and solute excretion in 10-, 20-, and 30-mo-old female rats revealed that they ate the same amounts of food and excreted the same amounts of glucose, sodium, and potassium irrespective of age but that in the 30-mo-old rats phosphate, calcium, and magnesium excretion rose. The glomerular filtration rate and p-aminohippuric acid clearance measured in conscious animals following moderate volume expansion did not differ with age, when expressed per 100 g body wt, but decreased markedly in the 30-mo-old rats when compared with kidney weight. This was related to the senile hypertrophy of the kidneys in the 30-mo-old group, which was reflected by increases in glomerular volume and length of the proximal tubules and by enlargement of the medulla, with the number of nephrons remaining constant with age. There was no evidence of glomerulosclerosis or kidney disease, and proteinuria remained at a low level in all three age groups. These results suggest that the diminished renal filtration rate observed in both conscious and anesthetized senescent rats is due to a reduced supply of blood per gram of kidney tissue and not to loss of nephrons. PMID- 3661750 TI - Partition of carotid baroreceptor response in two-kidney renal hypertensive dogs. AB - This study evaluated the mechanism of carotid sinus baroreceptor resetting in two kidney one-clip Goldblatt hypertension in dogs by partitioning the resetting between carotid sinus wall compliance and receptor neural elements. With dogs under halothane anesthesia, the left renal artery was constricted 70-80% with a Goldblatt clamp without disturbing the contralateral kidney. Ten weeks later, when mean blood pressure had risen to 151 +/- 6 mmHg (means +/- SE) compared with 105 +/- 5 mmHg in controls, we measured simultaneously whole nerve action potentials (N) and carotid sinus volume (V) during step changes in intrasinus pressure (P). Hypertensive N vs. P relationship was sigmoid shaped and shifted toward the P-axis compared with controls. Hypertensive V vs. P relationship was not significantly different from controls. The hypertensive N vs. V relationship derived from the composite plots of N vs. P and V vs. P was sigmoid shaped and shifted toward the V-axis compared with controls. These results suggest that the resetting of baroreceptors is due to changes in receptor properties rather than carotid sinus wall compliance. PMID- 3661751 TI - Resistance to adipocyte hyperplasia in ground squirrels given high-fat diets. AB - Mammalian hibernators prepare for the winter by depositing fat in existing fat cells. There is little, if any, production of new fat cells. This is curious because equivalent fat deposition in rats is associated with substantial fat cell production. To determine whether degree of weight gain, diet composition, or some special mechanism militating against adipocyte hyperplasia may underlie the absence of adipocyte hyperplasia in hibernators, male Richardson's ground squirrels, Spermophilus richardsonii, were fed a fattening high-fat diet for either 5 mo or 1 yr. The 5-mo high-fat feeding period caused peak body weights to increase 36% relative to the peak body weights seen in control animals fed ordinary chow. Despite this increase, there was no apparent increment in fat cell number in any of the major fat depots. Animals fed the diet for 1 yr reached body weights similar to those of the 5-mo group but showed significant adipocyte hyperplasia in all fat depots studied. Thus adult ground squirrels are clearly capable of enlarging their pool of mature fat cells, but they fail to do so, at least at certain times, in response to conditions of weight gain that cause considerable adipocyte hyperplasia in rats. PMID- 3661753 TI - Micropuncture study of proximal tubule pH in avian kidney. AB - Transepithelial potentials (PD) and pH gradients were measured by in vivo micropuncture in superficial proximal tubules of anesthetized European starlings. The average PD for 46 tubules was 2.24 +/- 1.17 mV (mean +/- SD), lumen negative. Only a single lumen-positive potential was recorded, even though late proximal segments are accessible to micropuncture. Proximal luminal pH, measured with single-barrel pH-sensitive microelectrodes, averaged 7.62 +/- 0.26. The pH of peritubular blood, also measured with microelectrodes, was 7.58 +/- 0.15. Correction of the luminal pH for the average PD resulted in a value of 7.58. A few measurements made with double-barrel microelectrodes indicated a pH in proximal tubules of 7.65 +/- 0.08 with a PD of -3.32 +/- 1.47 mV. Thus there appears to be no transepithelial pH gradient across these tubules. On the other hand, pH measurements of cortical collecting ducts averaged 6.40 +/- 0.37, indicating significant acidification in more distal segments. Starlings made acutely acidotic by HCl infusion had significantly reduced arterial and renal cortical pH values, but there was still no significant pH gradient across the proximal tubule. In conclusion, these superficial "reptilian-type" proximal tubules do not appear to have the capacity to maintain a pH gradient. Based on this and on the lack of lumen-positive chloride diffusion potentials, there appears to be no early proximal preferential bicarbonate reabsorption by these nephrons. PMID- 3661752 TI - Protection against fat cell hyperplasia in a hibernator, Glis glis. AB - Dormice, Glis glis, were fed a high-fat diet for 11 mo in one experiment: in another experiment they were fed a high-fat diet for 5 mo, either at room temperature (21.5 degrees C) or in a warm room (27 degrees C). Only in the latter group did adipocyte hyperplasia occur; this was significant in all the fat depots studied (inguinal, retroperitoneal, and gonadal). In the other groups there was no evidence of fat cell hyperplasia, despite weight gains from approximately 160 g (peaks on chow diet) to approximately 250 g (maximums on high-fat diet). Instead, fat cell size, assessed from biopsies of the inguinal area, became considerably enlarged. Taken together with earlier data from other species, the results suggest that hibernators are protected against fat cell hyperplasia. In dormice this protection appears to be present at all phases of their seasonal weight cycles. For species that experience several cycles of weight gain and loss in their lives, it may be adaptive to avoid increases in adipocyte number. PMID- 3661754 TI - Thyroid hormone depresses antioxidant enzyme maturation in fetal rat lung. AB - The surfactant system and antioxidant enzyme system of the lung have chronologically similar developmental patterns, and the maturation of both systems is accelerated by glucocorticoid hormones. To investigate whether thyroid hormone might also stimulate the development of the antioxidant enzyme system as well as the surfactant system, we injected pregnant rats with triiodothyronine (T3) or diluent. Fetal T3 offspring demonstrated significantly elevated T3 levels, had significantly increased lung tissue disaturated phosphatidylcholine (DSPC) and total phospholipid content, yet had significantly decreased activities of three lung antioxidant enzymes (AOE) (superoxide dismutase, catalase, and glutathione peroxidase). When dexamethasone was administered in combination with T3, fetuses demonstrated increases in lung DSPC content but decreases in AOE of magnitude equivalent to or greater than that seen with T3 alone. These findings indicate that thyroid hormone affects surfactant and AOE development in opposite ways and may have potentially harmful as well as beneficial effects on different aspects of lung development. PMID- 3661755 TI - Interaction of vasopressin with area postrema during volume expansion. AB - Effects of arginine vasopressin (AVP) on inhibition of renal sympathetic nerve activity (RSNA) during activation of cardiopulmonary reflexes by volume expansion were examined in conscious sinoaortic-denervated rabbits. The role of the area postrema in mediating these effects was also evaluated in rabbits subjected to area postrema lesion. Animals were subjected to 12% volume expansion with whole blood alone or during infusion of AVP (0.6 mU . kg-1 . min-1). Volume expansion in area postrema-intact animals caused a progressive reflex inhibition of RSNA (maximum = -36.5 +/- 3.3% delta RSNA). Vasopressin infusion did not significantly alter resting arterial pressure, right atrial pressure, heart rate, or RSNA. However, maximum inhibition of RSNA during volume expansion (-62.6 +/- 3.2% delta RSNA) was significantly augmented during AVP infusion, and the augmentation was reversed by a specific vascular (V1) AVP receptor antagonist. Vagotomy eliminated RSNA responses to volume expansion with or without AVP. In area postrema-lesioned animals, the RSNA response to volume expansion was similar to that of intact animals (-31.8 +/- 2.3% delta RSNA). However, AVP did not augment the RSNA response to volume expansion in lesioned animals (-30.4 +/- 2.5% delta RSNA). Thus exogenous AVP augmented cardiopulmonary reflex-mediated inhibition of RSNA due to volume expansion. This effect appeared to be mediated by the V1 AVP receptor and to require the presence of an intact area postrema. PMID- 3661756 TI - Differential effects of spinal transection on sympathetic nerve activities in rats. AB - We measured renal, splenogastric, and lumbar multiunit sympathetic activities in chloralose-anesthetized, paralyzed, and artificially respired Sprague-Dawley rats. Acute spinal transection reduced arterial pressure and lumbar sympathetic activity. However, renal and splenogastric activities were doubled after transection. We conclude that spinal systems exist in the rat that are capable of maintaining renal and splenogastric, but not lumbar, sympathetic activities after spinal transection. Cross-correlation and power spectral analysis of simultaneously recorded sympathetic activities indicated that renal and splenogastric activities often, but not always, shared periodicities near the respiratory rate. These shared periodicities were responsible for high correlations between renal and splenogastric activities. After spinal transection, the shared periodicities usually disappeared, and correlations were reduced. Renal and lumbar activities were rarely strongly correlated, and they rarely shared major periodicities. We conclude that brain stem systems often provide synchronization of abdominal sympathetic activities. However, these activities can be independently generated in both intact and spinally transected rats. PMID- 3661757 TI - Elevated renal nerve activity after spinal transection: effects on renal function. AB - Spinal transection approximately doubles renal sympathetic activity (RSA) in rats. These experiments localized spinal pathways inhibiting RSA and determined the effects of transection-elicited renal sympathetic hyperactivity on renal circulation and renal function. Experiments were conducted in chloralose anesthetized, paralyzed, artificially respired, male Sprague-Dawley rats. RSA was measured from an electrode on the left renal nerve. Renal arterial blood flow (RABF), glomerular filtration rate, urine flow rate, and renal sodium and potassium excretions were also measured. Localized lesions of the cervical spinal cord indicated that spinal generators of RSA were inhibited by pathways descending in the dorsal cervical cord. Autoregulation of RABF prevented transection-elicited increases in RSA from affecting renal vascular resistance. Renal sodium and potassium excretions were dramatically reduced after spinal transection, although these reductions were ameliorated somewhat by fixing posttransection renal arterial pressure at pretransection levels. We conclude that the vascular effects of transection-elicited elevations in RSA are minimized by autoregulation of RABF and that posttransection changes in renal function result from changes in both arterial pressure and RSA. PMID- 3661758 TI - Effects of parathyroid hormone on blood flow in different regional circulations. AB - Parathyroid hormone and, in particular, its 1-34 aminoterminal fragment, PTH-(1 34), are potent vasodilators of the coronary circulation. In addition the hormone exerts a powerful hypotensive effect in a variety of animals, suggesting that the polypeptide hormone is vasoactive in peripheral regional circulations as well. The purpose of this study was to determine the regional circulations that were responsive and the relative sensitivity of each to the vasoactive properties of the hormone fragment. An anesthetized instrumented open-chest and/or open-abdomen dog model was used. Blood flow was continuously monitored in left circumflex, left pulmonary, right renal, celiac, and superior mesenteric arteries. Doses of synthetic human PTH-(1-34) ranging from 0.00024 to 0.24 nmol/kg were administered by bolus intra-arterial injections. Although PTH-(1-34) produced a dose-related vasodilation in each of the above regional vascular beds, marked differences in sensitivity were observed. The peptide elicited large increases in coronary (178%) and celiac (162%) blood flow. Maximal renal and pulmonary responses were relatively small (increases of 30 and 23%, respectively). Compared with control values, blood flow in the superior mesenteric circulation increased only at the highest dose tested. Thus sensitivity to the vascular effects of the hormone fragment differs markedly between the regional vascular beds of the dog. PMID- 3661759 TI - Vasopressin release in sheep following various degrees of rehydration. AB - Restriction of the water intake of sheep to 0.5 1/day for 7-9 days increases plasma arginine vasopressin (pAVP), and voluntary rehydration causes a rapid fall in pAVP with no change in plasma osmolality. The extent of that inhibition of AVP release was assessed by comparing the decline of pAVP after drinking with pAVP disappearance curves obtained in the same sheep after stopping a constant infusion of AVP at 0.5 micrograms/h, which increased pAVP to the dehydration level. The fall in pAVP after drinking was almost identical with the disappearance curve showing that AVP release was almost completely inhibited during the 2-3 min taken for the sheep to drink 3-5 liters to satiate themselves. The response seemed, therefore, to be cued before the intake reached the satiating volume. When dehydrated sheep drank only 0.5 or 1.0 liter, in 30 s or less, pAVP again fell rapidly but only to a minimum approximately 15 min after drinking. The pAVP was unaltered in dehydrated sheep presented with water but denied access to it. Thus satiation was not necessary for rapid inhibition of AVP release after drinking, but satiation was necessary for this inhibition to be maintained. The initial inhibition was associated with falls in hematocrit and plasma total protein but not plasma osmolality. This isosmolar dilution occurred even in sheep that saw but were denied access to the water and suggests a shift of fluid from the extravascular space. PMID- 3661760 TI - Enhancement of quiet sleep in rabbit neonates by muramyl dipeptide. AB - Muramyl peptides that induce excess slow-wave sleep have been isolated from urine and brain. A synthetic analogue to those substances, muramyl dipeptide (MDP, N acetylmuramyl-L-alanyl-D-isoglutamine), was found to induce prolonged increases in slow-wave sleep and to increase electroencephalographic (EEG) delta-wave activity. MDP is also pyrogenic, although this activity can be separated from its somnogenic activity. To further investigate the somnogenic actions of MDP, neonatal rabbits were used in the present study. Intraperitoneal injection of 100 micrograms/kg MDP induced differential somnogenic and pyrogenic effects; from postnatal days 7-9, MDP increased duration of quiet sleep (QS, the precursor of adult slow-wave sleep) and decreased active sleep (AS) as judged by behavioral criteria. These animals were not febrile during the period of enhanced QS, nor did MDP alter EEG delta-wave activity at this age. From postnatal days 10-15, MDP induced prolonged (6 h) increases in duration of QS; both behavioral and EEG criteria were used at this age to determine duration of QS and AS. Maximum MDP induced effects occurred during the 2nd h, with a parallel increase in amplitudes of EEG delta-wave activity. At this age, MDP also elicited monophasic fevers and inhibition of AS, with maximum effects observed during hours 3-4 postinjection. After postnatal day 16, MDP-induced somnogenic and febrile responses were similar to those observed in adult rabbits. We conclude that the mechanisms responsible for behavioral sleep states are responsive to a sleep-promoting substance early in ontogenesis. PMID- 3661761 TI - Cholecystokinin and gastric distension activate oxytocinergic cells in rat hypothalamus. AB - Systemic administration of cholecystokinin octapeptide (CCK-8) prompts an abrupt increase in circulating levels of oxytocin (OXY) but not vasopressin (VP) in rats. The present study determined whether CCK-8 selectively stimulated OXY secreting neurons in the hypothalamic supraoptic nucleus of pentobarbital anesthetized male rats. Antidromically identified neurosecretory neurons were categorized into putative OXY- and VP-secreting cells on the basis of their firing patterns and response to peripheral baroreceptor activation. Of 36 OXY secreting cells studied, 30 demonstrated a 50-200% increase in firing frequency within 2 min of administering CCK-8 by intravenous or intraperitoneal injection, whereas none of the eight VP-secreting neurons studied was activated. In related experiments, 4-10 ml of air were used to inflate an intragastric balloon in rats; 20 of 22 OXY-secreting neurons displayed an abrupt and readily reversible increase in firing frequency, whereas only 2 of 17 VP-secreting cells were activated. Gastric distension similarly elevated plasma OXY levels in unanesthetized rats with indwelling gastric cannulas. Together with previous findings that the effects of CCK-8 on OXY release were attenuated by gastric vagotomy, these observations clearly demonstrate the existence of a sensitive neural link between the stomach and the neurohypophysis in the rat. PMID- 3661762 TI - Familial schizophrenia and treatment response. AB - Thirty-nine patients with chronic schizophrenia for whom hospitalization was clinically indicated received haloperidol for 4 to 6 weeks in a standardized dose schedule. Responders were compared with nonresponders for family history, baseline symptom factors, and ventricle-brain ratio (VBR). The lifetime risk for schizophrenia spectrum disorders was higher among first-degree relatives of nonresponders than among first-degree relatives of responders. Treatment responders had higher baseline scores on the factors of activation and hostile suspiciousness, but the groups did not differ in any other baseline symptom factor or in VBR. The authors suggest that there is an association between failure to respond to drugs and genetic loading for schizophrenia spectrum disorders. PMID- 3661764 TI - Mental illness awareness week. PMID- 3661763 TI - A relationship between anatomical and physiological brain pathology in schizophrenia: lateral cerebral ventricular size predicts cortical blood flow. AB - The authors studied the relationship between lateral cerebral ventricular size and regional cerebral blood flow during mental activation in 30 patients with schizophrenia. Patients with large ventricles had diffusely lower cortical gray matter blood flow than patients with small ventricles. In addition, an inverse correlation between ventricular size and prefrontal blood flow was observed while patients were attempting to solve a neuropsychological test specifically related to the prefrontal cortex. These data suggest that structural brain pathology impairs prefrontal physiology in schizophrenia, implicating a neural mechanism for the intellectual deficits characteristic of this disorder. PMID- 3661765 TI - A laboratory procedure for the induction of flashbacks. AB - The authors administered infusions of lactate intravenously to seven patients with a DSM-III diagnosis of posttraumatic stress disorder, six of whom also met DSM-III criteria for panic disorder. The lactate infusions resulted in flashbacks in all seven patients and panic attacks in six patients. The authors conclude that with further development intravenous lactate infusion may be used to study flashbacks and other dissociative phenomena and to determine the relationship between flashbacks and panic anxiety. PMID- 3661766 TI - The hypothalamic-pituitary-adrenal system in panic disorder. AB - The authors evaluated 24 outpatients with panic disorder by means of the afternoon continuous test for cortisol and the 1-mg dexamethasone suppression test (DST) and compared the results with those of 38 outpatients with major depressive disorder and 61 healthy control subjects. The mean basal cortisol level of the patients with panic disorder was significantly higher than that of the normal control subjects but almost identical to that of the depressed patients. Only three of the patients with panic disorder had abnormal DST results. These results indicate that patients with panic disorder have an abnormality of at least one function of the hypothalamic-pituitary-adrenal system which overlaps the abnormality in major depressive disorder. PMID- 3661767 TI - Views of practicing psychiatrists on the treatment of anxiety and somatoform disorders. AB - Psychiatrists in Australia were asked to recommend treatments for several anxiety and somatoform disorders. In previous surveys they had agreed about the preferred treatments for schizophrenia and major affective disorder but not about treatments for "neurotic depression" or agoraphobia. In the present survey, no treatment was regarded as critical by a majority of psychiatrists for any of the five anxiety and somatoform disorders studied. The authors conclude that because neurotic disorders form an important part of the workload of psychiatrists, consensus procedures should be used to develop guidelines for treatment until the research literature can provide more adequate guidance. PMID- 3661768 TI - Abnormal prolactin response to haloperidol challenge in men with schizophrenia. AB - Fourteen drug-free male patients with schizophrenia had a smaller and slower prolactin response to 0.5 mg of intravenous haloperidol than 14 normal age- and sex-matched control subjects. This finding supports the presence of dopaminergic dysfunction in schizophrenia. PMID- 3661769 TI - Outpatient group therapy for schizophrenic substance abusers. AB - A once-a-week outpatient therapy group was designed for schizophrenic substance abusers. Over 1 year, the group members (including dropouts) had a marked decrease in days of hospitalization. PMID- 3661770 TI - Symptomatic HIV infection of the CNS in a patient without clinical evidence of immune deficiency. AB - Major depression with psychotic features, dementia, and focal neurologic abnormalities appeared in a Haitian man without AIDS or other syndromes of immune compromise. Neurologic evaluation, including brain biopsy, was nondiagnostic, but CSF culture revealed human immunodeficiency virus (HIV). PMID- 3661771 TI - Bowel obsessions responsive to tricyclic antidepressants in four patients. AB - The authors report on four patients with disabling bowel obsessions who responded to tricyclic antidepressant medication despite the absence of depressive symptoms. The relationship of this symptom constellation to DSM-III obsessive compulsive disorder and social phobia is discussed. PMID- 3661772 TI - Inadequate plasma concentrations in some high-dose methadone maintenance patients. AB - The author studied 18 heroin addicts who had been maintained on 80 mg/day of methadone and who abused drugs or alcohol. His findings suggest that in some cases of aberrant methadone metabolism, the dose can be raised to achieve plasma concentrations adequate to eliminate drug and alcohol abuse. PMID- 3661773 TI - Consequences of abrupt reduction of chronic symptoms. PMID- 3661774 TI - Neurological aspects of a schizophrenia-like psychosis. PMID- 3661775 TI - More on cocaine and panic disorder. PMID- 3661776 TI - Psychosis in obsessive-compulsive disorder. PMID- 3661777 TI - Perception of time. PMID- 3661778 TI - Auditory hallucinations and subvocal speech. PMID- 3661779 TI - Doom anxiety and Hoigne's syndrome. PMID- 3661780 TI - Attention deficit disorder and depression. PMID- 3661781 TI - Dementia and depression. PMID- 3661782 TI - Utilization of mental health care services. PMID- 3661783 TI - Poststroke mood disorders. PMID- 3661784 TI - Depression in women with normal-weight bulimia. PMID- 3661785 TI - Schneider's first-rank symptoms. PMID- 3661786 TI - Mania and head trauma. PMID- 3661787 TI - Symptom definition in evaluation of globus. PMID- 3661788 TI - Whither family planning. PMID- 3661789 TI - Strategies in primary health care. PMID- 3661790 TI - Back to the future with SI units. PMID- 3661791 TI - The international system of units (SI) in historical perspective. AB - American medical journals are shifting to selected SI (Systeme International d'Unites) units for reporting measurements. Limitation of SI units deemed suitable for use in reporting clinical laboratory results stems from recommendations put forth by the International Federation of Clinical Chemistry and the International Union of Pure and Applied Chemistry. Limitations are: 1) the liter as sole recommended unit of volume in concentration measurement; 2) substance concentration (unit mole) favored over mass concentration (submultiples of the kilogram); and 3) discouraging the use of the prefixes hecto-, deca-, deci , and centi-. Further discussion by the American Medical Association and other organizations is required before consensus in the US medical community can be reached as to extent of and time frame for conversion to SI for reporting clinical laboratory measurements. PMID- 3661792 TI - Torture and its treatment. AB - Physical and psychological torture of political detainees and prisoners is currently practiced in more than 90 countries. Types of torture and the diagnosis and treatment of torture victims are described based on the experience of Copenhagen's Rigshospitalet. PMID- 3661793 TI - Well child clinics and mass vaccination campaigns: an evaluation of strategies for improving the coverage of primary health care in a developing country. AB - Millions of children in developing countries are dying from diseases that could be prevented or treated by simple interventions. To examine ways to improve the delivery of these basic services, we evaluated well child clinics and mass vaccination campaigns under operational conditions in a rural area of Nicaragua. We found that mass vaccination campaigns using volunteers reached 77.1 per cent of the population under age six. At stationary well child clinics in which villages were invited to a health center and a small food ration was used as an incentive, attendance improved to 94.1 per cent. Similar attendance levels (99.2 per cent) were attained by mobile well child clinics also using a food incentive. Attendance at stationary clinics decreased with the distance of the village from the health center. However, stationary clinics took up only half as much health workers' time as mobile clinics. Our results suggest that stationary clinics employing food as an incentive could be used for villages or neighborhoods close to a health center while mobile clinics offering food should be reserved for more isolated villages. PMID- 3661794 TI - Forecasting coronary heart disease incidence, mortality, and cost: the Coronary Heart Disease Policy Model. AB - A computer simulation model was developed to project the future mortality, morbidity, and cost of coronary heart disease (CHD) in the United States population. The model contains a demographic-epidemiologic (DE) submodel, which stimulates the distribution of coronary risk factors and the conditional incidence of CHD in a demographically evolving population; a "bridge" submodel, which determines the outcome of the initial CHD event; and a disease history (DH) submodel, which simulates subsequent events in persons with a previous CHD event. The user of the model may simulate the effects of interventions, either preventive (i.e., risk factor modification) or therapeutic, upon mortality, morbidity, and cost for up to a 30-year period. If there were no future changes in risk factors or the efficacy of therapies after 1980, baseline projections indicate that the aging of the population, and especially the maturation of the post-World War II baby-boom generation, would increase CHD prevalence and annual incidence, mortality, and costs by about 40-50 per cent by the year 2010. Unprecedented reductions in risk factors would be required to offset these demographic effects on the absolute incidence of CHD. The specific forecasts could be inaccurate, however, as a consequence of erroneous assumptions or misestimated baseline data, and the model awaits validation based on actual future data. PMID- 3661795 TI - Contraceptive needs and practices among women attending an inner-city STD clinic. AB - To assess the potential need, interest, and benefits of provision of contraceptive services in sexually transmitted disease (STD) clinics, we surveyed 516 women attending an inner-city STD clinic regarding contraceptive and sexual practices, STD prevalence, knowledge of contraceptive-related STD prophylaxis, and interest in contraceptive services within the STD clinic setting. The study population was at high risk for unintended pregnancy and STDs; at time of interview 46 per cent of women were not contracepting and 59 per cent were treated for STD or STD exposure. Two-thirds of women had at least one prior pregnancy and 50 per cent had at least one living child. Only 26 per cent of women knew that some contraceptive methods may reduce the risk of STD acquisition; however, 62 per cent expressed interest in contraceptive methods which would reduce their risk of STD acquisition. This study suggests that provision of contraceptive services in STD clinic settings may address dual needs in a group at high risk for both unintended pregnancy and STD. PMID- 3661796 TI - An outbreak of watermelon-borne pesticide toxicity. AB - The largest reported United States outbreak of illness caused by a foodborne pesticide was due to aldicarb-contaminated watermelons. In Oregon, where the first episodes of toxicity were reported, 264 reports were received, and 61 definite cases were identified. Residues of aldicarb, a cholinesterase inhibitor, were found in 10 of 16 tested melons which had been eaten by persons meeting the case definition. The outbreak demonstrates the need for enhanced physician vigilance with respect to anticholinesterase intoxication. It also demonstrates the value of an established system for reporting of unusual illness to public health officials. PMID- 3661797 TI - Comparison of tests used to distinguish smokers from nonsmokers. AB - Questionnaire and biochemical measures of smoking were studied in 211 hospital outpatients. Eleven different tests of smoke intake were compared for their ability to categorize smokers and nonsmokers correctly. The concentration of cotinine, whether measured in plasma, saliva, or urine, was the best indicator of smoking, with sensitivity of 96-97 per cent and specificity of 99-100 per cent. Thiocyanate provided the poorest discrimination. Carbon monoxide measured as blood carboxyhaemoglobin or in expired air gave sensitivity and specificity of about 90 per cent. Sensitivities of the tests were little affected by the presence among the claimed nonsmokers of a group of 21 "deceivers" who concealed their smoking. It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply. PMID- 3661798 TI - The epidemiology and spectrum of surgical care in district hospitals of Pakistan. AB - On-site surveys of 19 district-level hospitals in Pakistan revealed that, in 1983, 23,839 procedures were performed. There were 98 different types of operations. Thirty-eight per cent were classified as General Surgery, 30 per cent Gynecology and Operative Obstetrics, 19 per cent Urology, and 13 per cent Orthopedics. In three regions, population-based data were obtained from the 12 hospitals which provided all surgical care to discrete populations. The overall rate of surgical operations per 100,000 population was 124, 1.5 per cent to 9 per cent of the rate in western countries. The ratio of surgeons per 100,000 population was 0.36, 1/80 the ratio in the United States. There were almost twice as many operations per surgeon as in the USA. These data indicate a severe shortage of surgeons in Pakistan's district hospitals. They also provide the spectrum and relative numbers of different operations performed at the district level. This information has been useful along with other factors in designing a surgical curriculum at the Aga Khan University in Karachi, Pakistan. PMID- 3661799 TI - Epidemiology of viral hepatitis among US Navy and Marine Corps personnel, 1984 85. AB - Six hundred and twenty-nine cases of viral hepatitis (A, B, and NonA-NonB) were reported among a total of 768,832 United States Navy and Marine Corps personnel during 1984 and 1985 via a passive surveillance system. Cumulative incidence for all three hepatitis types was higher than those reported for the general population at the same time. Hepatitis B was the most common diagnosis within all sex, rank, and race/ethnic description categories. Enlisted medical personnel (hospital corpsmen) had a disproportionately higher incidence of hepatitis B. PMID- 3661800 TI - Seat belt use law enforcement and publicity in Elmira, New York: a reminder campaign. AB - A three-week belt use law publicity and enforcement campaign in Elmira, New York, in November 1985, increased use from 49 per cent to 77 per cent; four months later belt use was 66 per cent. A reminder program, in April 1986, increased belt use to 80 per cent; use declined to 69 per cent four months later and to 60 per cent eight months later. Throughout these periods, belt use in Glens Falls, a comparison community, remained stable at just over 40 per cent. PMID- 3661801 TI - Impact of a newspaper mediated quit smoking program. AB - We present the results of a survey conducted to evaluate the impact of a newspaper mediated smoking cessation program conducted in Buffalo, New York in January 1987. Over half of all smokers surveyed reported exposure to the newspaper series; 13 per cent reported that the series prompted them to try to quit smoking, and 4 per cent stopped smoking for at least one week. We estimate that over 9,600 smokers in Erie County, New York stopped smoking for at least one week as a result of the newspaper's smoking cessation program. PMID- 3661802 TI - Experimentation with smokeless tobacco and cigarettes by children and adolescents: relationship to beliefs, peer use, and parental use. AB - Experimentation with both cigarettes and smokeless tobacco by children in grades 3-12 in a school district in Pennsylvania was related to peer experimentation, parental use, and personal beliefs about the harm of the product for both males and females. Experimentation with both products had begun as early as the third grade and increased with age, with a major increase in experimentation during junior high school. Nearly half the males in grades 7-12 did not believe smokeless tobacco was harmful. PMID- 3661804 TI - Men's reproductive health services in family planning settings: a pilot study. AB - A 1984 pilot survey of administrators of 35 agencies offering family planning services revealed that all offered counseling/educational services for males, and 89 per cent offered medical/supply services for males. Nevertheless, total utilization of these services is low. Major barriers related to the provision of services to male clients are resource limitations, inadequate training, and negative or ambivalent staff attitudes; these factors may contribute to the discrepancy between service offering and utilization. PMID- 3661803 TI - Prevalence and accuracy of home sphygmomanometers in an urban population. AB - The prevalence of ownership (7.5 per cent) and the accuracy of home sphygmomanometers were determined in a population-based survey in the Minneapolis St. Paul metropolitan area. Sixty-four per cent of home sphygmomanometers were accurate within +/- 2 mm Hg of a calibrating sphygmomanometer; another 26 per cent were within +/- 3-6 mm Hg. These results suggest that although many home sphygmomanometers are accurate, some are very inaccurate. Health care providers should advise regular calibration when home sphygmomanometers are used for therapeutic self-management of hypertension. PMID- 3661805 TI - An unwanted Christmas surprise: report of a field investigation on possible chemical contamination of a children's toy. PMID- 3661806 TI - Attempts to increase return of surveys. PMID- 3661807 TI - Preventable deaths related to floods. PMID- 3661808 TI - Freeze dried anterior cruciate ligament allografts. Preliminary studies in a goat model. AB - One ACL in each of 11 mature goats was replaced with a freeze dried bone-ACL-bone allograft. One year following implantation the goats had their knees evaluated biomechanically and for microvascularity and histologic changes. The reconstructed knees had a significantly greater total AP laxity (3.8 +/- 0.6 mm) (mean and SEM) than the controls (1.0 +/- 0.1 mm). Differences in primary AP laxity were responsible for 81% of the difference in total laxity, with only a 0.4 mm difference in secondary laxity. Neutral stiffness in the reconstructive knee was 17% of control, while stiffness at 30 newtons (N) of anterior force was approximately 50% of controls. Ligament stiffness in the linear region for the ACL allograft was 35% of the control value of 686 N/mm. The maximum load of the allografts was 571 +/- 45 N, or 25% of the contralateral ACL control strength (2301 +/- 155 N). Five of the seven allografts failed at the femoral insertion. Both elongation (83%) and energy (21%) to maximum load were less for allografts than controls. Histologic evaluation of the allografts revealed the presence of a regular oriented dense connective tissue which resembled a normal ligament. Microangiography revealed a periligamentous and endoligamentous vascular pattern reminiscent of a normal ACL and complete revascularization of the bone plugs. PMID- 3661809 TI - A review of nonoperative treatment of Jones' fracture. AB - Sir Robert Jones, in 1902, described a transverse fracture of the proximal diaphysis of the fifth metatarsal, which he treated conservatively with good results. Since that time, classification into acute and chronic categories by several authors has been proposed and most agree with the relatively high incidence of non-union. Controversy exists concerning operative versus nonoperative primary treatment especially in athletes. The purpose of this study was to determine if nonoperative treatment could be used effectively in treating these fractures. A retrospective study of nine patients with 10 Jones' fractures was completed. The cases were categorized as acute or chronic by clinical history and radiographic appearance. The average age was 23.6 years. There were eight males and one female. In this group, competitive athletes sustained chronic fractures, while acute fractures occurred in nonathletes. Treatment consisted of a short leg nonweightbearing cast until radiographic and clinical healing occurred, followed by 6 weeks of limited activity. Mean clinical and radiographic union of chronic fractures was 9.4 weeks; acute fractures, 22 weeks. All competitive athletes returned to their preinjury level of competition at an average of 12 weeks following initiation of treatment. There was one refracture. Our data indicate that nonoperative treatment of early chronic or subacute fractures without intramedullary sclerosis can compare favorably with surgical treatment procedures reported in other studies in returning athletes to play postinjury. We suggest serious consideration be given to the method herein as a form of primary treatment of the early chronic Jones' fracture without intramedullary sclerosis. PMID- 3661810 TI - Surgical management of Achilles tendinitis. AB - Inflammation of the Achilles tendon and its contiguous structures is one of the most common overuse problems seen in runners. There are actually several etiologies. Involvement of the tendon itself is secondary to areas of mucinoid or fibrotic degeneration, or may be a result of a partial rupture. The sheath (or mesotenon) may also become chronically inflammed. Retrocalcaneal bursitis seems to be a separate entity with hypertrophy and fibrosis of the bursa usually occurring in conjunction with a prominent posterior superior angle of the os calcis. The vast majority of patients can be successfully treated nonoperatively; however, there is a group of patients who are refractory to nonoperative management who would like to continue running, particularly if they are competitive. A retrospective review of 45 surgical cases in 37 patients was performed. All but two of these patients were competitive long-distance runners. There were 24 cases of Achilles tendinitis and/or tenosynovitis, 14 cases with retrocalcaneal bursitis, and 7 with a combination of both. Mean followup was 3 years (range, 1 1/2 to 8 years). Overall there were 87% satisfactory results. Ninety-two percent of the patients with involvement with the tendon and/or sheath had a satisfactory outcome as compared with 71% of patients with retrocalcaneal bursitis. Passive dorsiflexion in the 29 unilateral cases improved from a mean of 17 degrees preoperatively to a mean of 25 degrees postoperatively. We feel that surgery offers a solution for highly motivated runners with chronic posterior heel pain who would like to continue running when conservative measures have failed. PMID- 3661811 TI - High school football injuries: identifying the risk factors. AB - This epidemiologic survey of the literature on the factors contributing to the high number of high school football injuries consolidates the current information on the characteristics and risk factors associated with these injuries. To reduce the incidence of knee sprains and strains, the most common injuries to this population, the following preventive recommendations are presented: 1) optimum maintenance of playing fields; 2) use of the soccer-style shoe; 3) noncontact and controlled activities in practice sessions; and 4) increased vigilance over technique during injury-prone preseason practices. The authors conclude that more research into factors such as exposure time and activity at injury will further reduce the risk to the high school football player. PMID- 3661812 TI - The patient with symptomatic chronic anterior cruciate ligament insufficiency. Results of minimal arthroscopic surgery and rehabilitation. AB - Forty-nine patients with 51 chronic symptomatic anterior cruciate deficient knees were studied retrospectively by chart review and follow-up examination an average of 5.8 years postinjury and 1.5 years from arthroscopic evaluation, with or without arthroscopic surgery, and the institution of a conservative rehabilitation program. Subjective evaluation of function was obtained by questionnaire. At arthroscopy, meniscal lesions were seen in 37 of 51 knees, and degenerative changes were noted in 24 knees. The ACL was absent in 43 knees. Partial meniscectomy or suturing was performed on 20 patients. All patients had an average of 3 weeks of supervised physical therapy stressing hamstring strengthening. At followup, thigh girth measurements of injured and normal legs found thigh wasting in 40 patients. Seven of 33 patients radiographed showed evidence of degenerative changes. About two-thirds of the patients returned to some level of athletics and had no problems with activities of daily living. Twenty were able to return to pivoting sports, but only five could return to their preinjury levels of competition. Of the 18 patients who did not return to athletics, only 8 were considering or had had a ligament reconstruction. Those patients who chose to continue rehabilitation beyond the prescribed period and who modified their activities had a better functional outcome. PMID- 3661813 TI - Anterior cruciate reconstruction in the chronically unstable knee using an expanded polytetrafluoroethylene (PTFE) prosthetic ligament. AB - The purpose of this study is to review 30 patients with failed, multiply operated knees, or knees with gross instability which were reconstructed using the expanded polytetrafluoroethylene (PTFE) prosthetic ligament as a substitute for the ACL. The results were then compared with our experience with the proplast ligament used in a previous clinical series. This prospective review evaluated the patients preoperatively and at regular intervals during the postoperative period. The average followup was 24 months postoperation. Eighty-three percent of the patients had a satisfactory result, scoring greater than 140 points on a 200 point knee grading scale. Objectively, the anterior instability pattern was improved in 87% of the knees. Subjectively, pain of at least a mild degree persisted in 70% of the patients postoperatively. This pain seemed to correlate with articular cartilage changes documented intraoperatively. Major complications occurred in two patients. In conclusion, the PTFE prosthetic ligament was an improvement over the proplast ligament in the reconstruction of the multiply operated, unstable knee. The 83% satisfactory rate with the PTFE was promising compared to a 52% satisfactory rate using the proplast ligament. However, we encourage future long term studies of the PTFE prosthetic ligament in the reconstruction of the ACL in the chronically unstable knee. PMID- 3661814 TI - Infrapatellar contracture syndrome. An unrecognized cause of knee stiffness with patella entrapment and patella infera. AB - Infrapatellar Contracture Syndrome (IPCS) is an infrequently recognized cause of posttraumatic knee morbidity. Unique to this group of patients is the combination of restricted knee extension and flexion associated with patella entrapment. IPCS can occur primarily as an exaggerated pathologic fibrous hyperplasia of the anterior soft tissues of the knee beyond that associated with normal healing. It can also occur secondarily to prolonged immobility and lack of extension associated with knee surgery, particularly intraarticular ACL reconstruction. IPCS follows a predictable natural history which is divided into three stages. Symptoms, diagnostic findings, and recommended treatment are determined by the stage at presentation. Once beyond its early presentation, IPCS is best treated by an anterior intraarticular and extraarticular capsular debridement and release, followed by extensive rehabilitation. The authors review 28 consecutive cases of IPCS. At followup 3 months to 4 years postoperation, the patients had averaged 2.3 additional surgical procedures following their index procedure or injury. The average increase in extension at followup was 12 degrees with the average increase flexion 35 degrees. Eighty percent of patients demonstrated signs and symptoms consistent with patellofemoral arthrosis; 16% of the patients demonstrated patella infera. The authors conclude that prevention or early detection and aggressive treatment are the only ways of avoiding complication in these problem cases. PMID- 3661815 TI - Hand injuries in boxing. AB - Investigations of 100 consecutive hand injuries in boxing have shown that 39% occurred in the area of the thumb, including the radial carpals, metacarpals and phalanges and their joints. These injuries were mostly caused by forced abduction of the thumb. Thirty-five percent of the injuries occurred at the base of Metacarpals 2 to 5, including the wrist joint, and arose from forced flexion of the wrist. Twenty-six percent occurred in the phalanges and the rest of the metacarpals, excluding the bases. PMID- 3661816 TI - Lower extremity flexibility patterns in classical ballet dancers and their correlation to lateral hip and knee injuries. AB - Knee and hip problems account for up to 40% of injuries in classical ballet. Despite apparent flexibility, many dancers appeared to have tight iliotibial bands that contributed to lower limb problems. Thirty senior female ballet dancers were contrasted with thirty age-matched active volunteers for hip and knee range of motion, and the information derived was correlated with their orthopaedic medical histories. Dancers spent a reasonable period of time warming up, but it was usually with an unbalanced routine that emphasized hip abduction and external rotation to the exclusion of adduction work. This was reflected in the significantly lower range of passive hip adduction and internal rotation compared to the controls. Furthermore, the older and more experienced the dancer, the more this trend was exaggerated. This unbalanced flexibility may play a role in the production of lateral knee pain (30% of the dancers) and anterior hip pain (33% of the dancers). It is suggested that more attention should be given to a balanced stretching regimen as part of the dancers' warmup in an effort to reduce the frequency of some of the chronic hip and knee complaints. PMID- 3661817 TI - Androgenic-anabolic steroid effects on serum thyroid, pituitary and steroid hormones in athletes. AB - Endocrine responses in seven power athletes were investigated during a 12 week strength training period, when the athletes were taking high doses of androgenic anabolic steroids, and during the 13 weeks following drug withdrawal. During the use of steroids significant decreases (P less than 0.05 to 0.001) in the serum concentrations of thyroid stimulating hormone, thyroxine, triidothyronine, free thyroxine, and thyroid hormone-binding globulin (TBG) were found, whereas the value of triidothyronine uptake increased (P less than 0.001). In relation to the changes in the thyroid function parameters measured, we suggest that the primary target of androgen action was TBG biosynthesis. In five of the seven subjects, serum concentrations of growth hormone increased at some point of the study 5 to 60-fold. Because of the use of exogenous testosterone, serum testosterone concentration tended to increase. This increase was associated with a corresponding increase (P less than 0.001) in serum estradiol. Furthermore, there were major decreases in serum LH (P less than 0.01) and FSH (P less than 0.01) concentrations, and testicular testosterone production was therefore decreased. This was characterized by a very low serum testosterone concentration (5.1 +/- 1.8 nmol/l) 4 weeks following drug withdrawal. Cessation of drug use resulted in return of all the variables measured to the initial values, except for serum testosterone, which was at a low level (14.6 +/- 8.8 nmol/l) 9 weeks after drug withdrawal, indicating prolonged impairment of testicular endocrine function. No consistent changes were found in the eight control athletes. PMID- 3661818 TI - Sports tumors. AB - We present 36 patients who initially were thought to have sports-related injury but ultimately were diagnosed with a primary bone or soft tissue tumors or tumor like condition. The awareness of this possibility in the individual with a sports related complaint, who does not respond to standard management, may assist in earlier diagnosis and treatment of the suspected neoplasm. PMID- 3661819 TI - Popliteal artery entrapment in a high school athlete. A case report. PMID- 3661820 TI - Injury to the brachial plexus during Putti-Platt and Bristow procedures. A report of eight cases. AB - Eight patients with documented recurrent anterior dislocation of the shoulder sustained iatrogenic brachial plexus injuries during either Putti-Platt or Bristow procedures. Two patients also sustained axillary artery injuries. There were six males and two females. Postoperatively, complete paralysis of the musculocutaneous nerve was noted in six cases and incomplete paralysis in one case. Two patients had complete axillary nerve palsies. There were two cases of partial paralysis of the radial, median, and ulnar nerves, respectively. Seven of the patients underwent brachial plexus exploration an average of 16 weeks following their initial operation (range, 4 to 40). Suture material was removed from around or within two musculocutaneous nerves and one ulnar, one median, and one axillary nerve. Two lacerated musculocutaneous nerves were amenable to delayed primary repair. Two musculocutaneous, one median and one axillary nerve required grafting. Injury to the brachial plexus was associated with inadequate knowledge of regional anatomy, blind clamping of axillary artery lacerations, use of axillary incisions which limited exposure, and failure to identify the musculocutaneous nerve during Bristow procedures. If a brachial plexus injury occurs during a Putti-Platt or a Bristow procedure and the lesion does not rapidly, progressively, and completely recover, the brachial plexus should be explored since there is a high likelihood of structural neurologic injury. PMID- 3661821 TI - Epithelial misplacement in Peutz-Jeghers polyps. A diagnostic pitfall. AB - Early difficulties with the interpretation of the histopathology caused overdiagnosis of cancer in the Peutz-Jeghers syndrome; and there is still controversy about the magnitude of risk of gastrointestinal carcinoma. Most workers now believe that there is a small but definite increase in the incidence of gastrointestinal carcinoma in Peutz-Jeghers polyps and most of these cancers occur in the upper gastrointestinal tract. In a review of 491 Peutz-Jeghers polyps in the records of St. Mark's Hospital Pathology department, misplacement of epithelium was found in approximately 10% of small intestinal polyps and closely mimicked adenocarcinoma. This "pseudoinvasion" was not observed in polyps of the stomach or colon. The epithelial misplacement may involve all layers of the bowel wall; and the most helpful histological discriminators include a lack of cytological atypia, the presence of the normal epithelial cell subtypes and a brush border, hemosiderin deposition, and intramural mucinous cysts. Epithelial misplacement may account for the overdiagnosis of carcinoma arising in Peutz Jeghers polyps as reported in the literature. PMID- 3661822 TI - Endometrioid-like variant of ovarian yolk sac tumor. A clinicopathological analysis of eight cases. AB - The clinical and pathological features of eight ovarian yolk sac tumors with glandular patterns resembling those of endometrioid adenocarcinoma are described. The patients ranged in age from 11 to 34 years (mean, 22 years) and presented with abdominal pain or swelling. The serum alpha-fetoprotein (AFP) level was elevated at the time of presentation or later in all seven patients in whom it was measured. Seven tumors were unilateral, one was bilateral, and three had spread beyond the ovary. There was a contralateral streak gonad in two cases. The tumors were 6-35 cm in diameter; seven were solid and cystic, and one was a unilocular cyst with a small solid nodule in the wall. Microscopic examination revealed a prominent, and in two cases, pure endometrioid-like glandular pattern that often simulated that of an early secretory endometrium. Reticular, polyvesicular-vitelline, and hepatoid patterns of yolk sac tumor were also present in five tumors; minor teratomatous foci (squamous epithelium and cartilage) were present in one. Immunohistochemical staining revealed AFP, alpha 1-anti-trypsin (AAT), and carcinoembryonic antigen within the glandular epithelium; AFP and AAT were also present in areas showing the other patterns. Three patients died of recurrent or metastatic tumor 19-60 months postoperatively; in the remaining cases, there was a tumor-free follow-up of short duration. The endometrioid-like pattern reflects an unusual form of endodermal differentiation within yolk sac tumors that should be distinguished from endometrioid carcinoma. PMID- 3661823 TI - Gastric dysplasia. A histological follow-up study. AB - To evaluate the clinical and biological significance of gastric dysplasia, we reviewed the histology of all available specimens of gastric mucosa in 85 patients in whom dysplasia had been previously diagnosed. The initial diagnosis of dysplasia was mild (Dy I) in 23 cases, moderate (Dy II) in 41 cases, and severe (Dy III) in 21 cases. The length of follow-up varied from 3 months to 11 years, with an average of 42 months. The follow-up of cases with Dy I and Dy II suggests that both lesions progress slowly and in most instances will remain stable or regress. In 18 cases, a carcinoma was found--17 in the group of Dy III and one in the group of Dy II. Of the 18 carcinomas, nine were at an early stage. Our data suggest that severe dysplasia is a reliable marker of high risk of gastric cancer and represents a strong indication for a gastrectomy. PMID- 3661824 TI - Histology of the normal testis. AB - The gross and microscopic features of the normal adult, prepubertal, and aging testis are described. Qualitative and quantitative parameters of spermatogenic activity are presented in practical terms. Emphasis is placed on these findings, which are important to the pathologist in interpretation of diagnostic biopsy specimens other than neoplasms. PMID- 3661825 TI - Thyroid antibodies. PMID- 3661826 TI - Epidemiology of Giardia lamblia infection in children: cross-sectional and longitudinal studies in urban and rural communities in Zimbabwe. AB - Stool specimens from 3,038 children in rural and urban areas near Harare were examined for Giardia lamblia cysts. Preliminary studies, using specimens collected on three consecutive days from 157 known cyst passers, showed that over 89% of infections could be diagnosed on single stool specimens by examination of Gomori-stained smears. The overall prevalence of giardial infection was 19.4% with significantly more urban children (21.1%) passing cysts than rural children (16.7%). In urban areas the highest prevalence was in young (5-6 year) children, while in rural areas, the highest prevalence was in older (9-10 year) children. Of 132 children treated with Entamizole a metronidazole-diloxanide combination, 127 (96.2%) had ceased excreting cysts by the fifth treatment day. Follow-up examination of these children showed a high rate of reinfection, with 29.6% excreting cysts during the year following treatment. During the same period 13.3% of previously uninfected children had started passing cysts, while over half of infected, but untreated, children had undergone apparent "self-cure." Younger children were more likely to be reinfected than older children, and continued excreting cysts for a longer period of time. PMID- 3661827 TI - In vivo gluconeogenesis under different nutritional regimens during murine schistosomiasis. AB - The effect of schistosome infection on in vivo gluconeogenesis was studied in mice. Mice infected for 6 weeks displayed no nutritional pathology, regardless of nutritional treatment. All mice with patent infections (9 weeks) displayed decreased rates of growth and food consumption as well as significantly reduced gross conversion efficiencies. The glucogenic capacity, % pyruvate incorporated/g liver, was markedly reduced in infected fasted mice when compared with fasted controls. Total glucogenesis, % pyruvate incorporated/100 g body water, was the same in infected and control groups and the compensatory response in infected individuals was correlated with increased liver mass. The level of hepatic glycogen was significantly greater in infected fasted mice than in their unparasitized counterparts. PMID- 3661828 TI - Abdominal angiostrongylosis in an African man: case study. AB - A nodule removed from the cecum of a 25-year-old Zairian man contained a degenerated adult nematode. The surrounding tissue contained larvae and eggs in various stages of cleavage. Eggs and larvae were indistinguishable from those of Angiostrongylus costaricensis. These morphological features are described. The diameter and cuticle, and the anatomic location of the adult worm is consistent with A. costaricensis. The tissue reaction was chronic with granulomatous inflammation and numerous eosinophils. This is the first report of abdominal angiostrongylosis of a human in Africa. PMID- 3661829 TI - Acquired resistance to Fasciola hepatica in cattle using a purified adult worm antigen. AB - Calves were immunized twice in 4 weeks with a Fasciola/Schistosoma cross reactive, cross-protective defined immunity antigen (denoted FhSmIII(M)) isolated from F. hepatica adult worm extracts by antibody affinity chromatography and challenged 7 weeks later with F. hepatica metacercariae. Flukes were recovered at 16 weeks of infection at which time the immunized calves had 55% less F. hepatica than the controls. All of the immunized calves developed high antibody levels of FhSmIII(M), detectable in the ELISA, by 4 weeks after a single immunization. By 9 weeks of infection with F. hepatica the immunized calves had lower sorbitol dehydrogenase levels than the unimmunized, F. hepatica-infected control calves, indicating less liver damage in the vaccinated group. These studies demonstrate that subcellular F. hepatica macromolecules cross-reactive and cross-protective against S. mansoni also have the potential to serve as vaccines in cattle exposed to this parasitic disease. PMID- 3661830 TI - Characterization of an Onchocerca-specific DNA clone from Onchocerca volvulus. AB - A genomic library of a savanna isolate of Onchocerca volvulus was screened to detect recombinant plasmids containing highly repeated DNA sequences of this parasite. Four recombinant plasmids were identified which hybridized specifically to Onchocerca DNA, but not to DNA from humans, black flies, Brugia malayi, B. pahangi, or Wuchereria bancrofti. The recombinant plasmids had a low level of homology to Dirofilaria immitis. All recombinant plasmids contain related DNA sequences based on Southern hybridization analysis. Sequences related to these recombinant plasmids are present in different geographic isolates of O. volvulus and O. ochengi, an animal parasite. Two of the recombinant plasmids contain sequences also found in O. lienalis. One recombinant plasmid, puOvs3, has been characterized in detail, including DNA sequence determination. Radiolabeled puOvs3 is able to detect 100 pg of genomic DNA isolated from O. volvulus worms from both savanna and forest regions. It can differentiate O. volvulus from O. ochengi by Southern blot analysis. PMID- 3661831 TI - Sexual transmission of dengue viruses by Aedes albopictus. AB - Male Aedes albopictus experimentally infected with dengue virus types 1, 2, 3, or 4 transmitted their infection sexually to female Ae. albopictus. Such transmission was enhanced if the females had taken a bloodmeal 2 to 7 days prior to mating. Male Ae. albopictus also transmitted dengue virus vertically to their F1 progeny. Infected progeny were found among those derived from eggs laid greater than or equal to 73 hr after mating but not among those derived from eggs laid prior to that time. This suggests that virus probably was not transmitted directly to ova but, rather, underwent prior replication in the female genital tract. Female Ae. albopictus experimentally infected with dengue type 1 virus did not transmit their infection sexually to males. This finding supports the hypothesis that male mosquitoes naturally infected with dengue virus acquired their infection vertically. PMID- 3661832 TI - Reduced survival of adult Culex pipiens infected with Rift Valley fever virus. AB - The effect of Rift Valley fever (RVF) viral infection on the survival of female Culex pipiens was examined. In 3 experiments in which mosquitoes ingested RVF virus, there was a 44% decrease in survival to days 14-16 for transmitting vs. nontransmitting mosquitoes, and a 48% decrease in survival for individuals with disseminated vs. nondisseminated infections. These results were corroborated by other experiments in which survival of mosquitoes intrathoracically inoculated with RVF virus was compared with that of those inoculated with diluent. In both the per os and inoculation tests, uninfected mosquitoes survived significantly longer than infected mosquitoes. Even though mosquitoes with disseminated infections had a lower survival rate than did uninfected mosquitoes, dissemination and transmission rates were similar at days 7 and 14-18 after the infectious bloodmeal. This suggests that nondisseminated individuals were developing disseminated infections and becoming capable of transmitting virus between days 7 and 14-18 at approximately the same rate older transmitters were dying. The decreased survival associated with RVF viral infection should be considered in predictive models of this disease. PMID- 3661833 TI - Relapse patterns in Plasmodium cynomolgi malaria. PMID- 3661834 TI - Papers of the Society of Head and Neck Surgeons. 33rd annual meeting. London, England, April 25-30, 1987. PMID- 3661835 TI - Warthin's tumor: multicentricity and increasing incidence in women. AB - Warthin's tumors comprised 14 percent of all parotid tumors operated on. The average patient age in our series was 57.2 years. Eighty-seven percent of the tumors occurred in the parotid tail. The rest were in the deep lobe, or in an extraparotid location. Fifteen patients had multifocal tumors. The maximum number of tumor foci in one patient was six. A significant increase in the female incidence was noted with a 1.5:1 male-to-female ratio as compared with the previous male dominant ratio of 8:1. Eighty-two percent of the female patients in our group were smokers. We correlated a very high incidence of cigarette smoking in our series when compared with age-matched groups in both sexes within the general population. Since it is estimated that one of eight patients with Warthin's tumor will have multifocal disease, we suggest wider exposure and more meticulous operative exploration to avoid overlooked synchronous tumor foci and subsequent recurrence. PMID- 3661836 TI - Craniofacial resections for tumors involving the base of the skull. AB - Over a 10 year period, 42 patients with tumors involving the base of the skull underwent operation at our institution. Twenty-six patients had tumors involving the anterior fossa and cribriform plate, 3 patients had tumors involving the anterior fossa and orbit, 3 patients had invasion of the middle fossa, 5 patients had invasion of the temporal bone, and 5 patients had invasion of the clivus. A detailed analysis of the 26 patients who underwent craniofacial resection for tumors invading the anterior fossa cribriform plate region has been presented. Histologic studies revealed epithelial tumors in 18 patients, sarcoma in 6 patients, melanoma in one patient, and ossifying fibroma in one patient. The median survival in this group of patients was 60 months. Survival was influenced by histologic diagnosis. Malignant tumors involving the base of the skull can be successfully resected using a craniofacial approach with minimum morbidity and acceptable operative mortality as demonstrated in this experience. Unfavorable prognostic factors included massive intracranial extension, high grade tumor, and previous treatment failure. PMID- 3661837 TI - Preoperative outpatient nutritional support of patients with squamous cancer of the upper aerodigestive tract. AB - In this study, 59 percent of the patients with squamous cancer of the upper aerodigestive tract were considered malnourished by the independent evaluation of a registered dietitian. Malnourished patients tended to present in a more advanced stage of disease, underwent more extensive operative procedures, had more complications, experienced longer hospital stay, and had a higher proportion of irradiated patients compared with patients who were nutritionally healthy. Malnourished patients who received nutritional support preoperatively demonstrated lower complication rates and shorter lengths of hospital stay compared with malnourished patients who underwent similar operative procedures without preoperative nutritional supplementation. PMID- 3661838 TI - Surgical treatment of invasion of the upper aerodigestive tract by well differentiated thyroid carcinoma. AB - Forty-eight patients with well-differentiated thyroid carcinoma invading upper aerodigestive tract structures have been described. Age at diagnosis was found to be a negative prognostic factor, and duration of disease before invasion was found to be a positive prognostic factor. Treatment with radical surgery and adjuvant therapy provided no improvement in survival over treatment with near total (skeletonizing) excisions combined with adjuvant therapy. All patients treated with partial debulking procedures, with or without tracheotomy, died from disease. We believe that partial resection of upper aerodigestive tract structures without sacrifice of voice, normal breathing, or swallowing should be considered in patients with well-differentiated thyroid carcinoma. PMID- 3661839 TI - Effect of decicurie doses of radioactive iodine 131 on parathyroid function. AB - Although parathyroid deficiency has been reported after administration of relatively small doses of iodine 131, reports of such deficiency after the much larger doses given in the management of thyroid cancer are notable by their absence in the literature. We observed one such patient, then instituted a prospective study. We observed a 58 percent incidence of apparently diminished parathyroid reserve among 53 patients given high doses of I 131. Susceptibility does not appear to be related to age, sex, extent of thyroid operation, operative technique, the amount of thyroidal I 131 uptake, the use of external radiation to the neck, or to the presence of parathyroid glands or of Hashimoto's disease in the operative specimen; however, susceptibility may be related to the anatomic location of the parathyroid glands in relation to the thyroid gland. The administered dose of I 131 almost reached significant levels (p = 0.1) in the present study. The initial pretreatment serum calcium levels were consistently lower among affected patients (p = 0.01), suggesting the presence of a preexisting latent impairment of parathyroid reserve which was subsequently unmasked after the administration of I 131. Thyroid cancer is compatible with very long-term survival, and therefore, there is a considerable risk of delayed chronic hypocalcemia among patients who have received large doses of I 131, particularly female patients in the premenopausal age group. These patients deserve special management surveillance. PMID- 3661840 TI - Reconstruction of hypopharyngeal defects in cancer surgery: do we have a choice? AB - Between 1982 and 1985, 83 patients with hypopharyngeal or extensive laryngeal cancers underwent pharyngoesophagectomy (48 patients), circumferential pharyngectomy (8 patients), and partial pharyngectomy (27 patients), depending on the site and extent of tumor involvement. The resultant hypopharyngeal defects were reconstructed with gastric transposition, a tubed pectoralis major myocutaneous flap, and a pectoralis major flap patch, respectively. There were three hospital deaths in the gastric transposition group (6 percent) and none in both pectoralis major flap groups. The leakage rate was 8.3 percent in the gastric transposition group, 25 percent in the tubed pectoralis major flap group, and 3.7 percent in the pectoralis major flap patch group. Stricture was avoided with the interdigitation technique used at the tubed-flap-to-esophagus anastomosis, although the fistula rate was high. The overall complication rate was higher with gastric transposition. Although swallowing was satisfactory in all three groups, 42 percent of the patients with gastric transposition experienced regurgitation. Over a follow-up period of 16 to 50 months the local recurrence rate was 5 percent, and the actuarial survival rate was 55 percent at 24 months. PMID- 3661841 TI - Pharyngocutaneous fistulas in advanced cancer: closure with musculocutaneous or muscle flaps. AB - Two hundred cases of head and neck cancer were reviewed and 16 pharyngocutaneous fistulas identified, for an incidence of 6 percent. The fistulas were closed with pectoralis major muscle flaps in four patients, pectoralis musculocutaneous flaps in seven patients, sternocleidomastoid muscle flaps in four patients, and latissimus dorsi flaps in two patients. Four types of fistulas were identified, and flap selection was determined by fistula location. Successful closure was obtained in 15 patients (88 percent), although one patient died from recurrence with a persistent fistula. PMID- 3661842 TI - Healing between cartilage and bone ends. An experimental study. AB - Whether healing or nonunion occurs at the junction between cartilage and bone was studied in an animal experimental model. The costochondral junctions of the floating ribs of rabbits were excised and the cut ends of bone and cartilage reapproximated with wire. The process of healing was then observed. Fibrocartilaginous callus formed in the first week. Beginning in the second week, this was gradually replaced by bony callus, a process which started from the medullary cavity of the bone end. The cut end of the original cartilage showed no activity. The periosteum and perichondrium became continuous at 4 weeks. The site of ossification assumed the appearance of the original costochondral junction. The gap between the original cartilage and the new cartilage disappeared when fusion occurred at 48 weeks. Osteochondral junctions at various periods after operation were subjected to disruption force until the junctions were pulled apart. The average force required to break 16 junctions was 2,738 g, and was not related to the period of healing. PMID- 3661843 TI - Microsurgery for macrodefects: microvascular free-tissue transfer for massive defects of the head and neck. AB - Despite defect location and the fear of creating complex massive defects, coverage of large areas of soft tissue loss, with or without exposed calvaria, dura, and brain, can be reconstructed reliably with microvascular free tissue transfer. This technique permits separation of the oronasopharynyx from the intracranial contents, coverage of dural grafts, restoration of composite tissue loss, and achievement of superior aesthetic results in a single stage. When choosing vascular anastomotic sites, free-flap transfer permits a greater latitude in flap orientation, tailoring, and inset than is possible when using fixed pedicled rotation flaps. When confronted with a deeply invasive or gigantic malignancy, a multidisciplinary team approach is optimal. The risk associated with sophisticated ablative and reconstructive operative procedures is justified when dealing with potentially curable lesions. The success of these extensive procedures is related not only to the functional result and the aesthetic appearance, but most importantly to the resultant quality of life they allow. PMID- 3661844 TI - Voice restoration after total laryngopharyngectomy and cervical esophagectomy using the duckbill prosthesis. AB - We have presented a series of 10 patients who were successfully rehabilitated using the tracheoesophageal puncture technique for voice restoration. These patients underwent total laryngopharyngectomy or laryngopharyngoesophagectomy and reconstruction with visceral transposition (five patients), myocutaneous flaps (four patients), and skin graft and cervical flaps (one patient). All patients were able to produce adequate voice and carry on a conversation. Clinical evaluation of voice quality and acoustic analysis of voice samples indicate that the voice obtained in these patients was intelligible, and had adequate intensity, low pitch, and limited pitch variation. There were no complications related to the voice restoration procedure. It appears from our data and the limited experience reported in the literature that the tracheoesophageal prosthesis can be used successfully and safely for the speech rehabilitation of patients who undergo total laryngopharyngectomy, cervical esophagectomy, or both, regardless of the reconstructive method used. PMID- 3661845 TI - Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. AB - Although the TNM system is the accepted standard for head and neck tumor classification, there are often discrepancies between tumor size and survival. This retrospective analysis of 89 patients with squamous cell carcinoma of the buccal mucosa was carried out to evaluate tumor thickness and depth of invasion as prognostic variables and to compare them to the standard parameters. Recurrence rates increased with tumor size, clinical stage, thickness, and depth of invasion. In univariate analysis, sex, clinical stage, thickness, and depth of invasion were significantly related to survival (p less than 0.10). Multivariate analysis revealed that only thickness was an independent variable (p less than 0.0001). Patients with tumors less than 6 mm in thickness had a significantly better survival rate compared with those patients with tumors greater than 6 mm in thickness, regardless of the tumor stage. Measurement of tumor thickness should be included in estimating prognosis, planning therapy, and comparing results in patients with squamous cell carcinoma of the buccal mucosa. PMID- 3661846 TI - Rim mandibulectomy for cancer of the oral cavity. AB - Improvements in our understanding of the methods of mandibular invasion by malignancies and refinements in the biomechanical analysis of mandibular osteotomies led us to modify our standard operative procedure for this disease process. Over a 10 year period, we performed rim mandibulectomy to treat oral cavity malignancies with mandibular involvement. This retrospective analysis of 38 patients comparing rim mandibulectomy with the traditional segmental mandibulectomy has demonstrated equivalent local control rates between rim mandibulectomy and segmental resection (75 and 64 percent, respectively). Patients with rim mandibulectomies were more satisfied with their postoperative appearance, and some were able to wear lower dentures if well motivated. In performing the rim mandibulectomy, we found that smooth, curved osteotomies without step-offs resulted in a technically simple operation that was biomechanically sound and had a low complication rate. Rim mandibulectomy, because it is based on sound pathologic principles and does not disrupt the mandibular arch, is an operation that adequately resects the tumor without compromising the cancer operation or the patient. PMID- 3661847 TI - Polyamine metabolism in carcinoma of the oral cavity compared with adjacent and normal oral mucosa. AB - In this study, polyamine biosynthesis required for cellular proliferation showed elevated levels in neoplastic cells. Putrescine, spermidine, and spermine, as well as the rate-limiting enzyme ornithine decarboxylase, were measured to evaluate differences in tissue concentration in squamous cell carcinoma of the oral cavity, and in the normal adjacent, buccal, and retromolar trigone tissues. Mean polyamine levels (nanomoles per gram of tissue +/- standard error of the mean) were significantly elevated in tumor tissue at 136 +/- 42 nmol/g for putrescine compared with 41 +/- 9 nmol/g in adjacent, 25 +/- 5 nmol/g in buccal, and 41 +/- 14 nmol/g in retromolar trigone tissues. Tumor spermidine was 415 +/- 41 nmol/g compared with 192 +/- 34 nmol/g in adjacent, 184 +/- 34 nmol/g in buccal, and 214 +/- 63 nmol/g in retromolar trigone tissues. Tumor spermine was 461 +/- 41 nmol/g compared with 236 +/- 30 nmol/g in adjacent, 233 +/- 35 nmol/g in buccal, and 269 +/- 59 nmol/g in retromolar trigone samples. Ornithine decarboxylase activity was highly variable in tumor tissues. High levels of polyamines appear to be specific for this malignancy, whereas ornithine decarboxylase activity is not. Measurement of polyamine content may be useful in evaluating epithelial changes in the oral cavity. PMID- 3661849 TI - Metastatic patterns in squamous cell cancer of the head and neck. AB - This retrospective study on 832 head and neck cancer patients who died between 1961 and 1985 was carried out to determine the incidence and sites of distant metastases. All patients were staged prior to definitive treatment and were autopsied. The overall incidence of distant metastases was 47 percent. The hypopharynx had the highest incidence of distant metastases (60 percent), followed by the base of the tongue (53 percent) and the anterior tongue (50 percent). Of the 387 patients with distant metastases, 91 percent died with uncontrolled tumor either at the primary site or in the neck. The lung was the most common site of distant metastases (80 percent), followed by the mediastinal nodes (34 percent), the liver (31 percent), and bone (31 percent). Overall, 6 percent of the patients had stage I disease, 20 percent had stage II disease, 32 percent had stage III disease, and 43 percent had stage IV disease. The highest incidence of distant metastases was found in those patients with stage IV disease (193 of 350 patients, 55 percent). We believe that the initial stage of disease does appear to be related to the ultimate development of the distant metastases. PMID- 3661848 TI - Lung cancer in patients with head and neck cancer. Incidence and long-term survival. AB - Of the 3,907 cases of primary head and neck or lung cancer diagnosed between 1961 and 1984, 94 patients were identified with a history of cancer at both sites. The total incidence of lung cancer in our head and neck cancer patients was 5.4 percent. Of the 94 patients, 73 had both cancers diagnosed at our institution. These 73 patients were further analyzed. Squamous cell carcinoma accounted for 63 percent of the lung cancers. Twenty of the lung cancers were synchronous and 47 were metachronous after head and neck cancer. Of the synchronous lung cancers, 50 percent were postoperative stage I, whereas only 11 percent of the metachronous cancers were postoperative stage I. The lung cancer survival rate was significantly better for the synchronous cancer group at 5 years (34 percent) than for the metachronous cancer group (5 percent). The better survival rate was evidently due to the greater proportion of early-stage lung lesions. The relatively large number of advanced-stage lung lesions in the metachronous cancer group suggests that aggressive screening of head and neck cancer patients for lung cancer may detect more metachronous lung cancers at an earlier stage and thus improve the survival rate of these patients. PMID- 3661850 TI - Response to radiotherapy of head and neck tumors in AIDS patients. AB - Initial manifestations of AIDS in the head and neck area occur frequently. In fact, up to 40 percent of patients may have involvement of the head and neck. The most common malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. Since AIDS-related malignancies are a relatively new problem for radiation oncologists, optimal therapy for these neoplasms is unknown. A retrospective review of AIDS patients treated with radiotherapy has been performed. Fourteen patients were identified. Of these, five were treated for head and neck tumors (four for Kaposi's sarcoma and one for non-Hodgkin's lymphoma). Epidemic Kaposi's sarcoma, as well as non-Hodgkin's lymphoma, were seen to be as radioresponsive as the classical forms, but local control was difficult to achieve. Kaposi's sarcoma tended to recur marginally and within the field. Nonetheless, we believe radiotherapy can offer significant palliation for AIDS patients with head and neck tumors. It is of utmost importance that the head and neck surgeon must be acutely aware of the common patterns of presentation of this disease. PMID- 3661851 TI - Treatment results and patterns of failure in 646 patients with carcinoma of the eyelids, pinna, and nose. AB - From 1956 to 1978, 646 patients were treated with radiotherapy for carcinoma of the nose (350 patients, 54 percent), eyelids (159 patients, 25 percent), pinna (93 patients, 14 percent), and skin adjacent to the lip (44 patients, 7 percent). The histologic distribution was 72 percent basal cell carcinoma, 18 percent squamous cell carcinoma, and 10 percent mixed basal and squamous cell features. Tumors less than 2 cm in diameter were found in 602 patients (93 percent), whereas 44 patients (7 percent) had larger tumors. Tumor involvement of cartilage and bone was seen in 23 patients at the time of diagnosis. The 5, 10, and 20 year control rates were 99 percent, 98 percent, and 98 percent, respectively, for 502 tumors less than 2 cm in diameter. This compared favorably with control rates of 92 percent at 5 years and 79 percent at 10 years for tumors from 2 to 5 cm in diameter and 60 percent at 5 years and 53 percent at 8 years for 12 patients with massive tumors (p less than 0.0001). The histologic characteristics of the lesion had a strong influence on tumor control (p less than 0.02). Of the patients with cartilage or bone invasion, tumor was controlled in 19 (83 percent). Of these 19 patients, 11 had no evidence of disease for 3 years or more. Of all 646 patients treated, failure was seen in 60 (9 percent). It correlated well with the size of the lesion, being 7 percent for tumors of less than 2 cm and 50 percent for tumors of greater than 5 cm. Of the 60 patients in whom treatment failed, 48 (80 percent) had prior definitive therapy. Radiotherapy was an efficient modality to control operative failures; however, it was not as efficient at control in patients in whom previous radiotherapy failed. Operation was the treatment of choice to salvage patients in whom radiotherapy failed. Of the patients in whom retreatment failed, 10 were known to have died from skin cancer, and an additional 6 patients were presumed to have died from the cancer. This study has demonstrated a good control rate and good cosmetic results for small tumors of the eyelids, pinna, and nose. In addition, a good control rate was obtained in patients with cartilage and bone involvement. Treatment of massive tumors should involve planned operative resection with adjuvant radiotherapy. PMID- 3661852 TI - Necrotizing amebic colitis: a frequently fatal complication. PMID- 3661854 TI - [Proceedings of the 8th Seminar on Neuroanesthesia and Resuscitation: Acute cerebral ischemia and anesthesia and resuscitation. Lyons, 20-21 November 1986. 3]. PMID- 3661853 TI - Effect of incidental appendectomy on the development of wound infection in patients undergoing staging laparotomy for Hodgkin's disease. PMID- 3661855 TI - [State of the question of euthanasia in 1986]. PMID- 3661856 TI - [Effect of 3 new GABA-ergics on reserpine catalepsy and apomorphine sedation in rats]. PMID- 3661857 TI - [Bupivacaine 0.125% associated with fentanyl in obstetric analgesia. Apropos of 81 cases]. PMID- 3661858 TI - [Flash antibioprevention]. PMID- 3661859 TI - [Evaluation of the efficacy of cefuroxime for the prevention of infections after ORL surgery for cancer]. PMID- 3661860 TI - [Flash antibioprevention with cefuroxime in gastroduodenal surgery]. PMID- 3661861 TI - [Evaluation and assessment of pain in the acutely painful patient: methodological problems]. PMID- 3661862 TI - L-carnitine decreases the recovery time following halothane anesthesia in rats. PMID- 3661863 TI - [Physiopathology of cerebral vasospasm in meningeal hemorrhages]. PMID- 3661864 TI - [Nuclear magnetic resonance in cerebral vascular diseases]. PMID- 3661865 TI - [The cefuroxime-metronidazole combination in "flash" prevention of infections after colorectal surgery]. PMID- 3661866 TI - [Efficacy of a peroperative cefuroxime-metronidazole combination for the prevention of infections after cesarean section]. PMID- 3661867 TI - [Flash antibiotic prophylaxis with cefuroxime-metronidazole combination in gynecologic surgery]. PMID- 3661868 TI - [Analysis of the efficacy of a flash antibiotic prophylaxis in relation to infectious risk factors]. PMID- 3661869 TI - [Amniotic fluid proteins in physiological pregnancy]. PMID- 3661870 TI - [Natural killer activity and sensitization of peripheral blood lymphocytes to normal tissue antigens in pregnancy]. PMID- 3661871 TI - [Characteristics of lipid composition of the blood serum in obese pregnant women]. PMID- 3661872 TI - [Acute fatty liver in pregnancy]. PMID- 3661873 TI - [Results and prospects of the development of obstetrics and perinatology]. PMID- 3661874 TI - [Diagnostic value of cardiotocography in twin pregnancy]. PMID- 3661875 TI - [Congenital heart defects and pregnancy]. PMID- 3661876 TI - [Pregnancy complications and maternal and fetal outcomes in diseases associated with arterial hypertension]. PMID- 3661877 TI - [Clinical course and outcome of clomiphene-induced pregnancy]. PMID- 3661878 TI - [Informative value of various laboratory indicators for the diagnosis of complications of the suppurative-inflammatory nature of premature labor and premature rupture of fetal membranes]. PMID- 3661879 TI - [Various aspects of the management of premature labor after premature rupture of fetal membranes]. PMID- 3661880 TI - [The interferon system in obstetrical infection]. PMID- 3661881 TI - [Early diagnosis of hypogalactia in women in the puerperal period]. PMID- 3661882 TI - [Impedancometry in the early diagnosis of lactation mastitis]. PMID- 3661883 TI - [Role of controlled physical exercise in the complex treatment of pregnant women with hypertension]. PMID- 3661885 TI - [Serum immunoglobulin levels in pregnant women with late toxemia]. PMID- 3661884 TI - [Pregnancy and labor in women with a history of hypothalamic syndrome during puberty]. PMID- 3661886 TI - [Brain abscess in pregnant women]. PMID- 3661887 TI - [Spontaneous rupture of nephrocarcinoma in full-term pregnancy]. PMID- 3661888 TI - [Birth injuries of the nervous system in newborn infants and their significance from the neurological viewpoint]. PMID- 3661889 TI - [A method of volumetric measurement of uterine blood flow velocity]. PMID- 3661890 TI - [Determination of circulating blood volume]. PMID- 3661891 TI - [Principles and methods of conducting premature labor]. PMID- 3661892 TI - Sinker lung: acute metallic mercury poisoning associated with the making of fishing weights. PMID- 3661893 TI - Smokeless tobacco use among Alabama youth. PMID- 3661894 TI - Clinical progress in plastic and reconstructive surgery. PMID- 3661895 TI - A genetic services microcomputer data base. Part I. Design and implementation. PMID- 3661896 TI - Serologically substantiated case of Lyme disease and potential tick vectors in Alabama. PMID- 3661897 TI - Disseminating arthritis information by telephone in Alabama. PMID- 3661898 TI - The role of the Office of Health Extension, Public Service and Research in continuing education. A revolving door between the society of practicing health professionals and the community of scholars. PMID- 3661899 TI - Remarks on public health in Alabama. PMID- 3661900 TI - The function of a university professor. PMID- 3661901 TI - National priorities and influence. PMID- 3661902 TI - The surgical management of trigeminal neuralgia at the University of Alabama at Birmingham Medical Center 1981-1986: a comparative study. PMID- 3661903 TI - High school football game injuries from four Birmingham municipal fields. PMID- 3661904 TI - Nuclear imaging studies and sickle cell disease. PMID- 3661905 TI - A genetic services microcomputer data base. Part II. Results and trends. PMID- 3661906 TI - Diabetic neuropathies. Hypothetical schema of the natural history of diabetes neuropathy. PMID- 3661907 TI - Recurrent arthritis in a 12-year-old girl. PMID- 3661908 TI - AIDS education in the schools. PMID- 3661909 TI - Epilepsy among parents of children with cleft lip and palate. AB - It is well established that children of mothers with epilepsy may suffer from facial clefts more frequently than children of non-epileptic mothers. However, a wide range of prevalence rates in this particular population is quoted in the literature. The majority of studies were performed by screening epileptic mothers for the presence of facial clefts in their offspring. The present study screened a relatively large group of children with primary facial clefts and established the prevalence rate of epilepsy among their mothers. It was found that the frequency of epilepsy among Jewish Israeli mothers to children with facial clefts is four times higher and the frequency of facial clefts in children of epileptic mothers is six times higher than in the respective normal population. PMID- 3661910 TI - Predictive factors of seizure frequency and duration of antiepileptic treatment in rolandic epilepsy: a retrospective study. AB - Factors useful to predict seizure frequency and duration of antiepileptic treatment of children with benign partial epilepsy and rolandic spikes were retrospectively evaluated in 72 patients seizure-free for at least 5 years and off antiepileptic drugs for at least 2 years. Three groups were considered: Group I, 11 patients (15%) with a single seizure: Group II, 40 patients (56%) with 2 to 6 seizures; Group III, 21 patients (29%) with over 6 seizures. Significant predictors of rare seizure frequency were: presence of convulsive generalized seizures as the sole ictal manifestation, found in 17 patients of Group II and in one patient of Group III (p less than 0.001), and longer average interval between first and second seizure in Group II than in Group III (7.8 months versus 3.5 months, p less than 0.0001). Although the average duration of the disease was significantly shorter in Group II than in Group III (1.5 years versus 4.5 years, p less than 0.00001), the duration of the antiepileptic treatment was similar in both groups. Of the 8 untreated patients, 5 had a single seizure and one had 2 seizures. Therefore, it is suggested that antiepileptic treatment be delayed without risk until the third seizure occurrence and restricted to patients with no predictor of rare seizure recurrence. PMID- 3661911 TI - Prophylaxis of intracranial hemorrhage due to vitamin K deficiency in infants. AB - To determine the most effective way of preventing intracranial hemorrhage due to vitamin K deficiency in infants, we first performed a comparative study using Normotest on the effects of several regimens for the oral administration of vitamin K2. Based on the results, we gave vitamin K2 orally, 2 mg, at birth, and then, 4 mg, at 1 week of age (on discharge from the newborn nursery) to all infants except premature and low-birth-weight infants born in Nagasaki Prefecture, Japan. Since then, as the number of infants with vitamin K2 prophylaxis increased, patients with intracranial hemorrhage due to vitamin K deficiency decreased in number, and no patient was found in 1984. The incidence of this disease in infants with vitamin K prophylaxis was 1/68,500, which was one twentieth of that (1/3,500 live births) before the period when most neonates received vitamin K prophylaxis. From the results, we concluded that the oral administration of vitamin K2 at birth and 1 week of age prevents this disease. PMID- 3661912 TI - Congenital muscular dystrophy of non-Fukuyama type with characteristic CT images. AB - A 9-year-old Japanese boy with congenital muscular dystrophy (CMD) with normal intelligence was presented. He was extremely floppy and had joint contractures since birth. Motor milestones were delayed and he did not learn to walk alone. Intellectual development was normal and no convulsions were observed. On physical examination at 9 years old, he had diffuse muscle weakness and atrophy and flexion contractures of joints. Creatine kinase was normal and IQ was 95. Biopsied muscle showed myopathic changes consistent with muscular dystrophy. CT scans of the head revealed diffuse low density area in the white matter of the cerebrum. These findings suggest central nervous system involvement in CMD is not confined to Fukuyama-type CMD. PMID- 3661913 TI - Brainstem auditory evoked responses alteration in twin neonates. AB - The authors obtained BAER recordings for 20 premature twins and 20 premature non twins. The two groups were comparable as to conceptional age (36-37 weeks), gestational age, chronological age, birthweight, sex ratio and head size. The results showed a prolongation of the central conduction time (I-V interval) in the premature twins. This may be due to the intra-uterine growth retardation of twins. PMID- 3661914 TI - Maternal alcohol ingestion and neural tube defects: observation of four brothers in a family. AB - The authors report the observation of four brothers with myelomeningoceles, sons of an alcoholic mother. The typical signs of the alcohol fetal syndrome was seen in only one of them. The chronic alcoholism of the mother was the only known teratogenic factor during the four pregnancies. PMID- 3661915 TI - Abstracts from the 13th annual conference on childhood epilepsies in Kanto District. Tokyo, February 22, 1986. PMID- 3661916 TI - [Bases of scientific writing]. PMID- 3661917 TI - [Evaluation of the knowledge of asthma (comparative study)]. PMID- 3661918 TI - [Tympanometric abnormalities in children with allergic rhinitis]. PMID- 3661919 TI - [Psoriatic arthritis and hepatic cirrhosis]. PMID- 3661920 TI - Storage mite allergy among grain elevator workers. AB - A total of 139 workers (71% of the available work force) in four grain elevator stores in Aalborg, Denmark, participated in a cross-sectional study on the prevalence of storage mite allergy among grain elevator workers. All underwent interview, prick test with a standard panel of allergens and the storage mites Acarus siro, Lepidoglyphus destructor and Tyrophagus putrescentiae, RAST to the three above-mentioned storage mites plus Glycyphagus domesticus and wheat, measurement of serum total IgE, and spirometry. Pulmonary symptoms were present among 44%, nasal and eye symptoms among 48%. Thirty-one per cent complained of work-related respiratory symptoms. Fourteen per cent of these workers had only nasal symptoms. Comparing the prick test result and the history, 6.4% had respiratory storage mite allergy, while 15.9% were sensitized to storage mites. Storage mites seem to be the most important allergen among grain elevator workers in Denmark. Faunistic examination of samples of grain and dust showed that storage mites, in particular A. siro, L. destructor and T. longior, were found in 73% of grain samples, while all dust samples contained mites. PMID- 3661921 TI - House dust mites and human dander. AB - The occurrence of house dust mites was measured in the homes of 12 patients with the scaly skin disease, psoriasis. The median number of mites in the mattress dust and floor dust was 27 (range 10-153)/0.1 g and 56 (range 12-114)/0.1 g respectively, which is significantly higher than the background pollution of house dust mites in normal Danish homes. The results support the idea that the amount of mites in our homes not only depend on relative air humidity but also on the production of dandruff. PMID- 3661922 TI - [Serum thiopental values, spontaneous frontal muscle electromyography activity and compressed EEG amplitudes and frequency values in thiopental infusion anesthesia]. AB - Serum thiopentone (S-Thiop) was estimated every 10 minutes using a new high performance liquid chromatographic method during fentanyl-bolus-complemented (0.01 mg) thiopentone infusion anaesthesia (bolus of 5 mg/kg, infusion dosis 23.7 mg/min) for laryngo-microscopic procedures. Before stopping the infusion after 18/17 min (SD 8/5) (male/female) S-Thiop was (mean (SD) range) 16.0/12.4 (4.6/5.7) 5.9-26.8/5.1-26.6 mg/l; after stop of the infusion 12.8/10.5 (4.5/5.3) 7.6-25.5/4.5-23.4 mg/l. Patients reacted to verbal command after 11.5 (10.3) 11 81 min. There were no clinically relevant correlations between S-Thiop and frontal EMG and compressed 1-channel-EEG (ABM, Datex, Helsinki), nor with data recorded during recovery. Reasons may be: the total depolarisation block caused by succinylcholine; the method of compressing the EEG; subjective influences on the recording of recovery data; sampling in intervals of 10 min instead of at certain points of the anaesthesia course. We still recommend this total i.v. anaesthesia for the short time endolaryngeal procedures need; before using this method for longer periods additional pharmacokinetic studies should be performed. PMID- 3661923 TI - [Behavior of adrenaline, noradrenaline, blood pressure and heart rate in intubation in relation to different doses of fentanyl]. AB - In 24 patients undergoing ENT surgery the reactions of blood pressure, heart rate and plasma catecholamines were studied during standardized induction of anaesthesia as well as after additional fentanyl administration of 0.1 or 0.2 mg before intubation. In the control group (n = 8) six measurements were performed, i.e. one minute before and after the administration of the drugs for induction, as well as immediately after the insertion of the laryngoscope and one minute after intubation. In the reference groups two measurements were performed: before induction of anaesthesia and one minute after intubation, in the period of maximal circulatory reaction. 0.1 or 0.2 mg were administered in the fentanyl groups (n = 8 in each) after precurarization before injecting thiopentone. The blood pressure was measured by oscillometry, the heart rate was recorded by an ECG monitor, and the plasma catecholamines were determined by a radio-enzymatic method. In the control group without fentanyl only a rise in heart rate was observed in the induction period until laryngoscopy. After the insertion of the laryngoscope the increase in systolic and diastolic blood pressures, heart rate and plasma noradrenaline levels were marked. One minute after intubation these parameters rose again. The adrenaline concentration hardly changed during the entire period of induction. The administration of 0.1 mg fentanyl proved to be insufficient to depress the sympathoadrenergic reaction during intubation. Although plasma catecholamines did not rise, a marked increase in blood pressure and heart rate could not be avoided. The difference compared to 0.2 mg fentanyl was significant in the parameters blood pressure and heart rate (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661924 TI - [Lesion of the brachial plexus, caused by wrong positioning during surgery]. AB - We report three patients, which showed plexus palsies after routine operations. Compression and stretch of the nerves despite pads leaded to nerve injury in patient A. Abduction of the arm, fixed wrist, hypotension in steep Trendelenburg position and a preexisting shoulder-arm-syndrome were the causes in patient B. Hyperreclination of the head in semisitting position caused the lesion in patient C. The anaesthetist should know the risks of positioning to prevent nerve injuries. PMID- 3661925 TI - [Aspects of pressure build-up in the use of electronic infusion devices. I. Need for adequate output pressure]. AB - Today, the requirements infusion pumps and syringe pumps have to meet concerning the maximum pressure limit are based on aspects of technical feasibility rather than on clinical needs. Since, in the case of common operational disorders, factors such as time to alarm, bolus volume and accuracy depend on the pressure characteristics, a maximum pressure limit standard needs to be defined for routine clinical applications. For general application with peripheral and central venous lines this pressure limit should be under 15 psi and should allow step-by-step adjustment to even lower values. PMID- 3661926 TI - [Aspects of pressure build-up in the use of electronic infusion devices. II. Need for a pressure limit]. AB - A maximum pump output pressure under 15 psi which is adapted to the necessary back pressures and flow pressures can provide a reduction of problems related to pressure build-up. Thus, the time to alarm in case of occlusion and the bolus dosage after removal of the obstruction can be minimized. This is important in the use of critical drugs with short half-lives, such as catecholamines and vasoactive substances. On the basis of aspects described above, it appears necessary to reconsider technical requirements. Finally, the definition of accuracy and technical solutions for an improved alarm function of electronic infusion systems are discussed. PMID- 3661927 TI - [ARDS in Mycoplasma pneumonia]. AB - In this paper we describe a case of bilateral broncho-pneumonia due to invasion by mycoplasma pneumoniae, leading to ARDS. A high serum level of cold agglutinins, a mild haemolysis and a rash resembling that of an erythema multiforme were noted. The initial treatment was non-specific. After pathogen identification tetracycline therapy was initiated. Bacterial superinfections were treated with appropriate antibiotic schemas. The observed biphasic clinical course could be explained as an immunological phenomenon. PMID- 3661928 TI - [Plasma exchange in acute abdomen with multiple organ failure--a case report]. AB - Following four weeks of conservative treatment of acute pancreatitis a 43 years old female was admitted to our ICU in severe circulatory shock (MAP less than 50 mmHg despite dopamine and dobutamine 5 mcg/kg/min, and norepinephrine 0.4 mcg/kg/min), respiratory failure, incipient renal failure and coma. Laboratory examination revealed thrombopenia (14 G/l) and leucopenia (0.5 G/l), as well as impaired prothrombine time (20%) and partial thromboplastine time (greater than 2 min). As abdominal sepsis was suspected to be the most likely cause of the patients multiple organ failure, a laparotomy was planned. To improve coagulation prior to surgery, plasmapheresis was performed exchanging 4.8 liters of plasma with fresh frozen plasma. In addition 3 units of platelets were transfused. The effects of the plasmapheresis were an improvement of circulatory as well as coagulatory parameters. Laparotomy revealed toxic megacolon, whereas the pancreas seemed to be normal; a coecostomy and a transversostomy were performed. The patient thereafter improved gradually; catecholamine doses were reduced, renal function recovered and five days postoperatively weaning from the ventilator was possible. Platelet substitution (6 more units), fresh frozen plasma administration (76 units a 200 ml) and AT III substitution (total 10,500 U) had to be continued throughout the first week. Five weeks after this operation, which would have been impossible without preoperative plasmapheresis, the patient was discharged in good health. PMID- 3661929 TI - Tactile orotracheal tube placement test. A bimanual tactile examination of the positioned orotracheal tube to confirm laryngeal placement. AB - The development of a tactile clinical test of the positioned orotracheal tube is described which allows confirmation of its location within the larynx. It was possible, after preliminary experience with the test, to confirm laryngeal placement confidently in an average of 97% of cases in two concurrent series each of which consisted of 100 patients. Inevitably, there are limitations to its usefulness but it has the advantage that no special apparatus is required for its performance. The implications of this test are discussed in relation to difficult intubation, obstetric anaesthesia, the teaching of applied anatomy and checking by their trainers of intubations performed by very junior anaesthetists. Familiarity with this test should be considered essential for its reliable implementation. PMID- 3661930 TI - Hypercholinesterasaemia and suxamethonium resistance. AB - A case is reported of resistance to the muscle relaxing action of suxamethonium due to the rare inherited condition of hypercholinesterasaemia. Family studies suggest dominant inheritance. It is suggested the condition should be considered whenever there is unexpected resistance to the muscle relaxing action of suxamethonium. PMID- 3661931 TI - Histamine levels and cardiovascular responses during splenectomy and splenorenal shunt formation in a patient with systemic mastocytosis. AB - Systemic mastocytosis is a rare disorder characterised by the infiltration of many tissues by abnormal numbers of mast cells. Life-threatening episodes of bronchospasm and hypotension are common in response to a variety of triggers which cause mast cell degranulation. We present the case history of a patient with severe mast cell disease who successfully underwent splenectomy and portocaval anastomosis. Peri-operative therapy was directed towards mast cell stabilisation, and histamine-releasing drugs were avoided. Cardiovascular data, together with blood histamine levels and thrombin times, indicated that mast cell degranulation did not occur. A review of the current literature concerning mast cell disease as it relates to anaesthesia is presented and suggestions for the safe management of such cases are given. PMID- 3661932 TI - Suxamethonium apnoea in a 4-month-old twin. AB - A case of one infant of twins who developed suxamethonium apnoea is described. Investigation of the family revealed him to be homozygous for atypical cholinesterase while the other twin was normal. Tissue HLA and blood typing indicated the twins to be identical. PMID- 3661933 TI - Miller's syndrome. Anaesthetic management of postaxial acrofacial dysostosis. AB - A new case of Miller's syndrome is reported and the characteristic features are described along with a brief outline of related conditions. The anaesthetic management is discussed and the problems which may be encountered when dealing with this syndrome are highlighted. PMID- 3661934 TI - Spontaneous retrobulbar haemorrhage following anaesthesia. AB - A case is presented of retrobulbar haemorrhage following anaesthesia for the removal of a chicken bone from the pharynx of a patient with systemic lupus erythematosus. The aetiology and treatment are discussed. PMID- 3661935 TI - A new laryngoscope. A modified laryngoscope to facilitate intubation in cases of restricted access. AB - This is a report of a modification to one design of laryngoscope to increase the angle between blade and handle, to facilitate intubation in cases of difficult access, such as in obstetric practice or in patients in whom neck flexion is limited, for example by skull traction. The modification offers the unique advantage of two useful blade angles in one instrument. The first type described would be suitable for use in small units where it is thought that a laryngoscope solely for use in rare cases of difficult access would not be justified. It would also be suitable for inclusion in resuscitation kits for use both within and outside hospital. The second type would be more suitable for the maternity or spinal injuries unit, or the difficult intubation box of a general operating theatre suite. PMID- 3661936 TI - Arterial oxygen saturation during general anaesthesia for paediatric dental extractions. AB - Arterial oxygen saturation (SaO2) was measured in 50 healthy children undergoing dental extractions under general anaesthesia. An inhalational anaesthetic technique was employed, with an inspired oxygen concentration of 33%. There were decreases in SaO2 of greater than 5% of the baseline value in 70% of patients, and greater than 10% in 26% of patients. The majority of these decreases were associated with teeth extractions or during placement of dental prop and pack. Non-Caucasian children showed a significantly (p less than 0.05) greater maximum decrease in SaO2 from baseline value compared to Caucasian children. The maximum decreases in SaO2 from baseline value in children anaesthetised by supervised dental students, and in children whose extractions were performed by dental students, were significantly (p less than 0.05) greater than in children whose anaesthetic and surgery were performed by members of staff. PMID- 3661937 TI - The influence of premedication on the occurrence of dysrhythmias during oral surgery. AB - The incidence of cardiac dysrhythmia during inpatient dental anaesthesia with enflurane was studied following either hyoscine or droperidol as a supplement to papaveretum premedication. None of the subgroup given droperidol exhibited dysrhythmias, compared to 4.4% of those patients given hyoscine. This difference was not significant at the 5% level (0.2 greater than p greater than 0.1). PMID- 3661938 TI - A comparison of halothane and trichloroethylene with isoflurane. A study of drawover air anaesthesia with the Triservice anaesthetic apparatus. AB - Induction and recovery times were not significantly different between two groups that received halothane with trichloroethylene and isoflurane, respectively. Maintenance of anaesthesia and analgesia was also satisfactory. Isoflurane resulted in a higher heart rate (p less than 0.01), a lower respiratory rate (p less than 0.01) and a higher inspired oxygen concentration (p less than 0.05). Respiration may be more efficient. Other potential advantages of isoflurane for anaesthesia in the field are discussed. Despite the fact that it is 15 times more expensive, the use of isoflurane as sole agent is recommended. PMID- 3661939 TI - Cardiac output during an anaphylactoid reaction. PMID- 3661940 TI - The anaesthetist and Maternity Services Liaison Committees. PMID- 3661942 TI - Shaping tracheal tubes. PMID- 3661941 TI - Nitrous oxide and oxyhaemoglobin dissociation. PMID- 3661943 TI - Pleural aspiration with a central venous catheter. PMID- 3661944 TI - Prochlorperazine and vomiting after eye surgery. PMID- 3661945 TI - Management of labour and delivery in a patient with Guillain-Barre syndrome. PMID- 3661946 TI - Needlestick injury from indwelling steel needle. PMID- 3661947 TI - [Volatile anesthetics and n-alcohols inhibit the uptake of noradrenaline in pheochromocytoma cells]. AB - Studies with perfused animal organs did not show a significant inhibition of the norepinephrine uptake by volatile anesthetics However, the uptake of norepinephrine into isolated chromaffin granules proved to be halothane-sensitive , and there is indirect evidence for an inhibition of norepinephrine uptake by halothane in the dog saphenous vein. So far no literature is available on norepinephrine uptake into cultured cells in the presence of volatile anesthetics. The rat pheochromocytoma cell line PC 12, which shares many properties with adrenal medulla cells and also with sympathetic neurons, has been used as a model to study norepinephrine uptake and release. One of its properties in common with sympathetic neurons is the high-affinity uptake system for norepinephrine. Therefore, we have used PC 12 cells as a pharmacologically well established model system to study the effect of general anesthetics on the uptake of norepinephrine. METHODS: The experiments were performed with monolayers of PC 12 cells on 3 cm petri dishes. The cells were allowed to take up tritiated norepinephrine (0.25 microCI/ml) for 20 min at 36 degrees C in the presence and absence of general anesthetics. RESULTS AND DISCUSSION: The volatile anesthetics halothane, enflurane, isoflurane, and methoxyflurane in clinical relevant concentrations inhibited the high-affinity uptake of tritiated norepinephrine into the PC 12 cells (Fig. 1). We could further show an inhibition of norepinephrine uptake by n-alkanols at concentrations that cause anesthesia in tadpoles. Fig. 2 illustrates that a good correlation (r = 0.997 for the n alkanols, r = 0.934 for the volatile anesthetics) exists between anesthetic potency and the IC50 for norepinephrine uptake inhibition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661948 TI - [Effect of selected anesthetics on serum myoglobin levels after administration of succinylcholine. Comparison of halothane, enflurane and isoflurane with thiopental in adults]. AB - The type of anesthetic agent used influences the extent of the increase in serum myoglobin concentrations brought about by succinylcholine (sch). The purpose of this study was to compare the inhalational agents halothane, isoflurane, and enflurane with i.v. thiopental with respect to their effects on serum myoglobin levels following sch. Twenty-four male adults undergoing surgical procedures involving no muscle trauma were randomized and divided into four groups of six each. Following induction of anesthesia with a bolus injection of thiopental 2.5 3.5 mg/kg, patients in the four groups received either repetitive doses of thiopental plus N2O/O2 (4 l/min; FiO2 0.3) or one of the inhalational agents in N2O/O2 in dosages necessary for maintenance. Ventilation was carried out according to clinical judgement. Following a pre-sch phase of 15 min, sch 1 mg/kg was injected intravenously. Blood samples for determining myoglobin (normal range 30-60 ng/ml) were taken immediately prior to (control values) and 5 and 15 min after sch injection. Increases were defined as the difference of two values 15 min prior to and after sch. Statistical analysis was carried out by way of ANOVAs, P less than 0.05 being considered significant. The mean values of myoglobin prior to sch ranged from 52.3 to 57.7 ng/ml according to group (Table 1). The increase in concentration normally ranged from 1 to 7 times pre-sch levels, in some cases to 20 times. Table 2 shows the mean values. The type of anesthetic agent exerted no significant influence on serum concentration. PMID- 3661949 TI - [Resuscitation in the field of intensive care medicine: comparison of two periods of anesthesiologic intensive care separated by 10 years]. AB - Acute failure of vital functions is more likely to occur in patients in intensive care units (ICU) than in peripheral wards. In this retrospective study, which analyzes the cases over two distinct 1-year periods separated by a 10-year interval, we have attempted to reflect the results obtained in our own ICU and to compare them with data reported in the literature. One hundred thirty-three patients requiring cardiopulmonary resuscitation were entered in the study. Over the 10-year interval, the survival rate increased. The number of patients that could be successfully resuscitated increased from 75.7% to 89.6%, and the rate of survivors discharged from hospital increased from 22.5% to 42.8%. During the first study period 17.8% of resuscitated ICU patients could be discharged with a good prognosis; 10 years later the rate was 32.7%. Possible explanations for the improved outcome could be the more restrictive resuscitation policy and the decreased mean age of resuscitated patients. Earlier detection of threatening complications and improvements in resuscitative measures could also be responsible for the more favorable outcome. During the first study period, 64.3% of patients died if resuscitation had to be started on peripheral wards, whereas in the second study period 63.2% survived. These results indicate the importance of improved resuscitation training programs for the entire hospital staff. Furthermore, over the 10-year interval the reason for admission has changed from traumatized patients to individuals suffering from acute respiratory failure. A comparison of our results with data reported by others could be hampered by the use of different criteria as well as by the differences in patient populations treated. For this reason, widely accepted common criteria should be established for further epidemiological studies. PMID- 3661950 TI - Abstracts of posters presented at the international symposium Spinal Analgesia. Basic and clinical aspects. Munich, FRG, August 9-12, 1987. An official satellite symposium to the Vth World Congress on Pain, Hamburg. PMID- 3661951 TI - [Improving venous tolerance of methohexital]. AB - As there are still contradictions in the literature on the efficacy of different solvents to reduce venous pain after the injection of methohexital we restudied this problem. In an earlier investigation normal saline proved superior to distilled water. We now found that injection of an opioid prior to methohexital and addition of lidocaine to the methohexital solution leads to a strong reduction in the incidence of pain. PMID- 3661952 TI - [Effect of thiopental Na on the concentration of calcium ions in blood]. AB - The hemodynamic effects induced by thiopental and a decrease in blood ionized calcium are uniform. This investigation was undertaken to show a possible decrease in ionized blood calcium during induction of general anesthesia with thiopental. Twenty-four patients aged 19-79 years (median 57) were studied. None had any known parathyroid disease, malabsorption, or chronic renal insufficiency, and none were receiving calcium channel blockers. For the analysis of blood Ca++, pH, and PCO2, blood samples were drawn anaerobically into a heparinized syringe from an i.v. cannula. A special heparin solution was used (S4500 Radiometer, Copenhagen) to avoid the influence of heparin on the Ca++ determination. The initial 2 ml were discarded. No samples were drawn in the first 3 min after removal of the tourniquet. A maximum of 100 ml isotonic saline was infused between the two samplings. The infusion was stopped for at least 30 s before sampling. PCO2, B-Ca++, and pH were measured directly using the ABL 4 (Radiometer, Copenhagen) and the ICA 1 ionized calcium analyzer (Radiometer, Copenhagen). The standard deviation of repeated measurements of B-Ca++ within a short time using the same sample is 0.01 mmol/l on the ICA 1. The samples were drawn just before and 2 min after thiopental injection (median 5.9 mg/kg) was started. The pulse and blood pressure were simultaneously measured. The individual Ca++ measurements are shown in Table 1. The results of the investigation are shown in Table 2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661953 TI - ["Self-taming": an alternative to the prevention of succinylcholine-induced pain]. AB - Muscle pain associated with single-bolus administration of suxamethonium is reported to be one of the common complications of this technique. Since suxamethonium is the most commonly used relaxant in our department and priming with nondepolarizing muscle relaxants is also reported to be linked with complications, while the literature concerning this problem is very contradictory, we wondered if the so-called "self-taming" method represents an alternative to pretreatment with nondepolarizing muscle relaxants. One hundred thirty-two patients (69 male, 63 female) were randomly allocated to three groups. Anesthesia was induced with thiopentone 7 mg/kg body weight. Group 1 (n = 44) was pretreated with 2 mg pancuronium bromide 3 min prior to full relaxation with suxamethonium 1.5 mg/kg. Group 2 (n = 43) received no pretreatment. Group 3 (n = 45) received 4 mg suxamethonium i.v. after induction. One minute later the remaining dose of suxamethonium was applied ("self-taming"). Muscle fasciculation and postoperative myalgia were verified by means of a score. Neuromuscular transmission was recorded on a monitor after controlled train-of-four stimulus and time of onset of neuromuscular blockade was measured. With regard to muscle fasciculation, postoperative pain, and onset of neuromuscular blockade, "self taming" with suxamethonium yielded results identical to pretreatment with pancuronium bromide. It may therefore be considered as an alternative to pretreatment with nondepolarizing muscle relaxants. PMID- 3661955 TI - [Bupivacaine and mepivacaine on artificial lipid membranes. A comparison of physicochemical parameters]. AB - Mepivacaine and bupivacaine, frequently used local anesthetics, differ in a variety of clinical effects but show only small differences in chemical structure. In order to learn more about molecular mechanisms of action, we investigated the effects of these two local anesthetics on artificial membranes and liposomes. Methods. Artificial membranes were formed from dipalmitoylphosphatidylcholine - cholesterol or from a phospholipid mixture extracted from rabbit heart to separate into two aqueous phases (100 mM NaCl, 1 mM glycine, pH 7.4). Membrane current and potential were recorded after addition of local anesthetics on one side of the membrane. Electrophoretic mobility of liposomes, formed from phosphatidylcholine and a mixture of phosphatidylcholine with phosphatidylinositol, was measured by laser Doppler techniques. The surface potential (zeta potential) was calculated by Gouy-Chapman theory. Lipid/buffer partition coefficients were determined in phosphatidylcholine liposomes by centrifugation and spectrophotometric measurement of the concentration. Results. Mepivacaine and bupivacaine induce concentration-dependent electrostatic potentials on artificial membranes, resulting from incorporation of the charged drug form. Bupivacaine is more active than mepivacaine. The time of onset is short for mepivacaine and delayed for bupivacaine. The effects are retarded in the presence of glucose and are higher and more rapid for the carbonized form of bupivacaine (CO2 form instead of hydrochloride form). The electrostatic surface potential, measured by electrophoretic liposome mobility, is changed by the local anesthetics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661954 TI - [Pindolol in intraoperatively developing isorhythmic AV dissociation]. AB - The pathogenetic mechanism of isorhythmic AV dissociation (ID)--the often so called nodal rhythm--developing during anesthesia is unclear. It has been proposed that stimulation of the AV node is caused by elevated sympathetic tone and a simultaneous blockade of the sinus node. In our prospective, randomized study the effect of the beta-blocking agent pindolol in converting ID into normal sinus rhythm has been investigated. Methods. Fourty patients (27 men, 13 women) aged 17 to 81 years, ASA class I and II, who developed ID during an elective surgical procedure were divided into four equal, randomized groups. The biometric data, type of operation, and anesthesia technique were comparable: induction of anesthesia with thiopental, intubation, and continuation with N2O/O2 combined with halothane or enflurane. The patients in group A formed the control group. The other patients received pindolol in a dose of 0.5 (group B), 1.0 (group C), and 2.0 (group D) micrograms/kg over a period of 30 s intravenously. The frequency of restoration of sinus rhythm during a testing period of 15 min in the pindolol-treated patients was compared with the frequency of the spontaneous converting rate in the control group. Results. A spontaneous return to sinus rhythm occurred in 2 of 10 (20%) patients of the control group, whereas with pindolol the restoration of sinus rhythm was effected in 25 of 30 (83.3%) patients during the observation period of 15 min (p less than 0.001). The dose of 2.0 micrograms/kg pindolol (group D) was most effective.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661956 TI - [Effects of intubation anesthesia on the temporomandibular joint]. AB - Hardly any attention has so far been paid to temporomandibular joint (TMJ) dysfunction after endotracheal intubation. We examined perioperative lesions of the TMJ in 100 patients who underwent operations in areas other than the head and neck. Fifty of these patients were anesthetized with orotracheal intubation; the other 50 were operated under spinal or peridural anesthesia. The orotracheal intubations were carried out with Macintosh laryngoscopes (blatesize 3). Size 32 Kuhn tubes or Magill tubes were used in 25 patients each. Preoperatively and daily for the first 4 postoperative days, we repeated the history and examined the minimal distance between the occlusal edges of upper and lower incisors (SKD), deviations of the mandible during opening and closing movements, and snapping or grinding of the TMJ. We further measured the duration of intubation, technical difficulties, and the number of years of training of the anesthetist. Age, body length, and preoperative findings were compatible in both patient groups. Operating time was 25% longer in the spinal or peridural anesthesia group. Of the 50 patients with orotracheal intubation, 33 demonstrated a reduced ability of maximal oral opening of up to 35% on the 1st postoperative day. Snapping of the TMJ was observed in 80% of the orotracheally intubated patients on the 1st postoperative day, which was 20% above the preoperative value. TMJ grinding showed no significant changes. Two of the 50 intubated patients complained of TMJ pain, another two had occlusal disturbances, and two had a reduced SKD. There were no detectable differences within the group of intubated patients regarding type of tube or experience of the anesthetist.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661957 TI - [Stomach rupture following normo-frequent jet ventilation]. AB - We report a case of a gastric rupture following jet ventilation during laryngoscopy. PMID- 3661958 TI - [Clinical experiences with a new reusable pressure transducer]. AB - Invasive blood pressure monitoring is increasing in anesthesia and intensive care. Compared to noninvasive methods, it has some decisive advantages: (1) blood pressure trends can be assessed beat by beat, which is important especially in situations of cardiac arrhythmia; (2) respiratory changes in blood pressure as one sign of hypovolemia can be detected easily; and (3) pressure changes induced by the autonomic nervous system become apparent. We studied a new, reusable pressure transducer system, the Medex Novatrans-MX800 in routine intra- and postoperative monitoring of patients undergoing cardiac surgery using the following criteria: (1) handling; (2) accuracy of measurement; (3) durability; and (4) costs. The system is easy to use and has a low susceptability to breakdown. In 29 of 31 transducers tested, the error of measurement over a range of 0-150 mmHg was less than 2% as reported by the manufacturer. Two transducers showed errors of measurement over 5% after 60 times of reuse. The mean reusability rate until the transducer became defective was 75.8 +/- 17.3 in the operating room (19 transducers tested) and 59.7 +/- 29 in the intensive care unit (12 transducers tested, 11 still in use). A comparison of costs shows that the Novatrans-MX800 system is the cheapest system for invasive pressure monitoring available at this time. PMID- 3661959 TI - International aid in anaesthesia. PMID- 3661960 TI - The effect of halothane general anaesthesia on platelet function. AB - Major craniofacial surgery has the potential for very large blood loss, frequently greater than one blood volume. In order that an assessment could be made of any deficiencies of platelet function or coagulation, tests were performed at intervals during the operation. None of the coagulation parameters showed variation below normal limits during the operation, but in vitro platelet aggregation showed significant decreases to several agonists. PMID- 3661961 TI - Autologous blood transfusion for major vascular surgery using the Sorenson Receptal Device. AB - Twenty-five patients having aortic surgery had blood scavenged using the Sorenson Receptal Device (Group A) and were compared with twenty-five patients having homologous blood transfusion (Group H). Mean intraoperative blood loss was similar in both groups, Group A 3224 (SD 2392) ml, Group H 2999 (SD 1579) ml, but the mean homologous blood replacement was significantly different intraoperatively, Group A 1.2 (SD 1.7) units, Group H 2.7 (SD 1.8) units. Total intra-hospital homologous blood replacement was not significantly different, Group A 4.0 (SD 3.4) units, Group H 5.5 (SD 5.8) units. Mean haemoglobin concentration in the scavenged blood was 8.5 (SD 2.1) g/dl compared to 10.8 (SD 2.4) g/dl in the median aged homologous blood units crossmatched for Group H. Mean red cell half life in the scavenged blood was the same as that for the homologous blood, 24 (SD 5) days, but plasma-free haemoglobin and bacterial contamination was greater in the scavenged blood. There was no difference in the incidence of postoperative renal dysfunction, coagulopathy or mortality between the two groups of patients. PMID- 3661962 TI - Acute cardiovascular responses to internal carotid artery occlusion during carotid endarterectomy and to the restoration of internal carotid flow. AB - Heart rate, central venous pressure, radial artery pressure and electrocardiograph were recorded in 14 patients undergoing carotid endarterectomy under general anaesthesia supplemented with fentanyl and halothane and muscle relaxation as required. Induction of anaesthesia was followed by a significant reduction in systolic arterial pressure and a rise in central venous pressure (CVP). Thereafter CVP did not vary significantly and heart rate did not change significantly at any stage. After internal carotid artery occlusion, mean systolic pressure at one minute, 143 (SD 17) mmHg, and three minutes, 160 (SD 27) mmHg, were both significantly higher than prior to occlusion, 132 (SD 17) mmHg (P less than 0.01 and P less than 0.002 respectively). Similar significant changes occurred in diastolic pressure after carotid occlusion (P less than 0.02 and P less than 0.002 respectively). The restoration of flow through the internal carotid artery in patients operated on without a shunt was associated with a significant reduction in mean systolic pressure. The mean systolic pressure at one minute, 145 (SD 20) mmHg, and three minutes, 135 (SD 19) mmHg, were both significantly lower than that before restoration of flow, 159 (SD 17) mmHg (P less than 0.02 and P less than 0.05 respectively). Changes in mean diastolic pressure in this group at these times, while in the same direction, were not significant. The observed hypertensive response to carotid occlusion may assist in preserving cerebral perfusion while the internal carotid artery is occluded, but may be hazardous for patients with ischaemic heart disease. PMID- 3661963 TI - Placebo controlled comparison of midazolam, triazolam and diazepam as oral premedicants for outpatient anaesthesia. AB - Two short-acting benzodiazepines, midazolam 15 mg and triazolam 0.25 mg, were compared with diazepam 10 mg and placebo as oral premedicants in 120 patients presenting for minor urological surgery. Midazolam was found to produce the greatest degree of amnesia and sedation at the time of anaesthetic induction and triazolam was found to have the greatest degree of residual sedation at the time of discharge, four hours postoperatively. These effects are consistent with the greater potency and more rapid onset of action of midazolam at this dose compared with triazolam. The relative merits of the compounds as anxiolytics varied depending upon the observer, time and method of assessment. It was considered that the doses of midazolam and triazolam used were excessive for routine day case anaesthesia. PMID- 3661964 TI - Postanaesthetic patterns of care in minor gynaecological surgery. AB - A survey of 408 patients undergoing minor gynaecological procedures was undertaken to determine the optimal pattern of postoperative observation and feeding in the general surgical ward setting. Sixty per cent of all complications occurred within the first two hours after return to the ward. The rest were all of a visible nature, not requiring vital sign recording for detection. Oral intake was tolerated as soon as patients were conscious and co-operative. It is concluded that routine observations need not be recorded for more than two hours after return to the ward after minor gynaecological surgery. PMID- 3661965 TI - An evaluation of six disposable heat and moisture exchangers. AB - Six disposable heat and moisture exchangers were tested on patients undergoing anaesthesia requiring mechanical ventilation. Inspiratory humidity and temperature were monitored to find the steady-state values reached with each device together with the times taken for these to be achieved. The exchangers were tested in a non-rebreathing T-piece circuit and in a conventional circle system with a fresh gas flow of 6 l/min: the Siemens 150 provided 28 and 32 mg of water/litre of inspired gas (at about 30 degrees C) in 10 and 5 min respectively, but is rather heavy and bulky. The Portex Humidvent provided 25 and 30 mg/l, and although taking longer to reach steady state (27 and 15 min respectively) is small, light and cheap. The Siemens 151 provided 25 and 27 mg/l in 18 and 10 min respectively, but is heavier than the Portex exchanger. The performances of these three devices were not significantly different from each other in either study (P less than 0.05). For the T-piece system the Pall and Engstrom exchangers were the next most efficient. The Pall device provided 18 and 23 mg/l (in 18 and 8 min respectively) and the Engstrom provided 20 and 23 mg/l (in 19 and 10 min respectively). In the circle system, there were no significant differences between the performances of the Portex, Siemens 151, Pall and Engstrom exchangers. The Pall is also a very effective bacterial filter and has been found to be satisfactory in the intensive care setting. The Terumo appeared to perform no better than a circle system with catheter mount (13 mg/l at 27 degrees C). It would seem that more complex humidification equipment is not necessary during anaesthesia if an efficient heat and moisture exchanger is used. PMID- 3661966 TI - Physical characteristics and clinical evaluation of a new disposable fibreoptic transducer-tipped catheter system. AB - A new disposable fibreoptic transducer-tipped catheter manometer system was evaluated to assess its accuracy, stability of accuracy under prolonged simulated intra-arterial conditions, and dynamic characteristics. Maximum errors observed in the measurement of static pressure using a sample of five catheters (with one display unit) were 2 mmHg at 0 mmHg reference pressure, 2 at 20 mmHg, 4 at 40 mmHg, 4 at 100 mmHg and 9 at 200 mmHg. An immersion artifact caused a shift in baseline of up to 2 mmHg. Exposure of the transducer to 24 hours of simulated intra-arterial conditions (pulsatile pressure at 40 degrees C) resulted in errors of up to 7 mmHg for pressures up to 100 mmHg, and 11 mmHg for 200 mmHg, which were largely attributable to a drift in baseline pressure (up 6 mmHg by 24 hours). Consistent overestimation by the system suggested inappropriate gain setting within the display unit which, however, is not user-adjustable. The system exhibited uniform frequency response up to 33 Hz. PMID- 3661968 TI - Left cardiac border central venous catheter malposition. PMID- 3661967 TI - Paradoxical reactions to benzodiazepines--a genetically determined phenomenon? PMID- 3661969 TI - Acute tracheoesophageal fistula following oesophageal tube removal during anaesthesia. PMID- 3661970 TI - Neonatal anaesthetic management of a patient with Goldenhar's syndrome with hydrocephalus. PMID- 3661971 TI - Intracranial subdural haematoma after spinal anaesthesia. PMID- 3661972 TI - Recurrent laryngeal nerve palsy following endotracheal intubation. PMID- 3661973 TI - The role of the anaesthetist in anaesthesia. PMID- 3661974 TI - Epidural opioids. PMID- 3661976 TI - An unusual leak. PMID- 3661975 TI - Intubation of the patient with cervical spine injury. PMID- 3661977 TI - Circuit leaks. PMID- 3661978 TI - Oxygen saturation in children during transit from operating theatre to recovery. PMID- 3661979 TI - A computerized version of the Chou and Fasman method for predicting the secondary structure of proteins. AB - A novel computerized program has been developed for predicting the secondary structure of proteins from their amino acid sequences. The scheme of the Chou and Fasman method (1978, Adv. Enzymol. Relat. Subj. Biochem. 47, 45-148) is closely followed. Some of their qualitative rules have been converted to numeric scales to obtain unambiguous predictions. This program has been tested on 21 proteins with known three-dimensional structures constituting a 4457 amino acids data base. The percentage of correctly predicted amino acids is between 41 and 66% for a three-state (helix, sheet, and coil) description of protein secondary structure. PMID- 3661980 TI - A new enzyme immunoassay of microsomal rat liver epoxide hydrolase. AB - Antiserum against purified rat liver microsomal epoxide hydrolase was produced in the rabbit. We developed an enzyme-linked immunosorbent assay which is reliable with regard to its analytical criteria. The concentration of epoxide hydrolase was measured in liver microsomes of control rats and animals treated with F 1379 (250 mg/kg/day) for 5, 7, 14, and 21 days. This hypolipidemic drug was able to induce strong epoxide hydrolase activity and enhance protein concentration. The gradual increase in epoxide hydrolase concentration paralleled the increase of epoxide hydrolase activity, with stabilization occurring after the 14th until the 21st day of treatment. PMID- 3661981 TI - Identification and quantification of 5-hydroxypipecolic acid and hydroxyproline in mammalian brain and blood by selected ion monitoring. AB - A method for the analysis of 5-hydroxypipecolic acid and 4-hydroxyproline in mammalian brain and blood is reported. The identification and quantification of the two hydroxyimino acids were accomplished with gas chromatography/mass spectrometry including a selected ion-monitoring technique following HPLC prepurification. The lower limit of detection for the method is 2 to 10 pmol. The amounts of 5-hydroxypipecolic acid and 4-hydroxyproline in blood were 20 to 30 pmol/ml and 3 to 6 nmol/ml, respectively. Their concentrations in the rabbit whole brain were determined to be 5 and 120 pmol/g, respectively. PMID- 3661982 TI - High-pressure stopped-flow fluorometry at subzero temperatures: application to kinetics of the binding of NADH to liver alcohol dehydrogenase. AB - A stopped-flow apparatus operating in fluorescence mode over temperature and pressure ranges of +30 to -30 degrees C and 10(-3) to 2 kbar, respectively, is described. The system was interfaced on a special spectrofluorometer. Its general design is an improvement of the previous instrument (C. Balny, J. L. Saldana, and N. Dahan, (1984) Anal. Biochem. 139, 178-189) in that the observation chamber and the driving mechanism have been modified. The application of the method to kinetics of the binding of NADH to horse liver alcohol dehydrogenase at subzero temperatures and as a function of hydrostatic pressure is described. PMID- 3661983 TI - Preparation and characterization of radioactive castanospermine. AB - A procedure for the preparation of tritiated castanospermine is described. The tritiated alkaloid was shown to be chromatographically identical to the native material and exhibited the same inhibitory properties. Radiolabeled castanospermine tightly bound to purified intestinal sucrase. Following gel chromatography, each mole of enzyme was shown to have bound 1 mol of the radioactive alkaloid. Cultured MDCK cells were also shown to take up the labeled castanospermine. This compound should be a useful tool in the investigation of enzymes that are responsible for the processing of glycoprotein oligosaccharides. PMID- 3661984 TI - Purification and spectroscopic properties of 124-kDa oat phytochrome. AB - A simplified procedure for the isolation and purification of 124-kDa phytochrome from etiolated Avena seedlings has been developed using the method of ammonium sulfate back-extraction. After hydroxyapatite chromatography of seedling tissue extracts, the pooled phytochrome was subjected to ammonium sulfate back extraction instead of the usual application to an Affi-Gel Blue column. The resulting phytochrome had specific absorbance ratios (SAR = A666/A280) ranging from 0.85 to 0.95. Subsequent Bio-Gel filtration chromatography yielded highly pure 124-kDa phytochrome with SAR values ranging from 0.99 to 1.13. The absorption maxima of 124-kDa phytochrome were at 280, 379, and 666 nm for the red absorbing form of phytochrome (Pr) and at 280, 400 and 730 nm for the far-red absorbing form (Pfr). The A730/A673 ratio in Pfr was found to be 1.5 to 1.6. The mole fraction of Pfr under red light photoequilibrium was 0.88. No dark reversion was detected within 5 h at 3 degrees C. A photoreversible far-uv-circular dichroism was observable with all phytochrome preparations examined. Fluorescence and phosphorescence lifetimes were measured to further characterize the differences between the phytochromes prepared under different conditions. The Trp fluorescence and phosphorescence lifetimes of Pr and Pfr with the chromophore "X", probably polyphenolic in nature, were significantly shorter than those of phytochrome without the contaminant X. The short lifetime of the fluorescence of the Pr chromophore is attributable to X in the former. PMID- 3661985 TI - Studies of lectin-carbohydrate interactions by quantitative affinity chromatography: systems with galactose and ovalbumin as saccharidic ligand. AB - The potential of affinity chromatography for characterizing lectin-carbohydrate interactions is investigated. First, the effect of galactose on the chromatographic behavior of Ricinus communis phytohemagglutinin on Sepharose 4B is used to establish that quantitative affinity chromatography on polysaccharide matrices affords an unequivocal means of characterizing the interactions of lectins with monosaccharides in solution. Second, a method of characterizing lectin-glycoprotein interactions by affinity chromatography is illustrated in an experimental study with Sephadex G-50 as affinity matrix for examination of the interaction between concanavalin A and ovalbumin. Third, although no general solution to the problem of ligand multivalency in quantitative affinity chromatography has been found, an experimental protocol has been devised for the situation in which the partitioning solute (lectin) is univalent. PMID- 3661986 TI - A homogeneous immunoassay for the mycotoxin T-2 utilizing liposomes, monoclonal antibodies, and complement. AB - The trichothecene mycotoxin T-2 is a fungal metabolite known to contaminate agricultural products and cause intoxication of humans and animals. We have developed a homogeneous competition inhibition assay for T-2 mycotoxin based on complement-mediated lysis of liposomes. The T-2 mycotoxin was converted to an acid chloride derivative, subsequently coupled to the amino group of phosphatidylethanolamine, and incorporated with the phospholipid into unilamellar liposomes. Carboxyfluorescein, which is self-quenched at high concentrations, was entrapped in the liposomes as a release marker. We used a monoclonal IgG1 antibody specific for T-2 mycotoxin and a polyclonal anti-mouse Ig as a secondary antibody since the anti-T-2 IgG1 does not activate complement. In the absence of free T-2, the liposomes were lysed within 30 min after the addition of complement, releasing carboxyfluorescein into the surrounding buffer. In the presence of free T-2 toxin, the binding of antibodies to the liposomes was reduced, causing a corresponding decrease in lysis. This assay proved to be sensitive to T-2 toxin levels as low as 2 ng, which is 10-fold more sensitive than the present enzyme immunoassay using the same antibodies. PMID- 3661988 TI - Determination of small quantities of sulfate (0-12 nmol) in serum, urine, and cartilage of the mouse. AB - The colorimetric benzidine method of K. S. Dodgson and B. Spencer (1953, Biochem. J. 55, 436-440) for the measurement of inorganic sulfate can be scaled down about 100 times by using disposable 96-well microplates instead of individual cuvettes. Ten-microliter samples of serum and urine, derived from mice, can be analyzed in a simple, rapid, and reliable way without sacrificing the animals. Without prior isolation of sulfated glycosaminoglycans, ester sulfate in mouse patellar cartilage is liberated quantitatively as inorganic sulfate upon acid hydrolysis in 3 M HCl for 16 h at 80 degrees C. To this end the articular cartilage layer of the patella must be separated in toto from the underlying bone. Subsequent hydrolysis in polypropylene tubes gives accurate results. In contrast, hydrolysis in borosilicate glass vials is useless, since nanomoles of sulfate added cannot be recovered adequately. The thin patellar cartilage layer obtained from 10-week old male mice contains about 5 nmol of sulfate, an amount easily measured with the developed microplate benzidine method. PMID- 3661987 TI - Estrogen receptor purification by affinity chromatography using an orange triazine dye. AB - A rapid two-step procedure was devised for the purification of the estrogen receptor from the calf uterus. A 900- to 1700-fold purification of the estrogen receptor was obtained using ammonium sulfate precipitation followed by dye affinity chromatography with Reactive Orange 14 immobilized to Sepharose. The Reactive Orange 14-Sepharose was used to purify the estrogen receptor in the presence or absence of estradiol as well as to purify the progesterone receptor. The purified estrogen receptor retained its estradiol- and DNA-binding properties and sedimented into sucrose gradients as the 5 S receptor dimer. The Reactive Orange 14-Sepharose is easily prepared and offers a higher yield and purity of the estrogen receptor than that afforded by estrogen- or heparin-Sepharose chromatography. PMID- 3661989 TI - A pyrene fluorescence technique and microchamber for measurement of oxygen consumption of single isolated axons. AB - Pyrene fluorescence is quenched by oxygen in an inverse and linear manner related to the partial pressure of O2 in solution. We have developed a microchamber for measuring QO2 of a single isolated axon, monitoring the change in fluorescence of a pyrene probe. The probe consists of a Spectra/Por dialysis hollow fiber filled with 2.5 mM pyrene in paraffin oil. The probe is inserted into a 1-mm-i.d. 2-cm long quartz capillary tube with a freshly isolated crayfish medial giant axon. The capillary is mounted in an apparatus that forms an air- and water-tight seal except for a 0.2-mm-i.d. stainless steel tube at both ends permitting the exchange of solutions. An Olympus inverted microscope, equipped with epifluorescence optics and a 150-W xenon lamp, is used to view the preparation, generate the excitation light, and monitor the emitted fluorescence with a photomultiplier tube placed in the microscope TV port. A dichroic filter unit is utilized to select an excitation wavelength of 350 nm and collect emitted light above 420 nm. The signal is amplified with a Keithley 480 picoammeter and recorded on a strip chart. QO2 of isolated axons was 552 +/- 70 X 10(-6) mol O2/liter tissue X min. Following sequential treatment with 2 mM ouabain and 2 mM NaCN, QO2 decreased by 22 and 82%, respectively. These data are consistent with QO2 measurements of whole nerve cord made with a Clark electrode O2 monitor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661990 TI - Separation and purification of S49 mouse lymphoma histones by reversed-phase high performance liquid chromatography. AB - A rapid reversed-phase high-performance liquid chromatography procedure for the fractionation of histones from S49 mouse lymphoma cells is reported. The system utilizes a Vydac C4 macroporous column, heptafluorobutyric acid as solubilizing and ion-pairing agent, and an acetonitrile gradient. All five histone classes and several subclass species are separated, including two H1 species, H2B, two H2A species, H4, and two H3 species. Analytical to multimilligram semipreparative scale fractionations are demonstrated while maintaining resolution of all histone types. PMID- 3661991 TI - Terbium identifies double-stranded RNA on gels by quenching the fluorescence of intercalated ethidium bromide. AB - We report that the lanthanide cation terbium quenches the fluorescence of ethidium bromide bound to double-stranded RNA by 40-fold, whereas the quenching of double-stranded and single-stranded DNA is under 2.5-fold and the quenching of single-stranded RNA is under 5-fold. This observation was used to develop a convenient method of detecting dsRNA among other nucleic acids in an agarose or polyacrylamide gel. The sensitivity of the method is approximately 4 ng/mm2. PMID- 3661992 TI - Disintegration of isolated cells. AB - A simple device has been developed for the disintegration of isolated cells in isotonic or hypertonic media. It is based on the extrusion of a cell suspension through a small orifice under controlled pressure. The diameter of this interchangeable orifice has to be adapted to the cell type to be disrupted. The conditions fulfill the requirements for an efficient disruption of the plasma membranes and for good preservation of the particularly fragile subcellular components, lysosomes and peroxisomes, of rat hepatocytes and rat Leydig cells. PMID- 3661993 TI - Electronic imaging system for direct and rapid quantitation of fluorescence from electrophoretic gels: application to ethidium bromide-stained DNA. AB - We have built an electronic imaging system based on a modified charge-coupled device television camera that directly quantitates the distribution of fluorescence from electrophoretic gels, chromatograms, and other stationary sources. Exposure times can exceed 1 min. Unlike the photographic system that it replaces, the response of the camera is directly proportional to the intensity of incident fluorescence, and image data are digitized and stored in computer memory ready for analysis immediately upon completion of an exposure. We describe procedures for the display, normalization, and archival storage of image data and programs that use images of ethidium bromide-stained DNA in alkaline agarose gels to quantitate single-strand breaks in DNA. PMID- 3661994 TI - A microtiter plate assay for protein kinase C. AB - We report the development of a microtiter plate assay for protein kinase C. Reaction components and enzyme samples (protein kinase C purified by phosphatidylserine/cholesterol affinity or DEAE-Sephacel ion-exchange chromatography) were added to wells of a 96-well microtiter plate. The assay was started by the addition of [gamma-32P]ATP with a repeating pipet. After a 3-min incubation at 30 degrees C the wells were sampled six at a time with a 12-channel pipet and spotted onto phosphocellulose filter paper rectangles which were washed with tap water and acetone and counted for radioactivity. The microtiter plate method was more rapid than but gave results similar to those of a standard assay performed in plastic test tubes individually incubated in a 30 degrees C water bath. The microtiter plate procedure gave an intraassay (within one plate) variation of less than 9% and an interassay (between plates) variation of less than 5%. It was linear with time of incubation for 20 min and with amount of enzyme. This method can be used to expedite the assaying of column chromatography fractions for protein kinase C (and other kinase) activity. PMID- 3661995 TI - Circuit for the electromanipulation of plant protoplasts. AB - An electric circuit for plant protoplast manipulation is described. The circuit used readily available materials and was designed for use in teaching. This integrated circuit can be placed in a single small box with controls for the aligning voltage, the aligning frequency, the pulse voltage, and the pulse timing. The circuit can be supplied by any suitable source of dc power and can be easily altered for individual requirements. The circuit, as presented here, can be assembled for less than $250. PMID- 3661996 TI - Fiftyfold amplification of the Lowry protein assay. AB - The blue product of the Lowry et al. (1951, J. Biol. Chem. 193, 265-275) reaction interacts with malachite green (MG), inducing a change in the visible light spectrum. At A690 nm the absorbance of malachite green solutions increases 10 fold in the presence of Lowry blue (LB). Under the optimum conditions, 0.01 A700 nm unit of Lowry blue produces a change in A690 nm unit of malachite green of 0.5 and the delta A690 nm is a linear function of Lowry blue concentration. Conditions under which this 50-fold amplification can be exploited to detect less than 100 ng of protein (or 4 micrograms X ml-1) are described. A number of chemicals including sodium dodecyl sulfate can interfere with the assay but a strategy has been devised to overcome these problems. Amplification of the Lowry assay appears to involve a cooperative interaction between malachite green and the Lowry blue product such that about 23 molecules of malachite green undergo a spectral shift per molecule of a model reactant such as tyrosine. Malachite green can be used to amplify the molybdenum blue signal obtained in other assays. Less than 10 pmol of tyrosine can be detected using this procedure. Lowry blue also interacts with auramine O, giving a large increase in A500 nm and a 40-fold amplification of the LB signal. As with malachite green, there is a cooperative interaction between auramine O and LB. About 72 molecules of auramine O undergo a spectral shift per molecule of tyrosine. The product of this reaction is also fluorescent and could be exploited in a protein assay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3661997 TI - A spectrophotometric assay for strictosidine synthase. AB - A spectrophotometric assay for strictosidine synthase is described. Strictosidine is extracted with ethyl acetate and, where high substrate concentrations are used, the organic extract is washed with dilute ammonia to remove coextracted secologanin; after evaporation of the solvent, the residue is heated with 5 M H2SO4 for 45 min and the A348 value is measured. Strictosidine production is calculated from the response of similarly treated standards. A minimum production of 10-25 nmol of strictosidine may be determined. The assay is demonstrated using extracts of cultured Cinchona ledgeriana cells. PMID- 3661998 TI - Structural analysis of N-linked oligosaccharides by a combination of glycopeptidase, exoglycosidases, and high-performance liquid chromatography. AB - A simple, sensitive, and rapid method for the analysis of structures of N-linked carbohydrates is reported. The method involves four steps: preparation of carbohydrate chains from glycopeptides by N-oligosaccharide glycopeptidase digestion; derivatization of the reducing ends of carbohydrate chains with a fluorescent reagent, 2-aminopyridine, by using sodium cyanoborohydride; separation of oligosaccharide derivatives by reverse-phase high-performance liquid chromatography; and structural analysis of oligosaccharides by sequential exoglycosidase digestion. The elution positions of 50 standard oligosaccharide derivatives were determined by HPLC. The structure of an unknown oligosaccharide can be characterized by comparison of its elution position with those of the standard compounds. The method was applied to elucidate the structures of oligosaccharides in the myeloma IgG protein, Yot. PMID- 3661999 TI - On the choice of laser dyes for use in exciting tyrosine fluorescence decays. AB - The choice of laser dyes for exciting tyrosine fluorescence using synchronously pumped cavity-dumped dye laser systems is discussed. Rhodamine 560 was found to be optimal for a system based on an argon-ion pumping laser, whereas rhodamine 575 was preferred using a frequency-doubled Nd:YAG laser. Modifications of our fluorescence decay instrument to permit rejection of multiphoton events using a microchannel plate photomultiplier are described. An example of a four-component resolution of tyrosine decays illustrates the dramatic resolution capabilities attainable. PMID- 3662000 TI - Poly-N-acryloyl-Tris gels as anticonvection media for electrophoresis and isoelectric focusing. AB - We describe in detail the synthesis of an acrylic monomer, N-acryloyl tris(hydroxy-methyl)aminomethane (NAT), which was successfully used for the preparation of gels for electrophoresis and isoelectric focusing. The polymerization kinetics and transparency of the poly(NAT) gels crosslinked by N,N'-methylenebisacrylamide (Bis) are also shown. Poly(NAT)-Bis gradient (4-24%) gel resolves proteins according to their size. The exclusion limit of this gel is slightly over 3 X 10(6), which is more than threefold higher than the exclusion limit of the polyacrylamide gradient gel of the same concentration. The gel made of 6% NAT and 3% Bis represents a suitable matrix for isoelectric focusing. These results demonstrate that poly(NAT)-Bis gels could be advantageously used in those applications where the extensive sieving by the polyacrylamide matrix is not desir desirable. PMID- 3662001 TI - Microsequence analysis of peptides and proteins. VI. A continuous flow reactor for sample concentration and sequence analysis. AB - We have designed and tested a continuous flow reactor (CFR) for microsequence analysis of peptides and proteins. The CFR forms the site for immobilization of the peptide or protein substrate and automated Edman chemistry. The CFR was constructed from 0.125-in.-o.d., 0.0625-in.-i.d. Teflon tubing (length 2-3 cm) containing 5-10 mg of Polybrene-coated, spherical, porous silica (100-200-micron particle size). The silica is retained in the CFR with porous Teflon filters (Zitex) at the bed bottom and optionally at the bed top. The i.d. of the CFR was selected for a tight press fit when 0.0625-in.-o.d. Teflon lines are inserted at the top and bottom of the CFR. This design allows the replacement of the existing cartridge/glass fiber disk found in conventional microsequencers with a CFR with a minimal amount of changes. The advantages of the CFR over the previous design include a lower background or noise level and no need to precycle Polybrene before sample application, and the entire unit is inexpensive and therefore disposable. We believe that the decrease in noise, especially the decrease in the commonly observed diphenylthiourea peak, is due to the more direct flow path and relative absence of unswept area in the CFR. Several standard peptides and proteins were sequenced in the CFR to demonstrate the improved results. A direct comparison to the cartridge/glass fiber disk design demonstrated less background and higher initial and repetitive yields for the CFR. An additional advantage is the ability to directly concentrate samples on CFRs containing reverse-phase packing. We have successfully concentrated 1.0-ml samples (200 pmol) onto 5 mg of octyldecylsilyl-derivatized silica in yields of 95-100%. The resulting samples were microsequenced after addition of Polybrene-coated silica to the CFR with high initial and repetitive yields. This methodology promises to improve sample handling and microsequence analysis of low picomole amounts of peptides and proteins. PMID- 3662002 TI - Microelectrode of the Thomas type using a liquid membrane electrode. AB - By replacing the glass-based pH electrode (L. R. Pucacco, S. K. Corona, H. R. Jacobson, and N. W. Carter (1986) Anal. Biochem. 153, 251-261) with a liquid membrane-based pH electrode, a relatively easy-to-manufacture modified Thomas electrode has been developed. The liquid membrane-based modified Thomas electrode can be manufactured without the special equipment (forge) and materials (glass) required to make the glass membrane pH microelectrode (L. R. Pucacco and N. W. Carter (1976) Anal. Biochem. 73, 501-512). The sensitivity (57.4 +/- 0.22 mV/pH unit), response time (20.0 +/- 2.67 s), and electrical resistance (3.48 +/- 0.67 X 10(11) ohm) of this electrode are similar to those of the glass-based version. PMID- 3662003 TI - A method for detecting protein-DNA interactions at sites of chromatin replication. AB - Two versions of an approach to identify DNA-protein interactions at sites of DNA replication in HeLa cell nuclei are described. In this procedure, newly replicated DNA chains are first labeled and photosensitized in vitro by the incorporation of [alpha-32P] dCTP and bromodeoxyuridine triphosphate, respectively. Irradiation with ultraviolet light is then used to covalently crosslink the proteins that are adjacent to the photosensitized and isotopically labeled strands of newly replicated DNA. After the bulk of the DNA is digested with nucleases, the crosslinked proteins--marked by short covalently linked radioactive DNA tags--are fractionated by electrophoresis in sodium dodecyl sulfate-polyacrylamide gels and detected by autoradiography. With this technology, certain proteins have been shown to associate selectively with newly replicated DNA. The method appears adaptable for application to a variety of problems involving DNA-protein association. PMID- 3662004 TI - Effects of blood standards on interlaboratory variation in the assay of blood selenium. PMID- 3662005 TI - Lithium/sodium ion concentration ratio measurements in blood serum with lithium and sodium ion selective liquid membrane electrodes. PMID- 3662006 TI - Trace determination of nitrogen-containing drugs by surface enhanced Raman scattering spectrometry on silver colloids. PMID- 3662007 TI - High-performance tandem mass spectrometry: calibration and performance of linked scans of a four-sector instrument. PMID- 3662008 TI - Identification of mutagenic methylbenz[a]anthracene and methylchrysene isomers in natural samples by liquid chromatography and Shpol'skii spectrometry. PMID- 3662009 TI - Sampling of airborne polycyclic aromatic hydrocarbons. PMID- 3662010 TI - Extraction and recovery of polycyclic aromatic hydrocarbons from environmental solids using supercritical fluids. PMID- 3662011 TI - Simultaneous determination of linear alkylbenzenesulfonates, alkylphenol polyethoxylates, and nonylphenol by high-performance liquid chromatography. PMID- 3662012 TI - Estrogen conjugates in late-pregnancy fluids: extraction and group separation by a graphitized carbon black cartridge and quantification by high-performance liquid chromatography. PMID- 3662013 TI - Composite ion exchanger for removal of sodium-24 in neutron activation analysis of biological materials. PMID- 3662014 TI - Recovery of picloram and 2,4-dichlorophenoxyacetic acid from aqueous samples by reversed-phase solid-phase extraction. PMID- 3662015 TI - Determination of methylmercury in fish by gas chromatography--direct current plasma atomic emission spectrometry. PMID- 3662016 TI - Rapid determination of chromium in bovine liver using an atomic absorption spectrometer with a modified carbon rod atomiser. PMID- 3662017 TI - Use of Fourier transform infrared spectroscopy for quantitative analysis: a comparative study of different detection methods. PMID- 3662018 TI - Extraction--spectrophotometric determination of sulphur oxide. PMID- 3662019 TI - Enzyme sensor for the determination of lactate and lactate dehydrogenase activity. PMID- 3662020 TI - Hydroxyproline in pork. Analytical Methods Committee. PMID- 3662021 TI - Routine spectrophotometric determination of citric acid in milk powders. PMID- 3662022 TI - Spectrophotometric determination of malathion with methylene blue. PMID- 3662023 TI - Coronary arterial anastomoses. Study of their distribution in adult hearts specially emphasizing the Crista supraventricularis area. AB - After examining 100 hearts belonging to subjects who at the time of death had no record of coronariopathy, the presence of anastomoses between the 2 coronary systems was confirmed in 96% of the cases. Intramyocardial anastomoses located in the Crista supraventricularis accounted for 76% of the cases, four main types are described. The fact that crestal anastomoses always connect both coronary systems (even in cases of left dominance) is their most outstanding characteristic. The possible usefulness of this type of anastomoses was finally discussed. It was suggested that they might serve as a safety mechanism which would join areas severely affected by arteriosclerosis to others not so seriously damaged. PMID- 3662024 TI - [Craniofacial growth modified by the blood supply. 7. Dry weight of the skull and growth of the mandible]. AB - The dry weight of the skull and jaw bone increases faster in operated rats than in the controls during the fourth and 12 months, but their rates of growth do not differ in the 8th month. The distances measured on the mandible reveal definite sexual dimorphism in the development of the different lengths and heights, these distance being greater in the male rats. Growth in the length of the processes predominated over the growth of the body of the mandible. Local changes in the bone were observed at the points of origin and attachment of muscles. PMID- 3662025 TI - [Venous supply of the surface of the brain in cattle]. AB - The areas of venous vascularisation of the brain of the cattle have been shown by corrosion-anatomical methods and Chinese ink-gelatine injections. With the exception of the V. basalis medullae which connects with the veins of the vertebral plexus all the veins of the brain flow together into the dorsal system of sinuses. PMID- 3662026 TI - The adrenergic and AChE-positive nerves in pig vagina. AB - The experiments were performed on 5 sexually immature and 6 mature pigs. The segments of vagina were collected and then cut by means of a freezing microtome. The adrenergic nerves were detected according to Torre and Surgeon's (1976) glyoxylic method, and examined under a fluorescent microscope. Presence of AChE positive fibers was detected using Karnovsky-Roots (1964) method. Both the adrenergic and the AChE-positive fibres were found in all layers of vaginal and around the blood vessels. As results from the studies, pig vagina is much more innervated with AChE-positive nerves than with adrenergic ones. Distribution pattern of these fibers is similar in all layers of the vagina. No differences were found between innervation of vagina in sexually mature and immature pigs. PMID- 3662027 TI - Methotrexate neuroenteropathy--a histochemical study. AB - 10 mg/kg Methotrexate was injected daily for 5 d a week for a total period of 3 weeks and its effect on autonomic nerve profiles of jejunum was studied using histochemical methods. Initially (after 5 doses in a week) partial degeneration of adrenergic and cholinergic nerve supply was observed. Prolonged treatment (15 does in 3 weeks) was responsible for disappearance of about 30% of adrenergic and 50% of cholinergic nerve profiles. Early degenerative changes in the cholinergic nerve cells of the intestinal plexuses was also noted. PMID- 3662028 TI - Some biomechanical aspects of the structure of the equine tarsus. AB - The morphology of the bones of the equine tarsus has distinct kinematical and kinetic implications which are primarily expressed in the helical motion of the talocrural joint and in the transmission of forces by the rigid conformation of the subtalar articulations. PMID- 3662029 TI - Functional anatomy of the tela submucosa of the valva ileocecalis in the adult man. AB - The collagen and elastic fibres of the tela submucosa and their relationships with the tunica muscularis in the human ileocecal valve were studied in 61 anatomic specimens of adult individuals, using meso- and microscopical technics. 2 fibrous components were described: one intrafascicular, which arises from the muscular bundles, and another, interfascicular, which coming from the connective intermuscular layer of the tunica muscularis, pass between the annular bundles toward the tela submucosa. In the tela of the terminal ileum these fibrous components form, like the muscular bundles of the annular layer, a "polar" system, which vanishes at the level of the "marginal sphincter" and in the cecocolic aspect of the ileal papilla. A system of muscular-elastic-collagen bundles is described in these 2 last portions, extending from the tunica muscularis toward the tela submucosa. 2 patterns of arrangements were observed in the tela submucosa: one lamellar, in the terminal ileum and part of the ileal papilla, and another areolar, in the apex and part of the cecocolic aspect of the papilla. A morphometric study was performed in order to estimate the distribution of fat cells in the tela submucosa of the ileocecal valve. It revealed a gradual increase of fat cells amount toward the apex and cecocolic aspect of the papilla ilealis. Some morphofunctional considerations are made, concerning the ileocecocolic junction control. PMID- 3662030 TI - Effects of neonatal gonadectomy on structure of the bursa of fabricius in the chicken. A light histoquantitative study. PMID- 3662031 TI - [New contributions to the macroscopic and ultrastructural study of renal irrigation in the fighting bull]. PMID- 3662032 TI - Histological and histochemical characterization of the bovine rete ovarii through the estrous cycle and gestation. PMID- 3662033 TI - [Contribution of the ventral cervical branches to the innervation of the rhomboideus, serratus ventralis and trapezius muscles in domestic mammals. I. Dog, cat and pig]. PMID- 3662034 TI - Formaldehyde vapor levels in a gross anatomy laboratory during dissection of the dog. PMID- 3662035 TI - Evidence of lamina muscularis mucosae in rumen of buffalo (Bubalus bubalis). PMID- 3662037 TI - XVI Congress of the European Association of Veterinary Anatomists, Budapest, 24 29 Aug. 1986. Abstracts. PMID- 3662036 TI - [The will and knowledge of animals as topics of theoretical research on evolution]. PMID- 3662038 TI - [Morphological development of the seminiferous epithelium of the pig at different ages (Sus scrofa of the Landrace strain)]. PMID- 3662039 TI - Endocytosis and vesicular traffic in fetal and adult colonic goblet cells. AB - Structural and functional differences between adult and fetal colonic goblet cells have not been clearly defined. To compare the binding, uptake, and intracellular pathway of internalized apical membrane in fetal and adult goblet cells, cationic ferritin (CF) was used as a nonspecific probe. The initial distribution of membrane anionic sites was determined in segments of proximal and distal colon from fetal (18-22 days) and adult rats that were fixed prior to a 10 minute exposure to CF at 4 degrees C. Uniform binding along the apical membrane and microvilli was noted at all ages. To assess uptake and intracellular transport, segments of proximal and distal colon from fetal and adult rats were exposed to CF for 10 minutes at 4 degrees C prior to a saline wash and incubation in saline or Liebovitz L-15 medium for 3, 6, 15, 30, or 60 minutes at 37 degrees C. In addition, fetal rats between 18 and 22 days gestation (birth) were exposed to CF continuously for 10-30 minutes via an intracaecal injection. The results showed extensive uptake of CF in the fetal goblet cells and a more variable intracellular pathway than in with the adult. Within 3 minutes, numerous CF positive vesicles and tubules were present within the apical cytoplasm as well as interspersed among the secretory granules of the fetal goblet cell. Most of these vesicles were smooth surfaced, although some were coated. By 15 minutes, CF was frequently seen in multivesicular bodies, and occasionally in vacuoles in the vicinity of the Golgi. No CF was detected in Golgi cisternae.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662041 TI - Analysis of crystallite shape in rat incisor enamel. AB - The hydroxyapatite crystallites of mammalian enamel appear as hexagons when seen in cross-sections examined with the transmission electron microscope. Using goniometric transmission electron microscopy, stereo-pair electron micrographs and freeze-fracture replicas, two models have been proposed to explain the hexagonal crystallite profile. The "hexagonal ribbon" model proposes that hexagonal profiles are true cross-sections of elongated hexagonal ribbons. The "rectangular ribbon"model proposes that crystallite profiles are three dimensional rectangular segments (parallelepipeds), which are contained in the Epon sections and project as opaque hexagons in routine transmission electron micrographs. Morphological observations together with predictions from models indicate that the crystallites in rat incisor enamel are flat ribbons with rectangular cross-sectional profiles. The hexagonal images seen in electron micrographs of thin sections of enamel result from viewing parallelepiped-shaped segments of these crystallites as two-dimensional shadows. PMID- 3662040 TI - Regeneration of submandibular gland autografts in sympathectomized rats. AB - This morphologic study compares the regenerative response in submandibular gland (SMG) autografts placed in the tongues of previously sympathectomized rats to autografts placed in tongues of sham-sympathectomized rats. We hypothesized that sympathectomy would alter the process of cellular proliferation and inhibit cytodifferentiation in regenerating SMG autografts. Either 1 week, or 8 to 11 weeks following the SMG autografting procedure, the rats were sacrificed and their tongues were removed and sectioned in a cryostat. Frozen tissue sections containing the SMG autografts were either reacted for cholinesterase activity, treated with a glyoxylic acid mixture to induce histofluorescence, or stained for histologic examination. In addition, 3H-thymidine labeled and unlabeled cells were counted in autoradiographs of 1-week autografts, and these counts were used to calculate labeling indices. The 1-week SMG autografts from both the sympathectomized and the sham-sympathectomized rats were similar in histologic appearance, and neither group of autografts contained cholinesterase-positive or monoaminergic nerve fibers. The 8- to 11-week autografts from sympathectomized and sham-sympathectomized rats contained cholinesterase-positive fibers, but monoaminergic fibers were present in the autografts only from the sham-operated rats. Acinar cells were observed in one-third of the 8- to 11-week autografts of both the sympathectomized and sham-sympathectomized rats. This finding suggests that sympathectomy did not prelude cytodifferentiation in the autografts. The autoradiographic data revealed no statistically significant difference between the mean labeling indices of the 1-week autografts from the sympathectomized and sham-sympathectomized rats, which suggests that sympathectomy also did not alter the level of cellular proliferation in the autografts. PMID- 3662042 TI - Systematic distribution of muscle fiber types in the medial gastrocnemius of the laboratory mouse: a morphometric analysis. AB - Midbelly cross sections of the medial gastrocnemius muscle of young adult male laboratory mice were subjected to ATPase histochemistry with preincubation at pH 4.6. Through the use of a sampling grid and computer-assisted morphometric analysis, 26 to 35% of the total muscle fibers were sampled and classified as type I, IIa, or IIb. Photomicrographs (16 X 20 in.) of five muscles were divided into octants according to a standardized procedure. Total fiber counts and percent of fibers sampled were determined. Variability of sample size per octant was noted, but when averaged across entire muscles, it was in all instances greater than 33%. Fiber type frequency per octant was tested for goodness of fit to a random model by means of a chi-square statistic for equal expected frequencies. Deviation from random fiber type frequency was significant at the P = 0.001 level for every muscle. More importantly, when these data were pooled and again tested using the same method, the probability estimate was less than P = 0.001. This established that the variations in the fiber type proportions found in each mouse followed a common pattern. The systematic fiber type distribution confirmed by these morphometric and statistical methods supports the impression expressed by many muscle biologists that this muscle displays a consistent and complex intramuscular organization. PMID- 3662043 TI - Morphology of the carotid sinus wall in normotensive and spontaneously hypertensive rats. AB - The morphology of the carotid sinus region of the internal carotid artery was studied in spontaneously hypertensive rats (SHR) at 5, 8, 16, and 24 weeks of age. The carotid sinus region occupied the proximal millimeter of the internal carotid artery, and was easily recognizable by the presence of an extensive adventitial capillary plexus, which was absent on adjacent arteries (e.g., common and external carotid arteries). Methylene blue-stained whole-mount preparations showed the extent of baroreceptor nerves over the sinus. Baroreceptor fibers terminated in distinctive bulbous-like endings, which, at the ultrastructural level, were filled with mitochondria. No differences were noted in the sinus adventitial capillary network or baroreceptor distribution between SHR and age matched Wistar-Kyoto (WKY) normotensive control animals. With the onset of a significant rise in SHR blood pressure, the carotid sinus wall increased in thickness and total vessel size. The wall/lumen ratios were significantly larger in the SHR than in age-matched WKY ratios in all age groups. SHR carotid sinus vessel enlargement was uniform throughout the vessel tunics, with no significant change in the proportion of the tunica media occupied by smooth muscle cells. The increase in the carotid sinus wall thickness associated with increasing hypertension could affect the ability of the sinus to distend and may play a secondary role in the maintenance of hypertension by compromising baroreceptor nerve ending sensitivity. PMID- 3662044 TI - Morphogenesis of the truncus arteriosus of the chick embryo heart: movements of autoradiographic tattoos during septation. AB - In order to trace tissue movements during septation of the embryonic truncus arteriosus into aortic and pulmonary cardiac outlets, the cephalic margin of the developing tubular heart of chick embryos was tattooed at Hamilton-Hamburger Stages 20-22 using diffusion micropipettes filled with 0.5% agarose and radioactive macromolecular precursors (tritiated thymidine, uridine, and leucine). Following further incubation for 2, 48, or 96 hours, the locations of such tattoos were determined by autoradiography of sectioned tissue and computer reconstruction of the developing outflow tract. Two hours after tattooing, radiolabeled cells were clustered at the right distal margin of the myocardial tube, as intended. Two days later, during septation of the outflow tract into the two arterial streams, label was concentrated along the posterior margin of the myocardium, between the developing aortic and pulmonary valve anlagen to the embryo's right and left, respectively. Four days following tattooing, as truncal septation neared completion, remaining label was found primarily to the left of the aortic valve ring posterior to the pulmonary outlet. The movements of thymidine tattoos during septation were demonstrated in a series of 31 embryos, 14 fixed at 2 hours, 12 at 2 days, and 5 at 4 days following tattooing; similar results were seen in uridine and leucine labeled hearts. The motion of such tattoos in the developing chick heart suggests that the left side of the definitive semilunar valve ring derives from the right distal margin of the primitive tubular heart and that normal morphogenesis of the great arterial streams involves both retraction and rotation of the embryonic truncus arteriosus. PMID- 3662045 TI - Effect of optic nerve denervation on lens regeneration in adult newts, Triturus viridescens. AB - This experiment was designed to study the effect of optic nerve denervation on lens regeneration. Adult newts, Triturus viridescens, were divided into 4 groups: A) lentectomized newts, which served as controls, B) lentectomized newts with the optic nerve exposed and lightly palpated, C) newts with lens removed and the optic nerve cut simultaneously, and D) newts with lens removed first and optic nerve cut 7 days and 14 days later. Control animals required about 21 days to produce a new lens, and animals in group B demonstrated the same regeneration rate. In groups C and D, the regeneration rate was greatly retarded during the first 14 days. However, most of these animals regenerated a perfect new lens by 21 days postlentectomy. PMID- 3662046 TI - Neurulation in the mouse. I. The ontogenesis of neural segments and the determination of topographical regions in a central nervous system. AB - Ontogenesis of neural segments and positional relationships between the segments and other organs during neurulation were studied in 1,423 ICR mouse embryos by binocular dissecting, light, and scanning electron microscopy. Late in the presomite stage, two transverse sulci, preotic and otic, were seen on the prospective luminal surface of the neural folds. By somite stage 19, the former subdivided into five neuromeres, and by somite stage 21, the latter subdivided into four neuromeres. From the rostral, preotic sulcus, moreover, five other neuromeres were formed by somite stage 20, and between the otic sulcus and the first somite, two neuromeres were formed by somite stage 28. In the caudal part, from the level of the first somite, a total of 39 neuromeres were formed one after another by somite stage 39, and their positions almost correlated with each corresponding somite. Furthermore, the isthmus grew in the boundary between the fifth and sixth neuromere. The most protruding zone in the preotic sulcus formed the eighth neuromere and was located adjacent to the first branchial arch and the trigeminal ganglion. The most protruding zone in the otic sulcus also formed the 11th neuromere and was located adjacent to the second branchial arch. The 12th and 13th neuromeres were situated adjacent to the otic vesicle; the 23rd to 28th neuromeres, adjacent to the forelimb bud; and the 40th to 46th neuromeres, adjacent to the hindlimb bud. PMID- 3662047 TI - The effect of nerve section on the incidence and distribution of gap junctions in the odontoblast layer of the cat. AB - Gap junctions are numerous in the odontoblast layer of the dental pulp and may link sensory axons to odontoblasts. If these junctions do link axons and odontoblasts, they, together with the axons, should disappear after cutting the pulpal nerves centrally. Under general anesthesia the inferior alveolar nerve on one side of two young adult cats was sectioned. Under general anesthesia the animals were perfused with fixative 56 hours later and the coronal dental pulp prepared for electron microscopy. Ultrathin sections were examined from the level of the pulpal cornu and levels approximately one, two, and three mm below this. The incidence of cell processes and gap junctions was measured at different distances from the pulp predentin junction, and operated and control sides compared. The odontoblast layer at the level of the cornu differed from elsewhere in having, on the control side, a greater density of cell processes and gap junctions and in having clearly recognizable axons approaching to within 5 to 10 micron of the predentin. The only statistically significant changes after nerve section occurred in this layer and consisted of a decline in the incidence of cell processes and of gap junctions that link one cell process to another. There was no significant difference between the operated and control sides in the number of gap junctions linking cell processes to recognizable cell bodies. The odontoblast layer in the pulpal cornu contained substantial numbers of unsheathed axons, many presumably en route to the dentin. These axons may participate in gap junctions that link them to other cell processes, possibly even other axons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662048 TI - Pericytes in human cerebral microvasculature. AB - Two classes of pericytes are thought to exist in cerebral microvasculature, granular and agranular. This classification is based on the presence or absence of cytoplasmic, lysosome-like granules of variable size and appearance. The pericytes in structurally normal human brain tissue from 17 patients, male and female, ranging in age from 14 to 77, were examined. Light microscopic examination of single sections revealed that 67% of pericyte profiles contained granules in both sexes, and this ratio did not change with age. Following the serial reconstructions of 80 individual pericytes, it was found that all contained characteristic cytoplasmic granules. These data show that if truly agranular pericytes do exist in human cerebral microvasculature, they must constitute less than 5% of the population. PMID- 3662049 TI - [Spermatologic studies in 300 patients with varicocele of different degrees of severity and in various age classes]. AB - Spermatologic investigations were made in 227 patients with varicocele at the age of 19-23 years (average age 20.4 years) and in 73 patients with varicocele at the age of 24-40 years (average age 28.0 years). The spermatologic findings of the patients with varicocele were compared with the results of 55 andrologic healthy young men without varicocele. The diverse degrees have a different effect to the sperm quality. Only patients with the clinical signs of the varicocele orchidiopathy present a decreased sperm quality. The degree varicocele combined with other testicular disorders shows the worst sperm quality. The results in the higher age group explain, that the damage of the testicle increases with longer duration of the varicocele. Differentiating the spermatozoal morphology according to the "Dusseldorf morphological classification" you can find characteristic forms with hyperelongation of the head in patients with varicocele and spermatozoa with acrosomal defects in the degree varicocele combined with other testicular disorders. PMID- 3662050 TI - [Morphologic studies of spermatozoa in disorders of motility]. AB - On the basis of microscopical examination and further differentiation by special stain techniques, a new classification of defects of midpieces and tails of spermatozoa will be presented: First degree disorders i.e. abnormalities of the staining behaviour and minor structural defects, second degree disorders revealing breakes and coiling of spermatozoa tail, and finally severe third degree disorders only exhibiting a rudimentary anlage of the terminal segment of spermatozoa. The staining abnormalities of the first degree disorders are characterized by nonreactivity to the Polychrome stain of the Papanicolaou technique as well as to scarlet red stain of the Shorr technique. Although the majority of these spermatozoa do not exhibit morphological aberrations, they have to be regarded completely immotile. Considering this classification, we have observed a highly significant correlation between morphological findings of midpieces and tails and the total motility as well as the progressive motility of spermatozoa. PMID- 3662051 TI - Activity and localization of NADH-dependant oxidoreductase (diaphorase) in boar spermatozoa. AB - Investigations were carried out into the activity and localization of NADH dependant diaphorase in boar spermatozoa. Semen samples were collected from healthy boars, used in A.I. centers. The enzyme was extracted with distilled water and Triton X-100. Two forms of diaphorase were found-water-soluble and Triton X-100 soluble, showing low activity-0.36 U/ml and 0.26 U/ml. The enzyme was localized in the mitochondria, manifesting different intensities of reaction between sperm cells in the same ejaculate. It was found, that a part of the mitochondria and outer doublets showed positive reaction. It is suggested that the enzyme regulates the ratio between reduced and oxidized forms of NADH, takes part in the energy balance and possibly in the mechanism of sperm motility. PMID- 3662052 TI - Effects of isoflurane on myocardial blood flow, function, and oxygen consumption in the presence of critical coronary stenosis in dogs. AB - Because isoflurane has been reported to produce coronary steal, we studied 12 open chest, anesthetized (pentobarbital) dogs with critical stenosis (CS) of the left circumflex coronary artery (LCA). Sonomicrometers were implanted to measure systolic wall thickening, myocardial blood flow (MBF) was measured with microspheres (15 microns diameter), and regional venous sampling was performed to estimate regional oxygen extraction and myocardial oxygen consumption (MVO2). Anesthetic concentrations of isoflurane reduced arterial blood pressure dramatically, resulting in a maldistribution of MBF distal to the CS consistent with the pattern characterizing a transmural coronary steal effect. Elevation of arterial blood pressure with phenylephrine during high concentration isoflurane (1.7 +/- 0.1%) augmented MBF, but the maldistribution distal to the CS persisted. Despite the maldistribution, however, there was no indication of ischemia in the LCA region because systolic wall thickening, oxygen extraction, and MVO2 were not significantly different between the LCA and left anterior descending coronary artery (LAD) (control) areas. Because wall thickening, oxygen extraction, and MVO2 were markedly reduced by isoflurane in both the LCA and control areas, it was concluded that isoflurane substantially reduced myocardial oxygen requirements by inducing myocardial depression, reducing heart rate, and decreasing afterload. Consequently, the apparent maldistribution of LCA blood flow (coronary steal) was due to the hemodynamic and vasodilatory effects of isoflurane, but did not result in ischemia because the level of blood flow was at or above the requirements of the myocardium. PMID- 3662053 TI - The effect of nitrous oxide on cortical cerebral blood flow during anesthesia with halothane and isoflurane, with and without morphine, in the rabbit. AB - The effect of nitrous oxide on cortical cerebral blood flow (CBF) was examined during a varying background anesthetic state in the New Zealand White rabbit. Seventy percent nitrous oxide resulted in significant and similar increases in CBF during anesthesia with both 0.5 MAC of halothane (44 +/- 14 to 63 +/- 17 ml.100 g-1.min-1) (mean +/- SD) and anesthesia with isoflurane (34 +/- 9 to 41 +/ 11 ml.100 g-1.min-1). During anesthesia with 1.0 MAC halothane or isoflurane, N2O also increased CBF, but the increments (halothane, 73 +/- 34 to 111 +/- 54 ml.100 g-1 min-1; isoflurane 34 +/- 13 to 69 +/- 34 ml.100 g-1.min-1) were significantly greater than those observed at 0.5 MAC. When 0.5 MAC halothane or isoflurane was supplemented with morphine (10 mg/kg followed by an infusion of 2 mg.kg-1.min-1), the CBF effect of N2O was not significantly different from that observed with 0.5 MAC alone. It was concluded that, in the rabbit, the effects of N2O on cortical CBF vary with the background anesthetic state and that the increase in CBF caused by N2O becomes greater as the end-tidal concentration of halothane or isoflurane increases from 0.5 to 1.0 MAC. Morphine, when added to 0.5 MAC of halothane or isoflurane, does not alter the effect of 70% N2O on cortical CBF. PMID- 3662055 TI - Spinal anesthesia with hyperbaric lidocaine and bupivacaine: effects of epinephrine on the plasma concentration profiles. AB - The effects of epinephrine on the plasma concentration profiles and some derived pharmacokinetic parameters were studied after subarachnoid injection of hyperbaric lidocaine and bupivacaine solutions. Addition of epinephrine to the local anesthetic solution reduced the mean peak plasma concentration of lidocaine from 526 to 376 ng/ml, but did not significantly reduce the mean peak plasma concentration of bupivacaine (70 vs 56 ng/ml). Epinephrine did not affect the times at which the peak concentrations were reached, the terminal half-lives, or the total plasma clearances. The observed effects of epinephrine on the peak plasma concentrations are consistent with the vascular activity of lidocaine and bupivacaine, respectively. PMID- 3662054 TI - Cardiovascular responses to acute loading with nifedipine alone and nifedipine plus propranolol during inhalation anesthesia in monkeys. AB - The cardiovascular effects of the administration of nifedipine and nifedipine combined with propranolol were examined in 15 monkeys during 0.75 and 1.25 MAC of anesthesia with isoflurane, enflurane, or halothane. Hemodynamic variables measured included heart rate (HR), mean arterial pressure (MAP), left ventricular end-diastolic pressure (LVEDP), maximum rate of increase of the Left ventricular pressure (max LV dP/dt), and thermodilution cardiac output (CO). The infusion of nifedipine at a rate adequate to produce therapeutic blood levels during 0.75 MAC with each anesthetic decreased MAP and SVR, but had no effect on cardiac index (CI), max LV dP/dt, or HR. Increasing the anesthetic concentration from 0.75 to 1.25 MAC during nifedipine administration decreased HR and MAP in all groups and decreased CI with halothane and enflurane, but not with isoflurane. Addition of propranolol by infusion in amounts adequate to produce 75% beta-adrenergic blockade caused a further depression of CI, max LV dP/dt, HR, and MAP. However, the hemodynamic depression was significantly greater with halothane and enflurane than with isoflurane. Intravenous administration of calcium chloride (10 mg/kg) after calcium channel and beta-adrenergic blockade only partially reversed the hemodynamic depression that occurred with all three anesthetics. It was concluded that acute loading with nifedipine with and without propranolol exerts a greater cardiovascular depressant effect during enflurane or halothane anesthesia than during isoflurane anesthesia. The myocardial depressant effects of nifedipine and propranolol myocardial depressant effects of nifedipine and propranolol may be synergistic with the depressant effects of potent inhalation anesthetics. PMID- 3662056 TI - Antagonism of postoperative opioid-induced respiratory depression: nalbuphine versus naloxone. AB - The authors compared naloxone and nalbuphine as antagonists of opioid-induced respiratory depression to determine the relative efficacies and safety of the two agents. In a double-blind, randomized fashion, 90 anesthetized patients received a mean dose of 25 micrograms/kg fentanyl during surgery. Inadequate spontaneous respirations at the end of anesthesia were treated with either naloxone 0.08 mg or nalbuphine 2.5 mg IV every 2 min while heart rate (HR), systolic and diastolic blood pressures (SBP, DBP), respiratory rate (RR), and tidal volume (TV) were measured at 2-min intervals. Arterial blood samples for analysis of PaCO2, PaO2, and pH were drawn when spontaneous ventilation resumed, and 30 and 60 min later. Narcotic antagonism and respiration were deemed adequate when TV was greater than or equal to 4 ml/kg and RR greater than or equal to 8 breaths/min. Heart rate, SBP, DBP, TV and RR were recorded, as were the occurrence of renarcotization (RR less than 8) and analgesic requirements every 5 min during the recovery room stay. Sixty of 90 patients required narcotic antagonism at the end of surgery. No patient required more than three doses (0.24 mg) of naloxone or four doses (10 mg) of nalbuphine. Both antagonists produced similar and moderate increases in SBP and HR while restoring adequate spontaneous ventilation. There were no significant differences in TV, RR, or arterial blood gases (ABGS) between the two groups after narcotic reversal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662057 TI - Venous air embolism and active lung inflation at high and low CVP: a study in "upright" anesthetized sheep. AB - To assess the safety and efficacy of the maneuver of active lung inflation (ALI) after venous air embolism, measurements were made of pulmonary artery occlusion pressure (PAOP), central venous pressure (CVP), and superior jugular bulb pressure (JbP) as an index of cerebral venous sinus pressure in eight sheep before and after a 2-ml/kg air embolus and before and in the release phase of an ALI to a pressure of 4 kPa (30 mm Hg). (PAOP-CVP) difference decreased significantly after the air embolus with a further decrease after ALI (P less than 0.01). An increase in JbP occurred with ALI only when the CVP was elevated before the injection of air. After air embolism in neurosurgery, ALI may increase the likelihood of paradoxical embolism in patients at risk and may also fail to help in identifying the site of air entry. PMID- 3662058 TI - Embolized air collection in the superior vena cava of "upright" sheep. AB - In 34 studies on six "upright" anesthetized sheep central venous pressure from sites in the upper and lower superior vena cava (SVC) was recorded before, during, and after the injection into a neck vein of 1-ml increments of air every minute for 15 min. After the injection of air, the pressure recorded from the upper site increased significantly. This increase was the result of air collecting in the SVC with a consequent loss or partial loss of the SVC hydrostatic pressure difference. The time of onset and the duration of collection were not influenced by hyper- or hypovolemia nor by 1 kPa positive end-expiratory pressure. The readily identifiable change in the venous pressure in the upper SVC provided an earlier and more reliable warning of these small-volume air emboli than did a Doppler probe directed at the right side of the heart. PMID- 3662059 TI - Incidence of hypotension associated with epidural anesthesia using alkalinized and nonalkalinized lidocaine for cesarean section. AB - The onset of epidural anesthesia is accelerated by alkalinization of lidocaine with added epinephrine (LE). The possibility that decreases in systolic blood pressure (SBP) are also enhanced was studied in 21 patients having elective cesarean sections. Ten patients given LE + NaHCO3 (0.1 mEq/ml anesthetic solution) compared with 11 given LE alone had significantly (P less than 0.05) greater decreases in SBP (32% vs 19% from baseline values), as well as a greater rate of SBP decline to those minimum values (9%/min vs 3%/min, respectively). These differences were noted despite the fact that patients given LE + HCO3 received no less ephedrine and no more additional anesthetic than controls. Possible adverse effects of SBP reduction on uteroplacental blood flow suggest that caution be used in the use of alkalinized LE in obstetrical patients. PMID- 3662060 TI - The effect of ketanserin on blood pressure and platelets during cardiopulmonary bypass. AB - Ketanserin, a serotonin antagonist, was used to control blood pressure during cardiopulmonary bypass in 12 patients having cardiac surgery. The drug was administered as a 10 mg bolus followed by a continuous infusion of either 40, 80, or 120 mg/hr to maintain mean arterial blood pressure below 70 mm Hg. There were 16 hypertensive episodes of which 15 (93.7%) were successfully controlled with ketanserin. Mean arterial pressure decreased significantly from an average of 72 +/- 3 to 52 +/- 9 mm Hg after 1 min. The effect that ketanserin had on platelets was also evaluated. Neither adverse nor salutary effects were seen in the platelet count, though a significant inhibition of serotonin-induced platelet aggregation was observed. Ketanserin proved effective for controlling hypertension during cardiopulmonary bypass but, despite inhibition of serotonin induced platelet aggregation, it did not prevent thrombocytopenia. PMID- 3662061 TI - Comparison of midazolam and thiopental for rapid sequence anesthetic induction for elective cesarean section. AB - Sixty healthy mothers undergoing elective cesarean section received at random either midazolam 0.2 mg/kg or thiopental 3.5 mg/kg with succinylcholine 1 mg/kg for rapid sequence intravenous anesthetic induction. Maintenance of anesthesia was identical in all patients: 50:50 N2O in oxygen, halothane 0.5% and pancuronium 0.05 mg/kg. Hemodynamic responses were similar, as were the biochemical status of mothers and infants, and maternal to fetal blood gas/acid base gradients. Correlation between maternal arterial and fetal (umbilical venous/arterial) pH, PCO2 and base excess values were statistically better with midazolam. However, 1-min Apgar minus color (A-C) scores less than 5/8 (representing "severe" neonatal depression) were recorded in five infants after midazolam, three of whom required tracheal intubation, and one whose mother was given thiopental. This difference reached statistical significance (P less than 0.05). It is concluded that midazolam is less suitable than thiopental for anesthetic induction in patients undergoing cesarean section. PMID- 3662062 TI - Dezocine-MAC reduction and evidence for myocardial depression in the presence of enflurane. AB - The effect of dezocine, an agonist-antagonist opioid analgesic, on enflurane MAC (EMAC) was measured in dogs and, in a separate study, the hemodynamic effects of IV bolus doses of dezocine in the presence of a stable end-tidal enflurane concentration were measured. Study 1 (n = 8)--EMAC Reduction: Dezocine reduced EMAC in a dose-dependent fashion by a maximum of 58 +/- 3% (mean +/- SEM) after injection of 20 mg/kg. Cardiac toxicity prevented administration of higher doses. Study 2--Hemodynamics: Group 1 (n = 7) received dezocine 0.2, 1.5, 5, and 20 mg/kg IV each as a bolus over 30 sec. Group 2 (n = 5) was studied in exactly the same manner except that instead of dezocine, each dog received drug carrier solution alone (carrier). Significant hemodynamic differences between carrier and drug groups were observed only at the 20 mg/kg dose level, which produced death in one dog and a decrease in mean aortic pressure to 39 +/- 5% of baseline, in cardiac output to 60 +/- 9% of baseline, and in stroke volume to 69 +/- 9% of baseline in the remaining dogs. It is concluded that dezocine produces a dose dependent reduction in EMAC limited by cardiovascular toxicity. This toxicity appears to be related to direct myocardial depression by high doses of dezocine in the presence of enflurane. PMID- 3662063 TI - Analgesic doses of epidural morphine do not affect local glucose utilization in the spinal cord in rats. AB - The possibility of association between changes in spinal cord metabolism and changes in spinal cord neuronal activity by injection of morphine into the epidural space in amounts adequate to produce analgesia was examined. Fourteen Wistar rats were equally divided into two groups: a morphine group (epidural, 15 micrograms) and a control group (saline). Using the 2-[14C] deoxyglucose method, glucose utilization was measured in the spinal cord and in the brain, including structures related to pain modulation, in the presence and in the absence of analgesia produced by epidural morphine as confirmed by the hot plate test. Glucose utilization was shown to be similar in the spinal cord and in the brain in both groups of animals. The results suggest that analgesic doses of epidural morphine do not affect neuronal activity of the spinal cord by changing spinal cord carbohydrate metabolism. PMID- 3662065 TI - Postcholecystectomy pain relief by intrapleural bupivacaine in patients with cystic fibrosis. PMID- 3662064 TI - Comparison of pain associated with intradermal and subcutaneous infiltration with various local anesthetic solutions. PMID- 3662066 TI - Use of succinylcholine during elective pediatric anesthesia should be reevaluated. PMID- 3662067 TI - Hemodynamic changes associated with electroconvulsive therapy. PMID- 3662068 TI - Midazolam and cimetidine: lack of interaction is unproven. PMID- 3662069 TI - Pitfalls encountered in relating anterior fontanel pressure to intracranial pressure. PMID- 3662070 TI - Safe placement of the long-arm CVP. PMID- 3662071 TI - Anterior approach to sciatic nerve block in children: loss of resistance or nerve stimulator for identifying the neurovascular compartment. PMID- 3662072 TI - Hypotension during carotid endarterectomy. PMID- 3662073 TI - Intermittent oxygen delivery in an Ohmeda Unitrol anesthesia machine due to a faulty O-ring check valve assembly. PMID- 3662074 TI - Preoperative ranitidine and metoclopramide. PMID- 3662075 TI - Stretching with obstruction of an epidural catheter. PMID- 3662076 TI - Inexpensive heart rate monitor for epidural test doses. PMID- 3662077 TI - Trismus is not trivial. PMID- 3662078 TI - Effects of droperidol on sympathetic activity and baroreflex control of heart rate in humans. AB - The effects of intravenous droperidol, 0.2 mg . kg-1, on baroreflex control of heart rate and on plasma catecholamine levels were determined in 10 ASA physical status I unpremedicated patients. Baroreflex control of heart rate was assessed by a pressor test using phenylephrine. Plasma concentrations of norepinephrine and epinephrine were determined by high pressure liquid chromatography, and plasma droperidol concentrations were measured by radioimmunoassay, from blood samples withdrawn before baroreflex evaluation. All data were obtained before and 5, 10, and 15 min following droperidol administration. Baroreflex response was significantly decreased after droperidol at each time of the study with the maximal decrease (-47% from control) observed at 5 min. No resetting of baroreflex was present since the pulse interval at the reference pressure was unchanged. Plasma norepinephrine concentrations were moderately but significantly increased only at 5 min, while no significant change in epinephrine concentrations was observed. It is concluded that droperidol induces a moderate but sustained alteration of baroreflex function and a transient increase in plasma norepinephrine concentrations. PMID- 3662079 TI - Differential use-dependent (frequency-dependent) effects in single mammalian axons: data and clinical considerations. AB - The potential clinical scope of use-dependent block of conduction (UDB) was assessed by studying characteristics of UDB in vitro in individual mammalian axons. Single and repetitive stimulation was applied to rabbit cervical sympathetic and vagus nerves exposed to solutions containing lidocaine 0, 0.3, or 0.6 mmol/l (9.1 or 18.2 mg/dl) at 37 degrees C. Unit responses were recorded in dissected filaments or extracellularly in the vagus nodose ganglion. With lidocaine 0.3 mM, equilibrium conduction block, tested by single shocks, was rare. 40-Hz trains produced a significantly greater increase in latency (slowing of conduction) and a much greater incidence of UDB in the sympathetic units than in myelinated vagus axons of equivalent control conduction velocities or in unmyelinated axons. 10-Hz stimulation did not produce UDB. With lidocaine 0.6 mM, the incidence of equilibrium conduction block was too high among sympathetic axons to assess UDB, and significantly higher than among nonsympathetic myelinated and unmyelinated units. The observations support the hypothesis that the differential block of sympathetics observed clinically with spinal anesthesia may be, at least in part, a use-dependent (frequency-dependent) effect. UDB seems unlikely to contribute to local anesthetic block of pain impulses. PMID- 3662080 TI - Isoflurane causes endothelium-dependent inhibition of contractile responses of canine coronary arteries. AB - The authors sought to determine if isoflurane would attenuate effects of three different types of vasoconstrictors on isolated segments of canine epicardial coronary arteries removed from healthy dogs. As the endothelium has a major role in regulating epicardial coronary artery tone, and as it modulates the effect of many vasoactive substances, experiments were conducted both on normal rings and on rings whose endothelium had been mechanically removed. In addition, the endothelium is thought to be damaged in human atherosclerosis. Rings were suspected in organ chambers filled with modified Krebs-Ringer bicarbonate solution, aerated with 95% oxygen and 5% carbon dioxide, and connected to strain gauges for the measurement of isometric tension. Isoflurane 2.3% (1.5 MAC in the dog) was added to the aerating gas mixture in half the preparations, while the other rings served as control. The vasoconstrictors serotonin, phenylephrine, or prostaglandin F2 alpha were added in increasing concentrations to the bath solution. In the presence of endothelium, vasoconstrictor evoked contractions were attenuated by isoflurane. Maximal tension generated by prostaglandin F2 alpha in untreated rings was 114 +/- 18% (mean +/- SEM) of a reference contraction, while, following isoflurane, it was 46 +/- 8% (P less than 0.005). In the absence of endothelium, isoflurane attenuated neither prostaglandin F2 alpha nor serotonin evoked contraction, and had decreased effectiveness against phenylephrine mediated contraction (P less than 0.001). It is concluded that isoflurane attenuates vasoconstrictor-evoked contraction of isolated canine epicardial coronary arteries, and that this effect is mediated by the endothelium. PMID- 3662081 TI - Measurement of lung volume by sulfur hexafluoride washout during spontaneous and controlled ventilation: further development of a method. AB - An open circuit tracer gas washout method for measurement of lung volume in patients during anesthesia and intensive care is described and tested. The method employs a device for dispensing the tracer gas, sulfur hexafluoride (SF6), a fast SF6 analyzer, a pneumotachograph, and a computer. The dispensing device delivers SF6 into the airway in proportion to instantaneous inspiratory flow so that inspiratory SF6 concentration is held constant, usually at about 0.5%, regardless of the inspiratory flow pattern. The amount of SF6 present in the lungs at the end of a washin is calculated during washout from signals representing expired SF6 concentration and expired flow. From this, lung volume is derived. Accurate and reproducible results were obtained in lung model tests during ventilation with air, N2O in O2, and halothane in O2. Functional residual capacity (FRC) was measured both with SF6 washout and nitrogen washout in five mechanically ventilated patients. This gave the regression equation: FRCSF6 = 10 ml + 1.04 x FRCN2, r = 0.99. A similar close agreement was observed for total lung capacity (TLC) and residual volume (RV) measurements in eight healthy, spontaneously breathing subjects: TLCSF6 = 91 ml + 1.01 x TLCN2, r = 0.99; RVSF6 = -32 ml + 0.97 x RVN2, r = 0.95. Comparison with body plethysmography in eight healthy, sitting subjects gave the regression equation: FRCSF6 = 180 ml + 0.96 x FRCbox, r = 0.99. The median (range) for the coefficient of variation at duplicate determinations in 10 anesthetized, paralyzed, and mechanically ventilated adults was 3.0% (0.2-6.6%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662082 TI - Accuracy of response of six pulse oximeters to profound hypoxia. AB - Oxygen saturation, SpO2%, was recorded during rapidly induced 42.5 +/- 7.2-s plateaus of profound hypoxia at 40-70% saturation by 1 or 2 pulse oximeters from each of six manufacturers (NE = Nellcor N100, OH = Ohmeda 3700, NO = Novametrix 500 versions 2.2 and 3.3 (revised instrumentation), CR = Criticare CSI 501 + version .27 and version .28 in 501 & 502 (revised instrumentation), PC = PhysioControl Lifestat 1600, and MQ = Marquest/Minolta PulseOx 7). Usually, one probe of each pair was mounted on the ear, the other on a finger. Semi-recumbent, healthy, normotensive, non-smoking caucasian or asian volunteers (age range 18-64 yr) performed the test six to seven times each. After insertion of a radial artery catheter, subjects hyperventilated 3% CO2, 0-5% O2, balance N2. Saturation ScO2, computed on-line from mass spectrometer end-tidal PO2 and PCO2, was used to manually adjust FIO2 breath by breath to obtain a rapid fall to a hypoxic plateau lasting 30-45s, followed by rapid resaturation. Arterial HbO2% (Radiometer OSM-3) sampled near the end of the plateau averaged 55.5 +/- 7.5%. ScO2% (from the mass spectrometer) and SaO2% (from pH and PO2, by Corning 178) differed from HbO2% by + 0.2 +/- 3.6% and 0.4 +/- 2.8%, respectively. The mean and SD errors of pulse oximeters (vs. HbO2%) were: (table; see text) The plateaus were always long enough to permit instruments to demonstrate a plateau with ear probes, but finger probes sometimes failed to provide plateaus in subjects with peripheral vasoconstriction. Nonetheless, SpO2 read significantly too low with finger probes at 55% mean SaO2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662083 TI - Increased incidence of masseter spasm in children with strabismus anesthetized with halothane and succinylcholine. PMID- 3662084 TI - Introducer sheath malfunction producing insidious air embolism. PMID- 3662085 TI - Is the EEG a useful monitor during cardiac surgery? A case report. PMID- 3662086 TI - Left atrial injection of protamine does not reliably prevent pulmonary hypertension. PMID- 3662087 TI - A report of hepatic necrosis and death following isoflurane anesthesia. PMID- 3662088 TI - Comparison of rapid and conventional inhalation inductions of halothane oxygen anesthesia in healthy men and women. PMID- 3662089 TI - Selective blind endobronchial intubation in children and adults. PMID- 3662090 TI - Epidural anesthesia for vaginal delivery in a patient with idiopathic hypertrophic subaortic stenosis. PMID- 3662091 TI - Preoperative anxiety: does anxiety level the afternoon before surgery predict anxiety level just before surgery? PMID- 3662092 TI - Blood flow limits and pulse oximeter signal detection. PMID- 3662093 TI - Intraocular pressure changes during muscular hyperactivity after general anesthesia. PMID- 3662094 TI - Succinylcholine-induced hyperkalemia in near-drowning. PMID- 3662095 TI - A simple, easy, and inexpensive method for monitoring ETCO2 through nasal cannulae. PMID- 3662096 TI - One-way leak in mass spectrometer sampling system. PMID- 3662097 TI - A note of caution when using different cuffs with the DINAMAP. PMID- 3662098 TI - Another use for the fiberoptic bronchoscope. PMID- 3662099 TI - Inadvertent cannulation of an aberrant radial artery. PMID- 3662100 TI - Pollution associated with keyed filling devices. PMID- 3662101 TI - Midazolam-induced ventricular irritability. PMID- 3662102 TI - Prediction of "critical" coronary disease: are the "Consensus Conference" guidelines adequate? AB - Presenting features of 100 patients with significant left main coronary stenosis (LMCS) were reviewed. All presented with angina--on minimal exertion in 45, moderate exertion in 38, and severe exertion in 6--and 11 had unstable angina. Although the resting ECG was normal in 44, exercise testing was positive in 92% of patients tested. The authors conclude that symptoms and the resting ECG alone are unhelpful in predicting "critical" coronary disease. However, application of a management plan similar to that suggested by the Consensus Conference on coronary artery surgery would have selected the vast majority of such patients for angiography. PMID- 3662103 TI - Incidence and clinical course of right ventricular infarction: assessment with radionuclide ventriculography. AB - The incidence and prognosis of right ventricular infarction were studied by radionuclide ventriculography (RNV) in 50 consecutive cases of acute myocardial infarction. RNV was performed within thirty-six hours of symptoms and one month after onset. Right ventricular infarction was absent in all 25 patients with anterior infarction. It was found in 15 of the 25 patients with inferior infarction, accompanied by a marked reduction in right ventricular ejection fraction (28 +/- 8%), but was notably alleviated one month later with normalization of right ventricular ejection fraction (39 +/- 7%) and wall motion. These phenomena seem to be specific in right ventricular infarction. PMID- 3662105 TI - Primary lower extremity telangiectasias--relationship of size to color. AB - Sclerotherapy remains the treatment of choice for primary telangiectasias of the lower extremities, a half century after the treatment was first devised. No substantial improvements have been made, largely because little or no attention has been paid to the underlying physiology. Evidence is presented that these vessels are dilated by virtue of their proximity to small arteriovenous communications. This would explain the response these vessels demonstrate when injected with sclerosing solutions, as well as the relationship between their size and their color, which is documented by objective and subjective measurements. Two novel methods of treating telangiectasias with existing sclerosing solutions are described, and the characteristics of an ideal sclerosant for these vessels are proposed. PMID- 3662104 TI - Lower extremity blood flow in intermittent claudication--the role of oral glucose tolerance test. AB - Tobacco smoking is a risk factor for peripheral arterial disease. During oral glucose tolerance tests (OGTT) in a population study the author and co-workers have earlier shown that smokers have higher blood glucose values early postload and lower values at two hours compared with nonsmokers. Eighty-three patients, all with intermittent claudication but with a normal OGTT, have now been studied according to their response to an oral glucose load. The blood flow resistance during reactive hyperemia, as measured with a calf plethysmograph, was compared between subjects in the quartile of patients with the highest forty-five-minute blood glucose and those in the lowest quartile. The blood flow resistance was significantly higher in the group with a high forty-five-minute blood glucose, 13.3 +/- 1.34 vs 9.5 +/- 0.65 (mean +/- SEM), p less than 0.02. Blood pressure and blood lipids were similar in the two groups. It is suggested that an exaggerated early response in the OGTT might be an independent risk factor for peripheral arterial disease. PMID- 3662106 TI - Doppler echocardiographic detection of traumatic ventricular septal defect--a case report. AB - A case of traumatic ventricular septal defect diagnosed by Doppler echocardiography is described. The characteristic pulsed Doppler findings of a left-to-right shunt were recorded and the two-dimensional echocardiographic images of septal interruption were shown. Combined Doppler and two-dimensional echocardiography enhances the ability to detect the presence of a ventricular septal defect. Doppler echocardiography appears to be a useful noninvasive imaging modality in the evaluation of patients with cardiac trauma. PMID- 3662107 TI - Primary hemangiopericytoma of the heart associated with pseudoaneurysm of the pulmonary artery--a case report. AB - A thirty-three-year-old male with malignant hemangiopericytoma of the right ventricular outflow tract and the pulmonary artery associated with pseudoaneurysm formation at the latter is presented. Contrast computed tomography was helpful in diagnosing the pseudoaneurysm of the pulmonary artery. The positional change of the murmur, with a tumor plop caused by the pedunculated tumor of the right ventricular outflow tract, was detected. PMID- 3662108 TI - Evaluation of the vasodilator vs inotropic effect of milrinone using an animal model of left ventricular failure: reversal of disopyramide depression of the myocardium with milrinone. AB - Milrinone (M) has been shown to improve left ventricular (LV) performance in animal and human studies. M has strong vasodilator action, and whether increased LV performance is due primarily to vasodilation or to a direct positive inotropic effect is unclear. Ten mongrel dogs were studied. Disopyramide caused a significant and sustained decrease in LV function and was a good model for myocardial depression. At equal reduction in systemic vascular resistance (SVR), M reversed this LV depression to a significantly greater degree than nitroprusside (NP) did. At equal levels of vasodilation, M produced significantly greater improvement in indices of LV function than NP did in our model of disopyramide-induced LV failure. This suggest that its effect on LV function is not due entirely to afterload reduction, or to reflex sympathetic stimulation, but has a substantial component of direct inotropic stimulation. This study also demonstrated a reversal of disopyramide-induced LV dysfunction by M, which may be clinically useful since, as in many antiarrhythmics, myocardial depression may be a limiting factor in its use. PMID- 3662109 TI - Intermittent claudication associated with cancer--case studies. AB - Cancer was diagnosed in 15 patients among 300 consecutive patients with intermittent claudication. The cancer-associated claudication is characterized by a more accelerated course of claudication, more often requires vascular surgery, and moreover, the lasting relief of claudication depends upon the efficiency of cancer therapy. It is the authors' impression that cancer-associated claudication is predetermined by atherosclerosis and aggravated by cancer through the chronic hypercoagulability state secondary to neoplasm. The clinical picture is characterized by rapid progression, with the frequent necessity of vascular surgery for limb salvage and a higher incidence of graft occlusion. Awareness of this possibility of hidden malignancy may be related to the clinical picture of hemodynamic deterioration of the underlying arterial insufficiency. A high index of suspicion leads to earlier diagnosis of neoplasm. Effective oncologic therapy will often bring the symptomatic relief of ischemic symptoms in the lower extremities. This report indicates that associated neoplasm has a more vicious course of the underlying arterial insufficiency and intermittent claudication. PMID- 3662110 TI - Giant-cell arteritis causing severe aortic regurgitation secondary to aneurysm of the ascending aorta--a case report. AB - This report describes a case of aneurysm of the ascending aorta with secondary, severe, aortic valve incompetence following temporal arteritis in a sixty-five year-old woman. PMID- 3662111 TI - Vasospastic angina in thyrotoxicosis--case reports. AB - We encountered 2 patients with thyrotoxicosis accompanied at its onset by progressive angina. The ST segment was elevated in one patient and depressed in the other patient during the spontaneous attacks. Coronary arteriographic findings were normal during control, and spasm was induced by ergonovine. No patients had chest pain even without antianginal medication after successful treatment of thyrotoxicosis. The coronary artery may become sensitive to spasm during thyroid hormone excess even in cases without significant coronary artery disease and previous chest pain. PMID- 3662112 TI - Evidence for transferrin polymorphism in Spanish wild rabbits. AB - Serum samples from 412 Spanish wild rabbits were analysed by starch and polyacrylamide gel electrophoresis. Three different transferrin (Tf) phenotypes (A, AB and B) were observed by both methods. The occurrence of two codominant alleles (TfA and TfB with frequencies of 0.89 and 0.11 respectively) at an autosomal locus (Tf) was supported by the population data on genetic equilibrium. Electrophoretic mobility differences between the Tf variants A and B could not be explained by differences in sialic acid or iron contents. Each of the two Tf variants were shown to have two sialic acid residues by neuraminidase treatment. These variants had similar affinities for iron, and iron binding did not lead to the conversion of one variant into the other. PMID- 3662113 TI - Bovine haemoglobin beta A Zebu, beta A43(CD3)Ser----Thr: an intermediate globin type between the beta A and beta D Zambia is present in Indian zebu cattle. AB - Two bovine haemoglobin beta chains, electrophoretically identical with the beta A chain of Herefords, were obtained from Ongole and Banteng, Bos javanicus, cattle. The amino acid residue differences of the two beta chains were compared by electrophoresis, cation-exchange and reverse-phase chromatography, amino acid analyses, and Edman degradation in comparison with beta A chain. The results showed that two beta chains differed from the beta A chain of the Hereford breed by the substitution of serine with threonine at the beta 43 position. No other difference was found between the two chains and beta A. This new beta chain type was termed beta A Zebu, which forms a possible evolutionarily transitional type between the beta A and the rare variant beta D Zambia found previously in African zebu cattle. The beta A Zebu differentiates from the previous beta B by at least four amino acid substitutions involving five codon-base changes. PMID- 3662114 TI - Polymorphism of transferrin and esterase in Alaskan wolves: evidence of close molecular homology with the dog. AB - By the use of isoelectric focusing in polyacrylamide gels serum samples from 146 Alaskan wolves were studied with regard to transferrin (Tf) and esterase (ArE) polymorphism, comparing the phenotypic band patterns with those of selected Norwegian dogs. The study revealed Tf and ArE polymorphisms in the wolf with phenotypic band patterns being indistinguishable from the corresponding ones in dogs. This suggests the occurrence of the same two common Tf alleles in the wolf as in the dog. In the ArE system the results are consistent with the occurrence of three alleles which also occur in dogs whereas a fourth allele, so far not seen in dogs, is seen in Alaskan wolves. PMID- 3662115 TI - Production of alloantibodies against caprine lymphocyte antigens. AB - In all, 217 primiparous goats were each injected with blood cells from their own newborn kid. Eighty-five goats were given mononuclear cells, 61 were given leucocytes and 71 received whole blood. The goats were injected one, two or three times before collection of sera. Sera were also collected from 42 non-injected, primiparous goats. The sera were compared with regard to their potential value in class I histocompatibility typing. The percentage of potentially valuable sera was highest in the group of animals injected twice with whole blood (66 X 7%). However, this percentage was not significantly higher than the percentage in the group of animals injected once with whole blood (54 X 7%). It is concluded that injecting primiparous goats once with whole blood from their own newborn kid, is a rapid and easy method, which gives a high yield of alloantisera with potential value in class I histocompatibility typing. PMID- 3662116 TI - ISO-DALT characterization of 12 'new' equine plasma protease inhibitor (Pi) alleles. AB - Twelve equine protease inhibitory alleles, PiE, H, J, K, L2, O, P, Q, R, V, X, Z, have been characterized in terms of isoelectric point, molecular mass and inhibitory activity to bovine trypsin and chymotrypsin by ISO-DALT electrophoresis. Protein maps for 20 Pi alleles including those of the eight 'Thoroughbred' alleles (PiF, G, I, L, N, S1, S2, U) have now been determined. Five pairs of alleles, S1/S2, G/K, L/L2, P/R and U/Z, possessed varying numbers of common proteins ranging from one protein in the case of G/K and L/L2 to six in the case of U/Z. Based on these results and studies of the abnormal expressions of PiF, PiL and PiS1, a theory of at least three closely linked loci has been postulated to account for the marked heterogeneity of the equine protease inhibitory system. PMID- 3662117 TI - Frequencies of plasma protease inhibitor alleles in Australian horse breeds and the recognition of two new alleles. AB - Investigation of the plasma protease inhibitor system (Pi) in the Arabian and quarter horse breeds and re-examination of the standardbred breed resulted in the recognition of two new Pi alleles, designated E and L2. PiE is rare and has been found in only three quarter horses. In contrast, PiL2 is relatively common in the standardbred (0.107) and allowed subdivision of PiL into PiL and PiL2. Splitting of PiL resulted in an exclusion probability (PE) of 0.649 for the standardbred Pi system. Frequencies of the Pi genes have now been determined for four breeds (thoroughbred, standardbred, quarter horse and Arabian) of horses in Australia. PMID- 3662118 TI - Class I major histocompatibility complex antigens and C4 concentrations in sheep plasma. AB - Data are presented demonstrating that high concentrations of complement protein C4 in sheep plasma are associated with a particular class I OLA specificity. By way of contrast, a similar association could not be demonstrated between C3 plasma concentrations and OLA specificities. These data support the hypothesis that gene(s) determining C4 plasma concentrations are linked to the ovine MHC. PMID- 3662119 TI - Simultaneous phenotyping of pig plasma alpha-protease inhibitors (PI1, PO1A, PO1B, PI2) and four other proteins (PO2, TF, CP, HPX) by a simple method of 2D horizontal electrophoresis. AB - A simple and rapid method of 2D agarose gel (pH 5.4)-horizontal polyacrylamide gel (pH 9.0) electrophoresis was developed for the simultaneous phenotyping of pig plasma alpha-protease inhibitors (protease inhibitor-1 and -2; postalbumin-1A and -1B), postalbumin-2, transferrin, ceruloplasmin and haemopexin. These eight plasma proteins were clearly visible on gels stained with Coomassie Brilliant Blue G250. The 2D patterns and mobilities of several variants of alpha-protease inhibitors were described. By using two agarose gels and 10 polyacrylamide gels, 120 samples were easily analysed in a day. Since alpha-protease inhibitors show extensive polymorphism and as the gene for postalbumin-2 is closely linked to the halothane sensitivity locus Hal, this method is a useful tool for conducting parentage control and for predicting Hal genotypes of individual pigs. PMID- 3662121 TI - Genetic relationships between seven Spanish native breeds of cattle. AB - Ten genetic markers were studied in seven Spanish native cattle breeds, using a total of 725 animals. Of the ten, two were found to be monomorphic in all seven breeds. The genetic relationships of the seven breeds are estimated by three different genetic-statistical methods (genetic distances, main coordinate analysis and cluster analysis), which indicate three clearly distinct groups of populations: one where the Cardena Andaluza and Alistana Sanabresa are very closely related, one comprising Sayaguesa, Morucha, Asturiana de los Valles and Asturiana de la Montana cattle, and a third, genetically distant from the other two, comprising only Blanca Cacerena. The dendrogram drawn from the genetic distances matrix would seem to imply that the seven breeds are descended from different ancestors. PMID- 3662120 TI - Expression and genetics of caprine haemoglobins. AB - The expression of haemoglobin (Hb) has been studied in 260 Norwegian Dairy goats by the Immobiline technique at pH ranges 6.7-7.7, 6.9-7.6 and 6.9-7.5. The majority of goats exhibited two- or four-band patterns. In two-band types the average ratio between the anodal and cathodal band was 74:26. PAGE with 8M urea distinguished three phenotypes for the beta chains, proving that the Hb variation described is in the beta chain. Segregation data in 106 complete sire-dam offspring families agreed with the existence of four beta globin alleles--A2, A4, A6 and A8. Twenty-seven animals had reversed ratios (R) of Hb bands. In two-band phenotypes the average ratio was 36:64. In 15 complete families where one of the parents had reversed ratio, eight offspring received the R type, indicating a simple genetic control. After urea PAGE the R animals all showed the same alpha chain phenotype which differed from that of goats having common ratios of bands. An additional polymorphism appeared in nine animals as three- and five-band patterns which is assumed to be the result of heterozygosity for II alpha and for II alpha and beta globin genes respectively. PMID- 3662122 TI - Linkage studies in blood biochemical polymorphic markers of rabbits. AB - Five erythrocyte proteins (Adenosine deaminase, Ada; 6-Phosphogluconate dehydrogenase, Pgd; Esterase 1, Es-1; Esterase 3, Es-3; NADH-Diaphorase 2, Dia-2) and a serum beta-globulin protein (Esterase 7, Est-7) were studied in rabbits using starch gel electrophoresis. Samples were obtained from 317 Spanish Common individuals (38 families, 317 individuals). For the analyses of linkage, Morton's sequential probability ratio test was applied. Clear evidence for linkage between Es-1 and Est-7 (theta 0.2) was obtained, and no evidence of linkage was obtained for the remaining pairwise combinations of loci studied. PMID- 3662123 TI - Lymphocyte antigens in Norwegian goats: serological and genetic studies. AB - Altogether, 292 goat alloantisera were screened for antilymphocyte reactivity in a two-step dye exclusion microcytotoxicity test. Fifteen different lymphocyte antigen specificities were characterized by cluster analysis and absorption studies. The specificities were designated N1-N15 (N for Norwegian). Lymphocytes from 247 Norwegian dairy goats were tested. Each animal displayed from none to four of the characterized specificities. Lysostrip testing and family studies indicated that the specificities N1-N14 were coded for by multiple alleles belonging to at least two closely linked loci. It is suggested that these loci are part of the caprine major histocompatibility complex. Family studies gave strong evidence that the specificity N15 was not coded for by genes located in the same region as the other 14 specificities. Absorption studies showed that this specificity was located on both lymphocytes and erythrocytes. PMID- 3662124 TI - Detection of a new kappa-casein variant in cow's milk. AB - In German Simmental cattle a new kappa-casein variant was detected by isoelectric focusing, which cannot be distinguished from kappa-casein A by polyacrylamide and starch gel electrophoresis. It was named kappa-casein D. The frequencies of kappa casein alleles were kappa-Cn A 0.75, kappa-Cn B 0.24, kappa-Cn D 0.01. PMID- 3662125 TI - NADH diaphorase polymorphism in goat erythrocytes. AB - This paper describes for the first time polymorphism of the erythrocyte diaphorase in goats. Three diaphorase 1 phenotypes were observed in the red cells of goats. Breeding data indicated that polymorphism was controlled by two autosomal codominant alleles, DiaF and DiaS, the frequencies of which were determined in 14 different Spanish breeds of goat. PMID- 3662126 TI - Absence of detectable linkage between the G and H blood group loci in the pig. AB - Morton's lod score method used for the analysis of data from 168 backcross matings (1094 offspring) did not indicate linkage between the G and H blood group loci of the pig. Linkage closer than 0.413 could be excluded at the 1% significance level. PMID- 3662127 TI - Pruritus and rash after bathing in a 12-year-old girl. PMID- 3662128 TI - Specific IgG antibodies to Dermatophagoides pteronyssinus and egg white--their changes with age. AB - Dermatophagoides pteronyssinus-specific and egg white-specific IgG in 232 children and 42 adults were measured by the RAST method using monoclonal anti human IgG antibodies (HG2-25) as the secondary antibody. Changes in allergen specific IgG with the age of the subjects were examined. Allergen-specific IgG antibody in standard serum was designated as 1,000 U/mL. Standard curves were made for each measurement and the levels of allergen-specific IgG of the sera were expressed in units (U). Dermatophagoides pteronyssinus-specific IgG increases from 9 months of age until adulthood. The atopic group showed higher mean values than the non-atopic group (r less than .001). Egg white-specific IgG reaches a peak around 3 to 4 years of age. After this, it declines until adulthood. These results suggest that age factors and allergen factors must be taken into consideration when evaluating allergen-specific IgG antibodies. PMID- 3662129 TI - Long-term IgG4 determinations in hymenoptera-sensitive treated patients. AB - Honey bee and vespid venom immunotherapy have been practiced for the past 10 years. Several studies have evaluated the short-term effects of this therapy. The current study evaluated the long-term effects using venom-specific IgG4 determinations. Forty-six patients ranging in age from 3 to 67 years were followed for periods up to 6 1/2 years. All patients included in the study demonstrated Hymenoptera sensitivity on intradermal testing using 0.2 mL of venom extract at concentrations of 0.01 microgram/mL, 0.1 microgram/mL, or 1 microgram/mL. IgE-specific venom antibody levels were tested and found to be elevated. During the first year following institution of venom immunotherapy, 46/46 patients demonstrated an increase in venom-specific IgG4. After the first year of treatment, values reached a plateau. The IgG4 venom-specific antibodies remained relatively constant over the second and third years of the study. Thirty of the 46 patients were followed for more than 3 years. All of the 30, treated greater than 3 years with continuous immunotherapy, demonstrated a gradual decline in IgG4 levels. Despite very low or negligible levels of venom-specific IgG4 antibodies, six patients accidentally stung were still clinically protected. This study suggests that long-term immunity is not mediated in the same manner as that of short-term protection. PMID- 3662130 TI - The "Asthma Self-Efficacy Scale". AB - According to Bandura, a person's expectations that a favorable outcome will follow a particular behavior are not sufficient to promote the occurrence of the behavior; the person must also believe that he or she will be effective at performing the behavior. The latter is referred to as self-efficacy. It has become a major focus in assessing patient performance of skills required to manage their illness. The present paper describes the development, testing, and applicability of an instrument for assessing self-efficacy in asthmatic patients. It notes that the Asthma Self-Efficacy Scale is not only a reliable paper-and pencil instrument, but that it has a wide potential applicability throughout health care settings in measuring self-efficacy in asthmatic patients. The Asthma Self-Efficacy Scale is included. PMID- 3662131 TI - Serial immunologic studies in patients with mucocutaneous lymph node syndrome (Kawasaki disease). AB - Twenty cases of mucocutaneous lymph node syndrome (MCLS), from Fall 1984 to April 1986, are included in this study. The serial immunoglobulin levels including IgG, IgA, IgM showed polyclonal increased immunoglobulin levels during the first month. Only one-fourth of patients had high serum IgE levels. There was no correlation with house dust mite antigen skin test and anti-mite IgE levels. By using the polyethylene glycol and ELISA methods, IgE-circulating immune complexes were detectable in 60% of high serum IgE patients. IgG-circulating immune complexes were also detected in 70% by the polyethylene glycol method and 60% by Raji cell method. CH50 and serum properdin factor B level increased during acute febrile phase. Serial T cell subset studies showed OKT4 cells decreased progressively and OKT8 levels were within normal range during the first and second week. By the third week, OKT4 cells increased and OKT8 cells decreased. This progressed to the fifth week and returned to normal range 2 months later. During the acute febrile phase of the first week, Leu2+15+ cells increased and Leu2+15- cells decreased. After the second week, the Leu2+15+ cells decreased and Leu2+15- cells increased. This increase continued to the fifth week when the Leu2+15+ cells were at the lowest level and the Leu2+15- cells at the higher level corresponding to the OKT8 change. After the fifth week, the Leu2+15+ cells and Leu2+15- cells returned to normal. Patients had increased antibody-dependent cell-mediated cytotoxic reaction at the first week of the acute febrile stage. It decreased dramatically in the second week and returned to normal 2 months later.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662132 TI - Plasma histamine levels in normal and atopic children. AB - Plasma histamine was measured in 258 children by using a sensitive high performance liquid chromatographic method. A normal level of histamine, which was high at a lower age and low at a higher age, was determined. Atopic children had higher levels than normal children. The extent of atopic disease had a relationship with higher levels. The correlations between plasma histamine and basophil count and between plasma histamine and IgE were significant in atopic children but not in normal children. PMID- 3662133 TI - Comparison of airborne fungi in evaporative cooled and air conditioned homes. AB - The evaporative cooler (EC) is commonly used during the warmer months in millions of homes in the desert regions of the Southwestern United States. In this investigation fungi isolated from EC homes were compared with recoveries from air conditioned (AC) homes. Aspergillus tamarii was more abundant in EC homes (P less than .05) whereas Penicillium spp. were more prevalent in AC homes (P less than .05). Fusarium was recovered only from EC homes. Overall, more fungi were isolated from EC homes than AC homes both in terms of total numbers of isolates and numbers of species recovered. The EC appears to provide a niche for allergenic fungi that may be transmitted into the home or business. PMID- 3662134 TI - Proceedings of the literature review course for ABAI examination. May 1-3, 1987, Schaumburg, Illinois. PMID- 3662135 TI - [Micromethods and gas chromatography analysis of carboxylic acids produced from the fermentation of glucose in the identification of Corynebacteria]. AB - The identification of fermentative Corynebacteria currently isolated from human specimens is not very easy, even with the use of the useful guide edited by Hollis and Weaver. The purpose of this investigation is to present a classification based on the study of a large number of biochemical characters, including the use of micromethods, and the characterization of carboxylic acids produced from dextrose fermentation by gas-liquid chromatography. The results show that it is possible to classify fermenting Corynebacteria into two groups based on the production of propionic acid or the lack of it. We are thus able to separate distinctly Corynebacteria whose biochemical characters are very similar. Likewise, some tests included in the micromethods are useful for separating the species. PMID- 3662136 TI - [Increase in the desialylated forms of serum transferrin and alcohol consumption]. AB - In order to study a possible modification, secondary to alcohol consumption, of the distribution of various molecular forms of transferrin, we have compared its total serum concentration with that of several fractions in reference groups and excessive drinkers. The study was conducted in 50 patients; 35 drinkers admitted for detoxication, and 15 in the control group. The percentage of transferrin focalizing at pH 5.7 (Tf 5.7) is significantly higher in drinkers while the transferrin concentration is almost unchanged. During the weaning period, we observed a significant decrease of Tf 5.7 in two weeks. This parameter seems to be extremely sensitive regarding alcohol consumption; its specificity should be evaluated before coming to the conclusion that it present a definite advantage in the screening of excessive drinkers. PMID- 3662137 TI - [Simultaneous microdetermination of pyrazinamide and pyrazinoic acid by liquid chromatography]. AB - The technique reported here enables to titrate concomitantly pyrazinamide as well as its main metabolite, the 2-pyrazinoic acid. The serum sample is deproteinized with acetonitrile and the portion floating on the surface is injected on an anionic column of copolymer. The detection occurs at 270 nm and the sensitivity of the method enables its use during pharmacokinetic studies. The other anti tuberculous drugs, usually associated, produce no interference. PMID- 3662138 TI - [Determination of fructosamine on the Cobas-Bio centrifuge system. Importance of white reagent]. AB - An automated assay for fructosamine on Cobas-Bio centrifugal analyzer with subtracting the contribution of the albumin matrix present in standards is described. This rapid and simple test has suitable analytical performances. Fructosamine concentrations were measured in 100 healthy subjects and in 95 diabetic patients. For the diabetic patients, results were compared with those obtained from a commercialized test kit. PMID- 3662139 TI - [Normal serum concentration of retinol transport protein (RBP) measured by an immunonephelometric method]. AB - The authors give serum retinol binding protein (RBP) normal values, established by immunonephelometry, for two healthy populations in their hospital laboratory. The mean values for men's and women's group are significantly different. They note for women's group with estroprogestative drugs a higher mean value. Relations between retinol and RBP metabolism are known. RBP values give a good estimation of retinal reserves in patients. PMID- 3662140 TI - [Determination of blood iron: chromazurol B, ferrozine or the method selected by the SFBC (Societe Francaise de Biologie Clinique)?]. PMID- 3662141 TI - [Effect of the lactescence of the sample on the determination of blood phosphates in children on dialysis. Effect on other colorimetric determinations]. PMID- 3662142 TI - [Determination of uric acid: adaptation of a reagent for use with the parallel analyzer FP9]. PMID- 3662143 TI - Meeting of the Societies. Belgian Society of Clinical Chemistry. 3d International Symposium. Brugge, October 24-26, 1985. Human infertility. PMID- 3662144 TI - Quality control of culture media for in vitro fertilisation. AB - The organisation of a control programme to evaluate the quality of culture media for human in vitro fertilisation is described. The development of mouse embryos to the blastocyst stage in vitro was used as control system. It is shown that it was possible to screen for embryo toxic chemicals in the media so that these can be avoided in the human culture. The influence of temporary pH shifts on the mouse embryo development and in vitro fertilisation in the mouse are mentioned. Exposure to low pH before fertilisation caused a drastic reduction of the development of mouse embryos. No clear association is found between pregnancy rate using in vitro fertilised human oocytes and mouse embryo development. The control system cannot be used to improve media for human in vitro fertilisation. PMID- 3662145 TI - Cardiopulmonary interaction via the pleural space. Selected papers. Biomedical Engineering Society's 39th Annual Conference on Engineering in Medicine and Biology. September 14, 1986, Baltimore, Maryland. PMID- 3662146 TI - Heart-lung interaction: effect on regional lung air content and total heart volume. AB - To study the interactions between and within the heart and lungs, end-diastolic (ED) and end-systolic (ES) volumes and intrathoracic location of the heart, and the regional air content, volume and geometry of the lungs, were measured from three-dimensional image data generated with the Dynamic Spatial Reconstructor (DSR). The DSR was used to scan the full thoracic extent of anesthetized dogs and sloths at selected transpulmonary pressures. The results show that the dependent to nondependent gradient of regional lung opacity (or conversely regional air content) in the supine animal was not present in the prone animals. While the rib cage and diaphragm of the dog deformed markedly, the shape of the sloth's rib cage and diaphragm remained essentially constant with change in body orientation. As a consequence of these findings, we deduce that the observed change in gradient of regional lung air content in both dog and sloth are in response to changes in the intrathoracic position of the heart which alter ventral lung geometry and not a response to changes in rib cage or diaphragm geometry. In a second series of studies we reconstructed the 3-D extent of the heart at ED and ES in supine anesthetized dogs and demonstrated that the total heart volume (THV) (i.e. contained by the pericardial sac) during sinus rhythm differs by less than 5% between ED and ES. The DSR image data show that this is achieved by the epicardial apex remaining essentially fixed and that the plane containing the atrio-ventricular valves moves like a plunger towards the apex in systole. When atrial fibrillation is present, the THV no longer remains constant and decreases during systole, presumably because of increased stiffness of the atrial myocardium. We conclude from the experimental results that the heart plays an important role in determining regional differences in alveolar expansion, and that by maintaining a constant THV, the heart minimizes energy expenditure which would be caused by moving the lung. PMID- 3662147 TI - Augmentation of pressure in a vessel indenting the surface of the lung. AB - The lungs and intrathoracic cardiovascular structures compete for space within the thorax, interacting through their adjacent surfaces via the pleural space. Theoretical analysis and in vitro model studies (detailed here) established that when a vessel indents the lung surface, the increase in intravascular pressure with positive pressure lung inflation can be greater than the change in the pleural surface pressure measured outside of the interaction area. We define this phenomenon as intravessel pressure augmentation. We determined the average intravessel pressure gain as the slope of the linear regression of the pressure in a vascular structure or balloon indenting the lung on the pleural surface pressure measured by a flat disk-shaped device (disk). The analysis showed that the disk pressure overestimates the pleural pressure. Therefore, the derived pressure gain underestimated the pressure augmentation. In five dogs, the disk and a 2-ml balloon were placed in the lateral pleural space, and a segment of IVC was ligated at both ends and filled with saline. The dogs were ventilated with fixed tidal volumes, while the positive end-expiratory pressure was changed. The pressures were compared at the end of expiration. For the IVC segment, the pressure gains under four different tidal volumes were significantly greater than one [95% confidence interval of mean value (CIM) = 1.57 +/- 0.16, P less than 10( 4)], and for the small balloon, this was the case for three of four tidal volumes (95% CIM for all four volumes 1.13 +/- 0.04, P less than 10(-4)). We conclude that the surface interaction of the lungs with adjacent cardiovascular structures causes appreciable pressure augmentation in those structures during ventilation with the positive end-expiratory pressure. PMID- 3662148 TI - Mueller maneuver and LV function in coronary artery disease. AB - Decreasing pleural pressure impedes the ejection of blood from the left ventricle (LV), may lead to decreased LV compliance because of interdependence effects and leads to increased transmural LV systolic and diastolic pressure. Previous work from this laboratory has shown that patients with coronary artery disease (CAD) often develop akinetic segments of the LV wall during the Mueller maneuver. In the presence of increased LV transmural pressure regional akinesis could be caused either by the development of regional ischemia or by mechanical inhibition of motion of an area of nonfunctional myocardium as would be caused by previous myocardial infarction (MI). The present study was designed to distinguish between these two mechanisms by determining if the presence of CAD alone is sufficient to lead to regional akinesis or if prior MI is necessary. We used first pass radionuclide ventriculography (RVG) in the 30 degrees LAD supine position to measure LV ejection fraction (EF), end-diastolic (EDV) and end-systolic (ESV) volumes, heart rate and to assess regional wall motion during the Mueller maneuver. This was done in four groups of subjects: 13 normal subjects, 25 patients with CAD but no prior MI, 13 patients with prior nontransmural MI and 36 patients with prior transmural MI. All subjects had angina pectoris and underwent contrast coronary arteriography. Most also underwent routine contrast left ventriculography as well. There were no significant differences among the three patient groups as regards medications, extent and severity of CAD, and response to routine exercise tolerance testing. EF decreased significantly in the three patient groups (4%-9%, p less than 0.01) but not in the normals during the Mueller maneuver. Heart rate increased (5-10 bpm, p less than 0.05) in the normals and in patient groups 2 and 4. EDV decrease in all four subject groups (8%-10%, p less than 0.01), while ESV remained unchanged. Akinesis of the LV wall developed during the Mueller maneuver only in one group-2 patient, but did so in 17/36 patients with prior transmural MI (group 4, p less than 0.001). One-half of the akinetic LV wall segments seen during the Mueller maneuver on RVG were not seen on routine contrast ventriculography. We tested the effects of posture (supine versus upright) on the response to the Mueller maneuver in six normal subjects and found no changes in the response of EDV and ESV to the Mueller maneuver.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3662149 TI - Changes of phasic pleural pressure in awake dogs during exercise: potential effects on cardiac output. AB - Eighty experiments were performed with nine awake dogs to study the changes of phasic-pleural pressure with exercise. The increased minute volume with exercise was obtained by more frequent pleural pressure swings and by a substantial extension of the pressure swings in both directions. The cyclic changes of stroke volume following the pressure swings support the hypothesis that alterations of pleural pressure affect the stroke volume and can act, if necessary, as a secondary pump for the circulation. Mean pleural pressure during exercise fell by 2.5 cm H2O from the rest value of 12.1 cm H2O. The absolute right atrial pressure during exercise (-2.69 mm Hg) was not different from that at rest (-2.39 mm Hg). However, the transmural right atrial pressure of 7.6 mm Hg during exercise was higher than the pressure of 6.2 mm Hg at rest because during exercise the right atrium was perfused by 38% higher blood flow than that at rest. The phasic pattern of right atrial pressure shows that there is good reason to assume that during inspiration the extrathoracic veins are collapsed at their entrance into the chest, but this collapse is removed during expiration. There is no reason to assume an effective, sustained collapse of extrathoracic veins. Rather we can visualize a rhythmical change of flow in extrathoracic veins from transient limitation to transient acceleration. PMID- 3662150 TI - Interaction between high frequency jet ventilation and cardiovascular function. AB - We have studied the interaction of high frequency jet ventilation with cardiovascular pressures and flows. Results in dogs show that the amplitude of all intrathoracic pressures and flows fluctuate with a frequency equal to the difference between the heart rate and ventilator rate. The magnitude of this amplitude variation may be sufficient to obliterate periodically the pulsations in pulmonary artery and right atrial pressures. It is also shown that these cardiovascular beats can occur when the ventilator rate is close to integral multiples of the heart rate. Direct measurement of pleural pressure and the observation that the beats are markedly reduced when the chest is open support the hypothesis that the primary mechanism responsible for these beats is the interaction of the respiratory fluctuations in pleural pressure with the cardiac generated pressure pulsations. PMID- 3662152 TI - Use of negative intrathoracic pressure to obtain end-systolic pressure volume relations in dogs. AB - Left ventricular contractility can be assessed from the end-systolic pressure volume relationship (ESPVR). In this study we test the hypothesis that the same ESPVR can be obtained by varying LV loading with different levels of negative intrathoracic pressure as by varying LV filling. In six dogs mean aortic transmural pressure was used to approximate LV end-systolic pressure and LV volume was determined from data gathered from biplane cineradiograms of multiple markers placed in the LV midwall. In each preparation right heart bypass allowed control of cardiac output while the thoracic pressure was varied with a box surrounding a midsternal thoracotomy. Reflex effects were minimized by ganglionic blockade and bilateral vagotomy. ESPVRs were obtained by varying the cardiac output at constant thoracic pressure or by changing intrathoracic pressure at constant cardiac output. The slopes of the ESPVRs were not significantly different. This result implies that LV loading by negative intrathoracic pressure, in this highly controlled preparation, can be used to generate a systolic LV elastance similar to that obtained by varying LV filling. PMID- 3662151 TI - Extracardiac pressure changes do not alter contractile function of the isolated left ventricle. AB - To determine whether or not extracardiac pressure has an effect on left ventricular contractile function, we analyzed pressure-volume relationships of six isolated, perfused canine hearts in an air-tight chamber. The chamber pressure was set at -60, -30, 0, 30 and 60 mm Hg and left ventricular pressure volume relationships studied. The slope (Ees) and volume axis intercept (Vo) of the transmural pressure-volume relationship were used to compare the pump functions of an individual heart at the different extracardiac pressures applied. No significant difference in either Ees or Vo was seen with different extracardiac pressures. During isovolumic ventricular contraction, developed left ventricular pressure did not change over the range of extracardiac pressures applied. The same was true during ejecting contraction; when the downstream pressure of the computer simulated afterload circuit and the venous filling pressure of the preload circuit were changed in parallel with the extracardiac pressure, pressure-volume loops remained identical throughout their course for all of the extracardiac pressures applied. We conclude that transmural pressure is the overwhelmingly dominant loading factor governing LV contraction, and myocardial contractile function is unaffected by the absolute value of extracardiac pressure. PMID- 3662153 TI - Intrathoracic pressure fluctuations move blood during CPR: comparison of hemodynamic data with predictions from a mathematical model. AB - Whether blood flow during cardiopulmonary resuscitation (CPR) results from intrathoracic pressure fluctuations or direct cardiac compression remains controversial. We developed a mathematical model that predicts that blood flow due to intrathoracic pressure fluctuations should be insensitive to compression rate over a wide range but dependent on the applied force and compression duration. If direct compression of the heart plays a major role, however, the model predicts that flow should be dependent on compression rate and force, but above a threshold, insensitive to compression duration. These differences in hemodynamics produced by changes in rate and duration form a basis for determining whether blood flow during CPR results from intrathoracic pressure fluctuations or from direct cardiac compression. The model was validated for direct cardiac compression by studying the hemodynamics of cyclic cardiac deformation following thoracotomy in four anesthetized, 21-32-kg dogs. As predicted by the model, there was no change in myocardial or cerebral perfusion pressures when the duration of compression was increased from 15% to 45% of the cycle at a constant rate of 60/min. There was, however, a significant increase in perfusion pressures when rate was increased from 60 to 150/min at a constant duration of 45%. The model was validated for intrathoracic pressure changes by studying the hemodynamics produced by a thoracic vest (vest CPR) in eight dogs. The vest contained a bladder that was inflated and deflated. Vest CPR changed intrathoracic pressure without direct cardiac compression, since sternal displacement was less than 0.8 cm. As predicted by the model and opposite to direct cardiac compression, there was no change in perfusion pressures when the rate was increased from 60 to 150/min at a constant duration of 45% of the cycle. Manual CPR was then studied in eight dogs. There was no surgical manipulation of the chest. Myocardial and cerebral blood flows were determined with radioactive microspheres and behaved as predicted from the model of intrathoracic pressure, not direct cardiac compression. At nearly constant peak sternal force (378-426 N), flow was significantly increased when the duration of compression was increased from short (13%-19% of the cycle) to long (40%-47%), at a rate of 60/min. Flow was unchanged, however, for an increase in rate from 60 to 150/min at constant compression duration. In addition, myocardial and cerebral flow correlated with their respective perfusion pressures.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3662154 TI - CPR in children. AB - CPR has not been well studied in children and little is known about factors predictive of outcome. We conducted a study with three goals: longitudinal determination of demographic and laboratory data characterizing pediatric arrest victims; identification of factor(s) predictive of outcome; and determination of the prevalence of ionized hypocalcemia in pediatric arrest victims. All resuscitation efforts were documented during a one-year period in a 240-bed tertiary care children's hospital. Patients were classified into two groups- respiratory arrest (RA, requiring only assisted ventilation), and cardiac arrest (CA, absence of palpable cardiac activity requiring closed-chest CPR). Collected data and laboratory tests were analyzed using a step-wise discriminant analysis to determine which factors were predictive of outcome. There were 113 arrests in 93 children; 53 were CA victims and 40 were RA victims. CA had a high in-hospital mortality (90.6%) compared to RA (32.5%). The population was young (55% less than 1 year old) and 87% had at least one chronic underlying disease. No laboratory or demographic value was significantly associated with eventual outcome. The number of doses of epinephrine in CA victims, or bicarbonate in RA victims, was associated with eventual outcome. None of 31 CA victims receiving more than two doses of epinephrine survived to discharge. Low ionized calcium concentrations (less than 3.5 mg/dL) were identified in ten patients; septic shock was present in seven, and chronic renal failure in two.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662155 TI - A survey of participants in a mass CPR training course. AB - To determine demographic data and reasons for CPR course taking among 891 participants of a mass CPR training event, a questionnaire was distributed at the time of the course. Of the 728 persons completing this initial survey, 379 (52.6%) were less than 20 years of age. Only 41 (5.6%) took the course because of a family member or close relative with cardiac disease. Of this subgroup, seven (17.1%) had taken a previous CPR course, compared with 25.7% for the entire population. Thirty-eight percent of the 60-and-over age group mentioned cardiac disease as their reason for taking the course, compared to only 2.1% for the under-20 age group. To assess recall and actual performance of CPR, a follow-up survey was mailed to all participants six months after the course. Seventy-two percent were still confident in their ability to perform CPR, although no one had performed the technique on a real victim; 61.9% thought there should have been more manikin practice time; 92.2% still had their CPR refresher card. Only 32.3% would perform CPR on a known AIDS patient. This survey provides demographic and personal data that should be considered when planning future large-scale CPR training programs. PMID- 3662156 TI - Reinforcing CPR skills without mannequin practice. AB - We studied the effectiveness of two refresher methods on skills that did not involve mannequin practice. Sixty-seven Seattle subjects trained one year earlier were pretested and randomly assigned to one of two treatments that covered the technique of one-rescuer CPR: reading a three-page review (n = 33); or viewing a 15-minute videotape (n = 34). Subjects were tested on a recording mannequin immediately after the refresher. Pretest scores were low on almost all skills. After treatment, both groups demonstrated significant improvement (P less than .01), especially on checking the carotid pulse, correct hand position, and ventilation volume. Although students who had watched the tape performed better on compression rate (P less than .05), there was virtually equivalent improvement on the other skills regardless of treatment. Both methods showed promise for reversing skills degradation without mannequin practice. PMID- 3662157 TI - Cervical spine stabilization in pediatric patients: evaluation of current techniques. AB - We evaluated the performance of commercially available infant and pediatric cervical collars, both alone and in combination with commonly used supplemental devices (eg, Kendrick Extrication Device, half-spine board). One infant and 11 pediatric-sized collars were tested on mannequins representing an infant and a 5 year old child. Maximum forces generated by cooperative children were measured, then applied to the mannequins to reproduce head and neck flexion, extension, rotation, and lateral motion. Limitation of motion was measured in each direction for each collar and combination method. In general, collars of rigid plastic construction performed better than did foam types. However, when used alone none of the collars provided acceptable immobilization, with even the best allowing 17 degrees flexion, 19 degrees extension, 4 degrees rotation, and 6 degrees lateral motion. When combined with supplemental devices, immobilization to 3 degrees or less in any direction could be achieved. Findings were verified using cooperative children and selected collars. Overall, combination methods were more effective than cervical collars alone (P less than .001) or supplemental devices alone (P less than .05). The modified half-spine board used with a rigid collar and tape was the most effective combination method. We conclude that prehospital cervical spine stabilization in pediatric patients is best accomplished using a rigid-type cervical collar in combination with supplemental devices as described. PMID- 3662158 TI - A radiographic comparison of prehospital cervical immobilization methods. AB - Three methods of prehospital cervical immobilization were studied radiographically and compared to the short board technique (SBT). The methods were California Stif-Neck Immobilizing Collar (CSC), Kendrick Extrication Device (KED), and Extrication Plus-One (XP-One). Forty-five volunteers were immobilized in the short board (SB) and one of the test devices studied. Cervical movement in the sagittal and frontal planes was measured radiographically. Movement in the horizontal plane was measured directly. Two-tailed, paired t test analysis was performed comparing test devices to the SBT. The SBT proved to be significantly better (P less than .05) in the following comparisons: the CSC in extension and lateral bending; the KED in lateral bending; and the XP-One in extension. We confirm the SBT as the standard of comparison against which newer prehospital devices can be compared objectively. Of the three devices compared against the SBT, the factory-fabricated short board devices (KED and XP-One) provided the greatest degree of immobilization, in addition to logistical advantages over the SBT. PMID- 3662159 TI - Enhancement of phenytoin elimination by multiple-dose activated charcoal. AB - The effect of multiple-dose activated charcoal on the elimination of intravenously administered phenytoin was studied. Seven normal volunteers received phenytoin sodium 15 mg/kg IV with and without activated charcoal. During the charcoal phase, a total dose of 300 g was administered in repeated doses over 48 hours with sufficient sorbitol to produce one to two bowel movements per day. Serum phenytoin concentrations were determined from one to 72 hours after the infusions and were fitted to a one-compartment linear elimination model. The administration of multiple-dose activated charcoal reduced the phenytoin half life from 44.5 to 22.3 hours. In addition, phenytoin area under the curve was decreased and the elimination rate was increased. Multiple-dose activated charcoal is effective in enhancing the elimination of phenytoin in normal volunteers. Although future studies are needed to determine its role in treating patients with phenytoin toxicity, multiple-dose activated charcoal may provide a readily available, inexpensive therapeutic intervention. PMID- 3662160 TI - Cimetidine protection against alpha-amanitin hepatotoxicity in mice: a potential model for the treatment of Amanita phalloides poisoning. AB - The ingestion of the mushroom Amanita phalloides is associated with hepatic necrosis appearing clinically two to three days after ingestion. The mechanism of this toxicity is unknown, and no reliable antidote is available. Because of the similarity of Amanita poisoning to other toxins affecting cytochrome P450, we investigated the use of cimetidine (as a P450 cytochrome inhibitor) as an antidote against a primary toxin of the mushroom alpha-amanitin. Mice injected with alpha-amanitin and given cimetidine either prophylactically or within six hours showed histologic protection from the hepatic damage seen in control mice. Control animals displayed significant mitochondrial changes when examined by electron-microscopy, while the mitochondria of the cimetidine-treated animals were preserved, suggesting a possible site for toxin action. Further trials will be necessary before treatment of human cases with cimetidine is indicated. PMID- 3662161 TI - A comparative study of intraosseous versus peripheral intravenous infusion of diazepam and phenobarbital in dogs. AB - Authors of recent literature have made several references to the use of intraosseous infusion in emergency situations. This method has provided a useful route of medication and fluid administration when peripheral IV access has been unsuccessful. Controlled studies on intraosseous infusion have been limited. To more accurately evaluate the effectiveness of this technique, we administered diazepam to 20 dogs randomly assigned to either peripheral IV (n = 10) or tibial intraosseous (n = 10) groups. Intramedullary placement usually was performed within 15 seconds. Central venous diazepam samples were collected at one-, three , six-, ten-, and 20-minute intervals. Intraosseous infusion achieved and maintained serum diazepam levels comparable to those achieved by IV administration. This study was repeated with phenobarbital using a different set of 20 dogs with samples collected at one-, three-, six-, and ten-minute intervals. Results were similar in that the levels were comparable regardless of the use of intraosseous or IV administration. Complications using this technique have been few. When peripheral IV access is unobtainable, intraosseous infusion has been shown to be an effective and efficient alternative for administering medications and fluids. PMID- 3662162 TI - A chest pain clinic to improve the follow-up of patients released from an urban university teaching hospital emergency department. AB - During a 12-month period, 1,045 of 1,554 patients (67%) over age 30 seen in an urban teaching hospital emergency department with acute chest pain were released based on the clinical judgment of the examining physician. Patients who were released were offered follow-up within 24 to 72 hours in a hospital-based chest pain clinic. Of these 1,045 patients, 772 (74%) returned or were contacted by phone, and 29 were directly admitted; 14 had unstable angina, and eight had new myocardial infarctions. Because of its positive impact on the quality of care at an acceptable cost, the Chest Pain Clinic, which was originally instituted as part of a research protocol, has now become part of the routine spectrum of care provided at the University of Cincinnati Medical Center. PMID- 3662163 TI - The role of the emergency physician in the prevention of domestic violence. AB - In the United States, every 7.4 seconds a woman is battered by her husband. Of women who present to emergency departments with traumatic injuries, 16% to 30% report that their injuries were secondary to domestic violence. Not infrequently, battered women's medical and surgical problems are treated by ED staff and the women are released without any intervention directed toward the prevention of future battering and/or injury. Protocols are presented that require only minimal reorganization of staffing in EDs to provide essential services directed toward battered women's most serious health problem, chronic victimization. PMID- 3662164 TI - Tagamet-induced acute dystonia. AB - A 20-year-old woman presented with an apparent acute dystonic reaction after only five doses of cimetidine (Tagamet). The patient was on no other medications with the exception of oral contraceptives. Emergency administration of IV diphenhydramine HCL brought rapid reversal of this acute dystonic reaction without any neurological sequelae. To our knowledge, this is the first reported case of an acute dystonic reaction associated with cimetidine. PMID- 3662165 TI - Delayed fatal hyperkalemia in a patient with acute fluoride intoxication. AB - A 19-year-old man presented with acute fluoride poisoning. Initially his serum electrolytes were normal, but two hours later he developed ECG evidence of hyperkalemia followed by refractory ventricular fibrillation, suggesting that hyperkalemia may be important in the cardiotoxicity of acute fluoride intoxication. Treatment of fluoride-induced hyperkalemia consists of removal of fluoride from the body by dialysis, binding fluoride with aluminum or calcium, or enhancing fluoride excretion by inducing a metabolic alkalosis. Direct treatment of the hyperkalemia with glucose, insulin, and bicarbonate is ineffective. Quinidine may be an effective therapy for the hyperkalemia and ventricular irritability, but is as yet untested in human beings. PMID- 3662166 TI - Spinal epidural abscess: a rapidly progressive disease. AB - We report a case of spinal epidural abscess in a 42-year-old diabetic. The patient first presented with four days of low back pain with radicular symptoms following exertion. When he returned five days later with overt symptoms and signs of spinal cord compression, an epidural mass was diagnosed by myelogram and computed tomography scan. Following drainage of a large posterior epidural abscess, the patient was left with residual weakness requiring ongoing physical therapy. PMID- 3662167 TI - Retained foreign body in a child. AB - We present the case of a child who ingested or inhaled a foreign body that lodged between the esophagus and the trachea for more than 23 months. The only presenting complaint was of recurrent upper respiratory tract infections. The patient, a 3-year-old girl, required a tracheostomy to alleviate respiratory distress. She made a complete recovery after surgical removal of the foreign body through a neck incision. PMID- 3662168 TI - An unusual cause of headache: a dentigerous cyst in the maxillary sinus. AB - We report the case of a patient with a dentigerous cyst in the maxillary sinus presenting as two months of intermittent, unilateral, pressure-like headaches. The diagnosis was suspected after an upright Waters' projection radiogram and confirmed histologically after surgical removal. The patient was symptom free one year later. PMID- 3662170 TI - Occupational medicine--where do we get the training? PMID- 3662169 TI - Incarceration of the gravid uterus. AB - Incarceration of the gravid uterus is a rare but serious complication of pregnancy. Reported is the case of a gravida 2, para 1 26-year-old woman who presented with lower abdominal pain. The patient was 14 weeks pregnant and presented with a one-day history of abdominal pain and vaginal discharge. Examination revealed a retroflexed uterus with the cervical opening pointing toward the anterior abdominal wall. An ultrasound revealed a uterus incarcerated between the sacral promontory and the pubis. Manual reduction was performed successfully in the emergency department. PMID- 3662171 TI - Education vital to emergency physician involvement. PMID- 3662172 TI - Tetanus immunization recommendations for persons less than seven years old. American College of Emergency Physicians. AB - This position paper represents a reflection of expert opinions regarding current knowledge about tetanus immunization. It should complement, but not supplant, sound clinical judgment. PMID- 3662173 TI - The ferric chloride screening test. PMID- 3662174 TI - Use and misuse of statistics. PMID- 3662175 TI - Taser power. PMID- 3662176 TI - Delayed post-traumatic eyelid emphysema. PMID- 3662178 TI - Impact of drug screening in suspected overdose. AB - We studied how emergency qualitative drug screens were ordered and used during the evaluation of 405 consecutive adult patients presenting to a metropolitan emergency department with suspected drug intoxication. Physicians completed a two part questionnaire outlining diagnosis, diagnostic certainty, suspected drug(s), and management plans immediately following initial evaluation and again at the time of ED disposition. Screen results were reviewed prior to ED disposition in 361 (89%) cases. We found that qualitative drug screens were associated with substantial changes in diagnostic certainty, as measured by changes in probability estimates and changes in absolute mean log-likelihood ratios. In 196 cases for which all data were recorded prospectively, drug screens excluded a diagnosis of drug intoxication or specifically suspected drugs in 81 cases (41%), but identified previously unsuspected drugs in only 21 cases (11%, P less than .001). Management changes followed qualitative drug screen results in 16 of 361 cases overall (4.4%), but seven of these were also associated with diagnostic quantitative serum drug levels. Potentially critical interventions were begun in two cases following positive screens but delayed in another due to a falsely negative screen. Guidelines for more efficient test utilization are proposed. PMID- 3662177 TI - Natural course of iron delocalization and lipid peroxidation during the first eight hours following a 15-minute cardiac arrest in dogs. AB - Lipid peroxidation is thought to be a major contributing factor in neurological injury following cardiac arrest. Because iron availability is a prerequisite for lipid peroxidation, this experiment was designed to examine the natural time course of iron release, lipid peroxidation, and cerebral polyunsaturated fatty acid content following a 15-minute cardiac arrest in dogs. Large mongrel dogs were anesthetized with ketamine and halothane and divided into three groups of five each. In two groups, cardiac arrest was induced with KCl. After 15 minutes of cardiac arrest, the dogs were resuscitated by five minutes of internal cardiac massage, epinephrine, bicarbonate, and internal defibrillation. All ten dogs were resuscitated and supported by a standard intensive care protocol until tissue harvest. A 3-g portion of parietal cerebral cortex was obtained from the nonischemic dogs (n = 5), or at two hours (n = 5), or eight hours (n = 5) after resuscitation. Total tissue iron was measured by an atomic emission spectrometer; low molecular weight species (LMWS) iron by the o-phenanthroline test on an ultrafiltered sample; and lipid peroxidation by both the thiobarbituric acid test (TBARS) and determination of the tissue content of lipid double bonds, calculated by first fractionating the lipids by gas-liquid chromatography and then measuring the double bonds in each fraction by spectrometry and summing the results. Univariate ANOVA demonstrated all variables except total tissue iron to have significance at P less than .02. At two hours of reperfusion, LMWS iron and TBARS were significantly elevated above nonischemic control levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662179 TI - Cimetidine toxicity: an assessment of 881 cases. AB - We reviewed 881 documented cimetidine overdoses. The data were compiled and analyzed retrospectively from 2,612,236 poisoning cases reported to two nationwide poison surveillance systems from 1978 through 1985. Only cases of cimetidine exposures without coingestants were included. Age, sex, symptom occurrence, treatment site, reason and route of exposure, and medical outcome data were evaluated. Eight hundred eighty-one cases met the criteria and were analyzed. Children between 12 and 35 months of age accounted for 43% of the cases and 97% of all exposures were acute. Intentional overdosage accounted for 21%; 76% were accidental in nature. Gastric emptying was performed in 34%. No symptoms were observed in 79% of the cases, which included ingestions of up to 15 g of cimetidine. Only three patients had moderate clinical manifestations. No patients had major medical complications and there were no fatalities. Even patients in the moderate category experienced no life-threatening toxic manifestations. Cimetidine appears to have an extremely high therapeutic index in both children and adults and demonstrates a remarkable safety profile following acute overdose. PMID- 3662180 TI - Comparison of gastric lavage and thoracic cavity lavage in the treatment of severe hypothermia in dogs. AB - A study was undertaken to compare warm gastric (Group 1) and closed thoracic cavity (Group 2) lavage for rewarming severely hypothermic dogs. Adult mongrel dogs were monitored by intra-arterial catheter, central venous catheter, and ECG, and by central venous, esophageal, and rectal temperature probes. Animals were externally cooled to an average of 21.2 C using ice bags. Eight Group 1 and eight Group 2 animals underwent continuous warm saline gastric or closed thoracic cavity lavage, respectively, using afferent and efferent nasogastric and thoracostomy tubes. No animal suffered ventricular fibrillation during tube placement. The closed lavage system consisted of a high-efficiency heat exchanger, a roller pump infusion device, and a heat exchange fluid bath. The lavage fluid circulated at a flow rate of 550 mL/min and a temperature of 39 C. Thoracic lavage animals were followed clinically for 24 hours for evidence of complications, then euthanized and autopsied. The mean time required to rewarm the animals 10 C by central venous temperature probe was 210.9 +/- 18.6 minutes for the gastric group and 99.3 +/- 23.0 minutes for the thoracic group (P less than .001). Rectal temperature consistently lagged behind central venous temperature during both the cooling and rewarming phases in both treatment groups. All of the thoracic lavage animals made an uneventful recovery. Continuous warm saline thoracic cavity lavage for core rewarming of severely hypothermic dogs is more effective than gastric lavage, and appears to be safe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662181 TI - Effects of dichloroacetate administration during fatal hemorrhagic shock in immature swine. AB - During hemorrhagic shock, decreased perfusion and poor tissue oxygenation lead to increased lactate production. Previous animal studies have suggested that sodium dichloroacetate (DCA), an agent that decreases lactate production, can improve hemodynamics and survival when administered after severe hemorrhage. We used an unanesthetized porcine hemorrhagic shock model to assess the effect of DCA on survival time when administered during fatal hemorrhage. Immature female swine weighing 14 to 20 kg were splenectomized and instrumented with chronic indwelling aortic and right atrial catheters one week prior to hemorrhage. On the day of the experiment, the unanesthetized animals' aortic catheter was connected to a roller pump and blood was removed at a rate of 1.0 mL/kg/min until death occurred. Experimental animals (n = 8) received sodium dichloroacetate (25 mg/mL distilled water) 100 mg/kg IV bolus beginning 15 minutes after the start of hemorrhage followed by a 3 mg/kg/min constant IV infusion. Control animals (n = 8) received an equal volume of normal saline. Arterial pressure, heart rate, blood gases, serum lactate, and serum glucose were measured at baseline and every 15 minutes during hemorrhage. There were no significant differences in survival time (controls, 63 +/- 2.8 min; DCA-treated, 60 +/- 3.7 min), lactate levels, or blood pressures between the two groups. These results suggest that DCA does not decrease serum lactate or improve survival time when administered during ongoing severe hemorrhagic shock. Further study should be directed at the effects of DCA as an adjunctive treatment after hemorrhage has been controlled and tissue perfusion restored. PMID- 3662182 TI - Accuracy of urine urobilinogen and bilirubin assays in predicting liver function test abnormalities. AB - Components of the dipstick urinalysis (urine urobilinogen and urine bilirubin) are often used by emergency physicians to screen for the need to obtain liver function tests in many clinical situations. A prospective observational study was conducted to evaluate the sensitivity, specificity, and predictive properties of spot urine bilirubin and urobilinogen assays in the emergency department as screening test for serum liver function test (LFT) abnormalities. Of 122 patients, abdominal pain was the indication for laboratory evaluation in 54%; jaundice and constitutional symptoms were the indication in 29%. Overall sensitivities for both urine assays were 70% to 74% for serum bilirubin, but 43% to 53% for other LFTs; specificities were 77% to 87% for both urine screens. Positive predictive values show that the urine assays were 83% to 86% reliable for detecting at least one LFT abnormality. Negative predictive values were 85% for both urine assays for serum bilirubin elevations, but lower for other LFTs. Urine urobilinogen has its greatest clinical utility as a screen when a normal/abnormal threshold of 2.0/4.0 mg/dL is used. PMID- 3662183 TI - The reliability of excretory urography as a screening examination for blunt renal trauma. AB - A prospective study was designed to evaluate the reliability of excretory urography (EU) in excluding renal damage in patients with blunt abdominal trauma, using contrast-enhanced computed tomography (CECT) as the "gold standard" of diagnostic studies. Sixty patients with indications for genitourinary evaluation and with normal EU underwent CECT. Five renal injuries were demonstrated by CECT in patients with negative EU: one contusion, one subcapsular hematoma, two perirenal hematomas, and one renal laceration. All of these lesions resolved with conservative patient management. Thus, the CECT findings did not alter treatment in these five patients. PMID- 3662184 TI - Basic trauma life support. AB - The impact of traumatic injuries on modern society in terms of morbidity, mortality, and economic cost is enormous. Studies have shown that both advanced life support skills and rapid stabilization and transport of the trauma victim have a beneficial effect on the patient's ultimate outcome. The Basic Trauma Life Support (BTLS) course was designed to provide pre-hospital care providers with the skills necessary to provide a thorough assessment, initial resuscitation, and rapid transportation of the trauma victim. Early studies suggest that the material is easily learned by prehospital care providers and that the on-scene time for trauma cases is reduced following training in BTLS. More widespread training in BTLS may have a significant effect on the mortality and morbidity associated with traumatic injuries. PMID- 3662185 TI - Time study of patient movement through the emergency department: sources of delay in relation to patient acuity. AB - A continuous observation time study was used to track 1,568 patients through various stages of emergency department care in order to identify sources of delay. Patients initially were assigned to one of four categories of decreasing acuity, and flow profiles were compared for each category. Patients with lowest acuity level experienced long delays in moving through the ED, although the actual evaluation and treatment time was brief. Urinalyses, procedures, radiographs, and blood tests had an increasing impact on treatment times (45 minutes, 63 minutes, 65 minutes, and 126 minutes, respectively, compared to 31 minutes with no tests or procedures). Patients of increasing acuity moved more quickly, but with a longer evaluation and treatment time. The most critical patients moved most quickly but with a brief evaluation and treatment time due to a rapid disposition from the ED or death. This relationship suggests an emergency care system that is oriented toward the efficient care of high-acuity patients but that is less effective for low-acuity patients. This occurs despite the fact that low-acuity patients comprise the vast majority of the ED census, and represent a group for whom delay is a frequent source of patient dissatisfaction. PMID- 3662186 TI - Comparison of four ankle splint designs. AB - Plaster splinting is often considered the initial immobilization method for acute ankle injuries. Although the posterior splint design is most commonly recommended, clinical experience suggests that it is not the most durable in the outpatient setting. To determine the sturdiness of the four most common splint designs, each was tested for its resistance to plantar flexion 30 minutes after application. The splints tested were: standard posterior, ridged posterior, modified figure-of-eight, and sugar-tong. In six healthy subjects, significantly less plantar flexion was achieved with the sugar-tong splint than with the other designs. In addition, more force was generated per degree of plantar flexion achieved with the sugar-tong than with the other designs. These results suggest that the sugar-tong splint may be preferred in the acute treatment of ankle injuries based on its greater strength. PMID- 3662187 TI - Recurrent resuscitation and 'no code' orders in a 27-year-old spray paint abuser. PMID- 3662188 TI - Reflections of a teacher. PMID- 3662189 TI - Bilateral spontaneous pneumothorax: a rare entity. AB - A young otherwise healthy man presented with bilateral spontaneous pneumothorax that resulted in near respiratory failure and severe cardiac dysrhythmia. The magnitude of the patient's clinical manifestations resulted from his severely compromised pulmonary function with its attendant cardiovascular compromise. Prompt bilateral tube thoracostomy relieved his cardiopulmonary distress. This rare clinical entity should be considered in any individual with abrupt onset of severe cardiopulmonary distress. PMID- 3662190 TI - Shoulder pain and pneumoperitoneum following a diving accident. AB - We present the case of a diver who experienced the acute onset of shoulder pain after a rapid ascent. It was determined that the patient had decompression sickness ("the bends") of the right shoulder and pulmonary barotrauma resulting in secondary pneumoperitoneum. He underwent decompression, with prompt resolution of symptoms. Of the 14 cases of isolated pneumoperitoneum due to barotrauma reported in the world literature, three were due to gastric rupture. Shoulder pain in association with pneumoperitoneum may be due to diaphragmatic irritation or may be an isolated symptom of decompression sickness. Correctly determining the etiology of these findings is crucial to the appropriate management of the patient. PMID- 3662191 TI - An unusual presentation of Brown-Sequard syndrome. AB - We report the case of a man with Brown-Sequard syndrome following a fall in which he sustained fractures of the thoracic and lumbosacral spine. Despite characteristic neurological findings, the diagnosis was delayed due to the absence of history of penetrating spinal trauma and incorrect attribution of unilateral-like weakness and numbness to lumbosacral trauma. A directed history and examination revealed that the patient was stabbed in the back with a penknife while leaving a bus and stepped down onto a paralyzed leg, which collapsed beneath him. The patient was given an antibiotic, underwent a negative peritoneal lavage, and had myelography and nerve conduction velocity confirmatory for Brown Sequard syndrome. With rehabilitation he became ambulatory with a cane one month after the stabbing. PMID- 3662192 TI - Proptosis and diplopia following traumatic asphyxia. AB - We describe a previously unreported complication of traumatic asphyxia. An 11 year-old boy developed proptosis and diplopia following a crush injury in an automatic garage door. Computed tomography scan confirmed displacement of the eye. There was no retrobulbar hemorrhage or skull fracture, and the proptosis appeared secondary to traumatic displacement of orbital fat. Proptosis and diplopia resolved completely over six weeks. Visual disorders may be overlooked as a complication of trauma. PMID- 3662193 TI - Termination of paroxysmal supraventricular tachycardia by digital rectal massage. AB - A 71-year-old woman with an episode of paroxysmal supraventricular tachycardia (PSVT) complicated by angina pectoris and hypotension had her arrhythmia abruptly terminated by digital rectal massage (DRM) after other vagotonic maneuvers had failed. DRM termination of PSVT has not been heretofore reported. In treating PSVT by physical vagotonic maneuvers, DRM may be preferable to other techniques because of the decreased likelihood of complications noted with other such maneuvers. PMID- 3662194 TI - Naloxone-induced pulmonary edema. AB - We present the case of a 68-year-old woman with acute pulmonary edema secondary to the administration of naloxone to reverse an inadvertent narcotic overdose. The patient presented following a 12-hour history of increasingly bizarre behavior and confusion. A total IV dose of 1.6 mg naloxone was administered in an attempt to reverse the suspected overconsumption of a codeine-containing cough suppressant. She immediately became agitated, tachycardic, and diaphoretic; a clinical diagnosis of acute pulmonary edema was made. Following treatment with furosemide, nitroglycerin, and morphine sulfate, the patient recovered completely without further incident. Although naloxone is thought to be a safe drug with few complications, it should not be used indiscriminantly, and the smallest doses necessary to elicit the desired response should be used. PMID- 3662195 TI - Successful treatment with antivenin of marked thrombocytopenia without significant coagulopathy following rattlesnake bite. AB - We cared for two rattlesnake bite victims who developed platelet counts of 21,000/mm3 and 22,000/mm3. Both had only mild defibrination without evidence of intravascular clotting. In both cases, the administration of antivenin was followed promptly by a sustained rise in platelet counts. PMID- 3662196 TI - Acute goiter hematoma following blunt neck trauma. AB - Traumatic hemorrhage into the thyroid gland is rarely reported. We report the case of a 30-year-old man who sustained blunt trauma to his neck, resulting in hemorrhage into a previously existing goiter. The patient's goiter was drained in the hospital. He was doing well at a three-month follow-up. PMID- 3662197 TI - CDC recommendations on prevention of HIV transmission. PMID- 3662198 TI - Quality begins at home. PMID- 3662199 TI - Inaccuracy of QRS interval as TCA toxicity indicator. PMID- 3662200 TI - Rectal administration of diazepam. PMID- 3662201 TI - CT scanning in the low-yield population. PMID- 3662202 TI - M-mode echocardiographic values in sheep. AB - M-mode echocardiograms were recorded from 21 adult sheep (20 ewes, 1 whether). Fifteen echocardiographic measurements were taken and compared with body weights or heart rates, using linear regression equations. Significant correlations (P less than 0.05) were found when body weight was compared with left ventricular internal dimensions in systole (Yo = 0.187 Xo + 18.60, P less than 0.05) and diastole (Yo = 0.346 Xo + 26.69, P less than 0.02), septal thickness in systole (Yo = 0.0876 Xo + 7.64, P less than 0.05) and diastole (Yo = 0.0673 Xo + 4.45, P less than 0.05), aortic root dimension (Yo = 0.129 Xo + 23.40, P less than 0.05), and left atrial dimension (Yo = 0.194 Xo + 15.95, P less than 0.005). Heart rate was significantly correlated (P less than 0.05) with body weight (Yo = -0.245 X 96.71, P less than 0.05), ejection time (Yo = -0.0013 Xo + 0.376, P less than 0.001), velocity of circumferential fiber shortening (Yo = 0.0061 Xo + 0.928, P less than 0.05), mean velocity of mitral valve middiastolic closure (Yo = -0.184 Xo + 1.65, P less than 0.02), and left atrial dimension (Yo = -0.109 + 40.55, P less than 0.005). Fractional shortening of the left ventricle was (mean) 37.2 +/- 5.7% and the left atrial to aortic root ratio was (mean) 0.92 +/- 0.10. PMID- 3662203 TI - Electroretinography in Labrador retrievers given ketamine-xylazine anesthesia. AB - Electrophysiologic examination of scotopic and photopic retinal function was done in 31 young healthy Labrador Retrievers and 6 Labrador Retrievers with ophthalmoscopic signs of generalized progressive retinal atrophy (PRA). Scotopic responses to 4 stimulus intensities (b-wave threshold and 0.65-, 1.60-, and 2.59 log relative units above b-wave threshold, tests 1, 2, 3, and 6, respectively) were determined, using single-flash stimulation. Alternating current recorded single-flash c waves (stimulus intensity 3.18-log relative units above b-wave threshold, test 4) and 30-Hz photopic flicker (stimulus intensity 1.92-log relative units above b-wave threshold, test 7) responses were recorded. Results of the single-flash recordings from 31 healthy dogs were analyzed statistically. The method used allowed for a separation of rod and cone function. Tests 3, 6, and 7 were most useful in determination of retinal disease, when results of the healthy young dogs were compared with results obtained from generalized PRA affected dogs. Various doses of ketamine and xylazine in dogs with ophthalmoscopically normal fundi had no significant effects on a- and b-wave amplitudes when dogs were given single-flash stimuli 1.60-log relative units above b-wave threshold (test 3). Three 3-year-old dogs, with ophthalmoscopic signs of generalized PRA, had greatly reduced a- and b-wave amplitudes and unaltered or slightly shortened a- and b-wave latencies. One 3-year-old dog with normal-appearing fundi had responses similar to those of dogs with generalized PRA of the same age. On repeated examination 6 months later, this dog had ophthalmoscopic and angiographic signs of generalized PRA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662204 TI - Electromyographic evaluation of adult Labrador retrievers with type-II muscle fiber deficiency. AB - Labrador Retrievers with type-II muscle fiber deficiency were examined electrodiagnostically. Electromyographic changes consisted of positive sharp waves, fibrillation potentials, bizarre high-frequency discharges, and, rarely, myotonic-like discharges. Fasciculation potentials were recorded infrequently. Fibrillation potentials and bizarre high-frequency discharges were the most commonly observed electromyographic changes. Bizarre high-frequency discharges were prominent in muscles of the head and neck, proximal muscles of the thoracic limbs, and the thoracolumbar paraspinal musculature. Marked abnormalities were not observed in the motor nerve conduction velocity. Decremental responses of the evoked compound muscle action potential to repetitive nerve stimulation were not observed. PMID- 3662205 TI - Serum ferritin, serum iron, and erythrocyte values in foals. AB - Twenty-one healthy Thoroughbred and Quarter Horse foals were studied from birth until 1 year of age. Foals had access to an iron-supplemented creep feed before weaning and were fed an iron-supplemented concentrate as part of their diet after weaning at 4 months of age. Initial blood samples were taken before foals were allowed to nurse. Serum iron concentration, total iron-binding capacity, and PCV decreased during the foal's first 24 hours of life. Serum iron concentration decreased rapidly from 446 +/- 16 micrograms/dl (mean +/- SE) at birth to 105 +/- 11 micrograms/dl at 3 days of age. Serum ferritin concentration increased from a mean of 85 +/- 8 ng/ml at birth to 159 +/- 11 ng/ml at 1 day of age. Thereafter, ferritin concentration decreased gradually to a minimum of 61 +/- 6 ng/ml at 3 weeks of age, and then at 6 months increased to values similar to those from reference adult horses. The ferritin concentration in colostrum at birth was 354 +/- 42 ng/ml, compared with 25 +/- 2 ng/ml in milk 1 day later. The decrease and then increase in serum ferritin concentration occurred concomitantly with opposite changes in serum total iron-binding capacity. The mean PCV decreased gradually to a minimum at 3 months of age. This decrease was associated with an increasing number of microcytes, as determined with a cell-size distribution analyzer. PMID- 3662206 TI - Clearance of indocyanine green in dogs with partial hepatectomy, hepatic duct ligation, and passive hepatic congestion. AB - Clearance of 5 submaximal doses of indocyanine green (ICG) was measured in 5 dogs to determine the maximal removal rate (0.188 mg/kg of body weight/min) and Michaelis constant (Km, 1.25 mg/kg). From these results, 5 mg of ICG/kg of body weight was chosen on the basis of the recommendation that the dose should be at least 4 X Km to achieve sensitivity as a measure of hepatic function and independence from hepatic blood flow. Clearances of low (0.5 mg/kg) and high (5 mg/kg) doses of ICG were measured in 35 healthy dogs to determine reference values. Fractional disappearance was 15.1 +/- 10%/min for the low dose and 3.9 +/ 1%/min for the high dose; plasma half-life was 6.3 +/- 3.6 minutes and 19 +/- 4.8 minutes, respectively. The sensitivity of 2 doses of ICG was evaluated in dogs with 20% and 40% hepatectomy, nonhyperbilirubinemic obstructive cholestasis, or hepatic congestion; sham-operated dogs served as controls. Fractional disappearance and plasma half-life of ICG in the 40% hepatectomy and hepatic congestion groups were significantly different (P less than 0.05) from those in controls using both ICG doses, indicating that both doses were affected by hepatic perfusion, as well as hepatic mass. The fractional disappearance of the dye in the cholestasis group also differed significantly (P less than 0.05) from that of the controls at the high dose. Plasma clearance of both doses by dogs with 20% hepatectomy was not significantly different from that of controls. PMID- 3662208 TI - Relationship between Mycoplasma hyosynoviae infection and front limb weakness in Duroc swine. AB - A relationship between degree of Mycoplasma hyosynoviae infection and front limb soundness was examined in 254 Duroc swine. These pigs represented 3 lines of pigs (structurally sound, control, and unsound) from a population divergently selected for 4 generations for front limb soundness. Analysis of sera collected every 4 weeks between 6 and 26 weeks of age yielded complement-fixing antibody titers that were believed to be indicative of the degree of natural infection with M hyosynoviae. Analysis of several variables defined by using titer values failed to reveal significant differences among the 3 selected lines, but trends indicated higher mean and peak titer values for pigs from the unsound line. Correlations between titer variables and front limb soundness variables within genetic groups were low and not significantly different from zero. Correlations between all titer variables were calculated; the correlation between mean titer and peak titer was 0.81 (P less than 0.01), and between mean titer and age at detection of first titer, was -0.56 (P less than 0.01). Pooled heritability estimates were 0.51 +/- 0.28 for mean titer and 0.28 +/- 0.25 for peak titer. PMID- 3662207 TI - Evaluation of flow-volume curves generated by forced-expiratory spirometry in anesthetized dogs. AB - Positive-pressure plethysmography was used to generate partial and maximal flow volume data in 10 anesthetized dogs. Acetylcholine (ACh) administered IV induced significant (P less than 0.05) changes in tidal breathing, as evidenced by decreased tidal volume, increased respiratory rate and dynamic resistance, and decreased dynamic compliance. Partial forced-expiratory spirometry-determined from end inspiratory capacity and functional residual capacity, revealed changes in flow and volume as a result of ACh treatment. These changes were not seen in maximal curves (determined from total lung capacity). Peak expiratory flows were limited by the presence of an endotracheal tube. Use of instantaneous time constant variables to evaluate the concavity or convexity of the downslope of a flow-volume curve did not reveal differences after IV ACh administration. Seemingly, partial forced-expiratory spirometry was useful in detecting bronchoconstriction in anesthetized dogs. Accepted techniques of flow-volume curve analysis for the evaluation of small airway function were not sensitive enough to detect bronchoconstriction in the dog. PMID- 3662209 TI - Efficacy of levamisole and netobimin against Haemonchus contortus in lambs in Louisiana. AB - Efficacy of levamisole was evaluated in a suspected levamisole-resistant population of Haemonchus contortus in the Louisiana State University sheep flock. The efficacy of netobimin also was evaluated against this population of Haemonchus. In trial 1, 5 lambs naturally infected with H contortus were given 8 mg of levamisole/kg of body weight as a drench, and 5 lambs were not treated (controls). Nematode recovery after slaughter indicated 0% efficacy against H contortus. In trial 2, 30 nematode-free lambs were each given 8,300 F1 generation infective larvae of H contortus, which were derived from parent H contortus that survived 2 levamisole treatments in lambs being maintained in a nematode-free environment. Ten lambs were treated with 8 mg of levamisole/kg as a drench, 10 were treated with 20 mg of netobimin/kg as a drench, and 10 were not treated (control). Nematode recovery after slaughter revealed 62.3% and 99.8% efficacy for levamisole and netobimin, respectively, against H contortus. PMID- 3662211 TI - Directions. The American Nurses' Association. PMID- 3662210 TI - Effects of polysulfated glycosaminoglycan on chemical and physical defects in equine articular cartilage. AB - The effect of intra-articular polysulfated glycosaminoglycan (PSG) on repair of chemical and physical articular cartilage injuries was evaluated in 8 horses. In each horse, a partial- and a full-thickness articular cartilage defect was made on the distal articular surface of the radial carpal bone. In the contralateral middle carpal joint, a chemical articular cartilage injury was induced by injecting 50 mg of Na monoiodoacetate (MIA). Four of the 8 horses were not treated (controls), and 4 horses were treated by intra-articular injection of 250 mg of PSG into both middle carpal joints once a week for 5 treatments starting 1 week after cartilage injury. Horses were maintained for 8 weeks. There was less joint circumference enlargement in PSG-treated horses in MIA-injected and physical defect carpi, compared with that in controls. In MIA-injected joints, there was less articular cartilage fibrillation and erosion, less chondrocyte death, and greater safranin-O staining for glycosaminoglycans in PSG-treated horses. Evaluation of joints in which physical defects were made revealed no differences between control and PSG-injected joints. None of the partial thickness defects had healed. Full-thickness defects were repaired with fibrous tissue (which was more vascular and cellular in PSG-injected joints) and occasionally small amounts of fibrocartilage. Seemingly, PSG had chondroprotective properties in a model of chemically induced articular cartilage damage, whereas PSG had no obvious effect in a physical articular cartilage defect model. PMID- 3662212 TI - Program innovations attract students. PMID- 3662213 TI - All my life I've wanted to be a nurse. PMID- 3662214 TI - What advice would you give a beginning nurse. PMID- 3662215 TI - National student president juggles education, career. Interview by Terry L Selby. PMID- 3662216 TI - Buy liability insurance? Some factors to consider. PMID- 3662217 TI - An array of opportunities awaits nursing students. PMID- 3662219 TI - Model Act for state licensure of psychologists. PMID- 3662218 TI - Change and the American Psychological Association. PMID- 3662220 TI - Casebook for providers of psychological services. Board of Professional Affairs, Committee on Professional Standards, American Psychological Association. PMID- 3662221 TI - General guidelines for providers of psychological services. Board of Professional Affairs, Committee on Professional Standards, American Psychological Association. PMID- 3662222 TI - Guidelines for conditions of employment of psychologists. Committee on Academic Freedom and Conditions of Employment, American Psychological Association. PMID- 3662223 TI - Empirical studies of ethical issues in research. A research agenda. PMID- 3662224 TI - The maintenance of total ventilatory requirements through a chronic bronchopleural cutaneous fistula. AB - In patient with a chronic post-tuberculous bronchopleural cutaneous fistula (BPCF), minute ventilation, dead space, flow rates, arterial blood gas tensions, and oxygen consumption were measured during mouth breathing and after 30 min of steady-state breathing solely through the BPCF. Despite a 390-ml (18%) decrease in dead space when breathing took place through the BPCF, there were no significant changes in minute ventilation or respiratory rate. BPCF breathing was also associated with an increase in airways resistance as reflected by a 300-ml (35%) decrease in the FEV1 and a 16% decrease in the FEV1/FVC ratio. The increased resistance resulted in a 20 ml/min (18%) increase in oxygen consumption. Arterial blood gas tensions remained constant. We conclude that although ventilatory efficiency was not improved, this patient was able to satisfy his total minute ventilatory requirements, for the 30-min period, solely through BPCF breathing. PMID- 3662225 TI - Lung sound nomenclature. PMID- 3662226 TI - The Amberson lecture: tell it like it was. Part 2. PMID- 3662227 TI - Highlights: ATS symposia summaries and topics. American Thoracic Society. PMID- 3662229 TI - Guidelines for fiberoptic bronchoscopy in adults. American Thoracic Society. Medical Section of the American Lung Association. PMID- 3662228 TI - Essentials of a pulmonary consultation. American Thoracic Society. Medical Section of the American Lung Association. PMID- 3662230 TI - Pulmonary research: what topics? What costs? PMID- 3662231 TI - The diagnosis of emphysema. PMID- 3662232 TI - Annual tuberculosis screening of hospital employees--an idea whose time has not passed. PMID- 3662233 TI - The noninvasive respiratory care unit. PMID- 3662234 TI - Mechanisms of changes in nitrogen washout and lung volumes after saline infusion in humans. AB - This study was performed to determine the roles of increased intrathoracic blood volume and increased vagal tone in the changes in lung volume and nitrogen washout produced by saline infusion. In the first study, measurements of TLC, VC, FRC, ERV, and slope of phase III nitrogen washout (delta N2) were made on 8 subjects before, during, and after inflation of the leg compartments of medical anti-shock trousers (MAST). In the second study, 13 volunteers were infused intravenously with warm saline (30 ml/kg) for 30 min. Repeat measurements were made approximately 20 and 40 min after infusion. Each subject then received intravenously 0.03 mg/kg atropine, and measurements were repeated. In 7 of these subjects, a third study was performed in which the atropine was injected before saline infusion. Inflation of the MAST (see figures 5 and 6) caused a 1.9% decrease in VC, 5.3% decrease in FRC, and no change in delta N2. Saline infusion caused decreases in TLC, VC, and FRC (4.0, 3.1, and 10.1%, respectively) and a 15.0% increase in delta N2. Atropine reversed the change in delta N2 after saline infusion and prevented these changes when given prior to saline. Atropine had no effect on lung volumes whether given before or after saline infusion. We speculate from our data that saline infusion has 2 effects on the lung. One is a simple displacement of air by increased intravascular volume producing the reduction in lung volumes. The second is an increase in small airways resistance that is mediated by vagal reflex and blocked with atropine. PMID- 3662235 TI - Effect of effort on measurement of forced expiratory volume in one second. AB - The American Thoracic Society recommends that the largest FEV1 be reported from a set of forced expiratory vital capacity maneuvers performed with maximal expiratory effort. However, increased expiratory effort can decrease the FEV1. When we evaluated the peak expiratory flow rate (PEFR) in 5 normal subjects, measured from flow-volume curves, as a noninvasive index of expiratory effort, it was positively correlated with indices of effort obtained by using an esophageal balloon. We then measured the difference (dFEV1)between the largest FEV1 and FEV1 from the maneuver with the highest PEFR during 10 test sessions in 10 normal subjects. Thus, dFEV1 was always greater than or equal to 0. The mean dFEV1 was 110 ml for all sessions but decreased to 80 ml when maneuvers with poorly reproducible PEFR or forced expiratory vital capacity values were discarded. We also reviewed 9.471 spirometry sessions from outpatients and found dFEV1 to be greater than 50 ml in 26% of this population and greater than 151 ml in 7%. We concluded that during standard spirometry, FEV1 is inversely dependent on effort. Maximal effort decreases FEV1 because of the effect of thoracic gas compression on lung volume. We recommend that values from spirometry maneuvers that demonstrate submaximal effort, indicated by a decreased PEFR, be discarded. The flow-volume curve display of superimposed efforts facilitates the recognition of submaximal efforts. PMID- 3662236 TI - Assessment of the usefulness of helium-oxygen maximal expiratory flow curves in epidemiologic studies of lung disease in children. AB - Density dependence of maximal expiratory air flow (DD) has been used in adults as a test of early obstructive airway disease (OAD). Whether DD is useful as an epidemiologic tool to identify childhood risk factors for OAD is not known. In a population-based sample of 133 children 8 to 23 yr of age, we calculated density dependence at 50 and 25% of vital capacity (DD50 and DD25) (the ratios between maximal expiratory flow rates breathing helium-oxygen and air gas mixtures at each of these lung volumes), and the volume of isoflow (VisoV) (the lung volume, expressed as a percentage of vital capacity, at which maximal flow rates when breathing each gas mixture are equal), measured airway responsiveness using eucapnic hyperventilation with cold air, and obtained health and household information with questionnaires. Mean levels (+/- SD) of DD50, DD25, and VisoV were: 1.49 +/- 0.14, 1.37 +/- 0.18, and 10.7 +/- 10%. The DD50 significantly increased with age in these growing children (p less than 0.05), but DD50 was found to be significantly lower (1.42 +/- 0.14 versus 1.52 +/- 0.13; p less than 0.01) among children with nonspecific bronchial hyperresponsiveness. The DD50 also was significantly reduced among children with a history of a recent upper respiratory tract illness (URI) (p less than 0.01). There were no significant associations of DD with history of asthma, personal smoking, parental smoking, or respiratory illness during infancy. The reproducibility of DD50 was assessed on a subsample of 90 subjects in whom DD was measured during 2 surveys 1 yr apart.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662237 TI - Effects of milrinone on contractility of the rat diaphragm in vitro. AB - We studied the effects of the phosphodiesterase inhibitor, milrinone, on isometric force production in the isolated, directly stimulated rat diaphragm. Milrinone (500 micrograms/ml) significantly increased force during twitch stimulation and submaximal tetanic stimulation (p less than 0.05); force during maximal tetanic stimulation was significantly reduced by milrinone (p less than 0.05). The force-augmenting effects of milrinone were not abolished by pretreatment with indomethacin (10(-5)M). Baseline force production decreased when diaphragmatic strips were placed in a calcium-free bathing solution; force potentiation by milrinone, however, persisted in this medium. Pretreatment with milrinone more than doubled the mean time to fatigue (10.8 +/- 1.0 versus 5.1 +/- 0.6 min) during repetitive submaximal stimulation (p less than 0.01). In diaphragmatic strips fatigued by repetitive submaximal stimulation until force production was 60% of baseline, milrinone promptly improved force production; the magnitude of force potentiation after milrinone was quite similar in fresh and fatigued muscle. In conclusion, milrinone enhances diaphragmatic contractility during the most forms of direct stimulation, and delays and reverses diaphragmatic fatigue. PMID- 3662238 TI - Clinical significance of sleep apnea in the elderly. AB - The generally accepted polysomnographic criteria for diagnosis of sleep apnea is exceeded by elderly subjects with such frequency that the validity of its application to this age group has been questioned. We studied a group of elderly volunteers with nocturnal polysomnography and partitioned them into 2 groups based upon an apnea index of greater than or less than 5 per hour. The results of a protocol evaluating the presence of potential complications of sleep apnea including cardiac arrhythmias, systemic hypertension, cor pulmonale, daytime sleepiness, and cognitive impairment were compared for the 2 groups. No excess incidence of cardiovascular complications was found. Although an increase in daytime sleep tendency was shown for the group with more frequent apneas, no appreciable deficits in cognitive performance were demonstrated. Although apnea during sleep in the elderly may be associated with an increase in daytime sleepiness, it may not necessarily result in other physiologic or neuropsychologic consequences. Therapeutic intervention for these abnormalities should be carefully considered prior to the institution of treatment in light of these observations. PMID- 3662239 TI - Ambulatory evaluation of sleep disturbance and therapeutic effects in sleep apnea syndrome by wrist activity monitoring. AB - A new wrist actometer was used to obtain ambulatory activity-rest recordings in 18 patients with sleep apnea syndrome (SAS) and in 22 control subjects. A movement index (MI) and a fragmentation index (FI) during sleep time were computed, giving an estimate of the stability of sleep. In control subjects, we observed a clear differentiation between night and day activity levels. The distribution of MI and FI was very narrow, with a mean +/- SD of 13.9 +/- 5.4 and 16.1 +/- 5.8%. No correlation of MI and FI with body mass index, even in heavily obese subjects, was found; MI and FI decrease significantly with age. A diagnosis of SAS was made by standard all-night polysomnography. Patients with SAS had a significantly higher MI and FI than did control subjects (p less than 0.001). With respect to polysomnographic diagnosis of SAS, the sensitivity of activity recordings was 89%, whereas the specificity was 95%. Five patients were studied after treatment, and decreases in MI and FI at home were in good agreement with the improvement in their sleep as assessed clinically and by polysomnography. We conclude that this technique is useful for an objective measurement of sleep restlessness and fragmentation, and for a simple evaluation of therapeutic effects under real life conditions in SAS. PMID- 3662240 TI - Mild emphysema is associated with reduced elastic recoil and increased lung size but not with air-flow limitation. AB - Thirty-nine excised human lungs were examined to identify early changes in the small airways, their size distribution, and their elastic recoil in relation to mild degrees of emphysema. Elastic recoil measurement, single-breath nitrogen (SBN2) tests, and FEV1 were obtained from 18 lungs with no emphysema and 21 emphysematous lungs with no greater than Grade 5 emphysema score. The mean number of alveolar attachments per brochiole was determined from all the bronchioles cut in cross section. When the 2 groups of lungs were compared, the percentage of predicted elastic recoil of the nonemphysematous lungs was significantly greater at 50, 70, 80, and 90% of TLC than in the mildly emphysematous lungs. The TLC of the emphysematous lungs (% of predicted) was also significantly greater than in the nonemphysematous lungs. Pigment of the small airways was the only pathologic feature that was significantly greater in the emphysematous lungs than in the nonemphysematous lungs. Size distribution in the small airways was similar except for the airways zero to 0.2 mm, which were more frequent in the emphysematous lungs. When data from both groups were combined, elastic recoil was shown to be related to both the number of alveolar attachments (p less than 0.03) and the mean diameter of the small airways (p less than 0.01). We conclude that structural and functional changes in lungs with mild emphysema include reduced elastic recoil, increased lung size, and some size distribution changes in the small airways. Mild emphysema is not associated with air-flow limitation. PMID- 3662241 TI - The effects of ventilatory pattern on hyperinflation, airway pressures, and circulation in mechanical ventilation of patients with severe air-flow obstruction. AB - Patients with severe air-flow obstruction receiving mechanical ventilation are at risk of inadvertent pulmonary hyperinflation with morbidity and mortality caused by pneumothorax and circulatory depression. Nine patients with severe air-flow obstruction (5 asthma, 4 chronic air-flow obstruction) requiring mechanical ventilation were studied while sedated and therapeutically paralyzed. Pulmonary hyperinflation during steady-state ventilation was quantified by measuring total exhaled volume during 20- to 40-s apnea (end-inspiratory lung volume, VEI). Patients were studied at 3 levels of minute ventilation (VE) (10, 16, and 26 L/min) and at each VE, 3 levels of tidal volume (VT) (0.6, 1.0, and 1.6 L) and 3 levels of inspiratory flow (VI) (40, 70, and 100 L/min for VT = 1.0 L). There were progressive increases in VEI when VT was increased or when expiratory time (TE) was decreased either by an increase in rate (and hence VE) or by a decrease in VI (at a constant VE) reaching lung volumes as high as 3.6 +/- 0.4 L above FRC. Alveolar, central venous, and esophageal pressure rose in parallel with lung volumes, and hypotension was seen in most patients at highest lung volumes. Peak airway pressure (Ppk) was predominantly related to inspiratory flow and did not reflect changes in lung volume. Levels of ventilation required for normocapnia prior to paralysis (15.7 +/- 2.3 L/min) were associated with hypotension in 7 patients and probable hyperinflation in excess of 1.96 +/- 0.17 L above FRC. VEI is a simple, reproducible measurement of pulmonary hyperinflation and may be more important than Ppk in the causation of barotrauma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662242 TI - Quantitation of cellular and extracellular constituents of the pulmonary lining in rats by using bronchoalveolar lavage. Effects of silica-induced pulmonary inflammation. AB - The efficacy of bronchoalveolar lavage in the removal of cellular and extracellular components of the lining layer from the lungs of silica-treated and control rats was determined. Exponential functions were fitted to curves generated by plotting the quantity of lining layer constituent removed from the lungs by bronchoalveolar lavage versus the lavage number. From these exponential functions we determined the total amount of constituent available in the pulmonary extracellular lining and hence the efficacy of the lavage procedure in removing materials from the lungs. With control rats the removal of extracellular phospholipids, soluble protein, alkaline phosphatase, and beta-N acetylglucosaminidase by bronchoalveolar lavage occurred at significantly different rates. Removal of 95% of the total available extracellular phospholipid, beta-N-acetylglucosaminidase, soluble protein, and alkaline phosphatase from the lungs required 4, 4, 8, and 11 lavages, respectively. Removal of 95% of the total available alveolar macrophages required 18 lavages. The influence of pulmonary inflammation on the efficacy of the lavage procedure was investigated by injecting silica dust intratracheally into the lungs of rats (50 mg/200- to 250-g rat) and after 3 days performing the analyses. Silica caused an inflammatory condition in the lungs resulting in the accumulation of materials in the alveoli. Highly significant increases in soluble protein (16-fold), alkaline phosphatase (9-fold), and beta-N-acetylglucosaminidase (11-fold), polymorphonuclear leukocytes, eosinophils, and lymphocytes were observed. Alveolar macrophages and extracellular phospholipid were not significantly elevated at 3 days after dosing. Silica did not alter the efficacy of the lavage procedure in removing from the lungs any of the extracellular constituents of the lung lining.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662243 TI - Bronchoalveolar lavage and histologic characterization of late asthmatic response in guinea pigs. AB - To elucidate the mechanisms of late asthmatic response (LAR) observed in asthmatic subjects, we have developed an animal model of LAR using guinea pigs. Fifty guinea pigs were immunized with a mixture of Ascaris suum extract and aluminum hydroxide and then challenged with an inhalation of Ascaris suum extract without anesthesia. Twenty of the 50 guinea pigs showed a dual asthmatic response in which the LAR occurred 3 to 6 h after immediate asthmatic response (IAR). Histologic studies by rapid freezing with liquid nitrogen or bronchoalveolar lavage (BAL) were performed in 14 of these 20 guinea pigs with LAR and compared with those in 10 of 18 guinea pigs with only IAR, 10 control guinea pigs, and 10 nonimmunized but challenged guinea pigs. Both the percentage and the absolute number of neutrophils in the BAL fluid of the guinea pigs with LAR were significantly greater than those of the control guinea pigs (p less than 0.02) and than those of the nonimmunized but challenged guinea pigs (p less than 0.02). However, that of guinea pigs with LAR was not significantly different from that of guinea pigs with only IAR. On the other hand, histologic examination showed that eosinophil infiltration within the airway walls of the guinea pigs with LAR was more prominent than that of the guinea pigs with only IAR, and showed that there was no significant difference in neutrophil infiltration within the airway walls between the guinea pigs with LAR and the animals with only IAR. Contraction of airway (bronchus, bronchiole) smooth muscle, submucosal edema, and mucus in airway lumen were also observed in LAR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662244 TI - Lysophosphatidylcholine augments elastase-induced alveolar epithelial permeability and emphysema in the hamster. AB - We administered low dose porcine pancreatic elastase (PPE) with and without lysophosphatidylcholine (lysoPC), a naturally occurring constituent of lung lipids with known membrane-perturbing properties, to test the hypothesis that alveolar epithelial solute permeability is a determinant of the severity of elastase-induced emphysema in experimental animals. Four age- and weight-matched groups of hamsters received intratracheal injections of one of the following in a total volume of 0.5 ml TRIS buffered saline: (1) no additions, (2) 4 units PPE, (3) 135 micrograms lysoPC, or (4) 4 units PPE plus 135 micrograms lysoPC. Thirty minutes later the permeability surface area products (PS) of the alveolar epithelium to 14C-sucrose and 125I-dextran 70 were measured in excised, perfused lungs from some animals from each group. The remaining animals were killed at 6 wk, at which time pressure-volume relationships were measured in excised lungs, and the mean linear intercept was determined from sections of fixed lung tissue. Neither PPE nor lysoPC alone caused statistically significant increases in PS for either tracer. The PPE plus lysoPC caused statistically insignificant increases in sucrose PS but approximate tenfold increases in dextran 70 PS, which were highly significant (p less than 0.001). Although focal air-space enlargement was observed in some lungs 6 wk after exposure to PPE, pressure-volume relationships and mean linear intercepts were not significantly different from control values. Lungs previously exposed to lysoPC were indistinguishable from control lungs for all measurements. Severe emphysema was uniformly observed in animals that received PPE in combination with lysoPC; lysoPC had no demonstrable effect upon PPE-induced hydrolysis of native elastin in vitro.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662245 TI - Hypoplasia and immaturity of the terminal lung unit (acinus) in congenital diaphragmatic hernia. AB - We assessed the maturity of the lungs and the radial count in 10 infants with congenital diaphragmatic hernia who died in the immediate perinatal period. The lungs were all immature, with a histologic appearance of less than stated gestational age. The ipsilateral lungs were less mature in appearance than were the contralateral ones. The radial count, an assessment of acinar complexity, was reduced in all cases, and once again the ipsilateral lung was more affected. We present evidence that, in 4 of 6 lungs, volumes were more reduced than predicted from the radial count, and this may be due to loss of (airway) units. We have discussed the controversy about the appearance of the acinus in diaphragmatic hernia and present reasons to explain this. Hyaline membrane disease often occurs in diaphragmatic hernia, even at full term. Intra-alveolar hemorrhage is a common complication of diaphragmatic hernia. PMID- 3662246 TI - The relationship between exercise-induced asthma and plasma catecholamines. AB - In asthmatics, exercise (E1) is known to induce bronchoconstriction; a second period of exercise (E2) within 30 to 90 min induces a lesser degree of bronchoconstriction. The reason for the "refractory" bronchoconstrictor response to E2 is unclear. We studied 6 normal subjects (Group 1) and 12 stable asthmatics to examine the possible relationship between the refractory period and sympathoadrenal function. The asthmatics were further divided into 2 groups, based on the absence (Group 2, n = 5) or presence (Group 3) of an exercise induced bronchoconstrictor response. In each subject/patient, after control measurements of spirometry and venous blood sampling, a standard level of treadmill exercise was performed, and blood and spirometry were obtained at 1, 5, 15, and 25 min after the end of exercise. A second period of treadmill exercise, of the same level and duration, was then performed, and blood sampling and spirometry were repeated at the same time intervals after the end of exercise. There was no significant (p less than 0.1) difference in baseline plasma epinephrine (Ep), or norepinephrine (Np) levels; however, plasma dopamine (Dp) levels were significantly (p less than 0.05) higher in Group 3. In Groups 1 and 2, FEV1 did not change significantly after the first (E1) or second (E2) exercise periods, but there were significant (p less than 0.01) changes in Group 3 (maximal percent changes in FEV1, delta FEV1%, E1 = -14.4%, E2 = -8.8%), and the delta FEV1% after E2 was significantly (p less than 0.01) less than after E1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662247 TI - Airway smooth muscle and disease workshop. October 24-26, 1986, Rotherwick, Hants., U.K. Proceedings. PMID- 3662248 TI - Airway smooth muscle and disease workshop: contractile mechanisms. PMID- 3662249 TI - [Cessation of breast feeding: mothers exposed to the above-mentioned risk]. AB - We have investigated the incidence of breast-feeding and factors that concerns it, in 135 mothers who gave birth from January to July 1986 in our hospital. 97% of mothers began breast-feeding, but only 42% went on with it at third month of infant's life, and only 9.75% of them at sixth month. The most common reason for breast feeding failure is the "cry baby". The mother's age, the socioeconomic level, the mother-newborn bonding after delivery are related with lengthy breast feeding. In conclusion, the lower social levels are the target for the information in order to promote the breast-feeding. PMID- 3662250 TI - [Serum vitamin E in well-nourished and malnourished infants]. AB - Vitamin E (tocopherol) concentrations in blood plasma were determined in 48 infants and correlated with their nutritional status. Infants were divided into two groups as following: group I (n : 12) estimated well-nourished, and group II (n : 36) appreciated undernourished. Clinical nutritional status was evaluated according to their weight, height and skinfold thickness of triceps percentiles. Plasma vitamin E levels were analysed by a modification of the spectrophotometric micro-technique of Fabiank et al. (using 0.2 ml of plasma). There was difference in serum tocopherol levels between two groups: 1.21 (0.21) mg/dl: mean (+/- SEM) in group I in front of 1.84 (0.18) mg/dl in group II (0.10 greater than p greater than 0.05). On the other hand, vitamin E concentrations were correlated with the skinfold thickness of triceps percentiles by a logarithm curve: y = 2.25-0.31 1n X (r: 0.35, p less than 0.02). Probably, serum vitamin E levels do not reflect the tissue store status in undernourished infants without malabsorption. PMID- 3662251 TI - [Morbidity, vaccine coverage and immunity against measles, mumps and rubella in a Gallician population from 2 to 5 years old]. AB - Vaccine coverage, morbidity prevalence, and immunity to measles, rubella, and mumps, were estimated in 1985-1986 among a sample of 2 to 5 years old Galician children, studied through questionnaires and immunoenzymatic determinations of antibodies. According to the mothers, measles vaccine and measles-mumps-rubella vaccine were administered to 22.1% and 45.7%, respectively, of their children, whereas measles were reported in 17.9, mumps in 14.3%, and rubella in 2.9%. The seroconversion to rubella (50.7%) resulted significantly lower (p less than 0.001) than that to measles (75%) or mumps (68.6%). The three types of antibodies were found altogether in 32.1% of the subjects, and 5% of them showed none of these antibodies. The analysis of the serologic data stresses the need for reaching rapidly higher vaccination rates. PMID- 3662252 TI - [Lead poisoning in the school-aged child: results of a screening program using zinc protoporphyrin]. AB - The results of a zinc-protoporphyrin (ZPP) screening in 1983 among first-grade schoolchildren in Hospitalet de Llobregat (Catalonia, Spain) are presented. Tap water in this industrial city comes from the Llobregat river and is extremely hard, with an excessive level of salts. At this time, Spanish gasoline had high levels of lead. The purpose of the study was to evaluate the effect of environmental pollution on subclinical lead poisoning. These were 428 children in the study, 67% of those eligible. Causes for non participation were being absent from school on the screening day or lack of parental consent for participation in the study. Only in two children levels of ZPP above 40 theta g/100 ml were found; both cases had iron deficiency anemia with low blood lead levels. Mean ZPP levels were somewhat higher in the Collblanc district, which suffers higher air pollution from street traffic, and in children living in houses built before 1940. The relevance and implications of these findings are discussed. PMID- 3662253 TI - [Subcutaneous adrenaline versus inhaled salbutamol in the treatment of childhood asthmatic crisis]. AB - As a bronchodilator, inhaled salbutamol has been shown to be as pharmacologically effective as epinephrine. However the use of the pressurised aerosol is difficult for pediatric patients (mainly under the age of six). The use of spacers (inhalation chambers) could solve this problem. This study was undertaken to compare the clinical effectiveness and toxicity of these two drugs and to try to establish dosage schedules of inhaled salbutamol with spacer in the treatment of acute asthma. The study population consisted of 100 children who were admitted to the emergency room at our hospital with acute asthma. One group receives 0.01 mg/kg of epinephrine (A) (maximum 0.3 mg), the other two groups received inhaled salbutamol (S-1 = 4 puffs and S-2 = 7 puffs) in a period of 20 minutes. Clinical effectiveness was measured by the score of Wood-Downes at 0, 30 and 60 minutes; and no statistical differences were observed between the three groups. The clinical effectiveness was similar in the three groups and the side effects (especially the increase of heart rate) was higher in epinephrine group. Inhaled salbutamol is as effective as subcutaneous epinephrine in management of children in acute bronchoconstricting episodes with less side effects. PMID- 3662254 TI - [The abused child syndrome]. PMID- 3662255 TI - [Metatropic dysplasia: a new case]. AB - A new case of metatropic dysplasia in a 2.5 month old child is presented. Diagnoses was made in base of special face, long thorax, shortness of extremities with restricted joint mobility, kyphoscoliosis and a caudal appendage overlying the sacrum. Radiologically, expanded and irregular metaphyses of shortened tubular bones, platyspondyly and kyphoscoliosis. With growth, patients develop changes in body proportions. This syndrome is transmitted as an autosomal recessive. Prevention by genetic counseling is the principal measure. PMID- 3662256 TI - [Hydrops fetalis caused by endocardial fibroelastosis of the familial type]. PMID- 3662257 TI - [Acute suppurative thyroiditis]. PMID- 3662258 TI - [AIDS dementia: presentation of a pediatric case in the initial phase]. PMID- 3662259 TI - [Buschke's scleredema with a prolonged course in childhood]. PMID- 3662260 TI - [Amniotic band syndrome and a 47, XYY karyotype]. PMID- 3662261 TI - [Waardenburg syndrome with hare-lip and complete palatal cleft]. PMID- 3662262 TI - [Effects of phenobarbitol in the convulsive syndrome in newborn infants]. AB - Authors studied phenobarbital level's in serum in 21 newborns with convulsant syndrome. They consider serum's levels after five minutes and after 12-24 hours, the best time to study maximum action and duration of levels in relation to sedative limits. Non-radio-active immunoanalysis was used as markers instead reactive substances of enzymes. Enzymatic activities are measured by addition of substrates for enzyme employed (in this case G-6-PDH). PB dose employed was between 10 mg/kg IV in nine newborns and 20 mg/kg in another 13. All of them experienced a support dose between 2 and 4 mg/kg/24 hours during a week's time after sedation. Variable affects were: only 6 cases (28%) followed a good evolution with PB only. Two anticonvulsant drugs were used in 11 (52.4%) and 4 (19%) needed one more. They don't reach any relation between etiology of convulsant syndrome, PB doses and serum's levels. PMID- 3662263 TI - [Plasmacoagulase-negative Staphylococcus sepsis: experience in a neonatal intensive care unit]. AB - Among 1,049 admissions in the newborn department, during 18 months, authors found 148 positive blood cultures to staphylococci epidermidis (EPN). Recovery of EPN from blood should not be dismissed as a contaminant. 11 newborn were considered to have septicemia by EPN, that means 1.04% of all admissions and 5.6% of babies admitted in intensive care. They find that catheters (100%), assisted ventilation (45.4%) and previous surgery (36.3%) are significant predisposing risk factors. Clinical and laboratory pattern was not different of other sepsis except its late onset. Two patient died. Vancomycin is considered the drug of choice. PMID- 3662264 TI - [Intraventricular hemorrhage in healthy newborn infants at term]. AB - Cases of intraventricular haemorrhage in full term newborn reported in the literature are scarce and etiopathological factors responsive remain unclear. Authors report a series of four full term infants weighting normal for their gestational age, who developed intraventricular hemorrhage, without any previous etiological factor. Seizures were the onset in all the newborns and, two of them prothrombin test was decreased. Diagnosis was confirmed by cranial ultrasonographic and CT scan after Papilla's classification. Haemorrhage was grade IV in two cases, grade III in another and grade I in the last case. One of the patients died in neonatal period, and the three others developed hydrocephalus. Two of them required ventriculo peritoneal shunt. Follow-up was carried from 14 months to 4 years. Authors found that infants who developed widespread haemorrhage had a poor neurologic outcome. PMID- 3662265 TI - [Treatment with intravenous indomethacin of symptomatic ductus arteriosus in premature newborn infants]. AB - Sixty-four preterm infants (birth weight 1,393 +/- 483 g g and gestational age 30.1 +/- 2.7 weeks) developed a symptomatic ductus arteriosus, and were treated with intravenous indomethacin. Mechanical ventilation was needed by all of them, and 98% had IRDS. Pharmacologic ductus closure rate was 87%. Sixty-four per cent of patients had a permanent closure after first trial, and 74% after a second course of the drug. Ductus closure rate was found to be greater in patients with higher birth weight and gestational age. It was also higher in patients treated in the first week of life. Closure rate was higher in this group of patients treated with intravenous indomethacin, than in a previous group of a similar birth weight and gestational age, who received the drug by oral route (87% versus 64%). Incidence of necrotizing enterocolitis was found to be similar in both groups. Follow-up data showed that four infants (8.5%) had severe neurological sequelae, and another three cases (6.4%) developed severe respiratory problems. PMID- 3662266 TI - [Systemic Candida infections]. AB - Seven cases of neonatal systemic candidiasis are summarized. This means an incidence of 8.3% respect total amount of newborns admitted and 3.7% of babies admitted in the intensive care unit. Clinical presentation was not specific. Five blood cultures were positive and in two cases meningitis was recognized. Two cases died. Six cases were treated with amphotericin B and 5-fluorocytosine and in one case renal toxicity appear. PMID- 3662267 TI - [Pathology of the phagocytic mononuclear system. Apropos of 4 cases]. AB - Four patients, with disorders belonging to mononuclear phagocyte system diseases are described: a case of malignant histiocytosis; one of Weber-Christians disease and two siblings affected by familiar erythrophagocytic lymphohistiocytosis. An attempt is made to update classification of this group of diseases previously known as reticulosis, reticulohistiocytosis, reticuloendotheliosis, etcetera. PMID- 3662268 TI - [Genetic counseling]. PMID- 3662269 TI - [Intravenous indomethacin in the treatment of patent ductus arteriosus. A new form of preparation]. PMID- 3662270 TI - [Splenic abscess in an infant. Diagnostic value of echography]. PMID- 3662271 TI - [Medical treatment and treatment by interventional catheterization in the neonate with severe congenital cardiopathy]. PMID- 3662272 TI - [Importance of radiology in the study of cholestatic icterus in pediatrics]. PMID- 3662273 TI - [Preventive treatment of convulsions in perinatal asphyxia]. AB - A double blind randomized study has been performed in 17 newborn infants bearing a diagnosis of perinatal asphyxia and treated with phenobarbital (FB) or phenytoin (DPH) to prevent the onset of seizures. The initial dose for both drugs was 12 m/kg IM the first day, followed by 6 mg/kg/day through the seventh day. Patients were clinically assessed daily and drug blood levels were also determined daily by enzyme immunoassay (EMIT). Mean FB levels along the seven days were 17.6, 23.7, 25.6, 31.6, 31.4, 36.7, and 44.6 micrograms/ml. One child treated with FB exhibited seizures on the second day and six children showed drowsiness and bradycardia on the last two days, that were attributable to high levels of FB. Mean (DPH) levels along the study were: 4.6, 7.0, 9.7, 6.5, 4.5, and 5.2 micrograms/ml. Seizures occurred in one of the DPH-treated patients and signs of therapeutic inefficacy such as hypertonus and abnormal movements appeared in four children. PMID- 3662274 TI - Lovastatin (mevinolin) in the treatment of heterozygous familial hypercholesterolemia. A multicenter study. AB - STUDY OBJECTIVE: To evaluate the efficacy and tolerability of lovastatin under controlled conditions in heterozygous familial hypercholesterolemia. DESIGN: Randomized, double-blind, placebo-controlled, multicenter trial. SETTING: Five lipid clinics with a central laboratory and coordinating center. PATIENTS: 101 adult patients with heterozygous familial hypercholesterolemia. INTERVENTIONS: Patients were on a lipid-lowering diet throughout the study. After a 4-week placebo baseline period, patients were randomized to five equal treatment groups. Each group received a different sequence of placebo or lovastatin 5 to 40 mg twice daily or 20 to 40 mg once daily in the evening, during three consecutive 6 week periods. MEASUREMENTS AND MAIN RESULTS: The mean reductions in total plasma cholesterol and low-density lipoprotein cholesterol across the dosage ranges were 14% to 34% and 17% to 39%, respectively (p compared with zero and placebo less than 0.01). High-density lipoprotein cholesterol and apolipoproteins AI and AII rose slightly. Apolipoprotein B fell substantially at the higher dosage levels ( 23% at 40 mg twice daily, p less than 0.01), indicating a reduction in the concentration of circulating low-density lipoprotein particles. Maximum response was achieved in 4 to 6 weeks. Twice-daily dosing was slightly more efficient than once-daily dosing. Of those patients receiving 40 mg twice a day, 89% had a fall in low-density lipoprotein cholesterol of at least 20%, and 61% had a fall of at least 40%. Adverse effects attributable to lovastatin were minimal, and no patient was withdrawn from the study. CONCLUSION: Lovastatin was well tolerated and effective in the treatment of familial hypercholesterolemia. PMID- 3662275 TI - Complementarity of colestipol, niacin, and lovastatin in treatment of severe familial hypercholesterolemia. AB - OBJECTIVE: To compare the effectiveness of the ternary-drug combination of colestipol, niacin, and lovastatin with binary combinations of those drugs in treating patients with familial hypercholesterolemia. DESIGN: An open sequential study of serum lipoprotein responses in patients receiving diet alone (mean duration, 4 months); colestipol and niacin with diet (mean duration, 9 months); and colestipol, niacin, and lovastatin with diet (mean duration, 15 months). SETTING: Metabolic ward and lipid clinic of a university medical center. PATIENTS: Twenty-two patients with clinical characteristics of familial hypercholesterolemia (low-density-lipoprotein cholesterol, greater than 8.48 mmol/L; 21 of 22 with tendon xanthomas). INTERVENTIONS: Diet: less than 200 mg/d of cholesterol and less than 8% of total calories from saturated fat; colestipol, 30 g/d; lovastatin, 40 to 60 mg/d; and niacin, 1.5 to 7.5 g/d. MEASUREMENTS AND MAIN RESULTS: Mean total serum cholesterol and low-density-lipoprotein cholesterol levels of 4.86 +/- 0.62 mmol/L (188 +/- 24 mg/dL SD) and 2.89 +/- 0.54 mmol/L (112 +/- 21 mg/dL SD), respectively, were significantly lower during ternary-drug treatment than during colestipol-niacin treatment (p less than 0.003) or during treatment in which other possible binary combinations were given. The cholesterol content of very low-density-lipoproteins was lower and high-density-lipoprotein cholesterol levels higher during this phase than during the colestipol-niacin phase. CONCLUSIONS: Colestipol, lovastatin, and niacin are mutually complementary in treating hypercholesterolemia. This regimen produces reductions in serum cholesterol levels similar to those associated with regression of atheromatous plaques in animal studies. PMID- 3662276 TI - Intravenous verapamil for treatment of multifocal atrial tachycardia with and without calcium pretreatment. AB - Verapamil was given to 16 consecutive patients with multifocal atrial tachycardia. Intravenous verapamil was administered at a rate of up to 1 mg/min while heart rate and systolic blood pressure were being monitored. The final 5 patients received 1 g of intravenous calcium gluconate 5 minutes before treatment with verapamil; the first 11 received no calcium. The mean +/- SD heart rate decreased by 21% from 129 to 101 beats/min, a difference of 28, 95% confidence interval (CI), 18 to 38 (p less than 0.0005 by t-test), after a mean of 22 +/- 13 minutes from the start of verapamil administration. The mean verapamil dose was 17 +/- 7 mg (6 to 30 mg). Sinus rhythm was restored in 8 patients. Pretreatment with calcium did not block the effect of verapamil on heart rate (27% decrease with calcium compared with 19% decrease without calcium, a difference of 8%, 95% CI, -7 to 23; p = 0.29) but minimized the decrease in systolic pressure (11% decrease with calcium compared with 27% decrease without calcium, a difference of 16%, 95% CI, 7 to 27; p less than 0.01). Verapamil caused transient asymptomatic hypotension in 1 patient. Arterial blood gases were unchanged by verapamil. Thus, verapamil is safe and effective therapy for multifocal atrial tachycardia, consistently slowing the heart rate and often restoring sinus rhythm. Calcium pretreatment may reduce drug-induced hypotension without preventing the antiarrhythmic effect. PMID- 3662277 TI - The automatic implantable cardioverter-defibrillator in drug-refractory ventricular tachyarrhythmias. AB - STUDY OBJECTIVE: To assess the efficacy of the automatic implantable cardioverter defibrillator in preventing sudden death in high-risk patients. DESIGN: Nonrandomized cohort study. SETTING: A university teaching hospital with 500 beds. PATIENTS: Consecutive sample of 78 patients with symptomatic, sustained ventricular tachyarrhythmias that were previously drug-refractory. INTERVENTIONS: Before February 1985, patients received treatment with the defibrillator and amiodarone if they presented with loss of consciousness (group A) and amiodarone alone if they did not lose consciousness (group C). After February 1985, because the availability of the defibrillator was severely curtailed, patients who lost consciousness received treatment with amiodarone alone (group B). MEASUREMENTS AND MAIN RESULTS: The risk for recurrent arrhythmias was similar between groups. The actuarial risk for sudden death in group B was 31% (95% confidence interval, 11% to 51%) at 1 and 2 years, a value that was significantly higher than that for group A (p less than 0.003) or group C (p less than 0.03). The risk for dying suddenly with the first recurrence was 0.78 in group B, a value that was significantly higher than that for group A (p less than 0.003) or group C (p less than 0.002). CONCLUSION: The defibrillator is highly effective in preventing sudden death in patients whose presenting arrhythmias caused loss of consciousness (group A). In patients whose presenting arrhythmias did not result in loss of consciousness (group C), initial treatment with the defibrillator appears unnecessary. PMID- 3662278 TI - Severe symptomatic hyponatremia: treatment and outcome. A study of 64 cases. AB - A serum sodium concentration of 110 mmol/L or less is thought to be extremely dangerous; mortality rates of 33% to 86% have been cited. Experience at the University of Rochester School of Medicine does not corroborate this widespread belief. Among 62 patients with 64 episodes of severe hyponatremia, the mortality rate was only 8%, and most deaths were caused by underlying diseases; with a serum sodium concentration of 105 mmol/L or less, the mortality rate was 5%. Rapid correction of hyponatremia did not account for this favorable prognosis. Only 6% of the 64 cases were corrected to a serum sodium concentration of 120 mmol/L at recommended rates of 1.5 to 2 mmol/(L.h); half of the patients achieved this rate of correction because of a spontaneous water diuresis. In some settings, vigorous therapeutic efforts may have contributed to an adverse outcome. Rapid correction of hyponatremia is not indicated just because the serum sodium concentration is extremely low. PMID- 3662279 TI - Ribavirin treatment of the acquired immunodeficiency syndrome (AIDS) and the acquired-immunodeficiency-syndrome-related complex (ARC). A phase 1 study shows transient clinical improvement associated with suppression of the human immunodeficiency virus and enhanced lymphocyte proliferation. AB - STUDY OBJECTIVE: To assess safety, tolerance, and the clinical and laboratory effects of oral ribavirin in patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS-related complex. DESIGN: Three uncontrolled phase I trials of increasing duration: 14 days, 8 weeks, and 12 months. SETTING: Outpatient clinic of a university-referral hospital. PATIENTS: All patients were antibody-positive for the human immunodeficiency virus (HIV) by radioimmunoprecipitation assay, all had recovered from Pneumocystis carinii pneumonia, and none had Kaposi sarcoma at entry. Nine of ten patients with AIDS had less than 100 CD4+ lymphocytes/mm3 at entry and all patients with the AIDS-related complex had fewer than 200 CD4+ lymphocytes/mm3. Five patients with AIDS and five with the AIDS-related complex entered the 14-day trial. All but two patients with AIDS went on to the 8-week trial, along with seven additional patients with AIDS. Five surviving patients with AIDS and 3 patients with the AIDS-related complex went on to the 1-year study. INTERVENTIONS: Oral ribavirin, 1200 mg twice daily for 3 days was given, followed by 300 mg twice daily for 11 days. During an 8-week trial, a loading dose of oral ribavirin was administered for 3 days, followed by a dose of 300 mg twice daily for 8 weeks. Prolonged regimen of a 3-day loading dose was given, followed by a dose of 300 mg twice daily for 1 year. MEASUREMENTS AND MAIN RESULTS: Ribavirin treatment was well tolerated, with anemia requiring transfusion in one of the ten patients with AIDS receiving the drug for 8 weeks; no other significant toxicity occurred. Six of nine patients initially positive for HIV-1 in blood became negative during ribavirin treatment. Six of nine patients with AIDS had a twofold improvement in lymphoproliferative response to at least one lectin with ribavirin treatment. Mean survival from first episode of P. carinii pneumonia was 17.3 months in patients with AIDS receiving 8 weeks of ribavirin and 21.2 months in patients with AIDS receiving prolonged treatment. CONCLUSIONS: Oral ribavirin, 600 mg daily, was well tolerated and safe in the patients with severe AIDS and the AIDS-related complex. Ribavirin therapy merits extensive evaluation in a multicenter controlled trial to assess its efficacy. PMID- 3662280 TI - Fatal Rhizopus infections in hemodialysis patients receiving deferoxamine. AB - Four hemodialysis patients receiving deferoxamine for metal overload had fatal rhinocerebral rhizopus infections. Serious fungal infections are not commonly seen in patients on dialysis, and none of these patients had the usual risk factors for rhizopus infection. Deferoxamine is being used with increased frequency in dialysis patients for aluminum and iron overload states. We propose that there is a link between the deferoxamine therapy and this unusual infection. Deferoxamine may serve as a specific growth factor for Rhizopus species or may alter host immune function. We suggest searching for fungal organisms in patients with unexplained illnesses receiving deferoxamine. PMID- 3662282 TI - Congestive cardiomyopathy and illness related to the acquired immunodeficiency syndrome (AIDS) associated with isolation of retrovirus from myocardium. PMID- 3662281 TI - Lupus nephritis after total lymphoid irradiation: persistent improvement and reduction of steroid therapy. PMID- 3662283 TI - Disseminated multiple antibiotic-resistant gonococcal infection: needed changes in antimicrobial therapy. PMID- 3662284 TI - Idiopathic nephrotic syndrome. Puncturing the biopsy myth. AB - We used decision analysis to compare the conventional strategy of biopsy-tailored therapy with alternative strategies not using renal biopsy in treating adults with idiopathic nephrotic syndrome. We evaluated data on steroid and platelet inhibitor therapies and a new clinical strategy, empiric sequential therapy. This sequential approach involves use of short-term alternate-day steroid agents, followed by long-term platelet inhibitors for persistent nephrotic syndrome. Our results indicate that, contrary to usual practice, use of renal biopsy is not necessary in caring for adult patients with idiopathic nephrotic syndrome; empiric short-term alternate-day steroid therapy is equally efficacious. If the benefits of platelet-inhibitor therapy for treating membranoproliferative glomerulonephritis are confirmed, empiric sequential therapy also will be equally efficacious. Our study shows how decision analysis can be used to identify superfluous diagnostic procedures. PMID- 3662286 TI - 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors: a new class of cholesterol-lowering agents. PMID- 3662285 TI - The clinical evolution of Lyme arthritis. AB - To determine the clinical evolution of Lyme arthritis, 55 patients who did not receive antibiotic therapy for erythema chronicum migrans were followed longitudinally for a mean duration of 6 years. Of the 55 patients, 11 (20%) had no subsequent manifestations of Lyme disease. From 1 day to 8 weeks after disease onset, 10 of the patients (18%) began to have brief episodes of joint, periarticular, or musculoskeletal pain for as long as 6 years, but they never developed objective joint abnormalities. From 4 days to 2 years after disease onset, 28 (51%) had one episode or began to have intermittent attacks of frank arthritis, primarily in large joints; a few had polyarticular movement. The total number of these patients who continued to have recurrences decreased by 10% to 20% each year. The remaining 6 patients (11%) developed chronic synovitis later in the illness; of these, 2 (4%) had erosions, and 1 (2%), permanent joint disability. The spectrum of Lyme arthritis ranges from subjective joint pain, to intermittent attacks of arthritis, to chronic erosive disease. PMID- 3662287 TI - Equity in causation judgments. PMID- 3662288 TI - Geriatric hypernatremia [corrected]. PMID- 3662289 TI - Graduate medical education: a vital renewal for internal medicine. PMID- 3662290 TI - Clinical competence in colonoscopy. Health and Public Policy Committee, American College of Physicians. PMID- 3662292 TI - Primary pulmonary hypertension. PMID- 3662291 TI - Enhancing standards of excellence in internal medicine training. Federated Council for Internal Medicine. PMID- 3662293 TI - Aortic dissection and cocaine abuse. PMID- 3662295 TI - Isolation practices in hospitals. PMID- 3662294 TI - Prevalence of familial dysalbuminemic hyperthyroxinemia in Hispanics. PMID- 3662296 TI - Lyme disease misdiagnosed as a brown recluse spider bite. PMID- 3662297 TI - Mucormycosis infection in dialysis patients. PMID- 3662298 TI - Herpes zoster infection in a patient on methotrexate given prednisone to prevent post-herpetic neuralgia. PMID- 3662299 TI - Acquired immunodeficiency syndrome (AIDS) and sulfadiazine-associated acute renal failure. PMID- 3662300 TI - Disseminated Mycobacterium kansasii infection in the acquired immunodeficiency syndrome (AIDS) PMID- 3662302 TI - Lactic acidosis and bicarbonate therapy. PMID- 3662303 TI - Elevated serum creatine kinase levels in diabetic patients with the nephrotic syndrome. PMID- 3662301 TI - Neopterin levels correlating with the Walter Reed staging classification in human immunodeficiency virus (HIV) infection. PMID- 3662304 TI - Cyclosporine-induced acute renal failure in the nephrotic syndrome. PMID- 3662305 TI - Interaction of aluminum hydroxide and allopurinol in patients on chronic hemodialysis. PMID- 3662306 TI - More on drug fever. PMID- 3662307 TI - Norfloxacin and neutropenia. PMID- 3662308 TI - Pentamidine and fatal hypoglycemia. PMID- 3662309 TI - Randomization in clinical trials. PMID- 3662310 TI - More informative abstracts. PMID- 3662311 TI - Development of presenile cataracts in association with high serum levels of phenytoin. AB - We report the occurrence of bilateral cataracts in a young adult which developed shortly after documented high serum levels of phenytoin. There are two previous reports (five patients) in the literature implicating this drug as a cause of cataract formation in humans. This is the first case in which toxic levels were measured. PMID- 3662312 TI - Radial keratotomy increases the effects of disability glare: initial results. AB - Attempts to correct myopia by surgical intervention (radial keratotomy) are increasing, and disability glare is emerging as a common subjective postsurgical complaint. To date, efforts to quantify this complaint have failed. By measuring increment thresholds in the presence of a point-glare source, we have been able to measure large glare effects (up to six times normal) at low background luminance levels. PMID- 3662313 TI - The effect of timolol on anterior-chamber oxygenation. AB - The effect of timolol maleate, a nonspecific beta-blocking agent, on anterior segment oxygenation was studied using oxygen-sensitive microelectrodes inserted into the mid-anterior chamber of 13 cat eyes. The anterior-chamber oxygen tension was monitored continuously for two hours following the topical application of three drops of timolol 0.5%. Although a small, but significant, decline in oxygen tension of 19% was observed over the initial 90 minutes (P less than or equal to .05), the overall 10% decrease at the end of two hours was not considered either clinically or statistically significant when compared with a group of controls. Timolol, since it does not contribute significantly to hypoxia, may therefore be a more prudent choice for lowering intraocular pressure in disorders where hypoxia is believed to play an important role, such as in neovascular glaucoma and sickle-cell hyphema. PMID- 3662314 TI - The ocular manifestations of Rocky Mountain spotted fever. AB - To our knowledge, this is the first report of an iris nodule in a case of Rocky Mountain spotted fever (RMSF). The iris nodule may be similar to the "typhus nodule" of the central nervous system reported at autopsy in patients with typhus rickettsial disease. Previous case reports of RMSF have emphasized either anterior uveitis or retinal vasculitis. In the case reported here, both occurred in our patient as a result of RMSF. Also, we review the ophthalmic literature on rickettsial disease. PMID- 3662315 TI - Factors associated with retinal-vein occlusion in Hispanics. AB - Sixty-eight foreign-born Hispanic patients with angiography-proven retinal-vein occlusion (RVO) and 50 age-, sex-, and race-matched controls were evaluated for systemic disease. Thirty of the RVO patients had central retinal-vein occlusion, and 38 had branch retinal-vein occlusion. Hypertension, the most commonly associated factor, was present in 66.2% of the RVO patients in contrast to 18% of the controls (P less than .001). Other factors which were more common in the RVO population included open-angle glaucoma (19.1% vs 8%), diabetes mellitus (16.2% vs 12%), and atherosclerotic heart disease (14.7% vs 10%); these, however, were not statistically significant (P greater than .05). Hyperlipidemia was present in 12% of the controls and 10.3% of the RVO group (P greater than .50). This is in direct contrast to reports of nonHispanic populations where hyperlipidemia has been reported to be present in up to 60% of RVO patients. PMID- 3662316 TI - Misdiagnosis of iridocyclitis. AB - Flare cells, and hypotony do not always signify uveitis, but may also be presenting symptoms of a retinal detachment. Unexpected, unusually good intraocular pressure control in a difficult case of glaucoma is less often a cause for rejoicing and more often a result of a retinal detachment. PMID- 3662317 TI - Corneal sensation in retinal detachment surgery. AB - We compared the rate of recovery of corneal sensation in two randomly selected groups of patients with rhegmatogenous retinal detachment whose eyes were otherwise healthy. One of the groups underwent removal of the epithelium and, and the other was characterized by nonremoval of the epithelium. The corneal sensations were measured serially with an esthesiometer. The return of corneal sensation occurred sooner in the nonremoval group than in the removal group in the early postoperative period, but at three months, the difference was negligible. PMID- 3662318 TI - Remnants of Bergmeister's papilla and retinochoroidal colobomas. AB - The case of a patient having a Bergmeister's papilla associated with a small retinochoroidal coloboma and multiple pigment epithelial defects in one eye and a retinochoroidal coloboma in the other eye is described. Such abnormalities of neuroectodermal origin probably result from an anomalous maturation of the cells of the proximal part of the embryonic cleft in the sixth week of development. PMID- 3662319 TI - Extracapsular cataract extraction: prognosis and complications with and without posterior-chamber lens implantations. AB - Four-hundred-and-sixteen eyes that underwent cataract extraction over six years were analyzed. Extracapsular cataract extraction with posterior-chamber intraocular lens implantation (PCIOL) was performed in 186 eyes and extracapsular cataract extraction (ECCE) alone was performed in 230 eyes. The complications and visual acuity were compared in the two groups. The PCIOL group showed a low incidence of postoperative complications. In addition, there were no cases of corneal edema; retinal detachment occurred in 1.33%; cystoid macular edema occurred in 2.67%; and visual acuity recovered to 20/40 or better in 96.67% of eyes. The incidence of complications in the ECCE group was slightly higher. PMID- 3662320 TI - Sector iridectomy in the management of prolonged attacks of acute congestive glaucoma. AB - Clinicians still encounter patients suffering from prolonged episodes of primary angle-closure glaucoma. These patients often have been misdiagnosed or neglected initially. While laser iridotomies have proven most effective in the treatment of acute angle-closure glaucoma, there is a diversity of opinion regarding the treatment of chronic forms, in particular when the congestive phase has been of long duration (e.g., 3 to 14 days). The fact that ophthalmologists must still contend with the dreaded complication of malignant glaucoma attests to the difficulty of treating this condition. A series of cases have been collected during the past 15 years, all having prolonged episodes of primary angle-closure glaucoma, where the anterior-chamber angles could not be opened medically before surgery. We found that laser iridotomy is not efficacious in this situation, and indeed often impossible to perform due to corneal edema. Our patients were treated surgically with sector iridectomies, with an extremely high degree of success, and a minimal complication rate. The results are presented in tabular form. The mechanism of action is described, and the reasons for the success of this procedure explained. PMID- 3662321 TI - An unusual presentation of temporal arteritis. AB - Serious ocular and systemic complications may result from inflammatory processes of the orbit. Temporal arteritis is one such process that can affect the eye. The patient described herein is unusual because she presented initially with signs and symptoms similar to orbital cellulitis. As her disease evolved, she displayed marked, hemorrhagic chemosis with some limitation of abduction and resistance to retropulsion on the involved side. Laboratory and radiologic findings eliminated orbital cellulitis, limited Wegener's granulomatosis, and other systemic inflammatory disorders and led to the diagnosis of temporal arteritis. To our knowledge, this complex of presenting signs has not been previously reported. PMID- 3662322 TI - Abnormal ocular head postures: Part I. AB - All patients exhibiting the various types of abnormal head postures of ocular origin that were seen during the last two years are presented in order to determine the relative frequency of the different causes of these postures, and the purposes they serve. The treatment modality and results are also discussed. The manuscript is divided into four parts: Part I, II, and III concern head postures in incomitant strabismus. In Part IV, head postures in Ciancia's syndrome, restrictions, and refractive errors are described. PMID- 3662323 TI - Viscoelastic surgery. PMID- 3662324 TI - Ocular findings in mitral valve prolapse syndrome. AB - Thirty-two patients with mitral valve prolapse (MVP) underwent detailed ophthalmologic examination in order to detect the ocular abnormalities associated with this disorder. Three patients had Marfan's syndrome, and 29 had no associated systemic disorders. Of the latter, 19 (65.5%) were myopic (average, 2.00 diopters), 12 (41.4%) had lenticular opacities, and all had unusually deep anterior-chamber angles with prominent iris processes. None of the 29 patients had subluxated lenses. These findings support the view that MVP syndrome can be considered a generalized connective tissue disorder different from Marfan's syndrome. PMID- 3662325 TI - [Inhibition of the infectivity of Plasmodium gametocytes by the serum of the parasite host. Perfecting an experimental model]. AB - In the course of experimental malarial infections the infectivity of the gametocytes falls abruptly and at an early stage of the infection. This phenomenon is independent of the production of circulating antibodies. With Plasmodium yoelii nigeriensis infecting the white mouse, the maximum infectivity of gametocytes for Anopheles stephensi occurs on day 2, and on day 5 no more oocysts develop in the mosquito. The behaviour of the plasmodial strain in the mouse and particularly the "crisis" phenomenon were studied in detail in standardized experimental conditions. The decrease of the infectivity for the Anopheles begins just before the peak of parasitaemia, and a concomitant increase in the number of circulating gametocytes is observed. These events are very shortly followed by the crisis. The more severe is the crisis and virulent the infection, the earlier and more abrupt is the loss of infectivity. Previous studies having shown that this inhibition of the gametocytes infectivity was linked to a serum factor, our research aimed at setting up an experimental model allowing the identification of this factor. The intravenous injection of 5th day serum to mice harbouring infective gametocytes did not determine any loss of the gametocytes infectivity in the receiving mice. In order to study in vitro the effect of the 5th day serum, this one was added to blood from mice with highly infective gametocytes, and mosquitoes were fed on this through a membrane. As a result, a significant decrease of the infectivity of gametocytes was observed. This inhibition is immediate and does not appear to be "dose-dependent". Inversely, serum from mice still infective to the mosquito did not reduce the infectivity of the gametocytes. The experimental model set up thus comprises: a) mouse blood containing P. y. nigeriensis infective gametocytes to which is added the serum to be tested; b) Anopheles stephensi fed through a membrane; this allows quantifying the infectivity of the gametocytes in the presence of normal serum (control) or inhibitory serum. This model proved to be reliable; it should promote the study of any factor likely to modify the infectivity of Plasmodium gametocytes to the mosquito. PMID- 3662326 TI - [Protolamellodiscus raibauti n. sp., a new species of Diplectanidae Bychowsky, 1957 (Monogenea, Monopisthocotylea), parasite of Diplodus annularis (Linnaeus, 1758) (Sparidae)]. AB - The authors describe Protolamellodiscus raibauti n. sp., which differs from Protolamellodiscus serranelli (Euzet et Oliver, 1965) by the shape of the male copulative pieces, the haptor bars and hamuli. PMID- 3662327 TI - [Microscopic analysis of the effect of mercuric salts on the parasite concentration in feces]. AB - The fixation of mercuric ions on the uterin layer of the Ascaris lumbricoides egg wall is proved by light microscopic histochemical technics and electron microscopic microanalysis. These observations support the hypothesis of a possible reaction between the egg surface components and those of the dilution reagents. This reaction is used in the methods of concentration in coprology. In the case of mercuric salts, the free thiol components which are missing in all the Ascaris egg wall layers are not the factors of the reaction. PMID- 3662328 TI - [Cercarial chaetotaxy of Echinostoma revolutum (Froelich, 1802) and E. echinatum (Zeder, 1803) (Trematoda, Echinostomatidae)]. AB - The life-cycles of Echinostoma revolutum and E. echinatum were carried out by using cercariae emitted by naturally infected Molluscs. E. revolutum strain was issued from Lymnaea auricularia, E. echinatum from Lymnaea truncatula and Planorbis planorbis, Planorbarius corneus produced an Echinostome which may possibly be E. echinatum or another species E. sp. Metacercarial stages and adults were obtained from laboratory experimental hosts. None of these adult Echinostomes displayed well-defined morphological differences: nevertheless their respective larval stages exhibited discrepancies used for species diagnosis. Cercarial chaetotaxy is given for every batch and compared with that of other species described as E. audyi, E. lindoense and E. caproni; discriminating features are discussed. PMID- 3662329 TI - [Morphology of the tegument of Schistosoma intercalatum; comparison of three stocks from Cameroon, Zaire and Gabon]. AB - The study of the teguments of male Schistosoma intercalatum with SEM shows two different morphological types: a) Type Cameroon (Edea) (consistent with the previous studies by Kuntz et al.). b) Type Zaire (Kisangani) similar to type Gabon (Libreville). PMID- 3662330 TI - [A new model for the study of filarial physiopathology: Molinema dessetae in its definitive natural host, Proechimys oris. 1]. AB - The filarial rodent model Molinema dessetae/Proechimys oris, recently adapted in the laboratory allows studies on the host/parasite relationships. Development of filarial worm was described elsewhere, and the model standardized. Biological, parasitological data and antifilarial drug response were determined. Natural models can seldom be used in laboratory; in non natural models many informations on the host-parasite relationships are lost and pathological studies can only be fragmentary and punctual. With inbred Proechimys oris we have the possibility to investigate with a natural filarial model. Three rodent groups have been studied for over a period of one year. The first group comprises eleven parasite free animals; the second one, eight rodents infected once by L3, and the last with eight rodents regularly re-infected during the period of experiment. Several biological parameters were considered: weight, total red and white blood cell counts, haemoglobinemia, mean cell volume, differential leucocyte count, blood urea nitrogen, total serum proteins and electrophoretic pattern, endogenous creatinine clearance, circulating immune complexes. On the whole, more than 19,700 biological data were obtained and several multivariate statistical analysis were necessary for a valid interpretation. The Principal Component Analysis (ACP) shows in each infected rodent distinct trajectories related either with the age of the host or with the filarial infection itself. Three graphic methods were used: individual graphics of each rodent, graphics of each rodent group and, individual and group statistical center of gravity. At the end of the experiments, the rodents were autopsied and a detailed histological study of the whole body was made. Different lesions and stages of inflammatory processes found were analysed and classified as follows: granulomatous nodule with eosinophilic and neutrophilic polymorphs; foreign-body granulomatous nodule; sclerocicatricial nodule; mononucleate cell infiltrate. Secondary pathological alterations, such as irritative lesions and blocage of lymph and blood vessels, were found. A comprehensive study of all our qualitative histological results was performed by a second multivariate analysis: the Correspondence Analysis (AFC). This analysis confirmed the heterogeneity of each Proechimys infected and multi-infected groups. The cross checking between the ACP and AFC allows the separation of two physiopathological filarial groups; the first group (A) is characterized by moderate biological variations and the absence of hepatosplenic lesions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3662331 TI - [A 5th filaria of the genus Dipetalonema, parasite of South American monkeys]. AB - Description of D. freitasi n. sp., a parasite of Cebus capucinus: this species, close to D. caudispina, is distinguished by the slightly more complex structure of the vagina and right spicule, the lack of area rugosa on the tail and by the shorter microfilaria. Additional morphological data on the male of D. robini Petit et al., 1985 are given. A comparative table of 4 principal evolutive characters of the genus Dipetalonema (vagina, left and right spicules, epithelio muscular body wall) is given. D. caudispina and D. freitasi n. sp. represent a small primitive group opposed to the more evolved one made up of D. robini, D. gracile and D. graciliformis. PMID- 3662332 TI - [Chaetotaxy of the cercaria of Paramphistomum sp., a parasite of cattle in Vendee]. AB - The cercaria was shed by an Anisus rotundatus experimentally infected with a parasite of Bos taurus in Vendee (France). This Trematode was identified as Paramphistomum cervi. The snail natural host is unknown. The chaetotaxy of the cercaria differs from that of other European species of Paramphistomum and particularly from P. leydeni and P. daubneyi both species which occur in Vendee. The morphology of the adult precludes any relationship with P. ichikawai also present in Vendee. Therefore it very likely represents a species which was synonymised with P. cervi or a new species. PMID- 3662333 TI - Intestinal infections by Eimeria (s. l.) vanasi n. sp. (Eimeriidae, Apicomplexa, Protozoa) in cichlid fish. AB - Eimeria (s. l.) vanasi n. sp. is described from the intestine of a variety of cichlids in Israel and South Africa. Merogony and gamogony stages are both intra- and epiepithelial, Sporogony is exogenous with young zygotes being released from the fish in the faeces. Fully developed sporocysts are ellipsoid and apparently lacking both a Stieda body (characteristic of Eimeria s. st. and Epieimeria species) and a suture line (characteristic of Goussia species). In view of the present controversial generic status of piscine coccidia, the species is tentatively designated as Eimeria (s. l.) vanasi n. sp. (Eimeriidae, Apicomplexa, Protozoa). PMID- 3662334 TI - [Culture of a pathogenic protist isolated from the genital system and various organs of Primates]. AB - A relatively simple diphasic medium, the composition of which is given, allow the cultivation in vitro at 37 degrees C of the parasitic protist discovered in the genital system of Primates. From the study of the various cultural forms a first interpretation of the biological cycle of the parasite may be given. PMID- 3662335 TI - [A new model for studying filarial physiopathology: Molinema dessetae in its definitive natural host Proechimys oris]. PMID- 3662336 TI - The laboratory colonization of Phlebotomus ariasi (Diptera: Psychodidae). PMID- 3662337 TI - [Keratinophilic fungal flora isolated from small wild mammals and rabbit-warren in France. Discussion on the fungal species found]. AB - The occurrence of dermatophytes and other keratinophilic fungi was investigated in 237 small wild mammals and 125 european rabbit. The purpose of the investigation was to determine what were the species of fungi present in the these animals. Four species of dermatophytes were isolated: Trichophyton ajelloi, Trichophyton terrestre, Trichophyton mentagrophytes, Microsporum persicolor. Trichophyton terrestre was the most frequently isolated and it occurred more frequently than its presence could be explained by the contamination from soil. Members of the genus Chrysosporium were found in many animals: Chrysosporium keratinophilum, Chrysosporium tropicum, Chrysosporium multifidum, Chrysosporium pannorum, Chrysosporium georgii, Chrysosporium merdarium, Chrysosporium anamorph of Arthroderma curreyi, Chrysosporium anamorph of Arthroderma cuniculi, Anixiopsis stercoraria, Chrysosporium parvum. Wild small mammals and european rabbits in France, not only act as carrier of keratinophilic fungi and allied dermatophytes but also provide a suitable habitat for their survival as saprophytes. The recurrence of numerous species present on the coat, isolated fort the first time in France was remarkable. PMID- 3662338 TI - [Preparation of a modified hemoglobin solution of low viscosity used as a blood substitute]. PMID- 3662339 TI - [Stereotyped movements and substantia nigra-corpus striatum dopaminergic function in the rat: action of methylphenidate after inhibition of monoamine oxidase]. PMID- 3662340 TI - [Action of yohimbine and prazosin on the biliary secretion in the rat]. PMID- 3662341 TI - [Alkaloids of Melodinus celastroides. Isolation of four new alkaloids]. PMID- 3662342 TI - [Titration of antitetanus antibodies by enzyme immunoassay. Statistical studies for validation]. PMID- 3662343 TI - The subcutaneous pedicle flap: widening of its applications. AB - The subcutaneous pedicle flap is useful for reconstruction of a relatively small defect, and there have been many reports on its use in the facial region. With careful manipulation and thought given to the selection of the patient, it is also applicable to the trunk and extremities. During the last 7 years, we have treated 80 patients who had subcutaneous pedicle flaps applied to various parts of the body (57 on the face, 12 on the trunk, and 11 on the extremities). Eleven representative patients are presented in this article. Based on our experience, we are now confident that the subcutaneous pedicle flap is useful to reconstruct a free border or transient area of different tissues, such as the eyebrow, eyelid, lip, and nose. In the trunk, e.g., in the buttock and the breast, it is useful to reconstruct the natural convexity. We prefer using the V-Y advancement type of subcutaneous pedicle flap rather than the transposition flap. To increase the mobility of the advancement flap, the distal portion of the flap is undermined just below the layer of the subdermal plexus. This may prevent postoperative bulkiness and facilitate the reconstruction of natural contour. PMID- 3662344 TI - Psychiatric and psychosocial characteristics of patients accepted for rhinoplasty. AB - Sixty-four patients undergoing rhinoplasty, consecutively admitted to and operated upon at the Department of Plastic and Reconstructive Surgery, Malmo General Hospital, Sweden, were studied with regard to their medical history, personality, and psychosocial and psychiatric characteristics. Forty patients with a history of nose trauma were compared with 24 patients without such history. The aim of the study was to describe and evaluate background factors, with special regard to psychosocial characteristics that might possibly affect the outcome of rhinoplastic surgery. The trauma patients predominantly described themselves as sthenic, outgoing, self-reliant, insensitive to the opinions of others, and as individuals with a low degree of self-criticism. Their consumption of alcohol was fairly high, and they were often exposed to the risk of accidents with bodily injuries. Their major motive for rhinoplasty was to improve nose breathing. The nontrauma patients were characterized by various symptoms of psychoneurosis and somatic signs of anxiety. Their sensitivity was related to their appearance, and the major motive for rhinoplasty was to become less socially inhibited and to develop their personalities. An inverted factor analysis generally demonstrated that the two groups of patients could be recognized when common response patterns in the preoperative interview formed the basis for the categorization. The psychopathological mechanisms and anticipated adaptation after rhinoplasty are discussed for the two groups of patients. PMID- 3662345 TI - Hidden penis release: adjunctive suprapubic lipectomy. AB - We believe the hidden penis may be caused and concealed by a prominent suprapubic fat pad in addition to the restrictive fibrous bands of the dartos fascia fixing the shaft of the penis proximally while loose skin folds prolapse distally over the phallus. A penis of inadequate length or appearance may affect body image. Patients with this problem often require psychological support. Hidden penis may be distinguished from micropenis by palpating adequate corpora and showing a stretched penile length within 2 SD of normal. Excision of suprapubic fat with sectioning of the tethering dartos bands will release and increase the length of the penis. Suprapubic fat pad resection may also be helpful to elongate a short penis in cases of adult microphallus, or after partial penectomy because of trauma or cancer. Circumcision is contraindicated. PMID- 3662346 TI - A mucosal island flap to repair vermilion defects of the lips. AB - This article describes a one-stage technique to reconstruct up to one-third of the vermilion after full-thickness excision of the lips. It is based on a mucosal elliptically shaped random island flap from the inner lip, combined with a conventional skin flap from the surrounding area. The procedure can be performed under local anesthesia. Healing is achieved in 8 days. The technique has been employed in 9 patients, both on lower and on upper lips and even on different sides of the same lip. The results are aesthetically and functionally good. PMID- 3662347 TI - Primary surgery of the prolabium in bilateral cleft lip and palate--a comparative study of two methods. AB - In children with bilateral cleft lip and palate the short prolabium may cause problems during primary lip closure. The prolabium can be used as a lip structure to its full length or it can be partly or totally slid up into the columella. By comparing two groups of children differently treated, we have found that the prolabium as a lip structure should be used to its full length as a central element in primary lip repair, otherwise an excessively long upper lip with unusual scarring of the central portion is the result. PMID- 3662348 TI - Ocular myopathy with palpebral ptosis. AB - In 50% of patients with ocular myopathy with palpebral ptosis there is a familial occurrence. Only a few reports demonstrate several cases in a single family, however. Five patients within 1 family who had operations are discussed in this article. Methods used were levator resection and levator tucking. Follow-up results 9 years postoperatively were considered good to very good, and there were no signs of recurrence of the palpebral ptosis at that time. PMID- 3662349 TI - Dermofluorometric prediction of flap survival. AB - Techniques to predict flap survival would help the reconstructive surgeon, but while various modalities exist, none is consistently accurate. The standard clinical method of fluorescein visualization by ultraviolet light requires such a high dose that it precludes rapid repetition. Recently, assessment of cutaneous fluorescein with the dermofluorometer has allowed mini-dose fluorescein, quantification, and repetition. The fiberoptic dermofluorometer was tested on experimental and clinical flaps. An experiment was devised to determine if the dermofluorometer could accurately predict flap survival. Modified McFarlane flaps were raised in 10 250- to 300-g female Sprague-Dawley rats and divided into 10 1 cm grids. A dermoviability index was calculated for each grid. A reading below 30% correlated with flap necrosis. Our clinical experiences were less predictive. PMID- 3662350 TI - Management of acute facial powder burns. AB - To evaluate the management and outcome of acute facial powder burns, 10 patients admitted to a burn center (1980-1985) were reviewed. Facial burns resulted from black gun-powder in 7 and fireworks in 3 patients. Most burns occurred in teenage boys (6) and all but 1 were the result of carelessness on the part of the burn victim. While most facial burns were treated conservatively, 2 patients sustained traumatic tattooing and underwent immediate debridement using a variety of surgical techniques in sequence. Good aesthetic results were obtained and the details of this approach are presented. PMID- 3662351 TI - Surgery of postburn defects and deformities of the face. AB - On the basis of about 600 cases I discuss the problems related to late repair of severe facial burns. Besides the classical methods of tissue transposition, some recent approaches, such as free transfer of various flaps and the use of secondary island flaps from the retroauricular region, are presented. In my opinion, the quality of tissue for a reconstructive procedure in the facial region and the final result of the treatment should be the main concerns in treatment. Therefore, despite the general tendency to opt for the quickest treatment, the long-lasting, staged, and--if necessary--even the most sophisticated procedures are fully justified. PMID- 3662352 TI - Microcystic adnexal carcinoma: an unpredictable aggressive neoplasm. AB - Microcystic adnexal carcinoma is a rare, locally aggressive cutaneous neoplasm that has been recently recognized as a distinct entity. Typically it appears as a papular, flesh-colored mass on the face of women patients. Because of its benign appearance, it is often present for months or years before diagnosis. Histologically, there is a paucity of mitotic figures and other criteria usually associated with aggressive lesions. In this article we discuss 3 cases of microcystic adnexal carcinoma, each presenting as a small, localized lesion but all requiring extensive surgical extirpation with margin control using the Mohs tissue resection technique. PMID- 3662353 TI - Use of microvascular island pedicle flaps for facial tissue defects. AB - Microsurgical dissection was used with satisfactory results to construct a microvascular island pedicle flap for the coverage of small facial tissue defects in 3 patients. The advantages of this flap include improved survival, excellent mobility, and elimination of cosmetic problems usually encountered with rotation or distant flaps. PMID- 3662354 TI - Pediatric craniofacial remodeling instrument. AB - Craniofacial reconstruction in children is technically exacting and requires instruments specifically designed for these procedures. A new pediatric craniofacial remodeling instrument is described here and its applications are discussed. A case study is presented in which the instrument was used when an infant with craniosynostosis of the metopic suture line underwent a bicoronal craniectomy and supraorbital bar advancement and remodeling. PMID- 3662355 TI - Magnetic resonance imaging for diagnosis and preoperative planning in agenesis of the distal vagina. AB - Magnetic resonance imaging is a powerful new tool in the radiological armamentarium. Its advantages over computed tomography include better tissue differentiation, high resolution multiplanar imaging, and absence of ionizing radiation. Its advantage over ultrasound is complete depiction of anatomical detail of areas not ordinarily penetrated by the ultrasound beam, including bone, air, and bowel. We found it very useful in the evaluation of and preoperative planning for a 13-year-old girl with congenital agenesis of the distal vagina. PMID- 3662356 TI - Screw fixation of silicone implants. AB - A simple and safe procedure for fixation of silicone prostheses is presented. Two screws ensure accurate location, helping to avoid displacement and probably reducing the incidence of bone damage. PMID- 3662357 TI - Current concepts of instep island flap. AB - The durability of the instep island flap and the sequelae of the flap donor site were assessed. The average follow-up period for 13 patients was 3 years and 8 months. Flaps provided permanent durable reconstruction of the heel, if there was no scar in the flap preoperatively. Flaps with scar or free skin graft showed hyperkeratosis or fissure of the flap after transfer to the heel. Accordingly, conservative treatment, special shoes, or other surgical procedures should be considered for these patients. All flaps that were transferred as sensory flaps preserved light-touch cutaneous sensitivity and static 2-point discrimination within a measurable range. The sequelae due to the flap elevation were tenderness in the bifurcation of superficial branches from the common digital nerves and sensory disturbance of the forefoot. Indications and surgical techniques are discussed. PMID- 3662358 TI - Plastic surgery manpower, training, and prospects in Great Britain. AB - Compared with all other developed Western countries, Great Britain has a gross underprovision of trained and trainee plastic surgeons. As a result, it has become essential to define specific priority conditions admitted for treatment without unreasonable delay. This has resulted in large waiting lists for nonurgent surgery. In 1985 the average number of patients on each plastic surgeon's waiting list exceeded 400, of which over 60% had waited over 12 months for operative treatment. The implications of this situation for patient care and trainee experience are discussed. PMID- 3662359 TI - The fibrous capsules around static and dynamic implants: their biochemical, histological, and ultrastructural characteristics. AB - In this article, we report the findings of a small study comparing the histological, ultrastructural, and biochemical features of fibrous capsules formed around tissue-expanding devices (dynamic implants) and simple prostheses (static implants) in the human. Histologically and biochemically, the dynamic fibrous capsule appears to represent an early phase of scar tissue formation around an expanding foreign body, the dominant feature being increased cellularity caused by myofibroblasts. In view of the marked presence of these contractile elements, it is paradoxical that a lower capsular contracture rate should be reported to occur in breast reconstruction using a temporary expander. This lower rate presumably is because these myofibroblasts undergo modulation once the expansion process has ceased and the final prosthesis is in place. One may also assume that the fibrous capsule would retain features of early scar tissue if the expansion process is maintained indefinitely. This hypothesis can be evaluated by a long-term study in the animal. PMID- 3662360 TI - Prediction of internal arterial diameter from measurement of external diameter. AB - Internal and external diameters of sections of radial and ulnar arteries obtained from fresh cadavers were measured. Statistical analysis of the results obtained shows significant correlation (p less than 0.05). The wide range of values obtained suggests that, despite this degree of correlation, the internal diameter of an artery cannot be accurately predicted from the external diameter. PMID- 3662361 TI - Objectives for cleft palate repair. AB - Improved anesthesia and nutrition are permitting earlier safe cleft palate repair, with higher success rates. Three factors that are considered necessary to obtain satisfactory function of the soft palate for speech are (1) adequate length, (2) adequate mobility, which should include consideration of resting tension and elasticity of the levator and depressor muscles, and (3) the need for conformity of the dorsal surface to the pharyngeal wall, which this paper seeks to emphasize. These concepts are examined with reference to the literature and observations made by the author from endoscopic and x-ray studies and from electrical stimulation of the palate muscles prior to palate repair. A technique for relocating the musculus uvulae is described. It is concluded that at least 9 out of 10 palates are long enough at birth and have sufficient mobility, provided that this is not impaired iatrogenically, to obtain satisfactory speech. Emphasis needs to be placed on providing a normal dorsal convexity and, where levator activity appears to be inadequate, means need to be found whereby inappropriate activity or tension of the palate depressors can be diagnosed and effective treatment devised. PMID- 3662362 TI - The facial artery island flap. AB - A nasolabial island flap on the facial artery and anterior facial vein is described. This is a useful modification of the classic nasolabial flap for repair of defects in the floor of the mouth. The flap can be led directly into the floor of the mouth, and the pedicle can be passed deep or superficial to the mandible as required. This obviates the use of bulky carrier skin passing over the alveolus and allows all the nasolabial skin to be available for reconstruction of the defect. PMID- 3662363 TI - A simple new technique for injecting steroids into scars. PMID- 3662364 TI - What size prosthesis for augmentation mammaplasty? AB - A simple method of determining the size of prosthesis in augmentation mammaplasty is described. It depends on the insertion of sufficient prepacked 25-ml sachets to fill a brassiere the patient selected as being the cup size she would like. PMID- 3662365 TI - [Results of the surgical treatment of osteochondritis dissecans of the knee in adults. Apropos of 72 cases]. PMID- 3662366 TI - [Anatomical assessment of retroperitoneal adenopathies by surgical endoscopy. Apropos of 52 retroperitoneoscopies in 49 patients]. PMID- 3662367 TI - [Duplication of the inferior vena cava and surgical prevention of pulmonary embolism]. PMID- 3662368 TI - [An atypical case of solitary vertebral plasmacytoma]. PMID- 3662369 TI - [Mesenchymal fibromyxochondrosarcoma of the ribs. Apropos of a case]. PMID- 3662370 TI - [Magnetic resonance imaging of the prostato-bladder axis]. PMID- 3662371 TI - [Immune deficiency in severe infections: the egg and the hen]. PMID- 3662372 TI - [Lymphocyte abnormalities in postoperative peritonitis. Demonstration, course and prognostic incidence]. PMID- 3662373 TI - [Apropos of 45 recurrences after conservative treatment for breast cancer]. PMID- 3662375 TI - [Cancerous degeneration of an excluded esophagus after esophagoplasty for caustic stenosis]. PMID- 3662374 TI - [When is postoperative gastric suction useful? A randomized prospective study of 100 cases in biliary and colorectal surgery]. PMID- 3662376 TI - [Cancer arising on Barrett esophagus. Apropos of 16 cases]. PMID- 3662377 TI - [X-ray computed tomography in pancreatic diseases]. PMID- 3662378 TI - [Correction of inverted nipples. The blind method]. PMID- 3662379 TI - [Anterior decompression without graft in myeloradiculopathies caused by cervical arthrosis]. PMID- 3662380 TI - [Ogilvie's syndrome and chronic respiratory insufficiency. Apropos of a case]. PMID- 3662381 TI - [Enzyme activity of creatine kinase and its MB isoenzyme in endocardial countershock]. AB - Enzymatic activity of total serum CPK and of MB iso-enzyme was studied to assess changes in the myocardium caused by cardioversion. Assay of enzymes was performed prior to cardioversion and every two hours during the first 24 hours after it was administered. 79 instances of cardioversion were reported in a series of 56 patients, including 14 females (mean age 45 years). Cardioversion was employed in the treatment of 23 patients with supra-ventricular tachycardia, and in 56 cases to treat chronic ventricular tachycardia including 23 of ventricular tachycardia arising as a complication of myocardial infarction, 17 cases of arrhythmia inducing disorders of the right ventricle, 8 cases of primary cardiomyopathy, 7 of idiopathic ventricular tachycardia and 1 of a congenital disorder. The energy of the electric shock administered was 620 +/- 522 joules during the 3 shocks per session, on the average, delivered by an Odam capacitor discharge using a distal electrode connected to the positive pole of an endocardial electrode catheter. A maximum level of total serum CPK equal to 333 +/- 396 U/l was observed 6 +/- 3 hours after cardioversion. The highest level of isoenzymes MB recorded was 30 +/- 24 U/l 4 +/- 2 hours after cardioversion. Compared to electric shock administered to treat ventricular tachycardia, an electric current applied to the His bundle produced the least MB isoenzyme activity (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662382 TI - [A rare cause of heart failure: hypocalcemic cardiopathy]. AB - In this paper, the authors present the case of hypocalcemic cardiopathy observed in a female patient who underwent thyroidectomy which was complicated post operatively by the development of hypoparathyroidism. Two attacks of heart failure experienced by this patient were improved by the administration of calcium in combination with digitalis treatment. A study of cases published in the medical literature reveals that this condition is a rare cause of heart failure which develops only in the course of chronic hypocalcemia, with few neuromuscular clinical manifestations. The dual negative inotropic and hypovolemic effects caused by hypocalcemia explain the efficacy observed with the administration of calcium therapy, while the usual symptomatic treatment of this condition is inadequate. PMID- 3662383 TI - [Sudden death of a patient with a pacemaker caused by heart rupture in a "cloisonne" pericardium]. AB - Myocardial infarction is sometimes accompanied by bradycardia requiring either temporary or permanent cardiac pacing. In addition an MI reduces the amplitude of endocardial action potentials which produces the conditions for defective detection of spontaneous ventricular complexes by the pacemaker. In this particular condition, the competing cardiac rhythm which arises frequently causes malignant arrhythmias which are potentially fatal. This danger is increased even further by endocardial stimulation of the right ventricle with myocardial infarction of the right ventricle. We have reported in this paper the instructive case of a patient with coronary heart disease, hospitalized for third degree AV block with syncope which developed following a massive postero-diaphragmatic MI, but with few symptoms. After secondary extension of the necrotic area, the artificial pacemaker implanted manifested defective firing which resulted in development of ventricular fibrillation. The latter was controlled by cardioversion, but the patient died from disordered conduction after 30 seconds of complete asystole. For one minute, the pacemaker did not stimulate the ventricle because of "electrical stunt to the myocardium", caused by the shock from the defibrillator. Anatomical examination (at autopsy) confirmed the cardiac rupture. PMID- 3662384 TI - [Role of free radicals in ischemia and myocardial reperfusion. The oxygen paradox]. AB - The monovalent reduction of oxygen yields two reduced intermediate forms: the dioxide anion (O2), hydrogen peroxide H2O2, and the hydroxyl radical (OH.) several of which appear as radicals. Under normal conditions, the concentration of free oxygen radicals in the tissues is closely controlled because of the serious cell lesions which an accumulation of these radicals can cause. The aim of this paper was to discuss the origin and role of free oxygen radicals in cell lesions induced by myocardial ischemia/perfusion as well as results obtained in different experimental models using methods to trap these radicals. Overall these experimental results are encouraging and appear to offer new therapeutic possibilities which, however, have been evaluated only barely in man. PMID- 3662386 TI - Some observations on the nature of the calcium-cresolphthalein complexone reaction and its relevance to the clinical laboratory. AB - The reasons for the non-linearity of the standard curve for the calcium cresolphthalein complexone reaction have been investigated. Calcium forms both 1:1 and 2:1 complexes with cresolphthalein complexone; at low calcium concentrations the 1:1 complex predominates and causes non-linearity. At high calcium concentrations the cresolphthalein complexone concentration becomes limiting, resulting in flattening of the calibration curve. It is recommended that two-point calibration of the assay be performed using a low calcium standard rather than setting on the baseline. PMID- 3662385 TI - [Hemodynamic effects of labetalol on the humeral artery of the hypertensive patient. A double-blind study versus placebo]. AB - Forearm arterial hemodynamics, including measurements of brachial artery diameter and compliance with pulsed Doppler velocimetry were determined before and after acute administration of labetalol in patients with sustained essential hypertension. Labetalol caused a significant and rapid drop in blood pressure with a decrease in forearm vascular resistance and an increase in brachial blood flow. Brachial artery diameter did not change while arterial compliance significantly increased. The study provided evidence that labetalol caused a shift of the pressure-brachial artery diameter curve toward lower values of blood pressure, indicating a pharmacological effect of alpha and beta blockade on the hypertensive arterial wall. PMID- 3662387 TI - Plasma salicylate analysis: a comparison of colorimetric, HPLC and enzymatic techniques. AB - Three colorimetric techniques and one enzymatic technique have been compared with an HPLC method for the analysis of salicylate in the plasma of patients after self-poisoning with aspirin. The enzymatic technique was specific but expensive to perform. The colorimetric techniques were simple, cheap and precise. The Keller method, however, was susceptible to interference from endogenous substances. We report a modification of the Keller method that eliminates most of this interference and improves the accuracy of the analysis. The new method is easier and safer to perform under emergency conditions than the Trinder technique. PMID- 3662388 TI - The variability and dietary dependence of urinary oxalate excretion in recurrent calcium stone formers. AB - Twenty-two recurrent calcium stone formers had 24-h urinary oxalate excretions on their home diets which were significantly greater than those of 30 normal subjects (0.48 +/- 0.23 mmol/d; mean +/- SD compared with 0.31 +/- 0.11; P less than 0.01). The stone formers also demonstrated marked day to day variability in oxalate excretion indicating that a single normal urinary oxalate measurement did not exclude significant hyperoxaluria at other times. On a hospital diet containing 1000 mg calcium per day, urinary oxalate excretion fell significantly from 0.48 +/- 0.23 mmol/d to 0.32 +/- 0.12; P less than 0.01. As the urinary calcium excretion in and out of hospital was similar, it seems unlikely that low calcium intake at home was responsible for the hyperoxaluria. All patients had recurrent symptomatic stone disease and had been advised to avoid foods rich in oxalate. Whilst poor compliance is a possible explanation for the variability in oxalate excretion, we believe it is more likely that there is an inadvertent intake of oxalogenic precursors in their diet. As normal subjects do not demonstrate hyperoxaluria on similar home diets, stone formers may have a metabolic defect in the handling of these precursors. PMID- 3662389 TI - Protein interferes with ionised calcium measurement at the reference electrode liquid junction. AB - The ionised calcium concentration of sequential retentates prepared by ultrafiltration of a human control serum increased with increasing protein concentration when measured with both a Nova 2 and a Radiometer ICA1 analyser using their standard reference electrodes. In contrast, the ionised calcium in the same retentates fell slightly with increasing protein when the reference electrode liquid junctions of the instruments were changed from hypertonic to isotonic solutions, the values then paralleling those in the filtrates. Thus, the clinically significant positive relationship between ionised calcium and protein that has been reported with the Nova 2 and ICA1 analysers is almost certainly an effect of protein on the reference electrode liquid junction potential rather than a consequence of a Donnan effect on true ionised calcium distribution. PMID- 3662390 TI - Serum digoxin assays: investigation of use and abuse. AB - Digoxin requesting patterns were studied prospectively over a 6-month period. Clinicians were not forewarned that the study was being undertaken. Many samples received in the laboratory were taken at incorrect times after the drug had been given. This led to inappropriate action being taken in some cases. Appropriate action was taken on most patients who had toxic serum digoxin levels together with clinical signs. The role of subtherapeutic digoxin levels seems unclear as these elicit a wide variety of responses. PMID- 3662391 TI - Assessment of an enhanced chemiluminescent immunometric assay for TSH in 1127 patients. AB - An enhanced immunochemiluminometric assay for serum TSH ('Amerlite', Amersham, Bucks, UK) was studied in 1127 patients in routine clinical practice to assess its value as a first-line test of thyroid status. Good correlation with clinical thyroid status was found in the untreated euthyroid patients, in the untreated hyperthyroid and hypothyroid patients, in pregnancy and in the sick euthyroid. However, a large proportion of clinically euthyroid patients with nodular goitre, as well as those treated by thyroidectomy, radioiodine or antithyroid drugs and those on replacement l-thyroxine showed TSH values outside the reference range. Therefore, additional tests are likely to be needed frequently in these categories. PMID- 3662392 TI - Proteinuria and urinary hCG excretion. PMID- 3662393 TI - The oral glucose tolerance test--an assessment of the quality of its performance. AB - By means of a questionnaire, an attempt was made to assess the quality of performance and interpretation of the oral glucose tolerance test by laboratories participating in the UK External Quality Assessment Scheme for Clinical Chemistry. The results showed a general awareness of current recommendations in terms of both protocol for the test and criteria for interpretation of results, but some deficiencies were observed in both these areas and in some case deviations in protocol may have been sufficient to invalidate comparison of results with currently recommended criteria for interpretation of the test. PMID- 3662394 TI - The value of HbA1 and fructosamine in predicting impaired glucose tolerance--an alternative to OGTT to detect diabetes mellitus or gestational diabetes. AB - Glycosylated haemoglobin and glycosylated serum protein concentrations (fructosamine) have been monitored in patients suspected of diabetes mellitus (n = 183), in pregnant women suspected of gestational diabetes (n = 250) and in control groups (n = 184). The response to the standard 75 g oral glucose tolerance test was used to confirm or reject the diagnosis, using different criteria for detection of diabetes mellitus compared to detection of gestational diabetes. A slightly higher sensitivity was observed for fructosamine compared to glycosylated haemoglobin to detect impaired glucose tolerance (52 vs 44%) or gestational diabetes (17% vs 8%). For detection of diabetic oral glucose tolerance no difference was observed between glycosylated haemoglobin and fructosamine; sensitivity for both parameters was 67%. The results suggest that fructosamine is slightly more sensitive in detecting borderline-abnormal glucose tolerance, whereas no differences are observed for detection of clearly abnormal oral glucose tolerance tests. PMID- 3662395 TI - Glycated haemoglobin analyses--assessment of within- and between-laboratory performance in a large UK region. AB - The performance of glycated haemoglobin methods has been assessed in 20 laboratories. The methods used in these laboratories were affinity chromatography, electroendosmosis and ion-exchange chromatography. Assessment was based on the results returned by the participating laboratories on distributed specimens. Each method displayed acceptable precision and good linearity. Overall there were substantial differences in results reported by different laboratories, though within each method group these differences were less marked. PMID- 3662396 TI - Serum free thyroxine and free triiodothyronine concentrations in healthy fullterm, preterm and sick preterm neonates. AB - There are few data available on free thyroid hormone concentrations in the early neonatal period. With the widespread application of screening procedures for detecting congenital hypothyroidism there is a need for reference ranges in neonates. In this study we have evaluated thyroid function in healthy fullterm and preterm neonates, and sick neonates all within one to 10 days postnatal age. Our data indicates that free thyroxine but not free triiodothyronine is higher in fullterm neonates than the adult reference range and that both free thyroid hormone concentrations are reduced in healthy and sick preterm neonates as compared to fullterm neonates. Assessment of thyroid function in the early neonatal period needs to take into account these changes particularly in preterm and sick preterm neonates. PMID- 3662397 TI - Retinol binding protein as a small molecular weight marker of renal tubular function in diabetes mellitus. AB - A radioimmunoassay has been developed for the measurement in urine of retinol binding protein (alpha 2-microglobulin) and used as an index of renal tubular function in adult Type 1 (insulin-dependent) diabetics and to define reference ranges in non-diabetic controls. There was a significantly greater excretion (P less than 0.001) of retinol-binding protein in the diabetic group compared to the controls in both overnight and daytime samples. There was a weak positive correlation with albumin excretion (r = 0.33; P less than 0.01) but no correlation with HbA1, duration of diabetes or arterial blood pressure. The results indicate that retinol-binding protein excretion may be increased in diabetic subjects without increased albumin excretion. The possibility therefore exists that renal tubular damage may occur early in diabetic nephropathy without apparent glomerular dysfunction. PMID- 3662398 TI - Determination of iron in cardiac and liver tissues by plasma emission spectroscopy. AB - A simple plasma emission spectroscopic method for the determination of iron in liver and cardiac tissue is described. Using this technique, iron was extracted quantitatively from liver tissue of mass 14.2 to 65.4 mg wet weight, and heart tissue of mass 5.9 to 27.4 mg wet weight. Iron added to liver as aqueous ferric nitrate was recovered in the range 93 to 108%. Reference ranges for liver and myocardial iron on post mortem tissue gave respectively mean values of 0.841 mg/g dry weight (Range 0.310 to 1.600, n = 37) and 0.340 mg/g dry weight (Range 0.290 to 0.470, n = 8). Data on patients with haemochromatosis and transfusion siderosis are also presented. PMID- 3662399 TI - Rapid measurement of anticonvulsant drug concentrations in the out-patient clinic, using HPLC with direct injection of plasma. AB - A manual column-switching technique is described for the measurement of phenytoin, phenobarbitone, carbamazepine, and carbamazepine 10,11-epoxide. The analytical system is designed to be portable for use at the out-patient clinic and comprises an isocratic pump, UV detector and injection valve, together with a preparation column. Diluted plasma or serum is injected, without pre-extraction, onto a preparation column which replaces the sample loop on the injection valve. After washing unwanted material to waste, the preparation column is switched in line with the analytical column, where separation of analytes occurs. The precision, accuracy and carryover of this extra-laboratory system are comparable with those obtained with laboratory-based immunoassay systems. Operation of the system allows the reporting of results within 5 min of sample injection and requires no specialist skills. The technique should be of particular interest to district general hospital laboratories where workload does not justify the cost of an automated HPLC system as the total capital cost is comparable to that of a portable glucose analyser. In contrast to immunoassay systems consumable costs are minimal. The equipment is easy to transport and may be used in the out patient department to provide an analytical service similar to that provided for the determination of prothrombin time at the anticoagulant clinic. PMID- 3662400 TI - Urinary free catecholamines--diagnostic application of an HPLC technique to the investigation of neural crest tumours. AB - Experience in the use of an in-house urinary free catecholamine assay for the investigation of possible neural crest tumours in a District General Hospital laboratory is described. Elevated excretion of catecholamines and vanillylmandelic acid was found in a number of cases including phaeochromocytoma and neuroblastoma. These as well as several other situations in which elevated catecholamine and vanillylmandelic acid values were found are discussed. PMID- 3662401 TI - A simplified thin-layer chromatography system for the detection of commonly abused basic drugs. AB - A simple method for the detection of drugs of abuse and their metabolites in urine is described. By extraction of urine (20 mL) with a buffered ToxElut solid phase column all the commonly abused opioid drugs can be detected on a single thin-layer chromatography plate. Location of the spots is achieved by spraying the plate with iodoplatinate following acidification with dilute sulphuric acid. Sensitivity of the order of 1 mg/L is attained for most drugs. PMID- 3662402 TI - Radial diffusion as a simple and rapid method for screening superoxide dismutase activity. AB - Superoxide dismutases are of great interest due to their increasing medical applications in therapy and diagnosis of some diseases. The radial diffusion assay was evaluated for its usefulness as a simple, cheap and accurate assay for screening superoxide dismutase activity. In this assay O2- radicals were generated from the interaction of reduced riboflavin with molecular oxygen upon exposure of agar gel containing riboflavin and N,N,N,N-tetramethylethylene diamine (TEMED) to light. If nitrotetrazolium dye is also present, it will be reduced to the blue insoluble formazan, whilst if superoxide dismutase is present it will prevent this blueing. The developed assay was found to give reproducible estimates of pure samples of superoxide dismutase with a lower limit of measurements of about 10 mg. It can be adapted to measure the levels of superoxide dismutase in various crude biological samples. PMID- 3662403 TI - The effect of haemolysis on the measurement of plasma alkaline phosphatase activity. AB - The non-dialysable fraction of haemolysate causes an apparent reduction of plasma alkaline phosphatase (ALP) activity using 4-nitrophenylphosphate as substrate. Analyses using four different buffers showed that the decrease in enzyme activity is affected by the buffer used. The percentage reduction in ALP activity is dependent on the initial ALP activity but not on the isoenzyme present. When diethanolamine was used as buffer, sample blanking almost completely compensated for the apparent reduction in enzyme activity. However, when aminomethylpropanol, aminomethylpropanediol and tris-carbonate buffers were used, it appeared that haemolysate reduced the catalytic activity of the enzyme, since sample blank correction had minimal effect on the results. PMID- 3662404 TI - Artefactual elevation of plasma calcium results due to contamination of lithium heparin tubes. PMID- 3662405 TI - Psychological factors in cardiac arrhythmias. AB - Autonomic nervous control of the heart and the blood vessels is essential for optimal physical performance. Afferent nerves conduct impulses to the vasomotor and cardioaccelerator and cardioinhibitor centres resulting in efferent sympathetic and vagus output. Information inputs also from the environment and the person's thought processes are mediated from the cortex by the hypothalamus, the limbic system, and the autonomic nervous system to the heart and blood vessels. Emotional factors like anger, anxiety, and fear increase sympathetic output and influence heart rate. On the other hand, fear and the feeling of being in a helpless situation causes intensive vagal activation with ensuing severe bradycardia or asystole and vasovagal syncope. Although psychologic factors can cause extreme grades of tachy- or bradycardia they usually have no acute deleterious effects in the normal heart. In the diseased heart, however, consequences may be hazardous. Emotional factors are known to increase ventricular arrhythmias either directly or indirectly by increasing heart rate and causing ischaemia as in coronary heart disease. In animal experiments ventricular fibrillation threshold is lowered by aversive conditions. In heart diseases with sudden death as a well known complication increased sympathetic activity may give rise to fatal arrhythmias. In man the evidence of psychologic factors as the cause of life-threatening arrhythmias and sudden death is mostly anecdotal or circumstantial. Well designed studies are needed to evaluate the role of psychologic factors in arrhythmias. PMID- 3662406 TI - Headache and the influence of stress. A personal view. AB - Most headaches, including the chronic ones, have an organic background. This applies in particular to the unilateral headaches, but also probably to some of the global ones. In spite of this, there seems to be a clear, but variable influence of stress in the various types of headache. This effect may be a dual one. Thus, in migraine the effect of the low-degree, daily, annoying stress may be much worse than that of major stress, which may in fact prevent a headache almost even completely. A distinction should be made between the influence of stress on the headache as such and on the separate attacks. An example of this may be cluster headache: the mechanism underlying the long-term development may be under influences of external stressors, whereas the shortlasting, solitary attacks are scarcely influenced by such factors. The negative influence of stress is probably most apparent in common migraine and the acute form of tension headache. Headaches like the "atypical facial neuralgia" have been thought to have a strong, psychogenic background. Atypical facial neuralgia is one of the unilateral headaches, and bears a great similarity to cervicogenic headache. In the latter headache, attacks may even be precipitated mechanically, so that a psychogenesis or a marked stress-influence seems to be unlikely. In some cases of classic migraine, attacks seem to appear in their own inherent, stereotypical rhythm irrespective of outer events of a possible harmful nature. PMID- 3662407 TI - Psychosomatic aspects in dermatoses. AB - The purpose of this presentation is to offer a classification of psychocutaneous disease and to examinine factors which result in itching and scratching becoming chronic. Pruritus is a very common sensation in dermatoses. All forms of itching, whatever the cause, may be intensified by emotional stress. The patient sample of my own study consisted of seven diagnostic groups, giving a total of 99 patients. The dermatoses were: dermatitis herpetiformis, lichen ruber planus, chronic eczema, atopic eczema, neurodermatitis circumscripta, lichen corneus obtusus and pruritus psychogenes. The principal findings were as follows: 1. Many of the different mechanisms by which skin diseases became chronic had a psychological background. 2. Psychiatric disturbances were clearly more common than in the average population. Possibilities of psychiatric treatment were evaluated. The results confirm the hypothesis that in those skin diseases in which the disease mechanism is not yet sufficiently understood, psychosomatics is of considerable importance or offers an easier way to explain the mechanism. PMID- 3662408 TI - Psychosocial risk factors of diseases. V Medical Symposium of the Yrjo Jahnsson Foundation. Provoo, August 27-29, 1986. Proceedings. PMID- 3662409 TI - Social determinants of disease. AB - The primary purpose for identifying psychosocial risk factors is to prevent disease and disease complications. For 30 years, we have been doing research in this field and have been successful in identifying such risk factors as Type A behavior, social isolation, stressful life events, and various psychological patterns. However, our success in using this information to help prevent disease has been much more limited. One reason for this limited success is that we have focused virtually all of our attention on the study of individuals and almost no attention on the social environment within which people live. There are two major limitations of such a one-to-one approach: it is difficult for people to change their behavior and their life situation and even if some people do change, others enter the "at risk" population because no action has been taken to change those forces in society that stimulated the problem in the first place. In discussing the social determinants of disease, it is important that we develop a new approach that permits us to study not only individuals but also the social environment. An example of this approach is provided by researchers who were successful in preventing infectious diseases. The work of these researchers focused not on clinical entities or on individuals but on the environment. This resulted in a disease classification system that included concepts such as air borne, food-borne, water-borne, and vector-borne diseases. We have no such system for the study of non-infectious diseases. Considerable data already are available to help us to think about such a new classification system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662410 TI - Stress syndromes. AB - Some methodological problems in epidemiological research on stress syndromes are reviewed. It is pointed out that syndromes defined on the basis of physiological findings may be difficult to relate to psychosocial problems. This is exemplified by the early asymptomatic stages of hypertension. Men with this syndrome seem to report fewer life problems than other men. This could be due to systematic underreporting. It is shown that different illnesses may have different psychosocial correlates. Research has shown that early endocrinological response patterns during stress periods may be beneficial in the long-term perspective. PMID- 3662411 TI - Occupational class, psychosocial stress and morbidity. AB - The association between stress and morbidity was studied in an industrial population, which consisted of both white-collar and blue-collar workers (n = 902). Information about living and working conditions, health behaviour, mental well-being and morbidity were obtained by questionnaires, interviews, clinical examinations, and physiological and biochemical measurements. The same cohort was re-examined after five and ten years. Comparison of occupational classes showed consistently that living and working conditions, psychosocial stress, and health and sickness behaviour were more deleterious among blue-collar workers and their morbidity and mortality rates were higher than among white-collar workers. The effect of stress on health was examined both cross-sectionally and longitudinally. Psychosocial stressors at work were related to mental strain, perceived health, and absenteeism. Stress symptoms were strongly associated with perceived health, locomotor symptoms, smoking, drinking, and absenteeism. None of the stress indicators were related to blood pressure. In the follow-up the baseline indicators of stress predicted future chronic illness and angina pectoris, but not hypertension or myocardial infarction. Blood pressure changes were not related to psychosocial factors. Stress did not predict mortality in the ten year follow-up. The study suggests that psychosocial stress is mostly related and may be causally linked to such indicators of morbidity as perceived health, bodily symptoms and sickness behaviour. The aetiological contribution of stress to biologically defined morbidity may be weak. PMID- 3662412 TI - Psychoendocrine aspects of coping with distress. AB - The psychoendocrine aspects of coping with distress were studied under mental and physical laboratory strain as well as in response to naturalistic stress. In spite of the common underlying endocrine responses to distress, gender differences in psychological response appeared to modify endocrine responses to the experience of pain. If the aspiration level task in the laboratory was well controlled by the subject hypothalamo-pituitary stress hormones were no longer secreted. Furthermore, heavy, physical work elevated blood levels of stress hormones (dopamine, noradrenaline, adrenaline, prolactin, cortisol, somatotropin) but especially hypothalamo-pituitary hormones responded to psychological state factors. Hence the role of psychoendocrine coping mechanisms seems to vary and depends on various psychosocial and biological determinants. Controllability is one of the key factors in an individual's ability to cope. PMID- 3662413 TI - Stress and cardiovascular disease: mechanisms and measurement. AB - Physiological overreactivity to mental stress has been correlated with the subsequent development of cardiovascular diseases. This coronary-prone behavior (referred to as "hot reacting") is distinct from the Type A behavior pattern and is seen in about 1 in 5 apparently healthy individuals. This paper describes a noninvasive system for measuring hemodynamics that can reveal the mechanisms raising the blood pressure of hot reactors or hypertensives. The subject is challenged with a variety of mental and physical stressors while the hemodynamic responses are monitored. Blood pressure elevations are found to be caused either by increased cardiac output, increased resistance, or a combination. Output reacting represents the early stage of hypertension. Beta blockers or even nonpharmacologic methods are generally effective in controlling the blood pressure. Combined reactors may benefit from a moderate dose of a beta-blocker and a vasodilator. The vasoconstrictive reactors are at greatest risk and require more extensive evaluation as well as vasodilatory therapy. Utilization of the hemodynamic profile permits adjusting treatment to the underlying physiologic state which reduces side effects and enhances compliance. PMID- 3662414 TI - [7th French Congress of Endocrinology. Abstracts. Lyons, 6-8 October 1987]. PMID- 3662415 TI - [Influence of placental protein hormones on maternal physiology]. AB - Our data have demonstrated that maternal LH and FSH are repressed throughout pregnancy. Beside, we have discovered and characterized a variant placental GH. Our studies on the mechanism of anovulation and on pituitary GH suppression and GH physiology in pregnant women have contributed to demonstrate the autonomy of the fetoplacental unit and its effects on maternal anabolism and physiology. More specifically, human placental GH, coded by the GH-V gene appears responsible for the anabolic and somatotropic effects mediated by SM-C in the mother. The beneficial aspect of this mechanism for the species appears likely since placental tissues in which the GH-PL genes are deleted, express alternative gene(s) resulting in the production of a placental variant closely related or identical to pituitary 22K GH. PMID- 3662416 TI - [Drug administration through the rectum: reliability, tolerance]. AB - The main form of rectal administration of medications is the suppository. The rapidity of release of the active principle in the rectal fluid depends mainly on the physicochemical properties of the vehicle. Absorption per se is influenced by the liposolubility as well as the ionization of the medication, and by the site of its release since only the middle and inferior hemorrhoidal veins avoid the hepatic crossing. For molecules subjected to a major 1st hepatic crossing (lidocaine, propranolol, ergotamine...), pharmacokinetic studies demonstrate that the rectal route enables to obtain a bioavailability which is markedly higher by oral route, and plasma concentrations at a therapeutic level. The use, still experimental, of rectal osmotic pumps, provides balanced plasma concentrations which remain stable during the entire duration of the application. Undesirable side effects related to the administration of drugs via the rectal route, are, most of the time, local ones. The vehicles seem to be responsible for diffuse ano rectitis. Cases of rectal ulcerations with necrosis have been reported following the excessive use of suppositories containing dextro-propoxyphene or ergotamine. PMID- 3662417 TI - [Functional colonic disease and psychopathology. Importance of affective experiences]. AB - The responsibility of psychopathological disorders in the genesis of irritable bowel has led to recent interpretations which challenge the classical data concerning this disease. The present study was conducted from a questionnaire interview in 102 patients suffering from functional colopathy. It shows that these patients presented specific psychopathologic and biographic data. The patients with colopathy were anxious psychasthenics confined by their obsessive and narcisistic nature into a successful productive activity at the expense of pleasure seeking and interpersonal relationships. The emotional deficiencies of childhood found in almost all cases, in addition to separation anguish, undoubtedly led to an alteration of self-image. The pursuit of a successful activity seems to correspond to a perpetual attempt of control of anguish and a rehabilitation of the self-image. The precarious resulting balance often risk to be challenged by stresses or conflicts and force the physician to take complete charge of such a disease, carefully and patiently. PMID- 3662418 TI - [Non-surgical treatment of hemorrhoids]. AB - The treatment of hemorrhoids includes a vast array of medical and instrumental means. If there is no true medical treatment, there are numerous products in order to act on the symptoms or one of the factors of the hemorrhoidal complex. Thus, phlebotonics, local topical agents, anti-infectious and anti-inflammatory agents, myorelaxants, transit regulators. Instrumental means are essentially represented by sclerosing injections, infra-red photocoagulation, cryotherapy, and mainly elastic rubber bands. All these treatments, some of which were offered as a substitute to surgery, often give interesting results, but are not devoid of danger. The attitude of the medico-surgical proctologist is then to find a happy medium between a procedure which is insufficient and one which may become unnecessarily aggressive. PMID- 3662419 TI - [Surgical treatment of rectoceles]. AB - Rectocele is a posterior colpocele inhabited by an expansion of the anterior wall of the rectum. Its physiopathology is similar to that of other vaginal prolapse and is essentially dependent on the opening of the vulva secondary to a damage of the pelvi-perineal musculature. Its specific symptomatology is poor except for dyschesis. A colpocystogram may be helpful when there is a need to differentiate between rectocele and elytrocele. The surgical treatment of rectocele requires, most of the time, a vaginal approach with posterior colpo-perineomyorraphy. More rarely, when the rectocele is isolated, small and associated with another anorectal pathology, the endo ano-rectal approach may be used to perform the rectorraphy. PMID- 3662420 TI - [Life experiences in Crohn's disease. Study by questionnaire]. AB - 203 patients suffering from Crohn's disease were interviewed by questionnaire about the repercussion of the disease in their school, professional, and familial life. This study, conducted in 3 centers, shows that these patients usually experience little difficulty during their school attendance, and that they succeed, in the majority of the cases, in adjusting to their professional life. This adjustment appears, however, more problematical as far their leisures are concerned. PMID- 3662421 TI - [Carcinoid tumors of the rectum. Apropos of 2 cases with metastases]. AB - We are reporting two cases of carcinoid tumors of the rectum treated surgically. In both cases, there were nodes metastases and in one case liver metastases without carcinoid syndrome. Carcinoid tumors of the rectum are rare and usually asymptomatic; metastases are essentially located in the lymph nodes and the liver. PMID- 3662422 TI - [2 cases of psychogenic pruritus ani in the same family]. AB - The authors present two cases of idiopathic pruritus ani in the same family in which psychological factors seem to play an etiological role. PMID- 3662423 TI - [Effects of montmorillonite (beidellite) on the concentration of expired hydrogen]. PMID- 3662424 TI - Tracking the development of adiposity from one month of age to adulthood. AB - The development of adiposity was followed in 164 subjects from the age of one month to adulthood. The 25th and 75th centiles of the weight/height2 (W/H2) index were chosen as cut-off points to define the lean, medium and fat subjects at both one and 21 years of age. Only 42% of the children remained in their original category, that is 41% of the lean infants at one year stayed lean, 42% of the medium infants stayed medium and 41% of the fat infants stayed fat. Accordingly, most fat infants did not stay fat, but twice as many fat as non-fat infants became fat adults (41 and 20% respectively). The relative risk of being fat adults was 1 for the lean, 1 for the medium and 2 for the fat infants at one year. Several paths of development emerged: they were related to age at the second rise in adiposity, termed adiposity rebound, which usually occurs at about six years, as observed on skinfold thickness and W/H2 charts. The earlier the rebound, the higher the adiposity at adult age, whether this was measured by W/H2 index or subscapular skinfold. The cohorts of children who left the channel they had been following included fat infants with a late rebound who subsequently returned to normal, and lean infants with an early rebound who grew fatter. Other cohorts remained in their original groups, for example, fat infants with an early rebound who stayed fat and lean infants with a late one who stayed lean. Age at rebound provided two indications: the existence of a regulartory process among the transiently fat or lean infants who returned to average after a late or early rebound respectively, and pathological development among the children who became fat or lean after an early or late rebound. Age at rebound is an indicator of the subsequent development of fatness. PMID- 3662425 TI - National Study of Health and Growth: social and biological factors associated with weight-for-height and triceps skinfold of children from ethnic groups in England. AB - Baseline results of weight-for-height and triceps skinfold for a sample of Caucasian, Afro-Caribbean and Indo-Pakistani children living in inner-city areas are given and compared with children in an existing surveillance study representative of the English population. The data collected in 1982 for the representative sample and in 1983 for the ethnic groups gave useful information on 13,073 children in the age-range 5-11 years. The Afro-Caribbean children had a similar weight-for-height to the Caucasian children but they were thinner than the Caucasians in terms of triceps skinfold thickness. Indo-Pakistani children were lighter than any other group in the study. Indo-Pakistani boys had a higher triceps skinfold thickness in relation to NSHG standards than the girls. The Caucasian children in inner-city areas were consistently more obese than the Caucasian children in the representative sample. However, in a set of multiple regression analyses the independent social factors explained a minimal percentage of the variation of weight-for-height and triceps skinfold. Ethnic origin and parents' weight and height were most highly associated with child's weight-for height and triceps skinfold. The results highlight our limited knowledge of factors influencing obesity in childhood and point out the large differences of weight-for-height and triceps skinfold related to ethnic origin in the UK. PMID- 3662426 TI - Opportunity for natural selection with special reference to population structural measures among the Vadde. AB - Crow's indices of opportunity for natural selection have been studied among the Vadde, a fishing community of Kolleru Lake, Andhra Pradesh, India. The sample comes from 15 of the 60 fishing villages. The indices were computed both at the level of village and population units. A village sample of Palle, another fishing group in the area, has also been analysed for the purpose of comparison. An attempt has been made to explain variation in selection indices among the villages using population structural measures. A wide variation is found in both the fertility and mortality indices between the villages. The values were compatible with those found for other fishing groups studied previously, and in the middle of the range observed for the Indian populations (about 100) studied so far. Population structural measures are found to explain a significant amount of variation in Im and It but not in the fertility index. PMID- 3662427 TI - Non-random distribution of various sizes of human Y chromosomes in different ethnic groups. AB - One hundred and ninety normal males from three ethnically different populations (Caucasians, American blacks and East Indians) were selected to study the frequency distribution of length of the Y chromosome, fluorescent (f) and non fluorescent (nf) segments as a function of Y/F, f/F and nf/F indices. The QFQ techniques was performed to identify the f and nf segments. The frequency distribution of the total length of Y chromosome was not normally distributed in all three populations (P less than 0.05). Extensive statistical analysis revealed that the non-random distribution of the total length was due to skewness and kurtosis for both the n and nf segments. The clinical implications as well as evolutionary aspects of such variation in ethnic anthropology are discussed. PMID- 3662428 TI - Normal length changes in hand bones during adulthood: exploratory study of ray two. AB - A longitudinal analysis was made of total length changes of the four epiphyseal bones of ray two, the index finger, during adulthood. Matched pairs of standardized hand-wrist radiographs on 37 individuals between earlier (means = 22 years) and later (means = 54 years) adult age-grades show that the distal and middle phalanges continue to increase in overall length; the proximal phalange exhibits no change; and the metacarpal significantly decreases in size. The changes in these normal adults are also discernible in cross-sectional data but are not obvious statistically. Causes of the specific increases and decreases remain speculative. PMID- 3662429 TI - Age at menarche in Sardinia (Italy). AB - The median age at menarche in 1080 Sardinian girls (ages 11.00-16.49 years) was calculated with the status quo method and probit analysis as 12.78 +/- 0.06 years. PMID- 3662430 TI - Stabilizing selection in man: the effect of mother's age on birthweight variance. AB - In order to study the effect of mother's age on birthweight variance, data were collected from Official Vital Statistics of the USA, Japan and Italy. Birthweight means and variances were calculated for all single births and for live births only. The results demonstrated that birthweight variance regularly increases in babies born to mothers of increasingly older age (with the exception of the youngest mothers). Moreover, the higher the variance in all births, the more the variance diminishes after late fetal selection. Therefore, a feedback phenomenon takes place in the stabilizing component of selection, i.e. the difference between the variance of all births and that of live births. As a consequence, at least part of the higher number of fetal losses experienced by older mothers can be attributed to the increased birthweight variance of their children. PMID- 3662431 TI - Secular trends in weight, weight-for-height and triceps skinfold thickness in primary schoolchildren in England and Scotland from 1972 to 1980. AB - Measurements of height, weight and triceps skinfold thickness were obtained from English and Scottish schoolchildren from 15 birth cohorts over the period 1972 1980. Positive trends in weight were found for boys and girls in both countries, but in England they were less than expected from the increases in height. The increase in weight-for-height in Scotland was paralleled by a greater increase in triceps skinfold in Scottish than in English children. Scottish children remained shorter, lighter and thinner than English children, but similar in weight-for height. Separate monitoring of trends in obesity for English and Scottish children should continue. PMID- 3662432 TI - Growth in Turkish children in Stockholm. AB - Height, weight and body proportions were studied in 155 Turkish school children born in Sweden, living in a defined area in Stockholm. They were compared with Swedish children matched for sex, age and physical environment, and with a smaller number of Turkish children born in Turkey or in countries other than Turkey and Sweden. Parents' socio-economic levels were extremely low on a Swedish comparison. Growth was correlated to socio-economic background. The study was cross-sectional and longitudinal, combining growth data for key ages from health documents with contemporary data. Turkish schoolchildren under 10 years of age, born in Sweden, were significantly shorter than Swedish children, the difference beginning in the pre-school years. Turkish children born in Turkey were short on arrival in Sweden but soon caught up with the Turkish children born in Sweden. Genetic factors only could not explain the difference in height-for-age between Turkish children born in Sweden and Swedish children. With a longer period of stay in Sweden an increase in height-for-age would be expected. PMID- 3662433 TI - Distribution of transferrin (Tf) subtypes in several Mongoloid populations of East Asia. AB - The distribution of serum transferrin subtypes was determined by PAG electrophoresis and isoelectric focussing in a group of 2288 individuals from 10 Mongoloid populations of East Asia. The sample comprised 857 Chinese from different localities: Singapore (239), Malaysia (228), Taiwan (265), Hong Kong (65), Fouzhou (60); Koreans (332), Filipinos (281), Thais (455), Malays (335) and Indonesians (28). The frequencies of TfC1 varied from 0.73 to 0.79 in the Chinese and from 0.76 to 0.83 in the other Mongoloid populations. TfC3 was observed at a frequency of 0.02 in the Koreans and Chinese from Fouzhou. TfDChi was present in a low frequency (0.01 to 0.03) in all the populations. A low frequency of TfB was also present in all the populations. The phenotypic distribution of transferrin subtypes was at Hardy-Weinberg equilibrium in all the populations. PMID- 3662434 TI - Standard deviation score charts of skeletal maturity and its velocity in Swedish children assessed by the Tanner-Whitehouse method (TW2-20). AB - Reference values, means and standard deviations for skeletal maturity of Swedish children, evaluated in terms of the Tanner-Whitehouse method (TW2-20), have been expressed in mathematical functions. Almost 4000 radiograms have been assessed. The radiograms were taken on 212 children aged between one month and 18 years as part of a longitudinal study of growth and development. Up to the age of 10 years, the Swedish children had a more advanced skeletal maturation (about 0.5 SD) than the British children. Means and standard deviations have been used in preference to medians and centiles, since this makes it possible to use the results in the assessment of children with grossly deviating maturation. The selected functions were chosen in order to give a good description of the empirical distributions and no biological implications of the estimated parameters were sought. This method improves the assessment of skeletal maturity in several respects; reference values are given parametrically, which facilitates the computing of the individual standard deviation scores, and reference charts are presented for both attained scores and velocity scores (for boys between one and 13 years and for girls between one and 11 years). PMID- 3662435 TI - Population estimates of height and weight in Great Britain at ages 11 and 15, 1983 and ages 16-19 inclusive, 1980. AB - Height and weight tables for adults in Great Britain were published in this journal in 1985. A similarly representative sample, at ages 11 and 15, has become available as the result of a survey of schoolchildren's diets. The opportunity has been taken of linking the results of the two surveys, both of which were conducted by the Office of Population Censuses and Surveys for the Department of Health and Social Security, using the same measuring techniques. Quetelet indices have been calculated for these data at each age, using a method that depends only on knowing the means and standard deviations of the heights and weights, and on their covariance. Limits are derived within which 95% and 80% of the populations lie. PMID- 3662436 TI - Secular trends in the heights of women from the urban poor community of Hyderabad. AB - There are very few studies in India that have investigated secular trends in the heights and weights of adult women from the poorer socio-economic groups. Five hundred and twelve pairs of healthy mothers and daughters were enrolled and heights and weights recorded. The heights were not different in the two generations, but the daughters were lighter than the mothers. The number of mothers and daughters with heights under 145 cm were 35 and 34. If height corrections for mother's age is done, then it appears that the trend in this population is towards smaller size. PMID- 3662437 TI - Long-term ethanol consumption in the hamster: effects on tissue lipids, fatty acids and erythrocyte hemolysis. AB - Male Golden Syrian hamsters at 1 year of age were given a basal diet and either distilled water or 10% absolute ethanol in distilled water to drink for 1 year in order to determine the influence of prolonged ethanol intake on tissue long chain fatty acid, lipid composition and erythrocyte hemolysis in response to osmotic stress. Total lipids were extracted from liver, heart, plasma and erythrocytes. Individual lipid fractions were quantitated and the percentage fatty acid composition of the lipid fractions analyzed by gas-liquid chromatography. Although no significant changes in tissue lipid content or erythrocyte hemolysis were attributable to ethanol intake, fatty acid changes were marked in the ethanol-fed hamsters. The primary fatty acid changes were increased oleic acid (40-50%) and decreased linoleic acid (25-60%) which were observed in all tissues. Arachidonic acid was decreased only in triacylglycerol fractions. The results suggest that in the hamster long-term voluntary ethanol intake alters specific long chain fatty acids, but that erythrocyte membrane integrity and tissue lipid composition were not compromised. PMID- 3662438 TI - Effect of dietary cholesterol level on plasma campesterol concentration in rhesus monkeys. AB - High- and low-responding rhesus monkeys were fed diets containing 0.02, 0.15 and 0.75 mg/kcal cholesterol without or with 2% of a mixture of plant sterols for 6 weeks. No plant sterols were detected in the plasma of either high- or low responding animals fed the cholesterol-containing diets but with low levels of plant sterols. After addition of 2% plant sterols to the diets, only campesterol was found in the plasma of both groups of animals. The plasma campesterol concentrations in either the high- or the low-responding groups were highest on the diet with 0.75 mg/kcal cholesterol and lowest with 0.02 mg/kcal cholesterol. Also, on all three diets, the plasma campesterol concentration was higher in the high responders than in the low responders. We conclude, based on the plasma campesterol levels, that the level of cholesterol in the diet affected the plasma level by affecting the intestinal absorption of the sterol. The higher the dietary cholesterol level, the higher the absorption of campesterol, and thus the higher the plasma level. Also, the high responders absorb higher amounts of campesterol than the low responders, a finding similar to cholesterol absorption in the high-responding rhesus monkeys. PMID- 3662440 TI - Plasma lead and erythrocyte zinc protoporphyrin in neonates and young children in Kuwait. AB - Blood samples from a series of 797 nonselected Kuwaiti Bedouin infants less than 5 years old were analyzed for lead (Pb) and zinc protoporphyrin (Zpp). Elevated blood Pb concentration (greater than 25 micrograms/dl), which may indicate Pb poisoning, was found in 53 cases (6.8%). These children had a mean blood Pb concentration of 47.1 +/- 15.9 micrograms/dl. The correlation coefficient between the concentration of Pb and Zpp in the blood was r = 0.78, p less than 0.001. The results indicated that Pb intoxication in neonates and children may be a significant health problem in Kuwait, and that measurement of blood Zpp can be used as a simple, rapid, and inexpensive microscreening method for Pb poisoning in infants and neonates. PMID- 3662439 TI - [Standard values for serum esterified fatty acids in adult women in good health]. AB - Serum was obtained from two groups of 23 healthy female volunteers to determine the standard values of esterified fatty acids (EFA) contained in phospholipids, triglycerides and cholesterol. One group consumed an 'optimal' diet in regard to lipid and caloric content, under strictly controlled conditions, the other a free diet. All lipid fractions in serum from both groups were in the physiologic range so that the levels of EFA could be expected to be in the normal range. These data are comparable to those obtained from other series but they differ strongly from values established among the Eskimos, who have very low serum levels of arachidonic acid due to their traditional diet and probably to genetic factors. Determination of the standard values of EFA in healthy caucasian women may contribute to a better assessment of role of the therapeutic intervention on lipid parameters considered as atherogenic risk factors. PMID- 3662441 TI - Effects of various dietary selenium intakes on the levels of blood glutathione peroxidase and selenium in long-term fed rats. AB - Female Sprague-Dawley rats were fed a torula diet or wheat diets containing 4 levels of Se partially supplemented (24-402 ppb) for 120 days. Selenium content and glutathione-peroxidase (GSH-Px) activity in plasma and erythrocytes were measured every 20 days. In rats fed torula diet or basal wheat diet, plasma Se (P Se) increased for up to 60 days, then remained constant, while erythrocytes Se (E Se) and E-GSH-Px decreased in basal-diet rats during the first 40-60 days, then increased. In rats fed supplemented diets, P-Se and P-GSH-Px increased more rapidly than E-Se and E-GSH-Px, plateauing at 60-80 days. The best correlation was found between P-GSH-Px and dietary Se indicating that this index is the most sensitive for evaluating changes resulting from different Se intakes. In addition, correlations became more significant with time. The results from rats fed a low Se diet suggest the existence of regulatory mechanisms working in different ways and at different times in plasma and erythrocytes. PMID- 3662443 TI - [Piezo-electric lithotripsy technic with echographic guidance (EDAP LT 01)]. AB - Piezo-electric extracorporeal lithotripsy with ultrasonographic detection is performed with the following material according to the following technique: 1) A mobile firing head connected to the lumbar region by a simple inflatable cushion filled with sterile water. At the centre of the firing head, a 5 MHz real time transducer is used to locate the stone. 320 piezo-electric elements, arranged around the transducer, can induce, when focussed, a pressure of about 900 bars at the focal point in vitro. The focus is 15 mm X 5 mm. The generators are electronic. 2) The technique requires: understanding of ultrasonography in order to precisely locate the stone which, when it is intrarenal, is only missed in 1% of cases in our experience. Stones of the iliac ureter are not visible. Treatment requires the patient's confidence so that, due to the quality of the piezo electric wave, no anaesthesia is necessary. The firing time should be relatively long (45 min to 1 hr) in order to ensure good fragmentation. 26% of patients require retreatment. Secondary complications are rare (3% of endoscopic treatments). The technique is now proposed in 90% of cases without admission to hospital. The simplicity of the manipulation of the apparatus must not mask the fact that it is a technique which requires perfect mastery. Only urologists familiar with stone pathology and who are able to treat the complications of lithotripsy by endoscopy or by surgery should perform extracorporeal lithotripsy. PMID- 3662442 TI - Hair zinc and copper concentration in survivors of myocardial infarction. AB - Increased Zn/Cu ratio in the diet, and consequently in the body, was suggested to be of importance in the pathogenesis of atherosclerosis. Head hair of 29 male survivors of myocardial infarction and of 23 control males was studied for the concentration of Zn and Cu. The Zn hair concentration and Zn/Cu ratio in survivors of myocardial infarction was significantly higher in comparison with controls. The inclusion of the Zn/Cu ratio into the discriminant analysis using total cholesterol and HDL cholesterol considerably improved the coefficient R2 and decreased the number of cases not properly classified. PMID- 3662444 TI - [Uretero-caliceal anastomosis]. AB - We report our experience of ureterocalycostomy in two patients with good results. Some technical points and the indications of this plastic surgery are discussed. If ureteropelvic anastomosis is impossible, this method of surgery must be tried before performing urinary diversion, such as nephrostomy. PMID- 3662445 TI - [Obstruction of the upper excretory tract associated with primary urinary infection. Diagnosis, treatment and course. Apropos of 196 cases]. AB - The association of upper urinary tract obstruction and urinary tract infection is a relatively common disease which requires early diagnosis and systematic treatment. The diagnosis of this disease can be difficult as many patients present with totally asymptomatic forms which may be revealed suddenly and totally unpredictably by an episode of severe infection. 196 (16%) of the 1,225 patients operated between January 1977 and June 1985 for upper urinary tract obstruction also presented with urinary tract infection at the time of admission. Suggestive urological signs were present in only 49% of the patients and infectious signs were present in 39%. 26 patients had acute renal failure and 9 presented at least 3 signs of severity. The bacteria most frequently isolated were E. coli (29% of M.S.U.s and 11% of blood cultures) and Proteus mirabilis (30% of M.S.U.s and 11% of blood cultures). Treatment always consisted of a combination of surgery and antibiotic therapy. Surgery was conservative in only 71% of patients at the first operation. 23 patients required specific symptomatic treatment due to the presence of signs of severity. Renal function, evaluated on the basis of the serum creatinine, was considerably improved by treatment, particularly in patients with acute renal failure on admission. In terms of bacteriological results, 92% of patients were discharged from hospital with sterile urine. 20% of the patients reviewed as outpatients had persistent urinary tract infection, generally caused by Proteus mirabilis. Three patients (1.5%) died, including 2 from the initial infectious syndrome. PMID- 3662446 TI - [Epidermoid carcinoma of the bladder. Apropos of 46 cases]. AB - In order to define the prognosis of pure squamous carcinomas of the bladder, on the one hand (group I), and the possible aggravating role of the presence of squamous tissue in an invasive renal cell tumour, on the other hand (group II), 46 cases files of patients treated between 1975 and 1984 were analysed retrospectively. Group I consisted of 18 cases of pure squamous carcinoma (11 men with a mean age of 71 years and 7 women with a mean age of 74 years). 66% of cases presented with haematuria, but urinary cytology was of little help. The diagnosis was established by transurethral resection with 18 grade 3 tumours: stage A in 4 cases and stage B in 14 cases. 10 patients had unilateral (8 cases) or bilateral (2 cases) complications of the upper urinary tract. The presence of lymph node and/or haematogenous metastases was investigated by bone scan, hepatic ultrasonography, pulmonary tomography and, most importantly, by bipedal lymphography combined with percutaneous cyto-aspiration of suspicious nodes. 4 patients presented with invasion of the obturator lymph nodes (2 cases) and iliac lymph nodes (2 cases). 9 patients were treated by total cysto-prostatectomy, 6 patients by radiotherapy (60 Grays) and 3 patients did not receive any treatment. The overall survival was 12.5% after 2 years. None of the patients treated by radiotherapy were alive after 2 years. 29% of the patients treated by surgery survived for 2 years, but none of them were alive after 5 years, essentially as a result of local recurrence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662447 TI - [Monoclonal anti-prostatic acid phosphatase antibodies (production and characterization)]. AB - 5 monoclonal antibodies have been produced by Kohler and Milstein. The production and the characteristics of the monoclonal antibodies are presented. They are all IgG1 and have high specificity against prostatic cells producing prostatic acid phosphatase. These monoclonal antibodies can be used to perform immunoscintigraphies and immunolymphoscintigraphies to titrate prostatic acid phosphatase serum levels and to identify the prostatic origin of a tumor. PMID- 3662448 TI - [Polycystic dysplasias of the kidney. Apropos of 55 cases]. AB - The authors define their diagnostic approach and current management of Polycystic Renal Dysplasia (PRD) on the basis of a retrospective study of 55 children. Antenatal and postnatal renal ultrasonography and I.V.P. ensure early diagnosis of this congenital malformation; these two investigations together with cystography demonstrate the high incidence (16/55) of associated contralateral uropathy (vesicoureteric reflux, megaureter, hydronephrosis). Three therapeutic possibilities are discussed: therapeutic abstention and ultrasound guided cyst aspiration may be justified, but the authors prefer surgery as it allows confirmation of the diagnosis, elimination of the symptoms related to the cysts and their complications, confirmation of the absence of an associated nephroblastoma and treatment of any associated contralateral uropathy. In any case, it is impossible to restore the function of the dysplastic kidney, hence the importance of identifying any associated contralateral uropathy which could determine the vital prognosis. PMID- 3662449 TI - [Controlled obturator nerve block using electrostimulation: prevention of the stimulation of the obturator nerve during resection of the lateral walls of the bladder]. AB - An adductor contraction secondary to obturator nerve stimulation can occur during transurethral resection of a lateral bladder lesion and then can induce bladder perforation or hamper complete resection. Many technique have been advocated but they are ineffective or unreliable. Obturator nerve blockade in the obturator canal by local anesthesia with control by nerve stimulator can prevent these complications. The technique described, has been used in 12 patients it is reliable, fast and easy to perform. PMID- 3662450 TI - [Meeting of eastern urologists. Auxerre, 13 September 1986. Abstracts]. PMID- 3662451 TI - Lambert-Eaton myasthenic syndrome: I. Early morphological effects of IgG on the presynaptic membrane active zones. AB - In the freeze-fractured presynaptic membrane of the motor end-plate, the active zones consist of two parallel arrays and each array contains 10- to 12-nm particles arranged in two rows. In the Lambert-Eaton myasthenic syndrome (LEMS) and in mice treated with 10 mg/day of LEMS IgG, administered intraperitoneally for several weeks, there was a paucity and disorganization of the active zones, and clusters of 10- to 12-nm particles appeared. To further define the changes in the active zones, mice were studied that had been treated over 2 days with 104 to 180 mg of IgG. Treatment transferred the physiological defect of LEMS. Control mice received normal human IgG or no IgG. The spacing and density (number/unit area) of active-zone particles were evaluated in presynaptic membrane P-faces using computer-assisted stereometry. In the normal active zone, the distance between particles in a given row and between adjacent rows of an array was less than, but the distance between the two arrays was greater than, the distance between the two antigen-binding sites on human IgG. In mice treated with LEMS IgG, the initial alteration in the active zone was a decrease in the distance between particles in a given row and between adjacent rows of an array; the distance between the two arrays remained unaltered. In more affected active zones, the parallel orientation of the rows was disturbed and the arrays became clusters. There was a significantly reduced density of active zones and of large membrane particles associated with all active zones and clusters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662452 TI - Acetylcholine receptors in human thymic myoid cells in situ: an immunohistological study. AB - Myoid cells were studied by double immunofluorescence in sections of thymus from 47 patients with myasthenia gravis and 15 control subjects, using polyclonal sheep anti-troponin T and monoclonal antibodies to troponin I, striated muscle myosin, and acetylcholine receptor (AChR). The myoid cells were rare and located mainly in the medulla, and most were clearly positive for AChR; labeling was similar with four individual monoclonal antibodies specific for extrajunctional AChR and five that also recognize endplate AChR. They were mostly keratin positive and consistently HLA-DR-negative. In the myasthenia gravis samples, the myoid cells were similar but largely confined to medullary epithelial areas; AChR labeling was slightly weaker, but otherwise they did not differ noticeably from those of control subjects. A preliminary finding was of even rarer AChR positive/HLA-DR-positive antigen-presenting (possibly) cells seen in 9 of 9 myasthenia gravis samples and in none of 9 control samples. Although myoid-cell AChR appears antigenically similar to extrajunctional muscle AChR, and must therefore express the epitopes that myasthenics' antibodies recognize, these cells do not appear to be foci of immunological stimulation in myasthenia gravis. PMID- 3662453 TI - Cholinesterases within neurofibrillary tangles related to age and Alzheimer's disease. AB - Enzyme histochemistry showed that a substantial number of cortical neurofibrillary tangles contain acetylcholinesterase and butyrylcholinesterase activities in patients with Alzheimer's disease and in nondemented aged individuals. In some areas of the brain, tangles containing each of these two enzymes were differentially distributed. In other areas, there was a very close overlap between the two types of cholinesterase. PMID- 3662454 TI - Platelet membrane abnormality in Alzheimer's disease. AB - Fluorescence studies of membrane fluidity were conducted double-blind using platelet and red cell membranes prepared from 24 demented patients with probable Alzheimer's disease and 36 neurologically healthy subjects. The fluidity of the hydrocarbon and lipid-aqueous interface regions of cell membranes was determined at 37 degrees C by fluorescence spectroscopy using the lipid probes 1,6-diphenyl 1,3,5-hexatriene (DPH) and 1-[4-(trimethylamino)phenyl]-6-phenyl-1,3,5-hexatriene (TMA-DPH), respectively. The rotation rate of TMA-DPH in labeled platelet membranes did not differ between the groups. In contrast, the rotation rate of DPH in labeled platelet membranes from the demented patients (2.15 +/- 0.24 X 10(8)/sec, SD) was greater than that for the normal controls (1.93 +/- 0.13 X 10(8)/sec, SD, p = 3.8 X 10(-5)). This difference was reflected by a reduction in the steady-state anisotropy of DPH in labeled platelets from the demented group (0.1887 +/- 0.0085, SD) when compared to the respective mean for the controls (0.2000 +/- 0.0060, SD; p = 1.3 X 10(-7)). Abnormal membrane fluidity was significantly correlated with severity of dementia, but not with duration of illness or apparent age of onset. The findings do not support the hypothesis that Alzheimer's disease results from a pathological acceleration of the normal aging process, since normal aging is associated with decreased fluidity of cell membranes from platelets, as well as from lymphocytes, hepatocytes, and neurons. PMID- 3662455 TI - Trends in the incidence rates of stroke in Rochester, Minnesota, since 1935. AB - The Mayo Clinic medical records system and records-linkage system have been used to study trends in the incidence of stroke in Rochester, Minnesota, for comparison with U.S. stroke mortality trends. This study extends the observations back through 1935. The average annual incidence rate for the period 1935 to 1944 was 188 and 179 per 100,000 population for men and women, respectively--not significantly different from 200 for men and 178 for women for the period 1945 to 1954. The blood pressure level in these patients did not affect probability of survival or recurrent stroke. The trend in the incidence rate of stroke for women showed no change for the 20 years from 1935 to 1954, after which there was a gradual decline. For men there was little change until 1969, after which there was a sharp decline. We suggest that the gradual decline in U.S. stroke mortality rates for this early period may include an artifact introduced by changing codes and changing fashions of diagnosis. PMID- 3662456 TI - Phenylethanolamine N-methyltransferase activity is decreased in Alzheimer's disease brains. AB - Phenylethanolamine N-methyltransferase (PNMT) is the rate-limiting enzyme involved in the synthesis of epinephrine and a specific marker for epinephrine neurons. We have previously described the stability of this enzyme in a variety of pre- and postmortem conditions in human brain autopsy specimens and demonstrated its presence in areas of the human brain that are associated with memory and attention. We now report on 5 patients with Alzheimer's disease (AD) who had a decrease in PNMT activity of 37 to 48% in areas of the brain affected by the disease but not in the cerebellum, an area of the brain unaffected by the disease. The degree of decrease in PNMT activity in the hippocampus correlated significantly with the degree of dementia. We have provided direct immunochemical evidence that the decrease in PNMT activity in AD is due to the loss of this specific enzyme protein. PMID- 3662457 TI - Carbamazepine and cardiac conduction disturbances. AB - Carbamazepine-induced cardiac conduction disturbance is reported in 2 patients suffering from epilepsy. The cardiac defects disappeared in both patients after carbamazepine was discontinued, and reappeared in 1 patient after treatment was resumed. PMID- 3662458 TI - Intrathecal IgM synthesis in patients with Lyme disease. PMID- 3662459 TI - The value of intraoperative monitoring during carotid endarterectomy: a comment. PMID- 3662460 TI - Progabide in Parkinson's disease. PMID- 3662461 TI - Genetic structure and differentiation of human populations. AB - The concepts of genetic constitution and genetic structure are defined in terms of arrays of gene frequencies, the array and distribution of genotypes, and the distribution of probable ancestral contributions to the gene pool. These concepts can, however, be differentiated. Examples of their application to human populations, to illustrate their descriptive, analytical and epidemiological uses, show that the two concepts help to resolve different types of problems. PMID- 3662462 TI - Population genetic study in ten endogamous groups of West Bengal, India. AB - Ten endogamous population groups of West Bengal (India)--Rabhas, Garos, Mechs, Rajbanshis, Jalia Kaibartas, Bagdis, Lodhas, Mundas, Brahmins, Vaidyas--have been typed for twelve polymorphic systems: ABO, Gm, Km, Hp, Cp, Tf, Alb, Hb, aP, EsD, AK and PGM1. The results are compared with those obtained on other Indian populations. Serological and anthropometric data, which have been included into population comparisons, reveal a considerable genetic variability of the groups under study. This variability is obviously connected with the population history of West Bengal. PMID- 3662463 TI - Influences on assortative mating. AB - Age plays a considerable role in assortative mating. As regards this criterion we can distinguish a "rural, more traditional model" with high values of the coefficients of correlation, and an "urban model" with significantly lower values. Concerning eye and hair colour we find both these models as well as transitional forms. In contrast to this there are no important differences in assortative mating between the rural and urban populations regarding the physical traits. Size of population and length of marriage can strongly influence the values of these correlations. They decrease as the size of the population decreases, in which a person chooses his/her partner. Increasing age of the couples also results in a decrease of these correlations. PMID- 3662464 TI - Directional dental asymmetry in South Sinai Bedouin isolates. AB - Dental casts of 242 Bedouin children were used to study directional asymmetry (DA). Results of Student's t-test pair comparison showed that for permanent dentition, 4 out of 24 DA measures were statistically significant whereas for deciduous dentition, 8 out of 20 measures were significant (p less than 0.05). The magnitude of DA was on the average 1% of the total size of the tooth. No preference regarding dimension (buccolingual, mesiodistal) or jaw (maxilla, mandible) was detected for the DA. PCA results demonstrated the independent nature of DA measures in the dentition. PMID- 3662465 TI - [Correlates and predictors of the age of menarche]. AB - In a cross-sectional study of 452 girls between 10 and 16 years of age 36 indices of physical and 50 of mental development were tested for their correlation with age at menarche and chronological age, as well as for their predictive power for estimating menarche by multiple regression analysis. Indices of physical maturity and body weight when adjusted for chronological age showed the highest partial correlation coefficients with age at menarche. Among mental characters which show lower intercorrelations with menarche occurred the highest correlation coefficients for a handmotor factor "Spurennachzeichnen" and a factor "Gruppenabhangigkeit" (which indicates a type of social motivation). In general physical and mental factors correlate higher with chronological age than with age at menarche. By multiple regression analysis we determined 14 physical and 25 mental predictors explaining 21% and 17% respectively of the variance of age at menarche. The error of the estimate predicting menarche on body weight without knowledge of onset of menarche is +/- 1 year. Using chronological age in a sample of girls before menarche the error of the estimate only is +/- 6 months. To compare the predictive power of chronological age combined with body weight or with skeletal age the time interval is calculated within which 95% of girls attain menarche. The range of prediction extends from 4.3 to 1 year on chronological age (11-16 years); using mean body weight it can be improved by 1.8 to 6 months, while using mean skeletal age an improvement of 0.2 to 3.9 months is possible compared with body weight. The correlations between age at menarche and physical and mental variables are attributed to a common hormonal influence on rate of development. PMID- 3662467 TI - Recent advances in AIDS and Kaposi's sarcoma. 2nd International Workshop on AIDS/Kaposi's Sarcoma, Sorrento, June 2, 1986. PMID- 3662466 TI - [The bone, a complex construction. Thoughts of an architect]. AB - Having a precise knowledge of the construction methods of technical objects is helpful to understand the developing processes in nature, the patterns, the bearing capacity and the investment of energy and material of natural lightweight structures. An engineering framework out of bars and knots can be compared with a framework of bones--keeping in mind, however, that solid and soft components viz. bones, cartilage, sinews, muscles and filling liquids together are building a force guiding system. Such complex systems can most easily be explained by their development and "production". Fibre nets and networks provide flexibility and stiffness to the weak pneu- or hydroskeleton. Outer appearance and internal microstructure prove the bone to be a solidified and prestressed pneu. The load capacity of the bone is determined by the solid materials and the supporting, varying inner pressure in combination with the blood circulation. In contrast to that the pressure of cartilage made of similar materials is constant. All other force guiding networked fibre systems are supposed to have a bone-like structure with all states of solidification. Highly flexible fibre nets are capable of self alignment, self-remodelling and self-repair. A likewise self-organization can be found in the inner fibre net of the bone. In case of a fracture callus will seal the damaged pneu. The net structure of a strained bone has routings similar to the hypothetical flow of forces within solid bodies. The author evolves the thesis that the bone in the course of its forming process as well as in its final stiffened shape can be looked upon as a pneumatic system with regard to its load bearing behaviour. PMID- 3662468 TI - Human retrovirus infection and immunodeficiencies. Detection and significance of virus-neutralizing antibodies. PMID- 3662469 TI - Opportunistic infections in AIDS patients in Milan. PMID- 3662470 TI - Pharmacokinetics and tissue penetration of roxithromycin after multiple dosing. AB - The pharmacokinetics of the macrolide roxithromycin (RU 28965) were studied during and after administration of 150 mg every 12 h for 3 days (five doses) in six volunteers. The concentrations in serum, blister fluid, and urine were measured. Mean levels in serum taken at 1.5 h after the morning dose increased from 4.4 micrograms/ml on day 1 to 5.9 micrograms/ml on day 2 and 7.4 micrograms/ml on day 3. The mean serum and blister fluid elimination half-lives on day 3 were 13.2 and 12.5 h, respectively. Roxithromycin penetrated blister fluid well; the mean percent penetration (as measured by the ratio of areas under the curve) was 85%. After the final dose, a mean of 10.5% of that dose was recovered in 12 h as microbiologically active compound. PMID- 3662471 TI - Altered pharmacokinetic disposition of ciprofloxacin and vancomycin after single and multiple doses in rabbits. AB - The pharmacokinetic disposition of vancomycin and ciprofloxacin was assessed in rabbits before the efficacy of these compounds in experimental staphylococcal endocarditis was compared. Ciprofloxacin was given in single intravenous bolus doses of 25 and 35 mg/kg and also in a multiple-dose regimen of 35 mg/kg every 6 h. Vancomycin was given in a similar manner in single doses of 17.5 and 25 mg/kg and in a multiple-dose regimen of 17.5 mg/kg every 6 h. Serum was sampled frequently after injections and analyzed by microbiologic assay for drug concentration. The pharmacokinetic parameters of clearance and steady-state volume of distribution were calculated by compartment-independent methods. These studies revealed that clearance of ciprofloxacin was reduced significantly after multiple doses (7.42 +/- 0.85 [standard deviation] versus 6.09 +/- 0.71 liters/h, P less than 0.01). Although the half-life and volume of distribution increased after multiple dosing, the differences were not statistically significant. The disposition of vancomycin following single doses was significantly altered after the 25-mg/kg dose compared with the 17.5-mg/kg dose. Half-life, clearance, and volume of distribution changed from 1.27 +/- 0.2 to 1.60 +/- 0.21 h (P less than 0.05), 0.54 +/- 0.05 to 0.39 +/- 0.04 liters/h (P less than 0.01), and 0.37 +/- 0.04 to 0.31 +/- 0.03 liters/kg (P less than 0.05), respectively. The disposition of ciprofloxacin was not altered with increases in dose size, and the disposition of vancomycin was not altered after multiple doses. If such alterations in the pharmacokinetic disposition of antimicrobial agents are unanticipated, the higher and more prolonged than expected serum concentrations may have an effect on the outcome of experimental infections. PMID- 3662472 TI - In vitro susceptibility of Coxiella burnetii to antibiotics, including several quinolones. AB - Antibiotic susceptibility testing of the rickettsial Q fever agent Coxiella burnetii was performed by using persistently infected L929 fibroblast cells. The efficacies of a variety of antibiotics with different metabolic targets were tested and compared. The most effective antibiotics in bringing about the elimination of the parasite from infected cells included several quinolone compounds and rifampin. Of the quinolone compounds tested, difloxacin (A-56619) was the most effective, followed by ciprofloxacin and oxolinic acid. These three quinolones were apparently rickettsiacidal. After 48 h of exposure to microgram amounts of the compounds (ranging from 2 micrograms of difloxacin per ml to 5 micrograms of the other two antibiotics per ml), the number of intracellular parasites markedly declined; after 10 days of treatment, very few intracellular rickettsiae were detected. Rifampin (1 microgram/ml) was also very effective in eliminating the parasites. Some of the 13 other antibiotics tested that were somewhat effective included chloramphenicol, doxycycline, and trimethoprim. The persistently infected L929 cells were found to provide a convenient system for the relatively rapid determination of the susceptibility of C. burnetii to antibiotics. PMID- 3662473 TI - Pharmacokinetics of a single dose of rimantadine in young adults and children. AB - Single doses of rimantadine were given to children and young adults to evaluate the safety and pharmacokinetics of this antiviral compound. The half-life of rimantadine in young adults was 27.7 +/- 4.9 h for tablets and 27.8 +/- 8.0 h for syrup preparations. A total of 10 children, 5 to 8 years old, received a syrup preparation of rimantadine. The half-life of rimantadine in children was 24.8 +/- 9.4 h. A single dose of rimantadine was well tolerated in young adults and children. PMID- 3662474 TI - Environmental exposure of primary care personnel to ribavirin aerosol when supervising treatment of infants with respiratory syncytial virus infections. AB - The potential exposure to ribavirin aerosol in the environment was assessed in nurses caring for infants and children with severe lower respiratory tract infections due to respiratory syncytial virus. Ribavirin aerosol was administered via a ventilator, oxygen tent, or oxygen hood. Participants worked directly with infants receiving ribavirin for 20.0 to 35.0 h over a 3-day period. No toxic or adverse effects of ribavirin aerosol were observed in any of the 19 nurses studied, and ribavirin was not detected in erythrocytes, plasma, or urine collected after the potential exposure period. PMID- 3662475 TI - Effect of roxithromycin on acute toxoplasmosis in mice. AB - Roxithromycin effectively treated acute peritoneal murine toxoplasmosis. After five doses, starting 24 h after challenge, the 100 and 50% survival doses were 540 and 336 mg/kg per day, respectively. After 14 doses, starting 3 h after challenge, the 50% survival dose was 360 mg/kg per day. Toxoplasma gondii was recovered from the brain in 59 and 28% of surviving mice treated with 5 and 14 doses, respectively. PMID- 3662476 TI - Penicillin tolerance in Streptococcus faecium ATCC 9790. AB - Tolerant strains of Streptococcus faecium had higher levels of muramidase 2 and lower levels of trypsinactivable muramidase 1 than did susceptible strains. Susceptible strains lysed faster than did tolerant strains in buffer and at some antibiotic concentrations. The addition of Triton X-100 produced equal lysis rates for susceptible and tolerant cultures. PMID- 3662477 TI - Enhanced therapeutic efficacy of poly(ICLC) and ribavirin combinations against Rift Valley fever virus infection in mice. AB - The therapeutic efficacy of polyriboinosinic-polyribocytidylic acid stabilized with poly-L-lysine and carboxymethyl cellulose [poly(ICLC)] given alone or in combination with ribavirin was evaluated in Swiss Webster mice infected with Rift Valley fever virus. Four or more 20-micrograms doses of poly(ICLC) given at various intervals beginning 24 h after infection protected all mice against death. On the other hand, a treatment regimen consisting of only three doses of poly(ICLC) given 24 h postinfection resulted in a 50% survival rate. When initiated 48 h postinfection, an extended treatment regimen with the same dose was required to yield 40% survivors. Lower doses (5 micrograms) of poly(ICLC) per mouse were only marginally effective even when six injections were given between days 1 and 9 postinfection. The combined administration of ribavirin and poly(ICLC) initiated as late as 48 h postinfection was effective even when treatment consisted of doses that were ineffective when either drug was used alone. PMID- 3662478 TI - Effects of cefonicid and other cephalosporin antibiotics on male sexual development in rats. AB - The purpose of this study was to determine whether cefonicid, a cephalosporin antibiotic with a modified N-methylthiotetrazole (MTT) side chain, caused testicular toxicity when subcutaneously administered to Sprague-Dawley male rats from days 6 to 36 postpartum at doses of 50 to 1,000 mg/kg per day. Moxalactam (a cephamycin antibiotic which will be referred to as a cephalosporin for convenience throughout), which contains the MTT side chain, was used as a positive control and was administered at 100 to 1,000 mg/kg per day, and cephalothin, which lacks an MTT side chain, was used as the negative control at 1,000 mg/kg per day. Moxalactam caused a significant reduction in testicular and seminal vesicle weights in 37-day-old animals, and histological examination revealed bilateral multifocal atrophy of the seminiferous tubules at all dose levels. Animals reared to reproductive maturity had significant deficits in fertility, and histological examination revealed multifocal or diffuse atrophy of the seminiferous tubules at all doses with a severity greater than that observed in the 37-day-old animals. The histological findings were confirmed by marked reductions in testicular sperm production rates and cauda epididymal sperm numbers. Cephalothin and cefonicid had no treatment-related adverse effects on the sexual maturation of prepubertal, juvenile, or adult males. The absence (in cephalothin) or modification (in cefonicid) of the MTT side chain was not associated with adverse reproductive effects. The relevance of these findings to humans in prenatal and prepubertal stages of life cannot be determined at this time. PMID- 3662479 TI - Evaluation of (+)-cyclaradine-5'-esters as prodrugs for (+)-cyclaradine in animals. AB - Both (+)-cyclaradine-5'-methoxyacetate (CM) and (+)-cyclaradine-5' ethoxypropionate (CE) were converted to (+)-cyclaradine (C) in squirrel monkey and human sera at 37 degrees C. CE was more stable than CM. After oral administration (20 mg base equivalent per kg) of either CM or CE, no unchanged esters were observed in serum of squirrel monkeys, rabbits, or rats. Instead, C was detected, indicating conversions of CM and CE to C in vivo. In squirrel monkeys, the areas under the curve (AUCs) of C obtained from oral dosing with CM were 61% higher than those obtained from dosing with C, indicating that CM may be a good prodrug for C. In squirrel monkeys, rabbits, and rats, CE resulted in a 20 to 90% higher AUC of C than did CM, indicating that CE was better absorbed than CM. PMID- 3662480 TI - Kluyveromyces fragilis SS-437: an associatively-profiled thermotolerant yeast. AB - The lactose-utilizing Kluyveromyces fragilis SS-437 was found to have an associative temperature profile, but a thermotolerant growth yield behaviour. Cardinal growth temperatures were: 3 degrees C minimum for growth; 41.5 degrees C optimum; 44.5 degrees C final maximum (growth and death rates equalize); 46.1 degrees C initial maximum (maximum limit for growth). PMID- 3662481 TI - Three newly delimited species of Saccharomyces sensu stricto. AB - Deoxyribonucleic acid reassociation studies of 24 different wine and beer associated strains of Saccharomyces confirmed the presence of three separate species. S. cerevisiae and S. bayanus strains had only 22% of their genomes in common. S. pastorianus, with intermediate hybridization values between S. cerevisiae and S. bayanus (52 and 72%, respectively) could possibly be a natural hybrid of the two species. S. pastorianus replaces S. carlsbergensis with which it is homologous for 93% of its genome, since the former species was described first by Hansen in 1904. These data do not agree with the results of traditional physiological tests. PMID- 3662483 TI - Candida lyxosophila sp. nov., a new D-xylose fermenting yeast from southern Africa. AB - Six strains of an undescribed Candida species which ferment D-xylose tardily, were isolated from soil. A description of the new species, Candida lyxosophila, is given. PMID- 3662482 TI - Lipid composition of thermophilic moulds Acremonium alabamensis and Thermomucor indicae-seudaticae. AB - The total lipid content of Acremonium alabamensis and Thermomucor indicae seudaticae ranged 2.6-7.3 and 8.5-13.0% of dry mycelium, respectively during development. Neutral lipid fraction increased during growth while polar and phospholipids declined. Both moulds contained palmitic, oleic, linoleic and palmitoleic acids as major fatty acid components in lipids. Degree of unsaturation of lipids of A. alabamensis was greater than that of T. indicae seudaticae. Neutral lipids were more unsaturated than the polar lipids. The ratio of unsaturation index of polar lipids to neutral lipids was either one or less than one. The principal phospholipids of these moulds were phosphatidyl choline, phosphatidyl ethanolamine and phosphatidic acid. However, phosphatidic acid was not found in very high amounts as observed in Humicola grisea var. thermoidea. PMID- 3662484 TI - Candida amidevorans sp. nov., a new ascomycetous anamorph yeast from soil. AB - A strain of an undescribed Candida species was isolated from soil. A description of the new species Candida amidevorans is given and its distinction from the most closely resembling species of the genus is discussed. PMID- 3662486 TI - A new species of Cyphellophora. PMID- 3662485 TI - New basidiomycetous yeasts from southern Africa. II. Sterigmatomyces wingfieldii sp.n. AB - A new, insect-associated species of the emended genus Sterigmatomyces, St. wingfieldii, is described. A key to the emended genus is given. PMID- 3662487 TI - Degradation 1,2-dimethylbenzene by Corynebacterium strain C125. AB - In an attempt to obtain bacteria growing on 1,2-dimethylbenzene as sole carbon and energy source two different strains were isolated. One was identified as an Arthrobacter strain, the other as a Corynebacterium strain. Corynebacterium strain C125 was further investigated. The organism was not capable to grow on 1,3 and 1,4-dimethylbenzene. cis-1,2-Dihydroxycyclohexa-3,5-diene oxidoreductase and 3,4-dimethylcatechol-2,3-dioxygenase activity was found in cell extracts. When 3,4-dimethylcatechol was added to cell extract of 1,2-dimethylbenzene-grown cells, first a compound with the spectral properties of 2-hydroxy-5-methyl-6-oxo 2,4-heptadienoate was formed and subsequently acetate was produced. It is proposed that dioxygenases are involved in the initial steps of 1,2 dimethylbenzene degradation, and ring opening proceeds via meta-cleavage. PMID- 3662488 TI - Counterimmunoelectrophoresis compared with complement fixation and passive haemagglutination tests in the evaluation of the immune response in Campylobacter infections. AB - The immune response was studied in 238 human patients with Campylobacter jejuni/coli (CJC)-infections in Rotterdam by the counterimmunoelectrophoresis (CIE) test, a commercial complement fixation test (CFT) and the passive haemagglutination test (HA). Antibodies became detectable in the three tests around 4 days after the onset of complaints. Between the 7th and the 20th days after onset of illness 79%, 80% and 53% of the patients demonstrated antibodies by the CIE, the CFT and the HA, respectively. The HA took 30 days to reach 60% positive serum samples and this percentage declined to 35 by the 50th day. Antibody titres demonstrated in the CIE and the CFT declined more slowly. CIE and CFT performed with antigens from a limited number of heat-stable serotypes can be used in the evaluation of the humoral immune response in CJC-infections. PMID- 3662489 TI - In vitro tetracycline susceptibility of Chlamydia trachomatis in clinical specimens. AB - A novel approach to determine the tetracycline susceptibility of Chlamydia trachomatis directly from specimens without cell culture propagation and adaptation has been explored. Out of a total of 1290 genital specimens from a sexually transmitted disease clinic, 211 (16.4%) were positive for C. trachomatis. A tetracycline concentration of 0.032 microgram/ml completely inhibited the appearance of inclusions in all of the 211 positive specimens. Of the positive specimens, 120 (56.9%) and 18 (8.5%) respectively showed the presence of 1 to 9 and 100 or more inclusions per microtiter well in antibiotic free medium. Other antibiotics are being tested in the same manner. PMID- 3662490 TI - Netherlands Society for Microbiology, Medical Section, and Nederlandse Vereniging voor Laboratoriumartsen. Joint microsymposium. Bilthoven, 20 November 1986. Multiple antibiotic resistance among Enterobacteriaceae in hospitals. PMID- 3662491 TI - Sham feeding experience produces a conditioned increase of meal size. AB - The effect on intake of reversing the flavors and locations that had been associated with sham feeding and real feeding was measured in two experiments. Rats were equipped with chronic gastric cannulas to permit sham feeding. Flavors and locations were associated with a real meal of milk or with sham feeding the same volume of flavored milk or with sham feeding about six times as much milk. In both experiments, the flavors and locations with sham feeding produced a conditioned increase in meal size during real feeding. This conditioned increase in meal size appeared to be primarily due to a conditioned decrease in the satiating potency of the milk because it was dissociated from a conditioned increase in preference measured in a four-minute choice test. PMID- 3662492 TI - A comparison of the effects of phenylpropanolamine, d-amphetamine and d norpseudoephedrine on open-field locomotion and food intake in the rat. AB - d,l-Norephedrine (PPA) is available as an over-the-counter appetite suppressant and nasal decongestant in the U.S.A. The pseudoisomer d-norpseudoephedrine, is available as an appetite suppressant in Europe, and has been isolated as one of the stimulatory components (cathine) of the Khat plant. Some authors have misidentified cathine as PPA and this confusion in the literature has resulted. PPA and d-norpseudoephedrine possess significantly different pharmacological properties despite having identical structural formulae. Anorectic activity was determined in a food-deprived rat model. PPA and d-norpseudoephedrine were approximately one-tenth as potent as d-amphetamine with all compounds producing a dose-dependent decrease in food intake. Locomotor activity in an open-field apparatus was determined as an index of CNS stimulation. Male Sprague-Dawley rats treated with d-norpseudoephedrine, in doses between 10 and 50 mg/kg, exhibited significantly increased locomotor scores compared to saline (control) treated animals, an increase similar to that caused by 2 mg/kg d-amphetamine. PPA (5-50 mg/kg) failed to increase locomotion significantly. These results indicate that although each compound tested decreased food intake in a dose-dependent fashion, significant differences in open-field locomotion do exist between PPA, d norpseudoephedrine, and d-amphetamine. Stereoisomeric compounds, although structurally similar, frequently have different pharmacological effects. Thus extreme care must be taken to properly identify these compounds in the literature. PMID- 3662493 TI - Some determinants of the time course of saccharin ingestion in hungry rats. AB - In rats that are food- but not water-deprived, a saccharin "meal" is characterized by a progressive decrease in lap rate as the bout progresses. However, saccharin does not trigger a fixed rate of lapping at any point in the sequence. When rats have only intermittent access to saccharin early in the session, they increase their rates of lapping so that, within each few minutes, the amount of lapping (or some correlate such as volume drunk) is held constant. This happens over a wide range of restriction conditions. And if compensation cannot occur during a period of constraint, then it occurs afterward, promptly and precisely. When constraint is withdrawn, rats drink amounts such that the total amount of drinking (or its correlate), through that point in the ingestive bout, is defended. These findings imply that the controlling system includes (1) an integrator that keeps track of the amount of drinking that has occurred, even across interruptions; and (2) a short-term feedback loop that operates minute by minute within the bout. This loop regulates, not the rate of lapping to be emitted, but the amount of lapping to be done (or its correlate); Thus the decline in responsiveness to saccharin as drinking progresses reflects a depression of this regulated value, not of lap rate per se. PMID- 3662494 TI - Sodium appetite and cerebrospinal fluid sodium concentration during hypovolemia. AB - A lowered concentration of sodium in the cerebrospinal fluid (CSF) has been suggested as a critical signal for the elicitation of sodium appetite. This was evaluated in naive male Long-Evans rats made hypovolemic by subcutaneous injection of the colloid polyethylene glycol (PEG) in a hyperoncotic concentration. At 2, 5 or 8 h after PEG or vehicle injection, under conditions of availability or non-availability of water and 0.3 M NaCl for ingestion, the rats were anesthetized and samples of CSF and blood were taken. Water intakes of the PEG treated rats were elevated at 5 and 8 h, and 0.3 M NaCl intakes were elevated at 8 h in comparison to vehicle treated rats. When fluids were not available, CSF sodium concentrations were greater in PEG than in vehicle treated rats at 2, 5 and 8 h. When fluids were available, CSF sodium concentrations were greater in PEG than in vehicle treated rats at 5 and at 8 h. There was no correlation between CSF sodium concentration and saline intake. In summary, a lowered CSF sodium concentration is not a necessary condition for sodium appetite in the hypovolemic rat. PMID- 3662495 TI - Synthesis and properties of vinyl monomer/enzyme conjugates. Conjugation of L asparaginase with N-succinimidyl acrylate. AB - Monomer conjugation of an enzyme followed by copolymerization with free monomer is a useful method of enzyme immobilization. L-asparaginase was conjugated with N succinimidyl acrylate. Analysis of the conjugated enzyme via isoelectric focusing showed that a molar ratio of 9.5 free monomers per enzyme was needed during the conjunction for each vinyl group bound. Only 3% of the enzyme activity was lost per vinyl group added, and conjugation of an average of four monomers per enzyme thermally destabilized the enzyme only at temperatures above 50 degrees C. Activity of the enzyme at physiological temperatures was relatively unaffected. PMID- 3662496 TI - Monoclonal antibodies and immobilized antibodies. Patents and literature. AB - Antibodies in both their free and immobilized state have been the object of considerable industrial and academic interest. A variety of methods are used for preparing and immobilizing antibodies. Applications for monoclonal antibodies include the preparation of therapeutics, diagnostics, and in affinity fractionation. Recent US patents on monoclonal and immobilized antibodies and scientific literature on monoclonal antibodies are surveyed. A description of these patents and a list of references are given. PMID- 3662497 TI - Somatosensory activity relevant for motor output. A summary of presentations and discussion. AB - Several aspects of the function of receptors which contribute to somatic sensations are reviewed. First, there is evidence for a role of large-diameter cutaneous afferents in the reflex regulation of precision movements by the hand. Second, large-diameter muscle afferents from the intrinsic muscles of the hand, probably from primary muscle spindle afferents, can evoke specific sensations of finger movement. Third, the variable relationship between discharges in human C fibers from the hand and the specific sensation of pain is investigated. Activity in large-diameter cutaneous afferents can probably modify this sensation. Finally, the properties of small-diameter afferent fibers innervating joints are shown to be consistent with a role in the reflex regulation of joint integrity. PMID- 3662498 TI - Sensory-motor integration. Implications for neurological disease. Summaries of the symposium. Munich, April 20-24, 1985. PMID- 3662499 TI - Effects of growth, degeneration and regeneration on the sensory motor system. AB - Evidence was presented for regeneration and growth in the central nervous system of experimental animals and in the peripheral nervous system of man. Neurophysiological, neurohistological and neurochemical findings from the cerebellothalamocortical and the nigrostriatal projection systems as well as the motoneurons of the anterior horn and facial nucleus were presented and their possible functional implications discussed. Single unit recordings from regenerated primary afferents in human peripheral nerves were also shown and discussed in the light of their clinical relevance. The conclusions were reached that the findings of positive growth in the CNS following traumatic injury or in response to brain implants left little doubt that the CNS possesses the intrinsic capability of regeneration. The functional and clinical implications of this inherent capacity awaits further research. Recording the response behavior of regenerated primary afferents in man, on the other hand, provided more direct insight into functional deficits and their clinical correlates. PMID- 3662500 TI - Inactivation of Giardia muris cysts by free chlorine. AB - The chlorine resistance of cysts of the flagellate protozoan Giardia muris was examined. This organism, which is pathogenic to mice, is being considered as a model for the inactivation of the human pathogen Giardia lamblia. Excystation was used as the criterion for cyst viability. Experiments were performed at pH 5, 7, and 9 at 25 degrees C and pH 7 at 5 degrees C. Survival curves were "stepladder" shaped, but concentration-time data generally conformed to Watson's Law. Chlorine was most effective at neutral pH and was only slightly less so in acidic solutions. Comparison of inactivation data based on equivalent hypochlorous acid concentrations, which corrects for chlorine ionization, showed that the cysts have a pH-dependent resistance to inactivation. Concentration-time (C X t') products for free chlorine obtained at 25 degrees C ranged from a low of 50 mg min/liter at pH 5 to a high of 218 mg min/liter at pH 9 and were as high as 1,000 mg min/liter at 5 degrees C. It appears that G. muris cysts are somewhat more resistant to inactivation than G. lamblia cysts and rank among the microorganisms that are most resistant to inactivation by free chlorine. PMID- 3662501 TI - Protocol for sampling environmental sites for legionellae. AB - A protocol for sampling environmental sites was developed and used to identify possible sources of Legionella species in support of epidemiologic investigations at two hospitals. In hospital A, legionellae were isolated from 43 of 106 (40%) different sites. Three separate Legionella pneumophila serotypes and a previously unrecognized species were present in different combinations in the positive samples. Two of five cooling towers contained the same L. pneumophila serogroup 1 monoclonal type (1,2,4,5) as was isolated from patients. The same monoclonal type was also isolated from make-up water for the two cooling towers, a hot water tank, water separators in four main air compressor systems for respiratory therapy, and cold and hot water faucets. In hospital B, 13 of 37 (38%) sample sites contained legionellae, all of which were L. pneumophila serogroup 1. The monoclonal type matching isolates from patients (1,2,4,5) was found at the highest concentration in a hot water tank, but it was also present at four other sample sites. Since legionellae not related to disease may be found in many of the sites sampled, an epidemiologic association with the probable source should be established before intervention methods, such as disinfection, are undertaken. PMID- 3662502 TI - Microbial desulfonation of substituted naphthalenesulfonic acids and benzenesulfonic acids. AB - Sulfur-limited batch enrichment cultures containing one of nine multisubstituted naphthalenesulfonates and an inoculum from sewage yielded several taxa of bacteria which could quantitatively utilize 19 sulfonated aromatic compounds as the sole sulfur source for growth. Growth yields were about 4 kg of protein per mol of sulfur. Specific degradation rates were about 4 to 14 mu kat/kg of protein. A Pseudomonas sp., an Arthrobacter sp., and an unidentified bacterium were examined. Each desulfonated at least 16 aromatic compounds, none of which served as a carbon source. Pseudomonas sp. strain S-313 converted 1 naphthalenesulfonic acid, 2-naphthalenesulfonic acid, 5-amino-1 naphthalenesulfonic acid, benzenesulfonic acid, and 3-aminobenzenesulfonic acid to 1-naphthol, 2-naphthol, 5-amino-1-naphthol, phenol, and 3-aminophenol, respectively. Experiments with 18O2 showed that the hydroxyl group was derived from molecular oxygen. PMID- 3662503 TI - Effect of adaptation to phenol on biodegradation of monosubstituted phenols by aquatic microbial communities. AB - The adaptation of a mixed aquatic microbial community to phenol was examined in microcosms receiving phenol as a sole carbon source. Extended exposure (adaptation) to phenol resulted in adaptation of the microbial community to the structurally related aromatic compounds m-cresol, m-aminophenol, and p chlorophenol. The increased biodegradation potential of the phenol-adapted microbial community was accompanied by a concurrent increase in the number of microorganisms able to degrade the three test compounds. Thus, adaptation to the three test chemicals was likely a growth-related result of extended exposure to phenol. The results indicate that adaptation to a single chemical may increase the assimilative capacity of an aquatic environment for other related chemicals even in the absence of adaptation-inducing levels of those materials. PMID- 3662504 TI - 6-Methyl-1,2,4-benzenetriol, a new intermediate in penicillic acid biosynthesis in Penicillium cyclopium. AB - Penicillic acid-negative mutants were obtained from a color mutant derived from Penicillium cyclopium NRRL 1888 through N-methyl-N'-nitro-N-nitrosoguanidine treatment. One mutant (SK2N6) accumulated 6-methyl-1,2,4-benzenetriol, which was not previously known to be a metabolite of P. cyclopium, in addition to orsellinic acid and orcinol. The radioactivity of [1-14C]acetic acid was rapidly incorporated into 6-methyl-1,2,4-benzenetriol in a culture of P. cyclopium SK2N6. Moreover, the radioactivity of [14C]6-methyl-1,2,4-benzenetriol was efficiently incorporated into penicillic acid in a culture of P. cyclopium NRRL 1888. These data indicate that 6-methyl-1,2,4-benzenetriol is a precursor for penicillic acid biosynthesis. The results on the addition of 1,4-dihydroxy-6-methoxy-2 methylbenzene, 6-methoxy-2-methylbenzoquinone(1,4), and 1-O-methylorcinol to a culture of P. cyclopium SK2N6 indicated that only the former two compounds are converted to penicillic acid. Thus, a new portion of the penicillic acid biosynthetic pathway is proposed. PMID- 3662505 TI - Identification of dimethyl disulfide-forming bacteria isolated from activated sludge. AB - Twenty-four strains with high dimethyl disulfide (DMDS)-forming ability were isolated from activated sludge and identified to the genus level. These bacteria were classified into four groups (A, B, C, and D) by the API ZYM System (API System S.A., Montalieu, France). Group A (three strains) was identified as genus Lactobacillus by the API 20B System, by the method of Cowan and Steel, and by production of lactic acid as confirmed by gas-liquid chromatography. Group B (eight strains) was identified as genus Corynebacterium by API 20B and the Cowan and Steel method. Group C (one strain) was suggested to belong to genus Corynebacterium by the API 20B System. Group D (12 strains) was identified as genus Pseudomonas or Alcaligenes by the API 20B System, as genus Alcaligenes by the Cowan and Steel method, and as Achromobacter group Vd by the API 20NE System. However, on the basis of guanine-plus-cytosine contents in DNA and form of flagella, these strains were identified as genus Pseudomonas. Formation of DMDS from DL-methionine and S-methyl-L-cysteine was tested. DMDS-forming bacteria isolated from activated sludge formed DMDS from both precursors. In genus Pseudomonas, P. aeruginosa could not form DMDS from either precursor, but P. acidovorans, P. alcaligenes, P. pseudoalcaligenes, and P. testosteroni formed DMDS. In genus Alcaligenes, A. denitrificans subsp. xylosoxydans, A. denitrificans subsp. denitrificans, A. faecalis, and A. odorans formed DMDS from both precursors. Achromobacter group Vd formed DMDS from S-methyl-L-cysteine, but could not from DL-methionine. PMID- 3662506 TI - Use of sodium dodecyl sulfate-polymyxin B-sucrose medium for isolation of Vibrio vulnificus from shellfish. AB - The differential and selective sodium dodecyl sulfate-polymyxin B-sucrose medium (SPS) of Kitaura et al. (T. Kitaura, S. Doke, I. Azuma, M. Imaida, K. Miyano, K. Harada, and E. Yabuuchii, FEMS Microbiol. Lett. 17:205-209, 1983), which highlights alkylsulfatase activity, was evaluated for its potential use in the direct isolation and enumeration of Vibrio vulnificus from shellfish. V. vulnificus was detected by this method in six of nine shellfish samples collected from diverse geographic locales during the summer of 1986. Direct enumeration of V. vulnificus at 7.0 X 10(2) to 2.2 X 10(4) CFU/g of shellfish was achieved on SPS agar. All sample results were confirmed in parallel examinations by using conventional glucose-salt-Teepol (Shell Oil Co.) broth and alkaline peptone water enrichment with plating onto thiosulfate-citrate-bile salts-sucrose agar. Additionally, alkylsulfatase activity was evaluated in vitro for 97 strains representing 14 Vibrio spp. V. vulnificus and Vibrio cholerae-01 were the only species consistently found to possess this activity. The range of plating efficiencies for random V. vulnificus strains analyzed on SPS was 11 to 74% (mean, 39%). The use of SPS shows great promise for the study of shellfish and other environmental sources for V. vulnificus. PMID- 3662507 TI - Comparison of media for recovery of total coliform bacteria from chemically treated water. AB - Five broth media and two solid media were compared for their ability to quantitatively recover total coliform bacteria from chemically treated water. M Endo LES and mT7 media were used in the membrane filter technique. Lauryl tryptose broth, lactose broth, presence-absence broth, lactose broth with twice the amount of lactose, and lauryl tryptose broth with twice the amount of sodium lauryl sulfate were used in the fermentation tube procedure. The differences in recovery were not significant for the five broth media and M-Endo LES agar. The M Endo LES and mT7 media were not significantly different; however, the five broth media did yield significantly higher counts than mT7. PMID- 3662508 TI - Estimating downwind concentrations of viable airborne microorganisms in dynamic atmospheric conditions. AB - A Gaussian plume model has been modified to include an airborne microbial survival term that is a best-fit function of laboratory experimental data of weather variables. The model has been included in an algorithm using microbial source strength and local hourly mean weather data to drive the model through a summer- and winter-day cycle. For illustrative purposes, a composite airborne "virus" (developed using actual characteristics from two viruses) was used to show how wind speed could have a major modulating effect on near-source viable concentrations. For example, at high wind speeds such as those occurring during the day, or with short travel times, near-source locations experience high viable concentrations because the microorganisms have not had time to become inactivated. As the travel time increases, because of slow wind speed or longer distances, die-off modulation by sunshine, relative humidity, temperature, etc., potentially becomes increasingly predominant. PMID- 3662509 TI - Widespread occurrence of bacterial thiol methyltransferases and the biogenic emission of methylated sulfur gases. AB - A majority of heterotrophic bacteria isolated from soil, water, sediment, vegetation, and marine algae cultures methylated sulfide, producing methanethiol. This was demonstrated with intact cells by measuring the emission of methanethiol with a sulfur-selective chemiluminescence detector, and in cell extracts by detection of sulfide-dependent thiol methyltransferase activity. Extracts of two Pseudomonas isolates were fractionated by gel-filtration and ion-exchange chromatography, and with sulfide as the substrate a single peak of thiol methyltransferase activity was seen in each case. Extracts of several bacterial strains also contained thiol methyltransferase activity with organic thiols as substrates. Thus, S-adenosylmethionine-dependent thiol methyltransferase activities are widespread in bacteria and may contribute to biogenic emissions of methylated sulfur gases and to the production of methyl thioethers. PMID- 3662510 TI - Bacteriophages active against Bacteroides fragilis in sewage-polluted waters. AB - Twelve strains of different Bacteroides species were tested for their efficiency of detection of bacteriophages from sewage. The host range of several isolated phages was investigated. The results indicated that there was a high degree of strain specificity. Then, by using Bacteroides fragilis HSP 40 as the host, which proved to be the most efficient for the detection of phages, feces from humans and several animal species and raw sewage, river water, water from lagoons, seawater, groundwater, and sediments were tested for the presence of bacteriophages that were active against B. fragilis HSP 40. Phages were detected in feces of 10% of the human fecal samples tested and was never detected in feces of the other animal species studied. Moreover, bacteriophages were always recovered from sewage and sewage-polluted samples of waters and sediments, but not from nonpolluted samples. The titers recovered were dependent on the degree of pollution in analyzed waters and sediments. PMID- 3662511 TI - Bacterial detoxification of diisopropyl fluorophosphate. AB - The ability of 18 gram-negative bacterial isolates to detoxify diisopropyl fluorophosphate, a structural analog of the agents soman and sarin, was investigated. Detoxification by both frozen cell sonicates and acetone powders was assayed by two methods, i.e., the hydrolytic release of fluoride, measured by a fluoride-specific ion electrode, and the disappearance of acetylcholinesterase inhibition in vitro. Frozen cell sonicates for all strains exhibited some activity (F- ion release). In general, acetone powder preparations produced higher activity than frozen cell sonicates did, and the highest activities were exhibited by strains with known parathion hydrolase activity. Two ranges in activity were observed, low level, ranging from 0.1 to 7.0 mumol/min per g of protein, and high level, detected only in parathion hydrolase-producing strains, from 47 to greater than 300 mumol/min per g of protein. Results indicate that parathion hydrolase was nonspecific in phosphoesterase activity. Also, it was an effective detoxicant at low concentrations and near-neutral pH. PMID- 3662512 TI - Enumeration of Klebsiella spp. in cold water by using MacConkey-inositol potassium tellurite medium. AB - MacConkey-inositol-potassium tellurite agar was field tested for its ability to selectively enumerate Klebsiella species from the waters of the Saint John River Basin, which include fresh and marine waters. Water temperature varied from 1 to 6 degrees C during the survey period. Results of the study indicated that 77% of the typical colonies on MacConkey-inositol-potassium tellurite medium were Klebsiella species, but the total Klebsiella population enumerated was greatly underestimated. PMID- 3662513 TI - A rapid test for chitinase activity that uses 4-methylumbelliferyl-N-acetyl-beta D-glucosaminide. AB - A total of 101 strains of bacteria from environmental and clinical sources, most of which were gram negative, were tested for chitobiase activity by using a filter paper spot test with 4-methylumbelliferyl-N-acetyl-beta-D-glucosaminide as the substrate. The results were compared with those obtained by a conventional plate method for chitinase activity by using colloidal chitin as the substrate. There was excellent agreement in the results for both methods. The filter paper spot test with 4-methylumbelliferyl-N-acetyl-beta-D-glucosaminide has the advantages of being rapid, simple to perform, and inexpensive. This method should be adaptable to a wider range of microorganisms, particularly those with unusual growth requirements. PMID- 3662514 TI - Survival and virulence of copper- and chlorine-stressed Yersinia enterocolitica in experimentally infected mice. AB - The effect of gastric pH on the viability and virulence of Yersinia enterocolitica O:8 after exposure to sublethal concentrations of copper and chlorine was determined in mice. Viability and injury were assessed with a nonselective TLY agar (tryptic soy broth containing lactose, yeast extract, and agar) and two selective media, TLYD agar (TLY agar plus sodium deoxycholate) and CIN agar (cefsulodin-Irgasan-novobiocin agar). Both copper and chlorine caused injury which was manifested by the inability of the cells to grow on selective media. CIN agar was more restrictive to the growth of injured cells than TLYD agar. Injury of the exposed cells was further enhanced in the gastric environment of mice. Besides injury, the low gastric pH caused extensive loss of viability in copper-exposed cells. Lethality in the chlorine-exposed cells was less extensive, and a portion of the inoculum (5.2 X 10(5) of 1 X 10(7) inoculated cells) reached the small intestine 5 min postinoculation. No adverse effect on the injured cells was apparent in the small intestine, and a substantial revival (approximately 70%) of the injury occurred in 3 to 4 h after intraluminal inoculation. The virulence of chlorine-stressed Y. enterocolitica in orally inoculated mice was similar to that of the control culture, but copper-stressed cells showed reduced virulence. Virulence was partly restored by oral administration of sodium bicarbonate before the inoculation of copper-exposed cells. Neutralization of gastric acidity had no effect on the virulence of the control or chlorine stressed cells. The results of this study indicate that the extensive injury caused by the low gastric pH does not affect the virulence potential of chlorine exposed cells. However, extensive cell death in the mouse stomach is responsible for the reduced virulence of the copper-stressed bacteria. PMID- 3662515 TI - An alkaline approach to treating cooling towers for control of Legionella pneumophila. AB - Earlier field and laboratory studies have shown that Legionella species survive and multiply in the pH range 5.5 to 9.2. Additionally, the technical feasibility of operating cooling towers at elevated alkalinities and pH has previously been documented by published guidelines. The guidelines indicate that these conditions facilitate corrosion control and favor chlorine persistence which enhances the effectiveness of continuous chlorination in biofouling control. This information suggests that control of Legionella species in cooling towers can be accomplished by operating the towers under alkaline conditions. To test this possibility, we collected water samples over a period of months from a hospital cooling tower. The samples were analyzed for a variety of chemical parameters. Subsamples were pasteurized and inoculated with non-agar-passaged Legionella pneumophila which had been maintained in tap water. Correlation of subsequent Legionella growth with corresponding pH and alkalinity values revealed statistically significant inverse associations. These data support the hypothesis that operating cooling towers outside of the optimal conditions for Legionella growth (e.g., at elevated alkalinities and a pH greater than 9) may be a useful approach to controlling growth in this habitat. PMID- 3662516 TI - Microbial degradation of oxalate in the gastrointestinal tracts of rats. AB - Rates of oxalate degradation by mixed bacterial populations in cecal contents from wild rats ranged from 2.5 to 20.6 mumol/g (dry weight) per h. The oxalate degrading activity in cecal contents from three strains of laboratory rats (Long Evans, Wistar, and Sprague-Dawley) from four commercial breeders was generally lower, ranging from 1.8 to 3.5 mumol/g (dry weight) of cecal contents per h. This activity did not increase when diets were supplemented with oxalate. When Sprague Dawley rats from a fifth commercial breeder were fed an oxalate diet, rates of oxalate degradation in cecal contents increased from 2.0 to 23.1 mumol/g (dry weight) per h. Obligately anaerobic, oxalate-degrading bacteria, similar to ruminal strains of Oxalobacter formigenes, were isolated from the latter group of laboratory rats and from wild rats. Viable counts of these bacteria were as high as 10(8)/g (dry weight) of cecal contents, which was less than 0.1% of the total viable population. This report presents the first evidence for the presence of anaerobic oxalate-degrading bacteria in the cecal contents of rats and represents the first direct measurement of the concentration of these bacteria in the large bowel of monogastric animals. We propose that methods used for the maintenance of most commercial rat colonies often preclude the intestinal colonization of laboratory rats with anaerobic oxalate-degrading bacteria. PMID- 3662517 TI - Correlation of in vitro challenge testing with consumer use testing for cosmetic products. AB - An in vitro microbial challenge test has been developed to predict the likelihood of consumer contamination of cosmetic products. The challenge test involved inoculating product at four concentrations (30, 50, 70, and 100%) with microorganisms known to contaminate cosmetics. Elimination of these microorganisms at each concentration was followed over a 28-day period. The test was used to classify products as poorly preserved, marginally preserved, or well preserved. Consumer use testing was then used to determine whether the test predicted the risk of actual consumer contamination. Products classified by the challenge test as poorly preserved returned 46 to 90% contaminated after use. Products classified by the challenge test as well preserved returned with no contamination. Marginally preserved products returned with 0 to 21% of the used units contaminated. As a result, the challenge test described can be accurately used to predict the risk of consumer contamination of cosmetic products. PMID- 3662518 TI - Growth kinetics of Pseudomonas alcaligenes C-0 relative to inoculation and 3 chlorobenzoate metabolism in soil. AB - Pseudomonas alcaligenes C-0 was isolated from activated sewage sludge by enrichment with 3-chlorobenzoate (3CB) as the sole carbon source. The carbon balance from [14C]3CB in pure culture could be accounted for in substrate, biomass, and CO2 from all sampling periods and inoculum densities (0.012, 0.092, 0.20, and 0.92 micrograms of dry cells X ml-1), and inorganic chloride was produced stoichiometrically. Monod parameters as determined in culture were compared with the kinetics of 3CB metabolism in soil with decreasing inoculum densities (1.9 X 10(-1), 1.9 X 10(-3), and 1.9 X 10(-5) micrograms of cells X g 1). 3CB was refractile to attack in soil by indigenous microflora, but it was completely metabolized upon inoculation with P. alcaligenes C-0. The saturation constant KS was much higher in soil than in culture, but the yield coefficient Y and the growth rate constant were the same in both systems: mu max = 0.32 h-1; Y = 34 micrograms cells X mumol-1; KS = 0.18 mM in culture and 6.0 mM in soil solution (1.1 mumol X g-1 of soil). The parameter estimates obtained from the highest inoculum density could be used for the lower inoculum densities with reasonable agreement between predicted and observed 3CB concentrations in soil, although the residual sum of squares was progressively higher. Since the growth rate of P. alcaligenes C-0 in soil was comparable to its growth rate in culture, inoculation should be a viable strategy for biodegradation of 3CB in soil if indigenous microflora are unable to exploit this metabolic niche. PMID- 3662519 TI - Ancymidol blocks trichothecene biosynthesis and leads to accumulation of trichodiene in Fusarium sporotrichioides and Gibberella pulicaris. AB - Ancymidol, a plant growth regulator, inhibited biosynthesis of diacetoxyscirpenol by Gibberella pulicaris (Fusarium sambucinum) in a defined liquid medium. Ancymidol also inhibited biosynthesis of T-2 toxin by a wild-type strain of Fusarium sporotrichioides and biosynthesis of diacetoxyscirpenol, deacetylated calonectrin, and dideacetylated calonectrin by mutant strains of this species. Ancymidol-treated cultures accumulated the hydrocarbon trichodiene, a biosynthetic precursor of the trichothecenes. Ancymidol did not block trichodiene accumulation by a trichodiene-producing mutant strain of F. sporotrichioides. Ancymidol appears to block the trichothecene biosynthetic pathway after formation of trichodiene and before formation of trichothecenes containing four or more oxygen atoms. PMID- 3662520 TI - Electrophoretic mobility and hydrophobicity as a measured to predict the initial steps of bacterial adhesion. AB - The relationship between physiochemical surface parameters and adhesion of bacterial cells to negatively charged polystyrene was studied. Cell surface hydrophobicity and electrokinetic potential were determined by contact angle measurement and electrophoresis, respectively. Both parameters influence cell adhesion. The effect of the electrokinetic potential increases with decreasing hydrophobicity. Cell surface characteristics determining adhesion are influenced by growth conditions. At high growth rates, bacterial cells tend to become more hydrophobic. This fact can be of ecological significance for controlling the spread of bacteria throughout the environment. PMID- 3662521 TI - Requirement of succinate dehydrogenase activity for symbiotic bacteroid differentiation of Rhizobium meliloti in alfalfa nodules. AB - Transmission electron microscopy was used to study the cellular morphologies of a wild-type Rhizobium meliloti strain (L5-30), a nitrogen fixation-ineffective (Fix ) succinate dehydrogenase mutant (Sdh-) strain, and a Fix+ Sdh+ revertant strain within alfalfa nodules and after free-living growth in a minimal medium containing 27 mM mannitol plus 20 mM succinate. The results showed a requirement of succinate dehydrogenase activity for symbiotic differentiation and maintenance of R. meliloti bacteroids within alfalfa nodules and for succinate-induced cellular pleomorphism in free-living cultures. Also, the Sdh- strain had a 3.5 fold lower rate of oxygen consumption in the defined medium than did the wild type. PMID- 3662522 TI - Plasmid-encoded copper resistance and precipitation by Mycobacterium scrofulaceum. AB - A copper-tolerant Mycobacterium scrofulaceum strain was able to remove copper from culture medium by sulfate-dependent precipitation as copper sulfide. Such precipitation of copper sulfide was not observed in a derivative that lacks a 173 kilobase plasmid. In addition, the plasmid-carrying strain has a sulfate independent copper resistance mechanism. PMID- 3662523 TI - Use of chitinase to assess ruminal fungi associated with plant residues in vitro. AB - Treatment of fibrous residue from in vitro digestion trials with chitinase was evaluated gravimetrically and microscopically to determine the associated fungal biomass. The percent dry weight removed by chitinase with time paralleled changes in the number of sporangia associated with leaves. The fungal biomass contributed about 12% dry matter to the residue of leaves incubated with ruminal fluid plus streptomycin and penicillin. PMID- 3662524 TI - Demonstration of mucosa-associated microbial populations in the colons of mice. AB - Gram-stained sections prepared in a microtome-cryostat and examined by light microscopy confirmed the observation with scanning electron microscopy made by other workers that microbes inhabit a zone adjacent to the mucosal surface of the proximal colon of mice. Microbes in the midcolon, in contrast, are restricted to the fecal pellets occupying the intestinal lumen. PMID- 3662525 TI - Mechanism-based inhibitors of dopamine beta-hydroxylase. AB - The copper-containing monooxygenase dopamine beta-hydroxylase catalyzes the hydroxylation of dopamine at the benzylic position to form norepinephrine. Mechanism-based inhibitors for dopamine beta-hydroxylase have been used as probes of the mechanism of catalysis. The variety of such inhibitors that have been developed for this enzyme can be divided into three groups: (i) those in which the inactivating species is formed by abstraction of a hydrogen atom to form a radical intermediate; (ii) those in which the inactivating species is formed by abstraction of an electron to form an epoxide-like intermediate; and (iii) those in which the product is the inactivating species. A mechanism consistent with inactivation by all three groups of inhibitors which proposes that hydroxylation of dopamine by dopamine beta-hydroxylase involves formation of a benzylic radical has been developed. The benzylic radical is formed by abstraction of a hydrogen atom from the substrate by a high-potential copper-oxygen species. PMID- 3662526 TI - The effect of bovine serum albumin on the synthesis of prostaglandin and incorporation of [3H]acetate into platelet-activating factor. AB - The binding of fatty acids by bovine serum albumin (BSA) is well documented. However, the interaction between the synthesis of prostaglandins (PGs) and the trapping of arachidonate released from cellular lipid stores is not as well understood. In this communication, we relate the trapping of fatty acids to the synthesis of PGs and the incorporation of [3H]acetate into platelet-activating factor (PAF). Our results show that, as determined by radioimmunoassay, BSA inhibits bradykinin (BK) (5 ng/ml) and ionophore A23187 (10 microM)-stimulated synthesis of PGs in human embryo lung fibroblasts (IMR-90) in a concentration dependent manner. Experiments using prelabel with [3H]arachidonate followed by extraction and thin-layer chromatography show that, in the presence of 2 mg/ml BSA, IMR-90 release essentially only fatty acid following stimulation with bradykinin. Little if any prostaglandin and no endoperoxide are detected. In the same experiment, in absence of BSA, about 70% of the released label is detected as prostaglandin. alpha-Cyclodextrin, another trapper of fatty acid, inhibits PG synthesis in much the same way. BSA and alpha-cyclodextrin also inhibit prostacyclin synthesis in endothelial cells derived from the calf pulmonary artery. However, the inhibition of PG synthesis in these cells is not as complete as that in the IMR-90. In contrast to the effect of the trappers on PG synthesis, BSA and alpha-cyclodextrin are observed to potentiate BK- and ionophore stimulated incorporation of [3H]acetate into PAF in the endothelial cells. The labeled PAF is not released from the cells in either the presence or absence of the trappers, leading us to conclude that BSA causes an increase in acetate labeled cellular PAF by trapping released fatty acid. PMID- 3662527 TI - One-dimensional and two-dimensional nuclear magnetic resonance studies of the reaction of phenyldichloroarsine with glutathione. AB - 14C-labeled phenyldichloroarsine (PDA) enters the red blood cell and forms a 1:2 adduct with intracellular glutathione. Upon gel filtration of the hemolysate, [14C]PDA was recovered with the glutathione-containing fractions. One-dimensional and two-dimensional nuclear magnetic resonance spectroscopy were used to confirm the structure of the adduct and elucidate its stereochemistry, stability, and reactivity. PMID- 3662528 TI - Very long chain fatty acid beta-oxidation by subcellular fractions of normal and Zellweger syndrome skin fibroblasts. AB - Very long chain fatty acid (VLCFA) beta-oxidation was compared in homogenates and subcellular fractions of cultured skin fibroblasts from normal individuals and from Zellweger patients who show greatly reduced numbers of peroxisomes in their tissues. beta-Oxidation of lignoceric (C24:0) acid was greatly reduced compared to controls in the homogenates and the subcellular fractions of Zellweger fibroblasts. The specific activity of C24:0 acid beta-oxidation was highest in the crude peroxisomal pellets of control fibroblasts. Fractionation of the crude mitochondrial and the crude peroxisomal pellets on Percoll density gradients revealed that the C24:0 acid oxidation was carried out entirely by peroxisomes, and the peroxisomal beta-oxidation activity was missing in Zellweger fibroblasts. In contrast to the beta-oxidation of C24:0 acid, the beta-oxidation of C24:0 CoA was observed in both mitochondria and peroxisomes. We postulate that a very long chain fatty acyl CoA (VLCFA CoA) synthetase, which is different from long chain fatty acyl CoA synthetase, is required for the effective conversion of C24:0 acid to C24:0 CoA. The VLCFA CoA synthetase appears to be absent from the mitochondrial membrane but present in the peroxisomal membrane. PMID- 3662529 TI - Effect of guanosine triphosphate on the release of Ca2+ from intracellular store sites of saponin-treated human peripheral lymphocytes. AB - The effects of guanosine triphosphate (GTP) on the release and uptake of Ca2+ in nonmitochondrial intracellular store sites of human peripheral lymphocytes were examined. GTP in the presence of 3% polyethylene glycol released Ca2+ from the intracellular store sites of lymphocytes in a dose-dependent manner, and the maximal release was obtained at 10 microM GTP. GDP and 5'-GMP also enhanced the release of Ca2+. On the other hand, Ca2+ uptake in the presence of oxalate by saponin-treated lymphocytes was stimulated by GTP and this stimulation was abolished when polyethylene glycol was concomitantly present. The dose dependence of the stimulated Ca2+ uptake by GTP was much the same as that of the Ca2+ released by GTP. These results indicate that GTP has an inherent activity to release Ca2+ as well as to stimulate the uptake of Ca2+ in nonmitochondrial intracellular store sites of saponin-treated lymphocytes. The stimulatory effect of polyethylene glycol on GTP-mediated Ca2+ release may occur by inhibiting functions of the Ca2+ pump. PMID- 3662530 TI - Glycosphingolipid composition of human semen. AB - Glycosphingolipids were extracted from human semen and purified. Based on the fluorometric assay of sphingosine, in spermatozoa a content of 4.4 +/- 0.9 nmol/10(8) cells of gangliosides and 22.1 +/- 1.7 nmol/10(8) cells of neutral glycosphingolipids was determined. Seminal plasma contained 4.1 +/- 0.6 nmol gangliosides and 29.3 +/- 1.5 nmol neutral glycosphingolipids per milliliter. The glycosphingolipid component patterns of human spermatozoa and seminal plasma were determined by thin-layer chromatography. Four neutral glycolipids were isolated and their carbohydrate moieties were characterized. All of these glycolipid components belonged to the globo-series. Gas chromatography, combined gas chromatography/mass fragmentography, and exoglycosidase treatments revealed the following structures for the glycosphingolipids of human semen: Glc1-Cer, Gal beta 1-4Glc1-Cer, Gal alpha 1-4Gal beta 1-4Glc1-Cer, and Gal-NAc beta 1-3Gal alpha 1-4Gal beta 1-4Glc1-Cer. In addition, the occurrence of trace amounts of lactoneotetraosyl- and lactoneohexaosylceramide was detected by immunostaining after thin-layer chromatographic separation. Human spermatozoa, as well as seminal plasma, contained the gangliosides Glac1,Glac2, a sialolactoneotetraosylceramide, and a sialolactoneohexaosylceramide. The gangliosides were identified on the basis of their running characteristics by high-performance thin-layer chromatography, exoglycosidase treatment, and immunostaining after thin-layer chromatography. The ceramide composition of the glycolipids in human spermatozoa, as well as in seminal plasma, was dominated by C22:0-behenic acid and the saturated sphingoid d18:0, sphinganine. PMID- 3662531 TI - Structures of the sugar chains of mouse immunoglobulin G. AB - The asparagine-linked sugar chains of mouse immunoglobulin G (IgG) were quantitatively liberated as radioactive oligosaccharides from the polypeptide portions by hydrazinolysis followed by N-acetylation, and NaB3H4 reduction. After fractionation by paper electrophoresis, lectin (RCA120) affinity high-performance liquid chromatography, and gel filtration, their structures were studied by sequential exoglycosidase digestion in combination with methylation analysis. Mouse IgG was shown to contain the biantennary complex type sugar chains. Eight neutral oligosaccharide structures, viz, +/- Gal beta 1----4GlcNAc beta 1----2Man alpha 1----6(+/- Gal beta 1---- 4GlcNAc beta 1----2Man alpha 1----3)Man beta 1--- 4GlcNAc beta 1----4(+/- Fuc alpha 1----6)GlcNAc, were found after the sialidase treatment. The molar ratio of the sugar chains with 2,1, and 0 galactose residues was 2:5:3. The galactose residue in the monogalactosylated sugar chains was distributed on Man alpha 1----3 and Man alpha 1----6 sides in the ratio of 1:3. The oligosaccharides were almost wholly fucosylated and contained no bisecting N acetylglucosamine which is present in human, rabbit, and bovine IgGs. PMID- 3662532 TI - Identification of a blood group A active hexaglycosylceramide with a type 1 carbohydrate chain in plasma of an A1 Le(a-b-) secretor. AB - A blood group A active hexaglycosylceramide with a type 1 carbohydrate chain was identified in the plasma of an A1 Le(a-b-) secretor. The analysis was done on the total non-acid glycosphingolipid fraction using mass spectrometry, NMR spectroscopy, and anti-A antibody immunostaining on thin-layer chromatograms. PMID- 3662533 TI - The orientation of transhydrogenase in the inner mitochondrial membrane of rat liver. AB - The orientation of the transmembranous enzyme, pyridine dinucleotide transhydrogenase, in the inner mitochondrial membrane of rat liver has been determined by evaluating effects of proteases on the integrity of the enzyme in mitoplasts and submitochondrial particles. Following treatment of these membranes with the nonspecific protease, proteinase K, antigenic proteolytic products were detected by immunoblot analysis using polyclonal antibody prepared against purified bovine heart enzyme. Proteinase K treatment of mitoplasts converted the 110,000 transhydrogenase monomer into a single immunoreactive species having Mr 75,000. This proteolytic product is stable to further incubation with the protease. Treatment of submitochondrial particles with proteinase K resulted in the disappearance of the 110,000 monomer and the transient formation of an intermediate product with Mr 52,000. Information from these proteolysis studies was used to construct a model of the orientation of transhydrogenase in the inner mitochondrial membrane. This model indicates that transhydrogenase (Mr 110,000) contains a core of proteolytically inaccessible proteins within the membrane (Mr 23,000) bounded by extramembranous domains on the matrix (Mr 52,000) and cytoplasmic (Mr 35,000) face of the inner mitochondrial membrane. PMID- 3662534 TI - Oxidation of 15-hydroxyeicosatetraenoic acid and other hydroxy fatty acids by lung prostaglandin dehydrogenase. AB - The oxidation of the 15-hydroxy group of prostaglandins of the A, E, and F series by the NAD+-dependent prostaglandin dehydrogenase (PGDH) has been well documented. In addition to prostaglandins, we have observed that the purified lung PGDH also will oxidize 15-HETE to a novel metabolite that was isolated by reverse-phase HPLC and identified by gas chromatography-mass spectrometry as the 15-keto-5,8,11-cis-13-trans-eicosatetraenoic acid (15-KETE). The Km for 15-HETE was 16 microM, which was 2.5 times lower than the value obtained for PGE1. In addition to 15-HETE, 5,15-diHETE and 8,15-diHETE also were substrates for the lung PGDH with Km values of 138 and 178 microM, respectively. Other hydroxy derivatives of eicosatetraenoic acid that did not have a hydroxy group at carbon atom 15 did not support the PGDH-mediated reduction of NAD+. In addition to the 15-hydroxy derivatives of eicosatetraenoic acid, 12-HHT also was a substrate for the lung enzyme with a Km of 12 microM. These data indicate that omega 6-hydroxy fatty acids, in addition to prostaglandins, are also substrates of the lung NAD+ dependent PGDH and that the enzyme does not require the cyclopentane ring of prostaglandins. PMID- 3662535 TI - Time-dependent inhibition of sucrase and isomaltase from rat small intestine by castanospermine. AB - Castanospermine (1,6,7,8-tetrahydroxyoctahydroindolizine) is a potent time dependent inhibitor of the sucrase-isomaltase complex purified from rat small intestine, in vitro. First-order kinetics for the inactivation of sucrase and isomaltase by castanospermine were observed. Protection studies showed that castanospermine competes for the glucosyl subsite with the substrates of sucrase and isomaltase. The second-order rate constants (k1) for the association reaction between castanospermine and the protein complex were calculated to be 6.5 X 10(3) and 0.3 X 10(3) M-1 s-1 for sucrase and isomaltase, respectively. Only barely detectable reactivation of the inhibited isomaltase was detectable over 24 h, whereas about 30% reactivation of the inhibited sucrase was observed in 24 h (k2 = 3.6 X 10(-6) s-1). These results suggest that castanospermine functions as a transition-state analog that binds extremely tightly to sucrase and isomaltase. PMID- 3662536 TI - Metabolism of selenocyanate in the rat. AB - Rats injected subcutaneously with 2 mg Se/kg body weight of [75Se]selenocyanate or [14C, 75Se]selenocyanate excreted dimethylselenide (DMSe) in the breath and trimethyl-selenonium ion (TMSe) in the urine. The 24-h respiratory DMSe and urinary TMSe excretions were 26.8 +/- 8.1 and 14.5 +/- 5.1% of the dose, respectively. Tissue concentrations of 75Se were highest in the kidneys (1.89 +/- 0.2% dose/g), liver (1.46 +/- 0.2% dose/g), and blood (0.50 +/- 0.05% dose/ml), and lower (greater than 0.3% dose/g) in the other tissues. Trimethyl-selenonium was the major form (61%) of selenium in urine. Approximately 2% of the dose of doubly labeled SeCN- was excreted unchanged in urine (about 12% of urinary Se). 14C from doubly labeled SeCN- was not present in the methylated selenium metabolites, but a major 14C urinary metabolite was identified as thiocyanate. These results indicate that a substantial part of selenocyanate in the body undergoes metabolism and Se is excreted in methylated forms following scission of the C-Se bond. PMID- 3662537 TI - Polyethylene glycol-induced heteroassociation of malate dehydrogenase and citrate synthase. AB - Studies by dynamic and total intensity light scattering, ultracentrifugation, electron microscopy, and chemical crosslinking on solutions of the pig heart mitochondrial enzymes, malate dehydrogenase and citrate synthase (separately and together) demonstrate that polyethylene glycol induces very large homoassociations of each enzyme, and still larger heteroenzyme complexes between these two enzymes in the solution phase. Specificity of this heteroassociation is indicated by the facts that heteroassociations with bovine serum albumin were not observed for either the mitochondrial dehydrogenase or the synthase or between cytosolic malate dehydrogenase and citrate synthase. The weight fraction of the enzymes in the mitochondrial dehydrogenase-synthase associated particles in the solution phase was less than 0.03% with the dilute conditions used in the dynamic light scattering measurements. Neither palmitoyl-CoA nor other solution conditions tested significantly increased this weight fraction of associated enzymes in the solution phase. Because of the extremely low solubility of the associated species, however, the majority of the enzymes can be precipitated as the heteroenzyme complex. This precipitation is a classical first-order transition in spite of the large particle sizes and broad size distribution. Ionic effects on the solubility of the heteroenzyme complex appear to be of general electrostatic nature. Polyethylene glycol was found to be more potent in precipitating this complex than dextrans, polyvinylpyrrolidones, ficoll, and beta lactoglobulin. PMID- 3662538 TI - The effect of retinoic acid on proteoglycan turnover in bovine articular cartilage cultures. AB - This paper describes proteoglycan catabolism by adult bovine articular cartilage treated with retinoic acid as a means of stimulating the loss of this macromolecule from the extracellular matrix of cartilage. Addition of retinoic acid (10(-12)-10(-6) M) to adult bovine articular cartilage which had been labeled with [35S]sulfate for 6 h after 5 days in culture, resulted in a dose dependent increase in the rate of loss of 35S-labeled proteoglycans from the matrix of the tissue. Concomitant with this loss was a decrease in the proteoglycan content of the tissue. Incubation of cultures treated with 1 microM retinoic acid, at 4 degrees C, or with 0.5 mM cycloheximide, resulted in a significant decrease in the rate of retinoic acid-induced loss of proteoglycans and demonstrated cellular involvement in this process. Analysis of the 35S labeled proteoglycans remaining in the matrix showed that the percentage of radioactivity associated with the small proteoglycan species extracted from the matrix of articular cartilage explants labeled with [35S]sulfate after 5 days in culture was 15% and this increased to 22% in tissue maintained in medium alone. In tissue treated with 1 microM retinoic acid for 6 days, the percentage of radioactivity associated with the small proteoglycan was 58%. Approximately 93% of the 35S-labeled proteoglycans released into the medium of control and retinoic acid-treated cultures was recovered in high density fractions after CsCl gradient centrifugation and eluted on Sepharose CL-2B as a broad peak with a Kav of 0.30 0.37. Less than 17% of these proteoglycans was capable of aggregating with hyaluronate. These results indicate that in both control and retinoic acid treated cultures the larger proteoglycan species is lost to the medium at a greater rate than the small proteoglycan species. The effect of retinoic acid on proteoglycan turnover was shown to be reversible. Cartilage cultures maintained with retinoic acid for 1 day then switched to medium with 20% (v/v) fetal calf serum for the remainder of the culture period exhibited decreased rates of loss of 35S-labeled proteoglycans from the matrix and increased tissue hexuronate contents to levels near those observed in tissue maintained in medium with 20% (v/v) fetal calf serum throughout. Furthermore, following switching to 20% (v/v) fetal calf serum, the relative proportions of the 35S-labeled proteoglycan species remaining in the matrix of these cultures were similar to those of control cultures. PMID- 3662539 TI - Sulfhydryl oxidase-catalyzed formation of disulfide bonds in reduced ribonuclease. AB - Sulfhydryl oxidase isolated from bovine skim milk membrane vesicles catalyzes de novo formation of disulfide bonds with the substrates cysteine, cysteine containing peptides, and reduced proteins using molecular oxygen as the electron acceptor. Initial rates for sulfhydryl oxidase-catalyzed oxidation of reduced ribonuclease exhibited typical Michaelis-Menten kinetics at low substrate concentrations. Substrate inhibition of the oxidative activity was observed at ribonuclease concentrations greater than 40 microM, similar to that observed with reduced glutathione or other small thiol substrates. The inhibition was more pronounced when ribonuclease activity was used to monitor the rates, presumably due to concentration-dependent formation of nonnative disulfide bonds. Thus, a maximum in the rate of regain of ribonuclease activity was observed at a 40 microM concentration, while optimum recovery was observed at 30 microM. The Michaelis constant obtained with reduced ribonuclease is 17.4 microM which corresponds to a sulfhydryl concentration of 0.14 mM, a value that compares favorably with the best small thiol substrate, reduced glutathione. Disulfide containing intermediates in the oxidation pathway, as determined by ion-exchange chromatography of alkylated reaction mixtures, appeared to be similar for air oxidation and enzyme-catalyzed oxidation of the protein. The pH optimum, tissue location, and kinetic characteristics of sulfhydryl oxidase are compatible with a suggested physiological function of direct catalysis of disulfide bond formation in secretory proteins or indirect participation through provision of oxidized glutathione for protein disulfide-isomerase-catalyzed thiol/disulfide interchange. PMID- 3662540 TI - Thermal perturbation studies of membrane-bound acetylcholine receptor from Torpedo: effects of cholinergic ligands and membrane perturbants. AB - Thermal perturbation techniques have been used to probe structural features of the nicotinic acetylcholine receptor (AcChR). The information obtained from differential scanning calorimetry (DSC) of AcChR membranes (M.C. Farach and M. Martinez-Carrion (1983) J. Biol. Chem. 258, 4176) in the absence and in the presence of cholinergic ligands and local anesthetics, is comparable to that obtained from a simpler technique of heat inactivation of the alpha-bungarotoxin (alpha-Bgt) binding sites on the AcChR protein in similar samples. When AcChR membranes are heated at approximately 1 degree C/min, heat inactivation of toxin binding sites has a characteristic T50 value (temperature at which 50% of the initial capacity to bind alpha-Bgt remains) of approximately 60 degrees C. When heated at a constant temperature during increasing periods of time, the rate at which heat inactivation occurs is also characteristic of the temperature chosen for the experiment. The above thermal parameters are also sensitive to perturbation of the AcChR membrane matrix by the presence of subsolubilizing concentrations of detergents. Moreover, elimination of detergents by dialysis allows us to evaluate the reversibility or irreversibility of AcChR thermal destabilization induced by detergents or other membrane perturbants. Under the experimental conditions used, structural destabilization induced by octylglucoside or cholate can be fully reversed by detergent dialysis, while that exerted by deoxycholate cannot. "Thermal gel" analysis of the aggregation of AcChR subunits induced by heat (G. Soler, J. R. Mattingly, and M. Martinez Carrion (1984) Biochemistry 23, 4630) has also been used to assess the effects of detergent presence on the AcChR protein. When deoxycholate is used as the perturbing agent, there is a particularly effective sulfhydryl-mediated aggregation of the gamma-delta subunit group, which appears to correlate with the irreversible destabilization of alpha-Bgt binding sites induced by that detergent. PMID- 3662541 TI - Effects of crosslinking on the thermal stability of hemoglobin. I. The use of bis(3,5-dibromosalicyl) fumarate. AB - The double-headed aspirin, bis(3,5-dibromosalicyl) fumarate, has been used to crosslink hemoglobin A between Lys 82 beta 1 and Lys 82 beta 2 (J. A. Walder et al. (1979) Biochemistry 18,4265). Denaturation experiments were used to compare the stability of this crosslinked protein to that of hemoglobin A. Thermal denaturations, done in 0.01 M 4-morpholine-propanesulfonic acid, pH 7, containing 0.9 M guanidine to prevent precipitation at high temperatures, were monitored by changes in absorbance between 190 and 650 nm using a diode array spectrophotometer. The sample was heated from 25 to 70 degrees C at 0.3 degrees C/min. The data were analyzed by using both a two-state model and a novel first derivative method. As expected, methemoglobin A had a single, broad transition with a midpoint of 40.7 degrees C. The crosslinked methemoglobin showed a transition at 57.1 degrees C. Two minor transitions, one of which was apparently due to residual unmodified hemoglobin, were also observed in the crosslinked sample. Thus, a single crosslink between only two of the four subunits can lead to a significantly more stable molecule. These results can be explained by Le Chatelier's principle, since crosslinking prevents dissociation of the beta subunits and, thereby, holds the entire tetramer together. PMID- 3662542 TI - Activation of branched-chain alpha-ketoacid dehydrogenase in isolated hepatocytes by branched-chain alpha-ketoacids. AB - The effects of branched-chain alpha-ketoacids on flux through and activity state of the branched-chain alpha-ketoacid dehydrogenase complex were studied in hepatocytes prepared from chow-fed, starved, and low-protein-diet-fed rats. Very low concentrations of alpha-ketoisocaproate caused a dramatic stimulation (50% activation at 20 microM) of alpha-ketoisovalerate decarboxylation in hepatocytes from low-protein-fed rats. alpha-Keto-beta-methylvalerate was also effective, but less so than alpha-ketoisocaproate. alpha-Ketoisocaproate did not stimulate alpha ketoisovalerate decarboxylation by hepatocytes from chow-fed or starved rats. To a smaller degree, alpha-keto-beta-methylvalerate and alpha-ketoisovalerate stimulated alpha-ketoisocaproate decarboxylation by hepatocytes from low-protein fed rats. The implied order of potency of stimulation of flux through branched chain alpha-ketoacid dehydrogenase was alpha-ketoisocaproate greater than alpha keto-beta-methylvalerate greater than alpha-ketoisovalerate, i.e., the same order of potency of these compounds as branched-chain alpha-ketoacid dehydrogenase kinase inhibitors. Fluoride, known to inhibit branched-chain alpha-ketoacid dehydrogenase phosphatase, largely prevented alpha-ketoisocaproate and alpha chloroisocaproate activation of flux through the branched-chain alpha-ketoacid dehydrogenase. Assay of the branched-chain alpha-ketoacid complex in cell-free extracts of hepatocytes isolated from low-protein-diet-fed rats confirmed that alpha-ketoacids affected the activity state of the complex. Branched-chain alpha ketoacids failed to activate flux in hepatocytes prepared from chow-fed and starved rats because essentially all of the complex was already in the dephosphorylated, active state. These findings indicate that inhibition of branched-chain alpha-ketoacid dehydrogenase kinase activity by branched-chain alpha-ketoacids is important for regulation of the activity state of hepatic branched-chain alpha-ketoacid dehydrogenase. PMID- 3662543 TI - [Combination effects of cis-dichlorodiammineplatinum (II) and sodium thiosulfate on renal dysfunction]. AB - Forty-five patients with lung carcinoma were randomized to receive CDDP alone (STS (-) group) or combination of sodium thiosulfate (STS (+) group). Among the 45 patients, 42 had primary lung carcinoma and four had metastatic lung carcinoma. The combination of CDDP and STS infusion was performed in twenty-three patients and CDDP alone in 22 patients. The patients given STS were evaluated for renal function and pharmacokinetics. Urinary excretion of beta 2 microglobulin (BMG) and urinary concentration of N-acetyl-beta-D-glucosaminide (NAG), which reflect the function of the proximal tubules, were almost normal in the STS (+) group, but abnormally high in the STS (-) group. For serum BMG, BUN, creatinine, and 24-h creatinine clearance, which reflect glomerular function, no significant differences were found between the two groups. Urinary platinum excretion over 24 h was 29% in the STS (+) group and 21% in the STS (-) group. Total concentration of serum platinum after 24-h administration of CDDP was 2.1 micrograms/ml in the STS (+) group and 2.4 micrograms/ml in the STS (-) group. This study indicated that the combination of CDDP and STS promotes urinary excretion of CDDP, and rescues the dysfunction of the proximal tubules. PMID- 3662544 TI - [Effectiveness of cis-dichlorodiammine-platinum in the treatment of advanced neuroblastoma]. AB - Twenty cases of advanced neuroblastoma treated at the Pediatric Surgical Department of Chiba University from 1975 through 1985 were discussed. Cis dichlorodiammineplatinum (CDDP) and VM-26 were administered to 7 patients with disseminated neuroblastoma resistant to treatment with cyclophosphamide, doxorubicin and vincristine. One complete remission, 4 partial remissions, and 2 minor responses were observed in our series. These results were far better than in our previous study, in which patients were treated with regimens containing cyclophosphamide, doxorubicin and vincristine. Several kinds of side effects were observed in children treated with CDDP. Vomiting occurred in all of them, and bone marrow toxicity was found in 5 among 7 patients. There was one case of severe nephrotoxicity caused by severe proximal tubular dysfunction with increased urinary loss of sodium, leading convulsion. PMID- 3662545 TI - [Treatment of gynecological cancer with cis-platinum]. AB - Seven patients with gynecological cancer were treated with cis-platinum. Cis platinum at 50 mg/m2 was administered by intravenous infusion for 2 hours, followed by 2,000 ml of intravenous fluid. This treatment was repeated every three weeks. Five of the seven patients were evaluable. These patients included those with ovarian cancer (3 cases), metastatic ovarian cancer (1 case), and endometrial cancer (1 case). One patient attained a complete response, two a partial response, and two showed progressive disease. The response rate for both complete and partial response was 60%. Gastrointestinal symptoms were most frequently found. Nephrotoxicity was generally mild, but one patient had to discontinue cis-platinum treatment due to severe nephrotoxicity. Cis-platinum treatment is considered to be effective and useful for gynecological cancer. Second-look operation and two-channel chemotherapy were also discussed in this paper. PMID- 3662546 TI - [Tissue concentration of (2"R)-4'-O-tetrahydropyranyladriamycin in renal cell carcinoma and urinary bladder tumor (second report)]. AB - Twenty milligrams of (2"R)-4'-O-tetrahydropyranyladriamycin (THP) was administered intravenously to 14 patients with renal cell carcinoma and 11 with urinary bladder tumor at the start of surgery. Heparinized peripheral blood samples were collected at regular intervals and separated into plasma and blood cell fractions by centrifugation for the estimation of the THP concentration. The THP concentrations in the surgical specimens were also studied. In the tissue of renal cell carcinoma, the nuclear fraction was obtained by fractionation in order to estimate the THP concentration. The THP concentrations of the plasma and blood cell fractions in both renal cell carcinoma and urinary bladder tumor gradually decreased with the lapse of time after administration. In renal cell carcinoma, grade 3 tumors revealed lower tissue and nuclear concentrations of THP than those of grade 1 and 2 tumors. Likewise, the tissue and nuclear concentrations of high stage tumors were lower than those of low-stage tumors. On the other hand, in urinary bladder tumors, the THP concentrations in the tumors were found to be higher than those in normal urinary mucosa and muscle. PMID- 3662547 TI - [A case of carcinoma in the lower abdomen treated successfully with oral administration of bestrabucil]. AB - A 72-year-old female was admitted because of a palpable hard tumor, 15 X 7 cm in size, in the left lower quadrant of the abdomen. According to a diagnosis of retroperitoneal tumor, laparotomy was performed, revealing a large tumor extending between the descending colon and the pelvic cavity, which could not be separated from the retroperitoneum, uterus, left ovary, urinary bladder or rectum. A number of metastatic nodules were disseminated to the peritoneum and mesenterium. The pathological diagnosis of the nodules was poorly differentiated carcinoma of transitional cell type, origin unknown. After discharge, oral administration of bestrabucil (100-200 mg/day), the benzoate of an estradiol chlorambucil conjugate, was given to the patient at an outpatient clinic. The tumor ceased to be palpable when the total amount administered reached at 14 g. Ultrasonography and computed tomography demonstrated significant reduction in tumor size. A decrease in the peripheral leukocyte count was observed after every consecutive administration and it took about 2 months to recover to the normal level. No other side effects were observed in this case. Although administration was stopped at a total amount of 16.1 g, reenlargement of the tumor has not been observed for 9 months. PMID- 3662548 TI - [Thermochemotherapy of unresectable pancreatic carcinoma (hot water and intra arterial chemotherapy using noradrenaline)]. AB - A 86-year-old man with unresectable pancreatic carcinoma was treated with thermochemotherapy. In most of the body and tail affected by the tumor, which did not show any cytotoxic damage after intraarterial chemotherapy, an enhanced antitumor effect was achieved by hyperthermia, which heated the tumor using hot water in a balloon placed on the pancreas, and which was delivered through a vinyl tube leading out of the body for 40 minutes while administration of antitumor agents mixed with noradrenaline was simultaneously given into the celiac artery. In this case, we observed that using noradrenaline with contrast material injected into the celiac artery it was possible to delineate the tumor area by computed tomography of the pancreas. PMID- 3662550 TI - Condylomata acuminata in the evaluation of child sexual abuse. PMID- 3662549 TI - [Clinical evaluation by flow cytometry in the mechanism of action of CDDP with arterial injection of bromo deoxyuridine]. PMID- 3662551 TI - Langerhans' cells in vitiligo. PMID- 3662552 TI - Cross-reference of same patients in different studies. PMID- 3662553 TI - Mohs micrographic surgery as only means of optimal patient outcome? PMID- 3662554 TI - Fatal malignant melanoma associated with a completely regressed primary melanoma in a patient with cutaneous T-cell lymphoma. PMID- 3662555 TI - Seromucinous (salivary) ectopia of the perianal region. PMID- 3662556 TI - Dermatologic manifestations associated with an anorectal malformation. PMID- 3662557 TI - Daily psoralen therapy in vitiligo. PMID- 3662558 TI - Dysplastic nevus syndrome. PMID- 3662559 TI - Psoriasis practices. PMID- 3662560 TI - Infections caused by black fungi. PMID- 3662561 TI - The treatment of severe psoriasis. A national survey. AB - In 1974, we conducted a randomized survey of dermatologists to determine trends in the use of chemotherapeutic agents for psoriasis. The present survey updates and extends the earlier one to include phototherapy, photochemotherapy, and other modalities being used in the treatment of psoriasis too extensive or severe for topical agents alone. Questionnaires were sent to approximately 20% of dermatologists nationwide and also to all training/research programs. Results of the survey include: (1) approximately 523,000 patients with psoriasis were treated by dermatologists in 1984, and 30% of these were severe enough to require more than topical care; (2) the majority of dermatologists use ultraviolet B (71%) and methotrexate (58%), while 36% use psoralen and ultraviolet A; (3) creatinine clearance rates and liver biopsy specimens are being obtained for approximately half of methotrexate-treated patients; and (4) of those physicians using methotrexate, most (74%) use weekly divided orally administered methotrexate doses. PMID- 3662562 TI - Betamethasone dipropionate in optimized vehicle. Intermittent pulse dosing for extended maintenance treatment of psoriasis. AB - A study was done of extended maintenance therapy using either betamethasone dipropionate (Diprolene) in optimized vehicle (OV) (ointment) or placebo in patients with psoriasis vulgaris. Of 59 patients originally enrolled in the study, 38 assessable patients achieved clearing of at least 85% improvement from baseline with traditional betamethasone in OV twice a day for two to three weeks before intermittent pulse dosing was attempted. Thereafter, the test medication was used on weekends (three consecutive doses at 12-hour intervals) once a week. Fourteen patients (74%) of the betamethasone in OV group and four patients (21%) of the placebo group maintained a remission status for 12 weeks. Intermittent pulse dosing with betamethasone in OV seems safe and efficacious maintenance therapy in selected psoriatic patients. PMID- 3662563 TI - Are generic formulations equivalent to trade name topical glucocorticoids? AB - Trade name glucocorticoid formulations triamcinolone acetonide, fluocinolone acetonide, and betamethasone valerate were compared with their generic equivalents because of increasing substitution of generic formulations for trade name formulations. The vasoconstrictor assay was the method used for these comparisons. Large differences were found between generic and trade name formulations containing the same steroid in the same concentration in both cream and ointment vehicles. If generic substitutions are to be used for trade name formulations, the physician must be aware that significant differences in therapeutic effectiveness may be expected. PMID- 3662564 TI - Thin malignant melanomas with regression and metastases. AB - The significance of partial regression in thin malignant melanomas (0.76 mm or less) of the skin was evaluated to determine if the regression was associated with the later development of metastases in patients who previously were considered to have a favorable prognosis. Of 575 patients with primary cutaneous melanoma treated and followed up by the Division of Surgical Oncology at the University of Illinois, Chicago, we found that 103 (18%) had tumors that measured less than 0.76 mm. Of these, 30 (29%) showed histologic evidence of partial regression. In six (20%) of the 30 patients, visceral metastases developed and the patients died. All six had more than 77% regression of their primary tumors. Of the remaining 24 patients, only one had regression greater than 77% and she is still alive three years after diagnosis. Most of these 24 (83%) patients had regression of less than 50% (mean, 29.9%). No metastasis occurred in the 73 patients who had thin melanomas without histologic evidence of regression. It is apparent from this study that patients with thin melanomas who show partial regression cannot be included in the "low-risk" group if the extent of regression is 75% to 80% or more. PMID- 3662565 TI - Melanoma within a southwestern Hispanic population. AB - The New Mexico Melanoma Registry and New Mexico Tumor Registry identified 81 cases of melanoma involving the skin and mucous membranes of Hispanics. The clinical and pathologic characteristics of these tumors were compared with those observed in whites. The frequency of melanoma in Hispanics appears to be no more than a sixth of that observed in whites. Female patients were more prevalent within the Hispanic population. The median patient age at diagnosis was similar in Hispanics and whites. A much larger proportion of melanomas in Hispanics occurred on the palms, soles, and in subungual regions. Acral lentiginous melanomas were correspondingly more frequent among Hispanics, as was mucous membrane melanoma. Melanomas arising from the palms, soles, subungual regions, and mucous membranes tended to be advanced in stage, to occur in older individuals, and to metastasize. These cases explain the generally poorer prognosis for Hispanic patients compared with whites. The epidemiology of melanoma relevant to these findings is discussed. PMID- 3662566 TI - Clinical and histologic features of pityriasis lichenoides et varioliformis acuta in children. AB - Pityriasis lichenoides et varioliformis acuta (PLEVA) is commonly thought of as a disease of young adults, yet we identified five cases, involving patients who were 3, 5, 6, 8, and 11 years of age, among 13,000 consecutive specimens submitted to a general dermatopathology laboratory during a 15-week period. The clinical and histologic features of PLEVA in our cases were similar to those reported for adults, except that no lesions were observed on the scalp or mucous membranes of children. A high index of suspicion and biopsy specimens of suspected lesions are often needed to differentiate PLEVA from other papular and crusted eruptions seen in the pediatric age group. These include reactions to arthropods, Gianotti-Crosti syndrome, varicella, and erythema multiforme. Histologically, papular eczema and pityriasis rosea may be misdiagnosed as PLEVA. PMID- 3662567 TI - Subcutaneous phaeohyphomycosis caused by Exserohilum rostratum in an immunocompetent host. AB - A healthy, 55-year-old woman developed a subcutaneous abscess and systemic symptoms of nausea, dizziness, and chills following minor trauma to her leg. Histopathologic examination of a skin biopsy specimen revealed golden-brown colored mycelial elements, and culture resulted in growth of a dematiaceous fungus identified as Exserohilum rostratum. Surgical excision of the abscess and concomitant oral therapy with ketoconazole resulted in resolution of symptoms. In previously reported cases of human phaeohyphomycosis caused by Exserohilum and related Bipolaris species in both immunocompromised and immunocompetent hosts, treatment has varied from topical antimicrobial therapy to combined surgery and intravenous antifungal chemotherapy. Our experience leads us to believe that surgical debridement of an accessible focus of infection along with orally administered ketoconazole may provide adequate therapy in an immunocompetent host. PMID- 3662568 TI - Adult Kawasaki syndrome. AB - Kawasaki syndrome (KS) is an idiopathic, acute, febrile, exanthemous illness that primarily affects infants and children. We describe a 20-year-old black woman who fulfilled the clinical criteria for the diagnosis of KS and excluded other possible causes. In addition, we reviewed data on 21 patients with adult KS reported in the English literature and accepted ten cases as representing this syndrome. The epidemiologic, clinical, laboratory, and pathologic features of the 11 cases representing adult KS are discussed. Although the initial reports of adult KS in the United States may have actually represented toxic shock syndrome, the occurrence of KS in adults should be acknowledged. PMID- 3662569 TI - Recurrent and metastatic cutaneous neuroendocrine (Merkel cell) carcinoma mimicking angiosarcoma. AB - An elderly man presented with bright red-to-purple confluent nodules and plaques of the scalp that appeared clinically consistent with angiosarcoma. He had undergone surgical removal of a similar lesion from his left temple seven months before this presentation. Although routine histologic examination was not sufficient for diagnosis, Merkel cell carcinoma was diagnosed by immunohistochemical studies and electron microscopy. In addition, oat cell carcinoma of the lung was excluded with a computed tomographic scan of his chest. With chemotherapy, the recurrent and metastatic lesions of Merkel cell carcinoma completely resolved, rapidly recurred, and resolved a second time with chemotherapy. Eight months following the fourth course of chemotherapy, the patient again developed widespread cutaneous lesions. He committed suicide within one month of this last recurrence. An autopsy revealed no primary tumor other than of the skin. PMID- 3662570 TI - Transepidermal elimination of nevus cells. A possible mechanism of nevus involution. AB - Nevus cell nests were seen histologically within the upper levels of the epidermis in biopsy specimens obtained from three patients with clinically banal appearing nevi. Although the presence of melanocytes arranged as solitary units or grouped in nests in the upper layers of the epidermis is one histopathologic feature of malignant melanoma, we believe this finding represents transepidermal elimination of nevus cells and may be one mechanism of nevus involution. PMID- 3662571 TI - Dietary management of dermatitis herpetiformis. AB - Dermatitis herpetiformis (DH) is an extremely itchy, papulovesicular skin disease characterized in part by the presence of IgA at the dermal-epidermal junction. Eighty-five percent to 90% of DH patients have granular deposits of IgA at the dermal-epidermal junction, and essentially all of these patients have an associated, for the most part asymptomatic, gluten-sensitive enteropathy (GSE). The association of GSE and DH suggested that the cutaneous manifestations of DH could be controlled by the use of a gluten-free diet. Institution of a gluten free diet in patients with DH and granular IgA deposits has been shown to be effective in controlling the cutaneous eruption of DH. Seventy percent to 100% of patients who begin a strict gluten-free diet have been shown to be able to decrease the dosage of medication needed to control their DH after a mean of eight to 18 months on the diet. Furthermore, 40% to 70% of patients with DH can control their skin disease completely, without any medication, after longer periods of time on the gluten-free diet (two years and longer). Although the gluten-free diet has been shown to be of great benefit in the control of the skin manifestations of DH, at the present time there is no evidence to suggest that the gluten-free diet is in any way protective against the risk of intestinal lymphoma that has been documented in GSE. Evaluation of the cutaneous IgA deposits in DH skin after long periods of time on a gluten-free diet suggests that there may be a slight decrease in the intensity of the IgA deposits, but the true pathogenetic relationship between the cutaneous IgA deposits, the cutaneous manifestations of DH, and the associated GSE remains unknown. PMID- 3662572 TI - Metallothionein gene regulation in Menkes' syndrome. AB - The characteristic feature of Menkes' disease is a maldistribution of bodily copper; decreased copper levels are present in the serum, brain, and liver, whereas excess levels are present in gut, kidney, and most other nonhepatic tissues. Using cultured fibroblasts, we have shown that low extracellular copper concentrations induce synthesis of metallothionein, a copper-binding protein, in Menkes' cells but not in normal cells. This is due to a defect in a diffusable regulatory factor that is probably involved in copper metabolism. To further understand the role of the defective factor in transcription, assays have been developed to study the metal-dependent binding of nuclear proteins to metallothionein gene control sequences. PMID- 3662573 TI - Tumors on a leg. Mycosis fungoides (MF). PMID- 3662574 TI - A newborn with a solitary nodule on the scalp. Infantile myofibromatosis (solitary type). PMID- 3662575 TI - Persistent bullae on the penis of an elderly man. Balanitis xerotica obliterans. PMID- 3662576 TI - Multiple penile papules. Syringoma. PMID- 3662577 TI - Plastic wrap revisited. The stratum corneum two-compartment model and its clinical implications. PMID- 3662578 TI - Balloon dilatation in congenital heart disease. PMID- 3662579 TI - Giving drugs per rectum for systemic effect. PMID- 3662580 TI - Are intelligence tests outmoded? PMID- 3662581 TI - Maternal smoking during pregnancy and lower respiratory tract illness in early life. AB - In a national study of 12,743 children maternal, but not paternal, smoking was confirmed as having a significant influence on the reported incidence of bronchitis and admission to hospital for lower respiratory tract illness during the first five years of life. Reported rates of admissions to hospital for lower respiratory tract diseases were found to be as high in children born to mothers who stopped smoking during pregnancy as in those whose mothers smoked continuously both during and after pregnancy. Rates of admissions to hospital for lower respiratory tract diseases in children whose mothers started smoking only postnatally were no higher than in those whose mothers remained non-smokers. Postnatal smoking seemed to exert a significant influence on the reported incidence of bronchitis, but less than smoking during pregnancy. These findings suggest that maternal smoking influences the incidence of respiratory illnesses in children mainly through a congenital effect, and only to a lesser extent through passive exposure after birth. PMID- 3662582 TI - Breast feeding increases concentrations of IgA in infants' urine. AB - To investigate the influence of breast feeding on mucosal immunity the concentrations and daily outputs of IgA and lactoferrin in urine were measured in 10 breast fed and 12 infants fed on formula milk at 6 and 12 weeks of age. The concentrations and outputs of secretory IgA in urine were significantly higher in the breast fed group by a factor of three. The secretion of IgA in urine by the breast fed infants was characteristic of the baby and was not related to the intake of IgA from breast milk. Lactoferrin concentrations were similar in the two groups at both ages. In addition to secretory IgA, two thirds of all samples contained proteins with alpha chain but no secretory component antigenic determinants. Breast feeding seems to increase the local production of secretory IgA into the urinary tract during early childhood, thus providing enhanced protection from infection. PMID- 3662583 TI - Fluctuating dystonia responsive to levodopa. AB - Four cases of hereditary progressive dystonia with diurnal fluctuation were studied. All were sporadic; three of them mimicked spastic diplegia; and the fourth showed some similarity to torsion dystonia. Emotional or cognitive disturbance, or both, was seen in three. The correct diagnosis was suggested by fluctuating signs and symptoms, which worsened towards evening, but this was reached only after many years of handicap, hospital admissions, and invasive diagnostic procedures. Typically there was a prompt, pronounced, and sustained response to moderate doses of levodopa. Sleep recordings were obtained in three patients and showed increased body movements during rapid eye movement sleep. Several close relatives had periods of increased leg movements during sleep. It is suggested that hereditary dystonia responsive to levodopa should be considered as the diagnosis in children with fluctuating signs of motor disability syndromes, simulating torsion dystonia or spastic diplegia. Polysomnographic studies may be helpful in diagnosis and may also detect early or subclinical cases. PMID- 3662584 TI - Glycosylated haemoglobin and glucose intolerance in cystic fibrosis. AB - Sixty four patients, age range 1-20 years, with cystic fibrosis had their tolerance to glucose assessed according to their glycosylated haemoglobin (HbA1) concentrations. Raised concentrations were found in 24 (37.5%). Oral glucose tolerance tests were performed on 21 patients with raised HbA1 and 13 patients with normal HbA1 concentrations. C peptide responses were also measured to assess islet cell function. Patients with normal HbA1 had normal glucose tolerance and C peptide response. Seven of 21 patients with raised HbA1 concentrations were glucose intolerant. The remaining 14 patients with raised HbA1 concentrations had normal glucose tolerance but a reduced C peptide response, suggesting impaired islet cell function. There were no appreciable differences in the incidence of chest infections, respiratory function, and chest x-ray scores among patients with normal HbA1 concentrations, raised HbA1 concentrations, and normal oral glucose tolerant tests, and patients who were glucose intolerant. No correlation was found between HbA1 concentration and age or Shwachman score. Measuring HbA1 concentrations periodically is useful in detecting and monitoring glucose intolerance in patients with cystic fibrosis. PMID- 3662585 TI - Familial Hashimoto's thyroiditis with kidney impairment. AB - A 12 year old boy and his two sisters with Hashimoto's thyroiditis and renal impairment were studied. Three generations of this family had autoimmune thyroid disease: Graves' disease was diagnosed in the first generation, and the second and third generations had thyroid enlargement with abnormal thyroid function and immunological abnormalities. The disease in this family could not be explained simply by the types of human leucocyte antigens found. Renal disease in autoimmune thyroid disease is uncommon, treatment difficult, and the prognosis unknown. The proteinuria disappeared in all three children during the three and a half years of follow up, which implies that the renal impairment may be transitory in some patients. PMID- 3662586 TI - Comparison of budesonide and beclomethasone dipropionate for treatment of asthma. AB - Beclomethasone dipropionate (BDP) and budesonide (BUD) were each given in a dose of 200 micrograms twice daily by metered dose inhaler to 10 asthmatic children already dependent on treatment with steroids. In a double blind randomised crossover study each course lasted one month. No clinically important differences were found between the two treatments when symptom scores, symptom free days, additional use of salbutamol, and results of lung function tests were considered. Metyrapone mildly reduced the plasma concentration of 11-deoxycortisol in two patients during treatment with budesonide, and in four during treatment with beclomethasone. It is concluded that although they are usually safe, both drugs may cause mild adrenal suppression when given in a dose of 200 micrograms twice daily. PMID- 3662587 TI - Children and mothers at clinics: who is disturbed? AB - One hundred and eighty one white children aged 6 to 11 years who were attending medical outpatient clinics with their mothers were studied to assess the prevalence of psychological disturbance in the children, and anxiety and depression in the mothers. Teachers were also asked to assess the children independently using the Rutter scales. Mothers assessed 70 (39%) of the children as being disturbed, 20 of whom were also assessed as being disturbed by their teachers. A further 15 children were assessed as being disturbed by their teachers but not by their mothers. Thirty five (19%) of the mothers assessed themselves as anxious and two as depressed using the hospital anxiety and depression scale. Anxious and depressed mothers were significantly more likely to assess their child as being disturbed. In contrast, the teachers' assessments of the children were not affected by the mental state of the mothers. These findings confirm that mothers' perceptions of their children are modified by their own moods. PMID- 3662588 TI - Energy and nitrogen balances in very low birthweight infants. AB - Energy and nitrogen balances were performed in 12 very low birthweight infants fed on either human milk or on a preterm formula. Energy and nitrogen retention were significantly higher in those given the formula feed (p less than 0.05). Highly significant correlations were found between nitrogen intake and nitrogen retention and between energy retention and nitrogen retention (p less than 0.001). Multiple regression analysis failed to show any effect of energy retention on the correlation between nitrogen intake and nitrogen retention in babies fed on human milk. Protein deficiency seems to be the most likely explanation of poor growth in infants fed on human milk. PMID- 3662589 TI - Comparison of weight:height ratio and arm circumference in assessment of acute malnutrition. AB - Doctors working in famine relief commonly use the weight:height ratio and the circumference of the mid-upper arm to assess the nutritional state of children under 5. Threshold values indicating moderate and severe malnutrition are usually taken as 80% and 70%, respectively, of the expected weight:height ratio and arm circumferences of 13.5 cm and 12.5 cm, respectively. A study of 1260 children aged 1-5 showed that the thresholds of these two variables yielded significantly different proportions of children with malnutrition, the proportion being much larger when arm circumference was used as the criterion. Adjusting the thresholds would result in closer correspondence between the two variables. PMID- 3662590 TI - Prader-Willi syndrome in siblings, due to unbalanced translocation between chromosomes 15 and 22. AB - In a family in which the father carried a balanced translocation between chromosomes 15 and 22 two of his children had Prader-Willi syndrome and an unbalanced chromosome complement, having lost the proximal bands from the long arm of chromosome 15. His four other surviving children were normal but carried a balanced translocation. PMID- 3662591 TI - Green or blue light phototherapy for neonates with hyperbilirubinaemia. AB - A total of 262 neonates were treated with green (350-650 nm) or blue (300-600 nm) light phototherapy for a similar length of time. There was no significant difference in the rate of bilirubin photodegradation between the groups. PMID- 3662592 TI - Indicators of malnutrition in leukaemic children. AB - In 24 children with acute leukaemia a low serum albumin concentration (31 g/l or less) and a median weight:height ratio of less than 0.95 on admission were indicators of severe weight loss. PMID- 3662593 TI - Stress fractures: a diagnostic problem. AB - Three cases of stress fracture, in which diagnosis was aided by sequential radiographs and radionuclide scanning are presented; and a procedure for their management, which attempts to eliminate the need for invasive investigations, is suggested. PMID- 3662595 TI - Diagnosis of rotavirus gastroenteritis by smell. AB - Clinical features cannot differentiate rotavirus gastroenteritis from other types of diarrhoea. Sixty eight stool specimens were examined by nurses on an infant gastroenteritis ward. Of these, 69% were correctly classified by smell alone. The results are significant (p = 0.009) and support the suggestion that rotavirus stools have a characteristic smell. PMID- 3662594 TI - Single dose and pulsatile treatment with human growth hormone in growth hormone deficiency. AB - The growth and growth hormone profiles in four children receiving three different regimens of treatment with human growth hormone (hGH) were compared. There was no significant difference in the rate of growth between the regimens; the rate of growth fell dramatically after treatment. Pulsatile administration of hGH was no better than conventional treatment. PMID- 3662597 TI - My enuresis. PMID- 3662596 TI - Hypogammaglobulinaemia and negative anti-HIV antibodies in AIDS. AB - Repeated bacterial infections are frequent in children with AIDS owing to the B cell abnormalities produced by HIV infection. We report on two infants who presented with hypogammaglobulinaemia and with no HIV antibodies, but with epidemiological, immunological, and clinical features of AIDS. PMID- 3662598 TI - Vasoactivity of the major intracranial arteries in the newborn child. PMID- 3662599 TI - Management of asthma in schools. PMID- 3662600 TI - Autosomal dominant polycystic kidney disease in children. PMID- 3662601 TI - Histological study on the fate of haptenated epidermal cells injected intradermally in guinea pigs. AB - The percutaneous administration of in vitro haptenated epidermal cells (EC) has become established as a procedure to produce contact sensitivity (CS) in experimental animals for routine use. The cells have also been found to elicit a significant delayed-type skin reaction by intradermal test in the animals sensitized by painting the skin with the hapten. The fate of 2,4 dinitrophenylated (DNP) isogeneic epidermal cell suspensions (EC) injected intradermally was investigated histologically in intact or 2,4 dinitrochlorobenzene (DNCB)-sensitized strain 13 guinea pigs to study the role of the cells in CS. DNP-EC were found to proliferate actively in the dermis and formed EC nests with central keratinization and then elicited inflammatory reaction associated with necrosis of the epidermal structures 7 days after injection in the intact animals. DNP-EC injected intradermally into the animals which had received and reacted against DNCB underwent a suppression of EC proliferation. These findings are discussed in relation to the role of the haptenated EC in CS. PMID- 3662603 TI - Disseminated bilateral hyperkeratotic variant of porokeratosis Mibelli. AB - Clinical, histopathological, and ultrastructural features of a new clinical variant of porokeratosis Mibelli (PM) are presented. We report a solitary case of a patient, male aged 62, who developed disseminated verrucous nodules on the buttocks and the lower extremities 3 years before diagnosis. Histopathologically, all specific signs of the keratinization disorder of PM were demonstrable; in addition, however, multiple cornoid lamellae were found at the margin as well as in the center of the lesions, which only in part showed relationships to the epidermal appendages. In the papillary dermis, numerous ectatic capillaries were conspicuous. Using electron microscopy the same specific abnormalities of the keratinization process as known from classical cases of PM could be demonstrated: autophagocytic cells that revealed perinuclear edematization and vacuolization, accumulation of autophagic vacuoles and heterolysosomes, and dyskeratotic corps ronds-like cells that become transformed to fibrillar or Civatte bodies. Problems of the classification, differential diagnosis, and pathomorphogenesis are discussed. PMID- 3662602 TI - Modulation of melanoma-associated antigens by monoclonal antibodies as visualized by radioimmunoelectron microscopy and radioantibody binding assay. AB - There is a wealth of information about monoclonal antibody (MAb) specificity and function on fixed tissues, yet little is known about formation and release of antigen-antibody complexes and their functional behavior in vivo. We analyzed the pathway of radiolabeled MAbs directed against melanoma-associated antigens by radioimmunoelectron microscopy (RIEM) on metabolically active cells of the melanoma cell lines SK-MEL-28, MeWo and Colo 38 at different time intervals. In parallel, binding and release of MAbs were investigated by the radioantibody binding assay (RBA). Both procedures gave essentially concordant results. Preferentially stable binding of immune complexes (ICs) to the cell surface after 30 and 120 min was shown for the MAb L10. Internalization was demonstrated for the MAb M.2.9.4. At the ultrastructural level, direct evidence of this phenomenon was obtained by visualization of radioactivity within the cytoplasm after 120 min. In the RBA this process was indicated by resistance of bound MAbs to acid buffer desorption. RIEM pointed to different transport mechanisms: constitutive internalization by endocytotic vesicles, or receptor-mediated endocytosis by coated vesicles. Shedding was indicated for the MAb R24 by release of the ICs from the cell membrane. It was demonstrated that stable fixation of ICs on the cell surface or modulation by internalization led to high accumulation rates, while shedding of antigen-antibody complexes resulted in a low accumulation of the MAb in tumor cells. Assuming that the potential of MAbs for clinical application is determined by the biological behavior of antigen-antibody complexes, these methods are suitable for demonstration of antigenic modulation by MAbs and eventually enable us to predict the localization, penetration and distribution pattern of individual MAbs in the melanoma patient. PMID- 3662605 TI - Exposure to alcohol and tobacco and the risk of laryngeal cancer. AB - The association between various risk factors and laryngeal cancer was evaluated using a case-control design. Subjects were chosen from the Missouri Cancer Registry from 1984 and 1985. The analysis was limited to white males and included 63 cases and 200 controls. The odds ratios (ORs) associated with previous tobacco use, adjusted for age and alcohol use, followed an increasing linear trend (p less than .01). Similarly, a dose-response relationship between alcohol use and laryngeal cancer (p less than .05) was identified. The risk for laryngeal cancer was increased synergistically by alcohol and tobacco. After controlling for alcohol and tobacco, the only occupational category with an elevated risk was nonconstruction laborers (OR = 3.82; 95% confidence interval = 1.87-5.77). Further studies of the interaction between alcohol and tobacco, occupational factors, and laryngeal cancer etiology are suggested. PMID- 3662604 TI - Contrasting disease patterns in psoriasis and atopic dermatitis. AB - In this report we investigate the simultaneous occurrence of psoriasis and atopic dermatitis (AD) as well as the association with infectious skin diseases. Among 29,159 patients hospitalized between 1953 and 1983, 8.5% (2,467 patients) were treated for psoriasis, while 1.6% (470 patients) were hospitalized for AD treatment. On the basis of incidence rates for both diseases, 36 patients (0.14%) with both psoriasis and AD were expected to be seen. However, the two conditions were simultaneously present in 2 patients only. Approximately 30% of the AD patients were suffering from either bacterial or viral infection, while this complication occurred in 6.7% of psoriatics. In addition, among 48 patients hospitalized for eczema herpeticatum 39 were atopics and none was psoriatic. The data demonstrate that the occurrence of psoriasis and AD in one and the same patient is quite rare and this may be related to conflicting immune defense patterns. Thus, increased sensitization against foreign protein together with high susceptibility to cutaneous infection present in AD is in contrast to high phagocyte responsiveness in psoriasis, where concurrent infections are rare. PMID- 3662606 TI - Pulmonary impairment in a cotton textile factory in Nigeria: is lifetime alcohol intake with low cigarette smoking a confounding factor? AB - A study of 60 Nigerian workers who seldom smoked and who were exposed for 2-15 yr in the printing, dyeing, and maintenance sections of a cotton textile factory showed a 38% airway and 20% "probably airway" symptoms. The airway symptoms were significantly (p less than .005) associated with a decrement in spirometric lung function before and after adjustment for age, height, and duration of employment. The change in residual pulmonary function (PFT) per year of employment was three times higher for the subjects with airway symptoms than for subjects presenting no symptoms. Lifetime alcohol intake was significantly (.025 greater than p less than .01) negatively correlated with pulmonary function and obstructive and restrictive lung disease parameters. Together with body weight, alcohol bottle years accounted for between 18 and 22% of the variation in lung function, in a forward and reverse stepwise regression analysis. When duration of employment was standardized, subjects with considerable alcohol intake had significantly (.025 greater than p less than .005) lower pulmonary function before and after adjustment for age and height. When the residual PFT was further adjusted for duration of employment, the subjects with higher alcohol intake had significantly (.01 greater than p less than .005) higher residual per year of employment. The subjects presenting airway symptoms had significantly (.05 greater than p less than .005) higher alcohol intake than those in other symptom categories. These data suggest that alcohol intake is a probable confounder in the observed airway and PFT changes. PMID- 3662607 TI - A retrospective cohort study of mortality among New York State Farm Bureau members. AB - A retrospective cohort study was conducted to examine mortality among 18,811 male farm owners and operators in New York State from 1973-1984. Farm Bureau membership lists were used to identify the study population, and vital status was determined through record linkage with death certificate and motor vehicle files. The comparison group consisted of the 1980 United States Census population of men who resided in the same towns as did the farmers. The results indicated that the study cohort experienced fewer than the expected numbers of deaths overall and for each major cause category except accidents. Specific causes with significant mortality deficits included cancer of the lung (standardized mortality ratio [SMR] = 47.0); diabetes mellitus (SMR = 57.5); ischemic heart disease (SMR = 65.3); bronchitis, emphysema, and asthma (SMR = 26.7); and cirrhosis of the liver (SMR = 29.7). The only specific cause with a significantly elevated mortality was accidents other than motor vehicle (SMR = 146.5). The investigation differs from previous research in method, setting, and population, but the pattern of findings is generally consistent with that of other studies. PMID- 3662608 TI - Chronic obstructive pulmonary disease symptom effects of long-term cumulative exposure to ambient levels of total suspended particulates and sulfur dioxide in California Seventh-Day Adventist residents. AB - Risk of chronic obstructive pulmonary disease symptoms due to long-term exposure to ambient levels of total suspended particulates (TSP) and sulfur dioxide (SO2) symptoms was ascertained using the National Heart, Lung, and Blood Institute (NHLBI) respiratory symptoms questionnaire on 7,445 Seventh-Day Adventists. They were non-smokers, at least 25 yr of age, and had lived 11 yr or more in areas ranging from high to low photochemical air pollution in California. Participant cumulative exposures to each pollutant in excess of four thresholds were estimated using monthly residence zip code histories and interpolated dosages from state air monitoring stations. These pollutant thresholds were entered individually and in combination in multiple logistic regression analyses with eight covariables including passive smoking. Statistically significant associations with chronic symptoms were seen for: SO2 exposure above 4 pphm (104 mcg/m3), (p = .03), relative risk 1.18 for 500 hr/yr of exposure; and for total suspended particulates (TSP) above 200 mcg/m3, (p less than .00001), relative risk of 1.22 for 750 hr/yr. PMID- 3662609 TI - Selenium status, lipid peroxides concentration, and glutathione peroxidase activity in the blood of power station and rubber factory workers. AB - Concentration of selenium in whole blood and plasma, lipid peroxides in plasma, and glutathione peroxidase activities in red blood cell hemolysates and plasma were determined in 49 coal power plant workers and in 50 rubber factory workers. The results were compared with those obtained for 58 nonindustrial controls. Whole blood selenium was significantly lower and plasma lipid peroxides were significantly higher in power plant workers when compared to the nonindustrial group. In the rubber factory workers, whole blood selenium and red blood cells and plasma glutathione peroxidase activities were significantly lower than in the control group. Urinary output of selenium was also significantly decreased in rubber factory workers. Slightly elevated lipid peroxides were also observed in that group. It seems reasonable to conclude that the lower blood selenium and decreased urinary output of this element may result from increased loss of selenium with perspiration. No correlation has been observed between selenium concentration and glutathione peroxidase activity and between enzyme activity and lipid peroxides concentration in the industrial group. PMID- 3662610 TI - Fibers in idiopathic retroperitoneal fibrosis: a case report. AB - A case of idiopathic retroperitoneal fibrosis in a 33-yr-old female is reported. Many fiber-like crystals were noted within macrophages and the interstitial tissue of the lesion. The crystals appeared tan in hematoxylin- and eosin-stained slides and were birefringent under polarized light. The identity of the crystals was not established. PMID- 3662611 TI - The fullness of time in epidemiology. PMID- 3662612 TI - Newborns classified by umbilical blood lead concentration. PMID- 3662613 TI - Mortality experience of employees with occupational exposure to DBCP. PMID- 3662614 TI - The future of psychiatric nursing--revisited. PMID- 3662615 TI - American Nurses Association's social policy statement: Part 1. PMID- 3662616 TI - The phenomenon of shame: Part 2. PMID- 3662617 TI - The development of the self: Part 3. PMID- 3662618 TI - The psychodynamics of envy: Part 4. PMID- 3662619 TI - Assessment groups for preschool children: a preventive program. PMID- 3662620 TI - The effect of gender role preference on decision-making strategies of married couples. PMID- 3662621 TI - Alleviating the discharge crisis: the effects of a cognitive-behavioral nursing intervention for depressed patients and their families. PMID- 3662622 TI - Behavioral home management of cathartic withdrawal in a laxative-dependent elderly woman. PMID- 3662623 TI - A causal model of loneliness among older single women. PMID- 3662624 TI - [Effects of hypothermia on the testis. II. Histochemical and histoenzymatic studies]. PMID- 3662625 TI - [Obliteration of renal cysts and polycystic kidneys]. PMID- 3662626 TI - [Spontaneous subcapsular renal hematoma in a patient on hemodialysis]. PMID- 3662627 TI - [Association of renal tuberculosis and carcinoma]. PMID- 3662628 TI - [Natural history of a renal tumor: 24 years' development]. PMID- 3662629 TI - [Ureterohydronephrosis in patients with neurogenic bladder: conservative treatment]. PMID- 3662630 TI - [Extracorporeal lithotripsy with the HM3 lithotripter in children]. PMID- 3662631 TI - [Secondary metastatic tumors of the bladder: apropos of a case]. PMID- 3662632 TI - [Cavernous angioma as a cause of ischemic testicular necrosis]. PMID- 3662633 TI - [Ureteral obstruction by an isolated aneurysm of the common iliac artery]. PMID- 3662634 TI - [Endometrial adenocarcinoma of the prostate. A tumor of controversial origin]. PMID- 3662635 TI - [X-ray of the corpus cavernosum in a case of penile trauma]. PMID- 3662636 TI - HLA class II antigens (DR, DQ loci) and peripheral arthritis in ankylosing spondylitis. AB - Fifty one patients with ankylosing spondylitis (AS) were typed for HLA-A, B, C, DR, and DQ antigens. The antigen frequencies were compared with those of a normal population and with a B27 positive control group. All but one of the patients with AS were HLA-B27 positive. A positive linkage disequilibrium between Cw1, Cw2, DR1, and the B27 antigen was observed. Patients with AS showed a significant increase in DQw2 antigen compared with the B27 positive control group. No differences in antigenic frequencies were observed in patients having peripheral arthritis and patients with only axial involvement. Seven out of nine patients (78%) with an erosive peripheral arthritis were DR7 positive, suggesting that DR7 or genes closely linked could be related with a more aggressive peripheral joint involvement in patients with AS. PMID- 3662637 TI - Brucellar arthritis: a study of 39 Peruvian families. AB - A study was conducted to characterise the articular manifestation of Brucella melitensis within a family in Peru. From January 1981 to June 1986, 39 families with 232 individuals were evaluated. Brucellosis was diagnosed in 118 family members (attack rate of 50.9%). A lower attack rate was observed in children less than 10 years' old compared with other age groups (p less than 0.02). Complete clinical data were available in 92 of the 118 affected members. Moderate and severe forms of the diseases were more prevalent in women than in men (41.8% v 13.5%; p less than 0.001). Twenty eight of the 92 patients developed some brucellar complications; the articular involvement was the most prevalent (23.9%). Arthritis was also more common in women than in men (34.5% v 8.1%; p less than 0.01). Children appeared to have less articular involvement. Overall, the following pattern was observed: peripheral arthritis (54.5%); unilateral sacroiliitis (23.0%); mixed arthritis (4.5%), and spondylitis (9.1%). Spondylitis was seen only in the elderly with chronic brucellosis. Four patients developed extra-articular rheumatism. Within members of family groups, brucellar arthritis occurred less frequently than in individual patients from the same hospital. This suggests that many family cases were diagnosed in the early stages. PMID- 3662639 TI - Prevalence of cartilage lesions in foot joints: a test of the concept of limited and progressive lesions. AB - Lesions in the articular cartilage of the joints of the first ray of feet amputated from 54 patients in the age range 10-79 years have been categorised by site, size, and stage of development. The large number of small lesions in early stages of development, appearing from an early age, and the few lesions with extensive bone exposure, occurring only in later years, lend corroboration to the concept of limited and progressive lesions, as established for the hip joint. PMID- 3662638 TI - Yersinia specific immune complexes in the synovial fluid of patients with yersinia triggered reactive arthritis. AB - Yersinia specific immune complexes were demonstrated in the synovial fluid of three patients out of 12 with yersinia triggered reactive arthritis. They were not detectable in the synovial fluid of any of the 16 control patients, including nine with reactive arthritis triggered by factors other than yersiniae. Platelet reactive IgG was detectable in the synovial fluid of eight out of the 12 patients with yersinia triggered reactive arthritis and in three of the 16 control patients, all three having rheumatoid arthritis. An enzyme linked immunosorbent assay and a platelet 125I labelled staphylococcal protein A test were used to measure yersinia specific immune complexes and platelet reactive IgG respectively. The results obtained show for the first time the occurrence of bacterial antigens, derived from the causative strain, in the synovial fluid in yersinia triggered reactive arthritis. PMID- 3662640 TI - Structural characteristics of articular cartilage proteoglycan in IgG induced experimental immune synovitis. AB - The early changes (five weeks) in the structure of newly synthesised and endogenous articular cartilage sulphated proteoglycans were studied in lapine IgG induced experimental immune synovitis. Rabbits with immune synovitis (IS-IgG) were compared with animals with a developed hypersensitivity to IgG (I-IgG) and with non-treated normal weight matched controls. Medial and lateral femoral condyle and tibial plateau cartilage was pooled and radiolabelled for 24 h in vitro with 35SO4. The samples constituted tissue from regions underlying pannus and from pannus free sites. Cartilage from animals with IS-IgG showed a significantly diminished amount of newly synthesised and endogenous proteoglycan aggregate and an increased amount of hydrodynamically small proteoglycans. Newly synthesised (obtained by in vivo radiosulphate labelling) and endogenous proteoglycans showed a similar profile. The proteoglycan monomer fraction from animals with IS-IgG failed to form proteoglycan aggregates in the presence of excess hyaluronic acid. In the group with IS-IgG linear regression analysis showed a statistically significant relationship between the synovial pathology scores (but not cartilage pathology score) and diminished newly synthesised and endogenous proteoglycan aggregate. PMID- 3662641 TI - Osmotic flows across the blood-joint barrier. AB - The effective osmotic pressure across the blood-joint barrier is a key factor controlling synovial fluid volume and joint effusions. The effect of plasma colloid osmotic pressure (COP) on trans-synovial flow was studied directly in rabbit knees expanded by intra-articular fluid infusion. The synovial microcirculation was perfused with blood of varying COP. Absorption of fluid from the joint cavity was a linear function of COP; but albumin COP was only 78% effective across the blood-joint interface. Hyperosmolar solutions of small solutes (e.g., glucose) generated transient osmotic flows across the blood-joint barrier, but far less effectively than albumin. The hydraulic permeability of synovium increased at pathological intra-articular pressures--a phenomenon of potential importance to effusion kinetics. PMID- 3662642 TI - Studies in laboratory animals to assess the safety of anti-inflammatory agents in acute porphyria. AB - The safety of various anti-inflammatory drugs in acute porphyria was assessed by examining their effect on rat hepatic haem synthesis. Azapropazone, chloroquine, and gold increased delta-aminolaevulinic acid (ALA) synthase activity, indicating that they are liable to precipitate porphyric crises. Aspirin, ibuprofen, indomethacin, ketoprofen, flurbiprofen, phenylbutazone, naproxen, prednisolone, and penicillamine did not increase ALA synthase activity and should be safe in porphyria. Though these animal studies can be used as a guide to prescribing in patients with acute porphyria, some caution is still required as species may vary in their response to inducing agents. PMID- 3662643 TI - Inhibitory effects of anti-inflammatory drugs on type II collagen induced arthritis in rats. AB - The effects of steroidal and non-steroidal anti-inflammatory drugs on the established lesion of type II collagen induced arthritis in rats were evaluated by measuring the hind paw oedema and anti-type II collagen antibody titre. Dexamethasone, a steroidal anti-inflammatory drug, reduced the anti-type II collagen antibody titre and markedly suppressed the established lesion of type II collagen induced arthritis in rats. A rebound of the arthritis, i.e., a rapid recovery of the hind paw swelling took place after withdrawal of the treatment with steroidal anti-inflammatory drugs, including dexamethasone, prednisolone, and hydrocortisone. On the other hand, indomethacin, benoxaprofen, piroxicam, and tiflamizole, which are cyclo-oxygenase inhibitors in prostaglandin synthesis, had no effect on anti-type II collagen antibody titre, but suppressed the established lesion of the arthritis without causing an apparent rebound of the arthritis after withdrawal of the drug treatment. These results suggest that the level of anti-type II collagen antibodies has no relation to the intensity of hind paw swelling in the established lesion of the arthritis, though the antibodies contribute to the incidence of the arthritis. It also indicates that non steroidal anti-inflammatory drugs having inhibitory action on cyclo-oxygenase are useful antiarthritic drugs without causing the rebound phenomenon, an untoward side effect after withdrawal of steroidal anti-inflammatory drugs. PMID- 3662644 TI - Polyarthritis and angioimmunoblastic lymphadenopathy. AB - Angioimmunoblastic lymphadenopathy (AILD) is a lymphoproliferative disorder with well established clinical and histological features, one of the clinical manifestations being a peripheral polyarthritis. A case of AILD with a symmetrical non-erosive peripheral polyarthritis is described, including the findings in the synovial fluid and histology of the synovium. There was a marked reduction in the number of peripheral blood T lymphocytes bearing the CDT8 phenotype in both the peripheral blood and synovial fluid. The arthritis was difficult to control, requiring large doses of corticosteroids, which produced significant side effects. Levamisole 150 mg, one day each week, was effective in controlling the arthritis and returning the numbers of CDT8 lymphocytes to normal. The aetiology of AILD is unknown, though a defect in T cell regulation, in particular T cell suppression, with a secondary B cell proliferation has been postulated. The demonstration of reduced numbers of lymphocytes bearing the CDT8 phenotype in this patient supports that theory. PMID- 3662645 TI - Farber's disease (lysosomal acid ceramidase deficiency). AB - The patient presented with progressive joint deformity, a hoarse voice, subsequent cachexia, and myoclonic seizures. She was first seen aged 22 months and died aged 6 years. A diagnosis of Farber's disease was made by demonstrating a deficiency of acid ceramidase both in leucocytes and fibroblasts. PMID- 3662646 TI - Vasculitis and renal disease in nail-patella syndrome: case report and literature review. AB - A 57 year old man with nail-patella syndrome (NPS) and associated renal disease is described who developed an inflammatory polyarthropathy and polyarteritis-like vasculitis. Vasculitis and serum complement abnormalities have not previously been reported in NPS. NPS is a rare autosomal dominant connective tissue disorder affecting both mesenchymal and ectodermal tissue. The condition is reviewed with particular reference to its renal pathology, including the distinctive electron microscopic (EM) finding of collagen deposition in the glomerular basement membrane (GBM). The possibility of the underlying collagen abnormality acting as a trigger for immune-inflammatory changes is discussed. PMID- 3662647 TI - Prolonged spontaneous pneumomediastinum in adult dermatomyositis. PMID- 3662648 TI - Pseudothrombophlebitic onset of septic arthritis in a patient with systemic lupus erythematosus. PMID- 3662649 TI - Preliminary observations on the role of magnetic resonance imaging for polymyositis and dermatomyositis. AB - The potential use of magnetic resonance imaging (MRI) for inflammatory muscle disorders was evaluated in 13 patients with polymyositis and dermatomyositis. Abnormalities in signal intensity (p = 0.0076) and fat replacement (p = 0.0177) were identified and correlated significantly with clinical disease activity. In addition, MRI was useful in directing muscle biopsy of selected abnormal areas. PMID- 3662650 TI - Viscosity of plasma in patients with rheumatoid arthritis. AB - The viscosity of plasma (PV) was investigated in 27 outpatients with classical or definite rheumatoid arthritis (RA) according to the American Rheumatism Association (ARA) criteria. The measurements showed a significantly raised PV in patients with RA (p less than 10(-5)) compared with a control group. There was a positive correlation between the PV and the blood erythrocyte sedimentation rate (B-ESR), and the increase in the PV is largely explained by increased concentrations of the plasma proteins, fibrinogen, and IgG. PMID- 3662651 TI - Evolution of benign rheumatoid nodules into rheumatoid arthritis after 50 years. AB - A patient with benign rheumatoid nodules who developed rheumatoid arthritis after 50 years is described. PMID- 3662652 TI - Incomplete Behcet's syndrome with unusual manifestations. AB - We report a case of incomplete Behcet's syndrome with two major criteria plus interstitial pneumonia. The patient had also hypoplastic bone marrow and disseminated intravascular coagulation developed during the terminal stage. PMID- 3662653 TI - Serum salicylate levels in a breast fed infant. AB - All drugs should be given with caution to pregnant or breast feeding women. Recent concern about the role of salicylates in the aetiology of Reye's syndrome has prompted the DHSS to restrict the use of aspirin in children. The case of a 9 week old breast fed infant whose serum contained 0.47 mmol/l of salicylate is reported. Her mother was taking aspirin 2.4 g/day, and it is concluded that salicylates must not be taken by breast feeding mothers. PMID- 3662654 TI - Patterns of rheumatoid arthritis and systemic lupus erythematosus in Hong Kong. PMID- 3662655 TI - Lymphadenopathy in rheumatic patients. PMID- 3662656 TI - Desensitisation to allopurinol: a cautionary tale. PMID- 3662657 TI - Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux. AB - Existing Roux-en-Y bile diversion procedures for duodenogastric reflux coupled with distal gastric resection or antrectomy and vagotomy have varied success due to interruption of the physiologic relationships between stomach and duodenum, the reduction of the gastric reservoir, the side effects of vagotomy, and the effect of the Roux limb on gastric emptying. A new bile diversion procedure, suprapapillary Roux-en-Y duodenojejunostomy, was studied, which eliminates the need for gastric resection to prevent jejunal ulcers by preserving duodenal inhibition of gastric acid secretion and the protective effects of duodenal secretion on the surrounding mucosa. Experimentally, the incidence of jejunal ulceration was significantly decreased by the preservation of the proximal duodenum. Clinically, bile diversion by suprapapillary Roux-en-Y duodenojejunostomy alleviates symptoms of duodenogastric reflux disease without being ulcerogenic (in the presence of normal gastric secretion) or prolonging gastric emptying. PMID- 3662658 TI - Computerized axial manometry of the esophagus. A new method for the assessment of antireflux operations. AB - This is a presentation of a new manometric parameter of the mechanical competence of the lower esophageal sphincter (LES), the lower esophageal sphincter vector volume (LESVV). It is determined by computer analysis of continuous-pressure measurements during constant speed pullback of a radially oriented 4- 6- or 8 channel manometry catheter across the LES. Patients were studied with this method both before aggressive medical therapy for esophagitis and before and after Nissen fundoplication. LESVV accurately predicted failure of medical therapy and success of the fundoplication. In patients with successful fundoplication, LESVV demonstrated a 100-fold increase in mechanical competence of the LES, even in the absence of increased LES pressure or length, increasing from 113 +/- 63 mm3 to 11357 +/- 3733 mm3. PMID- 3662659 TI - Gastroplasty and fundoplication for complex reflux problems. Long-term results. AB - Between 1964 and 1984, 430 patients with complex reflux problems were managed by a modified Collis gastroplasty and partial fundoplication. The indications for selecting the addition of gastroplasty were as follows: (1) obvious acquired shortening due to peptic esophagitis and stricture, and (2) subtler degrees of acquired shortening frequently encountered in cases that required reoperation and in patients with massive sliding hiatal hernia. The addition of gastroplasty in this second group obviates the risk of even minimal tension on the repair. Follow up is complete in 382 patients (90%), and extends 1-20 years. Two hundred fifty patients have been followed up for 5 or more years and 101 patients for more than 10 years. Results were classified as follows: good: asymptomatic, or inconsequential symptoms requiring no therapy; fair: improved, but with symptoms and/or endoscopic findings requiring intermittent therapy; poor: unimproved or worse. Patients are divided into four categories, and the results are tabulated below (see Table 2). The best results are obtained in patients with acquired shortening due to esophagitis with and without stricture who have had no prior antireflux surgery and have no associated primary motor disorder. The proportion of unsatisfactory results is almost tripled (20% fair or poor) after reoperation after one or more failed antireflux procedures. When reflux esophagitis and stricture are associated with a primary motor disorder, only half of the patients have a good result sustained throughout long-term follow-up. PMID- 3662660 TI - Ileal pouch-anal anastomosis for chronic ulcerative colitis. Long-term results. AB - The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the temporary ileostomy was 29% (bowel obstruction, 22%; pelvic sepsis, 5%), with one death due to pulmonary embolus. The probability of a successful outcome at 5 years was 94%. Of the 24 patients who failed (6% of total), 18 did so within 1 year (4%), three during year 2 (1%), three during year 3 (1%), and none thereafter. Stool frequency (7 stools/24 h), the occurrence of pouchitis (14%), and satisfactory daytime continence (94% of patients) remained stable over 4 years after operation, whereas nocturnal fecal spotting decreased (51% of patients to 20%). Women had more spotting than men, whereas patients over 50 years old had more stools per day than those 50 years or younger. In conclusion, ileal pouch-anal anastomosis achieved a reasonable stool frequency and satisfactory continence in patients with ulcerative colitis over the long-term. These results support the ileal pouch-anal anastomosis as a safe, satisfactory alternative to permanent ileostomy. PMID- 3662661 TI - Upper extremity ischemia caused by small artery disease. AB - One hundred patients with ischemic finger ulceration had detailed prospective evaluation to determine the incidence of associated diseases, response to treatment, and natural history of the condition. A potentially serious associated disease was detected in each patient including autoimmune disease in 54%, Buerger's disease in 9%, arteriosclerosis obliterans in 9%, hypersensitivity angiitis in 22%, and miscellaneous diseases in 6%. Conservative treatment with soap and water scrubs, antibiotics, and local resection/debridement resulted in long-term healing without recurrence in 88% of patients. Most recurrences occurred in patients with autoimmune disease, usually scleroderma or CRST. PMID- 3662662 TI - Splenectomy for primary and recurrent immune thrombocytopenic purpura (ITP). Current criteria for patient selection and results. AB - Of 565 patients with thrombocytopenia admitted to Duke University Hospital between 1975 and 1985, 100 had splenectomy. Ninety-eight patients had failed chronic immunosuppressive therapy and three patients had acute intracranial bleeding or total absence of platelets in the peripheral blood smear, and had urgent splenectomy. At primary splenectomy, accessory spleens were identified and resected in 18% of patients. There was no operative mortality. Fifty-eight patients had an excellent response to splenectomy and their steroids were tapered off within 3 weeks. Thirteen patients had a poor response to primary splenectomy of whom eight remitted spontaneously and five required accessory splenectomy resulting in complete remission in three patients. Twenty-nine patients were considered nonresponders, 25 of whom had radionuclide scanning for accessory spleens. Seven of these patients had accessory spleens identified but only four consented to accessory splenectomy. In three of the four patients, a complete remission was achieved. Neither platelet antibody titers nor measurements of platelet survival or turnover predicted platelet response to splenectomy. However, immune thrombocytopenic purpura (ITP) in older patients was significantly less likely to respond to splenectomy. These data support continuing use of splenectomy in selected patients with ITP and an aggressive search for accessory spleens in patients who relapse since they are easily localized at operation by hand-held isotope detector probe. PMID- 3662663 TI - Management of infected pancreatic necrosis by open drainage. AB - Twenty-eight consecutive patients with infected pancreatic necrosis were managed by extensive unroofing of the superior retroperitoneum, blunt pancreatic sequestrectomy, laparotomy pad packing of the lesser sac over a layer of Adaptic gauze, and scheduled re-explorations at intervals of 2-3 days (open drainage). Wounds were permitted to heal by secondary intention. All patients were maintained on intravenous hyperalimentation. Three of the 28 patients died (11%); none died of sepsis. Procedure-specific complications included: pancreatic fistula (10 patients), incisional hernia (8 patients), persistent functional gastric outlet obstruction (2 patients), retroperitoneal venous hemorrhage (2 patients), and intestinal fistula (1 patient). Limited initial experience with dynamic pancreatography and serial monitoring of acute phase reactants as indicators of pancreatic necrosis is promising. Compared with historic controls, open drainage of infected pancreatic necrosis represents a significant advance over more conventional surgical approaches. Controlled studies and more widespread experience are necessary for further evaluation of this procedure. PMID- 3662665 TI - Studies on the dynamics of transmission of onchocerciasis in a Sudan-savanna area of North Cameroon II. Seasonal and diurnal changes in the biting densities and in the age-composition of the vector population. AB - Near the perennial breeding sites in the main water courses the highest monthly biting rates were recorded from June to August (early rainy season) and again from December to February (dry season), but near the rainy season breeding sites in the affluents, or at fly-catching sites, more than 2 km inland from the nearest main river breeding site, the highest rates were recorded between August and December (mid-rainy to early dry season). The variation of the biting rates over the year depended on the waterflow of the main rivers and on the differential dispersal of the flies from the breeding sites during the dry and rainy seasons. At the beginning of the rainy season, when the rivers started flowing, an immigration of non-local flies was observed at the river Mayo Rey near Tchollire, presumably coming from Simulium breeding sites in the Adamaoua mountains to the South. During three years 77,374 flies were caught by daily catches between 06.00 and 18.30 hours. During the dry season the biting activity of nulliparous and parous flies was highest between 09.00 and 10.00 hours and 16.00 and 17.00 hours, 9% and 22% of the total day-catches respectively. In the rainy season the peak biting rates occurred between 06.00 and 07.00 hours (9%) and again from 16.00 to 17.00 hours (14%). The lowest biting rates were observed between 11.00 and 12.00 hours in both dry and rainy seasons (4% and 3% of the total catch). Nulliparous flies showed higher variations in biting activity than did parous flies, leading to the highest proporation of parous flies during midday.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662664 TI - Studies on the dynamics of transmission of onchocerciasis in a Sudan-savanna area of North Cameroon I. Prevailing Simulium vectors, their biting rates and age composition at different distances from their breeding sites. AB - Along the main water courses in the sparsely populated areas of the Sous Prefecture of Tchollire, the vectors of onchocerciasis were mainly Simulium damnosum s. str. and S. sirbanum, together with a small proportion of S. squamosum. Over a period of one to three years, vector biting rates were measured at 23 fly-catching sites in the vicinities of nine villages with different endemicities of onchocerciasis. Annual Biting Rates (ABR) on man were estimated as 26,100-83,800 fly-bites per man per year along the rivers Mayo Rey and Vina du Nord, and 11,000-37,400 at rainy season tributaries. Biting rates decreased rapidly at increasing distances from the river, and were between 10,700 and 2400 at 2-10 km cross-country from the breeding site. Lowest biting rates (50-6000) were measured at the village centres. The ABR varied from year to year in relation to the water-discharge of the main rivers, the coefficient of variation of the mean being 34-49%. The parous rates were 64-73% at the perennial breeding sites and only 17-44% away from the breeding sites, indicating dispersal mainly of young nulliparous flies and a reduced flight-range after oviposition. PMID- 3662666 TI - Studies on the dynamics of transmission of onchocerciasis in a Sudan-savanna area of North Cameroon III. Infection rates of the Simulium vectors and Onchocerca volvulus transmission potentials. AB - Populations of Simulium damnosum s.str. and S. sirbanum were examined for infections with filarial parasites during three years in the areas of Tchollire and Touboro, at sites at different distances from Simulium breeding rivers, and in relation to villages with different endemicities of onchocerciasis. A total of 60,353 flies from 23 fly-catching sites were dissected. The overall infection rate was low, 11.8% of 35,357 parous flies dissected. 1681 flies (4.8% of the total parous) contained 3557 infective larvae, 68.8% of which were morphologically indistinguishable from Onchocerca volvulus and 31.2% were infective 'Type D' larvae of non-human origin, indicating a high degree of zoophily of the fly populations. It was estimated that only 20-40% of all bloodmeals were taken from man. The majority (54%) of all infective O. volvulus larvae were found in the heads of the flies, the remainder being in the thorax (34%) and abdomen (12%). Only 54% of the O. volvulus infective larvae left their vectors during a bloodmeal which, however, was not completed in most cases. During the rainy season infection rates with O. volvulus infective larvae were 3.5% of the total parous flies, as compared with 1.8% during the dry season. The average number of infective larvae of O. volvulus per infective fly was 2.6 and 2.2 during the rainy and dry seasons respectively. These variations in the vectorial efficiency of the fly populations, as well as variations from one site to another, could be explained by different survival rates and man-biting habits of the various vector populations during the dry and rainy seasons and in different regions, rather than by different endemic profiles of onchocerciasis in the human population. The intensity of transmission varied seasonally and was highest (1609 to 3076 infective larvae/man/year) near the main breeding sites, where transmission was almost perennial. At distances of more than 3 km from the river transmission was mainly restricted to the rainy season and the Annual Transmission Potential was below 200, whereas low to zero levels of transmission were measured inside villages more than 3 km distant from the river. The coefficient of variation of the Annual Transmission Potentials over the three years of studies was from 31% to 192% of the mean, being higher that the variations in the corresponding levels of the biting rates, due to the low numbers of infective flies dissected at sites with low transmission.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3662667 TI - Studies on the dynamics of transmission of onchocerciasis in a Sudan-savanna area of North Cameroon IV. The different exposure to Simulium bites and transmission of boys and girls and men and women, and the resulting manifestations of onchocerciasis. AB - The sojourn times of the human population were monitored over one year at 12 sites in the vicinity of three villages in the Cameroon Sudan-savanna, where the Onchocerca volvulus transmission potentials had been measured one year previously. Boys stayed longer outside the villages, and were exposed 2.1 to 2.7 times more than girls to transmission of onchocerciasis, whereas the exposure of men was similar or only moderately higher than the exposure of women. In boys, the onset of infections and ocular lesions was earlier and the average microfilarial density at the buttock (2.2, 9.4 and 79.3 mff snip-1) was much higher than in girls (0.1, 5.8 and 42.2 mff snip-1 at the three villages respectively). These differences were maintained in the adult population, where the average microfilarial density was 52.3, 80.4 and 183.1 mff snip-1 in men and 15.6, 49.6 and 114.7 mff snip-1 in women. Ocular lesions due to onchocerciasis were found in 5, 13 and 55% of the male population in the three villages, as compared with 2, 3 and 8% of the female population. There was a close relationship between the degree of exposure to the transmission of disease and the resulting microfilarial load in the skin which was not different for the two sexes, and a similar trend was seen for the occurrence of ocular lesions due to onchocerciasis. The influence of an early and heavy infection on the evolution of disease manifestations is discussed. PMID- 3662668 TI - Studies on the dynamics of transmission of onchocerciasis in a Sudan-savanna area of North Cameroon V. What is a tolerable level of Annual Transmission Potential? AB - The prevalence and intensity of infection with Onchocerca volvulus were assessed in population surveys in nine villages, situated at different distances from Simulium damnosum s.l. breeding sites. The prevalence varied from 48 to 89%, the arithmetic mean densities of microfilariae per skin snip were between 16 and 109, and severe ocular lesions were found in from 1 to 22% of patients. Annual Transmission Potentials (ATP) were measured for up to three years in the near vicinity of nine villages at several fly-catching sites. Weighted means of the ATP over the three years, and of the sojourn times of the human population, were calculated at three of the villages, where the prevalence of onchocerciasis was 51, 61 and 89%. An average ATP of 100 larvae or less in the head, thorax and abdomen of the flies was associated with an onchocerciasis prevalence of 50 to 60%, a mean microfilarial density below 40 microfilariae per skin-snip, less than 5% of ocular lesions, and no onchocercal blindness. This value might therefore be considered to be an indication of the level to which the transmission must be reduced in the savanna in order to prevent the occurrence of severe ocular lesions or blindness. It is lower than the present level accepted by the Onchocerciasis Control Programme in the Volta River Basin. PMID- 3662669 TI - Prognostic indices of typhoid perforation. AB - Fifty-eight cases of typhoid perforation are presented. Each case was treated surgically, and the causes of the high post-operative mortality rate are discussed. In this series of patients, the chances of survival after typhoid perforation seem to depend on the following factors: Fever: There is a significantly better prognosis if the perforation occurs in the first week of fever. Period before surgical treatment: The longer the time interval between perforation and surgery, the worse is the prognosis. Serology: Patients giving a negative Widal result and showing a high 'H' antigen titre are more likely to survive. Size of perforation: A patient who has a perforation larger than 10 mm in diameter appears to have a poor chance of survival, but this is not statistically significant. Type of surgery: Resection of the ileum with end to end anastomosis apparently gives the best prognosis, and simple closure of the perforation seems the next best. Drainage of the peritoneum and ileostomy appear mainly ineffective, but these were only carried out in severe cases. PMID- 3662670 TI - Parasitic infections in Yakima Indians. AB - Two hundred and five Yakima Indians (age range: one to 66 years) were examined for parasitic infections, and various environmental exposures to infection. A questionnaire was completed by each participant and an anal swab, blood specimens and a single faecal sample were obtained. Eight of 181 swabs (4.4%) contained eggs of Enterobius vermicularis. Of 89 faecal specimens submitted, 12 (13.5%) and 1 (1.1%) respectively contained Giardia lamblia and Cryptosporidium. Sera were screened for antibodies to Toxocara canis, Echinococcus granulosus and Toxoplasma gondii, utilizing enzyme immunoassay, indirect haemagglutination (IHA) and indirect fluorescent antibody tests respectively. Toxocara seroprevalence was 31% (38/123). Seven of 39 (18%) sera were reactive to E. granulosus antigen in the IHA test, but none was positive for arc 5 antigen in the double immunodiffusion test. The seroprevalence of T. gondii was 20% (23/114). PMID- 3662671 TI - Epidemiological studies of snake bite in French Guiana. AB - The incidence of snake bite and the presence of venom antibody in previous snake bite victims was investigated in French Guiana. The incidence proved to be highest (600/100,000) in inhabitants of bush regions and lowest (45/100,000) in urban areas. Of 43 sera tested for specific venom antibody 22 (51%) were positive, and most of these individuals suffered severe or moderate poisoning. The main species involved, as assessed by detection of venom antibody by ELISA, were Lachesis muta, Bothrops brazili, B. bilineatus and B. atrox. The significance of these findings is discussed. PMID- 3662672 TI - The subgenus Euphlebotomus (Diptera: Psychodidae) in China, with description of a new species, Phlebotomus yunshengensis. AB - In 1982 many phlebotomine sandflies were collected in the mountainous area of southern Sichuan along the Sichuan and Yunnan frontier. In three places in this area specimens were found of a new species belonging to the subgenus Euphlebotomus Theodor, 1948, which includes Phlebotomus argentipes, the important vector of Kala-azar in India. PMID- 3662673 TI - A preliminary survey of phlebotomine sandflies in limestone caves of Sichuan and Guizhou Provinces, south-west China, and description and discussion of a primitive new genus Chinius. AB - Some limestone caves in Sichuan and Guizhou Provinces were surveyed with light sticky traps for phlebotomine sandflies in 1982, and specimens were mounted in Berlese's medium. Ten species belonging to three genera were found. Among them was a remarkable primitive fly, considered to be a new taxon, for which a new genus Chinius is proposed in honour of the late Professor Yao Tin Chin, a pioneer of modern medical entomology in China. PMID- 3662674 TI - Trypanosome infections in Glossina spp. inhabiting peridomestic agroecosystems in Nsukka area, Anambra State, Nigeria. AB - Trypanosome infections in Glossina spp. inhabiting three peridomestic agroecosystems in Nsukka area were studied by dissection from April 1984 to July 1985. Approximately 0.65% of 4620 G. tachinoides and none of 17 G. palpalis were found with maturing or mature trypanosome infections. Of these infections, 20% were due to the Trypanosoma brucei group, 40% to the T. congolense group, and 40% to a mixture of the T. brucei and T. congolense groups. Trypanosome infection rates did not differ significantly with seasons or sex of fly, but they differed significantly with location. An apparent difference was observed in the frequency with which male and female G. tachinoides were infected by the various trypanosome species. Also there was a difference in the variety of trypanosome species encountered in the three locations. In infective flies, while the salivary gland, labrum and midgut were scantily to very heavily infected, the hypopharynx was never heavily infected. Dependence of tsetse flies on domestic pigs as the major source of blood meals, commercial activities in the area, the inherently limited vectorial capacity of palpalis group tsetse, and the fact that most flies apparently obtained their first blood meal when two to four days old, were identified as some of the factors responsible for the observed infection rates. The epizootiological and epidemiological implications of these findings are discussed. PMID- 3662675 TI - In vitro cultivation of rickettsia-like-organisms from Glossina spp. AB - A method is described for the in vitro cultivation of the rickettsia-like organisms (RLO) from Glossina spp. which are believed to be associated with susceptibility to trypanosome infection. Cultures of RLO were established by infecting a mosquito cell line (Aedes albopictus) with haemolymph taken from teneral flies. RLO from nine species of Glossina have been isolated and maintained in continuous culture using this technique. PMID- 3662677 TI - Gynandromorphism in Rhipicephalus appendiculatus (Acari; Ixodidae). PMID- 3662676 TI - Oxamniquine resistance in Schistosoma mansoni: fact or fiction? PMID- 3662678 TI - The urgent need for major reform of the professional liability system. PMID- 3662679 TI - How big and when? PMID- 3662680 TI - Assessment of exercise oxygen consumption as preoperative criterion for lung resection. AB - Determination of preoperative pulmonary function is crucial in avoiding complications from pulmonary resection. Many have employed static pulmonary function testing in an attempt to decrease morbidity and mortality from lung resections. The purpose of the present study was to correlate preoperative static pulmonary function, one-second forced expiratory volume (FEV1), and exercise O2 consumption (MVO2) with postoperative morbidity and mortality. Fifty consecutive patients underwent preoperative FEV1 and MVO2 determinations. A criterion for surgical resection included an FEV1 greater than 1.7 liters for pneumonectomy, greater than 1.2 liters for lobectomy, and greater than 0.9 liters for wedge resection. The surgeon was blinded as to the results of MVO2 studies. Mean age was 63.8 years (range, 47 to 76 years). There were 10 pneumonectomies, 28 lobectomies, and 12 wedge resections. Among the 50 surgical candidates selected solely on the standard FEV1 values, mortality was 4% (2/50) and morbidity, 12% (6/50). Stratification on the basis of exercise performance showed a 29% mortality (2/7) and a 43% morbidity (3/7) in patients with an MVO2 less than 10 ml/kg/min. Patients with an MVO2 less than 20 but greater than 10 ml/kg/min had a 10.7% morbidity (3/28), and there were no deaths. No patients with an MVO2 greater than 20 ml/kg/min sustained any morbidity or died (p less than 0.001). We conclude that exercise is an important criterion in the preoperative evaluation of patients for pulmonary surgery. An MVO2 less than 10 ml/kg/min is associated with significant morbidity and mortality. PMID- 3662682 TI - Tube drainage of lung abscesses. AB - We treated 14 patients who had complicated lung abscesses (all over 4 cm in diameter); 9 patients had concomitant respiratory failure requiring mechanical ventilation. A percutaneous tube was inserted in 11 patients (3 subsequently underwent rib resection) and 3 underwent rib resection with operative insertion of the tube. The resultant bronchopleural fistulas did not interfere with respiratory management despite the use of mechanical ventilation, and only 2 patients required subsequent surgical closure. Eleven patients were discharged from the hospital. Complications were minimal and consisted of 2 episodes of hemorrhage, 1 during operative debridement of the abscess and 1 delayed. Both complications were managed successfully. Three patients died in the hospital, only 1 from complications of the lung abscess. We have concluded from this review that tube drainage can be safe, simple, and efficacious. We recommend it for the treatment of complicated lung abscesses even when associated with respiratory failure and mechanical ventilatory support. PMID- 3662681 TI - Controlled reperfusion following regional ischemia. AB - The ability to reverse acute coronary occlusion with fibrinolytic agents and percutaneous transluminal angioplasty has increased interest in the revascularization of ischemic myocardium. This study defines changes in global ventricular function, mass, and compliance during acute coronary occlusion and following reperfusion with blood in the beating and arrested heart. In 17 dogs on cardiopulmonary bypass, the proximal left anterior descending coronary artery was occluded for 45 minutes. In 12 dogs, flow was reestablished by releasing the coronary snare in the beating heart. In the other 5 dogs, the snare was released during a continuous 10-minute infusion of blood potassium cardioplegia in the arrested heart. Coronary occlusion resulted in significant decreases in stroke work index and left ventricular (LV) mass, but compliance was unchanged. Reperfusion in the beating heart increased LV mass compared with the values measured before ischemia (104 +/- 5 versus 95 +/- 5 gm; p less than 0.05) and decreased LV compliance (39 +/- 4 versus 53 +/- 4 ml at LV end-diastolic pressure of 8 mm Hg; p less than 0.05). In contrast, with blood cardioplegia-based reperfusion in the arrested heart, LV mass and LV compliance remained unchanged from control values. We conclude that revascularization of acutely ischemic myocardium in the beating heart further impairs LV function by increasing LV mass and decreasing compliance. This damage can be avoided by reperfusion with blood cardioplegia in the arrested heart. PMID- 3662683 TI - Instrumental perforation of the esophagus in benign disease. AB - Over a period of seven years, a total of 1,831 endoscopic procedures were performed in patients with benign esophageal disease. These comprised flexible esophagoscopy (848), flexible esophagoscopy and dilation (924), pneumatic dilation (29), and rigid esophagoscopy (30). There were 14 episodes of perforation: 1 was cervical, 2 were abdominal, and 11 were perforations of the intrathoracic esophagus (7 occurred at or immediately above a stricture). The diagnosis was made immediately in 9 and within six hours in all but 1 patient. Treatment was emergency surgery in 12 patients, 2 of whom died. The major cause of death was respiratory failure. The overall incidence of perforation was 0.76%. The incidence of perforation was 0.35% (3/848) for flexible esophagoscopy alone, 0.38% (3/792) for dilation with Maloney mercury-weighted bougies, and 3.8% (5/132) for dilation with other bougies. Our experience indicates that instrumental perforation in benign esophageal disease carries a considerable mortality rate in spite of prompt recognition and surgical treatment. Successful dilation with mercury-weighted bougies can be achieved in 86% of benign strictures with an incidence of perforation similar to that for flexible esophagoscopy alone. Difficult strictures and the use of other bougies are associated with a tenfold higher incidence of perforation. PMID- 3662684 TI - Surgical management of lymphomas involving the chest. AB - The efficacy of surgical judgments in the management of thoracic lymphoma was studied through review of 34 patients with primary mediastinal lymphomas, 30 patients who needed one or more thoracic operations after treatment of extrathoracic lymphomas, and 5 patients with primary lymphocytic infiltrates (PLI) of the lung. In all patients with primary lymphocytic infiltrates of the lung, thoracotomies were required in order to establish the correct diagnosis. Patients with primary mediastinal lymphoma required 74 surgical procedures (2.2 per patient) to establish the correct diagnosis. In retrospect, 40 operations were not beneficial. The procedures that provided diagnostic samples were 15 anterior mediastinotomies, 8 full thoracotomies, 3 median sternotomies, and 8 lesser procedures such as mediastinoscopy. Patients who needed thoracic procedures after treatment of extrathoracic lymphomas had 41 thoracic operations (1.37 per patient). Five operations were needed to manage complications of thoracic lymphoma or its therapy. To evaluate new radiographic findings, there were 35 operations (1.3 per patient) at a mean interval of 5.0 years following initial treatment; the findings were recurrent lymphoma in 62% and new lesions in 38% of patients. Among new lesions, there were 2 bronchogenic cancers; 9 enlarging mediastinal-pleural masses were not caused by lymphoma. The accurate diagnosis of thoracic lymphoma or new thoracic lesions in patients with lymphomas usually requires enough tissue for immunophenotyping. Providing adequate tissue samples and treating new lesions that are not lymphomas often require major thoracomediastinotomies for immunophenotyping. PMID- 3662685 TI - Operation for hypertrophic subaortic stenosis in the aged. AB - To determine if operative palliation of idiopathic hypertrophic subaortic stenosis (IHSS) is worthwhile in the elderly, hemodynamic, cardiac conduction, symptomatological, functional, and survival data were examined in 52 patients (39 women) 65 years old and older (mean age, 69 years; range, 65 to 81 years) who had a left ventricular myotomy and myectomy (LVMM) (Morrow procedure) alone or with concomitant operations. Seventy-four percent of all operative survivors underwent catheterization an average of 6 months postoperatively. The mean follow-up was 54 months (range, 5 to 120 months). The population was divided for analyses into those with coronary artery disease (CAD) (N = 11,21%) and those without (N = 41). The peak resting left ventricular outflow tract gradient was reduced from 65 +/- 16 mm Hg to 3 +/- 1 mm Hg (p less than 0.01) in the group with CAD and from 95 +/ 13 mm Hg to 17 +/- 9 mm Hg (p less than 0.001) in the group without CAD. Significant reductions in peak gradients in response to provocation also occurred in both groups. New conduction abnormalities occurred in 72% of survivors, 85% of whom showed improvement in regard to symptoms. The overall average New York Heart Association Functional Class was 3.2 +/- 0.1 preoperatively and at latest follow up, 1.9 +/- 0.1 (p less than 0.001). The hospital mortality for LVMM alone in the absence of CAD was 8% with a 5-year actuarial survival of 75 +/- 8%. LVMM in the presence of CAD resulted in an operative mortality of 27% (N = 3); all deaths were related to an acquired ventricular septal defect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662686 TI - Paced latissimus dorsi used for dynamic cardiomyoplasty of left ventricular aneurysms. AB - Two patients are described, each with a large left ventricular aneurysm and severe coronary artery disease, and each with an ejection fraction lower than 30% and in congestive heart failure. In both, the left latissimus dorsi (LD) muscle was used in the repair of the ventricular aneurysm because preoperative studies demonstrated that there was concomitant coronary artery disease, and there was a strong suggestion that resection of the entire aneurysm would seriously compromise the residual ventricular capacity. One patient had an 18-year history of coronary occlusion with two infarctions. A large, calcified ventricular aneurysm developed, and despite vigorous medical treatment, intractable congestive heart failure and angina persisted. The diffuse coronary artery disease made this patient a poor candidate for bypass grafting. The other patient sustained an acute myocardial infarction 5 months prior to operation. The left anterior descending coronary artery was totally occluded, and a large apical aneurysm developed along with an akinetic anterior wall and septum. After his heart attack, the patient had progressive dyspnea on exertion. Following operation in both patients, the transpositioned LD, then a component in the repair of the left ventricular wall, was electrically trained to synchronously contract with each systole, driven by a standard dual-chamber cardiac pacemaker. Steady improvement and a return to normal activities were observed in both patients. There was an indication of improved ejection fraction with synchronous contraction of the skeletal muscle. PMID- 3662687 TI - Primary repair of acute ascending aortic dissection. AB - Primary repair of acute ascending aortic dissection was performed in 14 patients. Repair included resection of the intimal tear where applicable, a circumferential suture line in the ascending aorta at the site of the tear, and wrapping of the intrapericardial ascending aorta with Teflon felt to contain the distal residual false channel. The aortic valve was resuspended in 6 patients. The single operative death was unrelated to the method of repair. Two late deaths at 4 and 6 years were due to preexisting multisystem disease. In 1 patient, new aortic insufficiency with an isolated aneurysm of the noncoronary sinus of Valsalva developed at 26 months, and was repaired successfully at another institution. These results compare favorably with those reported by others employing more extensive surgical procedures for repair of acute ascending aortic dissection. PMID- 3662688 TI - Valve replacement in children: guidelines for selection of prosthesis and timing of surgical intervention. AB - One hundred fifty-nine patients ranging from 3 months to 18 years old (mean, 8.1 +/- 3.7 years) underwent 162 primary valve implantations. A porcine valve was used in 104 patients, a St. Jude Medical valve in 40, and a Bjork-Shiley valve in 18. The valve replaced was the aortic in 25 patients, the mitral (systemic atrioventricular [AV] valve) in 43, the pulmonary in 71, and the tricuspid (pulmonary AV valve) in 23. Hospital mortality was 6%. Patients with a Bjork Shiley valve received warfarin sodium anticoagulation, and those with a St. Jude Medical valve were given salicylates and dipyridamole. Follow-up is available on all patients 0.6 to 12 years postoperatively (mean, 6.3 +/- 2.6 years). New York Heart Association Functional Class improved in 62% and remained unchanged in 38% of the patients. Thromboembolic complications occurred in only 8 (57%) of 14 patients with a St. Jude Medical valve in the right (pulmonary) side and in 3 (12%) of 26 with the valve in the left (systemic) side of the circulation. Bacterial endocarditis developed in 3 patients, all with porcine valves. Early valve replacement, less than 2 years after detection of hemodynamic deterioration, resulted in improvement in the ventricular ejection fraction in 25 of 29 patients (from 81 +/- 14% to 90 +/- 12% of normal; p less than 0.05). In contrast, the ejection fraction remained abnormal in all 22 patients with delayed valve insertion (more than 2 years) (81 +/- 16% of normal preoperatively and 80 +/- 10% of normal following operation; p = not significant). PMID- 3662689 TI - The Blalock-Hanlon operation: an anachronism? AB - Some surgeons advocate early correction of dextrotransposition of the great arteries (D-TGA) using hypothermic circulatory arrest when Rashkind balloon atrial septostomy is inadequate. An alternative procedure is a Blalock-Hanlon closed atrial septectomy. From 1971 to 1985, 19 patients underwent the latter procedure for D-TGA at our institution. Three had it as the first procedure, and 16 had undergone Rashkind balloon atrial septostomy, which was unsuccessful. Age at performance of the Blalock-Hanlon closed atrial septectomy ranged from 1 day to 5 months (mean, 2.51 months). There were no operative deaths. Subsequently, 18 children have had a Mustard procedure, and 1, a Rastelli procedure (average age at definitive repair, 25.31 months). One death followed definitive repair (combined mortality, 5%). On room air, average partial pressure of arterial oxygen rose from 23.25 mm Hg prior to closed atrial septectomy to 31.45 mm Hg at discharge. Average hematocrit fell from 58.37% prior to closed atrial septectomy to 53.94% prior to definitive repair. At the time of definitive repair, percentile height ranged from the 3rd to the 95th percentile (mean, 44th percentile) and weight ranged from the 3rd to the 90th percentile (mean, 32.5th percentile). In 1 infant, transient neurological symptoms developed three days following Blalock-Hanlon atrial septectomy. The symptoms were due to multiple cerebral infarctions thought to be caused by emboli. No permanent neurological deficit resulted. We believe that the infant with an inadequate Rashkind balloon atrial septostomy prior to age 6 months should undergo a Blalock-Hanlon septectomy followed by definitive repair timed on the basis of the baby's growth, associated anomalies, and evidence of pulmonary hypertension. PMID- 3662690 TI - Thoracic splenosis. AB - Two rare cases of intrathoracic splenosis are reported. This phenomenon occurs almost exclusively in young men who have experienced splenic rupture and diaphragmatic laceration. The late occurrence of splenosis in the thoracic cavity poses problems in the differential diagnosis of solitary or multiple pleural based nodules. It is important to recognize this entity from a clinical, radiographic, and therapeutic perspective. PMID- 3662691 TI - Pulmonary artery sling with tracheal stenosis: one-stage repair. AB - Pulmonary artery sling with tracheal stenosis is a difficult management problem. We describe the use of cardiopulmonary bypass as a method to facilitate one-stage repair. PMID- 3662692 TI - Postperfusion coronary stenosis. AB - A patient is described who had left main coronary artery stenosis four months after aortic valve replacement. He was seen with unstable angina, and subsequent catheterization revealed stenosis of a previously normal left main coronary artery. The diagnosis, treatment, and means of prevention are discussed. PMID- 3662694 TI - Intraaortic balloon entrapment. PMID- 3662693 TI - Arterial bypass of the descending thoracic aorta with the BioMedicus centrifugal pump. AB - Bypass of the descending thoracic aorta is frequently advocated as an adjunct for repair of traumatic tears and degenerative aneurysms. Many methods of bypass have been proposed to provide distal perfusion and reduce left ventricular afterload during cross-clamp of the thoracic aorta. We describe a simple method of direct arterial (aortoaortic or aortofemoral) bypass using the BioMedicus centrifugal pump with limited systemic heparinization. PMID- 3662695 TI - Topical cooling of the right atrium. PMID- 3662696 TI - Differential contractile responsiveness of femoral arteries from healthy and diabetic dogs: role of endothelium. AB - Phenylephrine-induced contraction and acetylcholine-induced relaxation of isolated femoral arterial strips (with and without endothelium) of diabetic (alloxan-treated) and metabolically healthy dogs were determined. Alloxan treatment did not change the contractile responsiveness to phenylephrine (PE) of the arteries with intact endothelium. After mechanical removal of the endothelial layer, however, the maximum force generated by the diabetic vessels (22.0 +/- 2.0 mN.m-2) significantly exceeded the maximum contraction produced by the nondiabetic arteries (14.6 +/- 1.8 mN.m-2). The dose-response curve of diabetic arteries to PE was steeper than it was in non-diabetic strips. The EC50 values for PE were similar in these two groups (0.45 +/- 0.12 and 0.58 +/- 0.20 mumol/l in diabetic and nondiabetic vessels, respectively). In the arteries with intact endothelium, acetylcholine produced concentration-related reduction of PE-induced tone. This endothelium-dependent relaxant activity of acetylcholine was similar in the healthy and diabetic arterial strips, IC50 for acetylcholine being 0.17 +/ 0.02 and 0.20 +/- 0.03 mumol/l, respectively. These results suggest that functional alteration of endothelium (probably an increased release of EDRF) prevails in diabetes. This may be important in reducing the hyper-responsiveness of diabetic arterial smooth muscle to PE. PMID- 3662697 TI - Effects of RU 24969 on serotonin release in rat brain cortex: further support for the identity of serotonin autoreceptors with 5-HT1B sites. AB - Rat brain cortex slices and synaptosomes preincubated with [3H] serotonin were used to study the effects of the 5-HT1 receptor agonist RU 24969 (5-methoxy-3 (1,2,3,6-tetrahydro-4-pyridinyl)-1H-indole) on the electrically (3 Hz) evoked 3H overflow from superfused slices and the potassium (12 mmol/l)-evoked 3H overflow from superfused synaptosomes. In slices superfused in the presence of 6 nitroquipazine (an inhibitor of serotonin uptake), the electrically evoked overflow was inhibited by RU 24969 and the reference compound serotonin (maximum inhibition obtainable: by about 50 and 60%, respectively; IC25 and IC30: 33 and 150 nmol/l, respectively). The inhibitory effect of RU 24969 on the evoked overflow was attenuated by cyanopindolol (a beta-adrenoceptor blocker with antagonistic properties at 5-HT1 receptors). In the absence of 6-nitroquipazine, RU 24969 did not increase the basal efflux and tended to be more potent in inhibiting the evoked overflow than in the presence of 6-nitroquipazine. The correlation of the release-inhibiting potencies of serotonin receptor agonists with their affinities for 5-HT1B binding sites (Engel et al., 1986) was slightly improved by inclusion of RU 24969, whereas that with the affinities for 5-HT1A binding sites (which was worse than the former correlation) was not changed. In synaptosomes superfused in the presence of 6-nitroquipazine, RU 24969 inhibited the potassium-evoked overflow. The inhibitory effect of RU 24969 was antagonized by cyanopindolol, which by itself did not affect the evoked overflow. It is concluded that RU 24969 acts as a highly potent agonist (with an intrinsic activity of about 0.8) at the presynaptic serotonin autoreceptor in the rat brain cortex. Furthermore, the present results support the assumption that these receptors belong to the 5-HT1B subtype. PMID- 3662698 TI - Effect of rolipram, a phosphodiesterase inhibitor and potential antidepressant, on the firing rate of central monoaminergic neurons in the rat. AB - Rolipram is a potent phosphodiesterase inhibitor, active in classical pharmacological tests used in the screening of antidepressants (AD). In contrast with classical AD, rolipram does not block the reuptake of monoamines, but its action on the metabolic degradation of cyclic AMP may enhance adenylate-cyclase linked catecholaminergic and serotonergic transmission. Biochemical studies showed that rolipram induces various modifications in the turnover of monoamines but the net effect of these modifications on the electrical activity of monoaminergic neurons remained to be elucidated. Thus, the influence of rolipram on the firing rate of central locus coeruleus (LC) noradrenergic neurons, mesolimbic (A10) dopaminergic neurons and dorsal raphe (DR) serotonergic neurons was investigated. When rolipram was perfused into the jugular vein, it produced a long-lasting excitatory effect on LC neurons, a prolonged but usually partial inhibitory effect on A10 neurons and no consistent effect on DR neurons. The action of rolipram on monoaminergic neurons contrasts with that of most classical and new AD in which the electrical activity of LC and/or DR neurons decreases. PMID- 3662699 TI - Lymphatic and portal venous absorption of phenobarbital and thiopental in the dog. AB - Lymphatic and portal venous absorption of gastrically administered thiopental and phenobarbital were compared in the dog. Thiopental concentrations in lymph were significantly higher than phenobarbital concentrations for 30 min after drug administration. Disparity between portal plasma and lymph concentrations for thiopental during the first 15 min was about 1/3 as great as the same difference for phenobarbital. Thiopental displayed an average of twice the affinity for lipid (chylomicron) lymph as did phenobarbital. Because of its greater lipid solubility, thiopental is absorbed more by lymph than is phenobarbital. Both barbiturates are absorbed more quantitatively by the portal rather than lymphatic circulation, probably due to variation in the rate of flow of these 2 systems. PMID- 3662700 TI - Activities of 5-methylfurfuryltrimethylammonium iodide and related compounds at vascular endothelial muscarinic receptors of the rat aorta. AB - 5-Methylfurfuryltrimethylammonium iodide (5-MFT) is a furan analog of muscarine and was studied for its cholinergic activity at vascular endothelial receptors of the rat aorta. Other related compounds have different substitutions at position 5 of the furan ring and include the following compounds: 5-hydroxymethyl- (5-HMFT), 5-chloromethyl- (5-CMFT), 5-bromomethyl- (5-BMFT), 5-iodomethyl- (5-IMFT), and 5 methoxy- (5-MOFT) furfuryltrimethylammonium salts. The furan analogs relaxed helical strips of rat aorta which contracted with norepinephrine (10(-6)M). These relaxations were endothelial cell-dependent. The ED50's for muscarinic activities increased in the following order: 5-MFT = ACh less than dl-muscarine less than 5 HMFT = 5-CMFT less than 5-MOFT less than 5-BMFT less than 5-IMFT. Among the furan analogs, 5-MFT was found to be a full agonist at the endothelial cells; other furan analogs were only partial agonists. The affinities and relative intrinsic efficacies of the most potent analogs decreased in the following order: ACh = 5 MFT greater than dl-muscarine greater than 5-HMFT greater than 5-CMFT. Atropine and scopolamine antagonized relaxations by furan analogs. KB values for atropine and scopolamine against ACh, 5-MFT or 5-HMFT as agonist were not different, indicating that these agonists and antagonists were acting at the same muscarinic receptors. The KB of atropine and of scopolamine increased when 5-CMFT was used as an agonist, indicating that 5-CMFT may cause relaxation by acting at other sites besides endothelial muscarinic receptors. The endothelial muscarinic receptor might be classified tentatively as of M2 or Ms type. These studies did not exclude the possible heterogeneity of the endothelial muscarinic receptors. PMID- 3662701 TI - Constipation. A pressing issue. PMID- 3662702 TI - Of hydras, lemmings, and diagnostic tests. PMID- 3662703 TI - Predisposing factors for the development of malignant essential hypertension. AB - To clarify predisposing factors for malignant hypertension, we retrospectively investigated the histories of 39 patients with malignant hypertension and 39 patients with benign hypertension. Between the malignant and benign groups, there was a statistically significant difference in blood pressure but not in age when hypertension was first noticed. The number of patients who had discontinued drug treatment was significantly greater in the malignant group (19; 49%) than in the benign group (11; 28%). Insufficient sleep, overwork, and/or mental burden of long duration were factors noticed within one year before the occurrence of the malignant phase in 11 (37%) of the 30 patients in that group in whom this information was available. Patients in the malignant group tended to belong to a lower social class. These results suggest that severe hypertension from an early phase, interruption of drug treatment, and physical and/or mental burden may predispose to the development of malignant hypertension, and that these predisposing factors are likely to be associated with social class. PMID- 3662705 TI - Diuretic-associated hypomagnesemia in the elderly. AB - Serum magnesium concentration was measured in 320 consecutive elderly patients (mean age, 81 years) receiving diuretic therapy at the time of hospital admission. When compared with serum concentrations of 250 elderly patients who were not taking diuretics at the time of hospital admission, only the group taking thiazide diuretics had a significantly reduced mean serum level. The 24 hour urine sampling from representative subgroups demonstrated impaired magnesium conserving ability in hypomagnesemic subjects receiving loop and thiazide diuretic therapy. Patients taking therapy that included a potassium-sparing diuretic had no significant evidence of reduced magnesium-conserving ability. Dietary assessments of the study population revealed suboptimal magnesium intake in the diet. PMID- 3662704 TI - Neurofunctional testing for the detection of diabetic peripheral neuropathy. AB - We have studied associations of neurofunctional testing with other indexes of diabetic peripheral neuropathy in patients unselected for neuropathy. The tests included vibratory sensitivity (assessed with the Vibration Sensitivity Tester and the Biothesiometer) and thermal sensitivity (assessed with the Thermal Sensitivity Tester). Values for diabetic patients were markedly higher than those of control subjects. The neurofunctional tests were strongly correlated with each other. There were also significant associations between the neurofunctional and nerve conduction indexes. Asymptomatic patients had higher values than those of the control subjects for each test. When clinical and nerve-conduction criteria were a better indicator than thermal sensitivity. Neurofunctional testing appears to be useful for both the clinical and research assessments of diabetic peripheral neuropathy. PMID- 3662706 TI - Abnormal ventilatory chemosensitivity and congenital myopathy. AB - Abnormal ventilatory function is common in patients with neuromuscular disorders. This report describes depressed ventilatory response to both hypoxia and hypercapnia, as well as arterial oxygen desaturation during sleep in a family with congenital myopathy. The index patient also had an abnormal ventilatory response to metabolic acid loading. There was clinical evidence of proximal muscle weakness, and a muscle biopsy specimen was consistent with myopathy. The reduction in ventilatory drive, however, could not be explained solely by ventilatory muscle weakness. This report describes a distinct familial syndrome of congenital myopathy and abnormal ventilatory response to hypercapnia and hypoxia. All affected family members had unique facial features, proximal muscle weakness, and impaired ventilatory responses. The combination of impaired ventilatory drive and reduced ventilatory muscle strength leaves patients particularly vulnerable, and heightened awareness of this association is important in the treatment of these patients. PMID- 3662707 TI - Serum sex hormone-binding globulin in amiodarone-treated patients. A marker for tissue thyrotoxicosis. AB - The lodinated antiarrhythmic drug amiodarone frequently causes an elevation of the serum thyroxine (T4) level in patients who remain clinically euthyroid. Less frequently, true iodine-induced hyperthyroidism may occur. The clinical and laboratory distinction between these two conditions is often difficult. Since the serum sex hormone-binding globulin (SHBG) concentration is elevated in hyperthyroidism, this study was carried out to evaluate the serum SHBG concentration as a possible marker of hyperthyroidism in patients receiving amiodarone. Patients treated with amiodarone were divided into three groups: clinically euthyroid with normal serum T4 and triiodothyronine (T3) concentrations, clinically euthyroid with elevated serum T4 and normal T3 concentrations, and clinically hyperthyroid with elevated serum T4 and T3 concentrations. The mean serum SHBG concentration was significantly elevated in amiodarone-induced hyperthyroid patients, while it was normal in euthyroid patients treated with amiodarone who had normal or elevated serum T4 concentrations. The results suggest that the hyperthyroxinemia induced by amiodarone is not associated with excess thyroid hormone action in the liver unless the serum T3 concentration is also elevated. PMID- 3662708 TI - Prototype quantitative assay for fibrinogen/fibrin degradation products. Clinical evaluation. AB - A new quantitative assay for fibrinogen/fibrin degradation products (FDPs) was clinically evaluated in 123 tertiary-care patients for whom the standard semiquantitative FDP assay had previously been ordered. On the basis of a comprehensive chart review, 24 patients were categorized as having disseminated intravascular coagulation (DIC), 84 were considered not to have had DIC, ten had fibrinolysis (nine of ten streptokinase induced), and five had a complicated coagulopathy whose exact nature could not be determined. The quantitative and semiquantitative FDP values were significantly correlated. However, the FDP level indicative of DIC was lower by the quantitative assay than by the semiquantitative assay, approximately 18 mg/L vs 40 mg/L, respectively. The advantages of the quantitative over the semiquantitative assay included improved precision and ability to closely monitor changes in the severity of the coagulopathy. PMID- 3662709 TI - Regression of melanoma nodules in a patient treated with ranitidine. AB - Human malignant melanoma may regress spontaneously or with immunotherapy, such as Calmette-Guerin bacillus, interferon alfa, interleukin-2, and interleukin-2 plus lymphokine-activated killer cells. Histamine type 2 receptor antagonists can modulate immune function by inhibiting suppressor T-cell induction and activity, and melanoma regressions have been reported after the use of cimetidine with coumarin or interferon alfa. This article describes the complete regression of melanoma nodules in a patient treated with ranitidine hydrochloride, another histamine type 2-receptor antagonist. Ranitidine and cimetidine should be considered to be possibly active immunotherapeutic agents in the design and evaluation of clinical trials. PMID- 3662710 TI - Seafood shucking as an etiology for Aeromonas hydrophila infection. AB - Aeromonas hydrophila has been increasingly documented as a hardy organism responsible for severe infection in the compromised host. This case report illustrates how A hydrophila may survive prolonged freezing and how seafood shucking may cause sepsis. This report serves as a caution to the immunocompromised seafood lover. PMID- 3662711 TI - Unsuspected pernicious anemia in a patient with sickle cell disease receiving routine folate supplementation. AB - Although the issue of folate supplementation in sickle cell anemia remains controversial, routine supplementation has become common. The major drawback to indiscriminate folate therapy is the potential of masking findings of vitamin B12 (cobalamin) deficiency. This has been dismissed as a problem in sickle cell anemia because of the generally young age of the patients. However, because young blacks, especially women, are at higher risk for developing pernicious anemia than whites, sickle cell anemia and pernicious anemia can be expected to coexist occasionally. In this article we describe such a patient and recommend that routine folate supplementation should not be given in sickle cell anemia before determining the vitamin B12 status. PMID- 3662712 TI - Patients who refuse treatment in medical offices. AB - Five hundred sixty-two consecutive patient visits to a medical office were prospectively evaluated for the presence of ethical problems. During 23 (4.0%) visits, patients refused recommended medical intervention. Refusal was defined as the rejection of preventive health measures, diagnostic evaluation, hospitalization, and other office procedures. Preventive health measures, vaccinations, and cancer screening were the most common types of intervention refused (n = 10). Diagnostic studies, such as roentgenograms, biopsies, and cardiac stress testing were also commonly refused (n = 9). The reasons for the refusal included psychologic factors, such as fear and anxiety, previous "bad" experiences with the recommended intervention, distrust of physicians, and problems of communication. Fourteen patients suffered no major consequences from their refusal, five of whom were seen twice during the study. Five patients had a delayed diagnosis and one patient died of a myocardial infarction after refusing hospitalization for unstable angina. PMID- 3662713 TI - Management considerations in treating metabolic abnormalities associated with theophylline overdose. AB - We treated a patient who intentionally overdosed with theophylline complicated by metabolic disturbances. Management of the patient's hypokalemia with moderate doses of potassium chloride resulted in hyperkalemia with associated electrocardiographic changes. The rapid clearance of theophylline due to the administration of oral activated charcoal was believed to be a contributing factor. It is likely that theophylline-induced hypokalemia is due to intracellular sequestration of potassium and that as the theophylline level decreases potassium will reequilibrate out of the cell. The case provides support for the conservative management of metabolite abnormalities associated with theophylline overdose. PMID- 3662714 TI - Plasmacytoma of the breast. An unusual case of recurrent myeloma. AB - An unusual case of multiple myeloma is presented in which recurrence of the disease after a four-year remission was heralded by an infiltrating plasmacytoma of the breast. The clinical and histologic features of this neoplasm are presented and compared with ten previously reported cases of plasmacytoma of the breast. PMID- 3662716 TI - Diazepam labeled nephrotoxin based on one case. PMID- 3662715 TI - Beliefs about osteoporosis. PMID- 3662717 TI - Serious side effect of nifedipine. PMID- 3662718 TI - Discrepancies between the calculated digoxin clearance and the serum digoxin level in elderly patients. PMID- 3662719 TI - Reappraisal of the United Kingdom epidemic of fatal asthma. PMID- 3662721 TI - Disseminated gonococcal infection in elderly patients. PMID- 3662720 TI - Rifampin drug interactions. PMID- 3662722 TI - Hearing and functional assessment of the elderly. PMID- 3662723 TI - Enhanced bleeding with cefoxitin or moxalactam: statistical analysis within a defined population of 1493 patients. PMID- 3662725 TI - [Biological significance of the separation of intravesicular porphyrins of the metacestode of Taenia solium by thin layer chromatography and electrophoresis]. PMID- 3662724 TI - [Quantification of estrogen receptors in meningiomas]. PMID- 3662726 TI - The sensory process in man: its analysis by means of cortical and subcortical evoked potentials. PMID- 3662727 TI - [Scanning and transmission electron microscopic observations on the stroma of the rat adenohypophysis]. PMID- 3662728 TI - [Unfocused CO2 laser irradiation of rat osteoblasts cultured in vitro]. PMID- 3662729 TI - Effects of microinjection of a cholinergic agonist into the locus coeruleus on the gain of vestibulospinal reflexes in decerebrate cats. AB - 1. Experiments were performed in precollicular decerebrate cats to determine whether activation of locus coeruleus (LC) neurons elicited by local injection of the cholinergic agonist carbachol modifies the dynamic characteristics of responses of forelimb extensors to selective stimulation of labyrinth receptors resulting from roll tilt of the animal. 2. Injection of 0.1-0.4 microliter (usually 0.25 microliter) of carbachol at a concentration of 0.02-0.1 micrograms/microliter of sterile saline into the LC of one side, which slightly increased the tonic contraction of limb extensors ipsilateral to the side of the injection, greatly decreased the amplitude of the multiunit EMG response of the ipsilateral triceps brachii to animal tilt at 0.15 Hz, +/- 10 degrees. Correspondingly, the response gain of this forelimb extensor decreased. Moreover, a significant increase in phase lag of the responses was observed. These findings did not result from the increased postural activity, since they were still observed when the limb position was adjusted so that the spontaneous EMG activity remained constant throughout the experiments. 3. The changes in posture as well as in response characteristics of the forelimb extensor to labyrinth stimulation produced by carbachol injection appeared a few min after the injection and soon reached a plateau level which persisted for several hours before returning to the control levels. 4. The effects described above involved mainly, if not exclusively, the limbs ipsilateral to the side of the injection. However, the effects of local injection into the LC of one side could be reproduced on the contralateral side following injection into the LC of that side. 5. The increase in phase lag of the multiunit EMG responses of the triceps brachii to labyrinth stimulation appeared at a threshold lower than that required to decrease the response gain of this extensor muscle. These findings suggest that different neuronal populations within the LC complex, one projecting directly to the spinal cord, the other projecting indirectly through the pontine reticular formation, are involved in the control of phase angle and gain of the vestibulospinal reflexes, respectively. However, as soon as the threshold was reached the effects described above were dose-dependent. 6. Histological controls indicated that the structure responsible for the postural and reflex changes described above corresponded to the LC. In fact, postural and reflex changes opposite in sign to those described above were obtained when the same amount of carbachol was injected into the dorsal aspect of the pontine reticular formation (pRF) located immediately ventral to the LC.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3662730 TI - Spontaneous and conditioned behavior of Wistar and Long Evans rats. AB - Spontaneous behavior (locomotion, feeding, drinking, and exploration in a two box apparatus) as well as conditioned behavior (passive and active avoidance responding, and freezing in the light-dark box apparatus) were studied in naive male Wistar and Long Evans rats. Concerning spontaneous behavior, Long Evans rats were more active during both light and dark periods, and showed better exploratory performance than Wistar rats. Concerning conditioned behavior, Long Evans rats acquired and retained better active and passive avoidance responses, and exhibited longer initial freezing than Wistar rats in the range of 0.6-1.4 mA footshocks. The results better define the important behavioral differences existing between the two strains, Long Evans rats showing consistently a higher level of alertness and a better conditioned performance. PMID- 3662731 TI - Effects of microinjection of cholinergic agonists into the pontine reticular formation on the gain of vestibulospinal reflexes in decerebrate cats. AB - 1. The question of which pontine neuronal groups and related receptors can mediate the cholinergic induction of the increased gain of vestibulospinal reflexes elicited by sinusoidal stimulation of labyrinth receptors was investigated by injecting in precollicular decerebrate cats either carbachol, which is a mixed muscarinic-nicotinic agonist, or bethanechol, which is a pure muscarinic agonist, via a cannula stereotaxically oriented in different pontine tegmental structures. 2. Injection of 0.1-0.2 microliter of carbachol solution (0.01-0.2 microgram/microliter of sterile saline) into the dorsal aspect of the pontine reticular formation (pRF), which slightly decreased the tonic contraction of limb extensors ipsilateral to the side of the injection, greatly increased the amplitude of the multiunit EMG response of the ipsilateral triceps brachii to roll tilt of the animal at 0.15 Hz, +/- 10 degrees, leading to selective stimulation of labyrinth receptors. Correspondingly, the response gain of the forelimb extensor to labyrinth stimulation increased. Moreover, a slight decrease in phase lead of the responses was observed. These findings were not attributable to decreased postural activity, since they were still observed when postural EMG activity was reflexly maintained by an increased static stretch of the muscle. No changes in the dynamic characteristics of the responses were observed in the contralateral triceps brachii. 3. The changes in posture as well as in response gain produced by the carbachol injection appeared suddenly, but partially declined to reach a plateau level which persisted for several hours before returning to the control level. Moreover, the magnitude of the effects increased in relation to the dose of the cholinergic agonist. 4. Histological controls indicated that the structure responsible for these postural and reflex changes was located in the dorsal aspect of the pontine tegmentum immediately ventral to the principal locus coeruleus (LC); this area corresponds to the peri-LC region and the surrounding pRF including the dorsal aspect of the central tegmental field. The effects were still obtained after chronic kainic acid lesioning of the gigantocellular area of the medulla. 5. An increase in gain of the vestibulospinal reflex which was as potent, dose-dependent, and site-specific as that previously observed with carbachol, appeared after injection of the pure muscarinic agonist bethanechol.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3662732 TI - [The Stockholm syndrome. On the psychological reaction of hostages and hostage takers]. AB - The Stockholm Syndrome seems to be an automatic, probably unconscious emotional response to the traumatic experience of being a victim. It affects hostage and hostage-taker alike and serves to unite both, being victims of the siege environment, against outsiders. This positive emotional bond between victim and subject is a defense mechanism of the ego under stress. The priority in dealing with hostage situations is the survival of all participants. The Stockholm Syndrome may save the life of victim and subject alike, as it reduces the subjects tendency towards violence and thus the possible necessity for a seizure by the security forces. PMID- 3662733 TI - [Criteria for differentiating self- or other-inflicted injuries of alleged or real victims]. AB - A synoptic study of six cases of self-inflicted sharp force injuries is presented, where young, mostly female people had simulated assaults to gain sympathy or other personal advantage. The morphological distinctives of simulated assault wounds from such of real assault are worked out and the common situative and motivative background is cleared up. PMID- 3662734 TI - [Possibilities of priority diagnosis in skull gunshot wounds]. PMID- 3662735 TI - [Ultrastructural differences of fibrin coagulation before and after cardiovascular arrest]. AB - The reconstruction of killing offences often requires the differentiation between vital and postmortal blood traces at the sites of action and finding. Earlier investigations seemed to imply the possibility of such a differentiation depending on the different clot structure. We therefore examined clots prior and after 10 minutes of complete occlusion of the upper extremity morphologically and morphometrically with the REM. The morphologic comparison of these clots revealed narrow, round shaped fibrin fiber networks for clots of native blood, whereas clots after occlusion showed linear, rarely connected long fibrin fibers. The morphometry of the fibrin free spaces revealed a significant enlargement of the single fibrin free spaces as well as of the total fibrin free space after occlusion. For capillary blood a significant decrease in fiber diameter was observed after occlusion. The examination of clinical clotting parameters revealed alterations of thrombocyte aggregation for the collagen induction, a slightly reduced thrombocyte retention and slightly steeper flanks in the thromboelastogram after occlusion. The reason for these changes was interpreted as lack of high energetic phosphates in the retraction process as the clotting cascade itself requires a very high amount of these phosphates. Use of these results in the forensic practice will have to take factors as temperature, drying out, surface-structure and many others into account. PMID- 3662736 TI - [Our experience with the diagnostic value with the dexamethasone suppression test in 100 cases of affective and non-affective mental disorders]. PMID- 3662737 TI - [Increased response of lactic acid to ischemic muscle contraction in chronic alcoholism]. PMID- 3662738 TI - [Experimental hydrocephalus. Morphologic and ultrastructural study of the choroid plexus]. PMID- 3662739 TI - [Morphologic variants of the somatosensory cortical evoked potentials of normal median and peroneal nerves]. PMID- 3662740 TI - [Myasthenia gravis associated with penicillamine treatment]. PMID- 3662741 TI - Children of depressed parents. Increased psychopathology and early onset of major depression. AB - Data on the psychiatric diagnosis, overall functioning, and treatment of 220 6- to 23-year-old subjects who were at high or low risk for major depression are presented. The subjects' diagnoses were made by a child psychiatrist based on best-estimate evaluation of diagnostic information derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Epidemiologic Version) with the subjects and separately with their mothers about their children. The major findings were an increased overall prevalence of major depression and substance abuse, psychiatric treatment, poor social functioning, and school problems in the children of depressed proband parents compared with children of normal proband parents. Overall prepubertal depression was uncommon and the sex ratios were equal. After 12 years of age, there was an increasing preponderance of female subjects in the group with major depression. The mean age at onset of major depression was similar for male and female subjects. However, it was significantly earlier in the children of depressed probands (mean age at onset, 12 to 13 years) compared with the children of normal probands (mean age at onset, 16 to 17 years). Symptom profiles and additional types of diagnoses in the depressed children from either proband parent group did not differ. These children are being followed up longitudinally to determine the prognostic significance, persistence, recurrence, and recall of their symptoms. Several research and clinical strategies are suggested by these data. PMID- 3662742 TI - The clinical picture of major depression in children and adolescents. AB - Symptom frequency and severity were compared in two sequential clinically referred samples of 95 children and 92 adolescents, aged 6 to 18 years, all medically healthy, assessed with the Schedule for Affective Disorders and Schizophrenia for School Age Children, Present Episode, who met unmodified Research Diagnostic Criteria for major depressive disorder (MDD). There were no significant differences between the two groups in the majority of depressive symptoms. However, prepubertal children had greater depressed appearance, somatic complaints, psychomotor agitation, separation anxiety, phobias, and hallucinations, whereas adolescents had greater anhedonia, hopelessness, hypersomnia, weight change, use of alcohol and illicit drugs, and lethality of suicide attempt, but not severity of suicidal ideation or intent. Adolescents with a duration of the depressive episode of two years or greater had significantly higher rates of suicidal ideation and intent, lethality, and number of suicide attempts than youngsters with depressive episodes of shorter duration. A principal components factor analysis of psychiatric symptoms was carried out in all 296 youngsters evaluated during the same period who met DSM-III criteria for any Axis I diagnosis. The majority had an affective disorder. Factors were quite similar for both adolescents and children and included an "endogenous" and an "anxious" factor, as in many studies of adult depression. In addition, three other factors were found: negative cognitions, appetite and weight changes, and a conduct factor. Suicidal ideation was a component of both the negative cognitions factor and the conduct factor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662743 TI - Suicide in subtypes of major affective disorder. A comparison with general population suicide mortality. AB - We investigated the risk of suicide among 705 patients with primary unipolar depression, 302 patients with secondary unipolar depression, and 586 patients with bipolar affective disorder (BAD). The suicide rates among the study subjects were compared with that of the general population of Iowa, the area from which the subjects were selected. An increased risk of suicide was found in all psychiatric groups, except the group of female patients with BAD, which was associated with a lower risk of suicide than unipolar disorders. Thirty suicides (73.2%) occurred during the first two years of follow-up; this trend was particularly pronounced in female patients with primary unipolar depression and male patients with BAD. PMID- 3662744 TI - Clinical features of illness in siblings with schizophrenia or schizoaffective disorder. AB - Evidence implicating genetic or prenatal-perinatal environmental causes in the familial aggregation of schizophrenia led us to study 53 sets of siblings, two or more of whom had chronic psychosis, either schizophrenia or schizoaffective disorder. We looked for similarities in clinical features and concordance of diagnosis within sibships to test for shared familial causes. Clinical variables, including diagnosis, specific symptoms, age at onset, and nongenetic perinatal factors, were studied. Auditory hallucinations, paranoid delusions, thought disorder, negative symptoms, and poor premorbid social adjustment did not significantly correlate in siblings. Concordance was found for schizoaffective disorder and history of major depressive episodes, suggesting that schizophrenia with a depressive component and Research Diagnostic Criteria schizoaffective illness may represent a specific etiologic subtype(s) of the illness, whereas the other noted symptoms may represent the variable expression of the disorder. Age at onset and at first hospitalization were significantly correlated, consistent with genetic or other familial factors on time of onset. Birth complications were significantly more frequent among the schizophrenic compared with non-psychotic siblings, had a familial component, and tended to be associated with an earlier age at onset. Thus, nongenetic perinatal factors may increase the risk for schizophrenia in a familial form of the illness and contribute to the correlation of ages at onset in siblings. PMID- 3662745 TI - Noradrenergic function in schizophrenia. AB - Yohimbine, an alpha 2-adrenergic receptor antagonist that increases noradrenergic function, was administered to 16 healthy subjects and 18 drug-free schizophrenic patients with (n = 10) and without (n = 8) tardive dyskinesia (TD). Outcome measures of this double-blind, placebo-controlled study included changes in behavior, plasma 3-methoxy-4-hydroxy-phenylglycol (MHPG) level, blood pressure, and heart rate. A subgroup of six patients experienced a notable dysphoric arousal reaction that occurred 60 to 90 minutes following administration of 20 mg of yohimbine, this reaction was not observed in healthy subjects. The schizophrenic group as a whole (not the subgroup) showed a statistical trend toward a greater yohimbine-induced increase in plasma MHPG level and systolic sitting blood pressure. The patients with TD did not differ from those without TD or from healthy controls in their response to yohimbine. These results do not support the hypothesis that noradrenergic dysfunction plays a strong central role in the pathogenesis of schizophrenia or TD. However, further studies of noradrenergic dysfunction in sub-groups of patients with schizophrenia are indicated. PMID- 3662746 TI - The evening urine cortisol excretion test in depression. PMID- 3662747 TI - Seasonal dexamethasone suppression test results. PMID- 3662748 TI - Importance of timing and duration of phototherapy. PMID- 3662749 TI - A transmission electron microscopic study of rabbit liver sinusoids with special remarks on an experimentally induced canalicular system and the "pored domes" in the endothelial cells. AB - Rabbits were starved for a week and then allowed to take the standard diet; the animals were sacrificed after 20 or 24 hr. One group of the animals were treated in winter, and the other, in summer. Control animals were fed solid rabbit food ad libitum. In the control rabbits, short rudimentary canaliculi and occasional small-sized pored domes were found in the thicker portions of the endothelial extension. In the animals experimentally treated in winter, well-developed meandering canaliculi with vacuolar expansions and constrictions appeared in the thicker portions and perikaryonal cytoplasm. In addition prominent pored domes were produced. The canaliculi often formed sponge-like networks with openings both to the sinusoid and the Disse's space. The development of the canalicular system and pored domes correlated to an increased blood flow through the sinusoids; this seemed to be induced upon sudden feedings after lengthy starvation. The rabbits subjected to the experimental treatment in summer exhibited no distinct development of the canaliculi and pored domes. This result was ascribed to the inhibited functions of the rabbit liver during this season. PMID- 3662750 TI - Nerve regeneration through cryo-treated xenogeneic nerve grafts. AB - Cryo-treated nerves whose Schwann cells had been killed by repeated freezing and thawing were xenogenically grafted into sciatic nerves from rats (Wistar, as donor) to mice (ddy strain, as recipient) to examine whether Schwann cell basal lamina tubes of cryo-treated xenogeneic grafts were effective conduits for regenerating axons. For comparison and evaluation of the effectiveness of this technique, experiments using grafts without the cryo-treatment were carried out. Cells in cryo-treated xenografts degraded into cell debris immediately after grafting and then were phagocytized by macrophages. After the cellular components had been removed from the graft, Schwann cell basal laminae remained intact in situ, serving as conduits for the regenerating axons. The process of nerve regeneration was almost the same as that observed in cryo-treated auto- and allografts, except that the regeneration was slightly delayed in the xenogeneic graft. In contrast, an extensive cell infiltration occurred in the non-treated grafts. It appeared that the donors Schwann cells in the graft deteriorated due to immunological reactions and were finally eliminated by macrophages, leaving their basal laminae undamaged in situ. The initiation of nerve regeneration including perineurial sheath formation in non-treated grafts was, therefore, significantly delayed, but once begun, it proceeded in the same manner as in the cryo-treated grafts. These findings strongly indicate that Schwann cell basal laminae can serve as effective pathways for regenerating axons even in the xenograft. Moreover, cryo-treated xenogeneic grafts are more desirable than non treated ones, since dead Schwann cells in the former can be removed in the early period (4-14 days) from the graft without causing any immunological reaction, thus resulting in the facilitation of nerve regeneration. PMID- 3662751 TI - Interrelationships between germ cell differentiation and transformation of basolateral profile of Sertoli cells during rat spermatogonial cycle. AB - After treatment with either trypsin, 8N HCl or 5N KOH, or with mechanical dissociation, normally hidden aspects of the seminiferous epithelium were exposed to observation by scanning electron microscopy (SEM). These included the basal surface of seminiferous epithelial cells, the basolateral processes of the Sertoli cell, junctions of the processes, and the basal or adluminal recesses. With the progressing stages of the spermatogonial cycle, three kinds of spermatogonia show different profiles and topographic relations. The basolateral processes of the Sertoli cells can be categorized into four types: conical, wedge shaped, sheet-like and cup-shaped processes. The first two of the basolateral processes are joined together by close contact and/or overlapping junctions to form the floor of the basal recesses, and they encircle small-sized spermatogonia. The sheet-like processes mutually join by seam line junctions to form the ceiling of the basal recesses. During the spermatogonial cycle, the basal recesses first appear as separated lacunae, then form continuous labyrinth like trenches, and finally make complicated honeycomb-like lacunae. The cup shaped processes also are joined by close contact and/or overlapping junctions and are tightly attached by the primary spermatocytes with doughnut-like or linear bodies. The cordal arrangement and adluminal shift of the diverse spermatogonia will be discussed along with the cyclic transformations of Sertoli cell processes and their junctions. PMID- 3662752 TI - Appearance of microglial cells in the postnatal rat retina. AB - The development of microglial cells in the postnatal rat retina is described using histochemical techniques for acid phosphatase and peroxidase as well as silver impregnations for microglia. On the second postnatal day, round acid phosphatase-positive macrophages appeared on the vitreal surface of retina, locating themselves close to developing blood vessels. Later, microglial precursors invaded retinal tissues, reaching the outer plexiform layer by the tenth postnatal day. In all stages studied, microglia or their precursors were peroxidase-negative. The transformation of round microglial precursors into adult ramified microglia is also described. Owing to the relation found between developing microglia and blood vessels, a vascular origin is proposed for the retinal microglial cells. PMID- 3662754 TI - A scanning electron microscope study on the autonomic groundplexus in the lamina propria mucosae of the guinea-pig small intestine. AB - The occurrence and fine structure of the autonomic groundplexus in the lamina propria mucosae of the guinea-pig small intestine were studied by scanning electron microscopy after removing connective tissue elements by maceration in hydrochloric acid. Transmission electron microscopy was also performed to investigate the fine structure of the neuronal and glial elements in the autonomic groundplexus. Nerve fasciculi consisting of neuronal processes and enteroglial cell sheaths formed a three-dimensional network intercalated between blood and lymph vessels. Processes of enteric neurons ran within the enteroglial cell framework. No blind ends of nerve fasciculi were found. Terminal varicosities of neuronal processes were frequently exposed on the surface of the nerve fasciculi. The locations of these naked varicosities may represent the sites of interaction between the enteric neurons and their target tissues. PMID- 3662753 TI - An immunohistochemical study of the endocrine cells in the gastrointestinal mucosa of the Caiman latirostris. AB - Twelve endocrine cell types immunoreactive for either 5-hydroxytryptamine (5-HT), somatostatin, gastrin, motilin, neurotensin, bovine pancreatic polypeptide (BPP), avian pancreatic polypeptide (APP), pancreatic glucagon, enteroglucagon, glicentin, secretin or cholecystokinin (CCK) were found in gastrointestinal mucosa of Caiman latirostris. Moderate numbers of enteroglucagon-immunoreactive cells, a few 5-HT-, somatostatin- and motilin-immunoreactive cells and rare pancreatic glucagon-immunoreactive cells were found in the fundic stomach. Numerous gastrin-immunoreactive cells and moderate numbers of somatostatin- and motilin-immunoreactive cells were seen in the pyloric stomach. Moderate numbers of 5-HT-, gastrin-, motilin- and enteroglucagon-immunoreactive cells, a few somatostatin-, neurotensin- and BPP-immunoreactive cells, and rare APP-, pancreatic glucagon-, glicentin-, secretin- and CCK-immunoreactive cells were observed in the proximal intestine. Moderate numbers of 5-HT-immunoreactive cells, small to moderate numbers of neurotensin- and enteroglucagon immunoreactive cells and occasional somatostatin-, motilin- and BPP immunoreactive cells were seen in the distal intestine. Moderate numbers of neurotensin-immunoreactive cells and a few 5-HT-immunoreactive cells were found also in the cloaca. Cells immunoreactive for gastrin releasing polypeptide, bombesin and gastric inhibitory peptide were not observed in the caiman gastrointestinal epithelium. The differences in endocrine cell types between the caiman and alligator are discussed in terms of their topographic distribution. PMID- 3662755 TI - Electron microscopic study on the hepatic sinusoidal wall of the soft-shelled turtle (Amyda japonica) with special remarks on the smooth muscle cells. AB - The hepatic sinusoids of the soft-shelled turtle (Amyda japonica) were examined by transmission electron microscopy. The sinusoidal wall was composed of endothelial cells, Kupffer cells and Ito cells. The basal surface of the hepatocyte facing the Disse's space was covered by a continuous basal lamina. In addition to the Ito cells, the Disse's space contains a considerable number of smooth muscle cells. Many of these were distributed sporadically, while others appeared as a sphincter circling the sinusoid. The smooth muscle cells in the Disse's space showed the following features: 1) The nucleus was located eccentrically near one end of the cell. 2) The surface vesicles and pits, mitochondria and dense patches along the myofilament bundles were all sparse as compared with those known from mammalian smooth muscle cells. 3) Cytoplasmic processes or ruffles were protruded into the Disse's space. 4) A weak basal lamina could be recognized. Sinusoidal endothelial cells were characterized by many large electron lucent lysosomes in their perikaryon and by small fenestrae in their attenuated cytoplasm. Ito cells sending out several cytoplasmic processes, possessed a single large lipid droplet on one side of the nucleus. A single cilium budding from the distal centriole into the Disse's space was found in an Ito cell. Extrasinusoidal macrophages were considerably numerous in the soft-shelled turtle liver. Some of the macrophages were apparently migrating into the sinusoid, there to presumably transform into the Kupffer cells. PMID- 3662756 TI - Mucus release of surface mucous cells of the mouse stomach with special reference to cell maturation stages and dietary conditions. AB - The secretory activity of surface mucous cells was quantitatively studied in the mouse stomach under three different dietary conditions: ad libitum feeding, fasting for 15 hrs, and refeeding 1 hr after 15-hrs fast. Surface mucous cells were classified into isthmus cells, foveolar cells, surface cells and degenerating cells according to stage of maturation. The number of exocytosis and cytoplasmic granules was calculated in unit length of the apical plasmalemma for cells in each stage. Foveolar and surface cells in fasted animals manifested higher exocytotic activity than the other two groups (P less than 0.01). This suggests that physical and chemical stimuli of the gastric content may greatly affect the secretory activity of the cell. Although the number of cytoplasmic mucous granules proved largest in the upper part of the foveola and less at the mucosal surface under any dietary condition, exocytotic activity did not differ significantly between the foveolar cells and surface cells. Degenerating cells very actively discharged mucus, regardless of dietary condition. It is reasonable to postulate that the cells secrete mucus in order to cover the surface and protect the mucosa from damage during degeneration. PMID- 3662757 TI - Correlated histochemical and electron microscopic studies of the esophageal epithelium in the salamander, Hynobius nebulosus. AB - The esophageal epithelium of the adult salamander, Hynobius nebulosus, was studied by histochemistry, including periodic acid-Shiff (PAS), alcian blue both at pH 2.5 and pH 1.0, and alcian blue (pH 2.5)-PAS with or without neuraminidase digestion, and scanning and transmission electron microscopy. The epithelium was columnar in type, comprising partly pseudostratified and partly two-layered architecture; it consisted mainly of ciliated cells, goblet cells, and basal cells. The ciliated cells consisted of two types, light and dark: both types, especially the latter, frequently contained numerous small mucous granules in their apical portion. Ciliated-mucous cells were also occasionally present. Immature ciliated cells were frequently found. Goblet cells were divided into two types: Type I cells possessed electron lucent mucous granules, which frequently contained dense specific inclusions, and frequently bulged into the lumen; Type II cells had moderately electron-dense mucous granules with no inclusions and a conical apex which did not exceed the level of the lumen. The Type I cells were closely distributed throughout the esophagus, while the Type II were mainly dispersed in the cranial portion, remarkably decreasing in the caudal portion. Correlated histochemical and electron microscopic observations suggested that, in the Type I cell, mucous granules contain acid mucosubstances, while in the Type II, they possess neutral mucosubstances, and that in the Type I cell mucous granules consist of sialic acid-containing glycoproteins and their swollen portions are more highly sulfated than the non-swollen ones. PMID- 3662758 TI - The vasculature of the guinea-pig thymus: topographic studies by light and electron microscopy. AB - The three-dimensional vascular distribution and the vascular-parenchymal relationship in normal guinea pig thymus were studied by light, scanning and transmission electron microscopy. Interlobular arteries arising from one thymic artery entered the thymic parenchyma where they branched into arterioles and then formed capillary networks in the cortex and in the medulla. Most cortical capillaries drained to the surface via perpendicular venules which merged into the subcapsular veins. Some vessels of the inner cortex, however, returned blood to the postcapillary venules (PCVs) at the cortico-medullary junction and in the medulla. The vascular supply of the guinea pig thymus is thus characterized by a dual circulation in which venous blood drains either via a subcapsular or via a cortico-medullary route. The endothelium of the postcapillary venule (PCV) was flat and often contained migrating lymphocytes. These venules were surrounded by a perivascular space (PVS) which separated the vessel from the parenchyma and which contained many lymphocytes. This PVS was not lined by cells but was delimited on one side by the abluminal surface of the venular endothelium and on the other side by a thin, sheet-like layer formed by cytoplasmic processes of epithelial reticular cells. This epithelial sheet was not continuous, as there were frequent interruptions or gaps where the PVS communicated directly with the intercellular mesh of the thymic parenchyma. The PVS did not form a continuous longitudinal channel but was interrupted by epithelial trabeculae. Some macrophages and a few plasma cells were seen in the parenchyma near the PVS. These findings suggest that the PCV and the PVS in the thymus may function as pathways for the migration of lymphocytes into or out of the blood circulation. PMID- 3662759 TI - Myocardial lesions and the alteration of atrial granularity in dystrophic mice. AB - Atria from dystrophic and non-dystrophic mice were examined by light and electron microscopy. Particular attention was paid to the granularity of the specific atrial granules and the development of the Golgi apparatus. At the light microscopic level, both a decrease in number and degenerative changes were recognized in the atrial cardiocytes, which were intercalated by increased connective and adipose tissues. At the electron microscopic level, the dystrophic atrial cardiocytes showed a variety of degenerative changes and a decreased number of granules; the impaired development of the Golgi apparatuses were noticed. A quantitative analysis revealed that the number of the granules per unit area in dystrophic cardiocytes was significantly smaller in both the right and left atria, and that the relative area occupied by the Golgi fields of the dystrophic was significantly smaller in the right atrium than in non-dystrophic controls. These findings indicate that the synthesis of atrial natriuretic polypeptide (ANP) is inhibited in dystrophic mice. It is suggested that the water and electrolyte imbalance known in dystrophic cases can be accounted for by the impaired secretion of ANP in the heart. PMID- 3662760 TI - Three-dimensional structures of the connective tissue papillae of the tongue in newborn dogs. AB - Connective tissue papillae underlying epithelial cell layers of the lingual papillae of newborn mongrel dogs were exposed by long term hydrochloric acid treatment and observed by scanning electron microscopy. Each of the filiform papillae of ovoid shape (100-130 microns in diameter) contained a connective tissue papilla representing a smaller elliptical protrusion (90-100 microns in length, 70-80 microns in width). Its overview showed a horse-shoe shaped, opening anteriorly. Its posterior curvature projected a conical node with a rounded apex. Each of the fungiform papillae (150 microns in diameter) contained a connective tissue papilla of rounded shape (100 microns in diameter) whose upper surface was facetted with several slight depressions. The entire surface of the connective tissue papillae was found to be covered by networks of collagenous fibers of varying thickness, running in various directions. The basal surface of the epithelium revealed regularly distributed round holes that corresponded to the connective tissue papillae. In the filiform papillae, a small elliptical bulge was seen on the anterior side of each hole. Light microscope observation indicated that the anterior column of the filiform papillae contained a granular layer with moderate keratohyaline granules, whereas the posterior column did not show such a granular layer. PMID- 3662761 TI - The first report of the occurrence of cilium in fat-storing cells in the reptilian liver (Eumeces algeriensis, Daudin 1802). AB - Fat-storing cells in the liver of an adult Schneider's skink were investigated by means of transmission electron microscopy. The fat-storing cells were localized in the perisinusoidal space or in the hepatic "recessus". They revealed a single cilium originating from one of the paired centrioles and projecting into the perisinusoidal space. The functional significance of a single cilium in the fat storing cell is still unclear. PMID- 3662762 TI - Teaching pathology and laboratory medicine. PMID- 3662763 TI - Mesenteric cyst-ovarian implant syndrome. PMID- 3662764 TI - Review of proficiency testing performance of laboratories accredited by the College of American Pathologists. AB - The Commission on Laboratory Accreditation of the College of American Pathologists (CAP), Skokie, III, monitors the proficiency testing of accredited laboratories by regular review of the Cumulative Survey Management Report. Analytes are targeted for review on the basis of repeated "unacceptable" results in the CAP Survey Program. Approximately 1% of proficiency testing results are repeatedly graded unfavorably. Directors of 271 Great Lakes Region laboratories reported the causes of and the corrective actions taken for 583 targeted results over a two-year period. Targetting of results in 31% was attributed to methodologic or instrumentation problems, 19% to technical performance factors, and 27% to clerical errors. Only 3% were ascribed to the Survey materials or to the criteria used for grading, and 20% of the problems remained unexplained after investigation. There was improvement in 496 (88%) of 583 targeted. During the study period, results from 96% of laboratories showed improved performance for all or a majority of the targeted analytes. PMID- 3662765 TI - Acquired immunodeficiency syndrome and the clinical laboratory worker. PMID- 3662766 TI - Histiocytic necrotizing lymphadenitis of Kikuchi and Fujimoto. PMID- 3662767 TI - The undergraduate pathology curriculum revisited. PMID- 3662768 TI - Pathology of the spleen in the acquired immunodeficiency syndrome. AB - The pathologic findings of the spleen at autopsy in 101 patients with the acquired immunodeficiency syndrome are described. Grossly visible lesions were present in 52 patients. Microscopically, the histologic patterns of red and/or white pulp could be classified into five groups: group 1, in white pulp only, was characterized by lymphoid depletion; group 2, in red or white pulp, by a proliferation of histiocytes; group 3, in red or white pulp, by a plasma cell/immunoblastic reaction; group 4, in red or white pulp, by a mixture of cells in malpighian corpuscles or trabeculae without significant proliferation or depletion; and group 5, in red pulp only, by packed cords with empty sinuses. These patterns of reaction could be correlated with infectious agents. Disseminated opportunistic infections involved the spleen in 27 cases; of these, the red pulp had a histiocytic or mixed pattern in 89%, and the white pulp showed lymphoid depletion in 52%. Other lesions, including neoplasms in five patients, did not predominate in any group. Splenic opportunistic infections in acquired immunodeficiency syndrome may correlate with histologic patterns of reaction and give an indication of immune response. PMID- 3662769 TI - Bronchial granular cell tumor. Presentation of three cases with tissue culture and ultrastructural study. AB - Three granular cell tumors, two arising from the bronchi and one from the trachea, are described. Two of the cases were studied by tissue culture and electron microscopy of the original tumor tissue and the cultivated cells. The granular cells grew actively in culture and showed a specific pattern in vitro different from tumors of fibrohistiocytic and schwannian origin. Ultrastructural examination of the newly grown cells allowed follow-up of the progressive cytoplasmic granulation of cells, with a transition from elements with an ultrastructural morphology consistent with the "early granular cells" described in tumor tissue in previous studies to fully developed mature granular cells. PMID- 3662770 TI - Intrapulmonary thymoma. AB - A 50-year-old man presented with a lung mass in the left upper lobe, which was shown by electron microscopy to be a thymoma. There was no evidence of a mediastinal mass. The lymphocytes of the tumor reacted with monoclonal antibody T101, a pan T-cell marker, and with OKT8. B1 and B2 surface antigens characteristic of B lymphocytes were not detected. Tumors of thymic epithelial cells completely covered by pleura without mediastinal involvement are rare. PMID- 3662771 TI - Leiomyosarcoma of the inferior vena cava. AB - A 61-year-old woman with symptoms of inferior vena caval obstruction was investigated with computed tomography and ultrasound imaging and found to have a tumor of the inferior vena cava. Transvenous biopsy revealed a leiomyosarcoma, which at surgical exploration was considered to be unresectable. Autopsy showed that the tumor extended form its origin in the inferior vena cava just above the left renal vein to the right atrium. Hepatic metastases were documented. This rare tumor has seldom been diagnosed prior to exploratory surgery or necropsy and should be included in the differential diagnosis of inferior vena caval obstruction. The case illustrates the relative ease and efficacy of transvenous biopsy in establishing this diagnosis antemortem. PMID- 3662772 TI - The pathology curriculum in US medical schools. 1986 survey by the Association of Pathology Chairmen. AB - Responses to questionnaires on teaching pathology to medical students from 71.6% of US medical schools indicate the following: (1) average class size continues to decrease; (2) in very few schools is instruction entirely interdisciplinary; (3) use of small-group teaching has increased slightly since 1982; (4) average curriculum time remains 250 hours per year; (5) clinical pathology instruction is frequently integrated with systemic pathology (mean time allocation, 40 hours per year); (6) lecture and study of gross and microscopic specimens remain mainstays of instruction; (7) honors/pass/fail grading systems are used by 54.7% of respondents (none use class rank); (8) multiple-choice examinations are a major method of evaluation; (9) graduates seeking post-medical degree training in pathology range from 0% to 6% of each class (mean, 2.13%); and (10) problems most often encountered are that there are too many students per class, and that students are unprepared for pathology. PMID- 3662773 TI - Synthesis of new 3-(pyridin-6-yl)pyrazolo[1,5-a]pyrimidines. PMID- 3662774 TI - Crystal and molecular structure of 2-[N-allyl-N-(2,6-dichlorophenyl)amino]-2 imidazoline hydrobromide. PMID- 3662775 TI - [Ecdysone from roots and seeds of Helleborus species]. PMID- 3662776 TI - [Amino acids. 8. Peptide synthesis with (+-) 5-hydroxy-2-pyridylglycine ((+-) pyg (5-OH)), a new heterocyclic substituted amino acid]. PMID- 3662777 TI - [Contents of tropical medicinal plants. 29. Synthesis of Annonidin B]. PMID- 3662778 TI - Overwork-induced axonal hypertrophy in the soleus nerve of the rat. AB - Effect of overwork, induced by synergistic tenotomy (bilateral tenotomy of the gastrocnemius and the plantaris muscles) of the soleus muscle, was evaluated on areas of the large myelinated axons (LMA) (greater than 19.5 micron 2), in the soleus nerve (the tibial nerve branch innervating the soleus muscle) of the rat. Three lots (n = 12-16) of young adult male (body weight of 275 to 325 g), Sprague Dawley rats were used. One lot of 16 animals was kept as normal, while the other two underwent bilateral L4 or L5 spinal nerve sectioning. Six to seven animals each from the normal, L4-, and L5 neurectomized animals underwent bilateral synergistic tenotomy of the soleus so that the soleus was retained as the sole plantar-flexor of the ankle joint. The remaining animals were kept as normal or neurectomized control groups. Thus, the six groups studied were normal control (n = 9); normal synergistically tenotomized (n = 7); L4 neurectomized control (n = 8); L4 neurectomized and synergistically tenotomized (n = 6); L5 neurectomized control (n = 8); and L5 neurectomized and synergistically tenotomized (n = 7). Seven days after surgery, the soleus muscles were used to evaluate the muscle weights. The soleus nerves were evaluated for the number plus areas of the LMA by computerized planimetric procedures. The data revealed a 13.9% (p less than 0.05) increase in areas of the LMA in the L5 neurectomized control group; whereas the L5 neurectomized and synergistically tenotomized group showed a 39.6% (p less than 0.01) increase in areas of the LMA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662779 TI - Heating rabbit joint by microwave applicator. AB - Heating the joint to high temperatures using a microwave device may inhibit metabolic activity of the synovial tissue and enable higher penetration of antiinflammatory drugs into the joint cavity. To measure the temperature distribution of local thermotherapy, the hind joints of eight rabbits were heated by a 915 MHz microwave power source, using a special applicator. Temperatures of 44.0 +/- 2.8C, 36.1 +/- 3.8C, 39.6 +/- 2.3C, and 35.2 +/- 1.5C were measured after heating in the joint cavity, cartilage, muscle, and skin, respectively. The only significant increase in the temperature was recorded in the heated joint cavity (p less than 0.01). This new microwave device can be a therapeutic tool in treating joint diseases because of its advantage of heating the target organ only, eg, synovium, while sparing the adjacent tissues. PMID- 3662780 TI - Interface pressures in above-knee sockets. AB - The interface pressures in above-knee sockets of amputee patients were measured during the stance phase of the gait cycle. The pressures were monitored with a pneumatic sensor array that covered the inside of the socket. A pressure map of the socket surface was developed. This map has been related to the fit of the prosthetic socket. The pressures generated by the quadrilateral socket and the Normal Shape Normal Alignment (NSNA) socket were compared. Significant variations were noted in pressure distribution between the two sockets, but the magnitudes of the pressures in well-fitting sockets of both types were similar. Thus, magnitude of pressure in an above-knee socket may provide a more useful guide than distribution for predicting the fit of an appliance. PMID- 3662781 TI - Forces and impulses during aided gait. AB - Walking aids stabilize, support, and restrain/propel the locomotion of a body with functional deficits due to musculoskeletal and neuromuscular disorders. The relative contribution of limbs and aids in these functions was quantified in three patient groups: those with postoperative total hip replacement (THR), tibial fracture, and paraplegia. Aid forces were recorded and resolved into three components. Floor-to-foot forces were measured anterior-posteriorly and vertically. Results were interpreted by temporal relationships between aids and limb, symmetry of restraining/propelling forces, and peak forces during limb and aid loading phases. Impulse values (area under the force-time curve), presented as histograms, readily demonstrated the contribution of aids and limbs to locomotion. Results showed (1) variability in aid loadings among THR subjects, and between ipsilateral and contralateral sticks; (2) symmetrical restraining and propelling aid loadings of fracture subjects; and (3) that aid impulses directed medially were greater than the combined anterior-posterior direction amounts in four of seven subjects performing three-point gait. It is suggested that this technique of quantifying aid usage by impulse histograms be used to evaluate and prescription and sizing, gait training, and crutch design. PMID- 3662782 TI - Reliability of the activities of daily living scale and its use in telephone interview. AB - Activities of daily living (ADL), a popular outcome assessment tool for studies of disabled populations, was evaluated for use in multicentered studies. The interobserver reliability of a modified Barthel Index of the ADL was evaluated on 18 stroke patients. Reliabilities between administrators of the ADL and between observers of the ADL administrations were r = .99 for total scores and r greater than .90 for most of the individual component items. The validity of ADL evaluation based on telephone interviews was demonstrated relative to ADL scores obtained on 72 patients in a direct test of their performance capabilities. The correlations between the performance-based ADL and the interview-based ADL were r greater than .97 for the total score and r greater than .85 for most of the individual items. The modified Barthel Index of the ADL is a reliable measure for assessing stable stroke patients, supporting its use in multicenter studies. In addition, the high validity observed in the telephone interview supports its use in longitudinal studies and large surveys where direct performance evaluation is not feasible or too costly. PMID- 3662783 TI - Prediction of stroke rehabilitation outcome from psychologic screening. AB - A psychologic screening battery, including assessment of perceptuomotor, attentional, memory, and emotional functioning, was presented to 134 patients at initiation of stroke rehabilitation. Significant differences in performance on tests based on side of involvement of stroke were noted. Poorer performance on sensory suppression errors and motor persistence score was found for individuals with left-side involvement and the opposite for word fluency score. Examining subjects with left- and right-side involvement separately using stepwise multiple regression, psychologic tests were able to account for 55% and 42%, respectively, of the variance in discharge outcome, as measured by the Barthel Index. Accounting for variance associated with change in Barthel Index score during rehabilitation proved more difficult, with R2 values of 0.14 and 0.07, respectively. Motor persistence score and half-hour recall proved to be the strongest of the psychologic tests in predicting rehabilitation outcome. PMID- 3662784 TI - Functional recovery after hip fracture. AB - This investigation was designed to describe the 12-month functional recovery following hip fracture, testing the hypothesis that intensive rehabilitation would enhance the level of functional recovery. The study included 50 patients with intertrochanteric, and 25 patients with subcapital hip fractures who were admitted to the Massachusetts General Hospital teaching service (67% women, mean age = 78 yr). Twenty-nine percent of the patients died in the year after fracture. Among survivors, only 33% and 21% regained their prefracture function in five basic and six instrumental activities of daily living, respectively. Twenty-six percent regained their prefracture level of social/role functioning. There were no statistically significant differences in mortality, hospital discharge status, or pattern and level of functional recovery, between patients receiving experimental and standard approaches to hospital rehabilitation. PMID- 3662785 TI - Carbidopa-levodopa therapy for movement disorders. PMID- 3662786 TI - Indomethacin, hypoglycemia, quadriplegia. PMID- 3662787 TI - Triple-contrast computed tomography in the evaluation of penetrating posterior abdominal injuries. AB - Routine exploration of stable patients who have penetrating injuries of the posterior abdomen results in a high rate of unnecessary operation. Prolonged observation, while safe, is expensive and potentially morbid in the event that a retroperitoneal injury has occurred and treatment is delayed. To evaluate these injuries, we have developed and employed a protocol for computed tomographic (CT) scanning of the abdomen employing oral, intravenous, and rectal administration of contrast material to visualize the retroperitoneal contents. Between Jan 1, 1985, and Dec 1, 1986, 40 patients were studied in this manner. In each case, the path of penetration could be determined exactly by tracing the course of air and hematoma through the tissues. All retroperitoneal organs could be evaluated well enough to exclude injuries requiring intervention. The majority of patients showed subcutaneous penetrations only. All six significant intra-abdominal injuries were diagnosed correctly and confirmed at laparotomy. All 34 patients deemed by CT not to have significant injury were observed for 72 hours, and all were discharged uneventfully. Triple-contrast CT appears to be of great value in the triage of penetrating posterior abdominal trauma into operative and nonoperative groups. PMID- 3662788 TI - Comparison of transit times in the J-shaped and the isoperistaltic lateral ileal reservoir--using isotope technique in rabbits. AB - An ileal reservoir appears to reduce stool frequency and urgency in conjunction with endorectal ileal pull-through operations. The optimal type of reservoir construction has not been determined. In a rabbit model, the isotope transit time, measured as a percentage of isotope remaining in a segment of intestine one hour after injection, was 79% for the J-shaped reservoir (JR) and 57% for the lateral isoperistaltic reservoir (LR). Transit times in ileal segments longitudinally incised and closed and control segments were 49% and 63%, respectively. The mean reservoir volume three months after operation was 53 mL for LR, 101 mL for JR, 20 mL for longitudinally incised and closed ileal segments, and 25 mL for control segments. Although reservoir function between the LR and JR may be similar at six to nine months postoperatively, it appears that the JR empties more slowly and becomes more distended during the first three months after construction in the rabbit model studied. PMID- 3662789 TI - Tissue salvage by mapping of skin surface transcutaneous oxygen tension index. AB - Healing of both pathologic and surgical wounds is strongly dependent on adequate skin blood flow and oxygenation. The transcutaneous oxygen tension (PtcO2) index (regional PtcO2 index = RPI = limb PtcO2/chest PtcO2) and wound healing were assessed prospectively in 159 wounds in 113 high-risk patients referred for standard noninvasive tests. Patients were managed by referring practitioners on the basis of clinical assessment and standard tests. Treatment was divided into local procedures and amputations. Of 93 local procedures, 48 healed (RPI = 0.72 +/- 0.10 [mean +/- SD]) and 45 failed (RPI = 0.25 +/- 0.12). Of 66 amputations, 45 healed (RPI = 0.64 +/- 0.09) and 21 failed (RPI = 0.28 +/- 0.11). Well oxygenated skin healed reliably regardless of the cause of the wound. Regional skin oxygenation studies aid rapid diagnosis of ischemia and allow maximal conservation of tissue in limb salvage situations. PMID- 3662790 TI - Acute renal failure and multiple organ system failure. AB - We treated 23 patients with acute renal failure who had multiple organ system failure. The patients ranged in age from 16 to 66 years (mean, 36 years). All patients underwent hemodialysis. Mortality increased with the number of organ systems involved, from 22% for patients with two systems involved to 100% for patients with four systems involved. The overall mortality was 47.8%. The association of ventilatory failure and sepsis resulted in the most deaths. Early resuscitation, eradication of the primary lesion, and hemodialysis are the most important points in the treatment and prevention of multiple organ system failure in patients with acute renal failure. Thus, the problems of single and multiple organ system failure in China are similar to those in other countries. PMID- 3662791 TI - Venous patch grafts and carotid endarterectomy. A critical appraisal. AB - Seventy-eight patients underwent 83 carotid endarterectomies (CEAs) with vein patch grafts from 1980 to 1985. A technically satisfactory endarterectomy was confirmed by completion arteriogram in all instances. Indications for venous patch graft included a diameter of the internal carotid artery of less than 3.0 mm (49 patients); an internal carotid artery diameter of less than 3.5 mm, with contralateral internal carotid artery occlusion (nine patients); unexpected stenosis detected by completion arteriogram (six patients); a reexploration for neurologic deficit following conventional CEA (three patients); and irregular surface or edges of the endarterectomy site or high extension of a plaque (16 patients). Late follow-up arteriograms (66 studies) after a mean two-year interval revealed three instances (4.5%) of recurrent asymptomatic stenosis. Four patients (6%) developed late occlusions; three were asymptomatic and one was associated with major stroke 2 1/2 years later. One patient (1.5%) developed a false aneurysm. One patient experienced a postoperative transient ischemic attack. There was no operative mortality. Six patients died in the late follow-up period. The venous patch graft ensured immediate patency of the internal carotid artery but failed to prevent recurrent stenosis or occlusion in internal carotid arteries less than 3.0 mm in diameter. PMID- 3662792 TI - Bone imaging findings in gangrene. AB - Review of three-phase bone imaging results in three patients with gangrene of the toes showed a unique pattern of absent perfusion and absent bony and soft-tissue uptake. In one of these patients, characteristic bone imaging findings were present before clear-cut clinical presentation. In our experience, the finding of absent uptake in a particular clinical setting is highly specific for gangrene. PMID- 3662794 TI - Thin malignant melanomas and recurrence potential. AB - Of 846 patients with stage I malignant melanoma that was less than 0.76-mm thick who were followed up for two to 31 years, 61 (7.2%) developed a recurrence. For those patients who did not initially undergo an elective lymph node dissection, the majority of first recurrences were at regional lymph nodes. Attempts have been made to identify those patients at risk of relapsing. Axial lesions, particularly those on the scalp, had the highest recurrence rate, with 15% of all thin scalp lesions recurring compared with only 4% of all thin extremity lesions. Three histological features proved to be useful prognostic indicators when analyzed by single-factor analysis. Evidence of ulceration in the primary lesion increased the recurrence rate from 6.7% to 26.1%. While only 4.3% of lesions displaying low mitotic activity recurred, this rate rose to 23.8% for those lesions of a high mitotic grade. Only 5% of Clark's level II lesions recurred, compared with about 12% of lesions at either level III or IV. Evidence of regression in thin lesions had no deleterious effect on prognosis. This study defines a small subset of patients who may benefit from elective lymph node dissection. PMID- 3662793 TI - Superoxide dismutase in rats with sepsis. Effect on survival rate and amino acid transport. AB - In a recent study, administration of the free radical scavenger superoxide dismutase (SOD) improved survival in rats with sepsis when administered two hours before induction of sepsis. The present study was designed to determine whether free radical-induced membrane damage is involved in the pathogenesis of decreased muscle amino acid uptake, noted in sepsis. Additionally, the effect on survival rate of SOD given after the onset of sepsis was studied. Sepsis was induced by cecal ligation and puncture in rats. Amino acid transport in incubated soleus muscles was studied using tritiated alpha-aminoisobutyric acid. Amino acid uptake was significantly reduced in muscle from rats with sepsis. Administration of SOD before induction of sepsis or added in vitro to incubated muscles with sepsis had no effect on alpha-aminoisobutyric acid uptake. Survival rate was not increased when SOD was given two hours after cecal ligation and puncture. The results suggest that free radical-induced membrane damage is not the mechanism of inhibited muscle amino acid transport in sepsis. Since survival was not improved by SOD administered after induction of sepsis, the role of the enzyme in the treatment of sepsis may be questioned. PMID- 3662795 TI - Resting energy expenditure of host and tumor is similar in rats with methylcholanthrene-induced sarcoma. AB - In the present study we assessed the resting energy expenditure of 30 free feeding control and methylcholanthrene-induced sarcoma-bearing rats prior to and following surgical removal of the tumor. Tumor-bearing rats demonstrated carcass wasting and massive tumor growth. The resting energy expenditure data in our model suggest that neither the presence and growth of a tumor nor its removal significantly change resting energy expenditure beyond the normal range for non tumor-bearing rats. We suggest that in the partition of energy costs between host and tumor, both carry a similar input, proportional to their relative weight, into the total combined resting energy expenditure of host and tumor. PMID- 3662796 TI - Incidence and mechanism of post-carotid endarterectomy hypertension. AB - Hypertension following carotid endarterectomy occurs frequently but is poorly understood. Its occurrence has been correlated with an increased incidence of neurologic complication. We identified those factors that correlate with an increased incidence of post-carotid endarterectomy hypertension. The records of 100 patients who underwent carotid endarterectomy at UCLA Medical Center from November 1981 to September 1983 were examined. One hundred fifty variables were surveyed to determine those factors associated with this problem. Fifty-eight percent of the study patients developed post-carotid endarterectomy hypertension (an increase in systolic blood pressure greater than 35 mm Hg over baseline, and/or blood pressure requiring treatment with sodium nitroprusside). Of patients who developed this problem, 93% had diabetes mellitus, 75% received isoflurane anesthesia, 71% had peripheral vascular occlusive disease, 71% underwent ipsilateral transient ischemic attacks, and 65% had high-grade ipsilateral carotid stenosis. These variables have in common the loss of or interference with cerebral autoregulation. Central dysautoregulation may set the stage for a positive feedback mechanism that results in increased blood pressure. Anesthetic agents that do not interfere with cerebral autoregulation may reduce the incidence of this complication, and an aggressive treatment program may prevent neurologic complications. PMID- 3662797 TI - Role of lipase in the pathogenesis of experimental esophagitis in the rabbit. AB - The role of lipase in the pathogenesis of reflux esophagitis was investigated in an experimental model in which an in situ isolated segment of rabbit esophagus was perfused (at pH 7) with a solution containing lipase in concentrations of 2 and 10 mg/ml. The severity of mucosal damage was assessed using the following indicators of mucosal integrity: transmucosal potential difference, net flux of sodium, and mucosal permeability to erythritol labeled with carbon 14, a neutral molecule with a greatest molecular diameter of 8.2 nm. Furthermore, the morphologic characteristics of esophageal damage were studied by light and scanning electron microscopy. The results suggest that lipase significantly decreased transmucosal potential difference and increased mucosal permeability to sodium and erythritol labeled with carbon 14. Morphologically, lipase induced cytoplasmatic vesiculation and widening of intercellular spaces within the basal cell layer. The epithelial cell layers were also often seen to be sloughed off with consequent exposure of the subepithelial connective tissue at the mucosal surface. The findings suggest that lipase has an adverse effect on the esophageal mucosa that may have pathogenetic significance in clinical reflux esophagitis. PMID- 3662798 TI - Techniques of liver resection. Comparison of suction knife, ultrasonic dissector, and contact neodymium-YAG laser. AB - Liver resections were performed in 18 pigs with an inexpensive disposable plastic suction knife, an ultrasonic dissector, or a contact neodymium (Nd)-YAG laser. Technical aspects and intraoperative and postoperative data were compared. Intraoperative blood loss was less with the suction knife (112 +/- 28 mL) than with the ultrasonic dissector (149 +/- 45 mL) or Nd-YAG laser (174 +/- 25 mL). Operating time was similar in all groups. The number of ligatures used in the Nd YAG laser group (12 +/- 1) was significantly less than in the ultrasonic dissector (27 +/- 2) or suction knife (32 +/- 2) groups. In the ultrasonic dissector group, there was an increase in postoperative white blood cell count and liver enzyme levels compared with the other two groups. Light microscopy revealed dilated bile ducts in the ultrasonic dissector resection group, which may reflect biliary stasis. There were no significant differences in mortality among the three experimental groups. Results indicated that the ultrasonic dissector and the contact laser method were not substantially better than an inexpensive, easily modified plastic suction catheter in performing a major nonanatomic liver resection in piglets. PMID- 3662799 TI - Immunodeficiency-associated thrombocytopenic purpura (IDTP). Response to splenectomy. AB - Immunodeficiency-associated thrombocytopenic purpura (IDTP) is a feature of the acquired immunodeficiency syndrome--related complex. Current therapeutic modalities for IDTP include splenectomy and the administration of corticosteroids or other agents. Empiric treatment of IDTP has been analogous to that for immunologic thrombocytopenic purpura (ITP). The present report reviews 15 patients who underwent splenectomy for IDTP, demonstrates the successful use of surgical therapy, and defines our indications for splenectomy in the treatment of this disorder. Thirteen of 15 patients had initially failed to respond to steroid therapy. Fourteen patients (93%) initially responded to splenectomy, with platelet counts increasing to 150 X 10(9)/L (150,000/mm3) or greater. A continuing complete response was achieved in nine patients (60%) following splenectomy. After postsurgical adjunctive therapy, durable remission was achieved in 73% (11/15) of the patients. Complications occurred in three patients, and there were no deaths. The mean follow-up was 12.4 months. Splenectomy may be performed in the treatment of IDTP with acceptable morbidity and likelihood of response. PMID- 3662800 TI - Cocaine packet ingestion. Surgical or medical management? AB - Current controversy focuses on whether patients having ingested packets of cocaine should be treated medically or surgically. We surgically treated two such patients in whom conditions did not allow for conservative medical management, ie, the packets caused small-bowel obstruction in one patient while toxic manifestations of cocaine occurred in the other patient. Initial emergent surgical treatment vs success with conservative medical management appears to be directly related to whether a patient voluntarily receives treatment or is involuntarily brought to the hospital on suspicion of smuggling cocaine packet ingestion. Early surgical intervention is warranted unless the method of packet construction is known to be of high quality and if the patient is totally asymptomatic. If these criteria are present, intensive care monitoring, with surgical intervention on any change in status, is preferred. PMID- 3662801 TI - Venous anomalies encountered in aortoiliac surgery. AB - Reconstructive procedures of the aortoiliac system are extremely common. Aside from ruptured aneurysms, most severe intraoperative hemorrhage is due to venous injuries. The ability to recognize and manage venous anomalies is essential. This article presents a review of major venous anomalies including (1) transposition of the inferior vena cava, (2) double vena cava, (3) retroaortic left renal vein, (4) circumaortic renal collar, and (5) preaortic iliac venous confluence. Embryologic development, operative recognition, and techniques of operative management are discussed. A case report is presented in which an anomaly similar to a preaortic iliac confluence was discovered during aortic reconstruction for a ruptured abdominal aortic aneurysm. This case differs from previously reported cases of preaortic iliac confluence in that the right common iliac vein persisted in its course anterior to the right common iliac artery. PMID- 3662802 TI - Patient positioning for subclavian vein catheterization. AB - The subclavian vein is a commonly used venous access route. Percutaneous cannulation is associated with complications and malpositioning of the catheter. We studied the potential effect of various body positions on subclavian vein catheterization using gross anatomic dissection and magnetic resonance imaging. Findings show that traditional recommendations for patient positioning with the shoulders retracted and the head turned away can act to distort the subclavian vein anatomy and make successful cannulation more difficult. Positioning the patient flat with the head and shoulders in a neutral position is suggested. PMID- 3662803 TI - Acute appendicitis in women. PMID- 3662805 TI - ASA adopts standards for the practice of anesthesiology. PMID- 3662804 TI - Intractable diarrhea in portal hypertension. PMID- 3662806 TI - Goitre and wasting induced in hamsters by hexachlorobenzene. AB - Male Syrian hamsters were treated with hexachlorobenzene (HCB) in their diet at levels of 100 ppm for 28 weeks, 200 ppm for 18 and 28 weeks, and 500 ppm for 6 weeks. All treatments caused at least a 2.5- to 3-fold increase in thyroid size, mainly by enlargement of some follicles. Serum thyroxine (T4) levels were unchanged, whereas levels of triiodothyronine (T3) eventually became depressed by greater than 60%. Uptake of 131I into thyroids was induced approximately 3-fold when estimated after feeding HCB (500 ppm) for 3 or 6 weeks. Hamsters also lost weight by depletion of adipose tissue, leading to 50% mortality in longer experiments. Results were distinct from the effects of the known antithyroid agent 3-aminotriazole or amitrole (200 ppm for 28 weeks), which did not affect survival and although causing thyroid enlargement depressed serum T4 and significantly elevated T3. The effects of HCB in hamsters were also different from those in rats (500 ppm HCB for 6 weeks) in which there was only a small increase in thyroid size (1.3-fold), serum levels of T3 were only slightly depressed but T4 levels were reduced by 74%. These studies are discussed with reference to the effects of other polyhalogenated aromatic chemicals on the thyroid, serum thyroid hormone levels and lethality. PMID- 3662808 TI - The effect of L-cysteine on the portion-selective uptake of cadmium in the renal proximal tubule. AB - Cadmium (Cd), co-administered with an excess of L-cysteine, accumulates rapidly in the kidneys of the rat. After subcutaneous (s.c.) injection of 3 mumol CdCl2/kg body wt the concentrations of Cd in the blood and kidneys increase with the dose of cysteine over the range 0.06-5.0 mmol/kg body wt. At cysteine doses of less than 1.5 mmol/kg body wt the ratio of the concentrations of Cd in the outer medulla and cortex of the kidney remains the same as that after the injection of Cd alone. This ratio, however, is more than doubled at dose levels of 5-10 mmol cysteine/kg body wt. Hepatic uptake of Cd is unaffected by doses of cysteine below 1.5 mmol/kg body wt but decreases markedly at higher doses. In animals that are dosed simultaneously with 5 mmol cysteine/kg body wt, renal uptake of 109Cd is known to occur in the straight segments of the proximal tubules. At a dose level of less than 1.5 mmol cysteine/kg body wt the present autoradiographical studies show that 109Cd is taken up predominantly by the proximal convoluted tubules of the kidney cortex. At the critical dose level (1.5 mmol/kg body wt), cysteine decreases the retention of Cd at the s.c. injection site, but probably has little effect on the distribution of Cd between protein and other carrier molecules in the blood. This distribution, however, is altered at higher cysteine dose levels. It is suggested that, under the latter conditions, stable Cd-cysteine complexes are formed in the blood and are filtered readily through the glomeruli.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662807 TI - Pleiotropic effect of the gene hairless on hepatotoxicity of 2, 3, 7, 8 tetrachlorodibenzo-p-dioxin in mice. AB - Treatment of mice of the A2G-hr/+ congenic line with 2, 3, 7, 8 tetrachlorodibenzo-p-dioxin (TCDD) resulted in the development of hepatic porphyria over a period of 4 weeks. Female mice responded to a lesser extent than did males. The degree of porphyria in haired heterozygotes (hr/+) was less than in the corresponding hairless homozygotes (hr/hr) and the haired mice had lower resting metabolic rates than hairless mice. Adaptation of mice of either genotype to a 32-33 degrees C environment resulted in a decrease in resting metabolic rate and a reduction in hepatic porphyrin levels. Histologically-demonstrated necrotic changes in livers were accompanied by increased activity of alanine aminotransferase and sorbitol dehydrogenase in the plasma; however, there was no clear temporal trend in plasma enzyme levels. Elevated environmental temperature reduced the plasma alanine aminotransferase activity. The study provided evidence for a pleiotropic effect of variation at the hr locus being expressed in TCDD hepatotoxicity. Suggestions for mechanisms whereby the effect can be mediated through alterations in resting metabolic rate are made. PMID- 3662809 TI - Renal handling of cadmium and cadmium-metallothionein: studies on the isolated perfused rat kidney. AB - The isolated kidney perfusion model was used to study the uptake of Cd and metallothionein (MT)-complexed Cd. Cd2+ at concentrations above 40 nM strongly depressed the glomerular filtration rate (GFR), whereas MT-complexed Cd (Cd-MT) at concentrations of 0.8-920 nM had no effect on the GFR. In contrast to Cd2+, Cd MT was readily reabsorbed by the kidney and uptake saturation for Cd-MT occurred at 240 nM. The maximal transport rate for Cd-MT calculated in this study was 18 pmoles Cd-MT . g-1 . min-1. The accumulation of Cd in the kidney was more efficient in the experiment using Cd-MT, in which case the Cd kidney contents were about 2-4 times higher than compared to CdCl2. PMID- 3662810 TI - Teratologic studies on the Himalayan rabbit: new aspects of thalidomide-induced teratogenesis. AB - The aim of our study was to determine the period of maximum sensitivity for the induction of characteristic malformations with thalidomide (TH) in Himalayan rabbits. TH was administered orally in different doses (50, 100, 150 and 200 mg/kg) four times at 24-h intervals starting at 192 h of gestation. The malformations affected various organs: renal defects (dysplasia) and limb anomalies (dysmelia)--which had never occurred spontaneously in this strain- appeared as dose-dependent effects of the drug. By administering single doses of TH (200 and 300 mg/kg body wt) between hours 192 and 264 of gestation, we discovered the different periods of maximum sensitivity for induction of renal dysplasia (clearly prior to the 220th h of gestation) and dysmelia (between hours 230 and 240 of gestation). The types of limb malformations that we observed in the rabbit were identical to those produced in man following the intake of TH. Three doses of TH (300 mg/kg each) given between hours 222 and 228 of gestation produced characteristic limb malformations in 9 of 11 litters treated. These results make it possible to conduct in vivo experiments on a readily available laboratory animal with minor drug exposure of the gravid dam and under avoidance of toxic side effects. PMID- 3662811 TI - Liver lipid metabolism in T-2 toxicosis. I. Effects of a single dose feeding of T 2 toxin to rats. AB - The acute effects of oral administration of a single dose of T-2 toxin (2.0 mg/kg body wt) to rats on whole liver lipid metabolism were studied at 8, 16 and 24 h post-treatment. Administration of T-2 toxin significantly increased liver and microsomal total lipids, free cholesterol, esterified cholesterol and triglycerides initially at 8 h, which subsequently returned to control values at 24 h. However, no significant alterations were observed in the contents of whole liver and liver microsomal total phospholipids and phosphatidyl choline, except that phosphatidyl ethanolamine and sphingomyelin + lysophosphatidyl ethanolamine contents in liver at 16 and 24 h and sphingomyelin + lysophosphatidyl ethanolamine content in liver microsomes at all three periods were significantly lower. The incorporation of 1-14C-acetate into whole liver and liver microsomal total lipids was reduced at 16 and 24 h post feeding. However, the incorporation of 1-14C-acetate into liver and microsomal free cholesterol, esterified cholesterol and triglycerides was significantly higher at 8 h, subsequently returning to the control value at 24 h; incorporation was significantly lower even into microsomal triglycerides. The incorporation of 1-14C-acetate into liver and its microsomal total phospholipids, phosphatidyl choline, phosphatidyl ethanolamine and sphingomyelin + lysophosphatidyl ethanolamine, was significantly decreased at all three periods post toxin treatment. The results suggested that T 2 toxin inhibited the incorporation of 14C-acetate mainly into liver and its microsomal phospholipids and their subfractions in rats. PMID- 3662812 TI - Effects of toxic chemicals on the release of pyrimidine compounds in cell culture. AB - Exposure of hamster embryo cells and BF lymphoblastoid cells to 18 known toxic substances and four nominally nontoxic substances results in the release of pyrimidines (and their nucleosides) into the culture medium. The extent of release is dependent on the specific chemical and the specific cells present in the assay. BF cells are not affected by exposure to benzo(a)pyrene, while the hamster embryo cells exhibit enhanced excretion on exposure to benzo(a)pyrene. This difference in response may be due to the difference in endogenous aryl hydrocarbon hydroxylase (BaP) activity. In contrast, diethylstilbestrol, which is metabolized by a peroxidase-mediated enzyme system, causes enhanced excretion in both cell types. Direct alkylating agents and Ni(+2) salts also cause enhanced excretion in both cell types. We have used concentrations of chemicals that give a 5% enhanced excretion as the criterion of low-dose response. Within the range of concentrations tested, chromate induces enhanced excretion in BF cells but not the HEC cells, and Pb(+2) induces enhanced excretion in HEC cells but not the BF cells. Benzene, dimethylnitrosamine, and Mg(+2) did not affect either cell type. 7,12-Dimethylbenzo(a)anthracene, anthracene, benzo(a)anthracene, phenylazoaniline, N-methyl, N-nitroso, N'-nitroguanidine, dioxane, and pyrene cause enhanced excretion in the hamster embryo cells while benzo(e)pyrene, ZnSO4 and cholesterol do not cause enhanced excretion in the hamster embryo cells. Of those chemicals causing enhanced excretion, the concentration range bracketing 5% enhanced excretion approximated low-dose exposures reported to result in toxic responses like cancer, teratogenesis or pulmonary disease. PMID- 3662813 TI - Barbiturate poisoning and gastrointestinal propulsion. AB - Anaesthetic doses of pentobarbitone (50 mg/kg) were found to inhibit gastric emptying and gastrointestinal transit in the rat. Gastric emptying was more profoundly suppressed than gastrointestinal transit. Phenobarbitone (150 mg/kg) had a similar effect. Since pentobarbitone and phenobarbitone also blocked the peristaltic reflex in the isolated small intestine of the guinea-pig, it would appear that the inhibitory effect of anaesthetic doses of barbiturates on gastrointestinal motility is mainly due to a direct action on the digestive tract. Together with the observation that considerable amounts of phenobarbitone were found in the stomach of an intoxicated patient 3 days after drug intake, these results might indicate that gastric lavage should also be considered in the treatment of protracted barbiturate poisoning. PMID- 3662814 TI - Lipid composition and fatty acid pattern of the gerbil brain after exposure to perchloroethylene. AB - Continuous inhalation of perchloroethylene (PCE) (320 ppm) for 3 months by Mongolian gerbils resulted in an altered fatty acid pattern of a brain phospholipid. A minor decrease in the brain weight was also observed. In ethanolamine phosphoglyceride of the cerebral cortex and the hippocampus, a decrease was found among the minor fatty acids derived from linolenic acid with a corresponding increase in several fatty acids of the linoleic acid family. Linoleic acid itself was decreased. Stearic acid was also decreased in both the cerebral cortex and the hippocampus. These changes in the fatty acid pattern indicate increased desaturation. PCE might alter the desaturase activity either directly by interfering with the protein moieties of the enzyme system, or indirectly by changing the properties of the lipid matrix. The observed changes in fatty acid composition are also consistent with the current hypothesis that solvents and anesthetics perturb the lipid matrix of membranes, possibly inducing complex compensatory changes in the membrane lipid composition. PMID- 3662815 TI - Differential effect of N-acetylcysteine on excretion of the metals Hg, Cd, Pb and Au. AB - Male Wistar rats were subacutely treated with sublethal doses of HgCl2, CdCl2, Pb(NO3)2, or Na-aurothiomalate. The metal preparations contained trace doses of radioactive nuclide. Based on the doses given and on the radioactivity excretion in urine and faeces the body burden was determined. After the metal treatment periods, some of the animals received N-acetylcysteine (up to 100 mg/kg daily, on 6 consecutive days, i.p.), and the effect of this potential chelator on metal excretion was monitored. The excretion of Hg (after dosing with HgCl2) was not influenced by N-acetylcysteine. The elimination of Cd in urine (after dosing with CdCl2) was increased by a factor of four. Also, the elimination of Pb [after dosing with Pb(NO3)2] was gradually increased (in faeces and urine) by increasing doses of N-acetylcysteine. After dosing with Na-aurothiomalate, the excretion of Au in urine was increased to about 30%. The data suggest some activity of N acetylcysteine in facilitating excretion of Pb, Cd or Au, but not of Hg. PMID- 3662816 TI - Differential susceptibility of immature rat testes to doxorubicin at critical stages of maturation. Biochemical and functional assessment. AB - The toxic effects of doxorubicin on the reproductive system of the male rat were studied at different susceptible stages of postnatal development. A multidisciplinary approach including the assessment of histopathological, functional and biochemical parameters was chosen. Groups of male rats were treated once with the compound (3 mg/kg) on postnatal day 6, 16, 24 or 45. Both the onset of reproductive capacity and fertility were determined by serially mating ten animals per group for 12 weeks beginning at the age of 45 days. Reproductive organ weights, sperm counts and epididymal androgen binding protein (ABP) were measured at intermediate (80-day-old rats) or terminal sacrifice (129 day-old rats). Age dependent differential doxorubicin toxicity was evident. Treatment of 6-day-old animals with doxorubicin severely impaired development of reproductive functions. Treatment of 16-day-old animals reduced fertility throughout the mating study, as well as body and reproductive organ weights and sperm counts. Initial toxicity was observed in the group treated at 24 days of age; particularly, low reproductive organ weights and low sperm counts were found. These findings proved reversible towards the end of the study. Neither biochemical nor functional impairment of the reproductive system could be observed in the group treated at 45 days of age. PMID- 3662817 TI - Comparison of the protection given by selenite, selenomethionine and biological selenium against the renotoxicity of mercury. AB - The protective effect of selenite, seleno-dl-methionine and biological selenium against the renotoxicity of mercury was tested in rats. As the source of biological selenium, the liver soluble fraction of rats given 60 mumoles/kg selenite 3 days before sacrifice was used. The aim of the experiments was to test whether protective efficiency follows the reported order of ability to form HgSe. Mercury was given subcutaneously in doses of 2.5, 5.0 and 7.5 mumoles/kg HgCl2 and selenium was given in equimolar doses at the same time as Hg2+. Liver soluble fraction, biological selenium or liver soluble fraction supplemented with selenite or seleno-dl-methionine were given orally, while in experiments without liver soluble fraction the two selenium compounds were given subcutaneously. Biological selenium was tested only at the two lower dose levels. Both biological selenium and seleno-dl-methionine decreased the urinary excretion of mercury in the first 48 h, but less so than selenite and only selenite decreased the renal content of mercury at the end of this period. Urinary alkaline phosphatase activity and plasma urea nitrogen at the 2.5 and 5.0 mumoles/kg dose levels decreased in the order of no selenium greater than biological selenium greater than seleno-dl-methionine greater than selenite. As the reported HgSe formation increases in the same order, the experiments support the role of HgSe formation in the protective effect. The degree of necrotic damage in the P2 and P3 regions of the proximal tubular cells increased in the same order as the biochemical indicators at the 5.0 and 7.5 mumoles/kg dose levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3662818 TI - Lung fibrosis induced by diquat after intratracheal administration. AB - Diquat toxicity to lung was evaluated at various intervals after intratracheal administration to rats. Twelve hours after the injection, both type I and type II pneumocytes developed degenerative changes which were similar in nature to those induced by paraquat. A much larger dose of diquat, however, was needed for the changes compared to paraquat, which is known to be actively taken up by the lung. This morphological evidence suggests that diquat may cause alveolar damage by the same mechanism as paraquat, although it is not actively taken up by the lung. Moreover, initial alveolar damage induced by diquat was followed by lung fibrosis, as with paraquat. Since paraquat is a well known fibrogenic agent, the common property of these two agents in alveolar damage may be a key to interpreting the development of lung fibrosis. PMID- 3662819 TI - Effect of exposure to carbon disulfide on tryptophan metabolism and the tissue vitamin B6 contents of rats. AB - Female Wistar rats were exposed to 100 ppm or 600 ppm carbon disulfide for 6 hours a day, 5 days a week for 12 weeks. During the exposure period, their urinary excretion of 4-pyridoxic acid was determined. The urinary excretions of xanthurenic acid and kynurenic acid after tryptophan loading were also determined. At the end of the exposure period, the rats were sacrificed and the levels of the five major forms of vitamin B6, pyridoxine, pyridoxal, pyridoxamine, pyridoxal phosphate and pyridoxamine phosphate, in the liver, kidneys and brain were determined by HPLC fluorometry. During the exposure the urinary excretions of xanthurenic acid and kynurenic acid after i.p. administration of tryptophan increased significantly in both experimental groups. However, urinary excretion of 4-pyridoxic acid decreased only slightly in the group exposed to carbon disulfide at 600 ppm and did not decrease in the group exposed to 100 ppm carbon disulfide. Furthermore, no significant changes were observed in the contents of vitamins B6 in any tissues examined. These results indicate that carbon disulfide does not cause vitamin B6 deficiency and thus that the disorders of tryptophan metabolism induced by carbon disulfide intoxication are not due to vitamin B6 deficiency. PMID- 3662820 TI - Effectiveness of a Prudhoe Bay crude oil and its aliphatic, aromatic and heterocyclic fractions in inducing mortality and aryl hydrocarbon hydroxylase in chick embryo in ovo. AB - Prudhoe Bay crude oil (PBCO) and its aliphatic, aromatic and heterocyclic fractions were tested on the developing chick embryo for (i) embryotoxicity (ii) their ability to induce hepatic and renal cytochrome P450 levels as well as hepatic, renal and pulmonary aryl hydrocarbon hydroxylase activities. On the basis of its concentration in PBCO, the aromatic fraction was responsible for most of the embryotoxicity as well as for the enzyme inducing ability. The NOS fraction constituted less than 7% (w/v) of PBCO but, on a weight equivalent basis, was roughly as potent as the aromatic fraction in causing embryotoxicity and in inducing cytochrome P450 levels and aryl hydrocarbon hydroxylase. The aliphatic fraction was found to be essentially inactive. The results are consistent with the concept that elevation of aryl hydrocarbon hydroxylase levels by certain components of PBCO may lead to increased embryotoxicity. PMID- 3662821 TI - Effects of pretreatment of male NMRI mice with enzyme inducers or inhibitors on clastogenicity of toluene. AB - Five groups of young male NMRI mice were pretreated with IP injections of three known inducers of cytochrome P450, Aroclor 1254, phenobarbital and 3 methylcholanthrene, and two inhibitors, metyrapone and alpha-naphthoflavone, 5, 3, 2, 1, and 1 day(s) before receiving toluene, respectively. Toluene was given to animals by IP injections of two similar doses 24 h apart. Increased formation of micronuclei within polychromatic erythrocytes of femoral bone marrow 30 h after the first injection of toluene was recorded. None of the treatments with an inducer or inhibitor alone gave a significant increase in the frequency of micronucleated polychromatic erythrocytes. However, pretreatment of animals with each inducer or even inhibitor resulted in an enhanced clastogenic activity of toluene. Simultaneous injections of an inhibitor and toluene clearly decreased the clastogenicities observed. Enhancement of the clastogenicity of toluene was more evident among Aroclor -pretreated animals than among the other groups. Treatment of animals with a mixture of toluene and benzene did not result in an additive clastogenic activity of benzene. IP injection of a mixture of toluene and every xylene isomer resulted in an enhanced clastogenic activity of toluene, although xylene isomers are not found to be clastogenic. PMID- 3662822 TI - Urinary excretion of acrylonitrile and its metabolites in rats. AB - Quantitative analysis of the dose-dependent urinary excretion of acrylonitrile and its metabolites was carried out in male Wistar rats following inhalation exposure of the animals to 1, 5, 10, 50 and 100 ppm acrylonitrile for 8 h. Quantitative analysis of acrylonitrile in urine was performed by gas chromatography. The urinary metabolites cyanoethyl mercapturic acid, S carboxymethyl cysteine and hydroxyethyl mercapturic acid were measured by a modified amino acid analysis, and thiodiglycolic acid by GC-MS. The excretion pattern of the compound and its metabolites was dependent on the exposure level; it is concluded that urinary determination of the unmetabolized acrylonitrile and two of its metabolites, cyanoethyl mercapturic acid and thioglycolic acid, may be useful for biological monitoring of industrial exposure. PMID- 3662823 TI - The effect of a lipid suspension on amitriptyline disposition. AB - A 5-h infusion of a lipid suspension or saline was given on separate occasions to four healthy volunteers taking amitriptyline. Mean plasma levels of amitriptyline plus nortriptyline were 14% higher at the end of the lipid infusion but the difference was not statistically significant. Infusion of a lipid suspension is unlikely to materially affect the severity of amitriptyline intoxication. PMID- 3662824 TI - The feasibility of sensitization studies using fewer test animals. AB - The possibility of reducing the number of animals in sensitization studies (maximization method) is discussed on the basis of results from 20 sensitization tests. It appears that the number of test animals in sensitization studies may be reduced to ten treated animals and five control animals without prejudice to the quality of the test. PMID- 3662825 TI - The classification of tymoviruses by cDNA-RNA hybridization and other measures of relatedness. AB - The relationships of twelve tymoviruses have been assessed by cDNA-RNA hybridization. In addition, the percentage molar nucleotide composition of the genome of the PD strain of Kennedya yellow mosaic virus and the percentage molar amino acid composition of the coat proteins of cacao yellow mosaic, Kennedya yellow mosaic and turnip yellow mosaic (Cardamine strain) viruses were estimated. These as well as published serological comparisons and genome and coat protein composition determinations were used to compute classifications of tymoviruses using various "metrics", and simple numerical methods were used to compare the classifications. Measures of relatedness estimated from cDNA-RNA hybridization and base ratio data correlated significantly with each other, but were less closely correlated with those calculated from amino acid data, and did not correlate with those calculated from serological tests. The serological relationships correlated significantly with estimates of relatedness calculated from amino acid data, but not with those based on hybridization or base ratio data. The differences between these classifications mostly resulted from the anomalous behaviour of eggplant mosaic virus, its particles are serologically close to those of other tymoviruses that naturally infect species of the tobacco family, whereas in cDNA-RNA hybridization tests eggplant mosaic virus is closest to the tymoviruses that infect legumes. Similar but smaller anomalies in the characteristics of other tymoviruses were also found. PMID- 3662827 TI - An attempt to treat rabies encephalitis in monkeys with intrathecal live rabies virus RV 675. Brief report. AB - A highly attenuated rabies virus, RV 675, proved innocuous but immunogenic when injected intrathecally into monkeys by the lumbar route. Attempts to use this virus to modify the course of fatal rabies encephalitis in monkeys were inconclusive possibly because of the brief encephalitic illness. Further studies are indicated to investigate RV 675 as a candidate therapeutic agent for rabies encephalitis. PMID- 3662826 TI - Cell type specific expression of pre S 1 antigen and secretion of hepatitis B virus surface antigen. Brief Report. AB - Production of the three hepatitis B surface (HBs) proteins was studied in a hepatoma cell line (PLC/PRF/5) and two HBs antigen secreting cell lines (HeLa and mouse L-cells), which had been transfected by a viral genome isolated by molecular cloning from PLC/PRF/5 chromosomal DNA. The DNA used for transfection contains the HBs-specific promoters and the enhancer which regulate the expression of HBs genes in the transfected cell lines. All three cell lines expressed well the small and middle HBs protein, but the larger pre S 1 containing protein was barely detectable in the L-cell. In vivo growth of the transfected HeLa cell as nude mouse tumour increased pre S 1 expression and suppressed secretion of HBsAg. PMID- 3662829 TI - [Increased antidiuretic hormone (ADH) during asthmatic attacks in children. Consideration for fluid management]. PMID- 3662828 TI - [Changes in immune complexes and IgG subclass antibodies following oral provocation tests in egg-sensitive adult asthmatic patients]. PMID- 3662830 TI - [Prognosis of childhood asthma: 22-35 years follow-up]. PMID- 3662831 TI - [Histologic studies on guinea pig bronchi following inhaled antigen exposure. I. Single antigen challenge-induced eosinophilic infiltration and epithelial damage in passively sensitized models]. PMID- 3662832 TI - [The effect of institutional therapy on physical parameters of children with severe bronchial asthma]. PMID- 3662833 TI - [Norfloxacin does not raise theophylline concentrations in plasma]. PMID- 3662835 TI - A pilot study on indoor air quality. A health effect oriented approach. PMID- 3662834 TI - [The effects of cepharanthine on experimental otitis media with effusion]. PMID- 3662836 TI - [Significance of thermophilic microorganisms in the development of diseases caused by contaminated air conditioners]. PMID- 3662837 TI - [Ventilatory function and immunologic status in women working in the spice processing industry]. PMID- 3662838 TI - [The effect of substituted benzaldehydes on hepatocyte parameters]. PMID- 3662840 TI - [Bronchial reactivity. Method for nonspecific bronchial provocation]. PMID- 3662839 TI - [Prevalence of occupational allergic contact dermatitis in workers exposed to plastic substances]. PMID- 3662841 TI - [Lactate dehydrogenase in the study of the effects of toxic and carcinogenic substances]. PMID- 3662842 TI - Removal and regeneration of the endothelium of the left common carotid artery of rats with induced hypercholesterolemia compared with normocholesterolemic animals. Experimental model to quantify the endothelial layer. AB - Male Wistar rats were used in a study of removal of the endothelium and endothelial regeneration in the large arteries. The endothelium was stripped completely by surgery from a well-defined segment, with no branches, of the left common carotid artery of rats, drying the vessel by blowing a gentle air stream through the lumen. The animals were fed the normocholesterolic or hypercholesterolic diets. The conditions of the denuded arterial segment were checked histologically at various intervals after the operation. The exposed area became covered with new endothelial cells growing from the two margins of the damaged area; regeneration was complete by about 20 days in normocholesterollemic rats (99.06%) and in a slightly lower proportion of the rats on the atherogenic diet (90.56%). The animals with induced hypercholesterolemia, however, had a significantly larger amount of missing endothelium on day 11 after surgery than the controls. This suggests that hypercholesterolemia affects not only the severity of the lesion but also the rate of endothelial repair. PMID- 3662843 TI - Separation and characterization of macrophages and smooth muscle cells in rabbit atherosclerotic lesions. AB - Atherosclerotic aortic intimas of cholesterol-fed rabbits were enzymatically dispersed into single cells by collagenase and elastase. And monocyte-macrophages (M phi) were separated from smooth muscle cells (SMC), using the ability of M phi to adhere to a plastic dish firmly even in the enzyme solutions. Round or oval, heavily lipid-laden cells, so-called foam cells (FC), belonged to the M phi fraction. M phi-FC showed very strong activity for non-specific esterase using alpha-naphthyl butyrate, while SMC showed little or no activity. Some of the FC were large and multinucleated (multinucleated giant foam cells). They also showed positive non-specific esterase staining and are thought to be derived from M phi. M phi-FC synthesized various proliferate in the medium and the number decreased gradually within several days. Some SMC were heavily lipid-laden; however, they retained their original spindle shape. SMC lost lipid droplets gradually as they proliferated to confluence. SMC from atherosclerotic lesions showed higher proliferative activity than those from normal-appearing medias of atherosclerotic aortas or control aortas. Almost no M phi-FC were obtained from the intima-medias of grossly normal portions of atherosclerotic aortas and control aortas. The present method will be useful for studying the role of these cells in the pathogenesis of atherosclerosis. PMID- 3662844 TI - Nifedipine suppressed atherosclerosis in cholesterol-fed rabbits but not in Watanabe heritable hyperlipidemic rabbits. AB - We studied the effects of nifedipine, a calcium antagonist, on atherosclerosis in cholesterol-fed rabbits and Watanabe heritable hyperlipidemic rabbits (WHHL rabbits). Japanese White rabbits were fed 120g of 2% cholesterol rabbit chow daily, and WHHL rabbits were fed standard rabbit chow. In each experiment, the rabbits were divided into two groups. Twenty milligrams of nifedipine was given orally twice a day to the nifedipine group, and the control group was given a placebo in the same way. The rabbits were sacrificed at the end of the 12th week in the case of cholesterol-fed rabbits, and the 20th week in the case of WHHL rabbits. Among the cholesterol-fed rabbits, the percentage of aortic intimal surface area covered by atherosclerotic lesions (AS%) was 25.9 +/- 7.6% (mean +/- S.D.) in the nifedipine group (n = 7), and 55.6 +/- 22.8% in the placebo group (n = 8) (p less than 0.01). The cholesterol content of thoracic and abdominal aorta in the nifedipine group was lower than those in the placebo group (p less than 0.05). Among the WHHL rabbits, the AS% was 33.4 +/- 14.1% in the nifedipine group (n = 5), and 27.0 +/- 11.7% in the placebo group (n =6) (n.s.). The aortic cholesterol and calcium contents also showed no significant differences between the two groups. We concluded that nifedipine suppressed atherosclerosis in cholesterol-fed rabbits but not in WHHL rabbits. The different responses suggest that the effect of nifedipine could be mediated by low density lipoprotein receptors or that the early exposure to hyperlipidemic serum from birth might affect cell functions of WHHL rabbits. PMID- 3662845 TI - Induction of early atherosclerosis in rats using parenterally-administered lipid emulsions. AB - It has been demonstrated by us and other workers that rats receiving I.V. infusions of Lipofundin-S will develop aortic changes indicative of early atherosclerosis. However, different lipid emulsions which are used in the clinical setting for parenteral nutrition vary substantially in chylomicron size and fatty acid composition. Therefore, in an attempt to better understand the mechanism by which a lipid emulsion might induce vessel lesions, we compared the nature of potential aortic changes resulting from infusions of Liposyn, Intralipid, or Lipofundin-S into the tail veins of Sprague-Dawley rats. Three groups of animals received either Liposyn (N = 10), Intralipid (N = 5), or Lipofundin-S (N = 9) at the rate of 6 g fat/kg body wt/day for 10 consecutive days. A fourth group (N = 5) received saline in equivalent dose to evaluate the effect of injection volume on vessel lesion formation. The other controls (N = 6) received no injections. Rats were sacrificed 24 hrs after the last infusion, and 1 mm rings from the top of the aortic arch and proximal third of the thoracic aorta were prepared for transmission electron microscopy (TEM). Examination by TEM allows two main conclusions to be drawn for both segments of the aorta. First, all three emulsions are capable of inducing early vessel changes which include endothelial damage, platelet adherence to damaged endothelium or subendothelial collagen, intimal phagocytic cells, and intimal smooth muscle cells surrounded by collagen bundles and elastin plates. Saline-infused rats only show occasional subendothelial swelling. None of the above-described changes are seen in any of the uninjected controls. Second, Lipofundin-S induces smooth muscle penetration of the intima in 7 of 9 rats, while Liposyn causes such changes in 2 of 10 animals. This difference in the efficiency with which the two emulsions induce the most advanced changes is statistically significantly by Chi Square (p less than 0.05). Intralipid produces smooth muscle penetration of the intima in 2 of 5 rats. The composition of the three emulsions suggests that the lower percent of linoleic acid and larger chylomicron size in Lipofundin-S may account for these differences, at least in part. PMID- 3662846 TI - [Immunological reactions of the bronchial mucosa in the morphogenesis of chronic bronchitis]. AB - Local immunity was studied using biopsy specimens obtained during bronchoscopy in 93 patients with various forms of chronic bronchitis. Reduced IgA synthesis and increased IgG synthesis by plasma cells of the lamina propria of bronchial mucosa were demonstrated, and the augmented IgG production along with penetration of various antigens into the lamina propria were shown to be responsible for a local immune-complex reaction involving the microcirculatory bed and resulting in perivascular sclerosis. The damaging and sclerosing processes that repeatedly occur in bronchial mucosa disrupt the epithelial-stromal linkages and interfere with the differentiation of surface epithelium. It is suggested that immunopathologic reactions are implicated in the setting up of a vicious circle which underlies the morphogenesis of chronic bronchitis. PMID- 3662847 TI - [Characteristics of the restructuring of the cardiomyocyte contractile apparatus in chronic ischemic heart disease]. AB - The contractile apparatus of cardiomyocytes was examined at the ultrastructural level in 20 heart biopsy specimens obtained during operations for aortocoronary bypass in patients with chronic ischemic heart disease (IHD). Myofilaments were found to have sustained compensatory-adaptive and destructive changes as well as changes indicative of impaired intracellular regenerations under conditions of chronic hypoxia and energy deficiency experienced by the muscle cells, with the result that myocardial contractility was substantially reduced. Together, these processes led to progressive restructuring of both the contractile apparatus of the cardiomyocytes and the cytoarchitectonics in general. This combined with signs of increasing hyperfunction of the contractile myocardium, which made the energy deficit worse and thus interfered with plastic processes in, and diminished the structural and functional capabilities of, the myocardium. On the other hand, distinct changes were noted in the cardiomyocytes that reflected their adaptation to the adverse conditions created by progressing coronary atherosclerosis. It is concluded that therapy for patients with chronic IHD should include measures aimed at promoting such adaptive changes. PMID- 3662848 TI - [Arterial hypertension in renal amyloidosis (a clinico-morphological analysis)]. AB - The incidence of arterial hypertension (AH) in patients with renal amyloidosis varied with its stage. Thus, AH was encountered in 13% of cases with renal amyloidosis at the proteinuric stage, 15% of those at the nephrotic stage, and 53% of those at the azotemic stage. One determinant of AH at the first two of these stages appears to have been damage to the antihypertensive system of the renal medulla, while the increased rate of AH at the azotemic stage was found to be associated with sodium retention in the body. AH in renal amyloidosis is an unfavorable prognostic factor, for it is conducive to amyloid shrinkage of the kidneys and to chronic renal failure. PMID- 3662849 TI - [Case of generalized hemochromatosis]. AB - A case of hemochromatosis--a disease in which iron is deposited in parenchymatous organs in the form of hemosiderin leading to fibrosis and functional impairment of these organs--is reported. The classical triad of symptoms seen in hemochromatosis (cirrhosis of the liver, diabetes mellitus, and skin pigmentation) are often supplemented by cardiomyopathy. In this case, postmortem examination revealed pigmentary cirrhosis of the liver and pancreas and hemosiderin deposits in the myocardium and other organs. The leading cause of death was concluded to be hemochromatosis of the heart. PMID- 3662850 TI - [Renal cell cancer in a polycystic kidney]. AB - A case report of a renal (mixed) cell carcinoma found in a 35-year-old male with acquired renal polycystosis who had died from chronic renal insufficiency treated with chronic hemodialysis is presented. The morphogenesis and pathogenesis of acquired polycystic transformation of the kidneys in patients with chronic renal failure and the possible relation of the former to renal cell carcinoma are discussed. A preblastomogenic role is suggested for sclerotic changes arising in polycystic kidneys as well as for hepatitis B virus which may act as an oncogene. PMID- 3662851 TI - [Leiomyosarcoma of the gallbladder]. AB - A case of leiomyosarcoma of the gallbladder in a 55-year-old woman is presented. The definitive diagnosis of leiomyosarcoma according to the histologic structure of the tumor was made by electron-microscopic study. Ultrastructure of this tumor type is characteristic of presence of myofilaments and cytoplasmic vesicles in the cytoplasm. PMID- 3662852 TI - [A nevus comprised of balloon-like cells]. AB - Histologic and ultrastructural findings made in a case of this rare tumor of melanocytic origin are described in detail. PMID- 3662853 TI - [A method for determining the phagocytic activity of polymorphonuclear leukocytes]. AB - The proposed method is said to provide more precise and reliable information about phagocytic properties of PNL at the light-optical and electron-microscopic levels than do the other currently available and widely used techniques. PMID- 3662854 TI - [Postmortem contrast cardioventriculography]. AB - A method of postmortal contrast cardioventriculography on the isolated heart is presented. The cardiac ventriculi are filled with 20% barium sulphate on the gelatinous base. The roentgenologic study is made before and after the selective filling of each ventricle with contrast medium, as well as on the transversal sections of the heart, providing the possibility to assess the character of hypertrophy and dilatation, the volume and the ventricular cavities of the heart. The informative value of the method is enhanced when it is combined with the postmortem coronarography, volume-weight and planimetric cardiometry. PMID- 3662855 TI - [Comparative characteristics of the stroma of renal adenomas and cancer]. AB - In a comparative study of 120 renal carcinomas and 10 adenomas it was found that in the adenomas the stroma as well as vessels were uniform with respect to distribution and degree of maturity and showed only scanty lymphoid infiltration, but that in the carcinomas, on the contrary, the distribution was irregular and lymphoid infiltration was much more abundant, particularly in areas of invasive growth. A close correlation was observed between stromal morphology and proliferative activity of the tumor. It is concluded that morphologic differences between these two kinds of tumor may be of use in diagnostic differentiation. PMID- 3662856 TI - [Morphology of mastocytosis]. AB - Histochemical and electron-microscopic studies of skin biopsy specimens from 65 patients with mastocytosis have enabled the authors to classify the various mastocytoses (on the basis of infiltrate topography and structural features of mast cells) into macular, pustular, and nodular varieties of cutaneous mastocytosis (urticaria pigmentosa) and mastocytoma. No differences in mast cell structure were detected between cutaneous and systemic mastocytoses. Electron microscopically, mast cells in both appeared normal, with a predominance of granules having a fine-grained or homogeneous matrix and a small number of lamellar structures. In mastocytomas, on the other hand, ultrastructural changes and considerable degranulation were observed in the mast cells. PMID- 3662857 TI - [Revision of the WHO histological classification of thyroid tumors]. PMID- 3662858 TI - [Cytologic characteristics of bronchial epithelial dysplasia from the viewpoint of the early detection of lung cancer]. AB - Cytomorphologic characteristics of bronchial epithelium have been examined in 58 patients with central lung cancer (42 patients in stage T1N0M0 and 16 in stage T1N1M0 and 84 patients with nonneoplastic diseases (tuberculosis, hamartoma, sarcoidosis, or chronic nonspecific inflammation), using smears from bronchial mucosa, imprints from tissue pieces biopsied on bronchoscopy, scrapings from lesions and surrounding tissues, and transthoracic puncture samples. In 34 of the 58 cancer patients, the changes in bronchial epithelium were categorized as moderate to severe dysplasia. A scheme summarizing malignant transformation of bronchial epithelium is proposed. It is shown that bronchial epithelial dysplasia can be recognized by cytologic examination, which may be used to advantage in screening subjects for early detection of lung cancer. PMID- 3662859 TI - [Role of pathological dedifferentiation in the level of exfoliation of elements of the multilayer epithelium of the uterine cervix]. AB - In cervical dysplasias, dissociation of intercellular junctions occurs to a degree that depends directly on the severity of the dysplastic process which involves the entire epithelium from the basement membrane to the surface layer. The present cytologic studies have demonstrated that as the severity of dysplasia increases, smears taken from exfoliative cells of the stratified squamous epithelium show proportional decreases in the number of cells from the upper epithelial layers and increases in that of cells from the lower levels. The findings obtained indicate that morphologic characterization of exfoliative cellular material may help in the early cytologic diagnosis of cervical disorders. PMID- 3662860 TI - [Ultrastructural study of the myocardial cells of the human sinus node in sudden coronary death]. AB - Light- and electron-microscopic studies were performed on hearts from 23 males (aged 34 to 69 years) who had died suddenly with coronary heart disease. The hearts from 6 males of the same age group who had succumbed to extracardiac causes (including injuries) served as controls. Chronic abnormalities and acute destructive changes in the sinus node were observed in 82.6% and 87% of the cases, respectively. Various types of destructive changes seen in specialized conducting myocytes of the sinus node are described. Lesions in the microcirculatory bed, neural elements, and the connective-tissue component of the nodal myocardium were detected. Contributions of the detected changes to cardiac arrhythmia and sudden coronary death are discussed. PMID- 3662861 TI - [Effect of blastolysin on the ultrastructure and functional activity of mast cells and eosinophils]. AB - Blastolysin is shown to cause degranulation of mast cells, resulting in a reduction of their histamine content and in their release of mediators that activate eosinophilic leukocytes (EL). These accelerate the deamination of the histamine released by mast cells to the extracellular medium. It is possible that blastolysin acts directly on EL granules which are largely responsible for histamine inactivation. PMID- 3662862 TI - [Interrelation of changes in the epithelium of kidney tubules and interstitium in nephrosclerosis based on morphometric and histochemical data]. AB - Kidneys from 90 individuals who had died from atherosclerosis, hypertensive disease, or chronic glomerulonephritis were examined following early autopsies. The nephron epithelium and the endothelium of peritubular capillaries were studied for activities and distribution patterns of NADPH2 dehydrogenase, lactate dehydrogenase, succinate dehydrogenase, and acid and alkaline phosphatases, for relative capillary and connective tissue volumes, and for lymphocyte, monocyte, and plasma cell numbers. A mathematical analysis of the histochemical and morphometric data provided information on the nature of changes in the renal microcirculatory bed and on the roles of free stromal cells in various forms of nephrosclerosis as well as on the zonal distribution of the parameters studied. Intercellular and vascular-cellular links were found to be weakest in the most advanced stage of chronic glomerulonephritis involving reduction of peritubular capillaries. In cardiovascular disorders, the morphofunctional characteristics of the microcirculatory bed and of its volume showed reciprocal changes, probably of a compensatory character. PMID- 3662863 TI - [Characteristics of the morphofunctional status of the tissue in the rat cerebral cortex in experimental renal arterial hypertension]. AB - Activity of some enzymes in the cerebral cortex of rats with experimentally induced renal arterial hypertension (AH) was studied histochemically. Histologic data provide the evidence for the disturbances in water-salt metabolism in AH. Morphometric study revealed an increase in the specific volume of smaller microvessels and moderate decrease in the specific volume of bigger microvessels. Vascular markers show different time course of activity changes in AH: the activity of alkaline phosphatase increases, while that of alpha-glycerophosphate dehydrogenase remains unchanged. The development of AH is accompanied by the increase in succinic dehydrogenase activity and the decrease in the activity of lactate dehydrogenase in neurons. The changes in the neuron-capillary relationship arising in AH can be one of the possible pathogenetic factors in the pathologic process progression. PMID- 3662864 TI - [Malignant paraganglioma of the retroperitoneal space developing with increased arterial pressure]. AB - Brief literature data on clinico-morphologic manifestation of retroperitoneal paraganglioma and its differential diagnosis with ectopic pheochromocytoma is presented. A female 31-year old patient is described with a rapid growth of retroperitoneal neoplasm and a concomitant increase of arterial blood pressure, first paroxysmal and then permanent. After the tumor excision (10 X 13 X 16 cm in size), not connected with the adrenal, the blood pressure recovered. The morphologic study provided the evidence for malignant paraganglioma different from ectopic pheochromocytoma in structural polymorphism and small size of neurosecretory granules. The arterial blood pressure increase is suggested to be due to tumor compression on the left kidney vessels. PMID- 3662865 TI - [Teratoid diktyoma of the eye]. AB - This rarely encountered ocular tumor, observed in a girl aged 9 years, was derived from an undifferentiated embryonal retina and bore structural resemblance to the primordial retina of the optical vesicle. The tumor contained tissues and structures extraneous to the eye and was therefore classified as teratoid medulloepithelioma. PMID- 3662867 TI - [Indeterminate form of Chagas' disease]. PMID- 3662866 TI - [Practical recommendations for examining the pulmonary pleura of fetuses and newborn infants using contact microscopy]. AB - It has been found that the pleura visceralis of fetuses and neonates is consistently involved in inflammatory processes occurring in pneumonias caused by Gram-negative organisms (Citrobacter sp., Escherichia coli, Klebsiella sp., Serratia marcescens) and may display signs of infection when the pneumonia is not yet apparent. This property of the pleura as a filtration membrane may help the pathologist in the early diagnosis of infectious disorders in neonates. Recommendations are given on the excision of pulmonary pleura and the staining of its preparations for contact microscopy whereby these can be examined during or shortly after the autopsy. Morphologic features of the infections caused by the indicated organisms are detailed. Citrobacter infections, for example, show a preponderance of macrophage responses, Klebsiella-caused lesions are characterized by involvement of the lymphatic bed, while those due to S. marcescens have hemolysis in the lung tissue and pleura as their main feature. PMID- 3662868 TI - [Hemodynamic consequences of ventricular stimulation with retrograde conduction. Experimental study in dogs]. PMID- 3662869 TI - [Hypertonic sodium chloride during experimental acute myocardial ischemia. Systemic and regional hemodynamic effects]. PMID- 3662870 TI - [Aneurysm of the coronary arteries]. PMID- 3662871 TI - [Patent ductus arteriosus with pulmonary hypertension]. PMID- 3662872 TI - [Special features of the stress test in patients with Wolff-Parkinson-White syndrome]. PMID- 3662873 TI - [Normal echocardiographic patterns in children from the city of Rio de Janeiro. III--Dimensions and functional evaluation of the left ventricle]. PMID- 3662874 TI - [Mitral valve prolapse and systemic arterial hypertension]. PMID- 3662875 TI - [A computer program for extracorporeal circulation]. PMID- 3662876 TI - [Systemic arterial hypertension: etiological diagnosis and evaluation of the effects on the kidney and heart as determined by nuclear medicine]. PMID- 3662878 TI - [How is the "acuity" of the "clinical eye"?]. PMID- 3662877 TI - [Nitrates: clinical pharmacology and therapeutic uses]. PMID- 3662880 TI - [Divisional blocks of the right branch in Chagas' cardiomyopathy]. PMID- 3662879 TI - [Cardiocirculatory performance as influenced by the action of exercise and the recovery behavior of patients with false positive exercise tests]. PMID- 3662881 TI - [Dilated cardiomyopathy. Study of initial forms]. PMID- 3662882 TI - [Endomyocardial biopsy in patients with peripartum cardiomyopathy]. PMID- 3662883 TI - [Acute pulmonary edema in pregnancy]. PMID- 3662884 TI - [Uncommon parasitism in the central adrenal vein of chronic patients with Chagas' disease]. PMID- 3662885 TI - [Intrathoracic pheochromocytoma. A case report]. PMID- 3662886 TI - [Silent myocardial ischemia. New approach for an old problem]. PMID- 3662887 TI - [Determining factors of abnormal responses to the early stress test in patients with uncomplicated acute myocardial infarction]. PMID- 3662888 TI - [Endocardial thrombosis and type of left vortical lesion in chronic Chagasic patients]. PMID- 3662889 TI - [Absence of immunological response of dogs to heterologous vascular grafts (human saphenous vein and aorta of Gallus gallus domesticus)]. PMID- 3662890 TI - [Denervation and heart disease in patients with chronic Chagas' disease]. PMID- 3662892 TI - [Changes in the heart conduction system in Chagasic patients suffering sudden death]. PMID- 3662891 TI - [Peripartum cardiomyopathy refractory to conventional treatment, but with good response to immunosuppressive medication. Report of a case]. PMID- 3662893 TI - [Mitral valve aneurysm associated with aneurysms of the sinus of Valsalva in a patient with Marfan syndrome. Case report]. PMID- 3662895 TI - [Physiopathology of pulmonary hypertension in chronic obstructive lung diseases]. PMID- 3662894 TI - [Rupture of the right atrium caused by blunt trauma. Report of a case operated on successfully]. PMID- 3662897 TI - Zonular dialysis in pseudoexfoliation syndrome. PMID- 3662896 TI - Additive effect of betaxolol and epinephrine in primary open angle glaucoma. PMID- 3662898 TI - Diagnostic criteria for Leber's congenital amaurosis. PMID- 3662899 TI - Bulbar conjunctival defects associated with gentamicin. PMID- 3662900 TI - A newly described complication of neodymium-YAG laser capsulotomy: exacerbation of an intraocular infection. Case report. PMID- 3662901 TI - Corneal ulceration caused by penicillin-resistant Neisseria gonorrhoeae. Case report. PMID- 3662902 TI - Corneal edema as a complication of a loose retinal tack. Case report. PMID- 3662903 TI - Is ophthalmic surgery a professional activity? PMID- 3662904 TI - Color photography vs fluorescein angiography in the detection of diabetic retinopathy in the diabetes control and complications trial. The Diabetes Control and Complications Trial Research Group. AB - During eligibility screening for the Diabetes Control and Complications Trial, we compared stereoscopic color fundus photography and stereoscopic fluorescein angiography in the detection of diabetic retinopathy in 320 patients (mean age, 24 years [SD, eight years]) with insulin-dependent diabetes (mean duration, 7.0 years [SD, 4.0 years]) and no or mild diabetic retinopathy. Of 153 patients classified as having no retinopathy according to color photographs of seven standard 30 degrees fields of both eyes, 21% of the patients had evidence of retinopathy (mostly one or two microaneurysms in one eye) on review of fluorescein angiograms, including two standard 30 degrees fields in each eye. Of those patients with no retinopathy detected on angiograms, 19% had retinopathy on review of color photographs. When used in conjunction with color photography, angiography allows a modest increase in sensitivity to the earliest signs of retinopathy, a gain potentially useful in some research applications, although not of demonstrated value in patient management. PMID- 3662905 TI - Laser power and postoperative intraocular pressure increase in argon laser trabeculoplasty. AB - Argon laser trabeculoplasty was performed on 45 open angle glaucoma patients with three different laser power levels (0.5, 0.7, and 0.9 W). We evaluated the influence of the treatment variables on the postoperative intraocular pressure (IOP) increase. The only statistically significant correlation we found was with the laser power. Most (75% [6/8]) of the serious IOP increases (greater than or equal to 10 mm Hg) were in the high-power group, and the average postoperative IOP increase was also greatest in this group. PMID- 3662906 TI - Recognizing glaucomatous field loss with the Humphrey STATPAC. AB - The results generated by the STATPAC program of the Humphrey Field Analyzer (Allergan Humphrey, San Leandro, Calif) from 72 eyes with documented early visual field loss and 98 normal eyes were examined. When global summary indexes and their significance levels were used to compare the tested eyes with age-matched normal values, STATPAC yielded a sensitivity of 93% and a specificity of 84%. In comparison, analysis by an independent, previously reported method yielded a sensitivity of 97% and a specificity of 90%. STATPAC results were strongly influenced by the reliability of the tested subjects. PMID- 3662907 TI - Intraocular pressure by noncontact tonometry with and without soft contact lenses. AB - We compared the intraocular pressure of 43 eyes (23 patients) with and without soft contact lenses. Two measurements were taken on each eye while the patients were wearing their soft contact lenses, and then immediately after the lenses were removed. Intraocular pressure measurements were taken by noncontact tonometry. The results showed that the power of the contact lens was a significant predictor of the change in intraocular pressure. In addition, when the 43 eyes were broken down into two groups, those with hyperopic lenses and those with myopic lenses, the difference in intraocular pressure was significantly larger for the group with hyperopic lenses than for the group with myopic lenses. PMID- 3662908 TI - Long-term effects of topically applied epinephrine on the blood-ocular barrier in humans. AB - Epinephrine (1.25%) was applied topically twice daily to both eyes of 22 patients with glaucoma or ocular hypertension. Half of these patients received topical indomethacin (0.5%) three times daily in one eye; the other half received indomethacin placebo under the same regimen. Blood-aqueous and blood-retinal barrier functions were determined by aqueous and vitreous fluorophotometry before and 1, 2, 3, and 7 months after initiation of treatment. Epinephrine-induced disruption of the blood-aqueous barrier, noted at two months, apparently remained constant until the completion of the study. At months 2, 3, and 7, indomethacin significantly inhibited this disruption. The blood-retinal barrier was unaffected. These results bear on the hypotensive mechanism of topically applied epinephrine. PMID- 3662909 TI - Reduction of phenylephrine drop size in infants achieves equal dilation with decreased systemic absorption. AB - We studied the effect of reducing eye drop size on the efficacy and systemic absorption of topical 2.5% phenylephrine hydrochloride in neonates and infants. Eleven neonates received an 8-microL drop volume in one eye and a 30-microL drop volume (commercial size) in the fellow eye. Mean pupillary dilation at 60 minutes was equivalent (4.86 mm vs 4.57 mm) for both eyes, respectively. The plasma phenylephrine level was determined for the two drop sizes in a second group of infants. Eight infants received an 8-microL drop volume in both eyes, while nine infants received a 30-microL drop volume in both eyes. The mean phenylephrine level at ten minutes was 0.9 ng/mL for the 8-microL drop group and 1.9 ng/mL for the 30 microL drop group. In neonates and infants, reducing the drop volume of topical phenylephrine may improve the risk-benefit ratio. PMID- 3662910 TI - Astigmatism associated with adnexal masses in infancy. AB - High degrees of astigmatism are common in infants with hemangiomas but have not been well documented with other adnexal masses. We reviewed records of 65 patients (69 eyes) with chalazions, epibulbar or orbital dermoids, hemangiomas, and dacryoceles. Astigmatism greater than +1.25 diopters (as high as +5.50 diopters) was most commonly associated with dacryoceles (eight of 12 eyes) and with hemangiomas (14 of 17 eyes). Plus cylinder axes were consistently oriented toward the lesion, and astigmatism tended to resolve with resolution of the lesions. Only one of the 17 eyes with dermoids and two of the 23 eyes with chalazions had astigmatism. Anisometropic amblyopia has been a prominent concern in the treatment of infants with hemangiomas. Patients with dacryoceles may be at similar risk. Repeated cycloplegic refractions are important in determining appropriate treatment of adnexal masses. PMID- 3662911 TI - Visual recovery from hypoxic cortical blindness during childhood. Computed tomographic and magnetic resonance imaging predictors. AB - We reviewed the clinical courses and computed tomographic (CT) and magnetic resonance imaging (MRI) scans of 30 infants and children with cortical blindness following hypoxic insults. The degree of injury to the striate and parastriate cortices and the area of the optic radiations were graded from 0 to 4 by a neuroradiologist. Only two children had normal scans of the posterior visual pathway and both had favorable visual outcomes. The visual recovery differed significantly with respect to the age at which the hypoxic insult occurred and CT and MRI abnormalities in the area of the optic radiations, but not with abnormalities in the striate or parastriate cortices. Our results suggest that CT and MRI scanning are helpful in prognosticating the visual potential of children with hypoxic cortical blindness. PMID- 3662912 TI - Autosomal dominant congenital cataract associated with chromosomal translocation [t(3;4)(p26.2;p15)]. AB - We studied a family in which congenital cataracts were found in a father and son who had a reciprocal translocation between the short arms of chromosomes 3 and 4 [t(3;4)(p26.2;p15)]. The father's parents and brother had normal chromosomes and no evidence of cataracts. While results of these studies do not prove a causal relationship, they do strongly suggest that the areas near the break points involved in the translocation (3p26.2 and 4p15) would be good sites for further investigations into the genetic basis of this type of cataract. PMID- 3662913 TI - Intraocular lens style and refraction in eyes treated with silicone oil. AB - The comparatively high refractive index of silicone oil significantly alters the refractive power of the human eye when it is placed into the vitreous cavity during retinal reattachment surgery. If cataract extraction and intraocular lens (IOL) implantation are subsequently performed, significant refractive errors result with most IOL styles if standard formulas are used to determine lens power. Thick-lens optical analysis of four IOL styles showed that the meniscus style yields the smallest difference between predicted (Binkhorst, Sanders Retzlaff-Kraff formulas) and actual postoperative refraction. This IOL style also minimizes the change in refractive error that accompanies subsequent alterations in the contents of the vitreous cavity, including removal of silicone oil and replacement with balanced salt solution. PMID- 3662914 TI - Diagnosis of neuronal ceroid lipofuscinosis by ultrastructural examination of peripheral blood lymphocytes. AB - A 7-year-old child with a history of seizures, psychomotor regression, and progressive visual loss was found to have juvenile type neuronal ceroid lipofuscinosis on the basis of characteristic ophthalmoscopic and electroretinographic findings. Although transmission electron micrographs of two separate skin biopsy specimens were normal, peripheral blood lymphocytes were vacuolated and demonstrated, by ultrastructural examination, characteristic "fingerprint profiles" confirming the diagnosis. Peripheral blood lymphocytes from the patient's mother, who had an acquired seizure disorder, demonstrated vacuolated lymphocytes with membranous formations and osmophilic granular bodies, as revealed by electron microscopy. Examination of peripheral blood lymphocytes can be a sensitive diagnostic test in suspected neuronal ceroid lipofuscinosis and may be useful in identifying carriers or family members in the early clinical stages of the disease. PMID- 3662915 TI - Topically applied aminocaproic acid concentrates in the aqueous humor of the rabbit in therapeutic levels. AB - Systemically administered aminocaproic acid, used to reduce the incidence of secondary hemorrhage in traumatic hyphema, has been shown to accumulate in the aqueous humor of rabbits in a dose-dependent manner. Eight topical preparations of aminocaproic acid were studied to determine aqueous humor concentrations. The vehicles studied included the following: sodium chloride, 0.85 g/dL; polyvinyl alcohol, 1.4 g/dL; hydroxypropyl methylcellulose, 0.4 g/dL; benzalkonium chloride, 0.01 g/dL; ethylenediamine tetraacetic acid disodium, 0.01 g/dL; dimethyl sulfoxide, 11 and 39.6 g/dL; and carboxypolymethylene, 4 g/dL. All contained 735 g/L of aminocaproic acid except for dimethyl sulfoxide (39.6 g/dL) and carboxypolymethylene (4 g/dL), which contained 238 and 600 g/L of aminocaproic acid, respectively. Aqueous humor and plasma samples were assayed for aminocaproic acid content following topical administration. Aqueous humor concentrations of aminocaproic acid ranged from undetectable (less than 0.01 mg/dL) to 5.75 mg/dL. Plasma concentrations ranged from undetectable (less than 0.01 mg/dL) to 9.85 mg/dL. Polyvinyl alcohol (1.4 g/dL) and carboxy polymethylene (4 g/dL) provided the highest aqueous humor aminocaproic acid concentrations. The aqueous humor levels with topical aminocaproic acid administration were comparable with those achieved by systemic administration. Plasma drug levels with topical aminocaproic acid were between 5% and 33% of levels achieved by systemic aminocaproic acid. This study demonstrates that aminocaproic acid can be effectively delivered into the anterior chamber of rabbits by topical application. PMID- 3662916 TI - Acute Hydrops in keratoglobus. PMID- 3662917 TI - Giant dermoid cyst of the orbit. PMID- 3662918 TI - Direct visualization of heterophorias through a unidirectional occluder. AB - A new occluder to perform the cover test allows visualization of the covered eye through the occluder and direct observation of heterophorias. The occluder is composed of an aluminium-polyester filter mounted on a support in front of a 2.2 V light bulb. PMID- 3662919 TI - Ophthalmology in Kenya. PMID- 3662920 TI - The size and composition of the submandibular glands in late-onset diabetes. AB - Postmortem submandibular glands from 14 patients with late-onset diabetes mellitus were examined in a histomorphometric study and were compared with 14 control glands. The diabetic glands were larger than the control glands and showed increased volume fractions of the stromal components, including vessels, and proportionally less parenchyma. These findings indicate that the increased total volume present in submandibular glands in late-onset diabetes is mainly to increased volumes of fibrous tissue, fat and vessels. PMID- 3662922 TI - Verrucous carcinoma of the larynx--a misnomer. AB - A serie of our observations of so-called "verrucous carcinomas" of the larynx show that these peculiar lesions do not develop true infiltrating growths or metastases, and do not fulfill the criteria of a true carcinoma. Our experiences indicate that these cases can be treated successfully by repeated endoscopic resections. We have found that no aggressive radical treatment - either by surgery or irradiation - is necessary in managing these lesions. Although the etiology of "Ackerman's tumor" of the larynx is still uncertain, we suggest that the lesions develop as the result of a virus infection and propose again the term "verrucous acanthosis" instead of verrucous carcinoma for this disease. PMID- 3662921 TI - Osmotically induced motility of outer hair cells: implications for Meniere's disease. AB - Osmolarity changes in inner ear fluids have long been considered to be contributing factors to Meniere's disease. Our present study demonstrates that small changes in the osmolarity of a surrounding in vitro medium induce fast contractions (hypo-osmotic solution) or elongations (hyperosmotic solution) in isolated outer hair cells of the guinea pig. These changes were reversible upon returning cells to iso-osmotic conditions. Up to five cycles of shape change could be sustained by these cells without obvious detriment to their morphology. These findings suggest that fluctuant changes in osmolarity of inner ear fluids can result in similar fluctuant changes of hair cell shape. Since the outer hair cells may control cochlear micromechanics and function by their active motility, osmotically induced abnormalities of cell dimensions and motility may contribute to the audiological manifestations of fluctuant hearing loss. PMID- 3662923 TI - Three-dimensional ultrastructure of the endolymphatic sac. AB - The subcellular structures of the epithelial cells of the guinea pig endolymphatic sac were studied. By using a newly developed scanning electron microscopy technique, the intracellular organelles could be studied three dimensionally and the topographic relationships analyzed. The light epithelial cell has an extensive network of endoplasmic reticulum which is characteristically arranged in a baso-apical direction. The connections between the inner surface of the plasmalemma and the endoplasmic reticulum were observed, as were connections between the Golgi complex and the endoplasmic reticulum. Our findings support the hypothesis that the endoplasmic reticulum might form transcellular channels through which the cell can transport water and ions from the lumen of the endolymphatic sac out into the subepithelial tissue. The dark epithelial cells seen in particular contained the smooth type of endoplasmic reticulum. Lysosomes were also observed in the dark cells, indicating that these cells probably have more of a secretory function. PMID- 3662924 TI - An immunological study of otitis media with effusion. Antibodies directed against coagulase-negative staphylococci in the effusion fluid. AB - From 14 chronic middle ear effusions (MEEs), 17 strains of coagulase-negative staphylococci (CS) were isolated. We then used an ELISA method to determine the antibody titers against these microorganisms in the corresponding effusion fluids and the blood sera of the patients and compared them to the antibody titers against a group of standard CS. In most cases, no specific immune response could be detected against the infecting CS in either the effusion fluids or in the sera. Our results can be explained by the inability of most CS strains to provoke a specific immune response in chronically inflamed middle ears due to their inhibition by non-specific antibodies, which reach the middle ear cavity by plasma leakage. The non-specific antibody titer against Staphylococcus hominis, however, seems to be much lower than against the other CS species. We found a high specific antibody titer against the infecting CS in the effusion fluid of a single case, but not in the serum. This finding supports the hypothesis that the middle ear mucosa has the ability to produce autonomous, local antibodies which are independent of a systemic immune response. PMID- 3662925 TI - Pathological findings in the human auditory system following long-standing gentamicin ototoxicity. AB - The clinical, audiovestibular and histopathological findings in a patient who suffered from a long-standing gentamicin-induced deafness are reported. In both temporal bones, the organ of Corti was completely absent, with only a few nerve fibres remaining in the apical part of the cochlea. Regenerative ingrowth of nerve fibers into the area of the degenerative organ of Corti was present apically in both ears. The stria vascularis exhibited considerable degeneration in all turns and loss of microvasculature was found in the basilar membrane. The spiral ganglion cells, the cochlear nerve and the central auditory pathways and nuclei appeared to be unaffected. PMID- 3662926 TI - Chondrosarcoma of the cervical vertebra: a case report. AB - A rare case of cervical chondrosarcoma is presented and its clinical behavior and treatment modalities are discussed. PMID- 3662927 TI - CT findings of aspergillosis in the paranasal sinuses. AB - The diagnosis of aspergillosis in the paranasal sinuses is preoperatively difficult to make in spite of the increasing number of reports showing its prevalence. However, because symptoms are usually non-diagnostic and infection is usually confined to a single sinus, X-ray findings are often suspect for possible neoplasm. We have studied six patients with aspergillosis, all of whom were suspected of having sinus tumors, but were otherwise healthy persons. Affected sinuses were examined by CT and the diagnosis of non-invasive aspergillosis was confirmed by operation. In this report, we have compared the CT and X-ray findings in our cases of aspergillosis. These findings indicate that CT is useful in the preoperative diagnosis of sinus aspergillosis. PMID- 3662928 TI - Nystagmus episodes related to sea sickness. AB - In order to test the possible presence of nystagmus during episodes of sea sickness, we performed electronystagmography (ENG) on nine subjects before and during sailing on a 35-ton vessel in a somewhat heavy sea. In addition, the accelerations of the x, y and z axes of the ship were also monitored and simultaneously recorded. Nystagmus was not detected in pre-sailing recordings, while all of the subjects demonstrated clear positional nystagmus during sailing. The nystagmus was episodic, direction-fixed and its intensity was greater in sea sick than in non-sick subjects. Our findings suggest that the nystagmus recorded is labyrinthine in origin and stems from temporary peripheral vestibular dysfunction elicited by sea sickness. PMID- 3662929 TI - Input-output functions of cochlear microphonics in chronic experiments on awake rabbits. AB - Chronically implanted electrodes were used to record cochlear microphonics (CM) in awake rabbits. Test stimuli were sine waves of 1,250, 2,500, 5,000 and 10,000 Hz, with intensities increased from 40 to 100 dB SPL. By using this long-term method for registering the CM, we have found that the form of the input-output functions recorded is in agreement with that from acute experiments as described in the literature. Our method proved to be valid for recording CM with constant amplitudes over a period of 8-10 weeks. Our present results form a basis for further investigations concerning noise overload. PMID- 3662930 TI - Immediate effects of cochlear implantation on voice quality. AB - Seminal quantitative group acoustic data are presented on voice quality changes following electrical stimulation (ES) of the auditory nerve via a single-channel cochlear implant (CI). It was found that the fundamental frequency (Fo) of our patients was significantly lower after the first day of ES, while intensity and speaking duration were not significantly different from pre-CI values. These results suggest that the CI provides enough frequency information less than 300 Hz to permit immediate and independent alterations in voice Fo towards normal hearing speakers values. Our findings also indicate that intensity and speaking duration require additional time before differences found become significant. Longitudinal data are still needed to determine if Fo continues to lower and if intensity and/or speaking duration change significantly to approximate values observed in normal-hearing individuals. PMID- 3662931 TI - DC potentials of the lateral wall of the scala media. AB - We recorded DC potential and resistance changes of the cochlear lateral wall in guinea pigs, using (3M KCl) electrolyte glass microelectrodes. The patterns found for slow penetration showed different potential and resistance characteristics at different segments of the lateral wall. In addition, our findings demonstrate that the monitoring of microelectrode tip resistance is a useful procedure for DC cochlear recordings. PMID- 3662932 TI - [The twenty-second conference of the Japanese Medical Society of Alcohol Studies. Toyama, September 29-October 1, 1987. Abstracts]. PMID- 3662933 TI - The cranberry juice cure: fact or fiction? PMID- 3662934 TI - Teaching Kock pouch catheterization and irrigation. PMID- 3662935 TI - Disinfection and sterilization. PMID- 3662936 TI - Effects of noise and hearing loss upon frequency discrimination. AB - Frequency discrimination in quiet and in the presence of several levels of low frequency masking noise was measured at 500, 1,000 and 2,000 Hz in both normal hearing and hearing-impaired subjects. The test signals were presented at 80 dB SPL; all test signals were at least 10 dB above each subject's masked threshold. As a group, the hearing impaired subjects had larger frequency difference limens than the normal subjects, especially in frequency regions of greatest sensitivity loss. The masking noise produced a similar increase in frequency difference limens in both groups. Although several previous speech recognition studies have demonstrated an interactive effect between the presence of hearing loss and masking noise, the results of the present study demonstrate that frequency discrimination performance for normal-hearing and hearing-impaired subjects is not differentially affected by the addition of masking noise. PMID- 3662937 TI - Psychosocial disadvantages associated with occupational hearing loss as experienced in the family. AB - A questionnaire has been developed to investigate the psychosocial disadvantages resulting from occupational hearing loss (OHL). It was designed to measure the awareness of the hearing disability, the coping strategies and the family response to the consequences of OHL. Answers to the questionnaire were obtained from 54 workers with various degrees of presumed OHL and from 44 normal-hearing workers employed in the same noisy plant. The results show that the family bears several consequences of the noise exposure and of the hearing loss of the worker and that its spontaneous reaction to OHL appears as one source of the psychosocial disadvantages experienced by the worker. The implications of these results for rehabilitative intervention are discussed. PMID- 3662938 TI - Can tinnitus mask hearing? A comparison between subjective audiometric and objective electrophysiological thresholds in patients with tinnitus. AB - Very little has been written in the literature about the masking effect of tinnitus on hearing. This possibility arose from the clinical observations of hearing fluctuating with the intensity of tinnitus. To explore this hypothesis, a group of 19 patients suffering from hearing loss and tinnitus underwent a complete audiological evaluation and their audiometric and ABR thresholds were compared. Two other groups who were examined in the same manner, served as control groups. The first group consisted of 19 age- and sex-matched subjects with relatively normal hearing and no tinnitus. The second control group was composed of 8 patients suffering from sensorineural hearing loss without tinnitus. The differences between the subjective and ABR thresholds within each group and between the groups were statistically analyzed. The objective thresholds in the tinnitus group were found to be lower than the subjective thresholds. PMID- 3662939 TI - Dynamic aspects of stapedial reflex in myasthenia gravis. AB - The modifications of stapedial reflex have been studied in 30 subjects affected by myasthenia gravis. The test was performed in basal conditions (i.e. at least 6 h after the last administration of an anticholinesterase drug), after the injection of Tensilon and again in basal conditions, 1 week after thymectomy. The reflex was elicited in 27 patients but in 1 case it appeared only after therapy. Among the various parameters analyzed, only rise velocity, decay velocity and amplitude have shown lower values in patients than in the normal group. These parameters increased significantly after the pharmacological test and 1 week after thymectomy in 60% of the cases. The data suggest that patients with more evident muscular damage are more likely to present a rise of stapedial strength after therapy. The efficiency of thymectomy has also been demonstrated. PMID- 3662940 TI - Comparison of auditory-evoked potential detection methods using signal detection theory. AB - The performance of statistical evoked-potential detection methods was compared with that of human observers and among themselves by means of receiver operating characteristics (ROC) curves. The test material was a collection of brain stem auditory-evoked responses obtained from 98 infants with 60 and 30 dB nHL clicks. The observers and the statistical methods had to discriminate these responses from control recordings obtained without acoustic stimulation. Although the observers' criteria on different days varied considerably, the discrimination capacity was more stable. The discrimination capacity depended on the observers' experience. The statistical methods tested were the correlation coefficient (CCR), the standard deviation ratio (SDR) and a new method named T2R. The most efficient detection method was T2R. For false-alarm rates of 0.01 the statistical methods were more efficient than the human observers. Signal detection theory is useful for the evaluation of evoked-potential analysis methods. PMID- 3662941 TI - Prediction of auditory brainstem wave V latency as a diagnostic tool of sensorineural hearing loss. AB - The lesion location (cochlear vs. retrocochlear) of sensorineural hearing loss may be differentiated with a diagnostic index (delta V), which is calculated from the wave V latency of the monaurally evoked auditory brainstem response (ABR), and from the pure-tone hearing threshold at 2 and 4 kHz. The delta V values obtained from 80 recruiting ears have proven to correlate linearly to the amount of the hearing loss, hence allowing to define appropriate confidence boundaries for cochlear hearing losses. In contrast, the delta V values obtained from 32 ears of patients with retrocochlear lesions--cerebellopontine angle (CPA) tumors- were all found to exceed the 95% upper confidence limits projected for cochlear lesions, thus giving a 100% rate of true results in the detection of retrocochlear pathology. These results, providing an ABR parametric model for the cochlear hearing loss, suggest a diagnostic strategy for the early detection of CPA tumors based on the exclusion of a cochlear hearing loss. PMID- 3662942 TI - Application of the three-channel lissajous trajectory of auditory brainstem evoked potentials to the question of generators. AB - In studies of generators of auditory brainstem-evoked potentials (ABEP), depth recordings and clinical correlates may not reflect all the activity involved. Although the 'inverse problem' is mathematically ill-posed, a synthesis of physico-anatomical data with a three-channel Lissajous trajectory (3CLT) may indicate the actual number and identity of generators. A 3CLT of ABEP in three dimensional voltage space, is isomorphic with the vector tip representing the momentary centrally located dipole in a uniform, spherical volume conductor. This isomorphism enables approximations of ABEP dipole equivalents to be made. 3CLT summarizes the surface activity in a single plot. It accentuates correlations within the orthogonal records, such as planarity of segments, allowing segmentation of the analysis epoch into components. These properties of 3CLT simplify the analysis of parametric effects on the surface distribution of ABEP components. The results of applying this technique indicate the experimental conditions under which the assumptions for the approximation of generators are closest to being fulfilled. Of all the points along the trajectory, apices (points with maximum absolute amplitude and curvature) have the most unique generators. The 3CLT to low-intensity and high-rate clicks, indicate more unique generators than the customarily used high-intensity slow-rate clicks, in which considerable temporal overlap of generator activity exists. PMID- 3662943 TI - Venom diseases in Australia and their treatment. PMID- 3662944 TI - A variety of death. PMID- 3662945 TI - Research trends in multiple sclerosis. PMID- 3662946 TI - Psychological problems in MS. PMID- 3662947 TI - Interpretation of plasma enzyme results. PMID- 3662948 TI - Two 'fishy' tales. PMID- 3662949 TI - Without understanding. PMID- 3662950 TI - Drug prescribing. A plea for accuracy and patient education. PMID- 3662951 TI - Printed prescriptions. PMID- 3662953 TI - New insight into acupuncture. PMID- 3662954 TI - Rational prescribing. PMID- 3662952 TI - General practitioner services. PMID- 3662955 TI - Adverse drug reactions. Important issues. PMID- 3662956 TI - Common prescribing errors. PMID- 3662958 TI - Diabetes mellitus in childhood. Adelaide Children's Hospital Diabetic Team. PMID- 3662957 TI - Injury to nose. PMID- 3662959 TI - A drug information system. PMID- 3662960 TI - Use of spreadsheets in the manipulation of medical data. PMID- 3662961 TI - A simple cure for chronic tennis elbow. PMID- 3662962 TI - Angina. PMID- 3662964 TI - Musculoskeletal disorders. PMID- 3662963 TI - Persistent neuromuscular viral syndrome. PMID- 3662965 TI - Doctor and patient evaluation of automated health testing at the Shepherd Foundation. PMID- 3662967 TI - Epidemiology of bovine ephemeral fever in Australia 1981-1985. AB - Bovine ephemeral fever is an important viral disease of cattle in Australia. The disease occurred each year, principally in summer and autumn, between 1981 and 1985. Queensland and the northern half of New South Wales were areas of greatest activity with only sporadic cases being reported from the Northern Territory and the northern third of Western Australia. Since 1981, the disease has been endemic in an extensive area of eastern Australia and has tended to occur in widely scattered outbreaks rather than the north-south advancing wave form of the epidemics of 1936-37, 1967-68, 1970-71 and 1972-74. The southernmost outbreaks between 1981 and 1985 were well within the limits of these earlier epidemics. The pattern of disease appears to have become seasonally endemic rather than periodically endemic in the northern two-thirds of eastern Australia. Ephemeral fever was not recorded in Victoria, Tasmania, South Australia or the southern part of Western Australia between 1981 and 1985. The disease was most frequently reported in cattle under 3 years of age, but also occurred in older cattle. PMID- 3662966 TI - Nephrotoxic activity in rats fed diets containing DL-3-(N-phenylethylamino) alanine. AB - Rats were fed DL-3-(N-phenylethalamino)-alanine which resulted in kidney lesions histologically identical with those produced by the structurally related compound lysinoalanine. Possible mechanisms for nephrotoxicity are discussed. PMID- 3662968 TI - Preliminary studies of the complement fixation test to confirm the diagnosis of bovine ephemeral fever. AB - A strain of bovine ephemeral fever (BEF) virus isolated in China in 1976 was adapted to growth in tissue cultures. A baby hamster kidney complement fixing (CF) antigen, stable at -20 degrees C for at least 120 days, was prepared from the BEF virus grown in tissue culture and used to test bovine sera for antibodies to that virus. CF antibodies were detected in all of 31 cattle after convalescence from experimental infection with BEF virus, in 208 (98%) of 213 cattle observed to have shown clinical ephemeral fever in an epidemic, in 96 cattle in these herds which did not show clinical signs of ephemeral fever and 16 cattle from herds in northern China outside the epidemic area. The CF antibodies to BEF virus were found to persist in 34 (89%) of 38 cattle which were bled 6 years after natural exposure to ephemeral fever. The CF antigen is economical to prepare and is suitable to differentiate ephemeral fever from other viral infections with which it could possibly be confused on clinical appearance. PMID- 3662969 TI - Genetic variation in mitochondrial DNA from some aboriginal Australians. AB - Mitochondrial (mt) DNAs from 17 aboriginal Australians, predominantly from the coastal region of the Northern Territory were isolated and digested with four four-base restriction endonucleases, two of which revealed variation between samples. The observed fragment patterns were used directly in parsimony analyses of phylogenetic relationships between the samples, and were also converted to estimates of the number of substitutions per nucleotide position between samples (delta), which estimates were then used in distance analyses of phylogeny. The inferred fragment patterns of the completely sequenced 'Cambridge' human mtDNA were also included in these analyses. No strong evidence of geographic variation was found, consistent with previous findings of Australian aborigines and other humans generally, although the most divergent sample was one of two from Sydney, indicating that further work is desirable. The estimate of mean difference between samples (diversity), 0.0017 +/- 0.0003 (mean +/- 95% confidence interval), is significantly lower than that reported previously for humans generally. PMID- 3662971 TI - kVp definitions and their impact on practical kVp measurement in diagnostic radiology. PMID- 3662970 TI - Non-esterified long-chain fatty acid metabolism in fed sheep at rest and during exercise. AB - The role of circulating, non-esterified, long-chain fatty acids (NEFA) as a source of energy for the whole animal and skeletal muscle was investigated in fed non-pregnant sheep at rest and during exercise. Infusion of tracer quantities of [1-14C]oleic or [1-14C]stearic acid was combined with the use of arteriovenous difference studies on fed sheep at rest or during a 2 h period of exercise on a belt treadmill moving at 4.5 km h-1. At rest all parameters of NEFA metabolism indicated a minimal role for oxidation. Thus the concentration in plasma (0.07 +/ 0.01 mmol l-1), entry rate (0.08 +/- 0.02 mmol h-1 kg-1 body wt), contribution to whole animal oxidation (1.2 +/- 0.3%) and utilization of NEFA by skeletal muscle (0.046 +/- 0.008 mmol h-1 kg-1 muscle) were all low. Exercise prompted a shift to lipolysis and accordingly the above parameters increased markedly some 13-24-fold. The circulating concentration of ketone bodies showed only a small increase during exercise and consequently the role of ketone bodies as an energy source during exercise was minimal. Glucose utilization by skeletal muscle was considerable in animals at rest and it represented the most significant potential fuel of skeletal muscle. Exercise resulted in a sustained increase of 3-4-fold in the utilization of glucose by skeletal muscle. Thus the traditional view that NEFA and not glucose is a predominant fuel of skeletal muscle of fed sheep should be appraised. PMID- 3662972 TI - Design and construction of "SUMRIS"--the Sydney University magnetic resonance imaging system. PMID- 3662974 TI - Fast magnetic resonance imaging using spiral trajectories. PMID- 3662973 TI - Computer system architecture for NMR imaging. PMID- 3662975 TI - A method for the calibration of graphics digitizers. PMID- 3662976 TI - Removal of spike interference from digitised angiographic images. PMID- 3662977 TI - Childhood autism. PMID- 3662978 TI - A 10 year review of systemic lupus erythematosus in Singapore children. AB - A 10 year retrospective analysis of the clinical features and survival of 24 Singapore children with systemic lupus erythematosus was made. The female to male sex ratio was 11:1. The median age at diagnosis was 9.3 years (range: 3.5-17.6 years), and the median duration of follow-up was 3.6 years (range: 3 months-10 years). The common modes of presentation were prolonged fever and malar rash (both 46%). Renal involvement (71%) was frequent. There were six deaths, three from chronic renal failure, two from infection, and one from carditis. The overall survival at 5 years was 0.800 (s.e.m. = 0.090), and at 10 years 0.698 (s.e.m. = 0.103). The survival for lupus nephritis was 0.727 at 5 years (s.e.m. = 0.116), and 0.586 at 10 years (s.e.m. = 0.130). Although the 5 year survival rate is comparable with other series, there were more deaths after the first 5 years, and morbidity from the disease as well as from therapy was considerable. PMID- 3662979 TI - The severity of acute asthma attacks in children admitted to hospital. AB - One hundred and twenty-six children admitted to hospital with an acute asthmatic episode were assessed as to the severity of their attack by the use of a clinical score. Fifty-one per cent had a score which equated with severe or very severe asthma. Frequent independent scoring indicated that observer bias was minimal. The proportion of children with severe asthma admitted to hospital in Christchurch was significantly greater than a similar study in England using the same scoring system. The rise in hospital admission rates for asthma in Christchurch is not due to an increase in the admission of children with milder forms of asthma. PMID- 3662980 TI - Food intake at age 8. 2. Frequency, company and place of meals. AB - In a sample of 141 healthy 8 year old children, over 95% had three main meals on each of the 4 days of the food record. Two-thirds had an afternoon snack and nearly one-half a morning snack on each of the 4 days, but only one-quarter had supper on each day. Seventy-one per cent of all meals were eaten at home with the family, 20% at school with friends, and less than 1% of meals were eaten at a restaurant or fast food outlet. These data show that amongst children of primary school age, take away sources of food make a very small contribution to the diet, and that eating habits at home are of greatest importance to the child's diet. PMID- 3662981 TI - Neonatal jaundice in 'healthy' very low birthweight infants. AB - The daily bilirubin levels during the first week of life in 94 premature very low birthweight (VLBW, less than 1500 g) relatively 'healthy' infants were determined. Mean daily bilirubin values peaked on the fourth day of life at 188.1 mumol/l (s.e.m. = 5.3). Twenty-eight infants developed hyperbilirubinaemia (bilirubin greater than 260 mumol/l), at which time they were exposed to phototherapy. When individual peak bilirubin values were evaluated, the overall peak value was 213.9 mumol/l (s.e.m. = 5.1) occurring at 4.81 days (s.e.m. = 0.11), although the value is most likely an underestimate, since the 28 pre phototherapy values were not truly peak values. Seventy-six (81%) infants experienced bilirubin levels greater than 170 mumol/l. The method of delivery apparently had no impact on the bilirubin levels. All the infants remained well and progressed satisfactorily. 'Healthy' VLBW infants experience a much greater incidence and severity of neonatal jaundice than mature infants with the same clinical status. PMID- 3662982 TI - Low colloid osmotic pressure in very low birthweight infants receiving assisted ventilation. AB - Plasma colloid osmotic pressure (COP) was measured in three groups of very low birthweight infants. Babies in Group 1 (n = 8) were breathing spontaneously and had no respiratory disease. Those in Group 2 (n = 9) received assisted ventilation for hyaline membrane disease (HMD), and those in Group 3 (n = 7) received assisted ventilation for other reasons (five apnoea, two pneumonia). Both assisted ventilation groups had lower mean COP values than spontaneously breathing infants. Mean values (s.e.m.) for Groups 1, 2 and 3, respectively, were: 15.3 (0.6), 11.3 (0.4) and 11.9 mmHg (0.5) (P less than 0.001) on Day 1; and 15.2 (0.4), 12.9 (0.4) and 12.8 mmHg (0.3) (P less than 0.001) on Day 2. The increase from Day 1 to Day 2 was significant for those with HMD (P less than 0.05). Colloid osmotic pressure correlated with mean blood pressure (r = 0.51; P less than 0.001) but not with birthweight, gestation, crystalloid fluid intake or pH. The role of low COP in the pathogenesis of acute respiratory failure in infants with uncomplicated HMD is unclear, but such low COP may contribute to development of pulmonary oedema as a complication, particularly if the ductus arteriosus is still patent and the infants are given high volume intravenous fluids. PMID- 3662983 TI - Acute cervical lymphadenitis in children. AB - A retrospective study of 78 children with acute cervical lymphadenitis treated in Newcastle over the last 9 years revealed that abscesses formed in 50 children despite antibiotic treatment. Children under 2 years of age were more likely to form an abscess than older children. The commonest organism isolated was penicillin-resistant Staphylococcus. Beta-haemolytic Streptococcus was isolated less commonly and isolation of penicillin-sensitive staphylococci was rare. Penicillin and amoxycillin alone are unsuitable as first line antibiotics. Severe infections and those failing to respond rapidly to initial antibiotic treatment should be admitted to a paediatric unit for intravenous beta-lactamase-resistant antibiotics. PMID- 3662984 TI - The neonatal recognition of partial 11q trisomy (previously 'trisomy 22'). AB - The recognition of chromosomal abnormalities in the neonatal period is important. Paediatricians should be aware that the partial 'Trisomy 22' (now partial 11q trisomy) syndrome has a recognizable phenotypic expression and is relatively common. The distinctive facies with a long philtrum, micrognathia, beaked nose and cleft palate, associated with hypotonia and other congenital abnormalities, should make early postnatal diagnosis possible so that parental counselling can be given without delay. PMID- 3662985 TI - Maple syrup urine disease in Hong Kong. PMID- 3662986 TI - Towards a comprehensive assessment of chronic pain patients. PMID- 3662987 TI - The multidimensional assessment and management of recurrent pain syndromes in children. PMID- 3662988 TI - Chronic pain in children. PMID- 3662989 TI - Avoidance behaviour and its role in sustaining chronic pain. PMID- 3662990 TI - Self-efficacy and disability beliefs in behavioral treatment of pain. PMID- 3662991 TI - Psychological intervention for the control of pain. PMID- 3662992 TI - A catastrophe theory model of the conflict helix, with tests. AB - Macro social field theory has undergone extensive development and testing since the 1960s. One of these has been the articulation of an appropriate conceptual micro model--called the conflict helix--for understanding the process from conflict to cooperation and vice versa. Conflict and cooperation are viewed as distinct equilibria of forces in a social field; the movement between these equilibria is a jump, energized by a gap between social expectations and power, and triggered by some minor event. Quite independently, there also has been much recent application of catastrophe theory to social behavior, but usually without a clear substantive theory and lacking empirical testing. This paper uses catastrophe theory--namely, the butterfly model--mathematically to structure the conflict helix. The social field framework and helix provide the substantive interpretation for the catastrophe theory; and catastrophe theory provides a suitable mathematical model for the conflict helix. The model is tested on the annual conflict and cooperation between India and Pakistan, 1948 to 1973. The results are generally positive and encouraging. PMID- 3662993 TI - A living systems process analysis of an urban hospital. AB - This article presents a study of a living system at the level of the organization. Specifically, it reviews a living systems process analysis of an urban hospital and its constituent departments. The relationship between a hospital department's performance of the living system's processes and its effectiveness is discussed. The general findings of the study and recommendations emanating from the analysis are included. PMID- 3662994 TI - Lack of evidence for a cerebral sodium modulating mechanism in the monkey. AB - Experiments were carried out in seven conscious macaque monkeys undergoing a water diuresis to determine the effects of raising carotid blood sodium concentration on renal sodium excretion and free water clearance. On separate days each animal received an intracarotid infusion of hypertonic sodium chloride (90 Eq NaCl/kg.body wt./min) for 5 to 10 min, the same hypertonic infusion intravenously, and an intracarotid infusion of isotonic NaCl. None of the infusions produced a change in sodium excretion. However, the intracarotid hypertonic infusion produced a sustained decrease in free water excretion while the other infusion did not. Creatinine clearance was not affected by any of the infusions. The results of these experiments support the view that while the brain of the primate contains an osmotic sensing mechanism it does not contain a mechanism which modulates sodium excretion. PMID- 3662995 TI - Atrial and ventricular myosins from human hearts. II. Isoenzyme distribution after myocardial infarction. AB - Human atrial and ventricular myosins were prepared from autopsy specimens from subjects with coronary heart disease. Cardiac myosin light chain isotypes were resolved using two-dimensional gel electrophoresis, whereas myosin isozymes were detected by pyrophosphate gel electrophoresis. Myocardial infarction and associated work overload cause a transition in the light chain complements of the myosins. Thus ventricular myosin light chains were found in pressure overloaded atria and atrial light chains have also been identified in the infarct ventricle of the human heart. Two molecular isoenzymes of the human atrial myosin, the relative proportions of which are changed after infarction, were separated under non-dissociating conditions by gel electrophoresis. A decrease in HA-3 and a corresponding increase in HA-1 were observed. Ventricular hypertrophy in patients with coronary insufficiency induces a second ventricle isomyosin, called HV-1, with the same electrophoretic mobility as HA-1. The relative part of this myosin type amounts to 20%. Comparative peptide mapping studies were carried out on myosin subfragment-1 preparations from normal and infarct ventricles. In the primary structures, the chymotrypsic digestions produced slight differences. These data demonstrate the heterogeneity of human atrial and ventricular myosins in patients with coronary heart disease. PMID- 3662996 TI - Coronary artery stenosis controlled by distal perfusion pressure: description of the servo-system and time-dependent changes in regional myocardial blood flow. AB - An animal model for the induction of coronary artery stenosis is described. In this model the degree of stenosis, as induced with commercially available hydraulic occluders, can be easily controlled by keeping constant the mean perfusion pressure (pcor) distal to the site of stenosis. This pcor is the input signal for a servo-system feeding a motor-pump, which determines the degree of inflation of the cuff around the left anterior interventricular coronary artery (LAICA). In each experiment pcor did not vary more than 2 mm Hg from the preset value of about 25 mm Hg. In 60 anesthetized open-chest dogs the time course of standard hemodynamic variables and regional myocardial blood flow in the center of the underperfused area, using the radioactive microsphere technique, were determined. Within 1 min after induction of stenosis heart rate and end-diastolic left ventricular pressure (plved) increased (by 20 and 60%, respectively) and mean aortic pressure and dplv/dtmax decreased (by 10 and 25%, respectively). After the initial decrease median myocardial blood flow further decreased between 1 and 5 min of stenosis from 0.63 to 0.32 ml.min-1.g-1 in the outer layers (P less than 0.05) and from 0.26 to 0.15 ml.min-1.g-1 in the inner layers (P less than 0.05), despite constant hemodynamic conditions and pcor. Between 5 and 120 min of stenosis these values remained unchanged in the outer layers, but decreased further in the inner layers to 0.08 ml.min-1.g-1 (P less than 0.05). The accurate control of pcor, the reproducibility of the levels of residual blood flow and the ease of handling the stenosis system indicate that coronary artery stenosis controlled by perfusion pressure distal to the stenosis is a useful animal model to study events during regional myocardial ischemia. With the use of this model of low flow ischemia a biphasic increase of myocardial vascular resistance was observed, which is initiated during the first minutes of coronary artery stenosis. PMID- 3662997 TI - Influence of tonicity on the viscoelastic properties of blood during isovolemic dilution. AB - The influence of isotonic or hypotonic dilution on viscoelastic properties of blood is examined. The viscous, as well as the elastic, properties of blood samples diluted with isotonic saline or pure water, respectively, and of undiluted whole blood samples are compared by means of a dynamic capillary viscosimeter (OCR-D, A. Paar K.G., Austria). The dilution (approximately 17% of the total blood volume) was performed isovolemically and retained the same rbc count. The rbc swelling observed as a consequence of changes in plasma osmolarity was tracked by the high resolution density measurement, according to the mechanical oscillator technique. Since no significant rbc swelling was found in the dilution with isotonic saline, viscoelastic resistance of blood was efficiently reduced in the observed range of shear rates (2 s-1-100 s-1). This decrease is due to reduced plasma protein concentration, which also lowers plasma viscosity by approximately 18%. Although plasma viscosity is significantly decreased in hypotonic dilutions (-12%), flow properties of the rbc suspensions are, in general, significantly impaired. This is due to the osmotic rbc swelling (hematocrit = +8%), which increases viscous resistance within the suspending fluid, as well as elastic resistance of the rbc due to a loss in rbc deformability. It can be concluded that isotonic dilution leads to a decrease in the viscosity of blood, whereas hypotonic dilution--in an order of magnitude which may occur during resorption of water--leads to increased viscous and elastic resistance of the blood. PMID- 3662998 TI - Impaired cholinergic vasodilation in the cholesterol-fed rabbit in vivo. AB - Endothelium-dependent cholinergic relaxation in vitro is impaired in large arteries of animals and man with atherosclerosis. To assess the physiological importance of this impairment, we compared vasodilator effects of acetylcholine and nitroprusside, an endothelium-independent agent, in control rabbits (n = 12) and rabbits fed a 1% cholesterol diet for 10 weeks (n = 8). The hindlimb of the rabbits was perfused via an extracorporal loop at a constant flow, and perfusion pressure was used as an index of total vascular resistance. The hindlimb vascular resistance was monitored during intraarterial bolus injections with graded concentrations of acetylcholine (0.01-1.000 ng) and nitroprusside (0.1-1.000 ng) which produced no change in systemic hemodynamics. Between 0.1 and 1.000 ng nitroprusside, resistance changes in control and cholesterol-fed rabbits were virtually identical. In contrast, the resistance change induced by acetylcholine was significantly suppressed in cholesterol-fed rabbits over a wide range of concentrations (1.0-1.000 ng; p less than 0.05). The results indicate that in a model of atherosclerosis there is a reduced vasodilatory responsiveness to the endothelium-dependent acetylcholine, whereas the effect of the endothelium independent nitroprusside is fully preserved. PMID- 3662999 TI - The effect of calcium concentration on spontaneous ventricular defibrillation and VF threshold. AB - In order to investigate the influence of the effective refractory period on spontaneous ventricular defibrillation, isolated rat hearts were perfused with Krebs-Henseleit solution containing 0.5, 2.7 and 5.1 mM calcium. After measuring the fibrillation threshold at spontaneous rate (SR), ventricular fibrillation (VF) was induced during basic ventricular pacing of 110% SR, or the highest rate permitting 1:1 electromechanical coupling. The VF threshold was significantly reduced from 13.6 +/- 3.5 to 7.9 +/- 5.3 and 5.1 +/- 3.4 mA at 0.5, 2.7 and 5.1 mM Ca++ concentrations, respectively. The incidence of spontaneous recovery from VF, induced during basic pacing, was 100%, 83% and 50% at calcium concentrations of 0.5, 2.7 and 5.1 mM, respectively, (p less than 0.01 for the incidences at 0.5 mM versus 5.1 mM Ca++). The incidence of spontaneous defibrillation decreased when the hearts were driven rapidly, with spontaneous recovery rates of 92%, 58% and 0% (p less than 0.0001] for corresponding increases in Ca++ concentration. Induced ventricular fibrillation of fine morphology was frequently observed at 5.1 mM Ca++. It appears that progressive impairment of spontaneous defibrillation is caused by an increase in calcium concentration, this effect being more pronounced at high ventricular rates. Variations in the effective refractory period, caused by alterations in extracellular calcium concentration and differences in intracellular Ca++ accumulation, may account for the above results. PMID- 3663000 TI - An easy and quick implantation procedure for the measurement of myocardial wall thickness using sonomicrometry. AB - Ultrasonic techniques for the measurement of ventricular dimensions are widely used in acute and chronic experiments. Implantation of ultrasonic crystals is associated with reversible and irreversible myocardial damage which might limit the interpretation of the obtained results, in particular during acute experiments. We therefore developed a sonomicrometric device which can be easily and quickly implanted, and thus reduces the reversible myocardial damage induced by prolonged surgical implantation. PMID- 3663001 TI - Lipid metabolism in the normoxic and ischaemic heart. Proceedings of an international symposium. Rotterdam, The Netherlands, September 22 and 23, 1986. PMID- 3663002 TI - Phospholipid alterations in canine cardiac sarcoplasmic reticulum induced by an acid-active phospholipase C. AB - Phospholipid alterations and phospholipase activities were studied in a preparation of canine cardiac sarcoplasmic reticulum (SR) known to contain lysosomes. Incubation of SR at pH 5.0 (37 degrees C) resulted in a loss in total lipid phosphorus which was maximal (10%) by 30 min. whereas a modest increase in lipid phosphorus occurred during incubation at pH 7.0. The content of phospholipid phosphorus was decreased (8.6-19.0%) in sphingomyelin, phosphatidylcholine, phosphatidylethanolamine, and phosphatidylserine when SR was incubated at pH 5.0; however phosphatidic acid increased 14% relative to control. Lysophospholipids were not detected. Liposomes of 1-acyl 2-[1 14C]-linoleoyl-sn glycero-3-phosphoryl-ethanolamine (14C-PE) were hydrolyzed by SR at pH 5.0 to yield radiolabelled diglyceride (18.1 nmol/hr mg protein) and free fatty acid (8.3 nmol/hr mg protein). SR-mediated diglyceride production at pH 5.0, but not free fatty acid release, was markedly potentiated when 14C-PE was peroxidized by preincubation at pH 5.0 for 3-24 hours at 37 degrees C. After 24 hours of preincubation at pH 5.0 the specific activity of SR-mediated diglyceride production was 188% of control. A comparable increase in diglyceride production occurred when 14C-PE was peroxidized at pH 7.0 and hydrolyzed by SR at pH 5.0. No increase in enzymatic activity occurred when liposomes were both preincubated and assayed at pH 7.0. When 14C-PE was exposed to air at pH 5.0 or 7.0 more polar radiolabelled derivatives were formed as determined by thin layer chromatography. Up to twice as much polar lipid was formed at pH 5.0 compared to pH 7.0.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663003 TI - The effects of ischaemia, lysophosphatidylcholine and palmitoylcarnitine on rat heart phospholipase A2 activity. AB - Phospholipase A2 activity was studied in the isolated rat heart following coronary artery ligation. In both the homogenate and mitochondrial fractions phospholipase A2 activity was significantly depressed at 20 min post ligation in the ischaemic region only. This is at a time of peak lysophospholipid concentration and severity of arrhythmias. No such depression of activity was seen in a crude sarcolemmal fraction, possibly due to washout of inhibitory factors during isolation. Lysophosphatidylcholine and palmitoylcarnitine, two amphiphiles known to accumulate during ischaemia, were both shown to be capable of inhibiting phospholipase A2. It is suggested that lysophospholipid and palmitoylcarnitine accumulation during ischaemia may contribute to the depression of phospholipase A2 activity seen and that the decreased metabolism of lysophospholipids may be of more importance in their accumulation than increased production by phospholipase A2. PMID- 3663004 TI - Metabolic disturbances during acute lack of oxygen: a short overview. PMID- 3663005 TI - Free fatty acid metabolism in "stunned" myocardium. AB - To assess whether myocardial lipid metabolism is altered in the "stunned" myocardium we have studied the metabolism of (1-14C)-palmitate during reperfusion in a modified rat heart preparation. Hearts were perfused retrogradely at a physiological flow rate (2 ml/min) in a non-recirculating system with erythrocyte enhanced Krebs-Henseleit buffer containing albumin 0.4 mM, glucose 11 mM, palmitate 0.4 mM and trace amounts of (1-14C)-palmitate. Left ventricular pressure was measured by a latex balloon in the left ventricular cavity. Control hearts were perfused at constant flow for 120 min. To achieve reversible ischaemic damage, myocardial perfusion was reduced by 95% for 40 min, followed by reperfusion at the control flow rate for 60 min (reperfusion group). For comparison, irreversible damage was produced by calcium free perfusion (calcium paradox group). In the reperfusion group, the developed pressure was severely depressed 5 min after reperfusion to 23% of the value in the control group (p less than 0.05) but recovered to 84% (NS) at 60 min. In the calcium paradox group, mechanical activity ceased completely without recovery. Myocardial uptake of (1-14C)-palmitate in the reperfusion group was similar to the control experiments for the entire reperfusion period, whereas a marked depression was observed in the calcium paradox group. 14CO2 production was severely depressed at the onset of reperfusion in both the reperfusion and calcium paradox group to 42% (p less than 0.05) and 29% (p less than 0.05) respectively. In contrast to the calcium paradox group, 14CO2 production in the reperfusion group recovered progressively to 70% (NS) of the control value during the 60 min of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663006 TI - The effects of dietary mackerel oil on the recovery of cardiac function after acute ischaemic events in the pig. AB - To investigate the effects of fish oil nutrition on cardiac haemodynamics and the biochemical response to ischaemia-reperfusion, young pigs (5 weeks old) were fed a 9% lard fat diet or a mixed diet of 4.5% mackerel oil and 4.5% lard fat for 16 weeks. In the mackerel oil fed pigs plasma cholesterol and triglyceride levels decreased by 22% and 58% (both p less than 0.05), respectively, while levels in the animals which received only lard fat did not change. The n-6 fatty acids present in cardiac and platelet membrane phospholipids underwent a partial replacement by n-3 fatty acids in the mackerel oil fed pigs. Under anaesthesia, multiple coronary artery occlusions (5 min) were interrupted by 10 min of reperfusion. The extent of recovery of cardiac function and reduction of adenine nucleotide levels were similar for both dietary groups. The incidence of reperfusion arrhythmias was significantly lower and the reactive hyperaemic responses were of longer duration in the mackerel oil fed animals. These effects cannot be explained by diet-induced alterations in thromboxane B2/6-keto-PGF1 alpha ratio, although a marked reduction in absolute levels of both prostaglandins was seen in the mackerel oil fed pigs (p less than 0.05). In conclusion, dietary fish oil caused changes in membrane fatty acid composition and plasma prostaglandin levels, although these did not affect alterations of cardiac performance during and after short periods of ischaemia. PMID- 3663007 TI - Effects of free fatty acids, lysophosphatides and phospholipase treatment on lipid peroxidation of myocardial homogenates and membrane fractions. AB - The effects of various free fatty acids, lysophosphatides and phospholipase treatments on the enzymatic and the non-enzymatic lipid peroxidation capacities in the heart homogenates and subcellular fractions were studied. The results showed a dose related inhibition of both the enzymatic and non-enzymatic lipid peroxidation with free fatty acids. A significant inhibition occurred as early as at the concentration of 25-50 microM of several fatty acids both in homogenates and in organelle fractions. In general, the inhibition was greatest with cis unsaturated, long-chain fatty acids. The inhibition was also induced by the pretreatment of the homogenates with phospholipase A2 but not with phospholipase C. The lysophosphatidyl cholines (16:0 and 18:1) had a stimulatory effect on the enzymatic lipid peroxidation capacity at the physiological concentrations. The results show that the stimulatory/inhibitory effect of various lipid amphiphiles on lipid peroxidation is strongly structure linked and the mitochondrial fraction is the most susceptible to the injury induced by lipid amphiphiles. PMID- 3663008 TI - Substrates for energy metabolism in the heart: the role of the interstitial compartment. AB - Evidence is presented that, as in cardiomyocytes, vascular endothelial cells use fatty acids, in addition to glucose, as a respiratory fuel. Attention is focused on the cardiac interstitium, lined by vascular cells and cardiomyocytes, which may be enriched with metabolic products from these cells. Also, certain proteins are present in the interstitial fluid (Qi) such as plasma proteins and fatty acid binding protein (FABP). However, the concentration of FABP is so low in Qi that albumin is more important to shuttle long chain fatty acids in the interstitial fluid between cardiomyocytes and the vascular compartment. Under hypoxic conditions (hypo)xanthine, lactate and fatty acids may be expected to accumulate in the interstitium, as well as proteins from adjacent cells, such as xanthine oxidase from endothelial cells. This enzyme, acting upon the elevated level of (hypo)xanthine, giving rise to O2-., may be involved in the damage of the ischaemic heart. The significance of the interstitium in ischaemia and in fibrosis following long standing cardiac lipidosis is briefly discussed, as well as the possible mechanisms involved in fatty acid transport in the heart. PMID- 3663009 TI - Triacylglycerol lipase activities in isolated myocardial cells from chronically diabetic rat hearts. AB - Diabetes was induced by the administration of streptozotocin (55 mg/kg or 70 mg/kg) to rats. After 21-25 days, myocardial cells (myocytes) were isolated from control and diabetic rat hearts. Rates of endogenous lipolysis, measured as the output of glycerol, were elevated in the chronically diabetic myocytes. Lipoprotein lipase activity was reduced in homogenates of diabetic myocytes. Neutral triacylglycerol lipase activity was increased in myocytes from rats made diabetic with the lower dose of streptozotocin, but not in myocytes from diabetic rats given the higher dose. Diabetes had no effect on acid lysosomal lipase activity. PMID- 3663010 TI - Lipoprotein lipase activity in ischaemic and anoxic myocardium. AB - Myocardial lipoprotein lipase (LPL) activity during ischaemia has not been fully understood, although it plays an important role in regulating myocardial fatty acid metabolism. In this experiment, the effects of ischaemia (Experiment A) and anoxia (Experiment B) on two distinct fractions of LPL, i.e. functional and nonfunctional forms were investigated in isolated, perfused rat heart. In Experiment A, hearts were perfused by Neely-Morgan working heart mode with Krebs Henseleit bicarbonate (KHB) buffer (95% O2:5% CO2), then whole heart ischaemia was induced by using a one-way aortic valve, simultaneously switching to the same buffer but containing heparin (5 mu/ml) for 20 min. In Experiment B, the hearts were perfused by Langendorff method with KHB buffer (95% O2:5% CO2) and the buffer was switched to KHB (95% N2:5% CO2) containing heparin for 20 min. Coronary effluent was collected at 5 min intervals and used for the measurement of functional LPL activities using 3H-glyceryltrioleate. The hearts were quickly frozen at the end of perfusion and homogenized. The suspension was used for the measurement of non-functional LPL activities. In Experiment A, functional LPL activities in ischaemia were significantly lower than in the aerobic condition. On the contrary, the nonfunctional LPL activity in ischaemia was significantly higher than in the aerobic condition. In Experiment B these values were also significantly lower than in the aerobic condition. However, there was no significant difference in non-functional LPL activity between the anoxia and aerobic condition. These results indicate that there is a conversion defect from the precursor of LPL to the functional form of LPL in ischaemia, whereas disturbed LPL synthesis might be involved in anoxic myocardium. PMID- 3663012 TI - Cardiac energetics. Basic mechanisms and clinical implications. PMID- 3663011 TI - The effect of exogenous L-carnitine on biochemical parameters in serum and in heart of the hyperlipidaemic rat. AB - In previous experiments we have demonstrated that L-carnitine administration is capable of reducing olive oil-induced lipidaemia in the rat. In the present study we determined the effect of L-carnitine on the levels of (acyl)carnitines in heart and serum in addition to its effect on serum levels of lipids and ketone bodies after olive oil gavage feeding. L-carnitine was found to reduce the level of myocardial long-chain acylcarnitine which was increased by the olive oil treatment. It also increased the levels of carnitine and acid soluble acylarnitines in both heart and serum. L-carnitine administration caused a clearcut decrease of olive oil-induced lipidaemia and ketonaemia. These effects of added L-carnitine strongly suggest that the stimulation of the beta-oxidation in the mitochondria (at the expense of extra mitochondrial triglycerceride synthesis) is suboptimal after fat loading. PMID- 3663013 TI - Effect of creatine depletion on myocardial mechanics. AB - The physiological significance of energy transport by means of shuttling creatine (C) and creatine phosphate (CP) between mitochondria and the energy utilizing sites was examined in C-depleted rat hearts. Feeding a diet containing structural analogues of C [either 1% guanidinoproprionic acid (GPA) or 2% guanidinobutyric acid (GBA)] led to the decrease of total myocardial C (C + CP) by 78% and 75% after seven weeks and by 89% and 82% after ten weeks. Mechanics of isolated papillary muscles were examined under isometric conditions at different temperatures, muscle lengths and frequencies of stimulation. No differences were found in the basic characteristics of contraction and relaxation among the hearts of normal, GPA- and GBA-treated rats at low workloads. However, when paired stimulation was applied, the interval at which fusion occurred was significantly longer in C-depleted than in controls. At high workloads, the developed force (DF) in C-depleted decreased in the same way as in controls, but its subsequent recovery took significantly longer and the recovered DF in C-depleted muscles was smaller than in controls. We conclude that C depletion has greater effects on the excitation to contraction coupling and recovery rather than on the DF during stimulation at high frequencies. PMID- 3663014 TI - Developmental differences in myocardial ATP metabolism. AB - Little is known about postnatal changes in myocardial purine metabolism. We therefore studied how ATP catabolism was affected by hypothermia and ischaemia in neonatal and adult hearts. Hypothermia during ischaemia protected isolated adult and newborn hearts against ATP decline. Reperfusion after normothermic ischaemia resulted in higher ATP levels in newborn hearts with less release of ATP catabolites. During normoxia adult hearts released mainly urate (80% of total purine release), while newborns released mainly hypoxanthine (64%). During early reperfusion adult and newborn hearts released mainly inosine (50-60%). The very low xanthine oxidase activity in the neonatal heart could be an important factor in the observed ATP preservation during reperfusion. PMID- 3663015 TI - Chronic cardiac reactions. III. Factors involved in the development of structural dilatation. AB - The significance of various factors for the development of structural dilatation in the chronically pressure-loaded and failing heart were evaluated. The investigations were performed on male rats with renal (Goldblatt II) and spontaneous (Aoki-Okamoto) hypertension at different stages of haemodynamic overload. Two groups of SHR were submitted to intermittent feeding (SHR IF); one group received additionally the beta-blocking agent atenolol (50 mg/kg b.w.; SHR IF + beta Bl.). Haemodynamic measurements were carried out under open chest conditions. Myosin isoenzyme pattern, hydroxyproline concentration and circulating blood volume were determined. Transformation to slower myocardium per se, induced by IF, did not lead to significant change in ventricular configuration. After additional blockade of beta-adrenergic receptors there were indications of unfavourable development of left ventricular configuration. Inhibition of hypertrophic mass increase due to curtailed adrenergic stimulation could be an influential factor in the development of dilatation. Further investigations, however, are required to establish the relationship between the adrenergic system, on the one hand, and degree of hypertrophy as well as structural dilatation of the ventricle, on the other hand. The established marked increase in hydroxyproline concentration of the dilated ventricle of SHR in congestive failure is consistent with the assumption of a causal link between the degree of fibrosis and structural dilatation. Observations on rats with aorto caval shunt and Goldblatt II rats with eccentric hypertrophy and corresponding increase in filling potential or circulating blood volume indicate a correlation between the latter and ventricular size. Thus, we assume that curtailed protein synthesis, fibrosis and regulatory processes related to water and electrolyte balance, but not myocardial transformation per se, play a role in the development of structural dilatation. The relative contribution of each factor, however, may depend on the experimental model that is used. PMID- 3663016 TI - Energetics studies of muscles of different types. AB - 31P-NMR studies were performed in isolated perfused striated and smooth muscles. Important qualitative and quantitative differences were found in resting muscles. In resting fast-twitch skeletal muscle the chemical potential of ATP obtained from the measured intracellular pH, ATP and inorganic phosphate concentrations and from the ADP concentrations calculated from the position of the creatine kinase equilibrium was -72 kJ/mol ATP. This high value was the result of a very low free ADP and inorganic phosphate content. In resting slow-twitch skeletal muscle, in smooth muscle, and in cardiac muscle at low work rates (literature data), the chemical potential of ATP was lower (approximately -50 to -60 kJ/mol), the difference being primarily due to a much higher inorganic phosphate content (especially in slow-twitch and smooth muscle) and/or a higher ADP concentration (especially in cardiac muscle). Upon stimulation or, for the heart, working at higher work rates, the pattern of chemical changes of phosphocreatine, creatine and inorganic phosphate was the same for all types of muscle. The phosphocreatine levels decreased and the inorganic phosphate concentration increased stoichiometrically without a change in the ATP content so long as the phosphocreatine pool was not totally depleted (greater than or equal to 10%). The rate and extent of these chemical changes was dependent on the inherent ATPase and ATP synthesis rates. The exception was in the intracellular pH changes. In fast-twitch and smooth muscle, pH decreased with contractile activity, as expected from the large glycolytic capacity. However, an alkalinization was observed in slow-twitch skeletal muscle and this difference was attributed to the uptake of H+ during the net hydrolysis of phosphocreatine to creatine plus inorganic phosphate, and to the absence of significant lactate production. The pH of cardiac muscle does not appear to change with work load. The common bioenergetic pattern in all types of muscles is consistent with a graded increase in ADP concentration (from below to well above the apparent Km for nucleotide translocase ANT) with increasing work as a regulator of mitochondrial respiration. In fast-twitch muscle these changes are also accompanied by large changes in inorganic phosphate concentration (3-30 mM) which may also play a role in metabolic regulation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3663017 TI - Myocardial energetics and diastolic dimensions of the heart in experimental hypertension. AB - The present study examined changes in left ventricular design and function in spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY), and in SHR exposed to voluntary physical exercise in running wheels (R-SHR) and their respective sedentary controls (C-SHR). End-diastolic volumes were obtained in vitro by determining the pressure-volume relationships of isolated hearts arrested in diastole. Cardiac function and myocardial oxygen consumption were also assessed in vitro by means of an antegrade working heart perfusion technique. Compared with WKY and C-SHR respectively, ordinary SHR and R-SHR had increased end-diastolic volumes, whereas the ratios between wall thickness and internal radius were relatively unchanged. Maximal cardiac performance was elevated in the structurally enlarged SHR heart compared with WKY, whereas it remained unchanged after chronic physical exercise. Long-term voluntary running in SHR caused an elevation of cardiac output due to an increased stroke volume, while arterial pressure was unaltered. The stimulus for the cardiac redesign to a structurally enlarged heart can probably best be explained by a chronic elevation in cardiac filling. Hence, enlarged left ventricles can then produce higher stroke volumes for given degrees of myocardial fibre shortenings. Thus, despite structurally enlarged left ventricles in SHR and in R-SHR and also increased arterial pressure in SHR compared with WKY (thereby elevating systolic wall stress), cardiac function was maintained and even augmented, which was not associated with an increase in total myocardial oxygen consumption. PMID- 3663018 TI - Decreased L-carnitine transport in mechanically overloaded rat hearts. AB - The transport of L[14C] carnitine was studied in rat hearts with a three-month old aorto-caval fistula. Tissue TG content was determined in order to assess the state of FFA utilization. The hearts were perfused with a bicarbonate buffer containing 11 mM glucose and variable concentrations (10-200 microM) of L[14C] carnitine. In some experiments, the active component of carnitine transport was suppressed by the adjunction of 0.05 mM mersalyl acid. The subtraction of passive from total transport allowed us to reconstruct the saturation curves of the net active transport of L-carnitine. Our results suggest that at physiological carnitine concentration (50 microM) the uptake of L-carnitine is significantly depressed in mechanically overloaded hearts. These changes are not related to alterations of coronary perfusion, since coronary flow rates (ml/min/g dry wt) are quite comparable in both groups tested. According to the Lineweaver-Burk analysis of the kinetics of saturable transport, the affinity of the membrane carrier for L-carnitine is considerably diminished in the overloaded hearts (Km[carnitine] 125 instead of 83 microM). The alterations of the kinetics of carnitine transport do not seems to be related to the decrease of the transmembrane gradient of sodium: the intracellular sodium content of the hypertrophied, but non-failing, hearts is quite similar to that of control hearts. In addition, carnitine deficiency does not lead to TG accumulation, at least under in situ conditions. PMID- 3663019 TI - Energetic aspects of inotropic interventions in rat myocardium. AB - Contractile force of the myocardium can be increased by different molecular mechanisms, and therefore different energetic consequences may result. The influence of the inotropic substances isoproterenol and UDCG-115 on myocardial energetics in isometrically contracting left ventricular rat papillary muscles was investigated by means of highly sensitive antimony bismuth thermopiles. Isoproterenol increased total heat and initial heat by 147% (p less than 0.01) and 69% (p less than 0.02) when normalized to tension-time integral, respectively. No significant change of both heat terms occurred due to UDCG-115. Initial heat was separated into tension-independent heat ("calcium cycling") and tension-dependent heat ("cross-bridge cycling") by means of a new method using 2,3-butanedione monoxime. Both tension-dependent heat per tension-time integral and tension-independent heat increased significantly, due to isoproterenol, from 4.9 +/- 1.17 to 7.6 +/- 2.72 mu cal/g.cm.s (p less than 0.05) and from 0.15 +/- 0.06 to 0.22 +/- 0.04 mcal/g (p less than 0.01). UDCG-115 influenced neither tension-independent heat nor tension-dependent heat per tension-time integral significantly. Thus, the economy of force development was not significantly altered due to UDCG-115 whereas isoproterenol significantly increased the energy necessary for activation, i.e. calcium cycling, and the energy necessary for force production, i.e. cross-bridge cycling. The basic mechanisms of these energetic changes are discussed. PMID- 3663020 TI - Mechanics of rat myocardium revisited: investigations of ultra-thin cardiac muscles under high energy demand. AB - Disregarding the influence of thickness on elevated strength of isolated preparations inevitably leads to erroneous tension-frequency relations, especially in the range of high frequencies. Thus, much of the confusion in interpreting the atypical negative staircase phenomenon of the rat heart is due to this. In view of the fact that the rat has become the preferred laboratory animal in cardiological research, it was imperative to reinvestigate force frequency relations using ultra-thin preparations of the rat right ventricle (d less than 0.1 mm). Contrary to popular opinion, it could be demonstrated that the rat myocardium shows a positive staircase in the range of physiological heart rates. An increase in tension is still attainable even at frequencies up to 600 min-1. The interval-strength relations exhibit a minimum at frequencies of 60-120 min-1, being shifted to higher frequencies with increasing diameter, vanishing completely for thick preparations (d greater than 1.0 mm). At high extracellular Ca++ concentration the positive staircase even of ultra-thin muscles is flattened. However, it can be reinforced when the strength, and thus the energy expenditure, is reduced by lowering the extension. The same is true for contractions under hypoxia. From these findings it seems probable that many investigations on isolated heart muscles of the rat, as well as other species, are objectionable when done under high energy demand, as diffusion problems will certainly limit any rise in contractility. PMID- 3663021 TI - Ultrastructural observations on the effects of different substrates on ischaemic contracture in global subtotal ischaemia in the rat heart. AB - Ultrastructural morphology was examined in myocardia perfused with different substrates, following the hypothesis that ultrastructural changes or differences would indicate the mechanism of early ischaemic contracture. Substrates used were glucose, acetate and no substrate (substrate-free). Isolated rat hearts were subjected to global low flow ischaemia followed by perfusion fixation at either no contracture, early contracture (5%) or full contracture (100%). Total tissue adenosine triphosphate (ATP) levels were analysed from myocardia of each group. Glucose perfused myocardia did not develop contracture for at least 30 minutes and maintained ultrastructural and ATP normality. Substrate-free and acetate perfused myocardia developed contracture after 10-12 minutes of ischaemia at which time myofibrillar morphology was altered within small sparse foci of developing mild oedema with contracture and hyperextension of myofibrils. ATP levels were normal. At full ischaemic contracture, both substrate-free and acetate perfused myocardia showed severe mitochondrial damage, oedema, myofibrillar contracture and hyperextension with accompanying distortion and swelling of the sarcoplasmic reticulum. PMID- 3663022 TI - Diastolic relaxation abnormalities during ischaemia and their association with high energy phosphate depletion, intracellular pH and myocardial blood flow. AB - Diastolic relaxation of cardiac muscle is an energy requiring process dependent upon restoration of a very low cytosolic calcium concentration. During demand ischaemia, induced by an increase in myocardial oxygen demand in the setting of restricted coronary blood flow, myocardial relaxation is impaired with a resultant decrease in left ventricular chamber distensibility. Metabolic studies suggest that high energy phosphate depletion alone cannot account for these relaxation abnormalities. Changes in myocardial pH and coronary blood flow modulate the impaired relaxation. The most likely hypothesis to explain impaired relaxation during demand ischaemia is that slow calcium uptake and incomplete calcium sequestration are characteristic of the physiology of angina pectoris and demand ischaemia, underlying the increased diastolic stiffness seen in these conditions. PMID- 3663023 TI - Inotropic changes in ischaemic and non-ischaemic myocardium and arrhythmias within the first 120 minutes of coronary occlusion in pigs. AB - In 16 anaesthetized open-chest pigs occlusion of the distal third of the LAD was performed. Local myocardial contractility within and outside the ischaemic area, measured using electromagnetic and ultrasonic probes, arrhythmias and plasma catecholamine concentrations were monitored during 180 min before and 120 min after occlusion of the distal LAD. 5 pigs developed ventricular fibrillation (VF) during phase 1 a of arrhythmias (1-6 min post occlusion) and a further 5 pigs during phase 1 b (10-30 min post occlusion). Segment lengthening within the ischaemic area, measured at the beginning of ventricular ejection, started within a few seconds of ischaemia and reached 11-13.5% of end-diastolic length prior to occlusion after 2 min of ischaemia. Between 2 min and 120 min after the onset of occlusion, no further segment lengthening was observed. There were no significant differences in segment lengthening between VF and non-VF pigs. However, within the VF group, mechanical alterations 2 min after the onset of ischaemia were more marked in pigs developing VF within phase 1 a than those with VF in phase 1 b. VES increased markedly after 50 min of occlusion and seemed to occur independently of further mechanical alterations, VF within the first 30 min of ischaemia often occurred without preceding VES. PMID- 3663024 TI - Phosphocreatine and adenine nucleotides in postasphyxial hearts with normal basal function and normal oxygen demand. AB - We investigated whether there is a relationship between the prolonged dysfunction after myocardial ischaemia and the postischaemic phosphocreatine overshoot phenomenon. In 16 open-chest rats 3 periods of 4 minutes of oxygen deficiency were performed and basal haemodynamic variables and the myocardial oxygen demand were determined during the recovery period. At the end of the 20 minutes recovery period, left ventricular pressure, dp/dtmax, ejection fraction, and myocardial oxygen demand were completely recovered. High energy phosphate levels, however, were still altered. The sum of adeninenucleotides was decreased to 78 +/- 4% of control (mean +/- SEM, p less than 0.05). The level of phosphocreatine was markedly elevated to 162 +/- 14 (mean +/- SEM). The persistence of the phosphocreatine overshoot phenomenon, while basal function was already normalized, indicates that a reduced function and thus a reduced energy demand of the contractile apparatus are not the cause of the phosphocreatine overshoot. We found no close relationship between high energy levels and basal function or oxygen demand in myocardium after mild oxygen deficiency. PMID- 3663025 TI - Changes in cardiovascular adrenoceptor response in rats subsequent to myocardial infarction. AB - Since sympatho-adrenal activity was greatest on the second day after experimental myocardial infarction in the rat, we investigated the responsiveness of cardiovascular adrenoceptors in pithed rats at this time and also determined the number of beta-adrenoceptors in the myocardium of the rats. In addition, the sympathetic outflow was measured, as a presynaptic parameter for estimating sympathetic nervous activity. The number of beta-adrenoceptor binding sites and the frequency responses of the heart were unchanged by myocardial infarction on the second day. There was also no difference from control animals with respect to sympathetic outflow. However, the rise in diastolic blood pressure, caused by electrical stimulation of the sympathetic nervous system, was far more pronounced in animals with infarction than in controls. In contrast, rats with myocardial infarction exhibited an attenuated response of diastolic blood pressure to infused noradrenaline. The observed effects can possibly be explained by changes of alpha-adrenoceptors, or perhaps by an enhanced degradation of catecholamines in the endothelium. PMID- 3663026 TI - Myocardial protection by antioxidant during permanent and temporary coronary occlusion in dogs. AB - In an ischaemic heart model the lipid peroxidation, scavenger state and ultrastructure were studied, to determine the action of a new antioxidant of dihydroquinoline type (MTDQ-DA). In dog experiments, the left descending coronary artery (LAD) was ligated permanently (30 minutes, 1, 2 or 3 hours) or temporarily (30 minutes, 1 or 2 hours of ischaemia followed by 1 hour of recirculation). The experimental protocol involved two groups: control animals without antioxidant treatment and animals treated with antioxidant infusion during the ischaemic and reperfusion period. In both groups, the thiobarbituric acid reactive product, the malondialdehyde (MDA), reduced glutathione (GSH) and superoxide dismutase (SOD) were measured, to illustrate the injured or scavenged state of the membrane system. In nontreated animals the permanent and temporary LAD increased the MDA content, decreased GSH concentration (mainly during reperfusion) and reduced SOD activity. Treatment with MTDQ-DA diminishes the characteristic biochemical changes. According to ultrastructural investigations, irreversible alterations (Ca deposits in the mitochondria, disruption of intramitochondrial membranes, hypercontraction bands) occurred only in the control group. Anti-oxidant therapy is able to reduce the myocardial damages both quantitatively and qualitatively. PMID- 3663027 TI - Promising reduction of ventricular fibrillation in experimentally induced heart infarction by antioxidant therapy. AB - Studies were undertaken using a synthetic free radical scavenger (MTDQ-DA) on regional ischaemic dog hearts; it was found that the rate of malignant ventricular arrhythmias and fibrillation after coronary ligature unexpectedly decreased. According to experiments on 22 dogs, the intravenous MTDQ-DA therapy decreases the unfavourable ECG consequences of left anterior descending branch ligature: already 5 to 10 minutes after drug administration the ST segment elevation, the QT interval lengthening and the occurrence of ventricular extrasystoles and salvos are diminishing. The so-called epicardial ST map ameliorates rapidly. MTDQ-DA as a blocking agent of free radicals is able to prevent the irritative stimuli around and in the border zone of an infarct, has a vigorous anti-arrhythmogenous effect and greatly reduces the electric heterogeneity. These unexpected results may lead to a promising therapy for the acute heart infarction. PMID- 3663028 TI - Acute and chronic changes of myocardial energetics in the mammalian and human heart. AB - In earlier studies using papillary muscles of the rat left ventricle and highly sensitive thermopiles we demonstrated that the heat liberated per gram of myocardium per unit of developed tension-time integral is decreased when the rats suffered from hypothyroidism or renal hypertension. This increase in economy of force production was shown to be associated with a decrease in myosin-ATPase activity and a change in isomyosin composition. In a recent study we showed an increase in heat per gram of mammalian myocardium per tension-time integral of 70% after application of isoproterenol. In order to study the relationship between energy costs and developed tension-time integral in the human heart, haemodynamics and myocardial oxygen consumption were measured. The data were obtained using a Millar microtip catheter pressure transducer and the argon method. Haemodynamics and myocardial energetics were analysed in 8 patients without significant heart disease before and after application of isoproterenol and in 10 patients with dilative cardiomyopathy (NYHA II-III). During one cardiac cycle, myocardial oxygen consumption per gram of LV myocardium per beat (MVO2/g x beat) is related to LV stress-time integral (integral of sigma xt). The economy of myocardial contraction (EC) was calculated by (formula; see text) EC was 11.3 +/- 3.2 in normal and 14.3 +/- 4.7 dyn x s x g/cm2 x mu cal in dilative cardiomyopathic hearts (NS). Isoproterenol decreased EC from 11.3 +/- 3.2 to 5.5 +/- 1.6 dyn x s x g/cm2 x mu cal in the normal hearts (p less than 0.01). In the rat myocardium, changes in economy of force generation were found due to catecholamines, pressure overload and hypothyroidism. In the human heart, similar energetic changes were observed due to catecholamines. No significant differences in energy of force production were seen between normal and dilative cardiomyopathic hearts. The effect of catecholamines in the mammalian and human myocardium is explained by changes in activation processes and in chemomechanical energy transduction at the level of the contractile proteins. PMID- 3663029 TI - Predicting postoperative haemodynamics in valve patients. AB - Patients with combined valve and myocardial disease often have poor haemodynamic status early postoperatively. This occurs in spite of normalization of the left ventricular work load by technically uncomplicated valve replacement. Therefore an algorithm was developed for predicting postoperative left ventricular performance, based on the Emax concept, (end-systolic wall stress/volume relationship as a load-independent ventricular function parameter). Load changes effected by valve normalization were included in the predictive methodology, with ventricular function assumed unchanged by surgery. The algorithm was tested in 12 valve patients who had less than 10% change in heart rate and left atrial pressure pre- vs postoperatively. Preoperative data were obtained during catheterization with quantitative ventriculography. The predicted data were compared to measured data on postoperative day I. There were non-significant differences between the means of predicted and of measured postoperative left ventricular stroke volume, end-systolic volume, end-systolic stress, stroke work, and aortic pressure. The postoperative myocardial function parameter fell by 3 20% below preoperative values in 8 patients not requiring high-dose catechol support and rose by 3-36% in those requiring support. This pilot study suggests the feasibility of a predictive haemodynamic algorithm in surgical valve disease. PMID- 3663030 TI - Mechanical determinants of myocardial energy turnover. AB - Energy turnover of the left ventricle does not differ in isovolumic contractions and contractions where pressure is released from peak to zero. This experimental result corresponds to predictions from a time varying elastance model of the mechanical and energetic properties of the left ventricle. To assess the validity of this model for cardiac muscle in general, experiments were designed to investigate whether mechanical and energetic behaviour of isolated cardiac muscle preparations could also be predicted from the time varying elastance model. The results obtained so far indicate, however, that not all experimental results can be accommodated by the model. This suggests that the value of the model may be limited. PMID- 3663031 TI - Cardiac energetics: significance of mitochondria. AB - The mitochondrial activity as the energy producing step during biological oxidation was observed at rest and its regulation by the energy consuming auxotonic contractile work, depending on the preload, afterload and beat rate in isolated superfused left guinea pig atria. The mitochondrial activity was measured by (1) continuous determination of the O2 uptake rate, (2) the rate of 14CO2 production from labelled glucose or FFA and (3) separate measurements of the atrial ATP-, ADP-, AMP-, CP- and NAD-concentrations, for determination of the energy state. Some results, with points of general interest, are reported and discussed, including this model, former studies about cardiac energetics and the efficiency of cardiac work, reviewed recently. PMID- 3663032 TI - Heat production and oxygen consumption following contraction of isolated rabbit papillary muscle at 20 degrees C. AB - The time course of oxygen uptake following isometric twitch contractions of isolated rabbit papillary muscles was measured using a polarographic oxygen electrode. Using a diffusion model we eliminated the effect of oxygen storage on the measured time course of oxygen uptake to determine the time constant of mitochondrial "off" kinetics. Two different approaches were followed. In Method 1, two steady-state levels were compared, whereas in Method 2, the time course of mitochondrial "off" kinetics was studied. Using Method 1 we found tau = 20 +/- 8 seconds (n = 7), whereas Method 2 yielded tau = 26 +/- 9 seconds (n = 11). These findings were compared with preliminary measurements of recovery heat production of the same preparation and at the same temperature. Heat produced after a train of 10 twitch contractions appeared to follow a monoexponential time course with a time constant of 24.9 +/- 9.5 seconds (n = 9). These results suggest that aerobic metabolism in isolated rabbit papillary muscle constitutes the only recovery process. PMID- 3663033 TI - Regulation of heart creatine kinase. AB - Magnetization transfer nuclear magnetic resonance (NMR) provides measurement of the velocity of the creatine kinase reaction in the intact heart. Standard one pulse NMR spectroscopy coupled with conventional biochemical analyses provides information about the average cytosolic concentrations of ATP, creatine phosphate (CrP), creatine (Cr) and H+ in the heart. By combining these techniques, we tested the hypothesis that the velocity of the creatine kinase reaction in vivo was regulated by changes in cytosolic concentrations of its substrates. We found that the reaction velocity cannot always be predicted from its metabolite levels. We interpreted these observations as support for the hypothesis that flux through the creatine kinase reaction is regulated by metabolite levels in microcompartments formed by localization of creatine kinase isozymes. PMID- 3663034 TI - [Deaths caused by so-called bolt-setting guns]. PMID- 3663035 TI - [Attempt at reconstructing an unusual suicidal multiple gunshot injury]. PMID- 3663036 TI - [Determination of age based on roentgen images of the chest]. PMID- 3663037 TI - [Lung embolisms in early and late deaths in polytraumatized patients]. PMID- 3663038 TI - [AIDS and prostitution]. PMID- 3663039 TI - [Protein and electrolyte changes in the perilymph in relation to the time of death]. PMID- 3663040 TI - [Cooling of a dummy under various conditions in comparison to cadaver cooling]. PMID- 3663041 TI - [Information value of potassium concentration in the vitreous humor for the time of death. Gaining precision by detecting antemortem dysregulation?]. PMID- 3663042 TI - [Determining the time of death--possibilities and limits of electrolyte determination in cadaveric cerebrospinal fluid]. PMID- 3663043 TI - [Circadian rhythm in determining the time of death]. PMID- 3663044 TI - [Colorimetry of livor mortis]. PMID- 3663045 TI - [Enzyme histochemical studies of the myocardium following acethydrazine poisoning]. PMID- 3663046 TI - [Glutamate pyruvate transaminase (GPT): a new demonstration method using agarose electrophoresis]. PMID- 3663047 TI - [Frequent occurrence of "panagglutinations" in old cadaveric blood samples]. PMID- 3663048 TI - [Corrected Rcf value in forensic toxicology--studies and experiences]. PMID- 3663049 TI - [Value of quantitative drug determinations in urine specimens]. PMID- 3663050 TI - [The cerebellum in sudden infant death; qualitative and quantitative studies]. PMID- 3663051 TI - [Extreme polyporencephalia in early childhood]. PMID- 3663052 TI - [Brain stem gliosis in sudden infant death: hypoperfusion or retardation?]. PMID- 3663053 TI - [Morphometry of organ capsules of connective tissue for estimating age]. PMID- 3663054 TI - [Modification of ABO determination of vaginal smears by common fixatives in general practice]. PMID- 3663055 TI - [Determination of zinc in vaginal smears]. PMID- 3663057 TI - [Kinetics of blood alcohol in long-term infusion with an ethanol solution]. PMID- 3663056 TI - [Skin appendages, a special aspect of forensic diagnosis and assessment]. PMID- 3663058 TI - [Effect of ethanol on the synthesis of calcitonin in the brain]. PMID- 3663059 TI - [Severity of injury, survival time and frequency of autopsy in fatal pedestrian accidents]. PMID- 3663060 TI - [Computer-assisted analysis of 330 fatal pedestrian accidents]. PMID- 3663061 TI - [Finding a skull. Case report on the identification and determination of the time after death]. PMID- 3663062 TI - [Biomechanics of liver rupture--results of experimental dynamic stress in situ and in vitro]. PMID- 3663063 TI - [Injuries in the abdominal area in frontal automobile collisions in a sled simulation]. PMID- 3663064 TI - [Morphology and biomechanics of kick injuries]. PMID- 3663065 TI - [Criminal and kinetic energy in homicides caused by blunt forces]. PMID- 3663066 TI - [Scope of to obligation of physicians to render first aid in the attempted suicide of an intimate partner]. PMID- 3663067 TI - [Equipment-induced injuries within the scope of medical practice--attempt at a review]. PMID- 3663068 TI - [Communicating examination findings to insurance carriers]. PMID- 3663069 TI - [In situ technics of cryostabilization and removal of tissue and organ material]. PMID- 3663070 TI - [Forensic significance of electric metallization of bathing water in deaths caused by electric current in the bath-tub]. PMID- 3663071 TI - [Forensic assessment of traffic injuries in survivors]. PMID- 3663072 TI - [Bullous electric-current marks]. PMID- 3663073 TI - [Suicidal saw-cut injury of the neck]. PMID- 3663074 TI - [A simple procedure for CO detection in blood using micro-headspace gas chromatography]. PMID- 3663075 TI - [Identification of an immersed cadaver based on dental status]. PMID- 3663076 TI - [Suicide from the forensic viewpoint]. PMID- 3663077 TI - [Critical velocity in skin (an experimental ballistic study with firearms of 4 mm and 4.5 mm calibers)]. PMID- 3663078 TI - [Independent genetic factor in suicide within the scope of manic-depressive disease. A statistical analysis of psychopathologic phenomena]. PMID- 3663079 TI - [Tissue mast cells of the heart in various causes of death]. PMID- 3663080 TI - [Morphometry and quantitative lipid extraction in lipomatosis cordis]. PMID- 3663081 TI - [Mechanics of neck compression]. PMID- 3663082 TI - [Reactive changes in soft tissue hemorrhage inside the larynx]. PMID- 3663083 TI - [Spontaneous or iatrogenic esophageal perforation?]. PMID- 3663084 TI - [Effect of intra-articular administration of Hyalase Dessau on chemically-induced gonarthrosis of the rat]. PMID- 3663085 TI - [Analysis of the details of hip contrast arthrograms in so-called congenital hip dislocation]. PMID- 3663086 TI - [Aplasia of the cruciate ligament: clinical, radiologic and arthroscopic aspects]. PMID- 3663087 TI - [Late results following high tibial osteotomy in varus gonarthrosis]. PMID- 3663088 TI - [Kohler disease. I: Long-term studies in 31 cases]. PMID- 3663089 TI - [Results of a survey on the treatment and psychosocial status of scoliosis patients treated with spondylodesis]. PMID- 3663090 TI - [Results of surgical treatment of tibial fractures in the district hospital]. PMID- 3663091 TI - [Personal indications for conservative therapy of fractures of the upper ankle joint]. PMID- 3663092 TI - [Epidemiologic studies of polytrauma]. PMID- 3663093 TI - Pathways of reducing equivalents in hepatocytes from rats. Estimation of cytosolic fluxes by means of 3H-labelled substrates for either A- or B-specific dehydrogenases. AB - The metabolism of [2-3H]lactate and [2-3H]glycerol was studied in isolated hepatocytes from fed rats. In order to estimate the rate of equilibrium between the 4A and 4B hydrogen atoms of NADH, we compared the flow of 3H from [2 3H]lactate and [2-3H]glycerol, the oxidations of which are catalysed by A- and B type dehydrogenases, respectively. Hepatocytes were incubated with lactate, glycerol and ethanol and tracer amounts of [2-3H]lactate or [2-3H]glycerol and the labelling rates of lactate, ethanol, glucose and glycerol phosphate were determined. The data were used to calculate the oxidation rate of NADH catalysed by lactate dehydrogenase, alcohol dehydrogenase, triosephosphate dehydrogenase and glycerol phosphate dehydrogenase. The rates were calculated by obtaining the best fit of a model to the experimental data by using a least-squares procedure. The results support our model and suggest that the fluxes through various dehydrogenases are sufficient to equilibrate the 4A and 4B hydrogen atoms of cytosolic NADH. The validity of the metabolic models used was evaluated by comparison of rates of NADH oxidation catalysed by cytosolic dehydrogenases as calculated by two different models. PMID- 3663094 TI - Phosphate transport by rat intestinal basolateral-membrane vesicles. AB - The characteristics of phosphate transport across intestinal basolateral membranes of the rat were determined by using enriched preparations in which uphill Na+-dependent D-glucose transport could not be demonstrated, but ATP dependent Ca2+ transport was present. Phosphate transport was saturable, Na+ dependent and exhibited Michaelis-Menten kinetics. Vmax. was 51.1 +/- 4.2 pmol/10 s per mg of protein and Km was 14 +/- 3.9 microM. The transport process was electroneutral. Tracer-exchange experiments and counter-transport studies confirmed the presence of a Na+-Pi carrier at the basolateral membrane. The presence of inside-positive membrane potential did not enhance phosphate uptake, indicating that the Na+ effect is secondary to the presence of the Na+-Pi carrier rather than an induction of positive membrane potential. The stoichiometry of this carrier at pH 7.4 was 2 Na+:1 phosphate, as shown by direct studies utilizing the static-head method. These studies are the first to determine the presence of a phosphate carrier at the basolateral membrane. PMID- 3663095 TI - Sugar uptake by fluid-phase pinocytosis and diffusion in isolated rat hepatocytes. AB - Measurements of sugar pinocytosis (fluid-phase endocytosis of radiolabelled sucrose, lactose and raffinose) in freshly isolated rat hepatocytes are disturbed by sugar diffusing into the cells through plasma-membrane blebs. Non-pinocytic entry may be even more pronounced at 0 degrees C, and is a major contributor to 'background' radioactivity. By electrodisruption of the plasma membrane, a distinction can be made between pinocytotically sequestered sugar and free sugar that has entered the cytosol by diffusion. Pinocytosis proceeds at a rate of 2%/h (relative to the intracellular fluid volume), whereas the rate of sucrose entry by diffusion is more than twice as high. Three pinocytotic compartments are distinguishable in isolated hepatocytes: (1) a rapidly recycling compartment, which is completely destroyed by electrodisruption, and which may represent pinocytic channels continuous with the plasma membrane; (2) a non-recycling (or very slowly recycling) electrodisruption-resistant compartment, which allows accumulation of the lysosomally hydrolysable sugar lactose, and which therefore must represent non-lysosomal vacuoles (endosomes?); (3) a lysosomal compartment (non-recycling, electrodisruption-resistant), which accumulates raffinose and sucrose, but which hydrolyses lactose. The last two compartments can be partially resolved in metrizamide/sucrose density gradients by the use of different sugar probes. PMID- 3663096 TI - Dihydrolipoamide dehydrogenase from Trypanosoma brucei. Characterization and cellular location. AB - Dihydrolipoamide dehydrogenase has been discovered in the bloodstream form of the eukaryotic African parasite, Trypanosoma brucei. The enzyme catalysed the stoichiometric oxidation of dihydrolipoamide by NAD+ and exhibited a hyperbolic dependence of catalytic activity on the concentrations of both dihydrolipoamide and NAD+. Chemical modification with the tervalent arsenical reagent p aminophenyldichloroarsine indicates the involvement in catalysis of a reversibly reducible disulphide bond. Plasma-membrane sheets were purified from T. brucei, and it was shown that virtually all the dihydrolipoamide dehydrogenase remained closely associated with this membrane preparation. T. brucei apparently lacks the 2-oxoacid dehydrogenase multienzyme complexes of which dihydrolipoamide dehydrogenase is usually an integral component. In the context of this absence, the possible function of trypanosomal dihydrolipoamide dehydrogenase is discussed, with particular reference to its cellular location in the plasma membrane. PMID- 3663097 TI - The isolation of a peptide from the catalytic domain of Bacillus stearothermophilus tryptophyl-tRNA synthetase. The interaction of Brown MX-5BR with tyrosyl-tRNA synthetase. AB - Tryptophyl-tRNA synthetase is irreversibly inactivated by Procion Brown MX-5BR with an apparent dissociation constant (KD) of 8.8 microM and maximum rate of inactivation k3 0.192 s-1. The specificity of the interaction is supported by two previously reported observations. Firstly, Brown MX-5BR inactivation of tryptophyl-tRNA synthetase is inhibited by substrates, and secondly, the animated derivative of Brown MX-5BR is a competitive inhibitor of tryptophyl-tRNA synthetase with a Ki of 2 X 10(-4) M with respect to both tryptophan and ATP. Tryptic digestion of the dye-affinity-labelled enzyme and subsequent resolution of the peptides by h.p.l.c. yielded one major dye-peptide peak. Amino acid sequence analysis resulted in the identification of the dye-binding domain centred on lysine-178. Tyrosyl-tRNA synthetase is also inactivated by Procion Brown MX-5BR, and this inactivation is prevented by ATP but not by tyrosine. The interaction of tyrosyl-tRNA synthetase with hydroxylated Brown MX-5BR exhibited non-competitive kinetics with respect to the amino acid-binding site and competitive kinetics against ATP with a Ki of 6 X 10(-6) M. PMID- 3663098 TI - Isolation and characterization of a novel haemoprotein b-559 from Bengal gram (Cicer arietinum). AB - A haemoprotein was purified to apparent homogeneity from Bengal-gram seeds. The purified protein exhibited an absorption maximum at 412 nm (Soret band) that upon reduction with dithionite gave rise to a shift in the Soret band to 426 nm with concomitant appearance of an alpha-band at 559 nm and a beta-band at 530 nm. In the reduced state the Bengal-gram haemoprotein showed reactivity towards CO, nitrite and hydroxylamine. SDS/polyacrylamide-slab-gel electrophoresis showed that the haemoprotein has Mr 78,000. Gel-filtration and ultracentrifugal analyses suggest that the Bengal-gram haemoprotein is oligomeric in nature. Since it differs from photosynthetic membrane cytochrome b-559 in solubility in buffer, in reactivity towards CO and in molecular size, it appears to be a novel haemoprotein b-559. PMID- 3663099 TI - A developmentally controlled change in the post-translational modifications on the lysosomal alpha-mannosidase of the cellular slime mould Dictyostelium discoideum. AB - During the development of the cellular slime mould Dictyostelium discoideum, a second form of a number of lysosomal enzymes begins to accumulate. The second ('late') form of these enzymes differs from the pre-existing ('early') form in post-translational modification. Pulse-chase experiments using [35S]methionine show that the late form of alpha-mannosidase-1 is made by synthesis de novo starting 8 h after the onset of development. These experiments show there is no interconversion between early and late forms in vivo. A one-dimensional peptide map indicated that the early and late forms of alpha-mannosidase have similar amino acid sequences. The two forms have a similar half-life in vivo when measured during the same period of development. Double-labelling studies were performed with 35SO4 and [3H]leucine or 32PO4 and [3H]leucine. and these studies indicated that the oligosaccharides present on the early form of alpha mannosidase contained more sulphate and phosphate than did those on the late form. The early enzyme had a 10-fold higher 35S/3H ratio and a 4-fold higher 32P/3H ratio. Endocytosis experiments using early and late alpha-mannoside showed that the early form was efficiently taken up by human fibroblasts, whereas the late form was poorly endocytosed. This suggests that the late form lacks the mannose 6-phosphate residue required for efficient uptake. PMID- 3663100 TI - Measurement of allantoin and uric acid in human body fluids. A potential index of free-radical reactions in vivo? AB - Free-radical attack upon uric acid generates allantoin [Ames, Cathcart, Schwiers & Hochstein (1981) Proc. Natl. Acad. Sci. U.S.A. 78, 6858-6862]. Methods are described for the accurate measurement of uric acid and allantoin in human body fluids. The concentrations of uric acid and allantoin in human serum and synovial fluid are reported. It is suggested that measurement of changes in allantoin concentration may be a useful index of free-radical reactions taking place in vivo. PMID- 3663102 TI - Measurement of the rate of substrate cycling between acetate and acetyl-CoA in sheep muscle in vivo. Effects of infusion of acetate. AB - 1. The rate of substrate cycling between acetate and acetyl-CoA in sheep hindlimb muscle was measured from the decrease of [14C]acetate specific radioactivity across the tissue in vivo. 2. The rate of cycling was 0.005-0.015 mumol/min per g and, in two of the three sheep investigated, was approximately doubled as a result of infusing 2 mol acetate/day intravenously. 3. The results indicate that this cycle contributes only approx. 0.5% of the total heat produced by the animal and would probably make only a relatively small contribution to any heat increment of feeding associated with diets producing large amounts of acetate. PMID- 3663101 TI - Neomycin cannot be used as a selective inhibitor of inositol phospholipid hydrolysis in intact or semi-permeabilized human platelets. Aminoglycosides activate semi-permeabilized platelets. AB - High concentrations of neomycin (2-10 mM) inhibited aggregation, but not shape change, of intact platelets by collagen, ADP and the Ca2+ ionophore, A23187, the last two studies being carried out in the presence of the cyclo-oxygenase inhibitor indomethacin. In contrast, over the same range of concentrations neomycin inhibited both aggregation and shape change induced by thrombin. Under these conditions activation of platelets by collagen and by thrombin, but not by A23187 or by ADP, is believed to be dependent on the hydrolysis of membrane inositol phospholipids. These data therefore suggest that the inhibitory action of neomycin on intact platelets is not related to its previously reported inhibitory effect on phosphoinositide metabolism. The selective inhibition of thrombin-induced shape change indicates a second site of action of neomycin on intact platelets. On platelets rendered semi-permeable with saponin, neomycin and a second aminoglycoside antibiotic, streptomycin (each 0.06-2 mM), stimulated secretion and aggregation responses. These effects were inhibited by indomethacin and by EGTA. Activation of semi-permeabilized platelets by neomycin is associated with the formation of inositol phosphates and phosphatidic acid, indicating activation by phospholipase C. This effect is also inhibited by indomethacin, implying that it is secondary to the formation of prostaglandins and endoperoxides. These results are discussed in the context of the use of neomycin as a selective inhibitor of polyphosphoinositide metabolism. PMID- 3663103 TI - Cystine storage in cultured myotubes from patients with nephropathic cystinosis. AB - Sorted muscle cells, cultured from a patient with nephropathic cystinosis, stored 100 times normal amounts of cystine. Subcellular fractionation and density gradient centrifugation confirmed that the cystine was located in a lysosomal compartment. 2. Myoblasts from cystinotic patients in culture underwent fusion to myotubes in a normal fashion. 3. The free thiol cysteamine effectively depleted cystinotic-muscle cells of cystine. 4. Cultured myoblast and myotubes offered a unique system for investigating the effects of lysosomal storage on differentiated cell functions. PMID- 3663104 TI - Role of NADP+ (corrected)-linked malic enzymes as regulators of the pool size of tricarboxylic acid-cycle intermediates in the perfused rat heart. AB - Cytosolic and mitochondrial concentrations of malate, 2-oxoglutarate, isocitrate and pyruvate in the isolated perfused rat heart were measured by non-aqueous tissue fractionation, taking the NADP-linked isocitrate dehydrogenase as indicator reactions for the free [NADPH]/[NADP+] ratios. The mass-action ratios of NADP-linked malic enzymes (EC 1.1.1.40) were found to be on the side of pyruvate carboxylation by more than one order of magnitude in both the cytosolic and the mitochondrial spaces in hearts perfused with glucose, whereas during propionate perfusion this ratio approached the equilibrium constant (Keq.) of malic enzyme. The results consequently indicate that the NADP-linked malic enzymes cannot be responsible for the feed-out (cataplerotic) reactions from the tricarboxylic acid cycle which occur during glucose perfusion. Only when other anaplerotic fluxes into the cycle are high, as during propionate oxidation, which results in accumulation of tricarboxylic acid-cycle intermediates, is a steady state reached which allows efflux via the malic enzyme. PMID- 3663105 TI - An h.p.l.c. assay for protoporphyrinogen oxidase activity in rat liver. AB - An h.p.l.c. method is described for the assay of protoporphyrinogen oxidase activity in rat liver. A relatively pure protoporphyrinogen IX substrate was obtained by selectively removing any protoporphyrin IX unreduced by sodium amalgam on a small disposable cartridge packed with a strong anion-exchanger. The protoporphyrin IX formed was extracted with dimethyl sulphoxide/methanol (3:7, v/v) containing mesoporphyrin as the internal standard for separation and quantification by reversed-phase chromatography. The Km for protoporphyrinogen was 9.5 +/- 1.6 microM, and the enzyme activities were 0.59 +/- 0.11 nmol of protoporphyrin IX produced/min per mg of mitochondrial protein and 33.5 +/- 2.7 nmol protoporphyrin IX produced/min per g of liver tissue homogenate. The method is applicable to the determination of enzyme activity in small amounts of human liver biopsy. PMID- 3663106 TI - Studies on the cellular location, physical properties and endogenously attached lipids of acylated proteins in human squamous-carcinoma cell lines. AB - The location of cell proteins with covalently attached lipid was examined in two human squamous-carcinoma cell lines. Cells were labelled with either palmitic acid or myristic acid and disrupted by sonication, followed by differential centrifugation of the cell lysates. SDS/polyacrylamide-gel electrophoresis of the resulting cell fractions indicated that most of the palmitate-labelled proteins were found in cell membranes, whereas most of the myristate-labelled proteins were found in the cytosol, although some were located in cell membranes. Experiments with lipid-labelled proteins extracted with the phase-separable detergent Triton X-114 showed that palmitate-labelled proteins behaved as hydrophobic proteins, partitioning into the lower phase of the detergent, whereas most of the myristate-labelled proteins remained in the upper phase. Although one of these cell lines expressed large amounts of epidermal-growth-factor receptor, this could not be labelled by either myristic acid or palmitic acid, whereas transferrin receptor was labelled by palmitic acid. The lipids normally attached to cell proteins in these two human squamous-carcinoma cell lines were characterized by labelling the cells with [3H]acetate. The labelled cell proteins were exhaustively extracted with organic solvents, and subjected to sequential alkaline and acid hydrolyses to release the attached lipids, which were then analysed by h.p.l.c. Most of the lipid released by the alkaline treatment chromatographed as palmitic acid or stearic acid, whereas the subsequent acid treatment released myristic acid as well as some palmitic acid and stearic acid. No other fatty acids apart from these were found attached to cell proteins. PMID- 3663107 TI - Inositol phosphate metabolism in bradykinin-stimulated human A431 carcinoma cells. Relationship to calcium signalling. AB - Stimulation of human A431 epidermoid carcinoma cells by bradykinin causes a very rapid release of inositol phosphates and a transient rise in cytoplasmic free Ca2+ concentration ([Ca2+]i). Bradykinin-induced inositol phosphate formation is half-maximal at a concentration of 4 nM and is not affected by pertussis toxin. H.p.l.c. analysis of the various inositol phosphates shows an immediate but transient accumulation of inositol 1,4,5-trisphosphate [Ins(1,4,5)P3], which reaches a peak value of approx. 10 times the basal level within 15 s and slightly precedes the rise in [Ca2+]i, both parameters changing in parallel. After a lag period, bradykinin also induces a massive accumulation of Ins(1,3,4)P3 and inositol 1,3,4,5-tetrakisphosphate [Ins(1,3,4,5)P4]. Our data support the view that part of the newly formed Ins(1,4,5)P3 is converted into Ins(1,3,4)P3 phosphorylation/dephosphorylation with Ins(1,3,4,5)P4 as intermediate. Furthermore, A431 cells were found to contain strikingly high basal levels of two other inositol phosphates, presumably inositol pentakisphosphate (InsP5) and inositol hexakisphosphate (InsP6), representing more than 50% of the total 3H radioactivity incorporated into inositol phosphates. The presumptive InsP5 and InsP6 are only slightly affected by bradykinin. Although Ins(1,3,4)P3 and InsP4 could function as second messengers, our results suggest that, unlike Ins(1,4,5)P3, neither Ins(1,3,4)P3 nor InsP4 are involved in Ca2+ mobilization. PMID- 3663108 TI - Infrared spectroscopy of heparin-cation complexes. AB - Hydrated and partially hydrated films and aqueous solutions of heparin, heparans and N-desulphated preparations of these polymers were studied by near- and fundamental-region-i.r. spectroscopy in the presence of a range of countercations. The results suggest that ion binding is not explicable solely in terms of simple electrostatic theory, and that specific cation effects, and the hydration pattern of the polymer-cation complex need to be taken into account. PMID- 3663109 TI - Biosynthesis and processing of the large and small subunits of succinate dehydrogenase in cultured mammalian cells. AB - Monospecific polyclonal antisera have been raised to purified bovine heart succinate dehydrogenase and to the individual large and small subunits of this enzyme. These antisera exhibit cross-reactivity with the corresponding polypeptides in rat liver (BRL), pig kidney (PK-15) and bovine kidney (NBL-1) cell lines, and were employed to investigate some of the events involved in the biogenesis of succinate dehydrogenase in the PK-15 cell line. Newly-synthesized forms of the large and small subunits of succinate dehydrogenase were detected in cultured PK-15 and BRL cells labelled with [35S]methionine in the presence of uncouplers of oxidative phosphorylation. In PK-15 cells, the precursor forms of the large and small subunits exhibit Mr values approx. 1000-2000 and 4000-5000 greater than those of the corresponding mature forms. When the uncoupler is removed in pulse-chase experiments, complete conversion of the precursors to the mature forms occurs within 45 min. Studies on the kinetics of processing and stability of the large subunit precursor revealed that reversal of precursor accumulation is rapid, with processing occurring with a half-time of 5-7.5 min, and that the accumulated precursor exhibits long-term stability when PK-15 cells are maintained in the presence of 2,4-dinitrophenol. PMID- 3663110 TI - The regulation of the oxidation of fatty acids and other substrates in rat heart mitochondria by changes in the matrix volume induced by osmotic strength, valinomycin and Ca2+. AB - 1. The rate of ADP-stimulated respiration with various substrates and the matrix volume of rat heart mitochondria were measured over a range of osmolarities of the medium. 2. The rate of oxidation of palmitoylcarnitine (in the presence of malate) was stimulated 7-fold by increasing the matrix volume from 0.6 to 1.0 microliter/mg of protein. Oxidation of octanoate showed a similar sensitivity to the matrix volume, whereas oxidation of other substrates showed little sensitivity until the volume fell below 0.7 microliter/mg of protein. 3. The matrix volume of heart mitochondria incubated under physiological conditions was about 0.8 microliter/mg of protein. 4. Low concentrations of valinomycin added to mitochondria incubated under such physiological conditions could activate the rate of ADP-stimulated palmitoylcarnitine oxidation by at least 100%. 5. Decreasing the matrix volume increased the reduction of the electron-transferring flavoprotein (ETF), suggesting an effect on electron flow between ETF and ubiquinone, as has been observed for liver mitochondria [Halestrap & Dunlop (1986) Biochem. J. 239, 559-565]. 6. A rapid decrease in light-scattering by heart mitochondria incubated in State 4 was induced by addition of Ca2+, reaching 50% of the maximal effect after about 30 s at 30 degrees C and with K0.5 for Ca2+ of 0.3 microM. This was not associated with a change in matrix volume, and is discussed in terms of a conformational change whose identity remains to be determined. 7. However, incubation of heart mitochondria at 37 degrees C in the presence of 0.65 microM-Ca2+ for 4 min did increase the matrix volume significantly, by 0.181 +/- 0.029 microliter/mg of protein (n = 7, P less than 0.001), similar to the Ca2+-induced changes observed with liver mitochondria [Halestrap, Quinlan, Whipps & Armston (1986) Biochem. J. 236, 779-787]. 8. The possible significance of these results in the co-ordinate regulation of fatty acid oxidation and the citric acid cycle in the heart responding to increased work load or hormonal stimulation is discussed. PMID- 3663111 TI - Substrate-derived two-protonic-state electrophiles as sensitive kinetic specificity probes for cysteine proteinases. Activation of 2-pyridyl disulphides by hydrogen-bonding. AB - 1. 2-(N'-Acetyl-L-phenylalanylamino)ethyl 2'-pyridyl disulphide [compound (III)] and 2-(acetamido)ethyl 2'-pyridyl disulphide [compound (IV)] were synthesized by acylation of the common intermediate, 2-aminoethyl 2'-pyridyl disulphide, to provide examples of chromogenic thiol-specific substrate-derived two-protonic state electrophilic probe reagents. These two reagents, together with n-propyl 2 pyridyl disulphide [compound (II)], provide structural variation in the non pyridyl part of the molecule from a simple hydrocarbon side chain in compound (II) to a P1-P2 amide bond in compound (IV) and further to both a P1-P2 amide bond and a hydrophobic side chain (of phenylalanine) at P2 as a potential occupant of S2 subsites. 2. These disulphides were used as reactivity probes to investigate specificity and binding-site-catalytic-site signalling in a number of cysteine proteinases by determining (a) the reactivity at pH 6.0 at 25 degrees C at I 0.1 of compound (III) (a close analogue of a good papain substrate) towards 2-mercaptoethanol, benzimidazol-2-ylmethanethiol [compound (V), as a minimal catalytic-site model], chymopapains B1-B3, chymopapain A, papaya proteinase omega, actinidin, cathepsin B and papain, (b) the effect of changing the structure of the probe as indicated above on the reactivities of compound (V) and of the last five of these enzymes, and (c) the forms of pH-dependence of the reactivities of papain and actinidin towards compound (III). 3. The kinetic data suggest that reagents of the type investigated may be sensitive probes of molecular recognition features in this family of enzymes and are capable not only of detecting differences in binding ability of the various enzymes but also of identifying enzyme-ligand contacts that provide for binding-site-catalytic-site signalling mechanisms. 4. The particular value of this class of probe appears to derive from the possibility of activating the 2-mercaptopyridine leaving group not only by formal protonation, as was recognized previously [see Brocklehurst (1982) Methods Enzymol. 87C, 427-469], but also by hydrogen-bonding to the pyridyl nitrogen atom when the appropriate geometry in the catalytic site is provided by enzyme-ligand contacts involving the non-pyridyl part of the molecule.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3663112 TI - Iron-mediated oxidative stress in erythrocytes. AB - Erythrocytes subjected extracellularly to iron-mediated oxidant stress undergo haemoglobin oxidation and membrane damage, which can be modulated by maintaining the energy requirements of the cells. The results presented here suggest that a balance exists between the oxidation state of the haemoglobin and the oxidative deterioration of the membrane lipids, which is dependent on the metabolic state of the erythrocytes. These findings have important implications for thalassaemic erythrocytes that may be exposed to excess plasma iron levels, in which excessive membrane-bound iron in the form of haemichromes is a characteristic feature and in which cellular ATP levels are lowered. PMID- 3663113 TI - Oxidation of protoporphyrinogen to protoporphyrin, a step in chlorophyll and haem biosynthesis. Purification and partial characterization of the enzyme from barley organelles. AB - The protoporphyrinogen-oxidizing enzyme from Triton X-100 extracts of the mitochondrial and etioplast fractions of etiolated barley was purified by using ion-exchange and hydroxyapatite chromatography. The purified enzyme from both organelle fractions exhibited a Km of 5 microM and was labile to mild heat and acidification. The pH optimum (5-6) and the substrate-specificity (mesoporphyrinogen was oxidized as rapidly as protoporphyrinogen) revealed properties very different from the protoporphyrinogen-oxidizing enzyme of rat liver or yeast mitochondria, which is specific for protoporphyrinogen as substrate. The purest fractions showed a polypeptide band corresponding to an Mr of approx. 36,000 on SDS/polyacrylamide-gel electrophoresis. This is the first purification and characterization of the enzyme from a plant, and indicates no readily detectable differences between the enzyme isolated from mitochondrial or etioplast fractions, although only the latter organelle has the capacity for both haem and chlorophyll synthesis. PMID- 3663114 TI - Chemical synthesis and growth-promoting activity of all-trans-retinyl beta-D glucuronide. AB - All-trans-retinol reacts with methyl (2,3,4-tri-O-acetyl-1-bromo-1-deoxy-beta-D glucopyran)uronate in the presence of Ag2CO3 to give the triacetate methyl ester of retinyl beta-glucuronide. Hydrolysis of this ester with sodium methylate in methanol gives retinyl beta-D-glucuronide in about 15% yield. The water-soluble retinyl beta-D-glucuronide was characterized by u.v.-visible, n.m.r. and mass spectra, by elemental analysis and by its susceptibility to hydrolysis by bacterial beta-glucuronidase. Retinyl beta-glucuronide, when administered intraperitoneally in saline (0.9% NaCl), supports well the growth of vitamin A deficient rats. PMID- 3663116 TI - Steady-state parameters of an enzyme from n.m.r. spin transfer with thermal variation. AB - N.m.r. spin-exchange analysis of enzymic reactions at chemical equilibrium is akin to radioactive-tracer-exchange analysis; unidirectional flux rates are obtained for the overall reaction. These data, by themselves, are not sufficient to define the values of all the individual rate constants or steady-state parameters. However, it is shown that, by measuring the dependence of the exchange rate constants on solute concentration and temperature, the individual rate constants, and hence the steady-state parameters, can be obtained for a simple enzyme system. PMID- 3663115 TI - The interaction of spermine and pentamines with DNA. AB - We studied the effects of spermine, two naturally-occurring pentamines isolated from the thermophile Thermus thermophilus and one synthetic pentamine on the aggregation and 'melting' temperature of calf-thymus DNA and on the B-to-Z transition of poly(dG-me5dC). All pentamines caused aggregation of DNA at much lower concentrations than that of spermine. Concentrations that increased the melting temperature of DNA and induced the B-to-Z transition in poly(dG-me5dC) were different for each pentamine, but were comparable with the concentration of spermine needed to cause these effects. Our results suggest that both the total charge and the distance separating the charge, which is a function of the length of the carbon chains between amino groups, are important for the induction of conformational changes in DNA. The biological role of pentamines in T. thermophilus appears to be related to their ability to promote DNA condensation at high temperature. PMID- 3663118 TI - Characterization of the basic glutathione S-transferase B1 and B2 subunits from human liver. AB - The basic glutathione S-transferases in human liver are composed of at least two immunochemically distinct polypeptides, designated B1 and B2. These subunits exist as homodimers, but can hybridize to form the B1B2 heterodimer [Stockman, Beckett & Hayes (1985) Biochem. J. 227, 457-465]. Although these basic glutathione S-transferases possess similar catalytic properties, the B2 subunit exhibits significantly greater selenium-independent glutathione peroxidase activity than subunit B1. The use of the ligands haematin, tributyltin acetate and Bromosulphophthalein as inhibitors of 1-chloro-2,4-dinitrobenzene-GSH conjugating activity clearly discriminate between the B1 and B2 subunits and should help facilitate their identification. Peptide mapping experiments showed that B1 and B2 are structurally distinct, but related, subunits; subunit B1 yielded 43 tryptic peptides, seven of which were unique, whereas subunit B2 yielded 40 tryptic peptides, four of which were unique. PMID- 3663117 TI - Increase in S-adenosylmethionine decarboxylase in SV-3T3 cells treated with S methyl-5'-methylthioadenosine. AB - Treatment of SV-3T3 cells with the spermine synthase inhibitor S-methyl-5' methylthioadenosine [AdoS+(CH3)2] led to a large increase in the activity of S adenosylmethionine decarboxylase (AdoMetDC) without affecting ornithine decarboxylase. The elevation of AdoMetDC activity was due to an increased amount of enzyme protein, as demonstrated by radioimmunoassay and by immunoblotting. The increase in AdoMetDC protein was caused by at least three factors: an increase in the amount of translatable mRNA, an increased translation efficiency of the mRNA and an increase in the half-life of the protein. The depletion of spermine brought about by AdoS+(CH3)2 appeared to be responsible for the increased synthesis of AdoMetDC and for part of the decrease in its rate of degradation. An additional stabilization of the enzyme protein was probably due to the binding of AdoS+(CH3)2, which is also a weak inhibitor of AdoMetDC. These results demonstrate the importance of cellular spermine concentrations in regulating the activity of AdoMetDC, which is a key enzyme controlling polyamine synthesis. PMID- 3663119 TI - Gene expression of type I, III and IV collagens in hepatic fibrosis induced by dimethylnitrosamine in the rat. AB - Dimethylnitrosamine (DMN)-induced hepatic fibrosis was used as an experimental model to study collagen-gene expression during liver fibrogenesis. Increase in the concentrations of the mRNAs for type I, III, and IV collagens was found to be an early event in the development of hepatic fibrosis, as the mRNAs for all three collagen types showed a definite increasing tendency by day 7 of DMN treatment. Prolyl 4-hydroxylase (EC 1.14.11.2) and galactosylhydroxylysyl glucosyltransferase (EC 2.4.1.66) activities were also distinctly elevated at this stage, whereas no increase could be detected in the liver collagen content. The increase in the mRNAs for type I collagen was the smallest and that for type IV collagen the greatest at all the time points studied. The relative concentrations of the mRNAs for the three collagen types on day 21 of DMN treatment were 350% of the control mean for type I collagen, 490% for type III and 660% for type IV. The data further indicate that the proportions of the mRNAs for the three collagen types are 1.0:0.9:0.2 in normal rat liver, 1.0:1.4:0.8 on day 14 of DMN treatment, and 1.0:1.3:0.5 on day 21. The early marked increase in the mRNA for type IV collagen suggests that enhanced production of basement membrane collagen may be an early event in the development of hepatic fibrosis. PMID- 3663120 TI - Turnover of factor X and of prothrombin in rabbits fed on a standard or cholesterol-supplemented diet. AB - The turnover of prothrombin and of factor X was investigated in rabbits fed on a 1%-cholesterol-supplemented or a standard diet by studying the evolution of radioactivity in blood and in plasma from these animals after the intravenous injection of either 125I-rabbit factor X or 125I-bovine prothrombin. For factor X, half-lives and fractional pool sizes were similar for the two groups of rabbits in the extravascular, intravascular and plasma compartments. However, the equivalent plasma fractional pool size for the two groups of rabbits was only 73% of that in the intravascular compartment. The fractional catabolic rate for the hypercholesterolaemic rabbits [0.064 +/- 0.007 (of the intravascular pool)/h] was not significantly different from that in the rabbits fed on the standard diet (0.074 +/- 0.008/h). However, the absolute catabolic rate, and therefore the rate of synthesis, was significantly higher (1.261 +/- 0.141 mg/day per kg body wt. of rabbit) in the rabbits fed on the cholesterol-supplemented than that in the rabbits fed on the standard diet (0.705 +/- 0.019 mg/day per kg). The prothrombin half-lives and fractional pool sizes were similar for the two groups of rabbits in the extravascular and the intravascular compartments. The fractional catabolic rate for the hypercholesterolaemic rabbits [0.041 +/- 0.003 (of the plasma pool)/h] was not significantly different from that in the rabbits fed on the standard diet (0.035 +/- 0.003/h). However, the absolute catabolic rate and therefore the rate of prothrombin synthesis was significantly higher (3.96 +/- 0.48 mg/day per kg body wt.) in the rabbits fed on the cholesterol-supplemented than that in the rabbits fed on the standard diet (2.24 +/- 0.12 mg/day per kg). PMID- 3663121 TI - Purification and properties of the soluble carnitine palmitoyltransferase from bovine liver mitochondria. AB - A new carnitine palmitoyltransferase (CPT) was purified to homogeneity from bovine liver mitochondria which were 96% free of peroxisomal contamination, as judged by catalase and glutamate dehydrogenase activities. The enzyme is easily removed from mitochondria, without the use of detergent. It is monomeric (Mr 63,500), unlike other preparations of CPT from mitochondria, and is most active with myristoyl-CoA and palmitoyl-CoA. The Km values are between 0.8 and 4 microM for a range of substrates from hexanoyl-CoA to stearoyl-CoA; these are much lower than values reported for other purified CPT preparations. The Km for L-carnitine is 185 microM measured with palmitoyl-CoA, and does not vary greatly with the chain length. This is also lower than the values reported for other CPT preparations, but higher than those cited for the medium-chain transferases. Kinetic and inhibitor studies were consistent with a rapid-equilibrium random order mechanism. 2-Bromopalmitoyl-CoA, which is an inhibitor of the outer CPT, inhibited the enzyme competitively with palmitoyl-CoA as the variable substrate, when added without preincubation. If the enzyme was preincubated with 2 bromopalmitoyl-CoA and carnitine, the activity did not reappear after gel filtration of the protein. The inhibitor was bound in a 1:1 stoichiometry per subunit of enzyme. PMID- 3663122 TI - The mode of action of Shiga toxin on peptide elongation of eukaryotic protein synthesis. AB - The effect of Shiga toxin, from Shigella dysenteriae 1, on the component reactions of peptide elongation were investigated. Enzymic binding of [3H]phenylalanine-tRNA to reticulocyte ribosomes was inhibited by 50% at 7 nM toxin. Elongation factor 1 (eEF-1)-dependent GTPase activity was also inhibited. Both reactions were not restored by addition of excess eEF-1 protein. In contrast, toxin concentrations of 200 nM were required to inhibit by 50% the elongation factor 2 (eEF-2)-dependent translocation of aminoacyl-tRNA on ribosomes. Addition of excess eEF-2 restored translocation activity. The eEF-2 dependent GTPase activity was unaffected at toxin concentrations below 100 nM, and Shiga-toxin concentrations of up to 1,000 nM did not affect either GTP.eEF 2.ribosome complex-formation or peptidyltransferase activity. Thus Shiga toxin closely resembles alpha-sarcin in action, both being primary inhibitors of eEF-1 dependent reactions. In contrast, the 60 S ribosome inactivators ricin and phytolaccin are primary inhibitors of eEF-2-dependent reactions of peptide elongation. PMID- 3663123 TI - Interactions of ovalbumin and of its putative signal sequence with phospholipid monolayers. Possible importance of differing lateral stabilities in protein translocation. AB - Surface properties of ovalbumin and of its putative signal sequence, and their interactions with phospholipids at an air-water interface, have been studied. The mature protein can form an interfacial film spontaneously from its bulk solution, whereas the signal sequence cannot. Mature ovalbumin also penetrates phospholipid monolayers from the subphase (independently of the type of phospholipid present), whereas its signal sequence does not. The surface stability of a spread film of the signal sequence is, however, higher than that of a film of mature ovalbumin. Above specific threshold concentrations of signal peptide and of mature ovalbumin in mixed films with phospholipids, two separate phases are formed. In such immiscible films, the signal sequence peptide is also able to support a higher lateral surface pressure than mature ovalbumin, at corresponding areas of peptide and mature protein in the mixed monolayers. It is suggested that the differing lateral stabilities of ovalbumin and of its putative signal sequence may be relevant to the translocation of ovalbumin across the membrane of the endoplasmic reticulum, and a scheme for its translocation is proposed that is based on these properties. PMID- 3663124 TI - Molecular composition of the phosphatidylcholines produced by the phospholipid methylation pathway in rat brain in vivo. AB - We examined the formation in vivo of molecular subspecies of brain phosphatidylcholine (PC) via the phospholipid-methylation pathway. [3H]Methionine was infused into a lateral cerebral ventricle, and 3H-labelled PC was isolated from brains of rats 0.1-18 h after the infusions. Three major subspecies of this PC, differing in their fatty acid compositions, were separated on silver impregnated t.l.c. plates, and the proportions of radioactivities in these three PC fractions were determined. The results indicate that newly-formed PC synthesized by methylation of phosphatidylethanolamine at 0.1 h after [3H]methionine contains a significantly higher proportion of polyunsaturated subspecies (i.e. those with six or four double bonds) than does PC obtained later times after injection of [3H]methionine. This change in the composition of 3H labelled brain PC occurs gradually and is not due to an influx of radioactive PC from the periphery. Our data suggest that polyunsaturated PC (hexaenes and tetraenes) produced in the brain by methylation of phosphatidylethanolamine turns over faster than does that containing more-saturated fatty acids. PMID- 3663125 TI - Unusual ciliate-specific codons in Tetrahymena mRNAs are translated correctly in a rabbit reticulocyte lysate supplemented with a subcellular fraction from Tetrahymena. AB - The codon usage of Tetrahymena thermophila and other ciliates deviates from the 'universal genetic code' in that UAA and probably UAG are not translational termination signals but code for glutamine. Therefore, translation in vitro of mRNA from Tetrahymena in a reticulocyte lysate is prematurely terminated if a UAA or UAG triplet is present in the reading frame of the mRNA. We show that the addition of a subcellular fraction from Tetrahymena thermophila enables a rabbit reticulocyte lysate to translate Tetrahymena mRNAs into full-sized proteins. The activity of the subcellular fraction is shown to depend on the combined function of a protein component(s) and a tRNA(s). The subcellular fraction is easily prepared and its usefulness for the identification of isolated mRNAs from Tetrahymena by their translation products in vitro is demonstrated. PMID- 3663126 TI - Purification of elongation factor 2 from human placenta and evidence of its fragmentation patterns in various eukaryotic sources. AB - While preparing human placenta elongation factor 2 (EF-2), whose purification and some molecular properties are reported, we noticed the presence of numerous protein fractions which did not have EF-2 activity, but were ADP-ribosylated by diphtheria toxin in the presence of NAD+. All these proteins, like EF-2, were selectively retained by a heparin-Sepharose column, which we used as an affinity chromatography step. This was also observed when EF-2 was prepared, by this purification step, from other sources, i.e. ox liver and two species of yeasts. In order to assess whether these proteins were a degradation product of EF-2, independent proteins or a mixture of both, they were analysed by subjecting them, after [14C]ADP-ribosylation, to exhaustive trypsinolysis. Only one radioactive peptide was found, thus suggesting that those proteins originate from EF-2 by some proteolytic process. Our findings indicate that this proteolysis does not occur after cell disruption, but is more or less active in the intact cell, depending on the system considered. PMID- 3663127 TI - Kinetic properties of hexokinase as assembled with a microcomputer data base. AB - We have constructed a relational data base containing the kinetic properties of the isoenzymes of hexokinase using the Knowledgeman data-base program on an IBM PC microcomputer. The natural subunit of this data base is the refereed publication, 165 of which were included. Reported values for the Mr (approx. 97,000) are in good agreement, but this agreement becomes progressively worse as one examines the Km values for glucose and ATP and the Ki for glucose 6 phosphate, where the reported values are spread over three orders of magnitude. Some quantities are very thinly or unreliably determined. Experimental conditions, especially free Mg2+ concentration, are rarely close to physiological. Reasons for the spread or uncertainty of numbers, and the distinctions that can be made between isoenzymes despite this spread, are discussed. PMID- 3663128 TI - Expression and developmental regulation of two unique mRNAs specific to brain membrane-bound polyribosomes. AB - Translation in vitro of membrane-bound polyribosomal mRNAs from rat brain has shown several to be developmentally regulated [Hall & Lim (1981) Biochem. J. 196, 327-336]. Here we describe the isolation and characterization of cDNAs corresponding to two such brain mRNAs. One cDNA (M444) hybrid-selected a 0.95 kb mRNA directing the synthesis in vitro of a 21 kDa pI-6.3 polypeptide, which was processed in vitro by microsomal membranes. A second cDNA (M1622) hybridized to a 2.2 kb mRNA directing the synthesis of a 55 kDa pI-5.8 polypeptide. Both mRNAs were specific to membrane-bound polyribosomes. Restriction maps of the corresponding genomic DNA sequences are consistent with both being single copy. The two mRNAs were present in astrocytic and neuronal cultures, but not in liver or spleen or in neuroblastoma or glioma cells. The two mRNAs were differently regulated during brain development. In the developing forebrain there was a gradual and sustained increase in M444 mRNA during the first 3 weeks post partum, whereas M1622 mRNA appeared earlier and showed no further increase after day 10. In the cerebellum the developmental increase in M444 mRNA was biphasic. After a small initial increase there was a decrease in this mRNA at day 10, coincident with high amounts of M1622 mRNA. This was followed by a second, larger, increase in M444 mRNA, when amounts of M1622 mRNA were constant. The contrasting changes in these two mRNAs in the developing cerebellum are of particular interest, since they occur during an intensive period of cell proliferation, migration and altering neural connectivity. As these mRNAs are specific to differentiated neural tissue, they represent useful molecular markers for studying brain differentiation. PMID- 3663130 TI - Collagen synthesis by cell lines derived from Mov-13 mouse embryos which have a lethal mutation in the collagen alpha 1(I) gene. AB - Mouse embryos homozygous for the Mov-13 mutation produce no collagen I, owing to transcriptional blockage of the collagen alpha 1(I) gene by a retroviral insert. Fibroblast-like cell lines derived from these embryos were compared with similar lines derived from heterozygous and wild-type embryos with respect to the total amounts, and types, of collagen synthesized. Total collagen synthesized by either cloned or uncloned cell lines correlated with their genotype, demonstrating no compensation for absence of collagen I production by an increase in synthesis of other collagen types. Procollagen alpha 2(I) chains were not detected in the homozygous cell lines, demonstrating that these chains do not form homotrimers, nor do they form heterotrimers with alpha-chains of other collagen types. Procollagen III levels were quantified by radioimmunoassay and found to be similar in all cell lines. PMID- 3663129 TI - Choline biosynthesis in sheep. Evidence for extrahepatic synthesis. AB - 1. Choline production by various tissues of the sheep was measured by determining venous and arterial free choline concentrations in blood samples taken from various vessels in conscious multicannulated sheep. 2. Significant production of free choline occurred in the upper and lower body regions, and specifically in the heart, brain and hind-limb muscles of sheep, but there was no significant uptake or output of phosphatidylcholine across these tissues, as determined by arterio-venous differences. 3. In contrast, in the rat there were no significant arterio-venous differences in the concentrations of free choline or phosphatidylcholine across the hind-body. 4. Synthesis of phosphatidylcholine from endogenous phosphatidylethanolamine and S-adenosyl-L-[methyl-14C]methionine was measured in experiments in vitro using microsomal preparations from a variety of sheep and rat tissues. 5. The biosynthetic activity was highest in liver from sheep and rats, although the activity in sheep microsomal preparations was about one-quarter of that in rat microsomal preparations. 6. Microsomal preparations from sheep lung, kidney, gut epithelium, brain, heart and skeletal muscles also showed considerable biosynthetic activity, but in the rat the activity was virtually confined to the liver. 7. Overall, the results show a significant production of choline in extrahepatic tissues of the sheep, with skeletal muscle contributing some 60% of this extrahepatic activity. Thus the extrahepatic production of choline in the sheep, together with the extensive reutilization of bile choline, can explain the maintenance of the large endogenous body pool of choline in this species. PMID- 3663131 TI - Cytosolic free Ca2+ in single rat heart cells during anoxia and reoxygenation. AB - Free Ca2+ in the cytosol ([Ca2+]i) of individual rat ventricle cells injected with aequorin was measured under anoxia. In glucose-free medium myocytes spontaneously shortened after about 60 min, although [Ca2+]i was still at or near resting levels. However, within minutes a net inward movement of Ca2+ across the sarcolemma developed and [Ca2+]i began to rise. Provided oxygen was readmitted before [Ca2+]i exceeded 2-3 microM, cells were able to restore [Ca2+]i to resting levels through caffeine-sensitive sequestration of Ca2+ in the sarcoplasmic reticulum. We suggest that Ca2+-independent shortening of anoxic cardiomyocytes reflects onset of rigor which triggers loss of [Ca2+]i homoeostasis. PMID- 3663132 TI - Acyl-CoA dehydrogenase activity in the riboflavin-deficient rat. Effects of starvation. AB - Riboflavin deficiency in weanling rats causes a metabolic disorder characterized by failure to oxidize fatty acids. The disorder is similar to that seen in several human diseases, some of which are responsive to pharmacological doses of riboflavin. Previous analysis of the riboflavin-deficient rat has shown that the failure of fatty acid oxidation is due to a decrease in the activity of the acyl CoA dehydrogenases of beta-oxidation. The activity of these flavoenzymes in liver rapidly decreases when a riboflavin-deficient diet is initiated. The objectives of these experiments were to analyse the effects of starvation on liver mitochondria isolated from the riboflavin-deficient rat. Our studies show that the decreased mitochondrial fatty acid oxidation induced by riboflavin deficiency is partially reversed by starvation. The extent of this reversal is proportional to the duration of starvation. The starvation-associated increase in fatty acid oxidation is mediated by an increase in the mitochondrial short-chain acyl-CoA dehydrogenase activity. The activity of this enzyme is increased such that the ratio of short-chain acyl-CoA dehydrogenase apoenzyme to holoenzyme does not change. We conclude that short-chain acyl-CoA dehydrogenase activity is limiting for fatty acid oxidation when its activity falls below a critical point. The increased mitochondrial specific activity of short-chain acyl-CoA dehydrogenase during starvation may result from an increased availability of flavin coenzyme or an increase in enzyme catalytic efficiency. PMID- 3663133 TI - Purification and characterization of the 27,000 Da calcium-binding protein of bovine brain. AB - A Ca2+-binding protein named CAB-27 was purified from bovine brain 100,000 g supernatant. The protein has a molecular mass of 27,000 Da as determined by SDS/polyacrylamide-gel electrophoresis and 35,500 Da by sedimentation-coefficient and Stokes-radius analysis. The protein contains about 26% Glx and Asx and 13% basic residues. The acidic nature of the molecule is confirmed by its pI of 4.80. In the presence of 3 mM-MgCl2 and 150 mM-KCl, CAB-27 binds 2.0 mol of Ca2+/mol of protein, with an apparent Kd of 0.2 microM. Ca2+-binding is unaffected by prior incubation of the protein at 80 degrees C for 2 min. Brain contains about 130 mg of CAB-27/kg. Immunoblotting identified CAB-27 in several bovine tissues; it appears to be particularly rich in brain and kidney. In addition, CAB-27 is identified as an inhibitor of bovine pancreas phospholipase A2 in vitro. The inhibitory activity of CAB-27 was 20-fold less potent than lipocortin. On the basis of the Ca2+-binding properties, intracellular concentration and tissue distribution of this protein, we suggest that CAB-27 may be an important intracellular Ca2+ receptor. PMID- 3663134 TI - Phosphatidylcholine metabolism in neonatal mouse calvaria. AB - Phosphatidylcholine metabolism was examined in neonatal mouse calvaria in vitro. Incorporation of choline into phosphatidylcholine was slow in this tissue. At 2 h after a pulse of [methyl-3H]choline only 30% of the tissue radioactivity was in the organic phase. Chromatography of the aqueous phase of the tissue extract revealed that more than half of the radioactivity was present as choline at this time. There was no accumulation of phosphocholine, which would have been expected if the cytidylyltransferase were the rate-limiting step in the CDP-choline pathway in the tissue. Choline kinase activity in calvarial cytosol was lower than choline kinase activity in liver cytosol of the same animals. No evidence for significant phosphatidylcholine synthesis through the methylation pathway was found in the calvarial tissue. Although rates of choline-phosphatidylcholine base exchange were higher in bone microsomes than in microsomes from liver, the rate of phosphatidylcholine production through this pathway appeared to be too slow to account for the phosphatidylcholine produced by the calvaria. Phosphatidylcholine synthesis in the calvaria was unaffected by 2 h of treatment with 10 nM parathyroid hormone, 0.1 nM-0.1 microM-1 alpha,25-dihydroxycholecalciferol, 5 microM-prostaglandin E1 or 2.5 nM-salmon calcitonin, or by 17 h of treatment with 10 nM-parathyroid hormone or 0.1 nM-1 alpha,25-dihydroxycholecalciferol. PMID- 3663135 TI - Characterization of N-linked oligosaccharides of an HLA-DR molecule expressed in different cell lines. AB - In order to determine the factors that influence the glycosylation of an integral membrane protein, we investigated the N-glycosylation of a molecule of the human major histocompatibility complex (MHC) class II, the HLA-DR antigen. This glycoprotein was studied in a human Epstein-Barr-virus-transformed B cell line and in a mouse fibroblastic cell line co-transfected with DR alpha and DR beta genes. We observed that the HLA-DR-antigen glycosylation pattern depends on the cell line in which processing takes place and is closely related to the glycosylation pattern of the overall cellular glycoproteins. Furthermore, when comparing the glycosylation of the separated alpha- and beta-chains, differences were noticed within the same molecule, showing the importance of the individual peptide backbone for the glycosylation process. PMID- 3663136 TI - Terminal-group oxidation of retinol by mouse epidermis. Inhibition in vitro and in vivo. AB - Locally applied retinol is metabolized to retinoic acid in mouse epidermis in vivo. To characterize the oxidation system we investigated the ability of soluble extracts of hairless-mouse epidermis to convert retinol and retinal into retinoic acid. The extracts oxidized retinol to retinoic acid in two steps catalysed by two NAD+-dependent enzymes that were resolved on h.p.l.c. The first enzyme catalyses the reversible oxidation of retinol to retinal and is an alcohol dehydrogenase isoenzyme. The second enzyme oxidizes retinal to retinoic acid. Retinol oxidation by epidermal extracts was inhibited by the alcohol dehydrogenase inhibitor 4-methylpyrazole and by the polyene citral. The toxicity and relatively low potency at inhibiting the epidermal alcohol dehydrogenase isoenzyme curtailed the use of 4-methylpyrazole in vivo. However, citral significantly inhibited retinoic acid formation from retinol in the epidermis in vivo. The ability to inhibit the oxidation of retinol to retinoic acid in mouse epidermis provides a potential method to resolve the roles of retinol and retinoic acid in epithelial function. PMID- 3663137 TI - Binding of inositol phosphates and induction of Ca2+ release from pituitary microsomal fractions. AB - Bovine anterior-pituitary microsomal fractions exhibit high-affinity, saturable and reversible binding of inositol 1,4,5-[32P]trisphosphate; 50% of the labelled ligand is displaced by 3.5 nM-inositol 1,4,5-trisphosphate. 0.5 microM-inositol 1,4-bisphosphate and 10 microM-ATP. Inositol 1,4,5-trisphosphate induces the release of Ca2+ from the microsomal vesicles (half-maximal effect at 290 nM), and its action is potentiated by inositol tetrakisphosphate (half-maximal effect at 4 microM). PMID- 3663138 TI - Reversible association of half-molecules of ovotransferrin in solution. Basis of co-operative binding to reticulocytes. AB - In the present paper, gel-filtration studies of diferric-ovotransferrin (Fe2OTf), the individual half-molecules of ovotransferrin (OTf) and equimolar mixtures of half-molecules have been interpreted according to the Gilbert theory as developed by Ackers & Thompson [(1965) Proc. Natl. Acad. Sci. U.S.A. 53, 342-349]. The data indicate that the half-molecules associate reversibly in solution and allow determination of a dissociation constant, Kd' = 8.0 (+/- 2.7) microM. Equilibrium binding studies have been performed using NH4Cl to block removal of iron from equimolar differentially iodine-labelled half-molecules (125I and 131I), in order to evaluate the binding of each to chick-embryo red blood cells under identical conditions. The amount of associated half-molecules over a range of concentrations has been calculated using the constant derived from the gel filtration experiments described above. A computerized non-linear least-squares regression analysis of the data leads to determination of Kd* (the apparent dissociation constant for the interaction between OTf or half-molecules and the transferrin (Tf) receptors of chick-embryo red blood cells) and Bmax (binding at infinite free-ligand concentration) for the half-molecules similar to those found for Fe2OTf. Recent reports confirm that the two iron-binding domains of both OTf and human lactotransferrin associate non-covalently in solution. Our work shows that the isolated half-molecules of OTf are able to reassociate in solution and that this reassociation has functional significance by allowing the complex to be recognized by the Tf receptor. PMID- 3663139 TI - Phospholipid synthesis in isolated alveolar type II cells exposed in vitro to paraquat and hyperoxia. AB - Isolated alveolar epithelial type II cells were exposed to paraquat and to hyperoxia by gas diffusion through the thin Teflon bottom of culture dishes. After exposure, type II cells were further incubated in the presence of labelled substrates to assess their capacity to synthesize lipids. Hyperoxia alone (90% O2; 5 h) had minor effects on lipid metabolism in the type II cells. At low paraquat concentrations (5 and 10 microM), hyperoxia enhanced the paraquat induced decrease of [Me-14C]choline incorporation into phosphatidylcholines. The incorporation rates of [Me-14C]choline, [1-14C]palmitate, [1-14C]glucose and [1,3 3H]glycerol into various phospholipid classes and neutral lipids were decreased by paraquat, depending on the concentration and duration of the exposure. The incorporation of [1-14C]acetate into phosphatidylcholines, phosphatidylglycerols and neutral lipids appeared to be very sensitive to inactivation by paraquat. At 5 microM-paraquat the rate of [1-14C]acetate incorporation was decreased to 50% of the control values. The rate of [1-14C]palmitate incorporation into lipids was much less sensitive; it even increased at low paraquat concentrations. At 10 microM-paraquat both NADPH and ATP were significantly decreased. It is concluded that lipid synthesis in isolated alveolar type II cells is extremely sensitive to paraquat. At low concentrations of this herbicide, lipid synthesis, and particularly fatty acid synthesis, is decreased. The effects on lipid metabolism may be partly related to altered NADPH and ATP concentrations. PMID- 3663140 TI - Ornithine decarboxylase production in vitro by using mouse cDNA. AB - Microgram quantities of ornithine decarboxylase (ODC, EC 4.1.1.17)-specific mRNA were synthesized by transcription techniques in vitro, by using a plasmid containing mouse cDNA coding for this enzyme. The homogeneous RNA preparation was then used for cell-free synthesis of ODC protein, in rabbit reticulocyte lysates. Analysis of products translated in vitro by polyacrylamide-gel electrophoresis revealed predominantly one protein produced, with Mr approx. 54,000, which was immunoprecipitable by anti-ODC serum. Two-dimensional gel-electrophoretic analysis showed that the protein ODC synthesized in vitro had a pI of approx. 5.4, similar to the native enzyme isolated from mouse tissues. In addition, quantification of activity and protein amount showed that the enzyme synthesized in vitro had a specific activity of approx. 63,000 units (nmol/min)/mg, consistent with the purified mouse kidney enzyme's specific activity of approx. 47,000 units/mg. An average of nearly 200 pg of ODC protein was produced in vitro from various RNA preparations. These data demonstrate that ODC-specific mRNA and active ODC protein can be produced by 'in vitro' technology, which should prove useful in studying functional and structural characteristics of these molecules. PMID- 3663141 TI - Fractional synthesis rates in vivo of skeletal-muscle myosin isoenzymes. AB - The synthesis rates of different myosin isoenzymes in a single muscle, and of the same isoenzymes in different muscles (soleus, masseter and plantaris), were measured. The rate of total protein synthesis was significantly higher in the soleus [greater than 95% slow myosin (SM)] than in the plantaris [greater than 95% fast myosin (FM)]. Two fast isoenzymes, FM2 and FM3, were synthesized at different rates in the masseter, and SM was synthesized at a faster rate than FM. Intermediate myosin had a synthesis rate similar to that of FM. There was a small but significant difference between the synthesis rates of the SM isoenzymes of the soleus and masseter muscles. FM3 was synthesized faster in the masseter than in the plantaris, whereas FM2 was synthesized faster in the plantaris than in the masseter. PMID- 3663142 TI - Structure of two new aminophospholipids from Methanobacterium thermoautotrophicum. AB - The methanogenic bacterium Methanobacterium thermoautotrophicum (A.T.C.C. 29183) was shown to contain two new aminophospholipids. These are 2-aminoethyl phosphate ester of diphytanylglycerol diether and a sugar containing bisdiphytanyldiglycerol tetraether. The two aminophospholipids were stable to acid methanolysis except for the sugar on the bisdiphytanyldiglycerol tetraether. Strong acid (6 M-HCl) hydrolysed the alkyl ether and aminophosphate ester bonds. The structure of the phosphate linkage was demonstrated by 31P n.m.r., and the 2 ethanolamine structure was elucidated by 1H- and 13C-n.m.r. spectroscopy and by fast-atom-bombardment m.s. PMID- 3663143 TI - The effect of concanavalin A on the rat electro-olfactogram. Differential inhibition of odorant response. AB - When the rat olfactory mucosa is treated with concanavalin A, it subsequently shows diminished sensitivity towards 60% of the 112 odorants tested (as judged by the amplitude of the electro-olfactogram response). Odorants containing four to six carbon atoms tend to show the largest (absolute) diminutions, suggesting a receptor for this kind of odorant, although the structural specificity is weak. The receptor seems to be of particular importance in the detection of thiols, carboxylic acids and hydrocarbons of the above size, since these compounds loose the highest proportion of their original signal. The concanavalin A appears to be binding to the glycan of one or more cell-surface proteins. The binding may be at, or close to, at least one odorant receptor. PMID- 3663144 TI - The effect of concanavalin A on the rat electro-olfactogram at various odorant concentrations. AB - We have studied the effect of concanavalin A (Con A) on the rat electro olfactogram response to several odorants. Each odorant was applied over a range of concentrations. For hydrophobic odorants whose response was affected by Con A, the diminution in response was maximal at odorant concentrations of about 1 microM in the olfactory mucus. The (odour) concentration-dependence of the change is compatible with the idea that Con A inactivates one or more types of olfactory receptor that normally bind odorants with dissociation constants of the order of 100 nM. With hydrophilic odorants we had to apply concentrations very much higher than this to elicit any response from the system. At these high concentrations we could observe Con A-induced diminutions in response. PMID- 3663145 TI - Stereoselective formation and hydration of 12-methylbenz[a]anthracene 5,6-epoxide enantiomers by rat liver microsomal enzymes. AB - The K-region trans-5,6-dihydrodiols formed in the metabolism of 12 methylbenz[a]anthracene (12-MBA) by liver microsomal preparations from untreated, phenobarbital-treated and 3-methylcholanthrene-treated male Sprague-Dawley rats were found by chiral stationary-phase h.p.l.c. (c.s.p.-h.p.l.c.) analyses to contain (5S,6S)/(5R,6R) enantiomer ratios of 93:7, 88:12 and 97:3 respectively. The absolute stereochemistry of a 12-MBA trans-5,6-dihydrodiol enantiomer was elucidated by the exciton-chirality c.d. method. The 5,6-epoxides formed in the metabolism of 12-MBA by liver microsomal preparations from untreated, phenobarbital-treated and 3-methylcholanthrene-treated male Sprague-Dawley rats in the presence of the epoxide hydrolase inhibitor 3,3,3-trichloropropylene 1,2 oxide were isolated from a mixture of metabolites by normal-phase h.p.l.c., and their (5S,6R)/(5R,6S) enantiomer ratios were found by c.s.p.-h.p.l.c. analyses to be 73:27, 78:22 and 99:1 respectively. The absolute configurations of 12-MBA 5,6 epoxide enantiomers, resolved by c.s.p.-h.p.l.c., were determined via high resolution (500 MHz) proton-n.m.r. and c.d. spectral analyses of the two isomeric methoxylation products derived from each of the 12-MBA 5,6-epoxide enantiomers. Enantiomeric pairs of the two methoxylation products were resolved by c.s.p. h.p.l.c. The results indicate that enantiomeric 5S,6R-epoxide and 5S,6S dihydrodiol were the major enantiomers preferentially formed in the metabolism at the K-region 5,6-double bond of 12-MBA by all three rat liver microsomal preparations. Optically pure 12-MBA 5S,6R-epoxide was hydrated predominantly at the C(6) position (R centre) to form 12-MBA trans-5,6-dihydrodiol with a (5S,6S)/(5R,6R) enantiomer ratio of 97:3. However, optically pure 12-MBA 5R,6S epoxide was hydrated nearly equally at both C(5) and C(6) positions to form 12 MBA trans-5,6-dihydrodiol with a (5S,6S)/(5R,6R) enantiomer ratio of 57:43. PMID- 3663146 TI - Different sites of inhibition of carnitine palmitoyltransferase by malonyl-CoA, and by acetyl-CoA and CoA, in human skeletal muscle. AB - The inhibition of carnitine palmitoyltransferase (CPT, EC 2.3.1.21) by malonyl CoA, acetyl-CoA and free CoA was studied in sonicated skeletal-muscle homogenates from normal human subjects and from five patients with a mutant CPT [Zierz & Engel (1985) Eur. J. Biochem. 149, 207-214]. (1) Malonyl-CoA, acetyl-CoA and CoA were competitive inhibitors of CPT with palmitoyl-CoA. (2) Acetyl-CoA and CoA inhibited normal and mutant CPT to the same degree, whereas malonyl-CoA inhibited mutant CPT more than normal CPT. (3) Triton X-100 abolished the inhibition of normal CPT by malonyl-CoA, but not by acetyl-CoA or CoA. Triton X-100 by itself caused loss of activity of the mutant CPT. (4) In the concentration range 0.1-0.4 mM, the inhibitory effects of any two of the three inhibitors were synergistic. (5) The inhibitory constants (Ki) for acetyl-CoA and CoA were close to 45 microM. The Ki for malonyl-CoA was 200-fold lower, or 0.22 microM. Addition of 40 microM acetyl-CoA or CoA resulted in a 3-fold increase in the Ki for acetyl-CoA. Addition of 20 microM-CoA resulted in a 3-fold increase in the Ki for acetyl-CoA. (6) The findings indicate that acetyl-CoA and CoA can inhibit CPT at the catalytic site or a nearby site which is different from that at which malonyl-CoA inhibits CPT. (7) The fact that small changes in the concentration of acetyl-CoA and CoA can antagonize the inhibitory effect of malonyl-CoA suggests that these compounds could modulate the inhibition of CPT by malonyl-CoA. PMID- 3663147 TI - Stimulation of the respiration rate of rat liver mitochondria by sub-micromolar concentrations of extramitochondrial Ca2+. AB - 1. The respiration rate of rat liver mitochondria was stimulated by up to 70% when the extramitochondrial Ca2+ concentration was raised from 103 to 820 nM. This occurred when pyruvate, 2-oxoglutarate, or threo-(Ds)-isocitrate was employed as substrate, but not when succinate was used. 2. Ruthenium Red prevented the stimulation of mitochondrial respiration by extramitochondrial Ca2+, showing that the effect required Ca2+ uptake into the mitochondrial matrix. 3. Starvation of rats for 48 h abolished the stimulation of mitochondrial respiration by extramitochondrial Ca2+ when pyruvate was used as substrate, but did not affect the stimulation of 2-oxoglutarate oxidation by extramitochondrial Ca2+. 4. Our findings are in accord with proposals that oxidative metabolism in liver mitochondria may be stimulated by Ca2+ activation of intramitochondrial dehydrogenases. PMID- 3663148 TI - An isotopic method for measurement of muscle protein synthesis and degradation in vivo. AB - In eight anaesthetized post-absorptive dogs we measured the concentration and specific radioactivity of phenylalanine and leucine in arterial and femoral venous plasma, together with hindlimb flow during a continuous infusion of L [ring-2,6-3H]phenylalanine and [1-14C]leucine. The femoral-venous plasma concentration was greater than arterial for both phenylalanine and leucine (P less than 0.05 for each). Despite net amino acid release there was a significant removal of both labelled phenylalanine and labelled leucine. Consequently, a significant dilution of specific radioactivity was observed between artery and vein for both radio-tracers. The uptake of leucine from the arterial circulation by the hindlimb exceeded by 2.6-fold that of phenylalanine; the measured molar ratio of leucine to phenylalanine in hindlimb muscle protein averaged 2.4 +/- 0.1. Since phenylalanine is neither synthesized nor degraded by muscle tissue, the measured removal of tracer and the dilution of tracer specific radioactivity across the hindlimb can be used to estimate rates of phenylalanine incorporation into, and release from, tissue protein. The estimated rate of protein synthesis by hindlimb averaged 644 +/- 250 nmol of phenylalanine/min. This was exceeded by the rate of tissue protein degradation (987 +/- 285 nmol of phenylalanine/min). The present results demonstrate that the dilution of the specific radioactivity of labelled phenylalanine can be readily measured across dog hindlimb. This measurement, coupled with an estimate of tissue blood flow, can provide a readily measured, non-destructive, method for estimation of protein turnover in specific muscle beds in vivo. Measurements can be made repeatedly over time in a single experiment, allowing the study of factors which regulate protein turnover. The method developed here in dogs can be readily extended to clinical studies. PMID- 3663149 TI - Structural studies on sialylated and sulphated O-glycosidic mannose-linked oligosaccharides in the chondroitin sulphate proteoglycan of brain. AB - We have previously described the structures of neutral and sialylated O glycosidic mannose-linked tetrasaccharides and keratan sulphate polysaccharide chains in the chondroitin sulphate proteoglycan of brain. The present paper provides information on a series of related sialylated and/or sulphated tri- to penta-saccharides released by alkaline-borohydride treatment of the proteoglycan glycopeptides. The oligosaccharides were fractionated by ion-exchange chromatography and gel filtration, and their structural properties were studied by methylation analysis and fast-atom-bombardment mass spectrometry. Five fractions containing [35S]sulphate-labelled oligosaccharides were obtained by ion exchange chromatography, each of which was eluted from Sephadex G-50 as two well separated peaks. The apparent Mr values of both the large- and small-molecular size fractions increased with increasing acidity (and sulphate labelling) of the oligosaccharides. The larger-molecular-size fractions contained short mannose linked keratan sulphate chains of Mr 3000-4500, together with some asparagine linked oligosaccharides. The smaller tri- to penta-saccharides, of Mr 800-1400, appear to have a common GlcNac(beta 1-3)Manol core, and to contain one to two residues of sialic acid and/or sulphate. PMID- 3663150 TI - Dexamethasone modulates the metabolism of type IV collagen and fibronectin in human basement-membrane-forming fibrosarcoma (HT-1080) cells. AB - The effect of dexamethasone on the synthesis and degradation of type IV collagen was studied in human fibrosarcoma cells, HT-1080. A dexamethasone concentration as low as 0.1 microM markedly increased collagen synthesis in HT-1080 cells labelled with [14C]proline. The increase in type IV collagen synthesis was not specific, since total protein synthesis was also increased. Further studies indicated that part of the increase was due to an increase in the specific radioactivity of the intracellular proline pool, after dexamethasone treatment. In fact, with dexamethasone concentrations of 0.1-10 microM the relative collagen synthesis was decreased, indicating that synthesis of other protein was increased more than that of type IV collagen. This was also confirmed by measuring the relative amount of type IV collagen RNA by using recombinant plasmid cDNA specific for the human procollagen pro alpha l (IV) RNA. The results indicated that relative collagen synthesis and the relative amount of type IV collagen messenger RNA was decreased similarly, indicating that dexamethasone affected type IV collagen synthesis at the pre-translational level. The dexamethasone induced effect on total protein and collagen synthesis was maximal after 12-24 h. Dexamethasone induced a marked accumulation of collagen into the cell layer, leading to diminished deposition of soluble collagen into the medium. Since bacterial-collagenase treatment of the cell layer drastically decreased the collagen content of the dexamethasone-treated cells, this indicates that dexamethasone caused an accumulation of collagen into the extracellular matrix of the cell layer. In contrast, the amount of fibronectin was markedly increased in the medium. Dexamethasone decreased the type IV collagen-degrading activity in HT 1080 cells. The HT-1080 cells contained glucocorticoid receptors, as demonstrated by two different methods: by a whole-cell binding assay and by using a cytosol gel-filtration method. The number of specific binding sites was similar to that in human skin fibroblasts. In conclusion, glucocorticoids affect the metabolism of type IV collagen and fibronectin in HT-1080 cells, and, since these cells contain specific glucocorticoid receptors, the effects are apparently receptor mediated. PMID- 3663151 TI - Age-specific nuclear proteins in the nematode worm Caenorhabditis elegans. AB - The nematode worm Caenorhabditis elegans is known to undergo characteristic morphological as well as physiological signs of senescence. Two-dimensional gel electrophoresis shows that alterations also occur in the pattern of the nuclear proteins as a function of age. Non-histone proteins whose level exhibits a steep fall with age are egg-specific and not involved in senescence. However, a distinct set of non-histones accumulates with age and can be considered as senescence markers. Some of these are glycoproteins, as shown by their concanavalin A-binding properties. One age-specific polypeptide, called 'protein S-28', was further characterized by peptide mapping and determination of its N terminal amino acid sequence. PMID- 3663152 TI - Observations on the structure of two human 7SK pseudogenes and on homologous transcripts in vertebrate species. AB - A comparison of the sequence of two human 7SK RNA pseudogenes, covering approx. 190 and 240 base-pairs of the structural gene, is presented. Both repeated elements are flanked by direct repeats and begin at the 5' end of the gene. Each terminates approx. 90 base-pairs short of the 3' end, the latter representing a continuous sequence and the former carrying an internal deletion of about 40 base pairs, this region being flanked in the progenitor gene by short repeated sequences. Southern blotting using a human 7SK pseudogene probe illuminated a series of multiple restriction fragments in mammalian genomes, with generally fewer fragments in the genomes of birds and reptiles and a single reactive fragment in DNA from terrapin (Pseudemys scripta elegans) and Xenopus laevis (South African clawed toad). In the latter case this fragment was only detectable on long exposure under the hybridization stringencies employed. 7SK transcripts were readily detectable in all mammalian, avian, reptilian and amphibian species analysed, although the gene appeared to be expressed at rather low levels in the ovaries of Xenopus laevis, possibly accounting for its failure to have become dispersed via 'retroposition' in this species. PMID- 3663153 TI - The behaviour of leucine aminopeptidase towards thionopeptides. AB - Thionoleucine S-anilide (Leut-anilide), Leut-Gly-OEt and Leut-Phe-OMe were synthesized and shown to be competitive inhibitors of leucine aminopeptidase from pig kidney. The kinetics of inhibition were determined in the presence of leucine 4-methylcoumarin-7-amide as substrate. Although the compounds showed only moderate inhibitory potency, it was found that all were resistant to hydrolysis by the enzyme, in contrast with the reported behaviour of some thionopeptide analogues of substrates for other Zn2+-peptidases such as carboxypeptidase A and angiotensin-converting enzyme. PMID- 3663154 TI - Output of lysosomal contents and cholesterol into bile can be stimulated by taurodehydrocholate. AB - Although biliary secretion of phospholipids and cholesterol is principally dependent on bile-salt secretion, at low bile-salt output secretion of some lipids continues; also the amount of cholesterol secretion is more than that of phospholipid under these conditions, but the origin of this cholesterol is not known. Taurodehydrocholate was continuously infused in isolated perfused rat livers under recycling perfusion conditions and the biliary lysosomal output and lipid output measured. The rate of acid phosphatase and beta-glucuronidase output increased 30-60 and 60-90 min respectively after liver isolation under these conditions. The rate of output of cholesterol and phospholipid increased in all the samples collected from taurodehydrocholate-infused livers. The increase in cholesterol output was approximately twice that of phospholipid output, leading to an increase in the cholesterol/phospholipid ratio in the bile. PMID- 3663155 TI - Hepatic uptake of amino acids at mid-lactation in the rat. AB - Hepatic availability and uptake of amino acids were measured in fed virgin and 15 day-lactating rats. Lactation did not induce any change in total amino acid availability (expressed per 100 g body wt.). Virgin rats showed a nil hepatic balance, and lactation induced a high net uptake. The high drainage of amino acids by mammary gland does not affect hepatic availability. PMID- 3663156 TI - Toxic effects of ozone on murine L929 fibroblasts. Damaging action on transmembrane transport systems. AB - Exposure of murine L929 fibroblasts to ozone caused inactivation of the energy coupled transport systems for 2-aminoisobutyric acid and Rb+. Ozone induced an increase of the apparent Km for 2-aminoisobutyric acid transport, with a constant Vmax, indicating impairment of the carrier function, rather than a decrease in the number of transport sites. The uptake rate of 2-deoxy-D-glucose, on the other hand, increased after exposure of the cells to ozone. This was caused by an increased Vmax. of facilitated diffusion, without increased after ozone exposure. Together with the K+ leakage described previously, this reflects ozone-induced impairment of the barrier function of the membrane. PMID- 3663157 TI - Effect of adriamycin on heart mitochondrial DNA. AB - The effect of Adriamycin on rat heart mitochondrial DNA was determined by initially labelling the DNA with [Me-14C]thymidine. Animals subsequently received intravenously either Adriamycin (10 mg/kg) or saline (1 ml/kg) (control group). Animals later received [Me-3H]thymidine and were killed at 6, 14, 24 and 36 h after this. The heart mitochondrial DNA was separated into the linear, non supercoiled and supercoiled forms by ultracentrifugation on formamide/sucrose sedimentation gradients, and the amount of 14C and 3H incorporated into the various forms of the DNA was determined by scintillation counting. The data suggest that Adriamycin may cause breakage of the mitochondrial DNA helix, and that it slows the rate of mitochondrial DNA synthesis and the formation of complete DNA molecules. These experiments show that Adriamycin does interact with heart mitochondrial DNA, and may explain the cardiac dysfunction association with Adriamycin use. PMID- 3663158 TI - Analytical methods for fitting integrated rate equations. A discontinuous assay. AB - The integrated rate equation for reactions with stoichiometry A----P + Q is: e0t = -Cf . ln(1-delta P/A0) + C1 delta P + 1/2C2(delta P)2 where the coefficients C are linear or quadratic functions of the kinetic constants and the initial substrate and product concentrations. I have used the 21 progress curves described in the accompanying paper [Cox & Boeker (1987) Biochem. J. 245, 59-65] to develop computer-based analytical and statistical techniques for extracting kinetic constants by fitting this equation. The coefficients C were calculated by an unweighted non-linear regression: first approximations were obtained from a multiple regression of t on delta P and were refined by the Gauss-Newton method. The procedure converged in six iterations or less. The bias in the coefficients C was estimated by four methods and did not appear to be significant. The residuals in the progress curves appear to be normally distributed and do not correlate with the amount of product produced. Variances for Cf, C1 and C2 were estimated by four resampling procedures, which gave essentially identical results, and by matrix inversion, which came close to the others. The reliability of C2 can also be estimated by using an analysis-of-variance method that does not require resampling. The final kinetic constants were calculated by standard multiple regression, weighting each coefficient according to its variance. The weighted residuals from this procedure were normally distributed. PMID- 3663159 TI - Isolation from human chronic-lymphocytic-leukaemia cells of membrane glycoproteins associated with Fc-receptor functions. Physical parameters and production of polyclonal antibodies. AB - Two membrane glycoproteins that bound immune complexes and inhibited Fc-receptor- (FcR-)mediated functions in vitro were purified from human FcR+ chronic lymphocytic-leukaemia cells. A multi-step purification was developed, consisting essentially in: (i) Tween 40 extraction of crude cell membranes; (ii) solubilization of membrane fragments by Renex-30; (iii) isolation of glycoproteins by affinity chromatography on Lens culinaris haemagglutinin Sepharose; (iv) papain treatment of the eluted glycoproteins followed by gel filtration chromatography; (v) purification by polyacrylamide-gel electrophoresis of two molecular species from the protein-size fraction enriched for immune complex-binding activity. The two electrophoretically isolated components displayed apparent molecular masses of 70 and 45 kDa by SDS/polyacrylamide-gel electrophoresis and restricted charge heterogeneity by two-dimensional analysis. Two-dimensional peptide mapping revealed the presence of many peptides in common between the two proteins and the absence of a number of peptides in the 45 kDa component. These two polypeptides were used as immunogens to produce polyclonal antibodies that cross-reacted with both proteins and specifically inhibited FcR mediated reactions in vitro. Furthermore, FcR-related components from detergent extracted lysates of the human K562 and U937 cell lines or human placental membranes were revealed by the putative anti-FcR antibodies adsorbed on Protein A Sepharose. PMID- 3663160 TI - Properties of highly viscous gels formed by neurofilaments in vitro. A possible consequence of a specific inter-filament cross-bridging. AB - Neurofilaments freshly isolated from bovine spinal cord form a reversible gel in vitro, consisting of nearly parallel and interlinked filaments organized in bundles. This phenomenon is obtained above a critical neurofilament concentration and is highly sensitive to denaturation. No gelation occurs with neurofilaments reconstituted from urea-solubilized subunits. The velocity of the gelation kinetics, optimum at a slightly acidic pH, is inhibited by low and high ionic strength and activated by millimolar concentrations of Mg2+ and other bivalent cations. No protein other than the purified neurofilament preparation itself (80 95% neurofilament triplet) is necessary for the formation of a gel. However, purified cytoskeletal proteins from microtubules and neurofilaments influence the viscosity of the native preparation. These observations suggest a reticulation in vitro between neurofilaments, dependent upon a fragile conformation of the polymers and possibly mediated through the high-Mr neurofilament subunits (200 kDa and 150 kDa). The significance of these results is discussed with regard to the inter-neurofilament cross-bridging in situ involving the 200 kDa subunit described by Hirokawa, Glicksman & Willard [(1984) J. Cell Biol. 98, 1523-1536]. PMID- 3663161 TI - Metal constitution of metallothionein influences inhibition of delta aminolaevulinic acid dehydratase (porphobilinogen synthase) by lead. AB - This study was undertaken to evaluate the effect of Zn and Cd pretreatment on the inhibition of delta-aminolaevulinic acid dehydratase (ALAD; porphobilinogen synthase, EC 4.2.1.24) by Pb. Male CD rats were pretreated with 200 mumol of Zn/kg s.c. (subcutaneously) or 18 mumol of Cd/kg s.c., 48 and 24 h before assay of ALAD. Pretreatment with Zn resulted in activation of hepatic and renal ALAD and attenuated the inhibition of this enzyme by Pb in vitro. Pretreatment with Cd increased hepatic ALAD activity, and the inhibitory effect of Pb on the hepatic enzyme was attenuated in this group. In contrast with the situation in liver, pretreatment with Cd did not affect the activity of renal ALAD and did not alter the inhibitory effect of Pb on the renal enzyme. The Pb IC50 (concentration causing half-maximal inhibition) values for hepatic and renal ALAD in Zn pretreated rats and for hepatic ALAD in Cd-pretreated rats were increased above control, whereas the IC50 for renal ALAD in Cd-pretreated rats was unchanged. Cytosolic binding patterns for the three metals were assessed by gel-filtration chromatography and disclosed that 203Pb was co-eluted with Zn and Cd bound to liver and kidney Zn-thioneins and liver Cd,Zn-thionein, although minimal binding of 203Pb to kidney Cd,Zn-thionein was observed. Estimation of the molar ratio of metals bound revealed Cd/Zn ratios of 2 and 5 for Cd,Zn-thioneins from liver and kidney respectively. The inhibition of purified ALAD by Pb was also attenuated by addition of purified Zn-thioneins and Cd,Zn-thioneins from liver and kidney in the following order: liver Zn-thionein = kidney Zn-thionein greater than liver Cd,Zn-thionein much greater than kidney Cd,Zn-thionein. Thus liver and kidney Zn thioneins and liver Cd,Zn-thionein with a low Cd/Zn ratio readily decrease the free pool of Pb available to interact with ALAD. These data also demonstrate that the capacity of metallothionein to alter the intracellular distribution of Pb and mediate the inhibition of ALAD by Pb is dependent on the tissue source and relative metal constitution of the metallothionein. PMID- 3663162 TI - Effect of adenosine and inosine on ureagenesis in hepatocytes. AB - Adenosine and inosine produced a dose-dependent stimulation of ureagenesis in isolated rat hepatocytes. Hypoxanthine, xanthine and uric acid were without effect. Half-maximally effective concentrations were 0.08 microM for adenosine and 5 microM for inosine. Activation of ureagenesis by both nucleosides had the following characteristics: (a) it was observed with either glutamine or (NH4)2CO3, provided that glucose was present; (b) it was not detected when glucose was replaced by lactate plus oleate; (c) it was mutually antagonized by glucagon, but not by adrenaline; and (d) it was dependent on Ca2+. We suggest that the action of adenosine and inosine on ureagenesis might be of physiological significance. PMID- 3663163 TI - Enzyme-substrate interactions in the hydrolysis of peptides by cathepsins B and H from rat liver. AB - The number of possible subsites of the rat liver cysteine proteinases cathepsin B and cathepsin H was determined in the N-terminal direction from the scissile bond. An elongation of the substrate peptide chain of up to four amino acid residues enhances the hydrolysis rate of both cathepsins. The greatest increase in activity was observed by elongation to the dipeptide substrate for cathepsin B and to the tetrapeptide substrate for cathepsin H. Both proteinases discriminate proline from their subsites S1 and S2, but accept it well in S3. A quantitative distinction between the endopeptidase and the peptidyl dipeptidase activity of cathepsin B was feasible by using two model peptides: (Formula: see text) (Z = benzyloxycarbonyl; X = NH2 or OH; the arrow shows the cleavage site). Whereas the peptide acid, representing the peptidyl dipeptidase substrate, was hydrolysed by cathepsin B twice as fast as the peptide amide as an endopeptidase substrate, cathepsin H clearly had a preference for the amide substrate. PMID- 3663164 TI - Prevention of peroxisomal proliferation by carnitine palmitoyltransferase inhibitors in cultured rat hepatocytes and in vivo. AB - 1. The induction of peroxisomal beta-oxidation activities by bezafibrate in cultured rat hepatocytes and in the rat in vivo was prevented by inhibitors of carnitine acyltransferase, e.g. 2-bromopalmitate, 2-[5-(4 chlorophenyl)pentyl]oxirane-2-carboxylate or 2-tetradecylglycidic acid. 2. The prevention of peroxisomal proliferation by carnitine palmitoyltransferase inhibitors could not be accounted for by inhibition of mitochondrial beta oxidation, since 2-bromo-octanoate, acting as an inhibitor of beta-oxidation, did not prevent the induction of peroxisomal activities in cultured rat hepatocytes. 3. The putative role of the acylcarnitine derivative of bezafibrate was analysed by studying the formation of bezafibroylcarnitine with bezafibroyl-CoA as substrate. However, no bezafibroylcarnitine formation was demonstrated in the presence of rat liver preparations capable of catalysing transfer to carnitine of medium- or long-chain fatty acids. 4. The prevention of peroxisomal proliferation by carnitine acyltransferase inhibitors may help in dissecting the causal relationship between the multiple effects mediated by peroxisomal proliferators. PMID- 3663165 TI - Peptide analysis of collagen produced from cDNA by transcription and translation in vitro. AB - When collagen CNBr-cleavage peptides are analysed by two-dimensional gel electrophoresis each peptide is resolved into a reproducible set of charged forms. To test whether this peptide heterogeneity resulted from polymorphic mRNA, collagen was produced by transcription and translation in vitro of a collagen cDNA clone, and the peptides were mapped by two-dimensional gel electrophoresis. A cDNA construct was produced by ligation of the 5' end of the rat phenylalanine hydroxylase cDNA [Dahl & Mercer (1986) J. Biol. Chem. 261, 4148-4153], containing the translation-initiation codon, to a human alpha 1(I) cDNA [Chu, Myers, Bernard, Ding & Ramirez (1982) Nucleic Acids Res. 10, 5925-5934] coding for a large portion of helical region including the complete CB7 and CB3 CNBr-cleavage peptides. This cDNA construct was ligated into the transcription vector pSP65, and cell-free translation of the mRNA transcribed from the pSP65 plasmid was performed with a rabbit reticulocyte lysate system. After CNBr cleavage of the hybrid protein translation products, the collagen CB7 and CB3 peptides were resolved by two-dimensional electrophoresis into the same multiple charged forms whether the mRNA was produced from the cDNA construct or was extracted from normal fibroblast cultures. This result demonstrated that the multiple peptide spots were not due to polymorphic mRNA species. The heterogeneity must result from some uncharacterized specific post-translational modification or chemical alterations during sample preparation. This method of expression and analysis of proteins from cDNA clones should be of considerable use in the identification and characterization of clones that code for mutant proteins. PMID- 3663166 TI - Sex-specific constitutive expression of the pre-neoplastic marker glutathione S transferase, YfYf, in mouse liver. AB - Hepatic glutathione S-transferase isoenzyme content has been investigated in both sexes of three inbred strains of mice (DBA/2, C3H/He, C57BL6). A polypeptide (Mr 24,800), which is immunologically related to Yf purified from rat lung, was found to be expressed as a major form in all male mouse livers but represented only a minor enzyme form in female mouse liver. Glutathione S-transferases comprising subunits with molecular masses of 25,800 (Ya) or 26,400 (Yb) were present in males and females of the three strains under investigation. Cytosolic isoenzymes from all strains and sexes were purified to apparent homogeneity and no significant inter-strain differences in the properties of the individual forms were observed. In addition, no differences were detected in the microsomal glutathione S-transferase content of the different strains or sexes. PMID- 3663167 TI - Interactions of nicotinamide-adenine dinucleotide phosphate analogues and fragments with pigeon liver malic enzyme. Synergistic effect between the nicotinamide and adenine moieties. AB - The structural requirements of the NADP+ molecule as a coenzyme in the oxidative decarboxylation reaction catalysed by pigeon liver malic enzyme were studied by kinetic and fluorimetric analyses with various NADP+ analogues and fragments. The substrate L-malate had little effect on the nucleotide binding. Etheno-NADP+, 3 acetylpyridine-adenine dinucleotide phosphate, and nicotinamide-hypoxanthine dinucleotide phosphate act as alternative coenzymes for the enzyme. Their kinetic parameters were similar to that of NADP+. Thionicotinamide-adenine dinucleotide phosphate, 3-aminopyridine-adenine dinucleotide phosphate, 5'-adenylyl imidodiphosphate, nicotinamide-adenine dinucleotide 3'-phosphate and NAD+ act as inhibitors for the enzyme. The first two were competitive with respect to NADP+ and non-competitive with respect to L-malate; the other inhibitors were non competitive with NADP+. All NADP+ fragments were inhibitory to the enzyme, with a wide range of affinity, depending on the presence or absence of a 2'-phosphate group. Compounds with this group bind to the enzyme 2-3 orders of magnitude more tightly than those without this group. Only compounds with this group were competitive inhibitors with respect to NADP+. We conclude that the 2'-phosphate group is crucial for the nucleotide binding of this enzyme, whereas the carboxyamide carbonyl group of the nicotinamide moiety is important for the coenzyme activity. There is a strong synergistic effect between the binding of the nicotinamide and adenosine moieties of the nucleotide molecule. PMID- 3663168 TI - The separation of glutathione transferase subunits by using reverse-phase high pressure liquid chromatography. AB - A simple method is described for the separation and quantification of the subunits of GSH transferases present in rat tissue extracts. This method, involving GSH-agarose affinity chromatography followed by reverse-phase h.p.l.c., is rapid and sufficiently sensitive to measure 5 micrograms of each subunit in a mixture. Examples are given of its application to extracts of rat kidney, adrenal, testicular interstitial cells and seminiferous tubules. The analysis of seminiferous tubules indicates that the technique may be of value for the identification of novel subunits. Preliminary separations of subunits from human GSH transferases are also described. PMID- 3663169 TI - Purification and characterization of a connective-tissue-degrading metalloproteinase from the cytosol of metastatic melanoma cells. AB - A metalloproteinase with activity against type IV collagen, type I collagen and gelatin has been purified from the cytosol of a highly metastatic mouse melanoma by anion-exchange, zinc-chelated and lectin-affinity column chromatography. The purified enzyme has a molecular mass of approx. 59 kDa and on isoelectric focusing in two-dimensional gels produced three spots with apparent isoelectric points (pI) between 5.7 and 6.1. Enzymic activity with collagen, but not gelatin, substrates was latent, requiring activation by trypsin or organomercurials. Trypsin activation of this metalloproteinase was accompanied by a change in molecular mass, whereas autoactivation after 1 month's storage, was not. The degradation of types I and IV collagen by the melanoma enzyme yielded products of lower molecular masses than those yielded by mammalian collagenases, this characteristic thus differentiating this metalloproteinase from classical collagenases. PMID- 3663170 TI - Siderosomal ferritin. The missing link between ferritin and haemosiderin? AB - A minor electrophoretically fast component was found in ferritin from iron-loaded rat liver in addition to a major electrophoretically slow ferritin similar to that observed in control rats. The electrophoretically fast ferritin showed immunological identity with the slow component, but on electrophoresis in SDS it gave a peptide of 17.3 kDa, in contrast with the electrophoretically slow ferritin, which gave a major band corresponding to the L-subunit (20.7 kDa). Thus the electrophoretically fast ferritin resembles that reported by Massover [(1985) Biochim. Biophys. Acta 829, 377-386] in livers of mice with short-term parenteral iron overload. The electrophoretically fast ferritin had a lower iron content (2000 Fe atoms/molecule) than the electrophoretically slow ferritin (3000 Fe atoms/molecule). Removal and re-incorporation of iron was possible without effect on the electrophoretic mobility of either ferritin species. On subcellular fractionation the electrophoretically fast ferritin was enriched in pellet fractions and was the sole soluble ferritin isolated from iron-laden secondary lysosomes (siderosomes). The amount and relative proportion of the electrophoretically fast species increased with iron loading. Haemosiderin isolated from siderosomes was found to contain a peptide reactive to anti ferritin serum and corresponding to the 17.3 kDa peptide of the electrophoretically fast ferritin species. Unlike the electrophoretically slow ferritin, the electrophoretically fast ferritin did not become significantly radioactive in a 1 h biosynthetic labelling experiment. We conclude that the minor ferritin is not, as has been suggested for mouse liver ferritin, 'a completely new species of smaller holoferritin that represents a shift in the ferritin phenotype' in response to siderosis, but a precursor of haemosiderin, in agreement with the proposal by Richter [(1984) Lab. Invest. 50, 26-35] concerning siderosomal ferritin. PMID- 3663171 TI - A new form of ferritin heterogeneity explained. Isolation and identification of a nineteen-amino-acid-residue fragment from siderosomal ferritin of rat liver. AB - Ferritin present within siderosomes of iron-loaded rats has a faster anodal mobility than that of cytosolic ferritin from the same rats. A 19-amino-acid residue peptide was isolated from this fast ferritin and shown to be derived from the C-terminal end of its L-subunit. A 17.3 kDa peptide seen on electrophoresis in denaturing gels of this ferritin accounts for the major portion of the original 182-residue subunit. The two peptides arise from cleavage within the 'insertion region' of the L-subunit sequence that occurs between the D and E helices and lies on the outside of the assembled molecule. This cleavage is present in about 80% of the L-subunits of siderosomal ferritin but nevertheless leaves the molecular structure otherwise intact. It gives rise to an apparent decrease in molecular size, accounting for the faster anodal mobility on native gels. Hence a new form of heterogeneity in ferritin preparations has been explained. PMID- 3663173 TI - Analysis of the molecular size of tomato (Lycopersicon esculentum Mill) fruit polyuronides by gel filtration and low-speed sedimentation equilibrium. AB - The cell-wall structures of tomato (Lycopersicon esculentum Mill) and other fruit are intimately linked with the nature of their polyuronides. Cell-wall polyuronides from unripe and ripe tomato fruit were isolated and purified and their molecular size and molecular-size distributions were compared. It was demonstrated that there is a considerable decrease in the weight-average Mr upon ripening (from 160,000 +/- 10,000 to 96,000 +/- 4000) and a corresponding increase in polydispersity, particularly at the low-Mr end of the distribution. The estimates of polyuronide molecular size and molecular-size distribution were obtained without the need for polyuronide standards of known Mr by using gel filtration chromatography combined with the absolute method of low-speed sedimentation equilibrium. PMID- 3663172 TI - Surface areas of 1-palmitoyl phosphatidylcholines and their interactions with cholesterol. AB - 1-Palmitoyl phosphatidylcholines (1-palmitoyl PCs), in which the 2-position was occupied respectively by C10:0, C12:0, C14:0, C14:1, n-7, C16:0, C16:1, n-7, C18:0, C18:1(t), n-9, C18:1, n-9, C18:2, n-6, C18:3, N-3, C18:3, n-6, C18:3(5t,9,12), C22:0, C22:1, n-9, C22:2, n-6, C22:3, n-3, C22:4, n-6, C22:5, n-6 or C22:6, n-3 fatty acids, were studied as monolayer films at the air/water interface. Results for molecular area indicated that the areas of the PC (phosphatidylcholine) did not continuously decrease as the length of one chain increased. For series of saturated, monoenoic and dienoic 1-palmitoyl PCs the smallest molecular area was occupied by the PC containing a 20-carbon acid at the 2-position. In the 18-carbon series, introduction of the first and third cis double bonds caused a large increase in molecular area, but in the 22-carbon series the first and second cis double bonds produced large increases in molecular area. Molecules containing three or more cis double bonds varied little in molecular area, regardless of chain length (18-22 carbon atoms). The influence of a trans double bond was intermediate between that of a saturated and a cis double bond. The 18- and 22-carbon series of PCs were studied in mixed monolayers with cholesterol and desmosterol. Condensation of molecular areas occurred in all sterol PC mixed films, and similar results were obtained with cholesterol and desmosterol. Condensation of PC containing a cis or trans double bond within 10 carbon atoms of the carboxy group initially increased with increasing surface pressure. Condensation of other PCs decreased as surface pressure increased. All cis- or trans-unsaturated PCs condensed maximally in mixtures of approximately equimolar ratios with sterols, but saturated PCs condensed to the greatest extent in mixtures that contained about 30 mol% sterol. PMID- 3663174 TI - Induction of functional uncoupling protein in guinea pigs infused with noradrenaline. Studies with isolated brown adipocytes. AB - Continuous infusion of noradrenaline over the interscapular brown fat of guinea pigs maintained at thermoneutrality (28-32 degrees C) induces changes similar to those after cold-adaptation. (1) Multilocular fat droplets appear within the brown adipocytes. (2) The number of mitochondria per adipocyte and the total number of adipocytes both increase. (3) Noradrenaline addition to isolated adipocytes causes near maximal uncontrolled respiration. (4) The cells become more sensitive to fatty acid-induced uncoupling. (5) The tissue-specific uncoupling protein per mg of mitochondrial protein is increased 5-fold. Specific alpha- and beta-agonists were also chronically infused. (6) Separate infusion of phenylephrine or isoprenaline was not able to stimulate mitochondriogenesis or hyperplasia. (7) Adipocytes from these animals could not be uncoupled by acute noradrenaline. (8) Simultaneous chronic infusion of phenylephrine and isoprenaline reproduced the effects of chronic noradrenaline infusion. PMID- 3663175 TI - Cyst(e)ine residues of bovine white-matter proteolipid proteins. Role of disulphides in proteolipid conformation. AB - Cyst(e)ine residues of bovine white-matter proteolipid proteins were characterized in a highly purified preparation. From a total of 10.6 cyst(e)ine residues/molecule of protein, as determined by performic acid oxidation, 2.5-3 thiol groups were freely accessible to iodoacetamide, iodoacetic acid and 5,5' dithiobis-(2-nitrobenzoic acid) (DTNB), when the proteins were solubilized in chloroform/methanol (C/M) (2:1, v/v). The presence of lipids had no effect on thiol-group exposure. One thiol group available to DTNB in C/M could not be detected when proteolipids were solubilized in the more polar solvent n-butanol. In a C/M solution of purified proteolipid proteins, SDS did not increase the number of reactive thiol groups, but the cleavage of one disulphide bridge made it possible to alkylate six more groups. C.d. and fluorescence studies showed that rupture of this disulphide bond changed the protein conformation, which was reflected in partial loss of helical structure and in a greater exposure to the solvent of at least one tryptophan residue. Cyst(e)ine residues were also characterized in the different components [PLP (principal proteolipid protein), DM20 and LMW (low-Mr proteins)] of the proteolipid preparation. Although the numbers of cyst(e)ine residues in PLP and DM20 were similar, in LMW fewer residues were alkylated under four different experimental conditions. The differences, however, are not simply related to differences in Mr. PMID- 3663176 TI - Biliary lipid secretion and its control. Effect of taurodehydrocholate. AB - Multiple short pulses of taurocholate (TC) brought about, in isolated perfused rat livers, the secretion of phospholipid and cholesterol into bile; the lipids showed an appreciable lag period behind the bile-salt secretion, and there was considerable variability in response, both between low and high dose pulses of TC and, at the higher dose, even between individual livers. When a background continuous infusion of taurodehydrocholate (a hydrophilic non-micelle-forming bile-salt analogue) was superimposed upon the short TC pulses, the lipid secretion showed much better control, and the lipid peaks were of more uniform size, following more closely, or more coincident with, the bile-salt output peaks. Taurodehydrocholate may provide a signal for the control of the supply and delivery of lipid vesicles to the bile-canalicular membrane, from where the lipid vesicles are then removed by the action of the pulses of TC. PMID- 3663177 TI - Redox state and lactate accumulation in human skeletal muscle during dynamic exercise. AB - The relationship between the redox state and lactate accumulation in contracting human skeletal muscle was investigated. Ten men performed bicycle exercise for 10 min at 40 and 75% of maximal oxygen uptake [VO2(max.)], and to fatigue (4.8 +/- 0.6 min; mean +/- S.E.M.) at 100% VO2(max.). Biopsies from the quadriceps femoris muscle were analysed for NADH, high-energy phosphates and glycolytic intermediates. Muscle NADH was 0.20 +/- 0.02 mmol/kg dry wt. of muscle at rest, and decreased to 0.12 +/- 0.01 (P less than 0.01) after exercise at 40% VO2(max.), but no change occurred in the [lactate]/[pyruvate] ratio. These data, together with previous results on isolated cyanide-poisoned soleus muscle, where NADH increased while [lactate]/[pyruvate] ratio was unchanged [Sahlin & Katz (1986) Biochem. J. 239, 245-248], suggest that the observed changes in muscle NADH occurred within the mitochondria. After exercise at 75 and 100% VO2(max.), muscle NADH increased above the value at rest to 0.27 +/- 0.03 (P less than 0.05) and 0.32 +/- 0.04 (P less than 0.001) mmol/kg respectively. Muscle lactate was unchanged after exercise at 40% VO2(max.), but increased substantially at the higher work loads. At 40% VO2(max.), phosphocreatine decreased by 11% compared with the values at rest, and decreased further at the higher work loads. The decrease in phosphocreatine reflects increased ADP and Pi. It is concluded that muscle NADH decreases during low-intensity exercise, but increases above the value at rest during high-intensity exercise. The increase in muscle NADH is consistent with the hypothesis that the accelerated lactate production during submaximal exercise is due to a limited availability of O2 in the contracting muscle. It is suggested that the increases in NADH, ADP and Pi are metabolic adaptations, which primarily serve to activate the aerobic ATP production, and that the increased anaerobic energy production (phosphocreatine breakdown and lactate formation) is a consequence of these changes. PMID- 3663178 TI - Antibody-affinity purification of novel alpha-L-fucosidase from mouse liver. AB - Previous studies have documented the presence of a novel alpha-L-fucosidase in mouse liver that contains unique basic isoelectric forms and that is antigenically similar to, but not identical with, human liver alpha-L-fucosidase [Laury-Kleintop, Damjanov & Alhadeff (1985) Biochem. J. 230, 75-82]. In the present investigation, mouse liver alpha-L-fucosidase was purified approx. 26,500 fold in 10% overall yield by antibody-affinity chromatography with the IgG fraction of goat anti-(human alpha-L-fucosidase) antibody coupled to Sepharose 4B. Native polyacrylamide-gel electrophoresis and SDS/polyacrylamide-gel electrophoresis indicated that the mouse fucosidase is highly purified if not homogeneous. Isoelectric focusing demonstrated that all enzymic forms found in crude mouse liver supernatant fluids were purified by the antibody-affinity procedure. PMID- 3663179 TI - The influence of temperature and membrane-fluidity changes on the olfactory adenylate cyclase of the rat. AB - At physiological temperatures, the activity of the olfactory adenylate cyclase of the rat is fairly insensitive to small changes in temperature. Membrane fluidization by benzyl alcohol also produces rather small modulations of cyclase activity, although this chemical also has a more specific effect on the enzyme. Insensitivity to temperature and membrane-fluidity changes are desirable properties for a transduction system which must function in an exposed environment. PMID- 3663180 TI - Peptide sequencing by magnetic deflection tandem mass spectrometry. PMID- 3663181 TI - Peptide sequencing by fast atom bombardment mass spectrometry: acid hydrolysis or tandem mass spectrometry? PMID- 3663182 TI - Kinetics of hexokinase D ('glucokinase') with inosine triphosphate as phosphate donor. Loss of kinetic co-operativity with respect to glucose. AB - When ATP, the normal phosphate donor for hexokinase D ('glucokinase'), is replaced by ITP, the positive co-operativity with respect to glucose disappears. This may be rationalized in relation to kinetic models for hexokinase D co operativity, which assume that with the normal substrates the chemical reaction and subsequent release of products occur so rapidly that binding of substrates cannot approach equilibrium and is therefore not constrained by the thermodynamic requirement that the Hill coefficient for substrate binding cannot exceed the number of binding sites. ITP is a much poorer substrate than ATP, however: its Km value at high glucose concentrations is 24 times the value for ATP, whereas the value of the limiting rate V is decreased about 8-fold. Consequently it is no longer possible for the ternary complex to be converted into products rapidly enough to generate kinetic co-operativity. The negative co-operativity with respect to glucose observed in 2H2O with ATP as phosphate donor also disappears when ITP is used instead of ATP. PMID- 3663183 TI - A rapid separation method for inositol phosphates and their isomers. AB - A technique is described using ACCELL QMA anion-exchange SEP-PAKs (Waters Associates) with ammonium formate-based solutions, whereby a sample can be processed within minutes to yield resolution of inositol phosphates. Isomers of inositol trisphosphate can then be separated by using this technique in combination with a rapid (5-6 min) isocratic h.p.l.c. procedure. The use of QMA SEP-PAKs offers a degree of reproducibility comparable with that of h.p.l.c. while maintaining the capacity for automation, allowing large numbers of samples to be processed rapidly. PMID- 3663184 TI - Stimulation by glucose of gluconeogenesis in hepatocytes isolated from starved rats. AB - Control properties of the gluconeogenic pathway in hepatocytes isolated from starved rats were studied in the presence of glucose. The following observations were made. (1) Glucose stimulated the rate of glucose production from 20 mM glycerol, from a mixture of 20 mM-lactate and 2 mM-pyruvate, or from pyruvate alone; no stimulation was observed with 20 mM-alanine or 20 mM-dihydroxyacetone. Maximal stimulation was obtained between 2 and 5 mM-glucose, depending on the conditions. At concentrations above 6 mM, gluconeogenesis declined again, so that at 10 mM-glucose the glucose production rate became equal to that in its absence. (2) With glycerol, stimulation of gluconeogenesis by glucose was accompanied by oxidation of cytosolic NADH and reduction of mitochondrial NAD+ and was insensitive to the transaminase inhibitor amino-oxyacetate; this indicated that glucose accelerated the rate of transport of cytosolic reducing equivalents to the mitochondria via the glycerol 1-phosphate shuttle. (3) With lactate plus pyruvate (10:1) as substrates, stimulation of gluconeogenesis by glucose was almost additive to that obtained with glucagon. From an analysis of the effect of glucose on the curves relating gluconeogenic flux and the steady-state intracellular concentrations of gluconeogenic intermediates under various conditions, in the absence and presence of glucagon, it was concluded that addition of glucose stimulated both phosphoenolpyruvate carboxykinase and pyruvate carboxylase activity. PMID- 3663185 TI - The photorespiratory hydrogen shuttle. Synthesis of phthalonic acid and its use in the characterization of the malate/aspartate shuttle in pea (Pisum sativum) leaf mitochondria. AB - A method is presented for the preparation of pure phthalonic acid (PTA) in high yields. This PTA was used to determine the capacity of the malate/aspartate shuttle in pea (Pisum sativum) leaf mitochondria. The inhibition of glycine dependent O2 uptake in the combined presence of 5 mM-aspartate and 5 mM-2 oxoglutarate (2-OG) was decreased by 55 +/- 22% (n = 13) in washed and 50 +/- 2% (n = 11) in purified mitochondria by 0.23 mM-PTA. This concentration of PTA had no effect on the oxidation of 5 mM-2-OG, suggesting that part of the observed inhibition of O2 uptake in the presence of aspartate and 2-OG was due to the production of oxaloacetate (OAA) by aspartate aminotransferase external to the mitochondrial inner membrane. Levels of external aspartate aminotransferase were estimated to be 24 +/- 1% (n = 4) and 13 +/- 1% (n = 4) of the total mitochondrial activity in washed and purified mitochondria respectively. Malate/aspartate-shuttle activity was estimated directly by measuring rates of malate efflux from isolated mitochondria and was found to match estimates of shuttle activity based on the PTA-insensitive inhibition of O2 uptake. Comparisons of malate/aspartate- and malate/OAA-shuttle activities indicated potentially similar rates of NADH export from pea leaf mitochondria under conditions in vivo. These extrapolated to whole-tissue rates of 5-11 mumol of NADH.h-1.mg of chlorophyll-1. The potential role of the malate/aspartate shuttle in the support of photorespiratory glycine oxidation in leaf tissue is discussed. PMID- 3663186 TI - Rat lung lectin synthesis, degradation and activation. Developmental regulation and modulation by dexamethasone. AB - Soluble lectins are widely distributed cell-agglutinating proteins. Their activity is developmentally regulated in several tissues, including the lung, but virtually nothing is known about the mechanisms of the developmental regulation or the turnover of these proteins. We studied mechanisms that might be responsible for the developmentally regulated changes in the activity of a lectin (beta-galactoside-binding protein) found in the lung, and determined if its activity or turnover could be modulated by treatment of rat pups with a glucocorticosteroid hormone (dexamethasone). Our studies on the activity and turnover of the lectin indicated that the peak of lectin activity (units/mg of protein) that occurred at age 12 days appeared to be brought about by two means: an increase in the activity of the lectin molecule itself (units/micrograms of lectin) that occurred at age 8 days, and 1.5-fold increase in the absolute rate of lectin synthesis at age 11 days. The decline in lectin activity was associated with a decrease in its rate of synthesis, return to the baseline extent of activation, and an increased rate of degradation. Treatment of rat pups with dexamethasone diminished the peak of lectin activity (units/mg of protein) by about 25%. This effect of dexamethasone was due, at least in part, to the complete prevention of activation of the lectin molecule (units/micrograms of lectin) and a premature increase in the rate of lectin degradation. Perhaps the normal fall in lectin activity after age 11 days is caused by mechanisms induced by the increase in serum corticosteroid that occurs at that age. PMID- 3663187 TI - Isolation and characterization of a mannose-specific endocytosis receptor from rabbit alveolar macrophages. AB - Rabbit alveolar macrophages express a plasma-membrane receptor that recognizes glycoprotein ligands bearing terminal mannose, fucose or N-acetylglucosamine residues. Macrophage membranes were washed extensively with buffers containing high salt and mannose or EDTA to remove endogenously bound ligand, before Triton X-100 extraction. The extracts were chromatographed on mannose-Sepharose. Elution with mannose, followed by dialysis and a second mannose-Sepharose step with EDTA elution, produced a preparation that migrated as single protein band of Mr 175,000 on SDS/polyacrylamide-gel electrophoresis. The purified protein binds mannose-BSA (bovine serum albumin) with a dissociation constant of 1.9 X 10(-8) M. Ligand binding is Ca2+ and pH-dependent, with maximal binding at neutral pH and low binding below pH 6.0. The binding of 125I-mannose-BSA is inhibited by ligands bearing high-mannose oligosaccharides, such as mannan or beta glucuronidase, as well as the monosaccharides mannose, fucose and N acetylglucosamine. Galactose, galactosylated BSA, glucose and mannose 6-phosphate are non-inhibitory. Amino acid compositional analyses indicate that the receptor contains high concentrations of aspartate/asparagine and glutamate/glutamine, and low amounts of methionine. The carbohydrate composition was studied by lectin overlays of electrophoretically transferred receptor, and the results indicate the presence of N-linked complex and O-linked sialylated oligosaccharides. A protein of Mr 175,000 was immunoprecipitated from radio-iodinated macrophage membranes with an antibody generated against purified rabbit lung mannose receptor. PMID- 3663188 TI - Characterization of Ca2+ uptake and release by vesicles of skeletal-muscle sarcoplasmic reticulum. AB - Homogenization of muscle gives a preparation of sealed vesicles derived from the sarcoplasmic reticulum. In the presence of ATP these vesicles will initially accumulate Ca2+ from the external medium and then spontaneously release this Ca2+ in two phases, an initial slow phase and a faster second phase. By measuring ATP concentrations in parallel with measurements of external Ca2+ concentrations we have shown that the second phase of release occurs when the added ATP has been exhausted, but that the first phase of release occurs in the presence of ATP. A similar pattern of uptake and release has been observed in the presence of acetyl phosphate, showing that ADP generated by ATP hydrolysis is not essential for the release process. The temperature-dependence of both phases of release is similar to the temperature-dependence of ATPase activity. Release is dependent on pH over the same pH range as affects binding of Ca2+ to the ATPase. Therefore we propose that Ca2+ release from vesicles of sarcoplasmic reticulum actively loaded with Ca2+ is mediated by the same Ca2+ + mg2+-activated ATPase as is responsible for uptake of Ca2+. PMID- 3663189 TI - Size heterogeneity of human cervical mucus glycoproteins. Studies performed with rate-zonal centrifugation and laser light-scattering. AB - Mucus glycoproteins (mucins) from cervical pregnancy mucus were fractionated by using rate-zonal centrifugation in a gradient of guanidinium chloride. The distribution of the macromolecules, as assessed by using sialic acid determination, suggested the presence of three populations of different size. Individual fractions were subjected to laser light-scattering performed as total intensity measurements as well as photon correlation spectroscopy. The results showed that points of inflexion were present in the distribution of both Mr and DT (translational diffusion coefficient) and that the three populations have Mr values of approx. 24 X 10(6), 16 X 10(6) and 6 X 10(6) respectively. The weight average Mr for the whole distribution, as calculated from the values obtained for the individual fractions, was 13.6 X 10(6), which is in good agreement with that found for the unfractionated material (11.1 X 10(6]. Plots of log RG (radius of gyration) and log (1/DT) versus log Mr are in keeping with the macromolecules being linear flexible chains. PMID- 3663190 TI - Extended and globular protein domains in cartilage proteoglycans. AB - Electron microscopy after rotary shadowing and negative staining of the large chondroitin sulphate proteoglycan from rat chondrosarcoma, bovine nasal cartilage and pig laryngeal cartilage demonstrated a unique multidomain structure for the protein core. A main characteristic is a pair of globular domains (diameter 6-8 nm), one of which forms the N-terminal hyaluronate-binding region. They are connected by a 25 nm-long rod-like domain of limited flexibility. This segment is continued by a 280 nm-long polypeptide strand containing most chondroitin sulphate chains (average length 40 nm) in a brush-like array and is terminated by a small C-terminal globular domain. The core protein showed a variable extent of degradation, including the loss of the C-terminal globular domain and sections of variable length of the chondroitin sulphate-bearing strand. The high abundance (30-50%) of the C-terminal domain in some extracted proteoglycan preparations indicated that this structure is present in the cartilage matrix rather than being a precursor-specific segment. It may contain the hepatolectin-like segment deduced from cDNA sequences corresponding to the 3'-end of protein core mRNA [Doege, Fernandez, Hassell, Sasaki & Yamada (1986) J. Biol. Chem. 261, 8108-8111; Sai, Tanaka, Kosher & Tanzer (1986) Proc. Natl. Acad. Sci. 83, 5081-5085; Oldberg, Antonsson & Heinegard (1987) Biochem. J. 243, 255-259]. PMID- 3663191 TI - Reaction of unsaturated uronic acid residues with mercuric salts. Cleavage of the hyaluronic acid disaccharide 2-acetamido-2-deoxy-3-O-(beta-D-gluco-4 enepyranosyluronic acid)-D-glucose. AB - Degradation of connective-tissue polysaccharides with bacterial or fungal eliminases and subsequent characterization of the reaction products are now part of standard methodology for the analysis of these compounds. However, the scope of preparative and analytical work based on the use of eliminases has been limited by the lack of procedures for specific removal of the unsaturated uronic acid residues generated in the eliminase reactions. In the present investigation, we have shown that these residues are cleaved by mercuric salts under mild conditions that are not likely to affect other structures in an oligo- or poly saccharide molecule. Thus the disaccharide generated from hyaluronic acid by digestion with chondroitinase AC or ABC was cleaved into a keto acid and free N acetylglucosamine within 10 min at room temperature upon exposure to 14 mM mercuric acetate at pH 5. The reaction of the disaccharide with mercuric salts was used for ready determination of the distribution of radioactivity between the glucuronic acid and N-acetylglucosamine moieties in radioactive hyaluronic acid that had been synthesized by IMR-90 fibroblasts from 3H-labelled monosaccharides. When the precursor was [3H]galactose, over 95% of the incorporated radioactivity was found in the glucuronic acid moiety. In contrast, cells grown in the presence of [3H]glucosamine synthesized a polysaccharide in which almost all of the label was located in the N-acetylglucosamine units. It is apparent from these experiments that the reaction of unsaturated uronic acid residues with mercuric salts provides a new tool with potential for many applications in the study of the structure and metabolism of connective-tissue polysaccharides. PMID- 3663192 TI - Studies on membrane proteins involved in ribosome binding on the rough endoplasmic reticulum. Ribophorins have no ribosome-binding activity. AB - A membrane protein fraction showing affinity for ribosomes was isolated from rat liver microsomes (microsomal fractions) in association with ribosomes by treatment of the microsomes with Emulgen 913 and then solubilized from the ribosomes with sodium deoxycholate. This protein fraction was separated into two fractions, glycoproteins, including ribophorins I and II, and non-glycoproteins, virtually free from ribophorins I and II, on concanavalin A-Sepharose columns. The two fractions were each reconstituted into liposomes to determine their ribosome-binding activities. The specific binding activity of the non glycoprotein fraction was approx. 2.3-fold higher than that of the glycoprotein fraction. The recovery of ribosome-binding capacity of the two fractions was about 85% of the total binding capacity of the material applied to a concanavalin A-Sepharose column, and about 90% of it was found in the non-glycoprotein fraction. The affinity constants of the ribosomes for the reconstituted liposomes were somewhat higher than those for stripped rough microsomes. The mode of ribosome binding to the reconstituted liposomes was very similar to that to the stripped rough microsomes, in its sensitivity to proteolytic enzymes and its strong inhibition by increasing KCl concentration. These results support the idea that ribosome binding to rat liver microsomes is not directly mediated by ribophorins I and II, but that another unidentified membrane protein(s) plays a role in ribosome binding. PMID- 3663193 TI - The role of aromatic side chain residues in micelle binding by pancreatic colipase. Fluorescence studies of the porcine and equine proteins. AB - Fluorescence techniques have been employed to study the interaction of porcine and equine colipase with pure taurodeoxycholate and mixed micelles. Nitrotyrosine 55 of porcine colipase is obtained by modification with tetranitromethane (low excess, in the presence of taurodeoxycholate) of the protein followed by gel filtration and ion-exchange chromatography. Verification of the residue modified was obtained by h.p.l.c. peptide purification and sequence analysis. Reduction and quantitative reaction with dansyl chloride yields a fluorescent derivative that is twice as active in conjunction with lipase as is native colipase and that exhibits a strong emission band at 550 nm. Addition of micellar concentrations of taurodeoxycholate causes a 4.3-fold increase in the emission maximum as well as a 70 nm blue shift to 480 nm. Inclusion of oleic acid to form a mixed micelle reduces these spectral effects. Scatchard analysis of the data yield a Kd of 6.8 X 10(-4) M and a single colipase-binding site for taurodeoxycholate micelles. The data, by analogy to a phospholipase system, are consistent with a direct insertion of dansyl-NH-tyrosine-55 into the micelle. The presence of a single tryptophan residue (Trp-52) in equine colipase provides an intrinsic fluorescent probe for studying protein-micelle interaction. The emission maximum of horse colipase at 345 nm indicates a solvent-accessible tryptophan residue which becomes less so on binding of micelles. A blue shift of 8 nm and a 2-fold increase in amplitude is indicative of a more hydrophobic environment for tryptophan induced by taurodeoxycholate micelles. There is also a decrease in KSV for acrylamide quenching in the presence of micelles, which further supports a loss of solvent accessibility. The most dramatic pH effects are observed with KI quenching, and may indicate the presence of negative charges near Trp-52. PMID- 3663194 TI - Purification and initial characterization of an enzyme with deacetoxycephalosporin C synthetase and hydroxylase activities. AB - Deacetoxycephalosporin C synthetase (expandase) from Cephalosporium acremonium (Acremonium chrysogenum) was purified to near homogeneity as judged by SDS/polyacrylamide-gel electrophoresis. The enzyme (Mr about 40,000) exhibited a pH optimum around 7.5. It required 2-oxoglutarate (Km 0.04 mM), Fe2+ and O2 as cofactors, and ascorbate and dithiothreitol were necessary for maximum activity. It was stable for over 4 weeks at -70 degrees C in the presence of 1 mM dithiothreitol. Activity was inhibited by the thiol-quenching reagent N ethylmaleimide, the metal-ion-chelating reagent bathophenanthroline, and NH4HCO3. The highly purified enzyme also showed deacetoxycephalosporin C hydroxylase (deacetylcephalosporin C synthetase) activity, indicating that both expandase and hydroxylase activities are properties of a single protein. These activities could not be separated by ion-exchange, dye-ligand, gel-filtration or hydrophobic chromatography. A beta-sulphoxide and a 3 beta-methylene hydroxy analogue of penicillin N were synthesized to test as potential intermediates in the ring expansion reaction, Neither compound was a substrate for the enzyme. A synthetic analogue in which the 3 beta-methyl group and the 2-hydrogen atom of penicillin N were replaced by a cyclopropane ring was not a substrate but was a reversible inhibitor of the enzyme. PMID- 3663195 TI - Purification and mechanistic properties of an extracellular alpha-L arabinofuranosidase from Monilinia fructigena. AB - 1. The alpha-L-arabinofuranosidase isoenzyme designated AFIII [Laborda, Archer, Fielding & Byrde (1974) J. Gen. Microbiol. 81, 151-163] was purified by sequential isoelectric focusing, hydrophobic chromatography, gel filtration and chromatofocusing. 2. The enzyme is a monomer of Mr 40,000. 3. On inactivation of the enzyme with 3H-labelled 1-alpha-L-arabinofuranosylmethyl-3-p nitrophenyltriazene, 0.64 mol of alpha-L-arabinofuranosylmethyl residues/mol of enzyme is estimated to become attached to protein. 5. Neither first-order nor second-order rate constants for hydrolyses of aryl alpha-L-arabinofuranosides are dependent upon leaving-group acidity [beta lg(V) = -0.16 +/- 0.11; Beta lg(V/K) = -0.11 +/- 0.07; n = 7; delta pKa = 4.5] 6. Bond-breaking is nonetheless rate limiting, as is shown by a value of 18(V) of 1.030 +/- 0.007 for the hydrolysis of p-nitrophenyl arabinoside. 7. Proton-donation to the leaving group is thus far advanced at the rate-limiting transition state for this enzyme. 8. Four alpha-L arabinofuranosyl pyridinium salts are substrates, and an approximate beta lg(V) value of -0.9 can be estimated. 9. The absolute rate enhancement with the 4 bromoisoquinolinium salt, 2.5 X 10(9), is comparable with that observed with pyranosidases. 10. Ring-opening mechanisms can therefore be dismissed, even though they are known in the acid-catalysed hydrolysis of arabinofuranosides. PMID- 3663196 TI - Amino acid sequence of acyl-CoA-binding protein from cow liver. AB - Acyl-CoA-binding protein from bovine liver was purified with the use of reverse phase h.p.l.c. in the final step. The complete amino acid sequence was determined by using a combination of gas-phase Edman degradation and electron-impact and fast-atom-bombardment mass spectrometry. The sequence was confirmed by determination of the Mr by plasma-desorption time-of-flight mass spectrometry. PMID- 3663197 TI - Hydrolysis of retinyl esters by non-specific carboxylesterases from rat liver endoplasmic reticulum. AB - The four most important non-specific carboxylesterases from rat liver were assayed for their ability to hydrolyse retinyl esters. Only the esterases with pI 6.2 and 6.4 (= esterase ES-4) are able to hydrolyse retinyl palmitate. Their specific activities strongly depend on the emulsifier used (maximum rate: 440 nmol of retinol liberated/h per mg of esterase). Beside retinyl palmitate, these esterases cleave palmitoyl-CoA and monoacylglycerols with much higher rates, as well as certain drugs (e.g. aspirin and propanidid). However, no transacylation between palmitoyl-CoA and retinol occurs. Retinyl acetate also is a substrate for the above esterases and for another one with pI 5.6 (= esterase ES-3). Again the emulsifier influences the hydrolysis by these esterases (maximum rates: 475 nmol/h per mg for ES-4 and 200 nmol/h per mg for ES-3). Differential centrifugation of rat liver homogenate reveals that retinyl palmitate hydrolase activity is highly enriched in the plasma membranes, but only moderately so in the endoplasmic reticulum, where the investigated esterases are located. Since the latter activity can be largely inhibited with the selective esterase inhibitor bis-(4-nitrophenyl) phosphate, it is concluded that the esterases with pI 6.2 and 6.4 (ES-4) represent the main retinyl palmitate hydrolase of rat liver endoplasmic reticulum. In view of this cellular localization, the enzyme could possibly be involved in the mobilization of retinol from the vitamin A esters stored in the liver. However, preliminary experiments in vivo have failed to demonstrate such a biological function. PMID- 3663198 TI - Disulphide bridges of bovine factor X. AB - Evidence is presented for the disulphide bridges in bovine Factor X. The protein was degraded by chemical and enzymic means, and all 12 disulphide bridges were isolated in separate peptides except for bridges nos. 6/7 in the light chain. All the disulphide bridges were found to be in positions corresponding to those found in other homologous domains. This report is the first verification of an epidermal-growth-factor-homologous domain having the same disulphide-bonding pattern as that found in mouse epidermal growth factor. PMID- 3663199 TI - Phosphorylation of partially purified 1-O-alkyl-2-lyso-sn-glycero-3 phosphocholine:acetyl-CoA acetyltransferase from rat spleen. AB - A new improved method for purification of the enzyme 1-O-alkyl-2-lyso-sn-glycero 3-phosphocholine: acetyl-CoA acetyltransferase (EC 2.3.1.67) from rat spleen is described. The catalytic subunit of cyclic AMP-dependent protein kinase in the presence of MgATP stimulated about 3-fold the activity of this partially purified enzyme activity. When [gamma-32P]ATP was included in the assay mixture, the analysis of phosphoprotein products by SDS/polyacrylamide-gel electrophoresis and autoradiography showed the incorporation of [32P]phosphate into a single protein band of about 30 kDa. Analysis of the phosphorylated amino acids indicated that the phosphate was incorporated into a serine residue. Activation of the acetylation reaction by the protein kinase was reversible. The reversal of the activation was coincident with the loss of the [32P]phosphate incorporated into the 30 kDa protein band, which suggests that the acetyltransferase is regulated by a phosphorylation-dephosphorylation mechanism dependent on cyclic AMP. PMID- 3663200 TI - Carcass glycogen repletion on carbohydrate re-feeding after starvation. AB - In mice, the response of carcass glycogen to glucose re-feeding after starvation is biphasic. The initial repletive phase is followed by partial (greater than 50%) glycogen mobilization. This turnover of carcass glycogen in response to carbohydrate re-feeding may play an important role in the provision of C3 precursors for hepatic glycogen synthesis. PMID- 3663201 TI - Liver microsomal membrane fluidity and lipid characteristics in vitamin A deficient rats. AB - Rat liver microsomes (microsomal fraction) were isolated from vitamin A-deficient and -sufficient rats and analysed for membrane lipid characteristics. Membrane fluidity was found to be significantly decreased in microsomes from the vitamin A deficient rats, but not in liposomes prepared from lipid extracts. Microsomes from vitamin A-deficient animals showed a significant decrease in C18:2, omega 6 and an increase in C22:5, omega 6 fatty acids. PMID- 3663202 TI - Extraction and recovery of inositol phosphates from tissues. PMID- 3663203 TI - Biological activity and mode of action of some dihydroorotic and dihydroazaorotic acid derivatives. AB - The conversion of six dihydroorotate analogues by the dihydroorotate dehydrogenase (DHO-DH) of plant and animal mitochondria was studied. In the case of plant DHO-DH the dehydrogenation of analogues was as follows: Dihydroorotic acid (DHO) (control, 100%), DHO-hydrazide (40%), azaDHO (13%), azaDHO-ethyl ester (23%), azaDHO-hydrazide (11%), dihydrouracil (0%), dihydrothymine (0%). When animal DHO-DH was used the analogues were practically not dehydrogenated. These compounds were also tested as inhibitors of DHO-dehydrogenation. AzaDHO, azaDHO hydrazide and azaDHO-ethylester inhibited this reaction by 75, 70% and 60%, respectively, for plant DHO-DH. AzaDHO and azaDHO-ethylester inhibited this reaction to 90% and 70%, respectively, for animal enzyme. The other analogues had no effect. The compounds showed a moderate antibacterial activity. AzaDHO was more active than azaDHO-ethyl ester and azaDHO-hydrazide. A considerable inhibitory effect of azaDHO and azaDHO-ethyl ester was observed on the growth of St. aureus mutant UV-2 and S. lutea. The analogues were little active against the experimental mouse tumors leukemia L 1210, Lewis lung carcinoma (LLC) and B-16 melanoma. AzaDHO-ethyl ester and azaDHO-hydrazide inhibited the growth of LLC by 59% and 56%, respectively. In addition, the effect of analogues on the growth of plant cells was studied. AzaDHO and azaDHO-ethyl ester inhibited the growth of tomato cells in suspension culture by 10% and 41%, respectively. PMID- 3663204 TI - [ATP-metabolizing enzymes in suspensions of isolated coupled rat brain mitochondria]. AB - An improved method for the isolation of rat brain mitochondria is described. The preparation exhibits a respiratory control index (RCI) of 6 or 7.3 in the presence of pyruvate and malate or glutamate and malate, respectively. RCI decreases to 2.5 in the presence of Mg++. When the phosphorylation of extramitochondrially added or formed ADP is suppressed by carboxyatractyloside (CAT) inhibition of the adenine nucleotide translocator, the remaining respiration amounts to 6 nmol O2/min X mg mitochondrial protein. These results and the ratio of 16 to 19 from the quotient of phosphorylating active-state respiration to CAT inhibited respiration refer to a high degree of mitochondrial coupling of respiration. Therefore the remaining respiration in the presence of Mg++ is due to a phosphokinase activity located outside the inner membrane of intact mitochondria or at nonphosphorylating mitochondrial fragments. The following activities were observed: Oligomycin sensitive ATPase, 47 mU/mg protein; hexokinase, 272 mU/mg protein; creatinphosphokinase, 116 mU/mg protein; and a surprisingly low activity of adenylatekinase, 57 mU/mg protein. PMID- 3663205 TI - Relation between microvilli membrane potential and glucose transport capacity of rat small intestine. AB - Transepithelial electrical potential differences induced by glucose were measured in rat small intestine under conditions of experimental diabetes, application of corticosteroids, adrenalectomy, and inhibition of adrenocortical functions. A close linear correlation between the capacity of monosaccharide absorption and the transepithelial potential difference was found. Microelectrode studies indicated that glucose-induced alterations of the transepithelial potential difference are due to depolarization of the potential difference across the microvilli membrane. Changes in the potential difference across the basolateral plasma membrane were not detectable after addition of glucose. PMID- 3663206 TI - Stimulation of proteoglycan synthesis by fibroblastic cells in culture due to the addition of "matrigenin" from bovine bone. AB - Hyaluronic acid is the major glycosaminoglycan characteristically secreted in culture by human synovial fibroblastic cells, but stimulated proteoglycan synthesis, as well as hyaluronic acid synthesis, was observed when a partially purified factor from bovine bone, containing "matrigenin" activity, was added to these cells. Cultures were labelled with [35S]SO4 and [3H]glucosamine and the radioactive glycoconjugates were extracted from the medium under dissociative conditions. After a preliminary separation of the radioactive high molecular weight compounds, the proteoglycans were separated from hyaluronic acid and glycoproteins by ion-exchange chromatography in 8 M urea. The proteoglycan fraction from the fibroblastic cells, whose synthesis was stimulated by the "matrigenin" activity, contained at least two species, the lower molecular weight proteoglycan eluting in the range of 400-600 K under dissociative conditions during gel filtration chromatography. PMID- 3663207 TI - Structural studies of lens fiber junction protein MP26 by cyanogen bromide cleavage. AB - The lens fiber-cell plasma membrane MP26 from chick, bovine, and human lenses yielded identical cyanogen bromide peptide maps, confirming the essential conservation of structure in the junction protein of vertebrate lens fiber cells. Immunoblot analyses of the cyanogen bromide peptide maps of human lens MP26 and of its age-dependent proteolytic product MP22 confirmed that MP22 is a derivative of MP26. The findings in this study are the first consistent with the positioning of the methionine residues in lens MP26 as predicted by its cDNA-derived sequence. PMID- 3663208 TI - Calcium-independent activation of two plant leaf calcium-regulated protein kinases by unsaturated fatty acids. AB - Two soluble Ca2+-dependent protein kinases from silver beet leaves (enzymes I and II) can be resolved from each other by chromatography on DEAE-cellulose. Enzyme II is substantially activated by arachidonic, oleic and linoleic acids in the absence of Ca2+ but not at high Ca2+ concentrations. Stearic and arachidic acids do not substantially activate either enzyme at low free Ca2+. Enzyme I differs from enzyme II in exhibiting a much lower degree of Ca2+-independent activation by unsaturated fatty acids. PMID- 3663209 TI - Adenine methylation in zein genes. AB - This paper reports the novel finding of adenine methylation in higher plants. Comparison of restriction patterns of genomic maize DNA digested with enzymes MboI and Sau3A enabled us to detect the existence of adenine methylation in zein genes. Adenine methylation within or around zein genes turned out to be similar in endosperm (where zeins are actively synthesized) and in seedling tissue (where zein genes are not expressed). Furthermore, adenine methylation patterns were found to be similar both in wild-type and opaque-2 mutant plants. These lines of evidence suggest that adenine methylation is unrelated to the regulation of gene expression. PMID- 3663210 TI - Incorporation of the carbocyclic analogue of (E)-5-(2-bromovinyl)-2'-deoxyuridine 5'-triphosphate into a synthetic DNA. AB - The carbocyclic analogue of (E)-5-(2-bromovinyl)-2'-deoxyuridine, C-BVDU, is a very potent and selective anti-herpes-virus compound. In order to synthesize and study the properties of a DNA that contains C-BVDU, the 5'-triphosphate, C-BVDUTP was prepared and evaluated as a potential substrate of the E. coli Klenow DNA polymerase enzyme. Although C-BVDUTP proved to be a very poor substrate also of this enzyme, it could be incorporated up to 3.6% into the synthetic DNA, poly(dA dT, C-BVDU). This level of substitution decreased significantly the template activity for DNA and RNA polymerases, as compared to that of poly(dA-dT). PMID- 3663211 TI - Biosynthesis of reovirus-specified polypeptides. Molecular cDNA cloning and nucleotide sequence of the reovirus serotype 1 Lang strain s2 mRNA which encodes the virion core polypeptide sigma 2. AB - Human reovirus serotype 1 Lang strain s2 mRNA, which encodes the virion inner capsid core polypeptide sigma 2, was cloned as a cDNA:mRNA heteroduplex in Escherichia coli using phage M13. A complete consensus nucleotide sequence was determined. The Lang strain s2 mRNA is 1331 nucleotides in length and possesses an open reading frame with a coding capacity of 335 amino acids, sufficient to account for a sigma 2 polypeptide of 37,682 daltons. Comparison of the serotype 1 Lang s2 sequence derived from cDNA clones of s2 mRNA with the serotype 3 Dearing S2 sequence derived from cDNA clones of the S2 dsRNA genome segment reveals 86 percent homology at the nucleotide level. The predicted sigma 2 polypeptides of the Lang and Dearing strains display 98 percent homology at the amino acid level. Of 147 silent nt differences in the translated region, 136 were in the third base position of codons. PMID- 3663212 TI - Alterations in tissue Mg++, Na+ and spinal cord edema following impact trauma in rats. AB - Alterations in water content and total tissue Na+ and Mg++ of rat spinal cord tissue were followed over time after a 100 g-cm impact injury to the T-9 spinal cord segment. Rats subjected to laminectomy but not trauma served as controls. In the injured segment there was a progressive increase in water content with increased Na+ and decreased Mg++ at 1 hour and 24 hours after trauma. At seven days, water and Na+ content remained elevated, whereas Mg++ levels had returned to preinjury baseline values. Because of its important role in many metabolic and physiological regulatory processes the early decline in Mg++ concentration after trauma may contribute to the development of secondary tissue damage after spinal cord injury. PMID- 3663213 TI - The membrane-anchor of Paramecium temperature-specific surface antigens is a glycosylinositol phospholipid. AB - The temperature-specific G surface antigen of Paramecium primaurelia strain 156 was biosynthetically labeled by [3H]myristic acid in its membrane-bound form, but not in its soluble form. It could be cleaved by a phosphatidylinositol-specific phospholipase C from Trypanosoma brucei or from Bacillus cereus which released its soluble form with the unmasking of a particular glycosidic immunodeterminant called the crossreacting determinant. The Paramecium enzyme, capable of converting its membrane-bound form into the soluble one, was inhibited by a sulphydril reagent in the same way as the trypanosomal lipase. From this evidence we propose that the Paramecium temperature-specific surface antigens are anchored in the plasma membrane via a glycophospholipid, and that an endogenous phospholipase C may be involved in the antigenic variation process. PMID- 3663214 TI - Inhibition of nuclear binding of triiodothyronine by antimycin A in cultured human fibroblasts. AB - We have tested the effects of several cell inhibitors on cell and nuclear content of T3 at equilibrium in cultured human fibroblasts. Monodansylcadaverine and colchicine inhibited in parallel, and near to the same extent, cell and nuclear content of T3. Antimycin A did not interfere with cell accumulation of T3 but induced a 10-fold decrease of nuclear T3. This effect was due to a decrease of the apparent affinity constant of the T3 nuclear receptor. Other metabolic inhibitors such as sodium azide or potassium cyanide were without effects. It is suggested that antimycin A blocks a nuclear T3 concentrating mechanism which maintains a gradient of free T3 between the nucleus on the one hand, and the cytosol and plasma, on the other. PMID- 3663216 TI - The aromatase active site: the C-6 "front" side of the androgen molecule is required for binding. AB - Solubilized microsomes from human placenta were partially purified by anion exchange chromatography on a quaternary methylamino-silica column. The aromatase active fractions were then used for measuring optical difference spectra with various androgens, substituted at positions C-1, 2, 6, 11, 16, 17, and 19. Of these, only androgens substituted at the C-6, or frontside of the steroid backbone induce a strong type I spectrum, as well as competitive inhibition with the natural substrate, 4-androstene-3,17-dione. An in-house made affinity support, synthesized by reacting 6 beta-bromo-androstenedione with aminohexyl Sepharose at pH 10-11 via a SN2-mechanism, was unable to trap the aromatase cytochrome P-450 component of the enzyme. A 3-dimensional model of the active site accounting for these interactions is proposed. PMID- 3663215 TI - Partial purification of cytochrome P450 from rat brain and demonstration of estradiol hydroxylation. AB - Cytochrome P450 was partially purified from brain microsomes of untreated rats. A difference spectrum of the dithionite-reduced CO-complex of the purified P450 showed essentially the hemeprotein absorbing exclusively at 449 nm. The purified brain P450 was able to catalyze estradiol (E2) hydroxylation leading to the formation of 6 alpha- and 6 beta-hydroxy(OH)E2, 4-OHE2, estrone, 6-oxoE2, 2-OHE2, 15 alpha-OHE2 and estriol. These results demonstrate that rat brain P450 is active in estradiol hydroxylation. PMID- 3663217 TI - Evidence for the involvement of hydroxyl radicals in nickel mediated enhancement of lipid peroxidation: implications for nickel carcinogenesis. AB - The administration of nickel to rats resulted in enhanced hepatic lipid peroxidation, levels of glutathione and iron with a concomitant decrease in glutathione peroxidase activity. These effects were dose dependent. Enhanced lipid peroxidation was found to be inhibited by the exogenous addition of ethylenediamine tetraacetic acid (EDTA), benzoate and ethanol while catalase and superoxide dismutase were ineffective in this regard. Our data strongly suggest the involvement of hydroxyl radicals in the nickel mediated enhancement of lipid peroxidation which may have their implications in the carcinogenicity of nickel compounds. PMID- 3663218 TI - Reduction and catalytic properties of cytochrome P-450 LM2 in reconstituted system containing monomeric carriers. AB - The membrane microsomal monooxygenase system can be reconstituted in solution from NADPH-specific flavoprotein and cytochrome P-450 which exist in the monomeric state in the presence of Emulgen 913 at molar ratio of the proteins and detergent of 1:1:300. Oxidized and dithionite-reduced monomers of cytochrome P 450 were much less thermostable than its initial aggregates, while thermal stability of NADPH-specific flavoprotein did not depend on its aggregation state. Binding spectra of cytochrome P-450 monomers with benzphetamine were atypical and had an absorbance minimum at 422 nm only. The addition of benzphetamine and/or flavoprotein to cytochrome P-450 monomers did not cause the spin equilibrium shift and the low-spin form content was higher than 85% in all cases. Investigation of the dependence of the initial rates of NADPH-dependent cytochrome P-450 reduction and benzphetamine oxidation on the stoichiometry of the flavoprotein and cytochrome P-450 at their constant total concentration showed that the molar ratio of 1:1 was required for maximal activity. Thus this system works in full accordance with the mass action law. PMID- 3663219 TI - Accumulation of a glycine rich protein in auxin-deprived strawberry fruits. AB - Growth of strawberry (Fragaria ananassa Duch. cv. Ozark Beauty) receptacles is regulated by auxin supplied from the achenes. The receptacle growth can be stopped at any stage by deachening the fruits, and can be resumed by exogenous application of auxin. In our earlier studies we demonstrated auxin regulated polypeptide changes at different stages of strawberry fruit development. Removal of achenes from fruits and growing the receptacles without auxin resulted in the time-dependent accumulation of 52,000 Mr polypeptide. Amino acid analysis revealed that the protein is rich in glycine. Our studies, with normal and variant strawberry receptacles, indicate that the synthesis and accumulation of this glycine-rich protein correlates with cessation of receptacle growth. These results suggest a possible role for the glycine-rich protein in cessation of growth. PMID- 3663220 TI - A novel role of fatty acid-binding protein as a vehicle of retinoids. AB - Intracellular transport and storage of retinoids were shown to be conducted by fatty acid-binding protein (FABP). When rat liver cytosol was gel filtrated, retinyl palmitate-binding activity was mainly eluted in the fraction with a Mr. of around 14,000, in which both FABP and cellular retinol-binding protein (CRBP) co-existed. From the binding analysis of purified FABP and CRBP to retinyl palmitate, FABP was found to have a relatively high affinity (Kd = 1.4 X 10(-6) M) to retinyl palmitate, while binding of retinyl palmitate to CRBP was scarcely detectable. By using anti-FABP serum, it was shown that FABP was distributed in organs relating to absorption and storage of retinoids, such as jejunum, ileum, and liver. In liver, the protein was localized in the parenchymal cells and with particularly high concentration in the perisinusoidal cells, probably fat-storing cells. PMID- 3663221 TI - N-glycansulfated fibronectin: one of the several sulfated glycoproteins synthesized by endothelial cells in culture. AB - N-glycanase, an endoglycosidase that cleaves the bond between asparagine and glucosamine, releases oligosaccharides with various degree of sulfation from endothelial cell fibronectin. As shown by analysis by polyacrylamide gel electrophoresis of culture medium conditioned by cells exposed to [35S]sulfate, endothelial cell fibronectin is one of a number of glycoproteins bearing sulfated oligosaccharides, synthesized by this cell type. PMID- 3663222 TI - HPLC-purified 2-[125I]iodomelatonin labels multiple binding sites in hamster brain. AB - Binding of 2-[125I]iodomelatonin in hamster brain synaptosomal membranes at 0 degrees C is rapid, saturable, reversible and sensitive to heat and trypsin treatment. Computer resolution of curvilinear Scatchard plots yielded high- and low-affinity components as follows: Kd1 = 0.32 +/- 0.14 nM, Bmax1 = 5.6 +/- 1.7 fmol/mg protein and Kd2 = 10.5 +/- 3.2 nM, Bmax2 = 123 +/- 33 fmol/mg protein (n = 3). Competition experiments indicated that 2-iodomelatonin and prazosin are the most potent inhibitors of high-affinity binding. Unlike prazosin, several alpha adrenergic agents and various neurotransmitters were ineffective. These findings suggest that prazosin may be a potent antagonist at a unique, non-alpha adrenergic, high-affinity binding site for melatonin. PMID- 3663223 TI - Stable transfer of a mouse dihydrofolate reductase gene into a deficient cell line using human adenovirus vector. AB - A plasmid containing the mouse dihydrofolate reductase (dhfr) gene was rescued in a human adenovirus in early region 3. Analysis of the insert in the recombinant virus revealed that the dhfr sequences were intact in the viral genome, whereas a part of the ampicillin gene in the plasmid sequences was deleted. The recombinant virus could successfully express this gene in a deficient cell line. A permanent dhfr+ cell line was established by stable transfer of the gene using the recombinant virus. PMID- 3663224 TI - Plasmid DNA adsorbed to pH-sensitive liposomes efficiently transforms the target cells. AB - We have previously reported that plasmid DNA entrapped in the pH-sensitive immunoliposomes effectively transforms the target cells (Proc. Natl. Acad. Sci. USA, in press). In the present study, we demonstrate that DNA adsorbed on the same liposome also transforms the target cells. The transformation activity is antibody dependent, as liposomes containing no targeting antibody had reduced activity. The activity could be significantly inhibited by excess non-specific DNA (salmon sperm). Since some DNA are likely adsorbed to the liposomes during the entrapment process, the activity of the entrapped DNA is partially accounted for by the adsorbed DNA. The possibility of developing a simple DNA-mediated transfection protocol using liposome adsorbed DNA is discussed. PMID- 3663225 TI - In vivo phosphorylation of titin and nebulin in frog skeletal muscle. AB - Titin and nebulin are two major protein components of the sarcomere matrix in striated muscles. Purified titin and nebulin from frog (Xenopus laevis) skeletal muscle are similar in size and in amino acid composition to their mammalian or avian counterparts. Both proteins contain substantial amounts of protein-bound phosphate: about 5 to 6 per titin subunit and 8 to 9 per nebulin subunit. Injection of radioactive inorganic phosphate into the dorsal lymph sacs of Xenopus laevis resulted in the significant incorporation of radioactivity into titin and nebulin within three days of incubation. Purified titin from in vivo labeled frog gastrocnemius muscle contains one mole of radioactive phosphoserine per mole of titin subunit. These data indicate that phosphorylation of frog titin and nebulin occurs in vivo. PMID- 3663226 TI - PSL, a nuclear cell-cycle associated antigen is increased during retinoic acid induced differentiation of HL-60 cells. AB - PSL(p55) is a nuclear 55kD antigen present in various mammalian cell systems, which has been first identified by use of human autoimmune antibodies (Barque et al. 1983, EMBO J. 2, 743). It has been shown to be associated with interphase chromatine and to be synthesized in during the S phase of the cell cycle. In this work, we have analysed the status of PSL in promyelocytic HL-60 human cells in exponential or stationary growth, or undergoing granulocytic differentiation in presence of Retinoic acid. By use of 2-dimensional electrophoresis, PSL was found to be composed of two acidic proteins designated p55A and p55B. Unexpectedly, estimated 10-20 fold higher amounts of each species were found in cells treated for 5 days with 10(-6)M Retinoic acid, than in asynchronously growing cells or resting cells. Moreover, the p55A protein was phosphorylated during the process. On the basis of these results, PSL appears to be involved in some steps of the granulocytic differentiation process. PMID- 3663227 TI - Inhibition of herpesvirus and human DNA polymerases by alpha-halogenated phosphonoacetates. PMID- 3663228 TI - In vitro febantel transformation by sheep and cattle ruminal fluids and metabolism by hepatic subcellular fractions from different animal species. AB - Febantel and one of its main metabolites, febantel sulphoxide, are chemically modified to only a slight extent when incubated in vitro with sheep and cattle ruminal fluids; other major metabolites, fenbendazole and oxfendazole, are respectively, oxidized to oxfendazole and reduced to fenbendazole. Febantel is negligibly metabolized by hepatic cytosol fractions but microsome preparations effect more extensive metabolic transformations. Important differences in this respect were found between microsome preparations from rat, horse, pig, cattle, sheep, chicken and trout livers. PMID- 3663229 TI - Hepatic microsomal N-demethylation of N-methylbenzamidine. N-dealkylation vs N oxygenation of amidines. AB - The microsomal oxidative N-demethylation of N-methylbenzamidine, a model compound for active substances containing the basic amidine function, was investigated. N Methylbenzamidine was converted into benzamidine and formaldehyde by aerobic incubation with non-induced microsomal fractions of rabbit liver homogenates and NADPH. The formation of benzamidine in the incubation mixtures under widely differing conditions was assayed using a newly-developed, high-performance, ion pair, reverse-phase partition chromatographic method. Optimal reaction conditions were determined. The benzamidine formation in the incubation mixture followed Michaelis-Menten kinetics and required the presence of molecular oxygen and NADPH. The effects of the inducer phenobarbital, methylcholanthrene, ethanol and N-methylbenzamidine itself on the activity were studied. Neither superoxide anion nor hydrogen peroxide was directly involved in the demethylation reaction. The direct involvement of cytochrome P-450 in this reaction is supported by the observation that the presence of inhibitors of cytochrome P-450, in particular of carbon monoxide, markedly decreased the rate of N-demethylation. This N demethylation of N-methylbenzamidine proves the hypothesis that benzamidines with hydrogen atoms in the alpha-position to the amidine nitrogen atoms are N dealkylated instead of N-oxygenated by the microsomal mixed function oxidase system. PMID- 3663230 TI - Metabolism of diethylstilbestrol in hamster hepatocytes. AB - Under certain modulating conditions the liver of the male Syrian golden hamster is a target organ for the carcinogenic effect of the synthetic estrogen diethylstilbestrol (DES). As a basis for mechanistic studies aimed at elucidating the role of metabolic activation in the process of DES-induced neoplasia, the metabolism of 14C-DES was investigated in freshly isolated hamster hepatocytes. These oxidative metabolites of DES, viz. Z,Z-dienestrol,3'-hydroxy-DES and 1 hydroxy-E-DES, were formed in 14.2, 9.1, and 0.3% yield, respectively, when hepatocytes were incubated with 50 nmol DES/mg cellular protein for 60 min. Glucuronides (4.0%) and sulfates (2.8%) of DES and of the oxidative metabolites were also found, and non-extractable binding of radioactivity to cellular protein was observed indicating the formation of reactive intermediates. The capability of hamster hepatocytes to oxidize and conjugate DES should allow the investigation of the effects of modulators on the metabolic activation of DES in this cellular system in order to help clarify the mechanisms of DES-induced hepatocarcinogenesis. PMID- 3663231 TI - Flavin-containing monooxygenase and ascorbic acid deficiency. Qualitative and quantitative differences. AB - Ascorbic acid deficiency causes qualitative and quantitative differences in the guinea pig hepatic flavin-containing monooxygenase (FMO). Kinetic studies with purified FMO indicated no significant change in the apparent Km of dimethylaniline or NADPH in ascorbate-supplemented or -deficient animals. Following purification of ascorbate-deficient guinea pig FMO by DEAE-cellulose and blue agarose chromatography, exogenous FAD was required for 15% of the FMO microsomal activity recovered. In contrast, only 5% of the total microsomal enzyme recovered from ascorbate-supplemented animals required exogenous FAD. Furthermore, there was an enhanced sensitivity to time-dependent nonlinearity with the purified ascorbate-deficient guinea pig FMO. The degree of time dependent nonlinearity was related to the concentration of substrate. Also, purified ascorbate-supplemented guinea pig FMO was stable for 4 weeks at -20 degrees, whereas the ascorbate-deficient enzyme was inactivated. A decrease in the quantity of ascorbate-deficient guinea pig FMO compared to ascorbate supplemented was indicated by a marked reduction in total FMO activity recovered from blue agarose chromatography and reduced protein staining intensity with SDS PAGE at 56,000 daltons. PMID- 3663232 TI - Effect of L-carnitine on ketone bodies, redox state and free amino acids in the liver of hyperammonemic mice. AB - L-Carnitine stimulates urea synthesis in mice given a LD100 of ammonium acetate. Unprotected mice show decreased levels of hepatic ketone bodies and lowered NADH/NAD+ ratio in both cytosol and mitochondria. L-Carnitine enhances markedly the production of beta-hydroxybutyrate and raises the NADH/NAD+ ratio in mitochondria. The alterations induced by ammonium acetate in the free amino acid pool are prevented by L-carnitine. The results shown in this paper indicate that L-carnitine stimulates fatty acid oxidation as well as flux through the Krebs cycle in hyperammonemic mice and that these effects may be responsible for the increase in urea synthesis in these animals. PMID- 3663233 TI - Inhibition of synaptosomal high-affinity uptake of dopamine and serotonin by estrogen agonists and antagonists. AB - High-affinity uptake of dopamine and serotonin into a synaptosomal preparation from rat cerebral cortex was inhibited by a number of estrogen agonists and antagonists in vitro in a stereoselective and competitive manner. The most potent estrogenic inhibitors in the dopaminergic and serotonergic system were ethinylestradiol (KI = 558 nM) and 2-hydroxyethinylestradiol (KI = 226 nM), respectively. Structure-activity relationships are discussed and compared with the effects of estrogens on noradrenaline uptake. However, as all physiologically occurring estrogens inhibited amine uptake only in the micromolar concentration range it seems unlikely that this direct interaction of estrogen with the amine carrier is responsible for the changes in dopamine and serotonin uptake observed during the estrous cycle or after in vivo administration of estrogens and/or progesterone. PMID- 3663234 TI - Kinetics of heat inactivation of phenyl valerate hydrolases from hen and rat brain. AB - Heat inactivation was studied at 45, 50, 55, and 60 degrees for all of the phenyl valerate hydrolases (PVase), including neurotoxic esterase (NTE) and inhibitor resistant esterase (IRE), in homogenates of hen or rat brain or in preparations of hen brain microsomal membranes. Hen and rat brain homogenates were prepared in buffer (50 mM Tris/0.20 mM EDTA, pH 8.00, at 25 degrees). Hen brain microsomes were suspended either in buffer or in aqueous dimethyl sulfoxide (DMSO, 40%, w/v), or solubilized either in aqueous Triton X-100 (0.10%, w/v) or in 40% (w/v) DMSO. Enzyme activities were measured at 37 degrees using phenyl valerate as substrate. Each enzyme activity in all of the preparations exhibited biphasic heat inactivation kinetics. Apparent rate constants were calculated for the fast (kf) and slow (ks) reactions, along with the relative amounts of activity in each component (Af, As) expressed as percentages of the total activity. For a given preparation and temperature, respective values of kf or ks were similar for PVase, NTE, and IRE, with a mean kf/ks ratio of 52 across all preparations. Af and As were a function of temperature. Mean values of the apparent activation energies (Ea) for all activities and preparations were 44 and 25 kcal/mol for the fast and slow inactivation reactions respectively. These results indicate that all phenyl valerate hydrolases in hen and rat brain undergo a common heat-induced structural change leading to loss of enzymic activity. PMID- 3663235 TI - Effects of administration of dopamine and L-DOPA to dogs on their plasma level of dopamine sulfate. AB - The effect of intravenous administration of dopamine (DA) or L-3,4 dihydroxyphenylalanine (L-DOPA), its immediate precursor, on the level of DA sulfate in dog plasma was examined, to clarify the source and physiological significance of DA sulfate which is present at high level in the plasma. After DA administration, the plasma level of free DA increased markedly, but the level of DA sulfate did not change. However, after administration of L-DOPA, the levels of both free DA and DA sulfate increased greatly. After a single injection of L DOPA, increase in the level of free DA was transient, but that of DA sulfate persisted for a long time. These results suggest that some of the DA sulfate in dog plasma is formed from circulating L-DOPA, not from circulating DA, and that formation of DA conjugate may play a role in regulating the plasma level of free DA. PMID- 3663236 TI - Amiodarone induced phospholipidosis. Biochemical, morphological and functional changes in the lungs of rats chronically treated with amiodarone. AB - Amiodarone, an antiarrhythmic drug, causes pulmonary fibrosis in some patients during chronic treatment but the mechanism is unknown. We studied the effects of amiodarone on pulmonary biochemistry, morphology and function at doses of 25 and 50 mg/kg/12 hr given to rats by gavage for four weeks. Plasma and pulmonary phospholipids were significantly augmented, 13% and 88% respectively, in the group given amiodarone 50 mg/kg/12 hr compared to pair-fed controls. Typical phospholipidosis-like light and electron microscopic alterations were seen in the lung, their severity related to the extent of biochemical changes induced by amiodarone. Pulmonary function tests revealed mild but not significant changes in O2 and CO2 alveolar exchange efficiency and lung compliance (P-V curve) of treated animals in comparison to pair fed controls. Plasma average concentrations of amiodarone and its main metabolite, desethylamiodarone, after four weeks were 2.46 +/- 0.18 and 0.73 +/- 0.13 micrograms/ml, respectively, in the 50 mg/kg/12 hr group. In the same group amiodarone and desethylamiodarone concentrations in lung were 163 +/- 26 and 569 +/- 153 times higher than those in plasma. A highly significant correlation was found between amiodarone concentrations in plasma and lung and phospholipid content in the lung. A subgroup of animals received amiodarone 50 mg/kg/12 hr for 8 weeks. The pulmonary phospholipidosis-like lesions were similar to those observed after one month of treatment, no fibrosis was evident on light microscopic examination. PMID- 3663238 TI - Inhibition of NADH oxidase and lactate dehydrogenase of Mycoplasma gallisepticum by copper complexes of 2,2'-bipyridyl analogues. AB - In the presence of copper, 2,2'-bipyridyl analogues possess growth-inhibitory activity against Mycoplasma gallisepticum. Inhibition of the energy yielding metabolism plays a role in the mechanism of action. We showed that probably inhibition of lactate dehydrogenase and NADH oxidase is involved. Both enzymes were inhibited in vitro and in vivo by several copper 2,2'-bipyridyl complexes. A two-step mechanism of action is proposed, i.e. first a copper complex enters the cell, then after dissociation of the complex the enzymes are inhibited by free copper. PMID- 3663237 TI - Effects of fenofibrate treatment on fatty acid oxidation in liver mitochondria of obese Zucker rats. AB - Obese Zucker rats were dosed orally for one week with fenofibrate (100 mg/kg). Liver weights of treated rats as expressed as percent of body weight were slightly increased, while protein, DNA and lipid contents were unaffected per g of liver or increased when expressed in whole liver. Compared with the control animals, activities of fatty acid oxidase, of the peroxisomal fatty acid oxidizing system and of catalase were markedly increased by fenofibrate both per g of liver and per total liver, while urate oxidase activity was unchanged when expressed per g of liver. The activity of monoamine oxidase and that of cytochrome c oxidase used as marker enzymes for mitochondria were increased only when expressed per total liver. However, fenofibrate treatment induced a pronounced increase in the activities of mitochondrial palmitoyl-CoA dehydrogenase and carnitine acyltransferases, particularly carnitine acetyltransferase. Fenofibrate also caused a significant increase of carnitine content in liver and hepatic mitochondria. The greatest observed increases were in free carnitine and in the rate of carnitine-dependent oleate oxidation, which might be favoured in vivo by a lesser sensitivity of CPT-I to a malonyl-CoA inhibitory effect. The present results suggest that fenofibrate treatment induces increased hepatic mitochondrial beta-oxidation in obese Zucker rats. PMID- 3663239 TI - Selectivity of serotonergic drugs for multiple brain serotonin receptors. Role of [3H]-4-bromo-2,5-dimethoxyphenylisopropylamine ([3H]DOB), a 5-HT2 agonist radioligand. AB - The affinities of putative serotonin receptor agonists and antagonists for 5 HT1A, 5-HT1B, 5-HT1C, and 5-HT2 receptors were assayed using radioligand binding assays. The 5-HT1 sites were labeled with the agonist radioligands [3H]-8-hydroxy 2-(di-n-propylamino)-tetralin [3H]-8-OH-DPAT, [3H]-5-HT, and [3H]mesulergine. The 5-HT2 receptor was labeled with the antagonist radioligand [3H]ketanserin or the agonist radioligand [3H]-4-bromo-2,5-dimethoxyphenylisopropylamine ([3H]DOB). The apparent 5-HT1 receptor selectivity of agonist compounds was found to be 50- to 100-fold higher when the 5-HT2 receptor affinity was determined using the antagonist radioligand [3H]ketanserin than when the agonist radioligand [3H]DOB was used. Quipazine, a putative specific 5-HT2 agonist, appeared to be only 3 fold more potent at 5-HT2 than at 5-HT1A receptors when [3H]ketanserin was used as the 5-HT2 radioligand. When [3H]DOB was used as the 5-HT2 radioligand, quipazine was determined to be 100-fold more potent at 5-HT2 receptors than at 5 HT1A receptors. 1-(3-trifluoromethylphenyl)piperazine (TFMPP), a putative specific 5-HT1B receptor agonist was apparently 10-fold more potent at 5-HT1B receptors than at 5-HT2 receptors when [3H]ketanserin was used as the 5-HT2 radioligand. When [3H]DOB was used as the 5-HT2 radioligand, TFMPP was found to be equipotent at 5-HT1B and 5-HT2 receptors. Using the 5-HT2 antagonist radioligand [3H]ketanserin, a similar pattern of underestimating 5-HT2 receptor selectivity and/or overestimating 5-HT1A or 5-HT1B receptor selectivity was observed for a series of serotonin receptor agonists. Antagonist receptor selectivity was not affected significantly by the nature of the 5-HT2 receptor assay used. These data indicate that, by using an antagonist radioligand to label 5-HT2 receptors and agonist radioligands to label 5-HT1 receptors, the 5-HT1 receptor selectivity may be overestimated. This may be an especially severe problem in serotonin drug development as drugs that interact potently with 5-HT2 receptors have been reported to be psychoactive and/or hallucinogenic. PMID- 3663240 TI - Fatty acid acylation of mucin by gastric mucosa: effects of sofalcone and sucralfate. AB - The effects of antiulcer drugs, sofalcone and sucralfate, on the activity of gastric mucosal mucus glycoprotein fatty acyltransferase were investigated. The acyltransferase enzyme, contained in the detergent extracts of the microsomal fraction of rat gastric mucosa, was incubated with the deacylated gastric mucin and palmitoyl-CoA substrates in the presence and absence of drugs, and the formed fatty acid acylated glycoprotein product was quantitated. In the absence of drugs, the enzymatic activity increased proportionally with increased concentrations of both substrates and of enzyme, and gave an apparent Km value of 5.6 X 10(-7) M. Introduction of sofalcone to the reaction mixtures led to an enhancement in the rate of mucus glycoprotein acylation. The rate of enhancement was proportional to sofalcone concentration up to 1.0 X 10(-5) M, with an apparent Km value of 3.7 X 10(-7) M. In contrast to sofalcone, the acyltransferase activity was inhibited by sucralfate. The rate of inhibition of mucus glycoprotein acylation by sucralfate was of the competitive type and at 1.0 X 10(-4) M reached a value of 25%. The apparent KI value calculated from the double-reciprocal plots for sucralfate was 9.1 X 10(-7) M. As the acylation of mucin with fatty acids plays an important role in the maintenance of gastric mucosal integrity, the results suggest that stimulation of the fatty acyltransferase enzyme by sofalcone may be one of the beneficial effects of this drug towards ulcer healing. PMID- 3663241 TI - Increased sensitivity of the microsomal oxidation of ethanol to inhibition by pyrazole and 4-methylpyrazole after chronic ethanol treatment. AB - Pyrazole and 4-methylpyrazole, inhibitors of the oxidation of ethanol by alcohol dehydrogenase, also inhibit microsomal metabolism of ethanol. The inhibitory effectiveness of these agents was increased in microsomes isolated from rats treated chronically with ethanol as compared to microsomes from pair-fed controls or from rats treated with other cytochrome P-450 inducers such as phenobarbital or 3-methylcholanthrene. Pyrazole and 4-methylpyrazole produced type II binding spectra with all the microsomal preparations. However, there was an increased affinity (lower Ks value) for these agents by the microsomes from the ethanol-fed rats. A correlation between Ks values and inhibitory effectiveness against ethanol oxidation by the various microsomal preparations could be observed. This suggests that an increase in affinity, which may reflect the induction of an alcohol-preferring isozyme of cytochrome P-450, is responsible for the increased inhibitory effectiveness of pyrazole and 4-methylpyrazole towards ethanol oxidation by microsomes after chronic ethanol treatment. One difference between pyrazole and 4-methylpyrazole was the increased affinity and inhibitory effectiveness of the latter but not the former with microsomes from rats treated with 3-methylcholanthrene. This could be due to the ability of 4-methylpyrazole, compared to pyrazole, to interact with and induce several isozymes of cytochrome P-450. Pyrazole and 4-methylpyrazole are often utilized to evaluate ethanol metabolism by alcohol-dehydrogenase-dependent and -independent pathways. However, the sensitivity of microsomal ethanol oxidation to inhibition by these agents, especially after chronic ethanol treatment, would suggest that their use in this regard is complex and could tend to underestimate the contribution of the microsomal pathway towards the metabolic tolerance found after ethanol treatment. PMID- 3663242 TI - DNA damage induced by reduced nitroimidazole drugs. AB - Five nitroimidazole drugs were reduced electrolytically and by gamma-radiolysis at fast (300 mumoles or 100% per hr) and slow (3-9 mumoles or 1-3% per hr) reduction rates in the presence of Escherichia coli DNA and single stranded or double stranded DNA from the bacteriophage phi X174. The degree of DNA damage depends upon the rate of drug reduction, where slow reduction produces more damage than fast reduction. The efficiency of damage produced is in the order metronidazole greater than ornidazole greater than azomycin greater than misonidazole greater than benznidazole which reveals a linear correlation between the one-electron reduction potential (E17) and the negative logarithm of the concentration of reduced drug at which 37% of the original DNA activity remains. Damage is not influenced by the presence of O2 at least between about 1-100 ppm. We suggest the protonated one-electron nitro radical anion as a possible candidate for the active damaging species and explain the basis of the relative cytotoxicity of these drugs under conditions of hypoxia. PMID- 3663243 TI - Role of aldehyde dehydrogenase activity in cyclophosphamide metabolism in rat hepatoma cell lines. PMID- 3663244 TI - In vivo selection of a low spin form of cytochrome P-448 from 3 methylcholanthrene-induced rat cytochrome P-450 isozymes by carbon tetrachloride. PMID- 3663245 TI - In vitro conversion of pyrazinamide into 5-hydroxypyrazinamide and that of pyrazinoic acid into 5-hydroxypyrazinoic acid by xanthine oxidase from human liver. PMID- 3663246 TI - Barbiturate-induced inhibition of rat brain histamine turnover. PMID- 3663247 TI - Calcium cyclotron resonance and diatom mobility. AB - The hypothesis that movement of biological ions may be predicted by cyclotron resonance theory applied to cell membranes is tested in these experiments. Diatoms (Amphora coffeaeformis) were chosen as the biosystem since they move or don't move, depending on how much calcium is transported across the membrane. The experiments demonstrate that a particular ion (calcium) is apparently moved across the cell membrane in response to the DC and AC values of magnetic flux densities (B) and the frequency derived from the cyclotron resonance theory. A clear resonance is shown and a rather sharp frequency response curve is demonstrated. The experiments also show a dose response as the AC value of the flux density is varied, and that odd harmonics of the basic cyclotron frequency are also effective. PMID- 3663248 TI - Developmental studies of Hanford miniature swine exposed to 60-Hz electric fields. AB - Evaluations of reproductive and developmental toxicology, including teratology, were included as part of a broad screening study in Hanford Miniature swine (HMS) to detect effects of exposure to electric fields. One group (E) was exposed to a uniform, vertical, 60-Hz, 30-kV/m electric field for 20 h/day, 7 days/week; sham exposed (SE) swine were housed in a separate, environmentally equivalent building. The first generation (F0) gilts were bred after 4 months of study; some were killed for teratologic assays at 100 days of gestation (dg), and the others produced an F1 generation of offspring. The pooled incidence of terata in these litters (teratologic assays and live births) was similar in the E and SE groups. The F0 females, which produced the F1 generation, were bred again after 18 months of exposure and were killed at 100 dg. Malformation incidence in E litters (75%) was significantly greater than in SE litters (29%). No consistent differences in litter size, fetal mass, or mass of fetal organs were detected. The F1 gilts were bred at 18 months of age; defective offspring were found in significantly more of the E litters (71%) than in SE litters (33%). These F1 females were bred again 10 months later and teratologic assays were performed on their second litters at 100 dg. The percentage of litters with malformed fetuses was essentially identical in the E and SE groups (70% and 73%, respectively). There appears to be an association between chronic exposure to a strong electric field and developmental effects in swine, although the change in incidence of malformations between generations and between the first and second breedings makes it impossible to conclude unequivocally that there is a cause-and-effect relation. PMID- 3663249 TI - Reproduction and development in rats chronologically exposed to 60-Hz electric fields. AB - Previous studies have raised the possibility of reproductive and developmental changes in miniature swine chronically exposed to a strong 60-Hz electric field. Two replicate experiments on rats were performed to determine if similar changes could be detected in animals exposed under a comparable regime, which was based on average, induced-current densities and on the chronology of reproductive development, as dosimetrically and biologically scaled. Beginning at three months of age, female rats of the F0 generation and their subsequent offspring were chronically exposed to a 60-Hz electric field (100 kV/m unperturbed) for 19 h/day for the duration of experimentation. After four weeks of exposure, F0 female rats were mated to unexposed male rats during the field-off period. No significant developmental effects were detected in their litters, confirming our previous results with swine and rats. The F0 females were mated for a second time at 7.2 months of age, and the fetuses were evaluated shortly before term. In the first experiments, the incidence of intrauterine mortality was significantly less in exposed than in sham-exposed litters, and there was a tendency (P = .12) for an increased incidence of malformed fetuses in exposed litters. Neither end point was significantly affected in the second experiment. Copulatory behavior of the female F1 offspring, which were bred at three months of age, was not affected in either experiment. There was a statistically significant decrease in the fertility of F1 exposed females and a significant increase in the fraction of exposed litters with malformed fetuses in the first experiment; both end points were essentially the same in the sham and exposed groups of the second experiment. That the significant effects detected in the first experiment were not seen in the second may be attributed to random or biological variation. Alternatively, the finding may indicate that the response threshold for induction of malformations lies near 100 kV/m. PMID- 3663250 TI - Thermoregulatory responses of the immature rat following repeated postnatal exposures to 2,450-MHz microwaves. AB - This study was designed to determine the changes that occur in the thermoregulatory ability of the immature rat repeatedly exposed to low-level microwave radiation. Beginning at 6-7 days of age, previously untreated rats were exposed to 2,450-MHz continuous-wave microwaves at a power density of 5 mW/cm2 for 10 days (4 h/day). Microwave and sham (control) exposures were conducted at ambient temperatures (Ta) which represent different levels of cold stress for the immature rat (ie, "exposure" Ta = 20 and 30 degrees C). Physiological tests were conducted at 5-6 and 16-17 days of age, in the absence of microwaves, to determine pre- and postexposure responses, respectively. Measurements of metabolic rate, colonic temperature, and tail skin temperature were made at "test" Ta = 25.0, 30.0, 32.5, and 35.0 degrees C. Mean growth rates were lower for rats exposed to Ta = 20 degrees C than for those exposed to Ta = 30 degrees C, but microwave exposure exerted no effect at either exposure Ta. Metabolic rates and body temperatures of all exposure groups were similar to values for untreated animals at test Ta of 32.5 degrees C and 35.0 degrees C. Colonic temperatures of rats repeatedly exposed to sham or microwave conditions at exposure Ta = 20 degrees C or to sham conditions at exposure Ta = 30 degrees C were approximately 1 degrees C below the level for untreated animals at test Ta of 25.0 degrees C and 30.0 degrees C. However, when the exposure Ta was warmer, rats exhibited a higher colonic temperature at these cold test Ta, indicating that the effectiveness of low-level microwave treatment to alter thermoregulatory responses depends on the magnitude of the cold stress. PMID- 3663251 TI - Effects of microwave exposure and temperature on survival of mice infected with Streptococcus pneumoniae. AB - Female CD-1 mice were injected with an LD50 dose of Streptococcus pneumoniae and then exposed to 2.45 GHz (CW) microwave radiation at an incident power density of 10 mW/cm2 (SAR = 6.8 W/kg), 4 h/d for 5 d at ambient temperatures of 19 degrees C, 22 degrees C, 25 degrees C, 28 degrees C, 31 degrees C, 34 degrees C, 37 degrees C and 40 degrees C. Four groups of 25 animals were exposed at each temperature with an equal number of animals concurrently sham-exposed. Survival was observed for a 10-d period after infection. Survival of the sham-exposed animals increased as ambient temperature increased from 19 degrees C-34 degrees C. At ambient temperatures at or above 37 degrees C the heat induced in the body exceeded the thermoregulatory capacity of the animals and deaths from hyperthermia occurred. Survival of the microwave-exposed animals was significantly greater than the shams (approximately 20%) at each ambient temperature below 34 degrees C. Based on an analysis of the data it appears that the hyperthermia induced by microwave exposure may be more effective in increasing survival in infected mice than hyperthermia produced by conventional methods (ie, high ambient temperature). Microwave radiation may be beneficial to infected animals at low and moderate ambient temperatures, but it is detrimental when combined with high ambient temperatures. PMID- 3663252 TI - Detection of 60-hertz vertical electric fields by rats. AB - Rats were trained to press levers to indicate the presence or absence of 60-Hz vertical electric fields at intensities from 0 to 27 kV/m (rms). The probability of detecting the field increased as the strength of the field increased. The shape of the detection curve (psychometric function) for most subjects (Ss) was similar whether the discriminative stimulus was the electric field or a tone. Two protocols were used to estimate the minimum field intensity necessary to detect the field (Reiz Limen, RL). The RL was estimated to be 13.3 kV/m (rms) when using one protocol (the staircase method) and 7.9 kV/m (rms) when using another protocol (the method of constant stimuli). PMID- 3663253 TI - Thromboangiitis obliterans (Buerger's disease) and smokeless tobacco. AB - Thromboangiitis obliterans, a distinct clinical and pathologic entity characterized by segmental inflammatory and proliferative lesions of the tunica media of small arteries and veins, has been reported frequently in men who have a history of heavy cigarette smoking. We report a case of thromboangiitis obliterans in a 38-year-old man that was clearly associated with the use of smokeless (chewing) tobacco. In addition to a physical history and examination and laboratory evaluation, a biopsy of the skin and deep subcutaneous tissue of the patient's left thigh was performed, and this revealed occlusion of 2 large dermal blood vessels by a highly organized thrombus. A regimen of nifedipine and antiplatelet therapy, plus complete abstinence from tobacco, resulted in resolution of the patient's symptoms and pain. Our findings may be of particular importance in view of the increasing popularity of smokeless tobacco and the complications which may result from its use. PMID- 3663254 TI - Felty's syndrome: long-term followup after treatment with auranofin. AB - Five patients who had Felty's syndrome were treated with auranofin, 6 mg/day, for a period that ranged from 4 months to 2 years. All patients experienced both an improvement in articular symptoms and a normalization of the leukocyte count. Auranofin appears to be an effective treatment for Felty's syndrome, and to have a lower degree of toxicity than parenteral gold. PMID- 3663255 TI - Systemic lupus erythematosus with Jaccoud's arthropathy mimicking juvenile rheumatoid arthritis. AB - We describe a girl who presented at age 5 with objective signs of arthritis and was initially diagnosed as having juvenile rheumatoid arthritis. Over the following years, she developed slowly progressive joint deformities indicative of Jaccoud's arthropathy. When she was 11 years old, symptoms typical of systemic lupus erythematosus appeared, accompanied by anti-DNA antibodies. This case illustrates that in children also, Jaccoud's arthropathy may be a precocious manifestation of systemic lupus erythematosus. PMID- 3663256 TI - Sickle cell crisis following intraarticular steroid therapy for rheumatoid arthritis. AB - We describe 2 patients who had coexistent rheumatoid arthritis and sickle cell disease. Both patients developed sickle cell crises following intraarticular injection of corticosteroids to control their arthritis. The mechanism of this phenomenon is not clear, but it is suggested that intraarticular steroids be used with caution in patients with sickle cell disease. PMID- 3663257 TI - Concomitant rheumatoid arthritis and Marfan's syndrome. PMID- 3663258 TI - Acetylator phenotype in patients with systemic lupus erythematosus. PMID- 3663259 TI - Arthritis and non-antibiotic-associated pseudomembranous colitis. PMID- 3663260 TI - Pedal gangrene caused by giant cell arteritis. PMID- 3663261 TI - Human immunodeficiency virus antibodies and systemic vasculitis. PMID- 3663263 TI - Effects of dietary supplementation with marine fish oil on leukocyte lipid mediator generation and function in rheumatoid arthritis. AB - Twelve patients with active rheumatoid arthritis supplemented their usual diet with 20 gm of Max-EPA fish oil, daily, for 6 weeks. Following this supplementation, the ratio of arachidonic acid to eicosapentaenoic acid in the patients' neutrophil cellular lipids decreased from 81:1 to 2.7:1, and the mean generation of leukotriene B4 (with calcium ionophore stimulation) significantly declined by 33%. The mean neutrophil chemotaxis to both leukotriene B4 and FMLP significantly increased toward the normal range at week 6. The generation of 5 lipoxygenase products by calcium ionophore-stimulated monocytes was not significantly suppressed, but a significant decline (37%) in platelet-activating factor generation was noted at week 6. The modulation of these measures of leukocyte inflammatory potential suggests that fish oil supplementation may have an antiinflammatory effect. PMID- 3663264 TI - Restricted heterogeneity of polyclonal rheumatoid factors. AB - The electrophoretic pattern of rheumatoid factor (RF) was investigated in 40 polyclonal sera, by using radiolabeled IgG. Thirty sera specifically bound IgG aggregates, correlating with their RF titer. The binding pattern was monoclonal or oligoclonal. The molecules responsible were classic RF antibodies, as shown by using purified IgM, inhibition experiments, and by the optimal size of aggregates (2,000-4,000 kd). These data show that RF heterogeneity is restricted in polyclonal sera, and this can have a bearing on several mechanisms. PMID- 3663265 TI - Effects of some cardiotonic agents on contractility of skinned fibers from mammalian heart. AB - Nine cardiotonics of different chemical structure were investigated on their ability to influence calcium-induced isometric contractions of chemically skinned porcine myocardial fibers. It was found that at a concentration of 10(-4) mol/l amrinone, enoximone, imazodan, milrinone, piperanometozine and piroximone were without effect on calcium-induced tension development of skinned fibers. 3-Amino 6-methyl-5-phenyl-2(1H)-pyridinone (APP), pimobendan and sulmazole enhanced the isometric contractions induced by 0.66 mumol/l Ca++ concentration-dependently. The intrinsic activity of pimobendan was much higher than for sulmazole or APP. Comparing equieffective concentrations inducing 35% additional tension development, the rank order of potency was: pimobendan greater than APP greater than sulmazole. PMID- 3663262 TI - Cartilage proteoglycans in synovial fluid and serum in patients with inflammatory joint disease. Relation to systemic treatment. AB - Proteoglycan concentrations in knee joint synovial fluid and in serum from patients with various inflammatory arthritides were studied using an enzyme linked immunosorbent assay. Patients with reactive arthritis, calcium pyrophosphate arthropathy, and juvenile rheumatoid arthritis (age less than or equal to 20 years) had the highest synovial fluid concentrations. These values differed significantly (P less than 0.001) from those in patients with rheumatoid arthritis, psoriatic arthropathy, and chronic HLA-B27-associated arthropathy. Rheumatoid arthritis patients receiving low-dose prednisolone treatment had higher synovial fluid (P = 0.006) and serum (P less than 0.001) proteoglycan concentrations than did those taking nonsteroidal antiinflammatory drugs or slow acting antirheumatic drugs. Serum proteoglycan concentrations were near the detection limits, and did not correlate with levels found in paired samples of knee joint synovial fluid. Patients with calcium pyrophosphate arthropathy had the highest mean serum level of proteoglycan. This assay of proteoglycan antigens is a useful tool in the study of proteoglycan metabolism in patients with joint disease. With its use, differences between disease groups and effects of therapy can be distinguished. PMID- 3663266 TI - Experimental studies on pharmacology, metabolism and toxicology with tiadenol disulfoxide. Dissociation of lipid lowering effects and the induction of peroxisomal and microsomal drug-metabolizing enzymes. AB - The hypolipidemic activity of tiadenol-disulfoxide, the major metabolite of 1,10 bis(hydroxyethylthio)decane (tiadenol, Eulip) in man and in the rat was assessed in various experimental models versus the corresponding activity of tiadenol. Tiadenol-disulfoxide in the normolipidemic rats lowers total serum cholesterol and serum and liver triglycerides in an extent comparable to that of the reference compound. Likewise, it is equally effective as tiadenol in preventing Triton-induced hyperlipidemia and Nath diet induced hypercholesterolemia; in addition tiadenol-disulfoxide is slightly more effective than tiadenol in increasing HDL-cholesterol in hypercholesterolemic rats. At hypolipidemic doses the compound causes no hepatomegaly, no induction of peroxisomal catalase and palmitoyl-CoA oxidase activities, no smooth endoplasmic reticulum proliferation and no induction of microsomal cytochrome P-450 and of cytochrome P-450 dependent enzyme activities: aminopyrine (aminophenazone) N-demethylase, aniline hydroxylase, zoxazolamine hydroxylase and hexobarbital oxidase. At the suprapharmacological dose of 300 mg/kg tiadenol-disulfoxide, if compared to the reference compound, shows a generally lower order of toxicity on these hepatic parameters. Orally administered tiadenol-disulfoxide is well absorbed by the gastrointestinal tract and is eliminated in urine at 45% of the dose in unchanged form, and the remaining being: glucuron-conjugated tiadenol-disulfoxide (10%), S oxidized metabolites (15%) and sulfoxidized carboxylic metabolites (15%). The compound is well tolerated both in mice and rats. The results of this comparative study demonstrate that: 1. tiadenol-disulfoxide is a substance with promising hypolipidemic properties; 2. tiadenol-disulfoxide is largely responsible for the hypolipidemic activity of tiadenol; 3. hepatomegaly consequent to tiadenol administration is the consequence of the response of the liver cell to the increased functional demand of the mixed function oxidase (MFO) system involved in the metabolism of the drug; 4. peroxisomal enzyme activities induction observed with both drugs at non-pharmacological doses does not play any role in their hypolipidemic action and is not associated with hepatomegaly. PMID- 3663267 TI - Plasma levels of proglumetacin and its metabolites after intravenous or oral administration in the dog. AB - The absolute bioavailability of 1H-indole-3-acetic acid, 1-(4-chlorobenzoyl)-5 methoxy-2-methyl 2-[4-[4-[[4-(benzoylamino)-1,5-dioxopentyl]oxy]propyl]-1- piperazinyl]-ethyl ester (+/-) (proglumetacin, CR 604) was studied in 12 dogs, in a triple cross-over experiment with single doses of i.v. proglumetacin diphosphate, oral proglumetacin diphosphate or oral proglumetacin dimaleate. Determined were proglumetacin, 2'-[4-(3-hydroxypropyl)-piperazin-1-yl]-ethyl-(1-p chlorobenzoyl-5-methoxy-2-methylindol-3-yl)-acetic acid (CR 1015), indometacin and proglumide in plasma. Proglumetacin and CR 1015 were found in plasma only after the i.v. administration. Conversely indometacin and proglumide were found after all administration routes. The areas under the curve of indometacin and of proglumide did not differ significantly after the three treatments, as shown by the analysis of variance. PMID- 3663268 TI - Pharmacological characterisation of a new potent and specific nonpolypeptidic cholecystokinin antagonist. AB - D,L-4-(3,4-Dichloro-benzoylamino)-5-(N-3-methoxypropyl- pentylamino)-5-oxo pentanoic acid (CR 1505) belongs to a newly discovered class of agents with cholecystokinin (CCK) antagonistic activity. CR 1505 displaces CCK-8 from the central CCK receptors at concentrations of 9.1 mumol/l, and from the peripheral CCK receptors at concentrations of 0.33 mumol/l. CR 1505 antagonizes in vitro the contractant effects of CCK-8 on gall bladder strips of the guinea pig at 0.79 mumol/l and those on the small intestine at 1.6 mumol/l. These antagonistic effects are dose dependent and of competitive type. The antagonistic activities of CR 1505 against contractions of smooth muscles elicited by CCK-8 are at least 1000 times more potent than those against the contractions elicited by acetylcholine, BaCl2, histamine, serotonin, Substance P, bradykinin or dimethylphenylpiperazine. CR 1505 is also practically ineffective against the contractions of the small intestine of the guinea pig elicited by electrical field stimulations either as "cholinergic twich" (0.05 Hz), or as "cholinergic contractions" (trains of 10 min at 1 Hz), or as "non-cholinergic contractions" (200 impulses at 5 Hz in presence of atropine). CR 1505 is therefore a potent, specific, competitive and reversible CCK antagonist. PMID- 3663269 TI - Pharmacological actions and acute toxicity of methyl- and phenyl-3-methoxy-4 hydroxy styryl ketones. AB - Some pharmacological actions and acute toxicity effects of methyl- and phenyl-3 methoxy-4-hydroxy styryl ketones have been described in experimental animals. The compounds antagonised the contractions evoked by a variety of agonists on several smooth muscle preparations in vitro. They produced inhibitory effects on spontaneously contracting uteri from pregnant rats and relaxant effects on pendular movements of rabbit duodenum and on dog intestinal movements in vivo. The compounds inhibited the castor oil induced diarrhoea in rat and propulsion of charcoal test meal in mice. Phenylbutazone showed similar effect on castor oil diarrhoea. The compounds failed to modify gestation period or parturition in pregnant rats. They antagonised bradykinin-induced bronchospasm in guinea pig. The compounds showed no significant effect on cardiovascular and respiratory systems: CNS and general behaviour were not affected even at high doses. Oral LD50 for both the compounds was greater than 2 g/kg. PMID- 3663270 TI - Bacterial pyrogens of different origin and pharmacokinetics of rifampicin. AB - Changes of pharmacokinetics of rifampicin (RFP, Rifadin were investigated on endotoxin pretreated still not ruminant calves. The animals served as their own controls and drug administration twice in a 1-week interval gave the same results. Endotoxin 0.02 micrograms kg-1 given intravenously 1 h prior to the oral administration of RFP (20 mg kg-1) induced considerable pharmacokinetic changes. The serum levels of the total drug were significantly lower after the endotoxin administration. The pharmacokinetic analysis revealed significant changes mainly in the distribution phase. When both toxin and drug were administered intravenously, the drug levels were higher. The results are discussed with reference to the pathophysiological endotoxin changes. After the toxin administration the bioavailability of oral RFP was 4-fold lower. PMID- 3663271 TI - [Absorption, distribution and metabolism of [14C]-levomenol in the skin]. AB - The purpose of the present investigations was to study the cutaneous absorption of sesquiterpenic alcohol, the major active principle of chamomile. For these investigations 14C-labelled levomenol ((-)-6-methyl-2-(4-methyl-3-cyclohexen-1 yl)-5-hepten-2-ol; (-)-alpha-bisabolol) was prepared by biochemical incorporation of [14C]-acetate into the molecule. 5 h after topical application of the radiolabelled substance onto nude mice half of the radioactivity was found in the skin. The other part was measured in tissue and organes. 90% of this radioactivity was analysed as intact levomenol. To demonstrate the distribution of the substance in the skin a part of this tissue was cutted into horizontal slices by a cryotome. From the slices autoradiograms were produced. The densitometric measuration showed that there was a fast penetration of levomenol into the skin. 5 h after the topical application the substance was displaced from outermost to innermost areas. From these results a fast cutaneous absorption and a long therapeutical effect of the antiphlogistic and spasmolytic levomenol in the skin can be expected. PMID- 3663272 TI - Serum concentrations of rutoside metabolites after oral administration of a rutoside formulation to humans. AB - In the present study a highly specific and sensitive method by gas chromatography mass spectrometry has been established for the determination of the blood levels of four metabolites of 5,7,3',4'-tetrahydroxyflavonol-3-rutinoside (rutoside, rutin), i.e. 3,4-dihydroxytoluene (DHT), 3-hydroxyphenylacetic acid (mPHAA), 3,4 dihydroxyphenylacetic acid (DHPAA), and 3-methoxy-4-hydroxyphenylacetic acid (homovanillic acid, HVA) after the oral administration of rutoside to healthy volunteers. By the established method the pharmacokinetics in the blood and the urinary excretion of those metabolites were investigated. Blood levels of DHT, mHPAA, DHPAA, and HVA started to increase at 4 to 8 h after the oral dosage of the rutoside formulation, Esberiven (further active ingredient: coumarin). At 8 to 12 h post-administration, blood levels reached a maximum level which was 2- to 3-fold the time 0 level. Blood levels decreased gradually afterwards and returned to the original level at 20 to 35 h. The sum of the four metabolites was at a maximum value at 8 h which then returned to the initial levels at 35 h yielding a half-life of 11 h. Total urinary excretion of metabolites was 50.5% of the dose in 48 h. PMID- 3663273 TI - Absolute bioavailability of metoclopramide given orally or by enema in patients with normal liver function or with cirrhosis of the liver. AB - Single dose studies were performed with three different dosage forms of metoclopramide (0.25 mg/kg body weight) in patients with normal liver function (i.v. (Paspertin): n = 4, oral liquid preparation: n = 4, rectal micro-enema n = 4) and patients with histologically confirmed cirrhosis of the liver (i.v.: n = 6, oral liquid preparation n = 4, rectal micro-enema: n = 8). Drug plasma concentrations were measured over 8 h by a specific gas chromatographic method. The median areas under the plasma concentration-time curves (AUC0-8) after i.v. and rectal administration were similar in both groups. In contrast, the median oral bioavailability was considerably higher in patients with cirrhosis of the liver (82%) than in patients with normal liver function (60%). It can be concluded from this study, that dosage adjustments may be necessary in oral treatment of patients with cirrhosis of the liver, especially if prolonged therapy is required. PMID- 3663274 TI - Bioavailability of amfepramone hydrochloride sustained release pellets formulation in healthy subjects. AB - The relative bioavailability and pharmacokinetic profile of two amfepramone (diethylpropion) hydrochloride oral preparations were evaluated in 12 normal volunteers using a newly developed gas-liquid chromatographic procedure to monitor the unchanged drug and its two major metabolites in urine, plasma and saliva. The sustained release pellets formulation (Regenon retard) provided excellent bioavailability and gave broad plateau levels extending over 6 to 8 h after administration, which were intermediate between the "peaks and troughs" shown by the same total dose of the free drug in three equal portions at 4-h intervals. PMID- 3663275 TI - Rapid procedure for the detection of hepatitis delta virus RNA in sera of HBsAg positive and anti-delta-positive patients. AB - A synthetic oligonucleotide duplex of 78 bp corresponding to part of the recently published RNA sequence of hepatitis Delta virus (HDV) was cloned into the plasmid pSBO1 and used for the detection of HDV RNA in sera of patients with chronic HDV infection by molecular hybridization. RNA containing the 78 bp sequence was synthesized in vitro and used as a positive control. For this purpose, a fragment containing the cloned oligonucleotide was transferred into the plasmid pSPT 18. HDV RNA was present in 5 out of 32 hepatitis B surface antigen (HBsAg)- and anti HD-positive patients. It was neither found in the sera of 19 HBsAg-positive, anti HD-negative patients, nor in the sera of 26 patients with chronic liver disease negative for both HBsAg and anti-HD. The method appears to be suitable for the detection of viruses of which either only parts of the genome or the entire sequence is known. PMID- 3663276 TI - Profiling applications in audiological supervision. PMID- 3663277 TI - Digital hearing aids. PMID- 3663278 TI - On the evaluation of hearing aid performance. PMID- 3663279 TI - Occupational hearing conservation: neglected opportunities. PMID- 3663280 TI - The Ann Arbor decision in retrospect. PMID- 3663281 TI - Hepatitis B viral infection: issues in nursing practice (continuing education credit). PMID- 3663282 TI - Hepatitis outbreak! Quick response is essential. PMID- 3663283 TI - Traditional and modern medicine in worker health care. PMID- 3663285 TI - Smell and taste disorders. PMID- 3663284 TI - Ethical considerations in research. PMID- 3663286 TI - Prehospital use of heparin locks: a cost-effective method for intravenous access. AB - Intravenous (IV) infusions were ordered in nearly 95% of paramedic runs called into a busy base station hospital. Most of the patients received IV lines for either prophylactic access or administration of single or multiple bolus medications. In this group of patients, the application of a heparin lock injection port directly to the IV catheter, followed by the injection of 10 units of heparin, was evaluated. Of 102 consecutive patients treated in the field, 98 (97%) were treated with heparin locks only. The total number of patients requiring an IV infusion drip (either by paramedics or in the emergency department of the receiving hospital) was 20 (20%). If all 102 patients had received conventional IV drip infusions, the total patient equipment charges would have been $4,610.40. The actual charges for all patients in this series, either with heparin locks or IV infusion sets, was $1,846.14--a 60% savings. The results of the study indicate that the heparin lock is a safe, convenient, and cost-effective method for maintaining IV access in the prehospital environment. PMID- 3663287 TI - Naloxone does not improve hemodynamics following graded hemorrhage in a canine model. AB - Two recent studies have demonstrated no improvement in hemodynamic parameters or survival following naloxone administration in hemorrhagic shock. This finding is in contrast to those of earlier studies, which consistently demonstrated a beneficial effect. The current study evaluated naloxone's ability to improve hemodynamics when administered following a fixed-volume hemorrhage, during a period of partial hemodynamic compensation. Thirteen conditioned beagles were anesthetized with pentobarbital (25 mg/kg intravenously), endotracheally intubated, and instrumented with a femoral arterial line and a pulmonary artery thermodilution catheter. Animals were then subjected to an estimated 50% graded hemorrhage (45 ml/kg) over one hour. Following hemorrhage, animals were observed for 90 minutes, then reinfused with shed blood over 30 minutes, and finally observed for an additional 60 minutes. Six animals received naloxone (2 mg/kg intravenously) 30 minutes after completion of hemorrhage and then 2 mg/kg/hr for the duration of the study. Seven control animals received an equivalent volume of saline. Heart rate, mean arterial pressure, central venous pressure, cardiac output, arterial and mixed venous blood gases, and serum lactate level were measured at regular intervals throughout the study. Cardiac index and systemic vascular resistance index were calculated at the same intervals. Overall, there were no statistically significant differences in the mean data values for mean arterial pressure, cardiac index, systemic vascular resistance index, or lactate, although lactate values were consistently higher in the naloxone group (two tailed independent Student's t test). We conclude that naloxone does not significantly improve hemodynamics when administered after a fixed-volume hemorrhage. PMID- 3663288 TI - The effect of activated charcoal on N-acetylcysteine absorption in normal subjects. AB - The discovery of the effectiveness of oral antidotes such as N-acetylcysteine (NAC) for acetaminophen poisonings has raised questions about the appropriateness of concomitant administration with activated charcoal. A number of studies have attempted to clarify this question without complete success. This study was designed to evaluate the difference in serum levels of NAC when given with activated charcoal. Nineteen patients completed a two-phase cross-over study in which they served as their own controls. Each subject in phase 1 received 140 mg/kg of diluted, chilled NAC orally, and venous blood samples were drawn for analysis. Phase 2 consisted of a 100-g dose of activated charcoal followed by NAC. Samples were transported immediately and assayed using spectrophotometry. A reduction in peak NAC level of 29% (P less than .02) and a reduction of total area under the curve (AUC) of 39% (P less than .001) was noted. Although it may be preferable to avoid completely the use of activated charcoal when using NAC to treat overdoses of acetaminophen, we recommend that if these agents are used together, doses of NAC be increased by 40% to compensate for the decreased oral absorption of NAC. PMID- 3663289 TI - Clinical diagnosis of bacterial vaginosis. AB - Bacterial vaginosis (often called nonspecific vaginitis or gardnerella vaginitis) is an incompletely understood disease whose initial diagnosis is often one of exclusion made when no trichomonads, yeast, or evidence of cervicitis is found during the initial examination of a woman complaining of a vaginal discharge. To increase the accuracy of the initial diagnosis, specific criteria were used before the clinical diagnosis of bacterial vaginosis was made. The presence of three of the following four criteria was necessary: 1) vaginal pH greater than 4.5; 2) clue cells on the saline wet mount; 3) thin, homogeneous-appearing discharge; or 4) positive potassium hydroxide "whiff test." A study on 100 consecutive women presenting to the emergency department with vaginal symptoms was done. Of those women meeting the criteria, 93% (54/58) obtained relief of their symptoms by treatment with metronidazole. Of those women not meeting the criteria, only 24% (10/42) were cured (P less than .001). The sensitivity, specificity, and total error rates of these criteria were 84, 89, and 14%, respectively. PMID- 3663290 TI - Poor tolerance of oral activated charcoal with theophylline overdose. AB - Vomiting is a common manifestation of theophylline toxicity and may limit the tolerance of orally administered activated charcoal (OAC). However, this potentially important interaction has received little attention. The records of 33 consecutive patients who presented to the emergency department with serum theophylline concentrations greater than 30 micrograms/ml and toxic symptoms and who were treated with OAC were reviewed. Seventeen (22%) of the 76 OAC doses were vomited. Six patients who had ingested theophylline as a single acute overdose vomited all 11 OAC doses administered, whereas 27 patients receiving chronic theophylline therapy vomited only six (11%) of 65 OAC doses. Vomited doses were associated with higher serum theophylline concentrations. Although theophylline related vomiting preceded OAC intolerance in all acute toxicity patients, this condition was not predictive of OAC vomiting for chronic toxicity patients. PMID- 3663291 TI - The intra-aortic balloon pump as an adjunctive therapy for severe myocardial contusion. AB - The management of patients with post-traumatic myocardial contusion requires close electrocardiographic and hemodynamic monitoring. When complications such as cardiogenic shock occur, aggressive treatment using Swan-Ganz catheterization for monitoring of intravascular volume and cardiac inotropic support are necessary. Failure to restore hemodynamic stability using these measures is an indication for the use of intra-aortic balloon pump counterpulsation. A case of successful management of a patient with post-traumatic myocardial contusion complicated by refractory cardiogenic shock using intra-aortic balloon pump counterpulsation is presented. Use of the intra-aortic balloon pump improved cardiac output, eventually resulting in hemodynamic stabilization. PMID- 3663292 TI - Fatal digoxin poisoning: an unsuccessful resuscitation with use of digoxin-immune Fab. AB - A 1-month-old infant suffered cardiac arrest shortly after presentation to the emergency department. The child had a history of heart disease treated with digoxin. The infant died despite intensive resuscitative efforts, including the use of digoxin-specific Fab antibodies. A brief discussion of this case and the use of digoxin-specific antibodies is presented. PMID- 3663293 TI - Subphrenic abscess: a pulmonary presentation. AB - A patient with subphrenic abscess can present with pulmonary or abdominal symptoms because of the location of the abscess adjacent to the diaphragm. This thoracoabdominal clinical complex has been described previously and, if chest symptoms predominate, may obscure the diagnosis of subphrenic abscess. The case of a patient with occult abdominal pathology who presented with respiratory complaints is discussed. PMID- 3663294 TI - Emergency department lumbar puncture: clinical application and utility of laboratory testing. AB - Lumbar puncture is an emergency department procedure for evaluating patients with suspected central nervous system infection or hemorrhage. To determine whether extensive testing of cerebrospinal fluid (CSF) obtained from emergency department patients was useful, charts of 104 adult patients who underwent lumbar puncture in a university hospital emergency department were reviewed. Examination of the CSF disclosed pleocytosis in 25 (24%) of the patients; the presence of red blood cells was considered to be clinically significant in two patients. An abnormal level of CSF protein was present in 62% of patients, and abnormal levels of glucose in 32%. Fungal element testing was negative each of the 72 times it was performed; Gram stain disclosed a bacterial pathogen in one patient. Cultures for fungus and tuberculosis were uniformly negative, as were all immunologic tests. Bacterial cultures grew a pathogen in one patient. No patient with a normal neurologic examination and normal initial CSF analysis was diagnosed subsequently as having acute central nervous system disease. The preponderance of negative or normal results of testing of CSF suggests that extensive testing may not be necessary for all patients. Limitation of sophisticated testing to only those samples with abnormal cell counts or chemistries or from patients at high risk should result in substantial cost saving without compromising patient care. PMID- 3663295 TI - Obtundation in the elderly patient: presentation of a drug overdose. AB - The case of an obtunded elderly woman is presented. The patient initially was thought to have suffered a cardiovascular accident but was discovered to have taken an overdose of flurazepam hydrochloride. Depression is a common and under recognized problem in the geriatric population. As a consequence, suicide rates are highest in the elderly. Over- and underdosing of both prescription and nonprescription drugs are common means available to the suicidal elderly patient. These overdoses are often attributed to unintentional patient errors and overlooked for what they are, attempted suicides, or they are missed entirely as a cause of the patient's presentation. This case illustrates the need to consider drug overdose in the obtunded elderly patient. PMID- 3663296 TI - Lithium intoxication: manifestations and management. AB - The clinical diagnosis of lithium intoxication can be elusive because of the slow onset and diversity of toxic manifestations. Mental status and neurologic symptoms often predominate. After the diagnosis is made, management depends on the clinical presentation and serum lithium level. Hemodialysis is the treatment of choice for severe lithium intoxication. Two cases of lithium intoxication are presented that demonstrate that predisposing factors and drug interactions play major roles. A review is given of the pathophysiology, presenting signs, symptoms, and approaches to treatment of lithium intoxication. PMID- 3663297 TI - New York moves into the present with emergency medicine. PMID- 3663298 TI - New York moves out from medieval emergency medicine. PMID- 3663299 TI - Adolescent suicide: sensationalism and sensitivity. PMID- 3663300 TI - Terminating unsuccessful advanced cardiac life support in the field. PMID- 3663301 TI - Housestaff management of pharyngitis in a university emergency department. PMID- 3663302 TI - The fetus ejection reflex. PMID- 3663303 TI - The fetus ejection reflex revisited. PMID- 3663304 TI - Minimizing harm and maximizing benefit during innovation in health care: controlled or uncontrolled experimentation? PMID- 3663305 TI - Does this work? We don't know, but it pays. PMID- 3663306 TI - How to find out if assuming the knee-chest position is superior to external cephalic version in turning the breech. Commentary. PMID- 3663307 TI - Cephalic version and ethnicity. Commentary. PMID- 3663308 TI - Nurses' responses to changes in maternity care, Part I. Family-centered changes and short hospitalization. PMID- 3663309 TI - Nurses' responses to changes in maternity care, Part II. Technologic revolution, legal climate, and economic changes. PMID- 3663310 TI - Mothers' beginning relationship with twins. PMID- 3663311 TI - A comparison of women's expectations of labor with the actual event. PMID- 3663312 TI - Evaluation of the prognostic value of morphometric features and cellular DNA content in FIGO I ovarian cancer patients. AB - Approximately 20% to 40% of the patients with a FIGO I ovarian tumor die within five years after the diagnosis. Morphologic studies (typing and grading) of the primary tumor are prognostically important, but poorly reproducible. Therefore, the prognostic value of more objective techniques, such as morphometry and flow cytometric (FCM) DNA determinations, were evaluated in 33 adequately staged FIGO I patients with at least a five-year follow-up. The overall five-year survival in the group was 64%. Three patient categories were defined on the basis of two easily measured morphometric features, the mitotic activity index (MAI) and the volume percentage epithelium (VPE), which an earlier study had proved to be significantly associated with prognosis. The five-year survival rates were 91% for 11 patients in category A (MAI less than 30 and VPE less than 65), 67% for 9 patients in category B (MAI less than 30 and VPE greater than or equal to 65) and 38% for 13 patients in category C (MAI greater than or equal to 30). FCM showed 25 of the tumors to be diploid and 8 to be aneuploid. The cellular DNA content was also of prognostic value: the five-year survival figures for patients with diploid and aneuploid tumors were 68% and 37%, respectively. Combination of the morphometric and FCM features showed that, in diploid tumors, the morphometric features have additional prognostic value: the diploid-tumor-patient survival rates in categories A, B and C were 91%, 63% and 50%, respectively. None of the eight patients with aneuploid tumors fell in the morphometrically favorable category A while seven were in category C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663313 TI - Diagnostic value of flow cytometric DNA determination combined with fine needle aspiration biopsy in thyroid tumors. AB - The nuclear DNA content and the numbers of cells in the S and G2M phases of the cell cycle were determined by flow cytometry (FCM) in fine needle aspirates of 187 thyroid tumors to evaluate the diagnostic value of nuclear DNA content determination in combination with aspiration cytology. DNA aneuploidy was present in 4 of 5 follicular carcinomas, 2 of 3 anaplastic carcinomas, 5 of 15 excised follicular adenomas and 2 of 20 excised adenomatous goiters; all 7 papillary carcinomas and 4 lymphomas were diploid in the aspirate. Aneuploid carcinomas had easily distinguishable S and/or G2M phases, unlike the benign aneuploid tumors. None of the histologically benign tumors or the nonexcised tumors had greater than 6% S-phase cells, and only one benign tumor had greater than 9% G2M-phase cells. In contrast, all lymphomas had greater than 10% S-phase cells and four of seven papillary carcinomas had greater than 9% G2M-phase cells. The use of FCM determination in combination with fine needle aspiration biopsy cytology improved the diagnostic potential of the latter technique. PMID- 3663314 TI - Morphometry of nuclear rings at high electron microscopic resolution. AB - In studying the fine structure of the nuclear chromatin, a new organelle was discovered, the nuclear ring. In its isolated form, this structure is rather like a geometric torus: a smooth, structureless ring. This paper presents the results of electron microscopic morphologic measurements on 424 isolated rings, i.e., rings found free of any fibrous connections. From the measurements of inner and outer diameters, other geometric features were also calculated. Overall, the size of the rings varied about fivefold. Inner and outer diameters were closely correlated, suggesting a rather stable thickness of the ring itself. The significance of the nuclear ring is as yet poorly understood. With its occasionally intimate connections to both chromatin fibers and to the inside of the inner nuclear envelope, its role is likely to be a crucial one. The membrane covering its opening is none other than the bilayer of the nuclear envelope. The concept of a patent opening or "pore" does not appear tenable in the face of this and related findings. PMID- 3663315 TI - [Fanconi syndrome]. PMID- 3663316 TI - [Neonatal septicemia caused by Staphylococcus epidermidis]. PMID- 3663317 TI - [Lidamidine as a promoter of the intestinal absorption of solutions intended for oral rehydration. Experimental model]. PMID- 3663318 TI - [Hyaline membrane disease: differences in the ventilatory response survivors and those with fatal outcome]. PMID- 3663319 TI - [Blood proteins and survival of critically ill infants with septicemia]. PMID- 3663320 TI - [Hypercalcemia and hyperaluminemia in children with chronic renal insufficiency]. PMID- 3663321 TI - [Chronic hereditary tyrosinemia]. PMID- 3663322 TI - [Protein-losing enteropathy in intestinal malacoplakia]. PMID- 3663323 TI - [Intestinal perforation caused by Candida albicans]. PMID- 3663324 TI - [Childhood enterobiasis as a public health problem]. PMID- 3663325 TI - [Influence of environmental factors on intrauterine growth]. PMID- 3663326 TI - [Normal weight of the newborn at term in the city of La Paz, Baja California Sur, Mexico]. PMID- 3663327 TI - Bile acids inhibit secretion of very low density lipoprotein by rat hepatocytes. AB - The influence of taurocholate on very low density lipoprotein (VLDL) triacylglycerol synthesis and secretion was studied by isolated rat liver parenchymal cells. The incorporation of [3H]glycerol into cell-associated and VLDL triacylglycerols were measured after incubation in medium containing 0.75 mM oleate. Taurocholate caused a maked decrease in VLDL [3H]triacylglycerol secretion from the hepatocytes: 50-150 microM taurocholate inhibited secretion of VLDL [3H]triacylglycerols by 70-90%. Similar results were obtained when the mass of secreted VLDL triacylglycerols was measured. Taurocholate caused a decreased secretion of VLDL [3H]triacylglycerols after 15-30 min incubation. A higher amount of cellular triacylglycerols was found in taurocholate-supplemented cells. Furthermore taurocholate did not change the intracellular lipolysis of triacylglycerols. These results suggest that bile acids interfere more probably with the assembly and/or secretion of VLDL-particles and not with earlier stages of VLDL formation, e.g. triacylglycerol synthesis. PMID- 3663328 TI - Formation of 4-ethoxy-4'-nitrosodiphenylamine in the reaction of the phenacetin metabolite 4-nitrosophenetol with glutathione. AB - Phenacetin, a constituent of several analgesic and antipyretic formulations has been made responsible for a variety of toxic and carcinogenic actions. 4 Nitrosophenetol, the N-oxydation product of intermediate 4-phenetidine, forms methemoglobin and binds covalently to sulfhydryl groups of proteins and glutathione. In the reaction of 4-nitrosophenetol with glutathione and other thiols an intermediate so-called "semimercaptal" is formed from which N-(thiol-S yl)-4-phenetidine S-oxide, N-(thiol-S-yl)-4-phenetidine and 4-phenetidine derive. Besides thiol adducts, a yellow compound is formed which was isolated as a pure crystalline product (elemental analysis) and identified by FAB-MS, EI-MS, 13C-, 1H-NMR, and UV-VIS spectroscopy as 4-ethoxy-4'-nitrosodiphenylamine. This nitrosoarene is formed by an unknown mechanism from 4-nitrosophenetol and 4 phenetidine under liberation of ethanol. In human erythrocytes this compound is easily reduced to 4-amino-4'-ethoxydiphenylamine (FAB-MS, EI-MS, 13C-NMR). During the reaction of 4-nitrosophenetol with red cells only traces of 4-ethoxy-4' nitrosodiphenylamine were formed, whereas up to 10% appeared as the reduction product 4-amino-4'-ethoxydiphenylamine. This latter compound is unstable in red cells and is metabolized further to unidentified products. PMID- 3663329 TI - The primary structure of the hemoglobin of spectacled bear (Tremarctos ornatus, Carnivora). AB - The complete primary structure of the alpha- and beta-chains of the hemoglobin of Spectacled Bear (Tremarctos ornatus) is presented. Following cleavage of the heme protein link and chain separation by RP-HPLC, their amino-acid sequences were determined by Edman degradation in liquid- and gas-phase sequenators. The hemoglobin of Spectacled Bear displays only five amino-acid exchanges to that of Polar Bear (Ursus maritimus, Ursinae) and Asiatic Black Bear (Ursus tibetanus, Ursinae) whereas 8 and 12 replacements, respectively, to Giant Panda (Ailuropoda melanoleuca) and Lesser Panda (Ailurus fulgens) can be found. This clearly demonstrates that the Spectacled Bear, the most aberrant bear of the Ursidae, is somewhat intermediate between Pandas and Ursinae. PMID- 3663330 TI - cDNA cloning of human inter-alpha-trypsin inhibitor discloses three different proteins. AB - Inter-alpha-trypsin inhibitor (ITI) is a serum protein of unknown function. Part of the molecule (formerly called HI30) is closely related to a tumor-derived protein acting as a growth factor for endothelial cells. We screened a human liver cDNA expression library with antibodies raised against human ITI and isolated several clones which could be divided into three groups according to their DNA sequences. The cDNA of the first group codes for a protein composed of alpha 1-microglobulin (alpha 1M) and urinary trypsin inhibitor (UTI) and is identical to that encoded by a clone originally found by screening a human liver cDNA library with oligonucleotides derived from amino-acid sequences of the two Kunitz-type domains of UTI. The proteins derived from the cDNA of the second and the third group of clones are distantly related to each other, but unrelated to the protein derived from group 1 clones. Partial amino-acid sequencing of ITI isolated from serum allowed the verification of large parts of the cDNA-derived amino-acid sequences. The results favour the view that ITI is not a single chain protein, but rather a very tight complex of several components or a mixture of such complexes. PMID- 3663331 TI - Antigen-gelonin conjugates. Preparation and application in experimental myasthenia gravis. AB - The antigen-specific immune suppression by gelonin-antigen conjugates was tested in two different systems: (i) the horseradish-peroxidase-stimulated T-cell proliferation in vitro and (ii) in vivo with experimental autoimmune myasthenia gravis (EAMG) in the rat. For this, the phytotoxin gelonin, a glycoprotein from Gelonium multiflorum, was purified and linked to the respective antigens. For the in-vitro assay a lymph node cell suspension from rats immunized with horseradish peroxidase was cultured in the presence of this protein and proliferation was measured by [3H]thymidine uptake. In-vitro proliferation was significantly inhibited by adding gelonin-horseradish peroxidase conjugates. The therapeutic effects of antigen-gelonin conjugates were tested in the rat model EAMG. For these experiments rats were immunized with purified nicotinic acetylcholine receptor from electric fish in order to develop EAMG. The success of the immunization was monitored by the change in physical performance tests, the change in anti-acetylcholine receptor antibody titer, and by the change in the number of ionic endplate channels using a novel electrophysiological method. The latter method permits a very accurate assay of functional damage of acetylcholine receptor at the endplate and correlates well with the clinical severity of the disease. Rats were conventionally immunized with acetylcholine receptor from electric fish. After the onset of EAMG as measured by physical performance tests and rise in antibody titer a group of the animals was injected with an acetylcholine receptor-gelonin conjugate and this treatment was repeated seven days later. The loss in functional acetylcholine receptor was significantly smaller in the therapy group than in the untreated EAMG group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663332 TI - Low-molecular-weight trypsin inhibitors of microbial origin. AB - Three hundred actinomyces cultures newly isolated from the soil of different regions of the Soviet Union were tested for their ability to produce inhibitors of trypsin-like proteases. Seven previously not known to produce trypsin inhibitors (Streptomyces bikiniensis 17-5, S. sporoclivatus 28-1, S. filamentosus 32-11, S. diastatochromogenes 20-4, S. lavendulae 29-4, S. violacens 52-8, and Streptoverticillium cinnamoneum 36-8) were found to possess high antitrypsin activity. The morphological and cultural properties of the strains and the dynamics of inhibitor production were investigated. S. bikiniensis 17-5 was studied in greatest detail. Its culture filtrate contained several inhibitors for trypsin and one for chymotrypsin. A mixture of oligopeptides with Mr of 300-500 was obtained by the described procedure which included the adsorption of the culture fluid filtrate on charcoal followed by ion-exchange chromatography on CM cellulose. Four trypsin inhibitors (Sb-IT1, Sb-IT2, Sb-IT3, and Sb-IT4) were isolated from the mixture in a highly purified state by reversed-phase high performance liquid chromatography. Sb-IT2 has been recognized as formylhistidylvaline with an Mr of 282. No trypsin inhibitor of this structure has been described previously. PMID- 3663333 TI - Use of a bioreactor consisting of sequentially aligned L-glutamate dehydrogenase and L-glutamate oxidase for the determination of ammonia by chemiluminescence. AB - A chemiluminometric method for the automated flow injection analysis of ammonia is described. The essence of the invention is the use of a bioreactor consisting of both immobilized L-glutamate dehydrogenase (GLDH) and L-glutamate oxidase (GLXD), which are sequentially aligned in this order in a minicolumn measuring 2.0 X 20 mm. The unidirectional constant flow of liquid through the column reactor minimizes the reversed diffusion of the solutes so that the following sequence of reactions is ensured. Thus, ammonia to be determined is first transformed by GLDH into L-glutamate, which then produces hydrogen peroxide by GLXD. Hydrogen peroxide in the effluent from the column is then determined by its chemiluminescence upon admixing with luminol and potassium ferricyanide. The present method gives linearity of the standard curve for ammonia up to 1.0 mM. It is at least 100 times more sensitive than the conventional method for ammonia assay using ultraviolet absorption measurement. PMID- 3663334 TI - Evidence for the existence of a specific binding site for indomethacin on bovine vesicular gland microsomes. AB - Using bovine vesicular gland microsomes and [14C]indomethacin we demonstrated the presence of a specific binding site for nonsteroidal anti-inflammatory drugs. Specific binding of [14C]indomethacin to microsomes was rapid, with most of the ligand bound by 2 min at 4 degrees C. In routine binding assays the incubation temperature was maintained at 4 degrees C, because the maximal specific binding was obtained. Specific [14C]indomethacin binding appeared to increase linearly with increasing protein concentration over the range of 0.1-1.0 mg of microsomal protein. Specific binding was saturable and Scatchard analysis of binding data showed a single class of binding sites with a dissociation constant (Kd) of 3.8 microM and a maximal number of binding sites (Bmax) of about 1272 pmol/mg of protein. When these binding data were plotted according to the Hill equation, a straight line was obtained with a Hill coefficient of 1.0. Structural specificity of the nonsteroidal anti-inflammatory drug site was studied with diclofenac, arylpropionic acids (ketoprofen and indoprofen), and aspirin. Diclofenac and arylpropionic derivatives were able to compete with [14C]indomethacin for binding to microsomes, while aspirin was a weak inhibitor. PMID- 3663335 TI - Antibodies anti-HTLV III and lymphocyte subsets of high risk subjects. AB - 208 assay for the research into anti-HTLV III antibodies and lymphocytes subsets were carried out on the same number of patients at risk. 11 homosexual man, 143 intravenous drug users (i.d.u.) and 3 children of drug addicts from hospitals in the Marche and Abruzzo and 51 haemophiliacs from hospital in Florence were examined. 3 determination of anti-HTLV III antibodies were taken from each subject using 3 different commercial Kits. The results concur with and confirm similar epidemiological studies that have been done. The haemophiliac group had the highest positive percentage (39.2%), then came i.d.u. (11.9%) and the homosexuals (10.0%). Furthermore, of the 38 positive totals, there were 22 with only one kit, 18 with two, and 15 with all three. The evaluation of the lymphocyte subsets did not strictly correlate with the presence of the antiretrovirus antibodies. PMID- 3663336 TI - Effect of sub-inhibitory concentrations of antibiotics on adhesion of Campylobacter jejuni in vitro. AB - The effects of sub-inhibitory concentrations (MIC 50 and MIC 25) of clindamycin, erythromycin and chloramphenicol on the adherence of Campylobacter jejuni to INT 407 cells were studied. The results indicated that the adhesion was inhibited at various extents, mostly by MIC 50, and that the inhibition increased with time. The interpretation of our data is that the antibiotics can interfere with the adhesin(s) synthesis. PMID- 3663337 TI - Detection, by an enzyme linked immunoadsorbant assay (ELISA), of IgM, IgG and IgA rheumatoid factors in patients with essential mixed cryoglobulinemia. AB - In order to investigate on some yet unclear aspects of the relationship between Rheumatoid Factor (RF) activity, cryoprecipitation and clinical features of Essential Mixed Cryoglobulinemia (EMC), we determined, by an ELISA technique, the IgM, IgG and IgA RF in 16 patients with EMC, 16 patients affected with seropositive Rheumatoid Arthritis (AR), taken as a reference, and 16 young, normal controls. For IgM RF a high rate of incidence of positive samples (11/16 = 69%) from the EMC group was found, with mean values significantly higher than controls (p less than 0.001) and quite similar to those of the RA group. The ELISA assay was performed at room temperature (RT) and at 37 degrees C, and only a slight increase of adsorbance values in the latter condition was observed. On the contrary, temperature revealed to be a critical experimental condition for the detection of IgG RF. In fact at 37 degrees C the mean values of EMC patients were similar to those of RA and control groups, while at RT a marked increase of adsorbance values was observed, in spite of the inactivation of IgMRF due to the preliminary pepsin digestion of the samples. More interesting are our results concerning IgA RF. In fact a high incidence of overnormal values (9/16 = 56.2%) were found in the EMC group, similar to those of RA patients, with mean values which significantly differ from the normal subjects (p less than 0.01). No relevant differences derived from the temperature at which the test was carried out. The relationship between IgA RF and clinical course of EMC seems to be a very stimulating aim for further investigations. PMID- 3663338 TI - Human leptospirosis in an area of central Italy: results from a serological survey. AB - The results of a serosurvey for leptospiral antibodies in a random sample of healthy subjects are reported. The study was carried out in an area where a waterborne outbreak of leptospirosis, due to leptospires of serogroup Australis, had occurred a month before. Sera were tested with the microagglutination technique. Leptospiral agglutinins were found in 13.8% of tested subjects, mostly in adult females. The highest prevalence rate was observed for serovar lora belonging to serogroup Australis. The leptospires of this group have a relevant spread in the study area in keeping with other surveys carried out in Italy. PMID- 3663339 TI - [Prevalence and incidence of hospital infections at the University Polyclinic of Palermo]. AB - Hospital infections (H.I.) were studied in the University Polyclinic of Palermo, a 1270 beds General Hospital. A prevalence study was carried out in four periods (December, February, June, October) on a sample of 590 patients from randomly chosen from medical and surgical departments. All patients present in the departments were investigated. Data were obtained from hospital records, using a form prepared according to the Italian Study Project of Hospital Infections (SIPIO), and through interview of the patients and/or of the medical staff. After excluding community infections, point prevalence was calculated; moreover, the day in which sign or symptoms of infections appeared was assessed. Cumulative incidence of H.I. and some risk factors associated were estimated using Kaplan Meier method and Cox model for multivariate analysis. PMID- 3663340 TI - Relapsing hepatitis associated with hepatitis A virus in a pediatric population. PMID- 3663341 TI - The role of a psychiatric liaison nurse in pediatric oncology. PMID- 3663342 TI - Dabbling in head and neck oncology (a plea for added qualifications). PMID- 3663343 TI - Treatment of impending carotid rupture with detachable balloon embolization. AB - Acute carotid artery rupture is frequently heralded by prodromal arterial bleeding. This warning signal provides the physician with a brief interval in which to hemodynamically stabilize a patient, electively occlude the carotid, and consequently improve the patient's chance of survival. For three years, we have employed an initial nonoperative approach to patients with impending carotid rupture. A trial of endovascular balloon occlusion followed by detachable balloon embolization of the carotid artery has been utilized. Patients unable to tolerate temporary occlusion underwent a vascular bypass procedure followed by embolization. Six patients have undergone this approach, and all had permanent cessation of bleeding. None died as a result of the procedures. One patient developed permanent neurologic deficits. Balloon embolization offers improved results over elective ligation and should be considered as an alternative treatment for patients in this dire predicament. PMID- 3663344 TI - Rhodamine 123 as a chemosensitizing agent for argon laser therapy. A new technique for treatment of superficial malignancies. AB - Rhodamine 123 (Rh 123), a mitochondrial-specific dye with an absorption maxima at 511 nm, was tested as a new chemosensitizing agent for argon laser treatment of P3 human squamous carcinoma cells. After exposure of P3 cells in vitro to Rh 123 at doses of 1, 3, 6, and 10 micrograms/mL for one hour, we observed significant inhibition of DNA synthesis, except at the lowest dose. Rhodamine 123 at 1 microgram/mL was selected to sensitize P3 tumor cells for treatment with the monochromatic argon laser at 514.5 nm. Exposure of P3 cells to laser energy levels of 700 to 950 J/cm2 (36 degrees C to 40 degrees C) after sensitization with Rh 123 completely inhibited tumor development of the P3 cells transplanted subcutaneously into nude mice. Control P3 cells treated with the laser alone at 36 degrees C to 40 degrees C or only with Rh 123 formed visible tumors by one week and continued to grow for the entire-week observation period. These results show that Rh 123 is a highly sensitive new fluorochrome for argon laser phototherapy of human squamous carcinoma cells. PMID- 3663345 TI - Intra-arterial chemotherapy for head and neck cancer. An update on the totally implantable infusion pump. AB - Intra-arterial chemotherapy for the treatment of localized malignant neoplasms in the head and neck is an appealing approach for several reasons. Perhaps the most important is the possibility of obtaining a regional advantage such that an increased drug concentration is delivered systemically. The patient may, therefore, be spared systemic toxicity. We report our accumulated experience using a totally implantable infusion pump in 37 patients. A total of 42 pumps were implanted: 28 single-catheter pumps and 14 dual-catheter pumps. Radionuclide imaging demonstrated total perfusion of the tumor in all patients. A combination of cisplatin (50 to 100 mg/m2) and floxuridine (0.01 to 0.045 mg/kg/d) was used to treat 26 patients. For these heavily pretreated patients, we observed a 43% complete and partial response rate in the subgroup of patients with squamous cell carcinoma. These results are comparable with those reported for these drugs administered systemically and for other drug combinations tested in the treatment of recurrence disease. PMID- 3663346 TI - Microvascular invasion in cancer of the oral cavity and oropharynx. AB - The presence of squamous cell carcinoma within capillaries and/or venules in the immediate vicinity of primary lesions of the oral cavity and oropharynx may be related to regional lymph node metastasis. To evaluate this possibility, we have reviewed the clinical and histopathologic features of 43 consecutive cases of previously untreated T2 or greater squamous cell carcinoma of these sites managed with simultaneous surgical treatment of the primary neoplasm and the neck. The incidence of histologically proved cervical metastasis for all lesions with vascular invasion compared with those without vascular involvement was highly significant. No statistical correlation was found for the clinical stage of neck disease or for the other pathologic features of the primary tumor, ie, size, appearance, differentiation, depth of invasion, periphery of lesion, inflammatory infiltrate, and perineural invasion, when compared with the histopathologic status of regional lymph nodes. PMID- 3663347 TI - The treatment of T3 glottic carcinoma with vertical partial laryngectomy. AB - Total laryngectomy has traditionally been considered the optimal treatment for patients with advanced glottic carcinoma who present with a fixed true vocal cord. However, using whole-organ sectioning techniques, it has been demonstrated that vertical partial laryngectomy is a sound oncologic procedure for selected fixed vocal cord lesions. During the period 1969 to 1984, 27 patients who presented at UCLA with T3 glottic carcinoma were treated using vertical partial laryngectomy. Follow-up for these patients averaged 4.0 years. The absolute two year disease-free survival rate for this group was 85% (23 of 27 patients), and the local cancer recurrence rate during a two-year postoperative interval was 11% (three of 27 patients). These encouraging results support the continued use of partial laryngeal surgery for a subgroup of patients with T3 glottic cancer. Successful patient selection requires a careful analysis of disease extent based on data obtained from physical examination, magnetic resonance imaging or computed tomographic scanning, and direct laryngoscopy. PMID- 3663348 TI - Multimodality therapy and distant metastases. The impact of natural killer cell activity. AB - One hundred eighty-two previously untreated head and neck cancer patients were stratified by pretreatment-quantitated natural killer (NK) cell activity (less than 60 lytic units [LU] vs greater than or equal to 60 LU) and followed up longitudinally for the development of distant metastases (DMs). Patients with NK activity of less than 60 LU (n = 99) developed DMs at a higher rate than the remaining group. Further stratification of patients on the bases of both regional nodal disease and treatment demonstrated that the risk of DMs predominantly involved one group, ie, patients with histopathologically documented nodal metastases, NK activity of less than 60 LU, and prior treatment with combined surgery and radiation therapy (12[46%] of 26 patients). If one of these three factors was absent, the risk of DMs was not greater than 12%, regardless of the factor. Head and neck cancer patients should be stratified by pretreatment natural immune status to determine the impact of therapy on disease progression. PMID- 3663349 TI - Postglossectomy deglutitory and articulatory rehabilitation with palatal augmentation prostheses. AB - For patients who may have significantly impaired deglutitory and articulatory functions after glossectomy, an important aspect of the rehabilitative management in our institution is the use of palatal augmentation prostheses. The aim is to reduce the free space between the roof and floor of the oral cavity to permit stronger lingual propulsion during oral deglutition and better linguopalatal contact during articulation. We evaluated ten patients who received this device after glossectomy during the past two years. Modified barium swallows and voice recordings were performed when possible with and without the use of the palatal augmentation prosthesis. Articulatory and deglutitory functions were evaluated on a scaled score ranging from 0 to 10 points. The scores of the patients' average immediate improvements were 4.5 points (range, 2 to 7) for articulation and 3.5 points (range, 2 to 7) for deglutition; the scores of average long-term improvements were 3.4 points (range, 2 to 7) and 2.2 points (range, 6 to 8), respectively. Patients using the palatal augmentation prosthesis experienced significant improvement in both functions. We believe that this device contributes greatly to rehabilitative therapy for patients who have undergone extirpative surgery for tumors of the oral cavity. PMID- 3663350 TI - Oral cavity reconstruction using the free radial forearm flap. AB - While a number of flaps are available that can "plug the hole" created by the resection of an oral cavity malignancy, the final functional and cosmetic result is often far from satisfactory. The ideal flap for this area should provide a one stage, reliable reconstruction (regardless of previous surgery or irradiation) with the options of thin pliable skin and/or vascularized bone. Donor-site morbidity must be acceptable. In our experience, the free radial forearm flap best approaches these ideals. Unfortunately, it has received relatively little attention in the otolaryngology literature. The results of using 15 of these flaps to reconstruct 14 oral cavity defects are reported here. Despite the fact that most of the reconstructions were performed in older patients who had undergone irradiation (nine of 14) and previous surgical treatment (ten of 14), there were no flap failures. Hospital stays were short (less than two weeks), cosmetic results were good, and all but one patient had resumed oral intake by the time of hospital discharge. The specific applications and limitations of this flap are emphasized so that the reader can better understand its role in head and neck reconstructive surgery. PMID- 3663352 TI - In vitro hyperdiploidy in head and neck cancer. A genetic predisposition? AB - The role of heredity in the cause of head and neck cancer has not been clarified. Contrary to the autosomal-dominant heritable cancer syndromes, there is no clear genetic pattern seen in oropharyngeal or laryngeal squamous cell carcinoma. Pedigree data demonstrating clusters of affected relatives suggest that some head and neck squamous cell cancers result from an interaction between environmental factors and germinal predisposition. Though no genetic marker has been described for head and neck epidermoid carcinomas, some heritable single tumor syndromes demonstrate increased amounts of hyperdiploidy (defined as a metaphase with more than 46 chromosomes exclusive of 92) in in vitro cultures of dermal fibroblasts. In the present study, dermal fibroblasts were cultured from 30 patients with biopsy-proved oropharyngeal and laryngeal squamous cell cancer. Compared with the percentage of cells with in vitro hyperdiploidy (IVH) of 0% to 1% in 155 clinically normal individuals without a family cancer history, 13 (43%) of these 30 patients had significantly elevated (7% to 12%) IVH. Six of the seven clinically affected women had IVH, a proportion significantly greater than that for the men. In vitro hyperdiploidy remained stable for each assayed cell line from the third through sixth passage. Each patient's IVH percentage of dermal and oropharyngeal fibroblasts remained nearly constant varying 0% to 1%. The stability of the hyperdiploid fraction independent of the biopsy site eliminates local factors as the sources of the elevated IVH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663351 TI - Pediatric orofacial and laryngopharyngeal rhabdomyosarcoma. An Intergroup Rhabdomyosarcoma Study report. AB - Eighty-nine children with localized rhabdomyosarcoma of orofacial and laryngopharyngeal sites were treated in accordance with the first and second Intergroup Rhabdomyosarcoma Study (IRS) protocols (IRS-I and IRS-II) between 1972 and 1984. Treatment included surgery (or biopsy) and chemotherapy for all patients and radiotherapy in the majority. The actuarial estimate of the three year survival rate for all patients was 83% and did not differ significantly by primary site, histologic findings, or presence of adenopathy. A trend for a worse survival rate was seen in clinical group III patients and in those less than 5 years of age at diagnosis. Factors associated with an increased risk of local/regional relapse included omission of radiotherapy and a radiation dose of less than 40 Gy (4000 rad). We conclude that treatment of these patients as recommended in the IRS-I and IRS-II protocols results in very good local and regional tumor control and survival rates. Salvage therapy for local/regional recurrence may yield long-term remission and possibly cure. PMID- 3663353 TI - Pathologic quiz case 2. Primary non-Hodgkin's lymphoma of bone (PLB), diffuse large-cell type. PMID- 3663354 TI - Pathologic quiz case 1. Thyroglossal duct carcinoma. PMID- 3663355 TI - Complications of total thyroidectomy. PMID- 3663356 TI - Vocal quality after endoscopic laser surgery. PMID- 3663357 TI - Legal liability in using nonapproved materials. PMID- 3663358 TI - Passive smoking and croup. PMID- 3663359 TI - Botulinum toxin for relief of spasmodic dysphonia. PMID- 3663360 TI - [Application of analytical morphometry to the study of the sagittal frontofacial profile in occlusive anomaly states]. PMID- 3663361 TI - Experimental radioinduction of chromosomal variants in man. PMID- 3663362 TI - [Non-enzymatic glycosylation in vitro of plasma protein fractions]. PMID- 3663363 TI - Calcium dependent adhesion structures in osteoclasts. PMID- 3663364 TI - [Interrelation between 25 blood chemistry constants in the rabbit and Mediterranean buffalo]. PMID- 3663365 TI - Modification of erythrocyte membrane fluidity in rats exposed to 2,5-hexanedione. PMID- 3663366 TI - [Fragmentation and reparative synthesis of DNA induced by 3 N-nitroso compounds in primary cultures of human hepatocytes]. PMID- 3663367 TI - EEG spectral analysis in migraine: effects of hyperventilation. PMID- 3663368 TI - "H response" to photic stimulation in migraine: study with the EEG spectral analysis. PMID- 3663369 TI - [Fauna encountered on Camogli tuna fishing nets. II]. PMID- 3663371 TI - [Effect of age on the survival of rat erythrocytes]. PMID- 3663370 TI - DNA-proteins complexes from dehistonized rat liver nuclei. A novel experimental approach to the nucleoid problem. PMID- 3663372 TI - Hormonal regulation of erythrocyte Na+,K+ cotransport. Evidence against "in vitro" effects. PMID- 3663373 TI - [Determination of theophylline in the plasma by rapid solid-phase extraction]. PMID- 3663374 TI - [Derivatives of pyrazole with antiaggregant activity]. PMID- 3663375 TI - [Catabolism of adenine nucleotides in human erythrocytes maintained at 0 degree C and at 37 degrees C]. PMID- 3663376 TI - [Comparison of methods for the determination of urinary albumin in humans]. PMID- 3663377 TI - [Function of vitamin E in the reinnervation of rat muscle]. PMID- 3663378 TI - [Correlation between histological type and blood group in pulmonary carcinoma]. PMID- 3663379 TI - Preliminary reports on the oxygen loading in blood of anemic patients. PMID- 3663380 TI - Contextual mood priming following left and right hemisphere damage. AB - This research examined the influence of mood-congruent and mood-incongruent contexts on recognizing affective prosody after brain damage. Predictions stemmed from an associative network theory of learning and memory. Thirty-three male subjects, 11 each in right hemisphere damaged (RHD), left hemisphere damaged (LHD), and normal control groups judged moods from the prosody of semantically neutral phrases. In one task, the prosodic stimulus phrases were judged in isolation. In another task, the phrases were preceded by short paragraphs which were either congruent or incongruent in emotional tone with the prosodic stimuli. These paragraphs were designed to prime specific mood choices. As anticipated, LHD subjects' prosodic mood recognition was more accurate when given congruent rather than incongruent affective contexts. Congruent contexts facilitated, and incongruent contexts disrupted, their prosodic mood judgments to the same extent as normals. RHD subjects showed a partial context decrement. They were less accurate than normal or LHD subjects in the congruent condition, and were unaffected by incongruent contexts. When given congruent biasing paragraphs, however, RHD subjects did experience facilitation on a par with that found for the other groups, indicating spared sensitivity to certain contextual factors. The distinction between automatic and effortful processes is offered as a potential explanation for the RHD group's pattern of performance. PMID- 3663381 TI - Line bisection by left-handed preschoolers: a phenomenon of symmetrical neglect. AB - When a normal dextral attempts to bisect a horizontal line placed across his/her midline, there is a tendency for the transection to be placed slightly to the left of true center, a tendency which may be a little more pronounced when the left hand is used. However, left-handed children at or younger than 5 years of age err substantially to the left with the left hand and to the right with the right hand. This symmetrical neglect of extents contralateral to the hand currently in use, which may possibly reflect relatively greater commissural immaturity in left-handers, was not seen in dextral children of comparable ages, whose performance closely followed adult patterns. PMID- 3663382 TI - Ratings of emotion in faces are influenced by the visual field to which stimuli are presented. AB - This experiment was designed to assess the differential impact of initially presenting affective information to the left versus right hemisphere on both the perception of and response to the input. Nineteen right-handed subjects were presented with faces expressing happiness and sadness. Each face was presented twice to each visual field for an 8-sec duration. The electro-oculogram (EOG) was monitored and fed back to subjects to train them to keep their eyes focused on the central fixation point as well as to eliminate trials confounded by eye movement artifact. Following each slide presentation, subjects rated the intensity of the emotional expression depicted in the face and their emotional reaction to the face on a series of 7-point rating scales. Subjects reported perceiving more happiness in response to stimuli initially presented to the left hemisphere (right visual field) compared to presentations of the identical faces to the right hemisphere (left visual field). This effect was predominantly a function of ratings on sad faces. A similar, albeit less robust, effect was found on self-ratings of happiness (the degree to which the face elicited the emotion in the viewer). These data challenge the view that the right hemisphere is uniquely involved in all emotional behavior. The implications of these findings for theories concerning the lateralization of emotional behavior are discussed. PMID- 3663383 TI - Primate learning tasks reveal strong impairments in patients with presenile or senile dementia of the Alzheimer type. AB - Eight subjects with the likely diagnosis of presenile or senile dementia of the Alzheimer type were tested on two frequently used primate learning tasks: a concurrent object discrimination task and a delayed non-match-to-sample task. In addition, various tests for cognitive, mnemonic, perceptual, and language functions were applied. The results suggest a severe decline of the Alzheimer subjects in all measures when compared with 10 control subjects matched for age, gender, and education. The two animal learning tasks revealed strong impairments, thus demonstrating a high sensitivity for the detection and assessment of human amnesic disorders. Implications of these findings for human neuropsychological, and especially comparative neuropsychological, research are discussed. PMID- 3663384 TI - Apraxia in a patient with atypical cerebral dominance. AB - Liepmann postulated that the left hemisphere of right-handed persons contains the "movement formulas" that control purposeful skilled movements of the limbs on both sides of the body. Accordingly, in right-handers apraxia should follow damage to the left hemisphere, whereas right hemisphere damage should not lead to apraxia. Although this is generally true, we recently examined a right-handed man who after a right hemispheric stroke became aphasic and apraxic with his nonparalyzed right hand. Our observations suggest that the right hemisphere of this right-handed man made a critical contribution to the planning and execution of skilled movements. This case provides evidence that right-handers should not be considered a homogeneous group in terms of cerebral motor dominance and that contrary to Liepmann's postulate, hemispheric dominance for the control of skilled movements does not entirely determine handedness. PMID- 3663385 TI - Perceiver bias in the processing of deliberately asymmetric emotional expressions. AB - Posers were requested to produce happy and sad emotional expressions, deliberately accentuated on the left and right sides of the face. Raters judged the emotional intensity of expressions when presented in original and mirror reverse orientation. Left-side-accentuated sad expressions were rated as more intense than right-side-accentuated sad expressions. Raters were biased to judge expressions as more intense when the accentuated side was to their left. The findings indicated that the perceiver bias in weighting information from the side of the face in left hemispace extends to judgments of emotional intensity. PMID- 3663386 TI - Recognition of letters traced in the right and left palms: evidence for a process oriented tactile asymmetry. AB - Three experiments were conducted to examine the relative ability of the cerebral hemispheres to identify capital letters traced in the palms of the hands. In Experiment 1, letters were presented either right side up or upside down, and the subject's task was to name the letter aloud or point to an identical letter using the stimulated hand. Analysis of the accuracy data revealed that the left palm/right hemisphere (LP/RH) performed this task significantly better than did the right palm/left hemisphere (RP/LH), particularly when the stimuli were presented in the upside-down orientation. In Experiments 2 and 3, subjects performed the same letter identification task; however, on half the trials, they were required to maintain either a spatial or verbal concurrent memory load (i.e., a 24-point Vanderplas & Garvin form or six low-imagery nouns, respectively). In the no-load condition of Experiment 2 (spatial forms), the previously observed LP/RH advantage was replicated. However, in the load condition, this LP/RH superiority was no longer in evidence. In Experiment 3 (low imagery nouns), the presence of a concurrent verbal task had minimal impact on the previously observed performance asymmetry as the LP/RH advantage was obtained in both the no-load and load conditions. The results of the three studies taken in composite suggest that (1) the operations utilized to identify letters traced in the palms of the hands are primarily spatial in nature and (2) that the observed performance asymmetry may be attributed to a right hemisphere superiority for the analysis and codification of information along a spatial dimension. These findings are discussed in terms of a "process-oriented" model of hemispheric asymmetry. PMID- 3663387 TI - [Role of Tween-80 used in the culture of cutaneous corynebacteria (JK group) on the composition of cellular fatty acids]. AB - This study of 8 strains of cutaneous corynebacteria, including 5 strains of "JK corynebacteria", concerns the fatty acid composition of cells grown in the presence or not of Tween 80, which enhances their growth rate. The fatty acid methyl esters were analysed by gas-liquid chromatography. The fatty acid profile of the 8 strains agreed with the general pattern of the genus Corynebacterium, with major amounts of palmitic acid (C16:0) and oleic acid (C18:1) and with only trace amounts of 10-methyl octodecanoic acid (tuberculostearic acid). Iso and anteiso branched acids were not present. The 5 strains had high levels of stearic acid (C18:0). When cells were grown in the presence of Tween-80, the fatty acid composition was modified for all strains: their profiles showed high levels of oleic acid (C18:1) and smaller quantities of palmitoleic acid (C16:1). These results confirm the advantage of fatty acid composition for identification of Corynebacteria, and particularly for cutaneous strains, and emphasize the influence of the culture medium, especially that of Tween-80. PMID- 3663388 TI - [Denitrifying activity and generation time in 4 species of Rhizobium]. AB - Denitrifying capacity and doubling time were measured among 44 strains of Rhizobium belonging to 4 species: B. japonicum, R. lupini, R. meliloti et R. leguminosarum. There was no correlation between doubling time and the rate of production of N2O in the presence of C2H2 in B. japonicum and R. lupini. In 38 other strains, only denitrifying capacity was measured. The percentage of strains showing denitrification capacity varied according to the species: 70% in B. japonicum, 90% in R. lupini, 37% in R. meliloti and 14% in R. leguminosarum. The strains of the latter species showed a very low level of denitrifying activity in comparison with the strains of the 3 other species. PMID- 3663389 TI - Similarities between crystal protein subunits of Bacillus thuringiensis strain 1884 serotype H14 and strain PG14 serotype H8a,8b, and their relationship with mosquitocidal activity. AB - Bacillus thuringiensis subsp. israelensis strain 1884 and B. thuringiensis subsp. morrisoni strain PG14 have the same toxicity toward mosquito larvae. Their protein crystal contents were compared either on native electrophoretic systems or on gel filtration. Analysis of electroeluted native proteins in SDS-PAGE showed that the 28-Kd protein alone, without the 68- or 130-Kd protein, was not larvicidal; however, toxicity was recorded as soon as 28- and 68-Kd proteins were associated. After gel filtration of 1884 soluble crystal, the 68-Kd protein alone, without 28 or 130 Kd, was not toxic; toxicity was also recorded when 28- and 68-Kd proteins and higher molecular weight proteins were associated. A comparable pattern was observed with PG14 soluble crystals. PMID- 3663390 TI - Ultrastructural midgut events in Culicidae larvae fed with Bacillus sphaericus 2297 spore/crystal complex. AB - Ingestion of Bacillus sphaericus 2297 spore/crystal complex by Culicidae larvae Anopheles stephensi, Culex pipiens subsp. pipiens and Aedes aegypti was rapidly followed by a dissolution of the protein crystalline inclusions inside the anterior stomach of the three species. During the first day of intoxication, B. sphaericus spores germinated within the midgut lumen, and were in a vegetative stage between 36-48 h after ingestion when the larvae began to die. Ultrastructural observations focused on larval midgut showed alterations which differed according to the mosquito species, being localized mainly in the gastric caeca and posterior stomach. With the bacterial concentration used, neither general cell swelling nor complete breakdown of the midgut epithelium was recorded before larval death. In A. stephensi larval midgut epithelium large low electron-density areas appeared, rough endoplasmic reticula formed numerous concentrical structures and mitochondria swelled. Large vacuoles (of unknown origin) appeared early on in the C. pipiens midgut cells, and rough endoplasmic reticula broke into small vesicles. Midgut epithelial cells of A. aegypti showed mitochondria swelling except in the anterior stomach, and a vacuolisation of smooth reticula: these aspects remained unchanged until the larvae died. PMID- 3663391 TI - Toxicity, viability and ultrastructure of Bacillus sphaericus 2362 spore/crystal complex used in the field. PMID- 3663392 TI - Biochemical studies on bilharzial and nonbilharzial hyperoxaluria: effect of pyridoxine and allopurinol treatment. AB - The urinary excretion levels of oxalic acid, calcium, kynurenic, and xanthurenic acids and serum pyridoxal and pyridoxal phosphate concentrations were determined for nonbilharzial and bilharzial hyperoxaluric patients with or without urinary stones. The effects of pyridoxine and allopurinol treatment were also studied. The different groups studied showed elevated levels of urinary oxalic acid, calcium, kynurenic, and xanthurenic acids as well as decreases in serum pyridoxal and pyridoxal phosphate concentrations. These data indicate that nonbilharzial hyperoxaluric patients suffer from dietary B6 deficiency, whereas bilharzial hyperoxaluric patients may suffer from impaired pyridoxine phosphokinase activity. Pyridoxine supplementation is recommended for the treatment of nonbilharzial hyperoxaluric patients. Allopurinol may be the proper drug in the treatment of oxaluria and stone formation or of bilharzial patients. PMID- 3663393 TI - Hypoglycemic effect of cotton seed aqueous extract in alloxan-induced diabetes mellitus in rats. AB - The aqueous extract of cotton seed is able to reduce blood sugar in alloxan induced diabetes mellitus in rats. A dose of 1000 mg/kg was found to be an effective dose. Cotton seed extract was able to enhance the liver glycogen, like glibenclamid, and was also able to reduce blood cholesterol which was found raised in the diabetic state. Further it was able to normalize the altered level in the liver lipid peroxide content. The role of cotton seed aqueous extract is suggested in the lipid metabolism which is altered during diabetes mellitus. PMID- 3663394 TI - In vivo and in vitro intervention with L-carnitine prevents abnormal energy metabolism in isolated diabetic rat heart: chemical and phosphorus-31 NMR evidence. AB - The beneficial effects of in vivo injections (200 mg/kg, twice daily) or in vitro perfusion (5.0 mM) of L-carnitine on an intrinsic abnormality in energy metabolism was investigated in isolated, perfused diabetic rat heart. Hearts were aerobically perfused for 60 min with elevated fatty acid substrate to simulate diabetic conditions. Phosphorus-31 nuclear magnetic resonance spectroscopy revealed a temporal decline in myocardial ATP levels (to approx 82%) during perfusion of diabetic hearts, but not in control hearts. This reduction was prevented by prior treatment in vivo with L-carnitine or by providing L-carnitine acutely in the perfusion medium. Chemical analysis of tissue extracts indicated that L-carnitine injections were effective in replenishing the decrease in total myocardial carnitine content which was present in diabetic hearts and in preventing the accumulation of long chain fatty acyl CoA. Perfusion with L carnitine also attenuated the elevation of long chain fatty acyl CoA in diabetic hearts. This study gives additional support to the hypothesis that decreases in ATP which occur in the isolated, perfused diabetic heart are correlated with a concomitant elevation in long chain fatty acyl CoA, a known inhibitor of adenine nucleotide translocase. In the presence of elevated exogenous fatty acids, a primary deficiency in the total myocardial carnitine pool would result in elevations in tissue concentrations of long chain fatty acyl CoA since carnitine is a required carrier for transport of fatty acids into mitochondria. Replenishment of the carnitine in vivo was shown to be sufficient to prevent subsequent alteration in long chain fatty acyl CoA and ATP in isolated perfused diabetic hearts despite the burden of elevated fatty acid substrates. PMID- 3663395 TI - Association of hemoglobin chains with the cell membrane as a cause of red cell distortion in thalassemia. AB - Hemoglobin chains were separated and their interaction with membrane ghosts was studied using their ability to quench the fluorescence intensity of a membrane embedded probe. It was observed that alpha chains bind faster and with higher affinity to the membrane sites than do beta chains. The fast reversible interaction of both chains with the membrane was followed by a time-dependent partial loss of reversibility. Band 3 cytoplasmic fragments (B3F) were isolated and their reaction with separated Hb chains was studied using fluorescence quenching techniques as well. The data demonstrate that the relative affinity of the chains for B3F and loss of reversibility of the reaction followed patterns similar to the corresponding interaction of the chains with whole membranes. Band 3 cytoplasmic poles are therefore suggested as the high-affinity sites on the membrane for hemoglobin chains. When globin was reacted with B3F, it was observed that this protein binds strongly to the same membrane sites, but practically irreversibly. Exchange of the HbA content of normal cells by separated alpha or beta chains resulted in membrane distortions in both cases, but alpha chains caused greater morphological changes than did beta chains. The results of this study may provide one explanation for the differences in the thalassemia syndromes when excess of either alpha or beta chains is involved. PMID- 3663396 TI - Inhibitory effect of gentamicin on gluconeogenesis from pyruvate, propionate, and lactate in isolated rabbit kidney-cortex tubules. AB - The effect of gentamicin on glucose production in isolated rabbit renal tubules was studied with lactate, propionate, malate, 2-oxoglutarate, and succinate as substrates. This antibiotic at 5 mM concentration inhibited gluconeogenesis from lactate by about 60% and that from either pyruvate or propionate by about 30%. In contrast, it did not alter the rate of glucose formation from other substrates studied. The rate of gluconeogenesis was higher at 1 mM propionate than at increasing concentrations of this substrate and was stimulated in the presence of 1 mM carnitine. However, the addition of carnitine did not affect the degree of inhibition of glucose formation by gentamicin. Since the mitochondrial free coenzyme A level was significantly lower in the presence of 10 than 1 mM propionate and increased on the addition of carnitine to the reaction medium, the inhibitory effect of propionate concentrations above 1 mM on gluconeogenesis in rabbit renal tubules may be due to a depletion of the free mitochondrial coenzyme A level, resulting in an inhibition of the mitochondrial coenzyme A-dependent reactions. In intact rabbit kidney cortex mitochondria incubated in State 4 as well as in Triton X-100-treated mitochondria, 5 mM gentamicin inhibited by about 30-40% the incorporation of 14CO2 into both pyruvate and propionate. The results indicate that the inhibitory effect of gentamicin on glucose formation in isolated kidney tubules incubated with lactate, pyruvate, or propionate is likely due to a decrease of the rate of carboxylation reactions. PMID- 3663397 TI - Effect of a 400-kilocalorie carbohydrate diet on human plasma uridine and hypoxanthine concentrations. AB - Seven healthy female volunteers were fed a 400-kcal carbohydrate diet for 4 days after eating a standardized diet for 3 days. Plasma uridine and hypoxanthine concentrations were measured by high-performance liquid chromatography. After 4 days on the 400-kcal diet, the plasma uridine concentration decreased by 35% but the plasma hypoxanthine concentration remained stable. PMID- 3663398 TI - Phospholipid methylation in canine myocardium: kinetic characteristics and the effect of endotoxin administration. AB - The kinetic characteristics and the effect of endotoxin administration on the enzymatic methylation of phospholipids in dog heart microsomes were studied using S-adenosyl-L-[methyl-3H]methionine as a methyl donor. Kinetic studies in control dogs reveal that the stepwise methylation of phosphatidylethanolamine to phosphatidylcholine was catalyzed by three different enzymes. Methyltransferase I catalyzed the methylation of phosphatidylethanolamine to phosphatidyl-N monomethylethanolamine, had a very low Km (approximately 1.5 microM) for S adenosylmethionine, and a pH optimum of 6.5, and it was stimulated by Mg2+ and Ca2+. Methyltransferase II catalyzed the methylation of phosphatidyl-N monomethylethanolamine to phosphatidyl-N,N-dimethylethanolamine, had a low Km (8 12 microM) for S-adenosylmethionine, and a pH optimum of 8.5, and it was stimulated by low concentrations (less than 1 mM) of Ca2+ but was unaffected by Mg2+. Methyltransferase III catalyzed the formation of phosphatidylcholine from phosphatidyl-N,N-dimethylethanolamine, had a high Km (approximately 33 microM) for S-adenosylmethionine, and a pH optimum of 9.5, and it was unaffected by Mg2+ or Ca2+. Experiments with trypsin digestion indicate that methyltransferases I and III were partially embedded while methyltransferase II was completely exposed to the surface of the membrane. Endotoxin administration (2 and 4 hr) decreased the Km and Vmax by 30 to 36% and 24 to 37.7%, respectively, for S adenosylmethionine. Since the enzymatic methylation of phospholipids has been implicated to play an important role in the regulation of membrane structure and function, the endotoxin-induced decreases in the Km and Vmax of phospholipid methylating enzymes in dog heart microsomes may contribute to the development of myocardial dysfunction in endotoxin shock. PMID- 3663399 TI - Metabolism of 1-methyladenosine. AB - 1-[methyl-8-14C] Adenosine was synthesized and its metabolic fate was determined in intact rat. It was found that approximately 57% of 1-[methyl-8-14C] adenosine administered iv was excreted unchanged in the urine and 33% of the excreted radioactivity in the urine was associated with the major metabolite 1-methyl hypoxanthine and about 4.5% was associated with 1-methylinosine. Very little adenosine or N6-methyladenosine was formed. It is concluded that 1 methyladenosine is initially deaminated by adenosine deaminase to 1-methylinosine which is then cleaved by nucleoside phosphorylase to 1-methylhypoxanthine. PMID- 3663400 TI - Superoxide dismutase and glutathione peroxidase activities in erythrocytes as indices of oxygen loading in disease: a survey of one hundred cases. AB - It has been established that the pyrogallol autoxidation method for the estimation of the activity of superoxide dismutase (SOD) (EC 1.15.1.1) is superior in precision and sensitivity to a superoxide-generating method (NADH/phenazine methosulfate linked to nitroblue tetrazolium reduction). Reference intervals were established in an urban population in the Far East for SOD activity in erythrocytes using the pyrogallol method, and for glutathione peroxidase (GSH-Px) (EC 1.11.1.9) activity in erythrocytes using a standard glutathione reductase-linked method. On this basis, erythrocyte SOD activities were significantly (P less than 0.05) depressed in cases of visceral cancer, acute myocardial infarct, congestive heart failure, respiratory failure, chronic renal failure, and diabetes mellitus, but within the reference interval in cases of lung cancer and asthma. Erythrocyte GSH-Px activity was significantly (P less than 0.05) depressed in cases of diabetes mellitus and chronic renal failure but elevated in respiratory failure and asthma. GSH-Px and SOD activities were well correlated in patients but not in the reference population. PMID- 3663401 TI - Evidence for the generation of transaminase inhibitor(s) during ethanol metabolism by rat liver homogenates: a potential mechanism for alcohol toxicity. AB - Since ethanol consumption decreases hepatic aminotransferase activities in vivo, mechanisms of ethanol-mediated transaminase inhibition were explored in vitro using mitochondria-depleted rat liver homogenates. When homogenates were incubated at 37 degrees with 50 mM ethanol for 1 hr, alanine aminotransferase decreased by 20%, while aspartate aminotransferase was unchanged. After 2 hr, aspartate aminotransferase decreased by 20% and by 3 hr, alanine and aspartate aminotransferases were decreased by 31 and 23%, respectively. Levels of acetaldehyde generated during ethanol oxidation were 525 +/- 47 microM at 1 hr, 855 +/- 14 microM at 2 hr, and 1293 +/- 140 microM at 3 hr. Although inhibition of alcohol oxidation with methylpyrazole or cyanide markedly decreased ethanol mediated transaminase inhibition, neither incubation with acetate nor generation of reducing equivalents by oxidation of lactate, malate, xylitol, or sorbitol altered the activity of either enzyme. However, semicarbazide, an aldehyde scavenger, prevented inhibition of both aminotransferases by ethanol. Moreover, incubation with 5 mM acetaldehyde for 1 hr inhibited alanine and aspartate aminotransferases by 36 and 26%, respectively. Cyanamide, an aldehyde dehydrogenase inhibitor, had little effect on ethanol-mediated transaminase inhibition. Thus, metabolism of ethanol by rat liver homogenates produces transaminase inhibition similar to that described in vivo and this effect requires acetaldehyde generation but not acetaldehyde oxidation. Since addition of pyridoxal 5'-phosphate to assay mixes did not reverse ethanol effects, aminotransferase inhibition does not result from displacement of vitamin B6 coenzymes. PMID- 3663402 TI - [Background EEG's and neurological prognosis of newborn infants]. PMID- 3663403 TI - [Recall memory of epileptic children]. PMID- 3663404 TI - [Brain development of the symptomatic obesity model mouse with brain dysfunction. I. Neuronal proliferation in the cerebellum]. PMID- 3663405 TI - [The relationship between skull asymmetry and CT findings--supine head position preference and brain damage]. PMID- 3663406 TI - [A study of chronic hypothermia in central nervous system disorders]. PMID- 3663407 TI - [Neuropathological findings on epidermolysis bullosa hereditaria (autosomal recessive dystrophic type)--a case report]. PMID- 3663408 TI - [A case of multiple sclerosis in a child which responded to methylprednisolone pulse therapy]. PMID- 3663409 TI - [Case of acrodermatitis enteropathica associated with the administration of a ketone formula]. PMID- 3663410 TI - [Three cases of trigonocephaly associated with trisomy 13]. PMID- 3663411 TI - [The diagnostic value of the Babkin reflex]. PMID- 3663412 TI - [Autopsy of a patient with cerebellar hypoplasia]. PMID- 3663413 TI - [An atypical form of juvenile myasthenia gravis associated with severe emaciation, muscle atrophy, ophthalmoplegia, bulbar signs and joint contracture]. PMID- 3663415 TI - [A case of late infantile ceroid lipofuscinosis--an electrophysiological follow up study]. PMID- 3663414 TI - [Thirteen-year-old girl presenting chorea after treatment of hyperthyroidism]. PMID- 3663416 TI - [Enlargement of the tongue and a deformity of the oral cavity in patients with Duchenne muscular dystrophy]. PMID- 3663417 TI - [Study of susceptibility to seizures in hippocampal kindling of suckling rats]. PMID- 3663418 TI - [Fisher's syndrome with a midbrain lesion demonstrated by MRI-CT]. PMID- 3663419 TI - The pathology of the early and late stages of primary pulmonary hypertension. AB - During the course of a case of primary pulmonary hypertension occurring in a 24 year old man lung tissue became available at heart-lung transplantation in 1986 and from a lung biopsy carried out in 1981. In 1986 the sections showed classic plexogenic pulmonary arteriopathy. In 1981 they revealed migration of myofibroblasts into the intima and lumen of pulmonary arteries and arterioles, the identification of the cells being confirmed by electron microscopy. During the five years that the pulmonary vascular pathology progressed to the formation of plexiform lesions there was an increase in the number of bronchiolar endocrine cells that were immunoreactive to bombesin and calcitonin. This study demonstrates that the classic pathogenesis of primary plexogenic pulmonary arteriopathy originates years earlier as a migration of cells of muscular pedigree from the media into the intima of the pulmonary arteries and arterioles. PMID- 3663420 TI - Ventricular septal defect after myocardial infarction: assessment by cross sectional echocardiography with pulsed wave Doppler scanning. AB - Eight patients who developed a ventricular septal defect after myocardial infarction were assessed by cross sectional echocardiography and pulsed wave Doppler scanning. Cross sectional echocardiography visualised the defect in four patients and gave an accurate assessment of global and regional left ventricular function in all eight. In all patients pulsed wave Doppler scanning detected turbulent flow at the apex of the right ventricle or adjacent to a wall motion abnormality affecting the interventricular septum. Pulsed wave Doppler detected coexisting mitral regurgitation in one patient and tricuspid regurgitation in another two. In all patients a left to right shunt was confirmed by oximetry and the location of the defect was identified by angiography or at operation or necropsy. Cross sectional echocardiography in combination with pulsed wave Doppler scanning is useful in the rapid bedside evaluation of patients with ventricular septal defect after myocardial infarction. PMID- 3663421 TI - Left ventricular function and oesophageal function in patients with angina pectoris and normal coronary angiograms. AB - Left ventricular function and oesophageal function (including oesophageal manometry and pH monitoring) were investigated and a psychiatric assessment carried out in 63 patients with angina pectoris and normal coronary angiograms. Twenty two (35%) patients had regional abnormalities of left ventricular wall motion (group A). Thirty six (57%) patients had an oesophageal abnormality (group B); 19 patients had gastro-oesophageal reflux and abnormal oesophageal motility, five had gastro-oesophageal reflux alone, and 12 had abnormal oesophageal motility alone. Only four had regional abnormalities of the left ventricular wall and abnormal oesophageal function. In nine (14%) patients left ventricular and oesophageal function were normal (group C). Psychiatric morbidity was significantly less common in group A than in groups B and C and was similar in group B and group C. A definite abnormality of left ventricular function, oesophageal function, or psychiatric morbidity is present in a high proportion of patients with angina pectoris and normal coronary angiograms and in some instances this may lead to specific treatment. If quantitative assessment of left ventricular function is normal, oesophageal investigations should be performed. Endoscopy of the upper gastrointestinal tract may demonstrate oesophageal disease, but, if findings are normal, oesophageal manometry and ambulatory oesophageal pH monitoring (including during treadmill exercise testing) should be carried out. PMID- 3663422 TI - Intravenous streptokinase treatment and serum C-reactive protein in patients with acute myocardial infarction. AB - Serum concentrations of C-reactive protein were studied in 23 patients with acute myocardial infarction. In 14 patients who did not receive thrombolytic treatment there was a linear relation between infarct size (determined by serial creatine kinase-MB determinations and thallium-201 isotope emission tomography) and the C reactive protein response. The correlation coefficient between the concentration time integrals of creatine kinase-MB and C-reactive protein was 0.96. The correlation coefficient between the creatine kinase-MB concentration-time integral and the peak serum value of C-reactive protein was 0.93. In the nine patients who received intravenous streptokinase treatment there was also a positive correlation between the concentration-time integrals of creatine kinase MB and C-reactive protein. The relation, however, depended on the success of the treatment. In patients with successful reperfusion the C-reactive protein response was only approximately 20% of that in patients in whom reperfusion failed or who received no thrombolytic treatment and who were matched by infarct size. When thrombolysis was successful the correlation coefficient between the concentration-time integrals of creatine kinase-MB and C-reactive protein was 0.86. Daily measurement of serum C-reactive protein is useful in evaluating infarct size in patients with acute myocardial infarction who do not receive thrombolytic treatment. In patients treated with streptokinase C-reactive protein concentrations may be used to assess the success of thrombolysis. PMID- 3663423 TI - The morphology of the right ventricular outflow tract after percutaneous pulmonary valvotomy: long term follow up. AB - Twenty nine patients (19 male, mean (SD) age 6.25 (0.5) years (range 0.16-15 years] with typical pulmonary valve stenosis were treated by balloon dilatation of the pulmonary valve. They were studied by echocardiography before the procedure, immediately after it, and at follow up (mean (SD) 10.2 (5.6) months, n = 18). The morphology of the pulmonary valve, the right ventricular-pulmonary artery gradient, and ratio of the systolic to diastolic endocardial dimensions (infundibular ratio) were examined. No patient had pulmonary regurgitation before the study. The valve gradient was significantly reduced (47%) from a mean (SD) of 72 (31) to 37 (23) mm Hg with no short term change in cardiac index after dilatation with a balloon with a mean (SD) diameter that was 118 (10.8)% of the valve annulus. The infundibular ratio was unchanged by the procedure (0.49 (0.11) (n = 21) before dilatation and 0.47 (0.14) (n = 16) after dilatation). In twenty seven patients the commissure of the pulmonary valve was seen to be torn after dilatation. Two patients with bicuspid valves had flail leaflets. Doppler examination at follow up showed mild pulmonary insufficiency in all 29 patients; the mean (SD) valve gradient (31 (+/- 21) mm Hg) at follow up was no different from the gradient found immediately after the procedure and infundibular ratio (0.58 (0.15) was not abnormal. These data indicate that commissural tears are the primary mechanism of valve disruption and demonstrate that the dynamic right ventricular outflow tract obstruction relaxes and gradient reduction persists at follow up. PMID- 3663424 TI - Transvenous cardioversion for the management of recurrent ventricular arrhythmias. AB - The efficacy of transvenous cardioversion and defibrillation for treating life threatening spontaneous ventricular arrhythmias was assessed in a study of 17 patients in a cardiac care unit. Eleven had ventricular tachycardia, five had ventricular fibrillation, and one had both. Transvenous cardioversion successfully terminated tachyarrhythmias on 42 separate occasions in ten patients. Stable electrode positions could not be achieved in two patients, recurrent late displacement occurred in one, and four patients had no further arrhythmias requiring cardioversion once the lead was placed. The energy levels required for successful cardioversion ranged from 0.05 J to 25 J for ventricular tachycardia and from 1 J to 25 J for ventricular fibrillation. The nine successful shocks of 1 J or less did not require sedation or general anaesthesia. High energy (25 J) endocardial shocks were unsuccessful in terminating arrhythmias in two patients, one with ventricular tachycardia and the other with both ventricular tachycardia and fibrillation. Minor unwanted effects of endocardial shocks occurred in five patients. These were acceleration of ventricular tachycardia in two patients and complications of pacing via the special lead in three others: failure of sensing occurred in all three and one patient also had a transient rise in pacing threshold. A postmortem examination in one patient who had received three unsuccessful high energy shocks revealed localised endocardial necrosis at the site of the distal electrode. Transvenous cardioversion offers advantages over external cardioversion but at present practical difficulties limit its application to patients with recurrent ventricular arrhythmias that cannot readily be controlled by conventional methods. PMID- 3663425 TI - Detection of arrhythmias: use of a patient-activated ambulatory electrocardiogram device with a solid-state memory loop. AB - A patient-activated ambulatory electrocardiogram device with a solid-state memory loop was used to investigate 100 unselected patients experiencing palpitation, dizziness, or syncope. Clinically useful information was obtained in 68% of patients. Frequently, sinus rhythm had been restored by the time the patient activated the device, but the arrhythmia had been stored in the pre-event segment of the memory--a distinct advantage over many other patient-activated devices. This recorder is complementary to conventional 24 hour electrocardiographic monitoring in the investigation of possible arrhythmias and is particularly suitable for patients with infrequent symptoms. Because the stored data can be rapidly analysed by any commercially available electrocardiograph the device is suitable for use in district general hospitals. PMID- 3663426 TI - Failure of propranolol to improve exercise tolerance in patients with mitral stenosis in sinus rhythm. AB - Propranolol reduces left atrial pressure at rest and during exercise in patients with mitral stenosis by lowering cardiac output and heart rate. Ten patients (aged 19-56) with moderate to severe isolated mitral stenosis were studied to determine whether propranolol increased their exercise tolerance. All were in sinus rhythm and free of left or right ventricular failure. Patients were trained in an individually graded bicycle or treadmill exercise protocol that provoked a reproducible degree of near maximal dyspnoea during the second three minute stage of exercise. Propranolol (80 mg or 120 mg) or matching placebo in two or three divided daily doses was given for one week in random double blind fashion. Exercise testing and questioning about subjective clinical response were carried out at the end of each week by an investigator who was unaware of the patient's heart rate. During propranolol treatment the heart rate was 19 beats/minute slower at rest and 38 beats/minute slower at peak exercise, but there was no change in mean exercise time to dyspnoea (274 s during propranolol vs 283 s during placebo). Four patients felt worse during the propranolol week, one patient felt better during the propranolol week, and five patients felt no difference between the two weeks. Propranolol did not improve objective or subjective exercise tolerance in patients with isolated mitral stenosis in sinus rhythm. PMID- 3663427 TI - Inheritance of hypertrophic cardiomyopathy: a cross sectional and M mode echocardiographic study of 50 families. AB - To determine the mode of inheritance of hypertrophic cardiomyopathy 193 first degree relatives (parents, siblings, and offspring) of 50 patients with hypertrophic cardiomyopathy were assessed by clinical examination, electrocardiography, M mode and cross sectional echocardiography, and necropsy when available. Thirty nine (20%) first degree relatives had hypertrophic cardiomyopathy--37% of parents, 25% of siblings, and 8% of offspring. Eight (23%) of 35 affected relatives diagnosed by echocardiography had normal clinical and electrocardiographic findings. In the total study group 43% of the male population and 30% of the female population were affected. This difference is statistically significant. In 28/50 families there was familial occurrence of hypertrophic cardiomyopathy. Familial occurrence was demonstrated in 17 of 18 families in which five or more family members were assessed. In 15 families the pattern of inheritance was consistent with an autosomal dominant trait; in the other 13 the affected members were identified in a single generation and the pattern of inheritance could not be determined. PMID- 3663429 TI - Interrupted right aortic arch in DiGeorge syndrome. AB - The clinical and necropsy findings in four cases of interrupted right aortic arch and right descending aorta associated with DiGeorge syndrome (congenital absence or hypoplasia of the thymus and parathyroids) are described. All patients had a mirror image of type B interruption, namely a right aortic arch with reversed branching pattern and an interruption between the right common carotid and right subclavian artery. In two patients there was a doubly committed subarterial ventricular septal defect and in the two other patients there was a perimembranous septal defect. Three patients had a bicuspid aortic valve. In a consecutive series of 185 necropsies in infants and children with congenital heart disease there were no cases of interrupted right aortic arch that were not associated with DiGeorge syndrome. These observations and previous reports indicate that the concurrence of these two rare conditions is more than fortuitous. In patients with an interrupted aortic arch the clinician should be aware of the common association with DiGeorge syndrome. If the interruption is associated with a right-sided descending aorta it is highly probable that the patient has DiGeorge syndrome. PMID- 3663428 TI - Cross sectional subcostal echocardiography: atrioventricular septal defects and the short axis cut. AB - A short axis echocardiographic cut of the heart from the subcostal approach was used to study the atrioventricular junction in 47 infants and children with congenital heart disease and 20 with normal hearts. Examination of the diastolic openings of both atrioventricular valves was able to establish normal developments of the valves and annuli even when this was found in cases of complex congenital heart disease. In 30 patients with atrioventricular septal defects the technique distinguished between a partial defect (when the two atrioventricular valves were linked transseptally) and a complete defect (when there was only one atrioventricular valve). A range of atrioventricular attachments was seen in these patients. Short axis echocardiography from the subcostal approach reliably identifies different forms of atrioventricular septal defects by defining the anatomy of the atrioventricular valves during maximal diastolic expansion. PMID- 3663430 TI - Diagnosis of double aortic arch by cross sectional echocardiography with Doppler colour flow mapping. AB - A case of double aortic arch in a 15 month old boy was diagnosed by cross sectional echocardiography supplemented by Doppler colour flow mapping. These examinations showed two very large vessels communicating with the aorta; the demonstration of anterograde flow in one vessel and retrograde flow in the other enabled a definite diagnosis of Edwards type IA double aortic arch to be made. PMID- 3663431 TI - Infection of modified Blalock shunts. AB - A left-sided interposition graft (modified Blalock-Taussig anastomosis) was constructed with polytetrafluoroethylene in a three month old child with tetralogy of Fallot. This shunt thrombosed and a replacement shunt became the site of chronic Pseudomonas infection. The second anastomosis was excised and a third interposition graft was inserted on the right side because the anatomy was unsuitable for a classical Blalock-Taussig shunt. The patient died when he was 12 months old, after signs of infection and shunt occlusion had developed. At necropsy the acutely thrombosed right sided shunt was found to be the site of Candida albicans infection. Gallium and labelled white cell scans, computed tomography, and ultrasound scans had all failed to identify the sites of infection, which were only confirmed at operation or necropsy. PMID- 3663432 TI - Treatment of glossopharyngeal neuralgia by carbamazepine. AB - An elderly woman who presented with Adams-Stokes attacks that were preceded by paroxysms of neuralgia was successfully treated with carbamazepine. Ventricular asystole was provoked by pharyngeal pain and coincided with loss of consciousness. Vagal reflexes are probably responsible for the bradycardia that causes the cardiac symptoms of glossopharyngeal neuralgia. Carbamazepine (600 mg/day) abolished the pharyngeal pain and associated cardiovascular manifestations in this patient for at least ten months. PMID- 3663433 TI - A case of subacute effusive constrictive pericarditis with a probable amoebic aetiology. AB - A 48 year old man with amoebic pericarditis did not improve after pericardiocentesis. Facilities for echocardiography and haemodynamic studies were not available. Cardiac compression was suspected and at emergency pericardiectomy subacute effusive constrictive amoebic pericarditis was found. The patient recovered. This is believed to be the first report of a case of subacute effusive constrictive pericarditis caused by amoebiasis. PMID- 3663434 TI - Ventilatory effects of meptazinol and pethidine in anaesthetized patients. AB - The ventilatory effects of three doses of meptazinol (20 mg, 30 mg and 48 mg) were studied in anaesthetized patients and compared with those of pethidine 20 mg. Minute volume, tidal volume, ventilatory frequency, inspiratory and expiratory times were measured and mean inspiratory flow rates calculated. Each patient received a first dose of drug which was followed after 5 min by a second identical dose. After the first injection the ventilatory effects of meptazinol were dose-dependent and meptazinol 20 mg had an effect similar to pethidine 20 mg. Following repeated injection the effects on ventilation were markedly different between the drugs. Carbon dioxide retention and other compensatory mechanisms attenuate the ventilatory depression of meptazinol, but these may be inadequate in the anaesthetized patient. PMID- 3663435 TI - Disposition and pharmacokinetics of meptazinol in the CSF. Studies after intrathecal administration in the non-human primate Erythrocebus patas. AB - A preliminary study is reported on the kinetics of meptazinol following intrathecal and i.m. administration in the Patas monkey. Following intrathecal administration (single dose of 0.5 mg) at T12/L1, meptazinol rapidly disappeared from the CSF with a T1/2 of 35 min. At 240 min after intrathecal injection, most of the meptazinol had been distributed within the spinal tissue near the region of the injection, with minimal amounts reaching the brain (less than 5% of the concentrations present in the lumbar and thoracic tissue). Following i.m. administration (16 mg kg-1) peak concentrations were present in the CSF and plasma within 60 min. Appreciable concentrations persisted in the CSF up to 180 min after i.m. administration. The results would suggest that meptazinol should give rapid but short acting pain relief following intrathecal injection with minimal CNS-related side effects. PMID- 3663436 TI - Analysis of suxamethonium sensitivity following termination of pregnancy. AB - The cholinesterase genotypes in the majority (25/35) of patients with suxamethonium sensitivity following termination of pregnancy are heterozygotes with an E1a gene. Twelve of these patients have the genotype E1uE1a. The reported duration of apnoea is minimal in the heterozygotes lacking the E1a gene (about 5 10 min) and maximal in the homozygotes E1aE1a (about 35 min). With few exceptions, the heterozygotes having an E1a gene are apnoeic for 10-15 min. The apparent low frequency of suxamethonium in these patients is discussed. PMID- 3663437 TI - Additional blood-gas variables for the rational control of oxygen therapy. With allowance for shifts of the oxygen dissociation curve. AB - When a sample of arterial blood is analysed for oxygen tension and, using a modern oximeter, for haemoglobin concentration and saturation, it is possible to calculate the position of the oxygen dissociation curve and two new variables: "P95" and "C(a-x)O2". P95 is the tension at which the haemoglobin would be 95% saturated and can, therefore, constitute a target tension for near-maximum arterial content of oxygen. C(a-x)O2 (the "conditional extraction" of oxygen) is the amount of oxygen, in ml/dl blood, which can be extracted from the arterial blood for a hypothetical mixed-venous oxygen tension PxO2. It is explained how it is possible to estimate the adequacy of tissue oxygenation by comparing any available estimate of the required extraction (normally about 5 ml dl-1) with conditional extractions calculated for three hypothetical values of PxO2 covering the clinical range. Methods of calculation are given. For accurate results at high arterial saturations, a peripheral venous sample may be required in addition to the arterial sample. PMID- 3663438 TI - Propranolol increases oxygen utilization during hypoxia. AB - The effects of propranolol on whole body oxygen consumption and blood oxygen content were measured in the dog during extreme hypoxic conditions. At 9% inspired oxygen four of eight control animals died within 40 min. An identical second group was pretreated with propranolol and none died during the same hypoxic stress. Hypoxia decreased oxygen consumption in both groups, but the decrease was less in the propranolol-pretreated dogs. A second set of 16 dogs was ventilated with 10% oxygen and all animals survived. A similar, although less pronounced, effect on oxygen consumption was noted and propranolol once again lessened the hypoxia-induced decrease in oxygen consumption. With hypoxaemia, metabolic acidosis developed in all animals and the arterio-venous oxygen content difference decreased; however, propranolol lessened the acidosis and the decrease in arterio-venous oxygen content difference. We conclude that, during hypoxia, propranolol increases oxygen utilization by the tissues and this might account for better survival. PMID- 3663439 TI - A model of the extradural space and a reappraisal of the extradural space pressure. AB - A model is described which was used to study the genesis of the pressure in the extradural space. It consists of a Perspex outer tube, with perforations covered with rubber septa to allow the insertion of needles, and Paul's tubing on the inside, representing the dura mater. The Paul's tubing is filled with water through a constant head of pressure apparatus. The response of the model to the insertion of an extradural needle and the reproduction of various clinical phenomena are described. The pressure in the extradural space is discussed in relation to the performance of the model. PMID- 3663440 TI - Heat and moisture exchangers in artificial ventilation. An experimental study of the effect of gas leakage. AB - The effect of gas leakage around an uncuffed tracheal tube on the performance of Heat and Moisture Exchangers (HME) was examined experimentally. Such leaks were shown to cause measurable decreases in the humidity output and efficiency of HME. The magnitude of the decrease in humidity output was shown to be dependent upon the proportion of expired volume which was leaked, and on the inspired volume. Other factors are discussed. PMID- 3663441 TI - Which pH paper? AB - Five different brands of pH indicator paper were used by 20 anaesthetists to test four buffer solutions. There were significantly fewer correct answers with two papers than with the other three. The worst paper in the study (Whatman full range) gave only 20% correct answers, compared with 92.5% from the best (Merck). PMID- 3663442 TI - Acute dilatation of the stomach during general anaesthesia. A case report. AB - We describe a case of acute dilatation of the stomach which occurred during general anaesthesia for cataract extraction. This resulted in aspiration pneumonitis. We report the case because of its unexpected and sudden appearance. The presentation and management of this case is described, together with a review of the anaesthetic problems which may occur. PMID- 3663443 TI - Malignant hyperpyrexia and isoflurane. A case report. AB - Malignant hyperpyrexia developed, and was successfully treated, in a 50-year old man undergoing pyelolithotomy. Early diagnosis with the assistance of end-tidal carbon dioxide monitoring facilitated prompt treatment with i.v. dantrolene. A positive muscle biopsy subsequently confirmed the diagnosis. The only likely triggering agent used was isoflurane. PMID- 3663444 TI - Post-marketing surveillance or drug acceptability study? PMID- 3663445 TI - Characterisation of theophylline metabolism in human liver microsomes. AB - 1. A radiometric high performance liquid chromatographic method is described for the assay of theophylline metabolism in vitro by the microsomal fraction of human liver. 2. Formation of the three metabolites of theophylline (3-methylxanthine, 1 methylxanthine and 1,3-dimethyluric acid) were linear with protein concentrations to 4 mg ml-1 and with incubation times up to 180 min. 3. The coefficients of variation for the formation of 3-methylxanthine, 1-methylxanthine and 1,3 dimethyluric acid were 1.2%, 1% and 1.6%, respectively. 4. Theophylline is metabolised by microsomal enzymes with a requirement for NADPH. 5. The mean (n = 7) Km values for 1-demethylation, 3-demethylation and 8-hydroxylation were 545, 630 and 788 microM, respectively, and the mean Vmax values were 2.65, 2.84 and 11.23 pmol min-1 mg-1, respectively. 6. There was a high correlation between the Km and Vmax values for the two demethylation pathways suggesting that the demethylations are performed by the same enzyme. 7. Overall the in vitro studies are consistent with the in vivo results which suggest the involvement of two cytochrome P-450 isozymes in the metabolism of theophylline. PMID- 3663446 TI - The accuracy of a pharmacokinetic theophylline predictor using once daily dosing. AB - 1. The accuracy of a computer based pharmacokinetic prediction method based on Bayesian analysis has been evaluated for an oral show release form of theophylline. 2. In 83 patients from seven centres 24 h serum theophylline concentration-time profiles were measured under a variety of circumstances. 3. Revised predictions of 24 h serum theophylline concentration profiles were generated by Bayesian analysis using single serum drug concentrations taken before, during and after the study days in different subgroups of those patients. Comparing the predicted and measured profiles the mean prediction error (bias) was 0.05 mg l-1 for peak concentrations and 0.04 mg l-1 for trough concentrations during once daily dosing. The corresponding root mean squared prediction errors (precision) were 2.59 and 1.17 mg l-1, respectively. 4. This accuracy is considered more than adequate for clinical purposes. 5. The technique can be used with a variety of other drugs and can form a valuable part of a routine therapeutic drug monitoring service. PMID- 3663448 TI - A modified trans-membrane migration method for measuring the effect of drugs on sperm motility. AB - 1. The trans-membrane migration ratio (TMMR) technique is a simple method for quantitating and comparing the effect of drugs on sperm motility. 2. The ultrafilter membrane (Nucleopore) used allows mixing between the solutions on either side resulting in 21-fold dilution of a drug initially mixed with semen. 3. The concentration of drug originally mixed with semen does not remain constant over the incubation time. 4. The phosphate buffer saline (PBS) in the lower chamber should be replaced by PBS containing the same concentration of drug as in the upper chamber so that a homogenous system is established throughout the incubation. 5. Reports of previous studies using this technique may have underestimated the effect of drugs on sperm motility. PMID- 3663447 TI - Circulatory and respiratory effects of infused adenosine in conscious man. AB - 1. The nucleoside, adenosine, was infused into six conscious healthy male subjects at rates up to 100 micrograms kg-1 min-1. 2. Compared with a control 0.9% saline infusion, adenosine in all subjects caused dose dependent increases in heart rate, skin temperature and minute ventilation with corresponding falls in PaCO2, estimated transcutaneously. 3. There were no changes in systemic blood pressure, airways resistance (measured by forced partial expiratory manoeuvres), or plasma catecholamines. At the top infusion rates subjects experienced tolerable chest and abdominal discomfort. 4. These findings conflict with some previous studies in anaesthetised man and animals, in which higher doses of adenosine and its long acting analogues have caused hypotension and central respiratory depression. 5. Although some of these changes may have been due to symptoms, the cardiovascular changes may have been due to a vasodilator action and the respiratory stimulation may have been due to an action on peripheral chemoreceptors. PMID- 3663449 TI - Cyclosporin-phenytoin interaction: re-evaluation using metabolite data. AB - 1 Freeman et al. (1984) evoked enzyme induction to explain the lower plasma concentration of cyclosporin following phenytoin co-administration in man. 2 We have examined the whole blood concentration data of two metabolites of cyclosporin, as well as unchanged drug, all measured by h.p.l.c., associated with the above mentioned study. 3 Phenytoin produced no significant effect on either the terminal half-life of both metabolites or the ratio of area under the concentration-time curve of metabolite to parent drug. 4 These data strongly suggest that phenytoin reduces the absorption of cyclosporin; they do not generally support the idea that phenytoin induces cyclosporin metabolism. PMID- 3663450 TI - Jejunal and ileal absorption of oxprenolol in man: influence of nutrients and digestive secretions on jejunal absorption and systemic availability. AB - 1 Study I evaluated the absorption of oxprenolol in the ileum, compared to jejunum, in healthy volunteers by an intestinal perfusion technique. Around 80 mg of drug were delivered as a saline solution directly in the small bowel. 2 Samples taken 30 cm distally to the site of perfusion showed that 63% of perfused oxprenolol was absorbed in the jejunum and 48% in the ileum; the differences were significant. 3 The plasma concentration-time profiles were similar for the two perfusions. The AUC and Cmax values of free and conjugated oxprenolol for the jejunal perfusion were significantly lower than those of ileum. They showed large but consistent intersubject variations in the two treatments. 4 Study II investigated, using the same technique, the influence of nutrients and digestive secretions on jejunal absorption and systemic availability of this drug. A saline (in treatments A and B) or a nutrient (in treatment C) solution containing oxprenolol was perfused into the jejunum below a balloon either inflated (A) or deflated (B and C). 5 The disappearance rate of oxprenolol from the jejunum was unaffected by endogenous secretions. The mean amount of drug absorbed along a 30 cm jejunal segment accounted for 52 (A) and 57% (B) of the total amount perfused. The intestinal absorption rate was markedly increased in the presence of nutrients (mean amount absorbed 96% for C). 6 The change in the rate of disappearance from the intestine had no effect on the systemic availability of oxprenolol (mean AUC values 8740, 8250 and 8020 nmol l-1 h for A, B and C, respectively) or its elimination from plasma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663451 TI - Calcium absorption and excretion in patients treated with verapamil. AB - 1. The effect of verapamil on the intestinal absorption of calcium was studied using a single isotope technique. Serum calcium and urinary excretion of calcium in the urine were followed in nine patients during treatment with verapamil for 2 months. 2. A dose of 80-120 mg (three times daily) resulted in a significant reduction of systolic and diastolic blood pressure. 3. There was no change in the intestinal calcium absorption (alpha) expressed as the fraction of given activity absorbed per hour (alpha = 0.82 +/- 0.19 vs alpha = 0.83 +/- 0.25; +/- s.d., NS) or of the excretion of calcium in urine (Ca/creatinine ratio 0.35 +/- 0.20 vs 0.31 +/- 0.33; NS). 4. Serum calcium was not significantly different before and during treatment (2.43 mmol l-1 +/- 0.10 vs 2.47 mmol l-1 +/- 0.14; NS). 5. This study demonstrates that verapamil, at doses recommended for clinical use, does not seem to affect the intestinal absorption of calcium, the serum calcium concentration or the excretion of calcium in urine. PMID- 3663452 TI - Cimetidine increases serum mebendazole concentrations. Implications for treatment of hepatic hydatid cysts. AB - In eight patients (five with peptic ulcer disease and three with hydatid cysts), the [14C]-aminopyrine breath test (ABT) and maximum serum concentration of mebendazole following a dose of 1.5 g of mebendazole three times daily were determined before and after treatment with cimetidine (400 mg three times daily for 30 days). Serum mebendazole concentrations were measured in blood samples taken 2 h after each drug intake. Cimetidine lowered the 14CO2 specific activity (SA) at 1 h (P less than 0.01) and increased the maximum serum concentration of mebendazole (P less than 0.01). A significant correlation was found between SA at 1 h and the highest concentration of mebendazole before (r = -0.71, P less than 0.05) and after (r = -0.82, P less than 0.05) cimetidine ingestion. Combined administration of cimetidine and mebendazole resulted in the complete resolution of previously unresponsive hydatid cysts. PMID- 3663453 TI - Propranolol disposition in patients with hepatosplenic schistosomiasis. AB - Eight Sudanese patients with hepatosplenic schistosomiasis and seven Sudanese controls were administered a single oral dose of long acting (LA), propranolol 160 mg; blood propranolol levels were measured at regular intervals for 12 h using g.l.c. In patients with hepatosplenic schistosomiasis, propranolol blood concentrations were greater (P less than 0.05) at all time intervals, Cmax 63.5 (29-143) ng ml-1 (median and range) than controls Cmax 23 (12-37) ng ml-1. Median AUC0-12 was also greater (P less than 0.05) (533 and 218 ng ml-1 h respectively), tmax were not significantly different. In patients and controls prior to treatment, standing heart rate (77.5 (60-110), 72 (68-74) beats min-1) systolic (120 (105-150), 110 (100-120) mm Hg) and diastolic blood pressure (75 (60-90), 70 (60-80) mm Hg) were not significantly different. However following propranolol administration a reduction (P less than 0.05) occurred in both systolic (median 20 mm Hg) and diastolic (median 12.5 mm Hg) blood pressure in the patients compared with controls. Heart rate was reduced by a median of 10 beats min-1 in both groups. These observations indicate that propranolol bioavailability in patients with hepatosplenic schistosomiasis is increased possibly due to reduced presystemic extraction. PMID- 3663454 TI - Tribulin output in neurological disorders. PMID- 3663455 TI - Gynaecology in prison. PMID- 3663456 TI - The role of gallium 67 scanning in the management of Hodgkin's disease. PMID- 3663457 TI - Gastric carcinoma arising during five years treatment with cimetidine for duodenal ulceration. PMID- 3663458 TI - Diphtheria--a forgotten disease. PMID- 3663459 TI - Toxic-shock syndrome due to staphylococcal infection of a burn. PMID- 3663460 TI - Acute small intestinal obstruction in the elderly. PMID- 3663461 TI - Chemosensitization by misonidazole in CCNU-treated spheroids and tumours. AB - Misonidazole has been demonstrated to enhance the cytotoxicity of several common antineoplastic drugs in vitro and in vivo, and its mechanism of action as a chemosensitizer, though still unknown, is thought to be dependent upon hypoxia. We have used fluorescence-activated cell sorting to evaluate chemopotentiation by misonidazole as a function of cell position in V79 spheroids and KHT tumours. CCNU toxicity was enhanced in all cell subpopulations of both tumours and spheroids, with greater consistency than might be predicted on the basis of the known variations in oxygen tension. Further, both misonidazole and CCNU as single agents were preferentially toxic in the less well oxygenated regions of each system, arguing that differential toxicity cannot be implicated in the chemopotentiation observed. In fact, increased treatment toxicity did not necessarily lead to increased chemopotentiation, nor was potentiation directly related to the metabolism/binding of the misonidazole. Chemopotentiation in multicell systems thus appears to be a complex, multi-factorial process. PMID- 3663462 TI - Photodynamic therapy in the normal rat colon with phthalocyanine sensitisation. AB - Photodynamic therapy (PDT) involves the interaction of light with an administered photosensitising agent to produce cellular destruction. It has promising potential for the local and endoscopic treatment of gastrointestinal cancer. There is however little data on the response of normal intestine to PDT. We have investigated the use of a new photosensitiser chloro aluminum sulphonated phthalocyanine (AlSPc) for colonic PDT. The peak concentration of AlSPc in the colon measured by alkali extraction occurred 1 h after i.v. injection. The cellular uptake demonstrated by laser fluorescence microscopy was greater in the mucosa than in the muscle. AlSPc was activated in the tissues by light from an argon ion pumped dye laser at 675 nm. The laser power was set at 100 mW and the fibre placed touching the mucosa. In control animals no macroscopic damage was seen. Temperature measurement using a microthermocouple array showed no temperature rise during light exposure. The energy (fluence), dose of sensitiser and time from sensitisation to phototherapy were altered and the area of necrosis measured. The geometry of the colon made theoretical analysis of the correlation between laser energy and size of lesion difficult. However, following direct measurement of the relative light intensity (fluence rate) in the colon we were able to confirm that there was a threshold fluence for colonic necrosis. The area of photodynamic damage seen 72 h after phototherapy fell with the fall in tissue concentration of AlSPc from 1 h to 1 month after i.v. injection. However, maximum tissue necrosis occurred when treatment was performed immediately after i.v. injection. In this situation, intense vascular spasm was seen and any light transmitted through the colon which fell on the small bowel mesentery caused a lethal ischaemic necrosis. The initial histological changes after PDT were vascular, followed by full thickness necrosis at 72 h. Healing by regeneration was complete by 2-3 weeks. Despite full thickness necrosis there was no reduction in the colonic bursting pressure at any time. Colon treated by hyperthermia had a reduced bursting pressure. Specific collagen stains showed that PDT did not alter the submucosal collagen architecture whereas hyperthermia did. PMID- 3663463 TI - Amiodarone is more efficient than verapamil in reversing resistance to anthracyclines in tumour cells. AB - We have previously demonstrated that amiodarone is able to reverse resistance of rat colon cancer cells to anthracyclines. We now compare the efficiency of amiodarone to verapamil one, another antiarrhythmic agent used in experimental systems and in clinical trials to enhance the effects of anthracyclines on resistant cancer cells. Amiodarone is more efficient than verapamil when both drugs are used at the same molar concentrations. Desethylamiodarone, the main metabolite of amiodarone, is as efficient as its precursor. Optimal concentrations of amiodarone are obtained without side effects in the sera of patients treated by oral administration followed by a loading infusion of amiodarone. On the other hand, maximal tolerated levels of verapamil reported in clinical trials are less efficient than amiodarone maximal levels in the reversal of resistance to anthracyclines in our experimental model in vitro. We suggest that amiodarone, which is more efficient and less toxic than verapamil, could be substituted for verapamil in future clinical trials. PMID- 3663464 TI - Infusion-rate independent cellular adriamycin concentrations and cytotoxicity to human bone marrow clonogenic cells (CFU-GM). AB - The effect of adriamycin (ADM) infusion-rate on cellular ADM concentrations and on clonogenicity of human haematopoietic cells was studied in vivo and in vitro. In patients an ADM dose of 30 mg m-2 was administered as a bolus injection, or as a 4 h or a 24 h infusion. In vitro the effect of ADM on clonogenic cell growth was determined after exposure during 5 min, 2 h and 24 h of human bone marrow cells to increasing ADM concentrations. ADM showed rapid intracellular accumulation, to levels 100-fold the plasma concentration in vivo or the incubation medium concentration in the in vitro experiments. After a bolus injection or 5 min exposure only approximately 10% of the cellular peak ADM was retained after elimination of the drug from the plasma or the incubation medium. Ninety percent of the ADM was apparently 'loosely' bound. After 4 h and 24 h constant-rate infusions and also after 2 h and 24 h incubations in vitro, the cells accumulated ADM gradually, and the subsequent washing-out of the cellular ADM was substantially less, most of the ADM being 'tightly' bound. Despite these different patterns of uptake and retention after in vivo short- and long-lasting infusion of the same total dose, the 'tightly-bound' cellular ADM concentrations were the same. Moreover, comparable cellular ADM concentrations, retained after efflux of the 'loosely-bound' cellular ADM fraction were equally cytotoxic to normal human clonogenic cells. Short-lasting cellular peak ADM concentrations which occur after a bolus injection or after short exposure to high ADM concentrations are not essential for the cytotoxic effect, in contrast to the retained, 'tightly-bound' cellular ADM levels. PMID- 3663465 TI - Stability of oestrogen receptor status in sequential biopsies from patients with breast cancer. AB - Sequential biopsies of breast cancer tissue were obtained from a total of 210 women in order to assess any change in oestrogen receptor (ER) status arising spontaneously or as a result of intervening therapy. A combined assay measuring both cytosol and nuclear oestrogen receptors was used for all samples. One hundred and fifty-five patients had biopsies of their primary tumour and of a later loco-regional recurrence; 26 had biopsies of their primary tumour and a recurrence or new primary in the opposite breast; and 29 had sequential biopsies of recurrent disease only. Overall only 61.2% of the primary tumours retained their original status with respect to both cytosol and nuclear oestrogen receptors on recurrence. These results were influenced by intervening therapy, however, and if only untreated patients are considered, over 70% of their recurrences contain the same combination of cytosol and nuclear receptors as found in the primary tumours. For tumours 'recurring' in the opposite breast, the pattern was similar with 69.2% retaining the same status as the first primary. The agent found most likely to alter I:R status was tamoxifen and in the samples taken from patients undergoing treatment with this drug, no tumour was found to contain measurable receptor. PMID- 3663466 TI - Evidence that multidrug resistance in Chinese hamster ovary cells is associated with alterations in the endoplasmic reticulum. PMID- 3663467 TI - Pretreatment tumour-antigen Ta-4 in serum of patients with squamous cell carcinoma of the uterine cervix. PMID- 3663468 TI - Atrophic gastritis and vitamin C status in two towns with different stomach cancer death-rates. AB - A survey was conducted of 513 men aged 65 74 years living in two British towns with high and low stomach cancer death-rates. The prevalence of severe atrophic gastritis (defined as a serum pepsinogen I less than 20 micrograms l-1) was significantly higher in the high-risk than in the low-risk town (14.5% and 7.7% respectively); it also tended to be higher in the manual workers, who are known to have a greater risk of stomach cancer than non-manual workers. The manual workers in the high-risk town were particularly likely to have had a partial gastrectomy. Plasma ascorbate concentration and fruit intake were lower in the high-risk area and lower social classes, suggesting a poorer vitamin C status. There was, however, no direct relationship between ascorbate concentration and the presence of severe atrophic gastritis. These findings are consistent with the hypothesis that risk of stomach cancer is determined in two stages--a long-term effect, producing atrophic gastritis; and a short-term effect in which vitamin C is protective. PMID- 3663469 TI - Spatial patterns in electoral wards with high lymphoma incidence in Yorkshire health region. AB - The possibilities of clustering between those electoral wards which display higher than expected incidences of cases of the lymphomas occurring between 1978 and 1982 are examined. Clusters are defined as being those wards with cases in excess (at a probability of less than 10%) which are geographically adjacent to each other. A separate analysis extends the definition of cluster to include high incidence wards that are adjacent or separated by one other ward. The results indicate that many high incidence lymphoma wards do occur close together and when computer simulations are used to compute expected results, many of the observed results are shown to be highly improbable both in the overall number of clustering wards and in the largest number of wards comprising a 'cluster'. PMID- 3663470 TI - Twenty-eighth annual meeting of the British Association for Cancer Research (in conjunction with the second annual meeting of the Association of Cancer Physicians). April 6-8, 1987, Newcastle-upon-Tyne, UK. Abstracts. PMID- 3663471 TI - Second annual meeting of the Association of Cancer Physicians (in conjunction with the 28th AGM of the British Association for Cancer Research). April 6-8, 1987, Newcastle-upon-Tyne, UK. Abstracts. PMID- 3663472 TI - Breast cancer and month of birth. PMID- 3663473 TI - Rodent fibroblast tumours expressing human myc and ras genes: growth, metastasis and endogenous oncogene expression. AB - The effects of expression of human c-myc and both mutated (T24) and normal forms of human Ha-ras-1 were studied in an aneuploid rat fibroblast line (208F). Mutated T24 Ha-ras was also studied in a near-diploid cell derived from early passage Chinese hamster lung fibroblasts (CHL). In contrast to the parental fibroblasts, cells expressing any of the human oncogenes engendered rapidly growing tumours in immune-suppressed animals. Blood- and lymph-borne metastases were observed from both ras- and myc-expressing cells. In general ras-expressing cells were more aggressive than those expressing myc. In the 208F background, expression of c-myc was associated with an incidence of mitosis similar to that in tumours expressing T24 Ha-ras, but incidence of single cell death by apoptosis was higher. Quantitatively, expression of human oncogene mRNA was constant during growth in vivo, and similar to that sometimes observed in human neoplasms. Of 9 endogenous proto-oncogenes, 7 showed no change in expression from the parental fibroblasts, but c-abl and c-fos were strongly expressed in all cells expressing human ras or myc. Thus these tumorigenic cells, although transfected with single human oncogenes, all expressed oncogenes with both nuclear- and membrane associated products. PMID- 3663474 TI - Potentiation of vincristine by vitamin A against drug-resistant mouse leukaemia cells. AB - Vitamin A has been shown to potentiate the cytotoxic action of anticancer agents like vincristine (VCR) against drug resistant mouse P388 leukaemia cells. In vitro tests showed enhancement by retinyl acetate of cytocidal activities of VCR against drug-sensitive leukaemia (P388/S) and VCR-resistant leukaemia (P388/VCR) cells in culture; retinyl acetate rather specifically potentiated VCR against cultured P388/VCR cells than P388/S cells. The cellular accumulation of radioactive VCR was significantly enhanced in cultured P388/VCR cells when retinyl acetate was present. The efflux of VCR from drug-resistant cells was blocked by retinyl acetate. The effect of the combination of vitamin A and VCR was also tested in vivo on the life-span of mice bearing P388/S or P388/VCR. Intraperitoneal administration of retinyl palmitate at 41.75 or 83.5 mg kg-1 was effective to potentiate the antileukaemic activity of VCR against P388/S bearing mice, and it also overcame vincristine-resistance in P388/VCR bearing mice. PMID- 3663475 TI - Synergistic cell inactivation by cis-dichlorodiammineplatinum in combination with 1-propargyl-5-chloropyrimidin-2-one. AB - A synergistic effect with respect to inactivation of human NHIK 3025 cells cultured in vitro was displayed when treatment with cis dichlorodiammineplatinum(II) (cis-DDP) and the mitotic inhibitor 1-propargyl-5 chloropyrimidin-2-one (NY 3170) were given in simultaneous combination. Cell inactivation was measured by loss of colony-forming ability. Treatment with NY 3170 alone produced no significant inactivation at concentrations up to 2 mM. However, treatment with NY 3170 in combination with cis-DDP induced increased cell inactivating effects equal to a doubling of either the concentration of cis DDP or treatment time. Scheduling of NY 3170 treatment in relationship to a 1 h cis-DDP pulse revealed that synergism occurred only when the two drugs were present simultaneously. The inactivating effect of 10 microM cis-DDP in combination with 2 mM NY 3170 given to synchronized NHIK 3025 cells at various stages of the cell cycle was also determined. For cells treated in S or in G2 + M cell survival was reduced by a factor of 5 after a 1 h treatment with the drug combination as compared to similar treatment with cis-DDP alone. The cells appeared to be most sensitive at the time of initiation of DNA synthesis. Here cell survival was reduced by a factor of 100 following treatment with the drug combination than following treatment with cis-DDP alone. Measurement of cell associated platinum by atomic absorption spectroscopy indicated that cellular uptake of cis-DDP was increased when NY 3170 was simultaneously present during drug treatment. PMID- 3663476 TI - A study of some variables in a tetrazolium dye (MTT) based assay for cell growth and chemosensitivity. AB - We have studied various factors involved in the optimal use of a tetrazolium (MTT) based colorimetric assay for cell growth and chemosensitivity. The assay is dependent on the ability of viable cells to metabolise a water-soluble tetrazolium salt into a water-insoluble formazan product. We have found that DMSO is the best solvent for dissolving the formazan product, especially where a significant amount of residual medium is left in the wells of the microtitre tray used for the assay. A reaction occurs between medium and a solution of MTT formazan in DMSO which changes the shape of the absorbance spectrum of the solution. The resulting optical density is not however greatly dependent upon the volume of added medium in the range 1-10 microliters. Between 10 and 40 microliters of added medium results in a gradually lower optical density than that produced by the smaller volumes. Above 40 microliters, the optical density increases again due to turbidity as protein precipitation occurs. When cells are incubated with MTT, the resulting optical density of the formazan product is dependent upon both the concentration of MTT and the incubation time. The optical density is stable for several hours after solution of the formazan in DMSO. A linear relationship is seen between optical density and cell number for incubation times of 2, 4, 6 or 24 h with 20 microliters of MTT (5 mg ml-1) added to 200 microliters medium. We have adopted 4 h as the standard incubation time for the assay. Only a small amount of MTT formazan product can be detected in the growth medium of wells in which cells have been exposed to MTT. Comparative chemosensitivity data for EMT6 mouse tumour cells show good agreement between results obtained using the MTT assay and results based on total cell count after a fixed period of growth. PMID- 3663477 TI - Evaluation of immunoreactivity with monoclonal antibody NCRC 11 in breast carcinoma. AB - Immunocytochemical staining with monoclonal antibody NCRC 11 of formalin fixed paraffin embedded tumour tissue has been studied in 444 cases of primary breast cancer with a minimum follow period of 6 years. The relationship between extent of staining, assessed on a four point scale, and patient survival has been confirmed. There are significant relationships between staining and both histological grade and oestrogen receptor status. No association has been shown between staining and lymph node stage or tumour size. Simplification of staining assessment by modification to two staining groups still allows significant separation of patients into prognostic groups and incorporation into an existing prognostic index. PMID- 3663478 TI - Characterization of radiation sensitivity of human squamous carcinoma A431 cells. AB - Studies have been performed to investigate the radiosensitivity of human squamous carcinoma cells. A431 cells were grown in vitro as exponential and fed-plateau monolayer cultures or as multicellular spheroids. Radiobiological studies of various cultures showed that fed-plateau phase cells were more sensitive (D0 = 1.3 Gy) than exponentially growing cells (D0 = 1.5 Gy). After a single dose of 12 Gy or two doses of 6 Gy irradiation, A431 cultures exhibited a large capacity for potentially lethal damage (PLD) repair (PLD repair factor = 17), but a relatively small sublethal damage (SLD) repair. In order to measure the radiation sensitivity of proliferating (P) and quiescent (Q) cells, enriched populations of P- and Q-cells were isolated from A431 spheroids. Flow cytometric analysis with acridine orange (AO) staining demonstrated that there was a shift of the RNA histograms in fed-plateau and spheroid cultures towards lower values, suggesting the presence of a subpopulation of Q-cells. Centrifugal elutriation was used to isolate the Q-cells from dissociated spheroid cells. Coulter cell volume distributions and flow cytometric analysis showed that Q-cells had a small cell volume (approximately 1380 microns3), low RNA content and a G1-like DNA content. Continuous labelling experiments with tritiated thymidine confirmed the non proliferating nature of the Q-cells. Irradiation of the Q-cells after isolation from spheroids with between 0 to 10 Gy showed that they were more radiosensitive (decreased D0) than the P-cells isolated from these spheroids. The latter were, however, similar in radiosensitivity to exponential G1 cells. PMID- 3663479 TI - Deriving cell survival curves from the overall responses of irradiated tumours: analysis of published data for tumour spheroids. AB - Curves of growth delay (GD) or 'cure' after graded doses of radiation have been analysed for 16 lines of human and animal tumours grown as multicellular spheroids in vitro. Dose-survival curves were derived for those cellular units from which spheroids regrow after unsuccessful irradiation (spheroid-regenerating cellular units, SRU). For 10 sets of data from 6 spheroid lines, the Do's and extrapolation numbers of the SRU derived by GD could be compared with the response of the clonogenic cells of the spheroids. For Do, a good correlation (r = 0.910) was found between the two; this was true also for Do derived from curves of spheroid 'cure' (7 sets of data from 6 spheroid lines) and clonogenic cells (r = 0.986). Using GD, the correlation of extrapolation numbers was less good (r = 0.682), the values for SRU commonly being higher than those for clonogenic cells. This may reflect features of the growth curves of spheroids after the lower range of doses of radiation. For human and animal tumour spheroids of 250 microns or less, derived Do ranged from 0.5 to 2.5 Gy. For spheroids of 350 microns or more, derived Do for animal tumour lines ranged from 3.4 to 4.2 Gy, for human lines from 1.5 to 2.1 Gy. PMID- 3663480 TI - Response of spheroids implanted in the peritoneal cavity of mice exposed to cyclophosphamide and ionizing radiation. AB - Chinese hamster V79-171B spheroids implanted in the peritoneal cavity of C3H mice were characterized as a model for evaluating the toxicity of drugs requiring metabolic activation in vivo. After 24 hours in the peritoneal cavity, spheroid cellularity and plating efficiency were not significantly decreased, and host cell infiltration was estimated between 5 and 10%. The oxygenation of spheroids in the peritoneal cavity was assessed using their response to ionizing radiation. Spheroids were recovered after irradiation, incubated for 20 minutes in vitro with the slowly penetrating fluorescent dye, Hoechst 33342, and reduced to single cells with trypsin. Cells were analysed for clonogenicity as a function of position within the spheroid by using fluorescence-activated cell sorting in conjunction with the Hoechst diffusion gradient. When spheroids were first placed in the peritoneal cavity, the hypoxic fraction was close to 100%, but after 24 hours, cell oxygenation increased, probably due to a decrease in cell respiration rate. However, the location of a spheroid within the peritoneal cavity did not influence the radiosensitivity of individual spheroids or the amount of Hoechst 33342 delivered to the spheroid when Hoechst was given intravenously; individual spheroids recovered from mice given an intravenous injection of Hoechst showed no greater heterogeneity in binding than that observed when spheroids were incubated with Hoechst in vitro. Mice implanted with spheroids were also exposed to cyclophosphamide; the external cells of 0.6 mm diameter spheroids were about 30% more sensitive than the internal cells to the toxic effects of both cyclophosphamide and X-rays, and the combination of the two agents was additive at all depths within the spheroid. PMID- 3663481 TI - Second primary malignancy after Hodgkin's disease, ovarian cancer and cancer of the testis: a population-based cohort study. AB - The risk of second primary malignancy was assessed in a population-based cohort study of all persons registered with Hodgkin's disease (n = 2,970), ovarian cancer (n = 11,802) and testicular cancer (n = 2,013) in the South Thames Cancer Registry during the period 1961-80, to identify for further study those second malignancies which might be treatment-related. A total of 244 second malignancies was observed. After adjustment for age, sex and calendar period, the relative risk of any second malignancy was 1.4 (90% confidence interval (CI) 1.1-1.7) after Hodgkin's disease, 1.1 (90% CI 1.0-1.2) after ovarian cancer and 0.7 (90% CI 0.5-1.0) after testicular cancer. In particular, the relative risk for leukaemia was 11.9 after Hodgkin's disease, 3.7 after ovarian cancer and 2.5 after testicular cancer. Excess risks were also observed for cancers of the cervix and lung after Hodgkin's disease, for cancers of the breast, lung and rectum after ovarian cancer, and for contralateral testicular cancer. Confounding by social class or smoking does not explain these observations. The excess risks of leukaemia and of second cancer were higher in patients first diagnosed with Hodgkin's disease and ovarian cancer in the 1970s than for those first diagnosed in the 1960s. Increased use of multiple-agent chemotherapy regimes for these tumours in the 1970s may have contributed to these increases in excess risk. PMID- 3663482 TI - The completeness of cancer registration in follow-up studies--a cautionary note. AB - In Britain the National Health Service Central Registers (NHSCRs) provide the facility for a study population to be 'flagged', initiating a system of notification to investigators of deaths and cancers that occur in the population. This system of notification is an invaluable resource for epidemiological research. A comment on its efficiency is provided here by a comparison of the system with an independently ascertained series of breast cancers. Fifty verified breast cancer cases were identified during a study of a flagged cohort of British women taking hormone replacement therapy. At the time of analysis (May 1985), some 2.5 years after diagnosis of the most recent case, twenty-eight of the 50 cases had not been notified to the investigators by the NHSCRs. Of these, fourteen had not been registered. Eight had been duly registered, but had not yet been recorded at the NHSCRs. Five of the remaining six cases were in the process of being notified. The implications of these findings for cancer researchers are discussed. The potential for omission and delay between the diagnosis of cancers in a flagged population and their notification to the investigators must be taken into account, if underestimation of the true level of cancer risk is to be avoided. PMID- 3663483 TI - Oral contraceptives and survival in breast cancer. PMID- 3663484 TI - Two further cases of t(2;13) in alveolar rhabdomyosarcoma indicating a review of the published chromosome breakpoints. PMID- 3663485 TI - Outcome of asthma induced by isocyanates. AB - Isocyanates are widely used in industry for the manufacture of polyurethanes. Although they are recognized as an important cause of occupational asthma, it is unclear whether asthma persists after avoidance of exposure. We have followed up 50 cases, all of whom had avoided exposure for at least 4 years. At follow-up, 82% continued to have respiratory symptoms and approximately half of these required treatment at least once per week. These results indicate that a significant proportion of those with isocyanate-induced asthma are likely to have persisting symptoms for at least several years after exposure is avoided. PMID- 3663486 TI - Underdiagnosis of asthma in the elderly. AB - One hundred and ninety-nine elderly men and women were assessed for their pulmonary function and their mental ability. One hundred and twenty-one patients had a PEFR less than 70% of the predicted for their age and height. Reversibility tests showed that 82 patients had 15% or more improvement in their PEFR following 200 micrograms salbutamol. However, only 6% of the patients were receiving respiratory-related medication. Further analysis showed that there was no correlation between the patients' age, sex, amounts of sputum production, wheeze, breathlessness, smoking habits, chest expansion, hospitalization, mental function and airway reversibility. 'Reversible' patients did, however, have a high incidence of cough and a low pre-test PEFR value. The predominant symptom of 'reversible' and 'non-reversible' patients was cough. The study emphasizes the importance of routinely performing lung function tests in elderly patients and the use of reversibility tests to identify reversible airways obstruction. These results suggest that in old age potentially reversible airways obstruction is often overlooked or misdiagnosed. PMID- 3663487 TI - Regional thoracic centres. PMID- 3663488 TI - Comparison of atopic and non-atopic patients dying of asthma. British Thoracic Society. AB - The British Thoracic Association conducted a confidential inquiry into death from asthma in adults aged 15-64 years in the West Midlands and Mersey Regions in 1979. Ninety patients were identified as having died of asthma. The 86 for whom sufficient information was available have been classified according to their atopic status: 52 (60%) were judged to be atopic and 34 non-atopic. A history of rapidly progressing severe asthma attacks and death within an hour of onset of the fatal attack was more frequent among the atopic patients. Half the atopic patients died in the 4 months May/June and September/October; in contrast almost half of the non-atopic patients died in the 4 months January to April. Half the atopic patients died at weekends whereas for non-atopic patients death was distributed evenly throughout the week. Respiratory infection was the most frequently recognized trigger of the fatal attack in both groups of patients. No trigger was recognized for 55% of patients (atopic 65%, non-atopic 40%). PMID- 3663489 TI - Spirometry and flow-volume curves in healthy, normal Pakistanis. AB - Previous studies have indicated that lung volumes in healthy, normal Pakistani adults are smaller than measurements reported in comparable healthy European populations; in order to confirm these findings and to examine the relationship of maximal expiratory flow rates to lung volumes, we studied 250 non-smoking healthy subjects (116 men and 114 women) between the ages of 18 and 65 years. The population sample was drawn from urban and rural areas of Pakistan, with low levels of air pollution. The results indicate that the forced vital capacity (FVC) and forced expired volume in 1 second (FEV1) were lower in the Pakistani population compared to European populations and North American populations of European descent. These data are in conformity with previous studies; however, in Pakistani men the effects of age on FVC and FEV1 were slight so that, after the fourth decade, the FVC and FEV1 values are very comparable between the European and Pakistani populations. Amongst Pakistani women, on the other hand, FVC and FEV1 remained lower than in their European counterparts throughout adult life. Maximal expiratory flow rates amongst the men did not correlate with age, and these values were very similar to those reported in age-matched European populations. In women, however, there was a significant correlation of maximal flow rates with age and height, and the maximal expiratory flows were decreased compared to European populations. These data indicate that in Pakistani men pulmonary mechanics may be different to their European counterparts, allowing for higher maximal expiratory flows at any given lung volume. PMID- 3663490 TI - Quality of life in patients with chronic airflow limitation. AB - One hundred patients with chronic airflow limitation (CAL) randomly selected from over 600 such patients seen in the previous 2 years at a respiratory referral centre were asked about the ways in which their lives were adversely effected by their lung problems. Major problem areas included dyspnoea on day-to-day activities, fatigue and certain areas of emotional function including embarrassment, depression, anxiety and frustration. Severity of airflow limitation was only weakly related to patients' problems. Patients did not volunteer items easily, and most problems were elicited by specific probes. In 36 subjects, relatives were asked about the patients' problems. Relatives tended to identify fewer items, but items identified were judged more important; there was a limited relation between spouses' and patients' assessment of CAL-related problems (Pearson's r = 0.42-0.60). These results suggest that physicians cannot rely on severity of airflow limitation as an indicator of the impact of CAL on patients' lives. Patients should be specifically asked about problem areas, especially emotional difficulties, and spouses' view of the problems should be obtained. PMID- 3663491 TI - Setting up and running a local tuberculosis service. PMID- 3663492 TI - Regular exercise and reduction of breathlessness in patients with cystic fibrosis. AB - The influence of regular exercise on breathlessness and its relationship to ventilation has not been studied previously. We have examined the effects of a training programme on eight patients (5 males, 3 females, mean age 20 years, range 17-27 years) with cystic fibrosis. Eleven minutes of exercise was undertaken each day for 2 months according to the Royal Canadian Air Force protocol. Daily diary cards were kept and the programme was supervised. Pulmonary function and responses to maximal exercise on bicycle ergometer were determined before and after completion of the training schedule. Breathlessness was assessed using visual analogue scales (VAS) and related to ventilation during submaximal exercise on two occasions prior to training, and at the end. Apart from a reduced RV (pre 1.90 +/- 1.11, post 1.20 +/- 0.28 P less than 0.05), all other indices of pulmonary function and exercise performance were unchanged. Before training the relationship of breathlessness to ventilation was highly reproducible for each patient. After training there was a statistically significant reduction in breathlessness but ventilation was unchanged. At a mean standardized ventilation of 31.6 litres/min the VAS scales were 26.7% pre- and 12.9% post-training (P less than 0.01). Breathlessness can be favourably influenced by exercise training independent of ventilation with a consequent improvement in submaximal exercise tolerance in patients with cystic fibrosis. PMID- 3663493 TI - Necrotizing sarcoid granulomatosis. AB - We report a patient with necrotizing sarcoid granulomatosis (NSG) and point out that while the latter may have certain histological and radiological features distinct from sarcoidosis, sophisticated immunological tests show that the two disorders have essentially similar underlying immune mechanisms. We also stress that although the clinical course of NSG has been repeatedly described as benign and responsive to steroid therapy, the young patient may initially be critically ill with symptoms suggestive of an infective process rather than a granulomatous cause. PMID- 3663494 TI - Mercury pulmonary emboli following intravenous self-injection. AB - The attempted intravenous injection of metallic mercury resulted in multiple mercury pulmonary emboli. Few of the abnormalities of respiratory or renal function reported previously were demonstrated. In particular the isotope ventilation/perfusion scan was unhelpful in confirming the diagnosis. Extravasation of mercury at the injection site produced a severe local inflammatory reaction and in the presence of toxic blood mercury levels surgical excision was undertaken. The blood mercury levels fell significantly but remain elevated within the toxic range to date. This may be due to the continued absorption of embolized mercury. The long-term effects of chronically elevated blood mercury levels is unknown. PMID- 3663495 TI - The changing pattern of bronchial carcinoma. AB - The figures for the incidence of bronchial carcinoma have been monitored in various age groups and in both sexes since 1975 when a previous paper on the subject was published. These figures are available up to 1983. The total incidence of bronchial carcinoma in men started to fall after 1974, while in women it is still rising. The incidence amongst men up to the age of 59 started to fall after 1960; in women, this occurred 20 years later, and it has fallen in the 60-64 age group since 1982. The incidence is still rising in older women, but is falling in all groups of men up to the age of 80. Thus the trend seen amongst the men in 1975 seems to be being repeated amongst the women. The fall in the incidence of bronchial cancer has occurred amongst the group of women who have smoked more than any of their predecessors. Some possible reasons for this surprising finding are discussed. PMID- 3663496 TI - Management of acute asthma: a survey of hospital practice and comparison between thoracic and general physicians in Birmingham and Manchester. AB - The assessment and treatment of 140 randomly selected patients with acute asthma admitted to hospitals in Birmingham and Manchester in 1978 were studied. A detailed history of attack severity was recorded in just over half the case notes on admission (55%) and objective evidence of severity was recorded in a smaller number (measurement of airflow obstruction in 31% and arterial blood gases in 42%). Twenty-one (31%) thoracic patients and 33 (45%) general medical patients received aerosolized bronchodilators from metered-dose inhalers alone and 31% of all patients were given no inhaled bronchodilator drugs. Although the asthma was considered severe enough to require admission to hospital 37% were not given a course of corticosteroid therapy. Response to treatment was monitored by serial peak flow measurements in only 51% overall. Discharge therapy included a bronchodilator inhaler and oral corticosteroids in less than half (43%) of patients. There was no major difference in severity of asthma in patients admitted under the care of 'thoracic' or 'general' physicians but significant differences were found in their assessment and treatment. 'Thoracic' physicians more often measured severity and the response to treatment objectively. They prescribed inhaled (rather than intravenous) bronchodilator drugs more frequently and were more likely to discharge patients with a bronchodilator inhaler, oral corticosteroids, prophylactic therapy and an outpatient follow-up appointment. PMID- 3663497 TI - Is there a circadian variation in respiratory morbidity? AB - In a retrospective study of the time of presentation to an accident and emergency department patients with acute respiratory symptoms presented more commonly at night compared to a control group with abdominal pain. In a subsequent prospective study doctors from a GP deputizing service were called much more frequently at night by patients with asthma than by those with other symptoms. These findings refute the suggestion that the observed increased mortality from respiratory diseases at night results from reduced medical care as a consequence of a reluctance of patients to present during the night. PMID- 3663498 TI - Short-course antituberculous chemotherapy for pulmonary and pleural disease: 5 years' experience in clinical practice. AB - One hundred and twenty-four patients have been treated with 6-month regimens for pulmonary and pleural tuberculosis over 5 years; 118 patients have completed treatment as planned. No patient has relapsed of the 109 followed up for 15 months from the end of chemotherapy, or in the remaining nine patients still under observation. Significant drug side effects requiring alteration of treatment occurred in only three patients. Six-month regimens in routine practice are well tolerated and are highly effective. PMID- 3663499 TI - Radiographic determination of total lung capacity in patients with acromegaly. AB - Total lung capacity (TLC) was measured from posteroanterior and lateral chest radiographs by the ellipsoid (TLCE) and planimetric (TLCp) radiographic methods in 16 acromegalic patients. These measurements were compared to the TLC measured by body plethysmography (TLCBP) in order to investigate the accuracy of the two radiographic methods. Our results showed that the mean value of TLCBP was 6.52 +/ 1.51 litres (mean +/- SD) or 120 +/- 13.3% of predicted values, statistically significantly increased from normal values (P less than 0.001). The mean value of TLCE was 7.09 +/- 1.8 litres and did not differ from the mean value of TLCBP (P greater than 0.125). The mean value of TLCP was 7.74 +/- 1.20 litres, statistically significantly increased from TLCBP (P less than 0.005). A statistically highly significant linear relationship was found between TLCE and TLCBP (r = 0.867, P less than 0.001) identical to the line of identity. Similarly a highly significant linear relationship was found between TLCP and TLCBP (r = 0.793, P less than 0.001) but to the left of the line of identity. It is concluded that both the ellipsoid and planimetric radiographic methods could be used to measure TLC in acromegalic patients but the planimetric method needed the appropriate correction. PMID- 3663500 TI - An outbreak of tuberculosis in an Oxfordshire school. AB - A primary school teacher was found to have pulmonary tuberculosis. Subsequent investigations showed that nine of her 32 pupils had been infected. The problem is discussed in the light of current recommendations designed to protect schoolchildren. PMID- 3663501 TI - Tuberculous hypercalcaemia with renal failure. AB - A patient with extensive pulmonary tuberculosis developed hypercalcaemia following rifampicin-induced interstitial nephritis. PMID- 3663502 TI - Granulocyte antibodies in leukaemic chronic lymphoproliferative disorders. AB - The anti-granulocyte activity of serum from patients with B-cell chronic lymphocytic leukaemia (CLL) and other lymphoproliferative disorders was investigated. Granulocyte-binding IgG was measured in 34 patients with CLL, 13 patients with hairy cell leukaemia, one patient with prolymphocytic leukaemia, two patients with Sezary cell leukaemia, and seven patients with chronic T-cell lymphocytosis who had a predominance of circulating large granular lymphocytes. Anti-granulocyte activity was absent in CLL and its variants, but present in the majority of granulocytopenic patients with chronic T-cell lymphocytosis. In one of these patients, granulocytopenia was associated with complement-activating IgG granulocyte antibody. Thus, antibody-mediated granulocyte injury appears to be an unusual occurrence in chronic lymphocytic leukaemia, but is a frequent complication of chronic T-cell lymphocytosis. PMID- 3663503 TI - Identification of blast cells in peripheral blood through automatic assessment of nuclear density: a new tool for monitoring patients with acute leukaemia. AB - The Technicon H*1 haematology system is provided with a new method for basophil count, neutrophil lobularity assessment and detection of blasts in peripheral blood through automated measurement of nuclear density. We compared the results of the H*1 blast flag with those of the microscope examination in 131 peripheral blood samples from 43 patients with acute leukaemia in different phases of their disease, to determine the degree of sensitivity and specificity of the system in this setting. In six patients at diagnosis or in overt relapse, all having large percentages of blasts at the manual differential count, a typical deformation of the profile of the mononuclear cell population on the display was consistently observed, regardless of the morphological subtype of leukaemic cell which was involved. Amongst 34 samples with 4-95% morphologically recognizable blasts on the peripheral blood film, the sensitivity of the system was 100% with no false negatives at all. In 43 samples, on the other hand, the H*1 blast flag was positive in the absence of any morphological evidence of blasts on the smear. These 'false positives', however, were always obtained from leucopenic patients who had more than 12% blast infiltration in the bone marrow, compared to the 0-6% value that was found in patients with a negative H*1 blast flag. These results suggest that the H*1 system is a highly sensitive tool for the detection in peripheral blood of even small concentration of leukaemic cells, which escape morphological identification. PMID- 3663504 TI - A myeloproliferative disease in two infants associated with eosinophilia and chromosome t(1;5) translocation. AB - Two children are described who presented at the age of 5 and 7 months with anaemia, a high white cell count with eosinophilia and thrombocytopenia. Both children had an identical balanced translocation t(1;5)(q23;q33) and no evidence of a constitutional abnormality. The response to treatment of one child was poor, the other remains well on therapy. This translocation has not been previously reported and is likely to represent a subclass of myeloproliferative disorder analogous to the monosomy 7 syndrome, although less common. The previous literature of acquired chromosome abnormalities involving chromosomes 1 and 5 is reviewed. PMID- 3663505 TI - Cytogenetics of bone marrow fibroblastic cells in idiopathic chronic myelofibrosis. AB - To determine the nature of the fibroblastic proliferation in myelofibrosis, we studied the cytogenetic composition of a pure population of in-vitro bone marrow fibroblastic cells (FC) from a patient with idiopathic chronic myelofibrosis who had trisomy 8 in her unstimulated peripheral blood cells. This cytogenetic abnormality was absent in all the FC studied supporting the premise that in the myeloproliferative disorders the myelofibrosis represents a secondary or non neoplastic reaction to the clonal proliferation of haematopoietic stem cells. PMID- 3663506 TI - Response to therapy in 37 patients with HIV-related thrombocytopenic purpura. AB - Thirty-seven patients belonging to the major AIDS-risk groups and with serum antibodies to the human immunodeficiency virus (HIV), were evaluated and treated between 1983 and 1986 because of profound chronic thrombocytopenia with clinical bleeding. Fifteen out of 26 patients achieved a significant response while on prednisone therapy. Six of them sustained their platelet count above 50 x 10(9)/1 following cessation of steroids. High dose intravenous immunoglobulin therapy gave a satisfactory initial response rate in 12 of 17 patients. Only two of 18 patients responded to danazol. Splenectomy was successful in 10 of 14 patients. PMID- 3663507 TI - Pre-transfusion non-invasive quality assessment of stored platelet concentrates. AB - The Platelet Monitor System has been designed to assess routinely prepared platelet concentrates (P.C.) during storage. The system is based upon observations of changes in light transmission induced by platelets in intact packs. It is practical, provides constant gentle agitation for P.C., and non invasively give continuous semi-quantitative evidence of the probable numbers of discoid platelets within each pack. The information yielded correlates both with established in vitro parameters of platelet behaviour, and with in vivo survival of platelets in normal healthy volunteers. The device safely provides the Blood Banker with the means to achieve on-going assessment of methods and improvements- or failings--in P.C. production. To the clinician it offers information throughout and even beyond present arbitrary storage limits, about which P.C. are likely to be of least or greatest value to a thrombocytopenic patient. PMID- 3663508 TI - An abnormal antithrombin III (AT III) with low heparin affinity: AT III Clichy. AB - We have identified an inherited qualitative deficiency of antithrombin III (AT III) in a family with apparently no increased incidence of venous thrombosis. Plasma antithrombin and anti-Xa activities were normal, but the interaction with heparin, heparan sulphate and low molecular weight heparin was uniformly decreased. An immunoblotting technique performed in plasma showed normal complex formation with thrombin. By using heparin-Sepharose affinity chromatography and crossed immunoelectrophoresis, the variant could be separated: at least two fractions of low affinity AT III were obtained. A minor one had no antiprotease activity; the other one was further purified to homogeneity and found to have normal specific activity in absence of heparin and a 50% decreased activity in presence of heparin. We propose to call this new variant AT III Clichy. PMID- 3663509 TI - Antithrombin III Glasgow: a variant with increased heparin affinity and reduced ability to inactivate thrombin, associated with familial thrombosis. AB - A functional antithrombin III (AT III) deficiency has been identified in two generations of a family with a high incidence of thrombosis. The deficiency presented as approximately 50% reduction in heparin cofactor activity compared to its antigen concentration. No abnormality was detected by crossed immunoelectrophoresis in the presence or absence of heparin. Plasma from the propositus was precipitated with dextran sulphate, applied to heparin-Sepharose and the AT III stepwise eluted with NaCl. The AT III had a reduced ability to inactivate thrombin, when this was monitored by substrate hydrolysis or by SDS polyacrylamide gel electrophoresis. Its mobility was normal by the latter technique using 10-20% gradient gels under reducing and non-reducing conditions. AT III from the patient was reapplied to heparin-Sepharose and eluted with a NaCl gradient. An active pool eluted in the same NaCl concentration range used to purify normal AT III, while predominantly inactive AT III eluted at higher NaCl concentrations. It is concluded that this variant, designated AT III Glasgow, has increased affinity for heparin but reduced ability to inactivate thrombin. PMID- 3663510 TI - Characterization of a new alpha zero thalassaemia defect in the South African population. AB - A new alpha thalassemia defect has been detected in the South African population. Restriction mapping of the alpha globin gene cluster in affected individuals has established that the defect is associated with the removal of 22.8-23.7 kb of DNA, including the psi zeta 1, psi alpha 1, psi alpha 2, alpha 2 and alpha 1 globin genes. The 5' endpoint of the deletion has been localized between the zeta 2 and psi zeta 1 globin genes, and the 3' endpoint lies 4-5 kb 3' to the alpha 1 globin gene. We have called the deletion - -SA in order to distinguish it from alpha zero thalassaemia defects described in other populations. PMID- 3663511 TI - Sickle cell disease in North London. AB - We have examined our experience of sickle cell disease in the London Borough of Haringey over the past 20 years. There are currently (1986) 145 patients on the Haringey Sickle Cell Register and when comparison is made with other centres, admission for painful crises in Hb SS disease is more frequent than in Jamaica, but the acute chest syndrome appears to be less common in the United Kingdom than in Jamaica. Splenomegaly is less frequent in Hb SC patients in this country and there is also a lower incidence of leg ulceration in both Hb SS and Hb SC disease in the United Kingdom than in Jamaica. The incidence of alloimmunization among transfused sickle cell disease individuals in Haringey is 21%, the most frequently encountered antibodies being anti-E and anti-Kell. All pregnant patients with sickle cell disease were managed with regular blood transfusion throughout pregnancy starting at 12 weeks of gestation. There were no fetal or maternal mortalities, although three babies born were 'small for dates' despite uneventful antenatal courses and adequate Hb A levels being achieved in the mother. Examination of the effect of seasonal variation on the incidence of hospital admissions for painful crises reveals no significant clustering of cases in a particular month or season of the year. PMID- 3663513 TI - Abstracts of papers, British Society for Haematology. London, 9 January 1987. PMID- 3663512 TI - Blunted erythropoietin response to anaemia in rheumatoid arthritis. AB - The relationship of serum immunoreactive erythropoietin to haemoglobin concentration was defined for 54 patients with rheumatoid arthritis (RA) and 41 patients with anaemia of varying aetiology (excluding pregnancy and renal insufficiency), not associated with RA. Significant inverse correlations between the logarithm of serum immunoreactive erythropoietin and the haemoglobin concentration were noted for the anaemic patients in both groups. The regression line for the RA patients had a similar slope, but a significantly lower y intercept as compared to that for the non-RA patients. Erythropoietin levels were also significantly lower for the group of RA patients than for the group of non RA patients when matched for comparable haemoglobin concentrations. These studies suggest that the erythropoietin response to anaemia in RA is intact but blunted relative to that for anaemia of other aetiologies. Lower levels of serum erythropoietin in anaemic RA patients may contribute to the pathogenesis of their anaemia. PMID- 3663514 TI - 1,25 Dihydroxy-vitamin D3 (1,25 (OH)2 vit D3) in the treatment of idiopathic myelofibrosis. PMID- 3663515 TI - Antibodies against glycosphingolipids in sera of patients with idiopathic thrombocytopenic purpura. AB - Evidence is presented for the existence of antibodies against platelet glycosphingolipids in sera of patients with chronic idiopathic thrombocytopenic purpura and antiplatelet antibodies. Increased binding of IgG/IgM to neutral glycosphingolipids or gangliosides extracted from donor platelets was measured by an ELISA in 17 sera of 30 patients. Thirteen sera, five with anticardiolipin antibodies, demonstrated an increased binding to sulphatides confirmed by immuno HPTLC. Four sera showed reactivity with the platelet minor gangliosides established by immuno-HPTLC. PMID- 3663516 TI - Autoimmunity against blood cells in human immunodeficiency-virus (HIV) infection. AB - In persons with AIDS or at risk from AIDS, autoantibodies against platelets and granulocytes were frequently detected. Platelet-bound immunoglobulins were demonstrated by immunofluorescence in all 16 patients with AIDS, in five out of seven patients with AIDS-related complex/persistent generalized lymphadenopathy (ARC/PGL) and even in seven of 10 healthy sexually active homosexual men. Granulocyte-bound immunoglobulins were found by immunofluorescence in 12 of the 16 AIDS patients, five of the seven patients with ARC/PGL and two of the 10 symptomless men. Red cell bound immunoglobulins were not detected. All patients with AIDS and ARC/PGL and three of the symptomless men were seropositive for human immunodeficiency virus (HIV). The platelet- and granulocyte-bound immunoglobulins could be eluted in 93% and 67% of the cases, respectively. This indicates that specific autoantibodies, rather than circulating immune complexes, which were frequently increased, accounted for the findings. There was no relation between the serological findings and the platelet and granulocyte counts. We conclude that autoantibodies against platelets and granulocytes are common in patients with AIDS and those at risk. PMID- 3663517 TI - Hairy cell leukaemia due to chronic exposure to benzene. PMID- 3663518 TI - Thromboplastin and oral anticoagulant control. PMID- 3663519 TI - Hybrid acute leukaemia. PMID- 3663520 TI - Is male predominance (4/1) in hairy cell leukaemia related to occupational exposure to ionizing radiation, benzene and other solvents? PMID- 3663521 TI - Cell kinetic effect of low dose arabinosyl cytosine. AB - Low dose arabinosyl cytosine (ARA-C) is effective for treatment of acute non lymphocytic leukaemia (ANLL). The mechanism of action is not clearly understood and it was suggested that low doses of the drug could induce leukaemic cells to differentiate. We investigated the effect of low dose ARA-C (20 mg/m2/d, divided into two doses s.c. at 12 h intervals, x 20 d) on the cell cycle distribution of leukaemic cells in four cases of ANLL. By comparison, four other cases of ANLL were studied during treatment with standard dose ARA-C (200 mg/m2/d as a continuous i.v. infusion x 7 d). Both treatments induced an accumulation of leukaemic cells in post G1 phases, at a variable extent and rate. During treatment by low dose ARA-C, the mitotic index (MI) fell slowly to zero in two patients who achieved a complete remission (CR), while it fell but recovered during treatment in the patients who did not achieve a CR. The MI fell rapidly to zero in the four cases treated by standard dose, who achieved a CR. These data are consistent with the known cytotoxic activity of ARA-C, via inhibition and slowing of DNA synthesis leading to defective cell proliferation and to cell death. PMID- 3663522 TI - Erythroid and myeloid maturation patterns related to progenitor assessment in the myelodysplastic syndromes. AB - Patterns of erythropoiesis and granulopoiesis were studied in 15 patients with myelodysplastic syndromes and in one with smouldering leukaemia by correlating CFU-C, BFU-E and CFU-E cloning efficiency with erythroid and myeloid maturation indices derived from quantitative 14C-autoradiography and with ferrokinetics. Maturation index of a cell lineage was defined as the ratio of cell production rate increase from the first to the last proliferative compartment over the corresponding normal value. The myeloid maturation index was reduced in all cases, but CFU-C progenitor frequency was increased by a factor of 3. Erythroid maturation index was also reduced in most cases, and BFU-E progenitor frequency was reduced by a factor of 2. Similarly, CFU-E cloning efficiency corrected for the erythroid maturation index was 2.5-10-fold lower than normal. Comparison of the erythroid maturation index with ferrokinetics revealed a constant ratio of ineffective erythropoiesis with a maturation disturbance in the proliferative pool twice that in the non-proliferative pool. These findings indicate basic qualitative and quantitative abnormalities and a difference in the patterns of production of erythroid and myeloid cells in the myelodysplastic syndromes: Myeloid progenitors are increased in number but their maturation is grossly abnormal. On the other hand, the apparent reduction in erythroid progenitors and the reduced erythroid maturation index are attributable to both premature cell death of the more mature erythroblasts and an increased proerythroblast proliferation, i.e. extra divisions in the proerythroblast compartment at the expense of maturation. PMID- 3663523 TI - Congenital dyserythropoietic anaemia type II (HEMPAS): characterization of aberrant intracellular organelles by immunogold electron microscopy. AB - Erythrocytes are reticulocytes obtained from peripheral blood of a congenital dyserythropoietic anaemia type II patient were examined by immunoelectron microscopy using anti-band 3 and anti-glycophorin A antibodies. Vacuoles which have membranous structures inside were stained heavily by these antibodies, indicating the presence of band 3 and glycophorin A in these vacuoles. Empty vacuoles which open to the cell surface and those present in cytoplasm were also stained by these antibodies at the inside of the wall. These observations suggest that the vacuoles are functioning for trapping and discarding the defective plasma membranes. On the other hand, small vesicles and ferritin-loaded vacuoles were not stained by these antibodies. In these experiments, peripheral cisternae and most of the intracellular membranous structures at blebs and clefts were not stained by the antibodies. Therefore, they are probably part of the endoplasmic reticulum or are derived from intracellular organelles but not from the plasma membranes. PMID- 3663524 TI - Effects after acute and chronic exposure to cotton dust: the Manchester criteria. PMID- 3663525 TI - A mortality study of Finnish pulp and paper workers. AB - Mortality among workers in the Finnish pulp and paper industry was evaluated in a retrospective cohort study of 3520 workers who had been employed continuously for at least one year between 1945 and 1961. Six subcohorts were formed according to six work areas: sulphite, sulphate, paper, and board mills, maintenance department, and power plant. National mortality rates were used for comparison. The mortality of a cohort of 1290 sawmill workers was also studied in order to have a socially, geographically, and occupationally similar group without the exposures typical of the pulp and paper industry for comparison. Smoking habits were surveyed. Mortality was followed up until 31 December 1981. Overall mortality for the entire cohort did not differ from that expected (1044 obs, 1029.4 exp, SMR 101), but there was an excess of deaths from diseases of the circulatory system among the men (489 obs, 404.9 exp, SMR 121). This was due to the excess of deaths from ischaemic heart disease found among the men at the sulphite, sulphate, and paper mills, maintenance department, and power plant, but not at the sawmill. The existing smoking data did not explain this finding and it may therefore be associated with occupational exposures. PMID- 3663526 TI - Unusual mortality pattern among short term workers in the perfumery industry in Geneva. AB - A cohort of 537 workers employed for less than one year between 1900 and 1964 in the Geneva perfumery industry was followed up from entry to the end of 1983. During the period of study, 251 workers died and 41 (8%) were lost to follow up. The standardised mortality ratio (SMR) was significantly above 100 for all causes (SMR = 120), all cancers (SMR = 127), lung cancer (SMR = 186), and violent death (SMR = 179). The highest SMR from all causes was associated with the shortest period of employment (less than two months) and it decreased significantly with longer duration. Such mortality excesses had not been recorded among the 1168 workers of the same industry employed one year or more, previously studied in similar fashion. Interviews among a random sample of 52 workers employed for less than two months seem to indicate that the prevalence of smoking, exposures to asbestos, and occupational accidents in other hazardous industries were higher for these workers than for the reference population. Furthermore, unmarried men were overrepresented among the study cohort. These findings support previous observations indicating that short term workers share atypical features related to high mortality from various causes. It is suggested that mortality in this subgroup should be analysed separately in occupational studies. PMID- 3663527 TI - Allergy to laboratory animals: a prospective study of its incidence and of the influence of atopy on its development. AB - The pattern of incidence of allergy to laboratory animals (ALA) has been studied prospectively in 383 individuals occupationally exposed to rodents and to rabbits. The incidence of the disease after one year of exposure to animals fell from 37% in 1980 and 1981 to 20% in 1982, 10% in 1983, and 12% in 1984. A similar reduction was noted after two and three years of exposure in the 1982 and 1983 cohorts. The reduction in incidence coincided with the introduction of a site order and code of practice for working with animals and an education programme designed to focus awareness on the problem. Although rats were believed to be the major cause of the disease, objective measurements of IgE antibody against rat urine allergen were positive in only half the symptomatic individuals. Antibodies to different animal derived allergens were, however, found in several other personnel. Symptoms were generally of mild or moderate intensity and affected mainly the nose, eyes, and skin; chest symptoms were found in only 1.6% of the exposed population. A study of the influence of atopy on the development of ALA showed that after one year of exposure to animals a significantly greater proportion of atopic individuals became symptomatic (19-43% compared with 3-6%). After two and three years of exposure, however, this discrepancy was not maintained, with more non-atopic individuals developing the disease. PMID- 3663529 TI - Investigating dose response relations in occupational mortality studies: something to keep in mind. PMID- 3663528 TI - IgM antibody production in mice intraperitoneally injected with zirconium oxychloride. AB - The effect of zirconium (Zr) on the humoral immune response was studied by measuring the level of IgM-plaque forming cells (IgM-PFC) against sheep red blood cells (SRBC) in the spleen of C57 BL mice intraperitoneally injected with zirconium oxychloride. Two experiments, a single injection of zirconium oxychloride of 1/5, 1/10, 1/50, and 1/100 of the LD50 for intraperitoneal injection and continuous injection of 1/20, 1/40, and 1/80 of the LD50 every other day for two or four weeks in mice, were carried out. In the case of a single injection zirconium oxychloride was intraperitoneally injected on days -1, 0, +1, +2, and +3 in relation to SRBC immunisation. The following conclusions may be drawn from this study: (1) Zr was shown to have an adjuvant like activity in relation to the humoral immune response, at least to IgM antibody production; (2) this effect was recognised not only with a single injection with Zr but also after continuous injection; (3) a single injection of Zr was more effective when the mice were treated with Zr 24 hours before or after SRBC immunisation; and (4) with regard to an injected dose of Zr, it was shown that a lower dose (1/50, 1/100 of the LD50 for a single injection and 1/40, 1/80 of the LD50 for continuous injection) led to a more enhanced level of IgM-PFC than a higher dose (1/5, 1/10 of the LD50 for a single injection, and 1/20 of the LD50 for continuous injection). PMID- 3663530 TI - Legionnaires' disease on an oil drilling platform in the Mediterranean: a case report. PMID- 3663531 TI - Accuracy of mothers' recall of birthweight and gestational age. AB - Information on the birthweight and gestational age of previous siblings is usually dependent upon maternal recall. This information is of importance in assessing the current risk of perinatal morbidity and mortality. The validity of maternal recall of birthweight and gestational age of 880 children born to 97 multiparas was examined by comparison with hospital records. About 75% of all reported birthweights were accurate to within 100 g and a similar proportion of reported gestational ages was correct to within 1 week. Recall was most accurate for most recent births as well as for earliest births and was not related to maternal age or education. There was a tendency for the smallness of low birthweight infants to be exaggerated by mothers. We conclude that within defined limitations, maternal recall of birthweight and gestational age of previous children is sufficiently accurate for clinical and even for epidemiological use. PMID- 3663532 TI - The blood flow velocity waveform in the fetal internal carotid and umbilical artery; its relation to fetal behavioural states in normal pregnancy at 37-38 weeks. AB - The relation between the blood flow velocity waveform in the fetal internal carotid artery (n = 12) and umbilical artery (n = 15) and fetal behavioural states at 37-38 weeks of gestation was studied. In the fetal internal carotid artery, under standardized fetal heart rate conditions, the pulsatility index (PI), as a measure of peripheral vascular resistance, was significantly lower during behavioural state 2F (active sleep) compared with state 1F (quiet sleep) according to the classification by Nijhuis et al. (1982), suggesting increased fetal cerebral blood flow during state 2F. In the umbilical artery, no significant difference in PI between the two behavioural states could be established. This suggests a fetal origin of the state dependency observed in fetal blood flow velocity waveforms. PMID- 3663533 TI - Cortisol and loss of malaria immunity in human pregnancy. AB - The concentration of both total (bound to corticoid-binding-globulin plus free) and free cortisol was determined in sera from two groups of pregnant women in Tanzania. One group consisted of 152 pregnant women (57 nulliparas and 95 multiparas) exhibiting clinical malaria during pregnancy, and the other group comprised 527 pregnant women (105 nulliparas and 422 multiparas), who did not have a record of malaria during pregnancy. The serum concentration of total cortisol was significantly higher in women with clinical malaria than in women without recorded malaria, and this is true for both nulliparae and multiparae. Free cortisol fractions did not differ significantly between these groups. Indications were obtained that higher total cortisol levels cause loss of malaria immunity rather than being concomitant with malaria infection only. The data are compatible with those of a murine malaria model. PMID- 3663534 TI - The influence of age on prognosis in carcinoma of the cervix. AB - Of 385 new patients with invasive carcinoma of the cervix FIGO stages IB-IV treated between 1970-1984 inclusive, 11% (43 patients) were aged less than or equal to 35 years. During the period studied there was a gradual rise in the proportion of such young women from 2% for the triennium 1970-1972 to 18% for 1982-1984. In women aged less than or equal to 35 years early stage disease predominated, 72% presenting with stage IB disease, compared with 29% in the older age group. For FIGO stage IB there was no significant difference in actuarial survival between younger and older patients (P greater than 0.1), both age groups having a 5-year survival rate of 81%. Similarly for FIGO stage II there was no difference in actuarial survival (P greater than 0.1) between younger and older patients who had 5-year survival rates of 66% and 63% respectively. In our experience the incidence of invasive carcinoma of the cervix in young women is rising, but stage for stage their survival is similar to that of older women. PMID- 3663535 TI - Recurrent acute leg cellulitis after hysterectomy with pelvic lymphadenectomy. AB - Recurrent acute leg cellulitis known to occur in patients with impaired venous or lymphatic circulation was surveyed prospectively in 270 patients after radical hysterectomy with pelvic lymphadenectomy and in 66 patients after hysterectomy with pelvic lymphadenectomy from 1977 to 1985. Among them, six (2%) and three (4%) patients experienced a total of 17 episodes of acute leg cellulitis, respectively. Analysis showed that postoperative percutaneous radiation therapy of the pelvic area was a highly significant risk factor. Penicillin prophylaxis is recommended for patients experiencing recurrent attacks. PMID- 3663536 TI - Untreated homocystinuria: a maternal death in a woman with four pregnancies. Case report. PMID- 3663537 TI - Postpartum hyperparathyroid crisis. Case report. PMID- 3663538 TI - 'Placental abruption' with disseminated intravascular coagulopathy in the second trimester of pregnancy with fetal survival. Case report. PMID- 3663539 TI - In utero meconium aspiration: an unpreventable cause of neonatal death. PMID- 3663540 TI - Langerhans' cell density in the normal exocervical epithelium and in the cervical intraepithelial neoplasia. PMID- 3663541 TI - The relation of birthweight to histological appearances in vessels of the placental bed. PMID- 3663542 TI - The short-term effect of radical hysterectomy on urethral and bladder function. PMID- 3663543 TI - Idiopathic acute fatty liver of pregnancy associated with transient diabetes insipidus. Case report. PMID- 3663544 TI - Screening for light-for-gestational age infants: a comparison of three simple measurements. PMID- 3663545 TI - In defence of the obstetrician. PMID- 3663546 TI - Evaluation of the WHO criteria for 75 g oral glucose tolerance test in pregnancy. AB - A group of pregnant women at high risk of developing diabetes in pregnancy had paired oral glucose tolerance tests (OGTT) using a 100 g load followed by 75 g load. When the World Health Organization (WHO) criteria and the National Diabetes Data Group (NDDG) criteria were compared, the 2-h plasma glucose value after the 100 g load was the most discriminative in differentiating those with normal glucose tolerance, impaired glucose tolerance and gestational diabetes mellitus. When only the 2-h plasma glucose values were assessed, the WHO test (75 g: 8 mmol/l) agreed with the NDDG test (100 g load: 9.2 mmol/l) in the diagnosis of glucose intolerance in 60% of subjects only. Using the same criteria at 2-h (8 mmol/l) the agreement between these tests was 47%. Reducing the glucose load from 100 g to 75 g produced a reduced glucose response in 49% of the subjects, with a significant decrease in the area under the glucose response curve. PMID- 3663547 TI - Achalasia and pregnancy. AB - Forty-one women with achalasia diagnosed between the ages of 18 and 45 years were interviewed and 37 of them who had been married at some time were asked to provide details of their fertility and reproductive histories. Thirty-six agreed to do so and were compared with 36 healthy age-matched women. The mean age at the time of study was 44 and the women had been married, on average, for 21 years. The disease developed at a mean age of 27 years and was diagnosed and treated at a mean age of 32 years. For a mean period of 5 years the disease was untreated. There were no significant differences in the number of conceptions or live births before or after the onset of symptoms or during the period when the disease was untreated. In only three of the 20 women who became pregnant after the onset of disease did symptoms become worse. Achalasia during pregnancy is probably best managed by endoscopic dilatation and there is no reason to consider termination. PMID- 3663548 TI - Postpartum pelvic arthropathy with unusual features. AB - Eleven patients seen in Malawi are described with a syndrome of postpartum pelvic arthropathy. They complained of severe pain mainly located in the symphysis pubis and all were unable to walk. The following unusual features were noted: the absence of obstetric trauma, a symptom-free interval between the delivery and the onset of the syndrome, the absence of gross widening of the symphysis pubis and the lack of abnormal mobility in the same joint. It is speculated that the syndrome described is not caused by rupture of the symphysis or softening under the influence of hormones but by swelling inside the intact fibrous confines of the joint. PMID- 3663549 TI - Apgar score, meconium and acidaemia at birth in small-for-gestational age infants born at term, and their relation to neonatal neurological morbidity. AB - Neonatal neurological morbidity was studied in relation to Apgar score, meconium stained amniotic fluid and acidaemia at birth in 247 small-for-gestational age (SGA) maturely born infants. SGA infants, and especially the severely SGA infants and those born abdominally, showed higher rates of neurological morbidity, acidaemia and meconium stained amniotic fluid than appropriate-for-gestational age (AGA) controls. The examined indicators of asphyxia at birth showed slightly higher correlation coefficients with the 'neonatal neurological optimality score' (NNOS) in SGA, than in AGA term infants, but the percentage of explained variance was low, except in the 23 infants born abdominally. In this group poor neurological outcome was restricted to the 14 infants who showed signs of fetal hypoxaemia diagnosed by decelerative fetal heart rate (FHR) patterns. In 11 of them, FHR decelerations occurred antepartum. These FHR abnormalities appear to be better predictors for the neonatal neurological outcome than indicators of asphyxia at birth. PMID- 3663550 TI - The obstetric and gynaecological implications of pseudoxanthoma elasticum. AB - The obstetric aspects of 54 pregnancies in 20 women with pseudoxanthoma elasticum (PXE) have been reviewed. Forty live births were delivered vaginally, three of them were preterm. Twelve pregnancies miscarried at between 6 and 14 weeks gestation and two were terminated in the 8th week for psychiatric reasons. Fetal losses in two instances were attributed to cervical incompetence. One baby died at 4 days of age from a complex congenital cardiac anomaly. No abnormal maternal genital or gastrointestinal bleeding was recorded. Hypertension complicated seven pregnancies. Abdominal striae developed in all patients, the severity of which correlated with weight gain and the number of pregnancies. All the women had normal gynaecological histories, none had excessive menstrual bleeding or increased episodes of menorrhagia. The eye, blood vessels and other organ systems involved in PXE were unaffected by pregnancy. Apart from the increased risk of first trimester miscarriage and the cosmetic deterioration of the abdominal skin, there are few serious complications in pregnancy in patients with PXE. PMID- 3663551 TI - Outcome of in-vitro fertilization and embryo transfer after different regimens of ovarian stimulation. AB - Sixty-eight women with bilateral tubal disease and fertile male partners underwent ovarian stimulation in 187 cycles for IVF after randomization to different ovulation induction regimens. All patients initially received 150 mg clomiphene citrate on days 5-9, this regimen induced sufficient stimulation in a smaller proportion of patients than the two other regimens used subsequently which included clomiphene in combination with human menopausal gonadotrophins (hMG). The fertilization rate was significantly reduced (52.4%) in oocytes collected from cycles stimulated with hMG alone (in a small sub-group of poor responders) compared with a rate of 64.1-66.4% in cycles stimulated with clomiphene alone or in combination with hMG. Embryonic development 44-48 h after insemination was significantly retarded when clomiphene alone was utilized but a higher proportion of fragmented or abnormal embryos was observed after stimulation with hMG alone. In 118 cycles embryo transfer was performed and 20 pregnancies were established, a pregnancy rate of 16.9%. All but two pregnancies were established when two or more embryos were transferred and when the embryos were at the 4-cell or later stage of development. The regimen of clomiphene in combination with 150 i.u. hMG resulted in significantly greater numbers of oocytes recovered and embryos available per patient for transfer than the other two regimens studied. PMID- 3663552 TI - Negative cone biopsies after colposcopy and their prediction. AB - A retrospective study of 899 cone biopsies revealed significantly more cones containing no dysplastic epithelium in patients who had a prior colposcopic assessment compared with those who had not been so assessed. A case-control study of 48 'negative' cones, 47 cones containing intraepithelial neoplasia (CIN), 44 microcarcinoma containing cones and 27 occult Ib containing cones has allowed five variables to be identified which can predict the presence of dysplastic or neoplastic tissue in the cone specimen. These variables include a colposcopic suspicion of invasion; a positive or worse pre-cone smear; two severely dyskaryotic smears within a 12-month observation period, previous abnormal histology and previous treatment for CIN. Using these criteria, 44% of 'negative' cones could be avoided without overlooking any cases of microcarcinoma or occult carcinoma. PMID- 3663553 TI - A spectrum of postpartum thyroid disease. Case reports. PMID- 3663554 TI - The importance of a slit-like lumen cross-section for the mechanical function of the cervix. PMID- 3663555 TI - Blair Bell Research Society. Joint meeting with the British Fertility Society. 11 December 1986. Abstracts. PMID- 3663556 TI - The night--a dangerous time to be born? PMID- 3663557 TI - Eyes or patients? Traps for the unwary in the statistical analysis of ophthalmological studies. AB - In reports on ophthalmological research the results of measurements on the eye are often expressed as mean and standard deviation based on m patients, n eyes (n greater than m). This approach leads to t tests that are invalid because the measurements on the two eyes of one subject are usually related, not independent. In a simulation study involving intraocular pressure data analysed in this way, the null hypothesis of no difference between groups was rejected at a nominal alpha = 0.05 level in 39 out of 200 simulations; thus the true alpha was nearly 0.2. This approach is excessively prone to produce false positive results. PMID- 3663558 TI - Cytological factors relating to posterior capsule opacification following cataract surgery. AB - Simulated extracapsular cataract extractions on cadaver eyes were performed which demonstrated that the cells of the anterior capsule remain largely intact and that only a small amount of cortical lens matter remains postoperatively. Human lens epithelial cells from normal and cataractous lenses were grown in culture. There was no appreciable difference in growth rate between cells from normal and those from cataractous lenses or between equatorial and central capsule cells. The cells grew from the cut edges of the capsule, suggesting that release from contact inhibition is an important factor in stimulating proliferation. The daughter cells became increasingly abnormal and metaplastic in successive generations, but there was no evidence of differentiation into fibroblasts within the 35-day culture period, suggesting that a retinal growth factor may be involved with the fibrosis occurring in opacification of the posterior capsule. A small anterior capsulotomy will release fewer cells from contact inhibition and hence reduce cell proliferation after extracapsular cataract extraction. PMID- 3663559 TI - Long-term results of treatment of idiopathic blepharospasm with botulinum toxin injections. AB - One hundred and one patients with idiopathic blepharospasm have been treated with injections of botulinum toxin A into the orbicularis oculi. Ten had previously had facial nerve avulsions and responded well, normal visual function being restored in the majority (7/10) for an average of 14 weeks. Without prior surgical treatment the response was more variable, but 71/91 regained normal or near normal vision. Older patients, those with a family history of the condition, and those without oromandibular dystonia responded slightly better. The severity of the blepharospasm, the length of the history, and spontaneous resolution of an episode of focal dystonia in the past had no influence on the outcome. Results were poor in the presence of an associated neurological disorder. Side effects, particularly a temporary partial ptosis, were common but were well tolerated. The average duration of improvement was eight weeks in men, nine in women, and there was no evidence of any increase in duration after multiple injections. Eighty nine patients continued with injections, 11 opted for surgical treatment, and one resumed drugs. PMID- 3663560 TI - Recurrent herpes simplex virus ocular infection: epidemiological and clinical features. AB - The epidemiological and clinical features of recurrent herpes simplex virus ocular infection (RHSV) were studied. Of 108 patients with primary herpes simplex virus ocular infection (PHSV) who were followed up for two to 15 years 35 (32%) suffered one or more recurrent attacks. The recurrence rate was significantly higher in patients under 20 years of age, but there was no significant difference between recurrence rates in males and females. Of 35 patients with RHSV 17 (49%) had one recurrent attack, 14 (40%) had between two and five, and four (11%) had between six and 15 attacks. The mean time interval between PHSV and the first four RHSV attacks was 10 months, and was shorter in subsequent attacks. The duration and severity of RHSV were reduced in successive recurrences. Patients with more severe conjunctivitis and lid lesions during PHSV ocular infection had a higher incidence of recurrent infection. The severity of the corneal signs in PHSV had no influence on the incidence of recurrent infection. Several clinical forms of RHSV were observed. Conjunctivitis associated with lid lesions was observed in 29 (83%) patients. In six (17%) patients the disease presented as an acute follicular conjunctivitis without characteristic lid or corneal lesions. Dendritic ulcer was found in three (9%) patients, and in one of them it was associated with a disciform keratitis. A chronic blepharoconjunctivitis developed in eight (23%) patients. The epidemiological and clinical features of RHSV were compared with those of PHSV. PMID- 3663561 TI - An evaluation of the NR-1000F Auto Refractometer in high refractive errors. AB - The manifest refractions of 37 high myopic and 16 high hypermetropic eyes in a total of 28 patients, aged 5 to 42 years, were determined on the Nikon NR-1000F Auto Refractometer. The data obtained were compared with the final clinical prescriptions for these eyes and analysed for degree of agreement for the spherical equivalents, sphere components, and cylinder powers and axes. The Auto Refractometer recordings for all the different refractive components were observed to skew towards more minus in the high myopic eyes but more plus in the high hypermetropes. The possible significance of these skewing patterns is discussed with reference to our earlier studies. PMID- 3663562 TI - Levator sling for Marcus Gunn ptosis. AB - A modified simple technique of sling operation is presented in 15 cases using the levator aponeurosis as the material for the sling as originally devised by Lemagne and Bemcher. The levator is cut behind the superior transverse ligament and the posterior part of the levator is cauterised and allowed to retract into the orbit. The horns are cut from behind forwards, and the levator, which is kept attached on the tarsal plate, is used to lift up the lid. This method eliminates the jaw winking phenomenon as well as lifting the lid. PMID- 3663563 TI - An association between 'desert lung' and cataract--a new syndrome. AB - Sixteen cases of desert lung with cataracts were previously reported on, and an additional 14 cases have now been encountered from the same area of which 13 had cataracts. The association of cataract with desert lung was not commented on in the previous report, because it was thought to be coincidental. It now appears to be real rather than coincidental. Analysis of these 33 patients showed the following: none had significant clinical signs; x-ray findings were mainly those of micronodular miliary infiltrates; 88% were found to have cataracts; 85% were females. The frequency of cataract among patients over the age of 50 years coming to the hospital for eye problems was 26%. These figures showed a distinct relationship between desert lung and cataract in the Arabian desert. The causal relationship is not as yet clear, but 'tandoor' baking is suggested as the main factor. PMID- 3663564 TI - A comparison of the effects of oral nadolol and topical timolol on intraocular pressure, blood pressure, and heart rate. AB - We compared the effects of oral nadolol 20 mg once daily and topical timolol 0.25% twice daily on the intraocular pressures of 22 glaucoma suspects, in a 12 week double-masked crossover study. Both nadolol and timolol reduced intraocular pressure (p less than 0.001). The reductions in intraocular pressure did not differ significantly after two weeks and four weeks of treatment. Nine of these subjects underwent treadmill exercise tests in order to compare the effects of nadolol and timolol on the cardiovascular system. The effects of the two treatments on blood pressure were comparable, but nadolol caused a significantly greater reduction in heart rate than timolol at rest (p less than 0.05). Nadolol reduces intraocular pressure effectively and may prove a useful alternative treatment for chronic simple glaucoma. PMID- 3663565 TI - Sport associated eye injury: a casualty department survey. AB - A survey was performed of all patients attending the combined Glasgow Eye Infirmary and Western Infirmary Eye Casualty Department with sports injuries. During an 18-month period a total of 246 patients presented with such injuries. Football was responsible for 110 (44.7%), rugby for 24 (9.8%), squash for 19 (7.7%), badminton for 16 (6.5%), and skiing for 9 (3.7%), and 68 (27.6%) were caused by other sports. One hundred and sixty-two patients (65.8%) had superficial or surrounding soft tissue injuries, 54 (22%) had more severe anterior segment damage in the form of hyphaema or traumatic uveitis, 17 (6.9%) had retinal damage manifest as oedema or retinal tear with or without detachment, and two (0.8%) suffered severe disruption of the globe with subsequent loss of the eye in each case. Forty-six (18.7%) required inpatient care and 200 (81.3%) were treated as outpatients, of whom 104 required at least one follow-up appointment (42.3% of the total). I conclude that with increasing time available for leisure activities there has been a parallel increase in sport associated eye trauma. PMID- 3663566 TI - A 6 1/2-years survey of intraocular and intraorbital foreign bodies in the North west Frontier Province, Pakistan. AB - A survey of 198 patients (210 eyes) with intraocular or intraorbital foreign bodies is presented. Most were males between 16 and 30 years of age, and 6.1% of cases were bilateral. The commonest cause was a flying particle while using a hand hammer, followed by fragments of bomb and mine blasts. Intraorbital foreign bodies occurred in 78 eyes and intraocular foreign bodies in 132 eyes. Irreparable damage caused 13 eyes (6.2%) to be enucleated. Ten eyes developed severe endophthalmitis or panophthalmitis requiring evisceration. One hundred and thirty-four (63.8%) foreign bodies were removed, and 76 (36.2%) foreign bodies could not be removed. The causes of non-removal, the various complications, and the pattern of foreign bodies in the eye or orbit in Pakistan are discussed and compared with those of other regions. PMID- 3663567 TI - Persistent choroidal detachment. PMID- 3663568 TI - Description of a human direct calorimeter, with a note on the energy cost of clerical work. AB - 1. A heat-sink calorimeter, suitable for the measurement of energy expenditure in human subjects over periods up to 26 h, is described. 2. The performance of the calorimeter is illustrated by a study of four normal subjects at rest or performing clerical work for a period of 7.5 h. Each condition was measured in duplicate in each subject. On the resting days the subjects were recumbent, and on the working days they were seated throughout the measurement period. Heart rate was monitored by infra-red telemetry and physical activity by an ultrasound movement detector. Urinary cortisol excretion was also measured as an indicator of stress. 3. In each subject the mean heat loss on working days was higher than that on resting days: the increase ranged from 5.1% to 16.7%, with a mean value of 10.0% (P = 0.015). There was no significant difference between resting and working days in heart rate, physical activity or urinary cortisol excretion. 4. The present study confirms that tiring clerical work has very little effect on 24 h energy expenditure. PMID- 3663569 TI - The role of condensed tannins in the nutritional value of Lotus pedunculatus for sheep. 4. Sites of carbohydrate and protein digestion as influenced by dietary reactive tannin concentration. AB - 1. Vegetative secondary growth Lotus pedunculatus was cut daily, and fed fresh at hourly intervals (600 g dry matter (DM)/d) to three groups each of three sheep fitted with permanent cannulas into the rumen and duodenum. Lotus fed to two of the groups was sprayed with low and high rates of polyethylene glycol (PEG; molecular weight 3350), which specifically binds the condensed tannins (CT). Nutrient intake and faecal excretion were measured directly, duodenal flows estimated from continuous intraruminal infusion of inert ruthenium phenanthroline (Ru-P) and CrEDTA markers, and rumen pool sizes measured at slaughter. 2. Dietary concentrations of total reactive CT (i.e. that not bound to PEG) were 95, 45 and 14 g/kg DM, whilst the corresponding values for free CT were 15, 5 and 2 g/kg DM. 3. Increasing dietary reactive CT concentration linearly increased duodenal flows of non-ammonia nitrogen, but linearly decreased the apparent digestibility of energy and organic matter, and rumen digestion of hemicellulose but not of cellulose. Rumen digestion as a proportion of total digestion was increased by the higher PEG rate for organic matter, energy, pectin and lignin. 4. High dietary CT concentration was associated with increased N retention. Rumen ammonia concentration and pool size showed only a slight decline on this diet, indicating that there must have been increased recycling of N into the rumen. 5. Increasing dietary reactive CT concentration had no effect on the rate at which carbohydrate constituents were degraded in the rumen per unit time (FDR), but increased the rate at which their undegraded residues (FOR) left the rumen per unit time. The latter appeared to be the principal mechanism by which rumen digestion as a proportion of total digestion was reduced at high dietary CT concentrations. From a comparison of FDR and FOR of carbohydrate components in lotus and Brassica oleracea diets, it was concluded that hemicellulose digestion was rate-limiting for rumen cell-wall digestion, probably due to bonding with lignin. However, the considerable post-rumen digestion of hemicellulose was not associated with post rumen lignin digestion. 6. It was concluded that a desired concentration of CT in Lotus sp. should represent a balance between the positive effect of CT in improving the efficiency of N digestion and their negative effect in depressing rumen carbohydrate digestion. A recommended concentration is 30-40 g/kg DM. PMID- 3663570 TI - Effects of lactation on circulating plasma metabolites in 'cafeteria-fed' rats. AB - 1. The effects of 'cafeteria feeding' on primiparous Wistar rats during lactation have been studied by measuring circulating levels of glucose, amino acids, lactate, urea and ammonia as well as glycogen levels in liver and muscle. 2. No significant changes in glucose levels were observed despite alterations in blood glucose compartmentation. 3. Compared with controls, the dams given the cafeteria diet had higher liver glycogen stores which were more easily mobilized at the peak of lactation. 4. Rats given the cafeteria diet showed a lower amino acid utilization than controls and adequately maintained circulating levels, as determined by the lower circulating levels of ammonia and urea. 5. No significant differences in body-weight were observed in the period studied despite increasing dam weight after weaning in the cafeteria-fed group. 6. The size of pups of cafeteria-fed dams was greater than that of controls, and the differences were marked after weaning, when the metabolic machinery of the cafeteria pup maintained high protein accretion and body build-up using fat as the main energy substrate characteristic of the preweaning stage. The controls, however, changed to greater utilization of amino acids as an energy substrate and adapted to high protein (low-biological-quality) diets with a significantly different pattern of circulating nitrogen distribution. PMID- 3663571 TI - The distribution of peptidase activity in the small intestine of sheep. AB - 1. The activity of peptidase enzyme(s) was measured in homogenates of mucosa taken at slaughter from sites along the length of sheep small intestine. 2. The activity of the homogenate towards six dipeptides showed a similar pattern of distribution for each substrate. Activity was lowest in the proximal duodenum, rising through the jejunum to peak in the mid-ileum and declining towards the terminal ileum. The distribution of activity towards two tripeptides was similar. 3. Studies using the inhibitor p-hydroxymercuribenzoate showed that the activity towards the dipeptides was mainly localized in the cytosol fraction, while that towards the tripeptides was evenly distributed between the cytosol and the brush border and activity towards a tetrapeptide was mainly associated with the brush border. 4. The results are discussed in relation to the site and mechanism of protein digestion and absorption in the ruminant small intestine. PMID- 3663572 TI - Exchanges of water and certain water-soluble minerals during passage of digesta through the stomach compartments of young ruminating bovines. AB - 1. Four ruminating bull calves were provided with cannulas in the rumen and abomasum and a sleeve sutured at the omosal-abomasal orifice that permitted digesta flowing from the omasum to be diverted and collected. 2. The calves were each given in turn a high-roughage (HR) and high-concentrate (HC) diet consisting mainly of dried grass and flaked maize in the proportions 3:2 and 1:2 by weight respectively. Water-soluble non-absorbable marker (polyethylene glycol) was also given and the diets were sometimes supplemented with magnesium sulphate. For each diet (HR(0), HR(Mg), HC(0), HC(Mg], collections were made from the rumen, reticulum, omasal outflow and abomasum, and flows of water, sodium, potassium and chloride calculated at these sites relative to intakes. 3. The general pattern of net exchange was similar for all the diets. Substantial additions of water and Na, a small addition of K and a small absorption of Cl occurred between mouth and reticulum. Substantial (approximately 40-60%) absorption of water and Na, a small absorption of K and considerable secretion of Cl occurred in the omasum. Quantitative comparisons indicated that addition of water and Na up to the reticulum, presumably in saliva, was significantly greater for the HR than the HC diets. Addition of Mg appeared to stimulate absorption of Na and water up to the reticulum for unknown reasons. Re-absorption of these components in the omasum varied for different calves and diets but appeared to be influenced primarily by a positive linear relation between amounts of digesta flowing into the omasum and amounts of water and Na absorbed from it. The proportion of water absorbed also increased with increasing entry rates of water. 4. Other findings showed that pH values rose slightly (about 0.2 pH units) but significantly in the reticulum compared with the rumen and that the value fell again by about the same amount during the passage of digesta through the omasum. Changes between omasal outflow and the abomasum were as expected, with marked additions of Cl, Na and water and a fall in pH. PMID- 3663574 TI - Hexose absorption from jejunal loops in situ in zinc-deficient and Zn supplemented rats. AB - 1. Immature, male Wistar rats were given a low-zinc semi-synthetic diet (2 mg Zn/kg) for 22-28 d. Control groups received a similar diet supplemented with 58 mg Zn/kg either ad lib., or in amounts matched to the consumption of the Zn deficient group. There was a rapid onset of reduced food consumption and growth retardation in the Zn-depleted animals. 2. Serosal surface area of small intestines taken from Zn-deficient rats was significantly reduced compared with that of control animals. Villi, dissected from samples of proximal jejunum, were markedly smaller than those of control rats and were present in greater numbers per unit area of serosa. 3. Luminal loss of galactose from jejunal loops in situ was significantly greater in the Zn-deficient rats compared with controls when expressed in terms of unit dry weight of intestine and serosal or villous surface area. Since only a small proportion of the total galactose remained in the mucosal tissue and associated extracellular space, this loss could only be accounted for by an increased efficiency of net trans-epithelial transport. Differences in total galactose absorption per unit length of jejunum were not so marked. 4. This intestinal adaptation to Zn-deficiency allows the maintenance of normal, and possibly increased, rates of hexose transfer into the body of animals exhibiting severe growth retardation, reduced food utilization and abnormal glucose metabolism. PMID- 3663573 TI - Dissociation of methionine synthetase (EC 2.1.1.13) activity and impairment of DNA synthesis in fruit bats (Rousettus aegyptiacus) with nitrous oxide-induced vitamin B12 deficiency. AB - 1. The effect of methylcobalamin inactivation by the anaesthetic gas nitrous oxide on the activity of the cobalamin-dependent methionine synthetase (5 methyltetrahydrofolate homocysteine methyltransferase; EC 2.1.1.13) reaction, and on DNA synthesis, in the fruit bat Rousettus aegyptiacus, was examined. 2. Methionine synthetase activity in the liver of bats exposed to N2O-oxygen (50:50, v/v) for 90 min/d averaged 32% of that of controls after 4 d of exposure and only 5% after 12-14 weeks of exposure. 3. DNA synthesis in the bone marrow, as reflected by the deoxyuridine suppression test, was unaffected by 4 d of exposure to N2O and only minimally affected after 5-10 weeks of exposure. 4. These results suggest that DNA synthesis in the fruit bat is unusually resistant to inhibition of methionine synthetase and imply the existence of a non-methylated circulating folate pool in this species. PMID- 3663575 TI - Nitrogen balance in relation to energy intake in entire male pigs weighing 75 kg. AB - 1. Nitrogen balance (NB) was determined in entire male pigs weighing 75.6 (SE 0.56) kg and given 1.43 MJ metabolizable energy (ME)/kg live weight (LW)0.75 per d of semi-synthetic liquid diets which varied in crude protein (N x 6.38):ME from 2.5 to 14.5 g/MJ. Maximum NB of 20.8 g/d was reached with diets containing at least 6.2 g protein/MJ ME. 2. The relation between energy intake and NB was then examined in pigs of comparable live weight (mean 73.8 (SE 0.39) kg) and receiving a liquid diet not limiting in protein. The diet, containing 10.0 g protein/MJ ME, was given at eight rates from 0.24 MJ ME/kg LW0.75 per d to ad lib. by approximately equal increments. Two animals were allocated to each level and two animals were fasted during the balance period. 3. The animals fed ad lib. achieved a mean intake of 1.84 MJ ME/kg LW0.75 per d. NB increased linearly as ME intake increased up to 27.6 MJ/d (1.096 MJ/kg LW0.75 per d) but thereafter remained constant at 22.8 g N/d. PMID- 3663576 TI - The effects of maternal folic acid and vitamin C nutrition in early pregnancy on reproductive performance in the guinea-pig. AB - 1. The effect of different intakes of folic acid (FA) and vitamin C on pregnancy in the Dunkin-Hartley guinea-pig was examined. Female guinea-pigs were subjected to three graded intakes of FA and vitamin C ('deficient', 'intermediate' similar to recommended daily intakes (RDI), and 'supplemented') during early gestation and up to the time of neural tube closure (17th day of gestation), and then returned to the RDI of these vitamins. 2. Plasma and blood cell concentrations of these vitamins were measured once before and at the end of the dietary treatments. Reproductive performance was assessed in terms of the number of resorbed and aborted embryos and weight and size of the live fetuses on the 36th day of gestation. 3. The short-term deficiency of either of these two vitamins, insufficient to affect maternal health, had a dramatic effect on the reproductive performance. 4. The RDI of FA was significantly less effective than the supplemented intake in preventing embryonic deaths. The RDI of vitamin C produced lighter and smaller live fetuses than the supplemented intake. 5. The implications of these findings with regard to vitamin status in early pregnancy in man are discussed. PMID- 3663577 TI - All-trans-retinoic acid inhibits retinol esterification by acyl-CoA: retinol acyltransferase (EC 2.3.1.76) from rat and human small intestinal mucosa. AB - 1. Formation of retinyl esters catalyzed by acyl-CoA:retinol acyltransferase (ARAT; retinol fatty-acyltransferase; EC 2.3.1.76) from intestinal mucosa has been studied in vitro in the presence of all-trans-retinoic acid. 2. The incubation system contained microsomal preparations from the tissue tested, radioactive retinol and palmitoyl-CoA. The product formed was separated from the substrates by chromatography on alumina columns. 3. All-trans-retinoic acid inhibited ARAT both from rat and human intestinal mucosa. 4. Inhibition occurred instantly. At a concentration of retinol of 80 microM, a 50% inhibition was obtained with 50 microM-retinoic acid. 5. The inhibition of ARAT by retinoic acid may be of importance for normal retinol absorption in patients receiving retinoid therapy. PMID- 3663578 TI - Comparative biological availability of manganese from extrinsically labelled milk diets using sucking rats as a model. AB - 1. Very little is known about the biological availability of manganese from human milk and other infant milk diets. To determine the relative Mn availability, and to examine whether the age and the duration of previous fasting affect Mn absorption, sucking rats were given human milk, bovine milk and infant formula (regular Similac; Ross Laboratories, Columbus, OH) extrinsically labelled with 54Mn. 2. Milk diets were given by gastric intubation and the radioactivity of the carcass, liver and digestive tract was measured 3 h after feeding. 3. The concentration of endogenous Mn was lowest in human milk (7-10 micrograms/l) and highest in rat milk (140-165 micrograms/l). Increasing the non-radioactive total Mn concentrations of either human milk or bovine milk up to 150 micrograms/l did not affect the absorption of 54Mn by 10-d-old rats. 4. No significant (P greater than 0.05) difference in 54Mn absorption was found among the three milk diets (human milk, bovine milk, infant formula) in 8- to 11-d-old rats. However, significantly more (P less than 0.05) 54Mn was absorbed from human milk and infant formula than from bovine milk when 13-d-old rats were used. 5. 54Mn radioactivity detected in carcasses of 8-, 9-, 10- and 11-d-old rats ranged from 25 to 27% of the dose from various milk diets. The activities of 54Mn in the carcasses of 13-d-old rats were 15, 11, and 16% of the dose from human milk, bovine milk and infant formula respectively. 6. The trend of 54Mn incorporation into liver was similar to that of the carcass and over 60% of the absorbed 54Mn was incorporated into the liver regardless of the type of milk used. 7. Absorption of 54Mn from extrinsically labelled rat milk using 9- or 10-d-old sucking rats was similar to its absorption from infant formula. 8. The absorption of 54Mn from the three milk diets decreased with age of the neonatal rats and 54Mn absorption from human milk, bovine milk, infant formula as well as rat milk was affected similarly by duration of previous fasting. PMID- 3663579 TI - Changes in plasma fibronectin during acute nutritional deprivation in healthy human subjects. AB - 1. Plasma fibronectin, a glycoprotein, is an opsonin of the reticuloendothelial system. 2. In ten healthy volunteers starved for 4.5 d, daily measurements showed a rapid reduction in plasma fibronectin, no alteration in either C3 or plasma transferrin and, at the end of the starvation period, an elevated serum albumin. 3. On refeeding, plasma fibronectin rapidly returned to its prestarvation level but plasma transferrin was significantly reduced and did not recover by the end of the study. 4. Changes in plasma fibronectin may be a sensitive index of nutritional status. The reduction of plasma fibronectin in short-term starvation may compromise host defence tolerance of injury and sepsis. PMID- 3663580 TI - alpha-Tocopherol supplements and high-density-lipoprotein-cholesterol levels. AB - 1. In a randomized, double-blind 6-month study, alpha-tocopherol (728 mg) or placebo were administered daily to seventy-eight volunteers (forty-nine men, twenty-nine women) to investigate the possible enhancing effect of vitamin E on plasma high-density-lipoprotein-cholesterol (HDL-C) levels. In addition, the available reported values from short-term (4-6 weeks) studies, as well as the 4 week results from the present study, were combined and analysed for factors which may modify the effect of alpha-tocopherol on HDL-C. 2. No consistent effect of alpha-tocopherol on plasma HDL-C levels was observed either in the combined 4 week values or in the 6-month study. Further analysis of the combined short-term values and 6-month values indicated that, in subjects with low initial HDL-C levels, treatment with alpha-tocopherol or placebo did not produce significantly different HDL-C changes. PMID- 3663581 TI - The effects of dietary acid stress on bone metabolism in young ovariectomized and intact rats. AB - 1. Two studies were performed to determine the effects of acid stress and ovariectomy on bone metabolism in young rats. In Expt 1, eighteen female weanling Sprague-Dawley-descended rats were ovariectomized, placed in one of three dietary groups and given a diet containing (g/kg): 6 calcium and 3, 6 or 12 phosphorus for 10 weeks. In Expt 2, thirty-two female weanling Sprague-Dawley-descended rats were ovariectomized, and thirty-two were left intact. Eight rats from each group were given a diet containing (g/kg): 6 Ca and 3 P, 12 P, 3 P + 1 S or 3 P + 20 ammonium chloride for 10 weeks. 2. Feeding diets containing 12 g P/kg resulted in decreased serum Ca and increased urinary P with no changes in femur composition. Feeding high-sulphate and ammonium chloride diets resulted in increased urinary Ca and, when combined with ovariectomy, lower femur Ca and P with no changes in femur hydroxyproline or hexosamines. 3. The findings reflect the more rapid turnover of the amorphous calcium phosphate salts found in greater amounts in bones of younger animals than for more stable apatitic crystals that predominate in bones of older animals. PMID- 3663582 TI - Effect of guar gum on gastric emptying in growing pigs. AB - 1. Simple gastric cannulas were surgically fitted to four pigs, initially of 30 kg live weight, to examine the effects of guar gum on gastric emptying. 2. Four semi-purified high-fat diets based on starch, casein, soya-bean oil and tallow were given to each pig. They contained 0 (control), 20, 40 or 60 g powdered guar gum/kg diet. The meals as fed contained 257 g dry matter (DM)/kg. 3. The contents of the stomach were evacuated, with rinsing, before feeding or 0.5, 1, 2 or 4 h after feeding. 4. The mean pH of the digesta was unaffected by guar gum until 4 h after feeding when the value increased as the amount of guar gum in the diet rose. 5. The only significant effects of guar gum on the emptying of digesta and its components (compared with the control diet) were to reduce the rate of emptying of (a) digesta 1 h after feeding (60 g/kg diet) and 4 h after feeding (40 and 60 g/kg diets), (b) dry matter and glucose 1 h after feeding (60 g/kg diet), (c) nitrogen 1 h after feeding (60 g/kg diet) and 4 h after feeding (40 and 60 g/kg diets). 6. When expressed on a half-time (T50) basis, the emptying of digesta and N (but not of DM and glucose) were significantly slower for diets containing 40 and 60 g guar gum/kg than for the control diet. 7. The apparent viscosity of the gastric digesta ranged between 0.5 and 23.7% of the values for the diets as consumed. 8. It was concluded that the effects of guar gum on gastric emptying of high-solid meals were small, and that this was unlikely to be an important aspect of the mechanism by which guar gum reduces postprandial blood glucose concentrations. PMID- 3663583 TI - Effect of guar gum on gastric emptying of test meals of varying energy content in growing pigs. AB - 1. Existing information on whether the action of guar gum in decreasing postprandial blood glucose concentrations is due, at least in part, to a reduced rate of gastric emptying is conflicting, possibly because three types of test meals have been used. In order to test whether the type of test meal used influences the action of guar gum, these three types of meal were compared, either without or with guar gum, in growing pigs. The meals were: a high-energy meal (HEM), a low-energy milky drink (LEMD) and a glucose drink (GD). 2. Six pigs were prepared with a simple gastric cannula which allowed complete removal of the stomach contents just before or 0.5, 1, 2 or 4 h after feeding. 3. The three types of test meal without guar gum gave rise to very different postprandial profiles of gastric pH and of digesta and dry matter (DM) emptying from the stomach. 4. Addition of guar gum to the GD significantly raised gastric pH at 0.5 and 1 h after feeding but, when it was added to HEM, gastric pH was only significantly raised 4 h after feeding. No significant effect on gastric pH was seen when guar gum was added to LEMD. 5. Although addition of guar gum to GD had no significant effect on the emptying of digesta from the stomach, when added to HEM the rate of emptying of digesta was significantly reduced 1, 2 and 4 h after feeding. Addition of guar gum to LEMD only significantly increased the amount of digesta remaining in the stomach 2 h after feeding. 6. There was no significant effect on the emptying of DM from the stomach when guar gum was added to either HEM or LEMD. However, addition of guar gum to GD significantly reduced the mean rate of emptying of DM 0.5 h after feeding. 7. Addition of guar gum to either LEMD or GD had no significant effect on the DM concentration of the evacuated gastric digesta. However, addition of guar gum to HEM significantly lowered the DM concentration of the evacuated gastric digesta 1, 2 and 4 h after feeding. 8. It was concluded that differences in test meal composition and also in the methods used to measure gastric emptying could account for the discrepancies previously reported. The results suggest that although guar gum may reduce the rate of gastric emptying under some conditions, this is unlikely to be the only mechanism by which it acts. PMID- 3663584 TI - In vivo cross-linking of protein disulfide isomerase to immunoglobulins. AB - To test the proposed role of protein disulfide isomerase in the synthesis of immunoglobulins (Ig), intact lymphocytes were treated with a thiol-cleavable, bifunctional cross-linking agent and lysed, and the lysates were immunoprecipitated with antibodies to either Ig or enzyme. When the immunoprecipitates were analyzed on polyacrylamide-sodium dodecyl sulfate gels, protein disulfide isomerase was found to be cross-linked to immunoglobulins. The extent of cross-linking was dependent upon the concentration of cross-linker added and the class of Ig. For IgMs and high concentrations of cross-linker, approximately one molecule of Ig was coupled per two molecules of enzyme. For IgGs, the extent of cross-linking was less. Finally, depletion of the intracellularly reduced glutathione by diamide was found to also result in the linkage of protein disulfide isomerase to IgM. These results therefore support the hypothesis that protein disulfide isomerase functions in the in vivo synthesis of immunoglobulins. PMID- 3663585 TI - 8-Hydroxy-5-deazaflavin-reducing hydrogenase from Methanobacterium thermoautotrophicum: 1. Purification and characterization. AB - The 8-hydroxy-5-deazaflavin (coenzyme F420) reducing hydrogenase from the obligate anaerobe Methanobacterium thermoautotrophicum delta H has been purified 41-fold to apparent homogeneity. The major active enzyme form is a high molecular weight aggregate of Mr ca. 800,000, composed of three subunits, alpha (Mr 47K), beta (Mr 31K), and gamma (Mr 26K). The hydrogenase is purified aerobically in reversibly inhibited form, and conditions for anaerobic reductive activation with H2, high salt, thiols, and electron acceptors have been defined. The minimal species transferring electrons from H2 to coenzyme F420 appears to be an alpha beta delta (Mr 115K) complex. The tightly associated redox cofactors per 115K species are 0.6-0.7 nickel atom, 0.8-0.9 flavin adenine dinucleotide (FAD), and 13-14 iron atoms in iron-sulfur centers. The subunits have been separated by denaturing gel electrophoresis, which has permitted determination of amino acid composition, subunit N-terminal sequencing, and preparation of subunit-directed antibodies. There is iron associated with the alpha-subunit, but placement of the nickel and FAD has not been established. PMID- 3663586 TI - 8-Hydroxy-5-deazaflavin-reducing hydrogenase from Methanobacterium thermoautotrophicum: 2. Kinetic and hydrogen-transfer studies. AB - Steady-state kinetic parameters have been obtained for the pure 8-hydroxy-5 deazaflavin-reducing hydrogenase. With H2 and 8-hydroxy-5-deazariboflavin (F0) as substrates, Km (H2) = 12 microM, Km (F0) = 26 microM, and Kcat = 225 s-1. In the back-direction, F0H2 is reoxidized (anaerobically) at 225 s-1. Initial velocity patterns, product inhibition patterns, dead-end inhibition by carbon monoxide, and transhydrogenation to Procion Red HE-3B suggest a two-site hybrid ping-pong mechanism. A kinetic derivation for the rate equation is provided in the Appendix. Studies with D2 and with D2O reveal that no steps involving D transfer are substantially rate determining. Further, D2 yields F0H2 with no deuterium at C5 while in D2O a 5-monodeuterio F0H2 product is formed, indicating complete exchange of hydrogens from H2 with solvent before final transfer of a hydride ion out from reduced enzyme to C5 of F0. PMID- 3663587 TI - 13C NMR studies of porphobilinogen synthase: observation of intermediates bound to a 280,000-dalton protein. AB - 13C NMR has been used to observe the equilibrium complex of [4-13C]-5 aminolevulinate ([4-13C]ALA) bound to porphobilinogen (PBG) synthase (5 aminolevulinate dehydratase), a 280,000-dalton protein. [4-13C]ALA (chemical shift = 205.9 ppm) forms [3,5-13C]PBG (chemical shifts = 121.0 and 123.0 ppm). PBG prepared from a mixture of [4-13C]ALA and [15N]ALA was used to assign the 121.0 and 123.0 ppm resonances to C5 and C3, respectively. For the enzyme-bound equilibrium complex formed from holoenzyme and [4-13C]ALA, two peaks of equal area with chemical shifts of 121.5 and 127.2 ppm are observed (line widths approximately 50 Hz), indicating that the predominant species is probably a distorted form of PBG. When excess free PBG is present, it is in slow exchange with bound PBG, indicating an exchange rate of less than 10 s-1, which is consistent with the turnover rate of the enzyme. For the complex formed from [4 13C]ALA and methyl methanethiosulfonate (MMTS) modified PBG synthase, which does not catalyze PBG formation, the predominant species is a Schiff base adduct (chemical shift = 166.5 ppm, line width approximately 50 Hz). Free ALA is in slow exchange with the Schiff base. Activation of the MMTS-modified enzyme-Schiff base complex with 113Cd and 2-mercaptoethanol results in the loss of the Schiff base signal and the appearance of bound PBG with the same chemical shifts as for the bound equilibrium complex with Zn(II) enzyme. Neither splitting nor broadening from 113Cd-13C coupling was observed. PMID- 3663588 TI - Examination of the Na+-induced conformational change of the intestinal brush border sodium/glucose symporter using fluorescent probes. AB - The Na+-induced change in conformation of the intestinal brush border glucose carrier has been examined by three procedures. In the first, we have measured the effect of Na+ on the binding of fluorescein isothiocyanate (FITC) to the glucose site; 100 mM Na increased the specific [blocked by D-glucose, p (chloromercuri)benzenesulfonic acid, and N-acetylimidazole] FITC binding to a 75 kilodalton polypeptide 3-fold. In the second series, we have examined the effect of Na+ on the susceptibility of the fluorescently labeled glucose site [pyrene isothiocyanate (PYTC) labeled] to a hydrophilic quencher (Tl+); 100 mM NaCl increased the fraction of PYTC sites available to Tl+ from 32% to 92% and decreased the apparent quenching constant from 94 to 44 M-1. Finally, in the third series, we probed the distribution of tryptophan residues 15-30 A from the glucose site using a "distant reporter group method", where tryptophan was used an an energy donor to anthracene isothiocyanate bound to the glucose site. Tryptophan quench reagents (I-, Cs+, and acrylamide) were then employed to probe the accessibility of the glucose site tryptophans in the presence and absence of sodium. In the absence of Na+, there were two major classes of glucose tryptophans--exterior surface residues and residues buried in the hydrophobic protein matrix. Na+ caused a redistribution of the donor tryptophans such that a higher percentage were accessible to I- (51% vs. 25%) and fewer were accessible to Cs+ (13% vs. 25%) and acrylamide (27% vs. 57%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663589 TI - Novel fluorescent phospholipids for assays of lipid mixing between membranes. AB - A series of fluorescent phospholipids has been synthesized, by a general and versatile procedure, with various fluorescent groups attached to the methyl terminal half of one acyl chain in an otherwise normal phospholipid structure. Phospholipids labeled with (dialkylamino)coumarin moieties, and to a slightly lesser extent those labeled with a bimane group, exhibit a strong and stable blue fluorescence in phospholipid dispersions that is relatively insensitive to the physical state of the lipid phase. The fluorescence of these labeled phospholipids is efficiently quenched by resonance energy transfer to lipids labeled with a [[(dimethylamino)phenyl]azo]phenyl or a methyl(nitrobenzoxadiazolyl)amino group when these acceptors are incorporated into the same bilayer as the donor species. Acyl chain labeled phospholipid probes, both of whose chains are at least sixteen carbons in length, exchange extremely slowly between lipid vesicles (less than 1% exchange/h). These properties allow various donor-acceptor combinations of probes to be employed in sensitive and reliable assays of lipid mixing accompanying membrane fusion. We demonstrate that, in two particularly demanding applications (assays of the calcium-mediated coalescence of phosphatidylserine vesicles and of the proton triggered coalescence of phosphatidylethanolamine vesicles), some combinations of acyl chain labeled probes offer substantial advantages over the commonly used N (7-nitrobenz-2-oxa-1,3-diazol-4-yl)phosphatidylethanolamine/N-(l issamine rhodamine B sulfonyl)phosphatidylethanolamine pair to monitor accurately the progress of lipid mixing between vesicles. PMID- 3663590 TI - Kinetics of the subtransition in dipalmitoylphosphatidylcholine. AB - The kinetics of the interconversions of the subgel and gel phases in dipalmitoylphosphatidylcholine have been studied by using differential dilatometry, differential scanning calorimetry (DSC), and neutral buoyancy centrifugation as a function of incubation temperature and deuteriation of the solvent. As seen by others, DSC scans show two peaks in the subgel transition region for incubation temperatures below 1 degree C. After incubation at 0.1 degree C, the DSC peak that occurs at the lower scanning temperature appears with an incubation half-time of 0.5 day and eventually converts into a peak at higher scanning temperature with an incubation half-time of 18 days. By varying the scanning rate, we show that these two peaks merge into one at slow scanning rates with a common equilibrium transition temperature of 13.8 degrees C, in agreement with equilibrium calorimetry and dilatometry (delta V = 0.017 +/- 0.001 mL/g). For incubation temperatures above 4.6 degrees C, only one peak appears in both scanning dilatometry and calorimetry. While the initial rate of subgel conversion is smaller at the higher incubation temperatures, after 300 h a higher percentage of the sample has converted to subgel than at the lower incubation temperatures. We suggest that higher incubation temperatures (near 5 degrees C) are preferable for forming the stable subgel phase, and we present a colliding domain picture that indicates why this may be so. Our results in D2O and the similarity of the kinetics of volume decrease with the kinetics of wide-angle diffraction lines also support the suggestion that the partial loss of interlamellar water plays a kinetic role in subgel formation. PMID- 3663591 TI - Reductive methylation as a tool for the identification of the amino groups in alpha-bungarotoxin interacting with nicotinic acetylcholine receptor. AB - alpha-Bungarotoxin (alpha Bgt) is a postsynaptic neurotoxin which blocks cholinergic transmission at the neuromuscular junction by binding tightly to the acetylcholine receptor (AcChR). The number of methylation sites in alpha Bgt has been shown to decrease significantly upon binding of the toxin to the AcChR [Soler, G., Farach, M. C., Farach, H. A., Mattingly, J. R., & Martinez-Carrion, M. (1983) Arch. Biochem. Biophys. 225, 872-878]. We have compared the chemical reactivities of amino groups in free and AcChR-bound alpha Bgt in an attempt to identify the regions in the alpha Bgt molecule that become masked upon binding to the AcChR. Free alpha Bgt and AcChR-bound alpha Bgt were reductively methylated with formaldehyde and sodium cyanoborohydride, and the rate of modification of each one of the available amino groups was followed by cleaving the methylated toxin with V8 protease and resolving the resulting peptides by reversed-phase, high-performance liquid chromatography. Under conditions of limited reagent availability, five of seven amino groups in free alpha Bgt reacted readily, whereas two other amino groups, probably those corresponding to Lys-51 and Lys 70, displayed lower reactivity. Upon binding to the AcChR, the rates of reductive methylation of residues Ile-1, Lys-26, and Lys-38 were considerably reduced (although to differing extents). The degree of protection was most pronounced for Lys-26. The rates of methylation of the amino groups in all other positions remained unchanged. These results allow further definition of the minimal binding surface of a representative neurotoxin. PMID- 3663592 TI - Thermodynamic characterization of interactions between ornithine transcarbamylase leader peptide and phospholipid bilayer membranes. AB - The interactions of the targeting sequence of the mitochondrial enzyme ornithine transcarbamylase with phospholipid bilayers of different molecular compositions have been studied by high-sensitivity heating and cooling differential scanning calorimetry, high-sensitivity isothermal titration calorimetry, fluorescence spectroscopy, and electron microscopy. These studies indicate that the leader peptide interacts strongly with dipalmitoylphosphatidylcholine (DPPC) bilayer membranes containing small mole percents of the anionic phospholipids dipalmitoylphosphatidylglycerol (DPPG) or brain phosphatidylserine (brain PS) but not with pure phosphatidylcholines. For the first time, the energetics of the leader peptide-membrane interaction have been measured directly by using calorimetric techniques. At 20 degrees C, the association of the peptide with the membrane is exothermic and characterized by an association constant of 2.3 X 10(6) M-1 in the case of phosphatidylglycerol-containing and 0.35 X 10(6) M-1 in the case of phosphatidylserine-containing phospholipid bilayers. In both cases, the enthalpy of association is -60 kcal/mol of peptide. Additional experiments using fluorescence techniques suggest that the peptide does not penetrate deeply into the hydrophobic core of the membrane. The addition of the leader peptide to DPPC/DPPG (5:1) or DPPC/brain PS (5:1) small sonicated vesicles results in vesicle fusion. The fusion process is dependent on peptide concentration and is maximal at the phase transition temperature of the vesicles and minimal at temperatures below the phase transition. PMID- 3663593 TI - Mechanism of hydroxylamine mutagenesis: tautomeric shifts and proton exchange between the promutagen N6-methoxyadenosine and cytidine. AB - Whereas the amino, but not imino, tautomer of the promutagen N6-methoxyadenosine (OMe6A) forms planar associates (base pairs) with the potentially complementary uridine [Stolarski, R., Kierdaszuk, B., Hagberg, C.-E., & Shugar, D. (1984) Biochemistry 23, 2906-2913], it has now been found, with the aid of 1H NMR spectroscopic techniques, that only the imino tautomer of OMe6A base pairs with the potentially complementary cytidine. The association constant for such heteroassociates is more than an order of magnitude higher than that for autoassociates of OMe6A. The formation of heteroassociates is accompanied by a marked shift in tautomeric equilibrium of OMe6A, with an increase in the population of the amino form from 18% to as high as 44% and a corresponding decrease in the population of the imino species. Furthermore, the presence of cytidine in a solution of OMe6A appreciably enhances the rate of tautomeric exchange between the two tautomeric forms. Formation of planar heteroassociates between cytidine and the imino form of OMe6A is also accompanied by proton exchange between the cytidine NH2 and the N6-H of the amino form of OMe6A. The rate constants for this exchange and for tautomeric exchange, determined by the saturation transfer technique, have been measured at various concentrations and temperatures. A model is advanced for proton exchange that takes into account the interdependence of tautomeric exchange and proton exchange, as well as the role of auto- and heteroassociates. The relevance of these results to the molecular basis of hydroxylamine and methoxyamine mutagenesis and to the phenomenon of proton exchange in other systems is briefly discussed. PMID- 3663594 TI - Two-dimensional NMR studies of the antimicrobial peptide NP-5. AB - Nearly complete proton resonance assignment of the rabbit antimicrobial peptide NP-5 has been made from two-dimensional NMR data taken at a single temperature. The assignment procedure involved acquisition of phase-sensitive double-quantum filtered correlation spectra, relayed coherence-transfer spectra, total correlation (homonuclear Hartmann-Hahn) spectra, double- and triple-quantum spectra, and nuclear Overhauser effect spectra. The combination of these complementary experiments simplified and accelerated resonance assignment of the peptide. Individual assignments were made at 20 degrees C for all amide and C alpha protons in the peptide, and for all nonlabile side-chain protons on 26 of the 33 amino acid residues in NP-5. Analysis of the proton-proton nuclear Overhauser effect connectivities, the slowly exchanging amide protons, and the proton chemical shifts in NP-5 indicates that the peptide has a stable, ordered structure in solution. These data also indicate that residues 19-29 in NP-5 are involved in an antiparallel beta-sheet that has a hairpin conformation. PMID- 3663595 TI - On the domain structure of antithrombin III. Tentative localization of the heparin binding region using 1H NMR spectroscopy. AB - The denaturation of human and bovine antithrombin III by guanidine hydrochloride has been followed by 1H NMR spectroscopy. The same unfolding transition seen previously from circular dichroism studies [Villanueva, G. B., & Allen, N. (1983) J. Biol. Chem. 258, 14048-14053] at low denaturant concentration was detected here by discontinuous changes in the chemical shifts of the C(2) protons of two of the five histidines in human antithrombin III and of three of the six histidines in bovine antithrombin III. These two histidines in human antithrombin III are assigned to residue 1 and, more tentatively, to residue 65. Two of the three histidines similarly affected in the bovine protein appear to be homologous to residues in the human protein. This supports the proposal of similar structures for the two proteins. In the presence of heparin, the discontinuous titration behavior of these histidine resonances is shifted to higher denaturant concentration, reflecting the stabilization of the easily unfolded first domain of the protein by bound heparin. From the tentative assignment of one of these resonances to histidine-1, it is proposed that the heparin binding site of antithrombin III is located in the N-terminal region and that this region forms a separate domain from the rest of the protein. The pattern of disulfide linkages is such that this domain may well extend from residue 1 to at least residue 128. Thermal denaturation also leads to major perturbation of these two histidine resonances in human antithrombin III, though stable intermediates in the unfolding were not detected. PMID- 3663596 TI - Infrared studies of fully hydrated saturated phosphatidylserine bilayers. Effect of Li+ and Ca2+. AB - The thermotropic phase behavior of fully hydrated Na+ and/or NH4+ salts of 1,2 dimyristoyl-sn-glycero-3-phospho-L-serine (DMPS) was determined by temperature dependent infrared spectra. The molecular level properties and thermal phase behavior of DMPS-Li+ complexes were also characterized by infrared spectroscopy. With increasing concentrations of Li+, the infrared spectra reveal the appearance of a second, more ordered, lipid phase which shows a gel to liquid-crystal transition at significantly higher temperatures (75-95 degrees C) than the Na+ or NH4+ salts of DMPS (39 degrees C). Li+ binds to the phosphate and carboxylate groups of DMPS, resulting in the following changes: (1) water of hydration is lost from both the carboxylate and phosphate groups; (2) there are changes in the conformation of the glycerol backbone but not in the P-O ester bonds of the phosphate group which remain in the gauche-gauche conformation; and (3) the packing of the fatty acyl chains becomes more ordered. In addition, the properties of the DMPS-Ca2+ complex were studied by infrared spectroscopy. While the DMPS-Ca2+ complex is also characterized by rigidly packed, well-ordered fatty acyl chains, the mode of Ca2+ binding to the DMPS head groups differs significantly from that of Li+ binding. By comparison, with dry DMPS-Ca2+ [Casal, H. L., Mantsch, H. H., Paltauf, F., & Hauser, H. (1987) Biochim. Biophys. Acta (in press)], the phosphate group undergoes a conformational change, probably to the antiplanar-antiplanar conformation, and loses its water of hydration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663597 TI - Microtubule elongation and guanosine 5'-triphosphate hydrolysis. Role of guanine nucleotides in microtubule dynamics. AB - The tubulin concentration dependence of the rates of microtubule elongation and accompanying GTP hydrolysis has been studied over a large range of tubulin concentration. GTP hydrolysis followed the elongation process closely at low tubulin concentration and became gradually uncoupled at higher concentrations, reaching a limiting rate of 35-40 s-1. The kinetic parameters for microtubule growth were different at low and high tubulin concentrations. Elongation of microtubules has also been studied in solutions containing GDP and GTP in variable proportions. Only traces of GTP present in GDP were necessary to confer a high stability (low critical concentration) to microtubules. Pure GDP-tubulin was found unable to elongate microtubules in the absence of GTP but blocked microtubule ends with an equilibrium dissociation constant of 5-6 microM. These data were accounted for by a model within which, in the presence of GTP-tubulin at high concentration, microtubules grow at a fast rate with a large GTP cap; the GTP cap may be quite short in the region of the critical concentration; microtubule stability is linked to the strong interaction between GTP and GDP subunits at the elongating site; dimeric GDP-tubulin does not have the appropriate conformation to undergo reversible polymerization. These results are discussed with regard to possible role of GDP and GTP and of GTP hydrolysis in microtubule dynamics. PMID- 3663598 TI - Direct interaction between the catalytic subunit of the calmodulin-sensitive adenylate cyclase from bovine brain with 125I-labeled wheat germ agglutinin and 125I-labeled calmodulin. AB - A calmodulin-sensitive adenylate cyclase has been purified to apparent homogeneity from bovine cerebral cortex using calmodulin-Sepharose followed by forskolin-Sepharose and wheat germ agglutinin-Sepharose. The final product appeared as one major polypeptide of approximately 135,000 daltons on sodium dodecyl sulfate-polyacrylamide gels. This polypeptide was a major component of the protein purified through calmodulin-Sepharose. The catalytic subunit was stimulated 3-4-fold by calmodulin (CaM) with a turnover number greater than 1000 min-1 and was directly inhibited by adenosine. The catalytic subunit of the enzyme interacted directly with 125I-CaM on a sodium dodecyl sulfate polyacrylamide gel overlay system, and this interaction was Ca2+ concentration dependent. In addition, the catalytic subunit was shown to directly bind 125I labeled wheat germ agglutinin using a sodium dodecyl sulfate-polyacrylamide gel overlay technique, and N-acetylglucosamine inhibited binding of the lectin to the catalytic subunit. Calmodulin did not inhibit binding of wheat germ agglutinin to the catalytic subunit, and the binding of calmodulin was unaffected by wheat germ agglutinin. These data illustrate that the catalytic subunit of the calmodulin sensitive adenylate cyclase is a glycoprotein which interacts directly with calmodulin and that adenosine can inhibit the enzyme without intervening receptors or G coupling proteins. It is concluded that the catalytic subunit of adenylate cyclase is a transmembrane protein with a domain accessible from the outer surface of the cell. PMID- 3663599 TI - Myosin isoforms in normal and dystrophic chickens. AB - The myosin isoform content in the affected fibers of chickens with inherited muscular dystrophy has been investigated with a new high-performance liquid chromatographic procedure for separation of the tryptic fragments of myosin subfragment 1 (S-1). The results indicate that dystrophic muscle contains substantial amounts of normal adult myosin, together with various myosin species present in normal 5-day posthatch chickens. Confirmation was obtained by comparative peptide mapping of the S-1 tryptic fragments and by N-terminal sequencing of 20-kDa species. Together with data on other contractile proteins and certain metabolic enzymes [Obinata, T., Takano-Ohmura, H., & Matsuda, R. (1980) FEBS Lett. 120, 195-198; Mikasa, T., Takeda, S., Shimizu, T., & Kitaura, T. (1981) J. Biochem. (Tokyo) 89, 1951-1962; Feit, H., & Domke, R. (1982) Cell Motil. 2, 309-315; Cosmos, E. (1966) Dev. Biol. 13, 163-181; Cosmos, E., & Butler, J. (1967) in Exploratory Concepts in Muscular Dystrophy and Related Disorders (Milhorat, A. R., Ed.) pp 197-204, Excerpta Medica, Amsterdam], the results are consistent with the hypothesis that there is a general defect in muscle maturation in avian dystrophy. PMID- 3663600 TI - Role of enzyme-peptide substrate backbone hydrogen bonding in determining protein kinase substrate specificities. AB - As part of a search for peptides that have specificity for selected protein kinases, the possibility that adenosine cyclic 3',5'-phosphate dependent protein kinase (A-kinase) recognizes the hydrogen-bonding potential of its peptide substrates was investigated. A-Kinase catalyzes the phosphorylation of five N alpha-methylated and four depsipeptide derivatives of Leu-Arg-Arg-Ala-Ser-Leu-Gly (peptide 1) at rates that differ by at least 7 orders of magnitude. These peptide 1 analogues each lack the ability to donate a hydrogen bond at selected positions in the peptide chain. If a particular amide hydrogen of a peptide amide is involved in hydrogen bonding, which is important for enzyme recognition, the prediction is that peptides which contain an ester or a N-methylated bond at that position in peptide 1 will be comparatively poor substrates. In contrast, if a depsipeptide has a reactivity comparable to that of peptide 1 but the analogous N methylated peptide has a poor reactivity with A-kinase, the result might indicate that the N-methyl group causes unfavorable steric effects. The depsipeptide that lacks a Leu6 amide proton is a good substrate for A-kinase, but the corresponding N-methylated peptide is phosphorylated far less efficiently. This result and others presented in this paper suggest that although enzyme-substrate hydrogen bonding may play some role in A-kinase catalysis of phosphoryl group transfer, other explanations are necessary to account for the relative reactivities of N alpha-methylated and depsi-containing peptide 1 analogues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663601 TI - Distinguishing among protein kinases by substrate specificities. AB - In the previous paper, N-methylated peptides were shown to be sensitive probes of substrate conformation within the adenosine cyclic 3',5'-phosphate dependent protein kinase (A-kinase) active site. While it has been shown that other protein kinases will catalyze the phosphorylation of the same peptide sequences as A kinase, there is as yet little information as to whether the protein kinases differentiate between substrates on the basis of conformation. For this reason, the conformationally restricted N-methylated peptides were used to probe the active site of guanosine cyclic 3',5'-phosphate dependent protein kinase (G kinase), which is homologous in sequence to [Takio, K., Wade, R. D., Smith, S. B., Krebs, E. G., Walsh, K. A., & Titani, K. (1984) Biochemistry 23, 4207-4218] and which has substrate specificities similar to [Lincoln, T. M., & Corbin, J. D. (1977) Proc. Natl. Acad. Sci. U.S.A. 74, 3239-3243] those of A-kinase. Although this enzyme appears to bind the peptides in a conformation resembling that of conformation A, it is more able to accommodate backbone methylation than is A kinase. A peptide substrate at least 700-fold selective for G-kinase over A kinase was found. Backbone methylation may, therefore, represent a way of making peptide substrates and inhibitors selective for a particular kinase. PMID- 3663602 TI - Extended binding inhibitors of chymotrypsin that interact with leaving group subsites S1'-S3'. AB - We have synthesized inhibitors of chymotrypsin, based on fluoromethyl ketones, that bind at S and S' subsites. "Small" inhibitors of serine proteases, which have previously been synthesized, only interact with S subsites. The parent compound is Ac-Leu-ambo-Phe-CF2H (1) (Ki = 25 X 10(-6) M). This inhibitor was modified by successively replacing H of the -CF2H group by -CH2CH2CONHCH3, (4), CH2CH2CONH-Leu-NHMe (5), -CH2CH2CONH-Leu-Val-OEt (6), and -CH2CH2CONH-Leu-Arg-OMe (7). Corresponding Ki values are 7.8 (4), 0.23 (5), 0.21 (6), and 0.014 (7) microM. Extending 5 to 6 by addition of Val-OEt at P3' does not decrease Ki. In contrast, extension of 5 to 7 by incorporating Arg-OMe at P3' decreases Ki approximately 15-fold, suggesting interaction between Arg and the S3' subsite but no corresponding interaction at that subsite with Val. These results are in accordance with results obtained with the homologous family of avian ovomucoid third domain proteins. Proteins with Arg at the P3' position show highly favorable interactions with the protease at the S3' subsite [Park, S. J. (1985) Ph.D. Thesis, Purdue University; M. Laskowski, Jr., personal communication]. These results establish that incorporation of residues which interact with S' subsites significantly increases the efficacy of inhibitors and that valuable information concerning the most effective amino acid composition of small inhibitors can be obtained from the amino acid sequence of protein inhibitors. PMID- 3663603 TI - Probe studies of the MgADP state of muscle cross-bridges: microscopic and wavelength-dependent fluorescence polarization from 1,5-IAEDANS-labeled myosin subfragment 1 decorating muscle fibers. AB - The microscopic and wavelength-dependent fluorescence polarization signals from the 5-[[[(iodoacetyl)amino]ethyl]amino]naphthalene-1-sulfonic acid (1,5-IAEDANS) labeled subfragment 1 of myosin (S-1) decorating muscle fibers in rigor and in the presence of MgADP are measured. Using microscopic fluorescence polarization, we select a small uniform volume (approximately 0.1 micron 3) from the muscle fiber and detect a high degree of angular order. From these data we show that the probe angular distribution from fibers in rigor is quantitatively different from that present when MgADP is bound to S-1. Using wavelength-dependent fluorescence polarization, we vary the wavelength of the excitation light and thereby change the direction that the probe absorption dipole makes with a reference frame fixed in S-1. From these data we show that the binding of MgADP to S-1 causes an angular reorientation of S-1 relative to the actin filament. The difference between the angular distribution of probes for the rigor vs. MgADP states cannot be accounted for by the addition of random probes. The microscopic fluorescence polarization experiments suggest that the earlier attempts to distinguish a rigor from a MgADP probe angular distribution by using the 1,5-IAEDANS probe failed due to the lower resolution of the optical technique employed. The wavelength dependent fluorescence polarization experiments indicate that the probe dipole orientation on S-1, at the typically used excitation and emission wavelengths, is not ideal for detecting the orientation change in the rigor to MgADP angular transition. PMID- 3663604 TI - Effects of cholesterol analogues and inhibitors on the heme moiety of cytochrome P-450scc: a resonance Raman study. AB - Interactions of cholesterol analogues and inhibitors with the heme moiety of cytochrome P-450scc were examined by resonance Raman spectroscopy. The Raman spectra of ferric cytochrome P-450scc complexed with inhibitors such as cyanide, phenyl isocyanide, aminoglutethimide, and metyrapone were characteristic of low spin state and were very similar. However, the effect of exchange of the sixth ligand from the oxygen atom (ferric low-spin state) to the nitrogen atom upon aminoglutethimide and metyrapone binding was seen as down-frequency shifts of the v3 band from 1503 to 1501 and 1502 cm-1, respectively, while cyanide and phenyl isocyanide binding caused an up-frequency shift of the v3 band to 1505 cm-1. The effects of cholesterol analogues [22(R)-hydroxycholesterol, 22(S) hydroxycholesterol, 22-ketocholesterol, 20(S)-hydroxycholesterol, and 25 hydroxycholesterol] on a Fe2+-CO stretching frequency of cytochrome P-450scc in ferrous CO form were examined. The 22(R)-hydroxycholesterol complex could not give a clear Fe2+-CO stretching Raman band due to a strong photodissociability. 22(S)-Hydroxycholesterol and 25-hydroxycholesterol complexes gave the Raman bands at 487 and 483 cm-1, respectively, whereas 20(S)-hydroxycholesterol and 22 ketocholesterol complexes gave Fe2+-CO stretching frequencies (478 cm-1) almost identical with that without substrate (477 cm-1). These findings suggest the existence of the following physiologically important natures of the cytochrome P 450scc active site: (1) there is a strong steric interaction between heme-bound carbon monoxide and the 22(R)-hydroxyl group or the 22(R)-hydrogen of the steroid side chain and (2) the hydroxylation at the 20S position may cause a conformational change of the side-chain group relative to the heme. PMID- 3663605 TI - NMR studies of cytochrome P-450scc. Effects of steroid binding on water proton access to the active site of the ferric enzyme. AB - Water proton relaxation rates of various complexes of cholesterol side chain cleavage cytochrome P-450 (-450scc) were investigated to gain information about the structure and dynamics of the steroid binding site. In all cases bulk water protons were found to be in rapid exchange with protons near the paramagnetic Fe3+ center, and the long electron spin relaxation time of the heme iron, tau s approximately 0.3 ns, resulted in fast relaxation rates. For the steroid-free enzyme, the closest approach of exchangeable protons is approximately 2.5 A, a distance consistent with a water molecule binding directly to the heme iron or rapidly exchanging with a coordinated ligand. When cholesterol was bound, the distance increased to approximately 4 A, indicative of displacement of water from the immediate coordination sphere of the heme but still in close proximity to the active site. For the complex with (22R)-22-hydroxycholesterol, a distance of approximately 2.7 A is observed, suggesting a reorganization of the active site when this intermediate is formed from cholesterol. Complexes of P-450scc with the competitive inhibitors (22R)-22-aminocholesterol, 22-amino-23,24-bisnor-5-cholen 3 beta-ol, or (20R)-20-phenyl-5-pregnene-3 beta,20-diol, also yielded distances of approximately 2.5 A and reveal no effect of side chain size on access of protons to the heme. In the nitrogen-coordinated amino-steroid complexes, the distances observed indicate solvent proton exchange with the heme-bound nitrogen ligand.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663606 TI - Characterization of interaction between DNA and 4',6-diamidino-2-phenylindole by optical spectroscopy. AB - We have examined the interaction between 4',6-diamidino-2-phenylindole (DAPI) and DNA using flow linear dichroism (LD), circular dichroism (CD), and fluorescence techniques. We show the presence of two spectroscopically distinct binding sites at low binding ratios with saturation values of 0.025 and 0.17, respectively. In both sites DAPI is bound with its long axis approximately parallel to the grooves of the DNA helix. Resolution of CD spectra shows that an exciton component is present at higher binding ratios, which we attribute to the interaction of two accidentally close-lying DAPI molecules. We also find evidence that DAPI, at least in the high-affinity site, binds preferentially to AT-rich regions. From the spectroscopic results, supported by structural considerations, we can completely exclude that DAPI is bound to DNA by intercalation. Binding geometries and site densities are consistent with a location of DAPI in the grooves of DNA, with the high-affinity site most probably in the minor groove. PMID- 3663607 TI - Sequence dependence for the energetics of terminal mismatches in ribooligonucleotides. AB - Stability increments of terminal mismatches on the core helixes AUGCAU and UGCGCA are reported. Enthalpy, entropy, and free energy changes of helix formation were measured spectrophotometrically for 15 oligoribonucleotides containing the core sequences and various mismatches. Free energy increments for mismatches in this series range from -0.5 to -1.1 kcal/mol. These increments for mismatches on AU base pairs are smaller than those measured previously on GC base pairs [Freier, S.M., Kierzek, R., Caruthers, M.H., Neilson, T., & Turner, D.H. (1986) Biochemistry 25, 3209-3213]. The terminal GU mismatches in the sequences GAUGCAUUp and UAUGCAUGp add approximately the same stability increment as the corresponding terminal AU mismatch. The stability increments for pyrimidine pyrimidine and pyrimidine-purine mismatches can be approximated within 0.3 kcal/mol by adding the stability increments for the corresponding 3' and 5' unpaired nucleotides (dangling ends). Stability increments for purine-purine mismatches are approximated well by the stability increment for the corresponding 3' dangling end made more favorable by 0.2 kcal/mol. These approximations are used to provide a table of stability increments for all 48 possible sequences of mismatches. PMID- 3663608 TI - Comparison of the conformation and orientation of alamethicin and melittin in lipid membranes. AB - The secondary structure of alamethicin in lipid membranes below and above the lipid phase transition temperature Tt is determined by Raman spectroscopy and circular dichroism (CD) measurements. In both cases structural data are obtained by fitting the experimental spectra by a superposition of the spectra of 15 reference proteins of known three-dimensional structure. According to the Raman experiments, in a lipid bilayer above Tt alamethicin is helical from residue 1 to 12, whereas below Tt the helix extends from residue 1 to 16. The remaining C terminal part is nonhelical up to the end residue 20 both above and below Tt. A considerable lower helix content is derived from CD, namely, 38% and 46% above and below Tt, respectively, in agreement with several reported values for CD in the literature. It is shown that the commonly used set of CD spectra of water soluble reference proteins is unsuitable to describe the CD spectra of alamethicin correctly. Therefore the secondary structure of alamethicin as derived from CD measurements is at the present state of analysis unreliable. In contrast to the case of alamethicin, the CD spectra of melittin in lipid membranes are correctly described by the reference protein spectra. The helix content of melittin is determined thereby to be 72% in lipid membranes above Tt and 75% below Tt. The data are in accord with a structure where the hydrophobic part of melittin adopts a bent helix as determined recently by Raman spectroscopy [Vogel, H., & Jahnig, F. (1986) Biophys. J. 50, 573]. The orientational order parameters of the helical parts of alamethicin and of melittin in a lipid membrane are deduced from the difference between a corresponding CD spectrum of a polypeptide in planar multibilayers and that in lipid vesicles. The presented method for determining helix order parameters is new and may be generally applicable to other membrane proteins. The orientation of the helical part of both polypeptides depends on the physical state of the lipid bilayer at maximal membrane hydration and in the ordered lipid state furthermore on the degree of membrane hydration. Under conditions where alamethicin and melittin are incorporated in an aggregated form in a fluid lipid membrane at maximal water content the helical segments are oriented preferentially parallel to the membrane normal. Cooling such lipid membranes to a temperature below Tt changes the orientation of the helical part of alamethicin as well as melittin toward the membrane plane.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3663609 TI - Localization of hydrophobic ions in phospholipid bilayers using 1H nuclear Overhauser effect spectroscopy. AB - The binding location for the hydrophobic ions tetraphenylphosphonium (TPP+) and tetraphenylboron (TPB-) was studied in sonicated phosphatidylcholine (PC) vesicles by measuring time-dependent and steady-state intermolecular 1H nuclear Overhauser effects (NOE's). Intermolecular cross-relaxation was also investigated by two-dimensional NOE spectroscopy. Information on the distance and order parameter dependence of the NOE's was obtained from a simple simulation of the NOE's in the alkyl chain region. Taken together, the NOE data and the simulation provide strong evidence that TPB- and TPP+, at low concentrations (less than or equal to 10 mol%), are localized in the alkyl chain region of the bilayer. At these lower concentrations of TPP+ or TPB-, no significant effect on lipid 13C T1 or T2 relaxation rates is detected. The proposed location is consistent with the expected free energy profiles for hydrophobic ions and with the carbonyl oxygens or interfacial water as the source of the membrane dipole potential. At higher ion/lipid ratios (greater than or equal to 20 mol%), TPB-/lipid NOE's increase. This results from a specific association of TPB- with the choline head group. PMID- 3663610 TI - Role of C-terminal tail of long neurotoxins from snake venoms in molecular conformation and acetylcholine receptor binding: proton nuclear magnetic resonance and competition binding studies. AB - The role of the "C-terminal tail" segment of long neurotoxins has been investigated. The C-terminal four to five residues of alpha-bungarotoxin and Laticauda colubrina b have been cleaved off by carboxypeptidase P. The effect of such deletion on the toxin conformation has been monitored in proton nuclear magnetic resonance spectra and circular dichroism spectra. The removal of the C terminal residues primarily affects the chemical shifts of proton resonances of the residues close to the cleavage site and does not induce a major conformational change. Therefore, the C-terminal tail of long neurotoxins does not appear to be important in maintaining the specific polypeptide chain folding. On the other hand, competition binding with tritium-labeled toxin alpha to Narke japonica acetylcholine receptor has revealed that cleavage of the C-terminal residues reduces the binding activity of alpha-bungarotoxin or Laticauda colubrina b to acetylcholine receptor. Thus it is likely that (the basic amino acid residues in) the C-terminal tail is directly involved in the binding of long neurotoxins to electric organ (and muscle) acetylcholine receptor. PMID- 3663611 TI - Conformation of Leu-Arg-Arg-Ala-Ser-Leu-Gly bound in the active site of adenosine cyclic 3',5'-phosphate dependent protein kinase. AB - Studies utilizing NMR spectroscopy have shown that adenosine cyclic 3',5' phosphate dependent protein kinase (A-kinase) probably binds Leu-Arg-Arg-Ala-Ser Leu-Gly (peptide 1) in one of two extended coil conformations (A or B). The relative reactivities of a series of N-methylated peptides based on the structure of peptide 1 might, therefore, be related to how well each can assume the A or B conformation. From estimates of the magnitude of steric interactions that would be induced by N-methylation of an amide in peptide 1 that is locked in either conformation, the ability of each peptide to form that conformation was predicted. The ability of A-kinase to catalyze phosphorylation of the N methylated peptides correlated well with the ability of each peptide to form conformation A, but not conformation B. In accord with these findings, the reactivity of an unreactive N-methylated peptide was partially restored by a second change, which allowed the peptide to assume conformation A. These results suggest that, when bound in the enzymatic active site, peptide 1 has a conformation that resembles structure A much more closely than structure B. PMID- 3663612 TI - Species specificity of anti-acetylcholine receptor antibodies elicited by synthetic peptides. AB - Two peptides corresponding to amino acid residues 351-368 of the alpha-subunits of Torpedo and human acetylcholine receptor (AChR) were synthesized. These peptides contain a segment (residues 355-364) which displays the greatest variability in amino acid sequence between the two species. Antibodies elicited against the two peptides cross-reacted with the respective native AChRs and were shown to be species specific by radioimmunoassay, immunoblotting, and immunofluorescence microscopy. Thus, antibodies against the Torpedo peptide cross reacted with Torpedo AChR but did not bind to mammalian or chicken AChR. Antibodies against the human peptide proved to be specific probes for mammalian muscle AChR. They cross-reacted with mammalian AChR (human, calf, mouse, and rat) but not with Torpedo or chicken AChR. These antibodies were also shown to react preferentially with the extrajunctional form of muscle AChR, as compared to their reactivity with junctional muscle AChR. In immunofluorescence experiments, the anti-human peptide antibody stained AChR aggregates in sectioned or ethanol permeabilized rat and mouse myotubes grown in culture but did not stain living myotubes. This indicates that the sequence 351-368 of the alpha-subunit of mammalian AChR is on the cytoplasmic face of muscle cell membranes, as predicted theoretically. PMID- 3663613 TI - Identification of regions of alpha-thrombin involved in its interaction with hirudin. AB - The contributions of various regions of human alpha-thrombin to the formation of the tight complex with hirudin have been assessed by using derivatives of thrombin. alpha-Thrombin in which the active-site serine was modified with diisopropyl fluorophosphate was able to bind hirudin, but its affinity for hirudin was decreased by 10(3)-fold compared to unmodified alpha-thrombin. Modification of the active-site histidine with D-Phe-Pro-Arg-CH2Cl resulted in a form of thrombin with a 10(6)-fold reduced affinity for hirudin. gamma-Thrombin is produced by proteolytic cleavage of alpha-thrombin in two surface loops corresponding to residues 65-83 and 146-150 in alpha-chymotrypsin [Berliner, L. J. (1984) Mol. Cell. Biochem. 61, 159-172; Birktoft, J. J., & Blow, D. M. (1972) J. Mol. Biol. 68, 187-240]. The gamma-thrombin-hirudin complex had a dissociation constant that was 10(6)-fold higher than that of alpha-thrombin. Treatment of alpha-thrombin with pancreatic elastase resulted in a form of thrombin only cleaved in the loop corresponding to residues 146-150 in alpha-chymotrypsin, and this form of thrombin had only a slightly reduced affinity for hirudin. By using limited proteolysis with trypsin, it was possible to isolate beta-thrombin which contained a single cleavage in the loop corresponding to residues 65-83 in alpha chymotrypsin. This form of thrombin had a 100-fold decrease in affinity for hirudin. Kinetic analysis of the binding of hirudin to beta-thrombin indicated that the 100-fold decrease in affinity was predominantly due to a decrease in the rate of association of the two molecules.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663614 TI - Interaction between adenovirus DNA-binding protein and single-stranded polynucleotides studied by circular dichroism and ultraviolet absorption. AB - The adenovirus DNA-binding protein (AdDBP) is a multifunctional protein required for viral DNA replication and control of transcription. We have studied the binding of AdDBP to single-stranded M13 DNA and to the homopolynucleotides poly(rA), poly(dA), and poly(dT) by means of circular dichroism (CD) and optical density (OD) measurements. The binding to all these polynucleotides was strong and nearly stoichiometric. Titration experiments showed that the size of the binding site is 9-11 nucleotides long for M13 DNA, poly(dA), and poly(rA). A higher value (15.0 +/- 0.8) was found for poly(dT). Pronounced changes in the circular dichroism and optical density spectra were observed upon binding of AdDBP. In general, both the positive peak around 260-270 nm and the negative peak around 240-250 nm in the CD spectra decreased in intensity, and a shift of the crossover point to longer wavelengths was found. The OD spectra observed upon binding of AdDBP are remarkably similar to those obtained with prokaryotic helix destabilizing proteins like bacteriophage T4 gene 32 protein and fd gene 5 protein. The data can best be interpreted by assuming that the AdDBP polynucleotide complex has a regular, rigid, and extended configuration that satifies two criteria: (1) a considerable tilt of the bases in combination with (2) a small rotation per base and/or a shift of the bases closer to the helix axis. PMID- 3663615 TI - NMR-pseudoenergy approach to the solution structure of acyl carrier protein. AB - A method for protein structure determination from two-dimensional NMR cross relaxation data is presented and explored by using short amino acid segments from acyl carrier protein as a test case. The method is based on a molecular mechanics program and incorporates NMR distance constraints in the form of a pseudoenergy term that accurately reflects the distance-dependent precision of NMR cross relaxation data. When it is used in an indiscriminant fashion, the method has a tendency to produce structures representing local energy minima near starting structures, rather than structures representing a global energy minimum. However, stepwise inclusion of energy terms, beginning with a function heavily weighted by backbone distance constraints, appears to simplify the potential energy surface to a point where convergence to a common backbone structure from a variety of starting structures is possible. In the case of the segment from residues 3 to 15 in acyl carrier protein, a nearly perfect alpha-helix is produced starting with a linear chain, an alpha-helical chain, or a chain having residues with alternating linear and alpha-helical backbone torsional angles. In the case of the segment from residues 26 to 36 a structure having a right-handed loop is produced. PMID- 3663616 TI - cDNA structure of murine C4b-binding protein, a regulatory component of the serum complement system. AB - A cDNA library representing total poly(A+) RNA from the livers of male B10.WR mice was screened with a 1097 base pair (bp) probe obtained from a partial human C4b-binding protein (C4BP) cDNA clone. Two cDNA clones were isolated, the largest of which was sequenced and found to be 1889 bp in length exclusive of the poly(A) tail. The predicted mouse C4BP polypeptide chain encoded by 1239 bp is 413 amino acid residues in length and has a calculated molecular weight of 45,281. The 370 nucleotide sequence upstream from the codon for the predicted amino terminus contains two possible in-phase translational start signals which yield leader sequences of 56 and 13 amino acid residues, respectively. The 3'-untranslated region is 277 bp long, and there are two potential overlapping poly(A) recognition signals, AATTAA and ATTAAAA, located 26 and 25 bp, respectively, upstream from the poly(A) tail; these are preceded by five other potential polyadenylation signals. Beginning at the amino terminus and continuing through to residue 358, there are six contiguous regions of internal homology, each about 60 amino acids in length. The carboxy-terminal 55 amino acid sequence shares no homology with the repeating units. Extensive homology was found with human C4BP at the amino acid level (61%) as well as at the nucleotide level for both the coding and 3'-untranslated regions. Significant differences, however, were observed between mouse and human C4BP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663617 TI - Molecular mechanics and dynamics calculations on (dA)10.(dT)10 incorporating distance constraints derived from NMR relaxation measurements. AB - Structural constraints derived from proton NMR relaxation measurements on poly(dA).poly(dT) in the form of interproton separations and orientation have been combined with molecular mechanics and annealed molecular dynamics calculations to derive a model for the solution-state structure of this molecule. Three different possible starting configurations, including the standard A and B forms of Arnott and Hukins [Arnott, S., & Hukins, D. W. L. (1972) Biochem. Biophys. Res. Commun. 47, 1506-1509] and the heteronomous (H) structure [Arnott, S., Chandrasekaran, R., Hall, I. H., & Puigjaner, L. C. (1983) Nucleic Acids Res. 11, 4141-4155], were examined. Both the B- and H-DNA structures converged to the same B-like structure (approximately C2'-endo conformation on both the A and T sugars, glycosidic bond torsional angle of 63-73 degrees) with the same energies and average helical parameters that gave good fits of the NMR relaxation rates. This model also accounts for the experimental observation [Behling, R. W., & Kearns, D. R. (1986) Biochemistry 25, 3335-3346] that the AH2 proton interacts more strongly with the H1' sugar proton on the T strand than on the A strand. Although the helix repeat angle (39 degrees) is larger than that for standard B DNA (36 degrees), this does not result in a significantly smaller minor groove, as monitored by the interstrand P-P separation. Calculations starting with the A DNA structure lead to a very high energy structure that gave a poorer fit of the NMR data. PMID- 3663618 TI - 2'(3')-O-glycyl oligoribonucleotides with sequences of the 3'-terminus of glycyl tRNA: chemical synthesis and properties in partial reactions of protein biosynthesis. AB - Specific syntheses of 2'(3')-O-aminoacyl oligoribonucleotides C-C-A-Gly (12), C-C A(AcGly) (7), U-C-C-A-Gly (17), and C-U-C-C-A-Gly (19), which are the 3'-terminal sequences of Escherichia coli Gly-tRNA (or AcGly-tRNA, respectively) are described. Compounds 12, 17, and 19 were synthesized by employing the benzotriazolyl phosphotriester approach with the following protection groups on the components: benzoyl for the heterocyclic amino groups, 2-chlorophenyl group for internucleotide phosphate protection, dimethoxytrityl and levulinoyl groups for blocking of the 5'-hydroxyl, methoxytetrahydropyranyl group for protection of the 2'-hydroxyl functions, and N-(benzyloxycarbonyl)orthoglycinate as the masked aminoacyl group simultaneously protecting the 2',3'-cis diol group of the 3' terminal adenosine moiety. The fully protected tri-, tetra-, and pentanucleotides were obtained via 5'-extension of di- and trinucleotide blocks after prior selective removal of the 5'-O-levulinoyl group with hydrazine. The blocked derivatives 11, 16, and 18 were totally deprotected by reactions with NH4OH, H+, and H2/Pd to yield the target compounds 12, 17, and 19 in good yields. C-C A(AcGly) (7) was synthesized according to a stepwise procedure via activation of preformed diesters with (mesitylenesulfonyl)tetrazole. C-C-A-Gly (12), U-C-C-A Gly (17), and C-U-C-C-A-Gly (19) were all acceptor substrates in the peptidyltransferase reaction with the Ac-Phe-tRNA-70S ribosome-poly(U) system. All three models also promoted EF-Tu-70S ribosome GTP hydrolysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663619 TI - Structure and dynamics of porcine submaxillary mucin as determined by natural abundance carbon-13 NMR spectroscopy. AB - Nearly all of the resonances in the 13C NMR spectrum of porcine submaxillary mucin glycoprotein (PSM) have been assigned to the peptide core carbons and to the carbons in the eight different oligosaccharide side chains that arise from the incomplete biosynthesis of the sialylated A blood group pentasaccharide (alpha-GalNAc(1-3) [alpha-Fuc(1-2)]-beta-Gal(1-3) [alpha-NeuNGl(2-6)]- alpha GalNAc-O-Ser/Thr). By use of these assignments, a nearly complete structural analysis of intact PSM has been performed without resorting to degradative chemical methods. Considerable structural variability in the carbohydrate side chains was observed between mucins obtained from different animals, while no variability was observed between glands in a single animal. The dynamics of the PSM core and carbohydrate side chains were examined by using the carbon-13 nuclear magnetic resonance relaxation times and nuclear Overhauser enhancements of each assigned carbon resonance. The peptide core of PSM exhibits internal segmental flexibility that is virtually identical with that of ovine submaxillary mucin (OSM), whose carbohydrate side chain consists of the alpha-NeuNAc(2-6)alpha GalNAc disaccharide. The longer oligosaccharide side chains of PSM, therefore, have no significant effect on peptide core mobility compared to the shorter side chains of native OSM or asialo-OSM. Although the dynamics of the shorter carbohydrate side chains shared by both OSM and PSM appear to be identical, the A and H blood group structures in PSM have reduced mobilities, indicating that the glycosidic linkages of the terminal sugars in these determinants are relatively inflexible. These results differ from most reports of glycoprotein dynamics, which typically find the terminal carbohydrate residues to be undergoing rapid internal rotation about their terminal glycosidic bonds. The results reported here are consistent with previous studies on the conformations of the A and H determinants derived from model oligosaccharides and further indicate that the conformations of these determinants are unchanged when covalently bound to the mucin peptide core. In spite of their carbohydrate side-chain heterogeneity, mucins appear to be ideal glycoproteins for the study of O-linked oligosaccharide conformation and dynamics and for the study of the effects of glycosylation on polypeptide conformation and dynamics. PMID- 3663620 TI - Oxygen infrared spectra of oxyhemoglobins and oxymyoglobins. Evidence of two major liganded O2 structures. AB - The dioxygen stretch bands in infrared spectra for solutions of oxy species of human hemoglobin A and its separated subunits, human mutant hemoglobin Zurich (beta 63His to Arg), rabbit hemoglobin, lamprey hemoglobin, sperm whale myoglobin, bovine myoglobin, and a sea worm chlorocruorin are examined. Each protein exhibits multiple isotope-sensitive bands between 1160 and 1060 cm-1 for liganded 16O2, 17O2, and 18O2. The O-O stretch bands for each of the mammalian myoglobins and hemoglobins are similar, with frequencies that differ between proteins by only 3-5 cm-1. The spectra for the lamprey and sea worm hemoglobins exhibit greater diversity. For all proteins an O-O stretch band expected to occur near 1125 cm-1 for 16O2 and 17O2, but not 18O2, appears split by approximately 25 cm-1 due to an unidentified perturbation. The spectrum for each dioxygen isotope, if unperturbed, would contain two strong bands for the mammalian myoglobins (1150 and 1120 cm-1) and hemoglobins (1155 and 1125 cm-1). Two strong bands separated by approximately 30 cm-1 for each oxy heme protein subunit indicate that two major protein conformations (structures) that differ substantially in O2 bonding are present. The two dioxygen structures can result from a combination of dynamic distal and proximal effects upon the O2 ligand bound in a bent-end-on stereochemistry. PMID- 3663621 TI - Inhibition of cholesterol biosynthesis by fluorinated mevalonate analogues. AB - The conversion of mevalonate to cholesterol in rat liver homogenates (IC50 = 0.01 1.0 mM) is inhibited by 6- (I), 6,6-di- (II), and 6,6,6-trifluoromevalonate (III), as well as 4,4-difluoromevalonate (IV). Addition of compound I, III, or IV to rat liver homogenates results in the accumulation of 5-phospho- and 5 pyrophosphomevalonate. The conversion of isopentenyl pyrophosphate to cholesterol is not inhibited by the fluorinated analogues. It thus appears likely that the decarboxylation of mevalonate 5-pyrophosphate is inhibited. Rat liver homogenates catalyze the phosphorylation of I and III. The inhibition of the decarboxylation of mevalonate 5-pyrophosphate by I and III was demonstrated directly with partially purified decarboxylase. Compound I is a remarkably effective inhibitor of the decarboxylation (Ki = 10 nM). Similar results were reported by Nave et al. [Nave, J. F., d'Orchymont, H., Ducep, J. B., Piriou F., & Jung, M. J. (1985) Biochem. J. 227, 247]. It is likely that the phosphorylated or pyrophosphorylated forms of all inhibitors tested are responsible for inhibition. We also describe a chemical method for the synthesis of mevalonate 5-pyrophosphate. PMID- 3663622 TI - Reaction of alkylcobalamins with thiols. AB - Carbon-13 NMR spectroscopy and phosphorus-31 NMR spectroscopy have been used to study the reaction of several alkylcobalamins with 2-mercaptoethanol. At alkaline pH, when the thiol is deprotonated, the alkyl-transfer reactions involve a nucleophilic attack of the thiolate anion on the Co-methylene carbon of the cobalamins, yielding alkyl thioethers and cob(II)alamin. In these nucleophilic displacement reactions cob(I)alamin is presumably formed as an intermediate. The higher alkylcobalamins react more slowly than methylcobalamin. The lower reactivity of ethyl- and propylcobalamin is probably the basis of the inhibition of the corrinoid-dependent methyl-transfer systems by propyl iodide. The transfer of the upper nucleoside ligand of adenosylcobalamin to 2-mercaptoethanol is a very slow process; S-adenosyl-mercaptoethanol and cob(II)alamin are the final products of the reaction. The dealkylation of (carboxymethyl)cobalamin is a much more facile reaction. At alkaline pH S-(carboxymethyl)mercaptoethanol and cob(II)alamin are produced, while at pH values below 8 the carbon-cobalt bond is cleaved reductively to acetate and cob(II)alamin. The reductive cleavage of the carbon-cobalt bond of (carboxymethyl)cobalamin by 2-mercaptoethanol is extremely fast when the cobalamin is in the "base-off" form. Because we have been unable to detect trans coordination of 2-mercaptoethanol, we favor a mechanism that involves a hydride attack on the Co-methylene carbon of (carboxymethyl)cobalamin rather than a trans attack of the thiol on the cobalt atom. PMID- 3663623 TI - Photoaffinity analogues of methotrexate as folate antagonist binding probes. 1. Photoaffinity labeling of murine L1210 dihydrofolate reductase and amino acid sequence of the binding region. AB - N alpha-(4-Amino-4-deoxy-10-methylpteroyl)-N epsilon-(4-azido-5- [125I]iodosalicylyl)-L-lysine, a photoaffinity analogue of methotrexate, is only 2-fold less potent than methotrexate in the inhibition of murine L1210 dihydrofolate reductase. Irradiation of the enzyme in the presence of an equimolar concentration of the 125I-labeled analogue ultimately leads to an 8% incorporation of the photoprobe. A 100-fold molar excess of methotrexate essentially blocks this incorporation. Cyanogen bromide digestion of the labeled enzyme, followed by high-pressure liquid chromatography purification of the generated peptides, indicates that greater than 85% of the total radioactivity is incorporated into a single cyanogen bromide peptide. Sequence analysis revealed this peptide to be residues 53-111, with a majority of the radioactivity centered around residues 63-65 (Lys-Asn-Arg). These data demonstrate that the photoaffinity analogue specifically binds to dihydrofolate reductase and covalently modifies the enzyme following irradiation and is therefore a photolabeling agent useful for probing the inhibitor binding domain of the enzyme. PMID- 3663624 TI - Photoaffinity analogues of methotrexate as folate antagonist binding probes. 2. Transport studies, photoaffinity labeling, and identification of the membrane carrier protein for methotrexate from murine L1210 cells. AB - A membrane-derived component of the methotrexate/one-carbon-reduced folate transport system in murine L1210 cells has been identified by using a photoaffinity analogue of methotrexate. The compound, a radioiodinated 4 azidosalicylyl derivative of the lysine analogue of methotrexate, is transported into murine L1210 cells in a temperature-dependent, sulfhydryl reagent inhibitable manner with a Kt of 506 +/- 79 nM and a Vmax of 17.9 +/- 4.2 pmol min 1 (mg of total cellular protein)-1. Uptake of the iodinated compound at 200 nM is inhibited by low amounts of methotrexate (I50 = 1.0 microM). The parent compounds of the iodinated photoprobe inhibit [3H]methotrexate uptake, with the uniodinated 4-azidosalicylyl derivative exhibiting a Ki of 66 +/- 21 nM. UV irradiation, at 4 degrees C, of a cell suspension that had been incubated with the probe results in the covalent modification of a 46K-48K protein. This can be demonstrated when the plasma membranes from the labeled cells are analyzed via sodium dodecyl sulfate polyacrylamide gel electrophoresis and autoradiography. Labeling of this protein occurs half-maximally at a reagent concentration that correlates with the Kt for transport of the iodinated compound. Protection against labeling of this protein by increasing amounts of methotrexate parallels the concentration dependence of inhibition of photoprobe uptake by methotrexate. In addition, no labeling occurs when a cell line that has a defective methotrexate transport system is similarly treated. Evidence that, in the absence of irradiation and at 37 degrees C, the iodinated probe is actually internalized is demonstrated by the labeling of two soluble proteins (Mr 38K and 21K) derived from the cell homogenate supernatant. PMID- 3663625 TI - Classical Raman spectroscopic studies of NADH and NAD+ bound to liver alcohol dehydrogenase by difference techniques. AB - We report the Raman spectra of reduced and oxidized nicotinamide adenine dinucleotide (NADH and NAD+, respectively) and adenosine 5'-diphosphate ribose (ADPR) when bound to the coenzyme site of liver alcohol dehydrogenase (LADH). The bound NADH spectrum is calculated by taking the classical Raman difference spectrum of the binary complex, LADH/NADH, with that of LADH. We have investigated how the bound NADH spectrum is affected when the ternary complexes with inhibitors are formed with dimethyl sulfoxide (Me2SO) or isobutyramide (IBA), i.e., LADH/NADH/Me2SO or LADH/NADH/IBA. Similarly, the difference spectra of LADH/NAD+/pyrazole or LADH/ADPR with LADH are calculated. The magnitude of these difference spectra is on the order of a few percent of the protein Raman spectrum. We report and discuss the experimental configuration and control procedures we use in reliably calculating such small difference signals. These sensitive difference techniques could be applied to a large number of problems where the classical Raman spectrum of a "small" molecule, like adenine, bound to the active site of a protein is of interest. The spectrum of bound ADPR allows an assignment of the bands of the bound NADH and NAD+ spectra to normal coordinates located primarily on either the nicotinamide or the adenine moiety. By comparing the spectra of the bound coenzymes with model compound data and through the use of deuterated compounds, we confirm and characterize how the adenine moiety is involved in coenzyme binding and discuss the validity of the suggestion that the adenine ring is protonated upon binding. The nicotinamide moiety of NADH shows significant molecular changes upon binding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663626 TI - Kinetic, structural, and spectroscopic identification of geminate states of myoglobin: a ligand binding site on the reaction pathway. AB - Elementary steps or geminate states in the reaction of gaseous ligands with transport proteins delineate the trajectory of the ligand and its rebinding to the heme. By use of kinetic studies of the 765-nm optical "conformation" band, three geminate states were identified for temperatures less than approximately 100 K. MbCO, which is accumulated by photolysis between 1.2 and approximately 10 K, was characterized by our previous optical and X-ray absorption studies [Chance, B., Fischetti, R., & Powers, L. (1983) Biochemistry 22, 3820-3829]. Between 10 and approximately 100 K, geminate states that are also identified that have recombination rates of approximately 10(3) s-1 and approximately 10(-5) s-1 (40 K). Thus, it is possible to maintain a steady-state nearly homogeneous population of the slowest recombining geminate state, Mb, by regulated continuous illumination (optical pumping). Both X-ray absorption and resonance Raman studies under similar conditions of optical pumping show that the heme structure around the iron in Mb is similar to that of MbCO. In both geminate states, the iron proximal histidine distance remains unchanged (+/- 0.02 A) from that of MbCO while the iron to pyrrole nitrogen average distance has not fully relaxed to that of the deoxy state. In MbCO the CO remains close to iron but not bound, and the Fe...CO angle, which is bent in MbCO (127 +/- 4 degrees C), is decreased by approximately 15 degrees [Powers, L., Sessler, J. L., Woolery, G. L., & Chance, B. (1984) Biochemistry 23, 5519-5523]. The CO molecule in Mb, however, has moved approximately 0.7 A further from iron. Computer graphics modeling of the crystal structure of MbCO places the CO in a crevice in the heme pocket that is just large enough for the CO molecule end-on. Above approximately 100 K resonance Raman studies show that this structure relaxes to the deoxy state. PMID- 3663627 TI - Temperature jump relaxation kinetics of the P-450cam spin equilibrium. AB - The ferric spin-state equilibrium and relaxation rate of cytochrome P-450 has been examined with temperature jump spectroscopy using a number of camphor analogues known to induce different mixed spin states in the substrate-bound complexes [Gould, P., Gelb, M., & Sligar, S. G. (1981) J. Biol. Chem. 256, 6686]. All temperature-induced spectral changes were monophasic, and the spin-state relaxation rate reached a limiting value at high substrate concentrations. The ferric spin equilibrium constant, Kspin, is defined in terms of the rate constants k1 and k-1 via Kspin = k1/k-1 = [P-450(HS)]/[P-450(LS)] where HS and LS represent high-spin (S = 5/2) and low-spin (S = 1/2) ferric iron, respectively, and the spectrally observed spin-state relaxation rate by kobsd = k1 + k-1. A strong correlation between the fraction of high-spin species and the rate constant, k-1, is observed. For a 3 degrees C temperature jump (from 10 to 13 degrees C), the 23% high-spin tetramethylcyclohexanone complex (Kd = 45 +/- 20 microM) is characterized by a ferric spin relaxation rate of kobsd = 1990 s-1, while the rates for the d-fenchone (41% high spin, Kd = 42 +/- 10 microM) and kobsd = 1990 s-1, while the rates for the d-fenchone (41% high spin, Kd = 42 +/- 10 microM) and camphoroquinone (75% high spin, Kd = 15 +/- 5 microM) complexes are 1430 and 346 s-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663628 TI - Binding of a nonionic detergent to membranes: flip-flop rate and location on the bilayer. AB - The kinetic aspects of amphiphile interaction with intact membranes (unilamellar and multilamellar liposomes, sarcoplasmic reticulum vesicles) were studied, with the nonionic detergent octa(ethylene glycol) dodecyl monoether (C12E8) as a prototype. C12E8 was bound to these membranes noncooperatively and with a maximum of 0.6-0.8 mol per mole of phospholipid, before the onset of solubilization. Binding was not affected by ultrasonication to expose internal binding sites on the inner leaflet. All detergent could be removed from the membranes by treatment with hydrophobic beads. Furthermore, bound detergent, also from the inside of multilayered liposomes, comprising 10-20 bilayers, was quickly released by dilution of the membranes, followed by gel filtration. The time course of these processes was investigated with a rapid-filtration apparatus, using glass fiber filters to deposit membrane material. Both detergent binding and removal could be described by a monoexponential process with a half-time of approximately 350 ms for all types of membranes. Binding of detergent enhanced the intrinsic fluorescence of sarcoplasmic reticulum vesicles. This occurred in less than 100 ms, probably as the result of direct interaction of C12E8 with Ca2+-ATPase at a few binding sites. The data show that flip-flop of C12E8 across lipid membranes is a rapid process that cannot account for incomplete detergent removal in reconstitution experiments [Ueno, M., Tanford, C., & Reynolds, J. A. (1984) Biochemistry 23, 3070-3076]. It is also suggested that other nonionized amphiphiles, including those with an anesthetic action, rapidly gain access to membrane proteins on the inside of the cell, even when used at low, clinical doses. PMID- 3663629 TI - Phospholipid fatty acyl chain asymmetry in the membrane bilayer of isolated skeletal muscle sarcoplasmic reticulum. AB - We previously showed [Herbette, L. G., Blasie, J. K., DeFoor, P., Fleischer, S., Bick, R. J., Van Winkle, W. B., Tate, C. A., & Entman, M. L. (1984) Arch. Biochem. Biophys. 234, 235-242; Herbette, L. G., DeFoor, P., Fleischer, S., Pascolini, D., Scarpa, A., & Blasie, J. K. (1985) Biochim. Biophys. Acta 817, 103 122] that the phospholipid head-group distribution in the membrane bilayer of isolated sarcoplasmic reticulum is asymmetric. From these studies, both the total number of phospholipid head groups and the total lipid, as well as the head-group species for these lipids, were found to be different for each monolayer of the membrane bilayer. In this paper, we demonstrate for the first time that there is significant asymmetry in the distribution of unsaturated fatty acids between the two monolayers; i.e., the outer monolayer of the sarcoplasmic reticulum contained more unsaturated and polyunsaturated chains when compared to the inner monolayer. X-ray diffraction measurements demonstrated that the time-averaged fatty acyl chain extension for the outer monolayer was approximately 20% less than for the inner monolayer. This is consistent with the concept that the greater degree of unsaturation in the outer monolayer may provide for a decreased average fatty acyl chain extension for that layer. This architecture for the bilayer may be related to both the "resting" state mass distribution of the calcium pump protein within the membrane bilayer and possible "conformational" states of the calcium pump protein during calcium transport by the sarcoplasmic reticulum. PMID- 3663630 TI - Topography of the Dictyostelium discoideum plasma membrane: analysis of membrane asymmetry and intermolecular disulfide bonds. AB - Through the application of a unique method for isolating plasma membranes, it was possible to specifically iodinate cytoplasm-exposed plasma membrane proteins in vegetative cells of the cellular slime mold Dictyostelium discoideum. The original procedure [Chaney, L. K., & Jacobson, B. S. (1983) J. Biol. Chem. 258, 10062] which involved coating cells with colloidal silica has been modified to yield a more pure preparation. The presence of the continuous and dense silica pellicle on the outside surface of the isolated plasma membrane permitted the specific labeling of cytoplasm-exposed membrane proteins. Lactoperoxidase catalyzed iodination was employed to label cell-surface and cytoplasm-exposed membrane proteins. The isolated and radioiodinated membranes were then compared and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The cell-surface and cytoplasmic face labeling patterns were distinct. A total of 65 proteins were found to be accessible to at least one surface of the membrane. Sixteen intermolecular disulfide bond complexes were observed in the plasma membrane of Dictyostelium; most of these complexes involved glycoproteins and, hence, were exposed to the cell surface. PMID- 3663631 TI - Distances among coenzyme and metal sites of NADP+-dependent isocitrate dehydrogenase using resonance energy transfer. AB - When the substrate isocitrate-Mn2+ is present, the fluorescent nucleotide analogue 2-[(4-bromo-2,3-dioxobutyl)thio]-1,N6-ethenoadenosine 2',5'-bisphosphate (2-BDB-T epsilon A-2',5'-DP) reacts irreversibly with pig heart NADP+-specific isocitrate dehydrogenase at the coenzyme binding site on one subunit of the dimeric enzyme [Bailey, J. M., & Colman, R. F. (1985) Biochemistry 24, 5367 5377]. The modified enzyme, which retains partial activity, binds 1 mol of NADPH or 1 mol of the coenzyme analogue, reduced thionicotinamide adenine dinucleotide phosphate (TNADPH), per dimer. TNADPH quenches the fluorescence of enzyme-bound 2 BDB-T epsilon A-2',5'-DP with an efficiency of energy transfer of 9.8%. From this value and the spectral properties of the donor and acceptor chromophores, a distance of 32 A was calculated as the average distance between coenzyme sites on the two subunits. Isocitrate dehydrogenase activity requires a divalent metal ion, such as Mn2+, Co2+, or Ni2+. Co2+ and Ni2+ have absorption spectra that overlap the emission spectra of enzyme-bound 2-BDB-T epsilon A-2',5'-DP. In the presence of isocitrate, each of these two metal ions quenches the fluorescence of the enzyme-bound reagent with an efficiency of energy transfer of 28-29%. From this value and the spectral characteristics of the energy donor and acceptors, an average distance of 8.0 A was estimated between the metal-isocitrate site and the labeled coenzyme site. These distances have provided constraints in formulating a model of the spatial arrangement of active-site ligands on isocitrate dehydrogenase. PMID- 3663632 TI - Triggering of the activity of phospholipase A2 by an electric field. AB - In this paper we show that the action of phospholipase A2 can be triggered by applying an electric field across a 1,2-didodecanoyl-sn-3-phosphoglycerol monolayer residing between an alkylated silicon surface and water. When the silicon wafer served as a cathode, rapid activation of porcine pancreatic phospholipase was observed and did depend on the magnitude of the applied potential. The degree of activation was different for the pancreatic phospholipase A2 and snake and bee venom enzymes. Maximally, a 7-fold activation of pancreatic phospholipase A2 was observed when the applied potential was 75 V. The effective field over the lipid film could be estimated to be approximately 25 175 mV, i.e., in the range of membrane potentials found in cells. On the basis of these results, we suggest that changes in membrane potential might be an important factor in the regulation of the action of intracellular phospholipases A2 in vivo. PMID- 3663633 TI - Fluorescence probe studies of the state of tropomyosin in reconstituted muscle thin filaments. AB - The monomer fluorescence of N-(1-pyrenyl)maleimide-labeled tropomyosin bound to F actin (PTm-actin) increases when myosin subfragment 1 (S1) binds to actin and is half complete when only approximately 1 S1 is bound to 7 actin subunits [Ishii, Y., & Lehrer, S. S. (1985) Biochemistry 24, 6631-6638]. Similar studies of the binding of S1 and S1-ADP to fully reconstituted thin filaments [PTm-actin troponin (Tn)] are now reported. The pyrene monomer fluorescence change was half complete when approximately 0.5 S1/7 actin subunits and approximately 1.5 S1/7 actin subunits were bound in the presence and absence of Ca2+, respectively. In the presence of Mg2+-ADP, when S1 binding is weakened, the S1 binding profiles and fluorescence changes were sigmoidal, with the cooperative transitions occurring at lower [S1] in the presence of Ca2+ as first shown by Greene and Eisenberg for S1 binding [Greene, L., & Eisenberg, E. (1980) Proc. Natl. Acad. Sci. U.S.A. 77, 2616-2620]. It was possible to fit both the binding and fluorescence data with the same parameters of a two-state (weak and strong S1 binding) cooperative binding model [Hill, T., Eisenberg, E., & Greene, L. (1980) Proc. Natl. Acad. Sci. U.S.A. 77, 3186-3190] for each Ca2+ situation if the fluorescence change is interpreted as the fraction of tropomyosin (Tm) units in the strong S1 binding state. These data indicate that the fluorescence change is a direct measure of the S1-induced change of state of Tm in the fully reconstituted thin filament.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663634 TI - Influence of solvent and of cation size on the conformations of lasalocid A lanthanide(III) ion complexes: circular dichroism and fluorescence studies. AB - The interaction of lanthanide(III) nitrates (La3+ to Lu3+) with the carboxylic ionophore lasalocid A (LS) has been studied by circular dichroism (CD) and fluorescence spectroscopic techniques in acetonitrile and in methanol. Analysis of the CD data in acetonitrile has revealed the coexistence of both 1:1 (ionophore:cation) and 2:1 complexes in solution. For 1.22 A greater than ionic radius greater than 1.13 A, 1:1 complexes are preferred, and for 1.13 A greater than ionic radius greater than 1.03 A, 2:1 complexes are preferred. Induced CD bands for Ln3+ ions have been observed upon binding to LS in acetonitrile. The LS Ln3+ complexes are less stable in methanol than in acetonitrile. CD spectral changes showed that the conformations of the complexes in methanol are different from those in acetonitrile. The complexes have rather open conformations in methanol compared to those in acetonitrile. The results underscore the importance of ionic radius, solvent environment, and ionization state of LS in determining the conformations of the ionophore-cation complexes. PMID- 3663635 TI - Resonance Raman spectroscopy of octopus rhodopsin and its photoproducts. AB - We report here the resonance Raman spectra of octopus rhodopsin and its photoproducts, bathorhodopsin and acid metarhodopsin. These studies were undertaken in order to make comparisons with the well-studied bovine pigments, so as to understand the similarities and the differences in pigment structure and photochemical processes between vertebrates and invertebrates. The flow method was used to obtain the Raman spectrum of rhodopsin at 13 degrees C. The bathorhodopsin spectrum was obtained by computer subtraction of the spectra containing different photostationary mixtures of rhodopsin, isorhodopsin, hypsorhodopsin, and bathorhodopsin, obtained at 12 K using the pump-probe technique and from measurements at 80 K. Like their bovine counterparts, the Schiff base vibrational mode appears at approximately 1660 cm-1 in octopus rhodopsin and the photoproducts, bathorhodopsin and acid metarhodopsin, suggesting a protonated Schiff base linkage between the chromophore and the protein. Differences between the Raman spectra of octopus rhodopsin and bathorhodopsin indicate that the formation of bathorhodopsin is associated with chromophore isomerization. This inference is substantiated by the chromophore chemical extraction data which show that, like the bovine system, octopus rhodopsin is an 11-cis pigment, while the photoproducts contain an all-trans pigment, in agreement with previous work. The octopus rhodopsin and bathorhodopsin spectra show marked differences from their bovine counterparts in other respects, however. The differences are most dramatic in the structure sensitive fingerprint and the HOOP regions. Thus, it appears that although the two species differ in the specific nature of the chromophore-protein interactions, the general process of visual transduction is the same. PMID- 3663636 TI - A photoreversible circular dichroism spectral change in oat phytochrome is suppressed by a monoclonal antibody that binds near its N-terminus and by chromophore modification. AB - Accompanying the phototransformation of native 124-kilodalton (kDa) oat phytochrome from red-absorbing form (Pr) to far-red-absorbing form (Pfr), there is a photoreversible change in circular dichroism (CD) in the far-UV region indicative of a 3% increase in alpha-helical folding of apoprotein. To elucidate the conformational change involved in the phytochrome phototransformation, several monoclonal antibodies have been used as epitope-specific probes. Monoclonal antibody oat-25 suppressed the photoreversible CD spectral change using phytochrome with an A666/A280 as Pr of 1.13. Monoclonal antibodies oat-22, oat-13, and oat-31 did not significantly affect the CD spectral change of phytochrome. Oat-25 requires an epitope near the N-terminus of phytochrome. Oat 22, oat-13, and oat-31 recognize epitopes on the N-terminus, chromophore containing half of phytochrome, albeit further removed from the N-terminus than that recognized by oat-25. Interestingly, oat-13 and oat-31 did, however, induce a time-dependent decrease in the far-UV CD, apparently due to aggregation of phytochrome (both Pr and Pfr forms). Monoclonal antibodies oat-26 and oat-28, which recognize epitopes on the C-terminus half of phytochrome, also did not suppress the photoreversible CD change, although oat-26 and oat-28 slightly inhibited it. The photoreversible CD spectral change can also be inhibited by sodium borohydride, which bleaches the chromophore by reducing it, and by tetranitromethane, which oxidizes the chromophore of phytochrome. Although explanations of these results based on indirect interactions between the chromophore and the N-terminus segment are possible, we propose that an additional alpha-helical folding of the Pfr form of the phytochrome may result from a photoreversible interaction between the Pfr form of the chromophore and the N-terminus segment. PMID- 3663637 TI - Magnetic resonance studies on the copper site of dopamine beta-monooxygenase in the presence of cyanide and azide anions. AB - In order to elucidate the coordination state of water molecules in the Cu(II) site of dopamine [( 3,4-dihydroxyphenyl)ethylamine] beta-monooxygenase, measurements of the paramagnetic 1H nuclear magnetic relaxation rate of solvent water in the enzyme solution containing cyanide or azide as an exogenous ligand were carried out to obtain the values of intrinsic paramagnetic relaxation rate decrements Rp1 and Rp2 for the ligand-enzyme 1:1 and 2:1 complexes, respectively. Rp1 (percent) values were 53 (pH 5.5) and 52 (pH 7.0) for cyanide and 38 (pH 5.5) and 32 (pH 7.0) for azide, while Rp2 (percent) values were 98 (pH 5.5) and 96 (pH 7.0) for azide. Although no Rp2 values for cyanide were obtained because of its reducing power at the Cu(II) site, the Rp1 and Rp2 values obtained above prove that the Cu(II) center has two coordinated water molecules that are exchangeable for exogenous ligands at either pH. Supporting evidence was provided by electron paramagnetic resonance (EPR) titration, in which the enzyme solution containing cyanide-enzyme (1:1) complex in an equal proportion to uncomplexed enzyme gave an observed paramagnetic relaxation rate decrement, Rp, of 23%. Another characteristic of the Rp1 and Rp2 values was their invariability with respect to pH, indicating that the three-dimensional structure of the Cu(II) site is pH invariant within the range examined. Binding constants of ligand to enzyme Kb1 and Kb2 for 1:1 and 2:1 complex formation, respectively, were also determined through an analysis of the Rp values; it was found that Kb1 was larger than Kb2 irrespective of pH. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663638 TI - Characterization of tryptophan environments in glutamate dehydrogenases from temperature-dependent phosphorescence. AB - Tryptophan room temperature phosphorescence in solution was detected in glutamic dehydrogenase from bovine liver and Escherichia coli with lifetimes of 1.2 and 0.65 s, respectively. Although these enzymes possess three and five tryptophanyl residues per polypeptide chain, respectively, the temperature dependence of the phosphorescence quantum yield estimates that the room temperature emission is due, in either case, to a single residue. Long triplet-state lifetimes and very small rates of O2 quenching indicate that these tryptophanyl side chains are embedded in a highly inflexible internal region of the macromolecule. Aided by sequence homology with dehydrogenases of known structure and theoretical predictions of secondary structure [Wootton, J.C. (1974) Nature (London) 252, 542 546; Brett, M., Chambers, G.K., Holder, A. A., Fincham, J.R.S., & Wootton, J.C. (1976) J. Mol. Biol. 106, 1-22], the phosphorescing tryptophans have been tentatively placed in the catalytic coenzyme binding domain of each enzyme. The particular sensitivity of the triplet-state lifetime in probing local changes in conformation provides a strong indication that within the time window of phosphorescence measurements the six subunits in the hexameric enzymes are equivalent. Furthermore, while in the bovine enzyme this parameter is markedly affected by the interaction with ligands which have a functional role, the constancy of the phosphorescence lifetime at various degrees of polymerization suggests that the association process is not accompanied by important conformational changes in the macromolecule. PMID- 3663639 TI - A large reservoir of sulfate and sulfonate resides within plasma cells from Ascidia ceratodes, revealed by X-ray absorption near-edge structure spectroscopy. AB - The study of sulfur within the plasma cells of Ascidia ceratodes [Carlson, R. M. K. (1975) Proc. Natl. Acad. Sci. U.S.A. 72, 2217-2221; Frank, P., Carlson, R. M. K., & Hodgson, K. O. (1986) Inorg. Chem. 25, 470-478; Hedman, B., Frank, P., Penner-Hahn, J. E., Roe, A. L., Hodgson, K. O., Carlson, R. M. K., Brown, G., Cerino, J., Hettel, R., Troxel, T., Winick, H., & Yang, J. (1986) Nucl. Instrum. Methods Phys. Res., Sect. A 246, 797-800] has been extended with X-ray absorption near-edge structure (XANES) spectroscopy. An intense absorption feature at 2482.4 eV and a second feature at 2473.7 eV indicate a large endogenous sulfate concentration, as well as smaller though significant amounts of thiol or thioether sulfur, respectively. A strong shoulder was observed at 2481.7 eV on the low-energy side of the sulfate absorption edge, deriving from a novel type of sulfur having a slightly lower oxidation state than sulfate sulfur. The line width of the primary transition on the sulfur edge of a vanadium (III) sulfate solution was found to be broadened relative to that of sodium sulfate, possibly deriving from the formation of the VSO4+ complex ion [Britton, H. T. S., & Welford, G. (1940) J. Chem. Soc., 761-764; Duffy, J. A., & Macdonald, W. J. D. (1970) J. Chem. Soc., 977-980; Kimura, T., Morinaga, M., & Nakano, J. (1972) Nippon Kagaku Zaishi, 664-667]. Similar broadening appears to characterize the oxidized sulfur types in vanadocytes. A very good linear correlation between oxidation state and peak position (in electronvolts) was found for a series of related sulfur compounds. This correlation was used to determine a 5+ oxidation state for the additional sulfur type at 2481.7 eV. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663640 TI - Influence of heme-surrounding amino acid residues on the manganese (V)-nitrido bond in manganese-substituted hemoproteins: resonance Raman evidence for porphyrin core expansion and reduction of the manganese(V)-nitrido stretching force constant. AB - Nitridomanganese(V) protoporphyrin IX was prepared by hypochlorite oxidation of the corresponding manganese(III) protoporphyrin IX derivative in the presence of ammonium ion and by photolysis of the corresponding azidomanganese(III) complex. Myoglobin and horseradish peroxidase containing this novel protoporphyrin derivative were prepared for the first time. These remarkably stable species were examined by electronic absorption, electron paramagnetic resonance, and resonance Raman spectroscopies. The MnV-N stretching modes of the nitridomanganese(V) substituted myoglobin and horseradish peroxidase were observed at 1010 and 1003 cm-1, respectively, by resonance Raman spectroscopy, while the MnV-N stretching frequency for nitridomanganese(V) protoporphyrin IX in 0.1 N aqueous NaOH was found at 1046 cm-1. The equilibrium dissociation energies of MnV-N bonds in these complexes were estimated from vibrational overtone spacings by introducing the Morse potential energy function, were found to be around 4.5 eV, and seemed independent of the surroundings of the manganese porphyrin, although its force constant decreased from 7.3 to 6.7 mdyn/A upon incorporation into apoprotein. The porphyrin ring modes of these nitridomanganese(V) derivatives were influenced greatly upon incorporation into apoproteins, suggestive of the occurrence of porphyrin core expansion. Upon this core expansion the MnV center moves into the mean plane of porphyrin plane, but the access of nitrido (N) toward MnV is restricted due to a steric hindrance from porphyrin pyrrole nitrogens. The resulting stretched MnV-N bond might cause lowering of the MnV-N stretching frequency upon incorporation into apoprotein. PMID- 3663641 TI - Transformation of calf uterine progesterone receptor: analysis of the process when receptor is bound to progesterone and RU38486. AB - Effects of different transforming agents were examined on the sedimentation characteristics of calf uterine progesterone receptor (PR) bound to the synthetic progestin [3H]R5020 or the known progesterone antagonist [3H]RU38486 (RU486). [3H]R5020-receptor complexes [progesterone-receptor complexes (PRc)] sedimented as fast migrating 8S moieties in 8-30% linear glycerol gradients containing 0.15 M KCl and 20 mM Na2MoO4. Incubation of cytosol containing [3H]PRc at 23 degrees C for 10-60 min, or at 0 degrees C with 0.15-0.3 M KCl or 1-10 mM ATP, caused a gradual transformation of PRc to a slow sedimenting 4S form. This 8S to 4S transformation was molybdate sensitive. In contrast, the [3H]RU486-receptor complex exhibited only the 8S form. Treatment with all three activation agents caused a decrease in the 8S form but no concomitant transformation of the [3H]RU486-receptor complex into the 4S form. PR in the calf uterine cytosol incubated at 23 or at 0 degrees C with 0.3 M KCl or 10 mM ATP could be subsequently complexed with [3H]R5020 to yield the 4S form of PR. However, the cytosol PR transformed in the absence of any added ligand failed to bind [3H]RU486. Heat treatment of both [3H]R5020- and [3H]RU486-receptor complexes caused an increase in DNA-cellulose binding, although the extent of this binding was lower when RU486 was bound to receptors. An aqueous two-phase partitioning analysis revealed a significant change in the surface properties of PR following both binding to ligand and subsequent transformation. The partition coefficient (Kobsd) of the heat-transformed [3H]R5020-receptor complex increased about 5-fold over that observed with PR at 0 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663642 TI - On the mechanism of the peroxidase-catalyzed oxygen-transfer reaction. AB - We reported evidence that horseradish peroxidase (HRP) and chloroperoxidase (CPO) catalyze oxygen transfer from H2O2 to thioanisoles [Kobayashi, S., Nakano, M., Goto, T., Kimura, T., & Schaap, A. P. (1986) Biochem. Biophys. Res. Commun. 135, 166-171]. In the present paper, the reaction mechanism of this oxygen transfer is discussed. The oxidation of para-substituted thioanisoles by HRP compound II showed a large negative rho value of -1.46 vs. the sigma + parameter in a Hammett plot. These results are in accord with the formation of a cation radical intermediate in the rate-determining step. Hammett treatments for HRP- and CPO dependent S-oxygenations did not provide unequivocal proofs to judge the reaction mechanism, because of the poor correlations for sigma + and sigma p parameters. Different behavior was found in kinetics and stereoselectivity between the two enzymes. Results in the present study and recent studies strongly suggested the formation of a cation radical intermediate. The oxygen atom would transfer by reaction of compound II and the cation radical intermediate. Although involvement of the cation radical was not confirmed in the CPO system, a similar mechanism was proposed for CPO. PMID- 3663643 TI - Substrate activation of porcine pancreatic kallikrein by N alpha derivatives of arginine 4-nitroanilides. AB - Hydrolysis of several N alpha-substituted L-arginine 4-nitroanilides with porcine pancreatic kallikrein was studied under different conditions of pH, temperature, and salt concentration. At high substrate concentrations a deviation from Michaelis-Menten kinetics was observed with a significant increase in the hydrolysis rates of almost all substrates. Kinetic data were analyzed on the assumption that porcine pancreatic kallikrein presents an additional binding site with lower affinity for the substrate. Binding to this auxiliary site gives rise to a modulated enzyme species which can hydrolyze an additional molecule of the substrate through a second catalytic pathway. The values of both Michaelis-Menten and catalytic rate constants were higher for the modulated species than for the free enzyme, suggesting a mechanism of enzyme activation by substrate. Kinetic data indicated similar substrate requirements for binding at the primary and auxiliary sites of the enzyme. Tris(hydroxymethyl)aminomethane hydrochloride and NaCl were shown to alter the kinetic parameters of the hydrolysis of N alpha acetyl-L-Phe-L-Arg 4-nitroanilide by porcine pancreatic kallikrein but not the enzyme activation pattern (ratio of the catalytic constants for the activated and the free enzyme forms). Similar observations were made when the hydrolysis of D Val-L-Leu-L-Arg 4-nitroanilide was studied under different pH and temperature conditions. PMID- 3663644 TI - Antigelling and antisickling bisphenyl oligopeptides and peptide analogues have similar structural features. AB - Single-crystal X-ray diffraction was used to determine the three-dimensional structures of two antigelling oligopeptides, L-lysyl-L-phenylalanyl-L phenylalanine and L-phenylalanylglycylglycyl-D-phenylalanine, and two antisickling peptide analogues, L-phenylalanine benzyl ester and N-phenylacetyl-L phenylalanine. Although these bisphenyl compounds are chemically quite different from one another, they demonstrate unusual structural similarities: The molecules have compact conformations in which the two phenyl rings are positioned approximately 5 A apart with interplanar angles approaching 90 degrees, thereby making intramolecular edge-to-face interactions. In addition, the polar atoms, nitrogen and oxygen, are in close proximity without forming intramolecular hydrogen bonds. The relative spatial distribution of polar and nonpolar atoms renders the structures compact and amphipathic. The intramolecular edge-to-face interaction between two aromatic rings, which brings a hydrogen atom with relative positive charge near the pi-electron cloud with relative negative charge, is enthalpically favorable and maintains the molecules in a compact and amphipathic conformation. Nonbonded potential energy calculations were used to characterize the energetics of the aromatic-aromatic interaction, and they showed that the observed geometry is stabilized enthalpically by a favorable interaction on the order of -1 to -2 kcal/mol. Structural differences between the two antisickling and the two antigelling agents suggest that molecular volume limits red cell membrane passage. These data provide a molecular structural framework from which to design and synthesize amphipathic bisphenyl compounds that both bind to deoxy sickle cell hemoglobin and cross the erythrocyte membrane. PMID- 3663645 TI - Determination of lipid asymmetry in human red cells by resonance energy transfer. AB - This report describes the application of a resonance energy transfer assay to determine the transbilayer distribution of 7-nitro-2,1,3-benzoxadiazol-4-yl (NBD) labeled lipid analogues. The validity of this technique was established by determining the relationship between the distance of separation of lissamine rhodamine B labeled phosphatidylethanolamine (N-Rho-PE) acceptor lipid and NBD labeled donor lipid and energy transfer efficiency. By determination of the distance between probes at 50% transfer efficiency (R0), the distance between fluorophores distributed symmetrically (outer leaflet label) and asymmetrically in artificially generated vesicles was determined. Calculation of the average distance between probes revealed a 14-A difference between NBD-lipid and N-Rho-PE localized in the same leaflet and in opposing leaflets, respectively. Application of this technique to the study of the transbilayer distribution of NBD-lipid in human red blood cells (RBC) showed that exogenously supplied NBD phosphatidylserine (NBD-PS) was selectively transported to the inner leaflet, whereas NBD-phosphatidylcholine remained in the outer leaflet. In contrast, pretreatment of the RBC with diamide (a SH cross-linking reagent) blocked the transport of NBD-PS. The absence or presence of NBD-PS in the outer leaflet was independently verified by employing "back-exchange", trinitrobenzenesulfonic acid derivatization, and decarboxylation with PS decarboxylase experiments. These control experiments yielded results which confirmed the lipid distributions determined by the resonance energy transfer assay. PMID- 3663646 TI - Functional reconstitution of the integral membrane proteins of influenza virus into phospholipid liposomes. AB - The integral membrane proteins of influenza virus, a hemagglutinin and a neuraminidase, have been incorporated into liposomes composed of either phosphatidylcholine or a mixture of phosphatidylcholine and phosphatidylethanolamine (2:1 w/w) using detergent dialysis. The virus spike glycoproteins for reconstitution were selectively solubilized by using cetyltrimethylammonium bromide to leave a "core particle", which lacked a lipid bilayer but possessed quaternary structure as observed by electron microscopy. The viral spike proteins were combined with exogenous phospholipid in excess sodium cholate followed by exhaustive dialysis for 150 h. Sodium dodecyl sulfate polyacrylamide gel electrophoresis showed that only the viral glycoproteins were associated with all the complexes formed. The level of sodium cholate remaining after dialysis was shown to be reduced to less than 1 molecule per 80 protein molecules. Viral proteins reconstituted into dimyristoylphosphatidylcholine liposomes were shown to have retained hemagglutination, low-pH-dependent hemolysis, and neuraminidase activities and were associated with a lipid bilayer in two types of complexes with average lipid to protein mole ratios after sucrose density gradient purification of either 590:1 or 970:1. The bilayer vesicles formed were of similar sizes and were shown by negative-stain electron microscopy to be 150-300 nm in diameter with well-defined spikes on their surface. Reconstituted liposomes of dimyristoylphosphatidylcholine were found to be unstable with respect to their trapped volume and therefore were unsuitable for fusion studies, unlike complexes formed with phosphatidylcholine or a mixture of phosphatidylcholine/phosphatidylethanolamine derived from hen eggs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663647 TI - Equilibrium and dynamic structure of large, unilamellar, unsaturated acyl chain phosphatidylcholine vesicles. Higher order analysis of 1,6-diphenyl-1,3,5 hexatriene and 1-[4-(trimethylammonio)phenyl]- 6-phenyl-1,3,5-hexatriene anisotropy decay. AB - Equilibrium and dynamic structural properties of minimally to highly unsaturated acyl chain, large, unilamellar phosphatidylcholine (PC) vesicles have been characterized by the dynamic fluorescence properties of 1,6-diphenyl-1,3,5 hexatriene (DPH) and 1-[4-(trimethylammonio)phenyl]-6-phenyl-1,3,5-hexatriene (TMA-DPH). Fluorescence lifetimes and equilibrium and dynamic rotational properties of these probes were analyzed by limited-frequency phase-modulation fluorometry in egg PC, palmitoyloleoyl-PC (POPC), dioleoyl-PC (DOPC), palmitoylarachidonoyl-PC (PAPC), and palmitoyldocosahexaenoyl-PC (P-22:6-PC) vesicles over a temperature range from 5 to 37 degrees C. DPH equilibrium orientational distributions were derived according to a model permitting bimodal orientational distributions in which the parallel probability maximum was aligned parallel to the bilayer normal and the orthogonal probability maximum was oriented parallel to the plane of the bilayer. TMA-DPH orientational distributions were derived according to the same model except that all probability was constrained to the parallel orientation. TMA-DPH fluorescence lifetimes were much more sensitive than those of DPH to variations in acyl chain composition and temperature although the same qualitative behavior was generally observed with both probes. Greater acyl chain unsaturation and higher sample temperatures each gave rise to shorter lifetimes consistent with increased water penetrability into the bilayers. Equilibrium order of the hydrocarbon core (as probed by DPH) and of the interfacial and head group regions of the bilayers (as probed by TMA-DPH) was reduced by increasing levels of unsaturation and by higher sample temperatures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663648 TI - Influence of cholesterol on equilibrium and dynamic bilayer structure of unsaturated acyl chain phosphatidylcholine vesicles as determined from higher order analysis of fluorescence anisotropy decay. AB - The influence of cholesterol on equilibrium and dynamic bilayer structure in minimally to highly unsaturated phosphatidylcholine (PC) vesicles has been examined by characterization of the dynamic fluorescence properties of 1,6 diphenyl-1,3,5-hexatriene (DPH) and 1-[4-(trimethylammonio)phenyl]-6-phenyl-1,3,5 hexatriene (TMA-DPH). Large, unilamellar egg PC, palmitoyloleoyl-PC (POPC), dioleoyl-PC (DOPC), palmitoylarachidonoyl-PC (PAPC), and palmitoyldocosahexaenoyl PC (P-22:6-PC) vesicles containing no cholesterol or approximately 15 or 30 mol % cholesterol have been examined. Equilibrium and dynamic DPH orientational properties were analyzed according to an orthogonal, bimodal orientational distribution function [Straume, M., & Litman, B.J. (1987) Biochemistry (preceding paper in this issue)]. The same mathematical formalism was applied to TMA-DPH except that probe orientational probability was permitted only in the distribution peak aligned parallel to the bilayer normal. TMA-DPH fluorescence lifetimes were consistently increased by incorporation of cholesterol into these vesicles. Greater acyl chain unsaturation and increasing temperature each promoted reduction of lifetimes in the presence or absence of cholesterol. DPH lifetimes were much less sensitive than those of TMA-DPH to changes in composition or temperature. This behavior is consistent with reduced water penetrability into liquid-crystalline bilayers as cholesterol content is increased and as acyl chain unsaturation and temperature are reduced. Cholesterol also induces substantial equilibrium ordering of the bilayer both at the hydrophobic core and at the bilayer-water interface. DPH orientational distributions were shifted in favor of alignment parallel to the acyl side chains. The distributions of both probes were narrowed in response to incorporation of cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663649 TI - Isolation of angiogenin from normal human plasma. AB - Angiogenin, a potent blood vessel inducing protein, was previously isolated from medium conditioned by a human adenocarcinoma cell line [Fett, J. W., Strydom, D.J., Lobb, R.R., Alderman, E.M., Bethune, J.L., Riordan, J.F., & Vallee, B.L. (1985) Biochemistry 24, 5480-5486]. We now report that a protein which is physically and functionally identical with angiogenin is present in normal human plasma and can be purified to homogeneity by CM 52 and Mono S cation-exchange chromatography. The plasma-derived angiogenin exhibits the same angiogenic and ribonucleolytic activities, amino acid composition, molecular weight, immunoreactivity, and chromatographic behavior as the tumor cell derived protein. Peptide mapping and sequencing studies indicate chemical identity of the two proteins. The present yield of angiogenin from either plasma or serum is 60-150 micrograms/L. These findings demonstrate that angiogenin is not a tumor-specific product and provide further opportunities for the investigation of the role and mechanism of action of angiogenin and its potential diagnostic or prognostic utility. PMID- 3663650 TI - Abnormal solubility behavior of beta-lactoglobulin: salting-in by glycine and NaCl. AB - The causes of the salting-in of beta-lactoglobulin by glycine and NaCl, a solubility behavior contrary to expectations, were probed by a detailed study of the interactions between these solvent components and the protein. The preferential interactions of beta-lactoglobulin with solvent components in aqueous glycine and NaCl systems have been compared with those of bovine serum albumin and lysozyme. At neutral pH, beta-lactoglobulin exhibited insignificant preferential interactions in glycine and NaCl at low cosolvent concentrations and an increasing preferential hydration at higher concentrations, the levels approaching the values expected from the other two proteins. These results indicate considerable binding of the electrolytes to beta-lactoglobulin, sufficient to compensate for the exclusion due to perturbation of the solvent surface tension. The difference between the preferential interactions of beta lactoglobulin and the other proteins with these two solvent additives was shown to be the cause of the increase of beta-lactoglobulin solubility even at high concentrations of the additives, at which they have salting-out effects on the other proteins. The preferential interactions of NaCl with the three proteins were examined as a function of pH. The results showed no pH dependence of the preferential hydration for bovine serum albumin and lysozyme, while this parameter increased significantly for beta-lactoglobulin at lower pH. This suggests that the binding of electrolytes to beta-lactoglobulin is due to a unique charge distribution on the surface of the protein around neutral pH, which imparts to this protein a large dipole moment. PMID- 3663651 TI - Trypsinogen-trypsin transition: a molecular dynamics study of induced conformational change in the activation domain. AB - The trypsinogen to trypsin transition has been investigated by a stochastic boundary molecular dynamics simulation that included a major portion of the trypsin molecule and the surrounding solvent. Attention focused on the "activation domain", which crystallographic studies have shown to be ordered in trypsin and disordered in its zymogen, trypsinogen. The chain segments that form the activation domain were found to exhibit large fluctuations during the simulation of trypsin. To model a difference between trypsin and trypsinogen, the N-terminal residues Ile-16 and Val-17 were removed in the former and replaced by water molecules. As a result of the perturbation, a structural drift of 1-2 A occurred that is limited to the activation domain. Glycine residues are found to act as hinges for the displaced chain segments. PMID- 3663652 TI - Sequence dependence of the B to Z transition in crystals and aqueous NaCl solutions for deoxyoligonucleotides containing all four canonical DNA bases. AB - A laser Raman study has been made on the conformation of a series of self complementary octameric deoxynucleotides that contain all four canonical deoxynucleotide bases [guanine (G), cytosine (C), adenine (A), and thymine (T)] in order to determine which sequences will crystallize in the Z form and which sequences will go into the Z form in aqueous solution at high salt concentrations (4-6 M NaCl). All four octadeoxynucleotides, d(TGCGCGCA) (I), d(CACGCGTG) (II), d(CGTGCACG) (III), and d(CGCATGCG) (IV), have been crystallized from low-salt solutions. The Raman spectra of microcrystals show that I, II, and IV crystallize in a rigorous Z form while III crystallizes in the B form. Sequences I and II go into a Z form in 4-6 M NaCl solution at 0 degrees C while sequences III and IV remain in the B form in 6 M salt. There are substantial differences in the Raman spectra of oligonucleotides in the Z form found in the crystal and in high-salt solutions. The Raman spectra of the Z forms in 6 M NaCl solution at 0 degrees C are not linear combinations of the Raman spectra of the complete Z form in the crystal and the complete B form in low-salt solutions. The terminal residues of these oligomers do not appear to be in a strict Z form. A detailed analysis of the ring puckers and syn/anti conformation for all of the residues both in solution and in the crystal has been made.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663653 TI - Locations and dynamical perturbations for lipids of cationic forms of procaine, tetracaine, and dibucaine in small unilamellar phosphatidylcholine vesicles as studied by nuclear Overhauser effects in 1H nuclear magnetic resonance spectroscopy. AB - Locations and dynamical perturbations for lipids of local anesthetics (procaine . HCl, tetracaine . HCl, and dibucaine . HCl) in sonicated egg yolk phosphatidylcholine (PC) vesicles have been studied by 1H-1H nuclear Overhauser effect (NOE) measurements. It was found that tetracaine and dibucaine bind much strongly to the neutral lipids than does procaine and that their mobilities are lowered to such an extent that spin diffusion is transmitted (i.e., omega 2 tau c2 much greater than 1). The intermolecular NOEs between drugs and PC were more effective in the case of dibucaine than with tetracaine, indicating that dibucaine binds to the lipids more strongly than tetracaine; this order agrees well with that of anesthetic potency. However, it was only tetracaine that gave any appreciable dynamical perturbation to the PC vesicles when they were monitored by the extent of transfer of the negative NOE from alpha-methylene protons to choline methyls, olefinic methines, acyl methylenes and terminal methyl protons. This finding was interpreted as being due to the differences in the locations of these drugs in small unilamellar vesicles: (1) procaine interacts with lipids very weakly at the outer surface of the vesicles; (2) tetracaine binds to the lipids both at the outer and inner halves of the bilayer, inserting its rod-like molecule in a forest of acyl chains of PC; (3) dibucaine binds tightly to the polar head-group of PC, which resides only at the outer half of the bilayer vesicles. It was concluded that the relative order of anesthetic potency within these drugs can be correlated not with the ability to affect membrane fluidity but with the ability to bind to lipids at the polar head-group of the bilayer vesicles. PMID- 3663654 TI - The hemagglutinins of the human influenza viruses A and B recognize different receptor microdomains. AB - A cryptically I-active sialylglycoprotein (glycoprotein 2) isolated from bovine erythrocyte membranes as Sendai virus receptor (Suzuki, Y., Suzuki, T. and Matsumoto, M. (1983) J. Biochem. 93, 1621-1633) contains N-glycolylneuraminic acid (NeuGc) as its predominate sialic acid and exhibits poor receptor activity for a variety of influenza viruses. Enzymatic modification of asialoglycoprotein 2 to contain N-acetylneuraminic acid (NeuAc) in the NeuAc alpha 2-3Gal and NeuAc alpha 2-6Gal sequences using specific sialyltransferase resulted in the appearance of receptor activity toward human influenza viruses A and B. The biological responsiveness chicken erythrocytes treated with sialidase and then reconstituted with derivatized glycoprotein 2 showed considerable recovery to influenza virus hemagglutinin-mediated agglutination, low-pH fusion and hemolysis. Specific hemagglutination inhibition activity of derivatized glycoprotein 2 was 5-16-times higher than that of human glycophorin. A/PR/8/34 (H1N1) virus preferentially recognized derivatized glycoprotein 2 containing NeuAc alpha 2-3Gal sequence over that containing NeuAc alpha 2-6Gal while the specificity of A/Aichi/2/68 (H3N2) for the sialyl linkages was reversed. B/Lee virus recognized both sequences almost equally. The biological responsiveness to the viruses of the erythrocytes labeled with the derivatized glycoprotein 2 containing NeuGc was considerably lower than that of derivatized glycoprotein 2 containing NeuAc. The results demonstrate that the hemagglutinins of human isolates of influenza viruses A and B differ in the recognition of microdomains (NeuAc, NeuGc) of the receptors for binding and fusion activities in viral penetration and the sequence to which sialic acid (SA) is attached (SA alpha 2 3Gal, SA alpha 2-6Gal). Inner I-active neolacto-series type II sugar chains may be important in revealing the receptor activity toward the hemagglutinin of both human influenza viruses A and B. PMID- 3663655 TI - Characterization of low- and high-affinity glucose transports in the yeast Kluyveromyces marxianus. AB - Glucose transport in the yeast Kluyveromyces marxianus proceeds by two functionally and presumably structurally distinct transporters depending on the carbon source of the culture medium. In lactose-grown cells, glucose was taken up through a high-affinity H+-sugar symporter (Km = 0.09 mM), whereas a low-affinity transporter (Km = 3.5 mM) was utilized in glucose-grown cells. The two transporters exhibited different substrate specificities. Galactose was demonstrated to be a selective substrate of the H+-glucose symporter (Km = 0.14 mM) and did not significantly enter glucose-grown cells. Fructose was a preferential substrate of the low-affinity carrier (Km = 3.5 mM), but it entered lactose-grown cells through a high-affinity H+-fructose symporter distinct from the H+-glucose one. Other putative substrates of the two glucose transporters were identified by competition experiments. 2-Deoxyglucose recognized both carriers with a similar affinity, while the non-phosphorylatable analogues 6 deoxyglucose, 3-O-methylglucose and D-fucose exhibited a 10-30 fold preference for the high-affinity transporter. PMID- 3663656 TI - Light-induced fusion of liposomes with release of trapped marker dye is sensitised by photochromic phospholipid. AB - Liposomes have been prepared from dipalmitoylphosphatidylcholine containing small amounts of a synthetic photochromic phospholipid, 'Bis-Azo PC'. In the dark, these are stable at room temperature, and contents do not significantly leak over weeks. Photoisomerisation results in immediate release of trapped marker, and in liposome fusion to form larger structures. Fusion has been detected using a fluorescence polarisation assay, and confirmed by electron microscopy. In mixtures, fusion occurs between 'photochromic' liposomes and those of pure lipid. Bis-Azo PC contains two photochromic acyl chains; analogues bearing a single photochromic chain appear to have little effect on bilayer permeability after isomerisation. Photo-induced leakage and liposome fusion suggest possible applications for localised drug delivery as an adjunct to phototherapy. The ability to non-invasively trigger fusion processes should be useful in fundamental studies of membrane interactions. We believe this to be the first report of photo-induced fusion to date. PMID- 3663657 TI - Evidence for glycoprotein components of the hepatocellular bile acid transporter. AB - The hepatocellular transporter, responsible for the uptake of bile acids and some foreign substances, can be shown to contain carbohydrate moieties. The hepatocellular uptake of cholate and phallotoxin is immediately inhibited by addition of wheat-germ agglutinin. Concanavalin A and lentil lectin reduce the uptake in a time-dependent manner. Apparently sialic acids or N-acetylglucosamine residues are involved in the translocation process. Polypeptides (Mr 50,000, 54,000) of the above transport system, identified by affinity labeling with [3H]isothiocyanatobenzamido cholate and [3H2]diisothiocyano-1,2-diphenylethane 2,2'-disulfonic acid, are heterogenously glycosylated. Binding of 80-90% of the 54, 50 kDa polypeptides to all immobilized lectins tested suggests that both high mannose and complex type oligosaccharides with fucose and terminal sialic acid residues occur as carbohydrate chains. A 67 kDa labeled polypeptide is not glycosylated. Pilot experiments for purification of the above glycosylated membrane proteins on concanavalin A, lentil lectin and wheat-germ lectin columns are described. However, lectin affinity chromatography is not suitable as a one step purification procedure for the labeled polypeptides. PMID- 3663658 TI - The interaction of N-oleylethanolamine with phospholipid bilayers. AB - Long chain acylamides of ethanolamine were previously found to increase in the infarcted canine myocardium. Subsequent in vitro experiments established a number of interesting biological and physiological properties of these compounds including alteration of rabbit skeletal sarcoplasmic reticulum function and inhibition of permeability dependent calcium release from heart mitochondria. These results suggested an interaction between the N-acylethanolamines and biological membranes. In the present work we show that the most potent species in previous studies, N-oleylethanolamine, forms stable complexes with phospholipid vesicles, lowers diphenylhexatriene polarization ratios in dimyristoylphosphatidylcholine and dipalmitoylphosphatidylcholine uni- and multilamellar bilayer vesicles, and also produces a concentration dependent decrease in the phase transitions of these lipid structures. In addition studies with parinaric acids also suggested that N-oleylethanolamine partitions preferentially into more fluid areas of the bilayer. The results are discussed in terms of possible effects on biological membranes. PMID- 3663659 TI - A single half-turnover of the glucose carrier of the human erythrocyte. AB - Single half-turnovers of the glucose carrier of the human erythrocyte have been measured by recruiting carriers to the outward-facing conformation by (a) pre exposing cells to extracellular maltose, or (b) pre-warming cells to 38 degrees C, before addition of D-[14C]glucose at 0 degrees C. Based on these experiments estimates of the number of glucose carriers per red cell range from 124,000 to 190,000. PMID- 3663660 TI - Purification and reconstitution studies of the nucleoside transporter from pig erythrocytes. AB - The pig erythrocyte nucleoside transporter has been identified as a band 4.5 polypeptide (Mr 64,000) on the basis of photoaffinity labelling experiments with the nucleoside transport inhibitor nitrobenzylthioinosine (NBMPR). This protein was purified 140-fold by treatment of haemoglobin-free erythrocytes 'ghosts' with EDTA (pH 11.2) to remove extrinsic proteins, extraction of the protein-depleted membranes with n-octyl-glucoside and subsequent gradient-elution ion-exchange chromatography on DEAE-cellulose. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of the purified material revealed the presence of only two detectable protein bands, one which co-migrated with the radiolabelled NBMPR binding protein, and a lower molecular weight species with an Mr of 43,000. The latter protein may be a degradation product of the band 3 anion-exchange transporter. The overall purification of the NBMPR-binding protein with respect to the Mr 64,000 band was 350-fold. Reversible NBMPR-binding to the partially purified band 4.5 preparation was saturable (apparent Kd 7.2 nM). Adjustment of the chromatography conditions to allow elution of the NBMPR-binding protein along with the majority of solubilised membrane phospholipid reduced the apparent Kd value to 3.0 nM. Purification of reversible NBMPR-binding activity during ion exchange chromatography was paralleled by an increase in the specific activity of nitrobenzylthioguanosine (NBTGR) -sensitive uridine transport as assayed in proteoliposomes reconstituted by a freeze-thaw-sonication procedure. PMID- 3663661 TI - Interaction of trans-parinaric acid with phosphatidylcholine bilayers: comparison with the effect of other fluorophores. AB - The effect of the fluorophore trans-parinaric acid on the structure of lipid bilayer was studied and compared with the effect of other 'perturbants'. These include commonly used fluorophores (diphenylhexatriene, heptadecylhydroxycoumarin, cis-parinaric acid and two fatty acids, palmitic and oleic acids). Differential scanning calorimetry (DSC) and proton nuclear magnetic resonance techniques were used to evaluate structural changes in the lipid bilayers. The thermodynamic parameters of dipalmitoylphosphatidylcholine multilamellar vesicles obtained from the DSC thermograms suggest that trans parinaric acid differs from the other 'perturbants'. trans-Parinaric acid has the most pronounced impact on the Tm, the width (delta T1/2) and the index of asymmetry of the main gel to liquid crystalline phase transition without any effect on its transition, delta H. The presence of trans-parinaric acid in the lipid bilayer of dimyristoylphosphatidylcholine small unilamellar vesicles influences the chemical shift difference between the choline protons of phosphatidylcholine molecules present in the two leaflets of the vesicle bilayer (delta delta H). This suggests that trans-parinaric acid affects the head group packing in the bilayer. Its main effect is abolishing the major alterations in head group packing that occur through the phase transition. The above data indicate that trans-parinaric acid is concentrated in the gel phase domains, whereby it stabilizes the phase separation between the gel and liquid crystalline phases, probably by affecting lipid molecules present in the boundary regions between these two domain types. PMID- 3663662 TI - Asymmetric disposition of detergents within vesicle bilayer and its effect on ion permeation through the membrane. AB - Phospholipid vesicles were prepared by detergent removal using hydrophobic porous beads, Amberlite XAD-2, or dialysis from detergent-phospholipid mixed micelles. The liposomes formed were found to be mostly unilammellar vesicles. The vesicle diameter was estimated, by both quasi-elastic light-scattering and gel-exclusion chromatography on Sephacryl S-1000, to be 80 nm for the vesicles formed by removal of octaethylene glycol monododecyl ether by the bead method. The effect of detergents within a bilayer on ion permeation was demonstrated. When the content of octaethylene glycol monododecyl ether reached a molar ratio of 0.2, the intrinsic ion selectivity of the phospholipid membrane between anion and cation was diminished. The ion permeability measured for vesicles with detergent incorporated into initially detergent-free vesicles was about 10-times greater than that for vesicles with detergent remaining following the process of detergent removal. This observation was explained by the different disposition of the detergent in the bilayer, that is, when vesicles were formed by the removal of detergent from mixed micelles, the residual detergent became distributed in both the outer and inner leaflets, and when the detergent was incorporated into initially detergent-free vesicles, the detergent became distributed only in the outer leaflet within the experimental time limits. This idea was supported by the NMR studies. It was also found that, as a detergent, octaethylene glycol monododecyl ether has a stronger effect on ion permeation than octyl glucoside. PMID- 3663663 TI - Solubilization and reconstitution of the sarcolemmal Na+-Ca2+ exchange system of vascular smooth muscle. AB - The Na+-Ca2+ exchange system of the sarcolemma of rat mesenteric artery was solubilized and reconstituted in soybean phospholipid vesicles. In the reconstituted system, the exchange process showed about 4-fold higher specific activity compared to that of native vesicles. The inhibitory effect of monensin and the stimulatory effect of valinomycin in the presence of K+ on Na+ gradient dependent Ca2+ uptake were preserved and were pronounced in the reconstituted system. The stimulation by valinomycin indicates that the exchange process is electrogenic. Thus, the stoichiometry, the characteristics and the mechanism of action which were difficult to study in the native vesicles can now be determined conveniently using the reconstituted system. Also, solubilization and reconstitution of the exchange system confirms its existence in vascular smooth muscle. PMID- 3663664 TI - Growth rate of myelin figures of egg-yolk phosphatidylcholine. AB - The growth length of myelin figures was measured in detail using a video tape recording system of optical microscopy. In the beginning stage of growth, the growth process was not adapted to the diffusion-limited process of lipid molecules, which has been recently proposed. Another interpretation for the growth mechanism was proposed, where the growth results from swelling. The initial growth rate measured was in good agreement with the estimated value in consideration with the water flux in the first approximation of the lipid concentration gradient. PMID- 3663665 TI - Fusion of influenza virus in an intracellular acidic compartment measured by fluorescence dequenching. AB - The fusion of influenza virus with cultured cells has been investigated. The virus was labelled with the fluorescent probe octadecyl rhodamine B and fusion was monitored as fluorescence dequenching due to dilution of the probe from the viral into a cellular target membrane. Fusion with the plasma membrane does not occur, unless the extracellular pH is temporarily lowered. At neutral pH fusion occurs only after a lag phase of 10-15 min, the time required for virus internalization, and the reaction is inhibited by NH4Cl, indicating that it takes place in an intracellular acidic compartment, most likely the endosome. This suggests that influenza virus infects cells via the endocytic pathway. PMID- 3663666 TI - Axial heterogeneity of organic cation transport along the rabbit renal proximal tubule: studies with brush-border membrane vesicles. AB - Brush-border membrane vesicles prepared from rabbit kidney outer cortex (rich in S1 and S2) and outer medulla (rich in S3) were used to evaluate the axial heterogeneity of tetraethylammonium transport in the proximal tubule. The vesicle preparations had similar Km values but the Vmax values differed, suggesting that axial heterogeneity of tetraethylammonium secretion may be due to differences in transport across the brush-border membrane. PMID- 3663667 TI - Interaction of spectrin with phospholipids. Quenching of spectrin intrinsic fluorescence by phospholipid suspensions. AB - Phospholipid suspensions prepared of phosphatidylethanolamine, phosphatidylserine and their mixtures are able to influence the intrinsic protein fluorescence of spectrin. In the case of phosphatidylethanolamine suspension up to 75% of protein fluorescence can be quenched. The interaction of phospholipid aggregates with spectrin is modulated by pH and ionic strength. Phospholipids, particularly phosphatidylethanolamine display a 'stabilizing' effect against the changes of protein fluorescence induced by increasing ionic strength and by thermal denaturation. PMID- 3663668 TI - Characterization of the D-glucose/Na+ cotransport system in the intestinal brush border membrane by using the specific substrate, methyl alpha-D-glucopyranoside. AB - By using isolated membrane vesicles, we have investigated the tenet that D glucose transport across the intestinal brush-border membrane involves at least two distinct, Na+-activated agencies (D-glucose transport systems S-1 and S-2), only one of which (S-1) can use methyl alpha-D-glucopyranoside (methyl alpha glucoside) as a substrate. Our results with this glucose analogue show that: (a) As a function of time, methyl alpha-glucoside uptake exhibits a typical overshoot, similar to but smaller than that given by D-glucose with the same vesicle batch. (b) Nonlinear regression analysis of substrate-saturation curves reveals that, contrary to D-glucose, methyl alpha-glucoside transport involves a single transport system which we have identified as S-1. (c) Methyl alpha glucoside exhibits an apparent affinity (defined as the reciprocal of Km) 4-times smaller than that of D-glucose for S-1 (Km(Dglucose) = 0.5 mM; Km(methyl alpha glucoside) = 2 mM). However, methyl alpha-glucoside has a Vmax (230 pmol/mg protein per s) identical to that characterizing D-glucose transport by this system. (d) In the absence of Na+, methyl alpha-glucoside uptake is indistinguishable from simple diffusion, confirming that Na+ is an obligatory activator of S-1. (e) Phlorizin behaves as a fully competitive inhibitor of methyl alpha-glucoside transport (Ki = 18 microM), again indicating that S-1 is involved. (f) Neither phloretin nor cytochalasin B affects methyl alpha-glucoside uptake. We conclude that methyl alpha-glucoside is a substrate specific for S-1, which permits study of the properties of this system without interference by substrate fluxes taking place through any other channel. PMID- 3663669 TI - Role of membrane sialic acid content in the adhesiveness of aged erythrocytes to human cultured endothelial cells. AB - Following our previous observation that the oldest normal red blood cells were the most adherent to human cultured endothelial cells, we attempted to simulate this age-related adherence. Among all the membrane modifications experienced by erythrocytes during their life-span, loss of sialic acids has attracted considerable attention. Using two different preparations of neuraminidase, we performed a sialic acid depletion on the youngest erythrocytes to reach a sialic acid content similar to that observed in physiologically aged erythrocytes. These pretreated youngest cells displayed limited increase in the adhesiveness to endothelial cells, lower than that found with intact oldest cells. To obtain an adhesiveness of pretreated cells similar to that of naturally aged cells, it was necessary to exceed 80% of sialic acid depletion. At this extent of desialation, modifications of the electrophoretic pattern of glycophorins were observed as well as the appearance of peanut agglutinin reactivity which were never found in physiologically aged erythrocytes. Therefore, the sialic acid loss cannot be considered as being a single determinant factor of the naturally aged red cell adhesiveness. PMID- 3663670 TI - Elevated intracellular Ca2+ affects Lii-Nao countertransport in human red blood cells. AB - Changes in cytoplasmic Ca2+ concentration and in Lii-Nao countertransport activity have been shown to be associated with essential hypertension. Elevated intracellular free [Ca2+], as well as abnormalities of Ca2+ binding and transport have been reported in cells from different tissues of hypertensive laboratory animals and essential hypertensive patients. Similarly, enhanced rates of Lii-Nao countertransport and the modified pattern of the temperature dependence of this activity in red blood cells from essential hypertensive patients have been previously demonstrated. The aim of the present study was to investigate possible interaction between changes in intracellular free [Ca2+] and the Lii-Nao exchange in human red blood cells. The ionophore ionomycin was used to allow Ca2+ incorporation into the cells in a dose-dependent manner. The elevation of intracellular [Ca2+], in turn, resulted in enhanced Li+ efflux from the cells. At 3 microM, ionomycin selectively and significantly enhanced the Lii-Nao countertransport but not Li+ leakage from the cells. EGTA totally abolished the effect of ionomycin, indicating that the effect is directly related to Ca2+. As low as 0.4 microM Ca2+ caused a statistically significant effect. The maximal effect of Ca2+ on the Lii-Nao countertransport was achieved around the external pH range of 6.8-7.5. In contrast, the leakage of Li+ was significantly enhanced by Ca2+ at a pH of 7.4 and above. Ca2+ did not affect the Km of the Lii-Nao countertransport for Li+. Amiloride, which inhibits Na+/H+ exchange, inhibited only 10% of the Ca2+-enhanced countertransport. It is concluded that Ca2+ may play a role in the regulation of Lii-Nao countertransport in erythrocytes. PMID- 3663671 TI - Effect of cell shape, membrane deformability and phospholipid organization on phosphate-calcium-induced fusion of erythrocytes. AB - Fusion of bovine and goat erythrocytes was studied using the phosphate-calcium protocol. Both bovine and goat red cells are resistant to fusion with phosphate and calcium, under conditions that promote fusion of normal human erythrocytes. Fusion resistance is not related to decreased (5%) membrane deformability of erythrocytes of these species, since chicken erythrocytes which are 40% less deformable than human erythrocytes undergo fusion with efficiency similar to human red blood cells. Incorporation of either phosphatidylcholine or phosphatidylserine into bovine erythrocytes mediated by lipid exchange/transfer protein, caused fusion of these erythrocytes. Fluorescence analysis of merocyanine 540 dye labeled erythrocytes, by flow cytometry, showed that the frequency of cells which exhibit dye binding was much less (35%) in dimyristoylphosphatidylcholine (DMPC) incorporated compared to untreated bovine erythrocytes (80%), indicating that incorporation of DMPC caused closed packing of lipids in the external leaflet of the bilayer. These studies show that fusion of bovine erythrocytes, mediated by phosphate and calcium, has a requirement for either specific phospholipids such as phosphatidylcholine, phosphatidylserine, or closed packing of lipids in the external leaflet of the bilayer. PMID- 3663672 TI - Modulation of red cell vesiculation by protease inhibitors. AB - Release of vesicles from human red cell membranes was induced either by ATP depletion or by incubation of the cells in presence of sonicated dimyristoylphosphatidylcholine (DMPC) vesicles. Vesicles released from ATP depleted red cells but not the DMPC-induced vesicles contained degradation products of band 3 protein. Furthermore, in ATP-depleted erythrocytes proteolytic breakdown products could be demonstrated that were not detected in cells incubated with DMPC. Proteolysis was neither significantly affected by the protease inhibitor N-alpha-tosyl-L-lysine chloromethyl ketone (TLCK) nor by other protease inhibitors tested in this study (diisopropylfluorophosphate, N ethylmaleimide and phenylmethylsulfonyl fluoride). Both vesiculation processes were inhibited in a concentration dependent way by TLCK while other protease inhibitors did not significantly influence membrane vesiculation. Phase contrast microscopy showed that TLCK diminished the DMPC-induced formation of echinocytes which is known to precede vesicle release. These results suggest that the influence of TLCK on membrane vesiculation is not primarily due to inhibition of proteolysis but to a direct interaction of the inhibitor with the intrinsic domain of the erythrocyte membrane. PMID- 3663673 TI - Lipid shape as a determinant of lipid composition in Clostridium butyricum. The effects of incorporation of various fatty acids on the ratios of the major ether lipids. AB - The lipid composition of Clostridium butyricum is strongly influenced by the aliphatic chain compositions of the membrane lipids. Growth on cis monounsaturated fatty acids in the absence of biotin was shown to affect the relative proportions of phosphatidylethanolamine, plasmenylethanolamine, and the glycerol acetal of plasmenylethanolamine most strongly, with smaller effects on the acidic lipids, phosphatidylglycerol and cardiolipin. The ratio of the glycerol acetal of plasmenylethanolamine to total phosphatidylethanolamine in cells grown on a series of fatty acids is shown to decrease in the following order; cis-vaccenic acid greater than or equal to oleic acid = C19-cyclopropane fatty acid greater than linoleic acid greater than petroselinic acid greater than elaidic acid greater than 14-methylhexadecanoic acid (anteiso-C17) greater than 12-methyltridecanoic acid (iso-C14). All fatty acids were extensively incorporated into the lipid acyl, alkenyl, and alkyl chains. There was considerable chain-elongation of the iso-C14 to iso-C16. The results are consistent with the hypothesis that the membrane lipid composition is strongly influenced by lipid shape and that the observed changes in lipid composition serve to stabilize the bilayer arrangement of the cell membrane. PMID- 3663674 TI - Na+ modulates the K+ permeability and the membrane potential of alkalophilic Bacillus. AB - In the absence of Na+ in the medium, the membrane potential of obligately alkalophilic Bacillus cells was found to be decreased by the addition of K+ to the medium, whereas K+ addition in the presence of Na+ had no effect. Rb+ showed essentially the same effect as K+. The decreased membrane potential was quickly restored by lowering the K+ concentration in the medium or by adding Na+ or Li+ to the medium. Thus, in the absence of Na+, the membrane potential of alkalophilic Bacillus seems to be affected by the concentration difference of K+ between inside and outside of the cell, and Na+ or Li+ in the medium suppresses the K+ effect. An exchange between extracellular Rb+ and intracellular K+ was observed in the absence of Na+. However, the exchange was greatly suppressed by the addition of Na+ or Li+ to the medium, indicating that Na+ in the medium modulates the K+ permeability of the alkalophilic Bacillus cell membrane. The K+ induced decrease in the membrane potential of alkalophilic Bacillus in the absence of Na+ is accounted for by the increased K+-permeability of the cell membrane. PMID- 3663675 TI - Characterization of amino acid transport systems in human placental brush-border membrane vesicles. AB - Brush-border microvillous plasma membrane vesicles were prepared from human full term placental syncytiotrophoblasts and purified 33-fold from the homogenate with reference to a membrane marker enzyme, alkaline phosphatase (EC 3.1.3.1). Transport of alpha-(methylamino)isobutyrate by the membrane vesicles was stimulated in the presence of an Na+ gradient from the outside to the inside of the vesicles. The initial rate of uptake in a 10-s period was enhanced with increasing concentration of Na+ in the external medium. The level of alpha (methylamino)isobutyrate transported into the vesicles reached a maximum 1 min after the start of incubation at 37 degrees C, and then decreased with time due to efflux. Extrapolation to infinite medium osmolarity showed no uptake, indicating transport of alpha-(methylamino)isobutyrate into membrane vesicles. The initial rate of uptake was dependent on temperature and pH: the highest rate occurred at 37 degrees C and the optimal pH was 8.0. When the alpha (methylamino)isobutyrate concentration was varied, the initial rate of uptake dependent on an Na+ gradient (out greater than in) obeyed Michaelis-Menten kinetics with Km and Vmax values of 1.07 mM and 3.23 nmol/10 s per mg of protein, respectively. Cross-inhibition patterns indicated that at least three Na+ dependent and two Na+-independent carrier-mediated pathways existed in the human placental brush border. One Na+-dependent pathway interacted with all substrates tested. Another Na+-dependent route interacted with L-proline, alpha (methylamino)isobutyrate, and L-methionine, while a third pathway was selective for L-methionine. One Na+-independent pathway was selective for L-cysteine, while the other pathway interacted with all substrates tested. PMID- 3663676 TI - Effect of temperature on the velocity of erythrocyte aggregation. AB - The velocity of the aggregation of human erythrocytes was examined in the range of 5-43 degrees C with a rheoscope combined with a video camera, an image analyzer and a computer. (1) With increasing temperature, the velocity of erythrocyte aggregation induced by fibrinogen, immunoglobulin G and artificial macromolecules (dextran of 70 kDa and poly(glutamic acid) of 50 kDa) increased. However, the relationship between the velocity of erythrocyte aggregation and the temperature was different among these macromolecules. (2) In 70% autologous plasma, the velocity of erythrocyte aggregation was minimum at 15-18 degrees C, and increased at both higher and lower temperatures. (3) The shape of erythrocyte aggregates in 12 mumol/l fibrinogen (containing 770 mumol/l albumin) and in 70% autologous plasma was dependent on temperature: three-dimensional below 15-18 degrees C and one-dimensional (mainly rouleaux) above 15-18 degrees C. However, the shape of aggregates in 27 mumol/l immunoglobulin G (containing 770 mumol/l albumin) was three-dimensional in all temperature ranges. (4) The temperature dependency of erythrocyte aggregation was discussed in terms of the changes of medium viscosity, of erythrocyte properties and of bridging macromolecules. PMID- 3663677 TI - The influence of membrane composition on the solubilizing effects of Triton X 100. AB - Multilamellar liposomes containing pure phosphatidylcholine (PC) or mixtures of PC with cholesterol, cholesteryl palmitate, beta-carotene, cardiolipin, phosphatidylethanolamine or gramicidin A have been treated with the detergent Triton X-100. Solubilization has been monitored as a decrease in turbidity of the liposome suspension, and also by determination of bilayer components in the solubilized fraction. The same solubilization pattern is found for unsaturated (egg yolk) or saturated (dimyristoyl) PC. Similar results are also found when dimyristoyl PC is solubilized above or below its gel-to-fluid transition temperature. Cholesterol solubilizes in parallel with PC; gramicidin A is solubilized preferentially to this phospholipid and the non-polar lipids cholesteryl palmitate or beta-carotene remain insoluble at detergent concentrations producing complete PC solubilization. Addition of cardiolipin or phosphatidylethanolamine does not seem to alter the general pattern of PC solubilization. Phosphatidylethanolamine is less soluble than PC, while cardiolipin solubilizes at the same detergent concentrations than PC. These results are considered in relation to previous studies with natural membranes. PMID- 3663678 TI - Identification of nuclear envelope proteins and glycoproteins which co-isolate with the nuclear protein matrix. AB - Nuclear envelopes and nuclear matrices were isolated from rat liver nuclei. Although differences in polypeptide composition of the structures are evident on SDS gel electrophoresis, they have an almost identical distribution of concanavalin A-binding glycoproteins. These matrix-associated concanavalin A binding glycoproteins derive entirely from the nuclear envelope and are recovered almost quantitatively in the matrix. They constitute easily identifiable markers for nuclear envelope association with matrix or other nuclear subfractions. Surface labelling of nuclei with 125I using solid-phase lactoperoxidase further confirmed that a large number of envelope-associated nuclear surface proteins co isolate with the matrix. Protein kinase activity, as well as endogenous substrates for the kinase(s) are shown to be the same in both envelopes and matrix. Envelope-derived proteins and glycoproteins may comprise a substantial proportion of total matrix protein. PMID- 3663679 TI - Phase equilibria of the ternary system 1-palmitoyl-sn-glycero-3 phosphocholine/oleic acid/water studied by NMR. AB - Part of a phase diagram for the system 1-palmitoyl-sn-glycero-3-phosphocholine (PamGroPCho)/oleic acid/water has been constructed from mainly 31P-NMR data and a previous determination of the phase equilibria of the binary PamGroPCHo/water system. It was found that the appearance of the phase diagram is very similar to those found for several simple soap/fatty acid/water or soap/long-chain alcohol/water systems. The most striking features observed are: (1) the lamellar phase can swell towards very high water contents (2) vesicles are formed after sonication and (3) the cubic liquid crystalline phase disappears upon addition of very small amounts of oleic acid. The self-association of the amphiphiles and the shape of the aggregates are discussed in terms of existing first-order approximative theories. PMID- 3663680 TI - Lateral electrical conduction along a phosphatidylcholine monolayer. AB - Lateral electrical conduction due to lipid-monolayers spread on the surface of pure water was observed under both d.c. and a.c. electrical fields. An apparent specific electrical conductivity is evaluated as high as approximately equal to 4.10(-2) mho/cm for the monolayer-water system of L-DPPC at 25 degrees C. Arrhenius plots of the apparent conductance show a deflection at a temperature corresponding to a crystalline-to-fluid phase transition of the surface monolayer. From the magnitude and temperature dependence of conductance and a comparison of results with those obtained by use of deuterated water, it is concluded that enhanced protonic conduction mediated by a network consisted of polar head groups of phosphatidylcholines and water molecules may be brought about near the lipid/water interface. PMID- 3663681 TI - The preparation and properties of immobilised dipeptidyl-aminopeptidase I (cathepsin C). AB - Dipeptidyl-aminopeptidase I (dipeptidyl-peptide hydrolase, EC 3.4.14.1) from bovine spleen has been immobilized by hydrophobic bonding to alkyl- or aryl Sepharoses. Optimum binding occurred with octyl- and phenyl-Sepharoses. The activity of the immobilised dipeptidyl-aminopeptidase I has been determined using glycylarginyl-p-nitroanilide as substrate and the pH optimum of the immobilised enzyme determined as well as the stability of the enzyme to repeated use. Preliminary studies using immobilised dipeptidyl-aminopeptidase I for the digestion of methionine enkephalin have been carried out using reverse-phase HPLC to analyse the reaction. PMID- 3663682 TI - Time-domain reflectrometry studies of water binding and structural flexibility in chymotrypsin. AB - Time-domain dielectric spectroscopy has been employed to probe the hydration properties and structural flexibility of chymotrypsin (EC 3.4.21.1). The dielectric properties of the hydrated protein above 100 MHz have been used to identify two categories of protein-bound water, the first being irrotationally bound to the protein with a second, relatively weakly bound, having a rotational freedom comparable with that of normal bulk water. A dielectric dispersion observed, centred at 12 MHz, has been attributed to the relaxation of the polar components of the protein structure. This dielectric loss became increasingly significant above a transition in the hydration dependence, where water is relatively weakly bound to the chymotrypsin. This is discussed in terms of the formation of water clusters on the protein surface which screen electrostatic interactions between protein-charged groups. PMID- 3663683 TI - The engineering of a more thermally stable lactate dehydrogenase by reduction of the area of a water-accessible hydrophobic surface. AB - A site-directed mutant of Bacillus stearothermophilus lactate dehydrogenase (lactate:NAD+ oxidoreductase, EC 1.1.1.27) has been engineered in which the conserved hydrophobic residue isoleucine-250 has been replaced by the more hydrophilic residue asparagine. This isoleucine forms a large part of a water accessible, hydrophobic surface in the active site of the apo-enzyme which is covered by the B-face of the nicotinamide ring when coenzymes are bound. Reduction in the area of this hydrophobic surface results in the mutant tetramer being more thermally stable than the wild-type enzyme. PMID- 3663684 TI - Conformational changes in concanavalin A associated with demetallization and alpha-methylmannose binding studied by Fourier transform infrared spectroscopy. AB - Infrared spectra of concanavalin A have been obtained both in the absence and in the presence of the metal ions, Mn2+ and Ca2+, and the saccharide, alpha methylmannose. Second derivative calculations have been used to determine the frequencies of the different amide I and II components. In the demetallized protein dissolved in H2O buffer, absorptions in the amide I, II and III regions at 1695 and 1634, 1532 and 1237 cm-1, respectively, are assigned to beta structure, while absorptions at 1563 and both 1318 and 1343 cm-1 are assigned to turns and bends. After deuterium exchange, the residual amide II maximum in the difference spectrum shifts from 1538 to 1563 cm-1, indicating that exchange is faster in the beta-structure than in the turns. In the presence of Mn2+ and Ca2+, the amide II band component at 1532 cm-1 shifts 4-6 cm-1 to higher wavenumbers, and the amide I band component at 1634 shifts 1 cm-1 in the same direction, both in H2O and 2H2O buffers, suggesting changes in the hydrogen-bonding network of a large portion of the protein, particularly in the beta-sheet regions. The addition of alpha-methylmannose increases the magnitude of exchange from 55% to above 90%. Comparison with existing X-ray crystallographic data has been made, and the usefulness of FT-IR to complement this technique is discussed. PMID- 3663685 TI - The use of folding patterns in the prediction of protein topologies. AB - We proved previously that the distribution of formation energies which may be associated with the predicted secondary structures (or nuclei) is specific of the folding process (Busetta, B. 1986, Biochim. Biophys. Acta 870, 327-338). We developed a new predictive algorithm for protein topologies, based on the search of standard 'folding patterns'. In another manner, the strongest predicted nuclei are used to propose a fast sequence-alignment process which is efficient for distantly related proteins. PMID- 3663686 TI - The roles of conserved aromatic amino-acid residues in the active site of human lysozyme: a site-specific mutagenesis study. AB - In order to probe the roles of Tyr-63, Trp-64 and Trp-109 in the active site of human lysozyme (peptidoglycan N-acetylmuramoylhydrolase, EC 3.2.1.17), six human lysozymes containing a mutation, Tyr-63 to Leu, Trp-64 to Phe or Tyr, Trp-109 to Phe or Tyr, and Glu-35 to Asp, were newly synthesized and their immunological and enzymatical activities were examined in comparison with the native enzyme. Enzymatic characterization indicated: (i) that the existences of an aromatic residue at position 63 and a tryptophan residue at position 64 are essential for the effective hydrolysis of glycol chitin substrate, but not for the lysis of bacterial substrate; (ii) that the conversion of Trp-109 to Phe or Tyr reduces the maximal velocity of the lytic reaction to 25% of the wild-type enzyme; however, the apparent affinity constant is not affected. Further, the difference between the activity against the charged substrate and that against the non charged substrate was discussed from a viewpoint of the electrostatic interaction between enzyme and substrate. PMID- 3663687 TI - Structural differences between blood-platelet tubulin and other mammalian tubulins. AB - Carboxymethylated pig blood-platelet tubulin subunits have been characterized by comparing their electrophoretic mobilities and two-dimensional tryptic peptide maps with those of tubulin subunits isolated from four other mammalian tissues. These were pig brain, pig lung, pig sperm and bovine kidney. In addition to the major blood-platelet alpha- and beta-tubulin subunits, minor alpha- and beta components could be resolved on sodium dodecyl sulphate-polyacrylamide gel electrophoresis. The major blood-platelet beta-tubulin, as well as the minor brain beta 2-tubulin subunit, were clearly tissue specific. In both cases, their two-dimensional peptide maps contained unique heavily labelled peptides. Distinct peptide maps were also observed for the major blood-platelet alpha-tubulin subunit as well as for sperm tail alpha-tubulin, both of which were missing peptides (different in each case) that were present in all of the other alpha tubulin maps. Under our conditions, a protein with a molecular weight of 70,000 and an isoelectric point of pH 6.4 co-purified with blood-platelet microtubules. PMID- 3663688 TI - Toxicity domain in presynaptically toxic phospholipase A2 of snake venom. AB - About 42 complete amino-acid sequences of phospholipases A2 (phosphatidylcholine 2-acylhydrolase, EC 3.1.1.4) are known, including those of 13 presynaptically toxic enzymes, but the structural features responsible for the neurotoxicity and distinguishing the toxins from the non-neurotoxic enzymes are far from being clear. In this study, we examined the charged-residue distributions and hydrophobic characteristics based on the sequence data and the predicted tertiary structure and proposed a possible toxicity domain. We found that the presynaptically toxic enzymes have three or four more basic amino-acid residues than the non-neurotoxic enzymes at positions 59, 60, 65, 70-73 and 97 or 98. These residues appear to cluster near the surface region at the N-terminal side. The cationic nature of this basic cluster in the toxin is enhanced by the alpha amino group of the N-terminus and the dipole moment of helices 96-110 and 1-10. Moreover, these toxic-site residues are usually associated with hydrophobic regions at 1-7, 64-81 and 97-109. PMID- 3663690 TI - Characterization of the small hydrophobic proteins associated with pulmonary surfactant. AB - Lipid extracts of bovine pulmonary surfactant, which retain many of the biophysical characteristics of natural surfactant, contain approx. 98% lipid and 2% protein, as determined by amino acid analysis. Polyacrylamide/urea gel electrophoresis reveals that lipid extract surfactant contained a major apoprotein band with apparent Mr 3500 and minor apoprotein bands with apparent Mr 15,000 and 7000. After reduction, the 15 kDa band disappears and is replaced by a prominent band with apparent Mr = 5000. Reduction also results in a relative diminution of the 7 kDa band and a relative increase in the intensity of the 3.5 kDa band. Edman degradation reveals two major peptide sequences which have been designated surfactant-associated peptide (N-terminal Phe) and surfactant associated peptide (N-terminal Leu) and a minor sequence designated surfactant associated peptide (N-terminal Ile). The latter surfactant-associated peptide appears to be related to the N-terminal Leu peptide but lacks the terminal Leu. N Terminal analysis by dansylation demonstrates that the 15 and 5 kDa (reduced) apoprotein species contain N-terminal Phe, Leu and Ile. The 3.5 and 7 kDa bands contain only N-terminal Leu and Ile. Chromatography of lipid extracts on silicic acid columns gives rise to fraction I, which contains protein and phosphatidylglycerol, and fraction II, which contains protein, phosphatidylglycerol and phosphatidylethanolamine. Fraction I was primarily composed of the 15-kDa apoproteins, while fraction II contained mainly the 3.5 and 7 kDa apoproteins. Both fractions exhibited biophysical activity after reconstitution with dipalmitoylphosphatidylcholine. These results indicate that lipid extracts contain an oligomer of 15 kDa containing surfactant-associated peptide (N-terminal Phe) and surfactant-associated peptides (N-terminal Leu or Ile) which interact through sulfhydryl and perhaps other bonds. Lipid extracts also contain 3.5 kDa monomers of surfactant-associated peptides with N-terminal Leu and N-terminal Ile which can dimerize through sulfhydryl and perhaps hydrophobic interactions. PMID- 3663689 TI - Triton X-100 promotes the accumulation of phosphatidic acid and inhibits the synthesis of phosphatidylcholine in human decidua and chorion frondosum tissues in vitro. AB - Triton X-100 is known to affect phospholipid metabolism and the generation of various signal molecules from cellular phospholipids. In the present work the effect of Triton X-100 on phospholipid metabolism of human decidua and of the primordial placenta (chorion frondosum) was studied. Triton X-100 (0.05%, v/v) added to tissue mince 30 min before the end of a 60 min incubation stimulated 2-4 fold (decidua) and 4-6-fold (placenta) the incorporation of [32P]phosphate ([32P]Pi) into phosphatidic acid, while markedly decreasing the labeling of phosphatidylcholine. Triton X-100 had no effect on the labeling of phosphatidylinositol in the decidua, and only a slight increase was observed in the placenta. When labeled glucose was used to assess phospholipid synthesis, the addition of Triton had no effect on phosphatidic acid, while decreasing the synthesis of phosphatidylcholine. Incorporation of [32P]Pi into phosphatidic acid was not accelerated by a submicellar concentration (0.01%) of Triton, whereas the synthesis of phosphatidylcholine was decreased irrespective of detergent concentration. Anionic or cationic detergents could not mimic the action of Triton on phosphatidic acid synthesis. Although Triton inhibited the synthesis of ATP in a dose-dependent manner, this could not account for the above results. Instead, it is suggested that diacylglycerol kinase and phosphocholine:CTP cytidylyltransferase are possible targets of the action of Triton X-100. PMID- 3663691 TI - Kinetics of the inactivation of the protein-lipid complex, firefly luciferase, by sodium deoxycholate and its reactivation by phosphatidylcholine. AB - Firefly luciferase has been shown to be a protein-lipid complex. Phospholipids and neutral lipids bound to luciferase have been identified. Sodium deoxycholate rapidly inactivated the enzyme, but an excess of phosphatidylcholine recovered luciferase activity. From the kinetics of inactivation and reactivation, a mechanism for interaction of the enzyme with detergents and phospholipids has been proposed. The substrates ATP and Mg2+ stabilized luciferase during delipidation. PMID- 3663692 TI - Hydrolysis of stereoisomeric alpha-tocopheryl acetates catalyzed by bovine cholesterol esterase. AB - The kinetics of the bovine cholesterol esterase-catalyzed hydrolysis of three stereoisomers of alpha-tocopheryl acetate (alpha T-Ac) have been examined in vitro at 37 degrees C in the presence of dimyristoylphosphatidylcholine and sodium cholate. In contrast to in vivo results obtained earlier in rats (Ingold, K.U., Burton, G.W., Foster, D.O., Hughes, L., Lindsay, D.A. and Webb, A. (1987) Lipids 22, 163-172), 2R,4'R,8'R-alpha T-Ac (RRR-alpha T-Ac) is hydrolyzed (to form 'natural' vitamin E) more slowly (by a factor of approx. 7) than SRR- (and SSS-)alpha T-Ac. It is concluded that chirality at position 2 plays the dominant role in determining Vmax. The Km values show that RRR-alpha T-Ac is 2.1- and 2.7 times more strongly bound to the enzyme than are the SRR- and SSS-alpha T-Ac, respectively. The reaction is subject to competitive inhibition by the product with RRR-alpha T being 2.3-times as powerful an inhibitor as SRR-alpha T. PMID- 3663693 TI - A new relationship between cholesterolemia and cholesterol synthesis determined in rats fed an excess of cystine. AB - The present study deals with an attempt to describe how the plasma cholesterol level is related to input into the plasma of cholesterol synthesized in the liver and in the intestine. It has previously been shown in our laboratory that, for a given absorption of alimentary cholesterol, the rat plasma cholesterol level decreases when internal secretion of cholesterol (cholesterol synthesized in the organs and poured into the plasma) increases. This relationship was established using rats in which the major source of cholesterol synthesis was the intestine. We used rats fed a cystine-enriched diet (5%) which was previously shown to increase cholesterolemia and internal secretion of cholesterol. It was first demonstrated that a significant positive linear correlation exists between individual values of cholesterolemia and those of internal secretion of cholesterol. Secondly, using [14C]acetate as the cholesterol precursor it was shown that ingestion of the cystine-enriched diet increased hepatic but not intestinal cholesterogenesis. Individual values of cholesterolemia were linearly correlated to those of [14C]acetate incorporation into the hepatic sterols. Results obtained by this method were validated by determining the 13C-labeling pattern of cholesterol synthesized de novo by the liver and the intestine after [13C]acetate infusion. Indeed, this labelling indicated that the dilution of exogenous acetyl-CoA in the liver was not changed by cystine feeding, whereas that in the intestine was enhanced. It is concluded that the plasma cholesterol level varies with internal cholesterol secretion, depending on the organ which determines the variations of this secretion: it decreases when intestinal cholesterogenesis increases, whereas it increases when hepatic cholesterogenesis increases. Finally, the use of [14C]acetate coupled with lipoprotein analysis in rats fed the cystine-enriched diet, in control rats and in rats fed a cholesterol enriched diet, allowed a new linear correlation to be demonstrated: between cholesterol concentration in LDL2 (lipoproteins of density 1.040-1.063 g/ml) and [14C]acetate incorporation into liver sterols. Our results suggest that LDL2 are produced by the liver in relation to cholesterogenesis in this organ. PMID- 3663695 TI - Conversion of sterols and triterpenes by mycobacteria. II. Transformation of 7 oxygenated sterols into androstane derivatives via a 7-deoxygenation. AB - The bioconversion of 7-oxygenated sterols by Mycobacterium aurum was studied in a preliminary investigation of the microbial conversion of wool wax. 7 Oxocholesterol was found to be transformed mainly into 3,17-dioxygenated androstane derivatives. 7 xi-Hydroxylated sterols were formed in an initial reduction step, and the C-7 hydroxyl group was then eliminated in a dehydration reaction. This was thought to take place during the isomerisation of cholest-4-en 3-one to cholest-5-en-3-one. Deuterium labelling experiments showed that this elimination proceeded faster for the C-7 alpha isomer, although it was not stereospecific. The C-7 alpha and C-7 beta-hydroxy isomers were weakly interconverted via the 7-oxo derivatives. Cholest-4-en-3-one, cholest-1,4-dien-3 one and cholest-4,6-dien-3-one all lost their side chains following a hydrogenation/dehydrogenation reaction. The resulting 3,17-dioxoandrostene or 3,17-androstadiene derivatives were mainly hydrogenated into 5 alpha-androstane 3,17-dione and 5 alpha-androstane-3 beta-ol-17-one. Elimination of the 3 beta hydroxyl groups giving cholesta-3,5-dien-7-one, and subsequent microbial degradation of the side chain was not observed to any significant extent. The convergence of the bioconversion pathways of cholesterol and the 7-oxygenated cholesterols enabled crude, partially auto-oxidised cholesterol to be used as a substrate for the production of 3,17-dioxygenated androstane derivatives by M. aurum. PMID- 3663694 TI - Deprivation and repletion of androgen in vivo modifies triacylglycerol synthesis by rat hepatocytes. AB - Given the same quantity of fatty acid, livers from male rats esterify less fatty acid and secrete less triacylglycerol in very-low-density lipoprotein than do livers from female animals. To elucidate the role of testosterone in maintenance of this male pattern, conversion of [1-14C]oleic acid into triacylglycerol was assessed in vitro by rat hepatocytes (male) following gonadectomy and replacement with testosterone. Following castration, incorporation of fatty acid into triacylglycerol was increased. In contrast, esterification of exogenous fatty acid into phospholipid, cholesteryl esters, and diacylglycerol was unchanged. Treatment with testosterone (75 micrograms/day) reduced incorporation of exogenous fatty acid into triacylglycerol. Higher doses of testosterone (200 or 100 micrograms/day) modified the effect, such that inhibition was observed only at low oleate (0.5 mM) concentrations. At higher substrate concentrations (1.0 2.0 mM) the inhibitory effect was no longer observed. Further, a similar dose dependent effect of testosterone was observed following in vivo treatment of castrate females with testosterone. These data support the concept of a regulatory role of testosterone in hepatic triacylglycerol synthesis. These findings also demonstrate a biphasic effect of testosterone, an effect that is dependent not only upon the dose of testosterone administered, but also on the concentration of fatty acid to which the hepatocyte is exposed in vitro. PMID- 3663696 TI - Time course of dolichol and dolichyl phosphate during chemical carcinogenesis in rat liver. AB - Hyperplastic liver nodules were induced in rats by administration of an initiator (diethylnitrosamine or 3'-methyl-4-dimethylaminoazobenzene) and/or a promoter (phenobarbital) by the method reported by Tatematsu et al. (1983, Carcinogenesis 4, 381-386). The dolichol content in the liver and liver microsomes of the rats treated with the initiator were approx. 1.5-times higher than that of the control and rats treated with only the promoter. However, the composition of dolichols was not changed. The time course of the dolichyl phosphate concentration in the rat liver treated with both initiator and promoter showed a pattern different from that in the control liver, the initiator-treated liver or the promoter treated liver. The main component of dolichyl phosphate in liver treated with both the initiator and promoter changed from that with 18 isoprene units to that with 19. It is suggested that the changes in liver dolichols and dolichyl phosphates may be related to the formation of hyperplastic liver nodules. PMID- 3663697 TI - Altered function and structure of low-density lipoprotein receptor in compactin (ML236B)-resistant mutants of Chinese hamster cells. AB - Mutants resistant to compactin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, have been previously isolated from the Chinese hamster V79 cell line. Two compactin-resistant mutants, MF-1 and MF-2, show altered responses to human low-density lipoprotein (LDL). Accumulation of fluorescent-labeled LDL was much reduced. Ligand blotting showed LDL receptor activity in MF-1 and MF-2 cells of about one half to one third that of V79. Internalization and degradation of LDL in MF-1 or MF-2 cells were about one tenth those in V79 cells, suggesting that the LDL binding as well as the LDL internalization of the compactin resistant clones was altered. Down-regulation of LDL receptor activity as well as hydroxymethylglutaryl CoA reductase was observed in V79 cells treated with LDL, while there appeared to be much less down-regulation in MF-1 and MF-2 cells. Using anti-LDL receptor antibody, MF-1 and MF-2 cells were found to produce smaller-sized mature forms of LDL receptor: the molecular mass of the mutant LDL receptor was 3-5 kDa smaller than that of the parental LDL receptor. Altered O linked oligosaccharides or amino acid sequence might account for the decreased molecular mass and aberrant properties of the LDL receptor in MF-1 and MF-2. PMID- 3663698 TI - Origin and fate of rat plasma cholesterol in vivo. Modelling of cholesterol movements between plasma and organs. AB - A cholesterol system model was developed in the rat following a single injection of red cells containing free (unesterified) [3H]cholesterol. The radioactivity of free and esterified cholesterol in the different parts of the system was measured during the 48 h following tracer introduction. The model consisted of seven compartments (red cell free cholesterol, plasma and liver free and esterified cholesterol, total cholesterol in the rapidly and slowly exchangeable carcass pools). The model was validated by the similarity between simulated and experimental values during the 48 h following tracer introduction. Both the fractional rate of cholesterol esterification in the plasma (0.44 h-1) and liver (0.01 h-1) and the fractional exchange rate of free cholesterol from the plasma towards the various organs (particularly 3 h-1 towards the liver for a total of 7 h-1) can be estimated with this model. The results show that cholesterol movements between the plasma and the different organs take place mainly through intense free cholesterol exchanges, resulting in a low net flux. PMID- 3663699 TI - Subcellular distribution and biosynthesis of rat liver gangliosides. AB - Gangliosides have generally been assumed to be localized primarily in the plasma membrane. Analysis of gangliosides from isolated subcellular membrane fractions of rat liver indicated that 76% of the total ganglioside sialic acid was present in the plasma membrane. Mitochondria and endoplasmic reticulum fractions, while containing only low levels of gangliosides on a protein basis, each contained approx. 10% of total ganglioside sialic acid. Gangliosides also were present in the Golgi apparatus and nuclear membrane fractions, and soluble gangliosides were in the supernatant. Individual gangliosides were non-homogeneously distributed and each membrane fraction was characterized by a unique ganglioside composition. Plasma membrane contained only 14 and 28% of the total GD1a and GD3, respectively, but 80-90% of the GM1, GD1b, GT1b and GQ1b. Endoplasmic reticulum, when corrected for plasma membrane contamination, contained only trace amounts of GM1, GD1b, GT1b and GQ1b, but 11 and 5% of the total GD1a and GD3, respectively. The ganglioside composition of highly purified endoplasmic reticulum was similar. Ganglioside biosynthetic enzymes were concentrated in the Golgi apparatus. However, low levels of these enzymes were present in the highly purified endoplasmic reticulum fractions. Pulse-chase experiments with [3H]galactose revealed that total gangliosides were labeled first in the Golgi apparatus, mitochondria and supernatant within 10 min. Labeled gangliosides were next observed at 30 min in the endoplasmic reticulum, plasma membrane and nuclear membrane fractions. Analysis of the individual gangliosides also revealed that GM3, GM1, GD1a and GD1b were labeled first in the Golgi apparatus at 10 min. These studies indicate that gangliosides synthesized in the Golgi apparatus may be transported not only to the plasma membrane, but to the endoplasmic reticulum and to other internal endomembranes as well. PMID- 3663700 TI - Metabolism of all-trans-retinol and all-trans-retinoic acid in rabbit tracheal epithelial cells in culture. AB - As reported previously squamous cell differentiation of rabbit tracheal epithelial (RTE) cells in culture is a multi-step process. This program of differentiation is inhibited by retinoic acid and retinol; retinoic acid is about 100 times more effective than retinol. To examine the metabolism of these agents in this in vitro model system, RTE cells were grown in the presence of all-trans [3H]retinol or all-trans-[3H]retinoic acid and their metabolites analyzed by high pressure liquid chromatography. RTE cells converted most of the retinol to retinyl esters, predominantly retinyl palmitate. A small fraction was metabolized to polar compounds, one of which coeluted with retinoic acid. After methylation this compound eluted as 13-cis-methyl retinoate and as all-trans-methyl retinoate. Conversion to 13-cis-retinol was also observed. All-trans-retinoic acid was rapidly taken up by RTE cells and converted to more polar (peak 1) and less polar (peak 3) metabolites. A proportion of all-trans-[3H]retinoic acid was metabolized to 13-cis-[3H]retinoic acid. These metabolic reactions appeared to be constitutive and were not induced by pretreatment with retinoic acid. The peak 1 metabolites were rapidly secreted into the medium whereas the peak 3 metabolites were retained by the cells and were not detected in the medium. Alkaline hydrolysis of the metabolites in peak 3 yielded retinoic acid, indicating the formation of retinoyl derivatives. Our results establish that RTE cells can convert all-trans-retinol to 13-cis-retinol and retinoic acid. RTE can metabolize all-trans-retinoic acid to 13-cis-retinoic acid and to an unidentified ester of retinoic acid. PMID- 3663701 TI - Nephrotoxicity and its prevention by vitamin E in ferric nitrilotriacetate promoted lipid peroxidation. AB - Iron and aluminum complexes of nitrilotriacetic acid cause severe nephrotoxicity in Wistar rats. In addition, a high incidence of renal cell carcinoma is seen in ferric nitrilotriacetate-treated animals. The present study was performed to see if lipid peroxidation is involved in ferric nitrilotriacetate toxicity. Ferric nitrilotriacetate had more bleomycin-detectable 'free' iron than any ferric salt, while iron complexed with desferrioxamine or ferric chondroitin sulfate had none. The toxicity of ferric nitrilotriacetate in vivo was more pronounced in vitamin E deficient rats. A thiobarbituric acid-reactive substance was present in the kidneys of vitamin E-deficient rats in amounts markedly elevated compared to vitamin E-sufficient, or vitamin E-supplemented rats. Non-complexed nitrilotriacetate or aluminum nitrilotriacetate did not produce any thiobarbituric acid-reactive substance in vitamin E-sufficient rats died by the 58th day of administration. We suggest that the iron-stimulated production of free radicals leading to lipid peroxidation is the major cause of ferric nitrilotriacetate-mediated renal toxicity. Vitamin E, a known scavenger of free radicals, is effective in protecting against this iron-induced toxicity. PMID- 3663702 TI - Isolation and characterization of a novel monoacylated glucopyranosyl neutral lipid from the plasma membrane of Acholeplasma laidlawii B. AB - The level of a normally minor component of the membrane polar lipids of Acholeplasma laidlawii B was significantly increased when the glucose supplement in the growth medium was reduced. Under such glucose-limiting conditions the proportion of this component was found to be dependent upon the fatty acid supplement and could approach 55-60% of the total polar lipids when palmitic acid was used to supplement the growth medium. A number of physical measurements, along with specific chemical and enzymic degradation studies followed by a careful analysis of the degradation products, enabled us to tentatively identify this lipid as a polyprenyl-alpha-D-glucoside with a long-chain fatty acid esterified to the 2-hydroxyl group of the sugar moiety. This lipid exhibited some unusual thermotropic phase properties and our observations suggest that it may not be easily miscible with the other membrane lipid components. The structure and physical properties of this unusual glycolipid also suggest that it may be capable of forming non-bilayer phases under physiologically relevant conditions. PMID- 3663703 TI - Lipid analysis of a novel type of cell secretion in the exocrine pancreas: the pancreasomes. AB - A novel type of cell secretion termed 'microvesicular secretion' has been described recently in the exocrine pancreas. According to this process, microvesicles are released by acinocytes in the pancreas acinar lumen. These microvesicles, identified as 'pancreasomes', were characterized by the presence of a major glycoprotein component originating in the exocrine acinar cell. In the present work, phospholipids of pancreasomes have been identified. Five classes of phospholipid were found: phosphatidylcholines, phosphatidylethanolamines, lysophosphatidylcholines, sphingomyelins and another minor class of ninhydrin positive phospholipid (phosphatidylserines or lysophosphatidylethanolamines). The ratios of neutral lipids to phospholipids were particularly high (3:1), as estimated by GLC of their fatty acid content. Analysis of fatty acid composition of pancreasomes lipids revealed a very high proportion of two saturated fatty acids, palmitic (40%) and stearic (24%), whereas two main unsaturated fatty acids, oleic (17%) and linoleic (8%), were found in smaller proportions. Differential scanning calorimeter studies on washed pancreasomes indicated that there was no lipid phase transition in their membrane, despite the absence of cholesterol. Our observations show that pancreasomes have an unusual lipid composition and confirm our previous conclusion based on protein analysis that the release of pancreasomes occurs according to an hitherto undescribed type of secretion, in which a glycoprotein is released associated with specific domains of the luminal plasma membrane. PMID- 3663704 TI - A 1H-NMR study of bilirubin IX alpha solubilization by cholate micelles: application of nuclear Overhauser effects. AB - The solubilization of bilirubin IX alpha in aqueous solution by sodium cholate micelles has been examined by 270 MHz 1H-NMR spectroscopy. Incorporation of bilirubin into the micelles is accompanied by specific shifts of bilirubin vinyl and bridgehead protons and the C18 and C19 methyl groups of the steroid. The observed chemical shifts show a monotonic concentration dependence suggesting that changes in aggregation size are continuous. Nuclear Overhauser effects (NOE) have been shown to be a useful probe or micellization. A 4:1 cholate/bilirubin mixture has been investigated by difference NOE spectroscopy. The observation of intermolecular nuclear Overhauser effects between peripheral protons of bilirubin and cholate are diagnostic of spatially proximate groups. Inter-cholate nuclear Overhauser effects increase in magnitude upon bilirubin incorporation suggesting closer packing of steroid molecules on solubilization of the pigment. Intramolecular nuclear Overhauser effects observed for solubilized bilirubin are consistent with a compact intramolecularly hydrogen-bonded conformation resembling that determined for bilirubin in the solid state. PMID- 3663705 TI - Characterization and comparison of lipids in different squid nervous tissues. AB - We have studied the lipid composition of brain (optic and cerebral lobes), stellate ganglia and fin nerves of the squid. Cholesterol, phosphatidylethanolamine and phosphatidylcholine were the major lipids in these nervous tissues. Phosphatidylethanolamine contained about 3% of its amount in [corrected] plasmalogen form. Phosphatidylserine and -inositol, sphingomyelin and ceramide 2-aminoethylphosphonate were also present in significant amounts. In addition, cardiolipin and free fatty acids were detected in brain (each 2-3% of total lipids) and stellate ganglia (about 1% each), but not in fin nerves. Phosphatidylethanolamine, phosphatidylserine and phosphatidylinositol from brain contained large amounts of polyunsaturated fatty acids, namely 20:4, 20:5 and 22:6 in the n-3 family. On the other hand, phosphatidylcholine, cardiolipin, and sphingomyelin, and ceramide 2-aminoethylphosphonate contained only saturated or monounsaturated C16-C18 fatty acids. The aldehyde moieties of ethanolamine plasmalogen were also C16-C18 saturated or monounsaturated. These lipid compositions are compared with those in other invertebrate nervous systems. PMID- 3663706 TI - Anomeric specificity of liver glycogenolysis. AB - In rat liver slices incubated in the absence of exogenous D-glucose, both the basal and glucagon-stimulated output of D-glucose resulted in the production of a greater relative amount of alpha-D-glucose than that found at anomeric equilibrium. Comparable results were obtained in isolated hepatocytes. In these experiments, the rate of glycogenolysis largely exceeded that of glycogen synthesis. These findings indicate that liver glycogenolysis represents an alpha stereospecific process. PMID- 3663707 TI - Alkali-labile oligosaccharide units of a sialoglycoprotein from rabbit erythrocyte membranes. AB - Two glycoproteins (apparent molecular weights 120,000 and 70,000) were extracted from rabbit erythrocyte membranes, and only one (Mr 120,000), which is a sialoglycoprotein, contained O-glycosidically linked sugar chains. Alkali-labile oligosaccharide units of the sialoglycoprotein were released as reduced oligosaccharides by NaOH-NaB3H4 treatment, and then purified by gel filtration on a Bio-Gel P-4 column followed by ion-exchange chromatography. From the results of methylation analysis, mass spectrometry and chromium trioxide oxidation, the main oligosaccharide unit was determined to be a linear trisaccharide (85% by weight), NeuNGc alpha(2----3)Gal beta(1----3)GalNAcol. In addition, small amounts of a tetrasaccharide (11% by weight) and a disaccharide (4% by weight) were found, which were determined to have the following structures, NeuNGc alpha(2----3)Gal beta(1----3)[NeuNGc alpha(2----6)] GalNAcol and Gal-GalNAcol, respectively. PMID- 3663708 TI - Amino acid sulfur as a source of sulfate for sulfated proteoglycans produced by Swiss mouse 3T3 cells. AB - The uptake of sulfate by Swiss mouse 3T3 cells is blocked in the presence of 1 mM 4-isothiocyano-4'-acetamido-stilbene-2,2-disulfonic acid (SITS). In the absence of an exogenous source of sulfate, glycosaminoglycans produced by cells in the presence of the inhibitor are sulfated to the same extent as those produced by cells grown in its absence. The sulfate utilized in the absence of medium sulfate has been identified as that produced by the oxidation of the sulfur present in the amino acids cysteine and methionine. This finding indicates that, under conditions of restricted exogenous sulfate, caution is needed in the interpretation of data obtained with the use of [35S]methionine and/or [35S]cysteine as a general protein label, since both tyrosine and a variety of types of protein-linked carbohydrate chains may be modified by sulfation. PMID- 3663709 TI - Ileal absorption of tyrosine-conjugated bile acids in Wistar rats. AB - We recently reported that tyrosine-conjugated bile acids, when injected intravenously into bile-fistula rats, are extracted by the liver and secreted intact into bile with an efficiency similar to that seen for taurocholate. Now the effect of tyrosine and glycyltyrosine conjugation of bile acids on ileal absorption has been studied in Wistar rats. 125I-labelled tyrosine- and glycyltyrosine-conjugated bile acid or [14C]taurocholate was injected in 400 microliters aliquots of physiological saline buffered to pH 7.8 into the ileal lumen of bile-fistula rats. Recovery of bile salts in bile was taken as proof of ileal absorption. In comparison with taurocholate, ileal absorption was about 10% less for cholyltyrosine and chenodeoxycholyltyrosine and about 50% less for deoxycholyltyrosine. Thus, tyrosine-conjugated bile acids are absorbed by the ileum and excreted into bile and may undergo enterohepatic circulation. Low recoveries of deoxycholyltyrosine relative to deoxycholylglycine suggested that side chain structure was important for ileal absorption of 3 alpha,12 alpha dihydroxy bile acids. Elongation of cholic acid to form cholylglycyltyrosine markedly reduced 90-min cumulative ileal absorption relative to cholyltyrosine. Although initial rates of recovery of cholylglycyltyrosine were comparable to those of the other bile acids, very little further absorption was seen in the last hour of the experiment, suggesting that this compound was rapidly degraded within the intestinal lumen. PMID- 3663710 TI - A versatile procedure for the radioiodination of proteins and labeling reagents. AB - For tracer or analytical studies it is often useful to label proteins by direct iodination or by reacting them with an iodinated reagent. A simple iodination technique with hydrogen peroxide is described for use with either carrier-free or low-specific-activity iodine. The method introduces less oxidative damage to proteins than any other procedure tested, yet the efficiency of labeling approaches that offered by the chloramine T or Iodogen methods. The method has been applied to the facile and inexpensive preparation of the iodinated Bolton Hunter reagent. This peroxide iodination procedure should be particularly useful for labeling proteins or peptides for structural investigations or for immunoassays. PMID- 3663711 TI - Modification of the glyoxalase system during the functional activation of human neutrophils. AB - The glyoxalase system catalyses the metabolism of methylglyoxal to D-lactic acid, via the intermediate S-D-lactoylglutathione. It is present in human neutrophils and undergoes a significant modification during functional activation--induction of chemotaxis, phagocytosis and degranulation. During the activation of neutrophils with serum-opsonised zymosan and the tumour-promoting phorbol diester 12-O-tetradecanoylphorbol 13-acetate, the activity of glyoxalase I increases and the activity of glyoxalase II decreases by 20-40% of their activities in resting cells, in the initial 10 min of the activation period. Determination of the Michaelis constant, Km, and the apparent maximum velocity, Vmax, for these enzymatic reactions indicates that the change in activity is due to a non competitive activation and inhibition of glyoxalase I and glyoxalase II, respectively. This is consistent with a modification of the glyoxalase enzyme protein during the activation response. This modification occurs under aerobic and anaerobic incubation conditions. The concentration of S-D-lactoylglutathione increases approx. 100% of the resting cell concentration during the initial 10 min of the activation period. The presence of S-D-lactoylglutathione in neutrophils may be related to its ability to stimulate microtubule assembly. PMID- 3663712 TI - HgCl2-induced changes in cytosolic Ca2+ of cultured rabbit renal tubular cells. AB - Fura 2 was used to measure changes in cytosolic [Ca2+] ([Ca2+]i) in cultured rabbit kidney proximal tubule cells exposed to HgCl2. Treatment with 2.5-10 microM HgCl2 resulted in an extracellular [Ca2+] ([Ca2+]e)-independent 2- to 12 fold increase in [Ca2+]i above resting levels of about 100 nM. Treatment with 25 100 microM HgCl2 caused a rapid [Ca2+]e-independent 10- to 12-fold increase in [Ca2+]i within 1 min followed by a recovery to about 2-fold steady state by 3 min. With 25-100 microM HgCl2, both magnitude and rate of Ca2+ increase were similar, but recovery was greater with increasing doses. A slower, secondary increase in [Ca2+]i followed which varied with HgCl2 concentration and required [Ca2+]e. The first increase in [Ca2+]i represents release from intracellular pools. Calcium channel blockers, calmodulin inhibitors, and mitochondrial inhibitors do not alter the patterns of [Ca2+]i changes due to HgCl2. The recovery response with higher HgCl2 concentrations appears to be triggered by Hg2+ and not by the increased [Ca2+]i. Sulfhydryl modifiers N-ethylmaleimide, PCMB and PCMBS produced [Ca2+]e-independent [Ca2+]i increases similar to those induced by low HgCl2 concentrations. Cell killing with HgCl2 was about 50% greater with normal [Ca2+]e than with low [Ca2+]e, suggesting that [Ca2+]e influx is important in accelerating injury leading to cell death. PMID- 3663713 TI - Functional differentiation of alveolar type II epithelial cells in vitro: effects of cell shape, cell-matrix interactions and cell-cell interactions. AB - Alveolar type II epithelial cells rapidly lose characteristics of differentiated function when cultured on plastic dishes. We have attempted to circumvent this problem by culturing type II cells under conditions that might better reproduce their environment in vivo. Cell-matrix interactions were studied by culturing isolated adult rat type II cells on Engelbreth-Holm-Swarm (EHS) tumor basement membrane. Aggregates of type II cells formed on the surface of the matrix during 4 days in culture. Microscopic examination of these aggregates revealed cuboidal cells that retained more characteristics of differentiated type II cells than did cells cultured on plastic. Type II cells cultured on EHS matrix incorporated a higher percentage of acetate into phosphatidylcholine (PC) than did cells on plastic, and a higher percentage of this PC was saturated. Phosphatidylglycerol (PG) synthesis by these cells was no different from that seen in cells on plastic. The effects of cell-cell interactions and cell shape were evaluated by culturing type II cells on feeder layers that in turn were grown on collagen gels. The feeder layer cells included fetal rat lung fibroblasts, adult rat lung fibroblasts, fetal rat skin fibroblasts, bovine aortic endothelial cells, and rat mammary tumor epithelial cells. One-half of the gels remained attached to the culture dish and one-half of the gels were detached after 24 h and allowed to float free in the medium. Type II cells grown in association with any of the attached feeder layers became flattened and lost their differentiated phenotype. These cells incorporated no greater percentage of acetate into PC than did cells on plastic. Saturated PC synthesis was modestly increased. PG synthesis declined in parallel with that seen in cells cultured on plastic. Type II cells cultured on feeder layers that were detached assumed their native cuboidal shape and also exhibited many morphological characteristics of differentiated function. These cells incorporated a significantly greater percentage of acetate into PC compared to cells on either plastic or attached feeder layers. Saturated PC synthesis also increased markedly. These cells, however, incorporated no greater percentage of acetate into PG than did cells on plastic or attached feeder layers. These data suggest an important role for cell shape and cell-matrix interactions and maintenance of type II cell differentiation. The effects of cell-cell interactions, while beneficial, appear to be non-specific. PMID- 3663714 TI - Inhibition of platelet aggregation by unsaturated fatty acids through interference with a thromboxane-mediated process. AB - cis- and trans-unsaturated fatty acids with 18 carbon atoms (oleic, linoleic, elaidic and linolelaidic acid) inhibited aggregation of washed rabbit platelets stimulated with collagen, arachidonic acid and U46619 when in the same concentration ranges. Thrombin-induced aggregation was not affected by any of them. Saturated fatty acid (stearic acid) had no effect on this response. The inhibition is independent of the induced change in membrane fluidity, since trans isomers could not induce the change in fluorescence polarization of 1,6-diphenyl 1,3,5-hexatriene. Unsaturated fatty acids, except linoleic acid, did not interfere with the formation of thromboxane B2 from exogenously added arachidonic acid. All the unsaturated fatty acids only slightly inhibited the arachidonic acid liberation by phospholipase A2 in platelet lysate. This indicates that the unsaturated fatty acids may block a process after formation of thromboxane A2 in response to collagen and arachidonic acid. The increase in phosphatidic acid formation stimulated with U46619 was inhibited dose dependently by each of the unsaturated fatty acids but that stimulated with thrombin was not affected by any of them. Phospholipase C activity measured by diacylglycerol formation in unstimulated platelet lysate was not inhibited by the fatty acids. The elevation of cytosolic free Ca2+ induced by arachidonic acid or U46619 and Ca2+ influx by collagen were inhibited almost completely at the same concentration as that which inhibited their aggregation. These data suggest that the unsaturated fatty acids were intercalated into the membrane and inhibited collagen- and arachidonic acid induced platelet aggregation by causing a significant suppression of the thromboxane A2-mediated increase in cytosolic free Ca2+, probably due to interference with the receptor-operated Ca2+ channel. PMID- 3663715 TI - Calcium signals in neutrophils can be divided into three distinct phases. AB - Rabbit neutrophils were loaded with the fluorescence probe indo-1 and cytosolic free calcium levels were monitored during chemotactic peptide (fMet-Leu-Phe) stimulation. The fMet-Leu-Phe-induced calcium signal consisted of three consecutive phases: (1) an initial peak that was independent of extracellular calcium, (2) a secondary shoulder that required extracellular calcium but was totally blocked by hyperosmolality and (3) a final plateau of elevated calcium that was dependent on extracellular calcium but insensitive to hyperosmolality. PMID- 3663716 TI - Biological, immunological and biochemical characterization of cleaved prolactin generated by lactating mammary gland. AB - We have previously shown that rat prolactin is proteolytically cleaved in its loop by peripheral tissues of the rat. Of the tissues examined to date, lactating mammary gland exhibits the highest prolactin-cleaving activity. The objective of this study was to characterize cleaved prolactin, biologically, immunologically and chemically. By modifying an established analytical method, we were able to generate large (micrograms) amounts of cleaved rat prolactin from cell fractions of rat mammary gland which could then be assayed for biological and immunological activity relative to intact hormone. The cleaved product showed no significant difference relative to the intact rat prolactin when assayed for its ability to compete with 125I-labelled ovine prolactin for the prolactin receptor and for its ability to stimulate the proliferation of rat Nb2 lymphoma cells. Cleaved rat prolactin, however, did show a 50-60% reduction in activity relative to intact rat prolactin when assayed by radioimmunoassay. Using Edman degradation and partial amino acid analysis, we determined that the second N-terminus of the cleaved rat prolactin begins at amino acid 149. The divergence of biological and immunological activity produced by proteolytic cleavage in the loop of rat prolactin suggests that biological and immunological sites differ in location. The possible physiological implications of a cleaved rat prolactin molecule generated by target tissue with maintained biological activity and reduced immunological activity are discussed. PMID- 3663717 TI - Differential kinase systems are involved in the rapidly turning over phosphorylation of prominent nuclear proteins. AB - The activity of endogenous nuclear protein kinases has been probed in an vitro assay system of isolated nuclei from Chironomus salivary gland cells. The phosphorylation of a set of seven prominent rapidly phosphorylated non-histone proteins and of histones H3, H2A and H4 was analyzed using ATP or GTP as phosphoryl donor and heparin as protein kinase effector. The core histones H2A and H3 both incorporate 32P from [gamma-32P]ATP as well as from [gamma-32P]GTP but their phosphorylation is differentially affected by heparin. The phosphorylation of H2A is blocked by heparin while that of H3 is even stimulated in the presence of heparin when ATP is used as phosphate donor. H4 is unable to incorporate phosphate groups from GTP but its ATP-based phosphorylation is heparin sensitive. Of the non-histone protein kinase substrates, we could only detect two, the 44-kDa and 115-kDa proteins, which are heparin sensitive with either ATP or GTP and, thus, strictly meet the criteria for casein kinase type II specific phosphorylation. The investigated histones and non-histone proteins can be grouped into three broad categories on the basis of their phosphorylation properties. (A) Proteins very likely affected by casein kinase NII. (B) Proteins phosphorylated by strictly ATP-specific protein kinases. (C) Proteins phosphorylated by ATP as well as GTP utilizing protein kinase(s) other than casein NII. Category B proteins can be subdivided into proteins phosphorylated in a heparin-resistant (B1) and heparin-sensitive (B2) manner. The phosphorylation of category C proteins may be heparin sensitive with ATP only (C1), heparin sensitive with GTP only (C2), heparin insensitive with both ATP and GTP (C3) or stimulated by heparin (C4). PMID- 3663718 TI - Phorbol esters activate the pathway for phosphatidylethanol synthesis in differentiating HL-60 cells. AB - 12-O-Tetradecanoylphorbol 13-acetate (TPA) has been shown to induce the formation of an unusual acidic phospholipid, phosphatidylethanol, in HL-60 cells. The synthesis of this lipid is dependent upon the presence of ethanol in the culture medium of TPA-treated cells; however, other exogenous alcohols can substitute as headgroup precursors with the formation of the corresponding phosphatidyl alcohol. The activation of the pathway for phosphatidyl alcohol synthesis appears to be mediated through protein kinase C. Studies of the time-course for the synthesis and accumulation of phosphatidylethanol suggest a possible involvement of the pathway for phosphatidyl alcohol synthesis in the TPA-induced differentiation of HL-60 cells. PMID- 3663719 TI - [Calculation of the spectrum of dielectric losses in the protein-water system]. AB - The spectrum of dielectric losses in the frequency range up to microwaves for haemoglobin solution (Hb) in water was calculated. For humidified Hb the concentration relationships of epsilon components having a break of curve with water concentration exceeding some critical value were also determined. For three water fractions in the solution to be calculated the model of confined rotators was applied. The fractions of ice-like water, H2O molecules with weak H-bonds and protein-bound water were investigated. The protein molecules considered as a rigid rotator were calculated in terms of the extended diffusion model. A qualitative agreement with the experimental data was obtained. A possibility is shown of establishing relations between the Debye times in the dispersion regions beta, delta, gamma and the model parameters. The latter characterize the microscopic motion of polar molecules during the correlation time of the rotator angular velocity. PMID- 3663720 TI - [Thermostability of protein structure in the native state and mechanisms of its maintenance]. AB - A comparison of temperature changes of the protein spectra with temperature behavior of other systems with hydrogen bonds shows high thermostability of the functional active structure of protein molecules. The stability of proteins space organization is regulated and supported by non-monotonous temperature changes of this organization. The physical mechanism of thermostabilization includes interaction of hydrophobic radicals of protein with the aqueous environment. PMID- 3663721 TI - [Photoconformational relaxation of protein structure from the data of tryptophan fluorescence]. AB - It was shown that the decrease of polarization degree with increasing the wavelength of protein tryptophane fluorescence lambda f was caused by the lengthening of the lifetime tau. A considerable rotational nanosecond mobility of the internal tryptophanyls was observed. This mobility is not spontaneous but caused by photoexcitation. The increase of tau with lambda f is observed not only for multitryptophan proteins but also for monotryptophan ones and for DL tryptophane in glycerol. The increase of tau is caused by relaxation processes occurring in close proximity to tryptophane after its photoexcitation and reflects the photoinduced nanosecond mobility of the tryptophane microenvironment. Photoconformational relaxation of protein in the nanosecond time range and possible role of this process in photoinactivation of enzymes are discussed. PMID- 3663722 TI - [The Ising model for the description of allosteric kinetics of polymeric enzymes]. AB - A new class of models for the description of the complex allosteric kinetics of oligomeric enzymes has been offered. Its regulation can be realized at the expense of two types of the cooperative interactions. First, the cooperative interaction of the neighboring enzyme protomers is examined on the basis of one dimensional Ising model; second, subunits that compose the protomer are described by analogy with the model of indirect cooperation of Monod--Wyman--Changeux. The methods of statistical physics open approach to the unification of the models of allosteric regulation in the modern biochemistry. A detailed analysis of the one ligand model of the polymeric enzymes was performed and possible ways of its generalization were shown. PMID- 3663723 TI - [Uncoupled oxidation in rat heart mitochondria]. AB - Isolated heart mitochondria possessing a high phosphorylation efficiency with pyruvate and malate as substrates oxidize NADH and ascorbate unassociated with ADP phosphorylation. This uncoupled pathway is expressed partially when succinate or NAD-linked substrates are oxidized. The uncoupled oxidation is likely to be the result of the presence of a mitochondrial population with the high-permeable inner membrane in intact tissues. The nature and origin of a uncoupled respiratory system and its role in the thermoproduction of endotherms are discussed. PMID- 3663724 TI - [Interaction of natural and synthetic polynucleotides with liposomes in the presence of divalent cations]. AB - The formation of complexes of polynucleotides (DNA, poly A.poly U) with liposomes from egg lecithins, L-alpha-phosphatidylcholine, dimirystoyl and other lipids in the presence of divalent cations was studied by differential scanning microcalorimetry circular dichroism and turbidimetry. It was shown that the secondary structure of polynucleotides (double or triple helix) was necessary for the formation of these complexes. This structure was partially destroyed during formation of complexes. It was shown, that three main types of lipids, i.e. phosphatidylcholine, phosphatidylethanolamine and sphingomyelin participate in interactions between liposomes, polynucleotides and Mg2+. PMID- 3663725 TI - [Erythrocyte photohemolysis sensitized by chlorin e6]. AB - Hemolysis of human erythrocytes photosensitized by chlorophyll derivative- chlorin e6 has been studied. This process was found to be oxygen-dependent. High photodynamic activity of chlorin e6 is explained both by its specific binding with cells and by its photophysics parameters. PMID- 3663726 TI - [Circular dichroism of actin from denervated skeletal muscles]. AB - Method of circular dichroism did not indicate any changes of the secondary structure of globular and fibrillar actin from denervated skeletal muscles. The matter that some conformational changes of the aromatic residues do in fact accompany denervation was confirmed by fluorescence studies but not by CD spectra. PMID- 3663727 TI - [Study of the interaction between the organophosphorus insecticide GA-41 and model membranes using NMR-spectroscopy]. AB - Interaction between organophosphorous insecticide GA-41 and liposomes formed from lecithin and multilamellar dispersion from lecithin and cardiolipin mixture (molar ratio is 7:3) has been studied by 1H- and 31P-NMR spectroscopy. The results obtained showed that while interacting with model membranes the GA-41 molecules intercalate into the range of hydrocarbon chains of phospholipids. At certain concentration of GA-41 its molecules induce the formation of some defects on bilayer structure, leading to permeability for Pr3+ ions. PMID- 3663728 TI - [Magnetic susceptibility and the structure of liposomes]. AB - Magnetic susceptibility of single liposomes sized 1-10 m was measured. Solid magnetic susceptibility of lipid-egg lecithin equalling chi et = -(5.038 +/- 0.035) X 10(-7) e.m.u./cm3 was determined. The liposome susceptibility was shown to be proportional to the number of bilayers in it and to reflect its packing. PMID- 3663729 TI - [Quenching of singlet molecular oxygen by screening pigments-- melanins and ommochromes]. AB - Synthetic DOPA-melanin and natural screening pigments--sepiomelanin and ommochromes are shown to quench the luminescence of singlet molecular oxygen (1O2) in aqueous (D2O, pD = 7.5-8.1) solutions. The rate constants of 1O2 quenching are found to be equal to (1.2 +/- 0.6) 10(8) M-1 s-1 for monomeric units in DOPA-melanin and to (3 +/- 1) 10(6) M-1 s-1 for ommochromes. The data suggest that screening is not the only function of melanins, which may play a role of inhibitors of photodynamic damage in living tissues. PMID- 3663730 TI - [Effect of lipids on CO recombination with ferrocytochrome P-450]. AB - Using the flash photolysis technique the kinetics of recombination of carbon monoxide with ferrocytochrome P-450 LM-2 was investigated. Ferrocytochrome P-450 was incorporated into liposomes prepared from different lipids: from microsomal lipids, phosphatidylcholine from egg yolk, dipalmitoylphosphatidylcholine. It was found that the activity and structure of ferrocytochrome P-450 conformers is affected by the lipid microenvironment. The kinetics of the CO-binding is affected also by the nature of lipids. PMID- 3663731 TI - [Long-wave limit of visual reception]. AB - It is shown that the community of the eyesight red boundary and photosynthesis in plant processes is defined by the upper level of the sun energy flux density near the Earth. The entropy production rate in relation to irreversible processes of the eyesight is calculated. PMID- 3663732 TI - [Relation between the parameters of lipid peroxidation and the constant potential of the rat brain]. AB - Studies were carried out of the relationship between the constant potential level (CPL) and the intensity of lipid peroxidation (LP) of the brain membranes in rats with different motor asymmetry. Strong correlation was found between CPL and the content of LP products (diene conjugates, hydroperoxides and Schiff bases) in the hemispheres of the brain (R = 0.7-0.8). PMID- 3663733 TI - [Correlation between the level of fluorescent aging pigments in homogenates of the rat cerebral cortex and the constant brain potential during late ontogenesis]. AB - A strong correlation (R = 0.5 + 0.88) was found between the constant potential level of the rat brain and the content of aging pigments in the brain cortex homogenates. The latter was measured by synchronous scanning of luminescence in each hemisphere separately. PMID- 3663734 TI - [Principles of dissociation of complex spectra of biologically active substances into bands corresponding to separate electron transitions]. AB - General principles of spectroscopic deconvolution of complex spectra into bands that correspond to separate electronic transitions are considered. Any spectroscopic deconvolution should be based on a physical model. The absence of the physical model makes the deconvolution senseless. The methods of postulation of physical models and their refinement resulting from self-consistent deconvolutions are discussed. We have performed deconvolutions of absorption spectra of different ionic and tautomeric forms of pyridoxamine, pyridoxamine-5' phosphate, pyridoxal, pyridoxal-5'-phosphate, common nucleic bases and their nucleosides. The results of the above-mentioned deconvolutions, as well as the serviceable program that allows to carry out such deconvolutions and recommendations for its usage are presented. PMID- 3663735 TI - [Nonlinear laser photomodification of nucleic acids induced by intercalating dyes]. AB - Results of a cycle of investigations of two-quantum affinity modification of nucleic acids (NA) are presented. The modification is induced by laser excitation of chromophoric molecules which are in intercalative complexes with NA. The following subjects are considered: theoretical basis of the two-quantum affinity modification: experimental investigation of nonlinear scission of DNA; theory and experiment on the light--induced diffusion of DNA. The latter is an effect which accompanies the scission and allows one to obtain information on it. The modification specificity and universality in a dye type are established experimentally. Influence of free radicals, oxygen, heating and hydrodynamical phenomena in bulk are excluded. The modification has been shown to be dependent on NA structure (secondary and tertiary) and to provide information on it. Total aggregate of the data obtained is in agreement with the suggested modification mechanism which is based on the radiationless transfer of two-quantum excitation energy from the chromophore to NA. PMID- 3663736 TI - Psychological changes associated with self-regulatory treatments of irritable bowel syndrome. AB - The psychological "side effects" of self-regulatory treatment (a combination of relaxation, thermal biofeedback, and cognitive therapy) for irritable bowel syndrome (IBS) were compared among 20 "successfully" treated patients, 12 "unsuccessfully" treated patients, and 9 patients who merely monitored symptoms for 12 weeks. Pretreatment and posttreatment scores on the Beck Depression Inventory, State-Trait Anxiety Inventory, and Psychosomatic Symptom Checklist were examined. "Successfully" treated patients had significant (p less than .01) reductions on all measures and significantly greater reductions on depression and state anxiety than the symptom monitoring group. Interestingly, the failures also showed a significant (p = .027) reduction in trait anxiety and no significant increases on other measures. PMID- 3663737 TI - Effects of attention and slow potential shifts on self-regulation of event related potentials. AB - Research on the effects of self-regulation of slow potentials (SP) and event related potentials (ERP) has failed to look at the possible interactions of these two kinds of brain potentials. The present study investigated such interactions by recording both ERP and SP potential changes in an operant ERP conditioning paradigm. Ten subjects participated in two conditions that were designed to differentially manipulate attention to the stimuli. In the operant conditioning task, subjects received auditory feedback as they attempted to increase the ERP amplitude at 180 msec poststimulus (P180), which was elicited by a subpainful shock stimulus to the forearm over 250 trials. In the distraction task, subjects were instructed not to attend to stimuli or feedback tones, but rather received and were tested on reading materials. Attention, as manipulated by these tasks, was not a determinant of changes in ERP amplitude since there were no significant differences in the size of P180 between attention conditions. While no significant change in the mean ERP amplitude occurred, subjects were able to produce ERPs above criterion threshold significantly more often during trials in the conditioning task than in the reading task. Thus, there was evidence of some learning. The difference in wave forms between hit and miss trials indicates a latency shift (with misses having a later ERP peak). This may indicate that latency, rather than, or in addition to, amplitude, is shaped during conditioning procedures. In addition, the CNV that developed between the shock stimulus and the feedback signal during conditioning was significantly larger in amplitude than in the distraction condition. This is taken as evidence of increased attention during conditioning. Since hit trials demonstrated larger contingent negative variation (CNV) amplitudes, production of CNVs may be instrumental in mediating hits. Therefore, attentional mechanisms may play a role in successful ERP self-regulation. No correlations were found involving P180, CNVs, or tonic slow potential shifts. Changes in tonic DC levels showed a suggestive trend between conditions. Although both conditions began with a negative shift, during conditioning the negativity increased, while during distraction the tonic level went to positivity. These trends support the hypothesis that attention and arousal increased during conditioning. The possible reasons for the lack of significant correlations between ERP and tonic or phasic slow potential changes in this paradigm are discussed. PMID- 3663738 TI - The effectiveness of biofeedback-assisted relaxation in modifying sickle cell crises. AB - Eight outpatients with sickle cell disease received six EMG and six thermal half hour biofeedback training sessions. Statistically significant changes in the desired directions were obtained for the following variables: (a) frontalis muscle tension, (b) digital temperature, (c) frequency of headache as a crisis symptom, (d) frequency of analgesic use, (e) perceived pain intensity, (f) frequency of self-treated crises, and (g) state anxiety. Nonsignificant changes in hospital chart data were found. A 6-month posttreatment follow-up questionnaire revealed the continued effectiveness of the training received regarding headaches and mild pains. PMID- 3663739 TI - Adaptation of a multicomponent treatment for irritable bowel syndrome to a small group format. AB - We evaluated a multicomponent treatment program for IBS that had been adapted to a small-group format. Patient acceptance was satisfactory with 14 of 17 potential patients completing treatment. No reductions of GI symptoms were noted in a 12 week symptom-monitoring baseline phase; diarrhea became significantly worse. Treatment led to significant (p less than .05) reductions in abdominal pain and diarrhea. Nine of 14 (64.3%) patients were clinically improved. PMID- 3663740 TI - [Identification of receptors in a system of functionally heterogeneous proteins specifically bound to androgens in rat liver cytosol]. AB - The methods of androgen receptor (RA) isolation and identification in rat liver cytosol were studied. It was shown that male rat liver contains a system of specific androgen (A)-binding proteins consisting of at least three main components: RA, delta 4-androstendione (delta 4-A)-binding component and an unusual estrogen-binding protein interacting also with A and the first two components in females. The identity of one of A-binding components to RA was proved by cumulative properties of this component which are similar to those of RA from other tissues. These properties are as follows: 1) high values of apparent association constant, Ka, for 3H-R1881 (2.8 +/- 0.3 X 10(8) M-1) and 3H 5 alpha-dihydrotestosterone (3H-DHT) (5.0 +/- 0.4 X 10(8) M-1); 2) low binding capacity--approximately 10 fmol/mg of protein of nonfractionated cytosol; 3) pronounced specificity of affinity for active A (DHT, R1881, testosterone); 4) large size of the protein molecule (6.5 +/- 0.25 nm); 5) ability to decrease this size to 3.2 +/- 0.08 nm in a high ionic strength buffer; 6) precipitation at low concentrations of ammonium sulfate: 7) strong interaction with heparin-Sepharose. The properties of the delta 4-A-binding component do not coincide with those of RA: it has a low Ka for 3H-delta 4-A (1.15 +/- 0.5 X 10(6) M-1), a high binding capacity (1.22 +/- 0,12 pmol/mg of protein of nonfractionated cytosol) and can bind various delta 4-3-ketosteroids irrespective of the degree and nature of their biological activity. It was concluded that preliminary isolation of rat liver RA on heparin-Sepharose can be used for differential identification and characterization of this protein. PMID- 3663741 TI - [Kinetics of 15 alpha-methyl-8-aza-16-oxagona-1,3,5(10), 13-tetraen-17-ona oxidation by cytochrome P-450 from rat liver microsomes]. AB - The kinetics of oxidation of 15 alpha-methyl-8-aza-16-oxagona-1,3,5(10),13 tetraen-17-on with rat liver microsomal cytochrome P-450 was investigated. The kinetic parameters, Km and Vmax, of the oxidation reaction were found to be equal to 1,3 X 10(-4) M and 4.0 X 10(-7) M X s-1, respectively. Using thin-layer chromatography, mass-spectrometry, PMR-spectroscopy and reciprocal synthesis, it was shown that 3-hydroxy-15 alpha-methyl-8-aza-16-oxagona-1,3,5(10), 13-tetraen 17-on is the main reaction product. PMID- 3663742 TI - [New data on the molecular heterogeneity of brain-specific protein S100]. AB - A comparative study of distribution of labeled products of endogenous limited proteolysis of the "major" (MF) and "minor" (S100-26) fractions of proteins S100 from rat brain by ion-exchange chromatography was carried out with a view of testing the hypothesis on the formation of proteins S100 molecular associates as a possible cause of molecular weight heterogeneity of proteins S100. There is evidence that proteins S100-MF and S100-26 are different species of brain specific S100 proteins. The experimental results also suggest that the brain specific proteins S100-MF and S100-26 are adsorbed both by glial cells and by neurons. Some physico-chemical properties of peptide proteolytic products of various species of proteins S100 were investigated. PMID- 3663743 TI - [An antioxidant prevents and reverses calcium-induced uncoupling of rat liver mitochondria]. AB - Accumulation of Ca2+ by rat liver mitochondria in the presence of inorganic phosphate results in spontaneous activation of respiration accompanied by a progressive loss of the accumulated cation. The lipid peroxidation inhibitor, ionol, completely prevents and reverses the Ca2+/phosphate-induced loss of accumulated Ca2+ and restores the respiration to state 4 level without having any effect on the rate of Ca2+ accumulation and respiration in the presence of an uncoupler. No correlation between the ionol-dependent loss of Ca2+ and the formation of malonic dialdehyde in mitochondria was found. The measurements of delta psi across the inner mitochondrial membrane during a progressive loss of Ca2+ suggest that the Ca2+/phosphate-induced "uncoupling" is mainly due to the appearance of electrogenic fluxes (but not Ca2+ cycling) which is under control of some products of initial steps of lipid peroxidation. PMID- 3663744 TI - [Characteristics of [3H]cycloheximide distribution, protein and DNA biosynthesis in rat organs after sublethal blocking of translation]. AB - The kinetics of accumulation and release of [3H]cycloheximide (CHI) as well as protein and DNA biosyntheses in some organs of the rats injected with sublethal doses of CHI were studied. It was shown that in the majority of organs under study (especially in the liver, kidneys and adrenals) the inhibition is completed within 12 hours after CHI injection followed by the resumption of protein and DNA syntheses. In the thymus and pancreas the levels of these biosyntheses remain below control values up to the 72nd hour. A positive correlation was observed between the decrease of CHI (or its metabolites) concentration and the beginning of protein and DNA syntheses in different organs. However, there was a reverse correlation between the high values of squares below the kinetic curves of CHI release from the liver, kidneys and adrenals and the intensive resumption of protein and DNA biosyntheses in these organs. It was thus assumed that in these particular organs CHI is subjected to intensive biotransformations. The contribution of the endocrine system to the induction of intensive compensatory protein and DNA syntheses in the liver were estimated from the viewpoint of the nature of reconstructive processes occurring in the appropriate organs. PMID- 3663745 TI - [Phospholipase A2 and reacylation of phospholipids]. AB - Transacetylation of labeled CoA-oleate and oleate into liposomes from dipalmitoyl phosphatidylcholine catalyzed by phospholipase A2 from rat liver mitochondria was studied. It was shown that the efficiency of CoA-oleate incorporation slightly exceeded that of oleic acid both in the phosphatidylcholine and lysophosphatidylcholine fractions. It was found also that some amount of the labeled substrate remains bound to the enzyme; the type of oleate and CoA-oleate binding differs, depending on their concentrations. The autonomy of lipid component formation in mitochondrial membranes is discussed. PMID- 3663746 TI - [The role of vitamin K3 in the hydroxylation of benz(a)pyrene in rat liver mitochondria after induction with 3-methylcholanthrene and phenobarbital]. AB - The "fast" phase reduction of microsomal cytochromes P-450 and P-448 and their benz(a)pyrene (BP) hydroxylase activity was investigated as a function of menadione concentrations. Within a narrow concentration range (1.5-3 microM) menadione activates cytochrome P-448 reduction and the BP hydroxylase activity. At higher concentrations menadione inhibits cytochromes P-450 and P-448 reduction and BP hydroxylation with participation of the both cytochromes. These data suggest that menadione molecules present in membrane lipids serve as an additional electron carrier to cytochrome P-448, the active site of which is embedded into lipids. The activating effect is unobserved is case of cytochrome P 450 with an active site localized in the aqueous phase. The number of different BP metabolites formed at low (3 microM) menadione concentrations in the microsomes of rats induced with 3-methylcholanthrene (MC) and phenobarbital (PB) was compared. In PB-induced microsomes the amount of 7,8-dihydrodiol rises whereas the total content of BP metabolites decreases. Contrariwise, in MC induced microsomes the synthesis of all BP metabolites is augmented. Menadione has a very weak effect on the ratio of different BP metabolites in PB- and MC microsomes, but strongly inhibits the formation of more polar metabolites. This results in a marked reduction of the number of "dangerous" BP diolepoxides. PMID- 3663747 TI - [Localization of tryptophan residues in NADPH-adrenodoxin reductase with respect to the NADPH-binding center]. AB - It was demonstrated that the NADPH-adrenodoxin reductase molecule contains ten tryptophan residues titrated by N-bromosuccinimide. The effectiveness of the non radiant energy transfer was used to calculate the average distance between the NADPH-binding site of the enzyme and tryptophan residues at different steps of N bromosuccinimide-induced modification. PMID- 3663748 TI - [Effect of monooxygenase reactions catalyzed by cytochrome P-450 on the microsomal membrane]. AB - Hydroxylation of dimethylaniline in rabbit liver microsomes is accompanied by inactivation of cytochrome P-450 and the formation of products inhibiting the catalytic activity of non-inactivated cytochrome P-450. Other enzymes and electron carriers of microsomal membrane (cytochrome b5, NADH-ferricyanide reductase, NADPH-cytochrome c and NADPH-cytochrome P-450 reductases) as well as glucose-6-phosphatase were not inactivated in the course of the monooxygenase reactions. Phospholipids and microsomal membrane proteins were also unaffected thereby. Consequently, the changes in the microsomal membrane during cytochrome P 450 dependent monooxygenase system functioning are confined to the inactivation of cytochrome P-450. PMID- 3663749 TI - [Relation between the thermostability of the tetrameric molecule of lactate dehydrogenase from swine muscles and the degree of occupancy of its active sites with ligands]. AB - Using differential scanning microcalorimetry and measurements of protein fluorescence, the thermal denaturation of lactate dehydrogenase (LDH) from porcine muscle (in the apo-form as well as in the form of the enzyme-pyruvate, enzyme-NAD+ and enzyme-NAD-pyruvate-adduct complexes) was studied. Pyruvate binding did not affect the thermal stability of LDH. NAD+ exerted a stabilizing effect on the enzyme, the value of which was proportional to the number of ligand molecules bound per LDH tetramer. The formation of the abortive LDH-NAD-pyruvate complex in one, two or three active centers of the enzyme tetramer did not influence the values of calorimetric parameters of thermal denaturation in comparison with those for the apoenzyme. The occupancy of all four active centers of LDH by the adduct resulted in a sharp increase of the enzyme thermal stability and tightness of the LDH adduct complex as compared with complexes formed upon partial saturation. The experimental results are suggestive of the existence of a concerted conformational transition of the LDH tetramer induced by the formation of the LDH-NAD-pyruvate complex in the last active center of the tetramer. PMID- 3663750 TI - [Phenobarbital-type induction of cytochrome P-450 in liver microsomes by perfluorodecalin]. AB - Cytochrome P-450 induction in hepatic microsomes after injections of rats with a fluorocarbon emulsion containing perfluorodecalin was studied in comparison with phenobarbital and methylcholanthrene type inductions. It was shown that perfluorodecalin injection as well as the phenobarbital one cause an increase in the cytochrome P-450 content, NADPH-cytochrome c reductase activity, the rates of benzphetamine N-demethylation and aldrin epoxidation in the microsomes. Using the Ouchterlony double immunodiffusion test with antibodies against cytochrome P 450b, an immunological identity of cytochrome P-450 isoforms during perfluorodecalin and phenobarbital inductions was shown. Upon "rocket" immunoelectrophoresis the recovery of cytochrome P-450 which is immunologically indistinguishable from cytochrome P-450b was approximately 72% in perfluorodecalin-induced microsomes. The activity of benzphetamine demethylase and aldrin epoxidase was inhibited by antibodies against cytochrome P-450b. These results suggest that in rat hepatic microsomes perfluorodecalin induces the cytochrome P-450 isoform whose immunological properties and substrate specificity correspond to those of phenobarbital-type cytochrome P-450. PMID- 3663751 TI - [The form of alpha-ketoglutarate dehydrogenase showing no cooperative properties during substrate binding]. AB - A form of alpha-ketoglutarate dehydrogenase was detected, which is characterized by the non-equivalency of active centers for substrate binding normally revealed by chemical modification techniques and typical for other enzyme forms. The properties of various forms of alpha-ketoglutarate dehydrogenase (both soluble and immobilized on Sepharose) were compared. It was shown that despite its dimeric structure the newly detected enzyme form binds alpha-ketoglutarate in a way similar to the monomer; in this case no substrate-induced non-equivalency of the subunits due to intersubunit interactions is observed. It was found that the independent functioning of the active centers of the enzyme is due to the loosening of intersubunit contacts. PMID- 3663752 TI - [Nuclear proteins--substrates for cAMP-dependent protein kinase]. AB - The phosphorylation of nuclear proteins of porcine brain cAMP-dependent protein kinase was studied. Some nuclear proteins after extraction from the nuclei served as substrates for protein kinase. Lysine-rich histones H1, H2a and H2b were found to accept phosphate during chromatin phosphorylation by cAMP-dependent protein kinase. Phosphorylation of intact nuclei revealed that in such a system only histone H1 is a substrate for cAMP-dependent protein kinase. In the presence of DNA the histones are phosphorylated by cAMP-dependent protein kinase in a different manner. It was concluded that DNA can determine the accessibility of protein substrates for the catalytic subunit of cAMP-dependent protein kinase. PMID- 3663753 TI - [Nonenzymatic incorporation of prostaglandin A1 into phospholipids in rat liver microsomes]. AB - The incorporation of [5,6(n)-3H]prostaglandin A1 (PGA1) and [1-14C]oleic acid into membrane phospholipids of rat liver microsomes was studied. It was shown that PGA1 is incorporated into phospholipids in a much lesser degree than oleic acid. PGA1 is incorporated into phosphatidylethanolamine and, in a lesser degree, into phosphatidylcholine and phosphatidylinositol + phosphatidylserine. The exogenous cofactors of fatty acid acylation (ATP, CoA, Mg2+) exert no marked influence on the incorporation of PGA1 into the phospholipids. PGA1 interacts with isolated rat liver phospholipids; the PGA1-phospholipid conjugate formed is not destroyed in the course of one- or two-dimensional thin-layer chromatography. On the other hand, PGA1 binding to unsaturated phosphatidylcholines is strictly dependent on the phospholipid oxidation index. It is concluded that PGA1 incorporation into rat liver phospholipids is a result of interaction of PGA1 with peroxidized phospholipids. PMID- 3663754 TI - [Aminazine--highly effective inhibitor of tubulin polymerization]. AB - Aminasine was found to repress tubulin polymerization into microtubules. This process is associated with the formation of anomalous structures--aggregates which contain, except tubulin, an increased amount of microtubule-associating proteins. The effect of aminasine on microtubules is specific, since it can be observed both in vitro and in vivo. Aminasine seems to be a helpful tool in studying the functions of tubulin and microtubules. PMID- 3663755 TI - [Pre-steady state kinetics of the ferroxidase reaction catalyzed by ceruloplasmin]. AB - Analysis of the presteady-state step of the ferroxidase reaction catalyzed by ceruloplasmin revealed that the kinetic curve for the reaction product accumulation versus time is characterized by an induction period, tau, whose value does not change within the pH range of 5.0-7.5. The value of tau decreases with a rise in the enzyme concentration and increases with a rise in the substrate concentration at constant Fe(II) and E0 concentrations. A reaction scheme is proposed which points to the existence of an induction period in the ceruloplasmin-catalyzed ferroxidase reaction. It was shown that the calculated values of tau = f([Fe(II)]0) and tau = f([E]0) obtained through the use of differential equations qualitatively coincide with the corresponding experimental values. PMID- 3663756 TI - [Effect of K+ concentration on the rate of synthesis of fast-labeling proteins in the adrenal cortex]. AB - The effect of K+ concentration on protein biosynthesis and 32P-incorporation into the acid-insoluble fraction of dog and guinea pig adrenal cortex slices was studied. An increase in K+ concentration in the incubation medium from 3 to 8-11 mM induced after 15-20 min of incubation a significant stimulation of 14C-leucine incorporation into the acid-insoluble fraction of post-mitochondrial supernatant. More extensive labelling of this fraction with 32P was observed. Addition of valinomycin caused a shift in the maximum of 14C-leucine incorporation towards lower K+ concentrations. The Na+,K+-ATPase inhibitors--ouabain and strophantin K- reduced the K+-stimulated protein synthesis. These data suggest that K+ transport into the cell is necessary for the stimulating effect to be manifested. Chelation of Ca2+ strongly decreased the incorporation of 14C-leucine into proteins in the presence of 5 mM K+. However, protein labelling increased with a gradual rise in K+ concentration up to 25 mM. PMID- 3663757 TI - [Effect of alkylresorcin on biological membranes during activation of lipid peroxidation]. AB - The effect of alkyl resorcin isolated from the cells of Azotobacter chroococcum and of its structural analog devoid of the alkyl chain (resorcin) on liver microsomes and brain synaptosomes of the rat as well as on rabbit skeletal muscle sarcoplasmic reticulum fragments during activation of lipid peroxidation was studied. Alkyl resorcin was shown to produce a much more potent antioxidant effect as compared with resorcin, since it inhibited lipid peroxidation in all the three types of membranes under study at much lower concentrations. Both alkyl resorcin and resorcin which inhibit lipid peroxidation prevented lipid peroxidation-induced structural-functional damages of synaptosomal and sarcoplasmic reticulum fragment membranes. Unlike resorcin, alkyl resorcin exerted an additional effect on brain synaptosomal membranes which consisted in the stabilization of barrier functions of membranes during incomplete inhibition of lipid peroxidation. The cumulative data suggest that stabilization necessitates the presence of both resorcin radical and alkyl chain in the alkyl resorcin molecule. PMID- 3663758 TI - [Effect of the lipophilic spin-labeled inhibitor of cytochrome P-450 on the activity of the microsomal system]. AB - It was shown that the lipophilic nitroxyl radical--2-hexyl-2,3,5,5-tetramethyl-4 (3-iodo-2-oxopropyliden)-im idazolidine- 1-oxyl, an affinity modified of rat liver microsomal cytochrome P-450, interacts with various forms of cytochrome P 450 as substrate type I, and it inhibits the oxidation of substrates specific for these forms. During its intravenous injection with egg phosphatidylcholine liposomes the radical is partly bound to liver microsomes, which is accompanied by a decrease of the oxygenase activity of microsomal preparations (by 30-50%) as well as by prolongation of the soporific effect of hexabarbital (2-3-fold). PMID- 3663759 TI - [Gangliosides from human placenta]. AB - Gangliosides of human placenta were studied, using biochemical methods and specific antibodies. The placenta was found to contain three types of gangliosides with oligosaccharide chains Lac, GgOse4 and nLcOse4. PMID- 3663760 TI - [Effect of glucocorticoid hormones on DNA synthesis and expression of ras proto oncogenes in proliferating rat liver cells]. AB - A single injection of partially hepatectomized rats with glucocorticoids results in the blocking of DNA synthesis as well as in the inhibition of the protooncogene Ha-ras-1 mRNA accumulation in proliferating rat liver cells. The kinetics of the both hormone-induced effects differ from those observed for tyrosine aminotransferase induction. The effect of glucocorticoids persists for at least 48 hours and does not depend on the time of the hormone injection. PMID- 3663761 TI - [Functional role of histidine residues of alpha-ketoglutarate dehydrogenase]. AB - The protective effect of alpha-ketoglutarate dehydrogenase substrate and its analogs on the enzyme inactivation by diethylpyrocarbonate was studied. The values of true rate constants for diethylpyrocarbonate-induced inactivation and the Kd values for the enzyme complexes with ligands were determined. A comparison of Kd values for a number of ligands suggests that the histidine residue of the enzyme active center interacts with the alpha-keto group of the substrate. A mechanism of this histidine residue involvement in the catalytic act is proposed. According to this mechanism, the imidazole ring of histidine which is responsible for the substrate activation causes a simultaneous formation of a catalytically active form of the coenzyme--thiamine pyrophosphate ilide. It is assumed that the lower (as compared with the enzyme-substrate complexes) values of rate constants of inactivation by diethylpyrocarbonate for alpha-ketoglutarate dehydrogenase complexes with succinate, glutarate, and oxaloacetate are due to additional protonation of the histidine residue, eventually resulting in the blocking of the analogs interaction with the coenzyme. PMID- 3663762 TI - [The role of tryptophan residues of NADPH-adrenodoxin reductase in the formation of complex with adrenodoxin]. AB - Chemical modification of tryptophan residues by N-bromosuccinimide was used to determine the role of these residues in the NADPH-adrenodoxin-catalyzed reduction of adrenodoxin, dichlorophenolindophenol and ferricyanide. It was shown that the rate of reduction of all electron acceptors diminishes with modification of tryptophan residues. The most significant decrease of the enzyme activity is observed in case of adrenodoxin-catalyzed reactions. It was suggested that tryptophan residues are responsible for the adrenodoxin reductase interaction with adrenodoxin. PMID- 3663763 TI - [Myosin and actin levels in poorly differentiated skeletal muscle tumors]. AB - Mouse low-differentiated rhabdomyosarcoma (LD RMS) A7 contains 4.5 mg/cm3 of skeletal muscle type myosin and 9.7 mg/cm3 of actin. When recalculated to a volume of cytoplasm of A7 cells, the myosin concentration increases to 12.5 mg/cm3, while that of actin increases to 27.1 mg/cm3. In skeletal muscles the tissue concentrations of myosin and actin is close to the cytoplasmic concentrations. In mouse femoral muscles the tissue and cytoplasmic concentrations of myosin (approximately 102 mg/cm3) and actin (approximately 67 mg/cm3) are 8 (for myosin) and 2.5 times (for actin) higher than the cytoplasmic concentrations of these proteins in tumour cells. The molar ratio of myosin to actin concentrations is 1:26 in the tumour and 1:8 in the muscles. Possible causes of the absence of skeletal muscle type myofibrils and the manifestations of coordination and discoordination of gene expression in LD RMS cells are discussed. PMID- 3663764 TI - [Binding of a holoenzyme and cAMP-dependent protein kinase subunits with cell nuclei]. AB - The interaction of cAMP-dependent protein kinase from porcine brain with nuclei isolated from the same source was studied. The shape of the curves for the holoenzyme and subunit binding to the nuclei points to the specificity of this interaction and allows for the calculation of the number of protein binding sites. An extremely low degree of binding of the regulatory subunit phosphoform to the nucleus was demonstrated. It was shown that in the nuclei the regulatory subunit binds to proteins whose molecular mass varies from 15,000 and 55,000 Da. Proteolytic fragments of the regulatory subunit do not interact with chromatin proteins; in the nuclei they are functionally inactive and are not involved in protein-protein interactions. PMID- 3663765 TI - [Directed modification of the structure of cytochrome P-450 substrates as a method of generating new inducers of the microsomal monooxygenase system]. AB - Using the previously obtained data on the substrate-type induction of monooxygenase by xenobiotics of phenobarbital type, the method of conversion of typical substrates for cytochrome P-450 into inducers of biosynthesis of this enzymatic system by blocking in the substrate molecule of the position subjected to oxidative conversion in the enzyme active center was tested. The introduction of the methyl group in the omega-1 position of amobarbital, of Cl- into positions 2 and 4 of biphenyl and the substitution of methyl groups for the isopropyl groups in the 4-N(CH3)2 position of aminopyrine provides for marked induction of these derivatives of cytochrome P-450 and some monooxygenase activities. PMID- 3663766 TI - [Therapeutic doses of menadione reduce the rotenone-induced inhibition of respiration and membrane potential generation in mitochondria]. AB - Menadione restores the rotenone-inhibited respiration of diaphragm muscle pieces in approximately the same degree as the respiration of heart mitochondria, i.e., to 30-40%. The respiration of heart mitochondria induced by 2-5 microM menadione (after its inhibition by rotenone) is partly coupled with ATP synthesis whose rate is much lower than that of oxidation of NAD-dependent substrates. The effects of menadione and mitochondrial energetics inhibitors on lymphocyte respiration and rhodamine 123 fluorescence in individual lymphocytes and their suspensions were compared. Menadione (2--5 microM) increased the rotenone + oligomycin suppressed delta psi m in lymphocytes. At 5-40 microM menadione did not act as an uncoupler and had little effect on the uncoupled lymphocyte respiration. All these effects were observed at menadione concentrations close to therapeutic ones. Vicasol, a water-soluble analog of menadione, exerted a similar effect. PMID- 3663767 TI - [The role of N-nitrosourea-induced changes in the nucleoid structure and activity of repair enzymes in the development of drug resistance in mice with leukemia L1210]. AB - Using centrifugation of the nucleoid in a neutral sucrose gradient, the damages in the secondary structure of DNA and the activity of repair enzymes, such as DNA polymerases alpha and beta and poly(ADP-riboso) polymerase, induced by 1-methyl nitrosourea (MNU) and 1.3-bis (2-chloroethyl)-1-nitrosourea (BCNU) injected at maximal nonlethal single doses to mice bearing parent leukemia cells (L1210/0) and resistant to MNU and BCNU leukemia L1210 cells (L1210/MNU and L1210/BCNU), were studied. The MNU-induced production of single-strand breaks in L1210/0 and L1210/MNU cells was more conspicuous in newly replicated DNA than in those in preexisting DNA. A more fast repair of the damages in newly replicated DNA was detected in L1210/BCNU and especially in L1210/MNU leukemia cells as compared with L1210/0 cells. The data obtained suggest that there are prone errors in the repair of DNA template, since most of the single-strand breaks were revealed in the newly replicated DNA synthesized on the repaired DNA. The repair of DNA damages in L1210/BCNU and especially in L1210/MNU cells was accompanied by the activation of DNA-polymerases alpha and beta and poly(ADP-riboso)polymerase. Both DNA-polymerases--alpha and beta--were shown to be involved in repair of DNA damages induced by MNU and only DNA-polymerase beta was involved in the repair of damages induced by BCNU. PMID- 3663768 TI - [Extracellular metalloproteinase from Legionella pneumophila]. AB - Using ion-exchange chromatography on QAE-Sephadex A-50, affinity chromatography on DNP-hexamethylenediamine-Sepharose and gramicidin S-Sepharose and gel filtration, a metalloproteinase was isolated from the cultural fluid of L. pneumophila (strain Philadelphia-1) grown for 20 hours. The enzyme was purified 1606-fold with a 31% yield. The enzyme has a Mr of 38,000, pI approximately 4.0 and optimum of proteolytic activity at pH 6.0-7.0, 55 degrees C. The proteinase is the most stable within the pH range of 6.0-9.0. The enzyme contains one atom of zinc per molecule. The amino acid composition of metalloproteinase is close to that of thermolysin and is characterized by a high methionine content--17 residues out of 348. In the B-chain of oxidized bovine insulin the enzyme hydrolyzes the bonds precedent to the amino groups of leucine, phenylalanine and tyrosine. The enzyme is inhibited by chelating agents--Na2-EDTA and o phenanthroline as well as by diethylpyrocarbonate. The serine and thiol proteinase inhibitors do not influence the enzyme activity. Under the given conditions of cultivation metalloproteinase is the major endopeptidase produced by L. pneumophila. Thus, the proteolytic system of Legionelles is characterized by the combination of metalloproteinase and the earlier described phenylalanine aminopeptidase. PMID- 3663769 TI - [Effect of the C35 analog of dolichol on the electrical properties of planar black bilayers]. AB - The effect of C35-dolichol on black planar bilayers from mixture of azolectin and cholesterol has been studied. C35-dolichol in concentration of about 10(-6) g/ml has been found to raise the bilayer conductivity, inducing current jumps with unclearly expressed conductivity level of 0.4-0.5 nSm. According to the data of the first and third harmonic during the several minutes after C35-dolichol addition along one side of the bilayer the capacity of the membranes and transversal module Young increase. It is supposed that dolichols induce the nonbilayer structure in membranes that is the basis for their transfer of oligosaccharides blocks across the membranes of Golgi apparatus. PMID- 3663770 TI - [Reactions of neurons in the sensory-motor cortex on different amounts of administered acetylcholine]. AB - As a result of acetylcholine iontophoresis with different currents 3-fold increase of transmitter compared with the threshold one for reaction has been shown not to result in change of a type of reaction pattern more than in 80.3% of neurones. Such increase of action force is quite enough for the significant lengthening of the reaction excitatory components in the most of investigated neurones. After the following repeated application of smaller quantity of transmitter the number of neurones with growth of frequency of excited impulsive activity recovers as well as the level of firing frequency decrease in the course of repetitive administration of transmitter. The effect of large doses of transmitter results in aftereffect expressed by increasing probability of excitatory component reduction during the repetitive applications of acetylcholine. PMID- 3663771 TI - [Formation of a generalized reaction of choice of object according to color in a young chimpanzee]. AB - It has been established that the necessary conditions for rapid formation of experience in chimpanzees are creation of the interspecific functional system experimenter-chimpanzee in which the mechanisms of imitation and refreshment and creation of situational conditional reflex may be equally used. The neurophysiological basis of the latter is the stage activity when each stage is the signal for the following and refreshment for the previous one. In the presence of these factors the possibility of formation of aim generalized reflex appears, that is the basis for creation of optimum conditions for perception and learning the given information. PMID- 3663772 TI - [Genetico-demographic approach in anthropological studies. III. The use of family names in the study of Khakass populations]. AB - Monofilety is a typical characteristic of most Khakass surnames. A special pool of surnames is historically associated with each of the ethnographic groups that allows to use them as a reliable ethnic determinant. The combination of matrimonial surnames does not occur by chance in the populations investigated. A significant mate assortativeness can be revealed due to the fact that people deliberately escape marital isonymy. If surnames are considered as selective neutral locus alleles, their distribution in the population can be compared to that of the genetic markers and used as an indirect method for the description of the genetic structure in the population. PMID- 3663773 TI - [Mosses as bioindicators of heavy metal pollution of the urban environment]. AB - The content of some heavy metals in leafy epigeous mosses and upper soil layer of the large Moscow parks has been studied. The peculiarities in accumulation of heavy metals by different moss species have been pointed out. The content of heavy metals in leafy epigeous mosses has been found to be closely connected with the content of these elements in upper soil layer. PMID- 3663774 TI - [Dynamic modelling of the simazine content of soil]. AB - A mathematical model of dynamics of simazine level in soil based on the hypothesis of several forms of simazine in soil and integral influence of environmental factors on inactivation has been worked out. The results of modelling are under discussion. PMID- 3663775 TI - Right hemisphere involvement in depression: toward a neuropsychological theory of negative affective experiences. AB - Several lines of inquiry provide converging evidence for a critical role for the right cerebral hemisphere in negative affective experiences. This research includes the assessment of affective consequences of both focal cerebral lesions and pharmacological inactivation of one or the other hemisphere, as well as experimental and physiological techniques assessing differential hemispheric activation. The specific nature of right hemispheric involvement is conceptualized as a tendency to become activated by aversive experiences, and once activated, to process stimuli in a manner consistent with the right hemisphere's more negative affective tone. A theory of right hemisphere involvement in depressive affect is presented in detail and its relevance to clinical phenomena, e.g., the co-occurrence of depression and pain, and sex differences in depression, is examined, as is congruence with cognitive theories of depression. PMID- 3663776 TI - Prolactin secretion during sleep: a comparison between depressed patients and healthy control subjects. AB - Although several neuroendocrine abnormalities have been described in depressed patients, relatively little attention has been paid to the pattern of prolactin secretion during sleep. Sleep disturbances are frequently found in depressed patients, and the sleep electroencephalogram (EEG) typically shows significant changes in the first and last 100 min, when prolactin secretion frequently occurs. In this study, carefully defined inclusion criteria were used to ensure comparability in the quality of the sleep maintenance, so that the pattern of sleep-related prolactin secretion in a group of 26 depressed inpatients could be compared to that in a group of 20 healthy control subjects. Starting from sleep onset, the patients did not show any statistically significant difference in either the serum prolactin concentration or the pattern of integrated prolactin secretion relative to the control subjects. A statistically significant relationship between prolactin secretion and the REM-non-REM sleep cycle could not be demonstrated in these subjects. PMID- 3663777 TI - Serum pseudocholinesterase in psychiatric patients. AB - Serum pseudocholinesterase activity was measured in 123 subjects: 16 agitated depressives, 12 retarded depressives, 7 acute schizophrenics, 14 residual schizophrenics, 16 healthy individuals, 45 surgical patients, and 13 first-degree relatives of 4 agitated depressive patients. The agitated depressive and acute schizophrenic patients had significantly higher pseudocholinesterase serum activity than their retarded inmates. As first-degree relatives of agitated depressive patients showed high levels similar to their ill relatives, a genetic component might play a crucial role. The level of pseudocholinesterase activity in serum of the surgical patients was significantly lower than that of all the psychiatric patients and the controls. The implications of this observation are still obscure. PMID- 3663778 TI - Laboratory evaluation for Cushing's syndrome in psychiatric patients with cortisol nonsuppression following the overnight dexamethasone suppression test. AB - Laboratory tests used for the differential diagnosis of Cushing's syndrome have infrequently been employed in investigations of psychiatric patients who demonstrate hypothalamic-pituitary-adrenal (HPA) overactivity, and these laboratory procedures have not previously been applied for the specific purpose of further evaluating the endocrine function of psychiatric patients with serum cortisol nonsuppression following the standard 1-mg overnight Dexamethasone Suppression Test (DST). Low-dose (4 mg/48 hr) and high-dose (16 mg/48 hr) DSTs were administered to 10 psychiatric patients who exhibited cortisol nonsuppression after the overnight DST. Patients all had normal suppression to both the low-dose and high-dose tests. HPA overactivity in these patients was thus not sufficient to meet laboratory criteria for the diagnosis of Cushing's syndrome. Study results suggest that psychiatric patients with abnormal cortisol suppression following the 1-mg overnight DST are likely to have normal responses when assessed by standard laboratory protocols used for the diagnosis of Cushing's syndrome. PMID- 3663779 TI - A preliminary study of plasma alpha MSH concentrations in depressed patients and normal subjects. PMID- 3663780 TI - Plasma 10-hydroxynortriptyline and renal function in elderly depressives. PMID- 3663781 TI - Dosage, threshold, and duration of ECT. PMID- 3663782 TI - Thioridazine and neuroleptic malignant syndrome. PMID- 3663783 TI - Columbus, grantmanship, and clinical research. PMID- 3663784 TI - Cortical "stress tests" in schizophrenia: regional cerebral blood flow studies. AB - A total of 261 regional cerebral blood flow (rCBF) studies were carried out on 34 medication-free patients with chronic schizophrenia and 50 normal subjects. rCBF, an indicator of local cortical metabolism and activity, was measured during the resting state and also during four cognitive activation tasks or "cortical stress tests." The latter included the Wisconsin Card Sort (WCS), a test of prefrontal lobe function; a simple numbers matching task, and two versions of a visual Continuous Performance Task (CPT). Multivariate comparisons of the two subject groups were performed for each of the five testing conditions, and discriminant function analyses for each condition were carried out to define mathematical models that differentiated normal subjects from medication-free patients. The best such model was determined and was then applied to another group of patients who had diagnoses other than schizophrenia or for whom the diagnosis was unclear. This group included two patients with clinical "frontal lobe syndrome" and radiological evidence of frontal lobe damage. The most robust differences between the groups were seen in frontal rCBF during the WCS. In the discriminant function analysis, rCBF during the WCS was the best discriminator between the two groups, retrospectively classifying 85% of the subjects correctly. rCBF during the resting state and one of the CPTs correctly classified subjects at a rate only marginally better than chance. When the model derived from WCS rCBF was applied to a second group of patients, the two patients with known frontal lobe disease were classified as "schizophrenic" with 100% certainty. Three other patients with psychotic illnesses were also assigned to this group with greater than 80% certainty, whereas a patient with character disorder (rule-out affective disorder) was classified as "normal" with a high level of confidence. These data suggest (1) that schizophrenia is characterized by a deficit in prefrontal function that is revealed when regionally specific demand exceeds the physiological capacity, and (2) that functional brain imaging studies, such as rCBF, can best identify brain abnormalities during "cortical stress tests." PMID- 3663785 TI - Interindividual differences in the susceptibility of the cortisol system: an important factor for the degree of hypercortisolism in stress situations? AB - Whereas in psychophysiological research, the specificity of the individual responses has been assumed to be an important trait variable influencing the investigated parameters in stress experiments or in psychopathological states, in psychoneuroendocrinology, the individual differences in the susceptibility of the investigated neuroendocrine axes have been widely neglected. The present study on the cortisol response of 12 healthy young men to 5 different stress tests is considered to be an initial orientation step into this field. All five stress tests (quiz, arithmetic tasks, stress film, cold pressor test, and physical exercise test) could be proven to be effective stimuli regarding the cortisol system. There was, however, a broad spectrum of cortisol responses among the 12 subjects, with a continuum between complete reactors and nonreactors. This did not correlate with the subjective judgment of stress at all. Although the data showed a tendency toward an augmented dispersion of the response frequencies in comparison with random variation, the limited sample size of subjects and stress tests did not allow a statistically significant proof of a stimulus-independent, individual response specificity. Further experimental clarification seems to be necessary to avoid misinterpretations of neuroendocrine data in psychiatric disorders due to neglect of this variable. PMID- 3663786 TI - Plasma dexamethasone kinetics during the DST after oral and intravenous administration of the test drug. AB - We compared early biophase kinetics of dexamethasone in 33 patients with a major depression who received a DST either by an oral (n = 20) or an intravenous (n = 13) route. After an oral DST, the dexamethasone kinetics between 14 suppressors and 6 nonsuppressors were indistinguishable during the early distribution phase. However, elimination of dexamethasone from the circulation was significantly enhanced in DST nonsuppressors, resulting in an association of decreased plasma dexamethasone with elevated post-DST cortisol levels. Following intravenous DST administration, we identified 5 nonsuppressors and 8 suppressors whose plasma dexamethasone kinetics were indistinguishable, and during the elimination phase, were in the same order of magnitude as those of nonsuppressors after an oral DST. We suggest that the actual plasma concentration at the conventional post-DST sampling times does not reflect the biopotency of the test drug to suppress the pituitary adrenocortical activity. Plasma dexamethasone concentrations after an oral DST that were associated with nonsuppressed cortisol seem to be coherent phenomena of the underlying endocrine disturbance, the precise nature of which deserves further study. PMID- 3663787 TI - Glutathione peroxidase and CT scan abnormalities in schizophrenia. AB - The search for morphological clues to the etiology of schizophrenia has led to widespread application of computed tomography (CT) scans in the examination of patients. These investigations have resulted in numerous reports over the past several years of brain atrophy and increased ventricle-brain ratios (VBR), suggestive of neuronal tissue damage, associated with the disorder. Altered activity of cellular antioxidant systems have been implicated in the neuronal cell loss that is associated with degenerative diseases of the central nervous system (CNS), but this phenomenon has not been investigated with respect to functional disorders like schizophrenia. A search for such a relationship in schizophrenics with evidence of brain atrophy has been initiated by measuring the activity of the important antioxidant enzyme glutathione peroxidase (GPx) in blood samples from a population of chronic schizophrenics and age- and sex matched nonschizophrenic mental patients as controls. A strong negative correlation has been found between GPx activity in both isolated platelets and erythrocytes and CT scan measures of brain atrophy and VBR in the schizophrenics, but not in the control population, which exhibited comparable CT scan abnormalities. These observations suggest a unique relationship of GPx to the mechanism of tissue damage in the schizophrenics. PMID- 3663788 TI - Early pharmacokinetics and clinical effects of oral D-amphetamine in normal subjects. AB - Seven normal subjects received 0.25 mg/kg D-amphetamine orally, both after an overnight fast and again after a standard breakfast. Plasma levels, subjective and cardiovascular effects, and observer-rated activation were assessed hourly for 5 hr. Food did not affect amphetamine levels. Plasma levels peaked at 2-3 hr. Maximum cardiovascular effects generally occurred at 1 hr, whereas maximum behavioral and subjective effects occurred at 2 hr. Subjective and behavioral effects declined thereafter, in spite of substantial amphetamine levels. A separate group of 8 subjects received 0.5 mg/kg D-amphetamine orally. Plasma levels, subjective and cardiovascular effects, and activation ratings were assessed hourly for 4 hr. Maximum plasma levels were approximately twice those seen in the first group. In this case, plasma levels peaked at 3-4 hr; blood pressure and subjective and behavioral effects were all maximal at 2-3 hr and were declining by 4 hr, in spite of stable or rising plasma levels. PMID- 3663789 TI - Reduced haloperidol and haloperidol: effects on homovanillic acid in caudate and prefrontal cortex. AB - The effects of acute administration of reduced haloperidol (RHAL) on homovanillic acid (HVA) in the caudate and prefrontal cortex were examined in rats. Haloperidol (HAL) was used as a reference compound. Concentrations of HVA and HAL were measured by HPLC/ECD. The maximal HVA response time was 3 hr after the injection, in both caudate and prefrontal cortex, for both RHAL and HAL. The potency of RHAL in the elevations of HVA in the caudate and prefrontal cortex was only about one-third to one-fifth that of HAL. The concentrations of HAL in the prefrontal cortex and caudate after RHAL administration were just about one-third to one-fifth those after HAL administration. These results suggest that less antidopaminergic activity of RHAL in this neuroleptic test might be explained by the lesser conversion of RHAL to HAL. PMID- 3663790 TI - Low plasma reduced haloperidol/haloperidol ratios in Chinese patients. PMID- 3663791 TI - Pituitary-adrenal disinhibition and suicide attempts in depressed patients. PMID- 3663792 TI - Hemispheric asymmetry of augmenting/reducing in visual and auditory evoked potentials. PMID- 3663793 TI - In vivo differentiation of cardiac vagal blocking effects of chlorpromazine and haloperidol. PMID- 3663794 TI - The duration of a neuronal trace of an auditory stimulus as indicated by event related potentials. AB - Event-related brain potential studies have revealed a component called the mismatch negativity (MMN) in response to occasional deviant stimuli presented in a sequence of homogeneous repetitive, 'standard', stimuli. This negativity probably reflects an automatic neuronal-mismatch process with a neuronal representation of the standard stimulus. The present study aimed at determining the duration of the assumed neuronal representation by varying the inter-stimulus interval (ISI) of a stimulus block. It was assumed that a deviant stimulus can elicit a MMN only when the neuronal representation of the previous standard stimulus still exists. It was found that a clear MMN was elicited by the deviant stimulus when the ISI was 1 or 2 s, but not when the ISI was 4 or 8 s. This suggests that the duration of the neuronal representation involved was less than 4 s. PMID- 3663795 TI - Event-related brain potentials and the perception of a phonetic continuum. AB - Competing predictions concerning phoneme discrimination were tested by means of event-related potentials. In research on speech perception, one tradition stems from the physiology of the auditory system whereas another emphasizes categorical perception which involves a marked psychological component. The stimuli were the end points of the Finnish (i)-(y) continuum together with the intermediate boundary sound. Two of these stimuli were presented in each block of trials. One (the 'standard') had a high probability while the other (the 'deviant') was rare. The so-called mismatch negativity (MMN) component of the ERP in response to deviant stimuli showed a large amplitude and short latency when these two stimuli were pure vowels (i) and (y). When the boundary stimulus and one of the pure vowels comprised the stimulus pair, a smaller and more delayed MMN occurred. This result may be taken as support that the discrimination occurs at a basic physiological level. On the other hand, cognitive perception was reflected in the different latencies of the P3 component to (i) and (y). In sum, the results lend support to multilevel hybrid models in the explanation of vowel perception. PMID- 3663796 TI - Hemispheric asymmetry of feedback-related potentials in a positioning task: comparison of right- and left-handed subjects. AB - Previous research has demonstrated that delayed nonverbal information feedback (IF) about the correctness of a positioning movement is preceded by a contingent negative variation (CNV) which is larger over the right hemisphere independent of movement side. It was hypothesized that this asymmetry is a manifestation of functional hemispheric specialization, and that, therefore, the distribution of the differences between CNV amplitude measures of the two hemispheres should be different in right-handed and left-handed subjects. The latter group should show a mean asymmetry score closer to zero, and a larger between-subject variance of the asymmetry scores. The present investigation was intended to test these assumptions in samples of rigorously defined right-handers (n = 12) and left handers (n = 8). The results revealed the expected group differences of the CNV asymmetry scores. In addition, the P1-N1 peak-to-peak amplitude of the IF-evoked potentials was similarly lateralized as the pre-IF CNV and showed the same group differences. In contrast, the handedness groups did not differ in the contralateral lateralization of the movement-related potential shift in the same task. PMID- 3663797 TI - Event-related potentials and selective attention to tones moving in location and pitch: an examination of movement velocity. AB - Event-related potentials (ERPs) were recorded from subjects who listened selectively to one of two classes of tone pips that arose from separate, virtual sound sources moving in spatial location and pitch. In different runs the speeds of the moving sources were varied; for the slow speed, the two classes of tones were easily separable, but for the moderate and fast speeds selective listening was difficult without practice. A prolonged negative shift of the ERP, beginning around 60 ms poststimulus and lasting over 300 ms, was observed when the eliciting tones were selectively attended. However, no differences at any phase of the negative ERPs were found as a function of movement velocity, in contrast to the decline of target detection performance for the fast speed. The results were interpreted as indicating that anticipation, based on contextual information, can play an important role in early input selection. PMID- 3663798 TI - Neuropsychological correlates of platelet monoamine oxidase (MAO) activity in female and male subjects. AB - Platelet monoamine oxidase (MAO) activity has been found to have behavioral (psychiatric and personality) correlates and is assumed to be linked to central transmitter systems and thus presumably to neuropsychological processes. In the present study, computerized neuropsychological tests, a reaction time (RT) test and a visuo-spatial problem solving test, the Perceptual Maze Test (PMT), were given to 32 female and 29 male students, each sex group divided into three subgroups on the basis of platelet MAO activity. The tests yield measures of laterality (reaction time for left- versus right-sided stimuli) and different aspects of cognitive strategy and skill, e.g. time used for inspection of the maze, for processing the stimulus pattern, and for checking the correctness of solutions. Low MAO female subjects had shorter RTs, pronounced for left-sided stimuli, and shorter inspection times in the PMT compared to other female subjects. Low and high MAO males had difficulties in inhibiting responses, when required, and low MAO males were more rapidly prepared to respond to new stimuli after short intervals than other males. In the PMT, high MAO male subjects spent a smaller part of the total time on inspection in relation to other male groups and had more rubouts than low MAO males, whose maze solving behavior indicated higher visuo-spatial ability. The results are discussed in terms of possible neurochemical bases of impulsivity and psychopathy, and of spatial skill. PMID- 3663799 TI - Neurofunctional assessment of schizophrenia: a preliminary investigation of the presence of eye-tracking (SPEMs) and quality extinction test (QET) abnormalities in a sample of schizophrenic patients. AB - This preliminary study evaluated the simultaneous presence of abnormalities in the regulation of eye-tracking and neuropsychological tests performance (tactile extinction) in a sample of schizophrenic patients. Both those measures of central malfunctioning appears to be quite specific to schizophrenic disorders and more related to the trait, rather than state characteristics. Even though preliminary, the results indicate a significant relationship between abnormalities in SPEM regulation and the distribution of tactile abnormalities, with more left-side extinguishing patients showing abnormal SPEMs. Some interpretations of the findings are given in the context of current hypotheses on the neurofunctional abnormalities of schizophrenics. PMID- 3663800 TI - The effects of signal value on short- and long-term habituation. AB - The present study examined the effects of signal value on short- and long-term habituation of the skin conductance response. Subjects (N = 48) attended the laboratory at the same time of day on two consecutive days. Day 1 comprised pretraining and training phases, and day 2 comprised the test phase. In the pretraining phase subjects received one presentation each of a tone and a vibration stimulus. In the training and test phases subjects received a randomly ordered sequence of 15 tones and 15 vibrations. All stimuli were of 4 s duration. During the training phase Groups E1 and E2 performed a motor response to the offset of one of the stimuli whereas a third group (Group C) did not. Neither Group E1 nor Group C performed the motor task during the pretraining and test phases. Both between- and within-group analyses of the training phase data indicated that responses were larger and habituation was slower to signal stimuli. Analyses of the test phase data and comparison of pretraining and test phase data indicated that long-term habituation occurred only to nonsignal stimuli. The results are discussed in terms of Wagner's (1978) theory of habituation. PMID- 3663801 TI - Electrodermal lability and simple reaction time. AB - Subjects identified as electrodermally labile or stabile (n = 10 per group) on the basis of non-specific electrodermal fluctuations and a trials-to-criterion measure of habituation were compared in a simple reaction time (RT) task that employed long, variable foreperiods (from 8 to 19 s). Labiles had significantly faster RTs across all foreperiods, but there were no differences in RT variability between the groups. Phasic heart rate responses recorded concurrently through the foreperiod showed a characteristic pattern of acceleratory and deceleratory activity, which was similar among both labiles and stabiles. The findings indicate that labiles and stabiles show a consistent difference in the speed of processing of a target imperative stimulus, which is not due to differences in response preparation processes. Overall, the results support the use of RT paradigms for evaluating individual differences in information processing associated with electrodermal lability. PMID- 3663802 TI - Tissue response of several polymeric materials implanted in the rat middle ear. AB - Implantation of three different polymeric composite materials in the rat middle ear showed that the nylon prosthesis was encapsulated more rapidly than the two poly(methyl methacrylate) based implants. Several PMMA based implants were only partially covered at the 6 mnth stage by a tenuous capsule made up of collagen and a mixed inflammatory cell infiltrate. The nylon material was covered at the 3 mnth stage with a thin capsule and healthy fibroblasts. PMID- 3663803 TI - Haemocompatibility of segmented polyurethanes investigated in vivo. AB - Samples of segmented polyurethanes differing in composition and in surface morphology were introduced into the left ventricles of hearts of goats for 72 h. After removal of the samples, their surface and the surface of the heart endothelium were evaluated visually with respect to the formation of thrombi. Differences in the interaction of the individual polyurethanes with blood were examined by XPS photoelectron spectroscopy, SEM, and by infrared (i.r.) reflexion spectroscopy. The results suggest ways for improving the haemocompatibility of the surfaces of polyurethanes used as parts of the total artificial heart. PMID- 3663804 TI - A polymeric controlled drug delivery device for peptides based on a surface desorption/diffusion mechanism. AB - Further investigations of the mechanisms underlying continuous peptide delivery from a newly developed Accurel polypropylene/collodion device are described. This module was prepared by lumen-loading an aqueous peptide solution into a piece of microporous Accurel polypropylene tubing which was subsequently end-sealed and encapsulated by a collodion membrane. By using vasopressin (VP) as a 'model' peptide, various aspects of the known semi-reversible protein/polymer surface interaction are shown to be present for VP and polypropylene i.e. prominent adsorption on the large surface area, which follows a bimodal adsorption isotherm, but with very limited desorption, and which can be enhanced by exchange with other proteins. Based on these findings as well as the observed steady state levels of VP on 24 h immersions in a small fixed volume, the previously proposed mechanism of pseudo-zero-order release could be evaluated further: the adsorbed peptide molecules function as a stock of near-constant activity, since desorption is rather limited, and as long as rapid exchange of bound peptide by external proteins can be prevented by a sufficiently thick (greater than 60 micron) collodion membrane, a slow long-term diffusion process will take place. Under 'infinite sink' conditions, the devices gave linear cumulative release curves for weeks. The present module is a novelty among the known membrane-controlled drug delivery reservoir systems, since it has been loaded by an unsaturated drug solution and because the encapsulating membrane is not the sole release-rate controlling factor. PMID- 3663805 TI - The in vitro response of osteoblasts to bioactive glass. AB - Osteoblasts from neonate rat calvaria migrated in culture from the endocranial surface of parietal bones onto fragments of bone-bonding 45S5 glass or non-bone bonding quartz glass. These organ culture units were maintained for up to 4 wk. No significant production of extracellular matrix (ECM) was seen on the quartz glass samples. However, osteoblasts colonized the 45S5 samples in multilayers and produced abundant ECM as seen by light (LM), scanning electron (SEM) and transmission electron (TEM) microscopy. The interface developed on 45S5 glass was designated as either Type I (non-collagen-bonding) or Type II (showing direct interdigitation of collagen with the calcium phosphate-rich glass surface). It was concluded that, since this in vitro method is capable of reproducing some aspects of the known in vivo behaviour of 45S5, such techniques may be developed as a means of batch-testing bioactive biomaterials and investigating bone cell/biomaterial interactions. PMID- 3663806 TI - Activation of complement in human serum by some synthetic polymers used for intraocular lenses. AB - Determination of the potential to activate complement can be used as one criterion in testing the biocompatibility of various synthetic polymers that are utilized in the medical field. Intraocular lenses (IOLs) made of poly(methyl methacrylate) (PMMA) with PMMA loops, poly(hydroxyethyl methacrylate) (PHEMA) lenses, silicone lenses, and PMMA lenses with polypropylene loops were examined in this study. The concentrations of the activation peptides C3a, C4a and C5a were measured by radioimmunoassay (r.i.a.) in human serum after incubation with and without IOLs for up to 12 h. The presence of silicone lenses caused an increase in C3a levels. In the presence of polypropylene loops, the concentrations of both C3a and C5a were significantly higher than in serum incubated alone. There was no statistically significant increase in the concentration of C4a caused by any of the materials tested. The results suggest that IOLs made from silicone or lenses with polypropylene loops activate the complement system via the alternative pathway. PMID- 3663807 TI - Polymers for biodegradable medical devices. II. Hydroxybutyrate-hydroxyvalerate copolymers: hydrolytic degradation studies. AB - The hydrolytic degradation of poly(hydroxybutyrate) together with a series of hydroxybutyrate-hydroxyvalerate copolymers has been studied. The effects of copolymer composition and molecular weight are presented together with the results of varying pH and temperature on the degradation rate. Degradation has been monitored by weight loss and water uptake measurements together with goniophotometric, surface energy and scanning electron microscopic studies. Some comparisons with the more widely used so-called 'biodegradable' polymers, poly(glycolic acid), poly(dioxanone) and the glycolic-lactic acid (90:10) copolymers are presented together with the effect of blood plasma on the degradation process. PMID- 3663808 TI - A material (PUPA) presenting both the properties of polyurethanes and the capacity of adsorbing a high quantity of heparin. AB - Polyurethanes are widely used for biomedical applications, but there is still a constant search for improved blood-compatible materials. We studied a material (PUPA) obtained by the interconnection between a poly(amido-amine), N2LL, capable of forming stable complexes with heparin and a commercial polyurethane, Pellethane 2363-80AE, using hexamethylenediisocyanate as the crosslinking agent. The amount of absorbed heparin (evaluated by biological tests) was generally much higher than that found on the poly(amido-amine) surface-grafted polyurethane. PMID- 3663809 TI - A plastic composite of alginate with calcium phosphate granulate as implant material: an in vivo study. AB - A comparison of calcium phosphate granulate with a composite of alginate and calcium phosphate granulate, shows that the composite has less particle migration, less biodegradation and better handling properties. The tissue response to both materials is similar. PMID- 3663810 TI - Resorbable materials of poly(L-lactide). VII. In vivo and in vitro degradation. AB - In vivo and in vitro degradation of high molecular weight poly(L-lactide) used for internal bone fixation has been investigated. Within 3 months as-polymerized, microporous PLLA (Mv = 6.8-9.5 X 10(5] exhibited a massive strength-loss (sigma b = 68-75 MPa to sigma b = 4 MPa) and decrease of Mv (90-95%). At week 39, the first signs of resorption were evident (mass-loss 5 wt%). Except for dynamically loaded bone plates no differences between in vivo and in vitro degradation of PLLA were observed. The increase of crystallinity of PLLA upon degradation (up to 83%) is likely to be attributed to recrystallization of tie-chain segments. A more ductile PLLA exhibiting a lower rate of degradation was prepared by extraction of low molecular weight compounds with ethyl acetate. PMID- 3663811 TI - The use of nylon pouches to prevent cellular attachment to implanted materials. AB - A nylon pouch system has been developed to permit the in vivo exposure of implantable materials to tissue fluids without complications arising from cellular attachment or from the bacterial attack. SEM observations have indicated that the pouches were effective in reducing the ingress of bacteria as well as reducing, and in some cases eliminating, cell infiltration through their mesh structure. Over a 7 d implantation period, the exterior surfaces of the nylon pouches were heavily infested with microorganisms but there was minimal growth of bacteria within the pouches. Non-infected pouches that were implanted for up to 25 wk showed heavy deposits of cellular matter on the external surfaces of the pouches and minimal deposits within the pouches. PMID- 3663812 TI - [Future medical aspects of nuclear magnetic resonance]. PMID- 3663813 TI - [Mass spectrometry analysis system for measuring blood gas partial pressure in syringe samples]. PMID- 3663814 TI - The analysis of multiple endpoints in clinical trials. AB - Treatment comparisons in randomized clinical trials usually involve several endpoints such that conventional significance testing can seriously inflate the overall Type I error rate. One option is to select a single primary endpoint for formal statistical inference, but this is not always feasible. Another approach is to apply Bonferroni correction (i.e., multiply each P-value by the total number of endpoints). Its conservatism for correlated endpoints is examined for multivariate normal data. A third approach is to derive an appropriate global test statistic and this paper explores one such test applicable to any set of asymptotically normal test statistics. Quantitative, binary, and survival endpoints are all considered within this general framework. Two examples are presented and the relative merits of the proposed strategies are discussed. PMID- 3663815 TI - Threshold dose-response models in toxicology. AB - After a brief discussion of the threshold concept in toxicology, we consider models for the estimation of thresholds in the case where the observed response is binary or quantal. A generalization of the four-parameter Tukey-lambda family of distributions is proposed as a useful class of models for threshold estimation. Properties of these models are discussed and the process of model fitting and evaluation is illustrated using a number of data sets. The discussion includes consideration of background or spontaneous response, and comparison with other models. One of these is the linear-plateau or hockey-stick model, which has been used in a number of toxicological studies. PMID- 3663816 TI - The analysis of cancer chemoprevention experiments. AB - This paper is concerned with the analysis of certain cancer chemoprevention experiments that involve Type I censoring. In experiments of this nature, two common response variables are the number of induced cancers and the rate at which they develop. In this study we assume that the number of induced tumors and their times to detection are described by the Poisson and gamma distributions, respectively. Using the method of maximum likelihood, we discuss a procedure for estimating the parameters characterizing these two distributions. We apply standard techniques in order to construct a confidence region and conduct a hypothesis test concerning the parameters of interest. We discuss a method for comparing the effects of two different treatments using the likelihood ratio principle. A technique for isolating group differences in terms of the mean number of promoted tumors and the mean time to detection is described. Using the techniques developed in this paper, we reanalyze an existing data set in the cancer chemoprevention literature and obtain contrasting results. PMID- 3663817 TI - Confidence intervals on the ratio of expected mean squares (theta 1 + d theta 2)/theta 3. AB - The variance component ratio delta = (theta 1 + d theta 2)/theta 3 is of interest in many fields of application. This paper proposes and compares two methods for constructing confidence intervals on delta. The better method is compared with a method proposed by Graybill and Wang (1979, Journal of the American Statistical Association 74, 368-374) for the special problem of constructing an interval on sigma 2E/(sigma 2A + sigma 2B + sigma 2E) in a two-fold nested design. An example concerning a heritability study is provided. PMID- 3663818 TI - Parental and sib likelihoods in genealogy reconstruction. AB - Estimation of genealogical relationships from genetic data provides an approach to answering many questions of population biology. In this estimation problem, previous work has shown that bilateral relatives such as full sibs may be more likely parents than the true parent individuals. This paper investigates the source of this paradox, and the circumstances under which it may arise. Alternative approaches to inferring parentage are proposed; these involve analysis of the distributions of log-likelihood statistics and of the bivariate distribution of sib and parent log-likelihoods. A Bayesian approach may also be superposed on the likelihood analysis, enabling any prior knowledge of the population to be incorporated. PMID- 3663819 TI - Efficient inference for random-coefficient growth curve models with unbalanced data. AB - Growth and dose-response curve studies often result in incomplete or unbalanced data. Random-effects models together with a variety of computer-intensive iterative techniques have been suggested for the analysis of such data. This paper is concerned with a noniterative method for estimating and comparing location parameters in random-coefficient growth curve models. Consistent and asymptotically efficient estimators of the location parameters are obtained using estimated generalized least squares. Two criteria for testing multivariate general linear hypotheses are introduced and their asymptotic properties are investigated. The results are applied to clinical data obtained on the blood ultrafiltration performance of hemodialyzers used in the treatment of patients with end-stage renal disease. PMID- 3663820 TI - Line-segment confidence bands for repeated measures. AB - For the case of repeated measures on Y with mean values linear in a concomitant variable Z in [a, b], a straight-line confidence band over [a, b] is given with width linear in Z. Graphical presentation of such line-segment confidence bands can help emphasize that appropriate inferences are limited to the range of the data. Because the line-segment bands are designed to cover a finite interval, they are usually more efficient than the widely used hyperbolic bands. Conditions for favorable relative efficiency of area bounded are given. This easily computed trapezoidal confidence region is formulated in terms of a growth-curve model. PMID- 3663821 TI - Two-sample rank tests for detecting changes that occur in a small proportion of the treated population. AB - In the course of studying a biological phenomenon thought to be a precursor to chromosome breakage, researchers have found that treatments sometimes produce a higher proportion of "outliers" than do controls. Our examples pertain to smokers and patients undergoing chemotherapy, although the statistical methods developed here would apply to subjects exposed to any other health hazard. We formulate the problem in a nonparametric setting. Locally most powerful rank tests are obtained for mixture alternatives. In one instance, the approximate scores test has the simple form of counting the number of treatment responses above a combined sample percentile. Our test statistics are compared to the Wilcoxon and normal scores tests using empirical power studies and asymptotic efficiencies. PMID- 3663822 TI - Two-stage models for the analysis of cancer screening data. AB - Methods are proposed for the analysis of the natural history of disease from screening data when it cannot be assumed that untreated preclinical disease always progresses to clinical disease. The methodology is based on a two-stage model for preclinical disease in which stage 1 lesions may or may not progress to stage 2, but all stage 2 lesions progress to clinical disease. The focus is on joint estimation of the total preclinical duration and the sensitivity of the screening test. A partial likelihood is proposed for the analysis of prospectively collected screening data, and an analogous conditional likelihood is proposed for retrospective data. Some special cases for the joint sojourn distribution of the two stages are considered, including the independent model and limiting models where the duration of stage 2 is short relative to stage 1. The methods are applied to a case-control study of cervical cancer screening in Northeast Scotland. PMID- 3663823 TI - Empirical Bayes estimates of age-standardized relative risks for use in disease mapping. AB - There have been many attempts in recent years to map incidence and mortality from diseases such as cancer. Such maps usually display either relative rates in each district, as measured by a standardized mortality ratio (SMR) or some similar index, or the statistical significance level for a test of the difference between the rates in that district and elsewhere. Neither of these approaches is fully satisfactory and we propose a new approach using empirical Bayes estimation. The resulting estimators represent a weighted compromise between the SMR, the overall mean relative rate, and a local mean of the relative rate in nearby areas. The compromise solution depends on the reliability of each individual SMR and on estimates of the overall amount of dispersion of relative rates over different districts. PMID- 3663824 TI - On the small-sample performance of Efron's and of Gill's version of the product limit estimator under nonproportional hazards. AB - Various proposals have been made to extend the product limit estimator to survival times beyond the largest observation in case that observation is censored. Two extreme extensions are examined with respect to bias and mean squared error (MSE). Their quality depends considerably on the "censoring constellation." The MSE of one extension appears to be robust against a wide variety of nonproportionalities of the hazard rates of the distributions of lifelength and time to censoring. PMID- 3663825 TI - A simple approximation for calculating sample sizes for detecting linear trend in proportions. AB - A simple approximate formula for sample sizes for detecting a linear trend in proportions is derived. The formulas for both the uncorrected and corrected Cochran-Armitage test are given. For two binomial proportions these reduce to those given by Casagrande, Pike, and Smith (1978, Biometrics 34, 483-486). Some numerical results of a power study for small sample sizes show that the nominal power corresponding to the approximate sample size is a reasonably good approximation to the actual power. PMID- 3663826 TI - Proof of safety vs proof of hazard. AB - This paper refines and extends the work of Bross (1985, Biometrics 41, 785-793). One method to determine whether an environment is safe or hazardous is to frame the problem in the context of hypothesis testing. Any "proof" of safety or hazard will depend on the size of both the Type I and Type II errors associated with the test. Many past environmental monitoring programs, however, have ignored the power of the design, regardless of whether the objective was proof of safety or hazard. PMID- 3663827 TI - Phase resetting in a model of cardiac Purkinje fiber. AB - The phase-resetting response of a model of spontaneously active cardiac Purkinje fiber is investigated. The effect on the interbeat interval of injecting a 20-ms duration depolarizing current pulse is studied as a function of the phase in the cycle at which the pulse is delivered. At low current amplitudes, a triphasic response is recorded as the pulse is advanced through the cycle. At intermediate current amplitudes, the response becomes quinquephasic, due to the presence of supernormal excitability. At high current amplitudes, a triphasic response is seen once more. At low stimulus amplitudes, type 1 phase resetting occurs; at medium amplitudes, a type could not be ascribed to the phase resetting because of the presence of effectively all-or-none depolarization; at high amplitudes, type 0 phase resetting occurs. The modeling results closely correspond with published experimental data; in particular type 1 and type 0 phase resetting are seen. Implications for the induction of ventricular arrhythmias are considered. PMID- 3663828 TI - Structural responsiveness of filamentous bacteriophage Pf1: comparison of virion structure in fibers and solution. The effect of temperature and ionic strength. AB - X-ray diffraction from fibers and magnetically oriented solutions has been used to study the effect of changes in environment on the helical symmetry and radial structure of the Pf1 virus particle. Detailed analysis of equatorial scattering to a spacing of 8-10 A was used to identify small radial motions of structural elements in the virus particle. R-factor ratios were used to determine the statistical significance of observed changes. Comparison of the structure of virus particles in fibers with those in solution indicated that the helical symmetry of the virions remains unchanged during fiber formation. In most fibers the virions appear to be slightly distorted by the tight packing of virus particles. This distortion results in an apparent increase in the radius of the virus particle of approximately 0.6 A. A change in the radius of the DNA is also observed. Increase in the concentration of solvent molecules during fiber formation results in penetration of the virus interior by some solvent components. NaCl is also able to enter the virus interior. The change in the helical symmetry of the virions at approximately 8 degrees C appears to be the same whether observed by diffraction from fibers or from solutions. Only subtle changes in radial structure are associated with the temperature transition. PMID- 3663829 TI - Two-step ligand binding and cooperativity. A model to describe the cooperative binding of myosin subfragment 1 to regulated actin. AB - The binding of actin to myosin subfragment 1 (S1) has been shown to occur as a two-step reaction. In the first step actin is weakly bound and then the complex isomerizes to the "rigor type" acto-S1 complex (Coates, J. H., A. H. Criddle, and M. A. Geeves, 1985 Biochem. J., 232:351-356). We propose here a model in which troponin/tropomyosin (Tn/Tm) controls the actin-S1 interaction by inhibiting the isomerization step. In this model the (actin)7 Tn/Tm unit is assumed to exist in two states: open and closed. S1 can bind to either of the two states but only the open form allows the isomerization reaction to take place. We demonstrate that this model can account for the cooperative binding of S1 and S1 nucleotide complexes to actin. The model provides a way of integrating both the effects of calcium and nucleotide on actin-S1 interactions. PMID- 3663830 TI - A new method for measuring the yield stress in thin layers of sedimenting blood. AB - A new method is presented to describe the low shear rate behavior of blood. We observed the response of a thin layer of sedimenting blood to a graded shear stress in a wedge-shaped chamber. The method allows quantitation of the degree of phase separation between red cells and plasma, and extracts the yield stress of the cell phase as a function of hematocrit. Our studies showed that the behavior of normal human blood underwent a transition from a solid-like gel to a Casson fluid. This transition began at the Casson predicted yield stress. The viscoelastic properties of blood were examined at shear stresses below the yield stress. The measured Young's elastic moduli were in good agreement with published data. The yield stress of blood showed a linear dependence on hematocrit up to 60%, and increased more rapidly at higher hematocrit. PMID- 3663831 TI - Molecular aggregation characterized by high order autocorrelation in fluorescence correlation spectroscopy. AB - The use of high order autocorrelation in fluorescence correlation spectroscopy for investigating aggregation in a sample that contains fluorescent molecules is described. Theoretical expressions for the fluorescence fluctuation autocorrelation functions defined by gm,n(tau) = [(delta fm(t + tau)delta fm(t] - (delta Fm(t] (delta Fn(t]]/(F)m+n, where delta F(t) is the fluorescence fluctuation at time t, (F) is the average fluorescence, and m and n are integers less than or equal to 3, are derived. Methods for determining the number densities and relative fluorescence yields of aggregates of different sizes from a series of Gm,n(0) values are outlined. The method is applied to 1,1' dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate suspended in solutions of water and ethyl alcohol. The technique presented may prove useful in detecting and characterizing aggregates of fluorescent-labeled biological molecules such as cell surface receptors. PMID- 3663832 TI - The crypt cycle. Crypt and villus production in the adult intestinal epithelium. AB - We propose a model for the growth of individual crypts that is able to account for the observed changes in the number of cells in crypts under normal conditions, after irradiation, and after 30% resection. Parameter values for this model are estimated both for mouse and man, and detailed predictions of crypt growth rates are made. This model does not predict a steady-state crypt size; rather it suggests that crypts grow until they bifurcate. We therefore propose a crypt cycle (analogous to the cell cycle) and present evidence that most if not all crypts in the adult mouse are cycling asynchronously and independently. This evidence consists of four experiments that indicate that branching crypts are randomly distributed over the intestinal epithelium, that the plane of bifurcation of branching crypts is randomly oriented with respect to the villus base, and that the size distribution of crypts is consistent with an expanding crypt population. We also report for the first time evidence of villus production in the adult mouse intestinal epithelium. We conclude that the crypt and villus populations in the adult mouse are not in a steady state. PMID- 3663833 TI - Orientation of lipid tubules by a magnetic field. AB - Lipid tubules, which are straight hollow cylinders consisting of lipid bilayers, are shown to orient in strong magnetic fields. Birefringence measurements were made of dilute samples of tubules of 1,2-bis(10,12-tricosadiynoyl)-sn-glycero-3 phosphocholine (DC23PC) in magnetic fields of up to 4 T. The tubules were found to orient with their long axes parallel to the field direction, with saturated orientation [P2 (cos theta] approximately greater than 0.95) found at approximately 2 T. From known distributions of lengths and the number of bilayers in the walls, a value delta chi = (-7 +/- 1) X 10(-9) erg cm-3 G-2 was calculated for the tubules, which compares well with some previously reported values for phosphatidylcholines. Magnetic alignment will permit more sophisticated structural studies of monomeric and polymeric tubules, and provide a method of orienting macromolecules in the tubule walls or interior. PMID- 3663834 TI - Brownian dynamics simulation of restricted rotational diffusion. AB - The restricted rotational diffusion of an axially symmetric particle is simulated by the Brownian dynamics technique. In addition to the wobbling-in-a-cone model, several continuous potentials are considered. The particle studied is particularly simple: a sphere anchored to a point fixed in space. However, presenting the results in a convenient, reduced form, they are valid for any axially symmetric particle. From simulated rotational trajectories, we calculate (P2(cos alpha] as a function of t, where alpha is the angle between two orientations separated by time t and P2 is the second Legendre polynomial. This correlation function is closely related to time-resolved electro-optic and spectroscopic properties. Simulated results for the cone model are in excellent agreement with the quasiexact results of Lipari and Szabo (1981, J. Chem. Phys., 75:2971-2976). Thus we confirm the good performance of the simulation technique and the validity of our working conditions. Novel results are presented for continuous restricting potentials, V(theta). The (P2) results for V = 1/2K theta 2 and V = Q(1 - cos theta) are practically the same if K and Q are chosen so tht the long-time (P2) values coincide. Thus, the quadratic potential seems to be a good representation of any monotonically increasing potential. However, for an uniaxial potential such as V = Csin2 theta, the decay is appreciably faster. The (P2) decays simulated for the continuous potentials are analyzed by the monoexponential version of the cone model. We found that such an analysis produces an overestimation of the true rotational diffusion coefficient of approximately 15% only, although for uniaxial potentials the error may be larger. PMID- 3663835 TI - Sarcomere length uniformity determined from three-dimensional reconstructions of resting isolated heart cell striation patterns. AB - A- and I-band striation positions have been obtained, three-dimensionally reconstructed, and statistically analyzed from the volumes of resting isolated heart cells. Striation patterns from optically discrete subvolumes are imaged along the length of these myocytes with a computer-interfaced optical microscope imaging system. Planar striation maps are reconstructed by the computer from sequentially obtained striation pattern images displaced across the width or depth of the cell in controlled steps. Multiple planar maps are combined to form full three-dimensional (3-D) reconstructions that illustrate the sarcomeric structure and ordering throughout the volume of the cell. These reconstructions demonstrate a high degree of striation registration throughout most regions of cardiac cells. The striation registration is often slightly (less than 10 degrees) skewed across the width or depth of nearly every cell and is occasionally disrupted between adjacent groups of sarcomeres. These disruptions in registration are always associated with the locations of the nuclei. Rigorous statistical analyses indicate small volumetric regions of the cell delineated by these disruptions can have significantly (0.014-0.113 micron) shorter or longer average sarcomere length periodicities. Unlike skeletal muscle "fibrillenstruktur," these data from cardiac cells exhibit no evidence of helical packing schemes for sarcomere order. These observations suggest that the relatively large nuclei displace and disrupt the normal registration of the sarcomeres, which is probably mediated by internal cytoskeletal structures. PMID- 3663837 TI - Collagen. An inelastic neutron-scattering study of low-frequency vibrational modes. PMID- 3663836 TI - Theoretical Fraunhofer light diffraction patterns calculated from three dimensional sarcomere arrays imaged from isolated cardiac cells at rest. AB - Sarcomere striation positions have been obtained throughout the volumes of calcium-tolerant resting heart cells by direct computer interfaced high resolution optical imaging. Each sarcomere position is stored in a three dimensional (3-D) matrix array from which Fraunhofer light diffraction patterns have been calculated using numerical methods based on Fourier transforms. Diffraction patterns have been calculated from heart cell data arrays oriented normal to a theoretical laser beam. Twelve characteristic features have been identified and described from these diffraction patterns that correlate to diffraction phenomena observed from both cardiac and skeletal muscle. This numerical approach provides the means to directly assess diffraction pattern formulation, the precision of layer line angular separation, layer-line intensity and angular asymmetries, line widths and fine structures in terms of the known diffracting source structures. These results confirm that theoretical calculations can predict real muscle diffraction patterns and their asymmetries. PMID- 3663838 TI - The calcium hypothesis and modulation of transmitter release by hyperpolarizing pulses. AB - Small presynaptic conditioning hyperpolarizing pulses reduce transmitter release to a depolarizing stimulus by a substantial amount, with little effect on release by a subsequent depolarization. This result, obtained at neuromuscular junctions and the squid giant synapse, has been offered as a disproof of the calcium hypothesis of transmitter release or the residual calcium hypothesis of synaptic facilitation. However, calculations based on several formulations of these hypotheses are shown to be consistent with the experimental results, and no fundamental modification of the hypotheses is necessary. PMID- 3663839 TI - Direct evidence for the formation of a monolayer from a bilayer. An ellipsometric study at the nitrogen-water interface. AB - Direct evidence for the formation of a monolayer from a bilayer was measured by ellipsometry after spreading unilamellar vesicles of dioleoyl phosphatidylcholine (DOPC) at the nitrogen-water interface. The ellipsometric isotherms of DOPC vesicles and DOPC spread from an organic solvent were compared and found similar. From the observed ellipsometric angle (delta delta) in the plateau region (-1.04 degrees) and literature data for refractive indices of an anisotropic film similar to DOPC, we have calculated a thickness of 20 +/- 1 A. These results strongly suggest that, similarly to DOPC spread from an organic solvent, DOPC vesicles form a monolayer when spread at the nitrogen-water interface. PMID- 3663840 TI - Self-association of adenosine 5'-monophosphate (5'-AMP) as a function of pH and in comparison with adenosine, 2'-AMP and 3'-AMP. AB - The concentration dependence of the chemical shifts for protons H-2, H-8, and H 1' of adenosine (Ado), 2'-AMP, 3'-AMP and 5'-AMP was measured in D2O at 27 degrees C under several degrees of protonation. All results are consistent with the isodesmic model of indefinite noncooperative stacking. The association constants for Ado decrease with increasing protonation: Ado (K = 15 M-1) greater than D(Ado)+/Ado (6.0 M-1) greater than D(Ado)+ (0.9 M-1). In contrast, a maximum is observed with 5'-AMP: 5'-AMP2- (K = 2.1 M-1) less than D(5'-AMP)- (3.4 M-1) less than D2(5'-AMP) +/- /D(5'-AMP)- (5.6 M-1) greater than D2(5'-AMP) +/- (approximately 2 M-1) greater than D3(5'-AMP)+ (less than or equal to 1 M-1). Self-stacking is most pronounced here if 50% of the adenine residues are protonated at N-1; complete base protonation reduces the stacking tendency drastically. Comparing the self-association of 2'-, 3'- and 5'-AMP shows that there is no influence of the phosphate-group position in the 2-fold negatively charged species, i.e., K congruent to 2 M-1 for all three AMP2- species. More importantly, there is also no significant influence observed if the stacking tendency of the three D2(AMP) +/- /D(AMP)-1:1 mixtures is compared (K congruent to 6-7 M-1); moreover, the measured association constants are within experimental error identical with the constant determined for D(Ado)+/Ado (K = 6.0 M-1). This indicates that any coulombic contribution between the -PO3(H)- group and the H+ (N-1) unit of the adenine residue to the stability of the mentioned stacks in D2O is small. However, experiments in 50% (v/v) dioxane-D8/D2O with the D2(5'-AMP) +/ /D(5'-AMP)- 1:1 system reveal, despite its low solubility, that coulombic interactions contribute to the self-association in an environment with a reduced polarity (compared to that of water). The implications of these observations for biological systems are briefly indicated. PMID- 3663841 TI - Potassium transport through lipid bilayer membranes facilitated by tentoxin dimers. A new mechanism of ion carrier transport? AB - The cyclic tetrapeptide tentoxin at concentrations greater than 5 X 10(-7) M selectively increases the ion conductivity for potassium of lipid bilayer membranes, while the naturally occurring derivative dihydrotentoxin has no influence on this property. Current-voltage curves, zero-current potential and charge-pulse measurements were used to characterize the action of tentoxin. The results suggest that a new mechanism of facilitated ion transport operates. The model of tentoxin dimerization and tentoxin-K+ association developed is in contradiction to the model of tentoxin pore formation described recently by Heitz et al. (Biophys. Chem. 23 (1986) 245). PMID- 3663842 TI - Fluorescence investigation on conformational state of rabbit muscle aldolase interacting with phosphatidylinositol liposomes. AB - Evidence of conformational changes in rabbit muscle aldolase upon binding to phosphatidylinositol liposomes and the effect of the interaction on the thermal conformational transition are reported. Interaction with phosphatidylinositol liposomes significantly decreases the aldolase tryptophanyl fluorescence and shifts the maximum wavelength to higher values. The dynamic quenching constant for the aldolase fluorescence quenching by acrylamide in the presence of liposomes is much higher than that for unmodified enzyme; this signifies an increase in accessibility of some tryptophanyl residues to small polar molecules. Indirect interaction between single phospholipid molecules, small micelles or any soluble impurities able to penetrate into the protein molecule interior does not seem to be involved in the conformational rearrangement. Native and liposome interaction-induced conformational states reveal different temperature dependences of the tryptophan residues exposure. The implications of the modification of the conformational state of the enzyme for its function in vivo are discussed. PMID- 3663843 TI - A comparison by ultracentrifugation of the effects on DNA of ethidium bromide and of acridine orange at low ionic strength. AB - The application of scaled particle theory to the gels formed by DNA in the ultracentrifuge has provided values for the effective length and the effective radius of the DNA particle. Ethidium bromide has been shown to cause extensive lengthening of the DNA in dilute salt. Acridine orange interaction with DNA resulted in modest changes in DNA dimensions. These results are explained in terms of binding for acridine orange and of denaturation of DNA by ethidium bromide. PMID- 3663844 TI - Dynamic light-scattering study of muscle F-actin. II. AB - By dynamic light scattering, the intensity autocorrelation function, G2(tau) = B[1 + beta[g1(tau)[2], was obtained over the scattering angles (theta) from 30 to 130 degrees in steps of 10 degrees for semidilute solutions of muscle F-actin and of F-actin complexed with heavy meromyosin in the absence of ATP (acto-HMM), where B is the baseline and beta a constant. The main findings were: (1) A 0.5 mg/ml F-actin solution gave nonreproducible spectra at theta less than or equal to 40 degrees but quite reproducible spectra at theta greater than or equal to 50 degrees, with beta = 0.9-0.8 at all theta values. Nonreproducibility of spectra at low theta values was concluded to be due to restricted motions of very long filaments confined in cages or zig-zag tubing formed by a major fraction of filaments, where the very long filaments were those at a distant tail of an exponential length distribution and the major fraction of filaments were those with lengths around Ln-2Ln, Ln being the number-average length. Spectral widths were compared with theoretical ones for rigid rods averaged over the length distribution with Ln = 900 nm, and were suggested to be largely contributed at high theta values from bending motions of filaments. (2) Acto-HMM solutions at 0.5 mg/ml F-actin and at weight ratios of HMM to F-actin of 0.5-2 gave spectra which, with respect to theta, behaved very similarly to those of F-actin alone. The spectral widths, however, drastically decreased with the weight ratio up to unity and stayed virtually constant above unity. In contrast to a previous study (F.D. Carlson and A.B. Fraser, J. Mol. Biol. 89 (1974) 273), beta values of acto HMM were as large as those of F-actin alone. Acto-HMM was concluded to travel a distance far greater than 1/K with a mobility smaller than that of F-actin, where K = (4 pi/lambda) sin(theta/2), lambda being the wavelength of light in the medium. These results suggest that acto-HMM gels are very soft even though they did not pour from an inverted cell. Based on several intuitive models which give a mutual relationship between the beta value and modes of motion of scatterers, we discuss the restricted motions responsible for nonreproducibility of spectra at low angles and large beta values of acto-HMM gels at all theta values and weight ratios so far studied. PMID- 3663845 TI - Demonstration of an associated anisotropy decay by frequency-domain fluorometry. AB - We used frequency-domain fluorometry to demonstrate the presence of an associated decay of fluorescence anisotropy. In such systems the individual correlation times are associated with distinct emitting species, each with its own characteristic lifetime and rotational correlation times. We obtained an associated system using 1-anilino-8-naphthalenesulfonic acid (ANS) in the presence of increasing amounts of apomyoglobin. When both free and apomyoglobin bound ANS contributed to the emission the differential polarized phase angles become negative at particular frequencies, even though the fundamental anisotropy (r0) is greater than zero. Additionally, the modulated anisotropy decreases at high frequencies. Both observations appear to be the unique consequence of an associated anisotropy decay, and are not possible for a multiexponential anisotropy decay of a single species. PMID- 3663846 TI - Sugar interaction with biologically active cis-PtCl2(NH3)2 (anticancer) and its inactive trans isomer. AB - The interaction of D-glucuronic and D-gluconic acids with cis- and trans PtCl2(NH3)2 (cisplatin and transplatin) has been investigated in aqueous solution and solid complexes of the type cis-[PtL(NH3)2]L.H2O and trans-[PtL2(NH3)2]L.H2O, where L = D-glucuronate or D-gluconate anions, are isolated and characterized by means of Fourier transform-infrared and 1H-NMR spectroscopy, and molar conductivity and X-ray powder diffraction measurements. Spectroscopic and other evidence indicated that the sugar anions bind monodentately in trans [PtL2(NH3)2].H2O and bidentately in cis-[PtL(NH3)2]L.H2O complexes through the carboxylate oxygen atoms and other sugar donor groups. The strong sugar intermolecular hydrogen-bonding network is altered to that of the sugar OH...NH3(H2O)...OH-sugar, upon platinum-ammine interaction. The D-glucuronate anion has the beta-anomer configuration both in the free salt and in these platinum-sugar complexes. PMID- 3663847 TI - Why is Mg2+ necessary for specific cleavage of the terminal phosphoryl group of ATP? AB - The mechanism of specific cleavage of the terminal phosphoryl group in hydrolysis of ATP, and the role of Mg2+ in the hydrolysis were studied by ab initio molecular orbital calculations. The tetravalent anion of methyl triphosphate was used as a model of the ATP anion, and its electronic structures were determined as a function of the distance between Mg2+ and its beta-phosphoryl group. We found that the closer location of Mg2+ to the beta-phosphoryl group than to the alpha- or gamma-phosphoryl group was effective in weakening the P-O bond at which the cleavage of ATP catalyzed by most enzymes takes place. Moreover, the orbital coefficient of the frontier electron of P gamma, which is related to the nucleophilic reaction, was shown to increase greatly with increasing interaction between Mg2+ and the beta-phosphoryl group. PMID- 3663848 TI - Structural and dynamical characterization of piroxicam by 1H- and 13C-NMR relaxation studies. AB - Carbon spin-lattice relaxation rates of an anti-inflammatory drug, piroxicam, have been measured. These results have been used in determining the reorientational rates of the proton carbon vectors. An analysis of internal motions within the pyridinyl moiety of piroxicam was carried out. Selective proton-carbon nuclear Overhauser effect (NOE) measurements were made in order to determine the solution structure of piroxicam. The effect of indirect NOE arising from exchangeable protons has been analyzed and considered. PMID- 3663849 TI - Salt effects on internal motions of superhelical and linear pUC8 DNA. Dynamic light scattering studies. AB - The plasmid pUC8 (2717 bp) has been studied in its native superhelical and Eco RI linearized forms by dynamic light scattering at NaCl concentrations from 1.1 mM to 1 M. The data were analyzed using the biexponential model for the dynamic structure factor described by us in a previous paper (J. Langowski, U. Giesen and C. Lehmann, Biophys. Chem. 25 (1986) 191). As before, we could identify two decay components corresponding to the center-of-mass diffusion and to internal motions of the DNA, where the fast component could be identified as a rotational diffusion contribution in the case for superhelical, but not for linear DNA. We found that the conformation of superhelical pUC8 is not affected by changing the ionic strength, while the amplitude of the internal relaxation increases approx. 2-fold when [NaCl] is raised from 1.1 mM to 1 M. The linearized DNA shows an increase of the diffusion coefficient with ionic strength which is, however, not quite as pronounced as that found by others (Z. Kam, N. Borochov and H. Eisenberg, Biopolymers 20 (1981) 2671), and, together with the unchanged conformation of the superhelical DNA, suggests a persistence length which is not strongly dependent on ionic strength. In contrast to the increasing amplitude of internal relaxation for the superhelical DNA, this amplitude remains constant or decreases slightly for linear DNA on going from 1.1 mM to 1 M salt. Our findings are further discussed with respect to possible models of the interwound form of superhelical DNA. PMID- 3663850 TI - A Brillouin scattering study of the hydration of Li- and Na-DNA films. PMID- 3663851 TI - Local deformation studies of chain molecules: differential conditions for changes of dihedral angles. PMID- 3663852 TI - Thermodynamic models for water-protein sorption hysteresis. PMID- 3663853 TI - Dynamic light-scattering study of semiflexible polymers: collagen. PMID- 3663854 TI - Theoretical determination of the CD of proteins containing closely packed antiparallel beta-sheets. PMID- 3663855 TI - Dynamic properties of oxy- and carbonmonoxyhemoglobin probed by optical spectroscopy in the temperature range of 300-20 K. PMID- 3663856 TI - A mixed beta-turn and beta-sheet structure for bovine tooth enamel amelogenin: Raman spectroscopic evidence. PMID- 3663857 TI - Prediction of protein--ligand interactions: the complex of porcine pancreatic elastase with a valine-derived benzoxazinone. PMID- 3663858 TI - Comparison by 1H-nmr spectroscopy of the conformation of the 2600 dalton antifreeze glycopeptide of polar cod with that of the high molecular weight antifreeze glycoprotein. PMID- 3663859 TI - Molecular mechanics modeling of oligonucleotide adducts of the antitumor drug cis diamminedichloroplatinum(II). PMID- 3663860 TI - Conformational constraints of amino acid side chains in alpha-helices. PMID- 3663861 TI - A theoretical study of the effects of driven motion on rotational correlations of biological systems. PMID- 3663862 TI - Sequential resonance assignment of the 500-MHz nmr spectrum of d-(CG)6 and its structure under low-salt conditions. PMID- 3663863 TI - IR spectra and conformational behavior of N-acetyl-(glycine, L-alanine, L leucine)-N'-methylamides in chloroform. PMID- 3663864 TI - Induced CD of DNA intercalators: electric dipole allowed transitions. PMID- 3663865 TI - Enthalpy and entropy changes for the intercalation of small molecules to DNA. II. Ethidium and propidium fluoride. PMID- 3663866 TI - The effect of anisotropic properties of randomly oriented particles on polarized light: an operational calculus for spatially heterogeneous distributions. PMID- 3663867 TI - Tryptophan fluorescence studies of plasma fibronectin: effects of environmental factors. PMID- 3663868 TI - Conformational behavior of the polysaccharide backbone of murein. PMID- 3663869 TI - Vibrational CD of polypeptides. X. A study of alpha-helical oligopeptides in solution. PMID- 3663870 TI - Molecular mechanics studies of parallel and antiparallel phosphate-methylated DNA. PMID- 3663871 TI - Synthesis, and conformational and biological study of 2-D-Ala,5-des-Met enkephalin hydrazide modified at the carboxylic end by poly-N-vinylimidazole. PMID- 3663872 TI - The thermodynamic parameters of the interaction of concanavalin A with glycosyl free liposomes: a microcalorimetric study. PMID- 3663873 TI - Beta-turns in bridged proline-containing cyclic peptide models. PMID- 3663875 TI - Calculating thermodynamic data for transitions of any molecularity from equilibrium melting curves. PMID- 3663874 TI - Proline-induced constraints in alpha-helices. PMID- 3663876 TI - The melting behavior of a DNA junction structure: a calorimetric and spectroscopic study. PMID- 3663877 TI - Interaction between morphine, an opioid agonist, and clonidine, an alpha adrenergic agonist, on the regulation of anterior pituitary hormone secretion in normal male subjects. AB - In order to investigate the possible interaction between opioid system and noradrenergic system in the regulation of pituitary hormone secretion, the effects of morphine (an opioid agonist, 10 mg i. v.), clonidine (an alpha adrenergic agonist, infusion of 0.3 mg in 15 minutes) and clonidine + morphine (infusion of the same dose of clonidine beginning 30 minutes before morphine 10 mg i.v.) on anterior pituitary hormone secretion were studied in six normal male volunteers. Morphine alone induced both an increase in TSH and PRL serum levels and a decrease in cortisol serum levels with no changes in GH serum levels. On the contrary clonidine was able to increase GH and TSH levels and to decrease cortisol levels; PRL secretion was not affected. As regards interaction between morphine and clonidine we observed that morphine-induced increase in PRL release was potentiated by clonidine pretreatment; as regards TSH secretion its increase was greater after the administration of the two drugs with respect to the effect of the single drugs. This study, in agreement with our previous data concerning LH secretion, confirms the important link between clonidine and opioid system in neuroendocrine function, too; the possible explanations of our data are discussed. PMID- 3663878 TI - Single dose and steady-state pharmacokinetics of adinazolam after oral administration to man. AB - An aqueous solution containing 1 mg of adinazolam mesylate per ml was administered orally as a single dose (40 mg) and with loading doses followed by hourly doses such that final dose rates of 1, 2, and 3 mg h-1 were administered to steady-state. Four subjects exhibited linear steady-state kinetics, while the other four exhibited Michaelis-Menten kinetics, based on measurement by HPLC of both unchanged drug and the major N-demethyl metabolite. The drug is very rapidly absorbed and has an intrinsic clearance of total (bound + free) drug which averaged 2.14 l min-1 based on the steady-state data and 1.17 l min-1 based on the single dose data, but these means do not differ significantly. The apparent metabolite clearance, CLmc/fm (where fm = fraction of adinazolam converted to the N-demethyl metabolite), averaged 0.170 l min-1 based on steady-state data and 0.179 l min-1 based on single dose data and these means do not differ significantly. Pharmacokinetic parameters, such as these clearances, had large intersubject variations. Three types of bioavailabilities were estimated from the data. PMID- 3663879 TI - Pharmacokinetic analysis of sustained-release dosage forms of theophylline in humans: comparison of single and multiple dose studies. AB - A pharmacokinetic analysis of two sustained-release dosage forms of theophylline (Theo-Dur and Theotrim) was carried out following single and multiple dose administrations of the two formulations in five healthy subjects. Despite the prolonged absorption after administration of the two sustained-release formulations, theoretical predictions of theophylline steady-state levels following multiple dosages based upon data obtained from the single dose study, correlated with the data of the multiple dose study. This study shows that the recommended dose and dosage regimen of new sustained-release formulations of theophylline can be based upon single dose studies. In the population studied, repetitive doses of 450 mg b.i.d. of Theo-Dur and Theotrim maintain steady-state concentrations of theophylline within the drug's therapeutic window. PMID- 3663880 TI - Disposition of a silicon-containing amide, an inhibitor of acyl-CoA: cholesterol acyltransferase, in dog and rat. AB - The pharmacokinetics of 3-(decyldimethylsilyl)-N-[2-(4-methylphenyl)-1 phenylethyl]propanamide (DMPP), an inhibitor of acyl-CoA:cholesterol acyltransferase, have been studied in the dog and the rat using 14C and 3H dual labelled drug. In both species, gastrointestinal absorption of DMPP was slow and incomplete, amounting to approximately 20 per cent of the oral dose given in corn oil. In the rat, use of PEG-400, Tween 80, ethanol, and aqueous CMC as vehicles resulted in similar or lower absorption than corn oil. Absorbed DMPP was rapidly and extensively distributed to body tissues. Data from the rat showed highest concentrations of radioactivity in the liver and spleen, while concentrations in the adrenals and lung also markedly exceeded circulating radioactivity levels. In both dog and rat. DMPP was completely metabolized prior to excretion. The routes of biotransformation involved hydrolysis of the amide bond, oxidation of the phenyl ring, and degradation of the decyldimethylsilyl propanoyl moiety. The metabolites of DMPP were excreted slowly, predominantly in the faeces. The elimination half-life of 14C was 105 h in the dog and 83 h in the rat, while that of 3H was approximately 32 h in both species. PMID- 3663881 TI - Amiodarone pharmacokinetics. II. Disposition kinetics following subchronic administration in rats. AB - A 30 mg kg-1 intravenous bolus of 14C-amiodarone (19 microCi kg-1) was given to male Sprague-Dawley rats pretreated with 0 (vehicle), 25 or 100 mg kg-1 day-1 of amiodarone HCl orally for 37-42 days to determine the effects of dose and duration of administration on the disposition kinetics of amiodarone. Serial blood samples and total urine were collected over 48 hours and assayed for 14C amiodarone by liquid scintillation counting following separation by HPLC. In all three groups, the blood 14C-amiodarone concentration-time curves declined bioexponentially with terminal half-lives (t1/2 beta) ranging from 14-22 hours. No differences in beta, t1/2 beta, or central compartment volume (Vc) were observed between the three groups of rats. In the rats pretreated with 100 mg kg 1 day-1 of amiodarone HCl for 5-6 weeks, amiodarone clearance (CL) and steady state volume of distribution (Vss) were reduced 52 per cent (12.2 to 5.9 ml min-1 kg-1) and 41 per cent (11.73 to 6.97 l kg-1), respectively. At the lower amiodarone daily dose, no changes in CL or Vss were observed. Negligible levels of radioactivity were detected in the urine. Amiodarone accounted for approximately 30-40 per cent of the total radioactivity in each blood specimen. This study demonstrated that CL and Vss were dose-dependent, and that beta, t1/2 beta and Vc were dose-independent. The results further suggested that the disposition kinetics of amiodarone were independent of the duration of drug administration. PMID- 3663882 TI - Comparative steady state bioavailability of conventional and controlled-release formulations of albuterol. AB - A new controlled-release (CR) dosage formulation of albuterol has been developed which is suitable for twice-a-day dosing. The present study was conducted in twelve healthy adult male volunteers to compare the steady state plasma levels obtained following repeated administration of a 4 mg CR tablet (q12h) compared to a 2 mg conventional table (q6h) for 5 consecutive days. The mean steady state plasma level-time curves for both the CR and conventional tablet treatments were comparable over time and reproducible. There were no significant differences in the AUC or Cmax values between the two treatments. The mean 48-h AUC values were 240.7 and 231.3 h X ng ml-1 for the conventional and CR tablets, respectively, while the corresponding Cmax values ranged from 5.3 to 6.8 ng ml-1 and 5.4 to 6.5 ng ml-1. There were no significant differences in Cmin values except for one 12-h (day 4) value. Cmin values ranged from 3.8 to 4.3 ng ml-1 and 3.0 to 4.8 ng ml-1 for the conventional and CR tablets, respectively. The data show that the 4 mg albuterol CR tablet (q12h) is bioequivalent to a 2 mg conventional albuterol tablet (q6h). The CR tablet formulation will offer the advantage of increased patient compliance; additionally, the CR formulation may prove to be especially beneficial in the treatment of nocturnal asthma. PMID- 3663883 TI - Development of a standard, freeze-dried serum containing the drugs assayed most often in French hospitals. AB - A quality control program for the therapeutic drug monitoring methodology used to determine serum levels of the fourteen drugs assayed most frequently by French hospital laboratories is described. The program has been adopted by the Societe Francaise de Biologie Clinique (SFBC), which provides participating laboratories with a statistical analysis of the performance data. The control samples developed for the program are prepared by spiking calf serum with, in one case, phenobarbital, phenytoin, carbamazepine, sodium valproate, amikacin, lithium carbonate, digitoxin and hydroquinidine, and, in the other case, caffeine, quinidine, digoxin, isoniazid and gentamycin. After freeze-drying the spiked serum, the drugs were shown to be stable for at least a year when stored at -20 degrees, +4 degrees and +22 degrees; at the end of this time, the samples were pathogen free. For checking therapeutic drug monitoring methods, the freeze-dried serum is diluted with distilled water (10 ml); these solutions are chemically stable, and remain pathogen-free, when stored in stoppered glass tubes at -20 degrees or +4 degrees for 4 weeks. PMID- 3663884 TI - Prediction of steady-state bioequivalence relationships using single dose data I linear kinetics. AB - Simulated data using a linear one- and two-compartment body model with different absorption characteristics were used to evaluate the ability of single dose bioavailability data to predict the relationships that exist at steady state. This was done by comparing the confidence intervals obtained from single and multiple dose data sets for the parameters of Tmax, Cmax, and area under the curve from time zero to infinity (AUC0-infinity). As a consequence of Tmax and Cmax decreasing and increasing from single to multiple dosing regimens, the confidence intervals for these parameters reflected these changes. The 90 per cent confidence interval expressed as a percentage of the reference mean increased or decreased for Tmax dependent upon the ratio of Ka test/Ka reference, and decreased for Cmax while the interval for AUC0-infinity exhibited no predictable pattern and appeared to be influenced by the amount of error in the data set. Alteration of either the dosing interval or the fraction absorbed did not affect the pattern of change in the confidence intervals for Tmax and Cmax, but the latter did result in a decrease in the interval for AUC0-infinity. Analysis of the confidence intervals for Tmax, Cmax and AUC0-infinity in bioequivalency studies for quinidine gluconate and procainamide hydrochloride following administration of single and multiple doses to different subjects appeared to be consistent with the patterns observed for the simulated data sets. PMID- 3663885 TI - Phenylpropanolamine pharmacokinetics in dogs after intravenous, oral, and oral controlled-release doses. AB - An adaption of a published high performance liquid chromatographic (HPLC) assay for phenylpropanolamine (PPA) in plasma was used to examine PPA pharmacokinetics in dogs. Plasma was extracted into ethyl acetate after the addition of 3.5 per cent sodium carbonate, and was then back-extracted into aqueous acetic acid. The acetic acid was injected onto a cyano column using a mobile phase of acetonitrile, dilute hydrochloric acid, and sodium heptane sulfonate. Detection was by UV absorbance at 210 nm. The relative standard deviation of replicate assays averaged 5.2 per cent over a concentration range of 50-1750 ng ml-1 plasma. PPA extraction recovery exceeded 90 per cent. The limit of detection was 30 ng ml-1 using 0.5 ml plasma and injecting 10 microliter. PPA disposition was characterized in three dogs administered PPA i.v. and orally in immediate-release and controlled-release formulations. The terminal elimination half-life averaged 3.5 +/- 0.5 h after the i.v. dose. Oral absorption from the immediate-release capsule was rapid and bioavailability was 98.2 +/- 6.9 per initial rapid cent. PPA absorption from the controlled-release dosage form was biphasic; an rapid phase was followed by a second, slower absorption phase which continued over 16 h. Plasma PPA concentrations then declined with a half-life roughly parallel to the i.v. and oral immediate-release half-lives. Oral bioavailability from the controlled release tablet was 93.7 +/- 5.9 per cent. PMID- 3663886 TI - Acetoacetyl-CoA ligase activity in the isolated rat hepatocyte: effects of 25 hydroxycholesterol and high density lipoprotein. AB - The activity of acetoacetyl-CoA (AcAc-CoA) ligase (E.C.6.2.1.16) in hepatocytes from rats was shown to be the same as the activity in homogenates of their livers. In hepatocytes treated with 25-hydroxycholesterol, AcAc-CoA ligase, 3 hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase and rates of sterol synthesis were substantially decreased. Hepatocytes treated with high density lipoprotein (HDL) exhibited a 2 to 4 fold induction of HMG-CoA reductase activity; however an accompanying increase in AcAc-CoA ligase activity and the rate of cholesterol synthesis was not observed. We conclude (a) that increases in the activity of HMG CoA reductase when mediated by HDL in hepatocytes do not result in a corresponding change in the capacity for sterol synthesis and (b) that changes in the activity state of HMG-CoA reductase can be dissociated from that of AcAc-CoA ligase. PMID- 3663887 TI - Comparison of the interaction of the anti-viral chemotherapeutic agents amantadine and tromantadine with model phospholipid membranes. AB - Amantadine and tromantadine are agents used against influenza and herpes infections, respectively. Tromantadine raises the bilayer to hexagonal phase transition temperature of synthetic phosphatidylethanolamines and is less disruptive to phospholipid packing. Tromantadine acts similar to cyclosporin A, previously demonstrated to inhibit viral-induced cell-cell fusion. We suggest the balance between the hydrophobic and hydrophilic group sizes would allow tromantadine to prevent membrane fusion more than amantadine and thus inhibit infection by viruses such as Herpes, which fuse with the plasma membrane. Study of agents which stabilize the bilayer phase of membranes may lead to efficacious inhibitors of viral infections requiring cell fusion events. PMID- 3663888 TI - Purification of four gelatin-binding proteins from bovine seminal plasma by affinity chromatography. AB - Bovine seminal plasma contains three similar acidic proteins, which we have previously designated as BSP-A1, BSP-A2, and BSP-A3. These proteins contain two homologous domains that are similar to type II structures present in the gelatin binding domain of fibronectin. The present data have revealed that these proteins, like fibronectin, also form complexes with gelatin, a denatured collagen. Based on this property, a single step affinity purification method has been developed. In addition to these three proteins BSP-A1, -A2 and -A3, another protein with an apparent molecular weight of 30,000 dalton (named BSP-30-kDa) also bound to the gelatin-agarose column. Elution of these proteins from affinity columns using a linear gradient of either urea or arginine gave essentially the same pattern with a high yield of 90-95%. The purified proteins were homogeneous by SDS-polyacrylamide gel electrophoresis, amino acid composition and HPLC. Chromatography of bull seminal vesicular fluid also exhibited an elution pattern similar to that obtained for bull seminal plasma. The availability of these purified proteins should aid in understanding the physiology of these gelatin binding proteins. PMID- 3663889 TI - Perihemorheology rather than parahemorheology. PMID- 3663890 TI - Fission and refusion of red blood cells using a micropipette technique. AB - In micropipette experiments with small capillaries and moderate high pressure difference (approximately 1000 Pa) cell fragmentation (fission) of human red blood cells without hemolysis was observed by TV-system for a large number of fresh red blood cells of different donors. After separation, the fragment moves away from the residual cell. In seven cases this process was evaluated quantitatively and was shown that the rate of the fragment was constant in time. Two mechanisms for this phenomenon are discussed. In particular cases a spontaneous re-fusion with the residual cell body in the capillary can be observed. In our opinion probably protein-depleted membrane surfaces arise and membrane fusion is possible simply by mechanical contact without additional electric fields and/or fusion agents. PMID- 3663891 TI - Intrinsic viscoelasticity of blood cell suspensions: effects of erythrocyte deformability. AB - The intrinsic viscoelasticity of erythrocyte suspensions holds great potential for specifying the deformability of the individual, noninteracting cells in an oscillatory shear flow field. In order to extrapolate to zero cell concentration, the complex viscoelastic modulus was measured as a function of hematocrit using 2 Hertz oscillatory flow and a shear rate of 10/sec. This was done for both normal cells and cells with severely reduced deformability when hardened with glutaraldehyde. Suspension media were blood plasma, isotonic saline, and Dextran solutions. The real parts of the complex intrinsic visco-elasticities were obtained by an extrapolation using a regression fit to Huggins' equation. For normal cells in native plasma the values ranged from 1.7 to 2, increasing to the range 2.4 to 3.1 when the plasma was diluted with isotonic saline solution. For hardened cells the value obtained was near 3.5. These results are compared with theories for suspensions of both rigid and deformable particles. Several theories for deformable particles predict an increase in intrinsic viscoelasticity with increases in the ratio of the viscosity of the interior of the particle to that of the suspending medium. This ratio controls the balance between rotational and deformational response of the cell in the flow field. The trends of these theories were observed in the measurements. PMID- 3663892 TI - Dynamics of membrane structure of frog erythrocyte ghosts measured with a nanosecond fluorometer. AB - The dynamics of membrane microstructure was studied as molecular motions of phospholipids for bullfrog erythrocyte ghosts by the DPH fluorescence depolarization technique with a nanosecond fluorometer. The bullfrog erythrocyte ghosts were obtained by hypotonic lysis and collagenase treatment. The constituents of membrane proteins were confirmed by the disk gel electrophoresis. The viscosity of erythrocyte membrane ghosts was estimated to be 3.3 +/- 1.0 at 10 degrees C, and 2.1 +/- 0.1 at 20 degrees C and 1.3 +/- 0.2 at 30 degrees C in the unit of poise and the wobbling angle of lipid molecule was 35 +/- 1, 41 +/- 1 and 43 +/- 1 degree at the respective temperatures on an average and +/- S.D. The viscosity is lower than that of human erythrocytes. The relatively low viscous phospholipid bilayer may be one of the factors for the deformability of bullfrog erythrocytes. PMID- 3663893 TI - Transvascular exchange of fluid and plasma proteins. AB - A theoretical model of transvascular exchange of fluid and plasma proteins in the microcirculation is developed based on fundamental laws of the fluid mechanics and on phenomenological transport equations of the irreversible thermodynamics. Intravascular axial changes of the pressure, flow and plasma protein concentration are taken into account as well as axial gradients of vascular permeability. Proper nondimensionalization of the resulting equations leads to the identification of dimensionless parameters which combine the transport characteristics of the endothelial wall and the intravascular flow resistance. In the theory, the dependence of the reflection coefficient on the transport coefficients of the vascular wall and on the plasma protein concentration is established. The model is applied to the cat mesentery and the rat intestinal muscle. The numerical simulations indicate that taking into account vascular protein permeability yields considerable differences in the axial distribution of the plasma protein concentration and transvascular fluxes in comparison with the case of protein impermeability of the endothelial wall. The results show that the maximum of the transvascular fluid and plasma protein movement resides at the site of the small venules while a minimum of the exchange occurs at the site of the midcapillaries. PMID- 3663894 TI - Pressure losses in non-Newtonian flow through rigid wall tapered tubes. AB - Pressure drop and pressure gradient were measured in steady Newtonian and non Newtonian flow through tapered tubes having angles of taper, alpha, between 0.5 degree and 1.25 degrees. Aqueous solutions of polyacrylamide, characterized as power law fluids, were used for the non-Newtonian flow measurements. These solutions had power law parameters similar in magnitude to those of blood. The pressure drop-flow rate data compared well with the predictions of a semi empirical flow model over a large range of flow rates (Re alpha up to 10 for Newtonian flow and 5.7 for non-Newtonian flow). The pressure gradient increased with distance, z, into the taper as the radius decreased. The linear relationship between pressure gradient and z, derived by Oka (Biorheology, 10, 207-212, 1973) was found to be valid only when alpha z was small. For the tapered tubes examined here, agreement was confined to the region near the inlet. If higher order terms in alpha z were taken into account the agreement was extended further into the taper. However, under higher flow conditions, when the inertial losses are not negligible, the semi-empirical model provides much better estimates of pressure gradient. PMID- 3663895 TI - Tube flow of human blood at near zero shear. AB - Pressure-velocity relations were obtained in vertical and horizontal glass tubes (I.D. 26 to 83 micron) perfused with normal human blood at feed hematocrits between 0.25 and 0.65. Perfusion pressures used corresponded to wall shear stresses up to 0.27 dyn cm-2. Red cell velocity measurements were made both immediately following implementation of perfusion pressure (with red cells still disaggregated) and in a steady state situation (with red cells aggregated). Analysis of the slopes of the linear relations between perfusion pressure and velocity showed apparent viscosity to decrease with the manifestation of red cell aggregation. In horizontal tubes, sedimentation and aggregation occurred simultaneously, and apparent viscosity increased due to axial asymmetry of cell concentration. Evidence for a yield shear stress (flow stagnation at positive driving pressure) was not observed. PMID- 3663896 TI - Viscous macromolecules inhibit erythrocyte hemolysis induced by snake venom phospholipase A2. AB - The effect of medium viscosity on lysis of red blood cells (RBC) induced by snake venom phospholipase A2 (PLA2) was examined. The medium viscosity was modified by the addition of various macromolecules which differ in their chemical nature and in their capacity to increase fluid viscosity. PLA2 and Ca++ were applied to cells suspended in viscous medium to induce hemolysis. It was found that the hemolysis is inhibited in direct proportion to increasing viscosity of the extracellular fluid. This phenomenon was observed with aggregated as well as disaggregated RBC. To examine whether the viscosity interferes with the accessibility of the enzyme to the cell, the medium viscosity was modified after binding of the enzyme to the cells; PLA2 was added to a RBC suspension in the presence of Ba++ which binds the enzyme to the cell membrane but does not activate it. The cell-enzyme complex was separated by gel filtration and suspended in viscous medium in the presence of Ca++ which activates the reaction. Also in this case RBC lysis was inhibited as the medium viscosity was increased. It is proposed that the action of PLA2 on RBC membrane is regulated by the viscosity of the cell surface aqueous environment. PMID- 3663897 TI - Rheology of synovial fluid. AB - After a discussion of the role of synovial fluid as a joint lubricant, rheological measurements are described with both normal (healthy) synovial fluids and pathological ones. Shear stress and first normal stress difference are measured as a function of shear gradient to calculate the apparent shear viscosity eta 1 and the apparent normal viscosity psi 7 as well as an apparent shear modulus G'. It is found, that in case of diseased synoviae all rheological parameters deteriorate. Most significant changes are observed with the zero shear viscosity eta 0, the shear modulus G', and a characteristic time theta 1, which is the reciprocal of the critical shear rate Dc which determines the onset of shear thinning. The rheological deterioration of synovial fluids is explained in terms of solute structure, whereby a molecular mass of the backbone hyaluronic acid of at least 10(7) g.mol-1 is required for satisfactory function. A theory of the rheological performance of normal synovial fluid as well as its pathological deterioration is proposed. PMID- 3663898 TI - Blood's critical Taylor number and its flow behavior at supercritical Taylor numbers. AB - When the inner cylinder of a fluid-filled Couette viscometer is rotated rapidly, a vortical flow pattern develops when a dimensionless value referred to as the critical Taylor number (Tc) is reached. We have determined its magnitude in our viscometer for three Newtonian fluids and for blood at 37 degrees C, using the inflection point of torque/RPM vs. RPM (sudden rise in apparent viscosity). Its position was identified by least squares line fitting. Because blood was studied, the viscosity used in Tc calculation was the apparent bob shear stress/shear rate ratio at the inflection marking vortical flow onset. For glycerol-water mixtures Tc was 41.8 +/- 0.3 (N = 11), for propylene glycol 42.0 +/- 0.2 (N = 14), for silicone oil 41.8 +/- 0.2 (N = 11). For healthy blood Tc was 40.7 +/- 0.9 (N = 140). This evidence against blood's increased resistance to flow instability was accompanied by a slower rate of rise in torque both above and below Tc compared to the three Newtonian fluids. Newtonian fluids and blood both developed wavy vortical flow at a rotation rate moderately higher than Tc. Blood resisted this unstable flow behavior more than the Newtonian fluids but it also experienced a slower rate of rise in torque with increasing rotation rate above the critical Taylor number. Shear-thinning is the simplest explanation for blood's mildly altered Taylor vortex behavior; blood's resistance to flow instability is otherwise not found to be sufficient to affect its flow stability in man. PMID- 3663899 TI - Rheology, biochemistry and functions of mucus. INSERM seminar. Reims, France, 12 March 1987. Abstracts. PMID- 3663900 TI - [Stabilization of pressure drop in the feeder arteries of rats as affected by an increase in blood flow]. AB - The dependence of the pressure drop (PD) along conducting vessels between the aorta and the distal end of a. saphena on the blood flow in the artery has been studied in rats. The PD was shown to react to rapid blood flow increase from 0.6 to 1.2 ml/min, with a drastic upstroke followed by a gradual decrease to the initial value within 20 s. When the blood flow was returned to the initial level the PD was recovered during 40 s. A rapid flow increase from 0.1 to 1.0 ml/min in 3 s was accompanied by proportional changes in PD. However, a slow blood flow increase from 0.1 to 1.5 ml/min in 600 s did not induce any marked changes in PD in the range of the blood flow from 0.5 to 1.5 ml/min. The observed stabilization of PD may be attributed to the property of conducting arteries to increase their internal diameter in response to blood flow increase. PMID- 3663901 TI - [Impulse activity of the bulbar cardiovascular neurons during myocardial ischemia and stimulation of the cortical sensorimotor zone]. AB - In acute experiments on cats performed under nembutal anesthesia the stimulation of sensorimotor zone in cerebral hemisphere cortex changed the impulse activity of interneurons of bulbar cardiovascular centre and not of the afferent neurons. The analysis of the activity of afferent neurons and interneurons has shown a decrease in coordination between the reaction of these cells to the development of ischemic myocardial lesions during the cortex stimulation. In these conditions bulbar cardiovascular neurons could both increase and decrease the impulse activity. These changes seem to be the reason for the growing incidence of idioventricular ischemic arrhythmias during cortical stimulation. PMID- 3663902 TI - [Sensitive control of heart rate in monkeys using burst stimulation of the vagus nerve]. AB - Burst vagus stimulation led to synchronization of the cardiac and vagal rhythms at certain frequency ranges. The increase of the number of impulses in a burst from 1 to 16 extended the range of synchronization and shifted it towards lower frequencies forming a total range of exact regulation of the heart rate within 85 -40% of the initial rate. It was suggested that vagal effect consists of tonic and synchronizing components. PMID- 3663903 TI - [Mechanism of stimulation of duodenal contractions by the greater splanchnic nerve]. AB - The mechanism of duodenal motor activity stimulation has been studied in dogs during irritation of the chest area of the greater splanchnic nerve. It has been established that a stimulating effect of the splanchnic nerve was not removed either by bilateral vagotomy or by separate and combined injections of bretylium tosylate and benzohexamethonium, but was removed by the blockade of M serotoninergic receptors of the autonomic ganglia with atropine or by the blockade of D-serotoninergic receptors of the smooth muscles with promethazine hydrochloride. The data obtained demonstrate the presence of noncholinergic and nonadrenergic fibers in the chest area of the greater splanchnic nerve, having a potent stimulating effect on duodenal contractions. According to our functional and biochemical tests, they are mediated by serotonin. PMID- 3663904 TI - [Effect of cardioplegia on nitrogen and energy metabolism of the human heart]. AB - The interrelation between the energy and nitrogenous metabolism of the myocardium during cardioplegia has been studied in patients with congenital valvular heart disease (tetralogy of Fallot--12 patients, ventricular septal defect--5 patients). Whole body hypothermia with repeated heart reperfusion with cold cardioplegic blood perfusate was used for the protection of the myocardium. However, ATP level of the myocardium of some patients decreased by 20% and more of the baseline. This loss was accompanied by a reduction in glutamate and aspartate levels and a rise in ammonium and alanine levels in the myocardium (by 17.7 +/- 3.8; 17.6 +/- 5.9; 61.4 +/- 12.5 and 92.4 +/- 26.3% of the baseline, respectively). PMID- 3663905 TI - [Emotional behavior disorders in rats during the formation of a generator of pathologically enhanced excitation in the basomedial nuclei of the amygdaloid complex]. AB - Microinjections of kainic acid and ferrous sulfate into basomedial nuclei of both amygdalae resulted in the formation of the generator of pathologically enhanced excitation (GPEE), as evidenced by the epileptical activity (EpA) registered in both nuclei. EpA of different intensity and pattern could be retained for more than three weeks. Hyperactive basomedial nuclei played the role of a primary pathological determinant which caused the complex of emotional and behavioural disorders. Continuous motor depression at the early stages alternated pathologically enhanced activity at the later stages. A number of signs could be considered as the evidence of the affective disorders (motivation suppression, enhanced irritation, anxious excitation). Stereotype behaviour, immobility, rigidity, different types of vegetative disorders (ptosis, constipation, piloerection, loss of weight, respiratory arrhythmia, dystrophic symptoms) were observed in most animals. The emotional, behavioural and vegetative disorders described are compared to the manifestations of the depressive syndrome. PMID- 3663907 TI - [The ceruloplasmin-transferrin antioxidant system during hyperbaric oxygenation in rats]. AB - Antioxidant system ceruloplasmin-transferrin (Cp-Tr) and malonic dialdehyde (MDA) concentration changes were studied in the rat serum after the exposure to hyperbaric oxygenation (HBO) at 4 atm for 25 min. 5 sessions of HBO led to an increase in serum MDA concentration. 5 HBO sessions were followed by the activation of Cp-Tr system. Afterwards MDA concentration began to decrease and by the 9th session even reached the initial levels. It is suggested that antioxidant system Cp-Tr takes part in the protection of the organism from toxic oxygen action. PMID- 3663906 TI - [Replacement therapy of acquired antithrombin III deficiency in experimental nephrotic syndrome]. AB - The influence of antithrombin III on hemostasis and renal function was studied in experiments on rats with nephrotic syndrome. The development of nephrotic syndrome was accompanied by the activation of blood coagulation and appearance of acquired antithrombin III deficiency due to its loss with the urine. The replacement therapy by bovine antithrombin III at a dose of 25 U/kg a day for 10 days decreased the signs of excessive thrombinogenesis in experimental animals and increased the amount of thrombin-antithrombin III complexes in the blood flow. The activation of coagulation in rats with nephrotic syndrome predominantly induced the disturbances of the excretory renal function which could be efficiently corrected by antithrombin III. PMID- 3663908 TI - [Effect of naloxone on hypoalgesia in rats exposed to prolonged immobilization stress]. AB - Significant hypoalgesia (tail-flick reflex at 60 degrees C) was observed in rats during the whole period of 24-hour immobilization in cramped cages, as compared to food-and-water deprived and control animals. This hypoalgesia was not antagonized by naloxone (1 mg/kg), however, the animals periodically receiving the drug during immobilization revealed aggressiveness and significant hypoalgesia after immobilization was discontinued (30-120 min observation). PMID- 3663909 TI - [Decrease in the effectiveness of a hypoxic stimulus during cooling of the vascular bed of an organ]. AB - Acute experiments on cats using perfusion of the innervated calf muscle and small intestinal vessels with self blood at a constant blood flow rate have established decreased sensitivity of vessels (cooled to 30 degrees C) to hypoxic stimulus effect (inhalation of 10% O2 in N2). The essence of the phenomenon consists in considerably smaller deviations of pre- and postcapillary resistance, capillary filtration coefficient, mean capillary pressure during simultaneous exposure to cold and hypoxia than during separate application of hypoxic or hypothermic stimuli. Organ distinctions in the degree and direction of changes in vascular resistance and metabolism have been observed. PMID- 3663910 TI - [Effect of vitamin E and thymalin on the development of experimental allergic encephalomyelitis]. AB - It has been established in the experiments on rats resistant to encephalomyelitis that vitamin E deficiency promoted and thymaline administration prevented the onset of the disease. The experiments on guinea-pigs sensitive to encephalomyelitis have shown that the combined administration of alpha-tocopherol and thymaline prevented the development of the disease. The results obtained make it possible to suggest that the resistance to encephalomyelitis depends on the level of membrane antioxidant defense and the condition of T-cell immunity. PMID- 3663911 TI - [Participation of catecholamines in the mechanism of heart damage during the alcohol withdrawal syndrome in rats]. AB - Withdrawal syndrome in rats was induced after ethanol administration in a dose of 4-5 g/kg b. w. twice daily for 5 consecutive days. Creatine phosphokinase and lactate dehydrogenase release from the isolated heart and catecholamine distribution in the heart have been investigated in rats suffering from alcohol withdrawal syndrome. Maximum rate of enzyme release was observed on the third day of withdrawal. The density of catecholamine neurons in intact hearts and the hearts of rats sacrificed 2-6 hours, 1, 3, and 7 days after the last ethanol administration was 86, 64, 28, 7 and 38%, respectively. The area of extraneuronal catecholamine distribution accounted for 2, 19, 46, 82 and 4%. Synchronous changes observed in catecholamine distribution and the rate of enzyme release suggest that catecholamines act as a trigger of heart damage in rats with alcohol withdrawal syndrome. PMID- 3663912 TI - [Fractionation of carbon isotopes in human atherosclerotic tissues]. AB - A decrease in heavy carbon isotope 13C content has been detected in atherosclerotically-altered aortic tissues. An extent of the isotope shift is increased with the intensification of sclerotic process in different regions of the aorta and depends on the patient's age. To explain the observed effect of isotope 13C content decrease in the altered aortic tissues it was suggested that the rates of biochemical conversions become considerably higher in sclerotically altered tissues. PMID- 3663913 TI - [Antioxidant-induced release of calcium in biological membranes]. AB - The effect of synthetic (BHT, 2,2,5,7,8-pentamethyl-6-hydroxychroman) and natural (alpha-tocopherol) antioxidants on Ca++-transporting systems was compared in platelets, brain synaptosomes, and skeletal muscle sarcoplasmic reticulum. It was shown that synthetic antioxidants, in contrast to alpha-tocopherol, induced Ca++ release manifested in platelet aggregation, stimulation of 5-hydroxytryptamine release by synaptosomes, synaptosome depolarization and inhibition of Ca++ transport and Ca++-ATPase activity in the sarcoplasmic reticulum. The disturbances of Ca++-homeostasis induced by synthetic antioxidants are considered as molecular mechanisms of complications encountered upon their application. PMID- 3663914 TI - [Use of phospholipids to repair rat liver membranes during carbon tetrachloride poisoning]. AB - The effect of phospholipid multilayer liposomes on the properties of endoplasmic reticular membranes has been studied in hepatic cells damaged with CCl4. It has been shown that the repair effect of phosphatidylcholine liposomes was manifested in vivo by normalization of phospholipid membrane composition, reduction in the degree of cytochrome P-450 inactivation, partial normalization of its hydroxylase activity and recovery of glucose-6-phosphatase activity. The degree of phosphatidylcholine unsaturation, and the introduction of antioxidants--SH compounds, sphingomyelin, phosphatidyl inositol--into liposomes did not influence the efficacy of liposomes. PMID- 3663915 TI - [Stabilizing effect of hydroxybenzimidazole and its derivatives on biological membranes during activation of lipid peroxidation]. AB - Inhibition of lipid peroxidation (LPO) by oxybenzimidazole (OBI) and its derivatives--alkyloxybenzimidazole (AOBI) and alkylethoxybenzimidazole (AEBI) was studied in liver microsomes and brain synaptosomes. It has been shown that both OBI and AOBI strongly inhibit LPO in microsomes and not synaptosomes. AEBI failed to inhibit LPO in microsomes. AOBI is more potent than OBI both in ascorbate- and NADPH-dependent LPO of microsomes. An antioxidant effect of both compounds is more marked in ascorbate-dependent LPO. The investigation of the possible use of AOBI for the protection of liver membranes in various pathological conditions associated with LPO activation seems promising. PMID- 3663916 TI - [Phosphatase activity of blood leukocytes and wound exudate during the experimental healing of an aseptic wound]. AB - Cytochemical investigations of plain aseptic wounds simulated in 110 Wistar rats revealed a clear-cut dependence between the variations in the activity of alkaline and acid phosphatases in neutrophilic leukocytes, monocytes and lymphocytes of the blood and wound exudate and the stage of the healing process. Elevated activity of the blood alkaline phosphatase correlated with the term of inflammation phase. PMID- 3663917 TI - [Study of the interaction of low-density lipoproteins with immobilized fibrinogen and fibronectin using an immunoenzyme assay]. AB - The interaction of serum low density lipoproteins (LDL) with fibrinogen, fibronectin and fibrinogen-fibronectin complex immobilized on polystyrene was studied. LDL binding by these proteins was assessed by enzyme-linked immunosorbent assay. It was shown that LDL interacts with both immobilized fibronectin and immobilized fibrinogen. The fibrinogen-fibronectin complex bound a greater amount of LDL than either component alone, in the same concentration as in the complex. The binding of LDL with immobilized fibronectin or fibrinogen increased in the presence of low concentrations of diluted fibrinogen or fibronectin, respectively, which suggests the formation of the three-component complex on the surface. The formation of fibrinogen-fibronectin-LDL complexes during homeostasis may promote the accumulation of LDL in the vascular wall. PMID- 3663918 TI - [Open-field behavior of rats following bilateral coagulation of the locus coeruleus]. AB - A modified open-field test was used in the experiments on rats. It was shown that animals 6 days after bilateral coagulation of locus coeruleus displayed weight changes and some behavioural parameters distinct from those of sham-operated and control animals. The most pronounced differences observed in animals after locus coeruleus coagulation, as compared to the control, were inversion and adaptive responses to a sudden brief stimulus, locomotor dysfunction and absence of response to handling. PMID- 3663919 TI - [Characteristics of the abstinence syndrome induced by the administration of the benzodiazepine antagonist CGS 8216 to rats following chronic treatment with diazepam]. AB - Male rats were treated with 5 and 10 mg/kg diazepam once daily for 5-30 days. After the drug discontinuation a benzodiazepine receptor antagonist CGS 8216 (2.5 10 mg/kg) induced a behavioural syndrome that might be characterized as an abstinence syndrome. The most typical signs of abstinence were head twitches, myoclonic seizures of forepaws, emotional hyperirritability, increased muscle tone of the tail, sniffing and chewing. These behavioural changes could be observed within 1-1.5 hours after CGS 8216 injection. The abstinence syndrome was induced by repeated CGS 8216 injections for 10-15 days after diazepam discontinuation. Further analysis has shown that that the intensity of abstinence was dependent on the dose and duration of chronic diazepam, as well as on CGS 8216 dose. It is suggested that CGS 8216-induced abstinence syndrome in rats chronically treated with diazepam might be used as a tool for studying the addictive potential of benzodiazepines. PMID- 3663920 TI - [Pharmacological analysis of the participation of ethanol-oxidizing enzyme systems in ethanol metabolism at different stages of experimental alcoholism]. AB - Using head space chromatography, the pharmacological analysis of changes in the activity of ethanol-oxidizing enzymatic systems: alcohol dehydrogenase, catalase, microsomal ethanol-oxidizing system under the effect of pyrazole and aminotriazole, has been performed on the model of experimental alcoholism in rats. It was shown that the rate of ethanol elimination from the rats' blood at all stages of experimental alcoholism was determined by alcohol dehydrogenase, while catalase and microsomal ethanol-oxidizing system activities did not play an important role. PMID- 3663921 TI - [Time dependence of the shedding of class I and II HLA antigens. Interrelation of the fluctuations of HLA-antigen shedding and 51Cr-labeled macromolecules]. AB - Soluble HLA-A, -B and -DR antigens were determined every 10 min with a rate nephelometry method in supernatants of human mononuclear cells cultured for 3 hrs. The time-dependent oscillations in the quantity of soluble HLA antigens with ultradian (circadian) rhythm characteristics were found. Quantity oscillations of HLA-A antigens were synphase to HLA-B ones and antiphase to HLA-DR antigens. Amplitude characteristics were found to depend on the temperature and cytoskeleton activity. PMID- 3663922 TI - [Preparation of monospecific antisera to IgA in laboratory animals using cascade immunization without preliminary isolation of the antigen]. AB - The proposed method of "cascade" immunization for the preparation of monospecific antisera to IgA of the experimental animals (mice, rats, guinea-pigs) requires no isolation and purification of an antigen, since it is based on using precipitation lines containing IgA. The subsequent steps of the method are the following: 1) preparation of a polyspecific antiserum against one of the secretions or IgA-containing serum fraction; 2) preparation of precipitation lines using this antiserum and some other secretions; 3) immunization of other rabbits with these precipitation lines to obtain monospecific anti-IgA antiserum. The antisera obtained do not require any additional absorption except for the removal of anti-IgA antibodies. The method can be used for the preparation of monospecific antisera to any other serum or secretion proteins. PMID- 3663923 TI - [Immunostimulating property of GABA]. AB - The influence of gamma-aminobutyric acid (GABA) on specific immunity indexes has been studied in in vitro and animal experiments. GABA was shown to facilitate the appearance of Thy-I-antigen on the surface of mouse bone marrow cells and stimulate immune response of mice to thymus-dependent antigen (SRBC). However, GABA had no effect on the immune responsiveness to thymus-independent Vi-antigens in these animals. PMID- 3663924 TI - [Effect of rat liver gangliosides on the interaction of liposomes with rat hepatocytes in vitro]. AB - The influence of rat liver GM1, GM2, GD1 and GT1 gangliosides on the interaction of liposomes with rat hepatocytes was investigated. It was shown that liposomes coated with GM1 and GT1 are effectively bound and captured by hepatocytes. Preincubation of hepatocytes with N-acetylglucosamine and D-galactose reduced the binding of GM1- and GT1-liposomes by those cells. The data obtained suggest that there are binding sites for some gangliosides on the surface of rat hepatocytes. PMID- 3663925 TI - [Morphofunctional characteristics of the thyroid gland in intact and partially sympathectomized rats of different age groups]. AB - The morphological and functional age-dependent changes have been studied in the thyroid gland of infantile (1-month-old), immature (2- and 3-month-old) and sexually mature (6-month-old) male rats. The decrease in thyroid functional activity with ageing was proved. Chemical sympathectomy (guanethidine at a dose of 15 mg/kg intramuscularly for 14 days after birth) was accompanied not only by morphological reconstruction of the thyroid tissue, but also (especially in 1 month-old rats) by a delay in transport-organic phase of iodine metabolism and a decline in thyroid hormone serum level. Later on, the compensatory hormonogenesis reinforcement occurs as a result of partial adrenergic innervation recovery. PMID- 3663926 TI - [Quantitative ultrastructural criteria of myocardial damage in postischemic reperfusion]. AB - Swollen clarified mitochondria were found during postischemic reperfusion in cardiomyocytes with and without signs of myofibril relaxation. The values of morphometric parameters of mitochondria were similar in both groups of cells studied. Mean indexes characterizing the condition of cardiomyocyte mitochondria may serve as quantitative criteria of the severity of myocardial damage: surface to volume, ratio, visual index of mitochondrial condition and relative volume density, i.e. volume density with respect to control cell volume. PMID- 3663927 TI - [Protective action of pantetine on the denervated stomach]. AB - Bilateral subdiaphragmal vagotomy was performed in sexually-mature Wistar male rats. To prevent neurodystrophic processes in the stomach mucous membrane some animals were injected pantetine subcutaneously at a dose of 30 mg/kg 5 times daily for 10 days. Pantetine injected to vagotomized animals decreased destructive lesions in the stomach mucous membrane. Enhanced biosynthesis and the inhibition of gastrin and serotonin release from G and Ec cells respectively have been observed. The results obtained substantiate the use of pantetine for the pharmacological correction of postoperative complications in patients after vagotomy. PMID- 3663928 TI - [Ultrastructural changes in erythrocytes and thrombocytes in patients with severe thermal burns of the skin in the burn shock period]. AB - The data obtained show that a great amount of deformed red blood cells, i.e. ovalocytes, cristate-shaped cells appear in the peripheral blood of patients with severe cutaneous burns during shock. In the most severe shocks a dramatic increase in degenerative forms of red blood cells in the blood has been observed. These are spheroids and spheroechynocytes frequently with impaired matrix structure. A correlation has been established between the progressing shock severity and the number of degenerative forms of red blood cells in the blood. Reversible changes of platelet fine structure were also noted. PMID- 3663929 TI - [Morphological evaluation of the viability of silicon-lavsan tracheal prostheses]. AB - Time course of the healing process in the tracheal wall during silicon-lavsan tracheal grafting was investigated in experiments on 108 dogs with a new model of tracheal prosthesis. The formation of granulation tissue was noted as a result of postoperative inflammatory reaction in the prosthetic area. The tracheal epithelial layer adjacent to the anastomoses was hypertrophic and acquired the features of squamous epithelium. Later, after the implantation the prosthesis was surrounded by a thick fibrous capsula. In anastomoses, at tracheal tissue- implant border there was a poorly expressed inflammatory reaction, which had a local character and was compatible with 3 and more years of life in most experimental animals. PMID- 3663930 TI - [Reactivity of the microcirculation bed of the small intestine mesentery in experimental dehydration in rats]. AB - The state of mesenteric microcirculatory bed has been studied in male rats 3, 6 and 12 days after the beginning of alimentary dehydration. It has been revealed that vascular, intravascular and extravascular changes were of particular importance. Spastic reactions of arterioles and precapillary arterioles, the activation of arteriolo-venular shunting and the reduction in capillary circulation accompanied by diminution of all microvascular diameters were among the most marked vascular phenomena. The intravascular changes were represented by decreased blood flow rate, erythrocyte aggregation and leucocyte adhesion. The extravascular phenomena were characterized by the appearance of local hemorrhages. PMID- 3663931 TI - [Quantitative characteristics of changes in the cellular composition and vascularization of aseptic wounds in rat skin, healing without treatment and during stimulation of repair processes by exogenous collagen]. AB - The changes in cellular composition and vascularization of aseptic wounds on the rat skin were assessed quantitatively using the ocular net without treatment and during stimulation of repair processes by exogenous collagen. An intensive increase in the number of macrophages, endotheliocytes and fibroblasts was observed in wounds without treatment by the fifth day, with maximum vascularization of the granulation tissue occurring by the seventh day. During stimulation of repair processes by collagen the macrophage reaction, proliferation of endotheliocytes and fibroblasts and vascularization of wounds were activated earlier, while the stereotype relationships of the cellular components remained unchanged. The intercellular relationships of the wound healing process are discussed. PMID- 3663932 TI - [New morphometric parameter for analyzing changes in the ultrastructure of cardiomyocytes--the relative volume fraction]. AB - Analysing the processes accompanied by changes in cardiomyocyte volume without the formation or loss of myofibrils, it has been proposed to use a new parameter "relative volume fraction" that denotes the volume occupied by the ultrastructure under investigation, as related to primary cell volume, and permits to estimate changes of the ultrastructural volume proper. The value of this parameter may be calculated according to the formula: (Formula: see text). PMID- 3663933 TI - [Method of studying the reactions of single vessels in situ]. AB - A new method of continuous measurement of vascular resistance has been proposed for studying the reactivity of single blood vessels. According to the method, blood flows through the artery, then through a rigid tube, serving as a reference resistance, and a flow control system and then returns back to the animal. The parameter of interest is pressure drop along the artery to reference resistance ratio. The method permits the study of practically intact vessels with diameters to 0.3 mm. Changes in blood viscosity have but a slight effect on the results of the measurement. PMID- 3663934 TI - A glycoprotein inhibitor of in vitro granulopoiesis associated with AIDS. AB - Patients infected with the human immunodeficiency virus (HIV) often present with neutropenia. To elucidate the mechanism(s) of this HIV-related neutropenia, we assessed the proliferative capacity of the granulocyte-macrophage progenitor cell (CFU-GM) from the bone marrow (BM) of 78 patients within the AIDS spectrum manifesting symptoms or signs related to HIV infection. Of these, 70 had a significant deficit in the growth of this committed progenitor when compared with normal controls (P less than .01). Further analysis revealed that the nucleated bone marrow cells from AIDS and AIDS-related complex (ARC) patients inhibited the growth of CFU-GMs from normal individuals when cocultured in agar (P less than .001). Control CFU-GMs were also inhibited when they were cultured over feeder layers containing patients' BM cells (P less than .001). Conditioned media obtained from the liquid culture of patients' BM cells did not inhibit normal control CFU-GM growth to a degree different from that of the cells themselves (P greater than .4). Analysis of these conditioned media by polyacrylamide gel electrophoresis (PAGE) revealed a unique glycoprotein (gp) with a mol wt of 84 kd. Further studies revealed that this gp possessed the inhibitory activity. These data suggest that this gp may be an important factor in HIV-related neutropenia. The presence of gp84 was independent of drugs administered to the patients. PMID- 3663935 TI - Molecular genetic survey of 16 kindreds with hereditary antithrombin III deficiency. AB - Molecular genetic techniques were utilized to examine antithrombin III (ATIII) gene status in 16 independently ascertained kindreds with hereditary ATIII deficiency. In one of these families antithrombin III deficiency is caused by hemizygosity of the ATIII locus. In the remaining 15 kindreds, two copies of the ATIII gene are present and appear to be grossly normal at the level of whole genome Southern blotting, suggesting that small deletions, insertions or limited nucleotide substitution(s) in the antithrombin III gene, or "trans-acting" defects at other loci involved in the processing, modification, and secretion of biologically active ATIII are responsible for the observed anticoagulant disorders. PMID- 3663936 TI - Effect of flow on polymorphonuclear leukocyte/endothelial cell adhesion. AB - The effect of flow on the adhesion of polymorphonuclear leukocytes (PMNL) to vascular endothelium was investigated using a parallel plate chamber with a well defined flow field. Washed PMNL were perfused over a monolayer of primary human umbilical vein endothelial cells (HUVEC) pretreated with formyl-methionyl-leucyl phenylalanine (FMLP, 1 X 10(-7) mol/L) for five minutes. In other experiments HUVEC were pretreated with interleukin 1 (IL1,2 U/mL) for four hours. PMNL adhesion to stimulated and control HUVEC was measured over a physiologic range of wall shear stresses. PMNL adhesion to nylon-coated surface was also studied. At a wall shear stress of 0.98 dynes/cm2,283 +/- 37.3 PMNL/mm2 (mean +/- SEM) adhered to FMLP-treated HUVEC while 195 +/- 20.3 PMNL/mm2 adhered to control HUVEC. At 1.96 dynes/cm2, 68 +/- 14.1 PMNL/mm2 adhered to FMLP-treated HUVEC and 42 +/- 6.0 PMNL/mm2 adhered to control HUVEC. At 3.92 dynes/cm2, virtually no PMNL adherence was noted on either control or FMLP-treated HUVEC. On IL 1-treated HUVEC at 1.96 dynes/cm2, 371 +/- 25.8 PMNL/mm2 adhered while 28 +/- 2.9 PMNL/mm2 adhered to control HUVEC. PMNL adhesion to IL 1-treated and control HUVEC dropped to 10.2 +/ 3.8 and 6.8 +/- 3.5 PMNL/mm2, respectively, at 3.01 dynes/cm2. The effect of flow on PMNL adhesion appears to be an important factor in determining the outcome of the PMNL/HUVEC adhesive interaction under these experimental conditions. PMID- 3663937 TI - Cytogenetic and cytochemical studies on progenitor cells of primary acquired sideroblastic anemia (PASA): involvement of multipotent myeloid stem cells in PASA clone and mosaicism with normal clone. AB - By cytogenetic and cytochemical analyses of individual hematopoietic colonies, we investigated clonality in progenitor compartments of primary acquired sideroblastic anemia (PASA). Two of our four subjects had reduced but countable numbers of CFU-E, BFU-E, and GFU-GM in methylcellulose culture. In one patient with cytogenetic abnormality of 47, XX, +8 in 67% of the bone marrow cells, cytogenetic analysis of individual erythroid bursts and granulocyte/macrophage colonies demonstrated two populations with and without 8 trisomy, the trisomy clone being 38% in BFU-E and 50% in CFU-GM. These findings indicate involvement of multipotent stem cells in PASA clone and mosaicism of two distinct populations in erythroid as well as granulocyte/macrophage progenitor compartments, the abnormal PASA clone and probably the normal clones. In another case with no cytogenetic abnormality, repeated iron staining showed that 31% to 40% of CFU-E and 25% to 54% of BFU-E had erythroblasts with heavy iron deposits. An ultrastructural analysis of 25 individual erythroid bursts revealed that 32% had highly dysplastic erythroblasts with marked ferruginous iron accumulation in the mitochondria. The other 68% and 15 normal bursts from a healthy control did not have noticeable dysplastic changes and iron deposits in the mitochondria. This cytochemical/ultrastructural mosaicism seems to be compatible with the cytogenetic mosaicism. However, whether the BFU-E derived from abnormal PASA clone selectively manifest iron accumulation in the mitochondria or whether the PASA clone itself shows variable degrees of abnormal iron metabolism remains to be determined by simultaneous performance of ultrastructural and cytogenetic analysis for single bursts. PMID- 3663938 TI - Phorbol esters sensitize platelets to activation by physiological agonists. AB - Phorbol esters such as phorbol 12, 13-dibutyrate (PdBu; 40 to 200 nmol/L) or 12-O tetradecanoyl phorbol 13-acetate (20 to 80 nmol/L) added to aspirinized platelet rich plasma (PRP) 5 to 15 seconds prior to various platelet stimuli (epinephrine, ADP, prostaglandin endoperoxide analog U44069, collagen, PAF, or vasopressin) potentiate the rate and extent of aggregation and ATP secretion induced by those agonists. Platelet aggregation, but not secretion, is potentiated at low concentrations of agonists; platelet secretion is potentiated at higher concentrations of the platelet stimuli. Potentiation of platelet responses was also observed when the preincubation time with PdBu was extended to 12 minutes and also occurred in washed platelets. The potentiating effect of phorbol esters is not mediated by formation of arachidonate metabolites or by released ADP. The sensitizing effect of PdBu on platelet aggregation induced by epinephrine is unique, since in contrast to the other platelet stimuli it is also found at maximal concentrations of epinephrine and does not diminish with prolonged preincubation of platelets with PdBu. Activation of protein kinase C ranges from 20% to 80% over control after 1 to 10 minutes of platelet pretreatment with PdBu but dramatically increases after subsequent addition of a stimulus such as vasopressin. In contrast, agonist-induced myosin light chain phosphorylation is reduced after platelet pretreatment with PdBu. The results indicate that protein kinase C activation enhances platelet aggregation and dense granule secretion triggered by physiologic stimuli, although it desensitizes agonist-induced myosin light chain phosphorylation. PMID- 3663939 TI - Minimally differentiated acute nonlymphocytic leukemia: a distinct entity. AB - Ten of 136 consecutive adult patients with previously untreated acute leukemia had morphologically undifferentiated leukemia by light microscopy. Leukemic cells from these patients were characterized by agranular cytoplasm, negative histochemical staining with sudan black (SB) and nonspecific esterase, and absent lymphoid cell surface markers and therefore were not classifiable according to the French-American-British (FAB) system. Electron microscopy with myeloperoxidase (MPO) staining revealed the presence of peroxidase positive cytoplasmic granules and endoplasmic reticulum in eight of the nine patients studied. Cells from the patient who was negative for MPO were also negative for platelet peroxidase. A series of monoclonal antibodies to myeloid antigens also revealed myeloid features with all patients having at least one myeloid differentiation antigen present on the surface of their cells. Common acute lymphoblastic leukemia (ALL) antigen was absent in the nine patients tested. Cytogenetic analysis of blast cells was abnormal in seven patients on whom adequately banded chromosomes were obtained although there were no consistent abnormalities. No patient had a Ph1 chromosome. Only two of the ten patients achieved a complete remission. Morphologically undifferentiated leukemia may have myeloid features when studied by transmission electron microscopy or with monoclonal antibodies for cell surface markers. Such studies should be performed when the leukemia cannot be classified using either light microscopy or lymphoid cell surface markers. Such patients infrequently achieve remission with standard therapy and constitute a distinct entity. PMID- 3663940 TI - Fibronectin is required for platelet adhesion and for thrombus formation on subendothelium and collagen surfaces. AB - Fibronectin (FN) plays a role in several adhesion mediated functions including the interaction of platelets with subendothelium. We investigated the role of plasma FN in platelet adhesion and platelet thrombus formation under flow conditions. We used two different perfusion models: the annular chamber with alpha-chymotrypsin-treated rabbit vessel segments, and the flat chamber with coverslips coated with fibrillar purified human collagen type III. Perfusates consisted of washed platelets and washed RBCs, suspended in normal or FN-depleted plasma. Perfusions were carried out for ten minutes at shear rates of 300 or 1,300 s-1. Platelet deposition and thrombus dimensions were evaluated morphometrically by a computerized system. We found that depletion of plasma fibronectin significantly reduced the percentage of total coverage surface and percentage of platelet thrombus, at both shear rates studied, and in both perfusion systems (P less than .01) (P less than .01). The dimensions of the platelet thrombi formed in perfusions at high shear rate were also significantly reduced in perfusions carried out with FN depleted plasma (P less than .01). Addition of purified FN to FN-depleted perfusates restored all values to those measured in the control perfusions. These results indicate that plasma FN is required for platelet aggregate and thrombus formation following adhesion under flow conditions. PMID- 3663941 TI - Membrane-associated sickle hemoglobin: a major determinant of sickle erythrocyte rigidity. AB - Micropipette aspiration tests on single erythrocytes have previously shown that the static rigidity (membrane shear modulus) of oxygenated sickle cells increased with increasing hemoglobin concentration, whereas the rigidity of normal cells was independent of hemoglobin concentration. Moreover, it was observed that after mechanical extension, sickle cells exhibited persistent deformation more frequently and to a greater extent than normal cells. To ascertain if differences in association of normal and sickle hemoglobin with the membrane could account for these observations, we measured rheologic properties of normal membranes reconstituted with sickle hemoglobin and sickle membranes reconstituted with normal hemoglobin. The static rigidity of normal ghosts reloaded with sickle hemoglobin was higher than those of either normal ghosts reloaded with normal hemoglobin or native normal cells. On the other hand, the increased rigidity of native sickle cells decreased to near-normal values following reconstitution with normal hemoglobin. Furthermore, we observed that normal ghosts reconstituted with sickle hemoglobin exhibited persistent bumps after mechanical extension, but no bumps formed on normal ghosts reconstituted with normal hemoglobin. Moreover residual bumps were not produced on sickle cells reloaded with normal hemoglobin. Since mechanical characteristics peculiar to sickle cells could be induced in normal cells by incorporation of sickle hemoglobin, and since normal characteristics could be restored to sickle cells by incorporation of normal hemoglobin, we suggest that the interaction of sickle hemoglobin with the cell membrane is responsible for augmented static rigidity of oxygenated sickle erythrocytes. PMID- 3663942 TI - Iron homeostasis in beta-thalassemic mice. AB - To explore the pathogenesis of nontransfusional iron overload in iron-loading anemia, we examined features of external iron exchange, internal iron kinetics, and tissue iron burden in adult mice with inherited gene-deletion beta thalassemia. Mice homozygous for beta-thalassemia display moderate anemia, reticulocytosis, and shortened red cell survival, whereas heterozygous carriers appear hematologically normal. Quantitative iron determination revealed that iron content and concentration in liver, spleen, and kidney, but not heart, were far higher (P less than .01) in 15-to 35-week old homozygous thalassemic mice than in age-matched normal and heterozygous controls; of these tissues, iron content increased with age only in kidneys (P = .01) of homozygous affected mice. Although plasma iron levels were only minimally elevated in homozygotes, plasma iron turnover was threefold greater (P less than .001) than that seen in heterozygote controls. Nevertheless hyperabsorption of enteric radioiron, discernible among homozygous thalassemic mice as late as 6 to 8 weeks after birth, was not observed in older mice, additionally, thalassemic and control mice at 18 to 34 weeks showed comparable iron excretion after intravenous radioiron. We conclude that adult mice with beta-thalassemia regain balanced external iron exchange, despite substantial tissue iron excess and accelerated internal iron transit. PMID- 3663943 TI - Elimination of clonogenic stem cells from human multiple myeloma cell lines by a plasma cell-reactive monoclonal antibody and complement. AB - The monoclonal antibody (MoAb) MM4 reacts with human multiple myeloma (MM) cell lines and bone marrow from patients with plasma cell dyscrasias but not with normal peripheral blood or bone marrow cells. Treatment with MM4 and rabbit complement (C') was cytotoxic to the plasma cell-derived cell lines GM 1312, RPMI 8226, and ARH-77, as demonstrated by chromium release microcytotoxicity and trypan blue exclusion assays. The same treatment eliminated greater than 99% of clonogenic myeloma stem cell colony formation of these cell lines, with less than 20% inhibition of normal human bone marrow pleuripotent progenitor colony formation in vitro. As an experimental model to explore the efficacy of MM4 + C' in purging MM-involved bone marrow, normal marrow cells were mixed with RPMI 8226 or GM 1312 cells in the ratio of 90:10 or 50:50 (marrow:myeloma cells). Colony growth assays indicated that MM4 + C' eliminated at least 2 logs of clonogenic myeloma stem cells in both 90:10 and 50:50 preparations, while sparing the majority of normal marrow progenitors (inhibition of CFU-C:10% to 13%; BFU-E:0%). The selectivity of MM4-mediated cytotoxicity may be useful for eliminating myeloma clonogenic stem cells from bone marrow of patients with multiple myeloma. PMID- 3663944 TI - Ultrastructural analysis of murine megakaryocyte maturation in vitro: comparison of big-cell and heterogeneous megakaryocyte colonies. AB - Two morphologically distinct types of murine megakaryocyte (MK) colonies are present after three to seven days in soft agar culture: (a) "big-cell" colonies composed of ten to 30 large, mature-appearing megakaryocytes and (b) "heterogeneous" colonies consisting of approximately 100 or more cells at various stages of differentiation. Cytochemical and immunocytochemical techniques were used to study MK maturation in colonies as well as normal mouse bone marrow. Acetylcholinesterase (AChE), a specific marker for murine platelets and MK, was found in the perinuclear cisterna, endoplasmic reticulum, and occasionally, Golgi cisternae of MK in three-day big-cell colonies and immature bone marrow MK. MK in seven-day big-cell colonies and mature bone marrow MK showed additional reaction sites in the demarcation membrane system and occasional granules. In seven-day heterogeneous colonies, small cells resembled immature bone marrow MK with respect to AChE localization, whereas large cells corresponded to mature bone marrow MK. With immunogold procedures at the ultrastructural level, polyclonal antibodies against human platelet membrane glycoprotein IIIa and antimouse platelet antiserum labeled bone marrow MK and all MK from colonies grown in soft agar cultures for three to seven days. Granulocytes and macrophages in both bone marrow and soft agar cultures were negative for AChE and these immunocytochemical markers. These data indicate that the pattern of expression of AChE during maturation of MK is similar in vivo and in vitro and demonstrate, when using this marker at the fine-structural level, that a greater range of MK maturational stages is present in heterogeneous colonies than is observed in MK in big-cell colonies. Furthermore, we have confirmed that small cells in heterogeneous colonies are MK and that these colonies are composed solely of MK and their precursors. PMID- 3663945 TI - Immunoglobulin and T cell receptor beta chain gene rearrangement analysis of ocular adnexal lymphoid neoplasms: clinical and biologic implications. AB - We investigated the organization of the immunoglobulin heavy chain (IgH) and the T cell receptor beta chain (T beta) gene loci in 20 ocular adnexal and four extraocular lymphoid neoplasms obtained from 18 patients presenting with an ocular adnexal lymphoid neoplasm. Fifteen ocular adnexal and four extraocular lymphoid neoplasms occurring in 13 patients were classified by morphological examination and immunophenotypic analysis as monoclonal B cell lymphomas. Each one of these 19 lymphoid neoplasms exhibited clonal IgH gene rearrangements upon hybridization of EcoRI- or HindIII-digested DNA to a heavy-chain joining region (JH)-specific DNA probe. The bilateral ocular adnexal monoclonal B cell neoplasms occurring simultaneously in two individuals exhibited identical clonal IgH gene rearrangements, which indicated their derivation from an identical B cell clone. The ocular adnexal and the extraocular monoclonal B cell neoplasms occurring in two of three patients also exhibited identical clonal IgH gene rearrangements, which suggested that they too were derived from an identical B cell clone. Five ocular adnexal lymphoid neoplasms were classified by morphological examination and immunophenotypic analysis as benign, polyclonal pseudolymphomas. Three of these five ocular adnexal lymphoid neoplasms exhibited clonal IgH gene rearrangements, which suggested the presence of monoclonal B cell populations that escaped detection by morphological and immunophenotypic examination. None of the 24 pathological samples exhibited clonal T beta gene rearrangements upon hybridization of EcoRI- or BamHI-digested DNA to a T beta gene DNA probe. The results of these studies demonstrate the value of Southern blot hybridization analysis for clonal IgH and T beta gene rearrangements in the diagnosis, classification, and investigation of extranodal lymphoid neoplasms originating and/or presenting in the ocular adnexa. PMID- 3663946 TI - Mechanism of erythrocyte aggregation and sedimentation. AB - Unstirred suspensions of erythrocytes form stable spherical aggregates of uniform size. The radius of the spheres depends upon the suspending medium and the hematocrit. Erythrocyte suspensions will undergo sedimentation only after these aggregates are formed. Aggregation is a two-step process: first, erythrocytes associate in long chains (rouleau formation). Next, these chains form spheres of uniform size. The requirements for this well-defined process are an electrolyte and a neutral or negatively charged macromolecule in the solution and a metabolically active red cell. If these conditions are not met, red cells either will not aggregate at all or will form amorphous aggregates. Rouleau formation and sedimentation are inhibited by 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid, an inhibitor of anion transport, but not by ouabain, a cation transport inhibitor. The kinetics of erythrocyte sedimentation reflects the aforementioned mechanism: no sedimentation occurs during rouleau formation. Once the spheres of uniform size are formed, they will settle according to the Einstein-Stokes equation. In this model, parameters of sedimentation kinetics are the delay before sedimentation starts, the rate of sedimentation in the steady state, and the radius of the sedimenting aggregate. The radius can be calculated from the rate of fall of the aggregates and agrees well with the microscopically observed radius. It is inversely proportional to the hematocrit, which explains the elevated sedimentation rates in anemia. PMID- 3663947 TI - Risk of AIDS for recipients of blood components from donors who subsequently developed AIDS. AB - Reported cases of acquired immunodeficiency syndrome (AIDS) in San Francisco as of March 31, 1986, include 92 individuals who had donated blood subsequent to 1978. Their donated blood components had been transfused into 406 different recipients. The current status of 336 of these recipients was ascertained as of April 1, 1986. Of these, 223 had died at the time of our first contact, almost all as a result of the condition for which they were transfused. Seven had developed AIDS; five of these died, two before entry into the study and three subsequently. Forty-six additional living recipients were interviewed and evaluated. Seven had the AIDS-related complex, 18 had antibody to the human immunodeficiency virus (HIV) but were otherwise healthy, and 19 had no detectable anti-HIV. Two had risk factors other than transfusion. The frequency of infection of the recipient decreased as the time interval between transfusion and the diagnosis of AIDS in the donor increased. This information should be useful when counseling patients who have been transfused with blood components from donors later found to be infected with HIV. PMID- 3663948 TI - Peroxidase-containing microgranules in human neutrophils: physical, morphological, cytochemical, and secretory properties. AB - A microgranule fraction, isolated from human neutrophils by using a novel high resolution Percoll density gradient system contained granules with the lowest density and diameter when compared with 12 other isopycnic granule fractions. Ultrastructurally, from 34% to 50% of the microgranules showed homogeneous diaminobenzidine (DAB) staining under conditions for localizing peroxidase reactivity. The presence of myeloperoxidase (MPO) was further confirmed by biochemical and spectral analysis and immunodiffusion methods. Periodate thiocarbohydrazide-silver proteinate (PA-TCH-SP) intensely stained vicinal glycols in the matrix of greater than 97% microgranules in contrast to the weak or absent staining seen in larger primary granules. Directly sampled segmented neutrophils contained small DAB- and PA-TCH-SP-positive granules, which often appeared in clusters. These DAB-positive microgranules selectively remained within the cells after stimulation of exocytosis with the calcium ionophore A23187. The enriched DAB-positive microgranule fraction recovered from A23187 treated cells also contained lysozyme and beta-glucuronidase but lacked vitamin B12 binding protein activity. A similar small, DAB- and PA-TCH-SP-positive granule type was also identified in normal promyelocytes and was the predominant or only granule type observed in leukemic or preleukemic myeloid cells from four patients. This study demonstrates a unique subpopulation of MPO-containing microgranules in normal and leukemic human myeloid cells that are distinguished from (other) primary granules by their extremely low density, small size, content of complex carbohydrates, and resistance to secretion. PMID- 3663949 TI - Thrombin-induced changes in platelet membrane glycoproteins Ib, IX, and IIb-IIIa complex. AB - Platelet membrane glycoprotein Ib (GPIb) and the GPIIb-IIIa complex have central roles in the interaction of platelets with the plasma coagulation system, damaged vessel walls, and other platelets. We investigated the effects of thrombin on these glycoproteins. Monoclonal antibodies were used to assess platelet surface glycoproteins by flow cytometry, total platelet glycoprotein content by immunoassay, and glycoproteins released from platelets, also by immunoassay. Five new observations were made with regard to thrombin-induced changes in platelet membrane glycoproteins: (a) The marked decrease in platelet surface binding of antibodies directed at GPIb was not confined to antibodies directed at the von Willebrand factor binding site. (b) There was a marked decrease in platelet surface binding of an antibody directed at GPIX, with maintenance of the 1:1 ratio of platelet surface binding of antibodies directed at GPIb and GPIX. (c) Changes in platelet surface binding of antibodies were not restricted to a distinct subpopulation of platelets. (d) There was no associated platelet release of glycocalicin (a proteolytic fragment of GPIb). (e) There was no associated platelet release of the GPIIb-IIIa complex. These thrombin-induced changes may be important in modulating the reactivity of platelets with the damaged vessel wall and with each other. PMID- 3663950 TI - Analysis of hemopoiesis. Proceedings of a symposium. October 17 and 18, 1986, Tarrytown, New York. PMID- 3663951 TI - Erythropoietin titers in response to anemia or hypoxia. AB - The normal response to anemic or hypoxic hypoxia is synthesis and release of erythropoietin in accord with the concept that erythropoietin production is controlled by a renal oxygen sensor. In this study, erythropoietin production, as predicted, was abrogated in patients with renal impairment (55 cases), but normal in nonuremic individuals. Specifically, patients with rheumatoid arthritis (34 cases), sickle cell anemia (25 cases), aregenerative anemia (27 cases), and aplastic anemia (13 cases) had erythropoietin titers overlapping with those observed in simple anemia (61 cases) at corresponding hematocrits. The response of polycythemic laboratory animals to hypoxia is more difficult to fit within the concept of an oxygen sensor responsive both to anemic and hypoxic hypoxia. If the polycythemia was induced by hypertransfusion, erythropoietin production in response to hypoxia was, as predicted, less than that observed in normal animals. If, however the polycythemia was induced by previous exposure to hypoxia, the animals responded to hypoxia as though they were not polycythemic. An explanation for this challenging observation may provide a clue as to the operation of the oxygen sensor. PMID- 3663952 TI - Annual meeting of the German and Austrian Societies of Hematology and Oncology. Wurzburg, October 4-7, 1987. Abstracts. PMID- 3663953 TI - Resistance to endocrine therapy. A panel discussion. PMID- 3663954 TI - Progesterone receptor activity and relapse-free survival in patients with primary breast cancer: the role of adjuvant chemotherapy. AB - The prognostic significance of progesterone receptor activity (PgR) with regard to the estimated relapse-free survival (RFS) was studied in 350 one-center patients with primary breast cancer. All receptor assays were performed in one laboratory; PgR levels greater than 10 fmol/mg protein were considered positive. Univariate as well as multivariate statistical analyses were used to examine the prognostic significance of several variables. Eighty-nine of the 350 patients received adjuvant CMF chemotherapy (cyclophosphamide, methotrexate, and 5 fluorouracil). The median observation period was 69 months (range 12-125 months). In the group of 261 patients who did not receive adjuvant CMF, the PgR-status lacked prognostic significance; only the lymph node status significantly affected the RFS (p less than 0.00001). In contrast, in the CMF-treated group of patients, the PgR-status was the most powerful predictor of recurrence (p less than 0.001). Premenopausal CMF-treated patients with PgR+ tumors had a significantly longer RFS than those with PgR- tumors (p less than 0.02). The present data urge the need for a reappraisal of the prognostic significance of PgR and of the mechanism of action of adjuvant chemotherapy in primary breast cancer. PMID- 3663955 TI - Urinary androgens and tumor estrogen receptor as predictors of ovariectomy response and of survival in advanced breast cancer. AB - Estrogen receptor (ER) status and urinary androgen (A) concentration were simultaneously determined in 50 premenopausal patients submitted to bilateral ovariectomy for advanced carcinoma of the breast. When both the hormonal parameters were positive (ER+ A+), the response to castration was favorable in 87.5% of the cases, with a survival rate of 39% at 5 years. No patient responded to the therapy when both the parameters were negative (ER- A-); none of them was alive at 5 years. An intermediate response (more than 50%) and survival rate at 5 years (more than 20%) was obtained in the group of patients with at least one of the two parameters positive (ER+ A-, or ER- A+). These responses were independent of the topography of neoplastic localizations and the length of the disease-free interval. PMID- 3663956 TI - The DNA labelling index: a prognostic factor in node-negative breast cancer. AB - The DNA labelling index (LI), representing the fraction of S-phase cells, was studied in 76 patients operated on for breast cancer from 1975 to 1979. No patient had lymph node involvement following axillary dissection (N-), and no adjuvant medical treatment was given. Patients were classified in one of two groups according to the median LI. Patient distribution by age, tumour size, and receptor status was identical in both groups. A higher frequency of grade 3 tumours was noted in the group with an LI above the median value. The cell proliferation rate was an important discriminative factor for metastatic potential. The probability of survival at 8 years for patients with a high LI was significantly lower than that of patients with low LI (36% versus 100%; p less than 0.001). Relapse-free survival at 8 years was respectively 56% and 83% (p less than 0.02). At 2 years, these values were 75% and 100%, indicating the early occurrence of metastases. By contrast, the LI had no prognostic value concerning loco-regional disease recurrence or survival after the appearance of metastasis. No relationship was found in this study between survival and other prognostic factors, namely tumour size, histological grade, or hormone receptor level. The LI currently appears to be the best prognostic factor for N- breast cancer. High risk patients identified by this method could thus be offered adjuvant medical treatment. PMID- 3663957 TI - Meningeal carcinomatosis from breast cancer: spinal cord vs. brain involvement. AB - Twenty-two patients with meningeal carcinoma due to breast cancer were retrospectively evaluated to determine what prognostic factors affected survival. Five patients survived for more than one year. The therapy in these long-term survivors was similar to that of those suffering early death. Patients with primarily brain symptoms survived a median of 21 days vs. 150 days in those with primarily spinal cord symptoms (p = 0.026). The site of involvement may be an important stratification parameter for future prospective trials. PMID- 3663958 TI - Analysis of interval breast carcinomas in a randomized screening trial in Stockholm. AB - In the interval between screening examinations, some cases of breast cancer are invariably detected clinically in patients whose mammogram was considered to be normal at the earlier screening. During the first interval in the Stockholm study, 60 interval cancers were detected, giving a rate of 1.8 cases/1000 examinations/24 months. About half of these interval cases (31/60) were true interval tumours in that no sign of them could be found on the first mammogram; the other half, non-true, were possible to trace on the first mammogram. It is mainly women under 50 who feature in the interval group, above all in the sub group of true interval cancers (p less than 0.05). The incidence of interval cancer rises, as expected, with the length of the interval (Fig. 1). In the final six months of the 2-year interval the incidence of interval cancers had risen to 88 per cent of the cancers detected in the control group in the same period of time. The cumulative incidence of interval cancers supports the hypothesis that the distribution of sojourn time in the interval 0-2 years is approximately rectangular. This means that shortening the interval by one-half would halve the number of interval cases. If mammography becomes a wide spread screening method for early detection of breast cancer, the number of non-true interval cancers could be a feed back on the effectiveness of the screening.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3663960 TI - Tropical gastroenterology. PMID- 3663959 TI - Association between season of first detection of breast cancer and disease progression. AB - The season of recurrence of tumour was investigated by follow-up of 1324 patients with breast cancer and compared with the season of initial tumour detection. Unlike primary tumours, where an increased incidence of detection has previously been observed in late spring and early summer, there was no significant seasonal variation in the time of recurrence. However, women with oestrogen receptor positive or progesterone receptor negative primary tumours recurred significantly more frequently in the same season that their primary cancer was initially detected. Overall there was an increased frequency of recurrence one year from diagnosis. Women less than age 50 who initially found their tumour in winter or autumn had a significantly shorter disease-free interval before recurrence than those first detecting their tumour in summer or spring. This relationship was independent of nodal status and tumour size. Tumours initially detected in winter or autumn thus appeared to follow a more aggressive growth profile. This study indicates that the season of first detection of a breast cancer relates significantly to aspects of the future biologic behaviour of the tumour. PMID- 3663961 TI - [Peroperative irradiation: the Massachusetts General Hospital technic and current experience]. AB - Intra-operative radiotherapy (IORT) is a technique developed since the early 60s mainly in Japan and in the U.S.A. It usually consists of a single fraction of electrons given intra-operatively. Doses range from 10 to 35 Gy and may be combined with external beam irradiation. The salient advantages are: 1) a better target volume definition with the surgeon; 2) the possibility of removing normal structures (such as the small bowel) from the beam and of so delivering a much higher tumor dose. The disadvantages are: 1) theoretically, a lesser effect on hypoxic cells compared with a fractionated regimen; 2) a requirement for perfect cooperation between surgeon and radiotherapist; 3) a cumbersome apparatus. From pilot studies conducted so far, it appears that advanced poorly or unresectable rectal carcinomas, retroperitoneal soft tissue sarcomas and gastric carcinomas may benefit from such an approach while resected or unresectable pancreatic carcinomas, in spite of extensive evaluation, do not. The management of prostatic, bladder, cerebral, intrathoracic and gynecologic malignancies with IORT is undergoing active prospective studies in some 60 Japanese, American (and, in 1986, 7 French) centers. The major technical issues and drawbacks of this technique will also be discussed. PMID- 3663962 TI - [Cardiotoxicity of 5-fluorouracil. Spasm or direct myocardial toxicity?]. AB - The authors report on a case of cardiotoxicity observed during a protocol including a 5-day continuous infusion of 5-fluorouracil; anginal manifestations recurred during a second treatment course. Coronary angiography, thallium scintigraphy and methergine test were all normal. An attempt to prevent the recurrence of such manifestations using a calcium inhibitor and nitroderivatives was unsuccessful. In connection with this case, six other with anginal manifestation and four sudden deaths under the same protocol, a review of the relevant literature is included in the discussion on the factors that may favor cardiotoxicity and the different etiopathogenic hypothesis. The generally accepted hypothesis is a coronary spasm but a direct cardiotoxicity of 5-FU cannot be. The only therapeutic possibility appears to be the definitive halt of 5-FU after the onset of such manifestations. PMID- 3663963 TI - Computed tomography in radiotherapy of prostatic carcinoma. AB - Hundred forty-four correlations are reported between radiological simulation and CT-scan in cases of prostate adenocarcinoma without metastases treated from 1980 to 1986 exclusively by transcutaneous radiotherapy using the box technique with 25 MV photons. Forty-eight percent of the cases were intracapsular forms. On the basis of correlation criteria defined, the prostatic boost volume was shifted in the sagittal plan in 18% of the cases. Suspect seminal vesicles were found in 60% of the cases. Our treatment plans were considered "correct" in 65% of the cases, "acceptable" in 26% of the cases and "unsatisfactory" in 29% of the cases. The corrections applied to the treatment plan do not vary according to grade but according to stage and concern mainly the posterior limit of the boost volume and to a lesser extent the superior and anterior limits. The boost volume should be determined specifically for each case. CT-scans thus seem indispensable in establishing treatment plans in prostate cancer. PMID- 3663964 TI - [Carcinomas of the nasopharynx in adults]. AB - From 1959 through 1980, 139 MO adult patients (greater than 15 Y.) presenting with nasopharyngeal cancer were treated by definitive radiotherapy: 103 (74%) undifferentiated carcinomas and 36 (26%) squamous cell carcinomas. Chemotherapy was prescribed only in case of failure of treatment. Case distribution is the following according to UICC classification: stages I and II: 12%, stage III: 16%, stage IV: 72%. Survival rate is respectively 70%, 45%, 20%. The overall 3 and 5 year survival rate is 46% and 30%. Almost 80% of the failures occur by the end of the second year. Local control is 95% for T1-T2, 73% for T3 and around 50% for T4 cases. Isolated node failure occurs in 2% and distant metastases in 30%. PMID- 3663965 TI - [Evolution of breast cancer mortality in Spain]. AB - A study is presented about the evolution of the breast cancer mortality in Spain between 1961 and 1980. This has been increasing strongly of several factors: 1) In actual increase of this disease, rising its adjusted death rates by age from 8/100,000 (1961) to 13/100,000 (1980) (increase = 62%); the truncated standardized rates between 35 and 64 years raised from 18/100,000 (1961) to 28/100,000 (1980): there is high correlation between both types of rates. 2) An increase of the female population at breast cancer risk (over 45 yr). A selective and significative rise of mortality from this cancer for the age groups under menopause, especially for the group 30-34 years (160%). The increase of female breast cancer mortality is statistically significant. It is necessary researching the causes of such increase. PMID- 3663966 TI - [Centroblastic and centrocytic centroblastic malignant lymphomas, predominantly splenic (or primary of the spleen). Anatomo-clinical study of 17 cases]. AB - Seventeen cases of splenic centroblastic-centrocytic or centroblastic lymphoma are reported. A large splenomegaly is discovered in all these cases as the prominent symptom. For this reason, all these cases can be considered as primary lymphoma of the spleen. Splenectomy is done in 7 cases for diagnosis a period of 2 to 8 months after the discovery of the splenomegaly. In these patients, no bone marrow biopsy was performed before splenectomy. In 8 other cases, the diagnosis of follicular lymphoma is proposed on a bone marrow biopsy performed with the aim to disclose an etiology for the splenomegaly. In 3 of these cases, a lymph node (2 cases) or a tonsil biopsy (1 case) discover a tumoral localization before the splenectomy. In the 2 last cases, the diagnosis is recognized on a lymph node biopsy. The most important clinical and biological data are compared for these 17 patients. The anatomopathological data are described. In 15 cases, a multimicronodular pattern is recognized on the spleen section. The 2 other cases express a multimacronodular pattern. The weight of the spleen is comprised between 450 and 3,350 g, with only 6 spleens weighing less than 1,000 g. The spleens with multimicronodular pattern correspond to a follicular centroblastic centrocytic lymphoma of low grade of malignancy in the Kiel-Lennert classification. The 2 multimacronodular spleens exhibit the histological aspect of a polymorphous centroblastic lymphoma of a high grade of malignancy. The equivalent of these histological types are given in the Working Formulation. The diagnosis with others diseases of the spleen is discussed. For fourteen patients, the follow-up is available. Six patients are alive, with an evolution of many years. Because of the few number of cases, it is not possible to correlate the histological subtypes according to Kiel or to the WF, and the clinical stage with the evolution. To perform such correlation, a multicentric study should be organized. PMID- 3663967 TI - [Hodgkin's nodular paragranuloma (nodular Hodgkin's disease, with lymphocytic predominance): apropos of 29 cases]. AB - The clinical and morphological features of 29 cases of nodular Hodgkin's disease, lymphocyte predominance type (NLPHD) are reported. This disease must be distinguished from other forms of Hodgkin's disease due to its nodular pattern with predominance of small lymphocytes, without sclerosis. Its main feature is the presence of rare lymphocytic histiocytic type Reed-Sternberg cells (LHRS). From a clinical point of view, we observed that the primary lymph nodes involvement are mostly seen in cervical and axillary sites, with a clinical stage I or II at diagnosis, without biological signs of activity and with a good prognosis and long duration of the disease. Two main aspects may be underlined: the frequent relapses after biopsy in lack of treatment, and a possible transformation into a large B cell lymphoma. Immunohistological stainings suggest that LH-RS cells are transformed B cells. NLPHD is a clinicopathological entity which must be currently considered and treated as Hodgkin' disease. PMID- 3663968 TI - [Possible efficacy of chemotherapy in a case of cardiac hemangiopericytoma]. PMID- 3663969 TI - Effect of biphenyl ether herbicides on the formation of mutagenic intermediates from procarcinogens by rainbow trout. PMID- 3663971 TI - Toxicity of crude oil to the metabolism of freshwater minor carp, Puntius sophore. PMID- 3663970 TI - Metabolism of n-butyl, n-hexyl, and n-octyl benzene in the bile of rainbow trout. PMID- 3663972 TI - Toxicity of vanadium to different freshwater organisms. PMID- 3663973 TI - Effect of mercury on taurine transport by the red blood cells of the marine polychaete, Glycera dibranchiata. PMID- 3663974 TI - Levels and ages of selenium and metals in sedimentary cores of Ise Bay as determined by 210-Pb dating technique. PMID- 3663975 TI - Comparison of ethanol toxicity to Daphnia magna and Ceriodaphnia dubia tested at two different temperatures: static acute toxicity test results. PMID- 3663976 TI - Comparison of occurrence and rates of chemical biodegradation in natural waters. PMID- 3663977 TI - Short-term effects of propanil on oxygen production by plankton communities from catfish ponds. PMID- 3663978 TI - Metabolism of monocrotophos and quinalphos by algae isolated from soil. PMID- 3663979 TI - Preference of the green peach aphid, Myzus persicae, for plants grown in sewage sludges. PMID- 3663980 TI - Radioimmunoassay of paralytic shellfish toxins in clams and mussels. PMID- 3663981 TI - Residues of insecticides, fungicides, and herbicides in fruit produced in Ontario, Canada, 1980-1984. PMID- 3663982 TI - Dissipation of methyl parathion and ethyl parathion from cotton foliage as affected by formulation. PMID- 3663983 TI - Organochlorine insecticide residues in some agricultural soils on the north coast region of New South Wales. PMID- 3663984 TI - Isolation and determination of benzo(a)pyrene glucuronide and sulfate conjugates in soybean leaves. PMID- 3663985 TI - Teratogenicity of oral chaetochromin, a polyphenolic mycotoxin produced by Chaetomium spp., to mice embryo. PMID- 3663986 TI - Effect of ultra ULV fenitrothion spraying on brain cholinesterase activity in forest songbirds. PMID- 3663987 TI - Differential accumulation of lead by soft tissues of rabbit. PMID- 3663988 TI - Determination of cadmium, copper, zinc, and lead in human renal calculi in both cadmium polluted and non-polluted areas. PMID- 3663989 TI - Mobilization of tissue cadmium in mice and calves and reversal of cadmium induced tissue damage in calves by zinc. PMID- 3663990 TI - Accumulation of pesticides in the organs of carp, Cyprinus carpio L., at 4 degrees and 20 degrees C. PMID- 3663991 TI - Effect of exposure to several pentachlorophenol concentrations on growth of young of-year largemouth bass, Micropterus salmoides, with comparisons to other indicators of toxicity. PMID- 3663992 TI - Primary biodegradation kinetics of anionic surfactants in marine environment. PMID- 3663993 TI - Metals in crayfish from neutralized acidic and non-acidic lakes. PMID- 3663994 TI - Mercury content in the water and marine organisms in Angke Estuary, Jakarta Bay. PMID- 3663995 TI - Measuring tri-n-butyltin in salmon by atomic absorption: analysis with and without gas chromatography. PMID- 3663996 TI - Physiological stress induced by vegetable oil factory effluent in Channa punctatus (Bloch): measurement of hepatic dehydrogenases. PMID- 3663997 TI - Effect of chlordane on testicular tissues of Swiss mice. PMID- 3663999 TI - Effect of exposure to lead on reproduction in male rats. PMID- 3663998 TI - Excretion of triclopyr herbicide in the bovine. PMID- 3664000 TI - Studies on the influence of calcium on cadmium absorbed by rat liver and the resistivity against the toxicity of cadmium in rat. PMID- 3664001 TI - Lead and cadmium concentrations in livestock bred in Campania, Italy. PMID- 3664002 TI - Air pollution effects on the structure of Citrus aurantium leaves. PMID- 3664003 TI - Application of an enzyme-linked immunosorbent assay (ELISA) to determine paraquat residues in milk, beef, and potatoes. PMID- 3664004 TI - Rapid estimation of 4,4'-dichlorobenzilic acid in human urine after dicofol exposure. PMID- 3664005 TI - Organochlorine pesticide contaminants in human milk from different regions of Turkey. PMID- 3664006 TI - Gas chromatographic/mass spectrometric determination of aniline in food oils associated with the Spanish toxic oil syndrome. PMID- 3664007 TI - Persistence and movement of atrazine in a salt marsh sediment microecosystem. PMID- 3664008 TI - Direct determination of benzidine in unaltered soil solution by liquid chromatography. PMID- 3664009 TI - Microbial enhancement of hydrazine degradation in soil and water. PMID- 3664010 TI - Effects of pH and temperature on the degradation of chloroacetones that are mutagenic. PMID- 3664011 TI - How does the vital pump work? PMID- 3664013 TI - Nasal occlusion during sleep in normal and near-miss for sudden death syndrome infants. AB - Obligatory nasal breathing has been suggested in the past as a contributor to sudden infant death syndrome (SIDS): nasal obstruction would result in death as infants were unable to breathe orally. To test this hypothesis, we studied 55 normal and 14 near-miss for SIDS infants during a whole-night polysomnography. On several occasions, the infant nares were gently occluded by the fingertips of the investigator. Infants continued to make respiratory efforts against the occluded nose for a variable time (apnoea time), then opened the mouth and started to breathe through it. Mean apnoea time in normal infants was 4.76 +/- 3.41 s (means +/- SD), and 6.54 +/- 4.25 s in near-miss for SIDS ones. These figures were not significantly different. Analysis according to sleep stage (quiet sleep: 4.08 +/- 3.24 s in normals and 6.50 +/- 4.18 s in near-miss for SIDS ones; active sleep: 6.54 +/- 3.67 s in normals and 6.58 +/- 4.76 s in near-miss for SIDS ones) did not disclose any significant difference between groups. There was no significant relationship between apnoea time and age in either group. In many cases, an arousal preceded the resumption of (oral) flow. However, in almost half of the occlusions, oral breathing was initiated during continuing sleep. We conclude: 1) infants are not obligatory nasal breathers, and 2) the nasal obstruction hypothesis should be discarded in the etiology of SIDS. PMID- 3664012 TI - Thyroxine treatment increases the hypoxic pulmonary vasoconstriction in isolated lungs from thyroidectomized rats. AB - The possibility that changes in energy metabolism are involved in oxygen sensing during hypoxic pulmonary vasoconstriction was tested indirectly by measurement of hypoxic-pressor reactivity in lungs isolated from rats with low and high levels of plasma thyroxine. In the first study, male rats were treated for one week after thyroidectomy with 50 micrograms (n = 6) or 100 micrograms (n = 6) thyroxine per 100 g body weight (b.w.) daily or with solvent (n = 6). The lungs were isolated and perfused at constant flow with salt-albumin solution. They were ventilated with air +5% CO2 in a humid chamber at 38 degrees C. The dose-pressor response to hypoxia and angiotensin II were measured. In the second study, thyroidectomized male rats were treated similarly with 100 micrograms thyroxine (n = 7) or solvent (n = 6) and isolated lungs were perfused with homologous blood obtained from thyroidectomized blood donors treated in the same manner. Then the dose-pressor responses to hypoxia and K+ were elicited. The hypoxic-pressor responses were bigger in thyroxine than in solvent-treated rats. The response to angiotensin II and K+ was not affected by thyroxine treatment. The results are consistent with the idea that hypoxic-pressor reactivity varies directly with the metabolic rate of lung tissue. PMID- 3664014 TI - Value of M-mode echocardiography in assessing pulmonary arterial pressure in patients with chronic lung disease. AB - Pulmonary valve echography was technically possible in 44 of 120 patients with chronic lung disease (CLD). Mean pulmonary arterial pressure (Ppa) was significantly correlated with right ventricular isovolumetric relaxation ratio (RVIRT/RVET) as derived from the movement of cusps in valves of the right heart (r = 0.842; p less than 0.001). Prolonged RVIRT was found in 52% of patients with Ppa greater than 20 mmHg and in all ten patients with Ppa greater than 35 mmHg. Other echographic signs, including abnormal right ventricular systolic time intervals (STI), 'a' wave amplitude, right to left ventricular ratio (RV/LV) and interventricular septum diastolic bulging (IVS-B), were less sensitive, but found more often; when higher Ppa was recorded at catheterization in a given patient (r = 0.869; p less than 0.001). Approximate echographic estimation of Ppa in patients with chronic lung disease is possible if right ventricular systolic and diastolic time intervals can be measured and if abnormalities in right ventricular dimensions, interventricular septum motion and pulmonary valve echogram are considered. In contrast to pulmonary fibrosis, technical problems in adequate visualization of right heart valves in chronic obstructive lung disease limit the use of M-mode echo assessment of Ppa to a clinically unacceptable 22% of subjects. PMID- 3664015 TI - Active sensitization discriminates between groups of calcium antagonists in lung parenchyma strips. AB - When considering the therapeutic potential of calcium antagonists in asthma, attention should be paid to the existence of marked differences among these compounds. In the present study, we have compared the effect of verapamil, diltiazem, nifedipine and trifluoperazine on contractions generated by different mechanisms (CaCl2 acting on K+ depolarized preparation, depolarization by KCl, receptor activation by acetylcholine) in lung parenchyma strips isolated from control and actively sensitized guinea-pigs. It was found that verapamil and diltiazem need higher concentrations in the sensitized specimens to elicit the same degree of inhibition obtained in controls. The reverse was found for trifluoperazine while nifedipine had an intermediate position. In conclusion, acute sensitization reveals differences between the various groups of calcium antagonists in their ability to influence agonist-induced lung parenchyma strip contraction, a finding that suggests that these drugs may also behave diversely in the clinical setting. PMID- 3664016 TI - [Method for the evaluation of flow rate from pulmonary sounds]. AB - We recorded the lung sound and flow rate from six normal subjects (3 male and 3 female). Sound was picked up at the trachea with a sensitive microphone held in a small probe. Flow rate was measured at the mouth using a Fleisch No. 3 pneumotachograph. Subjects were made to breath for 15 s, with an increasing peak flow rate starting from apnoea to around 2 l.s-1. Both sound and flow rate were directly digitized (i.e. without temporary analogic recording) at a sampling rate of 5120 Hz. Sound and flow were then divided in 128-sample blocks. For each block, the frequency spectrum was computed using the fast Fourier transform. Frequency spectrum depends on the flow rate in many ways. We computed the following formula on each spectrum: D = K.Fmean/(1 + A/Amean) where K and A are constant, Fmean and Amean are respectively the mean frequency and the mean amplitude of the spectrum computed on a 128-sample block. D may be considered as an evaluation of the flow rate every 50 ms. Plotted versus the measured values of the flow rate, D showed a linear relationship. This feature can be used as an almost instantaneous evaluation of the flow rate, or it is possible to compute the mean of D over consecutive 128-sample blocks. This has lead us to calculate the mean of the flow rate over 100, 200, ..., 800 ms. Of course, the longer the time window, the better the correlation between computed flow and real value. The values obtained for this correlation varied between 0.79 and 0.94. PMID- 3664017 TI - Airflow related to total lung capacity. PMID- 3664018 TI - Treatment of bronchial obstruction in asthma. AB - The bronchodilator effects of various sympathomimetics given as aerosols have been compared. Hexoprenaline, fenoterol and terbutaline were all effective bronchodilators and their effects lasted far longer than that of isoprenaline. Clenbuterol inhaled at night did not prevent 'morning dip' but the addition of slow-release theophylline was an effective combination. The mechanisms of action of these agents, and also of atropinic drugs such as ipratropium bromide and oxytropium bromide are discussed, and also the benefits of using mixtures of drugs. PMID- 3664019 TI - Treatment of bronchial obstruction in asthmatic children. AB - In asthmatic children, clenbuterol causes bronchodilatation for 12h. Ipratropium bromide plus fenoterol is effective in stopping dry irritable cough related to bronchial obstruction. Sustained-release theophylline is effective with therapeutic serum and saliva concentrations for 16h. Ambroxol hydrochloride provides an additional therapy for bronchial obstructure since it reduces cough and sputum output. Cromoglycate and ketotifen are appropriate for long term treatment, and a combination of bronchodilators may offer better control of nocturnal asthma. PMID- 3664020 TI - Glottic closure and high flows are not essential for productive cough. AB - For about 150 years, there has been emphasis on the importance of glottic closure and high flows in coughing. During voluntary coughing in normal subjects, the main expiratory flow usually begins as thoracic and abdominal pressures are rising. However, sometimes it starts at peak pressure whereas at other times flow and pressure rise together. Plateau flow in single coughs remains relatively constant in the face of large changes in pressure. In a group of coughs following a single inspiration, the fall in pressure is less during plateau flow. Consequently, for the same oral flows, it is likely that the mean linear velocity in the intrathoracic airways will be greater than in a single cough. Recordings have also been made of early morning involuntary coughing in patients with obstructive airways disease. Flow, volume and sound were recorded and sputum expectoration was noted. Sputum expectoration usually occurs after groups of coughs following single inspirations. Hence the movement of the equal pressure point peripherally may be important. These patients have very low flows and yet their coughs are productive. Sound often occurs during the whole of the low flow period immediately before the main expulsive phase. This could only occur if the glottis was open. Thus productive cough can occur without glottic closure and with low airflows. PMID- 3664021 TI - The cough reflex. A symposium. Martin, Slovakia, CSSR, 10-12 September 1986. Proceedings. PMID- 3664022 TI - The ionic composition of airway surface liquid and coughing. AB - The rapidly-adapting receptors (RARs) are strategically sited within the paracellular spaces between epithelial cells of the laryngeal and tracheal epithelium. These receptors in cats and dogs appear to respond to changes in the ionic composition of the aqueous fluid bathing the luminal surface of the airway. Studies using dogs and exposing laryngeal epithelium to solutions of differing ionic composition suggest that a reduction in [Cl-] below 75 mmol . l-1 or change in pH, less than 4 and greater than 8 together with a [K+] greater than 70 mmol . l-1 stimulates the (RARs). Coughing can be provoked in man, when breathing ultrasonically nebulized aqueous erosols, with solution low in [Cl-] or when the pH is less than 4 or greater than 8. Only a small response occurs when osmolarity is increased. The similarity of the pattern of chemical specificity of cough to stimulation of RARs suggests that, in man, changes of ionic composition of the airway surface liquid also stimulates RARs and this induces coughing. PMID- 3664023 TI - Cough and mucociliary clearance. AB - Cough is a host defence mechanism of the lungs. Theoretical considerations indicate that the efficacy of cough in clearing secretions is limited to the first few airway generations of the human lung. Studies utilizing radioaerosols as markers of mucus support the theoretical predictions and show that cough is effective in the proximal airways only in the presence of excess secretions. Limited studies on the efficacy of cough on regional clearance of secretions have been equivocal regarding its effect in the "peripheral" regions of the lungs. Persistent coughing can result in temporary slowing or even cessation of lung mucociliary clearance at the flow-limiting segments of the lung. The forced expiration technique, which is not accompanied by the compressive phase associated with cough, is more effective than coughing in clearing excess secretions from the lungs. PMID- 3664024 TI - The origin of cough sounds. AB - We have analyzed the origin of the first and second cough sounds recorded by tussiphonography. About 10,000 tussiphonograms were performed in about 1,000 healthy and diseased subjects. Changes in the first cough sound are due to pathological processes in the airways, for example, the presence of mucus or acute inflammatory disease. The first cough sound may then become divided. In bronchial asthma the first sound is also abnormal because of the narrowed airways. The origin of the second sound becomes clear by its absence in patients after laryngectomy or in those with paralysis of the vocal folds. The reappearance of the second cough sound may indicate rehabilitation of the vocal folds. With laryngotracheitis there is a pattern of multiple sounds. In patients with cough of psychogenic origin, the second sound is absent and cough sounds "bovine". Treatment of patients with bronchodilating drugs did not improve their pathological cough sounds in spite of improvement in airway obstruction. PMID- 3664025 TI - Information obtained from tussigrams and the possibilities of their application in medical practice. AB - The physiology of cough was studied using 2008 voluntary coughs. The tussiexpirograms verify that in a cough-series there are "double-flow" phases. The tussitachogram enables a more precise observation, for example, one can recognise five flow phases within one single cough. It proves, furthermore, that in the first five coughs the speed of airflow is always higher in the intermediate deceleration than in the acceleration phase. On the tussiphonogram one can differentiate seven phonetic phases. The simultaneously recorded tussigrams and tussiphonograms allow identification of two sounds, two intervals and noises. There are at least two possibilities for use of these data in clinical practice, 1) the measurement of the volume during the first second on the tussiexpirogram is a suitable control for the forced expiratory volume in one second (FEV1), 2) analysis of the voluntary prolongation of the intermediate deceleration during respiratory physiotherapy. PMID- 3664026 TI - Spectral analysis of cough sounds recorded with and without a nose clip. AB - The voluntary cough sounds of healthy volunteers, patients with chronic rhinitis, chronic rhinitis with bronchial asthma and asthma were recorded with and without a nose clip. A gated series of signals of the first cough sound lasting 200 ms was analysed by a system with a 20 ms delay of the first signal. In the case of filtered cough sounds, low-cut digitally, the mean values of averaged spectra of the healthy volunteers showed a first peak around 350 Hz, similar to the expiratory spectra of respiratory sounds. Second and third harmonics were also identified. The mean values of averaged spectra from the patients with airway disease differed significantly in the range of low frequency components. The upper airways work as narrow-band acoustic filters determining the harmonic contents of speech as well as those of cough sounds. To minimize these effects for acoustic analytical purposes, the application of a nose clip is suggested to find the cough harmonics related to those of pulmonary sounds. The voluntary cough sounds contain diagnostic information, but to build up a quantitative, diagnostic, decision-making system, further investigations as well as standardization of recording and analysis are necessary. PMID- 3664028 TI - Solution of large compartmental models using numerical transform inversion. PMID- 3664027 TI - The mechanism of aerosol-induced bronchoconstriction. AB - To gain insight into the mechanism of aerosol induced bronchoconstriction the differences between ultrasonically-nebulized aqueous-induced bronchoconstriction and cough are contrasted. Both normal subjects and asthmatics cough in response to inhalation of aerosol low in chloride ions (Cl-). This is putatively a result of stimulation of rapidly-adapting receptors (RARs). Normals do not develop bronchoconstriction as a result of inhalation of aqueous aerosols. Asthmatics however do but only when the tonicity is increased above or below normal; (Cl-) is not important. Inhaled lignocaine inhibits cough but not bronchoconstriction whilst sodium cromoglycate (SCG) inhibits bronchoconstriction but not cough. As SCG may inhibit vagal C-fibre receptors it is possible that different vagal afferent receptors are involved in cough and bronchoconstriction. Small but significant bronchodilatation in normals attenuates aerosol-induced cough which can be explained by central modulation of medullary cough neurones by slowly adapting receptors (SARs). As the same occurs with reflex bronchoconstriction, a complex organisation of vagal afferents can be suggested, where different receptors are responsible for cough and bronchoconstriction and SAR activity modulates the medullary neurones which initiate the two reflexes. PMID- 3664029 TI - Model geometries for sickled erythrocytes. PMID- 3664031 TI - Global stability of single-species diffusion Volterra models with continuous time delays. PMID- 3664030 TI - Sequential and synchronous growth models related to vertex analysis and branching ratios. PMID- 3664032 TI - Computational complexity of inferring phylogenies from dissimilarity matrices. PMID- 3664033 TI - Fractional exponential decay in the capture of ligands by randomly distributed traps in one dimension. PMID- 3664034 TI - Logistic population growth under random dispersal. PMID- 3664035 TI - A functional analysis of recidivistic arson. AB - Evidence from studies of pathological arson and normal fire setting as well as the authors' clinical experience with arsonists in a maximum security hospital is employed to generate a model of recidivistic arson within the conceptual framework of functional analysis. It is contended that certain psychosocial stimuli, in the context of major setting conditions, predispose the individual towards incendiarism which is initially positively and negatively reinforced. However, the longer-term consequences of arson are considered to maintain and exacerbate the antecedent problems encountered by arsonists. Specifically, arson is viewed as an attempt to exert a change in the arsonist's life conditions where alternative behaviours have proved, or are perceived to be, ineffective. The model incorporates adaptations of the displaced aggression and arousal hypotheses of arson, and examines possible developmental aspects of pathological arson from normal childhood fire play, and suggests that a transition from fire setting in the company of others to incendiarism alone constitutes a major factor in the pathological process. The social, clinical and theoretical implications of the model are discussed with reference to current management and treatment strategies as well as future research. PMID- 3664036 TI - Return of fear: perceived skill and heart-rate responsivity. AB - The hypothesis that high heart rate and low perceived skill would be associated with greater return of fear than low heart rate and high perceived skill was investigated in a group of 63 anxious musical performers. Musicians were taught progressive muscle relaxation and attention-focusing skills over the course of four weekly sessions. Return of subjective fear was assessed between training programme sessions and at a three-month follow-up assessment. Performance quality ratings served as the behavioural measure, anticipatory heart rate as the physiological measure, and subjective units of distress scales as the subjective measure. Four classification groups (high heart rate, low perceived skill; high heart rate, high perceived skill; low heart rate, low perceived skill; and low heart rate, high perceived skill) were formed on the basis of median splits of heart rate and perceived skill pre-assessment levels. Each group demonstrated subjective fear reduction, while heart rate reduced in the high heart-rate subjects, and performance quality improved overall at post-assessment. Follow-up return of fear was apparent in high heart-rate subjects, regardless of their perceived skill status. High heart-rate subjects reported more anxious thoughts than did low heart-rate subjects. Perceived skill was not clearly associated with return of fear. Post-hoc comparisons indicated that subjects who demonstrated follow-up return of fear had higher heart rate, lower perceived skill, more anxious thoughts, less performance skill and fewer performances over the follow up interval than subjects who did not demonstrate a return of fear. However, initial heart rate was the only significant predictor of follow-up fear levels. PMID- 3664037 TI - The development of a comprehensive headache diary--verbal descriptor scales. AB - A headache diary was developed to allow the ongoing assessment of subjective and behavioural components of headache pain. A modified version of Philips & Hunter's (1981) pain behaviour checklist which assesses three types of pain behaviour was incorporated for the latter. A scale based on pain descriptors was developed for the subjective component. This scale was factor analysed to reveal five aspects of headache pain, two reactive and three sensory. When the descriptors were scaled it was found that the amount of pain represented by some words was significantly greater in headache than non-headache subjects. Within each descriptor factor, the words do not appear to vary in intensity, with the exception of one reactive factor which appears to reflect overall evaluation of pain. Internal validity of the diary was investigated showing distinctive patterns of association between the subjective factors, pain behaviour, and pain intensity. External validity was assessed by the use of the diary in an intervention study and in delineating differences between migraine and tension headache groups. PMID- 3664038 TI - A parallel form of the Gudjonsson Suggestibility Scale. AB - The purpose of this study is twofold: (1) to present a parallel form of the Gudjonsson Suggestibility Scale (GSS, Form 1); (2) to study test-retest reliabilities of interrogative suggestibility. Three groups of subjects were administered the two suggestibility scales in a counterbalanced order. Group 1 (28 normal subjects) and Group 2 (32 'forensic' patients) completed both scales within the same testing session, whereas Group 3 (30 'forensic' patients) completed the two scales between one week and eight months apart. All the correlations were highly significant, giving support for high 'temporal consistency' of interrogative suggestibility. PMID- 3664039 TI - Prognostic factors in bulimia nervosa. AB - Factors predictive of outcome were sought from the data from a controlled study of the treatment of bulimia nervosa. Four different indices of outcome were used, and outcome was assessed at four points during a 12-month, treatment-free follow up period. It was found that the pre-treatment level of self-esteem was a consistent predictor of outcome with those patients having low self-esteem responding least well to treatment. There were no other consistent predictors of outcome. PMID- 3664040 TI - Dependency, self-criticism and depressive attributional style. AB - It has been proposed that dependency and self-criticism are independent forms of depressive experience. This study was designed to investigate whether one or both experiences are associated with a depressive attributional style. Internal and global attributions for hypothetical negative outcomes were found to be associated with both dependency and self-criticism, but neither of these aspects of depression were related to attributions for positive outcomes. PMID- 3664041 TI - Spatial memory and perception in stroke patients: the importance of order effects. AB - The performance of left and right CVA patients on two tasks, spatial matching and spatial recognition, was compared, using a design which also examined the effects of order of task presentation. All groups performed better on matching than on recognition trials, and the left CVA subjects obtained higher scores than right CVA subjects on both types of trial. A significant lesion X order interaction reflected the particularly poor performance of right CVA subjects who received the more difficult task (recognition) first. The clinical implications are discussed. PMID- 3664042 TI - The inter-rater reliability of the National Adult Reading Test (NART): a pilot study. AB - Twelve consecutive out-patients had their performance on the National Adult Reading Test (NART) audiotaped. This tape was then 'scored' for accuracy of pronunciation by 10 experienced clinical psychologists who use the NART in their routine clinical practice. The results indicate that the NART has a relatively high degree of inter-rater reliability. PMID- 3664043 TI - The Parental Bonding Instrument: factorial structure. AB - The Parental Bonding Instrument was administered to 49 schizophrenic out-patients attending a depot injection clinic. Subjects were instructed to rate each of their parents as they remembered them in their first 16 years. Principal components analyses followed by orthogonal varimax rotations were performed separately for mothers and fathers. The results suggested that the instrument is measuring two dimensions of parental characteristics; namely, care and overprotection. The findings lend further support to the internal structure of the instrument. The implications of the results for the prediction of relapse in schizophrenics and the expressed emotion construct are discussed. PMID- 3664044 TI - The effect of concurrent articulation on memory span in Alzheimer-type dementia. AB - This study explored the effects of concurrent articulation on memory-span performance, comparing patients with early Alzheimer-type dementia (AD) and matched controls. Reduction in memory span due to concurrent articulation was the same in AD patients as controls, supporting the notion that the contribution of articulatory rehearsal to memory-span performance is undiminished in early AD. PMID- 3664045 TI - Purpose in Life Test assessment using latent variable methods. AB - A psychometric assessment was conducted on a slightly revised version of the Purpose in Life Test (PIL-R). Factor analyses revealed a large general factor plus four primary factors comprising lack of purpose in life, positive sense of purpose, motivation for meaning, and existential confusion. Validity models showed that the PIL-R was positively related to a construct of happiness and was negatively related to suicidality and meaninglessness. Reliability estimates ranged from 0.78 to 0.86. The revised version can be presented compactly and may be less confusing to subjects than the original PIL. PMID- 3664046 TI - [Yersinia enterocolitica, an excellent model for the molecular study of the pathogenicity of invasive bacteria]. PMID- 3664047 TI - [Intrapulmonary neuro-epithelial bodies]. PMID- 3664048 TI - [Manual medicine]. PMID- 3664049 TI - [Thiamine triphosphate and bioelectrogenesis]. PMID- 3664050 TI - Fixed combinations of antibiotic drugs used in Central America. PMID- 3664051 TI - Use of chloramphenicol at Social Security health care centers in Bogota, Colombia. PMID- 3664053 TI - Changes in health care strategies in Costa Rica. PMID- 3664052 TI - An evaluation of bendiocarb and deltametrin applications in the same Mexican village and their impact on populations of Anopheles albimanus. PMID- 3664054 TI - Patterns of birthweights: a summary. PMID- 3664055 TI - Biotechnology and health in Latin America and the Caribbean. PMID- 3664056 TI - Ottawa Charter for Health Promotion. PMID- 3664057 TI - Health, drinking-water, and sanitation in rural areas. PMID- 3664058 TI - A role for water supply and sanitation in the child survival revolution. PMID- 3664059 TI - The treatment of rhegmatogenous retinal detachment. PMID- 3664060 TI - [Ultrastructural study of a choroidal balloon-cell melanoma]. PMID- 3664061 TI - [Dacryocystitis in children]. PMID- 3664062 TI - Orbital expansion of intraocular tumors. PMID- 3664063 TI - [Balloon technic with temporary buckling and without drainage]. PMID- 3664064 TI - How to prevent undercorrection in posterior chamber lenses. PMID- 3664065 TI - Ocular lues: a disease wearing many masks. PMID- 3664066 TI - Preventive treatment of retinal detachment. PMID- 3664067 TI - [Preventive argon laser treatment of degenerative lesions of the peripheral retina: clinical study]. PMID- 3664068 TI - [Preventive treatment of peripheral retinal lesions]. PMID- 3664069 TI - Treatment of retinal detachment in von Hippel-Lindau disease. PMID- 3664070 TI - Uveal effusion with exudative retinal detachment. PMID- 3664071 TI - [Retinal detachment and Q-switched Nd-YAG laser capsulotomy]. PMID- 3664072 TI - [Retinal detachment in patients from Zaire: etiological, clinical aspects, surgical treatment]. PMID- 3664073 TI - Structural surgery of nystagmus blockage. PMID- 3664074 TI - Increase of renal sympathetic nerve activity by metoprolol or propranolol in conscious spontaneously hypertensive rats. AB - 1 Mean arterial pressure (MAP), heart rate (HR) and renal sympathetic nerve activity (RSNA) were recorded in conscious spontaneously hypertensive rats (SHR). 2 Infusion of metoprolol (4 mumol kg-1 h-1) or propranolol (1.5 mumol kg-1 h-1) reduced HR and significantly increased RSNA. 3 Administration of metoprolol caused a sustained decrease of MAP starting in the third hour of infusion. In contrast, administration of propranolol induced a biphasic response in MAP. It is suggested that the increase of RSNA after both beta-adrenoceptor blocking drugs is due to a decrease in arterial baroreceptor activity. PMID- 3664075 TI - Diltiazem pharmacokinetics in the rat and relationship between its serum concentration and uterine and cardiovascular effects. AB - 1 The kinetics of diltiazem were investigated in ovariectomized (ovx) non pregnant and intact late pregnant anaesthetized rats following a bolus i.v. injection (2 mg kg-1) and during a 180 min i.v. infusion (50 micrograms kg-1 min 1 and 100 micrograms kg-1 min-1). Uterine contractions, mean blood pressure and heart rate were measured in the non-pregnant rats. 2 Measurement of serum diltiazem concentrations after bolus i.v. injection in ovx non-pregnant rats showed a biexponential decay with time from which the following parameters were calculated: volume of distribution area (V(area)) - 256 +/- 46 ml; rate constants k12 - 0.46 +/- 0.10 min-1; k21 - 0.09 +/- 0.01 min-1; kel - 0.13 +/- 0.03 min-1; elimination clearance - 3.2 +/- 0.3 ml min-1; distribution t1/2 (t1/2) - 1.4 +/- 0.3 min; elimination t1/2 (t1/2 beta) - 61.2 +/- 13.0 min. In pregnant rats, a biexponential decay was also observed with similar parameters to those in non pregnant animals except for markedly increased V(area) - 1004 +/- 184 ml; kel - 0.54 +/- 0.16 min-1 and elimination clearance - 14.8 +/- 2.3 ml min-1. 3 Measurement of serum diltiazem concentrations during infusion yielded the following parameters in non-pregnant ovx rats: V(ss)--79 +/- 10 ml; rate constants k12 - 1.02 +/- 0.21 min-1; k21 - 0.03 +/- 0.01 min-1; kel - 0.39 +/- 0.06 min-1; elimination clearance - 7.8 +/- 1.2 ml min-1. In pregnant rats a marked increase was observed in kel - 1.25 +/- 0.38 min-1 and elimination clearance - 36.4 +/- 13.8 ml min-1. 4 An immediate reduction in uterine contractions, mean blood pressure and heart rate was observed after bolus i.v. injection of diltiazem with a return towards control values as serum diltiazem concentrations declined. There were significant correlations between the inhibition of the 3 parameters and the log serum concentrations of diltiazem. Serum concentration-response curves indicated IC50 values of 0.5 microgram ml-1 for inhibition of uterine contractions, 0.7 microgram ml-1 for reduction in blood pressure and 1.2 micrograms ml-1 for reduction in heart rate. There were maintained reductions in the integral of uterine contractions, mean blood pressure and heart rate during infusion. 5 The metabolite desacetyldiltiazem was rarely detected after i.v. bolus injection and was not found in 5/13 rats infused with diltiazem, yet significant inhibition of uterine contractions was observed in all rats. Diltiazem was 3.2 fold more potent than desacetyldiltiazem as an inhibitor of contractions of the rat isolated uterus. 6 These findings indicate that the inhibition of uterine contractions is due to a direct action of diltiazem, and not the metabolite desacetyldiltiazem, and suggest only a slight selectivity for uterine inhibition compared to cardiovascular effects. PMID- 3664076 TI - Long-term imipramine treatment enhances locomotor and food intake suppressant effects of m-chlorophenylpiperazine in rats. AB - 1 Administration of the 5-HT1B receptor agonist m-chlorophenylpiperazine (m-CPP) to rats produces dose-dependent decreases in locomotor activity and food intake. 2 The locomotor suppressant effect of m-CPP was inhibited by the 5 hydroxytryptaminergic antagonist, metergoline, but not by phentolamine, propranolol, clonidine, or haloperidol. 3 The locomotor suppressant effects of m CPP were enhanced following long-term (but not short-term) treatment with imipramine, possibly reflecting the postulated development of a functional supersensitivity of 5-HT1B receptors mediating locomotion during longer-term antidepressant drug treatment. 4 The food intake suppressant effects of m-CPP were enhanced following both short (3-5 days) and longer-term (21 days) treatment with imipramine. Rapidly developing 5-hydroxytryptamine uptake inhibition may be responsible for this change, or it may represent an earlier adaptive change in the 5-HT1B receptors mediating food intake compared to more complexly modulated motor responses. PMID- 3664077 TI - How fast do cardioactive steroids act independently of diffusion in guinea-pig myocardium? AB - 1 The rate of onset of the inotropic effect of different cardioactive steroids (in order of increasing potency: dihydroouabain, digoxigenin, digoxin, ouabain, digitoxin) was studied in guinea-pig papillary muscles stimulated at 0.5 Hz. For an estimate of diffusion rate the time to defined levels of effect was evaluated in relation to the diameter of cylindrical muscles. 2 The dependence of onset rates on muscle diameter was more pronounced with a highly potent steroid, e.g., digitoxin, than with a less potent compound, e.g., dihydroouabain; that is, the apparent rate of diffusion was inversely correlated with the inotropic potency. Reduction of the ratio of receptor to steroid concentration with increase of ouabain or K+ concentration enhanced the apparent rate of diffusion. 3 Extrapolation to negligibly short diffusion distance indicated that the effects of the various steroids develop faster in the absence of diffusion. The effect of 50 mumol l-1 of dihydroouabain appeared more quickly than with ouabain in the perfused heart. The time courses of the inotropic effect in perfused hearts and in papillary muscles of diameters less than 0.75 mm were superimposable, indicating that the onset of the dihydroouabain effect was not controlled by diffusion. 4 After the interference of diffusion had been excluded, the rates of onset of action correlated inversely with the inotropic potencies of the steroids. The dissociation rate of the drug-receptor complex appeared to be related to the different receptor affinities. PMID- 3664078 TI - Involvement of cyclic nucleotides in prejunctional modulation of noradrenaline release in mouse atria. AB - 1 In mouse isolated atria previously incubated with [3H]-noradrenaline, 8-bromo cyclic AMP (3-270 microM) produced a concentration-dependent increase in the fractional stimulation-induced outflow of radioactivity. 8-Bromo-cyclic GMP induced a lesser increase in the stimulation-induced outflow. 2 The phosphodiesterase inhibitors: M&B 22948 (90 microM); ICI 63197 (30 and 90 microM) and 3-isobutyl-1-methylxanthine (90 microM) increased the fractional stimulation induced outflow. Together these results indicate that cyclic AMP may have a modulatory effect on noradrenaline release. 3 The inhibition of the stimulation induced outflow produced by clonidine (0.03 microM) and its facilitation produced by phentolamine (1 microM) were unaltered in the presence of 8-bromo-cyclic AMP (90 microM). However, in the presence of 8-bromo-cyclic AMP (270 microM), the facilitatory effect of phentolamine was enhanced, but the inhibitory effect of clonidine (0.03 microM) was unaltered. In the presence of ICI 63197 (30 microM) the inhibitory effect of clonidine (0.03 microM) was unaltered, but the facilitatory effect of phentolamine (1 microM) was slightly enhanced. 4 Isoprenaline (0.003-0.1 microM) enhanced the fractional stimulation-induced outflow, an effect blocked by propranolol (0.1 microM). In the presence of 8 bromo-cyclic AMP (90 microM), the facilitatory effect of isoprenaline (0.01 microM) was blocked. In the presence of ICI 63197 (30 microM) the facilitatory effect of isoprenaline (0.003 microM) was potentiated. 5 These results suggest that whereas beta-adrenoceptor-mediated enhancement of noradrenaline release is linked to the stimulation of adenylate cyclase and enhanced formation of cyclic AMP, alpha-adrenoceptor-mediated inhibition of noradrenaline release is not linked to inhibition of adenylate cyclase activity. PMID- 3664079 TI - Bronchial and vascular effects of Paf in the rat isolated lung are completely blocked by WEB 2086, a novel specific Paf antagonist. AB - 1 The effect of the platelet-activating factor (Paf) antagonist, WEB 2086, on Paf induced increase of pulmonary artery perfusion pressure (Pp), bronchial inflation pressure (Pi) and wet-to-dry lung weight ratios (W/D) was investigated in the rat isolated lung. 2 Lungs were perfused with Krebs-Ringer solution (KRS) as controls or with KRS containing WEB 2086 (0.1, 1.0, 10.0 or 100 micrograms ml-1) and then injected with a bolus of 20 micrograms Paf. 3 A dose-related inhibition of the Paf-induced increase of Pp, Pi and W/D was observed, being almost maximal for the 10.0 micrograms ml-1 and complete for the 100 micrograms ml-1 doses of WEB 2086 when compared to controls. 4 It is concluded that WEB 2086 is a highly effective and specific Paf antagonist in the pulmonary vasculature and bronchial tract. PMID- 3664080 TI - P2Y-purinoceptor regulation of surfactant secretion from rat isolated alveolar type II cells is associated with mobilization of intracellular calcium. AB - 1 The effect of methylene, thio, and imido substituted analogues of adenosine 5' triphosphate (ATP) on surfactant phospholipid secretion and calcium mobilization in rat isolated alveolar Type II cells was studied. 2 ATP was the most potent secretagogue of adenine nucleotides studied. The rank order of agonist potency for [3H]-phosphatidylcholine secretion was ATP greater than adenosine 5'-O-(3 thiotriphosphate) (gamma S-ATP) greater than beta, gamma-imido adenosine 5' triphosphate (AMPPNP) greater than beta, gamma-methylene adenosine 5' triphosphate (beta, gamma-CH2-ATP) greater than alpha, beta-methylene adenosine 5'-triphosphate (alpha, beta-CH2-ATP). The respective EC50S were 10(-6) M, 2 X 10(-6) M, 2 X 10(-5) M, and greater than 2.5 X 10(-4) M. 3 Exogenous ATP also induced a rapid mobilization of intracellular calcium monitored by changes in Fura 2 fluorescence. The rank order of agonist potency for calcium mobilization was similar to the rank order of agonist potency for surfactant secretion: ATP = gamma S-ATP greater than AMPPNP greater than alpha, beta-CH2-ATP. 4 There was no effect of EGTA on ATP-induced calcium mobilization, consistent with the hypothesis that exogenous ATP induces release of calcium from intracellular stores. 5 These data are consistent with a P2Y-purinoceptor regulating surfactant secretion from isolated Type II cells via mobilization of intracellular calcium, since: (a) non-hydrolyzed analogues of ATP are potent secretagogues, (b) beta, gamma-CH2-ATP was a more potent secretagogue than alpha, beta-CH2-ATP and (c) the rank orders of agonist potency for calcium mobilization and phospholipid secretion were the same. PMID- 3664081 TI - Type 1 hypersensitivity reactions in reconstructed tissues using syngeneic cell types. AB - 1. Type 1 hypersensitivity reactions in response to antigen challenge have been measured as short circuit current (SCC) responses in reconstructed tissues consisting of syngeneic cell types. 2. In all instances reconstructed tissues consisted of an epithelial monolayer grown on collagen-coated Millipore filters and a pad of peritoneal cells. Monolayers were formed of either HCA-7 or HCA-7 Col 1 cells derived from a human adenocarcinoma. Peritoneal cells were derived from rats or guinea-pigs sensitized to either ovalbumin or beta-lactoglobulin. 3. The SCC responses of the monolayers were dependent upon the 'concentration' of peritoneal cells in the reconstructed tissue. The threshold concentration was 0.4 X 10(6) cells when rat peritoneal cells are combined with an epithelial monolayer of 0.2 cm2. 4. The SCC responses in response to antigen challenge were selectively inhibited by the H1-receptor antagonist, mepyramine. Similarly the effects of exogenously applied histamine were antagonised by mepyramine. 5. The responses to antigen challenge were not inhibited by tetrodotoxin in reconstructed tissues. This result is in contrast to that with isolated intestinal epithelia from sensitized animals where tetrodotoxin inhibits the SCC responses to external field stimulation and to challenge with antigens. The consequences of these results for understanding the mechanisms of epithelial Type 1 hypersensitivity reactions are discussed. Suggestions are made to illustrate how the methods developed here may be employed to ask questions about the nature of mediators released and the types of cell responsible in human disease conditions. PMID- 3664082 TI - Effect of platelet agonists on airway reactivity and intrathoracic platelet accumulation. AB - 1 Intravenous infusion of platelet activating factor (Paf), adenosine diphosphate (ADP), collagen and the thromboxane-mimetic U46619 induced a dose-related accumulation of 111indium-labelled platelets into the thoracic region of anaesthetized guinea-pigs. 2 Intravenous infusion of Paf increased the reactivity of the airways to the spasmogen histamine. Such changes were not observed following treatment with ADP, collagen or U46619. 3 Paf-induced bronchial hyperreactivity is not secondary to pulmonary platelet recruitment, changes in basal lung function or cardiovascular changes. 4 Paf-induced bronchial hyperreactivity is not dependent upon the endogenous generation of ADP or thromboxane. PMID- 3664083 TI - Procoagulant activity of platelet arachidonic acid metabolites. AB - 1 Arachidonate metabolites have been extracted from indomethacin-treated human platelets after incubation with arachidonic acid. 2 After separation from platelet phospholipids, the extracts promoted the generation of large amounts of thrombin in normal plasma, but not in plasma devoid of lipoproteins. 3 The procoagulant activity was associated with a minor component of the mixture, which was active at concentrations below 10 micrograms ml-1. 4 The activity was similar to that of autoxidised arachidonic acid previously described. 5 Platelet arachidonic acid metabolites could play a role in the coagulation system. PMID- 3664084 TI - Inhibition of GABA release from slices prepared from several brain regions of rats at various times following a convulsion. AB - 1 A method is described for the measurement of the K+-evoked release of endogenous gamma-aminobutyric acid (GABA) from slices of rat cortex, hippocampus and striatum. 2 In tissue prepared 30 min following an electroconvulsive shock, K+-evoked GABA release (above basal release) was inhibited by 45% in cortex, 50% in hippocampus and 75% in striatum. A similar inhibition of release was observed with slices prepared from rats in which a convulsion had been induced by flurothyl. There was no change in spontaneous (basal) release following either procedure. 3 An inhibition of K+-evoked endogenous GABA release was also seen in tissue prepared 4 min postictally but not 2 h after the seizure. 4 No difference was observed in the release of [3H]-GABA from preloaded cortical slices prepared from rats given a single electroconvulsive shock. 5 It is proposed that a convulsion results in an inhibition of GABA release and that this inhibition may in turn inhibit GABA synthesis as described in the preceding paper. 6 It is also proposed that changes in the endogenous releasable pool of GABA may not be detected by preloading slices with [3H]-GABA. PMID- 3664085 TI - Individual variations of prostanoid agonist responses in rabbit aorta: evidence for the independent regulation of prostanoid receptor subtypes. AB - 1 The frequency and selectivity of individual variations of prostanoid agonist responses in aortic strips from a population of male rabbits was studied. Three levels of responsiveness to the thromboxane mimetic U46619 occurred: responders (R), intermediate responders (IR), and non-responders (NR). R could be subdivided into R1 and R2 based on an enhanced potency of prostaglandin F2 alpha (PGF2 alpha) in R2. In the total population (n = 92), the phenotype frequency was: R, 69%; IR, 11%; and NR, 20%. In a subgroup of this population in which R1 and R2 phenotypes were determined (n = 63), the phenotype frequency was: R1, 54%; R2, 19%; IR, 6%; and NR, 21%. 2 The four rabbit aorta phenotypes, R1, R2, IR, and NR, were characterized with respect to the rank orders of prostanoid agonist potency, agonist intrinsic activities, and the effects of the thromboxane receptor antagonist SQ29548. The rank order of prostanoid agonist potency was U46619 greater than PGF2 alpha greater than PGE2 in R1 and R2, and PGF2 alpha greater than or equal to PGE2 greater than U46619 in IR and NR. For each prostanoid agonist, the intrinsic activity was highest in R (R1 congruent to R2), intermediate in IR, and lowest in NR. In R1, SQ29548 inhibited all prostanoid agonist responses equally. The contractile effects of PGF2 alpha and PGE2 were partially resistant to inhibition by SQ29548 in R2. Prostanoid agonist responses were not inhibited by SQ29548 in IR. 3 The potency of histamine was equivalent in R1, R2, IR, and NR. 4 It is concluded that there are individual variations in the functional expression of thromboxane receptor sensitivity, i.e., prostanoid agonist responses inhibited by SQ29548. Also, there are individual variations in the functional expression of the sensitivity of a non-thromboxane receptor or receptors, i.e., prostanoid agonist responses not inhibited by SQ29548. It has been proposed by others that prostanoid receptors be termed P-receptors and that the prostanoid agonist to which they are most sensitive be indicated by a preceding letter, e.g., TP- for thromboxane receptor and FP- for PGF2 alpha selective receptor. Accordingly, we proposed a working hypothesis that suggests the four phenotypes could result from the independent regulation of the functional expression of TP- and FP-receptor subtypes with (a) R2 containing both the TP- and FP-receptor subtypes in a fully functional state; (b) R1 containing only the functional TP-receptor; (c) IR containing only the functional FP receptor; and (d) NR containing only a low efficacy FP-receptor system. 5 The mechanisms underlying the observed individual variations are unknown but could include changes in receptor number or affinity, changes in receptor-effector coupling, changes in a second messenger system, or changes in tissue degradative or uptake processes. Further study is needed to differentiate between these possibilities. PMID- 3664086 TI - Airways hyperreactivity and bronchoconstriction induced by vanadate in the guinea pig. AB - 1 The characteristics of vanadate-induced bronchoconstriction and airways hyperreactivity were observed in spontaneously breathing anaesthetized guinea pigs by measurement of airways resistance (Raw) and dynamic lung compliance (Cdyn). Vanadate (0.3-3 mg kg-1 i.v. over 25 min) increased Raw and decreased Cdyn in a reversible, dose-related manner. This action (1 mg kg-1 vanadate) was not inhibited by atropine (1 mg kg-1 i.v.), propranolol (1 mg kg-1 i.v.) or bilateral vagotomy, suggesting a direct effect on the airways smooth muscle. 2 An aerosol of vanadate (10% w/v in H2O) for 3 min decreased Cdyn by 19.5% (P less than 0.05, n = 6) but caused no change in Raw. 3 Histamine (3 micrograms kg-1 i.v.) caused a bronchoconstriction which was enhanced by vanadate in a dose related manner. This hyperreactivity (after 1 mg kg-1 i.v. vanadate) was unchanged after propranolol or bilateral vagotomy, but was partly blocked by atropine (enhancement by vanadate of the Cdyn change to histamine was diminished, P less than 0.02, n = 3). 4 Bronchoconstrictor responses to acetylcholine (6 micrograms kg-1 i.v.) and 5-hydroxytryptamine (6 micrograms kg-1 i.v.) were also enhanced by vanadate (1 mg kg-1 i.v.) Hyperreactivity after vanadate to the three bronchoconstrictors tested continued during vanadate infusion and was reversed 45 min after cessation of infusion. 5 Histamine (3 ;Lgkg-' i.v.) caused a transient tachypnoea which was also enhanced by vanadate (0.3-3mgkg-'i.v.), in a dose related manner, in association with the increased reactivity of the airways (r = 0.66, n = 11). 6 It is concluded that vanadate-induced airways hyperreactivity is non-vagal (efferent) and largely non-cholinergic in origin and appears to involve an action of vanadate within the lung itself. PMID- 3664087 TI - The effect of repeated electroconvulsive shock on GABA synthesis and release in regions of rat brain. AB - 1 The release of endogenous gamma-aminobutyric acid (GABA) from slices of rat cortex, hippocampus and striatum prepared both 30 min and 24 h after the last of a series of electroconvulsive shocks (5 seizures given spread out over 10 days) has been investigated. 2 No change in spontaneous (basal) release was observed. However, 30 min after the last convulsion, K+-evoked GABA release above basal release was inhibited in both hippocampus (20%) and striatum (33%) but not in the cortex. Release was still inhibited in striatum (22%) 24 h after the last seizure. 3 In confirmation of an earlier report, chronic electroconvulsive shock was found to increase basal GABA content in striatum and inhibit synthesis by 34%. The synthesis rate was also inhibited in the hippocampus (44%) but not in the cortex. 4 Glutamic acid decarboxylase activity was unchanged in all regions after repeated electroconvulsive shock treatment. 5 It is proposed that repeated electroconvulsive shocks lead to a substantial inhibition of release in the striatum and hippocampus and a long-term inhibition of GABA synthesis in these regions. Such changes may be associated with the altered monoamine biochemistry and function observed after repeated electroconvulsive shock and with the mechanism of the antidepressant action of electroconvulsive therapy. PMID- 3664088 TI - Influence of thyroid status on responses of rat isolated pulmonary artery, vas deferens and trachea to smooth muscle relaxant drugs. AB - 1 Responses to relaxant drugs have been examined on isolated KCl-contracted smooth muscle preparations from rats in which thyroid status was changed by prior treatment with either thyroxine (T4) for 1 week (preparations of pulmonary artery, trachea and vas deferens) or methimazole for 10-12 weeks (pulmonary artery preparations). 2 On pulmonary artery preparations, T4 treatment caused a significant increase in the magnitude of the relaxant responses to noradrenaline and isoprenaline but not those to adrenaline. The potency of noradrenaline was increased 5.6 fold but that of isoprenaline and adrenaline was unchanged. This resulted in a change in the relative potencies from adrenaline greater than noradrenaline (controls) to noradrenaline = adrenaline (T4-treated). Methimazole treatment caused a significant reduction in the magnitude of the responses to noradrenaline and in its potency (2.8 fold). Isoprenaline and procaterol were unaffected. 3 On pulmonary artery preparations, T4 treatment did not affect the magnitude of the responses to forskolin, sodium nitrite or isobutylmethylxanthine (IBMX) or their potency. In vitro treatment with the monoamine oxidase (MAO) inhibitors, iproniazid or pargyline, did not potentiate responses to either noradrenaline or isoprenaline. Therefore, it was concluded that the T4-induced changes in the magnitude of the responses to noradrenaline and isoprenaline and in the potency of noradrenaline were unlikely to be due to reduced activity of cyclic nucleotide phosphodiesterase(s) or MAO. 4 On preparations of vas deferens and trachea, T4 treatment had no effect on the magnitude of the responses to noradrenaline, isoprenaline, adrenaline or procaterol. 5 We concluded that, on pulmonary artery T4 treatment of rats increased, while methimazole treatment reduced, the magnitude of the responses to, and/or the potency of, the beta adrenoceptor agonists, noradrenaline and isoprenaline, by a mechanism which is specifically associated with the beta-adrenoceptors, and which is probably selective for the beta-subtype. T4 treatment caused no change in responses of vas deferens to beta-adrenoceptor agonists. On trachea the only change was a small increase in the potency of noradrenaline. The differences in the effects of T4 treatment on beta-adrenoceptormediated responses of rat pulmonary artery, vas deferens and trachea may be due to the differences in the beta-adrenoceptor populations of these three tissue types and/or differences in the effects of thyroid hormones on vascular compared with non-vascular smooth muscle. PMID- 3664089 TI - The effects of single and repeated electroconvulsive shock administration on the release of 5-hydroxytryptamine and noradrenaline from cortical slices of rat brain. AB - 1 A method is described of measuring the K+-evoked release of endogenous 5 hydroxytryptamine (5-HT) and noradrenaline (NA) from slices prepared from rat cortex. 2 There was no difference in either the spontaneous (basal) or K+-evoked release of 5-HT or NA from cortical slices prepared from handled animals and those given a single electroconvulsive shock (ECS) either 30 min or 24 h earlier. 3 In chronic studies, rats were either handled or given an ECS 5 times over 10 days and cortical slices prepared. There was no difference in 5-HT or NA release between the groups 30 min after the last treatment other than a modest attentuation of spontaneous NA release following ECS treatment. However 24 h after the last treatment K+-evoked release (above basal release) of 5-HT and NA was inhibited by 84% and 48%, respectively. 4 These data demonstrate that following a single ECS, normal 5-HT and NA release is seen at a time when GABA release is markedly inhibited. After repeated ECS the release of both monoamines was markedly inhibited. These 5-HT changes may be involved in the enhanced 5-HT receptor function seen after repeated ECS. PMID- 3664090 TI - Increased intestinal formation of Paf in endotoxin-induced damage in the rat. AB - Platelet-activating factor (Paf) has been proposed as a mediator of the gastrointestinal damage in endotoxic shock. The formation of Paf in rat jejunal tissue, determined following extraction and bioassay on rabbit washed platelets has therefore been correlated with the induction of damage following endotoxin administration. Intravenous injection of E. coli endotoxin led to a time dependent increase in the jejunal formation of Paf, which after 20 min was twenty fold greater than the control level. There was a significant correlation between elevated Paf release and intestinal hyperaemia and haemorrhage, thus supporting a role for Paf as a mediator of such damage. PMID- 3664091 TI - Effects of dantrolene on force development in slow- and fast-twitch muscle of euthyroid, hypothyroid, and hyperthyroid rats. AB - 1 The effects of dantrolene on twitch and tetanic force development were determined in soleus and gastrocnemius muscle of euthyroid, hypothyroid, and hyperthyroid rats. 2 Maximum twitch force of the gastrocnemius muscle was significantly more depressed by dantrolene than that of the soleus muscle in euthyroid and hyperthyroid rats. In hypothyroid rats, the effect of dantrolene on maximum twitch force was similar in soleus and gastrocnemius muscle. 3 Maximum tetanic force in soleus and gastrocnemius muscle was less depressed by dantrolene than the twitch force in either thyroid state. The effect of dantrolene on maximum tetanic force increased in both muscles in the direction hypothyroid--- euthyroid----hyperthryoid. 4 The results are discussed in terms of an effect of thyroid hormones on Ca2+ -cycling during force development, as a result of thyroid hormone-induced proliferation of the sarcoplasmic reticulum. PMID- 3664092 TI - Inhibition of the rate of GABA synthesis in regions of rat brain following a convulsion. AB - 1 The rate of synthesis of gamma-aminobutyric acid (GABA) in the cortex, hippocampus and striatum of rat brain was assessed by measuring the linear rate of accumulation of GABA following injection of amino-oxyacetic acid (AOAA). 2 Five min after a single electrically induced seizure there was a rise in GABA content in these brain regions and an almost total inhibition of the rate of synthesis. 3 Five min after seizure induced by the inhalant convulsant flurothyl there was no rise in GABA content in these brain regions but a similar marked degree of inhibition of GABA synthesis. 4 Two hours after the convulsion the rate of GABA synthesis had returned to control values in all three brain regions. 5 A single convulsion did not alter the glutamic acid decarboxylase activity in these brain regions either in the absence or presence of added co-factor (pyridoxal phosphate). 6 Evidence for an inhibition of GABA release following a convulsion which may be associated with the inhibition of GABA synthesis is presented in the following paper. PMID- 3664093 TI - Apparent affinity of some 8-phenyl-substituted xanthines at adenosine receptors in guinea-pig aorta and atria. AB - 1 Some 8-phenyl-substituted, 1,3 dipropyl xanthines have previously been demonstrated to have a 20-400 fold greater affinity for A1 binding sites in rat CNS membranes than for A2 adenosine receptors in intact CNS cells from guinea pigs. In the present study these compounds (1,3, dipropyl-8-phenylxanthine: DPPX; 1,3 dipropyl-8-(2 amino-4-chlorophenyl) xanthine: PACPX; 8-(4-(2-amino ethyl)amino) carbonyl methyl oxyphenyl)-1,3-dipropylxanthine: XAC; and D-Lys-XAC) together with two that have not been reported to exhibit A1-receptor selectively (8-(p-sulphophenyl)theophylline: 8-PST; 8-(4-carboxy methyl oxyphenyl)-1,3 dipropylxanthine: XCC) have been evaluated as antagonists of the effects of 2 chloroadenosine in two isolated cardiovascular tissues. 2 The isolated tissues used were guinea-pig atria (bradycardic response) and aorta (relaxation), which are thought to possess A1 and A2 adenosine receptors, respectively. 3 All the xanthines antagonized responses evoked by 2-chloroadenosine in both tissues but did not affect responses evoked by acetylcholine (atria) or sodium nitrite (aorta). 4 The xanthines, 8-PST, XAC, D-Lys XAC, XCC and DPPX appeared to be competitive antagonists of the effects of 2-chloroadenosine, as Schild plot slopes did not differ significantly from unity. The 1,3-dipropyl substituted compounds had pA2 values from 6.5 to 7.4 and were more potent than the 1,3 dimethyl substituted 8-PST (pA2 4.9 to 5). 5 For individual xanthines, there was no difference between pA2 values obtained in the atria and in the aorta. 6 Responses evoked by 2-chloroadenosine in atria and aorta were antagonized to a similar degree by PACPX (1 microM). The agonist dose-ratio evoked by 10 microM PACPX was no greater than that evoked by 1 microM of the xanthine in both tissues. This was probably a consequence of the limited aqueous solubility of PACPX. 7. These results fail to demonstrate A, receptor selectivity for DPPX, XAC, D-Lys XAC or PACPX in tissues from the guinea-pig. The A, selectivity previously found for these compounds may therefore be due to their high affinity for binding sites in rat CNS cell membranes. PMID- 3664094 TI - Resting, and rate-dependent depression of Vmax of guinea-pig ventricular action potentials by amiodarone and desethylamiodarone. AB - 1 The cellular electrophysiological effects of amiodarone and its metabolite desethylamiodarone (DEA) were studied in guinea-pig ventricular myocardium by use of standard microelectrode techniques. 2 Both compounds produced significant increases in action potential duration (Class III antiarrhythmic effect) and decreases in maximum rate of depolarization (Class I effect), at clinically relevant concentrations. 3 The Class I effects were rate-dependent, with small (0 16%) falls in maximum depolarization rate in the absence of stimulation ('resting block') and progressively larger effects at decreasing interstimulus intervals (range 1200-300 ms). 4 The kinetics of onset and offset of the Class I effect in response to a step change in driving rate were quite fast for both drugs (comparable to those reported for Class Ib agents). 5 It is concluded that this unique combination of Class III action plus Class I effects with fast onset and offset kinetics may help explain the great efficacy of amiodarone in antiarrhythmic therapy. PMID- 3664095 TI - The psychological well-being of supporters of the demented elderly. AB - Interviews were conducted with the co-resident supporters of 79 elderly subjects. Forty of these elderly subjects had been diagnosed as being demented (20 mildly, 12 moderately and eight severely) following psychiatric assessment. The supporters were screened for psychological well-being with the 60-item General Health Questionnaire (GHQ) and the Relatives' Stress Scale (RSS). Supporters of demented relatives showed significantly raised levels of stress on the RSS, but no increase in psychiatric morbidity on the GHQ, when compared with the supporters of non-demented relatives. The implications of these findings are discussed. PMID- 3664096 TI - The mental health of elderly couples. I. The effects of a cognitively impaired spouse. AB - In a general practice population, 274 elderly married couples completed the Mental Status Questionnaire (MSQ), the 60-item General Health Questionnaire (GHQ) and the Leeds General Scales for the Self-assessment of Depression and Anxiety. The only relationship detected between cognitive impairment on the MSQ and psychiatric morbidity in the partner was a fairly weak negative correlation between the wives' MSQ and the Leeds Depression score of their husbands. These findings differ from those of previous studies, which have found high rates of psychiatric morbidity in the relatives of demented patients, and the possible reasons for these differences are discussed. Most importantly, other studies have involved the relatives of patients referred to psychiatric services, and these families may be quite different from those in which the demented relative is not referred to a psychiatrist. PMID- 3664097 TI - The mental health of elderly couples. II. Concordance for psychiatric morbidity in spouses. AB - A community sample of elderly married couples completed the 60-item General Health Questionnaire and the Leeds General Scales for the Self-Assessment of Depression and Anxiety. Significant concordance was demonstrated between the spouses' scores on these scales. Concordance was higher for depression than for anxiety. There was little to support previous findings that wives are more likely than husbands to be concordant with an ill spouse. The spouse concordance rates for psychiatric morbidity were similar to those found in studies of younger married couples. PMID- 3664098 TI - Suicide in England and Wales, 1975-1984. AB - An investigation of the suicide rate in the decade 1975-1984 in England and Wales revealed an increase in rate for males of all ages, and a small decrease for young females. The increase for males has been greatest in the 25-54 years group. There has been a decrease in the number of suicides by poisoning with solids and liquids (including overdoses) for both sexes. Rates for poisoning by vehicle exhaust gas and by hanging, strangulation and suffocation have increased substantially during this period. In males, suicides by these methods now exceed those due to poisoning by solids and liquids. PMID- 3664099 TI - The dexamethasone suppression test and prediction of outcome in patients receiving ECT. AB - Twenty-six in-patients satisfying DSM-III criteria for major depressive episode were assessed using the Newcastle Diagnostic and ECT Predictor Scales and the dexamethasone suppression test (DST), prior to commencing a course of electroconvulsive therapy (ECT). The Newcastle ECT Predictor Scale was successful in predicting both immediate outcome and outcome over the 6 months following ECT; the DST was unsuccessful in predicting either immediate or 6-month outcome. PMID- 3664100 TI - Cerebral ventricular enlargement in chronic schizophrenia: consistencies and contradictions. AB - A study of cerebral ventricular size measured as ventricle to brain ratio (VBR) using computerised tomographic brain scan in chronic schizophrenics provided no support for suggestions that there are significant differences between patients who fall into different clinical subtypes. We found no significant difference in VBR between patients with and without a family history of schizophrenia or between those with or without paranoid symptoms. Applying Crow's classification, contrary to expectations, Type 1 patients had significantly larger ventricles than those with 'mixed' symptomatology (both Type 1 and Type 2 features). We also applied a variety of operational criteria which attempt to define schizophrenia as a whole: of these only Schneider's first-rank symptoms (FRS) yielded conclusive results--FRS-positive patients had significantly larger mean VBR than those without such symptoms. Previously, it has been suggested that ventricular enlargement is more closely associated with 'negative' than with 'positive' symptoms. PMID- 3664101 TI - The Scottish First Episode Schizophrenia Study. I. Patient identification and categorisation. The Scottish Schizophrenia Research Group. AB - Forty-nine first episode schizophrenics were identified and considered to be representative of the parent schizophrenic population. Patients were rated before treatment with the Present State Examination. Findings are presented with regard to Catego classes, prevalence of first rank symptoms, conformity to ICD diagnoses, Feighner and Research Diagnostic Criteria and presence of a depressive syndrome. Physical examination revealed isolated neurological signs; in addition two neuroleptically naive patients had abnormal involuntary movements. PMID- 3664102 TI - The Scottish First Episode Schizophrenia Study. III. Cognitive performance. The Scottish Schizophrenia Research Group. AB - Cognitive performance in 46 first episode schizophrenics was assessed within 1 week of admission to hospital by Progressive Matrices, Mill Hill Vocabulary Scale, Block Design and Similarities subtests of the Wechsler Adult Intelligence Scale, and Digit Copying Test. Patients' intellectual performance was at a dull normal level, just within one standard deviation from the mean. There was an association between the presence of anxiety and depression and lower scores on psychological tests. Patients assessed by the Present State Examination as belonging to the 'uncertain psychosis' category performed more poorly. PMID- 3664103 TI - The Scottish First Episode Schizophrenia Study. IV. Psychiatric and social impact on relatives. The Scottish Schizophrenia Research Group. AB - An assessment of 31 main care-giving relatives living with schizophrenics was carried out using the General Health Questionnaire and the Social Adjustment Scale by Self Report. More than 75% of relatives had a high probability of themselves being a psychiatric case. Relatives also showed social role dysfunction and impairment especially marked in social and leisure activities. Relatives' distress was related to the level of symptoms in patients, as assessed by the Present State Examination. PMID- 3664104 TI - Five-year outcome and prognosis in schizophrenia: a report from the London Field Research Centre of the International Pilot Study of Schizophrenia. AB - A sample of 100 schizophrenic patients admitted to London area psychiatric hospitals were examined as part of the International Pilot Study of Schizophrenia. Clinical and social outcome were variable. At 5-year follow-up, 49% had good symptomatic outcome and 42%, good social outcome. Poor social functioning at inclusion was predictive of poor symptomatic outcome. Illness history (IH), occupational functioning (OF), social relationship functioning (SRF), negative and non-specific symptoms (NNS) at initial evaluation, and their interaction with sex and race accounted for 32% of the 5-year symptomatic outcome variance (n = 84; F = 3.48; P less than 0.001). OF, SRF, housing status, NNS and their interaction with sex, race and age accounted for 47% of the social outcome variance (n = 62; F = 2.62; P less than 0.007). PMID- 3664105 TI - Clomipramine and 'drive' in people with anorexia nervosa: an in-patient study. AB - Drugs can sometimes be helpful within the overall treatment and management of anorexia nervosa. In this study we have examined the impact of clomipramine on food and activity in anorectics engaged in a treatment programme enabling them to regain normal body weight. Consumption of the drug was associated with increased appetite, hunger and calorie consumption during the early stages of treatment. There was no impact on ultimate outcome. In this study it was evident that the drug was unnecessary for weight gain, but it may be helpful in other programmes, both short and long term, where the patient has sufficient trust (to tolerate the enhanced hunger experience) but is not involved in the same behavioural constraints. However, its possible value in such programmes has not been proven here. Meanwhile, we take our findings as further evidence that clomipramine increases drive behaviour and appetite in humans and may be beneficial in the treatment of affective disorders because of this effect. PMID- 3664106 TI - The Memory Clinic. A new approach to the detection of dementia. AB - Memory impairment is a salient and early feature of developing dementia, but in practice is often not recognised until it has reached an advanced stage. The operation described is of a Memory Clinic opened on an experimental basis at the Geriatric Research Unit, University College London, in 1983, with the aim of identifying the causes of memory impairment in the elderly, with particular reference to the early detection of dementia. It proved possible to identify a group of people with early dementia who had previously been undiagnosed, and also to reveal deficiencies in the utilisation of existing services. Memory clinics would be a valuable addition to geriatric and psychogeriatric services. PMID- 3664107 TI - Chronic schizophrenic disorder. I. Psychophysiological responses, laterality and social stress. AB - Bilateral palmar skin conductance and heart rate were measured throughout a series of psychological tests and during both sitting and ambulant social interactions in 14 right-handed men with chronic schizophrenic disorder and 12 healthy volunteers matched for age and handedness. Miniature radio telemetry equipment was used to collect the physiological data. The schizophrenic group was effectively unresponsive to 70-dB auditory stimuli, while all but one of the control group responded and habituated to a nil response by the tenth tone in sequence. The schizophrenic group showed some evidence of increased skin conductance activity at rest, and in socially demanding conditions skin conductance level and variability were increased in the right hand. The present group of electrodermal 'non-responders' was not in general autonomically under active. Asymmetry of skin conductance activity during social interaction may be a characteristic of chronic schizophrenic disorder. PMID- 3664108 TI - Chronic schizophrenic disorder. II. Reaction time, social performance and arousal. AB - Reaction time, set index, critical flicker frequency, two-flash threshold, a sustained performance task and psychophysiological parameters from people with chronic schizophrenic disorder (n = 14) and a control group (n = 12) were analysed to assess the association between arousal, attentional dysfunction and social dysfunction in schizophrenia. Shorter reaction time, rated ability to mime and, in the schizophrenic group, scores on Venable's ward activity scale correlated with each other. In the schizophrenic group, prolonged reaction time latency correlated positively with skin conductance level in the right hand and negatively with skin conductance variability in the left hand, the latter being in the opposite direction to that for the control group. The results may provide support for the hypothesis that lateralised cerebral dysfunction is associated with performance deficits in people with chronic schizophrenic symptoms. PMID- 3664109 TI - Influence of husbands on the outcome of their agoraphobic wives' therapy. AB - Of 30 agoraphobic married women undertaking home-based behaviour therapy, 15 each had a female friend as co-therapist and 15 had their own husband as co-therapist. At 12 months follow-up, women spent a mean of approximately 40 minutes a day more outside the home alone than at baseline. Women assisted by female friends made somewhat more behavioural gains than those assisted by husbands. Women in both groups whose husbands had been more depressed 2 months after the beginning of therapy did less well at 6 months. Husbands who become more depressed may retard their wives' progress in therapy, but the effect was small, and was outweighed by other considerations. PMID- 3664110 TI - The concepts of mild depression. AB - The term 'depression' is now used to cover a wider range of emotional disturbances than was the case when psychiatrists confined their attention to patients referred to psychiatric hospitals. There is considerable confusion about the variety of meanings and the loose terminology leads to claims and counter claims about aetiology and treatment. The current classificatory systems and the variety of rating scales do not clarify issues concerning appropriate management. The guidelines for a clearer definition of a biogenic form of the concept of depression, which is likely to respond to antidepressant drug therapy, would be of considerable value to psychiatrists, non-psychiatric physicians and others who try to treat or help people in states of disordered emotion. Such guidelines are proposed. PMID- 3664111 TI - Severe depressive illness in the context of hypervitaminosis D. AB - Hypercalcaemia, whether due to undiagnosed hyperparathyroidism or some other cause, can lead to clinical depression. The patient described here developed a severe depressive illness in the setting of hypervitaminosis D after 15 years of inappropriate therapy with calcium gluconate and strong calciferol. The importance of monitoring serum calcium levels in anyone on vitamin D therapy is stressed. PMID- 3664112 TI - Tuberous sclerosis and the autistic syndrome. AB - A case of tuberous sclerosis presenting with autistic behaviour is described. Although tuberous sclerosis is a rare cause of the autistic syndrome, it should be more strongly suspected when autistic behaviour is associated with seizures in a young child. PMID- 3664113 TI - Asperger's syndrome and aminoaciduria: a case example. AB - An 18-year-old male, originally diagnosed as suffering from infantile autism but with a developmental history and clinical picture in keeping with Asperger's syndrome, and showing current signs of impairment of higher cerebral functioning, is presented. The subject and several males of his family present behavioural disturbances of an enduring type. An aminoaciduria was discovered in the subject and his father. A possible relationship between the metabolic disturbance and the neurological and behavioural disturbance is raised. Mechanisms for this relationship are discussed, including sporadic hyperlysinaemia. PMID- 3664114 TI - Expressed emotion in the families of the mentally handicapped: a pilot study. PMID- 3664115 TI - Delusional infestation and dementia: a case report. AB - The case of an 82-year-old woman with delusional infestation and senile dementia of the Alzheimer type is reported. Her symptoms of infestation ceased dramatically with pimozide given for 5 weeks, and did not recur during follow-up over 9 months. The importance of organic factors in patients with this disorder is emphasised. PMID- 3664116 TI - Anorexia nervosa and dysmorphophobia. PMID- 3664117 TI - Autocastration and biblical delusions in schizophrenia. PMID- 3664118 TI - Munchausen's syndrome and drug dependence. PMID- 3664119 TI - Attachment dynamic in adult life. PMID- 3664120 TI - 49 chromosome anomaly. PMID- 3664121 TI - Premorbid adjustment scale as a prognostic predictor for schizophrenia. PMID- 3664122 TI - Hyponatraemia masquerading as malignant neuroleptic syndrome. PMID- 3664123 TI - AIDS-Phobia. PMID- 3664124 TI - Neuropsychiatry. PMID- 3664125 TI - Temperament, personality and personality disorder. PMID- 3664126 TI - The dexamethasone suppression test in depression. A World Health Organization Collaborative Study. AB - The response to the dexamethasone suppression test (DST) was examined in 543 patients suffering from major depressive illness and 246 healthy controls, from 13 research centres, representing 12 different countries, in a World Health Organization Collaborative Study. In almost all the centres, the post dexamethasone plasma cortisol concentration was significantly higher in the patients than in the controls. Although there is variation between centres, this abnormal response to the DST was shown to be frequent in patients from widely different geographical areas. PMID- 3664127 TI - The structure of depressive symptoms in the elderly. AB - In a structured sample of 100 male and 100 female minimally impaired patients, aged 60 years and over, females were more depressed. Varimax factor analysis demonstrated four factor groupings which have clinical relevance - Depression, Anxiety, Cognitive impairment, and Psychosomatic disorder; their relative importance is different in males and females. Analysis of variance of the scores of clusters generated by cluster analysis demonstrated four groups of subjects - normal, mildly depressed, moderately depressed with borderline dementia and disability, and severely depressed with moderate dementia and frank disability. In the mildly and moderately depressed, symptoms of anxiety predominated. PMID- 3664128 TI - DSM-III personality disorder clusters in three populations. AB - DSM-III personality disorder clusters had not previously been tested for their ability to distinguish between different population groups. A major obstacle - different demographic characteristics of different populations - was overcome by using logistic regression. Three out-patient psychiatric referral groups (chronic pain, disability applicants and competency to stand trial) provided subjects; adjustments were made for age, race, sex and education. The groups were significantly different in the adjusted prevalence of DSM-III personality disorder clusters. Clinical association between personality disorder and drug or alcohol abuse was again confirmed. PMID- 3664129 TI - Improving the quality of care on psychiatric hospital rehabilitation wards. A controlled evaluation. AB - This study attempted to use feedback from the Model Standards Questionnaires (a series designed to measure the quality of care) to improve care on a psychiatric hospital's rehabilitation wards. Both a controlled and quasi-experimental design were used. The controlled design provided evidence that feedback from the Questionnaire concerned with the Individual Programmes of Treatment and Care led to improvements in these practices but not for the remaining three questionnaires. The quasi-experimental design indicated that the significant generalised improvement in care, over all questionnaires, was most likely due to the feedback. PMID- 3664130 TI - Communicability and thought disorder in schizophrenics and other diagnostic groups. A follow-up study. AB - To evaluate qualitative differences in the nature of thought disorder, the 'cloze' procedure and the Scale for the Assessment of Thought, Language and Communication were used to compare speech samples from schizophrenic, depressive, manic, schizo-affective and normal subjects at two different times. At the acute phase, thought-disordered subjects (schizophrenics, manics and schizo-affectives) were less communicable than non-thought-disordered subjects (depressives and normals). Communicability increased with remission of the more flagrant features of disturbance. Comparison of the thought-disordered diagnostic groups in the rate and pattern of remission of specific features of thought disorder indicated that factors reflecting goal-disrupted cognition distinguished the groups. PMID- 3664131 TI - A comparative hospital survey of psychotropic drug prescribing. AB - In a survey of psychotropic drug prescribing for in-patients in three different types of psychiatric hospitals, the prevalence of combinations of more than one psychotropic drug varied from 45% in one hospital to 94% in another, with significant consistent differences between the use of drug combinations in the various hospitals. Combinations of two antipsychotic drugs were particularly frequent; the hospital with the lowest prevalence of polypharmacy was the only one with an associated psychopharmacology unit. Access to clinical pharmacology teaching may be an important factor in determining appropriate drug-prescribing habits. PMID- 3664132 TI - The compulsory detention of males of different ethnic groups, with special reference to offender patients. AB - Compulsory detention rates of white, West Indian and Asian males under Part IV and Part V (offenders) of the 1959 Mental Health Act were compared: British-born West Indians and Asians were differentiated from migrants. Rates for Asians were similar to those for whites, but West Indians were significantly over-represented amongst compulsory detentions, especially as offender patients. A high total number of admissions and diagnostic differences accounted for the excess of West Indians admitted under Part IV, but not Part V. PMID- 3664133 TI - Behavioural treatment of life-threatening masochistic asphyxiation: a case study. PMID- 3664134 TI - Classification of parasuicide by cluster analysis. Types of suicidal behaviour, therapeutic and prognostic implications. AB - A classification of suicidal behaviour was derived by cluster analysis from descriptive data on parasuicide patients. The grouping was meaningful in terms of clinical interpretation and had both therapeutic and prognostic implications. The sample was broken down into three groups, identified as repeated, serious and non serious attempts. The repeated attempters had the worst prognosis at 1-year follow-up. When the sample was classified into five groups according to seriousness of the attempts, the repeater and non-serious groups were retained, while the serious attempts were split into three subtypes, which differed on nosological characteristics, treatment disposal and outcome. An excessively high successful suicide rate was found in a small group of elderly attempters. PMID- 3664135 TI - An American validation study of the Newcastle Diagnostic Scale. II. Relationship with clinical, demographic, familial and psychosocial features. AB - We completed the Newcastle Diagnostic Scale on 152 unipolar depressed in patients: its validity was supported by the findings that endogenous depressives were, in contrast to neurotic depressives, older, more severely depressed, with better social support, fewer life events, less personality disorder, and a lower morbid risk of alcoholism and antisocial personality in their first-degree relatives. The relationship between Newcastle scores and the morbid risk for alcoholism was non-linear, such that a cut-off score of 4, rather than 5, maximised the difference between the endogenous and neurotic groups with respect to familial alcoholism rates as well as other validating variables. PMID- 3664136 TI - An evaluation of the performing and recording of physical examinations by psychiatric trainees. AB - The physical examination on admission, as recorded in the psychiatric case notes, was assessed for 100 consecutive admissions under the age of 65. Assessment was made on the presence or absence of reference to 43 items of examination and the recording of the examinations was found to be uniformly poor. One of the authors re-examined 50 patients within 48 h of admission and the findings were then compared with the initial recorded examination. Significant unrecorded positive findings were most frequent in the neurological and locomotor systems. PMID- 3664137 TI - Five risk factors for depression. AB - Significantly more of 300 patients with non-endogenous depression compared with 300 matched controls were unemployed and had a poor marriage before the onset of depression, had a first-degree relative who had been treated for depression, had experienced separation for one year or more from a parent before 17 years of age and had three or more children under 14 years of age at home. However, significantly more of 44 patients with endogenous depression, than their 46 controls, also had a poor marriage before the onset of depression and 43% of them had a first-degree relative who had been treated for depression. Thus a family history of depression and a poor marriage before the onset of depression are associated with both non-endogenous and endogenous depression but unemployment, separation for one year or more from a parent before 17 years of age, and having three or more young children at home may be risk factors for non-endogenous depression. PMID- 3664138 TI - Cousin marriages and schizophrenia in Saudi Arabia. AB - The rate and degree of consanguinity in the parents of 143 schizophrenics who satisfied the DSM-III diagnostic criteria, was compared in the same number of controls matched for age, sex and socioeconomic class. A family history of disorders suggestive of schizophrenia in the offspring of consanguineous parents who were schizophrenic, was compared with the incidence of a similar history in the schizophrenic offspring of non-consanguineous parents. There was no statistically significant difference in the former, but there was in the latter. This finding supports the theory of a familial tendency towards schizophrenia and the possibility of recessive or a multigene pattern of inheritance. PMID- 3664139 TI - Electrodermal response as a monitor in electroconvulsive therapy. AB - A study comparing the use of electrodermal response with the cuff technique and clinical judgment as monitors in electroconvulsive therapy is reported. A sensitivity of 90.5% and a specificity of 41.7% were found and it is, therefore, suggested that this method is not used routinely. PMID- 3664140 TI - A schoolgirl with onset of anorexia nervosa during a concealed pregnancy. PMID- 3664141 TI - 'Imposed psychosis'. A case variant of the gaslight phenomenon. PMID- 3664142 TI - Consensus statement: panic disorder. PMID- 3664143 TI - Senile dementia and parietal lobe dysfunction. PMID- 3664144 TI - Gluten sensitivity in schizophrenia. PMID- 3664145 TI - Sub-cortical dementia. PMID- 3664146 TI - Anorexia nervosa or dysmorphophobia? PMID- 3664147 TI - Organic factors in catatonia. PMID- 3664148 TI - Panic attacks and hyperventilation. PMID- 3664149 TI - Use of paraldehyde. PMID- 3664150 TI - Autocastration in Ontario Federal Penitentiary. PMID- 3664152 TI - Neurological factors in obsessive-compulsive disorder. PMID- 3664151 TI - The continuum of psychosis and the gene. PMID- 3664153 TI - Neuroleptic malignant syndrome or lithium neurotoxicity. PMID- 3664154 TI - Mianserin and blood dyscrasias. PMID- 3664155 TI - Psychological complications following a mis-diagnosis of deafness. PMID- 3664157 TI - Industrial rheumatology and the shoulder. PMID- 3664156 TI - Syndrome of the black swan. PMID- 3664158 TI - Renal abnormalities in ankylosing spondylitis. AB - The incidence of renal abnormalities is increased in patients with ankylosing spondylitis (AS). Possible mechanisms include the effects of nonsteroidal anti inflammatory drugs (NSAIDs), an increased incidence of glomerulonephritis and the deposition of amyloid. We assessed renal function in 51 patients with AS randomly selected from those attending routine rheumatology clinics. Five patients were found to have a definite renal abnormality and three of them underwent renal biopsy. These showed one case each of IgA glomerulonephritis, focal segmental glomerulosclerosis and nonspecific tubulo-interstitial damage. A sixth patient had recurrent haematuria and borderline renal functional impairment but refused further investigation. The urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) was elevated in four patients; two had other biochemical evidence of renal damage while the other two patients appeared normal, although they had both received spinal irradiation in the past. The finding of a significant renal abnormality in 10% of AS patients suggests that evidence of renal involvement should be actively sought in this disease. PMID- 3664159 TI - Anticardiolipin antibodies in rheumatoid arthritis. AB - Anticardiolipin antibody (ACA) was present in the sera of 49% of 90 consecutive patients with rheumatoid arthritis (RA). The ACA was absent in 30 control patients with osteoarthritis. C-reactive protein levels equal to or exceeding 7 mg/dl were found in 10 patients all of whom were ACA positive. ACA was present in a larger proportion of rheumatoid factor (RF) positive than of RF negative patients. Male sex and extra-articular manifestations of RA were both more common in ACA positive than ACA negative patients. In the ACA positive group the lupus anticoagulant and VDRL tests were negative. However, a small number of patients had evidence of vascular events. PMID- 3664160 TI - The association of autoimmune thyroiditis with systemic lupus erythematosus. AB - There has been controversy over the possible association of autoimmune thyroiditis with systemic lupus erythematosus (SLE). We have therefore compared the prevalence of thyroid autoantibodies and abnormal thyroid-stimulating hormone (TSH) levels in 41 SLE patients with age- and sex-matched controls. Twenty-one (51%) of the SLE patients had thyroid antibodies compared to 11 (27%) controls (p less than 0.05). Ten SLE patients and five controls had elevated TSH levels, usually in association with the presence of thyroid autoantibodies. These results suggest that SLE is associated with autoimmune thyroiditis and that many patients with SLE have minor hypothyroidism. PMID- 3664161 TI - Work-related shoulder-neck complaints in industry: a pilot study. AB - Twenty-six industrial workers, selected from employment records, were examined with a questionnaire, anthropometric measures, muscle strength measurements and filming during work cycles to study the influence of ergonomic factors on shoulder-neck complaints. No differences were observed when comparing age or anthropometric measurements between the nine workers with and the 17 without shoulder-neck complaints. Significantly weaker shoulder muscles were found in workers with shoulder-neck complaints than in those without. A higher median strain on the shoulders in the working situation of workers with shoulder-neck complaints than in the group with no complaints was suggested from the results of a biomechanical analysis of the different work tasks. PMID- 3664162 TI - Chronic knee effusion and aspiration: the effect on quadriceps inhibition. AB - Inhibition of the non-weight-bearing quadriceps was studied in ten patients with chronic knee effusions. The muscles were tested with the knees both flexed and extended, before and after joint aspiration. More inhibition was seen when the knees were extended (p less than 0.005). There was no relationship between muscle inhibition and the size of effusion, pain experienced during contraction or the extent of weakness. Aspiration of joints did not reduce the amount of inhibition. Acute effusions have previously been shown to cause muscle inhibition, even when pain-free, and we suggest that the known changes in the compliance of chronically effused joints are responsible for the observed differences in the effect of acute and chronic effusions. PMID- 3664163 TI - The prescribing of chloroquine and hydroxychloroquine by consultant rheumatologists in the UK. AB - A questionnaire on chloroquine and hydroxychloroquine prescribing was circulated nationally to 212 consultant rheumatologists and 119 replies were analysed. Of all patients receiving second-line drugs, 10% were prescribed antimalarials, with hydroxychloroquine being used four times more frequently than chloroquine. Eighty five per cent of rheumatologists always used the same dose of hydroxychloroquine or chloroquine. Only 5% considered patient's weight in deciding the dose. Fear of ocular toxicity was expressed by many physicians; 54% had experienced corneal deposits; 4% retinopathy and 40% believed cumulative dose determined toxicity. Much confusion existed over the necessity for and frequency of ophthalmological monitoring. Only 56% requested ophthalmological tests before commencing treatment, although 86% monitored the eyes during therapy. Other side-effects were believed to affect 1-10% of patients, with no anticipated difference between doses of 250 mg chloroquine and 400 mg hydroxychloroquine daily. PMID- 3664164 TI - Diagnosis of pseudogout and septic arthritis. AB - A patient with septic arthritis of the wrists was noted to have concurrent calcium pyrophosphate crystals in synovial fluid aspirated from both joints. These were present in unusually large numbers and were associated with destructive changes of the joints. It seemed likely that the complete dissolution of calcified cartilage accounted for the liberation of such numerous crystals. Previous reports of pseudogout associated with septic arthritis have noted the presence of abundant calcium pyrophosphate crystals in synovial fluid. It is suggested that this feature should always raise the possibility of concurrent sepsis. PMID- 3664165 TI - Eosinophilic polymyositis presenting as a pseudotumour in the hypereosinophilic syndrome. AB - This report describes an unusual case of pseudotumour of muscle caused by an eosinophilic myositis associated with peripheral blood eosinophilia, systemic illness and a pericardial effusion. The relationship of this case to other reported cases of eosinophilic myositis and the hypereosinophilic syndrome is discussed briefly. PMID- 3664166 TI - Sport, exercise and arthritis. PMID- 3664167 TI - Ibuprofen does not affect fibrinolytic activity. PMID- 3664168 TI - Comparison of erect and supine radiographs of the hip. PMID- 3664169 TI - Use of Beighton score to compare joint mobility between groups. PMID- 3664170 TI - Seat-belts again. PMID- 3664171 TI - Common-sense beliefs about arthritis. PMID- 3664172 TI - IgA nephropathy in a young female with ankylosing spondylitis. PMID- 3664173 TI - Leprosy presenting as nodular vasculitis. PMID- 3664174 TI - Cancer: the failure of treatment. PMID- 3664175 TI - Quantitative magnetic resonance imaging in rectal carcinoma. AB - T1 and T2 relaxation times have been calculated in 30 patients with rectal carcinoma and seven patients with a fibrotic pelvic mass. The relaxation times were calculated using a multipoint iterative method with data from seven total saturation recovery and six spin-echo sequences. The results show that the calculated T1 relaxation value is a useful discriminant between carcinoma and pelvic fibrosis and should improve the detection of early tumour recurrence. PMID- 3664176 TI - Radiological features of systemic mast-cell disease. AB - Radiological studies were done on 23 patients with systemic mast-cell disease (SMCD). Significant changes occur most often in bones and less commonly in the gastrointestinal tract and other visceral organs. These changes may be related either to tissue infiltration by mast cells, or to the effect exerted on tissues by chemical mediators of the mast cells, although in some instances findings may be coincidental. Because the radiological changes are not unique to SMCD, their main value, in association with the clinical information, is in directing further studies for diagnostic confirmation and in estimating the extent of systemic involvement. PMID- 3664178 TI - Short and long fractionated schedules in radiotherapy and a proposed improvement. PMID- 3664177 TI - Breast "abscess": an unusual complication of catheterisation of the subclavian vein. PMID- 3664180 TI - Developer temperature in diagnostic departments. PMID- 3664179 TI - Financial considerations of contrast media in intravenous urography. PMID- 3664181 TI - Proceedings of the British Institute of Radiology. Radiology '87: forty-fifth annual congress and scientific exhibition. Southampton, April 1-3, 1987. Abstracts. PMID- 3664182 TI - Detection of splenosis by radionuclide scanning. AB - Splenosis is the autotransplantation of splenic tissue following trauma. The presence of residual nodules following splenectomy has been investigated by a sensitive scanning method employing reinjection of 99Tcm-labelled, heat-damaged autologous erythrocytes. Splenosis was detected in 11 of 19 patients who had had splenectomy for traumatic rupture of spleen. Four of them had multiple nodules, the others a single nodule. In one case, the splenic nodule did not take up the sulphur colloid, although it could be visualised on selective splenic scan. We found no splenic nodules in 23 patients who had splenectomy for non-traumatic reasons. It is concluded that the key factor in splenosis is trauma. PMID- 3664183 TI - The visible wall of a main bronchus: a new radiological sign of pneumomediastinum. AB - A new sign of pneumomediastinum (mediastinal emphysema), namely a visible wall of a main bronchus as seen in the mediastinum on frontal radiographs of the chest, is described. This sign was present in eight out of 20 random cases of pneumomediastinum in adolescents and adults. PMID- 3664184 TI - Influence on patient management of general practitioner direct access to radiological services. AB - We have looked at the effect of open radiological access on patient management during a 2-year prospective study in the radiology department of a teaching hospital and two general practices. Five hundred and thirty consecutive requests for radiological examination were studied. Chest radiographs (29.8%) and barium meals (17.4%) were the investigations most commonly requested. At the time of referral general practitioners indicated that if open radiological access had not been available, 78% of the patients would have been referred to specialist clinics. They also indicated that with a normal initial radiological examination only 12% would need referral to a specialist department. Open access appears to save outpatient consultations. PMID- 3664185 TI - Average soft-tissue and bone models for use in radiation dosimetry. AB - Average tissue compositions have been derived for seven groups of soft tissues found in "Reference Man". The analyses took into account some 40 soft tissues comprising the adult human. Different groups of soft tissues were selected to provide average tissue compositions of practical value in radiation dosimetry. In addition, as more reliable skeletal tissue data are now available, an updated tabulation is given of average bone formulations. Elemental compositions and mass and electron densities are tabulated for all of the derived systems. PMID- 3664186 TI - Radiation safety in the nuclear medicine department: impact of the UK Ionising Radiations Regulations. AB - The practice of nuclear medicine requires integration of radiation safety with patient care and radiopharmaceutical standards. Nationally there was useful discussion in the UK before the Ionising Radiations Regulations and Approved Code of Practice were published, although such consultation had been lacking when the Medicines Act was implemented. Most of the new considerations relating to nuclear medicine stem from Schedule 6 of the Regulations. Generally, the presence of a single patient does not require a controlled area. However, when several patients are present, or radiopharmaceuticals are being prepared prior to injection, a controlled area is required. Classification of workers is not likely to be required in a typical nuclear medicine department in the UK, although most parts of the nuclear medicine department will need to be controlled areas. These include the radiopharmacy, radionuclide dispensary, injection room, and imaging rooms if patients are injected in them. The importance of finger dose measurements is emphasised. Patient wards, however, need not be controlled areas. A particular concern in nuclear medicine was that patients should not need to be admitted to hospital merely to comply with legislation. This is possibly the case and clarification will probably be available when the Notes for Guidance are published. Most procedures in nuclear medicine departments will remain unchanged. Further information is required, however, on patient waiting rooms, handling flood sources, pregnancy, and breast feeding. Within the hospital, detailed and multidisciplinary discussion will need to take place within the forum of the radiation safety committee. PMID- 3664187 TI - Peripheral angiography in a standard fluoroscopy room. PMID- 3664188 TI - Unusual disco-vertebral changes in Gaucher's disease. PMID- 3664189 TI - Hodgkin's disease in a patient with polysplenia. PMID- 3664190 TI - Early radiation swelling remains a problem in the management of paediatric brain tumours. PMID- 3664191 TI - Pituitary size in hypothyroidism as determined by computed tomography. PMID- 3664192 TI - Radiological interest in mammographic screening. PMID- 3664193 TI - Change in therapeutic gain with photon contamination in a neuron beam. PMID- 3664194 TI - Severe mental retardation in Japanese bomb survivors irradiated in utero: a postscript. PMID- 3664195 TI - Proceedings of the British Institute of Radiology. Practical aspects of magnetic resonance imaging. Joint meeting with the Royal College of Radiologists. London, January 14, 1987. Abstracts. PMID- 3664196 TI - Uroradiology update. Meeting held jointly by the British Institute of Radiology, the Royal College of Radiologists and the Royal Society of Medicine (Section of Radiology). London, January 15, 1987. Abstracts. PMID- 3664197 TI - Renal carcinoma: a ten-year review 1971-1980. AB - A review of 72 patients who underwent nephrectomy for renal carcinoma between 1971 and 1980 is presented. All survivors were followed for a minimum of 5 years. The clinical features, type of operation and pathological findings were analysed for their influence on survival. Patients with stage 1 to 3 disease had a 65% 5 year survival rate, whereas all patients with stage 4 disease were dead within 2 years. The presence of malaise had a highly significant adverse influence on survival (P = 0.0014). PMID- 3664198 TI - Does the severity of presentation in children with vesicoureteric reflux relate to the severity of the disease or the need for operation? AB - The presenting symptoms, number of previous urinary tract infections, grade of reflux and incidence of renal scarring, together with an analysis of the need for reimplantation of the ureters, were assessed retrospectively in 222 patients with vesicoureteric reflux. The grade of reflux was found to be as severe in patients presenting after a single urinary tract infection as in those presenting after more than one infection. Regardless of whether patients presented with mild, moderate or severe symptoms, the degrees of reflux and renal scarring remained similar. There was no relationship between the severity of presenting symptoms and the eventual need for ureteric reimplantation. All children should be investigated when they present for the first time with a urinary tract infection, irrespective of age, sex or severity of symptoms. PMID- 3664199 TI - An assessment of the complications of the Brantley Scott artificial sphincter. AB - A Brantley Scott artificial sphincter has been inserted into 95 patients since 1981; more than half of the patients had lower urinary tract neuropathy and most of the others post-TUR incontinence. The main problem with the device has been cuff failure (12), which should be resolved by the new "dipped" cuffs. The major surgical complication has been erosion (10), usually associated with infection. Twenty-four patients had variable degrees of incontinence but the artificial sphincter remains the cornerstone of continence control when other methods have failed or are inappropriate. PMID- 3664200 TI - The complications of colposuspension. AB - Fifty patients with stress incontinence treated by a colposuspension procedure were reviewed symptomatically and urodynamically before and after surgery and followed up for 1 to 6 years (mean 4.5). Although 84% were continent post operatively, only 63% of those previously operated on for incontinence were dry, and only 44% were dry and complication-free in the long term. PMID- 3664201 TI - Clean intermittent self-catheterisation in the elderly. AB - The results of teaching the technique of clean intermittent self-catheterisation (CISC) to 20 elderly patients (aged 65-81 years) are reported. The patients were followed up for a maximum of 4 years. The use of this technique in the management of selected elderly patients with lower urinary tract dysfunction is discussed. PMID- 3664202 TI - The integrated cystoscope: an alternative to conventional and fibreoptic cystoscopy. AB - This report describes a new integrated rigid cystoscope which has been designed for diagnostic and therapeutic cystoscopy under local anaesthesia. The small external diameter (17.5 F) and large instrument channel permit maximum irrigant flow and operating potential whilst causing minimum discomfort to the patient. We believe this instrument to be a practical alternative to conventional cystoscopes, including the fibreoptic cystoscope. PMID- 3664203 TI - The role of partial cystectomy in the treatment of recurrent invasive bladder cancer following radiotherapy. AB - Seventeen patients with recurrent invasive bladder cancer following radical radiotherapy were treated by partial cystectomy. Thirteen patients required augmentation enterocystoplasty, using an ileal patch in 10 patients and large bowel in the others. After 4 years' follow-up, eight patients are alive and disease-free with good bladder function. Of the nine patients who died, six died from bladder cancer and three of these suffered local recurrences. Responsiveness to radiotherapy or tumour stage were not helpful in predicting local recurrences, but all patients who had this complication had anaplastic tumours. In selected patients this procedure offers an alternative to salvage cystectomy, especially where a urinary diversion may be inappropriate. PMID- 3664204 TI - Epidemiology of cancer of the prostate in Canada: 1950-1984. AB - Canadian patterns of morbidity and mortality from malignancies of the prostate were examined for the periods 1970 to 1980 and 1950 to 1984 respectively. Age standardised morbidity (ASMR) and mortality (ASDR) rates have risen dramatically during the two periods. The rise in ASMRs, at 1.07 additional new cases per 100,000 population per year since 1970 (P = 0.0001), is attributable to significant increases in age-specific morbidity rates for males aged 45 to 54, 55 to 64, 65 to 74 and 85+ (0.5 to 15.2 additional new cases per 100,000 population per year) (P less than 0.002). The significant increase in ASDRs, 0.09 additional deaths per 100,000 population per year since 1950 (P = 0.0001), is a reflection of significant increases in age-specific mortality rates for males aged 75 to 84 and 85+ (2.8 and 9.3 additional deaths per 100,000 population per year) (P = 0.001). PMID- 3664205 TI - A new technique for the management of urethral injuries. AB - A new technique for the management of urethral trauma is described. Initial suprapubic catheterisation is followed by endoscopic assessment after approximately 2 weeks. Realignment over a splinting catheter may then be achieved by instrumentation and endoscopy via both suprapubic and urethral routes. The development of the technique and the early results of a small series of patients are presented. PMID- 3664206 TI - Bone scintigraphy in testicular tumours. AB - The role of bone scintigraphy was assessed by follow-up and review of 61 patients with testicular tumours. Skeletal metastases were present in all five patients who died with seminoma and in two of the eight whose deaths were due to teratoma. The only patient with skeletal metastases to have a prolonged survival had a mixed teratoma/seminoma. Bone scintigraphy is indicated in patients with recurrence after radical treatment for seminoma and may be indicated in patients presenting with stage IV seminoma, to identify a sub-group with the worst prognosis. In other patients it is indicated only if there is a specific clinical suspicion of bone metastases. PMID- 3664207 TI - Penile deep dorsal vein cushions and erection. AB - During surgical treatment of impotence due to venous leakage, the deep dorsal veins from 10 patients were resected and studied histologically to see if any morphological anomaly could be implicated in the physiopathological mechanism of venous leakage. Normal venous cushions were present in these veins similar to those observed in the deep dorsal veins of patients with normal erections. Their function and possible deterioration are discussed. PMID- 3664208 TI - Giant leiomyoma of the bladder. PMID- 3664209 TI - Renal hydatid disease: an unusual aetiology. PMID- 3664210 TI - A urological pancreatic cyst. PMID- 3664211 TI - Out-patient percutaneous chemolitholysis of cystine stones. PMID- 3664212 TI - Opiate analgesic toxicity in patients with renal dysfunction undergoing surgery. PMID- 3664213 TI - Localised amyloidosis of the urethra. PMID- 3664214 TI - Malignant mesothelioma of the tunica vaginalis testis. PMID- 3664215 TI - Transurethral incisions and resections under local anaesthesia. PMID- 3664216 TI - Re: Congenital bulbar urethral stricture occurring in a father and son. PMID- 3664217 TI - The specialty of hepatobiliary surgery. PMID- 3664218 TI - Warfarin inhibition of metastasis: the role of anticoagulation. AB - Warfarin inhibits metastasis in animal models by mechanisms that remain unclear. A better understanding of this phenomenon may clarify processes underlying metastasis in human cancer. We have studied the effects of warfarin on metastasis in a rat model by intravenous injection of Mtln3 mammary carcinoma cells and subsequent counting of pulmonary seedlings. To determine whether warfarin acts principally on the tumour cells or the host, we pretreated either cells or animals with warfarin before intravenous injection of 10(4) Mtln3 cells. Pretreatment of tumour cells had no effect, whilst pretreatment of the host reduced median seedlings from 67 to 4.5 per animal (P less than 0.005). To determine whether warfarin was acting via its anticoagulant action, we reversed warfarin anticoagulation by intravenous injection of coagulation factors II, VII, IX and X. Restoration of coagulation for 12 h immediately after injection of cells completely reversed the warfarin effect (P less than 0.001), but if the injection of factors was delayed for 12 h it had no effect (P = 0.1753). We conclude that warfarin acts principally on the host, not the tumour cell, and that it acts via its effect on coagulation. The restriction of the effect to the first 12 h after tumour cell injection suggests a mechanism involving intravascular processes such as tumour cell survival or endothelial adhesion. PMID- 3664219 TI - Pre-operative assessment of fitness score. AB - Death within 30 days or survival after a major operation depends on three things: the severity of the disease and the operation, the technical proficiency of the surgeon and the ability of the patient to withstand both disease and operation. The first of these can be estimated by reference to published figures, the second can only be guessed at and the third has in the past been a matter of subjective judgement. With the aim of producing an objective assessment of the likelihood of survival, we have constructed a score system comprising 26 items including age, chronic disease and acute presenting disease. These items are each given a weight of 1 to 4 and the total fitness score for any patient ranges from 0 (fit) to 10 (unlikely to survive). We have validated this score prospectively in 1517 consecutive patients undergoing emergency or elective major abdominal operations (excluding appendicectomies and hernia repairs). In 492 operations in which the patient scored 0 or 1, one patient died (0.2 per cent); in 290 with scores of 2 or 3, one died (0.3 per cent); in 313 with scores of 4 or 5, five died (1.6 per cent). It was when the score rose to 6 or over that the chances of survival progressively declined: 16 died of the 105 patients who scored 6 (15.2 per cent) as did 74 of the 191 who scored 7 or 8 (38.7 per cent) and 70 of the 126 who scored 9 or 10 (55.6 per cent). We now use the score as part of our audit and enquire particularly closely into the death of any patient with a pre-operative score of less than 6. PMID- 3664220 TI - Selection of patients for surgery following peptic ulcer haemorrhage. AB - Surgery remains the only widely available and well-proven means of stopping haemorrhage from peptic ulcers and preventing its recurrence but carries an unavoidable morbidity. If surgery is to be used to maximum effect with minimum morbidity, an accurate means of predicting which patients will suffer further haemorrhage is needed. Although over 80 per cent of patients who rebleed have the endoscopic stigmata of haemorrhage, a policy of operation in all patients with stigmata would lead to a very high operation rate and a high proportion of unnecessary operations, as one-half of the patients with stigmata do not rebleed. Clinical data were collected prospectively from 278 cases of peptic ulcer haemorrhage. The data from a randomly selected 75 per cent of the cases were analysed by stepwise logistical regression. Patients who had the endoscopic stigmata of haemorrhage and who had a probability of further haemorrhage, calculated from the regression equation, of more than 0.2 were identified as a high risk group. This definition was validated using the 25 per cent of cases not used in the initial analysis. Eighty-four per cent of patients in the high risk group suffered further haemorrhage and all such patients therefore require early surgery: such a policy would have resulted in an operation rate of 28 per cent. Thirty per cent of the patients who had further haemorrhage were not identified as being at high risk but none of them had a severe rebleed. The regression equation greatly enhanced the value of stigmata in guiding surgical decision making and merits further evaluation. PMID- 3664221 TI - Gastric emptying and clinical outcome after Roux-en-Y diversion. AB - The results of 48 Roux-en-Y (RY) diversion procedures are reported: 41 were performed as secondary procedures and 7 as part of a primary operation for peptic ulcer. There was no operative mortality, but four patients developed temporary fistulae in the postoperative period and three patients required reoperation. Good clinical results were found when RY diversion was performed as a primary procedure or when the indication for operation was peptic ulceration. The overall results, however, were poor: 24 patients (50 per cent) felt that they had not benefited and 32 patients (67 per cent) remained in Visick grades III or IV. The main cause of failure was gastric stasis, especially of solid food. Gastric emptying studies were carried out after RY diversion in 22 patients, most of whom had symptoms of stasis. Emptying of liquids was found to be normal in most patients, but emptying of solids was delayed, the median t 1/2 for solids being 160 (75-370) min compared with 67 (50-85) min in DU patients. Bilious vomiting improved significantly after RY diversion, but 18 patients (38 per cent) complained of vomiting food and 32 patients (67 per cent) experienced postprandial distress or pain. Loss of the antral mill, vagotomy of the gastric remnant and, perhaps, resistance to gastric emptying by the Roux loop itself may together explain the delay in gastric emptying of solids after RY diversion. PMID- 3664222 TI - Total pancreatectomy for chronic pancreatitis. AB - A survey of six British centres collected data on 83 patients undergoing total pancreatectomy (TP) for chronic pancreatitis between 1977 and 1986. There were 57 men and 26 women with a median age of 38 years (range 19-61 years). Half were alcoholics and half had had previous acute pancreatitis. Besides jaundice (14 per cent) severe pain was the indication for the operation; regular opiates had been needed in 82 per cent of patients and 37 per cent were addicted to these drugs. All but 12 had had previous pancreatic or biliary surgery, with a median of two operations and a maximum of six. TP was a one-stage procedure in 32 patients, 42 had had distal resections and 9 proximal resections in the past; the pylorus was preserved in 30. Median operation time was 4 h (range 2-18 h) and median blood loss was 3 units (1-21 units). Intraoperative complications in 11 patients included haemorrhage in 9. Four deaths occurred within 30 days from bleeding (2), respiratory failure (1) and Roux-loop infarction (1). All but one of the 79 survivors required full pancreatic supplementation and 38 per cent had difficulties in endocrine control. At a median follow-up of 1.5 years (range 0.25 10 years), 57 patients (72 per cent) were pain-free and 9 (11 per cent) needed only occasional analgesia. Though 13 (17 per cent) still took regular analgesics, all were symptomatically improved. There have been 10 late deaths (13 per cent), all but one of which are attributable to the operation. PMID- 3664223 TI - Study of common bile duct exploration and endoscopic sphincterotomy in a consecutive series of 438 patients. AB - The outcome of 438 consecutive patients who had exploration of the common bile duct and/or endoscopic sphincterotomy (ES) in a 5-year period was reviewed. Patients were analysed according to four groups: 59 patients had planned ES followed by surgery resulting in 14 major complications (23.7 per cent) including 3 deaths (5.1 per cent) (group 1); 248 patients had surgery alone with 21 major complications (8.5 per cent) including 10 deaths (4.0 per cent) (group 2); 114 patients with gallbladder in situ underwent ES alone with 22 major complications (19.3 per cent) including 9 deaths (7.9 per cent) (group 3); 17 patients with remote cholecystectomy also had ES alone with 3 major complications (17.6 per cent) including 3 deaths (17.6 per cent) (group 4). There was no difference in mortality between the groups. Compared with group 2, major complications were significantly higher in group 1 (chi 2 = 11.0, d.f. = 1, P less than 0.001) and in group 3 (chi 2 = 8.6, d.f. = 1, P less than 0.003). Patients in group 3, however, were significantly older than those in groups 1 and 2, and the former also had higher medical and total risk factor scores than the latter (all P less than 0.001). The results indicate that routine pre-operative ES is of questionable value. ES alone is justified in elderly high risk patients; mortality in this group might be reduced by improved management of post-ES complications. PMID- 3664224 TI - Experience with the 'skew flap' below-knee amputation. AB - A review of 353 lower limb amputations over the last 7 years has been performed to assess the results of the skew flap myoplastic below-knee amputation which was introduced in April 1983 because of reported advantages in terms of wound healing and earlier ambulation. Comparing the first 3 1/2 year period with the second, the total number of amputations decreased by 31 per cent. The number of above knee amputations remained similar in the two periods (82,62), whilst the number of Gritti-Stokes amputations fell from 79 to 21 (0.001 greater than P greater than 0.01). The proportion of below-knee (BK) amputations increased from 50 (23.7 per cent) to 59 (41.5 per cent) (0.01 greater than P greater than 0.025). The groups were comparable in terms of previous vascular surgery and co-existing medical conditions. The time to full stump healing was significantly shorter in the skew flap group compared with the earlier Burgess type BK amputation (P = 0.001), and there was a trend to fewer stump failures in the skew flap group. We therefore feel that the skew flap amputation gives superior results to the Burgess BK amputation in terms of healing and a lower complication rate, allowing a higher proportion of BK amputations to be performed. A prospective randomized trial of the two techniques is in hand to determine the accuracy of this hypothesis. PMID- 3664225 TI - Defective fibrinolysis: a risk factor in early femoropopliteal graft thrombosis. AB - Resting plasma fibrinolytic activity and fibrinolytic activity after stimulation by 10 min of venous occlusion (fibrinolytic potential) were estimated in 51 patients before femoropopliteal reconstructive surgery. Twelve patients suffered a graft thrombosis in the first month. Resting plasma fibrinolytic activity was similar in patients with thrombosed grafts and those with functioning grafts. However reduced fibrinolytic potential was found to be a risk factor for graft thrombosis in the month after surgery (P = 0.01). Other risk factors were increasing age (P = 0.007) and the indication for surgery (P = 0.03). Thirty-four patients whose grafts were functioning after 1 month were followed up for a mean of 9 months. A further eight grafts thrombosed. Neither fibrinolytic activity nor fibrinolytic potential were found to be risk factors for late graft thrombosis. Fibrinolytic potential has been shown to be an independent risk factor for early graft thrombosis. Perioperative fibrinolytic stimulation might be a method of improving femoropopliteal graft patency. PMID- 3664226 TI - Changes in the apparently normal limb in unilateral venous ulceration. AB - Forty-seven patients with unilateral venous ulceration have been investigated to determine if any abnormalities were present in the contralateral limbs which had not had lipodermatosclerosis or ulceration. Ascending phlebography in the non ulcerated limbs showed post-thrombotic changes in 28 per cent and incompetent lower leg communicating veins in 19 per cent. This incidence was not significantly different to the limbs with healed ulceration (45 and 23 per cent respectively, chi 2 test, P = 0.10). Half volume refilling time measured by foot volumetry suggested that 79 per cent of the non-ulcerated limbs had evidence of deep vein incompetence or incompetent lower leg communicating veins, which was again similar to the incidence in the previously ulcerated limbs (85 per cent). Transcutaneous oxygen readings, expressed as a ratio of a reading at a standard site in the gaiter region of the leg over a reading from the upper arm, were significantly lower in non-ulcerated limbs (mean 0.84 +/- 0.26 s.d.) than in a cohort of age and sex matched controls (mean 1.02 +/- 0.14, Student's t test, P less than 0.001), and significantly higher than in previously ulcerated limbs (mean 0.68 +/- 0.31, P less than 0.01). Abnormalities in venous anatomy and function have been shown, in conjunction with evidence of reduced oxygen diffusion, through the gaiter skin before overt skin changes develop. PMID- 3664227 TI - Preservation of the entire anal canal in conservative proctocolectomy for ulcerative colitis: a pilot study comparing end-to-end ileo-anal anastomosis without mucosal resection with mucosal proctectomy and endo-anal anastomosis. AB - Mucosal proctectomy with endo-anal pull-through anastomosis (MP + PTA) for ulcerative colitis reduces resting anal pressure and low RAP has been found to correlate with minor leakage of faeces or mucus. Our hypothesis was that conservative proctocolectomy with an end-to-end ileo-anal anastomosis (EEA) would result in higher anal pressure and less leakage. Twelve patients were studied after EEA and 24 after MP + PTA: each was in good health several months after operation. After EEA, maximal RAP decreased from a median 90 cmH2O (60-116 cmH2O) to 70 cmH2O (25-104 cmH2O, P less than 0.01), whereas after MP + PTA maximal RAP decreased from 85 cmH2O (70-125 cmH2O) to 40 cmH2O (22-80 cmH2O, P less than 0.003). RAP after EEA was significantly greater than RAP after MP + PTA (P less than 0.001). The pressure profile of the anal sphincter in the EEA group did not differ significantly from that of the pre-operative group at any point from 6 to 1 cm from the anal verge, and the sphincteric high pressure zone averaged 4 cm in length both before and after operation. After MP + PTA, resting anal pressure at stations 1 to 4 cm from the anal verge was significantly less than pre-operative pressure (P less than 0.001) and the sphincteric high pressure zone was only 3 cm in length compared with 4 cm before operation. Anal squeeze pressures were similar in the two groups of patients. After EEA 11 of 12 patients achieved perfect continence, day and night, whereas after MP + PTA 58 per cent of patients experienced minor faecal leakage (P less than 0.01). These findings suggest that the entire anal canal should be kept intact in the course of conservative proctocolectomy for ulcerative colitis. PMID- 3664228 TI - Synchronous and 'early' metachronous carcinomas of the colon and rectum. AB - In a review of cases of colorectal cancer presenting to St. Mark's Hospital over the 16-year period 1970-85, 59 patients were found to have a synchronous carcinoma (3.4 per cent). Although 82 per cent of these synchronous tumours were distal to the splenic flexure (and hence within reach of a 60 cm flexible sigmoidoscope) only 42 per cent were detected pre-operatively: the remaining tumours were noted at surgery (24 per cent) or found incidentally on pathological examination of the resected specimen (34 per cent). Histological examination of these synchronous lesions revealed a high proportion with favourable stage (Dukes' A-75 per cent) and grade (well or moderate differentiation-90 per cent). Over the same 16-year period, 10 patients presented with an 'early' metachronous lesion (less than 3 years from initial surgery). Review of these cases noted negative findings on the initial barium studies in four patients and a failure to conduct full examination of the colon at initial presentation in the remaining six. It is concluded that full examination of the colon in all patients presenting with primary colorectal cancer is mandatory and that, in the light of this experience and recent reports in the literature, this should be by pre- or peroperative colonoscopy. PMID- 3664229 TI - Submucosal versus ligation excision haemorrhoidectomy: a comparison of anal sensation, anal sphincter manometry and postoperative pain and function. AB - Submucosal (SM) and ligation excision (LE) haemorrhoidectomy were compared to establish whether SM is a less painful procedure and whether anal sensation is better preserved by SM, and, if so, how this relates to postoperative function. There were 18 SM and 22 LE patients. Anal sphincter manometry and anal mucosal electrosensitivity were measured pre-operatively and 6 weeks after surgery. Postoperative pain was assessed by linear analogue scale. Anal sphincter pressures which were high pre-operatively fell to normal after surgery. Neither operation affected functional sphincter length or the recto-anal inhibitory reflex. Forty per cent of patients showed ultraslow waves on sphincter motility studies. These were associated with the highest pressures and in all but three cases disappeared after surgery. There were no differences in postoperative pain scores between the two techniques but there was a wide range from no pain to very severe pain in both groups. Submucosal haemorrhoidectomy preserved anal sensation better than ligation excision but this was not reflected in improved function. There was minor leakage and soiling in 50 per cent of patients from both groups and two SM and LE patients had initial faecal incontinence. All these symptoms had resolved by 6 weeks. PMID- 3664231 TI - Bacterial growth kinesis in generalized peritonitis. PMID- 3664230 TI - Treatment and outcome in 52 consecutive cases of ampullary carcinoma. AB - The results of treatment and outcome in 52 consecutive patients presenting to Leicester from 1972 to 1984 are presented. The number of patients diagnosed increased from two per year before the introduction of duodenoscopy to nearly five per year afterwards. Endoscopic drainage (ED) was attempted in 21 patients with a success rate of 81 per cent. In eight cases ED was used pre-operatively and in the remainder as definitive treatment. Twenty-four patients had a Whipple's resection (12.5 per cent mortality), four patients had a local resection (no deaths), ten patients had surgical bypass (60 per cent mortality) and thirteen patients had ED alone (23 per cent mortality). The major risk factor score was significantly greater in patients undergoing surgical bypass compared with Whipple's resection. Age and risk factor scores were significantly greater in patients who had ED drainage alone than in surgical patients. The 5 year survival rate for resection was 56 per cent versus 13 per cent for drainage procedures (P less than 0.001). Survival in resection cases was directly related to the degree of tumour differentiation and a new staging system. It is proposed that all patients with ampullary tumours should have endoscopic biopsy followed by ED; Whipple's resection remains the surgical treatment of choice. PMID- 3664232 TI - Nissen fundoplication and pyloroplasty in the management of gastro-oesophageal reflux in children. PMID- 3664233 TI - Reflux stricture of the oesophagus. PMID- 3664234 TI - Fine needle aspiration cytology of soft tissue tumours. PMID- 3664235 TI - Postsplenectomy infection. PMID- 3664236 TI - Node dissection in gastric cancer. AB - Three hundred patients who underwent absolute and relative curative gastrectomy and lymph node dissection for gastric cancer were reviewed with respect to postoperative mortality; proportion of patients with node involvement according to the extent of dissection; number of metastatic nodes dissected according to the extent of dissection; accuracy of macroscopic evaluation of node involvement and microscopic node involvement according to tumour location. If more nodes were dissected the proportion of patients with node involvement and the total number of metastatic nodes increased; conversely within R0 and R3 the extent of dissection did not affect postoperative survival. Finally when the presence and extent of node involvement was only macroscopically evaluated, the patients were classified incorrectly in 9.5 per cent of the N0 group and 20.2 per cent of the N1 group. The data suggest that lymph node dissection may be useful in the treatment of gastric cancer, and within the extent studied the employment of this procedure does not affect the postoperative mortality. PMID- 3664237 TI - Modified dissecting forceps for handling expanded PTFE arterial prostheses. PMID- 3664238 TI - Barrett's oesophagus: pH profile. AB - Twenty-four patients with a columnar-lined (Barrett's) oesophagus underwent oesophageal manometry and 24 h ambulatory oesophageal pH monitoring. The results were compared with 25 patients with oesophagitis studied in the same fashion. No significant difference in lower oesophageal sphincter pressure was demonstrated between the two groups. The Barrett's patients demonstrated significantly greater acid exposure in the distal oesophagus than oesophagitis patients. Clearance or refluxed acid was poorer in Barrett's patients than oesophagitis patients. Twelve of the Barrett's patients presented with complications of the condition, i.e. ulceration or stricture. No significant difference in acid exposure was demonstrated between Barrett's patients with or without complications. These results suggest that patients with columnar-lined (Barrett's) oesophagus have greater acid exposure than patients with oesophagitis. The development of complications of a Barrett's oesophagus may not be dependent on acid reflux alone. PMID- 3664239 TI - Adhesion obstruction following Nissen fundoplication in children. AB - The incidence of postoperative adhesion intestinal obstruction among 156 children who had undergone Nissen fundoplication for intractable gastro-oesophageal reflux was determined. There were 18 episodes of obstruction in 16 patients (10.3 per cent). The mean interval between fundoplication and adhesion obstruction was 10 months (range 10 days-4 years). Additional procedures performed at the original laparotomy substantially increased the risk of developing obstruction. Relaparotomy for adhesion obstruction was required by 21 per cent of patients who had a Ladd's procedure and 12 per cent who had appendicectomy. Presenting symptoms were not typical of intestinal obstruction because many of these children were unable to vomit. Only three did vomit but all had radiological appearance suggestive of small bowel obstruction. There were two deaths directly related to adhesion obstruction. PMID- 3664240 TI - Total gastric gangrene complicating adult Bochdalek hernia. PMID- 3664241 TI - Outcome of surgery for Graves' disease re-examined. AB - The outcome of surgery for Graves' disease in terms of early and late morbidity was studied in 161 patients undergoing subtotal thyroidectomy in the 10-year period 1976-1985. Eighty of these patients had a minimum follow-up of 5 years. There was a low operative morbidity and a zero mortality. The weight of thyroid tissue preserved (in the range 5-10 g) influenced the prevalence of hypothyroidism at one year and at five years. There was a cumulative incidence of hypothyroidism which could not be reliably predicted from biochemical results during the first year. Over 60 per cent of patients with subclinical hypothyroidism at 4 months (63 per cent) or 1 year (70 per cent) did not subsequently need thyroxine replacement within 5 years. Patients remained at risk of developing recurrent toxicity indefinitely and the risk was significantly greater in patients with small goitres (less than 50 g). Our results may be improved by leaving larger remnants (9-10 g) in most patients and smaller remnants (2-4 g) in those with small glands in whom alternative treatment, which is to be preferred, is not acceptable. After subtotal thyroidectomy for Graves' disease lifelong follow-up is necessary. PMID- 3664242 TI - Evaluating surgical risk: the importance of technical factors in determining outcome. AB - A total of 113 patients having elective resection of the alimentary tract were studied prospectively to examine the relationship of pre-operative clinical and nutritional assessment to the development of major postoperative complications. In addition, the operating surgeon made a risk assessment on a linear analogue scale before and immediately after operation. Major complications developed in 28 patients (25 per cent). Age, weight loss and relative weight did not select high risk patients, but patients with a serum albumin of 29 g/l developed significantly more complications than those with higher levels (60 versus 22 per cent, P less than 0.05). Clinical assessment also selected some high risk patients but patients selected by the surgeon's pre-operative assessment did not develop significantly more complications than those not selected (38 versus 21 per cent). However, the surgeon's postoperative assessment did select patients at significantly increased risk, especially when compared with his pre-operative assessment. Of 38 patients who were selected pre-operatively as high risk or who increased their risk ranking postoperatively, 20 (53 per cent) developed complications, as opposed to only 6 of 65 patients (9 per cent) who were low risk or decreased their risk ranking (P less than 0.001). The surgeons changed their ranking postoperatively in 44 patients and in 36 (82 per cent) the reason given was the technical ease or difficulty of the procedure. Using receiver-operating characteristic curves, immediate postoperative assessment was superior to any pre operative method of selecting high risk patients. Of 15 patients with normal serum albumin levels whose risk ranking increased postoperatively 6 (40 per cent) developed complications while none of the 7 patients with low serum albumin (high risk) who decreased their risk ranking developed complications. It is concluded that operative performance is the main factor in the development of postoperative complications and should be assessed in future studies of outcome. PMID- 3664243 TI - Bilateral ankle skin temperature as a predictor of early vascular graft patency. AB - The efficacy of postoperative bilateral ankle skin temperature as a predictor of early graft patency was prospectively evaluated in 138 consecutive cases of femoropopliteal bypass surgery. The difference between ipsilateral and contralateral ankle temperature (hourly registrations) was significantly greater in the patients with patent graft on postoperative day 1 than in those with an occluded graft. In measurements 8 h postoperatively, highest sensitivity (84 per cent) and specificity (93 per cent) of the test were obtained when the difference was +0.4 degrees C. The overall accuracy of prediction with this simple method was 89 per cent. PMID- 3664244 TI - Selective conservative and routine early operative treatment in acute limb ischaemia. AB - Arterial thrombo-embolectomy is often unsuccessful in those patients with acute limb ischaemia that have peripheral arteriosclerosis. During this study, conservative heparin treatment and, when needed, delayed surgery was employed in acute limb ischaemia when the ischaemia was less severe as judged by assessment of distal motor and sensory functions, regardless of the presumed aetiology of the acute ischaemia. The results are compared with those during a preceding period, when the routine treatment was emergency thrombo-embolectomy. The emergency operation rate was reduced to 49 per cent. There were overall fewer deaths with gangrene (8 per cent versus 18 per cent). In acute arterial thrombosis, more good results were obtained (76 per cent versus 47 per cent), whereas results were unchanged in embolic cases despite the reduced emergency operation rate. This study suggests that the choice of initial treatment of patients with acute limb ischaemia may be based on the severity of the ischaemia, and that patients with less severe acute ischaemia benefit from initial conservative heparin treatment. PMID- 3664245 TI - Pseudo-aneurysm of the profunda femoris artery following a stab wound. PMID- 3664246 TI - Pre-operative albendazole therapy for hydatid cyst. AB - Surgical management of hydatid cyst is associated with recurrence in 10 per cent of patients. The role of perioperative chemotherapy in prevention of recurrence has not been extensively explored. Sixteen patients with Echinoccus granulosus were treated with albendazole 10 mg kg-1 before operation; of fourteen patients who received albendazole for 1 month or more before operation only one (with doubtful therapeutic compliance) had viable protoscoleces, in contrast both of the two remaining patients who received only 1 and 3 weeks therapy had live disease at the time of operation. A 1 month pre-operative course of albendazole kills most if not all protoscoleces within hydatid cysts in man. This may allow pre-operative 'sterilization' of cysts and a reduction in the risk of recurrence. PMID- 3664247 TI - Resection in chronic pancreatitis. AB - In the absence of ductal ectasia there is no adequate alternative to pancreatectomy for severe chronic pancreatitis. A personal series of 30 such patients operated upon between 1977 and 1984 included 16 with distal pancreatectomy, 6 with proximal pancreatectomy and 12 with total pancreatectomy; 4 patients progressed from distal to total resection after an interval of 15-28 months. The mean age was 39 years with a male preponderance of 77 per cent. The main aetiological agents were chronic alcoholism (63 per cent) and previous acute pancreatitis (23 per cent). One patient died after total pancreatectomy, giving a 30-day mortality rate for all resections of 3 per cent. Postoperative complications necessitated reoperation in 10 per cent, and there have been 5 late deaths (17 per cent). Among 27 patients followed for a median of 4.5 years, pain relief has been good in 16, fair in 8 and poor in 3 (11 per cent). Proximal pancreatectomy has proved superior to distal pancreatectomy with regard to analgesia and the avoidance of diabetes. Although technically demanding, total pancreatectomy has improved symptoms substantially in 9 of 10 patients surviving for a minimum of 18 months. PMID- 3664248 TI - Surgical treatment of pancreatic pseudocysts. AB - Between 1966 and 1980, 54 patients (40 men and 14 women) with a mean age of 38 years were operated on for a pancreatic pseudocyst at the Department of General Surgery, University of Gottingen. The aetiology of the cysts was alcohol abuse in 35 patients, biliary diseases in 8, blunt abdominal trauma in 4, virus-induced in 2 and unknown in 5. With the exception of those who had had trauma, all patients were suffering from chronic pancreatitis. Surgical therapy included in all cases a cystojejunostomy (52 with a Roux-Y-limb and 2 with an omega loop). The mean follow-up period was 13 years (range 6 to 20 years). The late mortality was 15 per cent (8 of 52 patients). Recurrent cysts occurred in two patients (5 per cent) and relapse of pancreatitis in one third of the patients. Deterioration of carbohydrate metabolism was observed in 20 per cent of the patients. After drainage operation stool fat content became normal in 20 per cent and deteriorated in 13 per cent. Persistence or cessation of alcohol intake influenced the long-term results. From these data we conclude that both alcohol withdrawal and sufficient drainage of the pseudocyst are important factors in the prognosis of pseudocyst. PMID- 3664250 TI - The stabilized ring retractor: a technique for cholecystectomy. PMID- 3664249 TI - Management of periampullary carcinoma. AB - Forty-one patients presented to our hospital between 1959 and 1983 with periampullary carcinoma. Twenty-six (63 per cent) underwent radical surgery, eight (20 per cent) local excision of the tumour, six (15 per cent) had bypass procedures and one was treated by endoscopic sphincterotomy (2 per cent). Potentially curative resection was performed in 83 per cent of the 41 patients. The operative mortalities for radical, local and bypass surgery were 7.7 per cent, 25 per cent and 16.6 per cent respectively. The degree of tumour differentiation significantly affected survival while local spread did not significantly affect survival in patients treated radically. The 5 year survival rates (calculated actuarially) for radical, local and bypass surgery were 34, 44 and 0 per cent respectively. PMID- 3664251 TI - Out-patient treatment of haemorrhoids with bipolar diathermy coagulation. PMID- 3664252 TI - Assessment of hospital workload in war surgery. AB - The aim of treatment of casualties in war time is to offer a chance of survival to the greatest number of patients. This goal can be approached by selecting for treatment patients who have a real chance of survival and by reducing the duration of operations as much as possible. Should the operative time be limited to an assessed predetermined duration as proposed in certain armies? Conditions for the observation of war wounded were particularly favourable in the ICRC (International Committee of the Red Cross) Hospital in Peshawar (Pakistan) because all treatments were started and completed in the same place. During the summer of 1985, a major battle took place near the Pakistan border. Analysis of 212 operated patients, of whom 68 per cent arrived at the hospital less than 48 h after the injury, showed that the operations lasted 90 min on average. Abdominal procedures were the longest. Patients stayed in the hospital for an average of 4 weeks; those with lesions of the extremities stayed longer (5.8 weeks) than those with abdominal or thoracic lesions (4.3 and 3 weeks). The results show that the long duration of an operation has not been correlated either with an unfavourable outcome or with an increased postoperative workload. As far as possible, accelerating the turnover of operations by increasing the number of operating teams should be the objective rather than the selection of patients who require short operations. Such selection would have resulted in the death of most seriously wounded patients in this series. PMID- 3664253 TI - External abdominal wall hernias: experience with elective and emergency repairs in Nigeria. PMID- 3664254 TI - Renal impairment following biliary tract surgery. AB - Postoperative mortality has been directly attributed to renal failure in approximately 5 per cent of patients after surgery for obstructive jaundice. An analysis of 334 patients undergoing biliary tract surgery was undertaken to identify the perioperative factors associated with the development of renal impairment, and to estimate the contribution of renal failure to mortality. Thirty-eight patients (11 per cent) developed postoperative renal impairment (a two-fold increase in serum creatinine postoperatively or a rise of greater than 100 mumol/l). Ninety-three factors were examined in these and 196 control patients. Stepwise logistic regression analysis identified only three factors which were significantly associated with renal impairment: postoperative sepsis (P less than 0.0005), pre-operative serum bilirubin (P less than 0.0005), and pre operative urea (P less than 0.05). Renal impairment developed at a median 4 days after surgery and was associated with a median of two additional major postoperative complications, particularly sepsis and haemorrhage, for which 17 patients underwent reoperation. Twenty-eight (74 per cent) of the patients with renal impairment died in hospital, but in only one case was the cause of death directly related to renal failure. Twenty patients received specific therapy for renal failure, but only one of these survived. Pre-operative obstructive jaundice and postoperative infection are the major factors associated with renal impairment after biliary tract surgery. Renal impairment appears to be related to postoperative complications rather than directly to the surgical procedure itself. The development of postoperative renal impairment predicts a low chance of survival but appears to be an indicator, rather than a direct cause of a poor prognosis. PMID- 3664255 TI - Biliary lithiasis in the over seventy-five age group: a new therapeutic strategy. AB - Sixty-four gallstone patients aged 75 or more (mean age 83 +/- 5.1 years) were divided prospectively into two groups. They were mostly high-risk patients (average number of major risk factors, 2.2 +/- 0.9). Thirty-three showed one or several signs of lithiasis of the common bile duct and were treated with endoscopic sphincterotomy (ES) (31 successful cases, two technical problems) followed by early cholecystectomy (33 cases). Choledocholithiasis was present in 26 cases and stones were extracted in 25 cases. Two patients (6 per cent) died. ES caused no complications. Thirty-one other patients showed no sign of choledocholithiasis and were treated by cholecystectomy with operative cholangiography. Choledocholithiasis was found in two of these patients and treated by extraction and external drainage. Five of these patients (16 per cent) died. In 30 cases acute cholecystitis was found at operation, 15 in each group. ES is therefore an efficient procedure in high-risk patients, which facilitates operation, especially in cases of acute cholecystitis, and it is recommended in all cases of complicated biliary lithiasis. Early cholecystectomy is justified for these patients by the high frequency of associated acute cholecystitis. PMID- 3664256 TI - Effect of vagal denervation on canine gallbladder motility. AB - There is an increased incidence of gallstones after truncal vagotomy but the mechanism is unknown. Our aim was to study the early effects of vagotomy on fasting and postprandial gallbladder motility. A chronic model was constructed in 10 dogs to correlate gallbladder motility and emptying with interdigestive and postprandial duodenal motility both before and after selective hepatobiliary vagotomy (five dogs) and truncal vagotomy (5 dogs). During each study recordings were made for one complete interdigestive motor complex (IDMC) and for 90 min after a standard meal of (a) gallbladder and duodenal motility, (b) gallbladder emptying (by a dual radioisotope marker technique) and (c) duodenal output of bilirubin. In control studies the gallbladder contracted at the start of phase II of the interdigestive motor complex and ejected 20-25 per cent of its contents into the duodenum; after meals the gallbladder contracted within 5 min and emptied almost 80 per cent of its contents within 90 min. After both selective hepatobiliary vagotomy and also truncal vagotomy there was no significant difference in the pattern of contraction or emptying of the gallbladder either during fasting or postprandially. We conclude that gallbladder motility and emptying are entirely normal in the early period after vagal denervation. PMID- 3664257 TI - Case for conservative management of selected fibro-adenomas of the breast. AB - To assess the safety of a conservative approach to fibro-adenoma of the breast we prospectively studied 321 women with this clinical diagnosis, and performed aspiration cytology and excision biopsy. There was histological confirmation of fibro-adenoma in 217 (68 per cent), the remainder having various benign conditions and 4 (1.3 per cent) had carcinoma. Aspiration cytology had a sensitivity of 87 per cent and a specificity of 76 per cent for fibro-adenoma. Three cases of carcinoma were identified cytologically and the fourth was regarded as suspicious. To estimate the risk of missing carcinoma we compared the annual frequency of carcinoma with fibro-adenoma in young women and found a ratio of 1:470 between 15 and 19 years, 1:133 between 20 and 24 years and 1:9 in the 25 29 age group. To assess patients' views on non-operative treatment of benign breast masses we asked 124 women, 10 days postoperatively, whether they preferred a conservative approach for a cytologically benign lump: 26 (21 per cent) opted for conservative management in the future and 8 (7 per cent) would have preferred conservatism rather than their recent excision. A conservative approach is safe for clinically and cytologically benign breast lumps in women under 25 years, but very few will accept it. PMID- 3664258 TI - Endoscopic management of common bile duct stones without cholecystectomy. PMID- 3664259 TI - Very low birthweight survivors: illness and readmission to hospital in the first 15 months of life. PMID- 3664260 TI - The blood transfusion service and the National Health Service. PMID- 3664261 TI - Distribution of dopamine in the forebrain and midbrain of the red-eared turtle, Pseudemys scripta elegans, reinvestigated using antibodies against dopamine. AB - The distribution of dopamine (DA) immunoreactivity in the forebrain and midbrain of the red-eared turtle, Pseudemys scripta elegans, was studied using recently developed antibodies against DA. DA-containing cells were found around the glomeruli of the olfactory bulb but not in the telencephalon proper. In the diencephalon DA cells were observed in the preoptic region, several parts of the periventricular hypothalamic nucleus, the periventricular organ, the ependymal wall of the infundibular recess, the lateral hypothalamic area and the pretectal posterodorsal nucleus. In the midbrain DA cells were found in the ventral tegmental area, the substantia nigra and the presumed reptilian homologue of the mammalian A8 cell group. Dopaminergic fibers and terminals were observed throughout the whole brain, particularly in the telencephalon and diencephalon. The olfactory tubercle, the striatum and the nucleus accumbens appear to have the most dense innervation, but the anterior olfactory nucleus and the septal area also show numerous DA fibers and terminals. Cortical areas are in general not densely innervated by DA fibers. Compared to the results obtained for a lizard, Gekko gecko, with the same antibodies, the results of the present study are very similar as regards the distribution of DA neurons, fibers and terminals. In having better developed DA cell groups in the midbrain and a stronger innervation of the striatum, Pseudemys resembles mammals more than does Gekko. In contrast, the many cerebrospinal fluid-contacting DA neurons in the hypothalamus of Pseudemys are a primitive feature of the diencephalon. The previous immunohistochemical study of Gekko, a lizard, and the present account of Pseudemys, a turtle, indicate that at least two different lines of evolution exist within the reptiles with regard to the DA innervation of the dorsal ventricular ridge. One, including turtles and, probably, crocodilians with a weak DA innervation; and another, represented by lizards, with a strong DA immunoreactivity. PMID- 3664262 TI - Auditory pathways in the budgerigar. I. Thalamo-telencephalic projections. AB - Thalamo-telencephalic auditory pathways in the budgerigar (Melopsittacus undulatus) were studied using horseradish peroxidase (HRP) histochemistry and amino acids autoradiography. The results indicate that in this species the thalamic auditory relay nucleus, n. ovoidalis, projects upon a circumscribed region of the caudal and caudomedial neostriatum including field 'L' and immediately adjacent portions of the neostriatum intermedium, pars dorsolateralis (NIDL). This region of NIDL also receives inputs from another thalamic nucleus, n. dorsolateralis posterior (DLP). In the DLP is in receipt of tectal inputs. Projections of DLP upon NIDL were confirmed with amino acids autoradiography. The results of the HRP experiments indicate that different portions of n. ovoidalis project upon different portions of field 'L' and NIDL. Neurons in the dorsal and lateral portions of the n. ovoidalis project upon more medial portions of field 'L'. Neurons located centrally in the n. ovoidalis project upon central and lateral portions of field 'L'. Neurons in the ventromedial portion of the n. ovoidalis are labeled in all cases in which HRP is placed in either field 'L' or in the DLP projection field immediately adjacent to field 'L' proper. HRP injections placed in NIDL lateral to the projection fields of the n. ovoidalis and DLP label neurons within other diencephalic nuclei including the n. subrotundus. The caudal and intermediate levels of the neostriatum intermedium apparently serve as a complex processing area for many thalamic inputs in this species. The existence of multiple ascending thalamo-telencephalic projections from portions of the thalamus receiving inputs from both the visual (i.e., tectal) and auditory (i.e., n. mesencephalicus lateralis pars dorsalis) portions of the midbrain roof (i.e., from DLP and from n. ovoidalis) suggests the possibility that intermodal associations may take place in these telencephalic fields. Such partially converging pathways may provide a basics for intermodal associations which are important in individual recognition and social signalling systems in this species. PMID- 3664263 TI - Anatomy and differential growth of the lateral line system of the mottled sculpin, Cottus bairdi (Scorpaeniformes: Cottidae). AB - Scanning electron microscopy and standard histological techniques were used to describe the basic anatomy and postembryonic growth of the lateral line system of Cottus bairdi. The gross anatomy and distribution of lateral line neuromasts in canals and superficially on the skin are similar to what has been reported for many primitive actinopterygian fishes. Both canal and superficial neuromasts showed postembryonic growth in the number of hair cells and size of neuromasts, but canal neuromasts grew more elongate whereas superficial neuromast grew symmetrically. Neuromasts in the mandibular canal grew significantly faster than any other neuromasts and superficial neuromasts on the head showed the least amount of growth. Differential growth of the sculpin lateral line system may be related to the feeding behavior of the animal and to differences in the ambient levels of water noise to which larval and adult fish are exposed. PMID- 3664264 TI - Differential growth in the brain of the weakly electric fish, Apteronotus leptorhynchus (Gymnotiformes), during ontogenesis. AB - Growth characteristics of the total brain and of several individual brain regions are described in Apteronotus leptorhynchus. The increase of brain volume relative to total length growth results in a sigmoid growth curve, in which three phases- proportional growth, positive-allometric and negative-allometric growth--could be distinguished. This type of enlargement of the total brain is due to the differential volume increase of individual brain regions and to the increase in the volume of the rhombencephalic structures in particular. Pros- and mesencephalic regions mainly grow in accordance with the overall enlargement of the total brain throughout development, whereas rhombencephalic and certain nuclear structures show such isometric growth only with the onset of the juvenile period. The results are interpreted in the view of functionality of the individual brain regions. PMID- 3664265 TI - Hypothalamic substrates for brain stimulation-induced grooming, digging and circling in the rat. AB - Despite a great number of studies concerned with the induction of specific behavioural responses from the rat hypothalamus by electrical brain stimulation, hypothalamic response areas and underlying neural substrates have never been determined accurately. In this study the boundaries of the hypothalamic response areas for grooming, digging and circling were delimited using moveable electrodes, an enriched environment containing a variety of goal objects, and an appropriate statistical technique. A total of 641 hypothalamic sites in 71 male CPB/WU Wistar rats were electrically stimulated. Results are plotted on a detailed stereotaxic brain atlas of the rat hypothalamus. Positive sites for any behavioural response cluster into restricted hypothalamic areas. Discriminant analysis of both positive and negative electrode localizations yields areas with high, intermediate or low probabilities of inducing the behavioural response concerned. Each response has its own response area where probabilities are high, although there may be overlap. Even within response areas a distinction can be made between areas in which the response can be induced at relatively high or low threshold current intensities. Lowest threshold sites within electrode tracks are often clustered. In search of neuroanatomical correlates, grooming is related to the distribution of ACTH-immunoreactive neural elements, digging is related to the distribution of efferent fibres from the bed nucleus of the stria terminalis, and circling is related to the distribution of dopaminergic fibres of the nigrostriatal pathway. The results clearly point to the stimulation site being the most important determinant of the evoked behavioural response. Evidently behavioural specificity does exist within the hypothalamus. PMID- 3664266 TI - The rat striatum: a target nucleus for ascending axon collaterals of the entopedunculo-habenular pathway. AB - Direct projections from the entopeduncular nucleus (Ep) to the striatum were examined in the rat using retrograde tracing techniques. After injecting horseradish peroxidase (HRP) into the caudoputamen (CPU), labeled fibers could be traced medially to go through and/or terminate in both the globus pallidus (GP) and Ep ipsilateral to the injection. Interestingly, HRP-positive neuronal perikarya were observed in the Ep as well as in the GP after the CPU injections. These labeled Ep neurons were medium in size and restricted to the rostral 1/3 of the nucleus, in a distribution which overlapped the terminal fields from the CPU. A fluorescent tracer injection into the CPU resulted in retrograde labeling of Ep cells in the same fashion as after HRP injections. A second experiment was designed to determine whether the Ep cells projecting to the CPU have axon collaterals to any of the other known terminal fields of the Ep. Following True blue (TB) injections into the CPU and Diamidino yellow (DY) injections into the lateral habenular nucleus (lHb), all the TB-positive neurons in the rostral 1/3 of the Ep were unequivocally double-labeled with DY. On the other hand, the TB labeled Ep neurons were never double labeled with DY injected into the centre median-parafascicular complex (CM-Pf) or ventroanterior-ventrolateral complex (VA VL) of the thalamus or nucleus tegmenti pedunculopontinus pars compacta (TPC). The present study shows that single Ep neurons in the rostral 1/3 of the nucleus innervate both the striatum and lHb, and raises the possibility that these neurons may have a critical role in integrating motor and limbic functions in the basal ganglia. PMID- 3664267 TI - Clonidine modulates the ventrolateral medullary catechol metabolic hyperactivity induced by hypotension. AB - In vivo electrochemistry allowed recording of a catechol oxidation current in the ventrolateral medulla, caudal to the obex, in anesthetized rats whose ventilatory, metabolic and hemodynamic parameters were rigorously controlled. Hemorrhage or controlled hypotension induced an increase in the metabolism of catecholamines in the A1 noradrenergic group, which remained activated after full hemodynamic recovery. Clonidine (200 micrograms.kg-1 i.p.) given 30 min prior to hemorrhage or immediately before controlled hypotension suppressed partially the increased metabolism of catecholamines especially during the recovery period. This suggests that clonidine preserved phasic reactivity upon circulatory disturbances and decreased tonic hyperactivity following circulatory recovery. PMID- 3664268 TI - Effect of noise level on the Met-enkephalin content of the guinea pig cochlea. AB - Using a highly sensitive and specific radioimmunoassay for Met-enkephalin, we have monitored in two series of experiments the changes of the Met-enkephalin content of guinea pig cochleas following a 60 min exposure to different intensities of white noise (70 dB SPL, 90 dB SPL, 110 dB SPL). Our results indicate that the Met-enkephalin content was significantly lower after noise exposures than after exposure to the silence of a sound attenuated chamber. After a stimulation at 70 dB SPL, the levels of Met-enkephalin were 70% (series I) and 61% (series II) of those obtained after a period of silence. After a 110 dB SPL stimulation, these values fell to 41% (series I) and 55% (series II) of those in silence. These results strengthen the hypothesis that enkephalins are olivocochlear neuroactive substances. They suggest that the enkephalin-containing lateral olivocochlear system discharges with noise stimuli of moderate intensity. PMID- 3664269 TI - Transplantation of the fetal occipital cortex to the third ventricle of SCN lesioned rats induces a diurnal rhythm in drinking behavior. AB - Fetal hypothalamic transplants which include the suprachiasmatic nuclei (SCN), were shown previously to be capable of restoring circadian rhythmicity as manifested by both diurnal and free-running rhythms in drinking behavior in rats rendered arrhythmic by SCN lesions. The question arises as to whether the transplant must be homologous tissue or whether any other fetal brain tissue can produce similar effects. In this study rats with a lesion of the SCN and with clear loss of drinking rhythms received grafts of fetal occipital cortex placed into the third ventricle. Following the graft, animals were placed in LD conditions for 8 weeks and then in DD for another 8 weeks. The results indicate that the cortical graft induced recovery of a drinking rhythm under LD lighting conditions but that under DD the rhythm was lost again. These results suggest that non-hypothalamic tissue can mediate recovery of a diurnal rhythm but that hypothalamic tissue including the SCN is required to restore circadian function with maintenance of free-running rhythms. PMID- 3664270 TI - Neuronal cholecystokinin-like immunoreactivity is postprandially released from primate hypothalamus. AB - By use of the push-pull perfusion technique, release of neuronal cholecystokinin like immunoreactivity (CCK-LI) from hypothalamus of owl monkeys was investigated in relation to an intragastric meal. In overnight fasted, halothane-anesthetized owl monkeys, levels of CCK-LI in the hypothalamic push-pull perfusate were below assay sensitivity (less than 4 pg/30 min). After intragastric administration of a carbohydrate/amino acid meal, however, a 10-fold increase in CCK-LI release (51 +/- 7 pg/30 min) was observed in 5 out of 15 perfusion sites during the first postprandial 30 min. During the subsequent two 30-min intervals, release of CCK LI was still increased with 32 +/- 5 pg/30 min and 15 +/- 6 pg/30 min, respectively. Thereafter, CCK-LI release was below assay sensitivity again. Addition of 40 mM potassium chloride (KCl) to the perfusion solution, which causes neuronal depolarization, resulted in a second increase in CCK-LI release of 56 +/- 7 pg/30 min which was comparable to the meal-induced release. All sites that exhibited an increase in CCK-LI were located in the anterolateral aspect of the hypothalamus. In experiments without meal-induced release, KCl did not have any effect on CCK-LI in perfusate, suggesting that these particular sites did not contain CCK-releasing terminals. High performance liquid chromatography (HPLC) identified the C-terminal octapeptide of CCK (CCK-8) as the predominant molecular form of CCK within the owl monkey hypothalamus. No gastrin-17 was present.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664271 TI - Hyperalgesia to heat after intradermal injection of capsaicin. AB - Capsaicin injected intradermally into the human forearm lowered the pain threshold for heat at the injection site. Both the magnitude and duration of hyperalgesia were dose dependent over the range of 0.1-100 micrograms, given in a constant volume of 10 microliter. Thus, capsaicin may be a useful tool in studies of the neural mechanisms of hyperalgesia. PMID- 3664272 TI - Organization of ventral tegmental area cells projecting to the occipital cortex and forebrain in the rat. AB - Our horseradish peroxidase retrograde tracing study revealed a specific subpopulation of ventral tegmental area (VTA) neurons that send axons to the occipital cortex in the rat. A fluorescent retrograde tracing study demonstrated that neuronal populations in the VTA projecting to the occipital cortex are distributed in a manner separate from those projecting to forebrain structures such as the frontal/anterior cingulate cortices and nucleus accumbens. The scarcity of collateral projections from the VTA contrasts with the extensive collateralization of projection neurons in the substantia nigra pars compacta. Projections to the occipital cortex may define the distribution of cells comprising the VTA and thus the clear hodological separation of the A9 and A10 dopamine cell groups. PMID- 3664273 TI - Differential interaction of lectins with chemosensory receptors. AB - L-Alanine and L-arginine bind with similar affinity (Kd 10(-7)-10(-6) M) to receptors in both a sedimentable fraction (P2) from taste epithelium and isolated olfactory cilia from the channel catfish, Ictalurus punctatus. Lectins of differing carbohydrate specificity were used to determine the glycoprotein nature of the chemosensory plasma membranes and to differentially affect receptors for L alanine and L-arginine. The peroxidase-conjugated lectins concanavalin A (Con A), wheat germ agglutinin (WGA), and peanut agglutinin (PNA) were used to identify the glycoprotein components of the chemosensory plasma membranes after polyacrylamide gel electrophoresis. In both chemosensory membranes, numerous protein components were labelled by Con A and WGA. In contrast, a single predominant component was labeled by PNA in olfactory cilia, whereas several proteins in taste membranes were labeled by this lectin. When unconjugated lectins were preincubated with olfactory cilia, 60-70% of binding to L-alanine and L-arginine receptors was inhibited by Con A and WGA. PNA inhibited L-alanine but not L-arginine binding to olfactory receptors. Inhibition of olfactory receptor binding by lectins was time- and dose-dependent. By contrast, no inhibition of either L-alanine or L-arginine receptor binding in taste membranes was observed with any of the lectins. The differential labeling of the chemosensory membranes and the differential inhibition of receptor binding by lectins suggest that, despite ligand similarity, the chemosensory receptors in these membranes are not identical molecular species. PMID- 3664274 TI - Hypothalamic control of ovulation and behavioral estrus in the cat. AB - The estrous cat ordinarily ovulates only after a complex mating behavior pattern which involves an elaborate after reaction. The present experiments were designed to determine whether identical or separate hypothalamic areas control mating behavior and the release of an ovulatory surge of pituitary gonadotropin. With stereotaxic methods under chloralose anesthesia the hypothalami of naturally estrous or estrogen-gonadotropin-primed queens were stimulated bilaterally in one of the following regions: medial basal hypothalamus including the premamillary area (MBH) and the anterior hypothalamus including both medial and lateral divisions (AH, MAH, LAH). At the end of the stimulation period (5 V, 30 c/s, 5 ms duration, 30 s off for 30 min) bilateral anodal electrolytic lesions were made at the stimulation sites (3 mA for 30 s) with the central tips of the bipolar electrodes. Characteristically, ovulation was induced by stimulating the MBH but not the AH. Furthermore, the MBH lesions usually caused ovarian atrophy which led to anestrus, but the cats mated normally if supplied with exogenous estrogen. The anterior lesions left the ovaries in good trophic condition, and they could be ovulated by stimulating the MBH. However, the cats with anterior hypothalamic lesions in either the medial or lateral position repeatedly refused to accept the male even when primed with exogenous estrogen. The results from these combined stimulation and lesion experiments in the female cat indicate that a hypothalamic sex behavioral area lies rostral to and discrete from a tubero-mamillary area controlling the release of pituitary gonadotropin. PMID- 3664275 TI - Opioid-mediated inhibition from the subnucleus caudalis of spinal trigeminal nucleus to the neurons in the subnucleus oralis. AB - The influence of enkephalin-containing neurons in the subnucleus caudalis of the spinal trigeminal nucleus (STN caudalis) on the subnucleus oralis of the STN (STN oralis) was examined using chloral hydrate-anesthetized rats. In the STN oralis, conditioning stimuli applied to the STN caudalis 10-50 ms preceding the test stimulus inhibited spikes produced by tooth pulp stimulation in type B interneuron, which was activated by orthodromic stimulation but not by thalamic stimulation, without affecting those of the relay neuron. When the type B interneurons were further classified into type B1 and type B2 neurons, which were characterized by the occurrence of the STN caudalis-induced inhibition with long and short latencies, respectively, microiontophoretically applied naloxone reduced the STN caudalis-induced inhibition of th orthodromic spikes of type B1 interneurons with little effects on type B2 interneuron. Furthermore, naloxone reversible inhibition of tooth pulp-induced spikes of the type B1 interneurons were also observed during iontophoretic application of enkephalin. These results suggest that the type B1 interneurons in the STN oralis are inhibited by opioid peptides-containing neurons in the STN caudalis. PMID- 3664276 TI - Evaluations of combined premotor and supplementary motor cortex lesions on a visually guided arm movement. AB - The kinematics of a visually guided, multi-joint arm movement were examined before and after combined bilateral premotor and supplementary motor cortex lesions. Two rhesus monkeys were trained to move a manipulandum from a start zone to one of three equally spaced target zones and then return to the initial start zone. Various features of the movement trajectory including space error, time error, peak velocity and turnaround time were quantified and analyzed before and after the premotor and supplementary motor cortex ablations. Statistical analysis showed no major differences in the trajectories toward or away from the target between the pre- and postlesion state. The major difference following the ablation was an increase in the time spent in the target zone, reflecting an increase in time spent in redirecting the trajectory. Normalization of the movement duration revealed a slight delay in the initial part of the movement. These results suggest the premotor and supplementary motor cortex are involved in redirecting the trajectory and/or obtaining the target zone during the execution of a complex movement. PMID- 3664277 TI - Neuronal localization of pseudocholinesterase in the rat cerebellum: sagittal bands of Purkinje cells in the nodulus and uvula. AB - The histochemical distribution of pseudocholinesterase was studied in the rat cerebellum using Koelle's copper-thiocholine method. Throughout the cerebellum, pseudocholinesterase is uniformly localized in the endothelial cells of blood vessels and in the cell bodies and processes of the Bergmann glia. In addition, we demonstrate that exclusively in the ventral uvula and in the nodulus (lobules IXc and X of Larsell) pseudocholinesterase is localized in a small subpopulation of Purkinje cells. The cell bodies and dendrites of these labeled Purkinje cells form at least 4 distinct parallel bands extending along the sagittal plane of each of the lobules. Two broad bands on either side of the midline, approximately 800-900 microns wide and composed of 15-20 Purkinje cells have been designated as A bands. Two narrower bands, approximately 160-300 microns wide and composed of 5 7 Purkinje cells, on the lateral aspects of the lobules have been designated as B bands. The unique distribution of pseudocholinesterase in a small and anatomically restricted population of neurons suggests that in the cerebellum this enzyme may play a role in the metabolism of neuroactive substances. PMID- 3664278 TI - Motor correlates of phototaxis and associative learning in Hermissenda crassicornis. AB - Motor correlates of Hermissenda phototactic behavior and their modification by associative training were examined. Anatomical studies indicated the posterior three-fourths of the foot to be innervated by nerve P1 while the anterior portion was innervated by nerve P2. Bilateral lesions of either P1 or P2 pedal nerves in untrained animals reduced phototactic behavior. Extracellular recordings of pedal nerves from untrained animals revealed significant increases in total multi-unit activity (MUA) during a light presentation. Prominent components of nerve P2 activity were synchronous bursts apparent in peri-stimulus time (PST) histograms. Burst frequency was increased by light. Associative training resulted in significant decreases in light-evoked MUA frequency in P1 and light-evoked burst frequency in P2. Intracellular recordings were obtained from three classes of putative motoneurons with axons in P2. These were located using cobalt backfills and verified for each preparation by simultaneous extracellular recording from P2. The characteristic pattern of activity of these cells in the dark and its modulation by light was established. PMID- 3664279 TI - Local brainstem glucose utilization in the squirrel monkey. AB - The 2-deoxy-D-[14C]-glucose method for the measurement of local cerebral glucose utilization (LCGU) in individual brain nuclei and regions has been applied to the squirrel monkey (Saimiri sciureus). The determinations were conducted in five conscious, lightly restrained adult, female, Colombian squirrel monkeys. Local glucose utilization in brainstem structures (LBGU) was highest in nuclei involved in auditory and vestibular functions and in some nuclei involved in general motor activity. The values for glucose utilization (mumoles/100 g/min) were generally lower than in comparable structures reported by other authors in the rat and slightly lower than those in the macaque monkey. In the Beagle dog the values for "medulla" are markedly lower than for most individual structures in the squirrel monkey medulla, about equal in the inferior colliculus and appreciably higher in the superior colliculus. PMID- 3664280 TI - Effect of progesterone on monoamine turnover in the brain of the estrogen-primed rat. AB - The effect of progesterone (P) on monoamine levels and turnover was evaluated in 8 brain nuclei in estrogen-primed rats. Animals were subcutaneously (SC) injected with P or vehicle 21 hours after SC treatment with 5 micrograms of estradiol benzoate (EB). EB-primed animals treated with P showed high levels of lordosis behavior and an LH surge three hours later. Initial concentrations of norepinephrine (NE), dopamine (DA), serotonin (5HT) and 5-hydroxyindole acetic acid were determined in EB-saline treated controls 3 hours after P or vehicle. NE and DA turnover was estimated from the exponential decline of these amines 2 hours after IP injection of alpha-methyl-p-tyrosine (5 hours after P or vehicle). The accumulation of 5HT 20 min following IP injection of pargyline was used as an index of 5HT turnover. P did not affect the initial NE, 5HT or 5HIAA concentrations in any of the brain nuclei studied, but decreased DA content in the arcuate-median eminence region (Ar-ME). The DA rate constant was elevated in the nucleus of the diagonal band of Broca and the DA turnover rate was decreased in the Ar-ME. In the periventricular region (PVE, anterior hypothalamic level) the NE turnover rate (K, pg/microgram protein/hr) and rate constant (k, hr-1) decreased following P treatment. Progesterone treatment decreased the accumulation of 5HT in the ventromedial hypothalamus (VMN, pars lateralis) and the dorsal midbrain central grey (MCG). Progesterone effects on monoamine turnover were not found in the lateral septal, medial preoptic, anterior hypothalamic or dorsal raphe nuclei.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664281 TI - Central distribution and efferent origins of facial nerve branches in the chicken. AB - The central afferent distribution and the origins of visceromotor and somatomotor components of greater superficial petrosal (GSP), chorda tympani (CT), and hyomandibular (Hy) branches of the facial nerve were analyzed by the transganglionic and retrograde transport of horseradish peroxidase. Labelled sensory afferent fascicles of the GSP collected dorsomedial to the spinal trigeminal complex and passed caudally as the tractus solitarius. Fine-grain terminal fields were evident in ipsilateral n. sensorius n. facialis, nuclei ventrolateralis anterior (Vla), centralis anterior and presulcalis anterior of the solitary complex, and n. glossopharyngei et n. motorius dorsalis nervi vagi (n. IX-X). Minor contralateral projections to these nuclei occasionally were observed. CT sensory afferents exhibited similar ipsilateral projections, and specifically, the projection to Vla was qualitatively sparser than that from the GSP. Small multipolar and spindle-shaped somata of visceromotor n. salivatorius were labelled retrogradely from the GSP and CT. Large, oval somatomotor cells of the three subdivisions of the facial motor nucleus were labelled retrogradely from Hy, with no evidence of sensory afferent or visceromotor connections. PMID- 3664283 TI - Suckling behavior in rat pups with lesions which destroy the modified glomerular complex. AB - Seven-day-old sham operated rats and those with lesions of the rostral medial, lateral, or posterior medial olfactory bulbs were tested postoperatively for nipple attachment behavior and weighed daily. The posterior medial lesions included the area of the modified glomerular complex (MGC), a region of the bulb that has been implicated in suckling behavior. There were no significant differences among groups in nipple attachment latency or weight gain. These results do not support the notion that the MGC is essential for suckling in neonatal rats. PMID- 3664282 TI - Sprouting of striatal serotonin nerve terminals following selective lesions of nigro-striatal dopamine neurons in neonatal rat. AB - The effects of neonatal intracisternal 6-hydroxydopamine (6-OHDA; 50 micrograms) treatment on striatal serotonin (5-HT) nerve terminals in rat have been characterized using histo- and neurochemical methods. The 6-OHDA lesion caused a 60% reduction of striatal dopamine (DA) concentration when analyzed in the adult stage, while 5-HT levels were increased by about 40% and 3H-5-HT uptake in vitro was increased by about 60%. Using computerized image analysis, a marked increase in 5-HT-like immunoreactive terminal density was found in both rostral (+200%) and caudal (+50%) striatum. Pretreatment with the DA uptake blocker amfolenic acid completely counteracted the 6-OHDA-induced alterations in both DA and 5-HT neurons in the striatum, while pretreatment with the noradrenaline uptake blocker desipramine had no significant effects. Regional analysis of 5-HT levels in the CNS after neonatal 6-OHDA treatment or the combined desipramine + 6-OHDA treatment showed no significant effect in any of the brain areas analyzed, apart from the observed 5-HT increase in striatum. It was furthermore observed that the striatal 5-hydroxyindoleacetic acid (5-HIAA)/5-HT ratio was decreased, while the 3,4-dihydroxyphenylacetic acid (DOPAC)/DA ratio was increased following the 6 OHDA lesion, indicating compensatory mechanisms in turnover of transmitters. These alterations were completely reversed after pretreatment with amfolenic acid. The present results support the view that the 5-HT hyperinnervation following neonatal 6-OHDA treatment is a collateral sprouting response induced by lesioning of the striatal DA neurons. PMID- 3664284 TI - Inhibition of brain choline acetyltransferase by tetraplatin. AB - Tetraplatin inhibited choline acetyltransferase (CAT) from rat and bovine brain with I50 values of 13.5 and 40 microM, respectively. At 0.5 mM concentration, tetraplatin exhibited inhibition of the rat brain enzyme by 89%, whereas cisplatin yielded only 18% inhibition. With bovine CAT, tetraplatin showed noncompetitive inhibition with the substrate choline, Km 337 microM, Ki 29 microM, Vmax 2.83 nmoles acetylcholine formed/min/mg protein, and competitive inhibition with the substrate acetyl-CoA, Km 21 microM, Ki 16 microM, Vmax 3.85 nmoles acetylcholine formed/min/mg protein. PMID- 3664285 TI - Determination of molecular forms of brain acetylcholinesterase: technical considerations. AB - Sucrose density centrifugation has been used to characterize the relative levels of AChE molecular forms in different parts of the brain, during development, or in various disease states. We have examined the influence of various tissue or sample storage and handling techniques on the abundance of the 4S and 10S molecular forms of AChE in rat forebrain. Our results demonstrate that freezing either a subcellular fraction or the intact tissue causes dramatic shifts in the level of the 4S and 10S molecular forms as compared to the values obtained in fresh tissue. Total AChE activity was unchanged suggesting that 4S and 10S forms are equally active and that 4S AChE is easily dissociated from 10S. These observations suggest that 4S and 10S molecular forms in brain are extremely labile and that great care should be taken when studying the factors that regulate these forms. PMID- 3664286 TI - [Imported malaria--diagnostic and clinical features]. PMID- 3664287 TI - [The hemato-encephalic barrier and the study of its significance in neuroendocrine regulation]. PMID- 3664288 TI - [Correlation between the spatial magnitude of QRS vectors and left ventricular pressure in patients with congenital aortic stenosis]. PMID- 3664289 TI - [Sympathetic control of the common carotid artery in the dog]. PMID- 3664290 TI - [Central nervous system regulation of sodium excretion by the kidneys]. PMID- 3664291 TI - [The nipple stimulation test and possibilities of its use in obstetrics]. PMID- 3664292 TI - [Rare helminthiases diagnosed in Czechoslovakia]. PMID- 3664293 TI - [Occurrence of the oral flagellate, Trichomonas tenax, in children with chronic tonsillitis]. PMID- 3664294 TI - [Diagnosis and therapy of disorders of sexual activity after injuries of the posterior urinary tract]. PMID- 3664295 TI - [Importance of the use of standard 12-lead electrocardiography in the quantification of focal myocardial lesions]. PMID- 3664296 TI - [Summary of our findings on changes in voluntary cough sounds in pathologic conditions]. PMID- 3664297 TI - [Work capacity of women after therapy for gynecologic cancer]. PMID- 3664298 TI - [Pitfalls in the diagnosis and therapy of fibrosis and fibrolipomatosis]. PMID- 3664299 TI - [Kinetics of nitrogen washout from the lungs using oxygen as an indicator of air distribution]. PMID- 3664300 TI - [Phylogenetic aspects of functional asymmetry of the brain]. PMID- 3664301 TI - [How medical students evaluate their attraction to selected problems in psychiatry]. PMID- 3664302 TI - [Cisplatin and its derivatives--effective antineoplastic agents]. PMID- 3664303 TI - [Dynamic osteosynthesis in fractures of the tibial diaphysis using Ender rods]. PMID- 3664304 TI - [Use of microcomputers in the measurement of reaction time in people under various conditions]. PMID- 3664305 TI - [Evaluation of autonomic excitability in juvenile hypertensive patients using the diving reflex]. PMID- 3664306 TI - [Blood pressure in preschool-age and young school-age children and its relation to somatic development]. PMID- 3664307 TI - [Cortisol status in anorexia nervosa]. PMID- 3664308 TI - [Tick-borne encephalitis in Slovakia 1980-1984]. PMID- 3664309 TI - [Pontine hemorrhage in cerebral vessel aneurysms]. PMID- 3664310 TI - [Preparation of scientific and professional manuscripts for publication]. PMID- 3664311 TI - Antegrade colonic lavage in the management of acute colonic obstruction. PMID- 3664312 TI - Transverse myelitis and myelography. PMID- 3664313 TI - The resurgence of the witch doctor in post-colonial Africa. PMID- 3664314 TI - 'Gardening--the great test of health'. PMID- 3664315 TI - The effect of topical agents on haematopoiesis following thermal injury: studies on an animal model. AB - Several investigators have described 'toxins' in the serum of burned patients that result in systemic alterations and in an overall breakdown of host defences. One of these toxins isolated from the burn eschar resulted in 80 per cent mortality when injected into non-burned mice. However, if the eschar was pretreated with cerium before isolating the toxin, the mortality in the recipients decreased. This experiment suggested that the cerium neutralized the toxin. We have partially isolated from the serum of burned patients and mice a substance that inhibits erythroid colony formation in vitro. To test if cerium neutralized this erythroid inhibitor, we applied cerium or silver nitrate to the eschar of a mouse model of thermal injury. We found that neither agent altered the level of inhibitor or any of the granulocyte or erythroid parameters measured. PMID- 3664316 TI - Experimental study on topical antimicrobial agents in burns. AB - Numerous organic silver salts have been tested against a virulent strain of Pseudomonas aeruginosa which had been deliberately applied to the scalded tails of mice and deeper scald wounds on the backs of rabbits. Silver pipemidate was found to be more effective than silver sulphadiazine in treating these infected wounds. PMID- 3664317 TI - Evaluation of topical therapy with silver-kaolin (Argostop) in an experimental model of burn wound sepsis. AB - Burn wound therapy with silver-kaolin, a topical agent applied as an aerosol spray, was evaluated in male rats given a 20 per cent total body surface area, full thickness dorsal scald burn. Burn wounds treated with silver-kaolin healed at rates comparable to untreated wounds. No significant differences were noted in the numbers or types of organisms colonizing the wounds of treated and untreated rats at 5, 12 and 19 days post-burn. To evaluate the effectiveness of silver kaolin in treating burn wound sepsis, rats were inoculated on the wound surface with 2.5 x 10(8) Pseudomonas aeruginosa. This inoculum resulted in 100 per cent mortality in untreated rats. Rats treated with silver-kaolin had a mortality rate of 71 per cent, compared to a 9 per cent mortality rate in rats treated with 1 per cent silver sulphadiazine. When silver-kaolin was applied to the wound prior to bacterial inoculation, the mortality rate was reduced to 6 per cent. When wounds were treated with kaolin alone and then inoculated with bacteria, the mortality rate was 50 per cent, indicating that part of the effectiveness of silver-kaolin appeared to be due to a barrier effect. These results indicate that silver-kaolin may be useful for preventive topical antimicrobial therapy of acute burns or after wound debridement or excision, but is not suitable for therapy of wounds previously colonized by microorganisms. PMID- 3664318 TI - Admissions to a new burn unit in Gizan, Saudi Arabia. AB - In an attempt to introduce western treatment principles, Danish chiefs have been in charge of a new Burn Unit in Gizan for the first 2 years and 9 months. We have treated 348 burned patients with a median 16 per cent estimated area of burn (EAB). One-quarter of the patients had more than 25 per cent EAB. Flame burns were the most frequent and females suffered the more severe injury. The mechanisms of burning are discussed. PMID- 3664319 TI - Burn treatment in a new burn unit in Gizan, Saudi Arabia. AB - During the 2 years and 9 months when a new burn unit was under Danish leadership, 348 admitted patients were treated. Exposure treatment and Ringer's lactate were used for burn shock. Due to lack of blood, infections and discharge against medical advice, only 106 patients had operations. Fifty-six patients died from their burns and concomitant diseases, 44 of these were women, often with very extensive burns. Our results are comparable to those reported from departments in similar geographic areas. The special problems in treatment are discussed. PMID- 3664320 TI - Occupational burn injuries. AB - The epidemiology of occupational burns injuries in a well-defined population is analysed. Although a total of 371 persons sustained an injury, only a few were inpatients and just one required anti-shock treatment. The mean burn surface area was 0.66 per cent and 14 patients had full thickness burn injuries. There were no deaths. Men were found to be more prone than women to injury, especially young workers. The distribution by categories of work and causes of burn are illustrated. Scalds and contact burns were dominant, particularly in restaurants. The work by the National Labour Inspection is acknowledged. PMID- 3664321 TI - Childhood burns in Zaria, Nigeria. AB - From 1971 to 1980, 429 children with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. These were major burns in 275 patients, moderate in 82 and minor in 72. Fourteen of the patients were neonates, 102 infants, 228 were 5 years old or younger and 85 were older. Socioeconomic factors contributing to the injuries included the use of firewood for cooking at ground level and for warming the house and body during the cold season; loose indigenous garments; thatch-roofed huts and the post-partum rituals of mud-bed heating and hot baths. Flame burns exceeded scalds with a seasonal frequency which peaked during the harmattan. In the absence of a 'burn's unit', burned children were nursed on the general ward together with other sick children by the same nursing personnel supervised by general surgeons. Complications included wound infection, respiratory distress, measles, malnutrition and tetanus. One-fifth of the patients absconded. Overall mortality was 13 per cent but 29 per cent of the neonates died. Preventive strategy should include public information, nursery school supervision, economic development and architectural improvements. PMID- 3664323 TI - Creatinine phosphokinase values in electrical and thermal burns. AB - Twenty-six patients were evaluated with regard to CPK values in week 1 post-burn. Patients were allocated into two groups based on the severity of burn injury. Group 1 included patients with minor electrical or thermal injury, and Group 2 those patients with deep thermal injury and objective evidence of muscle necrosis. With the exception of day 5 post-burn, Group 2 had significantly increased CPK levels as compared to Group 1. This indicates that CPK levels, especially with electrical and deep thermal burns, are sensitive tests in evaluating the depth of burn injury such that an appropriate pre-operative strategy for debriding and grafting is possible. PMID- 3664322 TI - Extensive scalds following accidental immersion in hot water pools. AB - The scalds produced by immersion in hot water pools were extensive, usually of superficial depth on the upper parts of the body and deep dermal or full thickness skin loss on the lower parts. Blisters appeared rather slowly, within 2 days post-burn and often dispersed spontaneously. The estimated burned area on admission may thus be smaller than found subsequently. This study showed that the volume of fluid required for adequate resuscitation during the first post-burn day may be only 1.5 ml/kg/% BSA burned. Deep dermal burns were treated preferably by early tangential excision and grafting. The full thickness skin loss was treated by escharectomy and skin grafts. PMID- 3664324 TI - Early vascular grafting to prevent upper extremity necrosis after electrical burns: anastomotic false aneurysm, a severe complication. AB - From May 1972 to January 1982, early vascular grafting was used to re-establish circulation across the electrically burned wrist. Thirty-three thrombosed arterial segments (radial and/or ulnar arteries) were removed in 18 limbs and autografts of the greater saphenous or omental veins were used for the revascularization. One vascular graft, which had been sutured to the ulnar artery on day 3 post-injury, contained an anastomotic false aneurysm at the proximal anastomosis. One month after vascular grafting, this aneurysm ruptured and bled. An emergency exploration of the wrist confirmed the diagnosis and surgery successfully restored the circulation, avoiding amputation of the injured limb. Histopathological examination of the specimen was consistent with the presence of anastomotic false aneurysm. The pathogenesis of this complication is reviewed. Our experience indicates that circulation to a limb following electrical injury can be successfully restored by early vascular grafting, but emphasizes the importance of close periodical follow-up after graft acceptance due to the possibility of late anastomotic complications. PMID- 3664325 TI - Toxic epidermal necrolysis complicating a burn: a case report. AB - The case of a burned patient, whose fluid management was complicated by the development of toxic epidermal necrolysis, a condition which itself may mimic a burn, is presented. The possible causes, together with the diagnostic and therapeutic problems posed by this combination of ailments, are discussed. PMID- 3664326 TI - Carbamazepine-induced facial burns caused by a photocopier. AB - A 36-year-old woman on long-term anticonvulsant therapy with carbamazepine (Tegretol) sustained superficial facial and corneal burns after using a photocopier for 2 h. Photosensitivity is a rare side-effect of carbamazepine therapy, and progression to a superficial burn has not been reported previously. Photocopiers emit a very low level of ultraviolet irradiation: this would not cause burns in a normal patient but could possibly do so in someone who is sensitive to ultraviolet light. PMID- 3664327 TI - Severe hyponatraemia in burn patients secondary to hydrotherapy. AB - Severe hyponatraemia, hyperkalaemia and pre-renal uraemia were seen in two burn victims who were treated with repeated submersion in tap-water. A primary loss of salt through the burned surface area into the whirlpool bathwater has been documented in both cases. All these abnormalities have been partially corrected by adding salt to the whirlpool water. To our knowledge no similar documented cases exist in the literature. PMID- 3664328 TI - The Spencer Op-Site Applicator, a new technique for treating the burned hand. AB - A technique to apply Op-Site Incise Drape to the burned hand is described using the Spencer Op-Site Applicator. The technique allows for the use of a transparent, flexible, semi-permeable plastic glove in the management of the burned hand in all age-groups. This minimizes excoriation of normal tissue but allows full flexibility of the hand with good healing. PMID- 3664329 TI - The trauma of burns. PMID- 3664330 TI - A randomized trial comparing ketoconazole and nystatin prophylactic therapy in neutropenic patients. AB - A randomized trial was conducted comparing ketoconazole and nystatin in the prevention of oral candidiasis and appearance of invasive fungal infections in 51 neutropenic leukemic patients undergoing induction chemotherapy. Ketoconazole was administered in a 200 mg dose twice daily. Nystatin oral suspension was given in doses of 500,000 units four times daily. Surveillance cultures of the throat and urine were obtained prior to treatment and conducted weekly. Patients were enrolled in the study if the absolute granulocyte count was less than 1500/microliter, if physical examination revealed no evidence of oral candidiasis, no evidence of urinary tract infection, and there was no pulmonary infiltrate on chest x-ray. Patients were continued on study until the absolute granulocyte count reached 1500/microliter, evidence of oral candidiasis appeared, or presumed or proven invasive fungal infections appeared. Of the 46 evaluable patients, 22 received ketoconazole, 3 (14%) developed oral candidiasis, and 5 developed suspected systemic fungal infections (23%). Of 24 patients who received nystatin, 4 (17%) developed oral candidiasis and 8 (33%) developed systemic fungal infections, 4 proven and 4 suspected. Significantly more patients on the nystatin arm progressed to invasive fungal infections. Ketoconazole was not superior to nystatin in reducing the frequency of oral candidiasis but possibly reduced the frequency of invasive fungal infections. PMID- 3664331 TI - The association of solar ultraviolet and skin melanoma incidence among caucasians in the United States. AB - Using recent data from cancer incidence surveys and measures of UVB exposure levels at seven geographic locations within the United States, we estimate the dose-response relation between UVB and skin melanoma incidence. Mathematical models used information from general population interview studies conducted in these locations to adjust for potentially confounding factors such as age, skin color, ancestry, eye color, hair color, sunburn sensitivity, prevalence of moles, freckles, and hours spent outdoors, use of sunscreen/lotion, and other variables. The effect of geographic UVB exposure on incidence was found to be statistically significant (p less than 0.01) after adjusting for each variable and certain combinations of these variables. We found that incidence rates for those skin melanomas arising in the face, head, neck, or upper extremities (i.e, the most exposed sites) were more sensitive to UVB increases than the incidence rates for those lesions occurring in the ordinarily less exposed sites of the trunk and lower extremities. PMID- 3664332 TI - Pharmacology of combination chemotherapy of cytosine arabinoside (ara-C) and uracil arabinoside (ara-U) or tetrahydrouridine (THU) against murine leukemia L1210/0 in tumor-bearing mice. AB - Deamination of cytosine arabinoside (ara-C) by cytidine deaminase (Cyt DA) is the main mode of the inactivation of this drug in vivo. Tetrahydrouridine (THU) and the deamination product, uracil arabinoside (ara-U) are potent inhibitors of Cyt DA. We investigated whether ara-U or THU pretreatments can protect ara-C from excessive deamination in tumor- (L1210) bearing mice. In order to determine this, plasma concentrations of ara-C, ara-U, and the intracellular levels of ara-CTP, the active anabolite of ara-C, were assayed. The control peak plasma levels of ara-C and ara-U were 3.3 and 0.78 mM and they were eliminated with a half life (t 1/2) of 1.26 and 1.43 hours, respectively. One hour pretreatment with a nontoxic dose of ara-U (single dose of 300 mg/kg intraperitoneally), resulted in increased ara-C levels by 5.9-fold, while ara-U increased 14.3 fold in comparison with controls. A 24-hour (every 8 hours) pretreatment with ara-U increased ara-C plasma levels by 3.0-fold and it was eliminated with a t 1/2 of 1.21 hours. One hour pretreatment with THU (single dose 25 mg/kg intraperitoneally) enhanced ara C plasma levels by 5.3-fold. In control L1210/0 acid extracts, ara-CTP peaked at 2 hours and reached 2030 +/- 85 microM; ara-CTP was eliminated with a t 1/2 1.47 hours. The ara-CTP cellular concentrations after 1- and 24-hour pretreatments were 1875 +/- 534 and 2624 +/- 429 microM at 4 hours; the t 1/2 were 2.20 and 1.44 hours, respectively. The THU pretreatment resulted in a peak concentration of ara-CTP of 2208 +/- 366 microM at 2 hours and was eliminated with a t 1/2 of 2.54 hours. We concluded that all pretreatments increased both the peak plasma ara-C concentrations and the area under the plasma concentration-time curve (AUC). One hour ara-U pretreatment did not enhance the peak ara-CTP cellular concentration, but did extend the t 1/2. The 24-hour ara-U and the 1-hour THU pretreatments increased, to some extent, the cellular ara-CTP concentrations, but these differences were not statistically significant. THU pretreatment increased the time the peak occurred and the t 1/2 of ara-CTP. The area under the cellular ara-CTP concentration-time curve (AUC) in L1210 cells was either the same or increased by a small amount after the pretreatments.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3664333 TI - Response of transplantable tumors in mice and of macromolecular synthesis to 17 beta-acetamido-3-aza-A-homo-4 alpha-androsten-4-one. AB - 17 beta-acetamido-3-aza-homo-4 alpha-androsten-4-one has cytostatic activity against Ehrlich ascites tumor, L1210, and P388 leukemias in mice when administered intraperitoneally. The effect of the homo-aza-steroid on the incorporation of radioactive precursors to DNA and RNA of L1210 leukemia cells was investigated. It was found that treatment of cells with 12.5 micrograms/ml of the drug for 1 hour inhibited DNA synthesis by 81%. This was partly because the drug affected the radioactive thymidine pool in the cell. The inhibitory effect was found to be reversable. The incorporation of [3H]thymidine into DNA was lower when cells were incubated in the presence of S9 mix. It was also found that the same compound inhibited RNA synthesis by 67%. PMID- 3664334 TI - Comparative analysis of cellular and extracellular proteins secreted by two human tumor cell lines. AB - Two human tumor cell lines, melanoma (TWI) and colon carcinoma (HT-29), replicate continuously in serum-free C-ITS medium [Chee's essential medium (CEM) supplemented with insulin (5 ng/ml), transferrin (5 micrograms/ml), and (5 ng/ml)]. The TWI cells assume normal morphology during growth, whereas the HT-29 cells become rounded and tend to aggregate in C-ITS medium. Under these conditions the two cell types synthesize a number of different cellular proteins, and TWI releases a number of proteins to the medium. These proteins include some factors which are needed for spreading and adhesion of the cells to the growth substrate as shown by the growth of HT-29 cells in serum-free C-ITS medium conditioned by TWI cells. HT-29 cells do not synthesize such factors or perhaps, do so in negligible amounts. The serum-free medium conditioned by the TWI cells may provide an approach for the cultivation of various human tumor cells in vitro. PMID- 3664335 TI - Pelvic exenteration: an editorial response. PMID- 3664336 TI - The gifted child. PMID- 3664337 TI - What the doctor says. Fractures. PMID- 3664338 TI - What's new in teeth? Modern dentistry is saving teeth--and faces. PMID- 3664339 TI - Hunger. PMID- 3664340 TI - Focus Point--young people without homes. PMID- 3664341 TI - [An aid in the evaluation of the needs of hospitals for anesthesia-resuscitation specialists]. PMID- 3664342 TI - [Reflections on the needs of hospitals for anesthesia-resuscitation specialists]. PMID- 3664343 TI - [National union of nurses and midwife aide anesthetists]. PMID- 3664345 TI - [Pediatric anesthesia-resuscitation--the future?]. PMID- 3664344 TI - [Role of physician anesthetists and auxiliary personnel; juridical decisions]. PMID- 3664346 TI - [Coronary complications of carotid surgery]. PMID- 3664347 TI - [Determination of fentanyl in the plasma during caudal anesthesia in children]. PMID- 3664348 TI - [Acute strychnine poisoning. Apropos of a case with favorable course following curarization and respiratory assistance]. PMID- 3664349 TI - Ethical issues in automating nursing personnel data. PMID- 3664350 TI - Managing community health nursing. A personal computer tool for assessing, monitoring, and planning the distribution of public health nursing resources at the community level. PMID- 3664351 TI - Use of the microcomputer as a tool for subjective grading. PMID- 3664352 TI - Effects of intravitreal injection of fluorosilicone oil after vitrectomy in the rabbit eye. AB - Because fluorosilicone oil is heavier than silicone oil, it may be superior in the therapy of proliferative vitreoretinopathy. To evaluate the ocular toxicity of fluorosilicone oil we performed pars plana lentectomy and vitrectomy on 14 rabbit eyes and injected approximately 1.5 mL of the oil (viscosity 10,000 centistoke) into the vitreous chamber of 10. No clinical or histologic evidence of toxic ocular effects was noted up to 2 months after the procedure. PMID- 3664353 TI - Lobular delayed choroidal perfusion as an early angiographic sign of diabetic retinopathy: a preliminary report. AB - Between January 1982 and December 1983 stereo colour photography covering 10 standard fields of 30 degrees and fluorescein angiography were performed in 64 consecutive patients with diabetes mellitus who had no clinical evidence of diabetic retinopathy. Fifty-two patients were excluded on the basis of the slightest photographic or angiographic evidence of retinopathy or any other ocular disease. Electroretinogram oscillatory potentials were recorded in the remaining 12 patients. Four of the 12 had normal oscillatory potentials, colour photographs and angiograms, while 8 had angiographic evidence of lobular delayed choroidal perfusion and abnormal oscillatory potentials. Although only a small number of patients in the preclinical stages of diabetic retinopathy were studied, the results warrant that further attention be given to lobular delayed choroidal perfusion, which may represent early evidence of choroidal involvement in diabetic retinopathy. PMID- 3664354 TI - Prophylactic argon laser photocoagulation of the second eye in presumed ocular histoplasmosis syndrome. AB - Fifty-six patients with presumed ocular histoplasmosis syndrome who exhibited a disciform macular detachment or macular scar in one fundus and one or more inactive atrophic lesions within the high-risk area of the second eye were seen at the Retina Service of Maisonneuve-Rosemont Hospital, Montreal, between 1972 and 1984. All 56 were followed for at least 10 months. Of the 56, 28 had received prophylactic argon laser photocoagulation of the inactive chorioretinal lesions. The rate of activation of the lesions was similar in the treated and untreated groups (10/28 over a mean follow-up period of 44.2 months and 11/28 over a mean period of 43.2 months respectively). In the untreated group there was an increased risk of activation with a higher number of lesions (t = 2.386). In both groups the risk of activation increased with the proximity of the lesions to the centre of the fovea (chi 2 = 29.97). Of the 10 treated eyes that showed activation, 4 did so within 1 month, which suggests that prophylactic photocoagulation may not be without risk of complications. PMID- 3664355 TI - Injection of fluorosilicone oil and pars plana vitrectomy for complex retinal detachment. AB - Pars plana vitrectomy can be combined with injection of fluorosilicone oil to treat complex retinal detachments. We describe three cases to illustrate the technique, which is adapted according to the type and location of the retinal breaks. PMID- 3664356 TI - Silver nitrate injury to the cornea. AB - We describe a 42-year-old woman who suffered a corneal injury following the application of a silver nitrate stick to her lid for hemostasis after a chalazion had been incised and drained. Nine months later there were greenish-yellow deposits in the deep stroma that accounted for a persistent decrease in vision. Physicians should be aware of the potential for ocular injury with the use of silver nitrate applicator sticks. PMID- 3664357 TI - Effects of organic solutes on the Raman spectra of barnacle muscle fibers. AB - The Raman spectra observed from barnacle muscle fibers are quite complex because the cytoplasm of these cells contains several proteins and solutes. An extraction procedure was used to separate organic solutes from the contractile proteins. Glycine, trimethylamine oxide, taurine, and alanine were found to contribute to the Raman spectra of barnacle muscle fibers, while spectra of lobster fibers reveal the presence of betaine in addition. We have observed that the increase in osmolarity of the intracellular fluid caused by the augmentation of the salinity of sea water (density, 1.023-1.030) in which the barnacles were kept, induces a reduction of intensity of the amide I band. To distinguish among the different parameters which are modified by the sea water salinity, observations were made on glycerinated barnacle muscle fibers. The reduction of intensity of the amide I band in the Raman spectra of glycerinated muscle fibers was also observed with the addition of taurine (0.08 M) in the external relaxing solution. Therefore, under these experimental conditions, the Raman scattering intensity in the amide I region assigned to the alpha-helix conformation (1645-1650 cm-1) is increased when the concentration of organic electrolytes is reduced. However, as no significant decrease of the scattering intensity in the 1660-1670 cm-1 region where the amide I bands of either beta-sheet or disordered conformations normally appear was observed, the increase of intensity of the amide I band centered at 1645 cm-1 is assigned to a change of orientation of alpha-helical segments of the myosin molecules. Our results suggest that organic solutes influence the position of the S-2 segments relative to the thick filaments. PMID- 3664358 TI - Luteinizing hormone release in intact and castrate rams is altered with immunoneutralization of endogenous estradiol. AB - Changes in the dynamics of luteinizing hormone (LH) release in the adult ram following immunoneutralization of endogenous estradiol were investigated. Castrate rams were actively immunized against estradiol-6-bovine serum albumin for 7 months and then their patterns of episodic LH release and LH response to multiple injections of gonadotropin-releasing hormone (GnRH, two 5-micrograms doses given iv 2 h apart) were assessed (April). In comparison with control rams immunized against rabbit gamma globulin, estradiol-immunized rams (antibody titre approximately 1:5000) exhibited more frequent LH releases (11.7 +/- 0.3 vs. 9.3 +/- 0.8 pulses/8 h, P less than 0.05) and a greater LH response to the first GnRH injection (peak delta value 190 +/- 8 vs. 130 +/- 25 ng/mL, P less than 0.01). Estradiol antiserum collected from the castrate rams was used in the passive immunization of intact rams (antibody titre approximately 1:200) for 1 month (beginning mid-July). Although episodic LH release was always similar for control and immunized rams, testosterone levels in the latter group increased approximately 150%. In contrast with the castrate ram response, GnRH treatment (two 5-micrograms doses given iv 80 min apart) produced a "self-priming" effect on LH release in the intact rams, an effect that was dampened with estradiol immunoneutralization. Consequently, peak 2:peak 1 ratios for delta value and 80 min mean incremental increase were much smaller (P less than 0.01) for the immunized rams (approximately 2:1 vs. 4:1 for the control rams).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664359 TI - Stress- and cold-induced adrenocortical responses in repetitively immobilized or cold-acclimated rats. AB - To evaluate the role of adrenocortical hormones in stress- or cold-induced nonshivering thermogenesis, plasma corticosterone (CS) and deoxycorticosterone (DOCS) were measured with the aid of HPLC under various conditions. Repetitive immobilization stress (3 h/day, for 1 or 4 weeks) elevated the resting level (24 h after the last immobilization) of CS, but not DOCS. Acute stress (immobilization for 30 min) or cold exposure (-5 degrees C for 15 min) caused marked increases of CS and DOCS in both nonstressed naive controls and repetitively stressed rats. Four weeks, but not 1 week, of repetitive immobilization stress potentiated the responsiveness of CS to both acute stress and cold, and that of DOCS to acute stress, but not to cold. Cold acclimation (5 degrees C, 4 weeks) significantly elevated both corticosteroids but did not affect the resting levels (18 h after being transferred to 25 degrees C) or the responsiveness of both CS and DOCS to either acute stress or cold. These results suggest that repetitive immobilization stress, but not cold acclimation, could enhance nonshivering thermogenesis, at least in part, through an improvement in the responsiveness of adrenocortical hormone secretion to acute stress or cold. PMID- 3664360 TI - Does thromboxane mediate the indirect contractile action of leukotriene D4 in guinea-pig isolated lung parenchyma under equilibrium conditions? AB - The role that thromboxane A2 plays in contractions induced by leukotriene D4 in guinea-pig isolated lung parenchyma was investigated under equilibrium conditions. Lung tissue generated thromboxane A2 and prostacyclin spontaneously as evidenced by the slow accumulation of their biologically inactive metabolites, thromboxane B2 and 6-keto-prostaglandin F1 alpha, in the bathing buffer. Challenge of guinea-pig lung parenchyma with a high concentration (EC90 for tension generation) of leukotriene D4 (200 nM) produced a biphasic contraction of the tissue that consisted of an initial rapid increase in isometric tension followed by a slowly developing, well-sustained contracture. In addition, leukotriene D4 (200 nM) effected a transient increase (over basal) in the generation of thromboxane A2 and prostacyclin that lagged significantly behind the tension response. Kinetic analysis of the mechanical and eicosanoid generating effect of leukotriene D4 revealed that tension development could be suitably fitted to a biexponential function, whilst the release of both eicosanoids from the lung occurred monoexponentially. Pretreatment of the lung with the cyclooxygenase inhibitor, flurbiprofen, which effectively abolished both the spontaneous and the leukotriene D4-stimulated eicosanoid biosynthesis, significantly reduced both the first order rate coefficient of the first exponent and the maximum amplitude of this function with respect to control. This change in the kinetics describing leukotriene D4-induced contractions was explained by the fact that the initial rate of tension development was markedly reduced following pretreatment of the lung with flurbiprofen. Neither the inhibitor of thromboxane synthetase, dazmegrel, which selectively inhibited (by 95%) leukotriene D4-stimulated thromboxane A2 formation, nor blockade of 11 alpha,9 alpha-epoxymethano-prostaglandin H2 (U-46619)-sensitive (thromboxane A2) receptors with either AH 23848 or EP 092 affected the profile of leukotriene D4 induced tension development in guinea-pig lung. It is concluded that a high concentration of leukotriene D4 (200 nM) contracts guinea-pig lung by both a direct and indirect mechanism. Initially, a rapid short-lived contraction of the lung is manifest which is dependent, in part, upon the synthesis and release of cyclooxygenase product(s) other than thromboxane A2. This initial response occurs coincidently with, and is subsequently followed by, the development of a tonic well-sustained contracture that is the result of a direct action of leukotriene D4 on the contractile cells that comprise the lung. PMID- 3664361 TI - Sex- and species-related differences in the biotransformation of isosorbide dinitrate by various tissues of the rabbit and rat. AB - The biotransformation of isosorbide dinitrate (ISDN) by various tissues of the rabbit and rat was examined. Incubation of 2 X 10(-7) M ISDN at 37 degrees C with tissue homogenates of liver, lung, kidney, intestine, skeletal muscle, aorta, and erythrocytes from the rabbit and rat resulted in a significant disappearance of ISDN after a 30-min incubation (also, 5-min incubation for liver). The disappearance of ISDN in each tissue homogenate was accompanied by an equimolar production of the mononitrate metabolites, isosorbide-2-mononitrate (2-ISMN) and isosorbide-5-mononitrate (5-ISMN), with the exception of liver homogenates where the loss of ISDN could not be accounted for by mononitrate formation. The relative rate of ISDN disappearance in various tissue homogenates was for the male rabbit, liver greater than lung approximately intestine greater than kidney greater than erythrocytes approximately skeletal muscle approximately aorta; for the female rabbit, liver greater than kidney approximately lung approximately intestine greater than erythrocytes approximately skeletal muscle approximately aorta; and for the male rat, liver greater than intestine greater than erythrocytes greater than skeletal muscle greater than lung approximately kidney. A sex difference in the percent disappearance of ISDN was observed in homogenates of lung and intestine from male and female rabbits. In addition, a sex difference in the ratio of metabolite (2-ISMN/5-ISMN) formed by denitration of ISDN was seen in homogenates of lung, skeletal muscle, and erythrocyte lysate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664362 TI - The effect of dipyridamole on the initiation phase of postischemic acute renal failure in rats. AB - Several previous observations support the hypothesis that increased adenosine production and release mediate, at least in part, the reductions in renal blood flow and glomerular filtration rate in ischemic acute renal failure (ARF). If this hypothesis is correct, dipyridamole should potentiate these changes, since it blocks cellular adenosine uptake, thereby increasing the concentration and potentiating the effects of extracellular adenosine. Moreover, theophylline should block the effects of dipyridamole, since it is an adenosine receptor antagonist. These predictions were tested in three groups of anesthetized rats. All rats were subjected to 30 min of left renal artery occlusion; 30 min after relieving the occlusion, a 45-min clearance period was begun. The control group was given saline i.v.; the two experimental groups received either dipyridamole (24 micrograms X min-1 X kg-1) or dipyridamole plus theophylline i.v. (111 mumol/kg as a prime, 1.1 mumol X min-1 X kg-1 as an infusion). In the control group, the previously ischemic left kidneys exhibited decreased clearances of para-aminohippurate and inulin (CPAH and CIn), filtration fraction (FF), and urine/plasma inulin concentration (U/PIn), and increased urine flow (V), Na excretion (UNaV), and fractional Na excretion (FENa) in comparison with the contralateral right kidney. Dipyridamole pretreatment did not affect the right kidney, but it intensified the reductions in left kidney CPAH, CIn, and FF. Theophylline blocked all these effects of dipyridamole on the left kidney, and increased renal plasma flow (CPAH/PAH extraction), despite a decrease in systemic arterial blood pressure. These results are further support for the hypothesis that adenosine mediates, at least in part, the hemodynamic changes in postischemic ARF in rats. PMID- 3664363 TI - Metabolic activation of 1,1-dichloroethylene by mouse lung and liver microsomes. AB - 1,1-Dichloroethylene (1,1-DCE) causes lung and liver necrosis in mice. Covalent binding of [14C]1,1-DCE to isolated lung and liver microsomes from CD-1 mice required NADPH and was strongly inhibited by carbon monoxide. Lung and liver microsomes isolated from animals treated with phenobarbital demonstrated no changes in covalent binding of [14C]1,1-DCE compared with those from vehicle treated animals. While 3-methylcholanthrene caused no alterations in binding to lung microsomes, the same pretreatment resulted in significantly increased levels of binding to liver microsomes. Piperonyl butoxide caused significant decreases in covalent binding to lung and liver microsomes; SKF 525-A significantly inhibited binding to liver microsomes but had no effect on lung microsomes. The incubation of liver microsomes with inhibitors required more NADPH than those performed with lung microsomes. The results demonstrate that reactive metabolites of 1,1-DCE can be formed by lung and liver microsomes, and suggest the involvement of cytochrome P-450 isozymes in the lung and liver injury induced by the halocarbon. However, metabolic activation by lung and liver microsomes may additionally involve non P-450 dependent mechanisms as evidenced by relatively high levels of nonspecific binding of 1,1-DCE. PMID- 3664364 TI - Isolation of an N-alkylprotoporphyrin IX from chick embryo livers following the administration of 3,5-diethoxycarbonyl-1,4-dihydro-4-ethyl-2,6-dimethylpyridine. AB - The ferrochelatase-lowering activity of 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6 trimethylpyridine (DDC) analogues in chick embryo hepatocyte culture has been assumed to be due to the formation of an N-alkylprotoporphyrin IX. This assumption required confirmation. For this reason the 4-ethyl analogue of DDC was administered to phenobarbital-pretreated 19-day-old chick embryos. This resulted in hepatic accumulation of a green pigment with ferrochelatase-inhibitory activity. The green pigment was identified as an N-alkylprotoporphyrin IX by comparison of the electronic absorption spectra of its dimethyl ester and Zn complex with the corresponding spectra obtained from synthetic N ethylprotoporphyrin IX. PMID- 3664365 TI - Criteria for determination of lipid peroxidation in tissues: estimation in liver of mice intoxicated with carbon tetrachloride. AB - The profiles of lipid peroxidation products in liver homogenates or microsomal membranes prepared from CCl4-intoxicated mice were determined by several commonly employed methods. The level of conjugated dienes peaked within 30 min and then decreased, suggesting the transitory nature of lipid peroxides in vivo. Values for thiobarbituric acid positive material peaked 30 min after CCl4 treatment, diminished thereafter for a time, and gradually rose to a new maximum at 24 h; the first peak appears to represent lipid peroxides and the second represents further degradation products including malondialdehyde. Fluorescence intensity (excitation, 360 nm; emission, 430 nm) was closely correlated with the second peak. Our findings support the involvement of lipid peroxidation in CCl4-induced hepatotoxicity in mice and emphasize the necessity for several analytical indices of lipid peroxidation performed at different time intervals. PMID- 3664366 TI - Metabolic changes in a conidia-induced Claviceps paspali strain during submerged fermentation. AB - Chemical changes in the mycelium of the conidial Claviceps paspali mutant strain, isolated after gamma irradiation, were followed during the course of submerged fermentation and compared with the mycelial parent strain; both strains are capable of producing simple lysergic acid derivatives. The syntheses of lipids, carbohydrates, phosphates, nucleic acids, proteins, and alkaloids, as well as nutrient uptake, were determined. It was found that conidiation induced by mutagenic treatment was accompanied by a set of changes in the metabolic pattern. In the conidial mutant, the primary and secondary metabolic activities were repressed and the protein to nonprotein compound ratio of the cells was changed in favour of protein compounds. PMID- 3664367 TI - The production of alamethicins by Trichoderma spp. AB - The production of polypeptides containing a high percentage of 2-methylalanine residues by a number of isolates of Trichoderma spp. has been examined. It has been shown that good yields (0.5-1.0 g L-1) can be achieved on synthetic media provided an insoluble carbohydrate is included and provided single-spore isolates that have this production ability are selected from time to time. Such yields could not be obtained on any single nitrogen source investigated, but a mixture of potassium nitrate, glutamine, and 2-methylalanine was effective. It was shown that at least eight polypeptides were produced in shake-flask or tank fermentation and that the proportions of these metabolites depended on the fermentation temperature, its pH, age, and aeration. Fermentation conditions for enhancing the production (independently) of two of the metabolites at the expense of the others are given. These two metabolites have been obtained in crystalline form and details of some of their physical and chemical properties are given. PMID- 3664368 TI - Effects of temperature upon the cell-free translation system from Coxiella burnetii. AB - The rate and extent of coliphage Q beta RNA translation by cell-free extracts prepared from Coxiella burnetii were studied. When translations were conducted at temperatures elevated above 37 degrees C, both polypeptide elongation and frequency of initiation were by comparison increased. The ratios of products synthesized from the polycistronic phage mRNA also changed upon increases in translation temperature, especially at 45 degrees C. Although the organism is a moderate acidophile, initiation of protein synthesis in extracts did not occur below pH 6.2, and was superior when the pH was 6.8-7.2. The results are discussed in context with the known physiological characteristics of this obligate intracellular bacterium. PMID- 3664369 TI - Colour vision abnormalities in multiple sclerosis. AB - A battery of colour vision tests was employed to evaluate visual function in patients with multiple sclerosis (M.S.). Colour deficits were found in 45% of patients tested with the Ishihara plates and 42.5% of patients tested with the FM 100-Hue test. 65% of M.S. patients failed at least one of the tests. The colour vision deficits were not restricted to patients with optic neuritis or with visual evoked potential (VEP) abnormalities and there was no significant correlation between an abnormal VEP latency and a colour vision deficit. Colour vision testing may be a useful option to consider in the investigation of M.S. patients, even if there is no other evidence of visual system involvement. PMID- 3664370 TI - CT findings in late-onset epilepsy. AB - We reviewed the CT findings of 387 patients with new-onset seizures after the age of 50. Seizures were generalized in 212 patients, focal in 160, and indeterminant in 15. CT scanning revealed cerebral atrophy in 113 cases, ischemic lesions in 75, cerebral neoplasms in 20, and no abnormality in 177 cases. Tumours were found in only three patients with generalized seizures, and all three had focal neurological deficits at the time of CT diagnosis, while 17 neoplasms were discovered in patients with a focal seizure disorder. The majority of patients with late-onset epilepsy have a normal CT scan with cerebral atrophy being the most common abnormality detected. Cerebral vascular disease appears to be the most frequently identified cause of late-onset epilepsy, while cerebral neoplasms are uncommon. PMID- 3664371 TI - Acetylcholine receptor antibodies in myasthenia gravis: use of a qualitative assay for diagnostic purposes. AB - We have modified the techniques of Lindstrom and of Tindall to measure serum acetylcholine receptor antibody using human antigen bound to 125I-alpha Bungarotoxin. By using 10 microliters of serum and precipitating antigen-antibody complexes with an excess of staph A, we found that only one out of 43 patients with clinically diagnosed active generalized Myasthenia Gravis had no antibodies. In pooling these results with the results of tests done for diagnostic purposes we found positive results in 54/55 generalized active MG, 8/21 MG in remission, 16/37 ocular MG and 0/55 healthy controls. Two out of 38 non MG were also positive and their clinical diagnosis of botulism and penicillamine treated rheumatoid arthritis have been confirmed by a one year follow-up. Most of these sera were also tested for reactivity with fetal calf AchR. Six out of 49 samples positive with the human receptor were negative with calf receptor. We conclude that our technique is extremely useful for the diagnosis of Myasthenia Gravis and that fetal calf antigen cannot replace human antigen in the assay. PMID- 3664372 TI - Familial Parkinson's disease: possible role of environmental factors. AB - We report here six families with Parkinson's disease in whom the onset of symptoms tended to occur at approximately the same time irrespective of the age of the patient. The mean difference in the time of onset in different generations was 4.6 years while the mean difference in age of onset in children and parents was 25.2 years. We construe this pattern of age separation within families as suggestive of an environmental rather than genetic cause. Support for this view derives from the lack of correlation between occurrence of the disease and the degree of consanguinity. We conclude that our findings are in accord with the hypothesis which attributes the cause of some cases of Parkinson's disease to early, subclinical environmental damage followed by age-related attrition of neurons within the central nervous system. PMID- 3664373 TI - Involuntary movements with cerebellar tumour. AB - We describe a child with a cerebellar astrocytoma who presented with paroxysmal segmental rhythmic myoclonus. The movement disorder was characterized by focal onset in the left eyelid followed by a sequential march of clinical events. There were no clinical or laboratory findings to suggest brainstem infiltration or cerebral involvement. Marked clinical improvement followed tumour resection. We suggest that the cerebellar lesion was primarily responsible for the movement disorder. PMID- 3664374 TI - Hand wasting due to mid-cervical spinal cord compression. AB - Three patients presented with hand wasting and weakness secondary to mid-cervical spinal cord compression. This was due to cervical spondylosis in two patients and a meningioma in one case. This phenomenon is probably similar to that seen with foramen magnum lesions and may be due to spinal cord ischemia distal to the compression, secondary to venous stasis. PMID- 3664375 TI - Neurologic complications following intra-arterial cis-platinum chemotherapy. PMID- 3664376 TI - Abstracts of symposium on biology of cerebral endothelium. 26-28 June, 1987. Kingston, Canada. PMID- 3664377 TI - Substitutes for homologous blood transfusion. PMID- 3664379 TI - Lower extremity amputation in elderly patients. PMID- 3664378 TI - Postresection empyema. PMID- 3664380 TI - Equivalence in treatments. PMID- 3664381 TI - Use of the Huber-point needle in the Port-A-Cath system. PMID- 3664382 TI - McGoey-Evans total hip prosthesis. PMID- 3664383 TI - Management of urinary stress incontinence. PMID- 3664384 TI - Clagett open-window thoracostomy in patients with empyema who had and had not undergone pneumonectomy. AB - Patients with empyema not responding to simple chest-tube drainage and antibiotic therapy have been managed by a "Clagett"-type procedure that consists of open window thoracostomy, antibiotic irrigation and closure of the window. The results of such treatment were reviewed. Of the 103 patients with empyema treated between 1967 and 1983, 41 underwent open-window thoracostomy. Twenty-eight (group 1) had empyema after pneumonectomy, 13 (group 2) did not; however, 9 of the 13 in group 2 had undergone lobectomy. The mean follow-up was 46 months for group 1 and 42 months for group 2. When surgical closure of the open-window thoracostomy was attempted, the success rate in group 1 was 85% for those without concomitant bronchopleural fistula, but only 36% in patients with a fistula. In group 2 the respective success rates were 50% and 57%. Unsuccessful closure resulted in chronic fistulas in four patients in each of the two groups. Six deaths in group 1 and two in group 2 were related to the original disease, but one was an operative death. These results demonstrate both the effectiveness and limitations of open-window thoracostomy in the management of these difficult cases. PMID- 3664385 TI - Incidence of mediastinal node involvement in clinical T1 bronchogenic carcinomas. AB - The incidence of mediastinal node involvement of T1 non-small-cell bronchogenic carcinomas was determined in 262 patients for the period June 1981 to January 1986. All patients underwent mediastinoscopy as part of their evaluation. Thirty five patients (13%) had clinical primary T1 lesions. There were 17 adenocarcinomas, 10 squamous cell carcinomas, 6 large-cell anaplastic carcinomas and 2 bronchoalveolar carcinomas. Five patients had node involvement at mediastinoscopy: two had large-cell anaplastic carcinomas and one was a squamous cell carcinoma. Thoracotomy in the remaining 30 patients revealed 2 with pleural metastases, 1 with left upper lobe adenocarcinoma with metastases to the subaortic nodal area (not assessed by cervical mediastinoscopy). The other patients underwent resection, for a resectability rate of 90%. Therefore the overall incidence of mediastinal node involvement in this series was 17% (6 of 35) and was found to be highest among patients with large-cell anaplastic carcinomas (2 of 6), followed by adenocarcinomas (3 of 19) and squamous cell carcinomas (1 of 10). The larger number of large-cell anaplastic carcinomas in this series probably accounts for the higher incidence of N2 disease found compared with that of previous studies in the literature. Accordingly, preoperative mediastinal staging is recommended for all T1 large-cell anaplastic carcinomas and adenocarcinomas and for suspicious lesions of undetermined histology. PMID- 3664386 TI - Thoracoplasty: its forgotten role in the management of nontuberculous postpneumonectomy empyema. AB - The role of thoracoplasty in the management of empyema complicating pneumonectomy is controversial because alternative techniques, such as pedicled muscle transplants or open-space sterilization, have now replaced the conventional collapse procedures. Among 46 patients treated for postpneumonectomy empyema during the years 1975 to 1984, 17 underwent space-reducing thoracoplasty as the final step in pleural space management. Technical considerations, critical in the success of the operation, were: (a) single-stage extramusculoperiosteal resection of the second to the seventh rib, (b) sparing of the first rib to maintain integrity of the neck and shoulder girdle, (c) intercostal muscle closure of large fistulas and (d) adequate drainage of pleural and extrapleural spaces. Immediate control of the empyema was obtained in 15 (88%) patients. Fourteen patients were alive at the time of follow-up (mean 4.5 years) and none had major thoracic deformity or residual infection. Our data show that thoracoplasty is an excellent therapeutic option for patients with chronic postpneumonectomy empyema. Adherence to strict surgical principles ensures that the space is obliterated and the cosmetic result is satisfactory. PMID- 3664387 TI - Presidential address, 1986. The future of general surgery. AB - The future of general surgery is assured provided the discipline remains flexible, adaptable and innovative. A strong and continuing emphasis on education and continuing emphasis on education and research at all levels is essential to maintain these qualities. PMID- 3664388 TI - Surgical treatment of anal incontinence. AB - The records of 18 consecutive patients operated upon for fecal incontinence between January 1983 and March 1986 were reviewed. Anterior sphincteroplasty was performed on 11 patients with direct sphincter trauma. The results were excellent in eight, fair in two and poor in one. A postanal repair was performed on seven patients, with excellent results only in two, fair in four and poor in one. The indications for surgery and the results were assessed clinically and manometrically. A careful classification of the physiologic and anatomic derangements of the anal sphincter aids in the appropriate selection of candidates for surgical treatment. In general, anterior sphincteroplasty gives good results, whereas results of postanal repairs are less satisfactory. Manometry is of some use in providing objective measurements. PMID- 3664389 TI - Should cholecystectomy be done en passant for asymptomatic cholelithiasis? AB - The management of asymptomatic gallstones discovered during abdominal surgery is controversial. Should cholecystectomy be performed en passant? The authors report a 4-year survey of 109 patients with asymptomatic cholelithiasis who underwent surgery for other abdominal conditions: colorectal (31), gastric (24), vascular (20), gynecologic (21) and miscellaneous (13). Cholelithiasis was established preoperatively by ultrasonography in 52 of 55 examinations (95%). In the other 54, the gallstones were discovered at operation. Cholecystectomy was performed in 78 patients and in 31 the gallbladder was left in place. In the former group, 11 (14%) had complications, 2 being attributable to the cholecystectomy. Intraoperative cholangiograms were obtained in 43 and led to common-bile-duct explorations in 8. Common-bile-duct stones were found in seven. In the non cholecystectomized group, three died postoperatively and three were lost to follow-up. Twelve of the remaining 25 are still asymptomatic and 13 have had symptoms: 7 underwent cholecystectomy (4 for acute cholecystitis) between 2 weeks and 11 months after the initial laparotomy. Because of the low morbidity and the relatively high number of cholecystectomies that were subsequently necessary, the authors recommend cholecystectomy en passant unless there is a specific contraindication. They also recommend ultrasonography before major gastrointestinal or vascular surgery in order to plan for cholecystectomy. PMID- 3664390 TI - Colectomy and ileostomy in the management of ulcerative colitis. AB - For 30 years, colectomy with ileostomy has been the mainstay of the surgical treatment for ulcerative colitis. Between 1963 and 1985, 535 patients with inflammatory bowel disease were admitted to the Royal Prince Alfred Hospital in Sydney, Australia; 471 had ulcerative colitis and 64 Crohn's colitis. One hundred and eight-six of these patients underwent colonic resection. The proportion of patients who underwent surgery was the same for both disorders. There have been no deaths resulting from the surgical management of inflammatory bowel disease at our hospital since 1965. These patients should be treated safely by standard means before the more elaborate sphincter-saving procedures, currently recommended, are tried. PMID- 3664391 TI - Current status of the continent ileostomy. AB - The continent ileostomy has substantial advantages over the standard ileostomy in that it provides a socially acceptable, odourless, appliance-free stoma. The author presents the experience at the Toronto General Hospital from 1977 to 1984 with this procedure which was performed on 123 patients, in conjunction with proctocolectomy (36) and as a conversion from an ileostomy or colostomy (87). There were no postoperative deaths. Modifications to prevent nipple valve sliding have included the addition of staples across the valve and synthetic mesh slings around the outlet. Reservoir ileitis remains a difficult problem, most likely due to stagnant bacterial overgrowth. The operation should not be performed on patients with Crohn's disease, and in the obese, technical difficulties present considerable risk. The procedure should be confined to large centres where the surgeons are experienced in the procedure. PMID- 3664392 TI - Physiopathologic aspects of ileal reservoirs. AB - The author reviews some aspects of fecal continence after ileoanal anastomosis with an ileal reservoir. Also, the consequences of fecal stasis on small-bowel absorption and morphologic and bacteriologic features are discussed. Some recommendations for the follow-up of these patients are outlined. PMID- 3664393 TI - Postmastectomy lymphedema treated with the Wright linear pump. AB - Fifteen patients with postmastectomy lymphedema of the arm were treated with the Wright linear pump, a programmable, gradient pressure, sequential, intermittent compression pump. The group comprised volunteers in whom conservative measures had failed. This is a phase II trial to determine the efficacy of the pump. All patients had subjective improvement. Objectively, all showed a reduction in edema, but this was of variable degree and depended on the amount of pre-existing lymphedema in the arm. The Wright linear pump is easy to use and treatment was well tolerated. No fluid overload occurred due to treatment and no other medical problems were encountered. The Wright linear pump seems more effective than other pneumatic intermittent compression pumps available. PMID- 3664394 TI - Penetrating chest wounds: a 10-year review. AB - From January 1975 to December 1984, 93 patients with penetrating chest wounds were admitted to three hospitals in Regina. Sixty-three percent of the wounds were caused by knives and 34% by firearms. Sixty-three patients were treated conservatively, 18 patients had thoracotomy and 12 others underwent laparotomy. Of the 18 patients, 16 had wounds between the nipples; 8 of the 16 had injuries to the heart or great vessels. Whereas the majority of penetrating wounds to the chest may be treated by observation or thoracostomy alone, a surgical approach is recommended when penetrating injuries are thought to have traversed the mediastinum, because of the high incidence of associated cardiac injuries. In doubtful cases the decision should favour early thoracotomy. PMID- 3664395 TI - Lower extremity amputations: a 5-year review and comparative study. AB - In order to review major lower extremity amputations at the Toronto East General and Orthopaedic Hospital Inc. between 1979 and 1984, 60 patients with 42 below knee, 17 mid-thigh and 20 Callander through-knee amputations were studied retrospectively. The three amputation groups demonstrated comparable rates of stump healing. A previous history of vascular surgery on the extremity increased the risk for both delayed healing and failure to heal. The Callander through-knee amputees were rehabilitated earlier and more easily than were the mid-thigh amputees, and once rehabilitated they were more likely to continue using their prostheses. The authors recommend that, when possible, the chosen site of amputation for the majority of patients should be below the knee, but when this is not practical a through-knee amputation should be done in preference to a mid thigh amputation. PMID- 3664396 TI - Aorta-right atrial fistula: an unusual complication of ascending aortic dissection. AB - Ascending aortic dissection complicated by aorta-right atrial fistula is a very rare occurrence. The patient may present with atypical clinical findings such as a continuous murmur or atrioventricular block, making the diagnosis difficult. Surgical repair is straightforward unless the correct diagnosis is missed, in which case there may be difficulties during the initial period of cardiopulmonary bypass. This report deals with the successful management of a 67-year-old man with this condition. PMID- 3664397 TI - Pharyngoesophageal reconstruction with free jejunal grafts. PMID- 3664398 TI - Urinary stress incontinence. PMID- 3664399 TI - Below-knee amputation: a technical note. PMID- 3664400 TI - Closure of the mesenteric gap after small-bowel resection. PMID- 3664401 TI - Medical significance of occupant restraint on road-crash victims and the role of the medical profession. AB - Compulsory use of seat belts has been the single most important measure in reducing the number of deaths and injuries on the road. Seat belts are most effective in reducing head and facial injuries in frontal impacts, but less so with side collisions and roll-overs. There should be no medical exemptions to the wearing of seat belts. There is little evidence that seat belts, if properly worn, cause serious injury. The reduction in road deaths and injuries applies only to car occupants: the number of deaths in motorcyclists closely parallels the number of motorcycles in use. Likewise, the pedestrian death rate remains unchanged. PMID- 3664402 TI - Major mediastinal vessel injury: an underestimated lesion. AB - Of patients who sustain traumatic rupture of the aorta, 15% to 20% will reach the hospital alive. Without associated major brain trauma or irreversible abdominal injury, survival depends on early diagnosis and prompt surgical repair by an experienced surgeon. Regardless of whether there is radiologic evidence of rupture or rib fractures, a constant awareness of aortic rupture should be maintained, based on the history of the accident. Among 50 patients in whom a rupture of the thoracic aorta was diagnosed, 47 with traumatic rupture of the descending thoracic aorta were treated by the author. Of 34 involved in motor vehicle accidents and in whom a history of the accident was obtained, 30 (88%) were not wearing seat belts and 11 (33%) were involved in a lateral collision. Six percent of the 50 patients sustained a vertical fall of more than 10 m. PMID- 3664403 TI - Symposium on unexpected findings at laparotomy. PMID- 3664404 TI - Aortoenteric fistula: case review and a new surgical technique. AB - The authors describe a new surgical technique for the management of aortoenteric fistula and report on the diagnosis and management of five such cases. The new technique consists of stapling the afferent and efferent loops of bowel as close to the fistula as possible. In a bleeding patient this effectively stops the blood loss into the bowel; when a patient is not actively bleeding, it helps in the retraction of the bowel away from the operative site. The authors propose that this technique be used by a surgeon with limited vascular experience to temporize the blood loss and transport the patient to a vascular unit. The recommended procedure is total excision of the graft with an axillobifemoral bypass. Acute awareness of the condition and prompt early operation in a patient who has undergone aortic surgery will result in lower death rates. PMID- 3664405 TI - Obstructive jaundice and cholangitis due to choledocholithiasis: treatment by extracorporeal shock-wave lithotripsy. AB - Endoscopic shock-wave lithotripsy, although now the standard treatment of urolithiasis, has only recently been applied to cholelithiasis. The authors describe the case of an 88-year-old man, a high-risk patient with choledocholithiasis, in whom endoscopic stone extraction after sphincterotomy failed. Extracorporeal shock-wave lithotripsy was used for noninvasive stone fragmentation and the fragments were passed without complication. PMID- 3664406 TI - Rectal duplication in chronic large-bowel obstruction. AB - Rectal duplication is a rare congenital anomaly. The authors describe the case of a 52-year-old man with this condition, which caused chronic constipation. An unusual sequence of events led to the diagnosis of this anomaly at a repeat laparotomy and its eventual successful management. Awareness of the anomaly would greatly influence its early diagnosis and treatment. PMID- 3664407 TI - Risk of bacteremia with endoscopic sphincterotomy. AB - A prospective assessment of the risk of bacteremia with endoscopic sphincterotomy was made in 81 patients who underwent 95 procedures. Blood samples were taken for culture in all patients before and at 5 and 10 minutes after the last incision of the sphincter by the papillotome. An additional blood sample was obtained for culture within 30 seconds of the final incision in 32 of the 95 procedures. The rate of blood-culture positivity before the procedure was not significantly different from the post-incisional rate (1% compared with 3%, p greater than 0.05). No patient suffered from fever or chills during the 24 hours after sphincterotomy. PMID- 3664408 TI - Analysis of a Lane-plate internal fixation device after 64 years in vivo. AB - A patient presented for an above-knee amputation 64 years after successful internal fixation of a femoral fracture with a Lane plate. Chemical analyses of the plate and corrosion products were done using atomic absorption spectrophotometry, x-ray energy spectroscopy and x-ray diffraction. Mechanical properties of the fixation devices were measured using Rockwell-type instruments and metallographic analyses were also performed. In addition, pathologic and radiologic investigations of the underlying bone were carried out. Results disclosed that extensive corrosion had weakened the plate by 50%. The metallosis of the surrounding soft tissues and abnormal morphologic features of underlying bone were analysed. No appreciable cellular inflammatory or dysplastic reaction of adjacent tissues was identified. The underlying bone showed a persistent lack of mature compact bone and no evidence of remodelling. The products of corrosion were mainly ferrous carbonate and some ferrous chloride. The mechanism of the corrosion was the formation of a galvanic cell between the iron carbide and surrounding iron, with dissolution of the iron and formation of the corrosion products. PMID- 3664409 TI - Autologous blood for pleurodesis in recurrent and chronic spontaneous pneumothorax. AB - Open operation for recurrent pneumothorax may be necessary to resect or oversew a bulla. At the same time, to stimulate adhesions, the pleura may be abraded with gauze, chemicals used to cause inflammation or a partial pleurectomy performed. Operation is necessary to decorticate the lung if it has developed a thick peel, in the presence of gross bleeding (hemopneumothorax) or if a large bulla is present. Occasionally, a chronic pneumothorax is due to a persistent leak caused by an adhesion holding open a bulla. The adhesion may be cut at thoracoscopy, using diathermy, and the leak will close. Many chemical agents have been used to encourage adhesions: iodized talcum powder, silver nitrate, 50% glucose and water, Atabrine, nitrogen mustard and tetracycline. In this series, one to three instillations each of 50 ml of autologous blood were used after the lung was fully expanded, usually after the use of an apical chest tube. This procedure was successful in 21 (85%) of 25 patients with difficult, chronic or recurrent pneumothoraces. It is a practical and easy method of causing a chemical pleurodesis, without serious side effects. PMID- 3664410 TI - Endobronchial lipoma: report of three cases. AB - Endobronchial lipomas are rare, benign lesions that usually obstruct a major bronchus and cause irreversible pulmonary damage distally. Because of the age, sex and smoking history of the patients in whom they are found, they also simulate malignant tumours. The authors report three cases of endobronchial lipoma. Two of the patients had a long history of cough and respiratory symptoms, the third was asymptomatic. Two patients underwent lung resection and one was managed by local resection through a bronchotomy. The lipoma in all three patients was diagnosed preoperatively and treated successfully. PMID- 3664411 TI - Aortic surgery and horseshoe kidney: a challenging surgical problem. AB - Horseshoe kidney is a rare abnormality that complicates aortic surgery. Three such cases are presented and the literature is reviewed. Although the diagnosis was not made preoperatively in any patient, all were managed safely. Two patients required preservation of abnormal renal arteries and one required division of the renal isthmus for exposure. Special attention is drawn to the need for lateral angiographic projections of this condition and to the intraoperative injection of indigo carmine dye to delineate the proper line of division of the renal isthmus. PMID- 3664412 TI - Avulsion of the pectoralis major tendon in a weight lifter: repair using a barbed staple. AB - Avulsion of the pectoralis major tendon is uncommon. The usual mechanism is a sudden muscular contraction with the rupture occurring at any point between the muscle's origins on the clavicle and sternum and its tendinous insertion on the humerus. At least half the reported cases involve athletes. Primary repair is recommended. Surgical correction using a barbed bone staple to reattach the tendinous portion of the pectoralis major to its attachment at the lateral lip of the bicipital groove has not previously been described. The authors obtained an excellent postoperative result in a 20-year-old competitive weight lifter who was able to return to active body-building competition. They advocate prompt surgical correction of this lesion in any active healthy person. PMID- 3664413 TI - Free jejunal grafts in pharyngoesophageal reconstruction. AB - The free jejunal graft with microvascular anastomosis offers the head and neck surgeon a reliable, single-stage method of repair for small cervical defects and also for more extensive pharyngoesophageal defects where one or more loops of jejunum can successfully be used. If microvascular expertise is available, this method of reconstruction offers early alimentary rehabilitation and a physiologic repair. The free jejunal graft is a reliable method of reconstruction not only after failed gastric pull-up or when that procedure is not feasible, but also, where the facilities exist, as a primary method of pharyngoesophageal reconstruction. PMID- 3664414 TI - Remodelling in slipped capital femoral epiphysis. AB - In-situ pinning of a slipped capital femoral epiphysis is the most common form of treatment for this problem. To find out if remodelling of the upper femur after pinning occurs often enough to justify this form of treatment and whether secondary osteotomies are required for residual deformity, 82 patients with slipped capital femoral epiphyses were reviewed. X-ray films were studied sequentially, noting remodelling changes in the femoral head and neck. Sixty eight percent of moderate to severe slips that could be properly assessed showed signs of remodelling. The authors recognized two distinct remodelling processes- one, occurring early, affected the neck adjacent to the growth plate, the second appeared later, more distally along the femoral neck. Very few osteotomies were done for residual deformity. Pinning in situ of a slipped capital femoral epiphysis represents a simple, rapid and effective method of treatment, allowing remodelling even in more severe slips. PMID- 3664415 TI - A single treadmill exercise test does not accurately quantitate claudication. AB - The diagnosis of vascular occlusive disease is confirmed by documenting a fall in the ankle-brachial pressure index following a treadmill exercise test. The authors hypothesize that this test does not provide a reproducible quantitative assessment of the patient's disability due to the disease. In 25 patients a series of five treadmill exercise tests were performed on the same day. There was a significant (p less than 0.05) increase in the time to the occurrence of claudication when tests 3, 4 and 5 were compared with test 1. There was also a significant (p less than 0.05) rise in the maximum time walked comparing test 3 with test 1. There was no difference in the fall in ankle-brachial pressure index with each test. The majority of patients had achieved their maximum walking distance by test no. 3. It is concluded that a single treadmill exercise test will not accurately assess disability due to intermittent claudication and it is recommended that three tests be performed for a reproducible evaluation. PMID- 3664416 TI - Aquatic dermatology. PMID- 3664417 TI - Otitis externa associated with aquatic activities (swimmer's ear). AB - Infections of the ear canal may vary in terms of severity. Their frequency and morbidity qualify them as significant aquatic problems. The aquatic environment adds the conditional variable of moisture to the ear canal. Usually bacteria are introduced with the moisture and in the warm environment of the canal multiply, generate debris, invade the canal lining, and generate the symptoms of otitis externa. Fortunately, the incidence of this condition can be minimized by eliminating moisture in the canal. In situations where excessive moisture is likely to be introduced such as in swimmers, scuba divers, and deep sea divers the prophylactic measures of desiccation and acidification of the canal should be used. They are very effective. In the saturation diver, ear canal infections are not likely to resolve without interruption of diving activities. Individuals who have recurring ear canal infections require evaluation by an ear specialist to identify possible remedial problems that can trigger infection. Correction of anatomical problems or underlying dermatoses can prevent recurrences of OE. PMID- 3664418 TI - Injuries from sea urchins. PMID- 3664419 TI - The blue-ringed octopus bite and envenomation syndrome. PMID- 3664420 TI - Mini atlas of aquatic dermatologic lesions. PMID- 3664421 TI - Venomous fish stings (ichthyoacanthotoxicoses). PMID- 3664422 TI - Contact dermatitis to diving equipment, swimming pool chemicals, and other aquatic denizens. PMID- 3664423 TI - Aquagenic urticaria. PMID- 3664424 TI - Pseudomonas aeruginosa folliculitis ("splash rash"). PMID- 3664425 TI - Treatment of locally advanced thyroid carcinoma with combination doxorubicin and radiation therapy. AB - Since 1979, 41 patients with locally advanced thyroid cancers have been prospectively treated in our institution according to a combination regimen of low-dose Adriamycin (doxorubicin) and external-beam radiation therapy. Two types of treatment regimen were used depending on tumor histologic type. Group 1 patients with well-differentiated papillary, follicular, or mixed type tumor (n = 22) received the combined regimen consisting of once weekly administration of Adriamycin (10 mg/m2) before radiation therapy (RT). Radiation therapy was carried out with a daily dose of 200 cGy for 5 days per week to a total tumor dose of 5600 cGy. Group 2 patients with anaplastic giant and spindle cell carcinoma of the thyroid (n = 19) received the combined regimen, consisting of once weekly administration of Adriamycin (10 mg/m2) before hyperfractionated RT. Radiation therapy was carried out with a fractional dose of 160 cGy per treatment twice a day for 3 days per week to a total dose of 5760 cGy in 40 days. Initial complete tumor response rates in the group 1 and 2 were 91% and 84%, respectively. Local tumor control rates at 2 years after combined therapy were 77% and 68%, respectively. The median survival time was 4 years for group 1 and 1 year for group 2. There was no disproportionately enhanced normal tissue morbidity seen with this combined approach. Patients in group 1 have a good quality of life, once the local disease is under control due to the indolent course of the disease. On the contrary, most patients in group 2 promptly developed distant metastases and died from the disease. PMID- 3664426 TI - Hormonal treatment of advanced breast cancer. A randomized trial of tamoxifen versus nandrolone decanoate. AB - The response to tamoxifen (TAM) (10 mg to 20 mg twice orally) was compared with the response to nandrolone decanoate (NAN) (50 mg every second week or 100 mg every third week intramuscularly) in this randomized study in previously untreated women with advanced breast cancer. Patients were postmenopausal or postmenopause was induced with irradiation therapy. The two treatment groups were highly similar in different patient characteristics. Of 67 evaluable patients treated with TAM, ten (15%) had a complete or partial remission, 28 (42%) had stabilized disease and 29 (43%) had progressive disease. In the 60 patients treated with NAN, the figures were ten (17%), 22 (37%) and 28 (47%) respectively. The response rates did not differ significantly. Tam was as good as NAN in osseous metastases. Four of 34 patients responded to TAM and three of 38 patients responded to NAN. NAN had a tendency for better response in the treatment of visceral metastases. Six (43%) of 14 patients responded to NAN while only three (14%) of 21 responded to TAM (P = 0.11). The median duration of remission was 24 months in the TAM arm and 17 months in NAN (insignificant). As second line treatment, NAN after TAM gave one complete remission and three partial remissions, but none responded to TAM after NAN. The side-effects of both drugs were rare and mild. These data indicate that TAM and NAN are comparable in the treatment of advanced breast cancer. PMID- 3664427 TI - Effect of natural beta-interferon on cell proliferation and steroid receptor level in human breast cancer cells. AB - The effect of natural beta-interferon (beta-IFN) on cell proliferation and steroid receptor level was investigated in CG-5 human breast cancer cell line. beta-interferon determines an appreciable diminution of cell growth, at concentrations ranging from 100 to 1000 IU/ml, which is enhanced when serum content of the culture medium is lowered. Low concentrations of beta-IFN (10-100 IU/ml) produce, after a 5-day treatment, an increase in estrogen receptors (ER) and progesterone receptors (PR). No variation of ER and PR levels is observed when beta-IFN is added directly to the cell homogenate before the assay. Our data suggest that beta-IFN could affect hormone sensitivity through a modification of ER and PR in neoplastic mammary cells. PMID- 3664428 TI - Acute megakaryocytic leukemia. Flow cytometric analysis of DNA content at diagnosis and during the course of therapy. AB - Flow cytometry (FCM) for the determination of DNA content and cell cycle analysis was performed on multiple bone marrows from a case of acute megakaryocytic leukemia in a 71-year-old woman. Two aneuploid (multiploid) peaks were present at diagnosis. This multiploidy was a stable characteristic when studied temporally. The disappearance of the peaks in the bone marrow specimens directly correlated with complete remission morphologically. These findings further support the concept of FCM as an adjunct to morphologic study in identifying residual tumor burden. PMID- 3664429 TI - Bone marrow biopsies in patients with undifferentiated carcinoma of the nasopharyngeal type. AB - Bone marrow involvement was found in 21 of 56 patients with undifferentiated carcinoma of the nasopharyngeal type UCNT whose nasopharyngeal and bone marrow biopsies were available. Radiotherapy and chemotherapy (cisplatin, 5-fluorouracil and bleomycin) were given because of distant metastases. The microscopic aspects of bone invasion were investigated and were classified into three subtypes osteolytic, osteosclerotic and mixed type. The UCNT patients population was 10 years younger than that studied previously. Both the extent of the primary tumor (T) and cervical lymph node status (N) exerted an influence on the probability of metastases developing. Chemotherapy given to patients must be improved because UCNT with bone metastases is a disease with a poor prognosis. PMID- 3664430 TI - Carcinoid tumors of the thymus. An immunohistochemical study. AB - Five carcinoid tumors of the thymus were screened immunohistochemically for the occurrence of neuropeptides (ACTH, calcitonin, calcitonin gene-related peptide, cholecystokinin, gastrin, neurotensin, somatostatin, substance P), as well as of serotonin, chromogranin A, and neuron-specific enolase. Most of the patients exhibited local symptoms evoked by growing tumor masses in the upper mediastinum without any clinical evidence of endocrine activity. Light and electron microscopic examination showed characteristic uniform large epithelial cells in polar or palisade arrangement, containing variable amounts of electron-dense secretory granules. Only a few of the tested neuropeptide antisera reacted with the investigated tumors. Cholecystokinin-immunoreactive cell populations were seen in all tumors. Expression of neurotensin could be observed in three neoplasms, two of which also exhibited ACTH immunoreactivity. Chromogranin A immunoreactive cells were found in two neoplasms. Neuron-specific enolase showed strong staining in three tumors, one of the tumors also being immunoreactive for calcitonin. The results were confirmed by control reactions. Apart from the demonstration that conventional marker proteins are not reliable in identifying all carcinoid tumors, the present study proves that the visualization of neuropeptide-immunoreactive cells in thymus carcinoids does not necessarily correspond to the manifestation of the clinical symptoms. Furthermore, each of the investigated neoplasms, as also known from other carcinoid tumors, appears to be able to produce more than one hormone. PMID- 3664431 TI - Plantar lentiginous melanoma. A clinicopathologic study. AB - Twenty cases of plantar melanoma treated at Ellis Fischel State Cancer Center (EFSCC) since 1940 are analyzed to determine the clinical and histologic features of prognostic significance. The EFSCC experience confirms and extends the observations made in other recent studies of plantar melanoma. This clinical pathologic study suggests that one of the histologic patterns, the lentiginous growth pattern, shares some biologic features with lentigo maligna, namely the relatively indolent growth phase. Plantar melanomas may remain latent for a number of years making these patients good candidates for therapeutic cures if detected early. PMID- 3664432 TI - Metastatic neuroblastoma after 52 years of dormancy. AB - A metastatic neuroblastoma arose in a posterior mediastinal tumor that had been present for at least 52 years. The diagnosis of neuroblastoma was first made when the patient was 81 years of age from biopsy of a metastatic lesion to the femur and later from biopsy of the mediastinal mass. PMID- 3664433 TI - Progressive loss of vision in patients with high-grade non-Hodgkin's lymphoma. AB - Three cases of double-sided neuritis of the optic nerve in patients with lymphomas are described. Two patients with lymphoblastic lymphoma had no other signs of central nervous system (CNS) relapse. All three cases responded to high doses of corticosteroids and/or radiotherapy, suggesting a lymphomatous cause of the papillitis. Optic nerve involvement is reported to be rare in lymphomas, but may become more prominent with aggressive systemic therapy controlling manifestations outside the CNS. Possible causes of optic neuritis in patients with lymphoma are discussed and therapeutic measures are suggested. PMID- 3664434 TI - Clinical and radiologic characteristics of bone metastases in breast cancer. AB - Metastatic bone disease was evaluated in 380 consecutive patients at the time of first metastasis of breast cancer. Studies included radiographic examination, radionuclide examination, and bone marrow biopsy. Radiographs of the skeleton demonstrated metastases in 120 patients (32%), and in 40 of these patients (13%) the bone was the only site of metastases. The diagnostic efficiency was 82% for bone scanning, 80% for pain evaluation, 59% for s-calcium analyses, and 77% for s alkaline phosphatase analyses. Bone scanning is an effective method to exclude metastatic bone disease (sensitivity: 96%). A positive scan, however, requires radiologic confirmation (specificity: 66%). Bone scanning of the skeleton should be the initial staging procedure in all patients with recurrent breast cancer with no clinical or biochemical signs of bone metastases. Bilateral posterior iliac crest bone marrow aspirations and bone biopsies were positive in 82 out of the 320 patients who underwent biopsy. The frequency of positive bone marrow biopsy was significantly correlated with both the site of radiographic metastases and with the total number of involved bone regions. Routine bone marrow biopsies are indicated in patients with a positive bone scan, but a negative x-ray examination. In these cases biopsies should be performed bilaterally. PMID- 3664435 TI - The relative value of fecal occult blood tests and flexible sigmoidoscopy in screening for large bowel neoplasia. AB - The secondary prevention of colorectal cancer is based on the early detection of noninvasive cancer and removal of adenomatous polyps. The two commonly used screening tests are flexible sigmoidoscopy and guaiac fecal occult blood testing. Both were performed simultaneously and independently on 1176 asymptomatic volunteers followed by colonoscopic examination if either occult blood or a neoplasm was detected. Neoplasia (adenomatous polyps or cancer) were found in 48 screenees. Only ten had positive stool occult blood while 45 were detected by sigmoidoscopy. Analysis of sensitivity for neoplasia was 93.8% for sigmoidoscopy but only 20.8% for the occult blood tests, while the positive predictive values for neoplasia were 100% and 23.8% respectively. The fecal occult blood test detected only 18% of screenees with adenomas and 60% with invasive cancer. Flexible sigmoidoscopy detected 95% and 80% respectively. Analysis (kappa statistic) demonstrated little agreement between the two tests (P greater than 0.05), indicating that they are diagnosing different neoplasia. Evaluation of expected gain in diagnosing neoplasia, by combining both tests, gave 18% for the fecal blood test and 94% for the endoscopic test. These results confirm the complementary value of performing both tests, but especially the high sensitivity and predictive value positive of flexible sigmoidoscopy for adenomas, including those with severe dysplasia, and the converse for the fecal occult blood test. This latter test must be recommended and used within a screening program with caution and full understanding of its limitations. PMID- 3664436 TI - The long-term effects of treatment on the dental condition of children surviving malignant disease. AB - Fifty-two long-term survivors of childhood leukemia or solid tumors had a clinical dental examination along with 49 of their sibling. The 52, with an additional 30 examined in a previous study, were studied radiologically with a panoramic tomogram. All children with leukemia had received chemotherapy for 2 or 3 years and irradiation on standard protocols and the solid tumor group had received chemotherapy for 6 to 24 months. There was no difference between siblings and patients for dental caries, gingivitis, and oral hygiene, mouth opening, overjet, and overbite. More solid-tumor patients had abnormal occlusion (P less than 0.02) and those with abnormalities tended to have been treated at an earlier age. Enamel opacities and hypoplasia were more common in patients than siblings and in the leukemia than in the solid tumor group. Sixty-five percent of the children had abnormalities on radiologic examination including failure of the tooth to develop, small crown, hypoplasia of the crown, and abnormal root development. In most cases the radiologic abnormality could be correlated in time with the patient's treatment and a knowledge of the normal time of tooth development. Three teeth extracted during the course of the study were examined histologically and these showed prominent incremental lines which could be correlated in time with vincristine treatment. PMID- 3664437 TI - Patient education. Changing our focus. PMID- 3664438 TI - Motivation: the challenge for today's health promoter. PMID- 3664439 TI - Patient education. Issues, options and choices. PMID- 3664440 TI - Patient education. The outpatient way. PMID- 3664441 TI - Prenatal review classes. PMID- 3664442 TI - [Breast feeding--determining the essentials]. PMID- 3664443 TI - A routine method for cytogenetic analysis of small urinary bladder tumor biopsies. AB - A method that allows routine cytogenetic analysis of small cystoscopic biopsies from urothelial tumors is described. This method is based on prolonged mild collagenase disaggregation, a 12-16 hour culture, and harvesting procedures adapted to give maximal metaphase recovery. In addition to providing a means for cytogenetic studies of small biopsies from urinary bladder tumors, this method provides the advantages of direct preparations, with chromosome morphology and banding sufficient for karyotypic analysis. Conventional cell synchronization techniques, applied to this system, should enable high-resolution banding and optimize analysis. PMID- 3664444 TI - Translocation t(6;9)(p22.3;q34) in myelodysplastic syndrome--refractory anemia with excess blasts. AB - A 69-year-old male patient with refractory anemia with excess blasts (RAEB) was found to have a consistent chromosomal abnormality, t(6;9)(p22.3;q34), in the bone marrow and unstimulated peripheral blood cells. Twenty patients with t(6;9) and leukemia have been reported; some of them had a myelodysplastic syndrome (MDS) before developing overt ANLL. Our patient was still in the MDS stage when the t(6;9) was found. This result suggests that t(6;9) represents one of the pathways from MDS to leukemia in patients with ANLL. PMID- 3664445 TI - Paracentric inversions on the long arm of chromosome 5 in secondary myelodysplastic disorders. PMID- 3664446 TI - Chromosomal analysis of bladder cancer. II. A practical method. AB - Twenty-seven successive bladder cancer tissue specimens, varying from noninfiltrating to deeply infiltrating ones, were chromosomally analyzed using a new direct method. Recognizable metaphases were obtained from 25 specimens (93%). In nearly all cases, suitable C-banding and in nine cases G-banding was achieved. Essential steps in this method are colcemid application in two steps, interrupted by washing with Hanks' balanced sodium solution and two separated hypotonic treatments. This method is easy to use and not time consuming. PMID- 3664447 TI - Effect of high fat and nutrient depleted diets on colon tumor formation in mice. AB - We investigated the effect of high fat and nutrient depleted diets on the formation of colon tumors in female Swiss mice treated with 1,2-dimethylhydrazine (DMH). Mice received the following diets: control diet (laboratory chow, 5.5% fat) or chow with added starch and/or corn oil so as to supply a fat level of 5.5% (diet F6) or 23% (diet F23), while reducing the level of nutrients and dietary fiber per 100 calories to 61% of the level of the control diet. DMH was given as 5 weekly s.c. injections. Diets were given variously from 6 weeks before the first injection until 7 days after the last one (initiation period) or else for the subsequent 22 weeks until sacrifice of the mice (promotion period). A high fat diet (diet F23 vs. F6) tended to increase adenoma formation when fed during the initiation period but this requires further study. Feeding it in the promotion period increased the incidence of adenocarcinomas. A nutrient depleted diet (diet F6 vs. the control diet) caused a decreased incidence of adenocarcinomas. PMID- 3664448 TI - Analysis of transcripts homologous to acyl-CoA oxidase and enoyl-CoA hydratase/3 hydroxyacyl-CoA dehydrogenase induced in rat liver by methylclofenapate. AB - Methylclofenapate is a potent peroxisome proliferating agent and liver carcinogen in rats. Animals exposed to daily oral doses (2.5 mg/kg body wt.) for a 21-day period were studied to determine the levels of mRNA homologous to peroxisomal acyl-CoA oxidase and enoyl-CoA hydratase/3-hydroxyacyl-CoA dehydrogenase bifunctional enzyme in total liver RNA. Northern blotting revealed transcripts of approximately 3.8 and 3.3 kilobases (kb), homologous to acyl-CoA oxidase and the bifunctional enzyme, respectively. Levels of these transcripts began to rise at approximately 4 h after the initial dose of the agent, and reached maximum induction (35- and 60-fold, respectively, in excess of control levels) at 2-8 days after the start of the study. The kinetics of induction for acyl-CoA oxidase mRNA resembled those of palmitoyl-CoA oxidase activity, and the induction of mRNA preceded the expression of enzyme activity, further supporting a transcriptional control model of induction of the peroxisomal enzymes. The levels of mRNA induction for the peroxisomal enzymes were higher in the present study than those reported elsewhere for single doses of peroxisome proliferating agents and probably reflect the increased tissue levels achievable in long term carcinogenesis studies. PMID- 3664449 TI - Cancer mortality among relatives of children with soft-tissue sarcoma: a national survey in Italy. AB - Information was obtained on the living status or cause of death of 2223 close relatives of 195 children with soft-tissue sarcomas (STS) diagnosed under age 15. Three-hundred nine relatives had died, from all causes, before STS diagnosis in the index child. The expected figure estimated from age- and sex-specific mortality rates in Italy was 293.3. Cancer was reported as cause of death in 76 relatives (75.1 expected). Seven grandmothers, 2 aunts, 1 uncle and 0 mothers died from breast cancer vs. 4.6, 0.9, 0.0 and 0.2 expected. Three siblings died from cancer (0.2 expected, P less than 0.01), i.e. STS, ependymoma and non Hodgkin lymphoma. These results confirm and expand previous observations that STS in children are associated with other cancers, particularly childhood and breast cancer, in members of the same family. PMID- 3664450 TI - Endotoxin shock and tumour necrosis factor release in mannoheptulose-treated mice. AB - Administration of mannoheptulose partially protected mice infected with Listeria monocytogenes against the lethal effect of a subsequent endotoxin challenge. The ability of these animals to produce tumour necrosis factor was however unaffected. Mannoheptulose was observed to reverse the hypoglycaemic effect of endotoxin, possibly through inhibition of insulin secretion. The therapeutic significance of these observations is discussed. PMID- 3664451 TI - Tobacco-specific nitrosamines in the saliva of Inuit snuff dippers in the Northwest Territories of Canada. AB - Levels of tobacco-specific nitrosamines (TSNA), nicotine and cotinine were estimated in the saliva of 20 snuff dippers (Inuit, Northwest Territories, Canada). Levels of N'-nitrosonornicotine (NNN), 4-(methyl-N-nitrosamino)-1-(3 pyridyl)-1-butanone (NNK), and N-nitrosoanatabine (NAT) plus N-nitrosoanabiasine (NAB) found in the saliva following a 15-min period of keeping 0.5-1.5 g of moist snuff in the gingival groove are considerable: 115-2610 ppb NNN, 123-4560 ppb NAT + NAB, and up to 201 ppb NNK. The amount of TSNA in the saliva increases with the length of time that the snuff is kept in the mouth. The estimated total amount of 444 micrograms TSNA, the largest part of which will be swallowed, exceeds by far the amounts of nitrosamines ingested through drinking beer (0.34 micrograms/day), eating cured meat products (0.17 micrograms/day), or using cosmetics (0.41 micrograms/day). The relatively high levels of potentially carcinogenic TSNA in the saliva, together with the current popularity of snuff usage by teenagers, is of particular concern. PMID- 3664452 TI - Comparative metabolism of 7-methyl- and 7-ethylbenz[a]anthracene by rat-liver preparations. AB - The metabolism of 7-ethyl (7-EBA) and 7-methylbenz[a]anthracene (7-MBA) to dihydrodiols has been compared in incubations with hepatic microsomal fractions prepared from untreated rats. Although both hydrocarbons were found to be metabolised to similar extents, the relative proportions of their diols that were detected differed. For 7-MBA, the principal diols identified were the 8,9- and 5,6-derivatives, whereas for 7-EBA the 8,9- and 1,2-diols predominated; the 5,6 diol was only present as a minor product. These results imply that the presence of the sterically bulky ethyl group at position seven in the benz[a]anthracene ring system may, when compared to the analogous methyl derivative, enhance diol formation on the angular 1,2,3,4 benzo-ring, at the expense of metabolism at the K-region. PMID- 3664453 TI - Effect of the esophageal carcinogen methylbenzylnitrosamine and of a putative potentiating factor, a trichothecene mycotoxin, on O6-methylguanine-dna methyl transferase in rat esophagus and liver. AB - Epidemiological evidence from China and South Africa has implicated Fusaria mycotoxins in the etiology of esophageal cancer, although treatment of animals with extracts of Fusaria cultures did not cause cancer of the esophagus. Fusaria are the major producers of trichothecenes, and animal experiments have shown that these mycotoxins can damage the esophagus but they have not been shown to cause esophageal cancer. A plausible concept is therefore that esophageal cancer is initiated by the potent environmental esophageal carcinogens, certain nitrosamines, but that the levels of exposure are too low to cause clinical cancer unless their effects are enhanced by additional risk factors. Among the most likely enhancing factors in the regions mentioned above are Fusaria mycotoxins. As trichothecenes are known to inhibit sulphydryl-dependent reactions and to inhibit protein synthesis, experiments were carried out to determine whether potentiation of cancer could be mediated via inhibition of the DNA repair protein O6-methylguanine-DNA methyl transferase (O6MG-MT). The effect of diacetoxyscirpenol (DS) on O6MG-MT was studied. Chronic or acute treatment with DS did not alter the level of O6MG-MT in esophagus, or affect the depletion which occurs after injection of methylbenzylnitrosamine, or alter the rate of reappearance of O6MG-MT. A high dose of DS induced O6MG-MT in liver. These results suggest that if trichothecenes are risk factors for esophageal cancer, the effect is unlikely to be mediated by inhibition of O6MG-MT. Induction of the repair protein in liver may be relevant in the animal toxicoses caused by consumption of trichothecenes, but is unlikely to be implicated in the etiology of liver cancer in man. PMID- 3664455 TI - Smoking and lung cancer. PMID- 3664454 TI - The use of 125I-lectin probes in defining plasma membrane carbohydrate moieties in 3 subpopulations of human colonic carcinoma cells. AB - The molecular mechanism(s) responsible for the generation of phenotypic diversity within tumors is not understood. Since the cell surface/plasma membrane components are involved in a variety of important biological function such as growth and differentiation regulation which may be mediated through intercellular and/or extracellular matrix interaction, the plasma membranes from 3 human colonic carcinoma cell lines (originally isolated from a single primary tumor) were purified and characterized by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Membrane carbohydrate moieties were also characterized by a panel of 5 125I-labeled lectin probes following their electrophoretic fractionation and transfer onto nitrocellulose. Though these cell lines possessed diverse biological properties, their Coomassie blue stained electrophoretic protein profiles were found to be very conserved. The altered quantitative expression of only 1 membrane protein (Mr = 46 KD) was found to be associated with the more neoplastic HCT 116a cells which distinguished this cell line from the less neoplastic HCT 116b and HCT 116 cells. All 5 lectin binding profiles, on the other hand, clearly and easily distinguished the HCT 116a cells from the HCT 116b and HCT 116 cells. Thus, heterogeneity in terms of differences in membrane carbohydrate moieties was more obvious. PMID- 3664456 TI - Local toxicity during the subcutaneous infusion of narcotics (SCIN). A prospective study. PMID- 3664458 TI - Development and evaluation of a system for monitoring the quality of oncology nursing care in the home setting. PMID- 3664457 TI - The ethical and legal implications of hospice care. An international overview. PMID- 3664459 TI - Cervical dysplasia. An overview of current concepts in epidemiology, diagnosis, and treatments. PMID- 3664460 TI - The parent network in pediatric oncology. Supportive or not? PMID- 3664461 TI - Evaluation of competition as a method to recruit nurses into an employee self help quit-smoking program. A failed experiment. PMID- 3664462 TI - Flow cytometry analysis of DNA damage and the evaluation of cytotoxicity of alkylating agents. AB - Monoclonal antibody (MAb) F7-26 generated against nitrogen mustard (HN2)-treated DNA (O.S. Frankfurt, Exp. Cell Res., 170: 369-380, 1987) reacted with regions of local DNA denaturation (distortion) induced by DNA alkylation. The relationship between immunoreactivity of cellular DNA with MAb F7-26 and cytotoxic effects of HN2, L-phenylalanine mustard (L-PAM), and 1,3-bis(2-chloroethyl)-1-nitrosourea was studied in HeLa S3 cultures. Cells were treated with drugs for 1 h and assessed for cell survival by colony formation assay and for DNA immunoreactivity by flow cytometry. Cells were fixed in ethanol, exposed to MAb, and stained with fluorescein-labeled anti-mouse immunoglobulin. Immunofluorescence (IF) intensity was measured on a flow cytometer. For each drug the cell killing and the binding of MAb to DNA appeared in the same dose ranges. A strong correlation (r = 0.96) between cell survival (log10 surviving fraction) and IF was observed when data for HN2, L-PAM, and 1,3-bis(2-chloroethyl)-1-nitrosourea were combined. This correlation was apparent in the range of 1-5 log10 cell killing. Enhancement of L PAM cytotoxicity by buthionine sulfoximine (BSO) or hyperthermia was accompanied by a proportional increase of DNA immunoreactivity with MAb F7-26. The enhancement factors calculated from survival curves (a ratio of the dose decreasing cell survival by 1 log10 for L-PAM alone to that for L-PAM combined with modulating factor) were 1.67, 1.58, and 3.07 for BSO, hyperthermia, and BSO plus hyperthermia, respectively. For the same treatment regimens the enhancement factors calculated from drug dose-IF curves were 1.73, 1.34, and 3.79. A strong correlation between log10 surviving fraction and IF intensity (r = 0.93) was observed when data for L-PAM alone or L-PAM combined with BSO and/or hyperthermia were considered together in the range of 1-6 log10 cell killing. The cytotoxicity of alkylating agents and nitrosoureas and the effectiveness of factors modulating chemotherapeutic effects can be predicted by flow cytometry analysis of DNA immunoreactivity with MAb F7-26. PMID- 3664463 TI - Inheritance of Sinclair swine cutaneous malignant melanoma. AB - Genetic studies of familial human cutaneous malignant melanoma have failed to support a single mode of inheritance. To eliminate the complexities of genetic heterogeneity, we have turned to appropriate animal models to gain insights into possible genetic mechanisms that may be applicable to the human. Cutaneous malignant melanoma of Sinclair miniature swine is an inherited malignancy with many of the histopathological characteristics of human melanoma. The actual mode of inheritance of the melanoma has not been determined. Recently, we initiated experiments to characterize the swine major histocompatibility complex in melanoma- and nonmelanoma-bearing animals. These experiments led to the discovery of two loci that are involved in the expression of exophytic melanomas. The first locus lies within the swine major histocompatibility complex where one particular haplotype produces a phenotype in which the effects of a second locus are fully penetrant. The second locus segregates independently of the major histocompatibility complex. The melanoma-producing allele at this second locus is inherited in the heterozygous state and requires a somatic mutation of the normal allele to initiate tumor development. PMID- 3664464 TI - Thiol proteinase inhibitor in the ascitic fluid of sarcoma 180 tumor-bearing mice. AB - A thiol proteinase inhibitor (TPI) has been purified from the ascitic fluid of Sarcoma 180 tumor-bearing mice. The molecular weight of the inhibitor was estimated to be 67,000 on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and the substance inhibited papain, cathepsins B and L, but not cathepsins H and D and trypsin. The inhibitor also liberated kinin upon treatment with trypsin or mouse glandular kallikrein, indicating that the inhibitor is a kininogen, and the kinin liberated upon trypsinization was identified as bradykinin. An immunoreactive TPI with a molecular weight indistinguishable from that of the ascites TPI was found in plasma of non-tumor-bearing mice as well as that of tumor bearers. Plasma levels of immunoreactivity were increased up to twice the normal levels in tumor bearers inoculated with Sarcoma 180 or 3LL tumor cells. Supplementation of the purified ascites TPI into Sarcoma 180 culture medium caused a significant suppression of cell growth as well as [3H]thymidine incorporation at a concentration below that normally present in plasma. In contrast, addition of ascites-TPI to cultured mouse embryonic cells caused enhancement of cell growth as well as [3H]thymidine incorporation. These results indicate that in mice responding to tumor growth, a TPI corresponding to a kininogen is induced which may regulate tumor growth by countering tumor-related proteolytic activity. PMID- 3664465 TI - Absence of DNA overreplication in Chinese hamster cells incubated with inhibitors of DNA synthesis. AB - Previous reports have suggested that transient inhibition of DNA synthesis by chemicals or ultraviolet light causes some of the DNA to replicate more than once in one cell cycle, i.e., that it induces overreplication of DNA. The data that led to this suggestion were obtained from cesium chloride equilibrium density gradient analyses, in which cells were incubated with bromodeoxyuridine so that the DNA synthesized after incubation with the inhibitor could be densitometrically separated from the DNA that had been radioactively labeled before incubation with the inhibitor. An unresolved problem with these analyses was that the data also suggested that overreplication must have occurred in control cells, i.e., those not incubated with an inhibitor of DNA synthesis. We show here that the latter result is probably due to an artifact of cesium chloride equilibrium density gradient analysis, probably because of nonspecific trapping of DNA in regions of the gradients where there are large amounts of DNA. We also used another protocol that avoids this artifact; with this protocol any overreplicated DNA would be found where heavy-heavy DNA bands and nonspecific trapping cannot occur. When this protocol was used there was no evidence that transient inhibition of DNA synthesis induces overreplication of DNA. PMID- 3664467 TI - Evaluation of chimpanzee antiserum to human carcinoembryonic antigen. AB - An adult chimpanzee (Pan troglodyte) with an endogenous circulating carcinoembryonic antigen (CEA) level of 60 ng/ml was immunized s.c. with human CEA. After 1 year of immunizations, the anti-human CEA antibody titer had plateaued. This chimpanzee antiserum demonstrated high avidity specific recognition of human CEA and showed ionic strength effects for CEA recognition similar to those previously described for goat and baboon anti-CEA antisera. Radioimmunoassay of 93 human plasma samples for CEA content using chimpanzee anti CEA versus Roche goat anti-CEA antisera gave essentially identical results (R = 0.985). Endogenous CEA in chimpanzee blood was very poorly identified by chimpanzee anti-human CEA antisera compared to Roche goat antisera. Column chromatography of human and chimpanzee CEA in the presence of chimpanzee anti-CEA antibody showed only reactivity for the human CEA. In addition, chimpanzee antiserum had only minimal blocking effect on the binding of either goat or baboon antiserum to human CEA. We conclude from these studies that chimpanzee anti-human CEA antiserum recognized a determinant(s) on human CEA which was different from these recognized by goat or baboon antiserum to human CEA and this determinant(s) was poorly represented on chimpanzee CEA. In contrast, the human CEA determinant(s) recognized by baboon and goat anti-CEA antiserums were readily detected on chimpanzee (CEA). PMID- 3664466 TI - Extraction and partial purification of a hepatic stimulatory substance in rats, mice, and dogs. AB - A factor has been isolated from weanling rat liver which stimulates in vivo hepatic DNA synthesis in a dose dependent manner when injected into 40% hepatectomized rats. The factor has been partially purified by successive steps, involving ethanol precipitation, ultrafiltration through an Amicon PM 30 membrane, and finally fast protein liquid chromatography, resulting in a 38,000 fold increase in specific activity over that in the original cytosol. The factor contains a few bands in the molecular weight range of 14,000-50,000 on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Active fractions from fast protein liquid chromatography (F150), when injected into 40% hepatectomized rats, increased hepatic DNA synthesis 3-fold over the background stimulation due to the hepatectomy. The response was dose dependent over a range from 1.76 micrograms to 6.8 micrograms per 200-g (body weight) rat. Mitotic and labeling indexes confirmed that F150 stimulates both replicative DNA synthesis and cell proliferation. The factor is heat and neuraminidase resistant, trypsin sensitive, organ specific, but not species specific. PMID- 3664468 TI - Enhanced expression of a glyceraldehyde-3-phosphate dehydrogenase gene in human lung cancers. AB - We have shown that a Mr 37,000 protein whose expression is strongly enhanced in human lung cancer tissues is the subunit of glyceraldehyde-3-phosphate (GAPDH, EC 1.2.1.12). We have isolated a GAPDH complementary DNA from human lung cancer cells and deduced the complete amino acid sequence of the encoded protein. The structure of the lung cancer GAPDH is identical to that of liver GAPDH. In addition, we have found that GAPDH mRNA expression is markedly increased in human lung cancer tissues. These results disclose a molecular basis of increased glycolysis in cancer cells and reveal an important role of energy creating reaction in cancer cell growth. PMID- 3664469 TI - Structure and expression of a human class pi glutathione S-transferase messenger RNA. AB - We have used a rat glutathione S-transferase P (GST-P) complementary DNA as a probe to screen a human placenta complementary DNA library constructed in the lambda gt11 vector. One of the positive clones contained the complete coding region (630 base pair) and the entire 3'-noncoding region (78 base pair) of the putative human glutathione S-transferase pi (GST-pi) subunit mRNA. From the nucleotide sequence we deduced the complete amino acid sequence of the GST-pi subunit. It contained 209 amino acids with the relative molecular mass of Mr 23,224. Comparison of the amino acid sequences between GST-pi and GST-P subunits suggests that they are the corresponding enzymes in these species. GST-pi and GST P both consist of 209 amino acids and differ in only 30 amino acids (85.6% homology). The difference in amino acid composition can explain the large difference in isoelectric point between GST-pi subunit (pI 5.5) and GST-P subunit (pI 6.9). The expression of GST-pi mRNA in some normal and cancerous tissues, including some hepatoma cell lines, hepatoma, and colon carcinoma specimens was determined using complementary DNA as a probe. The results indicate that the mode of the expression of GST-pi in humans is different from that of GST-P in rats. PMID- 3664470 TI - Dietary fat modulation of murine mammary tumor metabolism studied by in vivo 31P nuclear magnetic resonance spectroscopy. AB - The effect of dietary fat concentration and saturation on high energy phosphate metabolites and phospholipid turnover in transplanted line 168 murine mammary tumors was studied using surface coil 31P-nuclear magnetic resonance spectroscopy. Female BALB/c mice were fed one of five diets each containing at least the minimum of essential fatty acids (EFA). Four diets contained additional safflower or palm oil for a total fat concentration of 5 or 20% by weight. The growth rate of tumors from mice fed the high safflower oil diet was significantly greater than the growth rate of tumors for mice fed all other diets including the one which contained the minimal EFA. 31P-nuclear magnetic resonance-observable phosphate metabolite ratios. ATP/Pi, ATP/phosphomonoester (ATP/PME), and PME/Pi, and tumor pH of line 168 tumors decreased with increasing tumor volume, indicating a shift from active to inactive tumor metabolism. The rates of those decreases with progressive tumor growth differed significantly among tumors of mice fed the different diets. Decreases in ATP/Pi, ATP/PME, and pH were the most rapid in the tumors of mice fed the high safflower oil diet and significantly faster than tumors of mice fed the diet containing minimum EFA. In addition, the decrease in the PME/Pi ratio of tumors was significantly greater in mice fed the high fat (high palm oil and high safflower oil) diets than mice fed the diet containing the minimum of EFA. The rate of decline of ATP/Pi and ATP/PME with progressive tumor growth was directly correlated with levels of linoleic acid as well as total unsaturated fat. High levels of a polyunsaturated fat had a significant effect on mammary tumor metabolism particularly during early stages of tumor growth. Differences in high energy phosphate metabolite dynamics relative to dietary fat were present in tumors of equal volume. Thus, dietary fat influences on mammary tumorigenesis may be related to high energy phosphate metabolites. PMID- 3664471 TI - Blood amino acid compartmentation in mice bearing Lewis lung carcinoma. AB - Blood amino acid compartmentation between plasma and red blood cells was studied in mice bearing the Lewis lung carcinoma. The animals showed a change in compartmentation with an increase in the concentration of most amino acids in the plasmatic fraction with the exception of glycine, glutamine, aspartate, asparagine, and taurine. This work focuses on the importance of studying the distribution of amino acids in both fractions when performing studies concerning amino acid metabolism in tumor-bearing animals. PMID- 3664472 TI - Purification and characterization of aplysianin E, an antitumor factor from sea hare eggs. AB - An antitumor factor, aplysianin E, inducing tumor lysis was purified to apparent homogeneity from the supernatant of a homogenate of eggs of the sea hare Aplysia kurodai. Purified aplysianin E was a 250-kDa glycoprotein containing three different subunits. This factor was half-maximally active at 2-114 ng protein/ml and lysed all the tumor cells tested but did not lyse normal white or red blood cells. Aplysianin E was labile on treatments with heat, low pH, urea, guanidine, sodium lauryl sulfate, and periodate, but not with proteases or organic solvents, Aplysianin E completely inhibited the syntheses of DNA, RNA, and protein by tumor cells within 2 h and caused their complete cytolysis within 15 h. Tumor lysis by aplysianin E was inhibited by N-acetylneuraminic acid, suggesting that recognition of the sugar moiety is a key step in cytolysis induced by aplysianin E. Aplysianin E also prolonged the survival of mice bearing syngeneic MM46 ascites or solid tumors. These results suggest that aplysianin E, found in an invertebrate, the sea hare, is a new antitumor factor. PMID- 3664473 TI - Correlation between drug uptake and selective toxicity of porfiromycin to hypoxic EMT6 cells. AB - Mitomycin C and its methylated analogue porfiromycin (Por) have significant potential as adjuncts to regimens presently used for treating solid tumors because of their preferential toxicity to cells existing in an hypoxic environment. An understanding of the factors producing the differential activity of these drugs under aerobic and hypoxic conditions would facilitate the development of new agents of this class. Previous studies have focused on the enzymes that reductively activate the mitomycins and on the interaction of these drugs with DNA; none of these studies has fully explained the differences in cytotoxicity observed under hypoxic and aerobic conditions. The present investigation demonstrates that the rate of Por uptake is directly correlated with cytotoxicity under both aerobic and hypoxic conditions. Uptake of Por into hypoxic cells is more rapid than into aerobic cells at equal drug concentrations. Hypoxic cells also accumulate drug in concentrations well in excess of those in the extracellular medium; this is apparently a reflection of drug sequestration in these cells. This sequestration of Por, which affects the rate and extent of uptake in hypoxic cells, does not take place in aerobic cells. The failure of aerobic cells to sequester drug is evidenced by the very rapid efflux of Por from these cells upon removal of extracellular Por and by the fact that aerobic cells attain a state of equilibrium between the intracellular and extracellular drug concentrations. The findings demonstrate that differences in the uptake and retention of Por are associated with the preferential toxicity of Por to hypoxic cells. PMID- 3664474 TI - Radioimmunotherapy of the GW-39 human colonic tumor xenograft with 131I-labeled murine monoclonal antibody to carcinoembryonic antigen. AB - We have investigated the therapeutic efficacy of a single injection of 131I labeled murine mouse monoclonal antibody (NP-4) against carcinoembryonic antigen using the human colonic tumor xenograft, GW-39, grown in the cheek pouches of adult hamsters. Therapeutic efficacy was dependent on the dose of radioactivity, the specificity of the antibody for the tumor, and the size of the tumor when the radioantibody was administered. A dose of 1 mCi of 131I-labeled NP-4 given 1 day after tumor transplantation completely inhibited the growth of 6 of 11 tumors over a 12-week period, and histological evidence indicated that viable tumor was absent in the tissue remaining at the injection site. Lower doses (0.5 mCi) of 131I-labeled NP-4 inhibited tumor growth over 90% in comparison to untreated animals, but the tumors eventually resumed growth. Delaying the administration of radioantibody for 4 or 7 days after tumor transplantation significantly reduced the therapeutic efficacy. Although the same dose of 131I-labeled irrelevant immunoglobulin G also inhibited tumor growth, 131I-labeled NP-4 was generally 2-3 times more effective in reducing tumor growth than was the control IgG. There was a 13% loss in body weight within 7 days after treatment with 1 mCi, but all the animals regained their weight by day 14, indicating that the level of radioactivity was tolerated well. Dosimetric calculations predicted that over 14 days a dose of nearly 2400 rads was delivered to the tumors with 131I-labeled NP 4. These results confirm our previous studies that 131I-labeled antibody can effectively inhibit tumor growth, but suggest that radioantibody therapy is most effectively administered when there is a low tumor burden. PMID- 3664475 TI - Induction of prostatic carcinomas and lower urinary tract neoplasms by combined treatment of intact and castrated rats with testosterone propionate and N nitrosobis(2-oxopropyl)amine. AB - The effect of exogenous testosterone on prostatic carcinogenicity of N nitrosobis(2-oxopropyl)amine (BOP) in intact and castrated rats was examined in Wistar-derived MRC rats. Daily administration of BOP (either s.c. or i.g.) for 3 days, at a dose of 20 mg/kg b.w. at the heights of prostatic cell proliferation induced by testosterone, led to development of a large number of prostatic tumors, the incidence of which, however, was dependent on the duration of testosterone administration. Testosterone given for life following BOP administration induced prostatic cancer in over 60% of rats, regardless of whether BOP was given orally or s.c., or whether the rats were orchiectomized or not, whereas tumor incidence was significantly lower in rats treated with testosterone for only a short period of time. One (3%) orchiectomized rat, which received testosterone only during BOP treatment, and four (15%) of rats treated with testosterone only for life also developed carcinomas. Histologically, a large number of BOP + testosterone-induced prostatic tumors were adenocarcinomas of various histological patterns and arose primarily from the dorsal lobe, whereas the great majority of squamous cell carcinomas were found in the ventral lobe. Simultaneously induced tumors were papillomas and carcinomas of the urinary bladder and urethra. Testosterone appeared to enhance the incidence of urinary bladder tumors, but not of the urethral tumors, whereas orchiectomy inhibited urethral carcinogenesis, and, to much lesser extent, urinary bladder tumor development. Rats treated weekly for 20 weeks with BOP (10 mg/kg/week i.g.) did not develop any prostatic tumors and all rats died of rectal cancer. Of rats treated similarly with BOP and with testosterone pellets for life following the last injection of BOP, 17% of rats developed prostatic cancer, all of the squamous cell type. Simultaneous testosterone and BOP treatment for 20 weeks followed by testosterone pellets for life resulted in a 39% tumor incidence (three adenocarcinomas, one anaplastic carcinoma, and five squamous cell carcinomas). The overall results suggest that testosterone plays an important role in the initiation of prostatic carcinogenesis, whereas the promotional phase is governed by the interaction of testosterone with other factors. PMID- 3664476 TI - Characterization of quantitative mucin variants from a human colon cancer cell line. AB - Colonic mucins are high molecular weight glycoproteins produced by goblet cells of colonic epithelium. Some studies have indicated that patients with colonic cancers that produce high amounts of mucin have a poorer prognosis than patients whose tumors produce low amounts of mucin. At present, however, the role of mucin in affecting the behavior of colon cancer cells is not well understood. To further elucidate the relationship between cellular mucin content and the growth characteristics and morphology of tumor cells, we utilized a replica plating technique and immunoscreening method to identify and purify variant clones of the human colon cancer cell line LS174T that produce high and low levels of mucin. This procedure enabled us to isolate two high mucin-containing variants (HM3 and HM7) and one low mucin-containing variant (LM12). These variants exhibited different morphology. Both high mucin variants tended to form cell aggregates and suspended cells with adjoining mucoid threads. The low mucin variant formed spread monolayers on the substratum with the formation of cell processes. Metabolic labeling using [3H]glucosamine demonstrated that high mucin variants synthesized 2-fold more mucin in the cell layer and secreted 3-fold more mucin into the culture medium than the low mucin variant. The colony-forming efficiency in semisolid agar for these variants positively correlated with their mucin content. High mucin variant cells when injected into athymic nude mice formed tumors 2-fold larger than those of the parental cells while the low mucin variant formed tumors only one-half as large as those of the parental cell line. These mucin variants should provide a useful model for understanding the biological behavior of mucinous colon cancer cells in vivo and in vitro. PMID- 3664477 TI - Effect of v-rasH oncogene transfection on estrogen-independent tumorigenicity of estrogen-dependent human breast cancer cells. AB - Spontaneous or therapeutically induced progression of hormone-dependent human breast cancer to a form not amenable to endocrine treatment has been frequently recorded in clinical settings. In an experimental model system, we have changed the estrogen-dependent tumorigenicity of a human breast cancer cell line, MCF-7, to an independent state by stably introducing a model oncogene, v-rasH, into this cell line by means of DNA transfection. We now show that the oncogene-transfected hormone-independent MCF-7 cells may secrete diffusible tumorigenic factors that not only support their own tumor growth in vivo, but are also humorally active in partially triggering the tumor growth of wild type previously nontumorigenic MCF 7 cells, even when the wild type cells are implanted at a distant anatomical site in the same animal. Estrogen-independent tumor formation by MCF-7 cells was also induced in 50% of animals given injection by continuous administration of conditioned media from MCF-7-ras cells. However, the wild type tumors had limited tumor growth. Tumors were verified as adenocarcinomas and by Southern blotting were shown to be derived from the cells injected. In an in vitro coculture assay, a 5- to 7-fold enhancement in anchorage-independent growth of MCF-7 cells was observed in the presence of MCF-7-ras feeder cell layer. These data suggest that v-rasH-induced estrogen-independent tumorigenicity of human breast cancer cells occurs by secretion of mitogens which may function in an endocrine manner. PMID- 3664478 TI - Microencapsulated tumor assay: new short-term assay for in vivo evaluation of the effects of anticancer drugs on human tumor cell lines. AB - A new in vivo has been developed for evaluating the antitumor activity of chemotherapeutic drugs. The assay is based on a microencapsulation technology developed by Damon Biotech, Inc., Boston, MA, which makes it possible to encapsulate human tumor cells in small (about 1 mm in diameter) microcapsules with semipermeable membranes. Microcapsules containing human tumor cells were injected i.p. into nude or C57BL/6 mice and drugs were administered i.v. The microcapsules were recovered at various intervals following treatment and determinations of drug effects were made based on the differences in the number of tumor cells recovered from the treated and nontreated animals. Using this assay we found that (a) encapsulated tumor cells grew better in the in vivo system than in vitro under the conditions tested; (b) drugs crossed the capsular membrane and killed or inhibited the proliferation of tumor cells; and (c) the antitumor effect was consistent with the relative therapeutic efficacy of drugs or level of resistance of tumor cells detected by other in vitro or in vivo tests. The tumor microencapsulation assay offers several properties which make it attractive for use in new drug development: (a) the antitumor activity of drugs can be tested against human tumor cells under conditions which provide for three dimensional growth and in vivo supply of nutrients; (b) the sensitivity of tumor cells can be assessed following exposure to drugs at concentrations which are achievable in vivo; (c) compounds requiring in vivo metabolic activation can be tested; (d) the effect of each drug injection can be quickly evaluated; (e) inhibition of tumor cell proliferation versus cytoreductive effects of drugs can be discriminated; (f) the test is applicable to virtually all histological types of human tumor cells; and (g) the tumor microencapsulation assay is a short-term, simple, and relatively inexpensive assay. PMID- 3664479 TI - Frequency and distribution of estrogen receptor-positive cells in normal, nonlactating human breast tissue. AB - We have analyzed the frequency and distribution of cells expressing estrogen receptor (ER) in cryosections of normal human breast tissue using quantitative microspectrophotometry and the estrogen receptor immunocytochemical assay. We found that the human mammary gland contained a small but distinct population of ER-positive cells, comprising approximately 7% of the total epithelial cell population from all biopsies. Stromal cells were found to be ER negative. The ER positive cells were distributed as scattered single cells, with the highest frequency and intensity of measured staining in the lobules as compared to the interlobular ducts. Moreover, on the average, 87% of the ER-positive cells were luminal epithelial cells or occupied an intermediate position in the duct wall. The intermediate cells were found not to express basal cell phenotype as determined by combined immunocytochemistry to ER and "common acute lymphoblastic leukemia antigen" selectively decorating myoepithelial cells (B.A. Gusterson et al., J. Natl. Cancer Inst., 77: 343-349, 1986). PMID- 3664480 TI - Cancer in first and second generation Americans. AB - Mortality or incidence rates of ten major neoplasms in migrants from several countries, their respective countries of origin, their American-born offspring, and United States whites were compared. Rates in succeeding generations of Americans increased most rapidly for colon cancer and most slowly for breast cancer, with ovarian cancer occupying an intermediate position and prostate cancer showing inconsistent patterns of displacement of rates among various ethnic groups. Rates of stomach, liver, and esophageal cancers declined rapidly in succeeding generations of migrants, although small residual excess risks compared to whites persisted in second generation Americans. These residual excesses were greatest for stomach cancer and least for cancer of the esophagus. Differences in rates of lung and bladder cancers were commensurate with differences in smoking patterns among the generations and ethnic groups considered. This was also true for pancreatic cancer in Asians, but not in Latin Americans. The etiological implications of these observations are discussed. PMID- 3664481 TI - Decreased risk of lung cancer in the cotton textile industry of Shanghai. AB - The relationship between lung cancer risk and work in the cotton textile industry was investigated in a large population-based case-control study in urban Shanghai, where the industry is a major employer of men and women. Personal interviews obtained occupational, smoking, and other information from 1405 newly diagnosed lung cancer cases and 1495 controls. A significantly low risk of lung cancer was associated with cotton textile employment [odds ratio (OR) = 0.7,95% confidence interval (CI) = 0.6-0.9]. In men, the decreased risk was observed among both smokers (OR = 0.7, 95% CI = 0.5-1.1) and nonsmokers (OR = 0.3, 95% CI = 0.1-1.0). In women, the risk was also decreased regardless of smoking status (OR = 0.8, 95% CI = 0.4-1.6 among smokers; OR = 0.9, 95% CI = 0.6-1.2 among nonsmokers). In both sexes, the reductions in risk tended to be greater for lung cancer cell types other than adenocarcinoma. Low risks were found regardless of occupations within the cotton textile industry; the OR for workers in textile processing who potentially had greater dust exposure was 0.8 (95% CI = 0.6-1.2), whereas the OR for those in other industry jobs was 0.7 (95% CI = 0.4-1.0). There was little difference in risk according to self-reported exposure to textile dust, and no clear trend with duration of employment or dust exposure. Reasons for the reduced risk of lung cancer in cotton textile workers without a dose response are unclear, although several methodological explanations were considered. The findings, however, appear consistent with prior epidemiological studies and are interesting in light of speculation about tumor-inhibitory factors, such as bacterial endotoxins, that are found in dusts from cotton and other fiber crops. PMID- 3664482 TI - Prolonged infusion of hexamethylene bisacetamide: a phase I and pharmacological study. AB - Hexamethylene bisacetamide (HMBA, NSC 95580), a potent polar-planar differentiating agent in vitro, was studied in a phase I trial as a 10-day continuous infusion administered every 4 weeks. Since preclinical evidence had demonstrated that the duration of HMBA exposure was an important variable in the induction of differentiation, and HMBA steady-state concentrations (Css) achieved during 5-day infusions were minimally effective at inducing in vitro differentiation, this study was conducted to evaluate the feasibility of maintaining HMBA Css for 10 days similar to levels achieved and maintained for 5 days. Twelve patients received 17 evaluable courses at three dose levels, 12, 15.8, and 20 g/m2/day. Platelet toxicity limited further dose escalation. Mean nadir and percentage of decrement in platelet counts were 175,000/microliter and 66%, and 43,500/microliter and 83%, at 15.8 and 20 g/m2/day, respectively. In this 10-day study, the percentage of decrement of platelet counts was linearly related to mean HMBA Css and to the area under the plasma concentration versus time curve (AUC). However, when combined platelet and pharmacological data from both 5- and 10-day studies were analyzed, it was apparent that the duration of HMBA exposure was an additional significant variable in predicting the magnitude of thrombocytopenia. Renal and metabolic toxicities that precluded dose escalation in previous 5-day trials of HMBA were mild and insignificant in this study. Mean HMBA Css were 0.65 +/- 0.09 mmol/liter at 15.8 g/m2/day, and 0.99 +/- 0.22 mmol/liter at 20 g/m2/day. Depletion of intracellular polyamines in peripheral blood mononuclear leukocytes was noted during several courses that were associated with profound myelosuppression, but no clear relationships were apparent between the magnitude of polyamine changes and toxicity or between fluctuations in polyamines and the magnitude of mean HMBA Css values. Based on this study, the maximum tolerated and recommended phase II doses for HMBA administered on this schedule were 20 and 15.8 g/m2/d, respectively. The administration of HMBA by a ten-day infusion at the maximum tolerated dose resulted in the delivery of lower daily doses and lower HMBA Css than on the 5 day schedule. The major toxicities differed on these schedules with thrombocytopenia being most prominent on the 10-day schedule and metabolic and CNS toxicities on the 5-day schedule.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3664483 TI - Clinical pharmacokinetics of the antitumor drug navelbine (5' noranhydrovinblastine). AB - Eleven patients with advanced cancer received navelbine (15 mg/m2) as a single i.v. bolus injection. At least 1 week later, the patients were given a 2-fold increased dose of navelbine (30 mg/m2) and, for seven of them, the 30-mg/m2 dose was repeated after a delay longer than a week. After each administration, plasma and urine were collected for 72 h and monitored for navelbine concentration by radioimmunoassay. The comparison of dose-normalized plasma level profiles showed significant time dependence (P less than 0.05) in four of the seven assessable patients. Some patients also exhibited significant (P less than 0.05) nonlinear (dose dependent) kinetic profiles. Only 3 of the 10 appreciable patients were characterized by both time independent and linear profiles. However, the plasma concentration decay curves presented a triphasic shape similar to that obtained with other antitumor Vinca alkaloids and the data were consistent with a three compartment pharmacokinetic model. The dose and/or time dependence evidenced for most of the patients did not result in marked changes in pharmacokinetic parameters among courses. The pharmacokinetics of navelbine were characterized by a high plasma clearance (0.27 to 1.49 liter.h-1.kg-1), a large distribution volume (8.2 to 48.2 liter.kg-1), and a long terminal half-life (22.1 to 67.8 h). Urine excretion was low (less than 7.9%). Thus, navelbine pharmacokinetics resembles that of other antitumor Vinca alkaloids. PMID- 3664484 TI - Retinoic acid-induced rapid loss of nuclear cyclic AMP-dependent protein kinase in teratocarcinoma cells. AB - To determine what effect retinoic acid might have in modulating cyclic AMP mediated events at the nucleus of teratocarcinoma cells, we have investigated the effect of retinoic acid treatment of F9 and PC13 cells on cyclic AMP-dependent protein kinase activity and the amounts of the RI and RII cyclic AMP binding proteins present in the nuclear fraction. Exposure of F9 cells to retinoic acid (0.1 microM) induces differentiation to parietal endoderm, while retinoic acid treatment (3 microM) of PC13 cells induces differentiation to visceral endoderm. In both cell types retinoic acid treatment causes a rapid (within 4 h) and pronounced (by 2-fold) decrease in nuclear cyclic AMP-dependent protein kinase activity. Conversely, as measured by cyclic [8-azido-32P]AMP photoaffinity labeling a similar rapid and pronounced decrease in the RI and RII regulatory subunits is observed at the nucleus. This decrease in nuclear cyclic AMP dependent protein kinases in at least two cell types may be an early event of retinoid action important in the initiation of differentiation. PMID- 3664485 TI - A unique tumor rejection antigen from the S91 murine malignant melanoma. AB - We have identified and described the characteristics of a unique tumor rejection antigen (tumor-specific transplantation antigen) obtained from the murine malignant melanoma S91. This antigen is highly restricted to the autologous melanoma and provides striking inhibition of its growth. Previously, we described common or shared tumor-specific transplantation antigens on the murine malignant melanomas B16 F10, K1735, JB/RH, and JB/MS. No cross-reactivity was obtained in this study between S91 and those four other malignant melanomas. The common tumor specific transplantation antigen resides on a glycoprotein molecule with a molecular weight of 65,000, termed B700, that shares homology with serum albumin as determined by NH2-terminal amino acid sequencing. B700, however, purified from S91 proved to be ineffective as an immunogen. PMID- 3664486 TI - Antitumor activity and pharmacokinetics in mice of 8-carbamoyl-3-methyl imidazo[5,1-d]-1,2,3,5-tetrazin-4(3H)-one (CCRG 81045; M & B 39831), a novel drug with potential as an alternative to dacarbazine. AB - A number of 3-alkyl analogues of the experimental antitumor drug mitozolomide [8 carbamoyl-3-(2-chloroethyl)imidazo[5,1-d]-1,2,3,5-tetrazin-4(3H )-one] have been screened against murine tumors in vivo. Only the compounds with a 3-methyl- or 3 bromoethyl group possessed significant antitumor activity against the TLX5 lymphoma. The 3-methyl analogue, 8-carbamoyl-3-methylimidazo[5,1-d]-1,2,3,5 tetrazin-4(3H)-one (CCRG 81045), was investigated further and found to possess good activity, when administered i.p., against the L1210 and P388 leukemias, the M5076 reticulum cell sarcoma, B16 melanoma, and ADJ/PC6A plasmacytoma. The drug was also active when administered p.o. to mice bearing the L1210 leukemia. A daily for 5 days schedule of 100 mg/kg CCRG 81045 produced increases of survival time of treated animals compared to controls of 176 and greater than 235% against the P388 and L1210 leukemias, respectively. In the female C57BL x DBA/2 F1 mouse the 10% lethal dose was 125 mg/kg daily for 5 days. CCRG 81045 was found to undergo mild alkaline hydrolysis and ring fission to form the linear triazene 5 (3-methyltriazen-1-yl)imidazole-4-carboxamide, which is the putative metabolite formed upon metabolic activation of the antitumor drug dacarbazine [5-(3,3 dimethyltriazen-1-yl)imidazole-4-carboxamide]. The half-life of CCRG 81045 at 37 degrees C in 0.2 M phosphate buffer (pH 7.4) was 1.24 h, whereas that of 5-(3 methyltriazen-1-yl)imidazole-4-carboxamide at 25 degrees C was reported to be 8 min (F. H. Shealy and C. A. Krauth, J. Med. Chem., 9:34-37, 1966). The half-life of CCRG 81045 in human plasma in vitro at 37 degrees C was 0.42 h. Pharmacokinetic experiments conducted in BALB/c mice produced plasma profiles of CCRG 81045, administered i.p. or p.o., which showed a rapid absorption phase, elimination half-lives of 1.13 h (i.p.) and 1.29 h (p.o.), and a bioavailability of 0.98. PMID- 3664487 TI - Chemosensitivity testing of human colorectal carcinoma cell lines using a tetrazolium-based colorimetric assay. AB - The in vitro chemosensitivity of 11 human colorectal cell lines to seven chemotherapeutic agents was determined using a semiautomated tetrazolium-based colorimetric assay (MTT assay). Four of the cell lines were from primary tumors and seven from metastases. Eight lines were from patients with no prior chemotherapy. From assay results, we predict 5-fluorouracil (5-FU) to be the sole active agent of the seven tested. This is based on two observations: the range of drug concentrations which produced 50% inhibition of cell growth was greatest with 5-FU (388-fold versus 5- to 30-fold with the other six agents); and the area under the curve (AUC) which produced 50% growth inhibition was within a clinically achievable range only for 5-FU. Since the assay AUC of 5-FU at 50% inhibition was in a clinically achievable range for only two of the 11 cell lines, we performed a multivariate analysis to explore parameters which predict 5 FU sensitivity. In the best fitting model, sensitivity was positively correlated with cloning efficiency in media and with cell surface TAG-72 (a tumor-associated glycoprotein found on epithelial tumors of ovary, lung, colon, and breast origin) expression. If validated with an in vivo test such as the nude mouse model, the MTT assay could be very useful in new drug screening for colorectal carcinoma, for examining combination chemotherapy for synergy, for exploring strategies for biochemical modulation, and perhaps in individualizing therapy when cell lines can be established from a patient. PMID- 3664488 TI - Use of insulation to reduce extremity temperature nonuniformity during whole body hyperthermia in dogs. AB - Previously we have shown in dogs that tibial bone marrow and s.c. tissue temperatures are lower than rectal temperature during the plateau phase of whole body hyperthermia with the use of a radiant heating device. In an attempt to increase thermal dose to these sites during whole body hyperthermia, we applied insulation to an extremity prior to the plateau phase of heating. We found that extremity insulation during whole body hyperthermia resulted in increased s.c. tissue and tibial bone marrow temperatures. With insulation, tibial bone marrow and rectal temperature were nearly equal but s.c. tissue temperature, although greater than without insulation, remained lower than rectal temperature. High efficiency extremity insulation or supplemental heating techniques may be necessary during whole body hyperthermia with the use of the radiant heat device in order to assure that extremities receive the prescribed thermal dose. PMID- 3664489 TI - Estrogen conjugates and serum factors mediating the estrogenic trophic effect on MCF-7 cell growth. AB - Estrogens stimulate growth of MCF-7 breast cancer cells in monolayer culture. Possible interference of serum factors leading to an estrogen-insensitive cell growth was analyzed in various experiments carried out on serum batches producing no estradiol stimulation. Out of five estrogen conjugates, only 3-glucurono estradiol partly suppressed the inhibition of hydroxytamoxifen; the conjugate also reduced the estrogen receptor content of the cells, probably by a down regulation process ("processing"). Moreover, prolonged subcultures in dextran coated charcoal-treated serum attempting to remove possible intracellular estrogens produced no growth stimulation. Interference by hormone carriers of the serum was ruled out by the fact that two strong synthetic estrogens, moxestrol and diethylstilbestrol with weak binding affinity for these carriers, were unstimulatory. Reduction of the carrier concentration also failed to confer any estrogen sensitivity. This lack of effect of most estrogen conjugates and serum carriers seems to contradict the hypothesis of their interference leading to an estrogen-insensitive growth. Presence in the serum of potential inhibitors towards estrogen action was also examined. Dilution of sera inducing an estrogenic stimulated growth failed to show any growth increase, either in the absence or presence of estradiol, thus excluding the possibility of a major influence of an antagonism on growth control. Moreover, clonogenic assays in soft agar eliminated the hypothesis that a difference between "active" (stimulatory with estradiol) and "inactive" serum batches may result from distinct adherence properties rather than from real growth stimulation. All of these data are consistent with the concept that serum factors which are not of estrogenic nature mediate the trophic effect of estradiol; their absence in some serum batches may lead to an estrogen-insensitive cell growth. PMID- 3664490 TI - Relationship between modulation of natural killer cell activity and antitumor activity of bropirimine when used in combination with various types of chemotherapeutic drugs. AB - Bropirimine (ABPP), a pyrimidinone, is currently under clinical trial for its antitumor potential. Bropirimine alone was marginally active against some experimental tumors such as B16 melanoma but was ineffective against others such as P388 or L1210 leukemia. However, it produced statistically significant synergistic activity against P388 leukemia when used in combination with cyclophosphamide (CY). The aim of this investigation was to determine whether the synergism could be achieved with different types of cytotoxic drugs. Actinomycin D (act D), adriamycin, 5-azacytidine, cisplatin, melphalan, mitomycin C, and vincristine were selected. Using an experimental protocol identical to that of CY and bropirimine combination therapy, and using a more or less equally effective dosage of the drug for the initial reduction of tumor burden (i.e., around 100% increase of life span), cisplatin and bropirimine also produced a statistically significant synergism over the treatment with cisplatin alone. The combination of bropirimine with either adriamycin, mitomycin, or vincristine was beneficial but the effect was not as consistent or as striking as that seen with the CY and bropirimine combination. It is clear, however, that the combination of act D and bropirimine was not synergistic under the experimental conditions. Since the antitumor activity of pyrimidinone has been reported to be mediated in part by its stimulation of natural killer cell activity, the effect of these cytotoxic drugs on the immunomodulatory activity of bropirimine was investigated. Like CY, cisplatin did not alter the augmentation of natural killer cell activity by bropirimine. However, adriamycin, mitomycin, or vincristine showed a marked inhibition (25-50%) of the augmentation. Act D completely inhibited the immunomodulating activity of bropirimine 4 days after drug administration and continued to show marked inhibition 18 days later. This may partially explain the reasons for lack of synergism between act D and bropirimine. A prolonged immunosuppressive effect exhibited by act D and the degree of tumor repopulation during this period could render bropirimine ineffective. In addition to the magnitude of initial tumor burden reduction by the chemotherapeutic drugs, the present results indicate that the immunosuppressive property of these drugs may also affect the outcome of chemoimmunotherapy. PMID- 3664491 TI - Chemoprevention of colon carcinogenesis by dietary organoselenium, benzylselenocyanate, in F344 rats. AB - The effect of feeding benzylselenocyanate (BSC) and its sulfur analogue, benzylthiocyanate (BTC), 2 wk before, during, and until 1 wk after carcinogen administration (initiation phase) on intestinal carcinogenesis induced by azoxymethane (CAS:25843-45-2) was studied in male F344 rats. Weanling rats were raised on a semipurified diet (AIN-76A diet; control diet). Beginning at 5 wk of age, groups of animals consuming the control diet were fed one of the diets containing 25 ppm BSC or BTC. An additional group was continued on the control diet. At 7 wk of age, all animals in 3 groups, except the vehicle-treated controls, were administered s.c. injections of azoxymethane (15 mg/kg body weight, once weekly for 2 wk). Animals were continued on the control diet and BSC and BTC diets until 1 wk after carcinogen treatment, when those groups receiving BSC and BTC diets were fed the control diet until termination of the experiment. Tissue and blood plasma glutathione peroxidase activity was measured in vehicle treated animals fed the control diet and BSC and BTC diets for 5 wk. The results indicate that body weights were comparable among the various dietary groups. BSC in the diet significantly inhibited the incidence (percentage of animals with tumors) and multiplicity (tumors/animal) of adenocarcinomas in the colon and multiplicity of adenocarcinomas in the small intestine compared to those fed the control diet. BTC in the diet had no effect on colon and small intestinal tumors. Selenium-dependent glutathione peroxidase activity was significantly increased in kidneys and colon and small intestinal mucosae of animals fed the BSC diet compared to animals fed the BTC and control diets. PMID- 3664492 TI - Collateral methotrexate resistance in cultured human head and neck carcinoma cells selected for resistance to cis-diamminedichloroplatinum(II). AB - A human head and neck squamous cell carcinoma line (SCC25) derived from a patient with no prior history of radiotherapy or chemotherapy was made resistant to cis diamminedichloroplatinum(II) (CDDP) by continuous escalation of weekly 30-min pulses of the CDDP from 0 to 0.2 mM over 20 months and then cloned and pulsed weekly with 0.2 mM CDDP for another 20 months. This afforded a resistant subline, SCC25/CP[1], with an IC50 for CDDP 12-fold higher than that of the parental cells. The SCC25/CP[1] cells unexpectedly proved to be cross-resistant to methotrexate (MTX) (24-fold for 30-min treatment and 8-fold for continuous treatment). Resistance was associated with a modest (about 2-fold) increase in the dihydrofolate reductase (DHFR) content according to radioligand-binding assay, and in the rate of cell division. In addition there was a 4-fold decrease in the fraction of long-chain MTX polyglutamates MTX(G4-6) in the cell after 24 h exposure to either 0.2 or 2.0 microM MTX. When the SCC25/CP[1] cells were kept out of CDDP for 8-9 months and 12 months to give the sublines SCC25/CP[2] and SCC25/CP[3], respectively, MTX sensitivity to continuous exposure returned to normal. The SCC25/CP[3] cells still exhibited a slightly elevated DHFR level, but their generation time became shorter than that of the parental SCC25 line. In addition the SCC25/CP[3] cells had an initial uptake velocity (V0) for MTX that was 9-fold greater than the V0 of the SCC25 or SCC25/CP[1] cells, while its ability to form MTX(G4-6) was comparable to that of the SCC25 cells. When SCC25/CP[2] cells were rechallenged with weekly 0.2 mM CDDP pulses for 4-6 months, a MTX-resistant line, SCC25/CP[4], was produced. The SCC25/CP[4] cells retained a slightly elevated DHFR content and a high proliferation rate, but the V0 for MTX influx was intermediate between SCC25 and SCC25/CP[3] cells. The ability to form the longer-chain polyglutamates MTX(G4-6) was again impaired. Thus, MTX cross-resistance can develop in cultured head and neck carcinoma cells when CDDP is used as the selecting agent for primary resistance. MTX resistance is multifactorial, as it is when MTX itself is used as the selecting agent, and appears to involve various combinations of altered growth rate, DHFR content, MTX uptake, and ability to form noneffluxing long-chain MTX polyglutamate species. These results are potentially of clinical relevance, since CDDP and MTX are often used in combination with other drugs or with radiation to treat patients with squamous cell carcinoma of the head and neck. PMID- 3664493 TI - Intrathecal administration of 4-hydroperoxycyclophosphamide in rhesus monkeys. AB - The preactivated cyclophosphamide analogue, 4-HC, does not require activation by hepatic microsomal enzymes to express its cytotoxic activity and therefore, unlike cyclophosphamide, may be useful for the regional therapy of cancer. In the present study, the pharmacokinetics and toxicology of 4-HC were studied following intraventricular administration of 0.4 mg to rhesus monkeys with chronic indwelling Ommaya reservoirs. 4-HC was measured in cerebrospinal fluid (CSF) and plasma with a high-performance liquid chromatography assay utilizing a fluorometric detector following derivatization with m-aminophenol. The mean peak level of 4-HC in ventricular CSF was 100 microM 5 min after administration. The drug was cleared rapidly and the elimination was monoexponential with a mean half life of 22 min. The mean clearance from CSF (0.33 ml/min) was 10-fold higher than CSF bulk flow. The drug was distributed throughout the subarachnoid space with lumbar levels approaching ventricular levels by 60 min. Neither acute nor chronic neurotoxicity or systemic toxicity was observed during the 6-wk observation period. Concentrations of 4-HC demonstrated to be cytocidal in vitro against human breast cancer, lymphoid leukemia, and rhabdomyosarcoma were readily achieved in CSF following intraventricular administration. This study demonstrates that intraventricular therapy with 4-HC is feasible and suggests that further study of this approach in the clinical setting should be considered. PMID- 3664494 TI - Effects of 3'-(3-cyano-4-morpholinyl)-3'-deaminoadriamycin and structural analogues on DNA in HT-29 human colon carcinoma cells. AB - The potent Adriamycin (ADR) analogue, 3'-(3-cyano-4-morpholinyl)-3' deaminoadriamycin (CMA), produces DNA-DNA cross-links in human and murine tumor cells. The cellular pharmacology of CMA, its derivative, 5-imino-3'-(3-cyano-4 morpholinyl)-3'-deaminoadriamycin (ICMA), 3'-(4-morpholinyl)-3'-deaminoadriamycin (MA), and ADR was evaluated in HT-29 human colon carcinoma cells to determine the structural requirements for the cross-linking activity of CMA, and the role of this activity in the antitumor effect of this agent. CMA was 50-fold more cytocidal than ICMA to HT-29 cells, 300-fold more toxic than MA, and 150-fold more potent than ADR. Both CMA and ICMA produced DNA-DNA cross-links in HT-29 cells but, consistent with its reduced cytotoxicity, the imino derivative was 30 fold less active than CMA. No DNA-DNA cross-links were observed with MA or ADR. CMA also showed cross-linking activity in isolated HT-29 nuclei, indicating that cytoplasmic activation was not required for this effect. Both CMA and ICMA produced cross-links in isolated lambda-phage DNA with CMA being 40-fold more active than the imino derivative, and this activity was unchanged in the presence or absence of a reducing agent. While MA and ADR produced DNA strand breaks in HT 29 cells, this damage was not observed with CMA and ICMA. This study indicates that the potent antitumor activity of CMA may be related to its ability to induce DNA cross-links, which can occur without the need for metabolic activation. The cyanide group appears to be essential for cross-linking and the quinone group may also be involved, but by a mechanism unrelated to its reduction. PMID- 3664495 TI - Effects of chronic dietary ethanol on in vivo and in vitro metabolism of methylazoxymethanol and on methylazoxymethanol-induced DNA methylation in rat colon and liver. AB - We examined the metabolism of 14C-labeled methylazoxymethanol (MAM) in male F344 rats pair-fed for 21.0 days either a liquid control diet, an isocaloric liquid diet containing 6.6% ethanol by volume (continuous ethanol diet), or the ethanol diet for 20.5 days followed by the control diet for 0.5 day (interrupted ethanol diet). Compared to rats fed the control liquid diet, metabolism of [1,2-14C]MAM acetate to exhaled 14CO2 was inhibited by 25 to 42% in rats fed the continuous ethanol diet, but was initially stimulated by 90% in rats given the interrupted ethanol diet. MAM-induced DNA methylation, as reflected in 7-methylguanine and O6 methylguanine content 24 h after carcinogen administration, was inhibited in the colon mucosae of rats fed the interrupted ethanol diet by 52 to 54%, and an even greater inhibition (71 to 86%) of DNA methylation occurred in the colon mucosae of rats fed the continuous ethanol diet. Liver DNA methylation was significantly inhibited (by 32 to 42%) only in those rats fed the continuous ethanol diet. Liver microsomes isolated from rats fed the 3 diets metabolized MAM to formic acid and methanol in vitro, but liver microsomes from rats fed the continuous ethanol diet were 12 to 15 times more active than liver microsomes from rats fed the control diet. Liver microsomes isolated from rats fed the interrupted ethanol diet were only 3 to 5 times more active in MAM metabolism than liver microsomes from rats fed the control diet, indicating very rapid turnover of the ethanol induced enzyme(s) catalyzing the oxidation of MAM. Although chronic ethanol feeding enhanced the activity of liver microsomes for MAM metabolism, ethanol was found to inhibit the reaction competitively. Hepatocytes isolated from rats fed the continuous ethanol diet were considerably more sensitive to MAM-induced unscheduled DNA synthesis than hepatocytes isolated from rats given the control liquid diet, indicating that the stimulation of MAM metabolism by dietary ethanol results in increased DNA damage, observable in an in vitro system. Thus, the increased metabolic activation of MAM, due to enzyme induction by ethanol which is observed in vitro, is not reflected in increased liver DNA methylation in vivo.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3664496 TI - Antitumor activity of 7-ethyl-10-[4-(1-piperidino)-1-piperidino]carbonyloxy camptothec in, a novel water-soluble derivative of camptothecin, against murine tumors. AB - The search for new water-soluble analogues of camptothecin (CPT) with higher activity and less toxicity has led to the development of a novel compound, 7 ethyl-10-[4-(1-piperidino)-1-piperidino]carbonyloxy-camptothecin (CPT-11), which showed significant antitumor activity against a broad spectrum of experimental tumor models by i.p., i.v., or oral administration. When its activity against L1210 was compared with that of CPT and known derivatives, CPT-11 was most effective, giving the highest maximum increase in life span (ILS) and showing good activity over a wide dose range. The antitumor activity of CPT-11 was shown against tumors not only in the ascites form but also in the solid form. Included among the more susceptible murine tumors are S180, Meth A fibrosarcoma, Lewis lung carcinoma, Ehrlich carcinoma, MH134 hepatoma, mammary carcinoma of C3H/HeN mice, L1210, and P388 leukemia. Probable cures of these tumors were induced frequently by CPT-11. The antitumor activity of CPT-11 against i.p.-implanted L1210 was superior to that of Adriamycin in maximum ILS, the number of cured mice, and the therapeutic ratio. CPT-11 at a dose of 100 mg/kg produced an ILS in excess of 300% with five of six mice surviving tumor free, and effected 100% tumor regression at 200 mg/kg, whereas the optimum dose of Adriamycin, 12.5-25 mg/kg, brought about 114-129% ILS with one of six mice surviving. The acute toxicity of CPT-11 was extremely low, particularly in the case of oral administration. CPT-11 is expected to be clinically useful. PMID- 3664497 TI - Regulation of N-nitrosodimethylamine demethylase in rat liver and kidney. AB - In previous work, the low Km form of N-nitrosodimethylamine (NDMA) demethylase has been demonstrated to be due to a specific form of cytochrome P-450 (designated as P-450ac) and to be the enzyme required for the metabolic activation of NDMA. The present work deals with the regulation of P-450ac in rat liver during development as well as the mechanism of induction of P-450ac in rat liver and kidney by inducers. NDMA demethylase activity was almost undetectable in the liver of newborn rats, increased after day 4, and remained elevated throughout the first 17 days of the neonatal period. The enhancement of NDMA demethylase activity during development was accompanied by corresponding increases of P-450ac content and P-450ac mRNA levels as determined by Western and slot blot analyses, respectively. No sex differences with respect to this enzyme were observed in the developing rats. Acetone treatment on late-term pregnant rats for 2 days resulted in transplacental inductions of P-450ac and P-450ac mRNA in the newborn rats. Pretreatment of young male rats and adult female rats with acetone or isopropyl alcohol caused increases of NDMA demethylase activity and P 450ac content in the liver but no significant change in the P-450ac mRNA level. These facts suggest the possible existence of a posttranscription regulatory mechanism under these induction conditions. The presence of P-450ac in rat kidney was demonstrated by Western and Northern blot analyses. The renal form of P-450ac seemed to be regulated in a fashion similar to the hepatic P-450ac regarding its response to inducing factors such as fasting and acetone treatment. PMID- 3664498 TI - Antibody-directed targeting of liposomes to human cell lines: role of binding and internalization on growth inhibition. AB - Small unilamellar liposomes containing methotrexate or methotrexate-gamma aspartate were conjugated to Staphylococcus aureus protein A and were thus able to bind cell-specific immunoglobulins for targeting to malignant human B- and T cell lines. We were able to demonstrate enhanced protein A liposome uptake and growth inhibition by targeting with an anti-major histocompatibility complex class II antibody recognizing two different B-cell lines. The enhanced growth inhibition was specific for the targeting antibody and amounted to a 2- to 3-fold lowering of the concentration of drug required to inhibit cell growth by 50% as compared to nontargeted liposomes or liposomes targeted with an antibody not recognizing a cell surface antigen. A strong association between enhanced growth inhibition and liposome internalization as assessed by fluorescent-activated cell sorter analysis of carboxyfluorescein containing protein A liposomes was seen. By contrast, specific enhancement of growth inhibition was not seen with several anti-idiotype antibodies or antibodies to T-cell differentiation antigens. Liposome internalization did not occur with these antibodies. Failure of growth inhibition and PA liposome internalization could not be explained by differences in cell binding of the antibody PA liposomes or the degree of protein A binding of the targeting antibody. Although the ability of the targeting antibody to bind to the cell and to protein A are important, these factors alone are not sufficient to guarantee internalization and growth inhibition. Variations in rates of internalization of various cell surface antigen-antibody complexes may account for different protein A liposome mediated cytotoxicities. PMID- 3664499 TI - Effect of cycloheximide or puromycin on induction of thermotolerance by heat in Chinese hamster ovary cells: dose fractionation at 45.5 degrees C1. AB - While studying the quantitative relationship between hyperthermia-induced heat shock proteins (HSPs) and thermotolerance (TT), we observed that heat induced a family of HSPs, particularly an HSP 70 family, that might be involved in the development of TT. When cells were heated for 10 min at 45.5 degrees C, they became thermotolerant to a second heat exposure at 45.5 degrees C, with a thermotolerance ratio of 5-6 at 10(-3) isosurvival at 12 h after heating. In parallel, during the 12-h interval, heat shock resulted in a 2-fold relative increase in the synthesis of three major HSP families (Mr = 110,000, 87,000, and 70,000). Rate of synthesis was expressed relative to total protein synthesis, as studied with one-dimensional polyacrylamide gels analyzed by counting radioactivity in selected protein bands. The increase of unique HSPs, if studied with two-dimensional gels, would probably be much greater. Furthermore, even though the development of TT was partially suppressed by treatment with cycloheximide (10 micrograms/ml) or puromycin (100 micrograms/ml) at concentrations that inhibited total protein synthesis by 96 or 99%, respectively, a family of HSP 70 was still preferentially synthesized. Nevertheless, when cells were labeled for 3 days, the total level of HSP families did not change either when TT developed after a triggering heat treatment or as the development of TT was partially inhibited by suppressing protein synthesis with cycloheximide or puromycin. Thus, TT could still occur when total levels of HSP families did not change and when synthesis of HSP families was less than in unheated control cells, which may imply that TT is unrelated to HSPs. However, the finding that the amount of TT increased with increased synthesis of both total protein and HSP families, as studied with different concentrations of cycloheximide or puromycin, suggests that heat-inducible proteins, in particular the observed preferential synthesis of the HSP 70 family, may be necessary for the development of TT. PMID- 3664500 TI - Effects of intermittent diethylstilbestrol diphosphate administration on the R3327 rat prostatic carcinoma. AB - Clinical trials have utilized intermittent diethylstilbestrol diphosphate (DES) therapy in advanced symptomatic prostatic carcinoma to diminish the morbidity of standard endocrine therapy. To determine the effect of intermittent DES administration on the Dunning R3327 rat prostatic adenocarcinoma 60 days following tumor implant, 6 groups were randomly assigned: control (N = 8), castrate (N = 10), high dose DES (N = 8, 1.6 micrograms/ml DES continuously in drinking water), low dose DES (N = 10, 0.4 microgram/ml continuously in drinking water), intermittent high dose DES (N = 10, 1.6 micrograms/ml DES in drinking water for 1 week, then off for 3 weeks), and intermittent low dose DES (N = 10, 0.4 microgram/ml DES for 1 week, then off for 3 weeks). Results indicate that low or high dose DES, and intermittent low or intermittent high dose DES during the week of administration were able to reduce serum testosterone to castrate levels (0.1 ng/ml). After withdrawal of intermittent DES, serum testosterone returned toward control levels (1.0 ng/ml). Initial mean tumor burden between control and treatment groups was not significantly different. All DES exposed rats had a tumor volume at death (range, 15.6-18.3 cm3) smaller than control (mean, 25.4 cm3) or castrate (mean, 40.8 cm3) rats. Despite this significant survival advantage from the time of randomization was achieved only in castrate (median survival, 331 days) or high dose DES (median survival, 359 days) groups compared to control (median survival, 225 days). Similarly, significant prolongation in tumor doubling time was achieved only by rats receiving castration or high dose DES. Intermittent DES administration controls tumor volume but does not provide a survival advantage. In this respect, intermittent DES is inferior to castration. PMID- 3664501 TI - Mechanism of action of 5,8-dideazaisofolic acid and other quinazoline antifols in human colon carcinoma cells. AB - The clonal cytotoxic effects and mechanism of action of a new series of 2-amino-4 hydroxyquinazoline folate analogues (5,8-dideazafolates) have been assessed using the human colon tumor cell line HCT-8. Of these compounds only 5-methyl-5,8 dideazafolate was potentially more effective than a compound previously identified, 5,8-dideazaisofolate (H-338, NSC 289517). HCT-8 sublines resistant to methotrexate, 5-fluorodeoxyuridine, and H-338 were either minimally or not cross resistant to the other agents. The cytotoxicity of H-338 was strongly dependent on the time of exposure; at exposure times shorter than 8 h it was essentially nontoxic. Thymidine alone, as well as leucovorin or folic acid, protected against the cytotoxic effects of H-338. This is consistent with thymidylate synthase (TS) as its only locus of action. Studies with dihydrofolate reductase and TS isolated from HCT-8 cells indicated that these quinazolines were weaker inhibitors of dihydrofolate reductase than was methotrexate, but they were not particularly potent TS inhibitors. However, synthetic poly-gamma-glutamate derivatives of quinazolines showed dramatically increased TS, but not dihydrofolate reductase, inhibition. TS inhibition increased as the polyglutamate chain length increased. Using isolated HCT-8 folylpolyglutamate synthetase, all the parent quinazolines containing L-glutamate were found to be substrates. With H-338, the results indicated that tetraglutamate or longer derivatives could be synthesized intracellularly. These results are consistent with our hypothesis that cytotoxicity by such quinazolines necessarily involves "lethal synthesis" from a prodrug; i.e., the nontoxic parent drug must be converted to polyglutamates before TS inhibition and subsequent cytotoxicity can occur. PMID- 3664502 TI - Genetics of multidrug resistance: relationship of a cloned gene to the complete multidrug resistant phenotype. AB - Resistance to multiple chemotherapeutic agents remains the major cause of failure in cancer chemotherapy. Multidrug resistant cell lines developed in vitro have provided a useful model for analyzing this phenomenon. We describe a complementary DNA, lambda DR11, which is present in normal cells and overexpressed in multidrug resistant cell lines. We have placed this complementary DNA in an expression vector which uses the beta-actin promoter to drive transcription and introduced this vector via transfection into drug sensitive cells. Cells expressing increased levels of lambda DR11 are resistant to the same broad spectrum of chemotherapeutic agents which characterize the multidrug resistant phenotype. The expression of this complementary DNA in transfected clones is dependent upon the number of copies of lambda DR11 integrated in the genome as well as the amount of selective pressure placed on the clone during selection of the clone. Furthermore, the number of copies of lambda DR11 in the genome and the expression of lambda DR11 can be modulated by releasing an individual clone from selective pressure or by increasing the selective pressure on the clone. The endogenous sequences encoding the multidrug resistance gene are not amplified in transfected drug resistant clones. Finally, the drug resistant phenotype is reversed in the transfected clones by verapamil just as drug resistance is reversed in multidrug resistant cell lines. PMID- 3664503 TI - Adriamycin resistance in human tumor cells associated with marked alteration in the regulation of the hexose monophosphate shunt and its response to oxidant stress. AB - We found that Adriamycin increased the pentose phosphate shunt activity in both Adriamycin-sensitive (WT) and Adriamycin-resistant (ADRR) human breast cancer MCF 7 cells. In contrast, hydrogen peroxide and cumene hydroperoxide markedly stimulated pentose-shunt activity in ADRR but only moderately increased the activity in WT cells. Furthermore, the altered oxidation-reduction regulation is associated with changes intrinsic to the key enzymes of the pentose-shunt pathway, glucose-6-phosphate dehydrogenase, and 6-phosphogluconate dehydrogenase and with glutathione peroxidase. We found the Vmax values for glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase were 50- and 4-fold lower, respectively, in ADRR than WT cells and the Kms of NADP+ were 10-fold lower in ADRR than WT. The activity of glutathione reductase in ADRR is 42% of that in WT. In spite of these changes, the response of the cells to both hydrogen peroxide and organic peroxide is not limited by either the capacity of the pentose shunt or glutathione reductase, but is determined by the activity of glutathione peroxidase and a glutathione transferase which possess peroxidase activity. The kinetic properties of the glucose-6-phosphate dehydrogenase in ADRR may, however, seriously limit the activity of cytochrome P-450 reductase, a major enzyme of Adriamycin conversion to a free radical. PMID- 3664504 TI - Microbial iron chelator-induced cell cycle synchronization in L1210 cells: potential in combination chemotherapy. AB - Parabactin, a microbial iron chelator (a siderophore), is shown to be a more potent cell synchronization agent than either desferrioxamine or hydroxyurea. When the L1210 cell cycle is blocked with parabactin, cells are held at the G1-S border. If the ligand is later washed away, the block is reversed, and the cells cascade into S phase. The cells are synchronized through three cell cycles. The siderophore-induced block is exploited in the inhibition of growth of L1210 cells by combination with the antineoplastics, doxorubicin (Adriamycin), cytarabine, and bischloroethyl nitrosourea. The growth-inhibitory effects of Adriamycin, cytarabine, and bischloroethyl nitrosourea in combination with parabactin are shown to be dependent on the time frame in which the combination of drugs is presented to the cells. The results are in keeping with changes in L1210 cell cycle kinetics induced by the catecholamide chelator, parabactin. PMID- 3664505 TI - Expression of cloned sequences in biopsies of human colonic tissue and in colonic carcinoma cells induced to differentiate in vitro. AB - A computer-based scanning and image-processing system has been developed to quantitate the relative level of expression of each of 4000 cloned complementary DNA sequences in small biopsies routinely removed from the mucosa of normal and neoplastic human large intestine. Individuals have been studied from well-defined population groups in which colonic epithelial cells have progressed to increasingly advanced stages of neoplastic transformation. Comparison of normal colonic mucosa to colonic carcinomas demonstrated alterations in expression of approximately 7% of the cloned sequences; fewer changes were found between benign colonic adenomas and either normal colonic mucosa or carcinomas. A subset of the sequences which change in expression during progression from normal mucosa, to adenoma, to carcinoma showed complementary changes when colon carcinoma cells were induced to differentiate in vitro with sodium butyrate; quantitative correlations between in vivo and in vitro results were highly significant. Comparison of normal colonic mucosa with mucosa from patients with the autosomal dominant disease familial polyposis revealed more extensive alterations in gene expression involving approximately 25% of the clones screened. Flat colonic mucosa in familial polyposis is therefore markedly aberrant and may be highly dedifferentiated, suggesting several possible mechanisms for the very high incidence of cancer that develops in this epithelium. PMID- 3664507 TI - Direct action of 17 beta-estradiol on mouse mammary ducts analyzed by sustained release implants and steroid autoradiography. AB - 17 beta-Estradiol is a recognized mammary mitogen, but uncertainty exists as to whether its normal action is mediated exclusively through the pituitary or whether in addition direct effects of estradiol on mammary tissue may play a role in mammary growth and development. To further investigate the action of estradiol on the developing mammary ductal system of young mice, implants of biocompatible ethylene vinyl acetate copolymer, which deliver small amounts of steroid locally to the target tissue, were implanted into the mammary glands of castrated females in which the ductal system was static and end buds had regressed. Within 3 days end buds appeared in the vicinity of the implants but not elsewhere in the gland and not in other glands of the animal, indicating direct stimulation. The new end buds were histologically normal, displaying a visible cap (stem) cell layer with high levels of DNA synthesis. The antiestrogen keoxifene, which competes with estrogen for its receptors, inhibited end bud formation in the estradiol implanted gland but failed to inhibit growth when implanted into the glands of intact, 5-week-old females. Time course and dose-response studies of estradiol stimulation were carried out in ovariectomized animals and were consistent with a direct action for estrogen. Steroid autoradiography revealed estrogen receptors in the lumenal cells of the end bud, in ductal epithelium, and in stroma adjacent to ducts, but none was detected in the rapidly proliferating cap cells. We conclude that estrogen, perhaps acting on nonepithelial target cells and probably in conjunction with extramammary factors, directly stimulates mammary ductal growth. PMID- 3664506 TI - Reduced levels of drug-induced DNA cross-linking in nitrogen mustard-resistant Chinese hamster ovary cells expressing elevated glutathione S-transferase activity. AB - We have reported previously (C. N. Robson et al., Cancer Res., 46: 6290-6294, 1986) the isolation of a Chinese hamster ovary cell line, designated CHO-Chlr, that exhibits resistance to bifunctional nitrogen mustards while maintaining the normal parental level of sensitivity to several other alkylating agents. We have compared the rate of formation and repair of DNA cross-links induced by mechlorethamine in CHO-Chlr and parental CHO-K1 cells, both in intact cells and in isolated nuclei. Equimolar doses of mechlorethamine induce significantly fewer DNA interstrand cross-links in CHO-Chlr cells than in CHO-K1 cells, but levels of DNA-protein adducts are approximately equivalent in the two lines. There is a correlation between the relative resistance of CHO-Chlr cells to mechlorethamine (34-fold) and the amount of drug required to induce approximately equal numbers of DNA interstrand cross-links in the two cell lines. This strongly implicates DNA-DNA adducts in the cytotoxic action of mechlorethamine. DNA cross-linking studies on isolated nuclei reveal only minor differences between the two lines even with identical drug treatments. The rate of cross-link repair is comparable in the two cell lines. These results, taken together with our earlier observation that the rate of drug accumulation is identical in these two lines, suggest that enhanced cytoplasmic drug detoxification is the underlying resistance mechanism in CHO-Chlr cells. We have measured cellular glutathione S-transferase activity, using both the general substrate 1-chloro-2,4-dinitrobenzene, and substrates with some specificity for the different classes of transferase isoenzymes. Total enzyme activity (as measured with 1-chloro-2,4-dinitrobenzene) is elevated 3-fold in the resistant cells. A 2- and 5-fold increase, respectively, in activity against ethacrynic acid and cumene hydroperoxide is detectable in CHO-Chlr cells. This elevation in catalytic activity in the resistant cells is reflected in higher levels of both the Yf- and Ya-type transferase subunits. PMID- 3664508 TI - Molecular dosimetry of DNA adduct formation and cell toxicity in rat nasal mucosa following exposure to the tobacco specific nitrosamine 4-(N-methyl-N-nitrosamino) 1-(3-pyridyl)-1-butanone and their relationship to induction of neoplasia. AB - The molecular dosimetry of O6-methylguanine (O6MG) formation in DNA and cytotoxicity in respiratory and olfactory mucosa was determined during administration of 4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone (NNK) to male Fischer 344 rats. The dose response for O6MG formation differed considerably between respiratory and olfactory mucosa. The dose response was nonlinear in respiratory mucosa where the slope of the curve was very large for doses of NNK ranging from 0.3 to 3.0 mg/kg but much smaller in the dose range of 10 to 100 mg/kg. In contract, the dose response in the olfactory mucosa did not demonstrate such a large change in slope over the same dose range. The concentration of O6MG formed to dose of NNK ratio, an index of efficiency of alkylation, increased dramatically only in the respiratory mucosa as the dose of NNK was decreased from 100 to 0.3 mg/kg. The concentration of O6MG was four times greater in respiratory than olfactory mucosa after treatment of rats with 1 mg/kg NNK. Alkylation in the two regions of the nose became similar as the dose of NNK was increased. In rats treated for up to 12 days with NNK (10 mg/kg/day), the concentration of O6MG was 60 to 90% greater in respiratory than olfactory mucosa throughout treatment. Regional differences in the amount of O6MG formed may stem from the presence of a low Km pathway for biotransformation of NNK in the cells of the respiratory mucosa. This conclusion is supported by autoradiographic studies. Four h after treatment with 1 mg/kg [3H]NNK, silver grains were more heavily concentrated in respiratory than olfactory epithelium. Histopathological examination of the nasal passages revealed dose related, cell specific differences in toxicity following treatment of rats with 10, 30, or 100 mg/kg NNK for 12 days. No toxicity was observed in the nose when 1 mg/kg NNK was administered. Bowman's glands underlying the olfactory mucosa and Steno's glands were the most sensitive sites for toxicity, exhibiting necrosis after as little as 2 days of treatment with 10 mg/kg NNK. Damage to these glands progressed in a dose- and time-dependent manner. Respiratory epithelium exhibited only mild toxicity while basal cell metaplasia was evident in olfactory epithelium. Rats treated with NNK for 20 weeks (50 mg/kg, three times a week) had a 45% incidence of carcinomas in the olfactory region. These neoplasms appeared to arise from Bowman's glands. In contrast, there was only a 5% incidence of malignant neoplasia and a 29% incidence of benign neoplasia in the respiratory region.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3664509 TI - Immunohistochemical determination of inducibility phenotype with a monoclonal antibody to a methylcholanthrene-inducible isozyme of cytochrome P-450. AB - A monoclonal antibody (MAb) to a methylcholanthrene (MC)-induced cytochrome P 450, designated MAb 1-7-1, was used for immunohistochemical staining of formalin fixed tissues from oil- and MC-treated C57BL/6, DBA/2, and [(C57BL/6 X DBA/2) F1 X DBA/2] F2 mice. An avidin-biotin-peroxidase complex immunohistochemical technique was used. For controls, the tissues were also exposed to MAbs 1-48-5 and HyHel-9 (to egg white lysozyme). In liver, MAb 1-7-1 specifically stained the cytoplasm of centrilobular hepatocytes of C57BL/6 mice treated with MC (80 mg/kg) 48 h before kill; staining was not observed with vehicle-treated C57BL/6 mice, with oil- or MC-treated DBA/2 mice, or with comparable antibody concentrations of control MAbs 1-48-5 or HyHel-9. In the F2 mice, about 50% were expected to be MC inducible (AhbAhd). Inducibility phenotype was determined by measuring the conversion of [14C]MC to oxidized and conjugated products by liver homogenates. In freshly fixed material from MC-treated mice, those livers shown by the determination of phenotype to be inducible also stained with MAb 1-7-1, whereas those not induced were immunohistochemically negative. Furthermore, there was a significant positive correlation between degree of staining and the level of MC metabolizing activity measured biochemically. The immunohistochemical procedure was also accurate in determination of inducibility phenotype of livers that had been in paraffin blocks for up to 2 yr if more concentrated antibody was used. In lung, MAb 1-7-1 stained specifically the alveolar walls and endothelium of blood vessels in MC-induced C57BL/6 mice only; the control MAbs and other mice gave negative results. Similarly, in kidney MAb 1-7-1 stained only glomeruli and interstitial tissue of MC-induced C57BL/6 mice and only endothelium of blood vessels in the colons of these mice. These observations are consistent with induction of the cytochrome P-450 recognized by MAb 1-7-1 in the endothelial cells of extrahepatic tissue. Immunohistochemical staining with MAb thus shows great promise for highly specific localization of particular species of cytochromes P-450 in tissues, for in situ quantification of these enzymes, and for determination of inducibility phenotype with fixed material. PMID- 3664510 TI - Pharmacokinetics of 111In-labeled OC-125 antibody in cancer patients compared with the 19-9 antibody. AB - We recently reported on the pharmacokinetics in 14 cancer patients of the 19-9 antibody radiolabeled with 111In. We have now repeated this investigation in 18 cancer patients using the OC-125 antibody, in part to compare the in vivo behavior of two murine monoclonal antibodies of the same subclass administered as the F(ab')2 fragments, by the same route and at the same dose. As in the earlier investigation, 1 mg of fragments was infused i.v., and organ quantitation was obtained for up to 72 h along with frequent blood and urine samples for chromatographic evaluation. Analysis of urine showed that activity clearance by this route amounted to 0.29%/h and consisted of labeled DTPA only in early samples and metabolic products thereafter. Analysis of serum samples often showed the presence of a high-molecular-weight species appearing within 24 h. This species is probably due to antibody binding to circulating antigen, although the percentage of circulating activity present as this species did not correlate well with circulating antigen levels. As before, organ accumulation was greatest in the liver, although levels were significantly reduced (12% compared to 20% of administered dose at 24 h, P less than 0.01). Plasma clearance was also significantly different: whereas the label in the case of the OC-125 antibody showed one-compartment clearance kinetics and remained in the plasma compartment, in the 19-9 case the label diffused to a second, unidentified compartment. PMID- 3664511 TI - Association of multiple copies of the c-erbB-2 oncogene with spread of breast cancer. AB - Amplification of c-erbB-2 was at least three times more frequent in breast cancer than in most other types of carcinoma, and was not found in sarcomas or hematological malignancies. Amplification of c-erbB-2 was found in 15 of 86 primary breast cancers and in 3 of 12 secondary breast cancers. Amplification was more common in breast tumors of advanced stage, and in tumors which had metastasized to regional lymph nodes sites. Gene amplification was observed in 21% (4 of 19) of primary tumors which recurred within 3 years of mastectomy and in 6% (2 of 32) of nonrecurrent tumors. PMID- 3664512 TI - Prognostic value of steroid hormone receptors: multivariate analysis of systemically untreated patients with node negative primary breast cancer. AB - The value of estrogen and progesterone receptor (ER and PgR, respectively) determinations in predicting the recurrence-free survival (RFS) has been evaluated in a group of 807 node negative breast cancer patients. All of these patients are enrolled in the Danish Breast Cancer Cooperative Group (DBCG) 77-1a and 82-a protocols for low risk patients, and none of them have received systemic adjuvant therapy. At a median observation time of 50 months and in an evaluation of the total patient population as an entity, ER+ patients had only a marginally significant (P = 0.07) longer RFS than ER- patients while PgR+ patients experienced a significant advantage (P = 0.02). Among patients subgrouped according to menopausal status, both ER and PgR statuses were found to be significant prognostic factors for predicting RFS in the premenopausal women (less than 50 years) but not in peri- or postmenopausal women. Using Cox's multivariate analysis, nuclear pleomorphy was found to be the only significant prognostic variable, while the value of PgR status as a prognostic factor approached significance (P = 0.065). Although knowledge of ER status did not significantly improve distinction between patients with good and poor prognoses in the relatively small subgroup of premenopausal patients (n = 120) when PgR status was known, ER+PgR- patients have a lower risk of recurrence or death than ER-PgR- patients. Using a log-likelihood model, significant and distinct cut-off limits for the definition of receptor positivity were found for premenopausal patients: these were 5 fmol/mg cytosol protein for ER and 10 fmol/mg cytosol protein for PgR. These cut-off levels may reflect the ability of the ligand binding assay method used to discriminate between tissues with and without receptor proteins. Qualitative assessment of receptor status was as valuable as quantitative expression of receptor concentrations in predicting the RFS of the natural course of the disease among node negative premenopausal patients. PMID- 3664513 TI - Evaluation of the pharmacological benefit and determination of the influencing factors of intraarterial cis-diamminedichloroplatinum administration in patients with uterine cervical cancer. AB - cis-Diamminedichloroplatinum (100 mg/m2) was administered to the same patients (n = 9) with advanced uterine cervical tumors, via i.v. and intraarterial (i.a.) (bilateral hypogastric arteries) routes. Measurement of plasma pharmacokinetic parameters enabled us to show up areas under the curve (AUC) of free cis diamminedichloroplatinum versus time significantly (P less than 0.01) lower after i.a. injection (mean value, 3.9 mg.h/liter) than after i.v. injection (mean value, 5 mg.h/liter). However, the increase in intratumoral concentrations after i.a. administration was only at the limit of statistical significance (P = 0.05). Consequently, the benefit of local i.a. administration, evaluated according to the method of Collins, was small (1.2-2.3). An explanation of the phenomena observed can be given using the generalized compartmental model of Collins. We have demonstrated that the parameters of this model can be entirely calculated by taking into account both the i.v. and i.a. pharmacokinetic measurements. Calculations from experimental data of the model parameters, clearances of the body (ClB), and exchange rate between the site of administration and the rest of the body (Q) were in accordance with the physiological values. On the basis of the parameter values, it was confirmed that the low benefit of i.a. administration was due to the fast blood exchange between the injection site and the rest of the body and the probable cis-diamminedichloroplatinum binding on healthy tissues irrigated by the hypogastric artery. PMID- 3664514 TI - Plasma pharmacokinetics and urinary excretion of hexamethylene bisacetamide metabolites. AB - In order to further understand the clinical toxicities of hexamethylene bisacetamide (HMBA) and to allow appropriate in vitro studies, we developed a suitable gas chromatographic assay and quantified plasma concentrations and urinary excretion of four metabolites which we had previously identified in urine of patients receiving 5-day HMBA infusions at 4.8-43.2 g/m2/day. 6 Acetamidohexanoic acid (AcHA) was the major plasma metabolite and reached steady state concentration (Css) by 24 h. AcHA Css increased from 0.12 +/- 0.02 (SD) mM at 4.8 g/m2/day to 0.72 mM at 43.2 g/m2/day. The Css AcHA:Css HMBA ratio decreased with increasing HMBA dosage. At dosages below 24 g/m2/day plasma Css of N-acetyl-1,6-diaminohexane (NADAH), the initial metabolite of HMBA, were below the limit of detection of our assay. With HMBA infusions of 24, 33.6, and 43.2 g/m2/day, Css of NADAH were 0.16 +/- 0.05, 0.14 +/- 0.06, and 0.19 +/- 0.04 mM, respectively. Css NADAH:Css HMBA ratios at 24, 33.6, and 43.2 g/m2/day were 0.18 +/- 0.06, 0.08 +/- 0.02, and 0.31 +/- 0.05, respectively. Plasma Css of 1,6 diaminohexane and 6-aminohexanoic acid were below the limit of detection of our assay. Each patient's urinary excretion of NADAH, AcHA, and 1,6-diaminohexane was consistent from day to day. The fraction of dose excreted in urine as AcHA was not affected by HMBA dosage and accounted for 12.7 +/- 3.9% of the daily dose. The percentage of daily HMBA dose accounted for by excretion of NADAH decreased with increasing HMBA dosage (10.8 +/- 6.0% at 4.8 g/m2/day to 4.2 +/- 1.2% at 33.6 g/m2/day). Urinary excretion of 1,6-diaminohexane always accounted for less than 3% of the daily dose. Our results indicate that: (a) plasma concentrations of AcHA alone cannot explain the degree of acidosis observed with toxic doses of HMBA; (b) NADAH is present in plasma at concentrations that we have found to cause differentiation in vitro; and (c) the probable rate-limiting step in HMBA metabolism is the initial deacetylation. PMID- 3664515 TI - Stability and pharmacokinetics of m-[131I]iodobenzylguanidine in patients. AB - A pharmacokinetic study was done to elucidate the body distribution, elimination, and metabolism of m-[131I]iodobenzylguanidine (m-[131I]IBG). For this purpose, an analytical method using solid phase extraction columns was developed. m-[131I]IBG was administered as an i.v. infusion according to different schedules with doses of 7,055 to 13,580 MBq/m2. At the start of the infusion m-[131I]IBG accounted for 93.0 +/- 2.3% (SD; n = 10) of the total radioactivity. At the end of the infusion m-[131I]IBG accounted for 88.0 +/- 7.4%. The non-m-IBG-bound radioactivity was predominantly 131I. The pharmacokinetic parameters (n = 7) are adequately described by a three compartment model. The parameters for m-[131I]IBG were determined with a mean terminal half-life of 37.0 h, a volume of distribution of 307 liters/m2, and an area under the curve value of 1091 kBq x h/ml. The total body clearance was 189 ml/min/m2. The values for 131I showed a terminal half-life of 71.6 h, a volume of distribution of 190 liters/m2, and an area under the curve value of 1537 kBq x h/ml. The total body clearance was 70 ml/min/m2. The selectivity of the m-[131I]IBG treatment might be improved by a reduction of 131I in the infusion fluid and further investigations are warranted. PMID- 3664516 TI - Accumulation of 2-amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole and 2 aminodipyrido[1,2-a:3',2'-d]imidazole, carcinogenic glutamic acid pyrolysis products, in plasma of patients with uremia. AB - In order to investigate the exposure of humans to 2-amino-6-methyldipyrido[1,2 a:3',2'-d]imidazole [(Glu-P-1) Chemical Abstracts Service:67730-11-4] and 2 aminodipyrido[1,2-a:3',2'-d]imidazole [(Glu-P-2) Chemical Abstracts Service:67730 10-3], carcinogenic heterocyclic amines, we developed a high-performance liquid chromatography method to detect Glu-P-1 and Glu-P-2 in biological samples, and compared the plasma levels of the carcinogens in normal subjects with those in uremic patients in which higher incidence of malignancy has been reported. Glu-P 1 and Glu-P-2 levels in plasma of uremic patients before induction of hemodialysis treatment were 12.62 +/- 3.65 (SD) pmol/ml (n = 5) and 14.81 +/- 5.17 pmol/ml (n = 5), respectively, whereas Glu-P-1 and/or Glu-P-2 could be detected in only two of seven normal subjects and the levels were lower than 3.1 pmol/ml. Approximately 10% of these carcinogens in plasma of uremic patients could be removed by the first hemodialysis treatment, and reasonable amounts of these carcinogens could be detected in the dialysate of uremic patients. However, significant amounts of Glu-P-1 and Glu-P-2 were still detected in plasma of all uremic patients even after 1 month-hemodialysis treatments. These results suggest that one of the excretory pathways of these carcinogens is via kidney. PMID- 3664517 TI - Expression of an unusual isozyme of lactate dehydrogenase in the serum of cancer patients and comparison with carcinoembryonic antigen. AB - Two studies reported here demonstrate a statistically significant association between metastatic cancer and the appearance of the k isozyme of lactate dehydrogenase in serum of affected patients. The first study included 190 coded samples from three types of cancer patients and matched controls; the second included 155 preoperative and 200 postoperative colorectal cancer patients. In the second, plasma carcinoembryonic antigen was compared with serum k isozyme of lactate dehydrogenase as an indicator of the presence of metastatic cancer. This comparison showed that both markers were independently useful for assessing patient status and predicted that a combination of the two should be a better discriminator for the presence of metastases than either marker alone. PMID- 3664518 TI - Conformation of the pentasaccharide corresponding to the binding site of heparin to antithrombin-III. PMID- 3664519 TI - Structural determination of D-fructans from Streptococcus mutans, serotype b, c, e, and f strains, by 13C-n.m.r. spectroscopy. PMID- 3664520 TI - Chemical structure of three neutral trisaccharides isolated in free form from bovine colostrum. AB - Three neutral trisaccharides, which comprise 25.1% of the neutral oligosaccharide other than lactose, were isolated from bovine colostrum, obtained 6 h after parturition, by l.c. on amino silica gel. The chemical structures were identified, by methylation analysis with direct m.s. and g.l.c.-m.s., and by structural analysis with 13C-n.m.r., as beta-D-Galp-(1----4)-[alpha-L-Fucp-(1--- 3)-]-D-GlcNAc (3-fucosyl-N-acetyllactosamine), beta-D-Galp-(1----3)-beta-D-Galp (1----4)-D-Glc (3'-galactosyllactose), and beta-D-Galp-(1----6)-beta-D-Galp-(1--- 4)-D-Glc (6'-galactosyllactose). The The first-named compound was a novel oligosaccharide from mammalian milk. PMID- 3664521 TI - Structure of the capsular polysaccharide of Klebsiella serotype K40. AB - The capsular polysaccharide from Klebsiella Serotype K40 contains D-galactose, D mannose, L-rhamnose, and D-glucuronic acid in the ratios of 4:1:1:1. Methylation analysis of the native and carboxyl-reduced polysaccharide provided information about the glycosidic linkages in the repeating unit. Degradation of the permethylated polymer with base established the identity of the sugar unit preceding the glycosyluronic acid residue. The modes of linkages of different sugar residues were further confirmed by Smith degradation and partial hydrolysis of the K40 polysaccharide. The anomeric configurations of the different sugar residues were determined by oxidation of the peracetylated native and carboxyl reduced polysaccharide with chromium trioxide. Based on all of these results, the heptasaccharide structure 1 was assigned to the repeating unit of the K40 polysaccharide. (Formula: see text) PMID- 3664522 TI - Synthesis of monodeoxyfluorinated, mucin-type oligosaccharide fragments. PMID- 3664523 TI - Vibrational assignments and isomerization rate-constants from time-dependent F.t. i.r. spectra of sugars. AB - Time-dependent F.t.-i.r. absorption spectra of alpha-D-galactose, alpha-D-fucose, alpha-D-glucose-1-d1, alpha-D-glucose-2-d1, and alpha-D-glucose-5,6,6-d3 were measured. The spectral changes were interpreted in terms of anomeric isomerization, and possible vibrational origins were suggested. The intensity changes seen for alpha-fucose were found to follow a reversible first-order rate equation and the rate constants obtained from different vibrational bands were found to be consistent among themselves and in reasonable agreement with those obtained by other techniques. PMID- 3664524 TI - Synthesis of methyl 3-O-alpha-D-mannopyranosyl-alpha-D-talopyranoside and methyl 3-O-alpha-D-talopyranosyl-alpha-D-talopyranoside. AB - Methyl 2-O-benzyl-3-O-(2,3,4,6-tetra-O-acetyl-alpha-D-mannopyranosyl)-alpha- D mannopyranoside (4) and methyl 2-O-benzyl-3-O-alpha-D-mannopyranosyl-alpha-D mannopyranoside (6) were prepared from a common intermediate, namely, methyl 2-O benzyl-4,6-O-benzylidene-3-O-(2,3,4,6-tetra-O-acetyl-alpha-D- mannopyranosyl) alpha-D-mannopyranoside. On treatment with tert-butylchlorodiphenylsilane, in N,N dimethylformamide in the presence of imidazole, 4 and 6 afforded methyl 2-O benzyl-6-O-tert-butyldiphenylsilyl-3-O-(2,3,4,6-tetra-O-acetyl -alpha-D- mannopyranosyl)-alpha-D-mannopyranoside (7), and methyl 2-O-benzyl-6-O-tert butyldiphenylsilyl-3-O-(6-O-tert- butyldiphenylsilyl-alpha-D-mannopyranosyl) alpha-D-mannopyranoside (8), respectively. Compound 8 was converted into its 2,3 O-isopropylidene derivative (9), and oxidation of 7 and 9 with pyridinium chlorochromate, and reduction of the resulting carbonyl intermediates gave methyl 2-O-benzyl-6-O-tert-butyldiphenylsilyl-3-O-(2,3,4,6-tetra-O-acetyl -alpha-D- mannopyranosyl)-alpha-D-talopyranoside and methyl 2-O-benzyl-6-O-tert butyldiphenylsilyl-3-O-(6-O-tert-butyldiphe nylsilyl- 2,3-O-isopropylidene-alpha D-talopyranosyl)-alpha-D-talopyranoside , respectively. Removal of the protecting groups furnished the title disaccharides. PMID- 3664525 TI - [Synthesis of modified tetrasaccharide sequences of N-glycoproteins]. AB - The tetrasaccharides O-alpha-D-mannopyranosyl-(1----3)-O-[alpha-D- mannopyranosyl (1----6)]-O-(4-deoxy-beta-D-lyxo-hexopyranosyl)-(1- ---4)-2- acetamido-2-deoxy alpha, beta-D-glycopyranose (22) and O-alpha-D-mannopyranosyl-(1----3)-O-[alpha-D mannopyranosyl-(1----6)]-O- beta-D-talopyranosyl-(1----4)-2-acetamido-2-deoxy alpha, beta-D- glucopyranose (37), closely related to the tetrasaccharide core structure of N-glycoproteins, were synthesized. Starting with 1,6-anhydro-2,3-di O-isopropylidene-beta-D-mannopyranose, the glycosyl donors 3,6-di-O-acetyl-2-O benzyl-2,4-dideoxy-alpha-D-lyxo- hexopyranosyl bromide (10) and 3,6-di-O-acetyl 2,4-di-O-benzyl-alpha-D-talopyranosyl bromide (30), were obtained in good yield. Coupling of 10 or 30 with 1,6-anhydro-2-azido-3-O-benzyl-beta-D-glucopyranose to give, respectively, the disaccharides 1,6-anhydro-2-azido-3-O-benzyl-2-deoxy-4-O (3,6-di-O-acetyl-2-O-benzyl-4 -deoxy- beta-D-lyxo-hexopyranosyl)-beta-D glucopyranose and 1,6-anhydro-2-azido-3-O-benzyl-2-deoxy-4-O-(3,6-di-O-acetyl-2,4 di-O-ben zyl- beta-D-talopyranosyl)-beta-D-glucopyranose was achieved with good selectivity by catalysis with silver silicate. Simultaneous glycosylation of OH 3' and OH-6' of the respective disaccharides with 2-O-acetyl-3,4,6-tri-O-benzyl alpha-D-mannopyranosyl chloride yielded tetrasaccharide derivatives, which were deblocked into the desired tetrasaccharides 22 and 37. PMID- 3664526 TI - [Conformation analysis of modified tetrasaccharide sequences of the N glycoprotein type--problem of the alpha-(1 to 6)-glycosidic bond]. AB - The conformational analysis of the recently synthesized tetrasaccharides alpha-D Manp (1----3)-[alpha-D-Manp-(1----6)]-4-deoxy-beta-D-lyx-hexp+ ++-(1----4)-D GlcNAc (2) and alpha-D-Manp-(1----3)-[alpha-D-Manp-(1----6)]-beta-D-Talp -(1--- 4)-D-GlcNAc (3) will be described. The preferred solution conformation of 2 and 3 is a gt-conformation, which is nearly identical with the preferred conformation of the naturally occurring tetrasaccharide alpha-D-Manp-(1----3)-[alpha-D-Manp-(1 ---6)]-beta-D-Manp -(1----4)-D-GlcNAc (1). The main structural feature is the backfolding of the alpha-(1----6)-linked D-Man to the reducing D-GlcNAc unit. Conformational analysis of the tetrasaccharides alpha-D-Manp-(1----3)-[alpha-D Manp-(1----6)]-beta-D-Manp -(1----4)-1,6- anhydro-beta-D-GlcNAc (4), alpha-D-Manp (1----3)-alpha-D-Manp-(1----6)]-4-deoxy-beta-D- lyx-hexp-(1----4)- 1,6-anhydro beta-D-GlcNAc (5), and alpha-D-Manp-(1----3)-[alpha-D-Manp-(1----6)]-beta-D-Talp (1----4)- 1,6-anhydro-beta-D-GlcNAc (6) gave additional proof for this backfolding. The substitution of the reducing unit leads to a smaller amount of gt- and a greater amount of gg-conformers. The method used for conformational analysis of 2-6 is a combination of n.m.r.-experiments and HSEA-calculations with the program GESA. Concerning the application of new 2D-techniques, the COLOC experiment turned out to be extremely useful in sequencing oligosaccharides. PMID- 3664527 TI - Synthesis of 5'-O-beta-D-glucopyranosyl and 5'-O-beta-D-galactopyranosyl derivatives of ribavirin. AB - The synthesis of 5'-O-beta-D-glucopyranosyl and 5'-O-beta-D-galactopyranosyl derivatives (13 and 15, respectively) of the antiviral agent ribavirin are described. Direct glycosylation of 2',3'-O-isopropylideneribavirin with either tetra-O-acetyl-alpha-D-glucopyranosyl bromide (4) or tetra-O-acetyl-alpha-D galactopyranosyl bromide (8) under Koenigs-Knorr conditions (i.e., silver carbonate, silver perchlorate, and Drierite in dichloromethane) followed by O deacetylation of the reaction product gave the corresponding ortho esters. However, treatment of 2',3'-di-O-acetyl-5'-O-tritylribavirin (11) with 4 under the Bredereck modification of the Koenigs-Knorr reaction (i.e., silver perchlorate and Drierite in nitromethane) and subsequent deacetylation furnished the desired 1-(5-O-beta-D-glucopyranosyl-beta-D-ribofuranosyl)-1,2,4-triazole-3 carb oxamide (13). Similarly, reaction of 11 with 8 in the presence of AgClO4, and deprotection of the condensation product, gave 5'-O-beta-D galactopyranosylribavirin (15). The beta-anomeric configuration of the D-glucosyl and D-galactosyl groups of 13 and 15 was assigned by 1H-n.m.r. studies. PMID- 3664528 TI - Purin-6-yl 6-deoxy-1-thio-beta-D-glucopyranoside. Enzymology, chemistry, and cytotoxicity. AB - Purin-6-yl 6-deoxy-1-thio-beta-D-glucopyranoside (4) is a substrate for almond beta-glucosidase and a weak competitive inhibitor of bovine liver beta-D glucuronidase (Ki approximately 20mM). Both 4 and purine-protonated 4 undergo hydrolysis catalyzed by dilute acid in the pH range 0.17-2.59. These results are compared with those previously obtained with ammonium (purin-6-yl 1-thio-beta-D glucopyranosid)uronate, (purin-6-yl 1-thio-beta-D-glucopyranosid)uronamide, purin 6-yl 1-thio-beta-D-glucopyranoside, and purin-6-yl 2-deoxy-1-thio-beta-D glucopyranoside, and it is concluded that the data support an involvement of substituents at C-5 in producing productive Michaelis-complex conformers. The 6 deoxyglucoside is more active than the D-glucosiduronic acid in an L1210 mouse screen. PMID- 3664529 TI - Molecular dynamics simulations of beta-D-glucopyranose. PMID- 3664530 TI - Surface markers and cytotoxic activities of lymphocytes in monoclonal gammopathy of undetermined significance and untreated multiple myeloma. Increased phytohemagglutinin-induced cellular cytotoxicity and inverted helper/suppressor cell ratio are features common to both diseases. AB - To determine whether monoclonal gammopathy of undetermined significance (MGUS) resembles multiple myeloma (MM) with regard to phenotype and functional activity, 16 patients with MGUS and 16 with untreated MM were studied for surface markers and cytotoxic activities phytohemagglutinin-induced cellular cytotoxicity (PHA ICC), antibody-dependent cellular cytotoxicity, natural killer (NK) activity. Our data showed a consistent immunological similarity between the two diseases. An increase in OKT8+ cells was evident in both patient groups and a significant reduction in the T4/T8 ratio, more pronounced in MM, was observed. Alterations in NK activity or ADCC were not found in MGUS or MM. A significant increase in PHA ICC was demonstrated in the two diseases. The increase in PHA-ICC observed seems to be attributable to an increased frequency and/or lytic efficiency of PHA-ICC lymphoid effector cells. These data suggest that similar immunological alterations are common to the two diseases. The greater helper/suppressor ratio reduction observed in MM seems to be related to the more severe clonal proliferation in these patients. PMID- 3664531 TI - Antibody-dependent cell-mediated cytotoxicity using a murine monoclonal antibody against human colorectal cancer in cancer patients. AB - Antibody-dependent cell-mediated cytotoxicity (ADCC) mediated by a murine monoclonal antibody against human colorectal carcinoma, antibody 19-9, with human effector cells was tested in 33 patients with various carcinomas, 16 patients with benign lesions, and 13 normal controls, using a 12-h 51Cr release assay using human colorectal cancer cells as targets. Peripheral blood mononuclear cells (PBM) from these groups of patients and normal controls achieved moderate levels of target cell lysis in the presence of the monoclonal antibody at the high effector to target cell ratio of 200:1. The ADCC activity of PBM in cancer patients was significantly higher than that in either normal persons or patients with benign lesions. Since the ADCC was shown to be mainly mediated by adherent monocytes in the PBM, ADCC activity of monocytes from cancer patients was compared to those from control groups at an effector to target cell ratio of 30:1. The results also showed that the lytic capacity of monocytes was significantly higher in cancer patients than that in the control populations. PMID- 3664532 TI - Infiltration of primary and metastatic melanomas with macrophages of the 25F9 positive phenotype. AB - In order to gain insight into the role of macrophages in human melanoma, we studied fresh-frozen material from 15 dysplastic nevi, 199 primary melanomas, 107 melanoma metastases, and paraffin sections from 98 primary melanomas with the monoclonal antibody 25F9 which recognizes an 86 x 10(3) dalton protein present on a subset of mature human macrophages. Considerable infiltration of tumors with 25F9-positive macrophages was observed in 2 dysplastic nevi (13%), 87 primary melanomas (44%), and 45 metastases (42%). The degree of intratumoral macrophage infiltration correlated with expression of class II HLA-DR antigens on tumor cells, in primary melanoma with a tumor thickness above 0.75 mm, and with the occurrence of metastases within 2 years. In paraffin sections, intratumoral 25F9 positive macrophages also correlated with metastatic spread of primary tumors after longer follow-up. Metastases revealed a higher degree of macrophage infiltration following systemic or local immunotherapy, compared with untreated metastases, or metastases removed during chemotherapy. Of 38 patients who died within an observation period of 1 year, 19 (50%) had considerable infiltration of metastases with 25F9-positive macrophages, whereas this was found in only 4 of 12 patients (33%), who survived for longer than 2 years following metastases removal. A higher degree of 25F9-positive macrophages correlated with a shift towards the T8-positive subsets within the T cell compartment of the infiltrate. Our results suggest that accumulation of 25F9-positive macrophages in melanomas indicates more aggressive tumor properties. PMID- 3664533 TI - IgM response and resistance to ascites tumor growth. AB - Antibody response and protection against Ehrlich ascites tumor (EAT) was studied in eight EAT-immunized strains of mice (AL/N, BALB/C, C57BL/6J, F1 (C57BL/6 x BALB/C), C57BL/10J, B10.BR, CBA/Ca, SW). The results showed a close association between IgM response and resistance to subsequent tumor challenge. Thus, protection was only achieved in those animals giving a measurable IgM response against EAT cell surface antigens, i.e., all inbred strains of mice tested, except CBA/Ca, and some outbred SW mice. The lack of IgM response to these antigens in CBA/Ca was not linked to the strain H-2 haplotype. Resistance could be passively transferred to nonimmunized mice by means of serum, or purified IgM, from protected immune animals. Moreover, complement depletion by cobra venom factor treatment did not modify the protection afforded to those mice. IgM reactivity to EAT cells was completely abolished by previous cell trypsinization. Trypsin removed but did not destroy the antigen(s) recognized by the IgM, since all its activity could be absorbed with the supernatant of the EAT cell trypsinization. Absorption assays with this supernatant treated with different agents, showed that lipids, simple peptides and nucleic acids were not important components of the antigenic determinants. On the contrary, its susceptibility to beta-galactosidase and particularly to a mild periodate oxidation, suggested that determinants recognized by the IgM against the EAT cell surface are carbohydrate in nature. PMID- 3664534 TI - Immunotherapy in a spontaneously developed murine mammary carcinoma with syngeneic monoclonal antibody. AB - A new spontaneously arisen murine breast tumor, designated JC, has been established in immunocompetent BALB/c mice. Upon reestablishment of tumor in vitro and in vivo, the epithelial murine tumor cells retained their original papillary adenocarcinoma morphology. Various immunotherapy protocols have been performed in previously implanted and progressively growing JC tumor in syngeneic hosts with a murine monoclonal antibody (McAb), F36/22 (IgG3). Affinity of McAb binding to JC tumor cells was determined to be 6.1 x 10(7) L/M. Quantitatively 1.2 x 10(5) molecules of McAb bound to a JC tumor cell. Immunotherapeutic effectiveness in vivo on a tumor mass after its establishment is a major feature of this experimental tumor model. When four sequential administration of McAb, i.p., at a dose of 400 micrograms 4 days apart were used, McAb-treated animals showed statistically significant tumor regression and longer survival than those of control animals treated with an irrelevant McAb of the same isotype. Two temporal phases of tumoricidal activity were observed as measured by tumor volume reduction. The first phase of tumoricidal response (tumor regression) was detected within days upon the first administration of McAb. A distinct second phase followed within 3-5 weeks after the last McAb administration, which resulted in tumor necrosis even in large tumors. Histological examinations revealed heavy infiltration of inflammatory cells at the beginning of the second phase. Similar tumor regression was also obtained from animals treated with a single dose (400 micrograms) of McAb followed by injections of McAb with complete and incomplete adjuvant, respectively. These results demonstrate that this syngeneic murine mammary tumor can serve as a potential preclinical model for investigation of parameters and mechanisms associated with McAb immunotherapy. PMID- 3664535 TI - Arterial uptake indices of low density lipoproteins after fatty streak formation in Cynomolgus monkeys. AB - To evaluate changes in arterial wall uptake of an atherogenic lipoprotein in early atherogenesis the uptake of labelled low density lipoprotein was measured in four segments of aorta in Cynomolgus monkeys with diet induced fatty streaks. The influx rate of low density lipoprotein was estimated from a simple kinetic model. The mean influx rate, expressed as plasma equivalents of tracer, was 69 nl.cm-2 per hour in fatty streak monkeys and 28 nl.cm-2 per hour in controls (p less than 0.001). Using additional assumptions, provisional estimates of the rates of apparent efflux were calculated. In fatty streak monkeys the mean apparent efflux rate, relative to the accumulation of tracer in the wall, did not differ significantly from the efflux rate in controls (8.7% per hour vs 7.9% per hour, p greater than 0.05). Thus intimal permeability to low density lipoprotein is increased at the fatty streak stage of lesion formation but apparent efflux may not be changed. The data fit the hypothesis that relative failure of efflux is a major cause of excess low density lipoprotein accumulation in the vessel wall in hypercholesterolaemia. PMID- 3664536 TI - Effect of autonomic nervous system modulation on retrograde atrioventricular nodal conduction in the human heart. AB - Although the influence of the autonomic nervous system on anterograde atrioventricular nodal conduction is well established, its effect on retrograde atrioventricular nodal conduction has not been examined systematically. Since retrograde atrioventricular nodal conduction in subjects with normal anterograde conduction may vary from intact retrograde conduction to complete retrograde block when assessed during ventricular pacing, in this study patients with (a) intact retrograde atrioventricular nodal conduction (group 1) were studied during parasympathetic (vagal) stimulation by carotid sinus pressure and during sympathetic inhibition (propranolol 0.2 mg.kg-1 intravenously) and (b) retrograde atrioventricular nodal block (group 2) were studied during vagal blockade (atropine 0.04 mg.kg-1 intravenously) and during sympathetic stimulation (isoproterenol 1-4 micrograms.min-1 infusion). In both groups changes in sinus cycle length and anterograde atrioventricular nodal conduction were measured. In group 1 vagal stimulation by carotid sinus pressure in 20 patients caused the cycle length at which retrograde atrioventricular nodal block was induced to be significantly lengthened from a mean(SD) of 375(59) to 451(51) ms in six patients; caused complete retrograde block in 10 patients; and had no effect in four patients. Sympathetic inhibition by propranolol in another 15 patients delayed the onset of pacing induced retrograde atrioventricular nodal block from a mean(SD) of 340(60) to 418(80) ms in 11 patients; caused complete retrograde atrioventricular nodal block in three patients; and had no effect in one patient. In group 2 vagal blockade by atropine caused a 1:1 retrograde response during ventricular pacing up to a mean(SD) cycle length of 470(135) ms in six out of eight patients. The infusion of isoproterenol caused the retrograde atrioventricular nodal block to be abolished and 1:1 conduction to be resumed up to a ventricular pacing mean(SD) cycle length of 364(57) ms in six out of eight patients. It is concluded that (a) the autonomic nervous system modulates retrograde atrioventricular nodal conduction in a similar manner to its anterograde counterpart and (b) that since retrograde atrioventricular nodal conduction was reversible after the administration of either atropine or isoproterenol retrograde atrioventricular nodal block may be dynamic (physiological) rather than fixed (anatomical) in nature. PMID- 3664537 TI - Effects of verapamil, nifedipine, and dilazep on left ventricular relaxation in the conscious dog. AB - The cardiac systolic and diastolic effects of the two major calcium blockers, verapamil and nifedipine, were studied and compared with those produced by dilazep, a relatively new vasodilator with calcium blocking properties, in conscious instrumented dogs to avoid the complications of anaesthesia and recent surgery. Mean arterial pressure was reduced by nifedipine and dilazep but not by verapamil, whereas peak left ventricular pressure was reduced only by dilazep and verapamil. Consistent tachycardia occurred, the rate being highest with nifedipine and lowest with dilazep. Left ventricular dP/dt was unaffected by dilazep, reduced by verapamil, and increased by nifedipine; this increase was no longer observed after beta adrenergic blockade. Ventricular relaxation was assessed by calculating the time relaxation constant, tau. Verapamil increased tau significantly only after beta adrenergic blockade, whereas nifedipine and dilazep reduced it both before and after beta adrenergic blockade. These data suggest that reflex beta adrenergic mechanisms may modulate the effects of calcium blockade on both systolic and diastolic performance. PMID- 3664538 TI - Myocardial and circulatory effects of inosine. AB - The action of inosine (2.5, 5, or 10 mg.kg-1.min-1 iv) was investigated in open chest rats (n = 46) and guinea pigs (n = 16). Left ventricular and aortic pressures, dP/dtmax, and stroke volume were measured. Additionally, isovolumic peak pressure and peak dP/dtmax were measured during short occlusions of the aorta for assessing myocardial performance independent of circulatory changes. In rats inosine caused a dose dependent decrease in dP/dtmax (-5%, -21%, -40% of preinfusion values), heart rate (-7%, -23%, -55%), and mean aortic pressure. Additionally, a subgroup of seven rats was paced at their initial preinfusion heart rate, but independently from the heart rate there was a reduction in dP/dtmax (-15%). The isovolumic measurements confirmed the negative inotropic effect of inosine in rats. Peak dP/dtmax was reduced to 85% of preinfusion values with a dose of 2.5 mg.kg-1 min-1 (to 70% of preinfusion values with 10 mg.kg 1.min-1). Similarly, the maximum isovolumic pressure for a defined filling volume was decreased by 30 mmHg (at 350 microliter; 5 mg.kg-1.min-1; p less than 0.05). The mean aortic pressure decreased with 2.5 mg.kg-1.min-1 inosine indicating vasodilative properties. In contrast to the significant effects in rats even 10 mg.kg-1.min-1 inosine did not have an effect on heart rate, mean aortic pressure, or dP/dtmax in guinea pigs. The isovolumic peak left ventricular pressure in guinea pigs was also unchanged after inosine infusion. Thus the haemodynamic effects of inosine were species dependent. PMID- 3664539 TI - An experimental model of chronic cardiac failure using adriamycin in the rabbit: central haemodynamics and regional blood flow. AB - Central haemodynamics and regional blood flow were studied comprehensively in conscious New Zealand White rabbits before and during the development of chronic low output cardiac failure produced by administration of the anticancer agent adriamycin. After eight weeks of adriamycin treatment, cardiac index fell from 326(40 to 225(56) ml.min-1.kg-1. This was accompanied by an increase in heart rate and total peripheral resistance but no change in mean systemic blood pressure. Myocardial function was shown to be depressed by the measurement of Frank-Starling curves, the slopes of which were appreciably flatter in adriamycin treated rabbits. Regional blood flow (measured by the radioactive microsphere technique) was redistributed. There were decreases in renal, splenic, small gut, and skeletal muscle blood flow, whereas myocardial and cerebral blood flow were unchanged. There was an increase in total body exchangeable sodium, indicating some salt and water retention. Systemic toxic effects of adriamycin could be limited by treating the animals for eight weeks with adriamycin and then allowing a two week recovery period before haemodynamic study. This would appear to be the optimal dosage schedule. PMID- 3664540 TI - Effects of changes in afterload impedance on left ventricular ejection in isolated canine hearts: dissociation of end ejection from end systole. AB - To examine how end systole differs from end ejection and also whether the slope of the end systolic pressure-volume relation can be approximated to that of the end ejection pressure-volume relation, nine isolated, perfused, paced canine hearts ejecting into a hydraulic loading system that simulated the aortic input impedance of a dog's arterial tree were studied. To measure left ventricular volume changes the heart was placed in a plethysmograph. Peripheral resistance (Rp) and arterial compliance (C) were independently varied from 1.9 (Rp = 1.9) to 3.3, 6.4, and 9.6 X 10(8) Pa.m-3.s (Rp run) with a constant value of compliance 1.3 X 10(-9) Pa-1.m3 (C = 1.3), and from C = 0.4 to C = 0.8, C = 1.3 and C = 2.3 (C run) with a constant value of resistance (Rp = 6.4). Five pressure-volume loops were obtained by changing the end diastolic volume at each value of compliance and peripheral resistance. It was clearly shown that ventricular ejection continued after end systole and the time duration between end systole and end ejection became longer with increasing arterial compliance (24(4) at C = 0.4 vs 49(4) ms at C = 2.3, p less than 0.001), while the time duration between end diastole and end systole was constant regardless of afterload impedance change. Regarding the left ventricular pressure-volume relation the end systolic relation was almost linear (r greater than or equal to 0.98) and the slope was not significantly affected by change in any afterload impedance tested. End ejection pressure-volume relation was also linear (r greater than or equal to 0.97) and the slopes in the peripheral resistance and compliance runs were lower than those of the end systolic pressure-volume relation in each corresponding run. The former slopes decreased at smaller values of Rp or larger values of C- namely, 4.4(0.6) at Rp = 9.6 vs 3.6(0.6) at Rp = 1.9, p less than 0.05; 4.8(0.6) at C = 0.4 vs 3.1(0.5) mmHg.ml-1 at C = 2.3, p less than 0.001. Thus it is concluded that end ejection is usually different from end systole and the time difference between them is affected by changes in arterial compliance. In addition, the slope of end ejection pressure-volume relation was dependent on the changes in afterload impedance and cannot be approximated to that of the end systolic pressure-volume relation. PMID- 3664541 TI - Thromboxane A2 analogue induced coronary artery vasoconstriction in the rabbit. AB - Diffuse coronary artery vasoconstriction was provoked in the rabbit by a stable thromboxane A2 analogue, STA2 (9,11-epithio-11,12-methano thromboxane A2). Injection of 25 micrograms.kg-1 STA2 into the left main trunk caused complete occlusion of the left anterior descending artery and narrowing of the left circumflex artery. Two minutes after injection, however, the diameter of the coronary artery returned to the control value (n = 10). The right coronary artery was also temporarily occluded by an injection of 25 micrograms.kg-1 STA2. Left ventricular end diastolic pressure increased significantly, and ST segment elevation of the electrocardiogram occurred during vasoconstriction. The angiographic findings showed that the vasoconstriction in the coronary artery induced by STA2 was similar to the diffuse vasoconstriction seen clinically. Induction of the vasoconstriction by STA2 was prevented by the preadministration of 25 micrograms.kg-1 of either a calcium antagonist, diltiazem, or a thromboxane A2 receptor antagonist, ONO 3708 (n = 10). The relation of the calcium movement to this vasoconstriction was studied in vitro using the isolated left circumflex artery in the rabbit. STA2 (50 micrograms.litre-1 to 0.5 mg.litre-1) produced a concentration dependent contraction of helical strips of left circumflex artery. Diltiazem (50-100 g.litre-1) suppressed this contraction dose dependently. ONO 3708 (10 micrograms.litre-1 to 1 mg.litre-1) caused a significant rightward and downward shift of the dose-response curve.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664542 TI - Tetraethylammonium induced coronary spasm in isolated perfused rabbit heart: a hypothesis for the mechanism of coronary spasm. AB - The vasoactive effect of tetraethylammonium, which is known to reduce potassium conductance of the membrane of arterial smooth muscle cells, was tested on large epicardial coronary arteries in isolated perfused rabbit hearts. These hearts were perfused selectively through the right and left coronary arteries. Left coronary angiography was performed using Krebs-Henseleit solution containing phenolsulfonphthalein under constant pressure, and the epicardial electrogram was recorded. In 59 of 114 hearts 30 mmol.litre-1 tetraethylammonium induced severe constriction of the left epicardial coronary artery, which was associated with electrocardiographic ST segment elevation in some cases. The induced spasm was prevented by diltiazem (200 nmol.litre-1), glyceryl trinitrate (2 mumol.litre-1), or nicorandil (10 mumol.litre-1), but not by phentolamine (1 mumol.litre-1) or atropine (1 mumol.litre-1). In hearts in which tetraethylammonium did not induce spasm, subsequent addition of ergonovine (100 nmol.litre-1) or alkalinisation of the perfusate (pH 7.65-7.70) provoked spasm. The tetraethylammonium induced spasm resembled the coronary spasm seen in patients with variant angina and was a reproducible in vitro model of coronary spasm. These observations support the hypothesis that the primary defect in patients with coronary spasm is decreased potassium permeability of the membrane of coronary arterial smooth muscle cells. PMID- 3664543 TI - Effect of alveolar pressure on pulmonary artery pressure in chronically hypoxic rats. AB - The effect on pulmonary artery pressure of a rise in alveolar pressure differed in chronically hypoxic rats (10% O2 for 3-5 weeks) compared with control rats. Chronically hypoxic rats have newly muscularised walls in arterioles in the alveolar region. Isolated lungs of chronically hypoxic and control rats were perfused with blood under conditions in which alveolar pressure was greater than left atrial pressure during both normoxia and hypoxia. Alveolar pressure was the effective downstream pressure. Pressure-flow lines were measured at low and high alveolar pressure (5 and 15 mmHg). During normoxia pressure-flow lines of chronically hypoxic rats had a steeper slope (higher resistance) and greater extrapolated intercept on the pressure axis (effective downstream pressure) than control rats. In both groups of rats the change from low to high alveolar pressure during normoxia caused an approximately parallel shift in the pressure flow line similar to the change in alveolar pressure. During hypoxia, which led to an increase in slope and intercept in both groups of rats, the effect of a rise in alveolar pressure differed in chronically hypoxic from control rats. In control rats there was a small parallel shift in the pressure-flow line that was much less than the increase in alveolar pressure; in chronically hypoxic rats there was a large parallel shift in the pressure-flow line that was greater than the increase in alveolar pressure. Thus in chronically hypoxic rats hypoxic vasoconstriction probably occurred mainly in muscular alveolar vessels, whereas in control rats it probably occurred upstream in extra-alveolar vessels. At constant blood flow the relation between pulmonary artery pressure and alveolar pressure was measured while alveolar pressure was reduced from approximately 15 mmHg to zero during both normoxia and hypoxia. In control and chronically hypoxic rats the slope of this line was less than 1. At an alveolar pressure of 2-3 mmHg there was an inflection point below which the line was nearly horizontal in control but negative in chronically hypoxic rats. During hypoxia the inflection point increased in control but not in chronically hypoxic rats, whereas the preinflection slope became negative. Apart from a rise in pulmonary artery pressure at all values of alveolar pressure, which occurred in both groups of rats, there was no change in the form of the curve in chronically hypoxic rats during hypoxia. These results also suggest constriction of extra-alveolar vessels in control rats and alveolar vessels in chronically hypoxic rats during hypoxia. PMID- 3664544 TI - Autonomic modulation of aminophylline influence on the electrophysiological effects of adenosine and adenosine triphosphate in the canine heart. AB - The influence of aminophylline, a competitive antagonist of adenosine, on the chronotropic and dromotropic effects of adenosine and adenosine triphosphate was studied in pentobarbital anaesthetised dogs under various modifications of the autonomic nervous tone. Adenosine and adenosine triphosphate (3 mumol.kg-1 each) were rapidly (greater than or equal to 1 s) injected into the right atrium during both sinus rhythm and right atrial pacing (cycle length 300 ms) before and after infusion of aminophylline (5 mg.kg-1) (n = 21) as well as after increasing doses of aminophylline (n = 10). Some dogs underwent either muscarinic blockade with atropine (0.2 mg.kg-1) (n = 10), or beta adrenergic blockade with propranolol (1 mg.kg-1) (n = 10), or complete autonomic blockade with atropine and propranolol (n = 10). Aminophylline (5 mg.kg-1) antagonised the negative chronotropic and dromotropic effects of adenosine triphosphate and adenosine in dogs pretreated with atropine or atropine plus propranolol but did not affect them in autonomically intact dogs. In addition, the electrophysiological effects of adenosine were antagonised by only the highest doses of aminophylline in autonomically intact dogs and by aminophylline (5 mg X kg-1) in dogs pretreated with propranolol. It was concluded that (a) alteration of the electrophysiological effects of adenosine triphosphate and adenosine by aminophylline is appreciably influenced by the autonomic nervous tone and (b) autonomic blockade is required for the manifestation of the antagonism by aminophylline of the electrophysiological action of adenosine and adenosine triphosphate. PMID- 3664545 TI - Role of adenosine in mediating the coronary vasodilative response to acute hypoxia. AB - To test the hypothesis that adenosine is required to mediate the coronary vasodilative response to acute hypoxia haemodynamic indices, regional myocardial blood flow, and oxygen and lactate metabolism were measured in nine closed chest anaesthetised domestic swine at control, after 3-5 min of 100% nitrogen inhalation, at second control, and after 3-5 min of 100% nitrogen inhalation plus adenosine deaminase infusion in the left anterior descending coronary artery. Cardiac lymph adenosine deaminase concentration was also measured in a separate group of four animals previously reported on. Heart rate was held constant by atrial pacing during the study. Aortic mean pressure did not change. Changes in arterial and anterior interventricular vein pH, PO2, PCO2, and oxygen content were similar for each intervention. Transmural left anterior descending artery zone flow increased significantly (p less than 0.01) compared with control (1.22(0.23) ml.min-1.g-1; mean(SD)) in response to hypoxia (2.73(0.92)). Intracoronary adenosine deaminase infusion (167 nmol.s-1), however, failed to blunt the flow response to hypoxia (1.33(0.30) to 2.79(1.32); second control to hypoxia plus adenosine deaminase respectively, p less than 0.01). Mean adenosine deaminase activity (nmol.s-1) in cardiac lymph was 105(85) at the end of 10 min of intracoronary infusion (167 nmol.s-1) and 203 (148) nmol.s-1 at the end of 15 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664546 TI - Velocity field of a Bjork-Shiley valve prosthesis: influence of the disc orientation. AB - An experimental investigation was carried out on the development of physiological flows downstream of a Bjork-Shiley valve prosthesis. The post-valvular velocity field was determined by an ultrasonic method in an elastic model of the aortic arch. The flow development in the ascending aorta was strongly dependent on the orientation of the tilting disc. The rotating direction of the vortices and the site of the maximum velocity were influenced by the orientation. PMID- 3664547 TI - Absence of coronary vascular reserve in myocardium distal to a fixed coronary stenosis. AB - In a study to test the hypothesis that vascular reserve is exhausted in the setting of a resting blood flow deficit, the left anterior descending or circumflex artery was cannulated and perfused from the left carotid artery. After reactive hyperaemia had been assessed a stenosis was produced with a screw clamp. In the first experiment a moderate stenosis (diastolic perfusion pressure 40 mmHg) was produced in the left anterior descending artery (three dogs) or left circumflex artery (three dogs). Blood pressure was held constant with aortic constriction during intracoronary adenosine infusion (6 mumol.min-1). The stenosis was then adjusted to the preadenosine perfusion pressure. In the second experiment the anterior interventricular coronary vein was also isolated and segment length crystals were placed in the ischaemic and non-ischaemic zones. Severe stenosis (flow reduction of at least 50% and evidence of decreased segmental shortening) was produced in the cannulated left anterior descending artery (eight dogs). Intracoronary adenosine was given with aortic pressure held constant by transfusion and coronary venous drainage. In the first experiment resting coronary flow (ml.min-1) decreased from 41(3) to 29(6) (p less than 0.05) with stenosis. Coronary flow increased from 29(6) to 34(7) (p less than 0.05) with adenosine and to 50(10) (p less than 0.05) with stenosis adjustment. Subendocardial flow (ml.g-1.min-1) decreased from 0.89(0.26) to 0.78(0.23) (p less than 0.05) with adenosine and then increased from 0.94(0.49) with perfusion pressure adjustment. Subepicardial flow tended to increase with adenosine, and increased further with stenosis adjustment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664548 TI - Hiatus hernia and reflux esophagitis. AB - Usually, axial hiatus hernia is a common disorder that produces no symptoms and requires no treatment and in the few patients who do experience symptoms, simple nonoperative treatment measures suffice. The typical symptoms of reflux esophagitis are heartburn and nocturnal regurgitation. Most patients respond well to nonoperative treatment; any associated axial hiatus hernia is not the cause of the symptoms of reflux esophagitis and does not need treatment. In the very few patients who do need an operation, fundoplication conducted through the abdomen is recommended. In nonaxial hiatus hernia the symptoms of intermittent obstruction and bleeding are due to volvulus of the herniated stomach; volvulus produces a closed-loop obstruction, a potentially dangerous condition. Surgical repair should be undertaken when the diagnosis is made, just as for other hernias of the abdominal wall and for the same cogent reasons. Prosthetic reinforced repair conducted through the abdomen is preferred. PMID- 3664549 TI - Pathology and treatment of giant papillary conjunctivitis. I. The U.S. perspective. AB - Giant papillary conjunctivitis is a disease we are seeing more and more. I believe it can be avoided with new ways of designing the lenses and new ways of cleaning them. Meanwhile, however, we need to improve cleaning, increase our use of enzymes, irrigate the conjunctiva, change lenses often, and use cromolyn sodium to stabilize the mast cells. These measures should enable our patients to continue using their contact lenses longer. PMID- 3664550 TI - Therapeutic rounds. Treatment alternatives for a patient with psoriasis. PMID- 3664551 TI - Clinical evaluation of pediculicidal and ovicidal efficacy of two pyrethrin piperonyl-butoxide formulations. AB - The pediculicidal and ovicidal efficacy of two pyrethrin-piperonyl-butoxide agents was evaluated in 40 children infested with head lice. Both commercial products, a lotion and a shampoo, had similar formulations. Specifically, the shampoo vehicle was tested to determine whether its surface-tension-lowering action made it more effective as an ovicidal agent than the lotion. Results of the study indicate that the shampoo is 49% more effective than the lotion as an ovicide. PMID- 3664552 TI - Idiopathic gynecomastia treated with tamoxifen: a preliminary report. AB - Sixty-one Chinese men with idiopathic gynecomastia were treated with 40 mg of tamoxifen daily for one of four months (median, two months). Eighty percent had complete regression of their breast swelling. No long-term side effects of tamoxifen were observed over a median follow-up period of 36 months. PMID- 3664553 TI - Comparison of diflunisal and an aspirin-codeine combination in the management of patients having one-visit endodontic therapy. AB - One hundred seventy-nine patients with asymptomatic or mildly symptomatic endodontic disease had single-visit therapy and were given either diflunisal (n = 94) or aspirin with codeine (n = 85) to control posttreatment pain. In this open label, randomized study, diflunisal was judged superior to the aspirin-codeine combination in all major categories evaluated. Of patients receiving diflunisal, 93.6% needed the medication for only one day. In contrast, 77.7% of patients receiving aspirin with codeine needed the medication for only one day. Almost 64% of patients receiving diflunisal needed only one dose, while 32.9% of patients using aspirin with codeine needed only one dose. Four or more doses were required by 5.3% of patients receiving diflunisal and by 23.5% of patients receiving the aspirin-codeine combination. In patients receiving diflunisal, 20.2% experienced side effects. In contrast, 29.4% of patients receiving aspirin with codeine reported side effects. Thirty-five percent of patients receiving diflunisal rated the analgesic as excellent; 5.3% rated it as fair or poor. In contrast, 12.9% of patients receiving aspirin with codeine rated the analgesic combination as excellent; another 12.9% rated it as fair or poor. Diflunisal was found to be generally effective and well-tolerated, and superior to aspirin with codeine in the management of pain from endodontic treatment. PMID- 3664554 TI - Intravenous diltiazem in the treatment of unstable angina: a study of efficacy and tolerance. AB - Ten patients four men and six women aged 35 to 78 years (mean, 57) who had been admitted to a coronary care unit because of unstable angina, received intravenous infusions of diltiazem for three to ten days after a 24-hour observation period. During the observation and treatment periods, the patients were monitored daily for number of attacks of angina, nitroglycerin intake, blood pressure, and ECG parameters. Routine laboratory tests were performed before and after diltiazem therapy. Two patients did not respond to treatment, but administration of diltiazem controlled anginal pain in eight patients, without producing side effects. In one case the dose had to be reduced because of atrioventricular dissociation; in three cases there was a modest increase in SGPT. Diltiazem was found to be a safe and effective drug for controlling anginal attacks in patients with unstable angina. PMID- 3664555 TI - "Treatment of vaginal candidiasis in pregnant women,". PMID- 3664556 TI - Comparison of isolated collagen fibrils from normal and atherosclerotic human carotid arteries: an immunocytochemical approach. PMID- 3664557 TI - Action of gostatin and beta-methylene-DL-aspartate (BMA) on cerebellar aspartate aminotransferase (AAT) histochemical reaction. PMID- 3664558 TI - Anti-calmodulin autoantibody in the sera of patients with malignancies of the urogenital tract: a new antibody against a cytoskeleton-related protein. PMID- 3664559 TI - [Social reconstruction and health care]. PMID- 3664560 TI - [Psychosomatic medicine in the eighties]. PMID- 3664561 TI - [The contribution of sociobiology to the question of sex differences in the human psyche]. PMID- 3664562 TI - [Biological determinants of human sexual behavior]. PMID- 3664563 TI - [Organizational provisions for psychotherapy in hospitals with a type II polyclinic]. PMID- 3664564 TI - [The incidence of various forms of sexual contact in homosexual men]. PMID- 3664565 TI - [HLA antigens in the mothers of children with cleft lip and palate]. PMID- 3664566 TI - [A hyperthermic bath increases the cytolytic activity of NK cells]. PMID- 3664567 TI - [Reproducibility of the histamine and acetylcholine inhalation provocation test]. PMID- 3664568 TI - [HDL-cholesterol and LDL-cholesterol in younger and older obese patients and the relation to atherogenesis]. PMID- 3664569 TI - [Microfixation of complement using rabbit complement in platelet and HLA immunology]. PMID- 3664570 TI - [The antiviral and antibacterial spectrum of Norga, an immunologic preparation]. PMID- 3664571 TI - [Major trends in research of antineoplastic chemotherapeutic agents in Czechoslovakia]. PMID- 3664572 TI - [Comprehensive diagnostic approaches to tumor metastases in the skeleton. II. Present role of bone scintigraphy in the diagnosis of metastatic osteopathies]. PMID- 3664573 TI - [Comprehensive diagnostic approaches to tumor metastases in the skeleton. IV. Cytomorphologic and biochemical diagnosis of bone metastases of stage II carcinoma of the breast]. PMID- 3664575 TI - [Oncology research, its results and needs]. PMID- 3664574 TI - [Comprehensive diagnostic approaches to tumor metastases in the skeleton. V. The relation of biochemical indicators to age in the diagnosis of bone metastases of stage II carcinoma of the breast. Analysis of additional diagnostic and prognostic parameters]. PMID- 3664576 TI - [A comprehensive diagnostic approach to tumor metastases in the skeleton. VI. The bone marrow in the metastatic process in malignant neoplasms]. PMID- 3664577 TI - [A comprehensive diagnostic approach to tumor metastasis in the skeleton. VII. Perspectives in the development of additional diagnostic methods for the detection of bone marrow and bone metastases of malignant neoplasms]. PMID- 3664578 TI - [Therapy of patients with nonseminomatous testicular tumors in the first clinical stage after orchiectomy]. PMID- 3664579 TI - [The development of malignant exudates]. PMID- 3664580 TI - [Electrophysiologic basis of the electrocardiographic diagnosis of myocardial infarct]. PMID- 3664581 TI - [Regulation of blood pressure using a special infusion pump]. PMID- 3664582 TI - [Modern possibilities in the diagnosis of intracardiac thrombosis]. PMID- 3664583 TI - [The importance of monitoring myoglobinemia in neuromuscular diseases]. PMID- 3664584 TI - [A reliable criterion of the severity of inflammatory disease due to infection--C reactive protein]. PMID- 3664585 TI - [Toxicity after repeated monthly administration of Duxon, a colloidal solution, to experimental rats]. PMID- 3664587 TI - [A medical dictatorship or a medical democracy?]. PMID- 3664586 TI - [Pain in multiple sclerosis]. PMID- 3664588 TI - [The physician and ideologic-theoretical problems in medicine]. PMID- 3664589 TI - [Immunology of human seminal plasma in normal and pathologic ejaculates]. PMID- 3664590 TI - [Balint groups a year later]. PMID- 3664591 TI - [Clinical and echocardiographic study of intracardiac thrombosis in acute myocardial infarct]. PMID- 3664592 TI - [ECG Holter monitoring during tocolysis]. PMID- 3664593 TI - [Significance of the variation in the R-R interval in the ECG at rest during screening for diabetic cardiac autonomic neuropathy]. PMID- 3664594 TI - [The role of dialysis in the treatment of sudden kidney failure]. PMID- 3664595 TI - [Evaluation of the adequacy of hemodialysis]. PMID- 3664596 TI - [Vitamin A and E in the serum in the nephrotic syndrome]. PMID- 3664597 TI - [Therapy of urinary tract infections with ciprofloxacin]. PMID- 3664598 TI - [Kidney function during a toughening competition]. PMID- 3664599 TI - [Care of workers in high risk occupations. The image of the humane mission of the socialist society]. PMID- 3664600 TI - Immunohistochemical localization of laminin, neural cell adhesion molecule, collagen type IV and T-61 antigen in the embryonic retina of the Japanese quail by in vivo injection of antibodies. AB - Antibodies against laminin (LN), fibronectin (FN), collagen type IV (Col IV), neural cell adhesion molecule (N-CAM), T-61 antigen, actin, tubulin and neurofilament protein were injected into the eyes of quail embryos (Coturnix coturnix japonica) of different ages. Twenty h after injection, the heads of the embryos were fixed and the antibodies visualized in sections with the use of fluorescein-isothiocyanate (FITC) or peroxidase-labeled second antibodies by light- and electron microscopy. Antibodies against cell surface molecules, such as N-CAM, LN, Col IV and T 61, labeled matrix and membrane components of the retinal cells in different antigen-specific patterns. Antibodies against intracellular antigens, such as actin, tubulin and neurofilament protein labeled nonspecifically the vitreous body and the inner basal lamina of the retina, but resulted in only a very weak and diffuse labeling of retinal cells. N-CAM was detected in high concentration in the optic fiber layer on the surface of axons and on the membranes of all retinal cells. Col IV, LN and T 61 antigen were found predominantly in the optic fiber layer. LN and Col IV were located on the surface of axons and the endfeet of ventricular (neuroepithelial) cells in a patchy distribution. The T-61 antigen was found in early stages in the cell-free space of the optic fiber layer, on the surface of ventricular cells and axons, and at later stages also in high-density patches between nerve fibers. The distribution of LN and T-61 antigen together with data from in vitro experiments suggests a crucial role of these proteins in axon extension in the avian retina during early development of the optic fiber layer. PMID- 3664602 TI - Freeze-fracture study of the lateral-line canal organ of the Japanese sea eel, Lincozymba nystromi. AB - Specializations of apical surfaces of hair cells, supporting cells and marginal cells in the lateral-line canal organ of Japanese sea eel, Lincozymba nystromi, were examined with a freeze-fracture technique. Apical surfaces of hair cells have a lower density of intramembrane particles (IMP) than those of the surrounding supporting cells. Density of IMP on the stereocilia is almost the same as that on the apical surface of hair cells. Junctions between hair and supporting cells were tighter than those between two supporting cells; those between supporting and marginal cells were tighter than those between hair and supporting cells, and those between two marginal cells were the tightest in the lateral-line canal organ. PMID- 3664601 TI - Muscle damage and repair in voluntarily running mice: strain and muscle differences. AB - Soleus, extensor digitorum longus and tibialis anterior muscles of mice voluntarily running in wheels for periods of 5 to 120 days were studied in spaced serial and serial cross-sections. Shortly after the onset of running and during the next 2 weeks, degeneration, necrosis, phagocytosis and regeneration of muscle fibers, satellite cell proliferation and cellular infiltration were found in soleus muscles of mice from all strains investigated (CBA/J, NMRI, C57bl, NIH, SWS and Balb/c). Tibialis anterior but not extensor digitorum longus muscles were also damaged. Predominantly high-oxidative fibers were affected (both slow oxidative and fast oxidative glycolytic in soleus, fast-oxidative glycolytic in tibialis anterior). Denervated soleus muscles that had been passively stretched during running were not damaged. Evidence was found that, during the early period of running, split fibers form by myogenesis within (regeneration) or outside (satellite cell proliferation) necrotic muscle fiber segments. Split fibers persisted in solei of long-term (2 to 3 months) exercised CBA/J but not NMRI mice. In 6 out of 20 solei of CBA/J runners exercised for 2 months or longer, fiber-type grouping was observed in the areas where extensive damage usually occurred in the early periods. The results show that different muscles are damaged and repaired to varying degrees and that marked interstrain and inter individual differences are present. It appears that acute muscle injury occurring upon onset of voluntary running is a usual event in the adaptation of muscles to altered use. PMID- 3664603 TI - Estrogens and cell death in murine uterine luminal epithelium. AB - The luminal epithelium of adult ovariectomized mice responds to estradiol-17 beta with a synchronised wave of DNA synthesis and mitosis. Estriol, however, although producing a similar DNA-synthetic and mitotic response fails to cause an increase in cell number owing to a wave of cell death occurring at mitosis. In the present study it was shown that cells died by two different routes. The majority died by apoptosis but, unusually, a minority also died by necrosis. In the apoptotic cells the cytoplasm became dense, the endoplasmic reticulum and nuclear cisternae dilated; chromatin became marginated the nucleus shrank and became deeply infolded and contorted. Apoptosis, however, was uncharacteristic in that the nucleus failed to fragment, form caps or show disruption before the cells died by membrane rupture. Furthermore, the cells were frequently lost in sheets from the epithelium into the lumen. Part of the biochemical explanation for this onset of cell death comes from the accelerated loss from the tissue of estriol when compared to estradiol-17 beta. This resulted in a decline in protein and rRNA biosynthesis and a failure to complete ribosomal maturation. Evidence in favour of this explanation came from experiments that showed a return to the estradiol 17 beta level of response and an inhibition of cell death when the occupancy of the estriol receptor was maintained. PMID- 3664604 TI - Electron-microscopic and immunocytochemical analyses of Weibel-Palade bodies in the human umbilical vein during pregnancy. AB - The present study was done to elucidate the biological significance of the Weibel Palade body of human umbilical vein endothelial cells. Quantitative determinations of these endothelial-specific granules throughout pregnancy revealed that their numbers and size per cell profile were maintained at low levels from 12 to 19 weeks of gestation; then both rapidly increased from 33 weeks to full term. This increase coincided with the development of the rough endoplasmic reticulum and an increase in the number of endothelial cell pinocytotic vesicles. Light-microscopic peroxidase anti-peroxidase and electron microscopic protein A-gold techniques provided evidence that factor VIII-related antigen was localized in the Weibel-Palade bodies. Furthermore, in vitro treatment of incubated umbilical vein tissue with compound 48/80, a histamine releaser, induced degranulation of Weibel-Palade bodies from the endothelium. The present study indicates that Weibel-Palade bodies are storage sites of both histamine and factor VIII-related antigen and have an important role in the obliteration of this vessel. PMID- 3664606 TI - Intraventricular blood vessels associated with the deep pineal gland of the Mongolian gerbil, Meriones unguiculatus. AB - Intraventricular blood vessels and choroidal-like cells were studied using scanning electron microscopy and correlative light microscopy. The intraventricular blood vessels were covered on their ependymal surface with a layer of cells essentially identical to the ependyma of the choroid plexus in the gerbil. Similar choroidal-like cells were seen either singly or in clusters associated with the cerebrospinal fluid-contacting pinealocytes of the suprapineal recess. Processes of the cerebrospinal fluid-contacting pinealocytes were seen extending to and making contact with the choroidal-like cells. The intraventricular blood vessels appeared to be derived from the choroid plexus, and typically took one of three courses in and around the surface of the deep pineal: (1) the vessels or their equivalent were located in the suprapineal recess with no indication of penetration into the substance of the deep pineal; (2) the vessels coursed from the suprapineal recess around the anterior surface of the habenular commissure to enter the ventral surface of the deep pineal; or (3) the vessels entered the parenchyma of the deep pineal from its dorsal surface and could be seen coursing through the substance of the gland. The close association between the choroidal-like cells and the intraventricular blood vessels with the deep pineal gland add morphological support for the possibility of interaction between the cerebrospinal fluid, or perhaps the choroid plexus, and the deep pineal gland. PMID- 3664605 TI - Endocytosis of native and cationized ferritin by intralobular duct cells of the rat parotid gland. AB - The ability of the intralobular ducts of the rat parotid gland to take up protein from the lumen was examined after retrograde infusion of native and cationized ferritin. At high concentrations (3-10 mg/ml), cells of both intercalated- and striated ducts avidly internalized the tracers. No differences were noted in the mode of uptake or fate of native or cationized ferritin. Large, apical ferritin containing vacuoles up to 5 microns in size were present in cells of the intercalated ducts after infusion for 15 min. Small, smooth-surfaced spherical or flattened vesicles and tubules containing ferritin were also observed, often in association with the large vacuoles. Ferritin uptake increased with increasing infusion time, up to 1 h. Uptake by the striated ducts was less consistent than by the intercalated ducts, and occurred mainly in small vesicles and tubules. Secondary lysosomes became labeled with ferritin in both cell types. Ferritin was not observed in the Golgi saccules, nor was it discharged from the cells at the basolateral surfaces. At low concentrations (0.3-1 mg/ml), uptake was reduced, especially by cells of intercalated ducts, and differences were noted in the behavior of the two tracers. Cationized ferritin was internalized mainly into vesicles and tubules of cells of striated ducts; little uptake of native ferritin occurred at low concentrations. These results demonstrate that the ductal cells of the salivary glands are capable of luminal endocytosis of foreign proteins. They also suggest that in addition to modifying the primary saliva by electrolyte reabsorption and secretion, and secretion of various glycoproteins, the ductal cells are able to reabsorb proteins secreted by the acinar cells. PMID- 3664607 TI - Localization of high-affinity GABA uptake and GABA content in the rat duodenum during development. AB - The localization of high-affinity uptake sites for 3H gamma-aminobutyric acid (3H GABA) was investigated in the rat duodenum during ontogenesis and also at the adult stage (from 15.5 days of fetal life up to 105 days post natum) by means of low- and high-resolution autoradiography. At all stages studied, specific endocrine cell types of the epithelium were labelled and an intense uptake was detected in the nervous tissue, especially in glial cells but also in scarce neurones. When the incubation medium was supplemented with beta-alanine (1 mM), a blocker of the glial uptake for GABA, the labelling persisted only in endocrine cells and in few neurones. The intensity and the frequency of the labelling decreased at later periods compared to the earlier developmental stages. The GABA content of the duodenum as measured by a new ion-exchange column chromatography HPLC-coupled method was higher in the early postnatal period compared to later stages. These observations suggest that GABA, in addition to being a neurotransmitter, may play an important role during development of the duodenum. PMID- 3664608 TI - Ultrastructural localization of acetylcholinesterase in the synganglion of the tick, Dermacentor variabilis (Say). AB - Light- and electron-microscopic enzyme cytochemistry was used to localize acetylcholinesterase (AChE) activity in the synganglion (brain) of the tick Dermacentor variabilis. High AChE activity was observed throughout the neuropil as well as adjacent to most neuronal perikarya. Intracellular activity was not observed by light microscopy. By electron microscopy, reaction product was localized at the plasma membrane of glia and neurons. Enzyme activity was not associated with the olfactory globuli neurons. In other types of neurons, small amounts of reaction product were observed in the Golgi apparatus and nuclear envelope. Large neurosecretory neurons contained activity that appeared to be associated with deep invaginations of the plasma membrane as well as intracellular membranes. AChE activity was also associated with processes of both neurons and glia. In most peripheral nerves AChE activity was associated with virtually all axons. Clearly then, AChE is associated with glia and non cholinergic neurons as well as with presumed cholinergic neurons. The widespread localization and large amounts of AChE in the tick brain exceeds that reported for other invertebrates and vertebrates. As has been suggested for other animals, AChE in the tick brain may have functions in addition to its known role in cholinergic neurotransmission. PMID- 3664610 TI - [A mathematical model of age distribution of cerebrovascular diseases mortality]. PMID- 3664611 TI - [Surveillance of birth defects in Bengbu]. PMID- 3664609 TI - Isolation and culture of cells derived from human cerebral microvessels. AB - Microvessels were isolated from non-neoplastic human cerebral cortical fragments resected for treatment of intractable seizure disorder. The microvessels were incubated in modified Lewis medium with 20 or 30% fetal bovine serum. Within 1-2 weeks, two cell populations emerged from the isolates. One type of cells had polygonal morphology, showed density-dependent contact inhibition at confluence in vitro, showed lectin-binding characteristics of endothelium (but only moderate positivity for factor VIII antigen), demonstrated induction of gamma-glutamyl transpeptidase when exposed to astrocyte-conditioned media, and responded to insulin by a pronounced increase in DNA synthesis. The other variety of cells grew in vitro more slowly in irregular strands separated by clear zones, showed ultrastructural features of smooth muscle, and isoelectric focusing of cell proteins revealed the presence of smooth-muscle-specific alpha-isoactin. Both types of cells could be serially subcultured. The ability to isolate and grow the two cell types, tentatively identified as human cerebral microvascular endothelium and smooth muscle, may facilitate studies of human blood-brain barrier function as well as the pathogenesis of cerebral microangiopathies unique to the human brain. PMID- 3664612 TI - [An investigation of epidemiology of psoriasis in Shanghai in 1985]. PMID- 3664613 TI - [Study on the prevalence of Parkinson's disease in Hongkou District, Shanghai]. PMID- 3664614 TI - [A survey of causes and epidemiology of death of pupils at middle and primary schools in Chengdu rural district, 1982-1984]. PMID- 3664615 TI - [A study on the epidemic characteristics of influenza in Qingdao]. PMID- 3664616 TI - [A study of identification of two atypical strains of Brucella melitensis]. PMID- 3664617 TI - [An investigation of geographical distribution and role in malaria transmission of Anopheles anthropophagus in Fujian]. PMID- 3664618 TI - [A surveilant report of malaria in the area of Gezhouba reservoir. The Scientific Collaborating Group for Surveillance of Malaria in Gezhouba reservoir]. PMID- 3664619 TI - [A new biological indication used in the surveillance of disinfection]. PMID- 3664620 TI - [Observation of effect of K-othrin for killing Periplaneta americana]. PMID- 3664621 TI - [A study on the epidemiological features and serotype distribution of Campylobacter jejuni enteritis in children]. PMID- 3664622 TI - [Present status and prospects of non-communicable disease epidemiology]. PMID- 3664623 TI - [Study of SpA-coagglutination in the detection of Bacteroides fragilis]. PMID- 3664624 TI - [Analytical methods stratified by confounding factors]. PMID- 3664625 TI - [Relation between epidemiology and immunology]. PMID- 3664626 TI - Quantitative analysis of coronary arteriograms by microprocessor cinevideodensitometry. AB - A rapid microprocessor technique for measuring the cross-sectional area, diameter, and relative percentage stenosis of coronary atherosclerotic lesions by cinevideodensitometric analysis was developed and validated. Video images of projected 35-mm coronary arteriographic cine frames were analyzed from cinevideodensitometric profile curves recorded for the catheter shaft, normal artery, and stenotic segment. In radiographic phantom studies of calibrated, contrast-filled, plexiglass cylinders, cinevideodensitometric measurements correlated linearly with percentage relative stenosis (r = 0.98; SEE = 4.1%), diameter (r = 0.99; SEE = 0.12 mm), and cross-sectional area (r = 0.99; SEE = 0.32 mm2). In postmortem studies of two patients dying after coronary arteriography, cross-sectional areas of arterial segments measured by cinevideodensitometry correlated well (r = 0.99; SEE = 0.71 mm) with areas of acrylic resin casts of the coronary arteries. Intraobserver variability (r = 0.99; SEE = 2.6%) and interobserver variability (r = 0.96; SEE = 5.3%) of cinevideodensitometric measurements of coronary arteriograms were low. Additionally, percentage relative stenosis measured in the right anterior oblique projection correlated well with measurements in the left anterior oblique projection (r = 0.98; SEE = 0.11 mm2) of patients with eccentric stenotic lesions. Lastly, cinevideodensitometric measurements were significantly (p less than 0.05) more reproducible than caliper measurements. This inexpensive dedicated microprocessor system provides rapid cinevideodensitometric measurements of coronary arterial dimensions, without requiring manual tracing of arterial segments or the major expense of a main-frame computer system. PMID- 3664627 TI - The simplified formula for the calculation of aortic valve area: potential inaccuracies in patients with bradycardia or tachycardia. AB - Since the Gorlin equation for calculation of aortic valve area is somewhat complicated, a simplified formula has been introduced in which the cardiac output (in liters/min) is divided by the square root of the peak pressure gradient across the valve (in mmHg), yielding a valve area in cm2. This study was done to examine the reliability of this simplified formula in patients with bradycardia or tachycardia. In 68 patients with aortic stenosis, aortic valve area was calculated with both formulae, and the results were compared with one another. In the 43 individuals whose heart rates were 65 to 100 beats/min, the results of the Gorlin equation and the simplified formula showed excellent agreement (absolute percentage difference, 8 +/- 8% [mean +/- SD]). In contrast, in the 25 patients whose heart rates were less than 65 or greater than 100 beats/min, the absolute percentage difference between the results of the two formulae was 18 +/- 13% (p less than 0.001). Although the results of the two equations were especially likely to be disparate in these patients, there was no predictable relationship between them. Thus, in patients with bradycardia or tachycardia, the simplified formula should be utilized with caution and cognizance of its potential inaccuracy. PMID- 3664628 TI - Efficacy and safety of outpatient cardiac catheterization. AB - Outpatient cardiac catheterization has become the standard in our laboratory. The only exclusion for outpatient study is current hospitalization for cardiac symptoms. Thus, any patient well enough to be at home is studied on an outpatient basis. We reviewed our experience on 4,094 diagnostic studies of which 3,537 (86%) were done on a same-day basis. The complication rates were generally lower than in published series with a mortality of 0.05%. There were no admissions for late bleeding. Ninety-seven percent of the procedures were done by the percutaneous technique utilizing 7-French catheters. Patients were heparinized, and protamine was not used. The low complication rate is to a large extent due to meticulous postoperative care by critical care nurses in an outpatient observation unit contiguous to the laboratory. Outpatient cardiac catheterization is a safe, cost-saving approach applicable to a large majority of cardiac patients. PMID- 3664629 TI - Massive hemoptysis associated with isolated peripheral pulmonary artery stenosis. AB - A fatal case of massive hemoptysis in a patient with isolated peripheral pulmonary artery stenosis is described. Such patients are predisposed to developing pulmonary artery aneurysms. When hemoptysis develops, erosion of an aneurysm into an adjacent bronchus should be considered and aggressive diagnostic evaluation undertaken. PMID- 3664630 TI - Total occlusion of the left main coronary artery in chronic stable angina pectoris. AB - We present the clinical and angiographic profile of three patients with class I stable angina pectoris. All had strong coronary risk factors, and stress testing was positive in stage one of the Bruce protocol. Coronary angiography revealed total occlusion of the left main coronary artery (LMCA), and aortocoronary bypass surgery was performed. Thus, total LMCA occlusion may be an unexpected angiographic finding in patients with class I angina. PMID- 3664631 TI - Coronary collateral blood flow in a patient with angiographically normal coronary arteries. AB - A 36-year-old man underwent coronary arteriography for evaluation of chest pain. His coronary arteries were smooth and free of obstructive disease. Selective right coronary injection revealed a large collateral vessel that opacified distal and proximal portions of the left circumflex coronary artery. Our case supports the view that coronary collateral vessels may occur in the absence of obstructive lesions. PMID- 3664632 TI - Approach to reduction of vascular complications of percutaneous valvuloplasty. AB - The large-bore arterial sheaths required for balloon valvuloplasty and intraaortic balloon pumps may be associated with substantial morbidity when introduced into the superficial femoral artery in elderly people, especially women and those with peripheral atherosclerosis. We report a total occlusion of the superficial femoral artery by a large intravascular sheath requiring subsequent surgical intervention. A femoral arteriogram using less than 10 cc of contrast through a 5F catheter can assure placement of the puncture into the common femoral artery prior to introducing the large sheath or catheter, thus reducing morbidity. PMID- 3664633 TI - Reporting, filing, and retrieval of coronary angiographic findings: a new personal computer-based system. AB - A software system for semiautomatic reporting and automatic filing of coronary angiographies has been developed and is suitable for an IBM Personal Computer (PC) with graphic tablet and printer. Coronary angiographic findings referring to the native anatomy, pathology, and post-surgical status can be easily recorded. The data is automatically coded and filed according to category of information. This system can analyze previously filed data and perform searches under one or more angiographic findings. This allows for a comparison of different series of patients. PMID- 3664634 TI - Semicircular curve catheter for pulmonary artery catheterization. AB - Catheters with a distal curve consisting of a half circle of 7.5 cm diameter have been found to markedly facilitate pulmonary artery catheterization from either arm in adults. The full semicircular curve holds the tip off the lateral wall of the right ventricular outflow tract facilitating its passage, reducing arrhythmias, and reducing the chance of perforation. The curve was factory-formed into both end-hole type catheters for pressures, pulmonary wedging, and blood sampling and formed into side-hole catheters with a closed-end, as the NIH, for pulmonary angiograms. In 179 of 182 procedures, it was observed clearly to facilitate, to make more gentle, and to speed pulmonary artery catheterization as compared to catheters with lesser curves. PMID- 3664635 TI - Left-sided superior vena cava: a rare anomaly precluding transvenous implantation of a permanent pacemaker. PMID- 3664636 TI - Selective removal of transcription-blocking DNA damage from the transcribed strand of the mammalian DHFR gene. AB - We find a dramatic difference in the efficiency of removal of UV-induced pyrimidine dimers from the transcribed and nontranscribed strands of the dihydrofolate reductase (DHFR) gene in cultured hamster and human cells. In hamster cells, 80% of the dimers are removed from the transcribed strand in 4 hr, but little repair occurs in the nontranscribed strand even after 24 hr. In human cells, repair is significantly faster in the transcribed strand than in the other strand. Furthermore, in the 5' flanking region of the human DHFR gene, selective rapid repair occurs in the opposite DNA strand relative to the transcribed strand of the DHFR gene. This strand is thought to serve as a template for transcription of a divergent transcript. These results have important implications for excision repair pathways and mutagenesis in mammalian cells. PMID- 3664637 TI - Inactivation of transcription by UV irradiation of T. brucei provides evidence for a multicistronic transcription unit including a VSG gene. AB - We have used inactivation of transcription by UV irradiation to map transcription units in trypanosomes. The relative inactivation rate of the transcription of mini-exon, 5S, and rRNA genes was inversely proportional to the previously estimated lengths of these transcription units. The telomeric transcription unit containing the gene for variant-specific surface glycoprotein (VSG) 221 was inactivated as a single unit of 60 kb. This long transcription unit comprises at least one other protein-coding gene and yields seven other stable mRNAs. These data thus provide evidence for a multicistronic transcription unit for cellular genes in a eukaryote. PMID- 3664638 TI - A genetic linkage map of the human genome. AB - We report the construction of a linkage map of the human genome, based on the pattern of inheritance of 403 polymorphic loci, including 393 RFLPs, in a panel of DNAs from 21 three-generation families. By a combination of mathematical linkage analysis and physical localization of selected clones, it was possible to arrange these loci into linkage groups representing 23 human chromosomes. We estimate that the linkage map is detectably linked to at least 95% of the DNA in the human genome. PMID- 3664639 TI - Revertants of v-fos-transformed fibroblasts have mutations in cellular genes essential for transformation by other oncogenes. AB - Morphologic revertants of FBJ murine sarcoma virus (v-fos)-transformed rat-1 fibroblasts were isolated using a novel selection procedure based on prolonged retention of rhodamine 123 within mitochondria of v-fos-transformed versus normal fibroblasts. Two classes of revertants were isolated: class I revertants have sustained mutations in cellular genes, and a class II revertant has a nonfunctional v-fos provirus. Somatic-cell hybridization studies suggested that the revertant phenotype was recessive to the transformed phenotype. Class I revertants were also resistant to retransformation by v-gag-fos-fox, v-Ha-ras, v abl, and v-mos, but could be retransformed by the trk oncogene and polyoma virus middle T antigen. These results suggest that the class I revertants sustained mutations in one or more cellular genes essential for transformation by some, but not all, oncogenes. Our data suggest the existence of common biochemical pathways for transformation. PMID- 3664640 TI - Pattern abnormalities induced by ectopic expression of the Drosophila gene hairy are associated with repression of ftz transcription. AB - The pair-rule segmentation gene hairy (h) is expressed and required in alternate metameres in the early Drosophila embryo. We show that h expression outside these domains, driven by an hsp70 promoter, suppresses the expression of fushi tarazu (ftz). The kinetics of action favor h acting directly as a transcriptional repressor. The resulting pattern defects, and the patterns of en and Ubx activity, can be explained if h acts via ftz and other pair-rule genes in the establishment of stable en domains. We present evidence that ftz is required for the initiation of Ubx transcription, but not for its maintenance. PMID- 3664641 TI - A defective interfering RNA that contains a mosaic of a plant virus genome. AB - A symptom-modulating RNA associated with tomato bushy stunt virus (TBSV) was investigated with respect to physical and biological properties. Linear RNA of approximately 396 nucleotides was packaged in viral coat protein and was dependent on TBSV for replication. Coinoculation of the small RNA with TBSV resulted in the attenuation of TBSV-induced symptoms and depression of virus synthesis in whole plants. Nucleotide sequence analysis revealed that the symptom modulating RNA was derived from 5', 3', and internal segments of the TBSV genome. The identification of this symptom-modulating RNA as a co-linear deletion mutant of the helper virus genome establishes it as the first definitive defective interfering RNA (DI RNA) to be identified in association with a plant virus. PMID- 3664642 TI - Transient activation of oocyte 5S RNA genes in Xenopus embryos by raising the level of the trans-acting factor TFIIIA. AB - The concentration of the trans-acting factor, TFIIIA, required for the activation of 5S RNA genes in Xenopus can be elevated in developing embryos by injecting a synthetic full-length mRNA into fertilized eggs. 5S RNA genes are activated by the increased factor concentration at the mid-blastula transition through mid gastrulation. The activated oocyte 5S RNA genes are then inactivated, leaving the TFIIIA-enhanced embryos with the same profile of differential 5S RNA gene activity as control embryos, i.e., synthesizing mainly somatic 5S RNA. Inactivation of the oocyte 5S RNA genes is complete by neurulation and can occur in the absence of DNA replication. We propose that this loss of gene activity is due at least in part to destabilization of transcription complexes that are associated with oocyte 5S RNA genes. PMID- 3664643 TI - Calorie restriction modifies the delayed-type hypersensitivity response to the hapten trinitrobenzenesulfonic acid and to hapten-modified syngeneic spleen cells. AB - We have studied the influence of different degrees of calorie restriction on the induction and the regulation of the delayed type hypersensitivity (DTH) response to trinitrobenzenesulfonic acid (TNBS) and TNBS-modified spleen cells (TNBS-SC), injected by the sc or the iv route. Immediately after weaning, BALB/c mice were placed on restricted diets for either 2 or 4 weeks and then the DTH response was induced. The results showed that a 37.5% restriction in the food supply significantly depressed the level of the DTH response induced by the sc injection of TNBS-SC. In contrast, a 25% restriction in the food supply was insufficient to depress the response. Calorie restriction did not modify the inhibitory influence of an iv injection of TNBS-SC on the DTH response. However, iv presensitization with free hapten or the simultaneous injection of TNBS-SC by the iv and the sc routes did not significantly depress the DTH response in calorie-restricted mice, indicating a defect in the inhibitory regulation of the DTH response in these dietary groups. PMID- 3664644 TI - [Determination of auto-antithyroglobulin antibodies in blood]. PMID- 3664646 TI - [Future clinico-pharmaceutical perspectives in pharmaceutical science]. PMID- 3664645 TI - [The effect of calcium on L-triiodothyronine binding to membrane receptors on human leukocytes]. PMID- 3664647 TI - [Delayed effects of the short-term administration of cytostatic agents]. PMID- 3664648 TI - [Relation of nonsteroidal anti-inflammatory agents and reserpine to calcium homeostasis]. PMID- 3664649 TI - [Cleft lip and palate: the effect of parity and multiple pregnancy]. PMID- 3664650 TI - [Absorption of amniotic fluid at 650 nm and hyaline membranes]. PMID- 3664651 TI - [Abortion in relation to reproductive behavior and the outcome of the subsequent pregnancy]. PMID- 3664652 TI - [Do oral contraceptives increase the risk of developing cholelithiasis?]. PMID- 3664653 TI - [Menarche and the menstrual cycle in outstanding and active female athletes]. PMID- 3664654 TI - [Experience with pre-pregnancy care of severe cervical incompetence and its surgical correction]. PMID- 3664655 TI - [Maternal satisfaction with obstetrical care and their attitude to fetal monitoring and the type of puerperal care unit (together with the child or separated from the child)]. PMID- 3664656 TI - [Congenital fatal toxoplasmosis sepsis]. PMID- 3664657 TI - [Childbirth in a rare disorder of cholesterol metabolism (cholesterol ester storage disease)]. PMID- 3664658 TI - [Physiologic substitution of estrogens and progesterones]. PMID- 3664659 TI - [Immunodiagnosis in women with ovarian carcinoma]. PMID- 3664660 TI - [New Czechoslovak legislation on artificial interruption of pregnancy]. PMID- 3664661 TI - [Liver diseases in pregnancy from the viewpoint of the obstetrician and pediatrician. I. Cholestatic hepatosis during pregnancy]. PMID- 3664662 TI - [Mobility of the spine in active female athletes during the climacteric]. PMID- 3664663 TI - [Colpitis]. PMID- 3664664 TI - [Antiestrogens of a nutritional origin in humans]. PMID- 3664665 TI - [Comments on gynecologic care in adolescence]. PMID- 3664666 TI - [Gynecologic problems through the eyes of the pediatrician and the adolescent medicine physician]. PMID- 3664667 TI - [Thoughts on the past, present, and future of pediatric gynecologic oncology]. PMID- 3664668 TI - [Gynecology of children and adolescents. A selection of reports presented at the statewide scientific conference of the Czech Society of Gynecology and Obstetrics. Ceske Budejovice, 2-3 October 1986. Abstracts]. PMID- 3664669 TI - [Humoral and nonspecific immunity at the end of pregnancy and in the puerperal period]. PMID- 3664670 TI - [Pregnancy in the premorbid period and during systemic lupus erythematosus]. PMID- 3664671 TI - [Fertility in women treated for adnexitis during adolescence]. PMID- 3664672 TI - [Vulvoplethysmographic reaction to visual stimuli in 100 women]. PMID- 3664673 TI - [Terminology of artificial interruption of pregnancy]. PMID- 3664674 TI - [Relation between the season of menarche onset and birth order in girls in eastern Slovakia]. PMID- 3664675 TI - [AIDS as an obstetrical problem]. PMID- 3664677 TI - [Artificial fertilization]. PMID- 3664676 TI - [Problems related to the sex ratio]. PMID- 3664678 TI - [Abstracts of reports presented at the 14th conference of the Commission on Experimental Cardiology and Physiology of the J. E. Purkinje Medical Society. 20 22 November 1985, Smolenice]. PMID- 3664679 TI - [Evoked responses of the retina and brain to structured photic stimulation: basic data]. PMID- 3664680 TI - [Reconstruction of traumatic damage to the orbital rim]. PMID- 3664681 TI - [Combined injury of the eye and orbit leading to loss of the eye]. PMID- 3664682 TI - [Unusual self-mutilation of the eye]. PMID- 3664683 TI - [Dystrophia albipunctata retinae and fundus albipunctatus]. PMID- 3664684 TI - [Retinal detachment in children]. PMID- 3664685 TI - [Electro-tonography study of patients treated with Timoptic]. PMID- 3664686 TI - [Sheathing of the retinal veins in multiple sclerosis]. PMID- 3664687 TI - [Personal experience with laser iridotomy]. PMID- 3664688 TI - [Personal experience with the Britt pulsed argon laser in the treatment of glaucoma]. PMID- 3664689 TI - [Unusual orbital injuries]. PMID- 3664690 TI - [Fibrous dysplasia of the orbit]. PMID- 3664691 TI - [The fluoroangiographic picture of sex-linked hereditary retinoschisis]. PMID- 3664692 TI - [Work capacity of glaucoma patients]. PMID- 3664693 TI - [The toxic effects of organophosphorus compounds on the rabbit eye. I. Ultrastructural changes in the cornea]. PMID- 3664694 TI - [Kenalog injection--one possibility in the treatment of chronic chalazion]. PMID- 3664695 TI - [The knowledge requirement of level I applicants for certification in medical first aid]. PMID- 3664696 TI - [The structure and function of crypts in the palatine tonsils]. PMID- 3664697 TI - [Clinical significance of HLA monitoring in carcinoma of the nasopharynx]. PMID- 3664698 TI - [Surgery of cholesteatoma in childhood]. PMID- 3664699 TI - [Impedance audiometry and brain stem evoked potentials in premature infants, neonates, infants, and toddlers]. PMID- 3664700 TI - [Hearing in workers under 30 years of age after 10 years' work in a noisy environment]. PMID- 3664701 TI - [Sampling of audiometric losses in 15-year-old students]. PMID- 3664702 TI - [Objective measurement of laryngeal stenosis using the Stenoquantograph and Mingograph]. PMID- 3664703 TI - [Sarcoidosis with involvement of the upper respiratory tract]. PMID- 3664705 TI - [Resocialization of patients after total laryngectomy]. PMID- 3664704 TI - [The effect of gentamycin on the ear]. PMID- 3664706 TI - [Treatment of hypopharyngeal carcinoma in the South Bohemia Region 1961-1980. Retrospective study]. PMID- 3664707 TI - [Hereditary nephropathies. I. The clinical picture in children and adults]. PMID- 3664708 TI - [Hearing tests using everyday outdoor sounds in pediatric patients]. PMID- 3664709 TI - [Development of hyperfunctional voice disorders in teachers studied 1972-1985 at the phoniatric department of the Medical School Hospital in Bratislava]. PMID- 3664711 TI - [Standardization of audiometry examinations]. PMID- 3664710 TI - [Actinomycotic and mycotic diseases in otolaryngology]. PMID- 3664712 TI - [Epidemiologic study of patients with laryngeal carcinoma in the South Moravia Region 1980-1985]. PMID- 3664713 TI - [Report on a study trip to Denmark]. PMID- 3664714 TI - [Biopsy examination of the myocardium in congenital heart defects]. PMID- 3664715 TI - [The repair process in experimental laser wounds. I. Skin and the external ear]. PMID- 3664716 TI - [The repair process in experimental laser wounds. II. Liver and spleen]. PMID- 3664717 TI - [The repair of experimental laser wounds. III. Striated muscle and adipose tissue]. PMID- 3664718 TI - [Mastocytes in Hodgkin's lymphoma]. PMID- 3664719 TI - [Early carcinoma of the stomach]. PMID- 3664721 TI - [The Lauren classification of gastric carcinoma (retrospective study of archival material from 1969 to 1983)]. PMID- 3664720 TI - [Reactivity of monoclonal antibodies against vimentin and desmin (VI-01) in human tissue]. PMID- 3664722 TI - [Generalized epithelioid granulomatous reaction with myeloproliferative syndrome associated with pleural mesothelioma and Kaposi's sarcoma]. PMID- 3664723 TI - [Specific value of ocular "bobbing" and "dipping"]. PMID- 3664724 TI - [Cerebrospinal fluid levels of selected hypophyseal hormones in expansive processes in the sellar region]. PMID- 3664726 TI - [16th statewide neurovascular symposium. Martin, 27-28 November 1986]. PMID- 3664725 TI - [Changes in psychological parameters after hemodilution in cerebrovascular diseases]. PMID- 3664727 TI - [Cerebrovascular malformations not visualized on arteriography]. PMID- 3664728 TI - [Focal brain ischemia in children--basic clinical aspects]. PMID- 3664729 TI - [Balloon catheters for percutaneous intravascular obliteration of cerebral vessels. Experimental experience]. PMID- 3664730 TI - [Relation between epileptic seizures and paroxysmal activity on the EEG in primary hemispheric tumors]. PMID- 3664731 TI - [Human leukocyte antigens in children with spinal muscular atrophy]. PMID- 3664732 TI - [Evaluation of information on neurologic medical records using a computer]. PMID- 3664733 TI - [Familial hemiplegic migraine. Differential diagnosis of transitory ischemic attacks ]. PMID- 3664734 TI - [Report on a visit to neurophysiology facilities in Sweden. 1]. PMID- 3664736 TI - [Symptomatic mental disorders]. PMID- 3664735 TI - [Phalloplethysmographic reaction in homosexual offenders]. PMID- 3664737 TI - [Lithium in affective psychoses in the aged]. PMID- 3664738 TI - [Theoretical outline of behavioral approaches in the therapy of obesity]. PMID- 3664739 TI - [Possibilities of therapeutic and educational treatment of criminal psychopaths in correctional institutions]. PMID- 3664740 TI - [Predictive criteria of the success of institutional therapy in sexology]. PMID- 3664741 TI - [Possibilities and limitations of psychology in the somatic disciplines]. PMID- 3664742 TI - [Defects in a child born to a mother dependent on barbiturates]. PMID- 3664743 TI - [The family visit as a diagnostic and therapeutic technic]. PMID- 3664744 TI - [Normovolemic hyponatremia in hospitalized children]. PMID- 3664745 TI - [Insulin resistance is dependent on the degree of compensation in juvenile diabetes]. PMID- 3664746 TI - [Results of screening for congenital hypothyroidism in Slovakia]. PMID- 3664747 TI - [Follow-up of patients with isolated pulmonary artery stenosis after an 18-year interval]. PMID- 3664748 TI - [Perinatal brain damage, cerebral blood flow and possibilities of its measurement]. PMID- 3664750 TI - [A few words directed to lecturers and their audience]. PMID- 3664749 TI - [The physician and the computer. 6. Evaluation of processes in biological systems]. PMID- 3664751 TI - [Amikacin resistance transfer in Enterobacteriaceae isolated at various departments of the Medical School Hospital]. PMID- 3664752 TI - [Physiologic values of thyroid hormones and the thyrotropic hormone in neonates]. PMID- 3664753 TI - [The role of invasive and noninvasive methods in the preoperative examination of children with congenital heart defects]. PMID- 3664754 TI - [The effect of risk factors in the onset and development of obstructive bronchitis in children]. PMID- 3664755 TI - [Incidence of neonates treated with exchange transfusion for hemolytic disease due to ABO system incompatibility during the past 16 years]. PMID- 3664756 TI - [Relation of anemia and acute inflammatory diseases in childhood]. PMID- 3664757 TI - [Hypotonic seizure states in children in the youngest age group]. PMID- 3664758 TI - [Pancreatic ascites in childhood]. PMID- 3664759 TI - [The clinical picture of 13q22-qter duplication in a 2-year-old boy]. PMID- 3664760 TI - [Mutual relation between the circumference of the head and the thorax in neonates]. PMID- 3664761 TI - [The physician and the computer. 8. Statistical methods]. PMID- 3664762 TI - [Possible use of music therapy in the treatment of emotional disorders in childhood]. PMID- 3664763 TI - [Suggestions in the care of children who took in toxic substances in Prague]. PMID- 3664764 TI - [Preventive care and dispensarization in a large city]. PMID- 3664765 TI - [A simple noninvasive method for collection of midstream urine in neonates and infants]. PMID- 3664766 TI - [Comments on the Registry of Congenital Defects in Czechoslovakia 1986]. PMID- 3664767 TI - [Bulletin from the Czech Ministry of Health, volume 33, parts 9-12-- 1985]. PMID- 3664768 TI - [The clinical picture of congenital liver fibrosis in children]. PMID- 3664769 TI - [Experience with continuous cardiac stimulation in children]. PMID- 3664770 TI - [Determination of phenylalanine-4-hydroxylase as a parameter in the differential diagnosis of hyperphenylalaninemia]. PMID- 3664771 TI - [Aortoventricular tunnel--a rare cause of aortic regurgitation in the neonate]. PMID- 3664772 TI - [The function of carnitine and clinical signs of its deficiency]. PMID- 3664773 TI - [The physician and the computer. 9. Multidimensional statistical methods]. PMID- 3664774 TI - [Morbidity in preschool-age children]. PMID- 3664775 TI - [A practical guide for measuring kidney size on the excretory urography image]. PMID- 3664776 TI - [Lost years of potential life--a supplement to mortality analysis]. PMID- 3664777 TI - [Aggression in children and adolescents with mental disorders at the Institute of Social Welfare as a factor in the deterioration of therapeutic and preventive care]. PMID- 3664778 TI - [A 3-year study of morbidity, retirement rate, and mortality in an industrial plant]. PMID- 3664779 TI - [The accident rate as associated with the injury rate in Czechoslovakia]. PMID- 3664780 TI - [Emergency care]. PMID- 3664781 TI - [Analysis of the relation between drug utilization and selected indicators. I]. PMID- 3664782 TI - [Drugs and old age]. PMID- 3664783 TI - [Drug utilization by older persons. II]. PMID- 3664784 TI - [Cooperation between the oncologist and roentgenologist in systemic treatment of metastases of malignant tumors]. PMID- 3664785 TI - [Benign non-tumorous destruction of the maxillary sinuses]. PMID- 3664786 TI - [Radiodiagnosis of unusual infectious joint complications in patients on long term dialysis]. PMID- 3664787 TI - [Combination of chondromyxoid osseous fibroma with angiolipoma? An unusual angiographic picture of a benign bone lesion--a contribution to the discussion]. PMID- 3664788 TI - [Radiodiagnosis of congenital pseudotumors of the kidneys]. PMID- 3664789 TI - [Correlation of regional oncologic mortality with natural radiation fields in Czechoslovakia]. PMID- 3664790 TI - Lethal effects of a linoleic acid hydroperoxide and its autoxidation products, unsaturated aliphatic aldehydes, on human diploid fibroblasts. AB - The lethal effects of linoleic acid and its hydroperoxide on human diploid fibroblasts were quite similar, and that of the reaction mixture from the autoxidation of the hydroperoxide was considerable. Some unsaturated aliphatic aldehydes, the secondary products of the hydroperoxide autoxidation, were identified and their toxicity toward the cells was examined. Among them, (E,E) 2,4-nonadienal, (E,E)-2,4-decadienal, and (E)-4-hydroxy-2-nonenal were the most toxic; e.g., in the presence of 25 microM nonadienal, decadienal, or hydroxynonenal, 75, 90, or almost 100% of the cells, respectively, underwent lysis within one day. Generally, alkenals were toxic and alkanals non-toxic. The toxicity was enhanced as the number of double bonds in each molecule was increased and also as the carbon chain was lengthened. PMID- 3664791 TI - Formation of reactive oxygen species and of 8-hydroxydeoxyguanosine in DNA in vitro with betel quid ingredients. AB - The formation of reactive oxygen species (ROS) from betel quid ingredients, namely areca nut, catechu and tobacco, was studied using a chemiluminescence (CL) technique. Aqueous extracts of areca nut and catechu were capable of generating superoxide anion and hydrogen peroxide at pH greater than 9.5. The formation of O2 was enhanced by Fe2+, Fe3+ and Cu2+ but inhibited by Mn2+. Tobacco extract failed to generate ROS under similar conditions. Saliva was found to inhibit both O2 and H2O2 formation from betel quid ingredients. Upon incubation of DNA at alkaline pH with areca nut extract and Fe3+ or catechu, 8-hydroxydeoxyguanosine was formed as quantified by high performance liquid chromatography (HPLC)/electrochemical detection. The data suggest a possible role of reactive oxygen species in the etiology of oral cancer in betel quid chewers. PMID- 3664792 TI - Aziridine biotransformation by microsomes and lethality to hepatocytes isolated from rat. AB - To clarify the relationship of aziridine biotransformation to their cytotoxic activities, the metabolism of optical isomers of typical cytotoxic and non cytotoxic aziridines was studied in isolated hepatocytes, rat liver microsomes, mitochondria and L-1210 mouse leukemia cells. Cytotoxic 1-methyl-2-beta naphthylaziridine (NAZ) gave nitrosomethane as one of the bioactivation products in isolated hepatocytes and simultaneously induced a marked decrease in cellular ATP followed by cell lethality. NAZ itself did not directly affect the respiratory function of mitochondria in isolated hepatocytes or in buffer solution, however, it inhibited the mitochondrial activity in the presence of microsomes in the buffer solution. Nitroso-t-butane or nitrosomethane dimer, used as a substitute for extremely labile nitrosomethane, strongly inhibited the respiration of mitochondria. On the other hand, optical isomers of 2 aziridinecarboxylic acid (AZC) which did not give nitrosomethane in isolated hepatocytes or microsomes also did not show cytotoxicity. Thus, the cytotoxicity of NAZ seems to be induced by bioactivation via cellular oxidases with the nitrosomethane generated being a major toxic component. This may occur with most of the cytotoxic aziridine derivatives. PMID- 3664793 TI - Crystal structure of (uracil-1-ylethyl)(adenin-9-ylethyl)tryptophan dipeptide: an interaction model between nucleic acid base and aromatic amino acid. PMID- 3664794 TI - [Structural study of an analog of ellipticine designed as antineoplastic, 1,4 dihydro-4-oxo-2,5,11-trimethyl-6H-pyrido[3,2-b]carbazole, with X-ray diffraction]. PMID- 3664795 TI - Enzymatic procedure for the synthesis of 11-deoxyprostaglandins. PMID- 3664796 TI - Tannins and related polyphenols of rosaceous medicinal plants. IV. Roxbins A and B from Rosa roxburghii fruits. PMID- 3664797 TI - Electrostatic interaction energy and solvent accessibility in the methotrexate reduced nicotinamide adenine dinucleotide phosphate-dihydrofolate reductase ternary complex. PMID- 3664798 TI - Synthesis and antibacterial activities of optically active ofloxacin and its fluoromethyl derivative. PMID- 3664799 TI - Semisynthetic beta-lactam antibiotics. IV. Synthesis and antibacterial activity of new ureidocephalosporin and ureidocephamycin derivatives containing a catechol moiety or its acetate. PMID- 3664800 TI - Chemical modification of glycyrrhetinic acid in relation to the biological activities. PMID- 3664801 TI - Synthesis of 2-phenylthiazolidine derivatives as cardiotonic agents. I. 2 Phenylthiazolidine-3-thiocarboxamides. PMID- 3664802 TI - Studies on the sesquiterpenoids of Panax ginseng C. A. Meyer. Isolation and structure determination of sesquiterpene alcohols, panasinsanols A and B. PMID- 3664803 TI - New heterobifunctional cross-linking reagents for protein conjugation, N (bromoacetamido-n-alkanoyloxy)succinimides. PMID- 3664804 TI - Non-enzymatic reduction of sennidins and sennosides by reduced flavin. PMID- 3664805 TI - Macrophage activation and immunostimulating activity of Sphaerotilus natans and its slime fraction. PMID- 3664807 TI - Calcium-binding protein isolated from rat liver cytosol reverses activation of pyruvate kinase by Ca2+. PMID- 3664806 TI - Chemical modification of essential histidine residues in Mn(III)-acid phosphatase by diethylpyrocarbonate in the presence of F- ion. PMID- 3664808 TI - Studies on the factors affecting pulmonary absorption of xanthine derivatives in the rat. PMID- 3664809 TI - Effect of ionic interaction on the entrapping of drug into porous microspheres and drug release characteristics. PMID- 3664810 TI - Purification of two specific antibodies against drug and carrier protein molecules. PMID- 3664811 TI - Human urinary kallikrein. II. Analysis of asparagine-linked oligosaccharides by using lectins. PMID- 3664812 TI - Studies on the temporal variations in the pharmacokinetics and metabolism of theophylline. PMID- 3664813 TI - Synthesis and spasmolytic activity of aminoalkyl 2-substituted-2-(1,2 benzisoxazol-3-yl)acetates. PMID- 3664814 TI - Synthesis of 6 beta-[131I](2'-iodo)ethyl-19-norcholest-5(10)-en-3 beta-ol and its tissue distribution in mice. PMID- 3664815 TI - Interaction between 7-anilino-4-methylcoumarin-3-acetic acid and human serum albumin. PMID- 3664816 TI - Conformational changes of the two different conformers of grifolan in sodium hydroxide, urea or dimethylsulfoxide solution. PMID- 3664817 TI - A new technique for in vivo percutaneous absorption. PMID- 3664819 TI - New fungal metabolites avellanins A and B from Hamigera avellanea, with pressor effect. PMID- 3664818 TI - PAF antagonistic activity of some thieno[3,2-f][1,2,4]triazolo[4,3 a][1,4]diazepines. PMID- 3664820 TI - Isolation and structure of regelin and regelinol, new antitumor ursene-type triterpenoids from Tripterygium regelii. PMID- 3664821 TI - Structure of theonellapeptolide Ie, a new tridecapeptide lactone from an Okinawan marine sponge, Theonella sp. (Theonellidae). PMID- 3664822 TI - Synthesis of dibekacin (3',4'-dideoxykanamycin B) from D-glucosamine and D glucose. PMID- 3664823 TI - The pharmacological activity of cannabinol and its major metabolite, 11 hydroxycannabinol. PMID- 3664824 TI - Synthesis of saframycins. I. Total synthesis (+/-)-saframycin B and its congeners. PMID- 3664825 TI - Hydrolysis of diphosphate ion to orthophosphate ion in the presence of calcium ion. Fundamental study of the development of the mixed crystal deposition disease. PMID- 3664826 TI - New toxic metabolites from a mushroom, Hebeloma vinosophyllum. II. Isolation and structures of hebevinosides VI, VII, VIII, IX, X, and XI. PMID- 3664827 TI - Syntheses and sleeping-time-prolonging effect of nitramarine and related compounds. PMID- 3664828 TI - Enzymes and catalysts. I. Pig liver esterase-catalyzed hydrolysis of heterocyclic diesters. PMID- 3664829 TI - An improved synthesis of the new angiotensin converting enzyme inhibitor CV-5975 via a chemoenzymatic process. PMID- 3664830 TI - Synthesis of head activator (HA)-related peptides and development of HA radioimmunoassay. PMID- 3664831 TI - Studies on peptides. CLI. Syntheses of cystine-peptides by oxidation of S protected cysteine-peptides with thallium(III) trifluoroacetate. PMID- 3664832 TI - Plant mucilages. XL. A representative mucilage, "Hibiscus-mucilage SF," from the flower buds of Hibiscus syriacus. PMID- 3664833 TI - Synthesis and oral absorption of hetacillin and hetamoxicillin labile esters. PMID- 3664834 TI - Studies on antitumor agents. VII. Antitumor activities of O-alkoxyalkyl derivatives of 2'-deoxy-5-trifluoromethyluridine. PMID- 3664835 TI - Sulfur-containing acylamino acids. I. Syntheses and angiotensin I converting enzyme-inhibitory activities of sulfur-containing N-mercaptoalkanoyl amino acids. PMID- 3664836 TI - Sulfur-containing acylamino acids. II. Syntheses and angiotensin I converting enzyme-inhibitory activities of N-mercaptoalkanoyl-S-ethyl-L-cysteine. PMID- 3664837 TI - Synthesis of 2-phenylthiazolidine derivatives as cardiotonic agents. II. 2 (Phenylpiperazinoalkoxyphenyl)thiazolidine-3-thiocarboxamid es and the corresponding carboxamides. PMID- 3664838 TI - Synthesis of 2-phenylthiazolidine derivatives as cardiotonic agents. III. Optically active isomers of N-methyl-2-(2-(2-(4 phenylpiperazino)ethoxy)phenyl)thiazolidine -3-carboxamides. PMID- 3664839 TI - Studies on hypolipidemic agents. III. Synthesis and esterase-inhibitory activity of omega-cycloalkyl-2-oxoalkyl arenesulfonates. PMID- 3664840 TI - Antiallergic substance from Asarum sagittarioides and synthesis of some analogues. PMID- 3664841 TI - Preparation of [1,2-3H,4-14C]16 alpha-hydroxyandrostenedione and its use for radiometric determination of human placental aromatase activity. PMID- 3664843 TI - Antitumor mechanisms of orally administered shiitake fruit bodies. PMID- 3664842 TI - Antitumor action of shiitake (Lentinus edodes) fruit bodies orally administered to mice. PMID- 3664844 TI - Renal effect of aqueous extract from salviae miltiorrhizae radix in normal rats. PMID- 3664845 TI - Isolation and identification of hypotensive principles in red-mold rice. PMID- 3664846 TI - Release characteristics of nifedipine sustained-release granules in vitro and in healthy subjects. PMID- 3664847 TI - Effects of concentration and degree of polymerization on the rheological properties of methylcellulose aqueous solution. PMID- 3664848 TI - Inactivation of lysozyme in a solution containing sodium bisulfite under scattered light. PMID- 3664849 TI - Metabolism and cytotoxicity of hydrazine in isolated rat hepatocytes. PMID- 3664850 TI - Amino acids and peptides. XVI. Synthesis of NG-tosylarginyl peptide derivatives- observation of lactam formation of arginyl residue. PMID- 3664851 TI - Microbial reduction of naphthoxypropionic acids. PMID- 3664852 TI - Studies on peptides. CL. Syntheses of [D-His2]-analogs of enkephalin and adrenorphin and several [D-Arg2]enkephalin analogs. PMID- 3664853 TI - Effect of grifolan on the ascites form of Sarcoma 180. PMID- 3664854 TI - Effect of calcium-binding protein on the activation of phosphorylase a in rat hepatic particulate glycogen by Ca2+. PMID- 3664855 TI - Conformation of grifolan in the fruit body of Grifola frondosa assessed by carbon 13 cross polarization-magic angle spinning nuclear magnetic resonance spectroscopy. PMID- 3664856 TI - Comparison of binding characteristics of human and bovine serum albumins with benzoates over a wide range of concentration. PMID- 3664857 TI - Total synthesis of esters of AK-toxin II and AF-toxin IIc starting from vitamin C as a chiral material. PMID- 3664858 TI - Two new antineoplastic diterpenes from Taxus mairei. PMID- 3664859 TI - [Analysis of the social requirements of nurses]. PMID- 3664860 TI - [Nursing care of acute myocardial infarction: analysis of 150 cases]. PMID- 3664861 TI - [Nursing of aged patients with coronary heart diseases at the recovery stage]. PMID- 3664862 TI - [Care of rectal cancer patients with the deep-sump drainage in the postoperative period]. PMID- 3664863 TI - [Care of patients undergoing regenerative operations on a substitute bladder from a pedicled omentum]. PMID- 3664864 TI - [Increasing the quality of ophthalmologic nursing activities]. PMID- 3664865 TI - [Care of patients with foreign bodies in their esophagus]. PMID- 3664866 TI - [Precautions in aspirin administration]. PMID- 3664867 TI - [The nursing process in practice]. PMID- 3664868 TI - [The care of patients treated by ultrasonic peritoneal dialysis]. PMID- 3664869 TI - [Nursing care of children with nephrotic syndrome treated by large doses of dexamethasone]. PMID- 3664870 TI - [Care of the respiratory failure patient rescued by high frequency jet ventilation]. PMID- 3664871 TI - [Pre- and post-operative care of patients with intracranial aneurysms]. PMID- 3664872 TI - [Care of electric burns with early flap repair]. PMID- 3664874 TI - [Technics of bipedal dyeing lymphangiography and the nursing of these patients]. PMID- 3664873 TI - [Nursing in metal-ceramic restoration]. PMID- 3664875 TI - Lipid peroxidation: Part I. Biochemical and biophysical aspects. PMID- 3664876 TI - [Award of the Organization for the Prevention of Blindness]. PMID- 3664877 TI - [In 1986, the rehabilitation of patients with recent visual deficiency and blindness after 25 years' experience]. PMID- 3664878 TI - [New prospects for patients with vision defects: use of visual possibilities]. PMID- 3664879 TI - [Implants in the anterior chamber, implants in the posterior chamber: visual acuity after 3 months]. PMID- 3664880 TI - [2 technics of muscle recession: the recul-avec-arc insertion method, nasal myectomy]. PMID- 3664881 TI - [Cataract extraction with maintenance of intraocular tamponade using silicone]. PMID- 3664882 TI - [Skull fibrous dysplasia, Wegener's disease or other diagnosis. Apropos of a case]. PMID- 3664883 TI - [A new theory on the stability of the lacrimal film and its application to pathology]. PMID- 3664885 TI - [Ocular endoscopy. I. Experimental model for studying implantation into the posterior chamber after extracapsular extraction of the crystalline lens]. PMID- 3664884 TI - [Treatment of various cases of retinal detachment by intra-vitreous injection of SF6: technic and indications]. PMID- 3664886 TI - [Treatment of blepharospasm by injections of botulinum toxin]. PMID- 3664887 TI - [Epithelial watershed zone during the development of choroid nevus]. PMID- 3664888 TI - [Origin of uveitis: evolution of results of an etiological evaluation over the last 20 years (1966-1986)]. PMID- 3664889 TI - [The lacrimal nerve. Macroscopic aspects and hypotheses on its functional role]. PMID- 3664890 TI - [A new case of linear and sebaceous nevus]. PMID- 3664891 TI - [Optic disk drusen and peripapillary subretinal hemorrhages]. PMID- 3664892 TI - [Unusual angiographic aspects of intra-ocular foreign bodies]. PMID- 3664893 TI - [Angiofluorographic aspect of choroid metastases]. PMID- 3664894 TI - [Retinal detachment of traumatic origin. Functional results in relation to the etiology and type of treatment]. PMID- 3664895 TI - [Section of posterior vitreal strands with the Yag laser]. PMID- 3664896 TI - [Angiography of limbic tumors]. PMID- 3664897 TI - [An unusual aspect of limbic epithelioma]. PMID- 3664898 TI - [The sound eye in so-called unilateral infantile glaucoma]. PMID- 3664899 TI - [Heredofamilial megalocornea]. PMID- 3664900 TI - [Course of optic nerve contusion aggravated by orbital repair]. PMID- 3664901 TI - [Ischemic optic neuropathy after general anesthesia with mask]. PMID- 3664902 TI - [Juridical evaluation of the prejudice in traumatic cataract]. PMID- 3664903 TI - [Keratomycoses. Elements of prognosis]. PMID- 3664904 TI - [Percutaneous pulmonary and mediastinal biopsies]. PMID- 3664905 TI - [Anti-phospholipid antibodies]. PMID- 3664906 TI - [Diagnostic significance of a new hematologic parameter: zinc protoporphyrin]. PMID- 3664907 TI - [Xipamide]. PMID- 3664908 TI - Spontaneous hyperuricemic acute renal failure. PMID- 3664909 TI - Arterial PaO2 and PaCO2 influence seizure duration in dogs receiving electroconvulsive therapy. AB - The influence of arterial O2 and CO2 tensions on electroconvulsive seizure duration was investigated in five mongrel dogs under consistent anaesthetic conditions. Seizure durations were measured in a randomized protocol of nine possible combinations of arterial gas tension spanning increased, normal or decreased levels of PaO2 and PaCO2. Seizure duration was directly related to PaO2 (p less than 0.00001) and inversely related to PaCO2 (p less than 0.0001). A significant synergism was evident at the extremes of PaO2 and PaCO2, with seizure duration being greater than predicted for hyperoxia-hypocapnia and hypoxia hypercapnia and shorter than predicted for hypoxia-hypocapnia and hyperoxia hypercapnia. We conclude that arterial gas tensions strongly influence ECT induced seizure duration and through this may influence the therapeutic efficacy of electroconvulsive therapy. PMID- 3664911 TI - The effects of cardiopulmonary bypass and profound hypothermic circulatory arrest on anterior fontanel pressure in infants. AB - The Ladd transducer was used to measure anterior fontanel pressure in 23 infants undergoing cardiopulmonary bypass and profound hypothermic circulatory arrest for surgical correction of congenital heart disease. Mean (+/- SD) minimum oesophageal and rectal temperatures of 11.3 +/- 1.5 degrees C and 18.1 +/- 2.2 degrees C respectively were achieved with a mean duration of arrest of 53.4 +/- 13.9 minutes. During reperfusion cardiopulmonary bypass after circulatory arrest, mean anterior fontanel pressure (18.3 +/- 6.4 mmHg) increased above baseline pre bypass values (10.6 +/- 2.9 mmHg) (p less than 0.005). Mean arterial blood pressure decreased significantly from pre-bypass values (57.0 +/- 11.8 mmHg) during both cooling (38.8 +/- 8.4 mmHg) and rewarming cardiopulmonary bypass (45.8 +/- 8.9 mmHg) (p less than 0.005). These changes were associated with a significant decrease in cerebral perfusion pressure during cooling (27.3 +/- 11.0 mmHg) and rewarming cardiopulmonary bypass (27.5 +/- 10.6 mmHg), compared with baseline pre-bypass values (46.5 +/- 12.3 mmHg) (p less than 0.005). The data demonstrate significant but transient decreases in cerebral perfusion pressure during cooling and rewarming bypass. PMID- 3664910 TI - Preoperative pulmonary blood flow and one-lung anaesthesia. AB - The distribution of pulmonary blood flow was measured in supine patients before surgery by means of lung perfusion scanning with 99mTc-macroaggregated albumin in an attempt to predict values of PaO2 during subsequent one-lung anaesthesia. The PaO2 values during one-lung anaesthesia were well correlated with the preoperative lung perfusion partition ratios (r = 0.84, p less than 0.05). In 9 of 40 patients, PaO2 was less than 80 mmHg during one-lung ventilation (FIO2 0.99). In these patients the lung perfusion ratios of the dependent lung were as low as 41.0-48.2 per cent. These results indicate that preoperative measurement of pulmonary blood flow can predict values of PaO2 during one-lung anaesthesia. PMID- 3664912 TI - Femoral nerve block with bupivacaine 0.25 per cent for postoperative analgesia after open knee surgery. AB - An assessment was made, in a randomised double-blind fashion, of the pain relief afforded by femoral nerve block (FNB) performed at the end of ligament reconstruction of the knee, using 0.25 per cent bupivacaine in ten patients, and normal saline in ten patients. All patients commenced "continuous passive motion" (CPM) of the operated knee after arrival in the Recovery Room. The postoperative analgesic requirement, both for intravenous fentanyl in the Recovery Room, and intramuscular and oral analgesia on the ward, was then studied. The time interval between FNB and first dose of analgesia was significantly longer in the bupivacaine group than in the control group. The bupivacaine group also required significantly less intravenous fentanyl in the Recovery Room. On the ward, there was no difference between the two groups in the total dose of intramuscular meperidine given in the first 12 hours postoperatively. We conclude that femoral nerve block is a useful adjunct in pain management after ligament reconstruction of the knee, especially in the early postoperative period, but does not decrease the total intramuscular dose of analgesia in the first 12 postoperative hours. PMID- 3664913 TI - A comparison of two types of epidural catheters. AB - The purpose of this study was to compare two epidural catheters--the Portex epidural catheter and Vas-Cath catheter. One hundred and fifty patients in labour who received epidural anaesthesia were selected and either one or the other catheter was used, based on random assignment. Ease of insertion, maintenance and removal of the catheter were assessed, as was the incidence of blood return and paraesthesiae during epidural catheter insertion. There were no significant differences between the catheters as far as insertion, maintenance and removal were concerned. However, the incidence of paresthesiae was 44 per cent with the Portex and 24 per cent with Vas-Cath catheters (p less than 0.008). The incidence of blood vessel trauma was 12 per cent with the Portex and 6.7 per cent with the Vas-Cath catheter (p = NS). Choice of epidural catheter is a factor to be considered in minimizing the incidence of blood vessel trauma or paresthesiae. PMID- 3664914 TI - A comparison of nalbuphine and meperidine in treatment of postoperative pain. AB - The analgesic efficacy and side effect profile of nalbuphine 20 mg IV and of nalbuphine 40 mg IV were compared to those of meperidine 75 mg IM in the immediate postoperative period. Pain intensity, pain relief, additional analgesic requirements and the overall acceptability of the treatment were recorded for 150 patients. No significant differences were found between the groups for any of the efficacy variables. Peak analgesic effects occurred at 15 minutes in both nalbuphine groups and at 30 minutes in the meperidine group. The mean time to additional analgesic medication was approximately 207 minutes in each group. The incidence of nausea and vomiting with meperidine was 22 per cent (95 per cent confidence interval 10 to 34 per cent) and with nalbuphine 20 mg the incidence was two per cent (95%CI -2 to 6 per cent). This difference was significant (p less than 0.01). The difference between nalbuphine 40 mg (10 per cent, 95%CI 1 to 19 per cent) and meperidine, was not considered statistically significant (p = 0.17). The analgesic efficacy of nalbuphine 20 mg was indistinguishable from that of nalbuphine 40 mg and from that of meperidine 75 mg. The significantly lower incidence of nausea and vomiting with nalbuphine is a major advantage for a recovery room analgesic. PMID- 3664915 TI - Arterial desaturation in healthy children during transfer to the recovery room. AB - The oxygen saturation in 71 healthy paediatric patients (3.5 months to 16.7 years) was measured by pulse oximetry during transfer from the operating room to the recovery room. These measurements were recorded continuously while the patients breathed room air. Of the patients studied, 28.1 per cent exhibited significant arterial desaturation of less than or equal to 90 per cent. The corresponding PO2 for this saturation level is less than or equal to 58 mmHg. In only 45 per cent of these desaturated patients was the desaturation recognized clinically by the presence of cyanosis. Age, type of anaesthetic, the use or avoidance of narcotics, and the use of controlled or spontaneous respiration had no significant relationship to the incidence of desaturation. Since more than a one quarter of all patients studied desaturated significantly, and since cyanosis can be difficult to detect clinically during the transfer period, the use of supplemental oxygen during transfer should be considered by the anaesthetist at the end of every paediatric general anaesthetic. PMID- 3664916 TI - Evaluation of the Humphrey A.D.E. breathing system. AB - A new breathing circuit (the Humphrey A.D.E., double lever model) was evaluated in adults to determine (1) the fresh gas flow (FGF) needed to achieve normocapnia during controlled ventilation and to just induce rebreathing during spontaneous ventilation, (2) end-expired CO2 (PECO2) at those FGF values, (3) the standard deviation of FGF requirements for controlled and spontaneous breathing (reliability of recommended FGF settings) and (4) the magnitude of change in PECO2 produced by varying FGF from the recommended values (sensitivity of the system). The FGFs that provided normocapnia with controlled ventilation and just induced rebreathing with spontaneous ventilation were 67 +/- 10 and 52 +/- 7 ml . kg-1 . min-1 (mean +/- SD), respectively. PECO2 values were 36.0 +/- 0.3 and 41.6 +/- 3.9 mmHg respectively. During controlled ventilation low reliability was offset by low sensitivity so that PECO2 changed little when FGF was raised or lowered from recommended values (0.2 mmHg/ml . kg-1 . min-1). In contrast, during spontaneous ventilation low reliability was additive with high sensitivity when using FGFs lower than the mean value that just induced rebreathing. A threshold was reached where lowering FGF from recommended values caused large changes in PECO2 (1.1 mmHg/ml . kg-1 . min-1). It is concluded that the FGF recommended by Humphrey for controlled ventilation is satisfactory. However, the FGF recommended by Humphrey for spontaneous ventilation may result in hypercapnia in some patients. This can be prevented either by using a higher FGF of 66 ml . kg-1 . min-1 routinely in all patients or by using lower flows with CO2 monitoring. PMID- 3664917 TI - Anaesthetic management and non-invasive monitoring for caesarean section in a patient with cardiomyopathy. AB - This paper describes the anaesthetic management of a 29-year-old woman for an elective repeat Caesarean section. A diagnosis of peripartum cardiomyopathy (PPCM) had been made after her first delivery by Caesarean section three years earlier. Although the patient was currently asymptomatic, recent echocardiography demonstrated persistent left ventricular dilatation. The choice of haemodynamic monitors and the clinical significance of PPCM in this situation are discussed. PMID- 3664918 TI - Effect of pre-eclampsia on plasma cholinesterase activity. AB - Plasma cholinesterase (PCHE) activity was determined using a colorimetric method in 11 healthy non-pregnant women, 11 healthy pregnant women at term, and 11 pre eclamptic pregnant women at term. The mean plasma cholinesterase activities for healthy non-pregnant women, healthy pregnant women and pre-eclamptic pregnant women were 438 +/- 81,257 +/- 25 and 173 +/- 18 units . ml-1, respectively. Our data suggest that there is a significant reduction in plasma cholinesterase activity in preeclamptic pregnant women when compared to healthy non-pregnant (p less than 0.001) and healthy pregnant women (p less than 0.001). PMID- 3664919 TI - Anaesthetic management for oophorectomy in pulmonary lymphangiomyomatosis. AB - Pulmonary lymphangiomyomatosis is an idiopathic disease, resulting in severe respiratory impairment. Bilateral oophorectomy has led to objective and subjective amelioration of the pulmonary pathology. In the anaesthetic management of such a patient, careful attention must be paid to pulmonary and systemic haemodynamics, and gas exchange. We describe the successful anaesthetic management of a 34-year-old female, using epidural anaesthesia, and pulmonary artery catheterization. Although the intraoperative and immediate postoperative courses were heralded by marked cardiorespiratory stability, refractory respiratory failure developed, and she died five months after surgery. PMID- 3664920 TI - Postoperative neuroleptic malignant syndrome. A case report. AB - A case of postoperative neuroleptic malignant syndrome is presented. A healthy 23 year-old male underwent a shoulder repair under uneventful fentanyl, halothane, nitrous oxide and oxygen anaesthesia. He received droperidol 5 mg IV and metoclopramide 10 mg IV intraoperatively to prevent postoperative nausea. Postoperatively, the patient developed autonomic instability, fever and generalized muscle rigidity. His level of consciousness was depressed. These findings were consistent with the diagnosis of neuroleptic malignant syndrome. The supportive treatment of the patient included active cooling measures, muscle relaxation and mechanical ventilation. The ability of anti-dopaminergic agents, including metoclopramide and droperidol, to precipitate the neuroleptic malignant syndrome is discussed. Treatment of the neuroleptic malignant syndrome is briefly discussed. PMID- 3664921 TI - Carbon dioxide retention associated with a humidifier defect. AB - A case is presented which describes a patient who developed hypercarbia resulting from a defective humidifier. A Puritan-Bennett Cascade I humidifier was incorporated into a circle system between the inspiratory dome one way valve and the patient. A screw which supports the thermal well to the head of the humidifier was missing, thereby allowing an intermittent leak to develop in the system. The leak was present when the system pressure dropped to ambient level; however, at positive system pressure the leak sealed. This allowed exhaled gases into the inspiratory limb of the circuit unchecked by the inspiratory valve yet when the breathing circuit was occluded at the patient end and submitted to pressures of 20 and 40 cm H2O, no leaks were detected. Intraoperatively, PaCO2 was noted to be as high as 68 mmHg just prior to removing the humidifier from the circuit and corrected to 38 mmHg within 15 minutes of removal of the humidifier. PMID- 3664922 TI - Cutaneous mastocytosis in children: anaesthetic considerations. AB - Despite considerable information and discussion about the risk of serious complications in patients with systemic mastocytosis undergoing general anaesthesia, little is known specifically about the risk to patients with isolated cutaneous mastocytosis. The experience of 29 general anaesthetics in 12 children with urticaria pigmentosa and three with solitary cutaneous mastocytoma was reviewed. No major complications were encountered and the four minor problems seen were self-limiting. The data from this study do not suggest that patients with urticaria pigmentosa or solitary cutaneous mastocytoma are at increased risk of life-threatening complications under general anaesthesia. PMID- 3664923 TI - Use of the Haloxair apparatus with an oxygen concentrator. PMID- 3664924 TI - Oxygen concentrators. PMID- 3664925 TI - Revised guidelines to the practice of anaesthesia. PMID- 3664926 TI - Nitrous oxide is contraindicated in endoscopic surgery. PMID- 3664927 TI - Hereditary angioneurotic oedema, tracheal intubation and airway obstruction. PMID- 3664928 TI - Defective anaesthetic breathing circuit. PMID- 3664930 TI - Pharmacokinetics and toxicology of sparsomycin in beagle dogs. AB - Sparsomycin is a cytotoxic drug exhibiting a broad spectrum of in vitro activity against murine tumors and many tumor cell lines. It also appears to be a potent stimulator of the antitumor activity of cisplatin against L1210 leukemia in vivo. However, because of its toxicity, the antitumor activity of sparsomycin on murine tumors in vivo has been disappointing. The purpose of our study was to investigate the pharmacokinetics of this drug as well as the possible mechanisms that produce sparsomycin toxicity. Tests on beagle dogs revealed that about 60% of the drug is eliminated by metabolic clearance, while 40% is eliminated by the kidneys. After a single bolus injection of 0.1 mg/kg sparsomycin without narcosis, sparsomycin was eliminated with a t beta 1/2 of 0.6-0.7 h, the AUC being 0.32-0.38 mg.h.l-1, and the volume of distribution (Vd) 0.26 l/kg. In addition to being subject to glomerular filtration, sparsomycin is probably also actively excreted and actively reabsorbed by the renal tubuli. Sparsomycin itself may inhibit its active tubular excretion, thus resulting in a decrease in the drug's renal clearance and its accumulation in the plasma. Sparsomycin appeared to be toxic primarily in the liver, disturbing its function and the synthesis of plasma proteins. Two out of five dogs developed hemorrhagic diathesis due to hypofibrinogenemia and deficiency of other blood-coagulation factors. Sparsomycin was not toxic to the bone marrow. PMID- 3664931 TI - The anti-oestrogen tamoxifen is a calcium antagonist in perfused rat mesentery. AB - The anti-oestrogen tamoxifen in the range 10(-7)-10(-5) M induced concentration related inhibition of potassium-stimulated vasospasm in the isolated perfused rat mesentery vascular bed. In contrast, responses to noradrenaline did not fall below control levels until the tamoxifen concentration exceeded 4 X 10(-6) M. Recovery of the potassium-stimulated responses was also concentration-related. The most likely explanation is that while tamoxifen can obstruct the entry of extracellular calcium, it is unable to prevent the intracellular release of the ion by noradrenaline. PMID- 3664929 TI - Uridine-induced hypothermia in mice and rats in relation to plasma and tissue levels of uridine and its metabolites. AB - Administration of high-dose uridine or cytidine (3500 mg/kg) resulted in severe hypothermia of 6-10 degrees C in mice. This effect of uridine was observed in three different mouse strains, C57B1/6, Balb/c, and Swiss. A high-dose of uridine also caused hypothermia in Wistar rats. Co-infusion of uridine with benzylacyclouridine, an inhibitor of uridine phosphorylase, partially prevented uridine-mediated hypothermia in mice. A low dose of uridine (100 mg/kg) resulted in a slight increase in temperature. Plasma pharmacokinetics of uridine (at 3500 mg/kg) were studied in two mouse strains, C57B1/6 and Balb/c, and those of cytidine only in C57B1/6 mice. Peak plasma concentrations of uridine in both strains after uridine administration were about 20 mM (at 30-60 min). The peak plasma concentration of cytidine in C57B1/6 mice after cytidine administration was about 12 mM and that of uridine, 1.3 mM. The mean residence time for uridine was about 105 min. The area under the plasma concentration-time curve for uridine was about 50 mmol h/l, and that for cytidine, about 25 mmol h/l. In various tissues of C57B1/6 mice the levels of uridine, uracil and total uracil and cytosine nucleotide pools were determined before and 2 h after uridine administration. Uridine levels increased about 53-fold in liver, about 70-fold in a colon tumor, and only about 7-fold in brain, while the corresponding uracil levels increased about 9-fold, 4-fold and 11-fold, respectively. Total uracil nucleotide pools increased about 8-fold, 3.2-fold and 1.6-fold, respectively. Cytosine nucleotide pools did not increase in the brain. In conclusion, high-dose uridine administration caused severe hypothermia. Plasma levels of uridine and uracil were enhanced to a considerably higher extent than the levels in the tissues. The hypothermia might be related to breakdown products of uridine, since inhibition of uridine breakdown partially prevented hypothermia and since in brain uracil nucleotide levels were only slightly increased after uridine administration, while those of uracil were more markedly increased than in other tissues. PMID- 3664932 TI - DNA cross-linking following exposure to cis-platinum in primary and serially passaged cultured cells derived from two murine fibrosarcomas. AB - We compared the kinetics of the repair of total (ISC plus DPC) cross-links and of proteinase-resistant (ISC) cross-links in cultured cells derived from two murine fibrosarcoma tumors, FSA and NFSA, after treatment with cis-platinum (cis-DDP), using a modification of the alkaline elution technique. The two tumors had previously been characterized for their response to cis-DDP in vivo; FSA cells gradually removed cross-links from their genome, whereas the NFSA cells showed no capacity to repair these lesions. The aim of the present study was to establish whether treatment of cells from these same two tumors grown under controlled culture conditions would affect either the nature of the lesions induced by cis DDP or the kinetics of repair of these lesions when compared with tumors treated with cis-DDP in vivo. The culture conditions represent two situations: in the first, the cells in culture approximated the proportion of tumor and normal host cells present in vivo, and in the second, the normal host cells had been eliminated by subculturing to produce cultures composed entirely of tumor cells. All cells were exposed to cis-DDP (either 10 or 20 micrograms/ml) for 1 h. The relative amounts of total cis-DDP-induced DNA crosslinks and of ISCs were then determined at various times after treatment. The results show that there was little difference in the behavior of these cultured cells compared to the in vivo response of the tumor from which they were derived. For FSA, each cell culture exhibited a capacity to repair DNA cross-links comparable to that of the tumor in vivo. For NFSA, the passaged cells again paralleled the behavior of that tumor in vivo, although in this case by showing no measurable capacity to repair cross links. The absence of a significant repair response in the NFSA tumor therefore appears to be an intrinsic characteristic of these tumor cells. PMID- 3664933 TI - Phase I clinical trial of recombinant human tumor necrosis factor. AB - A phase I and pharmacokinetic study of recombinant tumor necrosis factor (rH-TNF Asahi) was carried out in 29 patients, who received a total of 72 courses with doses ranging from 1 to 48 X 10(4) units/m2. Drug was given as 1-h i.v. infusions. Acute toxicities, taking the form of fever, chills, tachycardia, hypertension, peripheral cyanosis, nausea and vomiting, headache, chest tightness, low back pain, diarrhea and shortness of breath were seen, but were not dose-limiting or dose-related. Some early rise in SGOT, without any change in serum bilirubin, was noted at the highest doses. Eosinophilia, monocytosis, mild hypocalcemia and an increase in fibrin degradation products were seen in a few patients. The dose-limiting toxicity was hypotension, which occurred after the end of the drug infusion and was seen in all 5 patients treated at the highest dose. There was no mortality or long-term morbidity. There were no responses. Pharmacokinetic studies indicated a rapid plasma clearance and a short plasma half-life, generally less than 0.5 h. PMID- 3664934 TI - Phase I clinical trial of 1-(2-[2-(4-pyridyl)-2-imidazoline-1-yl]-ethyl)-3-(4 carboxy-phenyl) urea (CGP 15720A). AB - A phase I clinical trial of the intravenous administration of a novel pyridyl imidazoline ethyl carboxy phenyl urea was carried out in 42 patients with advanced solid tumors. Five schedules were evaluated: I, daily X 5; II, daily X 10; III, daily X 15; IV, continuous infusion for 5 days; V, continuous infusion for 7 days. Toxicity was not seen in schedule I (maximum dose 3 g/m2/day) and was minimal in schedule IV (6 g/m2/day). In schedule II it was seen at 2 and 3 g/m2/day, in schedule III at 2 g/m2/day and in schedule V at 6 g/m2/day. Dose limiting toxicity consisted of a syndrome of lethargy and fatigue. There were no definitely drug-related changes in hematologic or serum chemistry parameters. No responses were seen, but relief of pain in three patients with prostate cancer was noted. Pharmacokinetics indicate a short half-life, limited volume of distribution, and rapid renal clearance. The recommended dose for phase II studies is 3 g/m2/day X 10 or 2 g/m2/day X 15 days. PMID- 3664935 TI - Effects of verapamil on the pharmacokinetics of daunomycin in the rat. AB - We compared the pharmacokinetics of daunomycin in two groups of rats: one group was treated with daunomycin (7.5 mg/kg) alone and the other group was treated with daunomycin (7.5 mg/kg) plus the calcium antagonist verapamil (2 X 50 mg/kg i.p.). Due to a much slower decrease in plasma concentrations the daunomycin AUC0 ---infinity was dramatically increased (8 times) in the animals treated with anthracycline plus verapamil. The daunomycin plasma clearance was found to be decreased about 9 times in the verapamil-treated group. Verapamil had a differential effect on the tissue distribution of daunomycin. Of the organs examined the heart, liver, and lungs showed an increased (about 2-3 times) AUC of daunomycin. In the kidneys and spleen the AUCs of daunomycin were about equal in both groups of rats, while in the femoral bone marrow the daunomycin AUC was significantly reduced by the simultaneous administration of verapamil. Our data suggest that an increased risk for anthracycline-induced cardiotoxicity can be anticipated by the combined treatment of anthracycline drugs with calcium antagonists. PMID- 3664936 TI - Etoposide and cisplatinum in resistant lymphomas. AB - Etoposide and cisplatinum have used separately to treat refractory lymphomas. This report describes 22 patients in whom these two agents were used in conjunction. All had been extensively treated with standard therapies previously. The combination of etoposide and cisplatinum was chosen on the basis of preclinical evidence for synergy and because these agents do not cross-react. Cisplatinum was continuously infused for 5 days at a dose of 15 mg/m2/d. As a push a 100 mg/m2/d dose of etoposide was injected on days 1 and 2 of treatment. This schedule produced good responses in 18 patients, i.e. 15 partial remissions and three complete remissions. The side effects were acceptable. PMID- 3664937 TI - Response to BCNU of spheroids grown from mixtures of drug-sensitive and drug resistant cells. AB - Multicellular spheroids were grown from mixtures of rat brain tumor cells sensitive (9L) and resistant (R3) to 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU). As shown previously, after treatment with 3 microM BCNU, percentages of each cell subpopulation in mixed-cell spheroids were estimated with the sister chromatid exchange (SCE) assay and found to be approximately the same as percentages used to initiate spheroids. The sensitivity of 9L cells in mixed-cell spheroids treated with BCNU, estimated by changes in the number of SCEs induced by treatment, decreased as the percentage of R3 cells increased. When spheroids were disaggregated into single cells before treatment, however, the number of SCEs induced in the 9L population did not decrease but remained at levels similar to those found for spheroids grown from 9L cells only. These data suggest that the cell-cell interactions that influence BCNU sensitivity in mixed cell spheroids depend on three-dimensional intercellular contact. The response of purely 9L, purely R3, and mixed-cell spheroids to BCNU was also determined using the cell survival and spheroid growth delay assays. The surviving fractions of individual spheroids treated with 40 microM BCNU were slightly greater than expected; growth delays found for mixed-cell spheroids were 2-3 days less than expected. These findings suggest that cells in mixed-cell spheroids are more resistant to BCNU than would be predicted from the sensitivities of purely 9L and R3 spheroids. PMID- 3664938 TI - Evaluation of trans-tetrachloro-1,2-diaminocyclohexane platinum (IV) in murine leukemia L1210 resistant and sensitive to cis-diamminedichloroplatinum (II). AB - trans-Tetrachloro-1,2-diaminocyclohexane platinum (IV) (tetraplatin) was therapeutically effective in mice bearing leukemia L1210 resistant (L1210/DDPt) or sensitive (L1210/0) to cis-diamminedichloroplatinum (II) (cisplatin). Furthermore, the sensitivity of cultured L1210/DDPt and L1210/0 cell populations to tetraplatin, cisplatin, and dichloro-trans-dihydroxyisopropylamine platinum (IV) (CHIP) was a function of the concentrations used for each compound. The relative degree of sensitivity between cultured L1210/DDPt and L1210/0 cells for each compound on the basis of the LC99 (the concentration of each compound required to reduce the number of viable cells by 99% in each cell line) was 3 fold for cisplatin, 2-fold for tetraplatin, and 3-fold for CHIP; thus the cultured L1210/0 cells exhibited a greater degree of sensitivity than the L1210/DDPt cells to the platinum compounds. The data indicate that if reduction of platinum IV compounds to platinum II compounds or metabolites is required for antitumor activity, then the cultured L1210 cells are capable of this bioreduction independently of any host factors. PMID- 3664939 TI - The Third International Conference on Treatment of Urinary Tract Tumors with Adriamycin. September 26-27, 1986, Tokyo. Proceedings. PMID- 3664940 TI - The role of preoperative intra-arterial doxorubicin chemotherapy in combination with low-dose irradiation for bladder cancer. AB - Twenty patients with bladder cancer (T1, 3 patients; T2, 6 patients; T3, 8 patients; T4a, 3 patients) were preoperatively treated with intra-arterial doxorubicin chemotherapy in combination with low-dose irradiation. The originally scheduled operations were as follows: total cystectomy in 16 patients (T1 + cis, 1 patients; T2, 5 patients; T3, 7 patients; T4a, 3 patients), segmental cystectomy in 2 patients, and transurethral resection in 2 patients. The total dose of doxorubicin ranged from 120 to 540 mg (251.5 +/- 100.2 mg), and that of irradiation was from 4 to 36 Gy (24.4 +/- 7.3 Gy). Clinical and pathological effects were evaluated in all of the cases. Clinically, complete remission (CR) was observed in 14 cases (70.0%), partial remission (PR) was seen in 3 cases, a minor response (MR) occurred in 2 cases, and no response (NR) was seen in 1 patient; non patient showed progressive disease (PD). The pathological effects (according to the criteria of Shimosato et al.) were as follows: grade IV was seen in 10 cases, grade III in 3 cases, and less than grade II in 7 cases; however, viable tumor cell were not seen in 13 (65.0%) of the 20 cases. The bladder was preserved in 13 (81.3%) of the 16 cases for which total cystectomy had been recommended. All of the patients were followed up for periods ranging from 3 to 54 months (26.3 +/- 16.5 months), during which time 6 patients (30.0%) died (3 with cancer, 1 without cancer, and 2 unknown causes). The actual survival rate according to the stage of disease was 100.0% at 50 months in T1-T2 and 40.9% at 54 months in T3-T4a. In T3-T4a, the actual survival rate in pathologically complete responders was 60% (relative rate 68.8%) at 54 months, and the actual survival rate in incomplete responders was 25.0% (relative rate 27.1%) at 36 months. The results of our study are encouraging, especially in T1-T2 and T3-T4a cases, who showed a complete response. It is concluded that doxorubicin intra arterial chemotherapy combined with low-dose irradiation could be the first treatment of choice for locally invasive bladder cancer. PMID- 3664941 TI - Adjuvant chemotherapy for uroepithelial transitional cell carcinoma. AB - The effectiveness of adjuvant chemotherapy in transitional cell carcinoma of the bladder (T1/G3 and greater than or equal to T2) and the upper urinary tract were evaluated. Among a group of 136 patients (male 107, female 29) with such tumors, complete tumor resection was possible in 108, in whom duration of survival and disease-free interval with or without chemotherapy were compared. The combination of antineoplastic agents used was changed from 5-fluorouracil (5-FU) + vincristine (VCR) + bleomycin (BLM) or peplomycin (PEP) + mitomycin C (MMC) or 5 FU + VCR + PEP + cyclophosphamide (CPM) + adriamycin (ADM) to CPM + ADM + cis platinum (DDP) or methotrexate (MTX) + vinblastine (VBL) + ADM + DDP. Of the 59 patients in the chemotherapy group, 23 (39%) had side effects due to the treatment; however, fever and gastrointestinal symptoms were the chief adverse effects and were well tolerated. The 5-year survival rate and mean disease-free interval in the chemotherapy group were 76.3% and 24.6+ months, respectively, in bladder cancer patients, and 78.2% and 25.8+ months in those with upper urinary tract tumors. However, in the non-chemotherapy group (n = 49) the corresponding values were 62.7% and 21.1+ months in patients with bladder cancer and 67.3% and 42.0+ months in those with upper urinary tract tumor. There was a statistically significant difference (P less than 0.05) in the disease-free intervals of the two treatment groups for bladder cancer patients. Recurrence, regardless of time, was observed in 25% of chemotherapy cases and in 65% of non-chemotherapy cases, and this difference was also statistically significant (P less than 0.001). These results suggest that adjuvant chemotherapy for uroepithelial transitional cell carcinoma may be effective in extending survival and significant by protracting the disease-free period, especially in cases of advanced bladder cancer. PMID- 3664942 TI - Postoperative systemic adjuvant chemotherapy for bladder cancer. AB - Forty-six patients with bladder cancer without distant metastasis (M0) were treated by chemotherapy as an adjuvant after total cystectomy using three protocols (protocol I: adriamycin 50 mg/m2, cyclophosphamide 500 mg/m2, and cis platinum 50 mg/m2 i.v., starting at least 2 weeks after surgery every 3 weeks for three cycles; protocol II: adriamycin 30 mg/m2 on the 1st postoperative day, cyclophosphamide 300 mg/m2 on the 1st and the 7th days; protocol III: FT-207 60 mg/m2, p.o. every day for 1 year). Average follow-up periods after surgery by protocol were 18 months for protocol I, 31 for protocol II, and 43 for protocol III. Analysis of the survival curves showed no statistically significant differences among the three groups or between a historical control group of 106 patients and the entire patient population examined in the present study. The histopathological grades recorded in the 46 patients were G1, G2, and G3 in 1, 22, and 23, respectively. However, from a study of 48 pT3 and pT4 cases, the survival rate of 10 patients receiving protocol I therapy was statistically significantly higher than those of 12 patients treated according to protocol II and of 26 historical controls, at 1 year and 2 years, respectively. Toxic effects, with gastrointestinal symptoms including nausea and vomiting and myelosuppression (including leukopenia and anemia) were more frequent with protocol I. Alopecia occurred in about 80%-90% of patients treated according to either protocol I or II. Almost all patients could tolerate adjuvant chemotherapy, and none of them died as a result of these regimens. The results recorded in this study justify the evaluation of combination adjuvant chemotherapy with adriamycin, cyclophosphamide and cis-platinum in a prospectively randomized trial. PMID- 3664943 TI - The chemotherapy of advanced bladder cancer. AB - This paper traces the development of the use of chemotherapy in the management of advanced bladder carcinoma in Europe. A number of agents, including cisplatin, methotrexate, vinblastine, adriamycin, fluorouracil and cyclophosphamide, have been investigated singly and in combination in phase II studies, and it is envisaged that an ideal combination chemotherapy regimen giving lasting complete response will ultimately be used along with limited ablative surgery in the management of localised advanced bladder cancer. Careful application of the increasing knowledge of the biology of transitional cell carcinoma and strict adherence to rigid criteria of response in the assessment of new agents appears at last to offer hope of an improvement in the prognosis of invasive bladder cancer. PMID- 3664944 TI - Preoperative doxorubicin instillation in recurrent superficial bladder cancer. AB - Further recurrence of superficial bladder cancer after transurethral resection is frequent in patients who have already experienced recurrence. In an attempt to prevent or delay further recurrences in such patients, the effect of preoperative doxorubicin instillation was investigated. A total of 51 patients with recurrent superficial bladder cancer were randomized to receive either TUR alone or TUR with preoperative doxorubicin instillation. Doxorubicin was administered twice a week for 3 weeks before TUR surgery. An objective response (CR + PR) of the tumors was observed at operation in 12 of 25 (48%) evaluable doxorubicin-treated patients. Chemical cystitis was seen in 32% of the patients. Further recurrence after TUR was observed in 13 of 25 (52%) patients in the doxorubicin group, as against 15 of 23 (65%) evaluable patients in the control group. The mean disease free interval was significantly longer (11.8 as against 7.1 months) in the doxorubicin group. These preliminary results suggest that preoperative doxorubicin instillation might be effective for prolongation of the disease-free interval in patients with recurrent bladder cancer. PMID- 3664945 TI - Intra-arterial chemotherapy for bladder cancer. AB - Intra-arterial infusion chemotherapy with adriamycin (ADM) was carried out in 32 patients with bladder cancer prior to total cystectomy. An oblique incision approximately 12 cm long was made in the gluteal region to expose either the superior or inferior gluteal artery, into which a Teflon catheter was inserted and fixed. The distal end of the catheter was taken out from under the skin in the precordial region. Via this catheter, a single dose of 10 mg ADM was injected twice a week. Superior-gluteal-artery infusion chemotherapy was performed in 7 patients; the 5-year survival rate was 14.3%, which was not as high as expected. Inferior-gluteal-artery infusion chemotherapy was performed in 25 patients. Cisplatin (CDDP) was used with ADM in 8 patients. Radiation and/or hyperthermia were used in 11 patients. The 5-year survival rate in these 25 patients was 58.4%, which was considered to be satisfactory. Of these 25 patients, 5 were stage-T4 cases; for these, the treatment was ineffective, and all 5 died within 2 years. Of the 6 patients at stage T2, 1 died, as did 1 patient with carcinoma in situ (CIS). Of the 13 patients with bladder cancer at stage T3, 3 died; lymph node metastases were found in all 3 of these cases. Of the 25 patients who received inferior-gluteal-artery infusion chemotherapy, 9 died of cancer; all 9 died within 2 years due to distant metastases. There was no evidence of recurrence in any patient who survived for 2 years or more after total cystectomy. Therefore, inferior-gluteal-artery infusion chemotherapy may be effective as a preoperative adjuvant therapy with no serious side effects. PMID- 3664946 TI - Intravesical chemotherapy. AB - A total of 85 cases treated by intravesical administration of adriamycin (ADM) at Okayama University and other cooperating institutions were examined. Instillation of 50 mg adriamycin dissolved in 30 ml physiological saline was performed in two courses of 3 consecutive days, with a 4-day interval between the courses. The response rate was 70.6%. Following instillation therapy transurethral resection (TUR) was carried out in 69 cases (80%), segmental cystectomy in 7, and total cystectomy in 3. The follow-up period averaged 42 months, during which the recurrence rate was 57%; recurrence occurred within 18 months in 80% of these cases. Since the recurrence per patient-month x 100 was 3.348, the precise effect of intravesical chemotherapy in the prevention of recurrence was unclear. There were 9 cases of advanced disease (11% of the total, 18% of cases with recurrence). One patient with CIS (flat invasive tumor) seemingly achieved CR, but died 43 months after treatment due to metastatic disease. While this method is not always indicated in cases of CIS (flat invasive tumor), in cases in which it is indicated a drug causing only limited stimulation of the bladder mucosa should be used and long-term follow-up is essential. PMID- 3664948 TI - Early intravesical instillation of adriamycin with oral administration of 5 fluorouracil after transurethral resection for superficial bladder cancer: preliminary results. AB - In all, 199 patients were entered in this study by 21 collaborating hospitals. Patients with superficial transitional cell carcinoma of the bladder were randomized postoperatively into four groups. Group A received early (immediately and 2 days after transurethral resection) instillation of adriamycin (30 mg/30 mg); group B received early instillation of adriamycin with oral administration of 5-fluorouracil (200 mg/day); group C received delayed (7 days after transurethral resection) instillation of adriamycin (30 mg/30 ml); and group D received delayed instillation of adriamycin with oral administration of 5 fluorouracil (200 mg/day). All patients subsequently received instillations weekly for 2 more weeks, and then every 2 weeks for a further 14 weeks. After 4 months, they received one instillation per month for 8 months. 5-Fluorouracil was administered p.o. for 1 year. The postoperative follow-up period was 12 months. After 3 and 6 months there were significant differences in the non-recurrence rates between groups B and C. After 12 months the overall non-recurrence rates were 87.9% in group A, 83.5% in group B, 89.2% in group C, and 82.8% in group D, and there were no significant differences among the four groups. The number of patients entered and the follow-up period are not adequate for firm conclusions, and further studies are necessary. The main side effect was bladder irritation, which was observed in 38.8% of patients in the early instillation groups and in 26.3% of those in the delayed instillation groups. No severe systemic side effects were observed in this study. PMID- 3664947 TI - Current status of intravesical chemotherapy trials in the EORTC Urological Group. An overview. AB - The EORTC Urological Group is one of the 31 clinical groups and working parties within the European Organization for Research and Treatment of Cancer (EORTC). Intravesical chemotherapy has been used as chemoresection or chemoprophylaxis. Chemoresection has mainly been utilized in phase II studies to demonstrate ablation of existing disease and to study the mechanism of drug action. These studies are usually performed by individual members to obtain relevant information for the preparation of randomized trials. One example is a phase II chemoresection study with 4'-epi-doxorubicin (EPR). The EORTC GU Group extended its phase II trials to study remission in patients with primary carcinoma in situ. A new concept introduced in the prospective, randomized phase III trials includes the evaluation of chemoresection of a marker lesion as a prognostic factor in long-term prophylactic treatment. Chemoprophylaxis in the phase III trials aims to study the disease-free period, the recurrence rate and the long term survival. So far, a series of five phase III trials, totaling more than 2,000 patients, demonstrated the efficacy of chemoprophylaxis to reduce tumor recurrence rates. The variation in the results of the different trials are due more to the prognostic factors (characteristics of the tumors) than to the related efficacy of the chemoprophylactic drugs. The selection of currently employed drugs, Mitomycin C, Epirubicin and BCG, is based on reported results, lack of toxicity, and drug availability in Europe. The data collected will be of great importance to determine the optimal clinical management of superficial bladder cancer. PMID- 3664949 TI - Activated N-ras oncogene in a transformant derived from a rat small intestinal adenocarcinoma induced by 2-aminodipyrido[1,2-a:3',2'-d]imidazole. AB - DNAs from five intestinal adenocarcinomas induced by 2-aminodipyrido[1,2-a:3',2' d]imidazole, which is present in broiled fish, were subjected to transfection assay using NIH3T3 cells as recipients. The DNA from only one adenocarcinoma induced a morphologically transformed focus. Rat N-ras sequences were detected in the primary transformant and in three tested secondary transformants. In the activated N-ras oncogene, a G----T transversion at the first letter of codon 12 was detected. The original tumor DNA did not hybridize with the oligonucleotide representing the mutated allele, but did hybridize with the one representing the normal allele. From these data we concluded either that the activation of the N ras oncogene had occurred during the transfection or that the activated N-ras oncogene had been present in a minor population of cells in the original tumor. PMID- 3664950 TI - Formation and tumorigenicity of benzo[b]fluoranthene metabolites in mouse epidermis. AB - The metabolism in mouse epidermis of benzo[b]fluoranthene (BbF) was studied. [3H]BbF was applied topically, mice were killed at various intervals, and metabolites were extracted from the epidermis and analyzed by h.p.l.c. The major metabolites were identified by comparisons to standards as 4-, 5-, and 6 hydroxyBbF. Sulfate and glucuronide conjugates of these hydroxyBbF were also detected. Minor metabolites included 12-hydroxyBbF, BbF-1,2-diol, and BbF-11,12 diol. BbF-9,10-diol, the only known tumorigenic oxygenated derivative of BbF, was not detected. The further metabolism of BbF-9,10-diol was studied in vitro, using rat liver 9000 g supernatant. The major metabolites were identified by their spectral characteristics as 5- and 6-hydroxyBbF-9,10-diol. Little if any BbF 9,10,11,12-tetraol was detected. 5- and 6-HydroxyBbF-9,10-diol were not detected as metabolites of [3H]BbF in mouse epidermis. Several known and potential BbF metabolites--BbF-1,2-diol, BbF-11,12-diol, BbF-9,10-diol, BbF-9,10-diol-11,12 epoxide, 5- and 6-hydroxyBbF-9,10-diol, 1-hydroxyBbF, 5-hydroxyBbF, and 6 hydroxyBbF--were tested for tumor initiating activity on mouse skin. Among these, only BbF-9,10-diol showed high tumorigenic activity, but no evidence has been obtained for its formation in vivo from BbF. These studies do not support the hypothesis that BbF is metabolically activated through formation of the bay region diol epoxide, BbF-9,10-diol-11,12-epoxide. PMID- 3664951 TI - Heterocyclic aromatic amine-DNA-adducts in bacteria and mammalian cells detected by 32P-postlabeling analysis. AB - The formation of DNA adducts by the fried meat mutagen and carcinogen 2-amino-3 methylimidazo[4,5-f]quinoline (IQ) was studied by means of 32P-postlabeling of DNA digests and four-directional t.l.c. Three major and five minor adducts were detected in assays of DNA digests obtained from Salmonella typhimurium TA98 cells after treatment with IQ and rat liver postmitochondrial supernatant (S9). A qualitatively identical adduct pattern was obtained with nitro-IQ (3-methyl-2 nitroimidazo[4,5-f]quinoline), a new analogue of IQ with a nitro instead of the amino group. These two compounds, therefore, form the same ultimate metabolite. The same adduct pattern was also found after TA98/1,8-DNP6 (acetyltransferase deficient) cells were treated with nitro-IQ; this is probably due to a residual acetyltransferase activity in this strain. Upon treatment of TA98 cells with 1 mM IQ for 3 h one adduct was detected in 4.7 x 10(5) total bases; a considerably higher adduct frequency, one in 4.2 x 10(3), was induced by nitro-IQ (70 microM, 30 min). The IQ isomer 2-amino-1-methylimidazo[4,5-f]quinoline (isoIQ) and its nitro-analogue nitro-isoIQ (1-methyl-2-nitroimidazo[4,5-f]quinoline) also produced identical adducts. Their common adduct pattern was very similar to the IQ adduct pattern but was located in a position different from that of the IQ adduct pattern. DNA from Syrian hamster embryo (SHE) cells treated with IQ and S9 exhibited adducts apparently identical with those of Salmonella DNA. PMID- 3664952 TI - Stereoselectivity of cytosolic glutathione S-transferases with arene and alkene oxide substrates in various tissues and isolated hepatic and pulmonary cells of the rabbit. AB - The specific activity and stereoselectivity of cytosolic glutathione S transferases (GST) from various rabbit tissues and isolated cells were determined as an initial step in characterizing GST isoenzymes in the rabbit. Of the five tissues examined, liver cytosol had the highest specific GST activity with the polycyclic arene oxides (+/-)-benzo[a]pyrene 4,5-oxide (BPO), pyrene 4,5-oxide (PO) and (+/-)-benz[a]-anthracene 5,6-oxide (BAO), and kidney cytosol had the second highest. Lung, intestine and testis had relatively low activities with all three substrates. With the alkene oxide (+/-)-styrene 7,8-oxide (SO), testicular cytosol had the highest GST activity while liver cytosol had only half the activity of the testis. Cytosolic GST from liver and kidney were highly stereoselective for reaction of glutathione with the S-configured oxirane carbon atoms of BPO, PO and BAO, and all tissues but the intestine were enantioselective for (4R,5S)-BPO and (5S,6R)-BAO. With SO, the liver, kidney and testis preferentially catalyzed the reaction of glutathione with the benzylic carbon atom of (7S)-SO. There was virtually no enantioselectivity in lung cytosol with SO but a preference for reaction with (7R)-SO was noted in the intestine. The stereoselectivities found in the intestine with each of the four substrates were markedly different from the other tissues. Cytosol from isolated hepatocytes showed almost identical patterns of stereoselectivity with BPO and PO to those of whole liver cytosol. Similarly, the stereoselectivity of cytosol prepared from alveolar type II cells isolated from rabbit lung was the same as that of whole lung cytosol with these substrates, whereas cytosol of alveolar macrophages differed substantially from lung cytosol in both cases. There were marked differences in stereoselectivity of cytosol from freshly isolated Clara cells with BPO versus PO as substrate. With BPO, Clara cells were very similar to whole lung cytosol, but with PO they were not. The data are consistent with the differential tissue and cellular distribution of multiple GST isoenzymes in the rabbit. PMID- 3664953 TI - Potential significance of phenotypic heterogeneity of focal lesions at different stages in hepatocarcinogenesis. AB - In this study we used morphometric methods to investigate the number, size and phenotype of foci of altered hepatocytes in male rats after limited (7 weeks) oral administration of N-nitrosomorpholine (stop-model). We found a chronological sequence from clear and eosinophilic cell foci (CCF and ECF) of early appearance followed by intermediate and mixed (MCF) and basophilic cell foci (BCF). Eventually, neoplastic nodules (NN) and hepatocellular carcinomas (HC) developed. The animals killed first (7 weeks) showed a large number of CCF and ECF and virtually no MCF and BCF. During the following weeks, we observed a temporary increase in the number of MCF and a progressive decrease in the number of CCF and ECF. A few BCF appeared for the first time 5 weeks after cessation of treatment. Subsequently there was an increase in the number of BCF and a decrease in the number of MCF, the latter starting 20 weeks after withdrawal of the carcinogen. MCF were found most frequently in animals with a high incidence of CCF. BCF and tumours were found most frequently in animals with a high incidence of MCF. The increase in the number of CCF was due to the appearance of small foci of this phenotype. However, the increase in the number of MCF and BCF was not related to an increase in number of small foci of these phenotypes. On the contrary, while the total number of MCF and BCF increased, there was a decrease in the incidence of small foci, but an increase in the incidence of large foci of these phenotypes. From these results, we concluded that phenotypically different foci essentially reflect different stages in the process of hepatocarcinogenesis. Moreover, the lack of small MCF and BCF suggests that the transition from CCF and ECF to MCF and finally to BCF is the result of a conversion of large cell populations within foci from 'early' to 'late' phenotypes rather than the consequence of a repeated clonal selection. PMID- 3664954 TI - Inhibition of phorbol ester-mediated phenotypic changes in cultured cells by hypoxanthine. AB - Hypoxanthine induces the differentiation of certain transformed cells in vitro, so analyses were undertaken to determine whether this purine metabolite might influence the expression of transformed phenotypes induced in normal cells by chemical agents. Chinese hamster embryo cells and human skin fibroblasts in culture were treated with the promoting agent phorbol-12,13-didecanoate (PDD) with or without prior treatment with 3-methylcholanthrene (MCA), and various phenotypic effects were monitored. Hypoxanthine was found to inhibit significantly the formation of type III foci and the increase in saturation density observed for Chinese hamster cells treated with MCA plus the phorbol ester. Inosine and the hypoxanthine analogue allopurinol could also mediate the effect on saturation density, while xanthosine could not. An increase in the saturation density of human skin fibroblasts, which can be induced by the phorbol ester alone, was also inhibited by hypoxanthine. There was no significant effect on the growth rate or the intracellular nucleotide pools with hypoxanthine treated cells. The results suggest that a normal purine metabolite, hypoxanthine, can modulate the expression of transformed phenotypes induced in vitro by the known tumor promotor PDD. These observations could help in elucidating the cellular basis for promotion of carcinogenesis. PMID- 3664955 TI - Combination experiments with very low doses of three genotoxic N-nitrosamines with similar organotropic carcinogenicity in rats. AB - The study was designed to assess the syncarcinogenic activity of very low doses of N-nitrosodiethylamine (NDEA), N-nitrosopyrrolidine (NPYR) and N nitrosodiethanolamine (NDElA) in the liver of 1800 male Sprague-Dawley rats. The N-nitrosamines were administered throughout the rats' lives individually and in combination at three logarithmically spaced dose levels contained in drinking water. The dose levels in the individual dose-response experiments ranged from the lowest concentrations of previous experiments (NDEA, 0.1 mg/kg; NPYR, 0.4 mg/kg; NDElA, 2.0 mg/kg) to dosages 10 times lower and comprised a high, medium and low dose (escalation factor: 3.16). The high dose of the combination contained the three nitrosamine concentrations used as the medium doses of the individual nitrosamines. The medium combination dose resulted from the combined administration of the three lowest dosages, and the low combination dose consisted of three nitrosamine dosages which amounted to one-third of the low dosages respectively. Administration of these dosages was associated with a dose dependent incidence of liver cancer: NDEA induced 45, 3.8 and 2.5%; NPYR caused 21.3, 5 and 1.3%; NDElA generated 7.5, 1.3 and 2.5%; and the combinations induced 16, 4.2 and 1.7% respectively. Untreated controls showed 0.6% liver cancer incidence. Besides the liver, the gastrointestinal tract, the neurogenic tissue, the urinary tract and the hematopoietic and lymphatic tissue were affected by tumor incidences increased over that of controls. There was, however, no well defined dose dependency as with the liver tumors. These results indicate dose dependency of liver tumor formation even at very low exposure levels of the individual agents. The carcinogenic effects of the hepatotropic N-nitrosamines summed up in combination. The observed additivity was linear. Dose levels, which alone would presumably not have been carcinogenic, effected a significant cancer risk in combination. PMID- 3664956 TI - Mitogenic activity of chloroform and carbon tetrachloride in serum-deficient or calcium-deficient cultures of human embryonic lung fibroblasts. AB - It was demonstrated that chloroform--studied in the non-toxic concentration interval 0.025-0.1% w/v--as well as carbon tetrachloride at 0.0125-0.05%, can support proliferation of cell cycling human embryonic lung fibroblasts in Dulbecco's modified Eagle's medium (DMEM) complemented with 0.5% foetal calf serum. This serum concentration restricts the growth of the non-solvent treated fibroblast (control) cultures. Even after a pretreatment of the fibroblasts with the low serum-medium for up to 4 days, the cells responded to the mitogenic impulse of the solvents. This indicates that quiescent fibroblasts are also sensitive to the mitosis-stimulating effect of the solvents. The effect of the solvents in serum-free DMEM was followed in a short-term study in order to determine if cofactor(s) from serum are needed for expression of the mitosis stimulating activity of the solvents. Carbon tetrachloride was shown to be mitogenic for the fibroblasts. At solvent concentrations greater than or equal to 0.00078% w/v the cells were observed to proliferate about as rapidly as control cells incubated in 10% serum-containing DMEM. After change from solvent containing to solvent-free medium cell proliferation was soon inhibited. Chloroform was not mitogenic in the serum-free medium. The mitogenic activity of CHCl3 or CCl4 in solvent containing 10% serum and reduced content of calcium ions (0.05 mM) was then determined. It was shown that the solvents under the non physiological conditions support proliferation of the fibroblasts for 2-3 days depending on the solvent concentration. PMID- 3664957 TI - Effect of butyric acid on 12-O-tetradecanoylphorbol-13-acetate-(TPA) induced mouse skin ornithine decarboxylase (ODC). AB - Butyric acid was topically applied on the interscapular region of Swiss albino mice before and after application of 12-O-tetradecanoylphorbol-13-acetate (TPA) in various doses and at different time intervals. Skin taken from the painted area, 4 h after TPA application, was subjected to ornithine decarboxylase (ODC) enzyme estimation. It was found that butyric acid inhibited the TPA-induced mouse skin ODC activity. The effect was dependent on the dose and duration of the butyric acid application. PMID- 3664958 TI - Quantitation of growth-altered cell populations (tumor-initiation sites) induced in open-ended rat tracheal implants by split doses of benzo[a]pyrene. AB - The numbers of tumor-initiation sites (TIS) induced by split doses of benzo[a]pyrene (BAP) in open-ended rat tracheal implants (OETI) were quantitated as the average number of growth-altered cell populations isolated per carcinogen exposed OETI. These growth-altered cell populations were identified as primary cell cultures which survive in medium lacking a pyruvate supplement, a condition in which normal tracheal cells die. The OETI were exposed to an average total dose of 1450 micrograms BAP, which was delivered twice weekly from 170-, 76- or 41-micrograms BAP-gelatin pellets over 4.5, 9 or 18 weeks respectively. OETI exposed for 4.5 or 9 weeks had 0.33 TIS/trachea when growth-altered cell populations were selected at 14 days from the first and second outgrowth cultures. An additional 1.0-1.17 TIS/OETI were detected if selection was delayed until 63 days in the third and fourth outgrowth cultures. In contrast, 2.0 TIS/trachea were selected after 14 days of culture from OETI pre-exposed for 18 weeks, and an additional 2.50/trachea were detected if selection was delayed to 28-63 days of culture. The TIS from this last group were also distinguished by more rapid growth and a large number of multiple cell cultures from the same explant, which indicated that more than one TIS was present on the explant and/or the growth-altered cell population had expanded enough to appear in more than one outgrowth culture. These growth-altered cell populations had also acquired a high degree (83%) of subculturability, i.e. immortality. These results suggest that OETI exposed repeatedly for a long duration had many TIS of which many had received multiple hits necessary for rapid progression of neoplasia. A large number of TIS were induced by a 4.5-week exposure, when the total BAP dose was doubled to 2934 micrograms. In this case a total of 5.75 TIS were induced per OETI. However, the cell cultures grew slowly, few multiple cultures were obtained, and only 52% of the growth-altered cell populations were subculturable. PMID- 3664960 TI - Bioactivation of N-nitrosopiperidine to mutagens: role of hepatic cytochrome P 450 proteins and contribution of cytosolic fraction. AB - In the present study the role of two families of cytochrome P-450 proteins and the contribution of the cytosolic fraction in the activation of N nitrosopiperidine to mutagens in the Ames test were investigated. The bioactivation of this nitrosamine was preferentially catalysed by the phenobarbitone-induced cytochromes P-450, in contrast to the 3-methylcholanthrene induced cytochromes P-448. The mutagenicity of nitrosopiperidine catalysed by microsomes, in the absence of cytosol, was lower when compared with that observed with S9 fractions. Cytosol itself could not activate nitrosopiperidine but potentiated the microsome-mediated mutagenicity of the carcinogen. The cytosolic potentiation was still evident when microsomal metabolism was terminated, indicating that cytosolic enzyme(s) can further convert the microsome-generated metabolites to more potent mutagens. The cytosolic enzyme(s) was inducible by prior treatment of the rats with phenobarbitone or Arochlor 1254 but not 3 methylcholanthrene. The microsome-mediated activation of nitrosopiperidine could be supported by NADH in the absence of NADPH. It is therefore concluded that the activation of nitrosopiperidine to mutagen(s) involves, in addition to NADH- and NADPH-dependent microsomal enzymes, cytosolic proteins. PMID- 3664959 TI - Use of monoclonal antibodies to characterize the induction response of the cytochrome P-450-dependent mixed function oxidase system to nitrofluoranthenes. AB - In prior studies with neonatal rats we have suggested that nitrated polycyclic aromatic hydrocarbons (NPAH) are 3-methylcholanthrene (3-MC) type of inducers of cytochrome P-450. These observations have been extended by studying the effect of fluoranthene (FL) and its nitrated derivative, 3-nitrofluoranthene (3-NF) and a mixture of nitrated fluoranthenes (NFs) on the induction of hepatic and pulmonary monooxygenase activities in adult rats. We have characterized the effect of these compounds on hepatic cytochrome P-450 isozyme(s) using immunoblot analysis. The administration of 3-NF and NFs to rats resulted in highly significant induction (1.9- to 5.8-fold) of hepatic and pulmonary aryl hydrocarbon hydroxylase (AHH) and 7-ethoxyresorufin-O-deethylase (ERD) activities. FL was either ineffective or much less effective in inducing these enzyme activities. The enzyme induction response to these compounds occurred in the following order: NFs greater than 3 NF greater than FL. SDS-PAGE of hepatic microsomes prepared from FL-, 3-NF- and NFs-treated animals revealed a higher content of protein migrating in the P-450 region. Characterization of isozymes of P-450 was carried out by Western blot analysis with highly specific monoclonal antibodies (MAb) raised against 3-MC specific P-450 (MAb 1-7-1) and phenobarbital-specific P-450 (MAb-2-66-3) isozymes. Hepatic microsomes prepared from 3-NF- and NFs-treated rats showed two distinct immunoprecipitin bands with MAb 1-7-1 whereas microsomes prepared from FL-treated animals showed a sharp band with MAb 2-66-3. MAb 1-7-1 significantly inhibited (approximately 80%) AHH activity induced by 3-NF and NFs. On the other hand FL-induced AHH activity was only moderately (approximately 30%) inhibited by MAb 1-7-1 whereas higher inhibition (approximately 60%) was observed with MAb 2 66-3. Analysis of BP metabolites by h.p.l.c. revealed enhanced production of metabolites by liver microsomes from 3-NF- and NFs-treated animals. The formation of BP 7,8-diol was 1.8- to 2.4-fold increased following treatment of animals with 3-NF and NFs respectively. Addition of MAb 1-7-1 to a microsomal mixture from 3 NF- and NFs-treated rats inhibited the formation of BP phenols (60-75%) and BP 7,8 diol (52-60%). These inhibitory effects were not observed with microsomes prepared from FL-treated rats. These studies suggest that NFs induce specific monooxygenases in liver and that they are inducers of P-450 isozymes c and d. PMID- 3664961 TI - Cytotoxicity and sister chromatid exchanges in 9L cells treated with monofunctional and bifunctional nitrogen mustards. AB - To investigate the role of DNA interstrand crosslink formation on cytotoxicity and the induction of sister chromatid exchanges (SCEs), we treated 9L cells with the bifunctional mustard bis(2-chloroethyl)methylamine (HN2), which can alkylate DNA and form DNA interstrand crosslinks, or with two monofunctional mustards, bis(ethyl)-2-chloroethylamine and bis(methyl)-2-chloroethylamine, which can only alkylate DNA. On a molar basis, HN2 was 900-2400 times more cytotoxic and 471-686 times more effective at inducing SCEs than the monofunctional mustards. HN2 induced high levels of DNA interstrand crosslinks in 9L cells; no interstrand crosslinks were detected in cells treated with the monofunctional mustards. Comparison of the alkylating activity of each of the mustards by 4-(p nitrobenzyl)pyridine reactivity showed only a 4-fold difference, which is not sufficient to account for the large differences in cell survival and induction of SCEs. We conclude that the effectiveness of HN2 at inducing cytotoxicity and SCEs results from the formation of DNA interstrand crosslinks. PMID- 3664962 TI - Identification of C8-modified deoxyinosine and N2- and C8-modified deoxyguanosine as major products of the in vitro reaction of N-hydroxy-6-aminochrysene with DNA and the formation of these adducts in isolated rat hepatocytes treated with 6 nitrochrysene and 6-aminochrysene. AB - Since 6-nitrochrysene and 6-aminochrysene have shown activity in carcinogenicity bioassays, we have begun an investigation of their metabolic activation pathways and the nature of the carcinogen-DNA adducts that may be formed. N-Hydroxy-6 aminochrysene (N-hydroxy-AC), a candidate proximate or ultimate carcinogen and the highest polycyclic N-hydroxy arylamine homolog studied thus far, was prepared by direct chemical synthesis and characterized by 1H-n.m.r. spectroscopy. Its rate and extent of reaction with DNA in vitro was 20-30 nmol bound/mg DNA/30 min, which is 2-10 times greater than has been reported for several other carcinogenic N-hydroxy arylamines. Three major aminochrysene-nucleoside adducts were detected in enzymatic hydrolysates of this N-hydroxy-AC-modified DNA, and these were isolated and identified by mass and 1H-n.m.r. spectroscopy as N-(deoxyinosin-8 yl)-6-aminochrysene, 5-(deoxyguanosin-N2-yl)-6-aminochrysene, and N (deoxyguanosin-8-yl)-6-aminochrysene. These adducts accounted for 32%, 28%, and 22% respectively, of the total DNA adducts formed. We hypothesize that the deoxyinosine adduct is derived from spontaneous oxidation of the corresponding deoxyadenosine adduct prior to or during DNA isolation and adduct preparation. DNA isolated from Sprague-Dawley rat hepatocytes which had been treated with [3H]6-aminochrysene or [3H]6-nitrochrysene contained up to 12 pmol adducts/mg DNA (4 adducts per 10(6) nucleotides). High performance liquid chromatography (h.p.l.c.) analyses of enzymatic hydrolysates of this DNA indicated that the major products formed cochromatographed with the C8-deoxyinosine and C8 deoxyguanosine adducts. N-(Deoxyinosin-8-yl)-6-aminochrysene and N-(deoxyguanosin 8-yl)-6-aminochrysene accounted for 45% and 30% respectively, of the total DNA adducts formed in these cells. The preferential modification of deoxyadenosine by N-hydroxy-6-aminochrysene and the apparent facile oxidation of this adduct to a deoxyinosine derivative is thus far unique among the reactions of N hydroxyarylamines with DNA and would not be predicted on the basis of reactivity alone. PMID- 3664963 TI - Chromosome aberrations in mouse bone marrow cells following in vivo exposure to 1,3-butadiene. AB - Chronic exposure to 1,3-butadiene (BD) results in a marked increase in the incidence of thymic lymphoma in male B6C3F1 relative to NIH Swiss mice whereas no demonstrable differences in bone marrow (target organ) toxicity exist. Repeated exposure to BD is known to produce a macrocytic anemia and an increase in the frequency of micronuclei in circulating erythrocytes in both strains. The present study was undertaken to determine if chromosomal breakage, aneuploidy or both reflect differences in BD leukemogenicity observed between B6C3F1 and NIH Swiss mice. Mice were exposed to a single concentration of BD (1250 p.p.m.) for 6 h. Bone marrow cell preparations were made at 24, 48, 72 and 96 h after cessation of exposure. In both strains comparable increases in the frequency of chromosomal aberrations (of the chromatid type) were observed following exposure to BD. Significant differences in the number of chromosomes were not observed, although a pattern of chromosomal loss in cells from treated animals was observed. These results indicate that BD-treatment in vivo produces significant increases in chromatid aberrations but not aneuploidy in both strains. Therefore it is concluded that bone marrow toxicity, including cytogenetic abnormalities, is not predictive of leukemogenicity in these mice. PMID- 3664964 TI - 17beta-Estradiol-induced cell transformation and aneuploidy of Syrian hamster embryo cells in culture. AB - The ability of 17 beta-estradiol to induce morphological transformation of Syrian hamster embryo cells was examined and dose-dependent increases were observed over the concentration range of 1-10 micrograms/ml. However, treatment of the cells with 17 beta-estradiol failed to induce any detectable increases in gene mutations, chromosome aberrations, sister chromatid exchanges or unscheduled DNA synthesis. In contrast, over the dose range that was effective in inducing cell transformation, 17 beta-estradiol induced numerical chromosome changes (both chromosome gains and losses). These findings are similar to the reported observations with the synthetic estrogen, diethylstilbestrol, and support the hypothesis that aneuploidy induction is important in cell transformation and possibly carcinogenesis induced by estrogens. PMID- 3664965 TI - Tumor induction in mice administered neonatally with 3-amino-1,4-dimethyl-5H pyrido[4,3-b]indole or 3-amino-1-methyl-5H-pyrido[4,3-b]indole. AB - 3-Amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1) or 3-amino-1-methyl-5H pyrido[4,3-b]indole (Trp-P-2), which is a potent mutagen from pyrolysates of tryptophan, was given subcutaneously to neonatal ICR mice, and all animals were observed for 1 year. Tumors of the livers and lymphoreticular tissue were induced. In the mice given Trp-P-1, the incidences of these tumors were as follows: liver tumors in 45% of the males; malignant lymphoma in 13% of the males and in 24% of the females. In the mice given Trp-P-2, the incidences of liver tumors in the males were dose-dependent (12.5 mg/kg, 12%; 25 mg/kg, 18%), while those of malignant lymphoma varied within a range from 5 to 19%. Statistical analysis revealed that the incidences of the liver tumor in the mice given Trp-P 1 or Trp-P-2 and those of lymphoma in the mice given Trp-P-1 were significantly higher than those of the controls. In the control mice, the incidences of tumors were as follows: malignant lymphoma in 5% of the females; lung tumor in 14% of both sexes. PMID- 3664966 TI - Monoclonal antibodies detect conformational abnormality of uracil DNA glycosylase in Bloom's syndrome cells. AB - The immunoreactivity of normal human and Bloom's syndrome uracil DNA glycosylase was examined using a series of three anti-human placental uracil DNA glycosylase monoclonal antibodies. Immunoreactivity was determined by three separate and independent criteria: enzyme-linked immunosorbent assay (ELISA), enzyme inhibition studies and immunoblot analysis. As defined by each criteria, normal human uracil DNA glycosylase was immunoreactive with each antibody (37.04.12, 40.10.09 and 42.08.07). In contrast, each glycosylase purified from two separate non-transformed Bloom's syndrome cell strains was not reactive with antibody 40.10.09. First, no ELISA reactivity was observed with each glycosylase protein. Second, catalysis by each Bloom's syndrome glycosylase was not inhibited by antibody 40.10.09. However, each Bloom's syndrome enzyme was immunoreactive with antibodies 37.04.12 and 42.08.07. No immunoreactive glycosylase species was observed during the induction of the Bloom's syndrome enzyme during cell proliferation. However, immunoreactivity of the denatured Bloom's syndrome enzyme with 40.10.09 antibody was observed by immunoblot analysis. These results suggest that Bloom's syndrome uracil DNA glycosylase is characterized by a structural alteration in the native glycosylase protein secondary to the primary antigenic site recognized by the 40.10.09 antibody. This altered antigenicity may provide an immunological marker for the identification of this human genetic syndrome. PMID- 3664968 TI - A precursor-product relationship exists between oval cells and hepatocytes in rat liver. AB - Oval cell proliferation was induced in twelve male Fischer rats by administration of 2-acetylaminofluorene (2-AAF) for 2 weeks and by performing partial hepatectomy one week after the beginning of 2-AAF administration. Albumin expression in liver was studied by using in situ hybridization of 3H-labeled rat albumin riboprobe. Radiolabeled thymidine was administered to a group of animals at day 6 after partial hepatectomy. The animals were killed at 0, 3, 7, 9, 11 and 13 days after partial hepatectomy. Both oval cells and basophilic hepatocytes showed a prominent expression of albumin, whereas albumin expression in acidophilic pre-existing hepatocytes was decreased. Oval cell nuclei were exclusively labeled one day after administration of [3H]thymidine. At day 9, 11 and 13 basophilic hepatocytes became labeled and the area occupied by these cells increased. This is the first demonstration of the transfer of radiolabeled thymidine from oval cells to newly formed hepatocytes in vivo. Thus the precursor product relationship between oval cells and basophilic hepatocytes has been established. PMID- 3664967 TI - Enhancement of BHA-induced proliferative rat forestomach lesion development by simultaneous treatment with other antioxidants. AB - Synergistic effects of butylated hydroxyanisole (BHA) and other antioxidants on induction of rat forestomach lesions were investigated. Groups of F344 male rats were treated with 1% BHA plus 0.7% butylated hydroxytoluene (BHT), 1% BHA plus 1% propyl gallate (PG), 1% BHA plus 1% sodium L-ascorbate (SA), 1% BHA plus 1% DL alpha-tocopherol (alpha-TP), 0.4% BHT plus 0.4% BHA plus 0.4% PG plus 0.4% SA plus 0.4% alpha-TP, 1% BHA or 2% BHA. Further groups of 10 rats each received antioxidants without BHA as controls. Histological examination revealed significantly increased incidences of hyperplasia in the groups given BHA together with SA or PG at the prefundic region or at the mid region respectively. The forestomach changes induced by BHA together with SA were equal to those induced by 2% BHA. On the other hand, simultaneous treatment with BHA and PG or alpha-TP reduced the incidence of hyperplasia at the prefundic region. It is concluded that mixed treatment with BHA and other antioxidants exerted enhancing or inhibitory effects on the induction of hyperplasia at different sites of the forestomach epithelium. PMID- 3664969 TI - Distribution and metabolism of N'-nitrosonornicotine in the miniature pig. AB - The distribution and metabolism of [5-3H]N'-nitrosonornicotine ([5-3H]NNN) was studied in three 18-day-old miniature pigs. [5-3H]NNN was administered by intracardiac administration into the right ventricle of the heart to mimic uptake by the lung. Whole body autoradiograms taken 15-220 min after treatment showed high levels of radioactivity in the mandibular and parotid salivary glands, Harder's gland, lacrimal glands, glands of the snout and respiratory part of the nasal cavity, and the melanin of the eyes and skin. Bound radioactivity was most abundant in the nasal mucosa and liver. Analysis of tissues by h.p.l.c. showed the presence of high levels of [5-3H]NNN in the mandibular glands and Harder's gland. Levels of [5-3H]NNN and its metabolites were determined in arterial and venous serum, 0.5-220 min after injection. The disappearance of [5-3H]NNN from serum was biphasic. 4-Oxo-4-(3-pyridyl) butyric acid, a metabolite of [5-3H]NNN resulting from 2'-hydroxylation, which is a suspected activation pathway, was detected 0.5 min after injection and appeared to reach a steady state 2-220 min after injection. 4-Hydroxy-4-(3-pyridyl)butyric acid, from 5'-hydroxylation of [5 3H]NNN, and norcotinine, from denitrosation, were also rapidly formed. These experiments are the first in which the appearance of NNN metabolites in blood has been measured. The ratio of 2'-hydroxylation to 5'-hydroxylation varied from 0.27 to 0.60 in arterial serum and from 0.33 to 0.49 in venous serum in the period from 2-220 min. [5-3H]NNN accumulated in the stomach contents such that its levels were greater than those in arterial or venous serum, 60 min after injection. The results of this study demonstrate that the miniature pig is a useful model for the investigation of nitrosamine metabolism and indicate some similarities and differences in metabolism and distribution compared with the rat. PMID- 3664970 TI - Ionizing radiation enhances malignant progression of mouse skin tumors. AB - Chemical carcinogenesis in mouse skin has been divided into the process of initiation, promotion and progression. Recently we have shown that ionizing radiation acts as an initiator in this model system. In this paper we describe a three-stage experiment using ionizing radiation in the third stage of mouse skin carcinogenesis. CD-1 mice were initiated with N-methyl-N'-nitro-N nitrosoguanidine (MNNG) followed by biweekly promotion with 12-O tetradecanoylphorbol-13-acetate (TPA). After 20 weeks of promotion, the animals were treated with either acetone, TPA (twice a week for 2 weeks) or eight fractions of 1 MeV electrons (1 Gy/fraction over a period of 10 days). The conversion of papillomas to squamous cell carcinomas was 80% for animals treated with ionizing radiation compared with 25% for tumor-bearing animals treated with TPA. Ionizing radiation increased the number of cumulative carcinomas per group. The lack of an increase in the number of cumulative papillomas per group due to ionizing radiation suggests that the dose and fractionation protocol used in this study enhanced the progression of pre-existing papillomas. PMID- 3664971 TI - Inhibition of intercellular communication by nickel(II): antagonistic effect of magnesium. AB - The level of gap-junctional (cell-cell) communication was studied by the radioisotope transfer technique in NIH 3T3 cells exposed to NiSO4, MgSO4, or both salts combined. Monolayered NIH 3T3 donor cells were labeled with [3H]-uridine for 3 h and then co-cultured with non-labeled recipient NIH 3T3 cells for 3 h in the presence of 0.5-20 mM NiSO4, 1.0-100 mM MgSO4, or 5 mM NiSO4 plus 1.0-100 mM MgSO4. 12-O-tetradecanoylphorbol-13-acetate (TPA), 16-160 pM, served as a positive control. The exposed cells were fixed with 2.5% glutaraldehyde and processed for autoradiography. The cell-cell communication rate was based on the number of radioactive recipient cells in relation to the total number of recipient cells for 100 donor cells. NiSO4 disrupted cell-cell communication in a dose-related manner from 98% of the base value at 0.5 mM NiSO4 to 2% at 5 mM NiSO4. Cell viability was not affected by 0.5-5 mM NiSO4. The inhibitory action of 5 mM NiSO4 could be partially prevented by 5.0-100 mM MgSO4. However, MgSO4 did not prevent the inhibition by TPA. The results indicate that NiSO4 is capable of inhibiting cell-cell communication at concentrations that do not cause cytotoxic effects in NIH 3T3 cells during a 3-h period. In this respect NiSO4 resembles such classical tumor promoters like TPA. The antagonism by magnesium of the nickel-induced inhibition of cell-cell communication may indicate a contributory mechanism by which magnesium counteracts the carcinogenicity of nickel in vivo. PMID- 3664972 TI - Pet care during preadolescence: developmental considerations. AB - This exploratory study investigated pet care in relation to psychosocial development during preadolescence. A group of male and female preadolescents (n = 22) at appropriate grade level for age completed a dog care responsibility inventory. The results revealed that preadolescents in general do not routinely care for pets. Mothers appear to assume most pet care tasks. PMID- 3664973 TI - Global myocardial ischemia in the newborn, juvenile, and adult isolated isovolumic rabbit heart. Age-related differences in systolic function, diastolic stiffness, coronary resistance, myocardial oxygen consumption, and extracellular pH. AB - Controversy persists over the relative tolerance of the immature myocardium to global ischemia. Thus, we evaluated the physiologic effects of 30, 60, and 180 minutes of global ischemia in an isolated, isovolumic rabbit heart model, at 3 different ages: newborns (less than 1 week of age) (n = 36), juveniles (4 to 6 weeks old) (n = 36), and adults (5 to 7 months old) (n = 36). Following 30 and 60 minutes of ischemia, respectively, adults recovered 87 +/- 4% (mean +/- SEM) and 90 +/- 7% of baseline systolic function, and juveniles recovered 91 +/- 10% and 85 +/- 8%. In contrast, newborns recovered only 27 +/- 6% and 28 +/- 4% of baseline systolic function (p less than 0.05 compared to adults and juveniles). During ischemia, newborn hearts became stiff more rapidly, reaching 361 +/- 46% of baseline stiffness by 60 minutes, whereas adults and juveniles were at 122 +/- 33% and 92 +/- 18% of baseline stiffness (p less than 0.05 newborns compared to adults and juveniles). With reperfusion after 60 minutes of ischemia, the work efficiency of the newborn heart deteriorated to 39 +/- 7% of baseline, compared with 95 +/- 7% and 91 +/- 7% of baseline efficiency in the adult and juvenile hearts (p less than 0.05, newborns compared to adults and juveniles). The ratio of tissue wet-to-dry weights were similar in all age groups after ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664974 TI - Contrasting effects of static and pulsatile pressure on carotid baroreceptor activity in dogs. AB - The purpose of this study was to contrast the effects of static and pulsatile pressure on carotid baroreceptor activity over a wide range of mean arterial pressure. Static and pulsatile pressure were applied to the isolated carotid sinus of dogs anesthetized with chloralose. Recordings were obtained from single baroreceptor units as well as from the whole sinus nerve or a large strand of the nerve. Three observations are reported. First, in single units the pulsatile pressure threshold, which averaged 48 +/- 8 (SEM) mm Hg, was far below the static pressure threshold, which averaged 79 +/- 8 mm Hg (p less than 0.05, n = 15). Thus, pulsatility decreased the threshold by an average of 31 mm Hg in contrast to the minimal or lack of decrease in threshold reported by others in aortic baroreceptors. Second, at moderate arterial pressures a shift from static to pulsatile pressure caused a decrease in single and multiple unit activities. In single units, the decrease approximated 15% (from 42.0 +/- 2.1 to 35.5 +/- 1.9 spikes/sec, p less than 0.05, n = 25). In all units, there was no diastolic nerve activity ("silence") when diastolic pressure was 1 to 10 mm Hg above static pressure threshold; 80% of the units exhibited "diastolic silence" when diastolic pressure was 20-30 mm Hg above threshold and 40% of the units showed silence at diastolic pressures 40-50 mm Hg above threshold. In whole nerve recordings, pulsatility increased activity from 57 +/- 15 to 142 +/- 29 spikes/sec (p less than 0.05) at low mean arterial pressures (50 and 75 mm Hg), as expected from the reduction in pressure threshold noted in single units, and decreased activity by approximately 15% (from 373 +/- 69 to 320 +/- 55 spikes/sec, p less than 0.05, n = 9) at mean arterial pressures of 125 and 150 mm Hg. This decrease in activity with a shift from static to pulsatile pressure at moderate arterial pressures has not been reported previously. Third, the static pressure-activity curve was sigmoid, and its gain peaked sharply at 75-100 mm Hg; in contrast, the pulsatile pressure-activity curve was linear between 25 and 150 mm Hg, and its maximum gain was half the maximum gain during static pressure. These differences between the static pressure-activity curve and the pulsatile pressure-activity curve were noted during both increases and decreases in carotid sinus pressure; both curves exhibited some hysteresis during the decreases in pressure. PMID- 3664975 TI - Vibrational analysis of bioprosthetic heart valve leaflets using numerical models: effects of leaflet stiffening, calcification, and perforation. AB - The fundamental natural frequency of the closed cusps of porcine bioprosthetic valves, fabricated from the normal leaflets of pig aortic valves, was estimated using a finite element model. Both normal and stiffened leaflets were considered in the vibrational analysis. The effects of conditions that simulated degeneration, such as stiffening, central perforation, a tear, calcium deposits in the commissural attachments, and combinations of these were determined. The primary frequency of vibration of the normal leaflets was within the range of the dominant frequency of the heart sounds determined clinically by spectral analysis of the recorded phonocardiogram. If only one leaflet was stiffened or calcified, there was only a marginal change of frequency. With stiffening and calcification of the commissures of all 3 leaflets, the frequency of vibration increased. Introduction of a tear in a single leaflet of a stiffened and calcified valve markedly reduced the fundamental frequency. In view of the relation between the frequency content of heart sounds and the frequency of valve vibration, this mathematical simulation establishes a possible basis for the observation of a varying dominant frequency of heart sounds in patients with bioprosthetic valves that are in the process of degenerating. PMID- 3664976 TI - Transverse stiffness: a method for estimation of myocardial wall stress. AB - Determination of regional ventricular wall stress would allow quantification of both regional contractile state and its interplay with global function. Current methods for quantifying regional stress include mathematical modelling and measurements with strain gauges. Both methods are difficult to validate. We hypothesized that transverse stiffness (i.e., the ratio of indentation stress to strain as the ventricular wall is indented in the direction perpendicular to the wall) would be proportional to the stresses in the plane of the wall and could be used to estimate the latter. To test this hypothesis, 6 arterially perfused canine ventricular septa were mounted in an apparatus that could exert biaxial load in the plane of the wall. A servo system maintained the central third of the septa isometric during active contractions while the septa were paced at 30-60 pulses/min. In the center of the isometric region, a probe of 7 mm diameter indented the septa while the transverse indentation stress and strain were measured. For values of peak systolic in-plane stress from 0.56 to 2.6 g/mm2, the transverse stiffness varied from 1.2 to 11.7 g/mm2 and was linearly related to the in-plane wall stress in each septum (p less than 0.001, ANOVA). After cardioplegia, the transverse stiffness also correlated with passively applied wall stress for each dog (p less than 0.001). The slopes of the individual relations between transverse stiffness and wall stress from active contractions were similar to those from passively applied stress (mean +/- SEM; 1.82 +/- 0.36 versus 1.45 +/- 0.31, NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664977 TI - Mechanisms of sinoatrial pacemaker synchronization: a new hypothesis. AB - A model of electrically coupled sinus node cells was used to investigate pacemaker coordination and conduction. Individual cells were simulated using differential equations describing transmembrane ionic currents. Intrinsic cycle lengths (periods) were adjusted by applying constant depolarizing or hyperpolarizing bias current, and cells were coupled through ohmic resistances to form two-dimensional arrays. Activation maps of 81-225 coupled cells showed an apparent wavefront conducting from a leading pacemaker region to the rest of the matrix even though the pattern actually resulted from mutual entrainment of all spontaneously beating cells. Apparent conduction time increased with increasing intercellular resistance. Appropriate selection of pacemaker cycle lengths and intercellular resistances permitted the accurate simulation of the activation sequence seen experimentally for the rabbit sinus node. Furthermore, a simulated acetylcholine pulse applied to a randomly selected 20% of the cells in this model produced a pacemaker shift that lasted several beats. These results support the hypothesis that sinus node synchronization occurs through a "democratic" process resulting from the phase-dependent interactions of thousands of pacemakers. PMID- 3664978 TI - Role of changes in [Ca2+]i in energy deprivation contracture. AB - Mechanisms of energy deprivation contracture were investigated in cultured chick embryo ventricular cells. In the presence of zero-extracellular-Na+, (choline chloride substitution)-nominal-zero-Ca2+ [( Ca2+] approximately 5 microM), exposure of ventricular cells to 1 mM cyanide (CN) and 20 mM 2-deoxyglucose (2 DG)-zero-glucose solution resulted in the development of a contracture (video motion detector) in 5.9 +/- 0.5 minutes. Early after contracture development, the resupply of extracellular Na+, in the continued presence of CN + 2-DG, resulted in a rapid partial relaxation (t1/2 = 1.9 +/- 0.3 seconds), associated with an increase in 45Ca efflux, presumably due to transsarcolemmal Ca2+ extrusion due to Na+-Ca2+ exchange. Resupply of glucose and removal of CN + 2-DG, in the continued absence of Na+, resulted in an initially slower (t1/2 = 11.6 +/- 2.5 seconds), but more complete relaxation of contracture, which was not associated with increased Ca2+ efflux. Pretreatment with 20 mM caffeine delayed the onset of contracture (9.2 +/- 1.1 minutes) and resulted in a contracture that could not be relaxed by resupply of external Na+ only. Studies using the fluorescent Ca2+ probe indo 1 demonstrated that in zero-Na+-zero-Ca2+ solutions, contracture due to CN + 2-DG was associated with an initial rise in [Ca2+]i but that this did not account for all of contracture force development. In cells exposed to CN + 2-DG in the presence of normal extracellular Na+ and Ca2+ concentrations, a small rise in [Ca2+]i was associated with initial contracture development, consistently preceding the development of a larger accelerated contracture presumably due to ATP depletion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664979 TI - Effect of changes in ventricular relaxation on early diastolic coronary blood flow in canine hearts. AB - Since the gradient between aortic pressure and left ventricular diastolic pressure is a major determinant of coronary blood flow, a change in left ventricular relaxation by its effect on early diastole could diminish early diastolic coronary flow. Two interventions that resulted in impaired left ventricular relaxation, hypothermia, and reperfusion following a left anterior descending coronary artery occlusion were studied to evaluate whether there were associated changes in coronary blood flow. With both interventions, there was a significant prolongation of left ventricular relaxation (p less than 0.01) accompanied by a significant decrease in early diastolic coronary blood flow (p less than 0.01). Verapamil did not have a significant effect on these hemodynamic changes during hypothermia. However, verapamil significantly blunted the effects of reperfusion following ischemia on ventricular relaxation (p less than 0.002) and early diastolic coronary blood flow (p less than 0.01). Thus, impaired left ventricular relaxation has an adverse impact on early diastolic coronary blood flow, which, under the condition of reperfusion following regional myocardial ischemia, can be alleviated with calcium channel blockade. PMID- 3664980 TI - Conference on Mechanisms of Autonomic Cardiovascular Control. Keystone Colorado, February 26-March 2, 1986. Proceedings. PMID- 3664981 TI - Cerebral circulation: effects of sympathetic nerves and protective mechanisms during hypertension. AB - The first goal of this study was to examine bilateral effects of reflex activation of sympathetic nerves on the cerebral circulation. Seizures, which activate sympathetic nerves, were induced in animals with intact nerves and after bilateral cervical sympathetic denervation. Increases in cerebral blood flow (microspheres) and decreases in cerebral vascular resistance were similar in denervated and innervated animals. Thus, during intense metabolic stimulation, metabolic factors are the primary determinant of cerebral blood flow, and bilateral effects of sympathetic nerves are minimal. The second goal of this study was to examine the role of vascular hypertrophy in protection of the cerebral circulation. Cerebral perfusion pressure was decreased on one side by clipping one carotid artery in 4-week-old stroke-prone spontaneously hypertensive rats. Two to four months later, the clip was removed, and seizures were induced. Disruption of the blood-brain barrier in the cerebrum occurred predominantly on the clipped side. We suggest that reduction in perfusion pressure attenuates development of cerebral vascular hypertrophy and thereby increases susceptibility to disruption of the blood-brain barrier. Thus, hypertrophy of cerebral vessels during chronic hypertension may protect the cerebral circulation. PMID- 3664982 TI - Reductions in regional myocardial function at rest in conscious dogs with chronically reduced regional coronary artery pressure. AB - We have examined the temporal response of regional subendocardial function in conscious chronically instrumented dogs following implantation of a circumflex ameroid occluder. Collateralization was limited by ligation of epicardial anastamoses between the circumflex and adjacent coronary arteries at the time of instrumentation. Sonomicrometrically measured regional function in the circumflex coronary artery became depressed relative to that in the left anterior descending coronary artery bed under resting conditions with the onset of an aortic circumflex pressure gradient of 15 +/- 2.9 mm Hg (mean +/- SEM). At the time of total ameroid occlusion, the ratio of circumflex to left anterior descending coronary artery function fell to 68 +/- 8% of control, with mean circumflex coronary pressure decreasing to 60 +/- 1.6 mm Hg. Following ameroid occlusion, distal coronary pressure increased, and circumflex function recovered towards control but remained depressed relative to that in the left anterior descending coronary artery for 2-4 weeks. Measurements of regional subendocardial perfusion suggested a dissociation between subendocardial flow and function prior to but not following coronary occlusion by the ameroid. We conclude that this model results in reductions in regional function that are relatively prolonged and are not readily attributable to subendocardial infarction or a critical reduction in resting coronary flow. The data suggest that functional adaptations in response to gradually developing coronary occlusion are more complex than those associated with acute reductions in coronary artery pressure and flow. PMID- 3664983 TI - Neural modulation of transcapillary exchange of fluid and solutes in whole-organ preparations. AB - Activation of sympathetic adrenergic postganglionic fibers that release norepinephrine at the neuromuscular junction can influence resistance, capacitance, and exchange functions in the microcirculation. Although the predominant response is an increase in precapillary resistance that reduces blood flow through the tissue (at constant pressure perfusion), there are two distinct components that can be separated into an initial (1-2-minute) and late (2-15 minute) response. The initial (1-2-minute) response is a decrease in venous and capillary pressures in passive response to decreased flow promoted by an increase in precapillary resistance. Venous pressures are reduced even though postcapillary resistance is increased. The decrease in capillary pressure promotes absorption of fluid from tissue to plasma. Venous constriction results in a translocation of blood from the terminal venous system into the larger venous conduits toward the heart. Total blood volume in an isolated organ system decreases and is manifested as a decrease in volume (plethysmographic) or weight (gravimetric). The decrease in volume is result of three interrelated factors: 1) decrease in flow through the organ, 2) active venoconstriction and a translocation of blood out of the organ, and 3) absorption of fluid from tissue to plasma, which flows out of the organ with venous drainage. With continued sympathetic nervous system stimulation, the late response (3-15 minutes) is a gradual decrease in precapillary resistance that increases blood flow through the organ. Venous and capillary pressures passively increase in association with increases in flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664984 TI - Propagation of vasodilation in resistance vessels of the hamster: development and review of a working hypothesis. AB - In many tissues, a substantial fraction of total vascular resistance resides in the feed arteries that give rise to the microcirculation. We have explored the thesis that control of tissue blood flow is integrated over several levels of the vascular network, including feed arteries and microvessels. In response to muscular contraction, feed arteries (resting diameter 100-125 microns) of hamster cremaster and gracilis muscles dilated by 20-25%. Acetylcholine applied to distal microvessels of the cremaster induced a dilation that ascended into feed arteries not having direct contact with acetylcholine. In the hamster cheek pouch, iontophoretic application of acetylcholine onto an arteriole (diameter 20-30 microns) triggered a vasodilation that propagated along the arteriole. Propagation was not dependent on blood flow, indicating that the dilator response was conducted along the vessel wall. We found that preventing diameter changes in an arteriole segment along the apparent conducting pathway did not block propagated vasodilation, indicating that propagation was not mediated by a myogenic mechanism requiring changes in smooth muscle length. We investigated whether the conduction of a vasodilatory stimulus may be mediated by either a neural plexus intrinsic to microvessels or cell-cell coupling between the cells composing the arteriole. Tetrodotoxin (10(-6) M) did not block propagated vasodilation, indicating that propagation is not mediated by a neural pathway. Hypertonic sucrose solution applied to an arteriole segment along the apparent conducting pathway attenuated propagation significantly, which is consistent with its reported effect to decouple gap junctions between cells. Thus, propagated vasodilation in arterioles may be mediated by direct cell-cell conduction. PMID- 3664985 TI - Response of the microcirculation in rat cremaster muscle to peripheral and central sympathetic stimulation. AB - Microvascular diameter and flow responses to peripheral and central sympathetic stimulation were measured in different segments of the arteriolar network in rat cremaster muscle. For peripheral stimulation, a bipolar electrode was placed on the internodal segment of the lumbar sympathetic chain between ganglia L1 and L2. For central stimulation, a bipolar electrode was stereotaxically implanted in the posterior hypothalamus. Inside vessel diameter, red blood cell velocity, and volumetric flow rate were recorded in response to electrical stimulations of varying magnitude in four series-coupled segments of the arteriolar network: 1A, 2A, 3A, and 4A. Systemic arterial pressure was also monitored. The vasoconstriction and flow reduction produced by stimulation of the lumbar chain was graded with the frequency of stimulation over the range of 0.5-16.0 Hz in all arteriolar segments. Examination of the relation between stimulation frequency and vasoconstrictor response measured as percent of control diameter indicated a sequence of responsiveness to peripheral stimulation where 4A = 3A greater than 2A = 1A. No changes in diameter were recorded in the venous microcirculation at any level of stimulation. Stimulation of the posterior hypothalamus with currents of 38-300 microA for 60 seconds produced graded vasoconstriction in only 3A and 4A vessels. Fluorescence histochemistry for biogenic amines was used to examine the distribution of innervation to the microvasculature. All segments of the arteriolar network from 1A to 4A possessed an adrenergic innervation; no vessels of the venous network were found to be innervated. The results indicate that the pattern of response of the arteriolar network in rat cremaster muscle to peripheral and central sympathetic stimulation is segmentally differentiated and consistent with the distribution of the vasomotor innervation. PMID- 3664986 TI - Preoptic hypothalamic control of arteriolar vasodilatory responses. AB - Arteriolar responses to hemorrhage were directly observed in the skeletal muscle and intestinal circulations of two groups of animals. In one group, the periventricular tissue surrounding the anteroventral portion of the third cerebral ventricle (AV3V) was electrolytically lesioned 7-10 days before an acute experiment. In the other group, control surgical procedures were performed. Hemorrhage resulted in similar decreases in arterial blood pressure (30-60% prehemorrhage level) and intestinal blood flow (20-60% prehemorrhage level) in both groups. In contrast, arteriolar diameter significantly increased following hemorrhage in the spinotrapezius muscle of control-operated animals (141 +/- 9% prehemorrhage level) but did not change in animals with AV3V lesions (97 +/- 7% prehemorrhage level). In a previous study, electrical stimulation of intact AV3V tissue was shown to cause a sustained decrease in blood pressure (80-90% of control level) and a vasodilation in skeletal muscle arterioles (120-140% control level). Since stimulation of intact AV3V tissue evokes vasodilation and AV3V tissue ablation reduces hemorrhage-induced vasodilation, this region of the hypothalamus may play an important role in the regulation or modulation of some responses in the peripheral microcirculation. PMID- 3664987 TI - Vasoactive effects of serotonin on proximal coronary arteries in awake dogs. AB - This study evaluates the vasoactive effects and mechanisms of action of serotonin on epicardial arteries in awake dogs chronically instrumented with miniature piezoelectric dimension crystals on the proximal circumflex coronary artery. Serotonin (2-16 micrograms) infused as a bolus in the left atrium effected a dose related biphasic response, which was characterized by an initial increase in vessel dimension with a peak response at 45-75 seconds, followed by a delayed and more sustained vasoconstriction, with a maximum response at 2-8 minutes. The magnitude of the initial vasodilation was generally greater than the delayed vasoconstriction. The initial vasodilation remained unchanged after selective S2 blockade with ketanserin (0.3 mg/kg) and was only minimally but insignificantly attenuated when flow was held constant but was reduced after S1 and S2 blockade with methysergide (0.25 mg/kg). Selective S2 blockade with ketanserin (0.3 mg/kg) attenuated the delayed vasoconstriction in most but not all dogs; the effect of ketanserin was, however, not significant when the entire group was considered. Selective endothelial denudation effectively eliminated the initial vasodilation response to serotonin and significantly augmented the delayed vasoconstriction when the dogs were studied 1-2 days after denudation. The data indicate that in the awake dog, serotonin effects a biphasic vasomotor response characterized by an initial vasodilation that is mediated primarily through a direct endothelium dependent S1 mechanism followed by a delayed vasoconstriction that is probably mediated via a direct S2 effect on the vascular smooth muscle and is attenuated by the normal endothelium. PMID- 3664988 TI - Influence of chemoreceptors on neurohypophyseal blood flow during hypoxic hypoxia. AB - Neurohypophyseal blood flow was studied using radiolabelled microspheres in 13 dogs. Hypoxic hypoxia and carbon monoxide hypoxia with similar arterial oxygen contents (CaO2, approximately 8 vol %) were produced. Under conditions of hypoxic hypoxia, 100-200% increases in blood flow in caudate nucleus, white matter, neurohypophysis, and all other brain regions occurred. Similar blood flow responses were observed with carbon monoxide hypoxia in all brain regions except the neurohypophysis. The role of carotid and aortic chemoreceptors in mediating this blood flow response was studied in 6 additional dogs. Similar degrees of hypoxic hypoxia were produced in chemoreceptor-intact and completely denervated animals (CaO2 approximately 8 vol %, PaO2 approximately 33 mm Hg). Hypoxic hypoxia produced a 250% increase in neurohypophyseal blood flow and a concurrent rise in plasma arginine vasopressin from 8 +/- 3 to 52 +/- 8 pg/ml. Chemoreceptor denervation completely inhibited the increase in neurohypophyseal blood flow associated with hypoxic hypoxia. Arginine vasopressin was not increased by hypoxic hypoxia under conditions of complete denervation. A unique role for peripheral chemoreceptors in regulating neurohypophyseal blood flow is postulated. PMID- 3664989 TI - Skeletal muscle metabolism in patients with congestive heart failure: relation to clinical severity and blood flow. AB - We and others have previously demonstrated excessive phosphocreatine (PCr) depletion and acidosis in skeletal muscle during exercise in patients with congestive heart failure (CHF). In the present study, we performed serial measurements of PCr and pH during gradually incremental flexor digitorum superficialis exercise in 22 patients with CHF and 11 age-matched controls to determine: (1) whether abnormalities were present at the same relative workloads (a comparison that would at least partially compensate for differences in muscle mass), (2) the temporable course of the metabolic changes, (3) the relationship of the metabolic findings to clinical variables, and (4) the relationship of the metabolic abnormalities to forearm blood flow. The patients with CHF had significantly lower [PCr] and pH at all submaximal levels of exercise, and these abnormalities were apparent from the onset of low-level exercise. There was considerable heterogeneity among the patients with CHF with respect to the metabolic findings, with 14 of 22 exhibiting either PCr or pH values more than 2 SDs below normal. Patients whose capacity was more limited during the protocol had lower [PCr], and especially pH, at low loads than did other patients with CHF or the control subjects. The more symptomatic patients and those with more limited bicycle exercise tolerance also had lower pH values. In contrast, there were no significant differences in forearm blood flow between the patients and controls and no relationship between forearm blood and either clinical variables or the metabolic findings. These results indicate that skeletal muscle metabolic abnormalities are present in many patients with CHF and that they are not primarily due to either muscle atrophy or impaired blood flow. These changes may explain in part the marked heterogeneity of symptom status and exercise capacity of patients with similar degrees of cardiac dysfunction. PMID- 3664990 TI - Hemodynamics of the Mueller maneuver in man: right and left heart micromanometry and Doppler echocardiography. AB - Ten subjects with normal hemodynamics were studied during elective cardiac catheterization with right and left heart multisensor micromanometry to assess hemodynamic responses to the Mueller maneuver. Simultaneous right and left circulatory hemodynamics and left ventricular, pulmonary arterial, and aortic pressures were recorded, in addition to pulmonary arterial and aortic flow velocities. Steady-state cardiac outputs were determined by thermal dilution. Aortic systolic and mean pressures were not significantly changed during the Mueller maneuver, in contrast to a lower diastolic (p = .019) and higher pulse pressure (p = .016). Mean right atrial pressure (+/- SE) decreased from 7 +/- 1 to -17 +/- 4 mm Hg (p = .0002) and the right atrial "x" descent was markedly accentuated. Left ventricular end-diastolic pressure decreased from 12 +/- 4 to 3 +/- 13 mm Hg (p = .0025). Systemic vascular resistance and left ventricular peak positive dP/dt were increased during the Mueller maneuver (p less than .02), cardiac output and stroke volume were reduced (p less than .05), and there was no significant change in heart rate. Right and left peak flow velocities showed a trend toward a bilateral decrease (right, p = .054; left, p greater than .1), and times to peak flow velocity were increased in the pulmonary artery (p = .007) and reduced in the aortic root (p = .03). Normal subjects were studied separately by pulsed Doppler echocardiography. During the sustained Mueller maneuver, the internal jugular and right ventricular dimensions decreased, and superior vena cava Doppler flow was reduced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664991 TI - Left ventricular mechanics in the normal newborn. AB - The transition from fetal to neonatal circulatory status is accompanied by marked alteration in relative right and left ventricular systolic and diastolic pressure. These alterations would be expected to influence both global and regional performance of the left ventricle. To address this issue, sequential two dimensional echocardiographic studies were performed in normal newborns during the first days of life. Global and regional left ventricular wall motion were quantified by computer digitization with the use of an automated edge detection algorithm and a floating-center-of-mass model. Comparison was made with a control group of normal infants and young children and the sequential change over the first 5 days of life was assessed. Newborns were found to have a circular left ventricular configuration at end-diastole beginning on day 1. At end-systole, however, there was significant left ventricular distortion due to septal flattening, which persisted until day 3 and resolved entirely by day 5 of life. Regional wall motion analysis demonstrated a corresponding augmentation of septal and contralateral left ventricular free wall systolic movement during the first days of life, with a normal pattern attained by day 4. Due to the nonhomogeneity of the left ventricular wall motion in the first few days of life, standard single-dimension shortening fraction provided an unreliable measure of global left ventricular performance before day 4. Thus, systolic right ventricular hypertension at a level sufficient to distort the left ventricular configuration is present until day 4 or 5 of life, resulting in altered left ventricular regional wall motion. As a result, usual M mode echocardiographic assessment of left ventricular function is unreliable in this age group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664992 TI - Isolated atrial septal defect with pulmonary vascular obstructive disease--long term follow-up and prediction of outcome after surgical correction. AB - We examined the cases of 702 patients found to have isolated atrial septal defect of the secundum or sinus venosus type at catheterization from 1953 to 1978. Forty patients (6%), 34 women and six men, had pulmonary vascular obstructive disease, with a total pulmonary resistance greater than 7 U/m2; of these patients 26 (mean age 47 years) underwent surgical closure and 14 (mean age 44 years) received medical treatment. All patients were followed for at least 4 years, with a median follow-up of 12 years. At the most recent follow-up, 17 of the 40 patients were dead. Of the 22 surgically treated patients with total pulmonary resistance less than 15 U/m2, 19 were alive with significant regression of symptoms. All four surgically treated patients with total pulmonary resistance greater than or equal to 15 U/m2 were dead. Of the five medically treated patients with total pulmonary resistance less than 15 U/m2, four had died, and one was alive with significant progression of symptoms. Of the nine medically treated patients with total pulmonary resistance greater than or equal to 15 U/m2, six had died and the three survivors had progression of symptoms. In the surgically treated group, the following variables correlated with survival: total pulmonary resistance (p less than .00001), pulmonary arteriolar resistance (p less than .00001), pulmonary-to systemic resistance ratio (p = .004), systemic arterial oxygen saturation (p = .005), and pulmonary arterial oxygen saturation (p = .007). IN CONCLUSION: (1) Atrial septal defect with high total pulmonary resistance is uncommon and predominates in adult female patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664993 TI - Determinants of induced sustained arrhythmias in survivors of out-of-hospital ventricular fibrillation. AB - We prospectively studied 196 consecutive survivors of out-of-hospital ventricular fibrillation (VF) not associated with acute myocardial infarction and 46 consecutive, control patients without prior ventricular arrhythmias. Programmed stimulation included two extrastimuli (S3 protocol) in all patients and three extrastimuli (S4 protocol) in the last 140 study patients and in all control patients. Sustained ventricular tachycardia (VT) or VF was not induced in any control patient. In study patients, logistic regression identified two independent predictors of induced, sustained VT for both S3 and S4 protocols: prior spontaneous, sustained VT (37 patients; p less than or equal to .001) and prior myocardial infarction (113 patients; p = .005). With the S3 protocol, sustained VT was induced in 54% of patients with both prior myocardial infarction and prior sustained VT vs 4% without either; with the S4 protocol, sustained VT was induced in 91% vs 13%, respectively. Eighty-three percent of induced VT episodes had a cycle length less than 300 msec, and all required termination by cardioversion or pacing. VF was induced only in survivors of out-of-hospital VF without prior, spontaneous, sustained VT (S3 protocol, 9%; S4 protocol, 24%) but not in study patients with prior sustained VT (S3, p = .10; S4, p = .05) or control patients (S3, p = .06; S4, p = .01). The mean coupling intervals of extrastimuli that induced VF were not significantly different from the intervals that induced sustained VT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664994 TI - Chemically determined mineral content of explanted porcine aortic valve bioprostheses: correlation with radiographic assessment of calcification and clinical data. AB - Bioprosthetic valve calcification is usually assessed pathologically by gross inspection, radiographic studies, and histologic examination. Quantitation of mineral content by chemical assay has not been reported for failed clinical valves removed from adults. In this study, calcium determination by atomic absorption spectroscopy was done on 52 removed porcine valves after routine pathologic examination, including specimen radiography done by a standard technique. Specimens included 31 valves with calcific primary tissue failure, two calcified (but not overtly dysfunctional) valves removed simultaneously with failed valves, 14 nondeteriorated valves obtained at reoperation or autopsy after long-term implantation, and five valves removed within 1 month after insertion. Chemically determined mineral content varied widely among patients and duration of function. Valves with calcific failure had 113 +/- 68 micrograms/mg calcium overall (mean +/- SD) after 36 to 156 months (mean 87) of function. Almost all dysfunctional porcine valves with radiographically demonstrated calcific deposits had greater than 34 and 67 micrograms/mg calcium for mitral and aortic valves, respectively. Nondeteriorated valves (implanted 8 to 145 months, mean 57) had 5 +/- 6 micrograms/mg calcium. Failed aortic valves had more calcium than failed mitral valves and valves with calcific stenosis more than valves with regurgitation caused by calcification with tearing. Correlation of semiquantitative radiographic grading with chemically determined valve mineral was good, indicating that radiographic assessment of calcification may be used reliably for clinical comparisons between valves. PMID- 3664995 TI - Summation and inhibition by ultrarapid train pacing in the human ventricle. AB - Trains of ultrarapid stimuli that begin late in the refractory period have been reported both to produce early single captures to terminate tachyarrhythmias and to inhibit the response to subsequent threshold stimuli. To determine which characteristics of trains facilitate capture and which enhance inhibition, we compared the right ventricular strength interval relationship for single extrastimuli (S2) with that for 100 Hz trains with a duration of 100 msec in 29 patients. Pulse frequency was varied in 12 patients (50, 100, and 200 Hz) and train duration (50, 100, and 150 msec) was varied in 11 patients; the effect of procainamide (10.1 +/- 2.3 micrograms/ml) was assessed in 10 patients. Relative to S2, 100 Hz trains with a duration of 100 msec prolonged the effective refractory period (ERP) at low current strength (inhibition), but shortened the ERP at high-current strength (summation): at 0.5 mA, the train ERP was 47 +/- 6 (SEM) msec longer than the S2 ERP (p less than .001); at 16 mA it was 12 +/- 1 msec shorter (p less than .001). Trains prolonged the functional refractory period (FRP) slightly at low currents (13 +/- 3 msec, p = .001 at .05 mA), but did not shorten FRP significantly at high currents (2 +/- 2 msec, p = NS at 16 mA) because of increased stimulus-response latency. Inhibition increased with increasing pulse frequency (p less than .001), increasing train duration (p less than .001), and procainamide (p less than .01). Summation increased with increasing pulse frequency (p less than .001), but not increasing train duration or procainamide, suggesting that inhibition and summation depend on different electrophysiologic mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3664996 TI - Inconsistency of the slope and the volume intercept of the end-systolic pressure volume relationship as individual indexes of inotropic state in conscious dogs: presentation of an index combining both variables. AB - We tested the ability of the slope (Emax) and the volume intercept (Vo) of the end-systolic pressure-volume relationship (ESPVR) to indicate contractility changes in conscious dogs instrumented with sonomicrometers measuring left ventricular diameter in three orthogonal axes and a left ventricular pressure microtransducer. ESPVRs were generated by inferior vena caval occlusion under control conditions (C1 and C2) and during enhanced (I+) and depressed (I-) inotropic states achieved by infusion of dobutamine and injection of propranolol, respectively. No significant difference between the first control (C1) and I+ or between the second control (C2) and I- were found for either Emax (C1, 5.31 +/- 1.68 mm Hg/ml, mean +/- SD; I+, 5.37 +/- 1.44; C2, 5.20 +/- 1.62; I-, 4.18 +/- 1.32) or Vo (C1, 10.3 +/- 9.6 ml; I+, 7.3 +/- 9.1; C2, 9.9 +/- 9.0; I-, 12.7 +/- 12.5), despite significant changes in other indexes of contractility. Comparison of changes in Emax in individual animals in response to I+ and I- revealed that 63% were nonsignificant, 28% were significant and expected, and 9% were significant and paradoxical. Within defined volume limits and irrespective of individual changes in Emax and Vo, in all animals I+ shifted the ESPVR above and to the left of C1 and I- shifted the ESPVR below and to the right of C2. We thus integrated the changes in Emax and Vo by measuring the area beneath each ESPVR between defined limits of end-systolic volume. The values for area were: C1, 612 +/- 150 mm Hg.ml; I+, 745 +/- 191 (p less than .001); C2, 520 +/- 198; I-, 420 +/ 139 (p less than .001). We conclude that (1) neither Emax nor Vo are individually reliable indexes of changed contractility, and (2) the area beneath the ESPVR between defined end-systolic volume limits is a consistent indicator of variations in inotropic state. PMID- 3664997 TI - Effect of graded coronary flow reduction on ionic, electrical, and mechanical indexes of ischemia in the pig. AB - This study was performed to determine the relative sensitivities of ionic, electrical, and mechanical indexes of myocardial ischemia. We used ion-selective and bipolar plunge electrodes, epicardial unipolar electrodes, a suction electrode, and ultrasonic crystals to determine the changes in intramyocardial extracellular potassium ([K+]e) and extracellular pH (pHe), local activation, epicardial TQ-ST segment, monophasic action potential duration (MAPD), and regional contractility during graded coronary flow reduction in open-chest pigs. A carotid-to-coronary shunt was created to perfuse the left anterior descending coronary artery via a roller pump. The shunted coronary flow was reduced in a stepwise fashion at 5-min intervals. In 25 pigs, the approximate myocardial blood flow associated with the initial changes in each variable was as follows: midmyocardial [K+]e, pHe, and TQ-ST segment, 0.7 to 0.8 ml/min/g; subepicardial [K+]e and TQ-ST segment, 0.6 to 0.7 ml/min/g; segmental shortening, 0.5 to 0.6 ml/min/g; local activation and epicardial TQ-ST segment, 0.3 to 0.4 ml/min/g; epicardial MAPD, 0.15 to 0.2 ml/min/g. Our results indicate that changes in [K+]e, pHe, and TQ-ST segment provide the most sensitive means of detecting myocardial ischemia and of determining the effect of interventions capable of influencing the ischemic process. PMID- 3664998 TI - Reduction of reperfusion injury in the canine preparation by intracoronary adenosine: importance of the endothelium and the no-reflow phenomenon. AB - We hypothesized that the endogenous coronary vasodilator adenosine may reduce infarct size by progressively increasing reflow in a preparation of coronary occlusion-reperfusion. After 90 min of proximal left anterior descending artery occlusion, 20 dogs were randomized to blood reperfusion with (n = 10) or without (n = 10) adenosine into the proximal left anterior descending vessel at 3.75 mg/min for 60 min after reperfusion. Regional myocardial blood flow was determined serially with microspheres and regional ventricular function was assessed by a computerized radial shortening method. At 24 hr, the area at risk was defined in vivo with monastral blue dye and area of necrosis was determined after incubation of left ventricular slices in triphenyltetrazolium chloride. Hemodynamic variables were similar in the two groups during the experimental protocol. Infarct size was significantly reduced in treated animals, both when expressed as a percentage of the area at risk (9.9 +/- 2.8% vs 40.9 +/- 6.6%, p less than .001) and as a percentage of the left ventricle (4.6 +/- 1.3% vs 18.0 +/- 3.4%, p = .002). This was associated with significant improvement in radial shortening in the ischemic zone 24 hr after reperfusion (10.1 +/- 2.5 vs -2.8 +/- 2.2%, p less than .01). Regional myocardial blood flow was significantly increased in endocardial and epicardial regions from the lateral ischemic zone 1 hr after reperfusion in adenosine-treated animals. Light microscopy demonstrated decreased neutrophil infiltration in the ischemic zone and electron microscopy showed relative preservation of endothelial structure in the subendocardium with reduced neutrophil and red cell stagnation of capillaries in the treated group. These findings suggest that intracoronary administration of adenosine after reperfusion significantly reduces infarct size and improves regional ventricular function in the ischemic zone in the canine preparation. PMID- 3664999 TI - Regional effects of verapamil on recovery of excitability and conduction time in experimental ischemia. AB - This study was designed to test the hypothesis that verapamil has an effect on ischemia-initiated arrhythmias related to its regional influences on recovery of excitability and conduction time. Using a coronary perfused preparation of cat left ventricle that allows simultaneous electrophysiologic monitoring of both endocardium and epicardium, we studied the effect of verapamil on ischemia induced changes in transmembrane action potentials, conduction properties, and refractory periods of endocardial and epicardial muscle cells. Oxygenated Tyrode's solution was perfused through the left anterior descending coronary artery, while the preparation was superfused with Tyrode's solution gassed with 95% N2 and 5% CO2. "Ischemia" was produced by stopping coronary perfusion. During 30 min of ischemia, resting potential, action potential amplitude (APA), and action potential duration (APD) were reduced, and conduction time was prolonged in both endocardial and epicardial cells, but the changes were greater in the epicardial cells. Endocardial refractory periods shortened in parallel with APD shortening throughout 30 min of ischemia, whereas epicardial refractory periods shortened for the first 10 min and then increased due to development of longer postrepolarization refractoriness. As a result, there were significant differences in refractory periods between endocardial and epicardial cells at 10 and 30 min of ischemia, and rapid ventricular activity could be induced at these times. Exposure to verapamil (1 mg/liter) before cessation of coronary perfusion significantly limited the reduction of APA and the prolongation of conduction time during the first 10 min of ischemia in epicardial cells, but did not influence endocardial cells. During the remaining 20 min of ischemia, verapamil enhanced the reduction of APD of both epicardial and endocardial cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665000 TI - Circus movement in the canine atrium around the tricuspid ring during experimental atrial flutter and during reentry in vitro. AB - A Y-shaped lesion in the right atrium allows induction of atrial flutter in dogs. We recorded the activation sequence during this tachycardia from 96 endocardial bipolar electrodes using intracavitary electrode arrays during 12 separate episodes in three isolated perfused hearts. In each case a reentrant impulse circulated around the tricuspid valve orifice in either a clockwise or counter clockwise direction. Cutting the pathway terminated the rhythm and prevented its reinduction. There was no discrete segment of markedly slow conduction in the reentrant circuit. The tachycardia cycle length was decreased by methacholine and increased by lidocaine. Reentry was also induced in atrial tissue around the tricuspid orifice when this structure was isolated and superfused in vitro. Tachycardia cycle lengths varied from 205 to 399 msec, depending on the circumference of the ring and temperature. Induction of tachycardia by premature stimulation depended on differences in the duration of the effective refractory period among parts of the ring. Conduction velocity was relatively uniform and was slower during tachycardias than during pacing at long cycle lengths. Analysis of the response to premature stimuli that reset the tachycardia provided evidence for incomplete recovery of excitability between depolarizations during the tachycardia. Fast-response action potentials were recorded throughout the pathway and up to six to eight cell layers deep. Histologic studies showed the supravalvular lamina, a circumferential band of fibers several cell layers below the endocardial surface, to be continuous around the tricuspid orifice. Propagation through this layer best explains the conduction velocities observed in the intact heart during flutter in this preparation. PMID- 3665001 TI - Improved defibrillation thresholds with large contoured epicardial electrodes and biphasic waveforms. AB - A reduction in the shock strength required for defibrillation would allow use of a smaller automatic implantable cardioverter-defibrillator and would reduce the possibility of myocardial damage by the shock. Most internal defibrillation electrodes require 5 to 25 J for successful defibrillation in human beings and in dogs. In an attempt to lower the shock strength needed for defibrillation, we designed two large titanium defibrillation patch electrodes that were contoured to fit over the right and left ventricles of the dog heart, covering areas of approximately 33 and 39 cm2, respectively. In six anesthetized open-chest dogs, the electrodes were secured directly to the epicardium and ventricular fibrillation was induced by 60 Hz alternating current. Truncated exponential monophasic and biphasic shocks were given 10 sec later and defibrillation thresholds (DFTs) were determined. The DFT was 159 +/- 48 V, 3.2 +/- 1.9 J (mean +/- SD) for 10 msec monophasic shocks and 106 +/- 22 V, 1.3 +/- 0.4 J, for biphasic shocks with both phase durations equal to 5 msec (5-5 msec). The experiment was repeated in another six dogs in which the electrodes were secured to the pericardium. The mean DFT was not significantly higher than that for the electrodes on the epicardium: 165 +/- 27 V, 3.1 +/- 1.2 J for 10 msec monophasic shocks and 116 +/- 19 V, 1.6 +/- 0.5 J for 5-5 msec biphasic shocks. Low DFTs were also obtained with biphasic shocks in which the duration of the first phase was longer than that of the second.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665002 TI - Transseptal pressure gradient and diastolic ventricular septal motion in patients with mitral stenosis. AB - Previous studies from our laboratory have shown that the position of the ventricular septum relative to the two ventricles at end-diastole is determined by the instantaneous transseptal pressure gradient (TSG) defined as left ventricular minus simultaneous right ventricular pressure. Since patients with mitral stenosis often have exaggerated leftward (paradoxic) motion of the ventricular septum during early diastole, we studied seven patients with mitral stenosis undergoing cardiac catheterization to determine if position (and therefore motion) of the ventricular septum was determined by TSG throughout diastole. M Mode echocardiograms derived from a two-dimensional parasternal short axis view were recorded with simultaneous micromanometer measurements of left ventricular and right ventricular pressures. Six of seven patients demonstrated abnormal early diastolic leftward motion of the ventricular septum in at least one cardiac cycle. TSG measured at intervals throughout diastole ranged from -2.5 to +20 mm Hg, with abnormal TSG observed in most of the 40 cardiac cycles selected for analysis. The intracardiac position of the ventricular septum, defined as the distance from the right ventricular epicardium (RVEpi) to the left surface of the ventricular septum normalized for total cardiac dimension (RVEpi VS), was plotted against left ventricular pressure, right ventricular pressure, and TSG. Linear regression of pooled data from all patients (164 observations) demonstrated a highly significant correlation between the instantaneous TSG and the relative intracardiac position of the ventricular septum (RVEpi-VS = 1.52 TSG + 42.7; r = .79, p less than .0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665003 TI - Quantitative analysis of infarct size, contraction band necrosis, and coagulation necrosis in human autopsied hearts with acute myocardial infarction after treatment with selective intracoronary thrombolysis. AB - To assess the importance of contraction band necrosis (CBN) in patients with acute myocardial infarction (AMI) treated with selective intracoronary thrombolysis, CBN, coagulation necrosis, and infarct size (expressed as CBN + coagulation necrosis) were analyzed quantitatively in 16 autopsied hearts. Intracoronary thrombolysis was performed from 2 to 6 hr after the onset of AMI, and the time from the onset of AMI to death was 7 to 168 hr. Cineangiography revealed no evidence of good collateral circulation in any of the patients. The 16 patients were classified into three groups: six patients with successful thrombolysis (100% to 99% stenosis, group I), five patients with unsuccessful thrombolysis (100% to 100%, group II), and five patients with 99% stenosis before thrombolysis (group III). Among the three groups, there were no significant differences in the time from the onset of AMI to thrombolysis, the time from the onset of AMI to death, the cause of death, or the degree of collateral circulation. The percentage of the risk area involved by the infarct in group I (82 +/- 6%) was similar to that in group II (80 +/- 11%). Infarct size was not reduced in group I because collateral circulation was not good and because the degree of recanalization after thrombolysis was 1%. However, the percentage of the infarct area with CBN was significantly higher in group I (20 +/- 9%) then in group II (3 +/- 3%). This finding shows that diffuse CBN occurred after reperfusion in patients with AMI treated with thrombolysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665004 TI - Long-term prognosis of patients with variant angina. AB - The long-term prognosis of variant angina and the factors influencing it were assessed in 217 consecutive patients hospitalized in our coronary care unit and followed for a mean of 65 months (range 2 to 123). Cardiac death occurred in 30 patients and an additional 54 experienced a nonfatal myocardial infarction. Survival at 1 and 5 years was 95% and 89%, respectively; survival without infarction was 83% and 69%. Coronary disease and the degree of disease activity were strong predictors of survival by Cox analysis. Survival at 1 year was 99%, and that at 5 years was 95% and 94%, respectively, for patients with one-vessel disease (n = 81) and for those without stenoses of 70% or greater (n = 87). Survival at 1 and 5 years was only 87% and 77% for those with multivessel disease (n = 40). The Cox analysis selected left ventricular function, initial treatment, extent score, duration of angina at rest, and disease activity as multivariate predictors of survival without infarction. Coronary disease was a strong predictor (p less than .0001) of survival without infarction by univariate analysis. Treatment with nifedipine, diltiazem, or verapamil improved survival without infarction compared with other medical treatment (p = .002). Myocardial infarction occurred most commonly soon after diagnosis in patients with a short history of angina at rest. Late coronary events were almost never preceded by resting angina. PMID- 3665005 TI - Cardiovascular surgery 1986. Council on Cardiovascular Surgery, American Heart Association. Scientific sessions. Dallas, TX, November 17-20, 1986. PMID- 3665006 TI - Results of surgery for hypertrophic obstructive cardiomyopathy. AB - Between 1971 and March 1986, 61 patients underwent surgery for hypertrophic obstructive cardiomyopathy. Age at operation varied from 3.5 to 76 years (mean 38). The standard approach was a generous transaortic myectomy. One-quarter of the patients underwent concomitant repair of associated lesions. There was one operative and two late deaths, for an actuarial 5 years survival 93% (+/- 8%). Average follow-up is 3 years per patient. Sixty-four percent of these patients are asymptomatic and another 30% were in New York Heart Association class II. Persistent symptoms were usually related to arrhythmias. Early atrioventricular block did not occur, but two patients were paced for complex arrhythmias 3 and 4 years after surgery. Hemodynamic studies (n = 22), two-dimensional echocardiographic (n = 47), and Doppler assessments (n = 23) demonstrated a left ventricular outflow tract pressure gradient of 70 and 14 mm Hg before and after surgery, respectively, left ventricular diastolic pressure of 18 and 14 mm Hg, percent of patients with mitral regurgitation of 70% and 30%, percent of patients with systolic anterior motion of 100% and 35%, and percent of patients with aortic insufficiency of 9% and 49%. Eight-six percent of the patients catheterized had no resting obstruction. Subaortic myectomy produces symptomatic improvement by reducing the left ventricular outflow tract pressure gradient, mitral regurgitation, and left ventricular end-diastolic pressure, and probably improves longevity. PMID- 3665007 TI - Results of open heart surgery in patients with recent cardiogenic embolic stroke and central nervous system dysfunction. AB - Patients undergoing open heart surgery who have had recent cardiogenic embolic stroke or have central nervous system dysfunction pose a difficult management problem. There is always the risk that cardiopulmonary bypass and heparinization may exacerbate the neurologic injury. There is no clear data indicating what is a safe interval of time from the onset of neurologic symptoms to the time of surgery. Since 1982 we have operated on 15 patients with recent (2 to 28 days, mean 12.7 +/- 7.9 days) neurologic injury. Indications for surgery included recurrent embolization, sepsis, and hemodynamic deterioration. Three patients were comatose with no focal neurologic signs at the time of surgery, and 12 patients had focal neurologic deficits. All patients had preoperative computed tomographic scans. Embolic cerebral infarctions were documented in 12 patients, one patient had evidence of intracranial hemorrhage, and one patient had a subdural hematoma. Fourteen patients had native or prosthetic valvular endocarditis and one patient had a left atrial myxoma. All patients underwent corrective cardiac surgery. One patient died in the postoperative period from multisystem failure; all other patients have been followed since discharge (6 months to 4 years). All surviving patients demonstrated improvement in their neurologic symptoms and eight patients had complete neurologic recovery. The results of this study indicate that open heart surgery can be safely performed in patients with recent neurologic injury. PMID- 3665008 TI - Immediate and early postoperative evaluation of results of cardiac surgery by transesophageal two-dimensional Doppler echocardiography. AB - In cardiac surgery significant residual lesions increase postoperative morbidity and mortality. Although intraoperative epicardial real-time two-dimensional Doppler echocardiography (two-dimensional Doppler) is an accurate and efficient technique for assessing the presence and severity of a residual lesion, it requires placement of a transducer in the operating field and consequent obstruction of the operative procedure. Transesophageal two-dimensional Doppler echocardiography (transesophageal two-dimensional Doppler), which can be applied intraoperatively and postoperatively without such problems, was performed in 35 patients during cardiac surgery (12 patients) and/or at an intensive care unit within 6 hr after cardiac surgery (30 patients). In those with constrictive pericarditis, an extensive pericardiectomy was performed with effective monitoring by intraoperative transesophageal two-dimensional Doppler. Abnormal posterior wall motion was observed in the case of left ventricular rupture (type III) after mitral valve replacement 3 hr before clinical manifestation. After prosthetic valve replacement (18 St. Jude Medical valves, one Carpentier-Edwards valve, one Bjork-Shiley valve), no perivalvular leakage was detected, but minor physiologic transvalvular leakage was noticed in 11 patients with St. Jude Medical valves. In two patients with congenital heart disease, a small residual shunt was detected. In a patient in which a composite valve graft with direct coronary artery reattachment (Bentall's operation) was performed, reattachment was confirmed to be satisfactory. In conclusion, intraoperative and early postoperative monitoring of cardiac function by transesophageal two-dimensional Doppler echocardiography can improve the results of cardiovascular surgery by providing accurate information on cardiovascular structure and blood flow dynamics. PMID- 3665009 TI - The effect of cardioplegic oxygenation on the correlation between the linearized Frank-Starling relationship and myocardial energetics in the ejecting postischemic heart. AB - To ascertain whether oxygenated cardioplegia is beneficial during surgically induced global ischemia, 27 canine hearts underwent sonomicrometric determination of cardiac mechanics and energetics during volume loading on right heart bypass before and after 2 hr of potassium cardioplegic arrest with crystalloid, oxygenated crystalloid, or blood vehicles. The slope of the linear stroke work vs end-diastolic volume relationship, an index of contractility, was preserved by each vehicle. Similarly, oxygen utilization to perform external mechanical work during reperfusion was unaffected in all groups. However, there were significant 119% and 122% increases in basal oxygen utilization after both unoxygenated and oxygenated crystalloid cardioplegia (p less than .05) that were prevented by the blood-based vehicle. These data suggest that the salutary effects of blood cardioplegia on postischemic myocardial energetics may not be solely mediated by its oxygen-carrying capacity. PMID- 3665010 TI - Ventricular function after atrial cardioplegia. AB - Continuous retrograde coronary sinus cardioplegia (CSCP) has previously been carefully evaluated experimentally and shown to be efficacious during ischemia, even in the presence of coronary lesions and in the hypertrophied state. A new technique of retrograde cardioplegia delivery through the right atrium, using right ventricular distension and pressures of 60 mm Hg, has recently been described with excellent clinical results. This study was designed to specifically examine right ventricular function after atrial cardioplegia and acute passive right ventricular distension. CSCP (n = 10) was compared with cardioplegia delivered through the right atrium both continuously (n = 10) and intermittently (n = 8). When ventricular function was examined with the use of the load-independent relationship of stroke work vs end-diastolic length, there was a profound deterioration of right ventricular function in both atrial cardioplegia groups (44% and 37% of control values, respectively) after 1 hr of reperfusion. In contrast, biventricular function was fully preserved in the CSCP group 1 hr after reperfusion. Left ventricular function measured at the end of reperfusion was preserved in all three groups. Right ventricular ATP levels were slightly but significantly depressed in all groups and in the atrial cardioplegia groups, this metabolic change was also seen in the left ventricle. These metabolic and hemodynamic data may reflect the inability of atrial cardioplegia to cool the myocardium below 16 degrees C. Postoperative right ventricular dysfunction may be more common than has been previously thought when atrial cardioplegia is used, particularly in the absence of topical cooling. PMID- 3665011 TI - Ultrastructural assessment of the infant myocardium receiving crystalloid cardioplegia. AB - The effectiveness of cold crystalloid potassium cardioplegia was evaluated in 26 infants (age 27 days to 17 months, 7.5 +/- 5.2 months, mean +/- SD) who underwent intracardiac repair for various cardiac lesions. A myocardial biopsy sample was obtained before aortic cross-clamping (AXC) and 20 min after release of AXC (AXC time 22 to 161 min, mean 68 +/- 37 min), and semiquantitative assessment of the mitochondrial structure was made by scoring. The post-AXC score was significantly higher than the pre-AXC score (1.1 +/- 0.6 vs 0.4 +/- 0.4, p less than .001) for the whole group. Patients receiving preoperative catecholamine support had higher pre- and post-AXC scores than those who did not (pre-AXC score 0.7 +/- 0.4 vs 0.2 +/- 0.3, p less than .01; post-AXC score 1.4 +/- 0.5 vs 1.0 +/- 0.5, p less than .05). Infants less than 3 months old (n = 7) and those 3 to 12 months old (n = 11) had higher pre AXC scores than infants over 12 months old (n = 8). With respect to post-AXC score, only those less than 3 months old had significantly higher values than the other infants. These results indicate that the myocardial injury was not fully prevented by crystalloid potassium cardioplegia in infants, and that infants with preoperative heart failure and less than 3 months old appear to have increased myocardial susceptibility to ischemic injury under cardioplegia. PMID- 3665012 TI - Why are newborn hearts vulnerable to global ischemia? The lactate hypothesis. AB - Whether newborn hearts are more vulnerable to ischemic injury than adult hearts remains controversial. Our recent canine studies showed that newborn hearts had a shorter time interval between the beginning of global ischemia and the onset of contracture than the adult hearts. To reconcile this finding with the known better tolerance of newborn hearts to hypoxic perfusion, we hypothesized that the greater anaerobic glycolytic capacity of immature myocardium leads to greater accumulation of lactate during total ischemia, resulting in tissue acidosis and earlier irreversible damage. In this study, newborn and adult rat hearts were excised and incubated in normothermia for 0, 5, 10, and 15 min. The newborn myocardial lactate contents were significantly higher (p less than .05) than those in the adult hearts. In another series of rats, 20 meq/liter of KCl was injected to produce cardioplegia before the excision of the hearts. The differences in lactate levels were even greater. The data are consistent with the lactate hypothesis, and suggest that in clinical neonatal cardiac preservation, providing sufficient washout may be beneficial. PMID- 3665013 TI - Resistance of neonatal myocardium to injury during normothermic and hypothermic ischemic arrest and reperfusion. AB - We tested the hypothesis that neonatal myocardium is more sensitive to injury during cardiac surgery than adult myocardium. Groups of neonatal (4 to 5 days old) and adult (3 months old) isolated, blood-perfused rabbit hearts were subjected to periods of ischemic arrest and reperfusion without cardioplegic protection as follows. Protocol I consisted of 30 min of normothermic (37 degrees C) ischemic arrest and reperfusion, protocol II of 60 min of hypothermic (15 degrees C) ischemic arrest and warm (37 degrees C) reperfusion, and protocol III of 120 min of hypothermic ischemic arrest and cool (21 degrees to 25 degrees C) reperfusion. After protocol I, the neonatal hearts recovered 23% greater contractile function than the adult hearts; after protocols II and III the neonatal hearts recovered 51% to 55% more function than the adults. These results suggest that neonatal hearts tolerate the conditions of cardiac surgery better than adult hearts. PMID- 3665014 TI - Relative vulnerability of neonatal and adult hearts to ischemic injury. AB - To clarify the controversy over whether the neonatal heart is more or less susceptible to global ischemia than the adult heart, the time interval between the onset of ischemia and the beginning of contracture (TIC) was compared in neonatal (n = 6, 3 to 5 days old) and adult (n = 6, 4 to 5 months old) pig hearts. A comparison of the myocardial concentrations (mumol/g wet weight) of ATP, glycogen, lactate, and glucose-6-phosphate (G-6-P) was also done. The anesthetized animals underwent a sternotomy, and control right ventricular myocardial biopsy samples were taken. The heart of each was rapidly excised and placed in a 37 degrees C substrate-free Krebs-Henseleit bath. A compliant balloon was placed in the left ventricle to record pressure changes. Time to onset and peak TIC were recorded and additional proximal right ventricular biopsy samples were taken. Data were recorded as mean +/- SEM. Results demonstrated that neonatal hearts had a significantly shorter (p less than .05) TIC (29.5 +/- 1.7 min) than adult hearts (43.0 +/- 2.9 min) and exhibited more rapid lactate accumulation (2.5 +/- 0.5 to 22.1 +/- 3.0, p less than .001) and an increase in G 6-P (0.07 +/- 0.03 to 0.34 +/- 0.07, p less than .01) with a nonsignificant decline in myocardial glycogen (23.3 +/- 12.1 to 17.4 +/- 4.0, p greater than .05). Our findings indicate that neonatal hearts are more sensitive than adult hearts to global ischemia, which has potential implications for myocardial protection in pediatric cardiac surgery. PMID- 3665015 TI - The mechanism of myocardial reperfusion injury in neonates. AB - Oxygen free radicals and phospholipid degradation have been implicated in the pathogenesis of ischemia and reperfusion injury. The present study examines the involvement of such mechanisms in myocardial reperfusion injury in neonatal hearts. The isolated neonatal pig hearts from two different age groups, 0 to 2 days old (newborn) and 7 to 9 days old (week-old), were subjected to 60 min of normothermic global ischemia followed by 60 min of reperfusion. Although myocardial ischemia reduced superoxide dismutase, catalase, and glutathione peroxidase activities in both age groups, superoxide dismutase and catalase activities remained significantly lower in the newborn pig heart during ischemia and reperfusion. Oxidized glutathione release from the neonatal pig hearts was at minimum levels before ischemia, but it increased 10-fold at the onset of reperfusion and was significantly higher in the newborn heart. This indicates that generation of oxygen free radicals was enhanced in the newborn compared with that in the week-old heart. The increase in phospholipase A2 activity and decrease in acyl CoA synthetase and lysophosphatidylcholine acyl transferase activities during ischemia and reperfusion were associated with comparable loss of membrane phospholipids and accumulation of lysophosphatidylcholine and free fatty acids in both age groups, except that oleic acid content was significantly higher in the newborn heart during reperfusion. Myocardial damage appears to be potentiated in the newborn heart during reperfusion, as evidenced by higher release of creatine kinase and a lower content of high-energy phosphates. These results indicate that oxygen free radicals may play a crucial role in the occurrence of reperfusion injury in immature hearts. PMID- 3665016 TI - A comparison of methods for limiting myocardial infarct expansion during acute reperfusion--primary role of unloading. AB - Current use of angioplasty, thrombolysis, and surgical techniques for prompt reperfusion of an acute myocardial infarction raises questions concerning the optimum reperfusion technique for maximum myocardial salvage. Alterations in the conditions of reperfusion and/or the composition of the initial reperfusate can exert a significant effect on the extent of myocardial salvage. In an effort to define an optimum reperfusion technique, we used 40 dogs in a series of experiments in which the left anterior descending coronary artery (LAD) was snared for 2 hr followed by reperfusion by one of five methods for 4 hr. In addition, in a control group(group I, n = 6) the LAD was occluded for 6 hr without any reperfusion. In group 2 (n = 12), simulating medical reperfusion, reperfusion was achieved by simply releasing the snare for 4 hr. Group 3 dogs (n = 6) were placed on pulsatile left atrial-femoral bypass throughout 4 hr of reperfusion. Group 4 dogs (n = 9) were placed on percutaneous, synchronized pulsatile cardiopulmonary bypass during reperfusion. The procedure in group 5 (n = 7) dogs simulated coronary artery bypass grafting with cardiopulmonary bypass and cold blood, low-Ca++ cardioplegia during reperfusion. Group 6 (n = 6) was treated similarly except that during reperfusion amino acid-enriched cardioplegia was administered by warm induction techniques. At the end of 4 hr of reperfusion, the left ventricular area of infarction was determined by triphenyltetrazolium chloride staining and expressed as a percentage of the left ventricular area at risk for infarction (area of infarction [AI]/area at risk [AR]).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665017 TI - The rapid evolution of a myocardial infarction in an end-artery coronary preparation. AB - The potential for salvaging infarcting myocardium depends on the time course of the infarction process. To determine the rate of infarct evolution in an end artery coronary preparation similar to the coronary arterial system of the human heart, each of 84 swine underwent a reversible occlusion of the left anterior descending coronary artery for varying lengths of time, after which flow was reestablished into the occluded region for either 2 or 48 hr. Infarct size was assessed by nitro blue tetrazolium (NBT) staining and confirmed by histologic examination in the 48 hr animals. The region at risk of ischemic injury was determined by injection of monastral blue dye. Infarction progressed rapidly, with a mean of 1.9 +/- 1.5% of the risk region infarcting after 15 min of occlusion, 20.3 +/- 5.7% at 30 min, 43.3 +/- 4.8% at 45 min, 59.9 +/- 2.4% at 60 min, 70.6 +/- 1.7% at 90 min, 84 +/- 2.0% at 180 min, and 88.6 +/- 2.0% after 48 hr. Although there was good correlation in infarct sizing between NBT and histologic techniques at 2 and 48 hr of reperfusion, NBT underestimated infarct size at 15 and 30 min. These data suggest that in the setting of an end-artery coronary anatomy, reperfusion must be carried out within 90 min of coronary occlusion to achieve significant salvage of infarcting myocardium, a period of time much shorter than previously suspected. PMID- 3665018 TI - Relief of life-threatening ventricular tachycardia and survival after direct operations. AB - Among 123 patients undergoing a direct operation, with or without other cardiac surgical procedures, for life-threatening ventricular tachycardia as a complication of ischemic heart disease, 68% of surviving patients were free of the return of ventricular tachycardia or sudden death 2 years after operation and 55% were free of these events at 5 years. The instantaneous risk (hazard function) of these events was highest immediately after operation and declined rapidly, so that by 3 months after operation instantaneous risk had merged with the constant-hazard phase which persisted as long as the patients were followed. More advanced impairment of left ventricular structure and function (with the exception of left ventricular aneurysm) increased the risk of occurrence of these events. Among patients with a negative electrophysiologic study (EPS) at hospital discharge, freedom from recurrent ventricular tachycardia or sudden death was 85% at 3 years. Survival, taking into account hospital deaths, was 54% 2 years after operation and 33% at 5 years. Most commonly (65% of instances) death was a result of acute, subacute, or chronic heart failure. The use of the technique of encircling endocardial myotomy increased the risk of death. Survival was particularly poor after the return of ventricular tachycardia. Direct operations for ventricular tachycardia are most likely to succeed in the presence of a discrete left ventricular aneurysm. The results are particularly unfavorable when there is severe global left ventricular dysfunction and no aneurysm. Improved myocardial protection during operation, and more specifically EPS-guided operations, may reduce the early risk of death and of return of ventricular tachycardia. The late return of ventricular tachycardia may be more related to a progressive secondary left ventricular cardiomyopathy than to an inadequate operation. PMID- 3665019 TI - Plateletpheresis: an invaluable blood resource. PMID- 3665020 TI - Right-sided endocardial lesions and flow-directed pulmonary artery catheters. PMID- 3665021 TI - Acquired factor X deficiency in systemic amyloidosis. PMID- 3665022 TI - Donor blood-count changes during and after plateletpheresis. Comparison of two cell-separator techniques. PMID- 3665023 TI - Benign essential blepharospasm treated with botulinum toxin. PMID- 3665024 TI - ACHOO syndrome. Prevalence and inheritance. PMID- 3665025 TI - Concerning accuracy and precision of breath-alcohol measurements. PMID- 3665026 TI - Measurement of acetylcholinesterase in erythrocytes in the field. AB - We describe here a field method we developed for colorimetry of erythrocytic acetylcholinesterase (EC 3.1.1.7) in capillary blood samples. Three stable, premixed assay reagents and de-ionized water (but no centrifuge or balance) are required. This method, adapted for a microplate format, is essentially that of Ellman et al. (Biochem Pharmacol 1961;7:88-95) as modified by George and Abernethy (Clin Chem 1983;29:365-8). Assays were quantified and corrected for hematocrit by using a battery-powered colorimeter with a silicon carbide (blue) light-emitting-diode source. Advantages over existing field methods include better portability, ruggedness, greater precision, and lower cost per sample. PMID- 3665027 TI - Optimized kinetic method for automated determination of beta-hydroxybutyrate. PMID- 3665028 TI - Determining methemoglobin in blood by zero-crossing-point first-derivative spectrophotometry. AB - We determined methemoglobin in blood by zero-crossing-point first-derivative spectrophotometry. After lysis of erythrocytes, hemoglobin was converted into oxyhemoglobin and the first derivative spectrum was recorded between 405 and 425 nm. At the exact point where the first-derivative spectrum of oxyhemoglobin was zero ("zero-crossing point"), the first-derivative value of oxyhemoglobin and methemoglobin mixture was proportional to the methemoglobin concentration. The standard curve was linear for all proportions of methemoglobin. Within-assay precision (CV) was 3.4% for a 20% methemoglobin content. Correlation with results by the Evelyn and Malloy method was very good for high proportions of methemoglobin (greater than 10%), but the proposed technique was far better for low methemoglobin percentages because of its linearity, its high sensitivity, and its low detection limit. PMID- 3665029 TI - Properties of alkaline phosphatase isoenzymes in plasma of preterm and term neonates. AB - The isoenzymes of alkaline phosphatase (EC 3.1.3.1) in plasma of 37 preterm and 21 term neonates two weeks postpartum have been studied with regard to electrophoretic mobility, sialic acid content, inhibition properties, heat lability, molecular mass, and binding to lectins. Term infants generally had a single form of alkaline phosphatase present in significant amounts, identified by the above criteria as originating in bone. All the preterm neonates had two alkaline phosphatase isoenzymes in plasma, namely, bone- and fetal-type intestinal alkaline phosphatase. Liver-, placental-, and adult-type intestinal alkaline phosphatase were not detected in any of the plasma samples. PMID- 3665030 TI - Alkaline phosphatase isoenzymes in the plasma of preterm and term infants: serial measurements and clinical correlations. AB - Serial measurements of the bone and fetal intestinal isoenzymes of alkaline phosphatase (EC 3.1.3.1) in the plasma of 43 term and 43 preterm infants, from birth to six weeks later, indicate that the bone isoenzyme gradually increases over this period in both preterm and term infants fed with unsupplemented commercial formulas. Preterm babies given formula supplemented with calcium (with or without additional phosphate) had significantly lower bone isoenzyme activities for most of the study period. The concentrations of fetal intestinal isoenzyme increased, under the stimulation of milk feeding, from generally undetectable at birth to a peak during the first two weeks postpartum, and then declined. This increase was highly significantly negatively correlated with gestational age, the preterm infants having a much higher and more prolonged increase in this isoenzyme than did term infants. Unlike the adult isoenzyme, fetal intestinal alkaline phosphatase in plasma showed no relationship with blood group status. PMID- 3665031 TI - Liquid-chromatographic determination of five orally active cephalosporins- cefixime, cefaclor, cefadroxil, cephalexin, and cephradine--in human serum. AB - We report an isocratic "high-performance" liquid-chromatographic (HPLC) procedure for measurement of five orally administered cephalosporins (cefixime, cefaclor, cefadroxil, cephalexin, and cephradine) in 0.1 mL of human serum. Serum protein is precipitated with acetonitrile, the sample is centrifuged, and the supernate is evaporated under nitrogen. The residue is reconstituted in 0.1 mL of mobile phase, and 50 to 80 microL of this is injected onto a reversed-phase Altex Ultrasphere Octyl (C8) column. The five cephalosporins are resolved by elution with a pH 2.6 mobile phase of methanol/monobasic phosphate buffer (20/80) by vol), flow rate 2 mL/min. The column effluent is monitored at 240 nm. Cefixime serves as the internal standard for the analysis of the four other compounds, cephalexin as the internal standard for cefixime. We used two standard curves for all compounds: a low-range curve for concentrations commonly observed clinically and a higher-range curve for higher concentrations. The former were linear from 1.0 to 10 mg/L for cefaclor, cefadroxil, cephalexin, and cephradine and from 0.1 to 1 mg/L for cefixime. The high-concentration curves were linear from 1 to 10 mg/L for cefixime and from 10 to 100 mg/L for the other compounds. The detection limits were 0.1 mg/L for cefixime, 1 mg/L for the other cephalosporins. Mean within-run and day-to-day CVs were always less than 15% for all compounds studied. PMID- 3665032 TI - Time-dependent changes in bone, placental, intestinal, and hepatic alkaline phosphatase activities in serum during human pregnancy. AB - To measure changes in bone alkaline phosphatase (EC 3.1.3.1) activity in serum as a function of duration of pregnancy, we adapted our existing alkaline phosphatase (ALP) isoenzyme assay (which has been used to measure bone, hepatic, and intestinal ALP activities in serum, in the absence of placental ALP) to allow quantification of individual ALP isoenzyme activities in the presence of placental ALP. The resulting CV for repeat measurements of bone ALP activity in artificial isoenzyme mixtures ranged from 23% for samples in which the bone isoenzyme represented 7% of total ALP activity to 11% for samples in which bone ALP accounted for 48% of total ALP activity. Values for repeat determinations of bone ALP activity in human serum samples (i.e., including samples obtained from pregnant women and from nonpregnant controls) varied by an average of 18%. We find, in initial applications of this method, that (a) the amount of bone ALP activity in serum is increased during pregnancy (P less than .001), and remains increased at six weeks postpartum, in non-lactating women (P less than .001), and (b) bone ALP activity at term was not significantly different in pregnant women with pre-eclampsia, diabetes, premature rupture of membranes, or premature labor, compared with normal pregnancies at term. Our data support the hypothesis that maternal bone formation may be increased during pregnancy. PMID- 3665033 TI - Enzymic glycation may decrease activity of erythrocytic delta-aminolevulinate dehydratase in diabetes mellitus. PMID- 3665034 TI - Activity measurements of calcium, sodium, potassium, and chloride after equilibrium dialysis used to show lack of evidence for protein interference with calcium electrodes. AB - We measured the activity of Ca2+, Na+, K+, and Cl- with ion-selective electrodes after equilibrium dialysis of solutions with different albumin concentrations. The calculated Donnan ratio was the same for all ions in the same solution and increased with the albumin concentration, as predicted by the Donnan theory. The Donnan distribution ratio for Ca2+ was similar, as determined with instruments from three different manufacturers. For healthy subjects and patients with renal stone disease, we did not find any correlation between serum concentrations of ionized calcium and albumin. The discordance between measured ionized calcium and albumin-corrected total calcium depended on the correction algorithm we utilized. The difficulties of absolutely proving or disproving a protein error in these measurements are discussed, but our data are not consistent with protein being a source of error in measurements of ionized calcium. PMID- 3665035 TI - Direct, simultaneous measurement of chloramphenicol and its monosuccinate ester in micro-samples of plasma by radial-compression liquid chromatography. AB - A simple method of simultaneous analysis for chloramphenicol and chloramphenicol succinate in 10-microL samples of plasma is described. We injected the plasma samples directly into a radial-compression liquid chromatograph equipped with a precolumn module and a C18 insert. A mixture of acetic acid solution (pH 3)/acetonitrile (75/25, by vol) was used as mobile phase, at a flow rate of 4 mL/min. We separated the compounds in a 10-micron (particle size) C18 cartridge with a radial compression separation system and detected them in the effluent at 280 nm. The peak height for both compounds was linearly (r greater than 0.9993) related to concentration over the range investigated, 1-50 mg/L. We also performed the analysis with use of an internal standard (methylprednisolone) and obtained equally good results (r greater than 0.9995). We observed no interference from other antibiotics or drugs in the assay, and the inter- and intra-run precision at different concentrations was good (CV, 0 to 5.6%). We analyzed microsamples of plasma from an infant treated for meningitis with chloramphenicol sodium succinate intravenously. Total analysis time for each sample was less than 8 min. PMID- 3665036 TI - A candidate standard for use in calibration of total bilirubin in serum. PMID- 3665037 TI - Determination of conjugated and total bilirubin in serum of neonates, with use of bilirubin oxidase. AB - A new, simple, and rapid assay for conjugated bilirubin that does not require serum-matrix standards was developed by using the enzyme bilirubin oxidase (EC 1.3.3.5). This procedure can also be modified to measure total bilirubin. Measurements from these assays were compared with results obtained with the Sigma 605 (Jendrassik-Grof method), Sigma 550/551 (Walters-Gerarde method), and Kodak Ektachem (BuBc) bilirubin assays. The one-year study involved serum specimens from 283 infants younger than 30 days. Linear-regression analysis of data for conjugated bilirubin collected by this assay and by the Kodak Ektachem assay yielded a slope of 0.975, an intercept of 0.088, an Syx of 1.47 mg/L, and a correlation coefficient of 0.94 for a total of 49 specimens. Correlation was also good (r = 0.95) between results for total bilirubin by this assay and both the Sigma 605 and the Kodak Ektachem methods. PMID- 3665038 TI - Direct quantification of coproporphyrins and uroporphyrins in urine by derivative synchronous fluorescence spectroscopy. AB - The second-derivative synchronous fluorescence spectroscopic technique is applied to the simultaneous and direct assay of coproporphyrins and uroporphyrins in human urine. This technique resolves the overlapping conventional spectra, obviating the need for pre-analysis sample separation techniques, and measurements can be made in a single scan. The amplitudes of the derivative peaks are linearly related to uroporphyrin (0.4 to 300 micrograms/L) and coproporphyrin (0.4 to 250 micrograms/L) concentrations. The detection limit for both porphyrins is 0.1 microgram/L. Analytical recoveries range between 98 and 101%. Within- and between-assay CVs are reported. Results for 24-h urine specimens correlated well with those obtained by an extraction-ion-exchange chromatography combined method. The proposed method is inexpensive and requires no sophisticated detection equipment. PMID- 3665039 TI - Identification and analysis of nine metabolites of cyclosporine in whole blood by liquid chromatography. 1: Purification of analytical standards and optimization of the assay. AB - We describe an extraction and an isocratic "high-performance" liquid chromatographic (HPLC) separation of cyclosporine (CsA) and nine metabolites (M1, M8, M17, M18, M21, M25, M26, M203-218, and MUNDF1) from whole blood. Metabolites (for standards) were purified from human bile with liquid-liquid and solid-phase extractions, chromatographed on a cyanopropyl (CN) semipreparative HPLC column, and further purified on octyl, CN, and silica columns. The identity of each metabolite was verified with authentic standards on three chemically different HPLC columns and on the basis of cross-reactivity data from radioimmunoassay. For the routine analytical method, 1 mL of whole blood is diluted, hemolyzed, and applied to a Bond Elut CN (500 mg) cartridge to extract CsA, metabolites, and cyclosporin C, the internal standard. Interferences are removed by using four wash solutions and an additional cartridge of octyldecyl sorbent introduced prior to elution. Analytes are separated on a Zorbax CN analytical column maintained at 58 degrees C, with detection at 214 nm. Analytical recovery, as tested with three lots of CN sorbent, ranged from 47% to 95% for the 10 cyclosporines. Between-run CVs are less than 10% at 200 micrograms/L (concentration of each compound) and the standard curves are linear to 1500 micrograms/L. We also report a study of the separation mechanisms. PMID- 3665040 TI - Validation and application of a liquid-chromatographic/enzymatic assay for individual bile acids in the serum of rats. AB - A liquid-chromatographic technique with a post-column enzymatic reaction and fluorescence detection was validated for analysis of individual bile acids in the serum of rats. Extraction recoveries averaged 91.1% (SD 6.9%) for all bile acids. The assay was sensitive (minimum detection of 16.8 pmol per 100-microL injection), linear (r greater than 0.999 for concentrations ranging between 45 and 112,500 pmol per 100-microL injection), and reproducible (mean CVs for three different concentrations of standards and a serum pool ranged from 4.4% to 12.2%). In rats treated for three days with either neomycin, carbon tetrachloride, alpha-naphthylisothiocyanate, or total bile-duct ligation (five animals per group), total concentrations of bile acids were significantly increased (P less than 0.004). Concentrations of 16 of 17 individual bile acids differed significantly between groups (P less than 0.04). Examination of the relative concentrations (percent of total) of individual bile acids by canonical discriminant analysis placed each animal into the appropriate treatment or control group. Use of this technique in toxicological studies can help detect and identify specific types of disruptions in the enterohepatic circulation of bile acids. PMID- 3665041 TI - Determination, by radioimmunoassay, of the mass of lactate dehydrogenase isoenzyme 1 in human serum and of its rate of removal from serum after a myocardial infarction. AB - In this radioimmunoassay of lactate dehydrogenase-1 (LD-1; EC 1.1.1.27) in human serum we use a commercial LD-1-selective assay system and a goat antiserum. We have determined the fractional rate of disappearance from serum and the half-life of LD-1, in terms of both enzyme activity and enzyme mass, in 21 myocardial infarction patients. Our evidence suggests that this isoenzyme is inactivated in serum. Furthermore, our data suggest that the conventionally accepted half-life of about 110 h for serum LD-1 activity may grossly overestimate the actual LD-1 half-life in many post-myocardial infarction patients. PMID- 3665042 TI - Criteria for essential fatty acid deficiency in plasma as assessed by capillary column gas-liquid chromatography. AB - To develop criteria for deficiency of essential fatty acids (EFA), we used capillary-column gas-liquid chromatography to determine fatty acids (percentage of total fatty acids) in plasma obtained in the fasting state from 56 reference subjects and from 10 patients with intestinal fat malabsorption and suspected EFA deficiency. Fatty acid evaluations (percentage of total fatty acids) that allowed for a clear distinction (P less than 0.01) between reference subjects and patients, based on values two standard deviations below or above the reference mean, included values for linoleic acid (18:2w6) below 27%, and values for palmitic acid (16:0), palmitoleic acid (16:1w7), oleic acid (18:1w9), vaccenic acid (18:1w7), and Mead acid (20:3w9) exceeding 21%, 2.6%, 23.3%, 2.1%, and 0.21%, respectively. Ratios of total EFA to total non-EFA of less than 0.60 and of Mead acid to arachidonic acid of greater than 0.025 also served to identify patients, and were not found in reference subjects. Significant inverse correlations between percentages of plasma EFA and plasma mono-unsaturated fatty acids were noted. Our reference-interval data can be used to assess normality of plasma EFA status. PMID- 3665044 TI - Simplified sodium dodecyl sulfate-polyacrylamide gel electrophoresis of unconcentrated urine with enhanced resolution and detection sensitivity. AB - We applied a simple sodium dodecyl sulfate-polyacrylamide gel electrophoresis method to urine. The method, developed for serum protein analysis (Clin Chem 1984;30:475-9), has a high sample throughput and gives excellent resolution with unconcentrated urine. It clearly distinguishes and characterizes proteinuric urine (7.5 microL) by Coomassie Blue staining and gives complex silver-stained patterns with nonproteinuric urine (2 microL). The former is recommended for routine clinical screening, the latter for research purposes. PMID- 3665043 TI - Ascorbic and dehydroascorbic acids simultaneously quantified in biological fluids by liquid chromatography with fluorescence detection, and comparison with a colorimetric assay. AB - We describe a "high-performance" liquid-chromatographic method for separating and quantifying ascorbic acid (AA) and dehydroascorbic acid (DHA) in plasma and urine. We used a reversed-phase C18 column with an ion-pair reagent and detected the analytes by post-column reaction with 4,5-dimethyl-o-phenylenediamine to form a fluorescent derivative (measured at excitation and emission wavelengths of 365 and 440 nm, respectively). Isoascorbic acid (IA) is the internal standard. Retention times for DHA, AA, and IA are 5.6, 15.5, and 19.9 min, respectively. Between-day CVs for AA in plasma in concentrations of 8 and 20 mg/L were 9% and 7%, respectively. The limit of detection is 10 and 4 ng for AA and DHA, respectively. Results by the present method and the methoxyaniline colorimetric method for AA are comparably accurate. PMID- 3665045 TI - Evaluation of a fully automated centrifugal analyzer for performance of hemostasis tests. AB - We have evaluated the performance of a centrifugal analyzer, specifically designed for hemostasis tests, for methods based on clotting time as measured by light scattering, or based on splitting of chromogenic substrates. The results were compared with those obtained with a semiautomated coagulometer (clotting tests) or with a manually operated photometer (chromogenic tests). In general, the results with the centrifugal analyzer were at least as precise as those of the comparative methods, with greater output and ease of operation. Disadvantages of the instrument are its partial incompatibility with some commercial reagents and the relative rigidity of the operational parameters, which hinder its use for research. PMID- 3665046 TI - Optical kinetic method for calibration of spectrophotometer temperature: demonstration with the Cobas-Bio analyzer. AB - The pseudo-first-order rate constant for the Jaffe reaction with creatinine varies logarithmically with temperature and was calibrated in the range 25 to 37 degrees C to measure the temperature of the liquid in the lightpath of spectrophotometric instrumentation. The reagent concentrations can be adjusted to permit rate-constant measurements in time intervals from a few seconds to several minutes. The temperature increment that can be resolved is limited only by the analytical imprecision of the instrumentation used to measure the rate constant and the calibration temperature. In this investigation, a temperature SD of 0.03 degrees C could be measured. Two Cobas-Bio centrifugal analyzers, used to demonstrate the utility of this technique, were found to have temperature errors from -1.0 to -1.7 degrees C in the 30 to 37 degrees C range and overall temperature SD of 0.19 and 0.36 degree C, respectively, at 37 degrees C. Analysis of variance gave between-rotor SD of 0.14 and 0.34 degrees C and within-rotor SD of 0.13 and 0.11 degree C, respectively. We found temperature differences of 0.3 degree C between cuvets in a rotor, and gradients of 0.3 and 0.4 degree C, respectively, from the top to bottom of an individual cuvet in the two instruments. PMID- 3665047 TI - An assessment of the use of fixed limits to characterize intralaboratory performance by proficiency testing. AB - Currently, proficiency-testing (PT) programs are expanding the use of fixed limits to evaluate interlaboratory performance. These limits are an attempt to relate total allowable intralaboratory analytical error and performance in a PT program. Fixed limits are a means of counteracting the effects of overly stringent performance requirements derived from the interlaboratory group mean and standard deviations (SD) achieved by today's very precise analytical systems. Our previously described computer model of a PT program is used to delineate the quantitative relationship between the magnitude of intralaboratory coefficient of variation (CV) and bias that is compatible with fixed interlaboratory limits of 5, 10, 15, and 20% relative error. However, fixed limits alone do not fully characterize intralaboratory performance. The efficiency, or the percentage of times a laboratory's PT results are required to fall within the fixed limit, also must be considered when criteria for PT performance are being set. For example, a 10% fixed limit and a 80% efficiency will allow laboratories having CV-bias combinations from 8%-0%, 7%-4%, etc., to pass PT. The use of a 95% efficiency will allow CV-bias combinations from 4.8%-0%, 3.5%-4%, etc., to pass PT. We give a figure that depicts all possible combinations for four fixed limits and six efficiencies. PMID- 3665048 TI - Importance of time interval between repeated measurements of total or high density lipoprotein cholesterol when estimating an individual's baseline concentrations. AB - We studied intra-individual variation in total and high-density lipoprotein (HDL) cholesterol in healthy volunteers (22 men and 19 women, ages 19 to 62 years) on controlled natural diets. The within-person coefficient of variation (CV) depended on the interval between blood samples, increasing from about 2% to 3% for measurements made 24 h apart to 4% to 5% for measurements made at four-day intervals or longer. We conclude that within-subject fluctuations in total and HDL cholesterol have a time constant of several days. Multiple measurements are generally needed to decide whether an asymptomatic subject exceeds a certain concentration of total or HDL cholesterol; we recommend that such measurements be made at least four days apart. PMID- 3665049 TI - Bence Jones proteinuria in multiple sclerosis. AB - We report our findings of Bence Jones proteins (monoclonal free light chains of immunoglobulins) in concentrated urines of patients with multiple sclerosis, by using agarose electrophoresis and immunofixation. The lack of such findings in urines from healthy subjects and patients with other neurological disorders should stimulate further investigation. PMID- 3665050 TI - Effect of daylight on the reaction of thiols with Ellman's reagent, 5,5' dithiobis(2-nitrobenzoic acid). AB - The reaction of 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB, Ellman's reagent) with thiols is sensitive to daylight, in particular to ultraviolet radiation at wavelengths around 325 nm. Exposure to light at the absorbance maximum of the yellow product (the thionitrobenzoate ion) at 410 nm had no effect on the reaction. The light-sensitive species is apparently the DTNB, because a spectral irradiation experiment showed that the wavelength of light that produced the maximum rate of absorbance change coincided with the peak absorbance of DTNB, and it was well separated from the thionitrobenzoate absorbance peak. Ascorbate is ineffective as a stabilizer and can produce an apparent increase in the rate of DTNB destruction. In a practical example we found the light interference to be severe when hydrolysis of propionylthiocholine by plasma cholinesterase (EC 3.1.1.8) was measured after a 20-min incubation. The apparent cholinesterase activity in clear glass or plastic tubes exposed to diffuse daylight could be decreased to 25% of the value obtained for samples in light-excluded tubes. We recommend the reaction be carried out in artificial room light, with total elimination of daylight, because window glass does not sufficiently attenuate 325 nm wavelength irradiation. PMID- 3665051 TI - Sensitivity of the direct oxalate oxidase assay of urinary oxalate improved. AB - The direct colorimetric method for urinary oxalate has been modified to improve its sensitivity. Oxalate is precipitated overnight with calcium chloride and ethanol, the precipitate is redissolved, and the oxalate is measured by use of oxalate oxidase (EC 1.2.3.4), methylbenzothiazolinone hydrazone, and dimethylaniline. The color developed is more intense, analytical recovery averages 102%, and the overall imprecision is less than 5%. To assess the accuracy of the method, we used a gas-chromatography comparison method and control sera. Interference from ascorbate is negligible. The modified method retains its simplicity and is less expensive. PMID- 3665052 TI - Plasma estradiol concentrations in neonates. PMID- 3665053 TI - Performance evaluation of DataChem's clinical analyzer. PMID- 3665054 TI - Iodine contamination of urine samples by test strips. PMID- 3665055 TI - Calcium does not interfere with measurement of magnesium in the Dupont "aca-III". PMID- 3665056 TI - Erythrocyte glutathione concentrations in diabetics with cataracts, with and without glucose-6-phosphate dehydrogenase deficiency. PMID- 3665057 TI - A patient with an IgG paraprotein and complexes of lactate dehydrogenase and IgG in the serum. PMID- 3665058 TI - Practical observations and sources of error in assays of plasma catecholamines by "high-performance" liquid chromatography with electrochemical detection. PMID- 3665059 TI - Glucose interferes in fluorometry of serum citrate in diabetic patients with hyperglycemia. PMID- 3665060 TI - Stabilizing LD isoenzymes in control serum. PMID- 3665061 TI - Enzyme-linked immunosorbent assay of serum argininosuccinate synthetase. PMID- 3665062 TI - Hyponatremia in spontaneous hyperglycemia: correlation studies in 100 patients. PMID- 3665063 TI - Serum retinol-binding protein and creatinine in onset of and recovery from acute renal failure. PMID- 3665064 TI - Evaluation of the IL 482 CO-Oximeter. PMID- 3665065 TI - Comparison of high-sensitivity TSH assays used to evaluate suppressed patients. PMID- 3665066 TI - HDL-cholesterol assay with the Abbott "Vision System" evaluated. PMID- 3665067 TI - Inocor (amrinone lactate) interferences with TDX digoxin measurements. PMID- 3665068 TI - Lithium stability in clotted blood: storage guidelines. PMID- 3665069 TI - The fractional error as a means of assessing agreement between two methods measuring the same variable. PMID- 3665070 TI - Adaptation of a turbidimetric lipase assay to a centrifugal analyzer. PMID- 3665072 TI - Effect of anticoagulants on fructosamine determination. PMID- 3665073 TI - Results with a fructosamine kit for a group of diabetics in Southeast Asia. PMID- 3665071 TI - Measurement of serum estradiol: comparison of three "direct" radioimmunoassays and effects of organic solvent extraction. PMID- 3665074 TI - Citrate in urine estimated by a citrate lyase technique adapted to the Cobas-Bio. PMID- 3665075 TI - Nitroblue tetrazolium staining of serum fructosamine on agarose gel electrophoretograms. PMID- 3665077 TI - Instrument artifact affects TDM assays in the IL "Monarch". PMID- 3665076 TI - Maternal hypozincemia and low-birth-weight infants. PMID- 3665078 TI - Normal baseline values for CK-MB by two methods compared. PMID- 3665079 TI - Comment on the fructosamine quality-assessment survey. PMID- 3665080 TI - How early can ornithine carbamoyltransferase be measured in fetal liver? PMID- 3665081 TI - Identifying CK-MB and macro-CK by electrophoresis. PMID- 3665082 TI - Assay of serum fructosamine: internal vs external standardization. PMID- 3665083 TI - Reappraisal of carnitine concentrations in blood. PMID- 3665084 TI - Salivary melatonin assay in laboratory medicine--longitudinal profiles of secretion in healthy men. PMID- 3665085 TI - The sanitized Systeme International (SI) d'Unites. PMID- 3665086 TI - Direct analysis of tetrahydrobiopterin in cerebrospinal fluid by high-performance liquid chromatography with redox electrochemistry: prevention of autoxidation during storage and analysis. AB - Measurement of tetrahydrobiopterin in cerebrospinal fluid requires careful handling of samples during storage and analysis. Addition of dithioerythritol and deoxygenation of the mobile phase with helium prevents breakdown of tetrahydrobiopterin during chromatography. Tetrahydrobiopterin in cerebrospinal fluid is unstable at room temperature, 100% being lost within 3.5 h, this breakdown does not generate equivalent quantities of dihydrobiopterin and biopterin. Addition of dithioerythritol and diethylenetriaminepenta-acetic acid to cerebrospinal fluid prevents breakdown of tetrahydrobiopterin for 6 mth at -70 degrees C and for up to 5 h at 4 degrees C. At room temperature less than 5% of tetrahydrobiopterin was lost after 2 h. PMID- 3665087 TI - Biosensor for lactate determination in biological fluids. 2. Interference studies. AB - The selectivity of a yeast lactate biosensor with immobilized cells of aerobic yeast Hansenula anomala was studied. Reducing substances potentially present in blood plasma influenced both enzyme and yeast biosensors in the same way; the highest positive error was observed in the case of uric acid. With respect to the metabolic activity of the yeast cells the biosensor was absolutely specific for lactate during the first two weeks; later on the biosensor responded slightly to some other metabolites, especially some sugars and amino acids. Glucose could cause the highest degree of interference, its effect was however completely eliminated by adding sodium fluoride to the reaction solution. The concentration of other metabolites present in blood plasma is not great enough to call a significant positive error. The results thus support the general use of the yeast lactate biosensor for lactate determination in biological material. PMID- 3665088 TI - Relationship between effects of added albumin, initial free thyroxine value and endogenous serum-binding protein concentrations on Amerlex free thyroxine estimations. AB - We studied the effect of adding purified human albumin to sera on free thyroxine (FT4) values obtained with Amerlex radioimmunoassays. Apparent FT4 values increased with progressive addition of albumin in vitro. The effect was smallest with low and greatest with high initial FT4 concentrations, which were also linearly correlated with the incremental increase in FT4 values per g/l albumin added. Wide variations in either endogenous thyroxine binding globulin (TBG) or albumin concentrations in patient serum had little effect on the rate of increase in FT4 values when albumin was added in vitro. From Mass Action theory, calculations of the binding affinity of the endogenous albumin for the analog (2.1 X 10(5) l/mol) gave values nearly half that of the added albumin (3.94 X 10(5) l/mol). Distortions in Amerlex FT4 values caused by adding albumin in vitro may exaggerate its importance as a tracer binder and such results may be unrepresentative of patient samples. PMID- 3665089 TI - Guanidino compounds in serum and cerebrospinal fluid of non-dialyzed patients with renal insufficiency. AB - Twelve guanidino compounds were determined in simultaneously sampled serum and cerebrospinal fluid of eight non-dialyzed patients with renal insufficiency. Liquid cation exchange chromatography with a highly sensitive fluorescence detection method was used. In patients with serum urea levels about 10 times higher than in controls, the levels of guanidinosuccinic acid, creatinine, guanidine and methylguanidine, in serum as well as in cerebrospinal fluid, are at least 10 times higher than in control subjects. The levels of argininic acid and N-alpha-acetylarginine (in serum) and gamma-guanidinobutyric acid (in cerebrospinal fluid) are slightly increased (less than 10 X). The levels of the other guanidino compounds are close to normal values. A significant positive correlation exists between the guanidinosuccinic acid, creatinine and guanidine levels in serum and cerebrospinal fluid. The accumulation of several experimentally proven toxic guanidino compounds could contribute to the complex nervous system symptomatology and the hematological complications seen in renal insufficiency. PMID- 3665090 TI - Underestimation of serum albumin by the bromcresol purple method and a major endogenous ligand in uremia. AB - In hemodialyzed patients, the serum albumin concentration determined by the bromcresol purple (BCP) method was lower than that determined by an immunological method. The degree of underestimation appeared to be well correlated to the serum concentration of 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF), a major endogenous ligand substance present in uremic serum. CMPF inhibited in vitro the binding of BCP to serum protein and human serum albumin. Our results suggest that CMPF is a major interferent in the underestimation of the serum albumin concentration by the BCP method in uremia. PMID- 3665091 TI - Determination of total cholesterol in serum by flow injection analysis with immobilized enzymes. AB - Several photometric and fluorimetric methods are proposed for the determination of cholesterol by use of enzymes immobilized on controlled-pore glass and the normal and stopped-flow injection modes, achieving linear ranges of the calibration curves between 26-776 mumol/l and 5-265 mumol/l with excellent regression coefficients and good coefficients of variation. The methods have been applied to the determination of this analyte in serum with excellent results. PMID- 3665092 TI - CSF concentration and CSF/blood ratio of fuel related components in children after prolonged fasting. AB - In order to obtain information about blood and cerebrospinal fluid (CSF) concentrations, and CSF/blood ratio data of fuel related substrates at the end of a prolonged fast in children, we have selected biochemical data from fasting test procedures in 11 control children aged 3-5 yr, fasted 24 h, and 58 control children aged 6-15 yr, fasted 40 h. There was a good correlation between blood and CSF concentrations for glucose, acetoacetate and beta-hydroxybutyrate. The relation with age and sex has been analyzed only in the older children. CSF and blood values for glucose are positively related with age, and both ketones are negatively related with age. Lactate, pyruvate and alanine concentrations in blood and CSF are not related with age, except for CSF pyruvate. With respect to the CSF/blood ratio for the above mentioned components, only the value for acetoacetate is sex and age related. The calculated median caloric values for the sum of glucose, lactate, pyruvate and ketones in CSF are independent of age at the end of a 40-h fast. The diminished glucose contribution on the CSF caloric homeostasis in younger children is fully compensated by the ketone bodies. PMID- 3665093 TI - Isoenzyme specificities of immunoglobulins isolated from lactate dehydrogenase immunoglobulin complexes. AB - Lactate dehydrogenase (L-lactate: NAD oxidoreductase, EC 1.1.1.27, LD) specific immunoglobulins were isolated from LD-immunoglobulin complexes in sera from 11 patients and the isoenzyme specificity of the immunoglobulins was studied by sandwich electroimmunofixation (SEIF). The immunoglobulins differed in isoenzyme specificity, depending on the heavy and/or light chains. IgA kappa recombined with LD2 and LD3, and was thought to be the antibody to common structures (H2M) in LD2 (H3M) and LD3 (H2M2). IgA kappa in a IgA/G kappa lambda case recombined with LD3-5, so that the IgA kappa might be an antibody to M2 dimer in the isoenzymes. IgA lambda recombined only with LD3, and was thought to recognize the H2M2 structure of LD3. As IgG kappa and/or lambda recombined with all LD isoenzymes of LD1-5, the immunoglobulins might react with common structures in H and M subunits. IgG lambda recombined with LD2-5, particularly with LD5, so that the IgG lambda was thought to be an antibody to the M subunit in LD2-5. From the above findings and the tetrameric structure of the LD molecule, 18 types of antibodies to different antigenic determinants on LD molecules can be theoretically derived. Each of the present 11 cases of immunoglobulin corresponded to one of the 18 types, respectively. A formula which can theoretically determine the percent LD activity recombined with immunoglobulins is described. PMID- 3665094 TI - Evaluation of the average of patients: application to endocrine assays. AB - Recent work (Cembrowski et al, Am J Clin Pathol 1984;81:492-499) has shown that the average of selected patient data can theoretically be used to demonstrate systematic errors. We formerly demonstrate that the sensitivity or power of the 'average of patients' (AOP) is related to the index (NpSw2)/Sp2 where Np is the number of patient results averaged, Sw the within-run component of the standard deviation of the analytical method and Sp the standard deviation of the trimmed population. The utility of the AOP can therefore be assessed rapidly without power function curves or the calculation of the daily AOP itself. The index showed that, for 12 radioimmunoassays done in our laboratory, the power of the AOP was greatest for T3 uptake, then FTI, then T4. Daily AOP were followed for these tests with control results on parallel Shewhart plots. We also applied an exponential smoothing procedure on the AOP and control results to improve trend detection. These analyses demonstrated that the AOP can improve the detection of systematic errors and the differentiation of true errors from errors affecting only control specimens. PMID- 3665095 TI - Intracellular magnesium of mononuclear cells from venous blood of clinically healthy subjects. AB - Measurement of intracellular magnesium (Mg2+) may have advantages over serum Mg2+ measurements in the assessment of Mg2+ homeostasis in patients. An accurate and reproducible method of measuring the Mg2+ content of mononuclear cells (lymphocytes and monocytes) from the venous blood of human subjects utilizing commonly available reagents and equipment is described. A well-defined clinical population of 88 subjects (48 males and 40 females) was used as the normal population. The mean mononuclear cell Mg2+ content was 67.8 +/- 13.8 (SD) fg/cell giving a 95% confidence interval normal range of 40-95 fg/cell which compared favorably to the empirical 95% limits of 44-94 fg/cell. The serum Mg2+ measured at the same time was 0.90 +/- 0.06 (SD) mmol/l. No significant correlation was found when comparing serum and mononuclear cell Mg2+ concentrations. Additionally, no significant differences were found when serum and intracellular Mg2+ were analyzed for sex and age with the exception that intracellular Mg2+ tended to be slightly higher in the younger age groups. The routine performance of this assay may require as little as 7 ml of venous blood and was done with a coefficient of variation of 3.0-3.6%. PMID- 3665096 TI - A simple, reproducible and cheap batch method for the analysis of serum glycoproteins using sepharose-coupled lectins and silver staining. PMID- 3665097 TI - An improved spot-test for the detection of paraquat and diquat in biological samples. PMID- 3665098 TI - Analysis of 25-hydroxyvitamin D in plasma using solid phase extraction. PMID- 3665099 TI - Detergent induced lysis of erythrocytes in kwashiorkor. AB - The effect of the non-ionic detergent Nonidet P40 on lysis of erythrocytes in children suffering from kwashiorkor was studied. The concentration of the detergent causing 50% haemolysis was significantly reduced in these patients. Detergent haemolysis was more sensitive than osmotic fragility (which was reduced). The abnormality was only slight in marasmic children. PMID- 3665100 TI - Effects of surfactants on human serum biotinidase. PMID- 3665101 TI - Immunoradiometric assay of serum thyroid stimulating hormone (TSH) as a first line test in a mixed hospital population. AB - An immunoradiometric assay of thyroid stimulating hormone (TSH-IRMA) was evaluated as a first-line test for the diagnosis of thyroid disease in a prospective study of 318 consecutive patients in a major city hospital. The results of TSH-IRMA were compared with the diagnoses made by means of our usual diagnostic methods. Based on previous studies a serum TSH level of 0.15 mU/l was chosen as cutoff limit for calculation of diagnostic performance. For patients with serum TSH greater than 5.0 mU/l the results of TSH-IRMA were in accordance with the results of our routine radioimmunoassay. Patients with serum TSH levels between 0.15 mU/l and 5.0 mU/l were euthyroid (the diagnostic sensitivity was 100%). Consequently, the final diagnosis could be made with one test and within two days for 88% of patients. Patients with serum TSH less than 0.15 mU/l needed supplementary tests since only 32% of these patients had thyrotoxicosis, 32% had a non-toxic goiter, and 36% had no thyroid disease. PMID- 3665102 TI - Changes in magnesium, zinc and calcium in men and women after an acute myocardial infarction. AB - The relations between different elements in acute myocardial infarction (MI) led us to determine erythrocyte (Erc) and/or plasma (Pl) concentrations of magnesium (Erc-Mg; Pl-Mg), zinc (Erc-Zn; Pl-Zn) and calcium (Pl-Ca) in 34 men and 8 women upon admission to hospital and then on days 2, 3, 6, 10 and 12. On day 1, these two groups were compared with 58 reference men or 53 reference women. The changes in the different variables from day 1 to day 12 were analyzed by one-way ANOVA. In MI men, from day 1 to day 12, all cations were significantly modified. In MI women, only Erc-Zn and Pl-Ca remained unchanged. In both populations, Pl-Mg, Erc Mg and Pl-Zn increased significantly between day 1 and day 12. PMID- 3665103 TI - Black-white differences in serum Lp(a) lipoprotein levels. AB - Serum Lp(a) lipoprotein was determined in 81 black and 81 white healthy men and women matched for sex and age. The results show a highly significant increase of Lp(a) concentrations in blacks as compared to whites, and confirm the notion that Lp(a) lipoprotein levels are race-dependent. Whether high values of Lp(a) play an atherogenic role in blacks remains to be established in further studies. PMID- 3665104 TI - Evaluation of RU-27987 as a ligand to determine the progesterone receptor. AB - RU-27987, a synthetic progestin, which was recently developed by Roussel Uclaf, Paris, was tested for its validity as a ligand to determine the progesterone receptor in breast cancer. The results were compared to those obtained with R 5020 and ORG-2058, two ligands that are already in use worldwide. The intra- and interassay variation of receptor determination was similar for all 3 ligands. Receptor levels were analyzed with each of the 3 progestins in control cytosols and in 26 mammary carcinoma samples. A good correlation between receptor levels was found although the values of ORG-2058 were somewhat lower, but not significantly. This resulted in a lower proportion of receptor positive samples for ORG-2058 (11/26) compared to R-5020 (13/26) and RU-27987 (14/26). The affinity to the progesterone and to the glucocorticoid receptor, as well as the precision of the Scatchard plot analysis were comparable for the 3 ligands tested. Intra- and interassay variation of receptor determination were also similar. We therefore conclude, that RU-27987 is a suitable ligand to determine progesterone receptor in mammary carcinoma. PMID- 3665105 TI - Abnormal degradation of erythrocyte membrane proteins in hereditary spherocytosis. AB - The degradation rate of erythrocyte membrane proteins by membrane-bound proteases was compared in healthy controls and in patients with hereditary spherocytosis (HS). An increased degradation rate of spectrin and a decreased digestion rate of Band 3 were found in HS patients. These differences may be due to altered accessibilities of membrane proteins to proteases and/or to changes in the pattern of membrane-associated proteases and may be connected with the decrease in the spectrin: Band 3 ratio reported for erythrocyte membranes in HS. PMID- 3665106 TI - Increased serum lactate dehydrogenase isoenzyme 1 and macro creatine kinase type 2 in a patient with lung cancer. AB - A 72-yr-old man, having a lung tumor with metastatic spread to liver and bone, was hospitalized with a lactate dehydrogenase (LD; EC 1.1.1.27) activity and a creatine kinase (CK; EC 2.7.3.2) activity in serum of 30 and 2 times the upper reference limit (URL), respectively. The LD isoenzyme-1/LD activity ratio was 62% (2 times URL). This ratio was maintained throughout hospitalization, during which LD activity increased up to 90 times URL. Macro CK type 2 activity represented almost all of the CK activity, which increased up to 4 times URL during hospitalization. The patient died the 29th day after admission. The enzyme abnormalities were thought to stem from tumor tissue. PMID- 3665107 TI - Determination of glycated hemoglobin by affinity chromatography. AB - An affinity chromatography microcolumn assay for glycated hemoglobin was compared with electrophoretic and microcolumn ion exchange methods. The affinity method has an imprecision of less than 4% for non-diabetic and less than 2% for diabetic specimens. The method is neither affected by carbamylated or acetylated hemoglobin nor by high glucose concentrations. Method comparisons showed discordant results due to interferences in electrophoretic and ion exchange methods in 3%-6.5% of all cases. Nonlinear relationships between affinity methods on one hand and electrophoretic as well as ion exchange methods on the other indicate that the affinity method measures not only beta-terminal glycated hemoglobin but all glycated hemoglobins, providing enhanced sensitivity and diagnostic value. PMID- 3665109 TI - Modified auditory brainstem responses (MABR): Part I--Rationale and normative study. AB - Binaural, rapid rate, ABR stimulation at four intensity levels (MABR) as well as ABR at two intensity levels were carried out in 35 normal subjects. Latency and amplitude relationship with stimulus intensity of wave V of the MABR was extensively studied in these subjects. MABR recording is a rapid, sensitive, non invasive screening method readily done at the intensive care bedside. Less than 10 minutes is required in addition to the ABR examination time. Normality of the MABR potentials implies a high degree of peripheral auditory and brainstem functional integrity, augmenting information gained with standard ABR technique. Only clinical trials can decide if MABR sensitivity will exceed that of the ABR and prove helpful to diagnosis and patient care. PMID- 3665108 TI - Hypsarhythmia-infantile spasms in near-drowning: clinical, EEG, CT scan and evoked potential studies. AB - A 13-month-old child developed hypsarhythmia-infantile spasms after nearly drowning. Serial EEG, multimodality evoked potential, and CT scan of the brain revealed hypsarhythmia, disruption of ascending and descending tracts rostral to the mesencephalon, and a fairly severe degree of dilation of the ventricular system and subarachnoid space. We speculate that deafferentiation of the cerebral cortex is critical in the genesis of the hypsarhythmic pattern. PMID- 3665110 TI - Frontal intermittent rhythmic delta activity (FIRDA) in pial-dural arteriovenous malformation. AB - We report a case of FIRDA associated with a pial-dural arteriovenous malformation (AVM). The patient presented with headaches, papilledema and partial oculomotor nerve palsy. CT scan had failed to discover the AVM. After partial embolization of the AVM, the patient's symptoms and signs resolved, and the FIRDA disappeared. FIRDA has been thought to be caused by frontal lobe ischemia or periventricular edema. It has not been reported in benign intracranial hypertension (BIH). We postulate that the FIRDA in this case was due to the circulatory "steal" effect of the AVM, and not to the intracranial hypertension. Five percent of patients with dural AVM's present with a picture consistent with BIH. We recommend a diligent search for additional pathology if FIRDA is seen in association with presumed BIH. PMID- 3665111 TI - Electrocerebral silence and nasopharyngeal EEG. AB - This limited study of six comatose patients who showed clinical signs of brain death was conducted to seek answers to the proposed questions regarding the confirmation of concurrent activity in both scalp and nasopharyngeal electrode tracings, and the detection of any recordable activity from the nasopharyngeal electrodes once no further electrical activity is detected from the surface electrodes. It appears that the nasopharyngeal electrode tracings are as informative as scalp surface electrode tracing is as informative as a scalp surface electrodes tracing in cases of electrocerebral silence. Perhaps a larger patient population testing should be studied to re-affirm this observation. PMID- 3665112 TI - Ovulatory disturbances in patients with luteal insufficiency. AB - In order to study ovulatory disturbances in patients with luteal insufficiency we evaluated 210 cycles of 170 women from infertile couples by ultrasonographic follicle measurements and hormonal determinations. Only cycles with evidence of luteinization were included into the study. Mid-luteal progesterone (P) levels were determined in relation to the ultrasonographic ovulation time or, where the follicle failed to rupture, in relation to the LH peak. In spontaneous cycles with a mid-luteal P level below 32 nmol/l (10 ng/ml) a luteinized unruptured follicle (LUF) was found in 71.1% of cycles, whereas in spontaneous cycles with a mid-luteal P level above 32 nmol/l only 7.9% cycles exhibited a failure of the follicle to rupture. The same phenomenon was encountered in cycles in which agents had been given to induce ovulation. The incidence of LUF cycles in an average infertility population could be calculated to be as high as 50% if the mid-luteal P level is below 32 nmol/l and as low as 4% if the mid-luteal P level is above 32 nmol/l. The geometric mean mid-luteal P level in spontaneous LUF cycles was 32.5 nmol/l, compared to 55.2 nmol/l in spontaneous ovulatory cycles (P less than 0.001). We conclude that in patients with luteal insufficiency a high incidence is found of a failure of the follicle to rupture. The entrapment of the oocyte in the unruptured follicle constitutes an important cause of infertility in these patients. PMID- 3665113 TI - Somatomedin-C levels in treated and untreated patients with acromegaly. AB - With the aid of a recently developed commercially available radioimmunoassay for Somatomedin-C (Sm-C) we measured the Sm-C levels in 38 controls, 24 untreated acromegalics, 45 inactive acromegalics and five pituitary dwarfs. With the exception of the dwarfs, the age and sex distributions for the various groups were similar. In inactive acromegalics the basal GH level (calculated as the mean of four blood samples taken during the day) was less than 5 mU/l; it was depressed to, or less than, 2.5 mU/l during the 100 g oral glucose tolerance test. The mean Sm-C level found for control subjects was 20.4 +/- 5.1 nmol/l and for untreated patients 85.6 +/- 25.7 nmol/l (mean +/- SD, P less than 0.001). The mean Sm-C level for inactive patients who had undergone surgery and invariably showed a normalized paradoxical reaction to TRH was 18.2 +/- 7.1 nmol/l (NS) vs 16.1 +/- 8.2 nmol/l (NS) for those who underwent surgery plus postoperative pituitary radiation therapy. Only one out of 45 inactive acromegalics exhibited an increased Sm-C level. The Sm-C levels correlated significantly not only with the log GH levels (r = 0.82) but also with the fasting insulin/glucose ratio the integrated incremental insulin levels, the maximal insulin increase and the integrated glucose levels during the oral glucose tolerance test as well as the 24-h urinary excretion of calcium and hydroxyproline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665114 TI - Relationship between human prostatic epithelial cell protein synthesis and tissue dihydrotestosterone level. AB - To evaluate the role of small amounts of prostatic tissue dihydrotestosterone (DHT) as a stimulus to epithelial cell protein synthesis, we studied tissue from 27 patients given various androgen-blocking drugs for 1 week before transurethral resection of the prostate (TURP) and measured epithelial protein synthesis and DHT levels in the tissue specimens. Test drugs before TURP included megestrol acetate 160 mg per day, with and without Tamoxifen 40 mg per day, or ketoconazole 1200 mg per day. The tissue was processed immediately and epithelial cells separated by digestion of tissue with 0.5% collagenase. After separation, epithelial cells were labelled with either 3H-leucine or L-35S-methionine. The DHT level was measured in whole prostatic tissue. Megestrol acetate alone and with tamoxifen significantly decreased both the incorporation of 3H-leucine into protein and the tissue concentration of DHT; megestrol acetate plus ketoconazole significantly decreased L-35S-methionine incorporation into protein and the DHT level. When the data correlating DHT with protein synthesis using both labelling techniques were combined, the curves were parallel and a strong correlation was noted between DHT and protein synthesis over a wide range of values (P less than 0.001). These results suggest that in hormone-dependent prostatic cancer even small amounts of prostatic DHT such as may occur from adrenal androgens following castration may significantly stimulate protein synthesis of the tumour epithelial cells. PMID- 3665115 TI - Normal growth and pubertal development during bromocriptine treatment for a prolactin-secreting pituitary macroadenoma. AB - An 11-year-old male presented with a 2-year history of headache and lethargy. Serum PRL was elevated at 14,000 mU/l and computerized tomography showed a pituitary macroadenoma. Visual fields and fundi were normal and the testes showed early pubertal changes. There was normal responsiveness of serum cortisol but absence of GH response to hypoglycaemia. After bromocriptine therapy for 4 months serum PRL had fallen to 90 mU/l and the tumour was not visible on repeat computerized tomography. After 7 months treatment, repeat pituitary function testing showed restoration of GH response to hypoglycaemia. Treatment with bromocriptine was continued and there was spontaneous progression of normal puberty; the serum testosterone continued to rise, and height maintained the 50th centile. Bromocriptine therapy should be considered as initial therapy in the management of prolactinomas in prepubertal patients. PMID- 3665116 TI - Amenorrhoea in cystic fibrosis. AB - Menstrual history in relation to nutritional status and lung function was assessed in 45 adolescent and adult patients with cystic fibrosis (CF). Twenty patients had regular menstrual cycles (of whom six had been pregnant), 12 had primary or secondary amenorrhoea, 11 had irregular cycles and two were premenarcheal. Patients with regular menstruation had a significantly higher body mass index and percentage body fat (estimated from skinfold thickness measurements) than those with amenorrhoea (P less than 0.001), and also better lung function (P less than 0.01). A linear discriminant analysis indicated that of the four indices studied percentage body fat was the most important predictor of menstrual function. Ovarian and uterine morphology were studied by ultrasonography in 28 patients and 17 healthy controls. In 10 patients multicystic ovaries were noted. Even in patients with regular cycles uterine size was reduced (P less than 0.01) and in those with amenorrhoea appeared to be related to thinness. Amenorrhoea in CF is an appropriate adaptive response in preventing pregnancy, but the resultant oestrogen deficiency and psychological effects must be considered. PMID- 3665117 TI - Amiodarone iodine-induced hypothyroidism: risk factors and follow-up in 28 cases. AB - Amiodarone, an iodine-rich drug widely used for the treatment of cardiac tachyarrhythmias, may induce either hyperthyroidism or hypothyroidism. Of 467 patients chronically treated with this drug referred to our institution, amiodarone iodine-induced hypothyroidism (AIIH) developed in 28 patients (6%). AIIH patients were subdivided into two groups according to the presence (group A) or absence (group B) of underlying thyroid abnormalities. Thyroid autoantibodies were present in 10 of 19 patients from group A and 0 of 9 patients from group B. The thyroid 24-h radioiodine uptake (RAIU) was evaluated in 15 patients: low values (less than 4%) were found in three patients and detectable values (7-50%) were observed in 12. Perchlorate discharge tests were positive in all four patients tested. Follow-up data were available in 20 patients (16 in group A and four in group B). Hypothyroidism was transient in 12 (60%) and persistent for several months after amiodarone withdrawal in eight (40%). While all patients in group B had transient hypothyroidism, 50% of patients with underlying thyroid abnormalities (group A) had persistent hypothyroidism. Thyroid autoantibodies were found in seven of eight patients with persistent hypothyroidism and in only three of 12 patients with transient hypothyroidism. Conversely, seven of 10 patients with positive thyroid autoantibodies had persistent hypothyroidism and 9 of 10 patients with undetectable thyroid autoantibodies had transient hypothyroidism. These data indicate that: (i) AIIH may develop in patients with or without underlying thyroid abnormalities; (ii) RAIU is inappropriately elevated in many patients with AIIH; (iii) intrathyroidal iodine is not organified; (iv) serum thyroid autoantibodies represent a risk factor for the development of AIIH; (v) AIIH spontaneously remits after amiodarone withdrawal in patients without thyroid abnormalities, but may persist in patients with concomitant thyroid disorders, especially those with circulating thyroid autoantibodies. PMID- 3665118 TI - Factors in the outcome of transsphenoidal surgery for prolactinoma and non functioning pituitary tumour, including pre-operative bromocriptine therapy. AB - Radical transsphenoidal surgery in 58 patients with large non-functioning pituitary tumours relieved pressure symptoms and disconnection hyperprolactinaemia without loss of pituitary function, and verified the diagnosis. Pre-operative bromocriptine did not cause any shrinkage of non functioning tumours (n = 8), even up to 48 weeks. Thirty-two patients not given postoperative radiotherapy are being followed-up, and although two show minor CT scan evidence of tumour regrowth, for the others the delay in radiotherapy is enabling reproduction where required. In 20 patients with non-invasive macroprolactinomas radical surgery caused no loss of pituitary function but cured eight, of whom one has relapsed; none of eight invasive prolactinomas was cured by surgery. Pre-operative bromocriptine caused marked size reduction in seven of seven macroprolactinomas, but if continued beyond 6 weeks induced tumour fibrosis and uneven shrinkage which made surgery dangerous and unproductive. Selective transsphenoidal surgery relieved hyperprolactinaemia in 70% of patients with meso (n = 15) or microprolactinoma (n = 24) usually without loss of pituitary function: the relapse rate was 1 per 88 patient years of follow-up. Invasive prolactinomas, and macroprolactinomas showing uneven shrinkage with a short (up to 4 weeks) course of bromocriptine should have radiotherapy rather than surgery, while the patients most suited to surgery are those with mesoprolactinomas, or some macroprolactinomas with compact intrasellar shrinkage after short-term bromocriptine. Microprolactinomas generally did not benefit from surgery as compared to conservative therapy. In none of the tumour groups were the surgical findings an accurate predictor of postoperative pituitary function. PMID- 3665119 TI - Lack of vegetative and endocrine circadian rhythms in fatal familial thalamic degeneration. AB - A total lack of neuroendocrine and vegetative circadian rhythms was observed in a patient with a familial degeneration of the anterior and dorso-medial thalamic nuclei. Our findings support the role of the thalamus in regulating the periodicity of endocrine and vegetative functions. PMID- 3665120 TI - The distribution of oestradiol in plasma in relation to uterine cross-sectional area in women with polycystic or multifollicular ovaries. AB - The uterine cross-sectional area (UXA) of women with polycystic (PCO) or multifollicular ovaries (MFO) is significantly larger and smaller, respectively, than those of normal women during the early-mid-follicular phase of the menstrual cycle. In the present study the distribution of oestradiol in plasma from normal women and women with PCO or MFO was measured to determine if differences in the available fractions of oestradiol could account for the differences in UXA of women with PCO or MFO. No differences in plasma levels of oestradiol were detected and the concentrations of oestradiol present in a free state or bound to albumin were similar in normal women and women with PCO or MFO. The concentration of oestrone was significantly higher in plasma from women with PCO (516 +/- 120 pmol/l, mean +/- SD) than in plasma from women with MFO (389 +/- 91 pmol/l) or normal women (376 +/- 89 pmol/l). Differences in UXA for women with PCO or MFO as compared with normal women cannot therefore be attributed to differences in available oestradiol concentrations. It is possible that abnormalities in oestrogen metabolism within uterine or other tissues may account for the UXA of women with PCO or MFO. Increased plasma oestrone levels in women with PCO may provide more substrate for conversion to oestradiol within the uterus whilst the smaller UXA of women with MFO may reflect both lack of normal cyclical increases of oestradiol and formation of biologically inactive oestradiol metabolites. PMID- 3665122 TI - Visual field improvement induced by bromocriptine treatment. PMID- 3665121 TI - Role of gonadal steroids in the serotoninergic control of prolactin secretion in men. AB - The physiological regulation of PRL secretion seems to involve the central serotonin system, since plasma PRL levels are enhanced by serotoninergic agonists and serotonin re-uptake blockers. The aim of this study was to evaluate whether the influence of oestrogens on PRL is mediated by the hypothalamic serotonin system. The PRL response to fenfluramine, a serotonin agonist that releases the amine and inhibits its re-uptake, was assessed in 10 normal men (aged 18-25 years) and in six castrated men (aged 18-24 years). In both groups, the effect of fenfluramine on PRL secretion was also evaluated on the sixth day after receiving clomiphene citrate, an oestrogen antagonist and partial agonist. In castrated men, fenfluramine administration was also performed on the seventh day after the last dose of testosterone enanthate (200 mg i.m. every 3 weeks for 4 months). Our results demonstrate that in normal men fenfluramine treatment significantly enhances plasma PRL levels, and clomiphene citrate treatment significantly reduces this effect. In castrated men, fenfluramine is also able to enhance PRL secretion but to a lesser extent; after clomiphene citrate treatment the increase of plasma PRL levels induced by fenfluramine rises to the normal range. We therefore suggest that in man oestrogens and aromatizable androgens influence PRL secretion at least in part by involving the activation of the hypothalamic serotonin system. PMID- 3665123 TI - Remission of hypoparathyroidism during lactation: evidence for a physiological role for prolactin in the regulation of vitamin D metabolism. AB - We studied a young woman with surgical hypoparathyroidism who, on her usual maintenance dose of calcitriol, developed hypercalcaemia 9 d postpartum when lactation was established. Serum values of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) values were very high (127 pg/ml). The patient remained without exogenous calcitriol treatment for 40 d, during which time serum 1,25(OH)2D3 levels remained within the normal range and serum calcium fell with a half-time of 27 d. The requirements for calcitriol increased to antepartum levels when lactation had ceased. There was a close negative correlation between requirements for calcitriol and serum PRL values. After weaning, an episode of hypercalcaemia was induced by increasing the dose of calcitriol. On stopping calcitriol the serum 1,25(OH)2D3 fell to low values (4 pg/ml) within 2 d and serum calcium fell with a half-time of 3 d, necessitating the early reintroduction of calcitriol. We conclude that in hypoparathyroidism exogenous vitamin D requirements fall during lactation because of enhanced endogenous production of 1,25(OH)2D3. The lactation associated increase in circulating 1,25(OH)2D3 concentrations thus results from a parathyroid hormone-independent mechanism, possibly by an effect of PRL on the 1 alpha-hydroxylase. PMID- 3665124 TI - False localization of an aldosteronoma by dexamethasone-suppressed adrenal scintigraphy. AB - A patient with primary aldosteronism had bilateral adrenal tumours on computed tomography. Selenocholesterol scintigraphy showed uptake by the larger right adrenal gland and a tumour in the gland was also visualized by venography. In contrast, measurements of aldosterone concentrations in adrenal venous blood lateralized to the left side. At surgery the left adrenal gland contained an aldosteronoma and the right adrenal gland a large non-functioning adenoma. Thus, selenocholesterol scintigraphy incorrectly localized the functioning adrenal tumour. PMID- 3665125 TI - Familial hypocalciuric hypercalcaemia. III: Bone mineral metabolism. AB - Bone mineral metabolism was studied in 10 subjects with familial hypocalciuric hypercalcaemia (FHH) and 10 age-, sex- and surface area matched healthy controls. Bone turnover was estimated by urinary calcium and hydroxyproline excretions relative to creatinine (Ca/Creat and OHPr/Creat, respectively), serum bone Gla protein (S-BGP) and serum alkaline phosphatase (S-ALP). Bone status was evaluated by measurement of bone mineral content (BMC) on both forearms and X-ray examinations of the hands. Ca/Creat and OHPr/Creat (indices of bone resorption) were both significantly higher in the FHH group than in the controls. S-BGP and S ALP (indices of bone formation) tended towards a higher level in the FHH subjects, but the differences were not significant. The BMC values were similar in the two study groups and did not change with time. We conclude that these patients with FHH might have a bone turnover higher than normal, and that the increased bone resorption must be paralleled by an increased bone formation. PMID- 3665126 TI - Circulating TSH levels measured with an immunochemiluminometric assay in patients taking drugs interfering with biochemical thyroid status. AB - Serum TSH was measured using a high sensitivity immunochemiluminometric assay (ICMA) in patients receiving anticonvulsant drugs, heparin or non-steroidal anti inflammatory agents (NSAIs) and the results compared with those from groups of age- and sex-matched controls. The TSH results have also been compared with those of estimates of free thyroid hormone levels using Amerlex analogue method reagents. All patients were clinically euthyroid and TSH concentrations were in the normal, euthyroid range and did not differ significantly in any group studied. In contrast, Amerlex free T4 levels were significantly reduced in the patients treated with phenytoin (P less than 0.001), carbamazepine (P less than 0.01), sodium valproate (P less than 0.01) and heparin (P less than 0.001). Patients treated with NSAI agents showed no significant change in free T4 levels. Amerlex free T3 levels were also significantly reduced in the patients treated with phenytoin (P less than 0.005), carbamazepine (P less than 0.005) and heparin (P less than 0.001) but not in those treated with sodium valproate or NSAIs. These data support the view that measurement of circulating TSH with an assay of sufficient precision in the relevant range provides a reliable way of assessing thyroid status and could be used to exclude hyperthyroidism in patients taking the medications investigated in this study. PMID- 3665127 TI - The impact of long-term therapy by a multidisciplinary team on the education, occupation and marital status of growth hormone deficient patients after termination of therapy. AB - Forty-two GH deficient patients (14 isolated GH deficiency (IGHD), 28 multiple pituitary hormone deficiencies (MPHD), 23 males and 19 females) were evaluated after termination of hGH therapy and achievement of final height. IGHD patients were found to score higher in intelligence quotients (IQ) than the MPHD patients. The educational and occupational achievements of all patients positively correlated with their IQ level. Three patients achieved only elementary education, 26 completed high school and 13 had higher education. Thirty patients who had completed their education were employed, whereas 12 continued to study. Seventeen of the male patients and five females served in the Army. Eight patients were married and half of the single patients reported having a stable relationship with the opposite sex. The hypopituitary patients did not differ in five out of seven subscales of the human services rehabilitation scale when compared to a normal control group. These results which vary from those previously reported demonstrate the importance of long-term psychosocial counselling initiated at the time of diagnosis as part of the therapeutic approach in hypopituitary patients. PMID- 3665128 TI - The effect of glucocorticoids on corticosteroid binding globulin. AB - To evaluate the effect of glucocorticoids on corticosteroid binding globulin (CBG), we measured the binding capacity and binding affinity of cortisol for CBG in normal subjects, patients receiving glucocorticoids and patients with Cushing's syndrome. Normal subjects had a mean binding capacity of 3.8 (+/- SD 0.7) X 10(-7) mol/l and mean binding affinity of 1.96 +/- 0.48 X 10(-8) M. Patients with Cushing's syndrome had a 40% decrease in binding capacity (2.3 +/- 0.4 X 10(-7) mol/l) compared to control subjects and significantly lower mean binding capacity than patients receiving pharmacological (2.9 +/- 0.6 X 10(-7) mol/l) and physiological doses of glucocorticoids (3.4 +/- 0.6 X 10(-7) mol/l) (P = 0.05 one-way analysis of variance). Patients with endogenous cortisol excess also had significantly lower mean binding affinity (1.54 +/- 0.37 X 10(-8) M) than normal subjects and glucocorticoid treated subjects. These changes suggest that both endogenous and exogenous glucocorticoids can modulate circulating levels of CBG and may have important implications for patients receiving steroid therapy. PMID- 3665130 TI - Cushing's syndrome in pregnancy: the timing of definitive treatment. AB - Cushing's syndrome in pregnancy is rare but associated with a high fetal loss rate, premature labour and excessive maternal morbidity. There has been controversy regarding the safety and efficacy of surgical treatment during pregnancy. We describe two further cases, both due to adrenal adenomas, in whom the diagnosis was made at 28 and 31 weeks gestation. Both cases suffered from severe myopathy. The first case was not treated during pregnancy and developed wound and urinary infections after caesarean section and subsequent adrenalectomy. An incisional hernia in the caesarean section scar has been repaired twice. The second had an adrenalectomy when 29 weeks pregnant with rapid resolution of the features of Cushing's syndrome, particularly the myopathy, and had an uneventful vaginal delivery. The second case, and a review of those previously described, indicates that surgical treatment during pregnancy is safe and significantly reduces fetal losses, premature labour and maternal morbidity. PMID- 3665129 TI - Growth hormone blocking antibodies in a patient with deletion of the GH-N gene. AB - We present another patient with the rare disorder of isolated GH deficiency (IGHD) type 1A. The diagnosis was confirmed by the clinical course, serology and genetic structure. Analysis of the post GH treatment serum of this patient with several thoroughly characterized monoclonal antibodies against GH established the presence of polyclonal, high titre and high avidity IgG-class antibodies against GH. These had the ability to neutralize GH as they could inhibit the binding of radiolabelled GH to GH-receptors on IM9 lymphoblastoid cells. DNA restriction mapping indicated a deletion of the GH-N gene and a family DNA pattern that was consistent with the proposed autosomal recessive aetiology of this disorder. These findings explain the inability of this patient to synthesize GH and his total immunological intolerance to GH replacement therapy. PMID- 3665132 TI - Disturbances of the menstrual cycle in bulimia nervosa. AB - Blood was obtained three times a week throughout one menstrual cycle or during a 6-week period from 15 patients with bulimia nervosa and from 10 healthy age matched controls. Of the patients, three had amenorrhoea, eight had oligomenorrhoea and four had regular cycles. Normal follicular development, as judged from continuously low oestradiol (E2) values (less than 120 pg/ml or less than 440 pmol/l), did not occur in seven patients. Compared to patients with increasing E2 values (greater than 120 pg/ml), these seven had a significantly lower body weight. Among the eight patients showing follicular development (E2 greater than 120 pg/ml), four reported regular cycles, but only three developed normal plasma progesterone (P4) values during the luteal phase (P4 greater than 3 ng/ml or greater than 9.5 nmol/l). The luteal phase was of normal length in only one bulimic patient. PMID- 3665131 TI - The human leucocyte sodium pump in adrenocortical insufficiency. AB - In view of the known effects of cortisol and related compounds on sodium balance, we examined leucocyte 22Na+ efflux in patients with adrenocortical insufficiency. The ouabain-sensitive 22Na+ efflux rate constant, which reflects sodium pump activity, was lowered in secondary hypoadrenalism (mean 1.95 +/- SD 0.25 vs 2.33 +/- 0.45 h-1, P less than 0.002, n = 6). Patients with hypoadrenalism also had higher intracellular sodium content (mean 34.9 +/- SD 3.5 vs 27.8 +/- 9.5 mmol/kg dry weight, P less than 0.008) and lower intracellular potassium to sodium ratios (mean 9.7 +/- SD 0.7 vs 12.9 +/- 3.6, P less than 0.001). These defects in cellular sodium balance were corrected following replacement therapy with cortisol, prednisolone or dexamethasone. In-vitro incubation of normal leucocytes with 5-20 nmol/l dexamethasone led to an increase in the Na+/K+-ATPase activity. The effect of cortisol and related compounds on the distribution of sodium between intra- and extra-cellular fluid may be mediated by their action on the sodium pump. PMID- 3665133 TI - Lymph node response and its relationship to prognosis in carcinomas of the head and neck. AB - The lymph nodes of 32 patients operated on for carcinomas of the larynx and pharynx, were evaluated for the pattern of lymph node response. Pattern 1 (predominantly lymphocytes) and pattern 2 (predominantly germinal centres) showed a fewer number of nodal metastases than pattern 3 (non-stimulated nodes). Well differentiated carcinomas predominated in patterns 1 and 2, whereas moderately and poorly differentiated predominated in pattern 3. Patterns 1 and 2 predominated in clinical stages I-III, and pattern 3 in stage IV. The survival decreased progressively from pattern 1 to pattern 3. PMID- 3665134 TI - The nasopharynx and adenoid in children with glue ear compared with normal controls. AB - This study was designed to demonstrate whether any differences could be detected in the nasopharyngeal soft tissue size and postnasal space airway in children with glue ear compared with controls. Lateral cephalometric radiographs of 34 children with bilateral glue ear confirmed by paracentesis were compared with those of normal children matched for age and sex. There was no difference in the measurement of adenoid depth between the 2 groups. However, it was found that the palatal airway size was significantly smaller in children with bilateral glue ear than in normal children. Reduction in the palatal airway to 4 mm or less is found in most cases with bilateral glue ear, but only in 15% of normal controls. PMID- 3665135 TI - Adenoid infection: its relationship to otitis media, glue ear and tonsillitis. AB - In a prospective study, 69 children admitted for adenoidectomy were divided into 4 subgroups according to their symptomatology. These were: nasal obstruction alone; glue ear; recurrent ear aches and probable otitis media; and recurrent sore throats and probable tonsillitis. The adenoids removed were bacteriologically analysed to assess both the spectrum of organisms present and the colony counts per gram of adenoid tissue (10(5) organisms per gram was regarded as representing infection). There was no significant difference between the subgroups with regard to either the presence of infection or the spectrum of organisms grown. We conclude that while infection in the adenoid bed must be involved in the pathogenesis of bacterial otitis media, the concentration of organisms present in the adenoids is unimportant and other factors must be responsible for the migration of organisms up the Eustachian tube. PMID- 3665136 TI - Supraglottic laryngectomy: short- and long-term functional results. AB - A supraglottic laryngectomy offers the possibility of resection of a large portion of the larynx leaving the true vocal cords. From 57 supraglottic laryngectomies performed between 1971 and 1984 in the Department of Otolaryngology and Head and Neck Surgery of the University of Nijmegen, the 5- and 10-year actuarial survival rates were 80% and 59%, respectively. The deaths after 5 years were not directly related to the original tumour. The functional results with respect to the voice were excellent. In this study particular attention has been paid to the postoperative results with regard to swallowing and aspiration. More than half of the patients (56%) had occasional complaints of aspiration, especially when taking liquids. It is concluded that supraglottic laryngectomy is an excellent alternative, especially for the treatment of extensive supraglottic tumours without involvement of the true vocal cords. PMID- 3665137 TI - Globus sensation is not due to gastro-oesophageal reflux. AB - Oesophageal manometry and prolonged ambulatory pH monitoring were performed in 47 patients with the globus sensation, 48 control subjects and 28 patients with documented oesophagitis. Globus patients also underwent video-recorded barium examination and rigid endoscopy. Manometry was normal in 38 of the globus group (94%). The mean percentage time below pH 4 was 4.16 in controls, 5.11 in globus patients (NS) and 18.54 in oesophagitis patients (P less than 0.0005). Oesophageal acid exposure did not correlate with sex, smoking or heartburn and correlated with age only in oesophagitis patients (P less than 0.001). Biopsy showed mild laryngitis in 2 globus patients and distal oesophagitis in 6 (13%). Abnormal oesophageal acid exposure and distal oesophageal dysmotility are not aetiological factors in the majority of patients with globus pharyngis. PMID- 3665138 TI - Electrophysiological prognosis in facial paralysis. AB - Electrical prognosis was evaluated in 79 patients with facial paralysis, of spontaneous (n = 43) or post-traumatic origin (n = 36). Three electrophysiological tests were employed jointly: detection, stimulation and stimulodetection. The patients were reviewed at least 1 year later, in order to appreciate the agreement between the electrical prognosis and the clinical outcome (satisfactory or not). Those patients with a favourable prognosis on electrical testing had in the majority of cases a satisfactory outcome. The accuracy of the prognosis was also better in cases of early examination (within 15 days) and partial paralysis. PMID- 3665139 TI - Secretory otitis media in the adult. AB - Middle ear effusion secondary to Eustachian tube obstruction may complicate nasal and nasopharyngeal conditions. It may be the presenting feature of a nasopharyngeal tumour. A series of 94 adult cases of middle ear effusion was reviewed. Examination under anaesthetic of the postnasal space was performed in each case, but did not result in the diagnosis of a tumour in any patient in whom it was not strongly suspected clinically on the basis of non-otologic features. Patients having grommet insertion had better hearing for 9 months postoperatively than those having myringotomy alone. Treatment of coexisting nasal, nasopharyngeal or sinus conditions at the time of grommet insertion did not result in any long-term improvement in hearing levels in comparison with those patients in whom no such aetiological factor was identified. PMID- 3665140 TI - Prognostic parameters in metastatic spread of laryngeal cancer: clinico histopathological correlations. AB - The authors present a series of 130 patients with laryngeal tumours submitted to total or horizontal laryngectomy and to neck dissection. The possible correlations between the staging and histology of the primary lesion, tumour marker (LASA) and the incidence of lymph node metastases are examined. The information provided by clinical and histopathological parameters is no doubt useful, but the margin of clinical error is high. On the contrary, the tumour marker concentration (LASA) was significantly higher in the patients whose lymph nodes were found to be histologically invaded, than in those without metastatic spread. Consequently, the LASA test may assume clinical importance before surgical therapy and in the follow-up of treated patients. PMID- 3665142 TI - Studies on sweating and bacterial ecology in Juvenile Plantar Dermatosis. PMID- 3665141 TI - Juvenile Plantar Dermatosis--atopy or footwear? PMID- 3665143 TI - Characterization and quantification of sweating in a systemic hyperhidrotic patient. PMID- 3665145 TI - Atopic dermatitis--an obvious diagnosis? PMID- 3665144 TI - Dermatitis palmaris sicca--a distinctive pattern of hand dermatitis. PMID- 3665146 TI - Treatment of lichen amyloidosus by etretinate. PMID- 3665147 TI - The skin of the pre-term baby--a visual appraisal. PMID- 3665148 TI - A quantitative analysis of the Langerhans cell in chronic plaque psoriasis. PMID- 3665149 TI - Pigmented contact dermatitis from 'kumkum'. PMID- 3665150 TI - Microcomputer management of chemotherapy for psoriasis. PMID- 3665151 TI - Preliminary results following treatment of vascular lesions of the skin using a continuous wave tunable dye laser which emits at 577 nm. PMID- 3665152 TI - Nicotinate white response of monkey sexual skin--a model for atopic reactivity. PMID- 3665153 TI - Parakeratosis pustulosa. PMID- 3665154 TI - Post-irradiation digitate keratoses. PMID- 3665155 TI - Atypical pemphigus vulgaris associated with angio-follicular lymph node hyperplasia (Castleman's disease). PMID- 3665156 TI - Herpes simplex on nipples inoculated from herpetic gingivostomatitis of a baby. PMID- 3665157 TI - Quinine lichenoid photosensitivity. PMID- 3665158 TI - A case of sarcoid granulomata mimicking superficial thrombophlebitis. PMID- 3665159 TI - Magnetoencephalography: locating the source of P300 via magnetic field recording. AB - A description is given of the theory and instrumentation involved in measuring magnetic fields of the brain. The magnetic counterpart of event-related potentials are capable of locating more accurately the generators of these electrical signals. Preliminary results of the first application of magnetoencephalography in Australia are presented. These localize the generator of the auditory P300 event-related potential component to the temporal cortex. PMID- 3665160 TI - Neoplastic angioendotheliosis. AB - Neoplastic angioendotheliosis is a rare disease in which malignant cells are found within numerous blood vessels throughout the body in the absence of any detectable extravascular primary malignancy. The disorder has a propensity for clinical neurological involvement despite pathological evidence of systemic spread. To date 23 patients with neurological involvement have been described. This report adds a further 3 cases. There was no definite evidence to support the theory that the malignancy arises in endothelial cells; no primary extravascular tumour was found. At present a definite conclusion about the cause of the disease cannot be made. PMID- 3665161 TI - Cryptococcal infections of the central nervous system: a ten year experience. AB - Twenty cases of cryptococcal CNS infection treated at the Alfred and Fairfield Infectious Diseases Hospitals from 1975 to 1985 were reviewed. A predisposing immunological deficit was present in 40% of the cases and nearly half had evidence of pulmonary involvement. Severe headache was an almost universal presenting feature but fever and meningismus were not. Measurement of CSF cryptococcal antigen and CSF culture were far more reliable diagnostic markers than Indian ink smears. Cerebral CT scanning identified abnormalities in nearly 30% of cases, including 2 with cystic lesions and 2 with mass lesions. Combination therapy with amphotericin B and 5-fluorocytosine was used as first line treatment. Ventricular shunts were required for 2 patients with hydrocephalus, and persistently raised intracranial pressure often required frequent lumbar punctures and corticosteroids for control. Mortality was 30% and correlated with the presence of impaired conscious state, hydrocephalus or other neurological deficit, underlying immunodeficiency and low CSF glucose levels. PMID- 3665162 TI - Crossed facilitation and post-contraction depression of abductor pollicis brevis motor neurons. AB - Crossed facilitation of abductor pollicis brevis (APB) motor neurons by voluntary contraction of the contralateral APB was investigated using F response analysis. The integrated F response EMG showed a mean 4-fold increase during contraction. This enhancement was maintained until the onset of subjective fatigue and then declined. After isometric or isotonic contraction of the ipsilateral APB there was a significant depression of F responses with a progressive return to baseline values over a 6 minute period. The significance of the findings is discussed. PMID- 3665163 TI - Evaluation of the first 18 months of a specific rehabilitation programme for those with epilepsy. AB - This survey examined the outcome of the first 18 months of the specialized rehabilitation programme at Mt Wilga Rehabilitation Centre, which was designed to cater for the needs of those with epilepsy. Almost 60% of those who underwent the programme were employed at the time of the study, 65% had improved quality of life, approximately 45% acknowledged enhanced self-esteem, and about 45% had an improved control of epilepsy despite the fact that only 30% had their drug therapy altered and of these more than half had either the same or worse control of their seizures. The findings revealed that those patients who were admitted into the residential accommodation, rather than being provided with transport to allow daily attendance while living in their own homes, achieved greater benefit from the rehabilitative programme. PMID- 3665164 TI - Impairment of consciousness in migraine. AB - A series is reported of 25 subjects with migraine, whose attacks on some occasions involved impairment of consciousness. The disorder did not necessarily involve younger people, or occur early in the course of the malady. PMID- 3665165 TI - Cervical spondylosis and headaches. AB - The incidence of headaches in well documented cases of cervical spondylosis with neurological disability was reviewed. This was compared to that in a series of cases with a clinical diagnosis of tension headache in order to determine if there were any identifiable differences between the two types of headache. Fifty nine cases of cervical spondylosis were reviewed. Five of these patients had headaches. Fifty patients with tension headaches were also reviewed. No differences were seen when location or other qualitative features of the headaches were compared between the two groups of patients. We conclude that the incidence of headache is low in cervical spondylosis and that the pattern of headache has no features that distinguish it from that of tension headache, suggesting that the pathogenesis is similar. We therefore suggest that the basis of headache in patients with cervical spondylosis is secondary muscle contraction. PMID- 3665166 TI - Whiplash headache. AB - This study considers the natural history and characteristics of headache occurring after whiplash injuries. Previous descriptions generally failed to distinguish between the headaches seen at various stages after the injury. In a prospective study of 180 cases of acute whiplash injury, it was demonstrated that 82% suffered from headache. One hundred and twenty-two cases were analysed to describe the type of headache seen and it was shown that in the majority rapid improvement occurred over a matter of some weeks. In a retrospective analysis of over 5000 cases of whiplash injury, about 25% developed chronic disability. Practically all of these had headaches. A retrospective analysis of 100 cases describes a spectrum of headaches different from those seen after the acute illness. The pathogenesis of the two types of headache is likely to be different and this needs to be investigated before rational treatment can be instituted. PMID- 3665167 TI - Diagnostic strategies of fifth year medical students in a neurological case. The importance of the first hypothesis. AB - The problem-solving strategies of fifth year medical students were studied using two simulated cases. One of these cases involved a neurological problem which was unfamiliar to the students. With the use of stimulated recall the study looked at the origin of the first hypothesis. The symptoms given by the patient did not trigger an appropriate hierarchy of questions and the students resorted to problem-solving techniques, such as drawing on commonsense. In some cases they matched symptoms against clinical cases they had seen previously. Recall from lectures was used occasionally. Instead of rational methods of hypothesis generation, they were most likely to be influenced by recent clinical exposures. Students having identical experiences may have had differing perceptions of these exposures. As a result, their early hypothesis formation showed marked individual variation. These findings need to be considered in the light of how students learn and the content of the teaching that is meaningful to them. PMID- 3665168 TI - An analysis of cranial computerized tomography scanning in private neurological practice. AB - A one year prospective study was undertaken to evaluate the usage of the cranial CT scan in private neurological practice. The impetus for the study emanated from a general impression that patterns of referral to neurologists were changing with regard to the nature of the patients' condition and that a large number of patients had already had a cranial CT scan before neurological consultation. A total of 826 cases were reviewed. Sixty (7%) had had a recent cranial CT scan before consultation, and 90% of these cases were referred by the patients' general practitioners. A provisional diagnosis was attempted by the GP in 36% of cases, and 50% of these were correct. Ninety-five per cent of the CT scans were normal. Eighty-three (10%) patients were referred for cranial CT scan after neurological consultation. The neurologists' reasons for CT scanning included investigation of epilepsy (20%) and exclusion of a structural cerebral hemisphere lesion (16%), acoustic neuroma (10%) and other posterior fossa lesions (16%). Ninety-one per cent of these CT scans were normal. In all, 143 (17%) patients underwent cranial CT scanning; of these almost half (42%) had been referred for the CT scan by the general practitioner before neurological consultation. This study contrasts the CT scan referring patterns of general practitioners with that of a neurologist and questions the possible overuse of this facility. PMID- 3665169 TI - Acute encephalopathy following petrol sniffing in two aboriginal patients. AB - Two instances of acute encephalopathy following petrol sniffing in Australian Aboriginals are reported. In one case recovery was incomplete 6 weeks after cessation of exposure to the toxin. PMID- 3665170 TI - Bilateral intracerebral haemorrhage presenting with supranuclear ophthalmoplegia, bradykinesia and rigidity. AB - A 70 year old man recovered from a left putamenal haemorrhage in 1984 with a residual mild right hemiparesis. In 1985 he presented following the sudden onset of inability to stand. The clinical findings of supranuclear ophthalmoplegia, bradykinesia and rigidity resembled those of progressive supranuclear palsy. CT scan revealed a recent haemorrhage deep in the right hemisphere white matter in addition to a low density change in the left basal ganglia reflecting the site of previous haemorrhage. The patient's course was uncomplicated and the ophthalmoplegia resolved. Bradykinesia and rigidity persist. This case illustrates an unusual clinical presentation of bilateral intracerebral haemorrhage with supranuclear ophthalmoplegia, bradykinesia and rigidity. PMID- 3665171 TI - Amnesia following right thalamic haemorrhage. AB - A 52 year old patient with a right thalamic haemorrhage is described. She suffered from anterograde amnesia and memory impairment for both visual and verbal material. At follow-up after 3 months, despite being fully oriented and having good concentration, her memory impairment was still evident. Reassessment 3 years afterwards showed persistent deficits and no further improvement. PMID- 3665172 TI - Ventriculo-peritoneal shunting of acute hydrocephalus in vein of Galen malformation. AB - The case of an adult patient with acute hydrocephalus due to a vein of Galen malformation is reported. Ventricular shunting, apart from relieving the hydrocephalus, also resulted in shrinkage of the malformation and of the visual field defect. The possible mechanisms involved in this phenomenon are discussed. PMID- 3665173 TI - Isolated unilateral hypoglossal nerve palsy due to a chondroid chordoma. AB - A case is described of an isolated unilateral hypoglossal nerve palsy due to a tumour which was removed surgically from the hypoglossal canal. The pathological findings showed the features of a chondroid chordoma. This case is unusual because intracranial causes of isolated unilateral hypoglossal nerve palsies are rare, and because the chondroid chordoma had arisen laterally, either close to or within the hypoglossal canal. PMID- 3665174 TI - Otocerebral mucormycosis--a case report. AB - Mucormycosis is an often fatal infection caused by ubiquitous organisms of the order Mucorales. Infection is most commonly seen in the immunocompromised host, particularly in the setting of diabetic ketoacidosis. The most common presentation is with rhinocerebral involvement. We here report a case of otocerebral mucormycosis occurring in an elderly man with maturity onset diabetes who was not acidotic. The unusual site of infection delayed diagnosis until the pons had been invaded by the infecting organism which was demonstrated as a hypodense area on CT scan. Consequently radical excision of infected tissue was not feasible and the patient died. At post-mortem examination there was extensive infection and infarction of the parotid gland, inner ear and pons associated with arterial invasion by the fungus and septic cavernous sinus thrombosis. The case is described to demonstrate the existence of other modes of neurological presentation of mucormycosis apart from the well recognized rhinocerebral form. Early diagnosis is the key to successful therapy. PMID- 3665175 TI - Unusual paraspinal muscle lesions in ankylosing spondylitis. AB - Minicore, multicore, core-targetoid and other ultrastructural lesions were found in the paraspinal muscles of patients with AS. The 10 patients studied, all men with AS, showed varying degrees of muscle fibre atrophy, Z band streaming, rod body formation, minicores, multicores and core-targetoid fibres. Central core disease, rod body myopathy, minicore and multicore diseases are recognized clinical entities within the congenital group of structural myopathies. Target fibres are believed to be a feature of reinnervation. It is also known that experimental tenotomy causes core-targetoid changes, rod bodies, minicores and multicores. Therefore, it seems possible that tension is a necessary stimulus for the correct programming of synthetic muscle enzymes, and without this disorganization occurs. It may also be assumed, but in this case for genetic reasons, that similar biochemical systems are disturbed in the group of congenital myopathies. PMID- 3665176 TI - Lumboperitoneal shunting as a cause of visual loss in benign intracranial hypertension. AB - The causes of visual loss in benign intracranial hypertension are related to long standing papilloedema, ischaemic optic neuropathy or haemorrhage into a subretinal neovascular membrane. Decompression procedures generally preserve or improve visual acuity but surgical treatment with subtemporal decompression may lead to visual impairment. Such a deficit has been recorded in the past as occurring with ventriculography. Postulated mechanisms have included brain herniation, spasm of vessels supplying the visual cortices or retinal vascular disturbance. To our knowledge treatment with lumboperitoneal shunting has not previously been reported as leading to further significant visual loss in this condition. This report describes such an occurrence in a patient. Retinal vascular disturbance is postulated on the basis of several normal CT scans, normal CSF pressure measured after surgery and visual evoked responses suggesting retinal or optic nerve damage. PMID- 3665177 TI - The pyriformis syndrome: review and case presentation. AB - The pyriformis syndrome is a rare entrapment neuropathy in which the sciatic nerve is compromised by the pyriformis muscle or other local structures. It usually presents with sciatic pain and hypoaesthesia and a limp caused by weakness of the gluteus maximus muscle. Peroneal nerve innervated muscles and hamstrings are also usually affected. The diagnosis relies on the clinical presentation and the EMG findings. Other causes of symptoms should be excluded by careful examination, detailed x-ray studies of the lumbosacral spine (including myelogram), sacro-iliac and hip joints. A case of this syndrome occurring in a previously healthy 42 year old woman and her follow-up investigations are reported. PMID- 3665178 TI - Clonic perseveration. AB - Two patients are described in whom clonic perseveration was observed following infarction of the midbrain and thalamus. In one patient perseveration was confined to movements of one side of the body and was associated with a grasp reflex on the same side. In the other patient perseveration occurred in movements of both sides of the body and involved drawing, writing and speech. It was possible to induce clonic perseveration in both patients by passive limb movements, a feature of this condition which has not been described previously. Evidence is presented that this type of perseveration is, to some extent, under voluntary control. It is suggested that the role of psychological factors in perseveration has been underestimated in the past. PMID- 3665179 TI - The basis for aspirin dosage in stroke prevention. AB - Many strokes are thought to develop as a consequence of platelet aggregation on areas of arterial endothelial damage, with subsequent embolism or thrombus formation. Aspirin prevents platelet adhesion and aggregation by inhibiting the formation of thromboxane A2 by platelets. This suggests that aspirin could be used to prevent stroke. However aspirin also inhibits endothelial formation of the anti-aggregatory substance prostacyclin, though probably only in a slightly higher dose than that just capable of inhibiting platelet aggregation. Consequently, too high an aspirin dose may defeat its purpose. The effect of aspirin on platelets lasts for as long as they survive, whereas the effects of aspirin on endothelium are shorter. Theoretical considerations suggest that aspirin, given in brief pulses just to reach platelet inhibitory concentrations in plasma, and administered at the maximum interval that will maintain inhibition of platelet aggregation, should offer the most favourable balance between altered platelet and altered endothelial function from the viewpoint of stroke prevention. Data are presented showing that rapid rather than slow or delayed release aspirin preparations are necessary to achieve suitable plasma aspirin concentration-time profiles in humans, and that a peak plasma aspirin concentration of around 1.2 mg/L is necessary in vivo to inhibit aggregability of previously untreated platelets. PMID- 3665180 TI - Cerebral infarction due to presumed haemodynamic factors in ambulant hypertensive patients. AB - The role of haemodynamic factors in the pathogenesis of cerebral infarction is unclear. Watershed or distal field infarction is most often caused by haemodynamic mechanisms. Watershed cerebral infarcts can now be identified in stroke survivors using CT scanning. The clinical findings are presented of 14 patients with cerebral infarction in whom haemodynamic factors contributed to the stroke. Evidence for this diagnosis includes (i) a history of posture-related or exercise-induced syncopal attacks or neurological deficits before and in some cases after the stroke, (ii) the demonstration of watershed or distal field infarction on CT scan, (iii) commencement of symptoms after increase in antihypertensive medications, and (iv) improvement following reduction of treatment. Regional cerebral hypoperfusion may be a more common cause of cerebral infarction than is generally thought. Particular care should be exercised when potent antihypertensive medication is prescribed for elderly hypertensive patients. PMID- 3665181 TI - Subcortical arteriosclerotic encephalopathy: Binswanger's disease. AB - Binswanger, in his 1894 dissertation on the differential diagnosis of general paresis of the insane, described a slowly progressive dementia associated with macroscopic loss of white matter. In recent years interest in Binswanger's disease was rekindled with CT demonstration of extensive white matter low densities in some patients. To define the clinical spectrum, we reviewed 22 consecutive cases in which the CT appearances suggested a diagnosis of Binswanger's disease. Two patients had focal neurological deficits at presentation, but recent anoxic or hypoglycaemic insults could not be excluded as the cause of the CT abnormalities. The 20 remaining patients were demented and showed variable combinations of corticobulbar dysfunction and gait dyspraxia. The duration of symptoms ranged from a few months to several years. Sixty per cent of this group gave a history of discrete stroke events and focal cortical and/or lacunar infarcts were a frequent CT finding. Binswanger's disease is probably due to chronic or acute-on-chronic white matter ischaemia. The association with lacunar and cortical infarctions suggests that a combination of large and small vessel disease produces diffuse ischaemia maximal in white matter watershed zones. Binswanger's disease is clinically differentiated from multi-infarct dementia by its time course. PMID- 3665182 TI - Cranial CT scan appearances that correlate with patient outcome in acute stroke. AB - Certain clinical features are known to correlate with patient outcome in acute stroke, but the potential of cranial CT scan as an aid to predicting recovery after stroke remains unclear. In a prospective study, 178 acute stroke patients admitted to Royal Perth Hospital were assessed by 4 neurologists; 150 cranial CT scans were performed and these were reviewed by an independent radiologist. CT lesion characteristics were cross-tabulated against clinical indices of patient outcome. Lesions greater than 50 cm3 in volume were associated with a 23% mortality compared to a 5% mortality for lesions smaller than 50 cm3. The mortality rate from intracerebral haemorrhage was 25% compared to 9% for other disease. Of patients whose CT scan showed a mass effect, 35% had an altered mental state at discharge compared to only 2% of those without a mass effect. Of the patients with deep white matter lesions, 35% had an altered mental state at discharge compared to only 13% of patients with lesions in other sites, and only 50% were discharged home compared to 77% of patients with lesions in other sites. CT scan features that correlated significantly with a poor outcome following acute stroke were large lesion size, intracerebral haemorrhage, mass effect and deep white matter lesions. PMID- 3665183 TI - Electrically evoked skin vasodilatation: a quantitative test of nociceptor function in man. AB - Direct stimulation of intact forearm skin affects adjacent microvascular blood flux. Pulses of current, known to activate C-fibres effectively, were applied over a period of 1-16 seconds at 2 Hz using transcutaneous stimulation. An increase of up to 50% was observed in skin microvascular blood flux. Increased blood flux correlated well with increasingly painful sensations. Some subjects responded to one or two pulses at 2 Hz, 0.5 ms in duration and 150 volts. A response onset latency of 4-15 s, lasting up to 5 minutes, was recorded. At higher frequencies (4-8 Hz) and more pulses (16-32) vasoconstriction was frequently observed before the usual flux increase. After administration of local anaesthesia (2% ligocaine) the resting skin blood flux increased, but electrical stimulation still produced vasodilatation. The local cutaneous flare response to electrical stimulation was abolished or greatly reduced by capsaicin pretreatment. Excitation of small intracutanous forearm nerve C-fibres produces increased microvascular blood flux which is dependent on local release of vasodilator substances. Thus the neurogenic flare (axon reflex) may have a physiological role in regulating skin blood flow, and nociceptor function may be measured by applying the aforementioned transcutaneous electrical stimulation. PMID- 3665184 TI - Characterization of anti-liver kidney microsomal antibody in childhood autoimmune chronic active hepatitis: evidence for IgG1 subclass restriction, polyclonality and non cross-reactivity with hepatocyte surface antigens. AB - An indirect immunofluorescence technique was used to investigate the immunoglobulin class, IgG subclass, light chain type and complement fixing ability of anti-liver kidney microsomal antibody (anti-LKM) in the sera of six children and five adults with autoimmune chronic active hepatitis (aCAH). Anti LKM titres ranged from 1/80 to 1/20,480. In the children, the antibody belonged to the IgG1 subclass alone (titre 1/80-1/20,480) and was able to fix complement (titre 1/40-1/5120). In the adult group, antibody belonged to the IgG1 subclass in three cases (titre 1/40-1/640) whilst two belonged to both IgG1 (titre 1/640) and IgG4 (titre 1/40, 1/640). Such subclass restriction is similar to that found in other autoimmune disorders and may be genetically determined. Investigation of the light chain constituent of anti-LKM revealed that the kappa to lambda ratio was consistent with a polyclonal antibody response. To investigate the nature of the antigen to which anti-LKM is directed, the ability of these sera to bind to the surface membrane of isolated human hepatoma cells (Alexander cells) was investigated. Four of the eleven sera showed significant binding activity. Prior incubation of these four sera with Alexander cells abolished their membrane binding activity, but did not alter the anti-LKM titre. These results suggest that anti-LKM binds to cytoplasmic constituents alone and does not cross-react with surface antigens. PMID- 3665185 TI - Coxsackievirus induced myocarditis in mice: cardiac myosin autoantibodies do not cross-react with the virus. AB - After infection with Coxsackievirus B3 (CB3), H-2 congenic strains of mice on an A-background develop an immunologically mediated myocarditis associated with autoantibodies directed mainly against cardiac myosin. We tested these autoantibodies for cross-reactivity with the virus. Using immunoblotting and virus neutralizing assays with affinity purified antibodies and absorbed sera, we found that the autoantibodies to heart myosin did not cross react with CB3. In addition, myosin autoantibodies induced by immunization with cardiac myosin did not react with the virus. Western immunoblotting revealed that the anti-CB3 antibodies in the infected mice are directed against the capsid protein VP 2. We conclude that CB3 antigens do not stimulate an immune response that cross-reacts with cardiac myosin. PMID- 3665187 TI - IgG subclasses of specific antibodies in Ixodes ricinus-borne borreliosis. AB - Ixodes ricinus-borne borreliosis may run a protracted course. In this study we investigated the different IgG subclasses of antibodies to borreliae at different stages of the disease. In addition to the dominant subclass IgG1 and IgG3 response was found in most cases. This antibody subclass pattern with contributions of IgG2 often persists into the late stage of the disease and may last for decades. The IgG subclass response elicited by this spirochaetosis does not conform to the expected IgG4 restricted response after chronic antigenic stimulation. PMID- 3665186 TI - The method of preparation of an antigen may influence the cellular reaction to it in skin tests for delayed hypersensitivity: comparison between responses to two different reagents prepared from Mycobacterium tuberculosis. AB - Antigen preparations extracted from Mycobacterium tuberculosis by different procedures--PPD and 'New tuberculin'--were compared with respect to the cytology of the Type IV reaction they elicit in the dermis. The numbers and microanatomical localization of cells of the major lymphocyte and monocyte subsets were measured histometrically in immunocytochemically-stained sections of biopsies of the 48 h reactions. Despite the close similarity in size of the external appearance of the reactions provoked by the two preparations, 'New tuberculin' elicited a more extensive perivascular infiltrate and more numerous diffusely infiltrating M3-bearing cells: the number of diffusely infiltrating CD4 and CD8 lymphocytes was similar in reactions against the two antigen preparations. Thus the method used to prepare a skin test reagent may affect the nature of the cellular reaction it provokes: differences in content of various classes of antigenic macromolecules are probably important, but the relative content of other irritant constituents may also be important. PMID- 3665188 TI - Normal natural killer cell activity in Hodgkin's disease patients in remission. AB - Patients with untreated active Hodgkin's disease (HD) have a defect in cell mediated immunity. After therapy many HD patients still have long lasting abnormalities in T cell number and function. We examined whether NK activity is also permanently impaired in HD patients in remission. The mean NK activity of peripheral blood lymphocytes from 42 patients who were disease-free for 6-150 months was not different from that of healthy controls. Augmentation of NK activity after treatment of the cells by interferon in vitro was equal for patients and controls. Normal NK activity in HD in remission was independent of disease stage, age, remission duration and mode of therapy. Measuring PHA-induced lymphocyte proliferation and NK activity simultaneously demonstrates that patients with impaired cell-mediated immunity do not have concomitant reduction of NK activity. We conclude that NK activity in HD in remission is independent of decreased T cell mediated immunity. In addition, NK is resistant to long term suppression by the chemotherapy and radiation protocols that are used in HD. PMID- 3665189 TI - Difference in the placental ferritin levels measured by a specific monoclonal antibody enzymoassay in preterm and term delivery. AB - The use of a new monoclonal antibody (MoAb) enzymoassay for the specific measurement of placental ferritin (PLF) enabled it to be quantitatively determined in the sera of pregnant women, women at full-term and preterm delivery, and in their newborns. High levels of PLF were measured in the sera of pregnant women at 17 weeks of gestation up to full-term delivery as compared with normal adult women who mostly lack PLF. The level of PLF in the serum was irrespective of the total ferritin level. In full-term newborns, PLF concentration was lower than that found in their mothers although it increased compared to healthy adults. It was further found that in the blood of women who delivered at 29-36 weeks, PLF was undetected or was very low. Accordingly their preterm infants also exhibited very low or undetectable PLF in their serum. These results suggest the possible use of PLF as a prognostic indicator in pregnancy. PMID- 3665190 TI - Controlled study of the effects of dietary protein on blood pressure in normotensive humans. AB - 1. The object of this study was to determine whether meat protein per se is responsible for the higher blood pressures (BP) in omnivores compared with vegetarians. 2. Assessments were made by a double blind randomized control trial in 64 normotensive volunteers recruited from Royal Perth Hospital staff. 3. All volunteers were given a 'meat' substitute during the 2 week control period. Randomization was then introduced into two dietary groups: the first remained on the 'meat' substitute, and the other received a 'non-meat' substitute of vegetable protein, for the remaining 12 weeks of the trial. 4. The content of 'meat' and 'non-meat' substitute was designed quantitatively and qualitatively to represent the protein intake in recently studied diets of Australian omnivores and ovo-lacto vegetarians, respectively. The levels of fats (saturated and unsaturated), fibre, energy, Na+, K+, Mg2+, Ca2+ and carbohydrate in the intervention diets were similar. 5. These dietary changes were not associated with any significant changes in BP. Significantly lower urinary 3-methyl histidine excretions in volunteers receiving 'non-meat' supplements compared with the 'meat' eaters confirmed the dietary changes. 6. It was concluded that BP differences between omnivores and accultured vegetarians are unlikely to be due to differences in protein intake. PMID- 3665191 TI - Effect of graded low-dose noradrenaline infusions on noradrenaline clearance in normals and essential hypertensives. AB - 1. In normal subjects and essential hypertensives, plasma noradrenaline (NA) levels, and NA clearance (3H-NA constant infusion), were measured during graded infusion of NA. 2. Plasma levels of NA were similar in both groups, with parallel increases to levels approximately three times basal, but still in the upper normal range. 3. Clearance did not increase in either group with increasing plasma NA levels. There was no correlation between plasma NA achieved and NA clearance, which was similar in hypertensives and normotensives. 5. Insofar as plasma clearance reflects tissue clearance, these studies provide no support for the contention that altered NA metabolism might predispose to elevated NA levels in essential hypertension. PMID- 3665192 TI - Prenatal high salt diet increases blood pressure and salt retention in the spontaneously hypertensive rat. AB - 1. An examination was made of the effect of prenatal, high salt (5% w/w) and low salt (0.1% w/w) diet on the blood pressure and ability to excrete a salt load of mature spontaneously hypertensive rats (SHR) of the Okamoto strain maintained on normal salt (0.8% w/w) diet after weaning. 2. Prenatal high salt diet resulted in a significant exacerbation of the hypertension of 4 month old SHR when compared with animals given prenatal low salt diet. 3. Three month old SHR given prenatal, high salt diet exhibited a significantly reduced Na+ excretion following a single, oral salt load (150 mmol/l, 1% bodyweight) when compared with the low salt group. 4. Thus, prenatal, high salt diet may influence body fluid homeostasis in genetically susceptible individuals later in life. PMID- 3665193 TI - Handling of a sodium load by rats on a low sodium intake and frusemide. AB - 1. Groups of rats (n = 9-10 per group) were given a medium sodium (Na) diet or a low Na diet or a low Na diet plus low or high dose frusemide in order to have their body Na in a state of surplus or deficit or neither. 2. Body Na was measured by a 22Na whole body counting method involving Na-free chow and the drinking fluid as the only source of Na (22Na-labelled NaCl). Intraperitoneal NaCl (same specific activity) loads were given and their excretion was measured by repeated measurements of body Na over the next 48 h. 3. Rats in surplus excreted more than the load; those in neither surplus nor deficit excreted more or less exactly the load (allowing for growth); those with a small deficit retained enough Na to make up most of the deficit; those with a deficit that was larger than the load retained approximately the whole load. 4. The results support the Strauss-Hollenberg concept that there is a basal body Na above which Na is excreted and below which any available Na is retained. PMID- 3665194 TI - Effects of neuropeptide Y on left ventricular function in the conscious rabbit. AB - 1. Changes in arterial pressure, heart rate and left ventricular contractility induced by intravenous injections of neuropeptide Y (NPY; 1-30 micrograms/kg) were studied in the conscious rabbit. 2. NPY has a brief pressor effect associated with a bradycardia, an increase in left ventricular end diastolic pressure, and a prolonged fall in peak left ventricular dP/dt (LVdP/dt). 3. The haemodynamic changes increase substantially with increasing doses up to 10 micrograms/kg. Beyond 10 micrograms/kg there are only slight effects on heart rate or peak LV dP/dt. PMID- 3665195 TI - The effect of endogenous opioids on blood pressure during stress. AB - 1. A series of experiments were conducted to investigate the effect of endogenous opioids on blood pressure of laboratory rats during stress. 2. Rats subjected to 120 min immobilization showed a significant drop in systolic pressure which could be prevented by pretreatment injections of naloxone. 3. Adrenalectomized rats subjected to the same kind of stress showed a drop in systolic pressure equivalent to only 30% of the systolic pressure drop in the intact animals. This decrease in systolic pressure could also be prevented by pretreatment injections of naloxone. 4. It was concluded that the decrease in systolic pressure in intact rats during immobilization was mostly due to endogenous opioids released from the adrenal glands, whereas opioids of other origins such as the pituitary gland, were also important. PMID- 3665196 TI - Gastric mucosal defence mechanism during stress of pyloric obstruction in albino rats. AB - 1. The integrity of the gastric mucosa and its ability to secrete mucus are believed to be essential for protection of gastric mucosa against ulceration induced by aggressive factors active in any stress situation. This study involves a three-compartmental analysis of gastric mucosal barrier in pylorus-ligated albino rats. 2. Quantitative analyses of histologically identifiable gastric mucosal epithelial neutral glycoproteins and gastric adherent mucus from oxyntic and pyloric gland areas, and components of non-dialysable mucosubstances in gastric secretion were made under stress of pyloric obstruction for 4, 8, and 16 h durations. Epithelial mucin was identified by periodic acid-Schiff (PAS) staining technique and assessed from the ratio of gastric mucosal thickness to the depth of PAS positive materials in it. The remaining visible mucus adhered to the gastric mucosa was estimated by Alcian blue binding technique. The results were compared with that of identical control groups. 3. A significant reduction in mucosal epithelial PAS positive materials after 8 or 16 h of pylorus ligation was observed. 4. The Alcian blue binding capacity of the pyloric gland area was increased significantly after 4 h of pylorus ligation, while after 8 or 16 h it was reduced in both oxyntic and pyloric gland areas. 5. Significant reductions in the rate of gastric secretion and volume, as well as concentration of the components of non-dialysable mucosubstances, were observed, indicating decreased synthesis of mucus glycoproteins. 6. Disruption of the mucosal barrier may have occurred due to decreased mucus synthesis and acid-pepsin accumulation; both could be due to stress associated with gastric distension. 7. The present findings confirm the role of mucus in protecting the underlying gastric epithelium during stress. The adherent mucus offers a first line of defence and epithelial mucus a second line of defence. PMID- 3665197 TI - Cardiovascular responsiveness to arginine vasopressin in water-loaded and sodium depleted pregnant and non-pregnant sheep. AB - 1. In conscious ewes pregnancy was associated with a significantly increased heart rate and cardiac output, while mean arterial pressure (MAP) and stroke volume were unchanged. 2. The present study examines the effect of arginine vasopressin (AVP) infused at 0.3, 1, 3.0, and 10 micrograms/h, into water-loaded and sodium-depleted ewes, either non-pregnant or during the last third of gestation. 3. In the water-loaded state, MAP rose significantly at the lowest rate of infusion in both pregnant and non-pregnant ewes. Bradycardia occurred first at 0.3 micrograms/h in the pregnant ewes but not until 3.0 micrograms/h in the non-pregnant animals. 4. In sodium deficiency there was no increase in MAP at any rate of infusion in either group. Bradycardia occurred in both groups at 1 microgram/h. 5. This study shows that the pressor effects of AVP are unchanged by pregnancy. However, pregnant ewes are more sensitive to AVP-induced bradycardia when the ewes are water-loaded. PMID- 3665198 TI - Blastocystis hominis: evidence for human pathogenicity and effectiveness of metronidazole therapy. AB - 1. Clinical symptoms and oral treatment with metronidazole were studied in 103 patients with pure infections by Blastocystis hominis. 2. The results showed that excessive flatulence is the chief gastrointestinal symptom associated occasionally with diarrhoea and abdominal cramps. All the patients showed good responses with treatment of metronidazole and 74 patients whose stools were reexamined 1-2 months after the treatment demonstrated no signs of infections. 3. It is concluded that B. hominis is a pathogenic intestinal parasite and the infection could be eradicated successfully by oral metronidazole. PMID- 3665199 TI - Characterization of anti-acetylcholine receptor antibody activity in patients with anti-mitochondrial antibodies. AB - Antibodies binding to the acetylcholine receptor of human skeletal muscle were found in patients with different kinds of anti-mitochondrial antibodies. In patients with primary biliary cirrhosis (PBC), the antibody activity was found in monomeric and pentameric IgM as well as in IgG, whereas patients with other kinds of anti-mitochondrial antibodies had anti-receptor antibodies of predominantly IgG class. Mice transfused with immunoglobulins from patients with PBC showed a reduction of skeletal muscle receptors comparable to that found in mice who had received immunoglobulins from myasthenia gravis (MG) patients. The antibody affinity was of the same order of magnitude in MG and PBC but antibodies with multiple affinities were more common in PBC. In PBC, the anti-receptor antibody associated idiotype repertoire was markedly different from that found in MG. PMID- 3665200 TI - An immunosorbent assay for blood group I antigens in breast carcinoma. AB - Tumor cells elaborate and release into the circulation a variety of glycoproteins. An enzyme-linked immunosorbent assay (ELISA) was developed to monitor carbohydrate structures secreted into the circulation. Among these antigens are the structures specific for the blood group I antigens, which are incompletely converted to ABH antigens on the membranes of tumor cells. The I antigens in the sera of 67 women with breast carcinoma (BCa), 58 with benign breast disease (BBD), and 47 controls were measured by the ELISA. In this assay, I antigen from ovarian cyst mucin was bound to the wells of polystyrene microtiter plates. The monoclonal human anti-I antibody (Hy) was added to the wells along with perchloric acid extracts of patient and control sera at five different dilutions. The anti-I binding to the solid-phase I antigen was determined after incubation steps with peroxidase-labeled anti-human IgM and substrate. The amount of sera extracts giving 50% inhibition of anti-I (Hy) binding was determined from the inhibition curves which were corrected by integrating the slope values into that of the standard curve obtained with extracts of normal sera. The I antigens were significantly higher in pathologic stage (PS) IV sera (P less than 0.001), and comparable in PS I, PS II, and PS III and BBD sera to those in control sera. The anti-I (Hy) binds strongly Gal 1,4 GlcNAc 1,6 Gal (alpha GalNAc); Gal 1,4 GlcNAc 1,6 (Gal 1,4 GlcNAc 1,3) Gal; and to a lesser extent Gal 1,4 GlcNAc 1,3 Gal 1,4 GlcNAc (0.06, 0.09, and 0.35 mM, giving 50% inhibition, respectively). It was concluded that similar or related structures may be expressed on the membrane of metastatic BCa cells. PMID- 3665201 TI - Immune and nonimmune effector functions of IgG3 mouse monoclonal antibody R24 detecting the disialoganglioside GD3 on the surface of melanoma cells. AB - R24, an IgG3 mouse monoclonal antibody reactive with the disialoganglioside GD3, was found to be a potent mediator of human complement cytotoxicity and human effector cell cytotoxicity. Cytotoxicity correlated with the degree of antibody binding (GD3 cell surface expression) for each of the melanoma cell lines and melanocyte cell cultures tested. Melanoma cell lines binding low amounts of R24 (low GD3 cell surface expressors) were not lysed in R24-directed immune reactions, suggesting that a threshold number of R24 molecules bound per cell is necessary to initiate these cytotoxic mechanisms. Since both complement- and cell mediated reactions lysed the same subpopulations of cells in each cell line, both mechanisms appeared to depend on similar threshold quantities of bound R24 molecules. However, due to the heterogeneity of R24 binding in each cell line, the numerical value for this threshold could not be determined. Only in cell lines binding greater than 10(7) R24 molecules per cell were greater than 90% of the cells lysed. Normal melanocytes in culture were not lysed by R24-directed immune mechanisms, due to their low GD3 expression, indicating that monoclonal antibodies such as R24 may show tumor specificity with regard to effector functions even though normal cells express the relevant antigen. In contrast to the potent in vitro activity of R24, treatment of nu/nu mice bearing human melanoma grafts resulted in tumor inhibition only when started within 3 days of tumor cell inoculation. No effect was seen on established tumors. Thus, this in vivo mouse model failed to predict the clinical and pathological findings observed in treatment trials of R24 in human melanoma patients--urticaria involving skin metastases, cellular infiltration of tumor tissue, and tumor regression. In addition to activating immunologic effector functions, R24 had direct effects on melanoma cells, blocking their ability to attach to surfaces and causing tumor cell aggregation. These effects were again related to the number of R24 molecules bound to the cell surface; no aggregation was seen with cell lines binding less than 4 X 10(5) molecules per cell. Both immune and nonimmune effector functions may be involved in the tumor inhibitory activity of R24 in humans. PMID- 3665202 TI - Age-associated alterations in human natural killer cells. 1. Increased activity as per conventional and kinetic analysis. AB - We report a positive association between the human peripheral blood natural killer (NK) cell activity and the age (20-94 years) of 137 healthy volunteers. Irrespective of the methods of data representation, the elderly (greater than 80 years) express a statistically significant (at 0.001 level) higher (35-80.7%) mean NK activity when compared to younger adults (less than 40 years). Results of repeat assays and paired assays support a similar conclusion. This difference can be demonstrated at a wide range of effector or target cell concentrations or times of assay and is not influenced by in vivo lymphocyte count. Single-cell assay results suggest that an increase in the frequency of NK cells may be responsible for the higher NK activity in the elderly. These findings were confirmed by an enzyme-like kinetic analysis. Vmax, the maximum cytotoxic potential of the lymphocytes from the elderly, is nearly four times higher than that of younger adults. It is concluded that unlike the age-related general decline in T- and B-cell reactivity (as demonstrated here with concanavalin A and pokeweed mitogen), the NK cell system is highly active in a majority of the healthy elderly. PMID- 3665203 TI - Do viruses play an etiologic role in ankylosing spondylitis or psoriatic arthritis? AB - High venous blood levels of 2-5A, an adenylic acid polymer synthesized in the presence of double-stranded RNA and considered as a viral replication indicator, have been found in blood samples from ankylosing spondylitis and psoriatic arthritis patients, but not from patients with seropositive rheumatoid arthritis or acute chondrocalcinosis. These findings suggest the possibility that ankylosing spondylitis and psoriatic arthritis might be virus-induced diseases. PMID- 3665204 TI - Long-term prognosis and prognostic indices of IgA nephropathy in juvenile and in adult Japanese. AB - For a comparative study of IgA nephropathy occurring in Japanese adolescents and adults, the clinical and histological findings and prognosis (follow-up period; 12 +/- 6 years for children and 10 +/- 5 years for adults) were compared. The subjects studied included 98 children and 86 adults. Development into renal failure occurred in 9 children (9.2%) and in 20 adults (23.3%), (p less than 0.01). The actuarial renal survival rate at year 10 after the onset of glomerulonephritis in children and adults was 95% and 80%, respectively, and at year 20, 82% and 50%, respectively. The prognosis was definitely better in the children and this was attributable to the observation that (1) the glomerular injury at the initial biopsy in children was less extensive than in adults; (2) the frequency of complication with hypertension was lower in children (27.6%) than in adults (41.9%), (p less than 0.05); (3) hypertension was one prognostic indice, even in children, after age 30; (4) after age 40, aging and arteriosclerosis were more contributory than hypertension to the progress of IgA nephropathy; and (5) the quantity of intraglomerular immune deposits and the period of deposition were not related of prognostic indices. Thus, in the long term prognosis of IgA nephropathy in both children and adults, immunological disorders seem to have little influence while factors such as hypertension, arteriosclerosis and aging play important roles. PMID- 3665205 TI - Aluminum accumulation in children on chronic dialysis: predictive value of serum aluminum levels and desferrioxamine infusion test. AB - In 7 children on chronic dialysis the correlation between serum aluminum, aluminum after desferrioxamine (DFO) challenge and bone aluminum was studied. In children the DFO challenge test is not superior to the serum aluminum level for the estimation of aluminum body burden. A significant correlation between serum aluminum and bone aluminum content was found. In all children, except one, aluminum bone content was markedly elevated. PMID- 3665206 TI - Renovascular hypertension in spontaneous hypertensive rats: an experimental model of renal artery stenosis superimposed on essential hypertension. AB - Renovascular hypertension superimposed on essential hypertension, a condition encountered in the elderly, was studied. An experimental animal model consisting of a two-kidney one-clip Goldblatt preparation in the spontaneous hypertensive (SHR) rat, that would simulate this condition, was designed. A 0.25 mm silver clip was placed on the left renal artery of SHR male rats. The same procedure performed on WKY rats served as control. All experiments were performed on low, normal, and rich sodium diet. Systolic blood pressure (BP) was measured by tail cuff method. Plasma renin concentration (PRC) was determined before and after clipping of the renal artery. Results were as follows: Mean systolic BP increased significantly in clipped rats fed with normal and rich sodium diets. SHR showed an increase from 144 +/- 3 (mean + s.e.m.) to 168 +/- 3 mmHg, and WKY rats showed an increase from 120 +/- 2 to 139 +/- 5 mmHg. There was a two- to threefold rise in PRC. A low-salt diet given prior to clipping prevented the appearance of renovascular hypertension despite a significant rise in PRC. We concluded that renal artery narrowing plays a significant role in the rise of BP in the basically essential type of hypertension. PMID- 3665207 TI - Hemodynamic alterations in long-term insulin-dependent diabetic patients with overt nephropathy: role of blood hyperviscosity and plasma protein changes. AB - The possible relationship among blood rheology pattern, renal hemodynamics and proteinuria was investigated in 22 long-term insulin-dependent diabetic patients with overt nephropathy. Higher blood, plasma and serum viscosity and lower erythrocyte filtrability were found in our patients with overt nephropathy, than in patients without renal microvascular complications. Several negative correlations between blood viscosity and renal hemodynamic parameters (i.e., glomerular filtration rate and renal plasma flow) were demonstrated in the diabetics with overt nephropathy. Furthermore increased plasma fibrinogen, fibronectin and acute-phase protein levels were found in diabetics with overt nephropathy, compared to diabetics without renal changes. The data may suggest a pathogenetic role for blood rheology changes in the progression of diabetic glomerular complications. PMID- 3665208 TI - Serum myoglobin in patients on intermittent and continuous ambulatory peritoneal dialysis. AB - Serum myoglobin levels were determined in patients maintained on chronic peritoneal dialysis. Eleven intermittent peritoneal dialysis patients had a mean serum myoglobin of 174 +/- 29 ng/ml. In 7 patients tested serially, there was no consistent change in serum myoglobin: the mean level was 154 +/- 36 ng/ml pre dialysis and 170 +/- 20 ng/ml post-dialysis. Seventeen patients on continuous ambulatory peritoneal dialysis had a mean serum myoglobin of 215 +/- 18 ng/ml. Two patients given oral carnitine supplements had a substantial decrease in their serum myoglobin levels. Patients on peritoneal dialysis, like those on hemodialysis, tend to have elevated serum myoglobin levels, and neither form of dialysis affects serum myoglobin concentration. This hypermyoglobinemia may be due to metabolic changes in muscle. PMID- 3665209 TI - Can the nephropathy in Schonlein-Henoch purpura (syndrome) be prevented by early administration of steroids? PMID- 3665210 TI - Digoxin-like immunoreactivity in patients with chronic renal failure. PMID- 3665211 TI - Low risk of AIDS in hemodialytic patients. PMID- 3665212 TI - A case of acute brucellosis with membranous glomerulopathy. PMID- 3665213 TI - Effect of toxicity of bezafibrate in hemodialysis patients. PMID- 3665214 TI - Early diastolic time intervals during hypertensive pregnancy. AB - Early diastolic time intervals have been assessed by means of the echopolycardiographic method in 17 pregnant women who developed hypertension during pregnancy (HP) and in 14 normal pregnant women (N). Systolic time intervals (STI), stroke volume (SV), ejection fraction (EF), and mean velocity of myocardial fiber shortening (VCF) were also evaluated. Recordings were performed in the left lateral decubitus (LLD) and then in the supine decubitus (SD). In LLD, isovolumic relaxation period (IRP) was prolonged in the hypertensive pregnant women compared with normal pregnant women (HP 51 +/- 12.5 ms, N 32.4 +/- 15 ms p less than 0.05), whereas time of the mitral valve maximum opening (DE) was not different in the groups. There was no difference in SV, EF, and mean VCF, whereas STI showed only a significant (p less than 0.05) lengthening of pre ejection period (PEP) in HP. When the subjects shifted from the left lateral to the supine decubitus position, left ventricular ejection time index (LVETi) and SV decreased significantly (p less than 0.05) in both normotensive hypertensive pregnant women. IRP and PEP lengthened significantly (p less than 0.05) only in normals, whereas they were unchanged in HP. DE time did not vary in either group. In conclusion, hypertension superimposed on pregnancy induces lengthening of IRP, as well as of PEP, and minimizes the effects of the postural changes in preload on the above-mentioned time intervals. PMID- 3665215 TI - Short-term reproducibility of dipyridamole-echocardiography test. AB - The aim of this study was to assess the short-term reproducibility of dipyridamole-echocardiography test (DET) consisting of two-dimensional echo monitoring during dipyridamole infusion (up to 0.84 mg/kg in 10 min). The diagnostic end-point of the test is the detection of new onset or worsening regional asynergy. A group of 87 patients with rest and/or effort angina performed two DETS on two consecutive days. All 60 patients with a positive DET had a positive repeat test, and the 27 negative DETs were also negative on the following day. The timing of the asynergy was also very similar between the two tests, both in patients with angina on effort (r = .93, p less than 0.01) and at rest (r = .92, p less than 0.01). In conclusion, DET has a very high short-term reproducibility regarding the presence and timing of asynergy. PMID- 3665216 TI - Arm position as a source of error in blood pressure measurement. AB - The present study was designed to assess the value of correct positioning of a patient's arm when measuring blood pressure (BP). A total of 181 subjects were examined, 141 hypertensives on treatment, 25 untreated hypertensives, 15 normotensives. All the subjects underwent three BP measurements after a 5-min resting period in supine position. Then two BP readings were recorded in standing position with the arm either positioned by the patient's side or supported passively at patient's heart level. Average systolic BP (SBP) in standing position were 144.6 +/- 20.2 mmHg with the arm at the side and 136.4 +/- 21.1 mmHg with the arm at the heart level (p less than 0.001); average diastolic pressures were 99.0 +/- 12.0 mmHg and 90.2 +/- 12.3 mmHg (p less than 0.001), respectively. A fall in SBP greater than or equal to 20 mmHg from the supine to the upright position was detected in 18.2% of cases when measurement was performed at heart level; such a reduction was inapparent in two-thirds of cases when the arm was placed at the patient's body side. Incorrect positioning of a patient's arm during BP measurements in standing position leads to overestimation of BP values and masks the presence of postural hypotension. PMID- 3665217 TI - Influence of acute hyperglycemia on left ventricular function in diabetics assessed by echocardiography. AB - Myocardial dysfunction in diabetes mellitus is reversed by proper correction of metabolic changes. To assess the role of hyperglycemia on cardiac dysfunction, 50 g of dextrose were intravenously infused to 15 subjects with stable type 2 diabetes. Echocardiographic measurements were made at 0, 60, 120, 180, and 240 minutes. In spite of the high levels of blood glucose reached in diabetics, left ventricular ejection fraction, fractional shortening, and stroke volume did not experience significant changes. Moreover, cardiac output significantly (p less than 0.01) increased in diabetics secondary to an increase in heart rate. No cardiac changes were noticed in 7 healthy subjects studied in a similar fashion. However, their induced hyperglycemia was not as elevated as in the diabetic patients. These results suggest that acute induced hyperglycemia per se does not appear to impair left ventricular contractility in diabetics at resting conditions. PMID- 3665218 TI - Hemodynamic effects of oral isosorbide-5-mononitrate and dinitrate in ischemic heart failure. AB - Isosorbide-5-mononitrate (ISMN), the main metabolite of isosorbide dinitrate (ISDN) was recently introduced in clinical use. The hemodynamic effects of oral ISMN and ISDN, administered in equal doses, were studied in a randomized, crossover fashion in 20 patients with pump failure of ischemic etiology. Baseline hemodynamic criteria for admission into the study were: pulmonary capillary wedge pressure (PCW) of at least 20 mmHg and systolic arterial pressure (AP) above 90 mmHg. Hemodynamic parameters were serially measured and systemic vascular resistance was calculated up to 6 h postadministration of either ISMN or ISDN single dose (40 mg). Maximal effects obtained were statistically significantly different from baseline. While ISMN and ISDN appeared to be equipotent in reducing the filling pressure, with a maximum effect reached in 60-120 min, the mononitrate maintained its effects for a longer period. PMID- 3665219 TI - Superior vena caval obstruction by lipomatous hypertrophy of the right atrium. AB - A structural abnormality was suspected when passage of a Swan-Ganz catheter was obstructed at the distal superior vena cava (SVC). At autopsy, lipomatous hypertrophy of the right atrium markedly narrowed the lumen at the SVC-right atrial junction. PMID- 3665220 TI - Echocardiographic findings in pannus ingrowth on an omniscience mitral prosthesis. AB - Serial echocardiographic findings in a patient with an Omniscience mitral prosthesis presenting progressive perivalvular pannus ingrowth are described. The first echocardiographic study was carried out one year after prosthesis implantation and showed decreased prosthetic opening velocity. As prosthetic thrombosis was suspected, hemodynamic study was performed, which proved normal. The patient remained in functional grade II for a year and a half prior to the onset of progressive dyspnea and dizzy spells. Echocardiogram was thus repeated and revealed the presence of multiple dense echoes behind the prosthetic disc. Three months after this last study, the patient presented acute pulmonary edema and reduction of disc excursion and opening and closing velocities. Hemodynamic study suggested prosthetic obstruction. Surgery revealed the presence of perivalvular pannus trapping the prosthetic disc. The prosthesis was subsequently replaced by a Bjork-Sorin. This case emphasizes the usefulness of echocardiography in the early detection of perivalvular pannus ingrowth revealing prosthetic mobility anomalies, even before hemodynamic changes occur. PMID- 3665221 TI - Antitumor and antimetastatic activity of the differentiating agent N methylformamide in murine tumor systems. AB - N-Methylformamide (NMF), a cell-differentiating agent, was assessed for its antitumor activity against a fibrosarcoma (FSA), a hepatocarcinoma (HCA-I) and a mammary carcinoma (MCA-K), syngeneic to C3Hf/Kam mice. Tumors were grown as solitary tumors in the leg or as artificial or spontaneous micrometastases in the lung. NMF, at a dose of 300 mg/kg, was administered i.p. daily for 6 to 18 days. NMF slowed the growth of FSA and HCA-I tumors and totally inhibited the growth of the MCA-K tumor. However, the effect was transient; tumors resumed their pretreatment growth rate upon cessation of the treatment. Histologically, MCA-K tumors treated with NMF (300 mg/kg daily for six days) underwent considerable cell depopulation and reduction in mitotic activity. The number of artificial metastases, as well as the incidence and the number of spontaneous metastases, were markedly reduced by NMF. This resulted in a prolongation of the survival of mice that had artificial metastases of MCA-K tumor. The in vitro clonogenicity of MCA-K, but not of FSA or HCA-I cells, was reduced. However, in vivo reduction of MCA-K cell clonogenicity was minimal, if any. Thus, NMF is effective in restricting the growth of both solitary tumors and metastases, but the degree of response is highly dependent on tumor type. PMID- 3665222 TI - Loss of glucocorticoid receptors in B16BL6 murine melanoma associated with serial transplantation, metastatic selection and altered growth properties. AB - Glucocorticoid cytosolic receptors (GR) have been studied in both a primary and in a lung selected (metastatic) series of a B16BL6 murine melanoma. In the primary series tumour there was an initial increase in GR content from 40 to 95.6 fM mg-1 protein. GR levels then fell over the next 11 transplant generations to 10 fM mg-1 protein. In the metastatic series, in the course of six transplant generations, GR content of 73 fM mg-1 protein fell to below detectable levels, i.e. less than 5 fM mg-1 protein. Both the metastatic and primary series tumours showed a significant decrease in doubling times with increasing transplant generation. We therefore suggest that in the primary series tumours, after an initial phase of adaptation from tissue culture to in vivo conditions, the increased growth of the tumours is independent of the loss of hormonal control caused by a reduction in the glucocorticoid receptor content associated with serial transplantation. In the metastatically selected series of tumours, there appears to be a selective growth pressure brought about by the cyclic transplantation procedure which was also accompanied by an increase in metastatic ability. PMID- 3665223 TI - A morphometric study of invasion and metastasis in human colorectal carcinoma. AB - The cell nuclei within primary and nodal secondaries of colorectal carcinomas were analysed morphometrically in order to identify a primary subpopulation with similar characteristics to cells involved in lymphatic metastasis. No significant difference in nuclear area was seen between cell populations of the primary and secondary. However, a regional variation in mean nuclear area was present, suggesting a relationship between cells at the invasion front and in early nodal metastasis. This subpopulation differed from the cell populations of the primary and more advanced secondaries. These results are consistent with the existence of a morphometrically identifiable metastatic subpopulation within the invasion front of colorectal carcinoma. PMID- 3665225 TI - Canadian Cardiovascular Society, 1987. Scientific program and abstracts. Edmonton, Alberta, October 28, 29, 30, 31, 1987. PMID- 3665224 TI - NK-mediated reduction of malignancy in human melanoma cells treated with theophylline. AB - Theophylline-treated cells of the human melanoma line showed an increase in NK sensitivity in vitro and a concomitant decrease in tumorigenicity and spontaneous metastasis in Balb/c nude mice. The MeWo cells were heterogeneous and contained related subpopulations which were cloned to produce two cell lines, one hypodiploid (Cd-16) and one hypotetraploid (Ct-1). Prolonged (3 months) or short term (4 days) treatment of these cell lines with 1 mM theophylline markedly reduced the incidence and size of tumors in Balb/c nude mice early after s.c. injection and their ability to metastasize spontaneously to the lung was also reduced. The effect was much more pronounced with Cd-16 cells, which contain amplified DNA compared to Ct-1 cells which lack DNA amplification. Part of the tumor inhibition caused by theophylline was due to natural killer (NK) cells. Thus, in vivo treatment of nude mice with anti-asialo GM1, a procedure known to remove NK cells, partially reversed the inhibitory effects of theophylline on tumor formation and generation of metastasis by Cd-16 cells. Consistent with this observation theophylline treatment enhanced the in vitro NK sensitivity of Cd-16 cells four-fold whereas Ct-1 was enhanced only slightly. The data suggest that theophylline can act preferentially on certain tumor cell subpopulations to enhance their NK-sensitive phenotype and thereby inhibit their capacity to form tumors and to metastasize in nude mice. PMID- 3665226 TI - Fetal monitoring. PMID- 3665227 TI - Antepartum cardiotocography. AB - Antepartum cardiotocography remains a valuable adjunct in the management of the high-risk gravida. Twice weekly use of NST coupled with real-time ultrasound assessment of amniotic fluid volume appear reasonable approaches to testing. More controversial is the use of testing in all pregnancies. Clearly, if one could reduce the perinatal mortality to 1-2/1000, such universal application of testing could be justified. However, more pragmatic concerns, such as personnel and cost constraints have all but prohibited the adoption of this policy. Secondly, in an attempt to improve the predictive reliability of antenatal testing additional evaluation of patients demonstrating diminished AFV or variable decelerations should be considered. More frequent testing or consideration for delivery are reasonable management plans. Finally, the use of acoustic stimulation to reduce the frequency of persistently non-reactive NSTs offers considerable promise. Investigations in this and other techniques of surveillance are ongoing. The best single method remains to be discovered, but utilization of current techniques offers the obstetrician a reliable technique by which to assess fetal well-being. PMID- 3665228 TI - Objective and useful mobility assessment of patients with arthropathy of the hip and knee. AB - Walking ability was objectively assessed by measurements of endurance, oxygen consumption, and pulse rate response. Twenty-four control subjects and 38 patients with arthropathy of the hip or knee were asked to walk on a treadmill, initially at 1 km/hour, for four minutes. The speed was increased by 1 km/hour every four minutes, until the subjects has walked for four minutes at 7 km/hour, or until they could not continue. Oxygen consumption, heart rate, cadence, and step length were measured. The controls could all walk for 1400 m, reaching a walking speed of 6 km/hour, and showed a consistent relation between heart rate, oxygen consumption, and speed of walking. The majority of arthritic patients failed to reach either this distance or speed. They had a significantly increased metabolic cost, and there was a good correlation (r = 0.65 to 0.99) between the changes in pulse rate and oxygen consumption in each individual patient. The endurance, heart rate response, and oxygen consumption changes shown by patients proved to be reproducible characteristics in patients whose disease was static. PMID- 3665230 TI - Stabilization and prosthetic replacement in difficult fractures and bone tumors. AB - Comminuted fractures of the femoral shaft, especially when combined with fractures of the hip, may be difficult to treat. A four-sided titanium alloy locking nail with transfixing screws was designed in 1967 and allows compression of the fracture site. If necessary, the nail may be inserted without intraoperative roentgenograms, and permits early weight-bearing in most cases. One hundred seventy-one difficult fractures in femora, humeri, tibiae, and ulnae have been treated with this nail since 1974. Many cemented total hip arthroplasties are failing. A cementless, modular titanium alloy and alumina hip, based on the nail with a modular alumina or titanium head, will allow cementless hemi- or total hip arthroplasty. Porous, 200-microns ceramic coating on the stem allows bone ingrowth while transfixing screws allow full and immediate postoperative weight-bearing. A ceramic sleeve and spacers also allow modular replacement of the upper three-quarters of the femur for tumors and trauma. A similar shoulder and humerus is also available. Fifty-four hips and two shoulders have been successfully replaced since January 1983. In addition, 285 bones with pathologic or potential pathologic fractures caused by secondary tumors have been stabilized by the author between August 1972 and August 1986, with a variety of implants. PMID- 3665229 TI - Carbon fiber reinforced plastic (CFRP) plates versus stainless steel dynamic compression plates in the treatment of fractures of the tibiae in dogs. AB - In a series of 14 dogs, fractures of both tibiae were caused by a "bone-breaker" designed in the authors' department and observed to produce a consistent and realistic canine fracture. One tibia was plated with a carbon fiber reinforced plastic (CFRP) plate and the other with a dynamic compression (DC) plate. Roentgenographic examination demonstrated healing of the CFRP-plated tibiae with abundant callus, and almost total remodeling of the fracture callus between ten and 20 weeks. Biomechanical testing by three-point bending revealed little difference between the strength of union of the fractures at 12-16 weeks. At 20 weeks, although the numbers were too small for statistical confirmation, the CFRP plated tibiae were consistently stronger than the DC-plated tibiae. PMID- 3665231 TI - A revised objective rating system for patient selection for chymopapain chemonucleolysis. AB - A revised objective rating system, previously found useful for patient selection for lumbar laminectomy and discectomy, was evaluated in patient selection for chemonucleolysis by intradiscal chymopapain. Based on the severity of findings within each of four categories (neurologic signs, root tension signs, myelogram or computed tomography (CT) findings, and psychosocial environment), numerical scores are derived. A maximum score of 25 points is available in each of four categories for a total of 100 points. The objective rating score was determined in a series of 101 patients prior to treatment of lumbar disc herniation by chemonucleolysis. The patients were evaluated at least one year after injection. The objective rating score was predictive of the result of chemonucleolysis, and was even more strongly predictive of the ultimate surgical outcome, which included the results in 22 patients who were treated by laminectomy after chemonucleolysis failure. PMID- 3665232 TI - Laminectomy with and without spinal fusion. AB - This retrospective study evaluates two groups of patients surgically treated for a symptomatic, myelographically proven, herniated nucleus pulposus with a follow up period from 3.5 to 16 years. One hundred thirty-four patients were treated with laminectomy, discectomy, and fusion (LDF) between the years 1972 and 1978; 49 returned for follow-up examination. Two hundred patients had laminectomies and discectomies between the years 1968 and 1981; 40 returned for follow-up evaluation. Two of the disc patients had a repeat laminectomy for recurrent disc herniation, thus totaling 42 laminectomies. Each patient was scored on a scale from zero to 100. The LDF cases had an average score of 70 points. The disc cases had an average score of 69 points. Three of the LDF cases (6%) and eight of the disc cases (19%) had had a second operation. Laminectomy patients have a significantly higher reoperation rate than patients who have had spinal fusion along with laminectomy; however, the authors were unable to evaluate the results in the two groups by the overall score. PMID- 3665234 TI - Bateman hemiarthroplasty component disassembly. A report of three cases of high density polyethylene failure. AB - Mechanical failures occurred in three Bateman bipolar hemiarthroplasties in two patients. In all three occurrences, the disassembly of the bipolar prosthesis was caused by fracture of the polyethylene liner of the bipolar acetabular component. This caused the 22-mm head of the femoral component to separate and unlock from the acetabular component. Both patients have functional hips after replacement of the acetabular component with a new "self-centering" type. The mechanical design may predispose this bipolar hemiarthroplasty to disassemble. PMID- 3665233 TI - Postoperative discitis. Diagnosis and management. AB - Postoperative discitis (POD) continues to be a diagnostic challenge and its management remains variable. This article raises the following questions and presents new observations. What is the current role of the CT scan in POD? Is a uniform pathogen involved and is there a basis for the duration of intravenous antibiotics? What is the expected long-term functional result? In a retrospective analysis of 12 consecutive patients with POD followed for an average of 29 months (17-42 months), the CT scan was extremely sensitive in showing a pathogen was present. The CT scan was misread in over one-third of the cases. Gram-positive cocci were the only organisms cultured (10 of 13 cultures, 8 of 12 patients). The erythrocyte sedimentation rate (ESR) invariably fell predictably to normal within 90 days when patients were treated with IV antibiotics for more than 40 days. Most patients were clinically improved and subjectively better at follow-up examination. No correlation existed between the patient's subjective result and preexisting medical conditions, the type of antibiotic, or the length of treatment, the ESR, or the follow-up roentgenograms. PMID- 3665235 TI - Results of transtrochanteric rotational osteotomy for femoral head osteonecrosis. AB - Eighteen transtrochanteric rotational osteotomies have been performed in 17 patients for femoral head osteonecrosis (15 patients, Ficat Stage III disease; three patients, Ficat Stage IV disease) during a 51-month period and have 18 to 63 months of follow-up study. The best results were in the posttraumatic and nonsteroid-associated idiopathic cases in patients with small necrotic segments in the weight-bearing region, with no degenerative changes. Failures occurred in patients with large necrotic fragments, preexisting degenerative changes, and steroid- and alcohol-associated etiologies. Although joint arthroplasty was eventually required in ten hips, a period of temporization was achieved sufficient to bring them into the era of cementless hip arthroplasties. Indications for this operation should be restricted to those patients under 40 years of age with late Ficat Stage II or Stage III disease, in which the articular involvement in the lateral roentgenogram is 50% or less. PMID- 3665236 TI - Enlarged iliopsoas bursa. An unusual cause of thigh mass and hip pain. AB - Iliopsoas bursa enlargement, a rare cause of pelvic or inguinal mass, can be identified on computed tomography (CT) either incidentally or during clinical examination of a groin mass. When CT examination is equivocal, hip arthrography can establish the diagnosis. Iliopsoas bursa enlargement is frequently associated with preexisting hip arthrosis. In three cases of iliopsoas bursa enlargement, two had preexisting arthritis. A third patient showed no roentgenographic sign of hip disease. Iliopsoas bursa enlargement may be more common than previously reported and should be considered in patients with unexplained hip pain who demonstrate a soft tissue mass in the region of the iliopsoas bursa. PMID- 3665237 TI - Obturator hip dislocation with ipsilateral fractures of the femoral head and femoral neck. A case report. AB - A 28-year-old female pedestrians, struck by an automobile, sustained an obturator hip dislocation with concomitant ipsilateral fractures of both the femoral head and femoral neck. This unusual hip injury seems not to have been previously reported. The femoral neck fracture was widely separated from the shaft, and unfortunately, a 6-mm deep indentation fracture involved the anterosuperior portion of the articulating surface of the femoral head. This complex injury was treated with a press-fit bipolar prosthesis. PMID- 3665238 TI - Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly. AB - To promote early full weight-bearing and rapid rehabilitation, 20 elderly patients (average age, 82.2 years) with unstable intertrochanteric hip fractures were treated with a bipolar head-neck replacement. Seventeen patients had the prosthesis inserted as primary fracture management, and three, for salvage of failed internal fixation. The patients were ambulating with unrestricted weight bearing at an average of 5.5 days after the operation. The bipolar design may permit conversion to a total hip arthroplasty without removal of the femoral component, and may reduce the risk of acetabular cartilage damage. By using the greater trochanter as a landmark for precise placement of the femoral head, correct limb length was restored. PMID- 3665239 TI - Prosthetic replacement of the proximal humerus. AB - Eighteen patients had prosthetic proximal humeral replacement with either a metal or ceramic prosthesis. Three replacements were performed for fracture nonunions, five for benign neoplasms, six for low-grade malignancies, and four for high grade malignancies. Retention of elbow and hand function was good. In five of the 11 ceramic prostheses, failure occurred at the humeral-prosthetic junction even though it was designed for biologic fixation. Ten of 18 prostheses subluxated or dislocated. Twelve of 18 patients have had revision operations. While the revision rate in this initial series was high, valuable experience was gained for further investigations of shoulder arthroplasty. PMID- 3665240 TI - Surgical treatment of displaced olecranon fractures by tension band wiring technique. AB - Forty-five displaced olecranon fractures including 14 accompanying dislocated radial heads and seven radial head fractures were treated over a 13-year period by the tension band wiring technique. The use of supplemental internal fixation when necessary allows excellent results with the use of this technique, even in the presence of severe comminution or radial head dislocation. Primary silicone radial head implants fractured in all three patients in which they were used, necessitating repeat surgery in two patients to date. While loss of motion in terminal extension was a common aftermath of displaced olecranon fracture (59%), it was usually minor and functionally insignificant. True Kirschner-wire migration was not a common problem and can probably be eliminated by proper technique. The presence of gaps in the intraarticular surface of the semilunar notch of the ulna produced no ill effects and was compatible with excellent results. If only those cases with isolated olecranon fractures in this series are considered, there were good and excellent results in 29 of 30 cases (97%). Excision of the olecranon fragment(s) should be reserved for those cases when anatomic restoration cannot be achieved with internal fixation. PMID- 3665241 TI - Scapholunate gap with scaphoid nonunion. AB - Ten of 64 patients reviewed with scaphoid nonunion were found to have scapholunate gaps (SLG). A roentgenographic study of the entire group who were symptomatic, but had no prior surgery, showed the SLG. The SLG indicated severe ligamentous injury and instability, and was always associated with the presence of Doral Intercalated Segment Instability (DISI) and an increased scapholunate angle. Instability was progressive and associated with the early onset of arthritis. In the entire group of nonunions, high frequency of arthritis occurred with a predictable sequence of radioscaphoid and midcarpal degenerative changes. Terminal wrist arthritis in scaphoid nonunion developed in the scapholunate articulation, as a manifestation of rotary subluxation of the distal scaphoid fragment. PMID- 3665242 TI - Displaced olecranon fractures in adults. Biomechanical analysis of fixation methods. AB - Four commonly used methods of internal fixation for displaced olecranon fractures were analyzed in a biomechanical model to determine strength of fixation. A transverse osteotomy in fresh cadaver specimens was internally fixed and was tested to failure by rapid loading. Screw plus wire in combination provided the greatest strength of fixation. Energy to failure averaged 31.0 Nm for cancellous screw, 32.0 Nm for figure-of-eight wire, 35.3 Nm for Arbeitsgemeinschaft fur Osteosynthesefragen (AO) tension band, and 39.4 Nm for screw-plus-wire combination. Comparison of screw and wire in combination to screw alone or to figure-of-eight wire demonstrated a significant difference (p less than 0.05). The difference between screw plus wire and AO tension-band fixation did not achieve statistical significance (0.2 greater than p greater than 0.1). PMID- 3665243 TI - Displaced olecranon fractures in adults. Clinical evaluation. AB - Displaced fractures of the olecranon in adults were analyzed for pain, function, range of motion, and roentgenographic appearance. With one exception, the 38 transverse or oblique fractures were treated by reduction and internal fixation. Results were best in the group treated by screw plus wire in combination (average rating, 17.7 points). Other ratings averaged 17.2 for the intramedullary screw, 16.8 for figure-of-eight wire, and 16.7 for Arbeitsgemeinschaft fur osteosynthesefragen (AO) tension-band wire. Factors associated with poorer results included postoperative displacement or malreduction greater than or equal to 2 mm and articular involvement greater than or equal to 60%. Symptomatic metal prominence was particularly common after AO tension-band wiring, occurring in 80%. All seven comminuted fractures were treated by primary excision. The one comminuted fracture with greater than or equal to 60% articular involvement that was treated by excision had a poor result because of instability. PMID- 3665244 TI - Pneumococcal arthritis in a prosthetic knee. A case report and review of the literature. AB - Prosthetic joint infection caused by Streptococcus pneumoniae is a rare condition. An 86-year-old woman with a S. pneumoniae-infected total knee arthroplasty was successfully treated by a combined medical-surgical approach. PMID- 3665245 TI - Diagnostic and operative arthroscopy of the ankle. An experimental approach. AB - To determine safe and effective placements of the arthroscope, 14 freshly amputated ankle joint specimens were used for experimental diagnostic and operative procedures. Preoperatively, chondral and osteochondral lesions, articular defects, and loose bodies were created within the ankle joint. The following arthroscopic portals were investigated: anteromedial, anterocentral, anterolateral, posteromedial, and posterolateral. Overlapping of vision fields was noted with the three anterior portals. Optimum visualization of a lesion was obtained when the arthroscope was placed on the same side as the lesion. Lesions on the posterior aspect of the talar dome and within the posterior talar pouch required the posterior placement of the arthroscope for optimum visualization. The use of the anterocentral approach, with a 2.7-mm arthroscope yields good visualization of the anterior aspect of the joint, and very often, of the posterior compartment. Anatomic guidelines for the avoidance of neurovascular structures and the exact placement of the arthroscope in both anterior and posterior portals are presented and were specifically defined in two additional fresh ankle specimens. PMID- 3665246 TI - Knee arthrodesis following total knee arthroplasty in rheumatoid arthritis. AB - Twenty-seven knees in 23 patients, all with seropositive rheumatoid arthritis and failed total knee arthroplasty, were treated by arthrodesis. Twenty of the 27 knees were solidly fused. A fusion aligned in 7 degrees +/- 5 degrees of valgus and knee flexion from zero to 30 degrees was associated with the highest rate of arthrodesis, the lowest rate of progression of disease in other joints, and the highest functional scores. Stable fixation using either internal or external fixation gave the most predictable rate of arthrodesis. Persistent sepsis and bone stock losses were associated with failure of arthrodesis, even under the best circumstances. All of the 20 successfully arthrodesed knees were completely functional. PMID- 3665247 TI - Salvage procedures for complications of total ankle arthroplasty. AB - Total ankle arthroplasty (TAA) has been a satisfactory procedure with a low failure rate only when applied to the rheumatoid patient. For the active, posttraumatic patient, ankle joint fusion is superior and avoids the attendant high failure rate. In general, salvage of failed TAA is best solved by ankle fusion. Only in one of five cases (a compliant patient with a clear-cut correctable technical error) was a good result achieved with a revision arthroplasty. To maintain limb length, the authors transplanted iliac crest autogenic bone to fill a large defect. When tightly packed with bone, the joint is slightly distracted and compression enhances fusion. For septic loosening, osteotomy of the malleoli and fusion without grafting is recommended. Persistent pain unassociated with loosening an infection may be treated by removal of impingement of bone overgrowth. Soft tissue release to improve motion is rarely successful. Marginal skin slough was a problem in 8.5% of 71 cases. To facilitate healing, debridement of nonfunctional exposed tendons may be advisable. PMID- 3665248 TI - Pathomechanics of the femoropatellar joint following total knee arthroplasty. AB - Persistent discomfort in the femoropatellar joint is still one of the most disappointing aspects following total knee arthroplasty (TKA). Especially, TKA without patellofemoral replacement has a significant incidence of patellofemoral problems with a frequency between 5% and 45%. Pathomechanical factors in the development of retropatellar problems are loss of patellar thickness and retropatellar erosions. In 157 TKAs using Gschwend, Scheier, Bahler (GSB) joints without patellar resurfacing, pathomechanically postoperative vertical patellar malposition appeared to be the main cause of dysfunction. In many cases, the implantation technique leads to an artificial form of patella alta. This altered knee anatomy results in pathologic biomechanics, thus leading to reduced function. The combination of altered anatomy and reduced function leads to extensive patellar destruction and ultimately to intractable retropatellar pain. PMID- 3665249 TI - A new method for radiography of weight-bearing metatarsal heads. AB - A radiographic system has been developed that provides a standardized quantitative analysis of the forefoot. The patient stands fully weight-bearing on a horizontal plexiglass platform that is constructed to ensure reproducible placement between the cassette, patient, and beam. Measurements are made from the images of radiopaque rulers placed in line with the first metatarsophalangeal joint of each foot. The height of each metatarsal head can then be calculated based on measurements obtained on the radiograph. Graphs plotted from the data demonstrate the height of the metatarsal heads in a normal individual, changes in the height of the metatarsal heads with and without weight-bearing, before and after insole placement, and before and after metatarsal osteotomy. This information may be useful in obtaining a better understanding of abnormalities of the forefoot as related to bony anatomy and load distribution. PMID- 3665250 TI - Vitamin D deficiency rickets. A report on three cases. AB - A resurgence of classic vitamin D deficiency rickets has been noted in the recent pediatric literature, but no mention of it appears in recent orthopedic journals. Three cases of vitamin D deficiency rickets occurred in children whose ages ranged from 14 to 17 months. Similar to the experience of others, all three occurrences were in young black children who were sustained on breast milk for prolonged periods (9-17 months). Differing from other cases in the recent literature, the patients' families were not consuming vitamin D deficient diets to comply with religious beliefs. Simple treatment with vitamin D supplementation was effective once the diagnosis was established. PMID- 3665251 TI - Chondrocyte ultrastructure in exercise and experimental osteoarthrosis. A stereologic morphometric study of articular cartilage of young rabbits using transmission electron microscopy. AB - The effects of physical exercise (running) and immobilization (splinting) on chondrocyte ultrastructure were studied in the knee joint articular cartilage of 24 young rabbits. Synthetic activity of the chondrocytes was quantified by measuring the amount of rough endoplasmic reticulum (RER) from electron micrographs using a sterologic point-counting method. Extra loading of the joint by running, or by increased weight-bearing after splinting of the contralateral limb, caused a 20% and 30% increment of RER in the middle and deep zones of the cartilage, respectively, while immobilization decreased the amount of RER by 30% in the superficial zone. Some attempts to repair and regenerate were observed, especially in the deep zone of articular cartilage. Hypertrophy of cells and organelles, and cell replication were considered as signs of reparative processes. The accumulation of fine intracytoplasmic filaments (FIF) in chondrocytes, regarded as a sign of cell degeneration, was reduced in the exercise group. FIF also decreased in the deep zone chondrocytes of the immobilized group, which could be indicative of improved or retained viability of the chondrocytes. PMID- 3665252 TI - An evaluation of the bending stiffness of various tibial fixation methods. AB - The relative stiffness of human tibial fixation by plaster casts, intramedullary rods, external fixators, and dynamic compression plates was compared to the stiffness of the intact tibia. Four-point bending was performed on each specimen, first intact, and then after sequential instrumentation, thus allowing each specimen to serve as its own control. The mean stiffnesses obtained for the bone device complexes, as a percentage of the intact tibial stiffness, were 113 +/- 9% for the delta frame fixator, 57 +/- 14% for the dynamic compression plate, 28 +/- 2% for the unilateral external fixator (UEF) with stainless steel sidebar, 18 +/- 1% for the UEF with aluminum sidebar, 7 +/- 2% for the flexible intramedullary (IM) rods, and 6 +/- 2% for the cast. Even relatively flexible unilateral external fixators are much stiffer than cast or IM rod fixation, methods that usually lead to satisfactory union by secondary healing. If secondary union with callus formation is desirable, modifications of the external fixator may be necessary to provide more flexible fixation. This study may be one of the first attempts to quantitate the stiffness of tibial fixation in a standard cast and compare it with other devices. PMID- 3665253 TI - Infection in experimental arthroplasties. AB - Experimental bacterial infection following implant arthroplasties was investigated in rabbits. Bone cement and a stainless steel head and stem prosthesis were inserted after reaming of the femoral neck and shaft. Measured doses of Staphylococcus aureus were injected either into the femoral medullary cavity or intravenously. Intravenous challenge required high inocula to establish arthroplasty infection, whereas infection around the prosthesis was consistently established after inoculation of 10(3) bacteria into the femoral medulla. The erythrocyte sedimentation rate (ESR) proved the most reliable clinical test of infection. Hematogenous infection was difficult to reproduce. Three weeks after operation, the arthroplasty was as resistant as the normal hip. Antibiotics were administered in doses equivalent to doses used in the treatment of infections in humans. When gentamicin-impregnated cement was used, 60 times the number of organisms were required to establish infection. Flucloxacillin and Imipenem gave similar protection. Rifampicin gave protection to a level exceeding the lethal dose of organisms for the model. PMID- 3665254 TI - Congenital dislocation of the hip in Western Australia. A comparison of neonatally and postneonatally diagnosed cases. AB - Speculation that neonatally diagnosed congenital dislocation of the hip (CDH) may have a different etiology from cases diagnosed in the postneonatal period has not been examined in Australia because insufficient data have been available. A population-based study of CDH in children up to the age of two years who were born in Western Australia (WA) in 1981, 1982, or 1983 is the subject of this report. Study material comprised cases of CDH from the WA Congenital Malformations Register and denominator data (all births in WA for 1981-1983) from the Health Department of WA. From this material, rates of CDH were calculated for each of the study variables of interest. The rate of CDH was low for babies born to aboriginal mothers, and it is postulated that this may have a cultural basis, possibly in infant carrying postures. Overall, the prevalence of CDH for 1981 1983 was 6.4 cases per 1000 births, with 4.2/1000 diagnosed in the neonatal period and 2.2/1000 in the postneonatal period. Epidemiologic differences were noted between infants diagnosed in the neonatal period and those diagnosed postneonatally; rates of neonatally diagnosed CDH were higher in first births, breech presentation, and postmature infants than were rates of postneonatally diagnosed cases. Bilateral dislocation was more common (45.3%) in neonatally diagnosed cases than in postneonatally diagnosed cases (23.3%). These findings tended to support the idea that the time of diagnosis may define two distinct entities in CDH. PMID- 3665255 TI - The place of threaded pin fixation in the treatment of slipped upper femoral epiphysis. AB - Pin fixation in the treatment of slipped upper femoral epiphysis was evaluated in 60 patients admitted to the authors' hospital in Melbourne between 1970 and 1978. Forty-three cases were reviewed at an average of eight years following initial treatment. For chronic slips, in situ fixation with pins prevented further slip and promoted growth plate closure. The complication rate was low. Best results were achieved with two or three threaded pins placed into the posteroinferior segment of the femoral head to avoid avascular necrosis. Early upper femoral osteotomy was not required, as considerable bone remodeling occurred even after growth plate closure. In contrast, avascular necrosis was common following treatment of acute, severe slips, even with gentle internal rotation of the leg to reduce the acute component of the slip and pinning. PMID- 3665256 TI - Osteochondritis dissecans and osteochondral fragments managed by Herbert compression screw fixation. AB - Treatment of osteochondritis dissecans and osteochondral fragments using Herbert compression screw fixation combined with drilling gives satisfactory results. The Herbert screws may be inserted arthroscopically after identifying the lesion. The need for arthrotomy is eliminated in most instances. Management was by drilling and pinning for unseparated lesions and crater preparation with fragment fixation in cases with separated osteochondral fragments. The follow-up period is only four to 28 months. One case required arthrotomy. Ten patients with a four-month to five-year history of knee pain had unseparated lesions. Eight had excellent results with union, one required drilling and removal of sequestrae, and one remains unhealed. Three cases had separated osteochondral fragments. All three appear to have obtained union of the separated fragments without recurrence of separation. PMID- 3665257 TI - Herbert screw fixation of fracture of the head of the radius. AB - Herbert screw fixation of simple displaced fractures of the radial head involving up to one-half the articular surface is a reliable and effective technique. Following accurate reduction, the fracture surfaces are compressed with the Herbert scaphoid clamp and internally fixed with a Herbert screw, which is appropriately buried beneath the articular cartilage. Preliminary observations on two cases demonstrate rapid union and return of function occurring with anatomic reduction and sound fixation. PMID- 3665258 TI - Long-term results of conservative and operative management in complete paraplegics with spinal cord injuries between T10 and L2 with respect to function. AB - This study analyzed 87 athletes attending the Para Olympic Games at Stoke Mandeville in 1984. All athletes had had complete neurologic lesions between the levels of T10 adn L2. Clinical details were obtained from each athlete. Assessment then consisted of measurement of spinal movement in the sagittal plane using spondylometers and movement in the rotation plane using a rotameter. Body trunk strength was measured with the athletes in their own wheelchairs using a myometer. This gave a recording of kilograms of force. Trunk balance was assessed on both a static and a dynamic basis. The age, sex, follow-up period, and body weight for both spinal fusion and conservatively treated groups were similar. There was little difference in the incidence of pain between those treated by conservative and operative methods. There was statistically significant difference in the range of sagittal plane and rotation movement. There was no difference in flexor trunk power measured with the myometer between the two groups, but when extensor power was measured it was found to be 25% less in the spinal fusion group. There was no difference between the two groups when tested for static and dynamic trunk balance. Two other athletes who had had spinal fusions extending from the upper thoracic region to the sacrum showed unusually poor trunk stability. Overall, this study demonstrates that spinal fusion, particularly over multiple segments in complete paraplegics, has a deleterious effect not only on spinal movement but also on body trunk strength. PMID- 3665259 TI - Age changes in lumbar vertebrae and intervertebral discs. AB - Reduction of stature in old age has been attributed to loss of disc height. A measurement study of 204 cadaveric lumbar spines from subjects ranging in age from one day to 97 years confirmed data on loss of "spinal stature" but could not confirm a loss of disc height. With aging, there is a progressive increase in vertebral end-plate concavity, associated with decreased bone density. These changes are more evident and take place earlier in females than in males. In the cancellous bone of vertebral bodies, a decrease in the number of horizontal trabecular "cross braces" leads to fracture of the vertical weight-bearing "beams" supporting the vertebral endplate. The intervertebral discs expand centrally and become increasingly convex. Measurements of average disc height demonstrate that loss of disc height is unusual in a normal, aging population. Only a minority of lower lumbar discs from elderly subjects show "thinning" and degeneration (beyond Rolander's Grade 2). Thus, loss of stature in the elderly is attributable to loss in vertebral height rather than loss in disc height. Dessication and thinning of discs, or discs that "bulge like underinflated automobile tires" are not typical of elderly spines. PMID- 3665260 TI - [A case report of idiopathic hypokalemic periodic paralysis and idiopathic hyperCKemia with hypogammaglobulinemia in two brothers]. PMID- 3665262 TI - [Risk factor index in cerebral thrombosis--one objective tool for prophylaxis]. PMID- 3665261 TI - [Clinical and pathological studies on intellectual impairment in Duchenne muscular dystrophy, with special reference to patients with severe intellectual impairment]. PMID- 3665263 TI - [A case of spinal tumor by malignant thymoma]. PMID- 3665264 TI - [Syndrome of torticollis, head tremor, and segmental dystonia with cerebellar ataxia: a case report]. PMID- 3665265 TI - [A case of multiple sclerosis with deafness as the first manifestation]. PMID- 3665266 TI - [Three sisters suffering from Wolfram (DIDMOAD) syndrome]. PMID- 3665267 TI - [Kearns-Sayre syndrome associated with abnormal bowel movement]. PMID- 3665268 TI - [Ultraviolet hypersensitivity of cultured fibroblasts of a case of Cockayne's syndrome without clinical photosensitivity]. PMID- 3665269 TI - [Clinico-pathological characteristics of idiopathic chronic progressive sensory ataxic polyneuropathy]. PMID- 3665270 TI - [Two sisters with autosomal recessive muscular dystrophy (Miyoshi) with early involvement of limb girdle muscles]. PMID- 3665271 TI - [Fukuyama type congenital muscular dystrophy (FCMD) with a long survival--an autopsy case report]. PMID- 3665272 TI - [Loss of dendritic spines in hippocampal CA1 pyramidal cells in senescence accelerated mouse (SAM)--a quantitative Golgi study]. PMID- 3665273 TI - [Psychiatric symptoms and plasma levodopa dynamics in Parkinson's disease]. PMID- 3665274 TI - [Magnetic resonance imaging of lateral medullary syndrome]. PMID- 3665275 TI - [A case report of Behcet's disease with intracranial hypertension due to superior sagittal sinus thrombophlebitis]. PMID- 3665276 TI - [A case of myasthenia gravis complicated with chronic rheumatoid arthritis and Vogt-Koyanagi-Harada disease]. PMID- 3665277 TI - [A case of granulomatous polymyositis associated with asymptomatic primary biliary cirrhosis and immune thrombocytopenic purpura]. PMID- 3665278 TI - [A case of familial type IIa hyperlipoproteinemia with the clinical features similar to cerebrotendinous xanthomatosis]. PMID- 3665279 TI - [An autopsy case of carcinomatous sensory neuropathy with mediastinal malignant tumor]. PMID- 3665280 TI - [Event-related potential in Parkinson's disease]. PMID- 3665281 TI - [Chorea-acanthocytosis with catecholamine abnormality and orthostatic hypotension -a case report]. PMID- 3665282 TI - [Cerebral atrophy of senile dementia]. PMID- 3665283 TI - [An adult case of cleidocranial dysostosis with drop attacks]. PMID- 3665284 TI - [A case of citrullinemia with cluster type distribution of argininosuccinate synthetase in the liver]. PMID- 3665285 TI - The role of histocompatibility matching in the use of preserved nerve allografts. PMID- 3665286 TI - Ataxia telangiectasia in Chinese children. A clinical and electrophysiological study. AB - The clinical manifestations, immunological, chromosomal, and multimodal electrophysiological studies of five Chinese patients with ataxia telangiectasia are described. One died of hepatocellular carcinoma not associated with Hepatitis B-antigenaemia. Another died of respiratory failure. Two siblings are free of sinopulmonary infections although they are wheelchair bound. Computed tomography of the brain showed cerebellar atrophy in four cases. Nerve conduction studies showed evidence of axonal neuropathy in all cases with the earliest detection at six years. Electromyography showed mild denervation changes in two cases. Two patients had abnormal somatosensory evoked potentials and one had abnormal visual and brain stem auditory evoked potentials. The level of alpha foetal protein was elevated whereas the serum carcino-embryonic antigen was normal in all patients. PMID- 3665287 TI - Factors influencing the relapse risk at steroid dose reduction in myasthenia gravis. AB - In a selected group of 69 patients with myasthenia gravis treated with prednisone, the factors were studied that might have influenced the reoccurrence or exacerbation of clinical signs after initial improvement in two-thirds of the patients. It was not evident that the speed of dose reduction was responsible for the relapse in most patients. Azathioprine added to the prednisone regimen was found to reduce the relapse rate at steroid reduction. Pure ocular cases and patients who underwent thymectomy without thymoma had a higher chance to remain in remission after prednisone was stopped. Maintenance dose could be determined in 18 patients and was 0.42 mg/kg/2 d., but the difference between patients with or without azathioprine was not significant. PMID- 3665288 TI - The influence of attention on visual evoked potentials in normal adults and dementias. AB - In normal subjects (n = 58, 22-71 y) the influence of the attention level on the VEP latency is studied, as is done in an additional small group of dementias (n = 14). The motor reaction time test (MRT) was selected to measure the attention level. The MRT was administered simultaneously with the VEP (checkerboard pattern reversal). By comparing VEP in test and non-test situations it proved that administration of MRT during VEP examination does not influence the VEP latencies. In dementias the motor reaction time is delayed but the degree of MRT delay did not correlate with the VEP latencies. This holds true for healthy volunteers as well as for demented patients. It is thus concluded that the latency increase of the late peaks of the VEP in dementias cannot be attributed to attentional deficits. PMID- 3665289 TI - Risk of early anticoagulation in patients with small deep infarcts possibly caused by cardiogenic emboli. AB - From a prospective registry of 103 stroke patients on early anticoagulation for cardiac embolus we selected 23 patients with a small deep infarct. We studied the incidence of hemorrhagic infarction on CT, and the risk of early anticoagulation. We found no hemorrhagic infarction on CT in any case, and no bleeding complications during the three week observation period. Obviously, early anticoagulation can be started safely in patients with a small deep infarct possibly caused by cardiac embolism. PMID- 3665290 TI - Cerebrotendinous xanthomatosis (CTX): a clinical survey of the patient population in The Netherlands. AB - The clinical features and additional investigations of 20 Dutch patients suffering from cerebrotendinous xanthomatosis (CTX), an inborn error of metabolism in bile acid synthesis, are described. The onset was in the second or third decade. The clinical picture at the time of examination consisted of a combination of two or more of the following signs: cataract, xanthoma of a tendon, mental deterioration, pyramidal tract signs, cerebellar signs and epilepsy. Mental retardation was reported in patients. CT-scanning showed cerebellar hypodensity in 8 out of 16 patients but this feature did not correlate well with cerebellar signs. The EEG was abnormal in all but one patient. Treatment with chenodeoxycholic acid resulted in a normalization of EEG and biochemical abnormalities but not of the clinical signs. Cholic acid was equally effective but had much less side effects. The importance of a diagnosis in early life is stressed as well as the examination of clinically unaffected heterozygous relatives. PMID- 3665291 TI - Long-term observation of two cases of locked-in syndrome with recovery. Clinical and CT-scan features. AB - We report clinical features of two patients suffering from Locked-In Syndrome (LIS) who made a moderate recovery, some years after the onset: a 29-year-old man, with mitral valve stenosis, and a 41-year-old diabetic woman. CT scan findings showing cerebellar and brain stem atrophy, as well as hypodensity areas in the ventral pons, are described. PMID- 3665292 TI - Mannosidosis: a study of two patients, presenting clinical heterogeneity. AB - Two unrelated patients suffering from mannosidosis, aged 9 and 33 years, are reported, presenting two extremes in the phenotypic expression of this lysosomal storage disorder. Clinical, radiological, biochemical and therapeutical aspects of the disease are discussed. Our patients support the concept that mannosidosis is not a homogeneous syndrome but manifests wide clinical heterogeneity. PMID- 3665293 TI - High dose ketoconazole in the treatment of cerebral aspergilloma. AB - A 32-year-old Chinese woman with bilateral occipital aspergilloma was treated successfully with high dose ketoconazole (1200 mg/day) for six months in conjunction with amphotericin B and 5-fluorocytosine. No unacceptable side effects occurred. The use of high dose ketoconazole could be considered in CNS aspergillosis unresponsive to conventional anti-fungal therapy. PMID- 3665294 TI - Neurocutaneous melanosis associated with Dandy-Walker syndrome. AB - A young boy presented with mental retardation and seizures with extensive hairy naevi. After a fluctuating clinical course over the next 2 years, he worsened rapidly with signs of rising intracranial pressure. A CT scan revealed unsuspected features of Dandy-Walker syndrome. The clinical course is traced till the patient's death, and the implications of the coexistence of these rare conditions are discussed in view of the proposed hypotheses regarding the pathogenesis of Dandy-Walker syndrome. PMID- 3665295 TI - Cystic intracerebellar epidermoids with rim enhancement. A case report. AB - A case of two infected cystic epidermoids of the right cerebellar hemisphere is reported. One of the cysts showed peripheral contrast enhancement on CT. Relevant literature regarding the pathogenesis and CT diagnosis is reviewed. PMID- 3665296 TI - Detection of bile leakage from traumatic right hepatic duct laceration with technetium-99m DISIDA cholescintigraphy. AB - A woman was admitted to the hospital after blunt abdominal trauma. Initial ultrasound was equivocal but suggested a localized hepatic laceration. The patient was discharged but returned three weeks later with ascites and mild pain in the right upper abdominal quadrant. Hepatobiliary imaging identified a large bile leak originating from the porta hepatis but showed no evidence of parenchymal injury. No hepatic injury was found at surgery, but a laceration of the right hepatic duct was identified. Hepatobiliary imaging is the procedure of choice in diagnosing bile leaks from the extrahepatic biliary system. PMID- 3665297 TI - Hepatobiliary imaging and the use of intravenous morphine. AB - Thirty-one patients suspected of acute cholecystitis were studied prospectively using hepatobiliary imaging in conjunction with intravenous morphine. If persistent nonvisualization of the gallbladder occurred post-morphine, delayed 4 hour imaging was performed. Intravenous morphine correctly diagnosed acute cholecystitis in 94% of cases. Through the use of intravenous morphine, imaging time can be decreased from 4 to 1.5 hours. PMID- 3665298 TI - Comparison of technetium-99m sulfur colloid and technetium-99m albumin colloid labeled solid meals for gastric emptying studies. AB - A Tc-99m albumin colloid (Tc-AC) kit has been introduced as an alternative to Tc 99m sulfur colloid (Tc-SC) for liver-spleen imaging. Since there is no need for boiling, the use of Tc-AC reduces preparation time and manipulation. Tc-SC is one of the most commonly used radiopharmaceuticals for the labeling of solid-phase markers in gastric emptying studies. In vitro studies were performed to evaluate the labeling efficiency and stability in hydrochloric acid and in human gastric juice of intracellularly labeled chicken liver and scrambled eggs labeled with Tc SC and Tc-AC. Gastric emptying studies also were performed on 20 healthy volunteers with both Tc-SC and Tc-AC labeled scrambled egg sandwiches. There was no significant difference between Tc-SC and Tc-AC in the labeling efficiency of chicken liver (98% +/- 1% for Tc-SC, 96% +/- 2% for Tc-AC) and scrambled eggs (92% +/- 2% for Tc-SC, 91% +/- 3% for Tc-AC). However, both Tc-SC and Tc-AC labeled scrambled eggs showed a lower stability than chicken liver, particularly in human gastric juice. Gastric emptying curves from both meals in 20 normal subjects were also similar, with a mean half-emptying time of 85 +/- 13 minutes and 87 +/- 16 minutes for the meals containing Tc-SC and Tc-AC respectively. Tc AC is a reliable alternative to Tc-SC as a radiotracer for solid-phase gastric emptying studies. PMID- 3665299 TI - Uterine uptake of iodine-123 metaiodobenzylguanidine during the menstrual phase of uterine cycle. AB - Radioiodinated I-123 metaiodobenzylguanidine (MIBG) has been used for diagnostic purposes for detection of apudomas. In this paper normal physiological uptake of I-123 MIBG by the uterus during the menstrual phase of the uterine cycle is reported. It is likely that I-123 MIBG can be used to evaluate some of the problems in this context. PMID- 3665300 TI - Radioisotopic flow scanning for portal blood flow and portal hypertension. AB - The use of a simple, noninvasive, isotope scanning technique for the determination of relative portal blood flow and detection of portal hypertension is described. Using this technique the presence of portal hypertension was demonstrated in seven of nine patients known to have elevated portal venous pressure. By contrast, esophageal varices were demonstrated in only five of these patients, illustrating the potential value of the method. Furthermore, this technique has been adapted to the study of portal blood flow in patients with myeloproliferative disorders with splenomegaly but without disturbances in hepatic architecture. Results demonstrate that the high relative splenic flow resulting from the presence of splenomegaly may in turn be associated with elevated relative portal blood flow and portal hypertension. The theoretic reasons for the development of flow-related portal hypertension and its relationship to splenic blood flow are discussed. PMID- 3665301 TI - Scintigraphic evaluation of polyostotic fibrous dysplasia. AB - Bone scintigraphy is a sensitive imaging modality for detecting early lesions and polyostotic involvement in fibrous dysplasia. Common findings include multiple areas of focal uptake that are often unilateral and typically involve the ribs, tibia, femur, and craniofacial bones. A knowledge of various skeletal manifestations of fibrous dysplasia is helpful to distinguish it from Paget's disease, osteoblastic metastasis, and fractures. Several recent cases representing varying involvement of fibrous dysplasia are presented and the literature is reviewed. PMID- 3665302 TI - Diagnosis and treatment of neuroblastoma using metaiodobenzylguanidine. AB - Neuroblastoma is a lethal and not uncommon tumor in childhood. Early detection and display of the spread of the tumor is highly desirable for proper treatment. Nine children suspected of having neuroblastomas were examined by I-131 metaiodobenzylguanidine (I-131 MIBG) imaging. In two recent studies I-123 metaiodobenzylguanidine (I-123 MIBG) was used. A primary adrenal neuroblastoma was correctly identified in three cases. In two patients additional tumor sites were found. In one patient, who was in complete remission, no pathologic accumulation of I-131 MIBG was found. I-131 MIBG images were also normal in four patients with other types of neoplastic diseases. A boy with multiple metastases was treated with 100 mCi of I-131 MIBG. He developed transient gastrointestinal illness and there was no regression of the tumor deposits. In one girl with a large adrenal neuroblastoma high uptake of I-131 MIBG was observed. She received two therapy doses of I-131 MIBG (35 mCi and 75 mCi) with curative intention giving a total absorbed dose in the tumor of approximately 76 Gy. In spite of high retention of radioactivity in the tumor, regression did not occur, but her general condition was improved. In the present study, images of superior quality were obtained with I-123 MIBG imaging. It is concluded that imaging using I-131 MIBG or I-123 MIBG should be used in both the initial evaluation and the follow up of children with neuroblastoma. PMID- 3665303 TI - Bipartite liver. A case report. AB - Bipartite liver is a rare anomaly that has no apparent phylogenetic significance but does represent a distinct category of congenital liver malformations. Although no associated complications have been known to occur, the potential for internal herniation of the gastrointestinal tract may exist. PMID- 3665305 TI - Bone scintigraphy. Hypertrophic osteoarthropathy in biliary atresia. PMID- 3665304 TI - Demonstration of epicranial varix with technetium-99m labeled red blood cells. PMID- 3665306 TI - Positional changes in a hemangioma demonstrated by red blood cell imaging. PMID- 3665307 TI - Ewing's sarcoma of the thumb. Radiographic, angiographic, CT, and bone scan findings. PMID- 3665308 TI - Retroanastomotic herniation mimicking biliary leakage in a cholescintigraphic pattern. PMID- 3665309 TI - Calcinosis of childhood dermatomyositis with glucoheptonate angiogram. PMID- 3665310 TI - The utilization of technetium-99m CPI as a myocardial perfusion imaging agent in exercise studies. AB - Myocardial perfusion imaging with Tc-99m carbomethoxyisopropylisonitrile (CPI) was compared with Tl-201 imaging in 22 patients who were assessed for coronary artery disease. There was agreement between Tc-99m CPI and Tl-201 imaging for detecting segmental myocardial ischemia and fixed defects in 185/198 (93%) of left ventricular segments. There was also an excellent correlation between the two tracers for the detection of coronary artery disease (18/22 patients). Myocardial clearance of the isonitrile complex was slow, and there was no redistribution into ischemic regions; the normal to ischemic myocardial ratio remained relatively constant over time. Reinjection at rest was used to distinguish transient ischemia from infarction. The isonitrile complex was excreted rapidly via the hepatobiliary system. After 3 hours, background activity was reduced to about 20% of the initial activity. Tc-99m CPI appears comparable to Tl-201 thallous chloride for detecting coronary artery disease. Tc-99m CPI may be useful as a myocardial imaging agent because there is no myocardial redistribution, myocardial clearance is slow, and clearance from background tissues is rapid. PMID- 3665311 TI - Clinical significance of increased temporomandibular joint uptake by planar isotope bone scan. AB - Previous studies have suggested a role for the isotope bone scan in the evaluation of patients with temporomandibular joint (TMJ) related symptoms. The studies have not evaluated the frequency or significance of increased TMJ uptake in a random population. One hundred fourteen patients receiving routine bone scans were asked to complete questionnaires regarding TMJ symptoms. The data show that marked TMJ uptake is relatively rare (4%) and correlated with appropriately lateralizing symptoms in all cases. Lesser degrees of increased TMJ uptake correlated poorly (50% symptomatic). The authors suggest that increased TMJ uptake is a significant finding on routine isotope bone scans. The role of the isotope bone scan in the symptomatic patient remains unclear. PMID- 3665312 TI - Radionuclide angiography of azygos continuation of inferior vena cava in left atrial isomerism (polysplenia syndrome). AB - Interruption of the inferior vena cava with azygos continuation is present in at least 65% of the patients suffering from left atrial isomerism (polysplenia syndrome). First-pass radionuclide angiography using a peripheral vein of the foot correctly diagnosed interruption of the inferior vena cava in seven patients. Four had azygos continuation to the right superior vena cava and in three it was to the left superior vena cava. In all the patients, cardiac catheterization confirmed the diagnosis. Four underwent surgical correction (or palliation), three are waiting for an operation. Radionuclide angiography is a simple outpatient procedure and useful in the clinical diagnosis of this syndrome. PMID- 3665313 TI - Biliary imaging suggesting common duct obstruction in acute viral hepatitis. Case report. AB - A patient with right upper quadrant pain showed normal tracer extraction and a prolonged hepatocellular phase during biliary imaging, findings that are most consistent with complete common duct obstruction. He had no other evidence of biliary tract obstruction and was diagnosed subsequently as having viral hepatitis. Hepatitis must be considered when biliary imaging suggests complete common bile duct obstruction. PMID- 3665314 TI - Scintigraphic findings in acute gangrenous cholecystitis. AB - Nine patients who had surgically proven acute gangrenous cholecystitis and Tc-99m DISIDA scintigrams were reviewed retrospectively. Three types of scintigraphic findings were presented: 1) nonvisualization of the gallbladder, three cases; 2) nonvisualization of the gallbladder plus a rim sign, two cases; and 3) nonvisualization of the gallbladder plus an enlarged photon deficient area corresponding to the gallbladder fossa, four cases. A rim sign or an enlarged gallbladder fossa reflect the direct spread of inflammation from the gallbladder into the liver, causing impaired hepatocyte function. An enlarged gallbladder fossa may represent a later stage of a rim sign. Presumably tracer excretion by hepatocytes is affected initially by the inflammatory process, followed by impairment of tracer concentrating ability. Since the gallbladder may be suspended occasionally by a mesentery and not in contact with the liver, the secondary signs may be absent in acute gangrenous cholecystitis. PMID- 3665315 TI - The pericholecystic hepatic activity sign in a normal DISIDA study. Case report. AB - A patient with a normal DISIDA study underwent a laparotomy that revealed acute cholecystitis. Retrospective review of the DISIDA study showed pericholecystic hepatic activity. PMID- 3665316 TI - A simplified method of assessing hemodynamics in technetium-99m sulfur colloid liver imaging. AB - A total of 204 Tc-99m sulfur colloid hemodynamic studies of the liver taken at 5 second intervals were evaluated. The time when the gradually increasing activity in the liver becomes equal to the reducing activity in the heart pool is defined as the relative half clearance time (RHCT) of cardiac activity to the liver. The RHCT was measured in each scan and was correlated with clinical information, liver function tests, and static scan findings. Normal RHCT was established to be in the range of 40 +/- 20 seconds. This study indicates that the RHCT truly reflects the functional status of the hepatic blood flow as well as the phagocytic activity of the Kupffer cells of the liver when cardiac function is normal. A prolonged RHCT may indicate the presence of a parenchymal disease of the liver or cardiac failure with hepatic congestion, or both. The longer the RHCT, the more severe the pathologic condition of the liver, provided that cardiac function is normal. PMID- 3665317 TI - Hyperventilation thallium-201 myocardial imaging for the diagnosis of vasospastic angina. AB - In seven patients with vasospastic angina, a transient myocardial perfusion defect was demonstrated on Tl-201 myocardial imaging after hyperventilation (HV). The development of spasm on one or more coronary arteries after HV was confirmed by later coronary arteriographic studies, with the perfusing area of the coronary arteries being compatible with the scintigraphic location of the defect. Repeated 12-lead electrocardiograms failed to establish the diagnosis in one of the seven patients. It is concluded that HV Tl-201 myocardial imaging provides invaluable information in establishing a diagnosis of vasospastic angina. PMID- 3665318 TI - Mismatch between iodine-123 IMP and technetium-99m HM-PAO brain perfusion imaging in a patient with meningioma. AB - The discrepancy between three methods for cerebral perfusion imagings in the case of a man with meningioma is presented. Imaging with N-isopropyl-P-[I-123] iodoamphetamine (IMP) showed no activity in the tumor. Imaging with Tc-99m hexamethylpropyleneamine oxime (HM-PAO) and the local cerebral blood flow (LCBF) image with Xe-133 inhalation showed high tumor activity. IMP is a more accurate method for imaging the brain tissue blood flow. PMID- 3665319 TI - Leveen shunt visualization without function using technetium-99m macroaggregated albumin. AB - Nonfunction of a Leveen shunt was diagnosed in a 53-year-old cirrhotic woman by lack of lung visualization following intraperitoneal administration of Tc-99m MAA, despite imaging of the shunt tubing itself. Surgery confirmed the malfunction and follow-up study after surgical correction showed normal function. Using intraperitoneal injection, an end-organ must be seen to confirm shunt function. The method of Rosenthall et al may provide a more rapid diagnosis of nonfunction without the necessity of end-organ imaging. PMID- 3665320 TI - The last surviving wall. AB - A total of 66 patients with advanced coronary artery disease (CAD) and 36 with dilated cardiomyopathies (DCM) with ejection fractions less than 20% were analyzed retrospectively to establish patterns of wall motion in each of four quadrants on standard left anterior oblique gated radionuclide ventriculograms. In both disease states the best preserved wall motion was found in the basal free wall quadrant of the left ventricle. The two terminal disease states could not be differentiated on the basis of wall motion patterns. PMID- 3665321 TI - Diagnosis of a pneumothorax on the ventilation lung scan images. PMID- 3665322 TI - Uptake of iodine-131 by a Meckel's diverticulum mimicking metastatic thyroid cancer. PMID- 3665323 TI - Pseudo-splenic uptake in a DISIDA scan. A normal liver variant. PMID- 3665324 TI - Pharmacokinetics of lignocaine and bupivacaine in surgical patients following epidural administration. Simultaneous investigation of absorption and disposition kinetics using stable isotopes. AB - The pharmacokinetics of lignocaine (lidocaine) and bupivacaine following epidural administration were studied in 12 surgical patients using a stable isotope method. Shortly after epidural administration of the agent to be evaluated, a deuterium-labelled analogue was administered intravenously. Plasma concentrations of the unlabelled and the deuterium-labelled local anaesthetics were determined using gas chromatography and mass fragmentography. The pharmacokinetic behaviour of both agents was consistent with a 2-compartment open model and two parallel first-order absorption processes. The mean distribution and elimination half lives were 12 minutes and 100 minutes for lignocaine, and 22 minutes and 143 minutes for bupivacaine. The mean volumes of the central compartment and the mean steady-state volumes of distribution were: lignocaine, 43L and 99L; bupivacaine, 33L and 68L. Total plasma clearances averaged 0.95 L/min (57 L/h) for lignocaine and 0.52 L/min (31.2 L/h) for bupivacaine. The half-lives, characterising the fast and slow absorption processes, were 9.3 and 82 minutes for lignocaine, and 7.0 minutes and 362 minutes for bupivacaine; the fractions of the doses absorbed in the fast and slow processes were lignocaine 0.38 and 0.58, bupivacaine 0.28 and 0.66, respectively. The results indicate that the local anaesthetics are completely absorbed from the epidural space into the general circulation. The initial absorption rates of both local anaesthetics appear to be similar, but, later, the absorption of bupivacaine proceeds much more slowly than the absorption of lignocaine. PMID- 3665325 TI - The influence of food on the bioavailability of a slow release theophylline preparation. AB - Food-induced changes in the absorption of Theostat 300, a controlled release formulation of theophylline, have been studied in healthy volunteers. This open, randomised, 3-way, single-dose study involved 12 volunteers who received the drug either while fasting, or with a standardised low-fat (10g), or high-fat (60g) breakfast. Each subject was studied over a 3-week period, with 3 separate days of oral treatment and a 7-day washout period between treatments. The results showed no differences in AUC0-24 and tmax values between the 3 kinds of diet. The only differences observed concerned absorption. Food intake increased Cmax values by 20%. The steady-state peak concentration obtained by means of simulated plasma levels was not influenced by food intake. This slight food-drug interaction of Theostat 300 seemed to be of no clinical significance. PMID- 3665326 TI - Childhood dermatomyositis. Clinical course and long-term follow-up. AB - The presentation, clinical course, and long-term follow-up (3-22 years) of 39 children with dermatomyositis followed from 1962-1982 is presented. The medical course of these patients was complicated by respiratory diseases (20%), gastrointestinal diseases (24%), and calcinosis (30%). Patients presenting prior to 1972 received a wide variety of treatments. Since 1972, treatment has consisted of long-term prednisone, supplemented in some patients with azathioprine. Ten patients died (eight of whom were first seen before 1972) of complications after intestinal perforation (5) or aspiration pneumonia (5). Of 29 survivors, three have persistent calcinosis and/or contractures. Improved outcome since 1972 probably relates to better clinical assessment, management of complications, and regulation of drug therapy. PMID- 3665327 TI - May children with otitis media with effusion safely fly? AB - This study addresses the question of whether patients who fly with otitis media with effusion (OME) are at risk for the development of barotitis. Fourteen patients with otitis media with effusion were followed before and after air travel. No ear with OME became symptomatic, though two contralateral, previously "normal" ears did become symptomatic. An analysis of the physiology of this phenomenon is presented. PMID- 3665328 TI - Fatalities from undetected appendicitis in early childhood. AB - A survey of unexpected death in children 1 to 5 years of age in a defined community over a 9-year period revealed three deaths, representing 4.5 deaths per million at risk per year. These cases were preceded by recognized prodromal symptoms, yet proper diagnosis did not occur and prompt therapy was not instituted. A higher index of suspicion, improved attention to early symptoms, and decreased therapeutic delay are suggested to prevent these deaths. PMID- 3665329 TI - Mothers and their children look at baby pictures: the NICU experience in retrospect. AB - Photographs of Neonatal Intensive Care Unit (NICU) patients are frequently given to parents to promote bonding, but little attention has been paid to how families respond years later to viewing these special baby pictures. This study examines how 71 mothers of 3 to 7-year-old developmentally normal (DQ greater than or equal to 80) children who weighed less than 1,500 g at birth describe this experience. Compared to a group of mothers whose children were full term at birth, the NICU mothers described personally feeling and perceiving their children as more fearful (p less than .05), inquisitive (p less than .0001), worried (p less than .01), thoughtful (p less than .0001), and tearful (p less than .05). The responses of NICU mothers were significantly more highly correlated with their perceptions of their children's responses than were the mother-child correlations observed in a comparison group. The NICU children were reported by their mothers to ask about the NICU equipment, pain, being alone, their physical scars, and if their being "bad" caused their need for intensive neonatal care. Recommendations are provided on how pediatric care providers can assist NICU parents anticipate questions and respond to their children's concerns as they view these potentially distressing photographs. PMID- 3665330 TI - Lacunar infarction of the basal ganglia as a complication of hemolytic-uremic syndrome. MRI and clinical correlations. AB - Central nervous system (CNS) complications of hemolytic-uremic syndrome (HUS) commonly consist of alterations in mental status, seizures, and rarely hemiparesis. The authors report the clinical evolution of left hemiparesis and later choreo-athetoid movements in a patient who sustained a right lacunar infarction as a complication of HUS. The infarction is demonstrated on magnetic resonance imaging (MRI). PMID- 3665331 TI - Rhabdomyolysis complicating doxylamine overdose. AB - A 16-year-old male presenting with anticholinergic symptoms was found to have hematuria and oliguria. Evaluation of the patient revealed a serum creatinine of 2.2 mg/dl, myoglobinuria, and a creatine phosphokinase (CPK) level of 78, 750 IU/l with 99 percent fraction 3 isoenzyme. A toxic screen showed the presence of doxylamine, an antihistamine of the ethanolamine class, at a level of 75 times therapeutic. The patient did not have a history of trauma or seizures. The extremely high CPK level with the doxylamine overdose suggests that doxylamine may be associated with nontraumatic rhabdomyolysis. This is the first case report of rhabdomyolysis being associated with an antihistamine overdose. PMID- 3665332 TI - Strangulation of the uvula by hair wrapping. AB - A 13-month-old male presented with a hair wrapped around his uvula. The entwined hair subsequently caused autoamputation of the distal uvula. Although a non accidental etiology has been suggested for some cases of hair strangulation of appendages, this case indicates accidental strangulation of body parts is possible. PMID- 3665334 TI - The respiratory system in the newborn. PMID- 3665333 TI - Use of computed tomography in evaluation of acute respiratory distress in a 4.5 month-old with bronchogenic cyst. AB - A 4.5-month-old female presented with stridor and acute respiratory distress. Chest radiographs showed hyperinflation of the left lung. Computed tomography of the chest demonstrated a small bronchogenic cyst not clearly identified by other methods. PMID- 3665335 TI - Bias in pharmacokinetics and clinical pharmacology. PMID- 3665336 TI - On the use of drugs administered as racemates. PMID- 3665337 TI - The mechanism of the warfarin-rifampin drug interaction in humans. AB - The mechanism of the drug interaction in humans between warfarin and rifampin was investigated by monitoring the elimination kinetics and metabolic disposition of a single oral dose of pseudoracemic warfarin by GC/MS. The decrease in hypoprothrombinemia observed with concomitant administration of therapeutic doses of rifampin was accompanied by a substantial decrease in the elimination half lives of both warfarin enantiomers. Rifampin increased the clearance of (R) warfarin threefold and the clearance of (S)-warfarin twofold. The excretion profiles for warfarin and its metabolites in urine and feces were similar for both control and treated subjects with the exception that 4'-hydroxywarfarin (stereoselective for the (S)-enantiomer) was observed when rifampin was administered. 4'-Hydroxywarfarin is a metabolite of the drug hitherto undetected in vivo in humans. Based on formation clearance values estimated for 6-, 7-, and 8-hydroxywarfarin, rifampin appears to increase the clearance of the parent drug by induction of the cytochrome P-450 isozyme(s) responsible for aromatic hydroxylation. PMID- 3665338 TI - Disposition kinetics of moclobemide, a monoamine oxidase-A enzyme inhibitor: single and multiple dosing in normal subjects. AB - The absorption and disposition kinetics of moclobemide (Ro 11-1163), a new reversible and preferential monoamine oxidase-A enzyme inhibitor, were examined in 12 normal male subjects. An intravenous infusion was administered before and after a 15-day multiple oral dosing regimen (100 mg t.i.d.). Plasma concentration time data were obtained after each intravenous infusion, after the first oral dose, during two dosing intervals at steady state, and before the second daily dose on several days. The disposition values (percent coefficient of variation in parentheses) after the first and second intravenous infusions, respectively, were: clearance, 39.4 (15%) and 29.1 (12%) L/hr; elimination half-life, 1.60 (15%) and 2.00 (18%) hours; and volume of distribution at steady state, 84.3 (11%) and 80.7 (15%) L. The absolute oral bioavailability increased from 0.56 after the first oral dose to 0.86 and 0.90 after the first and second weeks of administration, respectively. The reduced metabolic, presumably hepatic, clearance may be the result of self-inhibition or metabolite inhibition of moclobemide clearance. PMID- 3665339 TI - Pharmacodynamics and pharmacokinetics of oral pirmenol. AB - The efficacy, pharmacokinetics, and pharmacodynamics of pirmenol, a class Ia antiarrhythmic agent, were studied in patients with frequent symptomatic premature ventricular complexes (PVCs). Pirmenol was given every 12 hours to eight patients in a dose-ranging protocol, and median PVC suppression of 94% (range 72% to 100%) was achieved. The median effective pirmenol dose was 300 mg/day (range 200 to 500 mg/day), and mean (+/- SD) trough plasma pirmenol concentration at the effective dose was 0.98 +/- 0.29 micrograms/ml. The mean half-life of elimination was 10.5 +/- 2 hours. There was considerable overlap among patients with respect to plasma pirmenol concentration and times at which PVC frequency returned to 25%, 50%, and 75% of baseline during drug washout trials. Altering pirmenol's dose interval (while maintaining a constant daily dose) from 12 to 6 hours did not improve drug efficacy. Pirmenol was given to seven patients for long-term therapy (24 to 44 months). Median PVC suppression at 24 months was 70%. Pirmenol is safe and well tolerated, and it can be administered twice daily for PVC suppression. PMID- 3665340 TI - Prednisolone and methylprednisolone kinetics in children receiving anticonvulsant therapy. AB - Prednisolone and methylprednisolone pharmacokinetic parameters were evaluated in asthmatic children receiving concomitant anticonvulsant therapy. On separate study days, 15 children receiving either phenobarbital, carbamazepine, phenytoin, or combination anticonvulsant therapy were administered an intravenous dose of prednisolone or methylprednisolone and compared with a pediatric population not receiving anticonvulsant therapy. Plasma clearance of prednisolone in subjects receiving phenobarbital, carbamazepine, and phenytoin and in control subjects was 302.7 +/- 74.6, 383.2 +/- 53.8, 378.9 +/- 50.7, and 214.0 +/- 28.8 ml/min/1.73 m2 (mean +/- 1 SD), whereas plasma clearance of methylprednisolone was 1179.1 +/- 519.4, 1687.0 +/- 109.9, 2209.5 +/- 473.8, and 381.7 +/- 98.4 ml/min/1.73 m2, respectively. Bioavailability of prednisolone after the oral administration of prednisone and methylprednisolone ranged from 86% to 104% during anticonvulsant therapy. Three individuals reevaluated 13 to 20 days after discontinuing anticonvulsant therapy demonstrated pharmacokinetic parameters similar to those of the control group. Limited studies performed in patients receiving combination anticonvulsant therapy did not demonstrate an additive effect on prednisolone elimination. Differences in the degree of enhancement of prednisolone and methylprednisolone disposition in all three anticonvulsant study groups suggest that different metabolic pathways may be involved. PMID- 3665341 TI - An evaluation of population pharmacokinetics in therapeutic trials. Part II. Detection of a drug-drug interaction. AB - The use of observational data, collected during the routine clinical care of patients, has been advocated as a means to obtain clinically relevant information regarding the pharmacokinetic parameters of drugs. However, the validity of this approach and its proper role in new drug development is unclear. This study was performed to evaluate the ability of three approaches to estimate population pharmacokinetic parameters: the traditional approach, mixed-effect modeling, and a simple pharmacokinetic screen. The evaluation was performed with data collected during a multicenter, open-label study evaluating the efficacy, safety, and pharmacokinetics of imipramine and alprazolam in combination. The traditional pharmacokinetic study demonstrated a 20% decrease in the clearance of imipramine in the presence of 4 mg/day alprazolam. Mixed-effect modeling extends these findings by suggesting that the interaction is dependent on the simultaneous concentration of alprazolam, a finding that was not possible under the study design typically used for traditional pharmacokinetic studies. Although the simple screen suggests the presence of the drug-drug interaction, limited information regarding pharmacokinetic parameters is available and those parameters that can be estimated are biased. PMID- 3665342 TI - Pharmacokinetics of rimantadine hydrochloride in patients with chronic liver disease. AB - Six patients with chronic liver disease and six sex-, age (+/- 5 years)-, and weight (+/- 5 kg)-matched healthy control subjects received a single dose of two 100 mg tablets rimantadine HCl. Eight additional patients with chronic liver disease who were not matched to healthy subjects received a single dose of two 100 mg tablets of rimantadine HCl. Blood and urine samples were collected and rimantadine concentrations were determined by a GCMS method. The values for maximum plasma concentration, AUC, elimination half-life, and renal clearance were not significantly different between patients and control subjects, independent of the statistical analyses (parametric and nonparametric) used. The mean apparent elimination half-life, volume of distribution, and total clearance in the matched patients with liver disease were 32 hours, 24 L/kg, and 676 ml/min, respectively. Renal clearance and the amount excreted in the urine unchanged were 63 ml/min and 10%, respectively. In conclusion, rimantadine pharmacokinetics were not appreciably altered in patients with less severe chronic liver disease. PMID- 3665343 TI - Diabetic impotence: risk factors in a clinic population. AB - Analysis of questionnaire replies from 292 diabetic men aged 20-59 revealed impotence in 23% (66), compared to 9% (7) of a sample of 81 non-diabetic outpatients. Further investigation of 45 impotent diabetic men and 45 matched non impotent diabetic controls revealed greater psychological stress and poorer glycaemic control in the impotent group. There were no significant differences in the frequency of peripheral neuropathy, retinopathy, nephropathy or large vessel disease in the 2 groups. 20% (9) of the impotent diabetic group had definite autonomic neuropathy which was not present in any of the non-impotent group. The frequency of early autonomic damage was, however, similar in both groups. Impotence in diabetic men is associated with hyperglycaemia, stress and definite autonomic neuropathy. Our data suggest that men with early autonomic neuropathy are frequently potent. PMID- 3665344 TI - Clinical correlates of basal hepatic glucose output and metabolic clearance rate of glucose using glucose-C-peptide-body mass indexes in ambulatory type 2 diabetic patients. AB - The use of glucose (G)--C-peptide (C)--body mass indexes (BMI) as clinical determinants of likely response to oral sulphonylurea agents in type 2 diabetic patients have been suggested by some investigators. The relationships between these clinical parameters are usually expressed as scores (C/G, G/BMI and C/BMI scores). Based on this approach, we have determined the significance of these clinical scores using isotopically-derived basal glucose fluxes (D[3-3H]glucose technique) in 26 subjects (10 type 2 diabetics and 16 nondiabetics) with a broad range (72-346 mg/dl) of fasting serum glucose (FSG) and BMI (19-39 kg/m2). The basal hepatic glucose output (HGO) correlated positively with FSG, BMI and G/BMI score and negatively with C/G score in the diabetic patients. We found no significant relationships between basal HGO and most of these parameters except FSG and G/BMI in the normal subjects. The basal metabolic clearance rate of glucose (MCR) significantly correlated, but inversely, with FSG and G/BMI score, but not with the C/G score or BMI in the diabetic patients. In the normal subjects, MCR significantly, but negatively, correlated with the BMI, but not with FSG, C/G or G/BMI scores. Neither basal HGO nor MCR correlated with fasting serum C-peptide, duration of diabetes or daily insulin dose. As a group, the basal HGO correlated positively with FSG, BMI and G/BMI scores but negatively with C/G Score. However, the basal MCR correlated negatively with FSG, BMI and G/BMI scores but positively with C/G score. In summary, the present cross sectional study provides additional information on the determinants of fasting serum glucose levels in type 2 diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665345 TI - Effects of leguminous seeds in a mixed diet in non-insulin-dependent diabetic patients. AB - The effects of moderate addition of leguminous seeds to a mixed diabetic diet were evaluated in 15 inadequately controlled patients with non-insulin-dependent diabetes mellitus. A control diet and a diet with an increased content of peas and beans (leguminous diet) were given consecutively for a 3-week period each on a metabolic ward. Seven of the patients started with the control diet and 8 with the leguminous diet. On an energy basis the diets comprised 20% protein and 33 34% fat, the ratio between polyunsaturated and saturated fatty acids was 1.4. The analysed dietary fibre contents of the control and leguminous diets were 24 and 37 g/day per 6.7 MJ (1,600 kcal) respectively. The content of digestible carbohydrates was similar in the 2 diets. The mean body weight did not differ after the 2 dietary treatment periods. All patients showed improved glucose control during treatment irrespective of the type of diet given. The fasting blood glucose concentration on admission was 14.3 +/- 0.9 mmol/l (mean +/- SEM). This value had decreased to 9.9 +/- 0.8 during the last week of the control period and to 9.7 +/- 0.6 during the last week of the leguminous diet period. The mean postprandial glucose concentration at 3 pm was significantly lower during the leguminous diet period. The mean urine glucose excretion was significantly lower during the leguminous diet period. The fasting serum lipid concentrations decreased during treatment with each diet, but there were no significant differences between these values at the end of the 2 diet treatment periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665346 TI - What is the significance of the abnormal oesophageal scintigram? AB - In a review of 52 oesophageal scintigrams carried out in 46 patients with a variety of oesophageal problems, there was no correlation between the results of this test and the findings in other tests of oesophageal function, or between the scintigram results and the patients' symptoms, with the possible exception of regurgitation. We conclude that the test is of little value. PMID- 3665347 TI - Abdominal aortic aneurysm causing duodenal obstruction. AB - Two cases of abdominal aortic aneurysm presenting with duodenal obstruction following truncal vagotomy and pyloroplasty are described. Barium examination revealed the site and cause of obstruction in both. In one case the aneurysm was successfully resected. PMID- 3665348 TI - Patterns of axillary lymphadenopathy demonstrated by mammography: implications for the asymptomatic woman in a breast screening programme. AB - Carcinoma of the breast is the commonest cause of mortality due to malignancy in women in England and Wales. Mammographic screening, with or without clinical examination, is being used increasingly to detect lesions at an earlier stage. In order to test the claim that an asymptomatic woman with axillary lymph nodes on mammography and no demonstrable underlying carcinoma has a greater than two-fold increased risk of developing subsequent breast cancer, a retrospective analysis was performed on 217 mammograms selected from approximately 40,000 screened women using a cluster sampling technique. A group of women with histologically proven breast carcinoma and two control groups were analysed. The incidence, site and pattern of axillary lymph nodes was compared in the three groups. The relative risk of the asymptomatic woman with axillary lymph nodes developing breast cancer was 1.08 times that of the asymptomatic woman without axillary lymph nodes. From these data we conclude that the presence of lymph nodes does not constitute a risk factor for the development of subsequent ipsilateral mammary cancer and should not influence the assessment of screening mammograms. PMID- 3665349 TI - Importance of the jaw radiograph in diagnosis of Burkitt's lymphoma. AB - An analysis of the plain film changes of the jaws in 51 histologically confirmed cases of Burkitt's lymphoma was carried out. In tumours confined clinically to the jaws there was a 91% incidence of effacement of the dental lamina dura while in tumours confined clinically to the abdomen there was an incidence of 72.7%. When tumour deposits were clinically present in more than one anatomical site, almost all cases showed effacement of the dental lamina dura. These findings emphasise the need for jaw radiographs to reinforce the diagnosis in suspected cases of Burkitt's lymphoma. PMID- 3665350 TI - Three-dimensional reformations of computed tomography in the assessment of facial trauma. AB - Three-dimensional (3D) computed tomography (CT) reformations were obtained in 15 patients presenting with facial injuries of differing severity. The 3D images were compared with standard radiographs and high resolution CT, including multiplanar reformations, and assessed under the headings of fracture detection, extent and displacement using a simple scoring system. 3D was valuable in severe trauma with multiple fractures, providing a clear demonstration of fraction extent and fragment displacement. 3D was much less useful in minor trauma in which little or no fragment displacement had occurred, and demonstrated fewer fractures overall than either radiography or CT in all categories of facial injury. When used as part of a high resolution CT examination 3D imaging can provide useful information to both radiologist and surgeon in cases of severe facial trauma. PMID- 3665351 TI - Magnetic resonance imaging of peri-aqueductal lesions. AB - Fourteen lesions in the peri-aqueductal region were evaluated by 0.5T magnetic resonance imaging (MRI) and computed tomography (CT). Fifty normal magnetic resonance studies of the same region were reviewed. The aqueduct of Sylvius is seen in the midline sagittal MRI sections in all normal patients. It is not usually visible in cases of benign stenosis but may be seen in membranous obstruction. Benign stenosis is distinguished from neoplastic obstruction by the lack of increased signal on T2 weighted techniques. Blood within pineal tumours is easily detected and may be differentiated from lipomas, cystic lesions and solid tumours of the brain stem. Arachnoid cysts are also visible in MRI scans. PMID- 3665352 TI - The left subphrenic crescent sign in direct cholangiography. AB - Left subdiaphragmatic collections of contrast medium were demonstrated in three patients during cholangiography. All the patients had undergone previous surgery for either biliary, gallbladder or pancreatic disease. The shape of the collections was crescentic and the underlying abnormality was an anterior subdiaphragmatic abscess. Left subphrenic abscesses should therefore be considered when crescentic left subphrenic accumulations of contrast medium occur during cholangiography. PMID- 3665353 TI - Percutaneous high brachial aortography. PMID- 3665354 TI - Nasopharyngeal carcinoma treated by radiotherapy and chemotherapy. PMID- 3665355 TI - Bile acid binding to dietary casein: a study in vitro and in vivo. AB - 1. Studies were carried out in vitro using an ultracentrifugation method to quantify bile acid binding to the different components of a Lundh test meal, and to determine what factors influence bile acid binding to one of the components (casein). We validated the ultracentrifugation method by showing good agreement with the equilibrium dialysis method. Studies were carried out in vivo on jejunal aspirate from 10 ileal resection patients in order to determine whether bile acid binding to casein could be demonstrated, and whether this influenced aqueous phase bile acid and fatty acid concentrations. 2. In vitro, the Lundh test meal was found to adsorb bile acid. The protein content of the meal (casein) alone accounted for this binding, which was abolished by use of casein hydrolysate. The binding to casein was a saturable process. Both binding affinity and binding capacity were significantly greater for taurocholate at pH 4.5 than at pH 6.5, and for dihydroxylated than for trihydroxylated bile acid, suggesting that hydrophobic bonding was involved. 3. In vivo, jejunal samples aspirated at pH greater than 6 from 10 ileal resection patients showed 25% binding of bile acid to protein. On substitution of amino acids for casein, mean binding was reduced to 16% (P less than 0.05), residual binding being attributed to endogenous protein. This was associated with an increase in fatty acid solubilization from 28% to 60% (P less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665356 TI - Human alveolar gas-mixing efficiency for gases of differing diffusivity in health and airflow limitation. AB - 1. Incomplete mixing of alveolar gas may be expressed as an equivalent alveolar dead space serving a remaining alveolar space in which mixing is regarded as complete. Calculation of this dead space during multiple-breath, inert gas wash in or wash-out leads to an estimate of 'multiple-breath alveolar mixing efficiency' (MBME). 2. We measured MBME in 25 healthy subjects and six patients with chronic airflow limitation (CAL), and in three asthmatic patients before and after bronchial provocation with histamine aerosol, from successive breaths during open-circuit, multiple-breath wash-in of a mixture containing helium (He) and sulphur hexafluoride (SF6). The simultaneous use of a light and a heavy gas helps to identify diffusive mechanisms. 3. MBME fell almost linearly with log Z, the proportion of total wash-in remaining uncompleted. For a given Z, MBME was always lower for SF6 than for He in the same subject. In health the lowest MBME (52.2%) was seen for SF6 in a man aged 21 years. The same wash-in yielded a ventilation distribution with an extreme range of specific ventilation of less than 1 decade. MBME of this order is thus consistent with estimates of ventilation distribution in health. 4. Patients with CAL showed a big increase in the volume of the conducting airways or 'series dead space' (VDS) for both gases, and VDS was always bigger for SF6 than for He. This very large VDS appears to be the main reason for wash-in delay in these patients, followed by impaired diffusive mixing in the peripheral air spaces. Ventilation maldistribution may play little part in the mixing defect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665357 TI - Increased arachidonic acid levels in phospholipids of human colonic mucosa in inflammatory bowel disease. AB - 1. Colonic mucosa from 19 patients with ulcerative colitis, eight with Crohn's disease and 14 controls were analysed for arachidonic acid (C20:4), linoleic acid (C18:2), oleic acid (C18:1), stearic acid (C18:0) and palmitic acid (C16:0). 2. Gas-liquid chromatography of lipid extracts showed that arachidonic acid was significantly higher in ulcerative colitis (19 +/- 4) and Crohn's disease (20 +/- 3) than in controls (13 +/- 5 micrograms/mg of protein) (means +/- SD). Neither the degree of inflammation nor treatment with sulphasalazine or prednisolone appeared to influence the fatty acid concentrations. 3. Seventy-five to ninety five per cent of the arachidonic acid was found in the phospholipid fraction after separation by thin-layer chromatography. There were no significant changes in the concentrations of the other fatty acids measured, although oleic acid was lower in inflammatory bowel disease. The ratios of oleic acid to stearic acid and to palmitic acid were lower in inflammatory bowel disease. 4. The alteration in the fatty acid profile may partly explain the increased synthesis of eicosanoids in colonic mucosa in inflammatory bowel disease. PMID- 3665358 TI - Intravenously administered frusemide increases glomerular permeability. AB - 1. The effects of frusemide on glomerular permeability were investigated in eight proteinuric patients by measuring the fractional protein and dextran clearances and correlating these observations with changes in renal haemodynamics. 2. Frusemide increased significantly the fractional albumin and IgG clearances. The fractional dextran clearances of molecules with a radius greater than or equal to 5.4 nm also increased significantly after frusemide injection. Pretreatment with indomethacin partly inhibited the increments in clearances of macromolecules. 3. The changes in the fractional protein clearances correlated significantly with those of inulin clearance There was also a high degree of correlation between the changes in fractional protein clearances and prostanoid excretion. 4. The data obtained suggest that frusemide increases glomerular permeability by influencing the effective pores of the glomerular capillary wall. The increased permeability possibly is due to changes in prostanoid synthesis. PMID- 3665359 TI - Adaptation to exercise-induced muscle damage. AB - 1. Serum creatine kinase (CK) and muscle soreness, common indicators of muscle damage, were assessed in 16 subjects after performance of two bouts of eccentric exercise spaced 7 days apart. The purpose was (1) to examine rapid muscle adaptation when the ipsilateral limb was exercised on the second bout and (2) to investigate possible central adaptations when the contralateral limb was exercised on the second bout. 2. The LSL group (n = 7) and the LOL group (n = 9) performed the exercise with the ipsilateral and the contralateral limb, respectively. Careful attention was paid to stabilization of the subject so that the contralateral limb was not active in isometric stabilization. 3. For the LSL group, a lower CK and soreness response was found on about 2 compared with bout 1. For the LOL group, no significant difference in CK response and soreness was found between bout 1 and bout 2. 4. No repeat bout effect was found when the contralateral limb was exercised; therefore central adaptation from performance of the first exercise was minimal. Because a lower repeated bout effect was found after bout 2 using the ipsilateral limb, it was concluded that an experimental design using ipsilateral muscle groups should provide a good model to study rapid muscle adaptation to exercise damage. PMID- 3665360 TI - Increased bronchial reactivity to histamine in diabetic autonomic neuropathy. AB - 1. Twelve male diabetic patients inhaled nebulized histamine in doubling concentrations from 0.03 mg/ml to 32 mg/ml until they reached the maximum concentration or until their forced expiratory volume in 1 s (FEV1.0) fell by at least 20%. Six had evidence of severe autonomic neuropathy (DAN), while the other six did not. 2. More of the DAN group decreased their FEV1.0 on histamine inhalation by at least 20% (P less than 0.02) and more of them decreased their maximal flow at 50% vital capacity by at least 20% than those in the group without DAN (P less than 0.05). 3. The fall in FEV1.0 and in maximal flow at 50% of vital capacity was greater (P less than 0.05) in the DAN group than in the group without DAN. 4. This suggests that diabetic patients with autonomic neuropathy have increased bronchial reactivity to histamine. This could either be due to differential damage of the respiratory autonomic nerves or, alternatively, to denervation hypersensitivity. PMID- 3665361 TI - Serum bile acid profile in thyroid dysfunction and effect of medical treatment. AB - 1. Serum non-esterified bile acid profile was examined in patients with thyroid dysfunction. Sixteen hyperthyroid patients, six hypothyroid patients, nine patients taking thyroid or antithyroid drugs and 26 healthy controls were studied. The medicated patients were euthyroid when serum samples were collected. Bile acid concentration was determined by the simplified microassay method involving mass fragmentation spectrometry. 2. The sum of the concentrations of the individual bile acids was not significantly different among the four groups. However, the composition of bile acid reflected the thyroid function. The most prominent bile acid was deoxycholic acid in the hypothyroid patients and chenodeoxycholic acid in the hyperthyroid patients. The serum bile acid profile of medically treated patients was similar to that of normal controls. The ratio of the sum of deoxycholic and cholic acid to that of lithocholic and chenodeoxycholic acid was found to be a good indicator of thyroid function, while the ratio of cholic acid to chenodeoxycholic acid correlated poorly with it. 3. The characteristic effect of thyroid hormone on the serum bile acid composition in man was the shift from the 'family' of cholic acid to that of chenodeoxycholic acid. This is in agreement with experimental results in the rat, and suggests a specific action of thyroid hormone on the hydroxylating enzymes involved in the conversion of cholesterol into bile acids. PMID- 3665362 TI - The effects of atrial fibrillation on coronary blood flow and performance of ischaemic myocardium in dogs with coronary artery stenosis. AB - 1. Atrial fibrillation may impair coronary blood flow by tachycardia and reflex vasoconstriction. It has not been documented, however, whether in the presence of coronary stenosis atrial fibrillation exceeds the effects of rhythmic atrial tachycardia. 2. The effects of experimentally induced atrial fibrillation compared with atrial tachycardia, therefore, were tested in 22 anaesthetized dogs. Stenosis of the left anterior descending coronary artery was induced to reduce coronary blood flow by about 40%. 3. In the presence of coronary stenosis, atrial fibrillation (ventricular rate: 234 +/- 21 beats/min) reduced coronary blood flow from 58 +/- 7 to 44 +/- 8 ml min-1 100 g-1 (P less than 0.001, mean +/ SEM) and subendocardial segment shortening (ultrasonic crystals) from 12 +/- 2 to 4 +/- 2% (P less than 0.0025), and resulted in a lactate production of 30 +/- 11% (P less than 0.005 vs sinus rhythm). 4. Atrial tachycardia (heart rate: 216 +/- 21 beats/min, NS vs atrial fibrillation) did not significantly change coronary blood flow and reduced segment shortening to 7 +/- 3% (P less than 0.05 vs atrial fibrillation). Significant lactate production did not occur. 5. Since mean arterial pressure fell from 100 +/- 4 mmHg at sinus rhythm to 89 +/- 3 mmHg (P less than 0.01) during atrial fibrillation but not during atrial tachycardia, it was held constant in 13 dogs by a pressurized blood reservoir. Coronary blood flow, however, fell from 43 +/- 6 to 36 +/- 5 ml min-1 100 g-1 (P less than 0.0025). 6. Thus atrial fibrillation may reduce coronary blood flow and induce myocardial ischaemia in the presence of coronary stenosis in excess of atrial tachycardia. PMID- 3665363 TI - Free fatty acids and leucocyte sodium transport. PMID- 3665364 TI - Hypomagnesaemia and increased sympathetic nervous system activity in the alcohol withdrawal syndrome. PMID- 3665365 TI - Interference with digoxin immunoassays. PMID- 3665366 TI - Rationale for disparate cimetidine dosage regimens: continuous infusion and once daily dosing. PMID- 3665367 TI - Altered aminoglycoside pharmacokinetics in critically ill patients with sepsis. AB - The pharmacokinetic disposition of aminoglycosides in critically ill patients with sepsis was studied. In an open-label study of the disposition of gentamicin and tobramycin, individualized pharmacokinetic values of 100 critically ill patients in the surgical intensive-care unit were compared with those of a concurrently monitored group of 100 surgery patients who were not critically ill. The a priori computer-predicted dosage requirements of the critically ill patients were also compared with the dosages derived from their individualized pharmacokinetic values, and intrapatient variation in the critically ill patients was studied. Serum concentration-time data were analyzed using a one-compartment model and the DataMed Clinical Support Services system to provide individualized dosage requirements. Initial dosing guidelines were also generated for the critically ill patients using the a priori model of the DataMed Clinical Support Services program and patient demographic information. The critically ill patients were significantly older, had higher serum creatinine concentrations (SCr), and had lower elimination rate constants (k) and total body clearances (CL) than the surgery patients who were not critically ill. The volume of distribution (V) was not significantly different. The a priori computer predictions for the critically ill patients were significantly lower than the individualized values for V, CL, dose, and amount of drug per 24 hours. The dosing regimen from the a priori model was the same as the individualized regimen in only 2/100 patients. In the 76 critically ill patients who had a second pharmacokinetic analysis performed, there was a significant decrease in k and CL from the first analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665368 TI - Decreased hepatic clearance of clindamycin in critically ill patients with sepsis. AB - Clindamycin pharmacokinetics was compared in critically ill patients with sepsis and healthy volunteers, and the relationship between pharmacokinetic values and physiological measurements obtained from the critically ill patients was characterized. Pharmacokinetic evaluations were performed on 10 patients with sepsis who were receiving clindamycin phosphate 900 mg i.v. every eight hours and on 6 previously studied healthy men receiving the same dosage regimen. Physiological variables measured included age, weight, cardiac index, systemic vascular resistance, central venous pressure, liver-function tests, alpha 1-acid glycoprotein concentration, and APACHE II score. Clindamycin was administered to the critically ill patients via a central venous catheter over 30 minutes; the healthy volunteers received their infusions via a peripheral venous catheter over 30 minutes. Blood samples were obtained at five minutes before and at various intervals after drug administration. Serum clindamycin concentrations were determined by a gas-liquid chromatographic method. Serum concentration data were analyzed using noncompartmental methods based on statistical moment theory, and the a priori level of significance was 0.05. The critically ill patients had significantly increased values for area under the curve (AUC), area under the moment curve (AUMC), mean residence time (MRT), and average concentration at steady state (Css), while total body clearance (TBC) was less than half that in the healthy volunteers. TBC in three of the critically ill patients was not different from that in the healthy volunteers. The apparent volume of distribution at steady state (Vss) was not significantly different between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665369 TI - Alterations in aminoglycoside volume of distribution in patients below ideal body weight. PMID- 3665371 TI - Guidelines for cardiopulmonary resuscitation and emergency cardiac care. PMID- 3665370 TI - Chlorpropamide pharmacokinetics in young healthy adults and older diabetic patients. PMID- 3665372 TI - Use of lidocaine to reduce pain associated with potassium chloride infusions. PMID- 3665373 TI - Management of corticosteroid-induced psychosis with lithium. PMID- 3665374 TI - Theophylline loading dose in obese patients. PMID- 3665375 TI - Possible interaction between ethanol and vaginally administered metronidazole. PMID- 3665376 TI - More on variability in aminoglycoside volume of distribution. PMID- 3665377 TI - Heparin dosage adjustment in patients with deep-vein thrombosis using heparin concentrations rather than activated partial thromboplastin time. AB - In patients with deep-vein thrombosis, heparin dosage adjustment based on measurement of heparin concentrations in whole blood was compared with conventional dosage adjustment based solely on activated partial thromboplastin time (APTT) measurement. Initially, all patients were given i.v. bolus doses of heparin sodium 70 units/kg followed by continuous infusion of 16 units/kg/hr. Seventeen patients (group 1) had their initial heparin dosages adjusted according to the results of the APTT value four hours after the start of heparin therapy; subsequent adjustments were made to maintain APTT values within the therapeutic range of 1.5 to 2.5 times the patient's baseline control. Fifteen patients (group 2) had heparin dosage adjusted four hours after the start of heparin infusion, based on apparent heparin clearance using the two-point method of Chiou et al., to maintain whole-blood heparin concentrations of 0.3 to 0.6 units/mL. APTT values less than 1.5 times control occurred in about 12% of group 1 patients at 8, 12, and 24 hours and in 11 of 17 (65%) for at least one value during the study. In group 2 patients, no APTT values were less than 1.5 times control. The patients in group 2 had faster symptomatic improvement and shorter hospital stays. Heparin dosing based on measurement of whole-blood heparin concentrations and application of a practical two-point pharmacokinetic model was superior to dosing based on APTT values. PMID- 3665378 TI - Evaluation of four methods for predicting lithium dosage. PMID- 3665379 TI - Comparison of four methods for predicting serum gentamicin concentrations in surgical patients with perforated or gangrenous appendicitis. PMID- 3665380 TI - Anticoagulant therapy when pregnancy is complicated by osteoporosis. PMID- 3665381 TI - Cefonicid-induced seizure. PMID- 3665382 TI - Predicting aminoglycoside dosage in critically ill patients with sepsis. PMID- 3665383 TI - Evaluation of a disposable, nonelectronic, patient-controlled-analgesia device for postoperative pain. AB - The safety and efficacy of a disposable, nonelectronic, patient-controlled analgesia (PCA) device for alleviating postoperative pain were evaluated. Patients who were to undergo abdominal surgical procedures under general anesthesia were instructed in the use of the Travenol Infusor with Patient Control Module. Patients used the PCA device upon emerging from anesthesia in the recovery room. The PCA device delivered a 1-mg i.v. injection of morphine sulfate upon patient demand, with a relative delay of six minutes between allowable administrations. Nursing staff evaluated pain and sedation every four hours using a five-point scale. In the 50 patients evaluated, the highest analgesic use occurred during the first four to eight postoperative hours. After the immediate postoperative period, patients experienced either mild or no pain during approximately 90% of the evaluation periods. No patient suffered respiratory depression during self-dosing. Results of a poststudy self-assessment questionnaire showed that 90% of the patients reported experiencing mild to moderate pain overall, and 78% reported only mild discomfort throughout the postoperative period. Ninety-two percent of the patients strongly preferred PCA therapy over intramuscular injections. The Travenol Infusor with Patient Control Module represents a safe and effective device for PCA therapy of postoperative pain. PMID- 3665385 TI - Efficacy of verapamil--hydrochlorothiazide-spironolactone therapy in hypertensive black patients. PMID- 3665384 TI - Infusion phlebitis associated with a programmable syringe-pump system versus gravity-feed minibottles. AB - The occurrence of infusion phlebitis in patients receiving intravenous antibiotics via a gravity-feed minibottle system versus a new syringe-pump system was compared. Patients at least 18 years old who had indwelling intermittent injection sites inserted for medication administration were randomized to either the minibottle system or the syringe-pump system. Antibiotics in minibottles were diluted in 50-100 mL of 5% dextrose injection; in the syringe-pump group, aminoglycoside antibiotics were diluted in 0.9% sodium chloride injection and all other antibiotics were diluted in sterile water for injection. Antibiotics were not piggybacked into running primary infusions in any of the study patients, and no other medications except for 0.9% sodium chloride flushes were administered through the catheters. All catheters were inserted in peripheral veins and evaluated for phlebitis by i.v. nurse specialists using standardized criteria. Catheters were changed upon the occurrence of grade 1 phlebitis or after a period of three days without the development of phlebitis. Over an 18-week period, 85 catheter sites (53 syringe-pump group versus 32 minibottle group) were evaluated in 30 patients (14 syringe-pump group versus 16 minibottle group). The mean +/- S.D. catheter life in both groups was 50.6 +/- 20 hours. Phlebitis occurred in 62% of syringe-group sites versus 66% of minibottle-group sites; the incidence and severity of phlebitis were not significantly different between groups. The majority of catheter sites were infused with cefazolin sodium. The potential for phlebitis using the syringe-pump system in this study appears to be similar to that of the gravity-feed minibottle system when appropriate diluents, diluent volumes, and infusion rates are used. PMID- 3665386 TI - Safety of amrinone for treating congestive heart failure in a premature neonate. PMID- 3665387 TI - Postoperative use of antibiotic irrigations. PMID- 3665388 TI - Amiodarone-induced infusion phlebitis. PMID- 3665389 TI - Error in equation for predicting warfarin dosage. PMID- 3665390 TI - Minimum urine collection periods for accurate determination of creatinine clearance in critically ill patients. AB - The accuracy of creatinine clearance (CLcr) determinations obtained from urine collections of less than 24 hours duration and the cyclical variation in creatinine excretion were studied in 10 critically ill patients with trauma or postoperative complications. Data from patients who received drugs or had diseases known to influence creatinine production or interfere with assay methods were excluded. Twelve consecutive two-hour urine collections and midpoint blood samples were obtained for each patient. Urine and serum samples were assayed for creatinine content by kinetic and enzymatic methods, respectively. The mean 24 hour CLcr was 110.6 +/- 47.0 mL/min. Clearance values determined from 8- and 12 hour collections were within 20% of the 24-hour CLcr value, and values determined from 14- to 22-hour collections were not significantly different from the 24-hour CLcr value. Mean differences between each 2-hour interval and the 24-hour interval were not significant for the 12 collection intervals. In critically ill trauma or postsurgical patients, the 24-hour CLcr can be estimated from an 8-hour urine collection if a deviation of up to 20% from the 24-hour value is clinically acceptable. No significant cyclical variation in creatinine excretion over 24 hours was found. PMID- 3665391 TI - Evaluation of eight methods for estimating creatinine clearance in men. AB - Eight methods for estimating creatinine clearance (CLcr) were compared in 65 men with serum creatinine concentrations (SCr) less than or equal to 1.5 mg/dL (group 1) and 65 men with SCr greater than 1.5 mg/dL (group 2). All patients had SCr values that did not fluctuate by more than +/- 10% for two weeks before and two weeks after measurement of CLcr. For each patient, predictions of CLcr by each of eight currently used formulas were compared with measured CLcr values; both regression analysis and predictive error analysis were used. Group 1 patients ranged in age from 32 to 64 years (mean, 53), weighed from 48 to 105 kg (mean, 73), and were from 63 to 79 inches in height (mean, 69). Group 2 patients ranged from 26 to 63 years of age (mean, 53), weighed from 34 to 141 kg (mean, 80), and were from 63 to 76 inches in height (mean, 70). Measured CLcr values ranged from 29.8 to 197 mL/min in group 1 and from 2.8 to 118 mL/min in group 2. Ranges of SCr values were 0.7-1.5 mg/dL (mean, 1.1) in group 1 and 1.6-7.1 mg/dL (mean, 2.8) in group 2; the formula of Cockcroft and Gault, which uses age, body weight, and SCr, had the highest correlation and the greatest accuracy in group 1, whereas the formula of Jelliffe, which uses body surface area and SCr, had the highest correlation and the greatest accuracy in group 2. Estimation of creatinine clearance can be improved by identification and use of the formula that is best suited to a specific patient population. PMID- 3665392 TI - Effect of using warfarin plasma concentrations in Bayesian forecasting of prothrombin-time response. AB - The predictive performance of a Bayesian computer program using prothrombin-time (PT) response data with and without warfarin plasma concentrations to forecast patients' PTs at the time of hospital discharge was evaluated. A log-linear pharmacokinetic-pharmacodynamic model was used to describe and predict warfarin dose response in patients recently started on warfarin sodium. Individual patients' pharmacodynamic variables relating warfarin concentration to clotting factor synthesis were obtained by Bayesian nonlinear regression analysis. Pharmacokinetic values for warfarin clearance and volume of distribution were either calculated using nonlinear regression from measured plasma warfarin concentrations or estimated based on literature-derived population regression equations. Percent mean absolute prediction error (precision) and prediction error (bias) for PT predictions were compared among and between analysis methods that used only literature data to estimate PT response and methods that used zero to five PTs with or without warfarin plasma concentrations. Eleven women and eight men completed the study. Predictions after four days of warfarin therapy using PT measurements beginning after either the first or third warfarin dose were clinically useful regardless of whether warfarin concentrations were used in the predictions. Predictions using fewer than four PT measurements were imprecise and biased. The Bayesian method in this study provided good predictions of PTs immediately before hospital discharge based on warfarin dosing and PT response after either four or five days of therapy. The use of warfarin plasma concentrations in the pharmacokinetic-pharmacodynamic model used here appears unwarranted. PMID- 3665393 TI - Effect of antacid suspension on the pharmacokinetics of ibuprofen. AB - The effect of antacid administration on the pharmacokinetics of ibuprofen was evaluated in a randomized, crossover study of eight healthy volunteers. Doses of 62 mL of aluminum and magnesium hydroxide suspension and single doses of ibuprofen 400 mg were used. Subjects received each of the following treatments at one-week intervals: ibuprofen alone; ibuprofen administered concurrently with one dose of antacid; antacid administered one hour after the ibuprofen dose; and antacid administered concurrently with the ibuprofen dose, plus three more antacid doses given every five hours. Blood samples were taken at various time intervals up to 24 hours after the ibuprofen dose. Serum samples were assayed for ibuprofen content using high-performance liquid chromatography. Values for AUC, Cmax, tmax, and k were not significantly different among treatment groups. The ranges of mean (+/- S.D.) values were 113.97 +/- 21.5 to 127.53 +/- 29.3 micrograms.hr/mL for AUC, 35.30 +/- 6.40 to 41.00 +/- 10.00 micrograms/mL for Cmax, 0.95 +/- 0.30 to 1.28 +/- 0.54 hr for tmax, and 0.346 +/- 0.026 to 0.388 +/ 0.040 hr-1 for k. For the doses used, concurrent administration of aluminum and magnesium hydroxide suspension and ibuprofen does not alter ibuprofen pharmacokinetics. PMID- 3665394 TI - Response of platelets to intravenous iron dextran in reactive thrombocytosis. PMID- 3665395 TI - Major withdrawal symptoms after abrupt discontinuation of phenobarbital. PMID- 3665396 TI - Long-term effects of beta-adrenergic blockade with nadolol on hepatic and renal haemodynamics and function in cirrhotics. AB - Non-cardioselective beta-blockers are used for prevention of re-bleeding from oesophageal varices in cirrhotics with portal hypertension. Nadolol, a non cardioselective beta-blocker with a low liposolubility and a low hepatic metabolism, has been demonstrated to decrease portal pressure in cirrhotic patients. Since cirrhotics need long-term treatment, we investigated long-term effects of beta-adrenergic blockade with nadolol on hepatic and renal haemodynamics and function in a group of patients with cirrhosis and portal hypertension. In 19 patients with cirrhosis, after one and six months of treatment with nadolol hepatic venous pressure gradient showed a significant and persistent decrease, averaging 19% and 22%, respectively. Hepatic function and renal haemodynamics and function remained unaffected. Oesophageal varices severity was lowered in 11/19 patients after one month, in 9/16 after six months, in 8/14 after 12 months and in 5/10 after 18 months. Our results showed that, also after long-term treatment, nadolol decreases portal pressure and, in approximately 50% of patients, oesophageal varices severity, without side-effects on liver and renal function. PMID- 3665397 TI - Diurnal blood pressure profiles and variability in normotensive ambulant subjects. AB - The 24-hour variability in blood pressure and heart rate of 14 normotensive subjects was examined under ambulatory conditions with a continuous, invasive method. The results were analysed with 30-second means calculated from beat-to beat values. The registered time series had three different types of variation: (1) a continuous, fast variation around the mean level; (2) a stepwise, permanent change to a new level; and (3) a slow, continuous rise or fall. Variability in blood pressure and heart rate was determined by the 80 percent range of variation calculated from the cumulative distribution as the difference between the 90th and 10th percentiles. The variability in blood pressure and heart rate was significantly greater during waking hours than during night-time. Variability followed a similar type of diurnal profile as the mean level. However, variability of diastolic pressure changed to a lesser extent than that of systolic pressure. Total 24-hour variability was on average 45 mmHg in systolic blood pressure, 24 mmHg in diastolic pressure and 40 b.p.m. in heart rate. Using night-time to describe the basal state, physical and mental activities in the evening and during daytime were found to raise variability in systolic pressure with 66%, diastolic with 8-16% and heart rate with 130-180%, respectively. The results show that in normotensive subjects the sleep-wake state and activity are the major factors that affect both the diurnal profile and the variability in blood pressure and heart rate. PMID- 3665398 TI - Digitized echocardiographic measurements of left ventricular function: reproducibility and physiological factors influencing the method. AB - The variability of digitized M-mode echocardiographic measurements and the potential influence of physiological factors on these was studied in 28 relatively young (less than 50 years) healthy subjects. All had heart rates within the normal range. Echocardiographic recordings were standardized in the end-expiratory phase. The coefficients of variation for direct echocardiographic measurements were less than or equal to 6% and for most digitized time derived variables less than or equal to 15%. They were generally greater for inter- than for intracycle comparisons. In systole, the peak shortening rate and the time period from the start of systole to the point of peak shortening rate showed the best reproducibility, while in diastole the peak filling rate, the rapid filling period and the percentage filling during the same period. In multivariate analysis, age and heart rate were found to influence the digitized derived systolic but not the diastolic variables. Their influence, however, on digitized echocardiographic measurements may vary with study subjects selection and should be considered when interpreting results. PMID- 3665400 TI - Respiratory infections. PMID- 3665399 TI - The transfer factor (diffusing capacity) as a predictor of hypoxaemia during exercise in restrictive and chronic obstructive pulmonary disease. AB - Thirty patients (17 with restrictive, eight with chronic obstructive pulmonary disease and five with combined pulmonary changes) were studied. Ordinary pulmonary function tests were made and in addition the transfer factor (diffusion capacity) was measured at rest and compared to the arterial oxygen tension at rest and during maximal exercise. There was a significant correlation (r = 0.89) between the transfer factor at rest and the oxygen tension during maximal exercise in both the patients with restrictive and those with obstructive lung disease, but no correlation was found between the transfer factor and the resting oxygen tension. Exercise induced hypoxaemia (PO2 less than 8-8.5 kPa) occurred in some patients and this could be predicted with an excellent sensitivity and specificity if a discrimination point for the transfer factor of 50 per cent of predicted or less was chosen. Determination of the transfer factor at rest is thus a good screening test for exertional hypoxaemia and can be used to select patients for exercise testing when the purpose is to detect hypoxaemia. PMID- 3665401 TI - Legionella and mycoplasma pneumonia--a community hospital experience with atypical pneumonias. AB - The clinician should be alert to the possibility of Legionella pneumonia in the community hospital setting. Importantly, degree of suspicion, that is, familiarity with extrapulmonary clinical and laboratory features of the typical pneumonias, nearly always leads to a correct presumptive diagnosis that may later be confirmed by serologic testing. Serologic testing has confirmed only a minority of cases. Since early empiric therapy is critical to survival in many of these patients, knowing how to arrive at a presumptive diagnosis based upon the clinical clue present or absent is essential in the community hospital setting. PMID- 3665402 TI - Sequence variation of bovine elastin mRNA due to alternative splicing. AB - Poly A+ RNA, isolated from a single 210 day fetal bovine nuchal ligament, was used to synthesize cDNA by the RNase H method, using AMV reverse transcriptase for first strand synthesis and DNA polymerase I for the second strand. The cDNA was inserted into lambda gt10 using EcoRI linkers, and recombinant phage containing elastin sequences were identified by hybridization with a 1.3 kb sheep elastin cDNA clone, pcSELI (Yoon, K. et al., Biochem. Biophys. Res. Comm. 118: 261-265, 1984). Three clones containing the largest inserts of 2.9, 2.8, and 2.6 kb were selected for further study. The complete sequence analysis of the 3 clones was correlated with the sequence of 10.2 kb of the bovine elastin gene. The analyses: (i) showed that the cDNA encompassed the great majority of the translated sequence, (ii) ordered the tryptic peptides of porcine tropoelastin, (iii) determined new amino acid sequences not previously found in the porcine peptides and (iv) demonstrated that alternative splicing of the primary transcript leads to significant variation in the sequence of the translated portion of the mRNA. PMID- 3665403 TI - Collagenolytic cathepsins of rabbit spleen: a kinetic analysis of collagen degradation and inhibition by chicken cystatin. AB - We have investigated the steady state kinetics of the degradation of native fibrillar collagen at pH 3.4 by four collagenolytic cathepsins of rabbit spleen. For each enzyme, the dependence of initial velocity on collagen concentration was well described by the Michaelis-Menten mechanism. Km, expressed as the concentration of triple-helical chains, and kcat values were determined for cathepsins B, L, N and S. The ratio of Kcat to Km suggest that cathepsins L and N are far more effective at collagen solubilization than either cathepsins S or B. Ki values were determined for the inhibition of collagenolytic activity at pH 3.4 using cystatin, a naturally-occurring cysteine proteinase inhibitor. All four cysteine proteinases were inhibited by cystatin in this assay system, although it was found to be a tighter binding inhibitor of cathepsin L, than for cathepsins N and S (approximately 5-fold less), or cathepsin B (approximately 500-fold less). PMID- 3665404 TI - The role of information in the development of social policy. PMID- 3665405 TI - How accurate are the perinatal statistics for your region? PMID- 3665406 TI - Potential benefits for patient care from computing. PMID- 3665407 TI - Waiting times and duration of hospital stay for common surgical operations: trends over time. PMID- 3665408 TI - Uptake of rubella vaccine among susceptible adults. PMID- 3665409 TI - Educating the medical administrator. PMID- 3665410 TI - Problems extracting data from hospital maternity records. PMID- 3665411 TI - Communicable disease report January to March 1987. PHLS Communicable Disease Surveillance Centre. PMID- 3665412 TI - Colposcopy and cervical biopsy of patients with inflammatory cytology. PMID- 3665413 TI - First aid and the unconscious diabetic patient. PMID- 3665415 TI - Abstracts from the Faculty of Community Medicine autumn 1986 conference--'Quality and Performance'. PMID- 3665414 TI - AIDS and its prevention in the adolescent. PMID- 3665416 TI - Partial purification and some biochemical properties of neonatal rat cutaneous glutathione S-transferases. AB - 1. Previous studies have demonstrated the presence of glutathione S-transferases in the skin of rodents and humans. This study represents the first attempt to purify cytosolic glutathione S-transferases from skin of 3-day-old rats. 2. A partial purification of the enzyme was achieved by a two-step procedure: affinity chromatography followed by HPLC. Two peaks, one major (P-1) and one minor (P-2), were resolved by HPLC containing about 82% and 10% of the recovered activity, respectively. 3. The major form exhibited an overall purification of about 2270 fold with a specific activity of about 73 mumoles/min/mg protein towards 1-chloro 2,4-dinitrobenzene. 4. The kinetic data for P-1 yielded mean Km values of 2.39 mM for 1-chloro-2,4-dinitrobenzene and 0.72 mM for reduced glutathione, while the respective average Vmax values were found to be 212 and 101 mumoles/min/mg protein. 5. Significantly inhibition of enzyme activity was noted in the presence of 0.2 mM HgCl2, 0.63 microM 1.2-naphthoquinone, 1.0 microM triphenyltin chloride, and 12.5 microM 17 beta-estradiol-3-sulfate. PMID- 3665417 TI - A Koelliker hemoglobin in chick erythrocytes. AB - 1. Adult chicken hemoglobins were analysed by ion exchange chromatography and isoelectric focusing and a minor hemoglobin fraction (HbK) was isolated. 2. Analysis of the constituent chains shows that HbK differs from the two major hemoglobins HbA and HbD in the alpha globin. 3. The amino acid composition, the tryptic peptide maps, the results of carboxypeptidase digestion and the functional properties show that the HbK alpha globin is quite similar to that of HbA except that the C-terminal amino acid Arg 141 is lacking. 4. HbK must then be considered a Koelliker-type hemoglobin. PMID- 3665418 TI - Specific UV-absorbancy of pure rRNA isolated from trout liver as a standard for the quantification of ribonucleic acid from fish tissues. AB - 1. Lyophilized crude rRNA from trout (Salmo gairdneri R.) liver was composed (w/w) of 2.9% protein, traces of DNA and glycogen, 13% water and 83% pure rRNA. The RNA content was derived from the discrepancy between effectively found (8.1%, w/w) and theoretical phosphorus content (9.6%, w/w). 2. The theoretical phosphorus content was calculated on the basis of the molar distribution of nucleotides in rRNA (UMP:GMP:AMP:CMP = 24.7%:30%:19.5%:25.8%), established upon cation exchange chromatography of alkali-degraded crude rRNA. 3. The extinction coefficient (corrected for moisture and none-ribonucleic acid contaminants) of pure rRNA in 0.2 N PCA after digestion in 0.3 N KOH at 37 degrees C for 90 min is 361 in terms of E1%260. That of undegraded, pure rRNA in water amounts to 279. PMID- 3665419 TI - Changes in bovine mammary insulin binding during pregnancy and lactation. AB - 1. Binding of insulin to microsomes from mammary glands of pregnant and lactating dairy cows was characterized. 2. Binding affinities of the insulin receptor did not change from pregnancy to lactation. 3. Maximal specific binding occurred in microsomes from cows in mid-pregnancy and declined in microsomes from cows in late pregnancy. 4. Insulin binding continued to decrease from early to mid lactation and increased during late lactation. 5. Results indicate that decreased sensitivity in mammary tissue from lactating dairy cows is at least in part a result of a reduction in insulin receptor number. 6. Results demonstrate further physiological differences between the ruminant and non-ruminant mammary gland. PMID- 3665420 TI - A precipitin for human serum proteins as released into the environment by stressed bait shrimp, Penaeus duorarum. AB - 1. A precipitin for human serum proteins is released into the environment by stressed bait shrimp, Penaeus duorarum. 2. Two-dimensional crossed immunoelectrophoresis revealed that the precipitin reacts (a) primarily with proteins belonging to the major group, alpha-1 globulin; and (b) with more proteins than a standard mammalian antiserum. 3. This study extends the variety of species known to liberate precipitins and suggests this response may be widespread among invertebrates. 4. The precipitins are easily collected in saline solution and, by virtue of their unique specificities, are potentially useful in diagnostic testing. PMID- 3665421 TI - Ubiquitous presence of calciferin-like and cathepsin D-like activities in the sera (vertebrates) and humoral fluids (invertebrates). AB - 1. Sera (or humoral fluids) from various animals (vertebrates and invertebrates) were assayed for calciferin-like and cathepsin D-like activities, indicating the ubiquitous presence of the latter and the former (with a few exceptions). Animals other than the mammals appeared to contain an organophilic calciferin-like activity in addition to a hydrophilic component (calciferin). 2. A correlation was found between the levels of calciferin and acid protease in most of the mammalian sera. An age-dependent decrease in calciferin (but not acid protease) was found in human sera. The possible presence of an acid protease-inhibitor was suggested. PMID- 3665422 TI - Quantitative studies of steroid bioconversions in the seminal vesicles of spawning male African catfish, Clarias gariepinus (Burchell), under natural conditions, and of non-spawning catfish under natural and fish farm conditions. AB - 1. Steroid bioconversions in the seminal vesicles of Clarias gariepinus were studied quantitatively in vitro by tissue incubations with [3H]pregnenolone, [3H]androstenedione and [14C]11 beta-hydroxyandrostenedione, respectively. 2. Spawning and non-spawning catfish, collected in the Hula nature reserve in northern Israel during the spawning period, and non-spawning animals, collected from a fish pond in the same region during the same period, were studied. 3.Spawning animals showed a significantly higher production of 17 alpha hydroxyprogesterone, 5 beta-pregnan-17 alpha-ol-3,20-dione and 5 beta-reduced androgens than non-spawning feral and pond catfish, as a result of a significantly increased contribution of the enzymes 5 beta-reductase and 3 alpha hydroxysteroid dehydrogenase (HSD). 4. In spawning catfish the concentration of gonadotropin in blood plasma were also significantly higher than in the plasma of non-spawning feral and pond catfish. This increase in gonadotropin level might have induced the rise in enzyme activity of 5 beta-reductase and 3 alpha-HSD. 5. It is concluded that the absence of a shift in steroidogenesis towards the production of 5 beta-reduced steroids may be among the factors preventing spontaneous spawning in male African catfish under husbandry conditions. PMID- 3665423 TI - A comparative study of the rate-limiting enzymes of cholesterol synthesis, esterification and catabolism in the rat and rabbit. AB - 1. The rat and rabbit are amongst the animal models most widely used in the study of human atherosclerosis, a disease state correlating with disturbances in cholesterol metabolism. 2. In order to relate the key regulatory enzymes of cholesterol synthesis, esterification and catabolism in the rat and rabbit to their differing degree of susceptibility to atherosclerosis, enzyme levels and their properties were determined in liver and intestine of both species. 3. Hepatic HMG CoA reductase and cholesterol 7 alpha-hydroxylase levels were significantly higher in the rat than in the rabbit, while intestinal HMG CoA reductase activity in the two species was comparable. Conversely, the capacity to esterify cholesterol as measured by ACAT activities was considerably greater in both sites in the rabbit compared to the rat. 4. The data suggest that differences in the key regulatory enzymes of cholesterol metabolism in both liver and intestine may reflect different methods of cholesterol utilization in the two species. PMID- 3665424 TI - Purification and separation of two soluble fucosyltransferase activities of small intestinal mucosa. AB - 1. Rat small intestinal soluble fucosyltransferase is purified more than 2000 fold using chromatographic procedures with DEAE-cellulose, CM-cellulose, GDP Sepharose and Concanavalin A-Sepharose. 2. Chromatography on Sephadex G15 of the final enzymatic fraction clearly separates two activities: a first peak incorporates fucose on asialoserotransferrin and a second peak on asialofetuin. 3. The use of small saccharidic acceptors (phenylgalactose, lactose, lacto-N fucopentaose I) and the analysis of fucosylated asialoglycoproteins indicate that the first activity corresponds to an alpha-(3/4)-fucosyltransferase and the second one to an alpha-(1-2)-fucosyltransferase. 4. Protein analysis by polyacrylamide gel electrophoresis in the presence of SDS for each enzyme shows two bands corresponding to a mol. wt of about 65,000 and 70,000. The two enzymes have the same sensitivity to the action of N-ethylmaleimide. PMID- 3665425 TI - Comparison of membrane phospholipid and its fatty acid compositions in developing rat salivary glands. AB - 1. Membrane phospholipid and its fatty acid compositions have been analyzed in 3- and 9-week-old rat salivary glands. 2. When compared between the three major glands (parotid, submandibular, sublingual) in adult rats, phospholipid compositions were similar, but for their fatty acid, characteristic properties from each phospholipid were shown. 3. Alterations in their compositions were also observed during development of the salivary glands. PMID- 3665426 TI - Enzymatic deacylations of esterified saccharides. II. De-esterifications of radiolabelled O-acylglucopyranosides by mice serum and liver esterases. AB - 1. 14C-Labelled methyl 2,6-di-O-pivaloyl-alpha-D-glucopyranoside (1) was used as a novel substrate for esterases from mouse serum and liver. 2. Stepwise de esterification of the diester substrate 1 was achieved, and data on time-course experiments are reported. 3. Kinetic studies were undertaken to compare deacylation rates for the enzymatic de-esterification of the diester substrate 1 using both, mice sera and liver microsomal fractions. 4. Serum and liver esterase activities were studied in mice treated with an immunostimulating agent, peptidoglycan monomer (PGM), and a comparison made with esterases from untreated mice. PMID- 3665427 TI - Acid phosphatases of the mosquito Culex tarsalis coquillett. AB - 1. Spectrophotometric and isoelectric focusing (IEF) electrophoretic characterization of the acid phosphatases (ACP) of the mosquito, Culex tarsalis, are presented. 2. ACP hydrolysis of P-nitrophenylphosphate (Pnp) was optimal at 37 degrees C, pH 5.25 in the presence of 15 mM MgCl2 and 0.1% (w/v) polyvinylpyrollidone (PVP). Vmax and Km values varied significantly between the various mosquito strains examined. 3. Several divalent cations (i.e. Mn2+, Ca2+, Ba2+ and Co2+), either the chloride or sulphate salts, were stimulatory for ACP. Both Cu2+ and Fe2+ (15 mM) were inhibitory. 4. Slight inhibition (i.e. 10%) of ACP activity was observed with dithiothreitol (100 mM) and 50% inhibition by cysteine (100 mM). 5. ACP activity was cyclic during the 15-day post-adult emergence period of the study. No significant differences were noted between the ACP specific activities of males and females nor between geographic strains. 6. IEF electrophoresis revealed three alpha-naphthyl phosphate hydrolytic ACP isozymes within the pH 4.5-5.5 range (i.e. ACP4.8, ACP5.3 and ACP5.5). 7. IEF ACP isozymes were stimulated by PVP, Mg2+, Zn2+ and inhibited by cysteine, EDTA (except ACP5.3) and NaFl. 8. IEF detection of ACP with Pnp revealed an ACP isozyme (ACP4.3) distinct from those ACP isozymes capable of alpha-naphthyl phosphate hydrolysis. PMID- 3665429 TI - Study of the metabolism of steroids in larvae of the fleshfly Sarcophaga bullata. AB - 1. Larvae of the fleshfly Sarcophaga bullata were injected with several 3H C21 and C19 steroids. After different incubation times, the larvae were homogenized and the metabolites were extracted and fractionated by Sephadex LH 20-, paper- and thin-layer chromatography. The chromatographic mobility of the labeled zones was compared with that of standard steroids. 2. Progesterone and 17 alpha hydroxypregnenolone were metabolized to 17 alpha-hydroxyprogesterone. Androstenedione, 17 alpha-hydroxyprogesterone and dehydroepiandrosterone were converted to testosterone. Transformation of pregnenolone to progesterone or 17 alpha-hydroxypregnenolone was not observed. 3. C21 or C19 steroid formation from cholesterol could not be demonstrated. 4. Sixteen metabolites, different from all our standard substances have been found. Their structure remains to be elucidated. PMID- 3665428 TI - Incorporation of intraportal ammonia-N into blood and tissue nitrogenous compounds in chickens fed low and high protein diets. AB - 1. 15N-Percentage of the amide of glutamine in total blood non-protein-15N was 42 and 48% in chickens fed 5 and 20% protein diets, respectively, when 15N-ammonia was intraportally-infused for 6 hr. 2. The infused ammonia-15N also appeared in the amide of free glutamine in the liver and kidney in large amounts at both levels of protein intake. 3. The 15N incorporated into glutamine-amide in the blood, liver and kidney and non-protein-15N in plasma were greater in chickens fed the low protein diet than in those fed the high protein diet (P less than 0.05 except kidney of P less than 0.01). 4. About 60% of the amide-N of the glutamine which was increased during 6 hr infusion of ammonia was derived from infused ammonia-N and the remainder from endogenous nitrogen, irrespective of protein intake. 5. These results suggest that glutamine is the most important intermediate in detoxication of intraportal ammonia in chickens. PMID- 3665430 TI - A comparison of transketolase assay and transketolase and lactate dehydrogenase activity levels in whole blood and red cell hemolysates and in leukocytes. AB - 1. A study was made of transketolase activity in red and white blood cells and of conditions for assay for transketolase activity and for assessment of the "TPP effect" in human and rat blood. 2. The ratio of the transketolase activity in white cells to that in red cells varied between 23 and 93. 3. Red cells or white cells can both be used for assessment of transketolase activity and the "TPP effect", but the best source for evaluation of transketolase activity and the percent change on addition of thiamin diphosphate appears to be whole blood. PMID- 3665431 TI - Comparative distribution of glyceraldehyde 3-phosphate dehydrogenase activity in human, guinea-pig, rabbit and mouse erythrocytes. AB - 1. Guinea-pig erythrocytes contain half the activity of the enzyme glyceraldehyde 3-phosphate dehydrogenase (G3PD) present in human cells. About 60% of their total activity is membrane-bound. 2. Rabbit erythrocytes also contain half the amount of the enzyme of human red cells. The distribution of G3PD in rabbit cells, however, is similar to that of human cells with 70% of the enzyme being membrane bound. 3. Mouse erythrocytes contain about two-thirds of G3PD activity present in human cells. All their enzyme activity is present in membrane-free hemolysate. 4. Non-human erythrocyte membrane proteins, in addition, have relatively greater amount of band 2.1, lack band 2.2, have a more heterogenous band 3 than its human counterpart, and have overlapping bands 4.1 and 4.2. PMID- 3665432 TI - The primary structure of histone H4 from the nematode Caenorhabditis elegans. AB - 1. The complete amino acid sequence of histone H4 from the nematode Caenorhabditis elegans has been established. 2. The polypeptide chain consists of 102 amino acids and has a completely alpha-N-blocked serine at residue 1. 3. The sequence differs from vertebrate H4 in position 73 by substitution of cysteine for threonine. 4. Lysine in position 20 is monomethylated. PMID- 3665433 TI - Effects of methylglyoxal bis(guanylhydrazone) and two phenylated analogues on S adenosylmethionine decarboxylase activity from Eimeria stiedai (Apicomplexa). AB - 1. Activity of S-adenosylmethionine decarboxylase, one of the rate-limiting enzymes of polyamine biosynthesis, was determined in oocysts of Eimeria stiedai, a coccidian parasite of the rabbit. 2. Several properties of the enzyme were compared to the mammalian enzyme. It showed considerably less substrate affinity than the analog enzyme from the rabbit. 3. The E. stiedai enzyme showed a low sensitivity to methylglyoxal bis(guanylhydrazone), a frequently used inhibitor of the enzyme in mammals, and two phenylated derivatives. 4. Results with the inhibitors are discussed in view of their potential use in chemotherapy. PMID- 3665434 TI - Identification of the receptor for toxin II alpha from scorpion Leirus quinquestriatus in isolated lobster and squid nerve membranes. AB - 1. Isolated membranes from lobster and squid nerves were labeled with Leirus quinquestriatus toxin II alpha. 2. Dinitrofluorophenylazide 125I-ScTx derivative was synthesized and covalently bound to the membranes. 3. It was found that the membranes of these nonmyelinated nerves present a single polypeptide located at approximately 220-230 Kd range labeled by the ScTx. 4. Rat brain membrane used for comparison presents two polypeptidic zones at 220 and 50 Kd labeled by the toxin. PMID- 3665435 TI - Protein kinase C activity in the spleen of trout (Salmo gairdneri) and the rectal gland of dogfish (Scyliorhinus canicula), and the effects of phosphatidylserine and diacylglycerol containing (n-3) polyunsaturated fatty acids. AB - 1. High speed supernatant fractions of trout spleen and dogfish rectal gland contained 22.5 and 7.2 nmol/min/g tissue of protein kinase C activity respectively. 2. The effect of Ca2+ concentration on the activities with phosphatidylserine (PtdSer) alone, diacylglycerol (DAG) alone and PtdSer and DAG together were determined. Both enzymes required Ca2+ but activity was independent of Ca2+ concentration within the physiological range of 0.1-10 microns. 3. The effect of PtdSer and DAG containing (n - 3) polyunsaturated fatty acids (PUFA) on the activity of protein kinase C from both tissues was examined. Both enzymes were active with all lipids tested and showed little or no discrimination between lipids differing in their contents of (n-3) or (n-6) polyunsaturated fatty acids. PMID- 3665436 TI - Tissue distribution and molecular heterogeneity of bovine thiol:protein disulphide oxidoreductase (disulphide interchange enzyme). AB - 1. The distribution of thiol:protein-disulphide oxidoreductase (disulphide interchange enzyme) in 17 bovine tissue extracts was determined by rocket immunoelectrophoresis and by measuring the reductive cleavage of insulin. 2. The relative concentration (per mg total protein) was found to be in the order: Pancreas greater than liver greater than lymph node greater than testes, fat tissue greater than parotid gland, brain, spleen, lung greater than small intestine, spinal cord, large intestine, kidney greater than paunch, aorta greater than skeletal muscle greater than heart. 3. The distribution of specific activity showed a similar pattern, irrespectively of whether glutathione or L cysteine was used as cosubstrate. 4. The concentration varied 200-fold and the specific activity 400-fold between pancreas and heart muscle, respectively. 5. Crossed immunoelectrophoresis demonstrated that a fast-migrating form of the enzyme was the only one present in almost all tissues, but 15% of the enzyme in liver was a slow-migrating form and 50% in heart muscle a medium-migrating form. 6. The lung contains a species having partial immunological identity to the enzyme. 7. Purified enzyme from bovine liver has a somewhat lower mobility than the fast-migrating form in extract. 8. The results seem to support the general view that the enzyme is involved in synthesis of disulphide-bonded extracellular proteins, although the presence of the enzyme in tissues like fat, brain, spinal cord, skeletal muscle and heart indicates other cellular functions as well. PMID- 3665437 TI - Triton X-100 solubilized bone matrix-induced alkaline phosphatase. AB - 1. Solubilized and membrane-bound alkaline phosphatase showed Michaelis-Menten behavior in a wide range of different substrate concentrations. 2. Membrane-bound alkaline phosphatase has a molecular weight of 130,000 and its minimum active configuration comprises two identical subunits of about 65,000. 3. The two forms of the enzyme behave similarly with respect to NaCl, urea and guanidine HCl. 4. Catalytic groups have pK values of about 8.5 and 9.7 for both membrane-bound and solubilized enzyme. PMID- 3665439 TI - Seasonal variation in diagnostic enzymes and biochemical constituents of captive northern bobwhites and passerines. AB - 1. A variety of biochemical measurements were taken periodically in captive northern bobwhite (Colinus virginianus L.), European starlings (Sturnus vulgaris L.), red-winged blackbirds (Agelaius phoeniceus L.) and common grackles (Quiscalus quiscula L.) to determine whether baseline values remain sufficiently stable throughout the year for general clinical use in the absence of concurrent control specimens. 2. Variables included whole blood hematocrit and hemoglobin, plasma lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, creatine kinase, butyrylcholinesterase, alkaline phosphatase, glucose, albumin, total protein, creatinine, urea nitrogen, uric acid, cholesterol, and triglycerides, and brain acetylcholinesterase. Butyryl- and acetylcholinesterase were included because of their specific uses in toxicology. 3. Significant seasonal differences were detected for each of the variables except brain acetylcholinesterase in at least one of the species. Significant species differences were detected during at least one season for all of the variables measured. 4. All species were maintained outdoors, but only northern bobwhites came into reproductive condition and showed sex-differences in the clinical variables during their normal breeding season. 5. It was concluded that reference values for the 18 clinical variables measured could be calculated from our data for adult specimens of the species studied, and that results for one species cannot be extrapolated with certainty to any other species. 6. Estimated normal bounds for each of the 18 variables measured by commonly used clinical procedures are presented for reproductively quiescent northern bobwhites, European starlings, red-winged blackbirds, and common grackles. PMID- 3665438 TI - Proton magnetic resonance spectroscopy of leech muscle and nervous system. AB - 1. Proton nuclear magnetic resonance spectroscopy (1H NMR) was used to measure the major intracellular metabolites in perchloric acid extracts of the Macrobdella decora muscle and nervous systems and the Oryctolagus cuniculus cerebrum. 2. Acetate, alanine, choline, glutamate, inositol, and lactate were assigned in the spectrum of leech ventral cord, leech muscle, and rabbit cerebrum. 3. Hirudonine and propionate were clearly observed only in the spectrum of leech muscle. 4. Creatine, N-acetyl aspartate, gamma aminobutyric acid, aspartate, and taurine, distinctive components of spectra of the mammalian cerebrum, were not seen in the invertebrate spectra. 5. 1H NMR spectroscopy provides a simple and rapid means of characterizing the major organic metabolites found in leech muscle and nervous tissues. PMID- 3665440 TI - Ammoniagenesis in mudskippers Boleophthalmus boddaerti and Periophthalmodon schlosseri. AB - 1. Glutamate dehydrogenase, aspartate transaminase and alanine transaminase were present in the gill, liver and muscle tissues of Periophthalmodon schlosseri and Boleophthalmus boddaerti. Both transaminases were found in the cytosol and mitochondria. 2. A complete purine nucleotide cycle was not present in the tissues studied. 3. Glutamine synthetase was not detected. Phosphate-dependent glutaminase was detected in both the cytosol and mitochondria. 4. Aspartate was the major substrate of ammoniagenesis in the mudskippers, though glutamate and glutamine were also oxidised. 5. Transdeamination was the major pathway for ammoniagenesis in the mudskippers studied. PMID- 3665441 TI - Skeletal muscle necrosis induced by a phospholipase A2 isolated from the venom of the coral snake Micrurus nigrocinctus nigrocinctus. AB - 1. The venom of the coral snake Micrurus nigrocinctus nigrocinctus was fractionated by reverse-phase high performance liquid chromatography and an acidic myotoxic phospholipase A2 was purified to homogeneity. 2. After intramuscular injection, the toxin induced rapid and drastic myonecrosis, as serum creatine kinase levels increased markedly, reaching their highest values by 1.5 hr. 3. Ultrastructural observations indicate that the plasma membrane was the first structure to be affected, with the presence of focal disruptions in its integrity. 4. Myofilaments were hypercontracted and formed dense clumps. Sarcoplasmic reticulum integrity was lost, as evidenced by the presence of many small vesicles in the cellular space. 5. Some mitochondria were swollen, whereas others contained dense intracristal spaces and flocculent densities. Moreover, some had only one membrane. 6. In conclusion, pathogenesis of myonecrosis induced by this phospholipase A2 is similar to that induced by crude Micrurus nigrocinctus nigrocinctus venom. PMID- 3665442 TI - Size and structure of the bird genome. II. Repetitive DNA and sequence organization. AB - 1. Highly repetitive, middle repetitive and single copy DNA were evaluated in 19 species of birds, belonging to nine orders, by means of a reassociation kinetics method. 2. A rather uniform pattern is present in all the species studied (single copy = 60-75%; middle repetitive = 13-20% and highly repetitive 10-20%). 3. Reassociation kinetics of fragments of different length confirms the presence of a long period interspersion pattern. 4. Among different orders, no significant differences are observed. 5. DNA sequence organization seems to be related to genome size, with an inverse correlation between DNA nuclear content and amount of interspersed repetitive sequences. PMID- 3665443 TI - Determination of glucose turnover in sea bass Dicentrarchus labrax. Comparative aspects of glucose utilization. AB - 1. Parameters of in vivo glucose utilization by sea bass (132 +/- 6 g, mean +/- SEM) acclimated at 15 degrees C in sea-water were measured after single injection of labelled glucose. 2. Glucose turnover rate (RG; mumol . min-1 . kg-1) was found to be 0.55-065 (2-3H glucose) and 0.34 +/- 0.42 (U14C glucose). 3. Glucose transit time was 443-449 min, glucose mass 233-261 mumol . kg-1, and glucose recycling 37%. 4. Oxygen consumption (MO2) amounted to 94 +/- 6.2 mumol . min-1 . kg-1. 5. The comparison with other fish species, mammals and birds, taking into account body size, temperature, diet, exercise, in poikilotherms and homeotherms leads to the calculation of a glucose turnover index (RGI = RG x 6 x 100 x MO2( 1)). 6. Value of this, generally lower in ectotherm teleosts (2-9), than in endotherms: mammals, birds and thunidae (22-60), confirms the minor quantitative importance of glucose in the metabolism of most fish. PMID- 3665444 TI - In vitro synthesis, release and uptake of storage proteins by the fat body of Manduca sexta: putative hormonal control. AB - 1. Two major proteins (P1 and P2) are synthesized by the fifth instar larval fat body of Manduca sexta and then released into the hemolymph. 2. These proteins are later sequestered by the pre-pupal fat body. 20-Hydroxyecdysone does not appear to affect the synthesis of either protein. 3. When day 2 fifth instar larvae are neck-ligated there is an excessive synthesis (supersynthesis) of P2 (arylphorin). 4. Juvenile hormone I (JH I) applications to ligated animals had no effect, but brain homogenate injections resulted in the inhibition of P2 synthesis. 5. Neck ligations of larvae between days 5 and 6 revealed a head critical period between day 5 + 12 hr and day 5 + 18 hr, after which the head is unnecessary for the sequestration of either protein by the fat body. 6. JH I and JH III applications to ligated larvae before the head critical period do not restore the ability of the fat body to sequester the storage proteins. 7. P1 and P2 appear to be synthesized differentially and P2 is sequestered by the fat body to a much lesser extent than P1. 8. P2 is the hemolymph storage protein of both larval and pupal stages, whereas P1 appears to be the storage protein of the pupal fat body. 9. The data indicate that the synthesis of arylphorin and the resorption of both proteins are controlled by a putative head factor(s). PMID- 3665446 TI - Measurement of signal period on a personal microcomputer and its application to the analysis of cardiac interval and blood pressure. AB - Personal microcomputers interfaced with analog-digital converters are capable of analyzing almost any biological signal, yet are limited in their ability to directly measure a signal's period/frequency. We describe a short program which measures the interval between periodic events up to 3.5 Hz. In addition, an expanded program which calculates the frequency distribution, distribution statistics, and cross regressions of cardiac interval and blood pressure is described. PMID- 3665445 TI - Sex and seasonal differences in the skin lipids of garter snakes. AB - 1. This study investigates the skin lipids of male and female red-sided garter snakes both in the breeding season and in the non-breeding season. 2. Skin lipids were analyzed by means of thin-layer chromatography (TLC) and gas chromatography/mass spectrometry (GC/MS). 3. Distinct differences exist in the skin lipids of males and females. 4. Samples obtained during the breeding season were qualitatively different from those acquired during the non-breeding season. PMID- 3665447 TI - Data acquisition and analysis of pulsatile signals using a personal computer: an application in cardiovascular physiology. AB - Software is described which collects and analyzes pulsatile analog signals using an APPLE PC and a modestly priced analog-digital interface. The program will input and output data, store and retrieve data to disk and display data on the monitor. Four types of data analysis determine mean, maximum and minimum values and frequency in various combinations. For example, the present program analyzes cardiovascular signals for heart rate, stroke volume, cardiac output, systolic, diastolic and mean pressures over a representative 10 s period. Simple modifications to the program are described which extend its range of application. PMID- 3665448 TI - On the solution of equations for feel-better hemodialysis. AB - In this paper, a scheme for "feel better" or optimal hemodialysis (OPTHD) based on a two-compartmental model has been proposed. Contrary to the conventional constant blood flow dialysis (CVTHD), this scheme suggests that the blood flow rate should vary in stages in order to avoid or minimize the disequilibrium syndromes during dialysis. A set of equations for computing the intracellular and extracellular solute concentrations during the OPTHD operation is developed and the computed results are illustrated. Comparing to the CVTHD, the OPTHD has the advantages of operating at a lower and smoother solute concentration difference between compartments for the same length of dialysis time, or it may achieve the same specific degree of blood cleansing within a shorter period of dialysis time. PMID- 3665449 TI - Computer monitoring of auditory brainstem responses. AB - A relatively low cost, bedside, portable, microcomputer based system for long term monitoring of human auditory evoked responses in critical care environments is described, and test data are presented. The system enables the user to acquire responses, detect significant peaks (usually peaks I, III, and V), store information and display trends (latency vs time graphs) automatically. Prior to processing, responses are digitally filtered so that no phase distortion is introduced. A peak detection algorithm takes into consideration both the different morphologies of the IV-V wave complex and the time-varying characteristics of the ABR waveform. Evaluations using normal subjects and intensive care unit patients show the clinical potential of automated long-term auditory brainstem monitoring. PMID- 3665450 TI - A simplex procedure for fitting nonlinear pharmacokinetic models. AB - A convenient and readily modifiable nonlinear regression procedure, based on two Pascal programs, is described. This procedure, suitable for running on both microcomputers and mainframes, is presented as utilized in ongoing clinical pharmacokinetic work. One program uses the simplex algorithm to fit data conforming to any of six models of drug disposition. In addition to the regression terms, it generates logarithmic plots of the function and calculates derived kinetic variables of drug distribution, elimination and clearance. This program is driven by another which batches together required data and parameter information to build a control file for solving multiple curve-fitting problems. PMID- 3665451 TI - Limiting efficiencies of the non-parametric median method for A exp(-kt) data. AB - Weighted least squares analysis and the median method are used to extract A and k from simulated single exponential decays. The standard deviations of these parameters (sigma p) depend upon the method of analysis. The sigma p are compared as efficiencies (= sigma 2p[least squares]/sigma 2p[median]). These efficiencies depend upon the range of the decay and the underlying error structure. These include errors independent of the data, approximately equal to the data and approximately equal to the square root of the data. Some efficiencies fall well below 25% for the median method. Such instances reflect the large cost of not knowing or not using the weights; they amount to ignoring greater than 75% of the data we strive to collect. PMID- 3665452 TI - Analysis of covariance by the SAS GLM procedure. AB - Analysis of covariance (ANCOVA) is an important statistical procedure for the analysis of biomedical data; the procedure is used for the comparison of means between two or more groups of subjects exposed to contrasting stimulus with adjustment for confounding bias. Although ANCOVA is available in all the major statistical packages (e.g. SAS, SPSSX, BMDP), not all the important statistical aspects of ANCOVA are explicitly considered by these packages. This article expands the analysis of a numeric example included in the SAS GLM procedure to cover several crucial statistical aspects relevant to ANCOVA, and to highlight the meaning of the statistical results obtained. PMID- 3665453 TI - Simplifying record linkage: software and strategy. AB - Although the methodology of record linkage is fairly well developed, there is a need for less expensive methods and simpler software to facilitate trying out different tactics to generate good linkages. The present work has built on a fourth generation language SAS (Statistical Analysis System) with accompanying macroprocessor, to develop a user-friendly and flexible system for both exact and probabilistic matching. The major features of the LINKS system are presented and illustrated using 1979-1984 information from the Manitoba Health Services Commission (MHSC) registry file with the Canadian Mortality Data Base. Initial runs with exact, then probabilistic, matching linked approximately 91% of the Vital Statistics records to corresponding MHSC records. Subsequent modification of parameters improved the linkage to 95%. PMID- 3665454 TI - Infant's apnea, bradycardia and tachycardia monitor based on the Z-80 microprocessor. AB - Home monitoring has been increasingly adopted by pediatricians to help in the prevention of sudden infant death syndrome. The home monitor can be made reliable, easy to operate, inexpensive, and capable of data storage. This can be done by using a microprocessor and a minimum number of integrated circuit chips. Simple real-time algorithm's and digital hardware have been developed to achieve this goal. PMID- 3665455 TI - A microcomputer system for on-line collection of blood flow and related physiological data. AB - A multi-disciplinary approach is described for the development of a microcomputer based on-line data collection system for blood flow experiments. Well designed software provides a flexible approach to data collection, which is particularly suited to blood flow research laboratories. The choice of well supported hardware ensures ease of development with minimum time and cost. PMID- 3665456 TI - A quick and efficient method of correct typesetting of tables on computers. AB - Alignment of numerical data in a table body may be achieved by first typing it single-spaced and without horizontal lines and with only the last lines of the stub-headings. Once the numerical data have been aligned under each column, stub headings may be completed, horizontal lines inserted and the whole table double spaced. PMID- 3665457 TI - Magnetic resonance imaging and the diagnosis of avascular necrosis of the femoral head. AB - Low back pain and/or pain radiating to one or both lower limbs can result from causes other than intervertebral disc disease. Recently three patients presented with low back pain radiating down the legs. When CT examination of the lumbar spine proved unrewarding, magnetic resonance imaging (MRI) was performed. Avascular necrosis (AVN) of the femoral head was diagnosed and subsequently treated before femoral head collapse occurred. In patients with unexplained low back pain, AVN of the hip should be considered and ruled out by MRI, even if conventional plain films, polytomes, and radionuclide scans are negative. The early diagnosis of AVN of the femoral head may be critical in determining whether a surgical revascularization procedure might be successful in treatment, or replacement with an endoprosthesis will be necessary, if femoral head collapse has already occurred. PMID- 3665458 TI - Iophendylate (pantopaque) and MR imaging of the spine. AB - Residual iophendylate in the spinal subarachnoid space may closely resemble certain spinal canal tumors on MR imaging of the spine. A knowledge of the appearance on MR imaging scans of iophendylate is essential to differentiate it from spinal tumors. PMID- 3665459 TI - Significance of the fluid-blood interface in intracranial hematomas in anticoagulated patients. AB - Six patients receiving anticoagulant medication who had laboratory evidence of impaired hemostasis as manifested by laboratory parameters exceeding the therapeutic range developed intracranial hemorrhages. None of these patients had a history of preceding trauma. None of the 6 anticoagulated had CNS symptoms prior to initiation of anticoagulant medication. Within the intracranial hemorrhage there was a fluid-blood interface in these 6 patients; this finding was seen only in hemorrhages in anticoagulated patients. In 3 cases the fluid blood interface changed to a homogeneous hyperdense lesion when adequate hemostasis was achieved. In one case there were multiple hemorrhages and in the other there was a solitary intracerebral hemorrhage. PMID- 3665460 TI - Ruptured middle cerebral aneurysm with accumulation of subarachnoid blood within convexity arachnoid cyst. AB - A case of acute rupture of a right middle cerebral bifurcation aneurysm with extravasation of blood into a distant arachnoid cyst is reported. PMID- 3665461 TI - Tuberous sclerosis: CT findings and differential diagnosis. AB - The CT findings in a patient with tuberous sclerosis are described with special emphasis upon the differential diagnosis. The presence of multiple bilateral subependymal nodular nonenhancing hyperdense calcified lesions is relatively characteristic of tuberous sclerosis when combined with the appropriate clinical findings. In some cases, cerebral cortical heterotopias are visualized as hypodense nonenhancing subependymal lesions. The finding of a subependymal giant cell astrocytoma is sometimes seen in patients with tuberous sclerosis, and the finding of a subependymal hyperdense enhancing lesion is consistent with this diagnosis. PMID- 3665462 TI - CT values in orbital hydatid cyst. AB - The CT values of 15 cases of orbital hydatid cyst operated upon by the author were reviewed. It was found that hydatid cyst of the orbit has high CT value, contrary to the low CT value of nonorbital hydatid. This discrepancy was confirmed by an experiment using human skull and two balls simulating hydatid cyst. One ball was put in the orbit and the other in the cranial cavity. When the skull was CT scanned it was found that the orbital ball CT value was about five times higher than the cranial ball, in spite of the fact that both balls had the same content. It was concluded that the orbital bony pyramid is the cause of this high CT value in orbital hydatid. Hence it is recommended that an orbital lesion with a high CT value can be a hydatid cyst. PMID- 3665463 TI - Superior sagittal sinus thrombosis with intracerebral hematoma. AB - Intracranial hematoma secondary to superior sagittal sinus thrombosis is a well described, but rare event. We present a case of interval resolution of a intracerebral hematoma in a patient with thrombosis of the sagittal sinus. PMID- 3665464 TI - Post-traumatic splenic hematoma hidden by an overdistended stomach: use of nasogastric to avoid pitfalls. AB - The use of a nasogastric tube to empty the stomach contents prevents compression of the splenic parenchyma and allows clear visualization of the anterior medial border of the spleen and perisplenic area. Unsuspected superficial lacerations or a contained hematoma by the splenic capsule may become apparent only following this procedure. A representative case is reported. Routine application of this simple procedure aids avoiding occasional pitfalls and helps in early diagnosis of splenic injury at the time of a CT study. PMID- 3665465 TI - Gastric carcinoma with bladder metastases presenting with urinary frequency. PMID- 3665466 TI - Obstruction of the small intestine due to an infected urachal cyst. PMID- 3665468 TI - Progress toward achieving the national 1990 objectives for sexually transmitted diseases. PMID- 3665467 TI - Health insurance for the nation's poor. PMID- 3665469 TI - Consensus development summaries. Newborn screening for sickle cell disease and other hemoglobinophathies. National Institutes of Health. PMID- 3665470 TI - Antibiotic prophylaxis for endocarditis. PMID- 3665471 TI - Free syringes for addicts. PMID- 3665472 TI - Baby M and public policy. PMID- 3665473 TI - Cost containment: a challenge to physicians. PMID- 3665474 TI - Gastric pull-up replacement of the pharynx and esophagus in cancer of the pharynx and larynx. PMID- 3665475 TI - Primary malignant liver tumors. A retrospective review. PMID- 3665476 TI - Halloween appendicitis: pin perforation of the appendix. PMID- 3665477 TI - M.D. Health Plan: the different HMO. A letter to CSMS members. PMID- 3665478 TI - The new woman physician: her growing numbers are not yet represented in organized medicine. AMA Advisory Panel on Women Physicians. PMID- 3665480 TI - Reflections on medicine. Compelling reality. PMID- 3665479 TI - Autologous blood: a better product. PMID- 3665481 TI - Sequential replacement of the thoracic aorta. PMID- 3665482 TI - A prescription for successful aging. PMID- 3665483 TI - Facing AIDS: health practitioners and public policy. PMID- 3665485 TI - Influence of aspirin on the pharmacokinetics of norethindrone. AB - The influence of a single dose of aspirin on the pharmacokinetics of the synthetic progestogen norethindrone was studied in rabbits. It was found that neither the 24-hr plasma levels nor the pharmacokinetic parameters of norethindrone following intravenous dosing were significantly altered by aspirin. However, after oral administration of norethindrone, the area under the plasma norethindrone versus time curve was significantly decreased by aspirin from 0.72 +/- 0.058 ng/ml X hr to 0.49 +/- 0.046 ng/ml X hr (mean +/- S.E) and the oral bioavailability was reduced from 56 +/- 4.2% to 38 +/- 3.6%, perhaps due to increased gut wall metabolism of norethindrone by aspirin. PMID- 3665484 TI - Interval out-patient female sterilization in Lagos. AB - Out-patient sterilization services were introduced by the Family Planning Clinic of the Department of Obstetrics and Gynaecology, College of Medicine, Lagos, in September, 1981. This paper reviews the results of the first five years of its availability. There were 96 out-patient interval sterilizations, 47 were by the laparoscopic and 49 by the minilaparotomy procedures, representing 0.7% of maternities. Both local and general anaesthesia was used for the procedures. The patients' ages ranged from 28-52 years, all but three being above 31 years. Their parity ranged from 2-15 with between 2-10 living children. Only five patients had less than four children. 37.5% had used no contraception before. Termination of pregnancy was performed at the same time as tubal ligation in 12.5%, and 75% of these were secondary to contraceptive failure. Three patients had emergency laparotomy although in only one was it related to the sterilization procedure. Three patients were observed for 24 hours with no complications. Two patients were re-admitted after one week with pelvic peritonitis. The major complication rate was 3.1%. The failure rate was one per cent. There have been no requests for reversal. The results are compared with those of patients having puerperal sterilization during the same period, who totalled 2% of the maternities. PMID- 3665486 TI - Scientific Group on the Mechanism of Action, Safety and Efficacy of Intrauterine Devices. December 1986. Background papers. PMID- 3665487 TI - IUD complications in perspective. AB - All methods of contraception are associated with the risk of pregnancy and complications. Although there is extensive literature on complications associated with the use of IUD, there are some aspects of IUD use that require further study including pelvic actinomycosis, pelvic inflammatory disease, and tubal infertility. Each of these are reviewed briefly. Ways in which the use of currently available IUDs may be made safer are discussed. PMID- 3665488 TI - The genus Yersinia: epidemiology, molecular biology and pathogenesis. 4th International Symposium on Yersinia. Melbourne, Australia, May 9-11, 1986. Proceedings. PMID- 3665489 TI - Diarrhea caused by Yersinia enterocolitica in children in Bangladesh. PMID- 3665490 TI - Drug susceptibility of Yersinia enterocolitica and Yersinia pseudotuberculosis. PMID- 3665491 TI - Significance of specific IgA antibodies in infections due to Yersinia enterocolitica and their complications. PMID- 3665492 TI - Revised biogrouping scheme of Yersinia enterocolitica. PMID- 3665493 TI - Chronic complaints and complement aberrations after acute Yersinia enterocolitica infection. PMID- 3665494 TI - Surface ultrastructure of a virulent Yersinia enterocolitica. PMID- 3665495 TI - Regulation of expression of V antigen and outer membrane proteins in Yersinia pestis. PMID- 3665496 TI - Roles of V antigen in promoting virulence in Yersiniae. PMID- 3665497 TI - Congo red pigmentation in Yersinia enterocolitica and related species. PMID- 3665498 TI - Plasmid-associated properties and biotypes of Yersinia enterocolitica serotype 03 strains. PMID- 3665499 TI - Properties of a protein antigen common to Yersinia enterocolitica and other gram negative bacteria. PMID- 3665500 TI - Adherence of Yersinia enterocolitica to resident mouse peritoneal macrophages. PMID- 3665501 TI - Yersinia in the dairy industry. PMID- 3665503 TI - Studies on the role of virulence determinants of Yersinia enterocolitica in gnotobiotic piglets. PMID- 3665502 TI - Experimental animal models of Yersinia infection and Yersinia-induced arthritis. PMID- 3665504 TI - Penetration of the intestinal mucosa by Yersinia enterocolitica lacking the virulence plasmid. PMID- 3665505 TI - Mouse strain difference in resistance to peroral Yersinia infection. PMID- 3665506 TI - Co-ordination of a nationwide survey on the presence of Yersinia enterocolitica 0:3 in the environment of butcher shops. PMID- 3665507 TI - Serological diagnosis of yersiniosis by immunoblot technique using virulence associated antigen of enteropathogenic Yersiniae. PMID- 3665508 TI - Human antibody response to individual chromosome- and plasmid-encoded antigens of Yersinia enterocolitica 0:3. PMID- 3665509 TI - Cloning and use of Vwa plasmid DNA as gene probes for virulent Yersiniae. PMID- 3665510 TI - Pathogenicity of Yersinia enterocolitica biotype 3B and 4, serotype 0:3 isolates from pork samples and humans. PMID- 3665511 TI - Immunogenicity of Yersiniae. PMID- 3665512 TI - Epidemiology and pathogenicity of Yersinia enterocolitica in New York State. PMID- 3665513 TI - Yersinia enterocolitica infection in humans and isolation of the microorganism from pigs in Japan. PMID- 3665514 TI - Disease spectrum of Yersinia enterocolitica serogroup 0:3, the predominant cause of human infection in New York City. PMID- 3665515 TI - Comparative epidemiology of Yersinia enterocolitica and related species in patients and healthy controls. PMID- 3665516 TI - Yersiniosis in Brazil. Summary of the data received at the Reference Laboratory for Yersinia in Brazil. PMID- 3665517 TI - Italian experience with yersiniosis (1978-1985). PMID- 3665518 TI - Pathogenic properties of Yersinia enterocolitica strains isolated in Italy. PMID- 3665519 TI - The Yersinia enterocolitica situation in Denmark. AB - The importance of pigs as the major Y. e. 0:3 reservoir is strengthened by the Danish investigations. Y.e. 0:3 is the only cause of yersiniosis in Denmark, and approximately 800 cases are recorded yearly. Approximately 10% of the Danish population harbour the HLAB27 factor, thus belonging to the high-potential risk group. In order to minimize the population's risk, important preventive measures by changing the slaughtering technique have now been taken. PMID- 3665520 TI - Yersinia enterocolitica infection in children in New South Wales. PMID- 3665521 TI - Designing clinical trials with arbitrary specification of survival functions and for the log rank or generalized Wilcoxon test. AB - This article describes a computer program that allows interactive determination of the length of accrual period and follow-up period sufficient to assure desired level of significance and power. The program allows for arbitrary specification of the hypothesized survival curves and the alternative survival curve. It allows use of either the generalized Wilcoxon test or the log rank test. The program can be run on an IBM personal computer. PMID- 3665522 TI - A method for predicting accrual, cost, and paper flow in clinical trials. AB - We consider a mathematical model for accrual and costs associated with randomized clinical trials. A model that predicts the cost as a function of time can be constructed from the design assumptions of the trial and estimates of per patient costs of recruitment, treatment, and follow-up. Our notion of cost is a general one and includes personnel and paper flow as well as money. Costs associated with accrual and follow-up are distinguished in order to more accurately model per patient expenses. We assume that the investigator will specify these expenses in the same fashion that accrual and survival rates are estimated for statistical design. The size of the patient population to be followed can then be modeled and used to estimate cost. Although relatively simple cost equations result for the assumptions of constant accrual and exponential survival, very general assumptions can be incorporated into the model. The model has the advantages of predicting the time course of costs, allowing for different accrual and follow-up costs, and being amenable to revision during the conduct of a trial. Examples of cost modeling in a lung cancer clinical trial and cost minimization are offered. PMID- 3665523 TI - Design features of a controlled clinical trial to assess the effect of a calcium entry blocker upon the progression of coronary artery disease. AB - This report presents the design and methodological features of a double-blind, randomized, placebo-controlled, trial in 383 patients with coronary artery disease. The study's principal objective is to determine whether chronic treatment with a calcium entry blocker can retard the progression of coronary artery disease. The study population consists of patients with coronary artery disease and a baseline coronary arteriogram that qualifies them as being at high risk for disease progression. After satisfying all entry criteria, patients were randomized to receive either the calcium entry blocker nicardipine or placebo. All indicated concomitant medications except calcium entry blockers are permitted. Patients are being followed clinically for 24 months before undergoing a second coronary arteriogram. The effect of the treatments on a variety of clinical and angiographic parameters will be determined. PMID- 3665524 TI - Is chronic illness a relevant topic for the critical care nurse? PMID- 3665525 TI - Emergency aspects of critical care. The updated ACLS standards. Part I. The lethal dysrhythmias. PMID- 3665526 TI - Assessment and resuscitation of the pediatric patient (continuing education credit). PMID- 3665527 TI - Cardiopulmonary cerebral resuscitation: nursing interventions (continuing education nursing). PMID- 3665528 TI - Establishing a standardized patient education program. PMID- 3665529 TI - Sensory preparation for patients undergoing cardiac catheterization. PMID- 3665531 TI - Life without computers in the ICU. PMID- 3665530 TI - Structured teaching and patient understanding of informed consent. PMID- 3665532 TI - Atrial fibrillation in Wolff-Parkinson-White syndrome: ECG challenge. PMID- 3665533 TI - Cardiac arrest: when documentation is critical. PMID- 3665535 TI - CPR record. PMID- 3665534 TI - CNS manifestations of acute renal failure. PMID- 3665536 TI - Nursing care plan. Compensating for xerostomia in the critically ill patient. PMID- 3665537 TI - Emergency aspects of critical care. The updated ACLS standards. Part II. The warning dysrhythmias. PMID- 3665538 TI - Catheter ablation of ventricular tachycardia and related nursing interventions. PMID- 3665539 TI - Insertion of a permanent pacemaker. PMID- 3665540 TI - Bedside electrophysiology study. PMID- 3665541 TI - Acute right ventricular infarction: recognition, evaluation, and treatment (continuing education credit). PMID- 3665542 TI - Differentiation of aberrant ventricular conduction from ventricular ectopic beats (continuing education credit). PMID- 3665543 TI - Assessment of systemic perfusion in the child. PMID- 3665545 TI - The role of collaborative nursing diagnosis in critical care. PMID- 3665544 TI - Continuous ambulatory peritoneal dialysis procedures. PMID- 3665546 TI - Variant angina. PMID- 3665547 TI - Physiologic role and regulation of potassium. PMID- 3665548 TI - Acoustic neuromas: nursing management during the acute postoperative period (continuing education credit). PMID- 3665549 TI - The Glasgow Coma Scale for patients with head injuries. PMID- 3665550 TI - Brain herniation syndromes. PMID- 3665551 TI - Intracranial pressure monitoring. Part I. Physiologic principles (continuing education credit). PMID- 3665552 TI - Acute bacterial meningitis in infancy and childhood. PMID- 3665553 TI - Standardized care plan for the child with bacterial meningitis. PMID- 3665554 TI - Establishing acid-base balance. PMID- 3665555 TI - Droperidol. PMID- 3665556 TI - How to be published without writing a book. PMID- 3665557 TI - The effects of UV-B irradiation on the corneal endothelium. AB - Rabbit eyes, in vivo and in vitro, were exposed to UV-B irradiation at 300 nm, from a mercury arc lamp with an 11 nm bandpass filter. Radiant exposure ranged from 0.1 J/cm2 to 0.5 J/cm2. In vivo, swelling of the cornea resulted over a 12 to 40 hr period, the extent and duration being directly related to exposure. Recovery of normal thickness was complete within four days. Corneas removed at 18 hr after exposure recovered normal thickness during a five hour perfusion period, except for those most heavily exposed. When removed at 42 hr post exposure all corneas thinned to almost normal thickness. SEM showed the endothelial cells of exposed eyes to have either exaggerated villi on the surface and a disorganized mosaic or, after higher exposures, to be devoid of villi and have loose, flap like cell borders and large "blebs." After exposure of isolated corneas mounted for perfusion, swelling again ensued and similar changes were observed in the appearance of the cells, except that "blebs" were not found. No significant changes were observed in the metabolic components ATP, ascorbate and glutathione, nor was there any indication of lipid peroxidation. At higher in vivo exposures, the aqueous humor did show a decrease in ascorbate concentration and an increase in protein content, which probably result from a breakdown of the blood-aqueous barrier. UV-B irradiation may cause or promote changes in the endothelium associated with aging, but the one time radiant exposures of the magnitude used in this study, appear to have no severe or permanently toxic effects. PMID- 3665558 TI - HMG CoA reductase activity of lens epithelial cells: compared with true rates of sterol synthesis. AB - The regulation of sterol synthesis in the lens was addressed in the present study by comparing changes in the activity of HMG CoA reductase to changes in true rates of sterol synthesis for bovine lens epithelial cells in culture. The lens cells possessed very high levels of reductase activity (165 to 241 units/10(6) cells) which doubled when the cells were grown in media depleted of lipoproteins. True rates of sterol synthesis were simultaneously measured from incorporation of tritiated water into digitonin-precipitable sterols. Rates of sterol synthesis increased an average 37% more than the increase in reductase activity when the cells were deprived of exogenous cholesterol. Although not perfect, the results indicate a close correlation between HMG CoA reductase activity and rates of sterol synthesis in lens epithelial cells. We conclude that the activity of HMG CoA reductase is a major determinant of the rate of cholesterol synthesis in the lens. PMID- 3665559 TI - Vitamin E in human neural retina and retinal pigment epithelium: effect of age. AB - Vitamin E levels were measured in retina and retinal pigment epithelium from human eye bank donors of from 12-82 years of age. In comparison to an age group of 12-45 years, humans 59-82 years of age had a higher concentration of vitamin E in both retina and retinal pigment epithelium. Depending on age, the concentration of vitamin E in retinal pigment epithelium was from 4-7 times higher than in retina. Vitamin E accumulated in the human retinal pigment epithelium in an age dependent fashion, so that by 80 years it was from 3-4 times higher than in those 20 years old. The level of vitamin E in young human retinal epithelium, however, was higher than in comparable bovine tissue. The age-related increase in human tissue vitamin E levels does not appear to be affected by postmortem time. PMID- 3665560 TI - Lectin-affinity isolation of microvillous membranes from the pigmented epithelium of rat retina. AB - The pigmented epithelium of the vertebrate retina phagocytizes the discarded tips of photoreceptors and it is likely that a specific cellular recognition process is involved in this phenomenon. The apical surface of retinal pigmented epithelium (RPE) contains microvilli which interdigitate with the outer segment regions of photoreceptor cells and it is this apical microvillous surface that is of particular interest with respect to phagocytosis. The present study is a report of a method to isolate a fraction that is enriched in microvilli from the apical surface of this highly polarized epithelial cell. Wheat germ agglutinin (WGA) conjugated sepharose beads are used to remove the microvillous membranes which are then observed with scanning and transmission electron microscopy. The proteins of this RPE-subfraction are separated through use of SDS-polyacrylamide gel electrophoresis. The relative molecular weights (Mr) and lectin binding properties of glycoproteins are examined in Western blots through the use of lectin-peroxidase conjugates as probes for carbohydrate residues. A preliminary comparison of membranes isolated from Long Evans (normal) and Royal College of Surgeons (dystrophic) rat retina RPE shows that the glycoproteins in these two preparations are different with respect to the binding of Concanavalin-A (Con-A) and WGA. In particular a glycoprotein in the normal RPE preparation with a Mr of 175K binds Con-A and WGA, but in the dystrophic RPE preparation binds little or no WGA. A glycoprotein present in the normal RPE preparation with a Mr of 86K binds Con-A and WGA, but both lectins have reduced binding sites in the dystrophic preparation. Limax flavus agglutinin (specific for sialic acid residues) binds to a high molecular weight glycoprotein with a Mr of 195K-196K which is present in both normal and dystrophic RPE membrane preparations and which also binds Con-A and WGA. PMID- 3665561 TI - The visual evoked potential contrast response function in recovering optic neuritis. AB - VEP contrast response functions were obtained in 7 patients with recovered optic neuritis and in 6 age-matched controls. A 1.5 c/d sinusoidal grating was counterphase modulated at 4 Hz (8 reversals/sec) about a mean screen luminance of 141 cd/m2. Grating contrasts ranged from 2% to 85% and were randomly presented. In all control observers, VEP amplitude was a nonmonotonic function of contrast; an amplitude inflection occurred between contrasts of 33% to 47% followed by a sharp increase in amplitude at higher contrasts. The slope of the function relating VEP phase to contrast was variable between observers at low contrasts but consistently "flat" at high contrasts. In spite of normal acuity and contrast sensitivity, VEP amplitude was severely attenuated at high contrasts in all optic neuritis eyes but there were no contrast-dependent phase abnormalities. The results were directed toward the issues of a) suprathreshold contrast processing in optic neurtis, b) relating a nonmonotonic VEP amplitude function to the contrast-segregating properties of single cells, and c) the relationship between VEP abnormalities and visual performance. PMID- 3665562 TI - Visual deprivation causes myopia in chicks with optic nerve section. AB - Deprivation of form vision restricted to a region of the retina produces myopia and axial elongation only in that region. We asked whether this control of eye growth by the presence or absence of visual stimuli might take place entirely within the eye. Chicks with neonatal optic nerve section, wearing an occluder that deprived one half of the retina of form vision, had vitreous chamber elongation and myopia both restricted to the deprived region. Chicks with optic nerve section but without occluders had eyes smaller than normal with severe hyperopia. These results suggest that two different mechanisms may control eye growth, one within the eye and the other in the brain. PMID- 3665563 TI - Mannosidosis: ocular lesions in the bovine model. AB - The ocular pathology of mannosidosis was studied in the bovine model. There was wide-spread vacuolation of many cell types including corneal epithelium, Descemet's endothelium, corneal fibroblasts, pigmented cells, lens epithelium, lens fibres, pigment epithelium and all cell types of the neuroretina. On electron-microscopy most vacuoles were seen to be membrane bound vesicles compatible with being secondary lysosomes and similar to those previously described elsewhere in the body. Additional vacuoles were seen due to dilatations between lens epithelial cells and between lens fibres. The cause of lens and corneal opacities seen in human patients is unclear from the present study but are presumably a consequence of the lesions noted. PMID- 3665564 TI - Phagocytic interactions of sialated glycoprotein, sugar, and lectin coated beads with rat retinal pigment epithelium. AB - Latex beads coated with mucin (a sialic acid containing glycoconjugate), N acetylglucosamine (GlcNAc), or with the lectins, succinylated wheat germ agglutinin (sWGA) (binds to GlcNAc) or Limax flavus agglutinin (LFA) (binds to sialic acid residues) were used as phagocytic particles. Phagocytosis of these coated beads by retinal pigment epithelial (RPE) explants was determined by bead uptake in normal (Long Evans) and dystrophic (Royal College of Surgeons, RCS/p+) rat retinas. Electron microscopy showed that beads coated with mucin or LFA lectin were not phagocytized by either dystrophic or normal RPE. sWGA-coated beads were phagocytized by both dystrophic and normal RPE, while GlcNAc-coated beads were taken up by dystrophic RPE only. Specificity of uptake for sWGA and GlcNAc bead coatings was shown by the reduction in the number of beads phagocytized in the presence of the appropriate competing sugar or lectin. The lack of phagocytic uptake of beads coated with a sialated glycoprotein or a sialic acid binding lectin suggests that sialic acid residues are not recognized as particulate ligands in this phagocytic assay. The data which show the uptake of beads coated with sWGA (binds only GlcNAc) together with results which showed WGA (binds both GlcNAc and sialic acid)-coated beads were not taken up, further suggest that GlcNAc residues may be involved in bead phagocytosis. The most striking difference between normal and dystrophic RPE engulfment of coated beads is the uptake of GlcNAc-coated beads by dystrophic RPE only. These results suggest that the receptor molecules on dystrophic RPE cell surface membranes may be different from those on normal RPE membranes. PMID- 3665565 TI - The state of sulphydryl groups in proteins isolated from normal and cataractous human lenses. AB - Individual crystallins, urea-soluble and urea-insoluble proteins were isolated from the nucleus and cortex of types I-IV cataractous lenses and normal lenses. The levels of protein sulphydryls (P-SH), disulphides (S-S), as well as surface (F-SH) and buried (S-SH) in these proteins were determined by reaction with 5, 5' dithiotris- (2-nitrobenzoic acid) or performic acid oxidation followed by amino acid analysis. During nuclear colour development there is a progressive decrease in the sulphydryl content of the crystallins. In the nuclei of advanced cataractous lenses, the P-SH decreases to 10% of the levels found in the normal nucleus. Similar but smaller changes take place in the cortex. No specific changes were found between the crystallins, with the exception of beta S crystallin. The cysteine remains constant in all lens types suggesting no higher oxidation products are formed. There is a significant shift in the distribution of cysteine in the nucleus of type III and IV lenses. Urea-insoluble proteins are the predominant species, accounting for about 70% of the total cysteine pool. This is consistent with the accumulation of modified insoluble polypeptides during senile nuclear cataract formation. PMID- 3665566 TI - The nature of disulphide bonds in rat lens proteins. AB - The nature of disulphide bonds in 3, 7 and 24 month old rat lens proteins has been determined in order to examine the possibility that there is a direct correlation between intermolecular disulphide bond formation and hardening of the lens during ageing. Significant levels of S-S were found in all of the crystallins, as well as in the insoluble proteins. However, no substantial changes in the molecular weight distribution of the proteins, or their constituent polypeptides, were observed after the reduction of these bonds. This indicates that almost all of the S-S bonds are intramolecular. It would appear that the hardening of the nucleus is not a result of intermolecular disulphide crosslinking during ageing. Instead, our observations suggest that intramolecular disulphide bonds may make the gamma-crystallin molecule more compact, thereby promoting closer packing in the nucleus where the concentration of this protein is highest. PMID- 3665567 TI - The effect of a retinal lesion on the distribution of B wave potentials on the sclera. AB - In the experiments presented here we have used the isolated perfused eye technique to investigate the distribution of ERG potentials on the sclera over local retinal lesions induced by xenon arc photocoagulation. Three lesioned dog eyes were examined. In two cases the lesion was allowed 28 days to stabilize, whilst in the third the experiment was performed two hours after treatment. Immediately after enucleation, the eyes were placed in a perfusion system capable of maintaining retinal function for many hours. The scleral ERG profile was then measured on the scleral surface over both treated and untreated areas of retina in the same eye. It was found that the ERG amplitudes were consistently lower over the treated areas of retina when compared to the untreated side of the same eye. More surprising was the discovery that the ERG distribution on the untreated side was significantly different to that observed in control eyes. In particular it was found that the limbal areas of sclera on the untreated side now had significant ERG amplitudes present, whereas the control eyes had close to zero amplitude in this region. It is concluded that the induced retinal lesions caused a widespread redistribution of ERG potentials around the entire surface of the globe. The potential applications of these results in the assessment of local retinal function is discussed. A schematic model is presented for the distribution of ERG potentials on the surface of control and lesioned eyes. PMID- 3665568 TI - DNA and cell cycle analysis of retinoblastoma. AB - We retrospectively analyzed archival retinoblastomas from 44 eyes. The percentage of cycling cells were increased in younger patients, those with advanced disease, and cases with poor prognosis. These data suggest that all cell cycle studies may yield important insights in retinoblastoma. PMID- 3665569 TI - Lectin binding in retinoblastoma. AB - Lectins were used as cytochemical probes to examine the relationship between normal retina and retinoblastoma. Cases of retinoblastoma in which there were either Flexner-Wintersteiner rosettes or fleurettes accompanied by nontumorous retina were studied with ten biotinylated lectins. Pineal and ocular tumors from cases of trilateral retinoblastoma were also studied. Con-A, LCA, PNA, WGA and RCA-I labeled tissue of each type to varying degrees, while BS-I, DBA, SBA, S-WGA and UEA-I bound neither tumor nor retina. The high degree of binding homology suggests biochemical as well as structural similarities between these tissues. PMID- 3665570 TI - Lipid synthesis in the bovine lens. AB - Lipid synthesis was investigated in bovine lens in organ culture for 9 hours using 14C acetate as a precursor. The greatest incorporation occurred in phospholipid fraction with phosphatidyl choline being the major phospholipid labeled. Considerable activity was incorporated in the free fatty acid fraction, cholesterol and cholesterol intermediates. A comparison of the lipid synthesis in bovine mouse and rabbit lenses showed the rabbit lens to be the most active, the adult mouse lens to be the least active and the bovine and young mice to be intermediate in value. PMID- 3665572 TI - Training for professional competence in general surgery. PMID- 3665571 TI - Evidence that fibroblast growth factor promotes lens fibre differentiation. AB - Lens epithelial cells from newborn rats undergo changes characteristic of fibre differentiation when cultured with rat neural retina or with a soluble mitogenic factor present in calf retina-conditioned medium. Mitogens have been isolated from retina in other laboratories, but have not previously been shown to promote fibre differentiation in mammalian lens. We prepared eye-derived growth factors I and II and alpha- and beta-retina-derived growth factors from bovine retinas. These factors all promoted lens fibre differentiation in our culture system, as assessed by morphological changes and the appearance of fibre cell-specific crystallins. There is now strong evidence that these retina-derived factors are identical to the acidic and basic forms of fibroblast growth factor (FGF), which is present in a variety of tissues. We found that acidic and basic FGF from rat brain also promoted lens fibre differentiation, suggesting that FGF is the factor from the retina responsible for inducing lens fibre differentiation. PMID- 3665574 TI - A look back. PMID- 3665573 TI - Current perspectives on blood substitutes. PMID- 3665575 TI - The craniofacial approach to severe facial injuries. PMID- 3665576 TI - Effect of cachexia on lipid saturation of erythrocyte membranes. PMID- 3665577 TI - Orthotopic and heterotopic xenotransplantation of human pancreatic cancer in nude mice. PMID- 3665578 TI - Preservation of myocardial high-energy phosphates during cardioplegic arrest with nifedipine. PMID- 3665579 TI - Comparative functional preservation of cold perfusion and nonperfusion in rat hearts isolated in the Langendorff preparation. PMID- 3665581 TI - Staging of patients with suspected isolated colorectal liver metastases. PMID- 3665580 TI - Alternative pathway complement activation induces reductions in effective hepatic blood flow. PMID- 3665582 TI - Steroid treatment of head injuries in children: the nutritional consequences. PMID- 3665584 TI - Allergic contact dermatitis mimicking mycosis fungoides. PMID- 3665583 TI - High-density seeding of cultured endothelial cells leads to rapid coverage of polytetrafluoroethylene grafts. PMID- 3665585 TI - Blister beetles: "Spanish fly". PMID- 3665586 TI - Lichen planus limited to the nails. PMID- 3665587 TI - Palmar subcutaneous lipoma. AB - We report the case of a patient with a large palmar subcutaneous lipoma. The unusual site of the lesion and the importance of a differential diagnosis to rule out angiolipoma are stressed. PMID- 3665588 TI - The clinical use of bronchoalveolar lavage. PMID- 3665589 TI - The close but mysterious ties between obstructive sleep apnea and the obesity hypoventilation syndrome. PMID- 3665590 TI - The esophagus. The neglected chest organ? PMID- 3665591 TI - Stair climbing as an indicator of pulmonary function. AB - Seventy male patients with a mean age of 56.8 years scheduled for pulmonary function testing were subjected to a stair climb in order to determine the relationship, if any, between the number of steps climbed and the results of pulmonary function testing. The number of steps completed was plotted against the different parameters which may be used as predictors of post-thoracotomy outcome. The stair climb acts as a stress test and, although there is a strong relationship to pulmonary function tests, it also is an indicator of many other parameters including cardiovascular status, cooperation, and determination. Based on results of this study, the stair climb can be used as a reliable screening test of pulmonary function. Also, preoperative patients who are unable to perform pulmonary function tests can be evaluated accurately for lung resection by use of the stair climb test. PMID- 3665592 TI - Inspiratory impairment in right ventricular performance during acute asthma. AB - Right ventricular function was investigated in seven asthmatic patients during an acute attack, using simultaneous bedside right heart catheterization and two dimensional echocardiography (2DE). Hemodynamic and echocardiographic data were compared during four successive periods of the respiratory cycle: inspiration, early expiration, mid-expiration, and late expiration. During inspiration, 2DE showed a significant increase in right ventricular area at both end-systole and end-diastole. This inspiratory right ventricular enlargement coexisted with a significant reduction in 2DE stroke area and pulmonary artery pulse pressure suggesting an inspiratory reduction in right ventricular stroke output. A transient depression of right ventricular function during deep inspiratory effort in asthma was thus strongly suggested. The negative pressure surrounding the right ventricle at inspiration is advocated as the causative factor enabling reduction in the hydraulic force effecting right ventricular ejection. The highly negative pleural pressure probably holds the right ventricular free wall and restrains its systolic inward motion, as suggested by the finding of a concomitant inspiratory reduction in right ventricular developed pressure and 2DE fractional area contraction. PMID- 3665593 TI - Continuous monitoring of mixed venous oxygen saturation during aortic surgery. AB - The correlation between mixed venous oxygen saturation (SvO2) and hemodynamic measurements was studied in 13 patients undergoing descending thoracic aortic aneurysm resection (DTAAR). A significant correlation (p less than 0.05) was found between cardiac index (CI) and SvO2 after the induction of anesthesia and at the end of surgery. However, no significant correlation could be found between SvO2 and CI during the most critical periods of the surgery that included the collapse of the left lung, the aortic clamping, and the aortic declamping. During DTAAR, continuous SvO2 monitoring is useful, but it cannot substitute for intermittent cardiac output and oxygen consumption (VO2) determinations. PMID- 3665594 TI - Clinical features of patients with high-altitude pulmonary edema in Japan. AB - Clinical studies were performed in 27 consecutive patients with high-altitude pulmonary edema who were transported from the mountains to Shinshu University Hospital, Matsumoto, Japan. The altitude of onset was 2,680 m to 3,190 m above sea level. Symptoms included marked dyspnea, cough, and stridor. Physical findings included cyanosis, tachycardia, and rales. Neurologic disturbances, which were seen in 17 patients, included headache, vomiting, memory disturbance, clouding of consciousness, or coma. Chest roentgenograms revealed patchy infiltrates throughout the pulmonary fields, often in an asymmetric pattern, and enlargement of the right ventricle. Hemodynamic studies by right cardiac catheterization showed that high-altitude pulmonary edema was noncardiogenic. Scintiscans of the lungs with technetium-99m-macroaggregated albumin (99mTc-MAA) performed in one patient showed decreased perfusion of 99mTc-MAA in the area of infiltrates. Pulmonary edema fluid collected through the endotracheal tube in two patients was rich in protein. Computerized tomograms of the brain showed small ventricles and cisterns, disappearance of sulci, and diffuse low density of the cerebrum, indicating cerebral edema in eight of nine cases. Retinal hemorrhage and papilledema were observed in five patients. PMID- 3665595 TI - Bronchodilatation with a metered-dose inhaler plus an extension, using tidal breathing vs jet nebulization. AB - The bronchodilating response to two doses of 100 micrograms of salbutamol introduced into an extension device (Aero-chamber [AC]), each followed by four tidal breaths, was compared with the nebulization of 2.5 mg of salbutamol in a saline solution during tidal breathing in a crossover study of ten patients with reversible airway obstruction. The forced expiratory volume in one second (FEV1) and the forced vital capacity 30 min after the drug administration improved significantly with both methods (p less than .001). The improvement of FEV1 with the AC (52.1 percent) compared with the nebulization (55.7 percent) was similar (p greater than .05). PMID- 3665596 TI - Forced expirations in normal subjects. Is the shape of the flow rate curve related to existence of a wheeze? AB - The flow rate curve takes different shapes during forced expirations performed by normal subjects. In some cases a wheeze may exist. In this study, we examine the conditions for appearance of a wheeze, before and after the peak flow, and the relationship between the wheeze and the shape of the flow rate curve. We analyzed ten parameters in 83 forced expirations produced by 32 normal subjects (16 men and 16 women) using multidimensional scaling techniques. Among these expirations, 53 presented a wheeze. The first two axes of the analysis define a plane on which forced expirations are divided into four quadrants. Two opposite quadrants (upper right and bottom left) contain the wheezing expirations, while the two others only have the ones with no wheezing. This distribution corresponds to specific shapes of the flow rate curve. We found that wheezes are associated with two main shapes. One of them consists of a short onset until a sharp peak, followed by a fast exponential decay. The other is about triangular, with a late appearance of the wheeze, and is only produced by women. PMID- 3665597 TI - Venous admixture to radial artery blood samples during cardiopulmonary bypass. AB - The possibility that venous blood could be withdrawn through a radial artery cannula when venous pressure is high was examined in 30 patients during cardiopulmonary bypass for coronary artery bypass operation. Progressive desaturation of radial artery blood occurred when venous pressure was equal to arterial pressure. Desaturation not only increased with duration of venous obstruction but also occurred immediately if the arterial tree was emptied after occlusion. We believe that these observations result from the transcapillary aspiration of deep venous blood and may produce a potential source of error in measuring arterial oxygen tension during cardiopulmonary resuscitation, cardiac tamponade, and profound right heart failure, as well as cardiopulmonary bypass. PMID- 3665598 TI - The impact of bronchoalveolar lavage cell analysis on clinicians' diagnostic reasoning about interstitial lung disease. AB - To assess the impact of bronchoalveolar lavage (BAL) on clinicians' diagnostic reasoning, we administered serial telephone questionnaires to all pulmonary physicians submitting BAL specimens to our laboratory from nonimmunocompromised patients with diffuse interstitial lung disease. Questionnaires were completed when the lavage specimens were first submitted and again after the results were reported to referring physicians. We recorded the clinicians' ordered list of likeliest diagnoses for the patient, a level of confidence in each diagnosis mentioned, and any proximate plans for further diagnostic tests. Of 78 patients in the study, information from the BAL fluid cell analysis caused clinicians to change their diagnostic thinking in 46 (59 percent). These changes were far more frequently appropriate (52 percent) than not (9 percent), and clinically impressive changes did occur but were infrequent (3 of 78 [4 percent]) in this series. Specifically, BAL permitted the unexpected diagnosis of Pneumocystis carinii in a patient not previously suspected to have acquired immune deficiency syndrome (AIDS) and appropriately encouraged clinicians to avert planned surgical biopsies in two patients subsequently found to have sarcoidosis. These findings suggest that when used to evaluate nonimmunocompromised patients, BAL fluid cell analysis can have an important impact on clinicians' diagnostic reasoning about their patients' interstitial lung diseases. PMID- 3665599 TI - Tobramycin in patients with cystic fibrosis. Adjustment in dosing interval for effective treatment. AB - The efficacy of the dosing regimen of tobramycin was investigated in 28 patients with cystic fibrosis who had an acute exacerbation of chronic pulmonary infection with Pseudomonas aeruginosa. The initial dose of tobramycin was 3.3 mg/kg of body weight three times daily (ie, 10 mg/kg/day). A highly significant relationship was found between the serum concentration of tobramycin before the dose and the change in the forced expiratory volume in one second (FEV1), both measured on the tenth day of treatment (rs = 0.75; p less than 0.001). In nine of the 16 patients who had a six-hour serum concentration of 1 mg/L or less on the tenth day of treatment, the eight-hour dosing interval of tobramycin was shortened to achieve a serum concentration of tobramycin of about 1 mg/L before the dose. In the other seven patients, the dosage of tobramycin was not changed. On the 20th day, seven of the nine patients in whom the dosing interval was shortened exhibited an increase in FEV1 of 20 percent or more. Such an increase was observed only in one of the seven patients in whom the dosing interval was not reduced (p less than 0.05). We conclude that individualizing the dosage of tobramycin in patients with cystic fibrosis results in a better clinical outcome. PMID- 3665600 TI - Abnormal autonomic function in diabetic and nondiabetic patients after first acute myocardial infarction. AB - We performed autonomic function testing in 68 patients, 34 with diabetes mellitus (group A) and 34 without (group B), at 72 h after a first acute myocardial infarction (MI) to determine the prevalence of autonomic dysfunction in these patients. Heart rate (HR) variation during 6 breaths/min obtained from mean of longest RR interval during expiration(E)/mean of shortest RR interval during inspiration (I) (E:I ratio), immediate HR response to standing = RR at 30th beat/RR at 15th beat (30:15 ratio) and postural fall of blood pressure were evaluated. In group A, 25 (78 percent) of 32 patients had an abnormal expiration inspiration ratio compared with 28 (85 percent) of 33 in group B. Twenty-six (76 percent) patients in group A and 16 (47 percent) in group B had an abnormal 30:15 ratio. Abnormal postural fall of blood pressure was seen in 16 (47 percent) patients in group A compared with ten (29 percent) in group B. During follow-up, four women in group A with an initial autonomic dysfunction died, and in group B, three patients with a normal autonomic function died. Thus, autonomic dysfunction does not seem to contribute to the high mortality among diabetics after an acute MI. PMID- 3665601 TI - Malignant primary cardiac tumors. The Cleveland Clinic experience, 1956 to 1986. AB - Malignant primary cardiac tumors have uniformly been associated with poor long term survival. We reviewed data on 11 patients with such tumors seen between 1956 and 1986. There were five men and six women, with a mean age at presentation of 44 years. Nine (82 percent) of 11 patients presented initially with respiratory symptoms, and 45 percent (five) presented with chest pain. No patient was asymptomatic on initial presentation. Forty-five percent (five) of the patients had elevated jugular venous pressure or a systolic murmur. Cardiomegaly was present in eight (73 percent) of 11 patients. Nine of ten patients had a hemoglobin level less than 12 g/100 ml, and 30 percent (3/10) presented with thrombocytosis. Seventy percent (eight) of the patients underwent surgical biopsy, and in 30 percent (three), surgical excision of the tumor was attempted. Angiosarcoma was the most frequent type of tumor (four patients), followed by malignant fibrous histiocytoma (three patients), mesothelioma (two patients), rhabdomyosarcoma (one patient), and primary lymphoma (one patient). Long-term follow-up data reveals that ten (91 percent) of 11 patients had died, with a mean duration from diagnosis until death of 9.7 months. Newer pathologic techniques for identification of sarcomas, aggressive surgical resection, and advanced chemotherapy for certain subgroups may contribute to better survival for patients with these tumors in the future. In addition, cardiac transplantation may play an important role in the future for those patients with localized disease. PMID- 3665602 TI - Polycythemia in chronic obstructive pulmonary disease. A study of serum and urine erythropoietin and medullary erythroid progenitors. AB - In order to investigate the mechanism of polycythemia in chronic obstructive pulmonary disease (COPD), serum and urinary levels of erythropoietin and medullary erythroid progenitors were studied in 21 patients; nine were nonpolycythemic (hematocrit, 39 +/- 4 percent; red blood cell [RBC] mass, 28 +/- 5 ml/kg; forced expiratory volume in one second [FEV1], 0.6 +/- 0.1 L), and 12 patients were polycythemic (hematocrit, 52 +/- 7 percent; RBC mass, 46 +/- 7 ml/kg; FEV1, 0.9 +/- 0.3 L). Hypoxia was severe in both groups, with mean arterial oxygen pressure of 47 mm Hg. The following parameters of tissue oxygenation were not significantly different between the two groups: arterial and mixed-venous oxygen saturations; cardiac output; oxygen utilization coefficient; 2, 3-diphosphoglycerate, and carboxyhemoglobin level. The level of erythropoietin was measured by bioassay in vitro. The level was increased in the serum of 85 percent (18) and in the urine of 38 percent (8) of the patients. There was no significant difference between the nonpolycythemic and polycythemic groups. Without exogenous erythropoietin, none of the subjects showed spontaneous colonies of erythroid progenitors. The addition of one unit of erythropoietin induced a similar normal proliferation of erythroid progenitors in both groups. The absence of adaptative polycythemia in the nonpolycythemic group with severe hypoxia was seemingly related neither to a quantitative deficit of erythropoietin nor to a lack of sensitivity of erythroid progenitors to its action. PMID- 3665603 TI - Pulmonary veno-occlusive disease following therapy for malignant neoplasms. AB - We report three cases of pulmonary veno-occlusive disease which developed following treatment for malignant neoplasms. Two patients received single agent BCNU chemotherapy for malignant gliomas. The third patient underwent combination radiation and chemotherapy for Hodgkin's disease. Isolated case reports of pulmonary veno-occlusive disease following therapy for malignant disease are reviewed and clinical features summarized. Pulmonary veno-occlusive disease in this setting is thought to be rare. However, the diagnosis is rarely suspected clinically and is difficult to diagnose pathologically. Therefore, the true incidence of this complication is unknown and may be higher than believed. It is important that both clinician and pathologist be aware of this entity; otherwise, elastic tissue stains may not be performed and the diagnosis missed. PMID- 3665605 TI - Multiple primary lung cancers. AB - From November 1957 to June 1984 at Shanghai Chest Hospital, 30 cases of multiple primary lung cancers were confirmed, based on clinical characteristics, diagnostic process, histologic type, treatment, and prognosis. Out of 3,815 cases of resected primary lung cancer, the incidence of multiple primary lung cancers was 0.8 percent. There were ten synchronous cases and 20 metachronous cases. Seventeen cases were unilateral, and 13 cases were bilateral, of which only one case was synchronous, and the remaining 12 cases were postoperative resection of an opposite lesion. Among the ten synchronous cases, four cases of multiple primary lung cancers were definitely diagnosed before surgery by chest x-ray films or fiberoptic bronchoscopy. Among the 20 metachronous cases, 11 cases were definitely diagnosed before surgery as the second primary lesion by chest x-ray films taken during periodic follow-ups after the initial resection, while nine cases were proven by thoracotomy. All of the 15 cases definitely diagnosed before surgery as multiple primary lung cancers were according to our criteria. Histologically, adenocarcinoma was relatively scarce, at a rate of 13 percent (4/30); but epidermoid carcinoma was predominant, at a rate of 87 percent (26/30), of which 11 cases were accompanied by adenocarcinoma or large-cell undifferentiated carcinoma. The average postoperative survival in the ten synchronous cases was 29 months and in the 20 metachronous cases was 26.2 months, counting from the time of the second operation. The criteria of clinicopathologic findings, early diagnostic procedure, and surgery for multiple primary lung cancers were also discussed. PMID- 3665604 TI - Skeletal muscle energetics, acid-base equilibrium and lactate metabolism in patients with severe hypercapnia and hypoxemia. AB - Quadriceps femoris muscle needle biopsies were performed in ten patients with chronic obstructive pulmonary disease and acute respiratory failure and in ten age- and sex-matched healthy control subjects. The main indices of skeletal muscle cell energy metabolism, intracellular acid-base equilibrium and lactate metabolism were evaluated. Reduced ATP and phosphocreatine content, intracellular acidosis related to hypercapnia, increased muscle lactate without alterations of the muscle lactate concentration gradient were observed in the skeletal muscle of the hypercapnic-hypoxemic COPD patients studied, in which group no correlation was found between hypoxia and energy or lactate metabolism parameters. These results suggest that an overall derangement of cell energy metabolism and acid base equilibrium is present in severely hypercapnic-hypoxemic chronic obstructive pulmonary disease and that in this condition skeletal muscle seems to metabolize anaerobically-even though, in addition to hypoxia, other factors interfering with both cell energy and lactate metabolism are likely to be present. PMID- 3665606 TI - Use of a lighted stylet to confirm correct endotracheal tube placement. AB - Despite the fact that endotracheal intubation is a skill essential for clinicians of varied specialties, the procedure is not without risk, especially when practiced in an emergency setting, particularly the field environment. Of all complications, none is more serious than unrecognized esophageal intubation. Clinical experience with a method of guided orotracheal intubation using a rigid wire lighted stylet prompted us to develop a technique to confirm correct intratracheal placement of an endotracheal tube using a new flexible lighted stylet designed for nasotracheal intubation. Endotracheal tubes were placed under direct vision at three sites in the upper airway of five unembalmed human cadavers: esophagus (20 cm from the teeth), trachea (20 cm from the teeth) and the right or left pyriform fossa. Thirty-five volunteer intubators were asked to identify tube placement using the transilluminated glow from the flexible nasotracheal lighted stylet. A total of 168 placements were made in 40 trials. Only one of 56 intratracheal placements was misidentified as esophageal. Of 112 extratracheal placements (esophagus or pyriform fossa), one was misidentified as intratracheal. The level of experience or training bore no relationship to the ability of the intubator to identify correct placement. We conclude from the study that this technique is a rapid and reliable method of confirming correct placement of endotracheal tubes. The use of this method could reduce, if not eliminate, unrecognized esophageal intubation in the field, emergency department, the critical care unit, and the operating room. PMID- 3665607 TI - Tuberculous pleural effusion and lymphadenitis treated with rifampin-containing regimen. AB - Rifampin, isoniazid, and ethambutol were administered in single daily dose for nine months to 91 patients with pleural effusion and 45 patients with lymphadenitis, both of tuberculous etiology. Clinical and roentgenographic clearance of pleural effusion was successfully achieved in all cases at the end of nine months of treatment. Followup of 80 cases of pleural effusion up to nine months, in 55 cases up to one year, and up to two years in 30 cases after completion of therapy, showed no recurrence. In the cases of tuberculous lymphadenitis, resolution of lymph nodes occurred in 31 cases (68.8 percent) at the end of nine months of treatment. Therapy had to be extended for varying periods for achieving successful response, and in five cases, medical treatment had to be supplemented with surgical drainage and excision of the nodes. Short course chemotherapy can be used to treat pleural effusion, but the same mode of treatment is less effective for cases of tuberculous lymphadenitis. PMID- 3665608 TI - Importance of venous return, venous resistance, and mean circulatory pressure in the physiology and management of shock. PMID- 3665609 TI - Concerning the importance of pharyngeal muscles in the maintenance of upper airway patency during sleep. An opinion. PMID- 3665610 TI - What is wrong with this chest roentgenogram? Right subclavian artery cannulation. PMID- 3665611 TI - In vivo comparison of two thermodilution systems. PMID- 3665612 TI - Is exercise training harmful after myocardial infarction? PMID- 3665613 TI - Spotting heart disease: Leopard syndrome. PMID- 3665614 TI - Intraventricular masses detected by radionuclide angiocardiography. AB - Two patients are described in whom intraventricular tumors were incidentally detected by radionuclide angiocardiography. This finding led, in one patient, to surgical cure. PMID- 3665615 TI - Severe restrictive pulmonary defect in a patient with adult-onset Still's disease. AB - Adult-onset Still's disease is characterized by seronegative arthritis, fever, and an evanescent skin rash. Earlier reports have described pneumonitis and pleuritis as manifestations of this disease. We report a patient with adult-onset Still's disease with severe restrictive ventilatory impairment and evidence of respiratory muscle weakness who responded to corticosteroid and aspirin therapy. PMID- 3665616 TI - Hypersomnolence with beta-adrenergic blockers. AB - An elderly, mildly demented, hypertensive male patient developed hypersomnolence on administration of propranolol for treatment of hypertension; no other cause for hypersomnolence was detected. Upon replacement of propranolol with atenolol, he felt better but continued to be quite somnolent. When atenolol was discontinued, he reported to have lack of sleep. On readministration of subtherapeutic doses of the same beta-adrenergic blocking agents, he once again experienced excessive sleepiness. By discontinuing beta-blocking agents and introducing captopril, he felt much better, became pleasant and talkative, and blood pressure was well controlled. Beta antagonists are important drugs in the management of many cardiovascular problems. Propranolol, a lipophilic beta blocking agent, and atenolol, a hydrophilic beta-blocking agent, are two of the major agents currently used clinically in the United States. Numerous neuropsychiatric side-effects of the beta-adrenergic blocking drugs have been reported, but hypersomnolence is not readily recognized as one of them. PMID- 3665617 TI - Fiberoptic bronchial blockade in a small bronchopleural fistula. AB - A patient with bronchopleural fistula was successfully treated by selective intrabronchial injection of doxycycline and blood under fiberoptic bronchoscopic guidance. This simple and relatively noninvasive therapeutic approach is an effective and safe alternative in treating selective patients with a bronchopleural fistula. PMID- 3665618 TI - Pulmonary involvement in zinc fume fever. AB - A patient with the clinical history of recurring zinc fume fever underwent an experimental welding exposure; this resulted in a systemic reaction and a distinct self-limiting response in the periphery of the lung, demonstrated by pulmonary function tests and bronchoalveolar lavage. These pulmonary changes observed for the first time in man were reproducible. PMID- 3665619 TI - Pulmonary aspergilloma diagnosed by fiberoptic bronchoscopy. AB - We report a patient with pulmonary aspergilloma in whom the mycetoma was visualized and biopsied during fiberoptic bronchoscopy. To our knowledge, this is the first report of pulmonary aspergilloma diagnosed in this manner. PMID- 3665620 TI - Successful treatment of right ventricular failure with atrial septostomy. AB - In the case reported, a patient with severe right ventricular failure following coronary revascularization was successfully weaned from cardiopulmonary bypass following creation of an atrial septal defect. This technique facilitated rapid decompression of the failing right ventricle by shunting blood to the more compliant left ventricle, thus augmenting left ventricular preload and enhancing cardiac output. Recovery of right ventricular function was demonstrated by progressive hemodynamic improvement, as well as reduction of right-to-left intracardiac shunting and resolution of arterial hypoxemia. PMID- 3665621 TI - Management of familial aortic dissection. AB - Aortic dissection uncommonly occurs in multiple family members, and this association is most commonly seen in kindreds with Marfan's syndrome. There is increasing evidence that such connective tissue disturbances may not always appear in their complete phenotypic pattern. This report describes two siblings with aortic dissection. It is proposed that this suggests underlying connective tissue disease and warrants investigation of close relatives. PMID- 3665622 TI - Charcot-Marie-Tooth disease and respiratory failure. PMID- 3665623 TI - Severe hypoxemia in farmer's lung with normal chest roentgenograms. PMID- 3665624 TI - Reactions to bronchoconstrictor drugs. PMID- 3665625 TI - Risk-benefits of peer review. PMID- 3665626 TI - On the use of chest tubes. PMID- 3665627 TI - Human placental alkaline phosphatase and acute lung injury. PMID- 3665628 TI - Pharmacokinetics of cinoxacin in elderly patients following repeated oral administration. AB - Cinoxacin is an antibacterial drug belonging to the quinolone class used in the treatment of urinary tract infections due to common gram-negative pathogens. Considering the high frequency of urinary tract infections in elderly people where aging represents a physiopathological condition frequently requiring an adjustment of the dosage regimen, the pharmacokinetic behaviour of cinoxacin (500 mg/12 h) in aged patients was investigated to find out if age-dependent differences may be established. The main differences detected were a shift to 4 h of the Tmax and a partly reduced clearance in comparison with data referred to younger people. On the other hand the findings showed that no accumulation occurred. High urinary concentrations of cinoxacin, exceeding the MICs for most urinary tract pathogens were found up to the 12th hour after administration. PMID- 3665629 TI - Gentamicin dosage regimen based on serum creatinine concentration. AB - In order to avoid gentamicin toxicity trough serum concentrations when drug monitoring is not available, a correction factor for serum creatinine was calculated and evaluated. In a first group of 35 patients under aminoglycoside treatment with variable serum creatinine (SCr) values, the regression plot of SCr concentrations versus half-life (T1/2) values was established: log T1/2 = log 2.28 + 1.45 log SCr, r = 0.90, p less than 0.01. A second group of 18 patients was treated with doses of 1.0 mg/kg of gentamicin. Dose intervals equivalent to 3 T1/2 were daily adjusted. The T1/2 was calculated from SCr according to the relationship established for the patients of the first group. All the patients studied maintained trough levels within the therapeutic range. PMID- 3665630 TI - Serum concentrations and adverse effects of chloramphenicol in pediatric patients. AB - Chloramphenicol serum concentration is often monitored to assure efficacy and prevent toxicity. We studied the relationship between steady-state chloramphenicol serum concentration and hematologic adverse effects in 45 pediatric patients. The mean peak serum concentration of chloramphenicol in patients with and without toxicity were not different (p less than 0.01): 22.7 micrograms/ml in neutropenic patients versus 23.1 micrograms/ml in those without neutropenia; 18.2 micrograms/ml in leukopenic patients versus 23.3 micrograms/ml in those without leukopenia; 22.2 micrograms/ml in patients with eosinophilia versus 23.9 micrograms/ml in those without eosinophilia; 23.7 micrograms/ml in patients with anemia versus 22.1 micrograms/ml in those without anemia. None of the patients developed thrombocytopenia. These data clearly demonstrate that chloramphenicol toxicity may not be predictable by serum concentration in pediatric patients receiving therapeutic doses of chloramphenicol succinate. Thus, frequent monitoring of chloramphenicol serum concentration does not appear warranted unless a patient appears unresponsive to a therapeutic dose or has received an excessive dose. PMID- 3665631 TI - Ciprofloxacin concentrations in human aqueous humor following intravenous administration. AB - 16 patients received an intravenous infusion of 200 mg ciprofloxacin 1, 2, 3 and 6 h, respectively, before cataract extraction. This dosage produced mean aqueous humor levels of 0.165 +/- 0.09 and 0.126 +/- 0.028 microgram/ml after 1 and 3 h, respectively. The mean serum levels were 1.760 +/- 0.873 and 0.854 +/- 0.283 microgram/ml after 1 and 3 h, respectively. These levels are above the minimum inhibitory concentration of ciprofloxacin for sensitive organisms. PMID- 3665632 TI - Effect of antibiotic protein binding on the killing rate of Staphylococcus aureus and on the paradoxical phenomenon. AB - The killing kinetics of Staphylococcus aureus, exposed to various concentrations of dicloxacillin in broth and in broth with 40 g/l human albumin was studied. When the free concentrations of dicloxacillin were identical in the two media, no difference in killing capacity could be demonstrated at concentrations above MIC, indicating that only the free antibiotic fraction is antibacterially active. However, at concentrations identical to the MIC, a better bactericidal effect in the medium containing albumin was found. In experiments where equal total concentrations were compared in the two media, an increasing bactericidal effect in the medium containing albumin could be demonstrated at concentrations between 10-100 X MIC. The most probable explanation for this was a prominent paradoxical effect with increasing antibiotic concentrations on the killing rate of S. aureus in broth. This effect was neutralized in the presence of albumin due to the lower free antibiotic concentration in this medium. PMID- 3665633 TI - New antiamebic acridines. II. Synthesis and DNA binding of a series of 9 acridanones and 9-iminoacridines. AB - A series of novel 9-acridanones and 9-iminoacridines has been prepared and investigated by a number of spectroscopic techniques in order to determine the nature and extent of the binding of these compounds to DNA. Results are discussed with reference to antiamebic activity in vitro. PMID- 3665634 TI - Bactericidal and antineoplastic effect of combination of norfloxacin and adriamycin. AB - Norfloxacin and adriamycin were tested alone and in combination for bactericidal activity against different strains of gram-negative bacteria. The antitumoral effect of a combination of norfloxacin and adriamycin was determined in mice bearing Ehrlich ascites carcinoma and in mice bearing P 388 leukemia. No interference with the antibacterial activity of norfloxacin or with the antitumoral activity of adriamycin was observed. PMID- 3665635 TI - Gentamicin- and methicillin-resistant Staphylococcus aureus: in vitro susceptibility to antimicrobial drugs. AB - Thirteen nosocomially significant, gentamicin- and methicillin-resistant (GRMR) Staphylococcus aureus isolates, all of phage group III/M (lysotype 42E/47/53/54/75/77/83A/84/85/94/96), were uniformly resistant against augmentin, erythromycin, fosfomycin, gentamicin, methicillin, oxacillin, penicillin G, tetracycline, and tobramycin, but differed in susceptibility to cefamandole, ciprofloxacin, clindamycin, imipenem, josamycin, the synthetic chinolone Ro 23 6240, and ofloxacin. All isolates were susceptible to chloramphenicol, coumermycin, fusidic acid, novobiocin, rifampin, teicoplanin, trimethoprim sulfamethoxazole (cotrimoxazole), and vancomycin. One isolate was of intermediate susceptibility to netilmicin. On a weight-for-weight basis, the 7 most active drugs were rifampin, coumermycin, cotrimoxazole, novobiocin, teicoplanin, fusidic acid, and vancomycin (in decreasing order) in terms of minimal inhibitory concentrations. With regard to minimal bactericidal concentrations, coumermycin, rifampin, vancomycin, teicoplanin, cotrimoxazole, ofloxacin, and ciprofloxacin (in decreasing order) were the 7 most potent antimicrobial drugs. Freshly defibrinated human blood [65% (v/v)] combined with chloramphenicol and rifampin, respectively, resulted in a weak additive effect (time kill curves). Indifferent effects were observed following combination of blood with ciprofloxacin, cotrimoxazole, coumermycin, fusidic acid, imipenem, netilmicin, novobiocin, ofloxacin, compound Ro 23-6240, teicoplanin, and vancomycin. Rifampin combined with novobiocin, teicoplanin, and vancomycin, respectively, in the presence of 65% (v/v) human blood, resulted in an additive effect. Combinations of rifampin with 9 other antimicrobial drugs in blood yielded essentially indifferent effects. PMID- 3665636 TI - Ceftriaxone given repeatedly cures manifest syphilis in the rabbit. AB - Repeated intramuscular injection of ceftriaxone to rabbits with manifest syphilitic orchitis leads to clinical cure as does penicillin, given the serum levels reached are similar to the ones obtained clinically in man. Totally different to untreated controls the Treponema pallidum hemagglutination (TPHA) titers remain relatively low and later even tend to decrease further. Thus, it seems justified to start clinical trials on the definite role of ceftriaxone in the treatment of clinical syphilis. PMID- 3665638 TI - Schools and development. PMID- 3665637 TI - Suicide among American Indian youth: a look at the issues. PMID- 3665639 TI - The emergent academic self-image of first graders: its response to social structure. AB - One aim of this investigation was to determine the kinds of information a large and racially diverse sample of urban first-grade children take into account in forging their image of an academic self, especially the extent to which evaluations of significant others versus self-evaluations are influential. Another aim was to determine whether the nascent academic self-image affects the school achievement of these first-grade children. There was no difference in children's academic self-image according to race or parent background, but children of the 2 sexes defined their images differently. Girls' images strongly reflected stereotypic sex-role notions; boys' images reflected instrumental role concerns. Math performance was relevant only for boys. Boys depended more on self evaluations than girls did, while girls depended more on parents' evaluations. Black girls were the only group for whom the academic self-image was a significant influence on achievement gains over first grade. The discussion points up the correspondence between these findings and what has been found for adolescents. PMID- 3665640 TI - Cognitive consequences of contrasting pedagogies: the effects of Quranic preschooling in Morocco. AB - A study was conducted in Morocco to assess the cognitive consequences of Quranic preschooling. 350 6-7-year-old children were selected in a way which allowed contrasts in terms of preschool experience (none vs. Quranic vs. modern), environment (urban vs. rural), maternal language (Arabic vs. Berber), and gender. 6 different memory tests were employed, as well as other cognitive, reading, and math tests. Results indicated specific and positive effects of Quranic schooling on serial memory but not on other memory or cognitive tasks. These findings replicate earlier reports by Scribner and Cole that Quranic schooling affects specific (and not general) memory skills. The reading measures indicated superior performance among those children with urban background, Arabic maternal language, and, to a lesser extent, Quranic schooling. It was concluded that the corpus of research from this and similar studies supports a "practice theory" of culture and cognition. PMID- 3665641 TI - The impact of cumulative change in early adolescence. AB - This article examines the impact of experiencing several major life transitions simultaneously in early adolescence. For many children, entry into the new life period of adolescence is marked by the transition from a relatively intimate elementary school setting into a more complex, impersonal junior high school environment. This major shift in organizational context is often accompanied by dramatic changes in biology and social definition. We hypothesized that transitions will be easier for children to cope with if the various adolescent changes come into focus at different stages rather than simultaneously. In a longitudinal study conducted in a large Midwestern city, schoolchildren were followed from sixth into seventh grade in 2 different types of school systems. The effect of multiple life changes (school transition, pubertal development, early dating behavior, residential mobility, family disruption) on students' self esteem, academic grade-point average, and participation in extracurricular activities was analyzed. The results identify children who are forced to cope with several life transitions concurrently as a group at risk. Theoretical implications are discussed, with development of the notion that individuals need an "arena of comfort" in at least some spheres of their lives. PMID- 3665642 TI - The transition to junior high school: a longitudinal study of self-esteem, psychological symptomatology, school life, and social support. AB - This research examined the psychological well-being of 159 white and black students during the transition to junior high school. Adjustment patterns were found to be complex and highly differentiated. Self-esteem was unchanged from the end of sixth through the middle of seventh grades, rising by the end of seventh grade. Girls reported an increase in depressive and other symptoms over time relative to boys. Perceived quality of school life plunged. Peer social support increased only for blacks of high academic competence. Although there were no race differences on overall self-esteem, multivariate analyses of symptom data revealed that blacks reported greater distrust of the environment than they reported negative internal states, whereas whites reported the opposite pattern. The discussion emphasizes the developmental and ecological context of the transition. PMID- 3665643 TI - The relation of parenting style to adolescent school performance. AB - This article develops and tests a reformation of Baumrind's typology of authoritarian, permissive, and authoritative parenting styles in the context of adolescent school performance. Using a large and diverse sample of San Francisco Bay Area high school students (N = 7,836), we found that both authoritarian and permissive parenting styles were negatively associated with grades, and authoritative parenting was positively associated with grades. Parenting styles generally showed the expected relation to grades across gender, age, parental education, ethnic, and family structure categories. Authoritarian parenting tended to have a stronger association with grades than did the other 2 parenting styles, except among Hispanic males. The full typology best predicted grades among white students. Pure authoritative families (high on authoritative but not high on the other 2 indices) had the highest mean grades, while inconsistent families that combine authoritarian parenting with other parenting styles had the lowest grades. PMID- 3665644 TI - Classroom factors and student characteristics predicting students' use of achievement standards during ability self-assessment. AB - The literature suggests that upper-elementary-school students have a strong inclination to conclude that they are competent in mathematics. How do students of widely varying abilities reach this conclusion? Do task structures, grading practices, and grouping patterns influence the achievement standards that students use in reaching a positive evaluation of their ability? Findings from analyses of 1,570 upper-elementary students who believe that they are good at math include the following. (1) The combination of differentiated task structures and infrequent grades is associated with students' low reliance on adults' assessments and across-domain comparisons as bases for their positive self concepts, but the combination of differentiated task structures and frequent grades is associated with heavy reliance on these 2 standards. (2) Students' use of social comparison and task mastery is stratified according to students' talent levels when grades are frequent, but when grades are infrequent even untalented students decide on the basis of (selective?) social comparisons and (exaggerated?) estimates of task mastery that they are good at math. PMID- 3665645 TI - Mathematics classrooms in Japan, Taiwan, and the United States. AB - Observations were conducted in Chinese, Japanese, and American classrooms during mathematics classes. Activities in 20 representative classrooms were observed in each of 2 grades (1 and 5) and in each country. Some observations focused on individual children and others on the teachers. Large cross-cultural differences were found in many variables related to classroom structure and management. These differences paralleled differences in achievement in mathematics among the 3 countries. A number of these variables also were significantly related to average level of mathematics achievement within the American classrooms. PMID- 3665646 TI - Self-system concomitants of discrepancies between children's and teacher's evaluations of academic competence. AB - The purpose of this study was to elucidate the psychological concomitants of discrepancies between fourth- to sixth-grade children's perceptions of academic competence and 2 measures of their "actual" competence in this domain: teacher ratings and achievement test scores. Over-, under-, and congruent child raters were identified on the basis of the 2 external standards and then compared on child and teacher ratings of self-esteem, self-regulatory style, and coping with perceived failure. 6 teachers and 121 lower- to upper-middle-class suburban students participated. As predicted, no differences were obtained between congruent and distorted (combined over- and under-) raters on these self-system variables. Consistent with previous research, overrating children showed higher self-esteem on self- and teacher ratings than underraters. After controlling for level of perceived competence, overraters scored higher on anxiety, and, when overrating occurred against the teacher standard, these children were rated by teachers as having lower self-esteem, poorer coping strategies, and less internalized self-regulatory styles. Comparing the 2 standards, self-reported difficulties were associated with underrating against the teacher's standard but not the achievement standard. Teacher reported difficulties were associated with the opposite pattern of underrating against the 2 standards. Motivational factors contributing to patterns of discrepancies are discussed, as are the educational implications of mismatches between teacher and student perceptions of objective and intrapsychic aspects of school experience. PMID- 3665647 TI - Socialization of perceived academic competence among highly competent children. AB - A sample of 81 academically competent third graders and their parents were studied (1) to determine whether the illusion of incompetence documented for fifth graders appears in younger children, (2) to examine whether parents' competence-related perceptions significantly distinguish children with varying levels of perceived academic competence, and (3) to develop a predictive model of the association between parent and child competence beliefs. More than 20% of the children--equal proportions of girls and boys--had self-perceptions that seriously underestimated their actual high abilities, and displayed a corresponding pattern of disparaging self- and other-achievement attitudes. Mothers' and fathers' perceptions of their children's abilities varied significantly with the perceived competence status of the children, as did the children's perceptions of their parents' appraisals. Using path analysis, preliminary support was found for a model in which children's perceptions of competence are influenced more by their parents' appraisals than by objective evidence of their achievements. The results are discussed in the context of research on the socialization of math attitudes and new work on parental belief systems. PMID- 3665648 TI - The social adaptation of mainstreamed mildly retarded children. AB - The purpose of the present study was to assess the social adaptation of mainstreamed mildly retarded children, comparing them to a matched sample of regular education students. Results indicated that mildly retarded children were quite rejected by their peers, and, compared to nonretarded classmates, they reported significantly more dissatisfaction and anxiety about their peer relations. With respect to behavioral style, there were no group differences in peer- or teacher-reported aggressiveness or disruptiveness. However, retarded children were perceived as more shy and avoidant, as less cooperative, and as less likely to exhibit leadership skills. Further analysis of the behavioral assessment data, via cluster analysis, revealed 2 subtypes of rejected retarded children: an internalizing group perceived as displaying high levels of shy/avoidant behavior and an externalizing group perceived as high in aggressive and/or disruptive behavior. In addition, the internalizing group reported higher social anxiety than did the externalizing group. Implications for school-based intervention research with mildly retarded children are discussed. PMID- 3665649 TI - Affective processes and academic achievement. AB - Achievement, empathy, depressive affectivity, aggression, and self-concept measures were obtained for 8-9- and 10-11-year-olds. Depressive affectivity and aggression were assessed by teacher ratings and self-reports. Empathy was assessed by audiovisual tapes. Measures were readministered to the younger group 2 years later. Achievement scores were highly stable. Significant test-retest correlations were also found for the affective measures. Self-reports were negligibly related to achievement. For girls, strong relations were found between empathy at age 8-9 and achievement in reading and spelling at age 10-11. Teacher ratings of depressive affectivity were inversely related to achievement for boys and girls at age 8-9, but significant at age 10-11 for girls only. Initial ratings of depressive affectivity were predictive of girls' subsequent achievement. A similar pattern was found for teacher ratings of aggression. PMID- 3665650 TI - The family-school relation and the child's school performance. AB - Using a nationally representative sample of American households, we examine the relation between parental involvement in schooling and the child's school performance. With a sample of 179 children, parents, and teachers, we investigate 3 hypotheses: (1) the higher the educational status of the mother the greater the degree of parental involvement in school activities; (2) the younger the age of the child the greater the degree of parental involvement; and (3) children of parents who are more involved in school activities do better in school than children with parents who are less involved. In an analysis of cross-sectional data, we discover support for the 3 hypotheses. The educational status of the mother is related to the degree of parental involvement in schooling, so that parents with more education are more involved. Parental involvement is related to the child's school performance. Also, parents are more involved in school activities if the child is younger. The mother's educational level and the age of the child are stronger predictors of parental involvement in schooling for boys than for girls. We do not, however, find a direct effect of maternal educational status on school performance independent of parental involvement in school activities. We discuss these findings in light of the relation between families and schools. PMID- 3665651 TI - Opportunities and constraints: black-white differences in the formation of interracial friendships. AB - In this article, we examine the effects of classroom characteristics on the interracial friendliness of students in desegregated classrooms. We argue that social psychological processes that affect cross-race sociability are set in motion by the classroom climate, the organization of instruction, and the class racial composition. The effects of these variables on the likelihood of cross race friendships are observed in longitudinal data from 455 students in 16 fourth through seventh-grade desegregated classrooms. The results show that classroom characteristics associated with "status-leveling" effects operate differently for black and white students. Ability grouping influences the interracial sociability of white students more than that of blacks, while the academic status of peers affects the cross-race friendships of blacks more than of whites. Race differences in the effects of classroom climate on interracial friendships are also observed. PMID- 3665652 TI - [Changes in the mineral portion of the bones in the area of pseudarthrosis]. PMID- 3665653 TI - [Cortico-diaphyseal indicators in the evaluation of the mechanical strength of the second metacarpal bone]. PMID- 3665654 TI - [Open dislocations and fractures of the distal crural epiphysis]. PMID- 3665655 TI - [Evaluation of the results of arthrodesis of the wrist joint]. PMID- 3665656 TI - [Isolated congenital defect of the pectoralis major muscle]. PMID- 3665657 TI - [Use of peripherally pedunculated Chinese forearm flaps in hand surgery]. PMID- 3665658 TI - [Ulnar nerve compression by post-traumatic pseudoaneurysm]. PMID- 3665659 TI - [Sciatic nerve injury in posterior fracture-dislocations of the hip joint]. PMID- 3665660 TI - [Discoid meniscus of the knee joint]. PMID- 3665661 TI - [Para-articular bone cyst]. PMID- 3665662 TI - [Compression equipment of our construction for external stabilization of fractures of the long bones]. PMID- 3665663 TI - [Compression screw and a set of tools for the treatment of femoral neck fractures]. PMID- 3665664 TI - [Superficial injuries of the articular cartilage]. PMID- 3665665 TI - [Deep injuries of the articular cartilage]. PMID- 3665666 TI - [Analysis of uterine contraction patterns in 200 cases of spontaneous on induced labor]. PMID- 3665667 TI - [Atypical metaplasia of the cervical gland in colposcopy]. PMID- 3665668 TI - [Effect of prophylactic antibiotics in total abdominal hysterectomy]. PMID- 3665669 TI - [Analysis of 129 cases of ovarian tumors in post-menopausal women]. PMID- 3665670 TI - [Circulating immune complex of ovarian epithelial carcinoma and its clinical use]. PMID- 3665671 TI - Visualization of DNA loops in nucleoids from HeLa cells: assays for DNA damage and repair. AB - An assay for visualization of DNA loops undergoing supercoiling changes has been developed. The assay utilizes the fluorescent dye, propidium iodide (PI), which intercalates into the DNA and under the proper conditions causes the supercoiling status of the DNA to change. Thus, the DNA can be seen as a fluorescent halo that changes diameter with PI concentration. At low PI concentrations (0-7.5 micrograms/ml) the supercoils are relaxed with increasing PI, while at higher PI concentrations (7.50-50 micrograms/ml) supercoils in the opposite winding sense are rewound with increasing PI. When HeLa cells were irradiated with 1-20 Gy of 137Cs gamma-rays, the ability to rewind the DNA supercoils was inhibited in a dose-dependent manner, presumably because of the presence of radiation-induced DNA strand breakage, which removed the topological constraints on the DNA loops. These lesions were repaired rapidly during post-irradiation incubation. The ability of the DNA loops to be rewound was restored within 8 min after 10 Gy of gamma-irradiation, such that no difference from control cells could be detected. The half-time for repair of the radiation-induced lesions that inhibit DNA rewinding was similar to that for repair of DNA single strand breaks. The assay has certain advantages over current methods for assaying DNA damage in that it involves measurement of single cells and it does not require the DNA to be labeled with radioactive precursors. PMID- 3665672 TI - Flow cytometric analysis of DNA in cells obtained from deparaffinized formalin fixed lymphoid tissues. AB - Flow cytometric analysis of DNA content was performed on nuclear suspensions prepared from fresh and from paraffin-embedded, formalin-fixed lymphoid tissues. We confirmed previous reports that it is possible to obtain nuclear suspensions from deparaffinized, formalin-fixed tissues, suitable for DNA analysis by flow cytometry. We observed a tendency for a larger coefficient of variation (CV) of the DNA measurements in the fixed tissues than in the unfixed material causing abnormalities in 2 of 19 lymphomas to become undetectable. Furthermore, samples from different paraffin blocks of a single tumor with an extra G1 (hyperdiploid) peak showed marked differences in the CV of the hyperdiploid peak while the CV of the diploid peak was similar in all samples. In both benign and malignant lymphoid tissues, the S-phase fraction was higher in paraffin-embedded tissues than in unfixed cells. This difference could be attributed to 4', 6'-diamidino-2 phenylindole dihydrochloride (DAPI), a DNA-binding dye commonly used in this technique. Nevertheless, intermediate and high grade lymphomas from paraffin embedded tissues generally showed a greater S-fraction than low grade lymphomas, a similar observation as with unfixed tissues. Therefore, DNA content analysis of nuclei extracted from paraffin sections may be inadequate to resolve slight aneuploidy, but the measurement of S-fraction size may remain diagnostically or prognostically valuable. Large retrospective studies will be necessary to determine the clinical impact of this technique in the analysis of lymphomas. PMID- 3665673 TI - Solid tumor preparation for clinical application of flow cytometry. AB - Intense interest in advanced squamous cell cancers of the head and neck (SCC of H&N) has resulted from the recent progress made in tumor responses with chemotherapy and radiotherapy. Unfortunately, the response patterns and clinical outcome of such patients are not adequately predicted on an individual patient basis using clinical parameters or conventional morphology. The study of flow cytometrically determined cellular parameters in such tumors is therefore of interest, but is hindered by inadequate tumor preparative technology. The previous article (10) in this journal describes the use of a murine SCC tumor, LC12, which was employed for comparative testing and determination of optimum techniques of preparation for this tumor. This report describes the application of these techniques to 144 specimens of human SCC of H&N. The mean total yield for these specimens is 7.4 X 10(7) cells/g of tissue. The mean viable enzymatic yield (3.3 X 10(7) cells/g) was higher than the mean viable mechanical yield (2.0 X 10(7) cells/g) except when lymph nodes were the source of the specimen (5.4 X 10(7) cells/g). The mean dye exclusion viability from enzymatically dissociated specimens were above 90%. Significant aneuploidal subpopulation losses were evident in mechanically dissociated and enucleated specimens. 65% of the enzymatically dissociated specimens were successfully cultured with a mean cloning efficiency of 2.1 X 10(-3). Preparative techniques derived from comparative testing with a murine standard tumor have been successfully applied to 144 specimens of SCC of H&N with resultant high yields and excellent viability. Technical problems detected during the preliminary testing with LC12 were confirmed in the human tumors. PMID- 3665674 TI - Flow cytometric analysis and sorting of plant chromosomes from Petunia hybrida protoplasts. AB - A method to obtain a high metaphase index and thereafter a plant chromosome suspension is described for Petunia hybrida (2n = 14). Mesophyll protoplast cultures have been used, giving easily disrupted cell walls and a high percentage of dividing cells after 42 h. On 2.5 mM colchicine-treated cells, metaphase indexes reaching 10% were routinely obtained. The lysis medium in which the protoplast-derived cells were disrupted was a simplified culture medium. After chromosome release, samples were stained with Hoechst 33342 dye and analysed by flow cytofluorometry. The histogram of fluorescence intensities included three peaks of metaphase chromosomes and a duplication of this flow karyotype provoked by "monochromatid chromosome." This interpretation was established after flow sorting; micronuclei could also be observed and sorted. Of the 7 chromosomes, only the largest formed a distinct peak while the others were incompletely resolved, due to the similar DNA content of various chromosomes. Model distributions of Petunia hybrida chromosomes have been computed according to the relative chromosome length. The theoretical histograms indicated that low variability is indispensable for resolving distinctive chromosome peaks. The experimental flow karyotype was consistent with one of the models having CV of 2.5%. PMID- 3665675 TI - Surface glycoproteins of differentiating neuroblastoma cells analyzed by lectin binding and flow cytometry. AB - Cell surface glycoproteins of mitotic neuroblastoma cells and cells differentiated by prostaglandin cyclic adenosine monophosphate treatment were quantified by flow cytometric analysis and specific fluorescent lectins. No differences in fluorescent lectin binding were seen between suspensions of mitotically active and differentiated N2AB-1 cells following exposure to either fluorescein (FL)-labeled soy bean agglutinin (FL-SBA) specific for N acetyl galactosamine or FL-concanavalin A (FL-CON A) which binds to mannose residues. These lectins, however, were shown to bind specifically to these cells as revealed by competitive blocking studies with hapten sugars. When FL Ulex europaeus (FL-UEA) specific for fucose was reacted with control or differentiated cells, no binding was seen even with an increased dose of lectin before or after enzyme treatment. However, differentiated N2AB-1 cells, reacted with FL-wheat germ agglutinin (FL-WGA) specific for N acetyl glucosamine, bound more FL-WGA than that seen for control cultures. Furthermore, specific sites for FL-WGA were shown to be saturable and were lost upon pretreatment of cells with neuraminidase. Neuraminidase pretreatment revealed masked sites for FL-CON A and FL-SBA since binding was increased at least twofold for these lectins on mitotic and differentiated cells. These data indicate that single cell measurements of surface glycoproteins can be made on living neural cells and that differentiation induces an increase in cell surface N-acetyl glucosamine residues. PMID- 3665676 TI - Effect of barium meals on gastric electromechanical activity in man. A fluoroscopic-electrogastrographic study. AB - The relationship between the cutaneously recorded electrogastrogram (EGG) and gastric contractions in man is unclear. We investigated: (1) the relationship between the electrogastrogram (EGG) signals and gastric contractions elicited by barium meals and (2) the effects of barium meals on frequency and amplitude of EGG signals. As documented by fluoroscopy in four healthy subjects, barium meals stimulated three per minute gastric peristalsis which corresponded with simultaneously recorded three cycle per minute (cpm) EGG waves. Eighteen other healthy volunteers ingested 45% (w/v) or 60% barium suspensions. As determined by Fourier analysis, the dominant EGG frequency before barium was 3 cpm in 16 subjects; two subjects had no distinct frequency peaks. After barium ingestion, the mean amplitude or power at 3 cpm and 1 cpm increased, but the increase was significant only after 45% barium. IN CONCLUSION: (1) individual EGG waves after barium reflect gastric peristaltic sequences, which are reflected in increases in amplitude or power of 3 cpm EGG activity; (2) density or viscosity of the barium meal affects the gastric myoelectric response; and (3) mechanical correlates of 1 cpm EEG activity are unknown. PMID- 3665677 TI - Effects of partial ileocolectomy and Crohn's disease on biliary lipid secretion. AB - The effects of interruption of the enterohepatic circulation of bile acids on biliary lipid secretion have only been studied experimentally, and quantitative data in patients are lacking. Therefore, biliary lipid secretion during steady state meal perfusion of the duodenum was studied in six patients with partial ileocolectomy, five patients with Crohn's disease, and five normal subjects. Bile acid outputs in the resection patients were significantly lower than in normal controls, (6.87 +/- 2.10 mmol/6 hr and 13.5 +/- 2.16, respectively; P less than 0.001) and were also decreased in two of the five Crohn's disease patients. Bile acid outputs in patients with resection progressively decreased in the course of the perfusion study; phospholipid and cholesterol secretion did not decrease to the same extent, and cholesterol saturation gradually increased. Bile of these patients, therefore, was frequently supersaturated due to uncoupling of bile acid secretion and outputs of the other biliary lipids. Bile acid outputs, although decreased, did not reach very low values, which shows that the enterohepatic circulation was not totally interrupted. Chenodeoxycholic acid was the main bile acid component of bile in patients with ileocolonic resection. Deoxycholic acid was absent from bile of four resected patients and two Crohn's patients. Two patients with active Crohn's disease had low bile acid outputs despite only moderate fecal bile acid losses. Therefore, decreased outputs may be caused by decreased bile acid pool not compensated for by increased bile acid synthesis in severely ill patients. PMID- 3665678 TI - Prospective assessment of risk of bacteremia with colonoscopy and polypectomy. AB - A prospective assessment was made of the frequency of positive blood cultures in patients undergoing colonoscopy with or without polypectomy. A total of 270 patients underwent 280 colonoscopies, of these, there were 105 patients that had 111 polypectomies. Blood cultures were taken prior to and within 15 min following each procedure. Six of 280 (2.1%) preprocedural blood cultures were positive. Seven of 169 (4%) blood cultures were positive within 15 min of insertion of the colonoscope in the colonoscopy only group. Eight of 223 (3.6%) blood cultures were positive within 10 min of the polypectomy. There was no clinical evidence of sepsis during the 24 hr following these procedures. In order to determine appropriate postprocedural sampling intervals, we induced a Staphylococcus epidermidis bacteremia with a mean of 1.16 X 10(6) colony forming units/ml on 10 occasions in seven dogs. Within 30 min of inoculation, we were able to detect only one colony forming unit/ml. The rate of positive blood cultures during colonoscopy alone and following polypectomy during colonoscopy is comparable to other gastrointestinal endoscopy procedures. The most optimal time to collect blood cultures in order to detect transient bacteremia is as soon after the procedure as is feasibly possible. PMID- 3665679 TI - Pharyngeal pump and esophageal transit. AB - In deglutition the pharynx appears to act as a pump to "inject" boluses into the esophagus. A new method for measuring the velocity profile of the leading edge of a radionuclide bolus has been developed and applied to boluses of different viscosity--water and treacle--in nine normal volunteers. The results show that the more viscous bolus (treacle) acquires a slower initial "injection" velocity (152 mm/sec vs 236 mm/sec) that only propels it over the proximal half of the esophagus. Peristaltic action must drive the bolus over the distal half. With water boluses, however, the higher initial velocity is sufficient to propel a part of the bolus at least to the gastroesophageal junction leaving minimal "work" to be performed by esophageal peristalsis. This confirms the important role of the pharyngeal pump in deglutition. The pump may be the major mechanism for ingestion of nonviscous liquids (water), peristalsis merely being required to "sweep up" what remains in the esophagus. PMID- 3665680 TI - Persistence of Campylobacter pyloridis despite healing of duodenal ulcer and improvement of accompanying duodenitis and gastritis. AB - Campylobacter pyloridis has been associated with antral gastritis and duodenal ulcer. To study the pathogenetic role of these organisms in duodenal ulcer, endoscopic biopsies, two from the first part of duodenum, four from antrum, and four from body and fundus, were taken before and after four weeks of cimetidine treatment (1.2 g/day) from 67 patients with active duodenal ulcer. The biopsies were examined for the presence and severity of any inflammation by two independent pathologists in the absence of any clinical information and for the occurrence and density of Campylobacter pyloridis by culture and Warthin-Starry stain. Before treatment, inflammation was present in 71.1, 100, and 25.8%, while the organisms were present in 34.3, 91.0, and 79.1% of the duodenal, antral, and fundal biopsies, respectively. With complete healing of duodenal ulcer, inflammation was present in 48.9, 98.2, and 30.2%, while the organisms were present in 25, 76.7, and 63.3% of the respective mucosae. With ulcer healing, duodenitis became significantly milder (P less than 0.05). With improvement of gastritis and duodenitis, there was no significant change in the occurrence and density of Campylobacter pyloridis. These findings indicate that healing of duodenal ulcer is not influenced by the presence of Campylobacter pyloridis, which is frequently found in the gastroduodenal mucosa of patients with duodenal ulcer, but does not appear to be associated with mucosal inflammation except in the antrum. PMID- 3665681 TI - Cimetidine and ranitidine protect against cold restraint-induced ulceration in rat by suppressing gastric acid secretion. AB - The effect of the H2-receptor antagonists cimetidine and ranitidine on pentagastrin-stimulated gastric acid secretion in anesthetized rats, and gastric mucosal lesion formation and gastric motility in unanesthetized cold-restrained rats was studied. Both cimetidine and ranitidine suppressed pentagastrin stimulated gastric secretion in a dose-dependent fashion. Cold restraint-induced lesion formation was not prevented with doses of both agents that inhibited acid secretion by 75%. Doses which suppressed pentagastrin-stimulated acid secretion more than 90% significantly prevented the development of gastric mucosal lesions produced by cold restraint. Doses of both H2 blockers which demonstrated significant suppression of lesion formation had no effect on cold restraint stimulated gastric contractility. We conclude that cimetidine and ranitidine suppress cold restraint-induced lesion formation by suppressing acid secretion and not by suppressing gastric contractility. PMID- 3665682 TI - Augmentation of postresection mucosal hyperplasia by plerocercoid growth factor (PGF). Analog of human growth hormone. AB - Postresection villus hyperplasia is a major compensatory mechanism in the short bowel patient. Substances capable of augmenting postresection mucosal hyperplasia could have therapeutic implications. Human growth hormone (hGH) and human growth hormone releasing factor (hGHRF) stimulate growth of the gastrointestinal tract; however, the diabetogenic actions of growth hormone limit its usefulness in clinical practice. Plerocercoid larvae of the tapeworm Spirometra mansonoides produce an analog of hGH void of diabetogenic side effects. We assessed effects of plerocercoid growth factor (PGF) on mucosal adaptation following 70% proximal jejunoileal resection in young rats. Mucosal weight, DNA, protein, and total sucrase activity per centimeter of bowel were increased in resected PGF-treated animals compared to resected controls. We conclude PGF augments intrinsic postresection mucosal hyperplasia following extensive intestinal resection. PMID- 3665683 TI - Modulation of collagen synthesis by fat-storing cells, isolated from CCl4- or vitamin A-treated rats. AB - In an attempt to elucidate the role of fat-storing cells (FSCs) in liver fibrosis, we investigated the collagen synthesis by FSCs freshly isolated from rats treated with CCl4, with vitamin A, and from untreated rats. FSCs from CCl4 treated rats contained a small number of lipid droplets and an abundant rough endoplasmic reticulum (RER), while those from vitamin A-treated rats showed numerous large lipid droplets and scanty RER. The population doubling times of FSCs isolated from normal, CCl4-treated, and vitamin A-treated rats were 38 +/- 4.3, 24 +/- 2.5, and 48 +/- 6.3 hr, respectively. The rate of collagen synthesis by FSCs from CCl4-treated rats was four- to sixfold enhanced, while collagen synthesis by FSCs from vitamin A-treated rats was suppressed. The ratio of collagen type I to type III produced by FSCs from CCl4 rats was enhanced as compared with control rats (94.7:5.3 vs 87.6:12.4). Therefore, FSCs can be considered to play an important role in the pathogenesis of liver fibrosis. PMID- 3665684 TI - Villous adenoma of the duct of Wirsung. AB - A patient presenting with recurrent pancreatitis was found to have a benign polypoid villous adenoma of the duct of Wirsung. The tumor was excised locally via transduodenal access to the duct. The patient has now remained free of pancreatitis for 24 months. Obstruction of the pancreatic duct by this rare tumor appears to have been the cause of pancreatitis. Villous adenomas of the pancreatic duct epithelium may be premalignant. PMID- 3665685 TI - Pseudolymphoma of the jejunum. PMID- 3665686 TI - Gastric xanthoma--an autopsy study. PMID- 3665687 TI - Endometrial cytology: six years of experience. AB - This article deals with a 6-yr mass screening program for the early detection of endometrial cancer, which took place 1978-1983. The diagnostic accuracy of endometrial cytology and the possibility of integrating this technique with the hysteroscopy and endometrial biopsy were studied. The authors analyzed 2,504 outpatients, all over the age of 45. The results of endometrial cytology were compared with those found using hysteroscopy and endometrial biopsy. Endometrial cytology showed high sensitivity in diagnosing endometrial cancer (97.7%) and high specificity in diagnosing true negatives. However, this technique was not adequate in identifying benign endometrial pathology, e.g., endometrial hyperplasia, polyps, or submucous fibromas. Epidemiological and clinical data in our series were fundamental in establishing mass screening for the early detection of endometrial cancer using integrated techniques. These data should be taken into consideration for creating new projects. The significantly high prevalence of endometrial neoplasia even in asymptomatic women over 45 years of age (4 per 1000) and the possibility of improving the accuracy of endometrial diagnosis using hysteroscopy and endometrial biopsy were the cornerstones of this project. PMID- 3665688 TI - The cytological features and DNA content of cervical adenocarcinoma. AB - The relationship among cytological features, DNA content, and degree of histological differentiation of cervical adenocarcinoma was investigated in an attempt to discover a more accurate means of screening for this cancer. In highly differentiated adenocarcinoma (so-called adenoma malignum), the nuclei were only somewhat more irregular in size and shape than those of normal columnar epithelial cells. The cells were arranged in slightly multilayered clusters. The cells of well-differentiated adenocarcinoma were usually columnar in shape, and they exfoliated side by side in clusters. In moderately differentiated adenocarcinoma, solitary cells with markedly atypical nuclei were combined with multilayered cell clusters. The cells from poorly differentiated adenocarcinoma were roundish, occurred as solitary cells or irregularly overlapping cell clusters, and showed markedly atypical nuclei. As the degree of histological differentiation decreased, as determined by measurement of the DNA content of the cells, the DNA distribution covered a wider range in terms of ploidy, and the number of cells exceeding tetraploid DNA content increased. PMID- 3665690 TI - Carcinoid metastatic to breast diagnosed by fine-needle aspiration biopsy. AB - We report a patient in whom fine-needle aspiration biopsy of a breast mass, clinically suspected to be a mammary adenocarcinoma, established the diagnosis of a carcinoid metastatic to breast. The aspirate smears resembled a primary breast carcinoma; however, subtle cytomorphologic differences were present. Ultrastructural and immunohistochemical studies of the aspirate material confirmed the diagnosis of metastatic carcinoid. PMID- 3665689 TI - The diagnostic cytology of nonspecific vaginitis. AB - Diagnostic cytology has not kept pace with the general growing interest in nonspecific vaginitis (NSV). This study on 114 patients compares Papanicolaou vaginal smears with bacteriologic cultures, whiff test, gram-stained vaginal smears, and vaginal pH in the evaluation of nonspecific vaginitis. Cytology is a valid practical test for diagnosis for nonspecific vaginitis; however, it must be emphasized that the coccoid morphotype is the same as the Gardnerella morphotype. Perhaps the Gardnerella morphotype is the most typical of all the inflammatory typologies found in vaginal smears, and it was indeed one of the first to be described in the history of diagnostic cytology--albeit with a slight misnomer. The question is of considerable importance since NSV is the most frequent and persistent of all collapses of the vaginal ecosystem. Cases of NSV must be screened to prevent more serious diseases of the female genital tract. PMID- 3665691 TI - Fine-needle aspiration cytology of neoplastic cysts of the pancreas. AB - Herein is reported the cytologic features of four cases of cystic neoplasms of the pancreas as seen in fine-needle aspirates. Cytologically, the cases fall into two distinct groups: mucinous cystic neoplasm and serous cystadenoma. The aspirates from the mucinous cystic neoplasms characteristically showed columnar mucus-secreting epithelial cells, some of which were arranged in a papilloglandular pattern, with abundant mucous material in the background. The aspirates from the serous cystadenoma yielded small sheets of cuboidal cells with small nuclei and clear cytoplasm, without a background of mucous material. This cytologic division corresponds closely to the histologic classification proposed by Compagno and Oertel and hence is of prognostic and therapeutic value. The diagnostic challenges confronted by the cytopathologist are (1) to differentiate neoplastic cysts from the inflammatory pseudocysts; (2) to differentiate neoplastic epithelium from the normal epithelium of the bowel and pancreatic ducts; and (3) to differentiate mucinous cystic neoplasms from serous cystadenomas. PMID- 3665692 TI - Fine-needle aspiration cytology of malignant lymphoma of the thyroid. AB - Our experience with fine-needle aspiration cytology in five cases of malignant lymphoma of the thyroid is reported. Only one case was correctly diagnosed as malignant lymphoma from the original cytologic reports. Three cases were misdiagnosed as anaplastic carcinoma of small-cell type and two of these three cases were subsequently revised as malignant lymphoma after a second aspiration. The final case was misdiagnosed as chronic thyroiditis at both the first and second aspirations; following a third aspiration, 8 mo later, it was correctly diagnosed as malignant lymphoma. Cytological findings of malignant lymphoma are as follows: many malignant cells are distributed as isolated cells and show monotonous features. Malignant cells are slightly larger than normal lymphocytes. Sometimes cleaved cells or large nucleoli are visible. The differential diagnosis of cytologic findings of malignant lymphoma and the other thyroid diseases is discussed in detail. PMID- 3665693 TI - The value of the Cytobrush for obtaining cells from the uterine cervix. AB - A study was undertaken to evaluate the efficacy of the Cytobrush compared with the cotton-tipped applicator for obtaining cells from the uterine cervix. Four consecutive Papanicolaou smears were obtained in 1,000 patients during a single clinic visit. In every patient, a total of four smears on two slides were submitted: one slide contained endocervical material obtained with a cotton tipped applicator and with the Cytobrush and the other slide contained ectocervical material obtained with both a cotton-tipped applicator and the Cytobrush. In endocervical smears, the Cytobrush technique produced numerous groups and clusters of cervical columnar cells in contrast to the use of the cotton swab. This was particularly true in older patients and pregnant women. In ectocervical smears, the detection of the squamous component was also higher in the Cytobrush smear than in cotton swab smears. However, the cell yield was not influenced by the cell sampling sequence in either endocervical or ectocervical specimens. It is the conclusion of this study that the utility of the Cytobrush technique for collecting specimens for endocervical and ectocervical smears is greater and provides a higher yield of cells than the cotton swab technique. Wider use of this simple procedure is encouraged. PMID- 3665694 TI - Origin of electroretinogram components. Symposia of the International Society for Clinical Electrophysiology of Vision (ISCEV). Mie, Japan and Palermo, Sicily. PMID- 3665695 TI - Normal strobe electroretinograms without pattern electroretinograms in albino rats. AB - Electroretinograms (ERGs) were obtained from pigmented and albino rats to step luminance changes of an unpatterned TV screen. Surround luminance was increased until the ERG became small and focal. In pigmented rats the ERG at on was positive, earlier, and about twice the amplitude of the negative ERG at off. All pigmented rats had pattern ERGs-0.5 cycles/deg in dark agouti rats and an octave less in hooded rats. Implicit peak times were similar to that of the sum of on plus off focal ERGs from the same animals (85 ms). In albino rats off responses were more like on. The resultant sum was consequently small. Both peak times were similar and did not move earlier than 120 ms as surround luminance increased. Pattern ERGs could not be recorded from albinos at any spatial frequency or surround luminance. These pigmented rat ERGs seem to have two major components. One follows luminance linearly; the other is a fully rectified nonlinearity with about one-third the amplitude. The albino rat retina apparently lacks the latter component. These deficiencies may occur in albinos of other species and be associated with their visual system abnormalities. PMID- 3665696 TI - First-order Wiener kernel visually evoked potentials obtained from multiple sclerosis patients. AB - Visually evoked potentials (VEP) were measured in multiple sclerosis patients with five sizes of reversing check stimuli. The VEPs were obtained using random binary sequence triggered check reversals. The random binary sequence was cross correlated with scalp potential responses to obtain the estimates of the linear response of the system. For each evaluation a series of five VEPs, one for each of five check sizes, was done. A correlation coefficient was calculated to evaluate check size versus amplitude of the major negative wave. A tabulation was made to compare Snellen chart visual acuity with these correlation coefficients. For the eyes with a Snellen acuity of 20/20, 63% of the VEP amplitudes increased as the check size was decreased with correlation coefficients of -0.6 to -1. For the eyes with a Snellen acuity of 20/70 or less the amplitude decreased with the check size decrease, showing a correlation coefficient of +0.6 to +1 in 45% of the evaluations. The check size giving the largest amplitude was also tabulated with respect to the visual acuity, but did not appear to have as strong a relationship to visual acuity. PMID- 3665697 TI - On the recovery of the electroretinogram after removal of intravitreal copper particles. AB - This report details the influence of the time lapse and surface area size of intravitreal copper foreign bodies on the electroretinogram (ERG) and the recovery of the potentials after removal of the particles. Pure copper wires were implanted temporarily into the vitreous body of rat eyes in the area of the ora serrata and the values of the ERG were compared with those of the intact fellow eyes. In three different procedures with groups of 12 animals each the following results were obtained: (1) The metal toxicity of small copper particles (0.3 mm2) remaining one day in the vitreous body reduced the amplitudes of the a1-, a2-, and b-wave only 10% by the end of the observation time of 260 days, (2) The loss of ERG amplitudes increased to about 25% under the influence of larger copper particles (1.3 mm2; time lapse one day); and (3) Copper particles with an active surface of 1.3 mm2 remaining two days in the vitreous body caused a permanent loss of about 50%. PMID- 3665698 TI - Incremental binocular amplitude of the pattern visual evoked potential during the first five months of life: electrophysiological evidence of the development of binocularity. AB - The amplitude of the pattern visual evoked potential (VEP) of a binocular stimulus has been shown to be generally larger than the VEP obtained monocularly. There is evidence that this effect can be considered an electrophysiological index of fusion. To study how binocular vision develops in infancy we evaluated the incremental binocular amplitude (IBA) in three infants in a longitudinal investigation during the first five months of life. The stimuli were phase alternating square-wave gratings with spatial and temporal parameters chosen to be appropriate for neonates. IBA was defined as the percentage increment of the largest binocular response compared with the monocular response. In the first two months of life IBA values were near zero, that is, no summation occurred. Between the second and third month IBA values rose markedly and after the third month its value was greater than 100%, demonstrating binocular facilitation. Thus in the first two months of life the eyes do not seem to cooperate as in adults. By the second and third month the binocular pattern VEP reflects an increasing binocular interaction. Other studies of the development of stereopsis have also found evidence of binocularity at similar ages. PMID- 3665700 TI - Age-related alterations in retinal function. AB - Age-related visual deficits that occur in the absence of recognized visual disease are frequently observed. Many of the optical factors contributing to these deficits have been delineated, but the contributing neurophysiological alterations have not been clearly defined. This investigation examined age related variations in the retinal and cortical processing of visual information. Pattern-specific retinal potentials (pattern electroretinogram or PERG in this series) and cortical potentials (VECPs) were recorded from nine young visual normals (20-30 years) and nine healthy elderly individuals (70-80 years). All subjects had best corrected visual acuity of 20/30 or better. Checkerboard patterns (7.5-60 min. checks) were modulated in a counterphase mode (2.0 and 7.5 rps). PERGs and VECPs were simultaneously recorded. Significant age-related alterations in waveform amplitude and latency were observed for both biopotentials. The VECP alterations were largely the result of the reduction in retinal illumination associated with senile miosis, but this factor could not account for most of the observed PERG alterations. These results suggest that neurophysiological changes in the retina may underlie some of the visual deficits observed in healthy elderly adults. PMID- 3665699 TI - Topographical study of stereo-related potentials. AB - In order to estimate objectively binocular vision and especially stereopsis, random dot stereograms generated by a personal computer were used. Brain activity during stereopsis was topographically studied by visually evoked potentials (VEPs). The potentials evoked by binocular viewing of patterns without disparity, e.g. correlogram, were very similar to the potentials evoked from patterns with disparity, i.e. stereogram, as many authors have already indicated. To derive the stereo-related potentials from the VEP elicited by stereograms, the potentials evoked by correlograms were subtracted from the potentials evoked by stereograms, and the differences of topographical distribution between normal and stereoblind subjects were investigated. PMID- 3665701 TI - The differential effect of optic nerve disease on pattern and focal electroretinograms. AB - We studied nine cases of retrobulbar neuritis with confirmed multiple sclerosis and six cases of optic atrophy from other causes. Pattern and focal electroretinograms (macular ERGs) were recorded with high (400 cd/m2) and low (40 cd/m2) intensity stimuli. Contrast sensitivity was also measured with a simple printed test. Luminance was not markedly important. High spatial frequency contrast sensitivity was significantly correlated with pattern ERG amplitude. Pattern and focal ERG amplitude ratio was usually reduced, but the effect was not correlated with contrast sensitivity or large enough to be useful clinically. In optic atrophy the pattern ERG (PERG) was clearly more severely reduced than the focal ERG (FERG). In retrobulbar neuritis both ERGs were equally and more severely reduced even though the visual losses were less. In unilateral cases the PERG increased then decreased after the initial attack, as previously described (Arden et al., 1982). The results suggest that retinal layers beyond the ganglion cells may be affected in retrobulbar neuritis, but proximally generated, pattern specific ERG components are selectively lost in optic atrophy. PMID- 3665702 TI - Visual evoked potential in the management of pituitary tumor during pregnancy. AB - We examined a pregnant woman with chiasmal syndrome in the late stage of pregnancy. Her vision was determined to be seriously threatened after 31 weeks' gestation. Study of the latency of preoperative visual evoked potentials (VEPs) in other patients with pituitary tumor showed that insofar as latency is not delayed, surgical decompression is expected to be followed by functional improvement of the optic pathway. We monitored optic nerve function by serially recorded VEPs, and labor was induced at 38 weeks because there had been no delayed response up to that time. After a decompressive operation, visual field and visual acuity recovered normally. Serially recorded VEPs can provide a useful monitor along with visual field and acuity tests in guiding therapy for a patient with threatened vision in late pregnancy and in determining whether or when to induce labor. PMID- 3665704 TI - Cone-mediated retinal function in cats during development. AB - Cone electroretinograms (ERGs) were recorded in kittens from 25 to 150 days of age and in adult cats. B-wave amplitudes in kittens between 25 and 94 days of age were either within the adult range or greater than adult responses. After about 100 days, all kittens had adult-like amplitudes. Cone b-wave implicit time was markedly prolonged at the earliest ages tested and only after 80 days was the timing like that in adult cats. Amplitude and timing of 40-Hz flicker ERGs confirmed the single flash cone ERG data. Critical flicker fusion frequency was mature by 74 days of age. These findings, taken together with previous results, indicate that there are differences in the time course of development of cone- and rod-mediated retinal function in the cat. PMID- 3665703 TI - Contrast sensitivity and pattern visual evoked potential in patients with glaucoma. AB - Contrast sensitivity and pattern visual evoked potential (VEP) were measured in cases of ocular hypertension and primary open-angle glaucoma at various stages. The visual field of each eye was examined quantitatively and the retinal nerve fiber layer and optic disc were precisely assessed with magnified stereoscope fundus photography. This study revealed that contrast sensitivity of the eyes with glaucoma was within the normal range in the very early stage of the disease. As optic nerve damage advanced, high- or low-frequency loss developed. Further optic nerve damage produced a level type of loss. Pattern VEPs also showed increasing abnormalities as glaucomatous optic nerve damage progressed. Measurements of contrast sensitivity and pattern VEP were found not to be as sensitive as quantified precise visual field measurement or color stereoscopic fundus photography for detection of minor optic nerve damage in cases of early glaucoma. These methods may be useful, however, as an objective and subjective monitor of progression of optic nerve damage in glaucoma. PMID- 3665705 TI - The pattern ERG in response to colored stimuli. AB - The pattern-evoked electroretinogram (PERG) was studied in response to square wave stripe patterns contrasting either between dark and colored stripes ("red black" or "green-black" luminance contrast pattern) or between the two colors (red-green chromatic contrast pattern). All lights were matched in photopic luminance. A two-channel Maxwellian view system was used to present the stimuli in the onset-offset mode. When no pattern was present a mixture of both colors was seen. Different spatial frequencies were studied and the amplitudes of the onset response were evaluated. When the two luminance contrast patterns were presented, the responses showed a spatial selectivity. However the combination of the two colors (red-green contrast) resulted in a monotonic decrease of the response with spatial frequency. The spatially selective behavior of the response to luminance contrast patterns could be associated with the on-off center surround organization of retinal receptive fields. The behavior of the response to chromatic-contrast patterns, on the other hand, could be explained by the action of color-opponent center-surround receptive fields as described in the primate. PMID- 3665706 TI - Pattern reversal retinal potentials in ocular hypertensives at high and low risk of developing glaucoma. AB - The human pattern-reversal retinal potential (PRRP) is a bioelectrical response which reflects neural activity generated in the proximal retina. Visual diseases which affect the retinal ganglion cells and the optic nerve often produce significant reductions in the amplitude of the PRRP. PRRP amplitude reductions are frequently observed in patients with primary open-angle glaucoma. This investigation was designed to determine whether patients with ocular hypertension who are at risk of developing glaucoma also exhibit PRRP amplitude reductions. The results indicate that PRRP amplitude reductions do occur in some ocular hypertensives, but many other ocular hypertensives do not exhibit PRRP abnormalities. PMID- 3665708 TI - Diabetes educators as philosophers. PMID- 3665709 TI - Blood-borne viruses and BGM, (blood glucose monitoring) PMID- 3665710 TI - On the insulin pump position statement. PMID- 3665711 TI - Promoting international communication. PMID- 3665707 TI - Retinal fluorotachometry. A clinically applicable method of retinal flow measurement. PMID- 3665712 TI - Diabetes and scuba diving. PMID- 3665713 TI - Reflections on diabetes education and culture. PMID- 3665714 TI - Diet and geriatric individual with diabetes. PMID- 3665715 TI - Designing culturally relevant educational materials for Mexican American clients. PMID- 3665716 TI - A model for diabetes health care delivery in developing countries. PMID- 3665717 TI - Development of the diabetes health belief scale. PMID- 3665718 TI - Treatment of the hospitalized hypoglycemic patient. PMID- 3665719 TI - Elementary schoolteachers' understanding of diabetes. PMID- 3665720 TI - Diabetes education in schools: South Central Kentucky experience. PMID- 3665721 TI - Determining effectiveness of educational interventions in diabetes. PMID- 3665722 TI - Using the food choice plan. PMID- 3665723 TI - Community-based education possible in local libraries. PMID- 3665724 TI - Improved diabetes control and knowledge during a diabetes self-help group. PMID- 3665725 TI - On becoming more clear: a research review with clues to instructors. PMID- 3665726 TI - Parents' understanding of and guilt over their children's blood glucose control. PMID- 3665727 TI - A team approach. Selecting teaching strategies to promote patient adherence. PMID- 3665728 TI - Early steps in the research process. PMID- 3665729 TI - The perception threshold to an electric stimulus deeply applied in the lower limbs in normal and diabetic subjects. AB - The loss of sensitivity to nociceptive stimuli is one of the main factors involved in the pathogeny of diabetic gangrene. The aim of this study was to develop a simple and practical method for selecting the cases prone to such a complication. The perception threshold (either voltage, mV or current, microA) was determined in 137 randomly selected diabetic patients and 38 non-diabetic controls, by an original electronic device using sinusoidal waves, delivered through two electrode needles introduced at a depth of 0.5 cm at two points located on the anterior aspect of the shank about 12 cm apart. At each of the eight frequencies studied (10, 20, 50, 100, 200, 500, 1000 and 2000 Hz) three electrical parameters (voltage across the needle electrodes, the resistive and the capacitive current component) were recorded when the subject first perceived the stimulus. A significantly higher perception threshold was found in diabetic patients vs. non-diabetic subjects, at all frequencies studied and with all three electrical parameters recorded. A greater difference in the perception threshold between diabetic and non-diabetic subjects (a ratio higher than 3) was, however, found using the resistive component of the current and at frequencies higher than 200 Hz. PMID- 3665730 TI - Diabetes in the Melanesian and Indian peoples of Fiji: a study of risk factors. AB - Epidemiological risk factor patterns for diabetes mellitus determined by hemoglobin A1 and fasting blood glucose criteria were compared in the biethnic (Melanesian and Indian) nation of Fiji. The 2 diagnostic criteria elicited essentially similar risk factor patterns in Indians but ranking of predictors was altered in Melanesians. By either criterion age was a dominant risk factor for diabetes in both ethnic groups with age2 a predictor in Indians of elevated hemoglobin A1 (chi 2 = 7.8, P less than 0.005) and fasting blood glucose (chi 2 = 25.3, P less than 0.0001). Age- and sex-adjusted prevalence of diabetes was higher in Indians than in Melanesians [RR = 2.5 (1.9-3.3)]. A positive family history was associated with increased risk of diabetes in both ethnic groups by the hemoglobin A1 criterion [pooled RR = 2.3 (2.0-2.6)] but was not significant in Melanesians under the fasting blood glucose criterion. A positive family history was a strong predictor of severe hyperglycemia in both ethnic groups. The relative risk for diabetes was greater in females [1.5 (1.2-9.1)], with no ethnic difference. There was no urban-rural difference in either ethnic group. The similar risk factor patterns for diabetes diagnosed by hemoglobin A1 and severe hyperglycemia suggest that elevated hemoglobin A1 may constitute a useful screening test for 'high risk' diabetic subjects. PMID- 3665731 TI - Metabolic and morphological changes of the heart in Chinese hamsters (CHAD strain) with spontaneous long-term diabetes. AB - We studied the effect of spontaneous long-term (9-10 months) diabetes on the heart of Chinese hamsters (CHAD strain) to elucidate the relationship between diabetes mellitus and cardiomyopathy. The diabetic hamsters, aged approximately 11 months, showed body weight loss, hyperglycemia (mean fasting plasma glucose 402 mg/dl), hypoinsulinemia, hyperlipidemia and ketonemia. The diabetic hamsters showed reduced activities of cytoplasmic glycolytic key enzymes; hexokinase, pyruvate kinase and phosphofructokinase, increases in cardiac glycogen and glucose-6-phosphate contents and a 40% decrease in cardiac ATP content, indicating decreased energy production. An accumulation of myocardial triglyceride and cholesterol was found in the diabetic hamsters. In addition, the cardiac norepinephrine content was increased in the diabetic hamsters, suggesting the presence of autonomic nervous disorder. Increased heart weight and thickening of the septum and both ventricular walls were found in the diabetic hamsters. Light-microscopic analysis revealed that 42.9% of the diabetic hamsters had myocardial degeneration without any vascular lesion of extramural large and intramural small vessels, whereas the non-diabetic controls had no myocardial or vascular lesions. These data suggest that the diabetic Chinese hamsters had cardiomyopathy, which is possibly caused by extravascular factors such as metabolic or autonomic nervous disorder although conclusive evidence is lacking. PMID- 3665733 TI - Problems when withdrawing corticosteroids. PMID- 3665732 TI - Weight change amongst Nauruans over 6.5 years: extent, and association with glucose intolerance. AB - We are reporting here the extent of weight change over 6.5 years of follow-up amongst 366 randomly selected Nauruans initially surveyed in 1975-1976. Although the initial level of obesity was high (mean body mass index: males 30.8 kg/m2, females 33.0 kg/m2), further increase in body mass index subsequently occurred in 285 subjects (78%). The weight loss that occurred amongst the other 81 subjects was generally mild (mean = 5.3 kg), and only 12 persons lost more than 10 kg. Weight loss was far more common amongst the older subjects: 40% of those older than 50 years compared with 10% of those less than 30 years showed a decrease in body mass index (P less than 0.001). After age adjustment, greater initial obesity was associated with subsequent weight loss (P less than 0.001), and higher baseline plasma glucose (P less than 0.001), and triglyceride levels (P less than 0.05) and lower plasma uric acid levels (P less than 0.01) were also predictive of some weight loss. Obesity and diabetes remained the major predictors of weight loss in the multivariate analysis. Subjects who lost weight showed similar deterioration in glucose tolerance over the 6.5 years (mean increase = 1.8 mmol/l) to those not losing weight (mean = 1.0 mmol/l) and weight loss was not associated with glucose tolerance improvement (or less deterioration) for either those diabetic, or those not diabetic initially. This result suggests that weight loss is not invariably associated with improvement in glucose tolerance amongst Nauruans. PMID- 3665734 TI - Evaluation of the dimethylglyoxime stick test for the detection of nickel. AB - The value of the dimethylglyoxime stick test for the detection of nickel was determined for 54 randomly purchased metal objects designed for prolonged skin contact, and for 15 metal alloys of known composition. Surface nickel content was determined by EDAX analysis (energy dispersive X-ray) and nickel release in synthetic sweat was measured by Zeemann atomic absorption spectrometry. The study confirmed that the dimethylglyoxime stick test will identify most nickel containing alloys. There are, however, important exceptions. In such cases provocative user tests or patch tests with the suspected alloy are indicated. PMID- 3665735 TI - [Objective assessment of the effect of sodium lauryl sulfate on the surface of the skin in childhood]. AB - The influence of sodium lauryl sulfate on physiological properties of the skin surface in children was assessed by continuous measuring of electric conductivity in the course of iontophoresis with physiological solution. The results achieved have shown that even very low concentrations of sodium lauryl sulfate (0.1% water solution) provoke changes of physiological properties in the skin surface. A concentration of 0.5% has been established to be the limit concentration of sodium lauryl sulfate which can evidently injure the barrier functions. The degree of changes in electric conductivity was not dependent on the intensity of the skin irritation. PMID- 3665736 TI - [Nuclear medicine--quo vadis?]. PMID- 3665737 TI - [Modification of resting and effort hemodynamics in essential arterial hypertension using antihypertensive agents]. AB - The haemodynamic effects of piretanide, acebutolol and nifedipine were tested and compared at rest and on exercise in an open study of patients with essential hypertension, grade II (WHO). All three drugs lowered the blood pressure significantly, both at rest and on exercise. There was no significant difference between the three drugs in their effect on resting blood pressure, but nifedipine and acebutolol were significantly more effective than piretanide in lowering it on exercise. Piretanide lowered the blood pressure by reduction in cardiac output and peripheral resistance, nifedipine entirely through a reduction of peripheral resistance, and acebutolol entirely through a reduction in cardiac output. Mean pulmonary arterial pressure, taken as a measure of left-ventricular filling pressure, was significantly reduced by piretanide and nifedipine, while it rose significantly under acebutolol. Taking into account the haemodynamics of essential hypertension (raised peripheral resistance, decreased cardiac output, frequently increased left-ventricular filling pressure), nifedipine most nearly fulfilled the role of an "ideal" antihypertensive agent. PMID- 3665738 TI - [Myocardial ischemia with normal coronary vessels. Indication of a vasospastic etiology]. AB - In a 43-year-old woman with ECG changes of an acute anterior and posterior wall infarct, associated symptoms and biochemical findings, coronary angiography demonstrated normal coronary arteries and a normal variant in the course of the left coronary artery. Vasospasms in another vascular bed (migraine) and highly positive 201-Thallium scintigraphy during acral cold provocation speak for coronary spasm as cause of the myocardial ischaemia in this patient. PMID- 3665739 TI - [Hydronephrosis caused by enlarged retroperitoneal lymph nodes in sarcoidosis]. AB - The diagnosis of sarcoidosis was made in a 40-year-old man when, in addition to enlarged mediastinal and hilar lymph nodes (sarcoidosis I), he also had peripheral lymph node enlargement. Pulmonary infiltrations (sarcoidosis II) developed subsequently. Three years after diagnosis pulmonary symptoms first became manifest, at the same time as pain in the kidney region. The urogram revealed hydronephrosis caused by enlarged retroperitoneal lymph nodes (CT scan). After treatment with corticosteroids the urogram was normal. PMID- 3665740 TI - [Illegality of decisions based on selection interviews for medical school. Decree of the Baden-Wurttemberg Higher Administrative Court, 26 June 1987]. PMID- 3665741 TI - [Pregnancy after radioiodine therapy]. PMID- 3665742 TI - [Plasma catecholamines in kidney insufficiency]. PMID- 3665743 TI - [Liposarcoma]. PMID- 3665744 TI - [Clinico-chemical studies on preparation for anesthesia]. PMID- 3665745 TI - [Cases of death following cell therapy]. PMID- 3665747 TI - [Life support care against the patient's will]. PMID- 3665746 TI - [Gc serum groups, HIV and AIDS]. PMID- 3665748 TI - [IGA concentration in serum, sputum and bronchoalveolar lavage in chronic bronchitis]. AB - IgA concentrations in serum, sputum and bronchoalveolar lavage were determined in 11 patients with chronic obstructive lung disease exacerbated by infection and in 22 with similar disease during an infection-free period. Patients with infection had a higher serum-IgA concentration than those without. But there was no difference in sputum-IgA concentration between the two groups. Both for sputum and broncho-alveolar lavage there was a positive correlation between anti elastolytic inhibition capacity and IgA concentration. In vitro it has been demonstrated that IgA concentration measured immunologically decreases with increasing elastase concentration, in line with increasing free elastolytic activity. Local IgA deficiency in patients with infection apparently results from proteolytic splitting of the immunoglobulin. PMID- 3665749 TI - [Clinical experience with bacterial contamination of Port-A-Cath systems in tumor patients]. AB - In 33 cancer patients with subcutaneously implanted Port-A-Cath systems (Pharmacia) who developed bacteremia with rigor and high fever, aerobic and anaerobic cultures were prepared from aspirated chamber blood. Organisms were isolated from 19 patients of whom 10 had fever, but none life-threatening. In seven patients the fever was caused by infected chamber blood, while in three it was impossible to prove whether it was due to chamber contamination or the underlying disease. Almost all of the causative organisms were skin saprophytes, most frequently Staph. epidermidis, Acinetobacter Iwoffi and apathogenic Corynebacteria. The pathway of infection was probably exogenous (iatrogenic) inoculation. Removal of the catheter system was not necessary. Since strict hygienic measures were instituted when using the system no further chamber contamination has occurred. PMID- 3665750 TI - [Perfusion of the extremities in malignant melanoma. Indication, technic and results]. PMID- 3665751 TI - [Second generation of an extracorporeal shock wave lithotripsy (Lithostar)]. PMID- 3665752 TI - [Vasectomy--pro and contra]. PMID- 3665753 TI - [Psoriatic arthritis]. PMID- 3665754 TI - [Anterior wall infarct in Hodgkin's disease]. PMID- 3665755 TI - [Ammonia determination in gastric juice. A new simple rapid test for Campylobacter pylori]. PMID- 3665756 TI - [Activity-initiated rate-adapted pacemaker therapy. Clinical results]. AB - In a prospective study of 23 patients the clinical effects of rate-adapted activity-sensed (by mechanical resonance oscillations) pacing (Activitrax system) were tested over a mean period of 8.1 +/- 3.8 months. This form of pacemaker treatment was used when, after exercise and on long-term ECG monitoring, the spontaneous heart rate had not exceeded 85 beats per min and there had been symptoms of decreased exercise tolerance. Lasting improvement in physical exercise tolerance was achieved in 11 of 17 patients after changing from fixed rate to rate-adapted pacing. Treadmill ergometry, randomised in the fixed-rate or rate-adapted mode, brought about a significant rise in exercise tolerance (P greater than 0.01). Contrary to results after external influences, insufficient rate increases in five patients in the course of static stress was of clinical significance and thus narrow the indications for this type of pacing. PMID- 3665757 TI - [Piperacillin dosage and elimination in premature infants]. AB - In 19 premature newborns (mean birth weight 1600 g, range 800-2430 g), receiving a daily dose of 100-150 mg piperacillin/kg body weight in four divided doses, serum concentration of the drug at the end of its interval of administration was a mean of 32.6 +/- 25.0 mg/l. In six mature newborns it was lower at 12.5 +/- 9.0 mg/l. The mean serum drug level on days 1, 5 and 10 in ten premature newborns at the end of the respective interval of administration was reduced to about 69% of the initial level. Elimination of piperacillin (half-life and clearance) was determined in the middle of their first week of treatment in 11 prematures. Compared with values in adults, mean half-life was increased fourfold. In individual cases it was increased tenfold. Compared with a control group of mature newborns, clearance was markedly reduced. Because of the danger of underdosage as a result of increasing maturation of elimination during the period of treatment, piperacillin should be given in slightly higher doses, 200-300 mg/kg in premature and mature newborns. However, the clearly prolonged half-life makes it possible to divide daily dosage into two doses. PMID- 3665759 TI - [HIV infection]. PMID- 3665758 TI - [Asbestosis and the rheumatic lung. Medical insurance assessment of combined lung diseases]. AB - A fibrosing pulmonary disease, which could not be further classified, was diagnosed in a 76-year-old woman who for 40 years had worked as a seamstress in the textile industry. For the last 16 years she had suffered from progressively increasing shortness of breath. She died three weeks after hospitalization during which she received intensive respiratory and circulatory supportive treatment. At post-mortem examination there was evidence of minimal asbestosis, of pulmonary manifestations of rheumatoid arthritis and of recurrent pulmonary thromboembolism, as well as of the consequences of two weeks of artificial ventilation during the terminal period. This constellation of histopathological findings was assessed in relation to the part played by her occupational disease. She had been previously awarded a pension as a recognized sufferer form asbestosis (50% reduction of earning power). The histopathological findings were not such--in view of the difficult diagnostic constellation while she was alive- as to contradict with a high degree of probability the finding that she had suffered from an occupational disease. PMID- 3665760 TI - [Atypical course of an erythema migrans disease]. PMID- 3665761 TI - [Goiter treatment with levothyroxine]. PMID- 3665762 TI - [Balloon dilatation of calcified aortic stenosis]. AB - Between November 1986 and March 1987, 14 patients (11 men and three women, aged 48-84 years, mean 71.3 years) had percutaneous transluminal balloon dilatation of calcific aortic valve stenosis. Peak transvalvar pressure gradients were reduced from a mean of 81.4 mm Hg (25-122 mm Hg) to a mean of 44.8 mm Hg (range 19-63 mm Hg). Calculated valve opening area was increased from a mean of 0.48 (0.3-0.86) cm2 to 0.75 (0.6-1.16) cm2. All but one patient were in stage III or IV (New York Heart Association) and most improved by about one stage. There were no complications that could be ascribed to the procedure. Blood transfusion was not required. PMID- 3665763 TI - [Mesenteric lipomatosis. A rare disease often misdiagnosed as ascites]. AB - A 53-year-old man, a known alcoholic, was admitted to hospital, because of abdominal swelling, with the admission diagnosis of ascites. Treated with diuretics a severe hypokalaemia developed with subileus and moderate clouding of consciousness. Computed tomography revealed the correct diagnosis of intraabdominal extraperitoneal (mesenteric, pelvic, retroperitoneal) soft-tissue lipomatosis. PMID- 3665764 TI - [Effect of homeopathy--a placebo effect?]. PMID- 3665765 TI - [Coenzyme Q10 in ischemic heart disease]. PMID- 3665766 TI - Rescue of developmental lens abnormalities in chimaeras of noncataractous and congenital cataractous mice. AB - In the study of the lens of a congenital cataractous mouse mutant (CAT), it has been shown that a loss of growth regulation at the cellular level causes gross lens abnormalities. The phenotypic characteristics of the cataractous mouse lens are similar to those seen in human congenital cataract and thus serves as a model system for medical research. In this present investigation, we have demonstrated that the abnormalities of the congenital cataractous lens can be rescued by forming chimaeras between DBA/2 (a noncataractous strain of mouse) and the CAT mutant. This report describes the histological, cellular and biochemical analysis of the resultant chimaeric eyes, and discusses possible mechanisms by which these results were achieved. PMID- 3665767 TI - Complicated colobomatous microphthalmia in the microphthalmic (mi/mi) mouse. AB - A study of the development of the eye in the cinnamon mouse, homozygous for the gene for microphthalmia (mi), has shown that the microphthalmia is due to failure of secondary vitreous formation associated with a coloboma. The retina is dystrophic but there is a residual population of large ganglion cells and the optic nerve also contains ganglion cells. All these ganglion cells have cytoplasm similar to the retinal ganglion cells in the normal controls. It is postulated that they communicate with axons in the optic nerve. In addition, the outer epithelial layer of the eye cup, which normally becomes pigmented, forms retinal tissue in the homozygous mouse and this is also true of the dorsal part of the eyestalk near the eye. PMID- 3665768 TI - Differential deposition of basement membrane components during formation of the caudal neural tube in the mouse embryo. AB - The distribution of basement membrane and extracellular matrix components laminin, fibronectin, type IV collagen and heparan sulphate proteoglycan was examined during posterior neuropore closure and secondary neurulation in the mouse embryo. During posterior neuropore closure, these components were densely deposited in basement membranes of neuroepithelium, blood vessels, gut and notochord; although deposition was sparse in the midline of the regressing primitive streak. During secondary neurulation, mesenchymal cells formed an initial aggregate near the dorsal surface, which canalized and merged with the anterior neuroepithelium. With aggregation, fibronectin and heparan sulphate proteoglycan were first detected at the base of a 3- to 4-layer zone of radially organized cells. With formation of a lumen within the aggregate, laminin and type IV collagen were also deposited in the forming basement membrane. During both posterior neuropore closure and secondary neurulation, fibronectin and heparan sulphate proteoglycan were associated with the most caudal portion of the neuroepithelium, the region where newly formed epithelium merges with the consolidated neuroepithelium. In regions of neural crest migration, the deposition of basement membrane components was altered, lacking laminin and type IV collagen, with increased deposition of fibronectin and heparan sulphate proteoglycan. PMID- 3665769 TI - Intercalation and the cellular origin of supernumerary limbs in Xenopus. AB - The hypothesis that a specialized polarizing zone controls the pattern of the anterior-posterior axis during limb development in Xenopus has been tested by analysing the cellular contribution to supernumerary limbs. Supernumerary limbs were generated by grafting hindlimb buds contralaterally between X. borealis and X. laevis to appose anterior and posterior limb tissues. Cells derived from these two species of Xenopus are readily identified by staining with quinacrine. The analysis of cellular contribution showed that supernumerary limbs consist of approximately half anterior-derived (57%) and half posterior-derived (43%) cells. These data are not consistent with the polarizing zone theory but are consistent with the hypothesis that both supernumerary limbs and normally developing limbs arise from intercalary interactions between limb bud cells with different positional values. PMID- 3665770 TI - Fate map for the 32-cell stage of Xenopus laevis. AB - A complete fate map has been produced for the 32-cell stage of Xenopus laevis. Embryos with a regular cleavage pattern were selected and individual blastomeres were injected with the lineage label fluorescein-dextran-amine (FDA). The spatial location of the clones was deduced from three-dimensional (3D) reconstructions of later stages and the volume of each tissue colonized by labelled cells in each tissue was measured. The results from 107 cases were pooled to give a fate map which shows the fate of each blastomere in terms of tissue types, the composition of each tissue by blastomere, the location of each prospective region on the embryo and the fate of each blastomere in terms of spatial localization. Morphogenetic movements up to stage 10 (early gastrula) were assessed by carrying out a number of orthotopic grafts at blastula and gastrula stages using donor embryos uniformly labelled with FDA. Although there is a regular topographic projection from the 32-cell stage this varies a little between individuals because of variability of positions of cleavage planes and because of short-range cell mixing during gastrulation. The cell mixing means that the topographic projection fails for anteroposterior segments of the dorsal axial structures and it is not possible to include short segments of notochord or neural tube or individual somites on the pregastrulation fate map. PMID- 3665771 TI - The ultrastructure of normal fetal and neonatal pig testis germ cells and the influence of fetal decapitation on the germ cell development. AB - The development of germ cells in the male pig was investigated ultrastructurally in normal and decapitated fetuses. The age ranged respectively from 30 days p.c. till one month after birth and from 52 days p.c. until birth. The ultrastructural organization of the germ cells changes dramatically between 30 days p.c. and 52 days p.c. which coincides with the formation of 'true' sex cords. From 52 days p.c. onwards the morphology is rather stable: cells show a 'hydrated' appearance and typical cell bridges. There is no obvious difference in the ultrastructure of germ cells in decapitated animals, their normal littermates and control animals. Therefore germ cell development in the pig is likely to be insensitive to gonadotropins during the fetal period. The development of pig germ cells follows closely the pattern described for several species. Quantitatively there is an increase in the ratio of germ cell/Sertoli cell per cross sectional diameter in the decapitated animals. PMID- 3665772 TI - The specificity of motor innervation of the chick wing does not depend upon the segmental origin of muscles. AB - In vertebrate embryos, motor axons originating from a particular craniocaudal position in the neural tube innervate limb muscles derived from myoblasts of the same segmental level. We have investigated whether this relationship is important for the formation of specific nerve-muscle connections, by altering the segmental origin of muscles and examining their resulting innervation. First, by grafting quail wing somites to a new craniocaudal position opposite the chick wing, we established that the segmental origin of a muscle can be altered: presumptive muscle cells migrated according to their new, rather than their original, somitic level, colonizing a different subset of muscles. However, after reversal of a length of brachial somitic mesoderm along the craniocaudal axis, or exchange or shift of brachial somites, the craniocaudal position of wing muscle motoneurone pools within the spinal cord was undisturbed, despite the new segmental origin of the muscles themselves. While not excluding the possibility that muscles and their motor nerves are labelled segmentally, we conclude that specific motor axon guidance in the wing does not depend upon the existence of such labels. PMID- 3665773 TI - A monoclonal antibody detects a difference in the cellular composition of developing and regenerating limbs of newts. AB - We have previously described a monoclonal antibody (called 22/18) that reacts with the early blastemal cells of the regenerating limb of the newt (Notophthalmus viridescens). In embryos of two newt species the antibody reacts with the epidermis, glial cells in the neural tube, the lens and cells in a restricted region of the aorta. In the developing limb bud less than 1% of the mesenchymal cells were reactive with 22/18, although most cells stained brightly with an antibody to another cytoskeletal component. When limbs were amputated prior to the arrival of nerves (axons and Schwann cells) at the amputation plane there was no extra reactivity with 22/18 as compared to the contralateral unamputated control, even though the amputated buds regenerated satisfactorily. Limbs amputated after nerves are present at the plane of amputation respond by forming a 22/18-positive blastema. The appearance of the 22/18 responses is a function of the stage of limb development as shown by amputation of forelimb and hindlimb buds at a larval stage where development of the forelimb is greatly advanced relative to the hindlimb. The distribution of the 22/18-positive cells in larval blastemas showed them to be closely associated with axons as detected by double staining with an antiserum to a neurofilament subunit. The clear antigenic difference between development and regeneration may be related to the relationship between embryonic regulation and epimorphic regeneration, and also to the acquisition of nerve-dependent proliferation of blastemal cells. PMID- 3665774 TI - [Analysis of respiratory sounds]. PMID- 3665775 TI - [Uterine rupture in Finland]. PMID- 3665776 TI - [Self administration of repeat catheterization]. PMID- 3665777 TI - [Use of lasers in surgery]. PMID- 3665778 TI - [Olfactory nerve meningioma]. PMID- 3665779 TI - [Cryogenic treatment of basal cell carcinoma of the eyelid]. PMID- 3665780 TI - [Subendocardial resection for recurrent ventricular arrhythmia]. PMID- 3665782 TI - [Complexity of facet symptoms in the lumbar spine]. PMID- 3665781 TI - [Treatment of malignant testicular tumors]. PMID- 3665783 TI - [A novel protein related to endometrial function]. PMID- 3665784 TI - [Bronchiolitis and rheumatic diseases]. PMID- 3665785 TI - [Uterine endoscopy of bleeding disorders in menopausal women]. PMID- 3665786 TI - [Radiation-induced cardiac injury]. PMID- 3665787 TI - [Deep venous thrombosis mimicking a ruptured baker's cyst]. PMID- 3665788 TI - [Ocular involvement in giant cell arteritis]. PMID- 3665789 TI - [The hyperventilation syndrome treated with antidepressive agents]. PMID- 3665790 TI - [Dysplastic nevus--a precursor melanoma]. PMID- 3665791 TI - [Protracted vomiting and colic]. PMID- 3665792 TI - Blepharo- and dermapigmentation techniques for facial cosmesis. PMID- 3665793 TI - A closer look at the thyroglossal cyst. PMID- 3665794 TI - Atypical cervical mycobacterial lymphadenitis in children. PMID- 3665795 TI - Who operated on Max? PMID- 3665796 TI - Staphylococcal enterotoxin "A" in raw and pasteurized milk. PMID- 3665797 TI - Early post operative wound infection in clean surgery at Khartoum. PMID- 3665798 TI - Morbidity and mortality from orbital cellulitis. PMID- 3665799 TI - Analysis of Kenyan drinking water. PMID- 3665800 TI - Acute appendicitis in Khartoum: pattern and clinical presentation. PMID- 3665801 TI - Retinal detachment in eclampsia. PMID- 3665802 TI - A small food-borne outbreak of hepatitis A. PMID- 3665803 TI - Risk of infections associated with umbilical vein catheterisation in newborn patients. PMID- 3665804 TI - District focus: the pharmacist and the availability of essential drugs of good quality: government policy. PMID- 3665805 TI - [New knowledge of protein nitrogen resorption in the colon]. AB - The absorption of protein nitrogen by the colon was assessed in 8 infants with colostomy by giving [15N] yeast protein in a dosage of 5-20 mg 15N/kg (92.4 atom % 15N). The absorption of 15N ranged between 87.1 and 98.1% of the administered dose, and the retention in the protein pool ranged between 81.0 and 95.7%. The incorporation of 15N in the plasma proteins was demonstrated by 15N-excess values between 0.01 and 0.10 atom-%, the TCA soluble fraction contained 15N-excess values of 0.04 to 0.19 atom-%. The results suggest that the colon can assimilate proteins when insufficient absorption of protein nitrogen in the small intestine occurs. The breakdown of protein is thought to result from the action of the colonic flora. PMID- 3665807 TI - [The Nobel Prize in physiology and medicine for 1986]. PMID- 3665806 TI - [Hematological and biochemical changes in human glucose-citrated blood preserved in polyvinyl chloride bags]. PMID- 3665808 TI - [Sperm-agglutinating, hemagglutinating and precipitating activity of an extract of Arum maculatum roots]. PMID- 3665809 TI - [Regional changes and the interrelationship of arterial system indices from the viewpoint of age]. PMID- 3665810 TI - Spontaneous motor unit firing in spinal muscular atrophy of childhood. PMID- 3665811 TI - Spontaneous electrical activity of end-plate noise in human muscles. PMID- 3665812 TI - Temperature-related changes in sensory nerve conduction: studies in normal subjects and in patients with paraproteinaemia. PMID- 3665813 TI - The practical value of electromyographic parameters in diabetic neuropathy: our experience in 1,276 patients. PMID- 3665814 TI - Accessory deep peroneal nerve. PMID- 3665815 TI - Chewing side preference in man correlated with handedness, footedness, eyedness and earedness. PMID- 3665816 TI - Assessment of denervation by recording of muscle sound following direct stimulation. PMID- 3665817 TI - [Value of systematic toxicological analysis in the management of drug addicts]. AB - This study was carried out between March and December 1985, on 50 drug addicts, including 45 heroin users, hospitalized for detoxication. We compared the clinical informations obtained at the time of admission with the toxicological informations obtained from blood and urinary samples. If the drugs said to have been used over the last 48 hours are always found, in 52% of these cases some other drugs are found too. The reasons of this difference between clinical and toxicological informations are analysed as well as their consequences on diagnosis and treatment. This data finally shows the importance of systematic toxicological analysis in the treatment of drug addicts as well as in the epidemiological studies. PMID- 3665818 TI - [Heterogeneity of the depressive mood. Construction of a polydimensional scale]. AB - The evaluation of depressive mood implies several levels of the clinician's inferences: behaviour observation, subjective experience report, affective communication... The authors report the first stages in the construction of a specific depressive mood scale administered to a major depressive disorder population of 52 patients meeting DSM III criteria. The principal component analysis splits mood into three main factors: dysphoria, expressed sadness, emotional blunting. These various emotional dimensions should be taken into account for the analysis of drugs effects. PMID- 3665819 TI - [Clomipramine and demethylclomipramine. Correlation of plasma levels and efficacy in 24 depressive patients]. AB - Plasma concentrations of clomipramine (CL) and demethylclomipramine (DMCL) were determined in 24 patients with an endogenous (9) or non endogenous (15) depressive syndrome, treated in hospital for 21 days, with clomipramine; simultaneous clinical evaluations were performed with Hamilton Rating Scale. Optimal therapeutic effect was observed when the sum of CL + DMCL plasma levels was less 200 ng/ml or more 400 ng/ml. In our responders, the CL/DMCL ratio was around 0.6. The relation between demethylation and clinical outcome is considered. PMID- 3665820 TI - [Demonstration, by the cartographic test, of an unusual reaction to intermittent light stimulation in patients with migraine]. AB - Topographic electroencephalography was carried out to study reaction to photic stimulation in 29 normal volunteers, and 12 patients who had presented frequent clinically confirmed migraines for at least 3 years. In the group of migraineurs photic stimulation resulted in an increase in the alpha band power. The difference between the two groups was statistically significant. This reaction to photic stimulation is of help in diagnosis and suggests that a diagnosis and therapeutic orientation might be possible in patients for whom clinical diagnosis is not clear. The specificity of the migraineur's reaction to photic stimulation and its possible origin are discussed. PMID- 3665822 TI - Neurologic emergencies. PMID- 3665821 TI - Legal aspects of emergency treatment of the neurologically injured patient. AB - Brain and spinal cord injuries are medicolegally hazardous for the emergency department staff and prehospital emergency care personnel to handle. The reason for this is because of the severity and permanence of their sequelae. A part of the problem involves the unpredictability of when neurologic symptoms and signs will develop. They may develop immediately after the injury, or they may develop at an unpredictable time minutes to hours thereafter. This article cites a few examples of neurologic injuries that resulted in litigation against emergency care personnel. PMID- 3665823 TI - Gait failure. AB - Gait failure is a common presentation in the Emergency Department, and one that may herald an acute neurologic episode. This article reviews the mechanisms of gait failure, some of their causes, and the appropriate examination techniques for determining possible diagnoses. PMID- 3665824 TI - Acute head pain. AB - The case of a patient presenting to the Emergency Department with acute head pain is presented in this article. The case is discussed from the standpoint of the meaning of the historical features in the case, and the physical examination features. The differential diagnosis of acute head pain in the Emergency Department is discussed. Potential diagnostic strategies and initial therapeutic regimens are covered. PMID- 3665825 TI - Pain management in the child. AB - The most common complaint motivating patients to seek care in Emergency Departments is pain. The specialty of emergency medicine has an ideal opportunity to practice compassionate, effective analgesic techniques. Children and adults should have pain treated with the same vigor and concern as if we ourselves or our family members were suffering. The technology is currently available for effective compassionate analgesic techniques to be provided to pediatric and adult victims of illness and injury presenting to Emergency Departments for care. Acute pain should be treated with the same priority given to the medical and surgical emergencies. There are many approaches to treating the above case, all allowing the necessary procedures to be done comfortably. If emergency physicians would treat the pain of their patients as they would want it to be treated in themselves or their families, then we will have made great strides as a specialty in mastering the art and science of analgesia. PMID- 3665826 TI - Evaluation of hydrocephalus shunts in the emergency room. AB - The workup of suspected shunt malfunction requires consideration of several factors, including history, physical and neurologic examinations, and appropriate laboratory and radiologic tests. Hydrocephalus is a benign condition, often compatible with normal neurologic function if properly controlled. It is therefore vital that patients with hydrocephalus have their shunts carefully maintained to avoid serious complications due to shunt obstruction and infection. By following the guidelines listed above, most shunt problems can be detected and appropriate consultation arranged. PMID- 3665827 TI - Rapid assessment of mental status in the infant and young child. AB - This article reviews some of the tests for determining mental status in the infant and child. This assessment, in the setting of acute insult, is considerably more difficult than it is in the adult, since language skills and performance expectations differ in this age group. PMID- 3665828 TI - Vascular syndromes. AB - Patients with suspected transient ischemic attacks are frequently seen in the Emergency Department. Accurate diagnosis is crucial but often very difficult because signs and symptoms often will have resolved when the patient is seen. This article reviews the details of the history and physical examination that may help to establish a correct diagnosis. PMID- 3665829 TI - The agitated patient in the emergency department. AB - A practical approach to the evaluation and management of the agitated patient is presented. Organic disorders must be ruled out in this type of patient before functional diagnoses are accepted as diagnoses of exclusion. In this article, a methodical approach to the treatment of the patient's agitation is outlined. If a reversible organic cause for the patient's behavior is not apparent and if the patient does not first respond to verbal communication, then the proper treatment of the patient's agitation includes mechanical and chemical restraints. The article concludes with a review of the pharmacology and indications for use of different classes of sedating agents. PMID- 3665830 TI - Emergency management of the head-injured patient. AB - The patient with severe head injury is a therapeutic challenge and demands all of the skills of the emergency medical specialist to manage traumatic injuries to the head, chest, abdomen, and limbs, as well as the specialized problems associated with respiratory care in a patient with raised ICP. The initial treatment is summarized in this article, which also reviews some of the most common types of head injuries and their sequelae. PMID- 3665831 TI - Mental confusion in the elderly. AB - Etiologies of confusion are discussed, including vascular, infectious, toxic metabolic, tumorous, convulsive, and vitaminologic. Other diverse conditions are reviewed, including normal-pressure hydrocephalus. PMID- 3665832 TI - Alcohol withdrawal seizures. AB - Seizures that occur in relation to alcohol withdrawal, following a period of prolonged intoxication in serious alcoholics, constitute a special syndrome with important prognostic and therapeutic implications. Inpatient management is desirable to eliminate other causes of seizures that occur for the first time in adult life and because such patients are at substantial risk for additional seizures and the development of delirium tremens. Drug therapy with benodiazepines may be effective during the withdrawal period but long-term anticonvulsant treatment is of no value. PMID- 3665833 TI - Effects of tumor necrosis factor on bone formation in vitro. AB - Tumor necrosis factor (TNF) was studied for its effects on bone formation in cultured rat calvariae. TNF alpha at 100-100,000 U/ml stimulated [3H]thymidine incorporation into DNA, an effect that appeared after 24 h of treatment and lasted 96 h. Transient (24-h) treatment with TNF alpha increased [3H]proline incorporation into type I collagen 24-72 h after the factor was removed; this effect was DNA synthesis dependent and blocked by hydroxyurea. Transient treatment with TNF alpha also increased alkaline phosphatase activity. In contrast, continuous treatment with TNF alpha for 48-96 h caused a marked inhibition on [3H]proline incorporation into type I collagen and alkaline phosphatase activity. TNF alpha caused a small increase in collagen degradation. Lymphotoxin had similar effects to those of TNF alpha. In conclusion, TNF alpha stimulates calvarial DNA synthesis which causes an increased number of collagen synthesizing cells, but TNF alpha has a direct inhibitory effect on osteoblastic function. PMID- 3665834 TI - Social subordinance in wild baboons is associated with suppressed high density lipoprotein-cholesterol concentrations: the possible role of chronic social stress. AB - Atherosclerosis and coronary heart disease are promoted by elevated serum low density lipoprotein cholesterol (LDL-C) and are retarded by increased high density lipoprotein cholesterol (HDL-C). Considerable variability in these lipoproteins has been observed in studies of captive animals subjected to extensive experimental manipulations, or by epidemiological studies of human beings. We have examined these variables in wild male baboons living undisturbed in their natural habitat in the Serengeti Ecosystem of East Africa. Among socially subordinate males, HDL-C and apolipoprotein A-I concentrations were significantly reduced by 31% and 25%, respectively, compared to concentrations in dominant individuals. There were no social rank differences in VLDL + LDL-C or its apolipoprotein (Apo B). Differences in age, sex hormone concentrations, rank related diet, body weight, or gene pools were unlikely to explain this rank related pattern. However, diminished HDL-C concentrations were associated with elevated basal cortisol concentrations, suggesting that exposure of subordinate individuals to elevated levels of social stressors could cause lower HDL-C concentrations. PMID- 3665835 TI - Cellular localization of angiotensinogen gene expression in brown adipose tissue and mesentery: quantification of messenger ribonucleic acid abundance using hybridization in situ. AB - The cellular localization of angiotensinogen messenger RNA (mRNA) in rat atria, aorta, and mesentery was studied using hybridization in situ. Angiotensinogen mRNA was identified in periatrial and periaortic brown adipocytes and in fibroblast-like cells of periaortic connective tissue and mesentery. Angiotensinogen gene expression in brown adipose tissue was confirmed by both Northern blot analysis and cell-free translation of RNA extracted from brown adipose tissue. For control rats, the level of angiotensinogen mRNA of brown adipose tissue, quantitated by Northern blot analysis, was 5% of the level in liver and showed a 12-fold increase in response to treatment with the combination of dexamethasone, ethynylestradiol, and T3. Comparison of the relative amounts of angiotensinogen mRNA detected by hybridization in situ in liver and brown adipose tissue, with the amounts determined by Northern blot analysis, revealed that hybridization in situ detected mRNA in brown adipose tissue with higher efficiency than in liver. These results suggest a role for angiotensinogen gene expression in brown adipose tissue function. In addition, these studies show that tissue-specific factors may modify the efficiency of detection of tissue mRNA using hybridization in situ. PMID- 3665836 TI - Stabilization, partial purification, and characterization of thyrotropin receptors in solubilized guinea pig fat cell membranes. AB - Specimens obtained during the course of efforts to purify the TSH receptor in guinea pig fat cell membranes solubilized with Triton X-100 displayed extensive loss of TSH binding activity, analogous to that seen by others during the purification of the TSH receptor in thyroid membranes. Therefore, as a preliminary to efforts to purify the TSH receptor in solubilized fat cell membranes (SFCM), experiments were undertaken to ascertain the factors responsible for this loss of binding activity and to find means for its prevention. Temperature proved to be the most important variable. SFCM stored at 70 C retained their activity with respect to the binding of bovine TSH (bTSH) for months, but binding activity was rapidly lost during storage of SFCM at 4 C, a loss due to a decrease in receptor number rather than binding affinity. Loss of binding activity during storage of SFCM at 4 C was unaffected by the addition of 1 mM cystine and was only slightly and temporarily retarded by a mixture of three protease inhibitors (phenylmethylsulfonyl fluoride, aprotinin, and leupeptin). These results indicated that loss of TSH receptors during storage at 4 C is not due to reduction of disulfide bonds or to proteolytic degradation. On the other hand, activity of the receptor was largely or entirely preserved during at least a week of storage at 4 C by the formation of a TSH-TSH receptor complex, by the addition of 40-50% glycerol either during solubilization or immediately thereafter, or by lyophilization immediately after solubilization. Receptors preserved by these three measures retained their original affinity for bTSH and their response to the TSH binding inhibitory activity of Graves'-immunoglobulin G. In the light of these results, SFCM were prepared in 40% glycerol and then subjected to TSH-affinity gel chromatography. The resulting materials contained at least 29.3% of the original binding activity, and their specific TSH binding activity was increased 227-fold. Saturation analysis of [125I]bTSH binding to this preparation revealed an association constant (Ka) (2.2 x 10(9) M-1), very similar to that in the original SFCM preparation. Binding of [125I]bTSH was inhibited in a dose-dependent manner by Graves'-immunoglobulin G, and in multiple preparations of the latter, TSH binding inhibitory activity measured in the affinity-purified receptor preparation was closely correlated with that measured in SFCM.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3665837 TI - A dose-response study of the effects of biosynthetic human growth hormone on formation and strength of granulation tissue. AB - The dose-response relationship between biosynthetic human GH (b-hGH) and biomechanical properties (maximum stress, strain at maximum stress, relative failure energy, and maximum stiffness) and collagen deposition of granulation tissue in sc implanted cellulose sponges were investigated after 7 days of implantation in female rats. GH was administered in doses of 0.5, 2.0, and 8.0 mg/kg body weight/day. In the first part of the experiment, treatment with b-hGH started 7 days before implantation of the sponges, in the second part at the day of implantation, and for the 2.0 mg also 2 days before implantation. When b-hGH treatment was started 7 days before implantation, collagen deposition, maximum stress, and maximum stiffness were increased in the sponges from all the hormone treated groups. In the group treated with 2.0 mg b-hGH/kg body weight.day, also an increase in failure energy was found. When b-hGH treatment was started at the day of implantation or 2 days before implantation, no differences in collagen deposition and biomechanical parameters were found. B-hGH treatment resulted in an increased weight gain in all three groups in the period before implantation, but only 8.0 mg b-hGH/kg body weight resulted in an increased weight gain during the following implantation period. The groups starting hormone treatment at the day of implantation showed an increased weight gain during the implantation period. The study shows that mechanical strength and collagen formation in sc implanted cellulose sponges in rats are increased by b-hGH when treatment is started 7 days before implantation with a maximum increase at a dose of 2.0 mg b hGH/kg body weight.day. PMID- 3665838 TI - Progesterone receptor regulation by 17 beta-estradiol in human endometrial carcinoma grown in nude mice. AB - Regulation of progesterone receptor (PR) in human endometrial carcinoma was investigated in vivo in a multisite nude mouse tumor experimental system by estrogen administration and withdrawal. The cytosolic PR concentration was low in tumors grown in the absence of 17 beta-estradiol, but increased rapidly upon estrogen administration, reaching a maximal receptor concentration of 1.4-1.6 pmol/mg cytosol protein within 7 days. Protein blot analysis using a monoclonal antibody (hPRa 1) raised against PR from EnCa 101 showed no immunoreactivity in tumors grown in the absence of estrogen. Immunoreactive proteins of mol wt 116,000 and 81,000 were detectable 8 h after estrogen administration and increased in intensity as the cytosolic PR concentration increased. Interestingly, the protein of mol wt 116,000 was composed of mol wt isoforms and was detectable as a doublet 8 h after estrogen administration and finally as a triplet. The effect of estrogen withdrawal on EnCa 101 PR concentration and structure was determined by removal of 17 beta-estradiol pellets (200 pg/ml plasma) from EnCa 101-bearing animals after achievement of maximal tumor PR concentrations. The PR concentration in tumor cytosols decreased in a biphasic manner after estrogen removal, with the initial rapid phase having a half-life of around 2 days. Cytosolic PR was still detectable 21 days after estrogen withdrawal. Protein blot analysis showed that immunoreactive proteins of mol wt 116,000 and 81,000 were also detectable up to that time. Photoaffinity labeling with [3H]R5020 demonstrated that the 81,000 mol wt protein, as well as each of the triplet proteins at mol wt 116,000, was specifically photoaffinity labeled. The 116,000-mol wt protein was detected as a triplet on protein blots until 13 days after estrogen withdrawal, when diminution in the intensity of the highest mol wt triplet protein was noted. PMID- 3665839 TI - 1,25-Dihydroxyvitamin D3 enhances phorbol ester-stimulated differentiation and protein kinase C-dependent substrate phosphorylation activity in the U937 human monoblastoid cell. AB - In the U937 human monoblastoid cell line, 1,25-dihydroxyvitamin D3[1,25(OH)2D3] through a specific interaction with the 1,25(OH)2D3 receptor promotes differentiation toward a more mature phenotype. In addition to this direct effect, 1,25(OH)2D3 also potentiates differentiation in response to lymphokines and (Bu)2cAMP. We examined the effect of 1,25(OH)2D3 on phorbol ester-stimulated differentiation. Either preincubation with or simultaneous exposure to 1,25(OH)2D3 enhanced phorbol ester-stimulated differentiation. Over a 72-h period, the increase in phorbol ester responsiveness was dependent on the duration of 1,25(OH)2D3 exposure. Enhancement of phorbol ester-induced differentiation was observed with 1,25(OH)2D3 concentrations ranging from 0.1-10 nM. The 1,25(OH)2D3 vitamin D metabolite was more potent than the 24,25 dihydroxyvitamin D3 and 25-hydroxyvitamin D3 metabolites in potentiating phorbol ester-induced differentiation. Phorbol esters can exert at least a portion of their effects on cellular function by activating protein kinase C. Thus, one mechanism by which 1,25(OH)2D3 could amplify signal transduction leading to potentiation of phorbol ester-stimulated differentiation would be by enhancing phorbol ester-stimulated phosphorylation. To examine this possibility, we measured protein kinase C-dependent substrate phosphorylation in extracts derived from cells pretreated with 1,25(OH)2D3. In extracts derived from cells treated with 1,25(OH)2D3, the protein kinase C-dependent phosphorylation of endogenous U937 substrates stimulated by calcium, phosphatidyl serine, and diolein was increased compared to that observed in vehicle-treated cells. The conditions required for 1,25(OH)2D3 to increase protein kinase C-dependent phosphorylation of endogenous substrates (concentration, duration of exposure, and metabolite specificity) were similar to those required to enhance phorbol ester-stimulated differentiation. Possibly mediating this enhanced phosphorylation was an increase in protein kinase C activity observed in extracts derived from 1,25(OH)2D3 treated cells. PMID- 3665840 TI - Administration of pharmacological amounts of 25(s),26-dihydroxyvitamin D3 reduces serum 1,25-dihydroxyvitamin D3 levels in rats. AB - Pharmacological amounts of 25(s),26-dihydroxyvitamin D3 were administered to normal, vitamin D-replete rats in order to assess its pharmacological activity. Treatment with 25(s),26-dihydroxyvitamin D3 (20 micrograms/day for 1 week) caused a marked and significant fall in the circulating concentration of 1,25 dihydroxyvitamin D (16 +/- 5 SEM vs. 28 +/- 4 pg/ml, P = 0.02). This reduction of 1,25-dihydroxyvitamin D was dependent on the dose of 25,26-dihydroxyvitamin D3 administered since a 5 micrograms/day dosing regimen failed to alter serum 1,25 dihydroxyvitamin D levels. Despite the 25-66% reduction in circulating 1,25 dihydroxyvitamin D concentration produced by 25,26-dihydroxyvitamin D3 therapy, serum calcium and intestinal calcium absorption remained normal. These results suggested that 25,26-dihydroxyvitamin D has a weak agonist action or that a further metabolite that stimulates bone calcium resorption and/or intestinal calcium absorption is formed. Rats predosed with 25,26-dihydroxyvitamin D3 (20 micrograms/day) for 4 days and subsequently dosed with both 1,25-dihydroxyvitamin D3 (0.15 micrograms/day) and 25,26-dihydroxyvitamin D3 for an additional 3 days, demonstrated serum 1,25-dihydroxyvitamin D levels significantly higher than that found for control rats (47 +/- 5 vs. 25 +/- 4 pg/ml, P less than 0.001) but significantly reduced from the value observed for rats receiving only 1,25 dihydroxyvitamin D3 (47 +/- 5 vs. 187 +/- 38 pg/ml, P less than 0.001). These results suggest that 25,26-dihydroxyvitamin D3 has a previously unrecognized action in affecting the metabolism of 1,25-dihydroxyvitamin D3. PMID- 3665841 TI - Growth of rat seminal vesicle epithelial cells in culture: neurotransmitters are required for androgen-regulated synthesis of tissue-specific secretory proteins. AB - Epithelial cells from enzymically dispersed seminal vesicle tissue of castrated adult rats were grown on collagen-coated surfaces in serum-containing medium for up to 6 weeks. Androgens were neither required for growth nor were they mitogenic. They also failed to induce the synthesis of tissue-specific secretory proteins that serve as markers of androgen action in vivo. A variety of potential growth factors and culture procedures (such as feeder layers, extracellular matrices, collagen gels, and growth from tissue explants) were examined for their ability to support androgen action. Testosterone and 5 alpha-dihydrotestosterone were only able to induce seminal vesicle secretory protein synthesis in the presence of neurotransmitters (acetylcholine, noradrenaline, or serotonin). The mechanism of this permissive effect of neurotransmitters on androgenic induction has been examined. It is not related to their mitogenic activity since other mitogens (epidermal growth factor and corticosterone) did not facilitate androgen action. Agents that raise intracellular cAMP were also ineffective so cAMP is probably not involved, but the phosphatidyl inositol pathway may be important. PMID- 3665842 TI - Dexamethasone increases adenylyl cyclase activity and expression of the alpha subunit of Gs in GH3 cells. AB - Glucocorticoids regulate responsiveness of many different cells and tissues to hormones that act by stimulating adenylyl cyclase. In a rat pituitary cell line, GH3, exposure to dexamethasone (150 mM for 72 h) doubled the specific activity of adenylyl cyclase in membrane extracts, whether the enzyme was stimulated by guanine nucleotides, vasoactive intestinal peptide, or forskolin. Dexamethasone treatment of GH3 cells also caused a 5-fold increase in RNA encoding the alpha chain of Gs (alpha s) as well as a 2-fold increase in membrane-bound alpha s polypeptide, measured by either of two assays: 1) Biochemical complementation of the alpha s deficiency of S49 lymphoma cyc- membranes in vitro; 2) Cholera toxin catalyzed ADP ribosylation of 45- and 52-kilodalton alpha s-polypeptides. These observations suggest that glucocorticoid-induced enhancement of adenylyl cyclase activity in GH3 cells is mediated, at least in part, by increased expression of alpha s. PMID- 3665843 TI - Detection and high performance liquid chromatography identification of the summer rises of vasopressin and oxytocin immunoreactivity in the rat pineal gland. AB - The vasopressin (VP) and oxytocin (OT) contents of the rat pineal gland during the summer period were determined by RIAs. Both the levels of VP immunoreactivity and OT immunoreactivity rose markedly in August. The highest level of VP immunoreactivity occurred on August 6 [82 +/- 19 fmol/gland (+/- SEM)], compared to basal levels of 14 +/- 2 fmol/gland. Basal levels of OT immunoreactivity of 20 +/- 8 fmol/gland increased to a peak level of 193 +/- 72 fmol/gland on August 14. Analysis of immunoreactive components by HPLC demonstrated that rises were due to the peptides coeluting with authentic VP and OT, respectively. Levels of immunoreactive VP and OT in the hypothalamus, pituitary gland, and hippocampus did not show variation during the summer. The results show that the VP and OT content of the pineal gland is regulated in a tissue-specific fashion by seasonal influences. PMID- 3665844 TI - Fecal and urinary excretion of six iodothyronines in the rat. AB - Fecal and urinary excretion rates of six iodothyronines were assessed in the rat maintained under normal steady state physiological conditions, to gain a more comprehensive understanding of the mechanisms of control of normal thyroid hormone economy and metabolism. Groups of young adult male rats were injected with trace doses of T4, T3, rT3, 3,3'-diiodothyronine (T2), 3',5'-T2, or 3' monoiodothyronine, each labeled with 125I, and feces and urine were collected separately for up to 10 days. Pooled fecal pellets were homogenized in saline, extracted in ethanol, evaporated under vacuum, and reconstituted in NaOH. Fecal extracts and urine were chromatographed on Sephadex G25 columns under conditions providing quantitative separations of components of interest. A new technique was also developed, based on a model of the in vitro extraction and measurement process, to correct chromatographic results for possible variable recoveries and possible artifactious degradation of radioactively labeled components. No iodothyronines or their conjugates were excreted in urine; all radioactivity was in the form of iodide. In feces, about 30% of the [125I]T3 injected was excreted as T3; and 24% of the [125I]T4 injected was excreted as T4, plus 4% as T3. Together, these results imply that about 24% of endogenous T4 production is excreted as T4 and 76% is irreversibly metabolized; and for T3, about 30% of endogenous T3 production is excreted as T3 and 70% is degraded. For the nonhormonal iodothyronines, about 6% of injected monoiodothyronine, 3% of injected 3',5'-T2, 2% of injected 3,3'-T2, and less than 1% of injected rT3 were excreted in feces as such, indicating that these substances are nearly completely deiodinated in vivo. Very little (1-7%) iodide was excreted as such in feces, which also were devoid of measurable conjugates. An open question is whether the substantial wastage of thyroid hormones in feces represents poor hormone economy in the usually accepted sense or a functional property of overall thyroid hormone regulation. PMID- 3665845 TI - Characterization of the estrogen-induced pS2 protein secreted by the human breast cancer cell line MCF-7. AB - Our laboratory has reported previously the cloning of a complementary DNA termed pS2, corresponding to a messenger RNA (mRNA) whose synthesis is induced by estrogen in the human breast cancer cells MCF-7. Examination of the possible open reading frames of this complementary DNA has led to the prediction that the pS2 protein could be a secreted polypeptide of either 58 or 63 amino acids in length. Using a rabbit antiserum prepared against a synthetic peptide corresponding to the last 31 amino acids of the putative protein, we show that a protein with the expected migration during sodium dodecyl sulfate gel electrophoresis can indeed be immunoprecipitated from either the culture medium of MCF-7 cells grown in the presence of labeled amino acids or the in vitro translation products of MCF-7 poly(A) RNA enriched in pS2 mRNA. Furthermore, in vivo and in vitro differential amino acid labeling allows us to conclude that the mature pS2 protein is probably secreted as a 58 amino acid long peptide. Finally, we show that pS2 protein synthesis is induced in MCF-7 cells by estradiol and phenol red, but not by the antiestrogen tamoxifen, in keeping with our previous results demonstrating estrogen induction of pS2 mRNA synthesis. PMID- 3665846 TI - Inhibition by melittin and fluphenazine of melanotropin receptor function and adenylate cyclase in M2R melanoma cell membranes. AB - Melanotropin (MSH) receptor activity in the M2R mouse melanoma cell line is tightly controlled by calcium by an unknown mechanism. The possibility that calcium regulation is mediated by calmodulin or a calmodulin-related calcium binding protein has been addressed in this report by studying the effects of two known calmodulin antagonists, fluphenazine and melittin, on MSH receptor function. Stimulation of adenylate cyclase (AC) in M2R plasma membranes by beta MSH was strongly inhibited by both antagonists. The concentrations of fluphenazine and melittin yielding half-maximal inhibition (IC50) of AC were 16 microM and 2.4 microM, respectively. Both fluphenazine and melittin also inhibit prostaglandin E1-, GTP gamma S, and forskolin-stimulated AC activity, as well as that of unstimulated enzyme, although inhibition is shown to occur at significantly higher concentrations of antagonist. We have shown that the calcium dependent rate-limiting step in MSH stimulation of adenylate cyclase, that of hormone binding, is strongly inhibited by these antagonists at concentrations identical to, if not lower than, those required for the inhibition of AC activity (fluphenazine-IC50, 14 microM; melittin-IC50, 0.7 microM). The actions of these antagonists, furthermore, appear to be calcium insensitive, as melittin affects the stability of both the high affinity (calcium containing) and low affinity (calcium depleted) receptor-MSH complexes. The sensitivity of the MSH receptor to inhibition by calmodulin antagonists resembles that described for purified calmodulin-sensitive enzyme systems, which suggests a possible role for calmodulin in MSH receptor function. Among peptide hormone receptors, this effect by calmodulin antagonists appears to be unique for the MSH receptor. PMID- 3665847 TI - Immunocytochemical localization of estrogen receptors in the normal male and female canine urinary tract and prostate. AB - We have used the monoclonal estrogen receptor (ER) antibody H222Sp gamma to localize ER by immunocytochemistry in frozen sections of the normal canine urinary tract of both sexes and of the normal prostate of the male. Striking regional heterogeneity of ER location was observed. In the urinary tract, specific ER staining was confined to nuclei of the transitional epithelium (mucosa) and subjacent stroma (submucosa) of the prostatic urethra in the male dog and of the proximal urethra in the female dog. In both sexes there was a gradient of ER staining intensity along these urethral segments. In the male, ER staining intensity was highest in the region of the verumontanum. The pattern and intensity of staining were similar in the male prostatic urethra and female proximal urethra, indicating a similar concentration of ER in these tissues, which have the same embryological origin. No specific staining was found in the kidney, ureter, bladder, or distal urethra of either sex. In the normal prostate, specific immunocytochemical ER staining was confined to nuclei of the prostatic stroma and prostatic ductal epithelium. Specific staining intensity appeared to be higher in the periurethral region of the prostate than in the periphery. No specific staining was found in the acinar epithelium of the prostate. Based on overall staining intensity there appeared to be a higher concentration of ER in the urethra than in the prostate. Scatchard analysis of [3H]estradiol binding confirmed a similar ER content in the urethra of male and female dogs and a higher ER content in the prostatic urethra than in the prostate itself (P less than 0.001). The location of ER in the normal canine prostate and prostatic urethra is consistent with the location of histological changes induced by estrogen administration, indicating that these immunoreactive ER probably represent biologically functional receptors. PMID- 3665848 TI - Immunocytochemistry versus binding assays of the estrogen receptor in the reproductive tract of spayed and hormone-treated macaques. AB - We used immunocytochemistry (ICC) with monoclonal antibodies to the estrogen receptor (ER) to localize ER in the oviducts, uteri, and cervix of untreated, estrogen-treated, and estrogen-progestin-treated spayed macaques. We also used binding assays with labeled estrogens to quantify nuclear and cytosolic ER levels in parallel samples of the same tissues. In untreated spayed animals, cytosolic ER levels were much higher than nuclear ER levels, but all specific staining was nuclear. After treatment for 14 days with estradiol (E2), the degree of staining for ER in cell nuclei in the oviduct, cervix, and endometrium had increased, and there were significant increases in both nuclear and cytosolic ER levels. In the myometrium, ER levels and ICC staining of nuclei increased minimally with E2 treatment. In animals treated for 2 weeks with E2 followed by 2 weeks with E2 and progesterone (P; sequential P treatment) the degree of nuclear ER staining in the oviduct, endometrium, and cervix greatly decreased, and cytosolic and nuclear levels of ER declined significantly. In the myometrium of such animals there was a minimal decrease in the degree of staining and a nonsignificant decline in cytosolic and nuclear ER levels. Sequential P treatment reduced the degree of nuclear staining in the oviduct and endometrium below that found in spayed animals; however, such treatment only lowered the amount of cytosolic, not nuclear, ER significantly below spayed levels in those same tissues. Some animals were treated sequentially with P and sampled 1, 3, 12, and 24 h after the onset of P treatment. By 1 h, nuclear ER levels in the endometrium were significantly suppressed, but cytosolic levels were not lowered until 3 h of treatment; ICC staining was also not substantially reduced until 3 h of P treatment. In the oviduct, nuclear ER levels were significantly reduced by 1 h of P treatment, but cytosolic levels were not lowered until after 12-24 h of P treatment; the degree of nuclear staining in the oviduct was also not substantially reduced until 12-24 h of P treatment. In myometrium, there was no significant decline in ER in nuclear or cytosolic fractions or any substantial decrease in the degree of nuclear staining at any time during this treatment. These observations suggest that the ER detected by ICC in the nuclei of target cells in frozen sections represents the total ER detectable by binding assays in cytosolic and nuclear fractions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3665849 TI - Antihuman growth hormone (GH) antibodies cross-react with the GH-like factor from plerocercoids of the tapeworm Spirometra mansonoides. AB - A factor produced by the plerocercoid stage of S. mansonoides mimics some, but not all, of the actions reported for hGH. The biological actions of plerocercoid growth factor (PGF) suggest structural similarity to human GH (hGH). Plerocercoid membranes were solubilized, and PGF was purified more than 1000-fold by hGH receptor affinity chromatography. The ability of purified PGF to displace [125I]hGH from monoclonal antibodies specific for four distinct nonoverlapping antigenic determinants of hGH and from an anti-hGH polyclonal antibody was tested in liquid phase RIA. All of the hGH antibodies cross-reacted with PGF, with potencies ranging from more than 60% to less than 1% that of the hGH standard. Of the four major epitopes of hGH defined by the monoclonal antibodies used in this study, only one is not represented to a significant extent in PGF. The epitope of hGH that is only marginally present in PGF is highly conformationally dependent, and a minor difference in the structure of PGF (compared to hGH) could result in a significant conformational change. The dramatic cross-reactivity between anti hGH antibodies and PGF suggests that the similarities in biological activities between these two substances are based in significant molecular homology. PMID- 3665850 TI - On the nomenclature of the somatomedins and insulin-like growth factors. PMID- 3665851 TI - Tracheal mucociliary transport in laboratory mice: evidence for genetic polymorphism. AB - Mean tracheal transport velocities of inhaled 3 mu coumarin-bound monodisperse latex spheres, measured by epi-fluorescence through the intact trachea of anesthetized mice, were 2.29 +/- 0.52 mm/min for C57BL/6J, 0.40 +/- 0.42 mm/min for DBA/2J mice and 1.47 +/- 0.87 mm/min for (C57BL/6J X DBA/2J) F1 mice. A nonparametric analysis of the observed proportions of mice expressing parental phenotypes in second filial, two first backcross and one second backcross generations confirmed the polymorphism to be genetically determined and consistent with a single-locus mode of inheritance. PMID- 3665852 TI - The pulmonary antibody-forming cell response in the guinea pig after intratracheal immunization. AB - Guinea pigs were immunized by an intratracheal instillation of 5 X 10(9) sheep red blood cells (sRBCs) with or without the immunoadjuvant maleic vinyl ether-2 (MVE). At 6 days post immunization, a peak IgM antibody-forming cell (AFC) response was detected in lung-associated lymph nodes (LALNs), lung tissue, lavage fluid, blood, and spleen. The time course of the response in the LALNs was similar to that of the response of the popliteal lymph node after footpad immunization. The use of MVE significantly enhanced this response. In addition, immunization with the sRBCs enhanced the phagocytic activity of the lung macrophages. The magnitude and kinetics of the AFC response seen in the guinea pig lung is compared to the response seen in other animals. PMID- 3665853 TI - Features of developing ferret tracheal epithelium: ultrastructural observations of in vivo and in vitro differentiation of ciliated cells. AB - Ultrastructural features of the developing, surface epithelium of ferrets from birth to 28 days of age were characterized. Progressive ciliogenesis in vivo was observed, beginning with cells covering the membranous portion of the trachea. Emerging cilia appeared in ultrathin sections and by scanning electron microscopy at sites correlating with accumulation of integral membrane particles seen in freeze-fracture preparations. Two patterns of ciliogenesis were observed: (1) the random emergence of cilia over the apical cell surface, and (2) initial emergence of cilia at the peripheral boundary of the luminal border of individual cells. Novel, ringlike structures were observed on the surfaces of nonciliated cells at all ages studied. Active ciliogenesis as well as the appearance of ring structures also were documented in the superficial epithelium from 1- to 5-day old animals maintained in vitro for up to 4 days. PMID- 3665854 TI - Comparative Ovarian Pathology Conference. September 24-25, 1985, Research Triangle Park, NC. PMID- 3665855 TI - Mesovarian leiomyomas in the rat. AB - Prolonged treatment with two chemically distinct beta-stimulants, Salbutamol and Terbutaline, resulted in mesovarian leiomyomas in Sprague-Dawley rats. Development of these tumors induced by Salbutamol was prevented by concurrent administration of the beta-blocker Propranolol. Mesovarian leiomyomas induced by Salbutomol did not show any regression or progression during a 44-week postdosing recovery period. This report also gives the first recorded incidence of spontaneous mesovarian leiomyomas in the rat. PMID- 3665856 TI - Experimental induction of ovarian Sertoli cell tumors in rats by N-nitrosoureas. AB - Spontaneous ovarian tumors are very rare in ACI, Wistar, F344 and Donryu rats; the few neoplasms found are of the granulosa/theca cell type. Ovarian tumors were also rare in these strains of rats when given high doses of N-alkyl-N nitrosoureas continuously in the drinking water for their life-span; however, relatively high incidences of Sertoli cell tumors or Sertoli cell tumors mixed with granulosa cell tumors were induced in Donryu rats after administration of either a 400 ppm N-ethyl-N-nitrosourea solution in the drinking water for 4 weeks or as a single dose of 200 mg N-propyl-N-nitrosourea per kg body weight by stomach tube. Typical Sertoli cell tumors consisted of solid areas showing tubular formation. The tubules were lined by tall, columnar cells, with abundant, faintly eosinophilic, often vacuolated cytoplasm, and basally oriented, round nuclei, resembling seminiferous tubules in the testes. In some cases, Sertoli cell tumor elements were found mixed with areas of granulosa cells. The induction of ovarian Sertoli cell tumors in Donryu rats by low doses of nitrosoureas may provide a useful model for these tumors in man. PMID- 3665857 TI - Ovarian toxicity and carcinogenicity in eight recent National Toxicology Program studies. AB - Ovarian toxicity and/or carcinogenicity has been documented for at least eight chemicals recently tested in National Toxicity Program prechronic and chronic rodent studies. The chemicals that yielded treatment-related ovarian lesions were 1,3-butadiene, 4-vinylcyclohexene, vinylcyclohexene deipoxide, nitrofurantoin, nitrofurazone, benzene, delta-9-tetrahydrocannabinol, and tricresylphosphate. Typical nonneoplastic ovarian changes included hypoplasia, atrophy, follicular necrosis, and tubular hyperplasia. The most commonly observed treatment-related neoplasms were granulosa cell tumors and benign mixed tumors. A relationship between antecedent ovarian hypoplasia, atrophy, and hyperplasia and subsequent ovarian neoplasia is supported by some of these National Toxicology Program studies. Pathologic changes in other tissues such as the adrenal glands and uterus were associated with the treatment-related ovarian changes. PMID- 3665858 TI - Experimental studies on health effects of nitrogen oxides. PMID- 3665859 TI - Classification of human ovarian tumors. AB - Most human ovarian tumors are classified into one of several categories based on presumed histogenesis and direction of differentiation. Separate categories are reserved for neoplasms composed of cells of several origins and for nonneoplastic disorders that simulate neoplasms. Using the World Health Organization Histologic Classification of Ovarian Tumors, histologic features for common and rare human ovarian tumors are described and illustrated. PMID- 3665860 TI - Effects of long-term nitrogen dioxide exposure on rat lung: morphological observations. AB - Rats continuously exposed to NO2 at 0.04, 0.4, and 4.0 ppm for as long as 27 months were submitted to morphological observation and electronmicroscopic morphometry of the lung. At 4 ppm exposure for 9 months, bronchial epithelium showed typical proliferation, which progressed further at 18 months. At this stage, proliferation of type II alveolar epithelium and edematous extension of interstitial tissue were evident and yielded fibrosis at 27 months. At 0.4 ppm, morphological changes in 18-month specimens were still ambiguous, although a tendency toward epithelial changes, as well as interstitial edema of the alveolar wall, was noticed under the electron microscope. Slight but definite alteration of the epithelium became evident after 27 months. At 0.04 ppm there were no remarkable changes throughout the entire exposure period. The morphometry revealed concentration- and duration-dependent increases in arithmetic mean thickness (AMT) of the alveolar wall. At 4 ppm, increase of AMT started as early as 9 months, became significant at 18 months, and showed a slight decrease at 27 months. This decrease was interpreted as a recovery of alveolar epithelium and decreased amount of septal edema, which in turn led to fibrosis. At 0.4 ppm, a slight increase of AMT started at 18 months and extended significantly in 27 months. A similar but insignificant tendency was found even at 0.04 ppm. The morphological alterations were parallel to the concentration and duration of exposure. These findings suggested that an intensive study should be conducted to confirm whether alterations were due to prolonged exposure and/or due to elevated sensitivity of the aged lung. PMID- 3665861 TI - A kinetic study on functional impairment of nitric oxide-exposed rat erythrocytes. AB - In acute in vivo exposure of rats to 25 to 250 ppm nitric oxide (NO) by use of a small exposure chamber for a single rat, the kinetic parameters of nitrosylhemoglobin (Hb-NO) and methemoglobin (MetHb) formation were estimated (with the aid of computer simulation) on the basis of experimental data. The biochemical and rheological injuries of erythrocytes were also examined. The time course of Hb-NO and MetHb formation in blood was compared with that simulated by a simplified kinetic model. The rate of MetHb formation from Hb-NO was much faster than MetHb reduction to ferrous form and dissociation of Hb-NO; thus, MetHb content was always greater than Hb-NO content. The activity of MetHb reduction decreased on exposure to a high concentration of NO, but the activity was recovered when rats were placed in clean air. Rheologically, the blood viscosity was scarcely altered, but a few undeformed cells were detected at high shear stress. Morphologically, echinocytic transformation was observed to some extent. Biochemically, the crosslinking of membrane proteins and the alteration of acyl chain composition of membrane phospholipids were not detected in the in vivo exposure, though the in vitro exposure of rat erythrocytes to high concentrations of NO revealed remarkable oxidative crosslinking among membrane proteins and hemoglobin. In conclusion, both for persistent methemoglobinemia and for membrane damage, the maintenance of reductive activity in erythrocytes is the most important determinant factor for the protection of NO-induced oxidative injury. PMID- 3665862 TI - Lipid peroxidation and antioxidative protection mechanism in rat lungs upon acute and chronic exposure to nitrogen dioxide. AB - This work was done to clarify the relation between the changes of lipid peroxidation and the activities of antioxidative protective enzymes in lungs of rats exposed acutely, subacutely, and chronically to nitrogen dioxide. It was confirmed that the activities of the antioxidative enzymes to protect cells from oxidative stress increased in an early phase, and then the activities decreased gradually. Lipid peroxides increased once in an early phase and then returned to the control level; thereafter, lipid peroxides increased gradually again. Lipid peroxidation as measured by ethane exhalation increased significantly with 0.04, 0.4, and 4 ppm nitrogen dioxide exposure for 9, 18, and 27 months, and a dose response relationship was clearly observed. The temporal changes of lipid peroxidation varied inversely with that of the activities of antioxidative protective enzymes. From these results, it was suggested that the increments of antioxidative protective enzyme activities in an early phase were complementary effects to protect cells from damage by lipid peroxides which were increased by nitrogen dioxide exposure, and that the complementary effects are lost in later phases of life-span exposure. Finally, loss of such protective complementary effects might relate to some chronic diseases in lungs. Therefore, the temporal changes described above are important characteristics in chronic exposure of air pollutants. PMID- 3665863 TI - Biotransformation of nitric oxide. AB - Previous investigations into the health effects of nitrogen oxides (NOx) have mostly been conducted with special reference to nitrogen dioxide (NO2) and its direct effects on the respiratory system, while the study of nitric oxide (NO) has been disregarded. We carried out a study on NO by exposing rats and mice to 15NO or administering 15N-nitrite and 15N-nitrate to these animals by IP injection in order to elucidate the metabolic fate of NO. The results of our study and previous findings led us to assume that the major metabolic path of inhaled NO is as follows: inhaled NO reacts with hemoglobin, forming nitrosyl hemoglobin (NOHb), and from NOHb, nitrite (NO2-) and nitrate (NO3-) are generated. Major quantities of NO3- are discharged into the urine and a certain amount is discharged into the oral cavity through the salivary glands and transformed to NO2-. Part of this NO2- is converted to N2 gas in the stomach. Nitrate in the intestine is partly reduced to ammonia (NH3) through NO2-, reabsorbed into the body, and converted to urea. Most of the metabolites of inhaled NO are excreted rapidly from the body within 48 hr. PMID- 3665865 TI - Chemical and toxicological characterization of residential oil burner emissions: I. Yields and chemical characterization of extractables from combustion of No. 2 fuel oil at different Bacharach Smoke Numbers and firing cycles. AB - Particulates and complex organic mixtures were sampled from the exhaust of a flame retention head residential oil burner combusting No. 2 fuel oil at three firing conditions: continuous at Bacharach Smoke No. 1, and cyclic (5 min on, 10 min off) at Smoke Nos. 1 and 5. The complex mixtures were recovered by successive Soxhlet extraction of filtered particulates and XAD-2 sorbent resin with methylene chloride (DCM) and then methanol (MeOH). Bacterial mutagenicity [see Paper II (8)] was found in the DCM extractables. Samples of DCM extracts from the two cyclic firing conditions and of the raw fuel were separated by gravity column chromatography on alumina. The resulting fractions were further characterized by a range of instrumental methods. Average yields of both unextracted particulates and of DCM extractables, normalized to a basis of per unit weight of fuel fired, were lower for continuous firing than for cyclic firing. For cyclic firing, decreasing the smoke number lowered the particulates emissions but only slightly reduced the average yield of DCM extractables. These and similar observations, here reported for two other oil burners, show that adjusting the burner to a lower smoke number has little effect on, or may actually increase, emissions of organic extractables of potential public health interest. Modifications of the burner firing cycle aimed at approaching continuous operation offer promise for reducing the amount of complex organic emissions. Unburned fuel accounted for roughly half of the DCM extractables from cyclic firing of the flame retention head burner at high and low smoke number. Large (i.e., greater than 3 ring) polycyclic aromatic hydrocarbons (PAH) were not observed in the DCM extractables from cyclic firing. However, nitroaromatics, typified by alkylated nitronaphthalenes, alkyl-nitrobiphenyls, and alkyl-nitrophenanthrenes were found in a minor subfraction containing a significant portion of the total mutagenic activity of the cyclic low smoke samples (8). Oxygen-containing PAH, typified by phenalene-1-one and its alkyl derivatives, are important mutagens from cyclic firing at high smoke conditions. Thus, oil burner effluents differ markedly from those of several other combustors, including the automotive diesel engine, where multiring PAH, typified by fluoranthene and alkylated phenanthrenes, account for a significant portion of the effluent mutagenicity. Implications for combustion and emissions source identification are discussed. PMID- 3665864 TI - Seasonal changes in lead absorption in laboratory rats. AB - A retrospective study of the relationship of season to the absorption of radiolead in laboratory rats was performed using data representing 305 animals from 36 experiments over 6 calendar years. Male Wistar rats weighing 200 to 250 g were given 1 microgram of radiolabeled lead in an aqueous solution, pH 4.0, in isolated small intestine, and absorption of the radiolead was quantified after a 4-hour interval using whole-body counting. Similar values of absorption occurred in the summer (June-August) and fall (September-November), 20.51 +/- 1.11% (1 SEM) and 23.0 +/- 1.23% of the test dose, respectively, but significantly lower values occurred in the winter (December-February) and spring (March-May): 16.51 +/- 0.77%, p less than 0.01, and 11.87 +/- 0.99%, p less than 0.01, respectively. Harmonic analysis yielded an excellent approximation of the mean quarterly absorption data. The resulting cosine function had a period of 4.08 +/- 0.05 quarter-years with an amplitude of 7.32 +/- 1.06%; predicted peak absorption values fell precisely between summer and fall. The relationships of these observations to possible mechanisms of lead absorption and to summertime epidemics of lead poisoning in children are discussed. PMID- 3665866 TI - Chemical and toxicological characterization of residential oil burner emissions: II. Mutagenic, tumorigenic, and potential teratogenic activity. AB - Extracts of effluents from a modern residential oil burner have been evaluated in several toxicological assay systems. Bacterial mutagens were detected in extracts from both the particulate and vapor phase emissions. Effluents from continuous operation were an order of magnitude less mutagenic than those from cyclic (5 min on, 10 min off) operations. No difference in the yield of bacterial mutagens per gram of fuel burned was found between cyclic operation under low and moderate sooting conditions. On the basis of elution behavior from alumina it appeared that the bacterial mutagens collected from high sooting effluents were more polar than those from low sooting effluent. An extract that was mutagenic in bacteria did not induce a significant increase in mutation frequency to human lymphoblasts. No evidence of tumorigenicity was observed in a limited number of newborn mice after IP injection of effluent extract when compared to historical control data. Putative nonmutagenic teratogens were detected in effluent using an attachment inhibition assay. The level of these agents was reduced in effluents from continuous oil burner operation. PMID- 3665867 TI - The consequences of parasitic infection for the behavior of the mammalian host. AB - As many as one billion people may be infected with animal parasites. The behavioral consequences of such infection, or of illness in general, is poorly understood. This issue is discussed using as an example infection of mice with Toxocara canis, the common roundworm of dogs. Current literature suggests that two-thirds of all dogs have been infected with this parasite, and 7% of all humans have antibodies to T. canis. T. canis completes its life cycle in dogs, but when it infects aberrant mammalian hosts (e.g., humans or mice), larvae migrate through various organ systems including the brain, where they can remain viable and mobile for extended periods of time. Changes in motor activity, sensory reactivity, and learning of mice infected with T. canis have been observed. The pattern of behavioral changes is influenced by the infection regime and exposure to other toxicants such as lead. PMID- 3665868 TI - Effects of prolonged administration of phthalate ester on the liver. AB - Di(2-ethylhexyl)phthalate (DEHP) was administered to male rats in the diet at concentrations of 2.0, 0.2, and 0.02% for up to 102 weeks. Low doses resulted in moderate increases in certain hepatic enzymes during the initial phase of exposure and in a continuous increase in the activities of these same enzymes throughout the treatment period. An increased level of dolichol and decreased concentration of dolichyl-P were observed. Furthermore, the rate of protein glycosylation diminished. Liver biopsies from patients subjected to hemodialysis demonstrated an increased number of peroxisomes. Phthalate ester seems to interfere with protein turnover, so that the half-life of total mitochondrial and microsomal protein is considerably increased. PMID- 3665869 TI - Ovarian disorders in domestic animals. AB - The histologic appearance of the ovaries and persistence of corpora lutea vary considerably among domestic animals, particularly between spontaneous and induced ovulators. The seasonally polyestrous mare has a variety of unique characteristics in ovarian structure and general reproductive function. Among the anomalies of ovarian development is the bovine freemartin with gonads containing a mixture of male and female elements. A variety of ovarian cysts occur in domestic animals, and persistent corpora lutea with associated reproductive perturbations occur in several species. Ovarian tumors are relatively uncommon in domestic animals, with most examples described in dogs, cats, and horses. These ovarian neoplasms are generally classified as epithelial, germ cell, or sex cord stromal tumors. PMID- 3665870 TI - Ovarian tumors of the hen. AB - Present available information regarding ovarian tumors in hens is incomplete in most aspects, and this lack of knowledge hampers use of hens as models for study of ovarian cancer. A study of 466 hens ranging from 2 to 7 years of age and covering a period of more than 3 years has provided much needed information relative to reproductive tract neoplasia. On the basis of this study, it is apparent that hens have a high rate of ovarian tumors, but that such tumors are uncommon in hens less than 2 years of age. Adenocarcinomas with a high degree of morphologic variability are the most common ovarian tumors in hens. Hormonal imbalance does not appear to be a factor in the development of these adenocarcinomas. Steroidogenic and morphologically distinctive granulosa cell tumors originating from follicles in atrophic ovaries represent another common ovarian tumor type. Unique to the hen are oviductal adenocarcinomas. These tumors arise from the albumin-secreting glands of the oviduct, occur with relatively high frequency, and must be differentiated from ovarian adenocarcinomas. PMID- 3665871 TI - Nonneoplastic lesions of the ovary in Fischer 344 rats and B6C3F1 mice. AB - The National Toxicology Program's pathology database on 2-year carcinogenicity studies was reviewed for nonneoplastic ovarian disease. Ovaries from 39,941 female Fischer rats and 41,444 female B6C3F1 mice were examined. A variety of inflammatory, degenerative, vascular, and proliferative lesions were documented and are described. The most common ovarian lesions in rats were cysts (6%). The most frequent ovarian lesions in mice were cysts (15%), acute inflammation (4%), degeneration (4%), vascular disease (2.5%), and atrophy (2%). There was no difference in incidence of ovarian disease between controls and treated animals. The frequency of ovarian disease in mice exceeded the frequency in rats in every category. PMID- 3665872 TI - Ovarian neoplasms in F344 rats and B6C3F1 mice. AB - The National Toxicology Program (NTP) classification system for rat and mouse ovarian tumors is presented. The classification system is based on previous classification systems and on a review of all the primary ovarian tumors from the archives of the National Cancer Institute (NCI) and NTP Carcinogenesis Testing Programs. The relative frequency and principal diagnostic features of 204 ovarian tumors from 39,851 female F344 rats and 587 ovarian tumors from 41,102 female B6C3F1 mice are described. The most frequently observed neoplasms in F344 rats were malignant granulosa cell tumors (29% of primary rat ovarian neoplasms observed), benign undifferentiated sex cord-stromal tumors (26%), benign granulosa cell tumors (16%), and benign Sertoli cell tumors (7%). The most frequent neoplasms in B6C3F1 mice were cystadenomas (24%), tubulostromal adenomas (24%), benign granulosa cell tumors (21%), and benign teratomas (8%). PMID- 3665873 TI - Synaptic vesicles in electromotoneurones. II. Heterogeneity of populations is expressed in uptake properties; exocytosis and insertion of a core proteoglycan into the extracellular matrix. AB - The three populations of synaptic vesicles in electromotor nerve terminals were analysed quantitatively. Empty vesicles (VP0), fully charged vesicles (VP1) and charged but smaller VP2-type vesicles are present in approximately equal amounts in the nerve terminal. The populations show differences in the kinetics of in vitro uptake of acetylcholine, ATP and Ca2+. VP0 and VP2 accumulate acetylcholine and ATP but no Ca2+, whereas VP1 shows negligible acetylcholine and ATP but high Ca2+ uptake. Thus the expression of uptake properties of this secretory organelle depend on the stage it has reached in its life cycle and might constitute a signal for processing. VP2 was found to contain much less core proteoglycan than VP0 and VP1 indicating that part of it has been lost by exocytosis. In synaptic extracellular matrix containing fractions an antigen is detectable that cross reacts with an antiserum against the vesicle proteoglycan. This material elutes upon gel filtration in a position similar to a smaller form of proteoglycan found in vesicles. We conclude that the electromotor nerve terminal releases a proteoglycan by the regulated secretory pathway that is deposited in the extracellular matrix. It might have a function in keeping pre- and postsynaptic structures in alignment constituting a transsynaptic signal. Based on the findings described, a model of the vesicles' life-cycle is discussed, whereby the VP2 population is the major source of quantal release of acetylcholine. PMID- 3665874 TI - Perforated MDCK cells support intracellular transport. AB - We have developed a method for perforating the plasma membrane of MDCK cells while retaining cellular functions. A nitrocellulose acetate filter was applied to the apical side of cells, grown on a glass coverslip, and allowed to dry. Segments of the apical plasma membrane adhered to the filter and were detached from the cell layer by shearing when the filter was peeled off. This allowed macromolecules such as antibodies and enzymes to diffuse into the cells. The cells were otherwise intact as judged by light and electron microscopy. The perforated cells maintained their capacity to support vesicular transport of proteins and lipids. Vesicular stomatitis virus infected cells readily incorporated [35S]methionine into G protein following permeabilization. This G protein was core-glycosylated during assembly in the endoplasmic reticulum, and was further transported to the trans Golgi with high efficiency. Experiments using lipid probes demonstrated that newly synthesized fluorescent sphingolipids were transported from the Golgi complex to the basolateral cell surface in perforated cells. Our results show that perforated cells provide a convenient and efficient alternative to cell-free assays for studying the molecular mechanism of intracellular transport. PMID- 3665875 TI - Activity of two different silencer elements of the chicken lysozyme gene can be compensated by enhancer elements. AB - The chicken lysozyme gene is constitutively expressed in macrophages. Transfection of recombinant genes containing different portions of the lysozyme 5' upstream region revealed the existence of two negative transcriptional elements within 1 kb upstream of the start sites. Both elements placed upstream or downstream of a heterologous promoter-gene unit repress transcription independent of their orientation and are therefore called silencer elements, although their repressing activities 3' of the gene are reduced. One silencer (N 1.0 kb) at position -1 kb consists of the central region of the chicken middle repetitive sequence element CR1 and can be divided into two functional domains. N 1.0 kb is active in all cell types tested. The other silencer (N-0.25 kb) at position -0.25 kb shows reduced activity in primary macrophages. Despite their different specificities, the activity of both silencer elements can be influenced similarly. An inverse linear relationship between the transcriptional activity of the tested constructs and the potential inhibition by the silencer elements was found: weak transcription units can be strongly repressed, whereas strong transcription units can be only weakly repressed. Such a mechanism may help to turn off completely a particular gene in situations or tissues where strong positive regulators are inactive. PMID- 3665876 TI - Cell-specificity of the chicken ovalbumin and conalbumin promoters. AB - A series of recombinant plasmids containing increasing lengths of the 5'-flanking promoter sequences of the chicken conalbumin and ovalbumin genes fused to the sequences coding for the SV40 T-antigen have been constructed. These recombinants were introduced into a variety of established cell lines and primary cultured cells by nuclear microinjection. Promoter activity was estimated by monitoring T antigen synthesis by indirect immunofluorescence. We show that the microinjected ovalbumin and conalbumin promoter regions do not function in chicken fibroblasts, kidney cells and in a variety of non-chicken cells, irrespective of the presence of steroid hormone receptors. In contrast, these promoter regions are active in primary cultured chicken embryonic hepatocytes and oviduct tubular gland cells, suggesting the presence of cell-specific transcription factors in these cells. Unexpectedly, promoter sequences close to the TATA boxes of both the ovalbumin and conalbumin genes are sufficient to confer cell-specific expression. Most of the controls exerted on the ovalbumin and conalbumin promoters in the whole animal appear to be reproduced in vitro by nuclear microinjection of the chimeric genes into the primary cultured cells. However, the microinjected ovalbumin promoter is active in embryonic hepatocytes and thus escapes the regulation imposed on the corresponding inactive endogenous gene. PMID- 3665877 TI - The chicken ovalbumin promoter is under negative control which is relieved by steroid hormones. AB - Steroid hormone regulation of activity of the chicken ovalbumin promoter was studied by microinjection of chimeric genes into the nuclei of primary cultured oviduct tubular gland cells. The chimeric genes contained increasing lengths of ovalbumin gene 5'-flanking sequences fused to the sequence coding for the SV40 T antigen. Promoter activity was estimated by monitoring synthesis of T-antigen. The activity of the ovalbumin promoter is cell-specifically repressed in these oviduct cells and the repression is relieved upon addition of steroid hormones. The -132 to -425 region of the ovalbumin promoter which is responsible for this negative regulation behaves as an independent functional unit containing the regulatory elements necessary for both repression (in the presence of steroid hormone antagonists) and induced derepression (in the presence of steroid hormones) of linked heterologous promoters. PMID- 3665878 TI - Site specific demethylation in the promoter of human gamma-globin gene does not alleviate methylation mediated suppression. AB - Human gamma A-globin genes with different patterns of methylation were synthesized in vitro. These methylated constructs were transfected into mouse L cells and their expression analyzed by S1-nuclease protection assays. We show that methylation downstream of +92 does not affect transcription while methylation downstream of -210 abolishes transcription. To test which of the six CpG dinucleotides between -210 and +92 plays a role in DNA methylation mediated suppression of transcription, we generated mutant gamma-globin genes which lack the three CpGs 5' to the cap site, the three CpGs 3' to the cap site, or all six CpGs. After in vitro methylation, we show that removal of methylated residues 5' or 3' to the cap site did not alleviate suppression, whereas removal of both 5' and 3' methylated residues restored partial expression. These results indicate that CpG methylation at different positions can cause suppression of expression and they are inconsistent with the hypothesis that site-specific demethylations in the promoter region can alleviate suppression. We propose that a minimum length of methylation-free DNA in the promoter area is the only requirement for expression of this promoter by ubiquitous transcription factors, and discuss these results with reference to methylation-free islands. PMID- 3665879 TI - Models of fibronectin. AB - The radius of gyration of human plasma fibronectin was determined by light scattering both under conditions in which the molecule is in an extended conformation (ionic strength 1.01 M, pH 8) and close to its native, more compact conformation (ionic strength 0.16 M, pH 8). These values were found to be 17.5 +/ 0.8 nm and 10.7 +/- 0.9 nm respectively, for a constant mol. wt of 533,000 +/- 8000, in excellent agreement with the value of 520,000 deduced from its known composition. A set of models, each made of two identical, end-to-end joined chains of 28 beads, was then constructed, and their calculated physico-chemical parameters were compared with those available for the whole fibronectin molecule and for some of its proteolytic fragments in both conformations. Two possible models for the circulating form are presented here: in both, the fibronectin molecule is in a compact, tangled conformation, with the amino-terminal end of one chain folded over to the carboxy end of itself or of the other chain either in a hairpin or in a circular fashion. With the exception of the carboxy-terminal fibrin(ogen)-binding domains, all the domains appear to be well exposed to the solvent, and thus free to interact with potential ligands. PMID- 3665880 TI - Possible function of the c-myc product: promotion of cellular DNA replication. AB - We have recently cloned a plasmid, pARS65, containing the sequences derived from mouse liver DNA which can autonomously replicate in mouse and human cells (Ariga et al., 1987). In this report, we show that replication of pARS65 in HL-60 cells can be inhibited by co-transfection with anti-c-myc antibody. In an in-vitro replication system using HL-60 nuclear extract, pARS65 functioned as a template. This in-vitro replication was also blocked by addition of anti-c-myc antibody. Specific binding activity of the c-myc product to pARS65 was detected by an immunobinding assay, suggesting that the c-myc protein promotes DNA replication through binding to the initiation site of replication. This has been substantiated using the antibody to help isolate a human DNA segment that can autonomously replicate in the cells. PMID- 3665881 TI - Chromatin from transcribed genes contains HMG17 only downstream from the starting point of transcription. AB - Monoclonal antibodies specific for the non-histone chromosomal protein HMG17 were used to isolate oligonucleosomes from the transcriptionally active chromatin of chicken liver and oviduct. The distribution of HMG17 with respect to the coding region of three genes was analyzed in these oligonucleosomes by employing two independent experimental approaches. In the vitellogenin II gene (active in liver) and the lysozyme and ovalbumin genes (active in oviduct) HMG17 was found only downstream from the respective starting points of transcription. The transition from HMG17-free to HMG17-containing chromatin is located at the transcription start. This directly demonstrates that the distribution of an abundant nuclear protein correlates with the observation of moderate DNase I sensitivity in upstream regions and of high sensitivity in the coding regions of active genes. PMID- 3665883 TI - Stable introduction of exogenous DNA into Trypanosoma brucei. AB - The lack of a homologous transformation system for trypanosomes is a serious handicap to the study of gene expression in these protozoans. Attempts to develop such a system have been complicated by the lack of suitable homologous vectors and ignorance of the requirements for mRNA synthesis which is discontinuous in trypanosomes. We have found that Trypanosoma congolense, a close relative of T. brucei, contains exceptionally small chromosomes, which can be isolated whole and distinguished from those of T. brucei by the presence of a unique satellite DNA. We show here that mini-chromosomes from T. congolense can be introduced into T. brucei by electroporation and detected by hybridisation with T. congolense satellite DNA. The introduced DNA can survive through several generations in the absence of any selective pressure. These results provide the basis for the development of a transformation system for trypanosomes. PMID- 3665882 TI - A hotspot for novel amplification joints in a mosaic of Alu-like repeats and palindromic A + T-rich DNA. AB - We have identified, in the amplified domain of adenylate deaminase (AMPD) overproducing Chinese hamster fibroblasts, a 2.6 kb recombinogenic DNA region which is frequently involved in amplification-associated rearrangements. The nucleotide sequence reveals a mosaic organization of four Alu-equivalent repeats of the B1 and B2 families and eight long A + T-rich DNA segments. Part of this region is enriched with long imperfect palindromes. The center of one palindrome contains a putative topoisomerase I cleavage site and this site defines the position of a novel junction which was formed by illegitimate recombination with anther A + T-rich DNA sequence located far apart on the amplified DNA. These findings and their significance are discussed in the context of related data from other systems and in the light of current models for eukaryotic DNA recombination, replication and organization. PMID- 3665885 TI - Utilisation of selected health facilities in Addis Ababa: survey and study method. PMID- 3665884 TI - The accessibility of DNA to dimethylsulfate in complexes with recA protein. AB - recA protein coats DNA co-operatively to form filaments approximately 100 A thick, which in the presence of ATP, and more stably so in the presence of the non-hydrolyzable analog ATP gamma S, have a helical appearance with a deep cleft in the protein coat. This protein helix follows the DNA helix, to which it imparts a new helicity of 18.5 bp per turn of 97 A pitch. Here we test the accessibility of the DNA in the complex to modification by dimethylsulfate, and find that the complexed DNA is approximately 2-fold more reactive on the major groove side than it was in B-DNA (methylation of guanine N7), while it is protected approximately 2-fold on the minor groove side (methylation of adenine N3), suggesting that the protein coats the DNA along the minor groove. Furthermore, N3 of cytosine, a residue involved in base pairing, is found exposed in complexes with single strands as it is in naked single-stranded DNA, while it remains inaccessible in complexes with double strands, suggesting that the latter is not melted at this stage of the strand exchange reaction. PMID- 3665886 TI - The pattern of chronic complications in adult Ethiopian diabetics. PMID- 3665887 TI - Ovarian cystic teratoma as a cause of obstructed labour. PMID- 3665888 TI - Crohn's disease in an Ethiopian. PMID- 3665889 TI - Isolated interruption of the aortic arch in an Ethiopian. PMID- 3665890 TI - Human chorionic gonadotrophin producing ovarian dysgerminoma. PMID- 3665891 TI - Diarrhoeal disease in 520 cases admitted to Jijiga Hospital, east Ethiopia. PMID- 3665892 TI - High prevalence of elephantiasis and cutaneous leishmaniasis in Ocholo, south west Ethiopia. PMID- 3665893 TI - Visceral leishmaniasis in the Dawa valley, south Ethiopia. PMID- 3665894 TI - Evaluation of a new slide latex agglutination test for diagnosis of vaginal candidosis. AB - A new commercial slide latex particle agglutination test for rapid (2 min) diagnosis of vaginal candidosis was evaluated and compared with conventional methods. Of the 263 women studied, 63 (23.9%) had yeasts in the vagina. Clinical signs of vulvitis or vaginitis were seen in 23 women (8.8%) and 40 (15.2%) were harbouring yeasts without clinical signs. Yeast counts were generally higher in women with clinical signs of vaginal candidosis than in those without. The test was positive in 15 of the 23 women (65.2%) with clinical signs, the incidence of a positive test increasing in direct proportion to the amount of yeasts isolated. The test's sensitivity, specificity and predictive values were comparable to those of microscopy and culture. Being both rapid and simple to perform, this new test offers a useful alternative to conventional methods for the diagnosis of vaginal candidosis. PMID- 3665895 TI - Serological evaluation of the outer membrane protein complexes of five saccharolytic intestinal Bacteroides species. AB - The purpose of this investigation was to develop a serological procedure for rapid identification of the following five Bacteroides species: Bacteroides distasonis, Bacteroides fragilis, Bacteroides ovatus, Bacteroides uniformis, and Bacteroides vulgatus. The outer membrane fractions were assayed using SDS polyacrylamide slab gel electrophoretic techniques. The species-specific protein band from each species as well as the group-specific protein were purified and used to develop an indirect enzyme-linked immunosorbent assay to detect the species-specific and group-specific protein from the outer membrane of five reference species. The sensitivity and specificity of the procedure were evaluated by indirect ELISA methodology using 506 clinical isolates of organisms in this group, ten other species of anaerobic gram-negative bacilli, and three species of aerobic gram-negative bacilli. Each species evaluated yielded unique outer membrane protein patterns, suggesting the potential for development of a rapid, species-specific diagnostic procedure. PMID- 3665896 TI - Streptococcus milleri infection of a hepatopulmonary hydatid cyst. AB - A case of hepatopulmonary hydatid disease in a Cypriot who presented with pyogenic infection with Streptococcus milleri is described. Although hydatid disease and pyogenic liver abscess are both rare in the UK, an underlying echinococcal pathology should be suspected in any patient from an area endemic for hydatid who presents with a pyogenic hepatic or hepatopulmonary abscess. PMID- 3665898 TI - Optochin resistance in Streptococcus pneumoniae strains isolated from blood and middle ear fluid. AB - Optochin resistant Streptococcus pneumoniae having typical pneumococcal morphology in culture and Gram stain and giving clear agglutination with anti pneumococcal polysaccharide antisera were isolated from primary cultures of blood and middle ear fluid. The isolated pneumococci were either fully sensitive to penicillin and other antimicrobial agents commonly used or relatively resistant to penicillin and resistant to cloxacillin, tetracycline, erythromycin, sulphatrimethoprim and clindamycin. PMID- 3665897 TI - Isolation of Corynebacterium group D2 from clinical specimens. AB - A total of 38 strains of Corynebacterium Group D2 isolated from clinical specimens in Belgian laboratories were characterized by pronounced urease activity, inability to acidify sugars and to reduce nitrates and multiresistance to antibiotics. Two strains were involved in clinical diseases. The organisms were found to have a more opportunistic than pathogenic behaviour. PMID- 3665899 TI - In vitro and in vivo susceptibility of Borrelia burgdorferi. AB - The antispirochetal activity in vitro and in vivo of several antibiotics against ten isolates of Borrelia burgdorferi from human spinal fluids and skin biopsies was determined. Borrelia burgdorferi was most susceptible in vitro to erythromycin, ceftriaxone and cefotaxime (MIC90: 0.06, 0.06, 0.12 mcg/ml respectively). Less activity was observed with tetracycline, amoxycillin and lincomycin (MIC90: 0.50 mcg/ml), imipenem and augmentin (MIC90: 0.25 mcg/ml), oxacillin (MIC90: 1 mcg/ml), ciprofloxacin (MIC90: 2 mcg/ml) and ofloxacin (MIC90: 4 mcg/ml). Penicillin G, normally regarded as appropriate treatment for Lyme disease, had an MIC90 of only 4 mcg/ml. With the exception of erythromycin, activity in vitro corresponded to the activity in vivo. Erythromycin, however, was less active in vivo, and penicillin G showed poor activity both in vitro and in vivo. PMID- 3665900 TI - Cell-wall deficient bacteria in inflammatory bowel disease. AB - Cell wall deficient forms of bacteria were isolated from 40-60% of patients with active inflammatory bowel disease, 15-25% of patients with inactive disease and only 5-7% of controls. The recovery rate from Crohn's disease and ulcerative colitis tissue filtrates did not differ significantly, but was raised in both groups in comparison with controls (p less than 0.01). It is concluded that a range of such bacteria have a possible aetiological role in inflammatory bowel disease. PMID- 3665901 TI - In vivo and in vitro activity of roxithromycin against Toxoplasma gondii in mice. AB - Roxithromycin protected mice against a lethal infection with the extremely virulent RH strain and the C56 strain of Toxoplasma gondii. Therapy initiated 2 h after infection with 2 X 10(3) or 2 X 10(4) RH or C56 tachyzoites protected more than 80% of the mice, compared with 0% of untreated controls (p less than 0.001). Paradoxically, Toxoplasma gondii was isolated more frequently (greater than 80%) in treated mice surviving infection with the less virulent strain (C56) than those surviving infection with the more virulent RH strain (less than 25%). Furthermore, in vitro studies revealed that roxithromycin at dosages up to 250 micrograms/ml had no effect on the proliferation of Toxoplasma gondii in murine peritoneal macrophage cultures. PMID- 3665902 TI - In vitro activity of the two new oral cephalosporins RO 15-8074 and RO 19-5247. PMID- 3665903 TI - In vitro activity of various new antimicrobial agents against group JK corynebacteria. PMID- 3665904 TI - Aetiology and treatment of bacterial meningitis. PMID- 3665905 TI - Three cases of bacteremia with group Ve-2 bacteria in France. PMID- 3665906 TI - Lack of invasiveness of Campylobacter pylori. PMID- 3665907 TI - Disseminated infection caused by Mycobacterium kansasii presenting as fever of unknown origin. PMID- 3665908 TI - Antibiotic interaction: interpretation of fractional inhibitory and fractional bactericidal concentration indices. PMID- 3665909 TI - Susceptibility of Clostridium difficile to metronidazole, its bioactive metabolites and tinidazole. PMID- 3665911 TI - Fluorescence resonance energy transfer between sites in G-actin. The spatial relationship between Cys-10, Tyr-69, Cys-374, the high-affinity metal and the nucleotide. AB - Intramonomer fluorescence resonance energy transfer spectroscopy was employed to investigate the spatial relationship between labels attached to the residues Cys 10, Tyr-69, Cys-374, the high-affinity metal binding site and the nucleotide binding site in G-actin. The separation between the fluorescence donor 5 (dimethylamino)naphthalene-1-sulphonyl (Dns) chloride (dansyl chloride) used to label Tyr-69 and the acceptor 4-dimethylaminophenylazophenyl-4'-maleimide (DABM) used to label Cys-374 was found to be 3.6 nm. The distance separating Dns on Tyr 69 from DABM on Cys-10 was found to be 2.7 nm. The distance separating the acceptor DABM bound to Cys-374 from the fluorescence donor formycin A 5' triphosphate (FTP) occupying the nucleotide binding site was determined to be 3.0 nm. A slightly larger separation was determined between the FTP site and DABM attached to Cys-10. In this case a value of 3.2 nm was obtained. The distance separating Dns on Tyr-69 from Co2+ in the high-affinity metal binding site was determined to be 1.1 nm. Finally, the separation of FTP, now acting as donor, from the Dns molecule attached to Tyr-69 and acting as the acceptor was determined to be 2.1 nm. The likely relationship between these label sites on actin is represented by a model which is used to assist in the determination of the actin structure, with particular reference to the environment of the metal and nucleotide binding sites. PMID- 3665910 TI - In vitro and in vivo synthesis of dolichol and other main mevalonate products in various organs of the rat. AB - The relative rate of biosynthesis of dolichol from [3H]mevalonate in nine rat organs was studied in slices and in the whole animal. This biosynthesis was also compared to that of cholesterol and ubiquinone. All tissues examined are able to synthesize dolichol, as well as ubiquinone and cholesterol. Comparison of the data from slices in vitro with the in vivo studies demonstrated relatively good agreement for dolichol and ubiquinone synthesis. Although dolichol of high specific radioactivity was recovered in the blood, redistribution between organs, such as occurs with cholesterol, appears to be insignificant. The highest rates of dolichol biosynthesis were found in kidney, spleen and liver. On the other hand, muscle makes the largest contribution to total body dolichol synthesis. Newly synthesized dolichol also appears in the bile, but excretion by this route is far from sufficient to account for dolichol turnover. Incorporation of mevalonate into the final products is mainly dependent on biosynthetic activity. For comparison of the biosynthetic rates in different organs, possible sources of errors (such as variations in the size of the precursor pool, limitation by the rate of precursor uptake or non-linear incorporation) were investigated the size of the mevalonate pool in various organs. Equilibration of this pool with exogenous mevalonate is a rapid and passive process. The size of the mevalonate pool does not determine the rates of cholesterol and dolichol biosynthesis, indicating the presence of regulatory steps in the terminal portion of these biosynthetic pathways. PMID- 3665912 TI - The carboxyl-terminal domain of murine H1(0). Immunochemical and partial amino acid sequence comparisons with other H1(0)/H1/H5 histones. AB - The carboxyl-terminal domain of murine H1(0) histone was compared with that of human H1(0), bovine H1(0) and other H1 and H5 histones. Two sets of antibodies were induced by murine H1(0). One set reacted with only the carboxyl-terminal domain of murine H1(0) and preferred the murine over the bovine and human proteins. The second set of antibodies reacted with the globular domain of murine H1(0) and did not distinguish among murine, bovine and human H1(0) species. There were five positions in the first 60 residues of the carboxyl-terminal domain in which the murine H1(0) differed from the human H1(0). In this region, the murine H1(0) had no more than 49% overall homology with other H1 and H5 histones; however, short sequences in the domain were very similar to short sequences that occur in rabbit H1.3, trout H1 and goose or chicken H5. In comparisons based on these and other published data, the carboxyl-terminal domain of H1(0) is found to be more variable among species than is the globular domain; the first two-thirds of the H1(0) carboxyl-terminal domain is largely unique and does not show great overall homology with H1 or H5, whereas the last third is again more conserved. As the first two-thirds of the domain is the only portion where the homology with H5 is less than 50%, it may be responsible for functional differences between H1(0) and H5. PMID- 3665913 TI - Absolute configuration of the unique 2,6-dideoxy-4-O-methyl-arabino-hexopyranose of the major phenolic glycolipid antigen from Mycobacterium kansasii. AB - The antigenicity and the structure of the major phenolic glycolipid from Mycobacterium kansasii have been established. A monoacetylated tetrasaccharide structure was proposed for the oligosaccharide moiety in which the distal sugar, unique in nature, corresponds to 2,6-dideoxy-4-O-methyl-alpha arabinohexopyranose. Its terminal position in the oligosaccharide part confers to this residue a key role in the antigen-antibody interaction. By improvement of the methanolysis procedure, this new kind of sugar was obtained in higher amounts than by hydrolysis of the glycolipid. Its 1H-NMR spectrum is presented and its optical rotatory power measurement agrees with a D absolute configuration while the deoxyhexoses involved in the glycolipid tetrasaccharide structure present the L absolute configuration. PMID- 3665914 TI - Identification and determination of absolute and anomeric configurations of the 6 deoxyaltrose residue found in polysialoglycoprotein of Salvelinus leucomaenis pluvius eggs. The first demonstration of the presence of a 6-deoxyhexose other than fucose in glycoprotein. AB - An oligosaccharide alditol, dHex-GalNAc-Gal-Gal-GalNAcol, has been isolated from polysialoglycoprotein, which was derived from the unfertilized eggs of Savelinus leucomaenis pluvius (a salmonid fish, Iwana in Japanese), by alkaline borohydride treatment followed by exhaustive digestion with sialidase. First, the structure of the terminal dHex residue in the above pentasaccharide has been assigned as 6 deoxyaltrose (= dAlt in pyranoid form) by a combination of structural methods (GLC, TLC, mass spectrometry, and 400-MHz 1H-NMR spectroscopy). The occurrence of a 6-deoxyhexose other than L-fucose in glycoprotein has not been previously reported. Next, the absolute configuration of this unusual sugar residue has been assigned as D on the basis of the exciton-splitting study of tris-p-bromobenzoate derivatives of methyl 6-deoxyaltrosides. The usefullness of this circular dichroic exciton-splitting method in the determination of the absolute configuration of carbohydrate components, only available in minute amounts, is emphasized. The anomeric configuration of the glycosidic linkage of the D altropyranosyl residue was deduced from 400-MHz 1H NMR spectroscopy. The 6-deoxy beta-D-altropyranosyl residue thus established has the same configuration as alpha-L-fucose but with the C-5 methyl group inverted, suggesting that the biosynthetic incorporation of D-dAlt parallels that of L-fucose, and a possible pathway is also considered. PMID- 3665915 TI - The conformation of bombesin in solution as determined by two-dimensional 1H-NMR techniques. AB - The 1H nuclear magnetic resonance spectrum of the tetradecapeptide, bombesin, has been assigned in (2H6)dimethyl sulphoxide solution and aqueous solution using two dimensional techniques. The chemical shifts in both solvents indicate that the molecule has little secondary structure and adopts a random coil conformation. A comparison is made between the spectra of various smaller bombesin fragments and the intact polypeptide. PMID- 3665916 TI - Complete amino acid sequence of an immunoreactive form of human pancreatic stone protein isolated from pancreatic juice. AB - The primary structure of a pancreatic stone protein form has been elucidated for the first time. The protein studied was the lowest-Mr form prepared from human pancreatic juice (PSP S1). The N-terminal sequence up to residue 65 had already been determined. The five peptides obtained after staphylococcal protease digestion of the carboxymethylated reduced and succinylated PSP S1 enabled the deduction of the entire sequence. The tryptic peptides arising from the digest of cyclohexanedione--treated PSP S1 and the amino acids released by carboxypeptidase P digestion of PSP S1 confirmed the data of the sequence. The peptides were purified by Sephadex filtration and, if required, by chromatography on DEAE cellulose or thin-layer cellulose. The amino acid sequences of the peptides were determined with a sequencer. From the sequence data it was deduced that the PSP S1 polypeptide chain contains 133 amino acid residues and has a Mr of 15,000. PMID- 3665917 TI - Biosynthesis of Lewis fucolipid antigens in human colorectal carcinoma cells. Partial characterization of LcOse4Cer and H-1 fucolipid fucosyl transferase acceptor activities. AB - Purified glycolipids were tested for their ability to serve as acceptors of [14C]fucose from GDP-[14C]fucose as catalyzed by cell-free extracts and purified membrane fractions of human colorectal carcinoma cells, SW1116, cultured in serum free medium. Purified lactotetraosyl ceramide (Gal beta 1----3GlcNAc beta 1--- 3Gal beta 1----4Glc-Cer or LcOse4Cer) and H-1 glycolipid (Fuc alpha 1----2Gal beta 1----3GlcNAc beta 1----3Gal beta 1----4Glc-Cer or IV2 Fuc alpha LcOse4Cer) stimulated incorporation of radioactivity into lipid-soluble glycolipid at a rate greater than ten times that of Lea glycolipid [Gal beta 1----3(Fuc alpha 1--- 4)GlcNAc beta 1----3Gal beta 1----4Glc-Cer or III4 Fuc alpha LcOse4Cer]. The enzymatic activities in crude and purified membrane fractions were optimized for substrate concentrations (glycolipid and GDP-fucose), detergent requirement (taurocholate), pH, time and protein. The radioactive product of H-1 fucosylation migrated as discrete and distinct bands on high-performance thin-layer chromatograms (HPTLC). Evidence for their identity with Leb fucolipid described previously [Fuc alpha 1----2Gal beta 1----3(Fuc alpha 1----4)GlcNAc beta 1--- 3Gal beta 1----4Glc-Cer or III4IV2 (Fuc alpha) LcOse4Cer] is presented. The radioactive product of LcOse4Cer fucosylation was mainly Lea fucolipid as determined by co-migration with authentic Lea fucolipid in three HPTLC systems as native and acetylated derivatives. Our results also indicated a low level of H-1 and Leb glycolipid synthesis from LcOse4Cer. On the basis of the optima, linearity for time, and enzyme-limiting conditions, we obtained a 12-19-fold purification of the LcOse4Cer and H-1 fucosyl transferase acceptor activities in three peaks of a sucrose gradient. The peak with the highest specific activity (peak 3) was highest in density and in Na+, K+, ATPase specific activity, although NADH-cytochrome-c reductase and UDP-GalNac transferase were also present in peak 3. The apparent Km values of LcOse4Cer acceptor activity and H-1 acceptor activity in peak 3 were significantly different (p less than 0.01) by statistical tests, 2.4 microM and 0.5 microM, respectively. These apparent Km values were much lower (10(3) X) and the pH optima were lower (4.8-5.3), than the corresponding properties reported for the alpha 1----3/alpha 1----4 fucosyl transferase purified from human milk. Our results suggest a role for the non glycosidic moieties of the acceptors and/or the tissue-specific or primitive expression of these fucosyl transferase activities. PMID- 3665918 TI - Characterization of a soluble carnitine acetyltransferase from Candida tropicalis. AB - Carnitine acetyltransferase was purified from the cytoplasmic fraction of Candida tropicalis grown on alkanes in continuous culture. By ion-exchange chromatography the enzyme was resolved in two fractions with the same specific activity of 80 U/mg. The molecular mass of both enzyme forms, determined by non-denaturing gradient gel electrophoresis, was 540 kDa. After SDS electrophoresis only one band of 64 kDa was detected indicating that both enzymes are oligomers each containing eight subunits. Isoelectric focusing in agarose under non-denaturing conditions demonstrated the presence of at least four different charged species in the pH range between 5.6 and 6.7. After isoelectric focusing in 9 M urea/1% Nonidet P-40 gels, both enzyme forms were resolved into four bands. Peptide mapping, performed by cyanogen bromide cleavage of polypeptides separated by denaturing isoelectric focusing followed by second-dimension SDS electrophoresis, revealed a very high degree of homology between these polypeptides. The presence of the octameric form of carnitine acetyltransferase already in the starting material was demonstrated by non-denaturing gradient gel electrophoresis and immunoblotting. Antibodies against carnitine acetyltransferase from C. tropicalis ATCC 32113 formed precipitation lines with extracts from several Candida species but not with extracts of Candida utilis, Candida ethanothermophilum and an another strain of C. tropicalis. PMID- 3665919 TI - Structure of sialyl-oligosaccharides isolated from bronchial mucus glycoproteins of patients (blood group O) suffering from cystic fibrosis. AB - The carbohydrate chains of the bronchial-mucus glycoproteins of six cystic fibrosis patients with blood group O were released by alkaline borohydride treatment. Low-molecular-mass, monosialyl oligosaccharide-alditols were isolated by anion-exchange chromatography and fractionated by high-performance liquid chromatography. Structural characterization was performed by 500-MHz 1H-NMR spectroscopy in combination with quantitative sugar analysis. The established structures range in size from tetra- up to heptasaccharides. They are all sialyl analogs of neutral oligosaccharides that were characterized previously [Lamblin G., Boersma A., Lhermitte M., Roussel P., Mutsaers J. H. G. M., Van Halbeek H. & Vliegenthart J. F. G. (1984) Eur. J. Biochem. 143, 227-236]. The NeuAc residue was found to occur either in alpha (2----3)-linkage to Gal, or in alpha (2----6) linkage to GalNAc-ol or Gal. PMID- 3665920 TI - Purification and some properties of a lectin from the hemolymph of Periplaneta americana (American cockroach). AB - A lectin showing specificity for human A-type red blood cells was purified to homogeneity from the hemolymph of the American cockroach Periplaneta americana by affinity chromatography on bovine submaxillary gland mucin. This lectin was a huge molecule with molecular mass of about 1500 kDa, with a single subunit of 30 kDa protein, and required Ca2+ for expression of lectin activity. Electron microscopic examination showed that these molecules were rods with helical structure with an average length of 50.5 nm and width of 10 nm. The molecule was suggested to contain tandemly aligned basic units of 10 nm length. PMID- 3665921 TI - The isolation of gamones 3 and 4 of Euplotes octocarinatus. AB - Gamones 3 and 4 of the ciliate Euplotes octocarinatus were isolated and purified to chromatographic and electrophoretic homogeneity. They are secreted into the culture medium by cells of certain mating types and induce cells of other mating types to unite in pairs and exchange gametic nuclei. The purified gamones are biologically active at concentrations as low as 0.1-1 pM. Both are polypeptides with unusually low pI values of approximately 3.2, and both have a carbohydrate content of less than 2%. Gamone 3 has an Mr of 18,800 and is slightly smaller than gamone 4, which has an Mr of 23,500. Gamone 3 was isolated from the starvation medium of cells homozygous for the mating type allele mt3 and gamone 4 was isolated from the medium of cells homozygous for the mating type allele mt4. Each of the two homozygous cell lines was found to secrete one gamone only. PMID- 3665922 TI - IUPAC-IUB Joint Commission on Biochemical Nomenclature (JCBN). Nomenclature and symbols for folic acid and related compounds. Recommendations 1986. AB - The folates are a group of heterocyclic compounds based on the 4-[(pteridin-6 ylmethyl)amino]benzoic acid skeleton conjugated with one or more L-glutamate units. The document is a revision of recommendations prepared by the IUPAC-IUB Commission on Biochemical Nomenclature in 1964. The main changes are a consequence of the much greater information that now exists about the stereochemistry of folates. Recommendations on the nomenclature of reduced compounds and substituents are included, as are proposed symbols and abbreviations. PMID- 3665923 TI - Two hydrophobic low-molecular-mass protein fractions of pulmonary surfactant. Characterization and biophysical activity. AB - Hydrophobic low-molecular-mass proteins were isolated from minced pig lungs and separated into two fractions. Electrophoresis of protein fraction 1 showed two major bands. Calculations of molecular masses from the electrophoretic mobilities are unreliable because of the extreme hydrophobicity of the peptides. However, the two bands were at positions corresponding to apparent molecular masses of about 3 kDa and 14 kDa, while sequence degradation disclosed only one major structure. Electrophoretic separation of protein fraction 2 revealed one band, at an apparent molecular mass of about 6 kDa. Microheterogeneities at the N terminus of both fractions were observed. However, the two fractions had different N terminal structures and amino acid compositions. Consequently they are concluded to represent different polypeptides without common segments. Bronchoalveolar lavage from humans also contains surfactant polypeptides and at least the fraction 2 peptide is highly similar in human and porcine surfactants. Artificial surfactant preparations, obtained by recombination of protein fraction 1 or 2 with a mixture of synthetic phospholipids, were evaluated with the pulsating bubble method and in experiments on artificially ventilated premature newborn rabbits. The addition of protein fraction 1 to the phospholipid mixture improved surface adsorption from more than 300 s to about 2 s and reduced minimum surface tension from more than 20 mN/m to nearly 0 as measured with a pulsating bubble. When this surfactant preparation was instilled into the airways of newborn rabbits, the tidal volumes at insufflation pressure 25 cm H2O was increased about twentyfold compared to the volumes obtained in non-treated controls. Preparations based on protein fraction 1 had better in vitro and in vivo properties than those based on protein fraction 2. Both these protein-based preparations were decidedly more effective than phospholipids alone. PMID- 3665924 TI - Use of protein blotting to study the DNA-binding properties of histone H1 and H1 variants. AB - Sub-types of histone H1 have been observed in a variety of tissues from several organisms. One of the best characterized H1 variants is H5 from avian erythrocytes. Several lines of evidence suggest that H5 has a greater affinity for DNA than H1 and is thus thought to account, in part, for the highly condensed and transcriptionally repressed state of avian erythrocyte chromatin. In trout there is an analogous erythrocyte-specific H1 variant, previously termed 'H5' [B.L.A. Miki and J.M. Neelin (1975) Can. J. Biochem. 53, 1158-1169). Using a sensitive and rapid protein-blotting procedure which is specific amongst the histones for histone H1 and its variants, we compared DNA-binding properties of the trout erythrocyte histone 'H5' and chicken H5. By increasing the NaCl concentration of the binding buffer, a gradual decrease in the amount of DNA that bound to chicken H1, trout H1 and trout erythrocyte 'H5' variant was observed, such that at concentrations above 0.37 M, negligible amounts of DNA were bound. By contrast, chicken H5 bound a significantly greater amount of DNA even at a concentration of 0.4 M NaCl. Based on the DNA-binding, properties, we conclude that the trout erythrocyte variant 'H5' is more closely related to H1 than to H5. By assaying the DNA-binding affinity of calf thymus H1 DNA-binding affinity of calf thymus H1 peptide fragments, generated by protease and chemical cleavage, and the sperm-specific H1 variants of the annelid, Platynereis dumerilii, which possess greatly shortened C-terminal tails, we conclude that a domain that includes a very small portion of the C-terminal tail and part of the globular domain is sufficient for the binding of H1 to DNA. PMID- 3665925 TI - Characterization of a mannosidase acting on alpha 1----3- and alpha 1----6-linked mannose residues of oligomannosidic intermediates of glycoprotein processing. AB - Baby hamster kidney (BHK) cell extracts catalyze the conversion of [3H]mannose labelled (Man)5GlcNAc and (Man)6GlcNAc oligosaccharides to a (Man)3GlcNAc species that retains affinity for concanavalin-A-Sepharose and appears to be Man alpha 1- --3[Man alpha 1----6]Man beta 1----4GlcNAc. The properties of the (Man)5GlcNAc hydrolase activity differ from lysosomal alpha-mannosidases as well as previously described processing mannosidases acting on oligosaccharide intermediates of N glycan assembly. Mosquito cell extracts catalyze hydrolysis of (Man)6GlcNAc but lack the (Man)5GlcNAc hydrolase activity detected in BHK cell extracts. Glycopeptide analysis has been carried out on a ricin-resistant BHK mutant RicR14 that lacks N-acetylglucosaminyl transferase I and fails to convert oligomannosidic N-glycans to complex-type chains, and mosquito cells that constitutively lack N-acetylglucosaminyl transferase I. In both cell lines, the cellular glycoproteins contain (Man)5GlcNAc oligosaccharide as the major stable component equivalent to a 15-20-fold increase compared with normal BHK cells. Although containing very high amounts of asparagine-linked (Man)5(GlcNAc)2, RicR14 cells exhibit (Man)5GlcNAc hydrolase activity at levels similar to wild type BHK cells. This result, together with previous work [Foddy, L., Feeney, J. & Hughes, R.C. (1986) Biochem. J. 233, 697-706] showing the complete inhibition of conversion of oligomannosidic intermediates to complex-type N-glycans in BHK cells treated with swainsonine, an inhibitor of mannosidase II but not the (Man)5GlcNAc hydrolase activity, argues against a major role for the (Man)5GlcNAc hydrolase activity in N-glycan assembly and suggesting other functions for the mannosidase activity in BHK cells. PMID- 3665926 TI - Type 1, blue copper proteins constitute a respiratory nitrite-reducing system in Pseudomonas aureofaciens. AB - Pseudomonas aureofaciens truncates the respiratory reduction of nitrate (denitrification) at the level of N2O. The nitrite reductase from this organism was purified to apparent electrophoretic homogeneity and found to be a blue copper protein. The enzyme contained 2 atoms of copper/85 kDa, both detectable by electron paramagnetic resonance (EPR) spectroscopy. The protein was dimeric, with subunits of identical size (40 +/- 3 kDa). Its pI was 6.05. The EPR spectrum showed an axial signal g at 2.21(8) and g at 2.04(5). The magnitude of the hyperfine splitting (A parallel = 6.36 mT) indicated the presence of type 1 copper only. The electronic spectrum had maxima at 280 nm, 474 nm and 595 nm (epsilon = 7.0 mM-1 cm-1), and a broad shoulder around 780 nm. A copper protein of low molecular mass (15 kDa), with properties similar to azurin, was also isolated from P. aureofaciens. The electronic spectrum of this protein showed a maximum at 624 nm in the visible range (epsilon = 2.5 mM-1 cm-1) and pronounced structures in the ultraviolet region. The EPR parameters were g parallel = 2.26(6) and g perpendicular = 2.05(6), with A parallel = 5.8 mT. The reduced azurin transferred electrons efficiently to nitrite reductase; the product of nitrite reduction was nitric oxide. The specific nitrite-reducing activity with ascorbate-reduced phenazine methosulfate as electron donor was 1 mumol substrate min-1 mg protein-1. The reaction product again was nitric oxide. Nitrous oxide was the reaction product from hydroxylamine and nitrite and from dithionite reduced methyl viologen and nitrite. No 'oxidase' activity could be demonstrated for the enzyme. Our data disprove the presumed exclusiveness of cytochrome cd1 as nitrite reductase within the genus Pseudomonas. PMID- 3665927 TI - Characterization of three constituent chains of collagen type VI by peptide sequences and cDNA clones. AB - Pepsin-solubilized collagen VI was prepared from human placenta and used to separate three constituent chains for determining partial amino acid sequences. Antibodies raised against the chains assisted in the identification and purification of several cDNA clones from three expression lambda gt11 libraries. Most of the clones hybridized to either a 3.5-kb or 4.2-kb mRNA species which by matching peptide and nucleotide sequences could be identified as coding for the alpha 2(VI) or alpha 1(VI) chain, respectively. Other clones hybridized to either an 8.5-kb mRNA which very likely encoded the alpha 3(VI) chain or to an unknown 2.0-kb mRNA. Northern blots revealed a considerable variation in the mRNA levels for each collagen VI chain in both skin and cornea fibroblasts and in several tumor cell lines. Limited sequence data generated from peptides and cDNA clones demonstrated a characteristic cysteine pattern at the junction between N-terminal globular domain and triple helix in all three chains. In addition, the data showed occasional interruptions of triplet sequences within the triple-helical domain and the presence of two Arg-Gly-Asp sequences which are potential cell binding structures. PMID- 3665928 TI - Structure and evolution of the repetitive gene encoding streptococcal protein G. AB - The complete sequence of the structural gene encoding the immunoglobulin G binding protein from Streptococcus G148 has been determined, as well as its 5' and 3' flanking sequences. The sequence reveals an open reading frame encoding a putative preprotein with a relative molecular mass of 63294. N-Terminal sequencing of the mature protein, spontaneously released from streptococcal cells, demonstrates that the signal peptide consists of 33 amino acids. The DNA sequence reveals extensive internal homologies similar to other cell-wall-bound receptors from gram-positive bacteria. Comparisons with a related gene previously isolated from another strain of streptococci revealed large differences in size, due to variations in the number of internal repeats. The structure of the gene suggests an evolution through multiple duplications. PMID- 3665929 TI - Synthesis, structure and spectroscopic properties of two models for the active site of the oxygenated state of cytochrome P450 [corrected]. AB - Two dioxygen adducts of thiolato-iron(II) porphyrins, [K(222)][Fe(TPpivP)(SC6HF4)(O2)] 1a and [Na(18c.6)][Fe(TPpivP)(SC6HF4)(O2)] 2 were synthesized by reaction of O2 with five-coordinate, high-spin, cryptated alkali metal thiolato-iron(II) 'picket fence' porphyrinate. They were characterized by visible and infrared spectroscopy: lambda max (log epsilon) = 360 nm (4), 427 nm (4.69), 560 nm (3.69), 610 nm (3.40) for both compounds; v(16O 16O) = 1139 cm-1 in chlorobenzene and fluorobenzene for 1a and 2. Single crystals of composition [K(222)][Fe(TPpivP)(SC6HF4)(O2)].[K(222)](SC6HF4)(C 6H5Cl)(H2O) 1b were obtained by diffusion of pentane/xylene mixtures into chlorobenzene solutions of 1a at -5 degrees C. Single crystals of composition [Na(18c.6)][Fe(TPpivP)(SC6HF4)(O2)] were obtained by slow diffusion of pentane into benzene solutions of 2. Structures of 1b and 2 were studied at 20 degrees C (1b) and -100 degrees C (1b and 2). 1b: space group P2(1)/c (monoclinic), a = 16.806(5) A (1.6806 nm), b = 14.331(4) A (1.4331 nm), c = 52.000(15) A (5.2000 nm), beta = 92.95(2) degrees, V = 12.507 A3 (12.507 nm3), Z = 4, Dcal = 1.28 g.cm 3 (t = 20 degrees C). The final R1 factor was 0.085 for 5238 reflections having I greater than 3 sigma(I). 2: space group P2(1)/c (monoclinic), a = 13.107(3) A (1.3107 nm), b = 27.055(4) A (2.7055 nm), c = 25.029(4) A (2.5029 nm), beta = 96.84(2) degrees, V = 8812 A3 (8.812 nm3), Z = 4, Dcal = 1.18 g.cm-3 (t = -100 degrees C). The final R1 factor was 0.088 for 6587 reflections having I greater than 3 sigma(I). The iron atom is, in both compounds, bonded to the four porphyrinato nitrogens (Np), the sulfur atom of the axial thiolate and one oxygen atom of the axially end-on bonded dioxygen molecule. The average Fe-Np distance found in 1b [1.994(4) A, 0.1994 nm] is not significantly different from that found in 2 [1.993(3) A, 0.1993 nm]. The Fe-S bond length is 2.367(3) A (0.2367 nm) in 1b and 2.365(2) A (0.2365 nm) in 2. The Fe-O1 distances with the oxygen atom of O2 bonded to iron are respectively 1.837(9) A (0.1837 nm) and 1.850(4) A (0.1850 nm). The end-on bonded O2 molecule is disordered in both complexes 1b and 2.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3665930 TI - Covalent binding of an NAD+ analogue to horse liver alcohol dehydrogenase in a ternary complex with pyrazole. AB - Examination of the model of the fixation site of the adenosine phosphate part of NAD+ on horse liver alcohol dehydrogenase led us to synthesize a NAD+ analogue N6 [N-(8-amino-3,6-dioxaoctyl)carbamoylmethyl]-NAD+ in order to alkylate the carboxylic acid group of Asp-273 and to convert the normally dissociable coenzyme into a permanently bound prosthetic group. This NAD+ analogue is coupled to the horse liver alcohol dehydrogenase in the ternary complex formed with pyrazole. In these conditions the degree of fixation varies between 0.4 and 0.58 coenzyme molecule/enzyme subunit molecule. The N6-[N-(8-amino-3,6 dioxaoctyl)carbamoylmethyl]NAD+ acts as a true prosthetic group which can be reduced and reoxidized by a coupled substrate reaction and the internal activity of this holoenzyme corresponds to the amount of analogue incorporated. PMID- 3665931 TI - Influence of diet on the transcriptional and post-transcriptional regulation of malic enzyme induction in the rat liver. AB - Fasted rats were refed a carbohydrate/protein diet, a carbohydrate diet (without protein) or a protein diet (without carbohydrate) to investigate, using a cDNA cloned in our laboratory, the regulatory mechanisms involved in hepatic malic enzyme induction. In the carbohydrate/protein diet, although the enzyme activity and the mRNA concentration of malic enzyme were increased about 7-fold above the levels in the fasted rat, the rate of transcription was increased only 2-fold. In the carbohydrate diet group the rate of transcription and the concentration of mRNA were increased to the levels in the carbohydrate/protein diet group, whereas the enzyme activity increased only to 60% of those levels. Protein appears to contribute to an increase in the translation of malic enzyme mRNA. In the protein diet group the transcriptional rate was not low, but the mRNA concentration was about half in comparison with the level of the carbohydrate/protein diet group. Further, dietary fat did not reduce the transcriptional activity, but reduced the mRNA concentration and the enzyme activity to half of the basal levels. Therefore, it is suggested that fat stimulates the degradation of the mRNA in liver cytosol, whereas carbohydrate tends to stabilize the mRNA. On the other hand 3,5,3'-triiodothyronine treatment increased the transcriptional activity by 1.5-2-fold above the basal values on all the diets and even on fasting. Thus, it is suggested that 3,5,3'-triiodothyronine increases the transcriptional activity of malic enzyme independently from nutritional regulation, while the nutrients are predominantly involved in the post-transcriptional steps. PMID- 3665932 TI - Isolation and characterization of ornitho-kininogen. AB - Ornitho-kininogen was purified from chicken blood plasma by a two-stage method using chromatography on columns of S-alkylated papain-Cellulofine and DEAE-5PW. The yield was 1.7 mg from 44 ml plasma. The isolated preparation gave a single band on sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS-PAGE) with or without 2-mercaptoethanol and on disc/polyacrylamide gel electrophoresis. The relative molecular mass, Mr, of ornitho-kininogen was estimated as 74,000 on SDS PAGE using the Ferguson plot method. Ornitho-kininogen was found to have the similar properties to those of mammalian high-Mr kininogen, in terms of the amino acid composition, molecular mass, and susceptibility to plasma kallikrein. No kininogen corresponding to mammalian low-Mr kininogen and rat T-kininogen could be detected in chicken plasma. In fact, ornitho-kininogen was degraded rapidly by bovine plasma kallikrein, liberating a kinin. This kinin was isolated from the digest by reversed-phase HPLC. The primary structure of the isolated kinin was determined as Arg1-Pro2-Pro3-Gly4-Phe5-Thr6-Pro7-Leu8-Arg9. The sequence of this peptide, named ornitho-kinin, was similar to that of bradykinin except for the substitution of Thr6 and Leu8 for Ser6 and Phe8. The isolated ornitho-kinin induced a contraction of chicken smooth muscle and had a strong hypotensive effect in the chicken. However, it did not contract the isolated rat uterus. It is suggested that this specificity difference is due to the replacement of Phe8 by Leu8. The sequence of residues 1-30 of ornitho-kininogen exhibited 43% identity with that of bovine kininogen. PMID- 3665933 TI - Integration of porin synthesized in vitro into outer mitochondrial membranes. AB - Porin, an intrinsic protein of outer mitochondrial membranes of rat liver, was synthesized in vitro in a cell-free in a cell-free translation system with rat liver RNA. The apparent molecular mass of porin synthesized in vitro was the same as that of its mature form (34 kDa). This porin was post-translationally integrated into the outer membrane of rat liver mitochondria when the cell-free translation products were incubated with mitochondria at 30 degrees C even in the presence of a protonophore (carbonyl cyanide m-chlorophenylhydrazone). Therefore, the integration of porin seemed to proceed energy-independently as reported by Freitag et al. [(1982) Eur. J. Biochem. 126, 197-202]. Its integration seemed, however, to require the participation of the inner membrane, since porin was not integrated when isolated outer mitochondrial membranes alone were incubated with the translation products. Porin in the cell-free translation products bound to the outside of the outer mitochondrial membrane when incubated with intact mitochondria at 0 degrees C for 5 min. When the incubation period at 0 degrees C was prolonged to 60 min, this porin was found in the inner membrane fraction, which contained monoamine oxidase, suggesting that porin might bind to a specific site on the outer membrane in contact or fused with the inner membrane (a so called OM-IM site). This porin bound to the OM-IM site was integrated into the outer membrane when the membrane fraction was incubated at 30 degrees C for 60 min. These observations suggest that porin bound to the outside of the outer mitochondrial membrane is integrated into the outer membrane at the OM-IM site by some temperature-dependent process(es). PMID- 3665934 TI - Biochemical characterization of polypeptide components involved in neurite fasciculation and elongation. AB - Polypeptide components and carbohydrate linkage types of F11 antigen and G4 antigen, two chick cell-surface glycoproteins implicated in neurite fasciculation and elongation [Rathjen, F.G., Wolff, J.M., Bonhoeffer, F. and Rutishauser, U. (1987) J. Cell Biol. 104, 343-353], have been studied in comparison to mouse L1 antigen. Tryptic fingerprint analysis does not reveal any relation of the 130-kDa components of G4 or F11 antigens to each other or to neural cell-adhesion molecules. The 180/190-kDa component of G4 antigen comprises parts of the 130-kDa and 80/65-kDa components and shares a sequence corresponding to the amino terminus of the G4 130-kDa component as shown serologically with anti-peptide sera. This closely parallels the relationship found for mouse L1 antigen components. In contrast, the F11 170-kDa component is different from the F11 130 kDa component, as shown serologically and by fingerprint analysis. A combination of chemical and enzymatic deglycosylation methods reveals that while O glycosylation cannot be detected F11 130-kDa, G4 130-kDa and L1 140-kDa components contain N-linked carbohydrates. Endoglycosidase H treatment shows that the oligosaccharides present in the G4 130-kDa component and mouse L1 are mostly of the complex type, while the F11 130-kDa component consists of two populations, one containing mainly complex-type carbohydrates and a second containing high mannose/hybrid-type carbohydrates. PMID- 3665935 TI - Activation and transfer of novel synthetic 9-substituted sialic acids. AB - In this report several NeuAc analogues differently modified at position C-9 were tested as substrates for CMP sialic acid synthase from bovine brain: the hydroxy group at C-9 was replaced by an amino, acetamido, benzamido, hexanoylamido and azido group. The synthase was partially purified by chromatography on CDP hexanolamine--Sepharose. CMP-glycosides synthesized were measured by analytical HPLC at 275 nm. Each NeuAc analogue was activated to the respective CMP glycoside: Km-values varied from 0.8 mM to 4.6 mM, the Km for NeuAc was 1.4 mM. Thus affinity of the enzyme was influenced only moderately by chemical modification at C-9. CMP-glycosides were synthesized on a preparative scale with good yield and characterized by analytical HPLC. In addition, 500-MHz 1H-NMR data of CMP-9-amino-NeuAc and CMP-9-acetamido-NeuAc were obtained. Each CMP-activated NeuAc analogue was a suitable donor substrate for Gal beta 1-4GlcNAc alpha 2,6 sialyltransferase from rat liver. Transfer was determined by the thiobarbituric acid method and by analytical HPLC at 200 nm. The results demonstrate that synthetic, not naturally occurring, non-labelled NeuAc analogues can be incorporated into glycoprotein with high yield. PMID- 3665936 TI - Monitoring the purification by high-performance liquid chromatography of cardiotoxins from Naja mossambica mossambica using phase-sensitive two dimensional nuclear magnetic resonance. AB - High-resolution phase-sensitive two-dimensional proton nuclear magnetic resonance was used to monitor the preparation by high-performance liquid chromatography of homogeneous proteins from the venom of Naja mossambica mossambica. This resulted in the characterization of a heterogeneous protein preparation VII2, which had been used in earlier structural studies by NMR, as well as a homogeneous protein CTXIIb and a nearly homogeneous protein fraction CTXIIa, which are now both subject to further investigations of their solution conformations. PMID- 3665937 TI - Structural variations in the alanine-rich antifreeze proteins of the pleuronectinae. AB - The sequence and activity of antifreeze proteins from two right eye flounder species were compared to assess the influence of structural variations on antifreeze capacity. The cDNA encoding the major serum antifreeze protein in the yellowtail flounder (Limanda ferruginea) was cloned from liver tissue. Its DNA sequence shows that the precursor to the antifreeze is a 97-residue preproportion. Edman degradation identified the N-terminus of the 48-amino-acid mature serum antifreeze protein and confirmed the sequence of the first 36 residues. A comparison with the previously determined winter flounder antifreeze protein and mRNA sequences shows strong homology through the 5' and 3' untranslated regions and in the peptide region. The mature protein section has the greatest sequence variation. Specifically, the yellowtail antifreeze protein, in contrast to that of the winter flounder, contains a fourth 11-amino-acid repeat and lacks several of the hydrophilic residues that have been postulated to aid in the binding of the protein to ice crystals. Intramolecular salt bridges are present in the antifreeze proteins from both species but in different registries with respect to the 11-amino-acid repeats. On a mass basis the yellowtail flounder antifreeze, though longer than that of the winter flounder, is only 80% as effective at depressing the freezing temperature of aqueous solutions. This lower activity might be due to the reduced number of hydrophilic ice-binding residues per molecule. PMID- 3665938 TI - Amino acid sequence similarity between malate dehydrogenases (NAD) and pea chloroplast malate dehydrogenase (NADP). AB - Purified pea chloroplast malate dehydrogenase (NADP) was reduced, S pyridylethylated with 4-vinyl-pyridine and cleaved with trypsin. The resulting peptides were separated by reversed-phase high-performance liquid chromatography. Several of these peptides were subjected to automated Edman degradation. The sequences obtained were compared to the published primary structures of malate dehydrogenase from the thermophilic bacterium Thermus flavus and with the sequence of heart mitochondrial and cytoplasmic malate dehydrogenase (NAD). Most peptides from choroplast malate dehydrogenase (NADP) showed high homology with sequences of the other malate dehydrogenases, especially with those of the bacterial enzyme. One of the sequenced peptides contains the active-site histidine residue which is conserved in all malate dehydrogenases. Our results suggest a common evolutionary origin for all malate dehydrogenases despite their different coenzyme specificities and regulatory properties. The sequenced peptides which revealed no homology were either located at the amino-terminal or at the carboxy-terminal region of chloroplast malate dehydrogenase (NADP). These novel sequences are most likely plant-specific extensions of an ancestral malate dehydrogenase and may be responsible for the unique light-dependent activation of the chloroplast enzyme. PMID- 3665940 TI - Assessment of mechanisms of ventricular arrhythmias from the surface ECG in 118 patients. AB - Mechanisms of ventricular arrhythmias were assessed by the application of ECG criteria derived from experimental electrophysiology. These interval criteria describe for ideal and modulated parasystole, resetable spontaneous automaticity, early and delayed afterdepolarizations and reentry, how QRS complexes of ectopic ventricular origin relate to those of supraventricular origin. Ventricular arrhythmias were studied in: (a) long-term, 1-lead ECG recordings of 85 patients with uncomplicated and untreated acute myocardial infarction (AMI) (group 1); (b) one-hour, 4-lead ECG recordings of 23 comparable patients with AMI (group 2), and (c) one-hour, 4-lead ECG recordings of 10 patients with chronic ventricular arrhythmias (group 3). All QRS complexes of ectopic ventricular origin having identical morphology (V type) were assumed to be the manifestation of a single site in the ventricle. The supraventricular rhythm in groups 2 and 3 was varied by programmed atrial stimulation to increase the range of intervals and patterns of the V types in the ECG. Positive evidence for a particular mechanism was obtained by applying tested criteria in 38% of 263 V types in group 1 (mainly reentry, but also early and delayed afterdepolarizations). In group 2, there was positive evidence in 67% of 84 V types (mainly reentry, but also early and delayed afterdepolarizations) and also in 67% of 18 V types in group 3, (mainly reentry). The application of these ECG criteria to ventricular arrhythmias identifies mechanisms in a satisfactory proportion. The yield can be increased by artificial variation of the heart rate. PMID- 3665939 TI - Characterization of N-linked gluco-oligomannose type of carbohydrate chains of glycoproteins from the ovary of the starfish Asterias rubens (L.). AB - Glycoproteins were isolated from the ovary of the starfish Asterias rubens (L.). After delipidation, sugar analysis revealed the presence of mannose, glucose and N-acetylglucosamine in a molar ratio of 9.0:1.3:2.3. Subsequently, hydrazinolysis, re-N-acetylation, reduction and high-voltage paper electrophoresis were carried out, resulting in a mixture of neutral oligosaccharide alditols which was fractionated on Bio-Gel P-4. The alditols, investigated by 500-MHz 1H-NMR spectroscopy, turned out to be of the oligomannose type or of the gluco-oligomannose type containing 9 mannose and 1-3 glucose residues. The most abundant compounds were established to be: (Formula: see text) and (Formula: see text). PMID- 3665941 TI - On the within-population relationship between dietary habits and serum lipid levels in Belgium. AB - In a Belgian population group of 15,954 male and 2116 female subjects, an epidemiological survey has been conducted to investigate the relationship between dietary fat intake and serum total and HDL-cholesterol. The study has established, both in men and in women, a significant positive relationship between serum total cholesterol and the dietary intake of saturated fat and a significant negative one between serum total cholesterol and the intake of polyunsaturated fat and the P/S-ratio of the diet. At equal levels of consumption, polyunsaturated fat has a decreasing effect on serum total cholesterol which is about half the increasing effect due to saturated fat. Polyunsaturated fat and the P/S-ratio decrease the HDL-cholesterol value but only with borderline significance. The present study demonstrates the importance of dietary fat as a determinant of the serum lipid level within a population. PMID- 3665942 TI - Activity of left ventricular thrombi of different ages. Assessment with indium oxine platelet imaging and cross-sectional echocardiography. AB - To evaluate the possible relation between the age of intracardiac thrombi and the presence and degree of their activity, 29 patients with left ventricular thrombi that developed after an anterior myocardial infarction were evaluated by means of 111In-oxine autologous platelet imaging. None of the patients was treated with anticoagulants or platelet inhibitors during either the acute phase of infarction or the follow-up. The time of appearance and the shape of left ventricular thrombi were assessed by serial cross-sectional echocardiograms, obtained within 24 hours of onset of the chest pain, every 24 hours until the fifth day, every 48 hours until the 15th day, and then every month for a follow-up of 1 to 17 months (mean: 8 months). At the time of the scintigraphic examination, left ventricular thrombi were aged 1 month in 9 patients, and 2 to 14 months in the remaining 20 patients. 111In-oxine imaging with autologous platelets was obtained in all patients at 4, 24, 48 and 72 hours, in the sagittal, 30 degrees and 45 degrees left anterior oblique projections. In 25 patients the degree of haematological activity of the thrombi was evaluated by dividing the values of thrombus activity/background activity, obtained at 4, 24, 48 and 72 hours, respectively, by the value observed at 4 hours (uptake index). Scintigraphic imaging showed the presence of an active thrombus in every patient. In the 9 patients with recent thrombi, the uptake index was significantly greater than in subjects with older ones (P less than 0.01). Hence, in patients with anterior myocardial infarction, untreated with anticoagulants or platelet inhibitors, haematologically active thrombi can be observed even more than one year after their appearance. The uptake of platelets on the surface of thrombi is greater in recent left ventricular thrombi than in older ones. PMID- 3665943 TI - Prognostic importance of early exercise testing in men with suspected unstable coronary artery disease. AB - In 276 men with suspected unstable coronary artery disease i.e. recurring chest pain of new onset, increasing symptoms of anginal chest pain in formerly stable angina pectoris or suspected non-Q-wave infarction, an exercise test was performed 2-7 days after admission. Coronary events i.e. cardiac death (N = 4), Q wave infarction (N = 11) and coronary artery bypass grafting (N = 34), were registered during one year follow-up. The indication for bypass grafting was incapacitating angina pectoris despite medication, and suitable coronary anatomy. Stepwise multiple regression analysis showed that S-T segment depression and limiting chest pain were the most important prognostic parameters regarding coronary events. In patients with S-T segment depression greater than 0.1 mV or limiting chest pain (N = 94) the occurrence of Q-wave myocardial infarction or cardiac death was 10.6% (N = 10) compared to 2.8% (N = 5) in patients without these criteria (N = 182) (P less than 0.01). Coronary artery bypass graft surgery was performed in 33% (N = 31) of the group with S-T segment depression greater than 0.1 mV or limiting chest pain but in only 1.7% (N = 3) of the other patients (P less than 0.001). Thus, in patients with suspected unstable coronary artery disease, whose symptoms and signs of ischaemia are stabilized by medication, an exercise test can safely be performed after a few days ambulation in the ward. The early exercise test provides important prognostic information regarding the risk for severe coronary events within the next year. PMID- 3665944 TI - Acute and chronic effects of molsidomine on pulmonary artery pressure and work capacity in patients with coronary heart disease. AB - To test the clinically supposed development of tolerance during chronic molsidomine therapy we studied a total of 11 patients with angiographically proven coronary heart disease at rest and during ergometric exercise (supine position; submaximal, i.e. 50 W for 3 min, and maximal exercise). Pulmonary arterial pressure (PAPmean, floating catheter), arterial blood pressure (RR, cuff method), work capacity (W x min) and duration of exercise loading (sec) were measured at rest and on exercise before and during chronic (4 weeks) oral therapy with 3 x 4 mg day-1 of molsidomine. Acute administration of 4 mg molsidomine reduced the mean arterial resting pressure by 12% and under submaximal exercise loading by 8%. After molsidomine, the PAPmean was reduced by 35% at rest; following a period of treatment of 4 weeks no significant decrease in efficacy could be discerned (PAPmean reduction by 31%). Under submaximal and maximal exercise the PAPmean dropped by 44% and 37%, respectively (35.5 +/- 6.7 cf. 19.9 +/- 4.5 mmHg; 39.2 +/- 6.5 cf. 24.8 +/- 7.0 mmHg), whilst simultaneously the work capacity increased by 93% (281 +/- 108 cf. 545 +/- 254 W x min). After 4 weeks treatment with 12 mg day-1 of molsidomine, the PAPmean of 22.4 +/- 6.6 mmHg and 30.1 +/- 9.9 mmHg under identical exercise loading conditions, remained significantly below the exercise load value prior to the onset of medication. The molsidomine-induced increase in the exercise tolerance was maintained throughout the long-term medication (537 +/- 268 W x min). With a four-week treatment with daily doses of molsidomine there was a persistent effect on the pulmonary arterial pressure and the work capacity. Thus development of tolerance during high dose, long-term molsidomine therapy is not to be expected. PMID- 3665945 TI - Detection of diastolic mitral regurgitation using pulsed Doppler and its implications. AB - Diastolic mitral regurgitation has been angiographically demonstrated in some patients with severe aortic regurgitation and/or nonobstructive cardiomyopathy. The purpose of this paper was two-fold: to study the feasibility of pulsed Doppler noninvasive detection of this unusually timed regurgitation on the basis of angiographic correlations in a group of 21 patients with such conditions and sinus rhythm with normal PR interval in 81% of the cases, and when diastolic mitral regurgitation was present, to study if it had clinical implications. Doppler detection was feasible in all cases and there were no false positive diagnoses. Comparison of haemodynamic data in patients without (group A) and with (group B) diastolic mitral regurgitation showed a significant increase in the mean values of pressures, particularly for the mean pulmonary artery and capillary wedge pressures (P less than 0.01 to 0.001), in group B. This study suggests that the recording of mitral flow velocity should be routinely performed in patients with such pathological conditions, since the finding of diastolic mitral regurgitation may have clinical significance. PMID- 3665946 TI - Left atrial volume changes in mitral valve disease: a cross-sectional echocardiographic study. AB - We used cross-sectional echocardiography to study left atrial volume changes in 25 patients with mitral valve disease who underwent cardiac catheterisation. Satisfactory 4 chamber views were obtained in 21. Left atrial systolic overload measured as systolic expansion index did not correlate with the severity of mitral regurgitation as assessed by contrast ventriculography and indicator dilution. The left atrial systolic expansion rate, and the maximum volume increase during the first third of systole, measured as the early systolic expansion index, differentiated well between moderate and severe mitral regurgitation, but not between trivial and moderate regurgitation. Calculation of the early systolic expansion fraction (fraction of total expansion occurring in the first third of systole) gave the best correlation with the degree of mitral regurgitation estimated by other methods. PMID- 3665947 TI - Early results after mitral valvuloplasty for pure mitral regurgitation. AB - In this study we present the results of 105 consecutive patients with pure mitral regurgitation who underwent surgical treatment. In all patients mitral regurgitation was associated with mitral valve prolapse: 54 patients underwent mitral valvuloplasty and 51 patients mitral valve replacement. Clinical assessment and echocardiography were used as follow-up criteria at one year after surgery. After mitral valvuloplasty, NYHA decreased from 2.7 +/- 0.8 to 1.1 +/- 0.7 (P less than 0.01) and workload capacity increased from 65 +/- 28% to 96 +/- 25% (P less than 0.001); left endsystolic atrial dimension and enddiastolic dimension decreased from 6.2 +/- 0.8 to 4.8 +/- 1.2 cm (P less than 0.001) and from 7.2 +/- 1.3 to 5.9 +/- 0.8 cm (P less than 0.01); ventricular contraction fraction did not change significantly. After mitral valve replacement, clinical and echocardiographic improvement was significant but less remarkable than after valvuloplasty; ventricular contraction fraction fell from 39 +/- 7% to 29 +/- 8% in contrast to patients undergoing mitral valvuloplasty in whom no significant change occurred. Complications were rare in both groups though only a minority of patients undergoing mitral valvuloplasty received anticoagulants. We conclude that mitral valvuloplasty in patients with pure mitral regurgitation when compared with the patients after mitral valve replacement. PMID- 3665948 TI - Rapid relief of spontaneous angina by intraventricular diltiazem: systemic and regional coronary haemodynamic determinants. AB - The authors describe a case of spontaneous angina during catheterization in a patient with left anterior descending and circumflex stenosis promptly relieved by diltiazem, 10 mg, given in the left ventricle. Coronary and systemic haemodynamics measured during and at the end of angina demonstrated an increase in blood flow to the ischaemic myocardium as the mechanism responsible for the diltiazem-induced angina relief. PMID- 3665949 TI - Ventricular fibrillation induced by transesophageal atrial pacing in hypertrophic cardiomyopathy. AB - Sudden death is a rather frequent occurrence in patients with hypertrophic cardiomyopathy, yet the mechanism is uncertain in most cases. We describe a case of an 18 years old patient with a family history of hypertrophic cardiomyopathy and sudden death in whom ventricular fibrillation could be repeatedly induced by means of transesophageal atrial stimulation with 1:1 AV conduction at a rate of 200 beats min-1 and prevented by pharmacological depression of AV node. The not particularly high ventricular rate at which VF occurred could suggest that in hypertrophic cardiomyopathy a major role in favouring VF induction is played by the electrophysiological properties of the myocardium and that sudden death can occur as a consequence of different atrial tachyarrhythmias. PMID- 3665950 TI - Isolated coronary ostial stenosis: observations on the pathology. AB - A 54 year old woman with isolated stenosis of the left coronary ostium died following cardiac catheterisation and emergency coronary artery bypass surgery. Histological examination showed the ostial narrowing to be a local and discrete plaque of atherosclerosis. Like most reported cases this patient was a young woman whose disease pursued an aggressive course. PMID- 3665951 TI - The usefulness of cross-sectional Doppler flow imaging in the detection of small ventricular septal defects with left-to-right shunt. AB - Small ventricular septal defects (VSDs) with left to right (L-R) shunt have been difficult to diagnose with conventional ultrasound techniques. Using the cross sectional Doppler flow imaging system, additional information can be obtained. In a group of 60 patients with a clinical diagnosis of VSD with L-R shunt, the new technique proved valuable, especially in detecting muscular and apical VSDs. PMID- 3665953 TI - Work absenteeism and well-being in patients treated for hypertension. AB - The purpose of this study was to analyse the effect of detection and treatment of hypertension on work absenteeism and other indicators of well-being. Because the study was performed as part of a trial comparing structured and regular hypertension care, we also analysed the impact of these different methods of organizing care. Matching for age and sex, three samples were drawn: one from regular medical care (N = 123) one from structured protocol care (N = 238) and one from normotensive subjects, aware of their blood pressure level (N = 128). Insurance data did not reveal any differences between the three groups in the amount of work absenteeism during a six-year period. Moreover, we found no short term rise in work absenteeism during the first year after diagnosis. Finally, interviews failed to show significant differences between the three groups with respect to general satisfaction with life or other aspects of psychological well being. We conclude that the patients treated for hypertension did not differ importantly from normotensive subjects with regard to illness-induced work absenteeism or other aspects of psychological well-being. PMID- 3665952 TI - Cardiac and pulmonary causes of dyspnoea--validation of a scoring test for clinical-epidemiological use: the Study of Men Born in 1913. AB - Dyspnoea is one of the earliest symptoms in several conditions, such as heart disease and airway obstruction. However, the early phases of these two conditions are hard to distinguish in a reproducible way. In a population study of the natural history and epidemiology of congestive heart failure a scoring test to differentiate the two conditions was developed. In this report the test is presented and evaluated against various clinical and laboratory measures in 644 men sampled from the general population. The test provides a 'cardiac score' and a 'pulmonary score', both based on history and findings at the physical examination. Men who had pulmonary scores (indicating a pulmonary cause of the dyspnoea) had significantly lower values of spirometry variables but no significant pulmonary congestion at X-ray compared to a reference group (no dyspnoea, no pulmonary scores). Men with cardiac scores had significantly larger hearts and more congestion but no significant change of variables measuring airways obstruction compared to the reference group (no dyspnoea, no cardiac scores). Even though there was a moderate overlap of impaired cardiac and pulmonary function in the dyspnoea group, perhaps due to smoking being a common causal agent, the test appears to differentiate the causes of dyspnoea in a manner similar to clinical evaluation but, in contrast to the latter, in a defined and therefore reproducible way. PMID- 3665954 TI - Bilateral atrial myxomas. Surgical correction after echocardiographic diagnosis. AB - A case is reported of bilateral atrial myxomas diagnosed noninvasively by echocardiography and successfully removed. The excised tumor mass consisted of a mobile right atrial myxoma prolapsing into the right ventricle and a less mobile, not prolapsing myxoma in the left atrium. The operation was performed entirely on the basis of echocardiographic findings, which correlated well with the operative results. Further investigation by computer tomography verified the diagnosis, but added no extra information of importance for therapy. Diagnostic aspects of the combined application of M-mode and cross-sectional echocardiography with Doppler echocardiography are emphasized. Postoperative follow-up echocardiography showed the complete removal of the myxomas and improvement of cardiac function. PMID- 3665955 TI - Epicardial repolarization mapping in man. AB - A simple method was developed for recording epicardial monophasic action potentials intraoperatively in man. Potentials were recorded rapidly and reliably from multiple epicardial sites using a hand-held probe. The feasibility of repolarization mapping was assessed in 30 patients. It was possible to record technically adequate signals from most left ventricular and posterior right ventricular sites (success rates 72% and 61%, respectively), but it was more difficult to achieve satisfactory recordings over the free wall of the right ventricle (success rate 36%). The onset of cardiopulmonary bypass resulted in a transient rise in action potential duration of approximately 30-40 ms in the first minutes of bypass. An approximate steady state was achieved thereafter. Reproducibility of the method was assessed by mapping a small number of sites repeatedly. The 95% confidence limits for an estimate of repolarization time, based on a single potential, were +/- 21 ms. With 4 probe applications at each site, the confidence limits of the estimated site mean were reduced to +/- 8 ms. Based on this approach, statistically significant differences between sites were demonstrated in 9 of 10 patients, confirming that the method is sensitive enough to provide information on regional differences in repolarization. Intraoperative epicardial repolarization mapping has been shown to be a practical possibility. The technique holds promise as a means of assessing the role of dispersion of repolarization in arrhythmogenesis in man. PMID- 3665956 TI - Acute antiischaemic properties of high dosages of intravenous diltiazem in humans in relation to its coronary and systemic haemodynamic effects. AB - The antiischaemic properties of intravenous diltiazem in recommended therapeutic doses are disputed. In 17 patients with coronary artery disease the systemic and coronary haemodynamic effects of diltiazem were assessed during a high-dose infusion (0.4 mg kg-1 per 5 min, followed by 0.4 mg kg-1 per 10 min). In addition, its potential antiischaemic properties were investigated during identical pacing stress tests, 30 minutes before (P1) and immediately after diltiazem administration (P2). Diltiazem reduced left ventricular systolic pressure from 133 +/- 5 to 116 +/- 5 mmHg (P less than 0.005, means +/- SEM), persisting until after P2. It decreased systemic and coronary resistance by 32% (P less than 0.001) and 29% (P less than 0.005), respectively, with a sustained increase in cardiac output from 5.9 +/- 0.4 to 7.3 +/- 0.6 l min-1 (P less than 0.01), but a brief 20% rise in coronary flow (P less than 0.05), after the bolus infusion only. Heart rate, contractility, left ventricular filling pressure and myocardial O2 consumption remained unchanged. Despite high plasma levels (673 +/- 81 micrograms l-1) diltiazem was well tolerated. During identical maximal pacing rates diltiazem considerably reduced myocardial O2 demand (double product: 16.3 +/- 0.8 (P2) vs 21.1 +/- 1.1 (P1), P less than 0.005), due to an 18% decrease in left ventricular systolic pressure, resulting in diminished coronary flow and myocardial O2 consumption during P2 (14% and 15%, respectively, P less than 0.05 vs P1). Diltiazem also significantly reduced pacing-induced ischaemia, indicated by normalization of myocardial lactate extraction (1 +/- 8% (P2) vs -41 +/- 12% (P1), P less than 0.05), and left ventricular filling pressure (13 +/- 2 (P2) vs 27 +/- 3 mmHg (P1), P less than 0.01), less ST-segment depression (0.12 +/- 0.01 (P2) vs 0.24 +/- 0.02 mV (P1), P less than 0.01) and improved contractility (Vmax 59 +/- 5 (P2) vs 48 +/- 3 s-1 (P1), P less than 0.05). Angina was absent or less in 15 patients during pacing after diltiazem. Thus, diltiazem, in high dosages, induces continuing systemic but short lasting coronary vasodilation, improves pump function without negative chronotropic and inotropic effects and has pronounced antiischaemic properties, predominantly due to diminished myocardial O2 demand. PMID- 3665957 TI - Left ventricular thrombi after short-term high-dose anticoagulants in acute myocardial infarction. AB - To examine the effect of short-term, high-dose anticoagulation on the subsequent occurrence of left ventricular (LV) thrombi after a first anterior wall acute myocardial infarction (AMI), 21 patients received placebo and 21 high-dose anticoagulants during the first 10 days of the acute infarction. They were studied with cross-sectional echocardiography 10 days and 1.3 and 6 months post infarction. At 1 month, 6 of 7 thrombi present in the placebo group at 10 days were still visible. No thrombi were detected at 10 days in the anticoagulation group, but 6 patients had developed a LV thrombus at 1 month. These 12 patients with LV thrombi were subsequently treated with oral warfarin for 2 months, after which all thrombi had disappeared. Warfarin was then discontinued, and a thrombus had recurred in 5 patients after 6 months. Apical akinesis at 10 days was a predictor for thrombus with a sensitivity and specificity of 100% and 72.2%, respectively. Three of the 13 patients with LV thrombi suffered stroke in contrast to none without thrombi (P = 0.025). We conclude that after discontinuation of short-term high-dose anticoagulation therapy in anterior AMI, LV thrombi may develop rapidly and lead to embolic complications, particularly in patients with persisting apical akinesis. PMID- 3665959 TI - Expected developments in cardiology 1986-2000. Scientific, clinical and economical aspects. 27-29 April 1986, Mainz, F.R.G. Proceedings. PMID- 3665958 TI - Myoglobin, creatine kinase-B isoenzyme, and myosin light chain release in patients with unstable angina pectoris. AB - In 27 patients presenting with angina pectoris at rest and normal serum creatine kinase (CK) activity, cardiac myosin light chains (CM-LC), myoglobin (MG), and CK B isoenzyme were determined in 7 serial blood samples by radioimmunoassays. Measurable amounts of CM-LC were found in at least one serum sample in 13 patients. MG was found to be elevated in 9, and CK-B in 8 of these patients. In the 189 serum samples determined, CM-LC were found more frequently elevated (21.7%) than MG (13.2%, P less than 0.05) or CK-B (12.2%, P less than 0.05). Coronary angiograms were obtained in 21 of the 27 patients. Elevated marker protein concentrations were found only in patients with coronary artery stenosis greater than or equal to 70% of at least one coronary artery. The incidence of elevated serum concentrations of any of the 3 marker proteins determined was higher in patients with 3 vessel disease than in those with 1 or 2 vessel disease (33.9% vs 15.6%, P less than 0.05), and it was higher in patients with a history of previous myocardial infarction than in those without (34.5% vs 11.4%, P less than 0.001). The findings suggest that in a subgroup of patients with angina pectoris at rest but without evidence of acute myocardial infarction, ischaemic damage of small myocardial areas can be detected by serological assays of high sensitivity. Among the marker proteins studied, CM-LC were found the most sensitive. PMID- 3665960 TI - Support of clinical research by foundations: the German view. PMID- 3665961 TI - Science or pursuit of creativity. PMID- 3665962 TI - Advance of medical technology and consequences for the medical community, industry and governments in the growing regulatory environment of Europe. PMID- 3665963 TI - Epidemiology and prevention of cardiac failure: Framingham Study insights. AB - The prevalence, incidence, secular trends, precursors and prognosis of cardiac failure (CHF) is investigated over 3 decades of follow-up of 5209 subjects. Some 485 men and women developed first evidence of CHF. Annual incidence increased from 3 per 1000 at ages 35-64 years to 10 per 1000 at ages 65-94 years with a male predominance because of higher rates of coronary disease. Half developing CHF had coronary disease, but only 10% were free of concomitant hypertension. Appearance of coronary disease conferred an 8-fold increased risk of CHF. Hypertension is the dominant precursor of CHF, increasing risk 2-6 fold; 70% had antecedent hypertension. Systolic pressure was more predictive than diastolic. Non-specific S-T and T-wave changes, intraventricular conduction disturbances and left ventricular hypertrophy were powerful predictors, even taking blood pressure into account. Other independent risk factors include: low vital capacity, rapid heart rate, diabetes, cardiac enlargement, overweight (in women), serum cholesterol (in men under 65 years of age), cigarettes, proteinuria and hematocrit. Risk of CHF can be estimated over a 30-fold range from profiles made up of these independent risk factors. A preventive approach is essential. Despite potent glycosides, diuretics, vasodilators and antihypertensive treatment CHF continues to be a lethal end-stage of heart disease with a 50% 5 year mortality rate. Sudden death is a prominent terminal feature occurring at 9 times the general population rate. PMID- 3665964 TI - Congestive heart failure. What has long-term medical treatment to offer and what does it cost? PMID- 3665965 TI - A model for assessing optimal health care. PMID- 3665966 TI - Pharmacological treatment of angina pectoris: to what extent can and must the primary physician persist? PMID- 3665967 TI - Clinical research: needs, priorities and possibilities in the European community. PMID- 3665968 TI - In vivo animal demonstration of the effect of vasoactive drugs using 195mAu and gamma camera techniques. AB - 195mAu, an ultrashort-lived (physical half life = 30.5 s) generator-produced radionuclide, has been used in an animal model to study, by gamma camera techniques, the peripheral effects of the vasoactive drugs norepinephrine and sodium nitroprusside systemically administered or epinephrine (intraarterially) injected at various concentrations. According to the results obtained by the analysis of time activity curves generated from areas of interest drawn on the proximal and distal parts of the limbs, the well known hemodynamic changes induced by these drugs, vasoconstriction (resulting in a decrease of the distal activity recorded), or vasodilatation (shortening the time of radioactivity appearance), could be observed. It is concluded that gamma camera techniques using the ultrashort lived radionuclide 195mAu allow the in vivo study of the effects of vasoactive drugs in an animal model and potentially in clinical situations. PMID- 3665969 TI - Scintigraphic evaluation of enterogastric reflux using 75Se-HCAT: methodology and first clinical observations. AB - The aim of this study was to assess the possibility of detecting enterogastric reflux (EGR) by 75Se-HCAT cholescintigraphy. The lowest detectable activity in the gastric area at different concentrations of the radiotracer in the gallbladder was preliminary measured both in a plastic phantom and in an in vivo model. Ten patients were studied after a single oral administration of 1480 KBq 75Se-HCAT. Gamma camera imaging was carried out for five consecutive days during both fasting and after meal ingestion. In our in vivo model an EGR corresponding to 1% of gallbladder content on day one and 8% on day five was detected. In three out of five patients in whom bile was present in the stomach at endoscopy, 75Se HCAT cholescintigraphy demonstrated an EGR, while in three out of five patients in whom endoscopy was negative, 75Se-HCAT cholescintigraphy detected EGR either during fasting or after meal ingestion. As EGR is not constant, 75Se-HCAT may be a useful tracer of bile to detect EGR over a prolonged period of time and in different physiological conditions. PMID- 3665970 TI - Abnormalities of esophageal transit in patients with sporadic nontoxic goitre. AB - Esophageal transit (E.T.) was investigated in 122 consecutive euthyroid patients with scintigraphically proven goitre, and compared to 26 control subjects. E.T. was quantified using the 81mKr transit time, a highly sensitive technique capable of detecting even minor E.T. disorders. Abnormal E.T. was observed in 39% of goitrous patients, while it was normal in all controls. Occurrence of delayed E.T. was not correlated with either goitre firmness, the presence of symptoms of neck discomfort, difficulties in swallowing, or nodularity. E.T. delay was more frequent and more severe with larger goitres. In addition, E.T. delay was significantly correlated with asymmetry and "low lying" goitres. In summary, the present studies are the first demonstration of frequent E.T. anomalies in goitrous patients. The data suggest that E.T. impairment could be mediated by two mechanisms: a direct compression effect in patients with large, asymmetrical, partially retrosternal goitres; and an indirect functional esophageal anomaly in patients with small goitres. PMID- 3665971 TI - The use of human albumin millimicrospheres tagged with 99mTc in the evaluation of the removal capacity of the reticuloendothelial system. AB - Liver uptake kinetics of 99mTc labelled millimicrospheres of human serum albumin (MM) was studied in 16 subjects. Every subject received four doses of MM intravenously. The uptake constant decreased progressively with increasing dose. The maximum liver removal capacity, a parameter which is independent of liver blood flow, was calculated according to the method of Iio and Wagner (1963). From these data we conclude that MM are taken up by the reticuloendothelial system (RES) with saturable kinetics, and they are suitable for clinical use to evaluate RES function in man. PMID- 3665972 TI - Visualization of the thoracic duct by lymphoscintigraphy. AB - Imaging of the thoracic duct is usually performed by radiological lymphography. However, this procedure, which uses an oil based dye injected directly into the lymph channels, has some adverse effects. In this paper we note that lymphoscintigraphy, a physiological and non invasive method, may visualize thoracic duct abnormalities, and might be particularly useful when radiological lymphography is contraindicated. PMID- 3665973 TI - Tc-99m-HMPAO: a new platelet labelling compound? PMID- 3665974 TI - Thallium-201 myocardial scintigraphy in coronary triple-vessel disease: an attempt to increase sensitivity using quantitative methods. AB - In order to increase the sensitivity of thallium-201 exercise scintigraphy in patients with triple vessel coronary disease (TVD), we first examined retrospectively myocardial scintigrams of 179 patients with TVD, as documented subsequently by cardiac catheterization. Ischemia had been diagnosed visually in 141 (79%), scar without ischemia in 25 (14%) and no apparent perfusion defect in 13 (7%) cases. The subset of TVD patients without scintigraphic ischemia (i.e. those with scar or no perfusion defect) was then compared to a control group with normal coronary angiography using four quantitative criteria: (1) in preset-count analog images, a quotient of the exposure times rest image/stress image; (2) in preset-time digital images, a quotient of counts/pixel in stress image/rest image using two different myocardial regions of interest (ROI); (3) a similar quotient using paracardial lung ROIs of three different sizes; (4) the absolute values of stress lung uptake. Quotients (1) and (2) were expected to be lower in TVD patients than in normal controls due to exercise-induced global ischemia, quotient (3) and value (4) were expected to be higher due to exercise-induced left ventricular dysfunction with increased lung uptake of thallium-201. All results showed a tendency to confirm these hypotheses; significant differences (P less than 0.05) between patients and controls were obtained in all lung quotients and in 3 of 12 myocardial quotients. No significant differences were observed in the exposure time quotients of preset-count images and in the stress lung uptake. Due to overlapping values, it was not possible to fix normal and pathological ranges of any quotient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3665975 TI - Routine exercise testing or thallium-201 scintigraphy for prediction of cardiac events post-myocardial infarction? AB - The efficacy of 12 lead exercise testing and rest/exercise 201Tl scintigraphy as indicators of coronary anatomy and prognosis was compared in 46 low risk survivors of acute myocardial infarction. The non invasive procedures were performed at discharge, and cardiac catheterization was performed six weeks post discharge. On exercise testing, ST depression in leads remote from the site of infarction was considered to indicate multivessel disease and reversible ischaemia. On 201Tl scintigraphy, a perfusion defect remote from the site of infarction indicated multivessel disease, while a defect which reperfused at rest indicated reversible ischaemia. During the mean follow-up of 13 +/- 3 months, 14(30%) patients experienced cardiac events. Thallium scintigraphy was a more sensitive, but less specific, indicator of multivessel disease than exercise testing. Both exercise testing and 201Tl scintigraphy had a similar sensitivity (79% vs 79%), specificity (78% vs 88%) and predictive accuracy (78% vs 85%) for predicting subsequent cardiac events. Thus, in our patient population, 201Tl scintigraphy could not be demonstrated to be superior to routine exercise testing in low risk patients post myocardial infarction. PMID- 3665976 TI - Evaluation of 3 dimensional space and time filtering on ECG gated 201Tl myocardial images. AB - Stress 201Tl myocardial images were obtained using a standard ECG gated acquisition protocol for 10 min per view. These images were filtered using a three dimensional space and time filter. The effects of filtering were evaluated by sectorial analysis. Comparing raw and filtered dynamic images, quantification demonstrated that filtering did not produce artefacts. A conventional static image was also obtained as the sum of the series of unfiltered dynamic images. Comparison of raw static and filtered diastolic images indicated that the latter demonstrated myocardial abnormalities more clearly (P less than 0.01) in 33 patients. Improvement in the signal to noise ratio produced by filtering made cinematic display and visual analysis possible which was not feasible with raw gated images. Clinical evaluation is in progress. PMID- 3665977 TI - Quantitative analysis by digital computer of 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatogram in diffuse parenchymal liver diseases. AB - 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatograms were analyzed to provide information about the liver and bile duct. Calculations were based on a four compartmental model and included corrections for blood, tissue, hepatic parenchymal and bile backgrounds. The time activity curves for 99mTc-PMT in the cardiac region were described as the sum of two exponential functions, while curves for the hepatic regions were described as the sum of three exponential components. The measured hepatograms were compared with simulations and good agreement between the two curves showed that the compartmental model adequately described the blood and bile activities in vivo. Hepatic excretion rate constants were 0.179 +/- 0.026 in three normal subjects, 0.102 +/- 0.012 in four patients with chronic hepatitis and 0.082 +/- 0.034 in six patients with liver cirrhosis. In the case of diffuse parenchymal liver disease, there were lower rate constants for the excretion from the liver to the bile ducts than in normals, and the relative distribution volumes were also larger than normal. Prior to the development of this compartmental model, no useful kinetic model had been found which could satisfactorily explain the time activity curves. Experience in human studies proves this method to be accurate in determining the rate constants for the hepatobiliary transport of 99mTc-PMT. PMID- 3665978 TI - Imaging of pelvic rhabdomyosarcoma by bone scintigraphy. AB - Urinary tract distortion caused by pelvic rhabdomyosarcoma was imaged during 99mTc-oxidronate bone scintigraphy for suspected metastatic disease. This appearance correlated well with the anatomy defined on other imaging modalities. Bone scanning also proved valuable in detecting an otherwise occult osseous metastasis from this unusual tumor. PMID- 3665979 TI - Gallium-67 imaging in the diagnosis of blastomycosis. AB - 67Ga imaging was used in a group of 13 untreated patients with documented South American blastomycosis in an attempt to obtain additional information on the site and extent of the lesions. All diagnoses were confirmed by demonstration of the fungi in the lesions or body fluids. Serologic tests were performed on all patients. 67Ga imaging was correlated with X-ray in all patients, and with bone imaging when bony lesions were suspected. 67Ga imaging was positive for all lesions detected on chest X-ray and by clinical evaluation. More importantly, lesions clinically unsuspected and missed by other diagnostic techniques were shown on 67Ga imaging: bony and hepatic lesions in three patients; a brain lesion in one patient and parotid gland involvement in five patients. There was good agreement between 67Ga imaging and clinical and laboratory data, scintigraphy being more sensitive. Follow-up studies after specific therapy demonstrated decreased uptake in the lungs and other sites. 67Ga imaging is a useful tool for detection of suspected and unsuspected lesions of blastomycosis and to evaluate the response of the disease to specific therapy. PMID- 3665980 TI - Changes in pulmonary mean transit time demonstrated by the scintigraphic first pass technique in patients receiving radiation therapy. AB - Pulmonary mean transit time was assessed in 32 patients. A significant difference in this parameter is demonstrated between normals and those patients who have received radiotherapy. PMID- 3665981 TI - Radiation risk to patients from nuclear medicine in Poland (1981). AB - This paper presents the method and results of an estimation of radiation risk to the patients subjected to in vivo diagnostic radio-isotopic procedures in Poland in 1981. The qualitative and quantitative structure of these examinations is also presented. The estimation of an expected number of the stochastic effects caused by the internal exposure to ionizing radiation from the administered radionuclides have been performed for the patients according to ICRP recommendations. The conclusion was that 33 fatal radiation induced cancers, caused mainly by thyroid procedures with 131I, may be expected in the future in the population of about 80,000 patients who were subjected to radioisotopic procedures in Poland in 1981. PMID- 3665982 TI - Thyroid carcinoma and hot nodule. AB - A 70-year-old woman presented with a nodule in the thyroid gland. 131I scintigraphy of the gland showed a hot nodule. Histology of the resected thyroid revealed a papillary adenocarcinoma. Although a thyroid carcinoma with a hot nodule seen on the radioiodine isotope scan is a very rare occurrence, it is clinically very important because it may indicate a thyroid malignancy. PMID- 3665983 TI - Imaging in plague. AB - An 8-year-old boy presented with elevated temperature, malaise, hepatosplenomegaly, mesenteric adenitis, and septic shock. Cultures of biopsied abdominal lymph nodes as well as the blood grew Yersinia pestes. The boy's condition improved after two weeks of chloramphenicol and cefotaxime (Claforan). Two days after stopping intravenous antibiotic therapy, the patient again became febrile and complained of abdominal pain. Abdominal imaging with 111In-labeled leukocytes did not show any abnormalities, however, 67Ga-citrate scintigraphy demonstrated an abnormal focus of increased radiopharmaceutical uptake within a confluence of necrosed lymph nodes within the right upper quadrant of the abdomen. In addition, abnormal 67Ga-uptake was seen within the left hip region. Correlative imaging with computed tomography is also presented. PMID- 3665984 TI - Detection of right atrial myxoma by Fourier phase analysis. AB - The usefulness of radionuclide imaging in the detection of cardiac tumors has been demonstrated previously in left atrial myxomas. We report a case of right sided myxoma successfully diagnosed by radionuclide imaging and evaluated by cine display, Fourier phase analysis and paradox image. These three techniques are now available in many computer programs for gated cardiac blood pool imaging and provide an additional tool for assessing cardiac tumors. Particularly, functional paradox and Fourier phase analysis seem promising tools in the detection of both left and right sided tumors. PMID- 3665985 TI - A long term scintigraphic bone abnormality after trauma: a pitfall in the survey for metastatic disease. AB - A solitary bone lesion was detected by 99mTc bone scintigraphy during a survey for metastatic disease. A trauma in this region which had occurred 47 years previously, was mentioned by the patient on questioning. This case report emphasizes the need for a precise history of traumatic events, no matter how long has passed, before a survey for metastatic disease or when an atypical lesion is noted on the bone scan. PMID- 3665986 TI - Antitumor activity of antiestrogenic phenylindoles on experimental prostate tumors. AB - Two antiestrogenic phenylindoles (D 16726 and D 15413) were tested for their prostatic tumor-inhibiting activity. Both compounds exerted a strong inhibitory effect on prostate and seminal vesicle weight of intact rats and mice comparable to that of diethylstilbestrol. Their estrogenic properties, however, are much lower than those of DES. Therefore, there is no direct correlation between estrogenic potency and inhibition of accessory sex organ weights. The tumor inhibiting activity of D 16726 and D 15413 on the androgen-dependent R 3327 Dunning prostatic carcinoma and the human prostatic tumor PC 82 implanted in nude mice equals that of castration or of diethylstilbestrol. Both 2-phenylindoles had good affinities for estrogen receptors from calf uterine and R 3327 tumor cytosol, but no affinities for androgen and progesterone receptors. As these 2 phenylindoles have much lower estrogenic properties than diethylstilbestrol, they may also have low side-effects, and can therefore be of interest for the therapy of the prostatic carcinoma. PMID- 3665987 TI - Precancerous mammary hyperplastic alveolar nodules in four strains of virgin mice with different mammary tumor potentials: influence of chronic caffeine ingestion. AB - Based on the stimulating effects of caffeine on the formation of precancerous mammary hyperplastic alveolar nodules (HAN) in mice, the onset time of HAN was estimated by chronic caffeine ingestion in four strains of virgin mice with varying mammary tumor potentials (SHN, SLN, GR/A and C3H/He). Beginning at 21 days of age at weaning, mice were given tap water with (0.05%) or without caffeine and were killed at 40, 60, 90, 120 and/or 150 days of age. In the caffeine-treated groups, HAN appeared at 60, 120, 60 and 90 days of age in SHN, SLN, GR/A and C3H/He, respectively, while no such changes developed in the controls at the respective ages. These are the consequence of stimulation by caffeine of the growth of very early foci of HAN and indicate that HAN appear after 40, 90, 40 and 60 days of age in SHN, SLN, GR/A and C3H/He, respectively. The onset time of HAN is associated with mammary tumor potential of virgin mice. Caffeine did not affect estrous cycle, plasma levels of prolactin and growth hormone and endocrine organ weights, suggesting that promotion by caffeine of HAN growth is minimally mediated by the endocrine system. PMID- 3665988 TI - Cigarette smoking and the risk of endometrial cancer. AB - The risk of endometrial cancer in relation to cigarette consumption was evaluated in a hospital-based case-control study of breast and genital neoplasms conducted in Milan, northern Italy. For the present analysis, 357 women (cases) with histologically confirmed endometrial cancer were compared to a group of 1122 women (controls) admitted for a large spectrum of acute conditions unrelated to smoking or to any of the known or potential risk factors for endometrial cancer. Compared with never-smokers, the multivariate relative risk estimates were for current 0.45 [95% confidence interval (CI) = 0.30-0.70] and 0.86 (95% CI = 0.50 1.46) for ex-smokers. The negative association of endometrial cancer with current smoking was not influenced by menopausal status as well as by other major identified potential confounding factors, i.e. menstrual and reproductive history, body mass index, oral contraceptive or estrogen replacement therapy use and family gynecologic cancer history. However, there was no evidence of a dose risk effect, since the relative risks were similar in moderate and heavy smokers. The present study confirms that smoking is less frequent in cases hospitalized for endometrial cancer than in a comparison group of patients with non-smoking related acute conditions. This negative association is perhaps explained in terms of reduced estrogen levels in smokers, though the influence and the importance of some uncontrolled selection bias (due, for instance, to longer hospital stay of smokers even when admission diagnosis was for non-smoking-related conditions) cannot be ruled out. PMID- 3665989 TI - Induction of natural killer cell activity by the antitumour compound flavone acetic acid (NSC 347 512). AB - Flavone acetic acid (FAA), an antitumour drug at present undergoing clinical trial for cancer treatment, has been found to activate natural killer cell activity in spleen cells of mice following in vivo treatment at doses of 45-330 mg/kg. The activity of FAA was measured using a 51Cr-release assay, employing the YAC-1 lymphoma line as a target cell population, and was found to be comparable to that of the interferon inducer polyinosinic acid-polycytidylic acid. The induction of activity was blocked by anti-asialo GM1 antibody. The time course of induction of activity by FAA was similar to that of the induction of haemorrhagic necrosis of the colon 38 tumour in mice, suggesting that natural killer cells or other components of the immune system may be involved in the action of FAA. PMID- 3665990 TI - Reduced DNA repair synthesis in healthy women having first degree relatives with breast cancer. AB - The DNA repair synthesis induced by UV-C irradiation was studied in unstimulated lymphocytes of 64 healthy women whose mothers, or sisters, or mothers and sisters had had breast cancer. For comparison we took 48 control women. As the parameter for the determination of DNA repair synthesis the incorporation of [3H]thymidine in the presence of 2 mM hydroxyurea was taken. The levels of [3H]thymidine incorporation were reduced by 19 of the 29 women whose mothers, in 17 of the 25 women whose sisters and in nine of the 10 women whose mothers and sisters had had breast cancer. By comparison a decreased level was found in only seven of the 48 control women. This difference between the controls and women having first degree relatives with breast cancer was significant in each group. In an earlier study a reduced DNA repair synthesis in breast cancer patients was established. The present findings suggest that DNA repair synthesis may be one of the factors involved in the genesis of breast cancer. PMID- 3665991 TI - Mechanism of potentiation of antitumor activity of 5-fluorouracil by guanine ribonucleotides against adenocarcinoma 755. AB - The effect of various guanine ribonucleotides on the antitumor activity of 5 fluorouracil (FUra) was investigated by its action on adenocarcinoma 755. 5'-GDP and 5'-GMP were both equally effective in potentiating the antitumor activity of FUra without increasing toxicity. 5'-GTP and 5'-IMP also potentiated the activity but not as much as 5'-GMP. 2'-GMP and 3'-GMP did not enhance the antitumor activity. In contrast, cGMP antagonized the effects of FUra. The incorporation of 3H-labeled FUra into RNA or DNA showed there was no obvious association between the incorporation and antitumor activity after any treatment with guanine ribonucleotides. The combination of FUra and 5'-GMP produced the greatest inhibition of RNA synthesis. The combination of FUra and 2'-GMP had no effect on RNA synthesis. The inhibition of RNA synthesis may be the result of decreased pyrimidine pool size and increased incorporation of FUra into RNA. Potentiation of the antitumor activity of FUra by 5'-GMP was reversed by the injection of cytidine. Moreover, the combination of 5-fluorocytidine (FCyd) and 5'-GMP showed greater antitumor activity than FCyd alone. These results indicate that a decreased CTP pool potentiates the antitumor activity of FUra. Thus, 5'-GMP or 5' GDP strongly enhanced the antitumor activity of FUra, and the potentiation resulted from the inhibition of RNA synthesis caused by reduction of the CTP and UTP pool sizes and increased incorporation of FUra into RNA. PMID- 3665992 TI - Breast cancer incidence and month of birth: evidence against an etiologic association. AB - To investigate the potential relationship between month of birth and breast cancer risk, the authors examined the month of birth of 14,289 women with breast cancer and 38,151 women with cancer of sites other than the breast. All cases were newly diagnosed between 1974 and 1984, and were identified through the Cancer Surveillance System, one of 10 population-based cancer registries comprising the Surveillance, Epidemiology and End Results Program of the National Cancer Institute in the United States. Although breast cancer cases exhibited spring and fall peaks in their month of birth (confirming a previous report), the month of birth of non-breast cancer cases followed a similar distribution. Such patterns have also been reported from populations in other parts of the United States, western Europe, Japan and Australia. These findings suggest that the seasonal variation observed in month of birth of women who develop breast cancer is a reflection of the pattern of births in the underlying population, rather than a new variant in breast cancer epidemiology. PMID- 3665993 TI - Significance of serum ferritin in patients with gastric and colorectal cancer. PMID- 3665994 TI - A phase II study of 4-deoxydoxorubicin in advanced breast cancer. PMID- 3665995 TI - Radical irradiation of localized inoperable lung cancer with concurrent chemotherapy and misonidazole: a phase I/II study. PMID- 3665996 TI - Pharmacokinetically guided dose escalation in phase I clinical trials. Commentary and proposed guidelines. EORTC Pharmacokinetics and Metabolism Group. PMID- 3665997 TI - Counting and sampling errors: (mis)interpretation of data from tritiated thymidine labelled human tumors. PMID- 3665998 TI - Exogenous doxorubicinol induces cardiotoxic effects in rats. AB - An investigation was performed in the rat to assess the cardiotoxic effects of exogenous doxorubicinol compared with those induced by an equimolar dose of its parent drug doxorubicin. Rats received synthetic doxorubicinol or doxorubicin 3 mg/kg i.v. weekly for 3 weeks and were observed for a further period of 4 weeks. Survival, body growth, ECG parameters, and heart histopathology were studied. Doxorubicin markedly affected rat body growth, as well as several ECG parameters such as S alpha T, R alpha T, alpha TP and T-wave. Typical cardiac histological alterations were also induced by doxorubicin. In a similar way, doxorubicinol treatment was associated with a significant inhibition of rat body weight increase, and the appearance of ECG alterations as well as both macro- and microscopic signs of cardiac tissue damage. However these effects were delayed in time and their severity was lower compared with doxorubicin. Overall results indicate that doxorubicinol induces a doxorubicin-like toxic syndrome mainly affecting the heart, although to a lower degree of severity than that caused by the parent drug. It is suggested that the lower toxic potential displayed by doxorubicinol might be due at least in part to its greater polarity and a consequently lower cardiac tissue uptake compared with doxorubicin. PMID- 3665999 TI - Colony assay with human tumor xenografts, murine tumors and human bone marrow. Potential for anticancer drug development. AB - The colony formation of human tumor xenografts from nude mice, of murine tumors, and of human bone marrow (CFU-C) has been investigated in vitro using a modification of the double-layer agar assay described by Hamburger and Salmon. Systematic modification of growth conditions and careful selection of viable tumor tissue enhanced the growth rate (at least 30 colonies per dish) of human tumor xenografts to 86% (98/114). The median plating efficiency was 0.07% which is comparable to the results observed by others using fresh human tumors. The growth of human bone marrow was stimulated with a placenta-conditioned medium, which allowed growth of granulocytic stem cell colonies (CFU-C). The median plating efficiency of the bone marrow was 0.08%. The murine tumors P388, L1210, B16 melanoma, Lewis lung carcinoma and colon carcinoma 38 grew very well in vitro. Excluding the Lewis lung carcinoma, the plating efficiency of these tumors was markedly higher than that of the human tumor xenografts and human bone marrow. The colony assay may have potential as a secondary screening system for identifying new active structures and also for indicating which tumor types are most responsive to a new antitumor agent. We test new structures in 20 well selected human tumor xenografts and in the P388 mouse leukemia in dose-response relationships. The two most responsive xenograft tumors are subsequently studied in vivo in nude mice in order to determine if a new compound presents antitumor activity in an in vivo organism at a dose around the LD10 level. If a remission or at least no change is observed in the subcutaneously growing tumor, the new compound undergoes large disease-oriented testing usually in 60 xenografts. The in vivo studies are necessary in determining whether a compound has a more specific effect on tumor cells than on the dose-limiting normal tissue. The comparison of in vitro/in vivo activity allows an assessment of the relevant in vitro dose based on in vivo pharmacological behavior of a drug. It seems justifiable to apply the conclusions of this approach to the clinical setting because mouse toxicity data, e.g. the LD10, correspond well to the maximal tolerable doses in man. Moreover, for compounds whose dose-limiting toxicity is bone marrow suppression, the comparison of drug dosages effective in vitro on human bone marrow and tumor xenografts may prove helpful. The proposed testing strategy has been applied to TGU and Tiazofurin. At the relevant dosages TGU exhibited very limited activity in 67 human tumor xenografts studied.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3666000 TI - The clinical significance of melatonin serum determination in oncological patients and its correlations with GH and PRL blood levels. AB - In order to investigate the pineal function and its relation with the hypophysis in human neoplasms, melatonin and GH serum levels were determined in 63 patients, 42 affected by solid tumours and 21 by lymphoma or leukaemia. In women with breast cancer PRL was also measured. Melatonin, GH and PRL were evaluated in 52 healthy subjects acting as controls. The oncological patients showed significantly higher mean melatonin serum levels than the control subjects. Mean melatonin values were lower in patients with solid tumours who had metastases, than in cases without metastases. Chemotherapy caused an evident decrease in melatonin levels. Surgery was followed by a fall in melatonin in patients without metastases. Mean GH serum levels observed in oncological patients were similar to those in control subjects and were not influenced by therapy. PRL levels were within the normal range in women suffering from breast cancer. PMID- 3666001 TI - Tetracycline in the treatment of malignant effusions: evidence for a cytostatic action of the decomposed drug. AB - During the in vitro growth of human carcinoma cell lines an inhibition of cell growth in media containing tetracycline was observed at a concentration which was about 1000 times below the one reached in the pleural fluid of malignant effusions after tetracycline instillation. During short time drug-cell contact only previously heated tetracycline showed growth inhibition like doxorubicin, a substance of similar structure and origin. Freshly prepared tetracycline inhibited cell growth only after several minutes of drug cell contact. Our observations in vitro suggest that decomposed tetracycline plays an important role in the control of malignant effusions. PMID- 3666002 TI - Teniposide (VM-26) in patients with advanced refractory ovarian cancer: a phase II study of the Netherlands Joint Study Group for Ovarian Cancer. AB - In 23 evaluable patients with advanced ovarian epithelial cancer refractory to combination therapy with cisplatin and an alkylating agent, teniposide (VM-26) was administered as a short-term i.v. infusion at a dose of 100 mg/m2 on days 1 and 2, every 3 weeks. Toxicity was moderate and comparable to the pattern known from other studies. No objective response has been observed, showing that teniposide is not active as second-line therapy in this disease. PMID- 3666003 TI - Estrogen and progesterone receptor assays in human breast cancer: sources of variation between laboratories. AB - The importance of cytosol preparation as a source of inter-laboratory variation in estrogen (ER) and progesterone (PR) receptor measurements was evaluated together with protein measurements and receptor assays for five laboratories in Sydney, Australia, using pooled, fragmented human breast cancer samples. Protein measurement was only a minor source of variation between the laboratories with a CV of 13%. For ER measurements, sources of variation due to either assay or cytosol preparation methods contributed 40 and 39% CV each. However, the variation due to assay method was reduced to 25% CV when the results from one laboratory with a known effect of a different ER assay protocol were excluded, suggesting that assay standardization could readily reduce this source of variation. In contrast, the source of a large cytosol error (39% CV) could not be identified. Variations in PR results were similar to ER, but the sources could not be accurately estimated. It is concluded that cytosol preparation as well as assay methods were major sources of between laboratory variation and need to be further investigated and standardized. This approach should reduce these sources of variation since it was found that the within laboratory cytosol and assay variations were only 13 and 18% CV, respectively, for the ER measurements. PMID- 3666004 TI - Morphine reduces vagal-stimulated gastric acid secretion through a central action. AB - The influence of morphine on gastric acid secretion stimulated by 2-deoxy-D glucose or electrical vagal stimulation was studied in anaesthetised rats with perfused stomachs. It was found that changes in gastric acid output induced by electrical vagal stimulation were not noticeably affected, whereas those evoked by 2-deoxy-D-glucose were significantly suppressed by morphine pretreatment. The depressant effect of the opiate on the acid secretion stimulated by 2-deoxy-D glucose was abolished by naloxone pretreatment. It is suggested that morphine inhibits vagal-stimulated gastric acid secretion in rats by acting predominantly on opioid receptors in the central nervous system. PMID- 3666005 TI - Possible involvement of protein kinase C (PKC) in the regulation of electrically evoked serotonin (5-HT) release from rabbit hippocampal slices. AB - Protein kinase C (PKC)-activating phorbol esters enhanced the electrically evoked 5-HT release from rabbit hippocampal slices preincubated with [3H]5-HT. The release was diminished by polymyxin B, an inhibitor of PKC. These results are compatible with a stimulatory effect of PKC on the 5-HT release induced by action potentials. The mutual effects of PKC affecting drugs on 5-HT release suggest a functional but not a competitive interaction. The attenuation or the enhancement of effects of 5-HT autoreceptor ligands at various 5-HT biophase concentrations found after PKC-affecting drugs are in line with the view that autoreceptor mediated events are not directly influenced by the enzyme PKC. PMID- 3666006 TI - Correlation of histamine H1 receptor function and [3H]mepyramine binding in porcine tracheal tissue. AB - In order to validate the use of [3H]mepyramine as a radioligand to label airway histamine H1 receptors, the results of radioligand binding experiments using porcine tracheal tissue membranes were compared with the results of physiologic studies measuring histamine-induced trachealis muscle contraction. Close agreement was found between histamine-induced [3H]mepyramine binding inhibition and histamine concentration-contraction-response curves. Close agreement was also found between the KD of mepyramine-induced [3H]mepyramine binding inhibition and the K beta of mepyramine antagonism of muscle contractions stimulated by 10(-4) M histamine. [3H]Mepyramine binding was found to be rapid, reversible, saturable and stereospecific. Only H1 agonists and antagonists displayed potent [3H]mepyramine binding inhibition in competition binding studies. The results fulfill criteria for histamine H1 receptor identification by radioligand binding with [3H]mepyramine. PMID- 3666007 TI - On the ionic mechanism of cyproheptadine-induced bradycardia in a rabbit sinoatrial node preparation. AB - The effects of cyproheptadine (0.1-10 microM) on the membrane potentials and currents of rabbit sinoatrial node were examined with the double-microelectrode voltage clamp technique. Cyproheptadine reduced the heart rate, maximum rate of depolarization and action potential amplitude. It also decreased the slope of phase 4 depolarization. On the current systems, cyproheptadine decreased the slow inward current (Isi), the time-dependent potassium outward current (Ik) and the hyperpolarization-activated current (Ih). The reduction of Isi was the major effect. Furthermore, Isi was progressively decreased by repetitive membrane depolarization during administration of cyproheptadine, an effect suggestive of frequency-dependent block of Isi. These electrophysiological observations indicate that cyproheptadine has a calcium antagonistic property, and additionally, decreases Ik and Ih in rabbit sinoatrial node. PMID- 3666008 TI - [3H]N-methyl-carbamylcholine, a new radioligand specific for nicotinic acetylcholine receptors in brain. AB - The present study characterized the binding of [3H]N-methyl-carbamylcholine ([3H]methyl-carbachol), a new radioligand, to rat cerebral cortex membranes and demonstrated the autoradiographic distribution of these sites in rat brain. With atropine used to block muscarinic acetylcholine sites and nicotine to define non specific binding, [3H]methyl-carbachol bound specifically, saturably and with high affinity (Kd = 11.0 nM, Bmax = 118.4 fmol/mg protein and Hill coefficient = 0.92) to a population of presumably nicotinic sites in cerebral cortex membranes. When nicotine was used to block nicotinic acetylcholine sites and atropine to define non-specific binding there was no specific binding of [3H]methyl-carbachol (concentrations up to 45 nM) to possible muscarinic sites in cerebral cortex membranes. The binding parameters under non-selective conditions (without blockade of either muscarinic or nicotinic acetylcholine sites) had very similar values to those obtained under nicotinic conditions (Kd = 8.0 nM, Bmax = 125.0 fmol/mg protein and Hill coefficient = 0.98). [3H]Methyl-carbachol binding was potently inhibited by nicotinic agonists and antagonists but only poorly displaced by muscarinic agents. Autoradiographic studies evidenced high densities of [3H]methyl-carbachol binding sites in the interpeduncular nucleus, various thalamic nuclei, superior colliculus and layers III/IV of the cortex. Such a distribution was very similar to those previously reported for nicotinic acetylcholine sites and other radioligands. These results suggest that [3H]methyl carbachol is a specific radioligand of the neuronal nicotinic receptor. Its stability and high selectivity constitute distinct advantages over previously used nicotinic radioligands such as acetylcholine and nicotine. PMID- 3666009 TI - Antinociceptive effect of systemic and intrathecal morphine in spinally transected rats. AB - The antinociceptive effect of morphine on the tail withdrawal reflex was examined in spinally transected rats. The efficacy of systemically administered morphine was significantly reduced within 24 h after transection, and continued to decline during the first three posttransection weeks. In contrast to the diminished effect of systemic morphine, the efficacy of intrathecal morphine was not reduced during the first three weeks after a spinal transection. These data demonstrate a significant difference in the functional effect of systemic and spinal morphine in spinally transected rats. The results indicate that the direct antinociceptive effect of morphine on the spinal cord is not reduced after spinal transection. PMID- 3666010 TI - Extracellular dopamine in rat striatum following uptake inhibition by cocaine, nomifensine and benztropine. AB - A microdialysis/smallbore chromatographic system was used to monitor changes in extracellular dopamine concentration in the striatum of the rat following administration of drugs that block catecholamine uptake. Analysis of 0.5 microliter of dialysate every 5 min showed dose-dependent elevations in extracellular dopamine following systemic administration of nomifensine (1 and 10 mg/kg), benztropine (5 and 25 mg/kg) and cocaine (3, 10 and 30 mg/kg). The order of potency in vivo was nomifensine greater than cocaine greater than benztropine. The short sampling interval allows accurate temporal profiles following pharmacological manipulations to be acquired. PMID- 3666011 TI - Differential regulation of M2 muscarinic receptors by guanine nucleotides in rat cerebral cortical and cardiac membranes. PMID- 3666012 TI - Muscarinic M1-receptors mediate the negative inotropic effect of methacholine in chicken but not in guinea-pig atria. PMID- 3666013 TI - Stimulation of dopamine D-2 receptors increases potassium permeability in mammotrophs. PMID- 3666014 TI - Apomorphine decreases stimulated dopamine release in rat nucleus accumbens but not in neostriatum: in vivo voltammetric data. PMID- 3666015 TI - Bezold-Jarisch reflex is inhibited by excitotoxin-induced destruction of vagal primary afferent neurons. PMID- 3666016 TI - Kelatorphan potentiates the effect of [Met5]enkephalin in the substantia gelatinosa of the cat spinal cord. AB - In anaesthetized spinal cats, kelatorphan, an inhibitor of enkephalin degradation, was administered microelectrophoretically while recording the excitation of lumbar dorsal horn neurones by noxious and innocuous peripheral stimuli. When administered near the cell bodies of laminae IV and V neurons, kelatorphan neither altered evoked responses nor potentiated the inhibition by [Met5]enkephalin of these cells. When ejected in the substantia gelatinosa, however, kelatorphan reduced the nociceptive responses of some laminae IV and V neurones, an effect blocked by electrophoretic naloxone. The selective inhibition of nociceptive responses by [Met5]enkephalin administered in the substantia gelatinosa was markedly potentiated by co-administration of kelatorphan, and this effect was also blocked by electrophoretic naloxone. Neurones inhibited by administration of kelatorphan alone in the substantia gelatinosa were excited by administration of naloxone alone at the same site. The results suggest that some dorsal horn neurones are tonically inhibited by an action of opioid peptides in the substantia gelatinosa, and indicate that enzymic degradation limits the action of both exogenous and endogenous enkephalin in this spinal region. PMID- 3666017 TI - Effect of azapropazone and allopurinol on myocardial infarct size in rats. AB - The effect of the xanthine oxidase inhibitor allopurinol and the non-steroidal antiinflammatory agent azapropazone on infarct size in rats, subjected to 48 h of occlusion of the left anterior descending coronary artery, were studied. Allopurinol (50 mg/kg i.p., twice daily from 24 h before to 48 h after LAD occlusion) and azapropazone (100 mg/kg i.p twice daily from 24 h before to 48 h after LAD occlusion) significantly reduced infarct size when compared to saline treated rats. These data point towards involvement of xanthine oxidase derived free radicals in evolving myocardial infarction in rats; beneficial effect of azapropazone in this model may be related to the drug's ability to inhibit xanthine oxidase as well as various key neutrophil functions. PMID- 3666018 TI - Does REM sleep deprivation induce subsensitivity of presynaptic dopamine or postsynaptic acetylcholine receptors in the rat brain? AB - Yawning behavior was used to evaluate the sensitivity of presynaptic dopamine receptors and postsynaptic acetylcholine receptors of normal and REM sleep deprived (REMSD) rats. The results show a lowering of the dose-response curve obtained with apomorphine and pilocarpine, as well as a shift to the right in the curve obtained with physostigmine. These results suggest that REMSD induces subsensitization of presynaptic dopamine receptors and/or postsynaptic acetylcholine receptors with different characteristics related to the mechanism of action of the cholinomimetic agent employed. PMID- 3666019 TI - Binding of the S(+)- and R(-)-enantiomers of bethanechol to muscarinic receptors in jejunal smooth muscle, nasal mucosa, atrial and ventricular myocardium of the rat. AB - Both the enantiomers of bethanechol displaced R(-)-[3H]quinuclidinyl benzilate from muscarinic binding sites in homogenates from rat jejunum, nasal mucosa, atrial and ventricular myocardium. Stereoselectivity of receptor binding for S(+) and R(-)-bethanechol was found in all tissues investigated (Ki S(+) less than Ki R(-)). Different proportions of high and low affinity binding sites for bethanechol enantiomers and S(+)-methacholine in jejunal smooth muscle, atrial and ventricular muscle and the presence of only low affinity binding sites in nasal mucosa point to differences in receptor-effector coupling in these tissues. The relative insensitivity of cardiac tissue for bethanechol compared to methacholine might be related to the much smaller proportion of high affinity binding sites found for S(+)-bethanechol in heart ventricular muscle. PMID- 3666020 TI - Chronic lithium treatment reduces norepinephrine-stimulated inositol phospholipid hydrolysis in rat cortex. PMID- 3666021 TI - Metabolite involvement in the behavioral effects of bromocriptine in cats. AB - There is a lag phase of 30-60 min before the onset of bromocriptine (BC) action. This delay may be necessary for the formation of active metabolites. The objective was to determine whether the abnormal behavioral effects induced by BC involve active hepatic metabolites. Thus, we studied the effect of an inhibitor of hepatic hydroxylation metabolism (SKF 525A) on the behavior of BC-treated cats. Experiments began after six weeks of habituation and involved i.p. injections of: (1) propylene glycol (drug vehicle); (2) SKF 525A (70 mg/kg); (3) BC (10 mg/kg); and (4) SKF 525A followed 30 min later by BC. Each cat received the four treatments with two weeks elapsing between consecutive experiments. The frequency of 12 behaviors was scored for 60 min after 1 h posttreatment. BC alone induced emergent behavioral changes (hallucinatory-like, limb flicks, abortive grooms) that were not observed following control injections (vehicle and SKF 525A). There was a complete elimination of BC-induced hallucinatory-like behavior/escape by SKF 525A pretreatment. Other emergent behaviors were similarly reduced but persisted in all cats. The large frequency of grooming induced by BC was significantly reduced. SKF 525A pretreatment was correlated with a significant increase in staring and quiet sitting and a failure of BC to increase activities such as rubbing, treading and kneading. But many other BC-induced behaviors showed no changes. The data demonstrated that particular BC-induced changes in cats are antagonized by SKF 525A. The behavioral suppression caused by SKF 525A is compatible with the involvement of active hepatic metabolites from BC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666022 TI - Diminution of contractile response of the aorta from endotoxin-injected rats. AB - The contractility of a helical strip of the thoracic aorta was studied in rats injected intraperitoneally with endotoxin. The contractile response to any of the agonistic agents, KCl, norepinephrine or 5-hydroxytryptamine was time dependently diminished in the endotoxin-injected rats compared to the controls. This diminution preceded the depression of blood pressure. When the external calcium concentration was increased from 2.5 to 7.5 mM after the KCl (80 mM)-induced contractile response reached a plateau, the diminished contractile response was reversed in the endotoxin-injected group. The strips from the endotoxin-injected rats showed a higher 45CaCl2 uptake into the vascular tissue with the KCl stimulated contraction. These findings suggest that the blood pressure depression during endotoxic shock may be attributed partially to the diminished contractility of the blood vessels and that this diminution is induced by a disorder of calcium utilization within vascular smooth muscle during vascular contraction. PMID- 3666023 TI - Protein kinase C: regulation of serotonin release from rat brain cortical slices. AB - The effects of phorbol esters on serotonin release were examined in an attempt to investigate the role of protein kinase C in the regulation of serotonin release. Rat brain parietal cortical slices were incubated with [3H]5-HT in the presence of pargyline in order to label the serotonin stores. Potassium stimulated (30 s) release and spontaneous [3H]5-HT efflux were examined in slices during superfusion with Krebs-Ringer solution containing chlorimipramine. Repeated K+ stimulations elicited reproducible responses with release ratios of approximately 1.0. Introduction of phorbol 12-myristate, 13-acetate (PMA) or phorbol 12,13 dibutyrate (PDBu) 20 min prior to S2, or S3 resulted in dose-related increases in [3H]5-HT or [3H]NE release. PMA was slightly more potent (93% increase) than PDBu in potentiating K+-stimulated [3H]5-HT release. Phorbol and 4 alpha-phorbol 12,13 didecanoate (4 alpha PDD) which do not activate protein kinase C did not alter serotonin release. In contrast, basal [3H]5-HT and [3H]NE release were altered to a far lesser extent which was not always dose related. The response to the phorbol esters was reversible, Ca2+-dependent and reached maximal effect after 20 min of superfusion. The putative protein kinase C inhibitor, 1-(5 isoquinolinesulfonyl)-2-methylpiperazine (H-7) inhibited K+-induced [3H]5-HT release significantly (11%) but did not alter basal efflux. The PMA facilitation of serotonin release was, however, markedly prevented by the enzyme inhibitor. The effect of PMA on release was found not to be directly mediated through the prejunctional serotonin autoreceptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666024 TI - Morphine releases endogenous adenosine from the spinal cord in vivo. PMID- 3666025 TI - Effects of 17 beta-estradiol and progesterone on agonist-stimulated inositol phospholipid breakdown in uterine smooth muscle. AB - Inositol phospholipid breakdown, from a [3H]inositol-labelled pool, induced by a variety of contractile agents was monitored in uterine smooth muscle slices pretreated with estradiol-17 beta or estradiol-17 beta and progesterone by measuring the accumulation of [3H]inositol phosphates. Agonist potencies for stimulating [3H]IP accumulation were not affected by hormone treatment but the maximum responses were dependent upon hormonal state. Maximum responses to carbachol, norepinephrine, prostaglandin F2 alpha were increased in progesterone dominated tissues but maximum responses to oxytocin were unaffected. Inhibition of agonist-induced responses by competitive receptor antagonists confirmed the receptor specificity of carbachol-, norepinephrine- and oxytocin-mediated responses. Partial membrane depolarization (25 mM K+) did not affect agonist induced maximal responses in either estrogen- or progesterone-dominated tissue. These data suggest that gonadal steroid hormones affect agonist-dependent intracellular calcium mobilization processes. PMID- 3666026 TI - Sustained nerve-mediated contractions of guinea-pig ileum during morphine withdrawal by washout. AB - The effects of morphine withdrawal by washout were examined in ilea from guinea pigs pretreated by subcutaneous implantation of two pellets, each containing 155 mg morphine. One week later preparations of the longitudinal muscle-myenteric plexus were set up in vitro in a modified Krebs solution containing morphine (1 microM). Within 5-15 min after washing in morphine-free Krebs, the preparations exhibited marked spontaneous contractions which became maximal after 20-60 min. The contractions resulting from morphine washout were greatly reduced by TTX and by hyoscine but not by hexamethonium, suggesting that excitation involved predominantly the cholinergic myenteric motor neurons, and was thus similar to that underlying the contraction induced by naloxone. In contrast to the naloxone induced contractions, however, those resulting from morphine washout were well sustained during periods of recording up to 5 h. Morphine washout therefore provides conditions suitable for investigating the mechanisms underlying the variety of withdrawal signs observed in the ileum in vitro. PMID- 3666027 TI - Strophanthidin and force regulation by intracellular sodium activity in cardiac Purkinje fibers. AB - The role of intracellular sodium activity (aiNa) in the inotropy of a low concentration of strophanthidin (5 X 10(-8 M) was studied in sheep cardiac Purkinje fibers by recording contractile force, aiNa and transmembrane potentials under conditions that vary aiNa. High [Na]O, strophanthidin and tetrodotoxin (TTX) changed force and aiNa in a closely related manner: on logarithmic coordinates, the data were well fitted by a single line obtained through the regression equation F = b (aiNa)s where b represents the intercept and s the slope of the relation. With low strophanthidin, force increases as a linear function of (aiNa) approximately 5 and with high [Na]O as a linear function of (aiNa) approximately 6. However, the combined administration of high [Na]O and strophanthidin results in a potentiated inotropic effect as force becomes a linear function of (aiNa) approximately 14. This potentiation and its abolition by TTX suggests that factors other than aiNa powerfully modify the inotropy of a low strophanthidin concentration. PMID- 3666028 TI - Anesthetics produce differential actions on membrane responses of the crayfish stretch receptor neuron. AB - The actions of ethanol, halothane and pentobarbital on the membrane electrical properties and synaptic transmission of isolated crayfish stretch receptor neurons were studied to determine possible sites of action contributing to differential effects previously described on physiological discharge activity. The three agents depressed GABA-mediated transmission and altered postsynaptic membrane electrical properties. Both pre- and postsynaptic sites of action appeared to contribute to the anesthetic-induced alteration of neuronal function. The agents studied produced different, concentration-dependent, membrane effects which included biphasic actions on membrane resistance and spike threshold. The results suggest that multiple-sites of action are involved and different anesthetics may not act via the same mechanism(s) at these sites. PMID- 3666029 TI - Gastric mucosal protection by acetazolamide derivatives: role of carbonic anhydrase and sulfhydryls. AB - Acetazolamide, a carbonic anhydrase inhibitor, prevents acute gastric hemorrhagic lesions induced by ethanol. We used acetazolamide and other carbonic anhydrase inhibitors to correlate their gastroprotective effects with the degree of inhibition of carbonic anhydrase. Since acetazolamide is a thiadiazole, we also investigated structurally related thiadiazoles that contain sulfhydryls to test the hypothesis that the protection against ethanol-induced gastric erosions is related to the presence of sulfhydryls. Dose-response studies with acetazolamide revealed that the protection did not correlate with the inhibition of carbonic anhydrase in the rat gastric mucosa. The carbonic anhydrase inhibitors sulfanilamide and ethoxzolamide, did not offer protection. Bismuthiol I, a thiadiazole with two sulfhydryls, was twice as protective as 2-amino-5-mercapto 1,3,4-thiadiazole with only one sulfhydryl group. We conclude that the protection by acetazolamide against ethanol-induced lesions is not related to the inhibition of carbonic anhydrase in the gastric mucosa. The gastroprotective effect of acetazolamide and its derivatives may be related to their content of sulfhydryls in an oxidized or reduced state. PMID- 3666030 TI - Cholecystokinin facilitates ejaculation in male rats: blockade with proglumide and apomorphine. AB - Systemic administration of the active, sulfated form of cholecystokinin octapeptide (CCK-8S), at a dose known to inhibit dopamine (DA) release, significantly reduced the latency to ejaculate and number of intromissions preceding ejaculation in sexually active male rats. This effect was identical to that reported for low doses of the DA receptor agonist apomorphine, which bind preferentially to presynaptic DA autoreceptors. The facilitatory effect of CCK-8S on ejaculation was blocked by the putative CCK receptor antagonist proglumide and by a presynaptic dose of apomorphine. Blockade of the effect of CCK-8S with a presynaptic dose of apomorphine is consistent with CCK induction of depolarization block in DA neurons. These data suggest that CCK-8S and apomorphine may reduce the ejaculation threshold in sexually active male rats by inhibition of DA release via two different mechanisms of action. PMID- 3666031 TI - Influence of the endothelium on the amplification by serotonin of vasoconstrictor responses to noradrenaline and sympathetic nerve stimulation in rabbit isolated ear artery. AB - The influence of the vascular endothelium on the amplifying effect of serotonin on steady-state responses to noradrenaline (NA) and sympathetic nerve stimulation (SNS) has been studied in the rabbit isolated ear artery. Removal of the endothelium abolished the dilator effect of acetylcholine (ACh, 1 microM) obtained in the presence of NA (0.3 microM). Responses to NA were increased after endothelium removal; however, responses to SNS were unaffected. Serotonin in a concentration which did not itself produce vasoconstriction (100 nM) increased responses of endothelium-intact preparations to NA and SNS and of endothelium denuded preparations to SNS but had no effect on NA responses of endothelium denuded preparations. If neuronal uptake was inhibited with cocaine (1 microM), serotonin markedly amplified responses to NA and SNS in both endothelium-intact and endothelium-denuded preparations. These results suggest that the endothelium influences the amplifying effect of serotonin on responses of rabbit ear artery to NA but not to SNS. Inhibition of removal of serotonin and NA by neuronal uptake may extend the facilitatory interaction between NA and serotonin to smooth muscle cells which are not subject to the inhibitory influence of an endothelium derived relaxing factor. PMID- 3666032 TI - Regional differences in reactivity and in the influence of the epithelium on canine intrapulmonary bronchial smooth muscle responsiveness. AB - Differences in the reactivity and in the influence of the epithelium on responsiveness of canine 2nd and 3rd generation airway smooth muscle were examined. Epithelium-containing 3rd generation airways produced a greater maximum contraction and were more sensitive to methacholine and histamine, but not to KCl, than corresponding 2nd generation airways. Mechanical removal of the epithelium increased the sensitivity to methacholine and histamine in 2nd generation airways; there was also an increase in the maximum response elicited by histamine, but not by methacholine, in epithelium-free preparations. In contrast, there was no significant difference in the sensitivity to or the maximum response elicited by histamine or methacholine in epithelium-containing and epithelium-free 3rd generation airways. Epithelium removal had no effect on KCl-induced responses in either airway region. The inhibitory effects of verapamil (1 microM) against KCl- and methacholine-induced responses were identical in preparations containing and lacking the epithelium. The results support the postulate of an epithelium-derived inhibitory factor modulating airway smooth muscle reactivity. Furthermore, the influence of the epithelium exhibits regional differences, being greater in larger airways. PMID- 3666033 TI - Preferential stimulation of ventral tegmental area dopaminergic neurons by nicotine. AB - The effect of intravenous (i.v.) nicotine on the single unit activity of midbrain dopamine (DA) neurons was studied in rats under either local or general anesthesia. Nicotine (50-500 micrograms/kg) produced a dose-related increase in the firing rate of nigral pars compacta DA cells (A9), up to 25% above baseline, irrespective of the preparation. The same range of doses was more than three times as effective on ventral tegmental area DA cells (A10) in rats paralyzed and given a local anesthetic. By contrast, the majority of these cells were temporarily depressed in deeply anesthetized animals. All of the above effects were reversed and prevented by i.v. mecamylamine suggesting the involvement of nicotine cholinergic receptors. Moreover, after nicotine-induced stimulation, low doses of i.v. apomorphine inhibited the firing rate similar to controls indicating that dopamine receptors are not directly involved in the nicotinic action. The results suggest that acute nicotine shares with other drugs of abuse the characteristic of being more effective in stimulating A10 than A9 neurons. PMID- 3666034 TI - Immediate and long-term effects of opiate antagonists on postictal behaviour following amygdala kindling in the rat. AB - Male Wistar rats implanted with bipolar electrodes in the amygdaloid complex were kindled. Subcutaneous injection of naloxone or naltrexone in low doses--0.12 and 0.24 mg/kg, respectively--dramatically reduced the postictal behavioural depression (BD) at 10 or 60 min. Remarkably, the BD was still reduced one day later. It would appear that the brain mechanisms involved in postictal BD use mu receptors since BD is quite sensitive to low doses of the preferential antagonists naloxone and naltrexone. The long-term effects, the most novel aspect of these studies, are probably related to immediate effects but could be produced through slow genomic processes or alteration of the response to endogenously released enkephalins. PMID- 3666035 TI - Pertussis toxin reduces the antiadrenergic effect of 2-chloroadenosine on papillary muscle and the direct negative inotropic effect of 2-chloroadenosine on atrium. AB - 2-Chloroadenosine reduced the contractile tension of guinea-pig atria directly, and inhibited the increase in tension produced by beta-adrenergic stimulation of guinea-pig papillary muscle. Both effects were reduced by 8-phenyltheophylline, a competitive antagonist at extracellular P1-purinoceptors. Treatment of guinea pigs with pertussis toxin reduced the sensitivity of both atria and ventricles to 2-chloroadenosine. Atria were significantly affected after treatment with 125 micrograms/kg toxin, but not 100 micrograms/kg. 60 micrograms/kg toxin had no effect on the sensitivity of the ventricles, but 100 and 125 micrograms/kg significantly decreased the antiadrenergic effect of 2-chloroadenosine. We conclude that both the direct and antiadrenergic effects are mediated by an inhibitory guanine nucleotide binding protein. PMID- 3666036 TI - 5-HT1B agonists induce anorexia at a postsynaptic site. AB - Ru 24969 and two other putative 5-HT1B agonists 1-(3-chlorophenyl)piperazine (mCPP) and 1-[3-(trifluoromethyl) phenyl]piperazine (TFMPP) and RU 24969 dose dependently decreased food intake over 4 h (and in the case of RU 24969 also over 24 h) in free-feeding male Sprague-Dawley rats. Decreasing the doses of the agonists below the range eliciting anorexia did not cause hyperphagia. The anorexic effect of RU 24969 over 4 h was antagonised by metergoline, (-)pindolol and (+/-)cyanopindolol, but not by ketanserin, spiperone or haloperidol. Metergoline and (+/-)cyanopindolol also antagonised the anorexic effect of RU 24969 over 24 h. This data is consistent with an action mediated by 5-HT1B receptors. Locomotor activity induced by RU 24969 was markedly antagonised by haloperidol despite its lack of effect on the anorexic response. Persistence of the anorexic effect of RU 24969 after p-chlorophenylalanine (pCPA) pretreatment suggests that 5-HT1B agonists induce anorexia at a postsynaptic 5-HT receptor. PMID- 3666037 TI - Change in hypothermia and catalepsy induced by cannabinoids or morphine in mice tolerant to these substances. AB - delta 8-Tetrahydrocannabinol (THC)- and 8 beta, 9 beta-epoxyhexahydrocannabinol (EHHC)-tolerant mice were tolerant to the hypothermia produced by morphine while 8 alpha, 9 alpha-EHHC-tolerant mice were not. Morphine-tolerant mice acquired partial tolerance to the hypothermic effect of 8 alpha,9 alpha-EHHC, but not to the effect of delta 8-THC and 8 beta,9 beta-EHHC. Cataleptogenic effects of all cannabinoids were enhanced in morphine-tolerant mice as compared to non-tolerant animals. It seems that morphine-tolerant mice exhibited hypersensitivity to the cataleptogenic effect of the cannabinoids without potentiation of the hypothermia. These results suggest that the morphine-tolerant mouse may acquire 'latent' cross-tolerance to the hypothermic effect of the cannabinoids. PMID- 3666039 TI - Potency of several non-steroidal antiinflammatory drugs on airways responses to histamine. AB - The effects of four non-steroidal antiinflammatory drugs (NSAIDs, indomethacin, flufenamate, aspirin and phenylbutazone) were investigated in anesthetized guinea pigs. Bronchoconstriction (increased airways resistance and decreased conductance and compliance) was obtained to histamine (1-3 micrograms/kg i.v.). Each of the NSAIDs (0.1-20 mg/kg i.v.) enhanced bronchoconstriction to histamine. Maximum effects were obtained 12-44 min after administration of the NSAID. The order of potency of the drugs in causing a 50% increase in resistance responses to histamine was indomethacin greater than flufenamate greater than aspirin greater than phenylbutazone. PMID- 3666038 TI - The influence of omeprazole on the protective effects of secretagogues against ethanol-induced gastric ulceration in rats. AB - The influence of omeprazole on the antiulcer effects of histamine, methacholine and pentagastrin on ethanol-induced gastric ulceration was studied. Histamine 5 mg/kg, methacholine 500 micrograms/kg or pentagastrin 100 micrograms/kg pretreatment s.c. markedly reduced ethanol (50%, 10 ml/kg p.o.)-induced gastric ulceration in pylorus-ligated conscious rats, but significantly elevated the gastric secretory volume and acid output. Omeprazole pretreatment 50 mg/kg s.c. reduced gastric secretion and abolished the ulcer-protecting effects of the three secretagogues. The same doses of histamine, methacholine or pentagastrin did not significantly alter the gastric secretory volume but increased the total acid output of ex-vivo stomach chamber preparations in anaesthetised animals. Histamine worsened ethanol-evoked ulceration whereas methacholine and pentagastrin had no effect on the lesions. Omeprazole pretreatment did not prevent ulcer aggravation by histamine. It is concluded that the antiulcer effects of the three secretagogues in conscious animals are probably due to the increased secretory volume which lessens the ulcerogenic action of ethanol by its dilution. Omeprazole reduces the secretory volume and thus prevents the antiulcer effect of these secretagogues. The findings with histamine and omeprazole in the ex-vivo stomach experiments support the suggestion that it is unlikely that increased gastric acid secretion affects the ulcerogenicity of ethanol in rat stomach. PMID- 3666040 TI - Carbamazepine up-regulates the binding of [3H]PK 11195 to platelets of epileptic patients. AB - The maximal number of binding sites (Bmax) and the equilibrium dissociation constant (KD) values for [3H]PK 11195 binding were determined in the platelet membranes of epileptic patients before and after 4 weeks of carbamazepine (CBZ) treatment, as well as in healthy controls. There was a decrease of 17.1% in the Bmax value of patients before treatment as compared to the controls whereas an increase of 50.3% was observed in CBZ-treated patients as compared to their pretreatment values. The up-regulatory effect of CBZ on peripheral benzodiazepine receptors was not accompanied by alterations in KD values. PMID- 3666041 TI - Muscarinic receptor heterogeneity in guinea pig intestinal smooth muscle: binding studies with AF-DX 116. AB - Muscarinic receptor subtypes in longitudinal and circular smooth muscles of the guinea pig ileum were characterized with the use of the cardioselective antagonist AF-DX 116 in binding competition experiments against 0.3 nM [3H] N methylscopolamine [( 3H]NMS). This compound recognized a heterogeneous receptor population in both smooth muscles, revealing the existence of different percentages of the cardiac (KD = 92-110 nM) and the glandular (KD = 1150-2541 nM) muscarinic receptor subtypes. These results, together with the low potency displayed by AF-DX 116 to inhibit the agonist-stimulated smooth muscle contraction and salivary secretion allow the suggestion that the glandular muscarinic receptor subtype, showing a low affinity for AF-DX 116, is involved in smooth muscle contraction. PMID- 3666042 TI - Dissociation of actions of BRL 34915 in the rat portal vein. AB - In rat portal vein, 0.5 and 5.0 microM BRL 34915 [(+/-)-6-cyano-3,4-dihydro-2,2 dimethyl-trans-4-(2-oxo-1-pyrrolidyl++ +)-2H- benzo[b]pyran-3-ol] abolished spontaneous rhythmic movements and norepinephrine (NE)-induced tension responses, respectively. Only the higher (5 microM) concentration of BRL 34915 increased 42K efflux and inhibited the NE-induced increase in 42K efflux. These results suggest that BRL 34915 inhibits spontaneous rhythmic movements and NE-induced tension responses by differing mechanisms of action and that only the block of the NE induced tension response is related to K+ permeability or conductance changes. PMID- 3666043 TI - Protein kinase C-mediated intracellular alkalinization in rat and rabbit aortic smooth muscle cells. AB - The influence of protein kinase C (C-kinase) activation on intracellular pH (pHi) of cultured rat (RASM) and rabbit (RBASM) aortic smooth muscle cells was studied by employing a pH-sensitive fluorescent-dye 2,7-biscarboxyethyl-5,6 carboxyfluorescein (BCECF). The known C-kinase activators 12-O tetradecanoylphorbol-13-acetate (TPA), phorbol 12,13-dibutyrate (PDBu) and mezerine as well as the agonist angiotensin II each caused an intracellular alkalinization of approximately 0.1-0.15 pH units in RASM and RBASM cells grown in serum-free conditions. TPA-induced alkalinization was sensitive to the Na+/H+ exchange blockers amiloride and 5-N-ethylisopropyl-amiloride (EIPA). These results suggest that protein kinase C activation leads to intracellular alkalinization in vascular smooth muscle cells and the increase in pHi might play an important role in receptor-coupled arterial contraction. PMID- 3666044 TI - Restoration of analgesic response of C57BL/6J-bgJ (beige-J) mice to morphine by carbachol. AB - C57BL/6J-bgJ (beige-J) mice respond poorly to the analgesic effects of centrally administered (intracerebroventricular; i.c.v.) morphine in the tail-flick test. In the present study C57BL/6J-bgJ mice, their littermate (heterozygous) controls, and normal Swiss mice were given carbachol (200 micrograms/ml) in their drinking water for three weeks. Carbachol had no effect on control animals. However, the carbachol-treated beige-J mice responded to i.c.v.-administered morphine (1 microgram) significantly better than untreated beige-J mice and nearly as well as the normal mice. PMID- 3666045 TI - Dopaminergic control of the cough reflex as demonstrated by the effects of apomorphine. AB - The effect of apomorphine on the cough reflex induced by electrical stimulation of the superior laryngeal nerve was studied in cats anesthetized with pentobarbital. Intravenous administration of apomorphine in doses which ranged from 0.1 to 1.0 mg/kg decreased the number of coughs in a dose-dependent manner. Haloperidol (0.3 mg/kg i.v.) did not significantly change the number of coughs. However, haloperidol administered 15 min prior to administration of apomorphine abolished the apomorphine-induced decrease in the number of coughs. These results suggest that dopaminergic mechanisms could have an important role in the regulation of the cough reflex. PMID- 3666047 TI - XIIth International Karlsburg Symposium on Problems of Diabetes. June 17-19, 1986. Aetiopathogenesis of type 1 diabetes. Selected papers. PMID- 3666046 TI - Inhibition of plasma cholinesterase prevents the dopamine DA-1 receptor mediated renal vasodilation produced by ibopamine. AB - We have studied the dopamine DA-1 receptor mediated renal vasodilator response of the inotropic pro-drug, ibopamine, the diisobutyrate ester of epinine. In anesthetized dogs pretreated with phenoxybenzamine and propranolol to eliminate alpha- and beta-adrenoceptor mediated responses, respectively, ibopamine and epinine produced dose-dependent renal vasodilation. Treatment of animals with the cholinesterase inhibitor, physostigmine, markedly inhibited the renal vasodilation produced by ibopamine, but had no effect on the renal vasodilator response of epinine. We conclude that hydrolysis of ibopamine by plasma cholinesterase to yield epinine is necessary for the production of the dopamine DA-1 receptor mediated renal vasodilator response to ibopamine. PMID- 3666048 TI - Insulin-dependent diabetes: strategy for immune intervention. AB - Increasingly, experimental results are underlining the role played by autoimmune mechanisms in the pathogenesis of type I insulin-dependent diabetes mellitus (IDDM). It has appeared logical to attempt to preclude the onset of IDDM by suppressing immune responses, but trials using steroids or azathioprine were unequivocal. Subsequently, a Canadian and a French group performed pilot studies to assay a new immunosuppressive drug, cyclosporine A (CyA) in human diabetes (Stiller et al., 1984; Assan et al., 1985). However, further testing is required to evaluate and confirm its potential benefits and possible risks. PMID- 3666049 TI - Genetic studies of IDDM in BB rats: the incidence of diabetes in F2 and first backcross hybrids allows rejection of the recessive hypothesis. AB - The BB rat spontaneously develops an IDDM with many analogies to human IDDM, i.e. the genetic basis is a puzzle, since more than one mode of inheritance of IDDM in BB rats has been proposed. These different proposals reflect the heterogeneity of BB rats used for genetic studies. This prompted us to investigate the inheritance of IDDM in two subpopulations of BB rats (BB/OK and BB/PhiK) by crossing studies with the production of (diabetic BB x LEW 1.A) F1, F2 generations and of first backcross hybrids onto BB (B1BB) and LEW.1A (B1A) rats respectively. Both BB rat subpopulations were different in origin, degree of inbreeding, incidence and age at onset of diabetes and in certain immunologic, metabolic and hematologic traits. All hybrids were serotyped and checked for diabetes by determination of urine and plasma glucose twice weekly up to an age of 200 days. None of the F1 and B1A hybrids developed diabetes. Some cases were observed in the F2 hybrids with a different incidence in the two subpopulations (2.3% in BB/OK, 11.0% in BB/PhiK). The percentage of diabetes in the B1BB hybrids was 13.8% (BB/OK) and 24.0% (BB/PhiK) respectively. All diabetic hybrids were characterized by at least one RT1uv haplotype which was derived from the original BB animals. These results demonstrated clearly (1) that the mode of inheritance depends on the genotype of the animals observed and (2) simple autosomal-recessive genetics cannot be accepted for BB rat diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666050 TI - A Gm haplotype study in relation with HLA-DR in 155 insulin-dependent diabetic patients and their affected and non affected siblings. AB - In order to assess interaction between HLA and Gm for susceptibility to IDDM, the families of 155 IDDM probands were typed for HLA class I, II, III antigens and 16 Gm allotypes (including G2m23). Haplotypes were obtained for both systems. Individuals bearing the equivocal haplotype Gm (formula; see text) were excluded. The frequencies of the 6 Gm haplotypes detected were comparable in IDDM patients, sibling controls and unrelated controls. The number of Gm haplotypes was compatible with random segregation whether or not the HLA genotype was taken into account. However, analysis of the HLA-DR allelic combinations showed an increase of the uncommon haplotype Gm (formula; see text) in IDDM patients bearing DR3 in the absence of DR4 (Gm (formula; see text) phenotype frequency 43% vs 24% in other allelic combinations, p less than 0.04). When 21 diabetic and 154 non diabetic siblings of the probands were compared, the combined presence of DR3/ non 4 and Gm (formula; see text) was observed in 7 (33%) affected and 11 (7%) unaffected siblings (p less than 0.001), conferring a relative risk of 6.4 to siblings who bear both markers. All DR3/non 4 positive affected siblings (7/7) also carried Gm (formula; see text) compared with 27% (11/41) of unaffected siblings (p less than 0.001). This result suggests, that in spite of the absence of segregation distortion, interaction between Gm and HLA gene products may play a role in the familial penetrance of IDDM. PMID- 3666051 TI - Humoral and cellular immune abnormalities in neonates of diabetic mothers: any pathological role? AB - Insulin antibodies, insulin complexes, T-cell subsets and T-cells bearing surface antigens indicating early activation were studied in 35 and 24 infants of diabetic and of normal mothers respectively, which were compared with normal adult control subjects. Anti-insulin antibodies were evaluated using a modified version of Andersen's method, insulin complexes were assessed by a method developed by us; total T cells, helper/inducer and cytotoxic/suppressor T lymphocytes, and early activated T lymphocytes were determined using the monoclonal antibodies OKT3, OKT4, OKT8 and 4F2 respectively. The presence of insulin antibodies was correlated to macrosomia, hypoglycaemia and respiratory distress syndrome. Insulin-anti-insulin complexes were found in some of the neonates and were likely to have been formed by maternal antibodies and insulin from the neonate. Modifications of T-cell subsets were found in the neonates both of diabetic and of normal mothers. --Despite the presence of these immune abnormalities in some infants of diabetic mothers, the clinical onset of diabetes was not diagnosed in any of the cases studied. Nevertheless, the immunological abnormalities in neonates of diabetic mothers have short-term pathogenetic effects which raises the question of their possible long-term effect. PMID- 3666052 TI - Complement-dependent antibody mediated cytotoxicity (C'AMC) in patients with newly diagnosed insulin-dependent diabetes mellitus. AB - Serum activities of complement-dependent antibody mediated cytotoxicity (C'AMC) were determined in 36 consecutive patients with newly diagnosed insulin-dependent diabetes mellitus (IDDM). The sequential exposure of 51Cr labeled neonatal rat islet cells to patient serum and rabbit complement revealed the presence of C'AMC in 28 IDDM subjects. The C'AMC titres ranged between 1:4 and 1:512 and were not related to the C'AMC activity of a given sample as measured at a standard dilution (1:4). In comparison to the clinical characteristics of 21 IDDM patients with negative C'AMC, higher C'AMC titres (greater than or equal to 1:32) were associated with a lower mean age at diagnosis of IDDM (12.2 +/- 2.1 vs. 19.0 +/- 2.3 years; p less than 0.05), with a higher frequency of infections up to 6 months prior to diagnosis (6 out of 11 vs. 3 out of 21 patients; p less than 0.05) and, although statistically not significant, a preponderance of female sex together with a decreased frequency of HLA-DR4. In contrast, fasting C-peptides levels, HLA-DR3 antigen frequency and Coxsackie B1-6 virus antibody titres were not related to the C'AMC titres. It is concluded that (1) C'AMC titration is superior to the detection of initial C'AMC levels for evaluating the strength of the complement-dependent humoral immune response towards islet cell surface (auto)antigen(s), and (2) infectious agents may be involved in eliciting a C'AMC response. PMID- 3666053 TI - Malignant lymphoma of the thyroid. AB - Eighteen cases of patients with malignant lymphoma of the thyroid are analyzed. Patients were treated by irradiation and/or chemotherapy and in 9 cases the operation of the thyroid was realized. Two patients of operated group and two patients of non-operated group died after 1-365 days due to malignant lymphoma. The mean follow up of living patients is 66.8 months. In 5 cases, the coincidence of malignant lymphoma and lymphocytic thyroiditis was proved. The diagnosis of malignant lymphoma of the thyroid in all cases but one was based on cytology gained from fine needle biopsy and then confirmed in most cases by histology. We advise to use fine needle biopsy as a simple and safe method in all solitary nodules of the thyroid of uncertain origin and urgent fine needle biopsy in cases of fast growing mass on the neck. Fine needle biopsy reliably differentiates between primary thyroid carcinoma, anaplastic carcinoma and malignant lymphoma of the thyroid. Difficulties can arise in differential diagnosis between malignant lymphoma and lymphocytic thyroiditis. PMID- 3666054 TI - Effect of hyperglycemia on serum T4 and T3 levels in rats. AB - In order to elucidate the effect of hyperglycemia on serum thyroid hormone levels, serum T4 and T3 concentrations were measured in rats with continuous intravenous glucose infusion. 30% glucose solution was infused into the left jugular vein at a rate of 1 ml/hr for 12 hr, and serum glucose level was maintained at 400 mg/dl. Serum T4 levels were slightly but not significantly decreased and serum T3 levels were significantly decreased by infusion of glucose for 12 hr. The ratio of serum T3 to T4 was not significantly changed in rats with glucose infusion. These results suggest an inhibitory effect of hyperglycemia on thyroid hormone release. PMID- 3666055 TI - The urinary iodide excretion in subjects on different diets. AB - The urinary iodide excretion in hospital subjects on regular and different restrictive diets was investigated. In subjects on a regular diet the average urinary iodide (microgram I-/g creatinine; mean +/- SD) was 104.7 +/- 36.7. In subjects on a low caloric diet the urinary iodide content was 101.1 +/- 24.2; in subjects starving for weight-reduction the mean value was 63.2 +/- 23.9, significantly different from the controls (p less than 0.005). In subjects on a high-caloric diet the urinary iodide was 145 +/- 45.4, in those on a hepatoprotective diet 96.8 +/- 18.8, respectively. The iodide excretion in subjects on an ulcer-protective diet was on the average 76.4 +/- 22.3 which was significantly different from those on a regular diet (p less than 0.01). PMID- 3666056 TI - Effect of natural sunlight on adrenaline and noradrenaline excretion in man. AB - Sympathoadrenal activity was evaluated in 6 healthy subjects by excretory rate of adrenaline and noradrenaline in 6 hour samples of urine throughout three consecutive days. Subjects were exposed to natural sunlight for 4 hours on the second day of experiment, the first and third days served for control measurements. Sunbath caused erythema in all subjects and it had no impact adrenaline on excretion. However, significantly higher no radrenalineexcretion was present during 6 hours after exposition to sunshine when compared to control days. PMID- 3666057 TI - Improved behavioral performance of rats after pre- and postnatal administration of vasopressin. AB - In two separate and independent experimental series it was studied, whether 8 arginine-vasopressin (AVP) or 8-lysine-vasopressin (LVP) administered daily in microgram amounts to pregnant rats, and/or to their offspring postnatally for 30 days, induce alterations that can be registered by a behavioral test. The realization of the test used, a foot-shock motivated brightness discrimination (BD) reaction, includes learning and memory processes. There is one general result of the two experimental series, which include 263 rats divided up in different combinations of pretreatment. Vasopressin (VP), AVP or LVP, pre- and postnatally administered, induces a significantly improved BD performance of approximately 40%, compared to the control groups. The improvement is detectable in different ages of the offspring, in females as well as in males. A smaller though also significant improvement was observed when AVP or LVP was injected only postnatally. The critical period in which the peptides are able to induce the alterations measured probably includes prenatal and postnatal periods in the lives of the rats. What molecular interactions actually underly the improved behavioral performance remain to be clarified. PMID- 3666058 TI - The influence of desmethylimipramine on the hypothalamic and neurohypophysial vasopressin content in pinealectomized male rats. AB - The effect of desmethylimipramine (DMI) on the hypothalamic and neurohypophysial vasopressin content was investigated in normal and pinealectomized male rats. The vasopressor activity of the hypothalamus and neurohypophysis was bioassayed by the method of Dekanski (1952). A single i.c.v. injection of DMI (20 micrograms; dissolved in 10 microliters of normal saline) decreased vasopressin content in the neurohypophysis of non-operated and sham-operated animals. In pinealectomized rats the vasopressin content in the neurohypophysis diminished and was not modified by an i.c.v. DMI injection. Repeated treatment with DMI (i.p.; 10 mg/kg, twice a day over five days) resulted in a distinct increase of the hypothalamic and neurohypophysial vasopressin in both normal and pinealectomized rats. PMID- 3666059 TI - Properties of in vitro nonenzymatically glycated plasma fibrinogens. AB - Nonenzymatic glycation of fibrinogen is species independent and depends only on the glucose concentration in the incubation mixture under selected in vitro conditions. An increased fibrin monomer aggregation in the presence of Ca2+ ions and a decreased proteolytic susceptibility of nonenzymatically glycated fibrinogens may favour the development of thrombophilic states. Blocking of lysine residues as well as restricted conformational changes induced by glucose attachment may be responsible for these effects. Fibrin stabilization by factor XIII is not impaired by nonenzymatic glycation of fibrinogen. Attachment of aortic endothelial cells to fibrin films from glycated fibrinogens is diminished. This phenomenon may be the result of blocked plasminogen activator binding sites in fibrin by nonenzymatic glycation. These effects may contribute in vivo to the accumulation of fibrin in those tissues most frequently affected by diabetic complications. PMID- 3666060 TI - 36 months continuous subcutaneous insulin infusion (CSII) in insulin dependent diabetes (IDDM)--influence on early stages of retinopathy, nephropathy and neuropathy--psychological analysis. AB - In extremely unstable (brittle) IDDM patients (n = 11) the metabolic effect of long-term (36 months) CSII proved to be superior to conventional insulin treatment (CIT) (statistical twins, n = 11): HbA1 = 8.6 +/- 0.3 versus 10.4 +/- 0.4, MBG = 5.6 +/- 0.3 versus 8.5 +/- 0.8, M (80)- value = 23.6 +/- 0.6 versus 56.7 +/- 10.2, GCI) = 37.3 +/- 15.6 versus 132 +/- 24.2. In addition, in CSII patients the metabolic control was significantly better than intensified conventional insulin treatment (ICT) before. Retinal morphology improved under CSII in 1 eye, did not change in 10 eyes and deteriorated in 11 eyes. Under CIT retinal findings improved in none, did not change in 16 and deteriorated in 16 eyes. Deteriorations under CSII appeared more frequently during the first than during the second and third year of treatment and seemed to be a consequence of too strict metabolic control and/or too fast decrease of the glycemia at the beginning of CSII. During 36 months of CSII no deterioration but in one case normalization of microproteinuria was observed. Under CIT three cases changed from normal into microproteinuria. Reduced motor nerve conduction velocity (MCV) and/or sensory nerve conduction velocity (SCV) could be normalized in most cases under CSII, but respiratory heart arrhythmia (RHA) at rest could not. Most patients--if highly motivated before starting CSII--remained positively motivated for long-term pump therapy. IN CONCLUSION: Our experiences over three years demonstrate a positive effect of CSII on the metabolism as well as on the course of early stages of microangiopathy and neuropathy. A longer period of observations will be necessary to evaluate this, conclusively. PMID- 3666061 TI - Fasting and post-calcium load serum calcium, parathyroid hormone, calcitonin, in male idiopathic calcium urolithiasis--evidence for a basic disturbance in calcium metabolism. AB - In male healthy controls (n = 12), male renal calcium stone patients with either normocalciuria (NC; n = 12) or idiopathic hypercalciuria (I-HC; n = 12), all ideally matched for age and body weight, the response of variables of mineral metabolism to a calcium-rich oral test meal was evaluated. In all groups the postprandial urinary cyclic AMP is decreased as compared with fasting urine, indicating that the parathyroid glands are suppressible by oral calcium. However, in I-HC serum total calcium was significantly higher than in controls both basally and in the postprandial period; the associated mid-regional (bioinactive) serum parathyroid hormone was also elevated, but serum parathyroid hormone recognizing the amino terminal (bioactive) region of the molecule was significantly decreased. Also in I-HC, serum alkaline phosphatase is elevated, whereas urinary hydroxyproline in both fasting and postprandial urine is unchanged. The NC group holds an intermediate position between I-HC and controls. It can be concluded that I-HC subjects may suffer from a more basic disturbance of calcium metabolism which may help explain the nature of their hypercalciuria. PMID- 3666062 TI - In vitro studies of microwave-induced cataract. II. Comparison of damage observed for continuous wave and pulsed microwaves. AB - Depth of damage caused by pulsed (PU) and continuous wave (CW) microwaves was estimated by scanning electron microscopy in rat lenses fixed immediately, after irradiation in vitro in circulating thermostatically controlled buffered saline. Pulses of 10 microseconds width and 24 kW peak power were delivered to the lens at different repetition rates in order to permit the same total energy to be delivered during 6, 20 or 60 min of irradiation at specific absorption rate (SAR) values of 0, 5.75, 11.5, 23, 69, 231 and 750 mW g-1; total energy [power (pow) x time] deposited in the lens was 0, 0.23, 0.46, 1.38, 4.6, and 15 W min g-1. Damage (granular degeneration of cells at the lens equator) was measured at the apex of penetration of the degeneration. The depth of degeneration (dep) of Pu or CW was compared either: (1) by a one-way analysis of variance (ANOVA) for the CW data alone and the 11 combinations of (pow x time); or (2) by using two alternative models to fit the data, to permit experimental distinguishment between: (a) reciprocal effects of pow x time; and (b) separate effects. Using the ANOVA analysis, the Pu mode of irradiation resulted in more damage at the same average power for every combination tested except one (23 mW g-1, 6 min). Although the separate-effects models explained more of the variation in depth of damage, the reciprocal effects model may provide an adequate fit for practical purposes and has the advantage of greater simplicity. For both models, the pulsed irradiation mode produced 4.7 times the depth of damage caused by CW irradiation. These results are discussed in relation to previous Pu-CW comparisons. It is proposed that this additional damage at the same average power is caused by thermoelastic expansion (TEE). PMID- 3666063 TI - Cleavage from the N-terminal region of beta Bp crystallin during aging of the human lens. AB - Polyclonal antisera have been made to synthetic peptides that correspond to the N terminal (residues 1-12) and C-terminal (residues 195-204) sequences of bovine beta Bp crystallin. Both anti-beta Bp1-12 and anti-beta Bp195-204 recognize specifically the beta Bp component of bovine lens. In the young human lens, anti beta Bp195-204 recognizes predominantly the 26,000 MW form of beta Bp, while in older lenses this same antiserum recognizes mainly the 22,000 MW in vivo proteolysis product. In contrast, during aging of the normal human lens anti-beta Bp1-12 recognizes only decreasing amounts of the 26,000 MW form of beta Bp, with no binding to the 22,000 MW form of this polypeptide. These results suggest that during aging of the normal human lens, the N-terminus of beta Bp is the preferred site of in vivo proteolysis. PMID- 3666064 TI - Recovery of rat lens epithelial cells after total or partial X-irradiation. AB - Irradiation of whole lenses interferes with the normal mitogenic response of lens cells to stimulation by mechanical wounding. Radiation exposure causes a delay and partial suppression of cells entering the S phase of the cell cycle. When cells are irradiated 1 day before wounding, DNA synthesis begins 20 hr after wounding and peaks 10 hr later with 20% cell labelling. The return to a normal wound response is gradual when the time interval between irradiation and wounding is lengthened. By 28 days, essentially complete recovery of the wound response occurs. Examination of the beginning of mitosis shows a similar pattern of recovery. When half of the lens is irradiated 1 day before wounding, delay and suppression of the wound response in the irradiated half of the lens epithelium is observed. However, if 4 days elapse between irradiation and mechanical wounding, complete recovery of cells responding to the mitogenic stimulus occurs. Cells of the shielded half of the lens appear to compensate for the reduced number of irradiated cells entering S phase so that peak labelling of shielded cells is 70% compared with 50% for control lens cells. An evaluation of mitotic figures confirms faster recovery of the entire lens when only half the lens is irradiated. Complete recovery of the cellular response of partially irradiated lenses occurs in 4 days in contrast to almost 28 days for wholly irradiated lens. PMID- 3666065 TI - Eye lens regeneration and the crystallins in the adult newt, Notophthalmus viridescens. AB - Upon lens removal, the adult Eastern Spotted newt, Notophthalmus viridescens, has the capacity to regenerate an ocular lens. Crystallins, proteins characteristic of the vertebrate lens, were studied from normal and 3-month regenerated adult newt lenses. When separated by high-performance liquid chromatography (HPLC) or Sephadex G-200SF column chromatography, the crystallins from normal and regenerated lenses were fractionated into what appear to be the classical four groups: alpha, beta High, beta Low, and gamma. Upon further examination by immunoelectrophoresis, the first peak contains both alpha and beta crystallins. This study provides evidence that most of the crystallins from the regenerated lenses share biochemical properties with those of the normal lens crystallins based on their native molecular weight, isoelectric point, and the molecular wt of their constituent polypeptides, indicating that the fidelity of gene expression in reactivated iris tissue is high. Some differences are found between normal and regenerated lens crystallins and are most obvious in the beta crystallin region: the proportion of beta crystallins is decreased in regenerated lenses when the total proteins are fractionated by column chromatography and some of the beta-crystallin polypeptide chains found in normal lenses are missing from regenerated lenses. Iris epithelial cells are normally withdrawn from the cell cycle and are synthesizing a tissue-specific product, melanin. After lentectomy these cells dedifferentiate, redifferentiate into lens cells, and their progeny then synthesize different tissue-specific proteins, crystallins. Little is known about the specific mechanism(s) for the activation of gene expression in eukaryotes, but the regenerating lens suggests itself as a good model in which to study this biological problem. PMID- 3666066 TI - Relationship of cholesterolgenesis to DNA synthesis and proliferation by lens epithelial cells in culture. AB - Cholesterolgenesis could be important for both cell growth and DNA synthesis in many cell types. Since the ocular lens seems at least partially dependent upon biosynthesis to supply its required cholesterol, cholesterolgenesis could have a special role in control of cell proliferation and DNA synthesis in the lens. We thus examined the effects of inhibiting sterol synthesis with mevinolin upon cell proliferation, upon accumulation of DNA, sterol and protein mass and upon DNA synthesis by bovine lens epithelial cells cultured in lipoprotein-deficient media. All DNA synthesis in the ocular lens occurs in the monolayer of epithelial cells which covers the anterior surface of this organ. Concentrations of mevinolin which largely prevented synthesis and accumulation of sterol by the cultured lens epithelial cells and stopped proliferation of these cells had no effect on the cell's DNA synthesis or accumulation of DNA mass. The inhibition of proliferation by mevinolin could be completely reversed by cholesterol added to the culture media in the form of low density lipoprotein. These findings indicate that an adequate supply of cholesterol is required by lens epithelial cells to proceed through the cell cycle. Inhibition of cholesterolgenesis by the lens in vivo could have profound effects upon lens growth and development. PMID- 3666067 TI - Does elevated glutathione protect the cell from H2O2 insult? AB - Utilizing glutathione ethyl ester (GSH-EE), the glutathione (GSH) level of lens epithelial cells can be increased as much as 1.9-fold. The epithelial cells maintain the additional GSH in the reduced form. This system was utilized to examine the relative effectiveness of cells with elevated GSH to withstand H2O2 insult. Three parameters were investigated, 86Rb accumulation, a measure of membrane function, ATP levels, an indication of overall metabolism and glyceraldehyde-3-phosphate dehydrogenase (GPD) activity, indicating intracellular enzyme susceptibility to oxidative insult. Under oxidative stress, much of the GSH is in the oxidized form but upon removal of the stress, rapidly returns to the reduced state. However, a loss of approximately 20% in GSH equilibrium levels has been consistently observed. Elevated GSH does not significantly increase the cells' ability to withstand or recover from oxidative stress. Indeed, elevated GSH was found to be somewhat deleterious, causing a decreased ability to recover from oxidative insult. However, in the case of GPD, a significant protection of activity was observed. The overall conclusion is that elevating intracellular GSH concentration does not increase the cells' overall ability to withstand oxidative damage. PMID- 3666068 TI - Biomarkers of aging. PMID- 3666069 TI - Fever and aging: central nervous system prostaglandin E2 in response to endotoxin. AB - The pathophysiology of the blunted febrile response often seen in elderly individuals with infection is not well understood. In this study, we attempted to determine the impact of aging on prostaglandin E2 release from the brain in response to endotoxin (LPS) stimulation. Eight young (4-6 month) and eight old (24-28 month) BALB/c mice were studied. Right and left half brains from old and young mice were either stimulated with LPS or control solution. Each mouse provided a stimulated and a control value. Results were reported for each mouse as the difference (stimulated minus control) in picograms of PGE2 released per milligram tissue and as the percent of baseline (control). Significant stimulation was demonstrated in the young mice, mean difference being +3.7 pg/mg, SD = 2.2 (Student's paired t, p less than 0.01) or +44% of control. In the old mice the mean difference was +2.9 pg/ml, SD = 6.7, or +22%, which was not statistically significant. Moreover, in three of eight old mice, there was a lack of PGE2 stimulation. The authors conclude that in a select group of old mice ("nonresponders"), the failure to mount a febrile response to an infection may be related to diminished release of PGE2 from the brain. PMID- 3666070 TI - Fetal and placental growth in young, primiparous and old, multiparous rats. AB - Fetal and placental weights and peripheral blood progestagen concentrations were examined on days 13, 16 and 22 of gestation in young (3-5 month) nulliparous and old (9-12 month) multiparous, albino Wistar rats. There was no difference in fetal weights at any stage examined whereas placental weights were significantly heavier in the old rats at days 16 (71%) and 22 (38%). Blood progesterone concentrations were similar in the two groups at days 16 and 22 although concentrations of the less biologically active progestagen, 20 alpha dihydroprogesterone, were higher (61%) at day 16 in the old rats. The relative hypertrophy of the placentas in the old rats could not be explained by reduced litter size or progesterone concentrations: it may represent a compensatory effect in response to a less favorable uterine environment. PMID- 3666071 TI - Comparison of calcium effect on in vitro calcitonin and parathyroid hormone release by young and aged thyroparathyroid glands. AB - Serum immunoreactive parathyroid hormone (iPTH) and calcitonin (iCT) levels are higher in young than aged rats. However, serum calcium concentration does not change with age suggesting that the calcium regulation of PTH and CT secretion may be affected by aging. We compared iPTH and iCT secretion in vitro at low and high calcium concentrations using thyroparathyroid glands removed from young (2-3 months), adult (12-13 months), and old (24-27 months) F-344 male rats fed regular rat chow. Glands from each animal were incubated for 3 h in serum-free culture media containing 1.0 mM calcium and then transferred to media containing 2.5 mM calcium for another 3 h. Immunoreactive PTH and iCT concentrations of the media after each incubation period were determined by radioimmunoassay. Immunoreactive PTH and iCT secretion per pair of glands was significantly higher in glands from older animals regardless of calcium concentration. The decrease in iPTH, and increment in iCT, secretion in response to 2.5 mM calcium by glands from old rats was smaller than that observed for glands from young animals. These age-related changes in the regulation of secretion by calcium may contribute to the increased iPTH and iCT secretion and serum levels seen in older animals. PMID- 3666073 TI - Proliferative activity of vervet monkey bone marrow-derived adherent cells. AB - Vervet monkey bone marrow-derived adherent cell population cultured in Fischer's medium supplemented with 12.5% fetal calf serum and 12.5% horse serum consists of two cell shapes: fusiform (type I) and polygonal (type II). Limiting-dilution cloning of the cells suggested that the two morphologically distinct cell types belong to the same cellular system even though they differ in their proliferative capabilities. The labeling index of type II cells, as measured by autoradiography, was found to be consistently lower than that of type I cells. It is probable that these two phenotypes represent different stages of differentiation, where progenitor type I gives rise to type II cells. The bone marrow-derived adherent cells were found to be cytokinetically at rest in vivo, using the thymidine suicide test, and relatively radioresistant with a D0 = 2.1 Gy and n = 2.36 at the time of explantation from the bone. Furthermore, in culture these cells are characterized by a relatively long cell cycle of 60 h, where the length of the S phase is 30 h, G2 is 12 h, M is 6 h, and G1 is 12 h. Thus the vervet monkey bone marrow-derived adherent cells represent a cell population with a low turnover rate both in vivo and in vitro. PMID- 3666072 TI - Bioenergetics in the aging Fischer 344 rat: effects of exercise and food restriction. AB - The capacity for energy production was evaluated in male, Fischer 344 rats as they advanced from adulthood through senescence. At 10 months of age, the animals were divided into three groups: sedentary, fed ad libitum (S); exercised by treadmill running, fed ad libitum (E); and sedentary, caloric restricted by alternate day feeding (R). Activities of selected enzymes, ADP-stimulated respiration and levels of cytochromes, were determined in homogenates of liver and gastrocnemius muscle prepared from young controls (10-month old S) and 18-, 24-, and 30-month old animals. In liver, age-linked decrements were found in the activities of 3-hydroxyacyl-CoA dehydrogenase (S, E, and R) and citrate synthase (S), and in cytochrome c content (S and E), whereas substrate-catalysed oxidations were unaffected. In the gastrocnemius muscle (S, E, and R), respiration, activities of enzymes of the Krebs cycle and glycolysis, and cytochrome content were decreased after the age of 18 months. Oxidative capacity was increased in muscle through exercise (about 40%) and in liver by food restriction (about 20%). Body and soleus muscle mass declined similarly in all groups (about 14% from 30 to 18 months of age), whereas the loss of weight in the gastrocnemius muscle was much greater (34%). The data indicate that energy metabolism in the senescent animal is competent to meet its needs and age-related declines in energy metabolism are secondary to the aging process. PMID- 3666074 TI - Proteins of fast axonal transport in regenerating rat sciatic sensory axons: a conditioning lesion does not amplify the characteristic response to axotomy. AB - The regeneration rate of axons following injury can be influenced by the past history of the neuron: if an axon received a "conditioning" lesion its regeneration rate from a subsequent "test" lesion is increased. Because regeneration is associated with the increased synthesis and fast axonal transport of growth-associated proteins of unknown functions, we investigated whether the increased regeneration rate (to 81%) seen in conditioned rat sciatic sensory axons following a test lesion was associated with an amplification of the increase in growth-associated protein expression. The test lesion did not produce any amplification of the increase in growth-associated protein expression resulting from the preceding conditioning lesion. We conclude that this aspect of the cell body reaction to axotomy is not involved in the conditioning lesion effect on regeneration rate, and, as a corollary, it appears that fast transported proteins whose expression alters after axotomy are not involved in the regulation of the regeneration rate. PMID- 3666075 TI - Stimulation of sciatic nerve regeneration in the adult rat by low-intensity electric current. AB - Morphometric analysis was used to evaluate regeneration in transected sciatic nerves of adult rats constantly stimulated with low-intensity direct current. The ends of the cut nerve were separated by a distance of 5 mm and inserted into a Silastic tube. Histological and electron microscopy criteria were used to measure and evaluate the cross-sectional area and the structure of the bridge connecting the distal and proximal stumps. After 3 weeks of stimulation (10 microA DC with distal cathode) the stimulated animals showed a cross-sectional bridge area twice the size of nonstimulated controls. The number of myelinated and unmyelinated axons, and the vascular areas, were also larger in the experimental group. This is the first quantitative analysis of low-intensity direct current-enhanced peripheral nerve regeneration in adult mammals. PMID- 3666076 TI - Spatial organization of human perioral reflexes. AB - Reflex responses recorded from the upper and lower divisions of the human orbicularis oris muscle were studied as a function of the site of stimulation. Stimuli were applied to 11 sites, ranging from the glabrous skin of the upper and lower lip vermilion borders to the hairy skin of the cheek. Highly localized, innocuous mechanical stimuli were created by displacing a servo-controlled probe over the surface of the perioral skin. Reflex response amplitude was strongly dependent on the site of stimulation. Stimulation of some sites, for example the ipsilateral corner of the mouth, the chin, and cheek, produced no responses, whereas stimulation of other sites, particularly the ipsilateral vermilion borders, produced large reflex responses. Changes in response amplitude as a function of stimulation site were the same for the upper lip and lower lip muscle recordings, with the largest responses at both recording sites produced by stimulation of the ipsilateral upper lip vermilion border. These results suggest that the upper and lower divisions of orbicularis oris share common synaptic drive, at least from inputs generated via reflex pathways, and that the upper vermilion border may be more densely innervated with mechanoreceptors than the lower. The latter hypothesis was supported by an additional experiment examining two-point discrimination thresholds for the glabrous skin of the upper and lower lips. Two-point thresholds were significantly smaller for the upper compared with the lower lip vermilion border. PMID- 3666077 TI - Kindling-like convulsive activities in the isolated ileum of the guinea pig. I. Electrical stimulation. AB - A kindling-like convulsive activity model produced by subthreshold, iterative electrical stimulation of the isolated male guinea pig ileum is described. In this model, the mechanical activity of the longitudinal muscular fibers of the ileum was systematically quantified in terms of the basic frequency, tonus, amplitude, and transient amplitude increments (A, n spikes/20 min) of "normal" contractions and presence of high-amplitude, paroxysmal, "epileptiform" contractures (B, n spikes/20 min). Changes in these parameters were statistically compared through consecutive stages of the same stimulated male ileum (I = initial activation, II = initial inhibition. IIIA = late activation, and IV = late inhibition) and equivalent stages of stimulated female and nonstimulated male ilea where "kindling-like" activities were only occasionally observed. Basic tonus, amplitude, and number of A spikes showed significant changes through consecutive stimulated male ileum "kindling" stages: increased from baseline to stage I, decreased from I to II, increased from II to III and from III to IIIA, and decreased from IIIA to IV. The number of B spikes significantly increased from II to III, III to IIIA, and IIIA to IV. No significant changes in baseline frequency were found through all stages nor in tonus, amplitude, A and B spikes between stage IV and the self-sustained activity observed 120 min after stimulation. In addition, there were significant correlations between B spikes vs. basic tonus and amplitude and A spikes when the stimulated male ileum shifted from stage II to IIIA (positive correlations) and from IIIA to IV (negative correlations). Basic tonus during stage I, basic amplitude during IIIA, A spikes during self-sustained activity and B spikes during III, IIIA, IV, and self sustained activity were in the stimulated male ileum larger than those in both the stimulated female and the nonstimulated male ilea. Tonus and A spikes during III and IIIA in the stimulated male ileum were larger than in the nonstimulated, whereas tonus during IV and self-sustaining activity and amplitude during II in the stimulated male ileum were smaller than in the female stimulated ileum. PMID- 3666078 TI - The deafferentation syndrome in the rat: effects of intraventricular neurotensin and cholecystokinin. AB - A deafferentation syndrome can be produced in rats by dorsal root ganglionectomies. This syndrome consists of scratching and/or biting of the anesthetic limb to the point of amputation. This behavior may serve as an experimental model to study certain aspects of chronic dysesthesias and/or pain caused by deafferentation in man. In this study, we made behavioral observations on the deafferentation syndrome and examined the possibility that intraventricular neurotensin and cholecystokinin alter the course of this syndrome. We found that neurotensin accelerated the scratching component without affecting the biting behavior. Cholecystokinin, however, attenuated the release of both components of the syndrome. PMID- 3666079 TI - Mandibular movements and jaw muscles' activity while voluntarily chewing at different rates. AB - As a way of learning about the motor control of chewing, we studied how well a subject could voluntarily chew in time with a metronome and defined the changes in the spatial and temporal aspects of the chewing pattern with changes in chewing rate. Timing and extent of mandibular movements were assessed in nine adults from Kinesiograph recordings; timing and level of activity in digastric and both masseter muscles were determined from surface EMGs. Each subject chewed gum in time with a metronome set randomly at 46, 100, 160 beats per minute or at a frequency close to his automatic chewing rate. Cycle-by-cycle analysis showed that subjects varied in their ability to keep pace with the metronome. When chewing at high frequencies, six subjects reduced gape, three did not. Contralateral deflection in opening, when present, was significantly reduced when chewing at high frequencies and this decrease was independent of vertical gape. Durations of opening, closing, and occlusal phases decreased in proportion to the decrease in total cycle duration. Burst duration of diagastric activity decreased about 29% compared with a 77% decrease in cycle duration over all chewing rates. At low frequencies onset of digastric activity occurred after onset of opening. At high frequencies digastric onset preceded opening. Burst durations of both masseter muscles decreased in concert with the decrease in cycle duration. Termination of activity in both masseters was synchronous and always occurred 100 +/- 20 ms prior to the next opening. Therefore, we conclude that (i) individuals vary in ability and strategy for controlling chewing rate voluntarily and (ii) with increases in chewing rates the shortening of burst duration for the digastrics is significantly less than for the masseters. PMID- 3666080 TI - Irradiation exposure modulates central opioid functions. AB - Exposure to low doses of gamma irradiation results in the modification of both the antinociceptive properties of morphine and the severity of naloxone precipitated withdrawal in morphine-dependent rats. To better define the interactions between gamma irradiation and these opiate-mediated phenomena, dose response studies were undertaken of the effect of irradiation on morphine-induced antinociception, and on the naloxone-precipitated withdrawal syndrome of morphine dependent rats. In addition, electrophysiologic studies were conducted in rats after irradiation exposure and morphine treatment correlating with the behavioral studies. The observations obtained demonstrated that the antinociceptive effects of morphine as well as naloxone-precipitated withdrawal were modified in a dose dependent manner by irradiation exposure. In addition, irradiation-induced changes in the evoked responses obtained from four different brain regions demonstrated transient alterations in both baseline and morphine-treated responses that may reflect the alterations observed in the behavioral paradigms. These results suggest that the effects of irradiation on opiate activities resulted from physiologic alterations of central endogenous opioid systems due to alterations manifested within peripheral targets. PMID- 3666081 TI - Absence of stretch reflex gain enhancement in voluntarily activated spastic muscle. AB - Static and dynamic stiffnesses of voluntarily activated elbow muscles were compared in spastic and contralateral arms of 15 subjects with spastic hemiparesis. Stiffnesses were estimated from the positional deflections induced by applying load perturbations to each forearm. In 11/15 subjects (73%), stiffness were comparable on the two sides. In the remaining 4/15 subjects (27%), stiffness were consistently greater on the spastic side, however, EMG recordings from these spastic muscles were of much smaller amplitude than those of the contralateral muscles, indicating that this increase was probably caused by changes in the mechanical properties of elbow muscles, rather than by stretch reflex enhancement. We conclude that for voluntarily activated muscles of spastic hemiparetic subjects, reflex stiffness (and presumably stretch reflex gain), of spastic and contralateral limbs is not significantly different. These findings impose important constraints upon theories attempting to explain spastic hypertonia, and they also provide guidelines for clinical quantification of spasticity. PMID- 3666082 TI - Signs of hemifacial spasm created by chronic periodic stimulation of the facial nerve in the rat. AB - We show in this paper that daily electrical stimulation of the facial nerve near its entrance to the brain stem in rats results in abnormalities in the electromyographic response of the facial muscles that resemble those seen in patients with hemifacial spasm. After about 4 weeks of daily electrical stimulation of the facial nerve for 1 min/day, stimulation of the temporal branch of the facial nerve resulted in an abnormal EMG response from the mentalis/orbicularis oris muscles, consisting of an initial deflection with a latency of about 6 ms, followed by a burst of EMG activity lasting 10 to 50 ms. We found such "lateral spread" of antidromic activity in all 10 rats that were subjected to chronic stimulation, but not in normal rats and not in rats that had electrodes implanted but which had not been stimulated. Measurements of neural conduction times suggest that the location of the cross transmission that gives rise to this lateral spread response is central to the site where the facial nerve exits the brain stem, probably in the facial motor nucleus. We take these results to support the hypothesis that chronic stimulation of the facial nerve can change the facial nucleus in such a way that it becomes hyperactive, and cross transmission between neurons that are innervating different facial muscles is facilitated. PMID- 3666083 TI - Collagen- and laminin-containing gels impede peripheral nerve regeneration through semipermeable nerve guidance channels. AB - Semipermeable guidance channels were filled with saline, collagen-, or laminin containing gels and used to repair a 4-mm sciatic nerve gap in mice. After 12 weeks, nerve cables regenerated in gel-filled channels displayed fewer myelinated axons than saline-filled channels. Remnants of the exogenous substrates were still in evidence, in amounts related to the initial collagen or laminin gel concentration. The impairment of nerve regeneration by collagen or laminin containing gels suggests that the regenerative environment created within semipermeable channels is not improved by the addition of growth substrates in a gel form. PMID- 3666084 TI - Ultrastructural characterization of the central component of the medial preoptic nucleus. AB - The fine structure of the sexually dimorphic central part of the medial preoptic nucleus was studied in male and female rats. Neurons of this subnucleus are characterized by having convoluted nuclear membranes and fibrillar nuclear inclusions. Within the perinuclear domain there is a well developed neurosecretory apparatus, i.e., Golgi complexes, assorted types of secretory granules, and lysosome-like bodies, whereas the marginal cytosol contains stacked cisterns of rough endoplasmic reticulum, nucleolus-like inclusions, and few mitochondria. The neuropil is made up of thick dendrites, fascicles of thin unmyelinated axons, and few small myelinated axons. Additionally four types of synaptic boutons were found according to the morphology of their vesicular contents. No apparent qualitative sex differences were noted. These cytologic features which suggest secretory activity, coupled with reports that have shown the presence of several neurohormones and peptides within the central part of the medial preoptic nucleus lend further support to the neuroendocrine nature of these neurons. PMID- 3666085 TI - Single-unit responses of serotonergic dorsal raphe nucleus neurons to environmental heating and pyrogen administration in freely moving cats. AB - Single-unit activity of serotonergic neurons in the dorsal raphe nucleus was examined in response to environmental heating and pyrogen-induced fever in freely moving cats. In the heating study, ambient temperature was rapidly raised from a baseline of 25 degrees to 43 +/- 1 degrees C and maintained at this level for 2 h. Cats displayed hyperthermia, intense panting, and signs of heat stress, however, the discharge rate of serotonergic neurons of the dorsal raphe nucleus was not significantly different from baseline at any time during heat exposure. Similarly, the activity of these neurons was not significantly altered at any time during an approximately 6-h long febrile response induced by the synthetic pyrogen muramyl dipeptide (50 micrograms/kg, i.v.). These results indicate that serotonergic unit activity in the dorsal raphe nucleus is not related to either the activation of behavioral or physiological mechanisms underlying heat defense, or to alterations in thermoregulatory mechanisms during the febrile response to exogenous pyrogen. Furthermore, because these neurons do not respond to an elevation in body temperature induced by either ambient heating or pyrogen, they do not appear to be directly temperature-sensitive. These results do not support a specific role for serotonergic neurons of the dorsal raphe nucleus in thermoregulation. PMID- 3666086 TI - Excitation of upper cervical inspiratory neurons by inspiratory neurons of the nucleus retroambigualis in the cat. AB - The experiments reported here examined inputs from inspiratory neurons of the nucleus retroambigualis to upper cervical inspiratory neurons. Antidromic mapping in contralateral C1 demonstrated the existence of axon collaterals for 9 of 19 nucleus retroambigualis axons tested (47%). Forty nucleus retroambigualis neurons were tested with antidromic mapping for a projection to the ipsilateral C1 segment; 9/40 (22%) had an ipsilateral axon (8 of these also projected contralaterally), and 2/40 (5%) had an axon collateral in ipsilateral C1. Cross correlation histograms suggested monosynaptic excitation of an upper cervical inspiratory neuron by a contralateral nucleus retroambigualis neuron in 4/69 cases (6%) and common input to the pair in 2/69 cases (3%). Six of the 69 cross correlograms were computed during antidromic activation of the nucleus retroambigualis neuron, and one of these six demonstrated direct excitation of the upper cervical inspiratory neuron by the retroambigualis neuron. We concluded that at least some upper cervical inspiratory neurons receive monosynaptic excitation from the contralateral, and possibly the ipsilateral, nucleus retroambigualis inspiratory neurons. These results, together with those published elsewhere for inputs from inspiratory neurons in the contralateral ventrolateral nucleus tractus solitarius, suggest that the rhythmic, inspiratory firing pattern of the upper cervical inspiratory neurons is due to excitatory inputs from these two inspiratory bulbospinal neuron populations. PMID- 3666087 TI - Behavioral state-specific inhibitory postsynaptic potentials impinge on cat lumbar motoneurons during active sleep. AB - High-gain intracellular records were obtained from lumbar motoneurons in intact, undrugged cats during naturally occurring states of wakefulness, quiet sleep, and active sleep. Spontaneous, discrete, inhibitory postsynaptic potentials (IPSPs) were found to impinge on lumbar motoneurons during all states of sleep and wakefulness. IPSPs which occurred during wakefulness and quiet sleep were of relatively low amplitude and had a low frequency of occurrence. During the state of active sleep there occurred a great increase in inhibitory input. This was the result of the appearance of large-amplitude IPSPs and of an increase in the frequency of low-amplitude IPSPs which were indistinguishable from those recorded during wakefulness and quiet sleep. In addition to a difference in amplitude, the time course of the large IPSPs recorded during active sleep further differentiated them from the smaller IPSPs recorded during wakefulness, quiet sleep, and active sleep; i.e., their rise-time and half-width were of longer duration and their rate-of-rise was significantly faster. We suggest that the large, active sleep-specific IPSPs reflect the activity of a group of inhibitory interneurons which are inactive during wakefulness and quiet sleep and which discharge during active sleep. These as yet unidentified interneurons would then serve as the last link in the brain stem-spinal cord inhibitory system which is responsible for producing muscle atonia during the state of active sleep. PMID- 3666088 TI - Selective uptake by Purkinje neurons of antibodies to S-100 protein. AB - Forty-eight hours after intraventricular injection, affinity-purified antibodies to S-100 protein localized in Purkinje cells whereas affinity-purified antibodies to goat immunoglobulin or to bovine serum albumin did not. This selective up-take may account for the susceptibility of some neurons to immunologic insult, and may provide further evidence to support hypotheses which invoke autoimmune mechanisms in the pathogenesis of central nervous system disorders. PMID- 3666089 TI - Effects of hydrocortisone on the ultrastructure of the thymic cysts of chicks. AB - Thymi from 10-day old male chicks injected subcutaneously with 5 mg of hydrocortisone for 2 consecutive days and sacrificed on the 4th day were examined by electron microscopy. With depletion of the lymphoid cells, cystic structures, consisting of inter- and intracellular cysts are more apparent in the hydrocortisone-treated chicks. The intercellular cysts vary in size and shape and are lined by cystic, endocrine-like and lymphoid cells. Luminal surfaces of the cystic cells contain microvilli. The lateral plasma membranes show complex interdigitations. The prominent terminal web contains vesicles and numerous core rootlets. Frequent membrane invaginations are apparent at the bases of the microvilli. The endoplasmic reticulum and the Golgi complex are moderately developed. Mitochondria are variable in number but are numerous in some cells. The cytoplasm also contains dense bodies, vacuoles and myelin figures. Endocrine like cells, containing numerous secretory granules and bordering directly on the follicular lumen suggest that their secretion may be discharged into the lumen. Cystic cells containing intracellular cysts are observed. Presence of cleft-like spaces, microvilli closely opposed to adjacent cytoplasmic processes or lateral microvilli may reflect responses to increase in absorptive or transport function. The present data suggest that hydrocortisone may modulate the structure and function of the cystic structures in the chick thymus. PMID- 3666090 TI - Autophagic mechanisms in diethylnitrosamine-induced tracheal papillomas of Syrian golden hamster. AB - Treatment with diethylnitrosamine induced tracheal papillomas in the Syrian golden hamster. Enlarged lysosomes (EL) occurred in a particular type of cells situated at the periphery of tumor lobules. The differentiated phenotype of these cells in secretory in nature. As to the significance of EL occurrence, two possibilities are considered: 1) EL formation is a part of disposal mechanisms after the autophagocytosis of undischarged secretory products by secondary lysosomes and 2) ELs are indicative of sublethal injury to cells of the outermost layer of tracheal papillomas. PMID- 3666091 TI - Effect of helium-oxygen mixture on myocardiac mitochondria of the rat. AB - Ultrastructural and stereological analysis of mitochondria of myocardiac cells from rats was performed after 2-hour breathing of helium-oxygen mixture. The following changes were observed in the cells of experimental animals as compared with the control ones: swelling of mitochondria, increase of the mean volume fraction of these structures and decrease of axial ratio of mitochondria. PMID- 3666092 TI - Binding of (125I) triiodothyronine to human peripheral leukocytes and its internalization. AB - Ultrastructural autoradiography showed high specific binding of (125I) triiodothyronine, as confirmed by a competition test, to plasma membranes, nuclei and mitochondria of human peripheral leukocytes. A high level of binding was also noted on the granulocytes' granules, especially in eosinophils. PMID- 3666093 TI - Internalization of triiodothyronine-bovine serum albumin-colloidal gold complexes in human peripheral leukocytes. AB - Complexes of triiodothyronine-bovine serum albumin-colloidal gold were specifically internalized in human peripheral leukocytes after 5 min of incubation. The specificity was partially lost after a longer incubation. PMID- 3666094 TI - Center-surround organization of Xenopus horizontal cells and its modification by gamma-aminobutyric acid and strontium. AB - The properties of axon-bearing horizontal cells were studied by intracellular recording in the light-adapted Xenopus retina. In this adaptational state, the only receptor input was provided by red-sensitive cones. Measurements of response amplitude as a function of stimulus diameter indicated that different units were divisible into two compartments on the basis of their receptive field dimensions: one with a mean length constant, lambda, of 170 microns, the other with lambda = 450 microns. Lucifer Yellow dye injection revealed that units having small receptive fields invariably were cell bodies, whereas units having large receptive fields always were axons. For both horizontal cell bodies and axons, the waveform in response to large spots or annuli consisted of a hyperpolarizing on-transient, followed by a depolarizing rollback to a sustained plateau during light on, and a rapidly depolarizing off-transient that overshot the dark potential level. In contrast, in responses to small spots, the depolarizing rollback was much reduced or absent. However, for small field compartments only, when concentric annular stimuli were flashed around steadily illuminated, small, centered spots, the horizontal cell waveform consisted primarily of a depolarizing potential during light on. This depolarizing component was reduced selectively when the preparation was superfused with Ringer containing 5 mM gamma aminobutyric acid (GABA). Following a brief exposure to 5-10 mM Sr2+, enhanced oscillatory potentials appeared in the horizontal cell light response during the depolarizing rollback and at light off. The modifications of the depolarizing rollback evoked by Sr2+ were antagonized by GABA. The strontium-induced alterations of the light response were not altered by 6 microM tetrodotoxin (TTX). The results are interpreted in terms of a feedback synaptic action exerted by horizontal cells upon cones, which is expressed as the depolarizing rollback component of the horizontal cell light-evoked waveform. The spatial properties of this component suggest that horizontal cell axons but not horizontal cell perikarya are capable of evoking a feedback signal in the cone. The actions of strontium indicate that calcium currents may play a role in shaping the feedback response. The ability of GABA to antagonize the Sr2+ effect upon the depolarizing rollback indicates that GABA may play a role in feedback. PMID- 3666095 TI - GABA and glycine modify the balance of rod and cone inputs to horizontal cells in the Xenopus retina. AB - Under mesopic conditions, the light-evoked waveform of horizontal cells in Xenopus retina reflects synaptic input from both rod and cone photoreceptors. These inputs interact non-linearly: the response to a weak red (cone-effective) flash is increased up to four-fold when the red stimulus falls on a green (rod effective) background by reference to the response elicited by the same red flash on a dark field. We refer to this phenomenon as enhancement. It was not observed either when stimulus and field wavelengths were reversed or were of the same color. Enhancement was not altered by polarization of the horizontal cell membrane up to +/- 30 mV with extrinsic current. Enhancement could not be elicited with any combination of test and background wavelengths under photopic conditions. Superfusion of the retina with GABA resulted in a hyperpolarization of the horizontal cell membrane and an emphasis of the rod input to the horizontal cell light-evoked response. Picrotoxin depolarized the cell and favored the cone input. Enhancement was altered in predictable ways by these drugs. Glycine reduced selectively the cone input to the horizontal cell, whereas its antagonist, strychnine, increased the rod input. The results are interpreted to indicate that the excitability of the horizontal cell is modified both by distal and proximal retinal circuits; a glycinergic interplexiform cell probably plays a role in the latter pathway. PMID- 3666096 TI - Comparison of the musculoskeletal structure of the orbits of the migrating and non-migrating eyes in the winter flounder (Pseudopleuronectes americanus). AB - The winter flounder, Pseudopleuronectes americanus, undergoes a metamorphosis that involves the migration of one eye across the top of the head to a position adjacent to the non-migrating eye on the right lateral side. The metamorphosis involves changes in the nervous and musculoskeletal components of the orbits. The major difference between the two eyes is that the orbit of the left eye is composed completely of bone, whereas that of the right is partially bounded by jaw muscles. The orbital bones of the left eye cause the path of the extraocular muscles and optic nerve to be deflected and twisted before insertion, causing the left lateral and medial rectus muscles to be significantly shorter than the same muscles of the right eye. These orbital asymmetries are necessary to accommodate the final position of the eyes in an extraorbital position on the right side, which is a specialized adaptation allowing the flounder to lead both a benthic and pelagic existence. PMID- 3666097 TI - Lung ventilation during walking and running in four species of lizards. AB - The relationship between locomotion and aspiration breathing was investigated in the lizards Iguana iguana, Ctenosaura similis, Varanus exanthematicus and Varanus salvator, and the quail Coturnix coturnix. Respiratory air-flow during walking and running on a 7.3 m track or on a treadmill was measured with a bidirectional flow meter attached to one nostril. In all four species of lizards, lung ventilation drops markedly during locomotion. Tidal volume decreases as speed increases, often by more than an order of magnitude at intermediate and high speeds, and the rate of decline is most pronounced at the lowest speeds. Minute ventilation peaks at or before the reported maximum aerobic speed and decreases at higher speeds. In contrast, quail increase their minute ventilation during running. Several observations support the hypothesis that the aspiration of lizards is mechanically constrained by locomotion which employs lateral vertebral bending and sprawling posture. 1. Minute ventilation decreases as running speed increases. 2. Disruption of ventilation is temporally coincident with the locomotor movements. 3. During running the largest breaths correspond to the strides of longest duration or to brief pauses in the locomotor movements. PMID- 3666098 TI - Anomalous 2-deoxyglucose uptake and acetylcholinesterase activity in cat LGN after optic chiasm section. AB - Sectioning the optic chiasm in young kittens denervates layer A of the lateral geniculate nucleus (LGN) on both sides of the brain. We removed one eye of these split chiasm kittens in adulthood, rendering the ipsilateral LGN devoid of primary retinal input. Nonetheless, one day after the eye removal, consumption of 14C-2-deoxyglucose (2-DG) was much higher in layer A than in layer A1 of the LGN. The anomalous 2-DG uptake was not due to enhanced cortico-geniculate or other visual input to layer A, but instead appears related to a marked increase in acetylcholinesterase activity in this layer following the early chiasm section. PMID- 3666099 TI - Retinal oxygenation from the choroid in hyperoxia. AB - The extraordinarily high rate of blood flow in the cat choroid allows the choroidal oxygen tension to rise to levels close to the arterial PO2, even with oxygen enriched breathing mixtures. The high PO2 in the choroid can elevate the oxygen tension of the inner retina above the saturation PO2 of hemoglobin when oxygen enriched breathing mixtures at one atmosphere or less are used as shown by polarographic oxygen tension measurements in the preretinal vitreous in cats. PMID- 3666100 TI - Regrowth of granulocyte-macrophage progenitor cells (GM-CFC) in suspension cultures of bone marrow depleted of GM-CFC with 4-hydroperoxycyclophosphamide (4 HC). AB - The hematopoietic capacity of bone marrow treated with 4 hydroperoxycyclophosphamide (4-HC) was studied using long-term suspension cultures. It was shown that, in the presence of a previously established marrow adherent cell layer (ACL), the 4-HC treated bone marrow, deprived of GM-CFC, generates GM-CFC in long-term suspension cultures in vitro. The kinetics of GM CFC reappearance in in vitro cultures indicate their origin from more primitive progenitors rather than from surviving GM-CFC. In the presented modification, the suspension culture system is useful in evaluating the transplantation potential of bone marrow purged in vitro with chemotherapeutic or biologic agents. PMID- 3666101 TI - A simple in vitro method of radiolabelling human erythrocytes in whole blood with 113mIn-tropolonate. AB - A simple and rapid in vitro procedure has been developed for selectively radiolabelling erythrocytes in whole blood using 113mIn-tropolonate. A maximum labelling efficiency of 97% was achieved, of which 95.5% was on the erythrocytes after only 5 min incubation of whole blood at room temperature. The optimum amount of tropolone for labelling whole blood was 10 micrograms of tropolone per ml of blood using acid-citrate dextrose (ACD) as the anticoagulant and 50 micrograms of tropolone per ml of blood using heparin. Under these optimum conditions, only 2.5% of the cell-bound 113mIn was released from the labelled cells during a 1 h in vitro incubation in cell-free plasma, irrespective of the anticoagulant used. These results suggest that 113mIn-tropolonate may prove to be a useful in vitro agent for labelling erythrocytes for short-term clinical investigations, especially at centres where 99mTc and 111In are unavailable. PMID- 3666102 TI - Cytochemical demonstration of 'platelet' peroxidase at the light microscope level. AB - A reliable and reproducible modified method was developed for the cytochemical demonstration of the so-called 'platelet' peroxidase at the light microscopy (LM) level. Interestingly, not only normal platelets and megakaryocytes showed the peroxidase activity, but also normal lymphocytes. As with the ultrastructural platelet peroxidase (PPO) method, myeloperoxidase (MPO) was also demonstrated in granulocytes. Peroxidase activity was exhibited by blast cells of acute myeloid leukaemia, including megakaryoblasts of megakaryoblastic leukaemia, by hairy cells of hairy cell leukaemia, by centroblasts of centroblastic lymphoma and by plasma cells of plasma cell leukaemia. The enzyme activity was also demonstrated in the mast cells of systemic mastocytosis. It seems that different forms of peroxidase are present in most haemic cells. Fixation and conditions of incubation are probably the determining factors for their demonstration. The method may allow further cytochemical discrimination at the LM level between blast cell populations which are negative for MPO by standard methods. PMID- 3666103 TI - Platelet glucose metabolism in type I diabetic subjects. AB - In a group of 35 type I diabetics, platelet glycolytic and glycogenolytic flux have been measured. In type I diabetic platelets glucose uptake was significantly reduced. The quite normal lactate production was obtained by a faster utilization of stored glycogen in these patients. Specific activity of glycolytic enzymes was normal, in particular the levels and kinetic properties of soluble and membrane bound hexokinase. The rate of glucose flux through the hexose monophosphate shunt, measured either in resting or in arachidonic acid-stimulated platelets, was normal in diabetics. Kinetics of glucose transport across plasma membrane have also been determined. Km was significantly increased in diabetic patients. No changes was shown in Vmax. Modifications present in membrane organization of patients could involve glucose transport protein. PMID- 3666104 TI - Specific binding of B-CLL cell-derived chemokinetic inhibitory factor (CIF) to human polymorphonuclear leukocytes. AB - The chemokinetic inhibitory factor (CIF) is a recently described B-cell derived lymphokine that mediates a chemokinetic inhibitory effect on human polymorphonuclear leukocyte (PMN) migration. In the present report the interaction of CIF with the neutrophil plasma membrane was studied. Normal human peripheral blood neutrophils and purified neutrophil plasma membranes selectively removed biologic activity from CIF-containing concentrates obtained during the purification procedure from conditioned medium. Removal was obtained at both 4 degrees C and 37 degrees C. Furthermore, HL-60 cells treated with dimethyl sulfoxide removed CIF activity (granulocyte-like cells) but HL-60 cells treated with 12-O-tetradecanoylphorbol-13-acetate (macrophage-like cells) did not. Purified human blood monocytes, cells from the macrophage-like U-937 cell line and cells from the basophilic leukemia cell line KU-812 did not remove CIF. These studies suggest that neutrophils express specific binding sites for CIF-activity. PMID- 3666105 TI - Intravenous gammaglobulin treatment for thrombocytopenic purpura in patients with human immunodeficiency virus (HIV) infection. PMID- 3666106 TI - A case of Bernard-Soulier syndrome: study of platelet glycoprotein Ib in a kindred. AB - The Bernard-Soulier syndrome is characterized by low platelet counts, abnormally large (giant) platelets, and impaired or absent platelet aggregation by the inducer antibiotic ristocetin. The recent discovery of the inherited biochemical defect and the deficient synthesis of platelet glycoprotein Ib (GP-Ib), has contributed greatly to the understanding of the disease. We report a case of the Bernard-Soulier syndrome presenting with bleeding from the pharynx after adenotomy. The patient and nearest family members were studied by a novel immunoperoxidase method for quantification of platelet glycoprotein Ib using a specific monoclonal antibody (AN51). PMID- 3666107 TI - High-dose intravenous methylprednisolone for refractory or resistant Diamond Blackfan anemia. PMID- 3666108 TI - HBsAg in platelets. PMID- 3666109 TI - Plasma fibronectin levels during daily plasmapheresis. PMID- 3666110 TI - [Effect of anticonvulsants on the psychotropic activity of tranquilizers in their joint use in an experiment]. AB - Effects of anticonvulsants (phenobarbital, hexamidine, benzonal, difenin, chloracon, trimetin, carbamazepine) on the psychotropic activity of tranquillizers (diazepam, chlordiazepoxide, meprotan, trioxazine, mebicar) were studied in experiments on mice and rats. Thirteen combinations were studied by using corazol test, "open field" and elementary-defensive conditioned response technique. According to all three tests the psychotropic activity was enhanced to the greatest degree by administration of hexamidine in combination with chlordiazepoxide. PMID- 3666112 TI - [Facilitation of memory trace retrieval by the action of amfonelic acid]. AB - Amfonelic acid exerting the central dopaminergic effect was studied on mice by the passive avoidance conditioned response method under amnesia induced by leaving the animals in a dark chamber following electrocutaneous stimulation and different terms of natural forgetting. Amfonelic acid was shown to prevent the amnesic effect, to improve retrieval of the conditioned response decreased as a result of amnesia or prolonged forgetting. PMID- 3666111 TI - [Normalizing effect of GABA derivatives on late behavioral disorders occurring in rats with early postnatal suppression of protein synthesis]. AB - Changes in the central nervous system activity caused by an early postnatal (7th day of life) injection of cycloheximide (CHX) were studied during experiments on adult rats. Disturbances in the process of learning in the experiments on conditioned reflexes of active and passive avoidance, difficulties in solving the extrapolatory task, weakening of habituation, motor hyperactivity, disorder of movement coordination were noted. Electrophysiological analysis by means of evoked potential recovery cycles revealed deficiency of GABAergic inhibition in the cerebral cortex. Hydroxybutyric salts of sodium and lithium as well as piracetam injected after CHX (from 8th through 14th days of life) normalized general behavior and learning capability of adult rats. Phenibut (beta-phenyl GABA) was inferior by its efficacy, GABA exhibited no distinct effect. PMID- 3666113 TI - [Identification of antidepressants based on the characteristics of EEG spatial organization]. AB - Methods of factorial and discriminant analysis were used for the analysis of the electroencephalographic reaction to gamonil and damilen. Specific features of EEG spatial reorganization were revealed for each of the thymoleptics which made it possible to recognize correctly the drugs in 87.5 and 92.3% of cases, respectively. PMID- 3666114 TI - [Comparative histofluorescent study of cardiac sympathetic nerves and adrenal catecholamines in rats under immobilization stress and administered a toxic dose of noradrenaline]. AB - Changes in the adrenergic nerves of the rat heart and dynamics of adrenal catecholamines during immobilization stress and administration of a toxic dose of noradrenaline were found to be of the same type in general. They were manifested by a decrease of the number of fluorescent nerve terminals in the cardiac ventricles and an increase of catecholamine content in the adrenal glands 24 hours after the beginning of the experiment. PMID- 3666115 TI - [Pharmacokinetic characteristics of ethacizine in patients with disorders of heart rhythm]. AB - Significant differences in values of the volume of ethacizine distribution and clearance at oral administration in patients with myocardial infarction from those in patients with other pathology were established. A considerable decrease of ethacizine bioavailability in myocardial infarction patients was shown. PMID- 3666116 TI - [S-methyl methionine (vitamin U) pharmacokinetics in rat and man]. AB - S-methyl methionine was shown to be rapidly absorbed, accumulated in the liver and kidneys and actively assimilated by the organisms of rats and man. Some constants of pharmacokinetics of different optical forms of S-methyl methionine were determined. The predominant use of L-form was found. The concurrent administration of D- and L-forms stimulates processes of D-form assimilation. PMID- 3666117 TI - [Toxicological characteristics of teturam in an alcoholic intoxication model in rats]. AB - Study of toxicological characteristic of teturam (200 mg/kg, administered into the stomach through a tube daily for 2 weeks) on the model of alcoholic intoxication in rats (ethanol, 8 g/kg, administered into the stomach through a tube daily for 1 month) confirmed the literature data on the drug's ability to enhance or maintain ethanol-induced pathological changes in the blood and internal organs. PMID- 3666118 TI - [Possibilities for behavior correction in a learned ethanol preference in female and male white rats]. AB - Correction of behavior of rats preferring for a long time ethanol but not water may be performed using the agents enhancing sexual activity of animals of both sexes: apomorphine (1 mg/kg), bromocriptine (1 mg/kg) and yohimbine (4 mg/kg). Normalization of behavior of the rats manifested by not only a decrease of total ethanol consumption but also by a change of alcohol preference. Bromocriptine exerted the predominant effect on females, and yohimbine on males. Apomorphine was effective in the animals of both sexes but its efficacy was higher in females. The agents produce opposite changes depending on the animal sex in ethanol level during the withdrawal period, the rate of ethanol elimination in the blood at its administration in a test dose and the reaction of self stimulation of the lateral hypothalamus. Female rats proved to be more sensitive to the drugs' effects related to changes in ethanol metabolism rate. Male animals were more responsive to the effects due to changes in the positive reinforcement system. PMID- 3666119 TI - [Effect of adrenomimetic and antiadrenergic agents on the gastric emptying function in peptic ulcer patients]. AB - Stimulation with isadrin and blockade with inderal of beta-adrenergic processes exert no significant effect on the time of food evacuation from the stomach. The alpha-adrenergic action of mezaton and ephedrine manifests itself in delayed food evacuation from the stomach at its initial accelerated evacuatory function. Blockade of alpha-adrenoreceptors with pyrroxan reduces the time of the stomach evacuation at the initial delayed gastric evacuation. PMID- 3666120 TI - [The additive index--a new preclinical indicator of the addictive potential of analgesic agents]. AB - A comparative study of analgesic and secondary-reinforcing properties of morphine, nalorphine, pentazocine and phencyclidine was carried out on mice. Different rations of their analgesic and reinforcement potencies were revealed. Based on these results, a new indicator--"addictive index" is proposed for characterization of the addictive potential of analgesics. PMID- 3666121 TI - [Synthesis and choleretic activity of 3-(2-aryl-5R-benzimidazol-1-yl) butanoic acids]. AB - Thirty 3-(2-aryl-5R-benzimidazol-1-yl)butanoic acids were prepared in order to evaluate substitution effects on the 2 and 5 positions of the heterocyclic ring upon the previously recorded choleretic activity of 3-(2-phenylbenzimidazol-1 yl)butanoic acid. A general choleretic activity is shown by the acids tested, which in several cases it is superior to that of the model compound and sometimes also to that of dehydrocholic acid. PMID- 3666122 TI - Derivatives of 1,2,3,3-tetramethyl-2-azabicyclo [2.2.2]-octan-5-trans-ol with antiarrhythmic and other activities. VII. AB - The synthesis of a series of alkyl and aryl ureas (II) starting from 5-trans-(3 aminoproxy)-1,2,3,3-tetramethyl-2-azabicyclo [2.2.2]-octane is described. Some compounds (II) showed appreciable antiarrhythmic activity in rats and infiltration anesthesia in mice, as well as weak hypotensive and bradycardic activities in rats. PMID- 3666123 TI - Compounds with potential anticancer activity. Benzenesulfonamido-pyrimidine derivatives. AB - Some derivatives of N-(5-pyrimidinyl)benzenesulfonamide, variously substituted at the benzene and pyrimidine ring, and variously methylated at ring and/or sulfonamidic nitrogens, were re-prepared. The activity of these compounds against lymphocytic leukemia P388 was evaluated and proved to be negligible or completely absent. PMID- 3666124 TI - Neurophysiological changes induced by 5-HT reuptake inhibitors in rabbits. AB - The EEGraphic, behavioural and autonomic changes induced by the administration of some inhibitors of serotonin (5-HT) reuptake were evaluated in the rabbit. The drugs examined were: Alaproclate (Ala), Citalopram (Cit), Fluoxetine (Fluo), Fluvoxamine (Fluvo), Indalpine (Ind), Zimelidine (Zim). It seems that all these drugs would act exclusively or prevalently on 5-HT uptake. The changes of the parameters studied were not homogeneous. Some of these drugs (Cit, Zim) induced an EEGraphic and behavioural "arousal" pattern, others (Fluo, Fluvo) a "slow wave sleep" one, others (Ala, Ind) a biphasic one (alteration of the two above mentioned patterns). The possible hypotheses subtending these data are discussed. PMID- 3666125 TI - [Substances inhibiting amine oxidases. III. Synthesis and amine oxidase inhibition of imidazoquinoline derivatives]. AB - The activity of copper and FAD dependent amine oxidases was tested with some derivatives of 3H-imidazo[4,5-h]quinoline and its isomers 3H-imidazo[4,5 f]quinoline, the chemistry of which is described in the literature (1), and Ki calculated. The methyl derivative of 3H-imidazo[4,5-f]quinoline was found to activate the copper bovine serum enzyme, but inhibits the FAD mitochondrial enzyme. PMID- 3666126 TI - [7-Substituted theophyllines. V. Azabenzhydrylaminoalkyl derivatives]. AB - Some 7-(azabenzhydrylaminoalkyl)theophyllines were prepared and pharmacologically screened. They showed low toxicity, antidepressant properties and, in some cases, antithrombotic activity. PMID- 3666127 TI - Potential antitumor agents. I. Synthesis of pyrroloindazole derivatives related to the pyrroloindole moieties of the antitumor antibiotic CC-1065. AB - The synthesis of some derivatives of the unknown 1(2),8-dihydropyrrolo[3,2 g]indazole is reported starting from 7-oxo-4,5,6,7-tetrahydroindole. The new pyrroloindazole derivatives resemble the B and C subunit structure of the antitumor antibiotic CC-1065. PMID- 3666128 TI - Studies on annelated 1,4-benzothiazines and 1,5-benzothiazepines. III--Synthesis and CNS activity of some 1-substituted derivatives of the novel heterocyclic system 4,5-dihydro-s-triazolo [3,4-d]-1,5-benzothiazepine. AB - A series of new 4,5-dihydro-s-triazolo [3,4-d]-1,5-benzothiazepines has been prepared. All the described compounds are representative of a novel ring system. Some of these compounds were tested for their CNS activity and effects comparable with the ones of diazepam were observed. PMID- 3666129 TI - Antihypertensive and antithrombotic activities of 6-(substituted phenyl)-5 hydroxymethyl-4,5-dihydro-3(2H)pyridazinones. AB - The synthesis of a series of 6-(4R-phenyl)-5-hydroxymethyl-4,5-dihydro 3(2H)pyridazinones is reported. The compounds were evaluated for their oral antihypertensive activity in rats and some of them [(V b), R = NH2] and [(V c), R = NHCOCH3] were found to induce a high decrease in systolic blood pressure. Moreover all the compounds displayed an antithrombotic activity comparable to, or greater than, that of ASA. PMID- 3666130 TI - Maintenance of accuracy during amino acid starvation. AB - The kinetics of the tRNA cycle is in itself capable of keeping the translational error level almost unaffected by amino acid starvation. There is no need to assume any yet unknown mechanism or property. Kinetic analysis shows that the concentration of aminoacyl-tRNA can stay high even for large reductions in aminoacylation, since the pool of uncharged tRNA normally is very small. An enhanced binding of uncharged tRNA to the ribosome could increase the effect and produce an extremely efficient error damping. A similar result is obtained when EF-Tu is partially inhibited by ppGpp. PMID- 3666131 TI - Differential regulation of muscle acetylcholine receptor gamma- and epsilon subunit mRNAs. AB - The contents of the mRNAs encoding the gamma- and epsilon-subunits of the nicotinic acetylcholine receptor as well as the single-channel properties of the receptor have been assessed in innervated, denervated and reinnervated rat muscle. The changes in abundance of the gamma- and epsilon-subunit mRNAs correlate with the changes in relative density of two classes of acetylcholine receptor channels. The results support the view that a switch in the relative abundance of the gamma- and epsilon-subunit mRNAs is a major mechanism in regulating the properties of acetylcholine receptor channels in muscle. PMID- 3666132 TI - Down-regulation of phorbol diester binding to NG115-401L neuronal cells is dependent on structure, concentration and time. AB - The down-regulation of [3H]PDBu binding to a neural cell line, NG115-401L, has been examined in response to two biologically active phorbol diesters, PDBu and PMA. Chronic treatment with PDBu or PMA causes a concentration- and time dependent loss of specific [3H]PDBu binding. The action of PMA is biphasic with respect to both concentration and time dependence. PMID- 3666133 TI - Expression of beta-nerve growth factor mRNA in rat glioma cells and astrocytes from rat brain. AB - A 50-base synthetic oligodeoxynucleotide complementary to a portion of mouse nerve growth factor (NGF) mRNA was used as a probe for analysis of the expression of NGF gene. Northern blot analysis showed the presence of a major 1.3 kb transcript, which was identical in size to mouse NGF mRNA, in both C6Bu1 cells and rat astrocytes cultured from newborn rat brain. Further, the rearrangement of DNA sequence in and around the NGF gene locus of C6Bu1 cells was not detected by Southern blot analysis. These results indicate the expression of NGF mRNA in both C6Bu1 cells and astrocytes from rat brain, suggesting that astrocytes may produce NGF protein in the rat brain, especially in developing rat brain. PMID- 3666134 TI - Primary structures of human protein kinase C beta I and beta II differ only in their C-terminal sequences. AB - Two types of cDNA clones encoding human protein kinase C (PKC) were isolated from a spleen cDNA library using rabbit protein kinase C beta I/beta II cDNA as a hybridization probe. Nucleotide sequence analyses of these cDNA inserts revealed complete primary structures of two distinct types of human protein kinase C beta I and beta II which differ only in their C-terminal 50 or 52 amino acid residues. It was concluded that there exist four distinct types of PKC, PKC alpha, beta I, beta II and gamma, in human as well as rabbit, and that the corresponding sequences are strictly conserved among mammalian species. PMID- 3666135 TI - Interaction of melittin with negatively charged phospholipids: consequences for lipid organization. AB - A characterization of the structural alterations induced by melittin in model membranes of dioleoylphosphatidic acid and egg phosphatidylglycerol is presented, based on the use of 31P-NMR, freeze-fracture electron microscopy and small angle X-ray scattering. In accordance with earlier findings on the cardiolipin-melittin system, melittin is found to have an inverted phase inducing effect on these negatively charged lipids, in contrast to the influence on zwitterionic phospholipids. In phosphatidic acid this is expressed in the formation of an HII phase; in phosphatidylglycerol a less ordered, non-lamellar structure with low water content is adopted. PMID- 3666136 TI - Proteolytic activation of protein kinase C in the extracts of cells treated for a short time with phorbol ester. AB - A 10 min treatment of human neutrophils with phorbol 12-myristate 13-acetate (PMA) has been reported to induce accumulation of the proteolytically activated Ca2+/phospholipid-independent catalytic fragment of protein kinase C in the cytosol of intact cells [(1986) J. Biol. Chem. 261, 4101-4105]. We investigated the proteolytic conversion of protein kinase C to Ca2+/phospholipid-independent form in the cytosol and membrane fractions of pig neutrophils. The activity of protein kinase C was measured with its specific oligopeptide substrate Ala-Ala Ala-Ser-Phe-Lys-Ala-Lys-Lys-amide designed previously. In our experiments the short-term treatment of neutrophils with PMA did not induce the accumulation of the proteolytically activated form of protein kinase C in the cytosol of intact cells. However, treatment of cells with PMA enhanced the limited proteolysis of protein kinase C during the preparation of cell extracts. PMID- 3666137 TI - Primary structure of elongation factor 1 gamma from Artemia. AB - Complementary DNA corresponding to elongation factor 1 gamma, which forms a complex with EF-1 beta, has been cloned. A lambda gt11 cDNA library has been screened with an antiserum against EF-1 beta gamma. The derived amino acid sequence of EF-1 gamma corresponds to 429 amino acids excluding the initiator methionine, which is absent in the mature protein. About half of the protein was sequenced by direct protein sequence analysis. No clear homology with any other protein was found. PMID- 3666138 TI - Vertical fluctuations of phospholipid acyl chains in bilayers. AB - The possibility of vertical displacement of acyl chains in lipid bilayers has been examined by quenching the fluorescence of 2-(9-anthroyloxy)palmitic acid with 5- and 16-doxylstearates in dipalmitoylphosphatidylcholine unilamellar vesicles. Measurement of lifetime and steady-state quenching showed that the dynamic component of quenching was independent of the transverse position of the quencher indicating that a quencher at the 16-position could interact with a fluorophore at the 2-position with high frequency. The differences in steady state quenching could be accounted for by the differences in the static component of quenching. The results provide further evidence for rapid vertical displacements of acyl chains in phospholipid bilayers. PMID- 3666139 TI - Enzyme and organic solvents: horse liver alcohol dehydrogenase in non-ionic microemulsion: stability and activity. AB - In a microemulsion made with Triton X-100, the stability of the enzymatic activity was higher than in ionic microemulsions. The stability increased with water content. The kinetic constants (Michaelis constant of NAD+ and maximum velocity) were close to those found in the previously studied microemulsions. The Michaelis constant of NAD+ expressed with respect to the buffer volume was higher than in water. The pH dependence of the kinetic constants in this microemulsion was determined. The activity determined by NAD+ reduction decreased with water content, whereas the redox activity determined via butanol oxidation coupled to retinal reduction was only slightly reduced. PMID- 3666140 TI - Large unilamellar liposomes with low uptake into the reticuloendothelial system. AB - Particulate drug carriers, including liposomes, are rapidly removed from blood by cells of the reticuloendothelial system (RES) with resulting adverse effects on this important host defense system. In order to overcome this and other major disadvantages of liposomes, we have altered liposome composition in an effort to achieve prolonged circulation half-lives. Gangliosides and sphingomyelin act synergistically to dramatically diminish the rate and extent of uptake of liposomes by macrophages in vivo. The significantly extended circulation times achieved by these modified large unilamellar liposomes overcome an important barrier to the targeting of particulate drug carriers to specific tissues in vivo. PMID- 3666142 TI - Sequence and expression of the chicken calcitonin gene. AB - The avian calcitonin gene was isolated and sequenced; two mRNAs are expressed by tissue-specific alternate splicing. The peptides encoded by the mRNAs are the protein precursors of either calcitonin or calcitonin gene-related peptide (CGRP). Calcitonin is expressed predominantly in ultimobranchial bodies and CGRP in brain. PMID- 3666141 TI - Hemoglobin Grange-Blanche [beta 27(B9) Ala----Val], a new variant with normal expression and increased affinity for oxygen. AB - Hemoglobin Grange-Blanche [beta 27(B9) Ala----Val] is a new variant found in a Portuguese family. The carriers present moderate erythrocytosis. Upon isoelectric focusing, Hb Grange-Blanche was slightly more cathodic than Hb A. beta Grange Blanche chain migrated like the G gamma chain when submitted to electrophoresis in the presence of urea-Triton X-100. The precentage of Hb Grange-Blanche was about 50% in the heterozygous state. Oxygen affinity was increased (P50 = 22 mmHg), but heme-heme interaction was normal. An abnormal tryptic peptide (beta T3) was isolated using HPLC. Its composition allowed us to deduce unambiguously the amino acid change. The latter is the third mutation found in position 27 of the beta-chain. Because of its normal expression and its elevated affinity for oxygen, Hb Grange-Blanche contrasts with Hb Knossos [beta 27(B9) Ala----Ser], a beta-thalassemic variant with low affinity. PMID- 3666143 TI - Molecular cloning and sequencing of cDNA for rat cathepsin L. AB - A near full-length cDNA for rat cathepsin L was isolated. The deduced protein comprises 334 amino acid residues (Mr 37,685) containing a typical signal sequence (N-terminal 17 residues), pro-peptide (96 residues), and the sequence for mature cathepsin L (221 residues). Rat cathepsin L shows 94% amino acid identity with mouse cysteine proteinase. Amino acid sequence homologies of rat cathepsin L with rat cathepsins H and B are 45 and 25%, respectively. These facts indicate that mouse cysteine proteinase is probably mouse cathepsin L and that cathepsin L is more closely related to cathepsin H than cathepsin B. PMID- 3666144 TI - Sequence of an intestinal cDNA encoding human motilin precursor. AB - A cDNA clone encoding the human motilin precursor was isolated from an intestinal library using synthetic oligonucleotide probes. The predicted amino acid sequence indicates that the motilin precursor consists of 115 amino acids and includes a 25-residue N-terminal signal peptide followed by the 22-amino-acid motilin sequence and a long, 68-residue C-terminal peptide. The amino acid sequence of human motilin predicted from the cDNA sequence is identical to its porcine counterpart, which has been determined by protein sequencing. Proteolytic processing of promotilin to motilin occurs at the sequence, Lys-Lys, this being the first reported instance of processing occurring at a pair of Lys residues. In other precursors it occurs at Lys-Arg, Arg-Arg, Arg, or very rarely Lys. PMID- 3666145 TI - Photooxidation products of primaquine. Structure, antimalarial activity and hemolytic effects. AB - Photooxidation of primaquine (1) and 5-hydroxyprimaquine (5) afforded a blue dye for which o-quinone structure 4 was elaborated. Similar oxidation of N ethoxyacetylprimaquine (10) afforded o-quinone 11. Tissue schizontocidal activity of 4 and 11, and bisquinolylmethine 3 prepared earlier, showed that none of them had noteworthy antimalarial activity, but all three produced methemoglobin. PMID- 3666146 TI - Amino acid sequence of iron-superoxide dismutase from Pseudomonas ovalis. AB - The amino acid sequence of iron-superoxide dismutase from Pseudomonas ovalis was deduced by the analyses of peptides derived from limited hydrolysis of the aminoethylated or pyridylethylated apoprotein with trypsin, Staphylococcus aureus V8 protease, and dilute acid hydrolysis. The polypeptide chain contains 195 amino acid residues and has a calculated Mr of 21,421. The sequence is highly homologous (65% identity) to the recently published sequence of the iron superoxide dismutase from Photobacterium leiognathi. It is also homologous to the known sequences of the manganese-superoxide dismutase by sharing 33-53% identical residues. Alignment of the superoxide dismutase sequences and the available structural information from X-ray crystallography suggest that the ligands to the iron in the P. ovalis superoxide dismutase are His-26, His-74, Asp-156 and His 160, which align with the ligands to the manganese in the Thermus thermophilus manganese-superoxide dismutase. The sequence information of the P. ovalis dismutase will facilitate refinement of the X-ray crystallographic data that are now available at 2.9 A resolution. PMID- 3666147 TI - The common structure and activities of four subspecies of rat brain protein kinase C family. AB - Elucidation of the complete sequences of four cDNA clones (alpha, beta I, beta II, and gamma) of the rat brain protein kinase C family has revealed their common structure composed of a single polypeptide chain with four constant (C1-C4) and five variable (V1-V5) regions. Although these sequences are highly homologous and closely related to one another V3-, V4-, and V5-regions of gamma-subspecies are slightly bigger than the corresponding regions of the other three subspecies. The first constant region, C1, contains a tandem repeat of cysteine-rich sequence (6, total 12 cysteine residues). The third constant region, C3, has an ATP-binding sequence which is found in many protein kinases. In adult rat whole brain, the relative activities of alpha-, beta I-, beta II-, and gamma-subspecies are roughly 16, 8, 55, and 21%, respectively. gamma-Subspecies is expressed after birth apparently only in the central nervous tissue, implying its role in the regulation of specific neuronal functions. PMID- 3666148 TI - Thesaurin a, the major protein of Xenopus laevis previtellogenic oocytes, present in the 42 S particles, is homologous to elongation factor EF-1 alpha. AB - We have purified in SDS X.laevis thesaurin a (Mr 50,000) which is part of the 42 S storage particles. Its N-terminal amino acid is blocked and several peptides obtained by V8 protease treatment were purified and sequenced. As expected from one of the functional roles of the 42 S particles (tRNA binding, protection against deacylation and exchange with the ribosome), the amino acid sequence of thesaurin a was found to be closely related to that of the elongation factor EF-1 alpha. We suggest that all three proteins involved in 5 S RNA and tRNA storage in previtellogenic oocytes, TFIIIA, thesaurin a and thesaurin b, have a dual function: storage and a role in transcription or in protein synthesis. PMID- 3666149 TI - Progressin: a novel proliferation-sensitive and cell cycle-regulated human protein whose rate of synthesis increases at or near the G1/S transition border of the cell cycle. AB - A novel proliferation-sensitive and cell cycle-specific basic protein, termed progressin (Mr = 33,000), has been identified in proliferating human cells of epithelial, fibroblast and lymphoid origin. Progressin is synthesized almost exclusively during the S-phase of transformed human amnion cells (AMA). Increased synthesis of this protein is first detected late in G1, at or near the G1/S transition border, reaches a maximum in mid to late S-phase, and declines thereafter. Contrary to histones, progressin synthesis is not coupled to DNA replication. As expected for an S-phase-specific protein, no detectable synthesis of progressin was observed in non-proliferating human MRC-5 fibroblasts and epidermal basal keratinocytes. Elevated, but variable levels of this protein were observed in proliferating normal fibroblasts and transformed cells of fibroblast, epithelial and lymphoid origin. Taken together the above observations suggest that progressin may be a component of the common pathway leading to DNA replication and cell division. PMID- 3666150 TI - The long 3'-untranslated regions of the PDGF-A and -B mRNAs are only distantly related. AB - A cDNA clone of about 2300 base pairs was prepared from the human osteosarcoma cell line U-2 OS by hybridization with a 22-mer oligonucleotide complementary to the NH2-terminus of PDGF-A. Restriction and sequence analysis showed that this clone contains the entire coding region for PDGF-A and a long 3'-untranslated region which is only distantly related to that in the mRNA of PDGF-B. PMID- 3666151 TI - A ferriprotoporphyrin IX-chloroquine complex promotes membrane phospholipid peroxidation. A possible mechanism for antimalarial action. AB - The effect of a ferriprotoporphyrin IX-chloroquine complex on phospholipid membranes was investigated on the basis of iron-induced lipid peroxidation using microsomal phospholipid liposomes. The ferriprotoporphyrin IX-chloroquine complex remarkably promoted peroxidative cleavage of unsaturated phospholipids in liposomes, compared with ferriprotoporphyrin IX alone. Neither the combination of protoporphyrin IX with chloroquine nor the combination of Fe3+-ADP with chloroquine promoted lipid peroxidation. DL-alpha-Tocopherol completely inhibited lipid peroxidation induced by the ferriprotoporphyrin IX-chloroquine complex. PMID- 3666152 TI - A 32-kDa protein associated with phospholipase A2-inhibitory activity from human placenta. AB - Two monomeric 32-kDa proteins, termed 32K-I (pI 5.8) and 32K-II (pI 5.1), were isolated from human placenta, which was solubilized by a Ca2+-chelator. Only 32K I was associated with PLA2-inhibitory activity. CNBr peptide mapping indicated that 32K-I was distinct from 32K-II and two 36-kDa proteins, called calpactin I and II or lipocortin II and I, which have been shown to possess PLA2-inhibitory activity. 32K-I bound to PS in a Ca2+-dependent manner. 32K-I was detected in many tissues except brain, cardiac and skeletal muscle. PMID- 3666153 TI - Labeling of human erythrocyte membrane proteins by photoactivatable radioiodinated phosphatidylcholine and phosphatidylserine. A search for the aminophospholipid translocase. AB - We have synthesized radioiodinated photoactivatable phosphatidylcholine (125I-N3 PC) and phosphatidylserine (125I-N3-PS). After incubation with red blood cells in the dark, the labeled PC could be extracted but not the corresponding PS molecule, indicating that the latter was transported by the aminophospholipid translocase, but not the former. When irradiated immediately after incorporation, N3-PS, but not N3-PC, partially blocked subsequent translocation of spin-labeled aminophospholipids. Analysis of probe distribution by SDS-polyacrylamide gel electrophoresis revealed that 125I-N3-PS labeled seven membrane bound components with molecular masses between 140 and 27 kDa: one (or several) of these components should correspond to the aminophospholipid translocase. PMID- 3666154 TI - An early intermediate of refolding alpha-lactalbumin forms within 20 ms. AB - The kinetics of alpha-lactalbumin refolding were studied by the stopped-flow method with the registration of CD and intrinsic fluorescence at several wavelengths. It was shown that the early kinetic intermediate forms during the dead-time of the experiment (20 ms). This intermediate has a considerable amount of secondary structure and unpolar clusters in its molecular structure but has no rigid tertiary structure. PMID- 3666155 TI - Purification and some characteristics of a beta-galactoside binding soluble lectin from amphibian ovary. AB - Soluble extracts of Bufo ovaries agglutinate sialidase-treated rabbit erythrocytes. Unlike other amphibian lectins this agglutination activity does not require the presence of calcium ions. It is specifically inhibited by D-galactose and its derivatives. Thiodi-D-galactoside is the most potent saccharide inhibitor followed by lactose and methyl-beta-D-galactoside, respectively. D-Fucose, D glucose and D-mannose do not inhibit the activity at concentrations at or above 100 mM. The lectin has been purified 500-fold to apparent homogeneity from the ovaries by salt extraction and affinity chromatography on lactose-aminophenyl agarose, with a yield of about 0.2%. The molecular mass determined by gel filtration under native conditions was 30 kDa; polyacrylamide gel electrophoresis in SDS gave a molecular mass of 15 kDa, suggesting that the lectin is a dimer. The lectin has an isoelectric point of 40 and contains a high proportion of acidic amino acids. PMID- 3666156 TI - The calcium-binding property of equine lysozyme. AB - It was found that equine lysozyme binds one Ca2+. It was eluted with equimolar Ca2+ from a Bio-Gel P-4 column. Human lysozyme did not behave similarly. Equine lysozyme is concluded to be a calcium metallo-protein like alpha-lactalbumin, which is a homologue of hen egg white lysozyme. PMID- 3666157 TI - Alteration in monocyte function in patients with breast cancer. AB - Migration, phagocytosis and lysozyme production of peripheral monocytes from 36 patients with breast carcinoma was compared with a group of 36 healthy controls. A significant reduction in monocyte random migration and migration towards a chemotactic agent (P less than 0.001) was observed in patients with breast cancer. Furthermore monocyte phagocytic activity was also significantly decreased (P less than 0.001) in breast cancer patients compared to the controls. In contrast lysozyme production by peripheral monocytes was significantly increased in patients with breast cancer compared to controls (P less than 0.001). The changes in monocyte function in patients with breast carcinoma were not due to abnormal blood biochemistry or to direct continuous serum inhibitors, suggesting that the defect may be intrinsic. This defect in monocyte function may play an important role in the control of malignancies by cellular immune processes. PMID- 3666158 TI - A trial of human alpha interferon as an adjuvant agent in breast cancer after loco-regional recurrence. AB - Thirty-two women who had developed loco-regional recurrence of breast carcinoma were entered into a controlled trial of adjuvant alpha-interferon. All patients had histological confirmation of recurrence, local treatment with radiotherapy and negative staging investigations. They were then randomized to either observation alone, or treatment with human alpha interferon 3 x 10(6) units subcutaneously daily for 1 year. There were no differences detected in the rate of local or distant relapse. With this lack of clinically significant efficacy and a high incidence of side effects, it is concluded that alpha interferon is of doubtful value in the adjuvant treatment of breast cancer. PMID- 3666159 TI - Association between breast and colorectal cancer in a sample of surgical patients. AB - The frequency of adenomatous polyps and adenocarcinomas of the large bowel in 95 patients mastectomized for breast cancer, and the prevalence of breast cancer in 77 women previously operated on for colorectal cancer were evaluated by means of a case-control study. The mastectomized patients as well as the control group, underwent a left-sided colonoscopy. The latter had been selected among women spontaneously referring to our gastroenterological out-patients clinic. The choice of this self selected control group could produce a under-estimation of the relative for colon cancer in mastectomized patients. Among mastectomized patients the frequency of adenomatous polyps and colorectal cancer was 10.5% and 5.3% respectively; while the control group showed 8.5% frequency for adenomatous polyps and 3.9% frequency for cancer. These figures are not statistically different. Patients operated on for colorectal cancer and the control group underwent clinical and mammographic examination. The prevalence of breast cancer among colorectal cancer patients and the control group women was 5.2% and 0.3% respectively (10 times higher): the difference was statistically significant (P less than 0.006). In spite of the relatively small number of studied cases, our finding are consistent with the hypothesis of a correlation between breast cancer and colorectal cancer. PMID- 3666160 TI - Faecal carcinoembryonic antigen (CEA) in patients with large bowel cancer. AB - The possibility that faecal CEA may be a more useful measurement than serum CEA for the detection of large bowel cancer has received very little attention. For this reason faecal CEA was measured before and after tumour resection in colorectal cancer patients and in a variety of control subjects. CEA was extracted from faeces by a new method with 3M KCl and assayed by an EIA technique utilising two monoclonal antibodies. Mean +/- SE faecal CEA in 32 cancer patients was 4.15 +/- 1.17 micrograms/g preoperatively. Values were not related to either stage of disease or serum CEA and they fell to 0.83 +/- 0.34 micrograms/g (n = 20) following tumour resection (P less than 0.05). Mean +/- SE faecal CEA in 34 control patients with no known colorectal disease was 0.94 +/- 0.49 micrograms/g which was significantly lower than in the cancer patients (P less than 0.05). Furthermore faecal CEA in 25 patients with non malignant colorectal disease was 1.44 +/- 0.63 micrograms/g which again was significantly lower than that in the cancer patients. It is concluded that as CEA is present in the faeces of the majority of colorectal cancer patients even at early stages of the disease its measurement here may be more useful for the detection of large bowel cancer than that in serum. PMID- 3666161 TI - A simplified surgical technical procedure for intra-arterial chemotherapy in secondary liver cancer. Experience in 50 patients. AB - The purpose of this study was to prove that only one intra-arterial catheter for hepatic chemotherapy can perfuse the whole liver in all anatomic cases, including cases with aberrant or accessory hepatic arteries. The ligations of various hepatic arteries induce the immediate aperture of intra hepatic arterial shunts and a total revascularization of the whole liver by the only remaining hepatic artery. Based on the experience from 50 consecutive cases of surgical implantation of intra-arterial catheters for local chemotherapy, the simplified technique is analysed principally as a function of anatomical variations of the hepatic artery. The usual procedure (catheter implanted into the gastro-duodenal artery) was performed in 58% of the cases, while in 28% of the cases this was possible only after section of a right and/or a left aberrant or accessory hepatic artery. Unusual implantations were necessary in 14% of the cases to ensure complete perfusion of liver. The evaluation was based on three criteria: intra-operative perfusion of fluorescein, post-operative scan with 99mTc macro aggregated albumin and objective clinical responses after intra-arterial chemotherapy. The perfusion of the whole liver was good in all cases except one. Unusual procedures gave the same clinical objective responses after intra arterial chemotherapy (61%) as usual procedures (48%) (chi-square: P = 0.40). PMID- 3666162 TI - Squamous cell carcinoma of the rectum arising in an area of squamous metaplasia. AB - Squamous cell carcinoma of the rectum is a rare tumour. The aetiology of the tumour is disputed, although in the present case there is strong evidence that squamous metaplasia of the rectal mucosa was closely related to the genesis of the carcinoma. PMID- 3666163 TI - [Epilepsy and pregnancy]. PMID- 3666164 TI - [Characteristics of acute pneumonia in middle-aged and elderly patients]. PMID- 3666165 TI - [Chronic cholecystitis in middle-aged and elderly people]. PMID- 3666166 TI - [Varicose veins of the lower extremities]. PMID- 3666167 TI - [Deontology in rendering first aid and emergency medical care]. PMID- 3666168 TI - [Work criteria of a department for treating poisonings]. PMID- 3666169 TI - [Intestinal lavage in acute peroral poisonings]. PMID- 3666170 TI - [Diagnosis and treatment of the initial stage of alcoholism]. PMID- 3666171 TI - [Longevity (material for talks)]. PMID- 3666172 TI - [Preparing children for school]. PMID- 3666173 TI - [The posterior type of face presentation, the clinically narrow pelvis]. PMID- 3666174 TI - [Epidemic cerebrospinal meningitis simulating influenza]. PMID- 3666175 TI - [Disordered extrauterine pregnancy]. PMID- 3666176 TI - [Effect of vitamin on the eye]. PMID- 3666177 TI - [Microcomputer programs for epidemiological health stations]. PMID- 3666178 TI - Are we exploiting the infertile couple? AB - We hope that this article brings into focus some problems that merit consideration and debate. These thoughts come from a group of individuals who are actively engaged in reproductive endocrine/infertility practices with special interests ranging from ovulation induction to IVF to laser surgery. As a group, we practice in all parts of the country, and the problems mentioned are not restricted to any individual or region. We urge that all of us be candid with ourselves and our colleagues about what we can and cannot do for the infertile couple. We suggest that gynecologists ask themselves this question and proceed when the answer is affirmative: "Is this procedure really in the patient's best interest?" PMID- 3666179 TI - Isthmic ectopic pregnancy and salpingitis isthmica nodosa. AB - Two hundred eighty-five charts were reviewed from patients who underwent surgery for ectopic pregnancy. Excluded were patients with previous tubal reparative surgery, linear salpingotomy, or failed sterilization. The incidence of isthmic ectopic pregnancy in the remaining 255 cases was 15.3%. The association of salpingitis isthmica nodosa (SIN) and isthmic ectopic pregnancy was determined by review of resected tubal segments. SIN was noted in 17 of 37 cases (45.9%) of isthmic ectopic pregnancy. SIN places the patient at risk for recurrent ectopic pregnancy or infertility. Recommended conservative management of isthmic ectopic pregnancy is segmental resection with postoperative emphasis on documentation of SIN when present. Postoperative hysterosalpingography is recommended with an abnormal contralateral tube or when SIN is noted in the resected tubal segment. Management options after an isthmic ectopic pregnancy when future fertility is desired are presented. PMID- 3666180 TI - An analysis of endometrial biopsies performed for infertility. AB - The authors evaluated 774 endometrial biopsies that were performed for infertility. Complications arose in 3.6%. Lag of more than 2 days was found in 19%; luteal phase defect (LPD) was diagnosed in 5.7%. Most of the incidence of LPD can be predicted from chance occurrence. There was no association between abnormal biopsies and basal body temperature patterns, or between pathology, pregnancy outcome, and treatment. Exceptions included women with multiple spontaneous abortions and patients treated with clomiphene citrate (CC). An endometrial biopsy was performed in a pregnancy cycle in 4.0%, with an abortion rate not significantly different from the total study group. The authors conclude that an endometrial biopsy is relatively safe; however, the diagnostic and therapeutic consequences are limited. Endometrial biopsies may be useful only if performed in cases of habitual abortion or ovulation induction with CC. PMID- 3666181 TI - Infertility and chlamydial infection. AB - The prevalence of humoral IgG and IgM antibodies to Chlamydia trachomatis was determined in 105 infertile women who underwent laparoscopy and/or laparatomy, and 90 pregnant women without any known fertility problems (control group). For chlamydial culture, cervical and urethral specimens were collected both from the infertile and the pregnant women, whereas specimens from the fallopian tubes were collected from the infertile women only. Among infertile subjects with abnormal fallopian tube findings, the prevalence of IgG as well as IgM antibodies to C. trachomatis was significantly higher than in the control group (P less than or equal to 0.001). Similar statistically significant differences in antichlamydial geometric mean titer (GMT) also were observed in sera from infertile subjects with fallopian tube abnormalities and the controls. The chlamydial isolation rate from lower genital samples was low both among the infertile and pregnant women. All tubal samples were culture negative. The present study indicates a close connection between infertility of tubal etiology and an immune response to C. trachomatis. The possibility of active or recent chlamydial activity in at least some of these infertile subjects is discussed. PMID- 3666182 TI - The nature of the intraperitoneal exudate associated with infertility: peritoneal fluid and serum lysozyme activity. AB - An intraperitoneal inflammatory process has been associated with infertility in women without anatomic distortion of the pelvic viscera, particularly with endometriosis. This phenomenon was investigated by measuring peritoneal fluid (PF) and serum levels of a major secretory product of the macrophage, lysozyme, in fertile and infertile women undergoing laparoscopy. Serum lysozyme levels were in the normal range and did not correlate with total PF lysozyme. Regression analysis revealed a negative correlation between adnexal adhesions and PF volume (P less than 0.05), PF leukocyte number (P less than 0.05), and total PF lysozyme (P less than 0.05). Significant correlations were found between total PF lysozyme and PF volume (r = 0.72, P less than 0.0001) and leukocyte number (r = 0.67, P less than 0.0001). These results suggest that a localized intraperitoneal inflammatory reaction is associated with infertility in the absence of anatomic distortion of the pelvic viscera. PMID- 3666183 TI - Factors influencing maintenance of sperm motility during in vitro processing. AB - Addition of serum to culture medium during washing of sperm was shown to significantly improve sperm motility upon subsequent 24-hour incubation, distinct from the beneficial effects of adding serum after washing. Commercial sources of human and bovine albumen tested did not preserve motility as well as serum, but addition to serum showed that the lesser effect was probably due to toxic contaminants. One of the most commonly available disposable plastic syringes was found to be markedly toxic to sperm. The materials found to have sperm toxicity also manifested toxicity to mouse embryos. These findings show that a similar degree of caution is advisable in testing of materials contacting sperm in vitro to that which has become standard practice for culture of human embryos. PMID- 3666184 TI - An increase in in vitro fertilization ability of low-density human sperm capacitated by multiple-tube swim-up. AB - Comparison was made of the efficacy of multiple-tube swim-up (MT-SU) and single tube swim-up (ST-SU) preparations on inducing human sperm fertilization ability in semen samples of less than 60 million motile sperm/ml. Two parallel groups of in vitro fertilization (IVF) patients possessing sperm density of this category had their sperm capacitated by MT-SU or ST-SU. The MT-SU patients' sperm fertilized 71 +/- 6.0% of eggs retrieved in comparison to 39 +/- 7.9% in the parallel ST-SU patients (P less than 0.001). Similarly, MT-SU increased the rate of human sperm penetration into zona-free hamster eggs. The increased fertilization rate of MT-SU sperm was not from acceleration of the acrosome reaction, but may be attributed to the higher efficiency of MT-SU in removing antifertility factors present in the seminal plasma from sperm. PMID- 3666185 TI - Follicular fluid concentrations of thiopental and thiamylal during laparoscopy for oocyte retrieval. AB - Because access into ovarian tissue of drugs used during anesthesia may be potentially harmful to the oocyte and/or follicular structure, we measured concentrations of thiopental (n = 15) and thiamylal (n = 9) in follicular fluid (FF) aspirates of 24 patients who underwent laparoscopic oocyte retrieval. In both groups, measurable amounts of the respective drug were found in all FF aspirates. Within individual patients, plasma concentrations of both drugs declined during the period of sampling between initial and final follicular aspiration. The mean plasma drug concentration was 7.99 +/- 3.97 micrograms/ml in the thiamylal group and 4.13 +/- 0.90 micrograms/ml in the thiopental group. Mean drug concentrations in FF were similar in both groups (thiopental 1.62 +/- 0.61 micrograms/ml; thiamylal 1.67 +/- 0.83 micrograms/ml). The mean FF/plasma concentration ratio during the sampling period was greater in the thiopental group (0.41 +/- 0.19) as compared with the thiamylal group (0.22 +/- 0.14). Several steps in the clinical management of these patients can be taken to reduce exposure of oocytes to drugs used during anesthesia. PMID- 3666186 TI - A correlative study on the embryotrophic property of patient's serum and the outcome of in vitro fertilization of human oocytes. AB - The embryotrophic property of patient's serum previously used for in vitro fertilization (IVF) was studied by culturing postimplantation organogenesis-stage mouse embryos in a medium containing equal parts of Dulbecco's modified Eagle's medium and the patient's serum. Results of embryo culture experiments were generally found to correlate well with the outcome of IVF. Serum of patients whose oocytes were fertilized and developed to cleavage-stage embryos scored highest for embryotrophic parameters such as morphologic score and protein content of the mouse embryo. There was no significant difference in terms of serum embryotrophic activity between patients who became pregnant after embryo transfer and those who did not. When mouse embryos were cultured in serum from cycles with poor IVF results, i.e., oocytes failed to be fertilized or fertilized oocytes failed to cleave or cleave abnormally, significantly retarded embryonic growth and a higher incidence of malformed embryos were observed. However, in two cases where IVF failed as a result of poor semen quality, the patient's serum was found to be supportive of mouse embryonic development. PMID- 3666187 TI - Follicular factors, serum estradiol, and outcome of pregnancy following in vitro fertilization and embryo transfer. AB - Success rate of in vitro fertilization and embryo transfer (IVF-ET) depends upon clinical and laboratory variables. This study compared follicular measurements and serum estradiol (E2) between 23 delivered and 23 nonpregnant controls following IVF-ET. E2, number of large follicles (no.), E2/no. ratio, total diameter of large follicle (TD), and the E2/TD ratio were compared between the two groups and between 23 women who delivered and 10 who aborted. E2 (P = 0.03), E2/no. (P = 0.006), and E2/TD (P = 0.005) were found to differ significantly between delivered and controls and between delivered and those who aborted. PMID- 3666188 TI - Ultrarapid freezing: a new low-cost and effective method of embryo cryopreservation. AB - The authors describe a rapid freezing method (ultrarapid freezing) that has been developed for cryopreservation of early cleavage stage embryos. In the present experiments, 2-cell mouse embryos were frozen under a wide range of conditions in an attempt to optimize their survival and viability in vitro and in vivo. The experiments show that embryos exposed briefly (2 to 2.5 minutes) to relatively high concentrations of dimethyl sulfoxide (3 to 4 M) and 0.25 M sucrose survive and develop when plunged directly into liquid nitrogen and thawed in a 37 degrees C waterbath when sealed in 0.25-ml plastic pailettes. Survival and viability rates of ultrarapidly frozen embryos after thawing were comparable to those obtained with conventional slow-freezing techniques. The authors believe that this freezing technique can be further improved and that the speed, ease, and low cost of the method make it a very attractive alternative to more conventional methods for freezing early cleavage stage embryos. PMID- 3666189 TI - Pregnancies following pronuclear stage tubal transfer. AB - Pronuclear stage tubal transfer (PROST) is a technique that involves in vitro fertilization (IVF) of oocytes, followed by the transfer of pronuclear oocytes into the fallopian tubes. It has been developed for its prognostic value of confirming fertilization in couples with oligospermia or asthenospermia and enabling fertilization in cases with antispermatozoal antibodies (ASAB). PROST has provided useful diagnostic information in the management of couples who have failed to conceive in other treatment programs and has particular advantages over IVF for those receiving fresh donated oocytes for ovarian failure. Fourteen pregnancies resulted from 52 transfers, providing a pregnancy rate of 27% per transfer. The pregnancy rates were higher than a matched IVF series in the male factor and female ASAB groups and reached statistical significance for the ovum donation group. It is anticipated that both pregnancy rates and fetal wastage will be improved over conventional IVF and embryo transfer for the described infertility groups. PMID- 3666190 TI - The effect of preimplantation culture conditions on murine embryo implantation and fetal development. AB - Ham's F-10 medium (Gibco, Grand Island, NY) and medium T6 with and without 15% fetal calf serum (FCS) were compared for their ability to support development of murine blastocysts with the capacity to implant and produce normal fetuses when transferred to pseudopregnant females. All media supported equal rates of blastocyst development from 2-cell embryos. In addition, there were no differences in the rates of blastocyst implantation. However, once implanted, blastocysts grown in T6 produced a significantly higher proportion of normal fetuses (58.5% to 65.9%) than blastocysts grown in either Ham's F-10 (2.4%) or T6 with FCS (27.6%). These results demonstrate that the rate of murine blastocyst development from 2-cell embryos in vitro is not a good criterion of healthy embryos. Murine blastocysts transferred in medium with 0% versus 50% FCS implanted and developed into normal fetuses at equal rates. PMID- 3666191 TI - A rat uterine horn model of genital tract wound healing. AB - A rat uterine horn model of genital tract wound healing is described. Healing was reflected by acquisition of strength and elasticity, measured by burst strength (BS) and extensibility (EX), respectively. A tensiometer (Instron Corp., Canton, MA) was used to assess these characteristics in castrated and estrogen supplemented or nonsupplemented animals. While the horn weights (HW), BS, and EX of contralateral horns were not significantly different, the intra-animal variation of HW was 7.2%, BS was 17.7% and EX was 38.2%. In a second experiment, one uterine horn was divided and anastomosed, and the animal given estrogen supplementation or a placebo pellet. Estrogen administration was found to increase BS and EX of anastomosed horns prior to 14 days, but had no beneficial effect at 21 or 42 days. The data suggest that estrogen may be required for optimal early healing of genital tract wounds. PMID- 3666192 TI - The relationship of infection with Chlamydia trachomatis to the parameters of male fertility and sperm autoimmunity. AB - The relationship of past exposure to C. trachomatis to the parameters of male fertility was examined in men from infertile couples whose wives had no known female fertility factors. In this population, the frequency of C. trachomatis antibody was low. Past infection with C. trachomatis was associated with a history of nonspecific urethritis, and with the presence of sperm agglutinating antibodies in serum. We found no difference in the seminal fluid analyses, physical examinations, or sperm penetration assays of the men with or without chlamydial antibody. PMID- 3666193 TI - Dehiscence of fallopian tubes following successful microsurgical anastomosis. PMID- 3666194 TI - Objective assessment of the effect of caffeine on sperm motility and velocity. PMID- 3666195 TI - Intrauterine device. PMID- 3666196 TI - Simultaneous gamete intrafallopian transfer and in vitro fertilization. PMID- 3666197 TI - Simultaneous IVF and GIFT. PMID- 3666199 TI - [Functional organization of the callosal connections in the auditory cortex of the cat]. AB - Homotopic transcallosal potentials of the cat auditory cortex primary projection area (AI) had the greatest amplitude, the minimal temporal parameters and the maximal stability of characteristics as compared with the responses of the auditory cortex associative fields AII, AIV, Ep. Heterotopic transcallosal responses in the AI field occurred in stimulation of the field under the same name whereas in the Ep field the responses occurred both in stimulation of the same and the AI and AII fields of the opposite hemisphere. The structure of transcallosal connections of the auditory cortex primary projection field seems to be characterized by homotopy whereas in associative fields the role of heterotopic transcallosal interactions seems to increase. Such a structure of transcallosal connections seems to maintain the important role of interhemispheric interaction in mechanisms of spatial hearing. PMID- 3666198 TI - [Interhemispheric asymmetry of homotopic transcallosal responses of the auditory cortex in the cat]. AB - In majority of 29 immobilized cats under study, the potentials in the right hemisphere had a greater amplitude and shorter latencies than in the left hemisphere when comparing 150-170 symmetrical points in the auditory cortex. The interhemispheric asymmetry depended on the sex of the animals: it was more obvious in females. The maximal asymmetry was observed in pregnant females. The described polarity of transcallosal influences in the auditory cortex seems to be associated with the predominant role of the right hemisphere in organization of spatial hearing. PMID- 3666200 TI - [Response characteristics of the neurons of the associative parietal cortex to stimulation of the brain stem nuclei and sensorimotor cortex]. AB - Excitatory responses of the parietal cortex neurons to stimulation of pontine nuclei, red nucleus and sensomotor cortex were found to prevail in cats. Most of the short-latency projecting neurons were localized in the surface layers of the cortex. Convergence ability of these neurons was revealed. Functional relationship of the parietal cortex with structures involved in organization of movement, i. e. sensomotor cortex, pontine nuclei and red nucleus, was found. Functional role of the parietal cortex in motor integration was discussed. PMID- 3666201 TI - [Participation of the green-sensitive retinal receptor of the cat in color discrimination]. PMID- 3666202 TI - [Kinetic analysis of smooth muscle reaction to acetylcholine]. AB - In the holothurian isolated muscle, physiological ambiguity of cholinoreceptors was found in respect to their affinity to acetylcholine. A few discrete pools of receptors were revealed in a single effector system, the pools differing in their main parameters (Pm, K and n) reflecting functional state of specific receptors for biologically active substances. PMID- 3666203 TI - [Regulation of spontaneous oscillations in the ureteral membrane potential by using physiologically active compounds]. AB - I. a. perfusion of the Krebs solution of the cat ureter virtually altered characteristics of slow wave activity (SWA) observed with the blood circulation. Introduction of physiologically active substances into the solution restored some characteristics of the SWA. The SWA seems to depend not only on ionic exchange and properties of electrically controlled channels, but also on the set of native physiologically active substances. PMID- 3666204 TI - [Changes in the oxygen transport properties of the blood of animals after a stay in a high-density normoxic gas environment]. AB - For 24 hrs after exposure of rats to normoxic nitrogen-oxygen mixture of high density, concentration of hemoglobin, the hematocrit value, the number of erythrocytes, the contents of 2,3-DPG in erythrocytes, and the plasma erythropoietic activity were increased. Within 72 hrs after the exposure the above parameters returned to normal. The data obtained suggest that rats exposed to normoxic nitrogen-oxygen mixture of high density develop compensatory changes of the blood O2-properties and erythropoiesis as the result of hypoxia and oriented to improvement of tissue oxygen supply. PMID- 3666205 TI - [Effect of the oxygen supply on the energetics of rat skeletal and heart muscle during perfusion]. AB - In the isolated perfused preparations of the rat soleus muscle and heart, energy expenditure of resting organ was related to perfusion rate and oxygen delivery. In the resting soleus muscle, this relationship was present up to the oxygen delivery 60-100 nmol/(g.s) and absent at higher levels. In the resting heart, the relationship was shown up to 460 nmol/(g.s). The efficiency of contractions of the soleus muscle increased with oxygen delivery decreasing below 40-80 nmol/(g.s) with constant mechanical power. The idea of oxygen consumption independence of oxygen supply (Pfluger's postulate) seems not to be universally correct. PMID- 3666206 TI - [Hypothalamic mechanisms regulating the activity of the respiratory neurons of the medulla oblongata in hypoxia]. AB - Under normal conditions of atmosphere pressure the electrical stimulation of hypothalamus induced activating influence on the medullary respiratory and reticular neurons. At the initial stage of the hypoxia (the altitude 4500-5000 m), against the background of hypoxic activation of firing rate, facilitating influence of tetanic stimulation of hypothalamus was lesser though it prevailed over its inhibiting action. At the maximal altitude (8000-9000 m), against the background of hypoxic depression of unit activity, the stimulation of hypothalamus exerted mainly a stimulating effect. That response was particularly obvious in the neurons with low spontaneous activity. PMID- 3666207 TI - [Effect of peptides on the secretory function of an isolated pancreatoduodenal stomach preparation]. PMID- 3666208 TI - [Effect of pentagastrin on the myoelectrical activity of the gastroduodenal area under M-cholinoreceptor activation and blockade]. AB - Pentagastrin (0.1-1.0 microgram/kg) first depressed and then augmented the myoelectrical activity of the stomach and pylorus. Acetylcholine (500 mu k/kg) potentiated and atropine (0.2 mg/kg) inhibited the pentagastrin effects. The data suggest involvement of the cholinergic mechanism in the pentagastrin-induced myoelectrical gastroduodenal activity. PMID- 3666209 TI - [Role of the duodenum in rapid adaptive reorganizations of saccharose hydrolysis and transport]. AB - After isolation of the chick duodenum from the lower parts of the intestine, no adaptation of the sucrose activity or hexose transport occurred. The data suggest that the adaptive factor is formed in the duodenum under the influence of sugars. PMID- 3666210 TI - [Radial and proximo-distal distribution of hydrolytic enzymes in the small intestine at rest and during digestion]. AB - Alpha-amylase was present in considerable amount in the chyme in rats both at rest and during digestion, in the latter case its level being increased. Activity of intrinsic intestinal enzymes dominated in the homogenate of the mucosa. Transition from fasting to feeding and digestion increased the level of alkaline phosphatase and dipeptidase activities in the homogenate of the mucosa. The data obtained suggest the final stages of biopolymers' hydrolysis to be localized in various enterocyte structures. The surface mucus, owing to absorbed pancreatic enzymes, binding proteins and other types of physiologically active molecules, is assumed to play the role of a specific molecular filter and take part in the initial stages of digestion. PMID- 3666211 TI - [Cation exchange in the crucian carp in media with various ion compositions]. PMID- 3666212 TI - [A floating microelectrode for research on brain neurons]. PMID- 3666213 TI - [Negative change in the potential of the cat cerebral cortex after transcallosal stimulation]. AB - The slow negativity (SN) evoked with rhythmic transcallosal stimulation in anesthetized cats is generated in the upper layers of the cortex. The amplitude and duration of SN increased after the application of tetraethylammonium solution to the surface of the cortex. The SN seems to reflect mainly the glial depolarization. PMID- 3666214 TI - [Effect of intracisternal administration of antisera against neurospecific enolase (protein 14-3-2) on avoidance behavior in rats]. AB - The antisera to three isoenzymes (alpha alpha, alpha gamma, and gamma gamma) of the rat neurospecific enolase were studied. gamma gamma-antiserum administered into the brain cistern (8 microliters) prior to learning, in contrast to two other antisera, impaired the retrieval of passive avoidance response within 1-28 days after learning. Maximal amnestic effect occurred in the first 3 days. Probable mechanisms of the neurospecific enolase participation in the formation of memory traces, are discussed. PMID- 3666215 TI - [Intraspecies animal behavior in a model of experimental cerebral ischemia]. AB - Specifics of intraspecies behaviour following ligation of both or either one of the two carotid arteries, were studied in rats. Certain behavioural features are altered in different ways depending on ligation of the right or left carotid artery. The approach can be applied to evaluation of graveness of the brain ischemic lesion. PMID- 3666216 TI - [Characteristics of hypothalamic self-stimulation in rabbits depending upon the intensity of the stimulating current]. PMID- 3666217 TI - [Changes in the evoked activity of the spinal cord after subarachnoidal administration of different amounts of colchicine]. AB - Colchicine solution (0.3-0.01%) depressed the motor activity and evoked potentials of the spinal cord within 1-7 days after subarachnoidal injection of 0.05 ml in white rats. Monosynaptic response of the ventral root was more depressed than the spinal cord dorsum potential. PMID- 3666218 TI - [Homosynaptic depression--a model of the habituation phenomenon]. AB - A high functional stability of the cat spinal cord motoneurons was shown in conditions of long-term orto- and antidromic activation with frequency corresponding to their natural rhythmicity. The depression of reflex discharges was shown to be related not to any postsynaptic depression or presynaptic inhibition but to a drop of probability of the transmitter release from the primary afferents' terminals. Analysis of signs of the habituation phenomenon revealed their similarity to the homosynaptic depression phenomenon and, consequently, their submittance to the same principles of experimental analysis and consideration. PMID- 3666219 TI - [Modulation of the chronotropic effect of the vagus nerve during stimulation of various sympathetic nerves in the cat]. AB - Sympathetic nerves were shown to perform potentiation or inhibition of synchronizing or tonic components of vagal chronotropic effect. The potentiation of the synchronizing component seems to be exerted through the ansa subclavia whereas the other effects--through the caudal cardiac nerve. PMID- 3666220 TI - [Effect of tone intensity and frequency on discrimination of the transition process of the acoustic stimulus]. AB - The discrimination threshold for the stimulus rise time is 1.5 msec in low and middle frequency range and increases abruptly up to 5-6 msec in the range of 10 15 kHz. The threshold of detection of the square waveform depends on the stimulus duration: it is 3.5 dB at the duration over 6.5 msec. The threshold of detection of transition process drops with the rise of intensity from 10 to 40 dB, remaining constant afterwards. PMID- 3666221 TI - [Mechanisms of realization of stimulating effects of serotonin on immune processes]. AB - Low dosages of serotonin and 5-hydroxytryptophan were found to stimulate rosette forming process in spleens of male CBA mice (5 X 10(6)) immunized with sheep red blood cells, in contrast to high dosages that are known to induce inhibition. The above finding suggests a bimodality of serotoninergic immunomodulation. Immune responses were compared between shamoperated, adrenalectomized, thymectomized mice and mice with lesion of hypothalamo-pituitary complex (the destruction of pituitary or its stalk). It was shown, that neither hypothalamo-pituitary-adrenal system by means of which the inhibitory effect of serotonin (high dose) was released, no thymus, where the increase of rosette-forming process was released in adrenalectomized mice which obtained high doses of serotonin. The dosage response curve suggests mediating of opposite serotonin effects via serotonin reactive structures with different serotonin sensitivity. PMID- 3666222 TI - [Effect of the natriuretic factor on the transport of electrolytes and energy metabolism in kidney cortex sections]. AB - The peptide material of the 2nd and 3rd fractions of the natriuretic factor did not affect the passive sodium transport while inhibiting the active transport in slices of the rat kidney cortex. This inhibition was accompanied by a decrease of both the succinic dehydrase system and Na+, K+-activated ATPase activities in the slices. The natriuresis caused by the natriuretic factor seems to be due to the inhibition of the active sodium transport. PMID- 3666223 TI - [Relation between blood indices during postnatal development of albino mice]. AB - Morphological indicators and those of reversible aggregation of red blood cells were studied in postnatal development of white mice. The linear correlation coefficient made it possible to estimate the interrelationship between the indicators of peripheral blood and marrow in mice, to describe the age dynamics of blood system indicators, and to determine the most informative indicators in the process of postnatal development of white mice. PMID- 3666224 TI - [Characteristics of thrombus formation in arterioles and venules]. AB - The model of laser-induced thrombosis revealed a greater thromboresistance in arterioles rather than in venules of the rat small intestine mesentery, which accounts for a less frequent thrombosis and a lesser size of thrombus along the blood flow direction, whereas their greater thrombogenic potential accounts for a faster growth of thrombus and a shorter time of the primary hemostasis. PMID- 3666225 TI - [Mechanism of activation of contraction of smooth muscle cells of coronary arteries induced by acetylcholine]. AB - Acetylcholine (ACh) caused a slight depolarization, decrease of the membrane resistance and tonic contraction of the circular muscle strips from bovine coronary arteries. On removal of Ca2+ ions by adding EGTA and Mg2+ ions, a drop in basal tone was observed, as well as the decrease of the membrane resistance and a considerable reduction of the SMC contractile reaction (by 90% from normal value) in response to ACh. In presence of verapamil, ACh also caused contraction which, however, was half of that in normal conditions. In the course of potassium depolarization, ACh produced contraction of the strip, the maximal decrease of contraction being observed at 80 mM potassium depolarization. The ACh-induced contraction of coronary arteries seems to be activated mainly by extracellular calcium ions. PMID- 3666226 TI - [Effect of initial length on the chronoinotropism of the myocardium]. AB - Shortening di the muscle initial length was found to enhance the postextrasystolic potentiation, the Bawditch stair and other signs of chronoinotropy. A hypothesis is advanced concerning the mechanisms underlying the effect of the cardiac muscle initial length on rhythm-dependent mechanical phenomena. PMID- 3666227 TI - [Changes in the contractile activity of the rat portal vein induced by parathyroid hormone]. AB - Comparative study performed in Wistar and Wistar-Kyoto rats, revealed the effect of parathyroid hormone on the phasic and tonic components of contractile activity of the portal vein smooth muscle cells. The hormone reduced the tonic tension of vessels. The autorhythmic activity frequency was decreased under the effect of the hormone which was followed by increased amplitudes of phasic contractions in the Wistar rats. PMID- 3666228 TI - [System analysis of the process of oxygen supply in young sportsmen during physical exercise of various intensities]. AB - Young sportsmen were found to have nonhomogeneous and qualitatively different participation of the hemodynamic, respiratory and tissue mechanisms in formation of the oxygen supply system on discretely increasing physical exercises. In maximal exercises, the O2 utilization in tissues is the main limiting section on oxygen consumption. Mathematic formulae are suggested to estimate the volume of blood circulation per minute according to the magnitude of oxygen consumption and respiratory capacity per minute. PMID- 3666229 TI - [Various mechanisms of neural regulation of the excretory and secretory functions of the stomach]. AB - Activation of the brainstem RF with small doses of aminasine increases the gastric secretory and excretory functions in dogs. Changes in these functions following bilateral vago-and splanchnicotomy suggest the gastric vagal nerves to be related both to the secretory and excretory functions. The vagal and celiac nerves are supposed to alter the permeability of the gastric glands as well. PMID- 3666230 TI - [Changes in the microcirculation in the rat mesentery during hypotension induced by adenosine]. AB - In anesthetized rats, i.v. administration of adenosine (2.5 mg/kg/min) for 30 min caused reduction of mean systemic blood pressure. A significant decrease of blood flow was found in mesentery microvessels as well as dilation of arterioles and venules. PMID- 3666232 TI - Does anyone have the right to die? The ethics of choice. PMID- 3666231 TI - [Amplifier-limiter of action potentials]. PMID- 3666233 TI - The nurse workforce: health care's most important human resource. PMID- 3666234 TI - 1968 Florida nursing study anticipated current national conditions. PMID- 3666235 TI - The kinetics of endogenous erythroid haemopoietic spleen colonies in mice between 4 and 10 days after irradiation with doses of 5, 7, or 9 Gy. AB - The kinetics of post-radiation haemopoietic tissue recovery was studied by evaluating quantitatively the results from histologic studies of the kinetics of endogenous erythroid spleen colony counts in subserial sections of spleens from mice irradiated with 5, 7, or 9 Gy of 60Co gamma-rays at intervals of 4, 6, 8, and 10 days following irradiation. Emphasis was put on individual types of colony forming cells and on time intervals at which these cells enter into action. Large numbers of rapidly maturing microscopic erythroid colonies appeared between 8 and 10 days after irradiation. From this finding we conclude that in addition to colony-forming cells giving rise to macroscopic colonies, large numbers of already differentiated progenitor cells--the products of the first regeneration wave with a peak approximately 6 days following irradiation--participate in the second wave of regeneration which is typically manifested from day 10 after irradiation. PMID- 3666236 TI - Immunologic markers and fine structure of alveolar cells in germfree pigs. AB - The objective of this study was to evaluate neonatal development of alveolar cells without any antigenic stimulation. The cells obtained by bronchoalveolar lavage from newborn and germfree Minnesota miniature piglets were characterized ultrastructurally and using different markers of pig lymphocytes and macrophages. Alveolar cells from newborn animals did not express any immunologic markers or phagocytic activity. Cells of the pulmonary immune system appeared in the airways at the twelfth hour, phagocytosing macrophages within the first day of postnatal life. Fc receptors were expressed sooner than complement receptors. Almost all lymphocytes were null cells. Macrophages and lymphocytes immigrated into alveolar spaces independently of external antigenic stimuli. PMID- 3666237 TI - Enzyme histochemical studies on rat amygdala in fetal alcohol syndrome. AB - Histochemical studies were made of the activity of oxidative and hydrolytic enzymes in rat amygdala in FAS (Foetal Alcohol Syndrome). Ethanol in a dose of 9 g/kg/day was administered to rats during pregnancy and lactation in 6% aqueous solution as the only available liquid. The control rats received an equivalent diet in which ethanol was substituted by an equicaloric amount of sucrose. The offsprings were examined at the end of the 6th postnatal week. The activity of the lysosome and membrane enzymes, as well of some enzymes participating in the neurotransmission, was changed. A different decrease of the activity of oxidoreductases of Krebs cycle, glycolysis and pentose cycle was observed. The changes in the enzyme activity in the amygdala in FAS suggest alterations in the metabolism of the nervous tissue, rather than structural damages of cell organelles. PMID- 3666238 TI - Histochemistry of the extracellular matrix of aging hyaline cartilage. AB - Cartilage proteoglycans (PGs) exhibit marked structural changes with increasing age. There is an increase in small PGs rich in KS as compared to larger PGs rich in chondroitin sulfate (CS) with increasing age. In the present study investigations have been performed to obtain more detailed information about the distribution of different glycosaminoglycans (GAGs). Changes were observed in the interterritorial matrix by means of ultrastructural visualization of PGs with acridin orange. The changes in the ultrastructural organization of the interterritorial matrix of costal cartilage are followed by significant changes in its mechanical properties. PMID- 3666239 TI - Comparative analysis of gastrin-immunoreactive and argyrophil cells in bony fish larvae. AB - A comparative study was made of enteroendocrine cells in the larvae of bony fishes (Teleostei): carp (Cyprinus carpio L.), big head (Aristichyts nobilis Richardson), silver carp (Hypophthalmichthys molitrix Valenciennes), and atlantic salmon (salmo salar L.). Argyrophil cells demonstrated by the method after Grimelius were found in all examined fish species. They are located in the pyloric appendices, stomach and intestinal mucosa. Gastrin-immunoreactive cells demonstrated by the immunocytochemical method were located in the pyloric part of the stomach in all examined fishes, except for the atlantic salmon in which they were not identified. The first argyrophil cells were identified at the age of about 10 days, while gastrin-immunoreactive cells proved to appear 5-7 days later. PMID- 3666240 TI - Micronucleus formation in lymphocytes of patients with fraXq27 syndrome. AB - Human chromosome carry different fragile sites, but the most interesting one is the fragile X chromosome, especially in relation to mental retardation. In this report we present micronucleus formation in 5 individuals with the fragile X syndrome and 11 control subjects whose lymphocytes were cultured under 1) hydroxyurea treatment condition suitable for the increasing expression of the fraXq27, 2) control conditions. It has been found that hydroxyurea (HU) added to the final concentration 1.3 X 10(-5)M increases the frequency of the fraXq and micronucleus formation in comparison with culture without HU. The same concentration of HU has induced neither "nonspecific" "spontaneous" chromosomal breakage nor micronucleus formation in the control subjects. PMID- 3666241 TI - [Circulating monocyte (macrophage)-specific antibodies in patients with autoimmune thyroid diseases]. AB - We investigated the presence of circulating monocyte-specific antibodies (monocytotoxic activities) by cytotoxicity tests and also the relationships between these monocytotoxic activities and the clinical data in autoimmune thyroid diseases. Subjects of this investigation include 16 patients with Graves' disease, 20 patients with Hashimoto's thyroiditis and 10 normal controls. To obtain monocyte-rich population, peripheral blood mononuclear cells of type 0 healthy donor were incubated on culture dishes for 12 hours and dish adherent cells were separated by pipetting. These monocyte-rich population were incubated with sample sera which were previously absorbed by lymphocytes of many different kinds of HLA types to eliminate anti-lymphocyte antibodies, and thereafter cytotoxicity tests were performed by adding rabbit complements. The monocytotoxic activities were expressed by %cytotoxicities and the value of %cytotoxicity over 3.9% (mean + 4SD of %cytotoxicities of normal controls) was considered to be positive in monocytotoxic activity. The results indicate that; 1) 8 patients (50%) of Graves' disease and 10 patients (50%) of Hashimoto's thyroiditis had positive values of monocytotoxic activity. 2) These positive values of monocytotoxic activity were markedly decreased after absorption of sample sera by monocytes, and these patients who had positive values of monocytotoxic activities to allogenic monocytes also had positive values of monocytotoxic activities to autologous monocytes. 3) Patients who had positive monocytotoxic activities also had high levels of TSH receptor antibody (TRAb) and anti-microsomal antibody, besides, monocytotoxic activity was significantly correlated with levels of TRAb in Graves' disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666242 TI - [Study on insulin resistance in rats treated with estrogen and progesterone- assessment with the euglycemic glucose clamp technic]. AB - To clarify the mechanism of insulin resistance in pregnancy, we have used the euglycemic glucose clamp technique in estradiol(E) treatment(n = 6), progesterone(P) treatment (n = 28), and Control(n = 29) female rats. E(10 micrograms/day) and P(10 mg/day) were injected subcutaneously into female rats for 14 days, to increase E and P concentrations to pregnant levels. Glucose production and glucose utilization were measured by using [3-3H]-glucose. The results were as follows, 1) Glucose production was almost suppressed at hyperinsulinemia(11,000 microU/ml) both Control and P treatment rats. Then at hyperinsulinemia, glucose utilization rate was almost equal to glucose infusion rate. 2) In P treatment rats glucose utilization was significantly lower (p less than 0.05) than in Control rats at hyperinsulinemia (11,000 microU/ml). 3) In P treatment rats glucose infusion rate was significantly lower than in Control rats at plasma insulin concentrations of 1,000 microU/ml(p less than 0.02), and 11,000 microU/ml(p less than 0.01), and lower than in E treatment rats at plasma insulin concentrations of 11,000 microU/ml(p less than 0.05). 4) In a dose-response curve for the effects of four different concentrations of insulin on glucose infusion rate, the insulin resistance induced by progesterone is characterized by a decreased responsiveness to insulin. The results suggest that progesterone may play an important role in inducing insulin resistance in pregnancy. PMID- 3666243 TI - [A method for the quantitative analysis of steroid hormones by HPLC/RIA]. AB - To solve the problem of cross-reaction in immunoassay and determine various steroid hormones simultaneously in a small amount of sample, a method for the quantitative analysis of steroid hormones was developed. This method is a combination of high-performance liquid chromatography (HPLC) and radioimmunoassay (RIA). The purpose of the study is the comprehensive analysis of steroid hormones profiles in normal subjects and adreno-cortical diseases. One hundred microliters of plasma was extracted by ether and the ether layer was evaporated. The residue was redissolved and separated by HPLC. Then fractions of steroid hormones were taken and determined by RIA. In this study, cortisol (F), androstenedione (A), 17 alpha-hydroxyprogesterone (17-OHP), testosterone (T), progesterone (P), estrone (E1) and estradiol (E2) were analyzed in normal adults, congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency and Cushing's syndrome. Results in normal adults were similar with those had been previously reported. In CAH, F was remarkably low and 17-OHP, A, T and P were remarkably high before treatment. During treatment some cases showed that 17-OHP, A, T and P were high, and 17-OHP and P tended to be within normal range, if F had been kept higher than about 20 micrograms/dl. In the analysis of Cushing's syndrome before treatment, there were definite differences between adenoma and hyperplasia. A, 17-OHP, T, E1 and E2 were higher in hyperplasia than those in adenoma. It is suggested that it is possible to diagnose the type of Cushing's syndrome with a small amount of plasma using this method. As a mass screening method of CAH at present, 17-OHP in dried blood on filter paper is determined, therefore the quantitative analysis of 17-OHP in dried blood on filter paper (9 mm disc) was attempted. The quantitative analysis proved to be possible, and it was considered to be applied as the secondary screening method of CAH by the use of dried blood on filter paper. PMID- 3666244 TI - Cardiac surgery at the Medical Center of Delaware: review of the first seven months. PMID- 3666245 TI - Thallium scans of the heart: comparison with coronary angiography in 135 patients. PMID- 3666246 TI - Possible abdominal abscess. Incidental adrenal adenoma. PMID- 3666247 TI - Are Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis caused by neurotoxins? PMID- 3666248 TI - Drugs and the athlete. PMID- 3666249 TI - The female athlete. PMID- 3666250 TI - Evaluation and treatment of common throwing injuries of the shoulder and elbow. PMID- 3666251 TI - Exercise testing in the asymptomatic subject. PMID- 3666252 TI - Sports medicine: who should practice it? PMID- 3666253 TI - Eating disorders and the athlete. PMID- 3666254 TI - Exercise induced asthma. PMID- 3666255 TI - Athletic amenorrhea. PMID- 3666256 TI - Skating injuries: first state sports research. PMID- 3666257 TI - Why certification? PMID- 3666258 TI - Detection of retroviral sequences in lymphocytes of psoriatics. PMID- 3666259 TI - [Local effect of the nonsteroidal anti-inflammatory drug indomethacin on psoriasis]. PMID- 3666260 TI - [Bactericidal activity of lysosomal proteins of peripheral blood neutrophilic granulocytes in psoriasis patients]. PMID- 3666261 TI - A double-blind study comparing meptazinol and pethidine for pain relief in labour. AB - A double-blind comparison of meptazinol 100 mg and pethidine 75 mg as analgesics during the first stage of labour was undertaken in 199 patients. Injections were allowed to be repeated at intervals of 2 h to a maximum of three doses. There were only minor differences between the two drugs with regard to pain relief and no differences in the need for supplementary epidural and pudendal blocks and neonatal status and behaviour. It is concluded that meptazinol and pethidine are of equal clinical value as analgesic injections during the first stage of labour. PMID- 3666262 TI - Effect of clomiphene citrate administration during the early luteal phase on the luteal function and pregnancy rate of women. AB - To study the effect of clomiphene citrate (clomiphene) administration during the early luteal phase of the menstrual cycle on the luteal function and the pregnancy rate in women, 75 infertile women who ovulated but did not conceive after clomiphene treatment during the early follicular phase and 6 normal cycling women were chosen. Clomiphene was administered orally to 35 of the 75 infertile women at a dose of 50 mg per day for 5 days from the second day of the rise in the basal body temperature (BBT) as well as during the follicular phase, while 40 control patients received clomiphene only during the follicular phase. In the test patients, the rate of pregnancy (25.7%) was significantly (p less than 0.05) higher than that of control patients (10.0%). On the 7th of the rise of BBT, the mean serum progesterone levels of the test patients and normal cycling women treated with clomiphene were significantly (p less than 0.05) higher than those of the control patients. However, the levels of serum estradiol, LH and FSH, the gonadotropin pulsatilities, and the pituitary responses to LH-RH in the test women were not significantly different from those of the control. These data suggest that, when administered during the early luteal phase, clomiphene may act directly on the ovary, enhancing the secretion of progesterone from the corpus luteum, and thereby increasing the rate of pregnancy in infertile women with clomiphene-induced ovulation. PMID- 3666263 TI - Histology and ultrastructure of human endometriotic tissues treated with dydrogesterone (Duphaston). AB - The histological and ultrastructural changes of ectopic endometrium were studied during treatment with dydrogesterone (Duphaston) in eighteen infertile patients with laparoscopically confirmed endometriosis. Three types of response to therapy, i.e. no response, moderate and good, are detailed. First, focal secretory transformation of the endometriotic epithelium with decidualization of the ectopic stroma was seen in four patients (no response to therapy). In all other patients, the endometriotic implants were undifferentiated (moderate response to therapy) or revealed morphologic features of involution (good response to therapy). Proliferation of endometriotic cells was not seen during treatment with Duphaston, while total eradication of microscopic implants was never observed. Endometriotic implants with good response to Duphaston therapy demonstrated an enhanced autophagic activity within many epithelial cells. Only two patients conceived during a one-year post-treatment follow-up. Both patients demonstrated a good response to therapy. PMID- 3666264 TI - N-acetylneuraminic acid and hostile mucus infertility. AB - A total of 39 samples of hostile mucus, as defined by postcoital examination, were examined for N-acetylneuraminic acid (NANA) deficiency, as measured by the enzymatic addition of NANA, spermatozoal penetration and immobilization. Only 56.7% of the mucus samples were deficient in NANA and this did not correlate with spermatozoal penetration or immobilization, which were negatively correlated. Thus, as the spermatozoal hostility in the mucus decreases, spermatozoal penetration increases. This finding also applies to hostile mucus not deficient in NANA. In contrast, resialylation of NANA hostile mucus, deficient and not deficient in NANA, although not enhancing spermatozoal penetration, did reduce spermatozoal immobilization. Thus, components of the mucus deficient in NANA and/or the lack of unbound NANA may contribute to mucus hostility, but it is not the only hostile factor. In addition, SEM studies of NANA-deficient mucin before and after resialylation were shown to have similar structures. Hence ultrastructural changes are not apparent in NANA-deficient mucin, and this supports the previous finding that NANA deficiency does not impede spermatozoal penetration. The spermatozoa from the husbands of the infertile couples formed three distinct groups in terms of spermatozoal penetration and immobilization in normal donor mucus. One group demonstrated normal levels of spermatozoal penetration and immobilization in donor mucus. A second group was demonstrable in which spermatozoal penetration was similar to that in the wife's hostile mucus, but had a normal level of spermatozoal immobilization. In the third group, both spermatozoal penetration and immobilization in donor mucus were similar to that in the wife's hostile mucus. The results demonstrate that not all hostile mucus is deficient in NANA, and that other unknown factors are involved. In addition, there are also male factors which may impede spermatozoal penetration and/or result in the inability of the spermatozoa to survive in normal donor mucus. PMID- 3666265 TI - Serum ferritin, folate and cobalamin levels and their correlation with anemia in normal full-term pregnant women. AB - Serum ferritin, folate, cobalamin and hemoglobin concentrations were determined by radioimmunoassay, radioisotopic assay, radioassay and an automated hematology analyser respectively, and then analysed in 221 normal full-term pregnant women in order to evaluate the incidence and the prevalence of nutritional anemia in pregnancy. None of them had received any hematonic during their pregnancy. Their mean age was 27.68 years and the mean duration of pregnancy was 39.51 weeks. Twenty-three (10.41%) of these previously non-anemic pregnant women had clinical anemia after full-term pregnancy. Of the 23 women, 11 (47.83%) had iron deficiency anemia, with serum ferritin less than 12 micrograms/l; another 11 women had some degree of iron depletion, with serum ferritin less than 20 micrograms/l. So in 22 of the 23 anemic women (95.65%) the cause of anemia may correlate to iron depletion. The remaining one had folate-deficiency anemia. No pure cobalamin deficiency anemia was found in this study. Among the 198 non anemic normal full-term pregnant women, 92 (46.46%) had iron depletion (serum ferritin less than 20 micrograms/l), of whom 35 (17.68%) had severe iron deficiency, with serum ferritin less than 12 micrograms/l. Another 3 had folate deficiency and 3 had cobalamin deficiency. By including all the anemic and non anemic pregnant women, 114 (51.58%) of them had some degree of iron depletion. In other words, pregnancy can produce a considerable degree of iron depletion in more than half of the previously non-anemic women. PMID- 3666266 TI - A case-control study of oral contraceptive use in women with adenocarcinoma of the uterine cervix. AB - To evaluate oral contraceptive (OC) use as a possible cause of the changed ratio between adenocarcinoma and squamous cell carcinoma of the uterine cervix a case control study was performed. The OC use among 23 women with adenocarcinoma of the uterine cervix was compared with that of a matched group of 46 women with squamous cell carcinoma. No differences in percentage of OC use, duration of such use or period of OC use in relation to diagnosis could be demonstrated between the two groups compared. PMID- 3666267 TI - Is a paediatrician required at caesarean section? AB - In a series of 460 consecutive deliveries there were 55 caesarean sections (mainly under epidural anaesthesia) without evidence of fetal distress and with a cephalic presentation. There was no statistically significant difference in the frequency of resuscitation in this group compared with 296 spontaneous vertex deliveries. It is concluded that a paediatrician is not routinely required at caesarean section under epidural provided there is no fetal distress and the presentation is cephalic. PMID- 3666268 TI - Birth progression and traction forces developed under vacuum extraction after slow or rapid application of suction. AB - A vacuum extraction recorder was used to provide an objective measure of the traction forces developed on the fetal head during 120 vacuum extractions. In half of the deliveries the vacuum was gradually and stepwise increased to -0.8 kg/cm2 before traction. In the others, a rapid application of vacuum to the same level was chosen. No significant difference could be recorded in the traction forces developed by the different methods. In fact, once an adequate level of vacuum had been achieved, high degrees of traction could be applied to the suction cup, regardless of the rate at which the vacuum was developed. Furthermore, the number and nature of neonatal complications were not influenced by the method chosen. PMID- 3666269 TI - Changes in thyroid status in pregnant women treated with ritodrine. 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 propranolol, a beta blocking agent, has proved to decrease T3 levels in man. Indeed, a statistically significant increase in T3 serum concentration and in T3/T4 ratio was found on the second day after the start of treatment with ritodrine (p less than 0.02 and less than 0.01 respectively). After discontinuation of treatment a decrease in T3 serum levels, compared to both treatment and pretreatment levels, was observed. The free T4 concentration showed a significant drop after the first week of treatment (p less than 0.01), but no changes were found in T4 and TSH levels. It was concluded that the beta 2-mimetic-mediated changes in thyroid status provide one more reason for restriction of the use of beta-mimetic drugs in hyperthyroidic patients and might offer an additional explanation for the undesirable chronotropic cardiac side-effects of the therapy. PMID- 3666270 TI - A loading-dose infusion scheme for intravenous tocolysis with ritodrine: a pilot study. AB - A loading-dose infusion scheme for intravenous ritodrine therapy was tested in twelve patients with preterm labour. We started with a rather high (386 micrograms/min) infusion rate, but the moment tocolysis was reached this infusion rate was reduced to a level needed to maintain the plasma concentration then found. Plasma samples of ritodrine were taken the moment tocolysis was reached and in the steady state, and compared with each other and with expected and calculated plasma concentrations. In the dynamic loading phase we found a half life for ritodrine of 1 h. This half-life of 1 h can be explained by cumulation of ritodrine in the central compartment and is therefore called cumulation t1/2. In developing an infusion scheme with a loading dose for ritodrine, this cumulation t1/2 of 1 h should be taken into account. PMID- 3666271 TI - Limited diagnostic value of lymphocytic karyotype in primary amenorrhea with streak gonads. AB - Cytogenetic data represent a first line diagnostic aid in gonadal dysgenesis. Generally, the results of a peripheral blood examination reflect the genotypic alteration of the patient. Nevertheless, on occasion one may encounter cases in which clinical and hormonal evidence suggestive of dysgenesis is not accompanied by an anomalous chromosomal finding, upon cytogenetic analysis of the peripheral blood. In these cases, a cytogenetic alteration may be present in cellular components of the ovary and the cutis. In the light of the above, two patients presenting with primary hypergonadotropic amenorrhea, streak gonads and normal peripheral karyotype are described. In one patient presenting with phenotype alterations, ovarian wedge biopsy via laparotomy followed by cytogenetic analysis of ovarian tissue and tissue from the cutis revealed a 45,X/46,XX-type mosaicism. In the other patient, the ovarian cytogenetic findings were unremarkable. Extending chromosomal analysis to several tissues, beyond the peripheral level, in selected cases, is discussed. PMID- 3666272 TI - Endometrial microbial flora of hysterectomy specimens. AB - Microbiological and histopathological specimens were obtained from three levels (fundal, middle and cervical) of the endometrium immediately after removing the uterus. Hysterectomy indication was menometrorrhagia and uterine fibroids in eight cases and chronic pelvic pain in two cases. All cultures for C. trachomatis, N. gonorrhoeae, M. hominis, U. urealyticum, herpes simplex virus, anaerobic and facultative bacteria were negative. Histopathological examination showed few plasma cells in the endometrium in four cases with the presence of uterine fibroids and in one case with adenomyosis. These results suggest that the endometrial cavity of a nonpregnant uterus is sterile. PMID- 3666273 TI - Pregnancy and functional paraganglioma. AB - The association of pregnancy with a catecholamine-secreting tumor is rare. The high maternal and fetal mortality rate is significantly reduced when the diagnosis is made antepartum and adequate management is started. In 1979 Burgess reviewed 42 cases with antepartum diagnosis, demonstrating the benefits of alpha blockade (Obstet Gynecol 1979; 53:266-270). When diagnosis was made in the third trimester of pregnancy, a combined procedure of cesarean section and tumor resection was best. The best surgical approach in first- and second-trimester diagnosis, however, remains controversial. A case with second-trimester diagnosis is described. Following a period of alpha- and beta-blockade, a combined surgical procedure in the third trimester resulted in a healthy mother and infant. Follow up procedures included a meta-iodobenzylguanidine scan of the mother. Postpartum, ultrasonography of the child's brain revealed periventricular leucomalacia. The prognosis associated with this finding is poor. Some more recent information about certain aspects of these tumors is also discussed. PMID- 3666274 TI - Acute abdomen in ruptured interstitial pregnancy following unilateral salpingectomy. AB - Interstitial pregnancy is an infrequent type of ectopic pregnancy. Two cases of acute abdomen due to ruptured interstitial pregnancy following salpingectomy, a rare event, are presented. Both patients were young women who had had a previous salpingo-oophorectomy due to ovarian cyst. The presenting symptoms were in the first case abdominal pain followed by hemorrhagic shock, and in the second a right iliac fossa syndrome simulating acute appendicitis. Surgical intervention consisted of wedge resection of the uterine segment involved. A review of the literature and practical considerations are presented. PMID- 3666275 TI - Breathing activity in fetal sheep during mechanical ventilation of the lungs in utero. AB - Effects of mechanical ventilation of the lungs of fetal lambs in utero are described. Feasibility studies were performed acutely on four fetuses at 140-142 days gestational age. Five fetuses were prepared for chronic experiments at 122 128 days gestation. Mechanical ventilation was used to produce changes in fetal blood gases for periods of up to 24 h in acute preparations or for repeated periods of 3-9 h on consecutive days in chronic preparations. This technique permits the study of fetal lambs in utero under conditions which normally occur after birth without producing maternal changes or using anesthesia and whilst the umbilical circulation remains open. Four situations were examined using ventilation in these chronic preparations: (1) expansion of the lungs whilst maintaining fetal normoxia and normocapnia; (2) fetal normoxia and hypocapnia; (3) hyperoxia and normocapnia; (4) hyperoxia and hypocapnia. None of these situations produced continuous fetal breathing, either during ventilation or after switching off the ventilator. We conclude that they do not provide appropriate stimuli to mimic those which normally produce continuous breathing after birth. PMID- 3666276 TI - Determinants of the onset of continuous air breathing at birth. AB - We used mechanical ventilation of the fetal lungs in utero on 11 fetal lambs at 140-145 days gestation to alter fetal blood gases and thus separate the influences of PaO2 and PaCO2 on extrauterine breathing after cord clamping. The fetus was delivered either into a 40 degrees C saline bath or onto a cold table. Mechanical ventilation was stopped 2 min after delivery and the time to onset of continuous air breathing was observed. Also two fetuses were ventilated in utero 5 or more days after chronic instrumentation at 127 days gestation; in these animals the time to onset of breathing (diaphragm EMG) was recorded after stopping the ventilator and occluding the cord. We conclude: (a) hypercapnia is a stimulus to breathing even in hyperoxia and at 40 degrees C; (b) hypocapnia delays the start of extrauterine breathing in hyperoxia at 40 degrees C; (c) hypoxia inhibits breathing in the absence of hypercapnia or cold; (d) cold overrides the effects of hypocapnia in normoxia or moderate hypoxia. PMID- 3666277 TI - Labour-related eclampsia. AB - Twenty-four cases of eclampsia managed in a hospital in Hong Kong over a five year period were reviewed. Four patients had antepartum eclampsia and one had postpartum eclampsia following elective caesarean section. Four of these five patients had severe pregnancy-induced hypertension (PIH) (greater than 160/100 mmHg). The other 19 patients had eclampsia occurring during labour or within six hours of delivery. This group included 10 patients with labour-onset PIH, none of whom developed severe hypertension before their convulsions. In the remaining nine patients, only five had severe hypertension before convulsion. The results suggest that labour-related eclampsia has become more common than antepartum eclampsia, and severe hypertension before convulsion is an infrequent finding and therefore an unreliable sign in these patients. PMID- 3666278 TI - Interaction of retinoids and tamoxifen on the inhibition of human mammary carcinoma cell proliferation. AB - The growth of chemically induced mammary tumors is inhibited by both hormone manipulation as well as by retinoids. Numerous mammary carcinoma cell lines are also inhibited by retinoids. Co-treatment of estrogen receptor (ER)-positive breast cancer cells resulted in an additive effect in terms of inhibition of cellular proliferation. The addition of varying concentrations of retinoic acid (RA) to varying concentrations of tamoxifen (TMX) resulted in an additive effect on the inhibition of proliferation of the ER-positive human carcinoma cell lines (MCF-7). Co-treatment of MCF-7 cells over time with RA and TMX resulted in enhanced inhibition of growth. A similar phenomenon was observed when other synthetic retinoids were combined with TMX. This enhanced inhibition by the combination of retinoids and TMX was also observed with other ER-positive cell lines (ZR-75, T47-D), while no effect was noted on the ER-negative cell lines (MDA-MB-231, Hs578T). PMID- 3666279 TI - Unfolding of iron and copper complexes of human lactoferrin and transferrin. AB - 1. Human lactoferrin and transferrin are capable of binding two iron or copper ions into specific binding sites in the presence of bicarbonate. 2. Urea and several alkyl ureas have been effective in unfolding these metal-protein complexes. 3. Biphasic transitions are observed for the unfolding of each of the metal complexes of these proteins as determined by direct visible spectroscopy suggesting the release of iron(III) and Cu(II) ions from both of these metal binding proteins during the unfolding process. 4. Greater stabilization and increased resistance to protein unfolding is observed for all iron(III) complexes compared to Cu(II) complexes of lactoferrin and transferrin as determined by isothermal unfolding and thermal denaturation. 5. Relative stabilization of the different metal-protein complexes investigated within this study were determined to be as follows: Lf-Fe(III) greater than Lf-Cu(II); Tf-Fe(III) greater than Tf Cu(II), and Lf-Fe(III) greater than Tf-Fe(III); Lf-Cu(II) greater than Tf-Cu(II). PMID- 3666280 TI - The selective S-alkylation of a methionine residue in an elapid venom cardiotoxin. AB - 1. The reaction of cardiotoxin with iodoacetamide or iodomethane at pH 3.0 afforded the corresponding methionine sulphonium derivatives. The major products were S-alkylated at Met-26 whilst the minor products were S-alkylated at both Met 24 and -26. 2. Reaction with iodoacetamide under denaturing conditions led to a reversal of the relative abundances of the two derivatives in the respective reaction mixtures. 3. The derivative S-methylated at Met-26 was about 5-fold less toxic than the parent cardiotoxin. That derivatised at both Met-24 and -26 was non-toxic, indicating the importance of Met-24. 4. The results are discussed in the light of a structural model, previous chemical modifications and 1H-NMR data. It appeared that Met-24 is important for the integrity of an important structural feature of cardiotoxin. PMID- 3666281 TI - Characterization of neutral glycosphingolipids from porcine erythrocyte membranes. AB - 1. Six neutral GSL fractions were purified from porcine erythrocyte membranes. 2. They were identified to be LacCer (14% of total neutral GSLs), 2-hydroxy acid rich and -poor Gb3Cer (3 and 7%, respectively) and Gb4Cer (71%) by means of NMR spectrometry. 3. Monohexosylceramides (5%) were composed of GlcCer and GalCer with near amount. 4. All these GSL classes contained a high concentration (more than 20% of total acids in each class) of 2-hydroxy fatty acids. 5. GalCer and GlcCer contained considerable amounts of C16- and C18-acids, and of C18 phytosphingosine, whereas C24-acids and C18-sphingosine were predominant in the other GSLs. 6. A minor GSL fraction (less than 1% of total neutral GSLs) which migrated more slowly than Gb5Cer on a thin layer plate and composed of several GSL components contained L-fucose. PMID- 3666282 TI - Altered thiol group status in the heart ornithine decarboxylase inactivated following perfusion with t-butylhydroperoxide. AB - 1. The perfusion for 15 min of isolated rat hearts with 100 microM t butylhydroperoxide leads to a 75% diminuition of the tissue GSH/GSSG ratio. 2. After t-butylhydroperoxide infusion, the isoproterenol-stimulated heart ODC was strongly inhibited. The addition of 2 mM DTT in the assaying buffer removed the ODC inactivation. 3. The inhibited ODC had an eluition profile similar to active ODC when chromatographed on a Sephacryl S-200 column; moreover, the ODC activity recovered after a thiol affinity chromatography as unbound fraction, was two times increased in the t-butylhydroperoxide perfused hearts in comparison to control. 4. The hearts perfused with 1 mM acetylcysteine after 15 min of perfusion with t-butylhydroperoxide recovered almost completely the initial ODC activity. PMID- 3666283 TI - Ketone bodies inhibit leucine degradation in chick skeletal muscle. AB - 1. DL-beta-hydroxybutyrate (4 mM) increased the net rate of leucine transamination and the net rate of 2-oxoisocaproate (KIC) production in extensor digitorum communis muscles from fed chicks. 2. DL-beta-hydroxybutyrate at 1 and 4 mM inhibited leucine oxidative decarboxylation in muscles from fed chicks. 3. Acetoacetate at 1 and 4 mM inhibited leucine oxidative decarboxylation and total leucine oxidation, but increased net KIC production in muscles from fed chicks. 4. Both DL-beta-hydroxybutyrate and acetoacetate at 1 and 4 mM inhibited the net rate of leucine transamination and the rates of leucine oxidative decarboxylation and total leucine oxidation in muscles from 24-hr fasted chicks. PMID- 3666284 TI - Characterization of cortisol binding sites in chicken liver plasma membrane. AB - 1. The presence of sites specifically binding [3H]cortisol in plasma membrane isolated from chicken liver has been determined. The kinetic parameters of this binding are: Kd = 4.5 nM and Bmax = 2225 fmol/mg protein in presence of 10(-6) M progesterone. 2. The affinities of several natural and synthetic steroids for the membrane binding site respect to the binding of 4 nM [3H]cortisol without competitor increased in the following order: Testosterone less than pregnenone less than dexamethasone less than progesterone less than prednisolone less than corticosterone less than deoxycorticosterone. 3. Other steroids such as estradiol, ouabain and triamcinolone acetonide does not bind to the plasma membrane. 4. Metal ions such as Ca2+ and Mg2+ did not modify the binding of [3H]cortisol. 5. Neither propranolol nor phentolamine, beta- and alpha-adrenergic antagonists affected [3H]cortisol binding to the plasma membranes. 6. The result suggest that the binding site detected is more specific for glucocorticoids and it is different of nuclear glucocorticoid receptor and progesterone receptor. PMID- 3666285 TI - Specificity of non-histone protein antigens in chicken liver nuclei. AB - 1. Chicken liver nuclei were fractionated by disruption with ultrasound and subsequent precipitation with divatent cations. A small, protein-rich fraction (CS), representing less than 5% of the total nuclear DNA reacted strongly with antisera to dehistonized chicken liver chromatin. 2. Further fractionation of the CS by DNA-affinity chromatography yielded two DNA-binding immunoreactive proteins (approximate Mr 35 and 56 kD). 3. We have shown previously (Kilianska et al., 1981, Kilianska, 1984) that this DNA-binding component strongly inhibited the in vitro transcription of RNA. PMID- 3666286 TI - Androgen-regulated expression of secretory protein synthesis in mouse ventral prostate. AB - Two proteins of molecular weights 25 and 12 kDa (p25 and p12 respectively), whose expression is regulated by testosterone, were identified in mouse ventral prostate. An antiserum raised to mouse ventral prostate secretion was used to demonstrate that p25 corresponds to the major secretory glycoprotein in mouse prostatic fluid. This antiserum does not cross-react with the major secretory proteins of the rat ventral prostate. Western blot analysis of mouse ventral prostate proteins using the prostatic secretion antiserum demonstrates that p12 and p25 are detectable at 3 weeks of age, but the maximum level of both proteins is not attained until 5 weeks of age. In addition, synthesis of p25 was also observed in prostate tissue derived from differentiated embryonic urogenital sinus tissue growing as implants under the renal capsule of syngeneic male hosts. PMID- 3666287 TI - A 62 kDa protein functions as estrogen receptor activation factor (E-RAF) in the goat uterus. AB - Goat uterine estrogen receptor activation factor, a 62 kDa protein existing in three molecular forms, E-RAF I, E-RAF IIA and E-RAF IIB, has been purified to homogeneity. The three forms are immunologically identical, but differ among themselves in their molecular Stokes radii and the sedimentation coefficients. The purified protein combines with the 4 S receptor-estrogen complex of the rat uterine cytosol to produce a 5 S receptor species. The E-RAF IgG cross-reacts with the nuclear 5 S receptor of the rat uterus but not with the cytoplasmic 4 S receptor. The E-RAF competes with the 5 S receptor for the DNA binding sites. PMID- 3666288 TI - Membrane fluidity regulates development of gonadotrope desensitization to GnRH. AB - Development of GnRH-mediated gonadotrope desensitization was examined under conditions in which membrane fluidity was altered by temperature and/or chemical means. Cultured pituitary cells were preincubated at temperatures ranging from 4 degrees C to 37 degrees C for 3 h with a desensitizing concentration of GnRH (10( 9) M) or with vehicle alone. Cells were then rinsed and responsiveness assessed by a second 3 h incubation with GnRH at 37 degrees C. As preincubation temperatures decreased from 37 degrees C to 23 degrees C, development of desensitization in gonadotropes was progressively reduced. At 23 degrees C and below, gonadotropes failed to become desensitized to GnRH. Decreases in membrane fluidity occurred over the same temperature range as measured directly by fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene incorporated into plasma membrane. When membrane fluidity was increased by incubating cells with the membrane mobilizing agent 2-(2-methoxy-ethoxy)-ethyl-8-(cis-2-n octylcyclopropyl)-octanoate (A2C), low temperature blockade of GnRH-mediated gonadotrope desensitization was reversed. A2C had no measurable effects on either GnRH receptor binding or number and caused no cytotoxic effects. These studies suggest that development of gonadotropine desensitization to GnRH can be regulated by the state of membrane fluidity. PMID- 3666289 TI - Hormonal regulation of RNA synthesis and specific gene expression in Xenopus oviduct cells in primary culture. AB - The studies described in this report were carried out as a first step towards the elucidation of mechanisms underlying the tissue specificity of regulation of gene expression by estrogen. Using a procedure established earlier in our laboratory for primary culture of Xenopus hepatocytes, we have characterized how estradiol 17 beta and progesterone affect the rate of synthesis of total RNA and that of accumulation of two oviduct-specific mRNAs in Xenopus oviduct cells in primary culture. In cells that had recovered from 'culture shock' 3 days after they were plated out, both hormones had only a slight or no effect on the overall rate of labelling of newly synthesized RNA over 24 h. Cloned cDNA probes for two mRNAs, termed 7F and 6G and specifying as yet unknown proteins expressed in the oviduct and not in the liver, were used to quantify the two mRNAs. The levels of both mRNAs declined for the first 2 days in culture after which they were stabilized. When added to the oviduct cell cultures 3 days after they were plated out, estradiol increased the steady-state concentration (relative to total RNA) of 7F and 6G mRNAs by 3- to 7-fold after 60-80 h, but with different time-course and dose-response kinetics for the two messages. The antiestrogen tamoxifen also exerted different degrees of antagonist effect on the estrogen-induced accumulation of 7F and 6G mRNAs. Although the protein products of these two oviduct-specific mRNAs have not yet been characterized, these studies set the stage for comparing the regulation by estrogen of their genes with that of vitellogenin genes in primary cultures of Xenopus oviduct cells and hepatocytes. PMID- 3666290 TI - Structure-activity analysis of microsomal antigen/thyroid peroxidase. AB - The interaction between thyroid microsomal autoantibodies and thyroid microsomal antigen/thyroid peroxidase (TPO) has been studied using both intact antigen preparations and their water-soluble trypsin fragments. In an analysis of sera from 30 patients with Graves' or Hashimoto's diseases, microsomal antibodies showed similar reactivity towards trypsin fragments (with TPO activity) and intact detergent (sodium deoxycholate, DOC)-solubilized human microsomal antigen preparations (r = 0.96). This raised the possibility that both the peroxidase active site and the major autoantigenic site(s) of microsomal antigen were present on the same trypsin fragments. Studies with porcine TPO showed that only a few sera contained microsomal antibodies which cross-reacted strongly with the porcine preparations. Further analysis was carried out by immunoprecipitation of 125I-labelled microsomal antigen followed by SDS-PAGE and autoradiography. These studies suggest that intact human microsomal antigen (a single-chain protein with Mr = 110,000) contains an intrachain loop of amino acids formed by a disulphide bridge. Trypsin treatment cleaves the antigen close to its transmembrane section and releases a water-soluble fragment (Mr = 100,000), containing the intact disulphide-linked loop of amino acids. Further trypsin action causes cleavage of the peptide bonds within the loop in some preparations. Consequently, three major water-soluble trypsin fragments (Mr = 100,000, 73,000 and 68,000) are formed all of which contain an intact disulphide bridge and have microsomal antibody binding activities. The integrity of the disulphide bridge in intact antigen/TPO preparations and their trypsin fragments is essential for autoantibody binding activity. PMID- 3666291 TI - Leucocytes mediate the hCG-induced increase in testicular venular permeability. AB - Human chorionic gonadotrophin (hCG) treatment of adult male rats induces microvascular changes in the testis consisting of abolished vasomotion, an accumulation of leucocytes in postcapillary venules and increased vascular permeability. To study the role of leucocytes, rats were made leucopenic with a specific antineutrophil serum (ANS). Testicular interstitial fluid volume was decreased in leucopenic rats. Leucopenic rats also failed to show an hCG-induced increase in venular permeability as in saline-treated rats. The normally pulsatile blood flow pattern (vasomotion) persisted in leucopenic rats but was abolished after hCG treatment both in saline-treated and leucopenic rats. Plasma testosterone concentration after hCG treatment was not affected by elimination of circulating polymorphonuclear (PMN) leucocytes. It is concluded that PMN leucocytes mediate in part the hCG-induced increase in testicular venular permeability but not the hCG-induced inhibition of vasomotion. PMID- 3666292 TI - Subunit dissociation and activation of wild-type and mutant glucocorticoid receptors. AB - Apparent molecular weights of wild-type and nti ('increased nuclear transfer') mutant glucocorticoid receptors were obtained from Stokes radii and sedimentation coefficients. At low salt concentrations molecular forms of Mr 328,000 and 298,000 of the wild-type and mutant, respectively, were predominant. Increasing ionic strength resulted in receptor dissociation. Dissociated forms of Mr 130,000 and 63,000 of the wild-type and mutant, respectively, were obtained at 300 mM KCl and above. Some metal oxi-anions prevented dissociation. Receptor activation to allow DNA binding produced the dissociated forms which could be separated from non-activated receptors by filtration through DNA-cellulose or by DEAE-cellulose chromatography. Non-activated wild-type and nti receptors eluted from DEAE cellulose under identical conditions while activated wild-type and nti receptors eluted differently. Partially proteolyzed wild-type receptors behaved identically to nti receptors. We conclude that the large forms of wild-type and nti receptors are heteromeric and contain only one hormone-building polypeptide per complex. PMID- 3666293 TI - Developmental expression and androgenic regulation of the mRNA for major secretory proteins of the rat epididymis. AB - The concentration of the mRNAs for two pairs of androgen-dependent secretory proteins of the rat epididymis has been measured by filter hybridization with cDNA during the course of post-natal development and following castration and androgen replacement of adult animals. The rate of synthesis of the secretory proteins, measured in an in vitro incubation system, was also ascertained during post-castration involution of the epididymis and during subsequent androgen replacement. The mRNAs for the proteins were first detected at 20 days of age and their levels increased rapidly to reach near adult levels between 30 and 40 days. In the caput epididymidis the levels of the mRNAs declined rapidly during the first week after castration and became undetectable by 16 weeks. Administration of testosterone propionate to animals castrated for 16 weeks reinduced the levels of mRNAs to maximum values by 1 week, but for one pair of proteins the reinduced maximum was only 30% of precastration values. This result, in conjunction with other information, is suggestive that this pair of proteins is under multihormonal control. In the cauda epididymidis, the kinetics of change in mRNA level during androgen withdrawal and replacement were slower than in the caput. In all instances, changes in the rate of synthesis of the secretory proteins followed by observed changes in their level of mRNA, suggesting an absence of androgenic control of translation in the epididymidis. PMID- 3666294 TI - Immunological relationship and binding capacity of prolactin receptors in cytosolic and membrane fractions of rabbit mammary gland. AB - We have recently identified and partially characterized a specific lactogen binding protein in rabbit mammary gland cytosol. In this report, studies using pregnant or lactating rabbits are described which further characterize the cytosolic lactogen binding protein in relation to the membrane-bound lactogen receptor. The data show that in pregnant or lactating rabbits the binding capacity (fmol/mg protein) of membranes is at least double that of the cytosol preparation although when expressed on a tissue content basis (fmol/g tissue) there was no membrane-cytosol difference in receptor number. Treatment of lactating rabbits with CB-154, however, caused a marked increase (100-150%) in the binding capacity of membrane-bound receptors with comparatively little effect (+20%) on the cytosolic lactogram binding protein. There was also a marked difference in the association constants for 125I-hGH, with the cytosolic lactogen binding protein exhibiting a 6-fold higher affinity than the membrane-bound receptor. Three anti-prolactin receptor monoclonal antibodies (M110, A82 (antagonists) and A917 (agonist) have also been used to assess the relative immunological characteristics of the cytosolic lactogen binding protein and the membrane lactogen receptor. Each monoclonal antibody was able to inhibit the specific binding of 125I-hGH to both membranes and cytosol in a dose-dependent manner. However, the order of potency was not identical being M110 greater than A917 greater than A82 in membranes and M110 greater than A82 greater than A917 in cytosol. A917 was at least 10 times more active in membranes than cytosol whereas A82 was at least 10 times more active in cytosol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666295 TI - The function of NADH-semidehydroascorbate reductase and ascorbic acid in corticosteroid hydroxylation. AB - We have demonstrated in rat adrenal (Natarajan, R.D. and Harding, B.W. (1985) J. Biol. Chem. 260, 3902-3905) that NADH-semidehydroascorbate reductase and ascorbate participate in an electron transport pathway (ETP) supplying reducing equivalents from NADH to cytochrome P-450scc. Here, we demonstrate that this ascorbate dependent ETP also supplies reducing equivalents to cytochrome P-450(11 beta/18) in both rat adrenal and bovine adrenal cortex. The activity is dependent upon addition of catalase or upon 'cold shock' treatment of isolated mitochondria. Comparison of the rates of 11 beta- and 18-hydroxylation supported by this ETP and by the classical pathway supported by various TCA cycle intermediates suggests that in vivo the ascorbate dependent pathway may be essential for maximal flow of reducing equivalents to the mitochondrial hydroxylases. Partial reconstitution of the ascorbate dependent 11 beta/18 hydroxylase activity was achieved with purified bovine outer mitochondrial and inner mitochondrial membranes fortified with supernatant from sonified mitochondria all preincubated with phosphatidyl choline. These preparations no longer require catalase or 'cold shock' treatment. Ascorbate and NADH semidehydroascorbate reductase are unable to support 17 alpha- or 21-hydroxylase activity in isolated bovine adrenal cortical microsomes whether incubated with purified outer mitochondrial membranes or not. PMID- 3666296 TI - Catecholamine content and adenylate cyclase activity in corpora lutea of different ages of the PMSG-treated immature rat. AB - The catecholamine content and adenylate cyclase response were studied in a well characterized corpus luteum model, where ovulation was induced by treatment of prepubertal Sprague-Dawley rats with pregnant mare's serum gonadotropin. The luteal content of noradrenaline, determined with HPLC, was constant during the first 7 days of pseudopregnancy, followed by a 3-fold increase in older corpora lutea. No detectable amounts of dopamine were found, while trace amounts of adrenaline were found in a few cases. The increase in noradrenaline content was not associated with a changed sensitivity of luteal adenylate cyclase to catecholamines. The response to adrenaline was maximal in 3-day-old corpora lutea, whereafter a decrease was seen. The significance of the increased endogenous levels of noradrenaline at the end of pseudopregnancy is at present unknown. However, the fact that the increase in noradrenaline occurs a few days before spontaneous luteolysis is of special interest, since it has been suggested that an adrenergic innervation is a prerequisite for the antigonadotropic effect of prostaglandin F2 alpha in the human corpus luteum. PMID- 3666297 TI - Immunoelectron microscopic studies on the cell surface location of the thyroid microsomal antigen. AB - The cell surface location of the thyroid microsomal antigen was studied by immunoelectron microscopy. Isolated, open human thyroid follicles were incubated with patient sera containing high titers of microsomal autoantibodies. Cell surface-bound antibodies were detected by the immunogold technique using IgG coated colloidal gold particles (10 or 15 nm). Immunocytochemical incubations were performed at 4 degrees C. Gold particles were concentrated at the apical cell surface of the follicle cells, while the basolateral cell surface was almost completely unlabelled. Quantitative evaluation of four experiments with follicle cells prepared from different patients showed that about 90% of the gold particles at the apical cell surface was associated with microvilli and that the concentration of gold particles at the microvillus membrane was, although with great intercellular variation, several times higher than that at smooth portions of the apical plasma membrane. This suggests that the microsomal antigen is organized in microdomains in the apical plasma membrane. In follicles labelled immunocytochemically at 4 degrees C and then incubated at 37 degrees C, gold particles were slowly internalized. The particles appeared in smooth and coated pits of the apical plasma membrane as well as in vesicles, vacuoles and lysosomes in the apical part of the cytoplasm. Membranes of TSH-induced pseudopods were always unlabelled. Our observations indicate that thyroid microsomal antigen immunoreactivity is present in the apical but not in the basolateral plasma membrane. The antigen with bound antibodies is internalized by micropinocytosis but not by macropinocytosis. The selective location of bound microsomal antibodies at the apical plasma membrane and their absence from the membrane of TSH-induced pseudopods are compatible with the idea that the microsomal antigen and thyroperoxidase are identical. PMID- 3666298 TI - Partial purification from human serum of a specific binding protein for human growth hormone. AB - Following the recent identification and characterization of a highly specific binding protein(s) for human growth hormone (hGH) in human sera, we now report our initial studies on its purification. Outdated blood blank serum was first fractionated by ammonium sulphate precipitation. The majority of the binding activity appeared in the 30-45% saturation fraction, which was then applied in sequence to an hGH-affinity column, to strong anion exchange (SAX) chromatography (a Mono Q column 0.01-0.2 M phosphate gradient), to a TSK phenyl hydrophobic interaction column (HIC) (0.75-0 M sulphate gradient in 0.1 M phosphate) and finally to a second SAX step. By Scatchard analysis the final product was purified approximately 16,500-fold compared to serum with an overall recovery of 5%. The binding affinity (Ka) of the purified material was approximately 0.4 X 10(9) M-1, very similar to that of whole serum (approximately 0.5 X 10(9) M-1). On silver-stained, sodium dodecyl sulphate-polyacrylamide gels, the final SAX product yielded a major doublet, under reduced conditions, of molecular weights (MW) 55,000 and 59,000. Although it is not known whether one or both of these bands might have hGH binding activity, the MW 59,000 band is very similar in size to one (MW 60,000) of two specific binding proteins observed by covalent crosslinking techniques. These data indicate that the specific hGH binding activity of human serum can be substantially purified and that it appears to exist in at least two forms. Further studies are required to determine the biochemical and physiological relationship, if any, between the two forms. PMID- 3666299 TI - Characterization and regulation of HMG-CoA reductase during a cycle of juvenile hormone synthesis. AB - The enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase was characterized in cockroach corpora allata which produce insect juvenile hormone III (methyl-(10R)10,11-epoxy-3,7,11-tri-methyl-2E,6E-dodecadienoate ). HMG-CoA reductase is a microsomal enzyme dependent on NADPH and dithiothreitol (or glutathione) for activity. The enzyme selectively reduced (3S)-HMG-CoA to (3R) mevalonate with an apparent KM of 7.6 microM. Mevinolin was a competitive inhibitor of HMG-CoA reductase with a KI of 2.4 nM. No evidence for a modulation of enzyme activity by phosphorylation was obtained. Levels of HMG-CoA reductase were not altered after incubation of the corpora allata with either mevinolin (to decrease isoprenoid flux) or with mevalonate or farnesol (to increase isoprenoid flux). Split pairs of corpora allata were used to compare JH III synthetic activity with HMG-CoA reductase activity during the cycle of JH III synthesis that controls vitellogenesis and oocyte growth in adult females. Both activities changed over 10-fold and peaked on day 5 after emergence/mating, but JH III synthesis did not parallel HMG-CoA reductase activity precisely thereafter. The half-life of HMG-CoA reductase measured in the presence of cycloheximide was significantly different between low and high activity glands and was not related to the half-life of JH III synthesis. The results suggest that HMG-CoA reductase should not be considered 'the rate-limiting enzyme' in juvenile hormone synthesis by Diploptera punctata corpora allata. PMID- 3666300 TI - Distribution and molecular forms of immunoreactive bombesin in the ovine median eminence. AB - The distribution and molecular forms of bombesin-like immunoreactivity (BLI) were determined in the ovine median eminence using a new, C-terminally directed antiserum. BLI was confined to neurons of the external zone of the median eminence, near small blood vessels, many of which also were immunoreactive for CRF. Each median eminence contained about 10 pmol of BLI (533 pmol/g tissue). Gel filtration and reverse-phase high pressure liquid chromatography (HPLC) demonstrated the existence of two molecular forms of BLI, which co-eluted with porcine gastrin releasing peptide (GRP)1-27 and GRP18-27 in a molar ratio of 1:2. The presence of BLI in the ovine median eminence and its co-localization in some neurons with CRF, suggest a possible role for peptides of the bombesin family in the regulation of pituitary function. PMID- 3666301 TI - Vasopressin gene transcripts in the bovine corpus luteum are defective. AB - cDNA clones corresponding to vasopressin gene transcripts were isolated from a lambda gt11 library made using mRNA extracted from a bovine corpus luteum of the early non-pregnant cycle. None of the characterized clones included the vasopressin-encoding exon A sequence, instead two of these clones included sequence from the first intron. Together these data and controls indicate that vasopressin gene transcription in this tissue does not yield translatable mRNA and that positive RNA-DNA hybridization signals are not necessarily evidence for local biosynthesis of the neuropeptide. PMID- 3666302 TI - Distinct neurotrophic factors from skeletal muscle and the central nervous system interact synergistically to support the survival of cultured embryonic spinal motor neurons. AB - Motor neurons isolated from 6-day-old embryonic chick spinal cords require muscle extract for survival in culture; however, it was found, that some motor neurons, identified by retrograde labeling with rhodamine, will survive in mixed spinal cell cultures in the absence of the extract. The motor neuron survival-promoting activity produced by spinal cells is soluble and differs from the factor present in muscle extract, the two activities acting in a synergistic manner: the spinal cell activity potentiated that of muscle to decrease its ED50 by an order of magnitude, the motor neuronal survival (30%) seen in the presence of both factors being more than the sum of their individual activities. This synergism was shown to be restricted to the action of the spinal cell factor on motor neurons, no effect of the factor being noted with sympathetic neurons. As a series of defined growth and survival factors present in the central nervous system (nerve growth factor, brain-derived neurotrophic factor, acidic and basic fibroblast growth factors) had no effect on motor neuron survival, we conclude that the molecule responsible for the motor neuron survival-promoting activity of the spinal cells is a previously undefined factor. PMID- 3666304 TI - Membrane depolarization facilitates sperm entry, large fertilization cone formation, and prolonged current responses in sea urchin oocytes. AB - Depolarization of the sea urchin egg's membrane is required for two processes during fertilization: the entry of the fertilizing sperm and the block to polyspermy which prevents the entry of supernumerary sperm. In an immature sea urchin oocyte, the depolarization is very small in response to the attachment of a sperm. The purpose of this study was to determine whether the depolarization evoked by sperm attaching to an oocyte can facilitate sperm entry or induce the block to polyspermy. Individual oocytes of the sea urchin with diameters which ranged from 86 to 102% that of the average diameter for mature eggs from the same female were examined. The oocytes have a membrane potential of -73 +/- 6 mV (SD, n = 80) and a very low input resistance compared to that of mature eggs. Single sperm, following attachment to an oocyte, elicit a brief, small depolarization with a maximum amplitude of 8 +/- 1.4 mV (SE, n = 15), frequently followed by the formation of tiny filament-like fertilization cones, but the sperm fail to enter. If oocytes are voltage-clamped at membrane potentials more negative than -20 mV, following attachment of the sperm small transient inward currents occur, similar filament-like cones form, and the sperm do not enter. When many sperm attach to an oocyte which is not voltage clamped, the depolarizations sum to create a large depolarization with an amplitude of 60 to 80 mV, which shifts the oocyte's membrane potential to a value between -10 and +5 mV; more positive values are not attained. At such membrane potentials, whether the potential is maintained by the summed depolarizations of many attached sperm or by voltage clamp, large fertilization cones form, the sperm enter, and the oocytes can become highly polyspermic. In oocytes voltage clamped at +20 mV, however, both sperm entry and fertilization cone formation are suppressed. Therefore, both types of voltage dependence for sperm entry are present in oocytes, although the depolarization caused by a single sperm is not large enough to permit its entry, nor is the depolarization caused by many sperm sufficient to prevent the entry of supernumerary sperm. PMID- 3666303 TI - Time course of hormonal independence for developmental events in neurons and other cell types during insect metamorphosis. AB - The ecdysteroid dependence of developmental events during the larval-pupal transformation of the tobacco hornworm, Manduca sexta, was studied using the technique of abdomen ligation to eliminate the ecdysteroid-secreting prothoracic glands (PTG) in the thorax. The time at which a particular developmental event no longer required the presence of the PTG for its successful completion, i.e., when the event became ecdysteroid independent, was determined for the dendritic regression and death of proleg motor neuron PPR, the degeneration of its target muscle PPRM, and the secretion of pupal cuticle by the abdominal epidermis. Groups of abdomens were ligated from synchronously developing larvae at 12-hr intervals over the 4-day period preceding entry into the pupal stage. PPR's dendritic regression became ecdysteroid independent over the first 24 hr of this period. When abdomens were ligated midway through this period PPR became arrested in a partially regressed state. Twelve hours after PPR's regression became independent, the degeneration of PPRM and the secretion of pupal cuticle by the epidermis acquired independence. Another 12 hr elapsed before PPR's programmed death became independent. Thus, different developmental events acquired ecdysteroid independence in a stereotyped temporal sequence, and even different events within a single cell, i.e., PPR's regression and death, became independent at different times. PMID- 3666305 TI - Decay of the oocyte-type heat shock response of Xenopus laevis. AB - Xenopus oocytes have a complex heat shock response. During transition of the oocyte into fertilized egg, the heat shock response undergoes several qualitative and quantitative changes culminating in its complete extinction. Heat shock induces oocytes to synthesize four heat shock proteins (hsps): 83, 76, 70, and 57. After ovulation, two additional proteins (hsps 22 and 16) are inducible. The heat shock response of spawned eggs can be modified by changing the ionic configuration of the external medium and by adding pyruvate and oxaloacetate to the media. Since Xenopus eggs do not synthesize mRNA, these modifications to the external medium apparently alter the utilization of preexisting messenger RNAs in protein synthesis. Artificial activation terminates inducibility of hsps 76, 57, and 16 and diminishes the hsp 70 response. Two new heat shock proteins-66 and 48 are also inducible in artificially activated eggs. Fertilization, on the other hand, terminates the heat shock response; no hsps can be induced. However, hsp 70 appears to be made constitutively in fertilized eggs. RNA blot analyses reveal that oogenic hsp 70 messenger RNA is retained in eggs and early embryos. This messenger is apparently used for heat-induced synthesis of hsp 70 before fertilization and for constitutive synthesis of hsp 70 in zygotes. PMID- 3666306 TI - Inductive interactions in the spatial and temporal restriction of lens-forming potential in embryonic ectoderm of Xenopus laevis. AB - The process of lens cell determination in amphibians is currently viewed as one involving a series of inductive interactions. On the basis of previous investigations, these interactions are thought to begin during gastrulation when the presumptive foregut endoderm and then the heart mesoderm come into contact with the presumptive lens ectoderm. This earlier period of induction is followed by the later interaction of the optic vesicle with the lens-forming ectoderm. Transplantation experiments were performed to determine the relative significance of the early and later periods of induction in the process of lens cell determination in the anuran Xenopus laevis. Various ectodermal tissues were transplanted either into the lens-forming region of open neural plate stage host embryos or over the newly formed optic vesicle of later neurula stage embryos. All transplanted tissues were labeled with the intracellular marker horseradish peroxidase to assess the exact origins of any induced lens structures. The results indicate that all nonneural ectodermal tissues have some lens-forming potential early during gastrulation; however, this potential is restricted to the lens-forming region, and perhaps nearby regions, later in development during the time of neurulation. Furthermore, the results show that the optic vesicle is not a substantial inductor of the lens in tissues that have not been previously exposed to the earlier series of inductive interactions that take place during gastrulation and neurulation. Since the optic vesicle does not appear to be a sufficient inductor of the lens, these earlier inductive interactions are, therefore, essential in the process of lens cell determination in Xenopus. These earlier inductive interactions lead to a steady increase in what may be called a lens-forming bias in the presumptive lens ectoderm during this period of development. The eventual loss in the ability of nonlens ventral ectoderm to respond to these lens inductors is presumably the result of other determinative processes that occur in this tissue. PMID- 3666307 TI - Molecular cloning and differential expression of somatic and testis-specific H2B histone genes during rat spermatogenesis. AB - We have cloned cDNA of a testis-specific histone, TH2B (a variant of H2B), and rat somatic H2B gene to investigate regulation of testis-specific histone genes during rat spermatogenesis. The amino acid sequences deduced from DNA sequences show extensive sequence divergence in the N-terminal third of the two histones. The rest is highly conserved. One cysteine residue was found in TH2B. No cysteine is present in somatic histones except in H3 histone. We investigated the expression of TH2B and H2B genes using the regions of sequence divergence as hybridization probes. The TH2B gene is expressed only in the testis, and the expression of this gene is detected 14 days after birth, reaching a maximum at Day 20. The level of H2B mRNA shows a reciprocal pattern. This contrasting pattern can be explained by the gradually changing proportion of spermatogonia and spermatocytes with testicular maturation. In situ cytohybridization studies show that H2B gene is expressed primarily in proliferating spermatogonia and preleptotene spermatocytes, whereas TH2B gene is expressed exclusively in pachytene spermatocytes which first appear in testis about 14 days after birth. H2B and TH2B genes appear to be ideal markers for the study of proliferation and differentiation events in spermatogenesis and their regulatory mechanisms. PMID- 3666308 TI - Abnormal enwrapment of intramuscular axons by distal Schwann cells with defective basal lamina in the muscular dysgenic mouse embryo. AB - In the muscular dysgenic (mdg/mdg) mouse embryo, both muscle and nerve are affected early during embryogenesis, from Embryonic Day 13 (E13). We now find that the mutation affects not only the degree of differentiation of the muscle and the pattern of motor innervation but also the relationship between Schwann cell and axon. We studied the sciatic nerve of normal and mdg/mdg embryos between E13 and E18 at the ultrastructural level. We found that in mdg/mdg nerve, (1) Schwann cells do not totally enwrap the growing axons in their most distal part, close to the growth cone, and (2) the terminal Schwann cells do not correctly surround the nerve endings and seal the corresponding synaptic contacts. Moreover, both types of mutant Schwann cell lack a normal electron-dense basal lamina. We found that there is an excess of axons relative to the Schwann cell population in the intramuscular portions of the mdg/mdg sciatic nerve. Our observations point toward a possible defect of the mechanism of migration and maturation of Schwann cells. Such a defect may in turn affect primarily or secondarily the mutual influences between Schwann cell and axon and lead to some or all of the major abnormalities observed in the mdg/mdg neuromuscular system, namely, multifocal polyinnervation, immature axon-myotube contacts, and abnormal T-tubule-sarcoplasmic reticulum junctions. PMID- 3666309 TI - Indeterminate cell lineage of the zebrafish embryo. AB - We have examined the clonal progeny descended from individual blastomeres injected with lineage-tracer dye in the zebrafish embryo. Blastomeres arising by the same cleavages in different embryos generated clones in which the types and positions of cells were highly variable. Several features of early development were correlated with this diversity in cell fate. There was no fixed relationship between the plane of the first cleavage and the eventual plane of bilateral symmetry of the embryo. By blastula stages the cleavages of identified blastomeres were variable in pattern. Moreover, cell fate was not easily related to the longitudinal and dorsoventral position of the clone in the gastrula. These results establish that single blastomeres can potentially generate a highly diverse array of cell types and that the cell lineage is indeterminate. PMID- 3666310 TI - Changes in the catalytic properties of DNA ligases during early sea urchin development. AB - Two distinct DNA ligases are expressed during early sea urchin embryogenesis. A light form (50 kDa) is found in unfertilized eggs (oocyte form) and a heavier enzyme (110 kDa) is observed at the two-cell stage (embryonic form). The chronology of the change reveals that the embryonic form is detected 90 min after fertilization. After the two proteins were purified, their catalytic properties were studied using different substrates. The oocyte ligase acts only on deoxypolymers while the embryonic form also ligates heteropolymers. The two enzymes were found to undergo both nick and cohesive-end ligation. With different kinds of restriction sites it was observed that the embryonic enzyme could also ligate blunt-ended DNA. These catalytic properties account for sealing of exogenous DNA and concatenation following DNA injection into eggs. The role of the oocyte form of the enzyme is unclear; one speculation is a role in repair of DNA breaks which might accumulate during long-term sperm and oocyte storage in the gonad. PMID- 3666311 TI - Positional heterogeneity of interaction between fragments of avian limb bud in organ culture. AB - We have previously succeeded in culturing whole leg bud from stage 21-23 chick embryos and observed a leg structure with typical cartilage pattern in vitro. In the present study, we have attempted the organ culture of the fragmented leg bud and investigated its capacity to form cartilage. Leg buds from stages 17-21 chick embryos were dissected into four pieces in the anteroposterior sequence (named 1, 2, 3, and 4, respectively) and cultured on a membrane filter in a medium consisting of Ham's F-12, chick serum, and chick embryo extract. After 6 days in culture, two central fragments (2 and 3) developed into large cartilaginous masses, while anterior (1) and posterior (4) fragments formed few or small cartilaginous masses. In addition, when these less chondrogenic fragments were combined, pinned together, and cultured, large cartilaginous masses were formed from 1 + 4 combinations but not from 1 + 1 or 4 + 4 combinations. These observations were analyzed quantitatively by measurement of 35SO4 incorporation into the sulfated glycosaminoglycan (S-GAG) and of final DNA content per explant, and by histological reconstruction of the chick-quail chimera explant. The results showed that (a) the 1 + 4 combination resulted in higher S-GAG synthesis and final DNA content than the 1 + 1 or 4 + 4 combinations in stage 18 and 21 leg buds (P less than 5%); (b) removal of ectoderm from the leg bud inhibited the increase observed for the 1 + 4 combination; c) in chick-quail chimera explants the cartilage formed from the 1 + 4 combination was largely of fragment 1 origin. These results demonstrate, first, the presence of a difference in chondrogenic capacity along the anteroposterior axis in the leg bud and, second, the occurrence of an interaction between anterior and posterior fragments which mimics the effects of grafting a zone of polarizing activity (ZPA). The mechanism of ZPA function is still unknown but the ectoderm may play some role. Some roles for ectoderm in ZPA function and differences in mesodermal responsiveness to ZPA factor(s) are suggested. PMID- 3666312 TI - Cell and cubitus interruptus dominant: two segment polarity genes on the fourth chromosome in Drosophila. AB - The cubitus interruptus Dominant 4-O [ciD] locus is a member of a class of genes required for the proper formation of the repeating segmental pattern of the embryo. We have found a second locus on the fourth chromosome, Cell (Ce), which is also required for proper segmentation. Mutations in Ce cause the elimination of the posterior half and anterior margin of each segment. The complementation pattern of ciD and Ce alleles is complicated; certain alleles complement fully while others do not. We have isolated a series of translocations which have breakpoints within the ciD gene. These mutations also disrupt Ce2 function, indicating that ciD and Ce2 are intimately associated. We have also studied the maternal contribution of the wild-type gene product of the ciD and Ce genes by pole cell transplants. These experiments suggest that there is no maternal contribution of the ciD+ and Ce+ gene products, and that they are not required for oogenesis. Thus, it appears that the ciD and Ce loci may represent a gene complex that is activated during zygotic development and is required for the proper formation of segments. PMID- 3666313 TI - Protein kinase C activity, protein phosphorylation and germinal vesicle breakdown in Spisula oocytes. AB - To test the possible role of protein kinase C (C-kinase) in regulating germinal vesicle breakdown (GVBD) in Spisula oocytes, we studied the effects of phorbol esters and antagonists of C-kinase on GVBD and protein phosphorylation. Responses to these agents were compared to those elicited by fertilization or increased extracellular K+. The tumor-promoting phorbol ester, 12-O-tetradecanoylphorbol-13 acetate (TPA), a potent agonist of C-kinase, elicited GVBD with half-maximal stimulation at 20 nM. By contrast, 4 alpha-phorbol-12,13-didecanoate, a phorbol ester which does not stimulate C-kinase, did not trigger GVBD. TPA accelerated GVBD when induced by excess K+, but it did not affect the time course of the process when initiated by fertilization. Three structurally different antagonists of C-kinase (W-7, H-7, and retinol) all blocked GVBD when induced by fertilization or TPA. When oocytes were preincubated with [32P]orthophosphate and then stimulated to undergo GVBD by fertilization, TPA, or 45 mM K+, protein phosphorylation was greatly increased, especially for a polypeptide(s) of about 45 kDa. Phosphorylation increased prior to GVBD. Retinol inhibited phosphorylation in activated eggs. C-kinase activity was demonstrated in oocyte extracts. These results strongly suggest that protein phosphorylation by C-kinase is involved in the pathway that regulates GVBD in Spisula oocytes. PMID- 3666314 TI - Neural crest development in the Xenopus laevis embryo, studied by interspecific transplantation and scanning electron microscopy. AB - The Xenopus borealis quinacrine marker and scanning electron microscopy have been used to study the appearance, migration, and homing of neural crest cells in the embryo of Xenopus. The analysis shows that the primordium of the neural crest develops from the nervous layer of the ectoderm and consists of three segments at early neurula stages. This primordium is located in the lateral halves of the neural folds behind the prospective eye vesicles. The histological and experimental evidence shows that the neural crest cells also originate from the medial portion of the neural folds. The neural crest segments in the cephalic region start to migrate just before the closure of the neural tube. Isotopic and isochronic unilateral grafts of X. borealis neural crest into X. laevis embryos were performed in order to map the fate of the cranial crest segments and the vagal-truncal neural crest. The analysis of the X. laevis host embryos shows that the mandibular crest segment contributes to the lower jaw (Meckel's cartilage), quadrate, and ethmoid-trabecular cartilages, as well as to the ganglionic and Schwann cells of the trigeminus nerve, the connective tissues, the mesenchymal and choroid layers of the eye, and the cornea. The hyoid crest segment is located in the ceratohyal cartilage and in ganglia VII and VIII. The branchial crest segment migrates from the caudal part of the otic vesicle and divides into two portions which contribute to the cartilages of the gills. The vagal-truncal neural crest starts to migrate later at stage 25. It migrates by means of the vagus complex in a ventral direction and penetrates into the splanchnic layer of the digestive tract. The trunk neural crest cells disperse into three different pathways which differ from those of the avian embryo at this level. PMID- 3666315 TI - Effect of hypocholesterolemia on cholesterol synthesis in small intestine of diabetic rats. AB - Studies by our and other laboratories have demonstrated that cholesterol synthesis is increased in the small intestine of insulinopenic diabetic animals. In normal animals, many factors have been shown to regulate cholesterol synthesis in the small intestine, including changes in plasma cholesterol levels. The purpose of this study was to determine the effect of lowering plasma cholesterol levels on small intestine cholesterol synthesis in streptozocin-induced diabetic rats. In diabetic rats, 4-aminopyrazolo[3,4-d]pyrimidine (4-APP)-induced hypocholesterolemia (plasma cholesterol levels less than 20 mg/dl) resulted in a 2.5-fold increase in small intestine cholesterol synthesis, which was most marked in the distal small intestine, decreasing proximally. In the distal small intestine the incorporation of 3H2O into cholesterol was 0.28 +/- 0.04 mumol.h 1.g-1 in diabetic rats versus 1.60 +/- 0.38 in diabetic rats administered 4-APP (P less than .01). This stimulation of cholesterol synthesis occurred in the upper villus, middle villus, and crypt cells isolated from the middle intestine of the 4-APP-treated diabetic animals. In agreement with these observations, "functional hypocholesterolemia" due to Triton WR-1339 administration also stimulated cholesterol synthesis 2.5-fold in the small intestine of normal and diabetic animals. In the distal small intestine, cholesterol synthesis was 0.43 +/- 0.10 mumol.h-1.g-1 in the diabetic rats versus 1.08 +/- 0.21 in diabetic rats treated with Triton WR-1339 (P less than .05). In both the 4-APP and Triton WR 1339 experiments, the response of the diabetic rats was similar to that observed in normal rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666316 TI - Regulation of lipoprotein lipase by glucose in primary cultures of isolated human adipocytes. Relevance to hypertriglyceridemia of diabetes. AB - Human adipose tissue lipoprotein lipase (LPL) is stimulated in vivo by an insulin glucose infusion. However, previous work by us showed no effect of physiologic insulin concentrations on LPL in isolated human adipocytes. To pursue further the regulation of LPL in vitro, primary cultures of isolated human adipocytes were prepared and exposed to glucose concentrations of 0-4.5 mg/ml. LPL activity was measured as activity secreted into the culture medium (CM), released from cells by heparin (HR), and extracted from cell digests (EXT). After 5 h in culture, a stimulatory effect of glucose on HR was observed. After 24 h there was a gradual increase in CM, HR, and EXT in parallel with increasing glucose concentrations of 0-1.0 mg/ml. At glucose concentrations greater than 1.0 mg/ml, however, there was a decrease in CM. At a glucose concentration of 4.5 mg/ml, CM was only 51 +/- 14% (P less than .02) of its value at glucose concentrations of 1.0 mg/ml. Cellular LPL (HR and EXT) was not affected by high glucose concentrations. Response of cellular LPL to the hormonal regulator insulin-like growth factor I (IGF-I) was modulated by medium glucose. HR in cultures treated with 50 ng/ml IGF-I was 166 +/- 40 and 147 +/- 23% of HR in control cultures at glucose concentrations of 1.0 and 2.5 mg/ml, respectively (P less than or equal to .05). However, IGF-I failed to stimulate HR at glucose concentrations greater than 2.5 mg/ml or less than 1.0 mg/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666317 TI - Altered protein phosphorylation in sciatic nerve from rats with streptozocin induced diabetes. AB - The effect of experimental diabetes on the phosphorylation of proteins in the rat sciatic nerve was studied. Nerves from animals made diabetic with streptozocin were incubated in vitro with [32P]orthophosphate and divided into segments from the proximal to the distal end, and proteins from each segment were then separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The principal labeled species were the major myelin proteins, P0, and the basic proteins. After 6 wk of diabetes, the incorporation of isotope into these proteins rose as a function of distance along the nerve in a proximal to distal direction and was significantly higher at the distal end compared with incorporation into nerves from age-matched controls. The overall level of isotope uptake was similar in nerves from diabetic animals and weight-matched controls. The distribution of 32P among proteins also differed in diabetic nerve compared with both control groups in that P0 and the small basic protein accounted for a greater proportion of total label incorporated along the entire length of nerve. In contrast to intact nerve, there was no significant difference in protein phosphorylation when homogenates from normal and diabetic nerve were incubated with [32P]-gamma-ATP. The results suggest that abnormal protein phosphorylation, particularly of myelin proteins, is a feature of experimental diabetic neuropathy and that the changes are most pronounced in the distal portion of the nerve. PMID- 3666318 TI - High glucose prolongs cell-cycle traversal of cultured human endothelial cells. AB - There is evidence suggesting that the diabetic state adversely affects replication of certain cell populations. We document that exposure to high ambient glucose (20 mM) induces delay in various phases of the cell cycle of human endothelial cells in primary culture. Cells in S phase were labeled with bromodeoxyuridine (an analogue of thymidine), and the cell-cycle position of the labeled cohort was analyzed by flow cytometry at successive time points. The movement of cells exposed to high glucose for 7-8 days was retarded both in S and G2 phases so that the increase in bromodeoxyuridine-positive cells over 24 h was 1.6-fold, versus 2.0-fold in control cultures. In experiments in which mitotic arrest with vinblastine was used to investigate the movement of cells out of G1 phase without interference from reentering cells, depletion of the G1 compartment was significantly inhibited in cultures grown in high glucose. The effects of chronic high glucose on cell cycle occurred while total protein synthesis was not diminished. Acute exposure to high glucose had no effect on cell-cycle traversal or cell generation time. Cell-cycle abnormalities observed in this study may relate to the DNA damage we have previously observed in endothelial cells exposed to high glucose and, if occurring in vivo, could be of pathogenetic importance for the vascular lesions and teratogenicity of diabetes. PMID- 3666319 TI - Competitive insulin autoantibody assay. Prospective evaluation of subjects at high risk for development of type I diabetes mellitus. AB - A quantitative fluid-phase radioassay for autoantibodies reacting with insulin (competitive insulin autoantibody assay, CIAA) was developed. The assay's features include 1) use of a physiologic amount of 125I-labeled insulin, 2) parallel incubations with supraphysiologic cold insulin (competitive), and 3) an incubation time of 7 days and a single-step multiple-wash polyethylene glycol separation. Mean +/- SE CIAA levels in 50 controls were 8 +/- 1.4 nU/ml (range 16-33.3). In 36 cytoplasmic islet cell antibody (ICA)-positive nondiabetic first degree relatives of type I (insulin-dependent) patients less than 30 yr of age, CIAA levels exceeded the normal range in 20 (55.6%) of 36 (mean 86.8 +/- 17.1 nU/ml). In 26 ICA-positive relatives greater than 30 yr of age, only 5 (19.2%) of 26 exceeded the normal range (mean 26.1 +/- 9.4 nU/ml); P less than .001 compared with younger ICA-positive relatives). Six ICA-negative HLA-identical siblings of type I diabetic patients had normal CIAA levels (mean 3.6 +/- 5.8 nU/ml), and only 2 of 13 ICA-negative identical twins discordant for diabetes (mean 15.4 +/- 6.6 nU/ml) exceeded the normal range. Nine (50%) of 18 ICA-positive schoolchildren exceeded the normal range (mean 105.3 +/- 36.7 nU/ml). Genetically susceptible subjects negative for CIAA (with only 3 exceptions) remained negative for CIAA on multiple determinations (3 conversions observed), and CIAA levels of positive subjects were relatively stable. Linear regression of the first CIAA level versus last (interval between sampling 1 mo to 10 yr) in genetically susceptible individuals showed a highly significant correlation (r = .95, P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666320 TI - Increased frequency of apolipoprotein epsilon 4 allele in type II diabetes with hypercholesterolemia. AB - The apolipoprotein E (apoE) phenotype and allele frequencies were examined in type II (non-insulin-dependent) diabetic patients with normolipidemia (n = 134) and hypercholesterolemia (type IIa hyperlipoproteinemia, n = 35; type IIb hyperlipoproteinemia, n = 42). The frequencies of apoE4-present phenotypes (apoE4/3, apoE4/4, and apoE4/2) were highest in the type IIa group (51.4%), followed by the type IIb group (38.1%) and the normolipidemic group (16.4%), respectively, whereas the frequency of the most common phenotype, apoE3/3, was lowest in the type IIa group (48.6%), followed by the type IIb group (61.9%) and the normolipidemic group (79.9%), respectively. There were significant differences in the apoE phenotype frequencies between the normolipidemic group and the type IIa and IIb groups. The frequency of the epsilon 4 allele was significantly higher in the type IIa (28.6%) and IIb (20.2%) groups than in the normolipidemic group (8.9%), whereas the frequency of the epsilon 3 allele was significantly lower in the type IIa (71.4%) and IIb (78.6%) groups than in the normolipidemic group (89.2%). The frequency of the epsilon 2 allele tended to be lower in diabetic patients with hypercholesterolemia. In addition, these frequencies were also examined in nondiabetic subjects (n = 59). The frequency of the epsilon 4 allele tended to be higher in hypercholesterolemic diabetic subjects (24.1%) than in hypercholesterolemic nondiabetic subjects (15.3%). These data suggest that diabetic patients with the epsilon 4 allele may be more susceptible to hypercholesterolemia than diabetic patients without the epsilon 4 allele and possibly nondiabetic subjects with the epsilon 4 allele, although the underlying mechanism is unknown. PMID- 3666321 TI - Inhibition of leukocyte chemotaxis by factor in alloxan-induced diabetic rat plasma. AB - The early local exudative cellular reaction in an inflammatory lesion was impaired in alloxan-induced diabetic rats due to reduced migration of neutrophils to the inflamed area. Neutrophils, however, were capable of moving from reserve compartments into blood in these animals. Furthermore, the functional integrity of their surface membranes, assessed by the capacity of the cells to adhere to nylon fiber, was not altered by alloxan diabetes. An intrinsic cellular defect also did not occur, because the cells were capable of responding to chemotactic stimuli in the Boyden chamber system, provided they were suspended in Eagle's medium or normal serum. Suspended in the corresponding diabetic serum, a blockade of the chemotactic response was observed. Increasing concentrations of diabetic serum, added to a suspension containing neutrophils collected from normal donors, progressively inhibited the response of the cells to a chemotactic stimulus. Hyperglycemia alone or hyperosmolality secondary to hyperglycemia, the presence of ketone bodies, or a direct effect of alloxan did not explain the results. In addition, the capacity to generate chemotactic factors remained intact in diabetic serum. Pretreatment of the diabetic animals with insulin resulted in a gradual recovery of the chemotactic response in vivo and in vitro. We conclude that alloxan-induced diabetic rat serum contains a substance that inhibits neutrophil chemotaxis and that insulin administration is essential for the clearance of this substance from plasma. PMID- 3666322 TI - Behavioural characteristics of children with permanent cortical visual impairment. AB - The common behavioral features of 50 children with permanent cortical visual impairment (CVI) are described. CVI is frequently associated with specific behavioural characteristics. The majority of these children have residual vision, but they all have variable and inconsistent visual performance, including visual acuity. They see better in familiar environments and when they understand what to look for and where to look for it. They often use touch to identify objects. Their ability to identify colours is much stronger than their perception of form. Many turn their heads to the side when they are reaching. Nystagmus and visual self-stimulation are exceptionally rare. They appear to have great difficulty with the cognitive evaluation of visual perception in spatial terms. Head elevation is worst in those with least vision, and without head elevation the possibility of visual stimulation is further restricted. PMID- 3666323 TI - A longitudinal study of brainstem auditory evoked potentials of preterm infants. AB - Brainstem auditory evoked potentials (BAEPs) of nine 'healthy' preterm infants were recorded at weekly intervals between 32 and 36 weeks conceptional age to study the relationship between stimulus intensity and central transmission time through the subcortical auditory pathway (i.e. the interval latency between peak I and peak V) as a function of conceptional age. Stimulus intensities of 70, 80 and 90 dB nHTL were used. Changes in click intensity produced changes in the absolute latency of all BAEP peaks, but the interval latency I to V remained constant. The absolute latencies and interval latencies reflected maturity, but varied widely between these preterm infants. The peak V latency and the I to V interval latency decreased with increasing conceptional age. Exponential regression analysis suggested that, above 70 dB nHTL, the time-constant of the calculated exponential function most likely represents maturation and function of the central subcortical pathway, and may give an indication of the infants' development. PMID- 3666324 TI - Magnetic resonance imaging of the brain of children with multiple sclerosis. AB - The results of magnetic resonance imaging (MRI) of the brains of three children with multiple sclerosis were compared with the results of computer tomography (CT). MRI made it possible to detect a particular configuration of white-matter hyperintensities with sharply angled patches and a multifocal pattern, even during remission. Thus the site and extent of cerebral plaques could be demonstrated more clearly and more exactly than with CT. At present MRI seems to be the most reliable method for confirming suspected cases of multiple sclerosis in childhood. PMID- 3666325 TI - Hemispherectomy for childhood epilepsy: a 36-year study. AB - Between 1950 and the present day 17 patients who had been treated for hemiplegic epilepsy by hemispherectomy were followed up. The outcomes of surgery in terms of survival, arrest of dementia, relief from gross disorders of behaviour and from habitual epilepsy were uniformly good. It is concluded that hemispherectomy has an enduring role in the treatment of hemiplegic epilepsy for patients who are carefully selected, prepared and postoperatively rehabilitated. PMID- 3666326 TI - Ventricular haemorrhages and hypoxic-ischaemic lesions in preterm infants: neurodevelopmental outcome at 3 1/2 years. AB - The association of cerebral ultrasound images and developmental outcome at age 3 1/2 years was studied in 50 preterm infants (mean gestational age 31 weeks, mean birthweight 1450 g). 25 children had normal neonatal scans and 25 had abnormal neonatal scans; 11 without and 14 with ventricular dilatation. At one year a repeat scan was done and neurodevelopmental outcome was assessed. Follow-up results at 3 1/2 years stress the importance of long-term follow-up: at one year four of the 50 children had developmental deficits, at 3 1/2 years 13 had such deficits. At 3 1/2 years the risk of neurodevelopmental deficits was extremely high for children with persistent haemorrhagic and/or atrophic ventricular dilatation. There was significant over-representation of children with developmental deficits in the group with abnormal scans, both neonatally and at one year. The incidence of cerebral palsy was high in the group with large haemorrhages extending into the parenchyma and/or periventricular leucomalacia. In the group with periventricular leucomalacia there was also a greater risk of mental retardation with severe behavioural problems. Follow-up at a later age than 3 1/2 years will be necessary to determine the effects on the motor, intellectual and emotional development of these children. PMID- 3666327 TI - Neurobiological findings in 20 relatively gifted children with Kanner-type autism or Asperger syndrome. AB - Seventeen children with classical Kanner autism and three children with Asperger syndrome, all of whom had Full-scale IQs above 65, were subjected to a neurobiological assessment, including CAT scan, auditory brainstem response, EEG, chromosomal cultures, cerebrospinal fluid, blood and urine examinations and a thorough physical examination. 15 of the 20 children had 'definite abnormalities' on at least one of these examinations. It is concluded that the number of cases of 'non-organic' autism, even among children with relatively higher intelligence, dwindles rapidly as our neurobiological assessment methods become increasingly sophisticated. PMID- 3666328 TI - Maturation of postural sway in young children. AB - The postural sway of 76 healthy young children aged from two to 14 years was investigated to identify age-related changes in the extent of sway, the effects of eye-closure, and the spectral composition of sway. Postural sway was measured from the excursions of the centre of pressure of ground reaction forces, and was analysed for both time and frequency. Within the age-range of the children tested, postural sway decreased linearly with age. Boys tended to become more stable at a faster rate than girls, but started from an initially greater level of instability. The children's Romberg quotients, which provide an index of the influence of eye-closure on sway magnitude, were remarkably low in comparison with adult values. Power spectral analysis of the postural sway showed that the principal energy was contained below 0.7 Hz for both lateral and antero-posterior sway, but that very young children had some power in the 0.8 to 2.0 Hz range. Taken together, these results confirm and extend the previously established view that children use visual information to control balance in a manner different from that of adults, and that it is not until after the age of seven years that adult-like balance-control strategies begin to appear. Also, in contrast to adults, the appearance of sway at high frequencies in children is not necessarily associated with any pathology. PMID- 3666329 TI - Cognitive functioning in albino children. AB - Twelve albino children with IQs in the normal range were psychometrically assessed and compared to a control group of equally visually handicapped children who were non-albino. A striking and consistent pattern of cognitive functioning emerged in the albino group (a large verbal/performance discrepancy in favour of verbal skills) which could not be attributed to their poor visual acuity. This unusual pattern of intellectual functioning may be related to the unique neuroanatomy and neurophysiology recently demonstrated in people with albinism. PMID- 3666330 TI - Co-ordination screening for children with and without moderate learning difficulties: further experience with Gubbay's tests. AB - Modified Gubbay tests, assessing various aspects of motor performance, were administered to 885 Manchester children in mainstream primary education, and centile tables were drawn up by age. Children who had performed badly on one of the four tests were retested two years later, when they were found to have 'caught up' with controls. The primary-school children reached a ceiling in their performance by the age of nine or 10 years. A further 482 children, aged eight years to 16 years 11 months and attending schools for children with moderate learning difficulties, were assessed. These children showed continuing improvement up to the age of 14, after which little further improvement was seen. Thus this ceiling occurred some five years later than for the children in mainstream schools. On the more complex tests performance was worse than would have been predicted by general intelligence. Implications for policies of integration into mainstream schooling are discussed. PMID- 3666331 TI - Infantile myopathy with type 1 fibre specific hypertrophy. AB - Two children are described whose clinical and muscle biopsy findings suggested a previously unrecognised variant of congenital fibre-type disproportion myopathy, characterised by selective hypertrophy of type 1 fibres. PMID- 3666333 TI - Aims and outcomes of physiotherapy for cerebral palsy. PMID- 3666332 TI - Environmentally induced transient motor signs in infancy. AB - Three children are described who developed abnormal motor signs in the lower limbs during late infancy. Although the clinical picture mimicked cerebral palsy, it was possible intermittently to demonstrate normal tone and function. The emergence of these signs coincided with periods of artificially increased stimulation of the feet and legs, and they disappeared rapidly after withdrawal of the stimulation. It is possible that environmental factors are involved in at least some children who develop transient abnormal motor signs. PMID- 3666334 TI - Rationalizing drug treatment for epilepsy. PMID- 3666335 TI - Energy management: the returns are worth the investment. PMID- 3666336 TI - Using energy savings to finance a retrofit. PMID- 3666337 TI - A water purification system for health care facilities. PMID- 3666338 TI - A managerial perspective on controlling the quality of patient care. PMID- 3666339 TI - Quality assurance in the small health care facility. PMID- 3666340 TI - Planning the provision and use of health care technology. PMID- 3666341 TI - Assessing quality in the "soft services". PMID- 3666342 TI - Disciplinary procedures: a framework for health professionals. Part 1. PMID- 3666343 TI - Meeting the needs of victims. PMID- 3666344 TI - Peripheral nerve concentrations of glucose, fructose, sorbitol and myoinositol in diabetic and non-diabetic patients. AB - Glucose, fructose, sorbitol and myoinositol concentrations were measured in biopsies of peripheral nerve obtained at above-knee or below-knee amputation. In diabetic patients nerve glucose (median [range]) (5.09 [1.62-12.82] vs 3.12 [1.81 4.01]) p less than 0.001, fructose (0.245 [0.060-1.280] vs 0.150 [0.053-0.385]) p less than 0.05, and sorbitol (0.028 [0.012-0.496] vs 0.016 [0.007-0.059] p less than 0.02, mumol/g wet weight) were significantly higher than in non-diabetic patients. No significant difference was found in myoinositol concentration (1.95 [1.00-3.55] vs 2.09 [1.27-5.40] mumol/g wet weight). Concentrations differed markedly from previously reported values in human nerve obtained at post-mortem. PMID- 3666345 TI - Metabolic control and progression of diabetic nephropathy. PMID- 3666346 TI - Partnership. PMID- 3666347 TI - Referral to hospital: perceptions of patients, general practitioners and consultants about necessity and suitability of referral. AB - A sample of new referrals from general practitioners to hospital specialists was examined from the points of view of the patient, general practitioner and consultant concerned with regard to the adequacy of the general practitioners' performance before referral, his ability to have managed without referral and the suitability of the specialist seen. Little agreement was found between the opinions expressed by the three groups, although some of the opinions expressed within the groups were found to be associated with characteristics of the groups. PMID- 3666348 TI - Improving communication between general practitioners and specialists. AB - An investigation was carried out in the Almelo district in the Netherlands to study referral problems and to improve communication and cooperation between general practitioners and specialists in the area. During September and October 1984 seven general practitioners referred 30 patients to internists. There appeared to be considerable disagreement between general practitioners and internists about the necessity of the referrals from a biomedical view point and less so about the objective of the referrals. Twelve referrals were labelled as 'problem referrals'. Each of these was reviewed by the general practitioner and the internist who were involved in the referral in the presence of the author. In these meetings agreement was reached on the objective and the necessity of each of the 12 referrals. The evaluation, however, showed marked differences between general practitioners and internists with respect to the effect of the project: most general practitioners said that participation in the study influenced their conduct in referring patients to specialists, while most internists replied negatively. PMID- 3666349 TI - Characteristics of general practitioners with high and low recall rates. AB - This study showed that general practitioners altered their workload and the clinical content of their practice by the number of patients that they asked to return and the number of doctor-initiated consultations that they carried out. Doctors with a high recall rate, who asked more of their patients to return, saw more chronic illness and investigated their patients' illnesses more. They were more likely to visit their patients and to make two or more diagnoses, their second diagnosis having an even greater bias to chronic illness. When they did give a prescription it was likely to be for two or more items at a consultation. They involved the primary health care team more and their patients were more likely to be elderly, female and of a higher social class. The low recall doctors asked few patients to return, saw less chronic illness and more acute episodic types of illness. They were more likely to see their patients in surgery and make a single diagnosis and give either none or one prescription. They were less likely either to involve the primary health care team or to investigate their patients. Their patients were younger, male and of a lower social class. Personality, undergraduate education, and postgraduate training seemed to be major influences on these differing characteristics. The results have implications for partnership, individual doctors and patients in the provision of whole person medicine. PMID- 3666350 TI - Measuring general practitioners' attitudes towards medical care. AB - The construction and development of a questionnaire which measures the attitudes of general practitioners towards their role in the medical care system is described. Factor analytic procedures identified seven reliable factor-based subscales. The subscales measured attitudes towards: a psychological orientation to patient care, government involvement in the health care system, preventive medicine, patient participation in the consultation, communication with patients, responsibility for decision making and the appropriateness of consultations. The responses of 387 randomly selected Australian general practitioners to this measure are described. Overall, there was strong support for the importance of fostering patient participation, facilitating open communication and understanding, having a psychological orientation, and implementing preventive activities in general practice. However, the sample was strongly opposed to a government regulated health care system. Age and sex of the general practitioner were shown to influence orientations on some dimensions. PMID- 3666351 TI - The patient's view of general practice in an urban area. AB - The paper reviews evidence from the health care professions about the quality and accessibility of general practice in London, which suggests that inner London is less well served than elsewhere, and recommends changes to the organization and equipment of inner London practice. Results from a community survey in north-east London are presented to show how the views about general practice among residents in a typical inner city district compared with those in a suburban area. The results suggest that while the respondents were generally satisfied with their doctor's practice, a significant minority were dissatisfied, particularly in the inner city. Some of the respondents' views seemed to differ from the model of desirable general practice suggested by the policy literature. In particular, single-handed practice was more popular with patients than group practice. The results reflect the importance to patients of good personal rapport and communication with their doctor, which seemed to them the most significant quality of general practice. The implications for policies to improve inner city practice are considered. PMID- 3666352 TI - The doctor, the patient and the relative: an exploratory survey of doctor relative relationships. AB - The contacts which doctors have with their patients' relatives are important, and raise interesting and sometimes difficult ethical issues. In order to develop hypotheses about doctor-relative relationships, a sample of 18 general practitioners in east London were interviewed. Their views are summarized in this paper, and from them a number of hypotheses concerning these relationships are proposed. Further research will be needed to test these hypotheses. PMID- 3666353 TI - Families, cancer and dying. AB - Cancer involves change in individuals and families. Family practitioners are in a unique position to meet the needs of families where cancer is present. By coordinating differing therapeutic interventions and developing therapeutic support within the community the physical, psychological, social and spiritual needs of those who are dying, and the needs of their families, can be met. PMID- 3666354 TI - Undertreatment of asthma in Dutch general practice. AB - The relationships between the medication prescribed and four measures of morbidity were assessed in 150 Dutch patients with asthma in general practice. Undertreatment was operationalized as a discrepancy between medication and morbidity severity. Of the patients, 11.3% were undertreated as measured by the number of days during which activities were interrupted by asthmatic symptoms. Additional measures such as the number of nights interrupted by asthma, number of attacks and episodes of wheezing, indicated that 28.0%, 24.0% and 34.5% of the patients respectively were undertreated. It is concluded that asthma seems to be undertreated in general practice in The Netherlands, a finding which is consistent with research on this subject in the UK and other countries. Possible reasons for the persistence of undertreatment of asthma are discussed, and suggestions for overcoming it are offered. PMID- 3666355 TI - Wanted: sound theory for soft values. PMID- 3666356 TI - [Neuronal correlates of word processing. I. Methodological aspects and research methods]. PMID- 3666357 TI - [Neurophysiological correlates of sleep disorders. I. Physiological characteristics of sleep and dynamic pathological activity of patients with temporal lobe epilepsy and different neuro- and psychopathological syndromes]. PMID- 3666358 TI - [Neuronal reactions and evoked potentials in subcortical brain structures during visual recognition. IV. Effect of the masking of visual stimuli]. PMID- 3666359 TI - [Right and left hemispheric characteristics in the recognition of skewed images]. PMID- 3666360 TI - [Hemispheric dominance in multiple dichotic testing]. PMID- 3666361 TI - [Voice reproduction of the pitch of complex 3-tone sounds with a weakly expressed harmonic structure]. PMID- 3666362 TI - [Measurement of the frequency-resolving power of hearing by evoked potentials]. PMID- 3666363 TI - [Lateralization of the voluntary regulation of mimetic expression]. PMID- 3666364 TI - [Concept of the equal pressure point and its related applications]. PMID- 3666365 TI - [Regulation of hemodynamics during simulation of the transition to weightlessness (mathematical modelling)]. PMID- 3666366 TI - [Circadian biorhythms of autonomic functions in 3- to 6-year-old children]. PMID- 3666367 TI - [Acclimatization iron deficiency]. PMID- 3666368 TI - [Physiological mechanisms of human thermoregulation during adaptation to cold]. PMID- 3666370 TI - [Scientists fighting for peace, against the nuclear threat]. PMID- 3666369 TI - [Is the strength-stiffness ratio of active muscles a single value?]. PMID- 3666371 TI - [Use of discriminant analysis for predicting occupational fitness]. PMID- 3666373 TI - [Changes in the indices of human basal metabolism during prolonged low-calorie nutrition]. PMID- 3666372 TI - [Effect of ametropia on aiming accuracy]. PMID- 3666374 TI - [Role of the individual characteristics of autonomic reactions to adaptogen action on physical and intellectual work capacity]. PMID- 3666375 TI - [Indices determining the efficiency of the occupational activities of skin divers]. PMID- 3666376 TI - [Anisoinotropism of myocardial cells: elementary histological picture of early ischemic dys-asynergy]. AB - Twelve autoptic hearts from victims of cardiogenic shock, within a few hours from infarction, were studied at light microscope. At the site of early ischemia, a discrepancy in contraction of myocardiocytic units along single fibers (otherwise normal) has been observed. It configurated as an asynergic contracture (with Z lines impinging upon A bands), side by side with relaxed elements (with evident I bands); frequent dehiscence of intercalated disks ensues, due to imbalanced mechanic strain. These morphologic features, only rarely seen in 20 control hearts, are consistent with pertinent knowledge in pathophysiology, and can be defined "anisoinotropism" of myocardial fibers. They seem to be the microscopic substrate for the contractile dys-asynergy, which is credited in modern clinical diagnostics among the earliest signs of cardiac ischemia. The discal injury may also imply an impairment in intercellular conductivity, with an arrhythmogenic potential (reentry). Anisoinotropism presents as the forerunner of the well known "contraction band degeneration-necrosis", by progressive coagulative denaturation of the contractile proteins, up to conglutination and cancellation of sarcomere structures. The changes described herein can be taken into consideration in histopathology of heart's acute ischemia, before the occurrence of patent pictures of initial infarction. PMID- 3666377 TI - [Natural history of patients with isolated atrial fibrillation]. AB - Sixty three patients (pts) (aged less than or equal to 50 years) with a history of "lone" atrial fibrillation (AF) and normal heart size at radiological examination were followed-up for a mean period of 95 months (range 1-360). The arrhythmia remained paroxysmal in 43 pts, became chronic in 13, while in 7 could not be reverted to sinus rhythm at the time of first observation. Clinical examination was normal in 58 pts; in 23 echocardiography disclosed mild abnormalities. In 2 pts auscultation revealed a mid-systolic apical click, i n one a mid-systolic murmur and in 2 click and murmur together. These findings were correlated to slightly pathological echocardiographic patterns. M-mode and B-mode echocardiography yielded normal results in 35 pts and showed minor pathological findings in 28 (16 with paroxysmal AF and 12 with chronic AF). Thyroid hormones, tested in 58 pts, were within normal limits in 53, showed decreased T4 in 2 and increased T3 in 3 (2 of whom in treatment with amiodarone). During the follow-up period, no patient had a deterioration of the clinical status from the cardiovascular point of view. However, one patient suffered an episode of cerebral embolism, with rapid resolution, and one a cerebral transient ischemic attack. In conclusion "lone" AF has a favourable prognosis and systemic anticoagulation is not indicated, particularly in the absence of left atrial dilatation. PMID- 3666378 TI - [Study of myocardial perfusion by means of scintigraphy with thallium-210 in left bundle branch block induced by exertion]. AB - Myocardial perfusion scintigraphy with 201-TL was performed in a group of subjects affected by exercise-induced, rate-dependent left bundle branch block (LBBB). The aim of the study was: to define the significance of the exercise induced conduction abnormality: "primitive" or "ischemic". 14 patients, aging 28 58 years (x = 42), 8 with chest pain (4 typical angina, 4 atypical angina) and 6 without any symptoms were studied. None had history of prior myocardial infarction or clinical and echocardiographic signs of heart disease. LBBB appeared at a heart rate ranging from 70 to 160 beats/min. 6 patients showed repolarization abnormalities (ST changes, deep and negative T wave) suggestive for ischemia, during successive QRS normalization. 201-TL-uptake was normal in 5 subjects; in the remaining 9 ones reversible TL defects were demonstrated in the septum (6), in the septum and apex (2), in the septum and inferior-apical wall (1). No patients had irreversible impaired perfusion. All the patients had normal coronary angiography, with negative ergonovine test for coronary artery spasm. In conclusion, in the majority of our subjects (64%) with exercise-induced LBBB, a reversible TL-uptake defect, usually located in the septum without diagnostic value of obstructive CAD, has been observed. Further studies will establish if the TL-defect is only an "apparent phenomenon" due to contraction abnormality secondary to LBBB, or, on the contrary, an expression of myocardial ischemia with normal coronary vessels as a consequence of the LBBB. PMID- 3666379 TI - [The heart of the athlete and cardiac aging]. PMID- 3666380 TI - [Malfunctioning of the Meadox bioprosthesis placed in mitral position. Description of 2 clinical cases]. AB - The Meadox valve, made up by a single bovine pericardial leaflet fixed in glutaraldehyde, is a "new-generation" bio-prostheses. In two patients those bio prostheses revealed early malfunction with abnormal stretching of the valvular tissue. In both cases the beginning symptom was a strong fremitus caused by the vibration, during systole, of valvular leaflet. In the first case mechanical solicitation onsed partial laceration of valvular leaflet with subsequent regurgitation into the left atrium and cardiac failure. In both cases, the evaluation by Doppler Echocardiography and polygraphic examination, allowed the diagnose of malfunction which was confirmed at surgery. The replacement of a new prosthesis was successful in both cases. PMID- 3666381 TI - [Vertebral fracture caused by electric cardioversion]. AB - A case of vertebral fracture following DC shock for ventricular fibrillation is reported. After a short review of the complications of this procedure the case is described and compared with two other cases known in literature. We conclude that, although this complication is uncommon, it must be kept in mind owing to its potential severity. PMID- 3666382 TI - Effect of omeprazole on gastric acid secretion in rat: evaluation of dose, duration of effect, and route of administration. AB - The effect of omeprazole on gastric acid output was studied in rats before and during stimulation by continuous administration of tetragastrin at 50 micrograms/kg-hour. From 5 to 20 mg/kg of omeprazole was given to animals intraperitoneally, perorally and intravenously from 2 to 24 hours before the gastric secretory study was started, and the respective effects on acid secretion were compared. In each administration group, 20 mg/kg of omeprazole was the most potent among the groups receiving 5, 10 or 20 mg/kg, when the drug was given 2 hours before the study. There were statistically significant differences between the control group given tetragastrin only and each of the groups given 20 mg/kg of omeprazole perorally, intraperitoneally and intravenously. There was no significant difference among the groups given 20 mg/kg of omeprazole intraperitoneally, intravenously and perorally. The effect of 20 mg/kg of omeprazole continued at least 24 hours after the agent was administered perorally. PMID- 3666384 TI - [Characteristics of the acute period of burns in alcoholic intoxication]. PMID- 3666383 TI - Pharmacokinetic studies of cimetidine in patients with liver disease. AB - The tolerability and metabolism of cimetidine administered for over 7 days were studied in 30 patients with liver diseases and 19 control subjects who had peptic ulcers. Cimetidine was well tolerated by these patients without any side effects. The cimetidine in the serum and urine was determined by high-performance liquid chromatography. The serum cimetidine levels and pharmacokinetic parameters of the patient group did not significantly differ from those of the control group after oral administration. Following intravenous administration, the half-life of cimetidine increased and cimetidine clearance decreased in the liver disease group. These differences seem to be totally explicable by the impaired renal function associated with the liver disease. Furthermore, accumulation of cimetidine in serum did not occur following continuous treatment with cimetidine in these patients. It was concluded that a reduction of cimetidine dosage is not necessary in patients with liver disease as far as their renal function is not disturbed, since the metabolism of cimetidine was not affected by the liver dysfunction itself. PMID- 3666385 TI - [Effect of transfusions of plasma containing antibodies to enhance body resistance on the phagocytosing macrophage system in burn injury]. PMID- 3666386 TI - [Blood serum protein spectrum of donors undergoing multiple, frequently repeated plasmapheresis]. PMID- 3666387 TI - [Morphofunctional quality of blood and erythrocyte concentrate preserved in polymeric containers and small glass bottles]. PMID- 3666388 TI - [Current status of the problem of detoxication]. PMID- 3666389 TI - [Importance of correcting the microcirculatory disorders in the transfusion therapy of acute kidney failure in experimental burn shock]. PMID- 3666390 TI - [Correction of the indices of physicochemical homeostasis by the infusion of a perfluorocarbon emulsion in treating hemorrhagic shock in dogs]. PMID- 3666391 TI - [Substitution of the blood of animals with solutions of modified hemoglobin having low and high oxygen affinity]. PMID- 3666392 TI - [Comparative evaluation of the thromboelastogram indices in in vitro research on emulsions of perfluoro-organic compounds]. PMID- 3666393 TI - [Measurement of the osmolarity of the blood plasma and urine for controlling the adequacy of the infusion-transfusion therapy of patients with severe combined trauma]. PMID- 3666394 TI - [Weekly biorhythm of the leukocyte count in the peripheral blood of healthy men]. PMID- 3666395 TI - [Collecting tubing for the PF-0.5 apparatus]. PMID- 3666396 TI - [Detoxifying blood corrector neohemodes in the treatment of endogenous toxicoses of different origins]. PMID- 3666397 TI - Effects of procaine and caffeine on the contractility of enzymatically isolated myocytes and intact cardiac tissue. AB - 1. Procaine and caffeine exerted opposite effects on the contractility of rat cardiac tissue. 2. Procaine enhanced and caffeine depressed isometric contractile force of right ventricular strips. 3. In enzymatically isolated cells, caffeine increased the frequency and decreased the amplitude of spontaneous contractions, while procaine retarded the beating rate but concomitantly raised the shortening amplitude of the myocyte. 4. Both drugs depressed the propagation velocity of the contractile waves. 5. The results are suggested to be due to the opposite effects of the two drugs on the Ca-release process of the sarcoplasmic reticulum. PMID- 3666398 TI - Sr2+ may differentiate high and low affinity Ca2+ stores in guinea-pig trachealis. AB - 1. In guinea-pig trachealis Ca2+ are mobilized from different stores to produce the contractions to various agents. 2. Sr2+ can substitute for Ca2+ and maintain responses to KC1 but not responses to A23187 or agents acting via drug-receptor interaction. 3. Resting tone and responses to KC1 are supported by low affinity Ca2+. 4. Responses to the other agents are supported by high affinity Ca2+. PMID- 3666399 TI - The effect of ethanol on spontaneous contractions and on the contraction produced by periarterial nerve stimulation and by acetylcholine in the rat isolated ileum. AB - 1. The effect of ethanol (0.01-1000 mg.ml-1) on tone, contractility, and the contractions produced by periarterial nerve stimulation and by acetylcholine was studied in the rat isolated ileum. 2. In low concentrations, ethanol reduced the spontaneous contractions by 60 +/- 1.5% and in high concentrations, it produced a marked contraction in the muscle (3.2 +/- 0.3 g, mean +/- SE, n = 6). 3. In the presence of adrenergic, histaminergic, serotonin and prostaglandin antagonists, ethanol (1.8 mg.ml-1) reduced the contractions produced by periarterial nerve stimulation, at 1-100 Hz with 20 V and 0.2 msec pulse duration, by 80 +/- 3.4%. Ethanol also reduced the contractions produced by acetylcholine (0.001-1 microgram.ml-1), the mean EC50 values were 0.1 +/- 0.01 microgram.ml-1, control, and 0.96 +/- 0.1 microgram.ml-1, in ethanol, respectively. 4. Although the mechanism of action of ethanol at the gut smooth muscle is not clear, it is known that it may block conduction, depolarize the cell membrane and cause release of intracellular calcium, which is, in part, responsible for the contraction produced by ethanol in the rat ileum. PMID- 3666400 TI - Pharmacological studies of water extract of the Zizyphus seed and the Zizyphus seed containing drug. AB - 1. The pharmacological properties of a water extract of the Zizyphus seed (HO2) and that of the Zizyphus seed containing drug (HO1) were studied. 2. After oral or intraduodenal administration of 3 g/kg of HO1 or HO2, the hypnotic effects induced by hexobarbital-Na (38 mg/kg, i.p.) and diazepam-induced sleep in mice were potentiated. 3. After oral or intraduodenal administration of 3 g/kg of HO1 or HO2, gastric juice secretion and ulcers induced by water immersion stress, histamine and reserpine in rats were inhibited. PMID- 3666402 TI - Influence of peripherally-administered peptides on ethanol-induced gastric ulcers in the rat. AB - 1. Subcutaneous administration of bombesin (50-200 micrograms/kg), cholecystokinin-8 (10-100 micrograms/kg) and epidermal growth factor (10-100 micrograms/kg) but not calcitonin gene-related peptide (25 micrograms/kg), neurotensin (500 micrograms/kg) or substance P (200 micrograms/kg) produced a marked and dose-related inhibition of ethanol-induced gastric lesions in rats. 2. These actions were inhibited by a non-ulcerogenic dose of indomethacin suggesting that prostaglandins are involved in the protective activity of bombesin, cholecystokinin-8 and epidermal growth factor. PMID- 3666401 TI - Mixed actions of hemicholinium at autonomic receptor sites of the rat vas deferens. AB - 1. The effects of hemicholinium (HC-3) on several autonomic agents in the isolated rat vas deferens were investigated. 2. HC-3 reduced slightly the effects of NE and DA. 3. The responses by cholinergic agents on the M1-ACh receptors were not modified, however HC-3 reduced, significantly, the responses on the M2-ACh receptors. 4. These results suggest that HC-3 besides its anticholinergic properties possesses ability to interact with adrenoceptors in the isolated rat vas deferens. PMID- 3666403 TI - Development of tolerance to effects of morphine on cardiac sympathetic response. AB - 1. In isolated guinea-pig atria, morphine potentiated the response to sympathetic stimulation in a naloxone-insensitive, but calcium-sensitive way. The potentiating effect of morphine disappeared in the presence of desmethylimipramine; moreover morphine enhanced the dose-effect curve for exogenous noradrenaline. 2. Morphine was ineffective in guinea-pig atria obtained from animals implanted with morphine pellets for 4 days; on the other hand DADLE and dynorphin-(1-13) maintained their usual inhibitory effect on cardiac sympathetic response in the same kind of preparation. 3. In atria obtained from morphine-tolerant animals and maintained in vitro in the presence of morphine, removal of morphine from the bathing solution caused a new potentiating effect. PMID- 3666404 TI - Cholinoceptor-mediated mechanical and electrical responses of rat oesophageal striated musculature. A comparison of two in vitro methods. AB - 1. Both muscarinic and nicotinic cholinoceptor agonists produce a contractile response of the rat oesophageal tunica muscularis externa (TME) in vitro. 2. The muscarinic receptor-mediated responses were confined to the distal 0.5 cm of the TME, which contains an admixture of smooth muscle. 3. Nicotinic receptor-mediated responses were obtained throughout the length of the TME striated musculature and consisted of a fast and slow component, representing TTX-sensitive contractions, associated with muscle action potentials, and electrically silent contractures, respectively. 4. Contractions were observed only in superfused preparations. 5. Contractures were resistant to changes in extracellular cation concentrations designed to eliminate generation of nerve and muscle action potentials or release of neurotransmitters. PMID- 3666405 TI - Influence of age on diurnal rhythms of adrenal norepinephrine, epinephrine, and corticosterone levels in soft-shelled turtles (Lissemys punctata punctata). AB - An investigation was made of what role aging plays on diurnal rhythms of norepinephrine, epinephrine, and corticosterone contents in the adrenal gland of soft-shelled turtles. To resolve this problem, juvenile and adult soft-shelled turtles were sacrificed at four different time intervals (0600, 1200, 1800, and 2400 hr) and adrenal hormonal levels were measured by spectrofluorometer. The findings revealed that peak norepinephrine, epinephrine, and corticosterone values were observed at 2400, 0600, and 2400 hr, respectively, and trough values for all the hormones were found at 1200 hr in both juvenile and adult animals. Thus, diurnal rhythms for all the hormones studied exist in both juvenile and adult animals. It is suggested that aging apparently has no influence on diurnal variations of adrenal hormones in turtles. PMID- 3666407 TI - Nychthemeral variations of plasma corticosteroids in captive female Lacerta vivipara Jacquin: influence of stress and reproductive state. AB - This work was designed to study nychthemeral variations of plasma corticosterone and aldosterone in captive female lizards Lacerta vivipara. In preliminary experiments, the possible alterations of plasma corticosteroids by various stress factors were researched. A prolonged blood sampling (up to 8 min) did not alter plasma corticosterone levels but a significant increase of plasma aldosterone levels was observed. Confinement (1 or 18 hr) in small individual cages before blood collection resulted in a significant increase of both corticosterone and aldosterone. Whatever the period investigated (vitellogenesis, gestation, 2 months after parturition), plasma corticosterone levels showed a unimodal daily rhythm correlated with the activity of the females in the laboratory. No shift of the peak was observed according to season but the mean minimal and maximal levels were lower during vitellogenesis than during the other periods tested. Nychthemeral variations of plasma aldosterone levels were similar to those of corticosterone but of lower amplitude. Adrenal response to a short confinement (less than 1 hr) before blood sampling varied during a 24-hr period (period tested: vitellogenesis). Only minimal levels of corticosteroids were significantly increased. The possible effects of a long duration of captivity under optimal thermal conditions are discussed. PMID- 3666406 TI - In vitro binding and utilization of lipoproteins by luteal cells from ferrets treated with dopaminergic drugs during pseudopregnancy. AB - The effects of administration of dopaminergic drugs in vivo on the binding and utilization of lipoproteins for progesterone synthesis in vitro by ferret luteal cells were investigated. Pimozide, a dopamine antagonist, and bromoergocriptine (CB-154), a dopamine agonist, were administered to pseudopregnant ferrets to alter prolactin (PRL) concentrations daily beginning the day after ovulation. The control group received the vehicle solution only. Corpora lutea taken on Day 13 after ovulation were dissociated and the cells were incubated with canine lipoproteins, cyclic adenosine monophosphate (cAMP), and 5-cholesten-3 beta-25 diol (25-OH-cholesterol). Canine high-density lipoprotein (HDL) and low-density lipoprotein (LDL) stimulated progesterone accumulation by luteal cells from pimozide-treated animals but not from CB-154-treated ferrets. However, when 25-OH cholesterol, which bypasses the LDL receptor, was provided as the substrate, steroidogenesis was stimulated in all groups. Together these observations suggest that dopaminergic alteration of PRL levels preferentially affects the utilization of lipoproteins. The uptake of canine HDL and LDL by luteal cells was saturable, and a high degree of cross-reactivity was observed. Heparin released surface bound HDL and LDL, suggesting that HDL was binding to the LDL receptor. The quantity of LDL which could be released from luteal cells by heparin treatment was greater in animals treated with pimozide and decreased by treatment with CB 154, relative to luteal cells from control animals. It was concluded that the chronic administration of pimozide or CB-154 alters serum PRL levels in vivo, and influences the subsequent binding and utilization of lipoproteins by luteal cells in vitro. PRL may increase the number of LDL binding sites in luteal cells, thereby enhancing lipoprotein uptake for progesterone synthesis. PMID- 3666408 TI - Estradiol-17 beta Silastic implants suppress oocyte development in the brook trout, Salvelinus fontinalis. AB - A technique for long-term implantation (i.e., 6 months) of steroid-containing Silastic capsules in brook trout was developed along with a method for longitudinal study of ovarian dynamics in individual females. Estradiol-17 beta implantation, extending from spring during early oogenesis through November, suppressed overall ovarian development in a dose-dependent manner, as determined by follicle size analysis and gonosomatic index, and reduced the peak of plasma estradiol-17 beta normally observed prior to ovulation in the fall. Frozen sections of follicles revealed that estradiol implants retarded the progression of vitellogenesis from primary to secondary stages in the largest size class of follicles. In particular, sections of ovarian biopsies from animals with three estradiol implants had only small follicles in September which cytologically were no more advanced than those in May. By contrast, animals receiving steroid-free implants had significantly larger follicles in September which entered the secondary stage of vitellogenesis and became increasingly competent to respond to progestogen treatment in vitro through October and November. Image analysis of ovarian biopsies indicated that estradiol implants deranged the normal group synchronous growth pattern of the brook trout ovary and tended to produce asynchronous growth, especially in animals with a single estradiol implant. PMID- 3666409 TI - Central GABAergic innervation of the pituitary in goldfish: a radioautographic and immunocytochemical study at the electron microscope level. AB - The GABAergic innervation of the goldfish pituitary was studied at the light and electron microscope levels by means of radioautography after in vitro incubation in tritiated gamma-aminobutyric acid (GABA) and immunocytochemistry using antibodies against GABA. Following incubation of pituitary fragments in a medium containing tritiated GABA, a selective uptake of the tracer was observed within the digitations of the neurohypophysis. Silver grain clusters were also observed in the adenohypophyseal tissue. At the electron microscope level, this uptake was found to correspond to nerve endings containing small clear and dense-core vesicles. These labeled profiles were located mainly in neurohypophyseal digitations in close apposition with the basement membrane separating the neurohypophysis from the adenohypophysis. However, they were also encountered in direct contact with most adenohypophyseal cell types in the different lobes. These results were confirmed by immunocytochemical data demonstrating the presence of numerous GABA immunoreactive fibers in both anterior and neurointermediate lobes. They were found either in the digitations of the neurohypophysis or in the adenohypophysis in direct contact with the glandular cells with a distribution and an ultrastructural aspect similar to those observed by radioautography. These data demonstrate that the pituitary of teleosts receives a massive GABAergic innervation. Although physiological data providing a functional significance for such an innervation are lacking, the present study suggests that, as already documented in mammals, GABA may be involved in the neuroendocrine regulation of pituitary functions in teleosts. PMID- 3666410 TI - Immunochemical and immunocytochemical studies of the crustacean vitellogenesis inhibiting hormone (VIH). AB - Immunochemical investigations, using dot immunobinding assay (DIA) and enzyme linked immunosorbent assay (ELISA), and immunocytochemical studies reveal the following new information about crustacean vitellogenesis-inhibiting hormone (VIH): (1) The structure of VIH is sufficiently different from that of the other sinus gland neuropeptides to allow a selective recognition of VIH by polyclonal antibodies. (2) From immunochemical criteria, VIH does not seem strictly species specific. The antisera raised against VIH of Homarus americanus cross-react with sinus gland extracts of Palaemonetes varians, Palaemon serratus, Macrobrachium rosenbergii, Carcinus maenas, and Porcellio dilatatus. (3) In the sinus gland of H. americanus, VIH immunoreactivity is localized mainly in electron-dense granules of medium size (110-185 nm in diameter) while, in P. dilatatus, the labeling is mostly on the largest granules (200-270 nm in diameter). PMID- 3666411 TI - Effects of various doses of thyroxine and triiodothyronine on the metamorphosis of flounder (Paralichthys olivaceus). AB - Two experiments were carried out to clarify the effects of thyroxine (T4) and triiodothyronine (T3) on flounder metamorphosis. In the first experiment, three doses of T4 were administered to premetamorphic flounder larvae together with thiourea (TU). Thiourea treatment (30 ppm in ambient seawater) alone caused metamorphic stasis in the fish, although the beginning of the right eye migration was not completely inhibited. T4 at 100 and 10 ppb in ambient seawater induced metamorphosis in the thiourea-treated larvae. The fish of these groups completed translocation of the right eye to the left side and resorption of elongated dorsal fin rays. However, 1 ppb T4 failed to induce metamorphic climax. The elongated dorsal fin rays continued to grow until the end of the experiment in the group treated with TU alone and in combination with 1 ppb T4. In the second experiment, premetamorphic flounder larvae were treated with two doses of T4 and three doses of T3. The T3 treatment was several times more potent than T4 treatment in the induction of metamorphosis. The results of the present study suggest that the metamorphic events of flounder larvae are dependent on the thyroid hormone concentration, and the relative biological potency of T4 and T3 on flounder metamorphosis is similar to that observed in mammals and amphibia. PMID- 3666412 TI - The parasitoid Apanteles kariyai inhibits pupation of its host, Pseudaletia separata, via disruption of prothoracicotropic hormone release. AB - When the parasitoid Apanteles kariyai laid eggs into host Pseudaletia separata larvae, before prothoracicotropic hormone (PTTH) was released in the last instar preparatory to metamorphosis, the host did not pupate and the larvae of the wasps emerged. The ecdysteroid titer of unparasitized intact larvae increased up to 1 microgram/ml 1 day before pupation, whereas the titer of parasitized larvae was maintained at a low level without the surge. Isolated prothoracic glands from intact larvae synthesized much more ecdysone than those of parasitized larvae both in vivo and in vitro. Administration of exogenous PTTH caused the activation of the prothoracic glands seen during parasitization. Injection of 20 hydroxyecdysone (20-HE) into the parasitized larvae caused by host's pupation, but did not affect the development of the wasp larvae. However, the sensitivity of the integument to 20-HE was lower in parasitized than in unparasitized larvae. Injection of a mixture of adult wasp calyx and venom fluids into last instar unparasitized larvae delayed their pupation, suggesting that calyx and venom fluids are factors contributing to disturbance of the normal function of brain prothoracic gland system. These results show that parasitization inhibits secretion and/or synthesis of PTTH and also delays the larval-pupal commitment of the integument by keeping the ecdysteroid level low. PMID- 3666413 TI - Ontogenesis of immunocytochemically demonstrable somatotrophs in the adenohypophyseal pars distalis of the developing chick embryo. AB - Growth hormone (GH)-containing cells in the hypophyseal pars distalis of the chick embryo were identified immunohistochemically using anti-chicken GH sera. GH cells are first demonstrable in Rathke's Pouch as early as Day 4.5 of incubation. By Day 9.5, when the two lobes (rostral and caudal) of the pars distalis are easily recognized, GH cells are confined exclusively to the caudal lobe. Although the number of GH cells increases gradually during embryonic development, there is a statistically significant difference between Days 10.5 and 12.5 in both the cellular density and the percentage of somatotrophs. GH cells, which contain coarse granules evenly distributed throughout the cytoplasm, varied in diameter from 9.3 micron on Day 4.5 to 11.8 micron on Day 20.5, while the nuclear diameter of these cells increased from 2.8 micron on Day 4.5 to 4.9 micron on Day 20.5. There was a statistically significant difference in the nuclear/cytoplasmic ratio between Days 4.5 and 13.5 and between Days 13.5 and 20.5 of incubation. Aspects of the regulation of growth hormone synthesis and secretion in the chick embryo are discussed. PMID- 3666414 TI - Evolution of marsupials traced by their neurohypophyseal hormones: microidentification of mesotocin and arginine vasopressin in two Australian families, Dasyuridae and Phascolarctidae. AB - Neurohypophyseal hormones of two species belonging to the family Dasyuridae, namely Dasyurus viverrinus (Eastern native cat) and Dasyuroides byrnei (Kowari), and of the single living member of the family Phascolarctidae, Phascolarctos cinereus (Koala) have been isolated and characterized by their retention times in high-pressure reverse-phase partition chromatography and either amino acid composition or amino acid sequence through a gas-phase microsequencer. Mesotocin and arginine vasopressin have been identified in the three species. The same hormones have previously been found in a species belonging to the family Phalangeridae, Trichosurus vulpecula (brush-tailed possum), whereas in five species of Macropodidae, mesotocin, lysipressin, and phenypressin have been characterized. Because the four Australian marsupial families examined up to now possess mesotocin and at least a vasopressin-like peptide, it is assumed that the primitive marsupial settler in Australia was endowed with mesotocin and arginine vasopressin. PMID- 3666415 TI - The phase relationship between the circadian rhythms of locomotor activity and circulating melatonin in the pigeon (Columba livia). AB - The phase relationship between the circadian rhythms of locomotor activity and circulating melatonin levels under LD 12:12 and constant dim light conditions (LLdim) was examined in pigeons. Our new radioimmunoassay technique had sufficient sensitivity to detect the concentration of melatonin from a small quantity of plasma, which enabled us to measure locomotor activity simultaneously with circulating melatonin rhythms from each individual pigeon. The relationship of phase between the two circadian rhythms in LLdim was the same as in LD. The rhythms of locomotor activity and melatonin levels free-run but maintain the relation of 180 degrees out of phase in LLdim. These results do not contradict the hypothesis that melatonin may entrain the circadian rhythm of locomotor activity in the pigeon. PMID- 3666416 TI - Cytochemical and biochemical characterization of neurosecretory material in the brain of an annelid, Ophryotrocha puerilis (Polychaeta). AB - In the brain of the protandric annelid Ophryotrocha, prominent axon terminals accumulate neurosecretory material in female-phase individuals. This material is not present in females after they have had social contact for 2 days and in males. After treatment with Formalin or glyoxylic acid, the axon terminals in isolated females are brightly fluorescent. The injection of reserpine into the coelomic cavity of such females prevents the development of fluorescence in the nerve endings. In an HPLC study of brains containing axon terminals filled with neurosecretory material, catecholamines were found to be present in large quantities. In specimens with empty axon terminals, the amount of catecholamines was significantly less. Thus the secretory material appears to contain catecholamines. The results presented suggest dopamine to be the major component of the neurosecretory material. PMID- 3666417 TI - Response surface of daily thyroid hormone rhythms in young chickens exposed to constant ambient temperature. AB - Response surface models were developed by multiple regression techniques to describe daily rhythms of plasma thyroid hormones in young chickens during acclimation to a wide range of ambient temperatures (Ta). Seventy-two Leghorn cockerels were raised in six environmental chambers under a 12L:12D light/dark cycle. Beginning at 21 days of age, two replicate chambers provided Ta treatments of 10, 24, or 38 degrees. During Day 6 of acclimation, blood samples were obtained at 0800, 1200, 1600, 2000, 2400, and 0400 hr for thyroid hormone analyses. Plasma triiodothyronine (T3) levels showed a convex response to the experimental region (10 to 38 degrees, and 0800 to 0400 hr under a 12L:12D light/dark cycle), whereas the plasma thyroxine (T4) response surface was concave. In particular, heat exposure (38 degrees) depressed (P less than .01) plasma T3 levels (2.8 ng/ml) below those of birds held at 24 degrees (4.5 ng/ml), whereas elevated (p less than 0.05) T3 concentrations were found in the 10 degrees treatment (5.0 ng/ml). Plasma T3 levels rose gradually during photophase and slowly declined during scotophase. Plasma T4 concentrations followed an opposite pattern with the daily zenith in scotophase and the nadir during photophase. Plasma T4 levels were sharply elevated in birds maintained at 38 degrees, particularly during scotophase. Although Ta did not change the daily amplitude or circadian frequency of the plasma T3 rhythm, an increased frequency or ultradian rhythm of plasma T4 was observed in cold-acclimated birds. The counter-responses of T3 and T4 to heat exposure and phase of the light/dark cycle were best seen in the molar ratio of plasma T3/T4 levels. The average daily T3/T4 molar ratio for heat-exposed birds was 0.16 while the average T3/T4 ratio was higher (P less than 0.01) for the 10 degrees (0.46) and 24 degrees (0.41) treatments. The opposing responses of plasma T3 and T4 levels to a wide range of Ta and phase of the light/dark cycle support a major role for circulating T3 in metabolic adjustments that chickens make to changes in the photothermal environment. PMID- 3666418 TI - In vivo effect of dopamine antagonists on melanocyte-stimulating hormone cells of the goldfish (Carassius auratus L.) pituitary. AB - Young goldfish were injected with three dopaminergic antagonists, pimozide, sulpiride, and domperidone, for 5 (low dose) and 7 days (higher dose). Cytological and immunocytochemical techniques using anti-alpha-melanocyte stimulating hormone (MSH) serum were applied to the pituitary. MSH cells in the three treated groups showed a decrease in immunoreactive cytoplasmic granules, a significant nuclear hypertrophy, and, after 7 days, a cellular enlargement. The nucleolus and the lamellar endoplasmic reticulum were more developed and some mitotic figures occurred. Erythrophores and occasional melanophores were in a stage of maximal dispersion. These changes were not apparent in the solvent injected controls. The responses to the three blockers of dopaminergic receptors were similar. These data suggest that MSH release seems to be under a dopaminergic inhibitory control in the goldfish. The other cell type of the pars intermedia (PAS-positive and calcium-sensitive in the goldfish) was not clearly affected by the three drugs. PMID- 3666419 TI - Effects of reserpine and chlorpromazine on the serotonin, norepinephrine, and epinephrine levels in the pineal-paraphyseal complex of soft-shelled turtles (Lissemys punctata punctata). AB - Turtles were injected intramuscularly with reserpine (0.5 mg/100 g body wt) and chlorpromazine (10 mg/100 g body wt) at 2400, 1800, and 0600 hr and were sacrificed at 6, 12, and 24 hr, respectively after the treatments, i.e., at 0600 hr. The spectrofluorometric findings revealed that the serotonin, norepinephrine, and epinephrine contents of the pineal-paraphyseal complex decreased at 6 hr, increased at 12 hr, and declined again at 24 hr after the treatments. It is suggested that reserpine and chlorpromazine act largely by favoring release with transient resynthesis of these amines in the pineal-paraphyseal complex of soft shelled turtles. PMID- 3666420 TI - Presence of thyroxine in eggs and changes in its content during early development of chum salmon, Oncorhynchus keta. AB - In order to examine the role of thyroid hormones during salmonid development, techniques were developed for quantitative extraction of thyroxine from eggs, whole embryos, and alevins of chum salmon (Oncorhynchus keta) at various stages of development. Frozen eggs, embryos, alevins, or fry were homogenized in ice cold methanol. The homogenate was centrifuged, and the supernatant was washed with a mixture of chloroform and 0.05% CaCl2. The aqueous layer was lyophilized, and the residue was redissolved in barbital buffer for thyroxine radioimmunoassay (RIA). Serial dilutions of the egg or tissue extracts gave inhibition slopes that were parallel to that of the thyroxine standard in the RIA. Immunoreactivity of the extracts coeluted with thyroxine standard in reverse-phase HPLC on an ODS column. Recovery of thyroxine from egg and tissue extracts was estimated from the recovery of 125I-labeled thyroxine added to the initial homogenates. Thyroxine content of eggs just after fertilization was 4-5 ng/egg, and this level was maintained until hatching. A decrease in thyroxine content was seen during yolk absorption. Total thyroxine increased to about 10 ng/fish, a level higher than that in the unfertilized egg, at the time of complete yolk absorption, and decreased within 10 days to a low level of 1 ng/fish. These findings are discussed in relation to the role of maternal thyroid hormones during early development and also to the onset of larval thyroid function. PMID- 3666421 TI - Steady-state analysis of alpha-melanotropin in the pars intermedia of Anolis carolinensis: effect of background adaptation. AB - The steady-state levels of alpha-melanotropin-stimulating hormone (alpha-MSH) related peptides were examined in the pars intermedia of the reptile Anolis carolinensis as a function of background adaptation. After a 7-day period, the content of immunoreactive alpha-MSH-related material in the pars intermedia of light-adapted animals was approximately fourfold higher than that of animals maintained on a dark background for the same period. The immunoreactive alpha-MSH related material present in the pars intermedia of light-adapted and dark-adapted animals was separately analyzed by gel filtration chromatography, reverse-phase HPLC, and cation-exchange chromatography. For light-adapted animals the major form of alpha-MSH had an apparent molecular weight of 1.5 kDa and a net charge of +4 at pH 3.5. Following reverse-phase HPLC this material eluted as a single peak of immunoreactivity with a retention time distinct from that of both mammalian ACTH(1-13)amide and N-acetyl-ACTH(1-13)amide. For dark-adapted animals a peak of alpha-MSH-sized material with an apparent molecular weight of 1.5 kDa was also detected. Following reverse-phase HPLC analysis this material eluted as an apparent single peak of immunoreactivity with a retention time distinct from that of the mammalian standards. Subsequent analysis of this major HPLC peak by cation exchange chromatography revealed the presence of at least two forms of immunoreactive alpha-MSH. These forms differed in relative proportions. The major peak of immunoreactivity had a net charge of +4, whereas the minor peak had a net charge of +3. The +3 immunoreactive form was not detected to any appreciable degree in light-adapted animals. PMID- 3666422 TI - Annual testicular activity in the gray partridge (Perdix perdix L.). AB - Seasonal changes in plasma androgens, testicular total protein content, gonosomatic index, and spermatogenic activity were studied in the grey partridge, Perdix perdix. Moreover, testicular androgen output after stimulation with ovine LH (oLH) was tested in vitro during different periods of the sexual cycle. Androgens and the gonosomatic index peaked in April, during which all the spermatogenic stages were observed. Total protein content in the testes was highest in January and March. Gonadal responsiveness to oLH was found to increase in the period April-May in coincidence with the hormone peak in the plasma, while February testes were irresponsive. PMID- 3666423 TI - Antidiuretic factor from the nervous corpora cardiaca of the migratory locust: improvement of an existing in vitro bioassay. AB - Nervous lobes of the migratory locust corpora cardiaca contain an antidiuretic (AD) factor which increases the fluid reabsorption of isolated recta in a dose dependent manner. Several extraction procedures were developed and compared. The very satisfactory thermostability of the AD factor was demonstrated. By using a succession of different incubating media on the same preparation, we improved our bioassay. The developed variant is faster and more sensitive than the existing test and saves time and biological material. PMID- 3666425 TI - Prolactin and growth hormone secretion during long-term incubation of the pituitary pars distalis of mature chum salmon, Oncorhynchus keta. AB - The effects of hypotonicity of the medium on prolactin (PRL) and growth hormone (GH) release from the pars distalis (PD) of mature chum salmon pituitary were examined during culture for 4 days. Large amounts of PRL and GH were released during the first 6 hr and secretion decreased rapidly thereafter. The amounts of GH released as well as the residual content in PD were 10 times greater than those of PRL. There was no difference in PRL or GH release between the PD incubated in isotonic medium (325 mOsm) and those in hypotonic medium (250 mOsm) even during the first 6 hr. Female PD secreted more PRL than male PD during the first 6 hr, whereas a sex difference was not observed in GH release. Considerable amounts of both PRL and GH remained in the PD at the end of the culture period. The amount of PRL released during 4 days of culture from female PD (37-39%) was greater than that from male PD (23-26%), and the amount of GH released was less in females (28-32%) than that in males (53-54%). Release of PRL and GH appears to be mainly under stimulatory hypothalamic control in the mature chum salmon. PMID- 3666424 TI - Annual reproductive cycle in the male red-sided garter snake, Thamnophis sirtalis parietalis: field and laboratory studies. AB - The reproductive cycle of male red-sided garter snakes (Thamnophis sirtalis parietalis) was studied in a laboratory-maintained population and in nature. Both populations exhibited a dissociated reproductive pattern in which spermatogenesis was initiated after the breeding season and sperm were stored in the vas deferens over winter. Although animals in both the laboratory and the field exhibited a dissociated reproductive pattern, temporal differences were evident in the two populations. Animals maintained in the laboratory initiated and completed spermiation much sooner than animals collected in the field. In the captive population, the renal sexual segment (RSS) could be identified but did not exhibit a seasonal fluctuation, indicating perhaps that androgen production was continuous, but at a reduced level. In nature, the RSS was hypertrophied at emergence, regressed following the breeding season, and again hypertrophied as circulating androgens increased in the fall, prior to hibernation. In both laboratory-maintained and field animals the circulating concentrations of testosterone and dihydrotestosterone at emergence were initially similar to the levels observed prior to hibernation but by 2 weeks postemergence had decreased to a relatively low level. Both the high androgen levels prior to hibernation and the rapid decrease during the spring courtship season may result from temperature influences on clearance rates. Plasma levels of corticosterone varied during the spring, first increasing upon emergence and then declining approximately 2 weeks following emergence. PMID- 3666426 TI - Induction of spermatogenesis and spermiation by a single injection of human chorionic gonadotropin in intact and hypophysectomized immature European eel (Anguilla anguilla L.). AB - Intact and hypophysectomized male silver eels (Anguilla anguilla) in fresh water received a single injection of human chorionic gonadotropin (hCG) (250 C) or solvent (0.15 M NaCl). No effect of solvent was observed. Spermatogonia proliferated in testis of hCG-treated intact or hypophysectomized eels. One month after the injection, primary and secondary spermatocytes were found. After 3 months, numerous spermatozoa were present. In hypophysectomized eels, hCG was also effective even though maturing germ cells were less numerous and spermiation was less frequent than in intact animals. Within 1 week after hCG injection, plasma levels of free and glucuroconjugated androgens (testosterone and 11 oxotestosterone) rose significantly in intact and hypophysectomized fish. The highest values were observed within 1 month, and then plasma levels decreased to pretreatment values. The most important changes were observed in the case of free 11-oxotestosterone. The long-term effects of hCG can be explained partly by the long half-life of this hormone. The effects of hypophysectomy on the response of testis to hCG caused us to think that some endogenous pituitary secretions must interfere in the intact fish so that maximal effects of hCG, especially on the induction of spermiation, are obtained. PMID- 3666427 TI - The influence of cytotoxins from Central Asian cobra venom and melittin from bee venom on the thermodynamic properties of phospholipid bilayer. AB - The interaction of cytotoxin Vc1 and Vc5 from Central Asian cobra and melittin from the bee venom with multilayer liposomes prepared from dimiristoylphosphatidylcholine with an addition of phosphatidic acid have been studied by the method of differential scanning calorimetry. Incorporation of Vc1, Vc5 and melittin into the lipid resulted in pronounced changes in the thermodynamic properties of the lipid. Polypeptides studied induced lateral phase separation in the lipid. Interaction between molecules of the toxins and the lipid resulted in the formation of a new lipid phase characterized by a higher melting temperature and lower phase transition enthalpy. PMID- 3666428 TI - On the direction of the diffusional electric field in a mucous layer. AB - A simple model of the mucous layer is used to illustrate the complex relationship of the diffusional electric field direction in the layer and parameters of the latter. It is shown that the field direction may depend not only on the ratios of mobile microion diffusivities but also on the characteristics of the layer (carboxylic group concentration and dissociation constant). The electric field direction is also shown to vary across the layer under appropriate conditions. The results are used to interpret the electrophoretic mechanism of the transport of macromolecules across the mucous layer on the surface of the digestive tract wall. PMID- 3666429 TI - Transcellular delta -mu H+ in Valonia ventricosa and its effect on delayed fluorescence. AB - The possible effect of the illumination-induced transcellular H+-gradient between the central vacuole and the external medium, on both the intensity and the kinetics of delayed fluorescence was studied by measuring both the membrane potentials and H+ fluxes across the plasmatic membranes, and the millisecond component of delayed fluorescence in single cells of the marine alga Valonia ventricosa. The kinetics of the formation of transcellular delta -mu H+ was shown to correlate with the induction kinetics of the millisecond component of delayed fluorescence. Disturbances of transcellular delta -mu H+ by electrical breakdown of the cell or by acidification of the external medium resulted in a decrease of the steady-state level of the light emission and in a decline of the minute oscillations observed in intact cells. The possible involvement of the membrane connections between the chloroplasts and the plasmatic membranes in the formation of transcellular delta-mu H+ is discussed. PMID- 3666430 TI - Megakaryocytes in rabbit pulmonary blood vessels. AB - Semiserial sections of lung capillaries of seven rabbits were examined for megakaryocytes. Triads of serial sections of each lobe were examined, and megakaryocyte counts per cm2 were determined. Median megakaryocyte count was determined for each lobe. The lobal values were used to calculate the was determined for each lobe. The lobal values were used to calculate the median cell counts for each experimental animal. Values of 0.16-0.64 megakaryocytes per cm2 were established as "normal". PMID- 3666431 TI - Secretory response to light in rat Harderian gland: possible photoprotective role of Harderian porphyrin. PMID- 3666432 TI - Endogenous sex hormone levels and breast cancer risk. AB - Sex-steroid hormones are a major determinant of the risk of breast cancer. We evaluated the relationship between obesity and endogenous estrogen levels in 79 healthy, postmenopausal women. Thirty-nine of the women were siblings of patients with postmenopausal-onset breast cancer; the remaining women were age-matched (+/ 10 yr) controls. Our hypothesis was that the siblings of the breast cancer patients would weigh more and that this excess weight would lead to higher serum estrone levels. The choice of unaffected family members of breast cancer patients reduces the concern that results may have been influenced by the cancer rather than antecedent to its development. Our findings demonstrated a statistically significant excess estrone level in the siblings compared to the controls (58.9 vs 47.8 pg/ml, P = 0.005). The siblings weighed 4.3 kg more than the controls. Matched pairs analysis (sibling-control), adjusting for weight, also showed significant differences in serum estrone levels. These differences were observed despite comparability in dietary intake, medication use, and personal medical history. These findings represent the first time that higher estrogen levels have been measured in siblings of postmenopausal breast cancer patients. This observation may represent an important link in our understanding of the relationship between genetic and environmental risk factors of breast cancer. One approach to subsequent genetic studies of breast cancer may be to focus on the possible biological determinants such as sex-steroid hormone level receptors, oncogenes, and gene products and not on the "familial aggregation" of breast cancer. PMID- 3666433 TI - Classification of rheumatoid arthritis: the importance of including data from the siblings. AB - A discriminant analysis has been applied to physical and laboratory data on a series of 37 patients with rheumatoid arthritis (RA). Good discrimination was found between RA when it was associated with organ-specific autoimmune phenomena and when it was not. When data from other members of the families was included there was consistently better discrimination than when using data from the patients alone. The results suggest that future studies of classification of variable diseases should include study of relatives. PMID- 3666434 TI - Tests of linkage and heterogeneity in Mendelian diseases using identity by descent scores. AB - When linkage between a recessive Mendelian disease and specific candidate genes is investigated, identity by descent scores in affected sib pairs may be used for tests of linkage and heterogeneity. Statistical tests for performing this analysis are presented. The efficiency and statistical power of the method are also investigated using computer simulations. PMID- 3666435 TI - Genetic epidemiology of myotonic dystrophy. AB - Prevalence rate of myotonic dystrophy (DM) was estimated in a large sample of the Italian population. Segregation analysis of the affected families suggests that subjects showing minor clinical signs, even in the absence of myotonic features, should be considered as bearers of the DM trait. An apparent excess of normal sibs among the offspring of DM subjects may be due to the late onset of the disease and possibly to a partial loss of affected individuals from the sample before diagnosis. Prevalence rate of DM in this study is estimated between 69 to 90 per million inhabitants; accordingly, DM might be the most frequent inherited neuromuscular disorder in human populations. PMID- 3666436 TI - A genetic analysis of clubfoot in Hawaii. AB - The roles of major genes and multifactorial inheritance in the etiology of clubfoot (talipes equinovarus) were investigated based on 365 nuclear families consisting of three major racial groups of Hawaiians, Caucasians, and Orientals in Hawaii. Complex segregation analysis was employed using the mixed model with four parameters: major gene displacement (t), degree of dominance (d), gene frequency (q), and heritability (H). Heterogeneity was evident among the racial groups in the pattern of segregation of clubfoot. The most plausible genetic model is the presence of major gene effects with the multifactorial component for the Hawaiian and Caucasian groups, whereas no major gene action is evident for the Oriental group. PMID- 3666437 TI - Age and prevalence of sickle-cell trait in a large ambulatory population. AB - We performed hemoglobin electrophoresis in 30,400 apparently healthy black individuals in the Washington D.C. Metropolitan area, who were participating in a community based sickle-cell screening program during the period 1978-1985. The overall prevalence of sickle-cell trait was 6.7%. The frequency of sickle-cell trait in various age groups, which included young children, adults, and individuals over 65 years of age, ranged from 6.4 to 7.4%. There were no statistically significant differences in the prevalence of sickle-cell trait among the various age groups, nor did we detect a significant trend for increasing or decreasing sickle cell frequency with advancing age (P = 0.418). Thus, in this population sickle-cell trait appears to have no effect on longevity. If the various complications of sickle-cell trait reported in the literature are not fortuitous, their frequency and/or severity must be too low to affect prevalence figures. PMID- 3666438 TI - Polymorphism of unique noncoding DNA sequences in wild and laboratory mice. AB - Two DNA probes, D17Tu1 and D17Tu2, were isolated from a genomic DNA library containing only two mouse chromosomes, one of which is chromosome 17, carrying the major histocompatibility complex (H-2), as well as the t complex genes. The D17Tu1 probe was mapped to the centromeric region of chromosome 17 and the D17Tu2 probe to the S region of the H-2 complex. Neither of the two probes appeared to detect any genes, but both contained unique, nonrepetitive sequences. Typing of DNA obtained from a large panel of mice revealed the presence of four D17Tu1 patterns in inbred mouse strains, one very common, one less common, and two present in one strain each. The two common patterns could not be detected in appreciable frequencies in the European wild mice tested (one of the two patterns was, however, found in Australian wild mice). Conversely, the patterns found frequently in European wild mice are absent in the laboratory mice. We therefore conclude that wild mice from the sampled regions of Europe could not have provided the ancestral stocks from which inbred strains were derived. Only one D17Tu1 pattern was found in all the populations of Mus musculus tested, while eight patterns were found in Mus domesticus, with virtually all the populations being polymorphic. We suggest that this difference reflects different modes in which the two species colonized Europe. The distribution of the D17Tu2 patterns in inbred strains correlates with the distribution of H-2 haplotypes. PMID- 3666439 TI - Nucleo-cytoplasmic interaction during macronuclear differentiation in ciliate protists: genetic basis for cytoplasmic control of SerH expression during macronuclear development in Tetrahymena thermophila. AB - A novel class of mutations affecting the developmental expression of SerH cell surface antigen genes of Tetrahymena thermophila is described. Unlike previous categories of mutation, the four independently isolated mutations of this class act through the cytoplasm to affect SerH genes during macronuclear development. That is, macronuclei which develop under the influence of mutant cytoplasm do not subsequently express H, most likely because the developmental processing of SerH genes is affected. The cytoplasmic effect is specific for the SerH locus and is independent of which SerH allele is present. In place of H, hitherto unknown antigens are expressed. Expression of SerH can be rescued during development either by wild-type cytoplasm exchanged between conjugants or by the homozygous wild-type genotype. The mutations segregate independently of the SerH genes and identify one, possibly two, bistable genes. Possible models to explain these results are discussed. PMID- 3666440 TI - Genetic analysis of X-chromosome dosage compensation in Caenorhabditis elegans. AB - We have shown that the phenotypes resulting from hypomorphic mutations (causing reduction but not complete loss of function) in two X-linked genes can be used as a genetic assay for X-chromosome dosage compensation in Caenorhabditis elegans between males (XO) and hermaphrodites (XX). In addition we show that recessive mutations in two autosomal genes, dpy-21 V and dpy-26 IV, suppress the phenotypes resulting from the X-linked hypomorphic mutations, but not the phenotypes resulting from comparable autosomal hypomorphic mutations. This result strongly suggests that the dpy-21 and dpy-26 mutations cause increased X expression, implying that the normal function of these genes may be to lower the expression of X-linked genes. Recessive mutations in two other dpy genes, dpy-22 X and dpy 23 X, increase the severity of phenotypes resulting from some X-linked hypomorphic mutations, although dpy-23 may affect the phenotypes resulting from the autosomal hypomorphs as well. The mutations in all four of the dpy genes show their effects in both XO and XX animals, although to different degrees. Mutations in 18 other dpy genes do not show these effects. PMID- 3666441 TI - Nucleotide sequence of the Adh gene region of Drosophila pseudoobscura: evolutionary change and evidence for an ancient gene duplication. AB - The alcohol dehydrogenase (Adh) locus (ADH; alcohol: NAD+ oxidoreductase, EC 1.1.1.1) of Drosophila pseudoobscura was cloned and sequenced. Forty-five percent of the "effectively silent sites" have changed between Adh in D. pseudoobscura of the obscura species group and the homologous DNA sequence in D. mauritiana, the latter representing the melanogaster species group. The untranslated leader sequence of the adult transcript of D. pseudoobscura has two deletions relative to the D. mauritiana message. The ADH protein sequences of D. pseudoobscura is missing the third and fourth amino acids at the N-terminus relative to the D. mauritiana enzyme. Of the remaining 254 amino acid positions, 27 (10.64%) differ between the two species. Amino acid replacements are randomly distributed into hydrophilic and hydrophobic domains of ADH. However, replacement substitutions are distributed nonrandomly across the three exons among D. pseudoobscura and members of the melanogaster subgroup, suggesting that functional constraints across the exons are different. Surprisingly, silent substitutions are also nonrandomly distributed with the third exon being the most divergent. This pattern suggests possible selective constraints on supposedly neutral silent substitutions and/or variation in underlying mutation rates across the gene. The presence of transcriptional and translational signals at the beginning and end of conserved sequences 3' to Adh implies the existence of a previously undescribed gene. Codon usage and patterns of nucleotide divergence are consistent with a protein coding function for this gene. In addition, conservation of nucleotide and amino acid sequence and similarity in hydropathy plots suggests that the gene 3' to Adh represents an ancient duplication of the Adh gene. PMID- 3666442 TI - Genetic organization of the agouti region of the mouse. AB - The agouti locus on mouse chromosome 2 acts via the hair follicle to control the melanic type and distribution of hair pigments. The diverse phenotypes associated with various agouti mutations have led to speculation about the organization of the agouti locus. Earlier studies indicated that two presumed agouti alleles, lethal yellow (Ay) and lethal light-bellied nonagouti (ax), are pseudoallelic. We present genetic data showing probable recombination between Ay and three agouti mutations (at, a, and ax), which suggest that Ay is a pseudoallele of the agouti locus. The close linkage of an endogenous ecotropic murine leukemia provirus, Emv 15, to Ay provides a molecular access to genes at or near the agouti locus. However, previous studies suggested that the Emv-15 locus can recombine with some agouti alleles and therefore we analyzed mice from recombinant inbred strains and backcrosses to measure the genetic distance between various agouti alleles and the Emv-15 locus. Our data indicate that the Emv-15 locus is less than 0.3 cM from the agouti locus. These experiments provide a conceptual framework for initiating chromosome walking experiments designed to retrieve sequences from the agouti locus and give new insight into the genetic organization of the agouti region. PMID- 3666443 TI - The allelic correlation structure of Gainj- and Kalam-speaking people. II. The genetic distance between population subdivisions. AB - The patterning of allele frequency variability among 18 local groups of Gainj and Kalam speakers of highland Papua New Guinea is investigated using new genetic distance methods. The genetic distances proposed here are obtained by decomposing Sewall Wright's coefficient FST into a set of coefficients corresponding to all pairs of population subdivisions. Two statistical methods are given to estimate these quantities. One method provides estimates weighted by sample sizes, while the other method does not use sample size weighting. Both methods correct for the within-individual and between-individual-within-groups sums of squares. Genetic distances among the Gainj and Kalam subdivisions are analyzed with respect to demographic, geographic, and linguistic variables. We find that a demographic feature, group size, has the greatest demonstrable association with the patterning of genetic distances. The pattern of geographic distances among groups displays a weak congruence with the pattern of genetic distances, and the association of genetic and linguistic diversity is very low. An effect of differences in group size on genetic distances is not surprising, from basic theoretical considerations, but genetic distances have not often been analyzed with respect to these variables in the past. The lack of correspondence between genetic distances and linguistic and geographic differences is an unusual feature that distinguishes the Gainj and Kalam from most other tribal populations. PMID- 3666444 TI - Dominance, pleiotropy and metabolic structure. AB - It is a common observation that most mutants have similar dominance relations for all the characters they are known to affect. As a model of pleiotropic effects we investigate a branched pathway where the two outputs represent two characters whose variation is affected by changes in any of the genetically specified enzymes in the system. We consider the effects on the phenotype (fluxes or intermediate metabolites) of substitutions at one locus represented by enzyme activities of the two homozygotes (mutant and wild type) and that of the heterozygote. Dominance indices for the characters pleiotropically connected by the metabolic system are calculated. We show that if enzymes behave 'linearly,' (first order), that is if saturation and feedback inhibition or other nonlinearities are absent, all fluxes and pools have identical dominance relations. The presence of such nonlinearity, however, leads to differences in dominance between different characters and we define the conditions where such differences can be important. PMID- 3666445 TI - Gametic disequilibrium measures: proceed with caution. AB - Five different measures of gametic disequilibrium in current use and a new one based on R. C. Lewontin's D', are examined and compared. All of them, except the measure based on Lewontin's D', are highly dependent upon allelic frequencies, including four measures that are normalized in some manner. In addition, the measures suggested by A. H. D. Brown, M. F. Feldman and E. Nevo, and T. Ohta can have negative values when there is maximum disequilibrium and have rates of decay in infinite populations that are a function of the initial gametic array. The variances were large for all the measures in samples taken from populations at equilibrium under neutrality, with the measure based on D' having the lowest variance. In these samples, three of the measures were highly correlated, D2, D (equal to the correlation coefficient when there are two alleles at each locus) and the measure X(2) of Brown et al. Using frequency-dependent measures may result in mistaken conclusions, a fact illustrated by discussion of studies inferring recombinational hot spots and the effects of population bottlenecks from disequilibrium values. PMID- 3666446 TI - On the theory of partially inbreeding finite populations. I. Partial selfing. AB - Some stochastic theory is developed for monoecious populations of size N in which there are probabilities beta and 1 - beta of reproduction by selfing and by random mating. It is assumed that beta much greater than N-1. Expressions are derived for the inbreeding coefficient of one random individual and the coefficient of kinship of two random separate individuals at time t. The mean and between-lines variance of the fraction of copies of a locus that are identical in two random separate individuals in an equilibrium population are obtained under the assumption that there is an infinite number of possible alleles. It is found that the theory for random mating populations holds if the effective population number is Ne = N'/(1 + FIS), where FIS is the inbreeding coefficient at equilibrium when N is infinite and N' is the reciprocal of the probability that two gametes contributing to random separate adults come from the same parent. When there is a binomial distribution of successful gametes emanating from each adult, N' = N. An approximation to the probability that an allele A survives if it is originally present in one AA heterozygote is found to be 2(N'/N)(FISS1 + (1 - FIS)S2), where S1 and S2 are the selective advantages of AA and AA in comparison with AA. In the last section it is shown that if there is partial full sib mating and binomial offspring distributions Ne = N/(1 + 3FIS). PMID- 3666447 TI - [Expression of genome repetitive sequences in rat bone marrow cells: cloning and characteristics of cDNA-copies of L1 element transcripts]. AB - Recombinant cDNA clones containing the repetitive sequences of major retroposon families--ID, B2 and L1--were isolated from the cDNA bank of rat brain. Their organization was studied by sequencing and hybridization analysis. It was shown for L1 that: 1) its transcripts are mainly found in the fraction of poly(A) +mRNA; 2) there is a population of full-length elements present in the rat genome. We also tried to estimate the copy number of these elements. Some aspects of their organization are discussed. PMID- 3666448 TI - [The role of metabolic and regulatory factors in the mutagenic activity of purine derivatives in microorganisms]. AB - The results concerning analysis of the mutagenic activity of analogues of nitrogen bases are given for Saccharomyces cerevisiae, Streptomyces antibioticus, Bacillus subtilis. The mutagenic activity of purine derivatives depends on their metabolic transformations in cell and on the activity of enzyme systems, involved in regulation of purine biosynthesis. The criterion of selection of purine analogues with genetic activity is proposed for yeasts, based on retroinhibitory ability of analogues of nitrogen bases. PMID- 3666449 TI - [Immunogenetics of immunoglobulins of the American mink. VI. Deviation from Mendelian segregation for Cgamma-allotypes H2, H3 and H4]. AB - The non-expression of parental allotype among mink F1 offsprings of monohybrid analyzing crosses was established for C gamma-allotypes. A phenotype ratio 0:1, instead of the expected Mendelian 1:1, was observed in some families. The non expression of allotype may occur in the progeny of mink with normal allotypic specificity. Deviations of allotypic expression had both qualitative and quantitative nature and did not depend on the direction of crossings. Sometimes, the appearance of allotype in a mink could not be expected on the basis of its pedigree. Instability of expression and inheritance of H2, H3 and H4 in many families may have masked the allelic or linkage relationships of these genetic markers. PMID- 3666450 TI - Chromosome segregation from cell hybrids. III. Segregation is independent of spindle constitution. AB - Hamster beta-tubulin (detected as a mutant subunit that confers Colcemid resistance) is either not expressed or is underexpressed in Chinese hamster-mouse somatic cell hybrids. This selectivity of tubulin expression suggests that a uniparental mouse spindle might preferentially engage mouse chromosomes and lead to loss of hamster chromosomes. However, the repression of hamster tubulin was found to have no bearing on the direction of chromosome segregation occurring in eight hybrids studied, some of which segregated predominantly mouse and other hamster chromosomes. PMID- 3666451 TI - Idiograms of horse chromosomes at prometaphase, early metaphase, and midmetaphase after R-banding by BrdU incorporation followed by the fluorochrome-photolysis Giemsa technique. AB - We present three idiograms of equine chromosomes, R-banded after BrdU incorporation and stained by the fluorochrome-photolysis-Giemsa technique. The haploid set of prometaphasic chromosomes shows 591 bands (range 7-38 per chromosome), the early metaphasic set 404 (range 5-26), and the midmetaphasic set 272 (range 3-18). Following cell synchronization with thymidine, more than twice as many R-bands were revealed on the resulting prometaphasic chromosomes, making possible the establishment of a very accurate and characteristic representation of this banding pattern in the domestic horse. PMID- 3666452 TI - The meiotic stage of preovulatory oocytes in mares. AB - Confusion exists as to whether the oocytes of the domestic horse are ovulated at the first meiotic metaphase (MI) or the second (MII). In this study eight oocytes were collected from the preovulatory follicles of 16 mares 36 h after human chorionic gonadotropin CG treatment. Six of the eight oocytes were judged to be at MII by the presence of the first polar body and this judgement was confirmed by semithin sectioning in one. Of the two that had no polar body, one was found to be at MII after fixation for chromosomal analysis and the meiotic stage of the other remained undetermined. Since all seven oocytes yielding conclusive evidence were at MII, it was concluded that horse oocytes, like those of most mammals studied, are ovulated after completion of the first meiotic division and formation of the first polar body. PMID- 3666453 TI - Facing the costs of caring. PMID- 3666455 TI - Coping with incontinence. PMID- 3666454 TI - Clothed for continence. PMID- 3666456 TI - Medical snubbing. PMID- 3666457 TI - A rice glutelin and a soybean glycinin have evolved from a common ancestral gene. AB - A cDNA clone covering the entire coding region for a glutelin subunit precursor has been identified from a library of endosperm-developing rice cDNA clones using a mixed oligodeoxynucleotide probe, and then by immunoprecipitation of hybrid selected translation product with an antiserum against the acidic polypeptides of the glutelin. Analysis of the cDNA insert revealed that rice glutelin is synthesized as precursor polypeptides which undergo post-translational processing to form the nonrandom polypeptide pairs, like glycinin precursors of soybean. By comparing the predicted protein sequence of this precursor from monocots with that of glycinin A1aB1b precursor from dicots, it was found that the overall 32% of the amino acid positions are identical in both proteins. Because regions which show identities are dispersed throughout both molecules, the similarity is not due to convergent evolution, but to divergence evolution from a common ancestral gene. PMID- 3666459 TI - Primary care geriatrics: toward medicine's mainstream. PMID- 3666458 TI - Isolation and characterization of the porcine growth hormone gene. AB - A cosmid clone containing the entire porcine growth hormone (PGH) gene has been isolated using a full-length PGH cDNA as the hybridization probe. The gene within the cosmid was subcloned into plasmids and completely sequenced. The coding, promoter, and both 5'- and 3'-noncoding sequences of the PGH gene were found to be highly conserved when compared to the previously sequenced genes coding for rat, human and bovine growth hormones, and also to the human placental lactogen gene. The high degree of conservation between the 5'- and 3'-noncoding regions of the genes from these different species indicates that growth hormone genes may be evolving by some unusual mechanism. The PGH gene was found to contain the unusual variant GC donor splice site. PMID- 3666460 TI - Evaluating the elderly patient: some overlooked aspects. PMID- 3666461 TI - Osteoarthritis as a misdiagnosis in elderly patients. AB - Musculoskeletal disorders are very common in the elderly, and x-ray evidence of irreversible damage due to osteoarthritis is found in probably all older people. Thus, when confronted by various pain symptoms in an older patient, the physician must always include osteoarthritis in the differential diagnosis. However, potentially reversible causes for the problem are too often ignored, and a misdiagnosis of osteoarthritis prevents or delays effective treatment of the actual underlying problem, with potentially serious consequences. Six case studies are offered illustrating this problem and pointers in differential diagnosis are suggested. PMID- 3666462 TI - Fluid and electrolyte balance in the elderly. AB - It is increasingly evident that many disorders common in the aging individual may be accompanied by disturbances of fluid and sodium balance, especially hyponatremia. Physiological alterations in water and sodium regulation have been identified as part of the normal aging process which may contribute to the relative frequency of fluid and electrolyte disorders in the elderly. Hyponatremia may present with a wide variety of symptoms and may be a clue to the existence of an underlying major disease process. Treatment involves both acute and long-term management based on identification of the causative disorder and understanding of the pathophysiologic mechanism which has led to development of hyponatremia. PMID- 3666463 TI - Drug therapy in the elderly: special considerations. AB - The tendency toward polypharmacy in the elderly, combined with age-related physiologic changes, increases the risk for adverse effects resulting from the interference of one drug regimen with another. Altering drug dosages for concomitant drug regimens is important if the patient is to gain maximum benefit from the drugs with minimal adverse effects. Altered pharmacokinetics in the elderly, impaired drug response, and adverse effects of polypharmacy are each discussed with respect to drug absorption, distribution, metabolism, and elimination. PMID- 3666464 TI - Steven R. Mostow, MD: why vaccinate the elderly?. Interview by Richard L. Peck. PMID- 3666465 TI - A report from an Interdisciplinary Conference on Mental Health and Aging. PMID- 3666466 TI - The physician and home care of the elderly patient. PMID- 3666467 TI - Educating professionals to understand religious sponsorship of long term care facilities. PMID- 3666468 TI - The content of textbooks in geriatric medicine: some directions for improvement. PMID- 3666469 TI - A national media awards competition in gerontology and geriatrics. PMID- 3666470 TI - Innovative approaches in teaching gerontological nursing. PMID- 3666471 TI - The goals of master-level gerontological students: an institutional study. PMID- 3666472 TI - Treatment of retinal detachment with congenital optic pit by krypton laser photocoagulation. AB - Five patients with a congenital pit of the optic nerve and serous detachment of the macular retina were treated with krypton laser photocoagulation to the juxtapapillary region in an attempt to induce resolution of the retinal detachment. The subretinal fluid resolved after laser therapy in four of the patients. In the fifth, the retinal detachment was successfully treated with pars plana vitrectomy. One patient developed a macular hole and decreased visual acuity, despite resolution of the subretinal fluid. PMID- 3666473 TI - Nd-YAG laser treatment in preretinal macular fibrosis. AB - Three eyes with preretinal macular fibrosis (PMF) were treated with the Q switched Nd-YAG laser. The PMF was idiopathic in two eyes and associated with a vitreous hemorrhage, due to ocular trauma, in the third eye. The three eyes had in common a partial posterior vitreous detachment with vitreous traction on the macula. The Nd-YAG laser beam was focused on the detached posterior hyaloid in front of the macular region. Some holes were made in this membrane or in the adjacent collapsed vitreous cortex. Treatment increased the visual acuity in the three eyes; the vitreous remained partially detached in the two eyes with idiopathic PMF and detached completely in the eye with the secondary PMF. The disentanglement of the fovelar area was revealed by the unfolded appearance of the retinal vessels on fluoangiography. PMID- 3666474 TI - Nutritional amblyopia. A histopathologic study with retrospective clinical correlation. AB - During a 10-year period ending in 1985, we observed atrophy of the maculopapillary bundle in both eyes of 25 cases examined post mortem. We retrospectively examined the clinical history and general autopsy findings for evidence of malnutrition. An adequate clinical history was obtained in 24 patients, and an autopsy was performed on 21 patients. Our review disclosed that all 25 patients had marked nutritional deprivation, most commonly from alcohol abuse (20 patients), advanced carcinoma (8 patients, 7 of whom were also alcohol abusers), and other malnutritional and disabling conditions (4 patients). A history of heavy smoking was documented in 11 patients. Our findings support the contention that dietary deficiency plays a role in the pathogenesis of the condition that in the past has been referred to as tobacco-alcohol amblyopia and more recently has been called nutritional amblyopia. PMID- 3666475 TI - The ability of salbutamol and theophylline to suppress immediate allergic conjunctivitis in the guinea pig. AB - Topically administered salbutamol was extremely effective in suppressing immediate allergic conjunctivitis in the guinea pig; a dose as low as 0.1% elicited 98% inhibition. Topical pretreatment with 1% propranolol completely blocked the suppressant action of 0.1% salbutamol. This was also the case after systemic propranolol (1 mg/kg SC); the beta-adrenoceptor antagonist itself has no effect on antigen-induced inflammation. The effect of 0.1% salbutamol was unaltered by pretreatment with the specific beta 1-adrenoceptor antagonist betaxolol (1 mg/kg SC). In marked contrast, the suppressant action of 0.1% salbutamol was profoundly inhibited by pretreatment with the selective beta 2 adrenoceptor antagonist ICI-118,551 (0.5 mg/kg SC). The experiments employing beta-adrenoceptor antagonists unequivocally demonstrate that the salbutamol suppression of immediate allergic conjunctivitis in the guinea pig is mediated via the activation of beta 2-adrenoceptors. The methylxanthine phosphodiesterase inhibitor theophylline was active after oral administration, 50 mg/kg eliciting an 80% inhibition. Theophylline was inactive topically at 1% and 5%, but this could be due to the fact that the compound was insoluble at these concentrations. Thus, procedures that elevate cyclic-AMP levels suppress immediate hypersensitivity reactions in the guinea pig conjunctiva. Whether or nor this offers an alternative approach to treat allergic conjunctivitis in humans remains to be determined. PMID- 3666476 TI - Lysosomal enzymes in tear fluids from patients with Terrien's marginal corneal degeneration. AB - We examined biochemically the lysosomal enzyme activities in tear fluids from patients with mild myopia, senile cataract, and Terrien's marginal corneal degeneration. Tear acid phosphatase activities in Terrien's degeneration were almost the same as those in mild myopia and senile cataract, while those of N acetyl-beta-D-glucosaminidase in Terrien's degeneration were higher. The high activity of tear N-acetyl-beta-D-glucosaminidase may be derived from the lacrimal gland and infiltrate histiocytelike cells in Terrien's marginal corneal degeneration. PMID- 3666477 TI - Effectiveness of silicone oil removal from rabbit eyes. AB - Silicone oil (1000 and 12,500 cs) and fluorosilicone oil (1000 and 10,000 cs) were dyed red and injected into a gas-created space in the vitreous cavity of 51 rabbit eyes. Later the oils were removed from the vitreous cavity either by lavage with balanced salt solution (group 1, 27 eyes) or by injecting a sodium hyaluronate solution, followed by lavage with balanced salt solution (group 2, 24 eyes). The average amount of oil retained in the vitreous cavity in group 1 was 0.0675 ml, and occasionally a large amount of oil was found (more than 0.1 ml in 30% of eyes). The average amount of oil retained in group 2 was 0.0114 ml, and no eye retained more than 0.1 ml of oil. The difference between the two groups was statistically significant (p less than 0.02), but there was no significant difference in oil retention within either group between the different kinds of oils, or between different viscosities of oil. The data suggest that residual oil can persist in the vitreous cavity despite thorough lavage, and that removal of silicone oil with the use of a sodium hyaluronate solution significantly lowers the risk of a large amount of residual silicone oil that is occasionally seen with conventional removal methods. PMID- 3666478 TI - Subretinal strands. Tissue culture and histological study. AB - Subretinal strands in proliferative vitreoretinopathy removed during vitreous surgery in ten cases were studied histologically; tissue culture was taken from five of the ten cases to obtain more material for investigation. Tissue culture was successful in all five cases. The cultured tissue just next to the original strand preserved the characteristics of the original tissue, whereas the portion distal from the original strand did not. Definite and/or suspected retinal pigment epithelial cells (RPE) were found in seven of ten original strands and four of five samples of cultured material. RPE were considered to be a predominant component of subretinal strands. PMID- 3666479 TI - Incidence of acute glaucoma in Finland from 1973 to 1982. AB - The incidence of acute closed-angle glaucoma was studied in 1796 patients derived from the hospital discharge registry of Finland for the years 1973-1982 (469 males and 1327 females). The average incidence was 3.8 cases/100,000 per year. The incidence showed a steep rise with age. The highest incidence was observed in both sexes in the group 80 years of age and older. The incidence was higher (Chi square 7.81, df = 1, P less than 0.01) among women (5.3/100,000 per year) than among men (2.0/100,000 per year). The age-adjusted incidence for the whole period of 1973-1982 showed no statistically significant rise. The seasonal variation of incidence was statistically significant (P less than 0.001). In winter (December, January, February) and in autumn (September, October, November) the incidences were higher compared to spring (March, April, May) and summer (June, July, August). This association was greater (P less than 0.001) among females than among males (P less than 0.05). Mean sunshine hours showed a reverse association with the incidence of acute glaucoma. The association was statistically significant when both sexes were pooled together (P less than 0.001). There was no sex interaction with regard to the association of incidence of acute glaucoma and mean sunshine hours. PMID- 3666480 TI - A method of measuring pupil-blocking force in the human eye. AB - A new method of measuring pupil-blocking force in the human eye is reported. The anterior segment of the eye was photographed using a slit-lamp apparatus and the color photographs then analyzed with a digitizer for converting the optical image of the anterior eye segment into the true image using a computer. This technique permits precise estimation of the relative positions of the anterior chamber, such as pupil margins, iris root insertions, and central anteroposterior pupillary axis. Pupil-blocking force was calculated from these data according to Hook's law. There was a statistically significant difference in pupil-blocking force between normal subjects (mean +/- SD, -0.027 +/- 0.029 lambda; lambda = Young's module) and patients with primary angle-closure glaucoma (mean +/- SD, +0.134 +/- 0.068 lambda) (P less than 0.001). In patients with primary angle closure glaucoma, during an acute attack the pupil-blocking force was markedly high. This technique for measuring pupil-blocking force will provide valuable data for the analysis of the mechanism of primary angle-closure glaucoma. PMID- 3666481 TI - The use of psychophysical, structural, and electrodiagnostic parameters to identify glaucomatous damage. AB - Fifty-one patients with early glaucoma and 29 patients without the disease had their contrast sensitivity, colour vision, differential light threshold, neuroretinal rim area, retinal nerve fibre layer, pattern-reversal electrogram and visually evoked potential examined. A stepwise discriminant analysis found that the combination of the vertical cup disc ratio, the diffuse nerve fibre layer score and the localized nerve fibre layer score correctly identified 98% of the normals and 84% of the glaucoma patients. Single parameters and various combinations of parameters were also examined for their ability to discriminate between the two groups. Fifty-two glaucoma suspects were similarly examined and were classified into those whose discriminant functions were normal or abnormal. PMID- 3666482 TI - Ultrastructure of the human posterior tunica vasculosa lentis during early gestation. AB - In human embryos with a gestational age of from 7.6 to 14.0/15.0 weeks, the posterior tunica vasculosa lentis (TVL) was examined by both scanning and transmission electron microscopy. Even at the very early age of 7.6 weeks the tunica was found to be fully developed. It consisted of a radiating network of tortuous capillaries. Their walls were composed of a continuous layer of endothelial cells, surrounded by a basement membrane and a discontinuous sheath of pericytes. The thickness of the basement membrane increased with increasing gestational age. As opposed to previous studies, the endothelial cells exhibited transitory fenestrations. In the neighborhood of the posterior TVL macrophages were found. PMID- 3666483 TI - [Physico-chemical transformations of the dust of industrial discharges and their hygienic significance]. PMID- 3666484 TI - [Possible approaches to the hygienic standardization of microwaves taking into account the results of cytogenetic research]. PMID- 3666485 TI - [Effectiveness of therapeutic and health-promoting measures with workers employing plasma technology]. PMID- 3666486 TI - [Standardization of human gravitational loads]. PMID- 3666487 TI - [Hygienic evaluation of electromagnetic fields in the 17-cm range based on research data on behavioral reactions]. PMID- 3666488 TI - [Decontamination of milk containing pesticide residues]. PMID- 3666489 TI - [Survival of opportunistic and pathogenic agents of infectious intestinal diseases in railroad ballast]. PMID- 3666490 TI - [Hygienic evaluation of working conditions in the manufacture of technological laser assemblies]. PMID- 3666491 TI - [Determination of air exchange in the undergarment space through he designed looseness of clothing using radioactive aerosols]. PMID- 3666492 TI - [Current problems in propagandizing a healthy life style]. PMID- 3666493 TI - [Comparative evaluation of gas chromatographic and photometric methods for determining chloropicrin in water]. PMID- 3666494 TI - [Quantitative determination of 4,4'-dipyridyl in water and air]. PMID- 3666495 TI - [Dependence of the statistical parameters of the complex and combined actions of surface-active substances on the value of the acute lethal dose]. PMID- 3666496 TI - [Mathematical modelling of poisoning from repeated exposure]. PMID- 3666497 TI - [Effect of animal husbandry sewage on the operating efficiency of municipal sewer installations for biological treatment]. PMID- 3666498 TI - [Hygienic characteristics of decorative facing materials made from the wastes of kinescope manufacture]. PMID- 3666499 TI - [Current problems of biomedical research in hygiene in light of the acceleration in scientific and technical progress]. PMID- 3666500 TI - [Joint work of a district epidemiological health station and the Standing Committee of the local Soviet of People's Deputies in protecting nature]. PMID- 3666501 TI - [Medical and health services for workers in agricultural production in the Carpathian Mountain region]. PMID- 3666502 TI - [Possible pollution of groundwater aquifers from the use of zenkor]. PMID- 3666503 TI - [Hygienic standardization of cuprous chloride in the atmosphere of populated places]. PMID- 3666504 TI - [Assessment of the effectiveness of sanitary improvement measures at a machine building plant during the 11th Five-Year Plan]. PMID- 3666505 TI - [Sanitary microbiological characteristics of Black Sea mussels in areas where they are cultivated]. PMID- 3666506 TI - [Toxicological characteristics of a new nitrification inhibitor, N-[6 chlorohexyl]-carbamoyl-3(5)-methylpyrazole]. PMID- 3666507 TI - [Morphological and morphometric research on the liver of rats with chronic phosphorus poisoning under different nutritional conditions]. PMID- 3666508 TI - [Effect of working conditions on the health status of workers manufacturing bromine and its derivatives]. PMID- 3666509 TI - [Toxicity of new dye derivatives of pyrazolone and hydroxynaphthoic acid and their solvent isoamylphthalimide]. PMID- 3666510 TI - [Toxicological characteristics of hydroxyethylated diisononyl phenol]. PMID- 3666511 TI - [Role of the design of children's outer winter clothing in the total insulating effect]. PMID- 3666513 TI - [Prediction of the toxicity of substances in water based on structure-activity relationship]. PMID- 3666512 TI - [Effect of the combined action of chemical pollutants and stress on changes in the morphobiochemical indices of the animal liver]. PMID- 3666514 TI - Generation of excited species catalyzed by horseradish peroxidase or hemin in the presence of reduced glutathione and H2O2. AB - Horseradish peroxidase (HRP) (EC 1.11.1.7) catalyzes the oxidation of reduced glutathione. This reaction is accompanied by light emission, which is attributed to the generation of singlet oxygen. The chemiluminescence is directly related to thiyl radical formation, as deduced from the correlation between the time course of HRP-compound II formation and light emission in the presence of different amounts of H2O2. Superoxide dismutase has an inhibitory effect on the chemiluminescence without affecting the HRP-compound II formation. This indicates the direct involvement of superoxide radicals in the production of photoemissive species. Replacement of HRP by hemin is also accompanied by chemiluminescence. PMID- 3666515 TI - Halogenated compounds as inducers of lipid peroxidation in tissue slices. AB - Twenty-seven halogenated compounds were screened as potential inducers of lipid peroxidation in rat liver, kidney, spleen, and testes slices. In addition to the known lipid peroxidation inducers--carbon tetrachloride and bromotrichloromethane -the novel compounds carbon tetrabromide, p-bromobenzyl bromide, and benzyl bromide increased lipid peroxidation in each of the tissues studied. Lipid peroxidation was measured by release of thiobarbituric acid-reactive substances (TBARS) from the tissue slices. The amount of TBARS released from liver slices incubated with bromotrichloromethane, carbon tetrabromide, dichloromethane, bromobenzene, chloroform, bromoform, benzyl chloride, bromochloromethane, and carbon tetrabromide correlated with the lethality of these compounds as evaluated by their oral LD50 in rats. The lethality of a number of the compounds tested did not correlate with their capacity to induce lipid peroxidation. PMID- 3666516 TI - Effects of paraquat on the green alga Dunaliella salina: protection by the mimic of superoxide dismutase, Desferal-Mn(IV). AB - Paraquat caused a time-, dose-, and light-dependent bleaching of the halophilic green alga Dunaliella salina. Sublethal levels of paraquat elicited increases in cell content of both superoxide dismutase and catalase, with changes in the pattern of electromorphs of these enzymes. Desferal-Mn(IV), which catalyzes the dismutation of O2- in vitro, protected against the toxic effect of paraquat. Desferal (desferoxamine mesylate) alone was toxic to D. salina, and the salts of Mn(II), Mn(III), and Mn(IV), in the absence of Desferal, did not protect. Desferal-Mn(IV) is green, but its absorbance was 15% or less than the peak absorbances due to the chlorophyll in D. salina under the conditions of exposure; hence, masking of incident light could not have been the basis of the protective effect of the complex. Incubation of the cells with Desferal-Mn(IV), for up to 8 h prior to the addition of paraquat, did not increase its protective action, and brief washing, following 30 min incubation with the complex, eliminated its protective effect. Neither catalase nor superoxide dismutase, added to the medium, provided protection against paraquat. These results support the view that Desferal-Mn(IV) gains entry into D. salina and protects against the lethal effect of paraquat by there catalyzing the dismutation of O2- into H2O2 + O2. PMID- 3666517 TI - Different levels of hyperoxia reversibly induce catalase activity in amphibian tadpoles. AB - Studies about the proposed antioxidant physiological role of the catalase (CAT) enzyme in relation to different environmental oxygen tensions are reported for the first time in amphibian larvae of Discoglossus pictus and Rana ridibunda perezi during their development. The CAT levels of whole tadpoles increased constantly in both species during the larval period, reaching a maximum during the metamorphic climax. All through development, CAT activity levels were always greater in D. pictus than in R. ridibunda perezi. This correlates well with the already reported higher SOD activity and hyperoxia resistance of the D. pictus species when compared to R. ridibunda perezi. Long-term acclimation to different levels of hyperoxia (40, 60, and 100% O2) showed dose-related increases in the CAT activity of D. pictus tadpoles. These increases did not take place when the animals were subjected to acute hyperoxia (24 h). The increase in CAT activity observed after 15 days of acclimation to acute hyperoxia (710 mm Hg: 100% O2) was reversed after 15 additional days of postacclimation to normal air (149 mm Hg O2). When recently metamorphosed frogs were acclimated to acute hyperoxia, significant increases in CAT activity were observed after 15 days, but not after 7 days. The results are interpreted as supporting a protective role for the CAT enzyme in amphibian larvae and froglets against oxygen toxicity. PMID- 3666518 TI - Electronically excited state generation during the reaction of p-benzoquinone with H2O2. Relation to product formation: 2-OH- and 2,3-epoxy-p-benzoquinone. The effect of glutathione. AB - The reaction between H2O2 and p-benzoquinone proceeds with consumption of both reactants with second order rate constants of 1.66- and 0.77 M-1S-1, respectively. The process is mainly supported by oxygen addition reactions to the quinone resulting in the formation of both 2,3-epoxy-p-benzoquinone and 2-OH-p benzoquinone. The former product accumulates in the assay mixture without participating in further reactions. The formation of the latter product implies free radical intermediates such as 2-OH-p-benzosemiquinone anion, which supports the generation of electronically excited states upon its oxidation by H2O2, presumably as part of an organic Fenton reaction. The relaxation of the excited state is accompanied by photoemission at 485-530 nm. Glutathione was found to counteract the oxidative aspects of the reaction between p-benzoquinone and H2O2 by a series of processes involving (a) a rapid reductive addition to the quinone with formation of a substituted p-benzohydroquinone; (b) an effective quenching of photoemission, which might be attributed to the deactivation of the excited state by the p-benzohydroquinone-glutathione adduct, and (c) the decomposition of the formed 2,3-epoxy-p-benzoquinone, also by reductive cleavage of the epoxide ring. PMID- 3666519 TI - Views on the wisdom of using antioxidant vitamin supplements. AB - In the Forum that follows, four authorities in nutrition and vitaminology present their divergent views on the use of antioxidant vitamin supplements. In this introduction, the basic dilemma between setting RDAs that insure an absence of deficiency symptoms and those that insure optimal health is discussed, as well as other factors that must be considered to reach a consensus on this controversial topic. PMID- 3666520 TI - Are the recommended allowances for dietary antioxidants adequate? AB - Recommended dietary allowances are standards for maintaining health. Claims that intakes substantially above the allowances may provide protection from xenobiotics and prevent diseases, including cancer, are examined critically for five nutrients that have antioxidant potential. Major criticism is directed at the failure of epidemiologists to recognize that for many of these nutrients, metabolic differences among individuals preclude a direct relationship between dietary intake and plasma or tissue concentration. Also, the fact that no differences in disease incidence have been described within various species of animals that have markedly different metabolic patterns for some of these nutrients has not been considered. It is concluded that the experimental and epidemiological evidence to data that increased intakes of certain nutrients will have beneficial effects on human health are tenuous. PMID- 3666521 TI - Dietary supplementation with antioxidants. Is there a case for exceeding the recommended dietary allowance? AB - The containment of damaging oxygen species by antioxidant nutrients has led to the speculation that the RDA for these specific nutrients may be overly low. Among these nutrients are vitamin E, vitamin C, and to a lesser extent beta carotene and selenium. Evidence for the role of these nutrients in cancer and heart disease is evaluated. The case is presented for an increase of two-fold for the vitamin C RDA and between three and five-fold for vitamin E; for establishing 15 mg as the RDA for beta-carotene; for no change in the vitamin A RDA; and for further study on selenium. PMID- 3666523 TI - Dietary standards and future developments. AB - The field of nutrition is in the midst of a major and rapid transition. Just how far we have come can be illustrated by the judgement that it is possible, and indeed desirable, to define multiple criteria of adequacy, multiple levels of requirement, and hence a multitiered population assessment. Moreover, in the past few years, there has also been widespread acceptance of other important concepts: no single dietary standard meets every user's needs; the quality of a diet, as well as its quantity, needs to be considered; alternative dietary standards are required and available; and finally, patterns of dietary intakes must be considered. Finally, there are fresh approaches to the relation of dietary factors and free radicals that appear to be most promising. Indeed, the issues are still unresolved, but a new definition of what RDA might mean may well emerge, along with the other evolving alternative dietary standards. The addition of a new category of naturally occurring compounds to be taken prophylactically under certain circumstances of high risk from free radicals, emphasizes the magnitude of the progress that has already been achieved. PMID- 3666522 TI - Micronutrients and cancer prevention: are the RDAs adequate? AB - The involvement of certain micronutrients (vitamin C, vitamin E, beta-carotene, selenium) in the antioxidant defense system against free radical cell damage, and of vitamin A in the differentiation of epithelial cells, has raised the question whether intakes of these nutrients in excess of their recommended daily allowances should be recommended to the general public for cancer prevention. The considerations surrounding this question are discussed, and it is concluded that such measures are unjustified by present epidemiological and experimental evidence. Any such action should await the outcome of ongoing intervention trials. PMID- 3666524 TI - [Computer-assisted analysis of changes in the fetal heart rate and biophysical profile of the fetus during pregnancy in the evaluation of the condition of the fetus and newborn infant. I. Computer-assisted analysis of the non-stress test of fetal heart function]. PMID- 3666525 TI - [Computer-assisted analysis of changes in the fetal heart rate and biophysical profile of the fetus during pregnancy in the evaluation of the condition of the fetus and newborn infant. II. Prognostic value of the parameters of the biophysical profile of the fetus]. PMID- 3666526 TI - [Studies of delayed hypersensitivity and composition of the population of mononuclear cells in the blood of patients with malignant ovarian neoplasms before and during the treatment]. PMID- 3666527 TI - [Effect of placental location on intrauterine fetal development and the status of newborn infants. I. Relation between birth weight and body height of the newborn infant and placental location]. PMID- 3666528 TI - [Effect of placental location on intrauterine fetal development and the status of newborn infants. II. Relation between the trophic state and the condition at birth of the newborn infant and placental location]. PMID- 3666529 TI - [Vesico-uterine fistula]. PMID- 3666530 TI - [Biochemical parameters of renal function in healthy women in the third trimester of pregnancy. I. Urinary excretion of NH4+ and H+ ions]. PMID- 3666531 TI - [Biochemical parameters of renal function in healthy women in the third trimester of pregnancy. II. Urinary excretion of Na+ and K+ ions]. PMID- 3666532 TI - [Syndrome of double uterus with atresia of the vagina, absence of one kidney and inguinal hernia]. PMID- 3666533 TI - [Activity of the adrenergic nervous system in the pathophysiology of pregnancy and labor. III. Plasma dopamine beta-hydroxylase activity in women during spontaneous abortion]. PMID- 3666534 TI - [Results of studies of the parameters of acid-base equilibrium in the umbilical cord blood of newborn infants in cases of placental insufficiency]. PMID- 3666535 TI - [Vaginal biocenosis before and after the treatment of vulvovaginal candidiasis and trichomonas vaginitis]. PMID- 3666536 TI - [Problems of the preventive use of antibiotics in cesarean section]. PMID- 3666537 TI - [Antibiotic therapy for eliminating infection after cesarean section]. PMID- 3666538 TI - [Changes in serum ferritin levels in pregnancy complicated by EPH gestosis]. PMID- 3666539 TI - [Effect of nipple stimulation on uterine contraction in women in prolonged pregnancy]. PMID- 3666540 TI - [Results of the search for ABO system antibodies among the adolescent female population]. PMID- 3666541 TI - [Chlamydia trachomatis in urogenital infections among patients at gynecological and dermatological clinics]. PMID- 3666542 TI - [Giant teratoma of the sacrococcygeal region in a fetus undetected during pregnancy]. PMID- 3666543 TI - Quantification of autonomic activity in the brainstem in normal, comatose and brain dead subjects using heart rate variability. AB - The heart rate variability is defined as variation in distance between sequential ventricular complexes in the electrocardiogram and can be given in percent by referring the standard deviation to the average values of heart rate. The bivariate distribution of heart rate variability and of heart rate shows a discrimination of the group of comatose patients from brain dead subjects and normals. PMID- 3666544 TI - Discriminant analysis of WAIS results in different types of dementia and depressed patients. AB - A Multivariate Analysis of Covariance and Discriminant Analysis were carried out on complete WAIS profiles obtained from three groups of demented patients: Multi Infarct Dementia patients, Senile Dementia of Alzheimer Type patients, and Alcoholic Dementia patients. A group of middle-aged Depressed patients was also included. WAIS did not differentiate among dementias, but Picture Completion and Block Design subtests proved to be effective in differentiating dementia from depression. PMID- 3666545 TI - The Hoffmann reflex (H-reflex) in senile dementia of the Alzheimer's type- preliminary results. AB - The Hoffmann reflex (H-reflex) and direct motor response (M) were investigated (latency, amplitude and excitability curves were analyzed) in patients with senile dementia of the Alzheimer's type (SDAT). M responses had similar latencies in SDAT patients and old control subjects. H reflex latencies were similar in SDAT patients and old control subjects but longer than in younger controls. The H max/M max ratio was also lower in SDAT patients and old control subjects than in younger controls. The excitability curve of the H-reflex (using a double shock procedure) in SDAT patients was lower than in non-demented old controls for all values of the interstimulus intervals. PMID- 3666546 TI - Influence of sex and anxiety on pain threshold and tolerance. AB - The influence of sex and anxiety on experimental pain perception was studied in a homogeneous population of 50 volunteer and healthy dental students. Three threshold (minimum perceptible threshold, pain threshold and pain tolerance threshold) were determined by delivering electrical stimulations, at regular intervals, on the left hand finger pads. At the same time, the students were asked to complete the Cattell's anxiety test, so allowing their degree of anxiety to be quantified. Statistical analysis of the results showed a lower pain tolerance threshold in females than in males and a significant correlation between the anxiety score and the pain tolerance threshold. The fact that females are more anxious than males could explain these results. PMID- 3666547 TI - Surface EMG evaluation of quadriceps femoris muscle in hemiplegic patients. AB - The method applied consists of evaluating the power spectra of the electromyographic (EMG) surface signal obtained during maximal isometric effort of the quadriceps femoris muscle. In hemiplegic patients it is possible to observe a particular frequency distribution towards the lowest values of the range considered. This trend might be accounted for by the morphological and enzyme- histochemical studies on the quadriceps femoris showing a selective atrophy of type 2 fibers. During rehabilitation treatment, however, it is imperative to consider parameters such as muscle strength changes and frequency values preferentially activated during the isometric effort (time-course). Observation of the pattern of the power spectra time-course therefore seems to contribute to a better view of the rehabilitation strategies suitable for exploiting the residual motor abilities. PMID- 3666548 TI - Raven's coloured progressive matrices: normative values on 305 adult normal controls. AB - The use of Raven's Coloured Progressive Matrices (PM 47) in experiments with brain-damaged patients is briefly reviewed. Because norms for adults are still not available, normative data were calculated on 305 normals; corrections for age and education and centile allocation of the scores are furnished. PMID- 3666549 TI - F-waves in evaluating uremic polyneuropathy: a long-term study after the application of continuous ambulatory peritoneal dialysis. AB - Electrophysiological parameters were studied in 8 patients with end-stage chronic renal failure (CRF). The patients had complete evaluations of the state of CRF, clinical neurological examinations and EMG studies, performed before starting continuous ambulatory peritoneal dialysis (CAPD) as well as 10 days, 2 months and 6 months after initiation of CAPD treatment. All the conventional electrophysiological parameters studied (motor and sensory conduction velocities, terminal latencies, muscle and nerve action potentials) had a tendency to shift towards normal values, the effect being more pronounced in the upper limbs. F wave maximum and minimum latencies improved quickly in the upper limbs, but very slowly, if at all, in the lower limbs. F-wave frequency became normal in 82% of the median and ulnar nerves, in 75% of the tibial nerves and remained unchanged in the peroneal nerves. F-wave identically, as represented by the "test of multiplicity", showed a general improvement in all nerves, including the peroneal. Studies of F-wave parameters, in addition to improving the diagnostic results, provide a more sensitive method, whereby the effects of CAPD can be examined quantitatively. PMID- 3666550 TI - Autoradiographic localization of the dopaminergic agonist 3H-dihydroergotoxine within the male reproductive system. AB - By the use of combined radioreceptor binding and autoradiographic techniques, we analyzed the anatomical localization of the dopaminergic agonist 3H dihydroergotoxine in tissue sections of rat male sex organs. The drug was bound by smooth muscle cells of the deferent duct, seminal vesicles and prostate gland as well as by the glandular tissue of seminal vesicles and prostate gland. These data allow us to hypothesize that the effect of dopaminergic agonists on male sexual function may be due, at least in part, to a direct interaction with dopamine receptors present in the reproductive organs. PMID- 3666551 TI - Isolated ophthalmoplegia of abduction. AB - A case of transient complete bilateral paresis of abduction is reported without esotropia. Loss of vestibular ocular reflex (VOR) responses of the abducting eye and intactness of all other slow VOR reactions were the leading symptoms. Since bilateral lesions of the pontine gaze centers in this initially comatose patient without signs of increased intracranial pressure were excluded, bilateral lesions of the abducens nerves appeared improbable. In view of normal function of the ascending tract of Deiters bilateral paramedian lesions between the vestibular and abducens nuclei appeared to be more likely. Clinical course with relatively rapid recovery after administration of thiamine, theoretical considerations, and some earlier reports led to the conclusion that in some metabolic-toxic disorders -apparently in this case of Wernicke's encephalopathy--intrapontine connections in the paraabducens area may be selectively vulnerable. A similar effect on oligosynaptic connections to the medial rectus nucleus could lead to a disordered inhibition of this muscle. The term "posterior INO of Lutz" should no longer be used because of the lack of any anatomical and physiological evidence for its existence. PMID- 3666552 TI - Circadian profiles and circaseptan periodicity in the frequency of administration of analgetic drugs after oral surgery. AB - The frequencies of 5706 demands for analgetic drugs after dental operations have been recorded. The highest consumption of analgetics is observed around postoperative day 7. On days 2 and 3, the circadian course of the frequencies peaks in the early morning (around 06.00). On days 6 and 7 the frequencies of analgetic administrations increase during the evening (around 18.00-20.00). The circadian profiles of frequencies therefore exhibit a phase jump of about 180 degrees during the postoperative period, indicating a change of dominance from a more protopathic type of pain to an epicritic one. PMID- 3666553 TI - Spasmophilia: a clinical neurophysiopathological and biochemical study. AB - Spasmophilia is a problem much debated as regards its nosographic location. Its paroxysmal onset in a "neurotic" patient has confined spasmophilia within a psychiatric syndromic complex for many years. In the present study, strict clinical criteria used in selecting a population of spasmophilic patients included clinical, neurophysiological, biohumoral and psychological evaluations, providing further information about the real organic features of this syndrome. Moreover, on the basis of an organic pathogenetic hypothesis, all patients were administered medical therapy which resulted in clinical amelioration in a significant number of cases. PMID- 3666554 TI - Role of liver atrophy, hepatic resection and hepatocyte hyperplasia in the development of portal hypertension in biliary disease. AB - Portal fibrosis is considered to be pivotal in the pathogenesis of portal hypertension associated with extrahepatic biliary obstruction. The histological features, however, include diffuse hepatocyte hyperplasia as well as portal fibrosis, but not cirrhosis, and it is possible that the contribution of hepatocyte hyperplasia in the initiation of portal hypertension is equally important. If so, we hypothesised that patients with biliary obstruction and a coincident condition such as liver atrophy, or hepatic resection, with the potential of accelerating the hepatocyte proliferation caused by biliary obstruction itself, might be expected to develop portal hypertension earlier than patients with biliary obstruction alone. To examine this concept we studied 10 patients with postcholecystectomy bile duct stricture, portal hypertension and liver atrophy, or hepatic resection (group I) and compared them with nine patients with postcholecystectomy stricture and portal hypertension, but no atrophy or resection (group II). Portal hypertension was diagnosed a mean 28 months (range 18-48 months) after cholecystectomy in group I compared with 62 months (range 36-100 months) for patients in group II (p less than 0.005 Mann Whitney test). Thus hepatocyte hyperplasia may be an important part of the mechanism underlying the development of portal hypertension in chronic biliary disease. PMID- 3666555 TI - Oral clonidine for proctalgia fugax. AB - A report is made of the successful use of oral clonidine for proctalgia fugax by the author on himself. The author, a 30 year old otherwise healthy man, has been having attacks of proctalgia fugax for several years. He had hitherto left the condition untreated. Last year, in a severe attack, he tried oral clonidine 150 micrograms twice a day and found it to be dramatically effective. He was completely relieved in three days and tapered off the drug thereafter. A further attack of proctalgia fugax after a month was again treated successfully with oral clonidine. The presumed aetiology of proctalgia fugax is discussed and the possible mechanism of action of clonidine in this condition is outlined. Further trials of clonidine appear to be worthwhile for this condition which has been described as incurable. PMID- 3666556 TI - Pseudopolycythaemia and coeliac disease. AB - We report two patients in whom introduction of a gluten free diet for coeliac disease was associated with the development of pseudopolycythaemia. PMID- 3666557 TI - Cancer after peptic ulcer surgery. PMID- 3666558 TI - Increased risk of cancer at multiple sites after gastric surgery for peptic ulcer. AB - Of 5018 patients who had undergone gastric surgery at St James Hospital, Balham, at least 25 years ago, death certificates have been received for 2768, whilst 1746 patients are still alive and are flagged (Office of Populations, Censuses and Surveys (OPCS) will notify us of their death and its cause) and only 504 could not be traced. Mortality from cancers of various organs has been determined using a 'years at risk' calculation in five year bands. There was no increase in mortality risk from any cancers during the first 15 postoperative years, but from 20 years after operation there was a significant excess risk not only of cancer of the stomach (4.5-fold), but also of the large bowel (1.6-fold), bronchus (3.9 fold), pancreas (4.0-fold), biliary tract (9.1-fold), oesophagus (2.3-fold), bladder (2.4-fold), breast (4.0-fold), and cancer of all sites (3.3-fold). These findings are consistent with the production in the operated-upon stomach of circulating carcinogens with a 20 year latency period. PMID- 3666559 TI - Gastro-oesophageal reflux and the migrating motor complex. AB - Distal oesophageal pH and gastroduodenal motor activity were recorded simultaneously throughout nocturnal (23 30-08 30 h) and diurnal (08 30-17 30 h) periods of fasting in seven healthy subjects. At night, episodes of gastro oesophageal reflux (GOR) accounted for 1.2 +/- 0.7% of recording time. Periods of gastric motor activity, representing the gastric component of the migrating motor complex (MMC), recurred every 78 +/- 31 min during the night and were interspersed with periods of gastric motor quiescence. Nocturnal episodes of GOR during periods of gastric motor activity were of longer duration (p less than 0.001) and more frequent (p less than 0.005) than during periods of gastric motor quiescence. At night, periodic gastric motor activity was thus correlated (p less than 0.001) with an increase in the duration and number of GOR episodes and associated with a 100-fold increase in oesophageal acid exposure. During the day, the gastric component of the MMC, recurring every 131 +/- 64 min, was correlated (p less than 0.02) with an increase in the duration and number of GOR episodes, and a three fold increase in oesophageal acid exposure. Further, 89% of nocturnal, and 83% of diurnal gastric MMCs were temporally associated with episodes of GOR. We conclude that fasting episodes of GOR occur coincidentally with the gastric component of the MMC. PMID- 3666560 TI - Electrodes for 24 hours pH monitoring--a comparative study. AB - Three pH electrodes in clinical use were examined--(1) antimony electrode with remote reference electrode (Synectics 0011), (2) glass electrode with remote reference electrode (Microelectrodes Inc. MI 506) and (3) combined glass electrode with integral reference electrode (Radiometer GK2801C). In vitro studies showed that both glass electrodes were similar and superior to the antimony electrode with respect to response time, drift, and sensitivity. The effect of the siting of the reference electrode on the recorded pH was examined in five human volunteers. The pH reading using a remote skin reference electrode was higher by a mean of 0.3 pH units (range 0.0-0.6) in the stomach, lower by 0.65 pH units (0.5-0.8) in the duodenum and lower by 0.3 pH units (0.0-0.6) in the oesophagus than that simultaneously obtained with an intraluminal reference electrode. Buccal reference electrodes gave similar readings to skin. Combined reference and glass pH electrodes are recommended for 24-hour ambulatory pH monitoring. PMID- 3666561 TI - Oesophageal manometry: how well does it predict oesophageal function. AB - The variability in manometric measurements of oesophageal peristalsis was assessed in 10 volunteers. The amplitude, velocity and duration of the peristaltic waves resulting from 10 separate 10 ml boluses of water were measured at fixed distances above the lower oesophageal sphincter (LOS). After a 10 minute rest period with the manometry catheter still in situ peristaltic values in response to a second group of 10 10 ml boluses were measured. The measurement of peristaltic amplitude at a fixed distance above the LOS showed wide interindividual variation--for example, at 8 cm above the LOS the variation between individuals was marked (p less than 0.001). At the same site, however, there was only a small intra individual variation noted with time (p greater than 0.25). Similar differences were noted at 16 and 4 cm above the LOS. For the first group of swallows, while the interindividual variation remained high (p less than 0.025), the measurement variation from site to site was of lesser magnitude (p greater than 0.1). Similar findings were noted for interindividual variation and site to site variation at the second group of swallows. The values for velocity showed a similar pattern of variation. From this study we conclude that manometric measurements can be used as a valid method for assessing the effects of drugs on peristalsis in individuals provided all measurements are made at the exact same level in the oesophagus and 'normal' subjects with a large inherent variation are excluded. Any studies comparing peristaltic values in different population groups - for example, normal v reflux patients, may not detect any significant difference even with large sample numbers. Any differences detected may be of no clinical importance because of the large normal variation. PMID- 3666563 TI - Small bowel resistances and the gastroduodenal brake. AB - Osmoreceptors in the upper small bowel may delay gastric emptying by inhibiting fundal tone and/or by increasing outflow resistances. In this study we examined the contribution of postpyloric resistances to this braking system. Seven dogs had gastric emptying of 250 ml 15% dextrose, labelled with 99mTc-DTPA, measured by gamma camera imaging (preoperative studies: n = 21). A proximal duodenal cannula was inserted and studies repeated in four modes: with the cannula closed (n = 14); with total diversion of gastric effluent through the cannula (n = 7); with diversion and downstream reinstillation of effluent at a constant rate (n = 14) equivalent to emptying calculated from studies without diversion; and with diversion and total reinstillation of effluent (n = 14). Gastric emptying at 90 minutes was similar in preoperative studies (48 +/- 5% - mean +/- SEM) and in those with the cannula closed (50 +/- 3%). By comparison 'total diversion' produced rapid emptying over 90 minutes (97 +/- 1%; p less than 0.001). Reinstillation of effluent at a constant rate reduced the 90 minute emptying to 59 +/- 6%, and total reinstillation slowed emptying further to 37 +/- 4% (p less than 0.05). Neither reinstillation protocol yielded gastric emptying rates that were significantly different from those in studies without diversion. With total reinstillation, emptying and hence reinstillation rates were more variable, proceeding in a step and plateau fashion. We conclude that canine jejunal osmoreceptor activity is mediated through the stomach, with postpyloric resistances playing little or no role. Gastric emptying curve analysis suggested that increments of rapid small bowel filling provoke exaggerated braking responses. PMID- 3666562 TI - H2 antagonists in the treatment of reflux oesophagitis: can physiological studies predict the response? AB - Ambulatory oesophageal pH, oesophageal manometry and fasting serum gastrin concentrations were carried out on 28 patients with reflux oesophagitis, before and during treatment with ranitidine 300 mg bd. Fourteen patients healed endoscopically at six weeks (group A) and 14 had residual oesophagitis (group B). Group A were characterised by a lower serum gastrin concentration before treatment (4.52 pmol/l; 2.4-10: mean and range) than group B (11.1 pmol/l; 3.5 21: p less than 0.05) and showed a marked reduction in acid reflux on treatment to near normal values. Mean per cent time below pH4 fell from 14.9 to 4.2 in group A (p less than 0.05) but was not affected in group B (14.2-15.6, not significant). Abnormal oesophageal motility was found in 13 patients from each group. This did not inhibit the response to ranitidine, and was not improved by healing of oesophagitis. PMID- 3666564 TI - Action of centrally mediated autonomic stimulation on human upper gastrointestinal transit: a comparative study of two stimuli. AB - Two well established experimental stressors, hand immersion in cold water, and mental stimulation with dichotomous listening, were applied to 37 normal subjects after the ingestion of a standard meal. Orocaecal transit was measured by serial exhaled breath hydrogen sampling. Cold water significantly delayed transit compared with warm water control (warm water 71.8 +/- 3.6 mins v cold water 93.2 +/- 5.7 mins p less than 0.01), with significant rises in blood pressure pulse rate perceived discomfort and plasma catecholamines. In contrast mental stimulation was unaccompanied by any change in transit (control; 67.4 +/- 4.7 v test 64.3 +/- 5.3 mins p greater than 0.1) despite a significant rise in pulse rate, skin conductance and plasma catecholamines. Repeated cold water immersion studies in eight individuals produced consistent orocaecal transit and autonomic responses, whereas mental stimulation showed reduced autonomic responses on repeat testing, suggesting that tolerance to the stimulus had occurred. The results of these studies show stimulus specific gastrointestinal response patterns to autonomic stimuli, and appear to have important implications for the design of future studies of human gastrointestinal autonomic physiology and for the investigation of patients with stress related gut dysfunction. PMID- 3666565 TI - 75Se HCAT test in the detection of bile acid malabsorption in functional diarrhoea and its correlation with small bowel transit. AB - The purpose of this study was to evaluate whether bile acid malabsorption assessed by the 75SeHCAT test, had a pathogenetic role in functional chronic diarrhoea and to ascertain whether the small bowel transit time (SBTT) could be correlated with the 75SeHCAT test results. The test was based on the counting of the abdominal retention of a 75-selenium labelled homotaurocholic acid. The 75SeHCAT test was carried out in a control group of 23 healthy adults and in 46 patients, 38 of whom were suffering from irritable bowel syndrome (IBS) of diarrhoeic form and eight patients who had undergone cholecystectomy and were suffering from chronic diarrhoea. Faecal bile acid loss was determined in nine patients, and in 14, serum bile acid increase after a standard meal was measured. In 17, SBTT was studied by hydrogen breath test after lactulose administration (21 g in 300 ml water). In 15 patients, choledochocaecal transit time was estimated by Tc99m-HIDA (111 MBq) cholescintigraphy. In 20 of 46 subjects, 75SeHCAT retention was below normal level, and in 19 cholestyramine administration relieved diarrhoea. 75SeHCAT results were related to faecal bile acid loss, while no correlation was found with serum bile acids and SBTT. The data suggest a possible wider use of the 75SeHCAT test in chronic diarrhoea to estimate bile acid malabsorption in irritable bowel syndrome, diarrhoeic form, and provide an effective treatment. In our patients small bowel transit velocity does not seem to be a pathogenetic factor of bile acid malabsorption. PMID- 3666566 TI - Phagocytes in cell suspensions of human colon mucosa. AB - Because little is known of the phagocytes of the human colon we enumerated these cells in mucosal suspensions and studied their phagocytic activity. Phagocyte rich suspensions were made by EDTA collagenase dissociation followed by elutriation centrifugation. Phagocytosis was evaluated by measuring cellular radioactivity after incubation of phagocytes with 3H-adenine labelled E coli ON2 and checked microscopically. Dissociation of normal mucosa from colorectal neoplasms yielded means of 1.9 X 10(6) eosinophils, 1.4 X 10(6) macrophages and 2 X 10(5) neutrophils per gram of mucosa. Visually normal mucosa of inflammatory states yielded 2.2 X 10(6) eosinophils, 2.3 X 10(6) macrophages and 7 X 10(5) neutrophils per gram of mucosa. Phagocyte rich suspensions of normal mucosa from tumour patients phagocytosed 21.8% of a pool of opsonised tritiated E coli ON2 and by microscopy 100% of mucosal neutrophils ingested bacteria, 83% of eosinophils were phagocytic, and 53% of macrophages contained bacteria. These results suggest that in the human colonic mucosa, the eosinophil is more abundant than the macrophage and the per cent of those cells exhibiting phagocytosis is intermediate between that of the macrophage and the neutrophil. Thus these three types of cells are actively phagocytic and share the potential for a major role in host defence against invasive enteric bacteria. PMID- 3666567 TI - One simple solution to hearing impairment. PMID- 3666568 TI - Amputation: last resort or new beginning? PMID- 3666569 TI - All through the night. PMID- 3666571 TI - Reducing incidents of illness posttransfer. PMID- 3666570 TI - Coping with relocation. PMID- 3666573 TI - Good news for those with diabetes. PMID- 3666572 TI - Drugs and the elderly. Basics revisited. PMID- 3666574 TI - Cytosolic estrogen and progesterone receptors as prognostic parameters in stage IB cervical carcinoma. PMID- 3666575 TI - In vitro chemotherapy sensitivity testing of human ovarian carcinoma: comparison of optical colony counting and [3H]thymidine incorporation assays. AB - Optical colony counting was used for assessing drug sensitivity of 87 samples (from 51 primary solid tumors, 19 metastatic solid tumors, and 17 ascites fluids) from 83 common epithelial type ovarian carcinomas. The evaluability rate by the optical counting method was 26.4%. Fifty of these samples were also assessed by a tritiated thymidine ( [3H]dThd) incorporation assay (evaluability rate by incorporation assay, 74%). In the 12 cases fully evaluable by both methods, the correlation coefficients for regression of drug sensitivity data between the methods ranged from 0.503 to 0.976 (mean, 0.745); for the combined data of these cases, the correlation coefficient was 0.707. The new [3H]dThd assay appears useful and efficient for performing in vitro chemotherapy sensitivity testing of human ovarian cancer. PMID- 3666576 TI - Aluminum in foci of pelvic calcification in neoplastic and nonneoplastic conditions. AB - Both aluminum and calcium are present in many pelvic concretions that have traditionally been attributed to calcium and phosphorus alone. There is considerable variation in both the amount and the distribution of aluminum when it is present. PMID- 3666577 TI - Antibiotic prophylaxis for radical abdominal hysterectomy. AB - Records of 35 patients with cervical cancer Stage IB operated with radical abdominal hysterectomy and pelvic lymphadenectomy were surveyed retrospectively for incidence of febrile morbidity and site-related infections. Febrile morbidity was observed in 6 patients (17%). No surgical site-related infections were observed. It is concluded that radical abdominal hysterectomy in our hospital does not carry any significant risk of postoperative site-related infections and that prophylactic antibiotics cannot be recommended. PMID- 3666578 TI - Use of second-look laparotomy in the management of patients with ovarian epithelial malignancies. AB - Between June 1976 and January 1986, 94 evaluable patients with stage I-IV disease underwent second-look laparotomy as part of their treatment for ovarian epithelial carcinomas. Stage and residual tumor size after initial debulking surgery demonstrated a significant association with absence of disease at reexploration. Forty-nine patients (52%) had no evidence of disease at second look laparotomy. Thirty patients (32%) had macroscopic residual tumor, and 15 patients (16%) had microscopic disease at reexploration. Patients with a negative second-look laparotomy had an excellent prognosis; uncorrected 2- and 5-year survival rates exceed 90%. None of the patients with stage I or II disease developed recurrent tumor after a negative second-look laparotomy. However, 7 of the 25 (28%) patients with stage III disease and a negative second-look have demonstrated recurrent carcinomas. Recurrences were documented from 15.4 to 51.7 months after second-look laparotomy and were located within the abdominal cavity. Life table methods demonstrated improved survival for patients with microscopic disease as compared to those with gross tumor at second-look survey. Both groups had similar mean patient ages and tumor stage distributions. Patients with microscopic residual disease had uncorrected 2- and 5-year survival rates of 76 and 64%. The 2-year uncorrected survival rate for patients with gross tumor at second-look laparotomy was 25%. Thirty patients with macroscopic disease at second-look laparotomy underwent a repeat attempt at tumor debulking. Seventeen patients completed second-look surgery with residual disease less than 1 cm in maximum dimensions. Life table methods demonstrated improved survival when residual disease was less than 1 cm. Regardless of residual tumor size after reexploration, patients with gross tumor had a worse survival than those with microscopic disease. PMID- 3666579 TI - Radioisotope bone scanning for the detection of occult bony metastases in invasive cervical carcinoma. AB - Radioisotope bone scans to search for occult skeletal metastases at initial staging were obtained in 540 patients with invasive cervical carcinoma admitted to the Gynecological Oncology Unit of the Tygerberg Hospital over a 36-month period. Positive scans were reported in 55 (10.2%) patients but subsequent radiographic examination revealed that of these, 43 were false positive. The 11 patients with bony metastases were all initially classified as Stage III or IV disease irrespective of the bone scan and the positive scans influenced the clinical staging in only 6 (1.1%) patients. All the bone scans in the 210 patients with clinical Stage I or II disease were negative. Bone scanning does not seem warranted at initial staging in Stage I or II invasive cervical carcinoma. PMID- 3666580 TI - Adjunctive hysterectomy following radiation therapy for bulky carcinoma of the uterine cervix: prognostic implications of tumor persistence. AB - Twenty-five patients underwent adjunctive extrafascial hysterectomy 14-60 days following completion of external and intracavitary irradiation for bulky carcinoma of the uterine cervix. Review of the operative histopathology and correlation with subsequent patient outcomes suggests that morphologically persistent cancer is prognostically ominous and that cancer near the surgical margin is viable in the majority of instances. PMID- 3666581 TI - Cervical adenocarcinoma: tumor implantation in the episiotomy sites of two patients. AB - The spread of cervical carcinoma associated with parturition through a tumorous cervix is rarely demonstrated. This report details two patients with adenocarcinoma of the cervix who delivered term fetuses vaginally and subsequently presented with tumor nodules in the episiotomy scars. Although both patients appear to have had their recurrences treated successfully, follow-up on one patient has been only 10 months since the completion of therapy. Tumor implantation of the episiotomy wound is a potential risk associated with vaginal delivery in a pregnant patient with cervical carcinoma. However, this iatrogenic mechanism of tumor spread may permit an opportunity for successful treatment of the local recurrence. PMID- 3666582 TI - Tumor interaction with vascular endothelium. AB - Clinical and experimental observations suggest that tumor-induced endothelial cell (EC) injury may be one of several initial events in the establishment of tumor metastases. This work investigates tumor-induced EC injury and the interaction between tumor-damaged EC and platelets. We used cultured bovine EC and extracts of four cultured human malignancies. EC injury was assessed by 51Cr and lactic dehydrogenase (LDH) release. Incubation of EC with melanoma, breast carcinoma or lung carcinoma caused significant LDH and 51Cr release, whereas colon cancer seemed ineffective. Increased adhesion of platelets to tumor-injured EC was noted. These observations indicate that certain varieties of tumor cause EC injury. Adhesion of platelets to tumor-injured EC results in the formation of platelet-tumor thrombi at the endothelial surface, an event that may initiate tumor invasion of the vessel wall. PMID- 3666583 TI - Use of a centrifugal analyzer for a chromogenic prothrombin time, a chromogenic activated partial thromboplastin time and a kinetic fibrinogen assay in a routine hospital laboratory. AB - A Cobas Bio centrifugal analyzer was used in a clinical laboratory for the performance of chromogenic clotting assays. Three commercially available photometric clotting tests--prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen--were compared with the traditional clotting assays during 3 months. No great discrepancies were found between the traditional assays and the new photometric assays. The chromogenic PT could replace the traditional thrombotest, PT and Normotest, because it was sensitive and accurate over a broad range of clotting factor activity. Furthermore the chromogenic PT could be used to discriminate between a decreased clotting activity due to vitamin K deficiency or to a decreased protein synthesis by the liver. A decreased protein synthesis was confirmed by measuring a decrease in the serum cholinesterase activity. The chromogenic aPTT could be used for the assay of heparin concentrations in the therapeutic range and turned out to be more sensitive for deficiencies of factor VIII and factor IX than a traditional clotting aPTT. We conclude that the accuracy and practicability of clotting assays are improved by the new assays without diminishing the clinical value of the results. PMID- 3666584 TI - Study of different factor VII deficiency variants in nine families from Spain. AB - Twenty-three patients with congenital factor VII (FVII) deficiency, belonging to 9 kindreds were studied. Immunological variants were classified according to the relationship between FVII coagulant activity (FVIIC) and the level of FVII antigen (FVIIAg), considering 3 previously described groups: VII-, VII+ and VIIR. Activation variants were determined by the reactivity pattern with three different thromboplastins. One patient was classified as VII-, 16 as VII+, and 6 as VIIR. Three patients belonging to the same kindred showed a Padua 2 FVII deficiency, and 1 patient showed a Padua 1 variant. There was no correlation between antigenic or activation variants and severity of bleeding tendency. Classical autosomal recessive mode of inheritance was observed in VII- and VII+ families. Nevertheless, a possible autosomal dominant trait was observed in VII+ kindreds. PMID- 3666585 TI - Hip surgery in a patient with severe factor VII deficiency. AB - We describe the clinical history of a 35-year-old woman with severe cross reacting-material-negative factor VII deficiency. Because of a severe hemophilic arthropathy of the hips, reconstructive surgery was indicated. After advice was obtained from 11 clinical hemostasis experts it was decided to use plasma for factor VII replacement during and after surgery and to use pneumatic boots to prevent thrombosis. Volume overload was treated with plasmapheresis and diuretics. The operation was carried out without abnormal blood loss and the patient recovered without thromboembolic complications. We conclude that continuous infusion of plasma is a suitable way to replace factor VII provided adequate venous access is available for plasmapheresis. PMID- 3666586 TI - Antithrombin III metabolism in two patients with a nephrotic syndrome caused by minimal chain nephritis and primary amyloidosis. AB - The metabolism and urinary excretion of 125I antithrombin III (AT III) was investigated in 2 patients with a nephrotic syndrome caused by minimal chain nephritis and primary amyloidosis, and acquired deficiency of AT III. Increased AT III catabolism was observed in both patients, even after correction for urinary protein loss. Increased AT III catabolism was due to increased influx from the extra- to the intravascular compartment in 1 patient, and to an increased fractional catabolic rate in the other patient who developed later a pulmonary embolism. Analysis of urine samples revealed biologically inactive whole AT III molecules and biologically as well as antigenically inactive fragments, respectively, whereas daily plasma gel filtration showed intact radioactive AT III. These observations reject the hypothesis that AT III deficiency in nephrotic patients is only due to urinary loss of AT III. PMID- 3666587 TI - In vitro and ex vivo effects of indobufen on human platelet aggregation, the release reaction and thromboxane B2 production. AB - We have done a comprehensive study in normal volunteers of the in vitro and ex vivo effects of the antiplatelet agent indobufen on platelet aggregation, the release reaction and thromboxane B2 (TxB2) production as induced by different concentrations of aggregating agents. At low concentrations (10 microM), indobufen completely inhibited secondary platelet aggregation, the release reaction and TxB2 production stimulated by ADP, epinephrine and low concentrations of platelet-activating factor (PAF acether). Higher concentrations of indobufen (100 microM) completely inhibited TxB2 production, platelet aggregation and ATP release induced by arachidonic acid (1 mM) or collagen (2 micrograms/ml). The inhibitory effect was partially overcome by higher concentrations of arachidonic acid (2 mM). Data obtained ex vivo 2 h after the oral administration of 200 mg indobufen to 8 normal volunteers were in keeping with those of the in vitro study. We conclude that indobufen inhibits platelet aggregation and the release reaction by inhibiting the platelet arachidonate pathway. PMID- 3666588 TI - Relationship between elevated fibrinopeptide A levels and alpha-2-antiplasmin. AB - In order to investigate whether alpha 2-antiplasmin (alpha 2-AP) levels may be related to thrombin activity, we measured alpha 2-AP and fibrinopeptide A (FPA) in 51 patients with clinical conditions frequently associated with increased thrombin activity. The diagnoses were: atherosclerotic disease, chronic inflammatory disease and hematological neoplastic disease. A significant negative correlation was found between alpha 2-AP and FPA (p less than 0.01). When patients were divided into three subgroups on the basis of their FPA levels, a significant reduction in alpha 2-AP was found in patients with the highest FPA concentration (greater than 9 ng/ml). Accordingly, a significant negative relationship between alpha 2-AP and FPA was found only in this subgroup (p less than 0.01). Our data suggest that the partial consumption of alpha 2-AP in patients with elevated FPA levels may reflect a subclinical fibrinolysis activation secondary to increased thrombin activity. PMID- 3666589 TI - Congenital metacarpal fusion associated with polydactyly. AB - A case of congenital fusion of metacarpal bones with polydactyly is reported. The fusion occurred between the proximal parts of the third and the fourth metacarpal bones. The same type of anomaly was induced in rat fetuses by oral administration of myleran. The anomalies for which the critical period is the same as both metacarpal fusion and polydactyly, were analysed. From the results of the experimental study, the authors propose that the cause of the metacarpal fusion associated with polydactyly is the combination of a disorder of ectoderm-mesoderm interaction and a deficit of mesenchymal cells in the limb bud. PMID- 3666590 TI - [Congenital radial dysplasia (thumb ray and radial carpus)--an atavism]. AB - A case of hypoplastic thumb with anomalies of the radial carpal bones is reported, believed to be atavistic in origin. PMID- 3666591 TI - [Anatomic variants of the muscles and tendons of the hand]. AB - Among the patients undergoing surgery of the hand, the author found four cases in whom the tendon of extensor pollicis brevis twice did not arise from the muscle belly. In another case, the tendon of extensor pollicis brevis arose from the tendon of the abductor pollicis longus. In a fourth instance it was completely lacking. The question is raised to what degree these anomalies are associated with the great variation in the range of motion of the first metacarpophalangeal joint. In an additional case an extensor digitorum brevis was found as a surplus aberrant muscle. By contrast with these clinically silent findings is a young man with discomfort symptoms of the ulnaris nerve that made discover an abductor digiti minimi longus. PMID- 3666592 TI - Ligamentotaxis in pseudarthrosis of the scaphoid bone (preliminary report). AB - Three cases are reported of pseudarthrosis of the scaphoid bone which have been treated by distraction with an external fixator employing ligamentotaxis. The investigations of Ilizarov and collaborators are discussed, pertaining as they do to stimulation of osteogenesis by distraction. Also considered are the possible indications for use of the method in some unfavourable fresh fractures of the scaphoid. PMID- 3666593 TI - [Local rotational flap of the nail]. AB - An original pattern of nail flap is described. It consists of a longitudinal band of lateral nail matrix and bed associated with its lateral wall. A vascular anatomic study with latex neopren infusion has been performed. The dorsal branch of the medial phalangeal artery could be shown to be the arterial pedicle of the flap. The venous system was shown to be concomitant. Eight nail autoplasties have been performed in eight cases, proving the reliability of the flap. It provides an interesting way of reconstruction of the nail in tumors, black longitudinal nail bands, posttraumatic and also post-infectious lesions of the nail. PMID- 3666594 TI - [Results of the conservative treatment of injuries of the palmar capsule-ligament system of the interphalangeal joints of the long fingers]. AB - Results are presented following conservative treatment of 79 patients for injuries of the palmar plate of the proximal interphalangeal joint. There was in addition, a slight shell-shaped chip in the base of the middle phalanx of 73 patients. These results show that the functional results are influenced by the age of the patient and the length of the immobilization. 36 of 43 (83.7%) patients under 30 years old, who were immobilized for two to three weeks, had very good results. Immobilization for a longer period of time brought very good results for only nine of fifteen (60%) patients. In the group over thirty years, seven out of fifteen (46.7%) patients had very good results with up to three weeks' immobilization. With longer periods of immobilization, only one out of six (16.7%) had a very good result. The authors recommend fourteen days immobilization in a finger cast with the proximal interphalangeal joint at 15 degrees and the metacarpophalangeal joint at 80 degrees of flexion. Operative correction should only be considered in cases with a tendency to sublux. PMID- 3666595 TI - [Tissue shock in free flaps in the experiment on the rat. Significance, classification and effect]. AB - In free transfers of groin flaps in neurotized rats, spasms of the pedicle and of the vessels of the flap itself were observed. These spasms were in many cases the cause of complications. Four kinds of spasms were distinguished: 1. Segmental spasm--practically always on the inferior epigastric artery, characterized by short sections of spasm of the artery, alternating with sections of normal dilatation. 2. Spasm of the whole artery. 3. Spasm in the flap itself- characterized by normal dilatation of the artery stem of the flap and by slowing or stopping of blood circulation through the flap. 4. Tissue shock of the flap characterized by spasm of the pedicle in the flap also. The present work further shows a method of assessing the amount of blood circulation through the flap and the results of local medication influencing spasm, including 1% Mesocain, 0.5% Marcain and Solutio Vischnjevskij. PMID- 3666596 TI - [Follow-up of patients with burn injuries following long-term ventilation]. AB - Follow-ups were performed five years post burn on 13 severely burned patients after long-term ventilation in order to identify damage to the trachea and lung. The study comprised clinical examination, tracheal X-rays, pulmonary function tests with whole-body plethysmography for thoracic compliance, and spiroergometry. Tracheal stenosis was detected in five patients (38%), two patients had reduced total lung capacity and functional residual capacity was increased. Six patients had high values of pulmonary resistance. The comparison between actual and predicted physical work capacity in the spiroergometry showed a reduction below 85% of normal in five patients, but only one patient had a marked low output (51%). It is remarkable that patients after long-term ventilation, even after inhalation trauma have only minimal impairment of pulmonary function and physical work capacity five years after trauma. The high incidence of tracheal-stenosis after tracheotomy has to be considered as a serious finding. PMID- 3666597 TI - [Surgical treatment of decubitus ulcers in the area of the ischium, sacrum and trochanter major]. AB - The operative management of pressure sores in the ischial, sacral and trochanteric region is based on the gluteus maximus muscle and its vascularization. Pressure sores in the sacral region were closed with eleven V-Y musculocutaneous flaps, for the ischial region with fifteen pendulum flaps, and for the trochanteric region with eight medial thigh flaps. In the four years follow-up of 24 patients three recurrences occurred and the post-operative morbidity was acceptable. The operative technique and the complications are further discussed. PMID- 3666598 TI - [Positive rheumatoid factor in joint pain]. PMID- 3666599 TI - [Ambulatory surgery of varicose veins]. PMID- 3666600 TI - [Reactive vasospasm in the newborn treated by papaverine infusion]. PMID- 3666601 TI - [Jaundice of pregnancy]. PMID- 3666602 TI - [Temporary atrioventricular block due to vasopressin]. PMID- 3666603 TI - [Thyrotoxicosis presenting as choreo-athetosis]. PMID- 3666604 TI - [Pulmonary cavitation following aseptic pulmonary infarction]. PMID- 3666605 TI - [The use of placebo: ethical aspects]. PMID- 3666606 TI - [Fresh and stored placental blood]. PMID- 3666607 TI - [The ethics of clinical research in children]. PMID- 3666608 TI - Studies on the life cycle of Cryptosporidium coccidia in experimentally infected chickens. AB - Experimental infections of 7-28-day-old chickens with Cryptosporidium oocysts isolated from spontaneously infected chickens demonstrated that the endogenous development of this parasite takes place simultaneously in the organs of digestive, respiratory and excretory systems and in bursa of Fabricius. It was demonstrated for the first time that the oocysts of Cryptosporidium are shed through the respiratory tract into the beak cavity. A novel rapid and simple method has been developed for the detection of oocysts. Its principle is the rinsing of the beak cavity. This method enabled to isolate the oocysts from experimentally infected chickens and immediately use them in the dose of 6 X 10(5) for peroral infection of a 37-day-old chicken. The prepatent period was 8 days, patent period 12 days. On days 4-7 after the first detection of Cryptosporidium oocysts in chicken excrements, the oocysts were detected also by the method of beak cavity rinsing. This indicates that the oocysts released from the respiratory tract are infective. This fact is important from the epizootological viewpoint in relation with possible spreading of Cryptosporidium infections in chicken farms. PMID- 3666609 TI - Finding of coccidia of the genus Cryptosporidium in the organs of calf excretory system. PMID- 3666610 TI - Pathology of natural isosporosis in nursing piglets. AB - In piglets suffering from natural coccidiosis, post-mortem examination showed that pathological changes induced by Isospora suis were evident from day 7 to day 14 of life, and particularly, by days 9 and 10. Macroscopically, the changes were manifest as enteritis varying from catarrhal to pseudomembraneous form. Microscopically, they consisted of more or less extensive atrophy of villi whose apical parts were necrotic, of metaplasia and erosion of epithelium. With the exception of duodenum and the adjoining sector of jejunum, the alterations were manifest along the entire small gut though intensity of lesions and incidence of endogenous stages of Isospora suis varied from sector to sector of the intestine. Predilected was a portion limited approximately by 50 and 140 cm cranially from ostium ileocecale, viz. the caudal sector of central jejunum and the cranial sector of the caudal jejunum. Within this area, lesions were more severe and frequent than in sectors situated cranially and caudally of it. The predilection persisted even in case of concurrent adenovirosis. The lesions contained meronts and gamonts at the same time though gamonts predominated. Advanced merogony and gametogony resulted in distinct displacement of cell nuclei and in cell walls bulging into the inner diameter of the gut. We assume that endogenous stages of Isospora penetrate the submucosis via the narrow opening at the orifice of lymph follicle; such was the case with gamonts and oocysts detected in activated lymph tissue of Peyer's patches. PMID- 3666611 TI - Contribution to the knowledge of Gyrodactylus gurleyi Price, 1937 (Monogenea: Gyrodactylidae). AB - Gyrodactylus longoacuminatus Zitnan, 1964, forma minor sensu Ergens (1985) was identified as G. gurleyi Price, 1937. Morphological and metrical evaluations of the hard parts of opisthaptor of more than 200 specimens provided data on the variability of this parasite; Cyprinus carpio haematopterus represents its new host. Since the shape of the hard parts of opisthaptor of G. gurleyi is very similar to that of G. longoacuminatus, further detailed studies of the two species will be necessary, particularly of their reaction to the changes of environmental temperature. PMID- 3666612 TI - Experimental verification of the effect of physical condition of Gobio gobio (L.) on the growth rate of micropopulations of Gyrodactylus gobiensis Glaser, 1974 (Monogenea). AB - It has been verified experimentally that the growth rate of G. gobiensis micropopulations is markedly affected by the physical condition of the host (Gobio gobio). If the fish were weakened by 50% oxygen deficiency and lack of food, the number of parasites increased much more rapidly than on the fish also unfed but kept in water with 100% oxygen content. If the fish weakened by oxygen deficiency were intensively fed, the growth of the parasite micropopulations started to slow down after 4-5 days. When the feeding was stopped, the number of parasites increased again after 10-11 days. These time shifts seem to be associated with the physical condition of the host improved by feeding or worsened by starvation. PMID- 3666613 TI - Characteristics of malic enzyme from the cysticerci of Taenia crassiceps (Zeder, 1800). AB - Kinetic parameters of partly purified malic enzymes (NADP+: L-malate oxidoreductase (decarboxylating) EC 1.1.1.40) from the cytoplasm and mitochondria of Taenia crassiceps cysticerci were compared. The cytoplasmic malic enzyme differed from the mitochondrial malic enzyme in the K'M for malate; other studied properties were identical. The chromatographies of both the cytoplasmic and mitochondrial enzymes were identical. They exhibited a hyperbolic dependence of the activity on malate concentration, sigmoidal kinetics was not observed. The effects of succinate and fumarate known as positive modulators of the activity of malic enzymes from other sources were not observed either in cytoplasmic or mitochondrial enzymes from T. crassiceps. It was found that the two enzymes can be partly inhibited by ATP. Molecular weight of the malic enzyme from T. crassiceps cysticerci was determined by chromatography on Sephadex G-200 (Mw = 116,700) and a four-step purification of the enzyme was performed. The properties of malic enzymes from the cytoplasm and mitochondria of T. crassiceps are compared with those of the malic enzymes from other parasitic worms and higher organisms. PMID- 3666614 TI - First record of Sphaerospora renicola Dykova et Lom, 1982 and Myxobolus encephalicus Mulsow, 1911, pathogenic protozoans of carp from the U.S.S.R. PMID- 3666615 TI - Bioconversion and binding of sterols by thermophilic moulds. AB - None of the fourteen thermophilic moulds was able to break down the aliphatic side chain of sterols, viz. cholesterol, lanosterol, sitosterol, and stigmasterol so as to yield 4-androstene-3,17-dione, 1,4-androstadiene-3,17-dione and progesterone. In Acremonium alabamensis and Talaromyces emersonii, cholestenone was detected as a product of fermentation of cholesterol whereas the former yielded stigmastadienone from stigmasterol and sitosterol. Lanosterol appeared to be resistant to fungal bioconversion. All the thermophilic moulds exhibited avidity for binding sterols to the mycelium, but the ability to bind sterol seemed to depend upon the nature of the organism and the sterol. PMID- 3666616 TI - An apparatus for studying the role of the cricothyroid articulation in the voice production of excised human larynges. PMID- 3666617 TI - Acoustical characteristics of speech following Pearson's subtotal laryngectomy: a case study. PMID- 3666618 TI - Influence of palatal fistulae on speech and resonance. PMID- 3666619 TI - [Functional evaluation of velopharyngeal insufficiency by anterior rhinomanometry]. PMID- 3666620 TI - Intraoral air pressure discrimination by normal-speaking subjects. PMID- 3666621 TI - Detection of diatoms in blood by a combination of membrane filtering and chemical digestion. AB - An improved method for detecting diatom in blood is reported. Blood of cadavers was obtained by cardiac puncture at inquest or from the left atrium directly at autopsy. The blood was hemolyzed by sodium dodecyl sulfate (SDS) and filtered through membrane filter (47 mm in diameter and 5 microns in pore size). When the blood was putrefied, two or three pieces of membranes filters were needed because of choking membrane pore. The membrane filters were digested with fuming nitric acid and diluted with distilled water. The diluted solution was filtered through membrane filter (25 mm in diameter) again. After drying the membrane filter was immersed in oil. Diatoms on the membrane filter were clearly observed microscopically. PMID- 3666622 TI - 1H-NMR of human saliva. An application of NMR spectroscopy in forensic science. AB - 1H-NMR was applied to the study of metabolites in human saliva specimens. Acetate, lactate, ethanol, glucose and some other substances were simultaneously identified and quantitated from the 1H-NMR spectra of saliva specimens treated with D2O. These experiments demonstrated the value of 1H-NMR as an analytical method in the field of forensic science and clinical pathology and toxicology. PMID- 3666623 TI - The illicit preparation of morphine and heroin from pharmaceutical products containing codeine: 'homebake' laboratories in New Zealand. AB - Since 1983 a large number of small-scale illicit laboratories producing morphine and heroin from commercially available, codeine-based pharmaceutical products have been encountered in New Zealand. The codeine demethylation procedure is based on the use of pyridine hydrochloride. Very simple laboratory equipment and reagents are required and these can be utilised by people with little or no chemical background, following a recipe-like procedure. The process yields a characteristic product known as 'homebake'. This process is fully described. PMID- 3666624 TI - Direct blood group typing of forensic samples using a simple monoclonal antibody assay. AB - A simple direct test for blood group antigens in samples of blood, dried blood, dried blood associated with fabric, semen, vaginal secretions, saliva and fingerprints is described. This test takes advantage of monoclonal antibodies which have been produced in this laboratory, but which are also becoming available commercially in ever increasing numbers. The test is sensitive and reliable as evidenced by its performance in blind studies of more than 700 blood samples. The test requires no special equipment and can be completed in 4 h. The test is sufficiently versatile that new antibodies can be added to the same test format as they become available. PMID- 3666625 TI - [Permeability of the cellular border zones of the cornea in vivo]. PMID- 3666626 TI - [Corneal complications following microsurgical interventions in patients with Werner syndrome--report on 9 patients]. PMID- 3666627 TI - [Preoperative corneal changes and surgical outcome in hydrophthalmus]. PMID- 3666628 TI - [Intraocular pressure in miners]. PMID- 3666629 TI - [Actual measurements of the living optic nerve papilla of the human]. PMID- 3666630 TI - [Therapy of atrophia gyrata]. PMID- 3666631 TI - [Temporal arteritis--a retrospective study]. PMID- 3666632 TI - [Iodine resorption following administration of PVP-iodine eyedrops]. PMID- 3666633 TI - [Animal experiment studies of the retinotoxic effect of low-level lead concentrations]. PMID- 3666634 TI - [Value of oculo-pression-tonometry in the determination of outflow resistance]. PMID- 3666635 TI - [Spontaneous eye movements and the vestibulo-ocular reflex in blind patients]. PMID- 3666636 TI - [Pattern evoked electroretinograms in normal and glaucomatous eyes]. PMID- 3666637 TI - [Effect of diagonal disparity on the random dot stereo VECP]. PMID- 3666638 TI - [Stereovision with a stereo distance test for street traffic situations]. PMID- 3666639 TI - [Indirect binocular ophthalmoscopy using the surgical microscope (OPMI6)]. PMID- 3666640 TI - [Glaucoma operations on the open chamber angle. Comparative studies of the Scientific Research Group of the German Ophthalmology Society]. PMID- 3666641 TI - [Emergencies in general practice. Injuries of the eyelid. Inspecting the eye for possible concomitant injuries]. PMID- 3666642 TI - [ Patients with cerebral functional disorders]. PMID- 3666643 TI - [Irritable stomach (non-ulcer dyspepsia)]. PMID- 3666644 TI - [The physician in the pharmaceutical industry]. PMID- 3666645 TI - [Therapy of pre-delirium alcohol withdrawal syndrome. Results of a comparative study of carbamazepine and clomethiazole]. PMID- 3666646 TI - [Model for a long-term lipid decrease]. PMID- 3666647 TI - [Is your equipment in order? Physicians deal with the new medical equipment ordinance]. PMID- 3666648 TI - [Cesarean section--indications and risks. Results of 20 years at an urban clinic]. PMID- 3666649 TI - [The elderly patient in medical consultation. Psychiatric aspects 2: The organic brain psychosyndrome in the aged]. PMID- 3666650 TI - [New therapeutic approaches in autoimmune diseases. The goal: selective modification of cell or antibody-mediated immunity]. PMID- 3666651 TI - [Muscle packets for weak hearts. Skeletal muscle supports heart action--a defibrillator implanted in the abdomen]. PMID- 3666652 TI - [Multiple sclerosis--disclosing the diagnosis. Attitude of patients: when? How? Disclose at all?]. AB - MS patient members of the German Multiple Sclerosis Society were asked about their opinions concerning time and circumstances of getting to know the diagnosis, based on their personal experiences. Citations from 126 answers to a questionnaire, which had been published in the newsletter of the society, are presented to illustrate typical statements. Two thirds of the patients insisted on being informed about the diagnosis as early and as extensively as possible. One third, however, was more reluctant and stated that extensive information about the diagnosis should be timed individually depending on expected development of the disease and disabilities. Information should be extensive, constructive, and tailored to the individual needs of each patient so that he could deal more effectively with his disease. Most contributions voiced severe criticism as to the practice of information experienced. The study was initiated to prepare a more systematic approach to a field which has not been investigated to a degree matching its importance and impact in everyday neurological practice. PMID- 3666653 TI - [Formation of EtO-PCDF by the treatment of alkali saponification on PCDF]. PMID- 3666654 TI - [Relationship between tissue distribution and acute toxicity of 2, 3, 4, 7, 8 pentachlorodibenzofuran in rats given sub-lethal doses]. PMID- 3666655 TI - [Influences of polychlorinated dibenzofuran on carcinogenesis]. PMID- 3666656 TI - [Studies on the therapeutic effect of squalane on symptoms of PCDFs poisoning in monkeys]. PMID- 3666657 TI - [Polychlorinated quaterphenyls concentration in the blood of normal persons]. PMID- 3666658 TI - [Relation between the gas chromatogram patterns of PCB in human blood and six skeletal congeners of PCQ in human adipose tissue]. PMID- 3666659 TI - [Study on the effect of an anti-coagulant agent (heparin) on renal injury in Japanese rabbits induced by habu snake (Trimeresurus flavoviridis) venom]. PMID- 3666660 TI - [The effect of hemodialysis on electrocardiographic changes. Analysis by the continuous long-term Frank lead monitoring system]. PMID- 3666661 TI - Arterial and venous effects of verapamil in normal volunteers. AB - 1. The effects of verapamil (120 mg orally) and a placebo on arterial pressure, heart rate, PR interval, arterial flows and diameters of the brachial and carotid arteries (pulsed Doppler technique), forearm vascular resistance, and venous diameter and compliance (cutaneous microstrain gauge and plethysmography) have been compared over a 10-hr period in six healthy volunteers during a double-blind and cross-over study. 2. Verapamil reduced diastolic blood pressure by approximately 10 mm Hg, did not affect heart rate and increased PR interval by approximately 15%. 3. Verapamil significantly increased brachial and carotid arterial blood flows by 56% (P less than 0.01) and 16% (P less than 0.05), respectively, but the diameters of these vessels were not significantly modified (+7 and +4%, respectively, NS). Forearm vascular resistance decreased by 40% (P less than 0.01), indicating that verapamil preferentially dilates small arteries. All these effects peaked at 2 h after drug intake and lasted for 6 h. 4. Verapamil increased hand dorsal vein diameter and flow by 95% (P less than 0.05) and 80% (P less than 0.05), respectively, from 2 to 4 h after drug intake but venous compliance, assessed by the venous diameter/venous flow ratio, was not significantly modified (from 0.71 to 0.69, NS), thus indicating that veins are not directly affected by this drug. PMID- 3666662 TI - Relationship between plasma mexiletine levels at steady-state. Presence of ventricular arrhythmias and side effects. AB - The relationships between plasma mexiletine levels and the presence of ventricular arrhythmias and side effects were studied on patients from IMPACT (International Mexiletine and Placebo Antiarrhythmic Coronary Trial). 630 patients who had suffered a myocardial infarction were randomized between placebo and mexiletine. Plasma levels were measured 1 month after the beginning of treatment. Arrhythmia findings (presence or absence of premature ventricular contractions (PVCs), couplets, runs, bigeminy, trigeminy, multiformity and various combinations) were assessed from 24-h ambulatory ECG recordings. The empirical logistic transform was used for modeling the relationships. For all these variables, except the presence of PVCs, trigeminy and runs, the association with plasma level was significant: the higher the plasma level, the lower the rate of occurrence of the particular arrhythmia. This was true whether or not the patient had the arrhythmia at baseline. Analyses based on the same model showed a significant correlation between plasma level and tremor, constipation, sexual problems and the presence of at least one side effect. As the levels of mexiletine at which side effects become frequent are in the same range as those necessary to suppress arrhythmias, the therapeutic range is narrow and individual dose adjustment should preferably be made. PMID- 3666663 TI - Effect of size and dosage strength on the bioavailability of two diltiazem formulations during repeated administrations in humans. AB - In angina pectoris, diltiazem is usually prescribed as two 60 mg tablets in the morning and two 60 mg tablets in the evening. In the course of the pharmaceutical development of this drug, it was therefore planned to study an experimental formulation containing 120 mg of diltiazem. On the basis of dissolution tests in vitro, a bioavailability study was initiated to compare the 120 mg experimental formulation to the standard 60 mg tablet. The study was conducted in 12 healthy volunteers who received the 2 treatments (one 120 mg tablet bid for 7 days versus two 60 mg standard tablets bid for 7 days) according to a cross-over design. Blood and urine samples were analysed by HPLC method with a UV spectrophotometric detection (sensitivity: 5 ng/ml). Analysis of variance did not show any significant difference between the two formulations for the following parameters: maximum plasma levels observed at steady-state, area under the curves and unchanged urinary diltiazem. From these results the extent of absorption of the 120 mg experimental formulation can be considered as bioequivalent to the administration of 2 tablets of the 60 mg commercially available diltiazem formulation. The time to peak, however, was delayed in 75% of the subjects with the 120 mg diltiazem tablet, showing that the surface area of the pharmaceutical preparation is of primary importance for drug dissolution and rate of absorption. PMID- 3666664 TI - Estradiol binding capacity of peripheral blood mononuclear cells in asymptomatic HBV carriers. AB - Peripheral blood mononuclear cells from asymptomatic HBV carriers and normal individuals were incubated with 3H-estradiol and cold estradiol at 37 degrees C. The radioactivity bound to these cells was then counted, and the estradiol binding capacity estimated. The estradiol binding capacity of the mononuclear cells was lower in asymptomatic HBV carriers than in normal individuals. This suggested that the unresponsiveness of the mononuclear cells to estrogen in asymptomatic HBV carriers, which we have reported previously, may be due to a deficiency in the estradiol binding capacity. PMID- 3666665 TI - Hypersideremic and hyperbilirubinemic effect of nicotinic acid in patients with Gilbert's syndrome. AB - Nicotinic acid test (NA) administration is followed by a rise in unconjugated bilirubin and serum total iron in healthy man. A similar concomitant effect has never been investigated in Gilbert's syndrome (GS) patients, who by definition have a hyperbilirubinemia higher than that of controls. The aim of this study was to verify whether, in addition to the hyperbilirubinemic action, NA could induce parallel hypersideremia in GS subjects. The data we obtained confirm in GS patients: 1. the well-known hyperbilirubinemia; 2. a delayed NA plasma concentration curve, and document that in GS the hypersideremic effect is comparable to that of controls. Previous investigators reported that NA produces an equimolar rise of bilirubin and iron levels in healthy man. In our study the extent of the sideremic response to NA occurring in GS patients is comparable to that seen in controls, and appears unrelated to the bilirubinemic values. If the NA effects are based on the documented hemolytic properties of NA, a disturbance in bilirubin handling by the liver of GS subjects appears to be plausible in the presence of almost normal behavior of NA-induced hypersideremia. PMID- 3666666 TI - Luminal bicarbonate outflow in chronic antral erosions is suppressed by pirenzepine. AB - The effects of pirenzepine and ranitidine on luminal HCO3- outflow occurring in subjects with chronic antral erosions have been investigated in a double-blind study. Thirty outpatients with chronic erosions of the gastric antrum were randomly treated for 4 weeks with either pirenzepine 50 mg b.i.d. or ranitidine 150 mg b.i.d. Endoscopic appearance and intragastric bicarbonate content were assessed before and after treatment. At endoscopic follow-up pirenzepine was found to be significantly more effective than ranitidine in promoting disappearance of antral erosions. In the ranitidine group the abnormally high intraluminal HCO3 content was reduced only in healed subjects, while no changes were observed in patients with persisting erosions. In contrast pirenzepine induced normalization of intragastric bicarbonate both in healed and in unhealed patients. The results suggest that pirenzepine suppresses luminal HCO3 leakage by functionally strengthening mucosal defences even before anatomical repair is obtained. PMID- 3666668 TI - Functional defect of zinc transport in patients with Crohn's disease. AB - In the present study, we investigated the question whether the zinc deficiency in Crohn's disease is, at least partly, related to defective zinc entry at the jejunal brush border membrane. Brush border membrane vesicles (BBMV) were prepared from surgically resected pieces of morphologically intact human jejunum by a Mg++ precipitation method. We studied zinc, D-glucose, sodium and D-mannitol uptake into BBMV in 27 patients: 1) 20 patients with Crohn's disease 2) 7 controls. In 8/20 patients with Crohn's disease we found a significant decrease in zinc uptake (-25% +/- 5%, p less than 0.05) into BBMV. This impairment of zinc uptake in 40% of our patients with Crohn's disease was not associated with changes in the transport rates for D-glucose, sodium or D-mannitol. In addition no differences in enzyme marker concentrations or electron microscopic appearance were found. PMID- 3666667 TI - Seasonal prevention of duodenal ulcer recurrences with pirenzepine. AB - Seasonal accumulation of duodenal ulcer recurrences suggests that maintenance therapy could be limited to the more risky periods. We carried out a 2-year, multi-centre, randomized, double blind study in 250 patients in whom the last ulcer proved to be healed at the endoscopy on entry. One-hundred-and-twenty-six patients in group A were given pirenzepine 2 X 25 mg while 124 in group B had 2 X 50 mg daily from the beginning of January to the end of March, and from the beginning of September to the end of November for two consecutive years. Test endoscopies were performed each year at the end of February, May and November. Both groups proved to be well comparable. Thirty-five patients dropped out from group A in the first and 10 in the second year; in group B 27 and 29, respectively. As the effect did not show any dose relation, the four yearly cycles were summarized. Recurrence rate checked in May was 22.1% while in both pirenzepine protected months it was 11.3% (p less than 0.0005) and 13.4% (p less than 0.001), respectively. We conclude that pirenzepine administered in the risky seasons prevents the peak ulcer incidence and reduces the recurrence rate to a level lower than in the non-risky season. Thus pirenzepine is effective in ulcer prevention even if administered in an interrupted manner. PMID- 3666669 TI - The information needs and fears of patients with inflammatory bowel disease. AB - A questionnaire containing a list of 36 questions and nine "fear factors" was sent to 139 patients with inflammatory bowel disease. Patients were asked to select the most and the least important questions and fear factors. Furthermore, the level of information and the source of information were recorded. 58% of the patients responded. The most important questions selected were possibilities of remission of the disease, and of developing cancer (47% and 43% of all answers respectively). Women judged questions regarding cancer, sex life, side effects of diagnostic techniques or drugs to be important more often than men, who were more interested in the cause, symptoms and natural history of the disease. Cancer was the fear factor selected most often (52%), being more important to patients with ulcerative colitis than to those with Crohn's disease, who in turn were more afraid of surgery than those with ulcerative colitis. 77% of the patients felt they had little or too little information. 87% received information from their physicians, 75% wanted to continue doing so. 62% wanted additional information from booklets, 18% from self-help groups. Thus, much information is lacking and many unjustified fears exist in patients with inflammatory bowel disease. This could probably be improved by providing more and better information by improved personal communication, and additionally from booklets or self-help groups. PMID- 3666670 TI - Can idiopathic megacolon cause functional motor abnormalities in the upper gastrointestinal tract? AB - Upper gastrointestinal symptoms are often found in patients with chronic constipation. We report a case of a child with severe chronic constipation due to idiopathic megacolon with megarectum, in which small-bowel motor abnormalities, demonstrated before treatment, were corrected by therapy. Possible pathophysiological mechanisms are discussed. PMID- 3666671 TI - Effect of calcitonin on the prolactin surge of proestrus. AB - The effect of calcitonin (CT) on the prolactin (PRL) surge of proestrus in rats was investigated under normal and perturbed lighting conditions. Salmon calcitonin (SCT) was injected i.p. on diestrus 2 or on proestrus, plasma PRL levels were measured by radioimmunoassay. SCT had no effect on the PRL surge under normal lighting conditions but it induced a small drop in PRL level measured on proestrus morning, 3 hours after CT injection. Animals submitted to perturbed light conditions had higher PRL levels than those kept under normal lighting. These data would indicate that for the female rats on proestrus the sensitivity to stress due to injection and blood sampling may be modulated by changing the photoperiod. SCT injection under these conditions may facilitate this destabilization in PRL level. PMID- 3666672 TI - Evaluation of neutrophil activity and circulating immune complexes levels in diabetic patients. AB - We have studied chemiluminescence produced by neutrophils stimulated by opsonized zymosan in insulin dependent (IDD) and non insulin dependent (NIDD) diabetic patients. Chemiluminescence was evaluated as the integral and maximum peak, total time and time to maximum peak of the response curve to opsonized zymosan. These values were then compared with circulating immune complexes (CIC) and glucose levels. Both IDD and NIDD patients had significantly higher values of chemiluminescence and CIC than normal controls. We also observed that patients who had the highest values of CIC and chemiluminescence levels were the ones with clinical microvascular complications. PMID- 3666673 TI - Increased thyrotropin binding in hyperfunctioning thyroid nodules. AB - The object of this study was to investigate TSH receptors in hyperfunctioning thyroid nodules (HFN). In HFN, obtained from seven patients, 125-I-TSH binding as determined by equilibrium binding analysis on particulate membrane preparations, was found to be significantly increased as compared with normal thyroid tissues (five patients; P less than 0.001). Scatchard analysis of TSH-binding revealed two kinds of binding sites for both normal thyroid tissue and HFN, and displayed significantly increased association constants of high- and low-affinity binding sites in HFN (Ka = 11.75 +/- 6.8 10(9) M-1, P less than 0.001 and Ka = 2.1 +/- 1.0 10(7) M-1, P less than 0.025; x +/- SEM) as compared with normal thyroid tissue (Ka = 0.25 +/- 0.06 10(9) M-1, Ka = 0.14 +/- 0.03 10(7) M-1; x +/- SEM). The capacity of the high-affinity binding sites in HFN was found to be decreased (1.8 +/- 1.1 pmol/mg protein, x +/- SEM) in comparison with normal thyroid tissue (4.26 +/- 1.27 pmol/mg protein; x +/- SEM). TSH-receptor autoradiography applied to cryostatic tissue sections confirmed increased TSH binding of the follicular epithelium in HFN. These data suggest that an increased affinity of TSH-receptor sites in HFN in iodine deficient areas may be an important event in thyroid autonomy. PMID- 3666674 TI - Basolaterally-localized hormone responsiveness of reconstructed monolayer from cultured kidney cells. PMID- 3666675 TI - Classification of normal colorectal mucosa and adenocarcinoma by morphometry. AB - Semi-automatic image analysis was used to make a morphometrical assessment of 15 nuclear and cellular variables in normal (n = 20) and malignant (n = 30) colorectal epithelium. Principal components analysis on the matrix of correlations between variables identified four main sources of variation within the dataset. These were, in decreasing order of importance: (1) nuclear size, nuclear cytoplasmic ratio and nuclear position within the cell; (2) the variability of nuclear size; (3) nuclear elongation and polarity; (4) nuclear shape and its variation. Discriminant analysis was conducted between histologically normal mucosa (n = 10) and adenocarcinoma in ulcerative colitis (n = 20). Using stepwise variable selection, the mean nuclear cytoplasmic ratio (normal, mean 20.4 (s.d. +/- 2.0); tumour, mean 39.7 (s.d. +/- 7.0)) and the coefficient of variation of nucleus to cell apex distance (normal, mean 19.2 (s.d. +/- 7.5); tumour, mean 47.8 (s.d. +/- 9.1)) were chosen as discriminating features. They were used to derive a discriminant function which gave perfect discrimination between the two groups. Scatter plots of these two variables confirmed complete separation of normal mucosa from adenocarcinoma and provided a simple method of applying the discriminant function. Discriminatory performance did not deteriorate when the function was applied to further normals (n = 10) and adenocarcinoma (n = 10). This study highlights the descriptive differences between normal and malignant colorectal epithelium and shows that case allocation may be made to these two lesion categories using a morphometrically-derived classification rule. PMID- 3666676 TI - Morphometrical analysis in ulcerative colitis with dysplasia and carcinoma. AB - Semi-automatic image analysis was used to assess the epithelium in ulcerative colitis with dysplasia and carcinoma. There were three main sources of variation within the dataset: (1) nuclear size, nuclear cytoplasmic ratio and nuclear stratification; (2) the variation of nuclear size; and (3) nuclear shape and polarity. Discriminant analysis chose the mean nuclear cytoplasmic ratio % and the coefficient of variation of nucleus to cell apex distance to derive a scoring system which completely separated normal mucosa (n = 20) and carcinoma (n = 30). The classification rule allocated all high grade dysplasia to the tumour category. Scores for regeneration and low grade dysplasia overlapped with each other and the normal and tumour groups. Scatter plots of the two discriminating variables showed good separation of regeneration and high grade dysplasia, and a degree of overlap with low grade dysplasia. The scatter plots allowed identification of overlapping and misallocated cases, requiring review of their histology and redesignation of the diagnosis in five cases. This study confirms quantitatively the visual criteria used in grading mucosal changes and their trend from regeneration through dysplasia to carcinoma. It underlines the necessity of assessing not only cytological but also architectural and inflammatory components when diagnosing regeneration and low grade dysplasia. Mucosal morphometry may be of use in confirming high grade dysplasia which is an indication for colectomy. PMID- 3666677 TI - The DNA content in cancer and dysplasia in chronic ulcerative colitis. AB - The nuclear DNA content was determined with a cytophotometric technique in colonic mucosa of 15 patients with long-standing ulcerative colitis. The epithelial lesions were classified into inactive colitis, low grade and high grade dysplasia and adenocarcinoma. The histogram pattern varied between narrow unimodal in quiescent colitis, broad unimodal in low grade dysplasia with some hypertetraploid values in three cases (27%) and aneuploid in 62.5% of the lesions with high grade dysplasia. In well-differentiated adenocarcinoma the histograms were broad unimodal, whereas the curves of moderately and poorly differentiated carcinomas were wider and aneuploid. The technique can be used for a prognostic purpose: in dysplastic lesions, the detection of aneuploidy is important because it is frequently found in the presence of invasion although it does not allow its prediction. Carcinomas with polyploid DNA distribution have a better outcome than tumours with aneuploid distribution. PMID- 3666678 TI - 'M' cells in the follicle-associated epithelium of the human colon. AB - The morphology of the epithelium overlying human colonic mucosal lymphoid follicles has been studied by electron microscopy. Epithelial crypts stop at the edge of the follicle and the centre is covered by a single layer of enterocytes. Numerous lymphocytes and, occasionally, other mononuclear cells, are associated with these enterocytes. The lymphocytes are situated in the intercellular spaces, invaginate the lateral cell wall and ultimately appear to be completely surrounded by the enterocyte. When the lymphocyte is near the centre of the enterocyte there is usually little change in enterocyte morphology, but when the lymphocyte is near the apical surface of the enterocyte, the latter closely resembles the membranous epithelial cells ('M' cells) of human small intestine. It is probable that, as with the 'M' cells in the small intestine, these colonic 'M' cells have an antigen sampling function. Their presence may explain the localization of the early lesions of some colonic inflammatory diseases, including Crohn's disease. They may also provide a portal of entry for some rectally-transmitted viral infections. PMID- 3666679 TI - Angiolymphoid hyperplasia with eosinophilia: report of a case arising from the radial artery. AB - A case of angiolymphoid hyperplasia with eosinophilia arising from the radial artery is presented. Histologically, there was proliferation of atypical endothelial cells forming vascular spaces and solid cords, with a background infiltrate of inflammatory cells and prominent tissue eosinophilia. Immunohistochemical studies demonstrated vimentin and factor VIII related antigen in the endothelial cells. The lymphoid infiltrate was polyclonal. These lesions, which typically occur in the dermis and subcutaneous tissue of the head and neck, are known by a variety of different names reflecting disagreement regarding their pathogenesis. The probable nature of the process is discussed. PMID- 3666680 TI - Lymphangioma (or alveolar adenoma?) of the lung. PMID- 3666681 TI - Plastic embedding of bone marrow biopsies. PMID- 3666682 TI - Diffuse proliferative glomerulonephritis. PMID- 3666683 TI - External stimuli affecting incubation behavior and prolactin secretion in the duck (Anas platyrhynchos). AB - The importance of general environmental, including visual and tactile, stimuli on behavior and prolactin secretion during the incubation phase of reproduction in the duck (Anas platyrhynchos) was investigated. Nest occupancy rapidly increased at the end of egg laying and marked the initiation of incubation. Two recesses from the nest each day were synchronized to dawn and dusk; the median occurrence was 0.23 hr after dawn and 1.17 hr before dusk. Mean recess length was 36.1 +/- 1.9 min at dawn and 40.5 +/- 2.1 min at dusk. Plasma prolactin concentrations during incubation, 25.8 +/- 2.3 ng/ml, decreased to baseline levels, 10.8 +/- 1.9 ng/ml, within 24 hr after nestbox removal. The withdrawal of tactile, but not visual, stimuli of the clutch during incubation by either anesthesia or denervation of the incubation patch caused significant decreases in prolactin plasma concentrations within 24 hr. Prolactin plasma concentrations decreased rapidly at the end of incubation in ducks which successfully hatched young as well as in unsuccessful incubators. Temperature manipulations of the clutch, either above or below normal, caused decreases in plasma prolactin concentrations in parallel with temperature modification. PMID- 3666684 TI - Hormonal control of female sexual behavior in the Japanese quail. AB - Four experiments were carried out to study the hormonal control of female receptivity and proceptivity in Japanese quail. Both aspects of reproductive behavior can be activated in a dose-dependent manner by injections of estradiol benzoate (EB). Progesterone (P) given in addition to suboptimal doses of EB has little additional stimulatory effect. Other aspects of the reproductive physiology such as enlargement of the cloacal diameter and growth of the oviduct also seem to be controlled primarily by estrogens with little or no additive effect of P. These conclusions were confirmed by injecting egg-laying females with an antiestrogen, tamoxifen, or an antiprogestin, RU38486. Only the former had marked effects on sexual receptivity, cloacal diameter, and oviduct weight. The inhibiting effects of tamoxifen could easily be reversed by injecting females with large doses of estrogen, which demonstrates that tamoxifen acts on an estrogen-dependent mechanism and not through nonspecific effects. PMID- 3666685 TI - Cooperative social coordination and aggression in male laboratory rats: effects of housing and testosterone. AB - A cooperative behavior, coordinated shuttling by pairs of laboratory rats in a rectangular chamber, can be influenced strongly by an interaction between housing and sex. Males and females learn readily when housed together socially, but individual housing ("isolation") causes severe deficits selectively in males. The aim of the present study was to examine the role of testosterone in the differential effects of housing on cooperation learning. Males of a Sprague Dawley derived strain were housed socially or individually and treated daily in one of three ways (six groups, n = 6 per group): (1) castrated, injected with oil vehicle (without testosterone); (2) castrated, injected with 500 micrograms testosterone propionate (exogenous TP); and (3) sham operated, injected with oil (intact, endogenous testosterone). Socially housed pairs learned readily in all treatment groups, using strategies of coordination in which stereotyped contact or aggressive interactions were interpolated. Individual housing was associated with a deficit, but only in the TP-treated and intact groups in which some pairs either did not learn or performed poorly. The deficit was associated with violent fighting and extreme and stable differentiation into dominants and subordinates, the latter exhibiting prolonged freezing. Oil-treated castrates, when housed individually, were unimpaired and actually surpassed their socially housed counterparts on some measures. Their success was associated with an increase only in low-level aggression. The housing-hormone interaction in male rats suggests that testosterone influences the capacity to develop cooperative behavior by modulating both aggression and its consequences for the relationship between partners. The use of social interaction models, including cooperation, for the study of behavior-hormone interactions was also discussed. PMID- 3666686 TI - Hormonal control of sexual and scent marking behaviors of male gerbils in relation to the sexually dimorphic area of the hypothalamus. AB - The sexual and scent marking behaviors of male gerbils are stimulated by testosterone (T) action in the preoptic area (POA) of the hypothalamus. The sexually dimorphic area (SDA) in the posterior POA, which also responds to T, is implicated in this process. This research studied the sensitivities of mating, marking, and the SDA to T metabolites and other steroids. Experiment 1 focused on mating. Male gerbils were implanted at castration with 2-mm Silastic capsules containing T, dihydrotestosterone (DHT), 19-nortestosterone (19-nor T), estradiol (E), or no hormone and were tested 3-7 weeks later. T, E, and 19-nor T maintained intromissions, but E-treated males rarely ejaculated. Controls and DHT-treated males stopped mounting. Experiment 2 compared the ability of these steroids to reinstate marking and mating using the same dose and a larger one (5 mm). Androstenedione, 19-hydroxytestosterone (19-OHT), and E plus DHT were studied as well. Volumes of the SDA and SDA pars compacta (SDApc) were also measured. Only T, 19-nor T, E, and E + DHT reinstated sexual behavior, but all steroids except 19-OHT stimulated marking. E and DHT synergized to elicit mating. For marking, they were no more effective together than alone. Steroid-treated males had larger SDAs than controls. Moreover, steroids that stimulated sexual activity produced larger SDAs than steroids that did not. SDA size correlated with copulatory rate, but not with copulatory efficiency. SDApc size correlated with copulatory efficiency, but not with copulatory rate. Like copulatory rate and efficiency, sizes of the SDA and SDApc did not correlate with each other. PMID- 3666687 TI - Sex hormones in lesbian and heterosexual women. AB - The authors measured plasma testosterone (T), androstenedione (A), and cortisol (C) levels in seven lesbian and seven heterosexual women matched for age and socioeconomic status. In addition, psychiatric symptoms, physical activity levels, depression, subjective sense of stress, and sexual behavior variables were assessed. There were no significant differences in sex hormone levels between the two groups of women, who were also comparable in psychiatric symptom levels, depression, and self-perceived stress. Lesbian women reported significantly more current physical activity relative to peers. Other than the sexual orientation difference which was a prerequisite for entry into the study, there were virtually no significant differences in sexual behavior although lesbian women tended to have achieved psychosexual milestones at a younger age. We were not able to corroborate the finding of Gartrell, Loriaux, and Chase (1977) that lesbian women have higher T levels, possibly due to the fact that the two groups were closely matched on several behavioral variables potentially affecting testosterone levels. PMID- 3666688 TI - Effects of corticosterone treatment on male aggressive behavior in a lizard (Anolis sagrei). AB - Social dominance in several species of lizards appears related to adrenal gland activity. The purpose of this study was to test whether the adrenal hormone corticosterone (CS) would inhibit the aggressive behavior of males of the lizard Anolis sagrei. Reproductively active males were randomly assigned to either CS or placebo (P) treatment groups or to an untreated stimulus male group. Both CS and P were administered in pellet form. Corticosterone pellets were designed to release approximately 4.8 micrograms of CS/day. Initially (Day 1), treatment males were implanted subcutaneously with a single pellet of either CS or P. After 1 week (Day 8), behavior tests were staged between treatment males and untreated stimulus males. The behavior of treatment males in response to stimulus males was videotaped. Significantly fewer CS-treated males than P-treated males approached the stimulus males, erected a crest, or showed biting behavior. Corticosterone treated males also displayed significantly less frequently than did P-treated males and gave fewer displays of a type associated with dominance. Mean combined testis weight at the end of the experiment was significantly less in CS-treated males than in P-treated males and spermatogenic activity in CS-treated males was reduced. Plasma testosterone in CS-treated males was nondetectable, whereas P treated males had normal levels of this steroid. These results indicate that CS can inhibit male aggressive behavior and testicular function in a lizard and support the hypothesis that the behavior changes observed in subordinate animals following defeat in agonistic encounters may in part be due to increased plasma CS levels. PMID- 3666689 TI - Effects of voluntary and forced exercise on lordosis behavior in female rats. AB - We measured sexual behavior (lordosis) in ovariectomized, steroid-treated, exercising female rats. When estradiol-treated animals exercised voluntarily, lordosis was directly related to the amount of exercise. Forced exercise (swimming) following treatment with estradiol 17 beta and progesterone significantly increased lordosis scores but only after animals swam for 2.5 hr per day. Lordosis behavior returned to baseline levels 7 weeks after forced exercise was stopped. Circulating levels of estrogen and progesterone measured immediately after behavioral testing did not differ between animals forced to exercise and their controls. The mechanisms responsible for the increase in lordosis behavior following exercise are unclear. It is possible that a change in body composition, a change in neural sensitivity to gonadal steroids, and/or changes in pituitary or adrenal function contribute to the increased lordosis behavior in exercised animals. PMID- 3666690 TI - Estrogenic contributions to sexual differentiation in the female guinea pig: influences of diethylstilbestrol and tamoxifen on neural, behavioral, and ovarian development. AB - We administered the synthetic estrogen, diethylstilbestrol (DES), or the antiestrogen, tamoxifen, to pregnant guinea pigs and observed the consequences for sexual differentiation of their female offspring. Hormones were administered during the period when treatment of fetuses with testosterone influences the development of sex-related traits (approximately Days 30 to 65 of gestation). Ovarian function, masculine and feminine sexual behavior, and the structure of a sexually dimorphic neural region in the preoptic area were assessed in adulthood in hormone-exposed animals and in oil-treated and untreated controls. Prenatal exposure to DES dipropionate (DESDP) caused masculinization and defeminization. DESDP-treated females mounted more than control females, both without hormonal stimulation and when given testosterone propionate (TP) as adults. The sexually dimorphic neural region was also masculinized in these females. In regard to defeminization, they showed delayed vaginal opening, impaired progesterone (P) production, an absence of corpora lutea, and impaired lordosis and mounting responses to estradiol benzoate (EB) and P. Prenatal treatment with tamoxifen produced a complicated pattern of results. Tamoxifen-exposed females evidenced less masculine-typical behavior, showing diminished mounting without hormonal stimulation and in response to TP. However, they also showed delayed vaginal opening, enhanced P production, and impaired mounting in response to EB and P. Their lordosis behavior and the volume of the sexually dimorphic neural region were unaffected. These results suggest that estrogens play a substantial role in sexual differentiation in the guinea pig. High levels of estrogen promote masculine-typical development, and unusually low levels may impair some aspects of both masculine-typical and feminine-typical development. PMID- 3666691 TI - Mental illness awareness week. PMID- 3666692 TI - Limited confidentiality and the pedophile. PMID- 3666693 TI - Avoiding negligent release: a risk-management strategy. PMID- 3666694 TI - An update on software. PMID- 3666695 TI - Aging parents as caregivers of mentally ill adult children: an emerging social problem. AB - More than one-third of long-term mentally ill adults live with their families, most with aging parents, a situation that accentuates the need for residential alternatives to home care for deinstitutionalized patients who will out-live their caregivers. The role of parenting mentally disabled adults may also impose undue stress on elderly persons. Objective and subjective parental burden, including fears for the patient's future, are increased by the mental health system's failure to offer education, support, training in problem solving, and a collaborative role in discharge planning to family members. Social policy implications of considering families as primary caregivers include the danger that government will be relieved of responsibility for care of the mentally ill, the creation of a potentially at-risk population among aging parents and other family members affected by the stresses of caregiving, and the reduction of the patient's potential for independent living. PMID- 3666696 TI - Changes in health care costs and utilization associated with mental health treatment. AB - Health insurance claims of families covered by Aetna's Federal Employees Health Benefit Program from 1980 through 1983 were analyzed to determine if any changes in total health care utilization and costs were associated with the initiation of mental health treatment. A total of 26,915 families in which at least one member received mental health treatment were compared with a randomly selected group of 16,468 families in which no member had received mental health treatment. Total health care costs for those receiving mental health treatment were significantly higher than costs for the comparison group. However, those costs dropped significantly after initiation of mental health treatment and continued to decline over the study period. The biggest declines occurred among persons age 45 and older, a finding that may have important policy considerations. PMID- 3666697 TI - Psychiatric residency training and the changing economic scene. AB - Efforts to contain the cost of medical care are having a profound impact on psychiatric residency training programs, which must cope with diminishing levels of funding from both federal and private sources. The programs are also being buffeted by other forces that help shape psychiatry's manpower needs, such as the corporatization of American medicine, new models of health care delivery, the regulation of medical care, the trend toward subspecialization, a perceived oversupply of physicians, and the growing number of mental health professionals who are not physicians. The author discusses how these developments are impinging on residency training programs and what the programs can do to meet the challenges they pose. He believes psychiatry will be best served by resisting tendencies to compromise on the quality of training for its future practitioners. PMID- 3666698 TI - Patient access to medical records in a forensic center: a controlled study. AB - Several psychiatric facilities have opened their records partially or completely to patients. The authors report the results of a two-part study in which 20 patients on a minimum-security unit of a forensic center were allowed to read their records and later to write in them. Staff and patient attitudes toward granting patients access to their records were measured before and during the study and were compared with staff and patient attitudes on two units where patients were not granted access. Only eight study patients actually read their charts and none wrote in them, but the majority of both study and control patients felt that access had been helpful. No significant differences in patient behaviors were found on any of the units as a result of access. Staff attitudes toward access did not differ significantly before or after the study, and few differences were found in staff charting practices. PMID- 3666699 TI - A survey of mental disability among state prison inmates. AB - To obtain a comprehensive picture of the levels of mental disability in the general state prison population in New York State, the authors gathered data on a random sample of inmates using a survey instrument adapted from the state's level of-care surveys of the psychiatric population. The sample consisted of 3,332 inmates in the general prison population (9.4 percent) and 352 inmates in prison mental health units. The survey results showed that 8 percent of the state's prison inmates have severe psychiatric or functional disabilities that clearly warrant some type of mental health intervention, and another 16 percent have significant mental disabilities that require periodic services. The specific nature and extent of these disabilities need to be assessed before appropriate services can be developed. PMID- 3666700 TI - Attitudes of black adults toward community mental health centers. AB - The attitudes of 411 black adults toward community mental health centers (CMHCs) and their relationship to seven demographic and sociocultural characteristics were assessed. Fewer than 20 percent of subjects had negative attitudes toward CMHCs, about 34 percent had positive attitudes, and about 47 percent had neutral attitudes. Female gender, married status, and a high level of racial consciousness were associated with more positive attitudes toward CMHCs but explained only about 11 percent of the variation in attitudes. The author suggests that mental health clinicians and service planners become more knowledgeable about the attitudes and values of all segments of the black community. PMID- 3666701 TI - A research development workshop to stimulate outcome research in consultation liaison psychiatry. AB - With shrinking federal resources, innovative approaches involving both professional organizations and federal program staff are needed to stimulate research in new or undeveloped clinical areas. National Institute of Mental Health staff and members of the American Psychiatric Association's task force on cost-effectiveness in consultation-liaison psychiatry applied a collaborative model, the research development workshop, to stimulate outcome research in consultation-liaison psychiatry, a field with little previous such research. As a result 12 grant proposals have been submitted to NIMH for review in the last three years, and six are now funded. In contrast, in the previous ten fiscal years none of the nearly 700 services research proposals focused on the consultation-liaison area. The model could be applied to other mental health fields in which research should be stimulated. PMID- 3666702 TI - A model program to teach parenting skills to schizophrenic mothers. PMID- 3666703 TI - Characteristics of high users of acute psychiatric inpatient services. PMID- 3666705 TI - Concurrent review. PMID- 3666704 TI - Assessing mental illness in SRO shelter residents. PMID- 3666706 TI - Expressed emotion. PMID- 3666707 TI - Adolescent suicide. PMID- 3666708 TI - Runaways. PMID- 3666709 TI - Studies of victims of violence. PMID- 3666710 TI - Adolescent psychiatry. PMID- 3666711 TI - Measuring program outcomes in Tucson. PMID- 3666712 TI - Promoting compliance with outpatient drug treatment. PMID- 3666713 TI - Predictors of response of antisocial patients to hospital treatment. AB - Although clinicians generally agree that patients with antisocial personality disorder should not be treated on general psychiatry units, little is known about the response to hospital treatment of personality disorder patients who have antisocial features or traits. In a study to identify predictors of positive and negative response to hospitalization, charts of all patients discharged from a private hospital with diagnoses of antisocial personality disorder or antisocial features over 52 months were reviewed. As a group the 33 patients did not respond well to treatment, and 70 percent left treatment prematurely. Significant predictors of negative response were histories of felony arrest and conviction; a history of repeated lying, aliases, and conning; and an unresolved legal situation at admission. Positive response was related to the presence of anxiety and an axis I diagnosis of depression. The authors believe that antisocial personality disorder is often underdiagnosed and that countertransference can present a significant obstacle to treatment of antisocial patients. PMID- 3666714 TI - A method for estimating underutilization of mental health services by ethnic groups. AB - Most studies of utilization of mental health services by ethnic groups have used parity as a measure of whether members of ethnic groups are receiving a fair share of services. The level of services is assumed to be adequate if the percentage of ethnic group members in the treatment population is the same as the group's percentage in the general population. However, service planning based on achieving parity fails to consider whether some groups have higher levels of need than others. The authors describe a method for more accurately projecting service needs of minority groups based on population data and on sample surveys of needs. The results help define more equitable service goals for all population groups. PMID- 3666715 TI - A management system to maximize compliance with standards for medical records. AB - A management system designed to maximize staff's compliance with standards for medical records in the periods between external audits was developed for an outpatient network of a large state hospital. The system was based on analysis of the processes and circumstances that enhance compliance with records standards, such as specifying a clear, concrete goal for each chart and having a time limited review process, and the major inhibitors, such as too-frequent and random audits and lack of internal or external rewards. Data collected on application of the system to 976 charts in the outpatient network showed the system to be effective; between the initial review and the rereview in the third month, the percent of records achieving more than 80 percent compliance with standards rose from 57 percent to 86 percent. PMID- 3666716 TI - Help-giving in self-help groups. AB - A longitudinal survey of members of self-help groups for families of the mentally ill in Pittsburgh examined members' perceptions about the types of help-giving activities that took place in the groups and the relationship between those activities and members' degree of satisfaction with the group. The activities that occurred most frequently, such as catharsis, explanation, and normalization, were related to nondirective, nonthreatening aspects of social support. The least frequent activities, such as confrontation or reference to group norms, were those that were more threatening and focused on behavioral change. The nondirective, nonthreatening activities were moderately correlated with members' satisfaction with the group. PMID- 3666717 TI - Issues in developing standards governing psychiatric practice in community mental health centers. PMID- 3666718 TI - Gold award. Brief psychiatric inpatient care for acutely disturbed patients. PMID- 3666720 TI - Significant Achievement Awards. A complete resource for information about lithium. Lithium Information Center, Department of Psychiatry, University of Wisconsin, Madison. PMID- 3666719 TI - Gold award. Helping angry and violent people manage their emotions and behavior. PMID- 3666721 TI - Significant Achievement Awards. Culturally relevant inpatient care for minority and ethnic patients. Ethnic-Minority Inpatient Programs, Department of Psychiatry, San Francisco General Hospital, University of California, San Francisco. PMID- 3666722 TI - Significant Achievement Awards. Therapeutic friendships for chronic mentally ill patients. Case Aide Program, Norfolk Mental Health Association, Inc., Norwood, Massachusetts. PMID- 3666723 TI - A hospital alternative for patients in crisis. PMID- 3666724 TI - Perils of social development for the schizophrenic patient. PMID- 3666725 TI - Turf issues in CMHCs. PMID- 3666726 TI - Chronicity in schizophrenia. PMID- 3666727 TI - Lithium in the elderly. PMID- 3666728 TI - Hospitals: making room for many faiths. PMID- 3666729 TI - Twin Cities hospitals' finances under siege. PMID- 3666730 TI - Twin Cities credit ratings may drop. PMID- 3666731 TI - Second quarter shows signs of a downturn. PMID- 3666732 TI - High mortality data call for planning. PMID- 3666733 TI - Touchstone awards reward excellence. PMID- 3666734 TI - "Don't Panic" educates consumers. PMID- 3666735 TI - 2nd-quarter predictions accurate. PMID- 3666736 TI - Minnesota HMOs: awash in red ink in '87, too? PMID- 3666737 TI - Study scrutinizes private case management. PMID- 3666739 TI - Massachusetts bill will be hard to follow. PMID- 3666738 TI - MR: profits climb, bad debt drops. PMID- 3666740 TI - Hospitals: know laws, set policies before drug testing. PMID- 3666741 TI - Coalitions search for reliable cost data. PMID- 3666742 TI - Stanley Works adds adoption benefits. PMID- 3666743 TI - Physicians shed light on marketing MR. PMID- 3666744 TI - Alternate care expansion continues: AHA data. PMID- 3666745 TI - Gains, losses among multis: AHA survey. PMID- 3666746 TI - Equipment leasing: a question of economics. PMID- 3666747 TI - Public support of drug testing increases. PMID- 3666748 TI - Localization of the human dihydropteridine reductase gene to band p15.3 of chromosome 4 by in situ hybridization. AB - We report the localization of the gene for dihydropteridine reductase (DHPR) to the human chromosome region 4p15.3 by in situ hybridization using a cDNA probe to the enzyme. The distal end of the short arm of chromosome 4 is of considerable interest because the gene responsible for Huntington's disease is located in this region. Although this part of the chromosome is being extensively studied, DHPR is the first well-characterised gene to be assigned to the region. Restriction enzyme fragment length polymorphisms have been detected with a number of restriction endonucleases, including AvaII and MspI. These features may make the DHPR cDNA clone a useful probe not only for prenatal diagnosis of DHPR deficiency but also for linkage studies of Huntington's disease. PMID- 3666749 TI - [Learning and coping]. AB - In the course of the last few years, the development of what can be called "modern-day diseases" has revealed the limits of medicine and a system which is primarily curative in nature. The recognition of these limits has launched the search for a new, therapeutic approach to health which is characterized by the modification of the target from the individual to a collectivity and by taking into consideration a true association of the different actors who are legitimate and indispensable partners in health promotion activities. Although this new approach is currently being applied in various ways throughout the world, there are still some unanswered questions: is the scientific foundation adequate? Is the objective of changing lifestyles legitimate? And particularly, are the methods and techniques effective? The answers to these questions inevitably depend on the projected objectives: are we trying to change current lifestyles or do we want to contribute to the process of social change? Evaluating the efficacity of the former does not really pose a problem. In evaluating the efficacity of the latter, on the other hand, it appears difficult to isolate certain environmental factors and identify the resistances which are due to the processes of socialization. It might, in fact, be wise to investigate the extent of necessary changes prior to evaluating the effectiveness of the methods used. At any rate, precipitous judgement should be avoided. A slow pace of change can be used as a gauge of depth and durability, and can avoid the extremism of moving from a splintered view of the individual to one that becomes oversocialized. PMID- 3666750 TI - Education for health. Lessons learned and new opportunities in eastern Africa. PMID- 3666751 TI - Organizational analysis in health education planning. PMID- 3666752 TI - [Desire, knowledge..., belief, choice, ...and ability]. AB - The evolution of various approaches to health education and additions from educational psychology have brought about a proposition of an easy-to-follow (thus useful) model for health educators based on five nouns: Desire, Knowledge, Belief, Choice, and Ability (Vouloir, Savoir, Se voir, Choisir et Pouvoir). 1. Desire creates the motivation which is essential to action, and can stem from: anticipating consequences; and/or an internal need to resolve problems; and/or external constraints; and/or an interest, reflecting a system of values. Motivation increases, of course, when more than one of the above factors comes into play and the effects are combined. 2. Knowledge is the cognitive competence which is acquired through direct experience, imitation of models, or "verbal apprenticeship" which provides the individual with a repertoire of effective solutions to various problems. 3. Belief concerns the concept of self-evaluation (or rather self-estime). An individual judges his/her capacity to act according to his/her capabilities, and the community according to its actual or potential human, financial and material resources. 4. An individual or community uses its "knowledge" to consider a series of possible solutions to a given problem and chooses the solution according to a base of preferences. In health, as elsewhere, all actions have positive and negative consequences. An example can be found in the alcohol/tobacco area: a certain positive image of smoking and drinking has been portrayed in many socio-cultural environments, and educational campaigns have had a difficult time convincing the public of the negative consequences of these actions. It is thus not surprising that the "balance" of the decision continues toward substance abuse. 5. After "desire, knowledge, belief and choice" have filtered potential solutions, the decisive step is left: the individual and/or community execute an action according to their ability to succeed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666753 TI - Promoting healthy behaviours: the nurse as a teacher of breast self examination. PMID- 3666754 TI - IUHE structures. International Union for Health Education. PMID- 3666755 TI - Temporal resolution: an insight into the video display terminal (VDT) "problem". PMID- 3666756 TI - Sleep duration at home and sleepiness on the job in rotating twelve-hour shift workers. PMID- 3666757 TI - Diversity of some gene frequencies in European and Asian populations. II. Fit of an isolation by distance model. AB - Six enzyme polymorphisms have been studied in European and Asian populations, using kinship as an index of genetic differentiation. Four clusters of populations are apparent, corresponding to four geographical regions. The differences between such groups account for a large fraction of genetic diversity, while minor differences are apparent between populations belonging to the same continent or subcontinent. The kinship as bioassayed from three loci (GLO, ESD, 6-PGD) correlates significantly with space, showing an exponential decline with the increase of distance between populations. PMID- 3666758 TI - Study on a Brazilian isolate. I. Population structure and random genetic drift. AB - A number of parameters were evaluated in order to determine the level of isolation of a small Brazilian community existing in partial geographic isolation and thereby evaluate the random genetic drift potential in the population. On a theoretical basis, it is concluded that the probability of genetic drift is low but cannot be excluded. The relatively small proportion of migrants (26%), the limited individual mobility, as given by marital distance (29 +/- 7 km), the mean migrational distance (46 +/- 11 km), the small effective size (122), and the value of the product Neme (26) agree with the possibility of genetic drift in this population. The observed coefficient of inbreeding (0.00239) is lower than that expected (0.0066) for random mating, suggesting some pressures against consanguineous marriage. PMID- 3666759 TI - Effect of C-banded heterochromatin on centromere separation. AB - The present study is to determine the effects of centromeric heterochromatin on centromere separation. Amniotic cell cultures in which the centromeric heterochromatin of one chromosome was at least twice as large (qh+) as the heterochromatin (qh) in the homologous chromosome were selected. Fifteen amniotic cell samples with 1qh+, 9qh+ or 16qh+ were studied. The size of the centromeric heterochromatin was directly correlated with the delay in centromere separation. The chromosome with the smaller centromeric heterochromatin tended to show earlier centromere separation than the homologue with the larger heterochromatin. Our results suggest that the quantity of centromeric heterochromatin may influence the genetic control of centromere separation. PMID- 3666760 TI - Distribution of blood groups in the East African Somali population. AB - The results of a population survey on blood group distribution in Somalia, East Africa, are presented. Over 1,000 subjects were tested for most blood groups included in the survey. The sampling covered the whole country and was well in accordance with the population density as estimated by the recorded birth places of the subjects. Altogether, 46 blood group antigens were tested, partly common antigens within 11 of the major blood group systems, but also infrequent and very frequent antigens, some not tested before in Africa, were included. The results were compared with the available data for other related peoples and for populations from the same geographical area. The standard genetic distances were also applied in the comparison. The results suggest that only a minor component in the genetic constitution of the Somali population can be ascribed to Caucasian admixture. They are markedly in contrast with some earlier findings. During the survey we observed a previously unknown Rh gene complex occurring with a polymorphic frequency in Somalis. PMID- 3666761 TI - Relationship between transferrin C2 and birth weight. AB - In previous investigations transferrin C2 has been found to be associated with spontaneous abortion and premature birth. In a study of newborn infants from northern Sweden, no significant correlation was found between birth weight and transferrin C2 of the infants. Thus transferrin C2 appears to be associated with reproductive disturbances and with premature birth, but not with birth weight in mature infants. PMID- 3666762 TI - Polymorphism of delta-aminolevulinic acid dehydratase in Basque populations. AB - Human red cell delta-aminolevulinic acid dehydratase (ALADH; EC 4.2.1.24) polymorphism was studied in three population samples of the Basque Country. The frequency of the ALADH2 was around 0.08 and similar to that in other European countries. PMID- 3666764 TI - On research in nursing practice. PMID- 3666763 TI - Haptoglobin groups and serum cholesterol levels. AB - The serum levels of cholesterol and cholesterol esters were studied in relation to haptoglobin groups in a series of 277 healthy blood donors from northern Sweden. Previous reports of associations between Hp 2-2 and high serum cholesterol levels were not confirmed, though a nonsignificant deviation in the same direction was observed. Possible mechanisms behind an association between haptoglobin groups and serum cholesterol were discussed. PMID- 3666765 TI - Convalescence and implications for nursing research. PMID- 3666766 TI - Experience of meaning in suffering. PMID- 3666767 TI - Unmet needs of the chronically mentally ill: will nursing respond? PMID- 3666768 TI - Methodological triangulation: a vehicle for merging quantitative and qualitative research methods. PMID- 3666769 TI - Nurse educator views of assignment of authorship credits. PMID- 3666770 TI - Teaching and learning: essential components of the nurse executive role. PMID- 3666771 TI - The nature of taxonomy. PMID- 3666772 TI - The phenomenological movement. PMID- 3666773 TI - Police story. PMID- 3666774 TI - An integrated approach to pain management. PMID- 3666775 TI - A routine assay method for estimation of free xylose during saccharification of xylan by xylose liberating endo-beta-D-(1----4) xylanase. PMID- 3666776 TI - Effect of egg as a sole diet on hepatic lipid peroxidation and related defence system in the rat. PMID- 3666777 TI - Modulation of muscle dehydrogenases by ascorbic acid in exhausted albino rats. PMID- 3666778 TI - Thermodynamics of spectroelectrochemical electron transfer in a mesotetra sulphonated phenyl porphyrin iron(III)-apomyoglobin complex. PMID- 3666779 TI - Dissociation constants & thermodynamic data of starch phosphorylase from banana (Musa paradisiaca) leaves using affinity horizontal polyacrylamide slab gel electrophoresis. PMID- 3666780 TI - Evidence for suggested mechanism of goat carboxypeptidase A catalyzed hydrolysis of acylpeptides. PMID- 3666781 TI - Effect of some monovalent and divalent cations on the electric field mediated hemolysis of human erythrocytes. PMID- 3666782 TI - Magnesium deficiency and metabolism of lipids in rats fed cholesterol-free and cholesterol-containing diet. PMID- 3666783 TI - Circular dichroic determination of DNA base composition. PMID- 3666784 TI - Effect of alcohol on the activity of lysosomal enzymes in rat brain. PMID- 3666785 TI - 19th meeting of the Society of Immunology. October 1-3, 1987, Ulm, Federal Republic of Germany. Abstracts. PMID- 3666786 TI - Age-related natural antibody specificities among hybridoma clones originating from NZB spleen. AB - In the studies presented here, age-related natural antibody specificities have been investigated in the autoimmune NZB mouse strain by cell fusion. The monoclonal immunoglobulins (MIg) secreted by productive hybridoma clones were examined for their antibody activities against a panel of antigens, including single- and double-stranded DNA, actin, tubulin, myosin, bromelain-treated mouse red blood cells (BrMRBC) and TNP-BSA, employing both direct and competitive enzyme immunoassays. The antibody specificities against this panel of antigens were strikingly frequent among hybridoma clones from neonatal NZB (49%) mice, compared to normal BALB/c neonates (8.8%) shown earlier. Among neonatal hybridomas with known antigen reactivities, 73% of the clones exhibited polyspecific binding. In contrast, the majority of hybridomas from 5- and 7-month old NZB spleen reacted monospecifically (76%) with the antigens tested. Such a characteristic reactivity pattern reflects an age-related evolution of B-cell repertoire expression. Unlike normal BALB/c mice, a high frequency of monospecific TNP-hapten-reactive clones (75%) was noticed among hybridomas of known antigen reactivities from 5- and 7-month-old NZB-strain mice, an age when autoimmune haemolytic anaemia sets in. In conclusion, an elevated frequency of autoreactive clones among neonates (49%) and an aberrant expression of TNP reactive clones in adults seem to be an outward signal of certain discrepancies at the level of B-cell repertoire expression in autoimmune NZB-strain mice. PMID- 3666787 TI - Antibody-dependent tumour cytolysis by human neutrophils: effect of synthetic serine esterase inhibitors and substrates. AB - The requirement for serine esterase activity in antibody-dependent cellular cytotoxicity (ADCC) in human neutrophils against Raji target cells has been investigated. The lysis was prevented when the serine esterase inhibitors TPCK and TLCK (chloromethyl-ketone derivatives of tosylamino acids) were introduced into the system. Moreover, neutrophils pretreated with TPCK or TLCK and washed were inhibited as well, via a process unaffected by the presence of adequate amounts of enzymatic substrates. This suggests that the inhibition mediated by TPCK and TLCK is independent of serine esterase blockade, therefore implying the inactivation of some other step crucial to the lysis. The addition of synthetic chymotrypsin substrates (tyrosine and phenylalanine esters) impaired the Raji cell lysis in a dose-related manner without altering the constitution of neutrophil-target conjugates. Trypsin ester substrates were ineffective. These results are in agreement with the involvement of a serine esterase activity with chymotrypsin-like specificity, which should participate in the lysis at a post binding step. We conclude that neutrophil-mediated ADCC, as developed in our model system, needs the intervention of a serine esterase or esterases, like other systems of cell-mediated cytotoxicity. PMID- 3666788 TI - Alteration of the protein composition in the haemolymph of American cockroaches immunized with soluble proteins. AB - Previous in vivo experiments demonstrating the existence of humoral immunity in cockroaches prompted us to investigate the composition and number of proteins that are newly induced or increased in quantity in the haemolymph of immune cockroaches compared to saline-injected control animals. SDS-PAGE analysis showed that six different haemolymph proteins of molecular weights 220,000, 162,000, 115,000, 102,000, 95,000 and 45,000 were induced in response to immunization by honeybee toxoid. However, only the 115,000 and 102,000 MW proteins consistently increased in quantity in the haemolymph of females immunized with various other soluble protein antigens, such as phospholipase A2 toxoid and inactivated creatine phosphokinase. Other experiments showed that the 115,000 MW band was not induced in immunized male cockroaches. Therefore, only the 102,000 MW protein was consistently enhanced in all samples of immune haemolymph from animals injected with various antigens. In addition, this protein was found in precipitates recovered from assays where immune haemolymph proteins were precipitated by the antigen. Gel filtration chromatography showed that this induced haemolymph protein is large, and bears an apparent native molecular weight of 600,000 +/- 80,000. This suggests that the 600,000 MW protein may consist of multiple subunits of 102,000. PMID- 3666789 TI - [Ballistometric study on the plastoelastic characteristics of the skin with respect to water content]. PMID- 3666790 TI - [Anti-SSA/Ro antibodies in lupus erythematosus]. PMID- 3666791 TI - [Staphylococcal scalded skin syndrome. A case of early onset with ultrastructural study]. PMID- 3666792 TI - [Familial basal cell nevus syndrome]. PMID- 3666793 TI - [Purpura pigmentosa chronica with linear pattern. Presentation of a case]. PMID- 3666794 TI - [Systemic amyloidosis associated with myeloma]. PMID- 3666795 TI - [Hypotrichosis, dystrophic onychopathy, and dental abnormalities in a case of histidinemia]. PMID- 3666796 TI - [Hidrotic ectodermal dysplasia associated with endothelial changes in the cornea]. PMID- 3666798 TI - [Epithelioid sarcoma]. PMID- 3666797 TI - [Pseudo "pili bifurcati": microscopic and ultrastructural aspects]. PMID- 3666799 TI - [Chemical aspects of hapten-carrier interaction in contact allergy]. PMID- 3666800 TI - [Possibility of therapy in post-zoster neuralgia]. PMID- 3666801 TI - [Treatment of Hailey-Hailey disease]. PMID- 3666802 TI - Dendritic cells in human peripheral blood: effective enrichment from the nonadherent cells. AB - Dendritic cells (DC) from human peripheral blood were enriched using a method including adherence on plastic, depletion of phagocytic cells, flotation on density gradient column and panning on antibody-coated surfaces. The course of cell separation was evaluated by characterizing the morphological, antigenic and functional features of the different cell fractions. Using the population depleted of strongly adherent cells as the source, we were able to achieve a cell fraction containing 40-65% of DC (the main contaminants being monocytes and natural killer cells). Functionally these cells were highly stimulatory in autologous mixed leukocyte reaction. On the other hand, cells which primarily adhered well and were detached after overnight culture contained less than 5% of DC (the main contaminants being monocytes) after the same purification protocol. The calculated yields of DC were 1-2 X 10(6) and less than 0.5 X 10(6) from the nonadherent and adherent populations, respectively. Thus we concluded that the adhesiveness of DC from human blood is so weak that they can more efficiently and in a more reproducible way be enriched from the primarily nonadherent cell fraction. PMID- 3666803 TI - Liposome as an adjuvant for the production of estradiol antibodies. AB - Mice immunized with liposome associated estradiol-bovine serum albumin conjugate (E2-BSA) showed a significantly higher estradiol-specific immune response than did mice injected with the free conjugate. The conjugation of estradiol with BSA is imperative, since injection of liposomes with estradiol in the lipid bilayer was found to be ineffective in inducing an immune response. Entrapment of E2-BSA in neutral and positively charged liposomes was found to be a potent mode of immunostimulation, even better than emulsification in complete Freund's adjuvant (CFA). Covalent liposome surface association of E2-BSA induced a good immunopotentiation. However, the response was lower than that observed with the entrapped conjugate. The affinity and the specificity of antisera, raised in different ways, were determined. PMID- 3666804 TI - Experimental study with leptospires in bandicoot Bandicota bengalensis. PMID- 3666805 TI - Autonomic hyperactivity on diazepam withdrawal in rats. PMID- 3666806 TI - Induction of chromosomal aberrations by prefeeding saccharin in albino mice. PMID- 3666807 TI - Effect of hypophysectomy on fat body of the frog Rana cyanophlyctis (Schn.) during vitellogenic growth phase. PMID- 3666808 TI - Effect of flutamide, a nonsteroidal antiandrogen on testis and accessory genital organs of male rats: a reevaluation in prepubertal and adult rat. PMID- 3666809 TI - Termination of pregnancy in mice with antiserum to chicken riboflavin carrier protein: alteration in lysosomal enzyme activities. PMID- 3666810 TI - Effect of parathyroidectomy on calcium and phosphorus regulation in the garden lizard Calotes versicolor (Daud.). PMID- 3666811 TI - Early influence of androgens on ascorbic acid content of hepatic tissue of the male albino rat Rattus norvegicus albinus (Linn.). PMID- 3666812 TI - Development of dietary regimen to achieve long term survival and subclinical vitamin A deficient status in mice. PMID- 3666813 TI - Time course changes in levels of ascorbic acid, acetylcholine and acetylcholinesterase activity in sciatectomized muscles of the frog Rana cyanophlictis Schn. PMID- 3666814 TI - Nature of atrophy in the frog, Rana cyanophlictis Schn. muscles subjected to denervation and disuse. PMID- 3666815 TI - Effect of metronidazole on immune mechanism in experimental animals. PMID- 3666816 TI - Effect of typhoid endotoxin on cardiovascular system of some animals. PMID- 3666817 TI - Anti-inflammatory action of ferulic acid and its esters in carrageenan induced rat paw oedema model. PMID- 3666818 TI - Effect of pirimiphos-methyl, an organophosphorus insecticide on hematological parameters in albino rats. PMID- 3666819 TI - In vitro effect of aspirin on NADPH producing pathway in developing human fetus. PMID- 3666820 TI - Multiplicity of antibiotic production in Aspergillus versicolor N5 under mutagenesis: versilin a new antifungal antibiotic. PMID- 3666821 TI - Pattern of hoarding in rats before, during and post-gestation period. PMID- 3666822 TI - Effect of testosterone propionate on subcellular distribution pattern of monoacyl glycerol in different regions of brain of castrated pubertal male rats. PMID- 3666823 TI - Effects of chronic and intermittent cold stress on physiological and tumour response in mice. PMID- 3666824 TI - Binding of anti idiotypic antibodies against anti FSH to FSH receptors. PMID- 3666825 TI - Stimulation of testicular activity and spermatogenesis in immature mice by oxytocin. PMID- 3666826 TI - Calcium dependent effects of dimethyl sulphoxide on isolated frog heart and skeletal muscle. PMID- 3666827 TI - Antinociceptive effect of intracerebroventricularly administered bradykinin in rat: role of putative neurotransmitters. PMID- 3666828 TI - Effect of relative immobilization on histochemical characteristics of various fibre types in myotomal muscle of the Indian major carp (Catla catla) fingerlings. PMID- 3666829 TI - Fatigue induced alterations in muscle transamination patterns of albino rat. PMID- 3666830 TI - Tissue and subcellular distribution of 65zinc in normal and zinc sulphate administered rats. PMID- 3666831 TI - Hormonal regulation of calcium in rat eye lens. PMID- 3666832 TI - Tricuspid valve involvement in rheumatic heart disease. PMID- 3666833 TI - Tracheostomy tubes--presenting as foreign bodies in tracheobronchial tree. PMID- 3666834 TI - Septal and posterior left ventricular wall motion and left ventricular function in juvenile mitral stenosis--an echocardiographic study. PMID- 3666835 TI - Chronic respiratory disease in Chandigarh teachers--a follow-up study. PMID- 3666836 TI - Pleural effusion in renal cell carcinoma--a rare presenting feature. PMID- 3666837 TI - Influence of associated tricuspid stenosis on pulmonary vascular changes in rheumatic mitral stenosis--a histopathological evaluation. PMID- 3666838 TI - Steroid responsive cardiopulmonary involvement in acute polymyositis. PMID- 3666839 TI - Unusual foreign bodies in airways. PMID- 3666840 TI - Castleman's disease of the lung hilum. PMID- 3666841 TI - Pyrexia of unknown origin as rare presentation of tuberculous thyroiditis. PMID- 3666842 TI - Broncho-pleuro-biliary fistula--a rare manifestation of pleuro-pulmonary amoebiasis. PMID- 3666843 TI - Rifampicin induced menstrual disturbances. PMID- 3666844 TI - Specific inhibition of natural killer (NK) activity against different alloantigens. AB - Allogeneic lymphocyte cytotoxicity (ALC), i.e., rapid rejection of i.v. injected allogeneic lymphocytes in unprimed hosts, is an example of NK activity. Apparently anomalous rejection patterns, such as acceptance of F1 hybrid cells by parental hosts and rejection of parental cells by F1 hybrid hosts in many strain combinations, would fit the hypothesis that the effector cells in ALC recognize the absence of certain self-molecules (passwords) rather than the presence of nonself determinants. However, cold target inhibition studies showed that ALC displays allospecificity: when a mixture of radiolabeled AO and DA cells were injected i.v. into euthymic or athymic PVG rats, adding a surplus of cold DA cells reduced killing only of labeled DA cells and vice versa. Furthermore, semiallogeneic cold target cells were ineffective in inhibiting elimination of fully allogeneic cells, which supports the argument against a modification of the hypothesis that self-determinants inhibit a postbinding stage of lysis. Finally, (DA x AO)F1 cells injected into (DA x PVG)F1 hosts were rapidly rejected, despite the fact that donor and host shared expressed DA determinants. In sum, our results show that a hypothesis based on inhibition of killing by self determinants can only be sustained with extensive modifications, and favor the alternative mechanism that the effector cells positively recognize the presence of allospecific determinants on the target cell surface. PMID- 3666845 TI - There are two C4 genetic loci and a null allele in the chimpanzee. AB - Genetic polymorphism in C4 in the chimpanzee was studied by agarose gel electrophoresis of desialated plasma and development of patterns by immunofixation with antiserum to human C4 and by a C4-sensitive hemolytic overlay. In general, immunofixation patterns showed multiple partially overlapping bands of which only the most cathodal had strong hemolytic activity. In analogy to human C4, the latter were designated C4B, whereas those detected by immunofixation which had little hemolytic activity were designated C4A. Chimp C4A and C4B reacted with human and mouse (monoclonal) anti-C4B and human anti-Ch1 but neither reacted with monoclonal anti-C4A or human anti-Ch2, Ch3, Rg1, or Rg2. On sodium dodecyl sulfate polyacrylamide gel electrophoresis, the alpha chain of C4B showed a slightly lower apparent relative mass than that of C4A at around Mr 93,000. There were three C4A variants and two C4B variants inherited in families as autosomal codominant traits, as C4A-C4B cosegregating pairs with no detectable crossing-over. These pairs were inherited with chimpanzee leukocyte antigen types C2 and BF variants without detectable crossing-over. Half-null C4 haplotypes with C4B QO were observed in family studies. Nine BF, C2, C4A, C4B allelic haplotypic combinations (complotypes) were identified among presumably unrelated chimpanzees. PMID- 3666846 TI - Two types of liver-specific F antigen are encoded by a locus located on chromosome 5 in mice. AB - Two types of liver-specific F antigen in mice were distinguished by an immunoblotting technique after IEF of liver extracts. The IEF banding patterns consist of several bands whose pI vary from 7.57 to 8.15. One type of antigen (designated F2 antigen) showed a pattern that lacked some basic bands which are present in the pattern of the other type of antigen (designated F1 antigen). The latter type was found in AKR, CBA, C3H, DBA/2, and SM strains, while the former type was found in A, C57BL, and many other strains. Breeding experiments indicated that this variation is controlled by a single autosomal locus designated Laf (liver antigen F). Linkage analysis showed that the Laf locus is linked to the Pgm-1 locus on chromosome 5. The recombination frequency between these two loci is estimated to be 0.173 +/- 0.037. The distribution of F1 and F2 antigen types among inbred strains is concordant with that of type 1 and type 2 F antigens, which have been previously distinguished by their immunogenic differences, i.e., whether alloimmunization with the liver extracts from a given strain of mice can produce the antibody to F antigen in certain strains of mice. It is suggested, therefore, that the Laf locus may encode an allogeneic moiety of F antigen molecules. PMID- 3666848 TI - Persistent infection of porcine kidney cells with Japanese encephalitis virus. PMID- 3666847 TI - Elucidation of the receptors in macrophage and Plasmodium yoelii interactions. AB - Binding of hyperimmune serum opsonized merozoites of Plasmodium Yoelii nigerensis to trypsinized macrophages suggested it to be mediated by FcII receptor. Receptor blocking inhibition with monoclonal antibody 2.4G2 directed against Fc receptor for IgG1/IgG2b provided evidence that Fc delta 2b on macrophage played an important role in the merozoite-macrophage interactions. In addition, a neuraminidase sensitive receptor was noted to mediate the binding of P. yeelii merozoites in the absence of serum. Binding inhibition studies with two monosaccharides, D-mannose and alpha-methyl mannoside, indicated the role of Mannose/Fucose receptor on macrophage in this interaction. PMID- 3666849 TI - Influenza surveillance in Pune (India) during 1983-85. PMID- 3666850 TI - Leukemoid reaction in Shigella dysenteriae type 1 infection. PMID- 3666851 TI - Crystal violet ring response as a marker for in vitro detection of pathogenic Vibrio parahaemolyticus & Shigella spp. PMID- 3666852 TI - Evidence of leptospiral infections in human samples in Madras city. PMID- 3666853 TI - Tissue schizontocidal activity of minocycline against a relapsing malaria parasite Plasmodium cynomolgi B. PMID- 3666854 TI - Effect of avermectin B1 (L-676) a metabolite from Streptomyces avermilitis on immatures of Culex quinquefasciatus. PMID- 3666855 TI - High affinity specific monoclonal antibodies against progesterone. PMID- 3666856 TI - Protein profile of amniotic fluid in normal pregnancy. PMID- 3666857 TI - Iron-deficiency in atrophic rhinitis & scleroma. PMID- 3666858 TI - 2-Deoxy-D-glucose induced enhancement of radiation damage in 5-bromo-2'-deoxy uridine sensitized mammalian cells. PMID- 3666859 TI - Influence of reserpine & guanethidine on the responses of the isolated rat ileum to catecholamines & propranolol & tolazoline. PMID- 3666860 TI - Chromosomal analysis of chorionic villi for foetal diagnosis in the first trimester. PMID- 3666861 TI - Absence of transovarial transmission of Chikungunya virus in Aedes aegypti & Ae. albopictus mosquitoes. PMID- 3666862 TI - Coexistence of hypertensive and coronary arterial disease. PMID- 3666863 TI - Antihypertensive effects of an aromatase inhibitor in the spontaneously hypertensive rat. AB - Recent studies from this laboratory have demonstrated that 19-nor deoxycorticosterone, a potent mineralocorticoid, has been excreted in excess in the urine of young spontaneously hypertensive rats (SHR). Although urinary 19-nor deoxycorticosterone levels decline before the onset of hypertension, preliminary evidence suggests that 19-nor-deoxycorticosterone is further oxygenated to other steroid products in older SHR. Since 19-hydroxylation is the essential first step in the formation of 19-nor-deoxycorticosterone from deoxycorticosterone and since the mechanism-based aromatase inhibitor 10-propargyl-androst-4-ene,3,17-dione preferentially inhibits 19-hydroxylation, this agent was administered to weanling SHR to determine whether inhibition of 19-nor-deoxycorticosterone formation could modify or prevent hypertension. Accordingly, either 10 mg of 10-propargyl-androst 4-ene,3,17-dione or vehicle (control) was injected daily for several weeks in 4.5 week-old SHR. Injection of 10-propargyl-androst-4-ene,3,17-dione reduced urinary free 19-nor-deoxycorticosterone and retarded the development of hypertension compared with the effect of vehicle injection (p less than 0.05). Mean blood pressure levels in SHR receiving 10-propargyl-androst-4-ene,3,17-dione were lower than those in SHR receiving vehicle for each of the first 8 weeks of treatment (p less than 0.05). These data support the importance of 10-nor-corticosteroids in the pathogenesis of hypertension in SHR. PMID- 3666864 TI - Role of prostaglandins and kinins in the renal pressor reflex. AB - In previous studies we identified an afferent renal nerve-dependent pressor reflex elicited by acute unilateral renal artery stenosis (50% decrease in renal blood flow) in conscious, instrumented rats with reduced responsiveness of arterial baroreceptor reflexes and the renin-angiotensin system. The pressor reflex involves a neurogenic increase in peripheral resistance. The present study examined the nature of the intrarenal stimulus underlying this renal pressor reflex. Rats were subjected to sinoaortic denervation and, 7 to 10 days later, were chronically instrumented with Doppler flow probes on the right renal artery, superior mesenteric artery, and abdominal aorta and with an occluder on the right renal artery. Following surgical recovery and inhibition of the renin-angiotensin system (captopril), animals received intravenous isotonic saline, 6% of body weight over 60 minutes. Saline infusion did not alter baseline hemodynamics, vascular neurogenic tone, or responsiveness to tyramine, but it attenuated the reflex by 70%. A second series of experiments examined a possible role for intrarenal prostaglandins, kinins, or adenosine in the activation of renal sensory receptors during renal stenosis. Prostaglandin inhibition with intravenous administration of indomethacin and meclofenamate virtually abolished the reflex in the face of enhanced tyramine responsiveness, whereas kallikrein inhibition (aprotinin) attenuated the reflex pressor response by 33%. Adenosine inhibition with aminophylline or adenosine deaminase had no effect on the reflex; these agents and aprotinin did not affect vascular neuroeffector responsiveness (tyramine). The data suggest that the renal pressor reflex may be mediated by renal sensory nerves, possibly chemoreceptors, whose activation could depend on renal excretory function and synthesis of prostaglandins and kinins. PMID- 3666865 TI - Inverse relationship between heart rate and blood pressure variabilities in rats. AB - The interplay of heart rate variability, baroreceptor control of heart rate, and blood pressure (BP) variability was examined in chronically instrumented, unanesthetized, freely moving rats in which the efferent neural influences on heart rate were pharmacologically altered. In each rat, BP was recorded continuously for 90 minutes in the control condition and in one or more of the following conditions: 1) beta-adrenergic receptor blockade by propranolol, 1 mg/kg; 2) cholinergic blockade by atropine, 0.75 mg/kg, and 3) combined blockade by propranolol plus atropine. Each BP recording was analyzed beat-to-beat by a computer that calculated heart rate and BP variabilities, both expressed as variation coefficients. In addition, under each condition the sensitivity of the arterial baroreceptor control of heart rate was assessed by measuring the reflex changes in pulse interval in response to BP changes induced by bolus i.v. injections of phenylephrine and nitroprusside. As compared with the control condition, 1) propranolol (n = 10) reduced heart rate variability by 23 +/- 4% (p less than 0.01), only slightly impaired baroreceptor reflex sensitivity, and did not significantly modify BP variability (+11 +/- 7%); 2) atropine (n = 11) reduced heart rate variability by 30 +/- 7% (p less than 0.01), drastically impaired baroreceptor reflex sensitivity, and increased BP variability (+40 +/- 8%, p less than 0.01); 3) combined blockade (n = 10) caused variability and baroreceptor reflex changes similar to those induced by atropine alone. Thus, heart rate variability depends on both vagal and sympathetic influences. However, only the former component affects BP variability, that is, it plays an antioscillatory role.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3666866 TI - Assessment of baroreceptor reflex sensitivity by means of spectral analysis. AB - A method of determining baroreceptor reflex sensitivity is proposed that is based on spectral analysis of systolic pressure values and RR interval times, namely, the modulus (or gain) in the mid frequency band (0.07-0.14 Hz) between these two signals. Results using this method were highly correlated (0.94; n = 8) with results of the phenylephrine method. In addition, compared with the values for the preceding rest period, the modulus decreased during mental challenge, as might be expected from the literature. PMID- 3666867 TI - Enhanced forearm blood flow during mental stress in children of hypertensive parents. AB - This study compared changes in forearm blood flow, forearm vascular resistance, blood pressure, and heart rate elicited by mental stress (mental arithmetic) in 12 adolescents with a hypertensive parent and 13 age-matched adolescents with normotensive parents. The two groups did not differ in resting forearm blood flow, forearm vascular resistance, heart rate, or blood pressure. During mental stress, children with a family history of hypertension had a significantly greater increase in forearm blood flow than did children of normotensive parents (+37.5 +/- 8.0 vs +12.8 +/- 7.5%; p less than 0.05) and a trend toward reduced forearm vascular resistance (p = 0.08). Mental stress significantly increased systolic blood pressure (p less than 0.0001), diastolic blood pressure (p less than 0.001), and heart rate (p less than 0.03) in both groups. The blood pressure and heart rate responses to stress were not significantly different between groups. There was no evidence of a prolonged response or a different pattern of recovery in children with a family history of hypertension. This study indicates that regional blood flow responses underlying similar blood pressure increases during mental stress may be different in adolescents with and without a family history of hypertension. PMID- 3666868 TI - Cardiovascular response to acute stress in spontaneously hypertensive rats. PMID- 3666869 TI - Urinary aspartate transaminase (AST) activity and detection of its inhibitors in normal urine. AB - Urinary aspartate-transaminase activity in the whole urine was found to be mean +/- S.D. = 8.46 +/- 0.69 l.U/l when measured immediately after urine collection. About 50% loss in enzyme activity was observed after 18 hours dialysis. An overall 176% increase in enzyme activity followed by Sephadex G-25 (fine) whole urine fractionation and a highly significant (P less than .001) partial inhibition by earlier Sephadex fractions and maximum inhibition by earlier Sephadex fractions and maximum inhibition of enzyme by fraction 7 have suggested the presence of both high and low molecular weight urinary inhibitors of aspartate-transaminase. Urea and ammonia presence and inhibitor activity in fraction 6 to 8 bear a close parallelism; both the substances produced 31% inhibition of partially purified goat liver GOT at concentrations approximating normal human urine. Therefore, low enzyme activity and its substantial loss in the whole urine and during dialysis may be due to the concomitant inhibitory effects of urea, ammonia and unidentified nature of high molecular weight substance(s). The present method may be effective in separating inhibitors and overcoming the disadvantages of dialysis in determining true urinary aspartate transaminase activity. PMID- 3666870 TI - Cardiotoxic effects of dichlorvos (DDVP) in albino rats. AB - Dichlorvos (O, O-dimethyl O-(2,2-dichlorovinyl phosphate: DDVP 76.6 X EC) an organophosphate pesticide had a profound effect on cardiac activity of albino rats. Adult male rats anesthetized with pentobarbitone were administered 30, 50, 70 and 90 mg/kg body weight of dichlorvos. The heart rate and electrocardiogram were monitored and acetylcholinesterase activity was measured in heart and brain. Dichlorvos produced abnormalities in ECG, decrease in heart rate, cardiac arrest and inhibition of cholinesterase activity. It is suggested that cardiotoxic effect of DDVP may be mediated by the accumulated acetylcholine as a result of cholinesterase inhibition. PMID- 3666871 TI - Effect of 'Arogyavardhini' against carbon tetrachloride induced hepatic damage in albino rats. AB - 'Arogyavardhini'-an indigenous formulation was evaluated for its hepatoprotective activity in rats, using two models of carbon tetrachloride (CCl4) hepatic damage, one simulating vital hepatitis and the other simulating fatty change. The protective effect was assessed from serum aspartate transaminase (AST) and alkaline phosphatase levels and from histopathological changes in liver. The results revealed that 'Arogyavardhini' (5 mg/100g, PO daily) was effective in minimizing the changes in serum levels of AST and alkaline phosphatase induced by CCI. The protective effect was also evident on histopathological examination. PMID- 3666872 TI - Effect of zinc administration on seminal zinc and fertility of oligospermic males. AB - Fourteen infertile males (age 24-45 years; married over 2 years) with idiopathic oligospermia (sperm count less than 40 millions/ml) were investigated for the effect of oral zinc sulphate (220 mg) for 4 months on their serum and seminal zinc levels, and seminal parameters. With zinc administration serum zinc levels remained essentially unaffected, however, seminal zinc levels increased significantly. There was significant improvement in sperm count, number of progressively motile and normal spermatozoa, and acid phosphates activity. Wives of 3 patients conceived. Observations suggest that zinc has potential to be used in male infertility. However, further studies are warranted. PMID- 3666873 TI - Influence of lithium on the anticonvulsant activity of carbamazepine. AB - The present study was undertaken to see whether the recently reported synergism between lithium and carbamazepine (CBZ) in mania also extends against convulsions. The anti-convulsant effect of various doses of CBZ was assessed in albino rats pretreated with vehicle or lithium salt (0.54 mEg/kg/day, p.o. for 9 days). The animals were subjected to 3 tests: maximum electro shock seizures (MES); minimum electro convulsive thresholds (MET) and pentylenetetrazol (PTZ) induced convulsions: abolition of hind limb extension after electro shock, increases in the MET for appearance of neck jerk and absence of convulsions for one hr after PTZ were taken as parameters of the anticonvulsive effect respectively. In the MES and MET tests lithum did not alter the anticonvulsive effect of CBZ. Lithium, however, potentiated the anticonvulsant effect of CBZ against PTZ-induced convulsions. PMID- 3666874 TI - Pulmonary diffusion indices in ageing adults. AB - The lung transfer factor (Tl) was measured by the single breath holding CO technique in 147 apparently healthy males and 88 females of 35-70 years of age, belonging to similar middle class of socio-economic and nutritional status. They were non-smokers, non-alcoholics and had no cardio-respiratory problems at the time of study. The male subjects with average age of 46.9 years, weight 63.9 Kgs, Height 168.9 cms, surface area 1.73 m2, Hb 12.7 gm% had Tl 29.41 +/- 1.78 mlCo/min/mmHg whereas female subjects with average age of 45-60 years, with Wt 63.2 Kgs, Ht. 155.5 cms, Surface area 1.57 m2, Hb 10.88% had Tl 22.49 +/- 1.28 mlCo/min/mmHg. Simple and multiple regression equation for age, Ht, Hb were worked out and their correlation with Tl discussed. PMID- 3666875 TI - Arginine protection against ammonia toxicity in exhausted rat. AB - Arginine administration (5 m moles/kg/day) to albino rats for 7 days, revealed that this vital basic amino acid possesses latent potentiality for the accentuation of urea cycle or at least for arginase activity. The mitigation of ammonia toxicity was observed to be more effective in the case of gastrocnemius and red vastus as compared to white vastus. Further, ammonia and lactate levels were also decreased by arginine in blood and thereby delaying the onset of fatigue by preventing ammonotoxemia and lactic acidemia. PMID- 3666876 TI - Alteration in gentamicin pharmacokinetics in acute traumatic paraplegics. PMID- 3666877 TI - Effect of sodium ascorbate on rat uterus and guinea pig atria in vitro. PMID- 3666878 TI - Apparatus for the measurement of reaction time. AB - An apparatus for the measurement of reaction time to both visual and auditory stimuli with a provision to vary intensity of stimuli and with facility for lateralisation of sound to the right or left ear has been described. PMID- 3666879 TI - Protective effect of ST-93 against ouabain induced arrhythmias in guinea pigs. AB - ST-93, a clonidine analog was studied for its antiarrhythmic activity in anaesthetised guinea pigs against ouabain induced arrhythmia. The amount of ouabain required (micrograms/kg) for the production of ventricular premature best. Ventricular fibrillation and cardiac arrest was recorded in control and drug treated group of animals. Both ST-93 and clonidine produced significant antiarrhythmic effect in guinea pigs. This protective effect was significantly blocked by yohimbine, suggesting that the antiarrhythmic effect is mediated through presynaptic alpha 2-adrenoceptors. PMID- 3666880 TI - Effect of lead on erythropoietic system of intact and splenectomized rats. AB - Erythropoietic alterations in normal and splenectomized mature male rats treated with aqueous lead acetate intraperitoneally at dosages of 4 mg/kg and 6 mg/kg body weight were observed over a period of 30 days. Significant retardation in growth might be due to gradual increases in lead toxicity. The elevated blood lead level, increased urinary delta-amino-levulinic acid (ALA-U) excretion, depletion in RBC and haemoglobin content and more number of reticulocytes in peripheral blood indicated the increased intensity of lead toxicity and inhibitory effect on haem biosynthesis. The accelerating action of lead on erythropoietic cellular series i.e. pronormoblast, early and intermediate normoblast and late normoblast was evident by the significant increase in number of cellular count both in intact and splenectomized rats after treatment with lead. PMID- 3666881 TI - Action of some amides of substituted ethylenediamines on central nervous system. AB - Five of the substituted ethylenediamine amides (LMG I to V) were tested for various CNS attributes and for acute toxicity (24 hr mortality). All compounds were potent analgesics in various animal tests, LMG V being most potent. All reduced spontaneous activity of mice and potentiated ether anaesthesia. However, CAR was not altered and anti-MES were not pronounced in rats. Compounds appear to have a wide safety margin considering ED50 and LD50 in mice. PMID- 3666882 TI - Effect of anaemia on respiratory and metabolic parameters during third trimester of pregnancy. AB - Pregnancy involves a considerable increase of metabolically active tissue. Anaemia a common occurrence during pregnancy hampers the normal metabolism of body due to Anaemic hypoxia. In present study oxygen uptake, Co2 output, Respiratory Exchange Ratio (RE) Resting Metabolic Rate (RMR) and Peak Expiratory Flow Rate (PEFR) were compared in normal women in IIIrd trimester of pregnancy (Hb 12 gm% or above) with anaemic women. Oxygen uptake and Co2 output were measured by Noyon's Dioferometer and PEFR by Wright's Peak Expiratory Flow Meter. RE and RMR were calculated. O2 uptake, Co2 output, RE and RMR were significantly increased whereas PEFR was significantly decreased in anaemic than in normal subjects during third trimester of pregnancy. PMID- 3666883 TI - Microanalysis of respiratory air samples, a simple device for undergraduate demonstration. PMID- 3666884 TI - Anticonvulsant and analgesic activity of 1,2,4-thiadiazoles--a preliminary report. PMID- 3666885 TI - Bioavailability of ampicillin (anhydrous) and ampicillin trihydrate. PMID- 3666886 TI - In vitro uptake and release of noradrenaline in chicken liver slices. PMID- 3666887 TI - Hypoglycaemic and hypolipaemic effects of Cyamopsis tetragonoloba (guar) in normal and diabetic guinea pigs. AB - Information available in literature is contradictory regarding the glycaemic and cholesterolaemic activities of various legume proteins. Present work deals with the study of the effect of 'Guar' feeding on serum total lipids, free and esterified cholesterol, triglycerides and phospholipids. Normal and alloxan induced diabetic guinea pigs were kept on the whole seed diet of 'Guar' for four weeks. Blood sugar and total lipid levels were found to be decreased significantly in normal and as well as diabetic animals; free and esterified cholesterol levels were also observed to be lowered significantly in normals, whereas esterified fraction alone was found to be lowered in diabetics. Significant fall in the levels of other lipids i.e., triglycerides, phospholipids and total lipids was also noticed. PMID- 3666888 TI - Role of mid-dorsal caudate nucleus in maintenance of body weight in rats on administration of foods with different caloric densities. AB - Rats were fed with food of different caloric densities by addition of kaolin or groundnut oil to the normal food powder. The food intake, caloric intake and body weights were noted. These observations were compared before and after bilateral destruction of mid-dorsal caudate nucleus. The food intake before caudatal lesion varied appropriately with the caloric density of food thus maintaining caloric intake and body weight. After mid-dorsal caudatal destruction this feedback mechanism of maintaining body weight was operative with low caloric density diet but not with high caloric diet. PMID- 3666889 TI - Study of photic versus non-photic cues as entrainers of circadian running activity in rats. AB - Though relative dominance of photic/non-photic cues on rodent circadian running activity is known, the exclusive role of non-photic entrainers in rats deprived of photic entrainers is not demonstrated and hence present work using retino hypothalamic pathway blocked male rats (n = 10) was initiated. Blocking is done by enucleation of eyeballs. Circadian running activity is studied before enucleation and after enucleation towards instinctual social cues, food, water and sexual cues provided in activity cage. Twenty four hour activity of rats was recorded kymographically for a fifteen day period before enucleation and for a similar period after enucleation. Analysis of the records revealed that eight animals had predominant diurnal rhythm whereas two animals had predominant nocturnal rhythm. Enucleation of diurnal rats neither altered total running activity pattern nor caused any significant change in the goal compartments thus showing absence of entrainment by photic cues. In contrast nocturnal rats showed gradual shift of activity towards day time on enucleation thus indicating that nocturnal animals were entrained by photic cues. The overriding influence of non photic entrainers on photic entrainers is discussed. PMID- 3666890 TI - Gustatory effects on intestinal motility of dogs. AB - Trained, unanaesthetised dogs with jejunal fistula and adapted to 2 h meal-time showed transient taste-correlated changes in pressure (mm H2O) but not in frequency of intestinal motility. Intestinal pressure was increased on bitter taste both before meal-time (4.7 +/- 0.2 mm) and after it (13.1 +/- 0.9 mm) over respective basal pressure (before meal 3.2 +/- 0.4 mm), after meal 10.6 +/- 1.4 mm), whereas it was decreased on sweetness of saccharin (before meal 1.1 +/- 0.1 mm, after meal 4.8 +/- 0.5 mm), and glucose (before meal 1.7 +/- 0.2 mm; after meal 8.8 +/- 0.9 mm). Taste-induced motility changes were more pronounced on starvation than on fed state. PMID- 3666891 TI - Emergencies in pediatrics. PMID- 3666892 TI - Emergencies in pediatrics. PMID- 3666893 TI - Acute renal failure. PMID- 3666894 TI - Pyogenic meningitis. PMID- 3666895 TI - Status epilepticus. PMID- 3666896 TI - Viral encephalitis. PMID- 3666897 TI - Organophosphorus poisoning. PMID- 3666898 TI - Opium and barbiturate poisoning. PMID- 3666899 TI - Corrosive poisoning. PMID- 3666900 TI - Acute naphthalene poisoning. PMID- 3666901 TI - Dhatura poisoning. PMID- 3666902 TI - Kerosene poisoning. PMID- 3666903 TI - Drowning and near-drowning. PMID- 3666904 TI - Electric shock. PMID- 3666906 TI - Acute abdomen. PMID- 3666905 TI - Burns. PMID- 3666907 TI - Acute head injury. PMID- 3666909 TI - Ocular emergencies. PMID- 3666908 TI - Otolaryngological emergencies. PMID- 3666911 TI - Pediatric advice on the telephone. PMID- 3666910 TI - Dental emergencies. PMID- 3666912 TI - Dosages of some common drugs. PMID- 3666913 TI - Shock. PMID- 3666914 TI - Anaphylaxis. PMID- 3666915 TI - Acute diarrhea and rehydration therapy. PMID- 3666916 TI - Acid-base disturbances. PMID- 3666917 TI - Status asthmaticus. PMID- 3666918 TI - Congestive heart failure. PMID- 3666920 TI - Neonatology II. XXIII National Conference of the Indian Academy of Pediatrics. November 14-16, 1986, New Delhi. Proceedings. PMID- 3666919 TI - Hypertensive emergencies. PMID- 3666921 TI - Controversies in neonatal care. PMID- 3666922 TI - Issues in neonatal hyperbilirubinemia. PMID- 3666924 TI - Prevention of low birth weight. PMID- 3666923 TI - Reduction of morbidity and mortality due to respiratory disorders in the newborn. PMID- 3666925 TI - Vitamin-B composition of breast milk from mothers of preterm and term babies. PMID- 3666926 TI - Evaluation of a sepsis screen in the diagnosis of neonatal sepsis. PMID- 3666927 TI - Early onset neonatal sepsis--vertical transmission from maternal genital tract. PMID- 3666928 TI - Evaluation of buffy coat smear examination in septicemia during infancy. PMID- 3666929 TI - Presidential address. XXIII National Conference of the Indian Academy of Pediatrics. PMID- 3666930 TI - Bacteriological profile of neonatal septicemia. PMID- 3666931 TI - CT-scan evaluation of term neonates with symptomatic birth asphyxia. PMID- 3666932 TI - Neonatal neurobehavioral assessment and outcome. PMID- 3666933 TI - Respiratory distress in newborn. A prospective study. PMID- 3666934 TI - Neonatology in the undergraduate medical education. Current status. PMID- 3666935 TI - Hairy pinna--a pathognomonic sign in infants of diabetic mothers. PMID- 3666936 TI - Planning follow-up of high risk neonates. PMID- 3666937 TI - Childhood leprosy. PMID- 3666938 TI - Approach to children with suspected immunodeficiency. PMID- 3666939 TI - Nutritional status in rural pregnant women of Bihar and Uttar Pradesh. PMID- 3666940 TI - Maternal employment and personality of the child. PMID- 3666941 TI - Anemia, undernutrition and physical work capacity of young boys. PMID- 3666942 TI - Bacterial etiology of meningitis with special reference to staphylococci. PMID- 3666943 TI - Impact of six years exposure to ICDS scheme on psycho-social development. PMID- 3666944 TI - Hb H disease. PMID- 3666945 TI - Disaccharide intolerance & ICC. VII. Effect of steroid therapy on lactosuria. PMID- 3666946 TI - Primary polydipsia in infancy. PMID- 3666948 TI - Child care--is it fair? PMID- 3666947 TI - Cephalic tetanus. PMID- 3666949 TI - Recurrent pneumococcal meningitis. PMID- 3666950 TI - Child labor. PMID- 3666951 TI - Zygosity of twin births. PMID- 3666952 TI - Asphyxiating thoracic dystrophy. PMID- 3666953 TI - The low-molecular-mass, cysteine-rich outer membrane protein of Chlamydia trachomatis possesses both biovar- and species-specific epitopes. AB - We isolated, by hydroxylapatite high-performance liquid chromatography, 14- and 15-kilodalton (kDa), cysteine-rich outer membrane proteins from Chlamydia trachomatis TW-5/OT (serovar B) and LGV-434 (serovar L2), respectively. Monoclonal antibodies (MAbs) were generated against the purified proteins, and their specificities were determined by immunoblotting. MAb B-14k recognized an epitope located on the 14-kDa cysteine-rich protein of the TW-5/OT strain and was immunoreactive with a comigrating 14-kDa protein that was common to all trachoma biovar strains, but it did not react with the 15-kDa, cysteine-rich protein of LGV biovar strains. In contrast, MAb L2-15k, which recognized an epitope located on the 15-kDa protein of the LGV-434 strain, reacted with the 15- and 14-kDa, cysteine-rich proteins of both LGV and trachoma biovar strains, but did not react with related proteins of two Chlamydia psittaci strains. Thus, the low-molecular mass, cysteine-rich outer membrane proteins of C. trachomatis possess antigenic determinants that are both biovar and species specific. Neither MAbB-14k nor MAb L2-15k was reactive by dot-blot assay when viable chlamydiae were used as test antigens, indicating that the cysteine-rich proteins are not accessible to antibody on the native chlamydial cell surface. PMID- 3666954 TI - Antigenic identity of biologically active antigens in coccidioidin and spherulin. AB - We recently reported the isolation of three clinically relevant antigens from coccidioidin; viz., the antigen that is reactive in the immunodiffusion (ID) assay for detecting tube precipitin (TP) antibody (designated IDTP); the antigen that is reactive in the ID assay for detecting complement-fixing antibody (designated IDCF); and the heat-stable (HS) antigen which, when demonstrated in soluble extracts of fungal cultures by using the IDHS assay, establishes the mycologic identification of Coccidioides immitis. This investigation was undertaken to determine whether the IDTP, IDCF, and IDHS antigens isolated from coccidioidin are of antigenic identity with components in spherulin. By employing the purified coccidioidin antigens in line-immunoelectrophoresis with spherulin and by assaying coccidioidin and spherulin by tandem two-dimensional immunoelectrophoresis against antisera produced to the purified antigens, we report that these three coccidioidin-derived antigens are antigenically identical to precipitinogens in spherulin. PMID- 3666955 TI - Pulmonary clearance of Mycoplasma pulmonis in C57BL/6N and C3H/HeN mice. AB - In C57BL/6N and C3H/HeN mice known to be free of all murine pathogens and matched for age, sex, and environmental factors, pulmonary clearance was measured over a 72-h time period after exposure to infectious aerosols of 35S-labeled Mycoplasma pulmonis. Reduced clearance of M. pulmonis in C3H/HeN mice relative to C57BL/6N mice was primarily due to impaired mycoplasmacidal activity in the lungs of the C3H/HeN mice. The C3H/HeN mice also had a slightly slower rate of mechanical transport of radiolabel from the lungs in the first 4 h after infection relative to the C57BL/6N mice but not at any later times. By 72 h after infection (relative to 0 h, C3H/HeN mice had an over 4,000% (1.75 X 10(7) versus 4.30 X 10(5] increase in neutrophils and an over 18,000% (more than 2 orders of magnitude) increase in numbers of M. pulmonis recovered from mechanically disaggregated lungs. In contrast, C57BL/6N mice reduced the number of M. pulmonis present by over 83% (nearly 2 orders of magnitude) before any increase in inflammatory cells, which was only a slight increase in lymphocytes and macrophages at 24 h after infection. These results directly link decreased mycoplasmal pulmonary clearance in C3H/HeN mice with the increased susceptibility to, and severity of, murine respiratory mycoplasmosis observed in this strain. The resistance of C57BL/6N mice appears to be related to nonspecific host defense mechanisms responsible for limiting the extent of infection. PMID- 3666956 TI - The immunogenicity and antigenicity of lipid A are influenced by its physicochemical state and environment. AB - We investigated the immunogenicity and antigenicity of synthetic lipid A and partial structures thereof. Included in the study were compounds which varied in the position of phosphate (1-mono-, 4'-mono-, and 1,4'-bisphosphates) and in the acylation (type, number, and distribution of fatty acids) and, in the case of monosaccharide compounds, the nature of the backbone sugar (D-glucosamine, D glucose, 3-amino-3-deoxy-D-glucose, and 2,3-diamino-2,3-dideoxy-D-glucose). With the aid of the passive-hemolysis and passive-hemolysis-inhibition assays and by absorption experiments, five distinct antibody specificities were detected in polyclonal rabbit antisera raised against sheep erythrocyte-coated lipid A and lipid A incorporated into the membrane of liposomes (liposome-incorporated immunogens). Three antibody specificities reacted with disaccharide antigens specific for a 1-mono-, 4'-mono-, and 1,4'-bisphosphorylated beta-1,6-linked D glucosamine disaccharide. Two antibodies reacted with either 1- or 4-phosphates of acylated D-gluco-configured monosaccharides and exhibited no cross-reaction with each other. However, they cross-reacted with disaccharide antigens with phosphate groups in the appropriate positions. We found that the physicochemical state and the environment of lipid A modulated its immunoreactivity. The immunogenicity was best expressed by erythrocyte-coated and liposome-incorporated immunogens. The antigenicity of lipid A was also greatly influenced by its physical surroundings. The reaction pattern of the above antibodies was highly specific in the hemolysis assay and in absorption experiments (the antibody reacted with antigen embedded in a cell membrane), whereas some cross reactivities were observed in inhibition studies (the antibody reacts with antigen in aqueous solution). By using liposome-incorporated antigens as inhibitors, nonspecific reactions were avoided and specific ones were enhanced. Thus the antibodies described above against lipid A recognize epitopes in the hydrophilic backbone, the exposure of which depends on the intrinsic physicochemical properties of lipid A on the one hand and the physical environment on the other. PMID- 3666957 TI - Effect of vaccination on feline Chlamydia psittaci infection. AB - Experimental ocular infection of specific-pathogen-free cats with the feline pneumonitis strain of Chlamydia psittaci produced an acute, severe conjunctivitis characterized by blepharospasm, conjunctival hyperemia, chemosis, and ocular discharge. Organisms were recovered from the conjunctiva for several weeks, and persistent genital and gastrointestinal infection also resulted from the ocular infection in some cats. Subcutaneous vaccination with live feline pneumonitis C. psittaci 4 weeks before ocular challenge significantly reduced the severity of the conjunctivitis. However, there was no effect on shedding of organisms from the eye or on the transmission of infection to the gastrointestinal and genital tracts. It is suggested that the acute stage of this ocular disease is caused largely by release of pathogenic antigen(s) from chlamydia-infected conjunctival cells, rather than by a direct cytopathic effect of chlamydial replication. Thus, vaccination with whole live organisms reduced the acute disease in experimentally infected cats but did not prevent shedding of the organism. The implications of these findings are discussed. PMID- 3666958 TI - Characterization of cyclophosphamide-rat model of cryptosporidiosis. AB - A cyclophosphamide-treated-rat model for cryptosporidiosis is described. The optimal conditions for inducing a cryptosporidial infection in rats were a 50 mg/kg dose of cyclophosphamide per day in the drinking water for a minimum of 14 days before inoculation with 10(4) or more infectious oocysts. Eighteen days after inoculation, 80% or more of the animals were infected. Cryptosporidia were attached to the terminal 24 cm of the small intestine, and the immunosuppressed animals remained infected as long as they received cyclophosphamide. However, the intestinal infection cleared within 7 to 10 days after cyclophosphamide was withdrawn. Oocysts continued to be detected in the feces for an additional 5 to 7 days after cryptosporidia were no longer visibly attached to the ideal enterocytes. This study characterized an animal model that can be used to investigate the pathogenesis of and evaluate therapeutic regimens for cryptosporidiosis in the immunocompromised host. PMID- 3666959 TI - Role of anaerobic flora in the translocation of aerobic and facultatively anaerobic intestinal bacteria. AB - It is thought that the normal enteric microflora acts not only to prevent intestinal colonization but also to prevent subsequent systemic dissemination of ingested, potentially pathogenic bacteria. To determine the relative roles of specific components of the intestinal bacterial flora in bacterial translocation out of the gut, mice were given various antimicrobial agents to selectively eliminate specific groups of intestinal bacteria. The cecal flora and the translocating bacteria in mesenteric lymph nodes were monitored both before and after oral inoculation with antibiotic-resistant Escherichia coli C25. Orally administered streptomycin selectively eliminated cecal facultative gram-negative bacilli, orally administered bacitracin-streptomycin eliminated all cecal bacterial species except low numbers of aerobic sporeformers, and parenterally administered metronidazole selectively eliminated cecal anaerobic bacteria. Compared with control mice, only metronidazole-treated mice had significantly increased rates of dissemination of intestinal bacteria into mesenteric lymph nodes, indicating that the exclusive absence of anaerobic bacteria facilitated the translocation of the intestinal facultative bacteria. In a parallel experiment with streptomycin-resistant E. coli C25 as a marker, parallel results were obtained. Metronidazole increased the translocation of the marker strain and the indigenous strains of intestinal bacteria. Thus, anaerobes appeared to play a key role in confining indigenous bacteria to the gut. However, intestinal colonization and translocation of E. coli C25 occurred most readily after bacitracin-streptomycin treatment, suggesting that in addition to anaerobic bacteria, other bacterial groups may play a role in limiting the intestinal colonization and extraintestinal dissemination of E. coli C25. PMID- 3666960 TI - Influence of growth temperature on virulence of Legionella pneumophila. AB - The effect of growth temperature on the virulence of a strain of broth-grown serogroup 1 Legionella pneumophila (Wadsworth F889) was examined by growing the bacterium at different temperatures and then infecting guinea pigs (by intratracheal injection) and guinea pig alveolar macrophages. The 50% lethal dose for guinea pigs infected with 25 degrees C-grown F889 was log10 5.0 CFU and that for 41 degrees C-grown F889 was log10 5.7 CFU, or a fivefold difference. Guinea pig alveolar macrophages were infected in quadruplicate with log10 3.8 CFU of F889 cells grown at either 25 or 41 degrees C. Counts of F889 in the alveolar macrophages infected with 25 degrees C-grown bacteria were 40% greater after 1 day of incubation (P = 2 X 10(-4)) than were counts in the alveolar macrophage suspensions inoculated with 41 degrees C-grown bacteria. However, the counts were not significantly different after 3 days of incubation. Examination of cover slip cultures of guinea pig alveolar macrophages infected with 25 degrees C-grown or 41 degrees C-grown bacteria showed that the bacteria grown at the lower temperature were twice as likely to be macrophage-associated after 1 h of incubation than were the bacteria grown at the higher temperature. Growth at the lower temperature was also associated with a change in reactivity with monoclonal antibodies, but not with a change in plasmid content. Thus, environmental temperature may play an important role in modulating the virulence of L. pneumophila, possibly by affecting bacterial adherence to host cells. PMID- 3666961 TI - Attachment of oral bacteria to a basement-membrane-like matrix and to purified matrix proteins. AB - The purpose of this study was to investigate the adherence of oral bacteria to an in vitro basement-membrane-like matrix and to selected individual macromolecular constituents of this matrix. Radiolabeled bacteria were incubated with basement membrane-like matrices isolated from PF HR-9 cells. Bacteroides gingivalis 33277, Fusobacterium nucleatum FN-2, and Actinobacillus actinomycetemcomitans GA3(A) bound to the matrix in the range of 44 to 70%, considerably higher than the ranges of A. actinomycetemcomitans GA3(NA) and SUNY AB67 (range, 20 to 25%). The attachment of selected strains of gram-positive bacteria such as Streptococcus and Actinomyces spp. was much less frequent (range, 6 to 25%). Competitive inhibition studies demonstrated that preincubating the bacteria with fibronectin significantly decreased the binding of B. gingivalis by 51% but increased the binding of other gram-negative and gram-positive organisms tested. Similarly, preincubating the matrices with antifibronectin antibodies decreased the binding of B. gingivalis by 31%, whereas the other bacteria tested were either unaffected or binding was increased. The adherence of bacteria to purified basement membrane proteins was also investigated. Strain and species differences were seen in binding, but no clear relationship emerged between binding to an intact matrix and binding to isolated matrix proteins. The results of this study suggest that some gram-negative oral bacteria commonly associated with periodontal disease, such as B. gingivalis, A. actinomycetemcomitans, and F. nucleatum, bound in high numbers to basement-membrane-like matrices in vitro. On the other hand, the gram positive strains tested bound in much fewer numbers. The results suggest that further studies with this in vitro model may aid in understanding the mechanisms by which oral bacteria adhere to basement membranes. PMID- 3666963 TI - Establishment of gastric Campylobacter pylori infection in the neonatal gnotobiotic piglet. AB - Campylobacter pylori, a gram-negative microaerophilic bacterium, has been implicated in the genesis of human gastritis, dyspepsia, and gastroduodenal ulceration. Previous attempts to reproduce the diseases in conventional laboratory animal species have been unsuccessful. To determine if neonatal gnotobiotic piglets were susceptible to C. pylori, we orally challenged two litters (n = 17) with 10(9) CFU after pretreating them with cimetidine. Controls housed in separate units received nothing or peptone water alone. Piglets were examined 1, 2, 3, and 4 weeks after challenge. Colonization by the bacterium and inflammation of the gastric mucosa persisted throughout the study period. Organisms were revealed by Warthin-Starry silver stain to reside between the mucus layer and the gastric epithelium. Culturing of samples from sites along the gastrointestinal tract revealed that the bacterium colonized essentially only the gastric and proximal duodenal mucosae. Gross pathological changes were restricted to the stomachs of infected piglets and consisted of submucosal edema, increased gastric mucus production, and progressive development of mucosal lymphoid follicles. Microscopic lesions consisted of transient neutrophilic infiltrates followed by diffuse and follicular infiltrations of mononuclear leukocytes into the mucosa and submucosa. Alcian blue-periodic acid-Schiff stains suggested that the infection resulted in the depletion of mucopolysaccharide production by deep gastric glands. These data indicate that gnotobiotic piglets reproduce many of the features of diseases associated with C. pylori in humans. PMID- 3666962 TI - Intrapulmonary growth of Staphylococcus aureus in rats during induced atelectasis. AB - Intrinsic pulmonary antibacterial defenses are mediated by alveolar macrophages and by noncellular factors. Mechanical ventilation in the resting tidal volume range leads to alterations in the physical characteristics of alveolar surfactant, alveolar instability, regional hypoxia, and systemic hypoxemia. While a number of experimental manipulations diminish the activity of the intrinsic antibacterial defense system, the effects of mechanical ventilation per se have not been systematically evaluated previously. We found that normal rats ventilated without sighing (periodic large breaths) manifested severe defects in pulmonary clearance of Staphylococcus aureus during 6-h experiments, such that growth of the inoculum occurred. Addition of a timer-controlled mechanism to cause the animals to sigh every 2 min, without other modifications in the experimental conditions, caused significant improvement in clearance. Analysis of cellular response, compartmentalization of viable bacteria, surfactant quantities and sedimentation characteristics, and protein influx indicated that the defect in clearance paralleled alterations in the physical state of surfactant and alveolar stability but was not strongly correlated with alterations in the other parameters we measured. The data show that defective pulmonary bacterial clearance is rapidly induced by measures which alter alveolar stability and suggest that intrinsic pulmonary defenses require maintenance of normal air liquid interfaces for optimal function. PMID- 3666964 TI - Metacyclogenesis is a major determinant of Leishmania promastigote virulence and attenuation. AB - The in vivo virulence patterns of promastigote populations defined on the basis of agglutination by the lectin peanut agglutinin (PNA) were studied for various cloned lines of Leishmania major. Promastigotes derived from logarithmic-phase cultures, which were routinely 100% agglutinated at 100 micrograms of PNA per ml, were relatively avirulent for BALB/c mice. The relative virulence of stationary phase promastigotes appeared to be attributable to the proportion of nonagglutinable (PNA-) promastigotes contained within these populations. Purification of PNA- organisms from stationary cultures provided for each clone the most virulent inoculum, supporting the view that this change in lectin binding accurately reflects the development of infective metacyclic stage promastigotes. By studying this marker, we found that there was considerable variation in the degree to which different strains and clones underwent metacyclogenesis during growth. Examination of a reportedly avirulent L. major clone revealed that metacyclogenesis was unusually delayed and inefficient for this clone, but that those PNA- promastigotes which could be recovered from late stationary-phase cultures were virulent for BALB/c mice. The loss of virulence associated with frequent subculture could also be attributed to a drastic diminution in metacyclogenesis potential over time. A clone which yielded over 90% PNA- promastigotes during growth within passage 1 generated fewer than 10% PNA- promastigotes during growth by passage 94. Subcloning of late-passage attenuated promastigotes yielded a clone for which no PNA- promastigotes could be generated during growth, and an infective population could not be derived from this clone. Thus, metacyclogenesis does not appear to be stable for even cloned lines of Leishmania promastigotes, and virulence comparisons between different strains and clones can be meaningfully made only if the metacyclic populations contained within the respective inocula are determined. PMID- 3666965 TI - A species-specific DNA probe for the detection of Mycoplasma gallisepticum. AB - An 800-base-pair DNA fragment from a partial genomic library of Mycoplasma gallisepticum was selected and used as a probe for the selective detection of this avian pathogen. The specificity and sensitivity of this probe were demonstrated by using dot blot and Southern hybridizations. PMID- 3666967 TI - Bacteremia in connection with transurethral resection of the prostate. AB - A bacteriological survey of 50 consecutive patients undergoing transurethral resection of the prostate was performed. Preoperatively, 28% of the patients had asymptomatic bacteriuria. In the postoperative period, 46% of all the patients developed transient bacteremia. A significantly higher rate of bacteremia was found in patients with hypertrophy of the prostate than in those with cancer of the prostate and in patients undergoing long-lasting surgical intervention. Patients who developed bacteremia due to pathogenic bacteria were hospitalized for a significantly longer period of time. PMID- 3666966 TI - Early diagnosis of spontaneous bacterial peritonitis: values of ascitic fluid variables. AB - In a search for clinical and laboratory factors that would aid in early diagnosis of spontaneous bacterial peritonitis, we identified two groups of patients with chronic liver disease and ascites: 1) 38 patients with 40 episodes of spontaneous bacterial peritonitis, and 2) 39 randomly selected patients with 40 sterile paracenteses who were matched for severity of liver dysfunction as a reference group. A variety of clinical and laboratory features were examined. The absolute lymphocyte count in peripheral blood was lower for the spontaneous bacterial peritonitis group (mean = 703/mm3 vs. 1,212/mm3, p less than 0.005). Four ascitic fluid variables, i.e., a white blood cell count of greater than or equal to 300/mm3, a polymorphonuclear leukocyte count of greater than or equal to 240/mm3, an ascitic fluid/serum LDH ratio of greater than or equal to 0.4, or an ascitic fluid/serum glucose ratio of less than or equal to 1.0, could separate the spontaneous bacterial peritonitis and reference groups with both sensitivity and specificity of greater than 70%. Although ascitic fluid total leucocyte and polymorphonuclear leucocyte counts are appropriate indicators for the early diagnosis of spontaneous bacterial peritonitis, the possibility of their false positivity should be warranted. The use of multiple tests including ascitic fluid/serum LDH and glucose ratios has better positive predictive value than a single test alone. PMID- 3666968 TI - Severe neutropenia in prolonged treatment with orally administered Augmentin (amoxicillin/clavulanic acid) PMID- 3666970 TI - Re: Bacteremia in patients suffering from cirrhosis. PMID- 3666969 TI - Teratogenicity of acyclovir in rats. PMID- 3666971 TI - Re: Epidemiological aspects of acute viral hepatitis in Portugal. PMID- 3666972 TI - Cystic fibrosis. Part I. PMID- 3666973 TI - [Significance and kind of nosocomial septicemia at the Internal Medicine Center of the Frankfurt University Clinic]. PMID- 3666974 TI - Computing in nephrology. PMID- 3666975 TI - Control of blood pressure on CAPD. PMID- 3666976 TI - Arteriovenous hemofiltration in children with multiple organ system failure. AB - In the last year nine critically ill children with multiple organ system failure (MOSF) were treated by continuous arteriovenous hemofiltration (CAVH). The mean number of organ systems involved was five per patient (range 4 to 7). Mean duration of hemofiltration was 136 hours (range 10 to 432 h.). Mean ultrafiltration rates of 6.4 +/- 3.0 ml/m2 b.s./min achieved mean serum creatinine levels of 2.39 +/- 1.49 mg/dl. Hypervolemia and pulmonary edema were corrected rapidly by CAVH. Total parenteral nutrition with a mean caloric intake of 62 +/- 15 kcal/kg b.w./day was provided throughout the hemofiltration period. In addition high ultrafiltration rates allowed delivery of large amounts of i.v. medications. CAVH is an ideal extracorporeal renal replacement system to control azotemia, fluid, electrolyte, and acid-base status in critically ill children. It carries the potential to improve survival rate in children with MOSF. PMID- 3666977 TI - Continuous arteriovenous renal replacement therapy. AB - As urea and creatinine clearances achieved by continuous arteriovenous hemofiltration tend to be low, efforts were made to increase urea and creatinine elimination by modifying the original continuous arteriovenous hemofiltration system. We investigated the urea and creatinine clearances of different continuous renal replacement therapy systems. Urea clearance achieved by spontaneous arteriovenous hemofiltration was 9.1 ml/min, suction-supported arteriovenous hemofiltration 15.3 ml/min, arteriovenous hemodiafiltration 15.4 to 19.3 ml/min, arteriovenous hemodialysis 18.9 to 22.1 ml/min. Creatinine clearances ranged between 11.1 (spontaneous arteriovenous hemofiltration) and 25.1 ml/min (arteriovenous hemodialysis). Continuous arteriovenous hemodialysis seems at present to be the ideal renal replacement therapy system to compensate azotemia in hypercatabolic patients. Its urea and creatinine clearances are high, its clinical tolerance good and it is simple and safe. PMID- 3666978 TI - Orally ingested microencapsulated urease and an adsorbent, zirconium phosphate, to remove urea in kidney failure. AB - Dialysis is the conventional treatment for chronic renal failure. It is cumbersome, expensive and time-consuming and thus alternate treatments have long been sought. A compact system consisting of haemoperfusion in series with ultrafiltration can nearly replace dialysis. A urea removal system is the only step required to complete this approach. The potential of combining a microencapsulated enzyme, urease, with an ammonium ion adsorbent, zirconium phosphate, to remove urea was examined in vitro. Urease converts urea to ammonium ions which are then adsorbed onto zirconium phosphate. This combination would be most effective in the intestinal tract. The capacity of zirconium phosphate is probably not enough to effect the removal of enough urea to completely replace dialysis in patients with no renal function. However, this system could potentially 1) delay the onset of dialysis therapy in patients who still have some renal function, either alone or in combination with haemoperfusion ultrafiltration, or 2) reduce dialysis treatment times. PMID- 3666979 TI - An investigation into EEG asymmetry in young children. AB - Language performance is thought to be related to the functional specialisation of the brain, and particularly to the degree of asymmetry of activity in the two cerebral hemispheres. A microprocessor-based system has been constructed to investigate the relationship between the analogous asymmetry of the EEG and language ability in young children. The system is based on the Intel 8086 microprocessor, with software written both in the high level language PL/M-86 and 8086 assembly language. A test script, instructing the child to perform various lateralised tasks, is played from a cassette recorder to provide a constant stimulus across subjects. The computed power spectra of the resulting EEG waveforms, and the hemispheric specialisation, represented by a derived dominance factor, have been analysed both visually and numerically. Results from a test group of 16 children have not shown a strong correlation between the dominance factors and the related reading quotient. PMID- 3666980 TI - Computerized speech-recognition and conversation. PMID- 3666981 TI - Microcomputer-based local area network system for controlling information on perinatal medicine. AB - We present an outline of our microcomputer-based Local Area Network (LAN) system designed to process information related to perinatal events. This system enables any of the medical personnel to use a microcomputer terminal installed at the bedside and also to process, in a real-time manner, new input-information together with past information, thereby correlating the processing of medical information to actual clinical care. In addition, using the utility subsystem, a more desired form of data-output can be substituted for conventional hand prepared clinical charts. Over a 3-month test period for clinical use, it became evident that this could serve as a suitable prototype system capable of covering the entire scope of information required by perinatologists. This system also enables any form of statistical assessment to be made of events, such as calculating the perinatal mortality rate and the incidence of preeclampsia. Problems arising from the clinical application of this system are given immediate attention and appropriate steps taken. PMID- 3666982 TI - Effect of demedullation on freezing injury in hind limbs of rats. PMID- 3666983 TI - Effects of chronic normobaric hypoxic and hypercapnic exposure in rats: prevention of experimental chronic mountain sickness by hypercapnia. PMID- 3666984 TI - Electrolyte changes in the blood plasma of broilers as influenced by cooling during summer. PMID- 3666985 TI - Circadian rhythm of aldosterone in dairy cattle during the summer. PMID- 3666986 TI - Effect of phosphate supplementation on oxygen delivery at high altitude. PMID- 3666987 TI - Chemotherapy with estrogenic recruitment and surgery in locally advanced breast cancer: clinical and cytokinetic results. AB - Thirty-nine patients with locally advanced breast cancer (T3b-4, N1-3 or inflammatory carcinoma) received 3 cycles of induction chemotherapy with estrogenic recruitment before surgery. The therapeutic regimen consisted of diethylstilbestrol (DES) orally on days 1-3, 5-Fluorouracil + Doxorubicin + Cyclophosphamide on day 4 q 21 days (DES-FAC). After surgery 6 additional cycles of chemotherapy (3 DES-FAC alternating with 3 DES-CMF with Methotrexate + F and C as in FAC) were administered. The objective response rate was 71.8% with 15.4% CR, and 56.4% PR; after surgery 36/39 (92.3%) patients were rendered disease free. So far, 13 of 26 patients in stage IIIb have relapsed (9 of 13 with inflammatory carcinomas). Three-year survival and progression-free survival are 60% and 53.5%, respectively. Twenty-three of the 39 patients were subjected to serial tumor biopsies during the first DES-FAC regimen to allow for tumor-cell kinetic studies during DES and chemotherapy. A significant estrogenic recruitment occurred in 16 patients (69.6%), irrespective of estrogen-receptor status. At surgery, 3-4 weeks after induction chemotherapy, tumor proliferative activity was significantly depressed in comparison to basal values. These results indicate that breast cancer cells can be recruited in vivo with DES and that chemotherapy following estrogenic stimulation is effective and feasible with acceptable toxicity. PMID- 3666988 TI - Cell-surface laminin-like molecules and alpha-D-galactopyranosyl end-groups of cloned strongly and weakly metastatic murine fibrosarcoma cells. AB - Indications from previous work that cancer cell-surface laminin-like molecules and alpha-D-galactopyranosyl end-groups may contribute to spontaneous metastasis were further investigated. Both moieties are known to mediate cell attachment to various foreign surfaces. Five strongly metastatic and 5 weakly metastatic cell clones from a murine fibrosarcoma were examined for the occurrence of both cell surface moieties by immunofluorescence flow cytometry and microscopy. None of these clones was rich in laminin-like molecules, which were least strongly expressed by the highly metastatic clones. The alpha-D-galactopyranosyl end groups were strongly expressed by all strongly metastatic clones and by 2 weakly metastatic clones, but were only weakly expressed by the other weakly metastatic clones. These results indicate that the laminin-like cell-surface molecules are not necessary for spontaneous metastasis formation. However, the alpha-D galactopyranosyl end-groups may be necessary, but are not sufficient for the cancer cells to form metastases. These carbohydrates are known to occur on the laminin-like molecules. The present results show that they must also exist on other cell-surface molecules. PMID- 3666989 TI - Evidence that sulphated polysaccharides inhibit tumour metastasis by blocking tumour-cell-derived heparanases. AB - Recent studies in this laboratory demonstrated that several sulphated polysaccharides can inhibit metastasis of the rat mammary adenocarcinoma 13762 MAT, probably by preventing the passage of tumour cells through the walls of blood vessels. In order to directly test this possibility, 13762 MAT cells were cultured with (35S)O4(=)-labelled subendothelial extracellular matrices (ECM) and ECM degradation was monitored in either the presence or absence of different sulphated polysaccharides. Degradation products were detected by sodium dodecyl sulphate polyacrylamide gel electrophoresis and subsequent autoradiography. The 5 sulphated polysaccharides that had previously been shown to possess anti metastatic activity were potent inhibitors of the degradation of subendothelial ECM by 13762 MAT cells. In contrast, of the 4 polysaccharides tested that failed to inhibit metastasis, 3 had no effect on ECM breakdown and one (carrageenan kappa) was substantially less effective at inhibiting ECM degradation than the anti-metastatic preparations. It was also shown that 13762 MAT cells produce a heparan sulphate-specific glycosidase (heparanase) that degrades the heparan sulphate side-chains of the ECM, the action of this enzyme rather than that of other ECM-solubilizing enzymes being inhibited by the antimetastatic sulphated polysaccharides. Additional experiments indicated that the anti-coagulant activity of the polysaccharides probably plays a minor role in their anti metastatic effects since heparin, almost completely depleted (98-99.5%) of heparin molecules with anti-coagulant activity by passage over an anti-thrombin III column, retained its ability to inhibit 13762 MAT heparanases and was almost as effective as unfractionated heparin at inhibiting tumour-cell metastasis. Collectively, these data suggest that sulphated polysaccharides inhibit the metastasis of 13762 MAT cells by inhibiting tumour-cell-derived heparanases involved in the penetration of the vascular endothelium and its underlying basement membrane by tumour cells. PMID- 3666990 TI - Adhesion of human breast cancer cell line MCF-7 to human vascular endothelial cells in culture. Enhancement by activated platelets. AB - The interactions of MCF-7 tumor cells with human vascular endothelial cells (EC) and subendothelial extracellular matrices (ECM) were morphologically observed by electron microscopy and quantitatively evaluated by labelling tumor cells with 111Indium-oxine. MCF-7 tumor cells adhered more rapidly to ECM than to the apical surface of a confluent monolayer of EC. The affinity of MCF-7 cells for type-IV collagen was greater than for fibronectin, suggesting that type-IV collagen contributes to the higher rate of adhesion of MCF-7 cells to the subendothelial ECM. Otherwise, the attachment of tumor cells to EC was increased in the presence of both washed platelets and 0.1% citrated platelet-poor plasma (cPPP), a condition accelerating platelet aggregation by tumor cells. The enhancement of MCF-7 adhesion to EC in the presence of platelets and cPPP was completely blocked by the addition of prostacyclin, or hirudin, a specific thrombin inhibitor. In ultrastructural studies, MCF-7 initiated EC retraction, and firm attachment and flattening occurred on exposed ECM. When MCF-7 cells were incubated with platelets and cPPP, most of the tumor cells adhering to the EC and inducing disruption of endothelial monolayer were closely packed and associated with platelet aggregates. MCF-7 cells appeared to adhere more efficiently to exposed subendothelial ECM when they were associated into multicellular aggregates containing platelets and trapped in a fibrin thrombus. Thus, this homologous human system of cultured vascular EC and breast carcinoma line MCF-7 cells may be used to assess anti-aggregant compounds for their ability to alter tumor-cell implantation on EC-lined surfaces. PMID- 3666991 TI - Lymphogenous and hematogenous metastasis of Lewis lung carcinoma in the mouse. AB - Quantitative and temporal comparisons were made between lymphogenous and hematogenous metastasis in the non-immunogenic model system of mice bearing transplanted 3LL tumors in their hind feet. The experimental evidence indicates that cancer cells disseminate from clinically detectable primary cancers by non exclusive routes in the blood-stream and in the lymphatics. Following a delay of approximately 2 weeks after injection of 3LL cancer cells into the foot, local lymph-node micrometastases occur, together with the first appearance of overt hematogenous metastases in the lungs. The anatomic extent of lymph-node involvement, determined by bioassays of orthotopic grafts, of ipsilateral popliteal, inguinal and lumbar nodes, provides an accurate indicator of hematogenous metastasis, even though lymphogenous and hematogenous metastasis are operationally independent in this tumor/host system. PMID- 3666992 TI - Non-toxic potentiation of cancer chemotherapy by combined C and K3 vitamin pre treatment. AB - The influence on the survival of ascitic liver tumor (TLT)-bearing mice of combined vitamins C and K3 administered before or after a single i.p. dose of 6 different cytotoxic drugs, all commonly used in human cancer therapy, was investigated. Combined i.p. administration of these vitamins produced a distinct chemotherapy-potentiating effect for all drugs examined, especially when injected before chemotherapy. This potentiating treatment did not increase the general and organ toxicity that accompanies cancer chemotherapy. The possible generation of peroxides followed by membrane lipid alteration, DNase activation and DNA destruction by combined vitamin C and K3 in catalase-deficient cancer cells might be involved in the mechanisms of this selective potentiation. PMID- 3666993 TI - Urea treatment for water retention in hyponatremic congestive heart failure. AB - We have studied the efficiency of urea in the treatment of hyponatremia and hydrosaline retention in a 76-year-old man with chronic ischemic congestive heart failure. Since increase of furosemide worsened the hyponatremia (120 mmol/l), 30 g/day of urea was added and induced the following changes: progressive weight loss (6.5 kg in one week), increased diuresis (from 0.750 to 1.950 l/day), increased salt excretion (from 40 to 165 mmol sodium/day) and correction of the hyponatremia (120 to 136 mmol/l). Blood urea and creatinine serum concentrations rose moderately without significant change in creatinine clearance (32 to 38 ml/min). No adverse effects related to urea administration were observed. Urea intake seems to be useful in the management of hyponatremia in our patient with cardiac failure. PMID- 3666994 TI - A questionnaire to assess premonitory symptoms of myocardial infarction. AB - To test the hypothesis that feelings of vital exhaustion precede the onset of myocardial infarction, and to develop a short questionnaire to assess these feelings, a prospective study was done among 3877 males, aged 39-65 years. During a 4.2-year follow-up period, 59 fatal or non-fatal infarctions occurred. The mean score of future coronary causes as determined by a questionnaire assessing feelings of vital exhaustion was significantly higher than the mean score of a control group matched for age, blood pressure, cholesterol and smoking. Given the validity of the model, it was possible to reduce markedly the size of the questionnaire. PMID- 3666995 TI - Coronary flow reserve and diastolic dysfunction in hypertrophic cardiomyopathy. AB - We studied 14 patients with hypertrophic cardiomyopathy during and after atrial pacing by simultaneous registration of left ventricular high fidelity pressure measurements and M-mode echocardiography together with great cardiac vein flow measured by thermodilution. Heart rate rose from 75 +/- 18 to 142 +/- 14 beats/minute with an increase of 93 +/- 30 to 127 +/- 46 milliliters/minute of great cardiac vein flow (increase of flow/beat: 0.8 versus 1.5 milliliters/beat in normal individuals; P less than 0.05). In addition, diastolic hemodynamic parameters (such as left ventricular end-diastolic pressure, T1 (time constant of relaxation) (of first 40 milliseconds) and T2 (of second 40 milliseconds) and LVdP/dt-) changed from, respectively, 27.4 +/- 7.1 to 24.0 +/- 10.3 mm Hg; (NS), 67.3 +/- 16.1 to 65.7 +/- 22.2 liters/second; (NS) 68.6 +/- 36.9 to 52.9 +/- 19.4 (P less than 0.05), and 1592 +/- 75 to 1302 +/- 48 mm Hg/sec; P less than 0.05. Left ventricular end-diastolic dimensions decreased whereas end-diastolic wall thickness increased from, respectively, 37 +/- 3 to 34 +/- 4 millimeters; (P less than 0.05) and 14 +/- 2 to 17 +/- 1 millimeters (P less than 0.05). Eleven of the 14 patients experienced angina pectoris concomitant with ST-T depression of 1 millimeter or more on the electro-cardiogram. No correlations were found between great cardiac venous flow and hemodynamically or ultrasonically derived diastolic parameters of left ventricular function. PMID- 3666996 TI - Ejection fraction response to upright exercise in hypertension: relation to loading conditions and to contractility. AB - The respective roles of peripheral and myocardial determinants of exercise ventricular performance were studied in 10 normal volunteers and in 9 mildly hypertensive patients without evidence of coronary disease. Hemodynamic measurements and equilibrium blood pool scintigraphy were simultaneously performed at rest and during maximal upright exercise. In hypertensive patients, mean systolic and diastolic blood pressure were, respectively, 199 +/- 23 and 102 +/- 12 mm Hg at rest, and 271 +/- 28 and 113 +/- 8 mm Hg at peak exercise. Ejection fraction response to exercise was normal (increase by more than 5%) in 4 hypertensive patients (normal hypertensive group: 63 +/- 4 to 77 +/- 6%) and in volunteers (65 +/- 3 to 78 +/- 4%) and abnormal in 5 hypertensive patients (abnormal hypertensive group: 66 +/- 6 to 58 +/- 10% at peak exercise). The abnormal response in the abnormal hypertensive group was not due to an inadequate decrease in systemic vascular resistance during exercise. By contrast, the ratio systolic blood pressure/end-systolic volume, an index of contractility, decreased by 2.3 +/- 4.9 in the abnormal hypertensive group, whereas it increased by 9.8 +/ 9.1 in the normal hypertensive group and by 7.3 +/- 2 in volunteers. Thus, abnormal exercise ejection fraction response in mild hypertension was not related to increased afterload but rather to intrinsic myocardial factors. PMID- 3666997 TI - Prevalence of atherosclerotic involvement of the internal carotid artery in hypertensive patients. AB - The prevalence of atherosclerotic involvement of the internal carotid arteries, as diagnosed through an echo-Doppler imaging system with pulsed Doppler spectral analysis was evaluated in 49 hypertensives who had a negative history for neurological symptoms and 49 matched controls. The prevalence was 24.5% in the hypertensive group and 10.2% in the controls with a statistically significant difference (chi-square = 6.07, P less than 0.01). Two hypertensives had severe stenosis (above 50% diameter reduction) and 7 had potentially embolic lesions (irregular surface, inhomogeneous appearance). No one of the matched controls was as severely involved. We conclude that arterial hypertension can account for enhanced prevalence of carotid artery disease in asymptomatic patients. PMID- 3666998 TI - The quantitative anatomy of the normal human heart in fetal and perinatal life. AB - A total of 367 human fetuses and newborn subjects weighing from 60 to 5000 g provided the material for a morphometric study of the heart. A total of 17 interventricular parameters were measured in each specimen, one of the parameters representing an innovation with regard to the classically used set of measurements. A new anatomo-geometric configuration is described for each ventricle along with a new component for the left ventricular outflow tract, designated as the aortic outflow tract. The appropriate stereometric formulas were used to calculate real ventricular volumes rather than the previously studied volumetric indices. Additionally, correlation indices were calculated for ventricular wall thickness as well as the circumferences and diameters of the atrioventricular and arterial valves. The results show that, in fetuses of up to 2700 g in body weight, ventricular wall thickness is greater in the right than in the left ventricle, although the opposite is true in fetuses weighing above 2700 g. Throughout the range of weights studied, ventricular volume was greater in the left than in the right chamber. Tricuspid and pulmonary valve circumference and diameter were consistently greater than in the mitral and aortic valves, respectively. We believe the new morphometric data and their innovative interpretation to have immediate applications in both the morphological and functional areas of cardiology. PMID- 3666999 TI - Cardiorespiratory response to exercise after definitive repair of univentricular atrioventricular connection. AB - To characterize the exercise hemodynamic responses after definitive operation for patients with univentricular atrioventricular connection, we compared the cardiorespiratory response to exercise of 4 patients who had undergone the ventricular septation procedure and 9 patients who had undergone the Fontan operation with that of 38 patients who had univentricular atrioventricular connection but had not undergone definitive operation. Exercise duration and total work increased significantly after the Fontan procedure but not after the septation operation. Rest or exercise (or both) ventilation improved significantly after the septation operation but less so after the Fontan operation. Blood oxygen saturation (rest and exercise) improved significantly after either procedure. Cardiac output and stroke-volume response to exercise remained abnormal in both groups of patients after operation. Although definitive operation for univentricular atrioventricular connection results in improved cardiorespiratory function at rest and exercise, these variables remain abnormal when compared with those of normal subjects. PMID- 3667000 TI - Congenital heart malformations associated with dilated cardiomyopathy. AB - From June 1977 to February 1986 we studied 31 children with dilated cardiomyopathy. Seven patients (22%) aged 8 months to 3 years had associated congenital cardiac lesions--tetralogy of Fallot (3), coarctation of the aorta (2), ventricular septal defect (1) and Ebstein's malformation (1). The diagnosis was confirmed by hemodynamic and angiographic studies in 5 patients and by autopsy in 2. Although different congenital lesions were present, all 7 patients had congestive heart failure, flattening of T-waves or ST-segment depression on the electrocardiogram and significant decrease in the left ventricular shortening fraction as judged by echo. We conclude that the incidence of dilated cardiomyopathy associated with congenital heart malformations is high in our pediatric population. The clinical status of patients appears to be more dependent on the improvement of dilated cardiomyopathy and less dependent upon the underlying congenital heart malformations. PMID- 3667001 TI - Non-invasive diagnosis of congenital coronary arteriovenous fistula by cross sectional and Doppler echocardiography. AB - A four-year-old child is reported in whom diagnosis of right coronary arteriovenous fistula draining into the right ventricle was made non-invasively, using cross-sectional and Doppler echocardiography. It was confirmed subsequently by coronary arteriography and surgery. PMID- 3667002 TI - Transient giant R waves--a manifestation of potentially reversible acute severe myocardial ischaemia. AB - A patient with acute severe myocardial ischaemia manifested with transient giant R waves and ST segment elevation during chest pain. This probably represents transient complete occlusion of a major coronary artery, the left anterior descending in this case. Myocardial infarction was prevented by aggressive medical and surgical management. PMID- 3667003 TI - Bradycardia-dependent aberrancy in type I second-degree atrioventricular block. AB - We present an example of bradycardia-dependent aberrancy in the left posterior fascicle in the presence of type I second-degree atrioventricular block occurring in the setting of acute inferior myocardial infarction. The need for prophylactic pacing of such cases is stressed. PMID- 3667004 TI - A severe case of myopotential interference in a patient with a respiratory dependent rate modulated pacemaker. AB - Symptomatic myopotential interference was observed in a patient with a respiratory-dependent rate modulated pacemaker (RDP3). During treadmill exercise, prolonged interference suspended the rate responsive function and resulted in reversion to the interference mode with the pacing rate falling back to the basic frequency during the interference. This loss of rate response resulted in severe impairment of exercise tolerance and reduction in cardiac output during exercise. The unit was replaced with a bipolar activity sensing rate modulated pacemaker. PMID- 3667005 TI - Comparative pharmacokinetic analysis of theophylline in serum and saliva. AB - The kinetics of theophylline disposition in serum and saliva was evaluated after single and multiple circadian administration of a sustained-release theophylline formulation (Euphyllin CR) to 20 asthmatic children. Salivary concentrations were proportional to serum drug levels, with the significant correlation of r = 0.92. The kinetics of theophylline absorption and elimination and the mean residence time were identical in both saliva and serum estimations. In steady-state conditions after multiple drug administration, the area under the concentration time curve and the magnitude of peak levels in saliva were reduced proportionally with decreased serum theophylline concentrations. The significantly higher volume of theophylline distribution in saliva confirmed that salivary concentrations represent the free, pharmacologically active fraction in plasma. The determination of theophylline salivary levels could therefore be of clinical importance. The values of the saliva/serum ratio determined in the elimination phase of concentration-time curves for individual patients were constant and stable over the treatment period of three weeks. Saliva appears to be a convenient and noninvasive alternative to blood for the assessment of the variable pharmacokinetic parameters of theophylline and for around-the-clock monitoring of individual dosage regimens, especially in paediatric patients. PMID- 3667006 TI - Evaluation of the effectiveness and safety of a controlled-release theophylline in patients with reversible and stable bronchial obstruction. AB - In this study the effectiveness and safety of a new controlled-release theophylline formulation were evaluated. Twenty patients (12 male, 8 female) affected by bronchial asthma (mean age 45 years) or chronic obstructive lung disease (mean age 58 years) were given the drug. During the 30 days of controlled release theophylline therapy, all patients reported a marked clinical improvement, confirmed by spirometric data (ventilation indexes, intrapulmonary air distribution, ventilation control, gas exchanges). Tolerability was excellent. PMID- 3667007 TI - A new sustained-release theophylline suspension for asthmatic children: evaluation of serum theophylline concentrations. AB - Theophylline level variability obtained with standard slow-release theophylline tablets was compared to that obtained with a new sustained-release theophylline suspension in asthmatic children. The sustained-release preparations were administered every 12 hours and serum samples were collected after ten days of treatment during the steady-state period. In this crossover study, the sequence of the two regimens (slow-release tablets versus slow-release suspension) was selected at random. Both preparations of theophylline were administered at a mean dosage (+/- s.d.) of 19.3 +/- 1 mg/kg/day. The results of our study demonstrated that theophylline serum levels remain within the therapeutic range for both preparations, but there was a greater fluctuation with theophylline suspension compared to the tablets. The tolerability of the two drugs was satisfactory. PMID- 3667008 TI - Serum theophylline concentrations and pulmonary function tests after administration of two sustained-release formulations containing theophylline in patients affected by chronic obstructive lung disease. AB - We compared serum theophylline concentrations in patients treated with one of two commercially available theophylline preparations: a sustained-release aminophylline and a sustained-release theophylline. Two comparable groups of 15 out-patients with stable, chronic obstructive lung diseases were studied: one group was given sustained-release aminophylline while the other took sustained release theophylline. Both drugs were administered orally for 7 days at a daily dose, equivalent to 12 mg/kg in terms of anhydrous theophylline. Serum theophylline concentrations were always significantly lower after treatment with sustained-release aminophylline than after treatment with sustained-release theophylline, which latter frequently caused undesirable side-effects. Moreover, patients receiving sustained-release aminophylline always showed serum theophylline concentrations lower than 10 mcg/ml. Pulmonary function tests were unaffected by the administration of either drug. We conclude that sustained release theophylline is more effective than sustained-release aminophylline in terms of induced serum theophylline concentrations. However neither drug was suitable for the treatment of patients with chronic obstructive lung disease without other concomitant therapy. PMID- 3667009 TI - Effect of verapamil on pulmonary function changes induced by fluid overloading in normal subjects. AB - The acute effects of the intravenous administration of 10 mg verapamil on pulmonary function changes induced by rapid saline infusion were studied in six normal subjects. Rapid intravenous fluid overloading caused on increase of closing volume (from 6.55 +/- 1.74 to 9.53 +/- 1.77%, p less than 0.05). After verapamil, the closing volume did not increase after infusion in three subjects and the mean increase was not significant (7.08 +/- 1.82 to 8.43 +/- 1.86%). These results suggest that the rapid administration of intravenous verapamil blunts respiratory function abnormalities caused by overhydration interstitial lung oedema. PMID- 3667010 TI - Amiodarone lung toxicity: role of pulmonary function tests. AB - Forty-three patients treated with amiodarone hydrochloride with an average daily dose of 204.7 +/- 79.4 mg/day for a mean period of 37.1 +/- 25.3 months, were studied by clinical examination, chest roentgenograms, pulmonary function tests and blood gas analyses. The habits of cigarette smoking were also recorded and expressed as cigarette pack/years. Pulmonary function tests did not show any differences from control subjects and no correlation was found between exposure to drug and lung function. However, one patient developed abnormalities in the chest X-ray (interstitial type) and a reduction of carbon monoxide diffusion capacity as a possible manifestation of amiodarone lung toxicity. Nine patients (22%) had a 20% decrease from normal in carbon monoxide diffusion capacity and three (7%) had a 15% decrease in total lung capacity. More treated patients had interstitial abnormalities in the chest X-ray (14%) than controls (5.5%). Although pulmonary function test abnormalities could be detected in patients taking amiodarone, they were not usually severe enough to interfere with gas exchange. Our results confirm the rarity of amiodarone lung toxicity when a low dosage is used, and suggest the advisability of periodical monitoring, including clinical examination, chest X-ray and pulmonary function tests in order to detect the earliest signs of amiodarone lung toxicity. PMID- 3667011 TI - Simultaneous radiotherapy and chemotherapy in the treatment of brain metastases of malignant solid tumours. AB - Between January 1982 and June 1985, 105 patients with brain metastases of malignant solid tumours were treated in the Robert Janker Clinic. In order to optimize the overall response rates, concomitant radiotherapy and cytostatic chemotherapy was used. In most cases the primary tumour was located in the breast or the lung. Radiotherapy was performed with a Cobalt 60 equipment. The whole brain was irradiated in daily fractions of 15 Gy up to total dose of 45 Gy. Using a slit-course technique this dose was distributed to the three cycles of chemotherapy and given simultaneously, i.e. 15 Gy/ by course. The chemotherapeutic regimen consisted of ifosfamide daily for five days at 2g/m2 and the nitrosurea derivative carmustin (BCNU) at 30 mg/m2 on days 1, 3 and 5. After a free interval of four to five weeks the concomitant radiotherapy and chemotherapy was repeated twice. The tolerance of the treatment was generally good; no severe haematological or gastrointestinal complications occurred. There was a complete and permanent alopecia in all patients caused by the radiation. All patients received a cranial computerized axial tomographic scan prior to and after the treatment. According to the criteria of the International Union Against Cancer, there was a complete remission in 26 of the 105 patients and a partial remission in 49; 19 patients showed a stable disease. Only 12 of the 105 treated patients had a progression of their metastases. Only patients with partial or complete remissions after the treatment belong to the "long-term" survivors. PMID- 3667012 TI - On interpretation in group psychotherapy: the need for refinement. PMID- 3667013 TI - Overcoming obstacles to the implementation of Yalom's model of inpatient group psychotherapy. PMID- 3667014 TI - Video in groups: implications for a social theory of the self. PMID- 3667015 TI - The ethical foundations of group psychotherapy. PMID- 3667016 TI - Developmental group therapy with autistic and other severely psychosocially handicapped adolescents. PMID- 3667018 TI - Group climate's principal dimension: affiliation. PMID- 3667017 TI - AIDS group psychotherapy. PMID- 3667019 TI - Physiologic responses to heavy-resistance exercise with very short rest periods. AB - Heavy-resistance exercise utilizing very short rest periods is commonly used by body builders to prepare for competition. The purpose of this study was to compare the acute responses of this type of heavy-resistance exercise protocol in competitive body builders (BB) and power lifters (PL). Nine male BB and eight PL were matched for age, size and experience. A ten-station heavy-resistance exercise protocol was used. Each subject performed three sets of 10 repetition maximum (RM) with 10-s rest between sets and alternated 30-s and 60-s rest periods between exercises. No differences were observed in total work between the groups, but BB used a significantly (P less than 0.05) higher percentage of their 1 RM in the bench press and leg press exercises. Heart rate, ratings of perceived exertion (RPE), and lactate levels were obtained during the exercise protocol; significant (P less than 0.05) increases were observed above rest for these variables. RPE was significantly correlated with lactate levels (r = 0.84). Plasma epinephrine, norepinephrine, dopamine, cortisol, and lactate levels significantly increased from pre- to 5 min post-exercise. Mean plasma volumes were reduced -16.6 (+/- 3.64)% and -20.6 (+/- 8.32)% following the exercise protocol for BB and PL, respectively. Significant (P less than 0.05) decreases in eosinophil counts were observed following exercise. No significant differences were observed between BB and PL for any of the physiologic responses measured. PL exhibited a higher incidence (100%) of clinical symptoms of dizziness and nausea compared to BB (11.1%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667020 TI - Changes of white blood cell count during prolonged exercise. AB - Leukocytosis was postulated to accompany short- and medium-length exercise; in this report, we have studied the changes in leukocyte count during and following prolonged exercise. White blood cell (WBC) counts were obtained in 15 endurance trained subjects before, during, and at a recovery period after an ultralong exercise (120 km march), lasting 24 h. WBC counts increased after 16 h march from a baseline value of 8.5 +/- 0.3 10(9) l-1 to 11.3 +/- 0.8 10(9) l-1 (P less than 0.05) and then declined to 7.1 +/- 0.9 10(9) l-1 after 24 h march with no further significant changes during 64 h of recovery. These observations were supported by previous findings in three separate marches performed by a second group (40, 70, and 120 km). A parallel increase in plasma creatine phosphokinase activity from 127 +/- 4.4 ul-1 to 539 +/- 106.3 ul-1 was observed after 16 h march (P less than 0.01), indicating muscle cell damage. Our findings suggest that in extremely long marches, WBC counts return to baseline values before exercise is terminated. This phenomenon may reflect WBC infiltration to damaged muscle tissue. PMID- 3667021 TI - Effect of electrical stimulation of high and low frequency on maximum isometric force and some morphological characteristics in men. AB - The effects of two methods of electrical stimulation on maximum isometric force, calf girth, and skinfold thickness of stimulated and nonstimulated (contralateral) legs were studied. Thirty-six male volunteers, divided into three groups, participated in the experiment. Groups I and II were subjected to the procedure of electrical stimulation of m. triceps surae daily for a period of 21 days. Group I was stimulated by an alternating current of low frequency (50 Hz); group II was also stimulated by an alternating current but of higher frequency (2000 Hz). Group III served as control group. In groups I and II significant increases of the maximum isometric force (as measured on an electronic dynamometer) of the stimulated (50.3% and 58.8%) and also of the nonstimulated (contralateral) muscles (39.7% and 32.2%) were found. In group III no significant increase of the maximum isometric force was registered. After the period of stimulation, the skinfold thickness was notably reduced by 21.6% in group II, and calf girth was enlarged in both experimental groups. Relatively large changes were realized in the calf girth and the skin-fold thickness of the nonstimulated legs. The changes in group III were insignificant. It is concluded that electrical stimulation with low as well as high frequencies exerts great effects on muscle force. PMID- 3667022 TI - Effect of sucrose and caffeine ingestion on performance of prolonged strenuous running. AB - To investigate the effect of sucrose or caffeine ingestion on the performance of prolonged running, five male distance runners attending senior high school (15.6 yrs) carried out running on a treadmill at an intensity corresponding to the individuals' 80% VO2 max until exhaustion. Before and 45 min after exercise, the subjects were given either a placebo (Con), sucrose (81 +/- 18 g) (Su), caffeine (384 +/- 13 mg) (Caf), or sucrose (72 +/- 22 g) plus caffeine (396 +/- 29 mg) (Su + Caf) solution. The duration of the exercise was significantly longer in Su, Caf, and Su + Caf than in Con. The duration in four of five subjects was longest in Su + Caf, although it was not significantly different from that in Su or Caf. Carbohydrate (CHO) utilization was highest in Su while fat utilization was highest in Caf. The energy supply from both sources was almost the same between Con and Su + Caf. The plasma glucose concentration was higher in Su than in Con. The plasma free fatty acid (FFA) level was higher in Caf than in Con. The plasma glucose and lactic acid concentrations were highest in Su + Caf while the plasma FFA level was the same as in Con. In conclusion, ingestion of sucrose, caffeine, or sucrose plus caffeine solution was equally effective in improving endurance during running carried out at an intensity of approximately 80% VO2 max. PMID- 3667023 TI - Oxygen consumption, lactate accumulation, and sympathetic response during prolonged exercise under hypoxia. AB - Six men (33 +/- 3 years old) performed 1 h ergocycle exercise (60% VO2 max) at sea level and at a simulated altitude of 3000 m. A similar relative exercise intensity corresponded to a lower absolute work load (139 +/- 4 W) in hypoxic than normoxic (163 +/- 4 W) conditions. Lower oxygen uptake (VO2) with no change in ventilation (VE), respiratory exchange ratio (R), and heart rate (Hr) were observed during exercise under hypoxia compared to normoxia. A slow rise in VO2, after the initial 5 min exercise, was observed in normoxic (+ 230 ml/min) as well as in hypoxic (250 ml/min) conditions that might be, in part, related to oxidative removal of blood lactate. Peak blood lactate concentration reached at 30 min of exercise was similar in normoxia (4.5 +/- 0.4) and in hypoxia (4.7 +/- 0.5). However, while the lactate level decreased during exercise at sea level, it remained elevated throughout exercise in altitude. Blood lactate concentration measured at the end of exercise was significantly (P less than 0.05) higher in hypoxic (4.4 +/- 0.3) than in normoxic (3.2 +/- 0.4) conditions. Catecholamine response to exercise was similar in both conditions. We conclude that during prolonged exercise at a given relative work load, hypoxia does not affect cardiorespiratory and sympathetic responses but tends to increase blood lactate accumulation. Higher blood lactate concentrations during hypoxic exercise seems to reflect alterations in the removal of blood lactate rather than changes in glycolytic flux. PMID- 3667024 TI - Metabolic effects of verapamil and propranolol during submaximal endurance exercise in patients with essential hypertension. AB - In contrast to beta-adrenoceptor blocking agents, calcium channel blockers do not appear to affect exercise tolerance in hypertensive subjects. A possible explanation is a difference in the metabolic effects of both types of drugs. Therefore, the effects of 4-week treatment periods with verapamil and propranolol on metabolic parameters during an endurance bicycle ergometer test were studied in eight patients with mild to moderate essential hypertension. Patients exercised at a work load which increased the heart rate to 150 bts/min during placebo. A single-blind, placebo-controlled, randomized cross-over design was used. The dose of propranolol and verapamil was adjusted to lower standing diastolic blood pressure less than 90 mmHg. Average daily doses were 155 +/- 21 mg propranolol and 390 +/- 44 mg verapamil. Exercise heart rate was reduced during propranolol and verapamil (P less than 0.01), but the reduction was more pronounced during propranolol than during verapamil (P less than 0.05). Minute ventilation and oxygen consumption were unchanged during propranolol and verapamil. The respiratory exchange ratio tended to increase during propranolol. Plasma glucose and lactate concentrations were unchanged during propranolol and verapamil. In contrast, plasma glycerol and nonesterified fatty acids were reduced during propranolol (P less than 0.05), but unchanged during verapamil. Plasma potassium levels were increased during propranolol (P less than 0.05). Despite the important direct and indirect role of calcium ions in the regulation of many metabolic processes, no effect of verapamil on metabolic parameters during submaximal exercise was found. In contrast, propranolol had an effect on fat and potassium metabolism during exercise. PMID- 3667025 TI - Ventilatory threshold in various groups of highly trained athletes. AB - The ventilatory threshold (VT) was determined on a treadmill in highly trained male marathon, male and female long-distance, young male long-distance, adult male and female and young female middle-distance runners, modern pentathlonists, adult canoeists of both sexes, young male canoeists and football players, and on a bicycle ergometer in table tennis players, water slalom paddlers, young female canoeists rowers, and ice hockey players. Young female canoeists were also examined on the paddling ergometer and rowers on the rowing ergometer. VT expressed in %VO2 max was higher the longer the duration of racing performance (in marathoners 86.7%). %VO2 max at the VT level depends on the type of load and is higher the better the organism is adapted to a load. In young female canoeists and rowers examined on the bicycle ergometer, we found the VT level at 74.2% and 74.6% of %VO2 max, respectively. In the case of specific loading, we recorded 84.8% and 85.0% of %VO2 max, respectively, in the same athletes. In the case of nonspecific loading highly trained individuals may have low VT values close to the level characteristic for normal subjects. In relatively equally trained young and adult athletes we did not find significant differences in %VO2 max at the VT level (for long-distance runners, 85.2% and 85.3%, respectively, in female middle distance runners, 82.8% and 82.7%, respectively, and in canoeists 81.3% and 78.9% of %VO2 max, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667026 TI - Effects of rapid weight reduction on force production and vertical jumping height. AB - The effects of three weight reduction methods on maximal strength, rate of force development, vertical jumping height, and mechanical power were studied in track and field athletes and volleyball players. The three methods were sauna, diet with diuretic, and diuretic alone. The reductions in weight achieved were 3.4%, 5.8%, and 3.8% of body weight after sauna, diet + diuretic, and diuretic, respectively (P less than 0.001). Maximal isometric leg strength and the rate of isometric force development were decreased after the sauna and diet + diuretic treatments. Dehydration caused by the diuretic method alone did not impair neuromuscular performances. As had been expected from theoretical calculations, the rise of the body center of gravity in vertical jumping was slightly improved with all three treatments, the improvement being the greatest following the diuretic treatment (7.1%, P less than 0.001). However, when the work performed was extended for 15 s, an improved power output could be observed only with the diet + diuretic treatment (P less than 0.01). No explanation for the results observed could be made in terms of physiologic parameters. PMID- 3667027 TI - Physiologic responses to treadmill running in adult and prepubertal males. AB - Little data are available directly comparing physiologic responses to endurance exercise in children and adults. To evaluate age related differences during maximal and submaximal treadmill exercise, physiologic parameters recorded during testing of 20 active prepubertal boys (aged 9-13 years) were compared with values obtained in nonathletic adult males aged 23-33 years. Maximum oxygen consumption (VO2 max) was 57.9 ml.kg-1.min-1 (6.9 SD) in the boys and 48.3 ml.kg-1.min-1 (4.9 SD) in the adults. Running economy examined both as VO2 at a treadmill speed of 9.6 kph and as the slope of linear regression of VO2 at four submaximal speeds was less in boys compared to men when values were expressed per kg body mass. Differences in running economy between the two groups disappeared, however, when related to body surface area. As expected, children had a higher stride frequency at a given treadmill speed, but running stride frequency was unrelated to economy with the two groups. Lower respiratory exchange ratios were observed at maximal and submaximal exercise in the children, which may reflect diminished anaerobic capacity or differences in substrate utilization. These results substantiate the high aerobic capacity previously observed in children and suggest that lower running economy in younger subjects may largely relate to a greater body surface are/mass ratio. PMID- 3667028 TI - Cancer ecogenetics: studying genetic and environment interactions through epidemiology. PMID- 3667029 TI - Use of quantified and frequency indices of vitamin A intake in a case-control study of lung cancer. AB - Recent publications have examined the extent of food frequency data needed to estimate nutrient intakes in epidemiological studies. The need for amount (usual portion size) data to supplement information on average frequency of intake has been questioned. In a case-control study of risk factors for lung cancer, we have collected data on frequency, amount and past pattern of intake for common or rich sources of vitamin A. These data have been combined with standard content information to calculate three different types of indices: one based on frequency alone, a quantitative index that included both frequency and amount, and a past weighted index that combined the frequency, amount and data on relative consumption in the past. Odds ratios by tercile of carotene, retinol and total vitamin A intake varied little between the frequency index and the quantified and past-weighted indices. Higher intakes of carotene and total vitamin A were associated with a lower risk for lung cancer regardless of index type. This consistency of results is explained by a stability of relative intakes regardless of index type. Spearman rank order correlation coefficients between the frequency and quantitative indices exceeded 0.90 for total vitamin A, carotene, and retinol. This stability is attributable to parallel trends of increased frequency of consumption and portion size at higher levels of nutrient intake. Because similar trends were observed in five main food groups included in these analyses, these findings may be generalizable to other nutrients. PMID- 3667030 TI - General epidemiology of breast cancer in northern Italy. AB - The role of the major identified risk factors for breast cancer was assessed using data from a hospital-based case-control study conducted in Northern Italy on 1108 women with histologically confirmed breast cancer and 1281 control subjects with a spectrum of acute conditions unrelated to any of the established or potential risk factors for breast disease. With reference to nulliparous women, the risk of breast cancer was below unity for those who first gave birth below age 25, and above unity for those with later first full-term pregnancy. However, in each stratum of age at first birth, the point estimate was below unity for women with five or more births. The relative risk for greater than or equal to 5 births compared with 1 or 2 was 0.6 (95% confidence interval = 0.4 0.9) when allowance was made for age at first birth. Likewise, there was a significant and independent effect of age at last birth which was evident in various strata of parity and age at first birth. The overall relative risk for last birth at 30 years or over compared with under 30 was 1.4 (95% confidence interval = 1.1-1.8). There was little relation of breast cancer risk with abortions or miscarriages. Breast cancer cases reported earlier menarche and later menopause; further, lifelong irregularities in menstrual pattern were less common among the cases (relative risk = 0.6, 95% confidence interval = 0.5-0.8). The risk estimates were elevated in women with positive history of benign breast disease, family history of breast cancer and greater body mass index.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667031 TI - A case-control study on breast cancer risk factors in a southern European population. AB - A case-control study has been carried out among women attending a screening service in Palermo (Sicily) from 1974 through 1983 to ascertain the distribution of the most frequently investigated risk factors for breast cancer in a southern European population. Information has been obtained from the archives of the screening service. The analysis was separately conducted for pre- and post menopausal cases and non-cases. Risk factors for pre-menopausal women are: nulliparity (nulliparous versus parous: OR 2.17, 95% CI 1.41-3.32); age at first birth (25-29 versus less than 20: OR 2.16, 95% CI 1.17-4.00); interval between menarche and first birth (greater than 20 years versus less than 6: OR 5.34, 95% CI 2.08-13.66); number of births (greater than 4 versus 1-2: OR 1.98, 95% CI 1.10 3.50). Risk factors for post-menopausal women are: nulliparity (nulliparous versus parous: OR 2.18, 95% CI 1.59-2.99); age at first birth (greater than 29 versus less than 20: OR 1.84, 95% CI 1.13-2.99); interval between menarche and first birth (16-20 years versus less than 6: OR 2.15, 95% CI 1.20-3.85). Age at menarche, age at menopause, breast feeding and family history were not found to be risk factors for breast cancer in the investigated population. The existence of influencing differences between northern and southern populations has been postulated. PMID- 3667032 TI - Risk factors for invasive cervical cancer and reduction of risk by 'Pap' smears in Thai women. AB - A case-control study of invasive cervical cancer was conducted in Siriraj Hospital, Thailand, as part of a WHO-sponsored collaborative study of neoplasia and steroid contraceptives. Data from 189 histologically confirmed cases and 1023 randomly selected hospitalized controls who were recruited from October 1979 through March 1983 were analysed to identify risk factors for cervical cancer in Thai women, and to assess the effectiveness of Papanicolaou smears (Pap smears) in preventing invasive cervical cancer in Thailand. Variables that distinguish women at significantly increased risk of invasive cervical cancer, to whom preventive programmes should be directed, include a history of treatment for abnormal vaginal discharge (an indicator of vaginal or cervical infection), a history of venereal disease, and little or no education (an indicator of low socioeconomic status). Risk of invasive cervical cancer decreased significantly as the frequency of Pap smears increased, and was reduced by 75% in women who had at least one Pap smear per year. PMID- 3667033 TI - Hodgkin's disease in the US Navy. AB - Hodgkin's disease incidence has an early peak in young adulthood. The US Navy maintains computerized career history and hospitalization information for one of the largest defined populations of young adults available for prospective studies. There were approximately 2.3 million person-years at risk in white male enlisted personnel involved in more than 80 occupations in the Navy from 1974-79. During this period 88 incident cases were identified. Navy age-adjusted incidence rates of Hodgkin's disease did not differ significantly from US population rates. There was a slight, but not significant, increased incidence with increasing length of Navy service. One occupation, machinists' mate, had about double the risk of Hodgkin's disease as the entire Navy (SIR = 2.3, p = 0.004) and the US population (SIR = 1.8, ns). Probable exposures of machinists' mates include: volatile solvents, metal dusts and, possibly, ionizing radiation. Further studies are needed, however, to clarify this association. PMID- 3667034 TI - Comparability of old and new World Health Organization criteria for definite myocardial infarction. AB - New epidemiological criteria for definite myocardial infarction are now in use as part of the international study of trends and determinants of cardiovascular disease coordinated by the World Health Organization (MONICA Project). In this paper we use data from a myocardial infarction register to assess the comparability of the old and new World Health Organization criteria for definite myocardial infarction. The new criteria were applied to 905 cases who had been categorized as definite myocardial infarction on the old criteria. 739 (82%) of these cases met the new criteria for definite myocardial infarction; a further 157 cases (17%) met the new criteria for possible myocardial infarction. This study indicates that the two sets of criteria produce results that are too dissimilar for reliable comparisons to be made between studies using different criteria for definite myocardial infarction. PMID- 3667035 TI - Trends in dietary fat and cigarette smoking and the decline in coronary heart disease in New Zealand. AB - Coronary heart disease (CHD) mortality declined by approximately 23.5% in New Zealand men aged 35-64 years between 1968 and 1980. The contributions of secular trends in dietary fat and tobacco consumption to this decline were examined using data from national consumption statistics and population based studies of risk factor levels. Per capita saturated fat and dietary cholesterol consumption fell by approximately 12% and 10% respectively during this period while polyunsaturated fat consumption increased by 73%. Per capita tobacco consumption fell by approximately 15%. Using equations developed by Keys and Hegsted it was calculated that the mean serum cholesterol level declined by between 6.6 and 10.3 mg/dl (2.9%-4.4%) during this period. The potential impact of these risk factor changes on CHD mortality was estimated using a Framingham multivariate logistic risk function. Between 38% and 51% of the observed decline in CHD mortality in men aged 35-64 years in New Zealand between 1968 and 1980 could be accounted for by the calculated changes in serum cholesterol and tobacco consumption. If serum cholesterol and cigarette smoking were reduced further to meet current recommendations, it is estimated that CHD mortality would decline by a further 26%-30% from the 1980 level. PMID- 3667036 TI - A population survey in Ontario regarding restrictive measures on smoking: relationship of smoking status to knowledge, attitudes and predicted behaviour. AB - A population survey of Ontario residents regarding knowledge of the health effects of smoking, attitudes towards restrictive measures, and predicted behaviour was carried out. Telephone responses of 490 current, 290 former, and 581 never smokers were compared. For both active and passive smoking, never smokers were most knowledgeable about health effects, former smokers being less knowledgeable, and current smokers least so. While a majority of each smoking status group supported some restriction on smoking in all 13 settings examined, there were consistent differences among the groups as to degree. Never and former smokers were in close agreement and were more restrictive in their attitudes than current smokers. Prohibition was more strongly favoured by all groups for health and day care facilities, schools, stores, and local transit systems than for other settings. While a majority of smokers thought there would be compliance with restrictions, non-smokers were less optimistic. Smokers were less likely than non-smokers to see a role for governments in enactment; municipal involvement was favoured over other levels by all groups. No group indicated much support for enforcement by police. These findings remained when multivariate analyses controlling for inter-group differences in sociodemographic characteristics were carried out. PMID- 3667037 TI - The influence of age, relative weight, smoking, and alcohol intake on the reproducibility of a dietary questionnaire. AB - To evaluate factors that affect the reproducibility of a semi-quantitative food frequency questionnaire used in a large prospective study we compared an extended 99-item questionnaire with a shorter, 61-item form completed by 1497 women with an interval of nine months between. Correlation coefficients for individual items assessed by the two questionnaires were highest for beverages (Spearman r = 0.70). For other foods, coefficients ranged from 0.60 to 0.70 for items eaten frequently (or habitually), to values between 0.34 and 0.45 for foods, such as sweet potatoes and ready made pie, that were eaten less frequently. For food items, the correlation between mean frequency of consumption and the reproducibility coefficient (Spearman r) was 0.51 (p less than 0.01), formally confirming that the reproducibility of measurements was positively associated with frequency of use. Pearson correlation coefficients for calorie-adjusted intakes of nutrients between the two questionnaires ranged from 0.40 for trans fatty acids to 0.71 for vitamin E (including supplements). These correlation coefficients did not vary materially between subjects in different categories of smoking status or tertiles of age or relative weight. Moderate alcohol use had minimal effect on correlation coefficients, but reproducibility was slightly reduced among heavier drinkers. These data indicate that this self-administered dietary questionnaire can provide reproducible information about individual food and nutrient intakes which is not altered materially by age and a number of important health habits. PMID- 3667038 TI - Multivariate analysis of ambient environmental factors and respiratory effects. AB - Relationships between respiratory health and environmental conditions (pollen, pollution and meteorology) are investigated in 204 subjects in four symptom groups in four geographical clusters in Tucson. Techniques used are principal components, factor and path analysis. Daily respiratory symptoms and peak expiratory flows were recorded during a three-year period. Ambient pollutants, meteorological conditions and pollen types were monitored in or near the clusters. Factor-based scales, which are climate and season specific, are developed for the environmental variables. Three pollutant/meteorological scales represent 'Summer', 'Winter', and 'Humidity'. Four pollen scales represent early and late spring, summer and fall pollen types. Relationships between environmental variables, respiratory symptoms and peak expiratory flow are analyzed with path diagrams, after accounting for age, sex, smoking habits and stove type. The different effects of the environment on asthmatics, allergics and airways obstructive disease subjects have been demonstrated. Many relationships were found between environmental factors and respiratory responses. The pollutant and meteorological variables are related to respiratory symptoms and peak flow directly as well as through interactions with pollen types. Some of the largest positive coefficients are seen in association with seasonal pollen types, specifically, rhinitis and dyspnoea. PMID- 3667039 TI - The effect of inaccuracies in death certification and coding practices in the European Economic Community (EEC) on international cancer mortality statistics. AB - An investigation into the effect of national death certification and coding practices on published mortality statistics in eight EEC countries is reported. Doctors in each country were asked to complete specimen death certificates for a bank of written case histories. Certificates from each country were coded by their own offices and then by a WHO reference centre. Within and between countries, discrepancies occurred both in the doctors' diagnoses and in the codes assigned to certificates. At an international level these differences had serious implications for the comparability of mortality data for cancers of the cervix and uterus, and for mesotheliomas. PMID- 3667040 TI - Cause-specific mortality among Koreans, Chinese and Americans in Japan, 1973 1982. AB - Mortalities from selected causes from 1973 to 1982 among Koreans, Chinese, and Americans residing in Japan were compared with those of Japanese. In the Korean population, besides the well-documented excess in mortalities from liver cancer, lung cancer, liver cirrhosis and male tuberculosis, a rather prominent elevation was observed for mortalities from female tuberculosis and diabetes mellitus in both sexes. Distinctive features in the Chinese population were increased mortalities from liver cancer and female lung cancer and lowered mortality from stomach cancer, and these findings are consistent with the observations among Chinese in other areas. Mortalities from diabetes mellitus and liver cirrhosis was moderately increased in this population as well. Americans in Japan by and large showed a mortality pattern similar to that in the US although mortality from stroke among female Americans was rather elevated during the period 1973 1977. Epidemiological studies on Koreans and Chinese in Japan with reference to their lifestyle are strongly required. PMID- 3667041 TI - A case-control study of rheumatoid arthritis in Lebanon. AB - A case-control study was conducted to investigate the risk factors contributing to the development of rheumatoid arthritis (RA) in Lebanon. One hundred cases of classical and definite RA were identified from various care facilities in Beirut. Each case was matched with another patient of the same age and sex and free from any arthritic problem. Data on demographic, socioeconomic, genetic and psychosocial factors were collected. Histories obtained from both case and control groups showed a significant difference as to their family history of RA (odds ratio = 2), their past history of trauma (OR = 4) and their history of tonsillitis (OR = 2.2). A significantly higher proportion of cases reported the occurrence of major life events prior to the onset of their disease (OR = 2.5). The perception of the nuclear family environment was compared in both case and control groups. More RA patients were brought up in a family of high conflict (OR = 5), low cohesion (OR = 2) and low expressiveness (OR = 3.5). PMID- 3667042 TI - Pregnancy outcome and social conditions of women under 20: evolution in France from 1972 to 1981. AB - Two studies based on national samples of births in France in 1972 and 1981 have enabled a comparison of the changes in perinatal risk and social situation of women under 20 years of age with those of women 20 and over. Preterm delivery among women under 20 remained stable during the 10-year period, while it declined significantly among older women. Also, the social situation of teenagers deteriorated in terms of occupational activity, educational level, presence of the child's father in the home, and his occupation. The changes in these social characteristics do not adequately explain the increased relative risk of preterm delivery among women under 20. PMID- 3667043 TI - The influence of secular effects and gravidity on the rate of ectopic pregnancy in a Norwegian population. AB - In order to assess the influence of secular effects and gravidity on the incidence rate of ectopic pregnancy, information from reproductive history questionnaires was obtained for 7804 gravid females identified through the Norwegian Twin Panel. The overall ectopic pregnancy incidence rate was 5.6 per 1000 estimated conceptions, with rates increasing for women born after 1950. Women experiencing their first pregnancy were at lowest risk for that pregnancy being ectopic. When women were stratified by whether they were born before or after 1950, gravidity still had an effect on the incidence rate of ectopic pregnancy. Conversely, year of birth was influential when stratifying by gravidity. The results obtained here suggest that the recent increase in the incidence of ectopic pregnancy is unrelated to the number of prior pregnancies. PMID- 3667044 TI - Assessing sex differences in neonatal survival: a study of discordant twins. AB - We identified 1699 liveborn twin pairs, discordant for sex. In this study, which essentially controls for gestational age, race, and maternal risk factors among males and females, there was no significant sex difference (108 male deaths and 103 female deaths) in neonatal mortality (p greater than 0.50). However, there was a sex difference in intrauterine growth, since 53% of the males, but only 42% of the females had birthweights greater than 2499 grams (p = 0.0002). A differential growth pattern can bias birthweight-specific assessments of survival. Such a bias may have been responsible for our finding that low birthweight white females had better survival than did males in that category, since there was no such sex difference found among white twins born prematurely (greater than 36 weeks gestation). Therefore, we recommend that accurate assessments of sex differences in neonatal survival should be on the basis of gestational age, controlling for race and maternal risk factors. PMID- 3667045 TI - Urinary tract infection in relation to diaphragm use and obesity. AB - We have examined factors influencing the rate of first referral to hospital for urinary tract infection among the 17,032 women taking part in the Oxford Family Planning Association contraceptive study. The risk of first referral declined with age, was higher in nulliparous women than in parous women, was higher in non obese than in obese women and was higher in current users of the diaphragm than in current users of other methods or no method of contraception. The main increase in the risk of referral in current diaphragm users occurred during the first 24 months when overall rates were 2-3 times higher in users than in non users or ex-users of the diaphragm. The negative association between hospital referral for urinary tract infection and obesity was unexpected. It was not explicable in terms of age, parity or diaphragm use. It may be that obese women are less likely to receive trauma to the genital area during sexual intercourse than non-obese women because adipose tissue offers them some protection. Another possibility is that increased oestrogenization in obese women, resulting from peripheral conversion of androstenedione to oestrone, has a beneficial effect on the bladder and urethra, thus reducing the liability to infection. PMID- 3667046 TI - The influence of illnesses on the food intake of young children. AB - The effect of illness on the food intake of 125 preschool children in a residential home was studied. The children had a mean of 6.8 episodes of illness per child per year. Upper respiratory infections, diarrhoeas and fevers depressed food intake by 15-20%. Measles resulted in prolonged and profound depression of appetite, and caused weight losses in the affected children. The number of days of depressed appetite due to illness had a cumulative effect on growth; poor increases in height and weight were seen in these children who had many days of reduced appetite due to illness. Measles vaccination is strongly recommended for improved growth and nutritional status of preschool children. PMID- 3667047 TI - An epidemiological study of the occurrence of habu snake bite on the Amami Islands, Japan. AB - This study was carried out in order to estimate the risk of habu snake bite on the Amami Islands in relation to meteorological and human behavioural factors. A time-series analysis of the seasonal variation of habu snake bite was also carried out in order to clarify the possible mechanism of the epidemiological features of habu bite. It was found that the risk of habu bite has been decreasing over a long period of time on both the islands of Amamioshima and Tokunoshima. In general, the risk is higher on Tokunoshima for males and on Amamioshima it is higher for females. There was a significant positive correlation between risk and time spent in the sugar cane fields. Analysis of annual cumulative risk revealed that the inhabitants of Tokunoshima were more likely to be bitten by the habu than those of Amamioshima. The probable explanation for this was the difference between the two islands in the size of cultivated area or the proportion of the labour force engaged in primary industry. Seasonal variation of habu bite showed a maximum occurrence in June. This seasonality was probably caused by the effects of climate on the activities of both humans and habu snakes. Meteorological conditions were investigated by multiple regression analysis for causal effects on the seasonal variation in the occurrence of habu bite; as a result, temperature and humidity were presumed to have an important influence. These facts supplied the most probable explanation for the highest incidence of habu bite being in June rather than in August--the hottest season--on the Amami Islands. PMID- 3667048 TI - Human immunodeficiency virus (HIV) infection in Jordan: a seroprevalence study. AB - Sera from 1124 Jordanian subjects were screened for HIV antibodies by enzyme immunoassay (EIA). The study population represented healthy rural and urban residents of Jordan as well as patients with hepatitis and their contacts, and patients with a variety of other diseases. Two patients with hepatitis had a positive test result by enzyme immunoassay and Western blot. Neither had AIDS like illness and both probably acquired HIV infection abroad. There were no other positive serologic results for the population. False positive reactions by EIA can arise following repeated freezing and thawing of sera. PMID- 3667049 TI - Epidemiological survey of a major outbreak of nosocomial legionellosis. AB - Forty-seven nosocomial cases of legionellosis due to Legionella pneumophila serogroup 1 were diagnosed in one major outbreak from November 1982 to March 1983 in a 960-bed teaching hospital. Contaminated water was considered to be a possible source of infection because, during that period, monthly samples were found to be positive with averages of 10(4) CFU/l. After chlorination of hot water associated with flushing of outlets, nearly all samples taken in the next two years were found to be negative. A case-control study was performed to examine potential risk factors. Three groups of controls were randomly selected among eligible patients. In a multivariate analysis, only three clinical factors were found to be associated with legionellosis patients: malignant illness (relative risk, RR = 3.5), presence of an ultimately fatal disease (RR = 2.6), and exposure to corticosteroids prior to admission (RR = 7.9). Investigations of in-hospital exposures suggest that during this nosocomial outbreak diagnostic or therapeutic respiratory procedures had not increased the risk of illness. Although the epidemiological association between water contamination and disease remains unclear, the eradication of L. pneumophila from the identified supply seems to have been effective in preventing disease in this hospital. PMID- 3667050 TI - Comparative prevalence of rabies antibodies among household and unclaimed/stray dogs as determined by the immune adherence haemagglutination assay. AB - The immune adherence haemagglutination assay (IAHA), widely used for human viral disease diagnosis, has been adapted for detection of rabies virus antibodies in dog sera. Rabies virus antibody titres obtained by the IAHA correlated well with those obtained by the currently accepted test for rabies antibody determination, the rapid-fluorescent-focus-inhibition test (RFFIT). Although it is not known if the antibodies detected in IAHA test represent neutralizing antibodies against rabies, IAHA has several advantages over the RFFIT: the IAHA is rapid, requiring about seven hours for results to be available; it is relatively inexpensive and easy to perform; uses reagents commonly available in any routine virology laboratory; and uses inactivated rabies virus, thus eliminating hazards associated with the use of live virus in RFFIT. Using this test we found that rabies antibody titres were significantly higher, and at the same time more prevalent, among household dogs than among the unclaimed/stray dogs. The results re-emphasize the increased hazard associated with unclaimed/stray dogs and the need for vaccination of all dogs. PMID- 3667051 TI - The association between malnutrition and diarrhoea in rural Bangladesh. AB - The interaction between diarrhoeal disease and nutritional status measured by anthropometry was investigated in approximately 1000 children aged 1 to 4 years during April-December 1976 in a rural area of Bangladesh. Data on diarrhoeal disease were provided by the mothers interviewed at seven-day intervals. Weight and height data were collected bimonthly. Children classified using anthropometric criteria--weight-for-age, height-for-age, and weight-for-height- were prospectively evaluated for incidence and duration of diarrhoea during a short (two-month) period and a long (eight-month) period. Incidence of diarrhoea was not found to be related to nutritional status measured by any of the anthropometric criteria for any of the periods. But duration of diarrhoea was found to be related consistently to nutritional status measured by weight-for-age and weight-for-height. Diarrhoea in the short term affected weight increment in the short term, but not in the long term and did not affect height increment for any of these periods. Diarrhoea in the long term affected both weight increment and height increment in the long term. PMID- 3667052 TI - Risk factors for AIDS among homosexual men in a moderate incidence area. PMID- 3667053 TI - Herpes zoster and multiple sclerosis. PMID- 3667054 TI - Lead exposure and children's IQ. PMID- 3667055 TI - Anaemia during pregnancy as a risk factor for infant iron deficiency: a dogma rebated? PMID- 3667056 TI - A SAS procedure for logistic regression modelling based on registry data. PMID- 3667057 TI - Smoking status among a group of morbidly obese men and women referred for gastroplasty. AB - The smoking habits of all morbidly obese patients referred for possible gastroplasty (between January 1, 1983 and December 31, 1985) were assessed. There were 240 patients, 198 women 83 percent) and 42 men (17 percent). Mean age for women was 38 +/- 9 years and weight 121 +/- 17 kg. Men were 36 +/- 9 years old and weighed 154 +/- 24 kg. Forty percent of each group smoked cigarettes daily and 10 percent of women and 12 percent of men were ex-smokers. Twenty percent of the females and 47 percent of the males were heavy smokers (greater than 25 cigarettes per day). Female ex-smokers were much more apt to be on treatment for hypertension than non-smokers (55 vs 10 percent, P less than 0.001). These morbidly obese patients in Southern Ontario smoked more heavily and in higher proportion than reported for adults in Ontario or Canada. Low socioeconomic status may partially explain these results. Better methods of controlling smoking and eating are needed for the morbidly obese. PMID- 3667058 TI - Predictive value of the index of desirable body weight for total body fat mass as measured by dilution of tritiated water--problems and limitations. AB - The index of desirable body weight is currently used for classification of patients' weights. We examined how it is related to the degree of adiposity, and whether it can serve in the prediction of body fat to the same degree as Quetelet's index. Sixty-five women and 142 men comprising a wide range of weight indices were studied. Body fat (F) was measured by the tritium dilution technique with a precision of +/- 1.26 kg. Regressions of F/W0 on the index of desirable weight W/W0 gave a correlation coefficient of 0.969 for women and 0.939 for men. Regressions of F/H2 on Quetelet's index W/H2 had correlation coefficients of the same order, i.e. 0.971 for women and 0.936 for men. Hence both indices are equally powerful for calculation of body fat within the study population. Further progress was achieved by multiple regression of F on W and W0 which yielded correlation coefficients of 0.976 for women and 0.953 for men. The residual standard deviation reflecting the mean difference between calculated and estimated fat was 3.4 kg for women and 3.8 kg for men. Despite this self consistency, prediction of body fat for persons outside the study population is only possible within wide limits. These are given by about twice the residual standard deviation. Therefore, prediction of body fat from weight indices can only be used for detection of larger abnormalities in body composition. PMID- 3667059 TI - The effect of smoking two cigarettes on resting metabolic rate with and without food. AB - Resting metabolic rate (RMR) was measured using a ventilated hood apparatus in 15 subjects before (BMR) and for 5 h after (5HEE) four treatments. In 10 smokers (five occasional and five habitual) the treatments were: food (600 kcal (2.51 MJ) breakfast) with and without smoking two cigarettes (F +/- S) and no food with and without smoking (NF +/- S). In five non-smokers duplicate measurements of food (F S) and no food (NF-S) were made. In non-smokers the thermic effect of food (TEF) averaged 9.35 per cent of the ingested energy. Duplicate measures of 5HEE showed good reproducibility both with and without food (c.v. 2.5 and 1.3 per cent respectively). In smokers, RMR did not increase after smoking even during the first 15-30 min. There were no apparent differences in response between occasional and habitual smokers. 5HEE and delta 5HEE (5HEE minus BMR) were significantly lower after food with smoking than without smoking (-16 kcal (67 kJ)/5 h, P less than 0.001 and -14 kcal (59 kJ)/5 h, P less than 0.02 respectively) but not significantly lower after smoking without food. TEF was lower with smoking (8.6 per cent of ingested energy) than without smoking (10.0 per cent of ingested energy) but the difference was not significant (P = 0.23). TEF in smokers regardless of treatment averaged 9.3 per cent of the ingested energy. We conclude that any effects of smoking two cigarettes in isolation after overnight deprivation are too small or too variable to consistently influence RMR or the thermic effect of food. PMID- 3667060 TI - Less food, less hunger: reports of appetite and symptoms in a controlled study of a protein-sparing modified fast. AB - This study compared reports of appetite and symptoms in 28 obese subjects randomly assigned to either a 500 calorie protein-sparing modified fast (PSMF) or a 1200-kcal balanced diet. During the first comparison month, subjects consuming the PSMF lost significantly more weight and reported significantly less hunger than did subjects consuming the 1200 kcal diet. Similar results were obtained for the second month, but differences in hunger were not statistically significant. There were no significant differences between conditions in subjects' ratings of their preoccupation with eating or in their ratings of the acceptability or disruptiveness of their diets. PSMF subjects reported significantly greater problems with cold intolerance, constipation, dizziness, dry skin, and fatigue. These symptoms remitted completely, however, when PSMF subjects consumed a 1200 kcal balanced diet. There were no significant differences between conditions in subjects' reports of psychological functioning. Results are discussed in terms of the need for further research to identify the characteristics of PSMF which confer anorexia. PMID- 3667061 TI - A comparison of constant feeding with bouts of fasting-refeeding at three levels of nutrition in the rat. AB - To investigate whether intermittent fasting alters subsequent utilization of ingested energy, we compared, in six groups of 450-g male Wistar rats, two modalities of food delivery: constant (CO) vs fasting for 3 days and refeeding for 7 days (F/RF). Both modalities were investigated at three planes of nutrition (100, 60 and 40 percent of ad libitum). The F/RF groups were offered, during the 7 days of refeeding, the same amount of food as the CO groups were offered in 10 days. With both 60 and 40 percent food restriction, there were no differences in body weight, body composition, or energy utilization between the F/RF and the CO groups after 4 (40 days) or 8 (80 days) cycles of fasting-refeeding. However, at both 40 and 80 days of study, lipoprotein lipase (LPL) activity was significantly higher in F/RF rats than in CO rats at all three planes of nutrition. Because 100 percent F/RF rats did not eat all food available during each refeeding period, a second experiment was conducted. Rats were fasted for 3 days then refed ad libitum until they reached the weights of 100 percent CO rats. The two groups did not differ in body weight, food intake, body composition or LPL activity after 4 (40 days) fasting-refeeding cycles. Thus, weight cycling produced by repeated bouts of fasting-refeeding did not result in increased efficiency of energy utilization. However, the combination of fasting-refeeding and overall caloric restriction produced greater LPL activity than constant food restriction. It has not been determined whether this elevated LPL activity would affect lipid accumulation upon ad-libitum refeeding. PMID- 3667062 TI - Body composition of lean and obese Zucker rats in parabiosis. AB - Parabiosis is the surgical union of two animals to produce a chronic blood exchange. This model has previously been used to demonstrate the involvement of a blood-borne factor in the feedback control of food intake and regulation of energy balance. It has been hypothesized that obese rats produce a humoral agent that acts centrally to inhibit food intake and accumulation of fat. In this study 50-day-old male or female Zucker rats were joined in either lean-lean pairs or lean-obese pairs. They ate ad libitum until 152 days of age when body composition was determined. Parabiosis inhibited growth in all rats compared with single controls. Lean partners of obese rats had reduced carcass weights, the same percent body protein but less fat than members of lean-lean pairs. Female rats showed larger changes in body composition than did males. These results suggest that obese Zucker rats produce the hypothesized regulatory signal but do not respond to it. PMID- 3667063 TI - Association for the Study of Obesity. London, England, June 25, 1987. Abstracts. PMID- 3667064 TI - Body circumferences as alternatives to skinfold measurements of body fat distribution in Mexican-Americans. AB - The ratios of circumferences (waist/hip, waist/thigh) have been proposed in lieu of skinfold measurements for studies of obesity and body fat distribution. The purpose of this paper is to present our experience in measuring a series of body circumferences and skinfolds in an obese population, and seek the relationship between these two kinds of variables as indicators of fatness and body fat distribution using canonical correlation analysis. With this method, weighted vectors of circumferences on the one hand and skinfolds on the other, are formed in such a way that the correlation between the two sets of variables is maximized. The weights (regression coefficients) and their signs help us select the best combination of circumferences which describe a component of centralized obesity. Our experience showed that 21 percent of women would have been excluded from this multivariate analysis due to skinfolds what could not be measured (mainly due to poor fold definition). Few men were so excluded (6 per cent), and almost all circumferences could be measured in both sexes. A first canonical correlation was substantial (0.84 in women, 0.89 in men) and appeared to relate to level of fatness. A second canonical correlation was moderate (0.59 in women, 0.42 in men) and statistically significant (P less than 0.01) in both sexes. Only in women was it independent of age, but in both sexes it reflected differences in central and peripheral (especially lower limb) fat. The simple waist/thigh ratio correlated well with the second canonical variate (0.79 in women, 0.67 in men).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667065 TI - Effect of diet and fenfluramine on thermogenesis in the rat: possible involvement of serotonergic mechanisms. AB - A single injection of 5-hydroxytryptamine (5HT, 1 mg/kg, s.c.) in rats stimulated resting oxygen consumption (Vo2) by 21 percent; this was reduced (to 8 percent) by pretreatment with hexamethonium (5 mg/kg, s.c.). DL-fenfluramine injection (20 mg/kg, s.c.) stimulated metabolic rate (Vo2) by about 40 percent, but caused only 11 and 15 per cent increases in animals pretreated with hexamethonium or metergoline (5 mg/kg, s.c.), respectively. Interscapular brown adipose tissue (BAT) activity, assessed from mitochondrial GDP-binding, was increased by 96 per cent in intact tissue 1 h after fenfluramine injection; this response was completely prevented by surgical sympathectomy of interscapular BAT. Metergoline significantly inhibited (by 46 percent) the acute thermic response (postprandial rise in Vo2) to a 40-kJ meal in normal rats, and depressed resting Vo2 in protein deficient rats by 18 percent, but did not affect resting Vo2 in control animals. BAT activity (mitochondrial GDP-binding) was elevated by 56 per cent in rats fed the low-protein diet, but this difference was almost completely abolished by prior treatment with metergoline. These data demonstrate a potent thermogenic effect of fenfluramine which apparently involves serotonergic pathways and activation of sympathetic outflow to BAT, and indicate that acute thermic responses to food and chronic thermogenic responses to low-protein diets may also involve serotonergic mechanisms. PMID- 3667066 TI - Smoking and weight in the 1983 Italian National Health Survey. AB - The relation between smoking habits and weight was evaluated using data of the 1983 Italian National Health Survey on 72,284 individuals aged 15 years or over, randomly selected within strata of geographical area, size of the place of residence and of the household in order to be representative of the whole Italian population. Female moderate smokers were less frequently overweight or obese, thus confirming previous observations in other populations. However, in contrast with other observations, male current smokers were not lighter than 'never' smokers, and in particular smokers were less frequently underweight. Thus, the relation between smoking status and indicators of body weight was heterogeneous in the two sexes. Further, in both sexes the relationship between amount smoked and obesity was not linear, heavy smokers being more frequently overweight than moderate smokers. In conclusion, although these population-based data confirm that smoking habits are a correlate of weight, the absence of any dose-effect relationship and the inter-sex differences suggest that the relation between smoking and weight in the Italian population is probably partly or largely indirect. PMID- 3667067 TI - A long-term aerobic exercise program decreases the obesity index and increases the high density lipoprotein cholesterol concentration in obese children. AB - The effects of long-term supervised aerobic exercise on the body weight, serum lipids and high density lipoprotein cholesterol (HDL-C) were studied in 41 obese children (21 boys, 20 girls) initially aged 11-years-old. The 2 year training program was performed during the daily school life. The intensity of training consisted of running 20 minutes seven times per week at a pace which corresponds to the blood lactate threshold. No dietary intervention was done. The obesity index significantly decreased after 1 year of aerobic exercise in both boys and girls by 55 percent and 48 percent respectively. Since the lean body mass increased throughout the 2 year study while the total body weight decreased, the weight loss is attributed to a decrease in fat. The concentration of HDL-C significantly increased in both boys and girls in the first year, 16 percent and 19 percent respectively and was a slightly lower value in the second year. After 2 years a significant reduction in the girls' serum triglyceride concentration was observed. However, the total cholesterol in serum was unaltered in either boys or girls throughout the 2 year study. In conclusion, a long-term supervised aerobic exercise program in obese children is beneficial and resulted in significant weight reduction with concomitant improvement of lipoprotein metabolism. PMID- 3667068 TI - Does exercise give an additional effect in weight reduction regimens? AB - The effects of dieting and exercise on RMR, body composition and maximal aerobic power were studied in 12 obese women. The subjects were paired on the basis of their body mass index and divided into a diet (D) and a diet + exercise group (DE). The treatment consisted of a 5-week period with a low-energy formula diet of 2.9 MJ and an 8-week period with a mixed diet of 1.7 MJ supplemented with 1.8 MJ normal foodstuffs. DE trained 4 h per week at 50-60 per cent of their maximal aerobic power with aerobics and fitness exercises. Body composition was determined by hydrostatic weighing and RMR was measured from 03.00 to 06.00 hours in a respiration chamber. Maximal aerobic power was measured on a continuously braked ergometer. The measurements were done at week 0, after 4 weeks (week 5), and after 12 weeks (week 13). Weight loss after 4 weeks was 8.2 kg (DE) and 7.9 kg (D) and after 12 weeks 13.2 kg (DE) and 12.2 kg (D). There were no significant differences between the groups. Fat loss was also not statistically different between DE (6.7 and 10.9 kg) and D (6.0 and 9.4 kg). Both groups showed a significant decrease in RMR per kilogram FFM after 12 weeks (DE: 18.2 per cent and D: 26.5 per cent). There was also a significant decrease in RMR for D (19.9 per cent) after 4 weeks but not for DE (12.2 per cent).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667069 TI - Gastric banding for morbid obesity: early results. AB - During the years 1981-85, 163 patients were treated with gastric banding for morbid obesity. Mean preoperative body weight (+/- s.e.m.) was 121.3 kg +/- 1.4, and mean overweight was 71.5% +/- 1.6 according to Broca's formula. Twenty-four patients had postoperative complications during the first 30 days, mostly minor. Four required reoperation and one of these died. Seventeen patients had late complications, six persistent vomiting necessitating reoperation, eight incisional hernia and three penetration of gastric wall by band. The weight loss was rapid during the first 6 months, and thereafter levelled off. After 2 years the weight loss was 33.4 kg +/- 2.4, corresponding to a mean weight loss of 27.6 percent +/- 1.9 of preoperative weight. There was no significant difference in weight loss expressed as a percentage of preoperative weight between patients operated with an outlet of 12 mm (45 patients) or 15 mm (118 patients), nor between males (37 patients) or females (126 patients). We conclude that our technique of gastric banding seems to be a relatively safe and reliable surgical treatment for morbid obesity. But our follow-up period has been limited to 2 years or less, and a longer follow-up is necessary before the method can be fully evaluated. PMID- 3667070 TI - North American Association for the Study of Obesity, 1987 conference. Diet, pharmacotherapy, and surgical treatment of obesity. Boston, Massachusetts, October 14-16, 1987. Programme and abstracts. PMID- 3667071 TI - Effects of CuCl2 on the dimer-tetramer equilibrium of concanavalin A. AB - Tetrameric concanavalin A at neutral pH dissociated into the dimer when CuCl2 was added in a concentration range comparable to protomer concentration. This effect of CuCl2 was largely suppressed when NaCl concentration was increased. Neither the conformation of the protein nor its binding activity to 4-methylumbelliferyl alpha-D-mannopyranoside was affected on addition of CuCl2. PMID- 3667072 TI - Reactions of N-hydroxysulfosuccinimide active esters. AB - N-Hydroxysulfosuccinimide esters are reactive functional groups employed in a variety of protein modification reagents, especially cross-linking reagents. For these compounds, hydrolysis is the most important reaction competing for reaction of the esters with nucleophilic groups in proteins. We have employed model compounds to investigate the rates of hydrolysis of N-hydroxysulfosuccinimide esters and their reactions with the alpha-amino group and the side chains of naturally occurring amino acids, under conditions comparable to those used for protein modification studies. The rats of hydrolysis observed were found to be very low, as compared with their rates of reaction with nitrogen nucleophiles found in proteins. Further, within the ranges investigated, the rate of aminolysis was observed to increase more rapidly than the rate of hydrolysis with increasing pH or with increasing temperature. Four amino acid side chains and the alpha-amino group were found to react measurably with N-hydroxysulfosuccinimide esters. At pH 7.4 and room temperature, the order of reactivity was found to be N alpha-Cbz-histidine greater than N alpha-Cbz-lysine approximately phenylalanine (alpha-amino group) much greater than N-acetylcysteine approximately N acetyltyrosine; however, the acylimidazole adduct formed with the side chain of histidine was found to be a transient product, subject to hydrolysis or reaction with another nucleophile. PMID- 3667073 TI - Reduction and reoxidation of the neurotoxin II from the scorpion Androctonus australis Hector. AB - Reoxidation of the totally reduced scorpion neurotoxin II from Androctonus australis Hector (four disulfide bridges) has been investigated. The totally reduced toxin was highly insoluble in neutral and alkaline conditions, which prevented the use of the usual air oxidation process for renaturation. We tested a new method in which the reduced molecules were first solubilized in 10% (v/v) acetic acid and then oxidized by air through dialysis against a series of buffers with a slow pH gradient from 2.2 to 7.0 or 8.0. In this system, up to 95% of the protein was recovered in solution. Addition of reduced and oxidized glutathione accelerated refolding and also permitted a better recovery of fully active peptide as measured by both toxicity to mice and ability to displace 125I radiolabeled toxin II from its binding site on rat brain synaptosomal fractions. The reoxidation reaction could also be monitored directly by high pressure liquid chromatography. A strong effect of guanidine hydrochloride concentration as well as the temperature was observed both on the solubility of the reoxidation intermediates and on the refolding pathway. Finally, the method used, i.e. dialysis reoxidation with a pH gradient from 2.2 to 8.0 in 0.1 M sodium phosphate, 0.1 M sodium chloride, 20 mM guanidine hydrochloride, 1 mM oxidized and reduced glutathione allowed regeneration in high yield (70%) of a reoxidized toxin form indistinguishable from the native toxin. A minor stable and inactive molecular species (about 30%) showing a difference in mobility by electrophoresis was also detected. PMID- 3667074 TI - Synthesis, resolution and characterization of ring substituted phenylalanines and tryptophans. AB - Experimental protocols have been developed for the synthesis and resolution of numerous ring substituted phenylalanines and tryptophans in half mole quantities. Physical constants on these amino acids are given and their behavior on ion exchange supports (amino acid analyzer and post column ortho-phthalaldehyde derivatization) as well as that of some selected N-methylated amino acids is described. Those amino acids were then derivatized (N alpha-protection with the t butyloxycarbonyl group) for solid phase peptide synthesis. PMID- 3667075 TI - Isolation and characterization of an abortifacient protein, momorcochin, from root tubers of Momordica cochinchinensis (family cucurbitaceae). AB - A glycoprotein with a molecular weight of 32,000 as estimated by SDS polyacrylamide gel electrophoresis, and characterized by an abundance of Asp and Glu residues and an absence of Cys residues in its amino acid analysis, was isolated from fresh root tubers of Momordica cochinchinensis using a procedure that involved acetone precipitation, ammonium sulfate precipitation, ion exchange chromatography on DEAE Sepharose CL-6B and gel filtration on Sephadex G-75. The protein was capable of inducing mid-term abortion in mice. The characteristics of this protein were compared and contrasted with those of the abortifacient proteins isolated from other plants of the Cucurbitaceae family. PMID- 3667076 TI - Synthesis of HC toxin and related cyclopeptides containing the (L-Ala-D-Ala-L-Ada D-Pro) sequence. AB - In studies leading to HC toxin synthesis, a phytotoxic cyclic tetrapeptide with the sequence cyclo (L-Ala-D-Ala-L-Aoe-D-Pro), we have determined optimal conditions for the cyclization which constitutes one of the most important steps in the synthesis of the toxin. All four possible sequences containing an optically active precursor, i.e. L-Ada = (2 S)-2-amino-9-decenoic acid instead of Aoe, have been prepared and subjected to cyclization. Owing to the differences in racemization risk during activation of the terminal carboxyl aminoacid different cyclization procedures have been applied. Cyclopeptide yields and selectivity between cyclomonomer and dimer both containing the title sequence are mainly controlled by the linear precursor sequence. The cyclic tetrapeptide is only obtained with D-proline in the C-terminal position, the best yield reached by the -ONSu activation method. Starting from the peptide, the (9S, 9R) HC toxin epimer on the epoxidic carbon atom has been further synthesized in two steps. PMID- 3667077 TI - Cyclic peptides. XXVI. Synthesis of AM-toxin II analogs by cyclization through ester bond formation. AB - In order to explore the route for the preparation of cyclodepsipeptide by cyclization through an ester bond formation, two analogs of AM-toxin II, cyclotetradepsipeptide, were synthesized. As a preliminary experiment, synthesis of [L-Phe3, L-Ser(Bzl)4]-AM-toxin II, containing L-Phe and L-Ser(Bzl) in place of L-App (2-amino-5-phenyl-pentanoic acid) and delta Ala (alpha, beta dehydroalanine), respectively, was attempted. Cyclization of H-L-Hmb-L-Phe-L Ser(Bzl)-L-Ala-OH in CH2Cl2 at 10 mM concentration using water-soluble carbodiimide (EDC) and 4-dimethylaminopyridine (DMAP) successfully gave a cyclic monomer in 16% yield. Cyclization of H-L-Hmb-L-App-L-Ser(Bzl)-L-Ala-OH under the same conditions also afforded a cyclic monomer, [L-Ser(Bzl)4]AM-toxin II, in 19% yield. Analytical parameters of these cyclic monomers obtained were identical to those of the authentic samples obtained by cyclization through a peptide bond formation. PMID- 3667078 TI - Synthesis of a new carrier for immunization: polytuftsin. Two examples of its use with peptides selected in the hepatitis B surface antigen. AB - Sequential poly(Arg-Thr-Lys-Pro) consisting mainly of the repeat of tuftsin Thr Lys-Pro-Arg was synthesized by condensing the p-nitrophenyl ester of Arg(HCl)-Thr Lys-(2-Cl-Z)-Pro in the presence of HOBt. Two haptenic sequences of the Pre-S region of hepatitis B virus antigen (10-26 and 39-55) were prepared by solid phase and coupled to polytuftsin via glutaraldehyde. The peptides, either free or coupled to polytuftsin, were administrated to mice and the antisera were assayed by ELISA. Coupling the peptides to the polypeptide significantly improved the anti-peptide antibody titer in Freund complete adjuvant or in NaCl 0.9%. Cross reaction between antibodies induced by the peptides and the native protein was also improved. Polytuftsin alone is very poorly immunogenic. PMID- 3667079 TI - Preparation and properties of some crystalline symmetrical anhydrides of N alpha tert.-butyloxycarbonyl-amino acids. AB - The preparation and properties of 16 crystalline symmetrical anhydrides of N alpha-tert.-butyloxycarbonyl-amino acids is described. PMID- 3667080 TI - Amino acids and peptides. XV. Synthesis of Gln-Val-Val-Ala-Gly and derivatives, a common sequence of thiol proteinase inhibitors and their effects on thiol proteinase. AB - The Gln-Val-Val-Ala-Gly sequence, which occurs frequently in several natural thiol proteinase inhibitors, and derivatives were synthesized by conventional solution methods and their effect on thiol proteinases were examined. The studies led us to the conclusion that certain of these peptides exhibited a weak inhibitory effect on the thiol proteinase, papain. One of them, Z-Gln-Val-Val-Ala Gly-OMe, showed a protective effect on papain from natural thiol proteinase inhibitor-induced inactivation. The relationship between structure and activity of these derivatives was studied and certain conclusions were derived on possible mode of action of these inhibitors. From these studies, it was concluded that Z Gln-Val-Val-OMe was the smallest peptide to exhibit some effect on papain. PMID- 3667081 TI - Metal-ligated amino acids and peptides as substrates for proteases. AB - Amino acids and peptides carrying a pentaamminecobalt(III) group at the carboxyl terminal have been prepared. It is shown that trypsin and papain accept such compounds as substrates provided the metal complex group is not too close to the enzyme-susceptible peptide bond. The possible applicability of this novel type of substrates in enzymatic peptide synthesis is discussed. PMID- 3667082 TI - Notes on the mind-body question. AB - The author traces the origin of the body-mind continuum in utero and on to the formation of a separate self. He starts with the principle that the mind is extended through the body rather than localized in the brain. He then follows the path of differentiation of the mind from bodily functions, as well as the differentiation of physiological learning from mental learning. Some somatic disturbances can be dated, in the sense that they could not occur at certain stages of development. This hypothesis is supported by observations relating to dating links to various conditions, i.e. on regurgitation, asthma and stuttering. The author also discusses the difference between non-integration and disintegration. PMID- 3667083 TI - The past unconscious, the present unconscious and the vicissitudes of guilt. AB - The concepts of present unconscious and past unconscious have been introduced in order to provide a useful theoretical schema for comprehending clinical psychoanalytic material. In the present paper these concepts, together with the notion of the second censorship, are made use of to provide a framework for understanding the way in which guilt feelings and the ideas associated with them are dealt with at different levels of consciousness. The technical approach linked with the theoretical ideas in this paper is described, with special reference to the relation between interpretation of the present and reconstruction of the past. PMID- 3667084 TI - The older analysand: countertransference issues in psychoanalysis. AB - The apparent reluctance among analysts to begin an analysis with a patient beyond his or her fifth decade, a view first articulated by Freud, is examined as an instance of counter-transference resistance. Although there is no greater consensus among analysts than the continuing necessity of self-analysis irrespective of age, it is an attitude which does not appear to be so readily extended to the older prospective analysand. This report examines counter transference issues within the context of a seven year classical analysis of an older female who began an analysis at the end of her sixth decade. The case illustrates the timelessness of psychological conflicts at all levels and the particular character of the analyst's counter-transferences that surfaced listening to the material of this older analysand. PMID- 3667085 TI - The longest pleasure: a psychoanalytic study of hatred. AB - The ability to hate is a skill indicative of ego development to the level of object constancy. People can be divided into three categories: those who cannot hate, those who hate but can not stop hating, and those who can both hate and get over hating. Among those who cannot stop hating are two sub-groups: those who live with their hatred by relying upon scapegoats, and those who repress their knowledge of their hatred. The latter subgroup includes a number of psychoanalytic patients whose repressed hatred presents a specific obstacle to transference due to the persistence of a blocking introject. Recovery from the complications of repressed hatred requires the analyst to participate in the comforting process that strengthens the patient through the retrieval of aggression lost to repression. PMID- 3667086 TI - Narcissism and unconscious communication. AB - In this paper I suggest that analytical material implicitly carries in it a message proceeding from the unconscious and which is transmitted through representations. The message is expressed only when the object is recognized as such by the subject. In the narcissistic situation the unconscious message is not emitted. The analysis of the analytical discourse shows that the narcissistic subject does not recognize the other as the object of the unconscious dialogue. Narcissism reaches its maximum expression in material empty of unconscious meaning. Narcissism is accomplished only by the collaboration of a subject and an object who have established a tie with the aim of maintaining the illusion that this subject can dispense with all objects. This tie is set up on the patient's side by means of the discourse empty of unconscious meaning and on the analyst's side by the pseudo-interpretation. The narcissistic self-esteem resides in the complacency which the patient obtains by keeping the verbal account deprived of unconscious meaning. When the analyst fails to show up the narcissistic resistance, he contributes to the establishment of this pathological self valuation. Narcissistic regressions always include identifications and in this they differ from the anobjectal stage that regression attempts to reach. PMID- 3667087 TI - On charm. AB - This paper undertakes a psychoanalytic investigation of charm. Mythology, art, literature, music, high and popular culture all bear witness to the importance of charm for the human psyche. As an attribute of personality, charm gives its possessor extraordinary power since we are all susceptible to its magic. In fact charm and magic refer to the same phenomenon, the promise of blissful sleep at the breast of Mother, the omnipotent charmer. Analysts may be especially susceptible to charm with its promise of conflict-free blissful sleep. Clinical material is presented to show how analytic work on charm can yield important therapeutic results. The charm of the psychoanalytic situation provides the opportunity for a psychoanalytic understanding of charm. PMID- 3667088 TI - Unconscious identification fantasies and family prehistory. AB - Discovery of the fact that a subject identifies in an obvious way with another is at first only the awareness of a present process: involuntary mimesis, obedience to early 'identifying designations' or simple imitation deliberately carried out. Much psychic work remains to be done before we can think of such phenomena as 'screen-identifications'. The psychoanalytic interpretation of these dynamic formations will lead to the resolution of genuine 'identification complexes' through the reconstruction of scenarios which I have named 'unconscious identification fantasies'. These fantasies stage characters from the infantile prehistory and family saga of a subject who may be compelled to live out in his behaviour, symptoms, dreams, or even sometimes delusions, episodes pertaining to the past existence of the 'ego's visitors' linked to the most archaic processes that constitute the personality. PMID- 3667089 TI - Pre-oedipal identification and the cathexis of autistic objects in the aetiology of adult psychopathology. AB - There are more and more references in the literature to patients who are difficult to categorize and who arouse a particular counter-transference reaction of boredom or paralysis in the analyst. The verbal communication seems ineffective, the analysis tends to become prolonged and without real change in the patient. The hypothesis is made that these phenomena may arise from the persistence of certain types of object cathexis originating in the normal autistic phase of development, where bodily sensations predominate and verbal communication is not yet established. Tustin's work is quoted as particularly illuminating this phase of the infant's life, and a clinical example is given. PMID- 3667090 TI - Matte Blanco. PMID- 3667091 TI - Postoperative complications following tonsillectomy and adenoidectomy--who is at risk? AB - Postoperative complications following a large series of adenotonsillectomies (784 patients) at the Children's Hospital of Philadelphia fell into two major categories: hemorrhage and airway problems. Bleeding requiring operative intervention occurred in one child in the immediate postoperative period and in 16 children (2.0%) within 7-10 days. Eight patients (1.0%) had minor bleeding requiring only observation, and 9 others (1.2%) reported mild bleeding at home. Airway obstruction requiring the reinsertion of an airway or intensive care observation occurred in 10 children (1.3%). In general, these children were younger and most had significant underlying medical problems. We conclude that many complications encountered after adenotonsillar surgery are intrinsic to the patient's disease and overall medical condition. Improved surgical and anesthetic techniques have minimized the complications noted in earlier studies. PMID- 3667092 TI - Bilateral posterior choanal atresia: a morphologic and histologic study, and computed tomographic correlation. AB - Bilateral posterior choanal atresia is an uncommon cause of respiratory obstruction in the newborn. Although the clinical syndrome and treatment options are well known, the abnormal histology has not been well described. Computed tomography (CT) is a useful tool in the radiologic diagnosis of choanal atresia, but has not been correlated with the histopathology. Two patients with CHARGE association (congenital heart defects, choanal atresia, retarded growth and development, hypogenitalism, and aural anomalies) and bilateral posterior choanal atresia were studied with CT. The atresia plates were removed at autopsy and sectioned in an axial plane for gross and microscopic study. The histopathology is described and correlated with the CT studies. These studies show that CT accurately defines the histopathologic abnormalities found in bilateral posterior choanal atresia. PMID- 3667093 TI - Tracheal agenesis. AB - Congenital anomalies of the tracheobronchial tree must be included in the differential diagnosis of children with symptoms of respiratory distress. Tracheal agenesis is a rare major congenital anomaly that has been uniformly fatal. Diagnosis requires a high index of suspicion utilizing roentgenographic and endoscopic examinations. PMID- 3667094 TI - A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. AB - Hypertrophy of the tonsils and adenoids is the most common cause of obstructive sleep apnea in children. There is relatively little known about the occurrence of subclinical variations in the dimensions of the oropharynx which may predispose to the development of obstructive sleep apnea in children without obvious craniofacial abnormalities. Fifty-one children (3-10 years) were divided into two groups: the first group consisted of 18 patients with small tonsils and no history of snoring who underwent tonsillectomy for chronic tonsillitis. They were compared to a second group of 33 patients with large tonsils who underwent tonsillectomy and adenoidectomy for symptoms of obstructive sleep apnea. Age, height, weight, body surface area and tonsil weight were correlated to the dimensions of the oropharynx obtained by direct measurement intraoperatively including the length of the soft palate, anterior-posterior depth of the nasopharynx and the distances between the medial tonsillar surfaces, anterior tonsillar pillars and lateral pharyngeal walls at mid-tonsil level. Increased patient height, weight and surface area correlated positively to increased distance between the lateral pharyngeal walls and to the length of the soft palate in the patients with small tonsils. No such correlation existed in the patients with obstructive adenotonsillar hypertrophy. In addition, the distance between the lateral pharyngeal walls was significantly decreased in the group with large, obstructing tonsils as compared to those with small tonsils and no history of obstruction (P less than 0.01). However, the patients with small tonsils and no obstruction had significantly longer soft plates (P less than 0.01) and less depth tot eh nasopharynx (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667095 TI - Efficacy of tonsillectomy and adenoidectomy as an outpatient procedure: a preliminary report. AB - One of the recent trends in medical practice has been the use of ambulatory surgery for a substantial number of surgical procedures. A prospective evaluation of tonsillectomy and tonsillectomy with adenoidectomy as outpatient procedures at the Children's Hospital Medical Center in Cincinnati, OH, is reported. Patients who were felt to be inappropriate candidates for adenotonsillectomies as outpatients included patients under 3 years of age, patients who lived more than one hour from the hospital and patients who demonstrated obstructive sleep apnea or who had other significant medical problems. A review of this 9-month experience indicates that outpatient surgery for adenotonsillectomy is both safe and cost-effective in most circumstances. In an analysis of complications requiring readmission to the hospital (bleeding, dehydration, poor social situation), patients who had their original surgery performed on an ambulatory basis had no more complications than patients who were hospitalized following their surgery. Excluding the professional fees for the surgeon and anesthesiologist, a savings of approximately 50% can be expected from the performance of a tonsillectomy and adenoidectomy on an outpatient basis. PMID- 3667096 TI - Otitis media with effusion: academic attainment and socioeconomic background. AB - In a recent paper (Brooks, D.N., Otitis media with effusion and academic attainment, Int. J. Pediat. Otorhinolaryngol., 12 (1986) 39-47) the relationship between severity of otitis media with effusion (O.M.E.) in childhood and eventual outcome was explored in a group of 64 individuals. Although the severity of O.M.E. was related to time loss from education through sickness during the first school years, no effect on academic attainment levels was found. Further data have been obtained on the socio-economic groupings (S.E.G.) of 59 of the children. No correlation was found between S.E.G. and either time lost from school through sickness or severity of O.M.E. A strong correlation was found between S.E.G. and eventual academic attainment level. PMID- 3667098 TI - The anterior cricoid split in puppies. AB - The acute and long-term effects of the anterior cricoid split on the subglottis of puppies intubated from 7 to 14 days are documented. The anterior cricoid split acutely increased the intralumenal cricoid surface area in puppies with intubation-induced airway injury. An intense inflammatory response with mucosal ulceration and granulation tissue is elicited by 14 days of intubation by using the canine model of induced subglottic stenosis developed by Supance et al. [19]. When animals intubated for 14 days underwent an anterior cricoid split on day 7, the airway appears essentially normal by day 14. The split cricoid cartilage maintained a 'U' configuration following the procedure. The region of deficient cartilage anteriorly is bridged by fibrous tissue with normal epithelium lining the lumenal surface. Splitting the cricoid cartilage anteriorly increased the intralumenal area and no long term complications resulted from the procedure. The mechanisms by which the anterior cricoid split expands the airway intralumenal area while maintaining airway support have been reviewed. PMID- 3667097 TI - Pediatric bronchoscopy during a 17-year period. AB - From 1969 through 1985, 1032 pediatric bronchoscopies were performed on a total of 748 children under 16 years of age. Of the children 27.4% were under 6 months of age and the smallest patient weighed 600 g. Rigid bronchoscopes with a diameter ranging from 2.5 to 6 mm were used. A flexible fiberoptic bronchoscope with a diameter of 3.5 mm was used only occasionally, mostly for the diagnosis of laryngeal dynamics. All the endoscopies were performed under general anesthesia, except for some laryngoscopies performed with a flexible bronchoscope. The most common indications for bronchoscopy were suspected foreign body (16.7%), stridor (14.5%), recurrent respiratory infections (12.3%) and dyspnoe (9.6%). Laryngomalacia was observed in 13.8% of the children investigated and in patients with inspiratory stridor laryngomalacia was diagnosed in 39.8% of the cases. Subglottic stenosis was confirmed in 7.0% of the children. Tracheal compression was found in 10.8% and tracheal stenosis in 2.5% of the cases. Bronchiectasis was observed in 2.5% and tuberculosis in only 0.5% of the cases. Bronchoscopy was completely normal in only 10.6% of the patients investigated. The complications of pediatric bronchoscopy in this series were infrequent. PMID- 3667099 TI - Pachyonychia congenita with laryngeal involvement. AB - Pachyonychia congenita (Jadassohn-Lewandowsky Syndrome) is a rare autosomal dominant disorder characterized by nail dystrophy, hyperkeratosis of the palms and soles, leukoplakia of the mucosa of the upper respiratory tract and anus, follicular keratoses especially about the knees and elbows, and palmar and plantar hyperhidrosis. We present a patient with pachyonychia congenita and an exophytic lesion in the larynx at the posterior commissure. He is the youngest of 4 family members with this disorder covering 3 generations. Each of the 4 patients also exhibited both oral leukoplakia compatible with the Jadassohn Lewandowsky syndrome (Ikonograph Dermatol. Lab., 1 (1906) p. 29), and subcutaneous cysts of the face and scalp as described by Jackson and Lawler (Ann. Eugenics (1951) 142. PMID- 3667100 TI - Carcinoma of the larynx in a child. AB - Squamous cell carcinoma of the larynx in children is a rare entity, only 21 cases have been reported in patients 10-years-old or younger. A 9-year-old girl presented because of dyspnea and mild hoarseness of one week duration. Laryngoscopy and bronchoscopy showed a supraglottic mass, which proved to be poorly differentiated squamous cell carcinoma. No neck nodes or systemic metastasis were present. The tumor regressed with radiation therapy (6400 rads) but local recurrence and lung metastasis were evident 6 weeks later. Chemotherapy was refused by the parents and the patient died in one month. It is believed that squamous cell carcinoma of the larynx in children parallels that of adults in many respects including response to treatment. However, our attempt to save the larynx by avoiding surgery and using radiotherapy alone was not successful. Squamous cell carcinoma of the larynx in children may be more aggressive than that of adults. The scarcity of cases impedes establishment of treatment protocols in children. Initial aggressive management using surgery, radiotherapy, and possibly chemotherapy may be warranted in children. PMID- 3667101 TI - Removable ventilating tube obturator--how to save a ventilating tube. PMID- 3667102 TI - Abstracts of the Third International Evoked Potentials Symposium. West Berlin, September 28-October 1, 1986. PMID- 3667103 TI - Kindling: a model for biobehavioral research. Reports from NATO Advanced Study Workshop. Maratea, Italy. May 18-21, 1986. PMID- 3667104 TI - Serotonin and kindling development. AB - The inhibitory effect of serotonin on the kindling model of epilepsy was investigated in the adult rat. Specific neurotoxins such as 5-6 or 5-7 dihydroxytryptamine were used to destroy serotoninergic neurons before kindling sessions, and an immunocytochemical control revealed, at the end of the experiments, the location and the extent of the lesions. The destruction of serotoninergic terminals in the epileptic focus (olfactory bulb or amygdala) facilitated the initial development of kindling obtained by stimulations of these structures. Lesions of pontis, centralis and dorsalis nuclei of the raphe enhanced the rate of olfactory bulb kindling. Finally, we transplanted foetal raphe cells into the olfactory bulb of adult rats before olfactory bulb kindling. The presence of viable grafts, controlled by immunocytochemistry, was associated with an increase of afterdischarge threshold in the olfactory bulb. All these results confirm the inhibitory function of serotonin on kindling development and demonstrate that serotoninergic neurons exert an important control both on local excitability and on the progressive establishment of kindling phenomena. PMID- 3667105 TI - Enhancement of recurrent inhibition by angular bundle kindling is retained in hippocampal slices. AB - Rats were kindled in the right angular bundle. EEG and monosynaptically evoked responses were monitored in the ipsilateral fascia dentata. Although every animal was kindled, Long Term Potentiation (LTP) of monosynaptic responses was observed only in part of the kindling sessions, suggesting that LTP is not required for kindling. Paired pulse inhibition of granule cell discharge was progressively enhanced by kindling. Transverse hippocampal slices (400-700 micron) of fully kindled rats were prepared 1 hour after the last seizure. Field potentials evoked by stimulation appeared completely normal. Spontaneous epileptiform discharges were not observed in control solution, in low [Ca++]0, in high [K+]0 or after high frequency stimulation. Paired pulse inhibition was enhanced in fascia dentata, but not in area CA1. Enhancement of inhibition may be caused by increased activity of inhibitory synapses or by a nonsynaptic hyperpolarizing current. The relation between the absence of spontaneous activity and enhanced inhibition in the fascia dentata is unclear. PMID- 3667106 TI - Kindling of audiogenic seizures in the rat. AB - A strain of Wistar rats was inbred in our laboratory for its susceptibility to sound. The seizures are characterized by one or two wild running fits which terminate in a tonic dorsiflexion with open mouth, followed by a catatonic state. During the tonic phase of the seizure, the cortical EEG is flattened for 2 to 3 s. Then, a slow and regular low-voltage (9-12 c/s) activity is observed during 40 to 60 s. When these animals are submitted to daily sound-stimulations, the behavioral as well as the EEG manifestations of the audiogenic seizures change progressively. After 5 to 30 exposures, the wild running becomes disorganized by occurrence of myoclonic jerks of the limbs and the body. In some animals, the tonic extension disappears and a myoclonic seizure develops progressively with facial and forelimb clonus, rearing and falling. In other animals, the tonic phase still occurs and is followed by a generalized clonic phase. During both the myoclonic and the tonicoclonic seizures, rhythmic spikes, polyspikes and spike and waves of high amplitude (1-10 c/s) during 40 to 120 s are observed on EEG recordings. These EEG modifications often outlast the sound stimulation. The pharmacological reactivity in rats exposed to single or repeated audiogenic seizures is similar: phenytoin and carbamazepine suppress both kinds of seizures at low doses whereas ethosuximide is efficacious only at high doses. In order to know whether the repeated exposure to sound or the repetition of seizures are responsible of the observed changes in audiogenic seizures, animals susceptible to sound were exposed daily to the seizure-inducing sound after previous injection of Diazepam, which prevented them from convulsing. On the other hand, sound susceptible animals were injected daily with a dose of PTZ inducing one or several convulsions without exposure to sound. None of these treatments ever facilitated the development of kindled audiogenic seizures. The progressive modification of behavioral and EEG modifications occurring when audiogenic seizures are repeated suggests that kindling has developed, the seizure extending from the brainstem to forebrain structures. PMID- 3667107 TI - A neural model theory leading to kindling effect of epilepsy. AB - The dynamics of neural nets constructed of discrete populations of formal neurons were investigated, beginning with the study of single probabilistic nets which were called netlets. The dynamics of these netlets was extended to include steady or slowly varying excitatory or inhibitory inputs. Results obtained with this approach showed simple hysteresis phenomena. However, by considering that the neural connections can be set up by means of chemical markers carried by the individual neurons the dynamics of such systems exhibits not only simple hysteresis but also multiple phenomena. Such hysteresis loops may be considered to represent the basis for short-term memory. The later study of probabilistic neural nets with chemical markers was generalized by considering the intrinsic noise of the system, caused by the spontaneous release of synaptic transmitter substance. On the basis of these studies of noisy neural nets we proposed a model for epileptic phenomena and a theory leading to kindling effect of epilepsy. PMID- 3667108 TI - Oestrogen binding sites in fresh human aortic tissue. AB - Biopsies of aortic tissue were obtained from patients undergoing heart surgery, and were tested for oestrogen binding sites. Tests were carried out using a 7 + 1 point dextran-coated charcoal method, and receptors were quantified both in the cytoplasmic and in the nuclear fractions using Scatchard plot analyses. Tests yielded positive results in 8 cases out of 13 (cytosol fraction) and in 10 cases out of 13 (nuclear fraction). Receptors showed high affinity for oestrogens, the Kd values ranging from 10(-11) M to 10(-10) M. These findings therefore suggest the occurrence of oestrogen receptors in human blood-vessels. PMID- 3667109 TI - Defibrotide in vitro inhibits neutrophil activation by a Ca++-involving mechanism. AB - Defibrotide, a polydeoxyribonucleotide provided with a pro-fibrinolytic and prostacyclin-like activity, was studied as an inhibitor of polymorphonuclear leucocyte activation in vitro. It was found capable of dose-dependently (1-8 X 10(-5) M) inhibiting FMLP-induced activation, as shown by a decrease of enzyme release and free-radical formation (superoxide anion generation and chemiluminescence). A similar inhibiting activity was observed on A23187-induced activation. An increase in extracellular Ca++ concentration significantly prevented the effect of defibrotide on ionophore stimulation. When PMA was employed as stimulating agent, the drug did not show any inhibiting effect. Finally the pre-treatment of cells with theophylline markedly reduced the inhibition by defibrotide of FMLP- and A23187-dependent activation. Since the stimulation of neutrophils by FMLP and A23187 depends on the increase of cytoplasmic free-calcium availability or extracellular calcium entrance respectively, whereas PMA activation is completely independent from any Ca++ change, the inhibiting effect of defibrotide could be attributed to a Ca++ involving mechanism. PMID- 3667110 TI - Involvement of dopamine receptors in experimental ulceration. AB - The purpose of this study was to characterize dopamine binding sites in gastric (mucosa and muscle) tissue and to examine changes of gastric dopamine receptors in response to variable periods of cold-restraint stress (CRS). Scatchard analysis of binding data in tissues of non-stressed animals revealed a single, homogeneous class of saturable high-affinity dopamine binding sites in gastric mucosa (Bmax = 21.3 pmol/mg protein; KD = 4 X 10(-7) M) and in gastric muscle (Bmax = 34 pmol/mg protein; KD = 0.6 X 10(-7) M). After 1 h of CRS, a time at which a low (30%) incidence of gastric ulcers was observed, the binding in mucosa had increased by 53%. Scatchard analysis revealed a significant increase in dopamine receptor number (Bmax = 37.6 +/- 7.0 versus 21.3 +/- 2.0 pmol/mg protein) and no significant change in affinity (KD = 6.8 +/- 1.6 versus 4 +/- 0.7 X 10(-7) M). No change in 3H-dopamine binding to muscle tissue was observed. These results indicate that up-regulation of mucosal dopamine receptors may precede the development of gastric ulcers. PMID- 3667111 TI - The effects of prolonged administration of cimetidine or pirenzepine on gastric mucosal cell kinetics, serum gastrin levels and acid secretory responses in rats. AB - 60 days' treatment of rats with cimetidine 160 mg/kg/die per os produced a significant increase in total gastrin cell number, gastrin cell density of antral mucosa as well as parietal cell density of fundic mucosa as compared with controls. By contrast, the same parameters significantly decreased in rats treated for 60 days with pirenzepine 16 mg/kg/die per os. Under the same conditions, immunoreactive serum gastrin levels were found to be significantly enhanced in cimetidine-treated rats, but not significantly changed in rats treated with pirenzepine. 48 hours after drug withdrawal, gastric secretory responses to pentagastrin were found to be significantly increased in cimetidine treated rats and decreased in pirenzepine-treated rats. These results suggest that a feed-back reaction to cimetidine-induced prolonged hypochlorhydria mediates hyperactivity of the gastrin cell system which, in turn, induces parietal-cell hyperplasia. The hyperplasia accounts for hypersecretive responses in cimetidine-treated rats. The inhibitory activity displayed by pirenzepine on the same parameters may be due to the blockade of vagal trophic influences on gastric mucosal cells and/or to the release of inhibitory factors such as somatostatin. PMID- 3667112 TI - Effects of white wine, Coke and water on basal and food-stimulated gastric acid secretion and gastrin release in the dog. AB - The effects of three types of white wine (10% ethanol; pH 2.84-3.26), Coke (pH 2.45) and water (pH 8.03) on basal and food-stimulated gastric acid secretion in dogs were investigated. Water and Coke did not significantly modify acid secretion and gastrin release under basal conditions. By contrast, white wine or water +10% ethanol significantly increased acid secretion, with a tendency to elevate plasma gastrin concentrations. Acid secretion and gastrin release induced by a standard meal were not significantly modified by previous administration of Coke and water. In contrast, white wine and water +10% ethanol significantly increased food-stimulated total acid output, without changing plasma gastrin levels. It is concluded that Coke and water have only trivial effects on basal and on food-stimulated gastric acid secretion and gastrin release in the dog. The gastric stimulant effect of white wine is mainly related to its percentage of alcohol regardless of the slight differences in pH of the solutions. PMID- 3667114 TI - The need for aseptic barriers. PMID- 3667113 TI - The long-term treatment of peptic ulcer after a bleeding episode. AB - We have studied 51 consecutive patients bleeding from peptic ulcer which was duodenal (D.U.) in 30, gastric in 17 (G.U.), anastomotic in 3 (Billroth 2), and oesophageal in 1 of them. One patient with G.U. was sent for surgery and 2 patients with D.U. died early; the others recovered through medical treatment and the ulcer healed after 6-8 weeks of treatment with ranitidine in 46 out of 48 patients. Subsequently, all the healed patients have been treated with ranitidine (150 mg at bedtime) for 6 months; by this time a new endoscopy showed an erosive antral gastritis in 2 patients with G.U. and 2 recurrences of D.U. Then the patients and their family doctors were invited to choose between the interruption of the treatment and its prolongation. 8 patients with previous G.U. preferred to stop treatment, and up to 1-2 years they did not show any recurrence; the remaining 5 patients carried on the maintenance treatment, and up to one year one of them showed an erosive antral gastritis. 15 patients with previous D.U. stopped the treatment and 5 of them after 1-24 months presented a recurrence with a new haemorrhage; 8 patients chose to continue the treatment and none of them for 6-24 months had recurrence. The limited number of the patients obviously does not allow a sound conclusion, but a trend is clearly seen which favours a prolonged maintenance treatment in patients with D.U. which has bled. PMID- 3667115 TI - An appropriate category of isolation for antibiotic resistant organisms. PMID- 3667116 TI - HIV infection per needlestick in health care workers. PMID- 3667117 TI - Infection control practitioners and AIDS. PMID- 3667118 TI - The relationship between APIC and SHEA: "closely watched trains". PMID- 3667120 TI - The detection of blood on nonporous environmental surfaces: an approach for assessing factors contributing to the risk of occupational exposure to blood in the autopsy suite. AB - A simple and inexpensive method to assess the contamination of environmental surfaces and the associated potential risk of exposure of autopsy room personnel to potentially hazardous materials is described. Blood was selected as a marker of contamination and HEMASTIX reagent strips were used to determine its presence on selected surfaces. The surfaces selected for examination typically do not come into direct contact with cadavers or tissues during a routine postmortem examination and thus are not included in routine cleanup. We documented the presence of blood on a variety of environmental surfaces in the autopsy suite and suggest that the contamination resulted from a breakdown in good work practices, most probably the indiscriminate handling or touching of materials and equipment with contaminated gloves. The risk of exposure to blood by the indirect route was deemed significant. The results of this study underscore the importance of establishing and consistently following good work practices and cleanup procedures to minimize the risk of exposure to blood before, during, and after postmortem examinations. PMID- 3667119 TI - Inactivation of human immunodeficiency virus by Betadine. AB - Human immunodeficiency virus (HIV), the etiological agent of the acquired immunodeficiency syndrome (AIDS), was treated with either Betadine (povidone iodine) Solution or Betadine Surgical Scrub. HIV inactivation was analyzed using the viral reverse transcriptase assay or by observing the cytopathic effect produced in HIV-infected, H-9, T-cell cultures. The minimum effective Betadine dose was 0.25% for complete inactivation of HIV that was treated for various time intervals (immediate vortex to ten minutes). The titer of HIV stocks used in these experiments (10(5) TCID50 per mL) was greater than amounts generally detected in clinical specimens. Our results provide a rationale for the use of povidone-iodine as a topical antiseptic against HIV in the clinic or laboratory. PMID- 3667121 TI - An outbreak of scabies among employees in a hospital-associated commercial laundry. PMID- 3667122 TI - Vibrio vulnificus. AB - V vulnificus is a halophilic or salt-requiring vibrio that has been isolated repeatedly from seawater and shellfish in coastal waters. This vibrio, first described by Hollis et al in 1976, can be differentiated from other similar vibrios by its ability to ferment lactose and by its lower tolerance for sodium chloride. V vulnificus, unlike most other vibrios, has seldom been incriminated as a cause of gastroenteritis but is a particularly virulent organism that causes severe wound infections in mostly healthy persons, or causes primary septicemia in persons with an underlying chronic disease, particularly chronic liver disease. Wound infections may range from relatively mild to severe and rapidly progressive cellulitis and myositis. Approximately 50% of patients with wound infections have some type of chronic underlying disease and the mortality rate is in the range of 15%. Wound infections are almost always associated with contact with seawater or the handling or cleaning of shellfish. Patients with primary septicemia have fever, chills, and prostration, and rapidly become hypotensive. Over 70% have distinctive bullous skin lesions that can strongly suggest the diagnosis in a patient with the appropriate history. The mortality rate is over 50%. There is a striking association between eating raw oysters and primary septicemia, with patients usually reporting having eaten raw oysters (or other shellfish) 24 to 48 hours before onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667123 TI - Microscopic estimation of bacteria and cells in urine. II. A clinical study on the application of the theoretical considerations to clinical practice. AB - An improved technique for diagnosing acute urinary tract infections (UTI) by means of microscopic estimation of bacteria, leucocytes, erythrocytes and epithelial cells in urine was tested clinically in a total of 1,807 samples obtained from hospital departments. Marked bacteriuria (greater than or equal to 10(5) bacteria per ml of urine) was found microscopically in 13.1% of the urines. Of these 1.9% were falsely positive. Altogether 3.5% of the samples were falsely negative. When the sample collection was controlled carefully and detailed information on possible collection errors was given regularly, sensitivity and specificity indices of the microscopic technique were 85.3 and 98.1, respectively. Microscopic finding of cocci, e.g. Enterococci and Str. agalactiae, was more difficult than that of rods. Alongside bacteriuria, finding of leucocytes (greater than 5 leucocytes per microscopic field) was of great importance for UTI diagnostics, and it strengthened further the microscopic diagnosis, while erythrocytes and epithelial cells were of very poor significance for UTI diagnosis. The results show that the microscopic technique described here is a reliable and suitable method for UTI diagnostics in routine clinical laboratories which examine daily large numbers of samples, most of them negative. PMID- 3667124 TI - Immune studies by the use of Multitest-Merieux in patients with kidney tumours. AB - Responsiveness to recall antigens was studied by the use of Multitest-Merieux in 20 cases of kidney tumour with and without deposits. The patients of either group, compared with the controls, had depressed scores of immunoreactivity. After surgical removal of the tumour-bearing kidney, immunoreactivity increased, regardless of the presence or absence of deposits. The number of reacting antigens also increased in every case. Lymphocyte transformation in vitro was also depressed, in comparison with the controls before surgery, but after the intervention the transformed blast cells increased in number. Multitest was found suitable for studies of delayed-type sensitivity. PMID- 3667125 TI - Fate of urinary calculi in children and teenagers. AB - Urinary calculi are more common in children and teenagers in the Middle East than in other parts of the world. The fate of 45 cases is discussed in this work. Twenty-one passed their stones, three with renal calculi were kept under observation, and 21 cases had different types of surgical intervention. There were only two bladder stones treated by cystolithotomy and only one nephrectomy was done. The low incidence of bladder stones and the high percentage of radio opaque stones, inspite of the relatively high incidence of stone disease in this age group, are probably due to the changing socio-economic conditions in Jordan. PMID- 3667126 TI - Surgery of calculous hydrocalyx (calyceoplastic surgery). AB - A modified surgical technique for calculous hydrocalyx, based on partial calyceal resection with simultaneous correction of the morphological abnormality responsible for stone formation is described. Access to the calyx is gained by a modified marginopolar resection. The modification developed by the authors consists in carrying the resection line laterally to the vertical axis of the kidney. The parenchyma is closed by U-shaped "hair-pin" stitches. Preparation of the limbic, pelvic and ureteral areas is abstained from, thus avoiding scarring which might affect renal lymph and blood flow and interfere with urinary transport. The results obtained in 85 cases of calculous hydrocalyx over an 8 year period were satisfactory. The rate of calculous recurrences was not higher than 3.5 per cent. PMID- 3667127 TI - Familial occurrence of blind-ending bifid and duplicated ureters. AB - Blind-ending bifid ureter in a girl with urinary tract infection, and a blind ending duplicated ureter in her younger sister are described. The embryology of this rare anomaly is briefly reviewed. PMID- 3667128 TI - Antireflux operations without catheter. AB - Forty-three patients are presented in whom 80 ureters were transplanted by Cohen's method without leaving a catheter in the bladder. No complications were observed and the incidence of urinary tract infection and dysuria was lower. The late results of the operation were good in every case. PMID- 3667129 TI - Anatomical considerations of selective pudendal neurectomy. AB - The pudendal nerve was examined in 100 cadavers of both sexes. Because of the variable number of trunks of the pudendal nerve, 5 types were distinguished: one trunked; two-trunked, rectopudendal; two-trunked, pudendo-penile (or clitoridal); three-trunked, recto-perineo-penile (or -clitoridal); four-trunked, recto-perineo-perineopenile (or -clitoridal). The authors' suggestions make it possible to perform selective pudendectomy, consisting in denervation of the sphincter urethrae muscle by neurectomy of the perineal branches of the pudendal nerve. PMID- 3667130 TI - "TUR syndrome" after transurethral resection of the prostate using suprapubic drainage. AB - In a retrospective study of 522 consecutive patients who were subjected to transurethral resection of the prostate with suprapubic trocar technique, six patients were suspected of having transurethral prostatic resection syndrome. The majority of the transurethral resections were performed by surgical or urological trainees. Only two patients fulfilled the criterion for TUR syndrome caused by absorption of irrigating fluid and defined as an electrolyte dilution corresponding to a plasma sodium level below 120 mmol/l. In the present paper the symptomatology and treatment of TUR syndrome are outlined with reference to the literature. The trocar technique clearly has minimized the risk of TUR syndrome, which emphasizes the value of the method. PMID- 3667131 TI - Congenital anomalies of the seminal ducts. AB - The frequency of individual congenital anomalies of the deferens, the seminal vesicles, the ejaculatory ducts and the utricle in 158 patients treated for sterility was determined by the method of deferentovesiculography by punction. Congenital anomalies were found in 14 patients (8.8%). Anomalies of rare occurrence are demonstrated in detail. The relation of such anomalies to sterility of patients is described. PMID- 3667132 TI - Defect in cholesterol esterification associated with renal diseases. AB - Changes in lipidaemia and in cholesterol esterification rate were investigated in 65 patients with chronic mesangial glomerulonephritis (GN), and in 26 patients with polycystic kidneys (PL), as well as in age- and sex-matched control groups. As compared to the controls, a slightly significant increase in cholesterol and triglyceride concentrations was found only for the GN group, whereas the rate of cholesterol esterification showed a highly significant reduction in both groups of diseased subjects. The average values of molar esterification rate (MER) were, respectively, 75.4 and 61.6 mumol . l-1 . h-1 for the GN and PL groups, the respective control values being 96.9 and 91.1. Fractional esterification rate (FER) reflecting the rate of cholesterol exchange between blood and tissues fell in the same two groups of patients to 4.38 and 4.40% . h-1, respectively (controls 6.93 and 6.17). Both the changes in cholesterol esterification rates and a relative increase in the ratio of unesterified to esterified cholesterol were found in patients with low as well as normal glomerular filtration rates. PMID- 3667133 TI - Pseudo-appendicitis presenting after vasectomy. A case report. AB - This case report highlights the importance of considering testicular pathology in the differential diagnosis of abdominal pain, and presents an unusual complication of vasectomy. The need for histological confirmation of the resected specimens is also stressed. PMID- 3667134 TI - Late recurrence of upper urinary tract urothelial tumours. AB - Two case reports of late recurrence of upper urinary tract urothelial tumours 13 years after ipsilateral local resection and 19 years after contralateral nephroureterectomy are used in the discussion on when to perform local resection. In accordance with existing literature we propose local resection in case of low grade upper urinary tract urothelial tumours. PMID- 3667135 TI - Pathology of ureterorenal units in various ureteral anomalies with particular reference to the genesis of renal dysplasia. AB - Renal morphology of various congenital ureteral anomalies was investigated to gain further insight into the genesis of associated renal dysplasia. Abnormality in the ureteral bud explains the genesis of renal dysplasia as long as the adjoining ureter is cranially ectopic. In caudal ectopy of either single or duplex system, no difference was found in the histologic quality of kidneys with G and H position orifice. In the single system kidneys of H position orifice, however, occurrence of renal dysplasia was not associated with obstruction, suggesting the operation of the "bud theory" even in single system caudal ectopy. In anomalies in which the ureteral orifice was not ectopic, it was suggested that renal parenchymal development was impaired by complete, but not by incomplete obstruction. The association of dysplastic ureter and renal dysplasia was not so frequent as anticipated and the hypodysplastic values of the kidneys with and without dysplastic ureters were similar, suggesting no direct causal relationship between them. PMID- 3667136 TI - Uretero-pelvic stenosis. AB - In a prospective series of 66 patients with uretero-pelvic stenosis ("genuine hydronephrosis") the clinical data and the results of treatment were registered. We found an estimated incidence per year of 5:100,000 inhabitants. In the age group under 10 years there was a striking majority of boys. Routine antimicrobial prophylaxis was not given; only one patient had clinical urinary tract infection postoperatively, but bacteriuria in the nephrostomy catheter was frequent. Follow up 12 months after dismembered pyeloplasty with postoperative nephrostomy showed 85% of the patients to be cured, i.e. with no symptoms and with normal drainage from the renal pelvis. In 5% of the cases (3 patients) the result was unsatisfactory. The technique can be recommended in the treatment of ureteropelvic stenosis. PMID- 3667137 TI - The vesicosigmoidal fistula: diagnosis and surgical treatment. AB - The authors report their experience in the diagnosis and treatment of 10 cases of vesicosigmoidal fistula. In accordance with the literature the most frequent presenting symptoms were of urinary origin. For the diagnosis urography was helpful, cystography and cystoscopy allowed the observation of a fistulous orifice, while barium enema confirmed, or removed probable doubts about the nature of the intestinal pathology. Surgical treatment varied from one-stage to multi-stage procedures. PMID- 3667138 TI - Blood loss in transurethral prostatectomy: epidural versus general anaesthesia. AB - The peroperative and postoperative blood loss was determined in 36 patients undergoing transurethral prostatectomy (TUR-P) using a photometric method. Seventeen patients were randomly allocated to epidural and 19 patients to general anaesthesia. No significant differences were found between the two groups in the total blood loss peroperatively, the corrected blood loss peroperatively (ml/g/min) or the blood loss postoperatively. The systolic blood pressures were equal in the two groups and no correlation between blood loss and blood pressure was demonstrated. The blood loss per g resected tissue was fairly constant and independent of prostatic weight, but bleeding per minute operating time increased significantly with prostatic size. As the total peroperative blood loss increases with operating time, rapid surgery is a possibility of reducing blood loss in TUR P. Visual estimation of blood loss during TUR-P of larger glands was unreliable with underestimates of about 100 per cent in one third of the patients, when bleeding exceeded 400 ml. Therefore we recommend an accurate determination of blood loss during resection of larger glands. PMID- 3667139 TI - Cytostatic therapy, its value and indications in the management of prostatic carcinoma. AB - Observations with cytostatic therapy of generalized prostatic carcinoma (PC) over 5 years are reported, cyclophosphamide (cpa) having been administered to hormone resistant patients. A standard therapeutic and follow-up scheme, enabling the results to be assessed objectively, had been elaborated. Objective remission or stagnation, confirmed on this basis, was attained in 50%, relief of pain in 60% of the cases. Side effects were negligible. Withdrawal of cytostatics was required in 2 cases. The results indicate that secondary cytostatic therapy significantly potentiated the effect of hormone therapy in generalized PC, and in case of hormone resistance it offers the only chance of therapeutic benefit. PMID- 3667140 TI - Therapeutic role of pelvic lymphadenectomy in carcinoma of the prostate: own experiences. AB - Precise determination of the extent of lymph node involvement is of decisive importance for therapy of prostatic cancer. For this reason staging pelvic lymphadenectomy is fully indicated. Some authors expect from pelvic lymphadenectomy a therapeutic effect, too. The procedure is performed as a part of radical prostatectomy or before radiation therapy. In the period 1978 to 1984 the authors followed two groups of patients treated with external radiotherapy using betatron Brown-Boveri. Group A--irradiation only, Group B--irradiation after previous en bloc pelvic lymphadenectomy. The total number of 0-7-year survival was 56% in Group A and 76% in Group B. In Group B no difference was found in survival of patients with negative or positive nodes. In Group A--with an error in determining N category of lymphography--the survival of patients with negative nodes was significantly higher. Five-year survival was 46% in Group A and 65% in Group B. PMID- 3667141 TI - Surgical therapy of congenital distal urethral stenoses in girls by meatoplasty. AB - In girls there are three distinct morphological kinds of congenital distal urethral stenoses in the broad sense. Incomplete meatal stenoses are the most frequent of these. Calibration of the urethra appeared to be the most reliable diagnostic tool in revealing distal urethral obstructions. To relieve the urodynamically interfering urethral stenoses we developed a resecting surgical technique. In a retrospective study the follow-up after meatoplasty of 163 girls with recurrent urinary tract infections was analysed. The long-term success rate totals up to 83.5%. PMID- 3667143 TI - Epithelial crescent in diabetic glomeruli. A case report. AB - The kidney as a target organ for secondary microvascular complications of diabetes mellitus represents a major problem. The pathology of diabetic glomerulopathy is well known. The coexistence of immunocomplex-mediated glomerulonephritis and diabetes mellitus has rarely been reported. The presence of crescents in glomerular disease of diabetes mellitus has been usually ignored in the literature. The present study describes one patient with epithelial crescentic diabetic glomerulopathy with rapidly progressive renal failure. PMID- 3667142 TI - Clinical and therapeutic studies in mesangial immunoglobulin A glomerulonephritis. AB - A long-term clinical and therapeutic study was performed in 47 patients with mesangial IgA glomerulonephritis. The male to female ration was 2.9:1. An episode of gross haematuria or the incidental discovery of asymptomatic microscopic haematuria with associated mild proteinuria heralded the apparent onset of renal disease. At the onset of observation 18 patients (38.2%) had high blood pressure. Other 17 patients developed hypertension during observation. Anaemia was uncommon. No essential abnormalities in serum protein and lipid patterns were found. Twenty-nine patients (61.6%) had higher levels of serum immunoglobulins- most frequently of IgA (42.5%). Twenty-two patients had low serum C3 levels (46.8%). The percentage of patients with renal failure increased from 21.2 to 36.1 during observation. Male sex, hypertension, proteinuria higher than 2 g/24 h, elevated ESR, high serum IgA levels, longer duration of the disease and older age of patients suggest an unfavourable outcome. Long-term treatment with a combination of azathioprine/acenocumarol, or indomethacin, or levamisole has no effect on the clinical manifestation and evolution. PMID- 3667144 TI - Dynamic heterogeneity: characterization of two cell lines derived from experimental lung metastases of mouse KHT fibrosarcoma. AB - We have recently demonstrated that KHT fibrosarcoma variant cells that form experimental metastases are generated by a stochastic process at high effective rates (approximately 10(-5)/cell/generation). The metastatic variant cells are unstable and are rapidly lost with an effective rate of reversion of approximately 10(-1)/cell/generation. In this study, we have examined the dynamics of generation of metastatic variant cells for two lines of KHT cells derived from individual experimental lung metastases in a single step selection. When grown in vitro, the KHT35-L1 cell population maintained a highly metastatic phenotype whereas the KHT3-L1c cell population reverted to a poorly metastatic phenotype. Our results indicate that there is an approximately 10-fold higher effective rate of generation of metastatic variant cells for KHT35-L1 cells relative to KHT3-L1c cells. Thus, a higher effective rate of generation of metastatic variants accompanies a stably expressed metastatic ability in fibrosarcoma cells and, as we have previously reported, in melanoma cells. PMID- 3667145 TI - Numerical evaluation of the kidney invasion test. AB - We have implanted MO4 transformed mouse cells attached to a collagen matrix (artificial tumor) under the renal capsule of syngeneic mice. It was our purpose to evaluate whether or not the kidney invasion test (KIT) could be used for the determination in vivo of the invasive capacity of cultured cell populations. Invasion was expressed in terms of the proportion of the depth of the invasive part of the tumor to the total tumor thickness (invasion rate), both measured macroscopically after hemisection of the kidney. Macroscopic findings were confirmed by histology. For MO4 cells the invasion index changed in function of time after implantation. The relationship 'invasion index versus time after implantation' was demonstrated to be constant in 3 independent groups of mice. Therefore, we propose determination of the invasion rate versus time in the KIT as a method to compare the invasive capacity in vivo of different cell lines. PMID- 3667146 TI - Adrenergic alpha 1 and alpha 2 binding sites are present in bovine retinal blood vessels. AB - Bovine retinal vessels have sites that specifically bind 3H-p-aminoclonidine (3H PAC) with an apparent dissociation constant of 0.12 nM and a capacity of binding of 0.15 pmol/g. In addition, these vessels have 3H-prazosin binding sites bearing a dissociation constant of 5 nM and a binding capacity of 5 pmol/g. To understand the implications for retina-optic nerve vascular physiology and pathophysiology, studies of the exact location of the binding sites, the bioavailability of the adrenergic agonists, and the physiological responses to receptor stimulation in both normal and pathological states are required. The neural elements of the retina also have binding sites for 3H-PAC with an apparent dissociation constant of 0.38 nM in larger quantities (6.7 pmol/g tissue) than in the vascular elements. There are also binding sites for 3H-prazosin in a lower amount than in the vascular fraction (3 pmol/g tissue) with a dissociation constant of 2.4 nM. These sites are presumably related to the use of norepinephrine and dopamine as neurotransmitters by retinal neurons. PMID- 3667147 TI - Angiotensin binding sites in bovine and human retinal blood vessels. AB - Blood vessels isolated from bovine and human retinas have sites that specifically bind 3H-angiotensin II (3H-Ag II) with an apparent dissociation constant (Kd) of 14 nM and a capacity of binding (Bmax) of 0.82 pmol/g. The binding sites for 3H Ag II appear to be influenced by guanine nucleotides (GTP) and cations (Mg2+ and Na+) in a way that resembles angiotensin II receptors in other tissues. The physiologic effect of blood-borne or locally-formed angiotensin II on retinal blood flow remains to be defined. PMID- 3667148 TI - Autonomic innervation of preretinal blood vessels of the rabbit. AB - The preretinal blood vessels, that is, blood vessels lying on the inner surface of the retina, were observed by SEM examination using digestion methods, TEM examination and fluorescence histochemical examination using the Falck-Hillarp method. The nerve endings on the preretinal arterioles were distributed from the optic disc to the periphery. The longest nerve terminals from the optic disc to peripheral arterioles were about 9 mm. There were also a few nerve endings on the preretinal veins. These nerve endings had a series of axonal varicosities with diameters between 0.5 and 1.5 mu, which contained empty synaptic vesicles and cored synaptic vesicles. The number of nerve endings on these arterioles decreased with the shortening of the diameter of the retinal arterioles. Fluorescent nerve fibers with axonal varicosities were distributed on the wall of the preretinal blood vessels in the fluorescence histochemical study. These fluorescent nerve fibers were numerous near the optic disc, but there were only a few fluorescent nerve fibers on the peripheral blood vessels. The nerve endings on the preretinal blood vessels disappeared following superior cervical ganglionectomy. The present study shows that the preretinal blood vessels in rabbit eyes are innervated by the sympathetic nerve originating from the superior cervical ganglion. PMID- 3667149 TI - Measurement of the volume flow and hydraulic conductivity across the isolated dog retinal pigment epithelium. AB - The isolated dog retinal pigment epithelium (RPE)-choroid was gently stretched on the inner surface of a spherical stainless mesh, retinal side upward, and clamped between half-chambers made of Kel-F. The volume flow across the tissue was monitored by the movement of water in capillary tubes connected to both chambers. With zero pressure difference across the RPE-choroid, retina-to-choroid fluid flow was determined to be 6.4 microliters/hr/cm2 (absorption). Removal of HCO-3 from the solution did not affect the fluid flow. However, the flow was reduced 88% in Cl- -free medium, indicating a coupling between water and Cl- absorption. The flow was also inhibited by ouabain (10(-5) M) and furosemide (10(-4) M). Hydraulic conductivity (Lp) of the RPE-choroid was determined to be 0.0126 microliters/min/cm2/mm Hg which places the dog RPE-choroid in the category of a "leaky" epithelium. PMID- 3667150 TI - Functional recovery of retinal pigment epithelial damage in experimental retinal detachment. AB - The integrity of the RPE barrier function in retinal detachment was studied in vitro. The retinal pigment epithelium (RPE)-choroid tissue was isolated from cynomolgus monkey eyes with acute (less than 1 hr), subacute (1-2 weeks), and chronic (8-20 months) retinal detachments, and clamped between Ussing-type chambers. Electrical characteristics and choroid-to-retina permeability to carboxyfluorescein were determined. In the HEPES-buffered bathing solution, transepithelial potential difference and resistance in eyes with acute retinal detachments (0.2 mV and 134 ohm-cm2, respectively) were significantly lower than subacute (7.9 and 350) and chronic (10.4 and 348) retinal detachments. Furthermore, the permeability was increased five-fold in acute retinal detachments with respect to subacute and chronic retinal detachments, indicating a breakdown of the RPE barrier in acute retinal detachment. No statistical difference was found between subacute and chronic retinal detachments. In this animal model, RPE barrier function is destroyed at the onset of retinal detachment, but recovers in a week or two, and is maintained in the chronic stage. Histological examination revealed that RPE recovery was accomplished by RPE proliferation and hyperplasia. PMID- 3667151 TI - Zinc uptake in vitro by human retinal pigment epithelium. AB - Zinc, an essential trace element, is present in unusually high concentrations in the chorioretinal complex relative to most other tissues. Because little has been known about the interactions between the retinal pigment epithelium and free or protein-associated zinc, we studied 65Zn uptake by human retinal pigment epithelium in vitro. When monolayers were exposed to differing concentrations from 0 to 30 microM 65Zn in Dulbecco's modified Eagle's medium with 5.4 gm/l glucose at 37 degrees C and 4 degrees C, we observed a temperature-dependent saturable accumulation of the radiolabel. With 15 microM 65Zn, we saw a biphasic pattern of uptake with a rapid first phase and a slower second phase over 120 min. Uptake of 65Zn was inhibited by iodacetate and cold, and reduced approximately 50% by the addition of 2% albumin to the labelling medium. Neither ouabain nor 2-deoxyglucose inhibited uptake. Cells previously exposed to 65Zn retained approximately 70% of accumulated 65Zn 60 min after being changed to radiolabel-free medium. Following removal of cells from the extracellular matrix adherent to the dish bottom, a variable amount of nonspecific binding of 65Zn to the residual matrix was demonstrated. These observations are consistent with a facilitated type of transport and demonstrate the ability of human retinal pigment epithelium in vitro to accumulate and retain zinc. PMID- 3667152 TI - Circadian rhythm in goldfish visual sensitivity. AB - To determine whether rod-mediated vision in goldfish is regulated by a circadian clock, absolute threshold was measured psychophysically in animals maintained in constant darkness. Responses were recorded approximately every 4 hr to a diffuse 532 nm stimulus, 5 sec in duration, with no background light present. Visual threshold tended to be lowest at the time of transition from light to dark, as experienced by the fish before it was placed in constant darkness. Threshold tended to be highest at the time of transition from dark to light. The average peak-to-trough fluctuation for five fish was 0.5 log unit in amplitude, and its period was about 24 hr. The results show that the rhythm in visual threshold can still be detected after 7 days of darkness, and that it can be entrained to a new light-dark cycle. These properties are characteristic of regulation by a circadian oscillator. PMID- 3667153 TI - Sensitivities in older eyes with good acuity: cross-sectional norms. AB - We measured several indices of foveal visual function for a large group of people aged 60 and older. The data reported in this paper are from individuals who had good acuity in each eye and met a number of other criteria for good ocular health. For each index, we described the rate of cross-sectional change with age using linear regression statistics. We found age-related change for eyes having 20/20 or better acuity to exist for several different indices. Sensitivity mediated by the blue-sensitive cones decreased with age, as expected. However, the rate of decrease was faster for females than for males. At least part of the difference was associated with different rates of lenticular change. Absolute sensitivity at long wavelengths also decreased with age, but at the same rate for each sex. Rayleigh color matches changed with age in a manner consistent with underlying age-related decreases of effective foveal cone photopigment density. However, not all indices showed age-dependent changes. For instance, the time constant describing the rate of photopic dark adaptation did not appear to change with age. PMID- 3667154 TI - Sensitivities in older eyes with good acuity: eyes whose fellow eye has exudative AMD. AB - We compared several indices of foveal visual function between two groups of people aged 60 and older. One group was comprised of individuals who had good acuity in one eye, but had a history of exudative aging macular degeneration (AMD) in the other eye. We measured visual function in these individuals' good eyes only. The second group was a normative group; it was comprised of individuals who had good acuity in each eye. None of the eyes which we tested from either group had funduscopic evidence of macular pathology other than macular drusen and/or hypopigmentation. We found that eyes whose fellow eye had suffered from exudative AMD themselves suffered compromised foveal function, even when they retained 20/20 or better acuity. Losses of sensitivity mediated by blue sensitive cones tended to be greater for 1 degree than for 3 degrees diameter test stimuli. Absolute sensitivity losses at long test wavelengths were probably due to several factors, including decreased effective cone photopigment density. Slow rates of recovery during dark adaptation were associated with the presence of many macular drusen and/or macular hypopigmentation. Eyes whose fellow eye had suffered from exudative AMD had more macular drusen and hypopigmentation than eyes whose fellow eye had not suffered from exudative AMD. PMID- 3667155 TI - Basic fibroblast growth factor is present in cultured human retinoblastoma cells. AB - Cultured human retinoblastoma cells express the basic fibroblast growth factor (bFGF) gene and they produce material similar, if not identical, to bFGF. The retinoblastoma-derived bFGF can stimulate the proliferation of capillary endothelial cells and this process is inhibited by anti-bFGF antibodies. It is conceivable that the retinoblastoma-derived bFGF contributes to the neovascularization of retinoblastomas. PMID- 3667156 TI - Lid suture myopia in chicks. AB - Domestic chicks reared under continuous light developed light-induced avian glaucoma (LIAG), including eye enlargement and flat cornea. Chicks reared under dim light developed dim light buphthalmos (DLB), a somewhat similar eye enlargement, superimposed on the LIAG effect when, as in one subgroup of the present experiments, the dim light was also continuous. Unilateral lid suture elicited experimental myopia on the operated side, additive to the LIAG and/or DLB effects. When the rearing conditions were diurnal (ie, not such as to induce LIAG eye enlargement), and the light of at least "normal" brightness, lid suture still caused unilateral myopia, accompanied by a pronounced bulging of the cornea. We discuss the probable effects of these changes on refraction and accommodation during the chick's development. PMID- 3667157 TI - Thermal gradients in the chick eye: a contributing factor in experimental myopia. AB - Domestic chicks were reared for 4 weeks with a plastic dome or a plastic ring glued to the skin surrounding the right eye. The domes, which degraded retinal images by reducing high spatial frequencies and contrast, have been reported to produce enlargement of the ocular globe and large myopic refractive errors. The rings, which do not produce refractive errors, did not affect vision and served as a control for the mechanical effects of having a device glued to the circumorbital skin. At the end of the rearing period, the chicks were anesthetized and a thermoprobe (a thermocouple in a 29 gauge needle) was inserted into the eye along the optic axis. Temperature readings were made at 1 mm intervals to a depth of 12 mm. Temperature readings also were taken of the circumorbital skin and the air inside the dome. The results indicated that the temperature in the dome eyes was elevated from 2.8 to 5.2 degrees C at the cornea and 0.7 to 2.0 degrees C at the axial sclera. Smaller elevations were found in the ring eyes. Two dome chicks that had lost their devices 24-48 hr prior to temperature measurement had thermal gradients that were nearly identical to those from untreated control eyes. Measurement of the air temperature inside the dome revealed a temperature elevation of nearly 4.0 degrees C above that recorded at an equal distance from control eyes. The circumorbital skin of treated eyes was 0.96 degrees C warmer than the comparable tissue of untreated eyes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667158 TI - Recession vs marginal myotomy surgery for strabismus: effects on spatial localization. AB - Palisade endings (PEs) are found at the musculotendinous junction in eye muscles and this is the site of much strabismus surgery. To assess the role of PEs in supplying proprioceptive information about eye position, we compared the effects of marginal myotomy and recession surgeries on tests of eye-hand coordination (open-loop pointing responses) taken before and after surgery in two groups of children having medial rectus weakening procedures for the first time. The results indicate that the myotomy is more proprioceptively "de-afferenting" than the recession, and we assume this is due to the greater disruption of PEs in this procedure. PMID- 3667159 TI - Latent/manifest latent nystagmus reversal using an ocular prosthesis. Implications for vision and ocular dominance. AB - Latent/manifest latent nystagmus (LMLN) is a jerk nystagmus with a decreasing velocity or linear slow phase whose fast phase is in the direction of the fixating eye. Change of the fixating eye by alternating tropias or cover will cause reversal of the LMLN to preserve this relationship. In the dark, where no fixation is possible, the fast phases of LMLN are in the direction of the intended fixating eye; actual visual input will override this effect of intention. A patient with persistent hyperplastic primary vitreous of the right eye, which was enucleated at age 9 due to glaucoma, had LMLN with fast phases to the left. His congenitally blind right eye was replaced with an ocular prosthesis whose movements were conjugate with his seeing eye. In the dark, we found that his LMLN spontaneously reversed as the normally fixating left eye became esotropic. Furthermore, as is the case with LMLN patients who have sight in both eyes, he was able to willfully reverse his LMLN in the dark by alternating his "fixating" eye. We conclude from these observations that the direction of LMLN is determined at a cortical level, is intimately related to the intended fixating eye and that eye "dominance" is predetermined and not altered by visual abnormalities, including blindness. PMID- 3667160 TI - Drug sensitivity of ten human tumor cell lines compared to mouse leukemia (L1210) cells. AB - L1210 leukemia cells, because of their rapid growth rate in suspension culture and high growth fraction, are ideally suited to screen in vitro for cytotoxic compounds. Although L1210 cells may mimic rapidly growing tumors, they have not been effective in selecting agents active against slow growing solid tumors. We expected that cell lines originating from human solid tumors, because of their slower growth rate and lower S phase fraction, would be more drug resistant than L1210. Therefore, we compared ten human tumor cell lines (5 melanomas, 4 colon carcinomas and 1 small cell lung carcinoma) to L1210 growth inhibition by 9 antitumor drugs. Not one human tumor cell line was consistently more resistant to all nine drugs than L1210 when the cells were exposed to drugs for about 2 doubling times. The drug sensitivity of 2 cell lines (L1210 and SK MEL 28) was again determined after a short term (2 hr) exposure and using growth inhibition and cell survival as end points. For both end points these two cell lines exhibited a random pattern of sensitivity to the drugs tested. Cell kill showed an order of sensitivity different than growth inhibition. The implication of these findings for drug-screening is discussed. PMID- 3667161 TI - Inactivation of human cells cultivated in vitro by the new mitotic inhibitors NY 4137 and NY 4138. AB - The effect of the two closely related drugs, the sulfone 2-(2-thenyl)sulfonyl-5 bromopyrimidine (NY 4137), and the sulfoxide 2-(2-thenyl)sulfinyl-5 bromopyrimidine (NY 4138), a sulfoxide, on the survival of cells of the human line NHIK 3025 was investigated. Cell survival was measured as the ability of single cells to form macroscopic colonies. Two-hour treatment with 0.012 mM NY 4137 resulted in 50% inactivation. The drug concentration of NY 4138 had to be adjusted about 10 times higher than that of NY 4137 for treatment periods of 2 or 24 h to obtain similar surviving fraction after treatment of asynchronous cells. Treatment of synchronized NHIK 3025 cells with NY 4137 showed that survival varied little with cell age. Following treatment with NY 4138, however, cells were particularly sensitive in G2 and in mitosis. As the survival curves for both drugs display a plateau region, where increasing the drug dose has little or no effect on cell inactivation, the presence of resistant subpopulations of cells is considered. High-performance liquid chromatography of drug solutions in cell culture medium showed that both NY 4137 and NY 4138 bound to, or were metabolized by, medium and/or cell components. The concentration of NY 4137 in cell culture medium, however, was reduced at a higher rate than NY 4138. The half-life of NY 4137 was on the order of 5 h, while the half-life of NY 4138 was over 24 h. These observations correlate well with the relative chemical reactivities for these drugs in nucleophilic displacement reactions. PMID- 3667162 TI - Release of methyl isocyanate from the antitumor agent caracemide (NSC-253272). AB - In recent phase 1 clinical trials, caracemide [N-acetyl-N-(methylcarbamoyloxy)-N methylurea; NSC-253272] has demonstrated a marked potential to produce severe central nervous system (CNS) toxicity. Recent in vitro studies of this antitumor agent have presented indirect evidence indicating that methyl isocyanate is a likely metabolite which results from incubation of caracemide with either phosphate buffer or human plasma. This report presents evidence that methyl isocyanate is formed from caracemide in a concentration- and time-dependent manner. These data implicate the caracemide-mediated formation of methyl isocyanate as at least a plausible explanation for the CNS toxicity exhibited by this drug. PMID- 3667163 TI - Enhancement of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) toxicity by acetohydroxamic acid analogues of 3-nitropyrazole in vitro. AB - A series of acetohydroxamic acid derivatives of 3-nitropyrazole were synthesized and evaluated for their ability to potentiate (chemosensitization) the activity of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) against EMT-6 mouse mammary tumor cells in vitro. The compounds were designed to test the hypothesis that the chemosensitizing activity of the analogues would be proportional to the rate of isocyanate formation via a Lossen rearrangement, in part a function of the leaving group at the N terminus of each acetohydroxamate. Substitution of acetohydroxamic acid side chains at the N-1 position of the parent 3 nitropyrazole resulted in compounds which were preferentially toxic to cells treated under hypoxic conditions, and which were capable of enhancing the toxicity of CCNU in hypoxia. As was observed for cytotoxicity, the enhancement of CCNU toxicity by these sensitizing agents was significantly reduced under aerobic treatment conditions. A strong correlation was established between hypoxic toxicity and chemosensitizing potency. The activity of the analogue, however, was not proportional to their excepted rates of Lossen rearrangement. Nevertheless, several potent chemosensitizing compounds were identified; some of which were 10 50 X's more potent on a molar basis than Misonidazole, the reference chemosensitizing compound. PMID- 3667164 TI - Phase II evaluation of bisantrene hydrochloride in refractory malignant melanoma. A Southwest Oncology Group Study. AB - Patients with a pathologically proven diagnosis of malignant melanoma were entered into a phase II trial of bisantrene. Eligibility criteria included: measurable, metastatic disease; performance status 0-2 SWOG; and adriamycin total cumulative dose of less than 400 mg/m2. The initial bisantrene dosing schedule was 260 mg/m2 every three weeks for good risk patients. Due to the absence of an objective response and the lack of severe toxicity in the first 25 bisantrene treated patients, the starting dose was increased to 300 mg/m2 for good risk patients. Fifty-one patients received a median of two bisantrene courses (range 1 11 courses). Leukopenia was the major toxicity. Fifteen (68%) of the 22 good risk, intermediate dose patients (260 mg/m2), and 8 (80%) of the 10 good risk, high dose patients (300 mg/m2) evaluable for toxicity experienced mild-severe leukopenia. None of the 51 patients experienced a complete or partial response to bisantrene. Median survival was 3.3 months. We conclude that bisantrene is ineffective in the treatment of metastatic melanoma. PMID- 3667165 TI - Phase II evaluation of dibromodulcitol and actinomycin D, hydroxyurea, and cyclophosphamide in previously untreated patients with malignant melanoma. AB - In this Eastern Cooperative Oncology Group (ECOG) phase II study, dibromodulcitol (DBD) and a combination of actinomycin D, hydroxyurea, and cyclophosphamide (AHC) were compared with methyl-CCNU, the current ECOG standard, in patients who had received no prior chemotherapy for disseminated malignant melanoma. The response rates were 6% (3/50) for AHC, 9% (3/34) for DBD, and 14% (7/49) for methyl-CCNU. Median survival times were 4, 5, and 6 months, respectively. Neither regimen appears to offer any advantage over methyl-CCNU as front-line therapy for patients with disseminated melanoma. PMID- 3667166 TI - A phase II study of (2"R)-4'-0-tetrahydropyranyladriamycin (THP) in hematological malignancies. AB - A phase II study of new anthracycline, THP, was conducted in 46 patients with hematological malignancies in a cooperative study. THP was given intravenously either at a dose of 13-34 mg/m2 for 3-5 consecutive days or 35-50 mg/m2 at 3-4 week intervals. Of 21 patients with acute leukemia, complete response (CR) was observed in 3 patients and partial response (PR) in 4. Of 22 patients with malignant lymphoma, CR was observed in 2 and PR in 6. The predominant toxicity was myelosuppression. Leukopenia was noted in 73% of patients and thrombocytopenia in 14%. Anorexia, nausea and vomiting were observed in 49%, 26% and 23%, respectively. Alopecia and acute cardiac toxicities were mild and recovered quickly on discontinuation of THP. Thus, THP was found to be effective for acute leukemia and malignant lymphoma. PMID- 3667168 TI - Computed tomographic lung density in children. AB - The effects of patient age, anatomic level, anteroposterior location, and phase of respiration on pulmonary density were analyzed retrospectively in 33 children and prospectively in 13 children. Density standards were positioned on the chest wall for correction of scanner performance changes. The subgroup of 32 children over 7 years of age, ie, with respiratory cooperation, was analyzed separately using moderate inspiration; its mean lung density (MLD) of three levels was -792 HU (95% range, -702-882 HU). Although MLD decreased with increasing age, a significant linear regression was found only in the prospective subgroup. Densities of the apical, subcarinal, and basal levels of the lung were not different. From maximal expiration to maximal inspiration, MLD decreased by 158 HU in the subgroup studied prospectively. Anteroposterior density gradients averaged 56 HU at the subcarinal level and increased with maximal expiration. PMID- 3667167 TI - Phase II study of esorubicin (4'-deoxydoxorubicin) in locally advanced or metastatic head and neck carcinoma. AB - Sixteen patients with locally advanced or metastatic head and neck cancer were treated with esorubicin (4'-deoxydoxorubicin) at a dose of 30-35 mg/m2 i.v. every 3 weeks. One patient was lost to the follow up after one cycle, whereas in the 15 evaluable cases a total of 34 courses were administered (median per patient: 2, range: 1-6). Pretreatment for parameter lesions consisted of radiotherapy in 5, chemotherapy in 3 and both treatments in 1 patients respectively. Overall, one partial response, one stable disease and 13 progressions were documented. Severe (grade 3 and 4) leukopenia, thrombocytopenia and anemia were noted in 3, 1 and 1 patients respectively. The only patient developing leukopenia and thrombocytopenia of grade 4 subsequently died because of pneumonia. On the other hand, non-hematologic toxicity was generally mild. At this dose and schedule, esorubicin demonstrated an activity less than 20% in head and neck cancer and therefore, no further evaluation is warranted. PMID- 3667169 TI - Nuclear magnetic resonance spectroscopy of acute and evolving pulmonary hemorrhage. An in vitro study. AB - The proton NMR relaxation times of lung tissue were determined in a rabbit model of acute and evolving pulmonary hemorrhage (PH). Pure PH was simulated by injecting blood into a single lobe using endobronchial catheterization. In vitro spectroscopic measurements of T1 and T2 were made and total water content was determined on lung samples that were excised at regular intervals. T1 and T2 were markedly longer in lungs with acute PH than in normal lungs (T1: 818 +/- 44 vs. 643 +/- 4 msec; T2 164.0 +/- 16.3 vs. 88.1 +/- 3.4 msec). Within the first 24 hours, evolving PH was characterized by a rapid and progressive decrease in T1 ( 50%) and T2 (-57%). Up to seven days after the instillation of blood, the T1 (450 +/- 43 msec) and T2 (69.7 +/- 1.9 msec) of lung with modeled PH remained below values of normal lung. The observed shortening of the relaxation times of lung disease with PH was closely paralleled by a decrease in tissue water content. PMID- 3667170 TI - Lactate accumulation in ischemic- and anoxic-isolated rat hearts assessed by H-1 spectroscopy. AB - Proton magnetic resonance (MR) spectroscopy with homonuclear editing was used to assess lactate accumulation in ischemic and anoxic hearts perfused according to the Langendorff method. An increase in the lactate signal was observed after 5 minutes of ischemia and after 10 to 20 minutes of anoxia. This study demonstrates that proton MR spectroscopy can be used to monitor the time course of MR-visible lactate levels in ischemic and anoxic isolated rat hearts. PMID- 3667171 TI - Flow effects in multislice, spin-echo magnetic resonance imaging. Model, experimental verification, and clinical examples. AB - Flowing blood is responsible for a number of complex effects on clinical magnetic resonance (MR) images. To help elucidate these effects, a computer model of a conventional multislice spin-echo pulse sequence was developed. Using TR, TE, and direction of slice acquisition, the model calculates and plots a profile of MR signal intensity vs. z-axis velocity. The model predicts complex profiles with multiple segments of MR signal loss depending on TR, TE, direction of flow, sequence and timing of slice excitation, and slice location relative to adjacent slices. Model predictions were verified by imaging a bulk-flow phantom, consisting of a rotating cylinder filled with a manganese chloride solution with T1 = 840 msec and characterized by a velocity-gradient resolution of 0.23 cm/sec/pixel. In conventional spin-echo MRI of medium and large vessels using body coils, in which the velocity gradients exceed 2-5 cm/sec/pixel, most of the flow artifacts are averaged and are difficult to appreciate. However, bright crescents or rings of MR signal occasionally are seen in the inferior vena cava and portal vein, which the model is invoked to explain. The bulk-flow phantom will find use as a tool for calibrating flow-sensitive pulse sequences when these become widely available. PMID- 3667172 TI - Analysis of dynamic computed tomography scan brain images. AB - Dynamic computed tomography (DCT) of the brain can be used to study the transit time of first passage of a bolus injection of intravenous contrast medium. Comparison of cerebral perfusion with corresponding sites in the left and right cerebral hemispheres is of diagnostic interest because a real difference may be indicative of differential damage. A method for estimating the mean transit time and approximating its standard error, by assuming a gamma function for the response curve and an appropriate error structure, is presented. Expressed as log linear regression, estimation is achieved by maximum likelihood using a statistical package such as GLIM or SPSSX. Statistical comparison of the mean transit time to or between corresponding sites can be made; issues of model fit and biologic interpretation need to be considered as an integral part of statistical inference. These methods enable users of CT equipment (without specific software for estimation of mean transit time) to use any log-linear routine for diagnostic purposes. An example of the fit procedure and interpretation in the light of clinical evidence is given. PMID- 3667173 TI - Combined surface display and reformatting for the three-dimensional analysis of tomographic data. AB - Radiologic examinations increasingly are based on sequences of cross-sectional images. In current clinical applications, the three-dimensional (3D) relationships contained in these examinations must be inferred by the observer through analysis of multiple two-dimensional (2D) images. In this article, methods for the direct display of 3D gray-level data are investigated. In the chosen approach, the 3D presentation of bone and skin surface serves to orient the viewer, while planar reformation and/or transparent projections can be applied for the assessment of soft-tissue structures in regions of interest. The resulting images represent the original image data in a way that is more suitable for observation of 3D relationships than the conventional cross-sectional viewing mode. This may facilitate the diagnostic process and enhance the interpretability of the images. Routine clinical application of this technique requires special computer hardware. Research applications, however, can be performed within tolerable times (10-30 sec/view) with computers found in radiologic research environments. PMID- 3667174 TI - Albumin labeled with Gd-DTPA. An intravascular contrast-enhancing agent for magnetic resonance blood pool imaging: preparation and characterization. AB - A paramagnetic-labeled macromolecule, albumin-(Gd-DTPA), was prepared for use as an intravascular contrast agent for magnetic resonance imaging. An average of 19 Gd-DTPA chelates were covalently conjugated to human serum albumin through the bifunctional anhydride of DTPA. The albumin-(Gd-DTPA) was characterized with use of high-performance liquid chromatography, sodium dodecyl sulfate gel electrophoresis, atomic absorption, biuret and Bradford protein tests, and by its effect on proton relaxation (relaxivity). The average molecular weight was 92,000 daltons, indicating the albumin conjugate was predominantly monomeric. The T1 relaxivity of albumin-(Gd-DTPA) was 273 mM-1 sec-1 relative to carrier concentration, which corresponds to a relaxivity of 14.9 mM-1 sec-1 relative to gadolinium concentration. The average conditional stability constant for albumin bound Gd-DTPA chelate was log K = 20.0. Spin-echo images of rats demonstrated persistent enhancement of vascular tissues and slowly flowing blood. Application of albumin-(Gd-DTPA) may augment the MR assessments of blood volume, tissue perfusion, and flow characteristics. PMID- 3667175 TI - Computed tomography, magnetic resonance imaging, and pathologic observations of the effects of intrathecal metrizamide and iohexol on the canine central nervous system. AB - A two-group crossover design experiment was used in eight dogs to compare the effects of intrathecally injected (0.25 mL/kg, 180 mg I/mL) metrizamide and iohexol. Additional acute observations were made in four of the dogs following a high dose (0.45 mL/kg of 300 mg I/mL) of each agent. In computed tomographic observations, there was progressive passage of each contrast medium across the interface between the cerebrospinal fluid and the brain, and statistically identical levels of each contrast medium were present in the cerebral gyri. There was a similar passage of contrast medium across the interface between the cerebrospinal fluid and the spinal cord. The rate of passage of each agent into the brain parenchyma suggested their active transport rather than a simple diffusion. In both T2-weighted magnetic resonance imaging and histopathologic studies, there was no evidence of cerebral edema following either high or low doses of each agent. In T1-weighted images made following the intravenous injection of gadolinium-DTPA (0.1 mmol/kg), the blood-brain barrier was intact. PMID- 3667176 TI - The case for radioprotective eyewear/facewear. Practical implications and suggestions. AB - Numerous eyeglass lens materials have been recommended for protection of radiologists' eyes from the cataractogenic effect of radiation during fluoroscopic procedures. For the most part, these lenses coincidentally attenuate x-ray beams because they contain elements of high atomic number that are added to increase refractive index. With a bean hardened to simulate scatter, direct transmission ratios were measured for 32 commercially available lens materials. Scatter to the eye, both through and around the glass lenses and secondary scatter to the eye from the radiologist's head, was determined with lenses mounted on a head phantom and a 1-cm3 ion chamber in the position of the eye. Transmission ratios for the various lenses ranged from 3% to 98% for an 80 kVp x ray beam (HVL = 4.5 mm Al). Measurements with the head phantom in place show that secondarily scattered radiation from the fluoroscopist's head contributes significantly to ocular exposure. Optimal radiation protection of the eyes during fluoroscopy depends not only on eyeglasses with leaded glass, but also on shielding of sufficient size and shape to reduce exposure to the surrounding head. PMID- 3667177 TI - Medical concerns for the adolescent athlete. PMID- 3667178 TI - Preparticipation sports evaluation. PMID- 3667179 TI - Physicians' role in high school athletics. PMID- 3667180 TI - Implementing minimal weight prediction equations for Iowa high school wrestlers. PMID- 3667181 TI - Systemic fluoride supplements for Iowa children: the physician's role. PMID- 3667182 TI - Sports medicine. PMID- 3667183 TI - The fluoroquinolone antibiotics: clinical indications and implications of several new derivatives of nalidixic acid. PMID- 3667184 TI - Lack of homology among potexvirus RNAs. AB - Representative cDNAs prepared against each of five different potexvirus RNAs were annealed to these and other viral RNAs to assess the extent to which these viruses might be related. In all cases, the cDNA hybridized to completion with its homologous RNA but failed to cross-hybridize significantly to any other viral RNA. Partial hybridization was detected when the cDNA of one virus was annealed to the RNA of a distinct strain of the same virus. We conclude that despite their morphological similarities, members of the potexvirus group have diverged substantially in nucleotide sequence. PMID- 3667185 TI - Exploratory numerical taxonomy based on biochemical and biophysical characters of the tymoviruses. AB - Three different exploratory analytical techniques, principal components analysis, reciprocal averaging and cluster analysis, were used to examine taxonomic relationships among the tymoviruses. The three techniques gave similar but not identical interpretations of the interrelationships within this group. Exploratory numerical analyses were useful in assessing relatedness, and they suggest that andean potato latent virus is misclassified as a strain of eggplant mosaic virus. PMID- 3667187 TI - Maturation of human immunodeficiency virus, strain LAV, in vitro. AB - The budding process of human immunodeficiency virus (HIV), strain LAV, starts with the formation of a crescent electron-dense layer directly underneath the cell membrane of infected CCRF-CEM cells. After completion of the formation of the circle of inner dense layer, immature virions with an electron-lucent center are released from the cells. Serial thin sections and stereo observation of thick sections showed that most of the immature virions adjacent to the cell surface had already come off the cell and some still had very thin connections to the cell. However, on rare occasions, virions at an intermediate stage between immature stage and mature virions with bar-shaped electron-dense cores were observed. Virions with dense cores were never observed to be connected to the cell surface. These observations support the idea that the last step of the maturation of HIV occurs outside the cell and that the electron-dense core seems to develop by rearrangement and dispersion of the substance of the inner dense layer of immature virions. PMID- 3667186 TI - Relation between HBsAg binding with polymerized human serum albumin and HBV replication. AB - The binding between hepatitis B surface antigen (HBsAg) and polymerized human serum albumin (poly-HSA) was studied in HBsAg-negative (25) and HBsAg-positive (92) sera by a sensitive enzyme-linked immunosorbent assay technique, and a correlation of binding activity was made with HBe-markers and hepatitis B virus specific DNA polymerase. The binding could be detected only in HBsAg-positive sera and was found to be independent of the presence of HBe-markers and DNA polymerase activity. Further, binding was noted in significantly higher proportions of sera samples from the patient group compared with the healthy carrier group (p less than 0.01). PMID- 3667188 TI - The response of the normochromic normocytic anaemia of chronic renal failure to desferrioxamine. PMID- 3667189 TI - Perinatal mortality. PMID- 3667190 TI - Poisoning by hemlock water dropwort. PMID- 3667191 TI - Strike and the medical profession. PMID- 3667192 TI - Chronic lung disease in a neonatal intensive care unit: 8 years experience. PMID- 3667193 TI - Campylobacter jejuni: a common cause of gastroenteritis in rural Ireland. PMID- 3667195 TI - Excessive head growth in early infancy: a feature of Sotos' syndrome. PMID- 3667194 TI - Basilar artery occlusion following chiropractic cervical manipulation. PMID- 3667196 TI - Elevated serum and mononuclear leukocyte thymidine kinase activities in patients with cancer. PMID- 3667197 TI - Blood samples in newborn infants. PMID- 3667198 TI - Chlormethiazole dosage. PMID- 3667199 TI - Mycobacterium tuberculosis hominis infection and AIDS. PMID- 3667200 TI - Perimortal initiatives: issues in foregoing life-sustaining treatment, suicide, and assisted suicide. PMID- 3667201 TI - Defining suicide. PMID- 3667202 TI - Sanctioned assisting suicide: impact on family relations. PMID- 3667203 TI - Results of reoperation for failure of cardiac bioprostheses. AB - A ten-year experience with reoperations for failure of cardiac bioprostheses is reported. 362 patients were operated for valve replacement with 412 bioprostheses. There were 35 (9.64%) reoperations for valve failure. Mean time between operation and reoperation was of 64.4 months. Operative mortality was 14.28%: 3 patients died for cardiac and 2 for extra-cardiac causes. Long-term mortality after reoperation was 6.25%. Morphological examination of the explanted bioprostheses confirmed the cause of bioprosthetic valve failure, due to calcific degeneration in 88.88% of case, to post-endocarditic rupture in 5.55% and to prosthetic thrombosis in 2.77%. The importance of timing reoperation is stressed in order to reduce the operative mortality. The conditions suitable for implantation of bioprostheses are listed. PMID- 3667205 TI - Surgical therapy in "early gastric cancer". AB - Regarding early gastric cancer (E.G.C.) some authors propose total gastrectomy while others believe that partial resection is the best solution especially when the site is in the distal portion. The histological characteristics of E.G.C. in 49 patients were examined: 95.9% of the EGCs were found in the antropyloric region and 4.1% in the corpus-fundus. 47 patients were submitted to distal gastrectomy and 2 to total gastrectomy due to localization in the fundus. The overall survival rate after 5 yrs. is 83%. The incidence of the antropyloric localization, the rarity of metastases to the lymph node stations of the 2nd and 3rd level, the way in which intramural spread, occurs and, above all, the optimal survival rate obtained after partial resection, indicate that partial gastrectomy for distal gastric tumors is a radical operation, with a low surgical mortality rate, followed by a prolonged symptom-free survival. PMID- 3667204 TI - Complications following surgery for severe head injury. AB - The number of patients who survive, after severe head injuries, is becoming more and more consistent due to the remarkable progress made in intensive care and rehabilitation units. The aim of this study is to identify, in addition to direct structural damage, medical and neurological problems and describe their frequency within a group of patients with severe head injuries. Neurologic, metabolic, gastrointestinal, genitourinary, respiratory, cardiovascular, cutaneous and endocrinologic problems were more frequently found. All these problems, which were identified during the first month after head injury, are discussed regarding their clinical significance, therapeutic approach, and morbidity. PMID- 3667206 TI - One-stage operation for diverticular disease. AB - The experience with 59 patients affected by diverticular disease who underwent surgery after failure of medical treatment, is reported. 40 patients showed one or more postoperative complications, 19 none. The operations performed were: in 46 cases one-stage resection with anastomosis, Hartmann's operation in 8 and other procedures in 5. Six patients died: 3 after Harmann's operation, 2 after colostomy and one after anastomosis. The mean stay in bed for complicated cases was 24 days after anastomosis and 36 after Hartmann's operation. Therefore anastomosis is preferred in all cases including those with stenosis, fistula or abscess provided that peritonitis is not present. The anastomosis is performed away from the site of abdominal sepsis. In cases with peritonitis the selected surgical procedure is usually Hartmann's operation. PMID- 3667207 TI - Laparotomy and splenectomy for Hodgkin's disease: a 12-year experience. AB - A 12-year experience with 154 laparosplenectomies for Hodgkin's lymphoma is reported. In 92 patients the clinical staging was confirmed, in 48 it was worsened, while in 14 it was improved. Therefore it is concluded that laparosplenectomy is still necessary for a proper assessment of clinical staging as well as for a correct therapeutic approach and prognosis in Hodgkin's lymphoma. PMID- 3667208 TI - Management of liver trauma. AB - A ten-year experience with the management of liver trauma is reported. The diagnostic approach is examined, stressing the role of selective arteriography. The management of the 78 observed cases is described. The need for biliary drainage to prevent postoperative leakages, is supported. Overall mortality in this series was 16.6%. PMID- 3667209 TI - Common bile duct exploration in a Libyan hospital. Utilization of choledochoscopy in an effort to improve results. AB - Over a three-year period, 849 patients had a cholecystectomy for gallstones, at the Central Hospital, Tripoli, Libya. In 133 patients the common bile duct was explored. Under the particular circumstances in which the operation is performed, choledochoscopy was shown to have important advantages to the patient in both locating common duct stones and in ensuring that none is left behind. PMID- 3667210 TI - Carcinoma arising in previously partially excised congenital choledochal dilatation. Case report and review of literature. AB - A 20-year-old man with congenital choledochal dilatation associated with carcinoma was treated. At the age of 10 years he underwent a cholecystectomy and partial resection of the cyst. At admission the patient complained of hypochondriac and back pain combined with bilious vomiting. He underwent a palliative operation. A review of the literature is presented on treatment and prognosis of patients with carcinoma arising in choledochal congenital dilatation previously treated by surgery other than excision. It is emphasized that the cystic dilatation should be removed at the time of the first operation. Furthermore, in patients who underwent surgical treatment without excision of the choledochal dilatation, the dilated biliary tract should be removed even in absence of subjective symptoms. PMID- 3667211 TI - A rare case of mucous-secreting villous adenoma of the bladder. AB - A case of mucous-secreting villous adenoma of the urinary bladder associated with cystitis glandularis is reported which led to radical cystectomy because of the extensive bladder involvement. An immunohistochemical study was performed in order to detect ABH tissue antigens. The histogenesis and the possible malignant potential of this neoplasm are discussed. PMID- 3667212 TI - Lingual thyroid. A case report. AB - Lingual thyroid is a rare example of ectopic thyroid involving major problems in diagnosis, surgical approach and operative procedure. A case is presented with wide review of the literature. The personal operative procedure performed through the oral route is described. PMID- 3667213 TI - The Sixth International Congress of the International Organization for Mycoplasmology (IOM). 26 to 31 August 1986, Birmingham, AL, USA. Proceedings. PMID- 3667214 TI - Identification of a repetitive genomic sequence that is distributed among a select group of mycoplasmas. AB - Homologous DNA sequences common to different Mycoplasma species were identified and isolated using interspecies DNA hybridization. Specific homologies were found in three species of porcine mycoplasmas that were not detected in species from other animal hosts. Restriction fragments bearing these common sequences were isolated from genomic libraries of M. hyorhinis and M. hyopneumoniae, and DNA sequence analysis confirmed the sequence conservation predicted from hybridization studies. Multiple homology signals were detected by probing M. hyorhinis genomic digests with the isolated restriction fragments, suggesting that these common sequences are present in many copies in that species. The repetition of this sequence is, however, more limited in the other porcine mycoplasma chromosomes. PMID- 3667215 TI - Sealed vesicles prepared by fusing Mycoplasma gallisepticum membranes and preformed lipid vesicles. AB - Sealed vesicles were obtained by fusing Mycoplasma gallisepticum membranes with asolectin-cholesterol vesicles. The fusion was induced by freezing and thawing followed by a brief sonication treatment and was detected using a fluorescence sedimentation behavior in a sucrose density gradient and were shown to be impermeable to small solutes. The advantages of such fused preparations for transport studies in mycoplasmas are discussed. PMID- 3667216 TI - Kinetics of cholesterol and phospholipid exchange between mycoplasma membranes and lipid vesicles. AB - The following modifications in the lipid composition of Mycoplasma gallisepticum or M. capricolum membranes led to changes in the rates of [14C]cholesterol and [14C]phospholipid exchange between cell membranes and an excess of small unilamellar vesicles: 1) increase in the cholesterol/phospholipid molar ratio from 0.25 to 0.92; 2) incorporation of synthetic, cross-linked phosphatidylethanolamine (PE) derivatives, 3) incorporation of sphingomyelin (SPM); and 4) increase in the phosphatidylglycerol/cardiolipin ratio of M. capricolum cell membranes by supplementing the growth medium with 0.5 mM CaCl2 CaCl2, and decrease in this ratio by supplementing the growth medium with 0.5 mM CaCl2 and 20 micrograms/ml egg phosphatidylcholine or with isopalmitic acid. The rates of radiolabeled lipid exchange decreased when the content of cholesterol, cross-linked PE, or SPM increased, indicating an inverse correlation between exchange rate and membrane lipid order. This is consistent with an exchange mechanism that involves the slow dissolution of the lipid from the surface of the donor particle. Lipidic particles appeared in trypsin-treated M. capricolum membranes obtained from cells grown with both Ca2+ and PC, whereas the hexagonal II phase appeared in membranes from cells grown with Ca2+. Cholesterol and phospholipid exchange rates were enhanced under the conditions in which the bilayer structure was destabilized by transitional states between the lamellar and hexagonal-II phases. Thus, mycoplasmas are well suited for examination of the influence of membrane lipid composition on rates of lipid exchange between membranes. PMID- 3667217 TI - Calorimetric studies of the thermotropic phase behavior of cells, membranes and lipids from fatty acid-homogeneous Acholeplasma laidlawii B. AB - We have investigated the comparative lipid thermotropic phase behavior of intact cells, isolated membranes and total membrane lipid dispersions from fatty acid homogeneous Acholeplasma laidlawii B by high-sensitivity differential scanning calorimetry. We find that the gel to liquid-crystalline phase transition temperature, enthalpy and degree of cooperativity are essentially identical in viable cells and isolated membranes and that these parameters are not affected by the thermal denaturation of the cellular or membrane proteins. In contrast, the extracted lipid dispersions, although having the same phase transition temperature, exhibit a greater enthalpy and a reduced cooperativity than do the lipids in cells or membranes. These results imply that lipid organization is identical in cells and isolated membranes, but different in the derived model membrane, probably due to the influence of membrane proteins and/or the presence of lipid bilayer compositional asymmetry in cells and membranes. We also demonstrate for the first time the existence of gel state polymorphism in a biological membrane. PMID- 3667218 TI - Isolation of a virus from Mycoplasma pulmonis. AB - A virus designated mycoplasma virus P1 has been isolated from Mycoplasma pulmonis. The virus infects M. pulmonis strain UAB 6510, and a plaque-forming unit assay has been developed. P1 has a tailed, polyhedral morphology with a head diameter of about 28 nm. Nucleic acid isolated from crude preparations of P1 virus contains double-stranded RNA, suggesting that P1 may be the first example of an RNA-containing mycoplasma virus. PMID- 3667219 TI - Cloning and sequencing of the genome of spiroplasma virus 4. AB - Spiroplasma virus 4 (Sp V4) has a circular single-stranded DNA. The replicative form (RF) of Sp V4 has been purified from infected cells of Spiroplasma melliferum, strain G1, and cloned in Escherichia coli (HB101) using plasmid pBR328 as the vector. The cloned RF was shown to be infectious by transfection. The Sp V4 RF was randomly subcloned in E. coli (TG1) using the M1 3 mp8 RF as the vector and sequenced by the dideoxy chain termination technique. We found that UGA is probably not a termination codon, but codes for tryptophan. Eight open reading frames, including that for the 65,000-dalton capsid protein, have been detected; they involve all three reading frames. PMID- 3667220 TI - SpV3 viruses of Drosophila spiroplasmas. AB - The presence of spiroplasmas in the hemolymph of four Drosophila willistoni group species has been shown to cause elimination of males from the progeny of infected females. These spiroplasmas, known as sex-ratio organisms (SROs), are found in D. equinoxialis (ESRO), D. nebulosa (NSRO), D. paulistorum (PSRO), and D. willistoni (WSRO). In addition, a nonmale-lethal spiroplasma (HIS) has been found in the hemolymph of D. hydei. Only the WSRO has been cultivated. Each of the Drosophila spiroplasmas sheds at least one endogenous virus into the hemolymph by a budding process. These viruses are short-tailed polyhedrons resembling the SpV3 virus of Spiroplasma citri, and all have been shown to lyse at least one other strain of SRO. The Drosophila spiroplasma viruses have been extracted from infected flies and purified by metrizamide gradient centrifugation. The viruses, thus purified, maintained infectivity and lysed indicator strains of SROs. Electrophoresis of viral DNA produced bands indicating genomes of three different sizes: 17, 21.8, and greater than 30 kbp. Some SRO strains have more than one SpV3 virus. Restriction endonuclease digestion of DNA of the spiroplasma viruses HSV and NSV (both 21.8 kbp) produce patterns on agarose gels that indicate linear, circularly permuted genomes. The fragments generated by cleavage of NSV with EcoRI have been cloned into pBR325 and amplified in Escherichia coli. Restriction endonuclease digestion of NSV DNA hybridized with these clones indicates that there are two different 21.8-kbp SpV3 viruses in NSRO. PMID- 3667221 TI - Amphiphilic properties of spiralin, the major surface antigen of spiroplasmas. A preliminary report. AB - Spiralin, a 28-kDa (kilodalton) polypeptide, is the major antigen of Spiroplasma citri and S. melliferum in which it usually represents more than 20% of total membrane protein. The amino acid compositions of the spiralins purified from both spiroplasma species unambiguously show that these proteins are homologous. In addition, several lines of evidence indicate that such a protein is present in the menbrane of S. apis. A 25-kDa polypeptide antigenically related to S. citri spiralin has also been purified from the membrane of the nonhelical variant ASP 1. The spiralin of S. melliferum B88 has been used as a model for extensive characterization. This antigen binds detergent under nondenaturing conditions, can be incorporated into liposomes, and forms protein micelles upon gentle removal of detergent. Digestion of the micelles with trypsin leads to the precipitation of an insoluble material containing a major polypeptide of 3.9 kDa. The amino acid composition of this fragment is different from that of intact spiralin. It is highly enriched in glycine and serine and, as an insoluble peptide, exhibits an unexpectedly high polarity index (PI = 51.4%). Screening for acyl proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunodetection in the membrane of S. melliferum indicates that spiralin is actually acylated. This set of properties is evidence that spiralin is an intrinsic membrane protein and strongly suggests that acylation triggers or facilitates integration of the molecule into the lipid bilayer of the spiroplasma membrane. PMID- 3667222 TI - Mycoplasma pulmonis proteins common to murine mycoplasmas. AB - The proteins of Mycoplasma pulmonis were examined by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and immunoblots using the following sera: antimedium, anti-M. arthritidis, anti-M. collis, anti-M. neurolyticum, and anti-M. muris. Fifteen proteins identified as genus-common were shared by M. pulmonis and at least one other mycoplasmal species. These proteins were shown not to be medium components, based on their reaction with antimedium serum. PMID- 3667224 TI - The Sixth International Congress of the International Organization for Mycoplasmology (IOM). 26 to 31 August 1986, Birmingham, AL, USA. PMID- 3667223 TI - Correlation of Mycoplasma-pulmonis-mediated hemolysis with translocation of a fluorescent cholesterol probe. AB - The relation between Mycoplasma pulmonis-mediated hemolysis and translocation of a unique fluorescent cholesterol probe was examined. The probe, cholesteryl 12(4 methyl-7-nitrobenz-2-oxa-1,3-diazole) dodecanoate, had fluorescent properties, which permitted microscopic assessment of probe transfer. Significant translocation occurred only after trypsin treatment of the erythrocyte, and the rate of transfer was increased in the presence of bovine serum albumin. This correlated with the previously reported hemolytic activity of M. pulmonis, thus relating the two activities and permitting their integration into a mycoplasma eukaryotic cell-cell interaction model. PMID- 3667225 TI - Animal models of Mycoplasma genitalium urogenital infection. AB - Male and female animals were inoculated urogenitally with Mycoplasma genitalium, recovered originally from men with nongonococcal urethritis. Mice, hamsters and male rhesus monkeys (Macaca mulatta) were resistant. Male cynomolgus monkeys (Macaca fascicularis) were not as sensitive as male chimpanzees (Pan troglodytes): 9 of 11 developed an obvious genital tract infection, some shedding organisms for more than 18 weeks. M. genitalium was recovered from the blood of two of them when large numbers of organisms were in the urethra. Most of the chimpanzees colonized with the organisms had increased numbers of polymorphonuclear leukocytes in the genital tract and developed a fourfold or greater antibody response. Female squirrel monkeys (Saimiri sciureus) and female tamarins (Saguinus mystar) exhibited low-level genital tract infections following intravaginal inoculation, whereas marmosets (Callithrix jacchus) and chimpanzees developed prolonged infections after similar inoculation; thus, female chimpanzees shed organisms for 12 to 15 weeks. Marmosets and grivet monkeys (Cercopithecus aethiops) developed salpingitis with antibody responses after intraoviduct inoculation, and baboons (Papio anubis) developed parametritis after intracervical inoculation. The results offer substantial evidence for the pathogenicity of M. genitalium for the urogenital tract of subhuman primates, and suggest that the microorganism may have a role in human genital tract infections. PMID- 3667226 TI - Ureaplasma-urealyticum-induced bladder stones in rats and their prevention by flurofamide and doxycycline. AB - Struvite calculi can be produced in the bladder of Sprague-Dawley male rats after injection of ureaplasmas into the renal medulla. Calculi appear 3 to 6 days after ureaplasma injection. We have studied the inhibitory effect of flurofamide, a potent inhibitor of Ureaplasma urealyticum urease, and doxycycline, on the formation of bladder stones. Flurofamide given orally in five doses (total 125 mg) over 3 days and doxycycline in seven doses (total 20 mg) over 4 days partially prevented stone formation only when given at the time of inoculation. Ureaplasmas disappeared rapidly from the urine. The inhibitory effect of flurofamide was higher than that of doxycycline. However, doxycycline seemed to be efficient when given for a long period (5 weeks). PMID- 3667228 TI - Western blot analysis of the human serum response to Mycoplasma hominis. AB - Mycoplasma hominis is a human genital pathogen with importance in postpartum pregnancy complications (postpartum fever/endometritis). Previous research has suggested that serum antibody levels to M. hominis are important in predicting which groups of women are at risk. M. hominis strain PG21 was examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blots to determine which protein antigens would be good candidates for use in serologic tests. Western blots of strain PG21 were probed with acute and convalescent human sera from patients with culture-confirmed M. hominis infections, animal sera directed against strain PG21 and other M. hominis strains, and sera from patients with confirmed infections from other sexually transmitted diseases (STD). Western blot analysis showed that the prenatal (Groups I, II, III) and convalescent (Group IV) M. hominis human sera reacted with proteins with apparent MWs of 106, 67, 46, and 40 kilodaltons (kDa). Only the convalescent sera (Group IV) and the prenatal sera (Group III) reacted with proteins having apparent MWs of 58 and 50 kDa. Animal antisera directed against all strains of M. hominis examined showed that these proteins were reactive in all strains, and other STD human sera did not react with proteins in strain PG21 corresponding to the apparent MWs of 50 and 58 kDa. Preliminary evidence suggested that proteins with the apparent MWs of 50 and 58 kDa may be viable candidates for use in serologic tests for the detection of human anti-M. hominis antibodies and help to eliminate cross reactivity observed with whole-cell lysates. PMID- 3667227 TI - Analysis of protein antigens of Mycoplasma hominis: detection of polypeptides involved in the human immune response. AB - Immunoblotting of polypeptide antigens after polyacrylamide gel electrophoresis was used to analyze clinical strains of Mycoplasma hominis. There was increased antibody titer for polypeptides comprising a wide range of molecular sizes between paired sera obtained from patients with indication of invasive infection. Eight of these antigens were shown to be candidate surface antigens. Absorption of hyperimmune rabbit serum with intact cells resulted in elimination or reduction in intensity of bands for these molecules. The antigens p115 and p98 appeared to be present in each of six clinical strains that were compared by reaction with the reference rabbit antiserum. There was considerable diversity of migration position for the remaining antigens in the profiles of these six strains. PMID- 3667229 TI - Comparison of caprine mycoplasmosis caused by Mycoplasma capricolum, Mycoplasma mycoides subsp. mycoides, and Mycoplasma putrefaciens. AB - We reviewed the disease process in goats caused by Mycoplasma capricolum, M. mycoides subsp. mycoides, and M. putrefaciens and compared mycoplasma-infected goats (particularly young kids) for microanatomic changes. M. capricolum and M. mycoides subsp. mycoides cause a nearly identical disease: septicemia leading to pyrexia, high morbidity and mortality, interstitial pneumonia, arthritis (including polyarthritis), and mastitis. Until recently, M. putrefaciens was known only as a cause of mastitis. However, a new isolate of M. putrefaciens may be transiently septicemic, as evidenced by polyarthritis with isolations from joints, lung, brain, kidney, pleural fluid, uterus, and urine. PMID- 3667230 TI - Comparison of enzyme-linked immunosorbent assay (ELISA) and indirect hemagglutination (IHA) in experimental Mycoplasma hyopneumoniae infection of pigs. AB - Twenty-five hysterectomy-derived piglets were infected intratracheally at 16 days of age with a field strain of Mycoplasma hyopneumoniae. Twenty uninfected piglets constituted the control group. Clinical symptoms were noted daily and sera collected weekly. The 45 pigs were killed from 1 to 20 weeks after infection. M. hyopneumoniae induced a temperature response, coughing and pneumonia. After 10 weeks, a noticeable regression of the macroscopic lung lesions was observed. The infection was followed by an antibody response, and the antibody titers reflected the disease stages. ELISA appears to be the most sensitive procedure to detect early and late antibody production. PMID- 3667231 TI - Early serological responses to Mycoplasma hyopneumoniae infection. AB - A complement fixation (CF) test for Mycoplasma hyopneumoniae antibody, using the complement dilution method, will detect infection in inoculated pigs at an early stage. The interval between inoculation and the first positive CF response- defined as 4.6 u of complement fixed--was determined for four separate methods of inoculation and for pigs with artificially induced pneumonia. Sera from two groups were tested by the enzyme-linked immunosorbent assay (ELISA). By CF, the i.v. group showed positive titers at 9.8 +/- 0.4 (mean +/- SE) days. All pigs in this group had positive titers, most of them at the maximum level of 31 u fixed. The i.p. group first showed positive titers at 13.3 +/- 1.0; 17 of 70 had no CF response. The s.c. group first showed titers at 21.1 +/- 2.6; 7 of 24 did not respond. Intranasal inoculation first produced a CF response at 14.3 +/- 0.9, and all pigs had positive titers. Pigs in contact with those with induced pneumonia first showed titers at a mean of 27.2 days (SE +/- 1.3), and all pigs exhibited a CF response. There was no significant difference between the CF test and ELISA results. PMID- 3667232 TI - Cross-reactions between Mycoplasma hyopneumoniae and Mycoplasma flocculare- practical implications for the serodiagnosis of mycoplasmal pneumonia of swine. AB - Previous studies using hyperimmune antisera revealed significant serologic cross reactions between Mycoplasma hyopneumoniae and M. flocculare. These findings, coupled with observations that M. flocculare infection may be widespread, indicated that antibodies to M. flocculare might be common in swine sera and thus cause nonspecific reactions in serodiagnostic tests for mycoplasmal pneumonia of swine (MPS). Information reported here indicates that this premise may be invalid. Twenty-one swine were infected experimentally with M. flocculare. Sera were collected every 2 weeks and tested against M. flocculare and M. hyopneumoniae antigens in an enzyme-linked immunosorbent assay (ELISA). Immunoassays against M. flocculare revealed that swine were slow to seroconvert, and that seroconversion was characterized by low titers. Significantly, none of the sera reacted with M. hyopneumoniae. M. hyopneumoniae reference antisera, and sera from swine naturally infected with M. hyopneumoniae and M. flocculare were also evaluated by an antibody inhibition procedure, i.e., sera were mixed with M. hyopneumoniae or M. flocculare antigen, incubated overnight and tested against M. hyopneumoniae antigen in the ELISA. Treatment with M. hyopneumoniae antigen markedly reduced or abolished seroreactivity, whereas treatment with M. flocculare antigen had little effect. These findings suggest that swine infected with M. flocculare usually do not develop sufficient levels of antibodies to detract from the specificity of the ELISA used to diagnose MPS. PMID- 3667233 TI - Use of monoclonal antibody in an enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies against Mycoplasma hyopneumoniae. AB - A double-sandwich ELISA using monoclonal antibody (McAb) has been developed for the detection of swine antibodies against Mycoplasma hyopneumoniae. McAb recognizing a 46-kilodalton (kDa) component of M. hyopneumoniae was employed for coating polystyrene microplate wells. In a comparison, the double-sandwich ELISA and complement fixation (CF) test antibodies were detected at almost the same time by both methods; however, ELISA antibodies persisted for a longer period than those detected by the CF test. In naturally infected pigs, passively acquired maternal antibodies were detected in piglets 1 to 2 months following birth. Antibodies produced by piglets were first detected at 3 to 4 months of age. The use of McAb improved sensitivity, specificity, and reproducibility of the ELISA for the diagnosis of mycoplasmal pneumonia of swine. PMID- 3667234 TI - Effect of nutrients and metabolic inhibitors on the growth of spiroplasmas. AB - Glycolytic intermediates replaced glucose as carbohydrate sources in a chemically defined medium CC-494N, whereas keto acids of citric acid cycle intermediates and glyoxylate were supplemented with 10 mM glucose. Glucose-6-phosphate, fructose 1,6-bisphosphate, 3-phosphoglyceraldehyde, and pyruvate supported limited growth for Spiroplasma floricola (23-6), whereas only pyruvate supported SR 3 spiroplasma and S. melliferum (AS 576). alpha-Ketoglutarate at 5 mM or greater, hematin, 2,4-dinitrophenol, sodium fluoride, and arsenite were dramatically inhibitory, whereas acetic anhydride, tricarballylate, acetylene dicarboxylate, and sodium cyanide were mildly inhibitory at 10 mM or lower. Malonate at 50 mM was not inhibitory. PMID- 3667235 TI - Spiroplasmas: gene structure and expression. AB - Upon sequencing of the SpV4 genome, eight putative open reading frames (ORFs) including that for the 65-kilodalton (kDa) capsid protein were detected. They involve all three reading frames. Three promoter sequences were found, as well as a transcription terminator and the initiation site for complementary strand synthesis. Ribosome binding sites and regulatory sequences are closely related to those of Eubacteria. Codon usage analysis showed that A and T terminated codons are preferably used. UAA is the major termination codon. Upon cloning of the full size SpV4 replicative form, the capsid protein gene could not be expressed in Escherichia coli, whereas the spiralin gene cloned in the same bacterium is expressed. These results suggest that in spiroplasmas, as in Mycoplasma capricolum, UGA is not a termination codon, but very probably codes for tryptophan. Spiralin contains no tryptophan. Hence, its gene contains no UGA codons and can thus be expressed in E. coli. On the other hand, the gene for capsid protein has nine UGA codons and cannot be fully expressed in the bacterium. Our results fully support the bacterial origin of spiroplasmas. PMID- 3667236 TI - Towards monoclonal antibodies against the apple proliferation mycoplasma-like organism. AB - A 6-week-old female BALB/c mouse was immunized with a preparation of partially purified sieve tubes of periwinkle (Catharantus roseus) plants infected with the apple proliferation mycoplasma-like organism. After fusion of the immunized spleen cells with myeloma cells, the supernatant fluids of the resulting hybridoma cultures were screened for the presence of antibodies in a differential avidin-biotin enzyme-linked immunosorbent assay (ELISA) using sieve tube preparations from either healthy or infected periwinkles as antigens. One hybridoma clone, giving a negative ELISA with the sieve tube preparation from healthy plants and a positive ELISA with that infected ones, was selected. This hybridoma also gave a negative ELISA when tested against sieve tube preparations from periwinkles affected by citrus greening or Spiroplasma citri, but a positive ELISA when tested against phyllody-affected sieve-tube preparations. PMID- 3667237 TI - Characterization of some new insect-derived acholeplasmas. AB - Further analysis of three sterol-nonrequiring Mollicutes (strains PS-1, TAC, and YJS) isolated from gut fluids of insects confirms their similarity to Acholeplasma. They are serologically distinct from acholeplasmas of vertebrates and several other sterol nonrequiring Mollicutes isolated from plant surfaces. The PS-1 strain had a DNA G + C content of 31 mol % and a genome size of 1,030 megadaltons (MDa). Optimum temperature is in the range of 23 to 30 C. Thirty-two new nonhelical Mollicutes isolated from a much wider range of insect hosts were examined for acholeplasmas. Twenty-five of the insect isolates were grown consistently in serum-free broth, with or without Tween 80 supplements. Two of the acholeplasmas were serologically related to Acholeplasma florum, 13 strains were serologically identical to the TAC isolate reported earlier, and 10 of the putative acholeplasmas could not be identified with current reference antisera. Seven of the new nonhelical insect isolates appeared to be sterol-requiring Mollicutes. One sterol-requiring isolate (ELCN-1) was recovered from the hemolymph of a firefly, and is the first report of nonhelical Mollicutes in the insect hemocoel. Two of the seven sterol-requiring Mollicutes, which were nonhelical in earlier passages in broth, later reverted to typically helical spiroplasmas. Confirmation of sterol-requiring, nonhelical Mollicutes in insects would provide an important ecological finding that insects constitute an important reservoir for both acholeplasmas and mycoplasmas. PMID- 3667238 TI - Detection of bovine serum antibody specific to Mycoplasma bovis and Mycoplasma californicum by enzyme-linked immunosorbent assay (ELISA). AB - ELISA for use in epidemiologic field studies of bovine mastitis, were developed to measure serum antibody to Mycoplasma bovis and M. californicum. Varying levels of serological cross-reactivity to seven heterologous bovine mycoplasmal species were demonstrated in each assay. Cross-reactivity was minimized by preincubation of cattle sera with suspensions of heterologous mycoplasma antigens, prior to measuring serum antibody to solid-phase antigen. Heterologous absorption improved the immunological specificity of the assays while avoiding the need to prepare species-unique antigens. Serum antibody was measured at one serum dilution. Test results were expressed as a ratio of the reactivity of a positive and a negative reference serum. A negative reference population (n = 127) was assembled. The percentile distribution of ELISA reactivity of these 127 sera were used to establish the classification criteria for each assay. The statistical methods used, while easily applied, were found to be sensitive to outlying values in the reference population. The resulting classification criteria provided controlled or known probabilities of false-positive misclassification in the two ELISA test systems. Sera from cattle with defined exposure histories were tested and classified according to these criteria. PMID- 3667239 TI - Spiroplasma citri detection by enzyme-linked immunosorbent assay (ELISA), culture and dot hybridization. AB - We have used ELISA and culture of spiroplasmas in SP4 or M1A medium to detect Spiroplasma citri in citrus trees, periwinkles (Catharantus roseus) and leafhoppers in Iraq and Syria. On the basis of hundreds of analyses, we have found that the sensitivity of ELISA and culture are of the same order of magnitude. With citrus, both tests are able to detect S. citri in 95% of symptomatic nursery or field trees. The tests are not sensitive enough to reliably detect S. citri in symptomless trees. Therefore, a DNA hybridization technique was developed. The radioactive DNA probe was prepared either with total S. citri DNA or with the cloned DNA fragment carrying the spiralin gene of S. citri. Used in dot hybridization, the probe was able to detect concentrations of S. citri one 100th the size of those revealed by ELISA. PMID- 3667241 TI - Development of a biotinylated probe for the rapid detection of Mycoplasma gallisepticum. AB - Mycoplasma gallisepticum causes respiratory diseases in the form of tracheitis and air sacculitis in chickens and turkeys. It is a major cause of reduced egg production, reduced hatchability, and downgrading of carcasses. Current means of diagnosis depend on the isolation and identification of the organisms, or on serological assays to detect serum antibodies. The evaluation of avian sera for M. gallisepticum antibodies is becoming more difficult to interpret, and thus less useful, due to the increasing use of killed M. gallisepticum vaccines. Maximum efficiency of M. gallisepticum disease control requires a rapid and sensitive identification system. A biotinylated total genome M. gallisepticum DNA probe was constructed by labeling the DNA with biotin-11-dUTP in a standard nick translation reaction. Hybridization reactions with 100 ng/ml of biotinylated probe were capable of detecting 75 ng of M. gallisepticum target-DNA and 1.5 x 10(4) M. gallisepticum/ml within 24 h. The probe did hybridize to other mycoplasma DNAs, but to a greatly reduced degree. PMID- 3667240 TI - Effectiveness of detergents in blocking nonspecific binding of IgG in the enzyme linked immunosorbent assay (ELISA) depends upon the type of polystyrene used. AB - Since nonspecific binding of immunoglobulins to polystyrene is a major factor in the nonspecific reactions observed in the ELISA, we studied the effect of a nonionic detergent (Tween-20) on the binding of human IgG to polystyrene. Pretreatment of polystyrene with detergent did not provide a permanent barrier to adsorption of IgG, because washing with water completely removed the blocking ability of detergents from low-binding plates, but only partially removed the blocking power from high-binding plates. On high-binding plates, human IgG molecules suspended in detergent solution attached to the plastic surface, an effect not seen with low-binding plates. Consequently, the binding power of the plastic that is used greatly affects the ability of nonionic detergents to prevent nonspecific binding of immunoglobulins. PMID- 3667242 TI - Ethical & policy issues in rehabilitation medicine. PMID- 3667243 TI - The moral costs of the Ontario physicians' strike. AB - In a strike to permit extra billing, physicians in Ontario, Canada, sought to balance their concerns for professional autonomy with their primary call to beneficence. But the right to reasonable compensation within a nationalized health care system is not on the same moral plane as the public's right to health care. Having failed to convince either the provincial government or the public of the soundness of their position, Ontario's doctors must now repair the damage done to the relationship with their patients. PMID- 3667244 TI - The noncompliant patient in search of autonomy. AB - From a medical perspective, patients who do not comply with the doctor's orders are usually seen as deviant, and deviance requires correction. But many chronically ill people view their behavior differently, as a matter of self regulation. In this light noncompliance supports people's desires for independence and autonomy, desires that align closely with the therapeutic goals of caregivers. PMID- 3667245 TI - Surgical risks and advance directives. PMID- 3667246 TI - Of monkeys, man and oysters. PMID- 3667247 TI - Pregnancy and prenatal harm to offspring: the case of mothers with PKU. AB - Ethical and legal traditions recognize prenatal duties to avoid harm to offspring. However, applying the harm principle to pregnancy requires a careful balancing of a baby's welfare with a pregnant woman's interest in liberty and bodily integrity. In the case of maternal PKU the mother can prevent harm to her baby by returning to the admittedly unpleasant diet that prevented her from being retarded. Informing, counseling, and access to medical care should be the primary policy. Seizures and forced treatment cannot be justified in this case, and only rarely in other situations. PMID- 3667249 TI - Avoiding conflict in AIDS cases. PMID- 3667250 TI - Drawing the line in brain death. PMID- 3667248 TI - A new threat to pregnant women's autonomy. AB - Courts and legislatures are increasingly being called upon to restrict the autonomy of pregnant women by requiring them to behave in ways that others determine are best for the fetuses they carry. The state should not attempt to transform pregnant women into ideal baby-making machines. Pregnant women make decisions about their behavior in the context of the rest of their lives, with all the attendant complexities and pressures. Our interest in helping future children by improving prenatal care would best be furthered by helping pregnant women to make informed, less constrained choices, not by punishing women or depriving them of choices altogether. PMID- 3667251 TI - Should psychiatrists practice on death row? PMID- 3667253 TI - The impaired physician. PMID- 3667252 TI - The physician as manager of disease. PMID- 3667254 TI - Prevention and control of AIDS--an interim report from the AMA Board of Trustees. PMID- 3667256 TI - Sputum cultures. PMID- 3667255 TI - Symphalangism and its introduction into Hawaii: a pedigree. PMID- 3667257 TI - Health Care Quality Improvement Act of 1986: a personal opinion. PMID- 3667258 TI - Headache may arise from perturbation of brain. PMID- 3667259 TI - Radiographic pathology of the temporomandibular joints, and head pain. PMID- 3667260 TI - Platelet fibrinogen receptors in migraine patients. PMID- 3667261 TI - Aseptic inflammatory meningeal reaction manifesting as a migrainous syndrome. PMID- 3667262 TI - Marijuana and migraine. PMID- 3667263 TI - Viewpoint: food induced "delayed reaction" headaches in relation to tyramine studies. PMID- 3667264 TI - Pattern-shift visual evoked responses in cluster headache. PMID- 3667265 TI - Whiplash and its relationship to migraine. PMID- 3667266 TI - More on ergotamine withdrawal. PMID- 3667267 TI - Sublingual flunarizine may still be effective management for acute migraine headache. PMID- 3667268 TI - Migraine, migrainous, migrainoid ... PMID- 3667269 TI - Measurement uncertainties of long-term 222Rn averages at environmental levels using alpha track detectors. AB - More than 250 replicate measurements of outdoor Rn concentration integrated over quarterly periods were made to estimate the random component of the measurement uncertainty of Track Etch detectors (type F) under outdoor conditions. The measurements were performed around three U mill tailings piles to provide a range of environmental concentrations. The measurement uncertainty was typically greater than could be accounted for by Poisson counting statistics. Average coefficients of variation of the order of 20% for all measured concentrations were found. It is concluded that alpha track detectors can be successfully used to determine annual average outdoor Rn concentrations through the use of careful quality control procedures. These include rapid deployment and collection of detectors to minimize unintended Rn exposure, careful packaging and shipping to and from the manufacturer, use of direct sunlight shields for all detectors and careful and secure mounting of all detectors in as similar a manner as possible. The use of multiple (at least duplicate) detectors at each monitoring location and an exposure period of no less than one quarter are suggested. PMID- 3667270 TI - Determining 222Rn diffusion lengths in soils and sediments. AB - Radon-222 diffusion length has been measured for 28 Danish soils and sediments. Samples were placed in a diffusion column connected to a 222Rn reservoir and the transport of 222Rn through the column was measured. The diffusion length was found by comparing the measured data to time-dependent diffusion theory. Dry silt, sand and gravel materials showed diffusion lengths from 160 cm to 190 cm. For wet clay materials, diffusion lengths of about 1 cm were found. PMID- 3667271 TI - Aerodynamic size associations of 212Pb and 214Pb in ambient aerosols. AB - The aerodynamic size distributions of short-lived Rn daughters (reported as 214Pb and 212Pb) in ambient aerosol particles were measured using low-pressure as well as conventional low-volume and high-volume impactors. The activity distribution of 214Pb and 212Pb, measured by alpha spectroscopy, was largely associated with submicron aerosols in the accumulation mode (0.08 to 2 microns). The activity median aerodynamic diameter ranged from 0.09 to 0.37 micron (mean 0.16 micron) for 214Pb and from 0.07 to 0.25 micron (mean 0.13 micron) for 212Pb. The mean values of the geometric standard deviation (sigma g) were 2.97 and 2.86, respectively. By comparison, the median diameters of cosmogenic 7Be and ambient SO4(2-) were about 0.24 micron higher. In almost 70% of the low-pressure impactor measurements, the activity distribution of 214Pb showed a small shift to larger particle sizes relative to 212Pb. This shift probably results from alpha-recoil detachment of parent 218Po, which preferentially depletes 214Pb from smaller particles. The subsequent recondensation of 214Pb causes an enrichment of larger aerosols. Early morning and afternoon measurements indicated that similar size associations of 214Pb occur, despite humidity differences and the potential for fresh particle production in the afternoon. Health physics implications of the results are also discussed. PMID- 3667272 TI - An improved environmental pathway model for assessing high-level waste repository risks. AB - An environmental pathway model useful for assessing the postclosure radiological risks from high-level waste repositories has been developed. The model describes more fully than its predecessors the long-term build-up of radionuclides in the biosphere and is consequently better suited to the analysis of the prolonged radionuclide releases potentially associated with geologic waste repositories. The effect of incorporating the additional features is to alter, in some cases substantially, the predicted population risks associated with a given long-term release of particular radionuclides. The model has been used to evaluate certain assumptions underlying the environmental standard for high-level waste repositories recently issued by the U.S. Environmental Protection Agency. PMID- 3667273 TI - Comparison of estimates of systemic Pu from urinary excretion with estimates from post-mortem tissue analysis. AB - Urinalysis data for 17 individuals with known exposure to Pu were supplied to six laboratories, each of which made an estimate of systemic deposition. In general, the evaluation was done with the Langham model or one of its derivatives, and the values obtained by the laboratories for any single case were typically within a factor of two of the mean for all laboratories. The estimates made from urinalysis data typically were several-fold greater than those made from autopsy data. The results indicate that estimates based on urinary excretion overestimate systemic deposition and tend to confirm previous observations that the Langham equation underestimates urinary excretion. PMID- 3667274 TI - Dosimetry of alpha-emitting radionuclides in bone--a practical approach. AB - The stopping power of bone and bone marrow as a function of alpha energy up to 10 MeV has been approximated in an integrable mathematical expression. Integration of the stopping power yields the particle path as a function of the particle energy. These two expressions have been used to calculate the stopping power and the dose rate for a planar bone-bone marrow interface. The calculations have been performed for four different bone marrow layers of 10 microns width as a function of the depth of burial in bone of a thin contaminated layer; five different alpha energies between 4 and 8 MeV have been considered. In addition, the stopping power and the dose rate have been calculated for various distances in marrow from the bone surface for a constant volume contamination. In both cases, most of the marrow lies in the range between 100 and 200 keV/micron, where most of the cell killing, mutation and transformation occurs. PMID- 3667275 TI - Estimate of lifetime dose in persons exposed occupationally to x rays in Poland. AB - Estimates are presented of the magnitude of doses incurred over prolonged periods by individuals exposed occupationally to x rays. The results of individual monitoring in Poland from 1966 to 1978 formed the basis of the estimates. Probability distributions of receiving a certain 40-y lifetime x-ray dose were assigned to several subgroups monitored by applying the method of Markov's chains. Independently, by linear extrapolation of the measured increment rate, the mean life doses were estimated for a number of subgroups. The results seem to demonstrate that occupational exposure to x rays in the subgroups studied is slightly diversified, and its current level is of the same order as the exposure due to background radiation. PMID- 3667276 TI - Altitude variation of cosmic-ray neutrons. AB - The altitude variation of the cosmic-ray neutron energy spectrum and the dose equivalent rate was measured at an average geomagnetic latitude of 24 degrees N by using the high-efficiency multi-sphere neutron spectrometer and neutron dose equivalent counter developed by the authors. The data were obtained from a 2-h flight over Japan on 27 February 1985. The neutron energy spectra measured at sea level and at altitudes of 4,880 m and at 11,280 m were compared with the calculated spectra of O'Brien and with other experimental spectra, and they are in moderately good agreement with them. The dose equivalent rate increases according to a quadratic curve up to about 6,000 m and then increases linearly between 6,000 m and 11,280 m. The dependence of dose equivalent rates at sea level and at an altitude of 12,500 m on geomagnetic latitude also is given by referring to other experimental results. PMID- 3667277 TI - Atmospheric radioactivity in Valencia, Spain, due to the Chernobyl reactor accident. PMID- 3667278 TI - Radon-222 flux density measurements using an accumulator: an alternative technique. PMID- 3667279 TI - A histologic study of the influence of cigarette smoking in suppressing Rn daughter carcinogenesis in dogs. PMID- 3667280 TI - Fallout 241Am in human livers from the Federal Republic of Germany. PMID- 3667281 TI - A personal computer access control system for radioisotope laboratories. PMID- 3667282 TI - Health care workers' perceptions of risks. PMID- 3667284 TI - Comments on 'Assessing the risks of Rn exposure: the influence of cigarette smoking'. PMID- 3667283 TI - Comments on 'Effects of continuous low-level exposure to radiofrequency radiation on intrauterine development in rats'. PMID- 3667285 TI - Comments on 'A survey instrument design for accurate beta dosimetry'. PMID- 3667286 TI - Acquiring expertise in dealing with child abuse. PMID- 3667287 TI - An advisory health clinic for the elderly. PMID- 3667288 TI - Promoting welfare milk. PMID- 3667289 TI - Sexual molestation of children: becoming aware. PMID- 3667290 TI - Liaison between the community and an acute hospital for the elderly. PMID- 3667291 TI - Children at risk: the changing role of the health visitor. PMID- 3667292 TI - The ethics of intervention in child abuse and sudden infant death. PMID- 3667293 TI - Know your organisations: post-adoption centre. PMID- 3667294 TI - A brighter future for the elderly. PMID- 3667295 TI - Project 2000: HVA response to health department consultation. PMID- 3667296 TI - A word on mandibular reconstruction. PMID- 3667297 TI - Surgery of massive fibrous dysplasia and osteoma of the midface. AB - Since most bony lesions of the midface will stop growing or regress, it is generally not appreciated when fibrous dysplasia and osteoma occasionally continue to grow, causing functional and cosmetic problems. To demonstrate the potential of the disease processes and management options available to the surgeon, a series of patients with massive fibrous dysplasia and osteoma of the midface is reviewed. Most of the patients show a facial deformity alone or in combination with telecanthus, epiphora, exophthalmos, or nasal obstruction. Several types of radical and conservative surgical procedures are described to remove or control the bony lesions, to restore facial contour, and to reconstruct the sinuses, nasal passageways, lacrimal collecting system, and medial wall of the orbit. PMID- 3667299 TI - Incidence of Wharton's duct stenosis in floor of the mouth cancers excised with scalpel or cautery vs CO2 laser. AB - Surgery of the floor of the mouth (FOM) using a scalpel or cautery has produced stenosis of Wharton's duct, necessitating further surgery because of painful enlargement to the gland or suspected metastasis. The laser has been proposed as an alternative method that might avoid this complication. A retrospective study comparing these excisional techniques was done at Walter Reed Army Medical Center between 1973 and 1983. Of a total of 58 lesions, 35 were T1N0M0 and 23 were T2N0M0 (two synchronous lesions being present). Of 35 lesions excised with a scalpel, 11 had an associated submandibular gland resection. Of the remaining 25, two developed secondary duct stenosis. Of 10 lesions excised with cautery, three had an associated excision of the submandibular gland. Of the remaining seven, two developed stenosis and one required subsequent excision of the gland. Of 12 lesions excised with laser, four developed stenosis and two required subsequent excision of the gland. Laser excision appears to be of no advantage in avoiding further surgery of the submandibular gland. A submandibular gland resection at the time of the original resection of T1N0 or T2N0 cancers of the FOM does not appear warranted. PMID- 3667298 TI - Squamous cell carcinoma of salivary gland origin. AB - A 30-year retrospective analysis of 50 patients with squamous cell carcinoma of the salivary glands was conducted, including 42 patients with parotid tumors and eight with submandibular lesions. Clinical staging, performed for 48 patients in whom adequate data were available, yielded the following results: Stage I, 17%, Stage II, 12%, Stage III, 71%. Surgery was the primary therapy in 45 patients (86%). The determinate "cure" rate at 5 and 10 years was 24 and 18%, respectively, for patients with parotid lesions and 20% for those with submandibular tumors. As with other malignant salivary gland tumors, advanced stage and pain as a presenting symptom were ominous findings. Locoregional recurrence was the usual site of failure in both parotid (51%) and submandibular (67%) cases. Radical surgical extirpation, preserving the facial nerve when possible, remains our treatment of choice. It is anticipated that planned postoperative radiotherapy will reduce our high locoregional recurrence rates. PMID- 3667300 TI - Sphenoidotomy. AB - Because of the complex anatomic relations of the sphenoid, the surgical approach to this sinus was only introduced 100 years ago. There are three approaches to the sphenoid sinus: transethmoidal, transseptal, and transpalatal. We present a case report, and discuss surgical anatomy, with attention to the important anatomic relationship of the cavernous sinus and its contents. A variant of the classical, sublabial, transseptal approach is described as follows: a window is created in the face of the sphenoid. This approach is particularly applicable to the surgery of mucoceles and allows easy postoperative inspection of the sphenoid sinus. PMID- 3667301 TI - Congenital granular cell tumor of the tongue. AB - Granular cell lesions in the oral cavity occur primarily on the tongue in adults (granular cell tumor) and exclusively on the alveolar ridge in newborns (congenital granular cell epulis). Because of the location, age of appearance, and certain clinical and histologic differences, these histologically similar lesions are considered separate clinical entities. This case report, however, describes the occurrence of a granular cell lesion on the tongue of a newborn. Although the etiopathogenesis of these lesions is unknown, the present case suggests a common etiologic relationship of these entities and tends to rule out an odontogenic origin for the congenital granular cell epulis. PMID- 3667303 TI - Therapies in nuclear medicine. Kansas City, Missouri, 20 September 1986. Proceedings. PMID- 3667302 TI - Histoplasmosis presenting as a neck mass. AB - A unilateral neck mass is an unusual clinical presentation for histoplasmosis. A patient with a large, unilateral neck mass caused by Histoplasma capsulatum is presented to alert readers to such a possibility and to illustrate some of the difficulties in diagnosing and managing the disease. PMID- 3667304 TI - Treatment of rheumatoid arthritis using radiopharmaceuticals. AB - One hundred and twenty one knees in 97 patients with seropositive rheumatoid arthritis and persistent knee synovitis were treated with the intra-articular injection of 270 mCi (30 GBq) of dysprosium-165 (165Dy) bound to ferric hydroxide macroaggregates. Of 81 knees evaluated at one year, 61% had good results, 23% had fair results and 16% had poor results. Of 44 knees evaluated at two years, 64% had good results, 16% had fair results and 20% had poor results. Knees with Stage I radiographic changes showed 72 and 81% good results at one and two years, respectively. Knees and Stage II radiographic changes showed 53 and 48% good results at one and two years, respectively. Leakage of radioactivity from the injected joint was minimal. Mean leakage to the venous blood was 0.15% of the injected dose. Mean leakage to the liver 24 h after injection was 0.64% of the injected dose. Mean leakage to the draining inguinal lymph nodes was 0.17% of the injected dose. These results indicate that 165Dy-ferric hydroxide macroaggregate is an effective agent for radiation synovectomy, particularly in knees with Stage I radiographic changes. The minimal leakage rates observed offer a definite advantage over previously used agents. PMID- 3667305 TI - Treatment of metastatic bone pain with strontium-89. AB - We have utilized 89Sr as palliative treatment for bone pain secondary to metastatic cancer in the skeleton of over 200 patients. The best results have been in patients with carcinoma of the prostate (80% response rate) and breast (89%). Results in a small number of patients with a variety of other cell types were not nearly as encouraging. Strontium-89 provides excellent palliation in the management of bone pain secondary to prostate and breast carcinoma. PMID- 3667306 TI - Therapeutic use of 90Y microspheres. AB - Glass microspheres 20-30 microns in diameter containing either 31P or 89Y that can be activated by neutron bombardment to 32P or 90Y respectively, have been produced for intra-arterial radiotherapy of liver tumors. The spheres are insoluble in body fluids, non-toxic, and can concentrate in liver tumors of animals by direct injection into the hepatic artery. This gives a higher radiation dose to the tumor than can be achieved with external beam therapy. Trials in rabbits and dogs have proven successful and this product (90Y TheraSpheres) is now entering limited human clinical trials. PMID- 3667307 TI - Radiolabeled monoclonal antibody B72.3 localization in metastatic lesions of colorectal cancer patients. AB - We have previously demonstrated a high degree of selective binding of monoclonal antibody (MAb) B72.3 to carcinomas of the colon, ovary, and breast in contrast to normal adult tissues using in vitro assays. In this report we demonstrate selective tumor localization in colorectal cancer patients after intravenously administering 131I-labeled MAb B72.3 IgG. Radiolocalization Indices (RI) (i.e. cpm 131I-labeled MAb per gram of tumor vs cpm per gram of normal tissues), were obtained by direct analyses of biopsy materials. Using an RI of greater than or equal to 3 as a positive localization, tumor lesions in various sites from 17/20 patients scored positive. In eight of these patients, all tumor lesions demonstrated RIs of greater than 3, while in five patients RIs of some lesions were greater than 10 and as high as 30-46. Seventy percent (99/142) of the tumor lesions showed RIs of greater than 3, while only 12 of 210 histologically confirmed normal tissues examined showed RIs of greater than 3. These tissues were either adjacent to the tumor or the draining tumor masses or, as in the case of two patients, was caused by high levels of circulating immune complexes that deposited in the spleen. Positive scintigraphic images (confirmed at surgery) were observed in 14/27 patients. No toxicity or adverse reactions were observed with either MAb. These studies provide absolute quantitative analyses of the actual delivery of radiolabeled MAb to carcinoma lesions vs a wide range of adjacent and distal normal tissues and establishes the means for other diagnostic and potential therapeutic applications of this antibody alone, or in combinations with other monoclonal antibodies. PMID- 3667308 TI - Radiation safety and handling of therapeutic radionuclides. AB - The use of radionuclides in therapy, both as sealed sources and in the radiopharmaceutical form, is discussed from receipt of radiopharmaceuticals through their use, to their disposal. The licensing requirements for use of therapeutic radionuclides is presented. Discussions dealing with receipt, storage and administration of radiopharmaceuticals are treated in detail, as well as suggestions for personnel monitoring. Procedures involved in the event of emergency surgery and/or death are discussed. The misadministration rules of the Nuclear Regulatory Commission regarding therapies were presented. PMID- 3667309 TI - Methods of calculating radiation absorbed dose. AB - The new tumoricidal radioactive agents being developed will require a careful estimate of radiation absorbed tumor and critical organ dose for each patient. Clinical methods will need to be developed using standard imaging or counting instruments to determine cumulated organ activities with tracer amounts before the therapeutic administration of the material. Standard MIRD dosimetry methods can then be applied. PMID- 3667310 TI - A new experimental model for studies of drug actions on myocardial metabolism. Application to a study of the influence of POCA. AB - In order to study myocardial metabolism by external detection, quantitative information on the metabolism of a gamma-emitting iodinated fatty acid (IHA) was obtained from time-activity curves of radioactivity in different compartments. A 4-compartment mathematical model was then developed; compartments 0, 1, 2, and 3 correspond respectively to vascular IHA, intracellular IHA, esterified forms, and iodide resulting from mitochondrial oxidation of IHA. We applied this model to a study of the influence of an inhibitor of fatty acid oxidation, POCA (2-[5(4 chlorophenyl) pentyl]-oxirane-2-carboxylate). Isolated rat hearts were perfused for 20 min with Krebs liquid containing increasing concentrations of POCA. IHA was then injected as a bolus at the entrance of the coronary network. The level of cardiac radioactivity was recorded for 30 min and the division into the 4 compartments was simulated at different concentrations of POCA. The drug appeared to increase the myocardial retention of IHA and slow down the speed of degradation and storage; the variations were dose-dependent. These results correspond to those obtained by intracellular analysis. The proposed method, which is reliable and sensitive, is an interesting experiment for pharmacological studies of cardiac metabolism. PMID- 3667311 TI - A refined method for assessing 99mTc-MDP whole body retention in prostate cancer patients. AB - Whole body retention (WBR) of 99mTc labeled methylene diphosphonate (MDP) has been shown to significantly differentiate various clinical stages of prostate cancer. Whole body measurements, when performed at 5 min and 24 h after i.v. administration of 99mTc-MDP, allows for the calculations of percentage whole body retention (% WBR) after one day. The latter can be expressed relative to either the anterior or posterior projection, or in combination as the geometric mean value. In an attempt to better describe the clinical course of prostate cancer patients with bone metastases we have refined the % WBR calculations to include a normalization factor. The latter consists of the mean 24-h value of WBR's as obtained from 10 prostate cancer patients without bony metastases as determined by bone scintigram. These values were determined for each projection to be: anterior = 26.5 +/- 4.7%, posterior = 37.5 +/- 7.4%, and geometric mean = 31.5 +/ 5.7%. The % WBR is then divided by the normalization factor of choice and expressed as (% WBR)N. These data are used to better express 99mTc MDP 24-h whole body retentions when following the clinical course of patients with metastatic carcinoma of the prostate. Caution should be exercised when interpreting these data when metabolic bone pathology is present. A false negative (% WBR)N value will result if an infiltration of the 99mTc-MDP occurs during administration. PMID- 3667312 TI - Labeling of antibodies with 64Cu using a conjugate containing a macrocyclic amine chelating agent. AB - The conjugation of a model antibody (rabbit-anti-HSA-IgG) with a functionalized derivative of cyclam (1-(3-aminopropyl)-4-methyl-1,4,8,11 tetraazacyclotetradecane) is reported. Coupling of this derivative to the antibodies was accomplished using commercially available heterobifunctional coupling agents. The conjugation technique produced minimal effects on the antibody binding activity. 64Cu complexes with this cyclam derivative have excellent stability in human serum and aqueous solutions containing 1 mM EDTA. The high stability of these Cu-complexes suggests that this system, or other analogous systems, may be useful for production of stable 67Cu-immunotherapeutic agents. PMID- 3667313 TI - Evaluation of 13N-amines as tracers. AB - The organ distribution and the metabolic fate of the 13N-amines 13N-beta phenethylamine, 13N-n-octylamine, and 13N-3,4-dimethoxyphenethylamine, were studied in detail. After administration 13N-amines were rapidly transferred to tissues and oxidized by MAO. 13N-ammonia formed thereby was converted into amino acids (mainly glutamine by glutamine synthetase) and trapped. 13N-amines were found to be potential metabolic trapping tracers for the study of disposition and metabolism of amines. PMID- 3667314 TI - The effect of procainamide, lidocaine and diphenylhydantoin on thallium-201 chloride uptake. PMID- 3667315 TI - Neutron activation analysis of trace elements in human hair: effect of dietary and environmental factors. AB - Effect of environment and dietary habits on trace element contents in human scalp hair has been investigated in the present work. Trace elements were detected with neutron activation technique. It was found that diet and environment contribute largely towards the trace elements in human body. Further trace elements Te, Lu, Ba, Cs, Yb, Re, Hf, In and Ir were detected for the first time in human scalp hair. PMID- 3667316 TI - Neutral technetium(II)-99m complexes as potential brain perfusion imaging agents. AB - A series of eight neutral technetium(II)-99m complexes of general formula tr [99mTcIID2X2]0, where D represents a chelating ditertary phosphine or arsine ligand and X represents a halide or pseudohalide ligand, has been prepared and characterized by HPLC comparisons to the known 99Tc analogs. Several members of this series exhibit significant brain uptake in rats, with maximum uptake (1.2% dose/brain at 1 min after injection) being exhibited by tr-[99mTcII (DIARS)2Cl2]0 where DIARS represents o-phenylenebis(dimethylarsine). Surprisingly, several cationic Tc(III) analogs, tr-[99mTcD2X2]+, also exhibit significant brain uptake, presumably via a mechanism which involves in vivo reduction to the neutral Tc(II) form. The complicated interrelationships among the chemical and biological properties of the tr-[99mTcIII/IID2X2]+/0 couples, and the dependencies of these properties on the nature of D and X, provide possible means by which this class of complexes might be manipulated to yield an effective 99mTc brain perfusion imaging agent. PMID- 3667317 TI - Rapid chromatographic determination of radiochemical impurities in 99mTc mebrofenin (Choletec). PMID- 3667318 TI - Identification of Hb Lepore-Washington-Boston in association with Hb E [beta 26(B8)Glu----Lys] in a Thai female. AB - The proposita was a Thai female showing signs of a mild anemia (Hb: 11.4 g/dl; RBC: 4.91 X 10(6)/mm3; reticulocytes: 2.4%; MCV: 70 fl; MCHC: 23.3 g/dl). Hemoglobins were isolated by DEAE-cellulose chromatography in the following relative amounts: Hb E + Hb A2 = 53%; Hb F0 = 30.0%; Hb delta beta-Lepore = 12.7%; Hb F1 = 4.3%. The beta E and delta beta-Lepore chains were isolated by CM cellulose chromatography and were subjected to tryptic peptide mapping on paper in comparison to normal beta A chains. Amino acid analysis of selected peptides permitted unambiguous identification of the abnormal hemoglobins as Hb E [beta 26(B8)Glu----Lys] and Hb Lepore-Washington-Boston, which has a delta chain sequence for residues 1-87, and a beta chain sequence for residues 116-146. The presence of a Lepore hemoglobin was further confirmed by Pst I digestion of the proposita's DNA. The association of the two hemoglobin variants gave rise to elevated levels of Hb F. PMID- 3667319 TI - Oligonucleotide screening of beta thalassemia mutations in the south east of France. AB - France is a non-endemic region for beta thalassemia. In this country, the sporadic cases of Cooley's disease encountered affect almost constantly subjects of Mediterranean origin. In this report, we have screened, using oligonucleotide probes, the distribution of the main beta thalassemia mutations present in the population of South-eastern France whose origins lie in the mixing of several Mediterranean ethnic groups. Among 105 beta thalassemia chromosomes, we have observed a limited number of alleles, since, by using oligonucleotide probes for six mutations, we have characterized the molecular defect in 90% of the chromosomes. The four main mutations were found in more than 85% of the chromosomes and the others in about 5%. The distribution of the beta thalassemia mutations within the various ethnic groups was determined. PMID- 3667320 TI - Minor components of Hb Bart's. AB - The minor components of Hb Bart's were separated by CM-cellulose chromatography, reverse-phase HPLC, and DEAE-cellulose chromatography. These were characterized by amino acid analysis, tryptic peptide analysis by HPLC, electrophoresis, and carbohydrate and phosphate analysis. Acetylated and glycated components of Hb Bart's were present in cord blood red cells. The ratio of gamma Ic/total gamma in Hb Bart's was nearly the same as that of Hb FIc/Hb F which may indicate that the gamma chain after its release from the ribosome is not a better acetylation substrate than Hb Fo. Glycation of the free gamma-chains seems to take place in vivo as readily as the major Hb components. PMID- 3667321 TI - Prenatal diagnosis of hemoglobinopathies: a potential application of high performance liquid chromatography. AB - High performance liquid chromatography was compared with carboxymethyl cellulose column chromatography data for analysis of globin chain composition and biosynthetic ratios in fetal blood. A formula was derived for mathematical correction for losses of small amounts of globin protein on the high performance liquid chromatography column. Radioactive globin chain ratios by high performance liquid chromatography are equivalent to those by carboxymethyl cellulose column chromatography, but only when carrier Hb A is added. We conclude that high performance liquid chromatography provides a suitable alternative to carboxymethyl cellulose columns, and has several advantages. PMID- 3667322 TI - Hemoglobin autoxidation at physiological concentrations. AB - Methemoglobin formation was studied at near physiological hemoglobin concentration. The reaction proceeds at a faster rate when the concentration of hemoglobin is high (15-18 mM in heme) than when it is low (2 mM). Constant shaking of hemoglobin preparations during the incubation decreases the differences seen in the rates of autoxidation between concentrated and dilute samples. When red cell hemolysate is used instead of pure hemoglobin, similar results are obtained. A comparison of rates of methemoglobin formation in hemoglobin solutions under low air pressure (1/2 atm) with those under normal air pressure (1 atm) shows no differences between concentrated and dilute samples. There is also no significant difference between the rates of autoxidation of dilute and concentrated solutions when the reactions are carried out under one atmosphere of oxygen (100 percent O2). The study of one patient with hereditary spherocytosis demonstrated higher hemoglobin autoxidation rate in spherocytes, which have higher hemoglobin concentration, than in normal biconcave red cells. These results suggest that: a) the rate of hemoglobin autoxidation at red cell hemoglobin concentration is significantly faster than rates obtained by studying dilute solutions; b) although the accelerated oxidation might be related to multiple factors, one seems to be less accessibility of oxygen when the hemoglobin solution is highly concentrated. PMID- 3667323 TI - Hb Sassari or alpha (2)126(H9)Asp---His beta 2 observed in a family from Northern Sardinia. PMID- 3667324 TI - Hemoglobin J-Rovigo or alpha (2)53(E2)Ala----Asp beta 2 in a Saudi patient. PMID- 3667325 TI - Sickle cell anemia in an Albanian family in Yugoslavia. PMID- 3667326 TI - Hb P-Nilotic or alpha 2(beta delta)2 in a Turkish family. PMID- 3667327 TI - A second family with Hb Minneapolis-Laos or alpha 2 beta (2)118(GH1)Phe----Tyr. PMID- 3667328 TI - [Fatty acid pattern in children with mucoviscidosis in relation to the degree of exocrine pancreas insufficiency]. AB - Fatty acid composition were determined by gas chromatography in serum triglycerides and cholesterol esters of 32 patients (aged 7-17 years) with cystic fibrosis. According to their exocrine pancreas function (determined with secretin cholecystokinin test), patients were divided in 3 groups. In comparison with previously measured values in 30 metabolically healthy children, patients with cystic fibrosis showed a significantly increased level of palmitic, palmitoleic, stearic, oleic, and linolenic acid in the triglyceride fraction and a significantly increased level of myristic, myristoleic, palmitoleic, stearic, oleic, and triene acid in the cholesterol ester fraction. However, in both fractions, concentration of linoleic acid was significantly decreased. It seems unlikely that malabsorption of ingested fat is responsible for the abnormalities in fatty acid pattern, because no significant differences could be found between the 3 patient's groups. PMID- 3667329 TI - Short-term testosterone treatment at bone age of 12 to 13 years does not reduce adult height in boys with constitutional delay of growth and adolescence. AB - Growth data and adult height from 22 untreated patients with constitutional delay of growth and adolescence (group 1) were compared retrospectively with those of 19 patients, who had received long-acting testosterone esters (100 to 250 mg per month, mean total dosage 1029 mg/m2) during 2 months to 3.25 years (mean duration 8.5 months, group 2). Age (group 1 15.4 +/- 1.2, group 2 16.2 +/- 1.4 years), bone age (group 1 12.6 +/- 1.3, group 2 13.1 +/- 1.2 years) at first examination (group 1) or start of treatment (group 2), and adult height (172.8 +/- 7.5 cm group 1, 176.8 +/- 8.0 cm group 2) were not significantly different. In group 2, there was no negative correlation between the total testosterone dose and adult height, and the latter corresponded to predicted height in the same way as in the untreated patients. It is concluded that short-term treatment with long-acting testosterone esters (100 to 250 mg per month during 6 months, starting at a bone age of about 12.5 years), which has positive psychosocial effects, does not have negative somatic effects and does not reduce adult height in these patients. PMID- 3667330 TI - Polycystic kidneys as the presenting feature of tuberous sclerosis. AB - Tuberous sclerosis is an inherited neurocutaneous disorder characterized by seizures, mental retardation, cutaneous lesions and visceral hamartomas. We describe a 17-year-old boy in whom polycystic kidneys of the adult type were fortuitously detected on routine check-up. The patient enjoyed good health and had no evidence of renal dysfunction. Closer scrutiny of his past history and his physical and laboratory findings disclosed that he had tuberous sclerosis. Our case adds to the scant reported experience with the association of tuberous sclerosis and adult-type polycystic kidneys, and suggests that a search of additional manifestations of tuberous sclerosis is warranted in children in whom adult-type polycystic renal disease is detected. PMID- 3667331 TI - Mesenterial histiocytic necrotizing lymphadenitis. Case report. AB - A 14-year-old girl was hospitalized with fever, jaundice, vomiting and right sided abdominal pain. A laparotomy was performed because of muscular defence and ascites. There was a mass of enlarged red and blue colored lymph nodes in the mesentery of the lower ileum loop. The histologic diagnosis of HNL without granulocytic infiltration was made. A septic-toxic shock developed after surgery. Respiratory insufficiency necessitated the use of a respirator, and acute renal failure with oliguria made hemodialysis necessary. The dramatic clinical course of the illness and the localization of the affected lymph nodes in the abdomen are unusual for an HNL; the lack of granulocytic infiltration contradicts the clinical picture of a bacterial infection. Neither a bacterial nor a viral pathogen could be found. However, the patient had been treated with antibiotics before. PMID- 3667332 TI - [Fulminant hepatitis in a newborn infant whose mother was a carrier of the hepatitis B surface antigen and e antibody]. AB - The authors describe a case of fulminant hepatitis in a 12-week-old infant whose mother was an asymptomatic carrier of the hepatitis B virus surface antigen and "e" antibody, the infection being unknown at the time of birth. They emphasize the importance of hepatitis B prophylaxis in all newborn children of surface antigen carrier mothers, irrespective of the situation concerning the hepatitis B virus e antigen. PMID- 3667333 TI - Obesity in a child with untreated coeliac disease. AB - This is the first report of obesity in an untreated coeliac patient diagnosed at the age of 5.1 years according to the criteria of the European Society for Paediatric Gastroenterology. Diagnosis of coeliac disease was suspected on the basis of recurrent episodes of abdominal pain and of family history. Gluten-free diet induced evident acceleration of both length and weight velocity and increase of weight excess, apart from resolution of the abdominal symptoms. The present case report demonstrates that obesity in a child does not exclude the diagnosis of coeliac disease. PMID- 3667334 TI - Empty sella syndrome and growth deficiency in childhood. AB - We describe four cases of empty sella syndrome in childhood associated with growth and neuroendocrine disorders. We note that empty sella syndrome probably presents with endocrine disorders more often in childhood than in adults and that its frequency seems to be underestimated. PMID- 3667336 TI - [Annual meeting of the Swiss Pediatric Society. Geneva, 12-13 June 1987. Abstracts]. PMID- 3667335 TI - Haemoglobin and iron deficiency in healthy one-year-old Swiss children: a study in private practice. AB - Haemoglobin (Hb) was measured in 348 full-term one-year-old infants in 7 private paediatric offices. In 36 (10.3%) subjects, the Hb value was less than 110 g/l, and in 7 (2.0%) less than 100 g/l. In 11 of 212 (5.2%) subjects, MCV was less than 70 fl. Twenty-six infants with an Hb below 115 g/l showed an increase of Hb of +10 g/l or more after a therapeutic trial with oral iron. No relationship was found between Hb levels and early introduction of whole cow's milk into the diet. It is concluded that screening for iron deficiency is justified in healthy Swiss infants: Hb and MCV measurements may be the initial step. PMID- 3667337 TI - Cellular heterogeneity in normal human urothelium: quantitative studies of lectin binding. AB - A panel of 10 FITC-labelled lectins (MPA, PNA, ConA, DBA, SBA, RCA-120, WGA, UEA, GS-I, GS-II+) was applied to cryosections of seven specimens of normal urothelium. Seven of the lectins (MPA, ConA, RCA, WGA, UEA, GS-I and GS-II) showed a pattern of increasing fluorescence intensity from basal to superficial cells of the urothelium whereas PNA, DBA and SBA showed more uniform binding throughout the urothelium. Urothelial cell suspensions labelled with FITC-lectins were studied by flow cytometry to quantify the variation in binding to different cells types. Three cellular subpopulations were identified in normal urothelium on the basis of their optical properties. Fluorescence intensity due to specific lectin binding was then measured separately for each subpopulation. Although there was some variation among individual cases, a general pattern emerged in this small series. WGA, RCA, and GS-II bind in large quantities to all urothelial cells while PNA, SBA, ConA and DBA show little binding. MPA, RCA, UEA and GS-I showed the most marked increase in fluorescence intensity from basal to superficial cells as observed microscopically and quantified by flow cytometry. PMID- 3667338 TI - Secretory glycoconjugates in the epithelium of the goat prostate. AB - Secretory glycoconjugates in the epithelium of the goat prostate were investigated with various electron microscopical histochemical methods that involved periodic acid-thiocarbohydrazide-silver proteinate, colloidal gold labelled lectin and related procedures. The three types of cells in the epithelium previously differentiated with the light microscope were substantiated: mucus-producing cells, protein-secreting cells and cells intermediate between both types. These three cell types contained varying amounts of neutral glycoconjugates; the histochemical nature of these carbohydrates was determined with particular emphasis upon the histophysiological functions of the accessory sex glands. PMID- 3667340 TI - Within-person variation in daily dietary intake of boys from Finland, the Netherlands, Italy, the Philippines and Ghana. AB - We have studied the within-person variation in daily dietary intake of energy, protein, fat, carbohydrate, cholesterol, saturated and polyunsaturated fatty acids in 8- and 9-year-old boys from five countries, using record and recall methods of dietary assessment. The average within-person coefficients of variation ranged from 19 to 31 per cent of the mean intake of energy, protein and carbohydrate; from 43 to 77 per cent of the mean intake of cholesterol, from 28 to 50 per cent of the mean intake of saturated fatty acids, and from 37 to 105 per cent of the mean intake of polyunsaturated fatty acids. Some of this variation may have been due to differences in the methods used to assess dietary intake. The day of the week on which food intake is estimated can also influence the number of measurements required to estimate precisely an individual's intake of energy or specific nutrients. From the results of this study it can be shown that it is not always justified to assume that every person in a population has the same within-person variance. This may lead to an underestimation of the number of measurements needed to estimate individual intakes. The results of this study are useful in the planning of dietary surveys when decisions are to be made about methods of data collection, sample size and length of the study, and also in the analysis and interpretation of the results of dietary surveys. PMID- 3667339 TI - Diabetes mellitus associated changes in glomerular glycocompounds: a fluorescence microscopical study. AB - Renal biopsy specimens showing histological alterations typical of advanced diabetic glomerulopathy were studied for changes in glomerular glycoconjugates, using fluorochrome-coupled lectins as probes. All samples studied showed a marked reduction in the binding of Triticum vulgaris (WGA) lectin in the glomerular basement membranes. On the other hand, 'new' glomerular binding sites for the lectins of Dolichos biflorus (DBA), Helix pomatia (HPA) and Arachis hypogaea (PNA), recognizing galactosyl moieties of glycoconjugates and giving no reaction in normal glomeruli, were seen in all samples studied. In addition, Wistaria floribunda lectin (WFA), recognizing galactosyl and, N-acetylgalactosaminyl configurations in glycoconjugates, gave a typical linear binding along the glomerular basement membranes, differing markedly from its reaction with normal kidney. Ulex europaeus (UEA I) showed reduced binding in the glomeruli of diabetic nephropathy. The results show that changes in glomerular glycoconjugates may appear in diabetic nephropathy, suggesting a disturbance in the turnover of the non-reducing terminal saccharide residues. In addition, the results show that lectins are useful probes for studying these changes further. PMID- 3667341 TI - Oral protein and energy supplements in cancer patients. AB - Reduced food intake is a common problem in patients with malignant disease. Oral supplementation is the simplest and least invasive method of increasing the nutrient intake, and a number of neutral protein and energy supplements are available. This study was carried out to assess the value of these supplements when incorporated into the everyday diet of cancer patients. The first stage of the study evaluated the palatability of the energy and protein supplements available. Polycal was found to be the most acceptable energy supplement and Protifar the most acceptable protein supplement. These two products were then used to assess their contribution to the protein and energy intake of cancer patients when incorporated into everyday food. The rise in protein and energy intake was statistically significant but the increase in energy was not thought to be clinically important. PMID- 3667342 TI - Some evidence for short-term caloric compensation in normal weight human subjects: the effects of high- and low-energy meals on hunger, food preference and food intake. AB - This study compared the effects of high- and low-energy lunches upon subjective motivation to eat and food intake. Subjects ate four cooked lunch-time meals on separate days, two of which were high-energy (1820 kJ or 435 kcal) and two low energy (1090 kJ or 260 kcal). The meals were of similar bulk, contained similar amounts of protein and carbohydrate but different fat contents, the low-energy meals containing very little. Motivational ratings and food preference assessments were completed before, and at hourly intervals for 3 h after the meals during which time subjects were not allowed to eat. Food intake diary records were kept for the rest of the day. Immediately after consumption of the meals none of the ratings differentiated between the high- and low-energy meals. At 1 h rated hunger was significantly higher after the low-energy meal and by 3h high- and low-energy meals were significantly differentiated by almost all measures. When subjects were allowed to eat freely, food intake records showed that energy intake was higher following the low-energy meal during the first 2 h but was lower thereafter. At the end of the assessment period (i.e. 8h after lunch) subjects had made a statistically non-significant 43 per cent compensation for the energy 'lost' at lunch. These findings are of theoretical importance since they provide evidence of short-term monitoring of energy. This study is of practical significance since it discloses certain consequences of using reduced energy foods which may form part of a weight control programme. PMID- 3667343 TI - Average portion weights of foods consumed by a randomly selected British population sample. PMID- 3667344 TI - Nutritionists' views on nutrition. AB - The gathering of nutrition workers from many parts of the world at the XIII International congress of Nutrition (Brighton, UK, 1985) offered a unique opportunity to survey their views about the theory, practical guidelines and methods of application used in their work. The following paper is a report on the responses to a questionnaire distributed to the participants. The results are given in terms of option percentages given by the various groups analysed. The material is presented under nine very general headings of: background of respondents; nutrition as a subject; research; use of 'tools' in applied nutrition; nutrition in disease; over- and under-nutrition; education; nutrition and the public; and manufactured foods. Presented is a summary of the choices made by 387 respondents. PMID- 3667345 TI - Potassium content of herbal teas. PMID- 3667346 TI - Vitamin C has a key physiological role in facilitating the absorption of non-heme iron from the diet. PMID- 3667347 TI - [Cogan syndrome: sudden, bilateral high-grade hearing loss]. AB - We report 2 cases of Cogan's syndrome. One female patient had a typical interstitial keratitis and bilateral hearing impairment, the other had dramatically progressive deafness, combined with failure of the left vestibule and severe conjunctivitis resistant to treatment and otitis externa. The typical Cogan's syndrome with interstitial keratitis developed only a few weeks later. The disease is caused by an auto-immune response. The hearing impairment is mainly due to endolymphatic hydrops. Corticosteroids are the treatment of choice. PMID- 3667348 TI - [Development of the larynx and trachea following division of the cricoid cartilage and segmental resection of the trachea in the growth stage. An animal experiment study]. AB - Laminotomy as described by Rethi, and segmental tracheal resection with end-to end anastomosis have proved useful in the adult for the treatment of stenoses of the larynx. In children, the question arises why these may interfere with the growth of the larynx and trachea. A vertical split of the cricoid cartilage followed by stabilization of the larynx by the temporary introduction of a Montgomery silicone T-tube was carried out on four kittens aged four to six weeks. A segmental tracheal resection with end-to-end anastomosis was performed on other animals of the same age. When the animals had stopped growing, the larynx and trachea were investigated both endoscopically and histologically. Following laminotomy the larynx underwent remodelling, resulting in an oval shape, the lumen being wide and the function of the vocal cords normal. Following segmental resection of the trachea, a circular stenosis was found, as a result of irregular growth of the sutured tracheal cartilages. In none of the animals, however were either functional disorders or respiratory distress to be observed. Thus, laminotomy or segmental resection of the trachea can be employed during the formative years without fear of clinically relevant growth disorders. PMID- 3667349 TI - Comments on palpatory observations with myocardial infarction, and suggestions for further investigation. PMID- 3667350 TI - Defensive medicine: spiraling costs. PMID- 3667351 TI - We need you! PMID- 3667352 TI - The manipulators. PMID- 3667353 TI - Thrombocytopenia and low-dose heparin administration. PMID- 3667354 TI - Lacrimal gland cyst: computed tomographic appearance. PMID- 3667355 TI - Left paraduodenal hernia: report of a case, with radiographic findings, including abdominal computed tomography. PMID- 3667356 TI - Isolation of Vibrio alginolyticus from a patient with chronic otitis media: report of case and review of biochemical activity. PMID- 3667357 TI - Acute adult vitamin A toxicity: report of a case. PMID- 3667359 TI - H and P: a medical paradox. PMID- 3667358 TI - Understanding AIDS. PMID- 3667360 TI - Meperidine-induced hypereosinophilia: report of a case. PMID- 3667361 TI - Cor triatriatum in the adult: report of a case. PMID- 3667362 TI - Mixed connective tissue disease: report of a case with fatal outcome. PMID- 3667363 TI - Louisa Burns memorial lecture: reform through research. PMID- 3667364 TI - The human and health significance of parent-infant contact. PMID- 3667365 TI - Alleviating stress in intensive-care unit neonates. PMID- 3667366 TI - Cardiac stress test. PMID- 3667367 TI - Comparison of three treatment strategies for esophageal cancer within a single institution. AB - Fifty-seven patients with esophageal cancer were treated with curative intent between January 1979 and June 1985. Seventeen were treated with radical radiation therapy alone (TD 4000-6500 cGy in 200-250 cGy fractions). Twenty-five were treated using radiation therapy (3000 cGy in 200 cGy fractions, day 1-19, and 2600-3000 cGy in 200 cGy fractions, day 50-68) and concomitant chemotherapy (5-FU and Cis-platinum). Fifteen were treated preoperatively by radiation therapy (3000 cGy at 200 cGy fractions) and concomitant chemotherapy (5-FU and Cis-platinum) followed by esophagectomy in 2-3 weeks. Chi square tests showed no significant baseline differences between the patients in the three different treatment groups with respect to A.J.C. stage, T status, location of tumor or histology. Median survival and 2-year survival for the three treatment groups were RT alone: 5 months and 0%, RT and chemotherapy: 12 months and 37%, RT, chemotherapy and surgery 13 months and 38%. A Cox multivariate analysis revealed significant predictor variables for increased survival were treatment strategy, RT dose delivered and T status. Increased local control was seen with either multimodality approach compared to radiation therapy alone. Our data suggests that a multimodality approach is superior as a curative treatment strategy, compared to RT alone, in esophageal cancer. In our series no significant differences were seen with respect to treatment outcome between the two multimodality approaches used. PMID- 3667368 TI - The problem of neck relapse in early stage supraglottic cancer--results of different treatment modalities for the clinically negative neck. AB - We reviewed the records of patients with Stage I and II epidermoid carcinoma of the supraglottic larynx treated at the Memorial Sloan-Kettering Cancer Center (MSKCC), New York, and at the Rotterdam Radio-Therapeutic Institute (RRTI), The Netherlands, between 1965 and 1979. At the MSKCC the treatment modality of choice for the primary tumor as well as for the neck had been surgery; of the 79 patients treated by surgery an elective neck dissection was performed on 31 patients. At the RRTI, however, the initial treatment for the primary tumor and the neck is radiation therapy. One-hundred and one patients were treated of whom 79% (80/101) had radiation therapy to the primary tumor as well as to both sides of the neck. This paper focuses on the problem of relapse in the neck, thus comparing patients treated in two large cancer centers by different treatment philosophies, that is elective neck dissection on one side of the neck versus elective radiation therapy to both sides of the neck. Twenty-nine percent of the patients from MSKCC (23/79) relapsed in the neck. The relapse rate was identical between the patients who did not have an elective radical neck dissection, and those who did. Among the patients who relapsed in the neck 65% (15/23) have died of the cancer, while among those who did not, none has died of supraglottic larynx cancer. Twenty-three percent (23/101) of the patients of the RRTI relapsed in the neck. Those who received radiation therapy to the primary tumor only relapsed regionally in 38% (8/21); treatment of both sides of the neck reduced the incidence of nodal recurrence to 19% (15/80). The majority of patients who relapsed in the neck eventually died of the cancer, that is 57% (13/23). Data from both institutions once again demonstrate the impact on survival of a relapse in the neck. Best strategies for decreasing the relapse rate in the neck are discussed; the conclusion was reached that, so far, elective radiation to both sides of the neck is the preferable treatment. PMID- 3667369 TI - Radiation therapy in early carcinoma of the true vocal cords (stage I and II). AB - Seventy-four patients with Stage I and twenty patients with Stage II carcinoma of the true vocal cords received radiation therapy from 1971 to 1983. Sixteen patients had second primary cancers with the most common site being the lung. The patients were treated with 4 MeV linear accelerator X ray or 60Co machine with the average total dose of 6600 rads in 33 fractions, 5 days a week by parallel opposing ports. Local control rate by radiation therapy was 86% in Stage I and 70% in Stage II. Eight of twelve (8 of 12) failures were salvaged by surgery. The actuarial 5-year survival was 92 and 80%. Seventy-six (76%) of patients had good quality of voice after treatment. PMID- 3667370 TI - Long-term results of a pilot study of low dose cranial-spinal irradiation for cerebellar medulloblastoma. AB - Between May 1974 and March 1983, 44 children with histologically verified cerebellar medulloblastoma were seen for post-operative cranial-spinal irradiation following attempted total tumor removal. Six patients were excluded from review because they received all or part of their treatment at another institution (3 patients) or did not complete the planned course of irradiation (3 patients). All of the 38 remaining patients were treated by a previously described technique on a 4 MeV Linear Accelerator with 55 Gy delivered to the primary tumor site. Prior to December 1978, 19 consecutive children (Group A) had spinal prophylactic doses of 30-40 Gy and brain prophylactic doses of 40-50 Gy. After the date, 25 Gy was given to the cranial-spinal axis of 19 consecutive children (Group B). This lower dose was arbitrarily selected with the hope of reducing morbidity in treated survivors and achieving the same tumor control. Risk factors that define good and poor prognosis were evaluated for each group, and there were no differences noted. Myelography and CSF cytology were not routinely performed. Follow-up for the 38 patients ranges from 20 months to 124 months. For the low risk patients, survival (12/15 or 80%) was independent of cranial-spinal radiation dose (Group A 6/8, Group B 6/7). For the high risk patients survival was poor (9/23 or 39%), not dependent on cranial-spinal radiation dose (Group A 5/11, Group B 4/12), and associated with failure at the primary site (10/14), often with CSF seeding (8/10). The other 4 failures include 2 who had moved outside the United States (details of failure are unknown), 1 with supratentorial, CSF seeding and distant metastases, and 1 with distant metastasis only. There were no isolated spinal failures. This pilot study shows that the prophylactic radiation dose to the cranial-spinal axis can be decreased to 25 Gy without jeopardizing control rate and survival in patients with medulloblastoma. PMID- 3667371 TI - Results of a pilot study of hyperfractionated radiation therapy for children with brain stem gliomas. AB - The majority of children with brain stem gliomas develop progressive disease within 18 months of diagnosis and treatment. Radiotherapy (RT) is of transient benefit in most patients and higher total doses of RT have been related to improved survival. The amount of RT which can be given is limited by the tolerance of the surrounding brain. Hyperfractionated RT theoretically allows higher doses of RT to be tolerated by the brain. Sixteen children with brain stem gliomas were treated on a hyperfractionated RT schedule, receiving 120 cGy of RT twice daily, to a total dose of 6480 cGy. All patients tolerated treatment well. Eleven of 15 (73%) evaluable patients had a response to treatment and two (13%) others had stable disease. One patient developed progressive disease during treatment. All patients were tapered off steroids by the completion of treatment. Thirteen of 16 (81%) patients developed progressive disease at a median of 7 months after diagnosis and three remain in remission 8, 12, and 15 months following diagnosis. These results were similar to those of historical controls. Two patients were surgically explored at time of relapse and 5 have had an autopsy. No acute or subacute neurologic toxicity was seen; but long-term detrimental effects on brain could not be assessed. The implications of this study are that escalations of the dose of hyperfractionated RT can be entertained for children with brain stem gliomas. PMID- 3667372 TI - The effect of TURP on prognosis in prostatic carcinoma. AB - Of 553 patients definitively irradiated for biopsy proven prostatic adenocarcinoma from January 1976 to March 1986, 287 patients with a minimum follow-up of 4 years were studied. One hundred sixty-two patients had transurethral prostatic resection (TURP); one hundred twenty-five patients did not. When subdivided by stage and histologic grade, those patients with poorly differentiated tumors who underwent TURP had a noticeably higher, but not statistically different, incidence of bony metastasis as compared to those who did not have TURP. Survival at 5 years also appeared to be better in patients with poorly differentiated and stage C disease without TURP. However, local tumor recurrence in poorly differentiated tumor with TURP was 42% as compared to 20% in the NO TURP group, p = .04. Moreover, when the incidence of osseous metastasis was assessed by local tumor status, 20% of the TURP patients with local tumor control developed metastases as compared to 66% of those with local failure. Similarly, within the NO TURP group, the incidence of bony metastasis was 16% for those with local control and 50% for those with local recurrence, p = .005 in both cases. Survival was likewise affected by local tumor control, regardless of whether or not TURP was performed. In patients with local tumor control, survival was 80% at 5 years with TURP and 86% without TURP (p greater than 0.1). In contrast, only 14% of patients with local recurrence and TURP were alive at 5 years which was not statistically different from the 32% survival in those with local recurrence but NO TURP. It seems, therefore, that comparing prognosis by TURP alone overlooks the inherent characteristics of the tumor and the extent of the disease. PMID- 3667373 TI - Perioperative interstitial irradiation in the conservative management of early breast cancer. AB - Conservation of the breast in early breast cancer with limited resection and radiation is proving to be as effective as modified radical mastectomy in survival and in loco-regional control. Management at the University of Kansas Medical Center consists of an interstitial implant at the time of lumpectomy to facilitate perioperative irradiation with Iridium-192 to the tumor bed. An axillary node dissection is also performed at that time. Two to 3 weeks later external beam irradiation is delivered to the entire breast. One hundred and twenty-three breasts in 120 patients have been treated between June 1982 and June 1986. There were 49 pathological Stage I, 63 Stage II, 8 Stage III carcinomas, and 3 carcinomas in situ, consisting of 72 T1, 43 T2, 5 T3, and 3 TIS lesions. Patients have been followed for a median of 30 months. One patient had a "true" recurrence in the breast. Another patient developed recurrence in a different quadrant. Ninety percent of the patients had good to excellent cosmetic results, 7% were considered fair, and 3% had poor results. Seven patients developed mild arm edema, 4 were found to have moderate edema, and 1 had severe arm edema. Our preliminary results indicate that interstitial irradiation immediately after excision results in excellent local control, with very satisfactory cosmesis and no morbidity due to the simultaneous excision and irradiation. PMID- 3667374 TI - Late radiation response of the canine trachea with change in dose per fraction. AB - Seventy-two dogs were given 36 to 74 Gy to the trachea in either 2, 3, or 4 Gy per fraction. Tracheal sections were histologically and morphometrically evaluated 6 months after irradiation to determine the relative percentage of goblet cells, submucosal glands, connective tissue and blood vessels. The percent of each tissue component was plotted against total dose, regression lines calculated and isoeffective doses obtained for construction of isoeffect curves. Probit analysis for probability of surface ulceration also was done. Another group of 32 dogs received either 36, 44, or 52 Gy in 4 Gy fractions and tracheas were similarly analyzed at 1, 3, and 12 months after irradiation. Goblet cells and submucosal glands decreased with increasing total dose in each of the dose per fraction groups while connective tissue increased. Lower doses per fraction had more shallow dose response curves and higher total doses were required to produce an isoeffect. The alpha/beta ratios for tissues at 6 months after irradiation were 3.5 Gy for decrease in goblet cells, 4.7 Gy for probability for surface ulceration, 4.5 Gy for decrease in submucosal glands and 1.8 Gy for increase in connective tissue. Goblet cells and submucosal gland numbers decreased within 1 month and remained significantly decreased at higher doses at 12 months. Although there was no dose response for vasculature volume at 6 months, significant perivascular and intimal fibrosis was observed. This study revealed significant damage to the trachea at high total doses and large doses per fraction. The relatively low alpha/beta ratios obtained indicates that these adverse effects are late effects. Significant sparing of the adverse late effects was present at lower doses per fraction. These results indicate that coarser fractionation schemes that include the trachea in the treatment volume could be potentially dangerous. PMID- 3667375 TI - Effect of anemia on tumor radiosensitivity under normo and hyperbaric conditions. AB - The effect of chronic anemia on tumor radiosensitivity in a murine tumor has been investigated. Anemia was induced by bilateral kidney irradiation given several months before tumor implantation. Anemic, anemic transfused, and normal non anemic age-matched tumor bearing animals were irradiated with X rays (2 F/24 hr) either in air, air plus misonidazole, or under hyperbaric oxygen. The most resistant response was that of tumors grown in normal mice treated in air. Anemia produced an increase in radiosensitivity which was further enhanced by red blood cell replacement. The most sensitive overall response was seen in the anemic transfused group treated with HBO. PMID- 3667376 TI - 5-Fluorouracil infusions and fractionated doses of radiation: studies with a murine squamous cell carcinoma. AB - The present investigation describes the effects on a murine squamous cell tumor of combined treatment using radiation and 5-Fluorouracil (5FU), with emphasis on 5FU infusions. The tumor, SCC VII/To, was grown intramuscularly in the hind legs of C3H mice. Radiation was given locally with 100 kVp X rays either alone or in combination with 5FU by i.p. bolus injections or 4-14 day infusions using subcutaneously implanted mini-osmotic pumps. Studies with radiation alone indicated regrowth delay increased with total dose. This increase was less for fractionated than single doses. The effects of 5FU alone were compared using i.p. injections or 4, 7 or 14 day infusions. Tumor response to single i.p. bolus injections or 4 day infusions were not significantly different. Up to total drug doses of 200 mg/kg, 14 day infusions were least effective on regrowth delay, 4 day infusions were intermediate and 7 day infusions were most effective. Above total drug doses of 200 mg/kg, effects of 14 day infusions on regrowth delay increased rapidly. The LD50 for single i.p. bolus injections and 7 day infusions were similar, 230 and a total drug dose of 270 mg/kg, respectively. When a 7 day infusion of 5FU (133 mg/kg) was combined with increasing total radiation doses (1 or 5 fractions), the increase in regrowth delay was additive. Combining a fractionated dose of 5 Gy per day for 5 days (5/5 Gy) with increasing total drug doses of 5FU (single i.p. bolus injections or 4, 7 or 14 day infusions) resulted in regrowth delays that were dependent on the total dose of 5FU. Administering a 133 mg/kg dose of 5FU (via a single i.p. bolus injection or 7 day infusion) starting 2 days before, during, or immediately after 5/5 Gy gave the same regrowth delay, indicating no effect of drug sequencing. In conclusion, the above data indicate that (a) 5FU infusions (greater than 4 days) are more effective than 5FU injections on regrowth delay and (b) combinations of 5FU and radiation, produce an additive tumor response, which occurs independent of mode, schedule, and time of 5FU administration, and is dependent on 5FU total dose. PMID- 3667378 TI - Enhancement of radiation-induced normal tissue damage by a fibrosarcoma. AB - Normal tissue damage in the legs of mice was enhanced by the presence of a fibrosarcoma (FSa I) in the leg at the time of treatment with single doses of 30 to 70 Gy. Damage was assessed by measuring leg contracture 23 to 365 days after irradiation of 8 mm diameter tumors. Animals with and without tumors were treated with 1.0 mg misonidazole/g body weight 30 min before irradiation to ensure that the tumors did not recur and interfere with the assessment of contracture. The data suggest that in some cases, late damage may be enhanced by destructive effects of the tumor on the tumor bed. PMID- 3667377 TI - Tumor targeting potential of liposomes encapsulating Ga-67 and antibody to Dalton's lymphoma associated antigen (anti-DLAA). AB - Dalton's lymphoma (solid tumor) was induced in Swiss mice by an 'Air-pouch' technique using ascites cells. A liposomal technique for radioimmunodetection and localization using Ga-67 and antibody has been developed. Dalton's lymphoma associated antigen (DLAA) was isolated and purified by ammonium sulfate fractionation and chromatography. The antibody to this antigen, anti-DLAA, was prepared by immunization of rabbits and purified by CNBr activated chromatography. The specificity of this antibody to the solid tumor antigen was ascertained by agar gel diffusion. Scintiscan studies were carried out using controls and Dalton's lymphoma bearing mice at various time intervals after i.p. administration of 10-20 mu ci of Ga-67, Ga-67 Ga-67 as liposomes and Ga-67 incorporated with antibody to DLAA as liposomes. Extensive studies carried out using liposomes of different sizes and charges revealed that anti-DLAA significantly improved the tumor uptake of Ga-67, thereby facilitating better visualization of the tumor. Negative and neutral liposomes delivered maximum radioactivity at the target tissue, whereas positive liposomes did not cause significant tumor accumulation of 67Ga. Biodistribution studies showed maximum tumor-associated activity that is 15.43% of the injected dose per gram tumor tissue was achieved with Ga-67 anti-DLAA liposomes compared to 6.6% with Ga-67 administered as such. Injection of Ga-67 liposome resulted in minimum tumor associated activity that is 5.33%, with maximum uptake by liver and spleen. This might be caused by accumulation of liposomes in these organs. Incorporation of anti-DLAA might significantly improve uptake of Ga-67 by target tissue, due to the specificity of the antigen antibody reaction. PMID- 3667379 TI - Effect of tumor colony definition on ionizing radiation survival curves of melanoma-colony forming cells. AB - Definition of survival and measurement of colony size in soft agar assays is important in establishing in vitro radiation survival curves. Conventionally, survival is assessed according to colony-forming ability. The distinction between small colonies that are abortive and those that are viable often involves a difficult and arbitrary choice for the investigator. We have examined the effect of different minimum colony sizes (greater than or equal to 25, greater than or equal to 50, greater than or equal to 75, and greater than or equal to 100 cells) on ionizing radiation survival curves for cells from established murine (CCL 53.1) and human (M1RW5) melanoma cell lines as well as from short-term human melanoma cell strains (C8146A, C8146C, C8161, C83-2C, C82-7A1, and C8442) and patient biopsy (83-4). Single cell suspensions were plated in the upper layer of the agar bilayer and cells were irradiated by single dose X rays. Giant cells did not form in colonies containing 50 or more cells. D0 values were highest (D0 values, from 390 to 100 cGy) for cells forming smaller colonies (greater than or equal to 25 cells, greater than or equal to 4-5 doublings) and lowest (D0 values, from 190 to 50 cGy) for cells forming larger colonies (greater than or equal to 100 cells, greater than or equal to 6-7 doublings). Therefore, apparent radiosensitivity was dependent on colony size selected for analysis. Precise measurement of colony size was important in establishing radiation survival curves because errors in determining the colony size will alter apparent radiosensitivity of cells. These results should help define the biological meaning of tumor colony growth in semisolid medium, and alter the interpretation of survival curves which measure sensitivity to agents using this assay. PMID- 3667380 TI - Regressing atypical histiocytosis: a case report of control following low dose radiation therapy. AB - A case of regressing atypical histiocytosis with a 10-year local course is reported. Long term control of a large fungating mass was achieved with low dose electron beam irradiation to 1500 cGy. Whereas spontaneous resolution of regressing atypical histiocytosis has been noted in the literature, this case demonstrates that certain lesions may be more aggressive than commonly assumed. In these particularly destructive lesions radiation therapy may have a role. PMID- 3667381 TI - Dose distributions around selectron applicators. AB - Measured and calculated dose distributions around selectron applicators, loaded with 60Co high dose rate pellets, are presented. The effect of the stopping screw, spacers, pellets themselves and the applicator wall on the dose distribution is discussed. The measured dose distribution is in almost perfect agreement with the calculated distribution in planes perpendicular to the applicator axis and containing a source. On the applicator axis directly below the applicator the measured dose amounts to about 75% of the calculated value, when only the stopping screw attenuates the beam from a pellet. When the beam is attenuated by spacers in addition to the stopping screw, the discrepancy between the calculated and measured dose may exceed 50%. Clinically relevant source geometries are also discussed. It is shown that for most regions around the applicator the method of a simple addition of dose contributions from individual point sources is an acceptable approximation for the calculation of dose distributions around the selectron applicators. PMID- 3667383 TI - Urethral invasion by prostatic cancer as a cause of postirradiation urethral stricture. PMID- 3667382 TI - A microdosimetric model of astatine-211 labeled antibodies for radioimmunotherapy. AB - Astatine-211 is an alpha-emitter with a short half-life (7.2 hr). This paper discusses the potential of 211At targeted by antibodies for tumor therapy and the possible advantage of 211At over beta- and gamma-emitting radionuclides such as 131I currently employed in the field of radioimmunotherapy. Since the longest range alpha-particle from 211At is only 67 microns and the rate of energy loss is high (track averaged linear energy transfer LT approximately 120 keV/micron), a disintegration of 211At produces a large and extremely localized deposition of energy. A Monte-Carlo model has been developed for studying the stochastic fluctuation of alpha-particle hits and energy deposition in cell nuclei in an attempt to determine the efficacy of 211At-labeled antibodies for tumor cell inactivation. Calculations have been performed for 2 extreme conditions: (a) the case of 211At retained in the capillary, and (b) for a homogeneous distribution of 211At-labeled antibody in the tumor. The results of these two calculations represent the boundary conditions between which any real solution must lie. Finally, developments to the model to include antibody transport across the capillary membrane and through the tumor tissue are discussed. PMID- 3667384 TI - Association of Residents in Radiation Oncology questionnaire on oral specialty boards. PMID- 3667385 TI - Suicide and the borderline depressed adolescent and young adult. PMID- 3667386 TI - Forced terminations. AB - Forced terminations are common clinical experiences and pose particular challenges and opportunities. They fall into four categories: mutually agreed upon, unilaterally forced by the patient, forced by realistic external circumstances, and unilaterally forced by the therapist. These differing situations are examined and compared, with attention directed to the use of reality as resistance, to the narcissistic injury in forced terminations, and to the potential transference-countertransference collusions to avoid powerful reactions to separation and loss. Problems with masochistic patients are considered opportunities for "bad endings." Technical considerations are discussed. PMID- 3667387 TI - The purloined self. PMID- 3667388 TI - The "real" relationship and analytic neutrality. PMID- 3667389 TI - The paranoid-schizoid position and pathologic regression in early adolescence. PMID- 3667390 TI - Techniques for reversing the failure of empathy towards AIDS patients. AB - Educating the general population and health care workers about the acquired immunodeficiency syndrome (AIDS) is of paramount importance. There is a need to address the many fears and anxieties concerning this dreaded illness. Experience has shown that simple information-giving alone does little to allay the panic in the general population and in hospital personnel. The paper offers a psychodynamic explanation of the origins of the irrational fear and anxieties around AIDS patients and why information alone does not help the anxieties hospital workers experience. We have suggested a training program using group process and videotape techniques which can address the underlying fears and concerns about AIDS patients. These sessions can help hospital staff to deliver more empathic care to this patient group. PMID- 3667391 TI - On failed intimacy. PMID- 3667393 TI - Pediatric residents' assessment of adolescents' experiences during pelvic examination. AB - We compared male and female pediatric residents' perceptions of adolescent females' attitude and experience during a pelvic examination. Females (n = 112) ages 12-19 years were randomly assigned to a male of female examiner and to a supine or semisitting pelvic-examination position. Pre- and postexamination questionnaires were completed by the patients. Female physicians were more accurate in assessing patient discomfort (p less than 0.006),pain (p less than 0.0004), and embarrassment (p less than 0.0006) during the pelvic examination. The correlation between the physicians' and the patients' assessments of the completeness of the examination was stronger for the male physicians (p less than 0.003). These relationships remained constant for both positions. The female physicians' appeared to base their perceptions of the patient-physician relationship partly on the emotional responses of the patient such as embarrassment, fear, and relaxation (p less than 0.02). In contrast, male physicians' perceptions were associated with patient expressions of pain and discomfort (p less than 0.02). PMID- 3667392 TI - Comparative analysis of the effectiveness of the diaphragm and birth control pill during the first year of use among suburban adolescents. AB - Little attention has been paid to the diaphragm as a contraceptive option for adolescents. To compare diaphragm and birth control pill use by adolescents, 124 females (aged 13-20 years) in a suburban-based adolescent health service were interviewed at least one year after receiving a contraceptive prescription. The 73 diaphragm choosers did not differ from the 51 pill choosers in age, race, or reason for their original visit to the health service. Diaphragm choosers, however, were better students, of higher socioeconomic status, and had had fewer prior pregnancies. In the year following prescription, continuous use for 12 months was reported by 43% of diaphragm choosers and 45% of pill choosers, with significantly more pill (26%) than diaphragm (8%) choosers reporting discontinued use for at least one month while remaining sexually active. Regular use (diaphragm every intercourse, missing less than or equal to 1 pill/month) was reported by 36% of diaphragm choosers compared to 88% of pill choosers; and at least one pregnancy during the year was reported by 15% of diaphragm choosers and 18% of pill choosers. At follow-up interviews, diaphragm subjects disliked the immediate annoyances of the diaphragm, and pill users expressed concern about the potential side effects of the pill. No single factor or set of factors correlated with continuous and regular use of either method. Because both methods present specific problems for certain patients, we suggest that in addition to the pill, the diaphragm should receive serious consideration as a contraceptive option for adolescents. PMID- 3667394 TI - Residents' perception of their skill levels in the clinical management of adolescent health problems. AB - Residents in six specialty training programs completed a 126-item questionnaire designed to assess their skill or confidence to manage adolescent health issues. The residency programs studied were family practice, internal medicine, pediatrics, emergency medicine, obstetrics/gynecology, and combined medicine/pediatrics. Although almost three-fourths of the residents were at least moderately interested in adolescent health care and 90% expected to care for adolescents, only 26% believed an adolescent rotation should be required during training. Residents generally considered themselves unskilled to manage adolescents in the areas of sexuality, handicapping conditions, and psychosocial problems. Significant differences in perceived skills were found among the specialty programs on 45% of the items presented. Resident training appears to be needed in the areas of adolescent growth and development, counseling, and sexuality. PMID- 3667395 TI - Effects of father-daughter contact on use of pregnancy services by Mexican, Mexican-American, and Anglo adolescents. AB - This study describes whether frequency and quality of father-daughter contact during adolescent pregnancy differ by ethnicity, whether this contact affects health behavior, and how ethnicity conditions the relationship between contact and behavior. Health behavior is defined as timing of pregnancy test and first prenatal visit. Data were gathered from a sample of 105 Anglo, Mexican-American, and Mexican adolescents interviewed at mid-pregnancy. Almost twice as many Mexicans (64%) as Mexican-Americans never saw their fathers (p less than 0.03). Girls living with their fathers obtained pregnancy tests significantly later (p less than 0.01) than those living independently. This relationship was maintained when ethnicity was held constant (p less than 0.01). When quality of contact was included, the relationship between residency with father and timing of pregnancy test became even stronger (p less than 0.003). PMID- 3667396 TI - Why adolescents do not attend school. The views of students and parents. AB - Despite the magnitude and importance of the problem, little is known about why many students are absent from school. This study assessed what a sample of excessively absent students and their parents believed were the reasons for the students' absences. In response to an open-ended question about their main reason for absence, almost half of the students reported a health-related reason. When asked whether any of 15 potential problems contributed to their absence, many reported common and acute physical illnesses, headaches or stomachaches, and other aches or pains. Half mentioned factors relating to low motivation or a concern about the school environment. The parents' responses were remarkably similar except they were more likely to cite emotional problems of the student, school violence, and racial problems. When individual student's responses were compared with those of his or her parents, agreement on individual items were little better than would be expected by chance. PMID- 3667397 TI - Diagnosing psychiatric disorders in adolescent females with abdominal pain. AB - Psychiatric diseases, recently renamed psychiatric disorders by the American Psychiatric Association, are commonly associated with abdominal pain in adolescents but may be difficult to diagnose. In a prospective study, we evaluated four psychiatric scales, including the Childhood Depression Inventory (CDI) and the Speilberger State-Trait Anxiety Inventory (STAI) as aids in the diagnosis of psychiatric disorders in 40 adolescent females with abdominal pain. Final diagnosis of organic-dysfunctional disease was made in 32 patients, and a psychiatric disorder was found in eight. Only the CDI (p = 0.001) and the State (p = 0.006) and Trait (p = 0.022) scales of the STAI had significantly different mean values between subjects with organic-dysfunctional disease and a psychiatric disorder. Almost all subjects with a psychiatric disorder had abnormally high scores, whereas the subjects with organic-dysfunctional disease did not. We conclude that three brief, self-administered psychiatric scales may be useful in differentiating between organic-dysfunctional disease and a psychiatric disorder in adolescent patients with abdominal pain. PMID- 3667398 TI - Influence of family planning counseling in an adolescent clinic on sexual activity and contraceptive use. AB - We evaluated whether family planning counseling (FPC) in an adolescent clinic promoted the onset of sexual activity among the non-sexually active teens and/or increased contraceptive use among the sexually active teens. The FPC focused on the teens' establishing sexual values, the right to say "no," abstinence and alternate forms of intimacy, consequences of intercourse, and the various contraceptive methods. Data for one year were collected on the adolescents' first and subsequent visits to a medically oriented, municipal outpatient adolescent clinic. There were 383 teenagers who qualified for the study. Of these, 35% (134) reported premarital sexual activity. During the study period, 3% (8) of the 249 nonsexually active teens reported becoming sexually active. Among the 134 sexually active teens at clinic entry, 27% reported using a contraceptive method at their most recent sexual encounter. Among the 142 sexually active adolescents at the conclusion of the study, 76% reported contraceptive use at their most recent sexual encounter (p less than 0.001). We conclude that the provision of FPC to nonsexually active and sexually active teens does not appear to promote the onset of sexual activity significantly among the non-sexually active group, although it significantly increases contraceptive use among the sexually active group. PMID- 3667399 TI - Gastroesophageal polyp diagnosed in an adolescent presenting with epigastric pain. AB - A gastroesophageal polyp is a rare finding. The case of an adolescent male presenting with epigastric pain and such a polyp is described. These polyps are usually described in the clinical setting of gastroesophageal reflux and esophagitis. Polyps can be identified radiographically as a characteristic filling defect at the gastroesophageal junction. Endoscopy should be used to confirm the diagnosis. Polypectomy is recommended when malignancy is suspected or where there is evidence suggesting that the polyp is causing symptoms. PMID- 3667400 TI - Prolonged suppression of hirsutism with combination therapy in an adolescent with insulin resistance and acanthosis nigricans. AB - Spironolactone and oral contraceptives have been used separately with some success in the treatment of hirsutism. Hirsutism associated with the Kahn type-A syndrome of insulin resistance, acanthosis nigricans, and polycystic ovaries may be severe and refractory to conventional treatment. In view of their different sites and mechanisms of action, spironolactone and an oral contraceptive were used in combination to treat severe hirsutism in a 13-year-old girl with features of this syndrome. The two therapeutic agents, apparently acting together, resulted in a marked reduction in facial hair and serum androgen concentrations, which persisted during 18 months of treatment. Testosterone and androstenedione levels fell from 100 ng/dl and 628 ng/dl, respectively, to 47 ng/dl and 230 ng/dl by six months and to 35 ng/dl and 156 ng/dl by 18 months. This result suggests that combination therapy may be an effective treatment for severe hirsutism. PMID- 3667401 TI - Thrombocytopenia in a bisexual adolescent male with a history of intravenous drug use. AB - Immunologically mediated thrombocytopenia has been reported as a manifestation of human T-lymphotropic virus type III (HTLV-III) infection and intravenous (IV) drug abuse. The case report describes thrombocytopenia in a bisexual adolescent male with antibody to the HTLV-III virus and a history of infrequent IV drug abuse. The case underscores the need to consider HTLV-III infection and/or IV drug abuse in the differential diagnosis of thrombocytopenia in an adolescent. PMID- 3667402 TI - Pseudocyesis as the presenting symptom in an adolescent patient with an incipient thought disorder. AB - A case is presented of an adolescent girl whose initial psychotic event was the appearance of pseudocyesis, which was terminated by a delusional miscarriage. The delusion was initiated by amenorrhea, which was probably due to a persistent luteal cyst and was perpetuated by the patient's underlying thought disorder. This case supports the somatopsychic hypothesis that pseudocyesis can be initiated by a coincidental physiologic change in a susceptible individual. Physicians must consider a psychotic delusional state in the etiology of pseudocyesis. PMID- 3667403 TI - President's address. Society for Adolescent Medicine annual meeting, March 21, 1987. PMID- 3667404 TI - Keeping pace with changes in animal agriculture. PMID- 3667405 TI - Surgical removal of heartworms. PMID- 3667406 TI - Compassion among physicians and veterinarians. PMID- 3667407 TI - Employed veterinarians as independent contractors--some legal considerations. PMID- 3667408 TI - Arthroscopic surgery for the treatment of osteochondral chip fractures in the equine carpus. AB - The technique and results of arthroscopic surgery for the removal of osteochondral fragments from 1,000 carpal joints in 591 horses are reported. Of the 591 horses, 580 were racehorses (including 349 Quarter Horses and 220 Thoroughbreds). The distal aspect of the radial carpal bone was the most commonly affected site, followed by the proximal aspect of the intermediate carpal bone and distolateral aspect of the radius. More than one carpal joint was simultaneously operated on in 58.9% of the Quarter Horses and in 37.4% of the Thoroughbreds. Marked differences in the amount of damage were noted at arthroscopy, compared with what was observed on radiography. Arthroscopic surgery was an effective technique for removing the osteochondral fragments as well as for treating other lesions. The overall functional ability as well as cosmetic appearance of the limbs were excellent. There was no postoperative intra articular infection. Postsurgical follow-up information was obtained for 445 racehorses. After surgery, 303 (68.1%) raced at a level equal to or better than their preinjury level, 49 (11.0%) had decreased performance or still had problems referable to the carpus, 23 (5.2%) were retired without returning to training, 28 (6.3%) sustained another chip fracture, 32 (7.2%) developed other problems, and 10 (2.2%) sustained collapsing slab fractures while racing. When horses were separated into 4 categories of articular damage, the performance in the 2 most severely affected groups was significantly inferior. One hundred thirty-three of 187 horses with grade-1 damage (71.1%), 108 of 144 with grade-2 damage (75.0%), 41 of 77 with grade-3 damage (53.2%), and 20 of 37 horses with grade-4 damage (54.1%) returned to racing at a level equal to or better than their preinjury level. In examining the prognosis relative to site of the fracture, the prognosis for both breeds was worst with lesions of the third carpal bone. PMID- 3667409 TI - Comparison of treatments for ovine foot rot. AB - Sheep affected with foot rot were treated by vaccination and/or hour-long footsoaks, without hoof paring. The response to each treatment was obvious, but the cure rate was not satisfactory for eradication efforts. Booster vaccination and hoof paring combined with medication applied topically greatly improved the response to treatment. There was little difference in response to footsoaking or footbathing when hooves were pared. PMID- 3667410 TI - Prevalence of Fascioloides magna in cattle and deer in Michigan. AB - A survey among 1.12 million cattle slaughtered in 357 packing plants in Michigan during 1977 to 1981 was conducted to determine the prevalence of liver fluke infection. The condemnation rate of liver fluke-infected livers was 0.41, 3.7, and 13.9% in the southern, northern-lower, and upper regions of Michigan, respectively. The same trend in infection rates was observed in white-tailed deer that had been examined in diagnostic laboratories in the state. A serologic survey among 50 randomly selected dairy farms detected Fascioloides antibody carrying cattle in 3 farms. The data on prevalence in slaughter cattle were slightly biased, because many slaughter cattle originated from other states in which F magna may be less common. PMID- 3667411 TI - Gastrointestinal zygomycosis in suckling pigs. AB - Gastrointestinal zygomycosis was diagnosed in 3 suckling pigs (10, 14, and 28 days old) with diarrhea that was unresponsive to treatment with broad-spectrum antibiotics. The 3 pigs were from separate farms, and littermates of the 3 pigs with similar clinical signs had died. At necropsy, 2 of the 3 pigs had catarrhal to fibrinonecrotic gastroenteritis, and the third pig had hemorrhagic gastritis without intestinal lesions. Microscopically, transmural necrosis of the stomach and intestines was associated with marked inflammatory cell infiltration and thrombosis and vasculitis of vessels of the lamina propria and submucosa. Numerous broad, irregularly branching, nonseptate, mucoraceous fungi were seen in the lumens of blood vessels and in the necrotic mucosa and submucosa. PMID- 3667412 TI - Ammoniated forage toxicosis in calves. AB - Two calves developed a CNS syndrome characterized by hyperesthesia, tremors, and incoordination while nursing dams that had been feeding on ammoniated forage. To increase digestibility, intake, and nitrogen content, low-quality forages were ammoniated at a rate of 3% dry weight. However, a CNS syndrome of unknown cause has been observed in cows and calves nursing cows that have ingested ammoniated forage. Serum electrolytes, glucose, and blood differentials of the 2 calves in this report were normal. However, the older calf had high serum and CSF ammonia concentrations. Both calves, sedated with acepromazine and given thiamine injections, were clinically normal 12 hours later. PMID- 3667413 TI - Identification of trichomonad-carrier cows. AB - Seven pregnant cows (gestation durations, 42 days to 7 months) were identified as culture-positive for Tritrichomonas foetus. For 6 of these pregnancies, 2 of the youngest fetuses were aborted, and calves were delivered by the other 4 cows. Two cows became carriers, maintaining trichomonad infections for 6 and 9 weeks after parturition. Carrier cows may be a source of reinfection for their herd mates. Hence, strategies for controlling trichomoniasis might include delaying the time of first breeding and aggressive culling of infected cows. PMID- 3667414 TI - Persistent urachal remnant causing intestinal strangulation in a cow. AB - A persistent urachal remnant causing small intestinal strangulation was found on exploratory laparotomy in a 2-year-old cow with colic. The persistent urachus consisted of a thin cord-like band that was attached ventrally to the umbilical region and caudally to the apex of the bladder. The band had formed an internal loop and had strangulated 6 to 8 cm of the distal portion of the ileum. The persistent urachus was detached manually at the umbilicus, ligated at the apex of the bladder, and removed; intestinal resection was not necessary. The urachal remnant was probably a congenital abnormality that may have become stretched during pregnancy, forming an internal hernial loop. PMID- 3667415 TI - Supernumerary ectopic penis in a bull. AB - A 1-month-old Beefmaster bull was admitted for removal of a congenital ectopic penis and sheath from the right paralumbar fossa. Gross and histologic evaluation of the excised tissue revealed a normal sheath containing a penis that terminated at a prostate gland, medial to the wing of the right ilium. Rectal palpation of the bull 14 months later disclosed no association between the excised ectopic tissue and the normal genital tract. PMID- 3667416 TI - Preputial hematoma in a stallion. AB - An 8-year-old Quarter Horse stallion was admitted with a swelling involving the prepuce, dorsal part of the scrotum, and root of the penis. The swelling was first noticed 10 days after breeding, with no evidence that it had resulted from a kick by the mare. The penis was retracted into the prepuce, except for a 10- to 15-cm protrusion of the glans penis. Treatment included warm hydrotherapy, massage, stockinette compression, antidiuretics, antibiotics, penile support, and exercise, without success. At necropsy, a massive preputial hematoma was found extending forward from the root of the penis to 12 cm proximal to the glans penis. The exact origin of the hematoma could not be determined. Most likely, bleeding had originated from the vascular plexus lying subfascially on the surface of the penis outside the intact tunica albuginea or from a branch of the external pudendal artery. PMID- 3667417 TI - Monitoring the progression of renal failure in a horse with polycystic kidney disease: use of the reciprocal of serum creatinine concentration and sodium sulfanilate clearance half-time. AB - Sequential reciprocals of serum creatinine concentration and sodium sulfanilate clearance half-times were used to monitor a horse with chronic renal failure. The horse was diagnosed as having polycystic kidney disease; at least one cyst was of distal tubular origin. Using the plots of the sequential data, a reasonably accurate prediction was made for complete renal decompensation to develop. PMID- 3667418 TI - Coxofemoral luxations in cattle: 22 cases (1980-1985). AB - Traumatic, unilateral coxofemoral luxation was diagnosed in 22 female dairy cattle (12 calves less than or equal to 13 months old, 10 adults). Physical examination differentiated between dorsal and ventral luxations, but could not distinguish luxations from fractures of the proximal aspect of the femur that occurred in 2 additional adults. Luxations were confirmed by radiography in 5 animals. Closed reduction was accomplished in only 1 calf. A craniolateral surgical approach to the hip, using mechanically assisted traction, was successful in reducing 95% (20/21) of the luxations. Craniodorsal luxations (16) were most common. Ninety-four percent of the animals were ambulatory before surgery. None had concomitant musculoskeletal injuries and 75% (12/16) survived for a long period. Five of 6 animals with ventral luxations arrived recumbent, with serious complicating musculoskeletal injuries, and only 2 of these animals survived for a long period. Calves had a better long-term survival rate (75% vs 50%) and a lower reluxation rate (17% vs 40%), compared with adults. PMID- 3667419 TI - Use of a bone plate for treatment of middle phalangeal fractures in horses: seven cases (1979-1984). AB - Four adult horses and 3 foals with middle phalangeal fractures were treated by arthrodesis of the proximal interphalangeal joint, using a bone plate. Six of the 7 horses survived greater than 2 years; 2 of the 6 horses had intermittent lameness after hard work, and 4 horses didn't have evidence of lameness. The use of a bone plate for arthrodesis of the proximal interphalangeal joint was a successful treatment alternative for middle phalangeal fractures in horses. PMID- 3667420 TI - Commentary: the crisis in education. PMID- 3667421 TI - A review of recruitment and retention programs for minority and disadvantaged students in health professions education. AB - Since the late 1960s, allied health educators have been providing special activities designed to recruit and graduate minority and disadvantaged students. Summer enrichment, prematriculation, and a variety of other student support programs have been used to benefit students, institutions, and society. Colleges of allied health are becoming increasingly concerned with recruiting and retaining all students. Fortunately, lessons learned from these special programs can be used to ensure the enrollment of capable learners and the graduation of competent allied health professionals. To accomplish this, student recruitment and retention must be viewed as a process of interrelated activities. Faculty, students, and administrators must be involved in planning, implementing, and evaluating programs to ensure that the components of the recruitment and retention process are meeting the needs of the learner and the institution. This article provides a historical perspective of these activities and suggests means by which process components could be made more effective. PMID- 3667422 TI - Attrition in an undergraduate program in allied health education. AB - The present study compared the characteristics of allied health professionals who completed a bachelor's degree program in allied health education with those who failed to complete the program, in order to develop recommendations for a retention program. The data base included all graduates and dropouts for the period September 1972 to August 1986. Analyses indicated that alumni and those who dropped out were remarkedly similar with regard to demographic characteristics such as age, sex, ethnicity, and prior academic achievement. Fifty percent of the dropouts occurred within the first semester, although attrition continued to occur over a five-year period. The reasons for dropping out were varied, and few were recorded for academic reasons. It was concluded that adult allied health professionals pose difficult problems for retention because motivation and commitment variables appear more important than academic ability or social/academic integration factors. These findings were consistent with research on attrition in higher education, and with the literature on adult learning. PMID- 3667423 TI - An examination of role identification by students in health education and health services administration. AB - This research was designed to test the extent to which health education and health services administration students' perceptions of their roles as professionals matched the expectations of professional faculty. These perceptions were found to match in general. However, doubt was cast on the extent to which internships or practicums contributed to this result, since there was no change in student responses between the beginning of the junior year and end of the senior year, a period which includes fieldwork and most of the professional coursework presumed to influence professional development. Additional research is required to test this result with other student populations in other health professions and identify the point at which professional role and task definitions are amenable to change. PMID- 3667424 TI - An investigation of managerial characteristics of health care managers: a comparison study. AB - This study compared the managerial trait profiles of health care managers with hospital administrators and managers in the general business community. It focused on two central issues: (1) the preparedness of health care managers for managerial responsibility as compared with managers in other occupations; and (2) the impact of gender differences on the trait profiles. Results indicated that, while differences existed between the groups studied, health care managers exhibited characteristics associated with managerial success. Additionally, gender differences were evidenced, inasmuch as women had stronger managerial profiles than their male counterparts. PMID- 3667425 TI - Morphometric analyses of the epididymis from normal and vasectomized rats. AB - To provide a structural basis for region-specific biochemical activities of rat epididymal cells and to assess the morphometric effects of vasectomy, tissue and cellular morphologic parameters for each of six histologically defined regions from the epididymis of long-term sham-operated and vasectomized rats were analyzed stereologically. In sham-operated rats, tubule diameter generally increased from region 1 to region 6 (163 microns to 338 microns) while tubular wall height decreased (35 microns to 17.5 microns) as did tubular wall volume density (0.48 to 0.12). For columnar epithelial cells, the absolute cell number/region ranged from 16.5 to 5.1 X 10(6) such that region 2 greater than region 1 greater than region 5 greater than region 4 greater than region 6 greater than region 3. Based on cell volume, the largest columnar epithelial cells were found in region 3 (2607 +/- 127 microns3). The epididymal tubule wall was made up of 91% columnar epithelial cells, 5% lymphocytes, and 4% basal cells. The relatively small tubular lumen, large wall volume, and large columnar epithelial cell number in the caput (regions 1 to 3) provide the structural basis for maximizing biochemical interactions between columnar epithelial cells and spermatozoa. In contrast, the distal cauda (region 6), with its large lumen and small tubular wall volume, is structurally optimized for the function of storage, which requires minimal columnar epithelial cell interaction with spermatozoa. In vasectomized rats, mean tissue volumes for most epididymal regions were significantly greater than in sham rats. The absolute number of lymphocytes in vasectomized rats significantly increased in several regions, thus implicating them in post-vasectomy events. PMID- 3667426 TI - Testicular hemodynamic changes after the surgical creation of a varicocele in the rat. Intravital microscopic observations. AB - The present study investigated the effect of a surgically induced varicocele on the dynamics of testicular blood flow. The surface vasculature of the normal and the varicocele-affected testis was examined utilizing intravital epi-illumination microscopy. Application of this technique to the study of the varicocele is new. Blood flow characteristics in surface veins were studied as the surface temperature of the testis was varied. Periodic, reproducible stoppages in blood flow, determined by direct observation of the red blood cells, were seen in seven of eight sham animals at the lower temperatures. These stoppages were abolished and blood flow increased at higher temperatures; stoppages reappeared at lower temperatures. The periodic stoppages were present in only one of eight rats with a proven varicocele (P less than 0.025) at any temperature studied. This loss of blood flow regulation may be the result of a loss of testicular arteriolar tone and may explain the increase in testicular blood flow and temperature elevation observed in association with a varicocele. These findings may provide new insights into the pathophysiology of the varicocele and highlight the need to study the microvascular sequelae of this vascular abnormality. PMID- 3667427 TI - Computerized videomicrographic analysis of rat sperm motility. AB - Quantitative methods for the determination of the concentration, percent motility and swimming speed of human and animal spermatozoa can assist in the objective analysis of sperm and semen quality. These parameters are among the most discriminating indicators for both clinical and toxicologic assessments of reproductive function. A computerized videomicrographic analysis system to measure sperm motility characteristics in the Fischer 344 rat was characterized and compared with both manual and semi-automated videomicrographic methods (Blazak et al, 1985). The system compares favorably, both in accuracy and sensitivity, to these more conventional methods. The most variable indicator of potential reproductive function in the Fischer 344 rat is the total sperm count from the cauda epididymidis (coefficient of variation [CV] = 24%), while parameters of sperm motility vary least. These include percentage of motile cells (CV = 15%), curvilinear velocity (CV = 9%) and linearity (CV = 10%), which is a ratio of straight-line to total distance traveled. It was concluded that the computerized system may be useful for routine assessment of changes in sperm quality that may occur in the rat after exposure to toxic drugs or chemicals. PMID- 3667428 TI - Correlation between defective motility (asthenospermia) and ATP reactivation of demembranated human spermatozoa. AB - Human spermatozoa treated with 0.05% Triton X-100 to remove the cell membranes became immotile but flagellar movement was reinitiated by addition of 0.06 to 1 mM adenosine triphosphate (ATP). The percentage of spermatozoa showing flagellar movement 2 minutes after addition of 1 mM ATP from men with idiopathic asthenospermia (mean +/- SD, 34 +/- 15%), oligozoospermia (17 +/- 21%), sperm autoimmunity (17 +/- 12%), vasoepididymostomy (20 +/- 22%), or idiopathic zero motility (0%) was significantly lower than with spermatozoa from normal men (54 +/- 12%). The percentage of reactivated spermatozoa was correlated with the proportion of live cells (Eosin Y stain, r = 0.602, P less than 0.001), percentage of motile cells (r = 0.761, P less than 0.001), and motility index (r = 0.759, P less than 0.001) in the same semen samples. When expressed relative to initial sperm motility, the proportion reactivated was similar for idiopathic asthenospermia (85%) and normospermia (82%). Thus, failure to produce ATP does not appear to be a frequent cause of low sperm motility in man. PMID- 3667429 TI - Pregnancy rates of beef heifers bred either on puberal or third estrus. AB - The objective of this study was to determine if pregnancy rates (PR) differed between beef heifers bred to fertile bulls on either their puberal (E1, n = 89) or third (E3, n = 67) estrus. Heifers were obtained from two lactations (Manhattan, L1; and Miles City, L2), and the experiment was conducted at Miles City. Heifers were assigned randomly within location to either E1 or E3. Heifers were fed to gain .56 kg.head-1 X d-1 and observed twice daily for estrus. After exhibiting first estrus (puberty) and breeding, each heifer in E1 was palpated rectally on d 6, 9 and 12 +/- 1 d (estrus = d 0) for the presence of a corpus luteum, and a venous blood sample was collected for assay of progesterone by radioimmunoassay. Heifers in E3 were palpated and bled on the same schedule as heifers in E1 after first estrus and after being bred to a fertile bull at third estrus. Pregnancy rates were determined by rectal palpation at approximately 38 d post-breeding. Location of origin did not affect (P greater than .10) weight at puberty or weight at breeding; however, heifers from L1 were younger (P less than .05) than heifers from L2 at puberty and breeding. Pregnancy rates were 57 and 78% for heifers in E1 and E3, respectively (P less than .05). Weight at breeding did not influence (P greater than .10) pregnancy rates. The probability of heifers in E1 becoming pregnant increased (P less than .05) with increasing age, while age was not a factor (P greater than .10) for heifers in E3. These results indicated that fertility of puberal estrus in beef heifers is lower than third estrus. Higher fertility of third estrus may be related to maturational changes associated with cycling activity. PMID- 3667430 TI - Effects of dietary energy level and supplemental protein source on performance of growing steers and nutrient digestibility and nitrogen balance in lambs. AB - Four experiments were conducted to evaluate three crude protein (CP) sources (urea, U; soybean meal, SBM; corn gluten meal, CGM) in diets based on corn silage (high energy) or grass hay (low energy). In Exp. 1 and 2, growing steers were fed all combinations of energy and protein source at 10.5 or 12% CP. Steers fed high energy diets or 12% CP had improved (P less than .05) daily gains and feed:gain over 84 d. Protein source had no effect (P greater than .05) on performance except that steers fed U consumed more (P less than .05) feed than those fed CGM. Steers were fed experimental diets to a common weight and switched to an 85% concentrate diet for finishing. During finishing, steers fed low energy diets in the growing period consumed more (P less than .05) feed and had increased (P less than .05) feed:gain compared with those fed high energy diets. Growing lambs were fed the same diets as steers. At 10.5% CP, lambs fed high energy diets had higher (P less than .05) digestibilities of dry matter (DM), organic matter (OM), nitrogen (N) and fiber components, and retained more (P less than .05) N. For lambs on 12% CP, high energy diets had higher (P less than .05) DM and OM digestibilities and lower (P less than .05) N digestibilities. At 12% CP, energy level had no effect (P greater than .05) on N retained. Protein source had no effect (P greater than .05) on N retention. There appeared to be no advantage in supplementing with ruminally undegradable proteins, i.e. CGM, in these experiments. PMID- 3667431 TI - Growth and carcass characteristics of cull cows after different times-on-feed. AB - Cull cows (N = 48) of similar age from Angus and Hereford breed types were assigned to one of four feeding periods (0, 28, 56 or 84 d) and subdivided into two groups, one implanted with Synovex-H and a non-implanted control. Cows were fed a high energy diet and slaughtered at the end of each feeding period. Average daily gain and feed efficiency were evaluated on each animal during the trial. The following carcass traits were evaluated: USDA yield and quality grade characteristics, boning yield, muscle weights, bone weights, pH and Warner Bratzler shear force of the longissimus muscle. The left side of each carcass was boned and proximate analysis was determined. No significant implant effects were encountered for any of the traits evaluated; therefore, data were pooled and evaluated by feeding period only. Carcass weight and boneless forequarter and hindquarter tissue weights increased significantly between each feeding period; percent kidney, pelvic and heart fat (KPH) and yield grade did not differ (P greater than .05) until d 56 and 84, respectively. Quality grade and marbling scores improved (P less than .05) between 28 and 56 d of feeding. Biceps femoris weight changed during the 84-d experiment from 4.1 kg on d 0 to 5.3 kg on d 84 (P less than .05). Proximate analysis of the boneless tissue indicated an increase (P less than .05) in extractable fat of approximately 6% for each feeding period (6.3% fat on d 0 to 25.4% on d 84).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667432 TI - Cytoplasmic genetic effects on preweaning growth and milk yield in Hereford cattle. AB - Performance records on Hereford cattle raised in two herds were used to evaluate cytoplasmic genetic effects on preweaning growth and milk production. Animals were traced through maternal lineage to foundation females to form cytoplasmic lines. Growth records were available on 1,189 calves at Raleigh and 1,599 at Plymouth representing 27 and 15 cytoplasmic lines, respectively. Milk records were available on 418 cows at Raleigh and 522 cows at Plymouth, representing 20 and 13 cytoplasmic lines. After adjustment for sire, cytoplasmic effects were significant for birth weight (BWT), average daily gain (ADG) and 205-d weight (WT205) in both herds. Cytoplasm accounted for 2, 5 and 5% of the variance for BWT, ADG and WT205 at Raleigh; and 1, 2 and 2% of the variance at Plymouth. After addition of maternal grandsire to the model, cytoplasm was still significant; however, variances were reduced at Plymouth. Cytoplasmic effects for milk yield were important at Raleigh (P less than .01) but marginal at Plymouth (P = .10). Variance components for cytoplasm accounted for 4 and 1% of the variance for milk yield at Raleigh and Plymouth, respectively. Ranges for least-squares constants for cytoplasmic lines corresponded to one of two standard deviations. Correlations among least-squares constants for ADG, WT205 and milk yield were high, suggesting that cytoplasmic effects were mediated through milk production. More research is needed to confirm these results before cytoplasmic inheritance is considered in breeding programs for beef cattle. PMID- 3667433 TI - Breed differences in uterine and ovarian measurements in gestating swine. AB - Ovulation rate, ovary weight, corpora lutea weight and uterine length were measured at 10 or 35 d of gestation in Duroc (199) and Yorkshire gilts (114). Embryos were counted at d 35. Yorkshires had significantly more corpora lutea than Durocs (13.6 vs 12.3 at d 10; 13.9 vs 12.4 at d 35). At d 10 breeds did not differ in uterine length, but by d 35 Duroc uteri were longer (P less than .01) than Yorkshire uteri (411 vs 375 cm) despite having fewer (P greater than .05) embryos (9.9 vs 10.5). Ovary weight did not differ between breeds at 10 or 35 d. Homogeneity analyses showed that the correlation matrices were significantly different between breeds at d 35 but not at d 10. In Durocs, high positive correlations existed between total embryo number and corpora lutea number (.57), ovary weight (.53) and corpora lutea weight (.25), whereas corresponding correlations were small in Yorkshires (.21, -.02 and -.03, respectively). In Yorkshires, strong negative correlations existed between total embryo survival and corpora lutea number (-.55), ovary weight (-.30) and corpora lutea weight ( .55), but in Durocs corresponding correlations were small (-.12, .14 and -.10, respectively). These results suggest that animal scientists should consider breed differences in levels of performance and its relationships among traits when designing or interpreting experiments. PMID- 3667434 TI - Feed efficiency, growth rates, body composition, milk production and milk composition of Targhee sheep selected for increased weaning weight. AB - Lactation and growth of three contemporary lines of grade Targhee sheep developed from the same genetic base were characterized by three experiments performed over a period of 2 yr. Two lines (HW and DH) had been selected for 120-d weaning weights for 24 yr prior to beginning these experiments. A third line (C) was a randomly selected control. Year I experiment contrasted 10 DH with 7 C ram lambs fed to 58 kg. Year II experiments utilized 9 C, 14 DH and 10 HW ram lambs and 11 ewes suckling twins from each line. All Year II ram lambs were born and weaned as twins, then fed to 50 kg. Mature DH and HW ewes were heavier (P less than .05) than C ewes (65.2 and 68.8 vs 54.9 kg), and the DH and HW lambs grew faster than C lambs both before (P less than .05) and after weaning (P less than .05). While both DH and HW lambs drank more milk (2,419 and 2,368 vs 2,059 g X d-1 X pair-1; P less than .10) only HW ewes showed a trend towards greater potential milk production than controls (HW = 2,774 vs C = 2,155 g X d-1 X ewe-1 P less than .12). The HW lambs tended to be leaner than C lambs (P less than .05), but DH lambs did not differ from either line. Lambs from DH and HW lines required less post-weaning feed (121.9 and 129.3 vs 152.0 kg P less than .05) and exhibited 17 and 16% greater weight per day of age at 50 kg than controls (P less than .05). The DH line displayed lower feed: gain ratios than controls in both post-weaning trials (6.68 vs 7.30 to 58 kg; 5.83 vs 6.24 at 50 kg; P = .06). PMID- 3667435 TI - Comparative effects of individual amino acid excesses when added to a corn soybean meal diet: effects on growth and dietary choice in the chick. AB - Six experiments were conducted with 8-d-old crossbred chicks to evaluate the effects of 4% excesses of DL-methionine (Met), L-phenylalanine (Phe), L tryptophan (Trp), L-lysine (Lys), L-histidine (His), L-threonine (Thr), L isoleucine (Ile), L-arginine (Arg), L-valine (Val) or L-leucine (Leu) on growth or dietary "choice" (i.e., self-selection) when added to 23% protein corn-soybean meal (C-SBM) diets. Arginine and His were supplied as the free base and Lys as Lys X acetate to avoid acid-base problems. In the growth studies, weight gain was reduced 92, 79, 53, 50, 47, 31, 29, 15, 9, 4 and 0% by additions of 4% Met, Phe, Trp, His, Lys, Tyr, Thr, Ile, Arg, Val and Leu, respectively. Improvements (P less than .05) in weight gain, feed intake and gain/feed occurred by addition of 1% Arg to the C-SBM diet supplemented with 4% excess Phe or Tyr. Addition of 1% Arg to the C-SBM diet supplemented with 4% excesses of most of the other amino acids also tended to improve performance, although diets imbalanced with Lys, Val or Leu did not respond to supplemental Arg. Self-selection studies revealed that chicks preferred the C-SBM diet containing 4% excess Lys over diets containing 4% excesses of Met, Thr, Arg or Trp. Moreover, chicks preferred diets with 4% excess Met, Thr or Arg over those containing an equal excess of Trp. When given a choice between the C-SBM diet and this diet supplemented with 4% Leu, chicks consumed similar quantities of both diets. PMID- 3667436 TI - Urea cycle metabolism: effects of supplemental ornithine or citrulline on performance, tissue amino acid concentrations and enzymatic activity in young pigs fed arginine-deficient diets. AB - Two experiments were conducted with young pigs to determine the efficacy of ornithine (Orn) or citrulline (Cit) as precursors of arginine (Arg). In Exp. 1, pigs were individually fed an Arg-deficient, semipurified diet (.18% Arg) supplemented with .3% Arg or an equimolar quantity of Orn or Cit. Supplemental Arg or Cit increased rate and efficiency of weight gain, but Orn addition was without effect. Free Arg in plasma 3 h post-prandial was increased by addition of either Arg or Cit to the basal diet. Liver Arg was elevated by dietary addition of Arg, Orn or Cit; kidney Arg and Orn were elevated only in pigs receiving supplemental Cit. Arginine or Cit addition to the diet increased Arg concentration in muscle tissue, but muscle Orn was unresponsive to any of the supplements fed. In Exp. 2, pigs were again fed the Arg-deficient, semipurified diet supplemented with .3% Arg or four times an isomolar quantity of ornithine. Arginine addition to the diet increased weight gain and feed efficiency, while Orn supplementation was without effect. Plasma Orn was increased by excess Orn, while plasma Cit was unaffected by supplemental Arg or Orn. Moreover, excess Orn increased free Orn and proline (Pro) in liver, kidney and muscle. Free Cit, however, increased only in liver from feeding excess Orn. In addition, excess Orn decreased both plasma ammonia and free glutamine (Gln) concentration in brain. Arginase activity was roughly 10, 40 and 100 times greater in hepatic tissue than in renal cortex, renal medulla or intestinal mucosa, respectively, while hepatic ornithine transcarbamoylase (OTC) activity was about 15 times greater than the activity present in mucosa tissue. Renal OTC activity was too low to be accurately measured. PMID- 3667437 TI - Justification of unilateral hysterectomy-ovariectomy as a model to evaluate uterine capacity in swine. AB - Experimental objectives were to measure the effect of ovulation rate on litter size at 86 d of gestation and at farrowing in 110 unilaterally hysterectomized ovariectomized (UHO) gilts and in 142 intact, control gilts and to evaluate postnatal survival and development of progeny. Surgery (UHO) was performed on gilts 8 to 12 d following first estrus. Control and UHO gilts were mated and then randomly assigned to be slaughtered at d 86 of gestation or allowed to farrow. Gilts scheduled to farrow were observed by laparoscopy on d 40 of gestation to count corpora lutea (CL). Ovulation rate (number of CL) was similar for control (12.1 CL) and UHO (11.9 CL) gilts, thus indicating that compensatory ovarian hypertrophy had occurred in UHO gilts and resulted in a near doubling of ova per uterine horn relative to control gilts. Average litter size at 86 d of gestation and farrowing was greater (P less than .01) for control than UHO gilts. At farrowing, litter size for control and UHO gilts was 9.0 +/- .3 and 5.7 +/- .3 pigs, respectively. Fetal losses were greater and pig weights at birth were less in litters by UHO gilts. Postnatal pig survival, growth rate to 14 d of age and 14-d individual pig weight did not differ for progeny of control and UHO gilts, and performance of UHO pogeny did not appear to compromise the usefulness of this animal model. Regression of litter size on ovulation rate was .41 +/- .15 pigs/CL for UHO and .60 +/- .12 pigs/CL for control gilts at d 86 of gestation. Regression was .07 +/- .17 pigs/CL for UHO and .42 +/- .14 pigs/CL for control gilts at farrowing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667438 TI - Effects of prepartum protein nutrition and birth weight on basal metabolism in bovine neonates. AB - Recipient beef heifers, pregnant with single demi-embryos, were paired to according to identical twin or full-sib embryo. Within pair, recipient heifers were assigned to one of two isocaloric diets containing a control or restricted level of protein (91 vs 55% of National Research Council recommendations) on d 190 of gestation. Following parturition, calves were weighed, fed 1 liter of colostrum, dried and placed in a metabolic chamber at 5 h of age for an 8-h determination of heat production (HP). Maternal body weight gains (P less than .001) during the last trimester and body condition scores at parturition (P less than .05) were reduced in heifers fed the protein-restricted diet. Calves born to heifers fed the protein-restricted diet had 11.4% lower (P less than .05) HP than calves born to control heifers (43.7 vs 49.3 kcal.kg-1.d-1). Birth weights, respiratory quotients and rectal temperatures of newborn calves were not significantly affected by prepartum protein restriction. Within treatment groups, the relationship between HP and weight was described by the equation: HP (kcal/d) = 2.30 wt1.86. The allometric exponent of 1.86 +/- .26 implied that weight specific metabolic rate was higher rather than lower in larger weight calves. We concluded that the thermogenic ability of neonatal calves may be compromised by prepartum protein restriction and(or) small birth weights. PMID- 3667439 TI - Transfer of bovine demi-embryos with and without the zona pellucida. AB - Bisected bovine embryos with or without the zona pellucida were transferred to recipients nonsurgically in five field trials. Embryos were collected from superovulated donors 6.5 to 7.5 d after estrus; only embryos of good and excellent quality were bisected. Demi-embryos were transferred either within a zona pellucida, without a zona pellucida, without a zona pellucida, or in the third and fourth trials, without a zona but embedded in 7% gelatin. Pregnancies were diagnosed at 44 to 68 d of gestation. In a preliminary trial, 9/29 zona pellucida-intact demi-embryos developed into fetuses compared with 1/10 zona pellucida-free demi-embryos (P greater than .1). The proportion of zona-free demi embryos developing to fetuses was not significantly different from the zona intact group in the second trial either, 24/49 and 5/19, respectively. In trial 3, the proportion of zona pellucida-free demi-embryos developing was 8/25; of zona-enclosed embryos, 29/88; and of zona-free demi-embryos embedded in gelatin, 8/22 (P greater than .1). Similarly, in the fourth trial the rate of development of zona-free demi-embryos to fetuses was 5/12, that of zona-enclosed embryos was 32/81, and that of zona-free demi-embryos embedded in gelatin was 3/12 (P greater than .1). In trial 5, survival of zona-enclosed demi-embryos to fetuses was 40/105, and of zona-free demi-embryos, 46/109 (P greater than .1). Except for trial 2, half of the demi-embryos were twinned, one to each uterine horn; twinning did not significantly affect the proportion developing to fetuses for any of the demi-embryo groups. It is concluded that placing post-compaction demi embryos into the zona pellucida for transfer does not improve pregnancy rates significantly. PMID- 3667440 TI - Relationships between uterine length and number of fetuses and prenatal mortality in pigs. AB - Relationships between the length of uterine horn and number of fetuses and prenatal mortality were characterized in 320 pregnant pigs at 3, 5, 7, 9, 11, 13 and 15 wk of gestation in a cross-sectional design. Genital tracts of all pregnant animals available on the days of collection were measured. Length of each uterine horn, numbers of fetuses and corpora lutea (CL) were recorded and prenatal mortality was calculated. With each additional fetus, length of the uterus increased 10 cm regardless of stage of gestation (P less than .001). The association of number of fetuses and uterine length was local and confined to that horn in which the fetus resided and did not extend to the opposite horn. As number of CL increased, number of fetuses also increased as did prenatal mortality. There was a significantly negative correlation between uterine length and prenatal mortality when animals were classified into four groups on the basis of number of CL; less than 10, 10 to 14, 15 to 18 and greater than 18. Results indicated that the number of fetuses and prenatal mortality were closely correlated with length of the uterus. Length of the uterus appeared to be an important limiting factor to litter size as number of CL increased. PMID- 3667441 TI - Influence of lasalocid level on forage intake, digestibility, ruminal fermentation, liquid flow and performance of beef cattle grazing winter range. AB - Three experiments were conducted to study the effects of lasalocid level on performance, intake, digestibility, ruminal fermentation and fluid flow of beef cattle grazing dormant, tallgrass prairie. In Exp. 1, 120 pregnant, mature beef cows of primarily Hereford breeding (avg wt = 471 kg) were randomly assigned to received 0, 100, 200 or 300 mg lasalocid X head-1 X d-1 in 1.82 kg supplement. Weight changes at 30, 60 or 90 d, condition score change and calf birth weight were not affected (P greater than .10) by lasalocid level. In Exp. 2, estimates of intake and digestibility were obtained with 40 pregnant, mature Hereford cows (avg wt = 474 kg) and 12 esophageal-cannulated, Hereford X Angus steers (avg wt = 225 kg), using Yb and indigestible acid detergent fiber as markers for fecal output and digestibility, respectively. Levels of lasalocid provided to cows and steers were similar, on a body weight (BW) basis, to those in Exp. 1 and corresponded to approximately 0, .22, .44 or .66 mg lasalocid/kg BW. Total diet and forage organic matter digestibility for beef cows decreased (P less than .01) at the .22 mg/kg BW level, but increased at the .44 and .66 mg/kg BW levels. Organic matter intake was not influenced (P greater than .10) by lasalocid addition. In Exp. 3, 16 ruminal-cannulated, Hereford X Angus steers (avg wt = 227 kg) were given the same lasalocid dosages per kg BW as in Exp. 2, and were used to study the effects of lasalocid on ruminal fermentation and fluid flow characteristics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667442 TI - Kinetics of intravenously administered 25-hydroxyvitamin D3 in sheep and the effect of exposure to ultraviolet radiation. AB - This report describes studies of 25-hydroxyvitamin D3 (25OHD3) kinetics in 10 yearling crossbred wethers (40 to 52 kg body weight) administered [3H] 25 hydroxyvitamin D3 [( 3H] 250HD3). The wethers were divided into two groups of five before dosing with the labeled compound: Group 1 wethers were exposed 2 h daily for 8 to 10 wk to ultraviolet radiation from fluorescent sunlamps. Plasma 250HD3 increased from 13 to 31 ng/ml by d 25 and then remained at a steady-state concentration until d 70. In the non-ultraviolet-exposed wethers (Group 2), plasma 250HD3 averaged 13.2 ng/ml and did not change over the course of the experiment. Six weeks after the start of the experiment three wethers from each group were injected intravenously with 50 microCi of [3H]250HD3, and the other two wethers from each group were similarly dosed 2 wk later. Blood was drawn at suitable time intervals for up to 240 h post-dosing. The kinetic data were satisfied by curve-fitting the data to a two-compartment, pharmacokinetic mathematical model. Individual and mean values for these kinetic analyses are presented with their statistical analyses. Physiological half-life of the tritiated 2500 HD3 in wethers exposed to ultraviolet irradiation was 388 +/- 26.4 h (means +/- SE); in the control it was 393 +/- 29.6 h (P greater than .05). In the wethers exposed to ultraviolet the elimination and clearance rates of 250HD3 were significantly greater than in the control wethers. A two-compartment model provided an acceptable description of 250HD3 disposition kinetics in wethers. Turnover rate constants did not seem to change, but changes were due to increased pool size in the irradiated wethers. PMID- 3667443 TI - Effect of intraruminally administered, selenium soluble-glass boluses on selenium status in cows and their calves. AB - Intraruminal selenium soluble-glass boluses were administered by balling gun to 65 of 125 crossbred beef cows (Shorthorn X Charolais) during the last trimester of pregnancy. Elevated (P less than .01) whole blood glutathione peroxidase (GSH Px) concentrations were observed monthly for the next 10 mo following initiation of treatment, reaching the maximum magnitude (263 vs 41) at the fourth month. Monthly milk samples showed elevated selenium concentrations (P less than .01, April through August; P less than .05 through September). Intraruminal, selenium soluble-glass bolus administration to gestating cows was highly effective in raising the selenium status of their progeny. Although the control calves were in low-selenium status, no acute cases of nutritional muscular dystrophy were observed during this experiment. PMID- 3667444 TI - Macromineral absorption in sheep fed tetany-prone and non-tetany-prone hays. AB - Two experiments were conducted to determine some of the factors that led to hypomagnesemic tetany associated with the feeding of two orchardgrass hays. Sixteen mature Columbia and Suffolk wethers (62 to 72 kg), four of which were fitted with ruminal and abomasal cannulae, were fed one of two tetany-prone orchardgrass hays or a non-tetany-prone bromegrass hay. In Exp. 1, 12 wethers were used in a completely random design metabolism experiment to measure apparent absorption and retention of macrominerals. In Exp. 2, four wethers with ruminal and abomasal cannulae were used in a completely random design experiment to monitor pre-intestinal mineral absorption and ruminal characteristics. This experiment was replicated once, with wethers remaining on their diets for 16 d in each replication. In the metabolism experiment, apparent absorption and retention of Mg as a percentage of intake were lower (P less than .01 and P less than .05) for one tetany-prone orchardgrass hay compared with the other orchardgrass hay. Pre-intestinal absorption of Mg in the cannulated wethers was greater (P less than .01) for the orchardgrass hays than for the bromegrass hay. Pre-intestinal Mg absorption was higher (P less than .01), both in terms of grams per day and a percentage of intake for the orchardgrass hay with the highest Mg content. In the noncannulated wethers, the percentage of water-soluble Mg in the feces was lower (P less than .01) for the tetany-prone hays, indicating that a decrease in Mg solubility in the intestine may have influenced Mg apparent absorption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667445 TI - Lasalocid and dietary sodium and potassium effects on mineral metabolism, ruminal volatile fatty acids and performance of finishing steers. AB - Thirty Angus steers averaging 357 kg were used to: 1) determine the effect of feeding lasalocid (33 mg/kg diet) on mineral metabolism and 2) determine the effects of varying dietary sodium (Na) and potassium (K) on finishing steers fed lasalocid. Treatments consisted of: 1) control (.25% Na, .5% K); 2) lasalocid (.05% Na, .5% K); 3) lasalocid (.25% Na, .5% K); 4) lasalocid (.05% Na, 1.4% K) and 5) lasalocid (.25% Na, 1.4% K). Ruminal fluid and blood samples were collected on d 28 and 90 of the 102-d study. Gain and feed conversion tended to be higher for steers fed lasalocid with the exception of the .05% Na, 1.4% K treatment. Control steers had lower (P less than .05) erythrocyte K concentrations, reduced (P less than .05) soluble concentrations of magnesium and copper in ruminal fluid and decreased plasma concentrations of zinc (P less than .05) and phosphorus (P less than .10) at 90 d compared with steers fed lasalocid and similar concentrations of Na (.25%) and K (.5%). Increasing dietary Na from .05 to .25% in the presence of lasalocid increased (P less than (P less than .05) molar proportion of ruminal acetate at 28 and 90 d reduced (P less than .05) propionate at 90 d. Increasing K from .5 to 1.4% decreased (P less than .01) soluble Na and increased (P less than .01) soluble K concentrations in ruminal fluid. Steers fed lasalocid (.25% Na, .5% K) had lower concentrations of K (P less than .10) and zinc (P less than .10) in liver than control steers. Sodium and K level also affected tissue concentrations of certain minerals. Results suggest that dietary Na and K influence mineral metabolism and that dietary Na affects ruminal molar proportion of acetate in cattle fed lasalocid. PMID- 3667446 TI - Phenylalanine requirement of the lactating sow. AB - Six mature Yorkshire X Landrace sows were randomly assigned to a 6 X 6 Latin square experiment on d 3 of lactation to determine the phenylalanine (Phe) requirement in the presence of excess tyrosine (Tyr). A control diet of corn sugar, cornstarch, whey, L-glutamic acid, solka floc, soybean oil, amino acids, minerals and vitamins was supplemented with L-Phe to provide .175, .250, .325, .400, .475 and .550% Phe and .47% Tyr. Each diet was fed to a maximum of 5.5 kg/d within each of six 7-d periods. Sow milk yield and average pig weight gain decreased (cubic, P less than .01) with increasing time period. Feed intake and average pig weight gain were depressed (quadratic, P less than .05) on the lowest Phe diet, but milk yield was not significantly affected. Daily nitrogen (N) intake was depressed (quadratic, P less than .01) when sows consumed the .175% Phe diet, but percent fecal N was not affected. Percent urine N decreased (quadratic, P less than .001) and percent N retained (without milk) increased with increasing Phe to .288 and .296%, respectively. Daily secretion of milk N as a percentage of N intake was not affected by diet. Percent overall N balance (with milk) increased with increasing Phe to .307%. Urea N decreased with increasing dietary Phe in both plasma (linear, P less than .01) and urine (quadratic, P less than .001) to a breakpoint at .285% Phe. A sharp rise (quadratic, P less than .01) in plasma Phe occurred at .299% dietary Phe. Plasma Tyr increased (quadratic, P less than .05) as dietary Phe increased, but no clear inflection point was obtained.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667447 TI - Effects of a dietary antimicrobial (carbadox) on liver cholesterol 7 alpha hydroxylase activity and bile acid patterns in the young pig. AB - Two experiments were conducted to investigate the effects of the antimicrobial carbadox (CX) on bile acid metabolism in the young pig. The pigs were fed a fortified, 19.5% crude protein, corn-soybean meal diet without or with 55 ppm CX. In Exp. I pigs were fed the diets for 28 d, then the level of activity of hepatic cholesterol 7 alpha-hydroxylase (CH-7 alpha), the rate-limiting enzyme of bile acid metabolism, was measured. The CX-fed pigs gained faster (P less than .05) and more efficiently (P less than .05) and had lower (P less than .02) CH-7 alpha activity than the control pigs. In Exp. II, pigs ranging in weight from 12 to 15 kg were fitted with indwelling catheters in the hepatic portal (HP) and anterior vena cava (VC) veins. Radiolabeled chenodeoxycholic acid (CDC) was infused into the HP and blood samples from both veins were taken at meal time and hourly for 6 h following six meals over 3 d. Bile was collected 14 d after infusion. Concentrations of lithocholic acid (LC) in the bile and hyodeoxycholic acid (HDC) in the plasma were reduced by dietary CX. Dietary CX did not significantly affect metabolism of plasma CDC or hyocholic acid (HC) as measured by radioactivity. Meal time (0800 vs 1600) affected (P less than .05) plasma CDC radioactivity at all times and the level of HDC radioactivity 2 h post-prandial. There was a meal time X dietary treatment interaction (P less than .02) on plasma HC radioactivity 2 h post-prandial. These data suggest that dietary CX inhibited intestinal microbial degradation of CDC and HC. PMID- 3667448 TI - Energy utilization and blood traits of ponies fed fat-supplemented diets. AB - The digestibility and heat production values for three fats of different origin were determined. Four pony geldings (225 kg) were used in a study consisting of four successive digestion trials utilizing a 4 X 4 Latin square design. The four dietary treatments were basal alone and supplemented with 15% corn oil, blended fat or inedible tallow. The blended fat was composed of a mixture of animal and vegetable fats. A 7-d preliminary period preceded a 7-d total fecal collection period for each trial. Heat production values were obtained by indirect calorimetry and calculated from oxygen consumption data. Fat supplementation increased (P less than .05) dietary metabolizable energy from a basal value of 3,224 kcal.kg intake-1.d-1 to a mean value of 3,984 kcal.kg intake-1.d-1 for the three fat diets. No difference in heat production was observed among the diets, averaging 2,883 kcal.kg intake-1.d-1. Fats increased (P less than .05) the energy balance (metabolizable energy-heat production) approximately 88% over the basal. Corn oil and blended fat produced the greatest energy balance of the fats. Utilization of energy in fats, calculated by difference, was not different, but tended to be highest in blended fat and lowest in the corn oil. Apparent fatty acid digestibility increased (P less than .05) with the addition of fat to the basal, partially due to the dilution of endogenous fecal fat, but digestion coefficients were not different (P greater than .40) among the high fat diets. PMID- 3667449 TI - Effect of lipoproteins and luteinizing hormone on progesterone production by large and small luteal cells throughout the porcine estrous cycle. AB - Large and small cells were isolated from porcine corpora lutea (CL) on d 10, 15 or 18 of the estrous cycle. They were incubated 13 to 16 h in cholesterol- and serum-free media and then supplied with 0, 10, 50 or 100 micrograms of either porcine low density lipoprotein (LDL) or porcine high density lipoprotein (HDL). Each dose was supplemented with 0, 10, 50 or 100 ng of porcine LH. Media progesterone (P4) content was assessed immediately before and 2 and 24 h after addition of lipoproteins and LH. Production of P4 by large cells always exceeded that of small cells. Day 10 large cells were stimulated by LDL, unaffected by LH, and either inhibited or unaffected by HDL. No treatment affected d 10 small cells. Day 15 large cells and small cells were stimulated by both lipoproteins (LDL greater than HDL). The large cells were stimulated to a small extent by LH at 2 h (P less than .05). Large cells could be isolated from only two of five preparations of d 18 CL. Day 18 small cells produced a small quantity of P4 in a response which qualitatively resembled that of d 15 small cells. Cell type, cycle stage and lipoprotein (particularly LDL) were the major effectors of P4 production. The minimal response to LH supports the theory of autonomy of the porcine CL with respect to P4 production. Days 10 and 15 bracket the period of commitment to luteolysis, and the nature of P4 production by each cell type changed over that period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667450 TI - Relationship of estrone and prolactin with growth and survival of piglets to 35 d of age. AB - The relationship between estrogen or prolactin (Prl) status of pigs at birth and subsequent performance was examined in ten (Study 1) or seven (Study II) Yorkshire litters. In both studies, piglets were bled (3 ml) from the suborbital sinus at birth, and then hourly for 12 h. Hematocrit (Hct) and concentrations of plasma protein (PP) and estrone (E1) were determined on all samples. Concentrations of Prl were determined only in samples at birth. Weights at 3 and 5 wk of age as well as percent survival to 5 wk were obtained. Mean concentrations of E1 and Prl in piglets at birth were 6.97 +/- 44 ng/ml and 9.12 +/- .32 ng/ml, respectively. A decrease in E1 occurred over the first few hours after birth. Hematocrit values also decreased postnatally, whereas concentrations of PP increased. Sex of neonate did not affect any of the blood characteristics studied. Correlations between E1, PP, Hct and Prl at birth and body weights at birth, 3 and 5 wk were nonsignificant. However, piglets with higher Prl values at birth showed a greater survival rate. In Study II, half of the piglets in each litter were implanted at birth with silicone rubber implants containing estradiol 17 beta. Estrone concentrations were significantly higher in implanted piglets than in controls over the subsequent 12-h period, but Hct and PP values were not affected by treatment, suggesting that treated piglets did not consume more colostrum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667451 TI - Post-prandial compositional changes of fluid- and particle-associated ruminal microorganisms. AB - Two ruminally cannulated cows were fed a diet containing 65% alfalfa haylage and 35% concentrate every 12 h. During two collection periods, whole ruminal contents were sampled before feeding, when feed not eaten was removed (1 h after initiation of feeding) and 1, 2, 3, 4, 6, 8, 10 and 12 h after removal. At each sampling, fluid-associated microorganisms were obtained by straining whole ruminal contents through eight layers of cheesecloth. A portion of the particle associated population was obtained by chilling squeezed particles before seven successive extractions with saline solution. Microbial ash concentrations ranged from 9.9 to 16.6% of dry matter, with differences due to population (P less than .01) and to time after feeding for both fluid- (P less than .05) and particle associated (P less than .01) microorganisms. Within 1 h after initiation of feeding, N decreased (P less than .05) from a pre-feeding concentration of 9.5% of organic matter to 7.7% for fluid-associated microorganisms, and from 9.2 to 6.7% for particle-associated microorganisms. Both populations did not return to pre-feeding concentrations until 6 h after feed removal. Nucleic acid concentrations decreased (P less than .05) in both populations after feeding, and did not return to pre-feeding concentrations until 6 h for fluid-associated and 4 h for particle-associated microorganisms. Nucleic acid-to-N ratios were higher (P less than .01) in the fluid- than particle-associated organisms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667452 TI - In vitro lactic acid inhibition and alterations in volatile fatty acid production by antimicrobial feed additives. AB - Batch culture fermentations were used to determine the effects of avoparcin, lasalocid, monensin, narasin, salinomycin, thiopeptin, tylosin, virginiamycin, monensin + tylosin combination, and two new ionophore compounds (RO22-6924/004 and RO21-6447/009) on lactic acid and volatile fatty acid (VFA) production. Ruminal fluid from cattle fed a high alfalfa hay diet was incubated with glucose for 12 h in a buffered medium to determine the effect of antimicrobial compounds on lactic acid concentration. Fermentations treated with antimicrobial compounds had higher final pH and lower L(+) lactic acid concentration. Narasin and salinomycin were more inhibitory than other ionophore compounds. Monensin and tylosin in combination was more effective than monensin alone. Among the nonionophore compounds, avoparcin was the least effective and thiopeptin, tylosin and virginiamycin were extremely effective in reducing lactic acid concentration. Ruminal fluid from cattle fed a diet of alfalfa hay and grain (50:50) was incubated with a mixture of sugars, casein and urea for 12 h in a buffered medium to determine the effect of antimicrobial compounds on VFA production. Generally, total VFA concentration was not affected by antimicrobial compounds except RO22 6924/004, tylosin and virginiamycin, which caused a reduction at high concentrations. Tylosin, monensin and tylosin mixture, thiopeptin and virginiamycin at high concentrations (greater than 6.0 micrograms/ml) increased the acetate proportion. All compounds increased the molar proportion of propionate. Tylosin and virginiamycin at high concentrations (greater than 6.0 micrograms/ml) decreased the proportion of propionate. Monensin and tylosin in combination had no effect on propionate proportion. Among the compounds tested, narasin and salinomycin were the most effective in enhancing propionate proportion. Ionophore compounds were more inhibitory to butyrate production than the nonionophore compounds. Batch culture fermentations may be used to quantitate the relative efficacy of antimicrobial compounds to alter ruminal fermentation characteristics. PMID- 3667453 TI - Nitrogen metabolism in crossbred steers with varying levels of Brahman using a nitrogen depletion-repletion regimen. AB - Nine N metabolism trials were conducted in a N-depletion-repletion regimen using five breed crosses of steers with 0, 25 or 50% Brahman. Three steers from each breed cross (avg initial wt 239 kg) were standardized for 3 wk on an 18% protein diet and depleted for 5 wk on a 7.5% protein diet and then repleted for 4 wk on the 18% protein diet. Nitrogen balance and blood and urinary N metabolites were monitored to determine changes in metabolic status due to changes in dietary N intake. Reduced N intake during the depletion period almost completely inhibited fiber digestion (P less than .01), while ruminal ammonia concentration fell from an average concentration of 156 during standardization to 22 mg/liter (P less than .01) during depletion. Organic matter digestion was depressed (P less than .05) due to the reduced fiber digestion. Absolute amounts of intake, fecal, urinary, absorbed and retained N were severely depressed during depletion. Apparent digestibility of N was reduced from an average of 68% during standardization to 42% (P less than .05) during depletion, but truly digested N was not affected. Nitrogen retained, as a percentage of intake, or absorbed was reduced only during the first week of depletion. Urea N comprised the major identified urinary fraction during standardization and repletion, whereas creatinine was the major fraction during depletion. Brahman-cross steers excreted more urinary N (P less than .1) and retained less N (P less than .13) during repletion than Angus X Hereford steers. Creatinine excretion was also higher (P less than .01) during depletion for Brahman-cross steers. Blood urea and albumin N concentrations were higher (P less than .05) during both depletion and repletion among Brahman crosses. These experiments suggest that blood measurements were more sensitive than N balance to changes in dietary N state and that faster recharge of blood N measurements in Brahman cattle may help mitigate adverse effects of N depletion stress. PMID- 3667454 TI - Growth and metabolism of growing beef calves fed tall fescue haylage supplemented with protein and(or) energy. AB - Endophyte (Acremonium coenophialum)-infected Kentucky 31 tall fescue was fertilized in mid-August, stockpiled, harvested November 4 to 6 and stored in a concrete stave silo. Ninety-six growing calves (189 kg) were assigned to the following treatments (24 calves/treatment): 1) corn silage (CS) plus .4 kg/d of soybean meal (SBM; 2) fescue haylage plus .4 kg/d of SBM; 3) fescue haylage plus 1.6 kg/d of corn and 4) fescue haylage plus 1.6 kg/d of corn and .4 kg/d of SBM. Daily gains and dry matter (DM) intakes during the 91-d trial were .52, 4.58; .51, 5.22; .59, 6.06; and .63, 6.18 kg for treatments 1 through 4, respectively. Daily gains of calves fed corn silage plus SBM and fescue haylage plus SBM were not different (P greater than .05). However, a difference (P less than .05) existed between treatments 1 and 2 vs 3 and 4. Feed conversion was improved (P less than .05) in calves fed corn silage. Calves in a metabolism trial were fed either 1) 6.2 kg November-ensiled fescue haylage or 2) 6.2 kg November-ensiled fescue haylage plus 1.6 kg/d of corn. Digestibility of DM, N-free extract (NFE) and TDN did not differ (P greater than .05) between treatments. Ether extract digestibility was greater (P less than .05) for the added corn diet, while that of CP was greater (P less than .05) for the fescue haylage diet. Nitrogen retained was higher (P less than .05) for calves fed added corn. A follow-up trial with 96 growing calves (190 kg) compared September- and November-harvested fescue haylages supplemented with either 1.3 or 2.6 kg corn/d.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667455 TI - Ruminal solubility of nitrogen and minerals from fescue and fescue-red clover herbage. AB - Ruminal solubility of N, K, P, Ca, Mg and S were measured for three forages at six growth stages. The three forages were Kentucky 31 tall fescue (TF), Kenhy fescue (KN) and a red clover-tall fescue mixture (RC). Disappearance parameters were measured by means of the dacron bag technique using cannulated steers. Exposures were for 48 h; maximum extent of disappearance for all elements occurred before this time. High proportions (greater than 60%) of P, K and Mg were released from all three forages during the first 3 h of incubation, with small losses thereafter. Amounts of N and S released during the first 3 h ranged between 40 to 75%. Ca had the lowest initial disappearance. Forages differed (P less than .05) in extent of mineral disappearance after 3- and 48-h incubations and in rate of disappearance (Kd) of the potentially available, slowly solubilizing, fraction of N, Ca and S. Across growth stages, TF had generally the lowest extent and rate of disappearance. With increasing maturity, Kd for Mg, Ca and S decreased (P less than .05). For each element, Kd was not correlated with herbage concentration or initial (3 h) disappearance. Partial correlations between disappearance of N, K, Ca, Mg and S after the 48-h incubation and herbage concentration were significant. Solubilization values corrected for rate of passage (ERS) showed significant differences among forages for K, Ca and S. Average ERS values for S and K were highest for KN; RC herbage had higher ERS values for Ca. Increases in forage maturity lowered (P less than .001) ERS for all elements. The results indicate that for all growth stages, ruminal solubility and potential availability of N and minerals from the three forages was high. The rate of release differed among elements and may have affected efficiency of microbial fermentation. Although ruminal solubility of minerals from TF was generally lower than from the other two forages, the difference was not sufficient to explain fully the lower apparent availability observed in previous studies. PMID- 3667457 TI - Effect of lasalocid on weight gains, ruminal fermentation and forage intake of stocker cattle grazing winter wheat pasture. AB - Fifty fall-weaned heifers with initial weights of 209 kg (yr 1) and 222 kg (yr 2) were used to determine effects of lasalocid on weight gains, forage intake and ruminal fermentation of stocker cattle grazing winter wheat pasture. The heifers grazed a single wheat pasture for about 100 d each year, and were individually fed 1.06 kg of supplement (6 d/wk) pro-rated to supply 0, 100 or 200 mg lasalocid.head-1.d-1. Also, eight mature Hereford steers with large rumen cannula were used to evaluate further effects of lasalocid (0 or 300 mg) on ruminal fermentation during two grazing periods (immature and mature wheat forage) of yr 2 and an additional third year. Daily gains of heifers fed 200 mg lasalocid/d were .11 kg greater (P less than .05) than those of heifers fed 0 or 100 mg lasalocid/d. One hundred milligrams lasalocid did not increase weight gains. Digestibilities of forage dry matter (DM) and organic matter (OM) were similar (P greater than .05) among treatments, and lasalocid did not affect (P greater than .10) forage intake. Ruminal ammonia concentrations (10.57, 15.22 and 17.81 mg/dl +/- 1.71) were increased (P less than .05) by both levels of lasalocid in yr 1, but differences among treatment means of 8.32, 11.95 and 11.66 (SE +/- 1.44) were not significant in yr 2. Lasalocid did not consistently affect total volatile fatty acids concentrations. The acetic:propionic acid ratios in heifers were not different (P greater than .05) among treatments, but were decreased (P less than .10) by lasalocid in cannulated steers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667456 TI - In vitro growth-promoting activity of porcine mammary secretions: initial characterization and relationship to known peptide growth factors. AB - We have examined the in vitro growth-promoting properties and growth factor content of porcine mammary secretions. Defatted, porcine colostrum stimulated the proliferation of fibroblast and epithelial-like cell lines of diverse species origins in serum-free medium and cellular DNA synthesis (4- to 119-fold) as monitored by uptake of 3H-thymidine into DNA of quiescent cells in culture. Porcine milk, although mitogenic, had reduced activity when compared with colostrum on an equivalent-volume basis. Furthermore, the relative mitogenic activity of milk, although still detectable at 3 wk, continued to decline with length of the lactation period. Fractionation of pig colostrum on gel-filtration columns revealed multiple peaks of (AKR-2B) fibroblast mitogenic activity (208, 66 and 4.6 kdaltons) and a heterogenous profile of epithelial cell mitogenicity. Polyclonal antibodies (IgG) specific for murine epidermal growth factor (EGF; the major mitogen in human and murine milk) or human platelet-derived growth factor (PDGF) did not inhibit the mitogenic activity of pig colostrum or milk, demonstrating lack of antigenic relatedness between the contributing porcine factors and mEGF or hPDGF. Also, we were unable to demonstrate similarity of the small Mr colostral factor with EGF by use of EGF radioreceptor assay. These results identify porcine colostrum and milk as sources of potentially important in vitro growth-promoting factors. The enhanced expression of these factors in early mammary secretions suggests their possible in vivo involvement in mammary and neonatal tissue growth processes. PMID- 3667458 TI - Breeding performance of bulls assigned either to 40 cows per bull or 80 cows per two bulls during the breeding period. AB - The reproductive performance of Angus (A), Polled Hereford (PH) and Santa Gertrudis (SG) bulls was compared when exposed to 40 cows/bull vs 80 cows/two bulls during a 90- to 95-d breeding period on pasture. Cows were A, PH and SG straightbreds and crossbreds of these breeds. Each year, cows were allotted at random within breed composition and age of dam to breeding groups. A replicate consisted of two 40-cow single-sire units with bulls of two breeds and an 80-cow two-sire unit with two bulls of the same breeds and all four bulls of the same age. There were eight replicates of PH and SG bulls and five replicates of PH and A bulls. At breeding time, 20, 16, 12 and 4 bulls were 2-, 3-, 4- and 5-yr-olds, respectively. Reproductive performance of bulls was evaluated in terms of calving rate (CR) of cows exposed to them and number of days (NOD) from the beginning of the breeding period until calf birth. The 80-cow groups calved 3.7 d earlier (P less than .05) in the calving period and had a similar CR compared with the 40 cow groups. The PH-A replicates calved 3.5 d earlier (P less than .05) and had 7.3 percentage units higher (P less than .01) CR than PH-SG replicates. Results of this study indicated that 80-cow two-sire breeding groups had an advantage over the 40-cow single-sire groups in terms of calves born earlier in the calving period, with no reduction in CR. PMID- 3667459 TI - Effect of efrotomycin on gain and feed efficiency for pigs from weaning until market weight. AB - Six studies involving 700 pigs were conducted in five separate swine research facilities to evaluate weight gain and efficiency of feed utilization in pigs fed the antibiotic efrotomycin. Pigs averaging 8.4 kg at the beginning of the studies were fed fortified corn-soybean meal diets that contained efrotomycin at 0, 2, 4, 8 or 16 ppm for an average of 120 d to market weight, about 92.1 kg. Pigs fed efrotomycin gained 5.9 to 8.9% faster (P less than .01) and were 1.7 to 4.0% more efficient (P less than .01) than those fed control diets. The improvement in growth rate was linear from 2 through 16 ppm, while feed efficiency (gain/feed) plateaued at 4 ppm efrotomycin. Treatment X study interactions were not significant for average daily gain or feed efficiency, showing that the response to efrotomycin was similar in each study. These studies indicate that efrotomycin is effective in improving gain and efficiency of feed utilization in swine from weaning until market weight. PMID- 3667460 TI - Effect of various levels of avilamycin on the performance of growing-finishing swine. AB - A series of 12 trials involving 1,710 crossbred pigs was conducted at eight geographical locations in the United States to determine the effect of avilamycin on average daily gain (ADG), average daily feed (ADF) and feed-to-gain ratio (F/G) of growing-finishing swine. Eight of 12 trials evaluated avilamycin concentrations at 0, 5, 10, 20, 40 and 60 ppm, while an additional four trials evaluated avilamycin concentrations at 0, 10, 20 and 40 ppm in swine grower and finisher diets fed ad libitum. All trials were conducted using a randomized complete block design with data from the 12 trials pooled for statistical analysis. Pigs fed 5, 10, 20, 40 or 60 ppm avilamycin had increased (P less than .05) ADG over control pigs. No differences were detected for ADF between control and avilamycin-fed pigs. Pigs fed 10, 20, 40 or 60 ppm avilamycin had improved (P less than .05) F/G over control animals. Average daily gain, ADF and F/G for pigs fed 0, 5, 10, 20, 40 or 60 ppm avilamycin were: 749, 763, 767, 769, 771 and 771 g; 2.38, 2.40 2.39, 2.41, 2.38 and 2.38 kg; and 3.17, 3.15, 3.12, 3.13, 3.09 and 3.09, respectively. Linear plateau procedures showed that the effective dose range of avilamycin for the growing-finishing phase is 5 to 10 ppm for improving ADG and 10 to 60 ppm for improving F/G. PMID- 3667461 TI - Divergent selection for postweaning feed conversion in beef cattle: predicted response based on an index of feed intake and gain vs fee: gain ratio. AB - As part of a divergent selection experiment (high vs low feed conversion) designed to obtain realized genetic parameter estimates for postweaning feed conversion, 35 Angus bull calves were selected each year from 1979 through 1983 to be fed in a 140-d postweaning performance test. From these 35 individually-fed bulls, the three most efficient and three least efficient (in terms of kilograms of total digestible nutrients required per kilogram of gain) were selected each year to each be mated to approximately 20 purebred Angus cows in a test herd. In the last 2 yr of the experiment, feed:gain ratios were adjusted for differences in maintenance requirements before selection. An alternative to selection based on feed/gain or adjusted feed/gain would have been to select on an index of feed intake and gain (Index3 = -1.0 feed intake + 3.87 gain) where feed intake was either unadjusted or adjusted (AdjIndex3) for differences in maintenance requirements. Residual correlations (year effects removed) among the four selection critera were large ([r[ greater than or equal to .76; P less than .01) as were correlations among ranks of the bulls based on the four selection criteria ([r[ greater than or equal to .75). Predicted genetic change for fee:gain ratio in both the high and low directions was greatest when selection was based on feed:gain ratio or Index3. Genetic changes expected to result from selection for feed:gain ratio or Index3 were similar, as were genetic changes expected due to selection for adjusted feed:gain ratio or AdjIndex3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667462 TI - Production efficiency of crossbred ewes and that of their daughters and granddaughters. AB - Ewes of eight crossbred groups, born in 1973 and 1974, were maintained under two pasture management systems for five and four production years, respectively. After that experiment terminated, those crossbred ewes produced Polypay-sired lambs in 1979 and were then sold. Ewe lambs from those three-bred crosses were backcrossed to Polypay rams to produce lambs from 1980 to 1983. Five ancestor descendant data sets (three involving dams and daughters and two involving granddams and granddaughters) were examined to study relationships between production efficiency of ancestor ewes and similar traits measured on their descendants. Ancestor cumulative prolificacy was positively but not significantly associated with cumulative prolificacy in the descendants. Regressions of descendant net revenue on ancestor net revenue were predominantly negative but generally were not significant. There was a tendency for prolific ancestors to produce costly but less profitable descendants. These results may be due to economic conditions (high feed costs and low lamb values) that persisted during the course of the experiment. PMID- 3667463 TI - A systems analysis approach for studying the effect of reproduction-enhancing biotechnologies on the genetic improvement of beef cattle. AB - A function is presented to which nonlinear programming techniques could be applied to quantify the potential of super-ovulation, embryo transfer, sexed semen, in vitro fertilization and in vitro maturation of oocytes used singularly or in combination to improve genetically beef cattle growth and(or) reproductive efficiency. The function to be maximized adds genetic gain times the sale price of the additional product brought about by the genetic selection program, and any income change due to change from the normal replacement rate of females, and subtracts the additional costs of the breeding program over a random breeding program. All this is expressed on a per-calf-sold basis to arrive at the economic return of the breeding program per calf raised to market age. The rate of increase in inbreeding can be restricted as desired. It is assumed that a progeny testing procedure is practiced for the selection of sires. The power of nonlinear programming to find maximums of functions with many variables and to measure how sensitive the genetic and economic returns are to various success rates for the biotechnologies mentioned above is discussed. PMID- 3667464 TI - Economic evaluation of alternative crossbreeding systems involving four breeds of swine. I. The simulation model. AB - A static, deterministic computer model, programmed in Microsoft Basic for IBM PC and Apple Macintosh computers, was developed to calculate production efficiency (cost per kg of product) for nine alternative types of crossbreeding system involving four breeds of swine. The model simulates efficiencies for four purebred and 60 alternative two-, three- and four-breed rotation, rotaterminal, backcross and static cross systems. Crossbreeding systems were defined as including all purebred, crossbred and commercial matings necessary to maintain a total of 10,000 farrowings. Driving variables for the model are mean conception rate at first service and for an 8-wk breeding season, litter size born, preweaning survival rate, postweaning average daily gain, feed-to-gain ratio and carcass backfat. Predictions are computed using breed direct genetic and maternal effects for the four breeds, plus individual, maternal and paternal specific heterosis values, input by the user. Inputs required to calculate the number of females farrowing in each sub-system include the proportion of males and females replaced each breeding cycle in purebred and crossbred populations, the proportion of male and female offspring in seedstock herds that become breeding animals, and the number of females per boar. Inputs required to calculate the efficiency of terminal production (cost-to-product ratio) for each sub-system include breeding herd feed intake, gilt development costs, feed costs and labor and overhead costs. Crossbreeding system efficiency is calculated as the weighted average of sub-system cost-to-product ratio values, weighting by the number of females farrowing in each sub-system. PMID- 3667465 TI - Economic evaluation of alternative crossbreeding systems involving four breeds of swine. II. System efficiency. AB - A static, deterministic computer model was used to calculate production efficiency (cost per kg of product) for four purebred and 69 alternative crossbreeding systems involving the Duroc, Yorkshire, Landrace and Spotted breeds of swine. Crossbreeding systems were defined as including all purebred, crossbred and commercial matings necessary to maintain a total of 10,000 farrowings. Driving variables for the model were predicted mean conception rates, litter size born, preweaning survival rate, postweaning average daily gain, feed-to-gain ratio and carcass backfat. Predictions were computed using breed effect and heterosis estimates obtained from experimental data involving the four breeds collected at the Oklahoma Agricultural Experiment Station between 1976 and 1979. The most efficient breed combinations for each of the nine types of crossbreeding systems evaluated were predicted to reduce cost per kg of product by 6.7 to 10.5%, relative to the most efficient purebred (Duroc). The Duroc X (Yorkshire, Landrace, Spotted) four-breed rotaterminal was predicted to be the most efficient system, followed by the Duroc X (Yorkshire, Landrace) rotaterminal. Duroc X (Spotted X Landrace) and Duroc X (Spotted X Yorkshire) static systems ranked third and fourth overall, respectively. Sensitivity analysis indicated that ranking of systems predicted to be most efficient under the default model was reasonably robust to varying input economic, genetic and management parameter values. Results of this study suggested that three- or four-breed rotaterminal or static systems should maximize effective use of heterosis and breed complementarity in swine production systems. PMID- 3667466 TI - Relationships between growth and productivity of range ewes. AB - The relationships between various measures of growth and productivity of range sheep were investigated, utilizing records of 1,109 range ewes sired by 269 rams. Body weights and degree of maturity of body weight at birth, weaning, 12 mo, 18 mo, 30 mo and absolute growth rate, absolute maturing rate and relative growth rate over various age intervals were studied relative to their relationship with productivity characters. Measures of ewe productivity were average annual production for the 4-yr period, 2 through 5 yr of age, for grease fleece weight, number of lambs born, number of lambs weaned and weight of lambs weaned. Heritability estimates were .31 +/- .11 for grease fleece weight, .42 +/- .12 for number of lambs born, .08 +/- .10 for number of lambs weaned and .03 +/- .10 for weight of lambs weaned. All production characters had positive phenotypic correlations (.04 to .22) with body weight at all ages. Both number of lambs born and weight of lambs weaned had small positive phenotypic correlations with growth rates over the 12- to 18-mo age interval. The genetic correlations between ewe productivity and weights at different ages were variable, ranging from -.71 between weaning weight and grease fleece weight to values greater than 1.00 for correlations between weight of lambs weaned and weights at birth, weaning and 18 mo. Degree of maturity at 12 mo had positive genetic correlations with all production characters. Estimated genetic correlations between number of lambs born and absolute growth rate, relative growth rate and absolute maturing rate over the 12- to 18-mo age interval were positive. PMID- 3667467 TI - Simulated efficiency of range beef production. I. Growth and milk production. AB - A revised version of the Texas A&M University Beef Cattle Production Model was used to simulate the effects of growth, milk production and management system on biological and economic efficiency of beef production in a northern plains, range environment. Animals varying in genetic potential for birth weight (BWA), yearling weight (YW), mature weight (WMA) and milk production (PMA) were simulated under both a weanling system of management (weaned calves custom-fed in the feedlot) and a yearling system (calves wintered on the ranch, then custom-fed after their second summer). The yearling system of management was biologically less efficient, but economically more efficient than the weanling system due primarily to heavier slaughter weights of fed animals. The advantage of the yearling system was most apparent for smaller genotypes. Herd efficiency improved with decreased BWA and increased YW, but changed little when WMA was varied while other growth traits were held constant. Increased PMA was favored for production of live weight at weaning and for production of slaughter product when feedlot costs were high. Increased PMA was not favored when feed costs for the cow herd were high. Economic weights generated from the simulation indicated the importance of selection for rapid early growth followed by selection for lighter birth weight. While larger genotypes were generally favored in this study, optimal cow size depended on economic conditions. Larger types were more biologically efficient and more economically efficient using standard costs, but medium- and small-size cattle were more efficient when feedlot costs were high. Small cattle were least efficient when feed costs for the cow herd were high. PMID- 3667468 TI - Simulated efficiency of range beef production. II. Fertility traits. AB - A modified version of the Texas A&M University Beef Cattle Production Model was used to simulate the effects of changes in potential for age at puberty (AAP), potential for probability of conception (PCA) and winter feed levels on biological and economic efficiency of beed production in a northern plains, range environment. Two management systems were simulated: a weanling system in which all calves except replacement heifers were custom fed in a feedlot immediately post-weaning; and a yearling system in which calves were kept on the ranch through their second summer, then custom-fed. Biological efficiency was defined as the ratio of TDN input to product output, and economic efficiency was defined as the ratio of total dollar cost to 100 kg product output. A simulated increase in AAP from 365 to 425 d resulted in slightly decreased economic efficiency under a yearling system of management. An increase in PCA from .75 to .85 caused decreased biological efficiency under both weanling and yearling management systems, suggesting biological inefficiencies associated with maintaining mature cows. Simulation results indicate that optimal supplementation levels and corresponding levels of observed fertility depend on the value of product derived from cull cows relative to the value of product derived from fed animals and on the costs of developing replacement heifers relative to the costs of maintaining mature cows. Decreased fertility causes change in the sources of products, not product loss per se. For this reason, survivability may be a more important aspect of reproduction than fertility. PMID- 3667469 TI - Simulated efficiency of range beef production. III. Culling strategies and nontraditional management systems. AB - A modified version of the Texas A&M Beef Cattle Production Model was used to simulate life-cycle biological and economic efficiency of various culling strategies and non-traditional management systems in a northern plains, range environment. Biological efficiency was defined as the ratio of TDN input (kg) to product output (kg), and economic efficiency was defined as the ratio of cost ($) to product output (100 kg), where products were live weight at weaning (LWW), empty body weight at slaughter (EBW) and fat-free weight at slaughter (FFW). Several economic scenarios were simulated. Culling cows at younger ages increased biological efficiency, but not necessarily economic efficiency. The simulated optimal age at culling was 8 yr, the same age at which simulated feed intake and milk production began to decline. Finishing young cows in the feedlot had little effect on biological efficiency and generally increased economic efficiency, although specific results depended on feed prices and relative values of cull cows vs fed animals. A simulated sex-controlled system in which only heifer calves were produced, while extremely biologically efficient for production of lean, resulted in relatively little output and was not economically efficient in most cases. Sex control combined with feeding of 2-yr-old cows was economically efficient, but not markedly more efficient than a conventional system. Results suggest that sex-controlled systems may be more appropriate where emphasis is on lean product and heifers can be bred at very early ages. General results indicate that producers should pay attention to relative values of cull cows and fed animals in choosing culling strategies and management systems. PMID- 3667470 TI - Analysis of gestation length in American Simmental cattle. AB - Records of gestation length (71,461) for Simmental cattle were distributed with mean 284.3 d and standard deviation 5.52 d. Gestation length was found to increase with percent Simmental and was 1.9 d longer for calves born to mature dams than for those born to heifer dams. Bull calves experienced gestation lengths 1.5 d longer than heifer calves. Sire, maternal grandsire, residual and total variances were estimated to be 2.42, .58, 22.78 and 25.78 d2, respectively, by Henderson's Method III. Heritability of gestation length was calculated to be .374 from the sire variance and .09 from the maternal grandsire variance. Direct additive genetic variance was considered to be of greater importance than maternal additive genetic variance. Correlations between the evaluations of sires for gestation length and heifer calving ease, birth weight and weaning weight were .26, .26 and .13, respectively. PMID- 3667471 TI - Estimation of variance and covariance components to determine heritabilities and repeatability of weaning weight in American Simmental cattle. AB - Components of (co)variance for weaning weight were estimated from field data provided by the American Simmental Association. These components were obtained for the observational components of variance corresponding to a sire, maternal grandsire, and dam within maternal grandsire model. From these estimates, direct additive genetic variance (Sigma2A), maternal additive genetic variance (Sigma2M), covariance between direct and maternal additive genetic effects (SigmaAM), variance of permanent environment(Sigma2pe) and temporary environment variance(Sigma2te) were determined. A procedure to approximate restricted maximum likelihood (REML) estimates of the observational components of variance based on the expectation-maximization (EM) algorithm is described. From these results, phenotypic variance ( ) of weaning weight was 667.88 kg2. Values forSigma2A, Sigma2M, Sigma2pe and Sigma2te were 79,30,58,38,49.45, and 469.97 kg2, respectively. Genetic correlation between direct and maternal additive genetic effects was .16. PMID- 3667472 TI - Effect of a major gene for growth on protein synthesis in mice. AB - Rates of protein synthesis of mice with a major gene (hg) for rapid postweaning gain (line Ch) and their normal counterparts (line CH) were determined at 21, 31 and 42 d of age with an intraperitoneal injection of a flooding dose of 14C leucine. A preliminary experiment demonstrated that the relationship between the specific activities of leucine in acid-soluble supernatants and carcass protein corresponded to the theoretical precursor-product relationship, indicating that the method is valid for estimating protein synthesis rates. Using this method at 21, 31 and 42 d of age, whole-body protein fractional synthesis rates (FSR) were 43.7, 32.7 and 29.1%/d and 41.9, 32.6 and 33.1%/d for lines CH and Ch, respectively. Although differences between lines were not significant, FSR decreased with age. Absolute synthesis rate (ASR), where ASR = (FSR) X (whole body protein), was greater (P less than .001) at 21, 31 and 42 d of age in line Ch as compared with CH, and increased (P less than .001) with age. The relative contributions of liver, gastrointestinal tract, heart-kidney-lung and remaining carcass to whole body protein ASR were not affected by line, but did change (P less than .05) with age. Whole body protein fractional breakdown rate (FBR), calculated as FSR minus whole body protein fractional growth, indicates that differences between lines CH and Ch whole-body FSR and(or) FBR exist only between 24 and 33 d of age, and that the maximum value of this difference probably does not exceed 10%. PMID- 3667473 TI - The long-term effects of a token economy on safety performance in open-pit mining. AB - A token economy that used trading stamps as tokens was instituted at two dangerous open-pit mines. Employees earned stamps for working without lost-time injuries, for being in work groups in which all other workers had no lost-time injuries, for not being involved in equipment-damaging accidents, for making adopted safety suggestions, and for unusual behavior which prevented an injury or accident. They lost stamp awards if they or other workers in their group were injured, caused equipment damage, or failed to report accidents or injuries. The stamps could be exchanged for a selection of thousands of items at redemption stores. Implementation of the token economy was followed by large reductions in the number of days lost from work because of injuries, the number of lost-time injuries, and the costs of accidents and injuries. The reductions in costs far exceeded the costs of operating the token economy. All improvements were maintained over several years. PMID- 3667474 TI - Effects of caffeine on classroom behavior, sustained attention, and a memory task in preschool children. AB - The effects of caffeine on the behavior of young children is an important issue, as children in our society consume considerable amounts of caffeine, primarily in soft drinks. This study investigated the effects of normative amounts of caffeine on the behavior of 6 normal children in a kindergarten setting. Using a reversal design, counterbalanced for order of conditions, children's behavior was examined during a baseline condition, a caffeinated beverage condition, and a noncaffeinated beverage condition. Measures included direct observation of off task and gross motor activity, actometer readings of movement, a Continuous Performance Test, a Paired Associates Learning Test, and teacher ratings of classroom behavior. Results suggest that caffeine exerts only small and inconsistent effects on the classroom behavior of kindergarten children. These results cast doubt on the importance of caffeine as a variable controlling the classroom behavior of normal kindergartners. PMID- 3667475 TI - The influence of child-preferred activities on autistic children's social behavior. AB - One of the characteristics of autistic children is severe social avoidance behavior. We assessed whether the type of activity (child-preferred vs. activities that were arbitrarily determined by an adult) engaged in during an interaction was correlated with the amount of social avoidance behaviors these children exhibit. Results revealed a negative correlation between appropriate child-preferred activities and social avoidance behavior. Additional analyses revealed that (a) social avoidance behaviors could be manipulated within a reversal design, and would predictably decrease when the children were prompted to initiate appropriate child-preferred activities; and (b) these procedures could be used to teach children to initiate child-preferred activities in community settings, resulting in reductions in social avoidance responses even after the therapist's prompts were completely removed. These data suggest that the manipulation of task variables may influence the severe social unresponsiveness that is characteristic of autistic children. PMID- 3667476 TI - A neurobiological nonalternative: rejoinder to Lewis, Baumeister, and Mailman. AB - Certain misrepresentations of our theory of self-stimulatory behavior by Lewis, Baumeister, and Mailman (1987) are corrected and several questions raised by the commentators are answered. Their proposed neurobiological alternative is considered briefly and judged to be insufficiently detailed, inadequate in scope, and therefore premature. PMID- 3667477 TI - Response interruption and DRL for the reduction of rapid eating. AB - We assessed the efficacy of several procedures for reducing the rate of eating responses during mealtime by three institutionalized mentally retarded clients. A time-based (15 s) response interruption procedure was implemented which resulted in little change in eating responses for 2 of 3 subjects. A spaced-responding DRL 15-s procedure resulted in decreases in eating responses to target levels only after a prompting procedure was added. Procedures were evaluated using a multiple baseline across subjects design with assessment of generalization to nontreated meals. A change in eating behavior during breakfast occurred only after direct training in the breakfast setting. Maintenance data were collected at 1- and 5 month follow-up periods. PMID- 3667478 TI - Facilitating transition times with handicapped preschool children: a comparison between peer-mediated and antecedent prompt procedures. AB - We examined the effects of a peer-mediated versus an antecedent prompt condition on the rate of independent movement and appropriate behavior of handicapped preschool children during three classroom transition times. Using an alternating treatments design, results showed that each treatment condition yielded increases in target behaviors; however, the antecedent prompt condition was superior during all three transition settings. In addition, teacher prompts to these children were significantly reduced during the intervention conditions, indicating that the children were making these transitions more independently. PMID- 3667479 TI - Evaluation of the effectiveness and efficiency of two stimulus prompt strategies with severely handicapped students. AB - In this study we compared the effectiveness and efficiency of two treatment packages that used stimulus prompt sequences and task analyses for teaching community living skills to severely handicapped students. Four severely and multiply handicapped students were trained to perform four tasks: (a) making toast, (b) making popcorn, (c) operating a clothes dryer, and (d) operating a washing machine. Following baseline, each student was exposed to two types of training procedures, each involving a task analysis of the target behavior. Training Procedure 1 (Traditional) utilized a least-to-most restrictive prompt sequence. Training Procedure 2 (Prescriptive) utilized ongoing behavioral assessment data to identify discriminative stimuli. The assessment data were used to prescribe instructional prompts across successive training trials. Performance on the tasks was evaluated within a combination multiple baseline (across subjects) and probe (across tasks) design. Training conditions were counterbalanced across subjects and tasks. Results indicated that both training procedures were equally effective in increasing independent task acquisition for subjects on all tasks; however, the prescriptive procedure was the more efficient procedure. PMID- 3667480 TI - Activity in vitro of CGP 31608, a new penem antibacterial agent. AB - The in-vitro activity of CGP 31608 (hereinafter termed CGP), a new penem, was tested by an agar dilution technique in comparison with imipenem, Sch 34343, cefotaxime, ceftazidime, aztreonam, ampicillin, gentamicin and ciprofloxacin. 480 clinical isolated were tested, some of which were selected because of their multiple resistance. CGP showed consistent activity against a wide range of species, having MIC90 values of 2-8 mg/l for almost all Enterobacteriaceae, Pseudomonas spp., Haemophilus spp., Corynebacterium spp. and Bacteroides spp. It was the most active agent tested against staphylococci having an MIC90 of 0.25 mg/l, showing no reduction in activity against methicillin-resistant strains. Lesser activity was observed against some streptococci, Proteus spp. and clostridia. Tests carried out in broth demonstrated that CGP activity was constant over a pH range of 6-8 and was unaffected by the presence of 50% serum or 50% urine. The rate of killing of CGP, gentamicin, cefotaxime and ciprofloxacin was investigated in broth against log and stationary-phase cultures of Staphylococcus aureus and Escherichia coli. The most rapid rate of kill was seen with ciprofloxacin, while CGP exhibited a more rapid bactericidal effect than cefotaxime against Staph. aureus. The stability of CGP was studied at two concentrations in serum, broth and phosphate buffer at 4 degrees C, room temperature and 37 degrees C. In serum the half-life was 112 h at 4 degrees C, 35 h at room temperature and 11.4 h at 37 degrees C. Protein binding tested at concentrations of 5-100 mg/l was 2-6.3%. PMID- 3667481 TI - In-vitro studies of antibiotic combinations for multiply-resistant coagulase negative staphylococci. AB - Coagulase-negative staphylococci are being implicated as pathogens with increasing frequency and this may in part be due to their development of resistance to a wide variety of antibiotics. Because vancomycin is the only drug generally available for treating these multiply resistant organisms, we have tested several combinations of antibiotics for activity in vitro against these organisms. These in-vitro studies suggested that rifampicin combined with either gentamicin or cefamandole might occasionally provide an efficacious alternative to vancomycin, while the novobiocin plus rifampicin combination might be an effective oral regimen against methicillin-resistant coagulase negative staphylococci. Resistance to co-trimoxazole was found in nearly all isolates tested. PMID- 3667482 TI - Interaction between ciprofloxacin and vancomycin against staphylococci. AB - The interaction between ciprofloxacin and vancomycin against nine isolates of Staphylococcus epidermidis from cases of infective endocarditis and three strains of S. aureus was studied. Killing curves indicated the presence of antagonism in the early stages, the clinical significance of which is uncertain. No synergy was found and the combination therefore does not appear to offer any advantages over vancomycin alone for the treatment of staphylococcal infections. PMID- 3667483 TI - Alterations of pharmacokinetic properties of gentamicin, penicillin G and two cephalosporins in septicaemic rabbits. AB - The pharmacokinetics of gentamicin, penicillin G, latamoxef and CPW 86-363, a novel third generation cephalosporin, were studied in healthy and septicaemic rabbits. Elevation of body temperature in infected animals was paralleled by statistically significant decreases in serum drug levels during the early stages of the distribution phase for penicillin G, latamoxef and CPW 86-363 whereas gentamicin showed increased serum drug levels during the early period. No significant differences were seen in tissue fluid levels (STIF) or normal and septicaemic rabbits for the four antibiotics used. Haemodynamic alterations and an increased permeability of blood vessel walls are presumed to contribute to changes in distribution properties of various drugs during experimental septicaemia. The qualitative differences among the antibiotics tested seem to be related to their physico-chemical characteristics. PMID- 3667484 TI - Intraventricular vancomycin for treatment of shunt-associated ventriculitis. PMID- 3667485 TI - In-vitro activity of paldimycin against methicillin-resistant and susceptible isolates of Staphylococcus aureus and S. epidermidis. PMID- 3667486 TI - Elastin in a neonatal rat smooth muscle cell culture has greatly decreased susceptibility to proteolysis by human neutrophil elastase. An in vitro model of elastolytic injury. AB - A neonatal rat aorta smooth muscle cell culture system with a unique elastin-rich extracellular matrix was used as a model substrate for elastases. To study the susceptibility to solubilization of insoluble elastin, cultures were incubated in the presence of human neutrophil elastase (HNE) or porcine pancreatic elastase (PPE) and in the absence of serum for periods up to 45 min. Both the incubation media and cell layers were then assessed for elastin and collagen markers, total protein, and lactate dehydrogenase (LDH). Although HNE and PPE exhibited comparable activity against elastin purified from the cell layer, HNE exhibited a 6.7- to 25-fold reduction in its elastin solubilizing activity using intact cell layers as compared with the purified elastin, whereas PPE exhibited only a 1.5- to 2.5-fold reduction. This effect could not satisfactorily be explained as preferential inhibition of HNE activity in the culture system, because the amount of protein solubilized by HNE was 59% that of PPE. The mean elastin content of PPE-solubilized protein was 110% that of the elastin content of the corresponding cell layer; the value for HNE-solubilized protein was only 16%. Thus, the amount of elastin per microgram of solubilized protein for HNE was 15% that for PPE. Possible explanations for the greatly diminished elastolytic activity of HNE in the culture system include the preference of HNE for other substrates in the cell layer, the inability of HNE to penetrate sufficiently into the cell layer, and the presence of sulfated glycosaminoglycans in the vicinity of the elastin that act in an inhibitory fashion. Although there was extensive proteolytic damage to the extracellular matrix, LDH and DNA measurements indicated that little loss of cells or cell viability occurred. The observed differences in elastolytic activity of HNE and PPE in the culture system parallel the relative emphysema inducing potency of the elastases in the hamster model of elastase-induced emphysema. PMID- 3667487 TI - Improved clonal and nonclonal growth of human, rat and bovine adrenocortical cells in culture. AB - This report describes the development of a culture system for long-term growth and cloning of human fetal adrenocortical cells. Optimal conditions for stimulating clonal growth were determined by testing the efficacy of horse serum (HS), fetal bovine serum (FBS), fibroblast growth factor (FGF), epidermal growth factor (EGF), fibronectin, and a combination of growth factors, UltroSer G, in stimulating growth from low density. Optimal conditions for clonal growth were achieved using fibronectin-coated dishes and DME/F12 medium with 10% FBS, 10% HS, 2% UltroSer G, and 100 ng/ml FGF or 100 pM EGF. Conditions for growth at clonal density were found to be optimal for growth of early passage, nonclonal cultures at higher densities. The improved growth conditions used for cloning were shown to allow continued long-term growth of nonclonal human adrenocortical cells without fibroblast overgrowth. All cells in cultures grown in HS, FBS, and UltroSer G had morphologic characteristics of adrenocortical cells, whereas cells grown in FBS only rapidly became overgrown with fibroblasts. Clonal and nonclonal early passage human adrenocortical cells had similar mitogenic responses to FGF and EGF. Whereas FGF, EGF, and UltroSer G showed similar stimulation of DNA synthesis and clonal growth in human adrenocortical cells and human adrenal gland fibroblasts, the tumor promoter 12-O-tetradecanoylphorbol-13-acetate stimulated growth only in adrenocortical cells and was strongly inhibitory to growth in fibroblasts. In both cell types, forskolin inhibited DNA synthesis. Human adrenocortical cell cultures were functional and synthesized cortisol, dehydroepiandrosterone, and dehydroepiandrosterone sulfate. The improved growth conditions for clonal growth of human adrenocortical cells also provided optimal conditions for long-term growth of cultured rat adrenocortical cells and increased the cloning efficiency of cultured bovine adrenocortical cells. PMID- 3667488 TI - GH3 cell secretion of growth hormone and prolactin increases spontaneously during perifusion. AB - GH3 cell secretory activity was studied in long-term perifusion to define previously reported spontaneous increases in growth hormone (GH) and prolactin production (PRL). Mechanically harvested cells (1 X 10(7)/column) were perifused at 4 ml/h for 72 h. A basal period of variable duration (8 to 12 h), during which hormone secretion was stable, was followed by steadily increasing secretion rates. Changes in cell number were not sufficient to account for increased hormone secretion rates: a) there was no significant change in cell count after 72 h (0.97 +/- 0.03 X 10(7); n = 18); b) mean cell column DNA content increased 25.5% above the base value, whereas GH secretion rose 385% and PRL rose 178% (n = 5). Observed differences in the duration of the basal secretion period, the basal secretory rate, and the magnitude of secretory rate increase were associated with several variables: a) variability within a subline was a function of passage number: GH secretion decreased and PRL secretion increased with subculture number; b) cells with identical lot and freeze numbers, but received at different times, behaved differently; c) the presence of an antifungal agent (nystatin) altered hormone secretion reproducibly. CONCLUSIONS: a) rates of GH and PRL secretion rise spontaneously in perifusion without a proportional increase in GH3 cell number; b) fluctuations in the rate of GH3 cell secretion of GH and PRL are not entirely random but are determined by several definable variables. PMID- 3667489 TI - Routine heat inactivation of serum reduces its capacity to promote cell attachment. AB - Heat inactivation (56 degrees C for 40 min) of bovine calf serum was shown to diminish its capacity to promote the attachment of cells to plastic or glass surfaces. This effect was not observed in stationary cultures (culture dishes) but became manifest under conditions in which the cells were subjected to a small amount of liquid shear force, i.e. by growing cells in roller bottles or culture tubes. Of four cell lines tested on bovine calf serum (SV-BHK, BALB-3T3, CV-1, and FS-4) SV-BHK and CV-1 cells showed the greatest sensitivity to loss of attachment-promoting activity. Fetal bovine serum also seemed to be affected by heat inactivation but to a lesser degree than bovine calf serum. Treatment of vessel surfaces with either unheated calf serum or specific attachment factors (gelatin, poly-D-lysine, and fibronectin) greatly increased cell attachment in the presence of heat inactivated serum. Heat inactivation did not seem to affect the ability of cells to grow after attachment. Of the four cell lines tested, the normal human fibroblast line (FS-4) was shown to be most effective at conditioning medium and restoring its capacity to promote the attachment of all four cell lines. PMID- 3667490 TI - A third world wheelchair. AB - A wheelchair was designed specifically for manufacture, maintenance, and use in Third World countries. An experimental prototype was constructed and tested, and subsequently, a production model was manufactured after modifications to the original design were made. PMID- 3667491 TI - Subjective memory impairment after stroke. AB - The responses of 95 stroke patients and 129 orthopaedic control patients were compared on a questionnaire of subjective memory abilities. Stroke patients reported more problems than orthopaedic controls, and relatives observed more problems in both groups than were reported by patients. Reassessment after 6 months showed that stroke patients rated their memories as worse but their relatives observed an improvement. Factors such as whether the patient was in hospital or at home, and the side of the lesion, were not found to be related to overall subjective memory impairment. PMID- 3667492 TI - Inquiring about the bizarre: false positives in Diagnostic Interview Schedule for Children (DISC) ascertainment of obsessions, compulsions, and psychotic symptoms. PMID- 3667493 TI - Comparison of two structured interviews on a psychiatrically hospitalized population of children. PMID- 3667494 TI - Reliability, validity, and parent-child agreement studies of the Diagnostic Interview for Children and Adolescents (DICA). PMID- 3667495 TI - Diagnostic concordance between the Child Assessment Schedule (CAS) and the Schedule for Affective Disorders and Schizophrenia for School-age Children (K SADS) in an outpatient sample using lay interviewers. PMID- 3667496 TI - Comparison of DISC and K-SADS-P interviews of an epidemiological sample of children. PMID- 3667497 TI - The Diagnostic Interview for Children and Personality Inventory for Children in studies of children at risk for anxiety disorders or depression. PMID- 3667498 TI - Diagnostic continuity from preschool to middle childhood. PMID- 3667499 TI - Comparisons of DSM-III defined pervasive developmental disorders in North Dakota children. PMID- 3667500 TI - A comparison of girls and boys with teacher-identified problems of attention. PMID- 3667501 TI - Attention deficit disorder with and without hyperactivity: comparison of behavioral characteristics of clinic-referred children. PMID- 3667502 TI - Conduct and oppositional disorder in clinically referred children with attention deficit disorder: a controlled family study. PMID- 3667503 TI - Changes in family function and relationships in children who respond to methylphenidate. PMID- 3667504 TI - Concordance among sources of information for ratings of anxiety and depression in children. PMID- 3667505 TI - Patterns of withdrawal and avoidance in developmentally disabled adolescents. PMID- 3667506 TI - Biopsychosocial characteristics of matched samples of delinquents and nondelinquents. PMID- 3667507 TI - Sexual abuse and psychopathology in hospitalized adolescents. PMID- 3667508 TI - Predicting school failure and assessing early intervention with high-risk children. PMID- 3667509 TI - Posttraumatic phenomena in a longitudinal study of children following a natural disaster. PMID- 3667510 TI - Social-cognitive aspects of therapeutic interactions. PMID- 3667511 TI - Psychological functioning in children with Crohn's disease and ulcerative colitis: implications for models of psychobiological interaction. PMID- 3667512 TI - Depressive symptoms in children and adolescents with cancer: a longitudinal study. PMID- 3667513 TI - Understanding controversies in visitation. PMID- 3667514 TI - Anorexia nervosa in Southeast Asian refugees: a report on three cases. PMID- 3667515 TI - Treatment of a 7-year-old boy with obesity-hypoventilation (Pickwickian syndrome) on a psychosomatic inpatient unit. PMID- 3667516 TI - Child and family psychiatry in China. PMID- 3667517 TI - Perceived competence and self-worth in emotionally disturbed children. PMID- 3667518 TI - Phosphoenolpyruvate:glycose phosphotransferase system in species of Vibrio, a widely distributed marine bacterial genus. AB - The genus Vibrio is one of the most common and widely distributed groups of marine bacteria. Studies on the physiology of marine Vibrio species were initiated by examining 15 species for the bacterial phosphoenolpyruvate:glycose phosphotransferase system (PTS). All species tested contained a PTS analogous to the glucose-specific (IIGlc) system in enteric bacteria. Crude extracts of the cells showed immunological cross-reactivity with antibodies to enzyme I, HPr, and IIIGlc from Salmonella typhimurium when assayed by the rocket-line method. Toluene-permeabilized cells of 11 species were tested and were active in phosphorylating methyl alpha-D-glucoside with phosphoenolpyruvate but not ATP as the phosphoryl donor. Membranes from 10 species were assayed, and they phosphorylated methyl alpha-D-glucoside when supplemented with a phospho-IIIGlc generating system composed of homogeneous proteins from enteric bacteria. Toluene permeabilized cells and membranes of seven species were assayed, as were phosphorylated fructose and 2-deoxyglucose. IIIGlc was isolated from Vibrio fluvialis and was active in phosphorylating methyl alpha-D-glucoside when supplemented with a phospho-HPr-generating system composed of homogeneous proteins from Escherichia coli and membranes from either E. coli or V. fluvialis. These results show that the bacterial PTS is widely distributed in the marine environment and that it is likely to have a significant role in marine bacterial physiology and in the marine ecosystem. PMID- 3667519 TI - Purification and some properties of sulfur:ferric ion oxidoreductase from Thiobacillus ferrooxidans. AB - A sulfur:ferric ion oxidoreductase that utilizes ferric ion (Fe3+) as an electron acceptor of elemental sulfur was purified from iron-grown Thiobacillus ferrooxidans to an electrophoretically homogeneous state. Under anaerobic conditions in the presence of Fe3+, the enzyme reduced 4 mol of Fe3+ with 1 mol of elemental sulfur to give 4 mol of Fe2+ and 1 mol of sulfite, indicating that it corresponds to a ferric ion-reducing system (T. Sugio, C. Domatsu, O. Munakata, T. Tano, and K. Imai, Appl. Environ. Microbiol. 49:1401-1406, 1985). Under aerobic conditions, sulfite, but not Fe2+, was produced during the oxidation of elemental sulfur by this enzyme because the Fe2+ produced was rapidly reoxidized chemically by molecular oxygen. The possibility that Fe3+ serves as an electron acceptor under aerobic conditions was ascertained by adding o-phenanthroline, which chelates Fe2+, to the reaction mixture. Sulfur:ferric ion oxidoreductase had an apparent molecular weight of 46,000, and it is composed of two identical subunits (Mr = 23,000) as estimated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Sulfur oxidation by this enzyme was absolutely dependent on the presence of reduced glutathione. The enzyme had an isoelectric point and a pH optimum at pH 4.6 and 6.5, respectively. Almost all the activity of sulfur:ferric ion oxidoreductase was observed in the osmotic shock fluid of the cells, suggesting that it was localized in the periplasmic space of the cells. PMID- 3667520 TI - Characterization of the lipopolysaccharide from a Rhizobium phaseoli mutant that is defective in infection thread development. AB - The lipopolysaccharide (LPS) from a Rhizobium phaseoli mutant, CE109, was isolated and compared with that of its wild-type parent, CE3. A previous report has shown that the mutant is defective in infection thread development, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis shows that it has an altered LPS (K. D. Noel, K. A. VandenBosch, and B. Kulpaca, J. Bacteriol. 168:1392-1462, 1986). Mild acid hydrolysis of the CE3 LPS released a polysaccharide and an oligosaccharide, PS1 and PS2, respectively. Mild acid hydrolysis of CE109 LPS released only an oligosaccharide. Chemical and immunochemical analyses showed that CE3-PS1 is the antigenic O chain of this strain and that CE109 LPS does not contain any of the major sugar components of CE3-PS1. CE109 oligosaccharide was identical in composition to CE3-PS2. The lipid A's from both strains were very similar in composition, with only minor quantitative variations. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of CE3 and CE109 LPSs showed that CE3 LPS separated into two bands, LPS I and LPS II, while CE109 had two bands which migrated to positions similar to that of LPS II. Immunoblotting with anti-CE3 antiserum showed that LPS I contains the antigenic O chain of CE3, PS1. Anti-CE109 antiserum interacted strongly with both CE109 LPS bands and CE3 LPS II and interacted weakly with CE3 LPS I. Mild-acid hydrolysis of CE3 LPS I, extracted from the polyacrylamide gel, showed that it contained both PS1 and PS2. The results in this report showed that CE109 LPS consists of only the lipid A core and is missing the antigenic O chain. PMID- 3667521 TI - Bacterial metabolism of alpha-pinene: pathway from alpha-pinene oxide to acyclic metabolites in Nocardia sp. strain P18.3. AB - Over 20 gram-positive bacteria were isolated by elective culture with (+/-)-alpha pinene as the sole carbon source. One of these strains, Nocardia sp. strain P18.3, was selected for detailed study. alpha-Pinene-grown cells oxidized, without lag, alpha-pinene, alpha-pinene oxide (epoxide), and the cis and trans isomers of 2-methyl-5-isopropylhexa-2,5-dienal. No other tested terpene was oxidized at a significant rate. alpha-Pinene was not metabolized by cell extracts in the presence or absence of NADH or NADPH. Cell extracts catalyzed a rapid decyclization of alpha-pinene oxide, in the absence of added cofactors, with the formation of cis-2-methyl-5-isopropylhexa-2,5-dienal. Further oxidation of the aldehyde to the corresponding acid occurred in the presence of NAD. Both activities were induced by growth with alpha-pinene. A rapid, nonenzymic transformation of the cis aldehyde into the trans isomer occurred in glycine buffer. The trans isomer was also a substrate for the NAD-linked aldehyde dehydrogenase. The distribution of the alpha-pinene oxide lyase in alpha-pinene utilizing Pseudomonas spp. was also investigated and was compatible with the two alternative ring-cleavage sequences that have been proposed on the basis of accumulated metabolites. PMID- 3667522 TI - Purification and properties of alpha-pinene oxide lyase from Nocardia sp. strain P18.3. AB - alpha-Pinene oxide is an intermediate in the degradation of alpha-pinene by Nocardia sp. strain P18.3 and some Pseudomonas strains. The epoxide is cleaved by a lyase which catalyzes a concerted reaction in which both rings of the bicyclic structure are cleaved with the formation of cis-2-methyl-5-isopropylhexa-2,5 dienal. The enzyme has been purified to homogeneity from Nocardia sp. strain P18.3. It was induced by growth with alpha-pinene and constituted 6 to 7% of the soluble protein of cell extracts. The apparent molecular weight of the native enzyme was 50,000 by ultracentrifugal analysis. Sodium dodecyl sulfate polyacrylamide gel electrophoresis gave two dissimilar subunits with apparent molecular weights of 17,000 and 22,000. The enzyme was devoid of prosthetic groups, had no cofactor requirement, and had a broad pH activity range, a Km for alpha-pinene oxide of 9 microM, and a turnover number of 15,000. Inhibitors included sulfhydryl reactive compounds, terpene epoxides, and pinane derivatives with substituent groups at carbon 3. A mechanism for the concerted reaction has been proposed in which decyclization is initiated by donation of a proton from the catalytic center to the oxygen of the epoxide with consequent destabilization. In vitro the enzyme was inactivated during catalysis, and a reactive cationic intermediate may be responsible for this phenomenon. The enzyme should be classified as a lyase EC 4.99.-.-. PMID- 3667523 TI - Three-dimensional structure of the regular tetragonal surface layer of Azotobacter vinelandii. AB - Fragments of the Azotobacter vinelandii tetragonal surface (S) layer, free of outer membrane material, were obtained by treating whole cells with 100 microM EDTA. The three-dimensional structure of the S layer was reconstructed from tilted-view electron micrographs of the S-layer fragments, after computer assisted image processing by correlation averaging. At a resolution of 1.7 nm, the S layer exhibited funnel-shaped subunits situated at one fourfold-symmetry axis and interconnected at the other fourfold-symmetry axis to form prominent cruciform linking structures. These data, in conjunction with a relief reconstruction of the surface of freeze-etched whole cells, indicated that the apex of the funnel-shaped subunit was associated with the outer membrane, while the funnel "opening" faced the environment; the cruciform linking structures were formed at the outermost surface of the S layer. Electron microscopy and image enhancement were used to compare the structure of the outer membrane-associated S layer with that of fragments of the S layer dislodged from the outer membrane. This analysis revealed an increase in the lattice constant of the S layer from 12.5 to 13.6 nm and an alteration in the position of the cruciform linking structures in the z direction. These conformational changes resulted in a reduction in the thickness of the S layer (minimum estimate, 5 nm) and an apparent increase in the size of the gaps between the subunits. In terms of the porosity of the S layer, this gave the appearance of a transition from a closed to a more open structure. PMID- 3667524 TI - Characterization of 1-chlorohexane halidohydrolase, a dehalogenase of wide substrate range from an Arthrobacter sp. AB - 1-Chlorohexane halidohydrolase from Arthrobacter sp. strain HA1 was purified to homogeneity by fractional precipitation, ion-exchange chromatography, gel filtration, and high-performance liquid chromatography gel filtration. The enzyme was a monomer with a molecular weight of about 37,000; its amino acid composition and N-terminal sequence were determined. The enzyme had a broad optimum around pH 9.5, a temperature optimum near 50 degrees C, an activation energy of 40 kJ/mol, and a molecular activity of 0.9 kat/mol. The substrate range of the enzyme included at least 50 halogenated compounds. 1-Chloroalkanes (C3 to C10), 1 bromoalkanes (C1 to C9), and 1-iodoalkanes (C1 to C7), but no 1-fluoroalkane, were substrates. Subterminally substituted, branched-chain, and nonsaturated haloalkanes were dehalogenated. Some halogenated aromatic substrates, e.g., bromobenzene and benzyl bromide, were hydrolyzed. Several alpha,omega dihaloalkanes were subject to double dehalogenation. Thus, 1,2-dibromoethane was hydrolyzed first to 2-bromoethanol and then to 1,2-dihydroxyethane. Crude extracts of strain HA1 were found to contain a debrominase that cleaved bromoalkanes with long alkyl chains. PMID- 3667525 TI - Dual control of Agrobacterium tumefaciens Ti plasmid virulence genes. AB - The virulence genes of nopaline (pTiC58) and octopine (pTiA6NC) Ti plasmids are similarly affected by the Agrobacterium tumefaciens ros mutation. Of six vir region complementation groups (virA, virB, virG, virC, virD, and virE) examined by using fusions to reporter genes, the promoters of only two (virC and virD) responded to the ros mutation. For each promoter that was affected by ros, the level of expression of its associated genes was substantially elevated in the mutant. This increase was not influenced by Ti plasmid-encoded factors, and the mutation did not interfere with the induction of pTiC58 vir genes by phenolic compounds via the VirA/VirG regulatory control mechanism. The effects of the ros mutation and acetosyringone were cumulative for all vir promoters examined. The pleiotropic characteristics of the ros mutant include the complete absence of the major acidic capsular polysaccharide. PMID- 3667526 TI - Complete dechlorination of tetrachlorohydroquinone by cell extracts of pentachlorophenol-induced Rhodococcus chlorophenolicus. AB - In this paper we describe the sequence of reactions leading from tetrachloro-para hydroquinone to 1,2,4-trihydroxybenzene by inducible enzymes of Rhodococcus chlorophenolicus. Tetrachlorohydroquinone was first converted to a dichlorotrihydroxybenzene in a reaction involving both hydrolytic and reductive dechlorination; no trichlorinated intermediate was detected. Dichlorotrihydroxybenzene was subsequently reductively dechlorinated to a monochlorotrihydroxybenzene and finally to 1,2,4-trihydroxybenzene. The cell extract also catalyzed, at a lower rate, reductive dechlorination of trichlorohydroquinone, mainly to 2,3-dichlorohydroquinone. To our knowledge this is the first demonstration of reductive aromatic dechlorination by bacterial enzymes. PMID- 3667527 TI - Nucleotide sequencing and characterization of the genes encoding benzene oxidation enzymes of Pseudomonas putida. AB - The nucleotide sequence of the genes from Pseudomonas putida encoding oxidation of benzene to catechol was determined. Five open reading frames were found in the sequence. Four corresponding protein molecules were detected by a DNA-directed in vitro translation system. Escherichia coli cells containing the fragment with the four open reading frames transformed benzene to cis-benzene glycol, which is an intermediate of the oxidation of benzene to catechol. The relation between the product of each cistron and the components of the benzene oxidation enzyme system is discussed. PMID- 3667528 TI - Purification and properties of protoporphyrinogen oxidase from an anaerobic bacterium, Desulfovibrio gigas. AB - Protoporphyrinogen oxidase has been solubilized from plasma membranes of Desulfovibrio gigas. The enzyme was purified to apparent homogeneity with single silver-stained protein bands on isoelectric focusing and sodium dodecyl sulfate polyacrylamide gels. This protoporphyrinogen oxidase has a molecular weight (Mr) of 148,000 and is composed of three dissimilar subunits of Mrs 12,000, 18,500, and 57,000, which are held together by sulfhydryl bonds. Unlike other protoporphyrinogen oxidases, which use molecular oxygen as an electron acceptor, this enzyme does not couple to oxygen. The protoporphyrinogen oxidase donates electrons to 2,6-dichlorophenol-indophenol but not to NAD+, NADP+, flavin adenine dinucleotide, or flavin mononucleotide. The natural physiological electron acceptor of the protoporphyrinogen oxidase from D. gigas is unknown. By using 2,6 dichlorophenol-indophenol as the electron acceptor, the Km and Vmax values for oxidation of protoporphyrinogen were determined to be 21 microM and 8.38 nmol/min per 70 micrograms of protein, respectively. The catalytic rate constant, Kcat, was calculated to be 17.7 mol of protoporphyrin formed per mole of enzyme per min of incubation, and the Kcat/Km was 0.84. Energies of activation were calculated from Arrhenius plots with 7,429 cal (ca. 31,080 J)/mol per degree below 10 degrees C and 1,455 cal (ca. 6,088, J)/mol per degree above 10 degrees C. Optimum enzyme activity was at 23 degrees C, and inhibition was observed with both N ethylmaleimide and iodoacetamide. PMID- 3667529 TI - Nucleotide sequence analysis of the gene encoding the Deinococcus radiodurans surface protein, derived amino acid sequence, and complementary protein chemical studies. AB - The complete nucleotide sequence of the gene encoding the surface (hexagonally packed intermediate [HPI])-layer polypeptide of Deinococcus radiodurans Sark was determined and found to encode a polypeptide of 1,036 amino acids. Amino acid sequence analysis of about 30% of the residues revealed that the mature polypeptide consists of at least 978 amino acids. The N terminus was blocked to Edman degradation. The results of proteolytic modification of the HPI layer in situ and Mr estimations of the HPI polypeptide expressed in Escherichia coli indicated that there is a leader sequence. The N-terminal region contained a very high percentage (29%) of threonine and serine, including a cluster of nine consecutive serine or threonine residues, whereas a stretch near the C terminus was extremely rich in aromatic amino acids (29%). The protein contained at least two disulfide bridges, as well as tightly bound reducing sugars and fatty acids. PMID- 3667530 TI - Initiation of chromosome replication in bacteria: analysis of an inhibitor control model. AB - This article contains an analysis of a version of the well-known inhibitor dilution model for the control of initiation of chromosome replication in bacteria. According to this model, an unstable inhibitor interacts with an initiation primer in a hit-and-destroy fashion to prevent successful initiation; both constituents are presumed to be RNA species that are synthesized constitutively. The model further postulates that the inhibitor interacts cooperatively with the primer, that the inhibitor gene is removed some distance from the origin of replication, and that an eclipse period exists during which the chromosome origin is not able to reinitiate. This unstable-inhibitor version is characterized by four parameters: the inhibitor half-life, the cooperativity index, the location of the inhibitor gene, and the eclipse period; computer simulations are used to study the effect of each of these on the DNA and interdivision time distributions in exponentially growing steady-state cultures. In neither case was any combination of parameter values found that could provide even moderately satisfactory agreement between the simulation results and experimental data. From the examples furnished and the associated discussion, it appears that there are none--that no combination of parameter values exists that can reasonably be expected to produce a significantly better fit than those tested. We conclude that the model in its present form cannot be a valid description of chromosome replication control in bacteria. It is pointed out that this does not necessarily apply to negative initiation control models in general, or even to all inhibitor-dilution systems, merely to the particular ColE1-like mechanism considered here. Nevertheless, recent experimental results, which can only be understood in terms of a very high degree of initiation synchrony within individual cells, offer strong evidence against stochastic models of this kind for the control of chromosome replication. PMID- 3667531 TI - Genetic relationships among the oral streptococci. AB - Genetic relationships and species limits among the oral streptococci were determined by an analysis of electrophoretically demonstrable variation in 16 metabolic enzymes. Fifty isolates represented 40 electrophoretic types, among which the mean genetic diversity per locus was 0.857. Mannitol-1-phosphate dehydrogenase was not detected in isolates of the sanguis species complex, and glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase were absent in species of the mutans complex. Clustering from a matrix of Gower's coefficient of genetic similarity placed the 40 electrophoretic types in 10 well defined groups corresponding to the Streptococcus species S. mutans, S. sobrinus, S. cricetus, S. rattus, S. ferus, S. oralis (mitior), two distinct assemblages of S. sanguis strains, and two subdivisions of "S. milleri." The assignments of isolates to these groups were the same as those indicated by DNA hybridization experiments, and the coefficient of correlation between genetic distance estimated by multilocus enzyme electrophoresis and genetic similarity indexed by DNA hybridization was -0.897 (P less than 0.001) for 50 pairwise combinations of isolates. S. ferus, which is widely believed to be a member of the mutans complex, was shown to be phylogenetically closer to species of the sanguis complex. PMID- 3667532 TI - Protein inclusions produced by the entomopathogenic bacterium Xenorhabdus nematophilus subsp. nematophilus. AB - The entomopathogenic bacterium Xenorhabdus nematophilus subsp. nematophilus produces two types of intracellular inclusion bodies during in vitro culture. Large cigar-shaped inclusions (designated type 1) and smaller ovoid inclusions (designated type 2) were purified from cell lysates, using differential centrifugation in discontinuous glycerol gradients and isopycnic density gradient centrifugation in sodium diatrizoate. The inclusions, composed almost exclusively of protein, are readily soluble at high and low pH values and in the presence of cation chelators such as EDTA, anionic detergents (sodium dodecyl sulfate), or protein denaturants (urea, NaBr). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of purified inclusions revealed a single 26-kilodalton protein (IP-1) in type 1 inclusions and a 22-kilodalton protein (IP-2) in type 2 inclusions. Analysis of these proteins by isoelectric focusing in the presence of 8 M urea showed that IP-1 is acidic and IP-2 is neutral. Furthermore, each protein occurred in multiple forms differing slightly in isoelectric point. Other variations in peptides released by trypsin digestion, immunological properties, and amino acid composition revealed significant structural differences between IP 1 and IP-2. Kinetic studies using light microscopy, sodium dodecyl sulfate polyacrylamide gel electrophoresis, and immunoblotting procedures showed that inclusion protein synthesis occurs only during the second half of exponential culture growth. Synthesis of inclusion proteins and their aggregation to form inclusions occurred concurrently. Possible functions for these abundant proteins are discussed. PMID- 3667533 TI - Two nonhomologus viruses of Cryphonectria (Endothia) parasitica reduce accumulation of specific virulence-associated polypeptides. AB - Double-stranded RNA responsible for transmissible hypovirulence of Cryphonectria (Endothia) parasitica affected the accumulation of specific polypeptides. Nonhomologous hypovirulence-causing double-stranded RNAs, originating in Europe or North America, affected accumulation of the same polypeptides. Fewer than 5% of detectable proteins were affected, indicating that hypovirulence is probably not the result of general debilitation of the fungus. PMID- 3667534 TI - Pathway of acetate assimilation in autotrophic and heterotrophic methanococci. AB - The autotroph Methanococcus maripaludis contained high levels of acetate-coenzyme A ligase, pyruvate synthase, pyruvate, water dikinase, pyruvate carboxylase, and the enzymes of the incomplete reductive tricarboxylic acid cycle. Phosphoenolpyruvate carboxykinase, citrate synthase, and isocitrate dehydrogenase were not detected. In contrast, the heterotroph Methanococcus sp. strain A3 contained acetate kinase, and acetate coenzyme A ligase was virtually absent. PMID- 3667535 TI - Two single-base-pair substitutions causing desensitization to tryptophan feedback inhibition of anthranilate synthase and enhanced expression of tryptophan genes of Brevibacterium lactofermentum. AB - A 5-fluorotryptophan-resistant mutant, termed 1041, was isolated from Brevibacterium lactofermentum AJ12036. The anthranilate synthase of 1041 was insensitive to feedback inhibition by tryptophan, and the specific activities of the anthranilate synthase and anthranilate phosphoribosyltransferase of 1041 were 29- and 23-fold higher than those in parental strain AJ12036, respectively. A single-base change (adenine to cytosine) that resulted in a Ser-to-Arg substitution was found in the trpE structural gene of 1041. This substitution was identified as the cause of the desensitization to feedback inhibition by tryptophan of anthranilate synthase in 1041. Another substitution (guanine to adenine) was found at a position in which a mutation would destabilize the rho independent terminator structure within the putative attenuator. The enhanced synthesis of tryptophan enzymes in 1041 could be caused by this substitution in the attenuator. PMID- 3667536 TI - Chemotaxis to plant phenolic inducers of virulence genes is constitutively expressed in the absence of the Ti plasmid in Agrobacterium tumefaciens. AB - The virulence (vir) genes are required in the early stages of plant tumor formation and are located together on the tumor-inducing (Ti) plasmid in Agrobacterium tumefaciens. Five of the vir genes are expressed inducibly in response to the following monocyclic phenolic compounds: acetosyringone, catechol, gallate, beta-resorcylate, protocatechuate, p-hydroxybenzoate, and vanillin. Of these compounds, only the latter six, excluding vanillin [corrected] served as chemoattractants and only the latter three served as growth substrates for A. tumefaciens A348. Strain A136, isogenic except for lack of the Ti plasmid, demonstrated chemotactic behavior and nutritional capabilities similar to those of strain A348. The chemotactic response to the vir gene inducers was expressed constitutively. PMID- 3667537 TI - Recurrent depression: an assessment of family burden and family attitudes. AB - Recognition that a psychiatrically ill family member has profound effects on family life and significant others has stimulated the need for more precise assessments of family members. The authors evaluated the burden experienced by those in the immediate environment of an individual with recurrent depressive illness as well as the beliefs they hold about the illness. This report presents a preliminary body of data on the level and types of distress shared by family members, especially family members living with the patient. Such information is valuable in designing educational interventions for family members in order to explore their attitudes and belief systems about depressive illness, to decrease the impact of family and other relationship stress on the patient, and to enhance the significant others' support of the patient. PMID- 3667538 TI - Preventive aggression devices (PADS): ambulatory restraints as an alternative to seclusion. AB - The authors introduce an ambulatory restraint procedure developed for a specialized inpatient unit with repetitively aggressive patients. Preventive Aggression Devices (PADS) reduce the length and frequency of seclusion and humanely foster a safer, more therapeutic environment for patients requiring a highly controlled environment. Indications and contraindications for PADS are listed, and criteria for their use are described. PMID- 3667539 TI - Anterior cortical atrophy in Fregoli syndrome. AB - The computed tomography scans of 10 patients with Fregoli syndrome and 10 matched controls were blindly assessed. Patients with Fregoli syndrome showed more frontal and temporal lobe atrophy than controls. Fregoli syndrome may be associated with dysfunction of these areas. PMID- 3667540 TI - A case of parasomnia at REM sleep onset. AB - A case is reported of dyssomnia at the onset of REM sleep with thrashing, shouting, and urinary incontinence throughout the night. The attacks did not respond to, and may have been worsened by, antiepileptic drugs and diazepam, and the patient had microsleeps and brief apneas during a night of severely fragmented sleep. The case underscores the value of differentiating REM and NREM disorders in patients with atypical nocturnal attacks. PMID- 3667541 TI - Erythema multiforme major in a patient treated with carbamazepine. AB - A bipolar patient is described in whom erythema multiforme major, or Stevens Johnson syndrome, developed after treatment with carbamazepine. The systemic and dermatological manifestations and some of the known causes of the syndrome are discussed. PMID- 3667542 TI - Carbamazepine for intermittent explosive disorder in a Prader-Willi syndrome patient. PMID- 3667543 TI - Trazodone-induced mania. PMID- 3667544 TI - High-dosage tranylcypromine in refractory depression. PMID- 3667546 TI - New uses for clonazepam in psychiatry. A symposium. Proceedings. PMID- 3667545 TI - Significant greater loss of medication from the injection site when fluphenazine (Prolixin) decanoate was injected intramuscularly as contrasted with subcutaneously. PMID- 3667547 TI - New uses for clonazepam in psychiatry: introduction and overview. PMID- 3667548 TI - Clonazepam in the treatment of prepubertal children with panic-like symptoms. AB - Three prepubertal children who suffered severe, incapacitating anxiety disorders with panic-like symptoms were treated successfully with clonazepam. The daily doses ranged from 0.5 to 3 mg. Symptoms were rapidly controlled after a therapeutic dose was attained, and no adverse effects were reported. The children were symptom-free at follow-up, which ranged from 5 months to 3 years. These three cases illustrate the diagnostic and therapeutic overlap between childhood and adult anxiety disorders and indicate the need for empirical studies aimed at evaluating diagnostic and treatment issues in childhood anxiety disorders. PMID- 3667549 TI - Primary structure of anti-lipopolysaccharide factor from American horseshoe crab, Limulus polyphemus. AB - The complete amino acid sequence of anti-lipopolysaccharide (LPS) factor purified from the hemocytes lysate of the American horseshoe crab, Limulus polyphemus, was determined by characterization of the NH2-terminal sequence and the peptides generated after digestion of the protein with lysyl endopeptidase, clostripain, and Staphylococcus aureus V8 protease. Upon sequencing the peptides by the automated Edman method, the following primary structure was obtained: (Sequence: in text). During the sequence analysis, two species of the protein, which differed from each other at one locus, were found and characterized. L. polyphemus anti-LPS factor was a basic protein consisting of a single polypeptide chain of 101 residues and a calculated molecular weight of 11,786 or 11,800. The hydrophobic NH2-terminal sequence and the clustering of positive charges found in the disulfide loop yielded a typical amphipathic character of this protein. Moreover, L. polyphemus anti-LPS factor showed 83% sequence identity with the Tachypleus tridentatus protein, and the sequence similar to that observed in the EF-hand structure was found to contain in the COOH terminal portions of these proteins, although its function is unknown. PMID- 3667550 TI - Binding of actin filaments to connectin. AB - The binding of actin filaments to connectin, a muscle elastic protein, was investigated by means of turbidity and sedimentation measurements and electron microscopy. In the presence of less than 0.12 M KCl at pH 7.0, actin filaments bound to connectin. Long actin filaments formed bundles. Short actin filaments also aggregated into irregular bundles or a meshwork, and were frequently attached perpendicularly to long bundles. The binding of F-actin to connectin was saturated at an equal weight ratio (molar ratio, 50 : 1), as determined by a cosedimentation assay. Larger amounts of sonicated short actin filaments appeared to bind to connectin than intact F-actin. Myosin S1-decorated actin filaments did not bind to connectin. The addition of S1 to connectin-induced actin bundles resulted in partial disaggregation. Thus, connectin does not appear to interfere with actin-myosin interactions, since myosin S1 binds to actin more strongly than connectin. PMID- 3667551 TI - The NADPH oxidase-dependent hemolysis of sheep erythrocytes with the membrane fraction of guinea pig peritoneal macrophages. AB - As previously reported, the membrane fraction of liquid paraffin-induced, guinea pig peritoneal macrophages exhibits an NADPH-dependent hemolytic activity toward sheep erythrocytes. This activity was inhibited with N-ethylmaleimide, superoxide dismutase, cytochrome c, catalase, desferrioxamine, mannitol, and benzoate. These inhibition profiles indicate that O2- generation by the NADPH oxidase, peroxidation of the membranous lipids with H2O2 or .OH secondarily formed from O2 , and hemolysis of sheep erythrocytes with the peroxides occur in this order in the hemolytic reaction. In fact, the lipid peroxides were found to be formed in the membrane fraction in the presence of Fe3+, subsequent to the O2- generation, and to act as a final hemolytic agent. PMID- 3667552 TI - Conversion of peanut trypsin-chymotrypsin inhibitor B-III to a chymotrypsin inhibitor by deimination of the P1 arginine residues in two reactive sites. AB - The deimination of the arginine residues in peanut trypsin-chymotrypsin inhibitor B-III caused the disappearance of its trypsin-inhibitory activity. Peanut protease inhibitor B-III was incubated with peptidylarginine deiminase, resulting in the conversion of 2.5 mol of arginine to citrulline and in the loss of its trypsin-inhibitory activity. However, the ability of the deiminated inhibitor to inhibit chymotrypsin was as strong as before. Structural analysis of the deiminated B-III indicated that the P1 arginine residues at both reactive sites, Arg(10) and Arg(38), were completely modified to citrulline by the action of peptidylarginine deiminase, and that the Arg(60) in the C-terminal region of B III was partially deiminated. These residues seem to be exposed on the surface of the molecule. The P1' arginine residue at the first reactive site, Arg(11), was not deiminated at all. PMID- 3667553 TI - Characterization of neutral glycosphingolipids from fetal human brain: evidence for stage-specific expression of the globo, ganglio, and neolacto series in the central nervous system. AB - Neutral glycosphingolipids were isolated from normal human fetal brains, at 22 to 23 weeks gestation. They were identified as monohexosylceramides, lactosylceramide, and glycolipids belonging to the globo (globotriaosylceramide) and ganglio (gangliotriaosylceramide) series. In addition, considerable amounts of neolactotetraosylceramide and III3-alpha-fucosyl-neolactotetraosylceramide were detected. Although neutral glycolipids of the globo, ganglio, and neolacto series have been demonstrated in the brains of cases with some sphingolipidoses, they are not present in appreciable amounts in differentiated normal brain. Therefore, the present and previous observations would imply that the metabolism of these glycolipid series actively occurs in the normal brain at an early stage of differentiation and continues thereafter in the brain in the case of some sphingolipidoses. The diseased brain is most probably accompanied by a disturbance of differentiation. PMID- 3667554 TI - Identification of new C27 and C24 bile acids in the bile of Alligator mississippiensis. AB - Biliary bile acids of Alligator mississippiensis were analyzed by gas-liquid chromatography-mass spectrometry after fractionation by silica gel column chromatography. It was shown that the alligator bile contained 12 C27 bile acids and 8 C24 bile acids. In addition to the C27 bile acids, such as 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholestanoic acid, 3 alpha,7 alpha,12 alpha trihydroxy-5 alpha-cholestanoic acid, 3 alpha,7 alpha-dihydroxy-5 beta cholestanoic acid, 3 alpha,12 alpha-dihydroxy-5 beta-cholestanoic acid, 7 alpha,12 alpha-dihydroxy-3-oxo-5 beta-cholestanoic acid, and 3 alpha,12 alpha dihydroxy-7-oxo-5 beta-cholestanoic acid, identified previously in the bile of A. mississippiensis, 3 alpha,7 beta-dihydroxy-5 beta-cholestanoic acid, 3 alpha,7 beta,12 alpha-trihydroxy-5 beta-cholestanoic acid, 7 beta,12 alpha-dihydroxy-3 oxo-5 beta-cholestanoic acid, 3 alpha,7 alpha,12 alpha,24-tetrahydroxy-5 beta cholestanoic acid, 3 alpha,7 alpha,12 alpha,26-tetrahydroxy-5 beta-cholestanoic acid, and 1 beta,3 alpha,7 alpha,12 alpha-tetrahydroxy-5 beta-cholestanoic acid were newly identified. And in addition to the C24 bile acids, such as chenodeoxycholic acid, ursodeoxycholic acid, cholic acid, and allocholic acid, identified previously, deoxycholic acid, 3 alpha,7 alpha-dihydroxy-5 beta-chol-22 enoic acid, 3 alpha,7 alpha,12 alpha-trihydroxy-5 alpha-chol-22-enoic acid, and 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-chol-22-enoic acid were newly identified. PMID- 3667555 TI - Properties of glutamate dehydrogenase purified from Bacteroides fragilis. AB - The dual pyridine nucleotide-specific glutamate dehydrogenase [EC 1.4.1.3] was purified 37-fold from Bacteroides fragilis by ammonium sulfate fractionation, DEAE-Sephadex A-25 chromatography twice, and gel filtration on Sephacryl S-300. The enzyme had a molecular weight of approximately 300,000, and polymeric forms (molecular weights of 590,000 and 920,000) were observed in small amounts on polyacrylamide gel disc electrophoresis. The molecular weight of the subunit was 48,000. The isoelectric point of the enzyme was pH 5.1. This glutamate dehydrogenase utilized NAD(P)H and NAD(P)+ as coenzymes and showed maximal activities at pH 8.0 and 7.4 for the amination with NADPH and with NADH, respectively, and at pH 9.5 and 9.0 for the deamination with NADP+ and NAD+, respectively. The amination activity with NADPH was about 5-fold higher than that with NADH. The Lineweaver-Burk plot for ammonia showed two straight lines in the NADPH-dependent reactions. The values of Km for substrates were: 1.7 and 5.1 mM for ammonium chloride, 0.14 mM for 2-oxoglutarate, 0.013 mM for NADPH, 2.4 mM for L-glutamate, and 0.019 mM for NADP+ in NADP-linked reactions, and 4.9 mM for ammonium chloride, 7.1 mM for 2-oxoglutarate, 0.2 mM for NADH, 7.3 mM for L glutamate, and 3.0 mM for NAD+ in NAD-linked reactions. 2-Oxoglutarate and L glutamate caused substrate inhibition in the NADPH- and NADP+-dependent reactions, respectively, to some extent. NAD+- and NADH-dependent activities were inhibited by 50% by 0.1 M NaCl. Adenine nucleotides and dicarboxylic acids did not show remarkable effects on the enzyme activities. PMID- 3667556 TI - Multidimensional stopped-flow photometry monitoring initial processes of platelet activation. AB - A group of initial processes in platelet activation, consisting of a platelet shape change, an intracellular calcium mobilization, a calcium efflux, and a membrane fluidity (mobility) change, has been examined in rabbit platelets by a multidimensional stopped-flow method with light scattering, light transmission, and fluorescence measurements. It was found that a 90 degrees light scattering change and internal calcium release (monitored in terms of chlortetracycline fluorescence) take place after a short lag (5 s at 25 degrees C and 2 s at 37 degrees C) following activation by thrombin. The duration of the lag was the same in both cases. During the initial lag period, a rapid increase in platelet membrane fluidity (mobility) was observed by the use of pyrene excimer fluorescence. These results suggest that the intracellular calcium mobilization and the shape change are triggered by the same rate-determining step, and increase in membrane mobility may play some role in the initial stage of platelet activation before intracellular calcium mobilization occurs. PMID- 3667557 TI - Cytoskeleton in vitro: preparation of isolated cytoskeletons with three dimensional architecture. AB - Cytoskeletons with three-dimensional architecture were isolated from cultured normal rat kidney cells. The preparation procedure consisted of Triton demembranization of suspended cells followed by differential and sucrose density gradient centrifugation. By using higher (0.5%) and lower (0.1%) Triton concentrations for demembranization, two kinds of isolated cytoskeletons (CSK), called H-CSK and L-CSK, respectively, were prepared. H-CSK and L-CSK displayed unique morphology and protein composition. Three classes of cytoskeletal filaments, microfilaments, intermediate filaments, and microtubules were shown to be major components in the electron microscopic images of the H-CSK. Stereoscopic electron microscopy of the H-CSK, dried by the critical point method, revealed that the cytoskeletal filaments are arranged in three-dimensional configurations even after isolation in vitro. Two-dimensional gel electrophoresis demonstrated that the H-CSK was composed mainly of actin, tubulin, and vimentin, reflecting its basic architecture. Electron microscopic images of L-CSK were more intricate than images of the H-CSK and showed, in addition to the filament types discussed above, anastomosing networks of short filamentous structures. These short filaments, with diameters of 3-8 nm and lengths of 30-150 nm, seemed to cross link other elements of the cytoskeleton. The morphology of these short filaments resembles that of microtrabeculae observed in situ. Two-dimensional gels of the L CSK showed over 100 protein spots when the gels were stained by the silver method. Subsequent treatment of the L-CSK with 0.5% Triton removed the microtrabeculae-like materials leaving as a residue the basic cytoskeleton similar to the H-CSK. Our observations indicate that microtrabeculae are composed of heterogenous proteins associated, in some instances, with a core structure of actin. PMID- 3667558 TI - Bile acid metabolism in isolated rat hepatocytes: studied by gas-liquid chromatography-mass spectrometry-selected ion monitoring. AB - Bile acid contents in isolated rat hepatocytes were determined by gas-liquid chromatography-mass spectrometry-selected ion monitoring with the use of deuterium-labeled internal standards. This allowed us first to monitor the actual amounts of not only major but also minor bile acid components present with sufficient sensitivity and specificity and to follow the changes of individual bile acids in cultured rat hepatocytes simultaneously. In freshly isolated rat hepatocytes, cholic and beta-muricholic acids were the major components, comprising 35 and 46% of the total bile acids, respectively. These two bile acids were found to be most actively synthesized during the first 2 h of incubation and continued to increase thereafter for up to 6 h (the end of the period studied). In contrast, chenodeoxycholic and alpha-muricholic acids, which are the precursors of beta-muricholic acid, showed slight increases only in the first hour of incubation and decreased thereafter. These results suggested that the conversion to beta-muricholic acid from chenodeoxycholic acid via alpha muricholic acid occurred rapidly in cultured rat hepatocytes. The secondary bile acids such as deoxycholic, hyodeoxycholic, and 3 alpha, 12 beta-dihydroxy-5 beta cholanoic acids declined steadily from the start of incubation, which supported the findings that further hydroxylation of these dihydroxy bile acids occurs in rat liver. PMID- 3667559 TI - Effect of forskolin on collagen production in clonal osteoblastic MC3T3-E1 cells. AB - The effect of forskolin on collagen production in osteoblasts was investigated by using clonal osteoblastic MC3T3-E1 cells cultured in a-minimum essential medium containing 0.1% bovine serum albumin. Forskolin increased the adenylate cyclase activity in membranes pelleted from homogenates of the cell line in a dose dependent manner. The drug caused a 13-fold stimulation at 10(-4) M, indicating that the compound directly acts on adenylate cyclase, leading to an increase in the intracellular cAMP content of the cells. Collagen accumulation in the cultures was elevated by one-day treatment with 5 X 10(-5) M forskolin to about twice that in the controls. The stimulation was mainly due to an elevation in collagen synthesis but not to an inhibition of intracellular collagen degradation because forskolin dose-dependently increased collagen synthesis; it also significantly increased the amount of low-molecular-weight hydroxyproline found in the cultures. Cells treated with forskolin produced mainly type I collagen, as found in bone matrix in situ, with only small amounts of other types of collagen. Furthermore, forskolin time-dependently inhibited DNA synthesis in the cells, indicating that the increase in type I collagen synthesis by forskolin was not due to stimulated cell proliferation. These results suggest that cAMP is closely linked to the differentiation of osteoblasts in vitro. PMID- 3667560 TI - Structural analysis of cloned cDNAs for polycyclic hydrocarbon-inducible forms of rabbit liver microsomal cytochrome P-450. AB - Two cDNA clones, pHPah1 and pHPah2, encoding polycyclic hydrocarbon-inducible forms of rabbit liver microsomal cytochrome P-450 were isolated and their nucleotide sequences were determined. The inserts of pHPah1 and pHPah2 contained open reading frames specifying the entire primary structures of cytochrome P 450s, consisting of 518 and 516 amino acid residues, respectively. The deduced amino acid sequences for pHPah1 and pHPah2 are 76 and 73% homologous with rat P 450c and P-450d, respectively, and 96% homologous with rabbit P-450 forms 6 and 4, respectively. We conclude that pHPah1 and pHPah2 encode the rabbit counterparts of rat P-450c and P-450d, respectively. A region highly conserved in all species of cytochrome P-450 so far examined, called the HR2 region, can be detected in the pHPah1 and pHPah2 primary structures, but another conserved region, HR1, cannot be observed. Northern hybridization analysis of total RNAs from livers of untreated and drug-treated rabbits demonstrated that the pHPah1 and pHPah2 genes are expressed in untreated animals, induced considerably by administration of 3-methylcholanthrene or beta-naphthoflavone, and suppressed by phenobarbital and isosafrole. PMID- 3667561 TI - Purification of betaine-aldehyde dehydrogenase from spinach leaves and preparation of its antibody. AB - Betaine-aldehyde dehydrogenase was purified from spinach leaves and characterized. The molecular weight of the enzyme was estimated to be 120 kDa by a gel filtration chromatography. The enzyme was judged to consist of two identical pieces of the monomeric subunit with molecular weight of 60 kDa. A specific polyclonal antibody was raised against the enzyme subunit. PMID- 3667562 TI - Calcium influx in a single rat basophilic leukemia cell as revealed with a digital imaging fluorescence microscope. AB - Using a digital imaging fluorescence microscope, we have detected a rapid transient increase in the free cytosolic calcium concentration in a single rat basophilic leukemia cell (RBL-2H3) after antigen stimulation. Calcium ions were transported very rapidly (within 1 s) after a lag time (about 10 s at 37 degrees C) from the external environment into the cytoplasm. On the basis of the present experimental results we conclude that the gradual changes in the overall fluorescence intensity observed for a cell suspension are due to the distribution of different lag times shown by different cells as to the calcium influx through membrane calcium channels. PMID- 3667563 TI - Purification and characterization of extracellular phospholipase A2 from peritoneal cavity of caseinate-treated rat. AB - Peritoneal exudate produced in rat injected with caseinate contained extracellular phospholipase A2. The activity required Ca2+ ion and had a pH optimum of 9 (Chang, H.W., Kudo, I., Hara, S., Karasawa, K., & Inoue, K. (1986) J. Biochem. 100, 1099-1101). This phospholipase A2 was purified about 14,000-fold to near homogeneity by the sequential use of column chromatography on Sephadex G 75, Toyopearl HW-65, and TSK ODS-120T reverse-phase HPLC. The final preparation showed a single protein band on SDS-polyacrylamide gel electrophoresis, and its molecular weight was estimated to be approximately 13,500. The enzyme hydrolyzed phosphatidylethanolamine (PE) and phosphatidylserine (PS) more effectively than phosphatidylcholine (PC). When 1-acyl-2-[1-14C]inoleoyl-sn-glycero-3 phospholipids were used as a substrate, the apparent Km values were 0.027 mM with PE, 0.032 mM with PS, and 0.1 mM with PC, and the Vmax values were 105 mumol/min/mg with PE, 71 mumol/min/mg with PC. The enzyme activity was inhibited by p-bromophenacyl bromide, dithiothreitol, and mepacrine. The amino acid sequence of the NH2-terminal portion and the amino acid composition of the purified enzyme were determined. They were different from those of rat pancreatic phospholipase A2, but very similar to those of phospholipase A2 secreted from rat platelets. PMID- 3667564 TI - Interactions between the omega- and beta-oxidations of fatty acids. AB - Long-chain monocarboxylic, omega-hydroxymonocarboxylic and dicarboxylic acids were activated approximately at the same rate by rat liver homogenates into their CoA esters (2-3 U/g liver). These acyl-CoA were substrates for rat liver peroxisomal beta-oxidation. The distribution of the peroxisomal oxidation of these substrates was also studied in various tissues. Rat liver mitochondria were capable of oxidizing long-chain monocarboxyl- and omega-hydroxymonocarboxylyl CoAs but not dicarboxylyl-CoAs. When the mitochondrial preparations were incubated in coupling conditions, the addition of either free decanoic acid or free 10-hydroxydecanoic acid resulted in an increase of the oxygen uptake conversely to the addition of decanedioic acid. The comparative study of the chain-length substrate specificity of peroxisomal fatty acyl-CoA oxidase and mitochondrial fatty acyl-CoA dehydrogenase activities revealed that, actually, both types of organelles, peroxisomes and mitochondria, contain "oxido reductases" active on long-chain monocarboxylyl-CoAs, omega-hydroxymonocarboxylyl CoAs and dicarboxylyl-CoAs. PMID- 3667565 TI - Identification of two variants of troponin T in the developing chicken heart using a monoclonal antibody. AB - Troponin T (TNT) expressed in the developing chicken cardiac muscle was examined by immunoblotting combined with two-dimensional electrophoresis (2-D PAGE) and peptide mapping. When the whole lysate of the neonatal heart was examined by 2-D PAGE, two TNT variants were detected on the gel by monoclonal antibody to TNT. Expression of the two variants was developmentally regulated: one isoform (type I) was expressed from embryonic through neonatal stages, and the other (type II) from the late embryonic stage through adulthood during cardiac muscle development. The type-I isoform, but not type-II isoform, was also expressed transiently in chicken skeletal muscle at embryonic stages. As judged from the peptide maps, the two isoforms differed in the N-terminal region but not in the C terminal region. PMID- 3667566 TI - Application of liposomes to generation of monoclonal antibody to glycosphingolipid: production of monoclonal antibody to GgOse4Cer. AB - Liposomes were applied to the immunization with GgOse4Cer and screening for production of monoclonal antibody to GgOse4Cer. Four-week-old and 22-week-old Balb/c mice were immunized with GgOse4Cer and Salmonella minnesota R595 lipopolysaccharides incorporated liposomes which were composed of dipalmitoyl phosphatidylcholine and cholesterol. Since antibody response to GgOse4Cer was higher in 22-week-old than 4-week-old Balb/c mice after immunization, 22-week-old Balb/c mice were used for the immunization prior to generation of the monoclonal antibodies to GgOse4Cer. The screening of monoclonal antibodies was performed by complement-dependent liposome immune lysis assay using GgOse4Cer-containing liposomes. Six kinds of monoclonal antibodies, AG-1, -2, -3, -4, -5, and -6, of the IgM class were established. The specificities of the monoclonal antibodies obtained were defined by complement-dependent liposome immune lysis assay using various glycosphingolipids incorporated in liposomes and by thin-layer chromatography (TLC) with immunostaining. All of the monoclonal antibodies reacted only with GgOse4Cer in the liposome immune lysis assay. In addition, the monoclonal antibodies reacted only with GgOse4Cer in the TLC immunostaining. However, none of the monoclonal antibodies obtained was capable of removing natural killer activity from C3H/He mice spleen cell suspensions in vitro. Liposomes may be useful in the procedures of immunization and screening for generation of antiserum and monoclonal antibody to GSLs. PMID- 3667567 TI - Occurrence of sulfatide as a major glycosphingolipid in WHHL rabbit serum lipoproteins. AB - Glycosphingolipids in serum and lipoproteins from Watanabe hereditable hyperlipidemic rabbit (WHHL rabbit), which is an animal model for human familial hypercholesterolemia (FH), were analyzed for the first time in this study. Chylomicrons and very low density, low density, and high density lipoproteins contained sulfatide as a major glycosphingolipid (12 nmol/mumol total phospholipids (PL) in chylomicrons, 19 nmol/mumol PL in VLDL, 18 nmol/mumol PL in LDL, and 14 nmol/mumol PL in HDL) with other minor glycosphingolipids such as glucosylceramide, galactosylceramide, GM3 ganglioside, lactosylceramide, and globotriaosylceramide. The concentration of sulfatide as a major glycosphingolipid in WHHL rabbit serum (121 nmol/ml) was much higher than that in normal rabbit serum (3 nmol/ml). Fatty acids of the sulfatides comprised mainly nonhydroxy fatty acids (C22, 23, and 24) and significant amounts of hydroxy fatty acids (about 10%) whereas long chain bases of the sulfatides comprised mostly (4E)-sphingenine with a significant amount of 4D-hydroxysphinganine (about 10%). Furthermore, sulfatides in the liver and small intestine from normal and WHHL rabbits (where serum lipoproteins are produced) were determined to amount to 260 nmol/g liver in WHHL rabbit, 104 nmol/g liver in control rabbit, 99.6 nmol/g small intestine in WHHL rabbit, and 31.2 nmol/g small intestine in control rabbit. Ceramide portions of the sulfatides in the liver were mainly composed of (4E)-sphingenine and nonhydroxy fatty acids, while those in the small intestine were mainly composed of 4D-hydroxysphinganine and hydroxy fatty acids. These results indicated that the sulfatides of serum lipoproteins were mostly derived from the liver (90% of the total), and that the remaining sulfatides (10% of the total) might be derived from the small intestine. These two sulfatides, which have different ceramide portions, could be useful markers for metabolic and biosynthetic studies of various lipoproteins in WHHL rabbit, and thus would be helpful to further elucidate the relationship between hypercholesterolemia and atherosclerosis in the rabbit. PMID- 3667568 TI - Fibrinogens Kawaguchi and Osaka: an amino acid substitution of A alpha arginine 16 to cysteine which forms an extra interchain disulfide bridge between the two A alpha chains. AB - Structural analyses of fibrinogens from patients with congenital dysfibrinogenemia, designated as fibrinogens Kawaguchi and Osaka, have been performed to identify the difference responsible for the lack of fibrinopeptide A release. For the structural studies, a new strategy was employed. Amino acid sequence analysis of one of the lysyl endopeptidase-peptides isolated from the abnormal fibrinogens indicated that in both fibrinogens, arginine-16 of the A alpha chain had been replaced by cysteine. To characterize the chemical nature of the sulfhydryl group of cysteine-16, a tryptic peptide containing cysteine-16 of the A alpha chain was prepared from intact fibrinogen Kawaguchi. The amino acid composition and the molecular weight determination of this aberrant peptide revealed that it was a dimeric NH2-terminal peptide corresponding to residues 1 19 derived from the abnormal A alpha chain. These results indicate that the half cystine at position 16 in the abnormal A alpha chain forms an intramolecular disulfide bridge with the same residue in the other abnormal A alpha chain and that fibrinogen Kawaguchi is a homo dimer composed of two identical abnormal halves. PMID- 3667569 TI - Carboxypeptidase digestion in the presence of detergents. AB - The detergents, sodium dodecyl sulfate (SDS), lauryl glutamate (LG), and octyl (polydisperse)oligooxyethylene (Octyl-POE), were tested as to their effects on the activities of carboxypeptidases A, B, and P. In general, Octyl-POE showed little inhibition and SDS showed the strongest inhibition. Carboxypeptidase B was only slightly inhibited by SDS. The inhibitory effect of SDS on these enzyme activities depended not on its concentration but on its absolute amount. For a constant amount of SDS, the activities of carboxypeptidases A and B remained almost constant with increasing reaction volume. Commercial carboxypeptidase B is usually contaminated by carboxypeptidase A. With the addition of SDS, almost only carboxypeptidase B activity was detected. PMID- 3667570 TI - Immunostaining on thin-layer chromatograms of oligosaccharides released from gangliosides by endoglycoceramidase. AB - A method for immobilizing oligosaccharides on a TLC plate for immunostaining has been developed. N-Glycolylneuraminic acid (NeuGc)-containing oligosaccharides derived from II3NeuGc-LacCer, IV3NeuGc-nLcOse4Cer, II3NeuGc-GgOse3Cer, and II3(NeuGc)2-LacCer by digestion with our newly isolated endoglycoceramidase (Ito, M. & Yamagata, T. (1986) J. Biol. Chem. 261, 14278-14282) and sialyllactose were chromatographed on polyamide 11 TLC or NH2-HPTLC plates, and covalently linked to the plates by reductive amination with sodium cyanoborohydride (NaBH3-CN). The immobilized oligosaccharides were detected by enzyme-immunostaining using NeuGc specific chicken anti-NeuGc-LacCer and horseradish peroxidase-conjugated rabbit anti-chicken IgG. II3NeuGc-nLcOse4 showed the highest reactivity with the antibody, followed by II3NeuGc-GgOse3. As little as 0.8 nmol of the NeuGc containing oligosaccharides was detected. The polyamide 11 TLC aluminum plate was found to be more suitable for the immunostaining than the NH2-HPTLC plate under the conditions used. For binding of the oligosaccharides to the NH2-HPTLC plate, reductive amination was found to be superior to the heating method reported earlier. PMID- 3667571 TI - The complete amino acid sequence of rice bran trypsin inhibitor. AB - The complete amino acid sequence of a double-headed trypsin inhibitor (RBTI) from rice bran was determined by a combination of limited proteolysis of the native inhibitor with Streptomyces griseus trypsin at pH 3 and conventional methods. RBTI consists of 133 amino acid residues including 18 half-cystine residues which are involved in 9 disulfide bridges in the molecule. The limited proteolysis at pH 3 produced a major split of Lys(83)-Met(84) and a minor split of Arg(107) Val(108) together with a non-enzymatic hydrolysis of Asp(19)-Pro(20) in the molecule. The established sequence showed that RBTI is composed of 4 domains, domains I and III, and domains II and IV being homologous to the first and the second domains of soybean Bowman-Birk inhibitor, respectively, indicating that RBTI has a duplicated structure of the Bowman-Birk type inhibitor. PMID- 3667572 TI - Urea-induced structural transformations in bovine serum albumin. AB - Urea-induced unfolding of bovine serum albumin and one of its fragments containing domain II + III has been studied by difference spectral and fluorescence emission measurements. The unfolding-refolding curves of both the proteins showed the presence of at least one stable intermediate when the transition was monitored at 288 nm. The presence of the intermediate was not detectable at 293 nm where only tryptophan contributed towards the protein absorption. However, both the proteins did show the presence of intermediate when the denaturation was monitored fluorometrically. Since domain III of the albumin is devoid of tryptophan, it is concluded that the formation of intermediate in the unfolding-refolding transition of serum albumin involves (i) unfolding of domain III, (ii) minor structural transformations in domain II, and/or (iii) the separation of the sub-domains of domain III from each other. PMID- 3667573 TI - Protein-O-carboxylmethyltransferase from cytosol and membranes of chicken erythrocytes. AB - Cytosolic protein-O-carboxylmethyltransferase was purified more than 4,000-fold in specific activity and membrane-associated protein-O-carboxylmethyltransferase carboxymethylase about 900-fold from chicken erythrocytes by use of a combination of affinity chromatography on immobilized S-adenosyl-L-homocysteine and gel filtration on Sephacryl S-200 (Pharmacia), together with 3-((3-cholamidopropyl) dimethylammonio)-1-propane-sulfonate as a detergent to solubilize the membrane associated enzyme. The two enzymes were characterized by examining the dependence of their activity on pH and on concentration of S-adenosyl-L-methionine using fetuin as an exogenous methyl-acceptor substrate, and were found to differ somewhat. The cytosolic enzyme had a pH optimum of 6.0 with an apparent Km value of 2.1 microM for S-adenosyl-L-methionine, whereas corresponding values for the membrane-associated enzyme were 6.5 and 0.71 microM. This report deals with the biochemical differences between purified cytosolic and membrane-associated protein carboxymethylase from the same cell source. PMID- 3667574 TI - In vivo phosphorylation of histones H1 and H5 in calf thymus and chicken erythrocyte as studied by 31P nuclear magnetic resonance spectroscopy. AB - The 31P NMR method was first applied to characterize in vivo phosphorylation of H1 and H5 in calf thymus and chicken erythrocytes as well as in vitro phosphorylation of H1 and H5 by cAMP-dependent protein kinase. The amino acid residues phosphorylated in vivo in the histones were exclusively serine residues, and the mole fraction of phosphoserine was estimated to be 0.34 and 0.27 per molecule of calf thymus H1 and chicken erythrocyte H5, respectively. Interestingly, chicken erythrocyte H1 was not phosphorylated in vivo. Three H1 subtypes from calf thymus H1 varied in the 31P NMR spectra, and the bisected fragments of calf thymus H1 and chicken erythrocyte H5 exhibited characteristic spectral patterns, indicating that there are considerable diversities of the degree of phosphorylation and phosphorylation sites in very-lysine-rich histones. Furthermore, it was found that the microenvironment of phosphoserine residues phosphorylated in vivo in calf thymus H1 and chicken erythrocyte H5 is quite distinct from that of phosphoserine residues phosphorylated in vitro by bovine heart cAMP-dependent protein kinase. PMID- 3667575 TI - Separation of peptides on the basis of the difference in positive charge: simultaneous isolation of C-terminal and blocked N-terminal peptides from tryptic digests. AB - The microscale separation of peptides based on the difference in positive charge was examined with tryptic digests of apomyoglobin and calmodulin. By this separation method, C-terminal and blocked N-terminal peptides could be selectively isolated in the same fraction without any chemical modifications. Separated peptides, including internal peptides, were further purified by reversed phase high performance liquid chromatography, and the purified peptides could be directly subjected to sequence and amino acid analyses. The N-terminal peptides of calcium-activated neutral protease were successfully isolated by this method. PMID- 3667576 TI - Interaction of silkworm larval hemolymph antitrypsin and bovine trypsin. AB - Antitrypsin isolated from silkworm larval hemolymph can inhibit bovine trypsin. The apparent molar ratio of silkworm antitrypsin (sw-AT) to trypsin at extrapolated null trypsin activity was determined to be 1.3 by titration of trypsin with sw-AT. The undissociability of the complex between sw-AT and trypsin on sodium dodecyl sulfate-polyacrylamide gel electrophoresis was confirmed by immunoblotting and fluorescence labeling techniques. Chemical analysis of the complex elucidated that it contained equimolar sw-AT and trypsin. Densitometric analysis of electrophoretic patterns obtained during the titration of trypsin by sw-AT suggested the presence of a suicide product formed from sw-AT. This was the reason why excess sw-AT was needed for complete inhibition of trypsin. In the complex, the sw-AT molecule was cut at one site but the fragments produced were still joined together. Trypsin in the complex was released by treatment at pH 10.0, and it was deduced that the complex formation involved acyl-bond formation between sw-AT and trypsin. The sw-AT component obtained from the alkali-treated complex possessed two kinds of NH2-terminal amino acid sequences. Non-covalent forces may bind the two fragments of sw-AT, which could be separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Amino-terminal amino acid sequence analysis of the large fragment gave a sequence identical with that of intact sw-AT. This indicated that the reactive site of sw-AT with trypsin was located at the COOH-terminal region of the molecule. These characteristics resemble those of inhibitors belonging to the serpin family. PMID- 3667577 TI - Continuing education needs of biomedical communicators. AB - Many authors speak of the need for health care professionals to attend continuing education workshops. This study sought to identify the continuing education topics and program characteristics preferred by alumni of the Biomedical Communications Division in the School of Allied Medical Professions at The Ohio State University (OSU). Results indicate a preference for topics which do not review material constituting the basic biomedical communications curriculum. Although the sample population was small and the author is aware of the problems associated with generalizing from the data, the data were helpful in planning continuing education workshops. PMID- 3667578 TI - Corporate connections. AB - Mutually beneficial connections can be made between academic institutions and industry to meet respective goals and objectives. The University of Texas System Cancer Center cooperated with a major oil company to form such a connection. The link provided the center with funds to produce videotaped cancer detection and prevention modules for employees of the company. This connection and others like it may prove essential to the future well being of biomedical communication units. PMID- 3667579 TI - Active site labeling of the RNA polymerases A, B, and C from yeast. AB - RNA polymerases A, B, and C from yeast were modified by reaction with 4 formylphenyl-gamma-ester of ATP as priming nucleotide followed by reduction with NaBH4. Upon phosphodiester bond formation with [alpha-32P]UTP, only the second largest subunit, A135, B150, or C128, was labeled in a template-dependent reaction. This indicates that these polypeptide chains are functionally homologous. The product covalently bound to B150 subunit was found to consist of a mixture of ApU and a trinucleotide. Enzyme labeling exhibited the characteristic alpha-amanitin sensitivity reported for A and B RNA polymerases. Labeling of both large subunits of enzyme A and B but not of any of the smaller subunits was observed when the reduction step stabilizing the binding of the priming nucleotide was carried out after limited chain elongation. These results illustrate the conservative evolution of the active site of eukaryotic RNA polymerases. PMID- 3667580 TI - A common myosin light chain is expressed in chicken embryonic skeletal, cardiac, and smooth muscles and in brain continuously from embryo to adult. AB - We have isolated cDNA clones of the mRNA for chick embryonic myosin light chain (MLC), L23, by cross-hybridization with chicken skeletal muscle MLC1 cDNA. The identification of the isolated cDNAs was carried out by in vitro translation of hybrid-selected mRNA. Sequence analysis of the cloned cDNAs revealed that the cDNA insert contained 832 nucleotides and predicted a polypeptide of 185 amino acids with a calculated molecular weight of 20,687. The deduced amino acid sequence for L23 showed high sequence similarities to those of adult alkali type MLCs from various tissues, indicating that L23 belongs to the alkali MLC group. Using the cloned cDNA as a hybridization probe, we have revealed by RNA blot analysis that the expression of L23 mRNA was regulated in temporal and tissue specific manners. The L23 mRNA of 1.1 kilobases is transiently expressed in embryonic skeletal, cardiac, and smooth muscles of chickens. It is also found in the brain of chickens during all stages of development so far investigated. Only a single gene for L23 was detected by Southern blot of chick genomic DNA. We therefore suggest that L23 is expressed from a single gene in both embryonic muscles and brain. PMID- 3667581 TI - Reactions of 3'-O-methylpyridoxal 5'-phosphate in aspartate aminotransferase. AB - The reaction of 3'-O-methylpyridoxal 5'-phosphate bound into the active site of aspartate aminotransferase with the substrate L-aspartate has been investigated. This methylated coenzyme is a very poor catalyst but it does function slowly to produce normal products of a transamination half-reaction. At pH 8.5 and above the characteristic absorption band of a quinonoid intermediate appears rapidly and becomes very intense when the aspartate concentration is raised to 2 M. At pH 6 the quinonoid band is not seen, but the conversion of the methylated coenzyme into 3'-O-methylpyridoxamine 5'-phosphate is about 7 times faster than at high pH with the pH dependence being determined by an apparent pKa of 8.1 at 30 degrees C. We suggest that the active site containing the methylated coenzyme carries a net charge 1 unit more positive than that of native enzyme. This causes a loss of some other proton from the active site and could leave the catalytic lysine-258 deprotonated in the quinonoid species. This may explain its inability to react rapidly. We have measured the spectral band shapes of the quinonoid species studied here and have compared it with that seen with native enzyme. Because of the close similarity we conclude that during normal transamination the proton bound to the imine nitrogen probably shifts onto the phenolic oxygen prior to or synchronously with the formation of the observed quinonoid species. PMID- 3667582 TI - Propionate-3-nitronate oxidase from Penicillium atrovenetum is a flavoprotein which initiates the autoxidation of its substrate by O2. AB - On the fifth day following inoculation into an unstirred liquid surface culture, Penicillium atrovenetum abruptly, and reproducibly, secretes large quantities (2 g/liter) of the toxic antibiotic 3-nitropropionate into the medium. Concomitantly and with the same time course, crude extracts of the fungus acquire the ability to catalyze the oxidation of 3-nitropropionate by O2. We purified this activity some 300-fold to homogeneity and find it to be a soluble, dimeric (Mr = 73,000) flavoprotein oxidase having FMN as prosthetic group with lambda max = 363 and 433 nm. The preferred substrates are propionate-3-nitronate (3-NP-2) and O2 while the reaction products are malonate semialdehyde, NO2-, NO3-, O2-., and H2O2. Of 13 nitronates tested only butyrate-4-nitronate is more than 2% as reactive as 3-NP 2. 3-NP-2 (0.1 mM) rapidly reduces E-FMN anaerobically to E-FMNH., the flavin semiquinone (t1/2 less than 5 s), but reduces E-FMNH. to the fully reduced enzyme (E-FMNH2) very slowly (t1/2 approximately 900 s). The steady state turnover number with 0.1 mM 3-NP-2 and infinite O2 is 350 s-1. Therefore, the enzyme must oscillate almost exclusively between E-FMN and E-FMNH. during aerobic turnover. (Formula: see text). The complicated and non-integral reaction stoichiometry provides further support for this free radical mechanism. Each mole of 3-NP-. generated enzymatically initiates the nonenzymatic autoxidation of at least 2.2 mol of 3-NP-2 through a free radical chain reaction. An appropriate name for the newly characterized enzyme is propionate-3-nitronate oxidase. PMID- 3667583 TI - Regulation of sterol biosynthesis and of 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity in cultured cells by progesterone. AB - Treatment of rat intestinal epithelial cells in culture (IEC-6) with progesterone (10 micrograms/ml) caused a strong inhibition of cholesterol biosynthesis as indicated by a decreased incorporation of radiolabel from [3H]acetate. This inhibition was accompanied by an accumulation of radioactivity in an intermediate which coeluted with authentic desmosterol upon high performance liquid chromatography (HPLC). In addition, treatment of cells with progesterone caused lesser accumulation of radiolabel in products with retention times (RT) of 7.9 and 13.5 min on reverse-phase HPLC. The RT-13.5 compound was tentatively identified as cholesta-5,7,24-trien-3 beta-ol based on its relative retention and on its conversion to cholesterol upon incubation with untreated cells. The RT-7.9 compound was identified as 24 (S),25-epoxycholesterol (S-EC) based on its coelution with authentic S-EC and by its conversion to 25-hydroxycholesterol upon reduction with LiAlH4. Incubation of IEC-6 cells with chemically prepared S-EC resulted in dose-dependent suppression of 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity within 6 h (I50 = 0.3 microM). Pretreatment of cells with progesterone prevented this suppressive effect. No suppression of reductase activity was observed in progesterone-treated cells in spite of obvious accumulation of S-EC in amounts sufficient to effect regulation; instead, a 2-3 fold increase in 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity occurred within a 24-h period. Following the removal of progesterone from the culture medium, reductase activity declined rapidly over the next 6 h. However, IEC-6 cells could not metabolize S-EC, derived either endogenously or exogenously, during a similar time frame; nor did progesterone affect the uptake of exogenous S-EC by IEC-6 cells. These results show that although progesterone treatment of cultured cells promotes the synthesis of a natural oxysterol suppressor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, the continued presence of progesterone prevents the regulatory action of S-EC. The unique nature of this interference is high-lighted by the observation that progesterone could not prevent the suppression of reductase activity by either 25 hydroxycholesterol or mevalonolactone. PMID- 3667584 TI - Biosynthesis of chick type VI collagen. II. Processing and secretion in fibroblasts and smooth muscle cells. AB - The biosynthesis of type VI collagen was studied in "matrix-free" chick embryo smooth muscle cells and fibroblasts. Omission of ascorbate from the culture affected to a great extent the secretion in fibroblasts but had a very minor effect on smooth muscle cells. Quantitative analysis of the secretion process in continuous time course and in pulse-chase experiments confirmed that fibroblasts and smooth muscle cells secreted type VI collagen with the same chain composition but with different kinetics: after 4 h of chase more than 60% of the labeled type VI collagen was present in the culture medium of fibroblasts, whereas at the same time interval less than 25% was secreted by smooth muscle cells. The different kinetics depends on intrinsic properties of the cells, since it was detected also in adherent cells. However, even in fibroblasts, secretion of type VI collagen was much slower than secretion of fibronectin, of which more than 50% was already in the cell medium after 1 h of chase. Treatment of the cells with inhibitors of hydroxylation and glycosylation caused a shift in mobility that revealed a size heterogeneity in the Mr = 260,000 subunit. No evidence of processing was observed in chick cells for any of the subunits that were synthesized and secreted uncleaved. In addition, after several days of chase the Mr of the subunits of type VI collagen isolated from the matrix remained unchanged, thus excluding that in the chick even a partial or incomplete processing takes place. PMID- 3667585 TI - Affinity labeling of phosphoglycerate kinase by 5'-[p-(fluorosulfonyl)benzoyl] 1,N6-ethenoadenosine. AB - Yeast phosphoglycerate kinase is irreversibly inactivated upon incubation with 5' [p-(fluorosulfonyl)-benzoyl]-1-N6-ethenoadenosine (5'-FSB epsilon A), an analogue to the nucleotide substrate. Marked protection against inactivation occurs with MgATP, ATP, MgADP, ADP, and 3-phosphoglycerate, suggesting that a part of the catalytic center is modified. The time dependence of the inactivation is characterized by a nonlinear kinetic profile. Curve fitting of various models for ligand binding to the enzyme suggested a two-site model. Modification of one of the sites appears to protect the catalytically essential site from modification. Stoichiometric studies show that the relationship between moles of 5'-FSB epsilon A incorporated per mole of enzyme and the residual enzymatic activity also shows nonlinear behavior. An extrapolated value of 1.5 mol of bound label/mol of enzyme corresponds to complete inactivation. The apparent overall pseudo first-order rate constant for the reaction between phosphoglycerate kinase and 5'-FSB epsilon A, as well as the separate rate constants for the modification, exhibit saturation behavior with respect to the concentration of 5'-FSB epsilon A, indicative of a rapid reversible binding of the reagent to the enzyme prior to modification. PMID- 3667586 TI - Time-resolved fluorescence of apoferritin and its subunits. AB - The decay of the intrinsic fluorescence of the apoferritin polymer and its subunits has been studied by pulse and phase shift techniques. Both techniques show that the fluorescence decay of all the samples tested cannot be described by a single exponential function. The fluorescence decay data of the apoferritin subunits obtained with either technique can be fitted satisfactorily with a function resulting from the sum of two exponential components. However, the polymer data obtained with the high resolution phase shift technique operated either by synchrotron radiation or by a mode-locked argon ion laser can be fitted better using a bimodal gaussian continuous distribution of lifetime components. The molecular basis for this distribution of lifetime values may lie in the heterogeneity of the tryptophan environment generated by the assembly of the subunits into the polymer. The binding of the first 100 irons to apoferritin quenches the intrinsic fluorescence without affecting the lifetimes in a proportional way. This finding may be taken as an indication that the quenching of the tryptophan fluorescence induced by the binding of iron has both static and dynamic components. PMID- 3667587 TI - Hydrolysis of the brain dipeptide N-acetyl-L-aspartyl-L-glutamate. Identification and characterization of a novel N-acetylated alpha-linked acidic dipeptidase activity from rat brain. AB - High performance liquid chromatography studies documented the presence of an enzyme activity, N-acetylated alpha-linked acidic dipeptidase (NAALA dipeptidase), in rat brain membranes that cleaves the endogenous brain dipeptide, N-acetyl-L-aspartyl-L-glutamate to N-acetyl-aspartate and glutamate. With ion exchange chromatography, which quantitatively separated [3,4-3H]glutamate from N acetyl-L-aspartyl-L-[3,4-3H]glutamate, we found that NAALA dipeptidase activity was essentially restricted to nervous tissue and kidney. We characterized NAALA dipeptidase activity in lysed synaptosomal membranes obtained from rat forebrain. Membrane-bound NAALA dipeptidase activity was optimal between pH 6.0 and 7.4 at 37 degrees C. Eadie-Hofstee analysis of kinetic data revealed a rather high apparent affinity for N-acetyl-L-aspartyl-L-glutamate with a Km = 540 nM and a Vmax = 180 nM/mg of protein/min. While NAALA dipeptidase showed a requirement for monovalent anions such as Cl-, the polyvalent anions phosphate and sulfate inhibited enzyme activity 50% at 100 microM and 1 mM, respectively. The divalent metal ion chelators EGTA, EDTA, and o-phenanthroline completely abolished activity, which was partially restored by manganese. Treatment of membranes with 1 mM dithiothreitol abolished NAALA dipeptidase activity. NAALA dipeptidase activity was also sensitive to the aminopeptidase inhibitors bestatin and puromycin, although not to the selective aminopeptidase A inhibitor amastatin. Structure-activity relationships inferred from inhibitor studies suggest that this enzyme shows specificity for N-acetylated alpha-linked acidic dipeptides. NAALA dipeptidase was also potently inhibited by the excitatory amino acid agonist L-quisqualate. Comparison of the properties of NAALA dipeptidase to those of previously characterized enzymes suggests that this is a novel peptidase which may be involved in the synaptic degradation of N-acetyl-L-aspartyl-L-glutamate. PMID- 3667588 TI - Phosphorylation of eukaryotic initiation factor 2 during physiological stresses which affect protein synthesis. AB - Phosphorylation of the alpha subunit of eukaryotic initiation factor 2 (eIF-2) is a major mechanism regulating protein synthesis in rabbit reticulocytes. To determine whether phosphorylation of eIF-2 alpha is a likely regulatory mechanism in the Ehrlich cell, we have measured the percent of cellular eIF-2 alpha which is phosphorylated in cells exposed to heat shock, 2-deoxyglucose, or amino acid deprivation, conditions which rapidly decrease the concentration of 40 S initiation complexes and inhibit protein synthesis. eIF-2 alpha and eIf-2 alpha (P) were separated by isoelectric focusing and were detected by immunoblotting with a monoclonal antibody we developed for this purpose. Under the above three inhibitory conditions, phosphorylation of eIF-2 alpha increased rapidly, and this increase correlated in time with the rapid inhibition of protein synthesis. In heat-shocked cells which were returned to 37 degrees C, both phosphorylation and protein synthesis remained unchanged for 10 min and then returned toward control values slowly and in parallel. The close temporal correspondence between changes in protein synthesis and phosphorylation supports an important regulatory role for phosphorylation in protein synthesis. An increase of 25-35 percentage points, to 50-60% phosphorylation from control levels of 20-30% phosphorylation, correlated with an 80-100% inhibition of protein synthesis. This steep curve of inhibition is consistent with a mechanism in which eIF-2 alpha (P) saturates and inhibits the guanine-nucleotide exchange factor. PMID- 3667589 TI - Potassium depletion selectively inhibits sustained diacylglycerol formation from phosphatidylinositol in angiotensin II-stimulated, cultured vascular smooth muscle cells. AB - Potassium depletion decreases blood pressure in vivo and blunts the pressor response to angiotensin II (ang II) without down-regulating the receptor. In cultured rat aortic smooth muscle cells, the ang II-induced signaling sequence is biphasic with rapid hydrolysis of the polyphosphoinositides producing an early (15 s) diacylglycerol (DG) peak and a transient rise in inositol trisphosphate (IP3) and more delayed phosphatidylinositol (PI) hydrolysis resulting in sustained DG formation (peak at 5 min). Exposure of intact vascular smooth muscle cells to low potassium growth medium for 24 h or acutely potassium-depleting cells with nigericin causes selective, marked inhibition of late DG formation (5 min peak inhibited by 60 +/- 8% and 84 +/- 7%, respectively). The early cell response, namely polyphosphoinositide hydrolysis, inositol bis- and trisphosphate production and the 15-s DG peak, is not affected. Analysis of 125I-ang II-binding data reveals no significant differences in either receptor number or binding affinity (Kd) in potassium-depleted cells. Together with its marked inhibitory effect on sustained ang II-induced DG formation, acute potassium depletion effectively blocks internalization of 125I-ang II: there is no significant internalization of the ligand after 5 min at 37 degrees C versus 64 +/- 7% internalization in control cells. Thus, potassium depletion does not alter ang II binding or initial membrane signaling in rat aortic smooth muscle but blocks ligand internalization and selectively and markedly inhibits the development of direct PI hydrolysis and sustained diacylglycerol formation. These findings suggest a role for ligand-receptor processing in generating the sustained cell response and potentially explain the lower blood pressure and decreased pressor response to ang II seen in hypokalemic states in vivo. Furthermore, the ability of K+ depletion to alter secondary signal generation may provide insight into the mechanisms underlying the K+ dependence of a variety of cell functions. PMID- 3667590 TI - Evidence that forskolin binds to the glucose transporter of human erythrocytes. AB - Binding of [4-3H]cytochalasin B and [12-3H]forskolin to human erythrocyte membranes was measured by a centrifugation method. Glucose-displaceable binding of cytochalasin B was saturable, with KD = 0.11 microM, and maximum binding approximately 550 pmol/mg of protein. Forskolin inhibited the glucose displaceable binding of cytochalasin B in an apparently competitive manner, with K1 = 3 microM. Glucose-displaceable binding of [12-3H]forskolin was also saturable, with KD = 2.6 microM and maximum binding approximately equal to 400 pmol/mg of protein. The following compounds inhibited binding of [12-3H]forskolin and [4-3H]cytochalasin B equivalently, with relative potencies parallel to their reported affinities for the glucose transport system: cytochalasins A and D, dihydrocytochalasin B, L-rhamnose, L-glucose, D-galactose, D-mannose, D-glucose, 2-deoxy-D-glucose, 3-O-methyl-D-glucose, phloretin, and phlorizin. A water soluble derivative of forskolin, 7-hemisuccinyl-7-desacetylforskolin, displaced equivalent amounts of [4-3H]cytochalasin B or [12-3H]forskolin. Rabbit erythrocyte membranes, which are deficient in glucose transporter, did not bind either [4-3H]cytochalasin B or [12-3H]forskolin in a glucose-displaceable manner. These results indicate that forskolin, in concentrations routinely employed for stimulation of adenylate cyclase, binds to the glucose transporter. Endogenous ligands with similar specificities could be important modulators of cellular metabolism. PMID- 3667591 TI - Influence of sequence and distance between two operators on interaction with the lac repressor. AB - The influence of additional operator or pseudooperator sequences on the lactose repressor-operator interaction has been investigated. Results of kinetic and equilibrium binding measurements suggest an important in vivo role for the Z-gene pseudooperator in repressor-operator binding; the formation of a ternary, looped complex is indicated by the influence of secondary operator sites on binding parameters. Although the binding affinity of the Z-gene pseudooperator [Oz] is only approximately 1/30 that observed for the primary operator [O], the binding affinity to DNA containing both Oz and O is significantly higher than either sequence alone or the sum of the two. This synergistic effect is enhanced further by replacing the pseudooperator sequence [Oz] with the primary operator sequence and results in an even stronger ternary complex in plasmids with duplicate primary sites. The distance between the center of the two primary operators affects the formation of a ternary complex in the linear DNA molecules. Decreased dissociation rate constants were observed with spacing of operator-like sequences between 300 and 500 base pairs (bp). Minimal influence of the second operator on repressor binding is observed when the operators are separated by approximately 4000 or approximately 100 bp. The significant influence of distance on kinetic and equilibrium parameters was demonstrated by measurements on plasmid pRW1511 [Oi-O-PL-Oz] cleaved with restriction enzymes either in the polylinker region to place Oi-O and Oz on opposite ends of the linear plasmid or outside this region to maintain the sites within 500 bp. These results are consistent with the formation of operator-repressor-pseudooperator ternary complex to generate a looped DNA structure. PMID- 3667592 TI - Influence of supercoiling and sequence context on operator DNA binding with lac repressor. AB - The dissociation of the repressor-operator complex from a series of negatively supercoiled plasmid DNAs was examined as a function of the sequence context, orientation, and spacing. The plasmids were grouped into four classes, each with common sequence context. The highest dissociation rate constants were observed for the plasmids containing only a single operator (or pseudooperator) sequence, while approximately 10-fold lower rate constants were measured for plasmids with the I gene pseudooperator in conjunction with either the Z gene pseudooperator or the primary operator. Comparison of the behavior of these two classes of plasmids demonstrated the importance of two operator sequences and supported a model of DNA loop formation to stabilize the repressor-operator complex (Whitson, P. A., and Matthews, K. S. (1986) Biochemistry 25, 3845-3852; Whitson, P. A., Olson, J. S., and Matthews, K. S. (1986) Biochemistry 25, 3852-3858; Whitson, P. A., Hsieh, W. T., Wells, R. D., and Matthews, K. S. (1987) J. Biol. Chem. 262, 4943-4946; Kramer, H., Niemoller, M., Amouyal, M., Revet, B., von Wilcken-Bergmann, B., and Muller-Hill, B. (1987) EMBO J. 6, 1481-1491). The third class, with intermediate dissociation rate constants, was comprised of plasmids which contained the primary operator and the higher affinity pseudooperator normally located in the Z gene. Neither the additional presence of the I gene pseudooperator nor the orientation of the primary operator relative to the Z gene pseudooperator significantly affected the dissociation rate constants. The binding characteristics of this group of plasmids demonstrated the essential role of the Z gene pseudooperator in the formation of intramolecular ternary complex and suggested an in vivo function for this pseudooperator. Plasmids containing two primary operator sequences were the class with lowest dissociation rate constants from lac repressor, and minimal effects of salt or spacing on dissociation of this class were observed. These data are consistent with formation of an intramolecular complex with a looped DNA segment stabilized by the combination of increased local concentration of binding sites and torsional stresses on the DNA which favor binding in supercoiled DNA. PMID- 3667593 TI - Structure of the carbohydrate moiety of human interferon-beta secreted by a recombinant Chinese hamster ovary cell line. AB - The carbohydrate structure of the major oligosaccharide of human interferon-beta (IFN-beta) synthesized by a genetically engineered Chinese hamster ovary cell line has been determined. Analysis of the glycopeptidase F-released carbohydrates by sequential exoglycosidase treatment, methylation analysis, and fast atom bombardment-mass spectrometry revealed that 95% of the IFN-beta oligosaccharides had the following structure: (Formula: see text). The remaining 5% of the carbohydrates are probably tri- or higher antennary oligosaccharide chains. The major oligosaccharide of the recombinant IFN-beta is remarkably homogeneous with respect to terminal galactose sialylation. NeuAc, which is alpha 2-3-linked to galactose in the human IFN-beta secreted by Chinese hamster ovary cells, can be re-incorporated with an alpha 2-6 linkage in vitro, into enzymatically desialylated IFN-beta using rat liver Gal beta 1-4GlcNAc alpha 2-6 sialyltransferase. The sugar chain is important for maintaining protein solubility as shown by the fact that IFN-beta protein precipitates after deglycosylation with glycopeptidase F. PMID- 3667594 TI - Identification of a new type of mammalian myosin heavy chain by molecular cloning. Overlap of its mRNA with preprotachykinin B mRNA. AB - In this paper, we report the polypeptide sequence, the mRNA sequence, and gene organization of a new category of mammalian myosin heavy chain, termed myosin I heavy chain-like protein (MIHC), on the basis of sequence analyses of cDNA clones isolated from a bovine intestinal cDNA library and a genomic DNA clone containing the MIHC gene. The MIHC mRNA shares its 3' sequence with the 5' sequence of the preprotachykinin B mRNA encoding the precursor for the neuromedin K neuropeptide. An overlap of these functionally unrelated mRNAs results from overlapping transcription of the same strand of the genomic DNA sequence. The deduced amino acid sequence comprising the amino-terminal two-thirds of the 119-kDa MIHC polypeptide is highly homologous to that portion of conventional myosin heavy chains which forms the globular head domain. The homology is particularly strong in the regions of sequence thought to be involved in forming the nucleotide- and actin-binding sites. By contrast, the deduced sequence comprising the carboxyl terminal one-third of MIHC shows no significant homology to that portion of conventional myosin heavy chains which forms the alpha-helical coiled-coil rod like tail. In this regard, MIHC more closely resembles the monomolecular, non filamentous, low molecular weight myosin I heavy chain from Acanthamoeba castellanii. Furthermore, the size of the MIHC polypeptide, together with its preferential expression in intestinal tissue, leads us to speculate that MIHC and the 110-kDa intestinal brush-border protein (Collins, J. H., and Borysenko, C. W. (1984) J. Biol. Chem. 259, 14128-14135), which binds actin and has myosin-like ATPase activity, are the same or closely related proteins. PMID- 3667595 TI - Phosphorylation and assembly of nicotinic acetylcholine receptor subunits in cultured chick muscle cells. AB - The assembly of the nicotinic acetylcholine receptor (AChR), an oligomeric cell surface protein, was studied in cultured muscle cells. To measure this process, the incorporation of metabolically labeled alpha-subunit into oligomeric AChR was monitored in pulse-chase experiments, either by the shift of this subunit from the unassembled (5 S) to the assembled (9 S) position in sucrose density gradients, or by its coprecipitation with antisera specific for the delta subunit. We have found that AChR assembly is initiated 15-30 min after subunit biosynthesis and is completed within the next 60 min. The alpha-subunit is not overproduced, as all detectable pulse-labeled alpha-subunit can be chased into the oligomeric complex, suggesting that AChR assembly in this system is an efficient process. The rate of AChR assembly is decreased by metabolic inhibitors and by monensin, an ionophore that impairs the Golgi apparatus. We have observed that the gamma- and delta-subunits of AChR are phosphorylated in vivo. The delta subunit is more highly phosphorylated in the unassembled than in the assembled state, indicating that its phosphorylation precedes assembly and that its dephosphorylation is concomitant with AChR assembly. These findings suggest that subunit assembly occurs in the Golgi apparatus and that phosphorylation/dephosphorylation mechanisms play a role in the control of AChR subunit assembly. PMID- 3667596 TI - Evidence for in vitro translesion DNA synthesis past a site-specific aminofluorene adduct. AB - The ability of Escherichia coli DNA polymerase I and T7 DNA polymerase to bypass bulky C-8 guanyl-2-aminofluorene adducts in DNA was studied by in vitro DNA synthesis reactions on a site-specific aminofluorene-modified M13mp9 template. This site-specifically modified DNA was prepared by ligating an oligonucleotide containing a single aminofluorene adduct into a gapped heteroduplex of M13mp9 DNA (Johnson, D. L., Reid, T. M., Lee, M.-S., King, C. M., and Romano, L. J. (1986) Biochemistry 25, 449-456). The resulting covalently closed duplex DNA molecule was then cleaved with a restriction endonuclease, denatured, and annealed to a primer on the 3' side of the adduct to form a template specifically designed to study bypass. In this system, any synthesis that was not blocked by the bulky aminofluorene adduct would proceed to the 5' terminus of the single-stranded template, while synthesis interrupted by the adduct would terminate at or near the adduct location. We have measured DNA synthesis on this template and find that the amount of radiolabeled nucleotide incorporated by either E. coli DNA polymerase I (large fragment) or T7 DNA polymerase was much greater than would be predicted if the aminofluorene adduct were an absolute block to DNA synthesis. Furthermore, the products of similar reactions electrophoresed on polyacrylamide gels showed conclusively that the majority of the DNA synthesized by either the T7 DNA polymerase or E. coli DNA polymerase I bypassed the aminofluorene lesion. Substitution of Mn2+ for Mg2+ as the divalent cation resulted in even higher levels of translesion synthesis. PMID- 3667597 TI - Site-directed mutagenesis of core sequence elements 9R', 9L, 9R, and 2 in self splicing Tetrahymena pre-rRNA. AB - The intron within the Tetrahymena thermophila nuclear large rRNA precursor is the best studied example of group I self-splicing introns. In this paper, we examine the structural and functional roles of four internal sequence elements which are characteristic of group I introns in the RNA-catalyzed processing reactions. Oligonucleotide-directed mutagenesis was used to generate mutations in sequence elements 9R', 9L, 9R and 2 of the Tetrahymena intervening sequence. Self-splicing activities of variant precursor RNAs were characterized by in vitro splicing following transcription with T7 or SP6 RNA polymerase. First, we confirm the proposed base pairing of sequence elements 9R and 9R' by construction and analysis of compensatory mutations. Mutations in elements 9R (G272A C274G) and 9R' (G100C C102U) each disrupt the pairing and eliminate self-splicing activity. A compensatory 9R/9R' mutation (G100C C102U G272A C274G) restores pairing and normal splicing activity. We conclude that 9R X 9R' pairing is a requirement for self-splicing. Second, we show that self-splicing activity is very sensitive to both nucleotide sequence and RNA secondary structure in the pairing segments of elements 9L and 2. Mutations within these regions at positions 266, 268, 307, and 309 can increase as well as decrease activity relative to wild type. Third, a mutation in the highly conserved nonpairing segment of element 9L (U259A A261C) increases KM for GTP from 29 to 120 microM, but does not otherwise affect splicing activity. The primary consequence of this mutation is a decrease in GTP binding energy of approximately 0.9 kcal/mol. Last, we show that a mutation in the highly conserved nonpairing segment of element 2 (A301C A302G G303C) eliminates transesterification activity, but does not affect 3' splice site hydrolysis. PMID- 3667598 TI - DNA polymerase insertion fidelity. Gel assay for site-specific kinetics. AB - A quantitative assay based on gel electrophoresis is described to measure nucleotide insertion kinetics at an arbitrary DNA template site. The assay is used to investigate kinetic mechanisms governing the fidelity of DNA synthesis using highly purified Drosophila DNA polymerase alpha holoenzyme complex and M13 primer-template DNA. Km and Vmax values are reported for correct insertion of A and misinsertion of G, C, and T opposite a single template T site. The misinsertion frequencies are 2 X 10(-4) for G-T and 5 X 10(-5) for both C-T and T T relative to normal A-T base pairs. The dissociation constant of the polymerase DNA-dNTP complex, as measured by Km, plays a dominant role in determining the rates of forming right and wrong base pairs. Compared with Km for insertion of A opposite T (3.7 +/- 0.7 microM), the Km value is 1100-fold greater for misinsertion of G opposite T (4.2 +/- 0.4 mM), and 2600-fold greater for misinsertion of either C or T opposite T (9.8 +/- 4.2 mM). These Km differences indicate that in the enzyme binding site the stability of A-T base pairs is 4.3 kcal/mol greater than G-T pairs and 4.9 kcal/mol greater than C-T or T-T pairs. In contrast to the large differences in Km, differences in Vmax are relatively small. There is only a 4-fold reduction in Vmax for insertion of G opposite T and an 8-fold reduction for C or T opposite T, compared with the correct insertion of A. For the specific template T site investigated, the nucleotide insertion fidelity for Drosophila polymerase alpha seems to be governed primarily by a Km discrimination mechanism. PMID- 3667599 TI - A point mutation in a type I procollagen gene converts glycine 748 of the alpha 1 chain to cysteine and destabilizes the triple helix in a lethal variant of osteogenesis imperfecta. AB - Synthesis of type I procollagen was examined in fibroblasts from a proband with a lethal perinatal variant of osteogenesis imperfecta. After trypsin digestion of the type I procollagen, a portion of the alpha 1 (I) chains was recovered as disulfide-linked dimers. Digestion of the protein with vertebrate collagenase and mapping of cyanogen bromide peptides suggested that a new cysteine residue was present between residues 551 and 775 of the alpha 1 (I) chain. Sequencing of cloned cDNAs prepared using mRNA from the proband's fibroblasts demonstrated that some of the clones contained a single base mutation that converted the glycine codon in amino acid position 748 of the alpha 1 (I) chain to a cysteine codon. About 80% of the type I procollagen synthesized by the proband's fibroblasts had a decreased thermal stability. The results, therefore, were consistent with the conclusion that normal pro-alpha 1 (I) chains and pro-alpha 1 (I) chains containing a cysteine residue in the alpha chain domain were synthesized in about equal amounts and incorporated randomly into type I procollagen. However, only about 10% of the alpha 1 (I) chains generated by trypsin digestion were disulfide linked. Further studies demonstrated a decreased rate of secretion of type I procollagen containing the new cysteine residue and decreased processing of the protein by procollagen N-proteinase in cultures of postconfluent fibroblasts. Both parents were phenotypically normal and their fibroblasts synthesized only normal type I procollagen. Therefore, the mutation in the proband was a sporadic one and is very likely to have caused the connective tissue fragility that produced the lethal phenotype. PMID- 3667600 TI - Biosynthesis and turnover of a Mr = 110,000 glycoprotein localized to the hepatocyte bile canaliculus. AB - Antiserum was raised in rabbits against a bile canalicular glycoprotein of Mr = 110,000 purified to homogeneity from of rat liver. The antisera specifically immunoprecipitated a Mr = 110,000 polypeptide from hepatocytes metabolically labeled with [35S]methionine. When hepatocytes in primary culture were incubated with tunicamycin before labeling with [35S]methionine in the presence of tunicamycin, the major polypeptide immunoprecipitated by the specific antiserum from Triton X-100 extracts of cells had a molecular weight of 59,000. Enzymatic removal of N-linked carbohydrates from the Mr = 110,000 glycoprotein by N glycanase digestion also yielded a polypeptide with minimum Mr = 59,000. In pulse chase experiments using [35S]methionine, the Mr = 110,000 protein detected by the specific antisera first appears as Mr = 85,000 and 75,000 intermediate species which are endoglycosidase H sensitive. The Mr = 85,000 intermediate form is lost first with time followed by the Mr = 75,000 form giving rise to the Mr = 110,000 form that is endoglycosidase H resistant. Neuraminidase digestion of the Mr = 110,000 form generated an Mr 85,000 form but with a different carbohydrate structure than the intermediate Mr 85,000 form detected in the pulse-chase experiments. The time required to accomplish the processing of the Mr = 85,000 and 75,000 forms is relatively slow. Finally, the terminal sugars are added and the mature Mr = 110,000 glycoprotein is rapidly transported to the cell surface. A minimum time of 90 min is required for the Mr = 110,000 bile canalicular glycoprotein to be synthesized, processed, and reach the cell surface which is long relative to the time required (10 min) for another domain-specific protein, the receptor for asialoglycoproteins, to reach the sinusoidal surface. The Mr = 110,000 bile canalicular glycoprotein turns over in the bile canalicular domain with a half-life of 43 h while the asialoglycoprotein receptor turns over in the sinusoidal domain with a half-life of 23 h. PMID- 3667601 TI - Expression and characterization of human antithrombin III synthesized in mammalian cells. AB - Antithrombin III (ATIII) has been expressed in transiently transfected COS-1 monkey cells and in stably transformed Chinese hamster ovary cells, and the resultant protein has been characterized for biological activity. Both cell types efficiently secrete high levels of heterogeneous molecular weight forms of ATIII antigen. The heterogeneity results from differences in post-translational modifications. However, only a small percentage (5-10%) of the total antigen expressed is biologically active. The fraction of biologically active ATIII has been purified from total ATIII by affinity fractionation on heparin-Sepharose. This fractionation indicates that the differences in the active and inactive forms of expressed ATIII result from differences in their ability to bind heparin. Purified ATIII has a specific activity very similar to that of plasma derived ATIII and exhibits typical heparin-accelerated ATIII activity. The biologically active fraction of ATIII appears to represent the higher molecular weight forms of the ATIII expressed and is likely not a result of altered asparagine-linked glycosylation; however, the nature of the post-translational modification required for ATIII activity remains unclear. The ability to express biologically active ATIII at such high levels should allow further investigations of the structural requirements for ATIII activity. PMID- 3667602 TI - Ascorbic acid inhibits lysosomal autophagy of ferritin. AB - Ascorbic acid retards ferritin degradation in K562 erythroleukemia cells leading to an increase in the availability of cellular iron (Bridges, K. R., and Hoffman, K. E. (1986) J. Biol. Chem. 261, 14273-14277). To explore the mechanism of this effect, the influence of ascorbate on subcellular ferritin distribution was examined. Cellular ferritin was pulse-labeled with 59Fe for 2 h, after which the cells were hypotonically lysed and fractionated on an 8% Percoll density gradient. Immediately after the labeling, all of the ferritin was in the cytoplasmic fractions at the top of the gradient. When the labeling was followed by a 24-h period of growth, a portion of the ferritin shifted to the lysosome associated fractions at the bottom of the gradient, consistent with lysosomal autophagy of cytoplasmic ferritin. When ascorbate was added to the culture medium during the 24-h incubation, the magnitude of the shift was reduced. This process was also examined by size-fractionation of the contents of labeled cells using a Sepharose CL-6B column. Immediately after labeling, ferritin emerged from the column in two peaks, indicating the existence of both ferritin monomer and aggregates within the cytoplasm. After a 24-h period of growth, the monomer peak disappeared, while a new ferritin peak coincident with lysosomes emerged again, indicative of lysosomal autophagy of ferritin. In cells cultured with ascorbate for 24-h, there was a marked attenuation of the shift of ferritin to the lysosomal fractions. The monomer peak disappeared, as in the controls, but there was instead, an accumulation of ferritin as cytoplasmic aggregates. The total ferritin content of the ascorbate-treated cells was increased by 4-fold over that of the control. These experiments indicate that ascorbate blocks the degradation of cytoplasmic ferritin by reducing lysosomal autophagy of the protein. The access to the cell of the potentially toxic iron stored within the ferritin molecule is thereby increased. PMID- 3667603 TI - The intracellular fate of vitellogenin in Xenopus oocytes is determined by its extracellular concentration during endocytosis. AB - We have investigated the effects of ligand concentration on the intracellular behavior of the yolk protein precursor vitellogenin in Xenopus oocytes. After internalization by receptor-mediated endocytosis, vitellogenin is delivered to a final storage compartment in mature, high density (1.23 g/ml sucrose) yolk platelets by a biphasic transport pathway. The first phase consists of a relatively rapid increase in the density of ligand-containing organelles to 1.21 g/ml, a region of the sucrose gradient containing a subpopulation of light yolk platelets and lysosomal enzyme activity. The second and rate-limiting phase in vitellogenin transport is the appearance of ligand in mature yolk platelets. The first phase of transport is accompanied by cleavage of vitellogenin into the mature yolk proteins. The majority of the light yolk platelets are not converted into heavy platelets when vitellogenin is absent from the medium for 24 h, indicating that they are a relatively stable organelle which does not mature into heavy platelets during this time period. The progress of vitellogenin through both phases of transport exhibits a concentration dependence, with much slower rates of density increase and lack of appearance in heavy yolk platelets at subsaturating ligand levels. The majority of vitellogenin entering oocytes at low ligand concentrations remains for at least 60 min in a low density endocytic compartment which is accessible to a second pulse of ligand. Vitellogenin colloidal gold tracer studies indicate that this low density compartment is composed primarily of multivesicular bodies. Low concentrations of vitellogenin residing in this compartment for 4 h are no longer accessible to newly internalized ligand, suggesting that movement into an organelle incapable of fusing with endosomes has occurred. PMID- 3667604 TI - Molecular mechanisms of the synergistic induction of ornithine decarboxylase by asparagine and glucagon in primary cultured hepatocytes. AB - In primary cultures of adult rat hepatocytes maintained in a salts/glucose medium, a more than 100-fold increase in ornithine decarboxylase (EC 4.1.1.17) activity was caused by asparagine and glucagon in a synergistic manner. The synthesis rate of ornithine decarboxylase was determined by [35S]methionine incorporation into the enzyme protein, and the amount of ornithine decarboxylase mRNA was measured by hybridization with a cloned rat liver ornithine decarboxylase-cDNA. The synthesis rate of ornithine decarboxylase was stimulated more than 20-fold by asparagine and glucagon together, but the amount of ornithine decarboxylase-mRNA was increased only 3-4-fold, indicating that translational stimulation was involved in the induction process. Asparagine alone stimulated the synthesis of ornithine decarboxylase without substantial effect on the amount of ornithine decarboxylase-mRNA, whereas glucagon alone increased the amount of ornithine decarboxylase-mRNA about 3-fold without a detectable change in either enzyme activity or enzyme synthesis. Asparagine, at least in part, also suppressed degradation of ornithine decarboxylase. PMID- 3667605 TI - Alterations in lipid-linked oligosaccharide metabolism in human melanoma cells concomitant with induction of stress proteins. AB - Challenge of human A375 melanoma cells with sodium arsenite induced the synthesis of stress proteins and stimulated [3H]mannose incorporation into a novel component migrating on sodium dodecyl sulfate-polyacrylamide gel electrophoresis with an apparent molecular mass of 14 kDa (designated M14). Enhanced M14 expression was elicited by heavy metals (zinc, copper, cadmium, and nickel), thiol-reactive agents (iodoacetamide and auranofin), and hyperthermia. The kinetics of M14 induction and recovery from stress were similar to those of the stress proteins, but M14 half-life was only 15 min. Incorporation of [3H]mannose into M14 was inhibited by tunicamycin but not by cycloheximide or actinomycin D. M14 was metabolically labeled with [32P]orthophosphate but not by [35S] methionine or [3H]asparagine. Further studies revealed that M14 was selectively soluble in chloroform/methanol/water (10:10:3) and sensitive to both endo-beta-N acetylglucosaminidase H digestion and mild acid hydrolysis. The latter released a water-soluble mannose-labeled moiety which eluted from Bio-Gel P-6 in a manner similar to Glc3Man9GlcNAc2. Together, these data suggest that M14 is a lipid oligosaccharide intermediate of N-linked protein glycosylation and that enhanced expression of this class of molecule in response to chemical insults and hyperthermia is a newly described cellular reaction to stress. PMID- 3667606 TI - Both near ultraviolet radiation and the oxidizing agent hydrogen peroxide induce a 32-kDa stress protein in normal human skin fibroblasts. AB - We have analyzed the pattern of protein synthesis in solar near ultraviolet (334 nm, 365 nm) and near visible (405 nm) irradiated normal human skin fibroblasts. Two hours after irradiation we find that one major stress protein of approximately 32 kDa is induced in irradiated cells. This protein is not induced by ultraviolet radiation at wavelengths shorter than 334 nm and is not inducible by heat shock treatment of these cells. Although sodium arsenite, diamide, and menadione all induced a 32-kDa protein, they also induced the major heat shock proteins. In contrast, the oxidizing agent, hydrogen peroxide, induced the low molecular weight stress protein without causing induction of the major heat shock proteins. A comparison of the 32-kDa proteins induced by sodium arsenite, H2O2, and solar near ultraviolet radiation using chemical peptide mapping shows that they are closely related. These results imply that the pathways for induction of the heat shock response and the 32-kDa protein are not identical and suggest that, at least in the case of radiation and treatment with H2O2, the 32-kDa protein might be induced in response to cellular oxidative stress. This conclusion is supported by the observation that depletion of endogenous cellular glutathione prior to solar near ultraviolet irradiation lowers the fluence threshold for induction of the 32-kDa stress protein. PMID- 3667607 TI - The site-specific cleavage of synthetic Holliday junction analogs and related branched DNA structures by bacteriophage T7 endonuclease I. AB - Various branched DNA structures were created from synthetic, partly complementary oligonucleotides combined under annealing conditions. Appropriate mixtures of oligonucleotides generated three specific branched duplex DNA molecules: (i) a Holliday junction analog having a fixed (immobile) crossover bounded by four duplex DNA branches, (ii) a similar Holliday junction analog which is capable of limited branch migration and, (iii) a Y-junction, with three duplex branches and fixed branch point. Each of these novel structures was specifically cleaved by bacteriophage T7 gene 3 product, endonuclease I. The cleavage reaction "resolved" the two Holliday structure analogs into pairs of duplex DNA products half the size of the original molecules. The point of cleavage in the fixed-junction molecules was predominantly one nucleotide removed to the 5' side of the expected crossover position. Multiple cleavage positions were mapped on the Holliday junction with the mobile, or variable, branch point, to sites consistent with the unrestricted movement of the phosphodiester crossover within the region of limited dyad symmetry which characterizes this molecule. Based on the cleavage pattern observed with this latter substrate, the enzyme displayed a modest degree of sequence specificity, preferring a pyrimidine on the 3' side of the cleavage site. Branched molecules that were partial duplexes (lower order complexes which possessed single-stranded as well as duplex DNA branches) were also substrates for the enzyme. In these molecules, the cleaved phosphodiester bonds were in duplex regions only and predominantly one nucleotide to the 5' side of the branch point. The phosphodiester positions 5' of the branch point in single-stranded arms were not cleaved. Under identical reaction conditions, individually treated oligonucleotides were completely refractory. Thus, cleavage by T7 endonuclease I displays great structural specificity with an efficiency that can vary slightly according to the DNA sequence. PMID- 3667608 TI - Endogenous polymers of ADP-ribose are associated with the nuclear matrix. AB - The metabolism of nuclear polymers of ADP-ribose has been implicated in several chromatin-associated processes. However, the distribution of endogenous ADP ribose polymers in the nucleus or within different fractions of chromatin has not been studied. Using a procedure which allowed the radiolabeling and detection of endogenous polymers of ADP-ribose, we have analyzed the nuclear distribution of these polymers in untreated cells and in cells subjected to hyperthermia, N methyl-N'-nitro-N-nitrosoguanidine, or both. When isolated nuclei from cells subjected to any of these conditions were digested with micrococcal nuclease such that 80% of the DNA was released, 90% of the total poly(ADP-ribose) remained with the micrococcal nuclease resistant chromatin fraction. When nuclear matrix fractions were prepared by exhaustive DNase I digestion in combination with three different salt extraction procedures (2 M NaCl, 300 mM (NH4)2SO4 or 25 mM lithium diiodosalicylate), the matrices contained less than 1% of the total nuclear DNA but 50 to 70% of the total poly(ADP-ribose). These data suggest that the nuclear matrix may be a major site of poly(ADP-ribose) metabolism. PMID- 3667609 TI - Pertussis toxin can activate human platelets. Comparative effects of holotoxin and its ADP-ribosylating S1 subunit. AB - The activation of phospholipase C in human platelets is coupled to agonist receptors via guanine nucleotide-binding protein(s), and prior treatment of permeabilized platelets with GTP gamma S, GDP beta S, or pertussis toxin modifies platelet responses to agonists. Pertussis toxin is thought to act primarily as an uncoupler of Gi from cell receptors due to its ADP-ribosylating activity. However, we have found that pertussis toxin by itself can act as an agonist for intact or permeabilized platelets. Though believed to lack receptors for pertussis toxin, intact platelets, when incubated with the toxin (5-20 micrograms/ml), undergo aggregation and accumulate inositol trisphosphate and phosphatidic acid. Treatment of platelets with aspirin, incubation in the presence of creatine phosphate/creatine phosphokinase, or omission of Ca2+ and fibrinogen do not affect toxin-mediated phospholipase C activation. These effects are not observed with the ADP-ribosylating S1 monomer of toxin in intact or permeabilized platelets. Further, modification of the holotoxin with N ethylmaleimide eliminates the toxin's ADP-ribosylating activity but does not affect its promotion of platelet aggregation and phospholipase C activation. Therefore, the activating effect of holotoxin is separable from its ADP ribosylating activity and does not depend either upon cyclooxygenase or the ADP that may be released during platelet activation. Given the combined potentially stimulatory and inhibitory effects of pertussis holotoxin, we suggest caution in interpretation of results with this material. PMID- 3667610 TI - Phospholipid metabolism in cancer cells monitored by 31P NMR spectroscopy. AB - Addition of choline, ethanolamine, or hemicholinium-3 (a choline kinase inhibitor) to the perfusate of human breast cancer cells monitored by 31P NMR spectroscopy resulted in significant changes to phosphomonoester (PME) and phosphodiester (PDE) signals. These results enable us to assign the PMEs to phosphcholine (PC) and phosphoethanolamine (PE), the PDEs to glycerophosphorylcholine and glycerophosphorylethanolamine, and to define the pathways producing them. The PMEs are products of choline and ethanolamine kinases, the first steps in phospholipid synthesis; and the PDEs are substrates of glycerophosphorylcholine phosphodiesterase, the last step in phospholipid catabolism. Furthermore, PC and PE peaks are twice as intense in cells at log phase versus confluency. We also observed these signals in vivo in human colon and breast tumors grown in mice. Since PMEs are low in most nonproliferating tissues, they could form a basis for noninvasive diagnosis. Also, PE and PC are situated between the control enzymes of two major synthetic pathways and will allow noninvasive 31P NMR studies of these pathways in intact cells and in vivo. PMID- 3667611 TI - A novel mannose containing phenolic glycolipid from Mycobacterium kansasii. AB - Using high-performance liquid chromatography, a new kind of phenolic glycolipid quantitatively minor, called phenolic glycolipid-II, was isolated from a lipidic fraction of Mycobacterium kansasii. The structure was determined by fast atom bombardment-mass spectrometry and proton nuclear magnetic resonance spectroscopy, as: 2,4-di-O-Me-alpha-D-Manp(1----3) 4-O-Ac-2-O-Me-alpha-L-Fucp(1----3)2-O-Me- alpha-L-Rhap(1----3) 2,4-di-O-Me-alpha-L-Rhap 1----phenolphthiocerol dimycocerosate. Phenolic glycolipids I and II differ only by their distal monosaccharide hapten which is 2,6-dideoxy-4-O-Me-alpha-D-arabinohexopyranosyl and the 2,4-di-O-Me-alpha-D-mannopyranosyl, respectively. This sugar appears to be characteristic and apparently unique in the Mycobacterium genus. Moreover, phenolic glycolipids I and II constitute with the lipooligosaccharides two classes of antigens of M. kansasii. PMID- 3667612 TI - Ligand binding channels reflected in the resonance Raman spectra of cryogenically trapped species of myoglobin. AB - Variations in the v2 region of the Raman spectra of cryogenically trapped photoproducts of different liganded myoglobins as a function of ligand (CO, O2, and n-butyl isocyanide) and species (whale, tuna, elephant) are reported. These variations are attributed to differences in the population of "open" (ligand accessible) and "closed" (ligand inaccessible) conformations of the distal heme pocket. Based on these findings and those derived from other spectroscopies including x-ray crystallography, NMR, IR spectra, and ESR, a working model is presented which accounts for how the conformation of the distal heme pocket, the geometry of the bound ligand, the identity of the ligand, and the dynamics of the dissociated ligand are all interconnected. PMID- 3667613 TI - A 25-kDa NH2-terminal fragment carries all the antibacterial activities of the human neutrophil 60-kDa bactericidal/permeability-increasing protein. AB - We have isolated, after limited proteolysis of the bactericidal/permeability increasing protein (BPI) of human neutrophils, a 25-kDa fragment that possesses the bactericidal and envelope-altering activities of the 60-kDa parent protein. On a molar basis, the fragment is as potent as holo-human BPI against rough Escherichia coli, is more potent than holo-BPI against more resistant smooth E. coli, and retains the specificity of BPI toward Gram-negative bacteria. NH2 terminal amino acid sequence analysis shows that the fragment is derived from the NH2 terminus of the BPI molecule. These findings suggest that all of the molecular determinants of the antibacterial properties of BPI reside within the NH2-terminal 25-kDa segment, implying a novel structural/functional organization for a cytotoxic protein. PMID- 3667614 TI - Effect of propeptide mutations on post-translational processing of factor IX. Evidence that beta-hydroxylation and gamma-carboxylation are independent events. AB - Post-translational processing of Factor IX includes glycosylation, cleavage of the signal peptide and propeptide, vitamin K-dependent carboxylation of specific glutamic acid residues to form gamma-carboxyglutamic acid, and beta-hydroxylation of aspartic acid at residue 64 to form beta-hydroxyaspartic acid. The human Factor IX cDNA coding sequence was modified in the propeptide region (residue -18 to -1) using oligonucleotide-directed site-specific mutagenesis, and the altered Factor IX cDNA was expressed in Chinese hamster ovary cells. The effects of the mutations on proteolytic processing, gamma-carboxylation, and beta-hydroxylation were assessed by direct structural analysis. After purification, the molecular weight of each of the recombinant Factor IX species and its NH2-terminal amino acid sequence were shown to be identical to those of plasma Factor IX. gamma Carboxyglutamic acid and beta-hydroxyaspartic acid analyses revealed that recombinant wild-type Factor IX contained 9.2 gamma-carboxyglutamic acid and 0.3 beta-hydroxyaspartic acid residues/molecule compared with 11.4 gamma carboxyglutamic acid and 0.39 beta-hydroxyaspartic acid residues in plasma Factor IX. When the 18-residue propeptide was deleted or when the cells were grown in the presence of sodium warfarin, secreted Factor IX contained no detectable gamma carboxyglutamic acid but 0.36 and 0.40 residues of beta-hydroxyaspartic acid, respectively. Point mutations leading to substitution of alanine for phenylalanine at residue -16 or glutamic acid for alanine at residue -10 contained 0.2 and 1.7 gamma-carboxyglutamic acid residues, respectively, and 0.2 residues of beta-hydroxyaspartic acid. These data confirm that the propeptide mutations made do not interfere with proteolytic processing and that the Factor IX propeptide contains a recognition site that designates the adjacent glutamic acid-rich domain for gamma-carboxylation. In contrast, beta-hydroxylation of aspartic acid 64 is an independent process which does not require vitamin K and is mediated through a hydroxylation recognition site in the mature Factor IX, not in the propeptide. PMID- 3667615 TI - Stopped-flow studies of spectral changes in human serum albumin following an alkaline pH jump. AB - A stopped-flow technique was used to study the spectral changes occurring in albumin following a pH jump from 11.3 to 11.8 at 25 degrees C. Ultraviolet difference spectra between various albumin species participating in the process are reported. These spectra are similar in shape to the difference spectrum between the phenolate and phenolic form of tyrosine. At pH 11.3 one-third of the 18 tyrosine residues in albumin are deprotonated. At pH 11.8 two-thirds are deprotonated. The total reaction was analyzed as a multistep unimolecular consecutive process completed in four or more steps. Estimates were made of the number of tyrosine residues involved in the individual transitions. The first transition occurs with a rate constant greater than 300 s-1, in which 4.3 tyrosine residues deprotonate. The second transition occurs with a rate constant of 56.6 +/- 5.9 s-1, deprotonating 1.5 tyrosine residues. During the third (3.4 +/- 2.8 s-1) and following transitions (less than 0.3 s-1), which could not be reproducibly separated, 0.7 tyrosine residues deprotonate. The rates of deprotonation are inconsistent with simple diffusional dissociation of protons from the tyrosine residues and reflect exposure of tyrosines through conformational changes of albumin or dissociations of stably hydrogen-bonded tyrosines. PMID- 3667616 TI - Stopped-flow studies of spectral changes in bilirubin-human serum albumin following an alkaline pH jump and following binding of bilirubin. AB - A stopped-flow technique was used to study the spectral changes occurring in bilirubin-albumin following a pH jump as well as following binding of bilirubin at 25 degrees C. The changes were studied in two wavelength ranges, 280-310 nm (tyrosine residues) and 400-510 nm (bound bilirubin). The changes were analyzed according to a scheme of consecutive unimolecular reactions. Spectral monitoring of a pH jump from 11.3 to 11.8 reveals that the bilirubin-albumin complex changes its structure in several steps. The UV absorption spectra show that 3.8 tyrosine residues ionize in the first step, 2.5 in the second, none in the third, and 0.8 in the fourth and following steps. The visible absorption spectrum of bound bilirubin changes in the second, third, and fourth steps. The bilirubin spectra of the different bilirubin-albumin complexes occurring in the transition show a common isosbestic point at 445 nm, indicating a change of the dihedral angle between the two bilirubin chromophores in a three-step reaction. It is suggested that 1 tyrosine residue is located close to the bilirubin site and is externalized in the second step. Bilirubin binding to albumin was monitored at two pH values, 11.3 and 11.8. At pH 11.3 the complex changes its structure in a three-step relaxation sequence. A change of the dihedral angle between the bilirubin chromophores can explain the spectral changes observed in the second and third relaxations. Protonation of 0.7 tyrosine residues occurs in the third relaxation, suggesting internalization of a tyrosine residue as a late consequence of bilirubin binding. At pH 11.8 a two-step relaxation sequence follows bilirubin binding. No tyrosine protonation occurs. Bilirubin is probably bound more superficially at pH 11.8 than at pH 11.3. PMID- 3667617 TI - Structure and catalytic mechanism of horseradish peroxidase. Regiospecific meso alkylation of the prosthetic heme group by alkylhydrazines. AB - Horseradish peroxidase is inactivated in a time-, H2O2-, and concentration dependent manner by phenylethyl-, ethyl-, and methylhydrazine. The pseudo- first order kinetic constants for these inactivation reactions at pH 7 are: phenylethyl (KI = 115 microM, kinact = 1.5 min-1, partition ratio = 11), ethyl (KI = 145 microM, kinact = 0.08 min-1, partition ratio = 32), and methyl (KI = 3000 microM, kinact = 0.12 min-1, partition ratio = 80). At pH 5, the constants for the phenylethyl reaction change to KI = 1540 microM and kinact = 0.86 min-1. A transient absorbance at approximately 830 nm, suggestive of an isoporphyrin intermediate, is seen during these reactions. The prosthetic heme is converted by each of the three alkylhydrazines into the corresponding delta-meso-alkylated heme. Complete inactivation of the enzymes by methyl-, ethyl-, and phenylethylhydrazine is associated with alkylation of 60-70, 70, and 90%, respectively, of the prosthetic heme groups. The absence of N-alkylation and the high specificity for the delta-meso position, even with agents as small as methylhydrazine, strengthen the proposal that electron abstraction is mediated by the heme edge rather than the ferryl oxygen of horseradish peroxidase. PMID- 3667618 TI - Antiparallel alignment of the two protomers of the regulatory subunit dimer of cAMP-dependent protein kinase I. AB - The purified type I regulatory subunit of cAMP-dependent protein kinase is a dimeric protein, and the two protomers of the dimer are linked by two interchain disulfide bonds. The disulfide linkages that join these two polypeptide chains have been identified in order to provide a structural basis for the orientation of the two chains in the asymmetric dimer. Disulfide bonds were found to exist exclusively between Cys-16 and Cys-37, and this assignment, thus, establishes a general antiparallel alignment of the two chains. Two other homologous proteins, the type II regulatory subunit and the cGMP-dependent protein kinase also are dimeric proteins. In all three proteins, a relatively small, nonhomologous, amino terminal segment of the polypeptide chain is essential for maintaining the dimeric aggregation state. PMID- 3667619 TI - Respiratory enzymes of Thiobacillus ferrooxidans. A kinetic study of electron transfer between iron and rusticyanin in sulfate media. AB - Thiobacillus ferrooxidans is a chemolithotrophic bacterium capable of fulfilling all of its energy requirements from the oxidation of soluble ferrous sulfate. Rusticyanin is a soluble blue copper protein found in abundance in the periplasmic space of this bacterium. The one-electron transfer reaction between soluble iron and purified rusticyanin has been studied by stopped flow spectrophotometry in acidic solutions containing sulfate. Second order rate constants for the reduction of rusticyanin by Fe2+, FeHSO4+, and FeSO4(0) were 0.022, 0.73, and 2.30 M-1 s-1, respectively. The pseudo-first order rate constant for the reduction of rusticyanin exhibited substrate saturation when the concentration of the total ferrous ion was varied in solutions of limiting sulfate. This saturation behavior was quantitatively described using the values of the second order rate constants listed above and the distribution of the total ferrous ion into its water-, bisulfate-, and sulfate-coordinated forms. Second order rate constants for the oxidation of rusticyanin by Fe3+ and FeSO4+ were 0.73 and 0.26 M-1 s-1, respectively. The electron transfer reactions between iron and rusticyanin monitored in vitro were far too slow to support the hypothesis that rusticyanin is the primary oxidant of ferrous ions in the iron-dependent respiratory electron transport chain of T. ferrooxidans. PMID- 3667620 TI - Abortive initiation by RNA polymerase II in vitro at the adenovirus 2 major late promoter. AB - We have investigated the formation of the first phosphodiester bond by RNA polymerase II in vitro. The template was a cloned DNA bearing the adenovirus 2 major late promoter; transcription factors and RNA polymerase II were provided by a HeLa cell nuclear extract. Dinucleotide primers and single nucleoside triphosphates were used as substrates. We found that accurate initiation does occur when only one phosphodiester bond can be formed; however, all of the resulting dinucleotide-primed trimers are abortively initiated. Synthesis of the trimers by RNA polymerase II requires ATP or dATP and is sensitive to low concentrations of alpha-amanitin. Treatments which abolish the ability of the preinitiation complex to synthesize long RNAs also eliminate the ability to abortively initiate. Abortive initiation proceeds for at least one-half h at 25 degrees C, at which point up to 4 mol of transcript/mol of template have been synthesized. The level of abortive initiation (per template molecule) is not significantly reduced by 0.025% Sarkosyl or by 10-fold dilution of the reaction, consistent with the initiation complex remaining intact during abortive initiation. PMID- 3667621 TI - Plasminogen activation by single-chain urokinase in functional isolation. A kinetic study. AB - The kinetics of the activation of Glu- and Lys-plasminogen by single-chain urokinase (sc urokinase) derived from the transformed human kidney cell line TCL 598 have been studied and compared with two-chain urokinase (tc urokinase). Plasminogen activation was determined by the increase in fluorescence polarization of fluorescein-labeled aprotinin, a high affinity inhibitor of plasmin. This methodology allows plasmin generation by sc urokinase to be measured in functional isolation, with no interfering generation of tc urokinase, sc urokinase was found to activate plasminogen to plasmin with apparent Michaelis Menten-type kinetics. The Km for Glu-plasminogen activation was 47.7 microM, with a catalytic constant of 2.91 min-1. Lys-plasminogen activation by sc urokinase was characterized by a Km of 11.7 microM and a kcat of 5.60 min-1. The Km values for the activation of Glu- and Lys-plasminogen by tc urokinase were found to be similar to those for activation by sc urokinase (36.8 and 9.0 microM, respectively), but the catalytic constants were higher at 36.0 and 118 min-1, respectively. Therefore, on the basis of the catalytic efficiency kcat/Km, sc urokinase seems to have 16-27-fold lower activity than tc urokinase. This activity of sc urokinase is in contrast to its lack of activity against a low molecular weight peptide substrate (less than 0.2% of the activity of sc urokinase). The activation of sc urokinase to tc urokinase by plasmin was also characterized (Km = 3.0 microM, kcat = 105 min-1). Using these data, it was possible to calculate the theoretical rate of plasminogen activation by sc urokinase in the absence of aprotinin, when tc urokinase is generated by the action of plasmin. The calculated rate was in good agreement with that determined experimentally using the chromogenic substrate D-Val-Leu-Lys-p-nitroanilide. These data demonstrate that sc urokinase has properties which distinguish it from conventional serine protease zymogens. The lack of activity against low molecular weight peptide substrates demonstrates the inaccessibility of the substrate binding pocket. However, there is a moderate activity against plasminogen, suggesting that plasminogen may be acting as both an effector and a substrate for sc urokinase. PMID- 3667622 TI - Independent elevation of cytosolic [Ca2+] and pH of mammalian sperm by voltage dependent and pH-sensitive mechanisms. AB - Previous work (Babcock, D. F., Rufo, G. A., and Lardy, H.A. (1983) Proc. Natl. Acad. Sci. U.S.A. 80, 1327-1331) established that increased cytosolic pH (pHi) promotes metabolic and swimming activity of bull sperm and that intracellular alkalinization results from elevated extracellular K+, presumably as a consequence of membrane depolarization. The present studies show that a persistent but reversible increase in [Ca2+]i accompanies the increase in pHi that similarly results from treatment of ram sperm with elevated [K+] in alkaline media. Because comparable increases in pHi occur in the presence or absence of external Ca2+ and because [Ca2+]i is unaltered by imposed changes in pHi alone, [Ca2+]i and pHi apparently are neither directly linked by transmembrane Ca2+/H+ exchange nor indirectly linked through Na+/H+ and Na+/Ca2+ exchange under these conditions. Instead, inhibition of K+-induced increases in [Ca2+]i (but not of increases in pHi) by prenylamine, diltiazem, nifedipine, or verapamil (C1/2 = 6, 20, 30, and 60 microM, respectively) indicates that voltage-dependent Ca2+ channels, distinct from previously described voltage-dependent effectors of pHi, operate in mammalian sperm to control [Ca2+]i. Treatment with Cs+ plus valinomycin (as an alternative method of membrane depolarization) increases pHi much more effectively than it increases [Ca2+]i, and thus also partially supports this contention. In contrast to an apparent insensitivity to pHi, K+-dependent increases in [Ca2+]i are promoted reversibly by elevation of pHo, probably reflecting local surface charge effects on channel activity (as suggested by patch-clamp studies in other systems). A selective increase in membrane permeability to Ca2+ that is induced by 12 mM NaF under nondepolarizing conditions is not a consequence of cellular aggregation, but is attenuated by the chelator deferoxamine, suggesting that GTP-binding protein additionally may couple sperm Ca2+ channels to surface receptors and promote channel opening during sperm capacitation, presumably in response to agonists produced within the mammalian female reproductive tract. PMID- 3667623 TI - Elevation of glutathione in phenylalanine mustard-resistant murine L1210 leukemia cells. AB - Murine L1210 leukemia cells resistant to the antineoplastic agent L-phenylalanine mustard have a 1.5-2.0-fold elevation in their cellular GSH and GSSG content as compared to drug-sensitive cells. Cellular uptake of L-[U-14C]cystine and its incorporation into GSH of the resistant tumor are correspondingly elevated. Synthesis of gamma-glutamylcysteine, GSH, and GSSG is elevated 1.5-2.0-fold in cell-free preparations of the resistant tumor. This increased synthesis of GSH is attributed to increased cellular content (1.6-fold) of gamma-glutamylcysteine synthetase. GSH synthetase activity is equivalent in both drug-sensitive and resistant cells. Investigation into the hydrolysis of selected peptides by cell free preparations of both sensitive and resistant tumors suggest that aminopeptidase M participates in the formation of L-cysteine from L-Cys-Gly. This is supported by the observation that these preparations readily degrade L-Leu-p nitroanilide and L-Ala-L-Ala-L-Ala, known substrates for aminopeptidase M, but not dipeptidase. The failure of the tumors to degrade Gly-D-Ala, a dipeptidase substrate, and the marked inhibition of L-Ala-Gly, L-Cys-Gly, and L-Ala-L-Ala-L Ala hydrolysis by Bestatin further support a role for aminopeptidase M in the generation of L-cysteine from L-Cys-Gly. These results suggest that the drug resistant tumor cell has developed an efficient mechanism for maintenance of elevated GSH which involves both gamma-glutamyl transpeptidase-initiated catabolism of GSH to cysteine and its reutilization by gamma-glutamylcysteine synthetase. PMID- 3667624 TI - A high melting (105 degrees C) form of chromatin characterizes the potential of cells for mitosis. AB - The nuclei from different types of dividing cultured cells melted as four thermal transitions: I (60 degrees C), II (76 degrees C), III (88 degrees C), and IV (105 degrees C). The fourth transition was the predominant endotherm in all types of cells examined. In the melting profile of nuclei obtained from nondividing density-inhibited fibroblasts, transition IV remained the major endotherm; however, it was lost in nuclei from differentiated myoblasts and nutrient depleted cells. In these cells, the loss in transition IV was compensated by a concomitant increase in transition III. In the nutrient-deprived cells the decrease in transition IV was followed by a gradual lowering in its melting temperature. The complete loss of transition IV was correlated with loss of cellular capacity to divide. PMID- 3667625 TI - Purification and characterization of proteoliaisin, a coordinating protein in fertilization envelope assembly. AB - We report the purification and characterization of proteoliaisin, a protein that participates in the assembly of the sea urchin fertilization envelope. Proteoliaisin was purified from egg cortical granule exudate to greater than 99% homogeneity using chromatography on DEAE-Sepharose and on phenyl-Sepharose. Native proteoliaisin is a highly asymmetric protein (f/fo = 2.0) composed of a single Mr approximately 230,000 peptide. Its asymmetry was demonstrated both by analytical ultracentrifugation and by nondenaturing polyacrylamide gel electrophoresis, a novel analysis that detects molecular asymmetry in heterogeneous protein mixtures. Proteoliaisin is enriched in six amino acids: aspartic acid/asparagine, glutamic acid/glutamine, glycine, and cysteine, which account for over 50% of its mass. Nearly all of the cysteine residues are disulfide bonded. The protein contains a small proportion of aromatic amino acids with phenylalanine greater than tyrosine greater than tryptophan. At neutral pH its absorbance maximum is at 274.5 nm, with an extinction coefficient of 0.43 ml mg-1 cm-1. Proteoliaisin forms a 1:1 Ca2+-stabilized complex with ovoperoxidase, another component of the fertilization envelope, with Kd = 1.1 X 10(-6) M. Proteoliaisin, a constituent of the specialized echinoderm extracellular matrix called the fertilization envelope, has certain structural similarities to mammalian extracellular matrix proteins. PMID- 3667626 TI - DNA-binding properties and characterization of human transcription factor TFIIIC2. AB - Interaction between the B-block region of adenovirus VA1 DNA and the human RNA polymerase III transcription factor (TFIII) C2 was analyzed using a gel DNA binding assay. The retarded band corresponding to the specific complex between TFIIIC2 and the regulatory B-block region was identified by DNase I footprint analysis, competition experiments, and gel shift assays using mutated and truncated virus-associated (VA) 1 DNA probes. The equilibrium constants for the binding reaction with the complete VA1 gene were determined. TFIIIC2 was found to bind to non-specific DNA sequences with a relatively low affinity (equilibrium constant Kn = 6 x 10(4) M-1), and to the B-block sequence with a high affinity (specific constant Ks = 2 x 10(11) M-1). Assuming one site per molecule, the total concentration of binding sites [C0] in the TFIIIC2-containing fractions ranged between 0.6 and 1.6 x 10(-10) M. This corresponded to 1500 TFIIIC2 molecules extracted per 293 cell. Sedimentation analysis of TFIIIC2 on a sucrose gradient showed both VA1 DNA binding activity and in vitro transcription activity cosedimenting with an apparent coefficient of 17-18 S, consistent with a molecular weight of 400-500 kDa. UV cross-linking of a 5-bromo 2'-deoxyuridine containing, 32P-labeled VA1 probe with the TFIIIC2 fraction, followed by DNase I digestion and analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, revealed a single 32P-labeled band migrating as a 250-kDa polypeptide. Compared with the sedimentation data, this result suggests that native TFIIIC2 may be a dimer of the approximately 250-kDa polypeptide. PMID- 3667627 TI - Time of c-fos and c-myc expression in human diploid fibroblasts stimulated to proliferate after prolonged periods in quiescence. AB - When human diploid fibroblasts such as WI-38 cells become crowded, they enter a viable state of quiescence (G0) in which they can remain for prolonged periods of time. These quiescent cells can be induced to re-enter the cell cycle by addition of fresh serum. However, cells held in G0 for long periods before stimulation require more time to enter DNA synthesis as compared to cells held in a quiescent state for short periods. We have used this model system to determine if a close temporal coupling exists between the time of expression of two proto-oncogenes associated with cell growth, c-fos and c-myc, and the time of entry into DNA synthesis. WI-38 cells were stimulated to enter DNA synthesis by the addition of fresh culture medium and serum at various lengths of time after plating, ranging from 7 to 34 days. At hourly intervals thereafter, cells were harvested and total RNA was isolated. These samples were then analyzed by RNase protection assay to determine the levels of c-fos and c-myc mRNA. Our results show that the time and pattern of c-fos and c-myc mRNA accumulation after stimulation is determined only by the time which the cells are treated with serum even when they exhibit a 19-h delay in the entry into DNA synthesis. In all of our experiments, c-fos could be detected 0.5 h after stimulation and remained detectable for approximately 2 h. Likewise, the peak of c-myc accumulation occurred at about 3 h after serum addition, regardless of how long it took to initiate DNA synthesis. These results suggest that the time of c-fos and c-myc induction clearly is not the only factor which determines the length of the prereplicative period and thus the ultimate time of initiation of DNA synthesis. PMID- 3667628 TI - Identification of a polypeptide growth inhibitor from bovine mammary gland. Sequence homology to fatty acid- and retinoid-binding proteins. AB - A polypeptide growth inhibitor purified from bovine mammary gland (mammary derived growth inhibitor) has been shown to reversibly inhibit proliferation of mammary carcinoma cells at concentrations of about 10(-10) M. The carrier of inhibitory activity has been identified biochemically as an about 13-kDa polypeptide and chemically by elucidating the amino acid sequence. No homology to any of the hitherto structurally investigated growth inhibitors (transforming growth factor beta, interferons) has been observed. The data revealed extensive sequence homology of mammary-derived growth inhibitor to a family of low molecular mass hydrophobic ligand-binding proteins, among them a fatty acid binding protein from rat heart, myelin P2, a differentiation associated protein in adipocytes (p422) and the cellular retinoic acid-binding protein. Interaction with as yet unknown hydrophobic ligands might play a functional role in the mechanism of growth inhibition excerted by mammary-derived growth inhibitor. PMID- 3667629 TI - Influence of the dwarf mouse mutation on skeletal and cardiac myosin isoforms. Effect of one injection of thyroxine on skeletal and cardiac muscle phenotype. AB - The dwarf mutant is an autosomal recessive mutation of the mouse which causes a defective development of those anterior pituitary cells responsible for the production of thyroid-stimulating hormone, growth hormone, and prolactin. These mice are thus genetically hypothyroid and provide a model system in which one can investigate the influence of thyroid hormone on the transitions of the myosin heavy chain isoforms. We have carried out a qualitative and quantitative investigation of the myosin heavy chain isoforms present at various developmental stages and following one injection of 1 microgram of thyroxine. Myosin heavy chains were identified by nondissociating gel electrophoresis, localized by indirect immunofluorescence, and quantitated by the enzyme-linked immunosorbent assay technique. We find that in skeletal muscle, the appearance of the adult fast myosin heavy chain is severely retarded, that the neonatal myosin heavy chain is never totally eliminated, and that there is an overall increase in the number of fibers containing slow myosin heavy chain. In cardiac tissue the adult phenotype is never attained and beta-cardiac myosin heavy chain remains the predominant isoform. A single injection of 1 microgram of thyroxine was sufficient to cause a slight acceleration in the appearance of the adult fast myosin heavy chain in skeletal muscle, but only after 6-8 days. However, in the cardiac muscle, one injection of thyroxine resulted in a more rapid but transient expression of the alpha-cardiac myosin heavy chain, suggesting that the mechanism of action of thyroid hormone is different in these two tissues. PMID- 3667630 TI - Expression of cDNAs for two isoforms of the catalytic subunit of cAMP-dependent protein kinase. AB - We have previously reported the cloning of cDNAs coding for two isoforms (termed C alpha and C beta) of the catalytic (C) subunit of cAMP-dependent protein kinase (Uhler, M., Chrivia, J., and McKnight, G. S. (1986) J. Biol. Chem. 261, 15360 15363). We have constructed cDNA expression vectors for the C alpha and C beta proteins using the mouse metallothionein promoter so that mRNA transcripts from the expression vectors are inducible with Zn. In stable transformants of NIH 3T3 and AtT-20 cells, the induction of both C alpha and C beta mRNA with Zn increases the cAMP-dependent as well as the cAMP-independent kinase activity. The C alpha and C beta proteins synthesized from these expression vectors can be detected by Western blot analysis and have slightly different molecular weights as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Interestingly, the levels of RI protein are also shown to increase in cells expressing high levels of the C alpha or C beta subunits although there is no change in RI mRNA. In contrast, the levels of RII protein are not significantly affected by increasing either C alpha or C beta expression in these cell lines. We conclude that cells can compensate for the increased levels of either C alpha or C beta subunits with a corresponding elevation of RI protein implying that both isoforms of C can interact with RI to form a holoenzyme. The relevance of these experimental results to the coordinate regulation of cAMP-dependent protein kinase subunits is discussed. PMID- 3667632 TI - Cholecystokinin mRNA in porcine cerebellum. AB - Using previously cloned cDNAs to pig brain prepro-cholecystokinin mRNA and slot blot and S1 nuclease protection assays, the relative cholecystokinin mRNA levels in different regions of the pig brain were measured. The relative amounts of cholecystokinin mRNA generally correlated well with the levels of cholecystokinin immunoreactive peptides in the various regions tested. One clear exception was noted in the cerebellum; in this region, levels of cholecystokinin mRNA were about 20% of the levels in brain cortex (or second highest level in all areas tested) whereas the mature forms of cholecystokinin peptides (cholecystokinin 58, cholecystokinin 8) were undetectable (less than 3 pmol/g). In vitro translation of cerebellar and cortical cholecystokinin mRNA indicated that there was no difference in the efficiency with which these two RNAs were translated into immunoreactive prepro-cholecystokinin. DNA sequence analysis confirmed that a cloned full-length cerebellar cholecystokinin cDNA was indistinguishable from its cortical counterpart and, therefore, must encode an identical prepro cholecystokinin. We conclude that there are pronounced regional differences in cholecystokinin expression in pig brain. The apparent discrepancy between levels of immunoreactive cholecystokinin peptides and cholecystokinin mRNA in the cerebellum could be explained by a high turnover rate for the peptides, differential processing of the peptides, or tissue-specific inhibition of cholecystokinin mRNA translation. PMID- 3667631 TI - Isolation and sequencing of a cDNA clone for a prolactin-inducible protein (PIP). Regulation of PIP gene expression in the human breast cancer cell line, T-47D. AB - We have initiated an analysis of the action of prolactin in a human breast cancer cell line (T-47D) by isolating and sequencing cDNA clones for a prolactin inducible protein (PIP). PIP cDNA (approximately 600 base pairs) was isolated from a lambda gt11 expression library prepared from mRNA extracted from T-47D cells treated with prolactin and hydrocortisone. The identity of PIP cDNA was confirmed by hybrid-selected translation. PIP mRNA is a single mRNA species of approximately 900 bases which responds to lactogenic hormones (human prolactin and growth hormone) in a time- and dose-dependent manner. Treatment of T-47D cells with human growth hormone (hGH) increased PIP mRNA levels by 4.6-fold, while the combination of hGH and hydrocortisone or dihydrotestosterone had a more dramatic, 12.4-fold, effect. The latter steroid was the most potent. Dihydrotestosterone plus hGH increased transcription of the PIP gene by 3.7-fold. Dihydrotestosterone alone was as effective as dihydrotestosterone plus hGH in increasing the transcription rate, while hGH alone had no effect. Thus, lactogen may regulate PIP gene expression at a post-transcriptional step. PIP mRNA was expressed at low levels in other human breast cancer cell lines which were prolactin receptor-positive; MCF-7 and EFM-19 lines were exceptions. PIP cDNA had an open reading frame of 146 amino acids, sufficient to encode the precursor form of the secreted PIP protein (approximately 14.5 kDa). The similarity of the predicted amino acid sequence of PIP to the sequence of a protein encoded by a gene expressed in the mouse submaxillary gland prompted us to look for PIP in human saliva. Western blot analysis confirmed the presence of PIP in human saliva. Therefore, the PIP gene is useful in studying the molecular actions of the prolactin/growth hormone polypeptide hormone family and the interaction with androgen, in mammary and other potential target cells. PMID- 3667633 TI - The N-acetylglucosamine-specific receptor of the thyroid. Binding characteristics, partial characterization, and potential role. AB - The binding characteristics of the GlcNAc binding protein present in thyroid membranes (Consiglio, E., Shifrin, S., Yavin, Z., Ambesi-Impiombato, F.S., Rall, J.E., Salvatore, G., and Kohn, L.D. (1981) J. Biol. Chem. 256, 10592-10599) were reinvestigated using neoglycoproteins as probes. Plasma membrane preparations from porcine thyroid specifically bound 125I-GlcNAc35-bovine serum albumin. Binding was dependent on the presence of calcium. Binding of ligand to receptor was minimal at neutral pH and maximal at pH 5.0. Equilibrium binding studies indicated positive cooperativity of binding and a site capacity of about 60 pmol/mg of protein. Competition studies were compatible with a specificity hierarchy of GlcNAc much greater than Gal; no recognition of mannose, fucose, or glucose moieties was noted. The receptor was detergent-solubilized from plasma membrane preparations and on the basis of the defined binding properties, purified by chromatography on a GlcNAc-Sepharose affinity column. The purified GlcNAc thyroid receptor has a subunit molecular size of about 45 kDa and appears to be an oligomer composed of three subunits. The receptor was identified as a component of thyrocytes by in situ cytochemical localization with fluorescent neoglycoproteins. In certain cases it was mainly present on, or near, the apical cell surface. It is suggested that this GlcNAc receptor functions in thyroglobulin metabolism, possibly involved in recycling of internalized thyroglobulin molecules back into the follicular lumen. PMID- 3667634 TI - Isolation and characterization of a 60-kilodalton glycoprotein esterase from liver microsomal membranes. AB - A glycoprotein having a subunit weight of approximately 60,000 was isolated from rabbit liver microsomes. It is a predominant component of the hepatic microsomal membrane and reacts rapidly with diisopropylphosphorofluoridate (DFP), resulting in the loss of enzymatic activity toward artificial substrates such as acyl esters of o-nitrophenols. Automated Edman degradation of this protein together with sequence analysis of peptides provided the NH2-terminal sequence of some 70 residues as follows: His-Pro-Ser- Ala-Pro-Pro-Val-Val-Asp-Thr-Val-Lys-Gly-Lys-Val Leu-Gly-Lys-Phe-Val-Ser-Leu-Glu-Gly-Phe-Ala-Gln- Pro-Val-Ala-Val-Phe-Leu-Gly-Val Pro-Phe-Ala-Lys- Pro-Pro-Leu-Gly-Ser-Leu-Arg-Phe-Ala-Pro-Pro-Gln- Pro-Ala-Glu-Ser Trp-Ser-His-Val-Lys-Asn (CHO)- Thr-Thr-Ser-Tyr-Pro-Pro-Met-Cys-Ser-Ser. A carbohydrate attachment was identified at asparaginyl residue 61. The COOH terminal peptide of the protein was isolated from two independent enzymatic digests, and its sequence was established as Arg-Glu-Thr-Glu-His-Ile-Glu-Leu. In order to isolate the DFP binding peptide, liver microsomes were labeled with [3H]DFP and the 60-kDa protein containing covalently bound DFP isolated in pure form. Following reduction and carboxymethylation, the DFP-labeled protein was fragmented with trypsin and the digest subjected to gel filtration. Digestion of the labeled peptide preparations with chymotrypsin followed by chromatography of the digest yielded two diisopropylphosphoryl (DIP) peptides. Automated Edman degradation of these peptides provided the following amino acid sequences: Gly Glu-DIPSer- Ala-Gly-Gly-Gln-Ser-Val-Ser-Ile-Leu-Leu-Leu-Ser- Pro and Thr-Val-Ile Gly-Asp-DIPHis-Gly-Asp-Glu-Ile-Phe. The active site serine peptide of the 60-kDa protein shows some 70% similarity to the active center region of choline esterases. While the postulated active histidyl residue in choline esterases has not been identified, it is proposed that the DFP binding histidine of the 60-kDa protein corresponds to His-438/440 of choline esterases. PMID- 3667635 TI - Carbon/graphite fiber reinforced poly(methyl methacrylate): properties under dry and wet conditions. AB - The flexural properties of poly(methyl methacrylate) (PMMA) reinforced with carbon/graphite (C/G) fibers with three different surface treatments were investigated by transverse bend testing after dry and wet storage. The fibers used were (1) commercially available fibers, (2) cleaned fibers, and (3) cleaned and sized fibers. The coating agents of commercial unidirectional and braided C/G fibers as well as impurities on C/G fibers for medical uses were characterized by means of high-performance liquid chromatography (HPLC). The agar overlay technique was used to assess the cytotoxicity of leachable elements from different fibers and processed composites. Composites with both unidirectional and braided tubular C/G fibers were investigated after storage in water. Fracture stress and flexural modulus decreased when "commercial" fibers were used as reinforcing material. Composites with cleaned and sized fibers gave only minor differences in flexural properties after dry and wet storage. By means of SEM micrographs the adhesion behavior of unsized C/G fibers, epoxy sized fibers, cleaned fibers, and cleaned and sized fibers were assessed. After water storage a substantial part of the cleaned fibers adhered to the matrix material. The adhesion capacity of the other fibers was reduced since the water absorption caused separation of fiber and matrix. PMID- 3667636 TI - Viscoelastic behavior of polyurethane vascular prostheses. AB - A method of evaluating the in vitro viscoelastic properties of microfibrous Biomer poly(ether-urethane-urea) vascular prostheses is outlined. Quasi-static and dynamic tests were carried out on Biomer grafts of diameter between 3.4 mm and 3.8 mm and wall thickness between 0.25 mm and 0.55 mm. It is shown that the quasi-static compliance of a Biomer graft may be determined from an equation relating transmural pressure, radius, and longitudinal strains in terms of the graft dimensions and material constants. The dynamic compliance spectra were evaluated as a function of the longitudinal and circumferential strains and temperature. Although the ratio of dynamic compliance to quasi-static compliance was linearly related to the logarithm of frequency it was not significantly affected by strains or temperature over the relevant ranges studied. Employing the usual assumptions of linear isotropic incremental elastic theory the dynamic elastic and viscous moduli were calculated as a function of frequency. Biomer grafts were more viscous than canine carotid and femoral arteries, especially at the higher frequencies. The variation in the ratio of dynamic to static incremental modulus with frequency was similar to that observed in the femoral arteries by Bergel (J. Physiol., 156, 458-469 (1961)). PMID- 3667637 TI - Bonding behavior between two bioactive ceramics in vivo. AB - The purpose of this study is to examine the chemical bonding mechanism between bioactive ceramics in vivo. Two experiments were performed. In the first experiment, rectangular specimens (5 mm X 5 mm X 25 mm) of apatite-wollastonite containing glass-ceramics (designated A.W-GC) were used. In the second experiment, plates (15 mm X 10 mm X 2 mm) of A.W-GC and three types of hydroxyapatite (designated HA) were used. The sintering temperature and porosity (%) of the three types of HA were 1200 degrees C (0.4%), 1000 degrees C (4.8%), and 800 degrees C (45%), respectively. In each experiment, two pairs of specimens of identical material, one bound with silk thread, the other not bound, were implanted subcutaneously into rats. In the first experiment, bonding of only bound specimens was observed at 3 and 6 months after implantation. The observation of interface by SEM-EPMA showed that a Ca-P-rich layer formed between the two specimens. In the second experiment, bonding of both bound and nonbound A.W-GC produced identical results 1 month after implantation. For HA sintered at 800 degrees C and 1000 degrees C, bonding was observed in every specimen. This phenomenon might be caused by the chemical change of hydroxyapatite occurring at different sintering temperatures. The Ca-P-rich layer was observed between two plates. These results suggest that self-repair of bioactive ceramic is possible under certain conditions. PMID- 3667638 TI - Experimental demonstration of the immunogenicity of silicone-protein complexes. AB - Although silicones, as a class, are nontoxic in animal and tissue studies, implanted silicone prostheses and medical devices are associated with various local and systemic host inflammatory reactions. They also have been associated with a form of autoimmune disease. To test the hypothesis that silicones may evoke an immunologically mediated inflammatory reaction, 10 guinea pigs were stimulated for 1 month with intraperitoneal injections of sterile medical-grade silicone oil admixed with homologous serum and complete Freund's adjuvant. Ten controls were stimulated with saline. Four additional animals were passively sensitized with splenic homogenates from four sensitized animals. Intradermal antigenic challenges consisted of silicone-homologous serum, pure silicone, saline-homologous serum, and purified protein derivative. Cutaneous reaction patterns were graded grossly and microscopically. Silicone-serum and purified protein derivative antigens evoked three to four times greater palpable lesions in all 10 actively and all 4 passively sensitized animals at approximately 24 h compared to controls. Biopsies showed a moderate to marked lymphocytic infiltrate. Control sites and naive animals showed only edema at the challenge sites. The data suggest that silicone-protein complexes are potentially immunogenic. PMID- 3667639 TI - Pluronic F-127 gel preparation as an artificial skin in the treatment of third degree burns in pigs. AB - A blinded study was designed to provide qualitative and quantitative evaluation on the possible therapeutic benefits of the use of Pluronic Polyol F-127 as a substitute skin in standardized third-degree thermal burns. Three separate burns, approximately 1600 mm2, were induced on the shaved backs of young, anesthetized pigs. Each animal served as its own control. One burn site was left untreated while the other two sites were covered with coded preparations of the Pluronic F 127 gel with additives. Polaroid photographs with a fixed focal-length camera were taken of all burn sites for planimetry analysis. Biopsies taken confirmed that third-degree burns were achieved. The pigs were followed for 30 days. The rate of healing of third-degree thermal burns was significantly accelerated over control sites when treated with Pluronic Polyol F-127 plus propylene glycol. When the bacteriostatic agent Garamycin was also added, the rate of healing remained significantly better than untreated controls. With the addition of Piracetam, burn wound healing was actually retarded within 30 days, when applied topically. Thus, wound healing was both accelerated and retarded as a function of the particular Pluronic preparation used to treat specific burn sites. This experimental modulation of wound healing suggests that the non-ionic poloxamer, Pluronic F-127, can significantly enhance the rate of wound healing by some unknown mechanism, possibly by stimulation of epithelial growth factor (EGF). PMID- 3667640 TI - The biodegradation of poly(ether urethanes). PMID- 3667641 TI - Posterior tibial-tendon transfer in patients with cerebral palsy. AB - The results of fifty-seven posterior tibial-tendon transfers through the interosseous membrane to the dorsum of the foot that were performed in fifty-one patients who had cerebral palsy, and who were followed for a mean of 9.3 years (range, five to twenty-six years), were evaluated in terms of pattern of gait, alignment of the foot, formation of callus on the sole of the foot, and requirements for bracing. A good or excellent result was achieved in twenty-seven of thirty feet in the hemiplegic patients, twelve of sixteen feet in the paraplegic patients, and two of eleven feet in the quadriplegic patients. We found that in order for the tendon transfer to be successful the foot had to be passively correctable to at least a neutral position and that the tendon had to be passed superficial to the extensor retinaculum and inserted into the lateral cuneiform bone. The heel cord should be lengthened before the tendon transfer. PMID- 3667642 TI - Further follow-up on socket fixation using a metal-backed acetabular component for total hip replacement. A minimum ten-year follow-up study. AB - In 1982, Harris and White reported the data after a minimum five-year follow-up of fifty-three total hip replacements in forty-seven patients in whom a cemented metal-backed acetabular component had been used. There actually had been fifty four total hip replacements in fifty-three hips, as in one hip a revision was done for a traumatic disruption of the initial acetabular component that occurred two months after the first insertion. Six of the fifty-four operations did not qualify for inclusion in this ten-year follow-up study, including four operations in three patients who had died before that time. The remaining forty-eight hips have been followed for ten to 13.5 years (mean, 11.3 years). With one exception, the ages of the patients at the time of the index operation ranged from seventeen to fifty years (mean, forty-one years). Six (12.5 per cent) of the forty-eight hips required revision because of symptomatic aseptic loosening of the acetabular component. In addition, two acetabular components, although they were not loose, were revised concomitantly with revision of the femoral component because of the presence of radiolucent lines at the cement-bone interface of the acetabular implant. One other acetabular component that was not loose was revised because of unexplained pain, one was removed because of sepsis, and for one only the polyethylene liner was exchanged because of damage to the polyethylene when the weld holding the femoral head to the femoral neck failed. Nine additional hips (19 per cent), although they were not revised, showed radiographic evidence of migration, and one (2 per cent) showed radiographic evidence of impending failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667643 TI - Multiple revisions for failed total hip arthroplasty not associated with infection. AB - Forty-five patients (forty-five hips) underwent repeat revisions of a total hip arthroplasty that had failed but was not associated with infection; seven of these patients had a third revision. The mean length of follow-up was approximately three years, and no patients were lost to follow-up. Twenty-eight of the forty-five patients had no or slight pain after the second revision, and thirty reported that their condition was improved. After the third revision, six patients had no or only slight pain, and five said that their condition was improved. On final roentgenographic examination, there was probable loosening (migration or subsidence of a component, lucency at the prosthesis-cement interface, fracture of the cement, or complete radiolucency at the bone-cement, or complete radiolucency at the bone-cement interface of more than one millimeter in at least one zone) of eight of the acetabular components and thirteen of the femoral components after the second revision and three acetabular components and one femoral component after the third. There was symptomatic loosening (moderate or severe pain and probable roentgenographic loosening) in six patients after the second revision and one after the third. Significant postoperative complications were noted in nineteen of the forty-five patients, and treatment was considered to be a failure in eleven hips after the second revision and in two after the third. PMID- 3667644 TI - Reconstruction of the anterior cruciate ligament using the bone-block iliotibial tract transfer. AB - The results of reconstructing the torn anterior cruciate ligament using the bone block iliotibial-tract transfer in thirty-seven patients were reviewed. After the operation, only one patient considered the function of the knee to be normal, but most (all but four) could participate in moderately strenuous work activities and some sports activities. The athletes who were operated on rarely were able to return to their pre-injury level of activity. Most of the patients continued to have clinical evidence of deficiency of the anterior cruciate ligament. All but five had a positive Lachman test and most had a positive pivot-shift sign. Fifteen results were rated satisfactory and ten were rated poor. Because of these disappointing results we have discontinued using the procedure. PMID- 3667645 TI - Disarticulation of the knee in children. A functional assessment. AB - We assessed the functional abilities of six patients who had had disarticulation of nine knees during childhood by analyzing their gait using electrocardiographic telemetry. Those who were more than five years old were further studied by timing them as they ran the fifty-yard (45.7-meter) dash and by testing the strength of the musculature of the hip girdle using a Cybex dynamometer. The physiological cost-index of Butler et al. was used to assess energy consumption. Three patients had had unilateral disarticulation and three had had bilateral disarticulation. Kinematic studies showed persistent bilateral abduction of the hip throughout the gait cycle in all six patients. The flexion-extension arc of the hip was decreased in the three who had had bilateral disarticulation. Increased flexion of the hip was noted on the normal side and decreased flexion, on the affected side in those who had had unilateral disarticulation. Phase reversal of pelvic obliquity was noted in the amputees who had had bilateral disarticulation. The prosthetic knee showed good flexion during the swing phase. All patients showed a mild decrease in the velocity of gait and in the length of step and stride. The patients who had had unilateral disarticulation showed decreased duration of the bilateral stance and single stance phases and increased duration of the swing phase. Those who had had bilateral disarticulation of the knee had a normal distribution of the components of the gait cycle: bilateral stance, single stance, and swing. The physiological cost-index for all six was within the normal range, indicating minimum energy handicap.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667646 TI - Mycobacterium marinum infection of the hand and wrist. Results of conservative treatment in twenty-four cases. AB - Inadequate debridement, extensive scarring, and breakdown of the wound have been commonly encountered after surgical debridement has been employed as the initial treatment of infection with Mycobacterium marinum involving the deep structures of the hand. Because of our disappointment with the results of this form of treatment, from 1982 to 1986 we treated twenty-four patients who had such an infection with rifampicin and ethambutol after a diagnostic biopsy was done. Surgical treatment was deferred until it was determined that the infection had not been controlled by the chemotherapy. The clinical outcome for these patients could be divided into three patterns: eleven patients (Group I) had a good result with no complications, three patients (Group II) had delayed healing of the wound, and ten patients (Group III) did not have a good response to conservative treatment and required one or more surgical debridements. Complications were sometimes associated with use of the drugs, and loss of visual acuity was a concern in three patients. In twenty-one (87 per cent) of the patients, at follow up the function of the treated hand was equal to that of the other hand. Persistent pain, a discharging sinus, and previous local injection of steroids were unfavorable prognostic factors. If these factors are present, surgical debridement is advised. PMID- 3667648 TI - Healing of the medial collateral ligament in rats. The effects of repair, motion, and secondary stabilizing ligaments. AB - The effects of repair, motion, and the integrity of the secondary ligamentous restraints on healing of the medial collateral ligament were studied in a rat model. Healing was assessed by measuring ligamentous laxity and tensile strength. All healing ligaments were weaker and more lax than their controls. Repair did not have a statistically significant effect on the laxity or the strength of the medial collateral ligament. Allowing active motion had a statistically significant beneficial effect on the strength of the medial collateral ligament. Stability was adversely affected by active motion if the secondary restraints had been transected; however, when the secondary ligamentous restraints were intact, active motion was beneficial and immobilization was harmful. PMID- 3667647 TI - Femoral anteversion. AB - Biplane roentgenography, axial roentgenography, and fluoroscopy are the usual roentgenographic methods of measuring femoral anteversion. These methods use a strict geometrical definition of anteversion. The computerized tomography method of measuring anteversion that was developed recently, and is now widely used, does not adhere to the accepted definition of anteversion and has not been tested for accuracy in a large series. In the present study, the widely used computerized-tomography method of measuring anteversion was tested on thirty-two femoral specimens. With that method, anteversion was consistently underestimated by an average of 10 degrees compared with direct measurements and was reproducible only to within +/- 3.6 degrees. Therefore, a new method of measuring anteversion using computerized tomography was developed. It was shown to be accurate to +/- 1 degree, as tested on the same specimens. This study demonstrated geometrically why the currently practiced computerized-tomography method of selecting the points that are used to define the axis of the femoral neck is not consistent with geometrical definitions of anteversion. A more accurate method for both defining the axis of the femoral neck and measuring femoral anteversion is described and recommended for clinical use. PMID- 3667649 TI - The biomechanical and morphological changes in the medial collateral ligament of the rabbit after immobilization and remobilization. AB - The effects of immobilization and remobilization on the biomechanical and morphological properties of the femur-medial collateral ligament-tibia complex and each of its components were investigated in the rabbit. Specimens that had been obtained after periods of unilateral immobilization of the knee and remobilization were evaluated for structural properties. In addition, the mechanical properties of the substance of the medial collateral ligament and the histological characteristics of both the substance of the ligament and its sites of insertion were evaluated. After immobilization, there were significant reductions in the ultimate load and energy-absorbing capabilities of the bone ligament complex, and an increased number of failures occurred by tibial avulsion. The tissue of the medial collateral ligament also became less stiff as a result of immobilization. Histologically, the femoral and tibial insertion sites showed increased osteoclastic activity, resorption of bone, and disruption of the normal attachment of the bone to the ligament. With remobilization, the ultimate load and energy-absorbing capabilities of the bone-ligament complex improved but did not return to normal. Failure by tibial avulsion became less frequent, and the stress-strain characteristics of the medial collateral ligament returned to normal. Histologically, the sites of insertion of the ligament also showed evidence of recovery. PMID- 3667650 TI - The tibial subchondral plate. A scanning electron microscopic study. AB - Non-arthritic tibial plateaus were obtained from fifteen cadavera and five above the-knee amputation specimens. After radiographs had been made, each sample was macerated and the topography of the subchondral plate was displayed by scanning electron microscopy. The surface features included small peripheral and submeniscal osteophytes, indentations, and holes penetrating the plate. The pattern of distribution of holes per square centimeter was different for the subchondral plate of the medial plateau than it was for that of the lateral plateau. More holes were present in the submeniscal area of the medial tibial plateau; the lateral tibial plateau showed a greater concentration of holes in its central area. By light microscopy, many holes were seen to be blood vessels that were lined by endothelium and contained erythrocytes. PMID- 3667651 TI - Melorheostosis of the hand. A case report with long-term follow-up. PMID- 3667652 TI - The use of tissue expansion to allow reconstruction of the knee. A case report. PMID- 3667653 TI - Reconstruction of the stump after below-the knee amputation. Soft-tissue expansion and local muscle rotation flaps: a case report. PMID- 3667654 TI - Hodgkin disease presenting as a lesion in the wrist. A case report. PMID- 3667655 TI - Chronic non-hematogenous osteomyelitis treated with adjuvant hyperbaric oxygen. PMID- 3667656 TI - Gait patterns in spastic hemiplegia in children and young adults. PMID- 3667657 TI - Perforation of the external iliac artery and ureter presenting as acute hemorrhagic cystitis after total hip replacement. Report of a case. PMID- 3667658 TI - A typology of spousal response to the crisis of severe burn. AB - Although there has been some discussion in the literature of the psychological responses of spouses during acute and chronic illness, the needs of the spouse and how these may affect psychosocial intervention at the time of acute thermal injury have not been assessed. The behavioral responses of spouses of 25 consecutive burn patients, analyzed retrospectively, were categorized in terms of the manner in which they related to the clinical nurse specialist and other members of the burn team. Three main types are described: Poor Relators, Good Relators, and Over-Relators; the last group comprised two subgroups, the Clingers and the Pseudo-Relators. These interactional styles required specific assessment and management approaches, which are discussed. PMID- 3667659 TI - Use of the fiberoptic bronchoscope to change endotracheal tubes in patients with burned airways: case report. PMID- 3667660 TI - The triple-component neck splint. PMID- 3667661 TI - Guidelines facilitate donor vessel selection outside the zone of electrical injury for vascular anastomosis. PMID- 3667662 TI - Immunomodulators for the prevention of infections in burned guinea pigs. AB - Patients with thermal injury suffer a high incidence of infectious complications secondary to impaired host resistance. Nonspecific immunostimulatory agents are being tested increasingly for their ability to correct the postburn immunosuppression. By means of a burned guinea pig model, three such drugs- indomethacin, cyclophosphamide, and cimetidine--were tested for their ability to correct immunosuppression and prevent lethal infectious complications. The burned animals were challenged with Pseudomonas aeruginosa 1244 on the third postburn day. Neither indomethacin nor cimetidine altered the animals' clinical course. However cyclophosphamide, at a dosage of 2 mg/kg body weight/day, improved survival from 30% to 57% and prolonged mean survival time from 5.72 to 7.77 days. Cyclophosphamide, at a dosage of 15 mg/kg body weight/day, decreased mean survival to 3.63 days and percent survival to 0. These data show that treatment with cyclophosphamide could be beneficial in severe burn injury patients, but further work is necessary due to the dose-dependent nature of the drug. PMID- 3667663 TI - Comparison of energy expenditure measurement techniques in severely burned patients. AB - The degree of accuracy of existing formulas for calculating energy expenditure can be determined by comparing them to the measured energy expenditure via indirect calorimetry. As a result, one can modify traditional predicted recommendations for nutrition alimentation of the burn patient with real-time data. In this study, 21 sequential adult admissions with second- and third-degree total body surface area (TBSA) burn wounds (range 21%-81% TBSA) underwent serial assessments of energy expenditure by indirect calorimetry. On admission, maximum, and discharge, measured energy expenditure (MEE) was compared with the calculations for predicted energy expenditure by the Curreri (CEE) and modified Harris-Benedict (MBEE) equations. The mean energy expenditure calculated from the Curreri equation on admission (CEEA) overestimated the mean MEE on admission (MEEA) by 25% (P less than 0.001) and on discharge (MEED) by 36% (P less than 0.0005). The mean modified Harris-Benedict equation overestimated the mean MEEA by 32% (P less than 0.0005) and the mean MEED by 39% (P less than 0.0005). No significant difference was noted between the mean MEE at maximum (MEEM) and the mean CEEA or the mean MBEEA. This indicates excessive overfeeding of the burn patient from admission to discharge by both standard formulas. Actual measured data provide a better indicator of varying nutritional needs throughout the hospital course than the standard formulas, and their use would result in significant savings in the expenses of enteral/parenteral nutritional supplements. PMID- 3667665 TI - The parascapular fasciocutaneous flap for release of the axillary burn contracture. AB - Major disturbances of shoulder function secondary to axillary burn contracture require some form of surgical release if conservative therapy has been unsuccessful. Any area large enough to need extensive skin grafts should be considered for reconstruction using a parascapular fasciocutaneous flap. This flap, which may be elevated easily, provides an option for single-stage correction of the deformity without the need for long-term rehabilitation or splinting. PMID- 3667664 TI - In vivo comparison of two silver sulfadiazine antimicrobial agents on burn wound infection. AB - A controversy exists with regard to the relative efficacy of two preparations of silver sulfadiazine (AgSD), Silvadene and Flint's Silver Sulfadiazine Cream. We compared the susceptibility of Staphylococcus aureus and clinical Gram-positive cocci, Gram-negative rods, and mixed floral isolates by the Nathan's agar well diffusion method and found no differences. However, when S aureus-infected rat burn wounds were treated with these antimicrobial creams over a period of ten days, Silvadene significantly lowered bacterial counts, whereas results after treatment with Flint's Silver Sulfadiazine Cream were no different from those of the control group, which received no treatment. These data imply that Silvadene controls S aureus-generated burn wound infections better than the Flint product. PMID- 3667666 TI - Early vascular grafting to prevent upper extremity necrosis after electric burns: additional commentary on indications for surgery. AB - Early vascular grafting has been used to reestablish circulation to the hand in the treatment of electric injuries of the wrist with arterial damage. Since 1972 this therapy has yielded good results by preventing necrosis of the injured hand and by helping to maintain function. However, the indications and timing for performing this operation still are poorly defined. The surgeon is faced with the difficult task of determining whether the injury is severe enough to affect distal circulation and thereby lead to necrosis. The lack of reliable clinical signs is chiefly responsible for this difficulty; however, the potential for delayed thrombosis of vessels complicates the problem. In this article, indications for early vascular grafting in an electrically injured wrist are discussed based on recent clinical experience, with emphasis on the use of arteriography. A case history involving electric burns of both upper extremities is presented as an illustration. PMID- 3667667 TI - Sulfuric acid burns in a child: histologic examination as an indication of wound depth. AB - We present a case of extensive cutaneous chemical burns from sulfuric acid in a baby girl. The patient's age and the appearance of her wounds made it difficult to judge the depth of the wounds in the early stages of care. Because of the uniform appearance of the wounds and the large areas of injury, tangential excision was considered but delayed; the wounds were monitored with serial histologic biopsies for assessment of depth and progression of healing. The presence of viable dermal tissue and adnexal structures on histologic examination encouraged a program of observation and local wound care, which led to progressive healing of the wounds in 18 days. Histologic monitoring of the wounds proved to be a helpful adjunct in the clinical management of this difficult case. PMID- 3667668 TI - Molten metal burns to the lower extremity. AB - In this study of ten consecutive patients sustaining molten metal injuries to the lower extremity who were treated with excision and grafting, treatment with compression Unna paste boot was compared with that with conventional dressing. Hospital stay was decreased from 12.2 days in the conventional dressing group (five patients) to 6.4 days in the Unna group (five patients). Ambulation was initiated on postoperative day (POD) 2.2 in the Unna group, compared with POD 8.0 in the conventional dressing group. Return to work was on POD 44.8 in the Unna group versus POD 86.3 in the conventional dressing group. Treatment of molten metal injuries to the lower extremity with Unna paste compression dressing resulted in shorter hospital stay, earlier ambulation, and more rapid return to work. PMID- 3667669 TI - The burn journal club: an effective multidisciplinary learning tool. PMID- 3667670 TI - Australian occupational therapy: current trends and future considerations in burn rehabilitation. PMID- 3667671 TI - Guidelines for evaluation of musculoskeletal extensibility. PMID- 3667672 TI - The Fire and Burn Safety Alliance. PMID- 3667673 TI - Burn wound care: silver sulfadiazine application. PMID- 3667674 TI - Constituencies, communication, and burn treatment. PMID- 3667675 TI - A comparative clinical assessment of a hollow-fibre membrane oxygenator (Capiox II) and a bubble oxygenator (Harvey 1500). AB - Personal experience is reported on the use of a membrane oxygenator, the Capiox II, which is clinically compared with a bubble oxygenator for medium-term perfusion. The characteristics considered were the efficiency of the heat exchanger, the oxygenating capacity, traumatic effects on the blood and the direct effect on the renal and cardiopulmonary systems. The Capiox II demonstrated a better oxygenating capacity, less platelet damage, a smaller variation in the free plasma haemoglobin, a significant difference in postoperative bleeding and blood transfusion requirements, but showed no variation in renal and cardiopulmonary function. The authors suggest that the Capiox II is to be preferred for extra-corporeal circulation of medium duration, for which it combines the advantages of both bubble and membrane oxygenators, while being less complex and costly than previously marketed membrane devices. PMID- 3667676 TI - Surgical treatment of left main coronary stenosis. Notes on 179 consecutive patients. AB - The authors report the clinical haemodynamic and angiographic data and early and late postoperative results of 179 patients consecutively operated on for left main coronary artery stenosis. Operative mortality was 3.9%; incremental risk factors were identified by univariate analysis and included female sex, unstable angina pectoris and congestive heart failure. Late postoperative mortality was 4.9%. After a mean follow-up of 31 months overall survival is 91.6%; the great majority of survivors are doing well, free from anginal pain, while 16.4% of patients experience recurrent angina pectoris of lesser severity than before operation (I-II C.C.S. class) and well controlled by medical treatment alone. PMID- 3667677 TI - Clinical experience with the Bjork-Shiley integral monostrut heart valve prosthesis in the aortic and mitral position. AB - From May 1982 to May 1985, 174 Bjork-Shiley integral monostrut (BSIM) heart valve prostheses were implanted in 160 patients. Eighty-eight valves were placed in mitral and 86 in aortic position. There were 92 males and 78 females with a mean age of 54.1 years (140 patients were in NYHA class III or IV (87.5%]. Single valve replacement was performed in 116 (72%) patients, 30 (19%) underwent multiple valve procedures and in 14 (9%) valve replacement was combined with coronary artery bypass surgery. There were no intraoperative deaths. Six patients died within the first month after surgery. One hundred and fifty-two (98.7%) patients were followed for a total of 190 patient years (average 14.8 months per patient). There were 8 late deaths (4.2 per 100 patient-years), 5 of these were valve related. Valve related complications were observed in 9 patients (4.5 per 100 patient-years). The overall incidence of peripheral embolization was 2.6 per 100 patient years. At the time of the follow-up study 136 (94%) patients were in functional class I and II. Fourteen patients with isolated AVR and six with MVR underwent hemodynamic evaluation on an average of 12 and 10 months after surgery. The early results suggest that the BSIM prosthesis represents a promising alternative in heart valve replacement, because there were no mechanical failures, thromboembolic complications are rare and hemodynamic performance is good. PMID- 3667678 TI - Swan-Ganz catheter induced pulmonary hemorrhage. AB - In over 3500 consecutive open heart procedures using Swan-Ganz catheterization at our institution, we have experienced three major pulmonary artery injuries secondary to this procedure. Pulmonary artery hemorrhage is a rare but frequently fatal complication and a mortality rate as high as fifty percent has been reported. In two of these cases, major retraction of the heart was needed for adequate exposure of the cardiac pathology. The Swan-Ganz catheter inadvertently was advanced into the wedge position for prolonged intervals of time, and periodic overdistention of the balloon occurred. The third case occurred in the cardiac catheterization laboratory. The need for aggressive surgical approach has been demonstrated. The authors have recommended steps to be taken when massive hemoptysis occurs and Swan-Ganz catheter perforation of the pulmonary artery is suspected. Re-evaluation of the "routine" use of the Swan-Ganz catheter may be necessary and overutilization may be a distinct possibility. When the use of this catheter is deemed appropriate, a more exact positioning of the distal portion of the catheter is mandatory if pulmonary artery perforation is to be avoided. PMID- 3667679 TI - Left ventricular function and coronary morphology with anomalous origin of the left coronary artery from the pulmonary artery. AB - Reconstructive surgery of the left coronary artery system was performed in two adult patients with anomalous origin of the left coronary artery from the pulmonary artery. Postoperative studies were carried out at 2 months and at 49 months. Left ventricular volume, left ventricular myocardial mass, and ejection fraction were normal postoperatively in one patient. In the second patient, the left ventricular volume was markedly reduced, but the decrease in left ventricular mass was less pronounced. Dilatation and tortuosity of the right coronary artery disappeared postoperatively in both patients. However, the dilatation and tortuosity of the left coronary artery persisted on coronary arteriogram. PMID- 3667680 TI - Graft inclusion technique for thoracoabdominal aortic aneurysms involving visceral branches with the aid of a femoro-femoral bypass. AB - Eleven patients in our institution with thoracoabdominal aortic aneurysms involving the celiac, superior mesenteric and renal arteries underwent surgical treatment with the aid of a partial femoro-femoral bypass during the last three years. Three patients with expanding aneurysms underwent emergency operations. Another three patients with extensive aneurysms had two-stage operations: initial aortic arch or descending thoracic graft replacement followed by thoracoabdominal graft replacement in the second stage. Exposure of the aneurysms was made through a left transthoracic, retroperitoneal abdominal approach in all patients. The surgical technique employed in most cases in this series was graft inclusion with direct reattachment of the visceral vessels by anastomosis to an opening made in the graft. Pairs of intercostal and lumbar arteries between the levels of the ninth thoracic and fourth lumbar regions were reconstructed in a similar fashion on the basis of monitoring somatosensory evoked potentials. The operations were performed with the aid of a partial femoro-femoral bypass with selective celiac and renal arterial perfusion in most cases. All patients but one survived the operation and are leading normal lives late in the postoperative period. Graft inclusion with the aid of a partial bypass is a valid technique for the treatment of thoracoabdominal aortic aneurysms involving visceral branches. PMID- 3667681 TI - Carotid siphon stenosis. AB - Seventy-one cases of carotid siphon stenosis were analyzed for symptom presentation, non-invasive diagnosis, angiographic and CT scan features, and outcome. Our experience indicates that carotid siphon stenosis is a dangerous lesion with serious neurological sequelae, including a high stroke rate. Indirect evidence is presented to suggest that distal embolization is a significant feature of carotid siphon lesion. PMID- 3667682 TI - Etiology and management of aorto-femoral bypass graft failure. AB - Over a nine-year period 1973 to 1982, 364 aorto-bifemoral bypass grafts were inserted for aorto-iliac occlusive disease and 45 graft failures were encountered. Twelve patients developed acute graft occlusion, occurring less than 30 days postoperatively (Group I). These failures were almost all due to technical problems, the most common cause was elevation of an intimal flap following local endarterectomy. Five patients (Group II) developed recurrent symptoms without actual thrombosis or occlusion of the graft, but were associated with neointimal hyperplasia at the distal anastomosis and evidence of distal atherosclerosis. Twenty-eight patients were late failures (Group III). These patients thrombosed their grafts more than 30 days postoperatively. Four patients thrombosed both limbs of the graft at separate intervals. Nineteen patients were found to have progressive atherosclerosis affecting their run-off vessels. Six patients were found to have stenosis limited to the distal anastomosis. False aneurysm, kinking of the graft, and proximal suture line stenosis were felt to be determining factors in 3 other incidences of graft failure. The most common treatment in Group I was thrombectomy and securing of the raised intimal flap. The patients in Group II were treated with local endarterectomy and patch angioplasty. Of the patients in Group III, the most common inflow procedure was thrombectomy, carried out in 17 cases. In Group III, 13 of 28 patients underwent profundaplasty to improve outflow. The importance of pre and postoperative angiography in defining the etiology of graft failure is stressed. It is important to rule out problems with the proximal anastomosis. Once inflow has been established, angiography should ensure that an adequate outflow procedure has been performed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667683 TI - Scanning electron microscopy as a diagnostic procedure in giant cell arteritis. AB - Forty-five consecutive patients (32 women and 13 men) underwent biopsy of the temporal artery because of suspected giant cell arteritis. Their ages ranged from 38 to 84 years, mean 68.1 years. Five patients (11.1%) four of them women, were found to be affected by the disease. Their ages ranged from 54 to 80 years, mean 69 years. Clinical and laboratory findings included elevated erythrocyte sedimentation rate, prolonged fever, continuous headache, sudden onset of unilateral blindness, intermittent mandibular claudication, severe anemia and myalgia. None of these, whether present in isolation or in various combinations, were of significant diagnostic value. All biopsies were examined both by light microscopy and by scanning electron microscopy. The former examination took about 5-7 days to complete, and the latter about 3 hours. Light microscopy studies showed that 46.6% of the arterial biopsies were normal, 42.3% were arteriosclerotic and 11.1% (5 specimens) were characteristic of giant cell arteritis. Scanning electron microscopy revealed that the biopsies obtained from all five patients found to have temporal arteritis displayed the "occlusive" pattern: the three-laminar appearance of the artery was markedly distorted or lost, the internal elastic lamina was barely detectable, and the densely hypertrophied media and intima filled the arterial lumen, virtually obliterating it. We conclude that scanning electron microscopy is a quick and accurate procedure for diagnosis of temporal arteritis and that positive findings may be taken as an indication for immediate steroid treatment. PMID- 3667684 TI - Tibial artery autogenous in situ vein bypass with adjunctive arteriovenous fistula. AB - A man suffering from severe intermittent claudication of the right calf and foot was successfully treated by femoro-tibio-peroneal trunk autogenous vein bypass with adjunctive arteriovenous fistula. Prior to operation, he was unable to walk more than 50 meters without resting. Preoperative arteriography revealed extensive occlusion of the popliteotibial arteries, except for indistinct visualization of the tibio-peroneal trunk, in which conventional reconstructive surgery seemed not to be feasible because of poor distal run-off. An autogenous vein bypass graft between the distal superficial femoral artery and tibio peroneal trunk was successfully made "in-situ", creating an adjunctive arteriovenous fistula. Postoperatively, the ankle pressure index of the posterior tibial artery was considerably increased from 0 to 0.65, and Doppler flow wave could be recorded. The patient can now walk more than 1,500 meters without resting. PMID- 3667685 TI - Iatrogenic vascular injuries following lumbar disc surgery. Case report and review of the literature. AB - Iatrogenic vascular injuries are unusual complications of lumbar disc surgery. The incidence of such injuries is very low but probably underestimated because clinical manifestations may be extremely variable depending on the extension of trauma whether artery or vein are injured or both. Diagnosis is suspected when early signs of retroperitoneal hemorrhage appear, but may often be delayed for weeks or years because formation of a pseudoaneurysm or an arteriovenous fistula which may be of gradual onset and produce only a few symptoms at the onset. Prompt diagnosis and aggressive treatment can hope to improve current mortality of more than 50%. A case of venous and arterial injury is reported, successfully operated on with an original technique of ilio-caval patching to avoid caval ligation. A review of the literature shows the predisposing factors and complex anatomy of such injuries, the clinical picture and the management of the emergency. PMID- 3667686 TI - Abdominal aortic aneurysm and dissection after blunt trauma. AB - A case of abdominal aortic aneurysm and dissection after blunt trauma is presented. Unlike traumatic lesions of the thoracic aorta, this condition seems to be extremely rare, and may therefore deserve publication. Conservative surgery (resection of the dissected intimal flaps, closure of the aortotomy with a Blalock-type vascular suture) gave good early and late (6 years follow-up) results. PMID- 3667687 TI - An unusual manifestation of congenital abdominal aortic coarctation. AB - Coarctation of the abdominal aorta is uncommon, occurring in only 0.5-2% of aortic coarctations. This disease is usually manifest by upper body hypertension. A case report of a thirty-three-year-old female who had the unusual manifestation of peripheral emboli to both lower extremities secondary to fibrin emboli from her infrarenal segmental aortic coarctation was presented. This is the only case we know of to be manifest in this manner. No others could be found in an English language literature search. PMID- 3667688 TI - Spinal osteomyelitis: an unusual complication in aortic graft surgery. AB - The case history of a patient with vertebral osteomyelitis due to a contiguous paraprosthetic aortic abscess is reported. This unusual complication may be associated with the indolent nature of paraprosthetic aortic infections. The diagnostic as well as therapeutic value of computerised tomography in this condition is emphasized. PMID- 3667689 TI - Lampbrush chromosomes of the chicken, Gallus domesticus. AB - We examined lampbrush chromosomes (LBC) prepared from chicken oocytes of 1-3-mm diam using both light and electron microscopy. Both macro- and microchromosomes form LBC with morphologies very similar to the well known newt and salamander LBC. In chicken LBC typical loops have a contour length of approximately 15 microns, although some loops range up to 50 microns. Multiple transcription units are present on some loops. Electron microscopic examination of Miller spread preparations reveals closely spaced nascent transcripts typical of LBC transcription. We used 3H-labeled chicken DNA as a probe for light microscopic level in situ hybridization to repetitive sequences associated with nascent RNA transcripts. Approximately 25 sites were labeled, primarily on the microchromosomes, plus sites on chromosome 2 and on the putative sex chromosome. The small genome size of the chicken (1.2 pg) presents a considerable advantage over that of newts or salamanders in further study of LBC structure and function. PMID- 3667690 TI - Dithiothreitol and the translocation of preprolactin across mammalian endoplasmic reticulum. AB - The translocation mode of preprolactin (pPL) across mammalian endoplasmic reticulum was reinvestigated in light of recent findings that nascent secretory polypeptides synthesized in the presence of a highly reducing environment could be translocated posttranslationally and independently of their attachment to the ribosome (Maher, P. A., and S. J. Singer, 1986, Proc. Natl. Acad. Sci. USA, 83:9001-9005). The effects of the reducing agent dithiothreitol (DTT) on pPL synthesis and translocation were studied in this respect. The translocation of pPL was shown to take place only cotranslationally. The apparent posttranslational translocation was due to ongoing chain synthesis irrespective of the presence of high concentrations of DTT. When synthesis was completely blocked, no translocation was observed in the presence or absence of DTT. The synthesis of pPL was retarded by DTT, while its percent translocation was enhanced. The retardation in synthesis was reflected in reduced rates of initiation and elongation. As a consequence of this retardation, which increases the ratio of microsomes to nascent chains, and of possible effects on the conformation of nascent pPL and components of the translocation apparatus, DTT may expand the time and chain length windows for nascent chain translocation competence. PMID- 3667691 TI - Lumenal location of the microsomal beta-glucuronidase-egasyn complex. AB - Mouse liver beta-glucuronidase is stabilized within microsomal vesicles by complexation with the accessory protein egasyn. The location of the beta glucuronidase-egasyn complex and free egasyn within microsomal vesicles was investigated. Surprisingly, it was found that neither the complex nor free egasyn are intrinsic membrane components. Rather, both are either free within the vesicle lumen or only weakly bound to the inside of the vesicle membrane. This conclusion was derived from release studies using low concentrations of Triton X 100 or controlled sonication. Both the intact complex and free egasyn were released in parallel with lumenal proteins, not with intrinsic membrane components. Also, beta-glucuronidase was protected from digestion by proteinase K by the membrane of microsomal vesicles. The hydrophilic nature of both the complex and free egasyn was confirmed by phase separation experiments with the detergent Triton X-114. Egasyn is one of an unusual group of esterases that, despite being located within the lumen or only weakly bound to the lumenal surface of the endoplasmic reticulum, do not enter the secretory pathway. PMID- 3667692 TI - Sorting of three secretory proteins to distinct secretory granules in acidophilic cells of cow anterior pituitary. AB - The distribution of three proteins discharged by regulated exocytosis--growth hormone (GH), prolactin (PRL), and secretogranin II (SgII)--was investigated by double immunolabeling of ultrathin frozen sections in the acidophilic cells of the bovine pituitary. In mammotrophs, heavy PRL labeling was observed over secretory granule matrices (including the immature matrices at the trans Golgi surface) and also over Golgi cisternae. In contrast, in somatotrophs heavy GH labeling was restricted to the granule matrices; vesicles and tubules at the trans Golgi region showed some and the Golgi cisternae only sparse labeling. All somatotrophs and mammotrophs were heavily positive for GH and PRL, respectively, and were found to contain small amounts of the other hormone as well, which, however, was almost completely absent from granules, and was more concentrated in the Golgi complex, admixed with the predominant hormone. Mixed somatomammotrophs (approximately 26% of the acidophilic cells) were heavily positive for both GH and PRL. Although admixed within Golgi cisternae, the two hormones were stored separately within distinct granule types. A third type of granule was found to contain SgII. Spillage of small amounts of each of the three secretory proteins into granules containing predominantly another protein was common, but true intermixing (i.e., coexistence within single granules of comparable amounts of two proteins) was very rare. It is concluded that in the regulated pathway of acidophilic pituitary, cell mechanisms exist that cause sorting of the three secretory proteins investigated. Such mechanisms operate beyond the Golgi cisternae, possibly at the sites where condensation of secretion products into granule matrices takes place. PMID- 3667694 TI - The crystal lattice of Paramecium trichocysts before and after exocytosis by X ray diffraction and freeze-fracture electron microscopy. AB - Paramecium trichocysts are unusual secretory organelles in that: (a) their crystalline contents are built up from a family of low molecular mass acidic proteins; (b) they have a precise, genetically determined shape; and (c) the crystalline trichocyst contents expand rapidly upon exocytosis to give a second, extracellular form which is also an ordered array. We report here the first step of our study of trichocyst structure. We have used a combination of x-ray powder diffraction, freeze-etching, and freeze-fracture electron microscopy of isolated, untreated trichocysts, and density measurements to show that trichocyst contents are indeed protein crystals and to determine the elementary unit cell of both the compact intracellular and the extended extracellular form. PMID- 3667693 TI - Sorting of sphingolipids in epithelial (Madin-Darby canine kidney) cells. AB - To study the intracellular transport of newly synthesized sphingolipids in epithelial cells we have used a fluorescent ceramide analog, N-6[7-nitro-2,1,3 benzoxadiazol-4-yl] aminocaproyl sphingosine (C6-NBD-ceramide; Lipsky, N. G., and R. E. Pagano, 1983, Proc. Natl. Acad. Sci. USA, 80:2608-2612) as a probe. This ceramide was readily taken up by filter-grown Madin-Darby canine kidney (MDCK) cells from liposomes at 0 degrees C. After penetration into the cell, the fluorescent probe accumulated in the Golgi area at temperatures between 0 and 20 degrees C. Chemical analysis showed that C6-NBD-ceramide was being converted into C6-NBD-sphingomyelin and C6-NBD-glucosyl-ceramide. An analysis of the fluorescence pattern after 1 h at 20 degrees C by means of a confocal scanning laser fluorescence microscope revealed that the fluorescent marker most likely concentrated in the Golgi complex itself. Little fluorescence was observed at the plasma membrane. Raising the temperature to 37 degrees C for 1 h resulted in intense plasma membrane staining and a loss of fluorescence from the Golgi complex. Addition of BSA to the apical medium cleared the fluorescence from the apical but not from the basolateral plasma membrane domain. The basolateral fluorescence could be depleted only by adding BSA to the basal side of a monolayer of MDCK cells grown on polycarbonate filters. We conclude that the fluorescent sphingomyelin and glucosylceramide were delivered from the Golgi complex to the plasma membrane where they accumulated in the external leaflet of the membrane bilayer. The results also demonstrated that the fatty acyl labeled lipids were unable to pass the tight junctions in either direction. Quantitation of the amount of NBD-lipids delivered to the apical and the basolateral plasma membranes during incubation for 1 h at 37 degrees C showed that the C6-NBD glucosylceramide was two- to fourfold enriched on the apical as compared to the basolateral side, while C6-NBD-sphingomyelin was about equally distributed. Since the surface area of the apical plasma membrane is much smaller than that of the basolateral membrane, both lipids achieved a higher concentration on the apical surface. Altogether, our results suggest that the NBD-lipids are sorted in MDCK cells in a way similar to their natural counterparts. PMID- 3667695 TI - Visualization of myosin in living cells. AB - Myosin light chains labeled with rhodamine are incorporated into myosin containing structures when microinjected into live muscle and nonmuscle cells. A mixture of myosin light chains was prepared from chicken skeletal muscle, labeled with the fluorescent dye iodoacetamido rhodamine, and separated into individual labeled light chains, LC-1, LC-2, and LC-3. In isolated rabbit and insect myofibrils, the fluorescent light chains bound in a doublet pattern in the A bands with no binding in the cross-bridge-free region in the center of the A bands. When injected into living embryonic chick myotubes and cardiac myocytes, the fluorescent light chains were also incorporated along the complete length of the A band with the exception of the pseudo-H zone. In young myotubes (3-4 d old), myosin was localized in aperiodic as well as periodic fibers. The doublet A band pattern first appeared in 5-d-old myotubes, which also exhibited the first signs of contractility. In 6-d and older myotubes, A bands became increasingly more aligned, their edges sharper, and the separation between them (I bands) wider. In nonmuscle cells, the microinjected fluorescent light chains were incorporated in a striated pattern in stress fibers and were absent from foci and attachment plaques. When the stress fibers of live injected cells were disrupted with DMSO, fluorescently labeled myosin light chains were present in the cytoplasm but did not enter the nucleus. Removal of the DMSO led to the reformation of banded, fluorescent stress fibers within 45 min. In dividing cells, myosin light chains were concentrated in the cleavage furrow and became reincorporated in stress fibers after cytokinesis. Thus, injected nonmuscle cells can disassemble and reassemble contractile fibers using hybrid myosin molecules that contain muscle light chains and nonmuscle heavy chains. Our experiments demonstrate that fluorescently labeled myosin light chains from muscle can be readily incorporated into muscle and nonmuscle myosins and then used to follow the dynamics of myosin distribution in living cells. PMID- 3667696 TI - Lowering pH in blood platelets dissociates myosin phosphorylation from shape change and myosin association with the cytoskeleton. AB - Platelet shape change induced by ADP is relatively independent of external pH over the range 6-7. If the chloride ion in the buffer is replaced by weak acids, however, shape change is rapidly and reversibly inhibited as a function of lowered pH (92% at pH 6.0). This inhibition is correlated with lowered internal pH caused by the weak acids, as measured by the 5,5-dimethyloxazolidine 2,4-dione technique. Shape change was 50% inhibited at internal pH 6.4 when 50 mM NaCl was replaced by propionate (PR). When platelets were stimulated with ADP 10-20 s after addition of PR to a final pH of 6 (PR6), both myosin light chain (MLC) phosphorylation and myosin and actin association with the cytoskeleton were reduced in correlation with the inhibition of shape change. But when ADP was added 30 s after PR6, the MLC phosphorylation was essentially the same in PR or in chloride, although shape change and myosin and actin association with the cytoskeleton remained inhibited. This was shown to be due mainly to endogenous phosphorylation of MLC. On return to neutral pH, platelets in PR immediately changed shape and myosin and actin became associated with the cytoskeleton. Two dimensional tryptic peptides of MLC showed two major spots after PR6 treatment, indicating that both the MLC kinase site and the protein kinase C sites were phosphorylated. The results show that increased internal pH is not required for shape change, although it may affect the rate. In PR6, as after phorbol esters, MLC phosphorylation can be uncoupled from shape change. The association of myosin and actin with the cytoskeleton is closely correlated with shape change, suggesting that shape change requires the active interaction of these contractile proteins. PMID- 3667697 TI - Cytoskeletal reorganization of human platelets after stimulation revealed by the quick-freeze deep-etch technique. AB - We studied the cytoskeletal reorganization of saponized human platelets after stimulation by using the quick-freeze deep-etch technique, and examined the localization of myosin in thrombin-treated platelets by immunocytochemistry at the electron microscopic level. In unstimulated saponized platelets we observed cross-bridges between: adjoining microtubules, adjoining actin filaments, microtubules and actin filaments, and actin filaments and plasma membranes. After activation with 1 U/ml thrombin for 3 min, massive arrays of actin filaments with mixed polarity were found in the cytoplasm. Two types of cross-bridges between actin filaments were observed: short cross-bridges (11 +/- 2 nm), just like those observed in the resting platelets, and longer ones (22 +/- 3 nm). Actin filaments were linked with the plasma membrane via fine short filaments and sometimes ended on the membrane. Actin filaments and microtubules frequently ran close to the membrane organelles. We also found that actin filaments were associated by end-on attachments with some organelles. Decoration with subfragment 1 of myosin revealed that all the actin filaments associated end-on with the membrane pointed away in their polarity. Immunocytochemical study revealed that myosin was present in the saponin-extracted cytoskeleton after activation and that myosin was localized on the filamentous network. The results suggest that myosin forms a gel with actin filaments in activated platelets. Close associations between actin filaments and organelles in activated platelets suggests that contraction of this actomyosin gel could bring about the observed centralization of organelles. PMID- 3667698 TI - Flagellar root contraction and nuclear movement during flagellar regeneration in Chlamydomonas reinhardtii. AB - When Chlamydomonas cells are deflagellated by pH shock or mechanical shear the nucleus rapidly moves toward the flagellar basal apparatus at the anterior end of the cell. During flagellar regeneration the nucleus returns to a more central position within the cell. The nucleus is connected to the flagellar apparatus by a system of fibers, the flagellar roots (rhizoplasts), which undergo a dramatic contraction that coincides with anterior nuclear movement. A corresponding extension of the root system, back to its preshock configuration is observed as the nucleus retracts to a central position. Anterior displacement of the nucleus and flagellar root contraction require free calcium in the medium. Nuclear movement and flagellar root contraction and extension are not sensitive to inhibitors of protein synthesis (cycloheximide), or drugs that influence either microtubules (colchicine) or actin-based microfilaments (cytochalasin D). Detergent-extracted cell models contract and extend their flagellar roots and move their nuclei in response to alterations of free calcium levels in the medium. Cycles of nuclear movement in detergent-extracted models require ATP to potentiate the contractile mechanism for subsequent calcium-induced contraction. Flagellar root contraction and nuclear movement in Chlamydomonas may be causally related to signaling of induction of flagellar precursor genes or to the transport of flagellar precursors or their messages to sites of synthesis or assembly near the basal apparatus of the cell. PMID- 3667699 TI - Effects of preganglionic denervation and postganglionic axotomy on acetylcholine receptors in the chick ciliary ganglion. AB - The regulation of nicotinic acetylcholine receptors (AChRs) in chick ciliary ganglia was examined by using a radiolabeled anti-AChR mAb to quantitate the amount of receptor in ganglion detergent extracts after preganglionic denervation or postganglionic axotomy. Surgical transection of the preganglionic input to the ciliary ganglion in newly hatched chicks caused a threefold reduction in the total number of AChRs within 10 d compared with that present in unoperated contralateral control ganglia. Surgical transection of both the choroid and ciliary nerves emerging from the ciliary ganglion in newly hatched chicks to establish postganglionic axotomy led to a nearly 10-fold reduction in AChRs within 5 d compared with unoperated contralateral ganglia. The declines were specific since they could not be accounted for by changes in ganglionic protein or by decreases in neuronal survival or size. Light microscopy revealed no gross morphological differences between neurons in operated and control ganglia. A second membrane component of cholinergic relevance on chick ciliary ganglion neurons is the alpha-bungarotoxin (alpha-Bgt)-binding component. The alpha-Bgt binding component also declined in number after either postganglionic axotomy or preganglionic denervation, but appeared to do so with a more rapid time course than did ganglionic AChRs. The results imply that cell-cell interactions in vivo specifically regulate both the number of AChRs and the number of alpha-Bgt binding components in the ganglion. Regulation of these neuronal cholinergic membrane components clearly differs from that previously described for muscle AChRs. PMID- 3667700 TI - Characterization of concentration gradients of a morphogenetically active retinoid in the chick limb bud. AB - It has long been suggested that the generation of biological patterns depends in part on gradients of diffusible substances. In an attempt to bridge the gap between this largely theoretical concept and experimental embryology, we have examined the physiology of diffusion gradients in an actual embryonic field. In particular, we have generated in the chick wing bud concentration gradients of the morphogenetically active retinoid TTNPB, (E)-4-[2-(5,6,7,8-tetrahydro-5,5,8,8 tetramethyl-2-naphthalenyl)-1-prope nyl] benzoic acid, a synthetic vitamin A compound. Upon local application of TTNPB the normal 234 digit pattern is duplicated in a way that correlates with the geometry of the underlying TTNPB gradient; low doses of TTNPB lead to a shallow gradient and an additional digit 2, whereas higher doses result in a steep, far-reaching gradient and patterns with additional digits 3 and 4. The experimentally measured TTNPB distribution along the anteroposterior axis, can be modeled by a local source and a dispersed sink. This model correctly predicts the site of specification of digit 2, and provides an empirical estimate of the diffusion coefficient (D) of retinoids in embryonic limb tissue. The numerical value of approximately 10(-7) cm2s-1 for D suggests that retinoids are not freely diffusible in the limb rudiment, but interact with the previously identified cellular retinoic acid binding protein. In addition, D affords an estimate of the time required to establish a diffusion gradient as 3 to 4 h. This time span is in a range compatible with the time scale of pattern specification in developing vertebrate limbs. Our studies support the view that diffusion of morphogenetic substances is a plausible mechanism of pattern formation in secondary embryonic fields. PMID- 3667702 TI - Apurinic site induction in the DNA of cells heated at hyperthermic temperatures. AB - The induction of DNA damage in cells heated at hyperthermic (43-48 degrees C) temperatures was determined by alkaline filter elution and alkaline sucrose gradient-sedimentation analysis of cell DNA denatured at pH 13.0. A class of DNA lesion which converted to strand breaks during denaturation of DNA at pH 13.0 was produced randomly throughout the cell DNA at temperatures as low as 43 degrees C. Induction of this lesion occurred with a T0 of 90 and 10 min at 45 and 48 degrees C, respectively. We estimate that these pH 13.0-detectable DNA lesions are produced in the cell DNA with a frequency of approximately 75 and 660 per min of heating at 45 and 48 degrees C, respectively. Since the lesions were quantitatively converted to DNA strand breaks at pH 13.0 with a half-time of 30 min, or less, we suggest that these pH 13.0-detectable DNA lesions are heat induced, abasic DNA sites. The induction of these lesions does not appear to be directly involved in the initial heat-induced inhibition of DNA synthesis. The presence of these lesions cannot be excluded as an explanation for the long-term inhibition of replicon initiated in heated cells. PMID- 3667701 TI - Cell cycle changes in water properties in sea urchin eggs. AB - This study concerned changes in the motional properties of cellular water during the first cell cycle of fertilized sea urchin eggs (Lytechinus variegatus). There was a significant decrease in proton NMR T1 relaxation time and in cytoplasmic ice crystal growth during mitosis and a significant increase in T1 time and cytoplasmic ice crystal size during cleavage. This was not caused by egg water content changes as reflected by egg volume measurements. Removal of both the fertilization membrane and the hyaline layer shortly after fertilization did not alter the pattern of T1 time changes at mitosis and cleavage as compared to whole eggs; thus, the pattern of T1 time changes was attributed to intracellular events. Treatment of fertilized eggs with cytochalasin B, an inhibitor of actin polymerization, did not block the fall in T1 time at mitosis, but did block cytokinesis and the increase in T1 time, which normally occurred at cleavage. A significant pattern of actin disassembly and reassembly at mitosis and cytokinesis was found by studies on the total amount of monomeric actin (G actin) using the DNase I assay. This led to the hypothesis that the observed changes in T1 time and ice crystal size during the first cell cycle were due to the depolymerization and polymerization of cytoplasmic actin. To test this, the effect of the in vitro polymerization of purified actin on the T1 time and on ice crystal growth was examined. It was concluded that changes in the T1 time and ice crystal growth upon polymerization of actin in vitro resembled the changes seen in vivo. These results suggest that changes in the motional properties of cytoplasmic water during the first cell cycle are due, at least in part, to the state of polymerization of cytoplasmic actin. PMID- 3667703 TI - Role of biosynthesis of cholesterol and isoprenoid derivatives in regulation of G1 progression and cell proliferation of 3T6 cells. AB - The growth of 3T6-cells was rapidly decreased, although not completely stopped, as a consequence of treatment of the cell cultures with serum-free medium. By analyzing the cell cycle traverse it was found that the decrease in growth rate was attributable to a 6-8-h delay in progression through the proximal part of G1. These effects of serum depletion on cell-cycle traverse and cell proliferation were compared with simultaneous effects on the activity of 3-hydroxy-3 methylglutaryl coenzyme A (HMG CoA) reductase and the biosynthesis of cholesterol and the two isoprenoid derivatives coenzyme Q and dolichol. The activity of HMG CoA reductase was unaffected during the first 8 h of serum depletion and depressed by approximately 50% during the next 16 h. In contrast, the rate of coenzyme Q and dolichol synthesis, as related to cholesterol synthesis, was substantially decreased, and within 4 h after shift to serum-free medium both were reduced by 70-80%. As distinguished from dolichol synthesis, the synthesis of coenzyme Q was even decreased following exposures of the cell cultures to cholesterol-poor serum. This indicates that the rate of coenzyme Q synthesis is dependent on the concentration of serum cholesterol, whereas rate of dolichol synthesis is stimulated by some other serum factor(s). In addition, supplementation with dolichol to serum-depleted cells partially normalized G1 traverse and DNA synthesis, whereas cholesterol or coenzyme Q was ineffective. Taken together, the results suggest that a certain level of de novo synthesis of dolichol is required to maintain normal cell-cycle traverse and growth of 3T6 cells. PMID- 3667704 TI - Mechanism of sucrose uptake by isolated rat hepatocytes. AB - The transport of molecules by nonspecific endocytosis has been described in many cell types, but it has not been characterized in hepatocytes. Because of its central role in the clearance of solutes from portal blood, endocytosis might represent a significant mode of cellular transport. We investigated the mechanism of sucrose uptake in an isolated hepatocyte system. Liver cells were isolated by perfusion and collagenization of rat liver, followed by differential centrifugation. Hepatocytes were then incubated with 14C-sucrose and harvested by spinning through oil in microfuge tubes. Radioactivity was standardized against DNA content. We found that sucrose uptake is concentration-dependent from 5 microM to 100 mM and follows first-order kinetics. Washout studies indicate that exocytosis is responsible for the dynamic equilibrium reached. Arrhenius analysis of temperature dependence yields a linear plot (Ea = 14.2 Kcal/mol). In addition, sucrose uptake is independent of cellular ATP levels. We conclude that sucrose is transported by fluid-phase micropinocytosis in isolated hepatocytes and that this transport mechanism may be important in the uptake of diverse molecules into liver cells. PMID- 3667705 TI - Superoxide dismutase activity and glutathione concentration during the calcium induced differentiation of Physarum polycephalum microplasmodia. AB - Microplasmodia of Physarum polycephalum differentiate into spherules when the CaCl2 concentration of their nutrient medium is increased to 54mM (high-calcium). The salts starvation medium routinely used to induce differentiation contains 8mM CaCl2. This medium will not induce spherulation in the absence of a calcium salt; no other metal is essential. High-calcium also induces the spherulation of a strain of Physarum that had not been previously observed to spherulate. The striking increase in superoxide dismutase activity (SOD) and the decrease in glutathione concentration (GSH) that are characteristic of salts-induced spherulation do not occur in salts media containing high-calcium. In the absence of calcium, no significant change in SOD is observed and very little change in GSH occurs. The immediate effect of the oxidative stress associated with spherulation may be the release of calcium stores into the cytosol. The parameters modulating this stress are, in turn, sensitive to exogenous calcium concentrations. PMID- 3667706 TI - Mouse embryonic stem cells exhibit indefinite proliferative potential. AB - The proliferative potential of embryonic stem cells was examined. In contrast to the current concept of the finite life-span being the hallmark of normal cells, we have been able to maintain these embryonic stem cells in vitro up to about 250 cumulative doublings with no indication of "crisis" or transformation. These cells could be considered normal on the basis of: (1) their apparently normal diploid karyotype, (2) their ability to extensively colonize embryos without causing tumors and developmental anomalies, and (3) their ability to form normal gametes when differentiated into the germ-line. These results suggest that embryonic stem cells prior to differentiation into germ and somatic cells are indeed immortal. PMID- 3667707 TI - Increased adherence of oxidant-treated human and bovine erythrocytes to cultured endothelial cells. AB - Bovine erythrocytes, which normally lack phosphatidyl choline in their membranes, when treated with either H2O2 or diamide (1-3 mM), showed a partial appearance of phosphatidyl ethanolamine (PE 40%) and phosphatidyl serine (PS, 30-33%) in the external leaflet of the bilayer and a concomitant increased (four- to five-fold) propensity to adhere to cultured bovine aortic endothelial cells. Similar treatment of normal human erythrocytes caused an alteration in the organization of the phospholipid bilayer and also resulted in their increased adherence to endothelial cells derived either from human umbilical vein or bovine aorta. Treatment of RBCs with H2O2 at low concentration (0.5 mM) resulted in cross linking of spectrin without significant changes in the orientation of aminophospholipids but the RBCs exhibited 15-20% increase in adherence to endothelial cells. Pretreatment of either human or bovine erythrocytes with antioxidants such as vitamin E (2 mM) prevented both oxidant-induced reorganization of phospholipids in the bilayer and enhancement of adherence to endothelial cells. Introduction of either phosphatidyl serine or phosphatidyl ethanolamine but not phosphatidyl choline into erythrocyte membranes increased their adherence to endothelial cells threefold. Oxidant-treated RBCs exhibited enhanced binding and fluorescence of Merocyanine 540 dye (MC-540), which is sensitive to the packing of lipids in the lipid bilayer. On flow cytometric analysis, 78% of H2O2 (0.5 mM)-treated erythrocytes compared to 30% of untreated RBCs exhibited MC-540 binding and fluorescence, indicating differences in the lipid packing in the outer leaflet of the bilayer. Oxidant-treated erythrocytes adhere preferentially to endothelial cells rather than to bovine aortic smooth muscle cells and skin fibroblasts. It is suggested that the alterations in the erythrocyte membrane surface due to spectrin cross-linking and the organization of the phospholipids concomitant with less ordered packing in the external leaflet of the bilayer, either induced by oxidative manipulation in normal RBC or in pathological erythrocytes, play a role in erythrocyte-endothelial cell interaction. PMID- 3667708 TI - Erythropoiesis in murine long-term bone-marrow cell cultures: dependence on erythropoietin and endogenous production of an erythropoietic stimulating activity. AB - Erythropoiesis was obtained in murine long-term bone-marrow cell cultures (LTBMCs) in the presence of erythropoietin (Epo) when the medium was frequently renewed. The level of the erythropoietic differentiation was shown to be a function of the erythropoietin concentration. In response to Epo addition, an activity which stimulates CFU-E proliferation in semisolid cultures of fresh bone marrow cells was detected in the LTBMC supernatants. These results suggest that another factor, whose synthesis may be under Epo control, participates in the stimulation of erythropoiesis in vitro. PMID- 3667709 TI - Reconstituted basement-membrane matrix modulates fibroblast activities in vitro. AB - Cellular growth and collagen biosynthesis were compared in dermal calf fibroblasts cultured on plastic or on a reconstituted basement membrane gel, termed matrigel. This matrix, extracted from Engelbreth-Holm-Swarm tumors, consists mainly of laminin, entactin, type IV collagen, and heparan sulfate proteoglycan. The multiplication rate of fibroblasts grown on matrigel was stimulated compared to that of monolayered cells cultured on plastic, and these cells formed multilayers after 4 days. Protein and collagen biosynthesis was reduced in fibroblasts cultured on matrigel. A higher proportion of the newly synthesized collagen (40%) was incorporated to the extracellular matrix in cultures grown on matrigel than in those grown on plastic (14%). Type III collagen was the preferential collagen type deposited on matrigel, and the ratio of type III:type I collagens secreted in the medium was also slightly higher in cultures grown on matrigel. Partially processed collagen was more abundant in fibroblasts grown on matrigel than in cells cultured on plastic. Finally, cells grown on matrigel exhibited a higher catabolic activity than cells grown on plastic. In this experimental model, the reconstituted basement-membrane matrix seems to influence the activities of fibroblasts significantly. PMID- 3667710 TI - Cytochemical and biochemical evidence of cathepsin B in malignant, transformed and normal breast epithelial cells. AB - Human breast cancer cell lines, as well as transformed mammary epithelial cells (HBL-100) and growth-stimulated normal breast epithelial cells showed positive cytochemical reaction with the proteinase substrate 2-(N-benzyloxycarbonyl-L arginyl-L-arginylamido)-4-methoxynapht halene, in the presence of 5 nitrosalicylaldehyde. The reaction product, small fluorescent granules, was distributed throughout the cytoplasm, in the perinuclear zone, in some cytoplasmic projections, and at the cell surface. Using a panel of various proteinase inhibitors, we found that the formation of the reaction product was an enzymic function of a cysteine proteinase. Using the substrate 7-(N benzyloxycarbonyl-L-arginyl-L-arginylamido)-4-methylcoumarin, we evaluated some biochemical properties of the cysteine proteinase, including pH-activity profile, pH stability, apparent relative molecular mass and sensitivity toward various proteinase inhibitors. We found that the proteinase from the studied breast epithelial cells exhibited characteristics of a mature form of cathepsin B. Taken together, the cytochemical and biochemical data provide evidence that human breast epithelial cells of cancer origin, as well as in the transformed or growth stimulated state express active cathepsin B and compartmentalize it into specific subcellular sites. PMID- 3667711 TI - Spreading behaviour of cultured fibroblasts from carriers of Duchenne muscular dystrophy. AB - Cultured skin fibroblasts from patients with Duchenne muscular dystrophy (DMD) are more sensitive than normal cells to prolonged exposure to the ionophore monensin. In a cell spreading assay in which cells were preincubated with monensin and subsequently allowed to adhere to and spread on a glass substratum in serum-free medium for 100 min, the mean transformed cell area of normal and DMD cells was 5.97 +/- 0.11 and 5.29 +/- 0.03, respectively. Cultured fibroblasts from carriers of DMD yielded a value of 5.59 +/- 0.03, which is intermediate between, and significantly different from, the values for both normal and DMD cultures. This result would be predicted on the basis of random X-chromosome inactivation in female carriers of this disorder. However, comparison of DMD carrier cell spreading data with data obtained from pooled and summated measurements taken from separate experiments using either normal or DMD fibroblasts suggest a more complex situation. Examination of the variance of the means of cell area for the true carrier population and the summated normal and DMD population provides evidence suggesting that some form of cellular interaction may occur between the two cell genotypes in culture. PMID- 3667712 TI - A simple microcomputer-based system for real-time analysis of cell behaviour. AB - An image analysis package based on a BBC microcomputer has been developed, which can simultaneously track many moving cells in vitro. Cells (rabbit neutrophil leucocytes, BHK C13 fibroblasts, or PC12 phaeochromocytoma cells) are viewed under phase optics with a monochrome TV camera, and the signal digitized. Successive frames are acquired by the computer as a 640 X 256 pixel array. Under controlled lighting conditions, cells can readily be isolated from the background by binary filtering. In real-time tracking, the positions of a given cell in successive frames are obtained by searching the area around the cell's centroid in the previous frame. A simple box-search algorithm is described, which proves highly successful at low cell densities. The resilience of different search algorithms to various exceptional conditions (such as collisions) is discussed. The success of this system in real-time tracking is largely dependent upon the leisurely speed of movement of cells, and on obtaining a clean, high quality optical image to analyse. The limitations of this technique for different cell types, and the possible configurations of more sophisticated hardware, are outlined. This system provides a versatile and automated solution to the problem of studying the movement of tissue cells. PMID- 3667713 TI - The ultrastructural localization of luciferase in three bioluminescent dinoflagellates, two species of Pyrocystis, and Noctiluca, using anti-luciferase and immunogold labelling. AB - In order to discover the intracellular location of luciferase in dinoflagellates, sections from a number of species were treated with a polyclonal anti-luciferase and the bound antibody was visualized at the electron-microscope level by indirect immunogold labelling. In two species of Pyrocystis and in Noctiluca, as in Gonyaulax, antibody became bound to dense vesicles, which correspond in size and position to light-emitting bodies detected in previous work. These vesicles resemble microsomes, are bounded by a single membrane and sometimes project into the vacuole. Unexpectedly, the trichocysts of Gonyaulax and Noctiluca and the related mucocysts of Pyrocystis also bound the antibody. This cross-reaction seems quite independent of bioluminescence, since the trichocysts of the non luminous Cachonina also reacted positively. The possibility is discussed that a protein, different from luciferase but having some antigenic similarity, is present in trichocysts and related organelles. PMID- 3667714 TI - Induced stabilization of the transmembrane potential of Drosophila cells by heat shock and periodic applications of chloramphenicol. AB - The transmembrane potential of Drosophila salivary gland cells is largely decreased (by 78% within 120 min) in response to the application of 5 mM chloramphenicol (CAP), with an initial slope of 0.5 mV min-1. This depolarization is reversed immediately after the CAP concentration is reduced to 0.06 mM by step wise dilution with normal medium. At the same concentration, thiamphenicol (TAP) induces only a small reversible depolarization by less than 30% within 120 min. These results are in agreement with the different effects of CAP and TAP on respiration and induction of the heat-shock genes, as known from previous data. The extent of induced membrane depolarization decreases with the number of repeated applications of CAP to the same cell, alternating with 75-min periods of recovery. Moreover, reduced sensitivity to CAP is also observed in cells recovering from a transient heat shock (30 min, 36 degrees C) 45 min prior to the addition of CAP. This phenomenon is inhibited by cycloheximide (0.1 mM), which suggests an involvement of heat-induced proteins in the stabilization of certain membrane functions. PMID- 3667715 TI - Dissociation and reassociation of trichocyst proteins: biochemical and ultrastructural studies. AB - Trichocysts, the crystalline exocytotic organelles in Paramecium tetraurelia, are composed of small, acidic proteins existing primarily as disulphide-linked dimers. We have disaggregated trichocyst proteins with heat, simultaneously observing the changes in morphology and protein composition. The tip matrix was most heat-labile; its subunits progressively broke away from the distal end. During this process, breakdown of the cylindrical shaft began. Shafts first became flattened and torn lengthwise, yielding smaller, interconnected pieces still having the crystalline arrangement of their 5 nm thick fibres. Ultimately this pattern became disordered, and discrete fibrils of the same thickness disengaged from the meshwork. In freeze-etched preparations these fibrils were composed of thinner filaments in side-by-side association. Disaggregation of the tip sheath began from the distal end before shaft dissociation was complete. Trichocysts broke down to thin fibrils, but probably not to monomeric subunits. At least three proteins were preferentially released in the initial phase of dissociation. Disulphide-reducing agent present during heating increased the rate of dissociation without altering the sequence of morphological changes or the order of release of individual proteins. The rate and extent of heat-induced dissociation were strongly dependent on pH and cation concentration. The stabilizing effects of low pH and of cations were additive. A cooled suspension of fully dissociated trichocysts reassociated into sedimentable aggregates with discernible filamentous order, but without the crystalline structure of intact trichocysts. Reassociation was dependent upon time, temperature and protein concentration. All but one of the trichocyst proteins re-entered the sedimentable aggregate during reassociation. Reassociation was faster and more complete at pH 6 than at pH 8 and was stimulated by Ca2+, Mg2+ and La3+. Trichocyst proteins dissociated in the presence of dithiothreitol did not reassociate, even after removal of the reducing agent. Trichocysts from mutants defective to varying degrees in trichocyst formation were subjected to similar experimental protocols. Heat-dissociated trichocysts of the mutants scc6 and ptA1 reassociated at rates similar to those of wild-type; ftA3 showed slower reassociation, and tam38 showed little or no reassociation. Reassociation of wild-type trichocyst proteins was blocked by the addition of an equal amount of tam38 trichocyst proteins.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3667716 TI - Chemotaxis towards pteridines during development of Dictyostelium. AB - Following a previous study indicating a sensitivity to folate during the developmental phase of Dictyostelium discoideum, a series of pteridines were investigated for their ability to induce amoebal chemotaxis during development of this organism. Several compounds were found to resemble folate in their ability to induce chemotaxis of both vegetative amoebae and amoebae developing during the first few hours of starvation. One compound, L-monapterin, was distinct in showing chemotactic activity only during the developmental phase after approximately 12 h of starvation. Tests using the polymerization of cytoskeletal actin as an assay for a cellular response correlated with chemotaxis showed that 10 nM-L-monapterin was a potent inducer of this response and that responsiveness appeared only after 12 h of development. The timing of these events may be correlated with the formation of tips containing stalk cells that occurs in multicellular aggregates at approximately 12 h, and suggests a role for L monapterin (or a naturally occurring, closely related pteridine) in cell sorting. The evolutionary significance of the roles of pteridines is discussed. PMID- 3667717 TI - Temperature and pH govern the self-assembly of microtubules from unfertilized sea urchin egg extracts. AB - A new method for microtubule purification from unfertilized sea-urchin eggs was developed in order to obtain large quantities of calcium- and cold-labile microtubules that contained microtubule-associated components important for mitosis. By taking into consideration the pH, ionic composition of egg cytoplasm, and the physiological temperature for growth of the Pacific coast sea-urchin Strongylocentrotus purpuratus, methods were developed for the assembly of intact microtubules directly from unfertilized egg extracts. The microtubules obtained by cycles of temperature-dependent assembly and disassembly are composed of tubulin and abundant microtubule-associated proteins. These microtubules are cold and calcium-labile and assemble at a critical protein concentration of 0.11 mg ml-1 at 24 degrees C. The yield of microtubule protein obtained by this new method is equivalent to that obtained with taxol (6-8 mg/20 ml packed eggs). Microtubules that have been fixed and prepared for electron microscopy are decorated with large, globular projections that are attached to the microtubule by thin stalks. PMID- 3667718 TI - Development of microtubule capping structures in ciliated epithelial cells. AB - Although capping structures are present at the tips of microtubules in both growing cilia and mature cilia, previous work has not determined the time of cap formation. The results reported here reveal that the large caps of mature palate cilia appear in cilia with lengths as short as 1.75 micron. In the growing palate cilium, a disk-shaped plate is formed at the tip during the first micron of growth. As the cilium elongates to 1.5-2.0 microns, a small plate forms underneath the disk-shaped plate that gives an asymmetrical appearance to the whole cap structure. The structure of the cap is complete in cilia longer than 2.0 microns. The hair-like structures that form the extraciliary crown appear on the membrane at the ciliary tip at the same time as the mature cap is forming. The formation of a cap structure is discussed in relation to microtubule assembly during ciliogenesis. PMID- 3667719 TI - Cell activation and adhesion. PMID- 3667720 TI - Distribution of an endogenous beta-galactoside-specific lectin during foetal and neonatal rabbit development. AB - The tissue concentration of an endogenous beta-galactoside-specific lectin is developmentally regulated in rabbit tissues during foetal and neonatal development. Immunoassay data and localization studies both indicate that the lectin is particularly associated with late embryonic and early postnatal development. No lectin could be detected in embryos prior to 21 days of gestation, whereas many tissues showed an increase in lectin around the time of birth. It is likely that in most tissues the high concentrations of lectin are largely due to increased synthesis by fibroblasts, which are particularly abundant and active in connective tissue during the extensive tissue reorganization taking place at this time. The lectin appears to be synthesized by other differentiated cell types also, notably myoblasts, alveolar cells and erythroblasts. The peak of lectin concentration seen in foetal liver probably reflects lectin associated with foetal erythropoiesis. The rabbit lectin has a low specific activity but its tissue concentration is correspondingly higher than lectin concentrations in other mammals. This conservation of total lectin activity suggests a fundamental role for the lectin dependent upon its saccharide binding activity. This and other indirect evidence suggests that these lectins are involved in the synthesis, secretion or organization of extracellular matrix components. PMID- 3667721 TI - Regulation of G2 by cell size contributes to maintaining cell size variability within certain limits in higher plants. AB - The variability of (1) surface area projection (size) at which cells terminate DNA replication, (2) the area at which they initiate mitosis, (3) the area at which they divide, (4) the duration of G2, and (5) the duration of G2 plus mitosis (in fact, prophase + metaphase + anaphase) has been estimated in steady state cell populations of Allium cepa root meristems. The coefficient of variation of cell area at termination of DNA synthesis was found to be 14% while the coefficient of variation of cell area at mitosis initiation was 13%. As there is also a substantial variability of G2 (the coefficient of variation was estimated to be 38%), the combination of these data indicates that cell size regulation of G2 contributes to maintaining cell size variability (and therefore DNA concentration) within certain limits. Mitosis also varies but less than G2 (the coefficient of variation of G2 + mitosis was found to be 31%). As the coefficient of variation of cell area at division (14%) is hardly larger than the coefficient of variation of cell area at initiation of mitosis, it can be suggested that coordination between cell size and mitosis duration helps to avoid a significant increase in the variability of cell size at the end of the division cycle. PMID- 3667722 TI - Quiescence and increased adhesion after mammalian DNA transfection of human fibrosarcoma cells. AB - When a population of human fibrosarcoma HT1080 cells was transfected with a mammalian expression vector and DNA pieces representing either the human whole genome or mouse bulk cDNA, there was a transient increase in the number of adhesive cells in the population. The number of cells with increased adhesion was proportional to the amount of transfected DNA; the increase occurred at a maximal frequency of between 10(-4) and 10(-5) per cell. Increased adhesion in these cells persisted for 9-12 days, corresponding to the period of highly efficient transient transfection, and was accompanied by arrest in cell division. Transfection of non-mammalian DNAs, reduction of transfected mammalian sequence length by restriction enzyme digestion, or omission of expression vector DNA did not permit these shifts in phenotype. The effects seen suggest that expression of specific transfected mammalian DNA sequences suppresses certain phenotypic characteristics in these transformed mammalian cells. PMID- 3667723 TI - General electromagnetic theory of total internal reflection fluorescence: the quantitative basis for mapping cell-substratum topography. AB - Total internal reflection fluorescence (TIRF) has recently been used to look at the contacts made between cells and a glass surface on which they are spread. Our method utilizes the fluorescence of a water-soluble dye that acts as an extracellular aqueous volume marker. Fluorescence is stimulated by the short range electric field near the glass surface that exists under conditions of total internal reflection. Since fluorescence is normally generated beneath a spread cell and not beyond it, the fluorescence of the image is related to the size of the cell-glass water gap. The images obtained are remarkable for their detail, contrast and the absence of confusing granularity due to cytoplasmic heterogeneity, which is commonly seen in interference reflection (IRM) images. We here develop a rigorous electromagnetic theory of total internal reflection in layered structures appropriate for cell contacts and apply it to quantitative TIRF. We show that: (1) TIRF, unlike IRM, can report cell-glass gaps in a way that is practically independent of the detailed physical properties of the cell; (2) TIRF is also far more sensitive than IRM for measuring cell-glass water gaps up to approximately equal to 100nm. These striking results explain the image quality seen by TIRF. As the initial step towards verifying our theory we show that measurement of the fluorescence stimulated by total internal reflection at a simple glass-water interface matches theoretical predictions. PMID- 3667724 TI - Establishment of a tissue culture system for epithelial cells derived from human pancreas: a model for the study of cystic fibrosis. AB - A tissue culture system for epithelial cells derived from human foetal pancreas has been established. The cultured cells show many ultrastructural features of interlobular duct cells. Immunocytochemical and histochemical evidence is presented in support of the view that these cells are ductal in origin. They are likely to be one of the few cell types that express the basic defect of cystic fibrosis in vitro. The cells may be passaged and sufficient material obtained to permit biochemical and molecular biological analysis. PMID- 3667725 TI - Levels of microtubules during the meiotic maturation of the Xenopus oocyte. AB - The total level of tubulin and the ratio of polymeric tubulin to tubulin dimer were measured by a colchicine filter-binding assay during meiotic maturation of the Xenopus oocyte. Although the total level of tubulin remains unchanged (0.12 +/- 0.03 micrograms/oocyte), the level of polymeric tubulin decreases during maturation (25% in prophase oocytes versus 20% in metaphase oocytes). The percentage of polymerized tubulin was estimated after drug (nocodazole and taxol) treatments and cold treatment in prophase and progesterone-matured oocytes; in all cases the microtubules present in mature oocyte are less stable than prophase microtubules. The presence of the nucleus modifies neither the level nor the stability of prophase microtubules. Our quantitative results as well as cytological arguments suggest that full-grown Xenopus oocytes may contain a cortical microtubular array. PMID- 3667726 TI - A monoclonal antibody recognizes a human nuclear protein resembling Xenopus oocyte nucleoplasmin. AB - The monoclonal antibody 10BG2 (IgG3) was derived from a mouse immunized with human pre B cells. In immunofluorescence studies the antibody revealed a human nuclear-associated determinant, which in interphase cells was entirely restricted to the nucleus. In metaphase cells 10BG2 antigen was detected throughout the cytoplasm with intensified staining at the periphery of chromosomes. 10BG2 antibody stained all human normal and transformed cells tested. In contrast, the antibody did not stain mouse 3T3 cells or Chinese hamster ovary (CHO) cells. Electrophoresis under denaturing and non-denaturing conditions revealed the 10BG2 antigen to be a 130 X 10(3) to 140 X 10(3) Mr protein with a subunit molecular weight of 29.5 X 10(3). This suggests the protein is at least a tetramer. On two dimensional gels the 10BG2 antigen had a streaked appearance and separated into two isoelectric variants (pI5.2, 5.4). The protein was also shown to be phosphorylated and thermostable, and remained in solution at pH 3.6. 10BG2 antigen was highly soluble in aqueous buffers and co-migrated on non-denaturing gels with the nucleosome-assembly protein, nucleoplasmin, purified from Xenopus oocytes. The similarity of 10BG2 antigen to nucleoplasmin is discussed. PMID- 3667727 TI - Clinical hypnosis in holistic nursing. PMID- 3667728 TI - Reversing destructive behavior: helping patients quit cigarettes. PMID- 3667729 TI - Vaginal birth after cesarean: recommendations, risks, realities, and the client's right to know. PMID- 3667730 TI - Holistic family therapy: individuals or families? A therapist's perspective. PMID- 3667731 TI - Nursing and worksite wellness: missing the boat. PMID- 3667732 TI - Qualitative versus quantitative nursing research. PMID- 3667733 TI - Children with epilepsy and their families. PMID- 3667734 TI - Psychotherapy and the school: an update. PMID- 3667735 TI - Correlates of social and academic competence in middle childhood. AB - The correlates of social and academic competence were investigated in 9-14 yr old children. Factor analysis of multiple measures of cognitive functioning, excluding IQ identified three dimensions: (1) Social Comprehension; (2) Cognitive Efficiency and (3) Divergent Thinking. The social comprehension dimension was derived from measures of humor and social cognition. Although strongly related to IQ, Social Comprehension still had a substantial unique relation to social competence in a school setting, as assessed by teachers and peers. While this dimension was the best predictor of social competence, IQ was by far the most powerful predictor of academic competence. PMID- 3667736 TI - Early onset rapid cycling bipolar affective disorder. AB - Four cases of rapid cycling bipolar affective disorder are described; the diagnosis being made by DSM(III) criteria. All are children, aged between 11 and 12 at the onset of the illness and all are of low intelligence. The follow-up has ranged from three to five years. The clinical symptoms and their response to treatment are described and the implications of this unusual presentation are discussed. PMID- 3667737 TI - The nature of mother and toddler problems--I. Development of a multiple criterion screen. AB - A multicriterion screen made up of the General Health Questionnaire, the Behaviour Checklist and a health visitor questionnaire was given in a community project. This paper describes the usefulness of the screen and compares it with others which might be used in similar situations. PMID- 3667738 TI - Piagetian conservation and response to cognitive therapy in attention deficit disordered children. AB - Cognitive therapy is often used in treating attention-deficit-disordered (ADD) children because of its purported ability to address this population's attentional deficits and behavioral difficulties and to create durable therapeutic effects. Nonetheless, research findings on these treatments have been inconsistent. This study sought to explain these inconsistencies by examining the influence of cognitive development on children's ability to benefit from such treatment. The ability to conserve number and substance was shown to influence treatment outcome, as measured by laboratory tasks of cognitive style and impulsivity. No effects were found on standardized academic achievement measures or on behavioral ratings by teachers or parents. Further study of individual development will be important in understanding the outcomes of cognitive therapy. PMID- 3667739 TI - Advances in chromatography 1986. Part II. Proceedings of the Twenty-second International Symposium held in Houston, TX, September 15-17, 1986 and of the Twenty-third International Symposium held in Chiba, October 7-9, 1986. PMID- 3667740 TI - High-performance liquid chromatographic determination of ampicillin and its metabolites in rat plasma, bile and urine by post-column degradation with sodium hypochlorite. AB - A high-performance liquid chromatographic method has been developed for the determination of ampicillin (1) and its metabolites [(5R,6R)-ampicilloic acid (2), the (5S,6R)-epimer (3) and the corresponding (2R)-piperazine-2',5'-dione (4)] in rat plasma, bile and urine. The method involves the separation of 1-4 from the background components of the biological fluids on a reversed-phase C18 column, using sodium heptanesulphonate as an ion-pairing agent and methanol in the mobile phase, followed by post-column degradation with 1.5 M sodium hydroxide 0.02% sodium hypochlorite solution at ambient temperature, and detection of the degradation product(s) of each compound at 270 nm. The detection limits were about 25 ng for each compound at a signal-to-noise ratio of 3. At concentrations of 2-5 micrograms/ml of each compound, the within- and between-run precisions (relative standard deviation) were 0.77-7.15% and 1.76-5.96%, respectively. The plasma, biliary and urinary levels of 1 and its metabolites were determined by the proposed method after intravenous administration of 1 to rats. PMID- 3667741 TI - Post-column derivatization system for the fluorimetric determination of guanidino compounds with ninhydrin by reversed-phase ion-pair high-performance liquid chromatography. AB - A post-column derivatization system for the fluorimetric determination of guanidino compounds by high-performance liquid chromatography was developed. A mobile phase containing ninhydrin was used as the fluorigenic reagent. Ten guanidino compounds were separated within 25 min on a Nucleosil C8 (5 microns) column (15 cm X 4.6 mm I.D.) by isocratic, reversed-phase ion-pair chromatography and detected as fluorophors derived from condensation with ninhydrin in an alkaline stream. In this simplified system only two pumps required to deliver the mobile phase and the alkaline solution. This method was applied to serum from patients on haemodialysis therapy. PMID- 3667742 TI - Improved method for the immobilization of heparin. AB - The optimal conditions for immobilizing heparin through its terminal formyl group were investigated. When Amino Sepharose (1 g) was suspended in 1 ml of phosphate buffer (pH 7) containing 30 mg of heparin and 3 mg of sodium cyanoborohydride, with shaking at room temperature, the maximum immobilization of heparin (10 mg of heparin per gram of wet gel) was reached within 2 days. The Heparin Sepharose thus obtained was stable: no significant loss of the heparin content was observed after storage for 4 months at 4 degrees C. Heparin was also immobilized by the same method with Amino TSK gel G5000PW instead of Amino Sepharose 4B and was successfully applied to the high-performance liquid affinity chromatography of fibronectin and thrombin. PMID- 3667743 TI - High-performance liquid chromatographic-fluorescence determination of human faecal bile acids. AB - A high-performance liquid chromatographic method with fluorescence detection has been developed for the determination of human faecal bile acids, especially free faecal bile acids. Faecal bile acids were extracted using an Amberlite XAD-2 column and then fractionated into four groups (free, glycine-conjugated, taurine conjugated and sulphated bile acids) on a piperidinohydroxypropyl Sephadex LH-20 column. The free bile acid fraction and free bile acids obtained after enzymatic hydrolysis and/or solvolysis of the three other fractions were derivatized with 1 bromoacetylpyrene and dicyclohexyl-18-crown-6-ether. The derivatized bile acids were separated stepwise on a Shim-pack CLC-ODS column using acetonitrilemethanol water (100:50:30) (A), (100:50:20) (B), and (100:50:0) (C) as mobile phases with changing automatically from A to C using a solvent changer. Calibration curves of bile acid standards were linear in the range between 20 and 400 pmole, when monitored at 370 nm (excitation) and 440 nm (emission). Percent recoveries of bile acids from human faecal samples were between 80 to 95%. The method is applicable to clinical use and is sensitive, reliable, and useful for the detailed determination of human faecal bile acids, especially of free faecal bile acids. PMID- 3667744 TI - Application of bis[4-nitro-2-(3,6,9-trioxadecyloxycarbonyl)-phenyl]oxalate to post-column chemiluminescence detection in high-performance liquid chromatography. AB - Bis[4-nitro-2-(3,6,9-trioxadecyloxycarbonyl)phenyl] oxalate (TDPO) was used to examine the peroxyoxalate chemiluminescence (CL) reaction for the detection of fluorescent compounds. Some fluorescent compounds (perylene, eosine, rhodamine, Rose Bengal, fluorescein and umbelliferone) gave higher CL intensities as the proportion of water in the reaction medium increased to ca. 40%, whereas dansylalanine, 8-anilinonaphthalene-1-sulphonic acid, 7-nitrobenzo-2-oxa-1,3 diazol-4-ylproline and dihydronicotinamide adenine dinucleotide gave opposite results. The effects of temperature and time on the post-column reaction in reversed-phase high-performance liquid chromatography (HPLC) were investigated. Under the optimal conditions, the detection limit for dansylamino acids was at the sub-femtomole level. The advantage of using TDPO in HPLC is its stability in the presence of hydrogen peroxide [ca. 10% loss of activity per 8 h vs. 60% per 8 h for bis(2,4,6-trichlorophenyl) oxalate]. PMID- 3667745 TI - Analysis of steroids. XXXVIII. The use of high-performance liquid chromatography with diode-array UV detection for estimating impurity profiles of steroid drugs. AB - High-performance liquid chromatography (HPLC) diode-array UV-spectrophotometric detection is used for estimating impurity profiles of steroid drugs. It is shown to be a very useful first screening method for the identification of UV-active impurities and degradation products, giving a rapid answer to many questions or at least providing important initial information to complement the results obtained by other spectroscopic techniques. In this paper the estimation of the impurity profiles of ethynyloestradiol, norgestrel, and norethisterone, and of the degradation product of RGH-1113 (3-chloro-, 6,9-difluoro-11 beta,16 alpha,17 alpha,21-tetrahydroxy-1,3,5-pregnatrien-20-one 16,17-acetonide 21-acetate) will be discussed. PMID- 3667746 TI - Strategy for the analysis of steryl esters from plant and animal tissues. AB - Methods are described for the analysis of intact steryl esters present in complex mixtures isolated from plant or animal tissues. A preliminary examination by analytical thin-layer chromatography (TLC) and capillary column gas chromatography-mass spectrometry (GC-MS) under electron impact (EI) ionisation reveals the complexity of the mixture and the nature of the steryl moieties. Preparative TLC is then utilised to separate the steryl esters into two broad groups, containing fatty acyl moieties of shorter (C2-C8) or longer chain length (C10-C22). The shorter-chain fatty acyl steryl esters are separated by adsorption high-performance liquid chromatography (HPLC) on a LiChrosorb Silica-60 column. The steryl esters with longer-chain fatty acyl moieties are analysed by reversed phase HPLC on either an Ultrasphere ODS, 5-micron, or a S3 Spherisorb ODS, 3 micron, column. Steryl esters with unsaturated fatty acyl moieties are eluted with the shorter-chain fatty acyl steryl esters. The presence of the unsaturated fatty acyl esters can be monitored by analytical argentation TLC, which will also reveal the degree of unsaturation. The steryl esters are fractionated into the saturated, mono-, di-, tri- and polyene acyl types by preparative medium-pressure liquid chromatography on a column of 10% AgNO3-silica gel. Each of these steryl ester types can then be resubmitted to reversed-phase HPLC or analysed by GC-MS on a short fused-silica capillary column with a bonded phase of the OV-1 type. GC MS on a magnetic-sector instrument under negative-ion chemical ionisation conditions with ammonia as the reagent gas produces fragment ions for both the steryl and fatty acyl moieties, thus permitting identification of the individual intact steryl esters. These various methods are illustrated by analyses of the steryl ester mixtures obtained from human plasma, barley seedlings, palm oil and rape seed oil. PMID- 3667747 TI - Sensitive method for carbohydrate composition analysis of glycoproteins by high performance liquid chromatography. AB - A new high-performance liquid chromatographic system has been developed for separating completely the neutral alditols and aminoalditols derived from sugars in complex carbohydrates. In combination with reduction by NaB3H4, this system affords a very sensitive and rapid method of monosaccharide composition analysis of glycoproteins and glycolipids. PMID- 3667748 TI - Analysis of ceramide and monohexaosyl glycolipid derivatives by high-performance liquid chromatography and its application to the determination of the molecular species in tissues. AB - Several molecular species of monohexaosyl glycolipids and ceramides were analyzed as their benzoyl derivatives by high-performance liquid chromatography on a silica column with mixtures of dioxane and hexane as eluents. Monohexaosyl glycolipid derivatives were classified according to their hydrophobic structures, and ceramides were separated based on the fatty acid groups and the long-chain bases. The method allowed us to observe the heterogeneities in the molecular species of cerebrosides and ceramides from the epidermis and dermis of the guinea pig, and clear differences in the molecular species were observed between the different regions. PMID- 3667749 TI - High-performance liquid chromatography-inductively coupled plasma profiles of cadmium, zinc, sulphur, and other elements in rat liver supernatants after cadmium injection. AB - The distribution of cadmium, zinc, sulphur and other elements in the liver supernatants of rats and their variation with time following a single intraperitoneal injection of cadmium chloride were characterized by high performance liquid chromatography (HPLC) coupled with an inductively coupled plasma. Cadmium that was bound to high-molecular-weight-proteins before the induction of metallothionein was analysed more easily using an Asahipak GS-520 column, whereas the distributions of other elements and of cadmium bound to metallothionein were better characterized on a TSK G3000SW column. Cadmium bound primarily to a distinct high-molecular-weight protein before the induction of metallothionein. After the injection its distribution shifted with time to metallothionein. An atomic emission spectrometer, employing an inductively coupled argon plasma and a vacuum UV monochromator was effectively used as a multi-element specific detector for HPLC. PMID- 3667750 TI - Quantitative analysis of sterols in serum by high-performance liquid chromatography. Application to the biochemical diagnosis of cerebrotendinous xanthomatosis. AB - A method for the simultaneous determination of 5 alpha-cholestan-3 beta-ol and cholesterol in serum by high-performance liquid chromatography was developed. After addition of internal standard (5 beta-cholestan-3 alpha-ol) and saponification with ethanolic potassium hydroxide, the sterols were converted into their benzoyl derivatives, which were subjected to reversed-phase liquid chromatography with ultraviolet detection at 228 nm. Only 0.1 ml of serum was needed to give a reproducible result. This method has been used for the biochemical diagnosis of cerebrotendinous xanthomatosis, a hereditary disorder of cholesterol metabolism. PMID- 3667751 TI - Determination of free amino acids in the cerebrospinal fluid of male rats by high performance liquid chromatography with fluorescence detection. Alterations in amino acid concentrations during sexual activity. PMID- 3667752 TI - Improvement of chemical analysis of antibiotics. XII. Simultaneous analysis of seven tetracyclines in honey. AB - An analytical system for the simultaneous determination of residual oxytetracycline, tetracycline, chlortetracycline, doxycycline, methacycline, demethylchlortetracycline and minocycline in honey has been established by a combination of simple thin-layer chromatographic (TLC) and precise high performance liquid chromatographic (HPLC) methods. In this system, screening by TLC can detect tetracyclines (TCs) at a level of 0.1 ppm in honey without the need for special equipment, and the quantitative method by HPLC can determine TCs with good recovery (83.7-99.6%) and coefficient variation (0.9-4.3%). PMID- 3667753 TI - Electrochemically treated glassy carbon electrode for amperometric detection in high-performance liquid chromatography. AB - The application of an electrochemically pre-treated glassy carbon electrode for the amperometric detection of electroactive components, such as tyrosine and oxipurinol, in biological samples was studied in order to demonstrate the usefulness of a pre-anodized electrode in high-performance liquid chromatography. The electrochemical pre-treatment was carried out in 0.2 M phosphate buffer (potassium dihydrogenphosphate-potassium hydroxide, pH 6.5) at 1900 mV vs. Ag/AgCl for 2 min. The pre-anodized electrode response for the oxidation of lactic acid and pyruvic acid was also studied. The electrochemical treatment enhanced and stabilized the electrode response to the oxidation of tyrosine and both acids. PMID- 3667754 TI - Reversed-phase ion-pair chromatography of oligodeoxyribonucleotides. AB - The separation of large oligodeoxyribonucleotides, synthesized chemically and subsequently deblocked, was carried out by reversed-phase ion-pair chromatography (RP-IPC) with a linear gradient of acetonitrile concentration. It was found that tetrabutylammonium phosphate is suitable as an ion-pairing reagent and produces a linear relationship between the base numbers of the samples and their elution volumes. It was also verified that various factors effective in reversed-phase chromatography, such as temperature, end-capping of the columns, differences in the type of C18 alkylating reagents and in the base silica, and the pore size of the base silica have little effect on the resulting separation by RP-IPC. PMID- 3667755 TI - High-performance liquid chromatographic system for the rapid purification of growth-hormone receptor in rabbit livers. AB - A system consisting of high-performance affinity chromatography and size exclusion chromatography has been developed for the rapid purification and isolation of relatively labile membrane proteins, such as growth-hormone receptor. The crude membrane sample containing growth-hormone receptor was obtained from rabbit livers by ultracentrifugation, followed by solubilization with Triton X-100. The sample was introduced into the high-performance affinity gel column through a large-volume loop injector. After removal of unretained proteins, the fraction containing the growth-hormone receptor was eluted with 6 M urea solution. The eluate from the affinity column passed directly into the size exclusion gel column, where rapid desalting and separation from contaminants were achieved. The eluate was monitored by UV absorption at 280 nm and fractionated for the subsequent binding assay with 125I-labelled human growth hormone. PMID- 3667756 TI - Solid-phase extraction of chloramphenicol with graphitized carbon black. AB - The sorption and desorption properties of graphitized carbon black (GCB) were evaluated for enrichment of highly polarizable chloramphenicol (CP) from biological fluids. The distribution of CP between GCB and water lay strongly toward GCB. Among the organic solvents examined, methanol gave the lowest adsorption coefficient. The optimum packing amount of GCB, and the optimum volume and flow-rate of the eluent were deduced from the breakthrough curve and methanol elution curve, respectively. The inner diameter of GCB extraction columns was chosen from the sorption efficiency curve obtained by plotting CP recovery against column inner diameter. The solid-phase extraction method using GCB was applied to the assay of CP in serum samples in the concentration range of 5 to 50 micrograms/ml. PMID- 3667757 TI - Purification of saikosaponins a, c and d. Application of large-scale reversed high-performance liquid chromatography. AB - The preparative separation of saikosaponins a, c, and d from Bupleurum falcatum was performed by high-performance liquid chromatography on a 100 X 11 cm I.D. axially compressed column, packed with 20-micron ODS silica gel using a step gradient with mixtures of acetonitrile and water as the mobile phase. Gram quantities of pure compounds were obtained in a single run. PMID- 3667758 TI - Fast, microbore, and fast microbore high-performance liquid chromatography of nucleic acid constituents. AB - Fast high-performance liquid chromatography (HPLC) (5-10 cm X 4.6 mm I.D. columns), microbore HPLC (25 cm X 2.1 mm and 1 mm I.D. columns), and fast microbore HPLC (5-10 cm X 2.1 mm and 1 mm I.D. columns) were successfully applied to the separation of nucleic acid constituents in standard mixtures and physiological fluids. Separations were obtained in isocratic and gradient elution modes. The separations obtained were compared with those achieved on a conventional 25 cm X 4.6 mm I.D. column. Factors evaluated included separation time, retention time reproducibility, peak height reproducibility, resolution, efficiency, sensitivity and linear response range. Practical factors, such as the amount of sample required and cost per analysis, were also examined. PMID- 3667759 TI - Affinophoresis of pea lectin and fava bean lectin with an anionic affinophore, bearing rho-aminophenyl-alpha-D-mannoside as an affinity ligand. AB - Affinophoresis is an electrophoretic separation technique for biological polymers with the aid of an affinophore, which is a macromolecular polyelectrolyte bearing affinity ligands. The affinophore migrates rapidly in an electric field, and consequently the electrophoretic mobility of molecules having an affinity for the ligand is specifically changed. An anionic affinophore-bearing mannosyl residue was synthesized for the affinophoresis of lectins. rho-Aminophenyl-alpha-D mannopyranoside and aminomethanesulphonic acid were coupled to about one-tenth and one-fifth, respectively, of the carboxyl groups of succinyl-poly-L-lysine with an average degree of polymerization of 120 by the use of a water-soluble carbodiimide. Extracts of seeds of pea (Pisum sativum) or fava bean (Vicia fava) were subjected to two-dimensional agarose gel electrophoresis, in which the first dimension was ordinary agarose gel electrophoresis and the second dimension was affinophoresis with the affinophore. The separated proteins were stained with Coomassie Blue R250. The lectins in both seed extracts were separated from a diagonal line formed by other proteins in the extracts. About 10 ng of the separated pea lectin was detected on a nitrocellulose blot by immunostaining with a horseradish peroxidase-conjugated second antibody. PMID- 3667760 TI - Novel chiral stationary phases for optical resolution by ligand-exchange high performance liquid chromatography. AB - Novel chiral stationary phases, (1R,2S)- and diastereomeric (1S,2S)-2 carboxymethylamino-1,2-diphenylethanol, were prepared from (1R,2S)- and (1S,2S)-2 amino-1,2-diphenylethanol, respectively, and were bound to silica gel pretreated with 3-glycidoxypropyltrimethoxysilane. The chiral stationary phases were found to be very effective for the optical resolution of amino acids, amino acid derivatives and hydroxy acids by ligand-exchange high-performance liquid chromatography. PMID- 3667761 TI - Separation of isolectins by high-performance hydrophobic interaction chromatography. AB - High-performance hydrophobic interaction chromatography (HP-HIC) was found to be an effective method for the separation of lectins into isolectin fractions. All of the purified lectins used in this study, Phaseolus vulgaris haemagglutinin (PHA), wheat germ agglutinin (WGA), Ricinus communis agglutinin (RCA), and Arachis hypogaea agglutinin (AHA), were prepared by affinity chromatography. HP HIC was performed on a column (15 X 2.1 cm) of TSK gel Phenyl-5PW at room temperature. The lectin sample, dissolved in 1.0 or 0.5 M ammonium sulphate in phosphate buffered saline (pH 7.4) (PBS), was applied to the column and eluted with a linear gradient from 1.0 or 0.5 M ammonium sulphate in PBS to 0 M ammonium sulphate in PBS at a flow-rate of 4 ml/min. In the case of RCA, addition of glycerol to the elution buffer resulted in sharper isolectin peaks. PHA, WGA, RCA, and AHA were rapidly separated into 5, 5, 4, and 6 isolectins, respectively. PMID- 3667762 TI - High-performance liquid chromatographic determination of hormonal peptides and their fluorenylmethoxycarbonyl derivatives. AB - Reference methods for the quantitation of peptide and protein hormones in blood are urgently needed and high-performance liquid chromatography (HPLC) is potentially applicable. Owing to the low concentrations of these substances in body fluids, very low detection limits have to be achieved. This can be done on the one hand by reducing the diameter of the separation column and increasing the number of theoretical plates, and on the other by derivatization. Angiotensin II was chosen as a model compound. Reduction of the inner diameter from 4 to 2 mm increased the peak height by a factor of 3.4 (theoretical value 4.0). The peptide was derivatized with 9-fluorenyl methylchloroformate in lithium carbonate-sodium hydrogencarbonate or sodium borate buffer at different pH values. The precision (coefficient of variation) was 10.4%, the linear range 1:40 (r = 0.998) and the detection limit 500 fmol of derivative on-column. The volume injected was 2 microliter. However, this is not sufficiently sensitive for the quantitation of most peptide hormones using an acceptable maximum specimen volume of 5 ml of serum or plasma. PMID- 3667763 TI - High-performance liquid chromatographic methods with fluorescence detection for the determination of branched-chain amino acids and their alpha-keto analogues in plasma samples of healthy subjects and uraemic patients. AB - High-performance liquid chromatographic (HPLC) methods have been developed for the quantification of branched-chain amino acids (BCAA) and their keto analogues (BCKA). Amino acids and their keto analogues were derivatized with o phthalaldehyde, 2-mercaptoethanol and o-phenylenediamine sulphate prior to HPLC. Both separations were performed on a reversed-phase column, using a multi-step gradient system with two solvents and a fluorescence detector. These methods are simple and sensitive and give highly reproducible results. By using an automatic system, the instability problem is avoided and the reaction kinetics are controlled. The use of a simple clean-up procedure with preparative cation exchange chromatography before BCKA analysis concentrates the dilute plasma sample. The methods were applied to the determination of BCAA and BCKA in plasma samples of healthy volunteers and patients with chronic renal disorders. The relationship between the concentrations of BCAA and BCKA in plasma for these two groups is shown. PMID- 3667764 TI - Amino acid analysis. I. Nuances of integration. PMID- 3667765 TI - New high-performance gel filtration columns for protein separation. PMID- 3667766 TI - Pre-column clean-up and liquid chromatographic determination of residues of N methylcarbamate pesticides in extracts of total diet. PMID- 3667767 TI - Purification of allergens by high-performance liquid chromatography. V. Purification of cat and dog epithelial allergens. PMID- 3667768 TI - Resolution of the enantiomers of thyroid hormones by high-performance ligand exchange chromatography using a chemically bonded chiral stationary phase. PMID- 3667769 TI - Separation strategies for o-phthalaldehyde-mercaptoethanol derivatives of amino acids for reversed-phase high-performance liquid chromatography. AB - Twenty-three o-phthalaldehyde-mercaptoethanol derivatives of primary amino acids in serum were separated with Waters C18 5-microns Radial-Pak Resolve columns, using aqueous phosphate-methanol mobile phase with acetate and tetrahydrofuran as modifiers. Resolution is critical in this system for glutamine/histidine, citrulline/glycine/threonine/3-methylhistidine, and tryptophan/methionine derivatives, and is affected by small changes in column properties or mobile phase. However, pre-run adjustments in gradient scheme and/or mobile phase composition can usually be used to obtain chromatograms in which all derivatives can be quantitated. For this purpose, and for general method development, we have written two very fast, interactive programs for the Zenith Z-100 Microsoft BASIC compiler: RTGRAPH, for retention, separation, and resolution plots; and LCSIM for simulations of multisegment binary gradient elution. These programs are shown here to be useful and accurate in most aspects required for developing strategies for this method. PMID- 3667770 TI - Comparative study of solid-phase and liquid-phase extraction techniques for isolation of phospholipids from plasma. AB - A liquid-liquid extraction technique and six solid absorbents, silica gel, octadecyl silica (C18), XAD-2, XAD-4, XAD-7 and XAD-8, were compared as effective tools for extraction of phosphatidylcholine (Ptd C), phosphatidylethanolamine (Ptd E), phosphatidylinositol (Ptd I) and phosphatidylserine (Ptd S) from plasma. Using liquid-liquid extraction the recovery of the four phospholipids was in the order of 60% in organic phase and 20% in the liquid interface. Neither silica gel nor C18 materials significantly adsorbed phospholipids from plasma. Amberlite resins were more selective for removal of phospholipids. A recovery of greater than 85% was obtained for Ptd C, Ptd I and Ptd S when XAD-7 or XAD-8 were used as adsorbents. A recovery of approximately 90% for Ptd E was obtained when XAD-2 or XAD-4 were used as adsorbents. A solvent mixture of isopropanol-acetonitrile (1:1) was found to be the most effective eluent for removal of phospholipids from amberlite polymeric resins. These results suggest that resins could be used as an extracting tool for removal of phospholipids from body fluids. PMID- 3667771 TI - Formation of artifactual metabolites of doxylamine following acid hydrolysis. AB - This study describes the use of gas chromatographic-mass spectrometric, high performance liquid chromatographic and capillary column gas chromatographic separation techniques in demonstrating the production of several artifactual compounds reported in the literature as metabolites of doxylamine. Rhesus monkey urinary extracts which contained doxylamine and doxylamine metabolites were examined with and without acid hydrolysis. The production of 1-phenyl-1-(2 pyridinyl)ethanol and 1-phenyl-1-(2-pyridinyl)ethylene under acid hydrolysis conditions was demonstrated. These artifactual products were shown to originate from the acid hydrolysis of 2-[1-phenyl-1-(2-pyridinyl)ethoxy] acetic acid and not from doxylamine. PMID- 3667772 TI - Determination of a new angiotensin converting enzyme inhibitor and its active metabolite in plasma and urine by gas chromatography-mass spectrometry. AB - A specific and sensitive gas chromatographic-mass spectrometric method for the simultaneous quantification of unchanged 3-[( 1-ethoxycarbonyl-3-phenyl-(1S) propyl]amino)-2,3,4,5-tetrahydro-2-oxo-1- 1-(3S)-benzazepine-1-acetic acid (I) and its active metabolite, the dicarboxylic acid (II), in plasma and urine has been developed and validated. 2H5-labelled analogues of I and II were used as internal standards. The compounds were isolated from plasma and urine under acidic conditions using XAD-2 resin or Extrelut 1 columns. Following derivatization with diazomethane, the samples were analysed by packed-column gas chromatography-electron-impact mass spectrometry with selected-ion monitoring. The analysis of spiked plasma and urine samples demonstrated the good accuracy and precision of the method, which is suitable for use in pharmacokinetic and bioavailability studies with the new angiotensin converting enzyme inhibitor prodrug I.HCl in humans. PMID- 3667773 TI - Identification of drugs in human serum by high-performance liquid chromatography with photodiode array detection and a search algorithm for ultraviolet spectra. AB - A system is described that identifies a number of unknown drugs (benzodiazepines, antidepressants and neuroleptics) in blood specimens for clinical-toxicological purposes. Reversed ion-pair high-performance liquid chromatography with a photodiode array detector saves the ultraviolet spectrum of every chromatographically significant peak. Post-run data-processing, provided by a microcomputer, retrieves candidate substances from a library of ultraviolet spectra. Selected standard ultraviolet spectra are compared with the unknown by five different similarity tests. The discriminatory efficiency of these algorithms has been determined. Multicomponent analysis, a built-in program of the spectrophotometer, provided the most reliable results. PMID- 3667774 TI - Simultaneous analysis of digitoxin and its clinically relevant metabolites using high-performance liquid chromatography and radioimmunoassay. AB - A specific assay for determining the urinary excretion of unchanged digitoxin and its metabolites is described. The procedure includes solvent extraction of urine at pH 8.5, reversed-phase high-performance liquid chromatography (HPLC) and radioimmunoassay (RIA) of equivalent fractions. Confidence limits showed good linearity and precision of recovery and high sensitivity, accuracy and specificity. Cross-reactivities were high for digitoxigenin (DGTN) and digitoxigenin bisdigitoxoside (Bis-DGTN), they were low for digitoxigenin monodigitoxoside (Mono-DGTN) or digoxin when [125I]digitoxin RIA was used. The interference of endogenous compounds in urine in the RIA was overcome by using HPLC. Compared with results reported in the literature, the urinary recovery of unchanged digitoxin was lower, being only 8.11 +/- 1.51% of the dose administered. Amounts of 6.52 +/- 1.31% were excreted hydrolysed as Bis-DGTN, Mono-DGTN, DGTN or C12-hydroxylated as digoxin. PMID- 3667775 TI - Metabolism of physostigmine in mouse liver microsomal incubations studied by liquid chromatography with dual-electrode amperometric detection. AB - The metabolism of physostigmine was studied by its incubation with the microsomal fraction of mouse liver. The metabolites formed were separated by reversed-phase ion-pair liquid chromatography and detected amperometrically by dual electrodes. Two major and six minor metabolites were found. Retention times and electrochemical characteristics were studied for these and compared with the hydrolysed products of physostigmine: eseroline and rubreserine. It can be concluded that none of the major metabolites is identical with these standards, and this is in contradiction to what has previously been assumed. Conjugation reactions of the metabolites with glucuronic acid and glutathione were also attempted, but no indication was found that these reactions take place during microsomal incubation. PMID- 3667776 TI - Sensitive ferrocene reagents for derivatization of thiol compounds in high performance liquid chromatography with dual-electrode coulometric detection. AB - Three N-substituted maleimides possessing ferrocene as an electrophore were prepared and evaluated for pre-column derivatization of thiol compounds in high performance liquid chromatography with dual-electrode coulometric detection. The utility of these reagents was investigated by employing N-acetyl-L-cysteine as a model compound. Among the three, N-(ferrocenyl) maleimide was the most favourable reagent with respect to reactivity, stability and electrochemical properties. The dual-electrode coulometric detection of the adduct showed high selectivity and sensitivity with a detection limit of 0.06 pmol. The proposed method is applicable to the determination of glutathione in biological specimens. PMID- 3667777 TI - Determination of theophylline and its metabolites in plasma and urine by reversed phase liquid chromatography using an amine modifier. AB - A high-performance liquid chromatographic method for the determination of the concentrations of theophylline and its metabolites in plasma and urine samples is presented. The method uses the decylammonium ion, an N-alkylammonium modifier, and makes it possible to separate theophylline and its metabolites from other uric acid or xanthine derivatives, especially 1,7-dimethylxanthine, a metabolite of caffeine. The plasma and urine purification procedure is convenient, rapid and reproducible, and it can be used to determine low plasma and urine concentrations. PMID- 3667778 TI - Radiometric-high-performance liquid chromatographic assay for nicotine and twelve of its metabolites. AB - A sensitive, reproducible radiometric-high-performance liquid chromatographic assay has been developed to measure concentrations of nicotine and twelve of its metabolites in biological fluids. Following administration of nicotine ([2 14C]pyrrolidine) to rats, the assay was used in a pharmacokinetic investigation. PMID- 3667779 TI - Column liquid chromatography of methotrexate and its metabolites using a post column photochemical reactor and fluorescence detection. AB - On irradiation with short-wavelength UV light in the presence of hydrogen peroxide, methotrexate and its metabolites 7-hydroxymethotrexate and 2,4-diamino N10-methylpteroic acid are cleaved into highly fluorescent products. This reaction can be used for the sensitive and selective detection of the compounds in biological fluids, following reversed-phase high-performance liquid chromatographic separation. Study of the effect of the mobile phase composition and irradiation time on fluorescence signal intensity showed that a residence time of ca. 3 s in the on-line photochemical reactor was best. The detection limit for methotrexate was 0.4 ng, for 7-hydroxymethotrexate 1.0 ng and for 2,4 diamino-N10-methylpteroic acid 0.6 ng. The addition of dimethylformamide to the mobile phase enhanced the selectivity of separation. PMID- 3667780 TI - High-performance liquid chromatographic assay for the experimental anticancer agent oxantrazole. AB - Oxantrazole is an anthrapyrazole analogue developed as an anthracycline-like agent with potentially reduced cardiotoxicity. A reversed-phase high-performance liquid chromatographic assay was developed using a C2 column and mobile solvent system of dimethylformamide-acetonitrile-0.2 M ammonium acetate, pH 4.5 (20:5:75, v/v/v) at a flow-rate of 1 ml/min. Drug and internal standard were detected by ultraviolet absorbance at 514 nm. Isolation of drug and internal standard was afforded by elution from C18 disposable isolation columns with a mixture of methanol-glacial acetic acid-0.02 M sodium acetate, pH 4.0 (12:1:3, v/v/v). The assay was linear (r2 greater than 0.99) over concentrations of 0.025-2.5 micrograms/ml and the limit of detection was 10 ng/ml plasma. Oxantrazole was unstable in neutral and particularly alkaline aqueous solutions. Utilizing this assay, plasma pharmacokinetics were determined following intravenous infusion of oxantrazole to beagle dogs. Plasma elimination was rapid with elimination phase half-life values less than 45 min. PMID- 3667781 TI - Liquid chromatographic analysis of alizapride and metoclopramide in human plasma and urine using solid-phase extraction. AB - A universal rapid, sensitive and selective high-performance liquid chromatographic method with UV detection at 230 nm has been developed for the determination of benzamide drugs in human plasma and urine. Sample pretreatment is carried out using solid-phase extraction columns, resulting in very high extraction recoveries of the compounds investigated (alizapride, metoclopramide, alpiropride, amisulpride). The detector response is linear from 25 to 10,000 ng/ml, and the detection limit is 3 ng/ml for alizapride and 10 ng/ml for metoclopramide. The proposed method is highly suitable for pharmacokinetic studies and for drug monitoring. PMID- 3667782 TI - Determination of metoclopramide and its glucuronide and sulphate conjugates in human biological fluids (plasma, urine and bile) by ion-pair high-performance liquid chromatography. AB - Metoclopramide was determined in human biological fluids (plasma, urine and bile) by reversed-phase ion-pair high-performance liquid chromatography using a newly introduced cyanopropyl column. The method is precise, selective and sensitive: the mean recoveries of metoclopramide from plasma, urine and bile were 74.4, 99.1 and 85.9%, respectively; the mean within- and between-run coefficients of variation were, respectively, 0.8 and 8.5% for plasma and 2.0 and 8.2% for urine at the drug concentration of 100 ng/ml, and 2.3 and 11.2% for bile at the concentration of 20 ng/ml; the lower detection limit was 2 ng/ml for 1 ml of each biological fluid. Enzymic hydrolysis of a urine or bile specimen was used in the identification of metoclopramide, as well as its glucuronide and sulphate conjugates, from the human samples. A preliminary study on metoclopramide determinations from plasma and urine samples of a healthy subject and from bile samples of a patient demonstrated the clinical applicability of the method for therapeutic monitoring and pharmacokinetic studies. PMID- 3667783 TI - Use of tert.-butyldimethylsilyl derivatives for gas chromatographic-mass spectrometric analysis of dipeptides. PMID- 3667784 TI - Silylated N,O-ketals from the reaction of ketones with N-trimethylsilylimidazole. PMID- 3667785 TI - Determination of plasma corticosterone using high-performance liquid chromatography. PMID- 3667787 TI - Rapid and sensitive assay of ornithine decarboxylase activity by high-performance liquid chromatography of the o-phthalaldehyde derivative of putrescine. PMID- 3667786 TI - Simultaneous determination of gamma-aminobutyric acid and polyamines by high performance liquid chromatography. PMID- 3667788 TI - Biospecific affinity chromatography of plasma fibronectin on cross-linked gelatin microbeads. PMID- 3667789 TI - Detection of fibrinogen heterogeneity by capillary isotachophoresis. PMID- 3667790 TI - Isotachophoretic analysis for the determination of urinary gamma-carboxyglutamic acid. PMID- 3667791 TI - Determination of revenast hydrochloride in human plasma by gas chromatography with nitrogen-selective detection. PMID- 3667792 TI - Gas chromatographic determination of chlorproethazine in plasma. PMID- 3667793 TI - High-performance liquid chromatographic analysis of pentoxifylline and 1-(5' hydroxyhexyl)-3,7-dimethylxanthine in whole blood. PMID- 3667794 TI - Hemoglobin-based blood substitutes: characterization of five pyridoxal 5' phosphate derivatives of hemoglobin. AB - Six fractions (I-VI) of pyridoxal 5'-phosphate (PLP) hemoglobin (Hb), prepared by the method of De Venuto and Zegna [J. Surg. Res., 34 (1983) 205] have been isolated and purified by anion-exchange high-performance liquid chromatography (HPLC). Total phosphate analyses indicate that I is HbA, II and III are double labelled, IV and V are tetra-labelled and VI contains 6 mol of phosphorus per mol of hemoglobin. The purified components have been resolved into their alpha and beta chains by preparative reversed-phase HPLC using a macroporous C4 support. Phosphate analyses indicate that the beta chains of II, III and IV each contain one phosphate per chain while the beta chains of V and VI each contain two phosphates. The alpha chains of IV and VI were found to be monophosphate labelled. Reversed phase HPLC analysis of the tryptic peptides of the beta chains indicates that the label is bound exclusively to the 1-valine residue in II, III and IV while both the 1-valine and the 82-lysine are labelled in V and VI. Similarly, modification of the 1-valine residue of the alpha chains of IV and VI was detected. Components II and III have the same molecular formula. Evidence is presented which shows that they are interconvertible and that they correspond to the PLP2-Hb species and component V is Benesch's PLP4-Hb [J. Biol. Chem., 257 (1983) 1320 and references cited therein]. Component IV is III with one additional PLP per alpha chain and similarly VI is V with monolabelled alpha chains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3667795 TI - Simultaneous determination of nicotine, cotinine and five additional nicotine metabolites in the urine of smokers using pre-column derivatisation and high performance liquid chromatography. PMID- 3667796 TI - Qualitative and quantitative analysis of a new sulphur-containing nitrosourea in blood by high-performance liquid chromatography. PMID- 3667797 TI - Micromethod for the determination of cefpiramide in human plasma and urine by high-performance liquid chromatography using automated column switching. PMID- 3667798 TI - [Analysis of serum cefotaxime and desacetylcefotaxime by high performance liquid ion exchange chromatography]. PMID- 3667799 TI - High-performance liquid chromatographic determination of amphotericin B in human serum. PMID- 3667800 TI - High-performance liquid chromatographic assay of the major components of gentamicin in serum. PMID- 3667801 TI - Determination of ciprofloxacin and its 7-ethylenediamine metabolite in human serum and urine by high-performance liquid chromatography. PMID- 3667802 TI - Quantitation of 1-(beta-D-glucopyranosyl)phenobarbital in plasma and bile. PMID- 3667803 TI - Simultaneous quantitation of d- and l-hexobarbital in rat blood by high performance liquid chromatography. PMID- 3667804 TI - Liquid chromatographic determination of paracetamol and dextropropoxyphene in plasma. PMID- 3667805 TI - Simultaneous determination of doxepin and nordoxepin in serum using high performance liquid chromatography. PMID- 3667806 TI - Analysis of DL-threo-alpha-(2-piperidyl)-2-trifluoromethyl-6-(4- trifluoromethyphenyl)- 4-pyridinemethanol phosphate (enpiroline), a new candidate antimalarial, in blood using high-performance liquid chromatography. PMID- 3667807 TI - Direct determination of debrisoquine and 4-hydroxydebrisoquine using a high performance liquid chromatographic switching technique. PMID- 3667808 TI - Differences in the constitutive forms of hepatic cytochrome P-450 in male and female adult beagle dogs. AB - Cytochrome P-450 isoenzymes were prepared from the solubilized liver microsomes of untreated adult male and female dogs, then separated into groups by high performance liquid chromatography (HPLC). Partial purification was also completed through DEAE-52 cellulose and phosphocellulose ion-exchange chromatography. For comparison, solubilized hepatic cytochromes P-450 were obtained from rats dosed with phenobarbital (PB), beta-naphthoflavone (BNF) or pregnenolone-16 alpha carbonitrile. Minimal molecular masses of cytochrome P-450 subpopulations were determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis. HPLC and ion-exchange chromatography results suggested the presence of two or three major and several minor cytochrome P-450 subpopulations. Three distinct groups were predominant in the female and two major and two or three minor subpopulations were found in the male. One of two isoenzymes prominent in BNF-dosed rats was present in the male but was missing in the female dog; another minor canine cytochrome similar to one found in PB-dosed rats was missing from the male. These data indicate qualitative and quantitative sex-dependent differences in the constitutive cytochrome P-450 populations of the dog and suggest that HPLC analysis may be useful for the interpretation of toxicological studies where microsomal enzyme induction is suspected. PMID- 3667809 TI - Measurement of glycated albumin in diabetic patients by biospecific affinity chromatography. AB - The percentage of glycated plasma albumin was measured by a procedure involving ammonium sulphate precipitation and Affi-Gel-Blue and phenylboronate chromatographies. The value correlates well with the amount of ketoamine-bound sugars determined by colorimetric assay (r = 0.98, n = 39). The normal mean value is 3.9 +/- 0.3% (mean +/- S.D., coefficient of variation = 7.7%, n = 32) and varies from 3.9 to 21% in diabetics (n = 54). A good correlation is found with the mean blood glucose value of the preceding twenty days (r = 0.92, n = 57). Because of its relative ease of determination, glycated albumin constitutes a good short-term glycemic index and an alternative to glycated haemoglobin in some specific cases. PMID- 3667810 TI - High-performance liquid chromatographic analysis of ascorbate-2-phosphate, adenine and hypoxanthine in stored human blood. AB - A high-performance liquid chromatographic procedure was developed to assay for adenine, hypoxanthine, and ascorbate-2-phosphate in both red blood cells and plasma. The samples were diluted and filtered through Centriflo filter cones to remove most of the blood proteins before injection onto the column. The application of the technique to an experimental blood preservation study is illustrated. PMID- 3667811 TI - Determination of the new monoamine oxidase inhibitor moclobemide and three of its metabolites in biological fluids by high-performance liquid chromatography. AB - A sensitive high-performance liquid chromatographic method has been developed for the determination of moclobemide and three of its metabolites in plasma and urine. The four substances and the internal standard were extracted from basified plasma (pH 11) with dichloromethane, with recoveries of generally more than 70%. A column packed with 5-microns Spherisorb hexyl phase and an eluent consisting of acetonitrile and aqueous phosphate buffer 30:320 (v/v) with a pH of 3.9 were found most suitable for the chromatographic separation of the four compounds of interest. Non-ideal interactions of the basic compounds and the N-oxide metabolite occurred with many other reversed-phase materials, as indicated by broad and tailing peaks. Limits of quantitation for moclobemide and its three metabolites in the range 20-30 ng/ml and a good intra-assay reproducibility ranging between 2 and 5% for concentrations over 100 ng/ml could be achieved for plasma, which increased to ca. 8-10% at a concentration of 50 ng/ml. PMID- 3667812 TI - Identification by gas chromatography-mass spectrometry of short-chain hydroxy acids produced by Fusobacterium species and Clostridium innocuum. PMID- 3667813 TI - Quantitation of biphenylacetic acid in plasma and synovial fluid by gas chromatography-mass spectrometry-mass spectrometry. PMID- 3667814 TI - Pulse injection analysis of the binding of serum proteins to porous polymer gels modified with formyl groups. AB - Highly porous spherical polymer gels were modified with formyl groups by a modified Friedel-Crafts reaction and the interaction of serum proteins with the modified gels were examined by pulse injection analysis. The introduction of formyl groups into the polymer greatly increases its protein-binding capacity, and the protein bound to the gel is not eluted by washing with acid, alkali or urea solution. The effects of temperature and the percentage of formyl group substitution on the binding capacity indicate that the binding process can be interpreted as initial approach of the protein to the polymer surface, caused by the hydrophobic interaction, followed by formation of a stable Schiff base between the polymer gel and the protein. Theoretical treatment of the elution behaviour of the protein from the polymer-packed column is also examined, with the assumption that there are three kinds of binding site in the polymer gel: surface, macropore and micropore regions. These polymers are shown to be useful for the removal of proteins from biological samples in clinical assays using immobilized enzymes. PMID- 3667815 TI - Gas chromatographic assay for cysteine sulphinate decarboxylase activity in animal tissues. PMID- 3667816 TI - Automatic amino acid analysis utilizing 4-fluoro-7-nitrobenzo-2-oxa-1,3-diazole. PMID- 3667817 TI - Method for determination of free and total glutathione and gamma-glutamylcysteine concentrations in human leukocytes and plasma. PMID- 3667818 TI - Analysis of isoniazid, acetylhydrazine and [15N2]acetylhydrazine in serum by capillary gas chromatography-ammonia chemical ionization mass spectrometry. PMID- 3667819 TI - Estimation of doxorubicin and doxorubicinol by high-performance liquid chromatography and advanced automated sample processor. PMID- 3667820 TI - High-performance liquid chromatographic determination of ribavirin in serum and urine and of its urinary metabolite 1,2,4-triazole-3-carboxamide. PMID- 3667821 TI - Determination of acyclovir in plasma by column liquid chromatography with fluorescence detection. PMID- 3667822 TI - Stereoselective high-performance liquid chromatographic assay for bupivacaine enantiomers. PMID- 3667823 TI - Rapid high-performance liquid chromatographic determination of nifedipine in plasma with on-line precolumn solid-phase extraction. PMID- 3667824 TI - Rapid simultaneous determination of baclofen and its gamma-hydroxy metabolite in urine by high-performance liquid chromatography with ultraviolet detection. PMID- 3667825 TI - High-performance liquid chromatographic determination of dextrorphan and 3 hydroxymorphinan in human plasma based on a selective pre-column sample clean-up. PMID- 3667826 TI - Simple liquid chromatographic method for the determination of ornidazole and metronidazole in human serum. PMID- 3667827 TI - Quantitative monitoring by high-performance liquid chromatography of the dissociation of human serum cholinesterase by limited proteolysis. AB - Proteolytic action on human serum cholinesterase, a tetrameric enzyme, results in a partial disintegration which can be recorded only qualitatively by time consuming electrophoretic techniques. In this study, a rapid high-performance liquid chromatographic method was used for the separation and determination of the active dissociation products. Separation of the cholinesterase subunits was accomplished by high-performance gel permeation chromatography on a combination of DIOL columns (Zorbax GF 450/GF 250) in 0.2 M phosphate buffer (pH 7.0). Detection and quantification of enzyme activity in the fractionated eluate were carried out using a Flexigem analyser (substrate, butyrylthiocholine). On limited tryptic digestion of partially purified human ChE, up to three peaks of enzyme activity could be identified. Their elution volumes corresponded to apparent molecular masses of 480,000, 270,000 and 120,000, indicating, in addition to the tetrameric holoenzyme, a dimeric and a monomeric form. Quantification of the relative amounts of individual enzyme activity peaks revealed that in the course of degradation, the dimer appeared first, followed by the monomer. This suggests that the first step in the sequence of dissociation is cleavage of the tetramer into a pair of dimers, then further into the monomeric subunit. During the incubation with trypsin, a significant change in the pattern of the different peaks had already occurred when the total enzyme activity was only slightly reduced. PMID- 3667828 TI - Cysteine adducts of human haemoglobin measured by isoelectric focusing in polyacrylamide gels with a non-linear pH gradient. AB - The in vitro formation of adducts from human haemoglobin formed by alkylation with methyl-methanesulphonate, dimethyl sulphate and iodoacetamide was determined with isoelectric focusing in ultra-thin polyacrylamide gels with a non-linear pH gradient. The most important adduct seen in the gels was identified as HbA alkylated at the beta-93 cysteine. Influences of the chemical nature of the alkylating agents and of the biological environment are discussed. The method is suggested to be applicable to monitoring the biological effects of low, long-term exposure to mixtures of alkylating agents or of exposure to unknown compounds. PMID- 3667829 TI - Gas chromatographic-mass fragmentographic determination of propiverine and its metabolites in plasma and urine. AB - 1-Methyl-4-piperidyl diphenylpropoxyacetate hydrochloride has been developed clinically for the therapy of urinary bladder dysfunction. A gas chromatographic mass fragmentographic method was developed for the determination of this drug and its seven metabolites in plasma and urine. The sample was first treated with a Sep-Pak C18 cartridge, the methanol eluate was evaporated to dryness, and the resulting residue was redissolved in distilled water. This solution was then extracted with chloroform and adjusted to pH 9.0 with 0.1 M sodium borate solution. The acidified aqueous layers were extracted with ethyl acetate. The chloroform layer, which contained non-polar metabolites, was concentrated to dryness, then subjected to trifluoroacetylation, decomposition and methylation. The extract from the plasma sample was trimethylsilylated. The dried residue of the ethyl acetate layer, which contained polar metabolites, was subjected to methylation, trifluoroacetylation and decomposition. Aliquots of each reactant solution were injected into the gas chromatograph-mass spectrometer and analysed by the selected-ion monitoring method using an internal standard. Detection was limited to 1-2 ng/ml of plasma and urine for each metabolite. A precise and sensitive assay for the determination of 1-methyl-4-piperidyl diphenylpropoxyacetate hydrochloride and its metabolites in plasma and urine was thus established, and it should prove useful in basic and clinical pharmacological studies. PMID- 3667830 TI - Highly sensitive determination of chlorpheniramine as fluorescence derivative by high-performance liquid chromatography. AB - A new method has been developed for the quantitative analysis of chlorpheniramine in human blood using high-performance liquid chromatography with a fluorescence detector. Benzyl chloroformate was found to be suitable as a fluorometric derivatizing reagent. A linear calibration curve ranging from 0 to 40 ng was obtained for chlorpheniramine, and the minimum detectable concentration was 0.1 ng/ml (whole blood) at a signal-to-noise ratio of 2. It was confirmed that chlorpheniramine levels in the blood of healthy adult volunteers could be precisely determined up to 96 h after a single oral administration of a tablet containing 4 mg of chlorpheniramine. PMID- 3667831 TI - Liquid chromatographic assay for the simultaneous determination of pyrazinamide and rifampicin in serum samples from patients with tuberculous meningitis. AB - A simple high-performance liquid chromatographic assay for the simultaneous determination of pyrazinamide and rifampicin in serum from patients with tuberculous meningitis is presented. The drugs and internal standard, p acetamidobenzoic acid, were extracted from the acidified sample containing 2% ascorbic acid at pH 4.2 into dichloromethane-diethyl ether (2:3). The solvent extract was evaporated to dryness with the aid of nitrogen and the residue redissolved in methanol (75 microliters). The concentrate was analysed by a liquid chromatograph using a reversed-phase 30-microns C8 pre-column linked to a 5-microns C8 analytical column with a gradient solvent programme, which delivered 6% to 48% (v/v) acetonitrile in phosphate buffer (10 mM potassium dihydrogenphosphate, pH 3.5) in 10 min at 1.5 ml/min. The eluate was detected at 215 nm. Twelve patients with tuberculous meningitis were given daily chemotherapy, and their serum samples were assayed for pyrazinamide and rifampicin. PMID- 3667833 TI - Reversed-phase high-performance liquid chromatographic assay for the simultaneous determination of diflunisal and its glucuronides in serum and urine. Rearrangement of the 1-O-acylglucuronide. AB - A reversed-phase ion-pair high-performance liquid chromatographic assay for the simultaneous determination of diflunisal and its ester and ether glucuronide in urine and serum has been developed. The determination of the ester glucuronide in serum has not been previously reported. The genuine glucuronide conjugates isolated from urine were used as standards. The ester glucuronide is found to be unstable, especially in neutral and basic solutions, and special precautions therefore have to be taken during sampling and sample treatment. Nine rearrangement/degradation products of the ester glucuronide were detected. PMID- 3667832 TI - High-performance liquid chromatographic assay for mitoxantrone in plasma using electrochemical detection. AB - A sensitive and specific high-performance liquid chromatographic (HPLC) assay was developed for the quantitation of mitoxantrone in plasma using electrochemical detection. Bisantrene was chosen as the internal standard. A reversed-phase, 10 microns muBondapak C18 analytical column (30 cm X 3.9 mm) with an isocratic mobile phase of 28% acetonitrile in 80 mM sodium formate buffer (pH 3.0) was used. The eluent was monitored by both electrochemical detection at an applied potential of +0.75 V vs. Ag/AgCl and visible absorbance at 660 nm. Only electrochemical detection was able to quantitate the internal standard and provided ten times higher sensitivity than visible absorbance for mitoxantrone with a detection limit as low as 0.1 ng/ml. Calibration curves in the range 0.1 1000 ng/ml showed good linearity (r = 0.998) and precision (coefficient of variation less than 10%). This HPLC method utilized a reproducible and inexpensive liquid-liquid extraction procedure. Using methylene chloride, the extraction efficacy of mitoxantrone from plasma was 85.3% with a coefficient of variation less than 2.1%. This new assay was then applied to measure mitoxantrone concentrations in plasma obtained from two leukemic patients receiving 12 mg/m2 mitoxantrone as a 1-h infusion. PMID- 3667834 TI - Precolumn derivatization for improved detection in liquid chromatography photolysis-electrochemistry. AB - Precolumn, homogeneous chemical derivatization with Sanger's reagent (2,4 dinitrofluorobenzene) is utilized to improve the chromatographic and detection properties of amino alcohols and amino acids. The 2,4-dinitrophenyl derivatives are separated using reversed-phase liquid chromatography and are detected using the hybrid photolysis-electrochemical (hv-EC) detector in tandem with UV absorbance detection. Following optimization of reaction, chromatographic, and detection variables, the derivatization-detection approach provides limits of detection in the low parts-per-billion range, with a linearity of roughly three orders of magnitude. Selectivity is based on retention times as well as dual electrode response ratios and a "lamp on/off" responsiveness criterion unique to the hv-EC detector. The method is applied to the determination of serine in beer. PMID- 3667835 TI - Analysis of OPA-derivatized amino sugars in tobacco by high-performance liquid chromatography with fluorimetric detection. AB - An analytical method is developed to quantitatively determine glucosamine, galactosamine, and mannosamine in dried-and-ground burley and flue-cured tobaccos. Extraction is shown to be quantitative in the range of 0.01 to 2.0% (w/w). The extraction procedure consists of shaking one g of sample with 50 mL of deionized water adjusted to pH 7 for 30 min. This extract is filtered directly into an autosampler vial. An autosampler is programmed to withdraw two different aliquots: one with o-phthalaldehyde (OPA) derivatizing solution and the second one from the tobacco extract. The derivatization reaction occurs in the tubing connecting the autosampler and the chromatographic column. The OPA derivatives of these aminosugars are then detected with a fluorimetric detector, and their simultaneous analysis is performed with an external standard. This method is shown to be selective, accurate, and precise. PMID- 3667836 TI - Determination of ethanol in alcoholic beverages by liquid chromatography using the UV detector. AB - Ethanol in certain beverages and in similar solutions may be determined by reversed-phase liquid chromatography (LC) using the UV detector. The mobile phase in this indirect photometric detection technique contains a low concentration of a UV-absorbing compound, such as acetone, that coelutes with the ethanol peak. Several variables such as the choice and concentration of the UV-detection agent are examined regarding their effects on the retention time, magnitude and linearity of peak area, and other aspects of quantitation. Except for filtering to remove particulate matter, samples can be injected without pretreatment. The concentration of ethanol in several types of beverages can be determined with 2% relative standard deviation, calibration is linear to 40% ethanol, and the minimum detectable concentration is 0.1%. PMID- 3667837 TI - HPLC analysis of commercial alkyl and aryl quaternary ammonium compounds used in organoclay type rheological additives. AB - Mixtures of aliphatic and aromatic "quats" can be qualitatively identified in a one step chromatographic run. After separation on a strong cation exchange column, the eluted components are detected using a UV and RI detector system in series. The quaternaries present in organoclays (e.g., BENTONE type products) can also be identified by prior destruction of the silicate with hydrofluoric acid followed by chromatography of the residual quat fluorides. PMID- 3667838 TI - The analysis of nitrate in environmental samples by reversed-phase HPLC. AB - A method is presented for the analysis of nitrate in natural waters and waste water by high-performance liquid chromatography (HPLC) with a reversed-phase octadecyl column, aqueous phosphoric acid/dihydrogen phosphate mobile phase, and UV detector. The optimum nitrate concentration is 0.3 to 3 mg/L as N with linear detector response below 3 mg/L. The detection limit is 0.007 mg/L. Relative standard deviations in the optimum range are consistently less than one percent. Several potential interferences have been investigated; nitrite and organic chromophores are resolved from nitrate and do not interfere. Hexavalent chromium and sulfate are slight positive interferences, negligible at typical environmental concentrations. The method produces results in agreement with the accepted chromotropic acid method except in samples from eutrophic lakes, for which evidence is presented indicating that the chromotropic acid is inaccurate. PMID- 3667839 TI - Use of chemically-bonded cyclodextrin stationary phase for high performance liquid chromatographic determination of feldene capsules. AB - A novel high performance liquid chromatographic method (HPLC) is presented for the quantitative determination of piroxicam in capsule formulation (Feldene capsule). Samples are separated on a chemically bonded beta-cyclodextrin column (Cyclobond I) with a mobile phase of 75% 0.05M phosphate buffer (pH 7.0) and 25% methanol. The effluent is monitored by a spectrophotometric detector with a 254 nm filter. The method is rapid, accurate, and precise. PMID- 3667840 TI - Using computers in quality assurance. PMID- 3667841 TI - Quality assurance: should you computerize? PMID- 3667842 TI - Integration of manual and computerized components in nursing quality assurance. PMID- 3667843 TI - Using computers to facilitate monitoring of nursing practice in a unit-based nursing QA program. PMID- 3667844 TI - Computer-generated quality assurance: nontraditional uses of the data. PMID- 3667845 TI - Using computers to evaluate nursing process documentation. PMID- 3667846 TI - The future of computer applications for nursing quality assurance. PMID- 3667847 TI - Innovations and excellence. PMID- 3667848 TI - How do peer review and quality assurance relate? PMID- 3667849 TI - Dimensions of computerized quality assurance systems. PMID- 3667850 TI - The isolation of the two electrophoretic forms of cowpea mosaic virus using fast protein liquid chromatography. AB - This report describes the first time entire viral capsids have been purified using fast protein liquid chromatography (FPLC) techniques. The FPLC is used here to separate the two electrophoretic forms of cowpea mosaic virus. The capsid forms are shown to be separated by the Mono-Q column without damaging the capsids. PMID- 3667851 TI - Application of solid phase aggregation of coated erythrocytes technique for detection of rinderpest antigen. AB - A solid phase aggregation of coated erythrocytes (SPACE) technique was standardized and used for the detection of rinderpest antigen in 129 samples of 9 visceral organs; from 50 clinical samples such as gum scraping, tongue scraping, faeces, urine, nasal swabs; blood from 18 rinderpest infected cattle and 2 field samples. The comparative sensitivity of SPACE, reverse phase passive haemagglutination and counter-immuno-electrophoresis tests was found to be 86.8, 84.5 and 79.8%, respectively. PMID- 3667852 TI - Use of biotinylated probes in serum hepatitis B virus DNA detection. AB - A dot-blot hybridisation assay for serum HBV DNA is described using a non radioactive (biotinylated) DNA probe. The assay is both sensitive (1 pg of HBV DNA) and reproducible, and shows several advantages over similar assays which use 32P-labelled probes for the routine detection of infectious virus particles both in blood and in other biological fluids. PMID- 3667853 TI - Diagnosis, prevention and treatment of viral infections. An informal symposium. Nijmegen, The Netherlands, March 1987. Proceedings. PMID- 3667854 TI - A sol-particle immunoassay for determination of anti-rubella antibodies; development and clinical validation. AB - A sol-particle immunoassay (SPIA) was developed for determination of anti-rubella antibodies. The test is based on antibody-coated gold sol particles, which may agglutinate in the presence of rubella haemagglutinin antigen. The agglutination which gives a decrease in optical density can be inhibited by specific antibodies present in sera incubated with the immunochemical reagents. The test is performed in microtitration plates and results can be read in a plate-reader. Clinical validation studies were performed comparing the anti-rubella SPIA with the haemagglutination inhibition test and with the latex agglutination test. The sensitivity of the SPIA was calculated to be 99%; the specificity of the test was at least 99.5%. The anti-rubella SPIA is highly suitable for large-scale screening to determine the rubella immune-status. PMID- 3667855 TI - Time-related factors in cancer epidemiology. Papers presented at a symposium. April 1985. PMID- 3667856 TI - Time-related factors in quantitative risk assessment. AB - In regulatory or decision-making contexts related to carcinogenic hazards, one would like to know the extra risks associated with various levels, durations, and ages of exposure to a carcinogen. To supply that information, quantitative risk assessments are required that make extrapolations on variables related to dose levels, timing of exposure, and age. Quantitative models that express age specific mortality rates as functions of the exposure pattern and that allow such extrapolations to be made are presented. The uncertainty inherently associated with those extrapolations is discussed and is found to be exacerbated by small data sets and inadequate data availability. Specific examples are provided that involve asbestos-induced mesothelioma and leukemia caused by benzene exposure. PMID- 3667857 TI - Looking backwards from outcome to exposure to assess cancer latency. AB - Assessing time relationships in cancer epidemiology involves linking exposure and cancer incidence or mortality on a time scale. The traditional approach is to make some exposure criterion the referent point, such as date of first exposure. However, the time relationships between exposure and cancer may also be usefully explored using the date of diagnosis (or death) as the referent point in time. This has been accomplished to date in industry-based case-control studies by estimating the etiologic fraction among ever exposed cases for years prior to death from cancer, and in the serially additive expected dose (SAED) model by estimating excess case exposure dose for each year prior to cancer death. Each of these measures assesses exposure in time windows (of arbitrary width) prior to cancer death or diagnosis. Both measures are mathematically related (by constants) to a measure of the fraction of excess case exposure dose achieved in each time window, where "excess" means beyond that expected on the basis of non cases or controls. This particular measure, the retrospective excess exposure fraction (REEF) in time windows, may be valuable in exploring time relationships between exposure and cancer. It is concluded that retrospective measures between cancer occurrence and exposure warrant further attention to maximize the informativeness of cancer epidemiology studies. PMID- 3667858 TI - Calculating cancer latency using data from a nested case-control study of prostatic cancer. AB - Assessing latency for neoplastic diseases is crucial for determining the causal effects of a complex mix of carcinogenic exposures. An initial assessment of cancer risks in a U.S. tire and rubber plant revealed a significant SMR of 140 for prostatic cancer. Using an industry-based, case-control death certificate study of prostatic malignancies, we found matched odds ratios of about 3 (p less than 0.025) for Batch Preparation, the work area with the greatest exposure to carbon black, solvents, and heavy metal oxides. To assess latency, we used the matched case-control series to calculate annual estimates of the odds ratio by determining the proportion of cases and controls employed for greater than 1 month in Batch Preparation during each year under study. This approach produced a plot with great fluctuations. To reduce variability in the resulting curve, a method was developed that measured the "etiologic fraction", which is its highest point represents an estimate of the peak of the latency distribution. For Batch Preparation the modal point was 29 years before death with the greatest risk occurring from employment in the mid-1940's. The latency method allows risk assessment for time and year of greatest exposure difference, thus suggesting appropriate prevention strategies. Applications of this method for other types of studies and exposures are discussed. PMID- 3667859 TI - Diagnostic plots for departures from proportional hazards in cohort study data. AB - The assumption of proportional hazards is routinely made in the analysis of cohort studies, whether a simple SMR calculation or a full survival analysis is used. In this paper, we introduce simple plots for checking the validity of the assumption. The plots are of two kinds. The first, which has been used previously for survival data, makes use of the fact that the individual integrated hazards are distributed as unit exponential varieties under proportional hazards, and involves plotting their estimates against expected exponential order statistics. The second displays the evolution of relative risk as a function of time, and in this case, a choice of time scale must be made for the plots. A score test for proportional hazards is also derived, and the methods are illustrated by data on cancer mortality among the employees of a South Wales nickel refinery. PMID- 3667860 TI - Some problems of inference in cohort studies. AB - This paper uses a detailed example to illustrate how to detect individual observations that disproportionately influence the results of hypothesis testing with relative risk regression models. PMID- 3667861 TI - A graphical approach to the identification and estimation of causal parameters in mortality studies with sustained exposure periods. AB - In observational cohort mortality studies with prolonged periods of exposure to the agent under study, independent risk factors for death commonly determine subsequent exposure to the study agent. For example, in occupational mortality studies, date of termination of employment is both a determinant of subsequent exposure to the chemical agent under study (since terminated individuals receive no further exposure) and an independent risk factor for death (since disabled individuals tend to leave employment). When a risk factor determines subsequent exposure and is determined by previous exposure, standard analyses that estimate age-specific mortality rates as a function of cumulative exposure can underestimate the true effect of exposure on mortality, whether or not one adjusts for the risk factor in the analysis. This observation raises the question, "Which, if any, empirical population parameter can be causally interpreted as the true effect of exposure in observational mortality studies?" In answer, we offer a graphical approach to the identification and estimation of causal parameters in mortality studies with sustained exposure periods. We reanalyze the mortality experience of a cohort of arsenic-exposed copper smelter workers using our approach and compare our results with those obtained using standard methods. We find an adverse effect of arsenic exposure on all cause and lung cancer mortality, which standard methods failed to detect. The analytic approach introduced in this paper may be necessary to control bias in any epidemiologic study in which there exists a risk factor which both determines subsequent exposure and is determined by previous exposure to the agent under study. PMID- 3667862 TI - A nonmathematical view of mathematical models for cancer. AB - A qualitative view of mathematical models for cancer is presented. The Armitage and Doll multistage and Moolgavkar two-stage models of cancer are discussed in terms of their physical models. Time-related factors for these models as well as some of their characteristics are presented. The effect of age at first exposure, duration of exposure, time since last exposure and stage of carcinogenic effect on risk are detailed. PMID- 3667863 TI - Interpreting time-related trends in effect estimates. AB - This paper reviews the sources of apparent time trends in effect. Apparent changes in effect may arise from changes in covariate distributions, background rates, exposure distribution, measurement quality, or selection factors. As with time trends in rates, time trends in effect must have at least one of these sources, since time itself has no effect. If background incidence is changing, however, time trends in effect become dependent on choice of effect measure, and interpretation must take this into account. Evidence that a trend arises from age , cohort-, or period-related phenomena can indicate the relative plausibility of different explanations of the trend. Conversely, the relative plausibility of each explanation may indicate whether the trend is most appropriately viewed over the axis of age, birth cohort, or calendar time. Nevertheless, studies of short duration relative to an apparent trend (such as most case-control studies) must invoke strong assumptions to justify focusing on a particular axis. Illustrations are given from studies of electronic fetal monitoring and of smoking and lung cancer. PMID- 3667864 TI - Use of multistage models to infer stage affected by carcinogenic exposure: example of lung cancer and cigarette smoking. AB - Statistical methods based on the Armitage-Doll mathematical model of the carcinogenic process are presented for analyzing epidemiologic case-control studies of cancer. These methods are proposed to provide inferences regarding the stage(s) in the cancer process at which the exposure of interest acts. An example of these methods is given which shows evidence that carcinogens in cigarette smoke appear to affect the transition rates for two separate stages in the development of lung cancer, and the relative magnitudes of these effects are estimated. The data for this analysis came from a European multi-center case control study of lung cancer. The results of the analysis show that: (1) the relative risk of lung cancer among continuing smokers compared to nonsmokers of the same age decreases as the age started smoking increases, while the rate of smoking stays fixed, a result which indicates a carcinogenic effect on an early stage in the process; and (2) the relative risk among ex-smokers compared to continuing smokers having the same duration and rate of smoking decreases with time since smoking stopped, a result which indicates a carcinogenic effect on a late stage in the process. Both results are shown to be best described by the hypothesis that cigarette smoking affects two stages. The estimated relative magnitudes of cigarettes' carcinogenic effects on the two stages indicate that the largest proportion of the total lifetime lung cancer risk among continuing smokers is due to its late stage effect, and that the proportion of risk due to causes other than smoking varies from 23% among men smoking 1-10 cigarettes per day to 6% among those smoking greater than 30 cigarettes per day. These findings imply that preventive measures directed toward inducing smokers to stop would have a potentially substantial payoff in reducing future lung cancer mortality. PMID- 3667865 TI - Fitting models of carcinogenesis to a case-control study of breast cancer. AB - Data from a case-control study of breast cancer in 441 cases and matched controls aged less than or equal to 38 in Los Angeles is fitted to two models of carcinogenesis: the two-stage model of Moolgavkar and Knudson; and a multistage adaptation of the log/log model proposed by Pike et al. In the two-stage model, risk factors (here age at menarche, age at first pregnancy, abortion, regularity of cycling, benign breast disease, and use of oral contraceptives (OCs] are postulated to act either by increasing the rate of mutation of normal to intermediate or of intermediate to malignant stage cells, or by increasing the proliferation rates of such cells. In the multistage model, it is postulated that all transition rates are equally determined by the rate of cell turnover, which is in turn influenced by risk factors. In both models, positive family history is modelled in two ways: (1) all cells may have started in an intermediate stage at birth, with probability depending on the number and degree of affected family members; or (2) as an event rate modifier in the same way as other covariates. With only menarche or menarche and family history included, the multistage and two-stage models both produced likelihoods very similar to those from a simple logistic model, though both fit better than the logistic model as more covariates were added to the model. The two stage models offer greater flexibility in modelling the time at which each factor is most effective. We found irregular menstrual cycling to reduce the rate of proliferation of normal cells or their mutation rate to intermediate cells by 50% (p less than 0.025) and use of OCs to increase these rates by 3.25 fold (p less than 0.01). Having completed a pregnancy of more than 26 weeks gestation appeared to reduce the rate of intermediate cell proliferation by 5% (p less than 0.05) relative to a baseline rate of 14% per year. Benign breast disease was associated with a 1.60 fold increased rate of the second mutation (p less than 0.025). In all models, family history was by far the strongest risk factor (RR = 4.44 from the logistic model, p less than 0.0001). Covariates showed similar effects in the multistage model, though their magnitudes were slightly different. PMID- 3667866 TI - Metabolic modeling of organ-specific doses to carcinogens as illustrated with alpha-radiation emitting radionuclides. AB - Quantitative estimation of doses of carcinogens delivered to physiologic targets facilities specification of organ-specific dose-response functions. Typically, exposure measurements, such as air or water concentrations of carcinogens, are used as dose surrogates in epidemiologic studies. An illustrative exception to this usual situation is the case of airborne alpha radiation-emitting radionuclides, for which organ-specific doses can be derived. A metabolic modeling approach for estimating doses delivered to the lung, gastrointestinal tract and bone is described for three classes of radionuclides: soluble uranium, insoluble uranium and plutonium. The dose models are defined in terms of biological retention patterns and organ-specific depositions affinities. Application of the metabolic modeling approach is illustrated with a hypothetical example of excess lung cancer risk projection in a cohort of persons exposed to plutonium. Also, a simple example is presented to demonstrate how adherence to the metabolic model structure can avoid gross overestimation of doses in the case of multiple in vivo lung counting measurements taken in close temporal proximity following a large exposure intake. PMID- 3667867 TI - Use of computer simulation to explore analytical issues in nested case-control studies of cancer involving extended exposures: methods and preliminary findings. AB - A Monte Carlo simulation program has been designed to generate case-control study data from hypothetical cohorts of individuals exposed to one or more carcinogens at intensities which vary over time. Exposure distributions are specified by such parameters as the probability of any exposure, the distributions of age at first and last exposure, the distribution of intensity as a function of time, and the correlations between exposures. Within subcohorts generated in this way, age specific cancer rates are computed based on the multistage model of carcinogenesis (other models will be considered in the future). Age and possibly exposure-dependent censoring rates are also computed. Cancer cases are randomly generated from the resulting age and cause of death distribution and age-matched controls are drawn by sampling from the survival distribution. The "true" exposure histories, used to generate the cases and controls, are then corrupted by various random and systematic sources of error. The resulting case-control data are fitted to simple exposure indices as well as more sophisticated models of carcinogenesis. In preliminary simulations of a single carcinogen, it appeared that exposure indices derived from the multistate model could correctly estimate the stage at which the carcinogen acted when exposure is limited to a constant intensity over time, even when that intensity was measured with considerable error. These indices also fitted substantially better than simple duration, average intensity, or cumulative exposure. Further investigations will assess such issues as the additional information obtained by appropriately exploiting a time-dependent history, the effect of time-dependent exposure measurement errors, and the robustness of inferences when the assumed model is incorrect. PMID- 3667868 TI - Age-related factors in cancers of the breast, ovary, and endometrium. AB - The most central epidemiological feature of cancers of the breast, ovary and endometrium is the enormous protective effect of menopause. Simple mathematical "models" of the age-incidence of these tumours suggests that their incidence by age 70 would be between 4 and 8-fold increased if women continued to menstruate into old age. Using the notion of "effective cell-cycle time" to explain this phenomenon, different "models" are constructed for each of these three tumour sites and shown to provide an excellent description of most of the known epidemiology of each of the cancers, and to provide a basis for predicting the long-term effects of various factors on the risk of these diseases. In particular, the model suggests that 5 years of combination-type oral contraceptive use will approximately halve the lifelong risk of both ovarian cancer and endometrial cancer. PMID- 3667870 TI - Nonparametric estimation of relative mortality functions. AB - The standardized mortality ratio (SMR), which is the ratio of the number of deaths from a particular disease observed in a study cohort to the number expected from national vital statistics, has a long history of use in epidemiology. Separate SMRs computed according to discrete intervals of time since initial exposure, time on study, age or calendar year are used to examine effects of these variables on relative mortality. Applying some recent ideas of Andersen et al. (Biometrics 1985; 41: 921-932), we discuss refinements of this procedure that yield a nonparametric estimate of the SMR as a function of one time-varying factor while at the same time adjusting for the effects of other factors in a regression equation. The method is utilized to study relative lung cancer mortality as a function of years since initial employment in cohorts of 8014 Montana smelter workers and 679 Welsh nickel refinery workers. Suggestions are made for approximating the relative mortality function using only data for cases and matched controls sampled from the full cohort. PMID- 3667869 TI - Methods for analyzing occupational cohort data with application to lung cancer in U.S. uranium miners. AB - We used two methods to examine how lung cancer death rates vary with cumulative exposures to radiation and tobacco among U.S. uranium miners. We assumed that exposures act proportionately on age-specific death rates among nonsmokers who are unexposed to uranium. The two methods produced similar results when death rate ratios were taken to be the product of radiation and tobacco effects. The estimates were discrepant when death rate ratios were taken to be the sum of radiation and tobacco effects. Both methods indicated better fit for the multiplicative model, as judged by the maximized loglikelihood values. Death rates estimated in this way for white males in the absence of mining and smoking increased only weakly with age. This weak relation suggests that our models of death rates fit poorly. It may be that cumulative exposures are inappropriate measures of the effects of radiation and tobacco on lung cancer death rates. PMID- 3667871 TI - The effect of luteal phase estrogen antagonism on endometrial development and luteal function in women. AB - Previous studies of the role of estrogen in primate luteolysis, designed to investigate the effects of estrogen antagonism or selective inhibition of luteal phase estrogen production on luteal function, have ignored the impact of such treatments on secretory endometrial development. We examined the effect of luteal phase estrogen antagonism on endometrial maturation and luteal function in six women. In each of two menstrual cycles in each woman, blood samples were obtained on alternate days from cycle days 3-9, daily until 1 day after the urinary LH surge (day 0), and again on alternate days until the onset of menses. In the second of each pair of cycles, clomiphene citrate (100 mg) was administered daily from 2 days after the LH surge until menses. Endometrial biopsy was performed 13 days after the LH surge in each cycle. Serum FSH, LH, estradiol, and progesterone (P) were measured by RIA. The endometrial histological date and concentration of cytosolic (C) and nuclear (N) estrogen (ER) and P (PR) receptors were determined. We found significant (P less than 0.05) increases in luteal phase serum FSH, LH, estradiol, and P levels in the clomiphene cycle compared to those in the control cycle. Endometrial histology was significantly (P less than 0.002) different during estrogen antagonism; a maturation delay of more than 2 days was found in all six women during the clomiphene cycle. Luteal phase duration was unchanged by clomiphene (P = 0.29). Endometrial ER-C [7.38 +/- 2.52 (+/- SEM) vs. 38.75 +/- 10.17 fmol/mg protein], ER-N (248 +/- 84 vs. 685 +/- 80 fmol/mg DNA), and PR-C (97 +/- 38 vs. 189 +/- 38 fmol/mg protein) were significantly lower (P less than 0.03) in the clomiphene cycle than in the control cycle, whereas PR-N was not different (P greater than 0.10). These data suggest that luteal phase estrogen 1) modulates endometrial PR and 2) plays an important role in secretory endometrial development. PMID- 3667872 TI - Variations in estrone sulfatase activity in human leukocytes. AB - Peripheral blood leukocytes isolated from men and women were studied for their capacity to metabolize estrone (E1) sulfate. Fresh human leukocytes (granulocytes and mononuclear cells) were incubated in phosphate buffer, pH 7.4, containing [3H]E1S for 1 h at 37 C. The samples were extracted with chloroform for measurement of the [3H]E1 formed, and the results were corrected for nonenzymatic hydrolysis. The mean E1 sulfatase activity in leukocytes isolated from normal women in the follicular phase of their cycle was 75% higher than that during the luteal [1840 +/- 179 (+/- SE) vs. 1048 +/- 101 fmol E1 micrograms protein-1 h-1; P less than 0.004] and higher than that in normal men (875 +/- 123; P less than 0.002), but was not different from that in menopausal (1349 +/- 151) or hirsute women (1700 +/- 222). In pregnant women, the mean leukocyte E1 sulfatase activity was significantly lower (861 +/- 147) than that in nonpregnant women in the follicular phase (P less than 0.003). These results suggest that progesterone may modulate E1 sulfatase activity, whereas estrogens do not. PMID- 3667873 TI - Effect of short term triiodothyronine administration on human leukocyte Rb(K) influx and Na efflux. AB - The effect of short term T3 administration on leukocyte ouabain-sensitive 86Rb(K) influx and Na efflux in normal subjects was investigated. At a dose of 60 micrograms daily for 7 days, T3 induced a significant increase in leukocyte 86Rb(K) influx and a significant fall in plasma K concentrations. Plasma and intracellular Na concentrations did not change. [3H]Ouabain binding, a measure of Na-K ATPase units, did not change. A week after T3 administration, 86Rb(K) influx, Na efflux, and plasma K concentrations were normal. In a series of five hyperthyroid patients, both ouabain-sensitive 86Rb influx and [3H]ouabain binding were significantly greater than in normal subjects. We conclude that T3 stimulates 86Rb(K) influx and Na efflux by leukocytes in vivo independently of [3H]ouabain binding and that this increase is rapidly reversible. However, in hyperthyroid patients both 86Rb influx and [3H]ouabain binding are increased, probably due to prolonged exposure to thyroid hormone excess. PMID- 3667874 TI - Distribution of serum calcium values in patients with familial benign hypercalcemia (hypocalciuric hypercalcemia): evidence for a discrete genetic defect. AB - One group has reported hypocalcemic individuals in families affected with familial benign hypercalcemia (FBH), suggesting either that FBH is merely an extreme of normality or that hypocalcemia is independently inherited in that kindred. To test these hypotheses, we examined the distributions of serum total calcium (Ca) values in 260 normal adults and 171 adult individuals in 21 FBH kindreds. We excluded from analysis the 21 adult probands, leaving 85 apparently affected persons (Ca, greater than 10.1 mg/dL or greater than 2.52 mmol/L) and 65 apparently unaffected individuals (Ca, less than or equal to 10.1 mg/dL or less than or equal to 2.52 mmol/L). Five FBH family members were hypocalcemic (less than 8.9 mg/dL or less than 2.22 mmol/L); of these, 3 had hypoproteinemia or hypoalbuminemia, 1 had surgical hypoparathyroidism, and 1 was pregnant (and thus excluded from further analysis). Histogram analysis suggested a bimodal distribution of Ca in the FBH families, and familial serum Ca levels were significantly elevated (P less than 0.001, rank sum). When only apparently unaffected family members were compared with normal individuals with serum Ca of 10.1 mg/dL or 2.52 mmol/L or less, the distributions were virtually identical. Our results indicate that hypocalcemia in members of families with FBH is of sporadic nongenetic origin. Furthermore, FBH is not an extreme of the normal distribution, but, instead, a clear disturbance with its own distribution about a supranormal mean serum calcium value. PMID- 3667875 TI - A case of recurrent malignant pheochromocytoma complicated by watery diarrhea, hypokalemia, achlorhydria syndrome. AB - A patient is reported who had undergone right adrenalectomy for pheochromocytoma and 15 yr later developed a recurrence in the same site complicated by the watery diarrhea, hypokalemia, achlorhydria syndrome. This tumor was histologically defined as a composite malignant pheochromocytoma-ganglioneuroblastoma (well differentiated type). Vasoactive intestinal polypeptide and catecholamine concentrations were elevated in both plasma and the tumor. The tumor somatostatin content also was high. The tumor was immunohistochemically determined to contain both vasoactive intestinal polypeptide and somatostatin. PMID- 3667876 TI - Inhibition of basal and metoclopramide-induced prolactin release by cabergoline, an extremely long-acting dopaminergic drug. AB - The aim of this study was to evaluate the effectiveness of the ergoline derivative cabergoline in inhibiting the serum PRL response to metoclopramide (MCP; 5 mg, iv) and the duration of this effect. Seven normal men received cabergoline (600 micrograms, orally) on day 0 and underwent a MCP test on days 1, 1, 4, 8, 15, and 28. Fasting serum PRL levels were significantly depressed from days 1-14; the nadir value occurred on day 4. MCP-induced PRL release was significantly inhibited up to day 28, with a nadir on day 4. Two months later, four of the men received placebo on day 0, and tests with MCP were performed on days -1, 8, and 28; basal serum PRL levels and PRL responses to MCP were superimposable on days -1, 8, and 28. These data indicate that cabergoline is an effective long-acting inhibitor of PRL release in normal men, suitable for use in the management of hyperprolactinemic patients. PMID- 3667877 TI - Pregnancy-associated endometrial alpha 2-globulin, the major secretory protein of the luteal phase and first trimester pregnancy endometrium, is not glycosylated prolactin but related to beta-lactoglobulins. AB - We previously reported that the major secretory protein of the endometrium during the first trimester of pregnancy, pregnancy-associated endometrial alpha 2 globulin (alpha 2-PEG), also represented the major secretory protein during the mid- to late luteal phase. Recently, the major secretory endometrial protein during the luteal phase of the menstrual cycle was identified as glycosylated PRL (G-PRL). Although certain properties of alpha 2-PEG resemble G-PRL, in this study G-PRL was demonstrated to be immunochemically distinct from alpha 2-PEG, and deglycosylation of alpha 2-PEG produced a protein unrelated to PRL. The sequence of the 38 N-terminal amnio acid residues of alpha 2-PEG was determined by a gas phase sequenator. A sequence of Met-Asp-Ileu-Pro-Gln-Thr-Lys-Gln-Asp-Leu-Glu-Leu Pro-Lys-Leu-Ala-G ly-Lys-Trp- His-Ser-Met-Ala-Met-Ala-Thr-Asn-?-Ileu-Ser-Leu-Met Ala-Thr-Leu-Lys -Ala-Pro was obtained which was unique and unrelated to that of PRL. However, sequence homology between alpha 2-PEG and the major milk whey protein beta-lactoglobulin of the horse was demonstrated. The data indicate that alpha 2-PEG is a unique protein and is a human homolog of the beta-lactoglobulin family. PMID- 3667878 TI - The ontogeny of serum GH binding protein in man: a possible indicator of hepatic GH receptor development. AB - Experiments in rabbits suggest that a serum GH binding protein (GH-BP) probably is derived largely from hepatic membrane bound GH receptors. Human serum contains a specific GH binding protein which can be easily measured by incubation with [125I] hGH and separation of [125I] hGH-BP complexes from free [125I] hGH by gel filtration through an Ultrogel AcA 44 minicolumn. In each assay GH-BP activity of a reference (normal young adult) serum is similarly run and the results are expressed as a percentage of the activity of the unknown serum divided by the GH BP activity of the reference serum after correction for the expected inhibition of GH binding resulting from the GH content of the unknown serum. The mean relative specific GH binding protein (RSGH-BP) of cord serum from 11 premature infants was only 3.2 +/- 1.4% (SE) and of cord serum from 17 full term infants was 14.9 +/- 2.5%. During the first two decades of life there was a progressive rise of RSGH-BP with considerable individual variation. The mean serum RSGH-BP of 13 such subjects was 54.5 +/- 6.2%. More uniform RSGH-BP results were obtained in serum from 15 young adults, 91.7 +/- 7.4%. Lower RSGH-BP 77.2 +/- 5.4% was found in serum from 12 healthy older adults (age 60 to 70 years). The low levels of RSGH-BP in fetal serum are consistent with the reported low concentrations of GH receptors in sheep and rat fetal liver membranes. We suggest the measurement of GH-BP activity provides a simple, noninvasive measure of the ontogeny of GH receptors of human beings. PMID- 3667879 TI - On the nomenclature of the somatomedins and insulin-like growth factors. PMID- 3667880 TI - Inverse seasonal relationship between melatonin and ovarian activity in humans in a region with a strong seasonal contrast in luminosity. AB - The effects of season on the activity of the pituitary-ovarian axis and the pineal gland were studied in 11 women by serum and urinary melatonin determinations and in 21 women by measurements of the serum concentrations of anterior pituitary and ovarian hormones during the dark and light seasons. A melatonin index was determined by integration of the area below the curve of serum melatonin concentrations during 24-h periods in both seasons. During the dark season, the daytime 12-h melatonin index and daytime urinary melatonin excretion were significantly higher than during the light season. In addition, the duration of the nocturnal melatonin pulse (serum melatonin levels, greater than 65 pmol/L) was lengthened during this season, whereas the mean serum estradiol concentration was significantly decreased at the time of ovulation and during the luteal phase of the cycle, indicating lowered ovarian activity. Luteal phase gonadotropin concentrations were increased during the dark season, which was also characterized by increased sex hormone-binding globulin (SHBG) and decreased free testosterone concentrations and free androgen indices (ratio of testosterone to SHBG X 700) throughout the menstrual cycle. The dark season was thus characterized by increased melatonin secretion and decreased ovarian and androgenic activities. In summary, we characterized two season-dependent hormonal phenomena. Although we did not prove any cause and effect association between melatonin and anterior pituitary-ovarian hormones, the inverse seasonal relationship in pineal gland and ovarian secretion suggests that melatonin is causally related to reproduction in humans. PMID- 3667881 TI - Monodeiodination of triiodothyronine and reverse triiodothyronine during low and high calorie diets. AB - The impact of varying caloric intake on peripheral monodeiodination and plasma disposal of T3, rT3, and the three diiodothyronines (T2) was studied in five normal subjects while they were consuming a low calorie diet (1200 Cal/day) and again while receiving a high calorie diet (3600 Cal/day). Toward the end of each diet period 240 nmol 3,3'-T2 (126 micrograms) and 80 nmol 3',5'-T2 (42 micrograms) were infused for 7 h, and a bolus injection of 137 nmol 3,5-T2 (72 micrograms) was followed by a 12-h infusion of 69 nmol 3,5-T2 (36 micrograms) and 111 nmol rT3 (72 micrograms) on another day. [125I]T3 (30 muCi) was injected on the third day. The T2 and rT3 concentrations were measured by RIA during the 2 days of infusion, and the serum disappearance of [125I]T3 was studied by immunoprecipitation and trichloroacetic acid precipitation of the labeled T3. Four to 5% of the plasma disposal of T3 was accounted for by 3'-monodeiodination, and 36-39% by 5-monodeiodination. Increasing caloric intake resulted in a higher overall plasma disposal rate of T3, but no change in the percentage of T3 metabolized by monodeiodination pathways. In contrast, 5'-monodeiodination accounted for 21% of the total plasma disposal of rT3 during the low calorie diet and 45% during the high calorie intake. This increase in 5'-monodeiodination of rT3 was at the expense of alternative pathways of disposal. A marked increase in the plasma clearance rate of 3,5-T2 was also found during the high calorie diet, indicating that the level of caloric intake affects pathways of metabolism other than outer ring monodeiodination. These studies emphasize the important role played by diet in the regulation of peripheral thyroid hormone metabolism through modulating outer ring monodeiodination, and that overnutrition changes other pathways of iodothyronine metabolism as well. PMID- 3667882 TI - A model for the study of the acute effects of melatonin in man. AB - The role of the pineal hormone melatonin in human physiology is uncertain. Previous studies correlated plasma melatonin levels with several physiological parameters or determined the responses to pharmacological doses of melatonin during daylight hours. We established an acute model that is more rigorously physiological. Constant nocturnal bright light in sleep-deprived normal men resulted in low plasma melatonin levels throughout the night, in contrast to sleep in the dark and dim light sleep deprivation nights. Subsequently, melatonin was infused during bright light exposure to approximate physiological levels. Plasma GH and PRL measurements in these four conditions revealed an effect of sleep deprivation independent of the presence or absence of melatonin. A subsample of these men had an intermediate level of melatonin suppression with 500 lux light intensity, relative to those during sleep and bright light. The results suggest that melatonin has no acute modulatory effect on the secretion of these two sleep-related hormones. PMID- 3667883 TI - Estrone and estradiol concentrations in human ovaries, testes, and adrenals during the first two years of life. AB - To determine the origin of estrogens in infant blood, we measured estrone (E1) and estradiol (E2) in the gonads of 50 girls and 64 boys who died suddenly between birth and 2 yr of age as well as in the adrenals of 18 of these infant girls and 16 of the boys. In the adrenals, E1 [median, 2.8 ng/g (10.4 pmol/g); range, 1.1-4.8 ng/g (4.1-17.8 pmol/g)] and E2 [median, 3.0 ng/g (10.9 pmol/g); range, 1.2-5.3 ng/g (4.4-19.5 pmol/g)] were found in similar concentrations and were independent of age and sex. In the gonads, E2 was the major estrogen, but the concentrations differed markedly between the sexes; E2 exceeded E1 almost 10 fold in the ovaries and 2-fold in the testes. On the average, the gonads of the infant girls had 5 times more E2 and 2 times more E1 than those of the boys. As in plasma, E2 concentrations were highest in the ovaries of 1- to 6-month-old girls [median, 10.5 ng/g (38.5 pmol/g); range, 1.1-55.1 ng/g (4.0-202.0 pmol/g)] and in testes of 1- to 3-month-old boys [median, 1.8 ng/g (6.6 pmol/g); range, 0.6-6.4 ng/g (2.3-23.5 pmol/g)]. Ovarian E2 concentrations declined to less than 3.0 ng/g (11.0 pmol/g) by the end of the first year of life, and testicular E2 declined to less than 1.0 ng/g (3.7 pmol/g) after only 6 months of age. Gonadal estrogen concentrations paralleled changes in gonadal morphology. Ovarian weights varied in a pattern of rise and fall similar to that of ovarian E2 concentrations; the biggest ovaries contained multiple macroscopic cysts. Testicular E2 closely correlated with Leydig cell development and testicular testosterone concentrations. We infer, therefore, that the surge of plasma E2 in infant girls originates from ovarian follicles and that of boys from testicular Leydig cells, and that these both occur as a result of the postnatal surge in gonadotropin secretion. The basal plasma E1 and E2 pool, however, is derived from the adrenals and remains at a comparatively constant level in both sexes. PMID- 3667884 TI - Comparative study of the lipolytic potencies of pituitary-derived and biosynthetic human growth hormone in hypopituitary children. AB - Whether stimulation of lipolysis is an intrinsic property of the human growth hormone (hGH) molecule or is due to contaminants of pituitary origin is controversial. We compared the rises in plasma FFA levels 4 h after an im injection of 0.2 U/kg of either pituitary hGH (n = 5) or biosynthetic methionyl hGH (n = 32) to hypopituitary patients. In each patient, plasma FFA levels also were measured during a similar period of fasting alone, without hGH injection. Plasma FFA levels rose between 0800 and 1230 h in both subgroups of patients during fasting alone. Injection of either pituitary or biosynthetic methionyl hGH led to a greater increase in plasma FFA than that induced by fasting alone, and the percent increases over baseline plasma FFA levels induced by either pituitary or synthetic hGH were similar. Triceps skinfold thickness before and after 3 months of treatment with biosynthetic hGH in 20 patients diminished by a mean of 2.5 mm, a decrease similar to that reported with pituitary hGH. We conclude that the acute and chronic lipolytic effect of hGH in man is an intrinsic property of the hGH molecule. PMID- 3667885 TI - Short stature, growth hormone, insulin-like growth factors, and serum proteins in the Mountain Ok people of Papua New Guinea. AB - Short stature in man may result from a deficiency of GH or insulin-like growth factors (IGFs). In African pygmies and other individuals with the pygmy trait, serum GH and IGF-II are similar to levels in taller subjects, but serum IGF-I levels are low. To determine whether another population with comparably short stature has similar or related defects, we studied the Mountain Ok population of Papua New Guinea. The mean height of adult men was 152 +/- 6.0 (+/- SD) cm (n = 141), and that of women was 146 +/- 5.7 cm (n = 150). Serum GH and IGF-II concentrations were in the normal (U.S.) range in the Mountain Ok subjects. In the men, serum IGF-I values were also normal, thereby distinguishing the endocrine profile associated with short stature in these subjects from that in African pygmies. Serum IGF-I was not measured in any Mountain Ok women. Since marginal dietary protein is characteristic of the traditional Papua New Guinea diet, we determined serum albumin and prealbumin concentrations in the Mountain Ok subjects. The serum proteins were in the normal (U.S.) range (30-50 g/L for albumin; 10-40 mg/dL for prealbumin), indicating that chronic or acute malnutrition was unlikely in these subjects. Taken together, these findings indicate that short stature in the Mountain Ok people of Papua New Guinea is associated with normal serum GH, IGF-I, IGF-II, and protein levels and indicate that other factors determine stature in some populations with short stature. PMID- 3667886 TI - Effect of epinephrine on the relationship between nonesterified fatty acid availability and ketone body production in postabsorptive man: evidence for a hepatic antiketogenic effect of epinephrine. AB - The effect of epinephrine (EPI) on the transformation of nonesterified fatty acids (NEFA) into ketone bodies (KB) in normal subjects was determined by measuring simultaneously NEFA ([1-13C]palmitic acid) and KB ([3-13C]- or [3,4 13C2]acetoacetate) kinetics at different NEFA levels in the presence of basal (control test) or increased (EPI infusion test) EPI concentrations. During the control test the initial (postabsorptive state) concentrations and turnover rates of NEFA and KB were 476 +/- 47 (+/- SEM) and 4.30 +/- 0.17 mumol kg-1 min-1 (NEFA) and 126 +/- 17 and 2.49 +/- 0.07 mumol kg-1 min-1 (KB). The fraction of NEFA converted into KB was between 11.5-14.6%. Raising NEFA levels to about 650 mumol L-1 (iv infusion of a triglyceride emulsion) resulted in an increase in this fraction to between 26-30.3% (P less than 0.01). When NEFA concentrations were next abruptly raised to high levels (near 3 mmol L-1) by heparin injection this fraction returned to near the initial values (15-19.2%). During the EPI infusion test the initial (postabsorptive) concentrations and turnover rates of NEFA and KB as well as the fraction of NEFA converted into KB (10.5-11.5%) were comparable to the initial values of the control test. Intravenous infusion of EPI (10 ng kg-1 min-1) raised NEFA between 600 and 750 mumol L-1, comparable to values during the triglyceride test, but the fraction of NEFA converted into KB remained between 8.2-12% (P less than 0.05 vs. control test); when NEFA then were raised to even higher values (near 2.5 mmol L-1) by the infusion of a triglyceride emulsion and the injection of heparin, this fraction decreased to between 4-8% (P less than 0.05 vs. initial values of the EPI test and P less than 0.05 vs. the control test). In conclusion, 1) the fraction of NEFA converted into KB appears to depend in part on the NEFA concentration; and 2) the net effect of EPI infusion was to decrease the fraction of NEFA converted into KB. PMID- 3667887 TI - Secretion of thyrotropin with reduced concanavalin-A-binding activity in patients with severe nonthyroid illness. AB - Patients with nonthyroid illness (NTI) often have reduced serum T3, free T3, T4, and free T4 concentrations. Paradoxically, serum TSH is usually in the normal range. The data suggest a diagnosis of hypothalamic hypothyroidism, in which TSH may have reduced biological activity because TRH, which is necessary for key steps in the glycosylation of TSH, is deficient. To study the glycosylation of TSH in patients with NTI, we measured the serum TSH concentration in 36 such patients hospitalized on our intensive care units and compared the results with those from a group of 18 normal subjects. Serum TSH was measured in 2 assays: 1) a sensitive TSH RIA of unextracted serum (TSH-RIA) and 2) a RIA of serum TSH after its extraction with Concanavalin-A (Con-A), a lectin which binds glycoproteins containing mannose residues in their oligosaccharide side-chains (TSH-Con-A). The ratio of TSH-Con-A to TSH-RIA was significantly reduced in the NTI patients [0.61 +/- 0.03 (+/- SE) vs. 0.89 +/- 0.05 in the normal subjects] due to reduced binding of the TSH to the Con-A. This change was not dependent on the extent of the abnormalities of thyroid hormone levels. The data suggest that the TSH secreted in NTI has altered glycosylation which is associated with reduced biological activity. This finding may explain in part the low serum T4 level in NTI patients in the face of an apparently normal immunoreactive TSH level. PMID- 3667888 TI - Circulating immunoreactive inhibin levels during the normal human menstrual cycle. AB - Serum inhibin concentrations were measured daily by RIA in six normal women throughout one menstrual cycle. The RIA was specific for inhibin, and inhibin subunits and related proteins cross-reacted minimally in it. In the early to midfollicular phase, inhibin levels changed little, while in the late follicular phase, inhibin levels rose, in parallel with estradiol (r = 0.43; P less than 0.05; n = 22), to a peak level of 714 (407-1267) U/L (geometric mean +/- 67% confidence limits) coincident with the midcycle LH and FSH surges. An inverse relationship was found between serum inhibin and FSH during the mid- to late follicular phase (r = 0.42; P less than 0.01; n = 45). Inhibin levels rose further during the luteal phase to a peak level of 1490 (1086-2028) U/L 7-8 days after the LH surge, and they correlated positively with serum progesterone (r = 0.76; P less than 0.001; n = 49) and inversely with serum FSH (r = 0.43; P less than 0.01; n = 49) throughout the luteal phase. We conclude that 1) circulating inhibin is detectable throughout the normal menstrual cycle; 2) in the late follicular phase, inhibin levels rise in parallel with estradiol, consistent with the concept that both are products of the maturing follicle; 3) in the luteal phase, the profile of inhibin suggests that it is a secretory product of the corpus luteum; and 4) the inverse relationship between inhibin and FSH in the follicular phase is consistent with the inhibin hypothesis, while at midcycle there is loss of the inhibitory effect of inhibin on FSH secretion. The inverse relationship between FSH and inhibin during the luteal phase suggests a hitherto unsuspected role for inhibin in the feedback regulation of FSH secretion. PMID- 3667889 TI - Plasma lipoproteins and lipase and lecithin:cholesterol acyltransferase activities in obese subjects before and after weight reduction. AB - Plasma lipoprotein concentrations and post-heparin lipoprotein lipase, hepatic triglyceride lipase (HTGL), and lecithin:cholesterol acyltransferase (LCAT) activities were determined in 10 obese women before and after weight loss. In period I, a diet was given to maintain constant weight for 3 weeks. In period II, total calories were restricted to 600 kilocalories/day for 3 weeks. In period III, caloric intake was adjusted to maintain weight at the lower level for 6 weeks. The lower calorie diet decreased plasma very low density, low density, and high density lipoprotein (HDL), cholesterol, and apolipoprotein B and A-I concentrations and molar enzyme activities, while the percent conversion of free to esterified cholesterol by the LCAT enzyme was unchanged. During weight stabilization at a lower state (period III), the mean plasma HDL cholesterol level increased, and lipoprotein lipase and LCAT activities increased to values higher than those in period I. The mean HTGL activity remained reduced. I conclude that successful weight loss improves the possibly atherogenic plasma lipoprotein profile of obese subjects. The increase in HDL cholesterol and cholesterol esterification, possibly explained by lowered HTGL enzyme activity, may increase the capacity of HDL to transport cholesterol from peripheral cells to the liver. PMID- 3667890 TI - Assessment of the pathogenetic role of physical exercise in renal stone formation. AB - The effects of moderate physical exercise (performed on a bicycle ergometer to 70 75% of maximum oxygen consumption) without fluid replenishment on urinary chemistries and crystallization of kidney stone-forming substances were compared to those of rest in six normal subjects. Moderate physical exercise significantly decreased urinary pH [from 6.35 +/- 0.32 (+/-SD) to 5.79 +/- 0.33; P less than 0.05] and citrate [from 121.1 +/- 63.5 to 88.2 +/- 44.4 mg/6-h period from initiation of physical exercise; P less than 0.05 (630 +/- 331 to 459 +/- 231 mumol/6 h)], owing to induced metabolic acidosis. The total renal excretion of stone-forming constituents decreased [for example, calcium from 31.2 +/- 15.8 to 21.4 +/- 6.5 mg/6 h (0.8 +/- 0.4 to 0.5 +/- 0.2 mmol/6 h), phosphorus from 155 +/ 42 to 127 +/- 27 mg/6 h (5.01 +/- 1.4 to 4.1 +/- 0.9 mmol/6 h), and uric acid from 172 +/- 60 to 117 +/- 13 mg/6 h (1.0 +/- 0.4 to 0.7 +/- 0.1 mmol/6 h), each P less than 0.05], probably due to extracellular volume contraction (from sweating) and enhanced renal tubular reabsorption. However, the urinary concentration of stone-forming constituents significantly increased during and after moderate exercise because of the fall in urinary volume from 847 +/- 312 to 290 +/- 36 ml/6 h (P less than 0.01). Thus, urinary calcium oxalate saturation increased significantly from 2.62- to 6.68-fold saturation (P less than 0.01). The urinary undissociated uric acid concentration significantly rose [from 31.6 +/- 24.8 to 125.7 +/- 60.3 mg/L (0.19 +/- 0.15 to 0.76 +/- 0.36 mmol/L; P less than 0.01)], due to higher total uric acid concentration and reduced urinary pH. The saturation of calcium phosphate (brushite) did not change significantly, because the rise in urinary calcium concentration was compensated for by reduced phosphate dissociation (from lower urinary pH). The propensity for spontaneous precipitation of calcium oxalate was greater after exercise, as less soluble oxalate was required to elicit nucleation of calcium oxalate [58.0 +/- 21.2 to 49.0 +/- 16.4 mg/L (644 +/- 236 to 544 +/- 182 mumol/L); P less than 0.05]. The results suggest that moderate physical exercise, without increased fluid intake to compensate for excessive sweating, may cause the crystallization of uric acid and calcium oxalate in urine and may enhance the risk of the formation of renal stones composed of these salts. PMID- 3667891 TI - Comparison of serum thyroid microsomal and thyroid peroxidase autoantibodies in thyroid diseases. AB - Recent evidence indicates that human thyroid peroxidase (TPO) has most of the characteristics of the thyroid microsomal antigen. The question of whether TPO accounts for part or all of the antigenic activity recognized by circulating anti microsomal antigen autoantibody (anti-M Ab) remains to be determined. The availability of an anti-TPO monoclonal antibody and of a highly purified TPO preparation allowed the development of specific and sensitive radioassays for anti-TPO autoantibody (anti-TPO Ab). In this study we compared anti-M Ab and anti TPO Ab levels in serum from 128 subjects, including patients with Hashimoto's thyroiditis (n = 31), idiopathic myxedema (n = 11), hyperthyroid Graves' disease (n = 45), miscellaneous nonautoimmune thyroid disorders (n = 9), and normal subjects (n = 32). Anti-M Ab and anti-TPO Ab were measured by radioimmunological methods employing two different assay designs: 1) competitive radioassay (CR), based on the inhibition of radioiodinated antibody binding to human thyroid microsomes coated on microtiter wells, using a) [125I]immunoglobulin G (IgG) containing a high anti-M Ab titer (for anti-M Ab determinations), or b) [125I]anti-TPO monoclonal antibody (for anti-TPO Ab); and 2) sandwich immunoradiometric assay (IRMA) using microtiter wells coated with thyroid microsomes (for anti-M Ab determinations) or immunoaffinity-purified TPO (for anti-TPO Ab determinations) and [125I]anti-human IgG antibody. Anti-M Ab also was measured by passive hemagglutination. Anti-M Ab titers by PH closely correlated with anti-TPO Ab levels whether assayed by IRMA (r = 0.905; P less than 0.00001) or CR (r = 0.922; P less than 0.00001). Even closer correlations were found when anti-M Ab and anti-TPO Ab both were measured by the same type of radioassay procedure (IRMA, r = 0.945 and P less than 0.00001; CR, r = 0.957 and P less than 0.00001). No differences in the correlation between anti-M Ab and anti-TPO Ab results were found when the data in patients with different autoimmune thyroid disorders were analyzed separately. Further and more direct evidence for the identity of anti-M Ab and anti-TPO Ab was provided by the ability of purified TPO to completely inhibit the binding to thyroid microsomes of radioiodinated IgG preparations containing high anti-M Ab titers. In conclusion, our results provide strong support for the concept that TPO accounts for virtually all of the antigenic determinants reacting with the autoantibodies commonly termed anti-M antibodies.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3667892 TI - [Morphological studies on the hilus of the kidney in Japanese adults]. PMID- 3667893 TI - [Practice of medical care for elderly people viewed from the crisis theory]. PMID- 3667894 TI - [An ultrastructural study on the changes in the anterior lobe of the pituitary gland induced by severe thermal burns]. PMID- 3667895 TI - [Radiation therapy of non-Hodgkin's lymphoma]. PMID- 3667896 TI - A modified finger lift test reveals an asymmetry of motor overflow in adults. AB - A method of eliciting motor overflow in neurologically intact adults is reported. A weight was placed on either the middle or ring finger of the left or right hand, and the subject was instructed to lift that finger. Involuntary finger lifts of the contralateral hand were recorded. There were 32 right-handers per experiment. In Experiments I and II, the amount of weight placed on the subject's finger was in proportion to body weight, whereas in Experiment III, it was in proportion to each finger's strength. Across experiments, motor overflow was more prevalent when the left, rather than the right, hand was weighted. This shows that the asymmetry in motor overflow previously reported in children and brain damaged adults also occurs in healthy adults, and that this movement asymmetry is not an artifact of the relative weakness of the left hand in right-handed individuals. PMID- 3667897 TI - Measurement of the dichotic listening ear advantage for intersubject and interstimulus comparisons. AB - Conventional dichotic listening techniques can unquestionably be used for nominal (left vs. right) categorization of ear or hemispheric differences. These techniques cannot, however, be used for ordinal comparisons of the size of ear advantages among different subjects or different tasks if the measure of the size of the lateral asymmetry is confounded with effects of varying overall performance, attentional bias, or choice of laterality index. A psychophysical procedure is described which is designed to avoid these confounds by measuring discrimination ability, in decibels, as the interaural intensity difference (IID) required for a specific accuracy. Results from two experiments with right-handed subjects showed an average right-ear advantage of about 3 db for phoneme discrimination and an average left-ear advantage of the same size for intonation discrimination. PMID- 3667898 TI - Single-case experimental designs in neuropsychological rehabilitation. AB - It is becoming accepted that single-case studies can offer important contributions to theoretical aspects of neuropsychology. Such recognition has not been so forthcoming in the field of rehabilitation, where single-case studies can be employed to evaluate neuropsychological treatments. This paper describes behavioural approaches to treatment of the neurologically impaired which include single-case experimental designs that have originated in the field of behavioural psychology. Examples of behaviour programmes for the treatment of apraxia and alexia are provided together with examples of single-case experimental designs used to evaluate memory therapy. The paper concludes with a brief discussion of the role of statistics in single-case studies. PMID- 3667899 TI - Relationships between IQ and neuropsychological measures in neuropsychiatric populations: within-laboratory and cross-cultural replications using WAIS and WAIS-R. AB - Several studies have reported positive correlations between measures of intelligence (a quasi-subject variable) and level of performance on neuropsychological tests; few, however, have presented test results by IQ grouping, which could be useful for comparative purposes. The present study examined the relationships of WAIS and WAIS-R Full Scale IQ to performance on a neuropsychological battery consisting of the Halstead-Reitan Battery (HRB), the Wide Range Achievement Test (WRAT), and the Wechsler Memory Scale (WMS). Four mixed neuropsychiatric samples provided cross-cultural and within-laboratory replications, two tested with WAIS and two with WAIS-R. Means and standard deviations for each measure were presented by five IQ levels within each sample. IQ was strongly related to scores on problem-solving tasks, auditory and linguistic measures, memory tasks, academic achievement levels, and tactual imperceptions, while motor functioning and sensory suppressions were less strongly related to IQ. IQ level was related to educational level in all samples. Correlations of years of education with dependent variables in the two WAIS-R samples were strong and replicable for WRAT scores, verbal memory measures, linguistic errors on the Aphasia Screening Test, and finger-tapping speeds but not for other HRB measures. Finally, IQ-HRB relationships were compared to those reported for other populations. PMID- 3667900 TI - Cognitive and task-related EEG correlates of arithmetic performance in adolescents. AB - Cognitive and neurophysiological correlates of arithmetic calculation, concepts, and applications were examined in 41 adolescents, ages 12-15 years. Psychological and task-related EEG measures which correctly distinguished children who scored low vs. high (using a median split) in each arithmetic subarea were interpreted as indicative of processes involved. Calculation was related to visual-motor sequencing, spatial visualization, theta activity measured during visual perceptual and verbal tasks at right- and left-hemisphere locations, and right hemisphere alpha activity measured during a verbal task. Performance on arithmetic word problems was related to spatial visualization and perception, vocabulary, and right-hemisphere alpha activity measured during a verbal task. Results suggest a complex interplay of spatial and sequential operations in arithmetic performance, consistent with processing model concepts of lateralized brain function. PMID- 3667901 TI - Language of hydrocephalic children and adolescents. AB - How adequate a substrate for the development of language is the young hydrocephalic brain? To answer this question, the development of five language domains (word finding, fluency and automaticity, immediate sentence memory, understanding of grammar, and metalinguistic awareness) was studied in children and adolescents, 75 with hydrocephalus in the first year of life, and 50 normal controls. The results revealed a limited resilience of language to the effects of early hydrocephalus. Resilience was indicated by the finding that, for several language skills, hydrocephalics scored at comparable levels to normals and improved their test performances as they matured. The limits to resilience were also apparent. Language development was not uniform after early hydrocephalus, and, within particular language domains, hydrocephalics were either less skilled or less able to maintain age-appropriate skill mastery than normal peers. Early hydrocephalus had diverse effects on language development: Of the variables measuring its forms, manifestations, and treatments, some were indicative of preserved language functioning while others were predictive of language deficit. The young hydrocephalic brain mediates language development in a manner that is adequate, but far from ideal. PMID- 3667902 TI - In-vitro steroid secretion of tertiary atretic bovine follicles in a superfusion system correlated to their histological features. AB - In monotocus mammals most of the tertiary follicles are atretic. The experimental design of a blind study was used to evaluate the steroid secretion pattern and histological features of atretic bovine follicles. Steroidogenesis of the vesicles was studied with the aid of a superfusion system, and the superfused follicles were evaluated independently using the histological classification elaborated by Marion et al. Twelve single atretic follicles removed during the follicular and luteal phases of twelve cows were superfused for 10 h and then histologically processed. Follicles in early and definite contracting atresia secreted predominantly testosterone, whereas follicles in definite cystic, advanced contracting and late atresia secreted predominantly progesterone. Such secretion was independent of the stage of the oestrus cycle of the animal, so that follicles with the same histological pattern had a characteristic steroid secretion pattern, which was not influenced by the stage of the oestrus cycle at the time of follicular removal. In conclusion, atretic follicles should be considered significant endocrine organs. PMID- 3667903 TI - Lead, magnesium, selenium and zinc in human seminal fluid: comparison with semen parameters and fertility. AB - The concentrations of lead, magnesium, selenium and zinc in seminal fluid from men with variable semen quality (sperm morphology, density and motility) and fertility were determined by atomic absorption spectrometer without or with Zeeman background correction. The mean (+/- SD) concentration of selenium in the samples (n = 142) was 28.8 +/- 9.5 micrograms/l, which was about a third of the corresponding serum value (77.8 +/- 13.3 micrograms/l, n = 140). The serum selenium level was significantly (P less than 0.001) higher in infertile than in fertile men, but the seminal fluid did not show such a difference. No correlation was obtained between selenium values in seminal plasma and sperm density or motility. The levels of lead in seminal fluid were very low with no correlation to the levels of magnesium, selenium and zinc or the semen qualities. The seminal fluid lead concentration was significantly (P less than 0.001) higher in infertile (3.6 +/- 3.2 micrograms/l, n = 79) than in fertile men (1.7 +/- 1.0 micrograms/l, n = 39). Magnesium (103.5 +/- 49.2 mg/l, n = 90) and zinc (141.1 +/ 71.7 mg/l, n = 157) concentrations in seminal fluid were comparable with previous reports. Both minerals showed a positive correlation to the seminal fluid selenium, while only zinc displayed a borderline correlation with sperm density. The present findings indicate that the determination of seminal fluid selenium may not offer any advantages over zinc and magnesium measurement in the fertility assessment and its role in human semen remains obscure. The low lead concentrations in the present material is a clear indication of low industrial exposure. PMID- 3667904 TI - Uterine evaluation by microhysteroscopy in IVF candidates. AB - Over an eight-month period, microhysteroscopy was performed on 180 women, candidates for in-vitro fertilization (IVF). One hundred and two of them were suspected of having uterocervical pathology (group I), and 78 were not (group II). Group I had microhysteroscopic abnormalities in 60.8% and group II in 21.8%. Microhysteroscopy showed 30.6% of 36 positive hysterographies to be false positive and 37.5% of 144 negative hysterographies to be false negative, producing a confirmation rate of 63.9%. Admission to the IVF programme depended on microhysteroscopic normality. One hundred and one women were accepted directly, and 20 refused ('primary decision'). Fifty-nine were deferred with treatable hysteroscopic abnormalities, pending medical (22) and surgical (37) treatment, 14 via the microhysteroscope. Of the 59 women deferred, 51 were finally admitted and 8 rejected after a microhysteroscopic check ('secondary decision'). Finally, 152 of the 180 candidates (84.4%) were admitted. Microhysteroscopy helped to determine the optimal route for embryo transfer in 23 women with cervical pathology. Term pregnancy rates per embryo transfer were similar with hysteroscopic findings primarily normal, or normal after successful treatment (11.2 and 10.8% respectively). Microhysteroscopy seems useful for selection of cases for IVF, accurately determining utero-cervical pathology or normality, aiding in surgical correction of abnormalities and facilitating the process of embryo transfer. We suggest that microhysteroscopy should be performed routinely on all IVF candidates. PMID- 3667905 TI - Oocyte retrieval under the guidance of a vaginal transducer: evaluation of patient acceptance. AB - Follicle puncture under the guidance of ultrasound has now been used for some years. The most important advantage of the ultrasound-guided technique compared with the laparoscopic technique is that the former can be performed under local anaesthesia. However, both the trans-vesical and the perurethral ultrasound guided puncturing routes may be quite painful for the patient. For that reason we have developed a trans-vaginal follicle puncture technique using a vaginal transducer. The aim of this study was to evaluate the patients' experience of pain with this new technique. Scanning of follicles was performed using a specially designed vaginal transducer that makes the patients having a full bladder unnecessary. Local anaesthesia was applied as a paracervical block. Follicles were then punctured through the vagina with a needle inserted through a needle guide attached to the transducer. Fifty-one patients answered a questionnaire about their experience of the puncture procedure. Only 10% of the patients found the puncture painful. Ninety-eight per cent of the patients felt no anxiety about going through the procedure again. We therefore conclude that trans-vaginal oocyte pick-up using a vaginal transducer is very well accepted by most women. PMID- 3667906 TI - In-vitro oocyte maturation: some questions concerning the initiation and prevention of this process in humans. AB - Human oocytes isolated from healthy non-preovulatory antral follicles which had not been stimulated spontaneously resumed meiosis at a low rate (31%) when compared with those from atretic follicles (73%). Human follicular fluid did not inhibit spontaneous maturation of rat oocytes in vitro, regardless of the quality or maturity of the follicle or the treatment of the patient. In the human, oocyte maturation may involve a stimulatory process as well as a removal of inhibition. PMID- 3667907 TI - The effect of morphology on the ability of human spermatozoa to penetrate zona free hamster oocytes. AB - The effect of morphology on the ability of human spermatozoa to penetrate zona free hamster oocytes was investigated using fractions of individual semen samples enriched for morphologically normal or abnormal spermatozoa, after separation by buoyant density centrifugation on self-generating Percoll gradients. Using this separation technique, the percentage of spermatozoa of normal morphology is greater in the lowermost 1 ml of the Percoll column (layer 1) than in the fraction recovered from higher up the column. Thus it was possible to compare two populations of spermatozoa from each semen sample in their ability to penetrate hamster oocytes. After normalizing the concentration of motile spermatozoa the mean hamster oocyte penetration rate was significantly higher with spermatozoa recovered from layer 1 (39 +/- 4%) compared with those recovered from layer 7 (21 +/- 4%), which suggests that morphologically abnormal spermatozoa do not have the same fertilizing capacity as those with normal morphology. PMID- 3667908 TI - Gender differences at birth and differences in fetal growth. AB - The discrepancy between the number of boys and girls born has been interpreted as a natural selection response to differential survival prospects. There also exists a discrepancy in birth weight, length, head circumference at birth of boys and girls; on the other hand, placental weights were not so strongly biased by the sex of the fetus. Metabolic differences between the sexes are clearly recognized in adults. It is therefore argued that the anthropometric differences at birth, examples of which are presented in this paper, can only be achieved if the products of conception are also expressing a sexual bias in metabolism and physiology. It would then be this bias which would determine the efficiency of the implantation and growth processes and lead to rates of survival to birth. The speculation arising from this and the experimental manipulation of the sex ratio is that the physiological component most likely to be involved would be the lipid compartment with its strong sex difference. PMID- 3667909 TI - Gamete intra-fallopian transfer (GIFT): a great leap forward? PMID- 3667911 TI - Failure of multiple passages to increase chlamydial recovery. AB - Because of a previous publication indicating that increasing the number of blind passages to five resulted in a marked increase in Chlamydia trachomatis isolation rates, we evaluated a multiple-blind-passage system in vials. Cervical specimens from 119 pregnant women and 82 specimens from other sources were tested for chlamydial infection. The recovery rate for C. trachomatis was not markedly increased after the first blind passage. Thus, we conclude that multiple blind passages are not necessary to maximize the C. trachomatis isolation rate in a vial system. PMID- 3667910 TI - Humoral immune response to polypeptides of Ureaplasma urealyticum in women with postpartum fever. AB - We investigated the antibody response in women with postpartum fever from whom Ureaplasma urealyticum had been isolated from the bloodstream. Acute- and convalescent-phase sera were tested for immunoglobulin G to the polypeptides of five serovars (1, 2, 3, 4, and 8), representing the two genomic clusters of U. urealyticum, by the immunoblotting (Western) method. Convalescent-phase sera from the five patients reacted more intensely and with more (up to 27) polypeptides from each of the five serovars, whereas acute-phase sera reacted weakly and with few polypeptides. Although antibody responses in these women with systemic infection could be detected by the use of any of the five different serovars as antigens, the patterns that were produced differed clearly between the two genetic clusters (serovars 1 and 3 versus serovars 2, 4, and 8). Apparently, a single serovar could be used to detect ureaplasmal antibodies in humans regardless of the serovar of the infecting strain. PMID- 3667912 TI - Relationship of CDC group EO-2 and psychrobacter immobilis. AB - Thirty strains of microorganisms previously classified in the CDC group EO-2 were studied to determine the relationship of this group and the recently proposed Psychrobacter immobilis. Results of transformation studies indicated that 9 of the 30 studied strains should be reclassified as P. immobilis. While transformation studies should be used to identify the Psychrobacter genus definitively, some presumptive characteristics useful in differentiating the CDC group EO-2 and P. immobilis were observed. The Psychrobacter genus, compared with the CDC group EO-2, grew well at 25 degrees C, lightly or not at all at 35 degrees C, and not at all at 42 degrees C, grew in nutrient broth without NaCl and with only one exception grew in 6% NaCl, usually did not produce acid from adonitol, dextrin, fructose, or D-mannitol, did not demonstrate the O-shaped cellular morphology, and usually possessed an odor resembling that noted from a phenylethyl alcohol blood agar plate. PMID- 3667913 TI - Toxoplasma gondii antigens recognized by sequential samples of serum obtained from congenitally infected infants. AB - The Sabin-Feldman dye test, the immunoglobulin M (IgM) immunosorbent agglutination assay, and the immunoblot technique were used to study the evolution of the antibody response to Toxoplasma gondii and to examine antigens of the organism recognized by antibodies in the sera of 12 congenitally infected infants and 7 mothers. In the sera of eight infants, a significant rise was noted in the dye test titers, while the serum of only one infant demonstrated a late increase in the IgM immunosorbent agglutination assay titer. In each infant and mother, antigens with approximate masses of 35,000 and 115,000 daltons were strongly recognized by IgG antibodies. An antigen(s) with an approximate mass of 4,000 daltons was recognized by IgM antibodies in the sera of each of the mothers but was recognized by antibodies in the sera of only two of the infants. PMID- 3667914 TI - Predominance of capsular polysaccharide type 5 among oxacillin-resistant Staphylococcus aureus. AB - The relationship between capsular polysaccharide types 5 and 8 and resistance of Staphylococcus aureus to oxacillin was studied with a collection of 406 clinical isolates from six French hospitals. Of 175 type 5 isolates, 84 (48%) were resistant to oxacillin. In contrast, only 8 of 160 type 8 isolates (5%) and 5 of 71 nontypeable isolates (7%) were resistant to oxacillin. Therefore, capsular typing of clinical isolates of S. aureus may facilitate the choice of first-line antibiotic therapy. PMID- 3667915 TI - Diversity of plasmids in Achromobacter xylosoxidans isolates responsible for a seemingly common-source nosocomial outbreak. AB - Achromobacter xylosoxidans, an uncommon yet highly resistant opportunistic pathogen, was isolated from nine hospitalized patients during an 8-month period. It had been isolated from only seven patients with either nonfatal infection or colonization from 1981 to 1984. From June 1985 to January 1986, A. xylosoxidans was isolated 18 times from seven different sites (sputum, 7 times; urine, 4 times; blood, 3 times; and lung, pleural fluid, wound tissue, and tracheal aspirate, 1 time each). Four patients died, including the three with bacteremia. All but two patients had nosocomial infections and either were on the same ward or were cared for by the same staff members. Eleven A. xylosoxidans strains yielded eight distinct plasmids (8, 21, 23, 26, 38, 50, 51, and 64 megadaltons). Whole-cell peptide patterns of 10 of these strains were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Isolates from the same patient contained the same plasmids and had identical peptide patterns but differed from other strains in both parameters. Plasmids were absent from the two community-acquired isolates. Although nosocomial strains showed similar antibiotic resistance patterns (only moxalactam and ticarcillin-clavulanic acid were uniformly active) and cross-contamination was strongly suggested epidemiologically, results of plasmid and peptide analyses did not support the possibility of a single-strain outbreak. PMID- 3667916 TI - Isolation of Staphylococcus aureus L forms from experimentally induced bovine mastitis. AB - Bacterial L forms were isolated from milk samples of dairy cattle infected experimentally with Staphylococcus aureus. Initially, bacterial L forms were induced in vitro from 12 of 44 S. aureus strains isolated from bovine mastitis. Cows were experimentally infected in two experiments with strains shown in vitro to be easily inducible to L form and with S. aureus Newbould 305. Each quarter of the mammary gland was infected with either 10(3) or 10(6) CFU of the test strains. Treatment was initiated with 100,000 U of penicillin G per quarter at the first signs of clinical mastitis. Milk samples were collected daily and cultured on bovine blood agar and PPLO agar (Difco Laboratories, Detroit, Mich.) with 10% horse serum and 5% NaCl. Staphylococcal L forms were isolated from milk samples collected from infected glands in both experiments after antibiotic therapy. Glands with the highest concentrations of leukocytes and bacteria were most likely to yield L forms in milk samples after treatment was initiated. Cows harboring L forms typically yielded parental organisms after cessation of antibiotic therapy. No detectable changes occurred in antibiotic susceptibilities, coagulase production, or biochemical activities in strains induced to L form followed by reversion to the parental form. These results demonstrated that L forms can occur during treatment of bovine mastitis and that L forms may be one explanation for the poor response of staphylococcal bovine mastitis to antibiotic therapy. PMID- 3667917 TI - Comparison of different procedures, transport media, and enrichment media for isolation of Campylobacter species from healthy laying hens and humans with diarrhea. AB - A comparison was made with some of the available transport and enrichment media for the isolation of Campylobacter species. The merits of duplicate versus single sampling were also investigated. Fecal samples from 721 healthy laying hens and 328 patients with diarrhea were included in the study. The media compared were modified Stuart medium, Campythio-glycolate medium, semisolid motility test medium, and Campylobacter enrichment broth. The isolation rate of Campylobacter species was significantly increased by taking duplicate instead of single samples. The highest outcome was found when one of the two samples was an enrichment medium, such as semisolid motility test medium. PMID- 3667918 TI - Monoclonal antibody typing of Chlamydia psittaci strains derived from avian and mammalian species. AB - A total of 77 Chlamydia psittaci strains of avian, human, and mammalian origin were grouped into four serovars with 11 monoclonal antibodies recognizing the lipopolysaccharide and the major outer membrane protein antigens. The avian and human strains, which were closely related to each other, were distinct from the mammalian strains. Immunological typing of C. psittaci with monoclonal antibodies seems practical. PMID- 3667919 TI - Improved selective culture media for Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus. AB - By modifying the previously described media tryptic soy-serum-bacitracin vancomycin (TSBV) agar and tryptic soy-serum-bacitracin-vancomycin-fluoride (TSBVF) agar, two improved selective culture media were developed for isolation and enumeration of Actinobacillus actinomycetemcomitans (A medium) and Haemophilus aphrophilus (H medium) in oral specimens. Both media were supplemented with fusidic acid and spiramycin, and carbenicillin was also added to A medium. The growth yields of pure cultures of A. actinomycetemcomitans on A medium and of H. aphrophilus on H medium were comparable with those on the reference media. Compared with blood agar, the selective media inhibited these species about 10-fold or less. In addition, A and H media suppressed the growth of pure cultures of Capnocytophaga spp. and Neisseria spp., commonly found as contaminants on TSBV and TSBVF, 10(5) times or more compared with that on blood agar. In samples from diseased periodontal pockets, the recoveries of A. actinomycetemcomitans on A medium and H. aphrophilus on H medium equaled those on TSBV and TSBVF, respectively. In about 50% of the cultures on the reference media, contaminating bacteria were detected at levels higher than 10(4) CFU/ml of sample. The corresponding value for both A and H media was about 2%. PMID- 3667920 TI - Detection of Clostridium difficile toxin in various tissue culture monolayers. AB - Thirty stool filtrates known to contain Clostridium difficile toxin based on previous testing on McCoy cells were tested for toxicity on primary African green monkey kidney (AGMK), McCoy, MRC-5, primary rhesus monkey kidney (RMK), and Vero cells. All 30 filtrates showed cytotoxic effect at greater than or equal to 1:100 dilution on McCoy and Vero cells. A total of 22 filtrates were positive on MRC-5 monolayers, while only 16 and 10 filtrates showed positive cytotoxic effect on AGMK and RMK cells, respectively. Another 630 stool specimens were tested on McCoy and Vero cells only. Of these stool filtrates, 70 were positive and 560 were negative with both cell lines, which thus gave 100% agreement. Vero cells can be used interchangeably with McCoy cells for the detection of C. difficile toxin in stool filtrates. PMID- 3667921 TI - Porphyrin test as an alternative to benzidine test for detecting cytochromes in catalase-negative gram-positive cocci. AB - A total of 66 strains of gram-positive cocci, including 21 catalase-negative members of the family Streptococcaceae and strains of Stomatococcus mucilaginosus, were investigated for the ability to produce porphobilinogen and porphyrin from delta-aminolevulinic acid as an alternative to the benzidine test for detecting the presence of cytochromes. Production of porphobilinogen correlated 100% with membership in the family Micrococcaceae. PMID- 3667922 TI - Successive bacteremias with "Campylobacter cinaedi" and "Campylobacter fennelliae" in a bisexual male. AB - A bisexual human immunodeficiency virus-seropositive male had successive bacteremias with "Campylobacter cinaedi" and "Campylobacter fennelliae." Because final identification of both isolates was not completed until 1 month after the last admission of the patient, a novel and nonstandardized antimicrobial susceptibility testing method was useful in guiding timely antimicrobial therapy. PMID- 3667923 TI - Effect of decontamination procedures on recovery of Nocardia spp. AB - Exposure to 0.5% N-acetyl-L-cysteine (NAC), 2% NaOH-NAC, or benzalkonium chloride in trisodium phosphate (Zephiran-TSP) was toxic for Nocardia isolates. The number of viable Nocardia cells in a standardized suspension was reduced by 10(2) to 10(6) after a 30-min exposure to 2% NaOH-NAC and by 10(4) or more after a 30-min treatment with Zephiran-TSP. PMID- 3667924 TI - Simultaneous transmission of Borrelia burgdorferi and Babesia microti by individual nymphal Ixodes dammini ticks. AB - Nymphal Ixodes dammini ticks, selected from a group of ticks in which 22 of 31 (71%) contained dual Borrelia burgdorferi and Babesia microti infections, simultaneously transmitted B. burgdorferi and B. microti to 4 of 7 (57%) hamsters exposed to individual ticks. PMID- 3667925 TI - Improved methods for isolation and enumeration of Malassezia furfur from human skin. AB - A medium for the isolation and enumeration of Malassezia furfur is described. Incubation at 34 degrees C yielded geometric mean counts (in CFU per square centimeter) of 2.6 X 10(3) on the forehead, 8.5 X 10(2) on the cheek, and 9.6 X 10(3) on the back. These counts compared favorably with microscopic counts and greatly exceeded those obtained with previously described media. PMID- 3667926 TI - Comparison of two transport systems for recovery of aerobic and anaerobic bacteria from abscesses. AB - An evaluation of two commercially available swab transport systems, Port-A-Cul (PAC; BBL Microbiology Systems, Cockeysville, Md.) and Anaerobic Specimen Collector (ASC; Becton Dickinson Vacutainer Systems, Rutherford, N.J.), in the recovery of organisms from clinical specimens was done. Fifteen abscesses were drained, and swabs of their contents were placed in the transport systems until they were inoculated for detection of aerobic and anaerobic bacteria. The swabs were plated immediately after collection and after delays of 4, 24, 48, and 72 h. A total of 70 bacterial isolates, 47 anaerobes and 23 aerobes, were recovered from specimens inoculated immediately after collection. The survival of anaerobic bacteria was better in the PAC system than in the ASC system. This was evident as the length of delay in cultivation was extended. At 4 h, 46 anaerobic isolates were recovered in the PAC system, compared with 39 in the ASC system (P less than 0.1). At 24 h, 45 isolates were recovered in the PAC system and 26 isolates were recovered in ASC (P less than 0.001); at 48 h, 40 were recovered in PAC and 15 were recovered in ASC; and at 72 h, 32 were recovered in PAC and 6 were recovered in ASC. There were no differences between the systems in the recovery of aerobic bacteria. These data demonstrate the usefulness of the PAC system in the recovery of anaerobes and the need for quality control of all transport systems for anaerobic bacteria. PMID- 3667927 TI - Bacteremia caused by CDC group Ve-1 in previously healthy patient with granulomatous hepatitis. AB - This is a case report of CDC group Ve-1 bacteremia in an otherwise healthy patient with granulomatous hepatitis. PMID- 3667928 TI - Improved toluidine blue-DNA agar for detection of DNA hydrolysis by campylobacters. AB - Our improved toluidine blue-DNA agar was compared with methyl green DNase test agar for the detection of DNA hydrolysis by campylobacters. The toluidine blue DNA agar gave clear-cut positive and negative reactions with campylobacter strains belonging to several species. PMID- 3667929 TI - A bridge to peace. PMID- 3667930 TI - Certified environmental audits: a proposal. PMID- 3667931 TI - Making the most of crises. PMID- 3667932 TI - Patterns of prenatal care in the United States. PMID- 3667934 TI - Joint occupational health research and manpower training projects in the Sudan, 1982-1985. PMID- 3667933 TI - Strategies for promoting health for specific populations. Office of Disease Prevention and Health Promotion, Public Health Service, U.S. Department of Health and Human Services. PMID- 3667935 TI - Intellectual deterioration and personality decompensation in schizophrenia. AB - The Army General Classification Test (AGCT) and the MMPI were administered to schizophrenic inpatients (N = 50) with initially high (mean standard score = 115) and low (77) intelligence at two timepoints separated by an average of 14 years. The Arithmetic scores of the more intelligent group declined significantly with time, but significant changes did not appear on the Vocabulary or Spatial Aptitude scores of that group. No significant mean changes appeared in the low-IQ sample. The high-IQ group's Arithmetic section deterioration resulted from an increased error rate, not a drop in speed. No changes beyond those attributable to chance appeared on the MMPI scales. The results suggest that an intellectual decline limited to certain skills and to a subset of subjects occurs in schizophrenia and that the deterioration is not attributable to personality decompensation as defined by the MMPI. Because these findings appear to contrast with most previous research in this area, they should be considered tentative until confirmed by independent studies. PMID- 3667936 TI - The effect of noncontingent feedback on attributional style. AB - The relationship between experiences with noncontingency and attributional style was examined in experimental and correlational models. One hundred and twenty-six college student subjects were provided noncontingent, contingent, or no feedback as to the correctness of their responses on a concept discrimination problem. They then completed an attributional style questionnaire, a scale designed to measure life experiences with noncontingency, and a depression inventory. The experimental hypothesis was that exposure to noncontingent outcomes, both in a laboratory and historically, would result in more depressive attributions than would exposure to contingent outcomes or to no outcomes. The manipulation of feedback contingencies produced the predicted effect on attributions for positive and negative events combined into a single composite difference score. A correlation between life experiences with noncontingency and attributions was found only for the positive events measure. However, such life experiences were correlated significantly with depression. PMID- 3667937 TI - Perception of implicit relationships between personality traits by schizotypic college subjects: a pilot study. AB - The perception of trait relationships was measured in both schizotypic and control college subjects (N = 46) by use of a similarity rating method. Schizotypic and control subjects were selected on the basis of their scores on four scales of schizotypy: Physical Anhedonia, Perceptual Aberration, Intense Ambivalence, and Somatic Symptoms. Schizotypes as a group were more variable in their ratings of trait relationships than were controls. When each scale was considered separately, only perceptual aberrators as a group were as consistent in their ratings of trait relationships as control subjects. These findings support the hypothesis that schizotypes fail to share the semantic trait structure accepted by most normal subjects and may be a possible explanation for previous findings of social deficits in schizotypes. PMID- 3667938 TI - Resiliency reconsidered: contemporary MMPI normative data for Barron's Ego Strength Scale. AB - Although it is more than 30 years old, Es remains one of the most frequently scored of the MMPI supplemental scales. However, there have been significant changes in MMPI response patterns among adults since the Es scale was first developed. New normative tables for the Es scale based on a contemporary census matched sample of normal adults are presented along with figures that illustrate changes associated with age and sex. PMID- 3667939 TI - The comparative validities of six MMPI repression scales. AB - The validities of six MMPI repression scales were compared using each of the other five and an independent measure as criteria (N = 190). The data gave little support to the Eichman, Welsh, and Haan Repression scales as operational definitions of this construct. The results for the Little-Fisher Denial, Byrne et al. R-S, and Haan Denial scales showed more promise. PMID- 3667940 TI - The MCMI as a measure of DSM-III Axis II diagnoses: an empirical comparison. AB - This study compared MCMI and clinician Axis II diagnoses for DSM-III diagnostic categories. Subjects were 151 consecutively admitted inpatients at a private psychiatric hospital. The MCMI was administered to all subjects shortly after admission and shortly before discharge. MCMI diagnostic impressions for both admission and discharge then were compared to clinician diagnoses. Results indicated that the MCMI diagnosed Axis II disorders much more frequently than did clinicians. Agreement rates between the MCMI and clinicians were uniformly low across all categories except dependent personality. In addition, there was a relatively low degree of correspondence between MCMI admission diagnoses and MCMI discharge diagnoses. Implications of these results are discussed. PMID- 3667941 TI - MMPI correlates of performance intellectual deficits in patients with right hemisphere lesions. AB - This study investigated the emotional adjustment of 50 patients with focal brain damage in the right hemisphere (RHD). The impact of functional loss (as assessed by the WAIS Performance IQ) was assessed by a multivariate comparison of the composite MMPI profiles of these patients as classified into three groups: Below Average, Average, and Above Average Performance IQ. Regardless of the extent of decline in Performance-related abilities, right hemisphere impairment was associated with symptoms of mild depression, loss of initiative, anxiety, denial, and somatic preoccupations. MMPI scores were not correlated significantly with their WAIS Performance IQs. Implications for neuropsychological assessment are discussed. PMID- 3667942 TI - Unusual test score combinations and unusual test score differences. AB - Vocabulary and Abstraction scores on the Shipley Institute of Living Scale are used to illustrate the relation between unusual test score combinations and unusual test score differences. It is demonstrated that a combination of two scores can be unusual even though the corresponding difference is not and that a difference between two scores can be unusual even though the corresponding combination is not. Clinicians should be aware that although the two methods of pattern analysis generally will lead to the same conclusion, they need not do so. PMID- 3667943 TI - Accuracy of estimates of premorbid intelligence based on demographic variables. AB - Regression equations have been presented for estimating premorbid IQs on Wechsler's intelligence scales, using the demographic variables employed to stratify the various standardization samples as predictors. The accuracy of the resulting estimates for classifying patients into Wechsler's seven IQ categories (from very superior to mentally retarded) was evaluated, and it was found that even the best estimates can be expected to misclassify more than half of all patients. Such estimates still can contribute to valid inferences about a patient's premorbid intelligence, but only when they are used in conjunction with information from other sources. PMID- 3667944 TI - Internal reliability of the WISC-R with male juvenile delinquents. AB - The internal reliability of the WISC-R was examined with a sample of 200 male delinquents. Scale IQ reliabilities ranged from .92 to .80, and subtest reliabilities ranged from .90 to .52. The standard errors of measurement for Scale IQs were approximately 1 point and for individual subtests significantly differed from that reported in the WISC-R manual. The results indicated the WISC R to be acceptably internally consistent when used with male juvenile delinquents. PMID- 3667945 TI - Situational factors and behavioral self-predictions in the identification of clients at high risk to drop out of psychotherapy. AB - Two hundred and eight adults who requested outpatient treatment at a community mental health center were asked to complete brief questionnaires immediately prior to and after their first therapy session. Questionnaires contained items that pertained to self-predicted length of stay in psychotherapy, situational barriers to regular attendance, and past behavior in similar situations (e.g., appointment-keeping with other health care professionals). Therapists also were asked to make predictions with regard to client length of stay. Questionnaire data were analyzed via a series of double cross-validated multiple regression and discriminant function equations, and results indicated that client and therapist predictions of length of stay in therapy were the most stable and consistent correlates of attendance behavior. PMID- 3667946 TI - Personality profiles of hospitalized pathological gamblers: the California Personality Inventory. AB - Studies of the personality of the pathological gambler have consisted primarily of case reports and findings on the MMPI. This article presents data on a sample of 70 pathological gamblers, 70 alcoholics in treatment, and 70 medical/surgical controls on the California Personality Inventory (CPI). Gamblers and alcoholics differed significantly from hospitalized controls on a number of scales, particularly on measures of socialization, ego control, and flexibility. Differences between the gamblers and alcoholics were few, with a trend for the alcoholics to be similar to the gamblers and intermediate between the other two groups. Implications for the treatment of the pathological gambler are discussed. PMID- 3667947 TI - Assessing pathological detoxification fear among methadone maintenance patients: the DFSS. AB - This study assessed the reliability, validity, discriminative accuracy, and factor structure of the Detoxification Fear Survey Schedule (DFSS). Prevalence of detoxification fear and its correlates also were assessed. Random samples from three geographically, culturally, and racially disparate populations (N = 271) of treated opioid addicts were used. The DFSS had a test-retest r = .935 and demonstrated several indicants of validity. A briefer version (DFSS-14) showed superior psychometric properties and could identify correctly 81% of the detox fear subjects while it excluded 55% of nonfear subjects. The DFSS-14 had a replicated three-factor structure that accounted for 62.1% of total item variance in the validation sample. Factor two, probably best named dose reduction fear, was replicated in all populations. A cut-off score set at the nonfear mean is recommended for clinical use. A brief clinical interview of positive scorers quickly should eliminate false positives and, thus, efficiently identify most of those with detoxification fear. PMID- 3667948 TI - Affective behavior modification: a case for empirical investigation. AB - Recent developments in behavioral and cognitive-behavioral theory emphasize the relationships between behavior, cognition, and effect, and their importance in understanding and modifying human behavior. This paper reviews some current arguments concerning these relationships, and outlines some possible implications for the future development of behavioral theory and practice. Some recent trends towards models which invoke complex and unobservable mechanisms to explain affect may provide a temporarily convenient framework for talking about highly complex phenomena. But it should be remembered that these models are not empirically verifiable. A focus on variables which can be defined and measured objectively is essential for the scientific development of behavioral theories that have real explanatory value, and for behavior modification practice. PMID- 3667949 TI - Private body consciousness, anxiety and the perception of pain. AB - Two studies are described which present data consistent with Barsky and Klerman's hypothesis that people who report pain in the absence of an identifiable organic etiology may be attending to and amplifying normal bodily sensations. The results of these studies demonstrated that young college students with a predisposition toward focusing attention on somatic symptoms (high private body consciousness) and scoring high on State Anxiety reported more areas of aches and pains and rated these sensations as more noxious. Additionally, the most frequent areas of pain identified corresponded to the areas commonly seen in a chronic pain population. An attempt to manipulate self-focused attention with a mirror manipulation in Study 2 failed to produce reliable results. PMID- 3667950 TI - Parallel forms of the Knowledge of Behavioral Principles as Applied to Children questionnaire: an independent, multi-centred, British replication. AB - The psychometric properties of the test entitled Knowledge of Behavioral Principles as Applied to Children and two shortened forms of this test were investigated in two samples of British subjects. The first consisted of 162 psychiatric nurses, psychiatrists, occupational therapists, physiotherapists and clinical psychologists attending behaviour modification courses. The second consisted of 49 teachers and nurses, all working with the mentally retarded, who completed the test by post. The whole test and the two sets of parallel forms all showed good internal consistency and sensitivity to change. Some shrinkage during replication was found. The 25-item forms showed evidence of the properties of parallel forms (equal means, standard deviations and standard errors) in both samples. The 10-item forms were also parallel in sample 1. However the 10-item forms did not remain parallel in sample 2 and so cannot always be recommended. PMID- 3667951 TI - Behavioral measures of multiple personality: the case of Margaret. AB - This report concerns the systematic study of a 28-year-old subject diagnosed as multiple personality. The purpose of this study was to examine similarities and differences in three of her distinct personalities, utilizing behavioral measures. Three tasks were presented to the personalities: a memory task; a perceptual-motor task; and an attention task utilizing event-related potentials. The memory task and perceptual-motor task indicated that the three personalities shared information and that learning extended from one personality to the next. The attention task indicated that the three personalities were differentially processing the stimuli that were presented to them, as measured by the ERPs. The results are discussed in the context of the individual case and of the phenomena of multiple personality. PMID- 3667952 TI - The importance of checking the assumptions of the professional referral source. AB - Behavior therapy has at times been portrayed as simply an assemblage of therapeutic "techniques". However, central to its practice is a behavioral analysis which eventually leads to the selection of the most efficacious intervention. Wolpe has repeatedly warned against reliance upon either patients' assumptions or one's own "too facile" interpretations. From this excerpt from an initial consultation it is apparent that one must also be wary of the assumptions made by professional referral sources. It is easy to be led astray by seductively "obvious" correlations between environmental events and psychophysiological reactions. Different etiologies call for different treatment strategies, and careful behavioral analysis is needed for an appropriate decision. PMID- 3667953 TI - A computer simulation for behavior therapy training. AB - Computer simulation technology has been applied to a wide variety of learning tasks; however, behavior therapy training has not been among them. A computer simulation has recently been developed for use in behavior therapy training. The simulation written for Apple II microcomputers reflects possible referral, assessment, and intervention procedures encountered by a behavior therapist in a mental health center. Forty-two pieces of assessment information may be drawn from 8 general areas, while 6 different interventions may be chosen after a diagnosis is reached. Simulation content and utility were rated highly by both practicing behavior therapists and trainees. PMID- 3667954 TI - Positive practice routines in overcoming resistance to the treatment of school phobia: a case study with follow-up. AB - The treatment is described of a 6-year-old first grade girl who refused to attend her classroom without adult accompaniment. For eight weeks an attempt was made, using different adult escorts, to prompt/shape classroom attendence through classroom exposure. However, the outcome was the development of an unwavering preference to remain in the principal's office after the child would not tolerate separation from these adults. Rather then continue to take her to the classroom, an intervention was initiated designed to structure her daily experiences and provide instruction. In this she was expected to practice several educational activities at designated times in the principal's office. This intervention resulted in a complete elimination of the child's classroom avoidance within five weeks and concomitant improvements in both social and academic functioning. Although the child's mother suddenly died during intervention, follow-up at one and 12 months in a different school indicated the maintenance of all therapeutic gains. Unique aspects of the procedures pertaining to refractory problems and some tentative behavioral guidelines to overcoming resistance to treatment are discussed. PMID- 3667955 TI - Labeling and functional language in a case of psychological mutism. AB - Talking was increased in an 11-year-old girl who recently had stopped talking to anyone in any setting, despite the absence of biological factors, mental retardation, and autism. Productive labeling (correctly naming picture cards) and functional language (talking about picture cards in the absence of such pictures) were interspersed with a series of treatment packages (including verbal instructions, imitation, tokens, and praise). Interventions for productive labeling were programmed in a changing-criterion design. Interventions for functional language were programmed in an ABC design. Higher levels of productive labeling and functional language were noted with the introduction of the particular package, in comparison to baseline. The results also showed the generalization of the procedures to the shaping of functional language in the absence of picture cards. PMID- 3667956 TI - Awareness training in the treatment of head and facial tics. AB - The effectiveness of awareness training alone in treating multiple tics in a young adult was assessed using a multiple baseline across behaviors design. The results showed that the awareness training was very effective in suppressing both head and facial tics and that the treatment effects generalized to a nonclinic situation. Follow-up data showed that both tics were still at low levels one, two, four and eight months after treatment. Treatment satisfaction ratings by the subject and social validation ratings by independent observers are also reported. PMID- 3667957 TI - Treatment of pica in an adult disabled by autism by differential reinforcement of incompatible behavior. AB - The usefulness of differential reinforcement of incompatible behavior was examined in the treatment of pica in a young man severely disabled by autism in a nonsheltered place of employment. The results indicated that a reduction in pica could be achieved by differential reinforcement of other behavior (DRO). Behaviors which were reinforced included remaining in this assigned location, keeping his hands on his work, working quickly and keeping his mouth clear. Reinforcements included favorite drinks, snacks, activities and praise. Treatment procedures were implemented by direct care paraprofessional staff. Withdrawal of treatment resulted in an increase in pica, with renewed reduction on reinstatement of the reinforcement schedule. PMID- 3667958 TI - The stress inoculation training management of self-mutilating behavior: a case study. AB - A combination of techniques, based mainly on the stress inoculation training approach, was used to treat severe self-mutilating behavior in a 32-year-old woman who for 15 years had manifested different kinds of this type of behavior. In 18 therapy sessions over 6 weeks in a psychiatric inpatient setting she achieved complete control of the self-mutilating behavior. After a year of follow up she was completely symptom free and had made additional social and personal gains. PMID- 3667959 TI - The next 25 years. The Royal College of Pathologists. PMID- 3667960 TI - Developing neuronal populations of the cat retinal ganglion cell layer. AB - An improved flat-mount procedure demonstrates that the developing ganglion cell layer of the cat retina contains two morphologically distinct populations of presumed neurons at all ages between embryonic day 36 (E36) and adulthood. One population resembles the adult "classical neurons" composing the ganglion cells and bar-cells of Hughes, while the remaining cells, which are smaller and possess much less Nissl substance, presumably correspond to precursors of the adult microneurons. Although the total neuron population of the retinal ganglion cell layer remains quite constant at all studied ages, its component subpopulations alter significantly during prenatal development; some 50% of classical neurons disappear before birth and the microneuron population doubles during the same period. An obvious centroperipheral gradient exists for classical neurons by stage E47, but the microneuron density gradient only becomes apparent at birth. A 2:1 centroperipheral ratio for the total neuron population is also apparent at E47. Centroperipheral neuronal density gradients continue to increase during postnatal growth. Loss of classical neurons during prenatal life as a result of cell death or transformation into microneurons, has been postulated as a mechanism for determining neuron density gradients. Cell death does occur in the ganglion cell population but it is not yet established whether microneurons of the ganglion cell layer originate from ganglion cell transformation or migrate as a differentiated class from the ventricular layer. However, it can be concluded that not all microneurons originate from ganglion cell transformation, because the total loss of classical neurons is less than the increase in microneuron numbers during development. The population magnitudes of both neuronal classes in the ganglion cell layer stabilise after birth. However, it is during the postnatal period that the adult cruciate density topography is achieved by both populations. It is concluded that differential areal growth is the prime mechanism for postnatal cell redistribution. PMID- 3667962 TI - Abrupt loss of dependence of retinopetal neurons on their target cells, as shown by intraocular injections of kainate in chick embryos. AB - We have examined the capacity of neurons in the chick isthmo-optic nucleus (ION) to survive when their target neurons in the contralateral retinal are destroyed by intraocular injections of kainate (KA) at different stages in development. The retinal vulnerability to KA builds up progressively from embryonic day 10 (E10) until a plateau is reached at E15 (see accompanying paper); and the effects on the ION increase in parallel, almost all the ION neurons being rapidly lost after the E15 injections. KA injection before E15 lesioned only part of the retina and caused degeneration only in the topographically corresponding region of the ION. Near the end of the natural cell death period in the ION (E17), this initial dependence on the target cells is rapidly lost. Already at E16 the injections kill less ION neurons, and by E19 they kill none of them. The ION neurons have become completely insensitive to the KA injections and appear normal more than 4 months later, although axotomy (by eye removal) at a similar age would by then have killed them. The ectopic ION neurons, scattered outside the ION but projecting to the retina, are never affected by KA injections at any age. PMID- 3667961 TI - Role of cell death in the topogenesis of neuronal distributions in the developing cat retinal ganglion cell layer. AB - The neurons of the developing and adult ganglion cell layer of the cat retina may be morphologically divided into two major populations. One population, the classic neurons, is mainly composed of ganglion cells, and of a small percentage of displaced amacrines, the bar cells. The remaining neurons are microneurons, which make up the majority of the displaced amacrine population. The loss of ganglion cells during the development has been attributed to cell death. It has alternatively been suggested that some ganglion cells may lose their axon and be transformed into displaced amacrine cells, without degeneration of the cell soma. Reexamination of foetal and postnatal cat retinas confirms the presence of degenerating cells in the ganglion cell layer. Their number appears to be at a maximum on embryonic day (E) 57 but declines rapidly until birth. The peak of cell death thus coincides with the decline in optic nerve fibre counts and classical neuron or ganglion cell numbers. Some cells in early stages of degeneration resemble classical neurons, but the original morphology of those advanced stages of degeneration could not be identified, nor was it possible to identify pyknotic microneurons at any stage. Substantial degeneration of the microneurons is not suggested but if it occurs, it is masked by an overall increase in the population of these cells before birth. Cell death in the microneuron population thus cannot yet be ruled out. It has been argued in the literature that fragments of degenerating cells in developing neural tissue are cleared by microglia within 10-14 hours. In order to test the hypothesis that operation of cell death can alone account for the observed loss of classical neurons in the foetal cat retina, we have modelled the effect of various presumed clearance times on corresponding neuronal population magnitudes. It is found that a constant clearance time of 10-24 hours would be consistent with the observed loss of classical neurons before birth. If this is true, then no ganglion cells would remain for transformation into amacrine cells. The absolute density of degenerating or pyknotic cells is found to be relatively constant across the retina. However their density expressed as a percentage of the local population of classical neurons is markedly higher in peripheral than central retina. In the former region, they compose more than 10% of classical neurons at stage E57. On the same day, the percentage distribution maps define an elongated central area containing only 3-5% pyknotic profiles. This region corresponds to the location of the future visual streak.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3667963 TI - Developmental and other factors affecting regeneration of crayfish CNS axons. AB - According to histological and ultrastructural criteria, nongiant CNS axons in newly hatched crayfish regenerate more rapidly and with greater frequency than do similar axons in adult crayfish. Regenerative ability is greater in one species (Procambarus clarkii) than in another species (Procambarus simulans), is greater at 20-25 degrees C than at 15-16 degrees C, and is greater in nongiant axons than in giant axons. In contrast to axonal regeneration, nerve cell bodies do not regenerate in newly hatched or adult crayfish of either species. While the ability to regenerate CNS axons differs between newly hatched and adult crayfish, the ultrastructural appearance of the CNS is very similar at any age it is examined. PMID- 3667964 TI - Viscerotopic representation of the upper alimentary tract in the medulla oblongata in the rat: the nucleus ambiguus. AB - The nucleus ambiguus has been reported to innervate various thoracic and abdominal viscera in addition to the musculature of the upper alimentary tract. However, the literature is contradictory as to how different regions of the nucleus ambiguus innervate specific organs. Therefore, a systematic investigation of the viscerotopic organization of the nucleus ambiguus was undertaken. In 102 rats, 0.5-10.0 microliter of HRP, WGA-HRP, cholera toxin-HRP or fluorescent tracers were injected into the IXth, Xth, and XIth cranial nerves and the major branches of the Xth as well as organs supplied by them. The results demonstrate that the nucleus ambiguus in the rat is made up of two major longitudinal divisions: a dorsal division comprised of three rostrocaudally aligned subdivisions representing the special visceral efferent component, and a ventral division comprised of at least two subdivisions representing the general visceral efferent component. The dorsal division corresponds to the nucleus ambiguus in the narrow sense and comprises a rostral esophagomotor compact formation, an intermediate pharyngolaryngomotor semicompact formation, and a caudal laryngomotor loose formation. Each of these formations displays a characteristic dendroarchitecture. The stylopharyngeal and cricothyroid motoneurons are displaced rostrad from the main pharyngeal and laryngeal motoneuronal pools. Thyropharyngeal (lower constrictor) motoneurons occupy the rostral half of the semi-compact formation and hyopharyngeal (middle constrictor) motoneurons its entire length. The ventral division of the nucleus ambiguus corresponds to the external formation, extends along the entire length of the medulla oblongata, and contains preganglionic neurons innervating the heart and supradiaphragmatic structures innervated by the glossopharyngeal and the superior laryngeal nerves. PMID- 3667965 TI - Immunohistochemical localization of calcium-binding proteins, parvalbumin and calbindin-D 28k, in the adult and developing visual cortex of cats: a light and electron microscopic study. AB - In the cat primary visual cortex, we investigated with immunohistochemical techniques the developmental changes in the cellular and subcellular localization of the Ca2+-binding proteins parvalbumin (PV) and calbindin-D 28K (CBP), in order to determine whether there is a correlation between the expression of Ca2+ dependent processes and the time course of the critical period for use-dependent plasticity. On the 54th day of gestation and at 1 week postnatally, both calcium binding proteins were present only in a subpopulation of neurons in layers V and VI. During subsequent maturation, the number of PV(+) and CBP(+) neurons increased significantly and labeled cells were detected in more superficial layers. Moreover, the homogeneous labeling of some CBP(+) neurons in layers IV to VI decreased and changed to a punctate pattern. In adult cats PV(+) neurons were evenly distributed throughout layers II to VI, whereas CBP(+) neurons were concentrated in layers II/III. Only a few immunoreactive cells had morphological features characteristic of pyramidal cells; the large majority were nonpyramidal. Electron microscopy confirmed the presence of PV- and CBP-reaction product within the perikarya, axons, and dendrites of labeled cells. It was associated preferentially with microtubules, postsynaptic densities, and intracellular membranes. Immunoreactive neurons received immunonegative asymmetric synapses on their dendritic shafts and made symmetric synaptic contacts with labeled and unlabeled somata and with unlabeled dendritic shafts. The large number and widespread distribution of immunoreactive neurons implies that PV and CBP play an important role in the regulation of calcium-dependent processes in the visual cortex. Furthermore, the developmental redistribution of PV and CBP points to changes in the organization of Ca2+-dependent processes during maturation. PMID- 3667966 TI - Evidence for the existence of a lateral cervical nucleus in mice, guinea pigs, and rabbits. AB - The lateral cervical nucleus of carnivores is large and is thought to play a prominent role in somatosensory processing. In contrast, early studies indicated that rats, mice, guinea pigs, and rabbits did not have a lateral cervical nucleus. However, we reported the existence of a lateral cervical nucleus in rats as a result of studies using retrograde transport techniques. In the present study, similar techniques were used to examine the possibility that early studies also overlooked the lateral cervical nucleus in mice, guinea pigs, and rabbits. In each of these species, a retrograde tracer was injected into the thalamus. These injections labeled a small number of neurons contralaterally in the dorsal part of the lateral funiculi of rostral cervical segments. Mice had the greatest number of neurons projecting from the lateral cervical nucleus to the thalamus, and rabbits had the fewest. PMID- 3667967 TI - Localized changes in olfactory bulb morphology associated with early olfactory learning. AB - Young rats exposed to an odor while receiving reinforcing stimulation come to approach that odor upon subsequent presentation. In addition, such pups have increased 14C-2-deoxyglucose (2DG) uptake within focal areas of the glomerular layer in response to that odor, compared to control animals experiencing the odor for the first time. In this study, the morphology of the glomerular areas underlying these 2DG foci was examined to determine whether early olfactory learning imposed local structural changes that could produce the enhanced 2DG uptake. Alternate sections either were processed with a silver and a Nissl stain to label both cell bodies and their processes or were histochemically treated for the mitochondrial enzymes cytochrome oxidase (CO) or succinic dehydrogenase (SDH) to define the glomerular core of the bulb; 2DG autoradiographs were aligned with adjacent stained sections, and regions underlying the high 2DG uptake foci were examined. In odor-familiar animals, large glomerular clusters that protruded into the external plexiform layer or the olfactory nerve layer were associated with the focal areas of increased 2DG uptake. Morphometric analysis of these regions revealed that the glomerular layer underlying the foci of high 2DG uptake was 30% wider in odor-familiar animals than comparable areas in odor-unfamiliar animals; the cross-sectional areas of individual glomeruli were 21% larger in odor familiar animals. The foci of enhanced 2DG uptake therefore appear to be associated with groups of enlarged glomeruli. These data demonstrate that early olfactory learning influences the morphology of the olfactory bulb. PMID- 3667969 TI - Effects of a lengthy period of undernutrition from birth and subsequent nutritional rehabilitation on the synapse: granule cell neuron ratio in the rat dentate gyrus. AB - Recent evidence showing alterations in spatial memory due to a period of undernutrition during early life has implicated the hippocampus as one of the brain centres that may be particularly adversely affected. However, there are very few quantitative morphological studies that have examined the neuronal and synaptic populations of the hippocampi from undernourished animals. We decided to carry out such experiments, paying particular attention to the granule cell of the dentate gyrus. Male rats were undernourished from the 18th day of gestation until 21, 75, or 150 days of age. Some of these previously undernourished rats were nutritionally rehabilitated between 150 and 250 days of age. Groups of well fed control and experimental rats were killed by intracardiac perfusion with 2.5% sodium-cacodylate-buffered glutaraldehyde. The right hippocampus from each rat was dissected out and processed for electron microscopy. Stereological procedures at the light and electron microscopical levels were used to estimate the numerical densities of granular cell neurons and molecular layer synapses in the dorsal lip of the dentate gyrus. These estimates were used to calculate synapse: neuron ratios. There were 5,056 +/- 347 (mean +/- SE) and 5,002 +/- 190 synapses per neuron in 21-day-old control and undernourished rats, respectively. By 75 days these values had increased to 9,215 +/- 588 and 6,683 +/- 237. The difference was statistically significant. By 150 days of age the value for control animals had fallen once again to 6,518 +/- 209 whereas undernourished rats had increased slightly to 7,689 +/- 288 (P less than .01); 250-day-old rats, previously undernourished from birth to 150 days of age, showed a substantial increase in the synapse: neuron ratio during the period of nutritional rehabilitation. Thus these nutritionally rehabilitated rats had 9,407 +/- 365 synapses per neuron whereas age-matched controls had only 6,323 +/- 239 (P less than .01). These results indicate that the rat dentate gyrus is vulnerable to undernutrition even during the postweaning period and that a lengthy period of undernutrition can alter the developmental growth curve for synapse: neuron ratios. PMID- 3667968 TI - Fetal tectal or cortical tissue transplanted into brachial lesion cavities in rats: influence on the regrowth of host retinal axons. AB - Fetal neural tissue was transplanted into suction lesions of the left brachium and pretectal region in young rats. Tectal tissue was grafted into 6-18-day-old rats and cortical tissue was transplanted into 17-20-day-old animals. The aim was to determine whether grafts could potentiate the regrowth of damaged retinal axons and, as a consequence, stimulate the axons to reenter their host target, the superior colliculus (SC). Fifteen to 581 days after transplantation, host retinal projections were traced by injecting the right eye with horseradish peroxidase (HRP). Parallel series of frozen brain sections were stained for HRP histochemistry, acetylcholinesterase, Nissl, or neurofibrils. At all ages studied, grafts survived and grew within the wound cavity; survival was better in the older animals. Most cortical grafts and a small number of tectal grafts filled the wound cavity and formed complete tissue bridges across the lesion. The majority of tectal grafts were attached to one or the other side of the lesion and were connected to the opposite lesion face by glial and connective tissue membranes that formed over the lesion site. In many animals that received tectal transplants, host retinal axons were traced growing into the grafts. Regenerating axons innervated specific, localized areas within the grafts, and it appeared that the axons retained the ability to recognize their appropriate target cells within the graft neuropil. Comparable ingrowth into cortical grafts was not observed. Optic axons were occasionally seen reentering the superficial layers of the host SC; however, compared to fetal tectal grafts, the density of host SC innervation was sparse. The implications of these data are discussed with regard to the possible use of fetal neural tissue grafts as reconstructive tissue bridges in the mammalian central nervous system. PMID- 3667970 TI - Immunocytochemical localization of gamma-aminobutyric acid in the hypoglossal nucleus of the macaque monkey, Macaca fuscata: a light and electron microscopic study. AB - The hypoglossal nucleus of the macaque monkey Macaca fuscata was investigated with light and electron microscopic immunocytochemistry with an antibody directed against gamma-aminobutyric acid (GABA). At the light microscopic level, GABA immunoreactivity was present in small neurons, punctate structures, and thin, fiberlike structures. These GABA-positive elements were distributed throughout the hypoglossal nucleus at rostrocaudal levels. There was no immunoreactivity in the hypoglossal motoneurons. The GABA-positive small neurons were fusiform or ovoid (15 X 9 micron) and extended a few proximal dendrites from both poles. At the ultrastructural level, these small neurons were characterized by a markedly invaginated nucleus and a scanty cytoplasm in which cisternae of rough endoplasmic reticulum were not organized into extensive lamellar arrays as seen in the motorneurons. The GABA-positive punctate structures at the light microscopic level were identified as vesicle-containing axon boutons at the electron microscopic level. These GABA-positive axon terminals made synaptic contacts mainly with the dendrites of the motoneurons and infrequently with the somata. The majority of them made symmetric synapses and they contained pleomorphic synaptic vesicles. However, a small number of GABA-positive terminals (7%) formed asymmetric synapses with the dendrites of motoneurons, and these contacts exhibited postsynaptic dense bars or Taxi bodies lying beneath the postsynaptic membranes. There were no GABA-positive boutons that contacted the cell bodies of the small neurons. Although GABA-positive myelinated and unmyelinated axons were seen as thin, fiberlike structures, these myelinated and unmyelinated axons rarely gave rise to boutons on the motoneurons. The present study suggests that GABAergic inhibition in the monkey hypoglossal nucleus occurs mainly on the dendrites of the motoneurons and to some extent on the somata. PMID- 3667971 TI - The GABAergic neurons and axon terminals in the lateralis medialis suprageniculate nuclear complex of the cat: GABA-immunocytochemical and WGA-HRP studies by light and electron microscopy. AB - In order to get more detailed information on the neural circuit of the lateralis medialis-suprageniculate nuclear (LM-Sg) complex of the cat, the GABAergic innervation of this complex was studied by GABA immunohistochemical techniques. Small immunoreactive cells were found throughout the LM-Sg complex. On the basis of their ultrastructural features, these GABAergic cells were identified as Golgi type II interneurons. The neuropil of this nucleus displayed a conspicuous granular immunoreactivity. Ultrastructurally, the immunoreactive neural profiles in the neuropil were identified as the presynaptic dendrites of interneurons, myelinated axons, or axon terminals. The GABAergic dendritic profiles, containing pleomorphic synaptic vesicles, were involved in synaptic glomeruli. Additionally, GABAergic axon terminals containing pleomorphic synaptic vesicles formed symmetric axodendritic synaptic contacts mainly in the extraglomerular neuropil. They appeared to correspond to either axon terminals from the thalamic reticular nucleus (TRN) or the axon terminals of interneurons. The projections from the TRN to the LM-Sg complex were studied by using wheat germ agglutinin-conjugated horseradish peroxidase (WGA-HRP). Following injection of WGA-HRP into the LM-Sg complex, a number of retrogradely labeled cells were observed in the TRN. The connections between the TRN and the LM-Sg complex appeared to be topographically organized, the dorsal TRN being connected mainly with the dorsomedial portion of the LM-Sg complex, and the ventral TRN being connected chiefly with the ventrolateral portion of the LM-Sg complex. Following injection of the tracer into the TRN, ultrastructural examination of anterograde labeling in the LM-Sg complex revealed that labeled terminals contain pleomorphic vesicles and make symmetric synaptic contacts mainly with small to medium-sized dendrites. The labeled terminals were not involved in synaptic glomeruli. The present results provide anatomic support for the contention that the projection cells of the LM Sg complex may be inhibited by both the TRN axons and interneurons, probably through the mediation of GABA. PMID- 3667972 TI - Primary afferent and propriospinal fibers in the rat dorsal and dorsolateral funiculi. AB - The purpose of this study is to determine the numbers of primary afferent and propriospinal fibers in the dorsal and dorsolateral funiculi of the rat. The reason for concentrating on these areas is that they contain large numbers of unmyelinated axons. Our data are axonal numbers from the S2 segment of spinal cord in animals that had unilateral dorsal rhizotomies or spinal cord isolations. The major conclusions are 1) that 23% of the primary afferent fibers in the dorsal funiculus are unmyelinated; 2) that there are approximately 12,500 unmyelinated primary afferent fibers in the dorsolateral funiculus, which is more than the number of primary afferent fibers in the dorsal funiculus and tract of Lissauer combined, and 3) that approximately 25% of the axons in the dorsal funiculus and 44% of the axons in the dorsolateral funiculus are propriospinal. These data modify and extend previous ideas of the organization of spinal white matter. PMID- 3667973 TI - Movement of newly synthesized membrane by fast transport along the axon of an identified Aplysia neuron. AB - In order to ascertain the form in which newly synthesized membrane is moved by fast axonal transport, we examined the distribution of label along an axon of the identified giant serotoninergic neuron (GCN) in the cerebral ganglion of Aplysia californica. Membrane glycoproteins were labeled by intrasomatic injection of 3H fucose, and segments of GCN's axon in the posterior lip nerve containing the transported organelles were examined at 1, 5, 15, and 24 hours by quantitative electron-microscopic autoradiography. To show that membrane which is rapidly transported is contained only in discrete organelles rather than in continuous sheets of axoplasmic reticulum, we systematically varied conditions of fixation. We found that we could distinguish vesicles from axoplasmic reticulum most reliably in axons fixed with 2% formaldehyde and 2% glutaraldehyde in cacodylate buffer. At short times after intrasomatic injection of 3H-fucose, dense-cored vesicles and multivesicular tubules were the only axonal organelles labeled. PMID- 3667974 TI - D-[3H]aspartate retrograde labelling of callosal and association neurones of somatosensory areas I and II of cats. AB - Experiments were carried out on cats to ascertain whether corticocortical neurones of somatosensory areas I (SI) and II (SII) could be labelled by retrograde axonal transport of D-[3H]aspartate (D-[3H]Asp). This tritiated enantiomer of the amino acid aspartate is (1) taken up selectively by axon terminals of neurones releasing aspartate and/or glutamate as excitatory neurotransmitter, (2) retrogradely transported and accumulated in perikarya, (3) not metabolized, and (4) visualized by autoradiography. A solution of D-[3H]Asp was injected in eight cats in the trunk and forelimb zones of SI (two cats) or in the forelimb zone of SII (six cats). In order to compare the labelling patterns obtained with D-[3H]Asp with those resulting after injection of a nonselective neuronal tracer, horseradish peroxidase (HRP) was delivered mixed with the radioactive tracer in seven of the eight cats. Furthermore, six additional animals received HRP injections in SI (three cats; trunk and forelimb zones) or SII (three cats; forelimb zone). D-[3H]Asp retrograde labelling of perikarya was absent from the ipsilateral thalamus of all cats injected with the radioactive tracer but a dense terminal plexus of anterogradely labelled corticothalamic fibres from SI and SII was observed, overlapping the distribution area of thalamocortical neurones retrogradely labelled with HRP from the same areas. D [3H]Asp-labelled neurones were present in ipsilateral SII (SII-SI association neurones) in cats injected in SI. In these animals a bundle of radioactive fibres was observed in the rostral portion of the corpus callosum entering the contralateral hemisphere. There, neurones retrogradely labelled with silver grains were present in SI (SI-SI callosal neurones). Association and callosal neurones labelled from SI showed a topographical distribution similar to that of neurones retrogradely labelled with HRP. The laminar patterns of corticocortical neurones labelled with D-[3H]Asp or with HRP were also similar, with one exception. In the inner half of layer II, SII-SI association neurones and SI-SI callosal neurones labelled with the radioactive marker were much less numerous than those labelled with HRP. In cats injected in SII, D-[3H]Asp retrogradely labelled cells were present in ipsilateral SI (SI-SII association neurones). Their topographical and laminar distribution overlapped that of neurones labelled with HRP but, as in cats injected in SI, association neurones labelled with silver grains were unusually rare in the inner layer III.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3667975 TI - Subcortical connections of the superior colliculus in the mustache bat, Pteronotus parnellii. AB - The mustache bat, Pteronotus parnellii, depends on echolocation to navigate and capture prey. This adaptation is reflected in the large size and elaboration of brainstem auditory structures and in the minimal development of visual structures. The superior colliculus, usually associated with orienting the eyes, is nevertheless large and well developed in Pteronotus. This observation raises the question of whether the superior colliculus in the echolocating bat has evolved to play a major role in auditory rather than visual orientation. The connections of the superior colliculus in Pteronotus were studied with the aid of anterograde and retrograde transport of wheat germ agglutinin conjugated to HRP. These results indicate that the superior colliculus of Pteronotus is composed almost entirely of the layers beneath stratum opticum. The retinal projection is restricted to a very thin zone just beneath the pial surface. Prominent afferent pathways originate in motor structures, particularly the substantia nigra and the deep nuclei of the cerebellum. Sensory input from the auditory system originates in three brainstem nuclei: the inferior colliculus, the anterolateral periolivary nucleus, and the dorsal nuclei of the lateral lemniscus. The projections from these auditory structures terminate mainly in the central tier of the deep layer. The most prominent efferent pathways are those to medial motor structures of the contralateral brainstem via the predorsal bundle and to the ipsilateral midbrain and pontine tegmentum via the lateral efferent bundle. Ascending projections to the diencephalon are mainly to the medial dorsal nucleus and zona incerta. Thus, the superior colliculus in Pteronotus possesses well-developed anatomical connections that could mediate reflexes for orienting its ears, head, or body toward objects detected by echolocation. PMID- 3667976 TI - Retinotopic organization in the dorsal lateral geniculate nucleus of the tammar wallaby (Macropus eugenii). AB - Electrophysiological recordings were made from 187 single cells in the tammar wallaby (Macropus eugenii) dorsal lateral geniculate nucleus (LGNd). The results show that it is topographically organized such that the superior visual field is represented dorsally, the inferior field is represented ventrally, the nasal visual field is represented caudally, and the temporal visual field is represented rostrally. The visual field of one eye ranges from -30 degrees nasal to +179 degrees temporal in azimuth and +73 degrees superior to -49 degrees inferior in elevation. Ganglion cells that had receptive field positions between 9 degrees and +179 degrees projected to the contralateral LGNd while the ganglion cells that projected to the ipsilateral LGNd had visual fields from 0 to +30 degrees. The binocular visual field extends 60 degrees in azimuth. This representation in the LGNd is expanded relative to the monocular representation. There is also an increased representation of the horizon in the temporal field corresponding to the visual streak of retinal ganglion cells. The binocular visual field is located where contralateral and ipsilateral laminae are shown to interdigitate by proline autoradiography. There are nine eye-specific laminae in the LGNd. Four receive afferents from the contralateral eye and five receive afferents from the ipsilateral eye. The lines of isoelevation are perpendicular to the coronal plane of section while the lines of isoazimuth are nearly parallel to the coronal plane. The lines of projection representing one visual direction are inferred to be perpendicular to the tangent of curvature of the laminae as in the LGNd of other mammals. The majority of cells (85%) recorded had on- or off centre responses. On- and off-centre responses were not apparently segregated in the LGNd but segregation may not have been revealed by the single-unit recording technique. PMID- 3667977 TI - Organization of anterogradely labeled spinocervical tract terminations in the lateral cervical nucleus of the cat. AB - The anterograde transport of horseradish peroxidase following injections into the cervical, thoracic, or lumbosacral spinal cord was used to examine the organization of spinocervical tract terminations in the lateral cervical nucleus (LCN) of the cat. A somatotopic organization of the labeling originating from different spinal levels was observed in the mediolateral dimension. Cervical labeling generally occurred in the ventromedial portion and lumbosacral labeling in the dorsolateral portion of the LCN. Thoracic labeling occurred both in the middle and the most lateral edge of the nucleus. In all cases, labeling was distributed over most of the rostrocaudal extent of the LCN. In addition, distinct patches of labeling were present in the medialmost portion of the nucleus, regardless of the spinal level injected. These observations corroborate the topographical organization of the LCN described previously on the basis of physiological and retrograde labeling data, and support the identification of the medialmost part of the LCN as a distinct portion of the nucleus. Terminal labeling in the LCN always occurred in multiple, longitudinally distributed fields. The afferent input to each terminal field coursed in separate, loose bundles of fibers that descended from the superficial dorsolateral funiculus. Large injections resulted in more extensive, overlapping terminal fields. These observations indicate that collateral projections result in several discrete representations of a given portion of the skin over the longitudinal extent of the LCN, but that topographical relationships are longitudinally maintained. It is suggested that these multiple terminal fields are the anatomical correlate of the functionally selective convergence of spinocervical tract terminations, that has previously been postulated on physiological grounds to explain the generation of LCN receptive fields with homogenous receptor input within a somatotopic framework. PMID- 3667978 TI - Spinocerebellar projections from the cervical enlargement in the cat, as studied by anterograde transport of wheat germ agglutinin-horseradish peroxidase. AB - The projection fields of spinocerebellar tracts arising from the cervical enlargement were studied by the anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP) in the cat. Following injections of WGA-HRP into the C5-C8 or T1 segments, labeled terminals were seen in lobule I to sublobule Vf of the anterior lobe, and lobule VI, sublobule VIIb, lobules VIII and IX, the simple lobule, crus II, and the paramedian lobule of the posterior lobe. In the sagittal plane of sublobules Ib-Vf and sublobules VIf and VId, the labeled terminals were distributed mainly in the superficial two thirds of the apicobasal extent. The labeled terminals in the anterior lobe accounted for about 70% of the total labeled terminals; the great majority were in lobule IV (17-20%) and lobule V (40%). The labeled terminals in the posterior lobe accounted for 30% of the total labeled terminals; the majority were in sublobules VIf (11-15%) and VId (6%). In the mediolateral extent, more than 50% of the total labeled terminals in each lobule were concentrated within 1.0 mm from the midline (the vermis) and 70-80% within 2.0 mm from the midline (the vermis and the medial part of the intermediate regions). A smaller number were also present in the intermediate region. Cases with lateral cordotomies revealed that the projections were bilateral but predominantly ipsilateral to the cells or origin and that the quantity of the ipsilateral projection was 66.5-75% of the total in each of sublobules IVb, Va, and VIf. The projection to the paramedian lobule was also predominantly ipsilateral. Projection fields in the horizontal plane were reconstructed from a series of transverse sections through each lobule. In sublobules Va-VIf labeled terminals were distributed in three areas: area 1 located within 0.25 mm from the midline in zone A1 of Voogd; area 2 located between 0.5 and 0.75 mm lateral to the midline in zones A1 and A2; and area 3, which appeared to be located between 0.75 and 1.5 mm lateral to the midline in zones A2-B. These areas extended longitudinally in the apical two thirds of the lobules. From the present and previous retrograde HRP studies it was suggested that the neuronal groups in the cervical enlargement (the medial lamina VI group and the central lamina VII group) project to lobules I-V of the anterior lobe and lobule VI, sublobule VIIb, and lobule VIII of the posterior lobe. They have strong projections to caudal lobules of the anterior lobe (lobules III-Va) and lobules facing the primary fissure (sublobules Vd-Vf and sublobules VIf and VId). PMID- 3667979 TI - Topographical organization of olivocerebellar and corticonuclear connections in the rat--an WGA-HRP study: I. Lobules IX, X, and the flocculus. AB - The organization of the olivocerebellar and corticonuclear relations for vermal lobules IX and X and the flocculus has been studied in the rat by using microinjections of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP). This axonal tracer allowed us to study simultaneously the olivocortical connections (revealed by retrograde transport) and corticonuclear connections (revealed by anterograde transport) from a single injection in the cerebellar cortex. The results indicate that four modules can be distinguished, each of which consists of a region of cerebellar cortex receiving afferents from a single small region of the inferior olive (IO) and sending efferents to one or several portions of the cerebellar nuclei and/or vestibular nuclei. The first module includes a medial part of lobule X as well as all the flocculus. It receives afferents from the dorsal cap (dc) and sends efferents to the small cell (s) zone of the dentate nucleus as well as to the medial vestibular (VM) nucleus and subnucleus y. The second module includes a medial parasagittal region located in lobules IX and X. It receives afferents from the ventrolateral outgrowth (vlo) and/or beta nucleus (vlo + beta nucleus) and sends efferents principally to the ventrolateral part of fastigial nucleus and to the superior vestibular (VS), inferior vestibular (VI), and VM nuclei. The third module includes a lateral parasagittal region in lobules IX and X. It receives afferents from the dorsomedial cell column (dmcc) of IO and sends efferents principally to the interpositus nucleus and subnucleus y. The fourth module includes the most lateral part of lobules IX and Xa. It receives afferents from the principal olive (PO) and sends efferents to the s zone of the dentate nucleus. These results are comparable to those obtained in the cat although a few differences are discussed. PMID- 3667980 TI - Development of the sex difference in neuron numbers of the superior cervical ganglion: effects of transection of the cervical sympathetic trunk. AB - The number of superior cervical ganglion (SCG) neurons does not differ for males and females on the day of birth, but by 15 days, after most of the normal neuron death has occurred, males have significantly more neurons than females. This difference persists in the adult. The present study was undertaken to determine whether the presence of afferent input to the SCG is required for the development of this sex difference. Bilateral transection of the cervical sympathetic trunk, which deafferents the SCG neurons, or a sham operation was performed on male and female Sprague Dawley rats on the day of birth. Numbers of neurons were counted in SCGs of animals sacrificed on either postnatal day 4 or 15, before or after normal development of the SCG sex difference. At 4 days, the number of SCG neurons in sham-operated males and females were not different, but by 15 days, females had lost a significant number of neurons, whereas the males had not. Transection of the cervical sympathetic trunk led to a significant loss of over 6,000 SCG neurons by postnatal day 4 in both males and females. Whereas some of this loss is due to axotomy of caudally projecting SCG neurons, at least half of the neuron loss is due to removal of the afferent input. At 15 days, sham operated males had significantly more SCG neurons than did sham-operated females, but the gender difference was not significant in animals with neonatally deafferented ganglia. Thus, the normal development of the gender difference in SCG neuron numbers requires an intact afferent input. PMID- 3667981 TI - Spatiotemporal convergence and divergence in the rat S1 "barrel" cortex. AB - The size and response magnitude of receptive fields were evaluated for cells in the rat cortical barrel-field by using standard vibrissal deflections of 1.14 degrees. Such stimuli fell within the plateau region of stimulus-response curves. The response of all neurones to all vibrissae within and surrounding centre receptive fields were analysed for probability and latency of response. It was found that cells in supragranular layers had small centre-receptive fields (average 1.6 vibrissae) with small excitatory surrounds (1.5 vibrissae) while cells in the granular layers had small, powerful centre-receptive fields (1.4) with moderately large excitatory surrounds (2.6). Neurones in infragranular layers possessed large but weak centre-receptive fields (2.6) with large surrounds (3.5). Sixty-four neurones in layer IV were studied, the precise locations of which were identified by using dye lesioning and cytochrome oxidase staining. There were no differences in receptive field size for cells within septa and barrel hollows, but the latter were twice as likely to produce two or more spikes per stimulus from the principal vibrissa (65% against 33%). Histological analysis showed that the principal vibrissa was synonymous with the appropriate vibrissa for the barrel on 86% (55 of 64) of occasions. A quantitative analysis of convergent input to three neighbouring barrels (E1, E2, and D1) showed considerable graded overlap of receptive field surrounds, although facial hair adjacent to the mystacial pad only influenced cells on the edge of the barrel-field. Individual vibrissae exhibited significant divergent input to adjacent inappropriate barrels, being preferentially directed to distant septal rather than barrel hollow cells. An analysis of latencies showed that 40% of barrel hollow cells and 48% of barrel septal cells responded at short (less than 10 ms) latencies to their appropriate vibrissa. In contrast, responses to inappropriate vibrissae were overwhelmingly of long latency (10-greater than 30 ms), only 2% of inappropriate responses from barrel hollow cells and 13% from septal cells being of short latency. These results suggest that direct inputs largely project to appropriate barrels. The possibility that divergent inputs are generated by intracortical mechanisms is discussed. PMID- 3667982 TI - Ultrastructural observations of the development of the fourth ventricular roof in the mouse brain. AB - The developmental changes of the fourth ventricular roof of the brain in mouse fetuses and neonates were observed by scanning and transmission electron microscopy with particular attention to the caudal portion where a median foramen might be formed during the fetal period. The fourth ventricular roof was continuously paved with a single layer of cuboidal or squamous neuroepithelial cells with poorly developed basement membrane until the 12th intrauterine day when the primitive choroid plexus appeared at the middle portion of the roof. With development of the choroid plexus, the roof caudal to the choroid plexus (membranous roof) became thinner, and it was mostly lined with a single layer of flat ependymal cells having cilia and microvilli and resting on a continuous basement membrane. These ependymal cells were connected with one another by a gap junction or an intermediate junction for the entire period examined, except at the 13th to 14th intrauterine days, during which the interependymal clefts were transiently widened up to 2 microns in width, in places, without disruption of the continuous basement membrane. Neither a median aperture nor wide intercellular pores were formed in the membranous roof during the fetal or neonatal term. PMID- 3667983 TI - Organization of vasotocin-immunoreactive cells and fibers in the canary brain. AB - The distribution of vasotocin (VT)-immunoreactive neuronal perikarya and fibers in the canary (Serinus canaria) was investigated with immunohistological techniques. The results suggest that most VT-stained cell bodies are located in three diencephalic regions. First, a large number of densely packed neurons are found in the paraventricular nucleus (PVN) and the anterior preoptic nucleus. Neurons here vary widely in size and shape. Small-size rounded neurons and large size multipolar neurons appear to concentrate in separate subdivisions. Second, a series of loosely organized cell groups of medium- to large-size cells occurs in the lateral parts of the hypothalamus. These aggregates of neurons apparently correspond to subdivisions of the supraoptic nucleus (SON). Third, diffusely distributed, lightly stained cells are found dorsal to the paraventricular nucleus in the dorsal diencephalon. A number of cells of this group seem to be located in the basal septal area and bed nucleus of the stria terminalis. Immunoreactive fibers and varicosities concentrate in brain regions that are associated with neuroendocrine, autonomic, and limbic functions. Axons from the PVN and SON form compact bundles of the hypothalamohypophysial tract in the lateral hypothalamus and then funnel into the internal zone of the medium eminence (ME). Furthermore, a heavy innervation seems to be present in the palisadal, external zone of the ME. A substantial number of fibers appear to leave the PVN toward extrahypothalamic areas. Most extrahypothalamic VT fibers innervate telencephalic and brainstem regions that are thought to be involved in mediation of limbic and autonomic functions. These areas include the lateral and medial septum, the lateral habenula, the substantia grisea centralis, the area ventralis (Tsai), the locus coeruleus, raphe nuclei, the nucleus tractus solitarii, and lateral medulla. In addition, fibers with immunoreactivity for VT innervate structures such as the optic tectum and the nucleus ovoidalis that have been implicated in sensory processing of visual and auditory information. Finally, VT fibers and varicosities occur in centers including the nucleus robustus archistriatalis and nucleus intercollicularis that have been implicated in vocal control. PMID- 3667984 TI - Regional distribution of cholecystokinin receptors in primate cerebral cortex determined by in vitro receptor autoradiography. AB - Cholecystokinin (CCK) is a putative peptide neurotransmitter present in high concentration in the cerebral cortex. By using techniques of in vitro receptor autoradiography, CCK binding sites in primate cortex were labeled with 125I Bolton-Hunter-labeled CCK-33 (the 33-amino-acid C-terminal peptide) and 3H-CCK-8 (the C-terminal octapeptide). Biochemical studies performed on homogenized and slide-mounted tissue sections showed that the two ligands labeled a high affinity, apparently single, saturable site. Autoradiography revealed that binding sites labeled by both ligands were anatomically indistinguishable and were distributed in two basic patterns. A faint and diffuse label characterized portions of medial prefrontal cortex, premotor and motor cortices, the superior parietal lobule, and the temporal pole. In other cortical areas the pattern of binding was layer-specific; i.e., binding sites were concentrated within particular cortical layers and were superimposed upon the background of diffuse label. Layer-specific label was found in the prefrontal cortex, anterior and posterior cingulate gyrus, somatosensory cortex, inferior parietal lobule, retrosplenial cortex, insula, temporal lobe cortices, and in the primary visual and adjacent visual association cortices. The areal and laminar localization of layer-specific CCK binding sites consistently coincided with the cortical projections of thalamic nuclei. In prefrontal cortex, CCK binding sites were present in layers III and IV, precisely paralleling the terminal fields of thalamocortical projections from the mediodorsal and medial pulvinar nucleus of the thalamus. In somatosensory cortex, the pattern of CCK binding in layer IV coincided with thalamic inputs arising from the ventrobasal complex, while in the posterior cingulate gyrus, insular cortex, and retrosplenial cortex, layer IV and lower III binding mirrored the laminar distribution of cortical afferents of the medial pulvinar. CCK binding in layers IVa, IVc alpha, IVc beta, and VI of primary visual cortex corresponded to the terminal field disposition of lateral geniculate neurons, whereas in adjacent visual association cortex, binding in layers III, IV, and VI faithfully followed the cortical distribution of projections from the inferior and lateral divisions of the pulvinar nucleus of the thalamus. We interpret the diffusely labeled binding sites in primate cortex as being associated with the intrinsic system of CCK-containing interneurons that are distributed throughout all layers and areas of the cortex. The stratified binding sites, however, appear to be associated with specific extrinsic peptidergic projections.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3667985 TI - Axonal growth cones in the developing amphibian spinal cord. AB - Axonal growth cones in the spinal cord of embryonic and larval Xenopus (stages 24 48) were filled with the anatomical tracer horseradish peroxidase (HRP). Growth cones of lateral and ventral marginal zones, including those of descending spinal and supraspinal pathways, were labeled by application of tracer to the caudal medulla or to one of several levels of the spinal cord. Central axons of sensory neurons were filled via their peripheral processes. Growth cone configuration varied widely but fell into five general categories: complex with both filopodia and veils, filopodia only, lamellipodia only, clavate, and fusiform. Several general patterns emerged from the distribution of these various configurations. Growth cones of younger animals generally were more complex than those of older ones. Growth cones closer to the leading edge of descending fiber bundles were more elaborate than those that followed. Growth cones of the dorsolateral fascicle, which carries ascending central processes of Rohon-Beard and sensory ganglion neurons, were very simple and followed a straight course rostrally, whereas those of descending axons of the lateral fiber areas were more complex and sometimes spread over almost the entire lateral marginal zone. Growth cones of Rohon-Beard central ascending axons were fusiform or clavate, while those of sensory ganglion axons showed several fine filopodia at their tips. Growth cones of both types of sensory axons change configuration as they approached the hindbrain, becoming more complex. This study demonstrates that the configurations of growth cones belonging to the same axonal pathway vary with age and with position along their routes, and that growth cones of different neuron classes exhibit characteristic ranges of morphological variation. PMID- 3667986 TI - A combined 2-deoxyglucose and neurophysiological study of primate somatosensory cortex. AB - The metabolic activity pattern produced in the primary somatosensory cortex (SI) of primates by repetitive delivery of a tactile stimulus is distinctly patchy. The functional significance of these patches, however, remains obscure. This investigation sought to determine the correlation between neural and metabolic activity produced by tactile stimuli and to evaluate the relationship, if any, between the neural activity and metabolic patches evoked by similar stimuli. Experiments were undertaken in which extracellular microelectrode recordings were carried out in animals that subsequently underwent a 2-deoxyglucose (2DG) study. Three types of relations were identified. First, the receptive fields (RF) and modality properties of neurons sampled in locations at which patches of metabolic label were found matched the "place" and "modal" properties of the stimulus used to produce 2DG labeling. Second, in cortical locations where the RF and modality properties of the sampled neurons differed from either the place or modal properties of the stimulus used to evoke the 2DG label, no above-background increases in metabolic labeling were found. Finally, in some cortical locations at which the receptive field and modality properties of the neurons matched those of the 2-deoxyglucose mapping stimulus, no above-background increases in metabolic labeling were found. This outcome leads us to suggest that moment-to moment changes in neural responsivity, which might remain undetected by conventional receptive field mapping methods, contribute to the patchy pattern of metabolic activity visualized by the 2-deoxyglucose method. PMID- 3667987 TI - Postnatal development of the inferior olivary complex in the rat: IV. Synaptogenesis of GABAergic afferents, analyzed by glutamic acid decarboxylase immunocytochemistry. AB - The postnatal maturation of the GABAergic innervation of the rat inferior olive was studied with an antiserum to glutamic acid decarboxylase (GAD), the GABA synthesizing enzyme. GAD-positive axons were present at a very low density in the periolivary and interlamellar regions of newborn rats, as well as in certain precise areas of the lamellae, at the mediodorsal limit. The immature distribution indicates that the GABAergic projections reach the inferior olive shortly before birth and that the greater part of synaptogenesis and the establishment of the adult organization occurs postnatally. Light and electron microscopic analyses disclosed that the maturation of this system of olivary afferents passes through three well-defined stages: (1) During the first, or immature stage (from PO to P5), GAD immunoreactivity is not confined to axon terminals, as in adult rats. The labeled fibers penetrate progressively into the periphery of the lamellae and reach their centers in an irregular manner by the end of the immature stage. This staggered invasion of the lamellae accentuates intraregional olivary differences and begins to take the adult configuration. As fiber penetration advances, the density of labeled axons establishing synaptic contacts increases, while the number of completely immunostained fibers decreases. This distribution prevails until the end of the immature stage and suggests that the GABAergic afferent projections remain in a "waiting compartment" from their prenatal arrival until the moment they invade the olivary parenchyma. (2). The second stage is designated as an intermediate stage of maturation and lasts from P7 to P10. During this period, GAD axoplasmic compartmentation occurs, and henceforth only axon terminals exhibit GAD immunoreactivity. Concomitantly, intraregional differences in the pattern of innervation become more marked, because of the continuing irregular distribution of the growing labeled axons. This intermediate maturational stage is also characterized by a rapid increase in labeled axon terminals bearing synaptic complexes and by the formation of complex synaptic arrangements, the protoglomeruli. From the beginning of protoglomeruli formation, GAD-positive axon terminals are one of their constituents, and they are systematically localized at the periphery of the incipient dendritic protrusions. (3) The final stage of maturation takes place from P10 to P15. During this stage, the adultlike pattern of GABAergic innervation of the inferior olive is attained. Toward P15, intraregional differences in GAD immunoreactivity are similar to those of the adult rat.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3667988 TI - Cellular degeneration and synaptogenesis in the developing retina of the rat. AB - We have investigated the time course and magnitude of cellular degeneration in the ganglion cell layer and the presumptive amacrine and bipolar regions of the inner nuclear layer during the development of the retina in the rat. Pyknotic profiles are present in the ganglion cell layer during the first 2 postnatal weeks, reaching peak numbers during the first 4 postnatal days (corresponding to the time of greatest loss of ganglion cells and their axons: Potts et al., '82; Lam et al., '82; Perry et al., '83). Two observations suggest that the majority of pyknotic profiles present in the ganglion cell layer during the second postnatal week are not ganglion cells. First, following injection of kainic acid into one superior colliculus, degenerating ganglion cells in the contralateral retina are cleared within 24-48 hours. Therefore, since most ganglion cell and axon loss occurs within the first postnatal week, few of the pyknotic profiles present in the second week are likely to be ganglion cells. Second, the time course of cellular degeneration in the ganglion cell layer during the second postnatal week follows a very similar pattern to that seen in the presumptive amacrine sublayer of the inner nuclear layer. Such a correspondence suggests that two phases of cell death occur in the ganglion cell layer: during the first postnatal week the majority of dying cells are ganglion cells, and in the second, most cell death is due to a loss of displaced amacrine cells. In the inner nuclear layer pyknotic profiles are most numerous in the presumptive amacrine region on postnatal days 6 and 7, and in the presumptive bipolar region on day 10. Synaptogenesis in the inner plexiform layer occurs later but reflects the order of cell death. Thus, conventional (presumed amacrine) synapses were first observed on day 11 and synaptic ribbons (indicative of bipolar synapses) on day 13. These observations suggest that amacrine and bipolar cells initiate synapses only after their numbers have stabilized. PMID- 3667989 TI - Stratified distribution of synapses in the inner plexiform layer of primate retina. AB - Distributions of bipolar (B) and amacrine (A) synapses and postsynaptic ganglion cell (G) dendritic profiles in the inner plexiform layer (IPL) were analyzed in EM montages of monkey central and human foveal and peripheral retinae. Synapses and profiles were counted and plotted for each 5% interval of IPL, with 0% at the inner edge of the inner nuclear layer and 100% at the outer edge of the ganglion cell layer. In monkey and human retinae, both A and B synapses occur throughout the IPL, but the ratio of A to B synapses varies from 2:1 to more than 6:1. In the monkey central retina, four bands of A conventional synapses are concentrated at 15, 35, 60, and 80% depth. In the human foveal slope, there are two main A bands at 45 and 85%, whereas in the human periphery, there are five bands at 15, 35, 60, 75, and 90%. In both species, A processes containing large dense-core vesicles are concentrated in three bands at 10-20, 50, and 80-90% depth, corresponding to previously described levels of peptides, dopamine, and GABA. B ribbon synapses are distributed fairly evenly throughout the IPL, with a suggestion of four broadly overlapping bands. Most B ribbons are presynaptic to one A and one G (B----A/G). In the human, there are significantly more B dyads with postsynaptic G's (B----A/G, B----G/G) in the fovea (91%) than in the periphery (66%), implying greater A cell processing peripherally. Also in the human, B terminals containing glycogenlike granules are concentrated in the outer half of the IPL, with agranular terminals in the inner half. Our results demonstrate multiple strata containing different types of synaptic contacts in primate IPL. PMID- 3667990 TI - Morphology of local "stridulation" interneurons in the metathoracic ganglion of the acridid grasshopper Omocestus viridulus L. AB - The morphological characteristics of five types of local spiking interneurons in the metathoracic ganglion of the acridid grasshopper Omocestus viridulus L. have been revealed by intracellular injection of the fluorescent dye Lucifer Yellow. All these neurons are active during induced stridulation and discharge in the stridulation rhythm. They are structurally unlike any of the metathoracic local interneurons previously described in the Acrididae. Type 1: Unilateral interneurons in the metathoracic neuromere; soma in anterior position; arborization dorsal, in anterolateral, posterolateral, and midline regions. Type 2: Unilateral interneurons in the metathoracic neuromere; neurite with characteristic hairpin bend; soma in lateral position; arborization through the lateral neuropil region. Type 3: Unilateral interneurons in the metathoracic and abdominal neuromeres; soma anterior at the base of the connective; arborization dorsal, in anterolateral, posterolateral, and midline regions, with ladderlike branches into the abdominal neuromeres. Type 4: Symmetrically bilateral neurons; soma in ventral median position; arborization dorsal, in anterolateral, posterolateral, and midline regions. Ipsilateral branches mostly smooth, contralateral mostly varicose. Type 5: Asymmetrically bilateral neurons, soma in ventral median position; ipsilateral branches mostly smooth, contralateral mostly varicose. The ipsilateral branches in particular penetrate all layers of the ganglion. The main arborizations of interneurons of types 1 and 4, and to some extent those of types 3 and 5, occupy the same region, which extends very far dorsally into the vicinity of the median and lateral tracts. There are additional antero- and posterolateral branches in the metathoracic neuromere, in positions where in principle they can overlap with the arborizations of the motoneurons. The interneurons of type 2, and to some extent type 5, arborize mainly in a lateral region that also includes deeper layers of the ganglion and hence encompasses the projections of mechanoreceptive proprioceptors. The interneurons of types 1, 3, and 4 have so-called "sister" neurons, identical to the typical neurons in their metathoracic arborizations but with additional collaterals that pass into the mesothoracic ganglion. PMID- 3667991 TI - Changes of neurotensinlike immunoreactivity in the striatum of the cat after intrastriatal injection of kainic acid. AB - In the course of our study on the effects of kainic acid (KA) on neuropeptidelike immunoreactivity in striatal neurons, it was found that neurotensinlike immunoreactivity (NT-LI) became visible immunohistochemically in cell bodies of some striatal neurons after injecting KA stereotaxically into the head of the caudate nucleus (Cd) of the cat. The adult cats injected with KA were allowed to survive for 1-56 days, and their brains were examined by the indirect immunoperoxidase method. In the intact Cd, NT-LI was observed in axonal elements that accumulated to form irregularly shaped patches and displayed a discrete island-and-matrix pattern. At the site of KA injection, where neuronal cell loss and gliosis were produced. NT-LI almost disappeared by the fourth day after KA injection. In parallel with these changes, many neuronal cell bodies with NT-LI became visible in striatal regions surrounding the site of KA injection. Most of these neuronal cell bodies that showed NT-LI were medium-sized and extended thick dendrites with spines; spiny processes were rarely seen on the cell bodies. On the other hand, when a lesion was placed in the head of the Cd by thermocoagulation, no NT-LI could be seen in cell bodies of striatal neurons. Thus it was presumed that NT-LI in cell bodies of medium-sized, spiny neurons of the cat striatum might be at a low level under normal conditions but enhanced in cell bodies of the neurons that survived the KA injections. PMID- 3667992 TI - Postnatal development of microtubules and neurofilaments in the rat optic nerve: a quantitative study. AB - In this paper the postnatal changes in the cytoskeleton of the rat optic nerve fibers are described and quantified. These changes are also compared with other parameters such as myelination and axonal caliber with the aim of describing a general pattern of optic nerve maturation from a morphological point of view. The results showed that during the first postnatal week microtubules outnumbered neurofilaments but between days 8 and 20 the neurofilaments rapidly increased and on day 20 were about twice as numerous as microtubules. This proportion remained almost unaltered from the end of the third week to the 44th postnatal day. The comparison with other parameters suggested that the cytoskeleton, and in particular the proportion between its components, may be a more reliable index for measuring optic nerve maturation than other variables commonly used. PMID- 3667993 TI - Gingivitis around the deciduous teeth of sheep. AB - Two-hundred and eight sheep from two farms were killed mostly in age-matched groups of 6 between the ages of 6 and 141 weeks. Sheep from one farm (W) had excessive tooth wear whilst sheep from the other (G) had little. The four deciduous incisor teeth and the third premolar from one side of the mandible of each sheep were examined by light microscopy. The inflammatory reaction in the gingiva around the sulcus and sulcular epithelial proliferation were subjectively assessed. Sheep from both farms initially showed a neutrophilic reaction. From approximately 25 to 100 weeks of age, sheep from farm G had a more extensive reaction than those from farm W involving neutrophils and mononuclear cells. The latter showed a more frequent tendency to spread on farm G than on farm W. The length of the sulcus was also more often greater on farm G. In contrast, the proliferation of the sulcular epithelium in both width and length was not greater on farm G. It is suggested that the severity of the gingivitis was arrested at a less severe stage on farm W than on farm G and that the pathogenesis of sulcular epithelial proliferation may different from that of gingival inflammation. PMID- 3667994 TI - A report on drug-induced kerato-conjunctivitis sicca in dogs. AB - Kerato-conjunctivitis sicca is reported in beagle dogs treated with an antispasmodic compound for 26 weeks during a routine toxicity study. There was a deficiency of lachrymal secretion associated with keratitis and corneal vascularization. Histopathologically, the changes were characterized by vascularization, fibroblast proliferation and infiltration of inflammatory cells in the substantia propria. In some cases, the inflammation also occurred in corneal epithelium, ocular conjunctiva and corneal limbi. PMID- 3667995 TI - Basophilic leukaemia in a dog. AB - Leukaemia in an 11-year-old bitch was characterized by the presence in the peripheral blood and bone marrow of cells with lobulated nuclei and numerous metachromatic cytoplasmic granules. The results of cytochemical stains for peroxidase and naphthol AS-D chloracetate esterase activity were negative. Ultrastructurally, the cytoplasmic granules were finely granular with no membranous coils or crystalline lattice structures. Based on these findings, the neoplastic cells were classified as basophils. PMID- 3667996 TI - Influence of thiamin supplements on furazolidone-induced cardiomyopathy in turkey poults. AB - Furazolidone (700 ppm) was fed to turkey poults from 2 to 5 weeks of age. The drug produced a cardiomyopathy and reduced the feed intake and growth of the birds. Thiamin was concurrently injected into the furazolidone-fed poults to determine whether the vitamin would prevent or reduce the severity of the cardiotoxic effect of the drug. Supplemental injections of thiamin had no significant effect on feed consumption or growth of the birds nor did they protect the heart against the cardiotoxicity. The conclusion is that furazolidone induced cardiomyopathy is not caused by a thiamin deficiency. PMID- 3667997 TI - Focal spongy changes in the central nervous system of sheep and cattle. AB - A focal form of vacuolation in the white matter of the thalamus of 13 sheep and 2 cattle is described. The individual vacuoles were similar in appearance to those reported in other forms of spongy degeneration, but they were differentiated by their consistent neuroanatomical localization in the thalamic radiation of all 15 animals. Thirteen of these were sheep used in toxicity experiments and 11 had shown signs of convulsive activity. PMID- 3667998 TI - Meniscal lesions in knee joints of broiler fowls. AB - Post-mortem examination of the knee joints of 28 broiler type fowls revealed abnormalities in one or both medial menisci. Certain abnormalities appeared to be associated with knee ligament disruption. These included torn or frayed menisci and those which were displaced, usually in a mesial direction. Histopathological studies revealed that each of these abnormalities was normally associated with degenerative meniscal lesions. Other meniscal abnormalities showed no association with knee ligament disruption. Such menisci can be regarded as being of aberrant shape and most commonly the medial meniscus was enlarged and "discoid". Discoid medial menisci frequently showed histological abnormalities. As in other species, it is suggested that discoid menisci are predisposed to injury probably because of their larger contact area. PMID- 3667999 TI - The effects of tick-borne fever on some functions of polymorphonuclear cells of sheep. AB - Peripheral leucocytes obtained from sheep experimentally infected with tick-borne fever had a significantly reduced capacity to phagocytose and kill Staphylococcus aureus in vitro. Infected neutrophils were also less able to attach to glass surfaces than normal neutrophils. The period of reduced phagocytic activity coincided with the period of parasitaemia and severe neutropenia. PMID- 3668000 TI - Cerebellar lamellar bodies in two strains of murine scrapie. AB - Lamellar inclusion bodies have been described by other authors in the granular layer of the cerebellum of people suffering from the unconventional slow-virus disease of kuru and were thought to be associated with the disease. In this study, these bodies were also found in mice infected with scrapie, which belongs to the same group of diseases, as well as their age-matched controls. PMID- 3668001 TI - Mycosis fungoides beginning in childhood and adolescence. AB - Mycosis fungoides is a form of cutaneous T cell lymphoma usually occurring in mid to late adulthood. We report 12 patients with mycosis fungoides whose eruption began before age 20 years, including one patient with histologic documentation at 5 years of age. The onset of mycosis fungoides during the first two decades may be more common than is generally recognized and should be included in the differential diagnosis of chronic dermatoses in children and adolescents. PMID- 3668002 TI - In vivo epiluminescence microscopy of pigmented skin lesions. I. Pattern analysis of pigmented skin lesions. AB - The importance of recognizing early melanoma is generally accepted. Because not all pigmented skin lesions can be diagnosed correctly by their clinical appearance, additional criteria are required for the clinical diagnosis of such lesions. In vivo epiluminescence microscopy provides for a more detailed inspection of the surface of pigmented skin lesions, and, by using the oil immersion technic, which renders the epidermis translucent, opens a new dimension of skin morphology by including the dermoepidermal junction into the macroscopic evaluation of a lesion. In an epiluminescence microscopy study of more than 3000 pigmented skin lesions we have defined morphologic criteria that are not readily apparent to the naked eye but that are detected easily by epiluminescence microscopy and represent relatively reliable markers of benign and malignant pigmented skin lesions. These features include specific patterns, colors, and intensities of pigmentation, as well as the configuration, regularity, and other characteristics of both the margin and the surface of pigmented skin lesions. Pattern analysis of these features permits a distinction between different types of pigmented skin lesions and, in particular, between benign and malignant growth patterns. Epiluminescence microscopy is thus a valuable addition to the diagnostic armamentarium of pigmented skin lesions at a clinical level. PMID- 3668003 TI - In vivo epiluminescence microscopy of pigmented skin lesions. II. Diagnosis of small pigmented skin lesions and early detection of malignant melanoma. AB - Pattern analysis by epiluminescence microscopy of pigmented skin lesions was tested in a study of 318 small pigmented skin lesions that were diagnostically equivocal when examined with the naked eye. An improvement of clinical diagnosis was achieved by epiluminescence microscopy for practically all lesions, both benign and malignant, and was equally impressive for melanocytic and nonmelanocytic lesions. Improvement in diagnostic accuracy was as follows: for small nodular melanomas, from 50% to 70%; for superficial spreading melanoma in situ, from 46% to 80%; for invasive superficial spreading melanoma, from 64% to 90%; and for early lentigo maligna and lentigo maligna melanoma, from 67% to 88%. Conversely, the diagnosis of pigmented Spitz nevi improved from 46% to 93% and of pigmented basal cell carcinomas from 60% to 90%, which appears equally important because most of these lesions had clinically been considered to represent melanomas. The use of epiluminescence microscopy also resulted in considerable improvement in the diagnosis of dysplastic nevi, which was particularly helpful in making therapeutic decisions. Epiluminescence microscopy greatly expands the diagnostic armamentarium available for pigmented skin lesions at a clinical level and thus increases the chances of detecting or ruling out melanoma in its earliest stages. PMID- 3668004 TI - Allergic contact dermatitis from bacitracin. AB - Bacitracin is a commonly used topical antibiotic. Although occasional reports of adverse reactions to bacitracin have appeared in the medical literature, it is considered to be a nonsensitizing agent by most dermatologists. A description of two patients who demonstrated allergic contact dermatitis from bacitracin is presented, with a review of the pertinent literature. PMID- 3668005 TI - Treatment of leishmaniasis nodosa (oriental sore) with intralesionally injected emetine hydrochloride. AB - Treatment of 31 patients with a total of 50 leishmaniasis nodosa (oriental sore) lesions with intralesional injections of emetine hydrochloride led to 100% cure. The injections were given once in 15 days except in the case of one patient, who was treated once a week. The total amounts injected were: 10 to 13 mg for lesions up to 0.5 cm in size in one injection and 160 mg for the largest lesion, which covered almost the entire surface of the patient's nose, in five weekly injections. PMID- 3668006 TI - Natural cell-mediated cytotoxicity in vitiligo. AB - Natural cell-mediated cytotoxicity was studied in 18 patients with vitiligo and 13 healthy age-, race-, and sex-matched control subjects. The 4-hour chromium51 (51Cr) release assay was used to determine the activity of natural killer (NK) cells in the peripheral blood against K562 and Molt-4 target cells. Patients with vitiligo had a 50%, 67%, and 60% decrease in the cytotoxic response with Molt-4 cells at effector-target ratios of 25:1, 50:1, and 100:1, respectively, in comparison with control subjects (p less than 0.001). This inhibition was consistent with an 80% decrease in the binding capacity of NK cells to Molt-4 target cells (p less than 0.005). In contrast, cytotoxic responses did not differ in patients and control subjects with K562 target cells. These results suggest that patients with vitiligo have a decreased capacity for effector cell recognition of Molt-4 target cells but not K562 target cells. Hence patients with vitiligo may have defective clones of NK cells that are incapable of initial recognition of Molt-4 target cells, a necessary prerequisite for target cell lysis. Perhaps this phenomenon occurs with other tumor cells, which would explain the association of vitiligo with certain internal malignancies. PMID- 3668007 TI - Estimation of prednisone intake in pemphigus vulgaris patients with the use of simple laboratory methods. AB - Prednisone is a widely used medication in dermatology, particularly in pemphigus patients. Simple objective laboratory methods are suggested for the evaluation of prednisone intake, taking advantage of the similar chemical structure of cortisol and prednisolone. A linear correlation was found between the dose of prednisone, above 40 mg/day, free urinary prednisolone, measured with an radioimmunoassay kit for cortisol that cross-reacts with prednisolone, and 17-hydroxycorticosteroids, measured by Metcalf's method. Approximately 9% of the prednisone administered was recovered as free prednisolone and about 40% as 17-hydroxycorticosteroids. It is suggested that these simple laboratory methods constitute a useful substitute for the more costly, sophisticated methods available at present for determining levels of prednisone and prednisolone. PMID- 3668008 TI - Lymphomatoid granulomatosis. AB - The clinical and pathologic appearance of seven patients with lymphomatoid granulomatosis who had skin lesions when first seen is reviewed. Six patients subsequently developed systemic disease. Although the gross morphology of the skin lesions is variable, the pathology is distinctive. An adequate deep biopsy shows the characteristic lymphohistiocytic infiltrate with variable numbers of atypical cells. Angiodestruction is less evident in the skin compared to other organs. The infiltrate surrounds and invades not only vessels but also nerves and epidermal appendages. The skin biopsy specimen can be differentiated from the lymphomatous infiltrates and Wegener's granulomatosis. Two of the patients who developed systemic disease were diagnosed by skin biopsy but clinicians failed to institute therapy, preferring to wait for other organ involvement. In addition, two patients developed lymphoma, one of which was confirmed at autopsy and one on subcutaneous and bone marrow biopsy 5 years after the initial skin diagnosis. Lymphomatoid granulomatosis can be diagnosed by performing a skin biopsy. Appropriate chemotherapy may result in a high percentage of complete remissions and therefore the dermatopathologist can play an important role in the early diagnosis of this potentially fatal disease. PMID- 3668009 TI - The nevoid basal cell carcinoma syndrome: sensitivity to ultraviolet and x-ray irradiation. AB - Demographic studies in patients with skin cancer have demonstrated the importance of exposure to ultraviolet and x-ray irradiation. This paper describes in vitro studies in peripheral lymphocytes from three patients with the nevoid basal cell carcinoma syndrome. Particular stress was placed on the following factors: (1) the distribution of the lymphocyte subsets, (2) the frequency of spontaneous sister chromatid exchange, (3) the effect of ultraviolet C (UVC) (254 nm) on deoxyribonucleic acid (DNA) synthesis, (4) the effect of UVC on the phytohemagglutinin-stimulated lymphocyte proliferation, and (5) the capacity to repair x-ray-induced DNA damage. Our data indicate that the distribution of the peripheral lymphocytes was normal, while the frequency of spontaneous sister chromatid exchange was high. The capacity of the lymphocytes to repair x-ray induced DNA damage was low in all three patients. In two patients the UVC-induced DNA synthesis was reduced, while an increased UVC-induced inhibition of lymphocyte proliferation was observed. These cellular responses in vitro to ultraviolet and x-ray irradiation correspond to the clinical features of the nevoid basal cell carcinoma syndrome. A clearly defective in vitro cellular response to x-ray irradiation, reflecting the clinically evident x-ray sensitivity in the nevoid basal cell carcinoma syndrome, has not been reported previously. PMID- 3668010 TI - Frequency, levels, and significance of blood eosinophilia in systemic sclerosis, localized scleroderma, and eosinophilic fasciitis. AB - Blood eosinophilia is a common feature of eosinophilic fasciitis and is variably reported in systemic sclerosis and localized scleroderma. Since these diseases share cutaneous fibrosis as the final outcome and have other clinical and pathologic features that are difficult to differentiate, the presence of blood eosinophilia may be a further source of confusion. In this study, we examined the frequency and level of blood eosinophilia in 715 patients with systemic sclerosis, 72 patients with localized scleroderma, and 22 patients with clinically active eosinophilic fasciitis. When defined as greater than 400 cells/mm3, eosinophilia was present in 7% of patients with systemic sclerosis, 31% of patients with localized scleroderma, and 83% of patients with eosinophilic fasciitis. Greater than 1000 eosinophils/mm3 were present less frequently in systemic sclerosis (1%) and localized scleroderma (8%) than in eosinophilic fasciitis (61%). No difference in the frequency of eosinophilia was present in patients with the limited cutaneous CREST syndrome or the diffuse cutaneous variety of systemic sclerosis, and in these patients the presence of eosinophilia did not correlate with the extent of cutaneous or internal organ involvement or with other laboratory abnormalities. Among patients with localized scleroderma, eosinophilia was more common in those with linear scleroderma and generalized morphea than in those with morphea, and both the frequency and level of eosinophilia were greater in individuals with clinically active disease (p less than 0.02). Eosinophilia was a persistent feature in untreated patients with active eosinophilic fasciitis, even up to 30 months of disease duration. PMID- 3668011 TI - Human immunodeficiency virus-associated vitiligo: expression of autoimmunity with immunodeficiency? AB - Persistent viral infections have been postulated to be trigger factors for the development of autoimmune disease. We report the development of vitiligo in four patients with human immunodeficiency virus (HIV)-related conditions and in one patient with hepatitis who later developed both psoriasis and acquired immunodeficiency syndrome (AIDS). Other common features were hepatitis and multiple other viral infections. Ribavirin was associated with repigmentation in one patient. Vitiligo may be an example of an autoimmune disease triggered by viral infection in a genetically predisposed host. PMID- 3668012 TI - Acrokeratosis paraneoplastica with esophageal squamous cell carcinoma. PMID- 3668014 TI - Iontophoresis in dermatology. PMID- 3668013 TI - Discoid lupus erythematosus occurring in a smallpox vaccination scar. PMID- 3668015 TI - Benign summer light eruption: the most common photodermatosis. PMID- 3668016 TI - Cardiac complications of psoralens plus ultraviolet A (PUVA) therapy. PMID- 3668017 TI - Topical tretinoin enhances percutaneous absorption of 5-fluorouracil in vitro. PMID- 3668018 TI - Ethics and economics and the future of dermatology continued. PMID- 3668019 TI - Letter of resignation from the Academy by Drs. Edward Sprague, Ernst Epstein, Donald Paulson, and Joel Teisch. PMID- 3668020 TI - Herpes simplex associated with Hailey-Hailey disease. PMID- 3668021 TI - Fatty acid metabolism in fasting elephant seal pups. AB - The turnover of two plasma free fatty acids (FFA) were measured in 5 northern elephant seal pups (Mirounga angustirostris) after approximately 2 months of post weaning fasting. Turnover was determined using simultaneous bolus injections of 14C-palmitate, 3H-oleate and Evans blue (EB) administered via an indwelling extradural intravertebral catheter. At this time in their natural fast, the seals exhibited plasma FFA levels and turnover values higher than reported for other marine mammals and most terrestrial carnivores. There was no consistent difference between plasma FFA turnover measured by palmitate or oleate tracers. The results imply that FFA metabolism is the primary source of energy during fasting. This is interesting in light of previous observations of minimal ketoacid accumulation and low levels of glucose and protein energy production during fasting in these juvenile seals. PMID- 3668022 TI - The inhibition and disposition of intestinal alkaline phosphatase. AB - A primary mechanism of amino acid inhibition of intestinal alkaline phosphatase is postulated to be the formation of a dissociable enzyme-amino acid complex at an allosteric zinc site. The degree of inhibition was highly correlated with the Zn2+ stability constant of each amino acid and the inhibition was reversible by the addition of exogenous Zn2+ or by dialysis. This allosteric amino acid inhibition proved to be a useful probe of the membrane arrangement of the enzyme in the intact tissue. The catalytic site appears to face the lumen based on the poor permeability of the substrate, the accumulation of the coproducts in the luminal bath, and the response of the enzyme to luminal pH. Amino acid inhibition of alkaline phosphatase in the intact tissue was only effective in the presence of sodium; whereas sodium was not required in butanol extracted preparations which lacked the sidedness of the intact tissue. Since amino acid uptake from the intestine is sodium dependent, the allosteric inhibitory site is probably intracellular. The results suggest that the intestinal alkaline phosphatase spans the apical membrane with the catalytic site accessible from the lumen and the allosteric inhibitory site from the cytoplasm. PMID- 3668024 TI - Uric acid and urea in relation to protein catabolism in long-term fasting geese. AB - Five ganders were subjected to an experimental fast comparable to that which spontaneously occurs during breeding in domestic geese, and during migration and breeding in various wild birds. Plasma uric acid and urea concentrations, and their excretion as a proportion of total nitrogen excretion, were studied in relation to daily change in body mass per unit body mass, mg/mdt. This variable has previously been found to reflect changes in protein catabolism over the three phases of fast: I, dm/mdt and protein utilization both decrease; II, they are maintained at a low value; and III, they increase. In the fed state, daily total nitrogen excretion was 5 gN X 24 h-1; uric acid, ammonia and urea accounted for 51, 15 and 5% respectively. The high remaining proportion of excreted nitrogen (29%), after subtraction of uric acid-N, ammonia-N and urea-N to total nitrogen, accords with the literature. During fasting, the changes in daily excretion of uric acid, urea, ammonia and total nitrogen followed a pattern essentially similar to that for dm/mdt. Uric acid accounted for a progressively increasing fraction of total nitrogen, up to 76% at the end of phase III, while urea remained at a constant 5%. Plasma concentrations of both uric acid and urea followed similar trends during the fast, in particular both increasing during phase III, i.e. when there was a rise in nitrogen excretion. This suggests they could be used as an index in field investigations, to determine whether birds which naturally fast in connection with specific activities have entered into the situation where proteins are no longer spared. PMID- 3668023 TI - The response of alkaline phosphatase to osmoregulatory changes in the trout, Salmo gairdneri. AB - The relationship between alkaline phosphatase and environmental salinity was examined in the rainbow trout and the migratory rainbow (steelhead), Salmo gairdneri. The enzyme activity in tissues involved in osmoregulation was strongly correlated with the adaptation salinity and thus to the degree of salt and fluid transport in those tissues. After transfer from freshwater to seawater, the specific activity of the enzyme increased over 260% in the intestine, decreased by 50% in kidney, and was unchanged in the liver, an organ not directly involved in osmoregulation. The sea-run steelhead trout response was similar to the nonmigratory rainbow; although, the pre-migratory transformation (smoltification) had no effect on enzyme activity. Amino acid inhibitors of alkaline phosphatase significantly reduced fluid absorption in the isolated intestine of rainbow trout, reaffirming the relationship between the enzyme and fluid movement. Electrophoretic identification of trout alkaline phosphatase isozymes, clearly distinguishes the enzyme from different tissue origins. However, from the analysis of intestinal electrophoretic patterns, osmoregulatory adjustments are not associated with the induction of new alkaline phosphatase isozymes, or in the large scale preferential stimulation of one of the two existing intestinal isozymes over the other. PMID- 3668025 TI - Structure and function of the hemocyanin from a semi-terrestrial crab, Ocypode quadrata. AB - Structural and functional studies of the hemocyanin of the semi-terrestrial ghost crab, Ocypode quadrata, demonstrate a variety of differences in comparison to the hemocyanin of aquatic crabs. These differences may be related to the terrestrial habit of this crab. Unlike aquatic crabs, the major (56%) blood component is the hexamer; the remaining 44% is dodecamer. The hexamers and dodecamers are not in rapid equilibrium. Electrophoretic analysis of the subunit composition indicates three major components referred to as 1, 3, and 4, and one minor component referred to as component 2. These components, although electrophoretically distinct, are alike immunologically. Components 1 and 2 are essentially absent from purified hexamers, whereas they compose 1/3 of the subunits in dodecamers. These results suggest that they are involved in linking hexamers to form dodecamers, and that two, rather than one, subunits are involved in the bridge. Oxygen-binding measurements show a higher degree of cooperativity, and a much reduced allosteric effect of L-lactate on the dialyzed hemocyanin as compared to the hemocyanin of aquatic crabs. Exercise rapidly induces a large drop in hemolymph pH (0.5 units) and a corresponding increase in lactate concentrations (to 10 mM). PMID- 3668026 TI - A study of the stability of Record of Performance milk samples for infrared milk analysis. AB - The effect of switching individual cow Record of Performance milk samples from on farm Babcock analytical system to centralized infrared analysis was investigated. The effects of lipolytic activity on the signals of the fat (5.73/5.58 and 3.48/3.56 microns) and protein (6.46/6.68 microns) wavelengths of filter instruments showed that lipolysis decreased the infrared fat signal and concurrently increased the protein signal. The chain length (3.48/3.56 microns) signal was unaffected by lipolysis due to the concordant movement of the reference wavelength baseline with the changes in the sample wavelength signal. Storage trials (3 d) of preserved milk samples indicated no direct relation between fat signal depression and chemically determined free fatty acid levels. Microbial growth and agitation also contributed to changes observed in samples studied under controlled conditions. Based on concurrent infrared, Babcock, and Mojonnier analyses of approximately 900 samples on d 1 and 3, there was a consistent but marginal drop in the carbonyl (5.73/5.56 microns) fat signal and an increase in the amide (6.46/6.68 microns) protein signal, but these changes were of limited significance. A study of 3-d and older samples indicated that significant levels of acid were produced, indicative of microbial growth. A comparison of Babcock results carried out on-farm, Mojonnier analyses in the laboratory, and their corresponding infrared results did not show statistically significant differences. Other than the inherent variability present in the individual cow samples, there were minor quality changes occurring under the present sample handling system due to a combination of lipolysis, microbial growth, and acid production. Refrigeration of Record of Performance samples during transport and at the central laboratory is recommended to minimize these changes. PMID- 3668027 TI - Rapid method for determination of milk casein content by infrared analysis. AB - Preliminary work was to develop a method for determination of milk casein content using commercially available infrared milk testing equipment. Fresh whole milk samples were split into two portions. One portion was tested for total protein with an infrared milk analyzer. The other portion was adjusted to pH 4.6 with a specific volume and concentration of phosphoric acid. Milk casein precipitated at pH 4.6 and was removed by filtration. Next, the noncasein protein filtrate was tested for protein content using an infrared milk analyzer. The difference between the percent protein of the original milk sample and the percent protein of the noncasein protein filtrate equals the percent milk casein. The infrared casein determination for 36 different individual herd milk samples was not significantly different from results obtained by the official International Dairy Federation casein testing method. The infrared method is faster than the chemical method and could be done with infrared milk testing equipment that is commonly available in many cheese manufacturing plants. Repeatability of the infrared method was comparable to the repeatability of the chemical method. PMID- 3668028 TI - Isolation and characterization of bovine mammary calmodulin. AB - Bovine mammary gland calmodulin, purified by conventional fractionation procedures, was compared with similarly purified bovine brain calmodulin. Affinity chromatography on W-7 agarose of the crude fractions from mammary gland and brain yielded pure proteins containing one trimethyllysine residue per 16,800 daltons with essentially identical amino acid compositions. Kinetic parameters of these two proteins with respect to their ability to activate phosphodiesterase were determined. The constants for half maximum activation were .39 and .44 nM for bovine brain and bovine mammary gland calmodulins, respectively; both proteins gave similar maximum velocities. Based on the amino acid composition and kinetic data, it is concluded that the two proteins are essentially identical. PMID- 3668029 TI - Influence of dietary protein on reproductive performance of dairy cows. AB - From 10 +/- 3.5 d after parturition to 149 +/- 3.5 d of lactation, 146 cows (109 Holstein and 37 Ayrshires) were fed either a 15 or 20% crude protein diet of 45% sorghum silage and 55% concentrate. Milk production was enhanced by the 20% protein diet, but percentage of milk fat and protein were unchanged. Average daily intake of DM was unaffected by diet. Actual decreases in body weight and condition were small, although cows on 15% protein lost more condition. Concentration of plasma urea nitrogen increased rapidly during the first 4 wk of the experiment with cows on the 20% protein diet maintaining a 10 mg/dl advantage after the 4th wk on experiment. Diet did not affect the postpartum interval to first normal corpus luteum and standing estrus. Cows were inseminated artificially between 55 and 145 d post-calving with one freeze batch of semen from one bull of each appropriate breed mainly by one inseminator. Overall, days open, services per conception, and percentage cows pregnant on experiment were 80, 1.40, and 85, respectively. Concentration of protein in the diet did not affect these reproductive traits. There was no conflict between the amount of dietary protein provided for lactation and reproduction in this experiment. PMID- 3668030 TI - Rumen and total diet digestibilities in lactating cows fed diets containing full fat rapeseed. AB - Effects of full-fat crushed rapeseed (0, 1, or 2 kg/d) on rumen and total digestion, rumen biohydrogenation, and rumen microbial protein synthesis were studied in lactating cows. Rumen digestibilities (%) of DM, NDF, and cellulose were 52.1, 46.1, and 51.8, respectively, for control. Rapeseed decreased rumen and total DM digestibilities and proportion of DM digested in the rumen. Rumen digestibility of cellulose was decreased by rapeseed, but this was apparently compensated by hindgut fermentation. Dry matter, NDF, and hemicellulose digestibilities were compensated at 1 kg but not at 2 kg/d. Biohydrogenation of 18:1 fatty acids increased with increasing dietary fat, whereas that of 18:2 and 18:3 was 85% on all diets. Fatty acid digestibility was not different among diets. Microbial nitrogen in the duodenum increased from 142 g/d for control to 191 g/d for 1 and 2 kg/d. Efficiency of microbial protein synthesis (grams of microbial nitrogen per kilogram organic matter apparently digested in the rumen) was 17.3, 24.8, and 26.6 for 0, 1, and 2 kg/d. Slow release of fat from crushed rapeseed minimized negative effects on rumen metabolism; 1 to 2 kg/d of full-fat crushed rapeseed may be fed to lactating cows without detrimental metabolic effects. PMID- 3668031 TI - Effects of changing housing on physiology of calves. AB - Holstein bull calves were assigned to be reared in either a stall until 47 d of age, then moved to a hutch; a hutch until 47 d, then moved to a stall; or an elevated pen. Jugular blood samples were obtained at 42, 49, and 56 d of age. Two trials were run during the fall of successive years with 5 to 7 calves per treatment per trial. Stalls were .56 X 1.2 m with elevated wooden slotted floors. Pens were 1.2 X 1.5 m with elevated wooden slotted floors and were located in the same open front building as the stalls. Hutches were 1.2 X 1.2 X 2.4 m long, and calves were restrained with a collar and 2.4-m chain. Calves were placed on treatment between 12 to 24 h after parturition. A treatment by day interaction for triiodothyronine, thyroxine, and adrenocorticotrophic hormone-induced cortisol release indicated that conditions responsible for treatment effects were largely reversed 9 d after moving from stalls to hutches or hutches to stalls. PMID- 3668032 TI - Blood studies and performance among calves reared by different methods. AB - Three methods of feeding calves were compared as follows: 1) milk replacer only with restricted movement, 2) milk replacer only with freedom of movement, and 3) hay, grain, and water with freedom of movement. No significant differences were noted for variables of acid-base balance (sampled while resting). An Fe deficiency, microcytic, hypochromic anemia, developed in the calves receiving milk replacer only. Average daily gain, carcass grade, and sale price were superior for calves receiving only milk replacer with freedom of movement as compared with those with restricted movement. A fourth method (calves nursing cows), represented by calves having a different origin, was compared as a supplemental group. Absolute numbers for lymphocyte and neutrophils were significantly higher for calves nursing cows than for calves reared by the other methods. PMID- 3668033 TI - Increased weight gain and effects on growth parameters of Holstein heifer calves from 3 to 12 months of age. AB - Two trials involving 280 Holstein heifer calves were to determine effects of increasing nutrient intake on growth (weight, height, and heart girth), dry matter intake, and water intake. In trial 1, 80 calves were fed from 60 to 172 d of age. More calf grower fed increased daily gain from .87 to .92 kg. Gain was further increased to .97 kg with higher energy content and to .99 kg with higher energy and higher protein content of calf growers. Alfalfa hay intake decreased as calf grower intake increased. Wither height and heart girth increased proportionally to body weight. Water intake was variable but proportional to dry matter intake. In trial 2, 114 heifers were fed alfalfa hay with either control or higher protein and higher energy heifer (accelerated program) growers from 187 to 369 d of age. Grass hay was fed to 86 heifers from 230 to 369 d of age with the same grower rations. Daily gain increased from .83 to .93 kg with the accelerated program. Hay intake decreased with higher grower intake on the accelerated program. When fed ad libitum on both programs, grass hay intake was about 5% lower than alfalfa hay. Heart girth at 369 d of age was increased on the accelerated program but there was no effect on wither height. Growth of Holstein heifers can be accelerated up to 1 kg daily gain from 3 to 12 mo of age without excessive fattening. PMID- 3668034 TI - Genetic basis of secondary type traits for Holsteins. AB - Classifications from the Holstein Association were for secondary and primary type traits. Full linear scale of 1 to 50 was used for primary type traits, but scores for secondary type traits perceived to be midscale (21 to 29) were not recorded. Scores for midscales were randomly assigned to cows based on normalized sire distributions from percentages of daughters scored 1 to 20 and 30 to 50. Procedure for assigning scores of 21 to 29 was tested with primary type traits and judged satisfactory. Estimates of heritability for secondary type traits agreed favorably with earlier estimates. Only three secondary type traits had heritability of at least .15, and they were relative height of front end, teat placement side view, and tailhead. Heritabilities for traits of legs and feet were uniformly low, and traits of legs and feet were closely related. Little practical gain was anticipated from selection for secondary type traits. PMID- 3668035 TI - Relationships between time of day, estrous behavior, and the preovulatory luteinizing hormone surge in Holstein cows after treatment with cloprostenol. AB - Using continuously observed primiparous cows, comparisons were made between cloprostenol-induced and preceding or succeeding spontaneous estruses in a crossover design. There were no significant differences between spontaneous and induced estruses in duration or intensity. In a second experiment, estrus was controlled by administration of two cloprostenol injections, 12 h apart, initiated at 0800 or 2000 h during the midluteal phase. Continuous observation and frequent blood sampling were used to determine relationships between behavior and plasma concentrations of LH and estradiol-17 beta. Relationships between plasma concentrations of estradiol-17 beta and the intensity or duration of estrous behavior were not detected. The intervals from treatment to the onset of estrus and to the LH surge were not affected by time of treatment but were highly correlated. The onset of the LH surge always followed the onset of standing to be mounted by 1 to 2 h. Initiating treatment with cloprostenol at 2000 h resulted in an increased proportion of animals exhibiting onset of estrus and increased mounting behavior at night relative to treatment at 0800 h. For efficient detection of estrus after cloprostenol treatment it is suggested that cloprostenol be administered early in the working day. PMID- 3668036 TI - Glycerolation and thawing effects on bull spermatozoa frozen in detergent-treated egg yolk and whole egg extenders. AB - Bull sperm in Experiment 1 were added to a standard egg yolk-Tris extender containing 0, .25, .5, 1.0, 1.5, and 2.0% (vol/vol) of the detergent mixture, sodium and triethanolamine lauryl sulfate. Glycerol was added in one step to the initial extender or in three steps after cooling semen to 4 degrees C. The extended semen was packaged in .5-ml French straws and frozen over static nitrogen vapor. Thawing was at 4, 30, and 60 degrees C. There was little difference due to the method of adding glycerol provided detergent was present. Percentages of motile sperm after freezing in the six concentrations of detergent, in ascending order, were 31, 45, 52, 51, 48, and 36. Percentages of motile sperm following thawing at 4, 30, and 60 degrees C were 36.5, 46.0, and 48.6. Acrosome retention also was better preserved with the higher thaw temperatures. A second experiment, similar in design to the first one, was conducted with whole egg-Tris extender. The best results were in whole egg-Tris containing .125% detergent where post-thaw motile sperm of 70.4% greatly exceeded 30.7% without sodium and triethanolamine lauryl sulfate. Fertility of sperm frozen in yolk-Tris-detergent was equivalent to whole milk used as a control. PMID- 3668037 TI - Use of 1 alpha-hydroxyvitamin D3 in the prevention of bovine parturient paresis. IX. Early and late effects of a single injection. AB - Israeli Friesian cows in the third or later lactation were injected intramuscularly (serratus muscle of the neck) with 1 alpha-hydroxyvitamin D3 in propylene glycol in order to compare the short-term and long-term effects of the drug. Following injection of 700 micrograms 1 alpha-hydroxyvitamin D3, the D derivative appeared in the plasma after 12 h and reached a peak 24 h after injection. Plasma 1,25-dihydroxyvitamin D increased as early as 6 h and peaked at 24 h. Plasma calcium increased after 6 h and peaked 4 to 5 d after the injection. The administration of a single dose of 350 micrograms 1 alpha-hydroxyvitamin D3 at 7 to 8 d before calving did not prevent periparturient hypocalcaemia observed in the uninjected control cows. A single injection of 700 micrograms 1 alpha hydroxyvitamin D3 7 to 8 d before parturition prevented hypocalcemia at calving. There were no significant differences in plasma calcium 4 to 21 d after calving between the injected and control cows nor were there any cases of delayed postparturient hypocalcemia or milk fever. Results suggest that 700 micrograms 1 alpha-hydroxyvitamin D3 prolonged the calcemic effect of the drug and prevented hypocalcemia at parturition, even if administered 6 to 8 d before calving. PMID- 3668038 TI - Effects of premilking stimulation on complete lactation milk yield and milking performance. AB - Effects of premilking preparation on complete lactation performance were measured with two groups of multiparous Holstein cows; 1) 17 cows received full stimulation, a 60-s routine, and 2) 16 cows received minimum stimulation, a 15-s routine, before machine attachment. Actual unadjusted average lactation milk yield for cows receiving full stimulation was 5.4% less than that for cows receiving minimum stimulation. When postpeak persistencies were compared by linear regression of either 1) daily milk weights or 2) 3.5% FCM from DHI records of milk yield and milk fat percent and fitted to lactation curves using an incomplete gamma function, cows receiving full stimulation produced 1) 2.8 or 2) 2.5% more milk per lactation than did cows receiving minimal stimulation. However, none of the treatment differences in mean milk yield was significant statistically. Milk flow rates, strip yields, and machine on-times were measured at 8-wk intervals throughout lactation. Cows receiving full stimulation had significantly higher average milk flow rates and shorter machine on-times starting at wk 32. There were no significant differences in strip yields or percent residual milk between cows receiving full and minimum stimulation. PMID- 3668039 TI - Relation of registration with yield and termination of first lactation in dairy goats. AB - First lactation records of 9941 Alpine, 2383 LaMancha, 11,203 Nubian, 3714 Saanen, and 4649 Toggenburg dairy goat does were obtained from the USDA to evaluate relation of registration (purebred, American, or grade) with lactation yield traits (mature equivalent milk and fat yields) and with reason for termination of lactation (normal, sold for dairy, or culled). Does were grouped by age at first kidding (11 through 16 mo or 21 through 26 mo) and by calendar year (1976 through 1978, 1979 through 1981, or 1982 through 1984). Data were analyzed within breed and year group for yield traits and within breed for reason of termination. Registration and age at first kidding accounted for little variation in mature equivalent milk and fat yields or in reason for termination. PMID- 3668040 TI - Digestibility by lambs of water-stressed alfalfa as determined by total collection or internal markers. AB - A lamb digestion trial was conducted to compare the ability of internal markers to predict digestibility of alfalfa. Lambs were fed alfalfa hay grown with varying amounts of water stress where water per harvest ranged from 10 to 20 cm/ha and yield ranged 1400 to 4200 kg/ha. In vivo dry matter digestibility was most highly correlated with digestibility determined using acid detergent fiber insoluble ash (r = .80) followed by acid insoluble ash (r = .69). In vivo digestibility of the fibrous components was most highly correlated with digestibility determined by acid detergent insoluble ash and indigestible neutral detergent fiber followed by acid lignin and acid insoluble ash. PMID- 3668041 TI - Ribonuclease activity and isoenzymes in raw and processed cows' milk and infant formulas. AB - Because of evidence of an immunologic role for ribonuclease II (E.C. 3.1.27.5) in mammals, its presence in milk was further characterized to provide a basis for study of possible contributions of its activity to the health of infants. Isoenzymes of ribonuclease II were quantitatively resolved from milk samples as small as 1 ml or less by chromatography on phosphocellulose. Three isoenzymes detected in bovine milk were the previously reported ribonucleases A and B and a form termed ribonuclease II-1. These isoenzymes were in the ratio of 70:30:1. Form II-1 was unique in its inability to hydrolyze polycytidylate. Bovine colostrum contained 10 to 15 times more ribonuclease II-1 than does milk and three times more total ribonuclease II per unit volume. Human milk contains about 1% the concentration of ribonuclease II found in cows' milk. Ribonuclease II activity in milk was quite stable in the acidic conditions of whey production and during low heat treatments. However, most of its enzymatic activity was lost with high heat treatments. No commercially manufactured milk-based or soybean-based infant formula assayed contained nearly as much ribonuclease activity as either human or bovine milk. PMID- 3668042 TI - Hydrolysis of bovine milk fat globules by lipoprotein lipase: inhibition by proteins extracted from milk fat globule membrane. AB - Extraction of membrane proteins from milk fat globules by GuHCl or by MgCl2 made the lipids more accessible to lipolysis by added lipoprotein lipase. The increase in lipolysis paralleled the loss of membrane proteins and was continuous up to 2.5 M GuHCl, which was the highest concentration used. About twice as much protein was extracted with 2.5 M GuHCl as with buffer only. The amount of protein lost was about 50% of total milk fat globule protein. Lipolysis of milk fat globules was inhibited by addition of the extracted protein. The extracted proteins also reduced lipolysis when added to whole milk. More protein was needed to inhibit lipolysis of milk fat globules treated with GuHCl compared with globules treated with buffer only. The inhibition by a given amount of protein decreased if more milk fat globules were used. Protein extracted with MgCl2 had similar effects as those extracted with GuHCl. The major components extracted with MgCl2 migrated in the 40 to 50-kdalton region on sodium dodecyl sulfate polyacrylamide gel electrophoresis. By gel filtration chromatography, two protein fractions were obtained, which inhibited lipolysis more efficiently than the total extract. As has previously been found for inhibition of lipolysis by skim milk, the amount of extracted protein needed to inhibit lipolysis varied between preparations of milk fat globules. Milk with propensity to cold-induced ("spontaneous") lipolysis was normalized by addition of extracted proteins. PMID- 3668043 TI - Photoacoustic analysis of some milk products in ultraviolet and visible light. AB - The research reported here demonstrates the possibility of using photoacoustic spectroscopy for milk product analysis. Milk products including yogurt, cheese, and market milk were analyzed in the ultraviolet visible range. A strong absorption peak was present at 280 nm for all the products. Relationship was linear between relative protein concentration of skim milk and the photoacoustic signal at 280 nm (r2 greater than .99). Powdered milks, prepared from skim milk that had been subjected to different heat treatments before drying, were analyzed, and a second absorption peak at 335 nm was noted for milks subjected to high heat treatment prior to the drying process. This second absorption peak appears associated with Maillard reaction products. Analysis of stored UHT heat treated milk and infant formulas showed a similar peak at 335 nm. The results suggest that the Maillard reaction is initiated during UHT treatment of milk, and associated pigments develop only during storage. The presence of the 335-nm band in the photoacoustic spectra of infant formulas is considered as the result of heat sterilization. It is anticipated that as photoacoustic spectroscopy becomes more common, its usefulness in the milk industry, in particular, and in food science, in general, will increase. PMID- 3668044 TI - Effect of protein concentration and protein source on the degradability of dry matter and protein in situ. AB - Degradability of DM and CP was determined in situ for barley, canola meal, corn gluten meal, barley silage, and four concentrate mixtures. Crude protein percent of concentrate mixtures 1 to 4, respectively, were barley plus canola 1, 15.1; barley plus canola 2, 21.0; barley plus corn gluten 1, 17.1; and barley plus corn gluten 2, 19.6. Degradability of each feedstuff was measured on each of four basal diets consisting of barley silage and one of the above concentrate mixtures fed in the proportion 40:60 (DM). The resulting CP percent of diets containing concentrates 1 to 4 were 12.3, 16.1, 13.8, and 16.4. Effective degradability for DM and CP, assuming a rumen outflow rate of .08 h-1, were: barley 77.7 and 79.8; canola meal 60.9 and 66.6; corn gluten meal 18.9 and 11.0; barley silage 47.0 and 81.1; barley plus canola 1, 76.4 and 77.4; barley plus canola 2, 72.5 and 71.8; barley plus corn gluten 1, 72.8 and 55.8; barley plus corn gluten 2, 70.2 and 47.4. With two exceptions (DM degradability of concentrate 4 and CP degradability of concentrate 2), basal diet had no significant effect on effective CP or effective DM degradability. Crude protein degradability of concentrate mixtures 1 to 4, respectively, as measured (77.4, 71.8, 55.8, and 47.4) was similar to degradability estimated on the basis of their ingredient content (75.7, 72.1, 49.6, and 43.0). PMID- 3668045 TI - Digestibility by sheep of total and cell wall monosaccharides of wheat straw treated chemically or chemically plus enzymatically. AB - Digestibility of total and cell wall monosaccharides was studied in sheep with ruminal and duodenal cannulae and fed three wheat straw-based diets: untreated, treated with SO2, treated with SO2 plus cellulase and a fourth diet, which was barley-based. In untreated straw, 90% of total monosaccharides are cell wall bound. Sulfur dioxide treatment solubilized mainly the matrix sugars, reducing their content from 22.1 to 9.76 g/100 g DM in straw. The combined treatment (SO2 plus cellulase) solubilized most of the cell wall sugars so that the most of the cell wall sugars so that the residual cell wall contained only 31% of the total sugars originally present. Treatments increased total monosaccharide digestibility from 63 to 90% and of cell wall monosaccharides from 58 to 84 and 88%. The proportion of digestible monosaccharides degraded in the rumen was increased up to 95% by the treatments. Total monosaccharide digestibility was similar in both treated straws, but degradation of the residual cell wall monosaccharides was somewhat lower in the combined treatment compared with the SO2-treated straw. PMID- 3668046 TI - Bioavailability of phosphorus from defluorinated and dicalcium phosphates and phosphorus requirement of calves. AB - Bioavailability of P from defluorinated phosphate and dicalcium phosphate and the P requirement were studied with 63 male Holstein calves. A P depletion diet containing .08% total P on a dry matter basis was fed to all animals for 4 wk beginning at 6 wk of age and 61 kg weight. Calves developed typical signs of P deficiency. The depletion period was followed by a 6-wk experimental period in which the same depletion diet was used as a control. Phosphorus from each of the two sources was added to make diets containing .14, .20, and .32% total P. Source of supplemental P did not affect weight gains, feed consumption, feed efficiency, serum inorganic P, serum alkaline phosphatase, or bone ash. PMID- 3668048 TI - Effects of parity, age, and stage of lactation at classification on linear type scores of Holstein cattle. AB - Linear type scores of 60,121 Michigan and Wisconsin cows classified from January through November 1983 were obtained from the Holstein-Friesian Association of America. Joint effects of parity, age, and stage of lactation at classification on linear scores of Holstein body conformation characteristics were examined. The mixed model used had a random factor of sire within herd and had fixed factors of herd and the three-way subclass of parity, age, and stage of lactation. Herd effect included differences due to herd environment, classifier, and season. Sires within herds and herds were absorbed while constructing equations for the three-way subclass factors. Parity, age, and stage of lactation affected linear type scores after adjustment for herd and sire differences. There was little evidence of a parity by stage interaction or a parity by age interaction. Adjustment factors for the three-way subclass effects were derived. When compared with adjustment factors derived in this study, current adjustment factors overadjust for age and parity effects and underadjust for stage of lactation effects. PMID- 3668047 TI - Incidence and inheritance of deficiency for uridine monophosphate synthase in Holstein bulls. AB - A partial deficiency of uridine monophosphate synthase has been discovered among Holstein dairy cattle wherein affected animals have half the normal activity of this enzyme and are heterozygous for a condition presumed to be lethal in the homozygous recessive state. A random sample of 287 dairy bulls, active in artificial insemination organizations, were assayed for their activity of uridine monophosphate synthase. Four bulls displayed reduced enzyme activity (heterozygotes) corresponding to a 1.4% incidence and were closely related to a common ancestor, Bull-X. Testing a total of 75 male descendants of Bull-X has uncovered 22 heterozygotes. Heterozygotes include 5 sons, 15 grandsons, 1 a double grandson, and 2 great grandsons of Bull-X. Reproductive failure from this enzyme deficiency has been minimal because matings between close relatives have been infrequent. If the incidence of heterozygotes active in artificial insemination increases, avoidance of matings between close relatives will become an inadequate safety measure to maintain reproductive fitness. Random mating of male heterozygotes to a female population with 2% incidence of heterozygotes may imply an additional .5% embryonic loss relative to matings involving bulls that are normal for uridine monophosphate synthase. PMID- 3668049 TI - A microcomputer-photographic method for evaluation of motility and velocity of bull sperm. AB - A semiautomated computerized system analyzed 35-mm negatives obtained from dark field microscopy and determined velocity of each sperm and percentage of motile sperm in the sample. Precision and accuracy of the system for percentage of motile sperm were evaluated in comparisons with track motility and videomicrography. Motility was evaluated at four times during processing for cryopreservation or after thawing. Based on the 95% confidence intervals for percentage of motile sperm, computer and track motility evaluations were more precise than videomicrography. Computer and track determinations of the percentage of motile sperm were correlated with the ratio of live to killed sperm in prepared mixtures. The computer system was reasonably precise and accurate. Correlations of spermatozoal velocity or motility with fertility were studied. The competitive fertility index, based on semen from nine bulls, was correlated with the computer-determined percentage of motile sperm at 0 to 1.5 h after thawing, velocity, or the combination of motile sperm and velocity. Such a computerized system may aid in prediction of fertility. PMID- 3668050 TI - Milk lipoprotein lipase activity during long-term administration of recombinant bovine somatotropin. AB - The effect of long-term administration of recombinant bovine somatotropin to dairy cows on milk lipoprotein lipase activity was investigated. Recombinant bovine somatotropin was administered daily to 32 cows (8/treatment). Treatments were 0 (control), 12.5, 25.0, and 50.0 mg/d or recombinant bovine somatotropin administered in once daily intramuscular injections. Treatments began at 28 to 35 d of lactation and continued until 294 d of lactation. Recombinant bovine somatotropin treatments had no significant effect on milk lipoprotein lipase activity; enzyme activity for each treatment was 97.87, 108.96, 99.96, and 92.43 units/ml of milk, respectively. A significant effect of the stage of lactation was unrelated to recombinant bovine somatotropin administration. Enzyme activity peaked at approximately 20 wk of the treatment or 25 wk postpartum. These results indicate that long-term administration of recombinant bovine somatotropin does not alter the processes that lead to lipoprotein lipase activity in milk. PMID- 3668051 TI - Characteristics of frozen colostrum thawed in a microwave oven. AB - Use of a microwave oven to thaw frozen colostrum was evaluated. Colostrum was collected from nine cows, four of which were immunized to produce specific colostral antibodies. Colostrum from each cow was frozen, subsequently thawed, and pooled. One-liter aliquots of the pooled colostrum were frozen and assigned randomly to three thawing treatments. Colostrum was thawed using one of three regimens: 10 min in a microwave oven at full power (650 W), 17 min in a microwave oven at half power (325 W), and 25 min in 45 degrees C water. Colostrum thawed in the microwave oven was slightly coagulated and had lower volume and total protein content than colostrum thawed in water. Casein and pH were not different among treatments. Both concentration and total content of immunoglobulin A were higher in the control than in microwave treatments. Neither amount nor concentration of immunoglobulin G and immunoglobulin M were different among treatments. Immunological activity, measured by a hemolytic test, was lower for microwave treatments than the control but did not differ between microwave treatments. Frozen colostrum thawed in a microwave oven should provide a reasonable source of colostrum when fresh high quality colostrum is not available. PMID- 3668052 TI - Survey of calf and heifer housing on Pennsylvania dairy farms. AB - Research has established a link between calf and heifer housing and calf health. To determine current calf and heifer housing practices in Pennsylvania, 329 dairy farms were surveyed. The study was designed to increase awareness on the part of dairy farmers in housing and management and to develop education programs and materials in the area of calf and heifer management. All surveys were conducted on the farm by personal interviews. Results showed 24.9% of the farms had maternity pens in a building separate from the milking herd, although half of these farms used maternity pens in conjunction with facilities of lesser quality for the health and management of the animals. The same number of farms used calf hutches as those keeping calves in dairy barns with cows. A high percentage of the farms weaned calves (moved from milk diets to dry feed diets) to recommended types of facilities that included group pens, loose housing, and group or superhutches. However, 49.5% of the facilities used for weaned calves were in conjunction with other dairy animals. Animal restraint facilities have also been identified as an area that needs more emphasis on dairy farms. Many areas of dairy replacement housing on commercial dairy farms were determined to be unsatisfactory according to recommended Pennsylvania standards. PMID- 3668053 TI - A novel system for mammary epithelial cell culture. AB - A method is described for the isolation and density gradient enrichment of mammary epithelial fragments from pregnant, nonlactating bovine tissue. Immunocytochemical analysis prior to and following culture revealed specific staining with antibodies to keratin, indicating that these cells are epithelial in nature. Fragments enriched for epithelium could be stored in liquid nitrogen for extended periods prior to culture. When cast within a three-dimensional matrix of collagen gel, the mammary fragments grew as branching, duct-like structures and displayed a 4-fold increase in cell number during 10 to 12 d of culture. PMID- 3668054 TI - Investigation of mouse mammary ductal growth regulation using slow-release plastic implants. AB - Mammary ductal development in the mouse is now thought to depend on an interplay of locally produced (glandular) and systemic mammogens. A novel plastic implant material, ethylene vinyl acetate copolymer (Elvax 40P), capable of the slow release of undenatured, bioactive molecules in situ, now enables treatment of small regions of the mammary gland for extended periods with hormones and growth factors. Here we describe results obtainable with this technique. Specifically, the classical mammogens, estrogen, growth hormone, and prolactin, as well as the nontraditional mammogens, epidermal growth factor and cholera toxin, were shown to stimulate ductal growth in zones around an implant in ovariectomized animals. The possibility that these observations reflect the existence of multiple mammogenic pathways is discussed. PMID- 3668055 TI - Mammary growth during lactation: implications for increasing milk yield. AB - Milk yield is greatly influenced by the size of the mammary secretory cell population. In rats, proliferation of cells during early lactation may account for as much as three-quarters of the increase in daily milk yield between parturition and peak lactation; the remainder is due to increased activity of existing cells. Conversely, in goats, all the initial decline in milk yield after peak lactation can be attributed to loss of secretory cells. Increased frequency of milking enhances milk yield and reduces secretory cell loss, whereas goats hemimastectomized at peak lactation undergo compensatory changes in the remaining gland, which include a complete maintenance of cell number for at least 18 wk. Cell proliferation is increased in both cases, showing that mammary growth can occur during established lactation. The significance of this observation is discussed in relation to ways in which the milk yield of dairy animals might be increased. PMID- 3668056 TI - A dermabrasion issue oversight. PMID- 3668057 TI - Laser surgery for children. PMID- 3668058 TI - Healing by second intention in porphyria cutanea tarda. PMID- 3668059 TI - Penile tumors: their management by Mohs micrographic surgery. AB - Penile tumors represent a difficult group of neoplasms requiring effective and curative treatment while minimizing tissue loss to prevent cosmetic and functional deformity. Over the past 6 years, we have treated 20 patients with penile cancer utilizing the fresh tissue technique of Mohs micrographic surgery. Tumors were excised with an average of 2.25 stages. Most defects (80%) were allowed to heal by second intention. Since surgery, four patients have developed metastatic disease in their regional lymphatic system, and one patient has died from metastatic spread. One patient has developed local recurrence. Micrographic surgery is a very useful treatment modality for patients with penile tumors. Patients with SCC of the penis should be considered for elective regional lymph node biopsy and/or dissection in conjunction with micrographically controlled excision of the primary tumor. PMID- 3668060 TI - Immunogenicity of injectable collagen implants. AB - The presence of antibodies to bovine and human collagens used in injectable collagen implants (ICI) was investigated in 103 normal sera. Significant levels of spontaneous nonprecipitin antibodies were observed, suggesting that immunization to ICI compounds may preexist even in the absence of connective tissue disease. PMID- 3668061 TI - Malignant melanoma with desmoplasia and neurotropism. AB - Desmoplastic (DMM) and neurotropic (NMM) malignant melanoma are two variants of the vertical growth phase of malignant melanoma. Both lesions commonly present clinically as firm nodules that are often mistaken for fibromas. Histologically, they are associated with a pleomorphic spindle cell population of cells that widely infiltrate the dermis. An accompanying fibrosis is present. DMM usually lies beneath a lentiginous proliferation of a typical melanocytes, whereas NMM may arise without obvious epidermal involvement. Because the lesions infiltrate widely, adequate therapy results only when complete extirpation is performed. Otherwise, there may be recurrence. Recurrent lesions act more aggressively. PMID- 3668062 TI - Hyperplastic acral keratoses--association with invasive squamous cell carcinoma. AB - We have observed hyperplastic epidermal lesions in sun-damaged skin on the backs of the hands, wrists, and forearms that, in some examples, contain foci of invasive squamous cell carcinoma. Atypia in these lesions is focal or absent. Because of their bland histology, physicians are likely to interpret small or superficial biopsies as indicating a benign lesion. However, careful clinical correlation and follow-up are recommended, as residual tissue may contain invasive carcinoma or its precursor. PMID- 3668063 TI - [Energy homeostasis and human adaptational potentials under extreme conditions]. PMID- 3668064 TI - [Growth kinetics of nonexponentially growing tumors and the life expectancy of tumor carriers]. PMID- 3668065 TI - [Role of heparin during the self-assembly of soluble fibrin intermediate oligomers]. PMID- 3668066 TI - [Role of individual typological characteristics of higher nervous activity in the formation and radiation resistance of reinforced conditioned motor-defense reflexes in rats]. PMID- 3668067 TI - [Changes in the composition of the nuclear matrix proteins of Zajdela hepatoma cells with novobiocin inhibition of DNA replication]. PMID- 3668068 TI - [Coagulating properties of the blood and its trace element composition in zinc exposure]. PMID- 3668069 TI - [Modelling of the cortically evoked somatic-autonomic syndrome by action on the emotiogenic centers of the hypothalamus]. PMID- 3668070 TI - Pheochromocytoma. PMID- 3668071 TI - Pulmonary aspiration during unsuccessful cardiopulmonary resuscitation. AB - The incidence of pulmonary aspiration in a group of patients who did not respond to cardiopulmonary resuscitation (CPR) was assessed at autopsy and found to be 29%. This figure is undoubtedly an underestimate of the total problem, and some indication of the potential for aspiration during CPR is revealed by the fact that 46% of the patients studied had full stomaches at autopsy. Clearly this fact has implications for CPR methods as suggested by Cummings and Eisenberg. The problem could be reduced by incorporating the use of cricoid pressure into the techniques of Basic CPR but this will require modification of current teaching. PMID- 3668072 TI - Continuous thoracic epidural analgesia for the control of pain in myocardial infarction. AB - Continuous thoracic epidural infusion of bupivacaine 0.25% for the relief of pain in acute myocardial infarction (AMI) was studied. The method was only employed for patients, who could not obtain adequate pain relief by parenteral opioid analgesics without unacceptable respiratory depression and/or emesis. The method was effective in controlling pain. The systolic blood pressure was reduced significantly, while the diastolic blood pressure and the heart rate did not change. PMID- 3668073 TI - Early evaluation of coagulase negative staphylococcus in blood samples of intensive care unit patients. A clinically uncertain judgement. AB - Of 2160 intensive care unit patients, 36 patients with positive blood cultures had coagulase-negative staphylococcus in one blood bottle, whereas the organism was present in two or more bottles in 38 cases. The groups were not significantly different in 27 clinical variables, obtained at the time of their first positive blood culture. There was also no significant difference in the antimicrobial sensitivities. No initial clinical data supported the classification of coagulase negative staphylococcus as either pathogen or contaminant. When the 74 patients with blood culture positive coagulase-negative staphylococcus were compared with three "control groups" ("absent septicemia," "probable septicemia" and "proven septicemia") they were not different from those with "probable septicemia." A discriminant analysis was performed comparing patients with "absent septicemia" and with "proven septicemia" in an attempt to classify patients with isolates of coagulase-negative staphylococcus in one of these groups at an early stage. Patients with two or more positive blood cultures were not statistically classified more frequently as septicemic than patients with one blood bottle positive for this organism. However, patients categorized as septicemic had a significantly higher mortality (59%) than those classified as non-septicemic (35%) (p less than 0.05). PMID- 3668074 TI - Energy expenditure in the acute renal failure patient mechanically ventilated. AB - Twenty mechanically ventilated patients with acute renal failure were studied on 31 occasions to determine their energy expenditure (EE) during a 2 h period before a hemodialysis. Oxygen consumption and CO2 elimination were measured continuously with a mass spectrometer system. EE (1660 +/- 48 kcal day-1) was close to the total caloric intake (1682 +/- 83 kcal day-1) and represented 1.19 +/- 0.03 times the predicted resting energy expenditure (PREE) with large inter individual variations (0.7-1.7 PREE). EE/PREE was higher when sepsis was present (1.31 +/- 0.03 versus 1.14 +/- 0.02; p less than 0.05). Glucose oxidation rate (4.35 mg kg-1 min-1) exceeded glucose intake (2.6 mg kg-1 min-1). Respiratory quotient was 1.02 +/- 0.01. Nitrogen loss was 17.3 +/- 1.7 g day-1 and nitrogen balance -11.9 +/- 1.9 g day-1. In conclusion, EE values were scattered but never exceeded 1.7 times the PREE. Sepsis increased EE. With a nutritional support covering EE, nitrogen balance remained markedly negative and a preferential utilisation of glucose and lipogenesis occurred. PMID- 3668075 TI - Electrolyte measurement by clinicians. AB - The development of automated techniques for the measurement of electrolytes using ion-selective electrode technology has resulted in the availability of such machines for use by clinicians. A study is described which compares values obtained for plasma sodium and potassium by interested clinicians using a Beckman Electrolyte 2 analyser, with results obtained by laboratory staff using a Beckman E2A autoanalyser. A total of 14 estimations each for sodium and potassium were made on 96 samples of venous blood from patients on an intensive care unit. Comparisons were made using the coefficient of variation and analysis of variance (ANOVA). Seventy-three percent of observations of sodium and 87% of observations of potassium made by clinicians lie within 2 mmol l-1 and 0.2 mmol l-1 respectively, of observations made by laboratory staff. Observations outside these ranges are examined. The authors conclude that the results obtained by interested clinicians lie well within acceptable limits for medical usefulness, that inappropriate therapy based on such results is unlikely, and that such estimations would appear to be safe and acceptably accurate. PMID- 3668076 TI - Psittacosis: diagnosis and management of severe pneumonia and multi organ failure. AB - Two patients were admitted directly to our Intensive Care Unit in acute respiratory failure due to pneumonia with septicaemic shock, renal and hepatic impairment. Sputum and blood cultures failed to grow any organisms and despite broad spectrum antibiotic therapy for 7 days, neither patient improved. Diagnosis of the rare pneumonic form of psittacosis was made following a raised titre. After treatment with tetracyclines, both patients made a rapid recovery. Retrospective direct questioning revealed that they had close contact with psitacine birds. PMID- 3668077 TI - Proceedings of the Nurses in Agreement: Controlling Our Future conference. Washington, D.C., March 19-20, 1987. PMID- 3668078 TI - Consensus and beyond. PMID- 3668079 TI - Nursing education and nursing practice: the need for consensus. PMID- 3668080 TI - Practice patterns of newly licensed registered nurses: results of a job analysis study. PMID- 3668081 TI - Continuing education for consensus on entry skills. PMID- 3668082 TI - The educational "pipeline" in nursing. PMID- 3668083 TI - What learning-disabled readers fail to retrieve on verbal dichotic tests: a problem of encoding, retrieval, or storage? AB - Three theoretical models were assessed as a framework for capturing learning disabled readers' faulty word retrieval. To this end, learning-disabled and skilled readers were compared on verbal dichotic listening tasks for free recall and cued recall of word lists organized by semantic, phonemic, and structural features. The results indicated that disabled readers were comparable on free recall but were inferior to skilled readers on cued recall. No ability group differences were found for categorical and noncategorical recall intrusions during the cued recall phase. Cued recall performance was further analyzed for individual differences in memory trace structure (via the Tulving & Watkins, 1975, reduction method), ear asymmetry, and the allocation of attention to word features prior to cuing. Results indicated that during the cued recall phase, disabled readers' memory traces were inferior in structure to those of skilled readers, even though the two ability groups produced comparable symmetrical recall patterns for the ear presentations. Further, disabled readers had lower selective attention scores for the interhemispheric processing of information prior to cuing than did skilled readers. Taken together, the results suggest that, prior to cued recall, disabled readers suffer from attentional difficulties during interhemispheric processing, which in turn influences the structural formation of their memory trace. PMID- 3668084 TI - The effects of maternal mood on mother-infant interaction. AB - The effects of depressed mood on mother-infant interaction were studied in 30 mother-infant dyads using the Velten mood induction procedure. It was predicted that maternal depressed mood would induce dysphoria in the infants, disrupt the infants' natural responsiveness to their mothers, and interfere with the mothers' ability to manage the interaction. In addition, it was predicted that such deficits would be the result of depressed maternal mood and not simply due to any change in maternal mood. The results indicated that the infants were sensitive to depressed mood and were less contingently responsive to their mothers than were controls. Also, mothers in the depression induction condition were less successful in eliciting positive responses from their infants than were controls. These results have implications for the development of a helplessness vulnerability in infants and for the two-way direction of effect present in depressed mother-infant dyads. PMID- 3668085 TI - A divided attention experiment with pervasively hyperactive children. AB - Task performance of 12 pervasive hyperactives and controls was studied in a divided attention reaction time experiment. The two groups differed with respect to task efficiency. The hyperactives were slower than controls, had more variable reaction times, and made more frequent errors. Task inefficiency could not be explained by a deficiency in divided attention or impulsive responding in the hyperactive group. Further, the observed differences in IQ between the groups could not account for the differential performance finding. It is concluded that input and/or output processes, probably in combination with energetical factors, might be disturbed in hyperactive children. PMID- 3668086 TI - An observational study of emotionally disturbed and learning-disabled children in school settings. AB - It has been alleged that populations of learning-disabled (LD) and emotionally disturbed (ED) children are essentially indistinguishable on important intervention-related symptoms. To examine this claim, a direct observation study of social interactions during class, lunch, and recess settings in two public schools was conducted. Teacher ratings of school behavior were also collected. The results indicated that the ED boys exhibited significantly more nonphysical aggression and noncompliance than the LD boys across settings, and that the LD boys had significantly higher rates of physical and nonphysical aggression and immature behavior than the LD girls. The correlations between the observations and teachers' ratings were modest but consistent with previous studies. The results are discussed with regard to their assessment and treatment implications. PMID- 3668087 TI - Attention deficit, conduct, oppositional, and anxiety disorders in children: III. Laboratory differences. AB - Children aged 5-13 years with DSM-III diagnoses of Attention Deficit (ADDH), Anxiety, (ANX), or Conduct plus ADDH (HC) Disorder and matched normal controls were compared on a set of laboratory measures of impulsivity, arousal, motor performance, activity level, and cognition, and on behavior ratings during testing. While ANX patients did not differ from their controls, ADDH and HC patients did on Verbal IQ, most of the behavior ratings, and on about one-third of the test variables. ANX patients were about 1 year older, and more likely to be female, than ADDH and HC patients. When age, sex, and verbal IQ effects were partialed out, very few differences among the three diagnostic groups remained. The importance of precise control of such variables is emphasized and the impact of the failure to do so in past studies is discussed. The question is raised whether the deficit in verbal IQ is not so much a defect of matching as the essential feature of ADDH from which most of the other commonly reported cognitive symptoms stem. PMID- 3668088 TI - Production deficiencies in free recall: a comparison of hyperactive, learning disabled, and normal children. AB - Free recall of weakly categorizable words was compared in hyperactive (ADDH), reading-disabled, and normal boys. During a baseline trial, hyperactive boys recalled fewer words and showed less category organization than both reading disabled and normal boys. Following a manipulation designed to encourage semantic encoding of words, hyperactive boys showed an immediate improvement in item recall and organization so that their free-recall performance was similar to that of reading-disabled and normal children. During later trials of a multiple-trial format, hyperactive boys recalled fewer words than did the reading-disabled and normal boys, despite maintaining equality in category organization. Rather than lacking the skill to use semantic organization as a strategy in free recall, hyperactive boys had difficulty in spontaneously generating the organizational strategy in response to instructions to remember and sustaining sufficient effort to task completion. PMID- 3668089 TI - Resolutions of control episodes between well and affectively ill mothers and their young children. AB - Control interactions between 87 well and affectively ill mothers and their 15- to 51-month-old children were studied. Spontaneously occurring control interventions (conceptualized as episodes of interaction between mother and child) were coded from 90 minutes of videotaped interactions in a naturalistic laboratory apartment setting. The results suggest developmental changes in mother-child interaction in the 2nd to 4th years of life: the increase of the rate of immediate maternal success (p less than .05) and compromise (p less than .05), on the decrease in maternal use of power (ultimate success by enforcement, p less than .01). Well mothers achieved compromise with their children, particularly daughters, more often than did affectively ill mothers (p less than .05). Affectively ill mothers more often than well mothers avoided confrontation with their children (p less than .05). The impairments in control interventions of affectively ill mothers were exacerbated by the severity of the disorder. PMID- 3668090 TI - Abusive parents' perceptions of child problem behaviors: an example of parental bias. AB - The behavior of children in 21 child abusive and 21 nonabusive matched comparison families were compared using home observations performed by professional independent observers and parental report measures (Becker Bipolar Adjective Checklist, Child Behavior Checklist, Parent Daily Report). Parental report measures of child conduct problems differed significantly between the two groups, independent observations showed few significant differences in rates of either child or parental behaviors. Results are discussed in terms of the validity of parental perceptions and reports of child problem behaviors, the informativeness of differing reports for diagnosis and clinical treatment, and the need to gather corroboration across various sources and settings before clinical decisions are made that may irrevocably alter a child's future development. PMID- 3668091 TI - An overview of a university student assistance program. PMID- 3668092 TI - Adult children of alcoholics on campus: programming for a population at risk. PMID- 3668093 TI - Students, alcohol, and college health: a special issue. PMID- 3668094 TI - Facing the issues. Students, alcohol and college health. PMID- 3668095 TI - Standards on alcohol and substance use, misuse, and dependency. Task Force on Alcohol and Drugs. PMID- 3668096 TI - Statement on college alcohol and drug abuse. PMID- 3668097 TI - Preventive medicine and college alcohol abuse. PMID- 3668098 TI - Alcohol use and alcohol problems: clinical approaches for the college health service. PMID- 3668099 TI - Computerized MAST for college health service. PMID- 3668100 TI - Alcohol abuse intervention in a university setting. PMID- 3668101 TI - Application of dipole analysis for the diagnosis of myocardial infarction in the presence of left bundle branch block. AB - The residue value on dipole analysis (the ratio of non-dipolar component to the measured body surface potentials) was estimated mathematically in 16 patients with left bundle branch block. Patients were classified into those with (group A, nine patients) and those without (group B, seven patients) a perfusion defect on thallium-201 myocardial scintigraphy. For the entire QRS complex the residue of group B was smaller than that of normal subjects (20.0 +/- 4.1% versus 24.6 +/- 3.5%, p less than 0.05). Group A showed a greater mean residue value than group B (27.4 +/- 4.4% versus 20.3 +/- 2.4%, p less than 0.01) only during the initial one-third of the QRS complex. All but one patient of group A and only one patient in group B showed a high peak on the residue curve during the initial stage of the QRS complex. The maximal residue value of group A during the initial QRS complex was significantly greater than that of group B (40.9 +/- 10.9% versus 23.4 +/- 5.4%, p less than 0.01). An arbitrarily selected criterion of the maximal residue value greater than or equal to 30% during the initial QRS complex showed a sensitivity of 89% with a specificity of 86% for the diagnosis of myocardial infarction in the presence of left bundle branch block. These results might be related to the complex ventricular activation around the infarcted area even in the presence of left bundle branch block in which intramyocardial conduction with a simple activation front predominates. Dipole analysis appeared to be a valuable method of diagnosing myocardial infarction in the presence of left bundle branch block. PMID- 3668102 TI - Superior vena cava and hepatic vein Doppler echocardiography in healthy adults. AB - Pulsed wave Doppler ultrasound recordings of blood flow velocity in the superior vena cava were made in 40 healthy adults (aged 22 to 69 years) during both normal respiration and 10 second episodes of apnea. The forward flow velocity pattern was biphasic, with systolic flow velocity greater than diastolic flow velocity. During apnea, peak flow velocities ranged from 32 to 69 cm/s (mean 45.7 +/- 8.4) during systole and from 6 to 45 cm/s (mean 27.2 +/- 8.3) in early diastole. Systolic flow velocity integrals also exceeded diastolic values. With atrial systole (A wave), forward flow velocities were reduced or flow was reversed. Thirty-nine of 40 subjects had A wave flow reversal during apnea, and in these the ratio of reverse to total forward flow velocity integrals ranged from 1 to 16% (mean 6 +/- 4%). Compared with values during apnea, there were higher mean values with inspiration and lower values with expiration for velocities and flow velocity integrals. Hepatic vein tracings, when adequate (12 of 40 subjects), showed forward flow characteristics similar to those from the superior vena cava, but with more frequent and larger A wave and ventricular end-systole (atrial V wave) flow reversals. Superior vena cava flow velocity variables were calculated in subgroups to assess the effects of age, respiratory pattern and increased venous return. This study defines normal Doppler ultrasound superior vena cava and hepatic vein flow velocities and their variation with respiration in healthy adults. These results can be used for comparison with patterns found in disease states. PMID- 3668103 TI - Intraoperative electrical ablation of ventricular arrhythmias: a "closed heart" procedure. AB - Both intraoperative endocardial mapping and surgical ablation for ventricular arrhythmias have until now required a ventriculotomy. Such an incision may be associated with an increase in morbidity and mortality, especially when performed through friable myocardium. A "closed heart" technique of intraoperative endocardial mapping and ablation of ventricular arrhythmias was developed in which a balloon array of 112 electrodes was introduced into the left ventricular cavity by a transmitral approach. The array permitted safe delivery of repeated electrical discharges of up to 150 J at each electrode. In four patients with coronary artery disease and no ventricular aneurysm, this "closed heart" technique was used to map and treat seven distinct ventricular tachycardias. The time taken to map each tachycardia varied from 3 to 13 minutes. Between 100 and 150 J was then delivered at each of 10 to 42 electrode sites, and the ablation procedure took 7 to 16 minutes per patient to complete. One patient died 24 hours postoperatively from preexisting thrombocytopenic purpura. There was no significant deterioration in left ventricular function in the three survivors and all have remained arrhythmia free, without antiarrhythmic agents, for 4 to 11 months. This technique offers a new method of surgical treatment of ventricular tachycardia without ventriculotomy, and is particularly suited to patients without a discernible left ventricular aneurysm. PMID- 3668104 TI - Accuracy of two-dimensional echocardiography in the diagnosis of aortic arch obstruction. AB - To evaluate the predictive accuracy of two-dimensional echocardiography in the diagnosis of aortic arch obstruction, 540 consecutive patients aged 2 days to 15 years (mean 2 months) who underwent subsequent cardiac catheterization and angiography were prospectively studied. At angiography, 51 patients had aortic arch obstruction; of these, 35 had juxtaductal coarctation, 15 isthmic hypoplasia and 1 a type B interrupted aortic arch. The presence of arch obstruction was correctly identified with two-dimensional echocardiography in 45 of 51 patients with this condition (overall sensitivity 88%). Two-dimensional echocardiography clearly defined a juxtaductal coarctation in 33 of 35 patients and isthmic hypoplasia in 13 of 15 patients (sensitivity 94% and 73%, respectively). The form and type of interrupted aortic arch were clearly distinguished from other forms and types of arch obstruction. Among the 489 patients without aortic arch obstruction, two-dimensional echocardiography wrongly diagnosed the presence of such obstruction in 9 patients (overall specificity 98%). Forty-six (92%) of the 51 patients had at least one associated intracardiac abnormality. Twenty-two (44%) had a ventricular septal defect, 21 (42%) a bicuspid aortic valve and 4 (18%) subaortic stenosis. Five patients had complex congenital cardiac malformations. All associated abnormalities were prospectively identified with two-dimensional echocardiography. Thus, two-dimensional echocardiography is highly specific in diagnosing aortic arch obstruction. It is less sensitive for the diagnosis of isthmic hypoplasia in the neonatal period. PMID- 3668105 TI - Hypothermia for the treatment of postsurgical greatly accelerated junctional ectopic tachycardia. AB - Three infants developed greatly accelerated junctional ectopic tachycardia with a heart rate greater than 200 beats/min after open heart surgery. When the heart rate exceeded 200 beats/min for 5 hours, all the infants had congestive heart failure and clinical signs of low cardiac output. Conventional therapy (cardioversion, lidocaine, verapamil, digoxin and ice to face) has been shown in the past to be unsuccessful in controlling the heart rate. Because hypothermia is known to decrease automaticity of the heart, these patients were treated with induced hypothermia. The goal was to arbitrarily decrease the junctional ectopic rate to less than 180 beats/min to increase cardiac filling time. The duration of the junctional ectopic tachycardia greater than 180 beats/min ranged from 0.5 to 17 hours after cooling began. The duration of the hypothermia ranged from 4 to 24 hours. Spontaneous reversion to sinus rhythm occurred either during the hypothermia or shortly thereafter in all three patients. The blood pressure and urinary output remained stable during hypothermia. Hypothermia is an effective means of controlling the rate of greatly accelerated junctional ectopic tachycardia after open heart surgery in infants. Although hypothermia does not convert junctional ectopic tachycardia to sinus rhythm, it slows the rate to a more acceptable level, allowing the infants' survival and eventual recovery of sinus rhythm. PMID- 3668106 TI - Type Ia tricuspid atresia with extensive coronary artery abnormalities in a living 22 year old woman. AB - Type Ia tricuspid atresia, with extensive coronary artery abnormalities, is identified in the oldest living patient with this condition, a 22 year old woman. Clinical characteristics include severe cyanosis, effort dyspnea, myocardial infarction in the past and persistent angina pectoris. "Ideal" pulmonary flow and adequate left ventricular function, despite an akinetic apical segment, are substantive factors for this exceptional longevity. Coronary abnormalities consist of: 1) total proximal occlusion of the left anterior descending coronary artery; and 2) partial diversion of coronary artery flow to a segmental pulmonary artery branch. Nonvisualization of the coronary sinus is also noted. Factors other than atherosclerosis may account for total proximal occlusion of the left anterior descending coronary artery. Survival is threatened by adverse effects of ongoing ischemic coronary events. PMID- 3668107 TI - End-systolic radius to thickness ratio: an echocardiographic index of regional performance during reversible myocardial ischemia in the conscious dog. AB - Regional myocardial dysfunction induced by ischemia is associated with less thickening and a larger ventricular radius at end-systole. Thus, end-systolic radius to thickness ratio measured by echocardiography may provide an accurate index of regional left ventricular function that is totally independent of cardiac motion. To test this hypothesis, a total of 14 transient (less than or equal to 10 minutes) coronary artery occlusions (8 left anterior descending, 6 left circumflex) followed by up to 24 hours of reperfusion were performed in six chronically instrumented conscious dogs providing multiple grades of regional ventricular dysfunction. Regional myocardial thickening fraction was determined with epicardial pulsed Doppler probes and served as an independent standard for comparison with simultaneous echocardiographic measurements. End-systolic radius to thickness ratio and radial shortening fraction were derived from the two dimensional echocardiographic short-axis view along 12 equidistant radii. In the ischemic zone, percent thickening fraction averaged 22 +/- 5% during baseline, decreased to -4 +/- 4% during occlusion with gradual return to baseline after reperfusion. End-systolic radius to thickness ratio averaged 1.39 +/- 0.25 before coronary occlusion and increased to 2.97 +/- 0.48 during occlusion with a gradual return to baseline values. A significant correlation was found between Doppler determined thickening fraction measurements and echocardiographic end-systolic radius to thickness ratio as well as radial shortening fraction for absolute values (r = -0.83 and 0.75, respectively; n = 65) and percent change from baseline (r = -0.86 and 0.78, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668108 TI - Effect of metaraminol during acute inferior wall myocardial infarction accompanied by hypotension: preliminary study. AB - This study was designed to evaluate the effects of metaraminol (Aramine) in six patients with evolving acute inferior wall myocardial infarction accompanied by hypotension and warm limbs. There were 16 episodes of acute inferior wall ischemia, and the response to therapy was judged by evaluating blood pressure and ST segment and T wave abnormalities. Three patients received intravenous isosorbide dinitrate and two received streptokinase as the initial therapy. The mean ST segment elevation was significantly reduced (from 4.94 +/- 1 to 0.5 +/- 0.7 [p less than 0.0001]) after metaraminol infusion was initiated. The average T wave height also decreased (from 6.8 +/- 2 to -1.3 +/- 2.5 mm [p less than 0.0005]). The average heart rate decreased from 82 +/- 11 to 69 +/- 9 beats/min (p less than 0.05) and the mean arterial blood pressure increased from 81 +/- 12 mm Hg before metaraminol treatment to 126 +/- 8 mm Hg after treatment. All these changes occurred within a few minutes after metaraminol therapy was instituted. In 12 episodes, accelerated idioventricular rhythm appeared concomitantly with the resolution of ST segment elevation. Coronary angiography performed between 4 and 10 days after admission demonstrated significant obstruction in all infarct related arteries, but none was totally occluded. Left ventricular function was normal in three patients and slightly hypokinetic in the inferior wall in two. These results indicate that in a selected group of patients with acute inferior myocardial infarction, metaraminol administration (in certain hemodynamic circumstances) can alleviate acute ischemia within a few minutes and thereby reduce ischemic injury. PMID- 3668109 TI - Mexiletine-quinidine combination: electrophysiologic correlates of a favorable antiarrhythmic interaction in humans. AB - Combination therapy with mexiletine and quinidine has been shown to be more effective than either agent alone. The ability of mexiletine monotherapy, quinidine monotherapy and mexiletine-quinidine combination therapy to suppress inducible sustained ventricular tachycardia was related to drug-induced changes in ventricular refractoriness, conduction times and monophasic action potential duration recorded from both ventricles. Ventricular tachycardia could no longer be induced in 7 (35%) of the 20 patients studied with combination therapy. This was a significantly higher proportion of patients than that of the groups responding to either monotherapy (quinidine, 10%; mexiletine, 5%). Ventricular effective and functional refractory periods were measured when applying single (S2), double (S3) and triple (S4) extrastimuli. Quinidine monotherapy increased functional and effective refractory periods of both single and multiple extrastimuli. However, when comparing measurements made during mexiletine treatment with those at baseline, mexiletine monotherapy increased only the refractory periods of S4. The effective refractory period of S4 during mexiletine monotherapy (200 +/- 20 ms) was significantly longer than at baseline (160 +/- 21 ms). Similarly, when comparing measurements made during combination therapy with those during quinidine monotherapy, combination therapy significantly increased the refractory periods only of multiple extrastimuli. The effective refractory period of S4 during combination therapy (253 +/- 26 ms) was significantly longer than that of quinidine monotherapy (223 +/- 27 ms).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668110 TI - Particular systolic time interval profile encountered in patients with atrial septal defect. PMID- 3668111 TI - Incidence and management of limb ischemia with percutaneous wire-guided intraaortic balloon catheters. PMID- 3668112 TI - Predictors of outcome for aortic valve replacement in patients with aortic regurgitation and left ventricular dysfunction: a change in the measuring stick. AB - Although left ventricular function is generally regarded as a key determinant of prognosis in aortic regurgitation, predictors of outcome of aortic valve replacement based on this factor have recently been questioned. This study was performed to examine the role of indexes of left ventricular function in predicting the outcome of surgery in patients with aortic regurgitation and left ventricular dysfunction. Fourteen patients with aortic regurgitation with a preoperative ejection fraction of less than 0.55 (average 0.45 +/- 0.02) who underwent aortic valve replacement were studied. The patients had 82 (58%) of a possible 140 predictors of negative outcome preoperatively, but 12 of the 14 patients had a decrease in symptoms and an increase in ejection fraction into the normal range after operation (average postoperative ejection fraction 0.59 +/- 0.04). Although improvement occurred despite the presence of many negative predictors of outcome, there was a significant correlation between postoperative ejection fraction and eight of the tested preoperative predictors. Preoperative end-systolic dimension correlated best (r = -0.91) with postoperative ejection fraction. An end-systolic dimension of 60 mm correlated with a postoperative ejection fraction of 0.55. The results indicate that preoperative ventricular function is still an important determinant of outcome of aortic valve replacement for aortic regurgitation. However, current medical and surgical techniques permit a better prognosis in the presence of reduced ventricular function than was previously considered possible. PMID- 3668114 TI - Symposium on modern thrombolytic therapy. PMID- 3668113 TI - Biochemical evidence of platelet activation in patients with persistent unstable angina. AB - Thromboxane released from activated platelets and prostacyclin of the vessel wall may act as potent antagonistic modulators of platelet aggregability and coronary vascular tone. Therefore, urinary excretion of their major metabolites, 2,3-dinor thromboxane B2 and 2,3-dinor-6-ketoprostaglandin F1 alpha, was studied in 16 patients presenting with prolonged angina at rest. The 10 patients whose condition did not improve under vigorous antianginal treatment within 48 hours exhibited higher thromboxane metabolite excretion than did the 6 patients who responded to therapy (2,208 +/- 1,542 versus 609 +/- 312 ng/g creatinine; p less than 0.001). Elevated values were also found in four of eight patients with sustained postinfarction angina. Enhanced thromboxane metabolite excretion was frequently associated with angiographic evidence of thrombus formation. When nine patients were restudied in a stable phase after 11 +/- 5 months, thromboxane metabolite excretion was consistently normal or high normal. Excretion of prostacyclin metabolites was not depressed in any patient but correlated weakly with thromboxane (r = 0.41). Thus, enhanced thromboxane production as an index of platelet activation may identify patients with active thrombus formation who could benefit most from platelet inhibitory treatment. PMID- 3668115 TI - Adverse effects of corticosteroid therapy. PMID- 3668117 TI - Anaphylaxis to intravenous furosemide. AB - A patient with long-standing hypertension developed urticaria, angioedema, and hypotension within 5 minutes after the intravenous administration of furosemide. Immediate hypersensitivity was documented by positive skin tests to furosemide as well as to related sulfonamide-based drugs. This is the first finding of an anaphylactic reaction to furosemide and underscores the need to consider such adverse reactions when patients who are sensitive to other sulfonamide-containing drugs are being treated. PMID- 3668116 TI - Extrapulmonary effects of maintenance corticosteroid therapy with alternate-day prednisone and inhaled beclomethasone in children with chronic asthma. AB - Extrapulmonary effects of alternate-day prednisone and inhaled beclomethasone dipropionate therapy were examined in 24 and 32 children with asthma, respectively. Early morning serum cortisol values were significantly lower among patients receiving alternate-day prednisone than among patients receiving inhaled beclomethasone dipropionate and control subjects at 24 hours but not at 48 hours after an alternate-day prednisone dose. Urinary-free cortisol output during the second 24 hours of the alternate-day prednisone regimen were similar to values among patients receiving inhaled beclomethasone and were significantly lower than among control subjects for both groups. Mean heights among patients before being placed on maintenance corticosteroids were at the thirty-fifth percentile and were similar for both regimens. This was significantly lower than initial measurements for control subjects who, on average, were near the fiftieth percentile for both children with asthma not requiring maintenance corticosteroids and normal healthy Iowa children. Mean heights for both corticosteroid-treated groups remained at the thirty-fifth percentile after more than a 2-year average duration of follow-up. Heights of children with chronic asthma not requiring maintenance corticosteroids were initially significantly higher (fifty-first percentile) than the patients who subsequently required maintenance corticosteroids and increased significantly to the sixty-first percentile during a mean 2.7-year follow-up. Heights of healthy Iowa children remained near the fiftieth percentile during a mean 7-year follow-up. Disproportionate weight gain, although it was not consistently present, was significantly more likely with the alternate-day prednisone. Other extrapulmonary effects of the corticosteroid regimens appeared not to be of clinical importance during the time period of the study. PMID- 3668118 TI - The prevalence of indoor allergens in the Baltimore area: house dust-mite and animal-dander antigens measured by immunochemical techniques. AB - Mattress dust samples from 42 homes in Baltimore, Md., were analyzed by ELISA and rocket immunoelectrophoresis (RIE) for major excrement allergens (P1 [equal to Dp 42], Df 6, and Dm 6) of house dust mites, Dermatophagoides pteronyssinus, D. farinae, and D. microceras, by RIE for cat major epithelial allergen (cat Ag 1) and horse major epithelial antigen (horse Ag 11), and by counter-current immunoelectrophoresis (CCIE) for cat and dog antigens. Dp 42 was detected by ELISA in 24 samples (57%) and Df 6 in 39 samples (92%). All samples were negative to Dm 6. Recorded levels varied from 50 ng of allergen per gram of dust (detection limit) to 15,000 ng/gm. A combined content of Dp 42 and Df 6 greater than 700 ng/gm was associated with a positive reaction in RIE. Concentrations of Dp 42 and Df 6 did not correlate (rS = 0.21; p greater than 0.05). Cat and dog antigens were frequently detected by CCIE (77% and 63%, respectively). CCIE titer to cat correlated well with quantitation of cat Ag 1 by RIE (p less than 0.01). Horse antigen was detected in few homes (5%). None of the specific allergen determinations correlated with levels of human serum albumin determined by RIE. PMID- 3668119 TI - Lectins and the radioallergosorbent test. AB - An investigation into the possible role of lectin binding of IgE in RAST of legume and wheat extracts is reported. Lectins from pea, broad bean, lentil, jack bean, soybean, peanut, and wheat germ were coupled to RAST discs. The discs were pretreated with lectin-specific sugars in an attempt to inhibit RAST with sera from 11 sensitive patients. In all cases, RAST was almost unaffected by the inhibitory sugars, indicating that nonimmune binding of IgE by lectins in legume or wheat RAST was not significant when RAST was carried out with allergens bound to the usual paper discs. IgE contains binding sites for all the lectins examined, and five of the sera had high total IgE greater than 300 IU/ml. It is suggested that competition by IgG and other serum glycoproteins may explain the lack of effect by the added sugars. All sera contained endogenous glucose at a level of about 3 mmol/L that may have accounted for some self-inhibition of the lectin binding by pea, broad bean, lentil, and jack bean lectins. There was, however, significant immune binding of some of the lectins by specific IgE, and it is concluded that these lectins may be important in expression of IgE-mediated allergic responses. PMID- 3668120 TI - Isolation and identification of pollen allergens of Artemisia scoparia. AB - The allergenic proteins of Artemisia scoparia pollen were separated and identified with ammonium sulfate precipitation, ion-exchange chromatography, gel filtration, and RAST-inhibition techniques. The important allergenic component Artemisia VI b that constitutes 29% of total protein in the extract was purified to homogeneity. It was found to be an acidic protein with isoelectric point 3.8 and molecular weight of 14,300. It was rich in carbohydrate, but the carbohydrate portion did not appear to be important for allergenicity. In the crossed immunoelectrophoresis reference pattern of the whole pollen extract, 37 precipitin lines could be identified on the anodic side, whereas Artemisia VI b could be observed as a single precipitin line. Immunologically, the whole pollen extract of A. scoparia demonstrated shared antigenic and allergenic determinants with Ageratum conyzoides-pollen extract. The use of fast protein liquid chromatography in partial purification of allergenic components is also discussed. PMID- 3668121 TI - Occupational asthma caused by isonicotinic acid hydrazide (INH) inhalation. AB - Occupational asthma caused by isonicotinic acid hydrazide (INH) inhalation occurred in a 26-year-old female hospital pharmacist after symptoms of allergic rhinitis. Intradermal, inhalation, and Prausnitz-Kustner tests were performed with INH dissolved in saline, INH dissolved in the subject's serum and incubated at 25 degrees C for 4 hours, and an INH conjugate with human serum albumin. An INH conjugate with bovine serum albumin was also used in the prick tests alone. All preparations caused rapid positive skin reaction in the patient. Prausnitz Kustner tests on the subject's mother were also rapidly positive. Furthermore, positive results were obtained not only in the inhalation tests with the three antigens but also in the environmental provocation tests. These results strongly suggested that the asthmatic symptoms of the subject were not caused by physical irritation from INH or other drugs and might be mediated by an IgE antibody specific to INH, a suggestion subsequently confirmed by in vitro enzyme-linked allergosorbent test for the antibody previously reported. This is the first precise description of INH-induced bronchial asthma, and the four kinds of INH preparations used in these tests might be very useful as tools of clinical diagnosis in INH allergy. PMID- 3668122 TI - Isonicotinic acid hydrazide as an antigen. AB - Detection by in vitro serologic techniques of circulating antibody directed against isonicotinic acid hydrazide (INH, known as isoniazid) in humans has not been reported. In the past few months, however, sera from a patient with a recent history of isoniazid hypersensitivity of the immediate type have been studied, and reaginic antibodies (IgE) specific to INH were detected by means of an enzyme linked allergosorbent test. Preliminary enzyme-linked allergosorbent tests also demonstrated that INH-specific IgE occurred in the serum of two of 150 patients with tuberculosis who had been treated with INH. PMID- 3668123 TI - Cockroach sensitization in laboratory workers. AB - Six laboratory workers who were exposed to American cockroaches (AC) and German cockroaches (GC) while they were performing immunologic experiments were evaluated for cockroach hypersensitivity. Prick skin testing and RAST were performed with whole body extracts (1:20 wt/vol) of AC, brown-banded (BB), and GC species as well as hemolymph and fecal (F) extracts of AC. Three of six workers reported work-related nasal and ocular symptoms associated with xenografting and bleeding of cockroaches. All three symptomatic workers exhibited cutaneous reactivity to at least one cockroach antigen. Elevated RAST binding was observed in one of the three symptomatic workers. A nasal provocation to AC was positive in the most symptomatic worker at a provocative dose of 3.2 X 10(-3) mg causing a 50% decrease of nasal flow rate from baseline. After pretreatment with nasal cromolyn, the provocative dose causing a 50% decrease from baseline increased to 2.6 X 10(-1) mg. Nasal provocation with the same concentrations of AC were negative in two skin test negative subjects. RAST-inhibition studies demonstrated cross inhibition of the serum-specific IgE binding to AC-hemolymph by AC, GC, and BB whole body extracts. However, specific IgE binding to AC-F was inhibited by AC F and AC but not by GC or BB whole body extracts, suggesting there was greater specificity of the F allergens. This study demonstrated that cockroach allergens elicit IgE-dependent upper respiratory sensitization in the workplace. PMID- 3668124 TI - Double-blind, placebo-controlled immunotherapy with mixed grass-pollen allergoids. I. Rush immunotherapy with allergoids and standardized orchard grass pollen extract. AB - Forty-five grass pollen-allergic patients were randomly assigned to three groups according to their skin test and RAST sensitivities and the severity of seasonal rhinitis. Eleven patients were treated with placebo (group 1), 19 patients (group 2) were treated with a six-mixed grass-pollen allergoid prepared by mild formalinization with a two-step procedure, and 15 other patients were treated with a standardized orchard grass-pollen extract (group 3). Because of a different immunotherapy schedule, only patients placed in groups 1 and 2 received the extracts in a double-blind fashion. Rush immunotherapy was performed in 3 to 6 days, and the maintenance dose was subsequently administered weekly for 4 weeks and every 2 weeks until the end of the grass-pollen season. During the season, a coseasonal treatment was administered. Systemic reactions occurred during the rush protocol in 36.8% of patients treated with allergoid and 20% of patients who received the standardized extract. Only patients treated with allergoid had systemic reactions during maintenance dose. The reactions observed with the standardized extract were more severe. Total doses of allergoid ranged from 2350 to 13,500 protein nitrogen units. Symptoms and medication scores during the peak of the season were analyzed. Patients treated with the standardized allergen had a significant reduction of the number of days of symptoms during the month of June (9.5 +/- 6.7 days; p less than 0.005) and of medication scores (1.3 +/- 1.4; p less than 0.01) compared to patients receiving placebo (19.4 +/- 8.1 days; medication score, 2.8 +/- 2.1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668125 TI - Morphologically distinctive forms of cutaneous mast cell degranulation induced by cold and mechanical stimuli: an ultrastructural study. AB - To determine whether morphological differences in the response of cutaneous mast cells characterize clinically distinct forms of urticaria, we used ultrastructural techniques to examine skin biopsy specimens from three patients with cold-induced urticaria and four patients with dermographism. Biopsy specimens were obtained before application of the stimulus and at the time of lesion formation. Patients with cold-induced urticaria exhibited morphological alterations only after stimulus application consisting of enlargement and uniform disorganization of some, but not all, granules, fusion of the membranes of adjacent granules, fusion of granule membranes with mast cell membranes, and discharge of electron-lucent and disorganized granule contents into the extracellular space. Mast cells from patients with immediate as well as delayed dermographism exhibited alterations before and after stimulus application consisting of enlargement of most granules, nonuniform (zonal) disorganization or solubilization of granule contents, fusion of granule membranes with mast cell membranes, and extracellular discharge of granule contents. Small cytoplasmic vesicles containing disorganized granular material were associated with the degranulation process. Endothelial cells lining nearby postcapillary venules exhibited prominent perinuclear condensation of contractile microfilaments during degranulation in both groups. Both before and after application of the stimulus, the walls of the superficial dermal vessels of the patients with dermographism were thinner and contained less extracellular matrix material than vessel walls of the patients with cold-induced urticaria. The morphologically distinctive types of mast cell degranulation that characterize these two clinically separable urticarial disorders may indicate different pathogenic mechanisms of lesion formation. PMID- 3668126 TI - A subclass IgG4-specific antigen-binding radioimmunoassay (RIA): comparison between IgG and IgG4 antibodies to food and inhaled antigens in adult atopic dermatitis after desensitization treatment and during development of antibody responses in children. AB - A liquid-phase, antigen-binding radioimmunoassay measuring subclass IgG4 antibody (ab) to allergens has been developed. This assay, which uses monoclonal anti-IgG4 to bind IgG4, allows direct comparison of class (IgG)- and subclass (IgG4) specific ab levels. These assays used radiolabeled purified allergens, Der p I (Ag P1) from the dust mite Dermatophagoides pteronyssinus, Lol p I (Rye 1), from ryegrass pollen, hen's egg ovalbumin, and beta-lactoglobulin from cow's milk. We have investigated IgG4 abs in several clinical situations. The results confirm that IgG ab responses to both inhalants and food proteins unequivocally include IgG4 ab. On average, the proportion of IgG4 ab to these antigens is far higher than the contribution of IgG4 to total IgG. In patients with adult atopic dermatitis, levels of both class and subclass ab were higher than in control subjects; however, the ratio of IgG4:IgG varied widely in patients and control subjects. During desensitization treatment of patients with perennial rhinitis, levels of IgG4 ab to Der p 1 increased sharply, but there were also increases in the total IgG ab responses so that the percentage contribution of IgG4 was only moderately increased (mean values: before, 29%; after, 36%). In a prospective study of children from atopic families, IgG4 abs to food proteins were detectable as early as 3 months. IgG abs to hen's egg ovalbumin and beta-lactoglobulin from cow's milk increased to a maximum at 3 years and declined by 5 years. However, specific IgG4 as a percentage of specific IgG increased progressively from a mean value of approximately 15% at 6 months to approximately 50% at 5 years of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668127 TI - The problem of memory in nutritional epidemiology research. PMID- 3668128 TI - Adherence to time and temperature standards and food acceptability. AB - The objective of this study was to examine time and temperature of food under actual operating conditions during product flow, from procurement through service, and to seek relationships to the amounts of food consumed during the noon meal by children in Head Start early childhood developmental centers. A process flow model was developed for a conventional foodservice system such as that used in Head Start. The preparation and service of the lunch menus served to 101 3- to 5-year-old children in three centers were studied during a 3-week period for adherence to time and temperature standards. Weight of food consumed was measured and evaluated by a preference ratings panel for acceptability. Food was well accepted, was consumed by the children, and received very good adult preference panel ratings. The largest variations from the time standard were in processing-heating hot vegetables, while the greatest temperature variations were across all process steps for entrees. Deviations from recommended time and temperature standards for handling of milk were significantly correlated with lower consumption of milk. PMID- 3668129 TI - Convective heat processing of turkey roll: effects on sensory quality and energy usage. AB - Twenty-four frozen, raw, boneless, ready-to-cook turkey rolls were cooked in an institutional electric convection oven to an internal temperature of 77 degrees C. Six treatment combinations of three cooking temperatures (105 degrees C, 135 degrees C, and 165 degrees C) and two holding conditions (not chilled and chilled for 24 hours) were studied. Turkey rolls from each treatment combination were subjected to three hot-holding times (0, 60, and 120 minutes). Electrical energy usage was monitored during heat processing of the turkey rolls, reheating the turkey slices, and hot holding the turkey slices. Aroma, juicy mouthfeel, texture, flavor, and flavor off-notes of the cooked turkey were evaluated by seven judges using 150-mm unstructured line scales. Chew counts also were recorded. Turkey cooked at 105 degrees C took significantly more time to cook (331 vs. 227 and 203 minutes) but consumed significantly less energy (3.4 vs. 3.8 and 4.5 kWh) than turkey rolls cooked at 135 degrees C and 165 degrees C, respectively. Significantly higher juicy mouthfeel scores were obtained when the turkey roll was cooked in the convection oven at an oven temperature of 105 degrees C, the turkey was not chilled, and the slices were held hot for 60 minutes or less. PMID- 3668130 TI - A computerized quantitative food frequency analysis for the clinical setting: use in documentation and counseling. AB - Documentation of nutrition counseling effectiveness is essential to reinforce its value in an era of escalating health care costs. Counseling effectiveness can be determined definitively only if dietary assessment is made both before and after intervention. Unfortunately, methods currently available have drawbacks that limit feasibility of routine use. A directly computer-readable Quantitative Food Frequency Analysis method, which eliminates the need for manual data entry, has been developed and instituted at the University of Southern California School of Medicine, Los Angeles, for outpatient counseling. A 1-hour interview, focusing upon "usual" intake, is conducted using pictorial menus for food items. Feedback is available to the patient and health care team immediately. The data base is derived from the National Heart, Lung, and Blood Institute Food Table; the intake of 61 nutrients, including 23 fatty acids, is computed. The computer printout consists of four components: a summary; an alert for foods high in fat, cholesterol, sucrose, alcohol, and/or sodium; a listing of all foods consumed by frequency, accompanied by their nutrient contribution to daily intake; and a bar graph relating current nutrient intake to recommended levels. This document serves as a counseling tool and can support claims for third-party payment. PMID- 3668131 TI - Comparison of nutrient intakes by male vs. female heads of households. AB - Nutrient intakes by male and female heads within a household were examined in regard to the feasibility of substituting dietary data of one partner for data of the other partner in diet/disease studies. Three-day individual food intake data from male and female heads of household were used when both members participated in the spring quarter of the Nationwide Food Consumption Survey 1977-78. The mean percentage of energy from fat was higher for male heads than for female heads, whereas the mean percentages of energy from protein and carbohydrate were higher for female heads than for male heads (p less than .05). However, the differences between male and female heads in percentages of energy from protein, fat, and carbohydrate were only 1.5 percentage points or less. At the current state of knowledge, that difference is too small to be associated with a difference in health status. In diet/disease studies involving percentages of energy from protein, fat, and carbohydrate, substitution of dietary data of one partner for data of the other partner does not appear likely to produce misleading results and, therefore, would not be precluded. Mean intakes of energy and all 12 nutrients examined as percentages of the RDAs differed significantly between male heads and female heads (p less than .05). In studies involving intakes of energy or any of the 12 nutrients examined, substitution of dietary data of one partner for data of the other partner is not recommended. PMID- 3668132 TI - Evaluation of a workshop model for teaching counseling skills to nutrition students. PMID- 3668134 TI - Hunger in America: an American Dietetic Association perspective (ADA timely statement). PMID- 3668133 TI - Factors affecting nutrition training in four family practice residencies. AB - Nutrition education at the four institutions studied was not highly effective. Not all educators were qualified in terms of education or experience. The individuals were not recruited using suggested faculty search methods, and turnover was high. Nutrition education was part of the distant environment for the family practice resident, rather than in the foreground. Nutrition education should be part of the scheduled activities of residents, so that they do not have to borrow time from patient care and other obligations. Then, the residents could devote their full attention to nutrition and see its importance as equivalent to that of other subspecialties. PMID- 3668135 TI - Morbidity and mortality associated with indwelling urinary catheters in elderly patients in a nursing home--confounding due to the presence of associated diseases. AB - A prospective study was conducted in a nursing home among elderly residents treated with and without indwelling catheters. Most of the patients were white females with a mean age of 82.3 years. The mortality at 6 months among catheterized patients was 30.2% compared with 10.1% among the noncatheterized groups (P less than 0.001). Patients with catheters differed significantly from those without in having more impaired mental status and diminished activities of daily living. They also differed significantly for eight of 30 diseases. Cerebrovascular and hypertensive disease were significantly more common in catheterized patients. In contrast, fractures and musculoskeletal disorders were significantly more common among noncatheterized patients. Catheterized patients had significantly more days with fever and symptomatic urinary tract infections and received antibiotics more often than did noncatheterized patients. We conclude that: (1) direct comparisons of morbidity and mortality among catheterized and noncatheterized populations are not valid because of confounding by the presence of associated life-threatening illnesses; and (2) catheterized patients have more clinical episodes of urinary tract infections and fever and are treated more frequently with antibiotics. PMID- 3668136 TI - Changing health perceptions among the elderly. PMID- 3668137 TI - Sexual dysfunction in the elderly male. PMID- 3668138 TI - Cimetidine use in nursing homes: prolonged therapy and excessive doses. AB - Patterns of cimetidine use were identified in a survey of 3032 patients in 31 nursing homes. Of these, 60 (2%) were receiving cimetidine. For these patients, ages ranged from 63 to 102 years (mean, 81 years). The patients received a range of 1 to 11 regularly scheduled medications (mean, 5.6 medications). Duration of cimetidine treatment averaged 19.6 months for 48 patients (81%) receiving the drug for longer than an eight-week course of therapy. Prescribing indications appeared unjustified in 54 of 60 patients (90%). Doses were rarely appropriately reduced for patient age, despite established reasons to do so and the well-known potential for adverse effects of cimetidine in the elderly. The risks associated with prolonged drug-induced suppression of gastric acid are not known. This study suggests that use of cimetidine without justifiable indication and for extended periods of time is common in nursing home patients. Studies are needed concerning the safety of long-term cimetidine use in elderly patients. PMID- 3668139 TI - The effect of an interdisciplinary geriatrics clinic visit on mental status. PMID- 3668140 TI - Drug prescribing for very elderly ambulatory patients: 1985. PMID- 3668141 TI - The impact of age on utilization of intensive care resources. AB - The impact of age on admission practices and pattern of care were examined in 599 admissions to a medical intensive care unit (MICU) and 290 patients on the conventional medical care divisions of the same hospital. Four age groups were compared: under 55, 55 to 64, 65 to 74, and 75 years of age and over. Severity of illness and prior health were assessed using the Acute Physiology Score (APS) and the Chronic Health Evaluation (CHE) instruments. Resource utilization was assessed using the Therapeutic Intervention Scoring System (TISS) and hospital charges. Patients 65 years of age and over comprised 48% of the MICU sample. The distribution of CHE was different among the four groups. Twenty-one percent of patients under 55 years of age had no prior chronic illness, as compared to less than 8% of older patients. The APS at admission was similar for all age groups, as was admission, daily, and total TISS. Hospital survival declined with age from 85% to 70%, while the likelihood of being designated do not resuscitate (DNR) increased from 10% to 24%. Differences in hospital survival disappeared when controlling for severity of illness and prior health, but differences in DNR status did not. Still, elderly DNR patients received as much resources as younger DNR patients and this was more than non-DNR patients. The sample of patients treated on conventional medical divisions had age distribution similar to the MICU sample. There was some evidence that admission APS (median, 5, 5, 6, 6, respectively, P = .055) and maximum APS (median, 5, 5, 7, 8, respectively, P = .023) differed slightly across age groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668142 TI - Assessment of depression in geriatric medical outpatients: the validity of two screening measures. AB - The validity of two screening measures for depression was assessed in a geriatric medical outpatient population. Sixty-eight patients completed both questionnaires; 31 also completed a clinical interview allowing for accurate diagnosis. Both screening measures were found to accurately identify those who were depressed. Clinical and research applications are discussed, including the complementary use of these screening measures with the physician's diagnosis. PMID- 3668144 TI - Role montage: life patterns of professional women. PMID- 3668143 TI - Predicting performance on the Mini-Mental State Examination. Use of age- and education-specific equations. AB - Inclusion of a mental status examination in research and clinical screening instruments lengthens the protocol, thereby adding to the difficulty of using instruments addressing all relevant issues under study without taxing participants. The purpose of the present study was to evaluate the possibility of substituting a subset of items from the widely used Mini-Mental State Examination (MMSE) for the entire examination in order to reduce the time needed to screen for cognitive status. Study data came from a health study of 783 community dwelling, white females, 65 years of age and over, selected randomly from a 20 census-tract area of northeast Baltimore. Results indicate that seven MMSE items can be used to reliably predict total MMSE scores. Because of an age X education interaction in the prediction of total MMSE scores, four age X education-specific predictive equations were developed. These four equations are most useful for predicting continuous MMSE scores rather than for categorizing individuals according to impaired versus unimpaired status. A short form of the MMSE and four age X education-specific scoring equations are presented and their potential utility discussed. PMID- 3668145 TI - A welcome to a crowded field: where will the new women physicians fit in? PMID- 3668146 TI - An Ecuador elective. PMID- 3668147 TI - Women and AIDS: the future is grim. PMID- 3668148 TI - Political attacks on vision therapy. PMID- 3668150 TI - Cyclotherapy in latent hyperopia. PMID- 3668149 TI - Vision therapy revisited: a restatement. PMID- 3668151 TI - Sensory fusion disruption syndrome. AB - Unlike the typical manifestation of acquired strabismus, patients with sensory fusion disruption syndrome are unable to fuse targets even when bifoveally aligned under ideal clinical conditions. This condition usually follows trauma and a period of coma. These patients suffer from chronic diplopia which is not relieved by optical or surgical means. Recognition of this entity may result in more effectual management. As a phenomenon, it serves as a potential clue to physiological composition of binocularity. PMID- 3668152 TI - Exotropia associated with defective accommodation. AB - Despite the close association of convergence and accommodation, accommodative dysfunction is not often associated etiologically with exotropia. We studied 13 adolescent and young adults having intermittent exotropia and severely reduced accommodative function. Most patients had a prolonged history of visual symptoms that had not responded to therapy in the past. Clinical testing indicated that the patients had severely reduced amplitudes of accommodation and difficulty sustaining accommodation. Exotropia was manifest when the accommodative response was inadequate; relative orthophoria existed when the accommodative response was adequate. Treatment of the accommodative defect as well as the strabismus was successful for some patients. We recommend careful evaluation of accommodation for adolescent and young adults with exotropia to rule out an accommodative defect as a contributing cause. PMID- 3668153 TI - Accommodative esotropia: efficacy of therapy. AB - Retrospective examination was performed on the records of 54 patients who had undergone treatment of accommodative esotropia. The patients were classified based on the Duane classification as having either convergence excess (n = 11) or equal esodeviations (n = 43). Over 90% of the patients achieved total restoration of normal binocular function with treatment. The results and implications of this study are discussed. PMID- 3668154 TI - Monovision correction for diplopia. AB - Acquired, incomitant strabismus frequently results in diplopia. Affected patients complain of chronic annoyance and frustration with the false image. Therapy has usually been aimed at either re-establishing binocularity by using prisms or vision training, or by eliminating one image through occlusion. An alternative approach is to allow each eye its own "domain," one eye corrected for distance vision and the other for near vision. This alternative may eliminate the competitive, unfusible images and yet maintain visual function in each eye. PMID- 3668155 TI - Prevalence of paradoxical anisometropia. AB - A sample population of patients with a certain degree of antimetropia or mixed anisometropia was selected. Binocular interference or paradoxical dominance was expected in some of them. This interference is such that the "seemingly worse eye" (the eye with the lesser visual acuity) dominates the binocular vision and leads the subject to wear corrective glasses or contact lenses even though the level of visual acuity in the other eye is adequate without correction. This is what we called paradoxical anisometropia. There was no amblyopia or strabismus present. Twenty percent of our subjects manifested some degree of binocular interference. PMID- 3668156 TI - Responses to a dry eye questionnaire from a normal population. AB - A dry eye questionnaire was completed by 500 patients who presented for the correction of refractive error. A sample of non-contact lens wearers was extracted (N = 177) and responses were compared between males and females, and between three subgroups according to age. Females responded at a significantly higher rate in regard to 4 of 24 questionnaire segments. Differences according to age were found for 5 of 24 questionnaire segments. Except for the question concerning arthritis, increased prevalence of dry eye findings in over-45-year old females was not found in this normal population. These results, combined with those reported previously, validate the use of the questionnaire as a screening instrument that will enable ocular sicca cases to be identified. PMID- 3668157 TI - Management of a young esotrope using vision therapy and prismatic prescription. AB - This case report illustrates the important issues concerning optometric management of the pediatric patient presenting with esotropia. Appropriate treatment options and prognostic factors are covered. The case demonstrates the successful, sequential treatment of a young, early-onset, esotropic patient through vision therapy and prismatic lens prescription. PMID- 3668158 TI - Vicarious liability. AB - "Vicarious liability" or "imputed negligence" is a doctrine that shifts legal responsibility from one individual to another so that, under the appropriate circumstances, an optometrist may be held responsible for the negligent conduct of agents, employees, partners, and others with whom the optometrist has created the necessary legal relationship. The application of vicarious liability to clinical practice is discussed, with emphasis upon relationships with other professionals, delegation of duties to employees, and referrals to other health care providers. PMID- 3668159 TI - Autonomic nervous system control of heart rate during baroreceptor activation in conscious and anesthetized rats. AB - Heart rate and blood pressure were recorded in conscious, freely behaving rats through a catheter in the tail artery during administration of nitroprusside or phenylephrine through a catheter in the jugular vein. The sympathetic and parasympathetic components were distinguished by treating the rats with atenolol or methyl-atropine. Reflex bradycardia induced by all doses of phenylephrine was almost totally blocked blocked following methyl-atropine treatment. Reflex tachycardia induced by small to moderate doses of nitroprusside was attenuated to an equal extent following atropine or atenolol treatment. A similar experimental schedule was followed with a separate group of rats to determine the effects of pentobarbital and urethane anesthesia on the baroreceptor reflex. Both pentobarbital and urethane equally attenuated the tachycardia response to a decrease in blood pressure. However, pentobarbital anesthesia resulted in a greater attenuation of the bradycardia response to an increase in blood pressure than did urethane anesthesia. These data support the conclusion that the parasympathetic nervous system is primarily responsible for baroreceptor reflex induced bradycardia in conscious rats. The sympathetic and parasympathetic systems contribute equally to control baroreceptor reflex-induced tachycardia except in extreme acute hypotension when the tachycardia is predominantly due to the activation of sympathetic nerves. The findings of the second experiment indicate that pentobarbital and urethane affect sympathetic systems differently. PMID- 3668160 TI - Identification and characterization of muscarinic cholinergic receptors in the human urinary bladder and parotid gland. AB - The binding characteristics of [3H]quinuclidinyl benzilate (QNB) to muscarinic sites in isolated plasma membrane fractions of the human urinary bladder and parotid gland were studied. QNB binding to both preparations was of high affinity and low capacity. Mean values for the apparent dissociation constants (Kd) for binding to membrane preparations from the urinary bladder and parotid glands were 22 and 34 pM and the Bmax values 234 and 456 fmol/mg protein, respectively. Significance of difference between Kd and Bmax values from the two tissues was at the level of P less than 0.005 and P less than 0.05, respectively. QNB binding was inhibited by muscarinic receptor antagonists with varying degree of effectiveness. The mean values for the inhibition constant (Ki) were significantly lower for oxybutynin, amitriptyline, and pirenzepine but higher for secoverine in preparations of the urinary bladder than of the parotid gland. The mean Ki values for quinidine and verapamil were lower in the urinary bladder than that in the parotid gland. Carbachol exhibited a marked selectivity for the urinary bladder (about 30-fold) compared with the parotid gland. The present data obtained in two human tissues that are highly cholinergic in their innervation give support to the argument for heterogeneity of the muscarinic cholinergic receptors. PMID- 3668161 TI - Hypothalamic stimulation counteracts sympathetically mediated gastrointestinal inhibition in chloralose-anaesthetised cats. AB - The inhibitory motor effect of the sympathetic gastrointestino-gastrointestinal (GI-GI) reflex was studied in cats with isolated innervated ileal (Thiry-Vella) loops. They were subjected to acute experiments under chloralose-gallamine anaesthesia where gastric volume, arterial blood pressure and heart rate were continuously monitored. The cervical vagi were sectioned and used for efferent stimulation. The hypothalamus was systematically explored by means of stereotaxically guided electrodes. When the abdomen was undisturbed, gastric contractile responses to central stimulation were virtually absent, regardless of whether a vagally induced tone was present or not. Distension of the isolated intestinal loop induced marked inhibition of vagally induced gastric tone, indicating activation of the GI-GI reflex. Under these conditions, about 17% of the hypothalamic points induced gastric excitation, due to withdrawal of sympathetic tone. The GI-GI reflex can thus be inhibited from diencephalic levels. This inhibition is not linked to any distinct cardiovascular 'pattern'. PMID- 3668162 TI - Oxytocin administered intrathecally preferentially increases heart rate rather than arterial pressure in the rat. AB - Oxytocin was administered intrathecally at a dose of 6.5 nmol to the 9th or 2nd thoracic level of the spinal cord in the rat. This increased heart rate but had no effect on arterial pressure. The increase in heart rate began within 1 and 5 min and reached a peak at 10-30 min; the maximum increase, at 10 min after administration, at the second thoracic level was 65.4 +/- 13.8 (S.E.M.) bpm (n = 9). When administration was at the 9th thoracic level the change at 10 min was 36.9 +/- 18.0 bpm (n = 14). Administration of hexamethonium systematically, to block nicotinic transmission in autonomic ganglia, prevented the cardioacceleration in response to intrathecal administration of oxytocin. When 6.5 nmol of oxytocin were administered i.v., there was an immediate decrease in heart rate by 42.5 +/- 16.5 bpm (n = 4) and an increase in systolic (6.3 +/- 6.4 mm Hg) and in diastolic (38.8 +/- 8.3 mm Hg) pressures (n = 4); this effect lasted 5-10 min. Administration of 1.625 nmol of oxytocin at the 9th thoracic level had an effect qualitatively similar to that seen with the higher dose, but the response was smaller in magnitude and more delayed in onset; 0.65 nmol of oxytocin were without effect. Transfer of label to the blood after intrathecal administration of [125I]oxytocin indicated that the level in the blood reached a maximum of 0.6% of the total injected by 30 min after administration. It is concluded that the intrathecal administration of reached a maximum of 0.6% of the total injected by 30 min after administration. It is concluded that the intrathecal administration of oxytocin increases heart rate via an action in the spinal cord, presumably on sympathetic preganglionic neurons. Our results are consistent with earlier suggestions that oxytocin may be a chemical mediator of synaptic transmission onto sympathetic preganglionic neurons. PMID- 3668164 TI - Regional vascular responses to an acute stressor in spontaneously hypertensive and Wistar-Kyoto rats. AB - The regional vascular responses to an acute intermittent footshock stressor were examined in Wistar-Kyoto and spontaneously hypertensive rats using the pulsed Doppler flow probe method. While both strains exhibited vascular resistance changes, which were typical of the 'defense response', the changes in regional vascular resistance were exaggerated in the spontaneously hypertensive rats compared to the Wistar-Kyoto. Despite these alterations in vascular resistance, and greater increases in heart rate in the spontaneously hypertensive rats, there were no differences in the pressor responses footshock between the Wistar-Kyoto and spontaneously hypertensive rats. These findings indicate that very specific regional hemodynamic changes accompany the characteristic sympathetic nervous system hyperresponsiveness of spontaneously hypertensive rats to environmental stress. PMID- 3668163 TI - Sympathetic innervation of the cornea from the superior cervical ganglion. An HRP study in the cat. AB - Horseradish peroxidase (HRP) was applied to the cornea in cats using a variety of methods. Small numbers of labeled neurons were observed in the superior cervical ganglion (SCG), the majority were located in the rostral half. This confirms previous histofluorescence data which indicated the SCG was the likely source of adrenergic fibers to the cornea. PMID- 3668165 TI - Location, distribution and projections of intracardiac ganglion cells in the rat. AB - Physiological studies indicate that cardiac parasympathetic nerves may act selectively at discrete cardiac sites. To determine anatomical sites at which selective integration of cardiac nerve activity may occur, the present study identified and described the location, distribution, and projections of intracardiac ganglion cells in the rat. The estimated 3992 ganglion cells per rat heart were located in 4 distinct groups, all above the atrioventricular groove: (1) between the superior vena cava and aorta (2.5% of total), (2) in the region of the superior interatrial septum (49.9%), (3) posterior to the left atrium (24.0%), and (4) posterior to the inferior interatrial septum and right atrium (23.5%). Only a few ganglion cells were located subepicardially within the infolding of the dorsal interatrial septum. Retrogradely transported fluorescent tracers injected into the left or right ventricles demonstrated that different groups of ganglion cells projected to discrete or selective regions of the heart. Projections to the left ventricle originate only from ganglion cells located posterior to the interatrial septum and the left atrium. In the rat, intracardiac ganglion cells, confined to 4 atrial regions, appear to have discrete sites of termination within the heart. It is proposed that selective activation of different intracardiac ganglion cell groups may elicit specific regional changes in cardiac parasympathetic nerve activity. PMID- 3668166 TI - A new method of photo-documentation for the follow-up of dysplastic naevi. PMID- 3668167 TI - Some basic photographic requirements for the study and application of biological science. PMID- 3668168 TI - 19th annual conference of the Institute of Medical and Biological Illustration at the University of York, September 1986. PMID- 3668169 TI - IBM's great AT slides. PMID- 3668170 TI - Confidentiality of illustrative clinical records--a code of practice,, guidance notes and recommendations. PMID- 3668171 TI - Paediatric photography. PMID- 3668172 TI - Less well-known methods for examination and photography of the corneal epithelium. PMID- 3668173 TI - A low-cost method of large field schlieren photography. PMID- 3668174 TI - Integrated information distribution systems: their implication for medical media. PMID- 3668175 TI - 3rd meeting of the European Neuroendocrine Association. London, September 9-11, 1987. Abstracts. PMID- 3668176 TI - Dress and self-esteem. PMID- 3668177 TI - Managing care of a client with organic brain syndrome. PMID- 3668178 TI - Selecting nursing activities for hospitalized clients. PMID- 3668179 TI - Quality monitoring in nursing homes. PMID- 3668180 TI - [Genetic problems associated with artificial reproduction using donor gametes: solutions adopted by CECOS (Centres d'Etude et de Conservations du Sperme]. AB - Artificial reproductions using donor sperms or oocytes are increasing. In this way they offer the doctor the chance of preventing genetic handicaps that cannot be obtained by natural reproduction, and that therefore should be used. To deny this medical power is dangerously nihilistic. The use of this power for eugenic or commercial ends can lead to abuses. Therefore a strict medical protocol is proposed: 1) The use should be exclusively therapeutic and should include the genetic reasons for using a donor gamete in reproduction. 2) The objectives should be defined and the methods that can be employed in the prevention of abnormal genetic inheritance. 3) Research should be carried out into the possible iatrogenic effects of these methods of artificial reproduction. PMID- 3668181 TI - [Comparative epidemiologic study of 120 patients with condylomatous lesions and 120 control patients]. AB - The authors compared 120 women who had condylomata with 120 controls. The patients were more frequently single or divorced than the controls. Age at first sexual intercourse was the same in the patients and in the controls, but the total number of sexual partners was higher in the patients than in the controls. The age at first pregnancy was 24 years in the patients and 28 in the controls. About equal numbers of genital infections were found in the history of the controls as in the patients. On the other hand some specific urogenital infections were more frequent in the patients. Chlamydia diagnosed by a positive level at 1/64 in the serum test occurred in 21.4 per cent of patients and 5.5 per cent of controls. PMID- 3668182 TI - [Frequency of hepatitis B antigens in the blood of pregnant women]. AB - In the antenatal clinics of the Hospital Foch at Suresnes we have instituted testing for hepatitis B antigens routinely of all mothers coming to the clinic so that we can look at the immune state of children born to mothers who have the hepatitis B virus and have hepatitis B antigens. The incidence of hepatitis B antigens altogether was 0.77%, which is twice as frequent as found in blood donors at the same hospital. This high incidence is found in women coming from the African and Asian continents where it is found at the same level in blood donors in the Hauts-de-Seine region. If however we examine women born in France who live in the towns the incidence is 0.32%. An enquiry in a standard medical form does not show a true risk factor. When, however, a more precise questionnaire is filled in, we found that risk factors were present in eight out of ten positive cases. We only made this enquiry on sero-positive women. When the baby was born we gave a 1 ml dose of anti-hepatitis B immunoglobulin (100 IU) followed by three injections of 1 ml of vaccine (HEVAC B Institut Pasteur) on the 1st, 30th and 60th day of life. A repeat injection was carried out when the infant was one year old. Altogether 32 newborns were treated: they tolerated the products well and it was effective because all infants developed anti-hepatitis B antibodies in every case that was followed up.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668183 TI - [Endometriosis of the uterine cervix. A hypothesis on its histogenesis]. AB - Three cases of endometriosis of the cervix in association with the results of previous studies on the embryogenesis of the uterus made it possible during a morphological study for the authors to hypothesise that cervical endometriosis could develop in mullerian rests which persist in the stroma of the cervix. Menstrual blood incites the development, but degenerate menstrual fragments of endometrium do not implant to cause this development. PMID- 3668184 TI - [Demonstration of blood in nipple discharges using the Hemoccult]. AB - Evidence of blood in discharge from one breast and from one duct in an indication to operate on for most surgeons. We have used hemoccult to demonstrate the presence of blood in certain discharges. Discharge cytology was systematic and when it was possible a correlation was done with the operative specimen. 55 patients were studied. In 23 cases hemoccult was positive and there was blood on the cytological smear. In 28 cases hemoccult was negative and the cytological smear showed no blood. In the remaining 4 cases the hemoccult was positive but the cytological smear failed to show any blood. There was no false negative test. There were three breast cancers. Among this series of 55 patients and the test was positive in each case. Using slides of hemoccult to detect blood in a nipple discharge is rapid and simple can be done in the doctor's office. However, the results of the test have to be strictly correlated with other elements of the work up in particular with mammography and galatography. PMID- 3668185 TI - [The contraction stress test by nipple stimulation: an alternative to the oxytocin test]. AB - Breast stimulation as a "contraction stress test" has been proposed as an alternative test to oxytocin to check the well being of the fetus. 162 breast stimulation tests were carried out in 146 patients with an indication for a "contraction stress test". The stress rate was 66.6%. 8% of the tests showed hyperstimulation without any fetal complications. There was no difference between the types of patients where the test was successful, failed or resulted in hyperstimulation. Where the tests failed, oxytocin tests were carried out. The time needed for these was, on the whole, double that taken for the breast stimulation tests. The two techniques can be comparable, both from correlation of the results with the indication and the outcome for the infant. The mothers tolerated the breast stimulation test very well indeed. PMID- 3668186 TI - [Prenatal origin of parent-infant bonding: 2: Implications for obstetric care]. AB - Modern Western obstetric care has concentrated mainly on the physical well-being of mother and fetus. In recent years, increasing awareness of psycho-social issues has led to changes in labour ward practices. It is suggested that changes in antenatal practice are now necessary in order to bring preventive measures to bear on many areas of potential developmental, marital and parenting difficulties. Building on the framework proposed in the preceding paper, we offer concrete systematic guidelines for extending the antenatal obstetric agenda to cover those additional and important aspects of pregnancy. PMID- 3668187 TI - [Twin pregnancy after iatrogenic menopause]. AB - The authors present the case of a young woman who had Hodgkin's disease when she was 29 years of age. This was treated with 5 courses of M.O.P.P. (Mustard (nitrogen mustard), Oncovin, Procarbazine, Prednisone). These courses were followed by radiotherapy and the patient was given the combined oestrogen progesterone pill while under treatment. After 20 months following treatment the patient was clinically and biologically menopausal. She was treated with hormone replacement therapy on alternate months. 10 months later, she started a twin pregnancy (there was no family history of twins) and after 37 weeks of amenorrhoea she delivered twins weighing 2,180 g and 2,300 g. The review of the literature shows that the ovaries are affected by this type of treatment, which causes ovarian fibrosis and failure of maturation, with disappearance of follicles. The effects of such treatment are variable and may leave the patients with normal ovarian function, or with a menopause from the outset. The essential prognostic feature is the age of the patient at the time of treatment. The dose of the antimitotic drugs used does not seem to have a great effect on ovarian function. The role of giving oestrogens and progestogens is disputed. The fact that twins occurred in this case could be explained by the fact that twin pregnancies do occur more often in the pre-menopause because the higher levels of gonadotrophins ripen several follicles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668188 TI - [Microsurgical treatment of lesions of the proximal segment of the oviduct. Isthmo-ostial reimplantation. Isthmo-ostial anastomosis and isthmo-uterine reimplantation]. AB - The authors, who operated on 187 patients with 277 interstitial sections of the isthmus, describe their microsurgical techniques for isthmo-ostial anastomosis, for isthmo-ostial reimplantation and for isthmo-uterine reimplantation. Histological analysis of the lesions and the anatomical features of the proximal segment of the tube justify their method. Patency is re-established and the results are encouraging. All the same, these partial proximal lesions can be markedly improved with success by medical treatment before operation. PMID- 3668189 TI - [Cervical dilatation by use of a vaginal suppository of meteneprost before voluntary interruption of the pregnancy in the first trimester]. AB - Instrumental dilatation of the cervix prior to first trimester absorption may be difficult and source of complications. Pharmacological dilatation is proposed in a prospective random study using vaginal suppository containing 10 mg of 9-deoxo, 16-16 dimethyl, 9 methylene PGE2 (Meteneprost). Mean cervical dilatation, 3 hours after treatment, was significantly higher in the treated group (8.1 vs 6 mm) and additional dilatation was facilitated by cervical softening. Side effects occurred in most of the treated patients (uterine pain) but on a minor scale. This procedure may be considered as effective, safe and easy. PMID- 3668190 TI - [Herpes in the pregnant woman and the newborn infant]. AB - Herpesvirus infection of the newborn is a rare though extremely grave disease that poses difficult problems for the obstetrician. It is nearly always due to genital herpes during pregnancy though in more half the cases this was unsuspected by the mother. Prophylactic measures exist--disinfection of the genital tract, elective cesarean section, administration of antivirals and Acyclovir in particular. The main difficulty resides in making the correct decision and the excessive recourse to cesarean section should not be replaced by the unreasoned prescription of antivirals taking into account the current uncertainly about their real efficacy and their long-term effects after administration in early life. The risk of neonatal herpes should therefore be evaluated from the clinical findings and 4 categories of women may be defined: those with the clinical manifestations of primary genital herpes on delivery or during the month before; those with the clinical manifestations of recurrent genital herpes on delivery or during the week before; those with only a previous history of genital herpes and finally all other women with no clinical manifestations or history of genital herpes. Only first two categories benefit from cesarean section and Acyclovir is only prescribed in exceptional cases as complementary therapy for the newborn infant. In the third category, clinical and virological monitoring alone is required and is currently prescribed during the perinatal period as it is reasonable to stop the systematic weekly virological monitoring at the end of pregnancy when this has been shown to be inappropriate. However, it remains true that more than half the cases of neonatal herpes arise in women in the fourth category. The only means of prevention that can be proposed is that they refrain from sexual or orogenital relationships during the last two months of pregnancy. According to our current knowledge, Acyclovir remains contraindicated during pregnancy except in exceptional cases when the mother's life is in danger. PMID- 3668191 TI - Vibrios in abundance: a growing genus. PMID- 3668192 TI - Characterization of non-01 Vibrio cholerae and V. mimicus isolated from fresh water in Bangladesh. PMID- 3668193 TI - Enteropathogenic bacteria and intestinal parasites in the stools of food handlers in Chiang Mai, Thailand. PMID- 3668194 TI - The possible role of rainfall in spreading Salmonella on Guam. PMID- 3668195 TI - Toxigenicity and drug sensitivity of Vibrio mimicus isolated from fresh water prawns in Bangladesh. PMID- 3668196 TI - Multiple drug resistant Salmonella typhi in Bangladesh. PMID- 3668197 TI - Childhood diarrhoea in Karachi. PMID- 3668198 TI - Return visits to the emergency department. AB - A persistent problem for emergency physicians is the patient who returns unscheduled to the emergency department with a problem that either has not improved or has worsened. The purpose of this study was to evaluate the frequency of revisits and the nature of the problems. All patients returning within 72 hours of their initial visit were entered into the study. The charts were evaluated for classification of problem, unavoidable v avoidable returns, and errors in medical care or patient education. Of the 64,336 patients seen during the study, 255 returned within 72 hours. Eighty-three (32.5%) of the returns were found to be avoidable with better patient education or medical care on the initial visit. The revisit population is a high-risk group of patients who should be approached carefully by emergency physicians. PMID- 3668199 TI - Acinetobacter calcoaceticus infection following a dog bite. AB - A frequent complication of dog bite wounds is bacterial infection. The choice of antibiotics is based upon the most likely organisms. Failure to achieve wound healing suggests that an uncommon organism(s) is present and should lead the clinician to culture the wound. A case of Acinetobacter calcoaceticus infection following a dog bite is described. PMID- 3668200 TI - Psychiatric presentation of medical illness. AB - A 37-year-old woman was seen in the emergency department for symptoms of depression. A careful mental status examination resulted in the discovery of an organic basis for the "psychiatric" presentation. As with any patient demonstrating behavioral abnormalities, this case illustrates the importance of an adequate history, physical, and mental status evaluation in ruling out organic etiology prior to labeling a patient's complaints as functional. Medical illnesses that can present as apparent psychiatric disease and the clinical clues that lead to the diagnosis of such cases are discussed. PMID- 3668201 TI - High-pressure injection injury: a hand-threatening emergency. AB - A variety of tools mounted with high-pressure nozzles cause a typical pattern of hand injuries. Often the relatively mild initial symptoms conceal the actual degree of tissue damage and the need for prompt treatment. As illustrated by a case of dye impression, early extensive surgical exploration and radical removal of the injected agent are mandatory to minimize sequelae and to avoid mutilating complications. Pathophysiology and surgical management of this hand-threatening emergency are outlined. PMID- 3668202 TI - Mystery root ingestion. AB - Patients frequently come to the emergency department or contact a poison center following exposure to plants. These cases are often challenging owing to difficulty in correct identification of the involved plant. A case of two patients who demonstrated anticholinergic syndromes after ingesting an unknown, wild plant is described. Chemical analysis of two suspect plants collected in the same location allowed a probable diagnosis of poisoning from ingestion of henbane (Hyoscyamus niger). PMID- 3668203 TI - Side effects of transdermal scopolamine. AB - Motion sickness can be experienced as the result of air or sea travel. Scopolamine can be used before travel to prevent this illness. This report describes two patients who used transdermal scopolamine preparations and experienced hallucinations and then confusion as side effects. The discussion concerns the recognition and treatment of these adverse effects. PMID- 3668204 TI - Transient first-degree AV block and sixth nerve palsy in a patient with closed head injury. AB - We present the case of an 8-year-old girl who suffered a closed head injury with the development of bilateral sixth-nerve palsies, and who was noted upon arrival to the emergency department to be in first-degree AV block. The sixth-nerve palsies and the first-degree AV block resolved simultaneously within 24 hours of injury. We discuss dysrhythmias and ECG changes previously reported with central nervous system diseases and their proposed etiology. PMID- 3668205 TI - Peripheral edema and chest pain in a young male. PMID- 3668206 TI - The man with the round face and left lower quadrant mass. PMID- 3668207 TI - EM filing system. PMID- 3668208 TI - Infection following a dog bite. PMID- 3668209 TI - Comparative study of assays detecting circulating immune complexes and specific antibodies in patients infected with Toxocara canis. AB - A sandwich ELISA method using previously described E/S antigen-specific monoclonal antibodies has been developed to detect circulating immune complexes in patients infected with Toxocara canis. This technique could be used for the study of the dynamics of the parasite-host relationship, as we believe the detection of immune complexes and/or soluble antigen to be an improvement over detection of antibodies only. In this parasitosis, antibodies may be present in residual levels for prolonged periods after active infection. PMID- 3668210 TI - Shedding of gravid proglottids and destrobilation in experimental infections of foxes with Mesocestoides leptothylacus Loos-Frank, 1980 (Cestoda). AB - The implications of the confused taxonomy of the genus Mesocestoides and the misuse of the name M. lineatus are described. In Southwest Germany rodents are intermediate hosts and red foxes are definitive hosts of M. leptothylacus. The shedding patterns of experimentally infected foxes showed that destrobilation occurs frequently and that there are long periods during which no gravid proglottids are shed at all. Lengths of worms can be taken as a measure of a possible crowding effect only when worms with gravid segments are present, i.e. at the end of the prepatent period (11 to 13 days) or at the beginning of a shedding period. PMID- 3668211 TI - Purification and characterization of a glycoprotein from the surface of Ascaridia galli. AB - Employing papain as the enzyme and agarose bound Ricinus communis agglutinin as the affinity gel, a glycoprotein has been isolated and purified from the surface of Ascaridia galli. The glycoprotein shows an apparent molecular weight of 68 kilo daltons and contains fucose, galactose, rhamnose and glucosamine as sugar moieties. Only 2% of its entire molecule has been found to possess alpha-helical configuration. PMID- 3668212 TI - Comparative study on polypeptide patterns of larvae of Trichinella isolates by two-dimensional electrophoresis. AB - The two-dimensional patterns (isoelectrofocusing-IEF/polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate-SDS) of S3 fractions of muscle larvae of four Trichinella isolates were compared. The comparative study concerned six groups of polypeptides. It was observed that the Garkavi isolate of Trichinella pseudospiralis was clearly different from the other isolates, and it showed the simplest IEF/SDS polypeptide pattern. The C-76 isolate of T. nelsoni had only four of the six groups, distinguishing it from the GM-1 isolate of T. spiralis and the Boev isolate of T. nativa that showed all the indicated groups. PMID- 3668213 TI - Superoxide dismutase activity in nematodes. AB - The activities of the enzymes superoxide dismutase (E.C.:1.15.1.1) and catalase (E.C.:1.11.1.6) were studied in purified extracts of four nematodes: Ascaris suum, Toxascaris leonina, Toxocara canis and T. cati adult males and females. No catalase activity was found in any of the extracts. The results reveal that the SOD activities of the four parasites presented species differences and also sexual differences within each species. Polyacrylamide gel electrophoresis pattern analysis confirmed that the mobilities, widths and band intensities varied according to the species and sex of the parasite from which the enzyme was obtained. PMID- 3668214 TI - Comparative analysis of amino acids of three species of gangesia (Cestoda: Proteocephalata). AB - A total of 21 amino acids were detected in the present investigations on three species of Gangesia (Cestoda: Proteocephalata) viz. G. bengalensis Woodland, 1924, G. hanumanthai Seth & Capoor, 1982 and G sanehensis Malhotra et al., 1981. The study was conducted in a sub-humid region around Allahabad, India. The implications of amino acid utilization in metabolic activities of fish tapeworms have been discussed. PMID- 3668215 TI - Observations on the transmission of Angiostrongylus cantonensis from snail to rodent. AB - A survey of Angiostrongylus cantonensis was carried out to investigate the mode of transmission from mollusc to rat in a fixed study area of Yoron Island from 1979 to 1982. Rattus rattus was found to be infected with a small number of worms in spite of heavy infection with third-stage larvae in Achatina fulica and an abundance of this snail in the area. Natural infection and/or susceptibility with A. cantonensis were confirmed in three small snail species. Bradybaena circulus, Fruticicola despecta and Luchuena reticulata. Young A. fulica was found to be infected with fewer third-stage larvae than mature A. fulica. It was concluded that molluscs which were infected with a small number of third-stage larvae of A. cantonensis play an important role in maintaining the life cycle of A. cantonensis. The percentage of rat stomachs containing mollusc tissue was relatively low, and the incidence and infection was low in rats. Infection with A. cantonensis did not occur very often in R. rattus in nature. PMID- 3668216 TI - Distribution of echinococcosis/hydatidosis in Italy. AB - Results of an epidemiological survey carried out in 88 slaughterhouses in Italy from 1979 to 1983 are reported. Data have been compared to national surveys previously conducted in 1955 and from 1968 to 1978. Analysis of various factors affecting the incidence of the disease in different areas of the country are reported. PMID- 3668218 TI - Abstracts of the 22nd meeting of the European Association for the Study of the Liver. Torino, Italy, 3-5 September, 1987. PMID- 3668217 TI - Antifilarial effect of Zingiber officinale on Dirofilaria immitis. AB - Dogs, naturally infected with Dirofilaria immitis, were treated with the residues of the alcoholic extracts of the rhizomes of Zingiber officinale (ginger). Twelve subcutaneous injections of the extract given at 100 mg/kg reduced microfilarial concentration in blood by a maximum of 98%. Fifty five days after the last injection there was 83% reduction in microfilarial concentration suggesting partial destruction of adult worms. Half of the treated dogs showed some lethargy at the beginning of treatment possibly due to the mass annihilation of microfilariae in blood. PMID- 3668219 TI - The relationship of stress management training to the experience of pain in clients with intractable angina. PMID- 3668220 TI - Holistic health associations in Michigan: organizational structure and individual member characteristics. PMID- 3668221 TI - Implementation of a course on holistic health practices in stress management. PMID- 3668222 TI - Healing: examining the perspectives. PMID- 3668223 TI - Energy fields: implications for nurses. PMID- 3668224 TI - Care of critically ill patients suffering from HIV infection. PMID- 3668226 TI - AIDS--catastrophe or challenge and opportunity for progress? PMID- 3668225 TI - Body image (Part 2). Helping patients to cope with changes--a problem for nurses. PMID- 3668227 TI - The Mead model for nursing--adapted from the Roper/Logan/Tierney model for nursing. PMID- 3668228 TI - Magnetic resonance in the evaluation of multiple sclerosis. PMID- 3668229 TI - Non-traumatic out-of-hospital cardiac arrests. Experience at Memorial Hospital of South Bend, 1985-86. PMID- 3668230 TI - Nephrolithiasis: clues for the stone detective. PMID- 3668231 TI - Maternal and fetal risks in women with heart disease. PMID- 3668232 TI - Maternal mortality in Indiana: a report of maternal deaths in 1985. PMID- 3668233 TI - Continuity of care and outcome in a family practice. PMID- 3668234 TI - Emergency evaluation of abdominal aortic aneurysms. PMID- 3668235 TI - Reader comments on article concerning management of renal and ureteral calculi. PMID- 3668236 TI - PADS: a program to identify and diagnose prescription drug diversion in Indiana. PMID- 3668237 TI - Microscopic structure of the brain of Barbus meridionalis Risso. I. Telencephalon. AB - The telencephalon of Barbus meridionalis is composed of two oval telencephalic lobes separated by a medial ventricle and joined exclusively by the anterior commissure. Histologically, the dorsal and ventral telencephalic areas are well defined, the limiting plane between them being a cell free zone. In the ventral area it is possible to distinguish the following parts: dorsal, supracommissural, postcommissural, lateral, intermedia and the nucleus entopenduncularis. In the dorsal area there are three peripheral longitudinal zones--medialis, dorsalis and lateralis--together with a central zone; caudally situated is a posterior dorsolateral region which is the main receptor site for olfactory fibers and closely associated to this is the nucleus tenia. The olfactory projections to the telencephalon course along two bundles: the medial and the lateral olfactory tracts. The telencephalon projects to diencephalic regions via three large bundles: the lateral and medial telencephalic bundles and the strio-medullary system. PMID- 3668238 TI - Volumetric asymmetry in the human amygdaloid complex. AB - The amygdaloid complex was parcellated into 15 nuclei based on cytoarchitecture in 19 human brains. The volumes of the nuclei were determined in the right and in the left hemisphere for each case. A multivariate analysis showed that the amygdaloid complex is asymmetrical between the hemispheres, with the lateral nucleus of the amygdala, which is larger in the right hemisphere, showing the strongest volumetric asymmetry. These findings are discussed in relation to the amygdala's role as a mediator between limbic and cortical processing, and in light of the right hemisphere's specialization for emotional behaviors. PMID- 3668239 TI - A volumetric comparison of brains between greylag geese (Anser anser L.) and domestic geese. AB - Volumes of brain and brain subdivisions in greylag and domestic geese are determined by cytoarchitectonical methods in order to confirm the reduction in brain weight of 16.13% due to domestication which was described in an earlier study. Olfactory structures, nucleus basalis and the 'piriform' corticoid layer are found to be particular different in shape and position compared to other birds, especially the pigeon. The volumes of brain parts in relation to the total brain are very similar in both: greylag geese and domestic geese. The extent of changes in brain parts due to domestication varies. The decrease of the prosencephalon by 18.8% is double the size of the rhombencephalon (9%). Remarkable are the reduction values of the tectum opticum (21.8%), the tractus opticus (37.3%), the hyperstriatum ventrale (26.1%), the archistriatum (22.4%), and the hippocampus (31%). Changes in brain size are compared with observations found in other domesticated birds. Evolutional, functional and environmental connexions are discussed as well. PMID- 3668240 TI - The development of vascularization in the postnatal rat paraventricular nucleus: a morphometric analysis. AB - The morphometric analysis of the capillar surface shows the existence of a large amount of vessels in the rat Paraventricular nucleus during postnatal development with respect to the hypothalamic control region in the Anterior hypothalamic area. Quantitative measurements, revealed differences between the subnuclei, but not between the magno- and parvocellular regions. Magnocellular portions involved in Neurohypophysis regulation, showed from 2 to 2.5 times more vascularization than the control region. However, the Posterior subnucleus that projects to the Spinal Cord showed a similar vascularization to that of the control region. PMID- 3668241 TI - Structure of the piriform cortex of the adult rat. A Golgi study. AB - The piriform cortex (PC) was studied in the adult rat with anilines, rapid Golgi and Golgi-Colonnier techniques. As in other animals in the PC of the adult rat three layers can be distinguished: layer I or plexiform layer, layer II or superficial cellular layer and layer III or deep cellular layer. Golgi impregnations allowed to describe seven different types of cells. Pyramidal cells, in which it is possible to distinguish three subtypes (superficial, middle and deep pyramidal cells) by virtue of their morphology and location. Bipolar cells, a very little and scarce type of cell restricted to layer I and that has not been previously described. Fusiform cells, similar to those found in other species. Semilunar cells, also like those described in other animals but which are only found in the posterior PC. These cells resemble other type of cell, the ovoid cells that neither have been described in other animals and, on the contrary, are only located in the anterior PC. Stellate cells, which are a very wide population of cells with variable sizes, dendritic patterns and locations. Horizontal cells, similar to pyramidal cells but oriented in horizontal direction and polymorphic cells, whose the most striking feature is their smooth and beaded prolongations. Morphological features of these cells are compared with those described in the cells of the PC of other animals. PMID- 3668242 TI - Immunocytochemical approach of GABAergic innervation of the mouse spinal cord using antibodies to GABA. AB - The distribution of gamma-amino-butyric acid containing neurons in the Mouse spinal cord has been studied at both the light and electron microscope levels using antibodies against GABA and revelation by the Fab-peroxidase technique. At the light microscope level immunoreactive profiles of perikarya and neuronal processes were particularly abundant in the superficial laminae (I-IV) of the dorsal horn. Scattered soma profiles were found in the other layers and more particularly in the lamina X where Liquor contacting immuno-reactive neurons could be detected. GABAergic cell bodies were very sparse in the ventral horn. Electron microscopic observations confirmed the light microscope results: terminals constituted synaptic symmetrical contacts that provide a morphological basis for inhibition in the dorsal horn and for post-synaptic inhibition of motoneurons in the ventral horn. PMID- 3668243 TI - Renal haemodynamic studies in obesity hypertension. AB - Previous investigations have reported the systemic haemodynamic characteristics of obese hypertensive patients; however, their renal haemodynamics have not been explored. This report compares the renal and systemic haemodynamic findings in obese and lean normotensive and hypertensive patients. Our results demonstrate that both normotensive and hypertensive obese subjects had an increased renal blood flow, total blood volume and cardiac output, with decreased total peripheral and renal vascular resistances in comparison with lean normotensive and hypertensive patients. Body weight correlated directly and significantly with total blood volume, cardiac output and renal blood flow but indirectly with total peripheral resistance. Therefore, the elevated cardiac output and volume expansion found in obese patients were associated with increased renal perfusion; this increased renal blood flow accounts for the reduced renal vascular resistance in patients with obesity hypertension. Thus, we suggest that this effect of volume expansion in obesity could counteract the opposing effect of active vasoconstriction produced by the hypertensive disease and may account for the difference in prognosis of obese and lean hypertensive patients. PMID- 3668244 TI - Blood pressure and salt appetite of cross-suckled spontaneously hypertensive and normotensive rats. AB - An examination has been made of the blood pressure (BP), saline preference and circulating renin-angiotensin system of spontaneously hypertensive rats (SHR) of the Okamoto strain, normotensive Sprague-Dawley (SD) rats, SHR suckled from immediately after birth on an SD foster mother (SHR-on-SD) and SD cross-suckled on an SHR foster mother (SD-on-SHR). While the BP of SD-on-SHR was not significantly different from that of control SD, SHR-on-SD had significantly lower BP than SHR suckled on their natural mothers. In two-bottle preference tests, neither the saline preference nor total fluid intake of cross-suckled SHR was significantly different from that of SHR controls. While the total fluid intake of SD-on-SHR was not different from that of SD controls, the saline preference of cross-suckled SD was significantly lower than that of control SD. The heart, adrenal and kidney weights of SHR were significantly greater than those of SD, but there were no significant differences between cross-suckled rats and their respective controls. There were no significant differences in plasma renin activity (PRA) or angiotensin converting enzyme (ACE) activity between any groups and these variables did not correlate with each other, with BP or with saline preference. Thus, some factor transferred from the SHR mother postnatally is required for full expression of the elevated BP, but not the exaggerated saline preference of the SHR. Conversely, the saline preference of SD, but not the BP, is altered by cross-suckling. PMID- 3668245 TI - Afferent pathways of neural reno-renal reflexes controlling sodium and water excretion in the cat. AB - We have studied the role of afferent renal nerve fibres in anaesthetized cats in mediating the decrease in sodium and water excretion from the contralateral kidney caused by unilateral renal denervation. Transient denervation of one kidney obtained by cooling of the left renal nerves increases contralateral efferent renal nerve activity and decreased sodium and water excretion from the opposite kidney. The results observed in animals with intact neural pathways were compared with those obtained after the left kidney had been selectively deafferentated by cutting the dorsal roots from T9 to L4. Bilateral section of dorsal roots did not affect the increase in sodium and water excretion from the transiently denervated left kidney, but entirely abolished the decrease in sodium and water excretion from the contralateral kidney. Neither the left nor the right dorsal root section alone, affected the response of the contralateral right kidney. Our data demonstrate that afferent renal nerve fibres project bilaterally to the spinal cord and form the afferent branch of the reno-renal reflex by which one kidney can control the function of the opposite one. PMID- 3668246 TI - Attenuation by propranolol of exercise training effects in spontaneously hypertensive rats. AB - The effects of propranolol (10 mg/kg) on systolic blood pressure (SBP), resting and exercising heart rates (HR), and body weight (BW) were examined in 11-week swim-trained spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats. In both species, SBP was significantly reduced by either propranolol or training, but the reduction was greater with propranolol than with training. However, when propranolol was administered to rats during training, their independent beneficial effects on SBP were annulled. HR was modified slightly by propranolol and training, but they both decreased BW. The mechanism of propranolol action on BW is not clear. Maximum oxygen uptake (VO2 Max), relative heart weight (RHW), and absolute heart weight (AHW) were measured after 11 weeks of training. In both SHR and WKY rats, VO2 Max was elevated by exercise training; moreover, VO2 Max was greatest among those receiving propranolol while training. However, the combined effects of propranolol and training produced a significant reduction of AHW in SHR. The RHW was increased by training, but it was decreased by propranolol. SHR rats were more sensitive to the effects of training and propranolol than WKY rats. In humans, several observations have been reported on the attenuation of certain exercise-induced cardiovascular and metabolic changes by beta-adrenergic blocking agents. Our results obtained with rats confirm some of those observations. It would seem that the hypertensive strain of rats could serve as a model for the study of attenuation mechanisms by beta-adrenergic blockers. PMID- 3668247 TI - Relationships between calcium metabolic indices and blood pressure in patients with essential hypertension as compared with a healthy population. AB - Relations between indices of mineral metabolism and blood pressure were examined in 182 subjects, comprising 58 patients with essential hypertension (EHT) and 124 healthy subjects attending a general health survey. Multivariate techniques of statistical analysis were employed to test the hypothesis of different relationships between blood pressure and calcium metabolism within the subpopulations and to eliminate confounding effects of age, sex and obesity. Plasma ionized calcium was inversely related and the urinary calcium excretion positively related to blood pressure in the total group. This was not significantly different between the groups. Serum parathyroid hormone (PTH) was, however, related to diastolic blood pressure only in the EHT group. The EHT patients had significantly lower plasma levels of ionized calcium, significantly higher levels of PTH and significantly greater excretion of calcium in the urine than the healthy subjects. The results of this investigation support the hypothesis that among patients with EHT the renal tubular reabsorption of calcium is impaired resulting in a reduction of plasma ionized calcium and thereby stimulation of PTH. The findings of linear relationships suggests the possibility of a direct association between calcium metabolism and the regulation of blood pressure. PMID- 3668248 TI - Effect of DOCA-salt treatment duration and anteroventral third ventricle lesions on a plasma-borne sodium pump inhibitor in rats. AB - We determined the effect of plasma obtained from rats treated with DOCA-salt for 6 and 28 days on sodium pump activity, measured as ouabain-sensitive Rb+ uptake in tail arteries from these rats. The effect of an electrolytic lesion in the area of the anteroventral third cerebral ventricle (AV3V) before DOCA-salt treatment was investigated in relation to the ability of plasma to inhibit vascular Na+ pump activity. Systolic blood pressures, plasma sodium and potassium concentrations, body weights and haematocrit were also measured. Six days after DOCA-salt treatment, there was a 22% suppression of vascular Na+ pump activity in these rats. This suppression was due to a plasma factor since plasma from these rats produced a similar degree of suppression in arteries isolated from untreated control rats. Furthermore, tail arteries from DOCA-salt rats treated for 6 days displayed normal Na+ pump activity when incubated in plasma from control rats or in Krebs-Henseleit buffer. There was no elevation of systolic blood pressure at the end of 6 days of treatment with DOCA-salt. Placement of an electrolytic brain lesion in the AV3V area before treatment with DOCA-salt abolished the ability of plasma to inhibit the vascular Na+ pump. Treatment with DOCA-salt for 28 days resulted in a significant increase in systolic blood pressure, a decrease in plasma potassium concentration, and a significant increase in vascular Na+ pump activity (26%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668249 TI - Low mortality from all causes, including myocardial infarction, in well controlled hypertensives treated with a beta-blocker plus other antihypertensives. AB - The aim of the present study was to monitor the efficacy of treatment, morbidity and mortality over a 10-year period in 939 moderate to severe hypertensive patients. All patients were treated in the same hypertension clinic with the beta 1-selective agent atenolol, administered either alone or more usually with a diuretic with or without a vasodilator or other agents. Survival rates were compared with predicted survival rates, had the hypertension not been treated, and also with those of a local reference population matched for age and sex. After a mean follow-up time of 6.1 years, mean blood pressure (BP) was significantly lowered from 183/109 to 145/87 mmHg. Biochemical disturbance was minimal. There were 79 withdrawals from treatment, of whom 37 were lost to follow up. There were 91 deaths on intention to treat. Systolic blood pressure (SBP) on treatment, and not initial BP, was a powerful predictor of mortality. Patients of all age groups with well-controlled SBP were less likely to die, particularly from myocardial infarction, than those with less well controlled SBP (P less than 0.001). However, due to possible J-curve relationships between treated BP and outcome, lowering SBP below 140-150 mmHg in the elderly, and the diastolic blood pressure (DBP) below about 85 mmHg, may not be beneficial. Total mortality and mortality due to myocardial infarction was about 60% [corrected], of predicted level, had a high BP not been treated, being similar to that in a local reference control population (age- and sex-matched). The death rate from stroke was reduced to about 50% of that predicted. Patients who died showed a mean fall in mean serum triglyceride concentration in contrast to the mean increase that occurred in survivors. It is concluded that patients with moderate to severe hypertension who obtain a high level of general health care and optimal control of BP for up to 10 years, experience a significant decrease in total mortality rate and death from myocardial infarction and stroke. PMID- 3668250 TI - Serum ionized calcium and pH: effects of blood storage, some physiological influences and a comparison between normotensive and hypertensive subjects. AB - The effects on serum ionized calcium (ICa) and pH of different storage conditions of blood or serum, and of physiological influences such as over-ventilation, food intake and dietary sodium intake have been investigated. Temperature and time related changes in ICa occurred with storage and were minimized by immediate separation of serum and storage at 4 degrees C, (6 h or less). Elevation of serum ICa and a fall in pH accompanied increased salt intake; over-ventilation induced an elevation of serum pH and a reduction in ICa. Day-to-day intra-individual variation of ICa was 0.93%. We proceeded to examine a group of age-, sex- and race-matched hypertensive and normotensive subjects under standardized conditions designed to minimize such technical and physiological artefacts. ICa was not significantly different in the two groups; however, serum pH was significantly elevated in the hypertensive group. In the combined group of normotensive and hypertensive subjects, serum pH was significantly correlated with blood pressure. Exclusion of the black subjects from the analysis did not alter the findings. PMID- 3668251 TI - Immune response to human immunodeficiency virus. In vivo administration of anti idiotype induces an anti-gp160 response specific for a synthetic peptide. AB - Anti-idiotypic antibodies (anti-Id) to chimpanzee antibodies directed against a synthetic peptide corresponding to a native epitope associated with gp41 of human immunodeficiency virus (HIV) envelope glycoprotein were produced in rabbits. The peptide was analogous to amino acid sequences 735 to 752 from the human T cell leukemia virus-IIIB isolate of HIV. Characteristics of the anti-Id preparation included: 1) detection of a shared determinant present on a second chimpanzee and one of three rabbit antibody preparations directed against the synthetic peptide, 2) failure to recognize an idiotype (Id) in BALB/c mouse antisera to the peptide, and 3) partial inhibition of the homologous chimpanzee Id preparation from binding either peptide or a recombinant HIV gp160 preparation. Immunization of BALB/c mice with the anti-Id induced an antipeptide response which bound a recombinant gp160 preparation without subsequent peptide or gp160 exposure. The anti-gp160 containing sera from mice immunized with anti-Id were able to inhibit the Id-anti-Id reaction indicating that an Id-positive antibody response was induced. This Id is not normally expressed in the murine anti-gp 160 immune response to the synthetic peptide and suggests that this anti-Id may activate normally silent clones. This study indicates that Id networks may be operational during the immune response to HIV epitopes. Alternatively, anti-Id may be useful in altering the serologic characteristics of an antibody response to HIV and may offer potential for modulating the immune response in this viral infection. PMID- 3668252 TI - Formyl peptide leukocyte chemoattractant uptake and release by cultured human umbilical vein endothelial cells. AB - Recent observations support an active role for the vascular endothelial cell in the induction and evolution of the inflammatory response. Since prior studies suggested that cultured bovine endothelial cells express high affinity binding sites for the neutrophil chemotactic oligopeptide formyl methionyl-leucyl phenylalanine (f-Met-Leu-Phe), we sought to further characterize the interaction between formyl peptide chemoattractants and human vascular endothelial cells. Cultured human umbilical vein endothelial cells and peripheral blood neutrophils specifically bound f-Met-Leu-[3H]Phe, whereas specific binding to cultured fibroblasts, smooth muscle, and epithelial cells was negligible. Endothelial cells expressed 3.6 +/- 0.7 X 10(5) binding sites/cell with a Kd of 210 +/- 31 nM. Although the hexapeptide formyl norleucyl-leucyl-phenylalanyl-norleucyl tyrosyl-lysine (f-Nle-Leu-Phe-Nle-Tyr-Lys) and the tetrapeptide f-Met-Leu-Phe-Lys completed with f-Met-Leu-[3H]Phe for binding to endothelial cells, specific binding of 125I-f-Nl-Leu-Phe-Tyr-Lys or f-Met-Leu-Phe-Lys-fluorescein to endothelial cells was not observed, suggesting that steric constraints on formyl peptide binding differ between endothelial cells and leukocytes. At 37 degrees C, cell-associated f-Met-Leu-[3H]Phe greatly exceeded that bound at 0 degrees C and was incorporated predominantly into a nondisplaceable compartment. Release of f Met-Leu-[3H]Phe or radioactive breakdown products from this compartment was time- and temperature-dependent with a t1/2 of approximately equal to 20 min at 37 degrees C. Resolution of the radioactive products released from f-Met-Leu-[3H]Phe loaded endothelial cells by thin layer chromatography indicated that greater than or equal to 57% of the released material co-migrated with intact f-Met-Leu [3H]Phe. Degradative release was blocked by agents that interfere with lysosomal acidification. The radioactive material released from f-Met-Leu-[3H]Phe-loaded endothelial cells bound specifically to neutrophils. This binding was inhibited 50.2 +/- 6.4% by a greater than or equal to 10(3)-fold excess of nonradioactive f Met-Leu-Phe whereas binding of authentic f-Met-Leu-[3H]Phe was inhibited 89.4 +/- 3.0%. Supernatant obtained from f-Met-Leu-[3H]Phe-loaded endothelial cells elicited a rise in neutrophil cytosolic free calcium ([Ca2+]i) measured by quin2 fluorescence. The change in neutrophil [Ca2+]i depended on ligand binding to the neutrophil formyl peptide receptor since endothelial supernatants were devoid of activity in the presence of the f-Met-Leu-Phe antagonist, tert-butoxycarbonyl-Phe Leu-Phe-Leu-Phe.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3668253 TI - Analysis of rat natural killer cytotoxic factor (NKCF) produced by rat NK cell lines and the production of a murine monoclonal antibody that neutralizes NKCF. AB - Natural killer cytotoxic factor (NKCF) is produced as a result of the interaction of murine, rat, or human natural killer (NK) cells with NK-susceptible targets. This factor has been linked to the target cell lysis mediated by the NK effector cell. In the present results, culture supernatants from rat large granular lymphocyte (LGL) tumors exhibited NKCF activity which lysed the susceptible targets, MBL-2 and YAC-1. NKCF production from these rat tumor lines was spontaneous and was not significantly increased by co-incubation of the LGL tumors with target cells, target cell membranes, or by preincubation of the LGL tumor cells with interferon or interleukin 2. In addition to NKCF activity, the supernatants lysed L929, indicating the presence of tumor necrosis factor (TNF) in these preparations. The presence of this latter cytokine was verified using specific antibodies to recombinant murine TNF which neutralized the L929 activity while not affecting the NKCF activity against MBL-2 or YAC-1. Mouse monoclonal antibodies (mAb) A0287, A0462, and A0316) which significantly inhibit the NKCF cytolytic activity of these LGL-derived supernatants were also produced. These antibodies were shown to cross-react with human NKCF in a manner similar to that seen in the rat. Interestingly these same mAb demonstrated no inhibition of L929 cytotoxicity from either LGL-derived supernatants or by recombinant murine or human TNF. To examine further the specificity of these antibodies, they were chemically linked to Sepharose 4B and found to remove a significant proportion of the NKCF cytolytic activity from LGL supernatants, while not affecting the TNF reactivities in these preparations. In addition, these antibodies demonstrated significant inhibition of cell-mediated cytotoxicity by rat LGL against YAC-1 target cells. Biochemical analysis of labeled NKCF-containing supernatants indicated the major protein recognized by these anti-NKCF mAb to be approximately 12,000 m.w. The use of these mAb against NKCF should be very useful in further purification and biochemical characterization of NKCF and in studying its role in a variety of cell-mediated cytotoxicity assays. PMID- 3668254 TI - Density-dependent recognition of cell surface GM3 by a certain anti-melanoma antibody, and GM3 lactone as a possible immunogen: requirements for tumor associated antigen and immunogen. AB - A mouse monoclonal antibody M2590, previously established after immunization of mice (C57BL/6) with syngeneic melanoma B16 cells and showing preferential reactivity with various types of melanoma over other tumor and normal cells or tissues, was shown to be directed to GM3 ganglioside. Since GM3 is widely distributed in essentially all types of animal cells, there is a conflict with the concept of a tumor-associated antigen and immunogen. Studies on the reactivity of M2590 antibody with various cells having different GM3 density at their cell surface, including cells treated with sialidase, liposomes, and solid phase lipid layer containing different GM3 concentrations, have indicated that 1) reactivity of the antibody M2590 depends greatly on the density of GM3 exposed at the cell surface, on liposomes, or on solid phase; and 2) there is a threshold density that is recognized by the antibody in all-or-none fashion. In addition, the antibody M2590 reacts not only with GM3 but also with GM3 lactone, and the binding affinity of the antibody to GM3 lactone is strikingly higher than to GM3; however, the antibody does not react with GM3 ethyl ester. GM3 lactone was detected in melanoma as 3H-labeled GM3 gangliosidol after melanoma cells were directly treated with NaB[3H]4. A comparative immunization of BALB/c mice with GM3 and GM3 lactone showed that GM3 lactone is a much stronger immunogen than GM3, although the antibody elicited reacts with both GM3 and its lactone. Thus, the real immunogen could be GM3 lactone, although it is a minor membrane component. PMID- 3668255 TI - NC cells. PMID- 3668256 TI - Measurement of the alpha 2 component of a novel oncodevelopmental antigen by a rapid electroimmunoassay. AB - A method was required for the quantification of a novel oncodevelopmental antigen which increases in the serum of pregnant women as well as patients with ovarian cancer. The native antigen is composed of two components having alpha 2 and beta electrophoretic mobilities. An assay method, involving electroimmunodiffusion according to Laurell, was developed for the measurement of the alpha 2 component of the antigen. The method is sufficiently sensitive to determine significant differences in the levels of antigen in the serum of non-pregnant and pregnant subjects, and patients with ovarian cancer. In addition to routine quantitation, the technique will also be an indispensable analytical tool in the purification of the protein. PMID- 3668257 TI - An improved method for elimination of mycoplasmas from cell cultures. AB - Cell lines infected by different species of mycoplasma (Mycoplasma orale, Mycoplasma hominis) were decontaminated by co-culture with human blood monocyte (BM)-derived macrophages and pooled human immunoglobulin preparations. Co cultures with BM-derived macrophages or murine peritoneal macrophages (PM) alone were not successful. The phenotype of infected cell lines did not differ from that of uninfected cell lines as revealed by morphological, enzymecytochemical, and immunocytochemical analysis. PMID- 3668258 TI - Statistical considerations in the quantitation of serum immunoglobulin levels using the enzyme-linked immunosorbent assay (ELISA). AB - Several methods for analyzing ELISA data have been evaluated using optical density values derived by reacting serial two-fold dilutions of a rhesus monkey (Macaca mulatta) reference serum with dilutions of peroxidase-conjugated monospecific antisera to human IgG and IgM in the micro-ELISA 'sandwich' technique using microplates coated with appropriately diluted antisera to human IgG and IgM. Representation of optical density as a linear function of log serum dilution was shown to be inappropriate and potentially misleading. Weighted non linear least squares analysis of a 4-parameter logit was demonstrated to be inappropriate because it required the specification of a somewhat arbitrary variance function and weight estimates varied substantially depending on the function used. Representation of optical density as a 4-parameter logistic function with estimation carried out on the log scale was shown to be the most appropriate procedure for determining the concentration of antigens or antibodies by the ELISA method. PMID- 3668259 TI - Determination of lysozyme activity by fluorescence polarization in rheumatoid synovial fluids and release of lysozyme from polymorphonuclear leukocytes by chemotactic factors. AB - A new method for the measurement of lysozyme activity, which is rapid, quantitative and sensitive, was established and applied to clinical material obtained from arthritis patients. The method is based on fluorescence polarization with the use of fluorescein isothiocyanate-labeled peptidoglycan. Using this method, we found that the synovial fluids obtained from rheumatoid arthritis contained more lysozyme activity than similar samples from osteoarthritis patients (P less than 0.001). Furthermore, we found that chemotactic factors and lysozyme-depleted rheumatoid synovial fluids could induce the release of lysozyme from human polymorphonuclear leukocytes in vitro. It is therefore suggested that lysozyme present in rheumatoid synovial fluids may derive in part from polymorphonuclear leukocytes and the action of chemotactic factor(s) within the fluids. PMID- 3668260 TI - Composition of IgA immune complexes precipitated with polyethylene glycol. A model for isolation and analysis of immune complexes. AB - Covalently cross-linked large and intermediate-sized IgA oligomers, prepared with IgA anti-dinitrophenyl (DNP) and bis-DNP-pimelic acid ester, were used to examine the ability of different concentrations (3.5%, 5% and 7%, w/v) of polyethylene glycol (PEG) to precipitate IgA immune complexes (IgA-IC). The size of the IgA-IC precipitated with PEG was determined by gradient polyacrylamide gel electrophoresis and quantitative autoradiography. The standard concentration of 3.5% PEG precipitated only a minor fraction (20%) of the IgA-IC. In contrast, 5% and 7% PEG precipitated 45% and 79% of the complexes, respectively. To test the influence of the antigen on the PEG assay. IgA-IC prepared with IgA anti-DNP and DNP conjugates of either bovine serum albumin or Ficoll were also used. Approximately 38% of these IgA-IC were precipitated with 3.5%, PEG. By comparison, the concentration of 5% and 7% PEG precipitated 60% and 76% of the IgA-IC, respectively. Distilled water rather than the standard borate-buffered saline was shown to be the optimal solvent for resolubilization of the PEG precipitates. Serum samples from 22 IgA nephropathy patients and 12 normal donors were tested with 3.5%, 5% and 7% PEG. Only the 7% PEG assay showed a significant difference between patients and controls (P less than 0.001) in the IgA levels of precipitates. Thus, the use of 7% PEG is recommended for the detection, isolation and analysis of large- and intermediate-sized IgA-IC. PMID- 3668261 TI - Ultrasensitive immunoradiometric assay for chorionic gonadotropin which does not cross-react with luteinizing hormone nor free beta chain of hCG and which detects hCG in blood of non-pregnant humans. AB - We have developed a sensitive, non-competitive, two-monoclonal antibody, sandwich type or immunoradiometric assay for human chorionic gonadotropin (hCG) which shows no cross-reaction with the free beta chain of hCG nor with human luteinizing hormone (LH). In the assay procedure, two, highly selected monoclonal antibodies reacted in solution with hCG to be quantified. One antibody was covalently conjugated to biotin. This antibody was specific for the beta subunit of hCG, and showed no reaction with LH nor the alpha subunit. The second antibody was labelled with 125I and was specific for intact hCG and LH, showing no cross reaction with beta hCG nor the alpha subunit. The separation system was a polystyrene ball conjugated with biotin. This ball bound via an avidin bridge the monoclonal 'sandwich' containing hCG. Counts per minute bound to the ball were directly proportional to the amount of hCG present. The assay was specific for whole hCG and showed no reaction with beta hCG, beta LH, intact LH nor the free alpha subunit. Sensitivity was adequate to detect 'hCG-like' material in all post menopausal women and, when single samples were obtained, in over 2/3 of normal men. When multiple samples were obtained, 'hCG-like' material was detectable in all eugonadal adults studied. PMID- 3668262 TI - Paradoxical responses during the chemotherapy of tuberculosis. PMID- 3668263 TI - Atypical meningococcal meningitis. PMID- 3668264 TI - Mycoplasma hominis meningitis in a preterm infant. PMID- 3668265 TI - Rat-bite acquired leptospirosis. AB - We report a case of leptospirosis in a boy following a rat-bite, an unusual mode of transmission for this infection. The use of antibiotics for fever following a rat-bite is discussed. PMID- 3668266 TI - Acyclovir in the treatment of neonatal varicella. AB - We describe two cases of neonatal varicella and the role of acyclovir in their treatment. PMID- 3668267 TI - AIDS in an infant causing severe failure to thrive. AB - A nine-month-old female Jamaican infant presented with a history of severe failure to thrive, recurrent pneumonia and developmental delay. She was found to have hepatosplenomegaly, generalised lymphadenopathy and hypotonia. Investigations revealed polyclonal hypergammaglobulinaemia, cytomegalovirus in her urine, and patchy lung infiltrates on her chest radiographs. Three separate tests were positive for human immunodeficiency virus in both the infant and her mother, suggesting vertical transmission, and confirming AIDS as the cause of the severe failure to thrive. PMID- 3668268 TI - A hospital outbreak of antibiotic-resistant Streptococcus pneumoniae. AB - We report six patients colonised with a multiply resistant strain of Streptococcus pneumoniae. PMID- 3668269 TI - Neutropenia associated with dual antimalarial chemoprophylaxis--use of bone marrow culture as an aid in further drug management. AB - Bone-marrow culture in soft agar was used to determine the cause of neutropenia in a visitor to Tanzania who had been taking both amodiaquine and proguanil for antimalarial prophylaxis. Desethyl-amodiaquine, a major metabolite of amodiaquine (but not amodiaquine itself, proguanil, cycloguanil or chloroquine) was implicated. Supplementary studies using amodiaquine binding techniques supported the notion that the parent compound, amodiaquine, was not the cause of the neutropenia. The bone-marrow culture technique proved useful in deciding further anti-malarial prophylaxis and in formulating the choice of curative antimalarial therapy, should this have proved necessary. The procedure may help in the managing other such patients with presumed drug-induced blood dyscrasias when the choice of appropriate and effective antimalarial drugs is limited. PMID- 3668270 TI - Assessment of an immunoassay for interferon-alpha in cerebrospinal fluid as a diagnostic aid in infections of the central nervous system. AB - A highly sensitive and specific immunoradiometric assay, based upon a monoclonal antibody, was used to measure interferon-alpha (IFN-alpha) in the cerebrospinal fluid (CSF) of patients with central nervous system infections and in controls with non-infectious neurological disorders. IFN-alpha was detected in all 21 patients with viral meningitis but in only one of four patients with non-viral aseptic meningitis. It was also present in the CSF of three of four patients with herpes encephalitis and five of seven patients with acute bacterial meningitis. By contrast, IFN-alpha was present in the CSF in low concentrations in only five (7%) of 71 neurological controls. This rapid test is positive in viral meningitis and may help in distinguishing viral infection from other causes of aseptic meningitis. It is usually negative in non-infective disorders but will not distinguish between viral and bacterial infections. PMID- 3668271 TI - Haemophilus aphrophilus as a cause of chronic suppurative pulmonary infection and intra-abdominal abscesses. AB - A chronic Haemophilus aphrophilus pulmonary infection associated with the formation of intra-abdominal abscesses in a previously healthy 38-year-old man is described. Other reports have related the isolation of H. aphrophilus to underlying malignant disease or, when the cause of endocarditis, to pre-existing valvular disease. The underlying condition, if any, in this case remains unclear. PMID- 3668272 TI - Brachial neuritis following infection with Epstein-Barr virus. AB - A 54-year-old woman developed stiffness across the shoulders and a mild headache during a motorcycle tour of the U.S.A. On return to the U.K. she complained of persisting exhaustion and painful muscles. Hospital admission was precipitated by her developing weakness in the right arm and paraesthesiae in the fingers. She was found to be suffering from infectious mononucleosis. PMID- 3668273 TI - Hepatitis B virus markers in the population of Dar es Salaam, Tanzania. AB - A total of 542 serum samples from healthy adults (medical students and medical staff, blood donors and pregnant women) residing in or near the city of Dar es Salaam, Tanzania were examined for markers of hepatitis B virus (HBV) infection. Of these samples, 95 (17.5%) were not found to contain any HBV marker when examined by enzyme-linked immunoassay for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc). HBsAg was demonstrated in 52 (9.6%) samples of which 7 (13.5%) were positive for hepatitis Be antigen (HBeAg) and 17 (32.7%) were positive for anti-HBc IgM. None of 9 HBsAg positive pregnant women were carriers of HBeAg. These results show that hepatitis B infection is very common in this country. The relatively low prevalence of HBeAg among HBsAg carriers may indicate that transmission of hepatitis B at birth is not of major importance. PMID- 3668274 TI - Acute infection with human immunodeficiency virus associated with facial nerve palsy and neuralgia. PMID- 3668275 TI - Successful use of oral acyclovir to prevent herpes simplex-associated erythema multiforme. PMID- 3668276 TI - Immune thrombocytopenia in pregnancy and the newborn: a review. PMID- 3668277 TI - Measurement of the rate of epidermal terminal differentiation: expression of involucrin by S-phase keratinocytes in culture and in psoriatic plaques. AB - At present little is known about the control mechanisms involved in coordinating cell production and maturation in epidermis. To investigate this, we have measured the rate of transit from the proliferative to the terminally differentiating compartment in confluent low-calcium cultures of normal epidermal keratinocytes, using involucrin as a marker of terminal differentiation. We estimate a rate of transit of 3.58 cells/5000 cells/h and a differentiation probability of 0.017, indicating a bias toward self-renewal. Surprisingly, some cells in culture synthesized DNA and expressed involucrin simultaneously. In psoriatic plaques, involucrin expression begins closer to the basal layer than in normal epidermis, and here too we found S-phase involucrin-positive cells. We also observed occasional mitotic involucrin-positive cells in psoriatic epidermis, although we were unable to detect them in culture. Our experiments show that temporal separation of proliferation and terminal differentiation is not obligatory, and thus, the kinetic organization of epidermis may be less rigid than some models imply. PMID- 3668278 TI - Pathway of granule formation in Merkel cells: an ultrastructural study. AB - Merkel cells (MC) are characterized by dense core granules morphologically similar to secretory granules of endocrine cells, as well as the presence in their cytoplasm of organelles involved in polypeptide synthesis. The aim of this study was to follow the pathway of granule formation in MC. Four compartments, the cis and trans Golgi cisternae, the condensing granules in the Golgi stacks, the bristle-coated granules, and the noncoated granules, are observed by transmission electron microscopy in MC. This suggests that: (1) the organelles usually involved in the formation of secretory polypeptides are present in the cytoplasm of MC; (2) the pathway of Merkel cell granule (MCG) formation appears to be similar to that of secretory endocrine or exocrine cells; and (3) MC might be involved in a secretory process. PMID- 3668279 TI - Staining of neuroendocrine Merkel cells of human epidermis using the uranaffin reaction. AB - The uranaffin reaction (UR) stains neurosecretory (NS) granules of the neuroendocrine system under certain experimental conditions of staining and rinsing solutions. Human normal neuroendocrine (NE) Merkel cells stained using the UR exhibit a positive reaction in their NS granules, ribosomes, and nuclear chromatin. The average values of maximum granular diameter (GD = 69.1 nm) and area (GA = 3637.8 mm2) of NS granules measured in the adult NE Merkel cells stained with UR are significantly greater than those (GD = 61.4 nm; GA = 2699.8 nm2) seen in the fetal NE Merkel cells also stained with UR. No differences in form factor are found between fetal and adult NS granules. On different samples of human adult and fetal epidermis it is demonstrated that UR is a useful cytochemical marker for the NS granules of normal NE Merkel cells. PMID- 3668281 TI - Absorption mechanisms of human melanin in the visible, 400-720 nm. AB - In this paper we propose that human melanin absorbs visible radiation through two distinct mechanisms: one that is in effect over the entire visible range and is linear in wavelength, and a second one that is evident at wavelengths in the range 400-500 nm and is exponential in frequency. These mechanisms are apparent in all human diffuse reflectance spectra that we have collected. We show that the absorber is the same in all human volunteer skin samples. By studying the diffuse reflection spectra of DOPA-melanin in solution and DOPA-melanin in powder form, we find that we can correlate the absorption mechanisms, one with melanin in solution (a low molecular weight form) and the other with melanin in powder (a high molecular weight form). Therefore, we propose that melanin exists in two distinct states. This model is of biologic significance, as it provides a reasonable interpretation for the diffuse reflection spectra obtained from delayed pigment (UVB-induced) and immediate pigment (UVA-induced). Delayed pigment appears as an increase of both forms of melanin (neomelanogenesis), whereas immediate pigment appears as an increase in the higher molecular weight form with a commensurate decrease in the lower molecular weight form: the two mechanisms change independently of each other. Finally, we show that we can distinguish spectroscopically between the delayed pigment and the immediate pigment. PMID- 3668280 TI - Evaluation of triacontanol-containing compounds as anti-inflammatory agents using guinea pig models. AB - A mixture of the aliphatic alcohol, triacontanol, and other chemically associated naturally occurring alcohols was applied to the denuded dorsal cutaneous surface of guinea pigs to evaluate anti-inflammatory activity. In the setting of a chemical irritation with 2% croton oil and in an allergic dermatitis created with dinitrochlorobenzene sensitization and challenge, the triacontanol-containing preparation was significantly more effective than vehicle alone (DHL skin cream) but not as effective as 0.05% Diprolene ointment. Lymphocyte stimulation was studied by tritiated thymidine uptake and morphologic examination for blast transformation. When triacontanol-containing compounds were solubilized in aqueous media, effects on lymphocytes were insignificant. When solubilized in ethanol, there was a marked effect on thymidine uptake but not on blast transformation when compared to parallel controls. PMID- 3668282 TI - Abnormalities of plasma and erythrocyte essential fatty acid composition in epidermolysis bullosa: influence of treatment with diphenylhydantoin. AB - The fatty acid composition of plasma and erythrocyte phospholipids was determined in children with various subtypes of epidermolysis bullosa (EB) and in their parents. Patients with recessive dystrophic, dominant dystrophic, simplex, or junctional forms of EB had a higher percentage composition of arachidonic acid in plasma and/or erythrocyte phospholipids compared to age-matched controls. Epidermolysis bullosa patients treated with diphenylhydantoin had lower levels of arachidonic acid in plasma and erythrocyte phospholipids than did untreated EB patients. Parents of children with the recessive dystrophic or junctional EB subtypes had higher linoleic and arachidonic acids in plasma and erythrocyte phospholipids than did controls. Plasma and erythrocyte total lipids were within the normal range in children with EB. Plasma zinc was also normal but plasma copper was elevated in children with recessive dystrophic EB. We conclude that higher arachidonic acid in plasma and erythrocytes may be related to the pathology of EB. PMID- 3668283 TI - An animal model for evaluation of topical photoprotection against ultraviolet A (320-380 nm) radiation. AB - Recent studies reporting UVA (ultraviolet A radiation 320-380 nm) as an integral part of the cumulative sun-induced damage in human skin have prompted an interest in developing effective UVA photoprotective agents. The development of such compounds has been impeded by the absence of a clinically relevant animal model for evaluating their efficacy. This report describes the development and use of such a laboratory animal system. Selected concentrations of oxybenzone (2-hydroxy 4-methoxybenzophenone) in vehicle (0.1% to 6%) or vehicle alone were applied to the depilated dorsal skin of 30 Hartley strain female albino guinea pigs. The skin was irradiated with solar simulated UVA from a xenon light source. Acute radiation-induced damage was assayed by erythema grading and inhibition of [3H]thymidine incorporation into epidermal DNA. Data from erythema grading studies indicated that a significant degree of photoprotection was achieved with 6%, 3%, and 1% solutions of benzophenone compared with the control vehicle; the 6% solution was significantly more photoprotective than the 3% and 1% solutions. A 6% solution afforded significant photoprotection when assayed by [3H]thymidine incorporation. PMID- 3668284 TI - Composition and morphology of epidermal cyst lipids. AB - The contents of epidermal cysts were used as a source of desquamated human keratinocytes uncontaminated by sebaceous, subcutaneous, or bacterial lipids. Lipids extracted with chloroform:methanol mixtures included six series of ceramides (41% of the total extractable lipid), cholesterol (27%), cholesteryl esters (10%), fatty acids (9%), cholesteryl sulfate (1.9%), a novel class of ceramide esters (3.8%), and a sterol diester (0.9%). Electron microscopy revealed that the lipids in the cyst contents existed as multiple intercellular lamellae, as in stratum corneum. One lamella, adjacent to the horny cell protein envelope, was resistant to lipid extraction and is thought to represent covalently bound lipid on the outer surface of the keratinocyte. The results indicate that the degradation of intercellular lipid lamellae is not required for desquamation. PMID- 3668285 TI - Effect of dimethylsulfoxide concentration on the permeability of neonatal rat stratum corneum to alkanols. AB - The effect of dimethylsulfoxide (DMSO) concentration on the permeability of neonatal rat stratum corneum to 14C labeled propan-1-ol and hexan-1-ol was studied in vitro. The permeability coefficients were determined from a range of DMSO-water systems. After soaking in water overnight, the same stratum corneum was used with water as both delivery and recipient phases for the alkanols. Concentrations below 70% DMSO reduced the penetration rate as a result of the solvent effect of DMSO and the formation of a DMSO-alkanol complex. Above 70% DMSO permeability increased, with a permeability coefficient greater than that from water being achieved at concentrations in excess of 80% DMSO. The second run, with water as delivery phase, showed that the effect was reversible below 70% DMSO, but that at higher concentrations DMSO had produced an irreversible change in the permeability of stratum corneum. We hypothesize a hydrogen bond mediated mechanism for the increased permeability. PMID- 3668286 TI - Effect of preheating on the permeability of neonatal rat stratum corneum to alkanols. AB - We heated flat sheets of neonatal rat stratum corneum for various times at temperatures between 40 and 90 degrees C before determining the permeability coefficient (Kp) of propanol and/or hexanol from water. Below 70 degrees C, Kp remained constant; at 75 degrees C, Kp increased linearly with exposure time; at 80 degrees C and above, there was a large increase in under 2 h, with no further increase on longer heating. There was a 15-fold increase in 6-h Kp between 70 degrees C and 80 degrees C, values being constant above 80 degrees C but at a figure less than for lipid-extracted stratum corneum. Thermal analysis showed that the increase in Kp corresponds to changes in the 80 degrees C lipid endotherm, suggesting that the increased Kp is due to a disordering of the lipid structures. The effect of treating preheated stratum corneum with dimethylsulfoxide (DMSO) vapor for 16 h was also studied. Below 70 degrees C, Kp was increased five-fold, but between 70 and 80 degrees C this difference was eliminated, so that above 80 degrees C the Kp was the same as with heat treatment alone. We concluded that both heat and DMSO affect the lipid structures of stratum corneum. DMSO produced a small, reversible structural change, while the effect of heat is irreversible and produces a greater degree of disorder in the lipid structures, but the lipid still contributed to the barrier effect of stratum corneum. PMID- 3668287 TI - Is GP37 related to human filaggrin? PMID- 3668288 TI - Cyclosporin A and epidermal cell growth. PMID- 3668289 TI - Fourteenth annual ADF meeting. Arbeitsgemeinschaft Dermatologische Forschung. Freiburg, F.R.G., November 13-16, 1986. Abstracts. PMID- 3668290 TI - Characterization of monoclonal antibodies generated to the cornified envelope of human cultured keratinocytes. AB - The cornified envelope of keratinocytes is an insoluble structure formed beneath the plasma membrane at the base of the stratum corneum. It is made by cross linking precursor proteins by a membrane-associated transglutaminase. We have prepared monoclonal antibodies to the cornified envelope of cultured human keratinocytes and used these to identify precursor proteins using Western blotting. We have uncovered a number of precursors including involucrin and a 195 kD membrane-associated protein, which had previously been reported. Antibodies to these precursors, with the exception of the one to involucrin, reacted with the epidermis of other mammalian species, suggesting structural conservation in at least some envelope components. PMID- 3668291 TI - Serum-free serial culture of adult human keratinocytes from suction-blister roof epidermis. AB - Coating cell culture flasks with natural extracellular matrix (ECM) enhanced the culture of adult human keratinocytes from suction-blister roof epidermis in an environment without fetal calf serum (FCS), bovine pituitary extracts or cellular feeder layers. A higher incidence of cell attachment on natural ECM was observed than on collagen and human fibronectins (HFN)-coated plastic dishes, and natural ECM was necessary for growth and proliferation of attached cells under the culture conditions used. Cells in primary culture grew to confluency on natural ECM-coated surfaces within about 14 days, and subsequent serial passage could be made up to fourth passage in collagen- and HFN-coated plastic flasks. Cultured keratinocytes in this serum-free environment formed colonies of small cuboidal, healthy cells with little keratinization or stratification and demonstrated antigenic characteristics of human basal cells. PMID- 3668292 TI - Functional heterogeneity of immune complexes in epidermolysis bullosa acquisita. AB - Epidermolysis bullosa acquisita is an inflammatory subepidermal bullous disease characterized by circulating and tissue-bound complement-binding anti-basement membrane zone autoantibodies to type VII procollagen. Lesions are characterized by neutrophil-predominant inflammation in some patients, but not in others. These features suggest complement activation and generation of complement-derived chemotactic factors for leukocytes by basement membrane zone immune complexes may contribute to inflammation, but that complexes may be heterogeneous in the ability to express that function. In this study, we measured the ability of basement membrane zone complexes from patients with (n = 4) and without (n = 6) neutrophil predominant inflammation to activate complement and generate complement-derived chemotactic activity using a complement-dependent neutrophil attachment assay. The results showed considerable heterogeneity in neutrophil attachment among EBA patients and that both the incidence (4/4 vs 2/6) and magnitude (81 +/- 34 vs 12 +/- 10 neutrophils/mm basement membrane zone) of attachment were greater in patients with neutrophil-predominant inflammation. Functional heterogeneity appeared to be due to differences in the amounts of complement-activating complexes formed at the basement membrane zone, which in turn appeared to be due to differences in the availability of circulating complement-binding anti-basement membrane zone antibodies. This was suggested by a positive correlation (r = 0.72, p less than 0.01) between neutrophil attachment and complement-binding anti-basement membrane zone antibody titers and the observation that high levels of neutrophil attachment could be generated in skin from patients with epidermolysis bullosa acquisita who did not have neutrophil predominant inflammation by treating their skin in vitro with complement-binding anti-basement membrane zone antibodies. These results suggest tissue complexes in epidermolysis bullosa acquisita are heterogeneous in the ability to activate complement and generate complement-derived chemotactins (C5a, C5a des arg), and that functional heterogeneity contributes to histologic heterogeneity. The functional immunologic-pathologic correlations observed in this study suggest epidermolysis bullosa acquisita is an autoimmune "collagen" disease. PMID- 3668293 TI - Changes in cell surface glycoprotein expression during differentiation of human keratinocytes. AB - Six cell surface glycoproteins defined by monoclonal antibodies were selected for study on human epidermal cells. In tests on tissue sections, three of the glycoproteins [J143 (gp140/30); T43 (gp85/36); H99 (gp38)] were expressed in the basal cell layer of the epidermis, whereas the other three glycoproteins [T179 (gp140/95); T16 (gp40/50); BT15 (gp80)] were preferentially expressed in maturing keratinocytes above the basal layer. We compared synthesis of these glycoproteins in fresh epidermis and in primary epidermal short term cultures using [35S]methionine for metabolic labeling. Synthesis of J143 was 8- to 20-fold higher and synthesis of T43 was 4- to 10-fold lower in cultured cells compared with fresh epidermis. BT15, an antigen strongly expressed on terminally differentiating keratinocytes, was synthesized at 5- to 15-fold higher levels in fresh epidermis than in cultured cells. Biosynthesis levels of H99, T179, and T16 did not change in cultured epidermal cells. Based on our findings, we propose a model of surface antigenic changes that occur during keratinocyte differentiation in vivo. PMID- 3668294 TI - Effect of aging on sebaceous gland activity and on the fatty acid composition of wax esters. AB - Using fused-silica capillary gas chromatography, we investigated sebum samples from 55 healthy individuals to discover the effects of aging on the sebaceous gland activity and on the fatty acid composition of wax exters. The sebaceous gland activity, which was expressed by the ratio of wax esters/[cholesterol + cholesterol esters] (WE/[C + CE]), showed a distinct change from infancy through maturity to senescence; the curve of the ratio made a peak in our subjects's 20s. Using the fatty acid analyses, we found an interesting relationship between C16:1 straight and C16:1 iso-branched chains, each of which occupied a large proportion in the fatty acids of wax esters; the former increased in proportion from infancy toward the 20s, with a correlation with aging (r = 0.788, p less than 0.01), and decreased thereafter until our subject's 50s (r = -0.611, p less than 0.01). In contrast, the proportion of the latter followed an entirely reversed course with advancing age. The percentages of C16:1 straight chain components were correlated positively with the WE/[C + CE] ratio (r = 0.642, p less than 0.01), while there was found to be a negative correlation between the proportion of C16:1 iso branched chain components and the WE/[C + CE] ratio (r = -0.556, p less than 0.01). The results suggest that more active sebaceous glands in lipid production excrete lipids with a higher proportion of C16:1 straight chain fatty acid and a lower proportion of C16:1 iso-branched chain fatty acid. As well as the sebaceous gland activity, the fatty acid composition in sebum wax esters is affected by advancing age in Japanese. PMID- 3668295 TI - Low density lipoprotein receptor expression on keratinocytes in normal and psoriatic epidermis. AB - Biochemical and morphologic studies on the interaction of low density lipoprotein (LDL) with cultured normal keratinocytes and squamous carcinoma cells have shown a negative correlation between LDL receptor activity and terminal differentiation of the epidermal cells [Ponec M et al, J Invest Dermatol 83:436-440, 1984 and Vermeer, BJ et al, J Invest Dermatol 86:195-200, 1986]. Whether such in vitro studies pertain to the epidermis in vivo is not known. To obtain information on the distribution of LDL receptors in the epidermis in situ, morphologic studies were performed using LDL-gold as an ultrastructural marker. When freshly isolated mouse and human epidermal cells were incubated with LDL-gold complexes, only keratinocytes with the morphologic characteristics of basal cells showed binding and uptake of LDL-gold. No LDL receptor activity was found on Langerhans cells, melanocytes or highly differentiated keratinocytes. Since cell separation techniques can destroy receptors, the staphylococcal epidermolytic toxin was utilized to produce intercellular and intra-epithelial splitting of the epidermis. In preparations of both normal mouse and human epidermis, LDL-gold binding was restricted to basal cells and a few suprabasal keratinocytes. In contrast, in psoriatic epidermis, and to a lesser extent, essential fatty acid deficient mouse epidermis, cells in the stratum spinosum showed abundant LDL-gold binding. Thus LDL-gold may be a useful marker for epidermal differentiation. PMID- 3668296 TI - Capacitive radiofrequency hyperthermia in the treatment of cutaneous murine melanoma. AB - We have evaluated localized capacitive radiofrequency hyperthermia in the treatment of murine S91 melanoma. Two hundred and ten DBA/2J male mice were implanted with 1 X 10(6) S91 murine melanoma cells innoculated into a noninflammatory upper dermal suction blister cavity. Two tumors were implanted per animal, so that each animal served as its own control in evaluating the effects of temperature, treatment duration, and tumor size on tumor growth following radiofrequency hyperthermia treatment. The data supported the following conclusions: (1) capacitive radiofrequency hyperthermia is effective in the treatment of murine S91 melanoma; (2) duration of treatment between 10 and 60 seconds at 52 degrees C does not influence effectiveness; and (3) treatment temperatures greater than 49 degrees C are needed for maximal effectiveness in the treatment of these tumors. Based on these preliminary findings, high temperature, short duration capacitive radiofrequency hyperthermia may prove to be a useful modality in the treatment of certain cutaneous malignancies. PMID- 3668297 TI - Reduced expression of surface receptors for synthetic N-formylated chemotactic oligopeptides by stimulated peripheral blood neutrophils in psoriasis. AB - Receptors for synthetic N-formylated chemotactic peptides on peripheral blood neutrophils were studied by the binding of fluorescein-labeled hexapeptide (N formyl-Nle-Leu-Phe-Nle-Tyr-Lys) to the cells in vitro at the range of concentrations 0.01-100 nM. Mean fluorescence of neutrophils was quantitated by a flow cytometry using FACS III. Comparison was made between 27 patients with psoriasis vulgaris and 14 normal controls. Various receptor states related to cell activities were induced by different temperatures, by incubation of cells with cytochalasin B and by preincubation with nonlabeled N-formyl-Met-Leu-Phe. This allowed us to distinguish between the specific binding of fluoresceinated hexapeptide to plasma membrane receptor already present (0 degree C), modulation of receptors by peptide and cytochalasin B stimulated degranulation (25 degrees C), and net binding, including internalization of peptide and receptor recycling system (37 degrees C). At peptide concentrations of 1-10 nM, the labeling of neutrophils at 25 degrees C and 37 degrees C, but not at 0 degree C, was found to be about 10-35% lower in psoriatic than in healthy subjects (p less than 0.002). The amount of fluorescein-labeled peptide bound to the cells at 25 degrees C was markedly increased by cytochalasin B, but to a much lower extent in psoriatic patients than in normal controls. Although the number of plasma membrane receptor for chemotactic peptides in the nonstimulated neutrophils was not altered in psoriasis, the receptor up-regulation induced by preincubation of the cells with 1-10 nM of nonlabeled N-formyl-Met-Leu-Phe at 37 degrees C was reduced when measured by subsequent fluoresceinated hexapeptide uptake at 0 degree C. Receptor recycling, as measured by an increase with time (0-30 min) in the binding of chemotactic peptide by neutrophils in which receptors had been down-regulated, was found to be within normal range in patients with psoriasis. These data indicate that nonstimulated, circulating neutrophils have a normal number of chemotactic peptide receptors on the cell surface, but are less able to recruit intracellular receptors to the cell surface. This finding may be related to smaller internal pools or less efficient translocation of these receptors. PMID- 3668298 TI - Adherence of dermatophyte microconidia and arthroconidia to human keratinocytes in vitro. AB - The early interaction, adherence, between dermatophyte conidia and human keratinocytes has been studied in vitro. Two spore forms were used: microconidia and arthroconidia produced in vitro. The adherence of spores from three dermatophyte species, Trichophyton rubrum, T interdigitale, and T quinckeanum, was investigated using keratinocyte suspensions from different skin sites. Time dependent adherence was demonstrated for all fungi studied with maximum adherence occurring between 3 and 4 h. There were no significant differences in adherence rates between the organisms studied. An order of affinity was established between keratinocytes from different sites and significant differences were demonstrated in adherence of microconidia to skin cells derived from sole versus knee. No differences in adherence rates were demonstrated in atopics versus patients with chronic dermatophytosis and normals. Adherence was inhibited, but not abolished, by subinhibitory concentrations of ketoconazole, itraconazole, and griseofulvin. The interaction between microconidia, arthroconidia, and keratinocytes was verified with scanning and transmission electron microscopy. PMID- 3668299 TI - Assessment of successful valve reconstruction by intraoperative transesophageal echocardiography (TEE). AB - In 17 patients (10 patients with mitral insufficiency, 5 patients with tricuspid regurgitation, 2 patients with mitral stenosis) the result of valve reconstruction was evaluated by intraoperative two-dimensional transesophageal contrast-echocardiography (TEE). Therefore, 1-2cc of an agitated contrast-medium (Gelifundol) were injected into the left or right ventricle. The result of reconstruction was assessed by the extent of regurgitant microbubbles into the left or right atrium. A successful valve repair could be demonstrated in 15 patients without or with only minimal regurgitation of contrast-fluid. In one patient residual severe mitral insufficiency after valve reconstruction could only be detected when valve function was examined by contrast-TEE in the beating heart. An intraoperative decision for valve replacement was made. In another patient, mild to moderate residual mitral incompetence was shown; no further surgical intervention was done. By TEE the function of reconstructed valves can be examined under physiological conditions in the beating heart. Surgeons can obtain additional intra-operatively information and certainty about the result of reconstruction and an early decision for valve replacement can be made if necessary. PMID- 3668300 TI - Aortic dissection detected by transoesophageal echocardiography. AB - The diagnostic value of transoesophageal echocardiography was evaluated in 24 patients with aortic dissection and compared to transthoracic two-dimensional echocardiography, computer tomography, aortography, surgery and autopsy. Using transoesophageal echocardiography we found in 5 patients a type I dissection, in 5 patients a type II and in 14 patients a type III dissection. Transthoracic two dimensional echocardiography was positive in 3/5 type I, 2/5 in type II and 2/14 in type III dissections. Computer tomography was unable to demonstrate an intimal flap in 1/2 patients with type I, 2/3 type II and 1/11 type III dissections. Aortography was negative in 1/4 type I, 3/5 type II and 3/12 patients with type III dissection. Additional information concerning thrombus formation, localisation of the entry tear, differentiation between true and false lumen, flow dynamics within the true and false lumen as well as accompanying aortic regurgitation may be obtained by transoesophageal echocardiography. PMID- 3668301 TI - Transvenous coronary angiography in dogs using synchrotron radiation. AB - The application of coronary angiography is limited because it requires arterial invasion and the direct injection of contrast agent into the coronary arteries. A prototype system has been developed which achieves sufficient sensitivity to the iodinated contrast agent to allow the visualization of coronary arteries in dogs after its intravenous injection. The system uses two fan beams of x-rays from an electron storage ring and a 300 element linear silicon detector. Two interlaced images, spaced at 150 eV above and below the K absorption edge of iodine (33.2 keV), are acquired and the logarithmic subtraction of these two images produces an image which has maximal sensitivity to iodine and minimal sensitivity to soft tissue and bone. This approach appears suitable for studies on human subjects. PMID- 3668302 TI - On-line mapping system for the visualization of the electrical activation of the heart. AB - A simple but still versatile datalogging system based on a VCR (video cassette recorder) has been developed. The VCR allows mass storage of data originating from a maximum of 256 channels as used, for example, in the recording of the time dependent potential distribution at the surface of the myocardium. Incorporated in the system is a display memory allowing on-line simultaneous visualization of the assessed recordings of 16 channels. On an interactive base display parameters (time-window, channel-selection) can be altered without loss of data. A link with a personal computer allows modification of system parameters and storage of data for off-line analysis of the recorded data. The high data rate to and from the VCR (4.3 MHz) fully utilizes the bandwidth available. A normal videotape can, therefore, contain up to 2 Gigabyte of data. Despite this, the use of the tapecounter and the decoding of the time-code inserted into the signal allows quick retrieval of the stored data without needing expensive equipment. The system described brings mass data logging within the reach of a vast number of laboratoria and cardiovascular centers. PMID- 3668303 TI - Mapping impulse propagation in the heart: an approach to the study of arrhythmogenesis. AB - A recording system is described which enables extracellular electrical activity from a large number of sites on the in situ heart to be registered simultaneously. The usefulness of this approach for the study of arrhythmogenesis is discussed. PMID- 3668304 TI - Interferon treatment of human stomach and breast carcinoma xenografts in nude mice. AB - Comparative effects of natural and recombinant interferons (IFNs)-alpha and -beta on xenografted human gastric and breast carcinoma lines in nude mice were studied. The lines were sensitive to IFNs. The breast carcinoma lines were more sensitive than the gastric carcinoma lines to IFNs. Natural IFN-beta was more effective than the other three IFNs on the gastric carcinoma lines. One breast carcinoma line was more sensitive to IFN-alpha whereas the other was more sensitive to IFN-beta. Large doses and frequent injections of IFNs were necessary for optimal effectiveness. PMID- 3668305 TI - Intrapleural application of human leukocyte interferon (HLI) in breast cancer patients with ipsilateral pleural carcinomatosis. AB - Seven patients with ipsilateral pleural carcinomatosis from breast cancer were treated by intrapleural application of a crude interferon-alpha (IFN-alpha) preparation (HLI). In 4 patients, previous systemic treatment had been without effect, and 3 patients had recurrence after initial remission. Pleural carcinomatosis was confirmed by cytology in 6 patients and by histology in 1 patient. HLI was given in doses of 2.2 X 10(6) IU two to six times. The effect was evaluated by cytological examination of the pleural fluid; malignant cells disappeared in all six patients who were evaluable. Pleural fluid, while not totally resolving, did not accumulate further after HLI. Disseminated tumor was present in all at the time of eventual death. No tumor was found in the pleura at autopsy of 2 patients and the pleural fluid was free of malignant cells at the time of last follow-up examination in the 4 others. These results seem to justify further investigation on larger groups of patients with better technique of application. PMID- 3668306 TI - Nurses' and patients' conceptions of wound pain and the administration of analgesics. PMID- 3668308 TI - Chronic pain and depression. PMID- 3668307 TI - The premature use of intravenous opioids. PMID- 3668309 TI - A workshop on thermal dose in cancer therapy: introduction. PMID- 3668310 TI - Studies relevant to a means of quantifying the effects of hyperthermia. AB - There is as yet no fully satisfactory method of defining 'thermal dose'. However, in order to relate different hyperthermal treatments it has been suggested that the relationship between heating time and temperature be used to derive an isoeffect parameter which might be useful in this context. The equation t2/t1 = RT1-T2, where t is the treatment time, T the temperature, R = 2 for T greater than 42.5 degrees C and R = approximately 6 for T less than 42.5 degrees C, has been shown to fit the isoeffect data from many studies both in vivo and in vitro. Whether or not this relationship is applicable when the temperature is varying has been tested using an animal model system, i.e. the response of the baby rat tail. It has shown that the relationship between time and temperature is indeed characterized by the above equation, and the phenomena of thermotolerance and step-down sensitization were clearly demonstrated. Tails were then alternated between waterbaths at different temperatures in order to simulate varying temperature. The measured effects were, in general, in good agreement with those derived from the formula. The maximum difference between the observed and predicted effect, obtained under rather extreme conditions unlikely to be experienced clinically, amounted to an under-estimate of the effective temperature by approximately 0.3 degrees C, i.e. a net small effect of thermotolerance. It is therefore suggested that the above formula for 'heat dose' provides a reasonable interim method for comparing clinical hyperthermic treatments. The formula does not, however, account for differing absolute sensitivities between tissues nor for effects of fractionating heat treatments. PMID- 3668311 TI - Thermal isoeffect dose: addressing the problem of thermotolerance. AB - A method of calculating a thermal isoeffect dose by converting thermal exposure into equivalent-minutes at 43 degrees C (EQ43) has been described previously by this investigator and others. Some investigators have suggested variations in the constants of this approach based on evaluations of the available in vivo data. The selection of these constants affect thermal dose calculations most at temperatures below 43 degrees C. Since treatment response appears to be most closely related to the dose in the coolest part of the tumour, the selection of appropriate constants may be quite important. The data suggest that these variations in constants are a consequence of thermotolerance. A more appropriate approach to address this problem is presented. The phenomena of thermotolerance complicates the practical application of this thermal isoeffect dose model. The dose modification caused by chronic thermotolerance which occurs during exposure at mild hyperthermic temperatures can be estimated by calculating the thermotolerance dose ratio (TTDR) between the equivalent-minute dose calculated with and without a transition temperature at 43 degrees C. The data suggest that the TTDR as a function of time can be mathematically described and used to correct for the dose modifying effect of thermotolerance. Using these results in a modification of the thermal isoeffect dose model causes a significant improvement in the fit for in vitro data below 43 degrees C. PMID- 3668313 TI - Thermal dose and time-temperature factors for biological responses to heat shock. AB - The application of hyperthermia in human cancer therapy, especially by radiotherapists who are accustomed to prescribing ionizing radiation treatments in physical dose units, has stimulated workers in this area to consider the possibility and utility of defining a unit of 'thermal dose'. Previous thermal dose definitions have, primarily, been based on biological isoeffect response relationships, which attempt to relate exposure times that elicit a given biological response at one temperature to exposure times at another temperature that elicit the same biological response. This 'equivalent time' method is shown to have certain limitations. For both 42.4 and 45 degrees C hyperthermia, these relationships accurately describe cell survival responses only when the heating rate is rapid (greater than 0.5 degrees C min-1 from ambient to hyperthermic temperature). Further, the form of these isoeffect relationships appears to be temperature range and cell/tissue-type dependent, and it is suggested that these relationships be referred to as a 'time-temperature factor' (TTF) to help distinguish them from possible physical thermal dose definitions. Two physical dose definitions are discussed, one being simply exposure time at some temperature and the other being a more fundamental definition, the free energy change which is a temperature-dependent driving force for chemical reactions. PMID- 3668312 TI - Clinical application of thermal isoeffect dose. AB - Clinically, there is strong rationale for developing a method which will provide a scientific basis for comparing the efficacy of one hyperthermia treatment with another. In order to accomplish this goal, methods must first be developed which will allow the clinician to know the three-dimensional temperature distribution in heated tissue. In this paper, examples of how this goal can be achieved are presented. Techniques for compensating for various modifiers of hyperthermia effectiveness are proposed. The limitations and advantages of these approaches are described and directions for future research are discussed. PMID- 3668314 TI - Some problems related to the clinical use of thermal isoeffect doses. AB - The well-known biological isoeffect relationship between treatment time and temperature has been suggested as a basis for a general biological heat dose unit which could be used to compare the effect of different heat treatment schedules. This is frequently expressed as 'equivalent heating time at 43 degrees C'. Such a conversion has in experimental studies been shown to be effective in comparing single heating schedules. However, clinical treatment has some features which may strongly influence the usefulness of an isoeffect heat dose. Firstly, the heat distribution is generally heterogeneous and fluctuates with time, which in some situations results in increased damage due to step-down heating. Secondly, in the situation where hyperthermia and radiation are given simultaneously, the time temperature relationship may be different from that in the case of heat alone, and from the effect of heat given as an adjuvant to radiotherapy. Thirdly, most clinical treatments are given as fractionated treatments, and it is almost certain that thermotolerance may influence the biological heat effect to some extent. However, with the unknown kinetics of thermotolerance the magnitude of this phenomenon cannot be predicted. A series of experiments in a C3H mammary carcinoma were performed in order to analyse some of these problems. PMID- 3668315 TI - Regional hyperthermia: a feasibility analysis. AB - Thirty patients received regional hyperthermia using the annular phased array system (APAS) in conjunction with either radiotherapy or chemotherapy. A total of 139 treatment sessions were available for analysis, averaging 4.6 per patient. The number of hyperthermia sessions per patient varied from 1 to 9 and was dependent on the patients' tolerance. The duration of the sessions also varied considerably. Although the goal of each session was to attain temperatures of 42 degrees C or higher for 1 h, minimally one-half hour, this was rarely achieved. Temperatures of 42 degrees C or higher were achieved in 95 (68.8 per cent) sessions. The time span at that level ranged between 1 and 40 min, median 8.5 min. The predominant limiting factor in 18 (60 per cent) of patients was local discomfort. Generalized discomfort (anxiety) as a predominantly limiting factor in 5 (16.6 per cent), systemic temperature elevation in 3 (10 per cent), and tachycardia in two (6.6 per cent) patients. Careful attention to technical details and patient preparation may ameliorate or eliminate some of the limiting factors and improve the efficacy of heat delivery. PMID- 3668316 TI - Canine muscle blood flow during fractionated hyperthermia. AB - Blood flow is an important parameter for obtaining uniform thermal distributions in tumour and normal tissue. This study investigated the effect of fractionated hyperthermia on muscle blood flow in 30 dogs treated interstitially. These animals were divided into five groups, each group receiving either 0 (control), 1, 2, 3, or 4 hyperthermia fractions separated by 72 h. Each animal was treated for 40 min at 45 degrees C. Blood flow was measured with four different radioactive microspheres at either 10, 20, 30, or 40 min of heating. During the first treatment, blood flow increased from control of 7.5 +/- 1.1 ml min-1/100 g of tissue to 39.6 +/- 5.8 ml min-1/100 g of tissue at 20 min of heating. Blood flow decreased over the next 20 min to 24.4 +/- 4.8 ml min-1/100 g of tissue. This pattern was repeated for all hyperthermia treatments and peak blood flows were observed for all groups between 20 and 30 min of heating. Peak blood flows reached 20.0, 16.5 and 11.0 ml min-1/100 g of tissue for animals treated with 2, 3, or 4 hyperthermia fractions, respectively. These data suggest that peak blood flow in normal tissue decreased with increasing numbers of hyperthermia fractions. Blood flow response to hyperthermia changes from fraction to fraction and description of the kinetics of these changes is important for understanding the response of normal tissue to heat. PMID- 3668317 TI - A comparison of schedules combining fractionated hyperthermia and irradiation in mice. AB - A comparison was made of three study arms delivering localized fractionated hyperthermia followed by irradiation for two weeks. The treatment results demonstrated 18-week survival and NED survival to be 35 per cent (7/20) and 30 per cent (6/20) respectively for heat and irradiation 5 days per week, 57.9 per cent (11/19) and 52.6 per cent (10/19) for combined treatment 3 days per week and 27.8 per cent (5/18) for heat 3 days per week and irradiation 5 days per week. It is felt that thermotolerance will account for the lack of difference between 24 h and 48 h irradiation schedules when irradiation is given daily. Irradiation fraction size, however, is suggested as a moderating variable as well. PMID- 3668318 TI - Differential sensitivity to hyperthermia of mouse normal haemopoietic stem cells related to proliferation activity and organ source. AB - Thermosensitivity of haemopoietic stem cells was studied in relation to the organ source and the proliferative state of the cells. Heat treatment was carried out at 41, 42, 43, 44 and 45 degrees C until about 1 per cent survival was reached. Treatments at 42 degrees C and below appear to be critical in revealing thermosensitivity differences between haemopoietic stem cells, characterized by the time T(o) at a given temperature to induce a lethal event. At these temperatures, foetal liver CFU-S (about 35 per cent in S phase) were more thermosensitive than steady-state bone marrow and spleen CFU-S (less than 10 per cent in S). We consider that these thermosensitivity differences cannot be attributed exclusively to differences in proliferation rates of the CFU-S, since exponentially-proliferating marrow CFU-S (48 per cent in S) does not significantly differ in sensitivity compared with steady-state CFU-S, while regenerating spleen CFU-S does (34 per cent in S). An Arrhenius analysis of heat survival curves of the different CFU-S allowed us to estimate only one activation energy (Ea) in the inactivation process of foetal liver and regenerating spleen CFU-S, and two Ea in the case of steady-state marrow and spleen CFU-S and regenerating marrow CFU-S. PMID- 3668319 TI - Local RF capacitive hyperthermia: thermal profiles and tumour response. AB - At the Cancer Institute we are using RF capacitive hyperthermia as an adjuvant to radiotherapy and/or chemotherapy in the local control of soft tissue sarcomas. We have studied the influence of bolus conductivity, electrode and phantom sizes on the rate of heating of agar phantoms. We have varied the bolus conductivity by varying the saline concentration in the bolus bags from zero to 2.0 per cent, during heating. We found that the rate of heating of phantoms increases and that of the bolus decreases with the increase in the saline concentration of bolus up to 1 per cent, irrespective of phantom and electrode sizes. However, for a given size of electrodes the rate of heating decreased with the increase in the phantom size. When the diameter and height of the phantom were equal to the diameters of electrodes the rate of heating of the phantom was nearly uniform. However, when the diameter of the phantom was larger than that of electrodes the rate of heating in the radial axis decreased with the increase in the radial distance. On the basis of this data we suggest the use of electrodes larger in size by 1.0-3.0 cm than the size of the tumour, where the size of the anatomical site to be heated is larger than the electrode size to be used. Phantom and clinical data have indicated that the presence of bone in the field of heating can lead to hot spots. Preliminary clinical results have shown that the response of sarcomas to thermo-chemo-radiotherapy was superior to that of either thermo-radiotherapy or radiotherapy alone. PMID- 3668320 TI - [The pathogenesis of cardiac cachexia--relationship between glucose metabolism and pathology of the liver]. PMID- 3668321 TI - [Cardiac function and exercise tolerance following mitral valve replacement]. PMID- 3668322 TI - [Assessment of preoperative ventricular function in right heart bypass operation in single ventricle]. PMID- 3668323 TI - [Repair of complete atrioventricular canal associated with subaortic extension of ventricular septal defect]. PMID- 3668324 TI - [A case report of Cor triatriatum (IIA) and total anomalous pulmonary venous connection (IIB)--consideration of preoperative diagnosis and intraoperative cardiac anatomy]. PMID- 3668325 TI - [Truncus arteriosus associated with interrupted aortic arch--a successful one stage operative case of 98-day-old infants]. PMID- 3668326 TI - [A case of carcinoid tumor of the right upper lobe bronchus treated by the bronchoplasty without lung resection]. PMID- 3668327 TI - [Ventricular septal aneurysm with ventricular septal perforation after blunt chest trauma--a case report]. PMID- 3668328 TI - [Successful Lecompte's operation of transposition of great arteries with ventricular septal defect and pulmonary stenosis]. PMID- 3668329 TI - [A surgical correction in transposition (levomalposition) of the great arteries with an unusual subarterial ventricular septal defect]. PMID- 3668330 TI - [Open drainage of lung abscess in infancy]. PMID- 3668331 TI - [Pulmonary cystic diseases--clinical study]. PMID- 3668332 TI - [Hemodynamics during exercise in mitral valvular disease at pre and post operative periods, and evaluation of operative procedure in mitral stenosis]. PMID- 3668334 TI - [Experimental study of extravascular lung water after hypothermic low flow perfusion]. PMID- 3668333 TI - [Relationship of tumor localizations and clinical problems in the apical invading lung cancer]. PMID- 3668335 TI - [Large tumors of the chest wall and its reconstruction with Marlex mesh--report of 5 cases]. PMID- 3668336 TI - [Ventilatory disturbance of the remaining lobes after lobectomy]. PMID- 3668337 TI - [A newly developed "single-valved assist device"--a combined pump for bypass and counterpulsation]. PMID- 3668338 TI - [Experimental assessment of myocardial electrolyte shifts during infusion of crystalloid cardioplegia]. PMID- 3668339 TI - [Modified Fontan procedure for complex cardiac anomalies--problems in the cases of RV type systemic ventricle]. PMID- 3668340 TI - [Additive effects of verapamil on blood potassium cardioplegia]. PMID- 3668341 TI - [Change in the tensile strength and water content in the myocardium following acute myocardial infarction--a consideration of the optimal time of the operation of postinfarction ventricular septal rupture]. PMID- 3668342 TI - [Chylothorax after cardiovascular surgery in children]. PMID- 3668343 TI - [Late result of nonvalved extracardiac conduit repair between venous ventricle and pulmonary artery]. PMID- 3668344 TI - [The multivariate analysis of postoperative hemodynamics in total correction of tetralogy of Fallot]. PMID- 3668345 TI - [Intestinal infarction without mesenteric vascular occlusion after open heart surgery: a case report]. PMID- 3668346 TI - [Malignant schwannoma of the heart]. PMID- 3668347 TI - [A case of desmoid tumor of the chest wall]. PMID- 3668348 TI - [Prosthetic valve endocarditis indications of surgical treatment from analysis of 11 cases]. PMID- 3668349 TI - [The 60th meeting of the Japanese Orthopaedic Association. Niigata, April 17 through 19, 1987. Abstracts]. PMID- 3668350 TI - [Tumor sterilization dose and radiation induced changes in the brain tissue in radiotherapy of brain tumors]. PMID- 3668351 TI - [Clinical evaluation of total-body hyperthermia for cancer analysed from data collected in Japan]. PMID- 3668352 TI - [Experimental investigation of direct current treatment using vascular catheterization technic--the 1st report]. PMID- 3668353 TI - [A case of esophageal cancer of superficial depressive type in an advanced age successfully treated with HCFU]. PMID- 3668354 TI - [Study on histological grading of malignancy of cervical adenocarcinoma]. PMID- 3668355 TI - [Familial occurrence of differentiated, non-medullary thyroid carcinoma]. PMID- 3668356 TI - [A clinicopathologic study of endometrial carcinoma with special reference to prognostic factors]. PMID- 3668357 TI - [Evaluating effect of oral-adjuvant chemotherapy of uterine cervical cancer after surgical treatment and estimating prognostic curves]. PMID- 3668358 TI - Development of a radioimmunoassay for quantitating prethrombin 2 in human plasma. AB - We have developed a radioimmunoassay (RIA) for prethrombin 2 (Pr2), a potential intermediate in the transformation of prothrombin to thrombin. Antisera against human Pr2 were raised in rabbits and the respective immunoglobulin G fractions were chromatographed on prothrombin-Sepharose. The specific antibody population obtained was used to construct a double-antibody RIA capable of measuring as little as 0.05 nmol/L of this component. The immunoreactivity of prothrombin was approximately 40,000 times less than that of Pr2 on a molar basis. Because of nonspecific contributions of plasma constituents to the immunoreactive signal, the measurement of Pr2 in this milieu required the use of a titration curve in which Pr2 was added back to Pr2-depleted plasma. This assay was then used to determine the levels of this species in two patient populations with increased prothrombin activation as determined by the prothrombin fragment F1 + 2 RIA, a measure of the in vivo cleavage of prothrombin by factor Xa. The mean Pr2 concentrations in eight patients with disseminated intravascular coagulation and six asymptomatic individuals with congenital antithrombin deficiency not receiving antithrombotic therapy were not significantly elevated as compared with those of normal controls (0.244 nmmol/L and 0.242 nmol/L vs. 0.184 nmol/L, respectively). Our studies show that Pr2 is cleared from the plasma of dogs with a t1/2 of approximately 25 minutes. Given that the t1/2 of F1 + 2 is estimated to be approximately 90 minutes, the low plasma levels of Pr2 observed in patients with thrombophilia cannot result from rapid clearance of this component.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668359 TI - Effects of hypothyroidism and short-term aging on whole blood thromboxane and arterial prostacyclin synthesis. AB - Hypothyroidism results in decreased platelet aggregation and has unique effects on the development of atherosclerosis and angina pectoris. Because prostacyclin and thromboxane A2 profoundly influence platelet function and vascular tone and are thought to be important in the development of atherosclerosis and angina pectoris, we studied the effects of hypothyroidism in rats on the in vitro elaboration of prostacyclin passively by aortic tissue and of thromboxane A2 by thrombin-stimulated whole blood. Hypothyroidism induced by iodine 131 (given at age 7 weeks) persistently caused a mild decrease in platelet count (P less than 0.01) and 30% decrease in immunoreactive thromboxane B2 (the hydrolysis product of thromboxane A2) generation per platelet (P less than 0.01) compared with age matched euthyroid rats. Between 20 and 23 weeks of age immunoreactive 6 ketoprostaglandin F1 alpha (the hydrolysis product of prostacyclin) generation decreased by 30% in euthyroid rats. In hypothyroid rats less than 23 weeks of age, 6-ketoprostaglandin F1 alpha production was the same as that of age-matched euthyroid rats. With further aging, 6-ketoprostaglandin F1 alpha production did not decrease as it did in euthyroid rats. Hypothyroid rats more than 20 weeks old had, therefore, significantly greater 6-ketoprostaglandin F1 alpha production than age-matched euthyroid rats (P less than 0.005). L-Thyroxine given daily for 28 days to 23-week-old hypothyroid rats caused a rapid increase in platelet count and a delayed normalization of the thromboxane synthetic abnormality. 6 Ketoprostaglandin F1 alpha production transiently increased in response to L thyroxine, but decreased to the euthyroid level after 28 days of therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668360 TI - Evaluation of the effect of a platelet activating factor antagonist on platelet activating factor and Ascaris antigen-induced airway responses in rhesus monkeys. AB - An acute airway response to aerosolized platelet activating factor (PAF) can be induced in certain rhesus monkeys. This PAF airway response is completely inhibited by the PAF antagonist, SRI 63-441, in normal monkeys. After the completion of these studies showing inhibition of the PAF airway response, we evaluated whether the PAF antagonist could inhibit three types of acute IgE mediated airway responses to Ascaris suum (A) in rhesus monkeys. The A aerosol test protocols used the following: a single A aerosol challenge system; a threshold dose of A challenge system, which consists of increasing A aerosol exposure until an airway response occurs; and two sequential A challenges in which the response to the second A challenge always occurs if there is a response to the first A challenge. When SRI 63-441 was tested as a potential antagonist of the A airway response in any of these three systems, no inhibition was shown. PMID- 3668361 TI - Plasma tetranectin in healthy male and female individuals, measured by enzyme linked immunosorbent assay. AB - Tetranectin is a novel protein recently isolated from human plasma. It is a tetramer, composed of four identical, non-covalently bound, 181-amino-acid polypeptide chains (Mr = 20,100). We report here the quantification of plasma tetranectin in 457 healthy individuals, aged from birth to 85 years, using a newly developed sensitive and reproducible enzyme-linked immunosorbent assay (ELISA). Tetranectin was demonstrable in all subjects investigated, and within each sex and defined age group the concentration was well controlled within a relatively narrow range. The mean plasma tetranectin level in newborn infants (cord plasma) was about 8 mg/L. This was significantly less than in later life, during which mean plasma tetranectin level varied between 10 and 12 mg/L. After the age of 9 years, tetranectin level was continuously higher in males than in females, but the variations through the span of life were almost identical. Thus, a transitory increase in plasma tetranectin was observed in early puberty, reaching its climax about the age of 11 to 12 in girls and 14 to 15 in boys. A quantitatively similar, additional peak was observed during the period of 50 to 59 years of age in both sexes, whereupon the tetranectin concentration gradually decreased. The biologic function of tetranectin remains to be elucidated. Recently, we have reported that tetranectin is contained within hepatocytes and various endocrine cells, all known to process peptide hormones or glucoproteins. We propose that tetranectin may be involved in intracellular and extracellular serine protease-mediated proteolysis. PMID- 3668363 TI - Trauma associated with the use of all-terrain vehicles. Complete spectrum of a national epidemic in rural Western Kentucky. PMID- 3668362 TI - Formation of light irreversibly sickled cells during deoxygenation-oxygenation cycles. AB - Changes in density, morphology, and monovalent cation content of sickle (SS) cells caused by repetitive sickling were investigated in vitro with a device by which red cells can be exposed to cycles of deoxygenation and oxygenation (d-o cycles). Experiments were done using the discocyte-rich, less dense fractions of SS cells. When such cells were subjected to d-o cycles in the presence of 2 mmol/L Ca2+, most became dense within 4 hours. The density of these cells was slightly lower than usual for irreversibly sickled cells (ISCs), and because they reverted to the discoidal shape after oxygenation, they were not considered ISCs. However, on further d-o incubation, they did assume the morphology and density typical of ISCs. After an additional incubation (20 hours), most cells decreased in density, became very fragile, and hemolyzed easily. Such light ISCs could also be formed from freshly prepared dense cells on d-o incubation. Once light ISCs were formed, they did not reconvert to dense cells on further incubation. It should be noted that light ISCs created in vitro tended to aggregate much more easily than ordinary (heavy) ISCs did, suggesting that the membrane of these cells may be very adhesive. PMID- 3668364 TI - U of L School of Medicine. A tradition of excellence. PMID- 3668365 TI - Physician manpower and graduate medical education. PMID- 3668366 TI - Doxycycline in acute bronchitis: a randomized double-blind trial. PMID- 3668367 TI - Toward a national health policy. PMID- 3668368 TI - A study of women's awareness and use of mammograms. PMID- 3668369 TI - Silicone ear splints in the management of acute haematoma auris. AB - A discussion of the rationale of management of acute haematoma auris and a description of a simple, reliable method of management using Otoform K Silicone impression material to form ear splints. PMID- 3668370 TI - The effect of tonsillectomy and adenoidectomy on the intra-tympanic pressure. AB - A group of 67 children were studied (mean age 7 years, 2 months) who underwent adenoidectomy and/or tonsillectomy because of either recurrent otitis media or upper respiratory tract infection. The mean pre-operative intratympanic pressure was -67.3 mmH2O (SD 65.1); three months post-operatively it was -21.9 mmH2O (SD 32.4), a highly significant improvement (p less than 0.001). The size of the adenoids had a nearly significant effect on the pre-operative intratympanic pressure (p less than 0.05). In children with large vs small adenoids the difference was highly significant (p less than 0.001). In a group of five children, tonsillectomy alone (adenoidectomy performed earlier) did not have any effect on the intratympanic pressure. No change in intratympanic pressure was seen in children with nasal allergy as compared with non-allergic children after adenoidectomy. PMID- 3668371 TI - Vestibuloplasty (a new one-stage operation for atrophic rhinitis). AB - It is proposed that primary atrophic rhinitis belongs to a group of conditions under the heading 'Reflex Sympathetic Distrophy Syndrome'. This leads to decalcification of the turbinals, as in Sudeck's atrophy. Collapse of the decalcified turbinals is brought about by the impact of the inspiratory stream, and this is followed by atrophic changes. Based on this hypothesis, a new operation ('Vestibuloplasty') has been devised in order to direct the stream away from the turbinals and to dissipate the force of the stream so that its impact on the turbinals is minimized. Following this operation, 92 per cent of the cases have benefitted; this is comparable to the result following Young's or a modified Young's operation. After vestibuloplasty the patient can breathe through the nose and clean the nose as normal persons do; a second-stage procedure for reopening the nostril is not necessary and the chances of recurrence are negligible as compared to those following Young's operation. PMID- 3668372 TI - Phase variation in nasal airways resistance assessed by active anterior rhinomanometry. AB - Measurements of nasal airways resistance in normal subjects have shown a significant difference between values obtained in the two respiratory phases. Higher overall values are found during expiration in both the unprepared and decongested nose but these differences fail to maintain statistical significance after application of a decongestant. This indicates that the phase of respiration in which measurement is made must be routinely recorded especially when measurement is made without decongestant, and comparisons of data made only with recordings from equivalent parts of the nasal cycle. PMID- 3668373 TI - Aetiology of recurrent aphthous ulcers (RAU). AB - A significant decrease in the pH of saliva has been detected in patients with recurrent aphthous ulcers (RAU). The decrease in pH was more prominent at night than between meals, and some persistent decrease was noticed even after recovery. The total proteins of saliva in RAU were also significantly decreased. These findings were similar to those observed in patients complaining of peptic ulcers, so it is recommended that patients with RAU should be treated with antacids as well as anticholinergic drugs, and that the possibility of concomitant peptic ulceration should also be investigated. PMID- 3668374 TI - Distant metastasis in malignancies of the head and neck. AB - It is a well known fact that disease in head and neck cancer remains confined above the clavicle in a majority of cases for a considerable length of time. The causes of death in head and neck cancer patients are known to be due to lymph node metastasis, fungation, asphyxia, cachexia, invasion of major vessels and infection. Distant metastasis occurs late in the disease. However, many reports have appeared in the literature which indicate a high incidence of distant metastasis in head and neck malignancies. Merino et al. (1977), in a clinical study, have indicated an incidence of 10.9 per cent. Studies based on autopsy findings, however, quote a much higher figure (30 per cent, Papac, 1984; 57 per cent, Gowen and Dessuto Nagy, 1963). Dennington and Caster (1980) reported that at least seven per cent of patients with head and neck cancer have distant metastasis when first seen. The present study was designed to find out the incidence of distant metastasis in our head and neck cancer patients. PMID- 3668375 TI - Paediatric tracheostomy. Fifty-seven operations on fifty-three children. AB - Fifty-seven operations on 53 patients represents the total experience of tracheostomy in children under 13 years during 1964-1985 in an area with half a million inhabitants. No complication occurred during surgery and no deaths were related to the operations. Complications followed 16 out of 30 (53%) operations on children under three years and four out of 27 (15%) of the remainder, an overall complication rate of 35%. Many fewer operations have been required since 1973 because of the successful employment of nasotracheal intubation in the treatment of upper and lower airway obstruction caused by acute infection. Obstruction by-pass remains the commonest function of tracheostomy, with congenital lesions and trauma now the commonest causes of obstruction as opposed to acute infection in the earlier years. Despite the successful use of nasotracheal intubation there were absolute indications for tracheostomy- blockage of the nasotracheal tube; inability to intubate a child with epiglottitis; and necessity for an artificial airway of long duration. PMID- 3668376 TI - The outcome of tracheostomy in children. PMID- 3668377 TI - Ceruminous adenoma in the osseous external auditory canal (a case report). AB - We report a 55-year-old male with cerminous adenoma originating in the osseous part of the right external auditory canal, and describe the clinical features and surgical treatment. PMID- 3668378 TI - Cystic cemento-ossifying fibroma of the ethmoidal cells (a case report). AB - A case report of an aggressive cystic cemento-ossifying fibroma of the ethmoidal cells is presented. Fibro-osseous lesions containing cementum are considered to be of periodontal membrane origin and are most common in the mandible and maxilla. Following the WHO classification, fibro-osseous lesions containing cementum are grouped together under the heading of cementoma and are divided into four subgroups. Cemento-ossifying fibroma is considered to be a variant of cementifying fibroma which is a sub-group of cementoma. The unique site of origin seen in this case is thought to have been the result of an ectopic periodontal membrane or of a primitive mesenchymal cell rest or incomplete migration of the medial part of the nasal anlage and differentiation into the periodontal membrane. PMID- 3668379 TI - Anaplastic thyroid carcinoma metastatic to the tonsil. AB - We describe a 65-year-old woman who presented with a left tonsillar tumour. Biopsy revealed metastatic anaplastic cell carcinoma of the thyroid. Metastatic tumours are rare in the tonsils. This case, to the best of our knowledge, is the first in which the thyroid was the primary site. PMID- 3668380 TI - An anomaly of the thyro-hyoid articulation. PMID- 3668381 TI - Necrotizing sialometaplasia of major salivary glands. AB - Major salivary glands have been rarely reported as sites of necrotizing sialometaplasia, a disease primarily affecting minor salivary tissue, particularly that of the palate. Eight cases of necrotizing sialometaplasia of the parotid and submandibular glands are presented and added to six reported earlier by Donath (1979). The clinical and pathologic findings in the 14 cases give strong support to the vascular-based-infarct genesis of necrotizing sialometaplasia. PMID- 3668382 TI - Inflamed adenolymphoma with cholesterol granuloma. AB - Twelve cases of adenolymphoma with inflammation are described. Pre-operatively, three of these patients presented clinical signs of inflammation in the parotid gland. In ten cases purulent exudate could be aspirated from the tumour. Rupture of the cyst may cause an aseptic inflammation in the surrounding tissue. It is concluded that adult patients with clinical or cytological signs of inflammation in the parotid gland must be supervised until the gland is normal in order not to miss an underlying tumour. PMID- 3668383 TI - Rhabdomyosarcoma of the head and neck. PMID- 3668384 TI - Superior orbital fissure syndrome in trigemino-facial zoster. AB - A case of trigemino-facial zoster presenting as Superior Orbital Fissure Syndrome is reported. Geniculate ganglion involvement was limited to the vestibular branch of the cochleo-vestibular nerve, without any hearing impairment or facial palsy. This case clearly illustrates that herpes zoster cranialis is a polyneuropathy of multifocal asynchronous viral activity and can present in numerous forms. PMID- 3668385 TI - Increased plasma bile alcohol glucuronides in patients with cerebrotendinous xanthomatosis: effect of chenodeoxycholic acid. AB - Large quantities of C27 bile alcohols hydroxylated at C-25 are excreted in the bile and urine of patients with cerebrotendinous xanthomatosis, a lipid storage disease that results from defective bile acid synthesis. The presence of both biliary and urinary bile alcohols reflects impaired bile acid synthesis. After treatment of samples with beta-glucuronidase, plasma bile alcohols were quantitated by gas-liquid chromatography-mass spectrometry. 5 beta-Cholestane-3 alpha,7 alpha,12 alpha,25-tetrol (334 micrograms/dl) was found to be the major bile alcohol, followed by 5 beta-cholestane-3 alpha,7 alpha,12 alpha,23R,25 pentol (65 micrograms/dl), and 5 beta-cholestane-3 alpha,7 alpha,12 alpha,24(R and S),25-pentols (62.5 micrograms/dl and 64.5 micrograms/dl, respectively) in the plasma of these patients. When compared to biliary and urinary bile alcohol excretions, the plasma pattern resembled bile where 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25-tetrol glucuronide predominated. In contrast, urinary bile alcohols were composed chiefly of 5 beta-cholestanepentol glucuronides with only small amounts of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25-tetrol glucuronide. Treatment with chenodeoxycholic acid, which suppresses abnormal bile acid synthesis in these patients, reduced plasma bile alcohol concentrations dramatically. These results show that large quantities of bile alcohol glucuronides, particularly 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25 tetrolglucuronide, circulate in plasma of patients with cerebrotendinous xanthomatosis. The plasma bile alcohols closely resemble biliary bile alcohols which indicates their hepatic origin. The large quantities of polyhydroxylated bile alcohols in the urine may suggest their formation, at least in part, from 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25-tetrol by renal hydroxylating mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668386 TI - Rapid separation of gram quantities of phospholipids from biological membranes by preparative high performance liquid chromatography. AB - We present a detailed description of a rapid preparative high performance liquid chromatography (HPLC) procedure for isolation of large scale quantities (a minimum of 200 mg) of rat liver microsomal and mitochondrial phospholipid classes in 40 min on a 25 X 2.5 cm preparative HPLC column of 7-mu silica gel particles using a linear gradient of hexane-isopropanol-water mixtures. A minimum of 1.5 g of phospholipids can be quantitatively separated per day into diphosphatidylglycerol (cardiolipin), phosphatidylethanolamine, phosphatidylinositol, phosphatidylserine, sphingomyelin, and a phosphatidylcholine-sphingomyelin fraction. The procedure uses no salts, buffers, acids, or bases, and the isolated phospholipids are suitable for preparing model membranes. PMID- 3668387 TI - On the possible use of the serum level of 7 alpha-hydroxycholesterol as a marker for increased activity of the cholesterol 7 alpha-hydroxylase in humans. AB - The possibility was investigated that the serum level of 7 alpha hydroxycholesterol can be used as a marker for cholesterol 7 alpha-hydroxylase activity. Six patients with gallstone disease were found to have a mean level of 7 alpha-hydroxycholesterol in serum of 30 +/- 4 ng/ml (mean +/- SEM) as measured by isotope dilution-mass spectrometry, using deuterated 7 alpha hydroxycholesterol as internal standard. After treatment with cholestyramine in a dose of 8 g twice daily for 2-3 weeks preoperatively, the serum level increased to 128 +/- 20 ng/ml (P less than 0.001). Eight other patients with gallstone disease had a mean level of 7 alpha-hydroxycholesterol in serum of 29 +/- 7 ng/ml. Treatment with chenodeoxycholic acid, 15 mg per kg body weight per day for 3-4 weeks before surgery, decreased the mean level to 20 +/- 7 ng/ml (P greater than 0.05). The activity of the cholesterol 7 alpha-hydroxylase in liver biopsies taken during operation was found to be 38 +/- 5 pmol/min per mg of protein in the group of patients treated with cholestyramine and 1.3 +/- 0.5 pmol/min per mg in the group of patients treated with chenodeoxycholic acid. Liver biopsies from a group of untreated patients (n = 13) had a mean cholesterol 7 alpha-hydroxylase activity of 7.6 +/- 1.5 pmol/min per mg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668388 TI - Identification of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25,26-hexol in human urine. AB - A new bile alcohol, 5 beta-cholestanehexol, was identified in the urine of healthy humans as the glucuronide. The bile alcohol glucuronide fraction was isolated by an ion exchange chromatography on piperidinohydroxypropyl Sephadex LH 20. After enzymatic hydrolysis, the bile alcohols were converted into trimethylsilyl ether derivatives and analyzed by a combination of gas-liquid chromatography and mass spectrometry. The major bile alcohol was 27-nor-5 beta cholestane-3 alpha,7 alpha,12 alpha,24,25-pentol. As minor constituents the following C26 and C27 bile alcohols were identified: 27-nor-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25,26-hexol, 5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25-pentol, 5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,26-pentol, 5 beta-cholestane-3 alpha,7 alpha,12 alpha,25,26-pentol. In addition to these bile alcohols, a new bile alcohol was identified as a sixth component of the urinary bile alcohols. The structure was assigned as (24S)-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25,26-hexol by the direct comparison of mass spectral data and chromatographic properties with synthetic standard. The average daily excretion of the new bile alcohol was 28.6 micrograms and 3.0% of the total bile alcohols. The presence of 27-nor-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25-pentol and 27-nor-5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25,26-hexol suggests that 26-hydroxylation of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,24,25-pentol is most likely for the biosynthesis of this new bile alcohol. PMID- 3668389 TI - Regulation of rat hepatic cholesterol metabolism. Effects of lipoprotein composition on acyl coenzyme A:cholesterol acyltransferase in vivo and in the perfused liver and on hepatic cholesterol secretion. AB - Lipoproteins that are removed from the circulation by the liver can deliver both cholesterol and triglycerides to the hepatocyte. Relative proportions of these lipids may vary in lipoproteins and, thus, their uptake may have differing effects on cholesterol homeostasis. To study this, lipoproteins containing the same amounts of cholesterol but different amounts of triglyceride were administered to intact rats or to an isolated perfused rat liver. The responses of acyl coenzyme A:cholesterol acyltransferase (ACAT), very low density lipoprotein (VLDL) triglyceride and cholesterol secretion, and biliary cholesterol content were examined after 2 hr. Administration of triglyceride-rich chylomicrons (average triglyceride:cholesterol = 136.5 by mass) in vivo or their remnants (average triglyceride:cholesterol = 32.7 by mass) to the perfused liver resulted in an 80% decrease in ACAT activity. In the perfused liver system, VLDL cholesterol and triglyceride secretion was increased while biliary cholesterol content decreased. Administration of standard chylomicrons (average triglyceride:cholesterol = 33.9 by mass) or their remnants (average triglyceride:cholesterol = 11.4 by mass) lowered ACAT activity by 24% in vivo, but had no significant effect on any of the parameters measured in the perfused liver system. Administration of cholesterol-rich VLDL (average triglyceride:cholesterol = 0.47 by mass) in vivo increased ACAT activity 1.4 fold, but administration of their remnants (average triglyceride:cholesterol = 0.17 by mass) had little effect on any of the parameters measured in the perfused liver. Thus, the lipid composition of lipoproteins removed by the liver elicited acute responses by parameters important in the maintenance of hepatic cholesterol homeostasis. These responses reflected the net effects of both the cholesterol and the triglyceride contents of the particles. PMID- 3668390 TI - Studies of the pathogenesis of Gaucher's disease: tissue distribution and biliary excretion of [14C]L-glucosylceramide in rats. AB - The time course of the clearance from the blood and the tissue localization of [14C]L-glucosylceramide, a nonmetabolizable enantiomorph of D-glucosylceramide that accumulates in Gaucher's disease, has been determined. 14C-labeled L glucosylceramide injected intravenously in the form of micelles or liposomes is rapidly removed from the circulation. Most of this lipid is taken up by the liver where it is found in both hepatocytes and nonparenchymal cells. This sphingolipid analog is promptly cleared from hepatocytes and a significant portion is recovered in the bile. The clearance of [14C]L-glucosylceramide from Kupffer cells is greatly prolonged in comparison with its brief residence in hepatocytes. These findings have significant implications regarding the pathogenesis and treatment of Gaucher's disease. PMID- 3668391 TI - Subcellular localization of retinoids, retinoid-binding proteins, and acyl CoA:retinol acyltransferase in rat liver. AB - Studies were conducted to define the subcellular localization of endogenous retinoids (vitamin A), retinoid-binding proteins, and acyl-CoA:retinol acyltransferase (ARAT) in liver and to determine whether their distributions were affected by hepatic vitamin A content. Quantitative subcellular fractionation techniques were used. Rats were fed purified diets either containing or lacking vitamin A to obtain animals with total retinoid stores ranging from 0.5 to 172 micrograms of retinol equivalent per gram of liver. Liver homogenates were fractionated by differential centrifugation to yield nuclear (N), mitochondrial lysosomal (ML), microsomal (P), and high-speed supernatant (S) fractions. N, ML, and P were washed two more times by resuspension and centrifugation to remove constituents bound nonspecifically. S was further resolved into "floating lipid" and underlying "cytosol" by prolonged ultracentrifugation. The distributions of marker constituents were not affected by vitamin A status. Most of the retinyl ester in the liver was recovered in the S fraction where it was entirely (greater than 95%) associated with floating lipid. About half of the total free retinol was also recovered in the S fraction, but it was mostly (2/3) associated with cytosol per se. A substantial portion (30%) of the free retinol was recovered in the 3 X -washed microsomal (P) fraction. Sufficient binding capacity for retinol was present in both P (as retinol-binding protein) and S (as cellular retinol binding protein) to quantitatively account for the amounts of free retinol present in the two fractions. ARAT activity in the liver was distributed among the subcellular fractions in a manner identical with an endoplasmic reticulum marker enzyme (NADPH-cytochrome C reductase).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668392 TI - Enzymatically induced alterations in the structure of rat serum lipoproteins. AB - Incubation of freshly isolated rat serum induces a large number of changes in the properties of the serum lipoproteins, especially the high density lipoproteins (HDL). The particle diameter of the HDL increases from about 10.4 nm to 12.3 nm and the protein content appears to increase by about 60,000 Daltons. Reactions catalyzed by lecithin:cholesterol acyltransferase (LCAT) lead to a marked decrease in cholesterol and phospholipid content, and an even greater increase in cholesteryl ester content. Especially noteworthy are the marked increases in apoE and apoA-IV which are found associated with HDL as a result of this process. Data indicate that the affinity of apoE and apoA-IV for the HDL particles may be influenced by the proportion of surface to core lipid and by the presence of products of the LCAT reaction. Changes in the apoprotein content of very low density lipoproteins are also observed, with A-I and A-IV appearing in this density interval. All of the above changes can be prevented by the inclusion of 5,5'dithiobis(2-nitrobenzoate) or p-chloromercuriphenylsulfonate during the incubation, or by heat treatment of serum at 56 degrees C for 30 min; these treatments are known to inhibit LCAT activity. It is concluded that LCAT action is the major cause of the various changes in HDL structure that are observed and that alterations in apoprotein content occur to correct the resultant imbalance between core lipid and coverage of this core by amphiphilic components. Increased apoE association with cholesteryl ester-rich HDL may provide an efficient means for receptor-mediated removal of cholesterol from the circulation. PMID- 3668393 TI - Cholesteryl esters of saturated fatty acids: cosolubility and fractionation of binary mixtures. AB - Factors affecting the solid state miscibility of saturated chain cholesteryl esters were determined from electron diffraction and differential scanning calorimetric measurements on a homologous series which included two types of crystal packing. Electron diffraction patterns from solution- and epitaxially crystallized microcrystals gave measured unit cell constants consistent with the bilayer crystal form for myristate, pentadecanoate, palmitate, and stearate esters. Cholesteryl undecanoate crystallized as the monolayer I structure and cholesteryl laurate was polymorphic, packing in either monolayer I or bilayer forms. No evidence was found for the monolayer II form of the laurate claimed in earlier work. It is clear that solid solution formation follows general rules formulated earlier by Kitaigorodskii for molecular crystals. A symmetry criterion must be satisfied first of all, i.e., two compounds that solidify in greatly different crystal structures will not form continuous solid solutions (e.g., cholesteryl undecanoate/cholesteryl myristate). Within a given crystal structure type, solid solution is permitted when the molecular volumes are similar. (For example, cholesteryl myristate forms an ideal solid solution with cholesteryl pentadecanoate, a nonideal solution with cholesteryl palmitate, and a eutectic of solid solutions with cholesteryl stearate.) For the polymorphic cholesteryl laurate, solid solutions of either the monolayer I structure (e.g., with cholesteryl undecanoate) or bilayer structure (e.g., with cholesteryl myristate) are permitted. PMID- 3668394 TI - Dynamical behavior of epidemiological models with nonlinear incidence rates. AB - Epidemiological models with nonlinear incidence rates lambda IpSq show a much wider range of dynamical behaviors than do those with bilinear incidence rates lambda IS. These behaviors are determined mainly by p and lambda, and secondarily by q. For such models, there may exist multiple attractive basins in phase space; thus whether or not the disease will eventually die out may depend not only upon the parameters, but also upon the initial conditions. In some cases, periodic solutions may appear by Hopf bifurcation at critical parameter values. PMID- 3668395 TI - The population genealogy of the infinitely--many neutral alleles model. AB - A process analogous to Kingman's coalescent is introduced to describe the genealogy of populations evolving according to the infinitely- many neutral alleles model. The process records population frequencies in old and new classes, and labels the new classes in order of decreasing age. Its marginal distribution is characterized in a form which is amenable to explicit calculations and the transition densities of the associated K-allele models follow readily from this representation. PMID- 3668396 TI - Evolution, games theory and polyhedra. AB - The problem of finding an Evolutionary Stable Strategy (ESS) for an animal species is defined. It is shown how such strategies are a subset of the equilibrium solutions for a particular non-zero sum game. These equilibrium solutions are then shown to arise from the vertices of a particular convex polyhedron. A method of finding these equilibrium solutions through the vertices and then the ESS solutions is given. This is illustrated by a number of numerical examples taken from the literature. Finally an alternative approach based on solving a Linear Complementarity Problem is discussed. PMID- 3668397 TI - Counting genealogical trees. AB - A class of genealogical trees is related to unlabelled graph-theoretical trees, allowing some counting problems involved with genealogical trees to be solved. PMID- 3668398 TI - A numerical study of the nonsteady transport of gases in the pulmonary capillaries. AB - A mathematical model is formulated for simulating the unsteady transport of gases in the blood flowing through the pulmonary capillaries. The formulation takes into account the transport mechanisms of molecular diffusion, convection and facilitated diffusion of the species due to haemoglobin. A time dependent situation is created by allowing to vary suddenly the partial pressures of the gases either in the venous blood or in the alveolar air. A numerical technique is described to solve the resulting time-dependent system of nonlinear coupled partial differential equations with the physiologically relevant boundary, entrance and initial conditions. The time required by the gases to achieve equilibrium is computed. It is shown that the dissolved oxygen takes longest in reaching equilibration whereas the carbon dioxide is the fastest. The various physiologically relevant unsteady situations have been examined. PMID- 3668399 TI - The meaning of illness: a phenomenological approach to the patient-physician relationship. AB - This essay argues that philosophical phenomenology can provide important insights into the patient-physician relationship. In particular, it is noted that the physician and patient encounter the experience of illness from within the context of different "worlds", each "world" providing a horizon of meaning. Such phenomenological notions as focusing, habits of mind, finite provinces of meaning, and relevance are shown to be central to the way these "worlds" are constituted. An eidetic interpretation of illness is proposed. Such an interpretation discloses certain essential characteristics that pertain to the experience of illness, per se, regardless of its manifestation in terms of a particular disease state. It is suggested that, if a shared world of meaning is to be constituted between physician and patient, the eidetic characteristics of illness must be recognized by the physician. PMID- 3668400 TI - Abortion: the extreme liberal position. AB - Discussions regarding abortion are often misguided and confused. This paper critically examines the extreme liberal view, which argues that neither the fetus, at any stage of development, nor the young infant has a right to life. It focuses on the general argumentative strategy employed by a number of philosophers in arriving at an extreme liberal view. An evaluative critique of an extreme liberal view is offered as a step toward clarifying and expanding upon the abortion debate. PMID- 3668401 TI - RADPLANET--a functional radiology digital image network. AB - RADPLANET is a functioning LAN (Local Area Network) designed to integrate the many and varied facilities of a university medical center radiology department (Department of Radiation Sciences) into an efficient unified resource providing state-of-the-art diagnostic capabilities and delivering precision radiotherapy. RADPLANET links diagnostic work stations, radiation-therapy planning work stations, and therapy machine stations into an integrated whole. The RADPLANET project exploits technology currently evolving in the PACS (Picture Archiving and Communicating Systems) community but also addresses digital image networking requirements peculiar to radiation therapy. RADPLANET is designed as a modular, expandable, piecemeal updatable system in order to incorporate new, more cost effective technology as it becomes available and to provide new resources to meet the needs of a growing department and an increasingly sophisticated medical profession. The paper discusses design criteria and rationale, current status of the network, and plans for continuing expansion and enhancement. PMID- 3668402 TI - Locative inferences in medical texts. AB - Medical research relies on epidemiological studies conducted on a large set of clinical records that have been collected from physicians recording individual patient observations. These clinical records are recorded for the purpose of individual care of the patient with little consideration for their use by a biostatistician interested in studying a disease over a large population. Natural language processing of clinical records for epidemiological studies must deal with temporal, locative, and conceptual issues. This makes text understanding and data extraction of clinical records an excellent area for applied research. While much has been done in making temporal or conceptual inferences in medical texts, parallel work in locative inferences has not been done. This paper examines the locative inferences as well as the integration of temporal, locative, and conceptual issues in the clinical record understanding domain by presenting an application that utilizes two key concepts in its parsing strategy--a knowledge based parsing strategy and a minimal lexicon. PMID- 3668403 TI - Initial impact of a clinical laboratory computer system. Themes common to expectations and actualities. AB - A longitudinal study is being conducted of a clinical laboratory computer information system's impact. This paper reports on effects that laboratory directors anticipated prior to installation, and effects reported by laboratory technologists 7 months postimplementation. Primary changes caused by the computer system were increases in the amount of paper work performed by technologists, and improvements in laboratory results reporting. The system generally was well accepted, but laboratory technologists differed in their responses to it. Technologists in some laboratories focused on work increases, whereas in other laboratories they emphasized improved information flow. The paper considers how changes in processes and outcomes of work might affect responses to a computer system. It also considers the implementation process, and suggests some areas where management could benefit from an improved understanding of responses to a computer information system. PMID- 3668404 TI - Image compression for medical imaging systems. AB - The physical size of typical digital images, in terms of the number of bytes of data one image contains, is large; e.g., a 1024 X 1024 image with 8 bits of data per pixel contains a megabyte of data. To transmit many such images over a network, sometimes over low-capacity phone lines to remote sites, or to store large numbers of images over a long period of time as part of the medical records for patients, the need for image compression arises to alleviate these large demands for image data storage and transmission capacity. This paper discusses image compression in terms of the information theory upon which it is based. The two basic categories of algorithms for implementing image compression are presented along with considerations for image quality and accuracy, which are of primary importance to the medical imaging community. PMID- 3668405 TI - Rapid prototyping of database systems in human genetics data collection. AB - This work examines some of the problems encountered in developing small and large database application systems involving human genetics data collection efforts that include data on individuals as well as family pedigree data. Rapid prototyping of a database application requires software tools to produce the application with little or no programming. Features of MEGADATS-4 that provide for rapid prototyping and for producing stand-alone applications are examined. PMID- 3668406 TI - Medical nomenclature and common conventions for trauma registries. AB - A trauma registry has been created containing lexicons of terms arranged to foster the adoption of standardized and extensible terminology for the nature and mode of injury. Identification of attribute sets for the nature-of-injury (body region:detailed part:type of injury) and for the mode-of-injury (mechanism:agent:activity:intent:setting) allows the assembly of a clear, concise, easily usable, nad extensible format for representing the appropriate level of detail for nomenclature or classification. This ability allows the use of a common list of terms that is adaptable for case records used in patient care as well as in trauma registry statistics. Several examples of reports using these attributes are shown. PMID- 3668407 TI - A preliminary conceptual framework for the design, development, and use of client oriented information systems in health. AB - Client-oriented information systems (COIS) in the health care arena are defined and discussed. The antecedents of these systems, as well as current examples of the systems, are described. Prior studies in this area suggest content for COIS but demonstrate lack of a conceptual framework to guide the design, development, adoption, and use of these systems. The purpose of the paper is to suggest a preliminary conceptual framework for future study of COIS that draws upon concepts from the field of management information systems. PMID- 3668408 TI - Layout of a multiplexed electrode VLSI circuit for monitoring evoked responses in cerebral cortex. AB - This paper summarizes the details of the design of an integrated circuit layout usable as a multiple-electrode implantable cerebral cortex sensor. The purpose of implanting multiplexed electrode circuits in a cerebral cortex is to monitor the electroencephalograph (EEG) and visual evoked response (VER) generated while the subject performs normal visual functions. A summary of the human image processing system is given as a background for the circuit design work. A typical subject for the research would be a laboratory animal. External power, clocking, and analogue data lines required for its operation posed problems for the original electrode chip. The second generation brain chip includes self contained-power with on-board multiplexing and clocking circuits. The most significant improvement is the incorporation of analogue to digital (A/D) converters. Through the use of A/D converters, brain signal data can be converted at the site of implant, eliminating induced noise from analogue wires used on the original chip. Conversion at the implant site, the primary visual cortex, yields a more accurate indication of the actual brain data. PMID- 3668409 TI - Databases for genetic services. Current usages and future directions. AB - Computer-based systems for the management of data in clinical genetics have become increasingly available for patient information storage and retrieval, evaluation and diagnosis, and pedigree data. The need for a national genetic services database has been recognized, and federal grants have provided funds for the development of state and regional databases for the evaluation of genetic services. Continuation of federal funding and the development of data systems that allow local, state, and regional needs to be met are essential for any progress to be made toward a national database. PMID- 3668410 TI - Measurement of physician specimen-handling errors and its contribution to laboratory information system quality. AB - To reduce the frequency of errors associated with hematology specimens and requisitions arriving in the hematology laboratories of a large urban teaching hospital, an intervention was conducted to alter the behavior of the medical students, interns, residents, and board-qualified physicians who ordered the tests, completed the requisitions, and drew the specimens. This paper presents the method used for measuring specimen quality, certain results derived from the method, and corresponding considerations for changes in the design of the system by which specimens are collected and delivered to the laboratory. These changes should improve the quality of the entire laboratory information system. PMID- 3668411 TI - 1987 Hawaii International Conference on System Sciences. Proceedings. PMID- 3668412 TI - On the use of statistics for representing the knowledge acquired from experts in a medical consulting system. AB - For making medical consulting systems, it is important and significant to select and devise the method for representing the knowledge acquired from professional experts. As quantities of data required for consultation are increasing according to the progress of medical science, we have to introduce some new kinds of statistics into a medical consultation system. From another point of view, since the process of diagnosis of experts is considered to be a kind of effective model for compressing (or condensing) data quantitatively and qualitatively, we discuss the use of statistics for representing the knowledge acquired from experts from the standpoint of data compression. PMID- 3668413 TI - An iterative requirements specification procedure for decision support systems. AB - Requirements specification is a key element in a DSS development project because it not only determines what is to be done, it also drives the evolution process. A procedure for requirements elicitation is described that is based on the decomposition of the DSS design task into a number of functions, subfunctions, and operators. It is postulated that the procedure facilitates the building of a DSS that is complete and integrates MIS, modelling and expert system components. Some examples given are drawn from the health administration field. PMID- 3668414 TI - A system for interactive volume analysis (SIVA) of 4-D biomedical images. AB - We have developed a powerful new microcomputer-based system that permits detailed investigations and evaluation of 3-D and 4-D (dynamic 3-D) biomedical images. The system comprises a special work station to which all the information in a large 3 D image database is accessible for rapid display, manipulation, and measurement. The system provides important capabilities for simultaneously representing and analyzing both structural and functional data and their relationships in various organs of the body. This paper provides a detailed description of this sophisticated system, as well as the rationale, background, theoretical concepts, and practical considerations related to implementation of even more advanced capabilities for interactive display and analysis of 4-D biomedical images. PMID- 3668415 TI - Resistance to computerization. An examination of the relationship between resistance and the cognitive style of the clinician. AB - The introduction of computer technology into the health care environment has been fraught with difficulty. The literature has identified that while there are many applications that have been successfully implemented, there are many others that have met significant resistance. As such, the diffusion of computer technology has been scattered and uneven in the health care arena. Some scholars attribute the problems of resistance to structural variables such as value conflicts, power conflicts, and ones that involve the man-machine interface. Other view the resistance as process-oriented, citing such key factors as inadequate training, lack of user involvement, and discomfort due to organizational change. It is held here that the essence of resistance to computerization in clinical settings is based upon the difference between the cognitive style of the user and that required by the computer. It appears that since the decision-making methods of the user tend to favor intuitive processes, he or she becomes more resistant to using a system that forces qualitative information into quantitative niches. This study examines the cognitive style of two groups of health care providers within a hospital, and attempts to provide insight into how personal decision-making processes are related to resistance to computerization. It is suggested that a more thorough understanding of this relationship will enhance the ability of health care facilities to implement new systems in the future. PMID- 3668416 TI - Anorectal manometry and anorectal disorders. PMID- 3668417 TI - Medical intensive care: indications for admission and outcomes. PMID- 3668418 TI - Keratosis pilaris: a clinico-histopathologic study. PMID- 3668419 TI - Bacterial, fungal and aflatoxin contamination of cereals and cereal products in Bangkok. PMID- 3668420 TI - Retinoblastoma in Ramathibodi Hospital. PMID- 3668421 TI - Glycemic effects of rice and glutinous rice on treated-type II diabetic subjects. PMID- 3668422 TI - Primary tumor of the rectovaginal septum: mesothelioma or papillary serous cystadenocarcinoma. A case report with transmission electron microscopy. PMID- 3668423 TI - Traumatic middle meningeal-cavernous sinus fistula treated by percutaneous transcatheter embolization. PMID- 3668424 TI - Penicillin-G induced granulocytopenia. PMID- 3668425 TI - Posterior fossa stroke in a patient undergoing embolization of occipital artery: a case report. PMID- 3668426 TI - Kasabach-Merritt syndrome treated by trans arterial embolization and radiotherapy. PMID- 3668427 TI - Effects of the anabolic steroid stanozolol on growth and protein metabolism in the rat. AB - The effects of the anabolic steroid stanozolol on whole body and muscle growth and protein metabolism in the rat have been examined. No responses could be found in normal well-fed male rats. Female rats responded to 1 mg/kg per day with an increased body and skeletal muscle growth rate and an increase in muscle protein synthesis. The anabolic action on muscle protein synthesis was due to increased RNA concentration with no change in the rate of protein synthesis per unit RNA (KRNA). Investigation of any anticatabolic effects of stanozolol treatment in male rats deprived of food for 24 h indicated no response of protein balance and turnover. However, rats treated with catabolic doses of corticosterone (50 mg/kg per day) did respond to stanozolol with decreased muscle growth inhibition due to better-maintained muscle protein synthesis. The latter response was due to a reversal of the corticosterone-induced reduction of KRNA, but with no effect on RNA concentration. Thus there appear to be at least two effects of stanozolol; an anabolic action evident only in female rats, involving increased muscle RNA concentrations, and an anticatabolic action involving inhibition of the corticosterone-induced fall in muscle RNA activity. In both cases, stanozolol influenced muscle protein synthesis with no evident effects on protein degradation. PMID- 3668428 TI - Receptors for lactogenic hormones in the ovine corpus luteum. III: Inhibition of 125I-labelled human growth hormone binding by a high molecular weight factor in ovine corpus luteum cytosol. AB - Ovine luteal cytosol fractions inhibited the specific binding of 125I-labelled human GH and ovine prolactin (oPRL) to ovine luteal microsomes in a dose dependent fashion. Inhibition was dependent on divalent cation concentrations, and was abolished by divalent metal ion chelating agents or by boiling. Inhibition was not due to ionic strength or salt effects on hormone binding, the release of endogenously bound oPRL into the cytosol fraction during tissue disruption and fractionation, or the presence of a soluble (or solubilized) lactogenic receptor in ovine cytosol preparations. Gel chromatography of cytosol fractions gave a molecular weight for the inhibitor of approximately 50,000. PMID- 3668429 TI - Failure of fasting and changes in plasma metabolites to affect spontaneous fluctuations in plasma concentrations of ovine placental lactogen. AB - The relationships between plasma concentrations of energy substrates and placental lactogen (PL) were investigated in pregnant ewes. In successive hourly samples of plasma PL, concentrations varied by +/- 30% but were not related to general activity or feeding of the ewes or the time of day. Fasting ewes for 72 h did not alter the pattern or the mean PL titres. Insulin-induced acute hypoglycaemia, hyperglycaemia and decreases or increases in free fatty acids (FFA) all failed to alter PL levels significantly during 5-h post-treatment periods. These experiments demonstrate that PL secretion in the ewe fluctuates markedly and is unaffected by changes in plasma glucose FFA concentrations. PMID- 3668430 TI - Growth hormone secretory profiles in conscious female rats. AB - An automatic method for repetitive microsampling of blood from conscious animals was used to obtain detailed GH secretory profiles from normal female rats, which were compared with those in males and ovariectomized females. Female rats showed a highly variable GH secretory pattern, with sustained periods of low, almost continuous secretion, followed by very rapid bursts of high amplitude and short duration, occurring mostly at night. There was no clear relationship between the pattern of GH secretion and the phase of the oestrous cycle in rats continuously sampled over a 5-day period. In ovariectomized rats, the day:night difference was maintained, though the nocturnal GH surges were larger and of longer duration than in intact females. Male rats produced multicomponent GH bursts which continued unchanged throughout the day and night. This study shows for the first time that female rats switch to a rapid, highly pulsatile pattern of GH release at night, which can only be resolved by rapid blood sampling over extended periods in conscious undisturbed animals. PMID- 3668431 TI - Retardation of preovulatory desensitization to negative oestrogen feedback: mechanism of the effect of progesterone in 5-day cyclic rats. AB - Recent studies have shown that oestrogen can induce desensitization to its own gonadotrophin-inhibiting effect in female rats by an action on the medial preoptic area (MPOA). Probably as a consequence of this action, sensitivity to the negative oestrogen feedback declines markedly between metoestrus and dioestrus of the 4-day ovarian cycle. To study this desensitization process in 5 day cyclic rats, females exhibiting regular 5-day vaginal cyclicity were ovariectomized on consecutive days of the cycle, injected with oestradiol benzoate (OB) or oil on the day of ovariectomy and autopsied 24 h after the injection. Estimation of the serum concentration of LH revealed that desensitization to negative oestrogen feedback occurred only between day 2 of dioestrus and pro-oestrus, i.e. 2 days later than in females with a 4-day cycle. In the latter animals, an injection of progesterone in metoestrus or early dioestrus, which induced lengthening of the ovarian cycle for 1 day, delayed the onset of desensitization to a degree similar to that found in spontaneously 5-day cyclic rats. In acutely ovariectomized females, progesterone implants placed in the MPOA, but not those located in the mediobasal hypothalamus, increased the LH inhibiting effect of low doses of OB. The results suggest that the prolonged secretion of progesterone recorded in 5-day cyclic rats retards follicle maturation and delays the forthcoming ovulation by acting, at least partly, on the MPOA and antagonizing the desensitizing effect of oestrogen. In this way, inhibition of gonadotrophin secretion by oestrogen is enhanced and the increase in tonic LH secretion necessary for the completion of follicle maturation is retarded. PMID- 3668432 TI - Catecholamines and ascorbic acid as stimulators of bovine ovarian oxytocin secretion. AB - The effects of catecholamines and ascorbic acid on cultured bovine granulosa cells have been examined to assess their possible role in the initiation and maintenance of luteal oxytocin secretion. The actions of these agents have also been compared with the previously reported ability of follicular theca tissue to enhance oxytocin secretion. Using granulosa cells cultured in serum-supplemented medium, we observed a highly significant enhancement of oxytocin secretion in the presence of adrenaline and noradrenaline, particularly over the concentration range 1-10 mumol/l. This effect was accompanied by smaller and less consistent changes in progesterone secretion and did not involve any change in the time course of oxytocin secretion. Acetylcholine was without effect. Ascorbic acid stimulated oxytocin secretion when used alone over a range of concentrations, but was also able to synergize with adrenaline. Lactic acid was ineffective. The stimulation of oxytocin secretion by adrenaline could be blocked by equimolar propranolol, but the stimulation of progesterone was not blocked. Propranolol had a variable effect on the ability of theca tissue to stimulate oxytocin secretion by granulosa cells but the results also suggested the presence of some beta agonistic activity in the culture medium. We conclude, first, that catecholamines may be involved in the regulation of ovarian oxytocin secretion, secondly, that ascorbate may regulate oxytocin secretion through its involvement in the biosynthesis of oxytocin but also through interaction with catecholamines and, thirdly, that the stimulatory action of theca tissue probably does not involve the action of beta-agonists. PMID- 3668433 TI - Passive immunization of pregnant goats against ovine LH. AB - Groups of three goats at 50, 90 and 130 days of gestation were passively immunized against ovine LH (oLH) by i.v. infusion of 8 ml serum equivalent of the immunoglobulin fraction of rabbit anti-oLH serum (LHAS). Goats at the same stages of gestation as above served as controls and received 8 ml serum equivalent of the immunoglobulin fraction of normal rabbit serum (NRS). Plasma concentrations of progesterone were determined by specific radioimmunoassay of blood collected at 20-min intervals from 6 h before infusion of LHAS or NRS to 12 h after infusion. Less frequent sampling was performed from 2 days before to 6 days after infusion. Plasma from all LHAS-immunized goats exhibited binding of oLH. Twelve hours after immunization, titres ranged from 1:135 to 1:215. All LHAS-treated goats had titres of less than 1:10 by 5 days after immunization, but a low level of oLH binding was still detectable. Treatment with LHAS or NRS did not shorten the length of gestation, with all goats delivering live offspring between 142 and 147 days after conception. Plasma concentrations of LH ranged from less than 0.15 micrograms/l to 4.8 micrograms/l and were greater than 0.15 micrograms/l in 181 of 255 samples (71%) for both the NRS-treated group, throughout the experiment, and the LHAS-treated groups before infusion of antiserum. Luteinizing hormone was not detectable in plasma samples obtained after LHAS infusion in goats at 50 or 130 days of pregnancy. Plasma concentrations of LH exceeded 0.15 micrograms/l in only five of 51 (10%) samples in 90-day-pregnant goats treated with LHAS, the maximum value reached being 0.80 micrograms/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668434 TI - Effect of adrenalectomy on LH release in sheep during the anoestrous season. AB - An experiment was conducted to measure LH pulse frequencies in bilaterally adrenalectomized Ile-de-France ewes during the mid-anoestrous season. Seven ewes were adrenalectomized under general anaesthesia and maintained on daily injections of 3 mg deoxycorticosterone acetate (DOCA). Adrenalectomy did not affect the patterns of LH release and the mean intervals between pulses in the adrenalectomized and sham-operated control ewes were 48 and 52 min respectively. Small implants of oestradiol significantly reduced the frequency of LH pulses in both groups and, in the presence of oestradiol, there were no differences in LH release between adrenalectomized and sham-operated ewes, with the mean interpulse intervals being 91 and 89 min respectively. In a second experiment, designed to assess the effects of DOCA on LH release, the mean interpulse intervals in unoperated control ewes (46 min) and unoperated ewes given daily injections of 3 mg DOCA (47 min) were similar to those observed in adrenalectomized and sham operated ewes. In the presence of small implants of oestradiol, the combination of DOCA and oestradiol decreased the pulse frequency significantly more than oestradiol alone (mean interpulse intervals of 85 and 65 min respectively) suggesting that DOCA may act as a progestagen in sheep. Thus alternative treatments to DOCA for the maintenance of adrenalectomized sheep must be found for future studies on the role of adrenal steroids in the reproductive system. It appears that adrenal steroids do not play a major role in the seasonal changes in LH release in the ewe. PMID- 3668435 TI - Adult rat Sertoli cells secrete a factor or factors which modulate Leydig cell function. AB - Production of testosterone and oestradiol-17 beta by Leydig cells from adult rats was stimulated by LH or dibutyryl cyclic AMP (10 and 2.5-fold respectively). The addition of spent medium from normal, hemicastrated or gamma-irradiated rat seminiferous tubule cultures, as well as from Sertoli cell cultures, to purified Leydig cells further enhanced both basal (44 and 53% for testosterone and oestradiol-17 beta respectively) and LH-stimulated (56 and 18%) steroid output. Simultaneously, a decrease (20-30%) in intracellular cyclic AMP levels was observed. This stimulating factor (or factors) secreted by the Sertoli cells is different from LHRH, is of proteinic nature and has a molecular weight ranging between 10,000 and 50,000; its synthesis is not controlled by FSH nor by testosterone. This factor(s) involved in rat Leydig cell steroidogenesis, at a step beyond the adenylate cyclase, does not require protein synthesis for testosterone formation whereas it does for oestradiol-17 beta production. It should be noted that a germ cell-Sertoli cell interaction modulates the synthesis of this factor(s). PMID- 3668436 TI - Diurnal rhythm of vasopressin but not of oxytocin in the cerebrospinal fluid of the goat: lack of association with plasma cortisol rhythm. AB - Diurnal rhythms in the concentrations of vasopressin (AVP) and oxytocin in cerebrospinal fluid (CSF) differ between species and are unrelated to changes in the levels of these hormones in the peripheral circulation. We have investigated neurohypophysial hormone rhythms in the CSF of the conscious goat by determining whether they are entrained by daily cycles of light and darkness and by assessing the effect of the suppression of plasma cortisol. Goats were implanted with cisternal cannulae under halothane anaesthesia and allowed to recover. They were accustomed to a 12 h light:12 h darkness lighting cycle (lights on from 07.30 to 19.30 h). After initial serial CSF and plasma sampling the daily cycle of light and darkness was reversed. Three goats were kept in constant light for 8 days before the study and five were given dexamethasone (5 mg/12 h) for 4 days. There was a significant (P less than 0.01) diurnal variation in CSF concentrations of AVP, with a maximum of 3.6 +/- 0.8 (S.E.M.) pmol/l at 12.00 h and a minimum of 1.4 +/- 0.3 pmol/l at 24.00 h. There were no significant changes in CSF concentrations of oxytocin or plasma AVP. After the light:darkness cycle was reversed the AVP rhythm in the CSF was disrupted after 24 h and reversed after 8 days. The diurnal rhythm of AVP in CSF persisted in animals exposed to constant light. After treatment with dexamethasone plasma cortisol was suppressed and showed no diurnal rhythm but the AVP rhythm in CSF remained unchanged. PMID- 3668437 TI - Cell kinetics of thyroid epithelial cells during hyperplastic goitre involution. AB - Thyroid epithelial cell kinetics were investigated in rats when a normal iodine diet was re-established after a long period of iodine deficiency supplemented with propylthiouracil (0.15%) for the last 2 months. In the first (prelabelling) experiment, all rats were labelled with a single injection of [3H]thymidine 2 days before iodine refeeding in order to follow the fate of the prelabelled cells. In the second experiment, the pulse-labelling index at the time of killing was measured; for this purpose the rats received [3H]thymidine 1 h before death. In these two experiments autoradiography was performed on histological sections. Thyroids were excised on day 0 and then at various intervals up to day 73 of iodine refeeding. Plasma tri-iodothyronine (T3) and thyroxine (T4) were very low until day 4 and then increased to reach control values on day 30. Thyroid concentration of iodide rose to 20 times the value on day 0, remained at this high level until day 2, and then diminished on day 4 to reach the control value on day 16. Plasma TSH concentrations were very high in iodine-deficient rats and did not vary significantly until day 8, when they fell rapidly to reach the control value on day 30. Thyroid weight, raised on day 0, decreased relatively quickly until day 4, then more slowly until day 30. Total thyroid epithelial cell number, high on day 0 (30.7 x 10(6) cells) was constant until day 16, then decreased until day 30 at which time a plateau was reached.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668438 TI - Collagen and non-collagen protein turnover in skeletal muscle of growth hormone treated lambs. AB - Long-term administration of GH to normal, well-fed lambs caused a significant increase in net muscle growth. This could be accounted for by increased rates of muscle protein synthesis, although red and white muscles responded differently. The increased rate of protein synthesis was due to an increased protein synthetic capacity (increased muscle RNA content) but efficiency per unit of RNA also tended to increase in red muscle. For similar increases in net growth protein turnover was increased to a much greater extent in red than in white muscle. The ratio of collagen to non-collagen protein was unaffected in both muscle types by GH treatment, even though collagen synthesis rates were significantly increased in red muscle. To date, GH is the only anabolic agent in ruminants which acts via increased rates of protein synthesis rather than by decreased rates of protein degradation. PMID- 3668439 TI - Relation between aggressive behaviour and circadian rhythms in cortisol and testosterone in social groups of talapoin monkeys. AB - Circadian rhythms in cortisol and testosterone in both blood and cerebrospinal fluid (CSF) were studied in four groups of male and female talapoin monkeys. Samples were taken 4 h apart under two conditions: whilst the sexes were kept separate (isosexual) and again after 24 h of interaction (heterosexual). There were similar rhythms in cortisol in males and females during the isosexual condition, though in blood (but not in CSF) mean levels were higher in females. Heterosexual interaction increased cortisol levels in both sexes (though more so in males), and also altered the shape of the rhythm, acrophase being delayed by 4 h in males and by 2 h in females. The amplitude of the rhythm was not altered. Cortisol levels were positively correlated in both males and females with the amount of aggression received from other males, but not from females nor with the animal's social rank. Circadian rhythms in serum testosterone in males were also altered by heterosexual interaction. Access to females delayed acrophase by 2 h, but had no effect on mean levels (unlike the effect on cortisol). As for cortisol, the amplitude of the testosterone rhythm remained unchanged. Serum testosterone was negatively correlated with aggression from males, but not from females nor with sexual interaction. This was associated with a pronounced decrease in the levels of testosterone during the night, not observed in males receiving no aggression from others. There was a non-significant trend towards a positive correlation between social rank and serum testosterone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668440 TI - Effect of 1,25-dihydroxyvitamin D3 on plasma concentrations of calcium-binding protein in normal and rachitic (vitamin D-dependent rickets type I) pigs. AB - An i.v. injection of calcitriol (1,25-(OH)2D3) had no effect within 2.5 h on plasma concentrations of calbindin-D9K (vitamin D-induced calcium-binding protein; CaBP) in hypocalcaemic pigs with inherited vitamin D-dependent rickets type I or in their normocalcaemic siblings or half-siblings. Three days later the plasma concentration of CaBP had doubled in the hypocalcaemic pigs, but was unaltered in the normocalcaemic siblings and half-siblings. Following daily i.v. injections of 1,25-(OH)2D3 for a further 5 days (days 4-8) plasma concentrations of CaBP increased in both the hypocalcaemic (days 4-8) and normocalcaemic (day 8) pigs, the effect being more rapid and greater in the hypocalcaemic 1,25-(OH)2D3 deficient animals. An i.v. injection of 1,25-(OH)2D3 to pure Yucatan pigs also had no effect on plasma concentrations of CaBP within 1.5 h, but in the following 1 h there was some indication of an increase in plasma CaBP levels. In contrast to the normal pigs, insulin-induced hypoglycaemia did not lead to a peak in plasma CaBP concentrations in the hypocalcaemic pigs. There was also no change in the plasma concentrations of 1,25-(OH)2D3 associated with the peak in plasma CaBP following insulin-induced hypoglycaemia in normocalcaemic pigs. These results suggest that changes in plasma concentrations of 1,25-(OH)2D3 are not directly involved in mediating the increase in plasma CaBP which follows hypoglycaemia induced by insulin in normal pigs, although 1,25-(OH)2D3 probably plays a permissive role. PMID- 3668441 TI - In-vitro evidence for the autoregulation of prolactin secretion at the level of the pituitary gland in the rat. AB - The autoregulation of rat prolactin secretion at the level of the pituitary gland was investigated, using a static incubation system. The rate of prolactin secretion from the female anterior pituitary gland in vitro was found to be constant when the medium was changed at 20-min intervals. However, when the medium was left unchanged and secretory products were allowed to accumulate, prolactin secretion began to decline within 60 min. This effect was not observed with the male tissue, where the level of accumulated prolactin did not reach that at which the inhibition occurred using female tissue. The nature of the putative secretory product causing the inhibition of prolactin secretion was investigated. Exogenous bovine prolactin (1-4 mg/l) caused an inhibition of endogenous rat prolactin secretion. Inclusion of monoamine oxidase in unchanged medium, to prevent dopamine accumulation in the medium (a possible consequence of co-storage and co-secretion with prolactin granules), did not prevent the inhibition observed in the control incubation. We therefore conclude that in-vitro autoregulation of prolactin secretion can occur at the level of the pituitary gland, probably due to the accumulated prolactin having a feedback action on the lactotroph. This might be of physiological significance if localized concentrations of the hormone within the gland are high. PMID- 3668442 TI - Growth hormone induction of insulin-like growth factor I messenger RNA in primary cultures of rat liver cells. AB - Primary liver cells from adult rats were used to study the hormonal regulation of mRNA coding for insulin-like growth factor I (IGF-I). IGF-I mRNA could be detected at a low concentration in liver cells prepared from hypophysectomized rats and cultivated for 3 days. When these cells were exposed to GH on the second day, a dose-dependent increase in IGF-I mRNA was observed. The continuous presence of serum was not a prerequisite for this response, since GH also induced IGF-I mRNA in a defined hormone-supplemented medium. It is concluded that GH can induced IGF-I mRNA in the liver by a direct mechanism. PMID- 3668443 TI - Arginine vasopressin and oxytocin in the bovine adrenal gland. AB - The concentrations of immunoreactive oxytocin and arginine vasopressin (AVP) and their respective neurophysins (NpI and NpII) were compared in bovine adrenal cortex and medulla. While the concentration of AVP was similar in both tissues there was more NpII in the medulla. The medulla also contained much more oxytocin and NpI than the cortex. The extracted AVP and oxytocin had identical retention times to those of the synthetic peptides on high-performance liquid chromatography (HPLC) and were biologically active in assays for antidiuretic and milk-ejection activity (with potencies of 310 units/mg and 340 units/mg respectively). Adrenal NpI and NpII behaved identically to commercially available neurohypophysial proteins on HPLC. Oxytocin, NpI and AVP were assayed in five subcellular fractions of bovine adrenal medulla prepared on discontinuous sucrose gradients. A high proportion of each co-localized with noradrenaline and adrenaline in the chromaffin granule fraction. Binding of [3H]AVP and [3H]oxytocin to crude bovine adrenal medulla membranes was dependent upon both time and temperature. The binding sites were specific and saturable: studies with the V1 AVP antagonist d(CH2)5Tyr(Me)AVP and the V2 agonist 1-deamino-8-D-AVP indicated that the AVP receptor was V1 in specificity. Scatchard plots showed that each ligand interacted with a single high-affinity, low-capacity binding site: oxytocin dissociation constant (Kd) 3.1 +/- 0.29 nmol/l, maximum binding capacity (Bmax) 89.6 +/- 18.4 fmol/mg protein (n = 3); AVP Kd 0.73 +/- 0.02 nmol/l, Bmax 26.5 +/- 8.3 fmol/mg protein (n = 3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668444 TI - Changes in peripheral progestagen levels in early pregnant gilts following injection of human chorionic gonadotrophin. AB - The capacity of human chorionic gonadotrophin (hCG) to raise plasma progestagen levels during the first 8 days of gestation in gilts was examined. The effective half-times of hCG in gilts treated with 500 and 5000 i.u. hCG were 29.1 and 26.3 h respectively (P greater than 0.05). Neither 500 nor 5000 i.u. hCG caused rises in peripheral concentrations of progesterone or pregnenolone sulphate, and plasma pregnenolone concentrations declined (P less than 0.05) following hCG treatment. Apart from diminished total corpus luteal weights in gilts treated with 500 i.u. hCG (P less than 0.05) and lower peripheral progesterone levels in gilts treated with 5000 i.u. hCG (P less than 0.05), ovarian and plasma steroid characteristics of hCG-treated animals between 23 and 25 days of gestation were similar to control values. Furthermore, treatment with hCG did not affect embryo survival during the first 4 weeks of pregnancy, and plasma oestrone/oestrone sulphate levels provided no evidence for differences between control and treated animals in trophoblastic outgrowth. These results challenge the rationale for the treatment of early pregnant sows with hCG in order to reduce the levels of embryonic wastage in early pregnancy. PMID- 3668445 TI - Salivary oestriol and progesterone concentrations in women during late pregnancy, parturition and the puerperium. AB - Oestriol and progesterone concentrations were measured by specific radioimmunoassays in the saliva of six women on a daily basis during the last month of pregnancy, at frequent intervals during labour and daily during the puerperium. Salivary steroid concentrations are thought to reflect the circulating concentrations of the free hormone, and hence may be more biologically relevant than the total plasma concentration, or the urinary excretion of a metabolite. There was no sign of a fall in salivary oestriol or progesterone concentrations before the onset of labour. During the first and second stages, the concentrations fluctuated widely, perhaps due to alterations in uterine blood flow. After delivery of the placenta, hormone concentrations declined abruptly. Oestriol reached undetectable levels of less than 0.1 nmol/l within a day, whereas progesterone concentrations declined somewhat more slowly, approaching follicular-phase values after 2-3 days. This slower decline in the concentration of progesterone may be due to a leaching-out of the hormone from body fat stores. The absence of any prepartum progesterone withdrawal presumably explains the characteristic postpartum delay in the onset of lactogenesis. PMID- 3668446 TI - Effect of oestradiol-17 beta on perineal and neck skin glands in heifer calves. AB - Ten 16-week-old Friesian x Hereford heifer calves were split into experimental and control groups. Experimental animals were given an implant of oestradiol-17 beta in the ear whilst controls were given blank implants. They were killed 14 days later. After implantation the experimental group had consistently greater (P less than 0.01) plasma concentrations of oestradiol-17 beta than the control group. After death, sebaceous gland volume in the perineal region was greater (P less than 0.01) in the experimental than in the control group, whereas sebaceous gland volume in the neck was smaller (P less than 0.01). Sweat gland volume in the perineal region was greater (P less than 0.01) in the experimental than in the control group. There was no difference between groups in the volume of sweat glands in the neck. PMID- 3668447 TI - How large a hormone can be measured by microencapsulated antibody? AB - The size of molecules able to be measured in immunoassays where antibody is encapsulated within semipermeable microcapsules is restricted by the pore size of the membrane. This study was performed to determine the approximate molecular weight cut-off of this membrane. Permeability was assessed by measuring which labelled hormones were able to enter and bind their respective microencapsulated antibody. Hormones with molecular weights of less than 4000 (angiotensin II, thyroxine, 17-hydroxyprogesterone, progesterone, testosterone and androstenedione) passed freely through the pores but larger molecules, with molecular weights in excess of 10,000 (parathyroid hormone, human GH, TSH) could not. Insulin, with a molecular weight of 6000 (approximate minimum diameter 3.5 nm), had restricted entry while the next smallest hormone tested, the 1-34 amino acid portion of parathyroid hormone (molecular weight 4000; diameter 1.8 nm), was able to bind encapsulated antibody, suggesting that the pore diameter is between 1.8 and 3.5 nm. It can now be predicted that the method is able to measure compounds with a diameter within this range and with a molecular weight below 6000. Microcapsules may be useful for improving specificity of assays where a cross-reactant is too large to penetrate the membrane. PMID- 3668448 TI - Plasma vitamin D-binding protein and free 1,25-dihydroxyvitamin D3 index in pregnant ewes and their fetuses in the last month of gestation. AB - A radioimmunoassay for ovine vitamin D-binding protein (DBP) has been developed. This assay can also effectively measure DBP in goat plasma. A suitable ovine DBP antiserum raised in a rabbit produced a single monospecific line of precipitation when reacted against purified sheep DBP and sheep plasma. The preliminary purification of 125I-labelled ovine DBP was carried out using adsorption chromatography, and the final purification immediately before addition to the assay tubes was achieved by high-pressure liquid chromatography. Displacement of 125I-labelled ovine DBP by dilutions of sheep and goat plasma or standard DBP gave parallel curves, and only weak competition was observed with calf and pig plasma. The assay detected as little as 26 pmol DBP/l with intra- and interassay coefficients of variation of 3 and 14% respectively. The mean plasma concentration of DBP in nine pregnant sheep (110-120 days of gestation) was 8.7 +/- 0.3 (S.E.M.) mumol/l. These levels were significantly (P less than 0.02; paired t-test) higher than those in matched fetal plasma (6.7 +/- 0.4 mumol/l) obtained in utero through a catheter in a carotid artery. Plasma DBP concentrations in pregnant sheep were also significantly (P less than 0.02) higher than in five normal non-pregnant sheep (6.8 +/- 0.5 mumol/l). The mean concentrations of total 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) in maternal and fetal plasma were 92.0 +/- 8.7 pmol/l and 152.5 +/- 18.0 pmol/l respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668449 TI - Cholecystokinin peptides as local modulators of thyroidal calcitonin secretion in the dog? AB - Cholecystokinin (CCK) is a heterogeneous gut hormone which is also synthetized in extra-intestinal endocrine cells and neurons. In order to examine the possibility that CCK peptides are local modulators of calcitonin secretion, we have studied the structure-activity relationship on calcitonin secretion from perfused canine thyroid lobes as well as the presence and molecular nature of CCK in the thyroid. Peptides containing the intact COOH-terminal tetrapeptide amide of CCK (CCK-4, CCK-5, pentagastrin, CCK-8 and gastrin-17) all induced dose-dependent (0.1, 3 and 100 nmol/l) increases in calcitonin release (P less than 0.05, n = 4) with biphasic secretion during 6-min infusion periods. The deamidated tetrapeptide and the COOH-terminal tripeptide were without effect. Gel chromatography of neutral water and acid-ethanol extracts of thyroid tissue, monitored by sequence-specific CCK and gastrin radioimmunoassays, disclosed a variety of CCK and gastrin peptides of which a predominant form resembled small molecular forms like CCK-4 and CCK-5. The presence in the thyroid of small CCK-like peptides and the pronounced effect of such peptides on calcitonin secretion suggest that calcitonin secretion is modulated by local release of small CCK peptides. They could originate from intrathyroidal nerves or from sub-populations of C-cells. PMID- 3668450 TI - Sexual activity increases plasma concentrations of cholecystokinin octapeptide and offsets hunger in male rats. AB - Male rats deprived of food for 48 h ignored food pellets immediately after ejaculating with a sexually receptive female rat as did males tested 5 min after i.p. injection of 5 micrograms cholecystokinin octapeptide (CCK-8) or males which had consumed food pellets for 1 h. The concentration of CCK-8 in plasma was increased to comparable levels (10.1 +/- 3.8 (S.E.M.); 11.3 +/- 3.7 and 7.2 +/- 0.5 pmol/l respectively, compared with 1.2 +/- 0.3 pmol/l for NaCl-injected controls) under each of these conditions, whereas the concentration of gastrin increased only after food consumption (18.4 +/- 3.8; 17.7 +/- 5.4 and 54.3 +/- 7.0 pmol/l respectively, compared with 21.5 +/- 2.1 pmol/l for NaCl-injected controls). The effect of ejaculation on the latency to starting to eat was partially reversed by i.p. injection of 50 mg of the CCK-8 antagonist proglumide, but neither treatment with proglumide or CCK-8 nor consumption of food affected the display of sexual behaviour. The results support the suggestion that CCK-8 is a 'satiety peptide' in the rat. PMID- 3668451 TI - Structural plasticity in the rat supraoptic nucleus during gestation, post-partum lactation and suckling-induced pseudogestation and lactation. AB - In the supraoptic nucleus (SON) of parturient and lactating rats, large portions of the surface membranes of almost all oxytocinergic neurons are directly juxtaposed with no glial interposition. A significant number of the same neurones are also contacted by the same presynaptic terminal ('double' synapses). Our present observations have revealed that direct appositions between adjacent neurons in the SON increase quite rapidly during the day before parturition. 'Double' synapses also become visible during late gestation, but they appear more progressively. Earlier studies have shown that 1 month after weaning, as in virgin rats, there are again very few appositions and 'double' synapses in the nucleus. We show here that the SON can remain structurally modified, and to the same degree, beyond normal weaning time so long as lactation is prolonged by renewing suckling litters. However, if the mothers are deprived of their pups immediately after birth, neuronal appositions disappear within 2 days and 'double' synapses by 10 days. In non-pregnant primiparous rats, continuous exposure to suckling litters leads to pseudogestation and eventually lactation (in 16-22 days). Examination of the SON in such animals revealed that the oxytocinergic system is already modified by day 12 of dioestrus; during suckling induced lactation, the anatomical changes are identical to those seen during a normal post-partum lactation. These observations indicate that neither gestation nor suckling alone are indispensable for the anatomical reorganization of the SON apparent at lactation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668452 TI - Mortality and causes of death in females with extra X chromosomes and males with extra Y chromosomes. AB - A prospective study of mortality in females with extra X chromosomes and males with extra Y chromosomes is reported. Among the 94 females who survived infancy and were then observed on average for 16 years there were 24 deaths compared with an expected mortality of 10.7. The greater than twofold increase is highly significant (p less than 0.005). The deaths were due to a variety of diseases but no significant increase from any single cause could be identified. Among 136 males with extra Y chromosomes observed on average for 12 years there were 10 deaths. This number is not significantly greater than the expected 6.4. No increase in mortality from a single cause was observed. PMID- 3668453 TI - Multiple sclerosis and motor neurone disease: survival and how certified after death. AB - This study assesses the outcome of a random sample of patients with multiple sclerosis (MS) and motor neurone disease (MND) selected from a previous study carried out between the years 1960 and 1972. Of the MND patients who are now dead, 20% of the women and 27% of the men lived longer than five years after hospitalised diagnosis, and two of these patients lived up to 19 years after diagnosis in hospital. Also, 10.7% of the random sample of MND patients were still alive in June 1985. Of the MS deaths 26.4% and of the MND deaths 20.4% did not have these respective conditions recorded on the death certificates. PMID- 3668454 TI - Incidence of motor neurone disease in the northern region. AB - The incidence of motor neurone disease in the Northern Region was studied for the year 1981 by means of hospital activity analysis records and questionnaire. The crude incidence rate was 2.2 per 100,000. This was not significantly different from the rate determined by using death certification. The age standardised incidence ratio for the region was 163 using the 1976 population and deaths from motor neurone disease in England and Wales as the reference. The female to male ratio was 1:1.8 and the average age of diagnosis was 63 years. No meaningful intraregional variation was observed. Thus mortality appears to reflect incidence fairly accurately. PMID- 3668455 TI - Association of infant alimentary and respiratory illness with parental smoking and other environmental factors. AB - The incidences of alimentary and respiratory illnesses were observed during the first year of life in 1565 infants born in Tayside during 1980. Significant correlations (p less than 0.05) were found between each of these outcomes and parental smoking, maternal age, social class, method of infant feeding, and heating fuels. Multiple logistic regression indicated a significant independent effect of parental smoking was related separately to alimentary and to respiratory outcomes, the relative risks being of similar strength. PMID- 3668456 TI - Relation between cigarette smoking and use of hormonal replacement therapy for menopausal symptoms. AB - The aim of this study was to characterise new users of hormonal replacement therapy (HRT) for the relief of menopausal symptoms and to compare these women with never-users of HRT; 402 new users and 804 never-users were studied. Hot flushes were the most common symptom in both users and non-users and were the most frequent reason for prescribing HRT. The prevalence of menopausal symptoms in non-users of HRT was high although substantially lower than that in users. HRT users were more likely to be current cigarette smokers than were never-users. There was also, within smokers, a significant relation between the number of cigarettes smoked and the likelihood of using HRT. This relation between HRT use and smoking could result from an anti-oestrogen effect of smoking, intensifying menopausal symptoms. Of potential clinical relevance is the suggestion that a proportion of women using HRT may be doing so in order to alleviate smoking induced symptoms. Users of HRT were also more likely to have used oral contraceptives than were never-users; this relation was probably behavioural. PMID- 3668457 TI - The Copenhagen case-control study of bladder cancer: role of smoking in invasive and non-invasive bladder tumours. AB - A population based study of 388 cases of bladder cancer including papillomas and 787 controls in Greater Copenhagen confirmed the role of smoking in the aetiology of bladder cancer. Significantly increased relative risks were found for persons who had smoked only cigarettes (RR = 2.9; both sexes combined) and for mixed smokers including cigarettes (RR = 3.6; both sexes combined). Multiple logistic regression analysis showed significant influences of the amount (pack years) of cigarettes smoked and a reduced risk among persons who had stopped smoking. No significant effects of smoking pipe or cigars/cigarillos were apparent, and the present study does not confirm previous suggestions of associations between the smoking of cigars/cigarillos and bladder cancer in Denmark. Only a slight increase in relative risk with the amount smoked was found. The influence of smoking on bladder cancer risk was similar for tumours in stages T1 and T2-4 at diagnosis and also for tumours of grades 1-2 and grades 3-4 at diagnosis. PMID- 3668458 TI - Diet, infection, and acute appendicitis in Britain and Ireland. AB - During 1979-82 hospital discharge rates after emergency admission for acute appendicitis were higher in Eire (17.4 per 10,000 population) than in England (10.3), Scotland (11.1), or Wales (12.3). Comparison of food consumption between the four countries, and between the health board areas of Eire and regions of Scotland, shows that appendicitis rates are highest in communities that consume more potatoes, sugar, and cereals, and less non-potato vegetables and fruit. The rates are also related to mortality from enteric and respiratory infections, to general practice consultations for infective disease, and to postneonatal mortality. This is evidence in favour of the hygiene hypothesis for the aetiology of appendicitis. PMID- 3668460 TI - Effects of subsidising bus travel on the occurrence of road traffic casualties. AB - Between 1975 and 1 April 1986, public transport by bus in the metropolitan county of South Yorkshire, England, was increasingly subsidised. Trends in road traffic accident casualties between 1974 and 1983 in all the six provincial English metropolitan counties have been compared in order to examine the possible effect of this unique subsidy on the incidence of road traffic accident casualties. During that period the total number of casualties in South Yorkshire did not change significantly compared to the other metropolitan counties. However, the proportion of all casualties in South Yorkshire who were bus occupants did increase relative to other metropolitan counties, indicating either an increase in the amount of bus travel or a decrease in travel by other modes. There was a large increase in bus patronage in South Yorkshire relative to the other metropolitan counties, and the conclusion is that it is the transport policy in South Yorkshire which resulted in an actual increase in distances travelled by bus. Since bus is the safest form of road travel, it is concluded that the public transport subsidy in South Yorkshire has benefited the health of the local population by providing the social amenity of additional travel at the least additional health cost. PMID- 3668459 TI - Epidemiology of multiple sclerosis in the north-east (Grampian region) of Scotland--an update. AB - The north-east of Scotland (Grampian Region) has undergone three incidence and prevalence surveys, including the present one, since 1970. Results from these indicate a true increase in the prevalence of the disease in the region. The incidence of the disease has remained continuously high and shows a slightly upward trend. Literature on the subject of repeated surveys in different regions of the world has been reviewed in detail. The need for a prevalence study from the south of the British Isles has been emphasised in order to enable one to judge if the increase in Scotland is in keeping with the pattern in the whole of the British Isles. The familial incidence of the disease was noted to be virtually unchanged between the three surveys. Certain other aspects of aetiological significance have been analysed, viz, clustering of patients at birth or at onset of the disease; ages of occurrence of childhood viral infections such as measles, mumps, chickenpox and rubella; and the role of canine distemper infection. PMID- 3668461 TI - Epidemiology of AIDS--statistical analyses. AB - Some central questions concerning the epidemiology of AIDS are addressed by statistical analyses. Applying standard maximum likelihood theory to reported cases of transfusion-associated AIDS in the US, the mean and standard deviation of incubation time for AIDS are estimated to be about 60 and 19 months, respectively. If these parameters are applied to the data from the San Francisco CDC cohort study, we find a good correspondence between estimated and reported cases of AIDS when the probability factor p is 0.27-meaning that about 27% of those infected with HIV are expected to develop AIDS during a period of 8-10 years. Application of the incubation time model and the probability factor p to the data on transfusion-associated AIDS makes it possible to estimate the number of transfusion-associated infections with HIV from 1978 to 1984. These estimates give an exponential increase in the number of cases, with a relative increase of 2.74 each year. It seems reasonable to assume that this increase reflects the spread of the virus within this period. PMID- 3668462 TI - Relative risk estimation from vital statistical data: validation, a pitfall and an alternative method. AB - A previously described method of obtaining an estimate of relative risk from routinely available data was applied to data on cigarette consumption and lung cancer mortality to test its validity. Some shortcomings of the method were noted and an alternative approach using weighted logistic regression gave results closer to those predicted on the basis of other studies, without the disadvantages of the original technique. PMID- 3668463 TI - Sudden infant death syndrome and environmental temperature: an analysis using vital statistics. AB - We examined the relation between the daily numbers of deaths ascribed to sudden infant death syndrome (SIDS) (n = 6226) and daily temperature in England and Wales over the five year period 1979-83. When the data were filtered to remove the dominant seasonal trend, and residual autocorrelation, we found a significant negative correlation of deaths with both the level and rate of change of temperature four to six days earlier, irrespective of age at death. Place of usual residence was obtained for 909 SIDS cases occurring during the unusually severe winter of 1981-82, and, using space-time clustering techniques, we confirmed previous findings of the lack of 'epidemicity' for this condition. These results are compatible with several previous hypotheses of the relation between the weather and SIDS and directly incriminate drops in temperature in the occurrence of the condition. PMID- 3668464 TI - High appendicectomy rates in Ireland: why? AB - Age-specific appendicectomy rates for Ireland have recently been reported to be substantially higher than those for Scotland. We attempted to determine the reason for this difference. Records of 940 appendectomies performed in one urban and one rural centre in Ireland over a 12 month period were examined to establish the frequency of acute appendicitis. Appendicitis rates were derived from these data. Appendicectomy rates are higher in Ireland because the incidence of acute appendicitis is greater than in Scotland or England and Wales and are not the result of variations in medical practice. PMID- 3668465 TI - Trends in mortality from lung cancer in Spain, 1951-80. AB - Lung cancer mortality rates in Spain were calculated for the years 1951 to 1980. Increasing age-standardised rates for men and levelled off ones for women were observed. Available cigarette consumption data suggest that these current trends could change at the beginning of the next century when there may be a levelling off of male rates and an "epidemic" of female lung cancer. PMID- 3668467 TI - Postneonatal mortality. PMID- 3668466 TI - Economic aspects of an epidemic of haemorrhagic conjunctivitis in a rural community. AB - The estimated economic loss due to an epidemic of acute haemorrhagic conjunctivitis in 1981 in a rural community of Goa studied by house-to-house survey of 7230 families is reported. Thirty-five per cent of families were affected and in 62% of these families more than three persons developed conjunctivitis. The affected were forced to be absent from work resulting in a reduction of the work force (loss of 7735 man days) and loss of income (Rs 1,33,300). The type of treatment followed and estimates of treatment cost are described. The economic consequences to the country of this widespread epidemic are described. PMID- 3668468 TI - Seasonal variation in birthdates of men with testicular cancer. PMID- 3668469 TI - Parental occupations and cancer. PMID- 3668470 TI - Emergence of the ability to discriminate a blue from gray at one month of age. AB - Two different methods which minimize achromatic cues were used to test the ability of 1-month-olds to discriminate gray from broadband blue (lambda peak = 475-480 nm). Unlike the newborns we tested previously, 1-month-olds demonstrated the discrimination with both methods. In Experiment 1 they showed preferences for each of four blue-and-gray checkerboards over gray squares of the same mean luminance, even though the luminance of the gray checks was varied in small steps over a wide range. In Experiment 2 they looked longer at a blue square than at a gray square, after they had been habituated to five other gray squares of varying luminance. Compared to previous results, these data imply an improvement between birth and 1 month of age in the discrimination of gray from broadband blue. Possible physiological changes underlying this improvement are discussed. PMID- 3668471 TI - Figural factors and the development of pictorial inferences. AB - The role of figural characteristics in the development of pictorial inferences was examined. Two versions of 10 three-picture story sequences were presented to kindergarten and third-grade children. One version maximized while the other minimized figural similarity among pictures. After viewing the sequences, the children were asked to discriminate old study pictures and inferentially consistent new pictures from distractors. While the kindergarteners identified significantly fewer inference pictures than the third graders in all conditions, there was less difference between the grades in the figurally similar conditions. Overall, the kindergarteners identified the fewest inference pictures in the presence of distractors that figurally matched the study pictures. These results indicate that although the pictorial inferences drawn by kindergarteners are heavily influenced by figural representations, such figural dependency cannot account for all of the observed developmental differences. PMID- 3668472 TI - Young children's spontaneous inspection of negative instances in a search task. AB - Forty children 1 1/2 to 3 1/2 years of age searched for stickers that were hidden underneath two discretely different classes of objects embedded in arrays containing several classes. The paper focuses on a previously unobserved strategy that appeared at 3 1/2. Whereas the younger children searched underneath those objects that looked like the objects the children knew had stickers, the 3 1/2 year-olds systematically explored not only the objects that did, but also the objects that did not, have stickers. Eight adults performed similarly to the 3 1/2-year-olds. Analyses of developmental trends in the data and the observation of individual children performing the tasks suggest that the children's increased inspection of the negative objects was not merely the result of a random or more exhaustive search. The children appear to have been attempting to determine which kinds of choices were the wrong ones. The attempt to define and delimit negative cases is a central aspect of reflective thought. PMID- 3668473 TI - da Vinci's window facilitates drawings of total and partial occlusion in young children. AB - When two or more objects are present in a scene, children 5 and 6 years of age rarely draw the scene such that one object totally or partially occludes another object. Instead they draw complete objects. The present study separated two components of drawing: perspective taking and graphic skill. Perspective taking was examined by comparing a free viewing condition with a restricted viewing condition in which a model could only be viewed through four apertures. Graphic skill was examined by comparing drawings requiring total occlusion with drawings requiring partial occlusion under both viewing conditions. Experiment 1 showed that 90% of 5- and 6-year-olds drew total occlusions under restricted viewing conditions but only 32% did so in the free viewing condition. Experiment 2 showed that drawings of partial occlusion were unaffected by viewing condition among 5 year-olds, but that restricted viewing increased the number of partial occlusions that 6-year-olds drew. Thus, failures of young children to draw occlusions have less to do with graphic skill than was previously thought. Instead, it is suggested that young children have a more general difficulty selecting one perspective and maintaining it over time. PMID- 3668474 TI - A test of color constancy in 4-month-old human infants. AB - Forty-five 4-month-old infants were tested for color constancy using a familiarization, paired-comparison paradigm. Infants were familiarized and tested with colored stimuli under two conditions: (1) no change in the illuminant between familiarization and test and (2) a change in the illuminant between familiarization and test. Infants correctly recognized the familiarization color when tested with no change in the illuminant. Infants tested with a change in the illuminant correctly recognized the familiar color under some conditions yet failed to do so under others. Several explanations are considered for these results and it is concluded that color constancy operates immaturely at 4 months of age. PMID- 3668475 TI - Children's use of multiple-counting skills: adaptation to task factors. AB - The purpose of the study was to determine conditions under which young children enumerate by counting in multiples. Thirty-eight kindergartners and first-graders enumerated dot displays and gave verbal reports of their strategies; additionally, they were given an independent assessment of multiple-counting skill. Dot displays varied according to overall numerosity, perceptual arrangement (random, clustered, rectangular), and numerosity of subgroupings. Children were relatively accurate at enumerating small-numerosity and nonrandom displays. They were relatively likely to report counting by multiples, rather than by ones, on small-numerosity and clustered displays. Contingent upon their skill level, children counted by multiple units (twos, threes, and fours) that corresponded to the numerosity of subgroupings (2, 3, and 4). Contrasting effects of different numerosities and perceptual arrangements are discussed in terms of contextual support for the use, and development, of numerical skills among young children. PMID- 3668476 TI - System-specific differences in behavior regulation: overrunning and underdrinking in molar nondepriving schedules. AB - In two experiments we tested the molar regulation prediction that animals adjust schedule performance to reduce deviations from baseline response totals. Both experiments constrained the baseline drink-burst length under molar nondepriving schedules but allowed rats to continue running without drinking. In Experiment 1, rats were required to run in order to drink. In Experiment 2, water was delivered independently of running by fixed-time (FT) schedules. Under the run-to-drink contingency, rats exceeded their baseline amounts of running (overrunning) but failed to maintain their baseline water intake (underdrinking). The total amount of running that did not lead to drinking approximated baseline running. Under the FT schedules, rats again underdrank, but total running approximated baseline. These results do not support previous studies that have shown molar equilibrium effects under nondepriving reciprocal schedules. We conclude that (a) contingent running may not substitute for independent running; (b) intermittent access to water reduces the total instigation for drinking; (c) molar regulation differs under reciprocal and nonreciprocal schedules; and (d) more dynamic, system specific regulatory models need to be developed. PMID- 3668477 TI - The comparator hypothesis of conditioned response generation: manifest conditioned excitation and inhibition as a function of relative excitatory strengths of CS and conditioning context at the time of testing. AB - In the present research water-deprived rats were used in a conditioned lick suppression paradigm to test and further develop Rescorla's (1968) contingency theory, which posits that excitatory associations are formed when a conditioned stimulus (CS) signals an increase in unconditioned stimulus (US) likelihood and that inhibitory associations develop when the CS signals a decrease in US likelihood. In Experiment 1 we found that responding to a CS varied inversely with the associative status of the context in which the CS was trained and that this response was unaltered when testing occurred in a distinctively dissimilar context with a different conditioning history, provided associative summation with the test context was minimized. These results suggest that manifest excitatory and inhibitory conditioned responding is modulated by the associative value of the training context rather than that of the test context. In Experiment 2 it was demonstrated that postconditioning decreases in the associative value of the CS training context reduced the effective inhibitory value of the CS even when testing occurred outside of the training context. Moreover, this contextual deflation effect was specific to the CS training context as opposed to any other excitatory context. Collectively, these studies support the comparator hypothesis, which states that conditioned responding is determined by a comparison of the associative strengths of the CS and its training context that occurs at the time of testing rather than at the time of conditioning. This implies that all associations are excitatory and that responding indicative of conditioned inhibition reflects a CS-US association that is below (or near) the associative strength of its comparator stimulus. It is suggested that response rules which go beyond a monotonic relation between associative value and response strength can partially relieve learning theories of their explanatory burdens, thereby allowing for simpler models of acquisition. PMID- 3668478 TI - Breathalyzer accuracy in actual law enforcement practice: a comparison of blood- and breath-alcohol results in Wisconsin drivers. AB - Breathalyzer and blood-alcohol results from drivers arrested for operating a motor vehicle while intoxicated and for related offenses were compared during a two-year period. Four hundred and four pairs of breath- and blood-alcohol results from specimens collected within 1 h of each other were studied. Blood-alcohol concentrations ranged from zero to 0.421% weight per volume (w/v). Breath-alcohol concentrations ranged from zero to 0.44 g/210 L. The mean Breathalyzer result was 0.16 g/210 L. The mean blood-alcohol result was 0.176% w/v. Compared to the blood alcohol result, Breathalyzer results were lower by more than 0.01 g/210 L 61% of the time, within 0.01 g/210 L 33% of the time, and higher by more than 0.01 g/210 L 6% of the time. PMID- 3668479 TI - Abuse of smoking methamphetamine mixed with tobacco: I. Inhalation efficiency and pyrolysis products of methamphetamine. AB - Experiments of smoking methamphetamine in tobacco have been investigated. Inhalation efficiencies of methamphetamine into tar were 6 to 17% according to the additive amounts, suction volume, and intervals of smoking. Major pyrolysis products of methamphetamine in tar were identified as methamphetamine, amphetamine, phenylacetone, dimethylamphetamine, N-formyl-, N-acetyl-, N propionyl-, and N-cyanomethyl-methamphetamine by the spectral analysis of infrared spectra (IR), mass spectra (MS), and proton magnetic resonance spectra (PMR), and comparison with the samples synthesized from authentic samples by one step. The largest pyrolysis product was N-cyanomethylmethamphetamine which is a new compound and easily metabolized to methamphetamine in the body. Methamphetamine itself transferred into tar was not so large, but the total active compounds in tar which would be metabolized to methamphetamine in the body were considerably larger. PMID- 3668480 TI - Correlations of injury, toxicology, and cause of death to Galaxy Flight 203 crash site. AB - This report details the medical investigation of the crash of Galaxy Flight 203, on 21 Jan. 1985, near Reno, Nevada. Sixty-eight persons died at the scene, two died during hospitalization, and one victim survived. After completion of autopsies on all victims, pathologists determined causes of death based upon injuries, evidence of smoke inhalation, and toxicologic results. Our research shows that the majority of victims survived the impact only to succumb to toxic gas and fire. We correlated the causes of death, various injuries, and toxicologic findings to body location at the crash site to aid in reconstructing the events surrounding the accident and to address medicolegal problems and safety considerations. Our experience clearly supports the need for thorough medical investigation, including autopsy of each victim and determination of the precise cause of death for all fatalities. PMID- 3668481 TI - Cranial fracture patterns and estimate of direction from low velocity gunshot wounds. AB - Cranial trauma produced by low velocity gunshot wounds is investigated in an autopsy series. In skeletonized remains with postmortem damage, or after surgical debridement, the primary internal or external beveling may become obscured, causing difficulty with the identification of entrance and exit wounds. The morphology of associated secondary and tertiary fractures based upon the mechanics of their production is discussed as a means of establishing bullet entrance and exit sites. PMID- 3668482 TI - Fatal verapamil poisoning. AB - A case of fatal verapamil poisoning is reported. The pathologic and toxicologic findings are discussed. PMID- 3668483 TI - A double homicide as a result of chloroform poisoning. AB - Homicidal poisoning using chloroform has been reported infrequently. Presented is a case of a double homicide involving a 29-year-old male and his 23-year-old fiance. Gas chromatographic methodology and tissue concentrations of chloroform are presented. Evidence strongly suggests forced inhalation using an impregnated cloth. PMID- 3668485 TI - Ethics and economics in medicine: a quandary. PMID- 3668484 TI - Primary hyperparathyroidism, hypercalcemia, paranoid delusions, homicide, and attempted murder. AB - This report describes a case of primary hyperparathyroidism in a 68-year-old man. The endocrine disorder, while suspected before the commission of homicide and attempted murder, was proven biochemically and histologically a number of months after the commission of the crimes. The acts of homicide and attempted murder followed the development of paranoid delusions, which rapidly resolved upon successful removal of a single cystic parathyroid gland adenoma. The unusual events that immediately followed the acts of violence indicate that the delusions occurred in a clear sensorium (absence of delirium). Psychological measures taken before and after surgery document improvement in subtle organic functioning while intelligence was unchanged. This report discusses the neuropsychiatric manifestations of hypercalcemia and reviews the literature. PMID- 3668486 TI - Contrasting perspectives on the malpractice problem. PMID- 3668487 TI - Tort reform critically needed. PMID- 3668488 TI - Florida medical care faces crisis. PMID- 3668489 TI - Motorboat propeller injuries. PMID- 3668490 TI - Peritonitis frequency in CAPD patients. PMID- 3668491 TI - Experience from a new wave ambulatory surgery center. PMID- 3668492 TI - The teacher becomes a patient: teaching interviewing to medical students. PMID- 3668493 TI - Career options and practice patterns of surgical specialists following residency training: national trends in fellowship training and subspecialty education. PMID- 3668494 TI - Mythology of excess health care utilization: tale of Blue Cross-Blue Shield guidelines for laboratory and other diagnostic procedures. PMID- 3668495 TI - Apparent post-mortem production of high levels of cyanide in blood. PMID- 3668496 TI - Mannose inhibition as a significant marker for differentiating among novobiocin resistant staphylococci of relevance in clinical microbiology. AB - A specific method for the identification of Staphylococcus saprophyticus among novobiocin-resistant species isolated from man is described. The test is based on novobiocin resistance, non-fermentation of D-mannose and early inhibition with late secondary growth on glucose/mannose + novobiocin agar plates. On this medium novobiocin-resistant Staphylococcus cohnii showed a confluent, continuous and homogeneous growth after 24 h which remained unchanged at 48 h whether or not it fermented D-mannose, whereas novobiocin-resistant Staphylococcus xylosus fermented D-mannose. These results are discussed in relation to a possible causal role of PTS enzymes and phosphomannose isomerase deficiency in mannose inhibition. PMID- 3668497 TI - Selective inactivation of an extra-cytoplasmic acid phosphatase of yeast-like cells of Sporothrix schenckii by sodium fluoride. AB - Suspensions of intact, yeast-like cells of Sporothrix schenckii exhibited an acid phosphatase (EC 3.1.3.2) activity against p-nitrophenyl phosphate of about 5 IU (g dry wt)-1, without recourse to membrane perturbation. This extra-cytoplasmic acid phosphatase was reversibly and competitively inhibited by orthophosphate (Ki = 2 mM at pH 5) but unaffected by L(+)-tartrate (in contradistinction to some of the cytoplasmic acid phosphatases of the same organism). Inactivation by NaF of the extra-cytoplasmic isoenzyme was irreversible and followed first order kinetics; sensitivity to NaF was decreased by the presence of citrate, phosphate or substrate. Neither Km (0.3 mM at pH 5) nor Vmax for this enzyme in acetate buffer was greatly affected by pH in the range 3-5 but the first order rate constant for inactivation by NaF was strongly dependent on pH (maximum at pH 3.5). Crude cell-free extracts of yeast cells had nine electrophoretically distinct acid phosphatase activity bands and, on the basis of the pattern of inhibitors, the extra-cytoplasmic activity was identified as Y-I, an isoenzyme that barely penetrates standard polyacrylamide gel electropherograms. Additional evidence for the assignment came from selective inactivation of this isoenzyme by short treatments of intact cells with NaF under conditions that did not allow penetration of the plasma membrane by the inhibitor and did not kill the cells. PMID- 3668498 TI - A mutant of Streptococcus pneumoniae that exhibits thermosensitive penicillin tolerance and the paradoxical effect. AB - Mutants of Streptococcus pneumoniae that contain active autolysin and yet cannot be induced to lyse during treatment with penicillin (Lyt+Tol+ mutants) have been described. We have now shown that these mutants are temperature dependent (32 degrees C); at 37 degrees C these bacteria underwent penicillin-induced lysis. In addition, mutants at the lysis-permissive temperature showed the so-called 'paradoxical response' to penicillin. Temperature shift experiments indicated that the change from tolerant to lytic response or vice versa is a fast process. No differences were detected in autolysin specific activity or in the kinetics of inhibition of protein, peptidoglycan and teichoic acid syntheses in cells treated with penicillin at 32 and 37 degrees C. The results of genetic crosses indicated that the thermosensitivity of penicillin-induced autolysis in the Lyt+Tol+ mutants is not a property of the autolytic enzyme itself. The observations suggest that the thermosensitive process in the mutants represents either a step(s) in autolysin regulation or involves some difference in the structure of the cell walls produced at 32 degrees C versus 37 degrees C. PMID- 3668499 TI - Fractionation of the Providencia stuartii cell envelope. AB - Cell envelopes (i.e. unfractionated inner and outer membranes) were obtained from Providencia stuartii by following procedures previously applied to the isolation of envelopes from Escherichia coli. The P. stuartii envelopes contained known inner membrane enzymes that included a variety of dehydrogenases and ATPase. The catalytic activity of the ATPase depended upon the concentration of magnesium ions, the substrate (ATP) level and the ratio of magnesium ions to ATP. Cell envelopes from P. stuartii were further fractionated to recover inner and outer membrane polypeptides by treatment with the detergent Sarkosyl. Proteins from the periplasmic region were recovered by a simple osmotic shock procedure also previously applied to E. coli. The purity of the various P. stuartii cell envelope fractions was assessed by a combination of techniques that included one- and two-dimensional gel electrophoresis of proteins, enzyme assays and detection of penicillin-binding proteins. PMID- 3668500 TI - The role of osmotic effects in haloadaptation of Vibrio costicola. AB - Growth rates of Vibrio costicola showed a broad optimum between 0.8 and 1.5 M NaCl, and there was no growth above 3.3 M-NaCl in a peptone-based medium. The minimum requirement of 0.5 M-NaCl for growth in NaCl alone was reduced to 0.3 M NaCl when the total solute concentration was raised to 0.5 to 1.0 M equivalent with sucrose or glycerol. Compared with equivalent NaCl concentrations, higher concentrations of sucrose were more inhibitory to growth, whereas glycerol had less effect. Increasing the medium NaCl concentration suddenly by 2- or 3-fold with either a constant starting, or final, salt concentration showed that, after the shift-up, the lag in growth, the rate of growth, and the inhibition of phospholipid synthesis depended both on the final NaCl concentration and the magnitude of the shift in salinity. The time-courses of phospholipid synthesis following a 2- or 3-fold shift-up in NaCl or sucrose media were very similar and exhibited a relative increase in phosphatidylglycerol synthesis over that of phosphatidylethanolamine. This 'switch-over' was not seen following shift-up in glycerol media when there was also a stimulation, rather than inhibition, of phospholipid synthesis. It is concluded that during phenotypic haloadaptation of V. costicola, osmotic effects play a significant part in the sensing of and response to raised external salinity. PMID- 3668501 TI - The effect of lipophilic weak acids on the segregational stability of TOL plasmids in Pseudomonas putida. AB - The effect of various lipophilic weak acids on the stability of certain TOL plasmids was investigated. Benzoate induced deletion of TOL plasmid DNA in Pseudomonas putida MT15, followed by loss of the plasmid; this effect was pH- and concentration-dependent, suggesting that undissociated benzoic acid was a more effective curing agent than the benzoate anion. Plasmid loss always approached a frequency of 100% after a lag and apparently depended on the prior occurrence of deletions, although deleted plasmid was stably maintained in the absence of the acid. m-Toluate, acetate and butyrate also induced deletions and plasmid loss at high frequencies, although these acids were less effective than benzoate. Benzoate inhibited the growth of plasmid-containing cells rather than permitting faster growth of cured cells on benzoate. Similar results were obtained with P. putida strains MT20 and MT84, which contain different TOL plasmids. We suggest that lipophilic weak acids induced deletions, possibly by excision of a transposon-like region, and disrupted the segregation of deleted plasmid. PMID- 3668502 TI - The cloning of chromosomal DNA associated with methicillin and other resistances in Staphylococcus aureus. AB - Competitive hybridization was used to detect the deletion of chromosomal DNA accompanying the loss of resistance to methicillin (and concomitantly, to cadmium, mercury and tetracycline) from a clinical strain of methicillin resistant Staphylococcus aureus (MRSA). The method was also used to screen a partial plasmid library of chromosomal HindIII fragments from the MRSA strain. Eight recombinant plasmid clones were identified as containing DNA included in the deletion. These clones were used as probes to screen a phage library of the total DNA of the same MRSA strain, resulting in the isolation of overlapping recombinant phage clones carrying 24 kb of the deleted DNA. Two of the cloned HindIII fragments were associated closely with methicillin resistance, as shown by probing DNA from an independent methicillin-sensitive/resistant transduced strain pair and from two MRSA strains following growth in the presence of high concentrations of methicillin. The endonuclease map of the cloned DNA indicates the presence of four copies of a direct repeat less than 1 kb in size. The map is also consistent with the presence in the chromosome of sequences for mercury resistance (mer A mer B) and for tetracycline-resistance plasmid pT181. PMID- 3668503 TI - Characterization and localization of plasmid functions involved in pock formation and pock resistance of plasmid pSK3 of Streptomyces kasugaensis MB273. AB - Deletion derivatives and recombinants of the plasmid pSK3, which is a cointegrate of pSK1 and pSK2 in Streptomyces kasugaensis, were constructed and analysed for their ability to transfer and 'pock' on strains carrying pSK1 or pSK2. Various deletions in the pSK1 and/or pSK2 regions of pSK3 were grouped into nine classes on the basis of their pock-forming ability and pock resistance. Analysis of these deletions and insertions provided tentative locations of DNA regions for two pock resistance determinants (Por1 and Por2), two pock-forming determinants (Poc1 and Poc2) consisting of plasmid transfer and spread determinants (Tra/Spr), and two replication determinants (Rep1 and Rep2) corresponding to the pSK1 and pSK2 regions of pSK3. In particular, the Por2 function in the pSK2 region was determined to be located in a 1.35 kb segment. PMID- 3668504 TI - Modulation of competence for genetic transformation in Streptococcus pneumoniae. AB - The spontaneous development of competence by cultures of Streptococcus pneumoniae in casein hydrolysate medium was strongly dependent on the initial pH of the culture medium. Cells growing in cultures beginning with a wide range of initial pH values (6.8 to 8.0) all developed competence, as measured by [3H]DNA uptake, [3H]DNA degradation and genetic transformation; but the initial pH of the medium affected both the timing of the occurrence of competence and the number of times the culture became competent. In cultures grown in media of lower initial pH, competence occurred only once, at high population densities, while in more alkaline media a succession of competence cycles occurred, beginning at lower cell densities. The critical population density required for the initiation of competence varied tenfold over the pH range studied. Successive competence cycles in an alkaline medium were not equivalent: while the percentage of competent cells in the first competence cycle was high (approximately 80%), that in the second competence cycle was lower (approximately 12%). Correspondingly, competence-specific proteins were less prominent in the labelled-protein pattern of the second competence cycle than in that of the first. These features of the physiology of competence control make it possible to adjust the expression of competence to suit various experimental requirements. PMID- 3668505 TI - Glucose-6-phosphate dehydrogenase and malate dehydrogenase enzyme electrophoretic patterns amongst strains of Bacteroides fragilis. AB - Fifty-two strains of Bacteroides fragilis were examined for their enzyme electrophoretic patterns of glucose-6-phosphate dehydrogenase (G6PDH) and malate dehydrogenase (MDH). All strains tested possessed high levels of both enzymes but the G6PDH reduced NADP whereas MDH was NAD-dependent. Twenty-seven strains produced single bands of both G6PDH and MDH. In all cases G6PDH migrated faster than MDH. Strains clustered by a single linkage algorithm were recovered in eight clusters at the 77% similarity level. The remaining 25 strains produced multiple bands of one or both enzymes. These were recovered in six clusters at the 72% similarity level using the same algorithm. The results of this study revealed considerable heterogeneity of enzyme patterns within B. fragilis. PMID- 3668506 TI - Characterization of mycobacterial immunoprecipitates by selective staining of enzymes. AB - Immune precipitation patterns of Mycobacterium intracellulare, M. phlei and M. smegmatis were analysed by selective enzyme staining procedures in order to characterize individual mycobacterial antigens. Enzyme activity was shown in eight precipitinogens of M. intracellulare, seven of M. phlei, and six of M. smegmatis. The identification of mycobacterial precipitinogens as enzymes is important since only a few mycobacterial antigens have been functionally characterized. PMID- 3668507 TI - The complete nucleotide sequence of tobacco rattle virus RNA-1. AB - The complete nucleotide sequence of tobacco rattle virus (TRV) strain SYM RNA-1 was determined from a series of overlapping cDNA clones. cDNA prepared by primer extension was used to determine the exact 5' terminus. The RNA sequence was 6791 nucleotides in length and contained four open reading frames (ORFs). The ORF nearest the 5' terminus coded for a polypeptide of predicted mol. wt. 134,000 (134K) and terminated at an opal (UGA) stop codon. Readthrough of this stop codon would result in the production of a protein of 194K. The gene for a 29K polypeptide started one base beyond the 194K stop codon and, in turn, was followed by the gene for a 16K protein at the 3' end of RNA-1. Amino acid comparisons of the 194K protein with the putative replicase of tobacco mosaic virus showed three regions of strong homology, suggesting that the 134K and 194K proteins were similarly involved in virus replication. The 5' terminal sequences of both genome RNA species of TRV strains ORY, N5 and PRN together with that of SYM RNA-2 were also determined. Alignments of these sequences showed that there was a 22 base repeated sequence close to the 5' terminus in all these RNA species. It was also shown that the 5' terminus of RNA-1 was homologous with the same region in RNA-2. PMID- 3668508 TI - Relationship between inhibition of cell growth and of transferrin receptor expression by interferon (IFN) alpha: studies in IFN-sensitive and IFN-resistant Daudi cells. AB - We previously showed that treatment of different cell lines with interferon-alpha (IFN-alpha) concurrently inhibited both cell growth and the rise observed in 125I labelled transferrin binding when cells are exposed to culture conditions that stimulate proliferation. To gain insight into the relationship between these two IFN-induced inhibitory processes, we investigated the effect of IFN-alpha on the binding of 125I-labelled transferrin to Daudi cells sensitive or resistant to its antiproliferative action. We found a close correlation between the ability of IFN alpha to inhibit cell growth and to inhibit transferrin receptor expression. Since growth inhibition induced by other agents is not always accompanied by an inhibition of transferrin receptor expression, the previous and present observations suggest that the inhibitory effect of IFN on this expression is at least one of the mechanisms by which IFN inhibits cell proliferation. We also observed that IFN-alpha did not modify transferrin receptor biosynthesis in IFN sensitive Daudi cells, suggesting that IFN-alpha may change the processing of the transferrin receptor molecules, making them unable to bind transferrin. PMID- 3668509 TI - Role of milk-derived IgG in passive maternal protection of neonatal ferrets against influenza. AB - Neonatal ferrets are protected against infection with influenza virus by colostral and milk-derived anti-influenza virus IgG after suckling on an immune mother. The levels of IgG elicited and then transmitted to neonates were similar when mothers were immunized by either live infection or killed vaccines. Maternal anti-influenza virus IgA and IgM appears not to cross the neonatal gut epithelium although both are present in maternal serum and milk. PMID- 3668510 TI - Genetic analysis of vaccinia virus Lister strain and its attenuated mutant LC16m8: production of intermediate variants by homologous recombination. AB - We prepared vaccinia virus variants by introducing part of the HindIII D fragment of the DNA of the parental Lister (LO) strain (temperature-resistant and forming large plaques and pocks) into the attenuated LC16m8 strain (temperature-sensitive and forming small plaques and pocks) by the use of a homologous recombination technique in vivo. Special attention was paid to the HindIII D fragment, since this fragment has an extra XhoI site in LC16m8 which is absent from LO. After HindIII D of LO was introduced as a calcium phosphate precipitate into rabbit kidney (RK13) cells which had been infected with LC16m8, five virus variants (LOTC-1 to LOTC-5) forming much larger plaques than LC16m8 were cloned. In LOTC 2, LOTC-4 and LOTC-5, the introduction of at least part of HindIII D of LO into the corresponding HindIII D region of the LC16m8 genome was apparent as judged by the disappearance of the XhoI site, whereas variants LOTC-1 and LOTC-3 retained the site. The biological characteristics of all the LOTC variants were similar to each other. Their plaque size and pock size were similar to those of LO, whereas they were rather akin to LC16m8 with regard to temperature sensitivity and neurovirulence. The present results strongly suggested that part of the HindIII D fragment was involved in determining biological characteristics affecting plaque size and pock size, but had little influence on temperature sensitivity and neurovirulence. PMID- 3668511 TI - Watch your Ps and Qs. Intermittent atrioventricular dissociation. PMID- 3668512 TI - Medical Preceptorship Program giving students taste of private practice. PMID- 3668514 TI - Microbial agents of diarrhea. PMID- 3668513 TI - Orbital and periorbital soft tissue infections secondary to sinusitis. PMID- 3668516 TI - Patient dignity, the physician, and nuclear war. PMID- 3668515 TI - Selective management of shotgun wounds. PMID- 3668517 TI - Effects of chronic melatonin administration on GABA and diazepam binding in rat brain. AB - In order to determine whether the in vitro ability of the pineal indoleamine hormone, melatonin, to modulate binding at the GABA-benzodiazepine receptor complex is operative in vivo we have examined the effects of chronic melatonin administration on 3H-GABA and 3H-diazepam binding in rat brain. Melatonin was injected daily in increasing doses for three weeks and animals were sacrificed at 2 or 26 hours after the final injection. A melatonin-induced enhancement of 3H GABA binding was observed in both single-point and saturation binding experiments. Scatchard analysis of 3H-diazepam binding revealed a melatonin induced increase in binding affinity at 26 hours in the forebrain and at 2 hours in the cerebellum with no significant changes in binding site concentration. These findings are consistent with the proposal that melatonin's psychopharmacological effects are due at least in part to its ability to enhance central GABAergic transmission by modulating GABA receptor activity. PMID- 3668518 TI - Effects of oral aspartame on plasma phenylalanine in humans and experimental rodents. Short note. AB - All aspartame does given to humans cause greater elevations in plasma (and, presumably, brain) phenylalanine than in plasma tyrosine. In contrast, doses of aspartame usually used in experiments on rodents preferentially elevate tyrosine. Since phenylalanine can inhibit brain catecholamine synthesis while tyrosine is the antidote for this effect, we determined the aspartame dose that would be needed to elevate phenylalanine more than tyrosine in rodents, using published data. In general rodents need 60 times as much aspartame, on a mg/kg basis, as humans to obtain comparable elevations in phenylalanine with respect to tyrosine. PMID- 3668519 TI - Failure to detect dopamine receptor IgG autoantibodies in sera of schizophrenic patients. Short note. AB - Autoantibodies against dopamine receptors in schizophrenic patients have been postulated. IgG was fractionated from sera of 15 schizophrenic patients (DSM III) in an acute episode. However, 3H-spiperone binding to dopamine receptors was not inhibited by this fraction. PMID- 3668520 TI - Differential effect of guanethidine on dopamine and norepinephrine pools in urine, heart and superior cervical ganglion in the rat. AB - The time-related changes of dopamine (DA) and norepinephrine (NE) pools were investigated in heart, superior cervical ganglion (SCG) and urine in rats treated chronically with guanethidine (50 mg/kg i.p. five days each week). The efficiency of sympathectomy was assessed by the great loss of NE in heart and superior cervical ganglion (SCG) (-96% and -76% respectively of control values on day 18) together with the ready reduction of NE and 3-methoxy-4-hydroxyphenylglycol (MHPG) in urine. The pattern of changes was quite different for DA, which was less readily affected and at a lesser extent than NE in heart and SCG thus suggesting the presence of norepinephrine-independent DA stores. Similarly the urinary excretion of free DA, free 3,4-dihydroxyphenylacetic acid (DOPAC) and free homovanillic acid (HVA) was slightly decreased only from the 9th day, whereas urinary conjugated DA remained unaltered. These results indicate that the greatest portion of urine free and conjugated DA, free DOPAC and free HVA derives from peripheral pools located outside noradrenergic neurons. Alternatively, the time-course of DA sensitivity to guanethidine suggests that a portion of urine DA may originate from DA stored independently from NE in noradrenergic neurons. PMID- 3668521 TI - Modification of dopamine and norepinephrine metabolism in the rat brain by monoamine oxidase inhibitors. AB - The treatment of Sprague-Dawley rats with monoamine oxidase (MAO) inhibitors (pargyline, tranylcypromine) profoundly affects dopamine (DA) and norepinephrine (NE) metabolism in the brain. In these rats injection of L-dopa led to large increases in norepinephrine (NE), normetanephrine (NMN) and 3-methoxytyramine (3 MT) in brain tissues. The response of MAO-inhibited rats to L-dopa contrasted sharply with those not treated with the MAO inhibitor; the latter showed no change in NE, NMN and 3-MT after similar administration of L-dopa. The increase of NE in pargyline-treated rats correlated closely with that of DA in the hypothalamus and in the brain stem. This response was greatly diminished in rats previously treated with the neurotoxin 6-hydroxydopamine, but was restored when the treatment with 6-hydroxydopamine was accompanied by desimipramine. This suggests that noradrenergic neurons were the origin of the NE response. The NMN and 3-MT increases occurring only in the rats treated with a MAO inhibitor were highly correlated. The results suggested that MAO inhibitor may affect entry of DA into catecholaminergic storage where NE synthesis takes place and from where DA is released. PMID- 3668522 TI - Effect of neonatal nomifensine exposure on adult behavior and brain monoamines in rats. AB - The aim of the study was to examine the effects of early postnatal exposure to nomifensine, an inhibitor of catecholamine uptake, on concurrent active (REM) sleep, on later alcohol related behavior and on monoamine concentrations in various brain regions of rats. For these purposes rats were given daily injections of 10 mg/kg nomifensine s.c. between the 7th and the 18th postnatal days. During the nomifensine exposure active sleep, expressed as a percentage of total sleeping time, was reduced. At one month of age, the nomifensine rats showed increased ambulation and had lower defecation scores in the open-field than the controls. Neonatal exposure to nomifensine increased voluntary intake of 10% (v/v) alcohol when the rats were 2-3 months of age. The rats, however, did not exhibit preservation in the T-maze, and similarly to control rats suppressed drinking 0.1 M lithium chloride even when thirsty. Measurement of cerebral monoamine concentrations at the age of 3 months suggested that neonatal nomifensine treatment interferes with the noradrenergic and serotonergic systems in several regions of the brain. Concentrations of noradrenaline and 5 hydroxyindoleacetic acid (5-HIAA) were decreased in the cerebral cortex and frontal cortex, concentration of 5-HIAA was decreased in the neostriatum, and concentrations of noradrenaline, 5-hydroxytryptamine (5-HT) and 5-HIAA were elevated in the lower brain stem. Taken together, these findings show that exposure to nomifensine during the 2nd and 3rd postnatal weeks suppresses neonatal active sleep, causes changes in the adult open-field behavior, and increases voluntary alcohol intake, perhaps due to a long-lasting alteration in brain monoamines. PMID- 3668523 TI - Spectral and kinetic studies on the binding of trithiomolybdate to bovine and canine serum albumin in vitro: the interaction with copper. AB - Spectral studies showed that copper and trithiomolybdate participated in a three way interaction with bovine and canine serum albumin. The interaction with the proteins was affected by increased pH and ionic strength. Kinetic studies of binding equilibria indicated that [35S] trithiomolybdate bound to both albumins at a single site. The affinity of the site, but not the capacity of the protein, was increased by copper. It was concluded that the site was distinct from the N terminal copper (and nickel) binding site, which is present on BSA but absent from CSA. Whether or not the N-terminal site has a role in copper transport is discussed. Reversible thiomolybdate-copper-protein interactions of this type may play a fundamental role in the pathogenesis of Mo-induced syndromes, since as the normal binding patterns are perturbed the interprotein equilibria are altered and the copper distribution patterns are modified. PMID- 3668524 TI - Spectroscopic properties of siroheme extracted from sulfite reductases. AB - Siroheme has been extracted from sulfite reductases and its properties in aqueous solution have been investigated by optical absorption, electron paramagnetic resonance (EPR), and magnetic circular dichroism (MDC) spectroscopy. The absorption spectrum of siroheme exhibits a marked pH dependence, and two pK values, 4.2 and 9.0, were determined by pH titration in the range 2-12. The first pK (4.2) is thought to correspond to the ionization of the carboxylic acid side chains on the tetrapyrrole rings, and the second pK (9.0) is attributed to displacement of the axial ligand chloride by hydroxide. The binding of the strong field ligands, CO, NO, and cyanide, were investigated by UV-visible absorption and, in the case of the cyanide complex, by low-temperature EPR and MCD spectroscopies. CO and NO were able to reduce and bind to siroheme without additional reducing agent. The EPR spectrum of the isolated siroheme (chloride ferrisiroheme) exhibits an axial signal with g perpendicular = 6.0 and g parallel = 2.0, typical of high-spin ferric hemes (S = 5/2), whereas the cyanide-complexed siroheme exhibits an approximately axial signal with g perpendicular = 2.38 and g parallel = 1.76 that is indicative of a low-spin ferric heme (S = 1/2). The low temperature MCD spectra and magnetization data for the as-isolated and cyanide complexed ferrisiroheme are entirely consistent with the interpretation of the EPR spectra. The results for ferrosiroheme indicate that the siroheme remains high spin (S = 2) and low spin (S = 0) on reduction of the as-isolated and cyanide-complexed siroheme, respectively. The isolated siroheme expressed sulfite reductase activity but the assessable catalytic cycle was much less than that of the native enzyme, showing the importance of the protein environment. PMID- 3668525 TI - The effect of cellular age on zinc levels in untreated and zinc-treated human diploid fibroblasts. AB - Cellular aging is accompanied by increased cellular permeability to zinc(II). The intrinsic zinc content of human diploid fibroblast cells increases with cell age, so that it quadruples from early to late passage, on a Zn(II) per cell or per cell volume basis, but it remains constant on a Zn(II) per protein basis. When the cells are challenged with toxic concentrations (0.2 mM) of Zn(II), both the rate of zinc incorporation into the cells and the amount of zinc incorporated at equilibrium increases considerably with age (unless measured as zinc per protein). In terms of growth inhibition, Zn(II) is more toxic to the cell than Cu(II), Mn(II), or Mg(II). PMID- 3668526 TI - Properties of glutathione peroxidase isolated from human plasma. AB - Human plasma glutathione peroxidase (GPx) was purified to homogeneity by ammonium sulfate fractionation, gel filtration on Sephadex G-150, chromatography on DEAE Sephacel, chromatofocusing with polybuffer, and gel filtration with Sephadex G 75. This isolation resulted in about 5,400-fold purification of the enzyme with a 32% yield in enzyme activity. The final preparation had a specific activity of about 28 units (mmoles NADPH oxidized) per milligram of protein. Determination of selenium on the purified enzyme revealed a content of 3.8 g atoms per mole GPx. Gel electrophoresis using SDS with standard proteins revealed a molecular weight of about 23,000 for the subunits, which would indicate a molecular weight of about 92,000 for the native enzyme. Amino acid analyses of the purified GPx indicated aspartate, glutamate, proline, glycine, alanine, and leucine as the predominant amino acids and cysteine, methionine, tryptophan, and histidine as the minor amino acids. PMID- 3668527 TI - Reactions of oxobis(acetylacetonato)-vanadium (IV) with some purine and pyrimidine bases and nucleosides. AB - A study of the reactions of purine and pyrimidine bases has been initiated with the V(IV) complex [V(O)(acac)2]. Two distinct modes of reaction have been recognized depending on the nature of the base. Simple adduct formation occurs when the base contains a sufficiently basic lone pair, but when bases contain acidic protons bound to nitrogen (inosine, thymine), cleavage of one acetylacetonate ligand occurs to give potentially polymeric species. This behavior is in contrast to that of the inert [Co(NO2)2(acac)2]-ion. PMID- 3668528 TI - Primary structure and tissue distribution of guinea pig gastrin-releasing peptide. AB - The primary structure of gastrin-releasing peptide from the guinea pig stomach has been determined by automated Edman degradation and shown to be identical to porcine gastrin-releasing peptide. Extracts of guinea pig brain and small intestine contained both gastrin-releasing peptide and its COOH-terminal decapeptide (neuromedin C) but the stomach extracts contained only gastrin releasing peptide. Within the small intestine, highest concentrations of gastrin releasing peptide-like immunoreactivity were found in extracts of the circular and longitudinal smooth muscle layers. PMID- 3668529 TI - Photoaffinity labeling of adenylate cyclase-linked serotonin receptors in Aplysia neurons. AB - Serotonin stimulated adenylate cyclase in Aplysia neurons with a Kact of 0.7 microM. Under the same conditions, 1-[2-(4-aminophenyl)ethyl]4-(3 trifluoromethylphenyl)piperazine stimulated adenylate cyclase with a Kact of 20 microM. The azido derivative of this compound, 1-[2-(4-azidophenyl)ethyl]4-(3 trifluoromethylphenyl)piperazine, or of serotonin, (4-amino, 3-nitrophenylazido serotonin), also stimulated the cyclase in the dark, but with lower efficiency (Kact greater than 10(-4) M). Irradiation of the membranes in the presence of 100 microM 1-[2-(4-azidophenyl)ethyl]4-(3-trifluoromethylphenyl)piperazine abolished 75% of the cyclase activity stimulated by 5 microM serotonin. Under the same conditions, 100 microM 4-amino, 3-nitrophenylazido-serotonin did not inhibit serotonin-stimulated adenylate cyclase activity. When [3H]1-[2-(4 azidophenyl)ethyl]4-(3-trifluoromethylphenyl)piperazine (20 microM) was irradiated with membranes for 5 min at 4 degrees C, a dozen peptides were labeled, as revealed by a fluorogram of sodium dodecyl sulfate-polyacrylamide gels. Among them, the labeling of five polypeptides (molecular weights of 45,000, 55,000, 63,000, 80,000, and 94,000) was protected by the presence of 0.2 mM serotonin during photolysis. These peptides may be related to serotonin receptors. PMID- 3668530 TI - Altered mitochondrial respiration in selectively vulnerable brain subregions following transient forebrain ischemia in the rat. AB - Mitochondrial respiratory function, assessed from the rate of oxygen uptake by homogenates of rat brain subregions, was examined after 30 min of forebrain ischemia and at recirculation periods of up to 48 h. Ischemia-sensitive regions which develop extensive neuronal loss during the recirculation period (dorsal lateral striatum, CA1 hippocampus) were compared with ischemia-resistant areas (paramedian neocortex, CA3 plus CA4 hippocampus). All areas showed reductions (to 53-69% of control) during ischemia for oxygen uptake rates determined in the presence of ADP or an uncoupling agent, which then recovered within 1 h of cerebral recirculation. In the ischemia-resistant regions, oxygen uptake rates remained similar to control values for at least 48 h of recirculation. After 3 h of recirculation, a significant decrease in respiratory activity (measured in the presence of ADP or uncoupling agent) was observed in the dorsal-lateral striatum which progressed to reductions of greater than 65% of the initial activity by 24 h. In the CA1 hippocampus, oxygen uptake rates were unchanged for 24 h, but were significantly reduced (by 30% in the presence of uncoupling agent) at 48 h. These alterations parallel the development of histological evidence of ischemic cell change determined previously and apparently precede the appearance of differential changes between sensitive and resistant regions in the content of high-energy phosphate compounds. These results suggest that alterations of mitochondrial activity are a relatively early change in the development of ischemic cell death and provide a sensitive biochemical marker for this process. PMID- 3668531 TI - 2-Pyrrolidinone in human cerebrospinal fluid: a major constituent of total gamma aminobutyric acid. AB - 2-Pyrrolidinone, the lactam of gamma-aminobutyric acid (GABA), is identified as the major constituent of total GABA in human CSF. Structural elucidation was done by mass spectrometry. In lumbar CSF of four patients, 2-pyrrolidinone represented about 54% of GABA found after acid hydrolysis, thus accounting for essentially all of the hitherto unknown GABA fraction in CSF. PMID- 3668532 TI - Molecular polymorphism of head acetylcholinesterase from adult houseflies (Musca domestica L.). AB - Acetylcholinesterase (AChE) from housefly heads was purified by affinity chromatography. Three different native forms were separated by electrophoresis on polyacrylamide gradient gels. Two hydrophilic forms presented apparent molecular weights of 75,000 (AChE1) and 150,000 (AChE2). A third component (AChE3) had a migration that depended on the nature and concentration of detergents. In the presence of sodium deoxycholate in the gel, AChE3 showed an apparent molecular weight very close to that of AChE2. Among the three forms, AChE3 was the only one found in purified membranes. The relationships among the various forms were investigated using reduction with 2-mercaptoethanol or proteolytic treatments. Such digestion converted purified AChE3 into AChE2 and AChE1, and reduction of AChE3 and AChE2 by 2-mercaptoethanol gave AChE1, in both cases with a significant loss of activity. These data indicate that the three forms of purified AChE may be classified as an active hydrophilic monomeric unit (G1) plus hydrophilic and amphiphilic dimers. These two components were termed G2s and G2m, where "s" refers to soluble and "m" to membrane bound. PMID- 3668533 TI - Effect of repeated treatment with a gamma-aminobutyric acid receptor agonist on postnatal neural development in rats. AB - The effect of treatment with the gamma-aminobutyric acid (GABA) agonist tetrahydroisoxazolo[5,4-c]pyridin-3-ol (THIP) on neural development was monitored in rats by following the expression of the neuron-specific proteins neural cell adhesion molecule (NCAM), D1, and D3 as well as the enzymes glutamate decarboxylase (GAD) and glutamate dehydrogenase (GLDH). As judged from the effect of the treatment on the expression of NCAM and GAD, GABA agonists have the capacity to accelerate and enhance neuronal development during the early postnatal period. However, as judged from the expression of D1- and D3-protein some adverse late effects may result from prolonged treatment with high doses of GABA agonists. The decrease in GLDH specific activity observed in THIP-treated rats during their late postnatal development possibly indicates a repression of glutamatergic neurons. PMID- 3668534 TI - A thermodynamic study of 5-[3H]hydroxytryptamine binding to human cortex membranes. AB - Kinetic and equilibrium measurements of [3H]-serotonin (5-hydroxytryptamine) binding to human frontal cortex membranes have been made between 4 and 30 degrees C. The effects of spiperone and ascorbate on binding have also been determined. Under the conditions used, binding was saturable and reversible. Affinity constants derived from kinetic and equilibrium data were comparable. Serotonin binding to several sites had substantial enthalpic as well as entropic components. PMID- 3668535 TI - Effect of ganglion blockade on cerebrospinal fluid norepinephrine. AB - The source of norepinephrine (NE) in CSF has been unclear. It has been suggested that CSF NE indicates central neural noradrenergic tone and is determined differently from plasma NE. If CSF NE depended specifically on NE release in the CNS, then interference with ganglionic neurotransmission would be expected to decrease plasma NE but not CSF NE. Hypotension caused by ganglionic blockade might be expected to increase CSF NE reflexively. We infused the ganglion blocker, trimethaphan, intravenously into anesthetized dogs and measured the effects on mean arterial blood pressure (MAP) and on cisterna magna CSF levels of NE. The results were compared with those obtained on administration of saline, clonidine (2 micrograms/kg), yohimbine (0.25 mg/kg), or nitroprusside and with those obtained when hypotension during ganglion blockade was prevented by concurrent treatment with phenylephrine. Trimethaphan decreased MAP by 40%, arterial NE by 64%, and CSF NE by 61%. Nitroprusside administered intravenously to produce the same 40% depressor response increased arterial NE by 612% and CSF NE by 155%. Prevention of ganglion blockade-induced hypotension using phenylephrine did not prevent the decrease in CSF NE caused by trimethaphan, and when phenylephrine was discontinued, the resulting hypotension was not associated with increases in CSF NE. The similar decreases in plasma NE and CSF NE during ganglionic blockade, and the abolition of reflexive increases in CSF NE during hypotension in ganglion-blocked subjects, cast doubt on the hypothesis that CSF NE indicates central noradrenergic tone and are consistent instead with at least partial derivation of CSF NE from postganglionic sympathetic nerve endings. PMID- 3668536 TI - Polypeptides of the Golgi apparatus of neurons from rat brain. AB - An antiserum was raised against fractions of the Golgi apparatus of neurons from rat brain. Immunoblots of these fractions with the antiserum showed two principal bands of 185 and 150 kilodaltons (kd) in apparent molecular mass. The antiserum reacted with five or six bands of 200, 150, 130, 100-110, 64, and 40 kd in apparent molecular mass in immunoblots of several crude brain membrane fractions. Affinity-purified antibodies from the different gel bands transferred to nitrocellulose paper were used in immunoblot and immunocytochemical studies. Antibodies eluted from the 200-, 150-, 100-110-, and 64-kd bands reacted not only with the corresponding band but also with the other three bands. Antibodies eluted from the 40-kd band stained only the corresponding band. On light and/or electron microscopic immunocytochemistry, the antiserum stained the Golgi apparatus of rat neurons, glia, liver, and kidney tubule cells. Weaker, segmented, and less consistent staining was observed in nuclear envelopes, rough endoplasmic reticulum, and plasma membranes of neurons. Antibodies eluted from the bands at 200, 150, 100-110, and 64 kd stained intermediate cisterns of the Golgi apparatus of neurons. These findings suggest that a group of related polypeptides of brain membranes is preferentially expressed or enriched in the Golgi apparatus of neurons. Polypeptides with apparent molecular masses of 185 and 150 kd probably represent moieties endogenous to membranes of the neuronal Golgi apparatus. PMID- 3668538 TI - Effects of angiotensin II on [3H]noradrenaline release and phosphatidylinositol hydrolysis in the parietal cortex and locus coeruleus of the rat. AB - Angiotensin II (ANGII) (3-100 nM) facilitated the potassium-evoked (22.5 mM) release of [3H]-noradrenaline ([3H]NA) from slices of parietal cortex in a concentration-dependent manner, but did not significantly alter the release of [3H]NA evoked in a similar manner from locus coeruleus slices. The facilitatory action of ANGII was blocked by saralasin (0.1-3 microM). Neither nimodipine (10 30 microM) nor phenylmethylsulphonyl fluoride (1 mM) altered either [3H]NA release or the facilitatory action of ANGII in the parietal cortex. Carbachol (0.01-3 mM) and raised potassium (22.5 mM), but not ANGII (3-100 nM), stimulated the production of inositol phosphates in parietal cortex slices. The potassium evoked increase in inositol phosphate production was unaffected by ANGII (3-100 nM). In the locus coeruleus, ANGII (3-100 nM) did not stimulate inositol phosphate production. The mechanism underlying the ANGII facilitation of [3H]NA release from the parietal cortex does not appear to involve either nimodipine sensitive calcium channels, or, as far as we have been able to determine, the release of calcium from intracellular stores following the breakdown of phosphoinositides. PMID- 3668537 TI - Traumatic brain injury in the rat: alterations in brain lactate and pH as characterized by 1H and 31P nuclear magnetic resonance. AB - Application of both phosphorus (31P) and proton (1H) magnetic resonance spectroscopy (MRS) to the study of brain metabolism permits the noninvasive measurement of intracellular pH and brain lactate level. We have used water suppression 1H MRS with novel lactate-editing techniques, together with 31P MRS, to characterize sequential changes in brain lactate level and pH in vivo over an 8-h period following fluid-percussion brain injury of graded severity in the rat. A transient fall in intracellular pH (from 7.09 +/- 0.07 at baseline to 6.88 +/- 0.09 at 40 min postinjury) occurred in animals subjected to moderate- (1.5-2.2 atm) and high- (2.5-3.3 atm) but not low-level (0.1-1.2 atm) injury; intracellular pH returned to baseline by 90 min postinjury. Transient elevations in brain lactate level were observed that temporally paralleled and were significantly correlated with the pH changes for all injury levels (r = 0.93, p less than 0.001). Postinjury alterations in intracellular brain pH and lactate level were identical in magnitude in animals subjected to either moderate or high level injury. However, animals subjected to moderate injury had a moderate chronic neurological deficit that persisted up to 4 weeks postinjury, whereas animals subjected to a high level of injury showed greater histopathological damage and a more severe chronic neurological deficit. These data suggest that the extent of posttraumatic intracellular cerebral acidosis in our model of experimental head injury is not directly related to the severity of functional neurological deficit. PMID- 3668539 TI - Reserpine increases chromaffin cell enkephalin stores without a concomitant decrease in other proenkephalin-derived peptides. AB - Reserpine increases the levels of enkephalins in adrenal medullary chromaffin cells; however, the origin of the newly apparent pentapeptides has been the subject of debate, because no increase in the levels of proenkephalin mRNA has been observed. The present study was performed for determining if the reserpine induced increase in context of enkephalins was derived from processing of preexisting fragments of proenkephalin. Bovine chromaffin cell enkephalins and larger enkephalin-containing peptides were separated by reversed-phase HPLC and identified by approximate molecular weight, elution with peptide standards, and enkephalin sequences contained. Treatment of the cells with reserpine increased the levels of enkephalins and of enkephalin-containing peptides of up to approximately 3 kilo-daltons without reducing the levels of larger enkephalin containing peptides. Similar results were obtained with another catecholamine depleting drug, tetrabenazine. In contrast, treatment of chromaffin cells with theophylline or forskolin increased the levels of both enkephalins and enkephalin containing peptides of all sizes. The results suggest that new synthesis of proenkephalin is required for the effects of reserpine, although proenkephalin processing is also altered by this drug. PMID- 3668540 TI - Cerebral glucose utilization: comparison of [14C]deoxyglucose and [6-14C]glucose quantitative autoradiography. AB - The [14C]deoxyglucose [Sokoloff et al., J. Neurochem. 28, 897-916 (1977)] and [6 14C]glucose [Hawkins et al., Am. J. Physiol. 248, C170-C176 (1985)] quantitative autoradiographic methods were used to measure regional brain glucose utilization in awake rats. The spatial resolution and qualitative appearance of the autoradiograms were similar. In resting animals, there was no significant difference between the two methods among 18 gray and three white matter structures over a fourfold range in glucose utilization rates (coefficient of correlation = 0.97). In rats given increasing frequencies of photoflash visual stimulation, the two methods gave different results for glucose utilization within visual pathways. The linearity of the metabolic response was studied in the superior colliculus using an on-off checkerboard stimulus between 0 and 33 Hz. The greatest increment in activity occurred between 0 and 4 Hz stimulation with both methods, probably representing recruitment of neuronal elements into activity. Above 4 Hz, there was a progressive increase in labeling with [14C]deoxyglucose up to 1.7 times control at 33 Hz. With [6-14C]-glucose, there was no further increment in change above a 30% increase seen at 4 Hz. Measurement of tissue glucose revealed no drop in the visually stimulated structures compared to control. We interpret these results to indicate that, with increasing rates of physiological activity, the products of deoxyglucose metabolism accumulate progressively, but the products of glucose metabolism are removed from brain in 10 min. PMID- 3668541 TI - Effect of pressure on the release of radioactive glycine and gamma-aminobutyric acid from spinal cord synaptosomes. AB - Exposure to high hydrostatic pressure produces neurological changes referred to as the high-pressure nervous syndrome (HPNS). Manifestations of HPNS include tremor, EEG changes, and convulsions. These symptoms suggest an alteration in synaptic transmission, particularly with inhibitory neural pathways. Because spinal cord transmission has been implicated in HPNS, this study investigated inhibitory neurotransmitter function in the cord at high pressure. Guinea pig spinal cord synaptosome preparations were used to study the effect of compression to 67.7 atmospheres absolute on [3H]glycine and [3H]gamma-aminobutyric acid ([3H]GABA) release. Pressure was found to exert a significant suppressive effect on the depolarization-induced calcium-dependent release of glycine and GABA by these spinal cord presynaptic nerve terminals. This study suggests that decreased tonic inhibitory regulation at the level of the spinal cord contributes to the hyperexcitability observed in animals with compression to high pressure. PMID- 3668542 TI - Dolichol-linked glycoprotein synthesis in G1 is necessary for DNA synthesis in synchronized primary cultures of cerebral glia. AB - Primary cultures of newborn rat cerebrum, which are composed of glial cells (principally astroglia), were used for examining the relationship between dolichol-linked glycoprotein synthesis and DNA synthesis in developing cerebral glia. The cells were synchronized by reducing the content of fetal calf serum in the culture medium from 10 to 0.1% (vol/vol) for 48 h between days 4 and 6 in culture. Reversal of the quiescent state by return of the cultures to 10% serum causes a marked increase in DNA synthesis 12-24 h later. A sharp increase in glycoprotein synthesis (incorporation of [3H]mannose) occurred in the first 12 h after serum repletion, preceding the increase in DNA synthesis. Tunicamycin, an inhibitor of the dolichol-linked pathway to glycoprotein synthesis at the first committed step in oligosaccharide formation, promptly and completely prevented the increase in glycoprotein synthesis and, in addition, the subsequent increase in DNA synthesis. The effects of tunicamycin on glycoprotein and DNA syntheses were reversible, and no comparable effect on total protein synthesis was observed. When tunicamycin was added only during a temporally circumscribed period in G1, i.e., from 3 to 9 h after serum repletion, the increase in DNA synthesis between 12 and 24 h after repletion was still markedly inhibited, i.e., to approximately 45% of the value in untreated cultures. The data thus show that there is a requirement for dolichol-linked glycoprotein synthesis for the subsequent occurrence of DNA synthesis and that this requirement is expressed late in the G1 phase of the cell cycle. PMID- 3668543 TI - Cholinergic stimulation of inositol phosphate formation in bovine adrenal chromaffin cells: distinct nicotinic and muscarinic mechanisms. AB - The ability of cholinergic agonists to activate phospholipase C in bovine adrenal chromaffin cells was examined by assaying the production of inositol phosphates in cells prelabeled with [3H]inositol. We found that both nicotinic and muscarinic agonists increased the accumulation of [3H]inositol phosphates (mainly inositol monophosphate) and that the effects mediated by the two types of receptors were independent of each other. The production of inositol phosphates by nicotinic stimulation required extracellular Ca2+ and was maximal at 0.2 mM Ca2+. Increasing extracellular Ca2+ from 0.22 to 2.2 mM increased the sensitivity of inositol phosphates formation to stimulation by submaximal concentrations of 1,1-dimethyl-4-phenyl-piperazinium iodide (DMPP) but did not enhance the response to muscarine. Elevated K+ also stimulated Ca2+-dependent [3H]inositol phosphate production, presumably by a non-receptor-mediated mechanism. The Ca2+ channel antagonists D600 and nifedipine inhibited the effects of DMPP and elevated K+ to a greater extent than that of muscarine. Ca2+ (0.3-10 microM) directly stimulated the release of inositol phosphates from digitonin-permeabilized cells that had been prelabeled with [3H]inositol. Thus, cholinergic stimulation of bovine adrenal chromaffin cells results in the activation of phospholipase C by distinct muscarinic and nicotinic mechanisms. Nicotinic receptor stimulation and elevated K+ probably increased the accumulation of inositol phosphates through Ca2+ influx and a rise in cytosolic Ca2+. Because Ba2+ caused catecholamine secretion but did not enhance the formation of inositol phosphates, phospholipase C activation is not required for exocytosis. However, diglyceride and myo-inositol 1,4,5 trisphosphate produced during cholinergic stimulation of chromaffin cells may modulate secretion and other cellular processes by activating protein kinase C and/or releasing Ca2+ from intracellular stores. PMID- 3668544 TI - Kinetics of neutral amino acid transport across the blood-brain barrier. AB - Neutral amino acid (NAA) transport across the blood-brain barrier was examined in pentobarbital-anesthetized rats with an in situ brain perfusion technique. Fourteen of 16 plasma NAAs showed measurable affinity for the cerebrovascular NAA transport system. Values of the transport constants (Vmax, Km, KD) were determined for seven large NAAs from saturation studies, whereas Km values for five small NAAs were estimated from inhibition studies. These data, together with our previous work, provide a complete set of constants for prediction of NAA influx from plasma. Among the NAAs, Vmax varied at least fivefold and Km varied approximately 700 fold. The apparent affinity (1/Km) of each NAA was related linearly (r = 0.910) to the octanol/water partition coefficient, a measure of NAA side-chain hydrophobicity. Predicted influx values from transport constants and average plasma concentrations agree well with values measured using plasma perfusate. These results provide accurate new estimates of the kinetic constants that determine NAA transport across the blood-brain barrier. Furthermore, they suggest that affinity of a L-alpha-amino acid for the transport system is determined primarily by side-chain hydrophobicity. PMID- 3668545 TI - Total prosthetic replacement of ankylosed knees. AB - Total knee arthroplasty is reliable for achieving pain relief, increasing range of motion, maintaining stability, and improving walking ability. In this study, the results in knees with a preoperative range of motion of 0 were reviewed to determine whether an ankylosed knee can be replaced successfully. In eight of nine knees, the results with regard to pain, stability, and walking ability were good at follow-up evaluations greater than 2 years after operation. Range of motion was also improved in all knees but was still limited. Motion achieved was in a physiologic arc with all knees having full, or nearly full, extension. PMID- 3668546 TI - Bilateral simultaneous total knee arthroplasty. AB - One hundred thirty-two patients (264 knees) who had simultaneous bilateral total knee arthroplasty and 77 patients who had unilateral procedures were reviewed for statistical comparison of the two procedures with respect to pain, tibial and femoral radiolucency, and all other complications as well as average hospital stay and hospital costs. Both groups had posterior cruciate condylar total knee prostheses. There were no significant differences except for tibial radiolucency, which was significantly higher in the unilateral group. Bilateral total knee arthroplasty as a single procedure does not increase the risk of postoperative or follow-up complications and decreases the probability of complications such as phlebitis and pulmonary emboli, because only one operation is necessary. The average hospital cost and length of stay were lower in the simultaneous group (decreased by 20% and 46%, respectively), compared with twice that of the unilateral group. PMID- 3668547 TI - Total hip arthroplasty in rheumatoid arthritis. A long-term follow-up study. AB - This study was undertaken to assess the clinical and radiographic results of total hip arthroplasty in rheumatoid arthritis patients with a minimum of 10 years of follow-up evaluation. Eighty-three hips in 51 of the original 104 patients were available for follow-up study an average of 12.1 years following surgery. The average age of the patients at the time of surgery was 39.9 years (range, 14-72 years). Fourteen hips were revised, 11 for mechanical loosening and 3 for late infection. The overall revision rate is 16.7%; the revision rate for mechanical loosening was 13.3%. According to Merle D'Aubigne-Postel hip rating scores in the 69 hips that did not require revision, 19 hips were excellent (28%), 37 were good (54%), 11 were fair (15%), and 2 were poor (3%). Therefore, 67 of 83 hips (80.7%) were satisfactory on follow-up study. Radiographic evidence of loosening in nonrevised hips was found in 11 acetabular and 2 femoral components. PMID- 3668548 TI - Inherent laxity in total knee prostheses. AB - The anterior-posterior and rotatory laxities of 14 total knee prosthesis designs were measured in a loading rig with compressive, shear, and torque loads representative of physiologic loads. The measured laxities covered a wide range, both greater and smaller than that of the anatomic knee. This range was mainly due to the curvature or flatness of the plastic tibial surface and conformity with the femoral component. Pressure patterns showed the corresponding contact track and area on the tibial surfaces. It is proposed that for normal function, the laxity of the device should complement the remaining anatomic structures to produce a combined laxity resembling that of the normal knee. Excessive prosthetic laxity will lead to the risk of instability, soft tissue attenuation, edge-loading on components, and high contact stresses on the plastic. Inadequate prosthetic laxity may lead to altered kinematics and excessive stresses at the interface, running the risk of long-term loosening. The authors show the laxities of many currently used devices, providing important background information for assessing the role intrinsic prosthetic constraint might play in total joint performance in clinical analyses. PMID- 3668549 TI - The relationship of lateral releases to patella viability in total knee arthroplasty. AB - A prospective clinical and radionuclide study was done to ascertain the effect of a lateral release on patella vascularity in total knee arthroplasty. Although the basic surgical procedure was the same in all 36 knees, postoperative technetium bone scans revealed a higher incidence (9 of 16, 56.4%) of vascular compromise in knees with a lateral release than in those without a lateral release (3 of 20, 15%). Although only one clinical complication (fractured patella not requiring secondary surgery) occurred, the lateral release itself appears to have a causal relationship with patella viability. It does not seem to be the sole determinant, however, because the development of a "cold" patella in three knees that did not have a lateral release implicates other factors, such as thermal necrosis and anatomic variation of the blood supply. PMID- 3668550 TI - Triple antibiotics for the treatment of infected joint replacements. Case report and commentary. AB - Combination antibiotics are frequently used in the treatment of infected joint arthroplasties to achieve synergistic activity against the infecting organisms. A case is presented in which triple antibiotic therapy was used in the treatment of an infected hip arthroplasty. The antibiotic combination proved to have an antagonistic effect despite documented sensitivities to the individual drugs. Serum antimicrobial assays are recommended in the treatment of all prosthetic joint infections. PMID- 3668551 TI - Acetabular lucent lines and mechanical stress in total hip arthroplasty. AB - The radiographs of 97 patients (117 hips) who had a straight-stem Muller femoral component and a non-metal-backed acetabular component were reviewed to determine whether the mode of acetabular loosening predicted by finite element stress analysis (FESA) is observed clinically. The follow-up period averaged 3.1 years (range, 2.0-4.6 years). Significantly more lucent lines were present in zones 1 and 3, compared with zone 2 (P less than .01). This finding corroborates the predictions of FESA and suggests that the production of acetabular lucent lines is due in part to chronic mechanical overload. PMID- 3668552 TI - Use of TARA hemiarthroplasty in advanced osteonecrosis. AB - The results of 25 TARA hemiarthroplasty procedures performed on 21 patients with radiographically documented Ficat stages III and IV osteonecrosis are reported. The average patient age at the time of surgery was 37.6 years (range, 22-55 years). The average length of follow-up study was 37 months (range, 25-60 months). Preoperative Harris hip scores averaged 51 points (range, 22-69 points). Postoperative scores averaged 90 points (range, 66-100 points). Good or excellent results were obtained in 22 of 25 hips. There were no cases of infection or component dislocation. Three component revisions were performed in two patients. Four patients required removal of trochanteric wires and one patient had excision of heterotopic ossification. This procedure appears to offer selected young patients with advanced femoral head osteonecrosis a very satisfactory initial result, while preserving many options for subsequent revision procedures. PMID- 3668553 TI - Knee arthroplasty in rheumatoid arthritis. Four- to six-year follow-up study. AB - A consecutive series of total condylar knee arthroplasties in patients with rheumatoid or related arthritis, with a 4-6-year follow-up period, was studied. Eighty-seven percent had an excellent or good overall result (score of 70 or more on the HSS knee rating scale). The median total score increased from 45 points before operation to 83 after operation. Sixteen complications, mostly minor, occurred in 14 patients. There were no early infections. Two prostheses were removed for deep infection, after 3 and 5 years. One patient had patellectomy for avascular necrosis. The crude prosthesis survival rate was 97%. Tibial radiolucencies were noted in 76% of cases; in 29% they were significant (2 mm or more in one or more of three zones). Two tibial components (2%) were believed to be mechanically loose, but no revisions for mechanical loosening were done. The presence of radiolucencies did not signify an inferior clinical result. PMID- 3668554 TI - Femoral revision total hip arthroplasty using a long-stem femoral component. Clinical and radiographic analysis. AB - Proximal femoral bone stock deficiencies exist during many femoral revision arthroplasties, thus providing inadequate support and fixation for conventional length cemented femoral components. The authors analyzed the long-term clinical and roentgenographic results of 165 hips requiring femoral revision arthroplasty with a long-stem femoral prosthesis. Intraoperative complications occurred in 23% of hips, with femoral perforations in 16% and femoral fractures in 5%. Of 110 hips with at least 5 years of follow-up study (average, 6.7 years), functional ratings were graded excellent in 34%, good in 36%, fair in 17%, and poor in 13%. Failures occurred in 17 hips (12%) and were attributed to aseptic loosening (11 hips), femoral component fracture (2), femoral shaft fracture (1), and sepsis (3). Symptomatic trochanteric separations occurred in 16% of hips. Rerevision or resection arthroplasty was required in 7 hips (5%) and recommended for another 10 hips (7%). Cemented long-stem femoral components (versus cemented conventional length stems) decrease the extent and progression of femoral lucencies, thereby lowering the incidence of mechanical failures and improving long-term functional results in cemented femoral revision arthroplasty. PMID- 3668555 TI - Studies on the pyrrolizidine antitumor agent, clazamycin: interconversion of clazamycins A and B. AB - Clazamycin, a novel pyrrolizidine antitumor antibiotic, exists in aqueous solution as a mixture of two epimers, clazamycins A and B [1A, 1B], the ratio of which is pH dependent. Several lines of evidence are presented, including the results of trapping experiments and a study demonstrating base promoted interconversion of the two forms, that implicate an azacyclooctenone species [3] as an intermediate in the interconversion process. This result supports a previous observation, that the C6a carbinolamidine hydroxyl of clazamycin is unreactive towards nucleophiles and may be significant in helping to elucidate the mechanism of action of this antibiotic. PMID- 3668556 TI - 5'-Hydroxyisoavrainvilleol, a new diphenylmethane derivative from the tropical green alga Avrainvillea nigricans. AB - A new brominated diphenylmethane, 5'-hydroxyisoavrainvilleol, was isolated from the tropical green macrophyte, Avrainvillea nigricans, using conventional chromatographic techniques. The structure is based on a combination of spectrochemical arguments, including a detailed analysis of the long range 1H-13C coupling constants. The natural product shows gram-positive antimicrobial activity. PMID- 3668557 TI - Antineoplastic agents, 122. Constituents of Combretum caffrum. AB - An investigation of the South African tree Combretum caffrum (Combretaceae) for antineoplastic constituents was conducted by employing the astrocytoma bioassay (9ASK). By this approach and a combination of solvent partition, steric exclusion, and adsorption chromatographic procedures, a substance designated combretastatin [1a] was isolated and found to display significant (71-90% astrocyte reversal at 1-100 micrograms/ml dose levels) astrocyte reversal and murine P-388 lymphocytic leukemia (PS) cell growth inhibition (ED50 0.011 micrograms/ml). The structure of (-)-combretastatin was elucidated by X-ray crystal structure analysis and confirmed by total synthesis. The absolute configuration at C-10 was assigned the R-configuration on the basis of Horeau esterification techniques. Other prominent, albeit PS-inactive, constituents were found to be 3,3',4'-tri-O-methylellagic acid [2] and acacetin [3]. PMID- 3668558 TI - Constituents of Tritonia crocosmaeflora, I. Tricrozarin A, a novel antimicrobial naphthazarin derivative. AB - A novel naphthazarin derivative, tricrozarin A, has been isolated from the fresh bulbs of Tritonia crocosmaeflora and was characterized as 5,8-dihydroxy-2,3 dimethoxy-6,7-methylenedioxy-1,4-naphthoquinone (2,3-dimethoxy-6,7 methylenedioxynaphthazarin). Tricrozarin A exhibits antimicrobial activity against gram-positive bacteria, fungi, and yeast in vitro and is the first tetra oxygenated naphthazarin derivative isolated from higher plants. PMID- 3668559 TI - Characterization and feeding deterrent effects on the aphid, Schizaphis graminum, of some derivatives of the sweet compounds, stevioside and rebaudioside A. AB - The intensely sweet compounds, stevioside [1] and rebaudioside A [2], and 15 of their derivatives, were tested for feeding deterrent activity against the aphid, Schizaphis graminum. Included with these compounds was steviol [4], the aglycone of stevioside and rebaudioside A that was one of the most active compounds in this investigation. Loss of feeding deterrent activity of steviol was observed on acetylation or glycosylation of the C-13 tertiary hydroxy group or on methylation of the C-19 carboxylic acid substituent. In contrast, the antifeedant activity of steviol was not greatly affected by modification of either the C-16 exomethylene group or the C/D-ring junction stereochemistry. 13C-nmr data have been obtained for 12 of the test compounds investigated. PMID- 3668560 TI - The dissociation of visuospatial neglect and neglect dyslexia. AB - A right-handed man with a left hemisphere lesion extending into the right hemisphere, with evidence of both a left-sided neglect dyslexia and right-sided visuospatial neglect is reported. When copying simple geometric designs he omitted to copy figures on the right-hand side of the page, when bisecting lines he tended to bisect the line to the left of the line's actual centre. He had a neglect dyslexia which was characterised by paralexic errors affecting the beginning (that is, left) of words. The occurrence of these two phenomena provides evidence of a dissociation of these forms of neglect. The findings are discussed in relation to the possible mechanisms of unilateral neglect. PMID- 3668561 TI - Hemispace-visual field interactions in visual extinction. AB - Visual extinction was studied in a patient with neglect from a right hemispheric lesion. Extinction occurred during double simultaneous stimulation within the same visual hemi-field (VHF). This finding suggests that interhemispheric rivalry is not a critical factor. During double simultaneous stimulation within the same VHF as well as with stimuli in different VHFs, the severity of extinction was determined by both the retinotopic and the hemi-spatial position of the extinguished stimulus. The location of the other stimulus, however, did not seem relevant. It is proposed that damage to a corticolimbic-reticular system reduces attentional capacity and that extinction during double simultaneous stimulation in the visual modality reflects an inability to distribute the limited attentional resources equally to two different locations. The severity of extinction is a measure of an unequal distribution of attention along a gradient within visual space. PMID- 3668562 TI - Alexia with agraphia of kanji (Japanese morphograms). AB - The case of the right-handed young Japanese woman with alexia with agraphia of kanji (the Japanese morphograms) due to a small circumscribed haematoma in the left posterior inferior temporal gyrus is described. Her chief complaint was the inability to read and write kanji. Detailed examination showed that her alexia with agraphia was much more predominant for kanji than kana (the Japanese syllabograms). These facts suggest that the processing of kanji and kana involves different intrahemispheric mechanisms. PMID- 3668563 TI - Measurement of total circulating blood volume following subarachnoid haemorrhage: methodological aspects. AB - The total circulating blood volume (TCBV) and total body/venous haematocrit ratio (Htb/Hv) was determined by simultaneous measurement of the red cell volume (RCV) and the plasma volume (PV) in 10 subarachnoid haemorrhage (SAH) patients, 10 supine bedresting control patients and 20 ambulant out-patients. The mean Htb/Hv of the SAH patients, 0.866, was found to be significantly lower than that of the supine controls, 0.908, and the ambulant patients, 0.909, (p less than 0.01). Using the ratio 0.866 the total circulating blood volume of the SAH patients was calculated from either their RCV or their PV and compared with their measured TCBV. Expressed as a percentage of measured TCBV the mean errors of these single volume determinations were 2.84% and 1.76% respectively. The significance of these changes in the Htb/Hv ratio of SAH patients is discussed in relation to the circulatory disturbances they suffer. PMID- 3668564 TI - Prognosis of patients with retinal embolism. AB - Eighty-five patients with retinal emboli, visible ophthalmoscopically, were studied retrospectively. All the patients had presented with transient or permanent visual loss. Follow up from the time of presentation was one year to 12 years with a mean of 4.5 years. Life expectancy in the 58 medically treated patients who presented with cholesterol emboli was significantly reduced (p = 0.028). Stroke was the commonest cause of death and was significantly more frequent than in the general population (p less than 0.001); there was also an increased total incidence of cerebrovascular disease (fatal and non-fatal) compared with the Oxfordshire Stroke Project (p less than 0.001). The mortality from ischaemic heart disease was not significantly increased. We report a series of 85 patients with retinal emboli, 69 of whom had cholesterol emboli (70 fundi), 15 calcific emboli and one platelet-fibrin embolus. The natural history of medically treated patients with cholesterol emboli is compared both with an age and sex matched population and with patients with amaurosis fugax but no visible retinal emboli. PMID- 3668565 TI - Paradoxical effects of temperature in multiple sclerosis. AB - Six cases of multiple sclerosis are reported in which cold produced a temporary exacerbation of symptoms and signs of the disease. Also, in one case investigated in detail by psychophysical methods, heating produced a paradoxical deterioration in vision and simultaneous improvement in sensory and motor function. The effect of temperature in multiple sclerosis is discussed and a physiological explanation for the paradoxical response to heating is suggested. PMID- 3668566 TI - Reaction times and attention in Parkinson's disease. AB - Ten patients with Parkinson's disease performed a simple reaction time task in which, on hearing a tone, they pressed a button with the left thumb. In the first experiment tones sometimes occurred unannounced and at other times were preceded (by between 0 and 3200 ms) by a warning signal. The second experiment was identical to the first except that the subject had simultaneously to perform a simple continuous task with his right hand. Patients had slower reaction times than controls under all circumstances. In general, however, the effect of a warning signal and the effect of a second task were the same for both groups. In the control group the effect of a warning signal depended on whether or not a second task was being performed. Specifically, the advantage of a warning signal for reaction time was lost after long intervals (greater than 200 ms) when a second task was being performed. Parkinson's disease patients lost this advantage even when they were not performing a second task. Animal studies have suggested that dopamine deficiency results in an increase in neural "noise" in the basal ganglia. The behavioural consequences of this may be that Parkinson's disease patients always perform as if they were carrying out another task at the same time. In contrast, their ability to benefit from a warning signal and to allocate attentional resources are unimpaired. PMID- 3668567 TI - Readiness potential of cortical area 6 preceding self paced movement in Parkinson's disease. AB - The vertex Readiness Potential (RP) (Bereitschaftspotential) preceding self paced voluntary movements is reduced in duration and amplitude in patients with Parkinsonism. It cannot be used as an index for delayed initiation of movement. The negative potential is commonly replaced by a positive slow wave. In hemi Parkinsonism, the abnormal RP is more apparent on moving the affected limb. The abnormal RP is related to the severity but not to the duration of Parkinsonism. Short-term fluctuations of akinesia and rigidity, spontaneous or caused by levodopa are associated with changes of RP duration and amplitude. The abnormality does not correlate with reaction or movement times. It is suggested that the Readiness Potential is a diffuse response of area 6 cortex (especially Supplementary Motor Area) evoked by pallido-thalamo-cortical afferents under dopaminergic control. It is not obligatory for pre-programming of voluntary movement. The authors postulate a dendritic potential of basket cells associated with a pallidal activated gate control of postural set. PMID- 3668568 TI - Cognitive concomitants of dopamine system stimulation in parkinsonian patients. AB - Verbal, visuospatial and motor functions were studied in eight Parkinsonian patients both during levodopa stimulated and unstimulated state and in eight matched, untreated, healthy controls. Profound changes in patients' motor status were accompanied by relatively selective effects on delayed verbal memory, a function which was also most impaired compared with controls. With dopaminomimetic therapy, tests of delayed verbal memory consistently improved, but did not reach control performance levels. These results could indicate a functional impairment in the mesocortical dopamine system, which can be attenuated, but not entirely corrected, by dopaminomimetic therapy. PMID- 3668569 TI - Rigidity and dorsiflexion of the neck in progressive supranuclear palsy and the interstitial nucleus of Cajal. AB - Rigidity and dorsiflexion of the neck are typical signs in progressive supranuclear palsy, but the responsible areas in the brain are unknown. To examine whether bilateral lesions of the interstitial nucleus of Cajal (INC) in the midbrain tegmentum contribute to the signs of patients with progressive supranuclear palsy, we have made bilateral INC lesions in cats and tried to correlate these studies with clinical and pathological data, including our case of progressive supranuclear palsy. Bilateral INC lesioned cats showed dorsiflexion of the neck and impairment of vertical eye movement, similar to progressive supranuclear palsy patients. Analysis of the previous clinical pathological studies and our case have shown that dorsiflexion of the neck in progressive supranuclear palsy patients was correlated more with INC lesions than lesions of the basal ganglia. PMID- 3668570 TI - Evaluation of the dermatomal somatosensory evoked potential in the diagnosis of lumbo-sacral root compression. AB - The dermatomal somatosensory evoked potential from the lumbo-sacral dermatomes was recorded from 21 patients with radiographically and surgically (20) proven lumbo-sacral root compression due to prolapsed intervertebral disc or canal stenosis. The potential was abnormal in 19 of the 20 surgically proven cases. The dermatomal somatosensory evoked potential is as accurate as myelography for diagnosis but has the advantage of being non-invasive and repeatable. It provides useful additional diagnostic and pathophysiological information about lumbo sacral root compression. PMID- 3668571 TI - A portable system for measuring cutaneous thresholds for warming and cooling. AB - Measurement of cutaneous thermal thresholds is a valuable technique for detecting small fibre neuropathy. A robust and portable microcomputer controlled system, which separately measures thresholds for warming and cooling, is described. Thresholds at three sites have been measured; the cheek, the dorsum of the hand and the sole of the foot. Regional variability and a correlation with age have been found, indicating the sensitivity of this system. PMID- 3668572 TI - Patellar clonus: an autonomous central generator. AB - The mechanisms underlying clonus are considered in relation to current theories. By the use of a lever attached to a printed motor forces have been applied to the upper edge of the patella, a steady stretching force in suitable hemiplegic patients started the clonic oscillations. With rhythmic forces it has been found that the underlying rhythm is very resistant to entrainment. The oscillation provoked by a steady bias is increased in amplitude but unchanged in frequency when inertia is added to the apparatus. The frequency of clonus at the ankle, patella and wrist is similar. These and other considerations lead to the conclusion that clonus is not due to the self re-excitation of stretch reflexes but to an autonomous central generator. PMID- 3668573 TI - Transient dystonia as a complication of varicella. AB - A case of transient post-varicella lingual-mandibular dystonia is presented. This case was compared with the eight previously reported instances of involuntary movement disorders which rarely follow varicella infection. PMID- 3668574 TI - Sex-linked recessive congenital ataxia. AB - A family is reported in which three boys, two full brothers and a half brother, presented with marked delay in motor milestones, severe limb and truncal ataxia, nystagmus, speech delay and moderate global retardation. Autosomal recessive and sex linked recessive forms of cerebellar hypoplasia are reviewed and it is suggested that this family may have a rare, if not unique, form of sex-linked cerebellar ataxia. PMID- 3668575 TI - Movement disorder associated with abnormal copper metabolism and decreased blood antioxidants. PMID- 3668576 TI - Ocular flutter, postural body tremulousness and CSF pleocytosis: a rare post infectious syndrome. PMID- 3668577 TI - Two cases of influenza B encephalitis. PMID- 3668578 TI - Late onset adrenomyeloneuropathy. PMID- 3668579 TI - Improved phonation during fever in brainstem dysarthrophonia. PMID- 3668580 TI - Unusual drug interactions between monoamine oxidase inhibitors and tricyclic antidepressants. PMID- 3668581 TI - Carbamazepine induced vasculitis. PMID- 3668582 TI - Visual evoked potentials and pattern electroretinograms in Parkinson's disease and control subjects. PMID- 3668583 TI - Syncope and sudden death attributed to carbamazepine. PMID- 3668584 TI - Necrotising hemorrhagic encephalopathy in an adult: Leigh's disease? PMID- 3668585 TI - The syndrome of irreversible lithium effectuated neurotoxicity. PMID- 3668586 TI - CICIAMS XIII World Congress, Lisbon, 1986. Third Round Table--'Rights of Health Personnel'. PMID- 3668587 TI - Rights of health personnel. Right to professional education. PMID- 3668588 TI - Rights of health personnel. The right to security in the exercise of one's own profession. PMID- 3668589 TI - Clinical parameters of adolescent Hispanic male hypertensive subjects: a new subject? AB - We have previously reported an increased prevalence of elevated blood pressure in Hispanic adolescent males. The pressure elevation did not correlate with weight. In this study, we evaluated the response to antihypertensive therapy of eight adolescent Hispanic males found to have elevated pressure during high school screening. All patients were placed on placebo tablets b.i.d. for 2 weeks with weekly blood pressure readings. Those with persistently elevated pressures (at or above the 95th percentile) underwent laboratory testing, exercise testing, and echocardiography. An age-matched group of Hispanic adolescents with blood pressure recording below the 90th percentile were also exercised. Patients were then placed on 0.1 mg clonidine b.i.d. for 12 weeks. Pretherapy exercise testing demonstrated an abnormal systolic hypertensive response (mean 193 +/- 43 mmHg) that improved after therapy (mean 167 +/- 28 mmHg). Echocardiographic data were normal. All patients had elevated levels of VLDL and triglycerides. Five patients also had HDL levels below the 50th percentile for age and sex. We conclude that this population is similar to other hypertensive adolescent populations in exercise response pre- and posttherapy with clonidine, but they demonstrated a unique clinical feature in the elevation of the VLDL and triglyceride lipoprotein fractions. PMID- 3668590 TI - Extra-adrenal pheochromocytoma manifesting renovascular hypertension. AB - A case with extra-adrenal pheochromocytoma, which was found by chance in the course of renovascular hypertension, is reported. The tumor was on the stenotic portion of the right renal artery. The results of examinations for pheochromocytoma were not conclusive, that is, inconsistent elevation of plasma catecholamines and urinary catecholamine excretion, equivocal results of pharmacological tests for pheochromocytoma, and negative results in [131I]metaiodobenzylguanidine scintigraphy. The stenosis of the right renal artery disappeared, the blood pressure was normalized by surgical resection of the tumor, and the extra-adrenal pheochromocytoma was finally diagnosed by pathohistological findings. Renovascular hypertension appeared to be the primary cause of this hypertension, judging from the significant decrease in blood pressure induced by an angiotensin II analog and a renal vein renin ratio of 7.3. Even in the case of obvious renovascular hypertension, the possibility of this unusual coexistence with pheochromocytoma should be considered. PMID- 3668591 TI - Therapeutic regression of vascular structure in essential hypertension: principles and benefits. Copenhagen, November 7th, 1986. Proceedings. PMID- 3668592 TI - In vitro characteristics of vessels from patients with essential hypertension. PMID- 3668593 TI - Extrinsic mechanisms of vascular growth. PMID- 3668594 TI - In vivo studies of peripheral vascular structure in hypertensive patients. PMID- 3668595 TI - Structural regression of the vasculature during antihypertensive treatment. PMID- 3668597 TI - First Interdisciplinary Conference on Hypertension in Blacks. April 3-5, 1986. Proceedings. PMID- 3668596 TI - Photoplethysmographic assessment of digital arterial compliance in the diagnosis and treatment of hypertension. PMID- 3668598 TI - World epidemiology of hypertension in blacks. PMID- 3668599 TI - Special management techniques for hypertension in blacks. PMID- 3668600 TI - Dietary sodium, potassium, and calcium in black hypertensive subjects. PMID- 3668601 TI - Sodium sensitivity and resistance of blood pressure. Racial and renal factors. PMID- 3668602 TI - Genetic studies in twins. PMID- 3668603 TI - Clinical cerebrovascular disease in hypertensive blacks. PMID- 3668604 TI - End-stage renal disease in hypertensive blacks. PMID- 3668605 TI - Renovascular hypertension and diabetic nephropathy in blacks. PMID- 3668606 TI - Twenty-year mortality in black residents of Evans County, Georgia. PMID- 3668607 TI - Nonpharmacologic therapy of hypertension in blacks. PMID- 3668608 TI - Separation of the tumor and brain surface by "water jet" in cases of meningiomas. AB - In the surgery of meningiomas one of the most delicate problems is the separation of the tumor from the brain surface. The authors generally recommend microsurgery to preserve the brain surface anatomically and functionally. For this purpose we have developed a new surgical technique according to our concepts of tissue care. After excavating the tumor from inside the tumor brain surface was separated by repeated "water jets" into the tumor arachnoideal space. The "water jet" was produced by an ordinary bulb syringe. The front pressure of the jets was 300-1000 mm of water and the side pressure 100-300 mm of water. In the tumor-arachnoideal space the spreading water (phys. NaCl) separates the brain from the tumor with utmost care. We operated on 55 meningiomas of different types with the "water jet" technique. The immediate results were anatomically excellent. Intraoperative and postoperative acute and late edemas appeared only in a few cases. The functions of the nearby brain were generally preserved. The surgery was uneventful when the tumor surface was smooth and the tumor was spherical. When the tumor surface was uneven, one part of the tumor extended under the dura as a thin layer or the tumor was multilobulated with expanded vessels between the lobules, more microseparation was necessary. We compared the results of the "water jet" technique with the results of the "pre-water jet" series. The surgery with the "water jet" technique was much shorter and its results were better than those of microsurgery alone. PMID- 3668609 TI - Corticosteroid toxicity in neuro-oncology patients. AB - Hospital charts from 59 patients with intracranial malignancy or epidural spinal cord compression were reviewed to establish the frequency of clinically important corticosteroid toxicities and to determine treatment or patient characteristics which were predictive for toxicity. Thirty patients (51%) developed at least one steroid toxicity and eleven (19%) required hospital admission for diagnosis and/or management of steroid-related complications. In this retrospective analysis the duration of steroid therapy and the total administered dose predicted for toxicity. Patients with toxicity also had a significant fall in the serum albumin level. Important corticosteroid toxicity occurs frequently in neuro oncology patients. Further research should be directed at developing non-toxic alternatives to corticosteroids. PMID- 3668611 TI - Treatment of autochthonous rat brain tumors with steroid plus heparin: a brief report. AB - Treatment of rats bearing intracranial gliomas induced by the avian sarcoma virus with heparin plus steroid has failed to effectively extend survival time. PMID- 3668610 TI - Studies on estrogen induced pituitary tumor in the rat with special reference to the relationship of the tuberoinfundibular dopamine neuron system. AB - Pituitary tumors were experimentally induced in female Wistar rats by repeated injections of estradiol dipropionate. The hypothalamus and pituitary tumors were studied simultaneously by fluorescence histochemistry and immunohistochemistry. The pituitary gland became larger with a concomitant increase of serum prolactin in proportion to the dose of estrogen. Estrogen-induced pituitary tumor exhibited a proliferating prolactin cells by the peroxidase immunohistochemical method. Ultramicroscopical findings showed that these tumor cells were in an extremely hyperfunctional state. The dopamine neuronal perikarya in the hypothalamic arcuate nucleus and their terminals in the external layer of the median eminence were examined by fluorescence histochemistry in the rats bearing estrogen induced pituitary tumor and it was concluded that in our experimental conditions, estrogen effected directly on pituitary rather than on the hypothalamus and consequently dopamine synthesis in the arcuate neurons and its release into portal capillaries were accelerated simultaneously in order to inhibit prolactin secretion from tumor cells. PMID- 3668612 TI - Intensive study of the biology of brain tumors. PMID- 3668613 TI - Fetal frontal cortex transplanted to injured motor/sensory cortex of adult rats. I. NADPH-diaphorase neurons. AB - Fetal frontal cortex from 18-d-old embryonic rat brain was transplanted into cavities of juvenile host motor/sensory cortex. Two to seven months later, sections were reacted for NADPH-diaphorase (NADPH-d) enzyme histochemistry. NADPH d-positive neurons survived in 11 of 13 grafts. All but one of the transplants had reduced numbers of these neurons, although in 3 transplants the reductions were moderate and not statistically significant. The distribution and morphology of NADPH-d neurons within most grafts was comparable to that of NADPH-d neurons in normal host cortex. At the margin of the 2 transplants with no NADPH-d neuronal perikarya, NADPH-d fibers crossed from host to transplant as far as a millimeter into the transplant, and on rare occasions, the host neurons that gave rise to these fibers were identified. This suggests that host-transplant interactions are possible. One transplant had an abnormally large number of NADPH d-positive neurons and fibers, possibly due to selective survival of these neurons. The data reported here for NADPH-d in cortical transplants may also apply to neuropeptide Y (NPY), since nearly all neocortical NPY neurons also contain NADPH-d. PMID- 3668614 TI - Serotonergic afferents to the rat olfactory bulb: II. Changes in fiber distribution during development. AB - The present studies have defined the developmental time course and distribution patterns of serotonergic fibers in the main olfactory bulb (MOB) using immunocytochemistry, anterograde tracing and image analysis. The results indicate that the deployment of serotonergic fibers to the main olfactory bulb is essentially a postnatal event in the rat. During the first 4 d after birth, 5-HT fibers infiltrate and begin to arborize in the MOB. The density of fibers in each layer is sparse during this period, but increases rapidly. By postnatal day 8 all layers are much more heavily innervated by 5-HT fibers. The surge of fiber growth into all layers is rapid; the fibers arborize earlier at caudal than at rostral levels. This may be related to the increased metabolic activity that is reported to occur selectively in the caudal parts of the immature olfactory bulb. After the second postnatal week, 5-HT fiber density increases much more gradually in all layers except the glomerular layer; in the glomerular layer, 5-HT fiber density continues to increase rapidly. It is also during this time that the olfactory bulb begins to grow substantially in volume. Bulb volume increases from the second week into adulthood (greater than 60 d); during the same period, the density of 5-HT remains relatively constant in the infraglomerular layers. Thus, from the second week onward, the growth of 5-HT fibers appears to be closely linked to the increasing volumes of these layers. The density of 5-HT fibers in the glomerular layer, however, continues to increase from the second postnatal week. Thus, the density of fibers in the glomerular layer increases more than the increase in glomerular size, indicating that the glomerular 5-HT fibers are proliferating more than could be accounted for by simple glomerular expansion. In the adult, 5-HT fibers are 2-3 times denser in the glomerular than the infraglomerular layers (McLean and Shipley, 1987). This preferential innervation of glomeruli may be the result of a protracted period of arborization by glomerular versus infraglomerular fibers. This could be due to the prolonged focal release of a trophic factor by glomerular-associated neurons or to the earlier production of an inhibitory factor by infraglomerular neurons. PMID- 3668615 TI - The role of striate cortex in the guidance of eye movements in the monkey. AB - We studied the effect of unilateral striate cortical ablations on smooth pursuit and saccadic eye movements in the monkey. The monkeys made quite accurate saccades to stationary stimuli in the field contralateral to the lesion, and they readily pursued foveal targets moving in all directions. However, when visual stimuli were stepped into the field contralateral to the lesion and then began to move, thus insuring that the moving stimulus was confined to the impaired visual hemifield, several oculomotor abnormalities emerged. Saccades to moving stimuli presented in the impaired field consistently undershot targets that moved away from the central fixation point after the step, and overshot targets that moved back towards the central fixation point. There was little or no smooth pursuit eye velocity generated in any direction to moving stimuli in the impaired field, and the monkeys could not generate smooth pursuit to stimuli maintained a few degrees from the fovea in the impaired field, although they were able to pursue such stimuli held in the normal field. Ablation of striate cortex also affected the latencies of saccades. When step-ramp stimuli were presented in the normal field, the monkeys delayed the initiation of saccades to targets moving towards the central fixation point, and hastened the initiation of saccades to targets moving away from the central fixation point. By contrast, changes in the direction of target movement did not affect the latencies of saccades into the impaired field. The deficits seemed permanent, lasting as long as the monkeys were tested--over 2 years in one case--but they were not total. Each monkey could use stimuli moving into the affected field to develop some eye velocity, although this residual ability had a much longer latency and lower gain than that provided by the intact visual system. These results show that striate cortex is intimately involved in the estimation of stimulus velocity critical to the genesis of smooth pursuit and saccadic eye movements. PMID- 3668616 TI - Cholinergic receptor mutants of the nematode Caenorhabditis elegans. AB - Potential acetylcholine receptor (AChR) mutants of the nematode are selectable by resistance to the neurotoxic drug levamisole, a probable cholinergic agonist. To determine which mutants may have achieved resistance through loss of levamisole receptor function, we have assayed mutant extracts for specific 3H-meta aminolevamisole binding activity in the presence and absence of mecamylamine. We find that mutants in 3 of the 7 genes associated with extreme levamisole resistance are obviously deficient in saturable specific 3H-meta-aminolevamisole binding activity. Mutants of the 4 other genes have abnormal binding activities that fail to undergo the apparent allosteric activation of saturable specific 3H meta-aminolevamisole binding activity caused by mecamylamine. Thus, all 7 genes appear to be required to produce a fully functional levamisole receptor. Mutants of several other genes associated only with partial resistance to levamisole have at least grossly normal receptor binding activities. PMID- 3668617 TI - Long-term increases in dentate granule cell responsivity accompany operant conditioning. AB - The efficacy of synaptic transmission from the perforant path (PP) to the granule cells in the dentate gyrus (DG) of freely moving rats was monitored electrophysiologically over the course of training in an appetitively motivated, discriminated operant paradigm. Every day, 22 hr after behavioral sessions, evoked potentials were recorded from the DG following stimulation of the PP over range of current intensities and the amplitudes of the population spikes were measured. Behavioral conditions involved training in an operant conditioning paradigm or a session of free-feeding. Significant increases in population spike amplitudes were observed over the 8 d of training, but not over the 8 d of free feeding. This training-induced increase in granule cell responsivity persisted for at least 10 d following the cessation of behavioral trials and was in many ways comparable to long-term potentiation (LTP), subsequently observed in these same rats 24 hr after tetanic stimulation. These data confirm and extend previous reports of synaptic enhancements following conditioning and suggest that such increases in synaptic efficacy may encode some aspect of learning. PMID- 3668618 TI - Representation of interaural time difference in the central nucleus of the barn owl's inferior colliculus. AB - This paper investigates the role of the central nucleus of the barn owl's inferior colliculus in determination of the sound-source azimuth. The central nucleus contains many neurons that are sensitive to interaural time difference (ITD), the cue for azimuth in the barn owl. The response of these neurons varies in a cyclic manner with the ITD of a tone or noise burst. Response maxima recur at integer multiples of the period of the stimulating tone, or, if the stimulus is noise, at integer multiples of the period corresponding to the neuron's best frequency. Such neurons can signal, by means of their relative spike rate, the phase difference between the sounds reaching the left and right ears. Since an interaural phase difference corresponds to more than one ITD, these neurons represent ITD ambiguously. We call this phenomenon phase ambiguity. The central nucleus is tonotopically organized and its neurons are narrowly tuned to frequency. Neurons in an array perpendicular to isofrequency laminae form a physiological and anatomical unit; only one ITD, the array-specific ITD, activates all neurons in an array at the same relative level. We, therefore, may say that, in the central nucleus, an ITD is conserved in an array of neurons. Array-specific ITDs are mapped and encompass the entire auditory space of the barn owl. Individual space-specific neurons of the external nucleus, which receive inputs from a wide range of frequency channels (Knudsen and Konishi, 1978), are selective for a unique ITD. Space-specific neurons do not show phase ambiguity when stimulated with noise (Takahashi and Konishi, 1986). Space specific neurons receive inputs from arrays that are selective for the same ITD. The collective response of the neurons in an array may be the basis for the absence of phase ambiguity in space-specific neurons. PMID- 3668619 TI - Neuronal colocalization of peptides, catecholamines, and catecholamine synthesizing enzymes in guinea pig paracervical ganglia. AB - The patterns of colocalization of neuropeptides, catecholamines, and catecholamine-synthesizing enzymes were examined in principal neurons and nerve terminals in guinea pig paracervical ganglia using a double-labeling immunohistochemical procedure. A small proportion of nerve cell bodies (less than 10%) had the characteristics of catecholamine-synthesizing neurons and presumably were noradrenergic. Another 50% of the nerve cell bodies contained immunoreactivity (IR) to dopamine-beta-hydroxylase (DBH), but did not have any other characteristics of noradrenergic neurons; they did not contain detectable catecholamines, or IR to dopa decarboxylase (DDC) or tyrosine (TH) hydroxylase, nor did they take up exogenous catecholamines. Half of the catecholamine neurons had neuropeptide Y (NPY)-IR, and a small number (0.5% total neurons) had somatostatin (Som)-IR. Most of the non-noradrenergic neurons with DBH-IR (40-50% total neurons) contained IR for dynorphin (Dyn), NPY, and vasoactive intestinal peptide (VIP), and about half of them (20-25% total) also contained Som-IR. Ten to twenty percent of neurons contained IR to Som, but not to any other antigen examined here. Nerve terminals with substance P (SP)-IR or enkephalin (Enk)-IR were prominent in all ganglia. SP-IR fibers formed dense baskets only around those neurons with DBH/Dyn/NPY/VIP (+/- Som)-IR, while fibers with very bright Enk-IR were associated selectively with those neurons with Som-IR alone. In addition, most TH-IR nerve cell bodies were surrounded by NPY-IR varicose nerve fibers. In conclusion, this analysis of combinations of peptides and enzymes contained in principal neurons of the paracervical ganglia allows us to identify as many as 11 different neuron populations. The functional significance of the presence of the same neuropeptide (e.g., NPY) in different neuron populations is as yet unknown. Some of these classes of neurons are associated specifically with immunohistochemically distinct types of presynaptic nerve fibers, which suggests that different immunohistochemically defined classes of neurons represent different functional pathways. PMID- 3668620 TI - Human muscle cultured in monolayer and cocultured with fetal rat spinal cord: importance of dorsal root ganglia for achieving successful functional innervation. AB - Adult human muscle cultured in monolayer was cocultured with explants of 13-14-d old rat embryo using (a) ventral spinal cord (VSC), (b) transverse section of whole spinal cord (WSC), and (c) WSC with dorsal root ganglia (DRG) attached (WSC + DRG). AChR clusters and AChE-positive patches, both at the nerve-muscle contacts, were studied at 5, 12, and 21 d of coculture with each of the 3 spinal cord preparations. In addition, AChE-positive patches were studied after 31-64 d of coculture with WSC + DRG to evaluate further organization of those patches. Compared to VSC and WSC cocultures, WSC + DRG induced significantly more AChR clusters per muscle fiber at the nerve-muscle contacts at 5 d of coculture, and the percentage of muscle fibers containing AChR clusters was higher at all 3 time points quantitated. The number of AChE-positive sites was the same with all 3 spinal cord preparations in early (day 5) cocultures. Between 12 and 21 d of coculture, the number of muscle fibers containing AChE patches increased significantly only with WSC + DRG, correlating with the increased number of contracting muscle fibers in that coculture system. Only in human muscle cocultured with WSC + DRG was successful innervation of the cultured muscle fibers achieved, as manifested by (1) contractions in a continuous rhythm of large groups of muscle fibers that were reversibly blocked by 1 mM d-tubocurarine (aneurally cultured human muscle does not spontaneously contract); (2) well developed cross-striations throughout the fiber; (3) well-organized AChE-positive sites; and (4) a trend from multifocal toward unifocal innervation of those muscle fibers. Our studies demonstrate that adult human muscle cultured in monolayer can be innervated by fetal rat spinal cord and that, in our system, DRG are essential for achieving functional innervation. PMID- 3668621 TI - Single-unit analysis of postnatal olfactory learning: modified olfactory bulb output response patterns to learned attractive odors. AB - Neonatal rats learn to approach odors associated with stimulation normally provided by their mother. The present report describes changes in olfactory bulb single-unit activity following olfactory learning in young rats. Rat pups were exposed from postnatal day 1 to 18 to either (1) peppermint-scented air while receiving tactile stimulation (Pepp-Stroked), (2) peppermint-scented air with no tactile stimulation (Pepp-Only), (3) clean air and tactile stimulation (Stroked Only), or (4) clean air and no tactile stimulation (Naive). On day 19, single unit activity was recorded from mitral/tufted cells in urethane-anesthetized, freely breathing pups in response to either peppermint or a novel orange odor. Mitral/tufted cell response patterns to peppermint were significantly altered in Pepp-Stroked animals compared to control pups. Peppermint exposure alone, not associated with tactile stimulation (Pepp-Only), did not affect subsequent single cell response patterns to that odor. In addition, the modification of response patterns was specific to peppermint and was not associated with a change in respiration rate. Furthermore, Pepp-Stroked pups had a relative behavioral preference for peppermint on day 19 compared to control pups. These results demonstrate that postnatal olfactory learning selectively modifies the subsequent response patterns of olfactory bulb output cells to the attractive odor. Furthermore, these results indicate that the initial coding of an odor's attractive value occurs within the olfactory bulb. PMID- 3668622 TI - Light microscopic immunocytochemical localization of pyruvate dehydrogenase complex in rat brain: topographical distribution and relation to cholinergic and catecholaminergic nuclei. AB - Pyruvate dehydrogenase complex (PDHC; EC 1.2.4.1, EC 2.3.1.12 and EC 1.6.4.3) includes 3 catalytically active mitochondrial enzymes involved in the formation of cellular energy through the tricarboxylic acid cycle and in the synthesis of ACh. We sought to determine whether immunocytochemically detected PDHC was enriched in neurons of the rat CNS, and, if so, whether the perikarya containing higher levels of PDHC immunoreactivity were differentially distributed with respect to their size or location within nuclear groups containing ACh, catecholamines or other unidentified transmitters. Under the labeling conditions used in this study, the peroxidase-antiperoxidase immunoreaction product for PDHC was detectable principally in neuronal perikarya. The intensity of immunoreactivity within perikarya was variable as judged visually and by cellular, computer-assisted densitometry. In the forebrain, the most intensely labeled perikarya were seen in the medial septal nuclei, the nuclei of the diagonal band, the nuclei basalis, the dorsal and ventral striatum, and the entorhinal cortex. More caudally, intense immunoreactivity was detected in perikarya in the supraoptic hypothalamic nuclei, reticular thalamic nuclei, lateral substantia nigra, most of the tegmental nuclei, lateral nuclei of the trapezoid body, raphe pontis and obscuris, and the caudal part of the lateral reticular nuclei. In addition, many of the motor nuclei of the cranial nerves, including the dorsal motor nuclei of the vagus and the hypoglossal nuclei, and the nucleus ambiguus contained perikarya with intense PDHC labeling. Densitometry revealed no differences in intensity of immunoreactivity in soma of varying sizes. However, the intensity of neuronal labeling for PDHC was significantly greater in several nuclear groups that were shown in adjacent sections to contain cholinergic, but not catecholaminergic, enzymes. In contrast, the primary olfactory cortex, pyramidal cell layer of the regio inferior of hippocampus, and the Purkinje cell layer of the cerebellum were regions having perikarya with intense PDHC immunoreactivity but lacking both the synthetic and the degradative enzymes for ACh. These results provide the first morphological evidence that PDHC, a general metabolic enzyme complex, is enriched in selective perikarya that are heterogeneously distributed in brain and are especially abundant in many of the regions containing cholinergic neurons. The heterogeneity of PDHC immunoreactivity suggests that certain cholinergic as well as noncholinergic nuclei may be selectively vulnerable to mitochondrial diseases involving pyruvate utilization. PMID- 3668623 TI - Vocalizations by a sexually dimorphic isolated larynx: peripheral constraints on behavioral expression. AB - The clawed frog Xenopus laevis uses sexually dimorphic vocalizations, mate calling and ticking, to advertise reproductive state. The basic unit of vocalization is a brief click, produced by the movement of cartilagenous disks located within the larynx. The rate of click production in the male-specific mate call (71 Hz) is an order of magnitude faster than the rate of click production in female typical ticking (6 Hz). To determine if vocalization rate is constrained by the periphery, male and female larynges were isolated and response of the muscles to nerve stimulation was studied. Laryngeal muscle response is markedly dimorphic in the 2 sexes, both in the amplitude potentiation of electromyograms and in the rate at which discrete tension transients can be produced. At 6 Hz (ticking), both sexes generate discrete tension transients in response to each stimulus pulse. In response to nerve stimulation at 71 Hz (mate calling), male laryngeal muscle generates discrete tension transients while female laryngeal muscle does not. Since expression of sex-specific vocalizations is regulated by androgenic hormones, responses of laryngeal muscle to nerve stimulation in androgen-treated adult females and castrated adult males were also examined. The responses of laryngeal muscle from castrated and intact males are similar. Androgen-treated female larynx is partially masculinized but does not produce tension transients at the mate call rate. These physiological results are in close agreement with behavioral observations. Sounds produced by the isolated larynx were nearly identical in spectral properties to those produced by an intact male. We determined that the production of a discrete tension transient is prerequisite to click production. Thus, one reason females do not mate call, even when treated with androgens, is that female laryngeal muscle cannot produce discrete tension transients at a rapid rate. PMID- 3668624 TI - Androgen regulation of muscle fiber type in the sexually dimorphic larynx of Xenopus laevis. AB - We used histochemical techniques [assays for adenine triphosphatase (ATPase) and succinate dehydrogenase (SDHase) activity] to identify muscle fiber types in the larynx of Xenopus laevis. Male muscle is made up of one fiber type, medium-sized fibers (approximately 9 microns2) that stain lightly for acid-stable ATPase and intensely for SDHase activity. In contrast, the female has 3 fiber types: small fibers (approximately 6 microns2) that stain intensely for ATPase and SDHase, medium-sized fibers (approximately 13 microns2) with moderate staining for ATPase and dark staining for SDHase, and large fibers (approximately 15 microns2) with little SDHase or ATPase activity. Long-term castration (6 months) has no effect on histochemical staining of adult male fibers. Long-term testosterone treatment (5 months) increases the proportion of medium-sized, moderately staining fibers in adult females, and reduces the proportion of both the small, darkly staining fibers and the large, lightly staining fibers. At metamorphosis, both males and females have 3 fiber types whose ATPase activity is similar to that of the adult female. However, no SDHase activity is observed. Treatment of juveniles for 3 weeks with testosterone results in nearly complete masculinization of muscle fibers, as judged by increased cross-sectional area, homogeneous ATPase staining, and a marked increase in SDHase activity. Thus, juvenile muscle is considerably more responsive to testosterone than is adult female muscle. We propose that the uniform metabolic properties of male laryngeal muscle contribute to the production of the rapid (66 Hz) mate call vocalizations characteristic of this species. Further, our results suggest that androgens direct the masculinization of laryngeal muscle fibers during postmetamorphic development. PMID- 3668625 TI - Determinants of multisensory integration in superior colliculus neurons. I. Temporal factors. AB - One of the most impressive features of the central nervous system is its ability to process information from a variety of stimuli to produce an integrated, comprehensive representation of the external world. In the present study, the temporal disparity among combinations of different sensory stimuli was shown to be a critical factor influencing the integration of multisensory stimuli by superior colliculus neurons. Several temporal principles that govern multisensory integration were revealed: (1) maximal levels of response enhancement were generated by overlapping the peak discharge periods evoked by each modality; (2) the magnitude of this enhancement decayed monotonically to zero as the peak discharge periods became progressively more temporally disparate; (3) with further increases in temporal disparity, the same stimulus combinations that previously produced enhancement could often produce depression; and (4) these kinds of interactions could frequently be predicted from the discharge trains initiated by each stimulus alone. Since multisensory superior colliculus neurons project to premotor areas of the brain stem and spinal cord that control the orientation of the receptor organs (eyes, pinnae, head), they are believed to influence attentive and orientation behaviors. Therefore, it is likely that the temporal relationships of different environmental stimuli that control the activity of these neurons are also a powerful determinant of superior colliculus mediated attentive and orientation behaviors. PMID- 3668626 TI - The development of hindlimb motor activity studied in the isolated spinal cord of the chick embryo. AB - The development of hindlimb motor activity was studied in an isolated preparation of the chick spinal cord. The motor output from lumbosacral segments was characterized by recording the pattern of ventral root and muscle nerve discharge in 6-14-d-old embryos. In addition, the synaptic drive underlying motoneuron activity was monitored electrotonically from the ventral roots. Spontaneous motor activity consisted of recurring episodes of cyclical motoneuron discharge. During development, both the number of cycles in each episode and the intensity of discharge in each cycle progressively increased. Monophasic, positive ventral root potentials accompanied each cycle of motoneuron discharge. Prior to the innervation of hindlimb muscles at stage 26, ventral root discharge was barely detectable despite the presence of large ventral root potentials. Following hindlimb muscle innervation, each cycle of activity was initiated by a brief, intense discharge that coincided with the rising phase of the ventral root potential. In embryos older than stage 30, the initial discharge was followed, after a delay, by a more prolonged discharge. The duration of ventral root potentials was shortest in the stage 26 embryos, but was similar in embryos at stage 29 and older. The developmental changes in the coordination of antagonist activity were documented by recording the pattern of discharge in sartorius (flexor) and caudilioflexorius (extensor) muscle nerves between stage 30 and stage 36. At stage 30 both sets of motoneurons were coactivated during the brief discharge that initiated each cycle. By stage 31 a second discharge occurred in each cycle. The second discharge was delayed in flexor, but not in extensor, motoneurons, which led to an alternating pattern of activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668627 TI - Ultrastructural analysis of the distribution of synaptic boutons from labeled preganglionic axons on rabbit ciliary neurons. AB - The number of preganglionic inputs that innervate rabbit ciliary ganglion cells is directly correlated with the number of dendrites arising from each ganglion cell (Purves and Hume, 1981). In general, the innervation of multiply innervated ciliary neurons by individual preganglionic axons is regionally restricted to a portion of the postsynaptic surface that usually includes the cell body and some, but not all, of the dendrites (Forehand and Purves, 1984). These observations suggest that dendrites modulate convergence to each cell by providing relatively separate postsynaptic domains for individual inputs. To examine this possibility further, I have assessed the distribution of synaptic boutons from individually labeled preganglionic axons on ciliary ganglion cells at the ultrastructural level. The results show that at least a third of the dendrites of these neurons are contacted exclusively by synaptic boutons from a single preganglionic axon. However, at least half of the dendrites (and nearly all of the cell bodies) of multiply innervated ganglion cells are innervated by at least 2 different preganglionic axons. Moreover, synapses from 2 different inputs often coexist in close proximity on the postsynaptic surface. Thus, individual preganglionic axons do not require exclusive dominion over a particular part of a postsynaptic cell in order to maintain their connection with the cell. These results suggest that competitive interactions between the inputs to these cells occur between the sets of boutons arising from different inputs, rather than at the level of individual boutons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668628 TI - Inhibitory interactions between spiking and nonspiking local interneurons in the locust. AB - Simultaneous intracellular recordings were made from pairs of spiking and nonspiking local interneurons in the metathoracic ganglion of the locust to search for interactions that might underlie tactile and proprioceptive reflexes of a leg. A spike in a spiking local interneuron is followed after a consistent latency (0.6 +/- 0.12 msec, mean +/- SD) by an IPSP in a particular nonspiking interneuron. The connection appears to be direct and chemically mediated. By contrast, manipulating the membrane potential of a nonspiking interneuron by injecting current through the recording electrode has no direct effect on a spiking local interneuron. The direct interactions between pairs of these local interneurons are thus one-way. If, however, the current injected into a nonspiking interneuron is sufficient to evoke a movement by exciting motor neurons, then the spiking interneuron can be excited or inhibited by the resulting reafference. The spiking local interneurons have excitatory regions in their receptive fields formed by arrays of exteroreceptors or by proprioceptors at specific joints. The inhibitory connections mean that the postsynaptic nonspiking interneurons have corresponding inhibitory regions to their receptive fields. Several spiking local interneurons with similar receptive fields may converge onto one nonspiking interneuron. Some nonspiking interneurons, however, have larger receptive fields than an individual spiking interneuron, again indicating convergence of inputs. The specificity of the inhibitory connections preserves the spatial representation of sensory information for use in particular reflexes. For example, touching hairs on the ventral femur evokes a reflex extension of the tibia. Spiking interneurons excited by these receptors inhibit a nonspiking interneuron that would cause the opposing and therefore unwanted flexion movement. Viewed in this behavioral context, the pattern of connections between the local interneurons forms the basis of the circuitry for the local reflex adjustments of posture and locomotion. PMID- 3668629 TI - Tight junctions of brain endothelium in vitro are enhanced by astroglia. AB - The belts of endothelial tight junctions, which impede diffusion between blood and brain, were reduced to fragmentary, small junctions in subcultured brain endothelium. When cocultured with the capillaries' nearest neighbor, the astrocytes, these endothelial tight junctions were enhanced in length, width, and complexity, as seen by en face views of the cell membranes with freeze-fracture electron microscopy. Gap junctions, common in brain endothelium in vitro but absent in mature brain capillaries in vivo, were markedly diminished in area from among the enhanced tight junctions of the cocultures. Thus, astrocytes in vitro play a role in the formation, extent, and configuration of the junctional complexes in brain endothelium, whose diffusion barrier may likewise be influenced by astrocytes in vivo. PMID- 3668630 TI - Fibronectin-like immunoreactivity in the developing cerebral cortex. AB - In the developing cerebral cortex of the mouse, binding of antibodies directed against the extracellular matrix glycoprotein fibronectin occurs with a distinct temporal and spatial pattern. On the 10th embryonic day (E10), when the wall of the telencephalic vesicle is made up of only the proliferating cells of the ventricular zone, antifibronectin (aFN) binding is restricted to the blood vessels and pia-arachnoid. Fibronectin-like immunoreactivity first appears in the neuropil as small points of immunofluorescence among the earliest postmitotic neurons that form the preplate (E11-12). A short time later (E12-13), aFN immunoreactivity becomes more diffuse but continues to be restricted to the preplate. As newly arriving neurons form the cortical plate within the preplate (E13-14), aFN binding is present in the marginal zone above the cortical plate and in the subplate below it. Both the marginal zone and the subplate contain early afferents and the cells that were previously part of the preplate. Binding of aFN is transient; by E18-19 it has diminished to the point where it is no longer detectable except in the blood vessels and pia-arachnoid. The transient appearance of fibronectin-like immunostaining in the zones that contain early cortical afferents suggests that fibronectin plays a role in forming the migratory pathway for the growth cones of these axons. In this role it may be acting in concert with other extracellular matrix components such as hyaluronectin, glycosaminoglycans, and laminin, which have been shown to have similar spatial distributions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668631 TI - Axonal signals regulate the differentiation of non-myelin-forming Schwann cells: an immunohistochemical study of galactocerebroside in transected and regenerating nerves. AB - Little is known about the factors involved in directing and maintaining the divergent differentiation of the 2 major Schwann cell variants, myelin and non myelin-forming cells, in peripheral nerves. There is strong evidence that the differentiation of myelin-forming cells depends critically on cell-cell signaling through contact with appropriate axons. In this paper we ask whether this remarkable dependence of the Schwann cell on axonal contact for full differentiation is unique to those cells that form myelin or whether axonal signaling is also an important factor in the differentiation of non-myelin forming Schwann cells. Sciatic nerves or cervical sympathetic trunks of adult rats were either transected or crushed and the axons allowed to degenerate and, in the case of crushed nerves, to regenerate into the distal stump for periods of time varying from 2 d to 9 weeks. The distal stump of the nerve was excised at specific times, the Schwann cells dissociated and immunolabeled with antibodies to galactocerebroside. In the sciatic nerve, which contains a mixture of non myelin-forming and myelin-forming Schwann cells, transection resulted in a loss of galactocerebroside expression from the surface of all the Schwann cells in the distal stump over a 9 week period, irrespective of their original phenotype. In crushed sciatic nerves, where axons were allowed to regrow into the distal stumps, the number of Schwann cells expressing immunohistochemically detectable quantities of galactocerebroside in the stump declined over the first 3 weeks, but by 9 weeks after crush the total percentage of galactocerebroside-positive cells in the nerve had risen to control levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668632 TI - Results of lumbar discectomy in the pediatric patient. AB - To determine the results of lumbar discectomy in pediatric patients, a review was conducted of the medical records of 74 consecutive patients (40 males and 34 females) younger than 17 years who underwent lumbar disc surgery between 1950 and 1983. During this period, only 3% of patients younger than 17 years who presented with the chief complaint of low-back pain eventually had lumbar disc operation. In 43 patients it was thought that an injury had precipitated the symptoms. Thirty-seven patients had a nerve deficit at the time of initial evaluation. Water-soluble contrast myelography with repeated postmyelographic computerized tomography is currently used to confirm the diagnosis. The disc operations were performed at the L4-5 level in 47% of patients, the L5-S1 level in 45%, the L3-4 and L4-5 level in 4%, and the L4-5 and L5-S1 level in 4%. Fourteen of the 74 patient underwent spinal fusion with their first operation. At 9 months postoperatively, 95% had good or excellent results. During an extended follow-up period of up to 34 years, 16 of the patients with early successful results required further back procedures. After all medical and surgical treatment in this group of patients, the results were excellent in 57%, good in 38%, and poor in only 4%. PMID- 3668633 TI - Outcome after severe head injury. Relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. AB - A consecutive series of 330 severely head-injured patients was studied prospectively. All of the patients were treated with the same protocols by the same physicians and staff in the same intensive care unit. All of the patients had intracranial pressure (ICP) monitoring. Of the 330 patients, 100 were in the pediatric age group (0 to 19 years of age) and 230 were in the adult group (20 to 80 years of age). Statistical analyses were performed with regard to outcome, Glasgow Coma Scale (GCS) score, ICP course, and incidence of surgical lesions. The average emergency room GCS score as well as the 24-hour GCS score for each group was the same. The percentage of patients having ICP that was normal, increased but reducible, and increased but not reducible in each group was the same. The pediatric patients had a significantly higher percentage of good outcomes (43%) than the adult patients (28%) (p less than 0.01). They also had a significantly lower mortality rate (24%) than the adult patients (45%) (p less than 0.01). At 1 year following injury, 55% of pediatric patients had a good outcome compared to 21% of adults (p less than 0.001); this trend was evident at 3 months, with the same p value. Pediatric patients with normal ICP had a higher percentage of good outcomes (70%) than the adult patients with normal ICP (48%) (p less than 0.05). There was no significant difference in outcome in pediatric and adult patients with mass lesions or with increased ICP, regardless of whether or not the pressure was reducible. There was a much higher incidence of surgical mass lesions in adult patients (46%) than in pediatric patients (24%) (p less than 0.001). PMID- 3668634 TI - Neurobehavioral functioning and magnetic resonance imaging findings in young boxers. AB - In a prospective investigation of neurobehavioral functioning in young boxers, 13 pugilists and 13 matched control subjects underwent tests of attention, information-processing rate, memory, and visuomotor coordination and speed. The results disclosed more proficient verbal learning in the control subjects, whereas delayed recall and other measurements of memory did not differ between the two groups. Reaction time was faster in the boxers than in the control subjects, but no other differences were significant. Ten subjects in each group were retested 6 months later and exhibited improvement in their neuropsychological performance as compared to baseline measurements. However, there were no differences in scores between the boxers and the control subjects at the follow-up examination or in the magnitude of improvement from baseline values. Magnetic resonance imaging, which was performed in nine of the boxers, disclosed normal findings. PMID- 3668635 TI - Magnetic resonance images of chronic subdural hematomas. AB - Magnetic resonance imaging (MRI) and computerized tomography (CT) scans of 18 patients with 20 chronic subdural hematomas were compared. In many ways, MRI was superior to CT for demonstrating the hematomas. In general, chronic subdural hematomas were hyperintense on both T1- and T2-weighted MRI. The T1 values of chronic subdural hematomas were significantly shorter than gray matter values and significantly longer than white matter values. The T2 values were significantly longer than both gray matter and white matter values. These findings were consistent with previous reports. However, six hematomas (30%) were iso- or hypointense on T1-weighted images. Possible mechanisms responsible for the difference in intensity of chronic subdural hematoma on MRI are discussed, and the important role of methemoglobin formation is emphasized. PMID- 3668636 TI - Lesions in Meckel's cave: variable presentation and pathology. AB - A series of 12 patients with mass lesions arising from Meckel's cave is presented. Patients' age on presentation ranged from 13 months to 71 years. Nine of the 12 patients had symptoms referable to the fifth cranial nerve, but only three complained of facial pain. The 12 patients presented eight different pathological entities, including meningioma, lipoma, schwannoma, malignant melanotic schwannoma, arachnoid cyst, neurofibroma, epidermoid tumor, and chordoma. Computerized tomography and magnetic resonance imaging were most useful in localizing the lesion to Meckel's cave. All 12 patients underwent a subtemporal approach to the lesion, and gross total removal was achieved in 11. Postoperative results were excellent with no increased neurological deficits seen 3 months postoperatively. Most patients had resolution of the cranial nerve deficits except for fifth nerve function, which was impaired in nine patients postoperatively. This series demonstrates that lesions in Meckel's cave can have a varied and unusual presentation, as well as an assortment of pathology. Total removal of lesions in this area resulted in relief of symptoms in most patients, with minimum morbidity. PMID- 3668637 TI - Collagen type III deficiency in patients with rupture of intracranial saccular aneurysms. AB - Samples of the middle cerebral artery (MCA) and the brachial artery were obtained post mortem from 14 patients who died following rupture of intracranial saccular aneurysms and from a control group of 14 age- and sex-matched patients who died of causes unrelated to aneurysm rupture. The biomechanical properties of ring shaped arterial specimens were investigated by loading the specimens at a constant deformation rate until rupture. The relative amounts of collagen type I and type III were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) studies of cyanogen bromide peptides of collagen prepared from the arterial samples. A deficiency of collagen type III was demonstrated in specimens of the MCA in six of 14 patients with a ruptured intracranial saccular aneurysm. This deficiency was not accompanied by alterations in the mechanical arterial strength but resulted in a significant increase in the extensibility at stress values corresponding to blood pressures between 100 and 200 mm Hg. No difference was found between aneurysm patients and the control group in regard to the biomechanical properties of the brachial artery, despite the presence of a significant deficiency of collagen type III. The increase in vascular extensibility of the MCA may represent alterations in the fibrous structure and functional integrity of the cerebral arteries of aneurysm patients with collagen type III deficiency. Together with aggravating hemodynamic stresses, this deficiency may be an important factor in the pathogenesis of saccular aneurysms. PMID- 3668638 TI - Quantitative study of microvessel ultrastructure in human peritumoral brain tissue. Evidence for a blood-brain barrier defect. AB - The form and function of blood vessels are determined by the cells that constitute their microenvironment. Brain tissue around tumors contains varying numbers of tumor cells that could influence local capillaries to lose their blood brain barrier (BBB), as they do in the tumor itself. Microvascular permeability cannot be measured directly in humans but can be inferred from a knowledge of vessel ultrastructure. The authors have examined the vascular ultrastructure associated with the BBB in human peritumoral brain tissue for evidence of BBB compromise and to correlate BBB features with the cellular components of the vessel microenvironment. Light microscopic examination of brain tissue samples in patients with primary brain tumors showed that the tissue lying beyond the visible edge of the tumor ranged from essentially normal to grossly infiltrated with tumor cells. Although some of the vessels were structurally normal, the microvessels as a group had elongated junctional clefts (unfused regions) and an increase in the density of endothelial vesicles. Furthermore, the cleft index (the percentage of the junctional profile that is unfused) varied directly with the local cell density. A subpopulation of vessels enveloped by a layer of tumor cells was grossly abnormal. However, vessels that were not immediately invested by tumor cells also showed some abnormalities. It is concluded that tumor cells infiltrating peritumoral brain tissue cause blood vessels to take on some of the structural characteristics of leaky vessels. Since direct contact is not required, and since the degree of abnormality correlates with the number of tumor cells in the environment, the authors suggest that this inductive influence is exerted over a distance and is dependent on the concentration of the inducing factors. PMID- 3668639 TI - Effect of hypertension on small-vessel healing after microvascular anastomosis. AB - Artery-to-artery microvascular anastomosis (MVA) has become an established therapeutic alternative for patients with giant intracranial aneurysms and other forms of cerebrovascular disease. Many patients afflicted with cerebrovascular disease also suffer from hypertension. To evaluate the effect of hypertension on healing of small arteries following MVA, 36 spontaneously hypertensive rats were subjected to end-to-side MVA of their common carotid arteries. At specific times after surgery the rats were sacrificed; the anastomotic site was removed and examined with light microscopy and scanning electron microscopy. All MVA's were patent, and there was no evidence of thrombus formation or stenosis at the operative site in any group. Also, there was no difference between the spontaneously hypertensive rats and the control normotensive rat group in the rate of endothelial coverage of the MVA. The presence of hypertension appears to have no effect on healing of small arteries in the rat. PMID- 3668640 TI - Experimental chronic subdural hematoma in mice. Gross morphology and light microscopic observations. AB - A new experimental model of chronic subdural hematoma in mice is described. A single intraperitoneal injection of 6-aminonicotinamide (25 mg/kg body weight) on the 5th postnatal day induced hydrocephalus in mice with almost 100% success. Approximately 60% of the mice spontaneously developed intracranial hemorrhage 20 days after the injection. About 1 week after the hemorrhage, a lens-shaped or spherical subdural hematoma was observed, accompanied by marked dilatation of the lateral ventricles and intraventricular hemorrhage. Histological examination revealed that the hematoma contained well-organized outer and inner membranes. Fresh hemorrhage surrounded by many hemosiderin-laden macrophages was seen at the margin of the hematoma adjacent to the organizing outer membrane, in which many fibroblasts and blood vessels were noted. The inner membrane of the hematoma was made up of several tiers of flattened cells with thin-walled blood vessels. The gross morphology and histology of these hematomas closely resembled those of human chronic subdural hematoma. PMID- 3668641 TI - Reevaluation of an experimental streptococcal canine brain abscess model. AB - An experimental cerebral abscess model in which alpha-hemolytic Streptococci were inoculated into the brain parenchyma of dogs was evaluated for assessment of antimicrobial therapy. Intracerebral ring-enhancing lesions were visualized by computerized tomography, but they resolved after time without therapeutic intervention. Histopathological study demonstrated evolution of the lesions into sterile granulomas. Quantitative cultures were performed and uniformly became sterile in the early cerebritis stage, approximately 3 days after bacterial inoculation. Therefore, this brain abscess model should not be utilized for the evaluation of new antimicrobial treatment regimens. Rather, other models which document persistent viable organisms within cerebral abscesses need to be developed. PMID- 3668642 TI - Carotid artery mixing with diastole-phased pulsed drug infusion. AB - Focal injury to the brain or retina is a frequent complication of drug delivery to the internal carotid artery (ICA) and may be due to poor mixing of the drug with blood at the infusion site. Rhesus monkeys were studied to determine whether phased drug delivery during diastole from a modified pulsatile angiographic injector would improve drug mixing in vivo. A radiolabeled flow tracer, carbon-14 iodoantipyrine (14C-IAP), was injected into the ICA of three monkeys in 80-msec pulses, each ending at least 50 msec before the end of local diastole. Local isotope concentration in the brain was determined by quantitative autoradiography. The ratio of highest to lowest concentration was 1.86 +/- 0.26 (mean +/- standard deviation) in the frontoparietal cortex, 1.65 +/- 0.42 in the frontoparietal white matter, 1.89 +/- 0.28 in the temporal cortex, and 1.39 +/- 0.17 in the basal ganglia. These results were similar to recordings in three control animals that received intravenous 14C-IAP to demonstrate complete drug mixing (1.37 +/- 0.12, 1.41 +/- 0.11, 1.70 +/- 0.08, 1.22 +/- 0.24, respectively), and contrasted to findings in five animals which received continuous intracarotid infusions to demonstrate standard ICA drug delivery (4.54 +/- 2.07, 2.94 +/- 1.45, 5.43 +/- 3.57, 3.60 +/- 2.90, respectively). Pulsed intra-arterial infusion during diastole provides a technically simple method for improving intravascular drug mixing, and results in drug delivery to tissue capillaries that is proportional to blood flow. PMID- 3668643 TI - Uniformity of intracarotid drug distribution with diastole-phased pulsed infusion. AB - Drug streaming has been implicated in the development of focal necrotic lesions in perfused tissues following intracarotid chemotherapy of brain tumors at low infusion rates. The narrow infusate path characteristic of streaming within laminar blood flow is not observed at high infusion rates such as are typical in contrast injection for angiography. By periodically pulsing the infusate at a high rate, the mechanisms of rapid mixing can be exploited while retaining the practicality of low average infusion rates. This in vitro study demonstrates the effects of the pulse-controlling parameters and the catheter characteristics and placement on mixing effectiveness. An internal carotid artery model including eight cerebral branches was infused with dye through various indwelling catheters, and individual branch effluents were collected and analyzed spectrophotometrically for dye concentration. While catheter placement dominates the factors that control infusate distribution, judicious selection of the pulse parameters can alleviate that dependence. A primary advantage is gained by phasing the pulse to occur during that period of the cardiac cycle when the blood flow is lowest at the injection site. The data clearly showed that diastole phased pulsed infusions are highly effective in producing a uniform infusate distribution at low average infusion rates. PMID- 3668645 TI - Bilateral anomalous course of the ulnar nerve at the wrist causing ulnar and median nerve compression syndrome. Case report. AB - The case of a patient with a bilateral compression syndrome of the ulnar and median nerves at the wrist is described. Both ulnar nerves, which were surgically explored at different times, followed an anomalous course and passed into the canalis carpi side by side with the median nerve. This variation in the course of the ulnar nerve is extremely rare and causes a unique syndrome with characteristic electromyographic patterns. PMID- 3668644 TI - Photochemically induced graded spinal cord infarction. Behavioral, electrophysiological, and morphological correlates. AB - Neurological and morphological outcome was evaluated in a rat model of graded spinal cord infarction initiated by a photochemical reaction. In this model, light-dye interactions induce primary microvascular stasis, resulting in consistent patterns of tissue necrosis. Four groups of rats underwent photoinduction times ranging from 30 seconds to 10 minutes. Neurological and electrophysiological functions were assessed starting 1 week after irradiation and continuing for 8 weeks. A functional neurological score was obtained by combining results from sensory and motor tasks, and electrophysiological function was evaluated from the somatosensory evoked potential recordings. In rats irradiated for short periods (30 seconds and 1 minute) mild behavioral deficits were documented. In contrast, electrical conduction was suppressed acutely in both groups; this recovered by 8 weeks to baseline or near baseline in the 30 second group but not in the 1-minute group. In rats irradiated for longer periods (5 and 10 minutes), severe behavioral and conduction abnormalities were detected at both the subacute and chronic testing periods. Although no significant difference in behavior was documented between the 5- and 10-minute groups acutely, the rats with 5-minute photoinduction time demonstrated a significant improvement in behavior over time whereas the group with 10-minute photoinduction time showed no improvement. A severe conduction block was present in both animal groups during the course of the study. Histopathological examination combined with morphometric measurements of the lesion area in cross section revealed four different degrees of spinal cord necrosis which correlated significantly with photoinduction times and neurological scores at 8 weeks. Reproducible degrees of ischemic damage to spinal cord parenchyma following primary microvascular occlusion result in a predictable sequence of behavioral and functional abnormalities, which in some cases recover with time. PMID- 3668646 TI - Neurosurgical management of carotid sinus hypersensitivity. Report of three cases. AB - Carotid sinus hypersensitivity (CSH) can cause severe bradycardia, hypotension, asystole, and cardiac arrest. Three patients with the combined (mixed) cardioinhibitory and vasodepressor form of CSH were studied with intensive cardiovascular monitoring. After medical management failed, the patients were successfully treated by transection of the glossopharyngeal nerve and upper rootlets of the vagus nerve at their exit from the brain stem. Methods of diagnosis of CSH, and the benefits and limitations of medical and surgical therapies are discussed. PMID- 3668647 TI - Unusual intercarotid anastomosis associated with anterior communicating artery aneurysm. Case report. AB - The case is presented of a 34-year-old man with subarachnoid hemorrhage from rupture of an anterior communicating artery aneurysm. The magnetic resonance imaging and angiographic findings are reported. Angiography showed the aneurysm plus an unusual anastomosis between the intracavernous portions of both internal carotid arteries. The anastomosis crossed posterior to the base of the dorsum sellae and was associated with absence of the right internal carotid artery and the A1 segment of the right anterior cerebral artery. This is the 11th case of such an unusual intercarotid anastomosis reported in the literature. PMID- 3668648 TI - Pituicytoma (pilocytic astrocytoma). Case report. AB - Tumors of the posterior pituitary are rare and the previous nomenclature has been confusing. A 40-year-old man presented with visual failure and disconnection hyperprolactinemia (830 mU/liter) due to a large invasive pituitary tumor shown to be a pituicytoma (pilocytic astrocytoma). Its astrocytic nature was confirmed by positive immunostaining for glial fibrillary acidic protein and the finding of cytoplasmic filaments on electron microscopy. This case report contains the pathological description of a pituicytoma and illustrates that a non-adenomatous pituitary lesion may masquerade as a pituitary adenoma. Large pituitary lesions associated with serum prolactin concentrations of less than 3000 mU/liter require early surgical biopsy. PMID- 3668649 TI - Symptomatic intracranial pneumatocele from mastoid sinus of spontaneous origin. Case report. AB - A case of a large intracranial pneumatocele arising from mastoid air cells is reported. The patient became symptomatic after multiple coughing spells and required craniotomy for repair of the dural hiatus. The possible etiology of such a large spontaneous pneumatocele is discussed in the context of a review of the pertinent literature. PMID- 3668650 TI - Postoperative magnetic resonance imaging artifacts. Report of three cases. AB - Artifacts are occasionally encountered on magnetic resonance imaging after operation. These may be due to minute metallic particles from neurosurgical instruments. Particles not detectable on plain x-ray films or computerized tomography scans may cause local change of magnetic resonance activity, resulting in a deceptive magnetic resonance appearance. Three illustrative case reports are presented. PMID- 3668651 TI - Neurotrauma care and the neurosurgeon: a statement from the Joint Section on Trauma of the AANS and CNS. AB - The AANS and CNS support the concept of organized neurosurgical trauma care consisting of the appropriate combination of prepared communities and institutions and of adequate numbers of committed neurosurgeons. Furthermore, we support the guidelines of the ACS regarding institutions designated to receive trauma patients, and support the concept of prehospital triage of trauma victims based upon well-trained EMS personnel guided by criteria selected by the local neurosurgical community. We support audit systems that include neurosurgeons to assess and improve the quality of neurotrauma care. By using the principles outlined above, neurosurgeons can plan, support, and evaluate whatever system their community or region requires for the optimal care of the neurotrauma patient. PMID- 3668652 TI - Neurobehavioral recovery after mild head injury. PMID- 3668654 TI - CT localization of brain tumor. PMID- 3668653 TI - Selective ventralis intermedius-thalamotomy. PMID- 3668655 TI - Preparation of vein bypass grafts. PMID- 3668656 TI - Syringomyelia in Paget's disease. PMID- 3668657 TI - The blood leukocyte count and its prognostic significance in subarachnoid hemorrhage. AB - This study reviews the white blood cell count in 75 patients with subarachnoid hemorrhage and correlates it with the clinical grade at admission, the outcome, the presence of angiographic spasm and blood clots in the cisternal spaces. Patients with subarachnoid hemorrhage with normal angiograms usually have slow white cell count and favourable outcome. In patients with subarachnoid hemorrhage due to ruptured aneurysms, their'is a clear correlation between the cell count and the entity of the cisternal hemorrhage and arterial spasm. Whereas the cell count is fairly correlated with the clinical grade at admission, a cell count exceeding 20,000 in associated with a 90% rate of poor outcome, even in patients with low clinical grade at admission. Therefore the count of the white blood cells seems to have high prognostic value in predicting the neurological deterioration due to arterial spasm. PMID- 3668658 TI - Bilateral calcified chronic subdural hematoma. Further pathogenetic and clinical consideration on the so-called "armored brain". AB - Calcified chronic subdural hematomas after shunting procedures for treatment of hydrocephalus have been rarely described. When the calcified wall is so large to extensively cover the surface of the cerebral hemispheres, this instance has been defined "Armored Brain". The Authors report the case of an eleven-year-old patient affected by triventricular hydrocephalus due to aqueductal stenosis, that was treated by a ventriculoatrial shunt. The post-operative course was uneventful and the patient recovered completely from the preexisting neurological deficits. Nevertheless, a CT scan performed 2 and 1/2 years later, revealed the development of a bilateral calcified chronic subdural hematoma, to such extent to configure a so-called "Armored Brain". Clinical course, pathogenesis and treatment of such kind of pathology are discussed in light of the data reported from the literature. PMID- 3668659 TI - Posterior fossa subdural hematoma. AB - One case of traumatic posterior fossa subdural hematoma (PFSH) is described. This location represent 1% of the subdural hematomas. Computerized Tomography (CT) was used in the diagnosis and follow-up of the hematoma. The etiology and physiopathology of this process are discussed. PMID- 3668660 TI - High cervical (C2-C3) spondylogenetic myelopathy treated by transoral approach. Case report. AB - It is reported a case that required transoral exposure of C2-C3 intervertebral space in order to remove a huge osteophyte spur projecting into the spinal canal and producing a severe myelopathy. This unusual surgical route was used because the relevant interspace was inaccessible via the standard anterior approach due to an extremely short neck. The case is reported both because of its rarity and to confirm that the transoral approach is simple, safe and resolvent and that its range of indication is steadily increasing to cover a broad spectrum of disease entities. PMID- 3668662 TI - Prognostic value and pathophysiologic significance of the rim sign in cholescintigraphy. AB - This study reviews 27 patients with nonvisualization of the gallbladder on cholescintigraphy. The preoperative diagnosis of acute cholecystitis was confirmed pathologically in 23. A rim of increased hepatic activity (RIHA) adjacent to the gallbladder fossa was seen throughout the study in 35% with acute cholecystitis and in no patients with chronic cholecystitis. Nine patients with "complicated" cholecystitis (defined pathologically as a late stage of the spectrum of acute cholecystitis) had a positive RIHA in contrast to no patients with "noncomplicated acute cholecystitis" (p less than 0.05). The sensitivity/specificity of the RIHA for "complicated" acute cholecystitis was 45%/100% and the positive/negative predictive value was 100%/39%. Liver tissue that was attached to the gallbladder by adhesions and removed at surgery was reviewed histologically and correlated with the presence or absence of a RIHA. The RIHA seems to be a useful indicator of patients presenting at a later stage of the pathologic spectrum of acute cholecystitis and perhaps at increased risk for complications. PMID- 3668661 TI - Acute myocardial infarct imaging with indium-111-labeled monoclonal antimyosin Fab. AB - Indium-111 monoclonal antimyosin Fab scintigraphy was used to detect myocardial necrosis in 52 of 54 patients (96.3%) with acute myocardial infarction. Infarcts were visualized when coronary arteries were persistently occluded (n = 10), became patent after thrombolysis (n = 33), or became patent after spontaneous reperfusion (n = 7). Posteroinferolateral visualizations were obtained in two patients with clinical and enzymatic evidence of infarction but normal electrocardiograms. Of the two patients in whom no infarcts were visualized, one had an anterior myocardial infarct. This patient underwent successful thrombolytic therapy, with attendant minimization of creatine kinase release. The other patient had a small, nonreperfused inferior myocardial infarct. Five patients with a history of remote infarction and acute necrosis showed antimyosin uptake only in regions concordant with the acute episodes of infarction, and radiolabeled antimyosin Fab localized in neither old infarcts nor normal, noninfarcted myocardium. Antimyosin Fab scintigraphy, thus, appears to be a highly specific means of delineating necrotic myocardium, at least in this limited and selected group of patients. PMID- 3668663 TI - Hepatic hemangiomas: evaluation by magnetic resonance imaging and technetium-99m red blood cell scintigraphy. AB - A study was performed to evaluate and compare the sensitivity of magnetic resonance imaging (MRI) and radionuclide blood-pool scanning in the detection of hepatic hemangiomas. All patients had known hemangiomas which were first detected on either ultrasound or computed tomography. Sixteen patients with a total of 23 lesions were investigated. Eleven patients had both MRI and blood-pool scans performed. In the group studied by both modalities, 18 lesions were detected ranging in size from 1 to 11 cm. All lesions were detected by both techniques. However, two of the 18 lesions had an atypical appearance on MRI. Our experience to date indicates that the anatomic location and specific diagnosis of hemangiomas can be made with a high degree of certainty when both MRI and blood pool scanning techniques are utilized. PMID- 3668664 TI - Quantification of left-ventricular regional dyssynergy by radionuclide angiography. AB - To determine whether variables obtained from Fourier analysis of gated equilibrium radionuclide angiographic (RNA) images can detect and quantify changes in left-ventricular (LV) regional wall motion induced by transient ischemia, 11 chronically instrumented dogs were simultaneously studied with hemodynamic measurements and RNA during control, left circumflex (LCx) coronary artery occlusion, and postocclusion conditions. The dogs were preinstrumented with aortic and LV catheters, electromagnetic aortic and LCx coronary artery flow probes, high-fidelity LV micromanometers, LCx coronary artery occluders, and 4-mm ultrasonic transverse LV diameter and 2-mm regional LV segment crystal pairs. Radionuclide LV regional phase and amplitude variables were calculated for each condition. The absolute changes in LCx region RNA mean, median, and standard deviation of mean phase correlated with the percent changes in LCx segment crystal fractional shortening (r = -0.71, -0.64, and -0.51, respectively; all p less than or equal to 0.01). Similarly, the absolute changes and percent changes in LCx region RNA mean amplitude per pixel correlated with the percent changes in LCx segment crystal fractional shortening (r = 0.89 and 0.94, respectively; both p less than 0.001). When these LCx region RNA phase variables were subgrouped according to mild or severe depression or augmentation in LCx segment crystal fractional shortening, progressive differences were observed between the average values for these subgroups (p less than 0.05 to p less than 0.001). These data, therefore, suggest that these regional RNA phase variables may be able to detect and quantify alterations in LV contraction patterns due to transient ischemia. PMID- 3668665 TI - Kinetics of interstitially administered monoclonal antibodies for purposes of lymphoscintigraphy. AB - The clearance rates of radiolabeled murine monoclonal intact IgG, F(ab')2 Fab and of an IgM following subcutaneous administration were evaluated in normal mice and rats using nuclear imaging and counting techniques. These studies suggest no significant difference in clearance rate exists between intact IgG and its F(ab')2 fragment, and little difference between these moieties and intact IgM. Fab is cleared considerably faster than the others, however. While significant differences in clearance rates exist, the magnitude of the differences are not as large as those following intravenous injection particularly when ambulation by the animal is allowed. When ambulation is allowed, clearance rates of all classes and fragments are accelerated and quite similar. Injection into the subcutaneous tissues of the footpad results in consistently faster clearance than an injection into the subcutaneous tissues of the abdomen. Ambulation considerably increased the clearance of antibodies, presumably by increasing lymph flow. These studies imply that the choice of intact antibody versus fragments for kinetic reasons may be less critical (particularly if ambulation is allowed) by the subcutaneous as compared with the intravenous delivery route. This kinetic information should be useful in designing imaging protocols with radiolabeled antibodies administered subcutaneously for purposes of imaging disease processes involving the lymphatics. PMID- 3668667 TI - Bone scintigraphic findings in patellar tendonitis. AB - Three patients with the signs and symptoms of patellar tendonitis were studied with technetium-99m utilizing the triple phase technique. The scans demonstrated characteristic abnormal radiotracer localization at the inferior pole of the patella or tibial tuberosity on early and delayed images. The regional patellar anatomy likely explains the bone scintigraphic findings in patellar tendonitis. PMID- 3668666 TI - Errors in longitudinal measurements of bone mineral: effect of source strength in single and dual photon absorptiometry. AB - The effect of changing strength during the useful life of a radiation source was evaluated in studies performed on four dual photon (DPA) and two single photon (SPA) bone absorptiometry instruments. Two DPA units and one SPA unit did not show any systematic dependence of measured bone mineral content or bone mineral areal density (BMD) on source activity when evaluated over an entire source life. One DPA and one SPA instrument, however, showed significant time trends associated with source activity. The fourth DPA instrument had a significant linear decrease in BMD over a source life in the automatic mode but performed better in the manual mode. PMID- 3668668 TI - Differential gallbladder contractility in fundal adenomyomatosis: demonstration by cholecystokinin cholescintigraphy. AB - The cholecystokinin cholescintigraphic findings of fundal adenomyomatosis in a 29 yr-old male with severe post-prandial pain are presented. Planar cholescintigraphy demonstrated a trilobed gallbladder contour. Following the administration of 0.02 micrograms/kg of cholecystokinin at maximal gallbladder filling, fundal dyskinesia was observed. Regional gallbladder ejection fractions were: whole gallbladder, 43%; proximal two-thirds of the gallbladder, 70%; and gallbladder fundus, 32%. First harmonic Fourier phase and amplitude images demonstrated: (a) decreased fundal amplitude values, and (b) a phase shift of the pixels in the gallbladder fundus. PMID- 3668669 TI - Sequential hepatobiliary scintigraphy demonstrating apparent transient biliary obstruction. AB - A case of acute acalculous cholecystitis in which sequential hepatobiliary scintigraphy demonstrated apparent transient biliary obstruction is presented. An initial technetium-99m diisopropyliminodiacetic acid ([99mTc]DISIDA) study in a patient suspected of acute cholecystitis showed persistent hepatic activity, nonvisualization of the gallbladder, and minimal intestinal activity seen only at 24 hr. Following a second injection of [99mTc]DISIDA administered shortly after the 24-hr image from the first study, the gallbladder and bowel were both visualized within 75 min. At subsequent surgery, acute and chronic cholecystitis were present without evidence of choledocholithiasis or other source of obstruction. Intrahepatic cholestasis following clearance of biliary obstruction may result in late bowel visualization on delayed cholescintigraphic images similar to that seen in partial obstruction. Accurate reflection of the state of hepatobiliary function may require reinjection with [99mTc]DISIDA. PMID- 3668670 TI - Coronary arterial disease in human diabetics and nondiabetics: a comparative study using dipyridamole thallium scintigraphy. PMID- 3668671 TI - Imaging metastases of thyroid carcinoma. PMID- 3668672 TI - Decentralization: are nurses satisfied? AB - Job satisfaction is often cited as one reason for decentralization. However, is it really an effective way to promote employee satisfaction? The author explores the impact of decentralization on the job satisfaction of staff nurses and first line managers. PMID- 3668673 TI - Marketing your nursing product line: reaping the benefits. AB - Survival in today's cost-conscious, competitive health care scene depends on strategic business skills, marketing, and product line management. As a major contributor to the delivery of health care, nursing practice must now include an orientation toward business with definable products. The authors discuss their success in developing a product line that results in professional growth, improved nurse recruitment and retention, and a greater competitive edge in the health care arena. PMID- 3668674 TI - A professional recognition system using peer review. AB - The concept of a Professional Recognition System or a Clinical Ladder is not new. In fact, many models appear in the literature and have been implemented in hospitals across the country. However, few models contain the element of peer review. This article describes the development process, structure, and function of a Clinical Ladder program at a pediatric tertiary level hospital. The program grew out of a desire and recognized need on the part of the professional nursing staff to reward outstanding nursing care. Based on the concept of peer review, it underwent many revisions and revealed many lessons that can be put to use by other persons attempting to implement such a program. PMID- 3668675 TI - Developing a research structure within the nursing department. PMID- 3668676 TI - Marketing women's health care. AB - Women's health care is a growing component of the health care business. Developing women's health services can offer hospitals and clinics the opportunity to generate greater revenue and gain the competitive edge. The nurse executive plays a critical role in the development of marketable women's health services. PMID- 3668677 TI - Statement on vitamin and mineral supplements. The Joint Public Information Committee of the American Institute of Nutrition and the American Society for Clinical Nutrition. PMID- 3668678 TI - Lipoprotein metabolism in a rat model of diet-induced adiposity. AB - Obesity in humans is associated with decreased plasma levels of high density lipoprotein (HDL), but the mechanisms effecting this relationship have not been established. Four treatment groups were used to develop a range of moderate adiposity: rat pups were raised in litters of 4 or 14 and fed from weaning diets of 6 or 24% fat (wt/wt) for 15-17 wk. Lipoproteins from plasma and from a recirculating in situ liver perfusion system were then separated and analyzed, lipoprotein lipase (LPL) activity was assayed in samples of adipose tissue and skeletal muscle and body composition and cholesterol concentrations of various tissues were determined. There was little effect of the diet or litter size treatments on plasma lipids or lipoprotein profiles. Compared to the marked changes in lipid and lipoprotein metabolism that have been observed in severely obese animal models, there was generally little effect of the treatments used to produce this model of moderate diet-induced adiposity. Adiposity was unrelated to plasma total cholesterol and triglycerides. While fatness was positively, although weakly, correlated with plasma levels of several HDL components, including HDL cholesterol, there were no consistent treatment effects on these measures. Plasma HDL levels and adiposity were unrelated to hepatic HDL production or tissue LPL activities. A review of the literature suggests that differences in plasma HDL responses to adiposity in humans and in experimental animals may be due to inherent species differences in lipoprotein metabolism. PMID- 3668679 TI - Toxicity of palmitoyl glycerol to mice: hypothermia and reversal of the toxicity. AB - Adult and weanling mice kept at low ambient temperatures show an increased sensitivity to the toxicity of dietary rac-1(3)-palmitoyl glycerol. When fed the palmitoyl glycerol, mice less than 6 wk old show a pronounced hypothermia that is prevented by adding safflower oil to the diet. A more moderate degree of hypothermia is seen with older animals. Once body temperature fell below 28 degrees C, replacing the toxic monoacylglycerol with safflower oil and/or raising the environmental temperature to 34 degrees C did not reverse the ultimate fatality caused by palmitoyl glycerol ingestion. If hypothermia was between 28 and 32 degrees C, high mortality was not reversed by feeding the unsaturated fat or raising the environmental temperature to 34 degrees C. However, a combination of both treatments reduced the mortality. Irrespective of body temperature, the hypothermia was eliminated by the warm ambient temperature, but mortality was high. Thus, although hypothermia is a sign of the toxicity of rac-1(3)-palmitoyl glycerol, it is not the immediate cause of death. PMID- 3668680 TI - Digestion, absorption and effects on cholesterol absorption of menhaden oil, fish oil concentrate and corn oil by rats. AB - Adult male rats were surgically provided with a drainage catheter in the left thoracic lymphatic channel and an indwelling duodenal catheter for constant infusion of physiological saline-5% glucose. After an overnight fast, animals were given a single duodenal dose of an aqueous emulsion containing one of the following: oleic acid, corn oil, menhaden oil or a fish oil concentrate (FOC) and [1,2-3H]cholesterol. Digestion and absorption were estimated by recovering the total fatty acids in the thoracic duct lymph over a 24-h collection period (after subtraction of the "baseline" endogenous fatty acids in the lymph). Cholesterol absorption in the thoracic duct lymph was significantly reduced (P less than 0.05) in the presence of menhaden oil or FOC compared to that in the presence of corn oil. With various fat feedings, the major increases in lymph fatty acids were directly related to the dietary fatty acid content. The relative amounts of eicosapentaenoic acid (EPA) and arachidonic acid (AA) in the thoracic lymph were influenced by the lipid content of the emulsion. The EPA/AA ratio in control, oleic acid and corn oil feedings ranged from 0.12 to 0.25. When marine oil was administered, the EPA/AA ratio was 0.78-0.98. The total amount of fatty acids found in the lymph after marine oil feeding was significantly less (P less than 0.01) than that found after corn oil feeding. The results suggested that the digestion and absorption of menhaden oil and FOC were decreased as compared with corn oil. The EPA/AA ratio was increased in the thoracic lymph after dietary fish oil feeding. PMID- 3668681 TI - Use of simultaneous curve fitting and a four-parameter logistic model to evaluate the nutritional quality of protein sources at growth rates of rats from maintenance to maximum gain. AB - A four-parameter logistic model was used to describe the dose-response relationship of rats fed diets containing 12 levels of casein, peanut meal or wheat gluten. The model was capable of accurately describing the entire response curve of rats fed diets containing each of the three protein sources. Incorporation of a technique known as parameter sharing into the curve-fitting process facilitated convergence of the parameter estimates for b (the response of rats fed a protein-free diet) and Rmax (maximum response) for all curves when compared with the values observed experimentally. Parameter sharing also provided a method by which the curves could be differentiated on a statistical basis. These data indicate that the relative value of a protein source is dependent on the concentration of the protein in the diet. The application of nonlinear models combined with parameter sharing provides a technique by which protein values can be evaluated at levels of animal response from maintenance to maximum growth. PMID- 3668682 TI - Effect of concentration of some dietary amino acids and protein on plasma urea nitrogen concentration in growing kittens. AB - The effect of various levels of leucine, isoleucine, tryptophan, histidine and phenylalanine with and without tyrosine in isonitrogenous purified amino acid based diets on plasma urea nitrogen (PUN) of growing kittens was examined. In addition, the effect of various levels of nitrogen supplied as amino acids or as a mixture of amino acids and protein on PUN was measured. PUN was not a useful predictor of the concentration of an amino acid that maximized either growth or nitrogen balance. Intake of nitrogen was highly correlated with PUN and accounted for 96% of the variation in PUN. PMID- 3668683 TI - Regulation of xanthine oxidase activity and immunologically detectable protein in rats in response to dietary protein and iron. AB - To investigate the mechanism for changes in xanthine oxidase activity in response to dietary protein and iron, we fed rats diets containing 50, 20 or 5% casein with either normal iron (35 mg Fe/kg diet) or low iron (5 mg Fe/kg diet). Xanthine oxidase activity changed in liver and intestinal mucosa in response to protein and iron, but immunologically detectable xanthine oxidase protein did not change. When total liver RNA isolated from these rats was translated by a rabbit reticulocyte lysate, we found no difference in the amount of xanthine oxidase that was translated. These results demonstrated that the changes in xanthine oxidase activity were not accompanied by changes in the amount of protein. Since xanthine oxidase can exist in an inactive desulfo form, we asked if xanthine oxidase activity was changed by the content of sulfur-containing amino acids in the diet. Xanthine oxidase activity in intestinal mucosa of the rats fed the 5% casein + methionine diet was significantly greater than that of the rats fed the 5% casein diet alone. These findings suggest that xanthine oxidase activity may be regulated by interconversion of active and inactive desulfo enzyme. PMID- 3668684 TI - Effect of zinc source and picolinic acid on 65Zn uptake in an in vitro continuous flow perfusion system for pig and poultry intestinal segments. AB - Twenty weanling pigs and fourteen 9-wk-old broiler chickens were used in three continuous-flow in vitro perfusion experiments using noneverted intestinal sacs to 1) determine differences in 65Zn absorption due to location within the intestinal tract, 2) evaluate 65Zn uptake from ZnCl2 and Zn-methionine (ZnMet) with or without added picolinic acid (PA) in pig intestinal sacs and 3) evaluate 65Zn uptake from ZnCl2 and ZnMet in chicken intestinal sacs. No differences in 65Zn uptake due to gut segment position were observed in the pigs. A Zn source x PA interaction was observed for 65Zn uptake into the pig gut tissue and for 65Zn uptake to the serosal side of the gut sacs. Total 65Zn absorption in the pig gut sacs from the two Zn sources was not different, but the addition of a 5 M ratio of PA to Zn depressed 65Zn absorption. No differences were observed in total 65Zn absorption or 65Zn uptake in poultry gut sac tissue. There was, however, greater uptake of 65Zn from ZnCl2 to the serosal side of the sacs than from ZnMet. The data indicate that 65Zn from ZnCl2 and ZnMet is similar in total absorption and that the addition of PA depresses Zn uptake. PMID- 3668685 TI - Depressed folate incorporation into milk secondary to iron deficiency in the rat. AB - The present study was designed to determine whether reduced folate incorporation into milk can account for folate depletion of iron-deficient suckling rats. Dams were fed diets containing 2 mg/kg folate and either 8, 12 or 250 mg/kg iron throughout gestation and lactation to produce severely iron-deficient, moderately iron-depleted and iron-sufficient states in 17-d-old pups (n = 15 litters/group). On d 17 of lactation, dams were separated from litters and given intraperitoneal injections of [3',5',7,9-3H]pteroylmonoglutamic acid ([3H]PteGlu) or physiological saline. Mean [3H]PteGlu incorporation into milk of severely iron deficient dams was 67% of that in iron-sufficient controls, while "total" and "free" milk folate activities were 54 and 61%, respectively. Values for milk [3H]PteGlu incorporation and folate activities were intermediate in moderately iron-depleted dams. Pup red blood cell folate activity was positively correlated with both free (r = 0.43, P = 0.004) and total (r = 0.37, P = 0.015) milk folate activities. Mean plasma folate activities of severely and moderately iron deficient pups were 68 and 86% of control values, respectively. Results show that in both mild and severe iron deficiency, reduced folate secretion into milk is at least partially responsible for impaired folate status of suckling pups. PMID- 3668686 TI - Influence of carbohydrate and fat intake on diet-induced thermogenesis and brown fat activity in rats fed low protein diets. AB - Voluntary intake of protein, fat and carbohydrate (CHO) was modified by feeding young rats either a control purified diet [% metabolizable energy (ME): protein 21, fat 7, CHO 72], a control diet plus sucrose solution (20%) to drink (final intakes 17, 6 and 77% ME as protein, fat and CHO, respectively) or a low protein diet substituted with either CHO (8, 7 and 85% ME as protein, fat and CHO, respectively) or fat (8, 20 and 72% ME as protein, fat and CHO, respectively). Total ME intakes corrected for body size were similar for all rats, but body weight, energy gain and net energetic efficiency were lower in both low protein fed groups than in the control group. The acute thermogenic response (% rise in oxygen consumption) to a standard balanced-nutrient meal was higher (12%) in sucrose-supplemented and in low protein groups (15-16%) than in control rats (8%). Brown adipose tissue protein content and thermogenic capacity (assessed from purine nucleotide binding to isolated mitochondria) were greater than control values in sucrose-fed and protein-deficient animals, and the greatest levels of activity were seen in low protein-fed rats with a high fat intake. The results demonstrate that the changes in energy balance, thermogenesis and brown adipose tissue activity that result from protein deficiency cannot be ascribed to changes in the level of energy intake or to a specific increase in the amount or proportion of either CHO or fat. They suggest that the protein-to-energy ratio must be the primary influence on thermogenesis and brown fat activity in these animals. PMID- 3668687 TI - Effect of animal and vegetable fats and proteins on distribution of cholesterol in plasma and organs of young growing pigs. AB - Young, growing pigs were fed for 8 wk diets containing either soy protein isolate or ground beef as the main protein source and soybean oil or beef tallow as the main fat source to examine effects of types of dietary protein and fat on cholesterol distribution between blood plasma, plasma lipoproteins and body organs. Type of dietary protein did not influence concentrations of a) cholesterol in plasma, b) low-density-lipoprotein (LDL) cholesterol, c) high density-lipoprotein (HDL) cholesterol or d) cholesterol in several organs of pigs. Pigs fed tallow had greater concentrations of plasma cholesterol and LDL and HDL cholesterol than did pigs fed soybean oil. Ratios of HDL to LDL were not altered by dietary fat. Cholesterol concentrations were greater in heart, skeletal muscle and viscera of pigs fed soybean oil than in those fed tallow. Plasma cholesterol varied reciprocally with cholesterol in several tissues. Thus, dietary beef and soy protein isolate had similar effects on cholesterol concentrations in plasma, LDL, HDL and organs, whether pigs consumed soybean oil or beef tallow as a major fat source. Soybean oil, however, exerted a hypocholesterolemic effect, irrespective of major source of dietary protein. PMID- 3668688 TI - An arginine-deficient diet in humans does not evoke hyperammonemia or orotic aciduria. AB - The essentiality of dietary arginine was examined in adult humans with three biochemical indices: plasma levels of ammonium and amino acids and urinary orotic acid excretion. Three male and two female subjects participated in the 10-d study. Subjects consumed an L-amino acid diet containing 0.74 g protein equivalent/kg body weight on d 1-5; these amino acid concentrations were doubled on d 6-10. The diet was devoid of arginine on d 3-8. Daily urine was collected and blood samples were drawn on 6 of the 10 d at 0, 0.5, 1, 2, 3 and 4 h after the breakfast meal. When arginine was removed from the diet, urinary orotic acid did not increase, in contrast to what has been reported in most other animal species tested. Plasma ammonium concentrations remained within normal limits throughout the study. A small postprandial decrease in plasma arginine concentration was observed when the arginine-deficient diet was consumed; this decline disappeared when the diet was resupplied with arginine. The results of this study suggest that over the short term the adult human's capacity for de novo arginine synthesis when fed a dietary deficiency of arginine is sufficient for the maintenance of normal cellular metabolism. PMID- 3668690 TI - Effects of nitrogen and energy metabolism on body weight in later life of male Wistar rats consuming a constant amount of food. AB - The effects of protein and energy metabolism at the whole-body level on body weight changes in later life of male Wistar rats fed 13.3 g of 20% casein diet per day (group 80) or 8.7 g/day (group 50) throughout life from 50 d of age were examined on d 600 and 800 of age. Although the rats consumed most of the food presented, their body weight started to decrease rapidly from about d 700 of age in group 80 and gradually from d 600 in group 50. On d 800 their body weights had decreased significantly (17% in group 80 and 11% in group 50). These decreases in weight were not due to decreased digestibility of the food, and in both groups a positive nitrogen balance was maintained on d 800 and the relative proportion of body protein was not different from that on d 600. In both groups, daily energy expenditure was significantly higher on d 800 than on d 600 because of an increase in the basal metabolic rate, not in physical activity, and consequently these balances were negative on d 800. From these results, it is concluded that the primary cause of the decrease in body weight in later life of aging rats consuming a constant amount of food is increased expenditure of energy. PMID- 3668689 TI - Use of a four-parameter logistic model to evaluate the protein quality of mixtures of Mormon cricket meal and corn gluten meal in rats. AB - Weanling Sprague-Dawley rats were fed diets containing corn gluten meal (CGM), Mormon cricket meal (MCM), MCM supplemented with methionine (MCM + Met) or CGM MCM mixtures as the sole source of dietary protein in purified diets. Animal response (weight or nitrogen gain) was analyzed as a function of nitrogen intake and described by a series of curves using a four-parameter logistic model. Parameter sharing was used to differentiate statistically between the response curves. When used for maximum nitrogen retention the quality of the protein sources could be ranked as follows: MCM + Met greater than 40 CGM-60 MCM greater than 50 CGM-50 MCM greater than 60 CGM-40 MCM greater than MCM greater than CGM. When used for maximum weight gain the ranking was as follows: MCM + Met greater than 40 CGM-60 MCM greater than 50 CGM-50 MCM greater than 60 CGM-40 MCM greater than MCM greater than CGM. The rankings of the protein sources when used for weight maintenance or nitrogen equilibrium were similar to those seen for maximum weight or nitrogen gain except for the ranking of MCM, which changed from fifth to first. These results show MCM to be a good quality protein source and that methionine is the first limiting amino acid when used for growth but not for maintenance. The shape of the response curves was dependent upon the response criteria as well as the source of dietary protein. The factors that may affect the shape of the dose-response curves and the application of nonlinear models toward animal feeding programs are discussed. PMID- 3668691 TI - Influence of pregnancy, lactation, litter size and diet energy density on the stomach and intestine of sows. AB - In the first experiment, 52 sows, each having raised one litter, were randomly assigned to the five following groups: control (nongravid) for pregnancy (CP), 110 d pregnancy (P110), control (nongravid) for lactation (CL), 4-wk lactation with 8 (L8) and with 12 (L12) piglets. In a second experiment, 36 sows, each having raised three litters, were randomly assigned to the following groups: control group (nongravid) fed a low-energy-density, 1% tallow diet (CLED) and two lactating groups, one fed the low-energy-density diet (LLED) and one fed a high energy-density, 10% tallow diet (LHED). At slaughter, the stomach, small and large intestine and cecum were excised, emptied and freed from fat. Lengths and pre- and post-defatting weights were measured. Portions of tissues were homogenized and analyzed for protein, pepsin, maltase, RNA and DNA. Pregnancy had no effect on the weights of the different components of the gastrointestinal tract. Liver and small intestine weights were larger in lactating sows than in the CL group. Sows nursing 12 piglets had heavier livers than those nursing 8. The fundic mucosa of the latter had higher total pepsin activity and total protein and RNA contents than that of L12 sows. LHED sows had heavier small intestine and lower total pepsin content of the fundic mucosa than LLED sows. PMID- 3668692 TI - Cellular development of skeletal muscle of rats during recovery from prolonged undernutrition. AB - The cellular basis for growth retardation of skeletal muscle was studied in male Sprague-Dawley rats. At birth, animals were assigned to control (C) or food restricted (R) groups. During lactation, food intake of the pups was reduced by limiting intake of the mother to 50% of controls. After weaning, pups received 40% of ad libitum intakes until 120 d of age. From 120 to 316 d, all animals were fed ad libitum. At 120 d, body weight of the R group was 41% of C and muscle and adipose weights were 54 and 16% of C, respectively. Muscle DNA in the R group was 47% of C, but protein-to-DNA ratio was normal. Fiber number was not different between C and R groups; however, muscle length and fiber cross-sectional area were 85 and 64%, respectively, of C values. After 196 d of recovery, weights of the body, skeletal muscles and adipose tissues averaged 76, 84 and 51% of C values, respectively. Recovery of skeletal muscle paralleled the recovery of fiber cross-sectional area (84%) and DNA content (86%). Daily injections of 100 micrograms of growth hormone from 120 to 148 d produced no additional recovery. This study establishes that growth retardation of skeletal muscle is associated with reductions in the development of cross-sectional area and DNA content of muscle fibers. PMID- 3668693 TI - Vitamin D metabolism and calbindin (calcium-binding protein) in aged laying hens. AB - Calbindin (calcium-binding protein) concentration, vitamin D metabolism and shell quality were investigated in young (7- to 9-mo-old) and aged (19- to 21-mo-old) laying hens consuming normal or low levels of calcium (Ca). Although egg weight and percent of cracked eggs were higher and egg production and shell density (mg/cm2) were lower (significantly, P less than 0.01) in aged hens, shell weight, plasma Ca and duodenal and egg shell gland calbindin were similar to those of young hens. Dietary Ca restriction reduced shell weight, shell density and structural bone and plasma Ca in both the young and aged birds. The production of 1,25-dihydroxycholecalciferol [1,25(OH)2D3] and its concentration in the plasma were higher in hens fed low dietary levels of Ca than in hens fed normal Ca levels only in the younger hens. However, a slightly higher production of 1,25(OH)2D3 and concentration of duodenal calbindin were also observed in severely Ca-restricted (1.4% Ca for 19 d) aged hens than in the younger hens. The results suggest that the aged hen loses its ability to adapt to changes in Ca intake or needs through mechanisms involving modulation of vitamin D metabolism. PMID- 3668694 TI - Cadmium-induced immunopathology is prevented by zinc administration in mice. AB - Six-week-old C57BL/6 male mice were exposed to 50 mg cadmium/L drinking water (50 ppm) for 3 wk, and killed at 0, 3 and 6 wk after cessation of treatment. In some groups, 500 mg zinc/L was added to the drinking water (500 ppm) with or after cadmium treatment. The number of direct and indirect splenic plaque-forming cells was higher in cadmium-treated mice at 0 wk than in untreated controls. Concurrent zinc administration prevented the enhancement of plaque-forming cell response. Proliferative response of spleen cell culture to the T-cell mitogens phytohemagglutinin and concanavalin A was slightly high in cadmium-treated mice at 0 wk and zinc administered after exposure to cadmium tended to lower it. The number of Lyt-2 positive cells in the spleen was lower and the ratio of L3T4 to Lyt-2 positive cells, reflecting the balance of immunoregulatory T-lymphocytes, was higher after cadmium treatment than in untreated controls. Concurrent zinc administration prevented the alteration of T-cell subsets. Cadmium and zinc treatment had no effect on liver, kidney, spleen and thymus weights and lymphocyte content of spleen, thymus and peripheral blood. Use of immunofluorescence with anti-mouse IgG and C3 showed no evidence of an autoimmune reaction in kidney sections. Liver and kidney cadmium concentrations were high at all observation times in the cadmium-treated animals. Tissue cadmium levels were lower in mice treated with both zinc and cadmium than in those treated with cadmium alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668695 TI - Messenger RNA levels of plasma proteins in rat liver during protein depletion and refeeding. AB - The levels of mRNA for albumin, transferrin, transthyretin, the beta-chain of fibrinogen and apolipoprotein E in livers from rats during protein depletion and refeeding were measured by hybridization to specific cDNA probes. A period of protein depletion of 3 d resulted in a 30-40% decrease in mRNA levels for all five proteins. These levels were further decreased by only 15-20% after additional protein depletion for 6 d. There was no noticeable change in mRNA levels within 4 h of refeeding by gavage with a casein hydrolysate suspension supplemented with L-tryptophan and L-arginine. Upon refeeding a 30% protein diet, mRNA levels returned to normal after 3 d. The work presented here suggests that changes observed in the protein synthetic rate following protein depletion and repletion are due to changes in mRNA levels altered as a consequence of the availability of dietary protein. PMID- 3668696 TI - Effect of dietary protein source on the activity of polysomal ornithine decarboxylase messenger RNA in rat liver. AB - To pursue the mechanism underlying dietary induction of ornithine decarboxylase (ODC) activity in rat liver, changes in free-polysome-associated messenger RNA (mRNA) activity for the enzyme were studied in rats fed diets containing either casein or zein. The enzyme activity increased 50- to 100-fold in 4 h after feeding a 50% casein diet. Changes in the amount of immunoreactive ODC protein roughly paralleled changes in the enzyme activity. Dietary casein was found to cause a several fold increase in polysomal mRNA activity coding for this enzyme, which preceded the increase in catalytic activity. Therefore, the induction of hepatic ODC by casein feeding is due partly to an increase in the activity of its mRNA associated with free polysomes and partly to some translational and/or posttranslational control. On the other hand, feeding the zein diet hardly increased ODC activity, immunoreactive ODC protein or free-polysomal ODC-mRNA activity. This indicates that adequate supply and balance of amino acids are required both for the increase in polysome-associated ODC-mRNA activity and for the translational and/or posttranslational mechanism(s) during the induction of hepatic ODC activity. PMID- 3668697 TI - Effect of long-term supplementation of folate on folate status in plasma and erythrocytes. AB - Folate nutritional status was estimated by radioassay of folate levels in plasma and erythrocytes during and after a long-term supplementation of folic acid. A 1 mg dose of folic acid per day was administered orally to 6 healthy subjects for 17 weeks. After 4 weeks of supplementation the mean folate concentration in plasma reached 11 ng/ml and remained constant thereafter, but decreased exponentially after stopping the supplementation. However, the folate concentrations in reticulocytes and erythrocytes increased linearly in all subjects during the supplementation. These results suggest that folate-rich, young erythrocytes are mixed at a constant rate with circulating ripe ones, which have a lower folate content, during folate supplementation. PMID- 3668698 TI - Erythorbic acid content in tissues of guinea pigs administered erythorbic acid. AB - The erythorbic acid (ErA) content in the tissues of guinea pigs administered ErA was compared with that of ascorbic acid (AsA). Guinea pigs were administered 1, 5, 20, and 100 mg ErA/day or 1, 5, and 100 mg AsA/day for 16 days and then sacrificed. The liver, adrenal glands, spleen, and kidneys were removed to determine the contents of ErA and AsA using HPLC. Only a small amount of ErA was found in four tissues of the animals administered 20 mg or more of ErA/day. On the contrary, AsA was found in the tissues of all animals administered 1 mg or more of AsA/day. The ErA content in the tissues was much lower than that of AsA even when the amount of ErA administered was the same as that of AsA. However, the body weight gains of animals administered ErA were similar to those of animals administered AsA. These observations suggested that the mechanism of the retention of ErA in the tissues was much different from that of AsA and that the vitamin C activity of ErA might be more than one-twentieth that of AsA. PMID- 3668699 TI - Relationship between twenty-four hour urinary creatinine excretion and weight, or weight and height of Japanese children. AB - Twenty-four hour (24-h) urinary creatinine excretion was measured and correlated with anthropometric measurements (height, weight, skinfold thickness, and arm muscle area (AMA)) in 119 healthy Japanese children, aged 2 to 18 years. The results indicated highly significant correlations between creatinine excretion and age (r = 0.88 for boys, 0.90 for girls), height (r = 0.91, 0.88), weight (r = 0.96, 0.94), and AMA (r = 0.91, 0.70). In the multiple regression estimation, weight alone, or weight and height, accounted for most of the variation in 24-h creatinine excretion (r2 = 0.93 for boys, 0.89 for girls), and the addition of other variables did not further improve the estimation. PMID- 3668700 TI - Effect of dietary glycine on methionine metabolism in rats fed a high-methionine diet. AB - The alleviation mechanism of methionine toxicity by dietary glycine was investigated in weanling rats fed a high-methionine diet. When rats were fed a 10% casein diet containing 2% methionine, the activities of methionine adenosyltransferase, cystathionine beta-synthase, and cystathionine gamma-lyase, which participate in the methionine metabolism in the transsulfuration pathway, were significantly enhanced. But the addition of 2% glycine to the high methionine diet did not cause further increase in these enzyme activities; the activities of methionine adenosyltransferase and cystathionine beta-synthase were rather decreased while cystathionine gamma-lyase activity was not altered. Methionine transaminase activity was essentially insensitive to the dietary addition of methionine and glycine. In rats fed a high methionine diet, the hepatic methionine level was significantly increased with a concomitant decrease in the levels of glycine, serine, and threonine. The addition of glycine to the high methionine diet effectively suppressed the enhancement of the hepatic methionine level and almost completely restored the glycine level, but it only partially restored the serine level and further decreased the threonine level. From these results, it is suggested that the alleviating effect of dietary glycine on methionine toxicity is primarily elicited by the restoration of the hepatic glycine level rather than by an increase in hepatic enzyme activity. PMID- 3668701 TI - Relationship between protein intake and nitrogen balance in obese patients on low energy diet. AB - The effect of nitrogen intake on nitrogen balance was studied in six obese patients receiving low energy diets. They were given a control diet containing 2,000 kcal of energy and 80 g of protein for the first ten days. Then they were given Diet A with 1,100 kcal of energy and 70 g of protein for the next 2 weeks, followed by Diet B with 1,100 kcal of energy and 50 g of protein for 2 weeks. The relationship between nitrogen intake (X, mg/kg) and nitrogen balance (Y, mg/kg) during the low energy diet periods was statistically significant, with Y = 0.388X 60.32 (SD = 17.71, r = +0.67, n = 11, p less than 0.05). The nitrogen and protein requirements were estimated from this equation to be 201.1 mg/kg and 1.26 g/kg, respectively. In our experiment, the nitrogen balance in obese patients was well maintained although total energy was reduced to 1,100 kcal/day in Diet A. It is suggested that protein quantity in the diets should be taken into account when a low energy diet is used for the treatment of obesity. PMID- 3668702 TI - Effects of low energy diets on protein metabolism studies with [15N]glycine in obese patients. AB - The effects of low energy diets on protein metabolism in terms of the metabolic pool, active protein pool, and active and inactive protein synthesis rates were studied using [15N]glycine in five obese patients (percentage of ideal body weight, 120-190%). For 10 days, the patients were given a control diet containing 2,000 kcal of energy and 80 g of protein. For the next 2 weeks, they were given Diet A with 1,100 kcal of energy and 70 g of protein, and for the last 2 weeks given Diet B with 1,100 kcal of energy and 50 g of protein. During the Diet A period, the active protein pool and the active and inactive protein synthesis rates were about the same as during the control diet period, although the metabolic pool tended to be slightly smaller than during the control diet period. During the Diet B period, the metabolic pool, active protein pool, and active protein synthesis rate were all significantly different from the values during the control diet period. The results suggest that protein metabolism in obese patients is not maintained with less than 70 g of protein daily when energy intake was restricted to 1,100 kcal/day. PMID- 3668703 TI - Effect of dietary taurine on cholesterol 7 alpha-hydroxylase activity in the liver of mice fed a lithogenic diet. AB - The effect of dietary taurine on hepatic cholesterol 7 alpha-hydroxylase activity was investigated in mice. At first, male ICR strain mice were fed a commercial non-purified diet for 4 weeks and killed at 01:00 h (midnight) or 13:00 h (daytime) and the cholesterol 7 alpha-hydroxylase activity in the hepatic microsomal fraction was measured. The enzyme activity was 5.9-fold higher at midnight than in the daytime. Next, to investigate the effect of dietary taurine on the activity of this enzyme, male ICR strain mice were fed semi-purified diets for 5 weeks: a cholesterol-free diet (standard), a lithogenic diet containing 0.5% cholesterol and 0.25% sodium cholate (C-CA), and a lithogenic diet supplemented with 5% taurine (C-CA + 5% taurine). All mice were killed at midnight and cholesterol 7 alpha-hydroxylase activity was measured. The enzyme activity of the mice fed the lithogenic diet was about 20% that of mice fed the standard diet. Dietary taurine increased the activity by 1.9-fold. Therefore, it was concluded that the inhibitory effect of dietary taurine on cholesterol gallstone formation was related to increased bile acid synthesis as reflected by stimulation of cholesterol 7 alpha-hydroxylase activity. PMID- 3668704 TI - Self-selection of histidine and arginine intake and the requirements for these amino acids in growing rats. AB - The regulation of histidine and arginine intake in rats was investigated using the self-selection feeding method. The usefulness of the self-selection feeding technique for the determination of amino acid requirements is also discussed. When weanling rats were offered a choice of two diets differing only in histidine or arginine content for 2 weeks, they chose diets to support maximal growth, with the exception of some groups that did not grow to the maximum level. Histidine and arginine intake of the self-selecting rats ranged from 0.25% to 2.22% and from 0.43% to 2.43% of the diets ingested. These results demonstrate clearly that rats have the ability to consume a minimum amount that satisfies histidine and arginine needs for maximal growth. Previous and the present results suggest that the self-selection feeding method is a useful technique for the determination of amino acid requirements in growing rats. PMID- 3668705 TI - Histopathology of acute myocardial necrosis: effects of immunosuppression therapy. AB - Endomyocardial biopsy is currently the best method to monitor cardiac allograft rejection. The histologic criteria of infiltration by mononuclear cells with pyroninophilic cytoplasm and acute myocyte necrosis indicate immunologic activation and require an increase of immunosuppressive therapy. Of particular concern is the persistence of necrotic fibers on biopsies for some time after ischemic episodes associated with the transplant procedure and after acute rejection episodes. Because the presence of acute myocyte necrosis plays a key role in the clinical decision on immunotherapy, we evaluated the resolution pattern of acute necrotic fibers under standard immunosuppression treatment. Myocardial infarction of the posterior papillary muscle was surgically induced in two groups of dogs that were killed (three from each group) at 4, 7, 14, and 21 days after surgery. The first group consisted of 12 control animals, and the second group was composed of 12 dogs, immunosuppressed with cyclosporine, methylprednisolone, and prednisone. The histologic sections demonstrated a persistence of myocyte necrosis for 14 days after infarction in the treated group but for only 7 days in the untreated control group. This slow resolution pattern needs more emphasis in clinical practice. Criteria other than myocyte necrosis should be used to differentiate ongoing from resolving rejection after the first rejection episode. Preservation injury may persist for 2 weeks after transplantation and be misinterpreted as acute rejection. PMID- 3668706 TI - Comparative effect of cyclosporin A and G on weight gain of primates during the pubertal growth period. AB - A double-blind study with six cynomolgus monkeys (mean age, 2.0 years) was carried out. All animals received immunosuppression therapy with 16 mg/kg/day of cyclosporin A or G (Norvaline cyclosporine), given intramuscularly in two divided daily dosages. All animals received a small dosage of steroids (0.1 mg/kg/day). After 14 months the dosage of cyclosporin G was increased to 20 mg/kg/day. During the first study year, weight velocity was normal in the cyclosporin G group and impeded in the group receiving cyclosporin A. During the second year of the study, the weight velocity was impeded in both groups. The weight gain was significantly less in the cyclosporin A group than in the group receiving cyclosporin G (p = 0.001). The results suggested that cyclosporine impeded weight gain in primates during the pubertal period. The effect was dosage-related and was less with cyclosporin G than with cyclosporin A. The mechanism is unclear, but the possible effect on the growth hormone merits further studies. PMID- 3668708 TI - Impact of education on cephalosporin prescribing patterns. PMID- 3668707 TI - Is pulmonary ischemia a factor in the reperfusion response? An experimental study in the chacma baboon. AB - A reimplantation or reperfusion response has been described in both the experimental animal and the human patient after various procedures involving pulmonary ischemia. We have investigated this phenomenon in a primate model. Ten chacma baboons were placed on cardiopulmonary bypass and cooled to 20 degrees C. Circumferential segments of the right main bronchus and pulmonary artery were denuded of all surrounding tissue. Each structure was then cross-clamped, which rendered the lung ischemic, during which time the organ was immersed in cold saline solution. Ischemia was maintained for 1.5 to 5 hours; after reperfusion and discontinuation of bypass, the right lung was biopsied and the chest closed. Chest radiographs, lung biopsies, and arterial blood gases were taken at intervals for up to 16 to 28 days. Right lung shadowing on chest radiography with concomitant histopathologic changes, indicative of a reperfusion reaction, were seen in only one animal, which had undergone lung ischemia for 1.5 hours. In one other animal that was ischemic for 5 hours, patchy opacification of the lung was seen on two occasions (days 8 and 15) with concomitant mild histopathologic changes. In conclusion, therefore, a major reperfusion response after pulmonary ischemia in the chacma baboon is possible but unusual. This would suggest that the appearance of pulmonary opacification on chest radiography within the first 4 weeks after heart-lung transplantation in humans is most likely attributable to some other condition, such as isolated lung rejection or infection. PMID- 3668709 TI - Prevention and control of AIDS--an interim report. AMA Board of Trustees, June 1987. PMID- 3668710 TI - Leiomyoma of the fourth part of the duodenum. PMID- 3668711 TI - [Reliability of the cochlear microphonics in clinical electrocochleography]. PMID- 3668712 TI - [An experimental study on the regeneration of maxillary sinus mucosa isografted in the rat tongue]. PMID- 3668713 TI - [Otorhinolaryngological findings of 95 cases of infectious mononucleosis]. PMID- 3668714 TI - [Treatment of psychogenic aphonia]. PMID- 3668715 TI - [A case report of non-traumatic aneurysm of the internal carotid artery]. PMID- 3668716 TI - [A case of nasopharyngeal amyloidosis]. PMID- 3668717 TI - [The evaluation for hearing aids fitting by using TR60 (a new system of hearing aids fitting)]. PMID- 3668718 TI - [Psychosomatic aspects of so-called pharyngo-laryngeal neurosis]. PMID- 3668719 TI - [Magnetic resonance imaging in the head and neck tumor diagnosis]. PMID- 3668720 TI - [Ultrasonic tissue characterization of parotid tumors--ultrasonic velocity of surgically removed tumor specimens, and its relationship with tissue constituents measured by microspectrophotometry]. PMID- 3668721 TI - [The statistical study of recurrent laryngeal nerve paralysis]. PMID- 3668722 TI - [An experimental study of ossicular vibration in human cadaver temporal bones]. PMID- 3668723 TI - [Surfer's ear]. PMID- 3668724 TI - [Measurement of internal auditory meatus by polytomography--comparison of normal cases and cases of acoustic tumor]. PMID- 3668726 TI - [Clinical and histopathological observations on sialadenosis]. PMID- 3668725 TI - [Salivary fistula of reconstructed cervical esophagus in hypopharyngeal cancer]. PMID- 3668727 TI - [Magnetic resonance imaging in otorhinolaryngology--with special reference to the influence of factors upon NMR parameters and differential diagnosis of otorhinolaryngologic lesions]. PMID- 3668728 TI - [Diagnostic significance of auditory brainstem responses and optokinetic nystagmus in central equilibrium disorders]. PMID- 3668729 TI - [Speech comprehension in a deaf patient with 22 channel cochlear implant]. PMID- 3668730 TI - Behavior, genetics and biochemistry of an allele of the mutant mouse spastic, spaAlb. AB - A new autosomal recessive mutation, characterized by an early defect in righting reflex and stiffened gait, progression to severe spasticity, tremor and rigidity, and death before weaning, appeared spontaneously on the C57BL/6 background. It was shown to be an allele of the mutant spastic spa, and shall be known as spaAlb. Mutant levels of [3H]strychnine binding are less than 10% of control levels in the brainstem and spinal cord. Autoradiographic examination of the distribution of [3H]strychnine binding sites in the mutant confirm a greatly reduced level of binding compared to control in all areas of the spinal cord, brainstem, and midbrain. PMID- 3668731 TI - Proliferative index in breast carcinoma determined in situ by Ki67 immunostaining and its relationship to clinical and pathological variables. AB - Sixty cases of primary breast carcinoma have been studied using a monoclonal antibody, Ki67, which recognizes an antigen expressed by cells in G1, S, G2, and M phases of the cell cycle but not Go. A Ki67 score (positive cells/total tumour cells) was determined, and possible relationships between this index of cellular proliferation and a number of clinical and pathological parameters were investigated. There was a strong positive correlation between the Ki67 score and mitotic index (p less than 0.001), a weak negative correlation with age (p less than 0.02), and weak positive correlations with histological tumour grade (p less than 0.03), tumour necrosis (p less than 0.01), and cellular reaction (p less than 0.01). No relationship was noted between the Ki67 score and tumour size, nodal status, tumour oestrogen receptor levels, or menopausal status. The Ki67 score may prove to be an objective indicator of biological behaviour and thus be of clinical significance, particularly since it is not strongly related to other clinical and pathological parameters used in predicting outcome in breast carcinoma. PMID- 3668732 TI - Epidermal growth factor receptors in lung tumours. AB - Immunocytochemical analysis of epidermal growth factor (EGF) receptor expression was carried out on frozen sections of 109 primary lung tumours resected at the Brompton Hospital from February 1984 to May 1985. Tumours with detectable levels of this proto-oncogene protein were significantly more frequent among squamous cell carcinomas than among other types of lung tumour. No truncated EGF receptors were detected in the tumours using two monoclonal antibodies (Mabs) directed against different portions of the receptor (EGFR1 and F4). Mab F4 is the first antibody to the EGF receptor to show reactivity in paraffin sections. Southern blot analysis of a subset of the tumours detected amplification of the EGF receptor gene in squamous cell carcinomas but not in adenocarcinomas. The one carcinosarcoma examined had a re-arranged and amplified EGF receptor gene. Measurement of EGF receptor expression in lung tumours can be of diagnostic value and may prove to be useful in the development of antibody-directed therapy. PMID- 3668733 TI - Pleural mesothelioma of epithelial type and pulmonary adenocarcinoma: an ultrastructural and cytochemical comparison. AB - Twelve diffuse pleural mesotheliomas of epithelial type have been compared with 20 intrapulmonary adenocarcinomas. All mesotheliomas were negative for epithelial mucin by diastase periodic acid Schiff staining and for carcinoembryonic antigen by immunoperoxidase staining, whereas 17/20 carcinomas stained for epithelial mucin and 15/20 for carcinoembryonic antigen. Hyaluronidase-sensitive alcian blue positive material was present in 6/10 mesotheliomas and 0/20 carcinomas. Previously described electron microscopic differences were validated, including one which has so far received insufficient emphasis: microvilli making direct contact through basement membrane deficiencies with collagen fibres on the abluminal side of tumour cells were identified in 10/12 mesotheliomas and in 0/20 carcinomas. PMID- 3668734 TI - Three-dimensional reconstruction of biliary pathways in primary biliary cirrhosis: a computer-assisted study. AB - Bile ducts and ductules were traced by means of computerized three-dimensional reconstruction in seven patients with primary biliary cirrhosis, three of them in the early asymptomatic stage and four of them with late disease. A patient with cryptogenic cirrhosis was also studied. Loss of bile ducts was confirmed, and was greater in the late stages as expected. Reconstruction demonstrated amputation of bile ducts of various sizes ranging from less than 40 micron to more than 80 micron in external diameter. Amputation was sometimes seen in relation to granuloma formation. The main or side branches of ducts could be traced to zones of proliferated ductules which, in turn, often communicated with liver-cell plates. Clusters of atypical ductules could be seen to communicate with liver cell plates but not with ductules and ducts. We concluded that proliferation of 'typical' ductules with well-defined lumens, characteristically seen in primary biliary cirrhosis, probably represents a means whereby bile continues to be drained from the liver in spite of interruption of ducts. Computerized three dimensional reconstruction proved to be a rapid and accurate way of accumulating the necessary data. PMID- 3668735 TI - Current status of measurement of DNA content. PMID- 3668736 TI - Quantitative X-ray microanalysis of bulk hydrated specimens: a method using gelatine standards. AB - A method of preparing and using gelatine blocks as standards for quantitative X ray microanalysis of bulk hydrated tissue is described. Each series of standards had several constant and one variable element. The average deviations in the X ray counts of the constant elements from the series means were used to correct the recorded count of the variable element in each block. This led to an improved linear relationship between X-ray counts and concentration. The elements tested, sodium, phosphorus, and potassium, were chosen as representatives of different parts of the X-ray spectrum. Sodium cannot be measured reliably below 50 mmol kg 1 wet weight, although phosphorus and potassium can be detected at concentrations of 5 mmol kg-1 wet weight. It is argued that this sensitivity of analysis is sufficient for studying electrolyte changes in certain pathological processes. PMID- 3668737 TI - Phagocytosis of necrotic muscle in muscle isografts is influenced by the strain, age, and sex of host mice. AB - In grafts of skeletal muscle the implanted muscle becomes necrotic, is phagocytosed and replaced by new muscle cells. This study investigates the hypothesis that removal (phagocytosis) of necrotic implanted muscle is impaired in grafts made into old Swiss mice. Isografts (154) of minced muscle were made between young (20 day) and old (140 day) mice of the strain Swiss, AKR, BALBc, C3H and C57BL. Grafts were examined histologically after 7 days. A relationship between impaired phagocytosis and increasing host age was confirmed for male Swiss mice but was not seen with female Swiss mice or the other four strains. The proposal that ageing of bone marrow was responsible for diminished phagocytosis in old Swiss mice was investigated by replacing the marrow of 33 lethally irradiated male Swiss mice with marrow cells from mice of different ages (20 and 140 day), before isografting minced muscle. The results clearly show that macrophage stem cell function is unimpaired with age. Testosterone levels might account for the impaired phagocytosis seen in many sexually mature male Swiss mice. Support for this proposal came from experiments in which 15 mice were castrated before implanting muscle isografts. This study shows that genetic factors rather than the age of mice influenced phagocytosis and muscle formation in grafts. PMID- 3668738 TI - Polycystic kidney disease in the first year of life. AB - To determine the frequency of autosomal recessive and autosomal dominant polycystic kidney disease (PKD) in infants and to compare the rate of progression of these conditions, we conducted a retrospective survey of 48 patients who were seen with PKD before 1 year of age and who survived the first month of age. Seventeen patients had recessive PKD; six had dominant PKD. Eighteen patients had insufficient data to categorize the type of PKD with certainty. Seven patients were classified as "other"; three had glomerulocystic disease and the remainder had multiple malformation syndromes or tuberous sclerosis. Renal ultrasonography and excretory urography accurately detected 15 of 17 patients with recessive PKD, but only one patient with dominant PKD was correctly diagnosed by excretory urography. The majority of patients in all groups required antihypertensive therapy. The 17 children with recessive PKD have been followed up for 6.1 +/- 4.3 (SD) years. Eight patients are doing well. Two patients have died; five others have required treatment for renal failure. Only one patient has an estimated glomerular filtration rate within the normal range after 6 years of age. Long term evaluation of most of the patients with dominant PKD is not yet available; however, by age 42 months one patient has required dialysis. To provide optimum genetic counseling and accurate diagnosis for patients with PKD, a combination of careful family evaluation, radiography, and liver or kidney biopsy is required. The outcome of patients who survive the neonatal period appears not to be so grim as previously feared, underscoring the importance of aggressive supportive care and the need for physician and family education. PMID- 3668739 TI - Long-term prognosis of giant coronary aneurysm in Kawasaki disease: an angiographic study. AB - The incidence of coronary obstruction subsequent to giant coronary aneurysm in Kawasaki disease was studied. In 20 cases, aneurysms with a maximal diameter greater than 8 mm were identified by coronary angiography 2 to 120 months (mean 16.9 months) after onset. There were 25 giant aneurysms among these 20 patients, all of whom underwent coronary angiography between 12 and 134 months (mean 31.7 months) after initial examination. Coronary obstruction occurred in six cases (30.0%), all within 4 years of onset of disease. There were five obstructive aneurysms in the right coronary artery (5/12; 41.7%) and two in the left coronary artery (2/13; 15.4%). One of these patients developed symptomatic myocardial infarction. Two had abnormal electrocardiographic findings suggesting myocardial infarction. In five cases, persistent perfusion defects were found by myocardial imaging. On the other hand, in two patients giant aneurysms persisted without obstructive changes for greater than 10 years. In both cases the aneurysm was in the left coronary artery and obstruction of the right coronary artery was found at initial angiography. These results seem to indicate the limited efficacy of antiplatelet therapy for giant coronary aneurysms in Kawasaki disease and that giant aneurysms are likely to progress to become obstructive within a few years even if antiplatelet therapy is given. Other forms of treatment, including surgery, should therefore be considered in such patients. PMID- 3668740 TI - Indomethacin therapy for patent ductus arteriosus: when is prophylaxis not prophylactic? PMID- 3668741 TI - Analysis of repeated measures designs. PMID- 3668742 TI - Fish roe poisoning in childhood. PMID- 3668743 TI - Hoarseness in immunocompromised children: association with invasive fungal infection. PMID- 3668744 TI - Air reduction of intussusception in infants and children. PMID- 3668745 TI - Erythrocytosis associated with spontaneous erythroid colony formation and idiopathic hypererythropoietinemia. PMID- 3668746 TI - Two-dimensional Doppler echocardiographic assessment of closure of the ductus arteriosus in normal newborn infants. AB - To elucidate the mechanism involved in closure of the ductus arteriosus (DA), 50 normal full-term infants were examined with two-dimensional and pulsed Doppler echocardiography. The examinations were performed initially within 1 hour after delivery and serially for 3 days. The two-dimensionally derived long-axis plane of the DA disclosed a characteristic localized protrusion into its lumen in 30% of the subjects within 1 hour, in 80% by 4 hours, in 96% by 8 hours, and in all by 24 hours after birth. In 10 infants in whom the intraluminal protrusion did not appear within 4 hours after birth, none had any recognizable changes in the inner diameter or length of the DA during this initial period. The development of the intraluminal protrusion resulted in localized narrowing of the ductal lumen. Doppler echocardiography revealed a high-velocity jet within and downstream from the narrowed portion of the DA. Thereafter, ductal narrowing progressed along the entire length. The intraluminal protrusion may be early evidence of ductal changes leading to eventual functional and anatomic closure. PMID- 3668747 TI - Tracheobronchial abnormalities in infants with bronchopulmonary dysplasia. AB - Twelve preterm infants with bronchopulmonary dysplasia underwent bronchoscopy to determine if airway abnormalities were contributing to persistent pulmonary problems. Indications for bronchoscopy were persistent atelectasis, lobar hyperinflation, or both on chest radiograph (11 patients), unexplained respiratory distress (three patients), and aspiration of tissuelike material from a tracheostomy (one patient). Bronchoscopy revealed abnormalities of the trachea, bronchi, or both in all infants, including partial or near total airway occlusion by abnormal growth of tissue (10 patients); tracheomalacia, bronchomalacia, or both (three patients); and inspissated secretions (two patients). Seven infants died during initial hospitalization. Tracheobronchial abnormalities should be considered as a cause of persistent pulmonary problems in infants with bronchopulmonary dysplasia. PMID- 3668748 TI - CNS infection after esophageal dilation. PMID- 3668749 TI - Outpatient therapy for serious infections. PMID- 3668750 TI - Influence of cigarette advertising on smoking. PMID- 3668751 TI - Impersonal science. PMID- 3668752 TI - The parenteral "numbers game"--newer ways of looking at particulate contamination. PMID- 3668753 TI - Sterile filtration under conditions of high pressure and bacterial challenge levels. PMID- 3668754 TI - Parenteral formulation development for the positive inotropic agent RS-82856: solubility and stability enhancement through complexation and lyophilization. PMID- 3668755 TI - A procedure for supplementing the AAMI B1 method for validating radiation sterilized products. PMID- 3668756 TI - Current practices in the use of media fills for the validation of aseptic processing. PMID- 3668757 TI - Mating behaviour of Keratinomyces ceretanicus with Arthroderma uncinatum. AB - Keratinomyces ceretanicus was described as a new taxon distinct from Trichophyton ajelloi. Because of the morphological similarity between the two species, their mating behaviour was studied. The optimum temperature for growth of K. ceretanicus was found to be 25 degrees C rather than 17 degrees C. The type culture produced moderate numbers of microconidia on potato glucose agar after 2 weeks at 25 degrees C and a large number of smooth, thick-walled, cylindro fusiform, 7-to 12-celled macroconidia. On Sabouraud glucose agar containing chloramphenicol and cycloheximide growth was partially but not completely inhibited. When crossed on a soil-hair medium, K. ceretanicus produced fertile gymnothecia typical of Arthroderma uncinatum with 10 (-) mating type isolates of A. uncinatum. As a result, it is concluded that K. ceretanicus is a facultative synonym of T. ajelloi. PMID- 3668758 TI - Experimental tinea pedis induced by non-abrasive inoculation of Trichophyton mentagrophytes arthrospores on the plantar part of a guinea pig foot. AB - Arthrospores of Trichophyton mentagrophytes were inoculated on to the plantar part of a guinea pig foot by a newly devised non-abrasive method. Anthropophilic and zoophilic isolates required inocula of 280 and 80 arthrospores to infect 50% of inoculated feet, but much larger inocula (5 X 10(4)) were used to establish infection consistently in all feet. Anthropophilic isolate NTM-105 invaded only the upper two-thirds of the horny layer and induced no inflammatory responses. On the other hand, zoophilic isolate SM-110 invaded the whole horny layer and provoked strong inflammatory responses and clinical manifestations. Although the histological features and modes of fungal spreading in the guinea pig skin were quite different between anthropophilic and zoophilic isolate infections, infecting fungi were always recognized in the stratum corneum of all inoculated feet throughout the observation period longer than 6 months. Thus, two types of persistent infections with T. mentagrophytes were established as a guinea pig model of tinea pedis. PMID- 3668759 TI - Use of a urease-antibody conjugate in an enzyme immunoassay for the detection of blastomycosis. AB - A urease-antibody conjugate was used in an enzyme-linked immunoassay (ELISA) for the detection of antibodies in blastomycosis. A Blastomyces dermatitidis immunodiffusion antigen was used as the reference antigen in a solid phase indirect ELISA procedure and the endpoints were determined visually. Urease ELISA results on serum specimens from patients with blastomycosis compared favorably (90%) with results obtained spectrophotometrically by the alkaline phosphatase enzyme system. Specificity was evaluated with assays on sera from patients with histoplasmosis (20% cross reactivity), coccidioidomycosis (0% cross reactivity) and on Histoplasma capsulatum skin-test positive individuals (0% cross reactivity). The ease of performance of the urease ELISA combined with no requirements for specialized spectrophometric equipment are factors that favor the continued development of the test as an alternative serodiagnostic method. The assay may prove to be useful and a valuable adjunct to fungal antibody screening procedures. PMID- 3668760 TI - Mycological studies on Microsporum equinum isolated in Finland, Sweden and Norway. AB - Sixteen isolates of Microsporum equinum from cases of equine dermatophytosis in Finland, Sweden or Norway were studied mycologically. All the isolates produced typical macroconidia and were negative in the hair perforation test in vitro and were urease-positive. The growth pattern of M. equinum on polished rice greatly resembled that of M. audouinii during the first 2-3 weeks of incubation. All the isolates were incompatible with Nannizzia otae, the teleomorph of M. canis, but fresh M. equinum isolates showed growth stimulation against the (-) tester strain of N. otae. No cleistothecia or pseudocleistothecia were seen. PMID- 3668761 TI - Identification of Mortierella wolfii, a causative agent of mycotic abortion in cattle. PMID- 3668762 TI - Effect of droperidol pretreatment on post-anesthetic vomiting in children undergoing strabismus surgery: the minimum effective dose. PMID- 3668763 TI - Detection of amblyopia with P-VEP during chloral hydrate sedation. AB - A major limitation of methods presently used for detecting amblyopia in preverbal children and infants is their dependence on patient cooperation. In response to this problem, we have introduced the use of chloral hydrate sedation as a means of obtaining the pattern visual evoked potential (P-VEP) in uncooperative infants. Twenty-five infants were studied: 14 with clinically diagnosed amblyopia, four with questionable amblyopia, and seven with no clinical sign of amblyopia. In patients with known amblyopia, P-1 amplitudes from the amblyopic eye were greatly diminished when compared with responses obtained from the non amblyopic fellow eye, with amplitude ratios ranging from 0 to 0.66 (mean 0.36). In contrast, P-1 responses from non-amblyopic infants were quite symmetrical, with amplitude ratios of 0.82 to 0.98 (mean 0.92). These results indicate that the P-VEP can be obtained during chloral hydrate sedation and that P-1 responses reflect the presence or absence of amblyopia. Performing P-VEP during chloral hydrate sedation thus holds promise as an important clinical tool for the diagnosis of amblyopia in uncooperative infants and children. PMID- 3668764 TI - Adie's syndrome as a cause of amblyopia. AB - Adie's syndrome comprises a tonic pupil, which may be associated with impairment of accommodation, in the presence of diminished or absent deep tendon reflexes. We report a case of a 4-year-old boy with Adie's syndrome in which latent hypermetropia was made manifest by accommodative paresis and resulted in reversible amblyopia. PMID- 3668765 TI - Results of early treatment of unilateral congenital cataracts. AB - Twelve infants with unilateral congenital cataracts treated at Boston Children's Hospital between 1978 and 1986 have now reached the age of 3.5 years or older. All infants had cataract extractions, aphakic contact lens fitting, and occlusion of the unaffected eye by 6 months of age. Patients with posterior lenticonus or persistent hyperplastic primary vitreous were excluded from this review. Early improvement of visual acuity in the aphakic eye was monitored by preferential looking tests, and occlusion of the sound eye was adjusted accordingly. E card visual acuities are now available on all 12 children. Five patients have 20/70 or better visual acuity, three patients have between 20/100 and 20/400 vision, and four patients have less than 20/400 in the aphakic eye. Two patients whose cataract surgery was done after 4 months of age had the poorest visual results. Difficulty maintaining occlusion therapy and interruptions of contact lens wear limited the development of better vision in some patients. The visual results to date in these 12 patients suggest that early aggressive treatment of unilateral congenital cataracts is worthy of consideration in most instances. PMID- 3668766 TI - Attachment for the Bausch & Lomb keratometer in pediatrics. PMID- 3668767 TI - Congenital orbital vascular malformation complicated by massive retrobulbar hemorrhage. AB - A 2-year-old female infant with a presumed diagnosis of infantile hemangioma of the left eyebrow developed acute proptosis of the left eye several days after a mild orbital trauma. Computerized axial tomography (CAT) and carotid angiography confirmed the presence of a vascularized mass in the retrobulbar space, spreading anteriorly to the orbital rim and the frontal area. Due to progression of the proptosis and the development of exposure keratitis, surgical intervention was necessary. A large vascular tumor and a massive hemorrhage occupying the orbit were removed. The pathological examination confirmed the diagnosis of a vascular malformation of the orbit, most probably orbital varices. A relatively good visual acuity was achieved after surgery by occlusion therapy. PMID- 3668768 TI - Intralesional methylprednisolone for Langerhans' cell histiocytosis of the orbit and cranium. AB - A 27-month-old girl had a rapidly expanding orbital frontal bone mass due to Langerhans' cell histiocytosis. The CT of the orbit showed a lateral orbital mass containing an irregular density that extended into the intracranial cavity through a lytic lesion of the bone. This is the first report of the use in the orbit of an intralesional steroid injection. Five months later the lesion had not recurred. This treatment spared the patient radiation therapy or a craniotomy with curettage. PMID- 3668770 TI - Papers presented at the 18th annual meeting of the Canadian Association of Paediatric Surgeons. Halifax, Nova Scotia, August 28-30, 1986. Part 2. PMID- 3668769 TI - Lacrimal hypersecretion in children. AB - To the differential diagnosis of epiphora in children we propose to add paroxysmal lacrimal hypersecretion. While certainly not a new entity, it should be considered in a child who is tearing intermittently without mattering or evidence of infection. Recognition of this problem may prevent anesthetic morbidity or unnecessary instrumentation of the nasolacrimal apparatus. PMID- 3668771 TI - Extraspinal ependymoma. AB - Two cases of extraspinal ependymoma are described. This is a low-grade tumor that recurs locally unless wide local excision is performed. It does metastasize, mainly to lymph nodes and lung. Its origin is likely from heterotopic ependymal cells called the coccygeal medullary vestige. PMID- 3668772 TI - Congenital atresia of the colon combined with segmental dilatation of the ileum: a case report. AB - Atresia of the colon is a rare form of congenital intestinal atresia. Other gastrointestinal anomalies have been reported in these patients, but to our knowledge, the association between colonic atresia and segmental dilatation of the ileum has not been reported. PMID- 3668773 TI - The practice of pediatric surgery in a medical school environment: is there a conflict between private practice and academic pursuits? AB - An 11-year review of the clinical practice and the academic activity of the Section of Pediatric Surgery at the University of Michigan was carried out. This was done in an attempt to determine whether or not increased clinical practice in a medical school environment would have a detrimental effect on academic productivity. Clinical activity was evaluated by analyzing the number of patients seen, the number of operations, patient days, admissions, and revenue generated. Academic activity was analyzed by measuring the number of hours of formal lectures and conferences, research space and personnel, the number of completed and active projects, grant support, and the number of publications. During this 11-year period, the number of operations performed increased from 525 per year to over 1,350, the number of office visits increased from 11 per week to 60 to 65, and the gross revenue increased six-fold. At the same time, the number of formal lectures and conferences given increased from 50 to 267 hours per year, the research space increased from 200 to 1,612 square feet, the research budget increased from $20,000 to $120,000 per year, grant support increased from 0 to $62,000 per year, and the number of publications increased from five to 17 per full-time equivalent (FTE) per year. In fact, this review indicates that during the time that clinical practice and revenue generation increased, so did academic productivity in the form of manuscript writing, project completion, and grant acquisition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668774 TI - Benefits, complications, and care of implantable infusion devices in 31 children with cancer. AB - This retrospective study of 31 pediatric oncology patients with subcutaneously implanted infusion devices details the required care and demonstrates the benefits and complications of the system. The Port-a-cath device was used in 29 patients; one had an Infuse-a-port, and two had Mediports. Ages of the patients ranged from 5 months to 16 years. The average time of catheter function was more than 163 +/- 149 days and the total experience was 5,208 patient catheter days. In all, five catheters were removed, one for suspected and one for proven infection, two with extravasations, and one patient had spontaneous extrusion and thrombosis. These totally implanted devices allowed safe administration of blood products, antibiotics, short-term hyperalimentation, and sclerosing chemotherapeutic agents to pediatric oncology patients with previously compromised venous access. PMID- 3668775 TI - Antimicrobial therapy of Broviac catheter infections in pediatric hematology oncology patients. AB - Long-term therapy of pediatric oncology patients has been facilitated by permanent indwelling venous catheters. Over a 3-year period, 54 Broviac catheters were placed in 43 oncology patients and two hemophiliacs. There were 20 episodes of sepsis in 14 patients and the most common bacteria were S epidermidis (4), S aureus (4), and K pneumoniae (3). Catheter exit site infections occurred ten times in six patients; S aureus eight of ten. Antibiotic therapy without catheter removal was successful in 18 of 20 children with catheter sepsis and 8 of 10 patients with exit site infections. These data strongly suggest that although catheter-related infections are common, removal of Broviac catheters is not required for successful treatment of the infection. PMID- 3668776 TI - Unilateral agenesis of the diaphragm. AB - During a period of 4 1/2 years, 37 infants with congenital diaphragmatic hernia were treated. The overall survival rate was 68%. Survival depended more on cardiopulmonary function than the size of the diaphragmatic defect. There was little evidence that infants with agenesis of the diaphragm formed a special group with a poor prognosis, and four of the ten patients with unilateral agenesis survived. A Dacron prosthesis is recommended as a substitute for the missing diaphragm. PMID- 3668777 TI - Congenital hydropericardium associated with the herniation of part of the liver into the pericardial sac. AB - A congenital pericardial effusion without a clinically obvious cause is rare. The presentation, diagnostic studies, and anatomic findings in three such cases are described. It is postulated that the fluid within the pericardial sac, was a transudate produced by a partially strangulated portion of the liver, trapped in an intrapericardial hernia with sac, which was present in each case. Encroachment with compression by the enlarged pericardium on the developing lung bud structures is the reason given for the pulmonary hypoplasia, associated with this form of diaphragmatic hernia. Severe pulmonary insufficiency was the presenting feature, while cardiac tamponade is noted for its absence, in these cases. PMID- 3668778 TI - Second operation for repair of biliary atresia. AB - In our experience with biliary atresia, there are few cases amenable to reoperation for recurrent jaundice. All authors would agree that specific conditions such as complete bile flow recovery from the first operation followed by early recurrence should be an unquestionable case for revision of the anastomosis, inasmuch as no biologic signs of ongoing cholangitis can be traced. The same decision would apply to the problem of bile leakage after hepatoportocholecystostomy. In other cases, however, one should be aware that these reoperations expose the child to ascitis, poor healing of the abdominal wound, liver failure, and also bring with the decision to reoperate undue hopes to the parents of the child. Moreover, if the child should be a future candidate for liver transplantation, it may be wiser to avoid useless laparotomies and abdominal dissections that are known to complicate the task of hepatectomy. PMID- 3668779 TI - Small bowel esophagoplasty without vascular microanastomosis: a preliminary report. AB - An intestinal segment through staged augmentation of its blood supply can be well suited to bridge a gap in the esophagus from the abdomen to the neck. PMID- 3668780 TI - [The effect of grinding on the porous texture and the solid-liquid surface exchange of paracetamol]. PMID- 3668781 TI - Determination of some cardiac glycosides by high-performance liquid chromatography. PMID- 3668782 TI - Studies on the promoting effect of lipid-surfactant mixed micelles (MM) on intestinal absorption of colloidal particles. Dependence on particle size and administration site. AB - The effect of oleic acid-HCO60 mixed micelles (MM) on the absorption of colloidal particles by the large intestine was investigated using the in situ closed loops of rats. Two species of colloidal particles with different sizes, colloidal inks (Platinum ink 2.4-10 nm, Rotring ink 100-800 nm) and colloidal gold particles (mean particle size 5, 20, 40 nm) were chosen. Macroscopic observation showed that in the case of Platinum ink the staining of the mucus of the whole large intestine was promoted by MM and the staining of the rectum remained even after removing the mucus layer. The regional lymph nodes and the thoracic lymph was also stained. On the other hand, in the case of Rotring ink, the stain in the large intestine after removing the mucus layer, in lymph nodes and in the thoracic duct lymph was not observed. The results of quantitative experiments using colloidal gold particles indicated: 1) the upper size limit of colloidal particles absorbed by the large intestine, under the influence of MM was approximately 40 nm, 2) colloidal gold particles were transported from the intestine selectively into the lymphatics and accumulated in the regional lymph nodes, 3) the absorption of colloidal gold particles was largely promoted by MM in the rectum area. PMID- 3668784 TI - Effects of urethane anesthesia and age on organ blood flow in rats measured by hydrogen gas clearance method. AB - Apparent blood flow rate in jejunum, kidney, liver or skeletal muscle was directly measured by the hydrogen gas clearance method in 7-week-old rats anesthetized with urethane at four dose levels (0.5, 0.8, 1.0 and 1.5 g/kg, i.p.). The apparent blood flow in each organ or tissue was reduced with the urethane dose. Jejunal blood flow was most sensitive to the dose-related decrease. Assuming that the organ (or tissue) to blood partition coefficient of hydrogen gas is unity and extrapolating the flow data to zero urethane dose for each organ, the flow rate values were almost comparable with the literature data in conscious rats. The applicability of the hydrogen gas clearance method to examine the effect of age on organ or tissue blood flow in rats was also discussed. Organs with relatively high sensitivity to aging were the stomach, jejunum and kidney. PMID- 3668783 TI - Characterization of heterologous desensitization of rat reticulocyte adenylate cyclase system. AB - Treatment of rat reticulocytes with isoproterenol caused about 50, 25, and 25% decreases in beta-adrenergic agonist-, fluoride-, and guanine nucleotide stimulated adenylate cyclase activities, respectively. The desensitization was also induced by dibutyryl adenosine 3',5'-cyclic monophosphate (cyclic AMP) and 1 (5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7) prevented the isoproterenol induced desensitization, suggesting the involvement of cyclic AMP in the desensitization. Time course studies revealed that the desensitization to NaF AlCl3 occurred faster than that to isoproterenol. Furthermore, the rate of the resensitization to NaF-AlCl3 by removal of isoproterenol was also faster than that to isoproterenol. Thus, it is likely that both guanine nucleotide-binding stimulatory regulatory protein, Ns, and beta-adrenergic receptor are sequentially involved in both desensitization and resensitization of the adenylate cyclase system in rat reticulocytes to isoproterenol. PMID- 3668785 TI - Sex difference of acetohexamide reduction in rat liver. AB - The acetohexamide reducing activity in hepatic 10,000 X g supernatant was significantly higher in male than in female rats. Evidence obtained in this study suggests that the microsomal carbonyl reductase may contribute to the sex difference in the reductive metabolism of acetohexamide in rats. PMID- 3668786 TI - Metabolism and pharmacokinetics of melatonin in the ewe. AB - The pineal hormone melatonin has been used to advance the onset of the breeding season in sheep and thus produce lambs earlier in the year. If this reproductive manipulation is to be used commercially, some knowledge of the route of metabolism and identity of possible metabolites is necessary. A major metabolite of melatonin in rodents and man is 6-hydroxymelatonin sulphate (acetyl methoxytryptamine-6-sulphate [aMT6S]). No significant amounts of this metabolite could be found in the plasma of untreated ewes. After subcutaneous implantation of melatonin for 5 months, plasma levels of aMT6S were also insignificant. On the other hand, both a single oral dose of melatonin (3 mg) and daily oral dosing gave rise to circulating levels of aMT6S in the range of 150 to 1,500 pg/ml for at least 18 h. The profiles seen after 180 days treatment were similar to those seen after a single dose, indicating that this route of melatonin metabolism is not induced by chronic administration. Intravenous injection of melatonin (200 or 20 micrograms) gave rise to detectable levels of aMT6S in the plasma. These results indicate that the quantitative aspects of melatonin metabolism differ according to the route of administration. PMID- 3668788 TI - Effects of superior cervical preganglionectomy on nerve vesicles and synaptic ribbons in the cat pineal gland. AB - Previous studies have shown that bilateral preganglionectomy of the superior cervical ganglia (SCGp) modifies the nerve vesicles and synaptic ribbons in the cat pineal gland. In the present study the nerve vesicles (NV) and synaptic ribbons (SR) were analyzed morphometrically after chronic preganglionectomy of the pineal sympathetic nerve fibers. It was shown that bilateral sympathectomy of the preganglionic fibers innervating the superior cervical ganglia (SCG) markedly reduces the number of dense cores of small dark vesicles (SDV) and, on the other hand, modifies the number and shape of the large dark vesicles (LDV). An increase in the number of the synaptic ribbons after chronic preganglionectomy of the SCG supports the hypothesis that the numerical reduction of dense cores of nerve vesicles in the cat pineal gland influences the level of synaptic ribbon formation. PMID- 3668787 TI - Short-term variations of circulating melatonin in the ewe. AB - Melatonin levels have been studied in venous blood sampled at different frequencies (0.5-, 2-, and 60-min intervals) form intact ewes. All samples were taken during the dark phase of either natural or artificial photoperiods. In one experiment samples were taken simultaneously from both jugular veins to investigate the possible effects of "streaming" on the levels measured. Plasma cortisol was measured to ascertain whether or not the frequent removal of blood activated the ACTH stress axis. Plasma melatonin levels showed considerable variation with peaks of up to 365 pg/ml on a baseline of between 30 and 60 pg/ml. There was consistent evidence of intermittent peaks, the frequency of which increased with an increase in sampling frequency. Plasma cortisol showed no correlation with either the frequency or the amplitude of the melatonin peaks. When plasma samples were taken from both jugular veins a similar melatonin pattern was seen in the samples from both sides, but samples taken from the left jugular vein invariably showed higher levels than those taken from the right vein. This may be due to differential vascular drainage of the pineal to the two sides. PMID- 3668789 TI - Effect of pinealectomy on thyroid hormone (T4 and T3) levels in plasma during annual reproductive cycle in the freshwater catfish, Clarias batrachus. AB - Thyroxine and triiodothyronine (T3) were measured by radioimmunoassay in serum and thyroid gland of the freshwater teleost Clarias batrachus. Pinealectomy increased the glandular levels of the thyroid hormones but decreased the plasma levels of T4 concomitantly with the increase of T3 levels. Most of the effects of pinealectomy on thyroid hormones were restricted to the gonadal development periods. Pinealectomy has shown no significant impact on thyroid hormones during the other periods of the reproductive cycle. Thus, it appears that the pineal gland is inhibitory to thyroid hormones during gonadal development and maturation. PMID- 3668790 TI - My name is John. I have AIDS. PMID- 3668791 TI - Should Christian nurses practice therapeutic touch? PMID- 3668792 TI - It happened one night. Eight frantic hours in a Pakistani hospital. PMID- 3668794 TI - A time for courage. PMID- 3668793 TI - Wholistic nursing care: a church & university join forces. PMID- 3668795 TI - AIDS: should nurses honor a patient's confidentiality or a partner's right to know? PMID- 3668796 TI - Aggressive euthanasia: how far will nurses go? PMID- 3668797 TI - An AIDS patient responds: compassion breaks down barriers. PMID- 3668798 TI - AIDS. Hospital lawyer respond: a case for confidentiality. PMID- 3668799 TI - AIDS. A physician responds: confidentiality may kill. PMID- 3668800 TI - AIDS. The nurse responds: a surprise ending. PMID- 3668801 TI - A double-peak phenomenon in the pharmacokinetics of veralipride after oral administration: a double-site model for drug absorption. AB - Equal doses of veralipride have been given to 12 healthy volunteers by three different administrations--intravenous infusion, oral solution, and oral capsules -in a randomized cross-over design. After the intake of the solution, but not after infusion or capsules, two maximum plasma concentrations have been observed and interpreted, according to a double-site model for drug absorption. PMID- 3668802 TI - Pharmacodynamic modeling of the EEG effects of ketamine and its enantiomers in man. AB - The pharmacodynamics of a racemic mixture of ketamine R,S(+/-)-ketamine and of each enantiomer, S(+)-ketamine and R(-)-ketamine, were studied in five volunteers. The median frequency of the electroencephalogram (EEG) power spectrum, a continuous noninvasive measure of the degree of central nervous system (CNS) depression (pharmacodynamics), was related to measured serum concentrations of drug (pharmacokinetics). The concentration-effect relationship was described by an inhibitory sigmoid Emax pharmacodynamic model, yielding estimates of both maximal effect (Emax) and sensitivity (IC50) to the racemic and enantiomeric forms of ketamine. R(-)-ketamine was not as effective as R,S(+/-) ketamine or S(+)-ketamine in causing EEG slowing. The maximal decrease (mean +/- SD) of the median frequency (Emax) for R(-)-ketamine was 4.4 +/- 0.5 Hz and was significantly different from R,S(+/-)-ketamine (7.6 +/- 1.7 Hz) and S(+)-ketamine (8.3 +/- 1.9 Hz). The ketamine serum concentration that caused one-half of the maximal median frequency decrease (IC50) was 1.8 +/- 0.5 micrograms/mL for R(-) ketamine; 2.0 +/- 0.5 micrograms/mL for R,S(+/-)-ketamine; and 0.8 +/- 0.4 microgram/mL for S(+)-ketamine. Because the maximal effect (Emax) of the R(-) ketamine was different from that of S(+)-ketamine and R,S(+/-)-ketamine, it was not possible to directly compare the potency (i.e., IC50) of these compounds. Accordingly, a classical agonist/partial-agonist interaction model was examined, using the separate enantiomer results to predict racemate results. Although the model did not predict racemate results well, its failure was not so great as to provide clear evidence of synergism (or excess antagonism) of the enantiomers. PMID- 3668803 TI - A minimax approach to the single-point method of drug dosing. AB - The single-point dose prediction method is based on the observation that for drugs obeying single compartment elimination kinetics there is a nearly constant reciprocal relation between the plasma level at a fixed time following a single loading dose and the dose that is required to maintain the desired steady state plasma level of the drug. This paper describes an improved method for choosing a plasma sampling time and a proportionality constant. It applies to either drugs administered intravenously or to drugs whose rates of absorption from the site of administration are very rapid compared to their rates of elimination from the body. The sampling time and proportionality constant chosen are those that minimize the maximum relative deviation of the maintenance dose estimated by the single-point method from the dose that would be estimated if the individual's true elimination rate constant were known. The paper also supplies a method to determine the maximum error that may be introduced into the estimation of the maintenance dose by using the single-point method. PMID- 3668804 TI - Area method for the estimation of partition coefficients for physiological pharmacokinetic models. AB - A new technique, the area method, is derived for the determination of partition coefficients for both blood-flow limited and membrane limited physiological pharmacokinetic models. This method was compared to a standard technique by Monte Carlo simulation. Partition coefficients were calculated for the blood-flow limited case for both eliminating and noneliminating organs. It was found that the area method compared favorably to a standard technique and was less prone to error. This may be attributed to the more subjective interpretation as to which data points are included in the terminal phase, since the standard method relies on the accurate determination of the terminal slope for the calculation of partition coefficients. Both methods are satisfactory for the calculation of partition coefficients with the area method being more accurate and precise. PMID- 3668806 TI - Theorems and implications of a model-independent elimination/distribution function decomposition of linear and some nonlinear drug dispositions. IV. Exact relationship between the terminal log-linear slope parameter beta and drug clearance. AB - An exact formula relating the terminal log-linear beta parameter and the drug clearance is derived. The expression is valid for drugs with a linear, polyexponential disposition kinetics. The formula is useful for calculating the clearance when the clearance has changed between drug administrations and requires only drug level data from the terminal, log-linear elimination phase in addition to data from a single separate i.v. administration in the same subject. Data from an i.v. administration are necessary in order to apply the disposition decomposition technique to isolate and uniquely define the distribution kinetics in terms of the distribution function h(t). The different clearances can then be calculated from the beta values of the log-linear terminal drug level data and the parameters of h(t). The theoretical basis of the method and its assumptions and limitations are discussed and various pertinent theorems are presented. A computer program enabling an easy implementation of the proposed method is also presented. The mathematical and computational procedures of the method are demonstrated using kinetic data from i.v. and oral administrations of cimetidine, diazepam, and pentobarbital in human subjects. The classical V.beta method of approximating the clearance as the product of volume of distribution and beta is considered for comparison. For the three drugs considered the V.beta method which assumes a single exponential disposition kinetics leads to excessive errors when applied in absolute clearance comparisons. However, when applied in relative comparisons in the form of the "beta correction" the errors cancel out to some extent depending on the magnitude of the distribution kinetic effect. Whenever possible it is advisable to apply the proposed method to avoid such errors. PMID- 3668805 TI - Theorems and implications of a model-independent elimination/distribution function decomposition of linear and some nonlinear drug dispositions. III. Peripheral bioavailability and distribution time concepts applied to the evaluation of distribution kinetics. AB - Disposition decomposition analysis (DDA) is applied to evaluate the rate and extent of drug delivery from the sampling compartment to the peripheral system, i.e., peripheral bioavailability. Four parameters are introduced which are useful in quantifying peripheral bioavailability. The compounded peripheral bioavailability, F comp, is the ratio between the total compounded amount of drug transferred to the peripheral system and the injected dose, D. The AUC peripheral bioavailability, FAUC, is the ratio between the area under the amount vs. time curves for the peripheral system and the sampling compartment. The distribution time td, is the time following an i.v. bolus at which the net transfer of drug to the peripheral system reverses in direction. The maximum peripheral bioavailability, Fmax, is the maximum fraction of an i.v. bolus dose that is present in the peripheral system at any one time. Equations are derived which permit estimation of those parameters from drug concentrations in the sampling compartment. Simple algorithms and a computer program are provided for estimating Fcomp, FAUC, td, Fmax, and other parameters relevant to DDA for drugs that exhibit a linear polyexponential bolus response. Estimates of Ecomp, FAUC, td, and Fmax are presented for several drugs. PMID- 3668807 TI - The use and abuse of models. PMID- 3668808 TI - Joint Japan-United States Congress of Pharmaceutical Sciences. Honolulu, Hawaii, December 2-7, 1987. Abstracts. PMID- 3668809 TI - Effect of age on the pharmacodynamics of phenobarbital and ethanol in rats. AB - The purpose of this investigation was to determine the effect of age on the sensitivity of the central nervous system (CNS) to the depressant action of phenobarbital and ethanol. For this purpose, one or the other of these drugs was administered by slow iv infusion to male rats of various ages until the animals lost their righting reflex. The drug concentrations at that time in serum, brain, and cerebrospinal fluid were determined. The results obtained in studies on 1, 9, and 18-month-old Sprague-Dawley rats and on 7, 16, and 24-month-old Fischer-344 rats showed that phenobarbital concentrations at the pharmacologic end-point decreased with increasing age, indicative of an increased sensitivity of older animals to the CNS depressant effect of the barbiturate. Similar studies with ethanol on Sprague-Dawley rats (only) showed substantially higher drug concentrations at all sampling sites in 5-week-old animals than in 9- and 12 month-old animals at the onset of loss of righting reflex, but no significant differences between the 9- and 12-month-old groups. This investigation, which was designed to exclude or account for pharmacokinetic variables and to avoid confounding secondary effects, such as hypothermia and development of acute functional tolerance, showed a substantial increase in CNS sensitivity to phenobarbital and ethanol with increasing age in rats between the age of 1 and 9 months, and a less pronounced increase (phenobarbital) or no significant change (ethanol) in rats between 9 and 18 months of age. PMID- 3668810 TI - Enhancement of the rectal absorption of sodium ampicillin by N-acylamino acids in rats. AB - The promoting efficacies of N-acyl derivatives of amino acids on the rectal absorption of sodium ampicillin were investigated using the rat rectal loop technique. N-Acyl derivatives with longer carbon chains in the acyl moiety showed a greater promoting potency. The promoting potencies of N-acyl derivatives of phenylglycine and phenylalanine were greater than those of glycine and alanine derivatives when compared at the same length of carbon chain in their acyl moieties. The promoting action of N-acylamino acids was not influenced by the presence of N-ethylmaleimide or ouabain. The promoting potencies of N-acylamino acids were depressed in the presence of calcium chloride in the rectal loop. The contribution of the calcium ion sequestration capacity of N-acylamino acids to their promoting efficacies is discussed. PMID- 3668811 TI - Kinetics of drug action in disease states. XXI. Relationship between drug infusion rate and dose required to produce a pharmacologic effect. AB - Computer simulations were performed to determine if the threshold dose of an infused drug (rather than the drug concentration in the biophase at onset of action) can be a suitable index for pharmacodynamic investigations as proposed by others. A two-compartment pharmacokinetic model with drug elimination from the central compartment was used for the simulations. Drug was administered into the central compartment by a constant-rate infusion, and concentrations in the central and peripheral compartments were calculated as a function of time. The pharmacologic effect was assumed to be reversible and to occur at a defined concentration (the effective concentration) in one or the other compartment. The dose required to produce an effective concentration (threshold dose) was determined as a function of infusion rate. The relationship between infusion rate and the dose required to produce an effective concentration in the peripheral compartment was found to be affected by drug distribution and elimination kinetics and by the effective concentration. The infusion rate-dose relationship showed a dose minimum at an infusion rate which others have designated as the "optimal dose rate" and have used for pharmacodynamic studies. No such minimum occurred for pharmacologic effects associated directly with drug concentrations in the central compartment. Since optimum dose rate and threshold dose are affected by both pharmacokinetic and pharmacodynamic alterations, it is concluded that this method (which avoids determination of drug concentrations) is not generally suitable for quantitative pharmacodynamic investigations. PMID- 3668812 TI - Nonlinear pharmacokinetics of unbound propranolol after oral administration. AB - After multiple oral doses, propranolol has been reported to accumulate to a greater degree than expected based on its terminal elimination rate constant and dosage interval. To determine whether the decrease in presystemic elimination can be attributed solely to a decrease in unbound intrinsic clearance or possibly a decrease in unbound fraction, we studied the pharmacokinetics of unbound propranolol in nine healthy subjects who were given 160 mg of regular or sustained-release propranolol orally as single doses, and once daily for 7 d. Unbound propranolol concentrations were calculated by HPLC and equilibrium dialysis on each serum sample. With regular propranolol, the mean unbound oral clearance (CLoral) decreased 29%, from 503 +/- 281 after a single dose to 359 +/- 143 mL/min/kg at steady state (p less than 0.05). Similarly, CLoral decreased 33% with sustained-release propranolol from 1077 +/- 514 to 721 +/- 385 mL/min/kg (NS). The corresponding accumulation ratios for regular and sustained-release propranolol were 1.39 +/- 0.49 and 1.61 +/- 0.81, respectively (NS). Therefore, the mean bioavailability of sustained-release relative to that of regular propranolol was 0.52 +/- 0.23 and 0.54 +/- 0.17 for single doses and at steady state, respectively. The percent unbound of propranolol ranged from 6.8 to 14.0 with an average of 10.1. Neither the percent unbound nor alpha 1-acid glycoprotein (AAG) serum concentrations were statistically different between single and multiple doses. The binding ratio was significantly correlated to AAG concentration (r = 0.776, p less than 0.05). The data support a decrease in unbound intrinsic clearance of propranolol with no change in unbound fraction, leading to an increase in bioavailability at steady state. PMID- 3668813 TI - Kinetics of theophylline clearance in gastrointestinal dialysis with charcoal. AB - The pharmacokinetic response of theophylline following the oral administration of activated charcoal was investigated in rabbits. Rabbits were continuously infused with a theophylline solution at a rate of 2.12 mg/h. At the fourth hour of theophylline infusion, 20 g of activated charcoal was administered by intubation to the rabbit (n = 12). The concentration of theophylline in serum gradually decreased after the charcoal treatment. The magnitude of the change in theophylline concentration induced by charcoal varied among animals. By comparing the steady-state theophylline concentration in the control and treated animals, the total body clearance was found to increase from 94.4 +/- 7.5 to 210 +/- 27 mL/h/kg (mean +/- SE). The rate of change of theophylline concentration in serum following charcoal treatment was fitted with a simulation curve by assuming a stepwise increase in clearance immediately following the charcoal treatment. The results indicated that activated charcoal exerted its maximum effect in increasing theophylline clearance immediately after its administration. PMID- 3668814 TI - Nuclear magnetic resonance analysis of methotrimeprazine (levomepromazine) hydroxylation in humans. AB - Two monohydroxylated metabolites of methotrimeprazine (levomepromazine), which previously have been identified in plasma and urine from psychiatric patients, were synthesized by nonenzymatic, FeCl2-catalyzed oxidation, isolated, and purified by preparative reversed-phase HPLC. Mass spectrometric analysis gave identical spectra for the two compounds, but did not reveal the positions of the OH groups. However, 1H NMR spectroscopy at 200 MHz demonstrated that one of the compounds, which had the shortest GC retention time on an OV-17 column, was hydroxylated in the 3-position on the phenothiazine nucleus, and that the other derivative was hydroxylated in the 7-position. The metabolism of methotrimeprazine differs, therefore, from that of its congener chlorpromazine, which is hydroxylated mainly in the 7-position in humans. PMID- 3668815 TI - Effect of liposomes on suspension stability. AB - The effect of positively charged liposomes on the stability of negatively charged indomethacin particle suspensions was investigated by adsorption, microelectrophoresis, sedimentation volume, and redispersibility. It was found that flocculation occurred in the neighborhood of the zero point of charge of the liposome:indomethacin suspensions. This resulted from the operation of van der Waals attraction under the condition of nil electrostatic repulsion. Correlation among the results of adsorption, microelectrophoresis, sedimentation volume, and redispersibility was good. The mixing effect of the suspension was examined by microelectrophoresis and confirmed by sedimentation volume and redispersibility. Results indicate that there was no difference between the method of dilution of the liposome:indomethacin concentrated suspension after mixing and the method of dilution of liposomes prior to mixing with the indomethacin suspension. This was due to interaction depending on the charge density of the particles. PMID- 3668816 TI - Limits to the concept of solid-state stability. AB - Recently published data about the decomposition of propantheline bromide in the presence of moisture resulted in a general, two-variable, phenomological equation relating the decomposition to the relative humidity and temperature. The true curve, however, is biphasic, since complete liquefaction occurs at some time point. This article deals with the development of a theoretical equation relating decomposition time, temperature, and relative humidity during the solid-state stage (i.e., during the period when solid is still present in the system). PMID- 3668817 TI - Determination of aspirin by pre-column transacetylation reaction of 3-aminophenol and reversed-phase high-performance liquid chromatography: simultaneous determination of aspirin, acetaminophen, and caffeine. AB - The accuracy of the measurement of aspirin by high-performance liquid chromatography (HPLC) is reduced by its hydrolysis into salicylic and acetic acids during sample preparation. The ready and quantitative transacetylation of 3 aminophenol by aspirin, giving 3-hydroxyacetanilide (which is stable), has been utilized as a pre-column reaction for the determination of aspirin either alone or in the presence of acetaminophen and caffeine by reversed-phase HPLC. PMID- 3668818 TI - Temperature dependence of the acid dissociation constants of chloroquine. AB - The pKa values of the conjugate acids of the antimalarial drug chloroquine were determined at various temperatures using fluorescence spectrophotometry and nonlinear regression in the data analysis. Both pKa values decreased by approximately one unit with increasing temperature over the range 0-37 degrees C with enthalpy changes of 46 and 49 kJ X mol-1. The ionization of chloroquine was found to be mainly controlled by the change in enthalpy. The chloroquine monocation was shown to be almost exclusively in the alkylamino protonated form at all temperatures studied. PMID- 3668819 TI - A stereochemical and conformational model of dopaminergic agonist and antagonist activity: further evaluation. AB - Conformational energy calculations using the Molecular Mechanics II (MM2) program have been performed on 2-aminotetrahydronaphthalene (ATN) and 2-aminoindan derivatives which are active or inactive at dopamine receptors. The results were used to test a stereochemical and conformational model previously proposed for dopaminergic activity. The conformer predicted to be optimal for agonist activity was found to have relatively low energy (less than 1.5 kcal/mol) for all of the agonists examined. The model successfully: (1) explained the relative activity or inactivity of compounds such as cis- and trans-1-methyl-5-hydroxyl ATN derivatives and the corresponding cis- and trans-octohydrobenzo[f]quinolines; (2) predicted the more potent antipode of 2-aminoindan dopaminergic agonists; and (3) explained the structure--activity peculiarities of 3-(3-hydroxyphenyl)-N alkylpiperidines in which the potency is increased for (3S)-isomers and decreased for (3R)-isomers when the N-alkyl group is greater than propyl. Predictions of postsynaptic dopaminergic antagonism were also made for some of the compounds. In agreement with previous conclusions, the inactivity of ATN derivatives with a 2 methyl or 5-propyl group was attributed to steric interference at the receptor since those groups did not have a significant conformational effect on the receptor ligand. PMID- 3668820 TI - Extended least squares (ELS) for pharmacokinetic models. AB - An important part of pharmacokinetic research is fitting models to observed data and estimating the parameters in the model. In general, parameter estimation in pharmacokinetics is a subset of the general problem of nonlinear regression or parameter estimation in nonlinear regression models. The same criteria, algorithms, and software used in other areas of science have been used in pharmacokinetics. Nonlinear modeling is a difficult mathematical and statistical task, often presenting problems. Any proposed new tool is of interest, and extended least squares (ELS) has been suggested as being better than the methods usually used. This suggestion and the evidence supporting it are examined; additional simulations are reported. With the evidence presently available, ELS does not seem to be superior to traditional least squares methods. PMID- 3668821 TI - Thermochemical investigations of associated solutions: 4. Calculation of carbazole-dibutyl ether association constants from measured solubility in binary solvent mixtures. AB - Experimental solubilities are reported for anthracene and carbazole in binary dibutyl ether plus n-hexadecane and dibutyl ether plus squalane solvent mixtures at 25 degrees C. Results of these measurements, used in conjunction with the extended nearly ideal binary solvent (NIBS) model, enabled calculation of the carbazole-dibutyl ether association constant. The numerical value obtained was independent of the hydrocarbon cosolvent, and compared favorably with previously reported values based on carbazole solubilities in solvent mixtures containing much smaller alkane cosolvents. PMID- 3668822 TI - Thermochemical investigations of associated solutions: 5. Calculation of solute solvent equilibrium constants from solubility in mixtures containing two complexing solvents. AB - Solubilities are reported for carbazole in binary dibutyl ether plus 1 chlorohexane mixtures at 25 degrees C. Results of these measurements are compared with solution models developed for solubility in systems containing specific solute-solvent interactions. A simple stoichiometric complexation model based on a 1:1 carbazole:dibutyl ether complex could describe the measured solubility to within an average absolute deviation of 1.7%. The calculated equilibrium constant, though, was about one-half of values previously determined from carbazole solubilities in several binary dibutyl ether plus alkane mixtures. A more sophisticated solution model, derived by assuming both 1:1 carbazole: dibutyl ether and carbazole:chlorohexane complexes, could describe the solubilities to within 2.4%. This latter model enables the carbazole-chlorohexane association constant to be calculated from experimental carbazole solubilities and a priori knowledge of the carbazole-dibutyl ether equilibrium constant. PMID- 3668823 TI - Comment on "Thermochemical investigations of associated solutions: calculation of solute-solvent equilibrium constants from solubility measurements". PMID- 3668824 TI - Biomechanical analysis of maximal pedal stress during ballet stance. PMID- 3668825 TI - Reese arthrodesis screw. Osteosynthesis of the interphalangeal joint. PMID- 3668826 TI - Sinus tarsi syndrome and its relationship to hallux abducto valgus. PMID- 3668827 TI - Maculopapular rash in a 23-year-old patient. PMID- 3668828 TI - Reflex sympathetic dystrophy syndrome. A case presentation. PMID- 3668829 TI - Roentgenographic manifestations of gout. A case report. PMID- 3668830 TI - Tibialis posterior tendon rupture. PMID- 3668831 TI - Modern intraocular lens implants in children with new age limitations. AB - Seventy-three children received modern designs of posterior and flexible anterior chamber intraocular lenses. Twenty-eight (38%) had anterior chamber and 45 (62%) had posterior chamber lenses implanted. Postoperative implant complications occurred in 38 (54%) eyes; the most frequent was secondary membrane formation. Six eyes (22%) with anterior chamber lenses and 25 eyes (58%) with posterior chamber lenses required posterior capsulotomies. Seventy percent of the posterior chamber lens recipients less than six years of age developed secondary membranes. All of these eyes had a discission except one Nd:YAG laser patient. Forty-eight percent of the patients with posterior chamber lenses over six years of age required posterior capsulotomies: 55% had Nd:YAG laser capsulotomies and 45% had discissions. Based upon these observations, we now recommend primary implantation of flexible anterior chamber lenses in three- to six-year old children who have tissue-free visual axes and for all secondary implantations. Primary posterior chamber lenses are recommended for children six years of age and older and for younger children who will tolerate a Nd:YAG laser capsulotomy. PMID- 3668832 TI - Intraocular lens resolution in air and water. AB - The resolution of 96 polymethylmethacrylate intraocular lenses with convexo-plano optics, ranging in power from 13 to 27 diopters, was measured in air and water. The resolution of each lens was expressed in linear units of resolving power, which is the maximum number of line-pairs that can be resolved per millimeter, as described in the current ANSI Standard Z80.7-1984. There was no clearly defined relationship between linear resolving power measured in air and that measured in water. Measurements on high power lenses (greater than 20 diopters) indicate that it is possible for an intraocular lens to meet the current 100 line-pair per millimeter standard for resolution and still be a limiting factor in a patient's best attainable visual acuity. An alternative method for evaluating lens resolution is to determine the resolution efficiency (the relative percentage performance of a lens compared to a diffraction-limited lens of the same dioptric power). Using these units, a consistent and predictable relationship from air to water was demonstrated. Our findings confirm that if a minimum standard of 30% resolution efficiency in air is established, in contrast to linear resolving power, the lens will perform near its diffraction limit when implanted in the eye. For intraocular lenses of materials other than polymethylmethacrylate, a minimum resolution efficiency in air other than 30% may be required. PMID- 3668833 TI - Myopic keratomileusis: initial results and myopic keratomileusis combined with other procedures. AB - Myopic keratomileusis (MKM) was performed on 58 eyes to correct for moderate to severe myopia. This represents the first consecutive 58 cases I performed. Average follow-up was 11.6 months, with the shortest time being three months. Average preoperative myopia was -11.16 diopters (D) with a range of -5.50 D to 21.62 D. Average postoperative myopia was +0.38 D with a range of -7.75 D to +8.50 D. Selected patients (11) had secondary procedures such as homoplastic MKM, astigmatism procedures, or radial keratotomy. The average postoperative correction for all 58 cases was then +0.11 D with a range of -6.37 D to +4.00 D; 88.5% of patients achieved 20/50 or better uncorrected visual acuity. The procedures, postoperative course, and complications are discussed. PMID- 3668834 TI - Comparative study of the elasticity and memory of intraocular lens loops. AB - The elasticity and memory of intraocular lens loops was tested by manufacturing lenses with matching physical properties but with loops of either polypropylene or VS-100 polymethylmethacrylate (PMMA). After establishing the reliability of measurements, these lenses were compressed under physiologic conditions for up to three years. The rates and extent of reexpansion of the loops were then measured. Given loops of equivalent initial flexibility, VS-100 PMMA has less long-term tendency to reexpand to its initial shape than polypropylene. PMID- 3668835 TI - Evaluation of endothelial cell function with anterior segment fluorophotometry in pseudophakic patients. AB - Determining fluorescein permeability of the endothelial cell layer provides information on the endothelial cell barrier. Following topical application of fluorescein, the time dependent change of its concentration in the corneal stroma and in the aqueous humor yields the transfer coefficient (Kc) of the corneal endothelium. Measurements with a fluorophotometer resulted in a Kc of 0.002 minute to 0.005 minute for normal eyes. Patients with corneal barrier dysfunction (cornea guttata, Fuch's dystrophy) showed an increased Kc of 0.006 minute to 0.013 minute. Up to five years postoperatively, none of the patients investigated after phacoemulsification and posterior chamber lens implantation showed a disturbance in the endothelial cell barrier function. PMID- 3668836 TI - Comparison of the properties of AMVISC and Healon. AB - A standardized investigation to compare the biophysical characteristics of two sodium hyaluronate products, AMVISC and Healon, was conducted. Results showed that the two products exhibited similar biophysical properties. AMVISC exhibited an average kinematic viscosity of 41,554 centistokes and a calculated average molecular weight of 2.04 X 10(6) daltons. Healon exhibited an average kinematic viscosity of 47,271 centistokes and a calculated average molecular weight of 2.43 X 10(6) daltons. PMID- 3668837 TI - Intraocular inflammation of denatured viscoelastic substance in cases of cataract extraction and lens implantation. AB - I present three successive pseudophakic cases that had intraocular inflammation (iritis) and bullous keratopathy presumably caused by denatured sodium hyaluronate (Healon). The denatured Healon was injected into the anterior chamber mixed with fresh Healon during routine planned extracapsular cataract extraction and intraocular lens implantation, when the cannula was reused after sterilization by disinfectants and autoclaving. A residuum of the viscoelastic substance remained inside the cannula and its nature was changed to a toxic chemical by the action of disinfectants and the sterilization procedures. The first two cases developed pseudophakic bullous keratopathy and had successful penetrating keratoplasties performed. The third case had minimal intraocular inflammation. The hypothesis that this intraocular reaction was due to denatured Healon was confirmed by use of a rabbit eye model. I recommend using a single-use disposable cannula for intracameral administration of Healon. PMID- 3668839 TI - Clinical experience with Nd:YAG laser vitreolysis in the anterior segment. AB - The clinical experience of two surgeons performing Nd:YAG laser anterior vitreolysis to disrupt vitreous strands adherent to surgical wounds with and without pupillary distortions and/or cystoid macular edema is presented. We describe our technique. The results indicate that vision improved in 50% of the cases, with visual acuity improving from 20/40 or better in three of 20 eyes preoperatively to 11 of 20 eyes postoperatively. No adverse effects or complications occurred in any of our 20 patients. Neodymium:YAG laser vitreolysis should be considered presently as the method of choice for initial treatment of vitreous strands incarcerated in the wound. PMID- 3668838 TI - Topographical anatomy of the ciliary sulcus. AB - The topography of the ciliary sulcus area in humans was examined by slitlamp biomicroscopy and scanning electron microscopy. Characteristics of this area included the following: the sulcus was angulated anteriorly; the ciliary processes were of unequal length; the zonules did not insert on the tips of the ciliary processes but, instead, inserted slightly posteriorly; the contour of the sulcus area was irregular; bands stretched from the base of the ciliary processes to the posterior surface of the iris, making the sulcus a potential space in some areas of the eye. Effects of this topography on IOL implantation are postulated. PMID- 3668840 TI - Prospective study of intraocular pressure 2 1/2 years after intracapsular cataract extraction and implantation of a semiflexible anterior chamber lens. AB - Fifty-one patients available for a 2 1/2 year follow-up after intracapsular cataract extraction and implantation of the semiflexible McGhan/3M, style 70 anterior chamber lens were evaluated for intraocular pressure (IOP). No significant change in the IOP could be demonstrated despite progression of iris like tissue adhesions between the iris and lens haptics at or close to the trabecular meshwork. Four eyes (7.8%) had IOPs greater than or equal to 22 mm Hg without medication, and four other eyes used timolol eyedrops with subsequent IOPs less than or equal to 18 mm Hg. Eight eyes (15.7%) demonstrated an IOP increase greater than or equal to 25% over baseline pressures. PMID- 3668841 TI - Practice styles and preferences of ASCRS members--1986 survey. AB - A survey of the practice styles and preferences of 1986 ASCRS members was taken in the summer of 1986. A total of 4,042 surveys were mailed in June of 1986 and 1,184 were returned--a return rate of 29%. The responses were analyzed using D Base III. Response rate was 5% greater than for the 1985 survey. There was no financial incentive for return of the survey other than return postage paid for by the author. Three main profile areas were analyzed: age of the ophthalmologist, volume of cataract surgery per month, and geographic location. Areas of interest were surgery locations, surgical techniques, Nd:YAG laser application, intraocular lens design preferences, radial keratotomy, and advertising in ophthalmology. The influence of age of the ophthalmologist, cataract surgery volume, and geographic location were cross-analyzed for each question. The results were compared to the results of comparable questions in the 1985 survey. This report looks at each question and looks for variances from the national average, as well as for trends from the 1985 survey. PMID- 3668842 TI - Radial keratotomy: a different point of view. PMID- 3668843 TI - 4- or 8-incision radial keratotomy. PMID- 3668844 TI - Acute effects of ethanol and diazepam on the acquisition and performance of response sequences in humans. AB - The present study assessed the acute effects of p.o. administered ethanol (0, 22, 45, and 67 g) and diazepam (0, 10, 20 and 40 mg) in normal adult humans responding under a multiple schedule of acquisition and performance of 10 response sequences. In each component of the multiple schedule subjects were required to complete a different sequence of 10 responses in a predetermined order using three keys of a numeric keypad. In the acquisition component a new response sequence had to be acquired each session. In the performance component the response sequence remained the same from session to session. The higher doses of ethanol (67 g) and diazepam (20 and 40 mg) increased overall percent errors above placebo levels; the lower doses of these compounds had no significant effect. The increases in percent errors were selective across the two schedule components. Ethanol increased percent errors significantly only in the acquisition component. Diazepam increased percent errors significantly in the acquisition component at a lower dose (20 mg) than was necessary to increase errors in the performance component (40 mg). Ethanol (67 g) and diazepam (40 mg) decreased overall response rates as an orderly function of dose. In contrast to the percent errors measure, the effects on response rates were not significantly different across the performance and acquisition components. Peak effects on percent errors and response rates varied between 30 and 70 min and 45 and 80 min postdrug for ethanol and diazepam, respectively, and the duration of effects of the higher doses was greater than 3 hr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668845 TI - Effects of magnesium chloride on cardiovascular hemodynamics in the neurally intact dog. AB - To assess the cardiovascular actions of magnesium in neurally intact animals, magnesium chloride (1-4 mM/min) administered i.v., producing a peak arterial magnesium level between 4.7 and 7.2 mg/dl, was given to alpha-chloralose anesthetized, open-chest dogs. Magnesium lowered heart rate by 36 +/- 11 beats/min (P less than .05), cardiac output by 0.7 +/- 0.2 liters/min (P less than .05), left ventricular (LV) peak dP/dt by 410 +/- 96 mm Hg/sec (P less than .05) and aortic and pulmonary artery pressures, but it did not change LV end diastolic pressure, systemic resistance or pulmonary resistance. Coronary blood flow also decreased by 39 +/- 11% (P less than .05), myocardial oxygen consumption by 88 +/- 22% (P less than .05) and myocardial oxygen extraction by 53 +/- 16% (P less than .05). When heart rate was held constant, magnesium still decreased LV systolic pressure, LV peak dP/dt and coronary blood flow. The increase in serum magnesium was accompanied by an increase in serum calcium (by 1.4 +/- 0.2 mg/dl; P less than .05) and a fall in serum potassium (by 0.21 +/- 0.1 mEq/l), but not by a change in serum sodium, myocardial electrolyte arteriovenous differences or arterial pH. Thus, at blood concentrations that are observed in humans after therapeutic dosages of magnesium, a depression of cardiac performance is observed in the anesthetized dog. Although magnesium produces a fall in coronary blood flow, this appears to be due at least in part to a decrease in myocardial oxygen requirements because myocardial oxygen extraction also decreases. Rapid changes in serum electrolytes accompany these hemodynamic effects. PMID- 3668846 TI - Influence of concomitant aspirin or prednisone on methotrexate synovial fluid concentration. AB - Methotrexate (MTX) is currently being used in the treatment of patients with rheumatoid arthritis. The purpose of this study was to investigate the effect of two classes of drugs, steroids and salicylates, on MTX synovial fluid concentrations. A novel canine model of monoarticular inflammation was used, in which each animal served as its own control with both inflamed and normal knees in the same animal. After the 6-week immunization process, animals in each group received either no drug (control), prednisone or aspirin (low dose and high dose) for 1 week before MTX. On the day of the study, each animal was given i.v. MTX, and serial serum and synovial fluid samples were obtained. Laboratory, histologic and clinical observations supported the presence of monoarticular inflammation. The end-of-infusion synovial MTX concentration in inflamed knees was significantly greater than in normal knees (P less than .05), but, 2 hr after the end of infusion, they were not different. The end-of-infusion ratio of synovial fluid MTX concentration to serum MTX concentration (both total and unbound) was significantly lower in the prednisone group than in the other treatment groups (P less than .05). The end-of-infusion ratio of the MTX synovial concentration in the inflamed knee compared with the normal knee at 2 hr was significantly lower in the prednisone group than in the other three treatment groups (P less than .05). These results have therapeutic implications for the use of MTX in treating rheumatoid arthritis. PMID- 3668847 TI - Relation of plasma morphine concentrations to severity of abrupt withdrawal in morphine-dependent monkeys. AB - Plasma morphine levels were measured during abrupt withdrawal in four chronically dependent female monkeys. Approximately 12 hr after withdrawal, the morphine plasma concentrations were about 8 to 10 ng/ml, at which time all of the animals showed mild to moderate symptoms of opiate withdrawal. Severity of withdrawal showed a negative correlation (r = -0.93, P less than .001) with the falling phase of plasma morphine. It may be concluded that, under the conditions of this experiment, significant morphine withdrawal symptoms arose despite measurable plasma concentrations of morphine and that the relationship between plasma concentrations and withdrawal may be quantified according to a linear pharmacokinetic model for a given chronic dose (3.0 mg/kg q 6 hr) of morphine. PMID- 3668848 TI - Pharmacokinetics of systemically administered cocaine and locomotor stimulation in mice. AB - Cocaine and its metabolites were measured in plasma and brain from mice injected i.p. with cocaine and monitored for spontaneous locomotor behavior. Cocaine concentrations in the brain reached peak values within 5 min after administration of cocaine. At all time points between 5 and 60 min the concentrations of cocaine in the brain were 7-fold higher, on the average, than those in plasma. The opposite was true for the concentrations of benzoylecgonine; brain to plasma ratios of benzoylecgonine were approximately 0.1 from 5 to 30 min after i.p. cocaine injection. After i.p. injection of either 10 or 25 mg/kg of cocaine, cocaine disappeared from plasma and brain with a half-life of 16 min and benzoylecgonine disappeared from plasma with a half-life of 62 min. There was good correspondence between locomotor stimulation and concentration of cocaine in the brain measured at 12, 22 and 32 min after i.p. administration of 25 mg/kg of cocaine. Among individual animals there was a significant correlation between their locomotor stimulation and their brain cocaine concentration, indicating that differences in cocaine levels in the brain between animals contribute to their different behavioral response; however, the correlation analysis also indicated the role of other factors determining the locomotor response to cocaine. PMID- 3668849 TI - Mouse thiopurine methyltransferase pharmacogenetics: biochemical studies and recombinant inbred strains. AB - Thiopurine methyltransferase (TPMT) catalyzes the S-methylation of 6 mercaptopurine and other heterocyclic and aromatic thiol compounds. In humans, TPMT activity is controlled by a common genetic polymorphism. C57BL/6J (B6) and AKR/J (AK) inbred mice have low hepatic and renal TPMT activities, whereas DBA/2J (D2) mice have high enzyme activities. Low TPMT activity is inherited in these mice as an autosomal recessive trait. The properties of TPMT in liver homogenates from B6, AK and D2 mice were compared in order to study the biochemical basis for inherited differences in TPMT activity among these strains. Biochemical and physical properties of hepatic TPMT were very similar in all three strains. Apparent Michaelis (Km) constants for 6-mercaptopurine were 0.98, 0.75 and 1.1 mM for B6, AK and D2 mice, respectively. Apparent Km values for S-adenosyl-L methionine, the methyl donor for the reaction, were 2.2, 1.5 and 3.0 microM for B6, AK and D2 mice. IC50 values for inhibition by 3,4-dimethoxy-5-hydroxybenzoic acid were 0.83, 1.0 and 1.2 microM, whereas IC50 values for inhibition by S adenosyl-L-homocysteine were 5.4, 6.6 and 5.8 microM for B6, AK and D2 mice, respectively. Half-life and slope values for thermal inactivation of hepatic TPMT were similar among B6, AK and D2 mice. No differences among strains in Rf values of the enzyme activity after electrophoresis were detected. Ion exchange chromatography with an NaCl gradient showed a major peak of TPMT activity that eluted with 51 to 56 mM NaCl for all three strains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668850 TI - Effect of age and sex on allyl alcohol hepatotoxicity in rats: role of liver alcohol and aldehyde dehydrogenase activities. AB - Allyl alcohol-induced hepatotoxicity was more severe in old male rats than in young-adult male rats, as measured by release of hepatic enzymes from injured cells and loss of hepatic microsomal cytochrome P-450. The extent of toxicity in female rats was greater than in males and was unaffected by aging. The purpose of this study was to examine possible causes for these differences. The activity of alcohol dehydrogenase (ADH) with allyl alcohol as substrate was measured in liver cytosolic fractions of rats at ages representing young adulthood, middle age and old age. ADH activities were 1.7 +/- 0.1, 2.3 +/- 0.1 and 2.6 +/- 0.1 mumol/min/g of liver in male rats aged 4, 14 and 25 months, respectively. ADH activities in young-adult and old female rats were 3.8 +/- 0.1 and 3.7 +/- 0.1 mumol/min/g of liver. There was a good correlation (r = 0.99, P less than .001) between liver ADH activity and allyl alcohol-induced hepatotoxicity, measured as the release of sorbitol dehydrogenase into the bloodstream. Cytosolic free NAD+/NADH ratios in male rats were not significantly different among the three age groups; the ratios were lowest in young-adult female rats. Low Km aldehyde dehydrogenase activities in liver mitochondrial and cytosolic fractions were similar among the three age groups of male rats, and the activities in female rats were not substantially different. The results indicated that increased ADH activity is the principal cause of the age-associated enhancement of allyl alcohol hepatotoxicity in male rats. PMID- 3668851 TI - Reversible inhibition of acetylcholine contracture of molluscan smooth muscle by heavy metals: correlation to Ca++ and metal content. AB - The present study examined the effects of three heavy metals on the acetylcholine (ACh) contracture and Ca++ kinetics of the anterior byssus retractor muscle of Mytilus edulis. An isolated tissue bioassay using anterior byssus retractor muscle was prepared according to standard procedures and the isometric tension produced in response to ACh was measured. Ten millimolar Ni++, Co++ or Cd++ reduced the maximum contracture response to ACh in zero-Ca medium in a time dependent manner. The inhibition was reversed upon restoration of medium containing 10 mM Ca++. The loss (and re-establishment) of contracture response to ACh corresponded to the influx (and efflux) of the heavy metal ions opposite to the direction of Ca++ flow. These results are consistent with the concept that the loss of the ACh contracture response is attributable to the displacement of tissue Ca++ from release sites by heavy metals. PMID- 3668852 TI - Suppression of inhibitory neural input to colonic circular muscle by opioid peptides. AB - The aim of this study was to identify the neurotransmitter responsible for the dominant inhibitory neural input that normally masks myogenic phasic activity in the intestine. Opioid agonists, including opioid derivatives of proenkephalin and prodynorphin, caused direct tonic and indirect phasic contractions of strips from the circular muscle layer of rat colon. Both contractile responses appeared to be mediated by preferential interaction with delta opioid receptors. Elimination of most, if not all, neural input with tetrodotoxin (TTX) induced concentration dependent phasic contractions. Neutralization of background vasoactive intestinal peptide (VIP) with VIP antiserum induced phasic contractions in previously quiescent muscle strips. The effect of VIP antiserum was concentration-dependent in the range of 1:960 to 1:60. A threshold concentration of VIP antiserum (1:960) increased the sensitivity of the phasic responses to [Met]enkephalin (100-fold) and TTX (20-fold) whereas exogenous VIP had the opposite effect. [Met]enkephalin and TTX inhibited basal VIP release by 43 +/- 8% (P less than .001) and 65 +/- 13% (P less than .01), respectively. It was concluded that VIP was the neurotransmitter responsible for the dominant inhibitory neural input to intestinal circular muscle and that opioid peptides induce phasic contractions by suppressing VIP release. PMID- 3668853 TI - Pharmacodynamic and pharmacokinetic interactions between lidocaine and verapamil. AB - Lidocaine (3 mg/kg i.v.) injected during steady-state verapamil infusions (3 micrograms/kg i.v.) induced slight and transient hemodynamic changes in nine conscious dogs. Systemic vascular resistance and left ventricular dP/dt decreased by 16% from 41 +/- 4 mm Hg/liter/min and by 20% from 2876 +/- 137 mm Hg/sec, respectively, whereas heart rate and cardiac output increased by 18% from 100 +/- 5 beats/min and by 17% from 2.5 +/- 0.2 liters/min, respectively. Simultaneously, lidocaine induced a transient but more pronounced decrease in verapamil plasma concentration of 48% from 60 +/- 3 ng/ml. This pharmacokinetic interaction was not the result of a lidocaine-induced decrease in the fraction of verapamil bound to plasma protein because in vitro lidocaine failed to displace verapamil from its protein binding site. Moreover, an increase in verapamil total clearance was not the only mechanism because steady-state lidocaine (6 mg/kg over 5 min followed by 60 micrograms/kg/min) in the presence of steady-state verapamil (200 micrograms/kg over 3 min followed by 3 micrograms/kg/min) also resulted in a transient decrease in verapamil plasma concentration from 59 +/- 9 to 23 +/- 2 ng/ml in six conscious dogs. Although verapamil did not affect lidocaine pharmacokinetics, in the presence of the steady-state lidocaine we recorded an increase in verapamil initial volume of distribution of 44% from 40 +/- 4 liters, and intercompartmental clearance increased by 88% from 101 +/- 20 liters/hr, combined with an increase in verapamil total clearance of 47% from 54 +/- 6 liters/hr (n = 6). PMID- 3668854 TI - Inhibition and induction of drug biotransformation in vivo by 8-methoxypsoralen: studies of caffeine, phenytoin and hexobarbital metabolism in the rat. AB - The effects of 8-methoxypsoralen (8-MOP) on drug metabolism in vivo were studied in catheterized rats. Rats were pretreated with a single i.p. injection of 5.4 or 27 mg/kg of 8-MOP, 30 min before an i.v. injection of either caffeine (CA; 10 mg/kg), hexobarbital (HB; 40 mg/kg), phenytoin (DPH; 15 mg/kg) or 5-(4' hydroxyphenyl)-5-phenylhydantoin (HPPH; 15 mg/kg). Clearance of CA, HB and DPH, respectively (drugs eliminated primarily by phase-1 biotransformation), decreased from 0.25 +/- 0.02, 2.9 +/- 0.2 and 1.6 +/- 0.1 liters/kg/hr (means +/- S.E.) in control rats to 0.062 +/- 0.006, 0.65 +/- 0.15 and 0.09 +/- 0.03 liters/kg/hr in rats pretreated once with 27 mg/kg of 8-MOP. In contrast, the clearance of HPPH, which is eliminated primarily by glucuronidation, decreased only slightly from 1.3 +/- 0.1 liters/kg/hr in controls to 0.89 +/- 0.02 liters/kg/hr in rats pretreated with a single injection of 27 mg/kg of 8-MOP. Induction of drug metabolism by 8-MOP was studied in vivo in rats pretreated with 50 mg/kg/day of 8 MOP for 3 days and given an i.v. injection of CA, HB, DPH or HPPH 24 hr after their last pretreatment. This regimen increased the clearance of CA from 0.25 +/- 0.02 liters/kg/hr in controls to 1.08 +/- 0.04 liters/kg/hr in pretreated rats but had no significant effect on the elimination of HB, DPH and HPPH. Thus, acutely, 8-MOP is a potent, nonselective inhibitor of phase-1 metabolism in vivo. In contrast, chronically, it is a specific inducer of the metabolism of CA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668855 TI - Effects of trimethyltin on repeated acquisition. AB - The behavioral effects of trimethyltin were studied in male White Carneaux pigeons using the repeated acquisition procedure, which required that the birds acquire a different four-response position sequence from day to day. After rates and patterns of acquisition of new sequences had stabilized, trimethyltin was administered i.m. at three different dosages (1.0, 1.3 and 1.75 mg/kg) to three different groups of birds, and saline was administered to a fourth group. The birds received one injection and then were tested daily for a period of up to 10 weeks. Trimethyltin produced increases in total errors within sessions, as well as decreases in rates of responding. Analysis of the pattern of error elimination within sessions suggested that error elimination did take place after trimethyltin administration in all birds, but that errors frequently were eliminated more slowly than in control birds. Over the 10-week testing period, there was a gradual recovery to control levels of both total errors and the pattern of error elimination within sessions. PMID- 3668856 TI - Contractile serotonergic receptor in rat stomach fundus. AB - Serotonin (5HT) is a potent agonist in contracting the rat stomach fundus although the nature of the receptor mediating the response has not been established. The present study was designed to explore the possibility that 5HT induced contractions in the rat stomach fundus were mediated by interaction with receptors identical with either 5HT1A, 5HT1B or 5HT1C binding sites or 5HT3 receptors. Contractile concentration-response curves for several 5HT agonists [5 carboxamidotryptamine, TR3369, MK212, quipazine, RU 24969, 8-hydroxy-2-(di-n propylamino)tetralin, TVXQ7821 and BEA 1654CL] were obtained in the rat stomach fundus. However, neither the potency nor maximum response of these agonists in contracting the rat stomach fundus correlated with the affinity of agonists at 5HT1A, 5Ht1B or 5HT1C binding sites. These agonists were interacting with 5HT receptors in the fundus based on the ability of 1-(1-naphthyl) piperazine (10(-7) M) to antagonize the contractile response of the relatively potent agonists. TVXQ7821 and BEA 1654Cl did not produce a marked contractile response in the fundus and also did not antagonize the contractile response to 5HT, suggesting that these agents have little, if any, affinity for the serotonergic receptor mediating contraction in the fundus. The putative 5HT1A-selective receptor antagonists, WB4101 and spiroxatrine, did not block 5HT-induced contractions in the rat stomach fundus in concentrations consistent with their affinity at 5HT1A binding sites. The nonselective 5HT1A and 5HT1B receptor antagonist, cyanopindolol, also did not block 5HT-induced contractions in the rat stomach fundus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668857 TI - Sources of activator calcium for extrinsic vascular tone and nimodipine inhibition of that tone in proximal vs. distal rabbit ear arteries. AB - The contractile responses of three artery segments of diminishing diameter in the rabbit ear (i.e., unstretched lumen diameter approximately 300 mu in central ear artery, unstretched lumen diameter approximately 150 mu in main side branch off the central ear artery and unstretched lumen diameter approximately 75 mu in terminal branch off the main side branch) to high K+, norepinephrine (NE) and 5 hydroxytryptamine (5-HT) were tested before and after their incubation in Ca++ free physiologic salt solution for times varying from 3 to 60 min. The time course of reduction of the contractile responses to K+ with Ca++-free conditions in all classes of vessels could be represented by monoexponential curves that were not significantly different from each other. The contractile response of all the ear arteries to NE and 5-HT was biphasic. The first rapid transient phase (phase I) was more resistant to change upon the removal of exogenous Ca++ than the second usually equilibrium-like component (phase II), which was dramatically and rapidly reduced (but not necessarily eliminated) by this procedure. The extent of decline upon Ca++ removal in most instances was greater for 5-HT than for NE. The rate of falloff of both phases of contraction to NE and 5-HT was faster in the smaller compared with the larger arteries. These results suggest that, as vessels in the rabbit ear arterial tree get smaller, the contribution of a tightly bound or intracellular Ca++ pool to both phases of amine-induced contraction becomes smaller, but this contribution is greater to the transient compared with the equilibrium phase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668858 TI - Protein kinase C and tracheal contraction at low temperature. AB - During exercise or dry air-induced asthma, airway walls cool. However, the role of temperature in the regulation of airway tone is not clear. Protein kinase C (PKC) is an important second messenger in the mediation of cell responses. To explore whether changes in temperature affect pathways involving PKC in airways, we examined the effects of phorbol esters, potent activators of PKC, in guinea pig tracheal rings at various temperatures. Phorbol-12,13-diacetate (PDA) caused a reduction in tracheal tone at 37 degrees C and an increase in tone when temperature was reduced to 22 degrees C. Increases in tone were also produced by PDA when cell membranes were depolarized by ouabain (10 microM) or KCl (30 mM) at 37 degrees C. Contractions produced by PDA at 22 degrees C were inhibited by lipoxygenase inhibitors [ETYA (5,8,11,14-eicosatetraynoic acid), NDGA (nordihydroguaiaretic acid) and phenidone] and a leukotriene receptor antagonist [FPL 55712 (sodium 7-[3-(4-acetyl-3-hydroxy-2-propylphenoxy)-2-hydroxypropoxyl] 4-oxo-8-propyl-4H-1-benzopyran-2-carboxylate)]. Contractions produced by PDA at 37 degrees C or 22 degrees C in the presence of ouabain (10 mM) or KCl (30 mM) were not affected by these drugs. These results indicate that changes in temperature have profound effects on responses resulting from PKC activation. At low temperature, the lipoxygenase pathway mediates responses. Thus, cooling has the potential to modify a major intracellular pathway regulating physiological responses of the airways. PMID- 3668859 TI - Cocaine disposition in the brain after continuous or intermittent treatment and locomotor stimulation in mice. AB - Intermittent s.c. and i.p. injections of cocaine (20 mg/kg; total 430 mg/kg for each animal) for 18 days resulted in locomotor stimulation of mice upon challenge with cocaine on the 25th or 26th day, compared with no locomotor stimulation in a saline-pretreated group. In contrast to the sensitization by intermittent cocaine administration, tolerance was found upon challenge after continuous administration of cocaine by minipumps (25 mg/kg/day; total 450 mg/kg for each animal) on a similar schedule. No differences were found between the sensitized and tolerant groups in the levels of cocaine and benzoylecgonine in plasma and brain 12 min after i.p. administration of a challenge dose of cocaine, suggesting that in these chronic experiments the changes in the locomotor response are not accounted for by dispositional effects. In contrast, in animals treated daily for 2 or 3 days i.p. with cocaine and challenged with cocaine 1 day later, there was both a greater locomotor stimulation and a higher level of brain cocaine than in saline-pretreated animals, suggesting a dispositional effect. Among individual animals there was a positive correlation between their locomotor stimulation by the challenge dose and their brain cocaine concentration. PMID- 3668860 TI - Antiarrhythmic activity of two quinidine metabolites in experimental reperfusion arrhythmia: relative potency and pharmacodynamic interaction with the parent drug. AB - We investigated the antiarrhythmic activity of two major metabolites of quinidine in human, 3-hydroxyquinidine and quinidine-N-oxide, alone and in combination with the parent drug in an experimental model using reperfusion arrhythmias in an isolated rat heart preparation. No definite pharmacological activity could be shown for quinidine-N-oxide up to concentrations of 16 mg/l. Quinidine and 3 hydroxyquinidine prevented ventricular fibrillation and ventricular tachycardia after coronary reperfusion in a concentration-dependent manner. The relationship between the drug concentration in the perfusate and the fractional suppression of arrhythmia could be described adequately for both compounds by the Hill equation. Whereas no difference was found for the Hill coefficient, the estimates of the concentration associated with 50% arrhythmia suppression was significantly higher for 3-hydroxyquinidine (10.7 +/- 0.3 mg/l vs. 2.2 +/- 0.25 mg/l), indicating that the relative potency of the metabolite was only about 20% compared to the parent compound. To investigate the pharmacodynamic interaction of the two compounds the concentration-response curve was determined for quinidine also in the presence of 3-hydroxyquinidine at a constant concentration of 4 mg/l. A method has been derived that allows quantitative assessment of the pharmacodynamic interaction of two compounds for which the concentration-effect relationship can be described by the Hill equation. The results indicate that the antiarrhythmic effects of 3 hydroxyquinidine and quinidine are additive. PMID- 3668861 TI - Possible heterogeneity of adenosine receptors present on myenteric nerve endings. AB - The presence of more than one adenosine receptor on enteric nerve endings was investigated using the electrically stimulated guinea pig ileum preparation and purified myenteric varicosities obtained from the same source. Competition experiments, using N6-cyclohexyladenosine and 5'-N-ethylcarboxamide adenosine as the labeled ligands allowed the binding characteristics of the adenosine receptor(s) on myenteric nerve endings to be examined. The results showed that both N6-cyclohexyladenosine and 5'-N-ethylcarboxamide adenosine were equieffective as displacers of labeled N6-cyclohexyladenosine binding. In contrast, the binding of labeled 5'-N-ethylcarboxamide adenosine revealed an inability of the A1 ligands N6-[R-1-methyl-2-phenethyl]adenosine and N6 cyclohexyladenosine to displace more than 50% of its specific binding. Competition curves generated using the potent and selective adenosine receptor antagonist 1,3-dipropyl-8-(4-sulfophenyl)xanthine revealed a clear difference between displacement profiles for N6-cyclohexyladenosine and 5'-N ethylcarboxamide adenosine. These data are indicative of the presence of more than one binding site on enteric nerve endings. Schild analysis of the antagonism of the presynaptic inhibitory effects of the nucleosides on the ileum using theophylline yielded linear isoboles with unit slopes indicating competitive antagonism. Similar analysis using 1,3-dipropyl-8-(4-sulfophenyl)xanthine yielded comparable results for the A1 agonists whereas 5'-N-ethylcarboxamide adenosine gave rise to a curvilinear isobole, a finding consistent with possible receptor heterogeneity. These findings show that data derived from both binding and functional studies support the existence of more than one adenosine receptor on myenteric nerves although they do not permit the subclassification of these sites as A1 or A2 receptor subtypes. PMID- 3668862 TI - Stereoselective glutathione conjugation and amidase-catalyzed hydrolysis of alpha bromoisovalerylurea enantiomers in isolated rat hepatocytes. AB - alpha-Bromoisovalerylurea (BIU) is used as model substrate for studies on the pharmacokinetics of glutathione conjugation in vivo. Its metabolism in isolated rat hepatocytes is presently studied. A major part of the substrate was conjugated with glutathione, but also amidase-catalyzed hydrolysis occurred, resulting in the products urea and alpha-bromoisovaleric acid (BI). The amidase activity was located in the microsomal fraction of the rat liver. The product of hydrolysis, BI, also was conjugated efficiently with glutathione. In glutathione depleted hepatocytes, no glutathione conjugates but only urea and BI were formed. A pronounced stereoselectivity in the metabolism of the BIU enantiomers was observed: (R)-BIU was conjugated with glutathione much faster than (S)-BIU. (S) BIU was hydrolyzed substantially in the cells and the glutathione conjugate of the hydrolytic product, (S)-BI, could be detected. At high BIU concentrations (500 microM of the racemate) intracellular glutathione was seriously depleted; then, the cosubstrate availability most likely was the rate-limiting factor in the conjugation of BIU with glutathione. More urea was formed from (racemic) BIU in isolated rat hepatocytes in the present study than in the perfused liver and the intact rat in previous studies. This in vivo-in vitro difference is tentatively assigned to differences in glutathione availability in these systems. The results suggest that BI may also be a useful model substrate to study the kinetics of glutathione conjugation in vivo and in vitro. PMID- 3668863 TI - Effect of AlCl3 and other acids on cerebrospinal fluid production: a correction. AB - Our earlier report that perfusion of Al and Ga salts through rat brain ventricles abolished cerebrospinal fluid (CSF) production is incorrect. We now realize there are three conditions which, when simultaneously present, will give a false reading of the events taking place. These are: metal salts, low pH with subsequent rise in pH during perfusion and use of blue dextran as the marker. When we perfused 10 mM AlCl3 or GaCl3 in vivo, all three conditions were provided, and led to the misinterpretation that all CSF production had been eliminated. In doing experiments that prevented the subsequent rise in pH during perfusion, or in using [14C]dextran as the marker in vivo, we found that Al and Ga (acting as Lewis acids at pH 4.7 and below), and also hydrochloric, phosphoric and acetic acids of the same pH, reduce CSF production by approximately 33%. We attribute this to the lowering of pH eliminating the uncatalyzed reaction OH- + CO2----HCO3- in secretory cells of choroid plexus. Acetazolamide blocks the HCO3- formation catalyzed by carbonic anhydrase, and reduces CSF production 42%. These mechanisms are additive in that, when acetazolamide and either Al or acetic acid are given together, there is a total reduction of 64%. Therefore, at least 64% of CSF production is dependent on formation of HCO3-. The mechanisms accounting for the balance of CSF production are not yet defined clearly. A significant portion of this production is expected to relate to transport of Cl-. PMID- 3668864 TI - Inhibition and induction of rabbit liver microsomal cytochrome P-450 by pyridine. AB - The effects of acute and chronic administration of pyridine (PY) on rabbit hepatic microsomal cytochrome P-450-catalyzed drug metabolism have been examined. PY inhibited cytochrome P-450-catalyzed drug metabolism in vitro and in vivo. Noncompetitive inhibition of microsomal drug metabolism was observed with inhibitory constant (Ki) values ranging between 2.0 and 6.0 mM. Acute PY administration, 100 mg/kg i.p., prolonged hexobarbital sleep time in rats 2.5 fold. Chronic administration of PY to rabbits resulted in increased hepatic microsomal cytochrome P-450 content, with induction of different form(s) exhibiting elevated catalytic activities toward PY, N-nitrosodimethylamine, alcohols and aniline. PY administration (100 mg/kg i.p. for 5 days) to rabbits increased hepatic microsomal cytochrome P-450 content over 2-fold relative to uninduced animals. Sodium dodecylsulfate-polyacrylamide gel electrophoresis of PY induced microsomes revealed protein bands of enhanced intensity occurring in the regions of P-450 LM3 and LM4. Both PY- and imidazole-induced microsomes were effective in the production of PY N-oxide, with Vmax values of 1.6 and 1.8 nmol/min/mg of protein, respectively. When rates were normalized for P-450 content, PY- and imidazole-induced microsomes produced 0.9 nmol of PY N oxide/min/nmol of P-450, comparable to that obtained for PB-induced suspensions. N-nitrosodimethylamine N-demethylase activity was enhanced 2.5- and 6-fold relative to PB- and beta-naphthoflavone-induced microsomes, respectively. A single low KM value of 0.17 mM was obtained for N-nitrosodimethylamine N demethylase activity in PY-induced microsomes; in contrast PB- and beta naphthoflavone-induced microsomes yielded biphasic kinetics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668865 TI - Electrophysiological evaluation of a partial agonist of dopamine receptors. AB - The ergot derivative trans-dihydrolisuride (TDHL) was tested for its effects on firing rates of dopaminergic (DA) neurons located in the substantia nigra pars compacta of chloral hydrate-anesthetized rats. Using extracellular single barreled microelectrodes, DA neurons were identified by their long duration, positive-negative action potentials and their slow bursting pattern of spontaneous firing, as well as by the location of recording sites through histological recoveries of dye deposits. Like haloperidol and clozapine, which are full DA receptor antagonists, TDHL antagonized the depression in DA neuron firing induced by systemic amphetamine. However, where full antagonists completely reversed the amphetamine effect, TDHL could do so only partially, the maximal effect being around half. Like DA agonists, but unlike DA antagonists, TDHL also depressed the spontaneous firing rates of DA neurons. But whereas the full agonist apomorphine completely inhibited firing of DA neurons, TDHL only depressed firing rates by about half, even at high doses. These data support the contention that TDHL is a partial DA agonist. PMID- 3668866 TI - Potentiation of enkephalin action by peptidase inhibitors in rat locus ceruleus in vitro. AB - Intracellular recordings were made from locus ceruleus (LC) neurons in slices of rat pons. It has been shown previously that opioids inhibit firing and hyperpolarize LC neurons by activating mu-opioid receptors. Concentration response curves were constructed by measuring the hyperpolarization, or outward current at -60 mV, caused by various opioid agonists added to the superfusing solution. Peptidase inhibitors (kelatorphan, bestatin and thiorphan) each increased the potency of Met-enkephalin, Leu-enkephalin and metorphamide but had no effect of their own on the LC neurons. Kelatorphan (20 microM) produced a 7 fold shift to the left of the Met-enkephalin dose-response curve. Higher concentrations produced no further shift. Thiorphan (3 microM) and bestatin (20 microM) each had a smaller potentiating effect on the Met-enkephalin hyperpolarization. The effects of Tyr-D-Ala-Gly-MePhe-Gly-ol and noradrenaline were not potentiated by these peptidase inhibitors. Electrical stimulation produced an inhibitory synaptic potential that was prolonged by cocaine (10 microM) and blocked by the alpha-2 adrenoceptor antagonist idazoxan (1 microM). After addition of idazoxan, hyperpolarizing synaptic potentials could be evoked even in the presence of kelatorphan (20 microM). These results indicate that peptide metabolism in the intact brain slice can account for a substantial decrease in the sensitivity of LC neurons to exogenously applied opioid peptides; even after peptidase inhibition, no evidence could be obtained for hyperpolarizing synaptic potentials due to the release of endogenous opioids. PMID- 3668867 TI - Pharmacologic profile of fezolamine fumarate: a nontricyclic antidepressant in animal models. AB - Fezolamine [N,N-dimethyl-3,4-diphenyl-1H-pyrazole-1-propanamine-(E)-2- butenedioate] is a new, nontricyclic agent under investigation as a potential antidepressant. In vitro, it was 3 to 4 times more selective in blocking synaptosomal uptake of [3H]norepinephrine than uptake of [3H]serotonin or [3H]dopamine. In classical behavioral tests using monoamine-depleted animals, it prevented the depressant effects of reserpine and tetrabenzine. In addition, it was active in the "behavioral despair" procedure. Its potency in three of these models was similar to that of standard tricyclics (e.g., imipramine, amitriptyline) or newer nontricyclic antidepressants (e.g., bupropion). In the mouse mydriasis and oxotremorine antagonism models, anticholinergic properties of fezolamine were weak or absent compared with imipramine and amitriptyline. Locomotor activity in mice was not increased by fezolamine at doses 2 to 16 times greater than effective antidepressant doses, suggesting the absence of central nervous system stimulant properties. Fezolamine did not inhibit monoamine oxidase activity in ex vivo studies and, unlike pargyline, did not produce locomotor hyperactivity in mice pretreated with L-tryptophan. In vitro studies using canine Purkinje tissue suggest that fezolamine has significantly less ability to depress myocardial conduction parameters than similar concentrations of imipramine. In a myocardially infarcted cat model, plasma levels of fezolamine 19 to 28 times greater than those achieved with imipramine were required before inducing significant depression of cardiac function and mean arterial pressure. Fezolamine, unlike imipramine, did not increase sinus rate. Fezolamine may thus show antidepressant efficacy in man with minimal anticholinergic or cardiovascular side effects common to tricyclic antidepressants. PMID- 3668868 TI - Mechanism of norepinephrine release elicited by renal nerve stimulation, veratridine and potassium chloride in the isolated rat kidney. AB - We have investigated the mechanism by which renal nerve stimulation (RNS), veratridine (Vt) and KCl promote release of norepinephrine in the isolated rat kidney perfused with Tyrode's solution and prelabeled with [3H]norepinephrine by examining the overflow of tritium elicited by these stimuli during 1) extracellular Ca++ depletion, 2) alterations in extracellular Na+ concentration and 3) administration of tetrodotoxin, amiloride, LiCl and calcium channel blockers. RNS (1-4 Hz), Vt (15-90 nmol) and KCl (150-500 mumol) produced renal vasoconstriction and enhanced the tritium overflow in a frequency- and concentration-dependent manner, respectively. Omission of Ca++ (1.8 mM) from the perfusion fluid abolished the renal vasoconstriction and the increase in tritium overflow elicited by RNA and KCl and substantially reduced that caused by Vt. Lowering the Na+ concentration in the perfusion medium (from 150 to 25 mM) reduced the overflow of tritium and the renal vasoconstriction caused by RNS (2 Hz) or Vt (45 nmol); the increase in tritium overflow in response to these stimuli was positively correlated with extracellular Na+ (25-150 mM). In contrast, KCl-induced tritium overflow was negatively correlated with extracellular Na+ concentration. Tetrodotoxin (0.3 microM) abolished the effect of RNS and Vt, but not that of KCl, to increase overflow of tritium and to produce renal vasoconstriction. Administration of amiloride (180 microM) enhanced the overflow of tritium but attenuated the associated renal vasoconstriction produced by RNS, Vt and KCl. Replacement of NaCl (75 mM) with equimolar concentration of LiCl enhanced the overflow of tritium elicited by RNS, Vt and KCl; the associated renal vasoconstriction remained unaltered. Administration of Ca++ channel blocker, flunarizine (2 microM), but not diltiazem (6 microM) or nifedipine (1.4 microM), inhibited RNS-, Vt- and KCl-induced overflow of tritium; nifedipine enhanced whereas diltiazem failed to alter tritium overflow elicited by these stimuli. The renal vasoconstriction produced by RNS, Vt and KCl was inhibited by diltiazem and nifedipine, as well as by flunarizine. These data suggest that RNS, Vt and KCl enhance release of the adrenergic transmitter by promoting influx of Ca++ into the nerve terminal, not by Na+-Ca++ exchange transport process, but rather through specific Ca++ channels that are distinct from those located in the vascular smooth muscle. PMID- 3668870 TI - The 64th annual meeting of the Physiological Society of Japan. Abstracts. April 1 3, 1987, Chiba. PMID- 3668871 TI - Your CE topic this month (No. 25). Osteoporosis in women: the importance of calcium. PMID- 3668869 TI - Effect of gamma-aminobutyric acid on neurally mediated contraction of guinea pig trachealis smooth muscle. AB - To determine whether gamma-aminobutyric acid (GABA) affects the contractile properties of airway smooth muscle and, if so, what the mechanism of action is, the authors studied guinea pig tracheal rings under isometric conditions in vitro. GABA and related substances, baclofen and muscimol, had no effect on the resting tension but reversibly depressed contractions induced by electrical field stimulation in a dose-dependent fashion, IC50 values (mean +/- S.E.) being 5.6 +/ 1.4 X 10(-6) M, 6.8 +/- 0.9 X 10(-6) M and 8.5 +/- 1.5 X 10(-5) M, respectively. In contrast, GABA did not alter the response to exogenous acetylcholine or the nonadrenergic noncholinergic inhibitory component. Pretreatment of tissues with bicuculline antagonized the inhibitory effect of GABA as well as that of baclofen. This inhibitory effect was not modified by propranolol, phentolamine, hemicholinium-3 or naloxone, but it was blocked by the Cl channel blocker furosemide and by the substitution of external Cl. These results suggest that GABA decreases the contractile response of airway smooth muscle to cholinergic nerve stimulation by inhibiting the evoked release of acetylcholine and that this effect is exerted by activating Cl-dependent, bicuculline-sensitive GABA receptors. PMID- 3668872 TI - LP/VNs can help their elderly patients overcome anxiety. PMID- 3668873 TI - Treating regressed elderly patients. Implications for the LP/VN. PMID- 3668874 TI - Caring for the stroke patient. A guide for LP/VNs. PMID- 3668875 TI - Your CE topic this month (No. 26). Gout: medical management. PMID- 3668876 TI - The Bulla ocular circadian pacemaker. I. Pacemaker neuron membrane potential controls phase through a calcium-dependent mechanism. AB - In an effort to understand the cellular basis of entrainment of circadian oscillators we have studied the role of membrane potential changes in the neurons which comprise the ocular circadian pacemaker of Bulla gouldiana in mediating phase shifts of the ocular circadian rhythm. We report that: 1. Intracellular recording was used to measure directly the effects of the phase shifting agents light, serotonin, and 8-bromo-cAMP on the membrane potential of the basal retinal neurons. We found that light pulses evoke a transient depolarization followed by a smaller sustained depolarization. Application of serotonin produced a biphasic response; a transient depolarization followed by a sustained hyperpolarization. Application of a membrane permeable analog of the intracellular second messenger cAMP, 8-bromo-cAMP, elicited sustained hyperpolarization, and occasionally a weak phasic depolarization. 2. Changing the membrane potential of the basal retinal neurons directly and selectively with intracellularly injected current phase shifts the ocular circadian rhythm. Both depolarizing and hyperpolarizing current can shift the phase of the circadian oscillator. Depolarizing current mimics the phase shifting action of light, while hyperpolarizing current produces phase shifts which are transposed approximately 180 degrees in circadian time to depolarization. 3. Altering BRN membrane potential with ionic treatments, depolarizing with elevated K+ seawater or hyperpolarizing with lowered Na+ seawater, produces phase shifts similar to current injection. 4. The light induced depolarization of the basal retinal neurons is necessary for phase shifts by light. Suppressing the light-induced depolarization with injected current inhibits light-induced phase shifts. 5. The ability of membrane potential changes to shift oscillator phase is dependent on extracellular calcium. Reducing extracellular free Ca++ from 10 mM to 1.3 X 10(-7) M inhibits light-induced phase shifts without blocking the photic response of the BRNs. The results indicate that changes in the membrane potential of the pacemaker neurons play a critical role in phase shifting the circadian rhythm, and imply that a voltage-dependent and calcium-dependent process, possibly Ca++ influx, shifts oscillator phase in response to light. PMID- 3668877 TI - The Bulla ocular circadian pacemaker. II. Chronic changes in membrane potential lengthen free running period. AB - We have used intracellular recording to directly measure the effects of three experimental agents, light, elevated potassium seawater, and lowered sodium seawater on the membrane potential of the putative circadian pacemaker neurons of the Bulla eye. These agents were subsequently tested for effects on the free running period of the circadian pacemaker. We report that: 1. When applied to the eye, light and elevated potassium seawater depolarized the putative pacemaker neurons, while lowered sodium seawater hyperpolarized them. The membrane potential changes induced by these agents are sustained for at least one hour, suggesting that they produce persistent changes in the average membrane potential of the putative pacemaker neurons. 2. The amplitude of the membrane potential response to the depolarizing agents varies with the phase of the circadian cycle. Depolarizations induced by light and elevated potassium seawater are twice as large during the subjective night than they are during the subjective day. No significant difference was found in the response to lowered sodium seawater at different phases. 3. Continuous application of each of these agents caused a lengthening of the free running period of the Bulla eye. Constant light increased the period by 0.9 h, while the other depolarizing treatment (elevated potassium seawater) increased the free running period by 0.6 h. Both treatments increased the mean peak impulse frequency of treated eyes. The hyperpolarizing treatment also increased the period of the ocular pacemaker (+0.8 h), but had little effect on peak impulse frequency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668878 TI - Neural mechanisms generating the leech swimming rhythm: swim-initiator neurons excite the network of swim oscillator neurons. AB - This paper describes newly identified excitatory connections linking the segmentally iterated swim-initiator interneurons with the network of oscillator neurons that generates the leech swimming rhythm. Apparently monosynaptic excitatory chemical connections are made from one class of swim-initiator neurons (cells 204/205) to several members of the swim oscillator network, including cells 28, 115 and, as described by Weeks (1982c), cell 208. A second class of swim-initiator neurons, cells 21 and 61, also excites this subset of the oscillator neurons. The unpaired swim oscillator neuron, cell 208, also chemically excites cells 28 and 115, apparently directly. Thus, in addition to its role as a member of the swim oscillator, the excitatory output from cell 208 to the swim oscillator adds to that provided by the swim-initiator neurons. The results of this paper enlarge the subset of identified swim oscillator neurons synaptically excited by the swim-initiator neurons. These newly described targets of the swim-initiators strengthen the hypotheses that: 1) the swim-initiator neurons supply much of the tonic excitatory drive responsible for activation and maintenance of the swim central motor program, and 2) the two classes of swim initiators, cells 204/205 and cells 21/61, act synergistically to initiate and maintain swimming. PMID- 3668879 TI - Defensive secretion of the tenebrionid beetle, Blaps mucronata: physical and chemical determinants of effectiveness. AB - The primary components of the defensive secretions of Blaps mucronata (Tenebrionidae) are two quinones (methyl-p-benzoquinone and ethyl-p-benzoquinone) and the hydrocarbon 1-n-tridecene. The hydrocarbon is shown, by comparison with longer- and shorter-chain n-alkanes and 1-n-alkenes, to be optimally suited as carrier of the quinones, and as a surfactant that promotes spread of secretion over the beetle's body following discharge from the gland openings at the abdominal tip. As shown from repellency tests with ants (Monomorium pharaonis) and topical irritancy tests with cockroaches (Periplaneta americana), the anti insectan potency of the secretion derives as much from the hydrocarbon as from the quinones. PMID- 3668880 TI - Correlation between auditory thalamic area evoked responses and species-specific call characteristics. II. H. Hyla cinerea (Anura: Hylidae). AB - Evoked potentials were recorded from the posterior dorsal thalamus of green treefrogs (Hyla cinerea) in response to single tones and combinations of two and three tones. 1. The responses to two tones were largest when one of the component tones was 500 Hz and when the second component was between 2000 and 4000 Hz (Fig.3). 2. The response to 500 + 3000 Hz showed nonlinear facilitation; i.e., the amplitude of the response was greater than the sum of the responses to the component tones alone (Figs. 4, 5). This result provides evidence that cells functioning as 'AND' gates will be found in this center. 3. When a third tone around 1200 Hz was added to a stimulus of 500 + 3000 Hz a 65% decrease in the evoked response amplitude occurred (Fig. 6). 4. The largest evoked response amplitude to a two-tone stimulus (500 + 3000 Hz) occurred when the rise-time was less than 50 ms (Fig. 7). 5. The two-tone tuning was found to be temperature dependent. The optimal lower frequency tone shifted downward with decreasing temperatures (Fig. 8). 6. When the temperatures of the neurophysiological and the behavioral experiments are matched, the optimal stimuli for evoking a large response are closely correlated to the parameters of the acoustic stimuli preferred by gravid H. cinerea females in discrimination tests. This center therefore appears to be very important for the processing of complex species specific sounds. PMID- 3668881 TI - Sleep and EEG spectra in the Syrian hamster (Mesocricetus auratus) under baseline conditions and following sleep deprivation. AB - Sleep was studied by continuous 24-h recordings in adult male Syrian hamsters, chronically implanted with EEG and EMG electrodes. Three vigilance states were determined using visual scoring and EEG power spectra (0.25-25 Hz) computed for 4 s episodes. The effects of two methods of total sleep deprivation (SD) were examined on vigilance states and the EEG power spectrum. The animals were subjected to 24 h SD by: (1) forced locomotion in a slowly rotating drum, (2) gentle handling whenever the hamsters attempted a sleeping posture. In addition, the hamsters were subjected to SD by handling during the first 3 h of the L period. Sleep predominated in the L period (78.2% of 12 h) and the D period (51.2%). The power spectra of the 3 vigilance states were similar during the L and D period. In NREM sleep, power density values in the low frequency range (0.25-6.0 Hz) exceeded those of REM sleep and W by a maximum factor of 8.3 and 2.8, respectively. At frequencies above 16 Hz, NREM and REM sleep power density values were significantly lower than during W. A progressive decrease in power density for low EEG frequencies (0.25-7 Hz) during NREM sleep was seen in the course of the L period. Power density values of higher frequencies (8-25 Hz) increased at the end of the L period and remained high during the first hours of the D period. The effect of prolonged SD on vigilance states and EEG spectra was similar by both methods and strikingly small compared to similar results in rats. In contrast, 3 h SD induced a large and more prolonged effect. The similarities and differences of sleep and sleep regulation are summarized for the hamster, rat and man. PMID- 3668882 TI - Entrainment of the circadian rhythm in the rat pineal N-acetyltransferase activity by prolonged periods of light. AB - Entertainment of the circadian rhythm in the pineal N-acetyltranferase activity by prolonged periods of light was studied in rats synchronized with a light:dark regime of 12:12 h by observing phase-shifts in rhythm after delays in switching off the light in the evening or after bringing forward of the morning onset of light. When rats were subjected to delays in switching off the light of up to 10 h and then were released into darkness, phase-delays of the evening N acetyltransferase rise during the same night corresponded roughly to delays in the light switch off. However, phase-delays of the morning decline were much smaller. After a delay in the evening switch off of 11 h, no N-acetyltransferase rhythm was found in the subsequent darkness. The evening N-acetyltransferase rise was phase-delayed by 6.2 h at most 1 day after delays. Phase-delays of the morning N-acetyltransferase decline were shorter than phase-delays of the N acetyltransferase rise by only 0.7 h to 0.9 h at most. Hence, 1 day after delays in the evening switch off, the period of the high night N-acetyltransferase activity may be shortened only slightly. The N-acetyltransferase rhythm was abolished only after a 12 h delay in switching off the light. Rats were subjected to a bringing forward of the morning light onset and then were released into darkness 4 h before the usual switch off of light. In the following night, the morning N-acetyltransferase decline, but not the evening rise, was phase advanced considerably. Moreover, when the onset of light was brought forward to before midnight, the N-acetyltransferase rise was even phase-delayed. Hence, 1 day after bringing forward the morning onset of light, the period of the high night N acetyltransferase activity may be drastically reduced. When rats were subjected to a 4 h light pulse around midnight and then released into darkness, the N acetyltransferase rhythm in the next night was abolished. The data are discussed in terms of a two-component pacemaker controlling the N-acetyltransferase rhythm. It is suggested that delays in the evening switch off of light may disturb the N acetyltransferase rhythm the next day only a little, as the morning component may adjust to phase-delays of the evening component almost within one cycle.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3668883 TI - Stress management for essential hypertension: comparison with a minimally effective treatment, predictors of response to treatment, and effects on reactivity. AB - Few studies of psychological interventions for essential hypertension have incorporated comprehensive coping skills treatment programs, evaluated the efficacy of such programs against credible, minimally effective controls, examined the effects of these interventions on pressor responses, or clarified the nature of person by treatment interactions. The present study examined the relative effectiveness of multimodal stress management training and a minimally effective treatment control (i.e. GSR biofeedback training) in the treatment of essential hypertensives' blood pressure at rest and in response to simulated stressful interpersonal situations. At the conclusion of an 8 week training period, stress management participants exhibited reliably lower resting diastolic blood pressure and tended to exhibit lower systolic pressure than controls. The former condition maintained their lower pressures through a 6-month follow-up period, but decreases in controls over follow-up rendered the conditions equivalent in blood pressure. No differences between conditions emerged in analyses on pressor responses. Stress management training was somewhat more effective for individuals scoring low rather than high on measures of trait anxiety and irritability. PMID- 3668884 TI - A two year follow-up of somatic complaints among Israeli combat stress reaction casualties. AB - The relationships of somatic complaints and health related habits to combat stress reaction and post-traumatic stress disorder were assessed one and two years after the 1982 Lebanon War. The sample consisted of 285 combat stress reaction Israeli casualties and 198 comparable controls. Results showed that higher rates of somatic complaints were reported by both combat stress reaction and post-traumatic stress disorder casualties at the two points in time. Theoretical and methodological implications were discussed. PMID- 3668885 TI - Psychological predictors for return to work after a myocardial infarction. AB - The relationships between a return to work (RTW) 6 months after a myocardial infarction and selected personality traits, emotional reactions, health knowledge and beliefs, expectations and global health perceptions have been examined in a prospective study of 249 patients below 67 yr of age. Patients' in-hospital expectations of their future work capacity proved to be a strong predictor for RTW. In addition, level of anxiety and depression during hospitalization and level of cardiac lifestyle knowledge were independently associated with RTW. These effects could not be explained by demographic, work-related, or medical factors. It is concluded that patients' early illness perceptions and affective reactions influence later work resumption. Outcome-specific expectancy measures may be the most effective methods for early identification of patients needing rehabilitation efforts after an acute somatic disease. PMID- 3668886 TI - The psychiatric and social characteristics of patients with functional dysphonia. AB - Of 121 consecutive outpatients seen in an ENT clinic who received a diagnosis of functional dysphonia, 71 who were referred to the speech therapy department were interviewed. Sixty one (86%) were women, and the mean age of the group was 47.6 yr. The commonest voice disorder was huskiness or hoarseness, and only five patients had a pure 'whispering' dysphonia. There was little evidence of major psychiatric disorder in the group: eight patients had a past psychiatric history; two had histrionic personality disorder, and 22 (33%) had clinically diagnosable mood disorders which were mainly anxiety/tension states. This descriptive study formed the background for an investigation of the psychosocial stressors preceding onset of functional dysphonia. PMID- 3668887 TI - The relationship between pre-operative anxiety and post-operative delirium. AB - Forty five elderly patients undergoing total hip replacements were assessed one day before and two days after surgery in order to explore the relationship between pre-operative anxiety and post-operative delirium. Anxiety was measured by the State-Trait Anxiety Inventory and delirium was measured by a decrease in various measures of cognitive functioning. No relationship was found and this is discussed in the light of two theories which would have predicted one. Other secondary findings are reported and discussed. PMID- 3668889 TI - The blending of colours. PMID- 3668888 TI - Body image distortion in non-eating disordered women and men. AB - This study of body image perception in 100 non-eating disordered women and men demonstrates that overperception of body widths, whilst accurately perceiving a neutral object, is not restricted to populations with eating disorders, nor is it peculiar to women. Men consistently overestimated body widths to the same extent as female subjects. Overall, 84% of women and 52% of men wished to weigh less. Considering those subjects within the 10% range of Mean Matched Population Weight (MMPW), men wished to be 0.75 kg heavier, whilst women at MMPW wished to weigh 3.25 kg less. For women, the subjects who were most satisfied with their actual weight were those who were well below MMPW. There is a tendancy that the greater the deviation of weight from normal, in either direction, the greater the degree of body width overestimation. These results suggest that the overperception of body width is more related to current weight than to concern about weight and shape, or to the presence or absence of an eating disorder. They question the use of empirical body size estimation measurement in eating disordered populations. PMID- 3668890 TI - Outbreak of methicillin resistant Staphylococcus aureus in a Royal Naval hospital. PMID- 3668891 TI - Pes anserinus transfer for antero-medial instability of the knee. PMID- 3668892 TI - Anthropometry in the Royal Navy. PMID- 3668893 TI - Jet ventilation during microlaryngeal surgery. An anaesthetic technique employing the Accutronic VS-150 High Frequency Jet Ventilator. PMID- 3668895 TI - The first Antarctic winter in tents: the Joint Services Expedition to Brabant Island. PMID- 3668894 TI - Lateral release for patello femoral pain. PMID- 3668896 TI - Relationship between age and NSAID. PMID- 3668897 TI - 137Cs in urine of tourists who visited Kiev late in April, 1986. Estimation of the intake of 137Cs and 239Pu due to the nuclear reactor accident. PMID- 3668898 TI - Circadian variation in lung tumor induction with X-rays in mice. PMID- 3668899 TI - Reduction of blood cholesterol levels in the population: can it be done? PMID- 3668900 TI - Self-care--opting out or opting in? PMID- 3668901 TI - Problem drinking. PMID- 3668902 TI - An analysis of lay medicine: fifteen years later. AB - Five hundred patients were asked what advice they had received before attending the doctor's surgery. The results were analysed and compared with an identical survey carried out in 1970. There have been few changes in the frequency and nature of lay advice over the last 15 years, with women still being the chief source of informal advice; the advice from men was generally to go to the doctor. Pharmacists play an increasing role and television is mentioned three times more often as a source of information in 1985 than 1970. Home doctor books are more up to date and are used more frequently. Self-care and lay advice remain important sources of medical care, suggesting that health education is a matter of priority. PMID- 3668903 TI - A search for subclinical infection during a small outbreak of whooping cough: implications for clinical diagnosis. AB - The transmission of whooping cough in a general practice community was followed after the identification of the first case for nearly three years. Intensive case finding was undertaken to detect contacts of known cases of whooping cough and to take pernasal swabs from those with any cough; 102 swabs were taken. In three months 39 cases of whooping cough were clinically diagnosed, 17 (44%) of which were confirmed bacteriologically. All had a prolonged paroxysmal cough, one-third reported a catarrhal phase, 18 (46%) vomited with paroxysms and nine (23%) whooped. No isolations of Bordetella pertussis were obtained from the 84 contacts with non-paroxysmal coughs. There was no evidence that subclinical bordetella infection (showing none of the signs of whooping cough) is a common occurrence.It is probable that many recognizable cases of whooping cough are missed because it can be a milder illness than is often realized and commonly exhibits neither whooping, vomiting nor a catarrhal phase. Paroxysms may be infrequent. The diagnosis of whooping cough should be suspected from a prolonged paroxysmal cough alone. PMID- 3668904 TI - Management of hypertension in twelve Oxfordshire general practices. AB - The general practice records of 2371 hypertensive patients on drug therapy in 12 practices were reviewed retrospectively. It was found that the mean systolic blood pressure of the patients had fallen by 29 mmHg and the mean diastolic pressure by 16 mmHg after one year of treatment and that there was a further reduction of 5 mmHg in the systolic pressure and 5 mmHg in the diastolic pressure at the most recent recording of blood pressure. Half of the patients had only a single blood pressure reading recorded before treatment was started and for 56% of the patients there was no record of smoking habit and for 69% no record of weight. Twenty-seven per cent of the patients suffered from mild hypertension, that is blood pressure less than 180/110 mmHg, and 56% were over 65 years of age. These results indicate the need for policies for selection of patients for treatment and for standards of recording. It is suggested that practices should review their results and undertake to treat elderly hypertensive patients and those with mild hypertension only when they can demonstrate that their policies are effective for young hypertensive patients and for those with moderate or severe hypertension. PMID- 3668906 TI - Video recording in general practice: the patients do mind. AB - The consent rate for video recording of consultations was examined in a semi rural training practice in Scotland using a sample of over 1000 patients. An attempt was made to reduce the coercive methods of obtaining consent used in previous studies. In a first study explanatory letters were left in the waiting area - 273 patients returning to reception were asked if they wished to be filmed at a later date - 61 patients (22%) agreed. In a second study 830 patients were handed an explanatory letter asking if they wished to be filmed - 48 patients (6%) volunteered. The overall consent rate for the two studies combined was 10%. The low rate of consent obtained from these patients questions the propriety of using coercive methods. PMID- 3668905 TI - Family influences on the development of psychological problems in teenagers. AB - A study was designed to test the opinion that teenagers at risk of psychological disturbance can be identified on the basis of their family background. A copy of the general health questionnaire (28-question version) was sent to 322 17- and 18 year-olds registered with a semi-rural group practice. The records of all the 195 teenagers who replied, and those of their parents, brothers and sisters were examined and any record of chronic illness and psychological or social problems noted. Teenagers with family disruption, legal difficulties, parental marital problems or maternal psychiatric disorder recorded in the medical notes of their families were significantly more likely to have a high score on the general health questionnaire than those without such a record. Teenagers with high scores had attended the surgery more frequently during the previous year than those with low scores. Further work may enable more precise recording of family problems and enable a group at high risk of developing distressing psychological symptoms to be clearly identified. By early identification of this group, the general practitioner may be in a position either to prevent problems arising, or to intervene more effectively if a crisis develops. PMID- 3668907 TI - Job-loss and morbidity in married men with and without young children. AB - The data resulting from a longitudinal study of the consequences of threatened and eventual job-loss on health in industrial employees was examined in order to analyse the influence of family size. When the risk factor of age was eliminated, no difference was found in the use made of health services by married men with at least two dependent children aged under 16 years and those with no dependent children. However, the wives of men with no dependent children consulted at a significantly higher rate than the wives of men with dependent children in the period when their husbands faced and then underwent job-loss. PMID- 3668909 TI - The synopsis record card: a stepping stone to the computer. AB - A synopsis record card has been developed for use in general practice to provide ready reference to the important facts of the patient's record. When such a card is available in the record wallet it is used at 50% of all patient consultations and significantly reduces the time needed to retrieve past data essential to the consultation. The card contains clinical details, and data on medication, drug idiosyncrasies, immunizations, screening procedures, social, occupational and family history and practice research. As synopsis records are particularly important in teaching practices and when referral letters to hospital or personal medical attendant insurance reports are written, provision has been made for the inclusion of data relevant to those functions. So that the card may act as an intermediary for record computerization, all elements needed in the construction of a computer record have been taken into account. The prototype card was circulated to 3000 RCGP members for comment and the majority of replies were favourable. Suggested modifications have been incorporated in the final design of the card. PMID- 3668908 TI - Job-loss and morbidity: the influence of job-tenure and previous work history. AB - As part of a longitudinal study on the consequences of job-loss on health the modifying influence of job-tenure on a group of factory workers made redundant when a meat products factory closed was examined. The older workers, both men and women, were divided into two groups which were comparable in all respects except for job-tenure. Statistically significant differences in morbidity were found when comparing the two groups of male employees and their families.However, the men with longer job-tenure (mean 30 years) had, with few exceptions, served the company since leaving school. All of the other men (mean job-tenure 11 years) had previously worked elsewhere or been unemployed. The uptake of medical services before and after factory closure was therefore compared in two groups of workers and their families. One group who had previous experience of the job market showed a significant rise in morbidity only during the unsettling three years before factory closure. The other group, whose working lives had been spent wholly with the company, showed only a slight anticipatory effect but then demonstrated statistically significant increases in consultation rates after job loss. Three years later they still showed no signs of adapting to their situation.The results suggest that previous experience of having no job or of having to change jobs may be just as influential as job tenure on the outcome of health before and after compulsory redundancy. PMID- 3668910 TI - Patterns of care for the elderly in general practice. AB - Little is known about the care provided for the elderly by general practitioners. This study is based on data from 89 030 consultations with patients of all ages of which 17 771 were with patients over 65 years of age. It was found that general practitioners carry out more follow-up work with their elderly patients than with their younger patients and they make more home visits and referrals to nursing and social services. However, they do less investigative work with elderly patients and the level of referral to consultants is the same for patients of all ages. Considerable variation was found between doctors in the pattern of care provided for older patients. The proportion of elderly patients on the list of a general practitioner had little effect on his overall workload. The implications of these findings for health service research and planning are discussed. PMID- 3668911 TI - General practitioners' awareness of the drinking and driving offender. PMID- 3668912 TI - Asthma and whooping cough. PMID- 3668914 TI - Extended residential courses. PMID- 3668913 TI - Benefits of the portable haemoglobinometer in group practices. PMID- 3668915 TI - Coxsackie B viruses and the post-viral syndrome: a prospective study in general practice. AB - In a prospective study sera from 140 patients with symptoms suggesting a post viral syndrome and sera from 100 controls were tested for neutralizing antibodies to Coxsackie B viruses. Sixty-five of the patients (46%) and 25 of the controls (25%) had significant antibody titres. The 65 positive cases who had presented with symptoms were followed up and retested six months later and again after one year. Of these 65 patients 36 (55%) were still unwell after one year and high antibody titres persisted in all but two of the patients. Recovery was not found to correlate with a fall in antibody level, but was more rapid in patients whose presenting symptoms were paraesthesiae, anorexia or dyspnoea. The importance of correctly identifying patients with the post-viral syndrome, who may otherwise be labelled neurotic, is emphasized. PMID- 3668917 TI - The importance of list size and consultation length as factors in general practice. AB - It is commonly believed that longer consultations are essential to better care and that this can only be achieved by lowering list sizes. The results of a survey of general practitioner trainers show that, on average, the time given to each patient was longer when general practitioners had lower list sizes, but that for a substantial minority of doctors list size played no part. Although the evidence is inconclusive, patients registered with lower list size general practitioners consulted more and received prompter attention. Doctors with smaller lists worked shorter hours and felt less overworked. However most of the correlates were weak owing to great individual differences of practice style between general practitioners. If a case for lower list sizes is to carry force, stronger evidence is needed that patients will receive more of their general practitioners' attention. PMID- 3668916 TI - Screening for psychiatric illness in general practice: the general practitioner versus the screening questionnaire. AB - This study compares the characteristics of general practitioners and a pen and paper test in the detection of psychiatric disorder in primary care settings. A psychiatrist interviewed a stratified sample of 283 patients drawn from 590 consecutive new illnesses seen in 15 general practices. Research diagnoses could be made in between one-quarter and one-third of the consecutive new illnesses. Two different research diagnostic systems agreed quite well with one another about who should be regarded as a psychiatric 'case' - although agreement between them for individual diagnoses was less impressive. Research diagnoses of psychiatric illnesses could be made in approximately 30% of new episodes of illnesses seen. If the DSM-3 system was used as a criterion of 'caseness', the specificity of the general health questionnaire was 75.4%, and the sensitivity was 87.1%. The general practitioners had fewer false positives than the questionnaire, but they were much more likely to miss psychiatric cases. Use of the general health questionnaire could increase their sensitivity from about 50% to 95%. PMID- 3668918 TI - Money and the nature of practice. PMID- 3668919 TI - Postnatal care--who cares? PMID- 3668920 TI - Consulting patterns: comparison between doctors' perceptions and patients' behaviour. AB - Changes in the structure of a practice and the gender of the partners were accompanied by the abandonment of a personal list system. Doctors' opinions about the consulting behaviour of patients in the practice were determined by questionnaire. The notes of 100 patients registered with each of the six partners were examined to determine the nature and number of consultations with each doctor for the years 1980 and 1984. Doctors were found to be unaware of the reasons for which patients consulted different partners. In addition, doctors' opinions about how patients should consult did not correlate with patients' consulting behaviour. It was also found that women consulted the female partners in the practice more commonly than the male partners only after the number of women partners in the practice had increased from one to two. PMID- 3668921 TI - Parents' attitudes to measles immunization. AB - A study of a cohort of children in Maidstone Health Authority examined the reasons for the failure to achieve targets for the uptake of measles immunization. Parents were interviewed before they were notified about measles immunization to determine their attitudes, beliefs and intentions regarding measles immunization and a further review was held with those whose child had no record of the immunization by the age of 20 months. The initial interview showed that most parents have a favourable attitude to measles immunization. However, many lacked knowledge, especially about valid contraindications, and claimed not to have received advice from a doctor or health visitor. The most common reasons for non-uptake of measles immunization were: the child had already had measles, concern about contraindications and delay owing to illness. This points to the importance of increasing doctors' and health visitors' knowledge of Department of Health and Social Security guidelines regarding valid contraindications and to the role of health visitors in promoting uptake. However there is also evidence that the gap between actual and target levels of uptake may be less than official figures suggest. PMID- 3668922 TI - General practitioner beds in Finland--lessons for the UK? AB - The Finnish Primary Health Care Act of 1972 aimed to provide comprehensive health care to the population. One consequence was an increase in the number of beds for the use of general practitioners, so that there are now 2.2 general practitioner beds per thousand population. Use of these beds varies with the location of the health station in which they are situated, but in rural areas approximates to that of general practitioner hospitals in the United Kingdom. Despite integration of general practitioner beds into overall planning, some potential benefits of these facilities have not been realized. For the UK, with traditions of personal general practice and continuity of care, the Finnish system offers one model of community care which may have medical and economic advantages. PMID- 3668923 TI - Primary medical care in Sri Lanka: hospital or general practice? AB - A study was undertaken to compare aspects of patient care in private general practice and in a hospital emergency care clinic in Sri Lanka. General practitioners were found to spend more time with each patient, were more likely to write some kind of patient record and were more likely to carry out immunizations and investigations. They prescribed less and referred to specialists less than their colleagues in hospital primary care. In concluding that general practitioners in Sri Lanka provide an important part of primary care the 'orthodox' view that developing countries cannot afford this type of system is challenged. PMID- 3668924 TI - Delayed psychiatric sequelae among Falklands war veterans. AB - The only published account to date of psychiatric complications among Falklands war veterans suggests that acute reactions are rare. Reported here are three cases of severe delayed reactions in Falklands veterans from South Wales. All three cases demonstrate a common pattern similar to that shown by Vietnam war veterans. Possible aetiological factors and prevention are discussed. It seems likely that relatives of combatants will also be affected and general practitioners are in a unique position to recognize and treat these problems. PMID- 3668925 TI - An Australian's impression of general practice in the United Kingdom. PMID- 3668926 TI - James Mackenzie lecture 1986. Quality of caring--landscapes and curtains. PMID- 3668927 TI - Workload in general practice. PMID- 3668928 TI - Anaphylactic shock reaction to measles vaccine. PMID- 3668929 TI - Visits to children: is admission always required? PMID- 3668930 TI - Bacterial vaginosis. PMID- 3668931 TI - Living without health--a challenge to patient and doctor. PMID- 3668932 TI - Diagnosis and management of problem patients in general practice. PMID- 3668933 TI - General practitioners and alternative medicine. AB - A questionnaire on the views, beliefs and attitudes of doctors regarding alternative medicine was sent to 274 general practitioners. Of the 222 who replied, 31% said that they had a working knowledge of at least one form of alternative medicine, 29% had read publications on alternative medicine and 41% had attended lectures or classes in alternative medicine. Twelve per cent had received training and 42% wanted further training in an alternative form of medicine; 16% currently practised a form of alternative medicine. The majority of doctors (95%) said that patients had discussed alternative medicine with them during the past year and over half (59%) had referred patients to alternative practitioners. Forty-one per cent of doctors believed that alternative systems of medicine were valid and over half of the doctors (54%) defined alternative medicine as additional to western medicine, not taught in western medical schools or not available on the National Health Service, compared with only 16% who defined alternative medicine as unscientific. PMID- 3668934 TI - The red eye: a general practice survey. AB - A postal questionnaire was sent to all general practitioners registered in the United Kingdom enquiring about their experience, practice and attitudes regarding the red eye. Of the 31 500 questionnaires sent out 8742(28%) were returned. The doctors demonstrated a high level of anxiety about this condition combined with a low level of investigation. There was wide variation in the treatment of choice for non-specific conjunctivitis, with 10% of doctors choosing a steroid containing product. Diagnostic and therapeutic activity were more closely associated with the age of the doctor than with experience of ophthalmology. Further training at undergraduate or postgraduate level for general practice ophthalmology appears desirable. PMID- 3668935 TI - Who cares for the patient with diabetes? Presentation and follow-up in seven Southampton practices. AB - A notes survey was undertaken by a group of eight general practitioners in seven Southampton practices to study the mode of presentation and follow-up of the diabetic patients on the lists of 24 doctors. The 431 known diabetic patients were classified as non-insulin-dependent (67%), insulin-dependent (20%), or, if they had commenced their insulin more than a month after the diagnosis had been made, 'insulin-treated' (13%). This classification allowed characterization of the truly insulin-dependent and non-insulin-dependent patients.Non-insulin dependent diabetics were older than insulin-dependent diabetics and had first presented at a greater age. Most patients in each treatment group presented with classical diabetic symptoms, diabetes-related infections, or recognized complications. The majority of these were diagnosed in general practice. However, over half of the asymptomatic non-insulin-dependent diabetic patients had been diagnosed by routine blood or urine testing in hospital. After 1979 fewer non insulin-dependent diabetic patients were referred to hospital for follow-up at diagnosis than before 1975.Most non-insulin-treated diabetics were followed up in general practice whereas most patients treated with or dependent on insulin were followed up in hospital clinics. Twenty-two per cent of all patients received diabetic care from both their general practitioner and hospital outpatient departments but 20% received no regular diabetic follow-up at all. One year after the initial study, 4% of patients were still without regular review, and 27 more patients had been identified who would have qualified for the original audit. PMID- 3668936 TI - Imported malaria in the UK: advice given by general practitioners to British residents travelling to malaria endemic areas. AB - General practitioners are in a key position to provide advice to those travelling to malaria endemic areas. A study of at-risk travellers revealed that 54% visited their general practitioner before their intended trip overseas and of these 79% were given advice about antimalarial precautions. Of those advised 98% carried antimalarial tablets with them on their trip but only 46% had any knowledge of other methods of personal protection against malaria. Fewer non-white than white British residents received information from their general practitioners.It is suggested that general practitioners should be better informed about current malaria transmission and currently recommended chemoprophylactic drugs and dosages. It is also suggested that the major public health priority should be to stimulate a greater involvement of non-health service agencies in order to make the public aware of the risk of malaria and seek medical advice before travel. PMID- 3668937 TI - Alcohol consumption in pregnancy--a health education problem. AB - The drinking habits, demographic characteristics and knowledge about the effects of drinking during pregnancy of 380 pregnant women in Belfast were investigated. Forty-five per cent of the women were non-drinkers, 39% were occasional drinkers and 16% were regular drinkers. The majority of women knew that alcohol could harm their babies but were unsure of the specific effects. Regular drinkers were more likely than occasional drinkers or non-drinkers to say that harm would only be done if alcohol was taken in excess. The topic of alcohol is rarely discussed at antenatal clinics and cases of fetal alcohol syndrome, an uncommon but preventable condition, are probably being missed as a result. There is a need for more health education for the general public, especially school children, and for increased awareness among health professionals that the problem of alcohol in pregnancy exists and is likely to increase if the trend towards alcohol abuse among the younger members of the population continues. PMID- 3668938 TI - A case of neonatal conjunctivitis caused by chlamydia? PMID- 3668939 TI - Rubella vaccination--what happens in practice. PMID- 3668940 TI - Weight reduction in the management of hypertension. PMID- 3668941 TI - Can general practitioners teach other general practitioners? PMID- 3668942 TI - Induction of oestrus and ovulation in farmed fallow deer (Dama dama) by using progesterone and PMSG treatment. AB - Twenty non-lactating fallow does were each treated with an intravaginal progesterone device (CIDR) for 14 days followed by an i.m. injection of 500 i.u. PMSG, 3-4 weeks before the expected start of the natural rut. An additional 7 does received no treatments and were used as controls. Induced oestrus was observed for 19 (95%) of the treated does, the onset occurring between 48 and 76 h after CIDR removal/PMSG administration. Laparoscopic examination 12 days after CIDR removal revealed ovulation rates ranging from 1 to 4 in treated does. Non ovulating luteinized follicles were also a feature of PMSG treatment and there was a significant inverse relationship between ovulation rate and numbers of luteinized follicles. Only 3 (14.3%) of the treated does conceived at or near the induced oestrus, the remainder returning to oestrus 21-27 days later. Mid-cycle progesterone concentrations were positively related to ovulation rate. All control does showed evidence of a recent single ovulation at laparoscopy, although first oestrus did not occur until 7-15 days later, indicating the occurrence of silent ovulations before the natural breeding season. PMID- 3668943 TI - A chromosomal method to distinguish between X- and Y-bearing spermatozoa of the bull in zona-free hamster ova. AB - The interspecific in-vitro fertilization system using zona-free hamster ova was adopted to distinguish chromosomally between X- and Y-bearing bull spermatozoa. Frozen semen samples were thawed and washed with modified BWW medium including 0.3% BSA (pH 7.2) to remove cryoprotective medium. Motile spermatozoa were recovered from the semen by the 'swim-up' method. These spermatozoa were treated with ionophore A23187 to facilitate capacitation. Adequate capacitation of spermatozoa was found by their movement patterns and the insemination was performed at the optimum time. The fertilized ova were cultured in Medium TC199 with 10% FBS including podophyllotoxin and vinblastine until they reached first cleavage metaphase. Chromosome slides were prepared by our gradual fixation-air drying method. The success rate of the method was 56% of the number corresponding to the zona-free ova used. Altogether 1116 spermatozoa from 4 different bulls were successfully analysed and the ratio of X- and Y-bearing spermatozoa was 542:574 (P greater than 0.3). PMID- 3668945 TI - A quantitative cytological study of polyovular follicles in mammalian ovaries with particular reference to the domestic bitch (Canis familiaris). AB - The incidence of polyovular types in the growing follicle population was estimated using quantitative cytology. Of 15 species studied, polyovular follicles were recorded in the following species and in ascending order of abundance: rabbits, rhesus monkeys, humans, cats, dogs. The incidence in bitches was 14% in animals aged 1-2 years but only 5% at 7-11 years old. The frequency of the various types of polyovular preantral follicle varied inversely with the numbers of oocytes per follicle and the probability of finding a follicle with more than 5 oocytes was remote. In young ovaries the frequency was constant in the early stages of growth but decreased in the largest preantral stage. The pattern in ageing ovaries was, by contrast, one of declining frequency such that few if any polyovular types completed development. The ovary of the ageing bitch was also characterized by a higher incidence of degenerating follicles and a much smaller pool of primordial stages. Polyovular follicles were larger than uniovular types at comparable stages which were defined by the number of granulosa cell layers. Their oocytes were smaller but the overall ooplasmic mass was increased with a corresponding increase in the mass of granulosa cells. PMID- 3668944 TI - Effect of exogenous LH on plasma concentrations of progesterone and oestradiol in relation to the cessation of egg laying induced by different moulting methods. AB - Artificially induced cessation of egg laying caused regression of the reproductive tract in hens, as well as changes in circulating concentrations of sex steroids. Hens were bled at several stages during and after artificial moult induced by fasting or overfeeding a diet low in calcium or high in zinc. Hens received a single injection of 200 i.u. of horse LH at Day 0, 7, 21, 35 and 77 (Exp. 1) or Day 0, 8, 23, 35 and 71 (Exp. 2) after start of the treatment to induce moult. Blood samples were taken before and 20, 40 and 60 min (Exp. 1) or 15, 30 and 45 min (Exp. 2) after LH injection. Hens which were fasted or given the diet high in zinc had low plasma progesterone concentrations and the response to LH was reduced or delayed. In hens fed low calcium the reduction in plasma progesterone was less pronounced and the responsiveness to LH was more or less maintained. Conversely, there was no response of oestradiol to LH in laying hens. However, oestradiol concentrations increased in moulting hens after LH injection, due to the high oestradiol secretion from the small white follicles, since all yolky follicles were atretic. PMID- 3668946 TI - Active immunization of cattle against partly purified follicular fluid from sheep. AB - Yearling cross-bred heifers were injected with 0.4 or 4 mg total protein in non ulcerative Freund's adjuvant (Groups A and C, respectively; N = 5 per group), or adjuvant with C. parvum (Groups B and D, respectively; N = 5 per group). Control heifers were not treated (N = 9). No antibodies were detected in heifers in Groups A and C and so these were excluded from the analysis. There was no effect of the treatment on Group B or D heifers after the priming or first booster injection. After a second booster injection one Group D heifer gave a triple ovulation, and two Group D heifers and one Group B heifer gave double ovulations, but for one oestrous cycle only. Group B heifers also showed a significant rise in FSH concentrations after the second booster injection. Group D heifers were given a third booster injection; there was an increase in the mean number of large follicles per heifer, and a decrease in oestrous cycle length, but no increase in ovulation rate. These results indicate that a transient increase in ovulation rate can be induced by actively immunizing cattle against partly purified follicular fluid from sheep. PMID- 3668947 TI - Ureaplasmas and mycoplasmas in chimpanzees of various breeding capacities. AB - Adult chimpanzees (24 male, 76 female) with low and high rates of conception were examined for ureaplasmas, arginine-metabolizing mycoplasmas and chlamydiae. Ureaplasmas were isolated from the throat of only 1 male and 1 female animal, but from the urethra of 29% of the males and from the vagina of 95% of the females. Mycoplasmas were isolated from the throat more often than were ureaplasmas, but from the genital tract with about the same frequency as ureaplasmas. The numbers of organisms, of either type, isolated from the vagina were larger than the numbers isolated from the male urethra. Chlamydiae were not isolated from any animal. The occurrence of ureaplasmas and mycoplasmas and the numbers of these organisms isolated were similar in animals with low or high rates of conception. Furthermore, no association was noted between the organisms in the lower genital tract and the occurrence of abortion and/or stillbirth. PMID- 3668949 TI - The measurement of daylength in the Ile-de-France ram. AB - Two groups of 12 adult Ile-de-France rams were exposed to artificial 6-month light cycles in which daily illumination was provided in one or two photofractions. In Group I, daylength increased linearly from 8 to 16 h in 3 months and decreased similarly from 16 to 8 h. The daily increment or decrement (5.33 min/day) was constant. In Group II, 8 h of light were given in two parts: the main one, 7 h, began at the time of dawn in Group I and an additional 1 h light pulse was coincident with the last hour of the former group. The onset of the pulse changed therefore each day and the interval between dawn of the first block and dusk of the second block of light increased from 8 to 16 h in 3 months and declined from 16 to 8 h the next 3 months. Testicular weight was estimated by an orchidometer every 2 weeks for 2 (N = 12/group) or 3 consecutive light cycles (N = 6/group). The testicular weight variations were identical in both groups. In the 6 rams of each group studied during 3 light cycles, variations of testicular weight were submitted to an harmonic regression analysis according to time and the computed values for the mean, amplitude, period and phase were, respectively, 260 g, 66 g, 185 days and 120 days in Group I and 262 g, 65 g, 181 days and 111 days in Group II. Analysis performed for each ram gave very similar values in all individuals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668948 TI - Suppression of luteal function in dogs by luteinizing hormone antiserum and by bromocriptine. AB - Beagle bitches were treated with equine anti-LH serum (ALHS) or the dopamine agonist bromocriptine at selected times during the 2-month luteal phase of the ovarian cycle or pregnancy. After a single injection of ALHS (10 ml, i.m.) at Day 42 of pregnancy (N = 2) or the ovarian cycle (N = 3), progesterone was reduced (P less than 0.05) to 7-24% of preinjection values within 1-2 days, and by 4-8 days returned to levels not different from those in control bitches treated with normal horse serum. Injections of bromocriptine (0.1 mg/kg, i.m.) daily for 6 days caused abrupt declines in progesterone which lasted 6-8 days in bitches treated at Day 8 or 22 of pregnancy (N = 5). In bitches treated at Day 42 of pregnancy (N = 3) or in non-pregnant cycles (N = 4) the bromocriptine treatment caused declines (P less than 0.05) in progesterone which were permanent, extensive (less than 2 ng/ml), and therefore abortive. The declines in progesterone in response to immunoneutralization of LH and to prolactin-lowering doses of a dopamine agonist demonstrate that normal luteal function in dogs requires both LH and prolactin. PMID- 3668950 TI - Prolonged epididymal sperm storage, and the temporal dissociation of testicular and accessory gland activity in the common sheath-tail bat, Taphozous georgianus, of tropical Australia. AB - Peak spermatogenic activity of the common sheath-tail bat occurs in autumn, declines over winter and ceases in spring. Accessory glands enlarge in spring when mating occurs, but are regressed at other times of the year. Spermatozoa are stored in the cauda epididymidis throughout the year, and their numbers increase progressively from early summer to late autumn. Sperm storage permits asynchrony of male and female cycles and allows each to be optimally timed in relation to environmental conditions. The temporal separation of primary and secondary sexual functions in the male enables the insemination of females close to ovulation and is a consequence of the burden of sperm storage being placed upon the male. PMID- 3668951 TI - Effects of cryopreservation on the motility characteristics of human spermatozoa. AB - Ejaculates (164) were obtained from 17 donors serving on an artificial insemination by donor panel. Semen analysis was performed before and after freezing by an integrated microcomputerized system employing the multiple exposure photography (MEP) method. Sperm count, motility, velocity, motility index (MI; product of the sperm velocity and percentage of motile spermatozoa) and motile density (MD) were determined for each ejaculate. After the initial evaluation the ejaculates were frozen in liquid nitrogen, thawed 24 h later, and assessed for post-thaw motility, velocity, MI and MD. The mean +/- s.e. sperm count and volume for this group of donors was 148 +/- 4 x 10(6)/ml and 3.1 +/- 0.1 ml, respectively. Mean +/- s.e. values obtained from the prefreeze analysis were: motility = 64 +/- 1%, velocity = 30 +/- 0.4 microns/sec, MI = 19 +/- 0.5 microns/sec and MD = 94 +/- 3 x 10(6)/ml. Post-thaw analysis revealed a significant reduction (P less than 0.01) in all values measured. Motility was reduced to 27 +/- 1%, MI was reduced to 5 +/- 0.3 microns/sec, and MD was reduced to 33 +/- 1 x 10(6)/ml. Velocity was the least affected by cryopreservation, being reduced to 21 +/- 0.5 microns/sec (P less than 0.01). Cryopreservation resulted in a marked shift in the frequency distribution of sperm motility and motility index towards subnormal values while in the majority of ejaculates velocity and motile density were maintained in the normal range. Significant differences were noted amongst donors in the percentage change of the various semen measures as a result of cryopreservation. When within-subject coefficients of variation were calculated, velocity was the least variable parameter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668952 TI - Relationship between concentrations of cortisol in ovarian follicular fluid and various biochemical markers of follicular differentiation in cyclic and anovulatory cattle. AB - Concentrations of cortisol were determined in pooled fluid of small (less than 10 mm) and large (greater than or equal to 10 mm) follicles of cyclic cattle (Exp. 1), and in fluid of the largest follicle of 17 post-partum anovulatory cows (Exp. 2). In Exp. 1, concentrations of cortisol in small follicles were greater (P less than 0.05) than in large follicles (14.7 versus 13.2 ng/ml), and varied significantly with stages of the cycle; small and large follicles had the highest cortisol concentration during the early luteal phase of the cycle. Large follicles had 2-fold greater concentrations of oestradiol than did small follicles, whereas small follicles had 2-fold greater concentrations of androstenedione than did large follicles. Across pools of follicular fluid, cortisol concentrations were correlated only to androstenedione concentrations (r = 0.65, P = 0.07). In Exp. 2, concentrations of cortisol did not significantly differ between oestrogen-active (oestradiol greater than progesterone in follicular fluid) and oestrogen-inactive (progesterone greater than oestradiol) follicles, although oestrogen-active follicles had a 24-fold greater concentration of oestradiol than did oestrogen-inactive follicles. Cortisol concentrations were correlated to hCG binding capacity of thecal cells (r = 0.35, P = 0.08) and to follicular diameter (r = 0.45, P less than 0.05). These results suggest that normally fluctuating concentrations of cortisol in follicular fluid of cattle play little or no active role in follicular differentiation in vivo. PMID- 3668954 TI - Stimulation of early embryonic development in the sheep by co-culture with oviduct epithelial cells. AB - To examine the effects of somatic cell support on the cleavage and viability of fertilized sheep eggs, 434 pronucleate eggs were co-cultured for 3 or 6 days on oviduct cells or fibroblasts and 77 eggs were cultured in medium alone. During the first 3 days in culture 95% of the single-celled eggs cleaved regularly to non-compacted morulae on either of the feeder-layers but only 13% underwent similar regular cleavage in medium alone. Despite the identical cleavage rates in the co-culture groups, only 33% of embryos grown on fibroblasts as compared with 80% of embryos grown on oviduct cells were fully viable as judged by their ability to develop normally after transfer to recipient animals. The viability of embryos in the oviduct group was equal to that obtained after the direct transfer of morulae from donor to recipient sheep. After 6 days in culture 42% of embryos co-cultured with oviduct cells developed into expanded blastocysts as compared with only 4.5% cultured on fibroblasts. In both co-culture groups virtually all the remaining embryos blocked during the 4th cleavage. When transferred, 30% of blastocysts grown from the pronucleate stage on oviduct cells were viable. We conclude that: (1) during the first 3 days after fertilization cleavage will progress at a normal rate on different feeder-layers but oviduct cells appear to be required for the acquisition of full embryonic viability.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3668953 TI - Effect of seasonal changes in Leydig cell number on the volume of smooth endoplasmic reticulum in Leydig cells and intratesticular testosterone content in stallions. AB - Testes from 47 adult (4-20 years) stallions obtained in November-January (non breeding season) and 41 adult stallions obtained in May-July (breeding season) were perfused with glutaraldehyde, placed in osmium and embedded in Epon 812. Percentage Leydig cell cytoplasm or nuclei in the testis was determined by point counting of 0.5 micron sections under bright-field microscopy. Testes from 6 randomly selected horses per season were processed for electron microscopy. The volume (ml) of SER/testis was calculated from the % SER in the cytoplasm % Leydig cell cytoplasm, and parenchymal volume. Number of Leydig cells was calculated from the % nuclei, parenchymal volume, histological correction factor, and volume of single nucleus. Intratesticular testosterone content was determined from the contralateral testis by radioimmunoassay. The volume of SER/g and testosterone/g tended to be higher in the breeding than non-breeding season. Leydig cell number/g, volume of SER/testis, testosterone/testis, and Leydig cell number/testis were significantly greater in the breeding than in the non-breeding season. Volume of SER/testis and testosterone/testis were related significantly to the cell number/testis, and SER/testis was related (P less than 0.05) to testosterone/testis. These results emphasize the importance of seasonal changes in the number of Leydig cells on the amount of SER available to produce testosterone and on testosterone content/testis in the stallion. PMID- 3668955 TI - Ovarian follicles during infancy in Romanov and Ile-de-France ewe lambs. AB - The ovaries of new born lambs (15 Ile-de-France and 19 Romanov, 34 ovaries) and of 4-week-old lambs (6 Ile-de-France and 12 Romanov, 18 ovaries) were examined histologically to compare ovarian follicular development in infant lambs of breeds differing in their prolificacy. Breed was the major factor affecting follicular population at birth. Ile-de-France lambs had a higher total number of growing follicles (P less than 0.001), and more preantral (P less than 0.001) and antral (P less than 0.005) follicles than did Romanov lambs. Furthermore, the size of the largest follicles was also reduced in Romanov compared to Ile-de France lambs. At 4 weeks of age, most of the features of the ovarian follicular population except the mean size of the third largest follicle were similar between the two breeds. However, atresia of antral follicles had appeared only in Ile-de-France and not in Romanov lambs. When a challenge with exogenous gonadotrophins (1000 i.u. PMSG followed by 1500 i.u. hCG) was attempted, ovulation was triggered in 2/6 and 0/12 Ile-de-France and Romanov lambs respectively. Massive follicular development was noted in 3/6 Ile-de-France lambs but in none of 12 Romanov lambs. Retardation of follicular development together with retardation in the establishment of ovarian sensitivity to gonadotrophins are therefore features typical of the ovaries of Romanov lambs compared to Ile-de France lambs during the post-natal period. PMID- 3668956 TI - In-vitro development and degeneration of stromal cells from the uterus of the rat at three stages of pregnancy. AB - On Days 6, 11 or 16 of pregnancy, endometrial tissue (Day 6) or decidual tissue (Days 11 and 16) were removed from rat uteri, dissociated into single cells and grown in culture. At intervals during the culture period, the cells were examined and the cell density was calculated. The cells from Days 11 and 16 of pregnancy were similar in appearance, being very large and flattened. Initially, cells from Day 6 were much smaller, but showed an increase in size and came to resemble cells from the later stages of pregnancy. Growth curves for cells from each of the three stages of pregnancy over the first 16 days of culture differed. Cells from Day 6 of pregnancy increased exponentially in number. In cultures of cells from Day 11, cell numbers were stable, and in cultures of cells from Day 16, an exponential decline was seen. Cells from Days 6 and 11 of pregnancy were cultured for 42 days, by which time only a few cells remained viable. Cultures of cells from Day 16 degenerated within 3 weeks. These results indicate that, in vivo, decidual cells are not controlled solely by a 'programmed lifespan'. Changes occurring during pregnancy, however, limit the potential of the cells for division and survival in culture. PMID- 3668957 TI - Antifertility effects of some sulphonamides and related compounds and their accumulation in the epididymides of male rats. AB - Nineteen sulphonamides and related drugs were screened for their antifertility effects in male rats. They were suspended in corn oil and fed orally to rats at 10 times the human dose for a period of 6 months. Of the 19 compounds tested, sulphamethazine, sulphapyridine, dapsone, sulphamethoxypyridazine, sulphaguanidine, sulphathizole, sulphamerazine and sulphadimethoxine reduced fecundity of male rats to 34.3, 37.6, 38.3, 53.6, 55.6, 58, 75 and 78.6% of control, respectively. The fall in fecundity was due to a reduction in the number of embryos compared with the number of corpora lutea per pregnant female, and, in some cases, was associated with a fall in epididymal sperm concentration and motility. Some of these compounds accumulated in the cauda epididymidis at concentrations equal to or higher than the free drug concentrations in the blood. It is proposed that the antifertility effects of some of these compounds may in part be mediated through a direct effect on epididymal stored spermatozoa, hence compromising some processes vital for fertilization. PMID- 3668958 TI - Uterine and oviducal protein secretion during early pregnancy in the mouse. AB - Changes in the protein composition of the embryo's environment during early development were studied by analysis of proteins synthesized and secreted by oviducal and uterine explants on Days 1-6 of pregnancy. Although secretions from ampullar and isthmic oviduct and uterus contained many proteins in common, each area also produced its own characteristic proteins. In the uterus, changes in the secretion pattern were found during the peri-implantation period, including both increases and decreases in particular proteins which appear to be dependent on the presence of embryos. Embryo-induced effects on uterine secretion began between 09:00 h of Day 4 and 09:00 h of Day 5. Oviducal secretions exhibited many of the embryo-dependent proteins found in the uterus, but the expression of these proteins did not appear to be influenced by the presence of embryos on Day 1 or Day 3. The characteristic pattern of secreted protein expression by each portion of the reproductive tract may reflect the specialization of each area for certain developmental events. PMID- 3668959 TI - Reproduction in Schlieffen's bat, Nycticeius schlieffenii, in the eastern Transvaal lowveld, South Africa. AB - The present study is based on 153 Schlieffen's bats collected over a 2-year period from September 1983 to September 1985. Spermatogenesis extends over a 10 month period with the first signs of spermatozoa in the epididymides by the end of April. Spermatozoa were present in the epididymides from the end of April until the beginning of September. Copulation begins during June (early winter) and the females have spermatozoa in the uterine horns from then until the end of August (late winter) when ovulation occurs. These bats are seasonally monoestrous with the great majority of births occurring during November. The number of conceptuses varied; a maximum of 5 pre-implanted embryos was recorded, but the maximum number of fetuses observed was 3. PMID- 3668960 TI - Uptake of immunoglobulin and albumin by granulated metrial gland cells in vitro. AB - Single cell suspensions of metrial gland tissue from rats at Day 14 of pregnancy were prepared for maintenance in vitro. During the first 2 days of culture IgG was detected in glycoprotein granule-containing granulated metrial gland (GMG) cells. Albumin was also detected in GMG cells at the same stages. The IgG and albumin were not detected during the next 4 days in culture. When metrial gland cells, maintained in vitro for 5 days, were incubated with rat serum for a further 24 h, IgG and albumin were detected in GMG cells. When similar cultures were incubated for 24 h with purified rat IgG or purified rat albumin, GMG cells were positive for IgG and albumin respectively. Albumin was not detected in GMG cells in wax sections of metrial gland tissue, although IgG has previously been demonstrated. The uptake of serum proteins by GMG cells in vitro has been clearly shown but the difference in IgG and albumin content of these cells in paraffin wax sections indicates that the means by which IgG accumulates intracellularly may be different in vitro and in vivo. PMID- 3668961 TI - Steroid production by dispersed cells from fetal membranes and intrauterine tissues of sheep. AB - The hypothesis was examined that the fetal membranes and the endometrium and myometrium of pregnant sheep have the ability to produce oestrogens and progesterone from exogenous precursors, and that this capacity might change during the course of pregnancy, and in relation to the onset of parturition. Cells were dispersed from samples of myometrium, endometrium, allantois, chorion and amnion from sheep at Day 50, Days 130-135 of pregnancy, and at term, in labour, and were incubated in the presence of pregnenolone and 20 alpha dihydroprogesterone as potential precursors for progesterone production, and oestrone sulphate and androstenedione as potential precursors for oestrogen production. In addition, the metabolism of radioactive progesterone and oestrone sulphate by the dispersed cells was examined. Pregnenolone was converted to progesterone in significant amounts by dispersed cells from chorion and endometrium only. At Day 130 and at term this conversion was blocked by the addition of trilostane, an inhibitor of 3 beta-hydroxysteroid dehydrogenase activity. There was no significant change in the net production of progesterone from exogenous pregnenolone with gestation. 20 alpha-Dihydroprogesterone was converted to progesterone by all tissues, and at each stage of gestation. Formation of progesterone from 20 alpha-dihydroprogesterone was invariably greater than that from pregnenolone, but did not change with pregnancy. Oestrone sulphate was converted to oestrone and oestradiol by all tissues. In the myometrium and chorion this conversion was lower at term than at Day 50 of pregnancy. In contrast, there was very little conversion of androstenedione to unconjugated oestrogen, minimal activity being demonstrable only in dispersed cells from the chorion in some preparations. Radioactive progesterone was converted to radiochemically pure 17 alpha-hydroxyprogesterone by chorion, and to radiochemically pure 20 alpha-dihydroprogesterone by amnion, chorion, allantois and endometrium obtained at term pregnancy. At term [3H]oestrone sulphate was converted to radiochemically pure oestrone by all tissues. We conclude that there is a tissue-specific distribution of different steroid metabolizing enzyme activities in the fetal membranes and intrauterine tissues of pregnant sheep. Of the substrates examined, 20 alpha-dihydroprogesterone and oestrone sulphate were preferred for progesterone and oestrogen production, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3668962 TI - Minimum and maximum extracellular Ca2+ requirements during mouse sperm capacitation and fertilization in vitro. AB - The minimum and maximum extracellular Ca2+ concentrations required to promote capacitation, the acrosome reaction, hyperactivated motility, zona penetration and gamete fusion in the mouse have been established. The traces of free calcium in Ca2+-deficient medium were shown not to enhance capacitation since the inclusion of EGTA to chelate free ions during a 120 min preincubation failed to alter the kinetics of capacitation from those observed in the absence of EGTA; 1 h after addition of 1.80 mM-Ca2+, both suspensions were highly fertile. Complete capacitation, when suspensions were immediately functional upon the addition of 1.80 mM-Ca2+, required the presence of greater than or equal to 90 microM-Ca2. Considerably higher concentrations were required to initiate optimal sperm responses: acrosome reaction, 900 microM; gamete fusion, 900 microM; hyperactivated motility, 1.80 mM; zona penetration, 1.80 mM. None of these changes was effected when Ca2+ was less than 450 microM. The responses to elevated Ca2+ were dependent on the length of incubation, being initially positive and then negative. A short (30 min) exposure to 3.40 mM-Ca2+ (x 2 the standard) accelerated capacitation, as evidenced by significantly increased acrosome loss, precocious expression of hyperactivated motility and enhanced fertilizing ability when Ca2+ was reduced to 1.80 mM. However, extended (120 min) preincubation irreversibly damaged sperm function. In the presence of 7.20 mM Ca2+ (x 4), fertilizing ability was inhibited at both 30 and 120 min, despite a high incidence of acrosome loss. The primary deleterious effect appeared to be on motility which was judged to be more erratic than in 1.80 mM-Ca2+, possibly due to elevated intracellular Ca2+. Because of the considerable difference in threshold Ca2+ concentrations, it is now possible to dissociate the Ca2+ dependent events of capacitation from those of the acrosome reaction and motility changes. PMID- 3668963 TI - Effects of photoperiod on androgen-binding protein and sperm fertilizing ability in the hamster. AB - Androgen binding protein (ABP) was detected in both the testis and epididymis of golden hamsters exposed to a long photoperiod (16L:8D). The concentration of ABP in the testis rose from 0.1 pmol/g testis in 2-week-old animals to attain maximum values (3.9 pmol/g testis) at 6-7 weeks, then declined to adult values (1.8 +/- 0.4 pmol/g testis) after 10-11 weeks of age. In contrast, the ABP concentration of the caput epididymidis reached maximum values at 4-7 weeks of age (14 pmol/g tissue) and declined to adult values (4.8 +/- 1.5 pmol/g tissue) by 10-11 weeks of age. ABP content of the corpus epididymidis was maximal (1.0 pmol/g tissue) at 2 weeks of age and thereafter declined to below detectable levels by 10-11 weeks. No ABP could be detected in the cauda epididymidis from animals of any age examined. Hamster ABP analysed by steady-state polyacrylamide gel electrophoresis had a relative mobility (Rf) of 0.33 compared to 0.41 for rabbit ABP. Sucrose gradient analysis of hamster ABP indicated a sedimentation coefficient of about 4 S. The binding of [3H]5 alpha-dihydrotestosterone [( 3H]5 alpha-DHT) to hamster ABP was very rapid with equilibrium occurring within 10 min. The dissociation of [3H]5 alpha-DHT from hamster ABP was also rapid (t1/2 = 2.77 min). Saturation analysis of ABP from mature animals yielded an apparent dissociation constant of 6.4 nM and an ABP concentration of 1.2 +/- 0.2 pmol/mg protein. The binding of [3H]5 alpha-DHT to hamster ABP was inhibited by 5 alpha-DHT greater than testosterone greater than greater than greater than oestradiol greater than cyproterone acetate. Exposure of mature hamsters to a short photoperiod (8L:16D) for 3 weeks resulted in a 42% drop in epididymal ABP levels (10.3 to 4.3 pmol/g tissue). Epididymal ABP further declined so that after 15 weeks in a short photoperiod it was 4% (0.4 pmol/g) of initial values. Accompanying this decrease in epididymal ABP concentrations was a decline in the fertilizing ability of spermatozoa from the distal cauda. When hamsters were transferred from a short to a long photoperiod (16L:8D), epididymal ABP content returned to about 50% of control values within 3 weeks. However, the fertilizing ability of spermatozoa from the cauda epididymidis of these animals did not return to control values after a 9-week exposure to a stimulatory photoperiod. PMID- 3668964 TI - Vulvovaginal candidiasis: historical perspectives and current trends. PMID- 3668965 TI - Clinicopathologic features of partial hydatidiform mole. AB - Partial hydatidiform mole (PHM) is a distinct entity, a triploid, diandric conceptus the placenta of which shows focal trophoblastic hyperplasia (a sine qua non of diagnosis) and focal hydatidiform change; the fetus usually survives until eight to nine weeks' menstrual age. The clinical presentation is varied and preevacuation diagnosis often difficult. No choriocarcinoma has been documented in association with PHM, but residual, nonmetastatic disease can occur. The diagnosis rests ultimately with the pathologist, who has to distinguish PHM from a common abortus with villous edema and from twins in which the partners are a complete mole and a normal conceptus. PMID- 3668966 TI - Subacute focal endometritis. Association with cervical colonization with ureaplasma urealyticum, pelvic pathology and endometrial maturation. AB - Subacute focal endometritis (SFE) has been associated with cervical Ureaplasma urealyticum colonization and is considered a significant indicator of pelvic adhesions or endometriosis. A retrospective analysis was performed comparing cervical isolation rates, endometrial maturation patterns and laparoscopic findings in 64 patients with SFE and in a control group of 70 unselected patients with no histologic evidence of SFE at endometrial biopsy. The data suggest that although the prevalence of pelvic damage of various types is high, SFE cannot be used as a reliable marker for pelvic adhesions or endometriosis; that SFE does not interfere with normal endometrial maturation; and that SFE is not invariably associated with cervical U urealyticum but may represent resolving infection. It is also possible that SFE represents endometrial autoimmunity either following mycoplasma infection or arising spontaneously. PMID- 3668967 TI - Scanning electron microscopy of the endometrium in functionally agonadal women receiving steroid replacement therapy with polysiloxane vaginal rings and cylinders. AB - We prepared a group of five agonadal women to receive donated embryos by delivering physiologic concentrations of 17 beta-estradiol (E2) and progesterone (P4) through a polysiloxane vaginal ring and cylinder delivery system. In order to detect endometrial surface ultrastructural asynchrony that might reduce prospects for successful embryo transfer, we performed scanning electron microscopy (SEM) on biopsies obtained from these five women and compared them against those from four normal, spontaneously ovulating controls. Light microscopy revealed all nine women to be in the late luteal phase (day 26 +/- 2) and with glandular-stromal synchrony. Further concordance was seen with SEM, with no discernible difference in the development of cilia, microcilia or apical secretory protrusions between the two groups. SEM, a technique that permits visual assessment of endometrial surface topography, demonstrated that this regimen of native E2 and P4 restored the surface ultrastructure of the prematurely menopausal human endometrium to correspond to that in the normal menstrual cycle. PMID- 3668968 TI - A urodynamic appraisal of success and failure after retropubic urethropexy. AB - Fifty patients were evaluated with microtransducer urodynamic evaluation before and three months after retropubic urethropexy. Despite a 92% subjective success rate (46 of 50 patients), 13 patients (26%) were found to be surgical failures on postoperative urodynamic evaluation. Prior incontinence surgery (28 patients) was not a statistically significant risk factor except in those with prior Marshall Marchetti-Krantz procedures; they were found to be at increased risk of failure (67%) (P less than .001). Prior hysterectomy had no effect on surgical outcome. Functional length in the sitting position was augmented by 4.3 mm (P less than .01) after the modified Burch procedure. However, there was no significant change in closure pressure. Patients who failed incontinence surgery had significantly lower preoperative closure pressures (P less than .005) and functional lengths (P less than .025). Urethral pressure profiles may be used to identify those patients with low-pressure, short urethras; they are at increased risk of surgical failure. PMID- 3668969 TI - Primary ovarian pregnancy two years after bilateral tubal ligation. A case report. AB - This is the first documented case of intrafollicular ovarian pregnancy following bilateral tubal ligation. The patency of the previously ligated tube was demonstrated by hysterosalpinography. It appears that the incidence of ovarian pregnancy is not related to the rising incidence of tubal pregnancy. PMID- 3668971 TI - One syndrome--many infectious agents. PMID- 3668970 TI - Practical applications of home diagnostic products. A symposium. PMID- 3668972 TI - Protein biosynthetic activity of polymorphonuclear leukocytes in inflammatory arthropathies. Increased synthesis and release of fibronectin. AB - We have investigated protein synthesis and release by polymorphonuclear leukocytes (PMN) to compare the protein biosynthetic activity of peripheral blood PMN and inflammatory synovial fluid (SF) PMN from patients with inflammatory arthropathies. We analyzed and compared the protein profiles produced by these cells, using patient matched peripheral blood and SF PMN as well as peripheral blood PMN from normals. Twenty-five patients with either rheumatoid arthritis, psoriatic arthritis or gout were studied. Fluorographs of SDS-polyacrylamide slab gels, performed using cell supernatants from metabolically labelled cells, revealed an increased release of de novo synthesized proteins by inflammatory SF PMN compared to peripheral blood PMN. Under reducing conditions, 4 clearly distinguishable high molecular mass products were observed (Mr 230,000, 185,000, 170,000 and 95,000). Two of the protein bands were found to be gelatin binding (Mr 230,000 and Mr 95,000). By Western blot, the Mr 230,000 protein was found to be fibronectin and the Mr 95,000 protein was shown to be identical to a recently described gelatinase. Thus, the activation of PMN in inflammation is accompanied by an increased release of a number of de novo synthesized proteins, including fibronectin. Our studies directly pertain to the in vivo inflammatory process since the PMN were not activated artificially in vitro. PMID- 3668973 TI - Detection of low molecular weight IgM by immunoblot analysis in rheumatoid arthritis. AB - The immunoblot technique was used to detect low molecular weight IgM (LMWIgM) in the serum and synovial fluid (SF) of patients with rheumatoid arthritis (RA). LMWIgM was detected in 64% of 58 RA sera and in 47% of 17 RA SF. The levels of IgM and rheumatoid factor (RF) were significantly higher in the positive sera of LMWIgM. Sequential studies revealed that LMWIgM appeared in the serum while the titer of RF was high. Our analysis also suggested the presence of several other oligomeric LMWIgM with monomeric IgM. PMID- 3668974 TI - Diminished uptake and degradation of soluble aggregates of IgG by monocytes of patients with rheumatoid arthritis and vasculitis. AB - We investigated the capacity of monocytes to degrade soluble aggregates of IgG in vitro in the absence (Fc receptor [FcR] mediated) and presence of complement (FcR and C3 receptor mediated). Adherent monocytes from 33 patients with active rheumatoid arthritis (RA) and rheumatoid vasculitis, 32 patients with inactive RA alone, and 20 healthy controls were incubated with 125I-aggregated IgG (125I AIgG) of restricted size with or without fresh serum. Normal monocytes degraded 9.8% of 125I-AIgG via FcR alone and the presence of complement enhanced degradation to 2.7%. Degradation of 125I-AIgG via FcR from patients without active RA suggested a depressed function of FcR. The maximal amount of 125I-AIgG which was bound by monocytes from patients with inactive and active RA, however, was increased compared to normals, suggesting a defect in intracellular processing in patients with RA. The degradation of 125I-AIgG in the presence of complement was also significantly depressed for both groups of patients. The monocytes from the patients also had decreased numbers of C3b receptors (CR1). Since CR1 are involved in the enhanced uptake of immune complexes bearing complement, the depressed capacity of monocytes from patients with RA to degrade 125I-AIgG in vitro may be caused both by a diminished uptake as well as a diminished capacity to degrade soluble AIgG. PMID- 3668975 TI - Clinical and genetic characteristics of upper gastrointestinal disease in rheumatoid arthritis. AB - Clinical and genetic studies were analyzed in 47 patients with rheumatoid arthritis (RA) who had upper gastrointestinal (GI) endoscopies. Fifty-three percent of patients with RA had peptic ulcers and/or erosions. Sixty percent of patients with ulcers and/or erosions had a history of peptic ulcer disease. Although a greater number of patients with ulcers and/or erosions was taking regular aspirin or indomethacin, comparable numbers of patients with abnormal and normal endoscopies were using nonsteroidal antiinflammatory drugs. Nineteen of the 25 patients (76%) with ulcers and/or erosions had type O blood. Patients with abnormal and normal endoscopies had similar frequencies of GI complaints and fecal blood loss. GI symptoms and occult fecal blood loss, therefore, are not prominent features of upper GI disease in RA. ABO screening may be helpful in determining which patients with RA are at risk for developing peptic ulcers and/or erosions. PMID- 3668976 TI - Disability in rheumatoid arthritis: comparison of prognostic factors across three populations. AB - We previously identified variables that predict functional disability in rheumatoid arthritis (RA). Because of potential instabilities in the statistical model, we sought to determine whether these predictors were consistent across populations: 2,448 consecutive patients with (RA) were followed prospectively at ARAMIS centers in Phoenix, AZ, Wichita, KS, and Saskatoon, SK. Average followup was 1.7 years in Phoenix, 3.4 years in Wichita, and 12 years in Saskatoon. Twenty four potentially predictive variables were analyzed by stepwise linear regression. Common predictors were age, sex, and duration of illness, suggesting that these variables are important predictors of disease regardless of the population being studied. In addition, the initial level of disability and radiographic variables are good predictors of disability. Elevated erythrocyte sedimentation rate and latex titers also were associated with future functional disability but do not have a linear relationship and predict less well. PMID- 3668977 TI - The impact of rheumatoid arthritis and osteoarthritis: the activities of patients with rheumatoid arthritis and osteoarthritis compared to controls. AB - We measured the impact of rheumatoid arthritis (RA) and osteoarthritis (OA) by comparing the activities of patients with these illnesses to controls matched for age, sex, and community of residence. Our results indicate that patients with RA experience more losses than controls in every domain of human activity and that patients with OA experience more losses in the performance of household chores, shopping and errands, and leisure activities. The methods described here provide a simple, reliable way to assess the impacts of illness in the same terms for all dimensions of human activity. PMID- 3668978 TI - High incidence of anticardiolipin antibodies in relatives of patients with systemic lupus erythematosus. AB - Anticardiolipin antibodies (aCL) were measured in the serum of 22 patients with systemic lupus erythematosus (SLE) and 101 of their first degree relatives. Four patients' sera (18%) were positive. Eight sera from relatives were strongly positive (7.9%). All 8 relatives came from different families, and only 3 of them were related to a positive positive proband. All 8 had clinical and/or other serological abnormalities, compared with only 30% of the aCL negative relatives (p less than 0.05). There were no reports or evidence of thrombosis, thrombocytopenia or spontaneous abortion among the aCL positive relatives. Our data indicate a strikingly higher incidence of aCL among relatives of lupus patients compared with controls. This may be associated with an increased incidence of abnormal clinical or serological findings in these individuals, and constitute a feature of a genetic predisposition to SLE. PMID- 3668979 TI - Cerebrospinal fluid immunoglobulins and neuronal antibodies in neuropsychiatric systemic lupus erythematosus and related conditions. AB - Neuronal antibodies found in the cerebrospinal fluid (CSF) of patients with systemic lupus erythematosus (SLE) may be locally produced, or may enter through a damaged blood-brain barrier. We measured CSF serum/albumin and IgG ratios, oligoclonal banding, and paired CSF/serum neuronal antibody in 36 patients and 98 controls. Only 14% of SLE CSF contained neuronal antibodies; 80% of these had clinically overt neuropsychiatric manifestations. None of 73 patients with noninflammatory central nervous system (CNS) disease had CSF-neuronal antibodies, compared with 8/61 with SLE or related inflammatory CNS disorders (p less than .001). In SLE, CSF neuronal antibodies were accompanied by high titer serum neuronal antibodies (p less than 0.03) or abnormal Q-albumin and occurred only when serum neuronal antibodies were present. CSF-neuronal antibodies appear to be related to immune-inflammatory CNS disease, especially SLE, and may traverse a damaged blood-brain barrier. PMID- 3668980 TI - Reproducibility of cold provocation in patients with Raynaud's phenomenon. AB - Twenty-five patients with Raynaud's phenomenon had serial cold challenges during a double blinded drug trial. The data were analyzed to determine the reproducibility of cold provocation in the induction of critical closure of the digital artery in patients with Raynaud's phenomenon. Finger systolic pressure (FSP) was measured after local digital cooling using a digital strain gauge placed around the distal phalanx. Nineteen of 25 patients completed the study. The prevalence of inducing a Raynaud's attack decreased with each successive cold challenge from 74% of patients at initial challenge to 42% at the 3rd challenge. A lower temperature was required to induce a Raynaud's attack at last challenge (10.6 +/- 0.6 degrees C) compared to the first cold challenge (13.2 +/- 1.0 degrees C). Our data demonstrate adaptation to a laboratory cold challenge through the winter months in patients with Raynaud's phenomenon and show it is an important factor in objectively assessing drug efficacy in the treatment of Raynaud's phenomenon. PMID- 3668981 TI - The frequency of sicca syndrome in an elderly female population. AB - In a population of 103 elderly Caucasian women, 39% had sicca symptoms and 24% had abnormal Schirmer's tear tests. Two (2%) satisfied criteria for Sjogren's syndrome and 12 (12%) were felt to have possible Sjogren's syndrome. Fifty percent of those with sicca were taking medications that might induce mucosal dryness. Fibrosis was noted on all 23 labial minor salivary gland biopsy specimens obtained. Mucosal drying medications and senile salivary gland atrophy seemed to contribute to the high frequency of sicca in this population with a lesser proportion of the subjects demonstrating previously undiagnosed Sjogren's and possible Sjogren's syndrome. PMID- 3668982 TI - IgM rheumatoid factor in Lyme disease: correlation with disease activity, total serum IgM, and IgM antibody to Borrelia burgdorferi. AB - We tested the sera of 50 patients with Lyme disease for IgM-rheumatoid factor (IgM-RF) using a sensitive ELISA. Levels of IgM-RF greater than 3 SD above the mean of normal subjects were found in 2 of 15 patients with erythema chronicum migrans, 7 of 10 with neurologic abnormalities, and 7 of 25 with Lyme arthritis (p = 0.038). Only 2 of these sera were positive by latex agglutination. In contrast, none of the 23 control patients with osteoarthritis, ankylosing spondylitis, or Reiter's syndrome had positive tests. The levels of IgM-RF correlated with disease activity (p = 0.002), total serum IgM levels (p = 0.002), and specific IgM antibody titers to Borrelia burgdorferi (p = 0.006). IgM-RF reactivity was absorbed with heat aggregated IgG (HAGG), but the titer of specific IgM antibody was insignificantly affected by this procedure. Thus, small amounts of RF are produced at certain times in many patients with Lyme disease, and IgM-RF production appears to be linked to the specific IgM response. PMID- 3668984 TI - Current aspects of osteoarticular pathology in patients undergoing hemodialysis: study of 80 patients. Part 1. Clinical and radiological analysis. AB - Eighty patients undergoing longterm hemodialysis were evaluated for joint function and radiographic abnormalities. Mean age of the population was 53 years, and mean duration of dialysis was 76 months (24 patients underwent dialysis for more than 10 years). Fifty-eight patients (72%) had joint symptoms; nonspecific arthralgia was the most frequent. Fifteen patients had morning stiffness and interrupted sleep due to arthralgias (shoulders 9, fingers 3) and 10 patients had diminished finger mobility. Radiographic evaluation showed 7 classes of lesions which are not characteristic of renal osteodystrophy or degenerative lesions, including erosive arthropathies of the fingers (8%), multiple carpal bone cysts (10%), cysts of the humeral head (9%), cysts of the hip (11%), erosive spondyloarthropathies (9%), cervical spondylolisthesis (5%) and multiple diaphyseal lacunae (1%). Overall, 42 distinct radiological lesions were observed in a total population of 23 patients. Twenty-nine of these lesions occurred in patients undergoing dialysis for at least 10 years. Certain clinical and radiological patterns were frequently combined after dialysis for more than 10 years: carpal tunnel syndrome, inflammatory joint pain, bone cysts and spondyloarthropathies. PMID- 3668983 TI - Psoriatic arthritis treated with oral colchicine. AB - We investigated the use of colchicine in psoriatic arthritis to determine if we could confirm the good results obtained in an earlier, uncontrolled study. Twelve of 15 patients with psoriatic skin lesions and arthritis completed a 16-week placebo controlled double blind crossover study. A significant improvement was noted in grip strength, Ritchie's index, joint size, joint pain and overall therapeutic assessment. Psoriatic skin lesions were not improved by colchicine. The few side effects observed were related to gastrointestinal intolerance, which were usually controlled by temporarily reducing the dose of the drug. Our results indicate that 1.5 mg colchicine daily is an effective treatment for psoriatic arthritis. PMID- 3668985 TI - Current aspects of osteoarticular pathology in patients undergoing hemodialysis: study of 80 patients. Part 2. Laboratory and pathologic analysis. Discussion of the pathogenic mechanism. AB - Clinical and radiological analysis of a population of 80 patients undergoing hemodialysis showed a high incidence of joint symptoms and radiological abnormalities which could not with certainty be attributed to renal osteodystrophy (Part 1). In this same population, laboratory and pathologic studies were performed. Blood chemistry proved abnormal in most cases (fibrinogen, aluminum, beta 2 microglobulin). Histopathologic studies (bone or synovial) were performed in 20 samples. Amyloid deposits were found in 8 samples, and crystal deposits in 3. We consider the idea that amyloid may be responsible for the observed lesions to be an interesting possibility. A better understanding of the behavior of different dialysis membranes may clarify the pathophysiological mechanisms of this disease. PMID- 3668986 TI - Osteoarthritic cartilage contains increased calcium, magnesium and phosphorus. AB - Using plasma emission spectroscopy, we measured the calcium (Ca), phosphorus (P), magnesium (Mg), and sulphur (S) concentration in femoral head cartilage from 7 patients with osteoarthritis (OA) and 22 normal patients. We found that in OA cartilage Ca = 271.9 +/- 32.7 mmol/kg dry weight compared to Ca = 113.2 +/- 12.6 mmol/kg dry weight in normal controls. The Ca:P molar ratio in OA cartilage was 1.93 compared to Ca:P = 2.27 in normals, and Ca:P = 1.67 in apatite crystals. We conclude that OA cartilage has a greater binding capacity for Ca, Mg, and P than does normal cartilage. Apatite crystals, if present, comprise maximally 0.4% wet weight of OA cartilage. PMID- 3668987 TI - Musculoskeletal problems in the family practice setting: guidelines for curriculum design. AB - Rheumatology training is essential for family practice residents, but major inadequacies have been described in current programs. In an effort to guide the design of our own rheumatology curriculum, all patient visits to a family health center over a 15-week period were surveyed. Musculoskeletal problems were reported overall in 23% of the 2285 patient visits and were commoner as patient age increased. Osteoarthritis and regional joint pain were the 2 most frequent problems noted, whereas systemic and inflammatory rheumatic diseases were unusual. Rheumatology curricula for family physicians should stress evaluation, management and prevention of problems in those defined areas. PMID- 3668988 TI - Hand function in the elderly: relation to osteoarthritis. AB - Hand function and osteoarthritis (OA) were assessed in 32 subjects, over 60-years old. The Smith Hand Function Test bore a relation to age, coordination and hand strength but not to the degree of OA. Hand strength also was not related to OA. Subjective hand disability, measured with the Stanford Health Assessment Questionnaire, correlated with radiographic OA and joint tenderness as well as with sex and hand strength. OA does not contribute significantly to the objective decline in hand function in the elderly but may contribute to a subjective sense of functional limitation. PMID- 3668989 TI - Mixed connective tissue disease with pulmonary hypertension: a clinical and pathological study. AB - Clinical and autopsy findings of 2 cases with mixed connective tissue disease (MCTD) associated with severe pulmonary hypertension are reported. Both cases showed marked intimal and medial thickening in small and medium sized pulmonary arteries. In one of the cases plexiform lesions, endarteritis obliterans, and fibrous intimal thickening of the pulmonary veins were recognized. In some cases with MCTD, pulmonary hypertension develops due to pulmonary vascular lesions which are similar to those of primary pulmonary hypertension. PMID- 3668990 TI - Relapsing eosinophilic myositis--a cause of pseudothrombophlebitis in an alcoholic. AB - A 51-year-old chronic alcoholic man presented with recurrent calf and thigh swelling and was investigated on several occasions for possible deep venous thrombosis. The episodes were precipitated by binge drinking. Muscle biopsy was performed on 3 occasions, revealing an inflammatory myopathy. On one of these occasions eosinophils were prominent in the interstitial infiltrate. Eosinophilic infiltrates in skeletal muscle may be a transient phase of the cellular process in the inflammatory myopathy and perhaps do not denote a specific nosological entity. PMID- 3668991 TI - AA amyloidosis in systemic lupus erythematosus. AB - A 37-year-old woman with longstanding systemic lupus erythematosus developed cardiac insufficiency, nephrotic syndrome, and azotemia. The findings at echocardiography and cardiac scintigraphy suggested amyloidosis, which was confirmed by rectal biopsy and fine needle biopsy of subcutaneous abdominal fat. Postmortem examination revealed systemic amyloidosis with massive deposits in the heart, spleen and kidneys. She had persistently increased concentration of serum amyloid A protein during the last 4 years of her life, and her amyloidosis was of the secondary (AA) type, as shown by immunohistochemical studies. PMID- 3668992 TI - Nonspecific inflammatory monoarthritis in the vicinity of bony metastases. AB - We describe a patient that presented with arthritis of a knee joint unresponsive to conventional treatment and who was found to have bony metastases of the distal femur from lung carcinoma. The presence of malignant cells could not be demonstrated in the synovial fluid or in the synovium. Our case illustrates the fact that malignant metastatic deposits in bone adjacent to a joint may cause a nonspecific synovial inflammation. PMID- 3668993 TI - Lipid laden macrophages in synovial fluid: a late finding in traumatic arthritis. AB - A 66-year-old man presented with arthritis of the right knee of 3 months' duration. Cytologic examination of synovial fluid (SF) showed numerous lipid laden macrophages. Radiographs and a nuclear scintigram established the presence of a fracture of the lateral tibial plateau. The diagnostic significance of lipid laden macrophages in SF is reviewed. PMID- 3668994 TI - Monoarthritis due to Mycobacterium chelonei. AB - A 48-year-old woman with infection of the tendon sheaths and proximal interphalangeal joint by Mycobacterium chelonei is described. Antibiotic therapy was not administered, and the patient recovered spontaneously. PMID- 3668995 TI - Hypocomplementemic vasculitis and systemic lupus erythematosus. PMID- 3668996 TI - Pseudorheumatoid deformity of the feet associated with parkinsonism. PMID- 3668997 TI - Experimental autoimmune spondylodiscitis associated with type II collagen induced arthritis. PMID- 3668998 TI - Inefficacy of diltiazem in the treatment of Raynaud's phenomenon with associated connective tissue disease: a double blind placebo controlled study. PMID- 3668999 TI - Rapidly evolving azathioprine induced pancytopenia. PMID- 3669000 TI - Auranofin: its use in patients with rheumatoid arthritis maintained with parenteral chrysotherapy. PMID- 3669001 TI - Macrolides with gastrointestinal motor stimulating activity. PMID- 3669002 TI - Antimalarial activity of 2-(substituted amino)-4,6-bis(trichloromethyl)-1,3,5 triazines and N-(chlorophenyl)-N'-[4-(substituted amino)-6-(trichloromethyl) 1,3,5-triazin-2-yl]guanidines. AB - A series of 2-[[(dialkylamino)alkyl]amino]-4,6-bis(trichloromethyl)-1,3,5 triazines (III) and N-(4-chlorophenyl)-N'-[4-[[(dialkylamino)alkyl]amino]-6- (trichloromethyl)-1,3,5-triazin-2-yl]guanidines (IV) were prepared from 2,4,6 tris(trichloromethyl)-1,3,5-triazine and 2-chloro-4,6-bis(trichloromethyl)-1,3,5 triazine. Compounds of type III showed modest antimalarial activity while XIa with the camoquin side chain was more potent. Analogues of type IV broadly exhibited modest antimalarial activity. PMID- 3669003 TI - Stereospecificity in allergic contact dermatitis to simple substituted methylene lactone derivatives. AB - The enantiomers of beta,gamma-dimethyl- and beta-methyl-alpha-methylene-gamma butyrolactones have been synthesized stereospecifically from glutamic acid and beta-hydroxy isobutyric acid, respectively. Guinea pigs have been sensitized (Freund complete adjuvant technique) and tested to them. Both enantiomers of beta methyl lactone as well as (+)-beta,gamma-dimethyl lactone induced enantiospecific allergic contact dermatitis (ACD); in turn, (-)-beta,gamma-dimethyl lactone showed no specificity. An interpretation is proposed. PMID- 3669004 TI - Synthesis and gastrointestinal pharmacology of the 4-fluoro analogue of enisoprost. AB - A 4-fluoro analogue of enisoprost was prepared and evaluated for gastric antisecretory and mucosal protective activity in animals. The synthesis centered upon cuprate chemistry but also involved a Wittig reaction to produce a cis fluoro olefinic moiety, a furan rearrangement/isomerization reaction to provide the necessary hydroxycyclopentenone, and a two-carbon-homologation procedure. The fluoro analogue was much less potent as a gastric antisecretory and mucosal protective agent than enisoprost. PMID- 3669005 TI - Design, synthesis, and testing of potential antisickling agents. 10. (2,2 Dimethylchroman-6-yl)alkanoic acids. AB - Five (2,2-dimethylchroman-6-yl)alkanoic acids were synthesized and tested for antigelling activities. It was envisioned that these agents might bind via hydrophobic bonding to nonpolar sites of the "donor-acceptor" regions of hemoglobin S. Several (2,2-dimethylchroman-6-yl)alkanoic acids containing 1-4 carbon atoms on the side-chain residue were designed to interact at the acceptor site, were synthesized, and were found to be moderately potent antigelling agents. The weak activity observed for two of the acids at low concentrations is rationalized in terms of weak binding affinities or multiple binding to active and nonactive sites. The effect of these compounds on shifting the allosteric equilibrium was small or negligible. The low toxicity of one of the (2,2 dimethylchroman-6-yl)alkanoic acids demonstrates the potential use of yet another class of compounds that can be modified in the development of antisickling agents. PMID- 3669006 TI - Angiotensin-converting enzyme inhibitors: perhydro-1,4-thiazepin-5-one derivatives. AB - alpha-[6-[[(S)-1-(Ethoxycarbonyl)-3-phenylpropyl]amino]-5-oxoperhydro -1,4 thiazepin-4-yl]acetic acids (monoester monoacids) and their dicarboxylic acids having the hydrophobic substituents at the 2- or 3-position of the thiazepinone ring were prepared and assayed for angiotensin-converting enzyme (ACE) inhibitory activity. The dicarboxylic acids having the pseudoequatorial amino groups at the 6-position and the pseudoequatorial hydrophobic substituents at the 2- or 3 position of the chair conformation of the thiazepinone ring had potent in vitro inhibitory activity. The monoester monoacids having the hydrophobic substituents at the 2-position suppressed pressor response to angiotensin I for a longer duration than those having the substituents at the 3-position when administered orally. The structure-activity relationship was studied by conformational energy calculations of the thiazepinone ring. PMID- 3669007 TI - Antitumor agents. 89. Psychorubrin, a new cytotoxic naphthoquinone from Psychotria rubra and its structure-activity relationships. AB - A new naphthoquinone, isolated from the alcoholic extract of Psychotria rubra, exhibited significant cytotoxicity in the KB cell assay (ED50 = 3.0 micrograms/mL). Spectral data was used to assign the structure of psychorubrin as 2. Naphthoquinone derivatives 6, 8, 13, and 14 were prepared and exhibited superior cytotoxic activity to that of psychorubrin. All were potential Michael acceptors whose conjugation had been extended. However, when a hydrophilic hydroxy group was present in such compounds, reduced in vitro activity was observed. PMID- 3669008 TI - Carbamate ester derivatives as potential prodrugs of the presynaptic dopamine autoreceptor agonist (-)-3-(3-hydroxyphenyl)-N-propylpiperidine. AB - Twenty derivatives bearing substituents on the phenolic function of (-)-3-(3 hydroxyphenyl)-N-propylpiperidine [(-)-3-PPP] were synthesized and tested as prodrugs. The carbamate ester derivatives were found to be the most suitable prodrugs, and especially the 4-isopropylphenylcarbamate 20 was capable of escaping the first-pass metabolism and still generating high plasma levels of the parent compound. Four hours after an oral dose of 100 mumol/kg to rats, a plasma level of 2400 nmol/L of (-)-3-PPP was detected by an HPLC method. This was 90 times the level reached after 4 h (27 nmol/L) when (-)-3-PPP itself was given orally at the same dose. PMID- 3669009 TI - Facile synthesis of 2-[(3-aminopropyl)thio]adenosine 5'-diphosphate: a key intermediate for the synthesis of molecular probes of adenosine 5'-diphosphate function. AB - Adenosine 5'-diphosphate (ADP) and, uniquely, its C-2 derivatized analogues are able to induce platelet activation. We here report the synthesis of 2-[(3 aminopropyl)thio]-ADP from ADP itself via 1,N6-etheno-ADP. 2-[(3 Aminopropyl)thio]-ADP induced platelet aggregation with a potency about one seventh that of ADP itself and should prove a useful intermediate in the synthesis of other probes of platelet function. PMID- 3669010 TI - Nitrogen-bridged conformationally constrained etorphine analogues. Synthesis and biological evaluation. AB - Three N-C8-bridged analogues 4-6 of the opiate etorphine (3) were synthesized and evaluated for opiate agonism and antagonism. In each case ring closure was effected by intramolecular N-alkylation with a suitably developed C8 side chain. Another key synthetic step was the selective monoprotection of diol 11, which allowed independent elaborations of the C7 and C8 side chains. All three analogues showed distinctly diminished agonist activities when compared to the corresponding N-methyl compound, 19(R)-n-butylorvinol (3). Furthermore, no antagonist activity was detectable. The results demonstrate that the conformation at the amino nitrogen in rigid morphinans is critical for potent opiate activity. PMID- 3669011 TI - Antiulcer agents. 2. Gastric antisecretory, cytoprotective, and metabolic properties of substituted imidazo[1,2-a]pyridines and analogues. AB - The search for a successor to 3-(cyanomethyl)-2-methyl-8 (phenylmethoxy)imidazo[1,2-a]pyridine, Sch 28080 (27), a compound that exhibits gastric antisecretory and cytoprotective properties and has undergone clinical evaluation as an antiulcer agent, has culminated in the identification of four related compounds that exhibit pharmacologic profiles similar to that of 27. In three of these potential successors an amino group functions as a surrogate for the 3-cyanomethyl substituent of the prototype. The present work concerns, in addition to an evaluation of the structure-activity relationships of a series of analogues of 27, preliminary studies of the pharmacodynamics and metabolism of 27, performed with the aid of cyano carbon labeled versions of the drug (13C labeled; 28; 14C labeled, 29). These studies have shown that 27 is well-absorbed and extensively metabolized and that the major metabolite of 27 is the thiocyanate anion. A similar study performed on 3-amino-2-methyl-8 (phenylmethoxy)imidazo[1,2-a]pyridine, labeled at the 3-position with carbon-13 (41) or carbon-14 (42), revealed that this compound, which has an antisecretory/cytoprotective profile comparable to that of 27, is also metabolized to thiocyanate anion, although this must occur via a different mechanism. The chemistry section includes a discussion of the potential sites of protonation of the pharmacologically similar 3-amino analogue 40 and the structurally related imidazo[1,2-a]pyrazine 67. Predictions based on charge density and protonation product stabilities are presented. That N1 is the site of protonation in these analogues has been definitively demonstrated by X-ray crystal structure analysis, which also unequivocally established the assigned imidazo[1,2-a]pyrazine ring structure. PMID- 3669012 TI - Antiulcer agents. 3. Structure-activity-toxicity relationships of substituted imidazo[1,2-a]pyridines and a related imidazo[1,2-a]pyrazine. AB - Investigation of the interrelationship between structure, antiulcer activity, and toxicology screening data derived from a series of compounds selected from structure-activity studies directed toward identifying a successor to 3 (cyanomethyl)-2-methyl-8-(phenylmethoxy)imidazo[1,2-a]pyridine, Sch 28080 (1), has identified 3-(cyanomethyl)-2,7-dimethyl-8-(phenylmethoxy)imidazo[1,2 a]pyridine (5), 3-amino-2-methyl-8-(2-phenylethyl)imidazo[1,2-a]pyridine (6), and 3-amino-2-methyl-8-(phenylmethoxy)imidazo[1,2-a]pyrazine (7). These analogues exhibit a combination of antisecretory and cytoprotective activity in animal models, while eliminating the adverse effects of the prototype 1. One of these, 3 amino-2-methyl-8-(phenylmethoxy)imidazo[1,2-a]pyrazine, Sch 32651 (7), has a profile meeting all criteria. PMID- 3669013 TI - Metabolic synthesis of arylacetic acid antiinflammatory drugs from arylhexenoic acids. 2. Indomethacin. AB - Arylacetic acid antiinflammatory drugs can be metabolically produced by beta oxidation of a 6-arylhex-5-enoic acid side chain. Such a mechanism provides for an in vivo sustained release of the active principle indomethacin from 6-[N-(p chlorobenzoyl)-2-methylindol-3-yl]hex-5-enoic acid (7). Similarly, biphenylacetic acid was produced from both 6-(4'-biphenylyl)hex-5-enoic acid and its lower even homologue, 4-(4'-biphenylyl)but-3-enoic acid. The indole derivative produced sustained analgesia in a yeast-induced hyperalgesia model over a 12-h period. Indomethacin plasma levels of 2 micrograms/mL were observed for up to 24 h. Such levels were less than those achieved for the analogous case in which biphenylacetic acid was produced from biphenylylhex-5-enoic acid, suggesting metabolic discrimination between hex-5-enoic substrates. When indomethacin was dosed in equipotent analgesic levels, the level of circulating drug was considerably higher than that seen for metabolically derived drug. Hence 6-hex-5 enoic acid derivatives of indomethacin are metabolized to indomethacin in vivo to give sustained analgesia at low apparent circulating plasma levels of free drug. The possibility of tissue compartmentalization enhancing biological efficacy is suggested by these observations. PMID- 3669014 TI - Synthesis and physicochemical properties of thiadiazolo[3,2 a]pyrimidinesulfonamides and thiadiazolo[3,2-a]triazinesulfonamides as candidates for topically effective carbonic anhydrase inhibitors. AB - A series of bicyclic 1,3,4-thiadiazolo[3,2-a]pyrimidine- and 1,3,4 thiadiazolo[3,2-a]triazine-7-sulfonamides were synthesized from 5-amino-1,3,4 thiadiazole-2-sulfonamide and evaluated for topical efficacy as ocular hypotensive agents. The compounds were tested for the physicochemical properties of sulfonamide pKa, free acid water solubility, CHCl3/buffer partition, and transcorneal penetration (kin), as well as for activity against carbonic anhydrase (I50). A number of these compounds exhibited lower sulfonamide pKa and higher water solubility than those of acetazolamide (1) and methazolamide (2), and one, 12, brought about a small reduction in IOP in the normal rabbit eye. PMID- 3669015 TI - Modulation of the antitumor activity by methyl substitutions in the series of 7H pyridocarbazole monomers and dimers. AB - The structure of the dimeric antitumor drug ditercalinium (NSC 366241) [2,2' ([4,4'-bipiperidine]-1,1'-diyldi-2,1-ethanediyl)bis[10 -methoxy-7H-pyrido[4,3 c]carbazolium] tetramethanesulfonate] was modified by introduction of methyl groups in various positions of the aromatic ring. Monomeric analogues with the nitrogen atom of the pyridinic ring in different positions have also been synthesized. Pharmacological properties and DNA interactions of the new compounds are reported. In contrast with the monomeric analogue of ditercalinium, which was inactive, methyl substitutions on the 10-methoxy-7H-pyrido[4,3-c]carbazolium in positions 6 or 7 led to monomers endowed with small but significant activity. As expected, dimerization of the methyl-substituted pyridocarbazoles yielded DNA bisintercalators with affinity slightly higher than that of the unsubstituted parent compounds. These dimers, characterized by a relatively better therapeutic index, have the same mechanism of action as ditercalinium. Otherwise, in monomeric and dimeric series, methyl substitution in position 4 or 5 provided inactive compounds unable to intercalate into DNA. All these results are in agreement with the previously proposed geometry for the complex of ditercalinium with DNA. PMID- 3669016 TI - Potential antitumor agents. 53. Synthesis, DNA binding properties, and biological activity of perimidines designed as "minimal" DNA-intercalating agents. AB - A series of compounds based on perimidine have been synthesized and evaluated for their DNA-binding properties and antitumor activity. The fused tricyclic permidine chromophore appears to be the minimal structural requirement for intercalative binding to DNA since the mode of binding could be dictated by the position of attachment of the side chain. The intercalating compounds have DNA association constants (log K = 5.8-6.5) and cytotoxic potencies (IC50 = 500-1500 nM) comparable to those shown by other classes of linear, tricyclic DNA intercalating antitumor agents (acridinecarboxamides, phenazinecarboxamides), but none of the compounds showed in vivo activity. PMID- 3669017 TI - Phenylephrine derivatives as leukotriene D4 antagonists. AB - Two series of phenylephrine derivatives were prepared and tested as inhibitors of leukotriene D4 (LTD4) induced and ovalbumin-induced bronchospasm in the guinea pig. The most potent compound of the urea series, (R)-N,N-diethyl-N-[2-hydroxy-2 [3-(2-quinolinylmethoxy)phenyl]ethyl]-N- methylurea (3, Wy-47,120), was orally active with ED50's of 56 mg/kg vs. LTD4 and 55 mg/kg vs. ovalbumin. When tested as an antagonist of LTD4-induced contraction of isolated guinea pig tracheal strips, 3 was a competitive inhibitor with a p kappa B value of 5.22. In the second series, (R)-3-methyl-5-[3-(2-quinolinylmethoxy)phenyl]-2-oxazolidinone (26, Wy-47,674) had oral ED50's of 36 mg/kg against LTD4 and 95 mg/kg against ovalbumin. Compound 26 selectively antagonized contractile responses of guinea pig trachea evoked by LTD4 (p kappa B = 6.09). In the cat coronary artery, 3 dilated the preparation and blocked the coronary constrictor effect of LTD4. Compound 3 (0.13 mg/kg, iv) also preserved myocardial integrity in rats 48 h after coronary artery ligation. When tested in the rat alcohol-induced gastric lesion model, 3 and 26 manifested a dose-dependent mucosal protection against ethanol. PMID- 3669018 TI - Synthesis, chemical reactivity, and antileukemic activity of 5-substituted 6,7 bis(hydroxymethyl)pyrrolo[1,2-c]thiazole biscarbamates and the corresponding sulfoxides and sulfones. AB - A series of bis(N-methylcarbamate) and bis[N-(2-propyl)carbamate] derivatives of 5-substituted 6,7-bis(hydroxy-methyl)pyrrolo[1,2-c]thiazoles was prepared. The compounds were tested for activity in vivo against P388 lymphocytic leukemia, and the chemical reactivities of the compounds were compared by using the model nucleophile 4-(4-nitrobenzyl)pyridine (NBP). The 5-(3,4-dichlorophenyl) substituted biscarbamates 6b, 8b, and 12b were inactive and unreactive toward NBP. The 5-methyl-substituted biscarbamates 6a, 7a, 8a, 9a, 12a, and 13a were all active against murine P388 lymphocytic leukemia. The chemical reactivities of the active compounds depended on the oxidation state of the sulfur. The reactivity toward NBP followed the order S greater than SO much greater than SO2. The sulfones 12a and 13a are the most active compounds in this series, and their lack of reactivity toward NBP led to the suggestion that 12a and 13a are activated in vivo. PMID- 3669019 TI - In vivo characterization of hydroxamic acid inhibitors of 5-lipoxygenase. AB - The hydroxamic acid functionally can be incorporated into simple molecules to produce potent inhibitors of 5-lipoxygenase. The ability of many of these hydroxamates to inhibit leukotriene synthesis in vivo has been measured directly with a rat peritoneal anaphylaxis model. Despite their potent enzyme inhibitory activity in vitro, many orally dosed hydroxamic acids only weakly inhibited leukotriene synthesis in vivo. This discrepancy is attributable at least in part to the rapid metabolism of hydroxamates to the corresponding carboxylic acids, which are inactive against the enzyme. A study of the structural features that affect this metabolism revealed that 2-arylpropionohydroxamic acids are relatively resistant to metabolic hydrolysis. Several members of this class of hydroxamates are described that are orally active inhibitors of leukotriene synthesis. PMID- 3669020 TI - 3-Pyrroline N-oxide bis(carbamate) tumor inhibitors as analogues of indicine N oxide. AB - The 2,3-bis[[(N-methylcarbamoyl)oxy]methyl]-3-pyrroline 1-oxide 5 was synthesized and tested in the murine P388 lymphocytic leukemia model. The compound showed significant reproducible activity and was more potent than indicine N-oxide. 1 Methyl-2-phenyl-3,4-bis[[(N-2- propylcarbamoyl)oxy]methyl]-3-pyrroline N-oxide (6) was less active than 5, and the 5,5-dimethyl analogue of 6, the pyrroline N oxide 7, was inactive. The N-oxide 7 cannot be converted to a pyrrole in vivo because of the gem-dimethyl substitution at C-5. PMID- 3669021 TI - Antimalarial activity of new water-soluble dihydroartemisinin derivatives. AB - The usefulness of sodium artesunate (3), a water-soluble derivative of artemisinin (1), is impaired by its poor stability in aqueous solution. To overcome the ease of hydrolysis of the ester group in 3, a new series of derivatives of dihydroartemisinin (2) was prepared in which the solubilizing moiety, which contains a carboxylate group, is joined to dihydroartemisinin by an ether rather than an ester linkage. The new derivatives were prepared in good yield by treatment of dihydroartemisinin with an appropriate alcohol under boron trifluoride etherate catalysis at room temperature. All major condensation products are the beta isomer. Hydrolysis of the esters with 2.5% KOH/MeOH gave the corresponding potassium salts, which were converted to free acids (8b-d) by acidification. The derivatives were tested in vitro against two clones of human malaria, Plasmodium falciparum D-6 (Sierra Leone clone) and W-2 (Indochina clone). No cross-resistance to the antimalarial agents mefloquine, chloroquine, pyrimethamine, sulfadoxine, and quinine was observed. In general, the new compounds are more effective against the W-2 than the D-6 strain. Esters (5a-d) possess activity comparable to that of the parent compounds 1 and 2; however, conversion of the esters to their corresponding carboxylates (7a-d) or acids (8b d), with the exception of artelinic acid (8d), drastically decreases the antimalarial activities in both cell lines. Artelinic acid, which is both soluble and stable in 2.5% K2CO3 solution, possesses superior in vivo activity against Plasmodium berghei than artemisinin or artesunic acid. PMID- 3669022 TI - Synthesis and antimalarial and antitumor effects of 2-amino-4-(hydrazino and hydroxyamino)-6-[(aryl)thio]quinazolines. AB - A variety of analogues of 2,4-diamino-6-[(aryl)thio]quinazolines with known antimalarial properties were prepared wherein the 4-amino group was replaced by hydrazino and hydroxyamino moieties. Such changes were found to reduce markedly the antimalarial and antitumor properties of this series. PMID- 3669023 TI - 1,2-Bis(sulfonyl)hydrazines. 3. Effects of structural modification on antineoplastic activity. AB - A series of 1,2-bis(sulfonyl)hydrazines was synthesized and evaluated for antineoplastic activity against the L1210 leukemia and the B16 melanoma. The most active agent to emerge from this study, 1,2-bis(methylsulfonyl)-1 methylhydrazine, produced a maximum % T/C for mice bearing the L1210 leukemia or the B16 melanoma of 340% and 278%, respectively. Two N-chloroethyl analogues, conceived as bifunctional alkylating agents, were also synthesized and evaluated for antineoplastic activity against the L1210 leukemia and the B16 melanoma. Although such a modification resulted in retention of antineoplastic activity against both tumor cell lines, it did not result in enhanced antineoplastic activity. PMID- 3669024 TI - Computer simulation of area-wide management strategies for the lone star tick, Amblyomma americanum (Acari: Ixodidae). PMID- 3669025 TI - Evaluation of Leptotrombidium (Leptotrombidium) fletcheri (Acari: Trombiculidae) as a potential vector of Ehrlichia sennetsu. PMID- 3669026 TI - Biology of a laboratory colony of Phlebotomus perniciosus (Diptera: Psychodidae). PMID- 3669027 TI - Dispersal of phlebotomine sand flies (Diptera: Psychodidae) in a Colombian coffee plantation. PMID- 3669028 TI - Host associations of Gigantolaelaps (Acari: Laelapidae) in the Cerrado Province of Central Brazil. PMID- 3669029 TI - Larval population dynamics of Culicoides variipennis (Diptera: Ceratopogonidae) in southern California. PMID- 3669030 TI - Dynamics of African tick (Acari: Ixodoidea) populations in a natural Crimean Congo hemorrhagic fever focus. PMID- 3669031 TI - Rapid evaluation of candidate materials preliminary to in vivo testing for systemic control of northern fowl mites, Ornithonyssus sylviarum (Acari: Macronyssidae). PMID- 3669032 TI - Isolations of Leishmania braziliensis (Kinetoplastida: Trypanosomatidae) from cryopreserved Colombian sand flies (Diptera: Psychodidae) PMID- 3669033 TI - Vacuum sampling for Psoroptes ovis (Acari: Psoroptidae). PMID- 3669034 TI - Ectoparasites of the pelagic cormorant, Phalacrocorax pelagicus, from the Pribilof Islands, Alaska. PMID- 3669035 TI - Medical ethics education. PMID- 3669036 TI - QALYfying the value of life. AB - This paper argues that the Quality Adjusted Life Year or QALY is fatally flawed as a way of priority setting in health care and of dealing with the problem of scarce resources. In addition to showing why this is so the paper sets out a view of the moral constraints that govern the allocation of health resources and suggests reasons for a new attitude to the health budget. PMID- 3669037 TI - The ethics of human cadaver organ transplantation: a biologist's viewpoint. AB - The rights of the various individuals involved in decision-making in cadaver organ donation are considered, and there is discussion of the relation of human cadavers to the planetary biomass. I conclude that the rights of the potential recipient should outweigh those of the other parties concerned and that education and legislation should recognise and promote this. PMID- 3669039 TI - Teaching medical ethics symposium. PMID- 3669038 TI - Health care ethics: a pattern for learning. AB - The British Medical Association (BMA) has called upon the General Medical Council (GMC) to instruct all medical schools to provide identifiable and substantial courses on medical ethics in their undergraduate curricula. The author reviews a postgraduate scheme of study in the ethics of health-care and suggests that it could provide some useful guidelines for teaching the subject at the undergraduate level. PMID- 3669040 TI - Teaching medical ethics to medical students and GP trainees. AB - This paper relates two experiences of teaching medical ethics, the first to a small group of clinical medical students, the second to a larger group of GP trainees. PMID- 3669041 TI - Combining law with medical ethics. AB - A postgraduate Diploma in Medical Ethics and Law was started in October 1984 by the Centre of Medical Law and Ethics at King's College. It is a part-time one year course designed so as to enable students to continue with full-time employment if they wish. It is multidiscipinary and is open to all who have a first degree in a relevant discipline, for example law, philosophy, theology, medicine and nursing studies. It is unique in combining medical law and medical ethics and has attracted students of high calibre from a variety of backgrounds during its first three years. Building on the experience of the diploma the course is being upgraded to an MA in 1987-88. It will be available either full time for one year or part-time for two years. PMID- 3669042 TI - Teaching medical ethics symposium. Reflections from New Zealand. AB - The Medical Faculty of the University of Otago, New Zealand is experimenting with a new approach to the teaching of medical ethics, making it an integral part of several courses in all years of the medical curriculum. During the author's twelve-month period as a visiting professor in the faculty, trial runs in ethics have been introduced in the preclinical sciences, in behavioural science and medical-decision analysis and in every clinical attachment. Proposals for permanent course requirements will be considered by the faculty after a full evaluation of these experiments by both students and teaching staff. If such courses are to be implemented and maintained, medical facilities will need to appoint specialists in ethics, at least on a part-time basis. PMID- 3669043 TI - Teaching medical ethics symposium. A student-led approach to teaching. AB - It is increasingly agreed that ethics has a place in undergraduate medical education. There is, however, debate about how it should be taught, and by whom. We present our experience of teaching ethics in a general practice module over six years. During this period there has been a shift from a teacher-centred to a student-centred approach in which students choose ethical issues to explore within a framework provided. The issues raised are discussed with examples, and the future directions of our ethics teaching outlined. PMID- 3669044 TI - Medical ethics and the clinical curriculum: a case study. AB - There are very few medical ethics courses in British medical schools which are a formal part of the clinical curriculum. Such a programme is described in the following, along with the way in which the long-term curriculum committee of the University College and Middlesex Hospital Joint Medical School was persuaded to make it compulsory for first-year students. Pedagogical lessons which have been learned in its planning and implementation are outlined and teaching materials are included concerning student and course assessment which should be useful for others engaged in similar work. Finally, some of the institutional obstacles facing such attempts are discussed, particularly problems concerning timetabling, different types of opposition and the consequent importance of building alliances among clinical teaching staff. PMID- 3669045 TI - Teaching medical ethics symposium. Medical ethics in Manchester. AB - Manchester's multi-disciplinary approach to medical ethics combines established methods and new initiatives. There is a longstanding Medical Group and also, plans are evolving for the inclusion of medical ethics teaching in the undergraduate curriculum, the start of an MA in Health Care Ethics in October 1987 and the establishment of the Centre for Social Ethics and Policy to act as a focus within the university for research and study in a wider context. PMID- 3669046 TI - Practical problems in the teaching of ethics to medical students. AB - Some practical problems in the teaching of ethics to medical students are described. The definition of the objectives of the course remains the central aspect, and is more important than the specific content. The use of student projects, buzz groups, case histories and discussion points is described. There is a need for student assessment or examination at the end of the course. The teachers require a broad background in philosophy, clinical medicine and teaching skills. The learning of the teachers may be as important as that of the students. PMID- 3669047 TI - CABGs and KINGS: relevance and realism in the teaching of clinical ethics in Camberwell. PMID- 3669048 TI - Exclusion mapping. AB - The basis for using information against linkage to some loci to support linkage to other loci is discussed and data on cystic fibrosis available up to late July 1985 used as an example. PMID- 3669049 TI - Tuberous sclerosis: a large family with no history of seizures or mental retardation. AB - A family is reported where tuberous sclerosis has probably affected five generations, but where none of the members has been mentally retarded and there is no history of seizures. PMID- 3669050 TI - Congenital cutis laxa with retardation of growth and development. AB - Seven patients with congenital cutis laxa are presented. The associated features include developmental delay, joint laxity, wide anterior fontanelle, growth retardation, dental caries, and osteopenia. The heterogeneity and inheritance of congenital cutis laxa are discussed. This particular syndrome appears distinct and is likely to be autosomal recessive in view of the two brother-sister sib pairs in this report. PMID- 3669051 TI - Homozygosity in piebald trait. AB - A severely affected child born to consanguineous parents is interpreted as being a homozygote for the dominantly inherited piebald trait. The striking phenotypic difference between the parents and the child implies intermediate inheritance of this condition, and the family also illustrates that consanguinity should not always be taken to indicate genetic heterogeneity and recessive inheritance. PMID- 3669052 TI - Properties of equine anti-lipopolysaccharide hyperimmune plasma: binding to lipopolysaccharide and bactericidal activity against gram-negative bacteria. AB - Anti-lipopolysaccharide equine hyperimmune plasma (anti-LPS), which has been used successfully to treat LPS (endotoxin)-mediated disorders, has been further characterised. IgG present in anti-LPS had the highest affinity for LPS prepared from Salmonella typhimurium, S. typhi, S. abortus equi and Shigella flexneri and intermediate affinity for Escherichia coli O55:B5, E. coli O127:B8 and S. enteritidis. Anti-LPS destroyed by means of complement activation a wide range of gram-negative bacteria, including various species and strains of Klebsiella, Enterobacter, E. coli, Sh. flexneri, Providencia, Salmonella and Pseudomonas. Control plasmas or saline had little or no effect. Maximum killing occurred within seconds to minutes. Electronmicroscopy showed that anti-LPS treatment of K. pneumoniae caused extensive cell wall and cytoplastic membrane disruption, followed by the appearance of spheroplasts and cell ghosts. Antibodies were required in 100,000-fold excess to inhibit the limulus amoebocyte lysate reaction with LPS from E. coli. Anti-LPS thus contains IgG that binds to a wide range of LPS, and can destroy a wide range of gram-negative bacteria by means of complement activation. PMID- 3669053 TI - Quantitative cell-adhesion assay for Clostridium difficile cytotoxin. AB - A quantitative assay for Clostridium difficile cytotoxin has been developed, based on the observation that suspended fibroblasts exposed to cytotoxin fail to adhere to plastic. A dye-binding technique was used to quantitate adherent cells, in order to obviate microscopy. Adherent BHK cells were fixed with glutaraldehyde and cell protein was stained with Coomassie blue R-250. Cell-bound dye was eluted and estimated spectrophotometrically. The amount of eluted dye was proportional to the number of adherent cells and cell staining was time dependent. Cytotoxin was purified by gel-permeation and ion-exchange chromatography and migrated as a single band on SDS-PAGE. After exposure of suspended BHK cells to purified cytotoxin, their adhesion to plastic was inhibited in a manner which depended on concentration of cytotoxin and on time and temperature of exposure. This study provides the basis for a C. difficile cytotoxin assay that is quantitative, rapid and reproducible and may have wider applicability in the study of other toxins or agents that inhibit cell adhesion. PMID- 3669054 TI - Surface properties of Yersinia species and epithelial cell interactions in vitro by a method measuring total associated, attached and intracellular bacteria. AB - A procedure was developed for enumeration of total associated, attached and intracellular bacteria after interaction of Yersinia spp. with epithelial cells in vitro. Isogenic cultures of Y. enterocolitica grown at 25 degrees C had greater affinity for epithelial cells (Henle, HeLa and Vero) than for polystyrene, and they invaded the cells. Y. kristenseni and Y. intermedia showed less attachment to either surface and were non-invasive. The degree of attachment to cells and invasion by Y. enterocolitica was related to number of bacteria added and interaction time, whereas attachment to polystyrene occurred rapidly and did not change. Y. enterocolitica was more hydrophobic when grown at 35 degrees C than at 25 degrees C according to partitioning in a biphasic dextran polyethylene glycol system, and attached strongly to both polystyrene and epithelial-cell monolayers. Y. kristenseni grown at 25 degrees C was also hydrophobic but did not have the same attachment properties. Y. kristenseni and Y. intermedia showed slightly reduced electrostatic interactions with the anion exchangers DEAE-Sepharose and DEAE-Trisacryl. Attachment of Y. enterocolitica to epithelial cells probably involves non-specific surface properties that are not entirely explicable by hydrophobic and electrostatic interactions, whereas invasion of epithelial cells appears to resemble "receptor-mediated endocytosis". PMID- 3669055 TI - Invasiveness of Yersinia enterocolitica lacking the virulence plasmid: an in-vivo study. AB - Rabbits were given, by the intra-gastric route, two isogenic strains of Yersinia enterocolitica that differed only in the presence or absence of the virulence plasmid. Clinical illness and characteristic morphological lesions of Y. enterocolitica infection were seen only in rabbits infected with the plasmid bearing strain (MCH700S). Although rabbits infected with a strain lacking the plasmid (MCH700L) remained healthy, mild histological changes in the small intestine, consisting of epithelial-cell damage, dilatation of lymphatics and a slight increase in neutrophil polymorphonuclear leukocytes in lamina propria, were seen in the first 12 h after inoculation. Bacteria, which were identified as Y. enterocolitica by indirect fluorescent antibody staining, were seen in dilated lymphatics. These early lesions tended to abate quickly and were no longer detectable at 24 h. Strain MCH700L was recovered from the mesenteric lymph nodes in increasing numbers until 24 h after inoculation; the number then began to decrease rapidly. In contrast, the early lesions in rabbits given strain MCH700S progressed to micro-abscesses, focal destruction of villi, and ulcerations beginning 24 h after inoculation; the number of bacteria recovered from the lymph nodes continued to increase beyond 24 h after inoculation. Bacteria were also recovered from the liver and spleen. These results suggest that both plasmid bearing and non-bearing strains of Y. enterocolitica are capable of penetrating the intestinal mucosa. However, the virulence plasmid is required for invading bacteria to proliferate in the host tissue and to establish infection. PMID- 3669056 TI - Quantitative bacteriology of the vaginal flora during the menstrual cycle. AB - The vaginal bacteriology of 10 healthy asymptomatic women was assessed during the menstrual cycle. Samples were taken from the posterior vaginal fornix for quantitative analysis. There were no significant alterations in the total vaginal flora at different stages of the menstrual cycle. The mean number of species isolated per specimen declined from 4.6 in week 1 to 2.9 in week 4. This decline was not caused by a decrease in the occurrence or concentration of any one organism or group of organisms. The vaginal pH decreased from a mean of 6.6 in week 1 to 4.3 in week 4, this increased acidity could not be attributed to the action of lactobacilli as their total incidence or concentration did not change during the menstrual cycle. PMID- 3669057 TI - Detection, quantitation and stability of the beta haemolysin of Aeromonas spp. AB - Amongst 58 isolates of motile aeromonads evaluated for the ability to produce beta haemolysin, haemolytic activity was significantly associated with strains belonging to the Aeromonas hydrophila and A. sobria groups. Of erythrocytes from nine animal species tested, mouse red blood cells provided the best indicator system for detection of beta-haemolysin activity. Furthermore, differences in the stability of the beta haemolysins of selected A. sobria and A. hydrophila isolates at different temperatures, and in the presence of urea or dithiothreitol were observed. PMID- 3669058 TI - The role of mycoplasmas, ureaplasmas and chlamydiae in the genital tract of women presenting in spontaneous early preterm labour. AB - The genital carriage of Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis was assessed in 72 women admitted to hospital in spontaneous preterm labour and in 26 women requiring preterm delivery for other reasons who formed a control group. Women in preterm labour significantly more often carried ureaplasmas, had large numbers of M. hominis and subsequently developed chorioamnionitis than women in the control group. M. hominis, in particular, occurred more frequently and in large numbers in women who had chorioamnionitis associated with ruptured membranes. Genital carriage of the various micro organisms appeared not to be associated with fetal growth retardation, although subsequent isolation of ureaplasmas from infants was common. It is suggested that mid-second-trimester vaginal specimens should be cultured on a research basis to establish whether these various micro-organisms identify women at risk of labouring preterm. PMID- 3669059 TI - Esterase electrophoretic polymorphism of methicillin-sensitive and methicillin resistant strains of Staphylococcus aureus. AB - Methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus from diverse geographic origins were analysed by polyacrylamide-agarose gel electrophoresis for esterase polymorphism. Three kinds of esterase bands, designated A, B and C, were defined by their ranges of activity toward five synthetic substrates and their resistance to di-isopropyl fluorophosphate. There were five allozymes of esterase A, four of esterase B and four of esterase C. Eighteen distinct combinations of allozymes (zymotypes) were distinguished amongst 105 strains analysed. Two major zymotypes were represented by 35 and 19 strains respectively, whereas other zymotypes were represented by one or, at most, seven strains. The coefficient of genetic diversity was lower for methicillin-resistant strains than for methicillin-sensitive strains. Most of the methicillin-resistant strains are represented by the two major zymotypes which differed from each other by the electrophoretic behaviour of the three esterases. These results indicate that, on the basis of esterase electrophoretic polymorphism, methicillin resistance is expressed in genetically different strains. PMID- 3669060 TI - The role of IgA1 rheumatoid factor in the formation of IgA-containing immune complexes in Henoch-Schonlein purpura. AB - The present study was performed to investigate the role of IgA rheumatoid factor (RF) in the formation of IgA-containing immune complexes and to determine the IgA subclass composition of IgA RF in patients with Henoch-Schonlein purpura (HSP). Immune complexes were isolated from the sera of 22 children with HSP and 13 controls by means of polyethylene glycol (PEG) precipitation. The percentage of IgG, IgA, and IgM precipitated by PEG was significantly greater in HSP patients than controls (p less than 0.01). There was a strong correlation (r = 0.723, p less than 0.001) between the amount of IgG and IgA in the PEG precipitates from HSP patients, but not controls. HSP patients had significantly higher levels of IgA RF in their serum (p less than 0.05) and in their PEG precipitates (p less than 0.05) compared to controls. There was a strong correlation between IgA RF concentrations in the serum and PEG precipitates in HSP patients (r = 0.910, p less than 0.001). PEG precipitation eliminated IgA RF activity from the serum of 7 of 8 HSP patients tested, and substantially reduced the titer in the remaining patient. IgA RF was recovered in the PEG precipitates from all patients. Testing of HSP patients showed that IgA1 was the predominant IgA subclass of the serum IgA RF (p less than 0.02) and PEG precipitate IgA RF (p less than 0.01). These results indicate that IgA RF is a constituent of IgA-containing immune complexes in HSP, and that IgA RF is composed primarily of IgA1. PMID- 3669061 TI - Antibodies to Coprococcus comes in sera of patients with Crohn's disease. Isolation and purification of the agglutinating antigen tested with an ELISA technique. AB - Previous studies showed that agglutinating antibodies to Coprococcus comes, an anaerobic Gram-positive coccoid rod isolated from the faecal flora of patients with Crohn's disease, are more frequently found in sera of Crohn patients than in ulcerative colitis patients and healthy subjects. Isolation of the antigen may be useful in developing a more sensitive and specific diagnostic test. The present study describes first a method to improve the presentation of the relevant agglutinating antigen by the bacterium and second, the purification by column chromatography of a relatively crude antigen extract of C. comes described previously by Hazenberg et al. (1). Comparative results with the agglutination reactions and ELISA technique of extensive series of patients with Crohn's disease and healthy subjects have shown that the agglutinating antigen of C. comes has been isolated. Although the present ELISA technique cannot replace the simple and reliable agglutination reaction for screening purposes, the purified antigen will allow further immunological studies and it is to be hoped that a deeper insight into pathogenesis of the disease will be gained. PMID- 3669062 TI - In vitro gliadin antibody production by peripheral blood mononuclear cells from patients with coeliac disease. AB - In vitro spontaneous IgG gliadin antibody production was shown in peripheral blood mononuclear cell (PBMC) cultures from 12/14 patients with active coeliac disease; in most cases no increase and sometimes a marked reduction of the in vitro synthesis was observed after pokeweed mitogen (PWM) addition. Lower levels of gliadin antibodies were also detected in PBMC cultures from 7/12 coeliac patients in remission; in all the cases the synthesis was increased by PWM. In vitro production was confirmed by higher levels in 7-day culture supernatants than in 0-day frozen-thawed cell pellets and by the inhibitory effect of cycloheximide. Spontaneous release of antibodies occurred within the first 3 days of culture, while PWM-induced antibody production reached a plateau after 7-9 days. The analysis of the in vitro gliadin antibody production is a promising technique to assess the regulatory mechanisms involved in the humoral immune response to gliadin. PMID- 3669063 TI - Furosemide-sensitive K+ (Rb+) transport in human erythrocytes: modes of operation, dependence on extracellular and intracellular Na+, kinetics, pH dependency and the effect of cell volume and N-ethylmaleimide. AB - The effect of extracellular and intracellular Na+ (Nao+, Nai+) on ouabain resistant, furosemide-sensitive (FS) Rb+ transport was studied in human erythrocytes under varying experimental conditions. The results obtained are consistent with the view that a (1 Na+ + 1 K+ + 2 Cl-) cotransport system operates in two different modes: mode i) promoting bidirectional 1:1 (Na+-K+) cotransport, and mode ii) a Nao+-independent 1:1 ki+ exchange requiring Nai+ which, however, is not extruded. The activities of the two modes of operation vary strictly in parallel to each other among erythrocytes of different donors and in cell fractions of individual donors separated according to density. Rb+ uptake through Rbo+/Ki+ exchange contributes about 25% to total Rb+ uptake in 145 mM NaCl media containing 5 mM RbCl at normal Nai+ (pH 7.4). Na+-K+ cotransport into the cells occurs largely additive to K+/K+ exchange. Inward Na+-Rb+ cotransport exhibits a substrate inhibition at high Rbo+. With increasing pH, the maximum rate of cotransport is accelerated at the expense of K+/K+ exchange (apparent pK close to pH 7.4). The apparent KmRbo+ of Na+-K+ cotransport is low (2 mM) and almost independent of pH, and high for K+/K+ exchange (10 to 15 mM), the affinity increasing with pH. The two modes are discussed in terms of a partial reaction scheme of (1 Na+ + 1 K+ + 2 Cl-) cotransport with ordered binding and debinding, exhibiting a glide symmetry (first on outside = first off inside) as proposed by McManus for duck erythrocytes (McManus, T.J., 1987, Fed. Proc., in press). N-ethylmaleimide (NEM) chemically induces a Cl--dependent K+ transport pathway that is independent of both Nao+ and Nai+. This pathway differs in many properties from the basal, Nao+-independent K+/K+ exchange active in untreated human erythrocytes at normal cell volume. Cell swelling accelerates a Nao+-independent FS K+ transport pathway which most probably is not identical to basal K+/K+ exchange. Ko+ less than Nao+ less than Lio+ less than Mgo2+ reduce furosemide-resistant Rb+ inward leakage relative to cholineo+. PMID- 3669064 TI - Denaturation of a membrane transport protein by urea: the erythrocyte anion exchanger. AB - Chloride equilibrium exchange was measured in the presence of intracellular and extracellular urea, several different alkylureas and thiourea. Urea half inhibited Cl exchange at about 2.5 M, but the other, less polar analogs had significantly higher potencies; e.g., butylurea half-inhibited at about 60 mM. Onset and reversal of inhibition occurred within less than 2 sec. The inhibition exhibited no obvious sigmoidal dependence on urea concentration, and at low concentrations dimethylurea was a noncompetitive inhibitor of Cl exchange. However, at higher concentrations the Dixon plots were curved upward and a Hill analysis of the dimethylurea data yielded a Hill coefficient of at least 1.5. When present on only one side of the membrane, the slowly penetrating thiourea inhibited Cl exchange with a higher potency from the outside of the cell. Cl/Br exchange was inhibited less under conditions of self-inhibition of anion exchange than in the absence of self-inhibition. These data indicate that the ureas inactivate the anion transporter by a reversible denaturation process, and that the function of the anion transport mechanism may be more sensitive to small perturbations of protein structure than are spectroscopically derived structural parameters. PMID- 3669065 TI - Interaction of [3H]dipyridamole with the nucleoside transporters of human erythrocytes and cultured animal cells. AB - Equilibrium binding of [3H]dipyridamole identified high-affinity (Kd approximately 10 nM) binding sites on human erythrocytes (approximately 5 X 10(5) sites/cell) and on HeLa cells (approximately 5 X 10(6) sites/cell). The equilibration of dipyridamole with these sites on human erythrocytes was compatible with a second-order process which proceeded at 22 degrees C with a rate constant of about 6 X 10(6) M-1 sec-1. Binding of dipyridamole to these sites correlated kinetically with the inhibition of the equilibrium exchange of 500 microM uridine in these cells and was inhibited in a concentration-dependent manner by nucleosides and other inhibitors of nucleoside transport, such as nitrobenzylthioinosine, dilazep and lidoflazine, but not by hypoxanthine, which is not a substrate for the nucleoside transporter of human erythrocytes. The results indicate that the substrate binding site of the transporter is part of the high-affinity dipyridamole binding site. Bound [3H]dipyridamole became displaced from these sites on human erythrocytes by incubation with an excess of unlabeled dipyridamole or high concentrations of nucleosides and inhibitors of nucleoside transport, but neither by hypoxanthine nor sugars. Dissociation of [3H]dipyridamole behaved as a simple first-order process, but the rate constant was about one order of magnitude lower (about 3 X 10(-3) sec-1) than anticipated for typical ligand-protein binding on the basis of the measured association rate and equilibrium constants. The reason for this discrepancy has not been resolved. No high-affinity dipyridamole binding sites were detected on Novikoff rat hepatoma cells, P388, L1210 and S49 mouse leukemia cells or Chinese hamster ovary cells, and their absence correlated with a greater resistance of nucleoside transport in these cells to inhibition by dipyridamole. All cells expressed considerable low affinity (Kd greater than 0.5 microM) and nonspecific binding of dipyridamole. PMID- 3669066 TI - Effect of membrane potential on furosemide-inhibitable sodium influxes in human red blood cells. AB - Furosemide-inhibitable Na influx (a measure of Na/K/Cl cotransport) was determined as a function of membrane potential in human red blood cells. The membrane potential was varied from -42 to +118 mV using valinomycin and gradients of K. The furosemide-inhibitable, unidirectional Na influx was independent of membrane potential over the entire range of potentials. The change in flux per mV, 0.443 mumol/(liter cells.hr.mV), was not significantly different from zero. The mean flux was 153 +/- 16 mumol/(liter cells.hr) (+/- SEM, n = 71). The ouabain and furosemide-resistant influxes of Na and K were also measured as functions of membrane potential using either valinomycin and K or a chloride free, tartrate flux medium to vary membrane potential. The unidirectional Na influx decreased slightly as the membrane potential was increased from negative potentials to about +10 mV. At higher membrane potentials Na influx rose dramatically with potential. This increase was not reversible and was also observed with K influx. PMID- 3669067 TI - Acetylcholine-induced Na+ influx in the mouse lacrimal gland acinar cells: demonstration of multiple Na+ transport mechanisms by intracellular Na+ activity measurements. AB - In the isolated, superfused mouse lacrimal gland, intracellular Na+ activities (aNai) of the acinar cells were directly measured with double-barreled Na+ selective microelectrodes. In the nonstimulated condition aNai was 6.5 +/- 0.5 mM and membrane potential (Vm) was -38.9 +/- 0.4 mV. Addition of 1 mM ouabain or superfusion with a K+-free solution slightly depolarized the membrane and caused a gradual increase in aNai. Stimulation with acetylcholine (ACh, 1 microM) caused a membrane hyperpolarization by about 20 mV and an increase in aNai by about 9 mM in 5 min. The presence of amiloride (0.1 mM) reduced the ACh-induced increase in aNai by approximately 50%, without affecting Vm and input resistance in both nonstimulated and ACh-stimulated conditions. Acid loading the acinar cells by an addition/withdrawal of 20 mM NH4Cl or by replacement of Tris+-buffer saline solution with HCO3-/CO2-buffered solution increased aNai by a few mM. Superfusion with a Cl(-)-free NO3- solution or 1 mM furosemide or 0.5 mM bumetanide containing solution had little effect on the resting aNai levels, however, it reduced the ACh-induced increase in aNai by about 30%. Elimination of metabolite anions (glutamate, fumarate and pyruvate) from the superfusate reduced both the resting aNai and the ACh-induced increase in aNai. The present results suggest the presence of multiple Na+ entry mechanisms activated by ACh, namely, Na+/H+ exchange, Na-K-Cl cotransport and organic substrate-coupled Na+ transport mechanisms. PMID- 3669068 TI - Relationships among type A behavior, employment experiences, and gender: the Minnesota Heart Survey. AB - Previous studies indicate that Type A behavior is more prevalent among men than women. This sex difference may reflect variations in men's and women's job experiences, some of which may act as catalysts for Type A behavior. This study examines the relationship of Type A behavior (measured by the Jenkins Activity Survey) to men's and women's work hours, occupational mobility, and job-related interactions, using data from a population-based survey of 2512 employed men and women conducted in Minneapolis-St. Paul, Minnesota, between 1980 and 1982. Among both sexes, Type A behavior is related to long work hours, high occupational mobility, and nonsupportive interactions with co-workers, all job experiences more common for men than for women. No sex differences are found in the relationships between Type A behavior and these job experiences. Also, no sex difference is observed in the unadjusted Type A scores or in these scores when either age, education, or marital status is taken into account. The expected direction of the sex difference in Type A behavior is reversed when work hours are controlled: women have a higher Type A score than men when work hours are considered. PMID- 3669069 TI - Breast self-examination practices and attitudes of women with and without a history of breast cancer. AB - Breast self-examination (BSE) practices and attitudes of three groups of women were compared using a mailed survey. Subjects were 59 women with previous breast cancer, 33 women with previously treated benign breast lump(s), and 80 general population women with no history of breast disease. Groups were compared on frequency, proficiency, and knowledge of BSE. Determinants of practice were examined using attitudinal variables from the Health Belief Model. Results indicated that the breast cancer group had significantly higher rates of BSE frequency, proficiency, and knowledge than did the general-population group. The breast cancer group perceived cancer to be significantly less threatening than did the other two groups, although the general-population group reported significantly less susceptibility to breast cancer. Within-group analyses revealed that barriers to BSE practice accounted for the greatest amount of variance in BSE frequency in all three groups. These results are discussed. PMID- 3669070 TI - The effects of information, behavioral rehearsal, and prompting on breast self exams. AB - This study evaluated the efficacy of three approaches to increasing breast self exam frequency in college-aged women. Program components included (1) an educational format which provided information on breast cancer and breast self examinations, (2) a demonstration format where examinations were demonstrated and practiced, and (3) a prompt format where subjects received monthly reminders to self-examine. Components were completely crossed in a factorial design with four assessment periods (pretreatment and 1, 3, and 6 months posttreatment). The results showed that the examination frequency increased over time and was significantly higher in the prompt conditions. Information and demonstration programs did not increase the exam frequency. The frequency also increased in the control group, suggesting that assessments may have also prompted the behavior. Implications of the results are discussed. PMID- 3669072 TI - Determinants of adherence to medical regimens by hypertensive patients. AB - This study employed multivariate analyses and structural modeling procedures to examine a model for the determinants of adherence to medical regimens. Fifty adult hypertensive patients at a health maintenance organization completed questionnaires and participated in home interviews over a 10-week period. Knowledge of medical regimens, information communication between the patient and the medical professionals, satisfaction with health-care providers, health locus of control, social support, and treatment disruption to life-style were assessed. Adherence was assessed through self-report and behavioral (i.e., pill-count ratio, percentage of kept medical appointments) indices. Finally, repeated blood pressure measurements were obtained. Structural modeling procedures revealed that greater expectancy for internal control over health and hypertension, greater knowledge of the treatment regimen, and stronger social support were significant determinants of adherence; in turn, higher levels of adherence facilitated blood pressure reduction. PMID- 3669071 TI - The effect of verbal commitment and treatment choice on medication compliance in a pediatric setting. AB - This experiment examined the manner in which verbal commitment and treatment choice affect medication compliance in a pediatric setting. Parents (N = 89) of children suffering from an inner ear infection (otitis media) were asked or not asked for a verbal promise to give their child all prescribed antibiotic medication (commitment manipulation) and allowed or not allowed to choose between two equally appropriate antibiotics as the treatment for their child (choice manipulation). Self-reports at follow-up visits, which were supported by urinalysis results, indicated that obtaining a verbal commitment significantly increased medication compliance. Verbal commitment also nonsignificantly increased the likelihood of a resolved infection at follow-up. Providing the parent with a choice of treatments had no effect on compliance or health outcome. PMID- 3669073 TI - Psychophysiological correlates of induced headaches. AB - The psychophysiological correlates of induced headaches were examined. Subjects with frequent muscle-contraction headaches, frequent migraine headaches, or infrequent headaches were exposed to a 1-h cognitive stressor while multiple electromyographic and cardiovascular measures were monitored. The stressor was associated with significant changes in all psychophysiological measures. Eleven of 16 headache subjects and 2 of 8 control subjects developed headaches. Significant associations between several psychophysiological variables and headache occurrence were found and individual differences in the association between psychophysiological variables and headaches intensity were examined. The results were consistent with the hypothesized role of cardiovascular factors in the pathophysiology of muscle-contraction headache. This was the first controlled demonstration of headaches occurring as a function of environmental stressors. PMID- 3669074 TI - Acute metabolic acidosis due to ibuprofen overdose. PMID- 3669075 TI - Orthopaedic management of myelomeningocele: general orthopaedic management. PMID- 3669077 TI - International Society for Heart Research. VIIIth Congress of the European Section. 13-16 September 1987, Budapest. Abstracts. PMID- 3669076 TI - Radiological seminar CCXLVI: radiographic evaluation of blowout fractures of the orbit. PMID- 3669078 TI - Group treatment of secondary erectile dysfunction. AB - The effects of three group treatment formats on 20 men with secondary erectile dysfunction and their partners were contrasted. After a comprehensive medical and psychological screening, each couple was assigned to one of three treatment groups (Communication Technique Training, Sexual Technique Training, Combination Treatment) or to one of two control groups (Attention-Placebo, No-Treatment). Couples in the three treatment groups and the attention-placebo group participated in their respective formats in twice-weekly sessions for a total of 20 hours. The no-treatment control group received sex education and treatment after a 5-week waiting list period. All three treatment groups fostered substantial gains so that between-format differences were not statistically significant. Subject variables which predicted success/experience ratio gains included age of the male partner, perceived level of relationship adjustment, and the male partner's success/experience ratio prior to treatment. Eighty-one percent of the treated men reached the criterion of 80% or greater success/experience ratio (successful penetration and subsequent ejaculation) at the 6-month follow-up. Good nocturnal tumescence prior to treatment was correlated with a better treatment outcome than poor tumescence. PMID- 3669079 TI - Penile prosthetics: characteristics of veteran patients and their spouses. AB - This study examined the characteristics of couples in whom the male partner was experiencing erectile difficulties and seeking treatment by surgical intervention with the penile prosthesis. The purpose was to examine and describe the psychological characteristics of the individual spouses as well as the nature of their relationship. Additional purposes were to develop an ongoing assessment program and establish normative data on this particular population. Twelve couples in whom the men were considered by their physicians as potential candidates for the penile prosthesis were the subjects. The Minnesota Multiphasic Inventory, the Marital Communication Inventory, and the Multi-Modal Marital Satisfaction Questionnaire were administered to husband and wife. The couples' communication scores were lower than expected from established norms. The scores on the Marital Satisfaction Inventory, however, indicate relatively high levels of satisfaction with the marriage overall. A high positive correlation was found between the measures of communication and marital satisfaction. The MMPI data indicate that there is no one profile configuration that is characteristic of either husbands or wives. As a group, neither the husbands nor the wives evidence any signs of psychopathology. A composite description of the couples is presented along with a description of the individual psychological characteristics of the husbands and wives as a group. The findings are discussed in terms of their implications for treatment, and recommendations for further research are indicated. PMID- 3669080 TI - Does marital therapy enhance the effectiveness of treatment for sexual dysfunction? AB - A controlled treatment trial was conducted with couples in which the woman suffered from secondary forms of sexual dysfunction. To test whether marital therapy is helpful in enhancing the effectiveness of symptom-specific therapy for sexual dysfunction, two treatment conditions were compared to a waiting list control group. All couples received 12 sessions of therapy directed to the sexual symptom. One half of the couples received nine sessions of relaxation and information before sex therapy, and the other half, nine sessions of marital therapy before sex therapy. Whereas both treatment conditions showed clinical and statistical improvement at termination and follow-up, treatment gains were more pronounced and more comprehensive for the couples who received the combination of marital and sex therapy. Generalization from marital therapy to sexual functioning was greater than generalization from sex therapy to marital adaptation. PMID- 3669081 TI - Convergent validity of observational and self-report measures of marital interaction. AB - Previous research findings have challenged the validity of couple's self-reports of their communication effectiveness. In the present study, observational ratings of couples' communication and spouses' self-reports on a multidimensional measure of marital interaction were obtained for a sample of 30 clinic and 12 nonclinic couples. The convergent validity of these two approaches to marital assessment was evaluated by identifying significant correlations for the total sample and for clinic and nonclinic couples, separately. In contrast to previous investigations of this nature, substantial convergence was obtained between the Couples Interaction Scoring System (CISS) and the Marital Satisfaction Inventory (MSI). In general, convergence of the two approaches was stronger for couples in marital therapy. Implications of these findings for clinical assessment and research with nonclinic populations are discussed. PMID- 3669083 TI - Space Life Sciences Training Program: Kennedy Space Center. PMID- 3669082 TI - Neurofibrillary tangles in association with congenital hydrocephalus. AB - Morphologic study of the brain from a retarded patient with progressive congenital hydrocephalus revealed widespread neurofibrillary tangles in the cerebral cortex and the brain stem. Senile plaques were not found. The tangles consisted of paired helical filaments. Scanning electron microscopic energy spectrometric analysis failed to demonstrate abnormal accumulation of aluminum or other elements in the involved neurons.For the first time the association of congenital hydrocephalus and neurofibrillary tangles is reported. This observation is consistent with the hypothesis of interference with axonal transport of neurofilaments as a common pathogenetic mechanism in the genesis of neurofibrillary tangles in human brains. PMID- 3669084 TI - A new view of sex education: with special reference to reproduction control. PMID- 3669085 TI - Fever and leukocytosis in acute cholecystitis. PMID- 3669086 TI - Recognizing the nutrition professional. PMID- 3669087 TI - AIDS: roles for black physicians. PMID- 3669088 TI - The incidence of AIDS among blacks and Hispanics. AB - Compared with whites, the acquired immune deficiency syndrome (AIDS) has affected blacks and Hispanics disproportionately. The cumulative incidence (CI) for black men was 2.6, and for Hispanic men 2.5, times the rate for white men. Intravenous (IV) needle use alone does not account for this difference. Not counting IV needle-using cases, the CIs for black and Hispanic men were 1.7 times the CI for white men. Although there were fewer cases in women than men, the white-to minority disparity was greater for women. The CIs for black and Hispanic women were 12.2 and 8.5 times, respectively, the CI for white women. Prevention programs are urgently needed and should focus on risky behavior (IV needle sharing and receptive anal intercourse), not just risk groups. PMID- 3669089 TI - Pregnancy in Hispanic women. AB - This article addresses some of the characteristics present among Hispanic women that may influence their course of pregnancy and their health in general.Many Hispanic people in the United States retain the customs and traditions of their country of origin. As a result, their use of preventive health care measures is lower than the majority of the population. Use of screening tests such as breast examinations and Papanicolaou smears are minimal among Hispanic women.Because of the tradition of paternalism among some in the Hispanic population, women are used to being told what to do, and as a result, they are hesitant to participate in their own health care. Physicians should be aware of the cultural differences and beliefs when treating pregnant Hispanic women. If these differences are understood and respected, the patient, in turn, will better respect the physician's opinion and advice. PMID- 3669090 TI - Management of intractable pain in cancer patients by implantable morphine infusion systems. AB - Ten patients underwent implantation of intrathecal morphine catheters with subcutaneous implantation of morphine Infusaid pumps for the treatment of intractable pain of malignant origin from May 1984 to October 1985. All patients exhibited a good initial response to intrathecal morphine and developed some degree of tolerance. All patients with bony metastasis and/or lumbarsacral plexopathy developed rapid tolerance.Depressive illness was noted in all patients undergoing a psychiatric evaluation prior to institution of morphine infusion therapy. Seventy percent of patients treated could be treated on an outpatient basis after pump implantation.Complications included a pump pocket infection requiring the removal of the implanted system. There was no pump failure, respiratory depression, urinary retention, or mortality related to the use of the morphine infusion system. It is recommended that intrathecal morphine infusion be instituted when narcotics have been identified as necessary for pain relief, before the development of significant systemic tolerance. PMID- 3669091 TI - Surgical considerations in the management of giant emphysematous bullae. AB - Nine cases with giant emphysematous bullae causing progressive incapacitating dyspnea due to gradual but progressive compression of adjacent lung tissue are reviewed. All the patients selected for surgery had peripheral arterial oxygen saturation of not less than 92 percent at rest. A total of 13 excisions was carried out in the nine patients with resultant increase in their postoperative arterial oxygen tension and improvement in exercise tolerance. There were no deaths from the operations. PMID- 3669092 TI - Plasma calcium in active pulmonary tuberculosis. AB - Fifty-two patients with active pulmonary tuberculosis were studied. Seventy percent of the patients were hypocalcemic at admission, but became normocalcemic after ten weeks of therapy. The improvement in hypocalcemia was thought to be due to either improved serum protein and albumin levels, which occurred after admission, or the reduced physical activity of the patients.Care should be taken in giving patients with pulmonary tuberculosis vitamin D supplements because of the possibility of hypersensitivity to vitamin D.The possible mechanisms of hypercalcemia in active pulmonary tuberculosis are discussed. PMID- 3669093 TI - Preoxygenation and pulse oximetry may delay detection of esophageal intubation. AB - A case of delayed detection of esophageal intubation is described. Preoxygenation and pulse oximetry were used, and the first indication of tube misplacement was arterial desaturation indicated by the pulse oximeter. The combination of preoxygenation and pulse oximetry may contribute to delays in early detection of endotracheal tube misplacement for the following reasons: (1) preoxygenation results in a pulmonary reservoir of oxygen sufficient to maintain arterial hemoglobin saturation for an extended period of time; and (2) the maintenance of normal arterial saturations for an extended period after inadvertent esophageal tube placement may lead the practitioner to initially seek other causes of declining oxygen saturations. Although pulse oximetry is an acknowledged advance in patient monitoring, it must not be utilized as an early indication of correct endotracheal tube placement. PMID- 3669094 TI - Transfer dysphagia in a patient with the rare combination of scleroderma and ankylosing spondylitis. AB - Esophageal involvement in scleroderma is generally confined to the body, manifested manometrically as impaired motility and decreased lower esophageal sphincter tone. Pharyngeal dysfunction has not been recognized. This is a report of a patient with the rare combination of scleroderma and ankylosing spondylitis, whose presenting complaint was transfer dysphagia due to impaired relaxation of the upper esophageal spincter as a result of tight overlying cervical skin, or sclerodermatous involvement of the sphincter itself. PMID- 3669095 TI - Age-dependent responses to 2-acetylaminofluorene in BALB/c female mice. AB - In order to evaluate the influence of age on 2-acetylaminofluorene (2-AAF) carcinogenesis, female BALB/c mice were fed diets containing 500 ppm 2-AAF for 6 mo, starting at 1, 7, or 13 mo of age. Groups of mice were killed immediately, 3 or 6 mo after termination of treatment, or were allowed to complete their life span. Mice corresponding to the age of each sacrifice group of the 2-AAF-treated mice and a life-span group were also included as controls. The study was moved to a different animal room area after 25 wk into the study. Thus, certain treatment groups were replicated to evaluate the impact of the change in environment. Controls and the young 2-AAF-treatment group killed at 7 mo of age were replicated twice in the new animal room at 6-mo intervals. Similarly, controls and the mid-aged treatment group killed at 13 mo of age were repeated once in the new animal room. This resulted in mice of each age/treatment group being treated simultaneously in the same room and killed as soon as treatment was stopped. The main histopathologic responses to 2-AAF were observed in the urinary bladder, liver, and mammary glands. In all three replicates urinary bladder hyperplasia was less severe when young mice were treated than when mid-aged or old mice were treated. In contrast, there was no clear influence of age on bladder tumorigenesis, although replicate variation in this response was very great. Tentatively one also may conclude that (1) sensitivity to the induction of mammary tumorigenesis by 2-AAF increased with the age of mice at the time of treatment, and (2) old mice were sensitive to induction of liver karyomegaly and cytoplasmic and nuclear inclusions, while young and mid-aged mice were resistant to this influence. Perhaps the most important conclusion to be made from this study is that replicate variation, probably due to environmental factors, may result in false conclusions concerning age sensitivity to a carcinogen if differing age groups are not treated simultaneously and/or key parts of an experiment are not replicated to eliminate the possibility of an influence of environmental factors or nonrandom assignment of animals to age groups. PMID- 3669096 TI - Effect of excess Fe on Cd or Pb absorption by rats. AB - Absorption of cadmium and lead from the gastrointestinal (GI) tract of adult rats was measured after gavage with solutions of 109Cd or 210Pb. Before the radionuclide gavage, animals were either fed or fasted for 24 h, or fasted and given a supplemental gavage of ferric or ferrous iron. Fasting caused a slight increase in 109Cd absorption that was not statistically significant; ferrous iron caused a three-fold increase; and ferric iron increased absorption 14-fold. In contrast, fasting increased 210Pb absorption fivefold, and the oxidizing agents ferric iron and quinhydrone blocked the effect of fasting. Gavage of 8-d-old rats with 109Cd and either ferric or ferrous iron doubled the amount of cadmium retained in the carcass and substantially decreased the amount retained in the GI tract. Some of the large fraction (60-70%) of 109Cd stored in the mucosa of the intestine was absorbed into the body with time. An excess of ferric iron had an opposite effect on the retention of lead in the carcasses of 8-d-old rats, decreasing it from 53% of the gavaged dose to 3%; the effect on the amount retained in the intestine was similar, decreasing it from 16% to 8%. These results suggest that the mechanisms for transport of cadmium and iron across the intestine may be similar in the adult and neonatal rat, but that the oxidizing effect of ferric iron on cadmium absorption is much greater in the adult. PMID- 3669097 TI - Influence of cadmium chloride, mercuric chloride, and sodium vanadate on the glutathione-conjugating enzyme system in liver, kidney, and brain of mice. AB - Sublethal doses of CdCl2 (3 mg/kg iv), HgCl2 (2 mg/kg iv), or NaVO3 (6 mg/kg iv) did not alter the content of reduced glutathione (GSH) in the livers of mice during the 24-h observation period. In the kidneys, a tendency to increased GSH content was seen, especially after HgCl2 treatment; in lung and brain the GSH levels were significantly lowered upon the treatment with all three metals. The activities of GSH S-transferase toward an aryl substrate (CDNB; 1-chloro-2,4 dinitrobenzene) was enhanced in all tissues by the administration of HgCl2 greater than NaVO3 greater than CdCl2. The activity of GSH S-transferase toward an epoxide substrate [1,2-epoxy-3-(p-nitrophenoxy)propane was only measurable in the livers and was inhibited 1 and 2 h after the administration of HgCl2 and NaVO3. It is concluded that sublethal doses of CdCl2, HgCl2, or NaVO3 do not impair the GSH concentration and GSH-conjugating enzyme activities toward the aryl substrate in different target organs of their toxicity, which is in contrast to results obtained in vitro. PMID- 3669098 TI - Effects of trimethyltin on the mouse hippocampus and adrenal cortex. AB - The effects of trimethyltin (TMT) on the mouse adrenal histology and its relationship with neuropathology occurrence was studied. Young, male CD-1 mice were divided into three groups: group I, injected on 3 consecutive days with 1.0 mg TMT/kg body weight (b.w.); group II, injected on 2 consecutive days with 1.5 mg TMT/kg b.w.; and group III, injected with a single acute dose of 3.0 mg TMT/kg b.w. Control animals were injected with saline solution. The brain and adrenal glands were sampled for light-microscopic examination. Although all animals received the same total amount of TMT, pathological changes in the granule cells of the fascia dentate appeared to be group III greater than group II greater than group I, suggesting that acute exposures produced a more severe damage to the fascia dentate neurons. Likewise, the adrenal weights of the animals were group III greater than group II greater than group I greater than or equal to control. Significant proliferation and enlargement of the eosinophilic or the "X zone" were observed in the TMT-treated, particularly groups II and III, animals. The expansion of the eosinophilic cell layer (X zone) was accomplished at the expense of the cortical fasciculata cells. Transformation of fasciculata cells into eosinophilic cells could also be demonstrated. As the eosinophilic cells are known to be active in corticosterone production as seen in stress situations, the proliferation of these cells may reflect a feedback response to the hippocampal hyperexcitation. PMID- 3669099 TI - Induction of metallothionein in rat primary hepatocyte cultures: evidence for direct and indirect induction. AB - The ability of a number of metals and organic chemicals to induce metallothionein (MT) synthesis in primary cultures of rat hepatocytes was tested to determine whether MT induction in vivo results from a direct effect of the agent on the liver or as a result of an indirect, physiologic response to the agent. Hepatocytes were exposed to metals [zinc (Zn), cadmium (Cd), mercury (Hg), manganese (Mn), lead (Pb), cobalt (Co), nickel (Ni), and vanadium (V)] or organic compounds [ethanol, urethane, L-2-oxothiozolidine 4-carboxylate (L-OTCA), or dexamethasone] and were assayed for metallothionein by the Cd/hemoglobin radioassay. Cell viability was monitored by protein synthesis activity and cellular K+ concentration. Increases in MT concentrations were noted for Zn (22 fold), Hg (6.4-fold), Cd (4.8-fold), Co (2.4-fold), Ni (2.2-fold), and dexamethasone (4.5-fold). However, even at maximum tolerated concentrations, Mn, Pb, V, ethanol, urethane, and L-OTCA did not increase MT. The results indicate that Zn, Cd, Hg, Co, Ni and dexamethasone induce MT in vitro and thus are direct inducers of MT synthesis in hepatic tissue. In contrast, Mn, Pb, ethanol, urethane and L-OTCA, which did not increase the MT content of hepatocytes, apparently do so in vivo by an indirect mechanism. PMID- 3669100 TI - Influence of oral administration of sulfamethazine on thyroid hormone levels in Fischer 344 rats. AB - Fischer 344 rats (810 of each sex) were divided into treatment groups and fed diets containing 0, 10, 40, 600, 1200, or 2400 ppm sulfamethazine. Serum samples were analyzed for levels of thyroid-stimulating hormone (TSH), total thyroxine (T4), total triiodothyronine (T3), and T3 uptake after 12, 18, or 24 mo of continuous dosing. There were no statistically significant differences in T3 levels or percent T3 uptake for either sex after any of the exposure periods. The serum T4 levels were lower (p less than 0.05) for females dosed at 1200 and 2400 ppm for 18 mo and for males dosed at 600, 1200, or 2400 ppm sulfamethazine for 24 mo than for those dosed at levels of 40 ppm or less. Serum TSH levels showed a general increasing trend (but not statistically significant) among animals receiving 600 ppm or more sulfamethazine. There was a significant dose-related reduction in (T3 + T4)/TSH ratio for both sexes (p less than 0.05) after 18 and 24 mo of exposure at dose levels of 600 ppm or more. A lack of response at 12 mo may have been due to the shorter treatment time. At each sacrifice period both sexes of rats fed sulfamethazine at 1200 and 2400 ppm had significantly heavier (p less than 0.05) thyroid weights than animals fed control diet. The heavier thyroid weights in the dosed animals may have resulted from increased TSH levels. The cause of reduction in serum T4 was not clearly evident. Therefore, the thyroid hormone to pituitary feedback mechanism apparently compensated for sulfamethazine effects in most animals. This would suggest that the thyroid gland was not irreversibly affected. PMID- 3669101 TI - 13-week subchronic toxicity study with morpholine oleic acid salt administered to B6C3F1 mice. AB - The effect of subchronic administration of morpholine oleic acid salt (MOAS) was studied in B6C3F1 mice. The dose levels of MOAS used were 0%, 0.15%, 0.3%, 0.6%, 1.25%, and 2.5% in drinking water. Reduced weight gains were noted in both sexes in the 2.5% group as compared to controls, but reductions were not significant. Water consumption values showed a dose-related tendency for a decrease in both females and males. Urine analysis showed significant elevation of specific gravity in the males in the 0.6%, 1.25%, and 2.5% groups and the females in the 1.25% and 2.5% groups. Significant elevation of plasma urea nitrogen was observed in males of the 1.25% and 2.5% groups and in females of the 0.6%, 1.25%, and 2.5% groups. The relative weight of the kidneys showed a dose-dependent increase that was statistically significant for the 1.25% and 2.5% MOAS groups in both sexes. Except for cloudy swelling of the proximal tubules of the kidneys in mice on the 2.5% regimen, no treatment-related histopathological alterations were observed in organs of either sex. PMID- 3669102 TI - Dermal penetration of carbofuran in young and adult Fischer 344 rats. AB - Dermal penetration of carbofuran was determined in young (33 d) and adult (82 d) female Fischer 344 rats employing in vivo and in vitro methods. In vivo dermal penetration at 120 h was 43% for young and 18% for adult rats. The half-time for carbofuran skin penetration (in vivo) was 128 h for the young and 400 h for the adults. The young to adult ratio of dermal penetration was greater than 1 at all time points (average 2.9) and had a maximum of 4.2 at 24 h. Cumulative urinary excretion approached about 95% of the absorbed dose in both the young and adult animals at 120 h. Whole-body retention was slightly higher in adults. Kidney showed the highest tissue-to-blood concentration ratio (4.6 in adult, 2.3 in young). The ratio for the carcass was 2.8 in the adult and 2.4 in the young. The urine/blood concentration ratio was high, 435 in the adult and 573 in the young. The feces/blood ratio was 44 in the adult and 65 in the young. Skin absorption by the in vitro continuous-flow system was 41% for the young and 11% for the adult at 72 h, compared to 36% and 13% by the in vivo method. The static in vitro method gave consistently lower skin penetration values of 12% for the young and 8.8% for the adult. Differences in the kinetics of retention and excretion were observed between the young and adult animals. PMID- 3669103 TI - Use of limited protocols to evaluate the genotoxicity of hazardous wastes in mammalian cell assays: comparison to Salmonella. AB - Dichloromethane extracts of four diverse hazardous wastes (coke plant, herbicide manufacturing, pulp and paper, and oil refining) were evaluated for mutagenicity in strains TA98 and TA100 of Salmonella. These extracts also were tested for biological activity in short-term mammalian cell assays, including mutagenicity in L5178Y/TK +/- mouse lymphoma cells, chromosomal aberrations and sister chromatid exchanges in Chinese hamster ovary (CHO) cells, morphological transformation in BALB/c-3T3 cells, and teratogenic potential in mouse limb bud cells. The mammalian cell assays were performed using limited protocols that consisted of a preliminary testing of the extracts for cytotoxicity in CHO cells in order to estimate the appropriate dose range for the other assays. These assays were then performed once with only a few doses of extract; all but the mouse limb bud assay were performed in the presence of metabolic activation. Although all four of the wastes were presumptively positive for either mutation or cytogenetic effects, none of the wastes transformed BALB/c-3T3 cells. Further studies are needed to establish which mammalian cell assays, if any, might be useful complements to the Salmonella assay for the purpose of screening hazardous wastes. PMID- 3669104 TI - Selective management of blunt abdominal trauma in children--the triage role of peritoneal lavage. AB - The evolution of selective laparotomy in children sustaining blunt abdominal trauma has been highly controversial. This report describes our experience and policy change during this transitional period. Emergency laparotomies performed in the pediatric age group (less than 14 yr) between 1980 and 1984, based on peritoneal lavage, were reviewed. Of 16 such patients, six (37.5%) had injuries identified at laparotomy necessitating operation, (four greater than Grade III spleen, one hepatic vein, one small bowel). The remaining ten patients (67.5%) had injuries which probably could have been managed nonoperatively (eight less than or equal to Grade II spleen, two less than or equal to Grade II liver). We additionally reviewed 46 peritoneal lavages done in children during 1984, and noted a 100% sensitivity but 86% specificity when considering essential laparotomies. Based on these data, we established a selective management protocol and initiated a prospective study in January 1985. The protocol consisted of: 1) routine peritoneal lavage (DPL) in children at high risk for abdominal injury, 2) immediate laparotomy for DPL positive for blood in conjunction with hemodynamic instability, 3) selective laparotomy for DPL positive for blood in a stable child, additionally evaluated by abdominal CT scan (major mechanism) or liver/spleen scan (minor mechanism), and 4) mandatory laparotomy for DPL effluent positive by criteria other than blood. This policy reduced unnecessary laparotomy, otherwise warranted by DPL, to 18% (2/11); both patients had Grade II splenic injuries. Five children sustaining low-energy trauma were managed nonoperatively following peritoneal aspiration of gross blood with L-S scan confirming minor solid visceral injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3669105 TI - Prognostic factors in severe accidental hypothermia: experience from the Mt. Hood tragedy. AB - The May 1986 Mt. Hood climbing disaster presented Portland area hospitals the opportunity to initiate a trial of extracorporeal rewarming using cardiopulmonary bypass in ten severely hypothermic patients (two survivors). The data from this experience as well as others previously reported can yield prognostic indicators of survival in cases of accidental hypothermia. These are demonstrated to include: the presence of underlying medical illness, duration of cold exposure, initial core temperature, mental status, the presence of spontaneous respirations, presenting cardiac rate and rhythm, and arterial oxygen tension. Profound hyperkalemia and markedly elevated serum ammonia levels indicate cell lysis; significant hypofibrinogenemia suggests intravascular thrombosis and each laboratory marker predicts a dire outcome. The treatment of choice for severe accidental hypothermia is felt to be rapid core rewarming on cardiopulmonary bypass. PMID- 3669106 TI - Acute gastric dilatation after trauma. AB - During a 2-year period, 248 consecutive patients were admitted with multiple trauma. Acute gastric dilatation was documented in 67 (27%) patients by review of all admission roentgenograms. There were 51 (76%) males and 16 females. Ages ranged from 2 to 80 years (mean, 29.2 years). The incidence of acute gastric dilatation in children was 44% vs. 25% for adults (p less than 0.05). The mechanism of injury was motor vehicle accident in 45 (67%), agricultural accident in 8 (12%), fall in four (6%), bicycle accident in four (6%), and miscellaneous in six (9%). There were 38 orthopedic, 35 craniocerebral, 34 abdominal, 31 thoracic, 27 maxillofacial, and 14 spinal injuries. Injury Severity Scores ranged from 4 to 66 (mean, 23.5). Thirteen (19%) patients presented in shock and there were four (6%) hospital deaths. No death was attributable to gastric dilatation. Nasogastric tubes were placed in 41 (61%) patients and 26 were managed without tube placement. Complications associated with acute gastric dilatation included pulmonary aspiration in three (4%) patients, gastric hemorrhage in three (4%), gastrointestinal perforation in one (1%), and prolonged ileus in 12 (18%). In addition, gastric dilatation rendered abdominal examination difficult and delayed peritoneal lavage. Acute gastric dilatation after trauma is frequent in our rural trauma center. Early placement of a nasogastric tube in the absence of a clear contraindication is strongly supported in the management of multiply injured patients. PMID- 3669107 TI - Hemoptysis in trauma. AB - In an attempt to more clearly delineate the importance and pathophysiology of moderate-severe hemoptysis, a clinical and experimental study was performed. The clinical portion consisted of a retrospective review of 344 patients undergoing thoracotomy for penetrating trauma. There were 138 patients with injuries to the trachea, mainstem bronchi or lungs. Six with GSW to the chest had severe hemoptysis in the Emergency Department (ED) and had a cardiac arrest just after endotracheal intubation. At thoracotomy, all six had air in their coronary arteries and could not be resuscitated, Of 14 patients with posterolateral OR thoracotomies, three had significant (20-30 mm Hg) drops in systolic pressure plus increased aspiration of blood into the dependent lung when turned onto their sides. Of 12 patients surviving surgery, six with continued aspiration of blood required prolonged ventilatory support. In an experimental study, minimally heparinized (0.07 units/ml) blood was infused into the lower trachea of 17 anesthetized normovolemic supine dogs at 0.15 ml/kg/min. The PaO2 fell from 100 +/- 11 to 65 +/- 16 mm Hg after infusion of 4.5 ml/kg of blood. At the same time peak ventilator pressure rose only minimally (8.5 +/- 1.7 to 11.2 +/- 3.1 mm Hg). The PCO2, mean PA pressure, PAWP, CVP, and cardiac output were essentially unchanged. In a second study of 18 dogs, reducing the systolic BP by one third reduced cardiac output by almost 48% and oxygen transport by 58%. After 4.5 ml/kg blood were infused into the trachea, the PaO2 fell from 84 +/- 19 to 52 +/- 9 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3669108 TI - Intraoperative hypogastric artery embolization for life-threatening pelvic hemorrhage: a preliminary report. AB - Percutaneous pelvic embolization has become a useful adjunct in the management of life-threatening hemorrhage from pelvic trauma. However, this approach may be preempted by the need for emergency laparotomy. The surgeon is then confronted with a hemodynamically unstable patient with an expanding hematoma in the face of other life-threatening injuries. Bilateral hypogastric artery ligation has failed in this scenario due to extensive collateralization of the pelvic circulation. We present our experience with intraoperative hypogastric artery embolization used in the management of four patients, and review the available literature on the subject. PMID- 3669110 TI - Transfers from emergency room to burn center: errors in burn size estimate. AB - Errors in estimation of burn size are commonplace in community hospital emergency rooms. In 24 of 132 transfers to a burn center the extent of injury was overestimated at the transferring emergency room by 100% or more. This incorrect burn size estimation seems related to reliance on guesswork or use of the Rule of Nines. The incidence of error is greater in smaller burns. PMID- 3669111 TI - Percutaneous peritoneal lavage using the Veress needle: a preliminary report. AB - A modification of past percutaneous methods for peritoneal lavage is described which combines the safety of the Veress Needle with the utility of a readily available introducer-dilator catheter. The technique has been used in 30 patients seen for blunt abdominal trauma and has been found to be a reliable and accurate method for peritoneal lavage. PMID- 3669109 TI - Stress hormones modulate neutrophil and lymphocyte activity in vitro. AB - There is increasing evidence that stress hormones and neurotransmitters may represent an information channel between the immune, endocrine, and central nervous systems. The goal of this investigation was to determine the in vitro effect of selected stress hormones on neutrophil and lymphocyte function using leukocytes from healthy volunteers. The following hormones were tested using a complete dose response curve including dosages within the physiological range; cortisol, epinephrine, norepinephrine, and glucagon. Cortisol did not affect neutrophil function, but did suppress lymphocyte blastogenesis. The catecholamines, epinephrine, and norepinephrine inhibited only neutrophil chemotaxis, while glucagon impaired both neutrophil chemotactic and bactericidal activity. When the individual hormones were combined into hormone cocktails, the inhibitory effect of both epinephrine and glucagon on neutrophil function was lost, while the inhibitory effect of cortisol on lymphocyte blastogenesis was greatly reduced. In fact, incubation of neutrophils in the stress hormone cocktail resulted in the neutrophils becoming hypermetabolic. Although the in vitro effects of these hormones on neutrophil and lymphocyte function do not fully correlate with the in vivo effect of trauma on immune function, these studies do support the general concept that the stress hormones may represent a link between the immune and endocrine systems. PMID- 3669112 TI - Candida infection in massively burned patients. AB - Immunosuppressed burned patients receiving antibiotics for suppression of bacterial infection are ideal hosts for opportunistic fungi. Massive excision of burns with autograft and homograft coverage has radically changed the course of disease. Three hundred ninety-three patients were admitted to the Shriners Burns Institute, of whom 125 patients had fungus cultured during their hospitalization and 42 patients subsequently developed involvement of three or more organs. Twenty-one of the 42 patients developed Candida septicemia requiring amphotericin B or flucytosine therapy. The mean third-degree burn in patients with Candida septicemia was 65% total body surface area compared to three-organ involvement/no clinical sepsis at 38% mean third-degree burn. Patients developing candidemia did so during the first week postburn and 7 days after excision therapy. It is hypothesized that massive burns with immunosuppression are further suppressed by repeated surgical intervention, anesthesia, and perioperative use of broad spectrum antibiotics, further predisposing these patients to early development of Candida septicemia. With early recognition of burn wound invasion by routine biopsies, wound swabs, and early amphotericin therapy, the mortality has been reduced to 14% compared to 60-90% reported in other series. PMID- 3669113 TI - The nature of congenital limb defects induced in lambs by maternal ingestion of Veratrum californicum. AB - Groups of ewes were gavaged Veratrum californicum root-rhizome material over various 3 day periods during early gestation and their late-term fetuses examined. Resulting from gavage near day 29 were shortening of fetal metacarpal, metatarsal and tibial bones. Fibulae bowed severely when tibiae were shortened. Medial bowing of forelimbs at the fetlocks resulted from unequal shortening of fused metacarpi. Severe joint articular surface defects and arthrogryposis were present in some of the lambs from treatment ewes. There was bilateral and twinning symmetry in limb bone shortening. Severity of limb defects varied with gestational stage at time of gavage. PMID- 3669114 TI - Arsenicosis in India. AB - Consumption of the hepatotoxin arsenic is very common in certain geographical areas of India and occurs as a result of the intake of arsenic contaminated water, vegetables, adultered opium, ayurvedic and indigenous medicines, and "home made brew". Arsenic levels were estimated in livers obtained after autopsy from patients of idiopathic cirrhosis, alcoholic cirrhosis, Indian childhood cirrhosis, non-cirrhotic portal fibrosis, fulminant hepatitis and Wilson's disease. Significantly increased levels of arsenic were found in all diseased livers investigated when compared with values obtained from control groups. The study suggests that elevated levels of arsenic may be associated with liver disease. PMID- 3669115 TI - High pressure injection injuries: a serious occupational hazard. AB - High pressure injection equipment such as airless paint sprayers, high pressure grease guns, and fuel injection apparatus constitute a serious safety hazard resulting in significant morbidity. These devices are capable of delivering contaminants such as paint, solvents, and grease at pressures ranging from 600 12,000 psi. This allows the substance to penetrate through a minute skin wound and to spread widely through fascial planes and tendon sheaths and to produce significant vascular compression and systemic toxicity. High pressure injection injuries frequently result in amputation. Fifty-five suspected high pressure injection injury cases were evaluated. Twenty were determined to be actual injection injuries from equipment producing pressures in the range of 1,500 12,000 psi. The injected contaminants included latex paint, mineral spirits, and concrete sealer. Fourteen injuries involved digits. Digital amputation was necessary in three patients. Hospital admissions averaged 6.5 days. Successful management of these cases involves awareness of the impending problem and rapid referral of the patient to an emergency department and to a competent orthopedic or plastic surgeon. PMID- 3669116 TI - Repeated hemoperfusion and continuous arteriovenous hemofiltration in a paraquat poisoned patient. AB - Prompt hemodialysis or hemoperfusion can be of value during the first 24 hours after paraquat ingestion particularly when the patient has developed acute renal failure. However, many cases of paraquat poisoning occur in areas where hemoperfusion facilities are unavailable. In contrast, continuous arteriovenous hemofiltration (CAVH) could be instituted easily. We have measured the removal of paraquat from the body by CAVH in a 46 year old male cane farmer who ingested 70 ml, 20% paraquat and died twelve days later from pulmonary fibrosis. Renal failure developed rapidly. Concentrations of paraquat were measured by an indirect competitive ELISA using a murine paraquat monoclonal IgG antibody. Hemoperfusion was performed daily for five days, beginning 78 hours post ingestion. By 180 hours, when the patient was in respiratory failure, hemoperfusion was replaced with CAVH which was continued for 46 hours. During this time interval, 1.1 mg paraquat was recovered in the hemofiltrate and 1.56 mg paraquat in the urine. The extraction of paraquat by the hemofilter was close to 100%. The plasma clearance of paraquat across the hemofilter was 6.1 ml/min and the renal clearance was 8.2 ml/min. The mean hemoperfusion clearance of paraquat was 50 ml/min and the total amount of paraquat removed by the 34 hours of hemoperfusion was 9 mg. Because of the relative ease with which CAVH can be performed, its low cost, compared to that of hemoperfusion or hemodialysis, and the continuous nature of the procedure, CAVH may be worth considering in paraquat poisoning. It could be used particularly in those patients who have developed renal failure or while patients are being prepared for hemoperfusion. PMID- 3669117 TI - Meprobamate kinetics during and after terminated hemoperfusion in acute intoxications. AB - We report four cases of severe meprobamate intoxication. Maximal plasma levels reached 800 (176), 816 (180), 863 (190) and 923 mumol/l (203 mg/l). All patients survived without sequelae including one patient resuscitated from cardiac arrest. The clinical course was complicated by coma, hypotension, and hypothermia in all patients. Three cases were treated with charcoal hemoperfusion with mean hemoperfusion clearance ranging from 134-164 ml/min compared to 174 ml/min in one case treated with resin filter and the same blood flow of 200 ml/min. In two cases, a mean renal meprobamate clearance of 15 and 23 ml/min was calculated comprising only 9-15% of the hemoperfusion clearance. The amount of meprobamate removed by hemoperfusion ranged from 1.6-6.2 g. In one case, the half-life of plasma meprobamate during hemoperfusion was 2.6 hours compared to 8.3 hours after hemoperfusion. Thus the half-life was reduced more than 3-fold. These data show that hemoperfusion may be indicated in severe meprobamate intoxication. PMID- 3669118 TI - Fatality due to acute hydrofluoric acid exposure. AB - Although hydrofluoric acid burns are frequent, fatality is rare. In the case of massive exposure, the prognosis is generally poor. We present two fatal cases resulting from extensive exposure to hydrofluoric acid which produced acute systemic metabolic acidosis with profound hypocalcemia and hypomagnesemia. Both patients died within three hours after the exposure. The current knowledge of treatment for severe hydrofluoric acid burns is reviewed and the importance of prevention and prompt recognition for proper treatment is emphasized. PMID- 3669119 TI - Abuse of phencyclidine (PCP) a laboratory experience. AB - Emergency Room patients at Riverside General Hospital who are found by the attending physician to have depressed sensorium and altered personality are routinely subjected to urine tests for various drugs of abuse including phencyclidine (PCP). The findings of the laboratory analysis of these patients are presented in this paper. The toxicology laboratory of this hospital performs screening procedures for various drugs on urine specimens by thin layer chromatography. Drugs detected are confirmed by gas chromatography and a homogeneous enzyme immunoassay technique. In 1981, 1.6% of the urine specimens of patients in the above-mentioned category were found to be positive for PCP. This percentage increased sharply during 1982 (5.8%) and 1983 (5.6%). During 1984 and 1985 the percentage dropped to 4.2% and 4.6%. It is implied from data that the abuse of this drug in this area has leveled off. The data also indicated that PCP is predominantly used by young adults with ages ranging from 21 to 30 years. The abuse of this drug in people over 40 years of age is comparatively very small. Among users of this drug, 67.5% are men and 32.5% are women. Out of 68 women found to be abusing PCP, 5 delivered their babies in this hospital. PCP was detected in the urine specimens of each of these babies. Four out of the five infants showed withdrawal symptoms such as extreme irritability, jitteriness, hyperactivity with high pitched cries and a poor ability to take food. PMID- 3669120 TI - Fatal iron intoxication in late pregnancy. AB - A case of intoxication with 5 g of elemental iron (25 g of ferrous sulfate) in a 30-year old woman at 36 weeks gestation is reported. Deferoxamine treatment was given with a delay of 26 hours after ingestion. A healthy infant was delivered by cesarean section 31 hours following ingestion. Subsequently, the patient developed hepatic necrosis, coma and hemostatic dysfunction and expired in cardiac failure after two weeks. The fatal outcome supports the view that the potential lethal dose of iron is lower for adults than for children. This case also demonstrates that major hepatic dysfunction can be a prominent feature of adult cases of iron intoxication. It is not unequivocal that early institution of deferoxamine treatment would have had a significant influence on the outcome. However, taking into account the well-documented efficacy of the drug in children and that no major adverse fetal effects have been associated with deferoxamine treatment in pregnancy, we suggest such antidote therapy to be considered for prompt institution in similar cases. PMID- 3669121 TI - Human poisoning by zigadenus. AB - Zigadenus (death camas) is a dangerous plant in the United States. The literature contains several well-documented nonfatal human cases of zigadenus poisoning. Fatal cases were recorded in interviews of 19th century western American Indians. This paper contains an account from early in the 20th century of some railroad workers who died shortly after eating the bulbs. The probable fatal dose, extrapolated from animal data, ranges from less than one-tenth pound (four-five bulbs) for a young child to a pound for an adult. Other parts of the plant such as nectar and seeds are also highly toxic. PMID- 3669122 TI - Scabies in urban Bangladesh. AB - As a part of a larger project on hygiene education and diarrhoeal diseases we followed 766 children less than 6 years of age from October 1984 to September 1985 in Dhaka, Bangladesh. The aims were to estimate the annual risk of infestation with scabies in children, to describe its involvement of other family members, and to determine some of the familial and individual risk factors for apparent infestation by scabies. During this period 589 (77%) children appeared to have been infected with scabies, and 125 (16%) children were infested for more than 6 months. Of the factors examined, direct and indirect indicators of decreased wealth and incorrect hygiene practices correlated with higher rates of apparent infestation, although scabies rates remained high at all socioeconomic levels. PMID- 3669123 TI - Childhood feeding practices and their effects on nutrition in a rural area of The Gambia. AB - We have studied the nutritional status of 118 children of the Serahuli tribe aged 0-5 years from Badjakunda, a village in North Bank, Upper River Division (URD) of The Gambia. Throughout the 9 month study period malnutrition was identified in a larger proportion of children than in similar recent studies elsewhere in The Gambia. We have found a relationship in villages in North Bank URD between the percentage of Serahulis in the population and the percentage of children with malnutrition. Serahulis in Badjakunda generally do not introduce weaning foods until the child is aged 1 year, while Mandinkas in the same area usually start such foods before their children are 6 months old. Children aged between 6 months and 2 years were at particular risk of malnutrition, this may be attributable to the feeding practices of Serahulis. PMID- 3669124 TI - Sociodemographic and behavioural factors associated with hospital malaria patients in Kanchanaburi, Thailand. AB - A hospital-based case-control study was conducted at Paholpolpayuhasena Hospital, Kanchanaburi, Thailand to investigate social and behavioural factors believed to be associated with malaria occurrence. Data were obtained from 210 malaria and 210 non-malaria patients presenting at the hospital from August to September 1984. All study subjects were interviewed by trained interviewers using a structured interview form. The results showed that the malaria cases were predominantly male, under age 30 and single. Bivariate analysis showed a significant association for knowledge of transmission, use of mosquito nets, and residing or working in forested areas 2 weeks before the illness with malaria occurrence. Logistic regression analysis revealed that age, education, duration of stay in the area and knowledge of transmission were significantly associated with disease occurrence. After adjusting for these variables, use of a mosquito net was also found to be significantly associated with occurrence. Residence or work place 2 weeks before the illness was another variable significantly associated with the presence of malaria infection even after adjustment for age and knowledge of transmission. The groups found in this study to be at high risk of malaria infection were younger age groups, forest-related workers and migrant workers. The results of this study suggest that efforts should be made to identify these people and target them for malaria health education. PMID- 3669126 TI - Pregnancy in chronic active hepatitis with cirrhosis. AB - Pregnancy in chronic active hepatitis and cirrhosis is rare. There is an appreciable perinatal mortality and the effect of pregnancy on the underlying liver disease remains uncertain. Two patients with autoimmune chronic active hepatitis with cirrhosis who became pregnant during an active stage of their disease while on therapy are described. Both had an uneventful pregnancy with successful deliveries. One of the patients had two other pregnancies but the pregnancy had to be terminated because of clinical deterioration. With close supervision patients with chronic active hepatitis and cirrhosis may have successful pregnancies. PMID- 3669125 TI - Leucopenia and abnormal liver function in travellers on malaria chemoprophylaxis. AB - Of 2887 travellers between the years 1984-1985, 451 on prophylactic antimalarials were studied retrospectively for adverse haematological or hepatic drug reactions and compared to 296 drug non-users. Travellers using amodiaquine, chloroquine, or pyrimethamine for less than 10 weeks had significantly lower total leucocyte counts than non-users. This was due to diminution of lymphocytes, not neutrophils. Travellers using amodiaquine for less than 10 weeks also had significantly higher serum aspartate aminotransferase (SGPT) levels than non users. Amodiaquine was associated with a 3.1-times increased risk (95% confidence limits 1.8-5.4) of abnormal SGPT values. We consider toxic products, including metabolites of amodiaquine, the most likely cause of amodiaquine-related hepatotoxicity in travellers. PMID- 3669127 TI - Prevalence and determinants of hepatitis B virus markers in pregnant women in West Java, Indonesia. AB - In Bandung, West Java, 300 consecutive pregnant women were screened for hepatitis B virus (HBV) markers at a prenatal consultation. The prevalence of HBsAg and of anti-HBs/anti-HBc was 4.7% (14/300) and 35.6% (107/300) respectively, while 59.7% (179/300) was sero-negative. Prevalence of HBV markers increased significantly with both age and parity. Women with less schooling and a low socioeconomic class seemed to be at higher risk for HBV infection (HBV-markers prevalence of 49.3% (35/71) and 58.3% (21/36) respectively). Among employed women, the subgroup of school-teachers had a significantly higher HBV-markers prevalence of 54.8% (23/42), with a HBsAg carrier rate of 11.9% (5/42). This could indicate an important nonparenteral transmission of HBV in schools. The prevalence of HBeAg in HBsAg positive women was 64.3% (9/14). Based on historical data on perinatal HBV transmission, this would lead to a HBV carriership in 2.4 to 3.5% of all newborns. Possible strategies of prevention of HBV infection in newborns are briefly discussed. PMID- 3669128 TI - Tuberculous liver abscess. AB - Tuberculous liver abscess is uncommonly seen in our experience. We report a case of a 17-year-old boy who presented with typical clinical features of liver abscess, where a diagnosis of tuberculous liver abscess was made on laparotomy and biopsy of the abscess wall. PMID- 3669129 TI - The investigation of Trypanosoma brucei isolates obtained from Glossina pallidipes in South Nyanza, Kenya. AB - During studies to determine the main Trypanosoma brucei rhodesiense transmission sites in Lambwe Valley, Western Kenya, Glossina pallidipes were collected from two areas in the valley and examined for trypanosome infection. T. brucei isolated from infected flies were tested for their response to the lethal effects of human blood (Blood Incubation Infectivity Test, BIIT) and also characterized using isoenzyme electrophoresis. Six of the 26 T. brucei tested were BIIT positive, two of which had enzyme profiles identical to human isolates. The 26 isolates were grouped into 10 zymodemes. Two zymodemes were identical to T. b. rhodesiense isolated from sleeping sickness patients, one of which was identical to the predominant zymodemes among patients from Lambwe Valley area. The other zymodeme was identical to an isolate from a patient from the Busoga (Uganda) sleeping sickness epidemic focus. These two Zymodemes were BIIT positive. It is suggested that there has been an exchange of human infecting organisms between the Kenya and the Uganda foci. PMID- 3669130 TI - Genetic aspects of speech disorders. PMID- 3669131 TI - Urban poor and primary health care: an analysis of infant mortality of an inner city community. PMID- 3669132 TI - Breath hydrogen test and stools characteristics after ingestion of milk and yogurt in malnourished children with chronic diarrhoea and lactase deficiency. PMID- 3669133 TI - Sorghum in a mixed diet for preschool children. I. Good acceptability with and without simple reduction of dietary bulk. PMID- 3669134 TI - Morbidity and mortality in term infants with intrauterine growth retardation. PMID- 3669135 TI - Morbidity pattern and cause specific mortality during infancy in ICDS projects. PMID- 3669136 TI - The malnourished children of the urban squatter families: a study in Porto Alegre, Brazil. PMID- 3669137 TI - Accidental scalds and burns in infancy and childhood. PMID- 3669138 TI - Maternal-child supplementary feeding programmes in Haiti. PMID- 3669139 TI - Child feeding habits in the People's Democratic Republic of Yemen. I. Breast and bottle feeding. PMID- 3669140 TI - Conventional cerebrospinal fluid investigations in the diagnosis of meningitis. PMID- 3669141 TI - Validity of weight/height in assessing the nutritional status of infants from birth to one year. PMID- 3669142 TI - Influence of weight changes in the neonatal period in the prediction of birth weight. PMID- 3669143 TI - Neonatal mid-upper-arm circumference as a valid proxy-measure for birth weight. PMID- 3669144 TI - Analysis of paediatric admission in the Gondar College of Medical Science Hospital. PMID- 3669145 TI - Dharavi project 1985. An investigation into patterns of infant feeding and malnutrition in the urban slum of Dharavi in Bombay. PMID- 3669146 TI - Regional cerebral blood velocity in infants. A real-time transcranial and fontanellar pulsed Doppler study. AB - To quantitate blood velocity while maintaining the real-time ultrasound image of the intracranial vessels in infants, we used a commercial phased-array pulsed Doppler scanner and developed a transcranial technique to measure the middle cerebral artery velocity, and a fontanellar approach to measure flow velocities in the basilar, internal carotid, anterior cerebral, and the pericallosal arteries. In 22 healthy term and 25 stable preterm infants, the peak spectral systolic velocities in the internal carotid and basilar arteries in term infants were 45 +/- 3.1, and 38.8 +/- 2.5 cm/sec, (mean +/- SEM), respectively. A hierarchical pattern of velocity variation was noted between the large and small intracranial vessels in both the term and preterm infants. The velocities were 30 40% higher in the proximal than in the smaller distal, anterior cerebral, and pericallosal arteries (P less than 0.05). Although the velocities in corresponding vessels were slightly lower in preterm infants than in the term, the differences were statistically not significant. In both groups, the end diastolic velocities did not change significantly among the large and small arteries; therefore, a significant variation in Pourcelot's index (PI, the ratio of maximum systolic-end diastolic difference to the systolic velocity) was noted between the internal carotid and the pericallosal arteries: 0.88 +/- 0.01 vs. 0.76 +/- 0.02, (P less than 0.05). A nearly parabolic velocity profile was documented in the vessels studied. PMID- 3669147 TI - Longitudinal trends in left ventricular cardiac output in healthy infants in the first year of life. AB - We studied left ventricular (LV) cardiac output as estimated by ascending aorta blood flow (QAo) longitudinally in 31 healthy infants from birth through the first year of life using noninvasive pulsed Doppler ultrasound technique. The temporal mean ascending aortic blood flow velocity (VAo) was measured with a 5 MHz pulsed Doppler velocimeter and on line integration system. Ascending aortic cross-sectional area (AAo) was determined using M-mode echography. Ascending aortic blood flow was calculated as QAo = VAo X AAo and was corrected to body weight (BW) in kilograms or body surface area (BSA) in meters squared. Mean ascending aortic flow velocity (VAo) remained relatively constant over the first year, averaging 20.5 +/- 3.4 cm/sec (+/- SD). Changes in AAo over time correlated strongly with changes in BW or BSA (r = 0.99). Therefore, changes in QAo correlated strongly with changes in AAo, BW, and BSA (r = 0.99). LV cardiac output corrected for body weight or BSA remained relatively constant throughout the first year, mean values ranging from 180-226 ml/min/kg or 3.06-3.76 L/min/m2 and averaging 204 +/- 45 ml/min/kg or 3.48 +/- 0.74 L/min/m2. A similar strong correlation was seen between serial changes in LV stroke volume and changes in BW or BSA (r = 0.99). PMID- 3669148 TI - Diagnostic accuracy of two-dimensional echocardiography for detection of left atrial thrombus in patients with mitral stenosis. AB - Two-dimensional echocardiograms of 56 patients with mitral stenosis, who subsequently underwent operation, were analyzed to evaluate the accuracy for the detection of left atrial thrombi. From left parasternal, apical, and subcostal cardiac windows, multiple planes (including standard planes and their derived scanning planes) were assessed for the presence or absence of mass echoes in the left atrium. The results showed 63% sensitivity, 95% specificity, 87% positive predictive value, 84% negative predictive value, and 83% overall diagnostic accuracy. Most of the false-negative cases had their thrombi confined to the left atrial appendage. We conclude that in patients with mitral stenosis, two dimensional echocardiography is promising for the diagnosis of left atrial thrombi, particularly when they locate or extend to the main left atrial cavity (not confined to atrial appendage). PMID- 3669149 TI - Ultrasonographic localization of breast tissue expander valves. PMID- 3669150 TI - Sonographic biophysical profile in the post-date pregnancy. PMID- 3669151 TI - Characterization of in vitro transcription and transcriptional products of measles virus. AB - Ribonucleoprotein complexes isolated from measles virus-infected HeLa cells contained an RNA-dependent RNA polymerase activity that catalyzed the incorporation of ribonucleotides into ribonucleic acid. The ribonucleoprotein complexes were composed of measles virus nucleoprotein, phosphoprotein, and a large protein, as well as viral RNA. The kinetics of RNA synthesis at different temperatures, time intervals, and protein, ribonucleotide, and mono- and divalent cation concentrations were analyzed. Enzyme activity was maximum at 4 h at 25 degrees C in the presence of 100 mM Na+-2.5 mM Mg2+-1 mM ribonucleotides. Actinomycin D and alpha-amanitin had no effect on the enzyme activity. Addition of cytoplasmic extracts from uninfected HeLa cells to the reaction mixture did not increase the incorporation of ribonucleotides into RNA. The in vitro synthesized RNAs were characterize by slot blot analysis and quantitated by densitometer scanning. All mRNAs coding for the structural proteins of measles virus were synthesized. Nucleoprotein RNA was the most abundant species made, followed by phosphoprotein, hemagglutinin, fusion protein, matrix protein, and large-protein RNAs. The system described here resulted in the first efficient transcription of measles virus RNA and analysis of products. PMID- 3669152 TI - Free and integrated forms of hepatitis B virus DNA in human hepatocellular carcinoma cells (PLC/342) propagated in nude mice. AB - Primary hepatocellular carcinoma cells (PLC/342) propagated in nude mice produce hepatitis B surface antigen of subtype adr, as well as core particles containing viral DNA and DNA polymerase. Free and integrated forms of hepatitis B virus (HBV) DNA in the tumor were isolated by molecular cloning, and their nucleotide sequences were determined. Both of the two representative clones of free HBV DNA had the same genomic length (3,158 base pairs) and had two stop codons as well as two deletions in the envelope gene. None of the seven distinct clones of integrated HBV DNA possessed the entire viral genome. The integrated clone sequences had deletions and rearrangements, and only two clones possessed the envelope gene including the promoter and enhancer sequences. The C gene, which codes for core protein, was preserved in the two free clones and one of the integrated clones. The P gene, which codes for DNA polymerase, had deletions at two positions of 21 and 36 base pairs in both free clones, but was carried in toto by one of the integrated clones. The nucleotide sequences of the S genes of two free and four integrated clones, as well as their two inverted repeats, were compared. All of the eight sequences of the S gene possessed two nucleotide substitutions in common that were not displayed by any of the reported HBV genomes. The sequences differed from one another by only 1.2%. They differed, however, from 11 reported HBV genomes of subtype adr by 2.4%, from an ayr genome by 1.9%, from 2 adw genomes by 6.9%, and from 2 ayw genomes by 5.9%. These results indicate that all free and integrated HBV DNA species in the PLC/342 tumor cell evolved from a common progenitor. The free HBV DNA underwent nucleotide substitutions during several integration events, resulting in integrated HBV DNA copies that were similar in sequence but distinct from the reported HBV genomes. PMID- 3669153 TI - Transformation of differentiated rat hepatocytes with adenovirus and adenovirus DNA. AB - Primary cultures of hepatocytes isolated by collagenase perfusion of adult rats were transformed by infection with adenovirus type 5 or transfection with adenovirus DNA. Total virion DNA or recombinant plasmid DNA containing the adenovirus E1A and E1B genes transformed hepatocytes at comparable frequencies. No foci of replicating hepatocytes were detected after transfection with a plasmid containing the E1A gene alone. The frequency of transformation by the adenovirus E1A and E1B genes was dependent on the composition of the culture medium. Transformation occurred at a low frequency when the transfected hepatocytes were maintained in a chemically defined medium (CDM), but the frequency was enhanced 8- to 10-fold when the cells were maintained in (i) serum supplemented medium or (ii) CDM supplemented with epidermal growth factor. Cell lines derived from the adenovirus-transformed colonies of hepatocytes expressed adenovirus E1A and E1B RNAs. When hepatocytes were maintained in CDM supplemented with dimethyl sulfoxide and transfected with plasmids containing the E1A and E1B genes, it was possible to derive cell lines that retained the ability to express several liver-specific genes, including albumin, transferrin, hemopexin, and the third component of complement. The amount of albumin secreted per cell varied from 1 to 5 pg per cell per 24 h, and in one cell line it was below detectable levels by passage 9. Adenovirus-transformed hepatocytes were not tumorigenic when inoculated subcutaneously into neonatal syngeneic rats. We conclude that the adenovirus E1A and E1B genes are capable of transforming adult rat hepatocytes, a differentiated epithelial cell type. PMID- 3669155 TI - Adrenal tumors: involvement of the inferior vena cava. AB - We report 3 cases of adrenal neoplasms with extension of tumor thrombus into the vena cava. Preoperative documentation of the presence and extent of vena caval involvement is mandatory before surgical extirpation of adrenal tumors. PMID- 3669154 TI - Cellular transformation by adenovirus type 5 is influenced by the viral DNA polymerase. AB - Early region 2B (E2B) of the group C adenoviruses encodes a number of proteins, including the 140-kilodalton DNA polymerase, which plays a role in the initiation of viral DNA replication. Temperature-sensitive (ts) mutants with mutations mapping to E2B are conditionally defective for both DNA replication in human cells and transformation of rat cells. Nucleotide sequence analysis shows that the E2B mutant ts36 possesses a single point mutation specific to the viral DNA polymerase; this transition of a C to a T at position 7623 changes leucine residue 249 in the polymerase to a phenylalanine. A wild-type (ts+) revertant possesses a codon specifying the original leucine at position 249. Phenotypic analysis of revertant and wild-type viruses derived by marker rescue from ts36 shows that these variants are wild type for both viral DNA replication and transformation. Thus, the single point mutation in the polymerase gene of ts36 is responsible for both defects. PMID- 3669156 TI - The role of oxalate and calcium oxalate activity and formation product ratio in patients with renal stones before and during treatment. AB - The participation of oxalate in nephrolithiasis was evaluated in 202 stone patients. The activity product and formation product ratios of calcium oxalate were substantially altered in the stone population. Treatment with thiazide derivatives and/or allopurinol was able to decrease urine oxalate and normalize the activity product and formation product ratios. Stone activity decreased in the stone population after treatment. Our data suggest that oxalate may have a critical role in nephrolithiasis activity. PMID- 3669157 TI - Prognostic variables in patients with transitional cell carcinoma of the renal pelvis and proximal ureter. AB - Recent technological advances in urological endoscopic surgery of the renal pelvis and proximal ureter via ureteroscopy or percutaneous nephroscopy have made it possible to consider parenchymal-sparing procedures in patients with transitional cell carcinoma. To define the role of these procedures in the management of renal pelvic or proximal ureteral transitional cell carcinoma we analyzed retrospectively 31 patients who underwent nephroureterectomy for transitional cell carcinoma of the renal pelvis and/or proximal ureter. High grade upper urinary tract transitional cell carcinoma and a history of metachronous or synchronous bladder transitional cell carcinoma were independent adverse prognostic factors. However, patients with low grade upper urinary tract transitional cell carcinoma and no evidence of a urothelial field change had a 100 per cent 5-year survival rate. It would appear that parenchymal-sparing endoscopic techniques should be regarded with caution in patients with either high grade transitional cell carcinoma of the renal pelvis and proximal ureter or a history of bladder cancer. PMID- 3669158 TI - Conservative surgery for transitional cell carcinoma of the renal pelvis. AB - From 1972 to 1986, 14 patients underwent a conservative operation for transitional cell carcinoma of the renal pelvis. Most of these patients had low grade (12), noninvasive (10) tumors involving a solitary functioning kidney (12). The operations performed were open pyelotomy with tumor excision and fulguration (8 patients), partial nephrectomy (5) and percutaneous nephroscopic fulguration (1). There was 1 operative death. Of the 13 surviving patients 8 (62 per cent) remained free of transitional cell carcinoma postoperatively, while 5 (38 per cent) had recurrent disease. Six patients (46 per cent) presently are free of tumor 6 months to 5 years postoperatively. Conservative surgical techniques can provide satisfactory treatment for selected patients with renal pelvic transitional cell carcinoma when preservation of functioning renal parenchyma is necessary to avoid kidney failure. PMID- 3669159 TI - The effect of nifedipine on cystoscopy-induced autonomic hyperreflexia in patients with high spinal cord injuries. AB - We evaluated the ability of the calcium channel blocker nifedipine to control autonomic hyperreflexia during cystoscopy in 7 patients with cervical spinal cord injuries. Nifedipine (10 mg.) alleviated autonomic hyperreflexia when given sublingually during cystoscopy and prevented autonomic hyperreflexia when given orally 30 minutes before cystoscopy. No adverse drug effects were observed. PMID- 3669160 TI - Conservative management of muscle-infiltrating bladder cancer: prospective experience. AB - Between May 1979 and July 1983, 217 consecutive patients with documented primary bladder tumors invading muscle were evaluated to determine the fate of patients with conservatively treated muscle-infiltrating bladder cancer. The disease was re-staged by urine cytology, bimanual examination with the patient under anesthesia and transurethral biopsy or resection. Of the 217 patients 172 underwent total or partial cystectomy and 45 (21 per cent, 37 with stage T2, 7 with stage T3a and 1 with stage T4 disease) did not because re-staging showed no residual tumor (stage T0) in 20, carcinoma in situ in 17, stage T1 tumor in 4 and local stage T2 cancer in 4. The median followup was 5.1 years (range 3 to 7 years). Of the 45 patients 30 (65 per cent) are free of tumor or have required transurethral resection and intravesical therapy for recurrent tumors but cystectomy has not been necessary. Of the 15 failures 11 underwent cystectomy 9 to 30 months after re-staging (7 are alive and 4 died of disease) and 4 are alive with metastatic disease (2 with negative bladder biopsies). Re-staging in the 4 patients who died showed stage T0 disease in 2, carcinoma in situ in 1 and stage T2 tumor in 1. The over-all survival rate was 82 per cent (37 of 45) and it was 67 per cent (30 of 45) for patients with a functioning bladder. The data suggest that endoscopic re-staging may identify a subset of patients with limited muscle infiltrating bladder tumors that can be managed conservatively without immediate cystectomy. PMID- 3669161 TI - Periurethral abscess. AB - From 1963 to 1985, 63 periurethral abscesses were treated in 47 men. The records were reviewed to characterize the natural course of the disease. The most common predisposing factors were a history of gonorrhea, previous periurethral abscess and urethral stricture disease. Treatment consisted of abscess drainage, suprapubic urinary diversion and intravenous antibiotic therapy, consisting of an aminoglycoside and a cephalosporin. Mortality was 1 of 63 patient hospitalizations (1.6 per cent). Improved survival over historical cohorts is attributed to the availability of better antibiotics and medical support. PMID- 3669162 TI - The erectile angle: objective criterion to evaluate the papaverine test in impotence. AB - Intracavernous papaverine injection may be the first diagnostic step in the assessment of the impotent patient. However, the appreciation of its effect must rely on the evaluation of penile rigidity. Since measurement of rigidity requires a sophisticated procedure that may not be available to the majority of practitioners, we attempted to find a simple and objective method to evaluate the results of this common test. We tested 50 patients complaining of impotence with intracavernous injection of 60 mg. papaverine. The length and circumference of the penis were measured before and after papaverine injection. The rigidity was determined by measuring the angle between the penis and the legs with the patient in the standing position. Afterwards, each patient underwent vascular (Doppler ultrasound and cavernometry) and neurological examinations. A total of 27 patients with no vascular abnormalities had an erectile angle of 96 degrees (range 90 to 130 degrees), while 23 patients had some vascular disorders (9 arterial lesions, 8 venous leakage and 6 combined lesions) and an erectile angle of 36 degrees (range 0 to 60 degrees). There was no significant difference between the groups in the increase of length and circumference of the penis after intracavernous injection of papaverine. The papaverine test can distinguish between patients with vascular and psychogenic problems. A negative papaverine test associated with a normal Doppler examination is characteristic of venous leakage. Measurement of the erectile angle after intracavernous injection of papaverine with the patient in the standing position is a simple, objective and reliable method to evaluate patients with vascular impotence. PMID- 3669163 TI - Radical prostatectomy for carcinoma in men more than 69 years old. AB - Between 1974 and 1986, 193 men with prostatic cancer were treated with bilateral pelvic lymphadenectomy and radical retropubic prostatectomy. Of the 193 patients 65 were 70 years or older (5 were 78 years old). Of the 32 men in this series who underwent a potency-sparing modification of the radical prostatectomy 7 were 70 years or older, the oldest being 77 years. A comparison of the morbidity and mortality of the 65 men in the older group with the 128 men in the group less than 70 years old revealed no significant difference. Long-term followup data demonstrated 57 men in the older age group to be well with no evidence of disease, with 10 in that group well with no evidence of disease greater than 5 years after the radical prostatectomy. We recommend radical prostatectomy for patients with clinically localized prostatic carcinoma whose general health suggests a 10-year or greater probable life expectancy, aside from tumor. PMID- 3669164 TI - The evaluation of microscopic hematuria: a population-based study. AB - From 1979 until 1983, 2,005 men underwent routine urological examinations. Of these men 85 (4 per cent) had asymptomatic microscopic hematuria. All men underwent complete urological evaluation. Significant urological disease was detected in 22 per cent of the patients. Therefore, complete urological evaluation can be justified in a nonselected group of men with microscopic hematuria. PMID- 3669165 TI - Retrograde nephrostomy tube placement during open surgical procedures requiring urinary diversion. AB - A new nephrostomy tube has been designed that allows for atraumatic passage by a stylet from inside the renal pelvis through the renal cortex. The technique for safe insertion is described. PMID- 3669166 TI - Vasoactive intracavernous pharmacotherapy--the nursing role in teaching self injection therapy. AB - Our physician-nurse team management of a program in vasoactive intracavernous pharmacotherapy to treat male impotence has provided a high degree of patient and partner satisfaction. Nurses participate in the assessment of the ability of a patient or partner to master the self-injection technique, and the potential of a couple for compliance with and commitment to the program, all of which are key factors for successful home therapy. A nurse also teaches the self-injection technique. Audiovisual materials and handouts are used as teaching aids to ensure that complete and consistent information is given. The patient or partner is required to perform a self-injection under nursing supervision before a prescription for home use written. Initial followup visits are scheduled with a nurse at 1 to 2-week intervals. At these visits the nurse identifies possible patient errors in self-injection technique, dose or frequency, and answers questions about the therapy. After the couple has mastered and is comfortable with home injection, followup appointments are scheduled with the physician at 4 week intervals to monitor for possible changes in response to treatment and for an examination of the phallus. PMID- 3669167 TI - Predictive criteria for failed sphincterotomy in spinal cord injury patients. AB - Nine patients with chronic high spinal cord injury who failed sphincterotomy secondary to detrusor hypocontractility underwent neurourological evaluation. Testing revealed an abnormality involving the sensory limb of the somatic sacral reflex arc (abnormal R wave) or at the level of the spinal interneuron pool (abnormal or absent S wave). This study strongly suggests that the sensory input from the bladder to the spinal cord, together with alteration in the sensory motor integration that occurs at the level of the interneuron pool, is important in influencing the characteristics of the detrusor contraction following high spinal cord injury. Predictive criteria for failed sphincterotomy are a slow increase to maximum intravesical pressure before voiding and abnormal lumbosacral sensory evoked potentials. PMID- 3669168 TI - Delayed spontaneous resolution of high grade vesicoureteral reflux after reimplantation. AB - Significant (grade III/V or greater, International Reflux Study) postoperative vesicoureteral reflux was noted in 4 children who underwent technically satisfactory ureteral reimplantation. All patients had moderate to severe preoperative ureteral dilatation necessitating ureteral tapering in 3 of the 8 ureters reimplanted. Reoperation was considered in all 4 children but a conservative approach was used, with subsequent spontaneous resolution of the reflux 19 to 55 months after reimplantation. We conclude that even high grade reflux after satisfactory reimplantation can resolve spontaneously. PMID- 3669169 TI - Ipsilateral ureteroureterostomy and pyeloureterostomy: a review of 15 years of experience with 25 patients. AB - We reviewed our 15-year experience with pyeloureterostomy and ureteroureterostomy in 25 children with ureteral duplication. Pyeloureterostomy was performed in 5 patients, including 4 with reflux and 1 with upper pole obstruction. The results were good in 4 and in 1 patient postoperative anastomotic obstruction developed. Ipsilateral ureteroureterostomy was performed in 20 patients, including 8 with reflux into 1 or both ipsilateral ureters, 7 with obstructed ectopic upper pole ureters without ureterocele, 4 with ectopic ureteroceles and 1 with incomplete ureteral duplication and obstruction of the common distal ureteral segment. At followup, which ranged from 3 months to 6 years, 17 patients had good postoperative results as demonstrated by improved upper tract drainage and absence of reflux. Of 6 patients who underwent simultaneous ipsilateral ureteral reimplantation at the time of ureteroureterostomy postoperative reflux was noted in 1, necessitating a second procedure. Ureteral stumps were left in 13 patients. Postoperative urinary infection occurred in only 3 of these patients, all as single episodes and 2 associated with persistent contralateral reflux. Significant luminal disparity at the time of ureteroureterostomy was noted in 18 patients and did not adversely affect results. PMID- 3669170 TI - Anterior urethral valves in the fossa navicularis in children. AB - Anterior urethral valves are an uncommon cause of lower urinary tract obstruction in children. They have been noted in the bulbous (40 per cent) and penile (30 per cent) urethra, and at the penoscrotal junction (30 per cent). None has been reported in the fossa navicularis. We encountered 3 cases in which anterior valves were located in the glanular urethra. This entity may be misdiagnosed as meatal stenosis and without a high index of suspicion it might be overlooked. The combination of distal obstruction and a normal urethral meatus should lead one to suspect this entity. Observation of the voided stream is extremely helpful in the diagnosis, since voiding urethrography often fails to include the penile tip and urethroscopy of the distal urethra often is unsatisfactory. Treatment can be performed either transurethrally or by excision through the meatus. PMID- 3669171 TI - Thiazide diuretics for the treatment of children with idiopathic hypercalciuria and hematuria. AB - We describe our experience in 14 children with idiopathic hypercalciuria and hematuria who received a finite course of thiazide diuretics. Thiazides reduced urinary calcium excretion and resolved hematuria in all cases. Serum calcium concentration was not altered with treatment. Serum potassium concentration decreased, and total carbon dioxide content and uric acid concentrations increased in response to therapy but these changes did not necessitate discontinuation of treatment. Thiazides were discontinued electively after 16 +/- 15 months of treatment (range 3 to 40 months). Six children maintained normal urinary calcium excretion, while 8 displayed excessive calcium excretion for 16 +/- 4 months after treatment was stopped. Renal calculi were not detected in any patient during this interval but hematuria recurred in 4 children. These findings suggest that thiazides are safe and effective for resolving hypercalciuria and hematuria. Thiazides may be discontinued safely in some children, while others will require further treatment courses or prolonged continuous therapy. PMID- 3669172 TI - Preoperative magnetic resonance imaging of vena caval tumor thrombi: experience with 5 cases. AB - Magnetic resonance scans were performed preoperatively in 5 patients who underwent surgical removal of renal or adrenal tumors with direct extension of the tumor into the vena cava. Of the patients 4 had renal cell carcinoma and 1 had adrenocortical carcinoma. Magnetic resonance imaging staged correctly the level of vena caval tumor thrombus involvement in 4 patients and missed the presence of right atrial tumor extension in 1. This noninvasive imaging modality can be used instead of contrast venography in most patients to assess the presence and extent of vena caval tumor involvement by renal cell carcinoma. Contrast venography should be used for those patients with suspected cardiac involvement and for those whose tumor thrombus extent remains unclear after magnetic resonance imaging. PMID- 3669173 TI - Spontaneous renal artery thrombosis: successful lysis with streptokinase. AB - We report a case in which a renal scan and angiography revealed a renal artery thrombosis. The only presenting symptom was left flank pain and no predisposing factors could be found on clinical or laboratory examination. Local infusion of streptokinase through an intra-arterial catheter led to complete dissolution of the thrombus despite the fact that it had been present for 13 days. The renal scan immediately after thrombolysis demonstrated the dramatic return of function to the involved kidney, although a repeat scan at 3 months showed evidence of the previous ischemia. Selective fibrinolytic therapy offers an option to surgery in selected patients with renal artery thrombosis. PMID- 3669174 TI - Pelvic lipomatosis: the nuclear magnetic resonance appearance and associated vesicoureteral reflux. AB - We report a case of pelvic lipomatosis with ureteral obstruction and vesicoureteral reflux. In addition to computerized tomography, nuclear magnetic resonance imaging provided definite and graphic proof of the diagnosis. Operative treatment consisted of ureteroileocystostomy. PMID- 3669175 TI - Intravesical herniation of small bowel after bladder perforation. AB - Intravesical small bowel herniation is a rare complication of bladder perforation, with only 1 case reported previously. We describe 2 additional patients in whom the diagnosis of bladder perforation was delayed or made difficult because the herniated small bowel presented as a filling defect without significant extravasation of contrast medium on cystography. In both patients additional investigative procedures were necessary to establish the diagnosis preoperatively. PMID- 3669176 TI - A simple substitute for a missing segment of the proximal anterior urethra. AB - We describe 2 patients with an absent segment of the bulbomembranous urethra, in 1 of whom the defect extended from the triangular ligament to the scrotal area. A simple method to restore continuity is presented, which is applicable to a wide variety of conditions resulting in the absence of a long segment of the bulbomembranous urethra. PMID- 3669177 TI - Penile necrosis secondary to an indwelling Foley catheter. AB - Penile necrosis is a rare entity but it may be brought about more readily if certain risk factors are present. Such factors are discussed in this paper and the reader is forewarned about this problem. PMID- 3669178 TI - Aberrant epididymal tissue: a significant clinical entity. AB - Epididymal anomalies are relatively rare and usually they are associated with an undescended testis. A 33 to 66 per cent incidence of epididymal anomalies has been noted in male subjects with cryptorchidism. An increased incidence of epididymal anomalies also has been noted in association with cystic fibrosis, von Hippel-Lindau's syndrome and in male offspring of women treated with diethylstilbestrol. The frequency and anatomical spectrum of epididymal anomalies among men with normal descended testes are not known. We describe 3 patients with bilaterally descended testes, who were found to have aberrant epididymal tissue at scrotal or inguinal exploration. The variable presentations of aberrant epididymal tissue in these 3 patients can be explained best by understanding the embryology and anatomy of the epididymis and its associated vestigial structures. In all likelihood the structures encountered in our patients were the ductus aberrans inferior and the paradidymis. These structures, which rarely are included in urological anatomical descriptions of the epididymis, can be significant clinically. Therefore, it is important that the urologist be aware of their existence and their means of presentation. PMID- 3669179 TI - Prostatic abscess owing to anaerobic bacteria. AB - Abscess of the prostate is seen infrequently. We report a prostatic abscess owing to anaerobic bacteria in a 46-year-old man with a 10-year history of irritable voiding symptoms. Preoperative computerized tomography confirmed the diagnosis of prostatic abscess, which was treated with transurethral resection and broad spectrum antibiotics. PMID- 3669180 TI - Transuterine resection of fibroids: a new approach to the management of submucous fibroids in selected patients. AB - Transuterine resection of fibroids is an effective alternative to hysterectomy in patients with uterine bleeding secondary to submucous fibroids. To date we have performed this procedure in 3 patients. In 2 patients transuterine resection was performed for uterine bleeding with a successful outcome. In the third patient the procedure was performed to treat infertility and the outcome is not yet known. The procedure should be performed by the combined efforts of a urologist and gynecologist. PMID- 3669181 TI - KUH notes. PMID- 3669182 TI - Re: Cystic fibrosis presenting in a 45-year-old man with infertility. PMID- 3669183 TI - Re: Predictive parameters of successful varicocele repair. PMID- 3669184 TI - Re: Condylomata acuminata in the pediatric patient. PMID- 3669185 TI - Intracavernosal injection therapy for impotence. PMID- 3669186 TI - Chronic papaverine treatment: the effect of repeated injections on the simian erectile response and penile tissue. AB - To investigate the effect of chronic papaverine treatment, seven monkeys underwent repeated intracavernous injections for one year. One monkey died after 56 injections; the others received a total of 100 each. The strength and duration of erection were recorded after each injection, and the erectile tissue was examined histologically at the end of the study. Over the long term, papaverine maintains its erection-inducing capability, but it does cause pathologic changes in the erectile tissue: minimal to marked fibrosis at the injection site and hypertrophy of smooth muscle in the non-injected area of the corpus. PMID- 3669187 TI - Effects of some calcium channel blockers on isolated human penile erectile tissues. AB - The effects of the calcium channel blockers (CCBs) verapamil, nifedipine and diltiazem on contractile activation of isolated human penile erectile tissues were investigated. Specimens of the corpus spongiosum (CS) and corpora cavernosa (CC) were obtained from men with a history of normal penile erection undergoing cystourethrectomy because of bladder malignancy. Preparations were mounted in organ baths and isometric tension was recorded. Deprivation of extracellular calcium abolished electrically induced contractions in both CS and CC preparations within 15 min.; norepinephrine (NE)-induced contractions were reduced by 90% (CS) and 83% (CC) after 30 min. All the CCBs reduced electrically induced contractions concentration-dependently, nifedipine being the most potent agent. Contractions induced by exogenous NE were depressed by about 50%, whereas high K+ (124 mM) induced responses were abolished. It is concluded that contraction in penile erectile tissues is mediated mainly by neuronally released NE stimulating postjunctional alpha-adrenoceptors. The contraction is highly dependent on extracellular calcium and can partly be inhibited by CCBs. It cannot be excluded that some CCBs injected intracavernosally may be useful for diagnosis and even treatment of erectile dysfunction. However, calcium channel blockade may not be as effective as a therapeutic principle as blockade of alpha adrenoceptors. PMID- 3669188 TI - The seminal vesicle in eight and 16 week streptozotocin-induced diabetic rats: adrenergic, cholinergic and peptidergic innervation. AB - The autonomic innervation of the seminal vesicle from 8 and 16 week streptozotocin-induced diabetic rats and age-matched controls was studied by pharmacological, histochemical and immunohistochemical methods. Contractions in response to electrical field stimulation, which were abolished using prazosin (2 microM) or tetrodotoxin (one to 1.6 microM), and to noradrenaline were significantly increased in both eight and 16 week diabetic animals. The contractile response to acetylcholine was significantly increased in the 16 week diabetic rats only, when compared with controls. Although these responses were significantly increased, no difference was found in ED50 and EF50 values between control and diabetic rats. Vasoactive intestinal polypeptide (0.3 microM) had no effect on resting tension or nerve-mediated responses. In seminal vesicles from control animals, both vasoactive intestinal polypeptide-immunoreactive and acetylcholinesterase-containing nerves were localised around the folds of the columnar epithelium of secretory cells, in contrast to neuropeptide Y immunoreactive and catecholamine-containing nerves which were found in the smooth muscle layers. In seminal vesicles from both eight and 16 week diabetic animals no difference was seen in distribution or density of acetylcholinesterase containing nerves; there was an increase in density and fluorescence intensity of vasoactive intestinal polypeptide- and neuropeptide Y-immunoreactive nerves and a decrease in catecholamine-containing nerves compared with controls. The results are discussed in relation to autonomic neuropathy in diabetes. PMID- 3669189 TI - A study of bladder dysfunction during streptozotocin-induced diabetes in the rat using an in vitro whole bladder preparation. AB - An in vitro whole bladder preparation has been used in this study to examine the effects of eight and 16 week streptozotocin-induced diabetes on detrusor function in the rat. In eight week animals cystometric recordings showed an increase in bladder capacity associated with a decrease in intraluminal pressure. Concentration-response curves revealed a significant increase in sensitivity of the detrusor to beta,gamma-methylene ATP, a potent purinergic agonist, and a trend towards subsensitivity to acetylcholine in bladders from eight week diabetic rats when compared to controls. The atropine-resistant (purinergic) response to neurogenic stimulation was increased over the frequency range two to 30 Hz and was significantly greater at two Hz. In 16 week animals the cystometrogram had partially recovered; capacity had decreased compared to eight week diabetics and intraluminal pressure was within the normal range. Concentration-response curves revealed no significant difference in the response to acetylcholine and a greatly reduced response to beta,gamma-methylene ATP in the 16 week diabetics compared to controls. The atropine-resistant neurogenic response was slightly, but not significantly reduced. The results are discussed in relation to clinical urodynamic measurements of human detrusor dysfunction in diabetes. PMID- 3669190 TI - Extracorporeal shock wave lithotripsy: the use of chemical treatments for improved stone comminution. AB - Extracorporeal shock wave lithotripsy (ESWL) can require more than two thousand acoustic shocks to achieve an adequate degree of renal calculus comminution. A decrease in the number of shocks necessary for effective treatment offers both technical and clinical benefits. The results presented here demonstrate that it is possible in particular cases to increase substantially the degree of comminution produced using a fixed number of acoustic impulses by exposing the stones to solutions of controlled pH and chemical composition during acoustic shock treatment. The largest increase in comminution was observed for magnesium ammonium phosphate hexahydrate/apatite stones exposed to citrate solutions. The smaller particle sizes are shown to result not only from stone dissolution but also from an increase in the ease of stone fracture during acoustic shocking. The degree of comminution of the largest fragment sizes was also found to be slightly increased for calcium oxalate stones by exposure to synthetic urine of elevated pH. These chemical methods of increased stone comminution appear to be directly applicable to particular cases and may have general clinical utility if suitable conditions affecting all stones can be found. PMID- 3669191 TI - Progesterone receptors in the female lower urinary tract. AB - When female estrogenized rabbits were injected i.v. with 3H-progesterone, the tritium concentration determined after one hour was about two to three times higher in urethra, urinary bladder and vagina than in the heart. High affinity progesterone receptors (KD = 1-2 nM) could be demonstrated in both cytoplasmic and nuclear fractions prepared from estrogenized rabbit urethra, bladder and vagina. The cytosolic receptor concentration in both urethra and bladder was about half of that in the vagina. The concentration of nuclear receptors in urethra was not significantly different from that in the vagina, but in the bladder the concentration was only about one fourth of that in the vagina or urethra. The mean KD of cytosolic receptors from bladder was significantly higher than the corresponding values in urethra and vagina. Progesterone binding sites in the bladder had a broader hormonal specificity than those in the urethra or vagina. The present demonstration of specific progesterone receptors in the female urethra might provide a possible link between estrogen progesterone interaction and the appearance of urinary incontinence during pregnancy in women. PMID- 3669192 TI - Inactivation of bladder tumor cells and enzymes by methylene blue plus light. AB - Using a cystoscopic light source and methylene blue as the sensitizing dye, photoactivation was examined in two types of experiments. In the first, the in vitro study destruction of two enzymes (glucose-6-phosphate dehydrogenase and lactic dehydrogenase) was examined in suspensions of whole and homogenized tumor cells from a transplantable bladder tumor. In the second or in vivo study rats were used to demonstrate that tumor cell suspensions treated with methylene blue plus light, when inoculated into susceptible rats, failed to "take" and produce new tumors. These experiments suggest a possible therapeutic use in treatment of human bladder tumors, though further study would be required. PMID- 3669193 TI - Investigative grammar. PMID- 3669194 TI - Extra-anatomic bypass: a closer view. AB - The results of 60 femorofemoral, 27 axillobifemoral, and 15 axillounifemoral bypasses were analyzed. Considered in this order, the operative mortality rate was zero, 11%, and 13%, respectively; initial hemodynamic failure was 7%, 13%, and 9%, respectively; 5-year overall primary patency rate was 67%, 62%, and 19%, respectively; and the secondary patency rate was 74%, 82%, and 37%, respectively. However, axillobifemoral patency was made to seem better by including six cases (12 graft limbs) performed because of nonocclusive disease (aneurysm or failure of graft performed for aneurysm). Excluding these, axillobifemoral primary and secondary patency decreased to 47% and 69%, respectively. Femorofemoral bypass results were made worse by cases performed because of unilateral failure of an aortic bifurcation graft. Exclusion of these bypasses increased primary and secondary patency rates to 74% and 82%, respectively. Occlusion of the major outflow artery (superficial femoral) markedly affected long-term patency of all three bypasses. Thus, "good" and "poor" runoff primary patencies were, respectively, for femorofemoral bypass 79% and 53%, for axillobifemoral bypass 92% and 41%, respectively (occlusive disease only), and for axillounifemoral bypass 54% and zero, respectively. This detailed breakdown of results explains the wide variances in the reported results for these extra-anatomic bypasses and provides a better perspective for their application in different clinical settings. PMID- 3669195 TI - The clinical course of diabetics who require emergent foot surgery because of infection or ischemia. AB - For the past 15 years at our institution, all acute diabetic foot problems have been treated on the vascular surgery service. The treatment approach has emphasized aggressive local foot surgery and frequent use of revascularization to avoid amputation. A total of 212 urgent or emergent foot operations were performed on 138 limbs in 114 diabetic patients for indications of infection, gangrene, or infected neurotrophic ulcers. The average number of operations per limb was 1.5 (range one to six) and per patients was 1.9 (range one to nine). Ischemia was sufficiently severe to require concurrent lower extremity revascularization in 48 limbs in 43 patients. Follow-up ranged from 1 month to 11 years (mean 3 years). Ultimately 36 major lower extremity amputations were required in 33 patients at time intervals ranging from zero to 86 months (mean 7 months) after the initial operation on the affected limb. These data indicate that an aggressive program of surgical treatment of diabetic foot problems combined with liberal use of lower extremity revascularization resulted in long term salvage of 73% of threatened limbs in these high-risk patients. These results form the basis for our recommendation that major lower extremity amputations be considered only as a last resort in diabetic patients with limbs threatened by foot infection or localized gangrene. PMID- 3669196 TI - Endoscopic laser resection of atherosclerotic plaque in a live animal model. A preliminary report on some technical difficulties. AB - This study was designed to determine whether laser energy could be used effectively to resect atherosclerotic plaque through an endoscope in a live animal model. Twelve adult Yorkshire swine with infrarenal aortic atherosclerosis had a 2.5 mm and/or 3.2 mm diameter fiberscope passed into the aorta from the femoral artery after proximal aortic balloon occlusion. Endoscopic argon laser resection of the atherosclerotic plaque was then attempted in eight pigs with an argon laser fiber (60 to 400 microns). We were able to visualize the raised atherosclerotic plaque in all 12 pigs with the larger 3.2 mm diameter fiberscope, which was easily passed into the aortoiliac system from the 4 mm diameter femoral vessel. The articulating end feature enhanced maneuverability within the lumen and allowed laser fiber direction. The 2.5 mm endoscope did not allow adequate visualization in any pig since the vessel could not be cleared of blood. The 2.5 mm endoscope was also passed from the femoral artery distally into the hind limb and still did not allow adequate visualization of the vessel wall because of persistent luminal blood. The 3.2 mm endoscope enabled vessel wall visualization distal to the femoral artery when the proximal artery was occluded. No aortas were grossly perforated by the laser energy. In all pigs undergoing endoscopic laser resection, raised plaques were removed both grossly and histologically, although the plaque edges were carbonized and frayed as well as vaporized. With the small spot size of the argon fiber, channels were drilled through plaque, frequently with incomplete recanalization of the lumen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3669197 TI - Indium 111-labeled white blood cell scans after vascular prosthetic reconstruction. AB - The clinical value of indium 111-labeled white blood cell (WBC) scanning done after vascular graft procedures was investigated to differentiate noninfectious postoperative inflammation associated with graft incorporation from early prosthetic graft infection. Indium 111-labeled WBC scans were initially obtained in 30 patients before discharge from the hospital and during the subsequent follow-up period (334 days). Fourteen of 30 patients (47%) had normal predischarge scans that included all 10 patients who had grafts confined to the abdomen and 4 of 20 patients (20%) who had grafts arising or terminating at the femoral arteries (p less than 0.05). Sixteen of 30 patients (53%) discharged with abnormal initial indium 111 WBC scans underwent serial scanning until the scan normalized or a graft complication developed. All of the 16 patients had grafts involving the groin region. Abnormal indium 111 uptake in the femoral region continued for a mean 114 days without the development of prosthetic graft infections. The sensitivity of indium 111-labeled WBC scans for detecting wound complications was 100%, whereas the specificity was 50%. Thus, the accuracy of the test was only 53%. We conclude that (1) abnormal indium 111 WBC scans are common after graft operations involving the groin region but are unusual after vascular procedures confined to the abdomen, and (2) in the absence of clinical suspicion, the indium 111-labeled WBC scan does not reliably predict prosthetic graft infection because of the low specificity of the test in the early postoperative period. PMID- 3669198 TI - Intraoperative video angioscopy compared with arteriography during peripheral vascular operations. AB - In a prospective study, we assessed the diagnostic and therapeutic applications of intraoperative angioscopy for peripheral vascular procedures. Sixty-seven vessels and 17 bypass grafts were examined with a flexible, multichannel, fiberoptic endoscope (outer diameter 2.8 mm), with video projection of a magnified image used during the following operations: femoropopliteal or femorotibial bypass (14), aortofemoral (six), axillopopliteal bypass (one), and femoral embolectomy (three). Preoperative angiograms were compared with the findings at prebypass intraoperative angioscopy. Immediately after bypass, angioscopic appearances of the graft, anastomosis, and distal runoff artery were compared with a completion angiogram. Significant disparity between angioscopy and arteriography occurred in five patients (21%), with resultant change of management in three (12.5%). In comparison to angioscopy, the arteriograms gave a false negative rate of 12.5% (3 of 24) and a false positive rate of 8% (2 of 24). Angioscopy was accurate for assessment of anastomoses in all cases and was particularly beneficial for monitoring balloon catheter embolectomy. Complications were limited to three instances of vasospasm when the scope was used in narrow vessels. No embolization, intimal trauma, infection, or vessel perforation occurred. We conclude that angioscopy promises to be a safe and accurate alternative technique for intraoperative assessment, monitoring anastomotic results and controlling therapeutic procedures. PMID- 3669199 TI - Creation and closure of temporary arteriovenous fistulas for venous reconstruction or thrombectomy: description of technique. PMID- 3669200 TI - Four years' results of a prospective, randomized clinical trial comparing polytetrafluoroethylene and modified human umbilical vein for below-knee femoropopliteal bypass. AB - Polytetrafluoroethylene (PTFE) (Gore-Tex) and human umbilical vein (Biograft) arterial grafts were compared for below-knee femoropopliteal bypass grafting in a prospective randomized clinical trial. One hundred five patients (105 limbs) entered the trial. Seventy-six percent suffered from rest pain, ulceration, or gangrene. The median postoperative ankle-arm blood pressure index was 0.36. Twenty-three limbs had three patent tibial arteries, 46 limbs had two tibial arteries, 31 limbs had one patent artery, and five limbs had isolated popliteal segments. Thirty-four percent were repeat operations. Fifty-five patients were allocated to receive PTFE grafts and 50 to receive human umbilical vein grafts. The two groups were comparable as to preoperative risk factors and operative and postoperative treatment. During the first 4 years (maximum 1609 days) 40 PTFE grafts and 24 umbilical veins occluded. At 1 year the PTFE patency rate was 53% and at 4 years was 22%. For umbilical vein the corresponding figures were 74% and 42% (p = 0.005, Gehan test). During follow-up the incidence of PTFE failure was on the average 2.1 times higher than that of umbilical vein failure (95% confidence limits 1.2 to 3.4). PMID- 3669201 TI - Nonresective therapy for aortic aneurysms: results of a survey. PMID- 3669202 TI - Failure of CT scanning to diagnose aortic graft infection. PMID- 3669203 TI - AIDS commission experiences more changes. PMID- 3669204 TI - Leads from the MMWR. Western equine encephalitis--United States and Canada, 1987. PMID- 3669205 TI - Leads from the MMWR. Regional distribution of deaths from residential fires- United States, 1978-1984. PMID- 3669207 TI - Computer programs to support clinical decision making. PMID- 3669206 TI - Cholera from raw oysters shipped interstate. PMID- 3669208 TI - Physicians on aeromedical teams. PMID- 3669209 TI - Worksite health promotion and health care costs and utilization. PMID- 3669210 TI - Leisure-time physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial. AB - The relation of self-selected leisure-time physical activity (LTPA) to first major coronary heart disease (CHD) events and overall mortality was studied in 12,138 middle-aged men participating in the Multiple Risk Factor Intervention Trial. Total LTPA over the preceding year was quantitated in mean minutes per day at baseline by questionnaire, with subjects classified into tertiles (low, moderate, and high) based on LTPA distribution. During seven years of follow-up, moderate LTPA was associated with 63% as many fatal CHD events and sudden deaths, and 70% as many total deaths as low LTPA (P less than .01). Mortality rates with high LTPA were similar to those in moderate LTPA; however, combined fatal and nonfatal major CHD events were 20% lower with high as compared with low LTPA (P less than .05). These risk differentials persisted after statistical adjustments for possible confounding variables, including other baseline risk factors and Multiple Risk Factor Intervention Trial group assignments. It is concluded that LTPA has a modest inverse relation to CHD and overall mortality in middle-aged men at high risk for CHD. PMID- 3669211 TI - Biomedical research in the industrial setting. Contrasts and similarities to academia. PMID- 3669212 TI - In developed countries, the Golden Age of Medicine is at hand--for the patients. PMID- 3669213 TI - A prudent approach to control of cholesterol levels. PMID- 3669214 TI - Businesses, federal government move to pick up AIDS gauntlet. PMID- 3669215 TI - Soviets, Americans allied in new war; common foe this time: alcohol abuse. PMID- 3669216 TI - On to 1988 Olympics ... with lessons learned. PMID- 3669217 TI - Leads from the MMWR. Rubella and congenital rubella--United States, 1984-1986. PMID- 3669218 TI - Autopsy--current issues. PMID- 3669219 TI - Age-related breast cancer therapy. PMID- 3669220 TI - Fleeting wisdom. PMID- 3669221 TI - Before Chernobyl: Savannah River. PMID- 3669222 TI - A formula for calculating the dosages of drugs in emergencies. PMID- 3669223 TI - Leapfrog leg. PMID- 3669224 TI - Wernicke's syndrome: what we don't teach. PMID- 3669225 TI - Coagulase-negative staphylococcal bacteremia in the changing neonatal intensive care unit population. Is there an epidemic? AB - A fivefold increase in the number of cases of nosocomial coagulase-negative staphylococcal bacteremia was investigated in a neonatal intensive care unit between 1975 and 1982. This apparent outbreak was not the result of increased isolation of coagulase-negative staphylococci from blood cultures nor an increased frequency with which blood cultures were obtained. Rather, it was attributable to a dramatic increase in the overall probability that a positive blood culture would be interpreted as "bacteremia" as opposed to a contaminant by both physicians and infection control staff. Specifically, there had been a 62.3% increase in neonatal intensive care unit bed use by very-low-birth-weight (less than 1000-g) infants between 1975 and 1982, and in both years, positive blood cultures were 3.8 times as likely to be perceived as clinically significant if obtained from such tiny infants. The growing number of very-low-birth-weight babies occupying neonatal intensive care unit beds, coupled with the observation that blood cultures positive for coagulase-negative staphylococci are almost four times as likely to be perceived as clinically significant if obtained from extremely premature infants, may account for the reported increase in nosocomial coagulase-negative staphylococcal bacteremia. PMID- 3669226 TI - Key and critical objectives for The Journal. PMID- 3669227 TI - The paradox of appropriate care. PMID- 3669228 TI - Practice variations: a challenge for physicians. PMID- 3669229 TI - Enhanced-potency polio vaccine nears licensing; policy to be studied. PMID- 3669230 TI - Prevention important in Soviet antialcohol efforts, but medical treatment also emphasized. PMID- 3669231 TI - Race, gender may help determine type of stroke. PMID- 3669232 TI - Matchmaking scheme solves Tay-Sachs problem. PMID- 3669233 TI - Leads from the MMWR. Reye syndrome surveillance--United States, 1986. PMID- 3669234 TI - Leads from the MMWR. Smoking-attributable mortality and years of potential life lost--United States, 1984. PMID- 3669235 TI - Leads from the MMWR. Outbreak of influenza-like illness in a tour group--Alaska. PMID- 3669236 TI - Prenatal care and HIV screening. PMID- 3669237 TI - Medical students are being taught SI units. PMID- 3669238 TI - Colestipol-niacin therapy and coronary atherosclerosis. PMID- 3669239 TI - The legal status of consent to withhold treatment. PMID- 3669240 TI - Thyroid failure in the elderly. PMID- 3669241 TI - The natural history of asymptomatic carotid artery occlusive lesions. AB - The purpose of this retrospective study was to determine the long-term prognosis of patients with asymptomatic pressure-significant (hemodynamically significant) internal carotid system lesions. Of 640 neurologically asymptomatic patients, 292 had pressure-significant internal carotid artery occlusive lesions as determined by ocular pneumoplethysmography, while 348 had a carotid bruit only without a pressure-significant lesion. The annual stroke rate for the first three years on a Kaplan-Meier life-table basis was 3.4% and 1.5% in the abnormal and normal ocular pneumoplethysmography groups, respectively, as compared with a rate of 0.5% in a normal age- and sex-matched population. The annual total event rate (transient ischemic attack and stroke) was 5.2% in the abnormal vs 2.3% in the normal group, with 56% of all events ipsilateral to the ocular pneumoplethysmography abnormality. These results indicate that patients with asymptomatic pressure-significant carotid system occlusive lesions are at greater risk for stroke than a normal ocular pneumoplethysmography group (twofold) and a general population (sevenfold). PMID- 3669242 TI - Probable Alzheimer's disease in an artist. AB - Sequential behavioral and neuropsychological assessments of an artist with probable Alzheimer's disease were made over a 2 1/2-year period. His painting skills underwent dramatic deterioration and a concomitant decline in intellectual ability occurred. Psychological measures suggested that his visuoconstructive skills were relatively less vulnerable to disruption by Alzheimer's disease than were other cognitive functions and that the diminished artistic ability involved motivational, mnemonic, and organizational skills until the later stages of the disease. These observations may contribute to understanding the neurological basis of artistic creativity, as well as the more specific effects of Alzheimer's disease on neuropsychological abilities. PMID- 3669243 TI - Facing the complex issues of pediatric AIDS: a public health perspective. PMID- 3669244 TI - Consensus conferences. PMID- 3669245 TI - The two cultures of biomedicine: can there be consensus? PMID- 3669246 TI - Dissolution of human insulin. PMID- 3669247 TI - Primer on allergic and immunologic diseases. Prepared by the American Academy of Allergy and Immunology. PMID- 3669248 TI - Future trends in allergy and clinical immunology. PMID- 3669249 TI - Charity care takes many forms. PMID- 3669250 TI - Leads from the MMWR. Outbreak of viral gastroenteritis--Pennsylvania and Delaware. PMID- 3669251 TI - Leads from the MMWR. Summary of the Second National Community Forum on Adult Immunization. PMID- 3669252 TI - Leads from the MMWR. Update on influenza activity--worldwide. PMID- 3669253 TI - Reye's syndrome and salicylates. PMID- 3669254 TI - The future of pediatrics. PMID- 3669255 TI - Philadelphia General Hospital. PMID- 3669256 TI - Phenylpropanolamine in patients with autonomic impairment. PMID- 3669257 TI - American influence on international medicine. PMID- 3669258 TI - Nipple priapism. PMID- 3669259 TI - The effect of marital status on stage, treatment, and survival of cancer patients. AB - The effects of marital status on the diagnosis, treatment, and survival of patients with cancer were examined in population-based data on 27,779 cancer cases. Unmarried persons with cancer had decreased overall survival (relative hazard, 1.23; 95% confidence limits, 1.19 to 1.28). We identified three complementary explanations for the poorer survival of the unmarried persons. First, unmarried persons were more likely to be diagnosed at a regional or distant stage (odds ratio, 1.19; 95% confidence limits, 1.12 to 1.25). After adjustment for stage, unmarried persons were more likely to be untreated for cancer (odds ratio, 1.43; 95% confidence limits, 1.31 to 1.55). Finally, after adjustment for stage and treatment, unmarried persons still had poorer survival. Previous studies have demonstrated that unmarried persons have decreased overall mortality. For cancer, our results suggest that the favorable consequence of being married on overall survival is secondary to the beneficial effects at several steps in the diagnosis, choice of treatment, and response to treatment. PMID- 3669260 TI - Autologous blood donation for elective surgery. Effect on physician transfusion behavior. AB - The hospital records of 69 autologous blood donors undergoing elective surgical procedures and those of matched controls were reviewed in an effort to assess whether autologous blood donation altered physician transfusion behavior. Physicians tolerated significantly lower admission (0.372 vs 0.437 [37.2% vs 43.7%]), nadir (0.304 vs 0.334 [30.4% vs 33.4%]), and discharge (0.326 vs 0.358 [32.6% vs 35.8%]) hematocrits in patients with autologous blood predeposits compared with matched controls. Additionally, 44 patients undergoing orthopedic procedures stored insufficient blood to prevent homologous blood exposure; ten of 17 patients could have avoided homologous blood if 4 U of autologous blood had been stored. Twenty-five patients undergoing nonorthopedic procedures stored an insufficient volume of blood to satisfy an unexpected transfusion need but were given transfusions of more than needed amounts of their own blood when transfusion was not clinically indicated. Future studies designed to maximize procurement of autologous blood are needed; a salutary effect on physician transfusion behavior would then be coupled with an autologous blood inventory that could eliminate homologous blood exposure in these patients. PMID- 3669262 TI - Fifty hours for the poor. PMID- 3669263 TI - Parameters for evaluation of lipid metabolism. AB - The influence of the clinical condition and the intravenous intake on parameters of fat metabolism has been analyzed. Compared to normal subjects, the correlation between plasma concentrations and the turnover rate of glycerol and free fatty acids varies in the opposite direction in nutritionally depleted and severely injured patients. The significance of plasma concentrations as an index of fat mobilization should be interpreted in relation to the clinical condition. Kinetic measurements are particularly interesting in hypermetabolic patients. Plasma triglyceride and cholesterol concentrations are markedly affected by surgical procedures. Any delay (in treatment) following the injury and the type of intravenous regimen used have an important influence on plasma lipid levels and should be taken into account when groups of patients are studied. The infusion of exogenous fat emulsions significantly affects not only plasma triglyceride levels but also phospholipid and cholesterol concentrations and will modify the plasma lipoprotein pattern. Measurements of plasma clearance and oxidation of fat can be used to evaluate individual tolerance and the metabolic utilization of lipids, but these procedures cannot be easily applied in routine clinical practice. Regular monitoring of plasma triglyceride, cholesterol, and phospholipid concentrations during and after cessation of fat infusion is recommended for each patient who is receiving daily fat infusions so that the safe rate of infusion for that individual can be determined. PMID- 3669264 TI - Optimal nutritional indexes in gastroenterology. AB - Malnutrition in gastrointestinal disease can result from several pathogenetic mechanisms. The resulting clinical and laboratory features of malnutrition vary according to the specific pathogenetic factors involved. Many of the causes of malnutrition in gastroenterology are similar to those found in other acute and chronic diseases. However, certain disorders, specific to gastroenterology, may alter nutritional indices independent of the usual causes of malnutrition. These include small bowel bacterial overgrowth and protein-losing enteropathy. The impact of these disorders on the indexes of nutritional status is discussed. PMID- 3669266 TI - Proceedings of the First International Workshop on Nutrition and Metabolism in Hospital Malnutrition. Nutritional Assessment in Hospital Malnutrition. Venice, Italy, April 26-27, 1985. PMID- 3669265 TI - Optimal nutritional indexes in chronic liver disease. AB - A population of 70 patients with liver cirrhosis, most of whom were nonalcoholic, was studied. Distribution of ideal body weight and body mass index was below the median of controls, but very few patients were below the cut-off points for normalcy. Distribution of triceps skinfold and arm muscle circumference was also below the median and, in most patients, was also below the cut-off points. Serum visceral protein concentrations and anthropometric parameters each were reciprocally correlated with one another, but no correlation was observed between visceral proteins and anthropometric parameters. Serum visceral proteins appeared to correlate better with the degree of liver damage than with the degree of malnutrition. Therefore, anthropometric parameters seem preferable to serum visceral proteins for the assessment of nutritional status in patients with liver cirrhosis. PMID- 3669267 TI - A kinetic approach to assessment of amino acid and protein replacement needs of individual sick patients. PMID- 3669268 TI - Surgical consideration of replacement of the ascending aorta and aortic valve with a composite valve graft--operative and long-term results of Bentall and DeBono procedure. AB - Our experience with the Bentall and DeBono procedure is reviewed. Between April, 1977 and April, 1985, seventeen patients underwent repair of annulo-aortic ectasia (9 cases), and dissecting aneurysm with aortic regurgitation (8 cases). Three patients had cardiac tamponade due to rupture of dissecting aneurysm. In regard to this procedure, we recently performed the continuous suture method on the prosthetic valve ring, coronary ostia, and distal anastomosis sites. In this study, there was one early death due to a sudden rupture of the dissecting aneurysm of the left thoracic cavity on the 10th postoperative day. In addition, there were two late deaths due to sepsis and suspected arrhythmia. The late follow-up period ranged from 6 months to 8 years (mean 35 months), and all patients were in NYHA Class I or II. We conclude that the composite valve graft method is an excellent technique for annuloaortic ectasia and ascending aortic dissections with aortic regurgitation because of its low operative mortality and fair survival rate. PMID- 3669269 TI - Intravenous isosorbide dinitrate infusion in the management of unstable angina pectoris refractory to conventional medical therapy. AB - During the past 2 years, 102 patients were treated for unstable angina pectoris (AP) in our department. Fifteen of them had recurrent chest pain at rest despite treatment with various anti-anginal agents, or prolonged chest pain unresponsive to sublingual nitroglycerin; they received intravenous isosorbide dinitrate (ISDN) infusion. A rapid bolus injection of 2 to 6 mg followed by an infusion of 2 to 5 mg/hr was given to 10 patients with acute chest pain, and 5 patients, who were free of chest pain at the time, but had repeated episodes of angina in the past 24 hours, were given ISDN infusion without a bolus injection. Chest pain disappeared completely in 13 patients, but recurred in 2 of them when the dose was tapered. Two other patients experienced recurrent chest pain during ISDN infusion, and additional boluses were given. The hospital course was uneventful in 11 patients. Four patients who had recurrent anginal attacks underwent emergency coronary cineangiography under intraaortic ballon counterpulsation and aorto-coronary bypass surgery. There were no hospital deaths, no one had subsequent acute myocardial infarctions, and only 2 patients had mild to moderate headache as a side effect. Although the patient population is small, intravenous ISDN infusion is useful in the management of severe unstable AP. PMID- 3669270 TI - Study on the atherosclerosis mechanism in chronic hemodialysis. AB - In order to clarify whether hemodialysis treatment accelerates atherosclerosis, forty-two patients undergoing chronic hemodialysis were investigated. Because it is non-invasive and repeatable, aortic calcification on chest-XP was used as an index of atherosclerosis. No patients had evidence of calcified atherosclerosis at the start of hemodialysis therapy. The patients were divided into three groups according to vascular changes. Group 1 (20 patients) showed no calcification during the observation period. Group 2 (11 patients) had mild or moderate aortic calcification (thin linear aortic calcification). In group 3 (11 patients), massive and severe calcification was accelerated by hemodialysis. 18 parameters which might be considered to promote atherosclerosis were evaluated in each group. The age in group 3 was 53.8 +/- 10.4 (mean +/- standard deviation) years, which was older than the 42.1 +/- 12.6 year age in group 1 (p less than 0.025). Duration of dialysis in group 3 was 121.9 +/- 30.5 months, which was significantly longer than the 82.0 +/- 31.0 months in group 2 (p less than 0.01) and the 77.3 +/- 55.3 months in group 1 (p less than 0.025). Serum HDL cholesterol levels in groups 2 (23.0 +/- 4.5 mg/dl) and 3 (20.9 +/- 6.6 mg/dl) were significantly lower than the 28.6 +/- 8.3 mg/dl in group 1, (p less than 0.025 and p less than 0.05, respectively). Serum parathormone-C level in group 3 was 14.7 +/- 8.6 ng/ml, which was significantly higher than the 6.1 +/- 6.0 ng/ml level in group 1 (p less than 0.01) and the 5.0 +/- 7.8 ng/ml level in group 2 (p less than 0.025). In discriminant analysis, age, duration of dialysis, hematocrit, serum HDL-cholesterol, parathormone-C, and alkaline phosphatase level were the independent factors used to distinguish the three groups. These findings suggest that 1) aging is a basal factor in the promotion of atherosclerosis, 2) hypo-HDL cholesterolemia is a major factor in the early phase of atherosclerosis, 3) hyperparathyroidism could have an important role in the late phase of atherosclerosis, 4) dialysis itself might promote atherosclerosis directly, and 5) blood pressure level is not major factor for atherosclerosis over a long observation period, at least in our study. PMID- 3669271 TI - A case with pseudo-scimitar syndrome: "scimitar sign" with normal pulmonary venous drainage. AB - The case reported here showed a radiological appearance of hypoplasia of the right lung, dextroposition of the heart, and a curved vascular shadow in the right lower lung field known as a scimitar sign. However, a computed tomography of the chest showed this abnormal vascular shadow draining into the left atrium (pseudo-scimitar sign). Therefore, in patients with a radiological appearance of the scimitar syndrome, computed tomography of the chest should be indicated to rule out the pseudo-scimitar sign. PMID- 3669273 TI - Symposium on current status of dilated cardiomyopathy. 50th annual scientific session of the Japanese Circulation Society, March 27, 1986, Kyoto. Proceedings. PMID- 3669272 TI - Morphological features of hypertrophic cardiomyopathy with congestive heart failure and a small left ventricular cavity. AB - To clarify the morphologic basis of marked congestive heart failure in cases of hypertrophic cardiomyopathy with a small left ventricular cavity, the size of myocytes, the extent of myocardial fiber disarray and fibrosis were quantitatively evaluated in two autopsied cases. Compared with the control hypertrophic cardiomyopathy, both cases had larger myocytes and less fibrosis, and one of them had markedly extensive myocardial fiber disarray. Probably, the hypertrophy of the myocytes or myocardial fiber disarray or both rather than myocardial fibrosis are important in the pathogenesis of severe congestive heart failure in these cases. PMID- 3669274 TI - Current status of dilated cardiomyopathy. PMID- 3669275 TI - A histopathological study of dilated cardiomyopathy--with special reference to clinical and pathological comparisons of the degeneration-predominant type and fibrosis-predominant type. PMID- 3669276 TI - Study of immunological mechanism in dilated cardiomyopathy. AB - To determine the immune disturbances involved in the pathogenesis of dilated cardiomyopathy (DCM), the conditions in humoral and cellular immunity of DCM patients were studied. To examine the status in humoral immunity in DCM patients, circulating anti-heart antibodies (AHAbs) were analyzed. Circulating-AHAbs were classified into 4 types "heterophile-like", "intracellular", "intercalated disc" and "nuclear" patterns by indirect immunofluorescence technique, and a high rate of heterophile-like antibody was found in DCM. The cytotoxicity of this antibody was examined in cultured myocardial cells using the two-step method of the complement dependent cytotoxic test. The mean cytotoxic index (CI) value of the heterophile-like antibody positive sera was 22.3, which showed an apparent cytotoxicity against the cultured cells and it may be complement dependent. In addition, the frequency of lymphocyte subsets using monoclonal antibodies (OKT4, OKT8, Leu7, Leu11) and natural killer (NK) activity were evaluated to determine whether DCM patients had an imbalance in cellular immune reactions, which support the hypothesis of an immune disturbance as the pathological mechanism of DCM. The peripheral lymphocyte counts were significantly lower in patients with DCM (1737 +/- 874/mm3) than in normal controls (NC, 2088 +/- 556/mm3) and in patients with ischemic heart diseases (IHD, 2395 +/- 469/mm3, both p less than 0.01). The percentage of T, B, OKT4 and OKT8 positive cells was not statistically different among DCM, IHD, and NC groups, whereas the percentage of T gamma cells was significantly reduced in DCM patients (6.5 +/- 5.0%, p less than 0.05). NK functional activity as tested in DCM patients was frequently deficient (24.1 +/- 16.7% in DCM, 36.7 +/- 12.2% in NC). After 4-hr incubation with recombinant interleukin2 (rIL2), rIL2 induced the enhancement of NK activity in 3 out of 4 DCM patients with low NK activity, although, there was a non-responder to rIL2 in this group. These results suggested that DCM patients have a low IL2 production and/or less numbers of mature cells with NK cell function. Therefore, an imbalance in humoral and cellular immune reactions may cause insidious myocardial damage and subsequently lead to development of DCM. PMID- 3669278 TI - Proceedings of the 51st annual scientific meeting of the Japanese Circulation Society. March 1987, Tokyo. Abstracts. PMID- 3669277 TI - Prognosis of dilated cardiomyopathy: from a retrospective to a prospective study employing multivariate analysis. AB - To determine the prognostic factors of dilated cardiomyopathy (DCM), a retrospective long-term investigation of 111 patients seen between 1967 and 1983 was carried out. Fifty-four deaths were divided into 3 subgroups: (1): sudden death (n = 6); (2): sudden death on the basis of heart failure (n = 17); (3): refractory heart failure death (n = 31). Multivariate analysis was employed to ascertain the prognostic score, which was constructed from the grading of the New York Heart Association functional classification, the cardiothoracic ratio, electrocardiographic findings and cardiac function. Individual variables were indicated on the first (I) and second (II) principal component axes. The mean center points for the death modes were as follows: (1): I = -0.4, II = +0.8, (2): I = +0.7, II = +1.1, (3): I = +1.4, II = -0.8. Surviving cases (n = 57) showed I = -0.6, II = +0.1. Forty-one cases examined during 1984-1985 were analyzed to evaluate the prognostic efficacy of this score. Fourteen of 17 cases (82%) located in the refractory heart failure death group died within one year after determination of the prognosis, showing thereby that the prognostic determination by multivariate analysis is effective. PMID- 3669279 TI - [Pharmacokinetic and clinical studies of cefuzonam in obstetric and gynecologic infections]. AB - Cefuzonam (CZON, L-105), a new semisynthetic cephem antibiotic, was studied in the field of obstetrics and gynecology, pharmacokinetically and clinically. Following is a summary of the results. 1. Concentrations of CZON in serum and genital organs following intravenous drip infusion of 1 g of the drug over 60 minutes were measured. Samples were taken during 40 to 190 minutes after the end of the infusion. Ratios of concentrations of the drug transferred into genital organs to the concentration in the cubital venous serum were 0.5 to 1.5 in many cases. Levels of the drug in the genital organs examined well exceeded MICs for common causative organisms in obstetric and gynecologic infections. 2. Therapeutic effects of 1 g or 2 g of CZON by drip infusion twice daily were evaluated in 8 patients. Overall clinical efficacy was 62.5% (5/8). No side effects or abnormal laboratory findings due to the drug were noted. The results suggest that CZON is a useful antibiotic for obstetric and gynecologic infections. PMID- 3669280 TI - [Pharmacokinetic and clinical studies on cefuzonam in obstetrics and gynecology]. AB - Cefuzonam (CZON), a new cephem antibiotic agent, was studied in terms of its pharmacokinetics and clinical efficacy in the field of obstetrics and gynecology, and the results were summarized as follows. 1. The absorption and the tissue penetration of CZON into intrapelvic genital organs were good. The peak serum level in uterine artery after an intravenous drip infusion of 1.0 g was 49.0 micrograms/ml, and the highest peak level of 23.0 micrograms/g in tissues was obtained. After drip infusion of 2.0 g, the peak serum level in uterine artery was 137 micrograms/ml and the highest peak tissue concentration was 54.6 micrograms/g. Tissue concentrations of the drug changed in a similar pattern to serum levels and a dose-dependent response was recognized. 2. The penetration of CZON into intrapelvic dead space exudate was good. The level reached a peak of 8.17 micrograms/ml 4 hours after and intravenous drip infusion of 1.0 g and diminished slowly. 3. The clinical efficacy of CZON at a daily dose of 2 g was evaluated in 21 cases of obstetrics and gynecologic infections. The efficacy rate was 85.7% (18/21 cases). Bacteriologically, the eradication rate obtained was 93.3%. No side effects or abnormal laboratory values were observed. PMID- 3669281 TI - [Experience with cefuzonam in the field of obstetrics and gynecology]. AB - Cefuzonam (CZON, L-105) was studied clinically in the field of obstetrics and gynecology, and the results obtained are summarized below: 1. The concentration of the drug in blood decreased rapidly after drip infusion was completed, and the concentration diminished after 1 hour to one tenth of the level detected at 5-9 minutes, and to an almost undetectable level after 3 hours. The rapid decrease of blood concentrations appears to indicate that the excretion of CZON was much faster than other antibiotics. No conclusive data were obtained on changes of concentrations with time in tissues due to the small number of cases analyzed and scattering of the data obtained. 2. The concentration in the pelvic dead space exudate reached a peak of 18.5 micrograms/ml at 30 minutes after the end of infusion and decreased to 0.092 microgram/ml after 10 hours. 3. CZON was administered to 5 cases of obstetric and gynecological infections. The efficacy was good in 4 cases and poor in 1 case. No side effects or laboratory test abnormalities were observed. PMID- 3669282 TI - [Clinical studies on cefuzonam in obstetric and gynecological infections]. AB - Seventeen patients with gynecological infections (5 cases each of Bartholin's abscess and adnexitis, 4 cases of endometritis and 1 case each of bartholinitis, pyosalpinx and vulvar abscess) were treated with cefuzonam (CZON, L-105) administered by intravenous drip infusion, 1-2 g twice daily, for 4 to 12 days (6 g to 23 g in total). The clinical effectiveness reached 94.1%, including 1 excellent case, 15 cases good, and a poor case. Bacteria were detected in 9 cases, and with CZON treatment, bacterial eradications were obtained in 6 case, but, in 3 cases, bacterial replacements were observed. No abnormal laboratory findings were noted. From the above results, CZON seemed to be a highly effective and useful agent for gynecological infections. PMID- 3669283 TI - [Clinical studies on cefuzonam in obstetrics and gynecological infections]. AB - To evaluate the usefulness and the safety of cefuzonam (CZON, L-105) against obstetric and gynecological infections, we conducted clinical trials and obtained the results summarized as follows. 1. Thirteen patients with obstetric and gynecological infections (intrauterine infection 2 cases, adnexitis 7, 1 case each of abscess of adnexa uteri, abscess of the vaginal wall, pyelonephritis, and mammitis) were treated with CZON. The CZON was administered by intravenous injection or intravenous drip infusion, 1 g twice daily for 4 to 7 days (8 g to 14 g in total). The clinical effect was good in 12 and poor in 1. 2. Four cases, on which other antimicrobial agents were ineffective, responded well to CZON. 3. The CZON displayed excellent effects on anaerobic bacteria (Peptostreptococcus anaerobius, Bacteroides fragilis) and Gram negative rods (Escherichia coli, Klebsiella pneumoniae). 4. No side effects or laboratory abnormalities were observed. 5. From the above results, CZON appeared to be an effective and useful drug for obstetric and gynecological infections. PMID- 3669284 TI - [Pharmacokinetic, bacteriological and clinical studies on cefuzonam in the field of obstetrics and gynecology]. AB - The distribution of cefuzonam (CZON, L-105) into the uterus and uterine adnexa was investigated and the usefulness and the safety of CZON in obstetric and gynecological infections were studied. The results are summarized as follows: 1. Following one shot intravenous injection of CZON 1 g, a good distribution of the drug into tissues of uterus and uterine adnexa was observed, with Cmax values of 15.7-33.9 micrograms/g, Tmax of 7.3-34.0 minutes and AUC values of 18.7-35.3 micrograms X hr/g. 2. In all of the 30 cases of obstetric and gynecological infections treated, CZON was evaluated effective. 3. Bacteriologically, 93.9% of total bacteria that had been isolated were eliminated by the administration of the drug. 4. Against all the strains of bacteria isolated before the treatment and replaced bacteria, MIC50, MIC80 and MIC90 of CZON were 0.20 micrograms/ml, 12.5 micrograms/ml and 25 micrograms/ml, respectively, showing low values. 5. Subjective and objective findings and clinical laboratory test values during and after the trial showed no side effects associated with CZON. PMID- 3669285 TI - [Pharmacokinetic, bacteriological and clinical studies of cefuzonam in the field of obstetrics and gynecology]. AB - To study the transfer of cefuzonam (CZON, L-105) into female genital organs, concentrations of the compound in pelvic dead space exudate were measured in cases of radical hysterectomy due to cervical cancer and analyzed by the two compartment model. When CZON 1 g was drip-infused intravenously, the concentration in the cubital vein blood was 46.95 micrograms/ml at 1 hour after the start of infusion. Concentrations in the pelvic dead space exudate reached the peak of 11.29 micrograms/ml at 2.44 hours after the start, were higher than 4 micrograms/ml after 8 hours and were higher than 1.7 micrograms/ml after 12 hours. The area under the concentration-time curve in the pelvic dead space exudate was 77.85 micrograms X hr/ml. From these results CZON was considered to be effective when administered at 1 g against infections of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, and haemophilus influenzae, but increased dose levels seemed necessary against infections of Staphylococcus epidermidis and Bacteroides fragilis. In 3 cases of obstetric and gynecological infections the efficacy of CZON was good in 2 cases and unknown in the other case. PMID- 3669286 TI - [Fundamental and clinical studies on cefuzonam in the field of obstetrics and gynecology]. AB - Fundamental and clinical studies on cefuzonam (CZON, L-105), a new oxime type cephalosporin, were performed and the results obtained are summarized below: 1. Concentrations of CZON were determined in serum, internal genital organs and retroperitoneal fluid after a single intravenous administration of 1 g dose. The peripheral serum level of CZON was 74.0 micrograms/ml at 15 minutes after the administration. A sufficient transfer of CZON into internal genital organs and retroperitoneal fluid was demonstrated. 2. In clinical trial, CZON was given to 11 cases with obstetrical and gynecological infections. Efficacies were evaluated as good in 9 cases and poor in 2 cases. No side effects were observed in any of the cases treated with CZON. In laboratory examinations, transient elevation of serum GOT, GPT and alkaline phosphatase was noted in 1 case. PMID- 3669287 TI - [Clinical studies on cefuzonam in the field of obstetrics and gynecology]. AB - In gynecological infections, especially intrapelvic infections, it is sometimes difficult to identify causal microorganisms. In those cases, it becomes a hard task to select most effective antibiotics, hence the use of wide-spectrum antibiotics becomes necessary. We recently had opportunities to clinically use cefuzonam (CZON, L-105) which has a wide range of spectrum against various bacteria including Staphylococcus aureus, Escherichia coli, Gram-positive and Gram-negative anaerobes, etc. The following is a summary of the clinical results: 1. In 7 cases of gynecological infections CZON was evaluated "excellent" in 1 case and "good" in 6 cases, thus the efficacy rate was 100%. 2. Against intrauterine infection caused by S. aureus, "excellent" effect was observed. 3. No sign of side effects was noted in any of the cases. 4. In 1 case, slight elevations of S-GOT and S-GPT were recorded but the elevations were transient. PMID- 3669288 TI - [Pharmacokinetics of cefuzonam in peripheral venous serum, uterine arterial serum and intrapelvic female organs]. AB - Concentrations of cefuzonam (CZON) in peripheral venous serum, uterine arterial serum and intrapelvic female organs of 29 women undergone simple total hysterectomy were determined by bioassay, using the cylinder-plate diffusion method. With an intravenous injection of CZON 1 g, the concentration at time 0 (Cp0) of peripheral venous serum and uterine arterial serum were 148.1 micrograms/ml and 155.4 micrograms/ml, respectively. Biological half-lives (T 1/2) of CZON were 1.07 hours in peripheral venous serum and 1.02 hours in uterine arterial serum. Concentrations in peripheral arterial serum were higher than 1.0 micrograms/ml at 4 hours after injection and remained at higher levels than minimal inhibitory concentrations necessary for most Escherichia coli strain for at least 4 hours. Concentrations of CZON in female organs were kept as high as peripheral venous serum, and ratios of CZON concentrations in uterine tube and endometrium to that in peripheral venous serum were 0.74 +/- 0.34 and 0.44 +/- 0.25, respectively. Since CZON is characterized by potent antibacterial activity and broad spectrum, it should be effective for infectious diseases of the female uro-genital tract. PMID- 3669289 TI - [Pharmacokinetics of cefpiramide concentration in lung tissues]. AB - Concentrations of cefpiramide (CPM) in human lung tissues were determined after 1 g intravenous bolus injection in 6 patients with lung tumors and pyothorax. Concentrations of the CPM in blood and lung tissues were determined and analyzed pharmacokinetically. Levels of CPM in the lung tissues reached 38.4 micrograms/g at 2 hours and declined to 27.7 micrograms/g in 6 hours. Levels of CPM in the lung tissues were higher than 50% of those in the serum between 100 minutes and 360 minutes after the administration of CPM. PMID- 3669290 TI - In vitro antimicrobial activity of cefpirome, a new cephalosporin with a broad antimicrobial spectrum. AB - The in vitro activity of cefpirome (HR 810), a new cephalosporin antibiotic having a 2,3-cyclopentenopyridine group in the 3-position side chain, was compared with in vitro activities of 5 other cephalosporins. HR 810 showed a broad spectrum of antimicrobial activity against Gram-positive and Gram-negative bacteria when tested using 71 standard strains and 876 clinical isolates. HR 810 inhibited 70% of the clinically isolated Staphylococcus aureus and Staphylococcus epidermidis strains when used at 0.59-0.84 microgram/ml, 2- to 25-fold lower than values of reference antibiotics, and the compound was also highly effective against Enterococcus faecalis which is relatively resistant to most of the existing cephem antibiotics. The activity of HR 810 against Enterobacteriaceae members (11 species), based on its minimal inhibitory concentrations inhibiting 90% of bacterial growth (MIC90S), was the highest among the cephalosporins used. Especially against Enterobacter species and Citrobacter freundii, the MIC90S of the compound were 4- to 64-fold lower than the values of the other antibiotics. Against Pseudomonas aeruginosa, HR 810 was as active as cefoperazone, an antipseudomonal agent. The minimal bactericidal concentrations (MBCs) of HR 810 were equal to or only 2-fold greater than the MICs for most of 12 standard strains tested. The compound markedly decreased viable bacterial counts at its MICs, thus showing strong bactericidal activities. The in vitro activity of HR 810 was not affected by pH or human serum content of agar media, but the activity against Gram-negative bacteria was lowered as the inoculum size increased. PMID- 3669292 TI - [Clinical effect of cefuzonam against infectious diseases in obstetrics and gynecology]. AB - Clinical studies of cefuzonam (CZON, L-105) were performed in patients of obstetrics and gynecology, and the results obtained are summarized below. 1. CZON was intravenously administered at a daily dose of 1-2 g to 11 cases including 3 cases with intrauterine infection (pyometra), 2 cases of intrapelvic infection (1 case of pelvic dead space infection and 1 case of pelvic peritonitis), 1 case of adnexitis, and others (2 cases of vaginal cuff infection, and 1 case each of vaginal abscess, Baltholin's abscess, and vulvar abscess). Clinical efficacy was excellent in 1 case and good in 10 cases. 2. CZON showed a good antibacterial effect in single and mixed infections. 3. Neither side effects nor abnormal values in clinical laboratory findings attributable to the drug were observed. PMID- 3669291 TI - [Clinical evaluation on the usefulness and safety of norfloxacin in a twice-a-day regimen against upper respiratory tract infections]. AB - Sixty-six patients with tonsillitis or pharyngolaryngitis received oral norfloxacin (NFLX) 200 mg b.i.d. or 300 mg b.i.d. for not less than 3 days in general at School of Medicine, Yokohama City University, and 6 related hospitals. The results are summarized as follows: 1. Ten patients were excluded from the study because 4 patients did not present at the follow-up visits, 4 patients did not follow the protocol and 2 patients had unclear infections. Thus, 56 patients were evaluated. 2. The fifty-six evaluable patients were classified as follows: Twenty patients were with tonsillitis and 36 were with pharyngolaryngitis. Thirty eight patients were treated with 200 mg b.i.d. while 18 patients received 300 mg b.i.d. Thirty-two patients were male and 24 patients were female. Three patients were inpatients and 53 patients were outpatients. Most of patients were light or moderate cases, and the 26 patients had mild underlying disorders. 3. Clinical improvements were observed in 11 of 15 patients (73.3%) with tonsillitis and 25 of 30 patients (83.3%) with pharyngolaryngitis (80.0% overall) within 7 days administration. 4. Clinical improvements were observed in 15 of all 20 patients (75.0%) with tonsillitis and 30 of all 36 patients (83.3%) with pharyngolaryngitis (80.4% overall). 5. Bacteriologically, "eradication", "decrease" and "replacement" were observed in 6, 2 and 1 patients, respectively. 6. As for adverse effects, nausea and headache were observed in 1 patient and abnormal changes in laboratory findings were noted in 1 patient (slight elevations of GOT and GPT). 7. Oral NFLX 200 mg b.i.d. or 300 mg b.i.d. was as almost equally effective as 200 mg t.i.d. in tonsillitis or pharyngolaryngitis. Thus NFLX 200 mg b.i.d. or 300 mg b.i.d. appears to give sufficient clinical efficiency. 8. When antibacterial activity and serum half-life of NFLX are considered, twice daily administration was confirmed to be sufficiently effective in the clinical application. PMID- 3669293 TI - [Committee on Chemotherapy for Mothers and Children; investigation on a method of intravenous drip infusion of amikacin]. PMID- 3669294 TI - [Pharmacokinetics of amikacin in infants and children]. AB - Twenty-one children, from 41 hours to 12 years of age, were given amikacin (AMK) for suspected bacterial infections. In the 41 hours old newborn infant, the half life of AMK was 6.9 hours. As infants' ages increase, half-lives of AMK became shorter. The trend toward a shorter half-life in an older child was the most marked during neonatal period. At an age of 7 days, the half-life was shorter than 3 hours. In infants exceeding 6 months of age, ages did not make differences in the length of half-lives. The apparent volume of distribution in newborn was, as average, 350.6 ml/kg body weight. The average for children 5 years and older was smaller, 280.7 ml/kg. The peak level-dose ratio was 2.8 (micrograms X ml-1 X mg-1 X kg) in newborns. There was a tendency that this ratio increased with age. The average ratio for children over 5 years was 4.5 (micrograms X ml-1 X mg-1 X kg). In summary, the 2 remarkable observations obtained from the present study were; 1) The trend that the half-life of AMK shortens as the child grows older was clearest in neonatal period. 2) Peak serum level produced by the same dose per kilogram body weight had a tendency to increase with ages of children. PMID- 3669295 TI - [Fundamental study of amikacin in the newborn]. AB - Amikacin (AMK) is one of the aminoglycoside antibiotics, derived from kanamycin A. It has a broad spectrum against Gram-negative rods but its usefulness is mainly in the efficacy against Gram-negative rods which do not respond to commonly used kanamycin and gentamicin. The efficacy and the safety of AMK have been confirmed in children and mature babies. In the trial reported here, we evaluated AMK in newborn. 1. AMK was administered to 13 mature and 8 premature babies via intramuscular injection or intravenous drip infusion for 30 minutes or 1 hour and its blood concentrations were determined. These administrations resulted in blood concentrations 4.47-9.67 mcg/ml with dosage levels 2.3 mg/kg (mean 6.92 +/- 1.66 mcg/ml), 5.86-26.1 mcg/ml with 5-6 mg/kg (mean 15.4 +/- 4.63 mcg/ml) and 27.5-37.7 mcg/ml with 7.5 mg/kg (mean 31.0 +/- 4.76 mcg/ml). Blood half-lives were 1.88 to 9.66 hours, showing longer half-lives in younger subjects. 2. Exchange transfusion (150-180 ml/kg) was performed in 5 mature babies and the variation of blood concentrations of AMK was studied. The study showed that blood concentrations of AMK after the exchange transfusion were 25.6 41.5% (mean 32.3 +/- 5.4%) of the levels detected before the transfusion. PMID- 3669296 TI - [A pharmacokinetic study in (mature and premature) neonates treated with amikacin through intravenous drip infusion]. AB - A pharmacokinetic study was conducted in neonates (mature, premature) to which amikacin (AMK) was administered through intravenous drip infusion. The results of the study are summarized below. 1. Changes in blood concentrations of AMK obtained after intravenous drip infusion over a period of 30 or 60 minutes were comparable to those after intramuscular injection. 2. When AMK was administered to neonates (mature, premature) at a single intravenous (30 or 60 minutes) dose of 6 mg/kg, peak levels of 15.5 to 26.3 micrograms/ml were attained. These values were within the range of 15 to 30 micrograms/ml which are considered to be safe and effective peak levels. 3. In 0 day-neonates, half-lives of blood AMK levels rather long and widely varied (3 to 8 hours) but, in about 7 day-neonates, half lives were 3 to 4 hours. 4. It is considered from the above results that the safe and effective blood concentrations of AMK in 0 to 7 day-old neonates can be obtained from intravenous administrations at each dose of 6 mg/kg repeated with intervals of 12 or 24 hours and, in 8 days or older neonates, from intravenous drip infusions over 30 or 60 minutes at each dose of 6 mg/kg repeated with intervals of 12 hours. 5. For neonates with very low birth weights, individual doses and intervals should be separately investigated. PMID- 3669297 TI - [Studies on the intravenous administration of amikacin to neonates]. AB - Amikacin (AMK) was administered mainly to neonates by either intravenous drip infusion or intramuscular injection and its pharmacokinetic changes were investigated. The results obtained are summarized as follows. 1. Serum half-lives of AMK in neonates at ages 0 to 3 days were longer than those at ages 4 to 10 days. Serum half-lives were prolonged particularly in neonates at an age 0 day. Neonates at ages 11 to 15 days, also showed longer half-lives in comparison to infants. Similar peak serum levels were observed in all the neonates with ages 0 15 days. 2. Similar serum AMK levels were obtained in neonates through intravenous drip infusion and through intramuscular injection at a same dose level. 3. When the drug was administered to neonates at 3.0 to 6.0 mg/kg by intravenous drip infusion, peak serum levels did not reach 30 micrograms/ml which is considered to be the critical level for AMK to be toxic. 4. Urinary excretion rates in neonates 11 day or older were almost the same levels as in infants. 5. AMK, when administered through intravenous drip infusion, was observed to have a higher migration rate to saliva when compared with kanamycin administered through intramuscular injection. 6. Based on the results obtained from the present study, the following doses seem to be optimal for neonates, but further studies are required to be conclusive. For neonates: 2.0 to 5.0 mg/kg daily in 1 to 2 divided doses. (For those at ages of 0 to 3 days: 2.0 to 3.0 mg/kg) For infants: 3.0 to 8.0 mg/kg daily in 1 to 2 divided doses through intravenous drip infusion over a period of 30 minutes to 1 hour. PMID- 3669298 TI - [Pharmacokinetics in neonates and infants following administration of amikacin]. AB - Sixteen neonates (at ages of 8 to 28 days) and 8 infants (at ages of 35 days to 1 year), who were in need of treatment with amikacin sulfate, were subjected to the present study. The drug was administered by intramuscular route (1.39 to 3.13 mg/kg) or by intravenous drip infusion over a 30 to 60 minutes period (2.94 to 6.00 mg/kg). Blood levels and urinary excretion of the drug were investigated with these subjects. The blood levels were also analyzed according to pharmacokinetic models. 1. When the drug was administered intramuscularly to neonates at average doses of 1.49 and 2.96 mg/kg and to infants at average doses of 2.97 mg/kg peak levels of 2.74, 6.53 and 8.55 micrograms/ml, respectively, were attained at 30 minutes after dosing. 2. When the drug was administered to neonates at average doses of 3.01 and 5.89 mg/kg by intravenous drip infusion over a 30 to 60 minutes period and to infants at average doses of 2.97 and 6.00 mg/kg in the same manner, peak levels of 7.70, 20.9, 9.40 and 23.0 micrograms/ml, respectively, were attained at the end of the intravenous drip infusion. 3. Urinary levels and recovery rates tended to increase with ages of these subjects. Urinary recovery rates for the neonates and the infants were 41.0 and 58.9%, respectively, on the average. 4. From a pharmacokinetic analysis of blood levels of the drug, it was concluded that, in any of the subjects who received the drug intramuscularly or by intravenous drip infusion, it would be possible to use the one-compartment open model. In the subjects who received the drug by intravenous drip infusion, however, it was determined the two-compartment open model would be the choice. 5. In the neonates and the infants, whose blood levels were analyzed according to the one-compartment open model, Ka values averaged 7.51 and 6.62 hr 1, respectively, with respective average Kel values of 0.32 and 0.66 hr-1. Average Vd values obtained were 0.36 and 0.26 L/kg, respectively. There was a negative correlation between the Vd values and the ages of the subjects, while there was a positive correlation between the Kel values and the ages. 6. Appropriate conditions for administering the drug by intravenous drip infusion to neonates and infants at ages of more than 1 week were investigated taking observed blood levels and achieved peak levels and trough levels calculated using the one-compartment open model into account.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3669299 TI - [Pharmacokinetics of amikacin in the pediatric surgical field]. AB - Amikacin (AMK) was intravenously administered to pediatric surgical patients, and its pharmacokinetics was studied. The results obtained are summarized as follow: 1. The serum levels following administration were similar to those which had been reported by others. Urinary excretion was excellent. 2. The concentration of AMK in pleural effusion of a postoperative premature baby was an effective level higher than MIC's to target organisms. 3. Bile levels of AMK were the highest soon after surgery on patients with biliary atresia, these declined as time passed. The high levels obtained were in the effective range where the levels were higher than MIC's against organisms isolated from bile of patients with biliary tract infections. Biliary excretions were good in cases with good hepato enteric circulation. 4. Biliary and urinary excretion rates were well correlated. PMID- 3669300 TI - [Pharmacokinetic and clinical studies on amikacin in neonates]. AB - Pharmacokinetic and clinical studies on amikacin (AMK) were performed in neonates and the results obtained are summarized as follows. 1. After intramuscular injection of single doses of AMK at 3 mg/kg, peak serum levels were 6.8 micrograms/ml in a 2-day-old neonate and 7.0 micrograms/ml in a 20-day-old neonate. Serum levels of AMK in the above 2 neonates at 8 hours after injection were 1.5 micrograms/ml and 1.4 micrograms/ml, respectively, and the half-life of AMK was 3.3 hours. After intramuscular injection of single doses of 4 mg/kg of AMK, the mean peak serum level was 8.1 +/- 1.1 micrograms/ml, and half-lives of AMK were 6.1 hours in a 1-day-old neonate and 4.0 hours in a 3-day-old neonate. The mean peak serum level of AMK reached at 1 hour after intramuscular administrations at single dose of 6 mg/kg was 10.5 +/- 0.5 micrograms/ml in a 3 day and a 4-day-old neonates. Serum levels at 8 hours after administrations were 3.1 micrograms/ml and 2.8 micrograms/ml, in the 3-day and the 4-day-old neonates, respectively. Half-lives of AMK in sera were 3.9 hours in the 3-day-old neonate and 3.5 hours in the 4-day-old neonate. 2. In three 2-day-old neonates, the mean peak serum level of AMK after an intravenous drip infusion for 30 minutes at single dose of 3 mg/kg was 10.0 +/- 1.1 micrograms/ml at the end of infusion and serum levels decreased to 2.3 +/- 0.6 micrograms/ml at 6.5 hours after infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3669301 TI - [Investigation on the use of amikacin in the newborn]. AB - The use of amikacin (AMK) in newborns was investigated and the results obtained are summarized as follows. 1. AMK was administered to 3 rabbits at an intramuscular dose of 6 mg/kg. Mean blood levels determined according to methods of bioassay (BIO) and fluorescent immunoassay (FIA) were 28.6 and 22.2 micrograms/ml, respectively, at 30 minutes after dosing. Then, the blood levels declined rapidly. Mean T 1/2 values obtained with the above 2 assay methods were 0.76 and 0.63 hours, respectively. 2. When AMK was administered at a dose of 5.7 mg/kg to a 64 day-old newborn by drip intravenous infusion for 30 minutes, a peak blood level was attained at the end of drip intravenous infusion, which was 20.0 micrograms/ml according to BIO and was 15.5 micrograms/ml according to FIA. The blood levels declined gradually thereafter with a T 1/2 value of 2.33 hours (BIO) or 2.03 hours (FIA). When the drug was administered at 5.3 mg/kg to a 26 day-old newborn using the same infusion method, the peak blood level obtained at the end of drip intravenous infusion was 18.0 micrograms/ml according to BIO and was 14.8 micrograms/ml according to FIA, and T 1/2 values were 4.76 and 3.68 hours, respectively. 3. As there was a close correlation between the values obtained with BIO and with FIA in both rabbits and clinical cases, with a coefficient of 0.990, and also the BIO values could be estimated using a formula of FIA value X 1.2 + 2.2, it would be possible to monitor AMK levels in the blood of patients at bedside using the FIA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3669302 TI - [Pharmacokinetics of amikacin in children and neonates]. AB - To evaluate pharmacokinetics of amikacin (AMK), one of the aminoglycoside antibiotics, children with ages from 2 days to 11 years were treated with various doses by various administration routes, and both plasma and urinary levels of AMK were determined. The following is a summary of the results obtained: 1. Of 6 children, three were treated with 2.0 mg/kg of AMK by a 30-minute intravenous drip infusion, and the other 3 with 4.0 mg/kg by a 60-minute. Peaks of average plasma levels were observed at the ends of the infusions in both cases, and their levels were 9.23 and 13.67 micrograms/ml, respectively, showing a dose dependency. Both half-lives and areas under plasma concentration-time curves (AUCs) were similar to those of adults. However, the volume of distribution (Vd) showed a lower value than that of adults. Peaks of average urine levels were 149.3 micrograms/ml with 2.0 mg/kg in 0-2 hours after the start of the infusion and 223.3 micrograms/ml with 4.0 mg/kg in 2-4 hours. Average urinary recovery rates within 6 hours after the start of the infusion were 95.4% with 2.0 mg/kg and 85.7% with 4.0 mg/kg. These recoveries were equal to or higher than that of adults. 2. When 3.0, 4.0 and 6.0 mg/kg of AMK were administered to 3 groups of mature or premature babies by intramuscular injection, average peak levels of AMK in plasma were 6.26, 8.61 and 12.60 micrograms/ml, respectively, at 30 minutes after the injection, showing dose-dependency. In these groups, the younger the day age after birth was, the longer the half-life became. The AUCs were larger as the half-life became longer. The Vd was larger than that in the intravenous drip infusion group, but, any particular was not observed. Average peak levels of AMK in urine were 78.83 micrograms/ml at 4-6 hours with a dose level of 3.0 mg/kg, 99.17 micrograms/ml at 2-4 hours with 4.0 mg/kg and 139.20 micrograms/ml at 0-2 hours with 6.0 mg/kg. Average urinary recovery rates within 6 hours were 36.57% with 3.0 mg/kg, 34.67% with 4.0 mg/kg and 43.77% with 6.0 mg/kg. These recovery rates were markedly lower than those observed in adults and children. One of the causes of this low recovery is that mature and premature babies have immature renal functions. 3. When 3.0 mg/kg of AMK was administered to three premature babies by a 30-minute intravenous drip infusion, the average peak plasma levels was 7.61 micrograms/ml at the end of the drip infusion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3669303 TI - [Inhibitory effects of peroxidase on the growth of mycoplasmas]. PMID- 3669304 TI - [Rib fracture after postoperative tangential irradiation in breast cancer]. AB - Incidence of rib fracture was analyzed for 118 postoperated breast cancer patients who were tangentially irradiated at the Department of Radiology, Kyushu University, from 1961 to 1976 and followed more than 5 years. Rib fracture was observed in 5% and 50% of cases treated with total radiation doses of 32.5 Gy and 52.5 Gy respectively. PMID- 3669305 TI - [Skin damage after postoperative tangential irradiation in breast cancer]. AB - Incidence of telangiectasia and ulcer among 118 postoperated breast cancer patients, who were tangentially irradiated at Department of Radiology, Kyushu University from 1961 to 1980, followed more than 5 years were evaluated. Telangiectasia occurred in 5% at 20-35 Gy, in 50% at 50-55 Gy. Ulcer occurred in 5% at 50-55 Gy, in 50% at 70-75 Gy. Skin tolerance dose in Rubin's Table (1972) is correct. PMID- 3669306 TI - [Pulmonary fibrosis after postoperative tangential irradiation in breast cancer]. AB - Incidence rate of pulmonary fibrosis with elevation of diaphragma was calculated for 118 postoperated breast cancer patients who were tangentially irradiated at the Department of Radiology Kyushu University from 1961 to 1980 and followed more than 5 years. 5%, 50% occurred at 40-45 Gy, 60-65 Gy, Rubin's Table (1972) is possible correct. PMID- 3669307 TI - [Thyroid dysfunction following external irradiation of the neck]. AB - Thyroid function after radiation therapy to the neck was studied in 120 patients, 110 of whom were suffered from malignant lymphomas. No patients had clinical symptoms from thyroid dysfunction, but 9 patients were given thyroid hormone after examination of thyroid function test. TSH elevation rate for 95 patients irradiated to the hole neck by dosage was 0%, 24%, 47% and 47%, for less than 30 Gy, 30-39 Gy, 40-49 Gy and 50 Gy or more, respectively. The effects of lymphangiography and systemic combination chemotherapy on the thyroid function were also discussed. PMID- 3669308 TI - [The development of radiation necrosis of the brain after radiation therapy]. AB - Examination by questionnaire of 102 institutions utilizing radiation therapy throughout the country revealed 97 cases of radiation necrosis of the brain, 41 cases of which have received only one course of radiation therapy with either high energy x-rays or 60Co gamma-rays and that have been histologically confirmed for necrosis. The dose fractionation relationship causing necrosis presumed by Strandquvist's diagram proved to be located along the line with the slope of 0.44 from the interception of 9.9 Gy with a single irradiation. Our own experience of brain tumor and cancer of the paranasal sinus told 2 with developed necrosis (incidence, 0.6%) of 325 cases on radiation therapy at a dose of 50-60 Gy and 5 (incidence, 2.0%) of 253 cases on radiation therapy at a dose of more than 60 Gy. PMID- 3669309 TI - [Late radiation effect on the eye]. AB - In order to analyze the chronic radiation injury on the eye, 264 cases with carcinoma of the paranasal sinuses were accumulated from the four large hospitals. 50% appearance dose of the chronic radiation injury, chiefly the radiation cataract, in 3, 5, 7 and 10 years after radiotherapy was 51.6 Gy, 28.3 Gy, 23.9 Gy and 21.6 Gy, respectively. PMID- 3669310 TI - [Analysis of tolerable radiation dose on the oral mucosa and mandibular bone- external beam and/or brachytherapy]. AB - Cooperative study from six institutes was made for the late radiation damage of oral mucosa and mandibular bone. Analysis was made for the selected patients with oropharyngeal cancer for external beam alone and with tongue cancer for interstitial implant. All of them were followed at least two years without recurrence having no secondary treatment after initial radiotherapy. As for external beam alone, frequency of the mucosal ulcer was not increased with high dose level, but tolerance dose for the oral mucosa was limited from associated mandibular damage. Late damages were not likely after brachytherapy alone. PMID- 3669311 TI - [The tolerance dose of the urinary bladder]. AB - The tolerance dose of the urinary bladder was estimated by studying the late injury of the urinary bladder in 79 cases of the carcinoma of the urinary bladder treated by external irradiation, in 253 cases of the uterine cervix treated by conformation radiotherapy technique or two-axes arc therapy combined with low dose rate intracavitary irradiation of small doses, and 55 cases of the carcinoma of the uterine cervix treated by low-dose rate intracavitary irradiation combined with whole pelvic irradiation with the center splitter. As a result, the tolerance dose in case of radiotherapy of the carcinoma of the urinary bladder was revealed to be as low as TDF 100. The tolerance dose in case of radiotherapy of the carcinoma of the uterine cervix treated mainly by conformation radiotherapy technique or two-axes arc therapy was proved to be TDF 110-120, and treated mainly by intracavitary irradiation 120 or over. PMID- 3669312 TI - [Radiation tolerance dose of the spinal cord following conventionally fractionated irradiation]. AB - 409 patients whose spinal cord were irradiated over 30 Gy with conventionally fractionated method were surveyed to study the relation between the dose of spinal cord and the incidence of radiation myelitis. Radiation myelitis was observed in 26 cases including 3 transverse myelitis ones. 5 year incidences of transverse myelitis calculated with life table method were approximately 0% at 40 Gy, 5% at 50 Gy, 10% at 60 Gy and 20% at 70 Gy. The radiation tolerance dose of the spinal cord was considered to be 50 Gy. PMID- 3669313 TI - [Osteonecrosis following radiotherapy in carcinoma of the uterus and pediatric tumors]. AB - Osteonecrosis following radiation therapy in 611 Patients with uterine cancer and 41 patients with pediatric tumor were studied. The 5- and 10-year cumulative bone injury rate after radiation therapy in uterine cancer was 4% and 15.6%, respectedly. Patients who are older than 60 years of age showed high occurrence of radiation bone injury. Otherwise, severe aletrations in shape and complete arrest of growth in irradiated growing bone were observed of even with small doses of 1600 cGy in the lower age level (0-3 age of years) at the time of treatment. PMID- 3669314 TI - [Study of abscopal effect and cellular infiltration of tumor nests using less fractionated, large-dose radiation]. AB - As reported by several authors, abscopal effect and favorable cellular infiltrations into the tumor nest caused by irradiation suggest the existence of cell immunity in the host. In our present study, as first step to elucidate the mechanism of the fact mentioned above, effects of radiation with a single dose irradiation was estimated in terms of the increase of survival rate and the inhibition of pulmonary metastasis, i.e. abscopal effect in the mice of irradiated tumor burden. Therefore, we examined the resected and pulmonary specimen after irradiation histopathologically. We also examined the effects of the administration of immune modulator PSK and OK-432. Results; 1) Increase of survival rate and inhibition of pulmonary metastasis were observed in groups of mice with inoculated tumor and with again inoculated tumor treated by a single dose irradiation, compared to either the control groups. 2) Also administration of immune potentiator with radiation enhanced the survival rate and inhibition of pulmonary metastasis in all experimental protocols. 3) Remarkable cellular infiltrations of tumor nest after irradiation were observed, and these cellular infiltrations suggest participation of immunoreaction. In the group of using immune modulator, the cellular infiltrations were observed more remarkable than the other groups. 4) Optimal radiation dose was proved to be 30 Gy in this study. PMID- 3669315 TI - [Prognostic factors in nonresected adenocarcinoma of the lung]. AB - We have studied the prognostic factors of 117 cases of unresected adenocarcinoma of the lung, and have examined these cases according to the following categories: age, sex, clinical stage, performance status (P.S.), serum albumin on admission, serum CEA, the presence of complication, the present status of an abnormal chest shadow from a year ago at the same location, and differentiation of cells. Significant differences were detected in the P.S., the serum albumin and the presence of complications by survival analysis through the use of covariate-Cox models. We also have noted that the difference between stage I and the other stages of the clinical stage was found to be significant by a generalized Wilcoxon test. In conclusion, the determining prognostic factors of an unresected adenocarcinoma of the lung are the P.S., the serum albumin, the presence of complications and the clinical stage. PMID- 3669316 TI - [Dependency on sex hormone in human esophageal cancer--measurement of the androgen receptor in resected specimens]. AB - Clinically it is well known that the incidence of esophageal cancer is much higher in men that in women. Further, the prognosis of the esophageal cancer is worse for men than for women. This seems to be dependent on the difference of environment of the sex steroid. In this paper, the androgen receptor (AR) has been measured in 21 cases of human esophageal cancer. Two cases of esophageal cancer that were implanted into nude mice were AR positive. In this EH-1 cell line, the binding sites were increased and the tumor growth was enhanced by testosterone administration, but the tumor growth was not inhibited by estrogen administration. PMID- 3669317 TI - [A clinical study of lobular carcinoma of the breast]. AB - In a review of 549 cases of breast cancer in the last 16 years, 7 cases with lobular carcinoma have been studied. All of the patients appeared well and were without recurrence. Two cases had been lobular carcinomas in situ, one of which had arisen in a small fibroadenoma associated with malignant phyllodes tumor in the opposite breast, and the other had shown multicentric foci of a lobular neoplasm. The remaining 5 cases had been invasive lobular carcinomas. The incidence of lobular carcinoma represented 1.3% (7/549) of all primary breast carcinomas, and had been increasing chronologically. Estrogen and progesterone receptors were positive in 5 eligible cases. PMID- 3669318 TI - [The value of follow-up bone scans in the management of postoperative breast cancer--when should it be performed?]. AB - We have reviewed the bone scans of 106 patients with breast cancer taken after surgery, in order to determine when follow-up bone scans should be performed. The results obtained are as follows: 1. The incidence of bone metastasis was seen to be 11.6% in stage I, 39.4% in stage II, 43.5% in stage III, 57.1% in stage IV, and 30.2% overall; 2. Of 32 patients with bone metastasis, 28 patients (87.5%) developed bone metastases within the first 4 years; 3. The scan conversion rate was found to be 31.9% and the time interval to conversion ranged from 4.5 months to 28.5 months; and, 4. The period from single to multiple metastases ranged from 2 months to 37.5 months. Our findings suggest that postoperative follow-up bone scans for stage I breast cancer should be performed annually or when symptoms develop, and follow-ups for stages II, III and IV at six monthly intervals for the first 4 years after surgery and then annually. PMID- 3669319 TI - [Study of the type of Co-60 source and applicators for carcinoma of the uterine cervix using a remote afterloading device]. AB - By means of a questionnaire sent to 114 hospitals using the remote afterloading device, the type of Co-60 sources and the type and material of the applicator for intracavitary irradiation of the cervical cancer has been surveyed. In 90% of the hospitals, the one-point source is used for the tandem source, and in 80% of these hospitals the easily flexible polyethylene tube is used as the material of the tandem applicator. For the ovoidal source, the one-point source in 40%. In seven hospitals, an unsuitable ovoidal applicator seems to have been chosen for the type of the Co-60 source. PMID- 3669320 TI - [Antipyretic effect of naproxen in neoplastic fever]. AB - Naproxen has been administered for 22 febrile episodes of unknown etiology in 21 patients with malignant tumors. Ten patients had malignant lymphomas, and the others had solid tumors. The highest temperature was 38.5 degrees C or more in all but one of the patients. Out of the 22 episodes, 2 episodes were found to have been caused by an infection. The naproxen doses ranged from 300 to 600 mg per day. Of the 20 episodes of neoplastic fever, the temperature decreased 1.0 degree C or more in 16 patients, in 13 of whom the temperature decreased to 37.0 degrees C or less. There was some evidence that suggests the existence of a dose response relation-ship. The initial use of 600 mg per day seemed to be appropriate. The antipyretic effect did not seem to be influenced by the type of the underlying tumors. Three patients continued to receive naproxen for one to to months. No side effect was observed, excepting for one patient who developed a mild nausea. We thus conclude that naproxen is an effective safe drug for the control of neoplastic fever. PMID- 3669321 TI - [Improvement of the diagnosis of sepsis in patients with severe hematological diseases by endotoxin assay using limulus coagulation enzymes with chromogenic substrate]. PMID- 3669322 TI - [Assessment of the bone marrow hematopoietic activity in aplastic anemia by point counting method in relation to the clinical status and prognosis]. PMID- 3669323 TI - [C-MOPP therapy in advanced diffuse lymphoma, large cell type (LSG)]. PMID- 3669324 TI - [Exchange transfusion and combination chemotherapy in the treatment of 4 cases of childhood malignant histiocytosis]. PMID- 3669325 TI - [Congenital stomatocytosis associated with decreased sodium content in red cells]. PMID- 3669326 TI - [A case of refractory chronic lymphocytic leukemia improved with melphalan dexamethasone combination chemotherapy]. PMID- 3669327 TI - [Acute plasma cell leukemia with a Philadelphia chromosome (Ph1)]. PMID- 3669328 TI - [Erythrocytosis associated with uterine leiomyoma: a case report]. PMID- 3669329 TI - [A case of chronic consumption coagulopathy with dissecting aortic aneurysm--with special reference to the effects of danazol]. PMID- 3669330 TI - [Megaloblastic anemia in a patient with Crohn's disease]. PMID- 3669331 TI - [Mycoplasma-induced autoimmune hemolytic anemia]. PMID- 3669332 TI - [A case of abdominal aortic aneurysm complicated with disseminated intravascular coagulation]. PMID- 3669333 TI - [Isolated thrombocytopenia as presenting symptoms of myelodysplastic syndromes]. PMID- 3669334 TI - [An autopsy case of primary splenic angiosarcoma: successful treatment with heparin for disseminated intravascular coagulation]. PMID- 3669335 TI - [Changing of cholelithiasis with time and the classification of cholelithiasis]. PMID- 3669336 TI - [Anatomy and abnormalities of the biliary system--diagnosis and therapy of cholelithiasis]. PMID- 3669337 TI - [New diagnostic systems--technics, efficiency and limitations. Cholangiography. a) ERCP]. PMID- 3669338 TI - [New diagnostic systems--the technic, efficiency and limitations. Cholangiography. b) Percutaneous transhepatic cholangiography]. PMID- 3669339 TI - [New diagnostic systems--technics, efficiency and limitations. Cholangioscopy. a) Peroral cholangioscopy]. PMID- 3669340 TI - [New diagnostic systems--technics, efficiency and limitations. Cholangioscopy. b) Percutaneous transhepatic cholangioscopy]. PMID- 3669341 TI - [New diagnostic systems--technics, efficiency and limitations. a) CT cholangiography]. PMID- 3669342 TI - [New diagnostic systems--technics efficiency and limitations. b) Selective percutaneous transhepatic cholecystography]. PMID- 3669343 TI - [New therapeutic methods--technics, application, efficiency and problems- endoscopic sphincterotomy]. PMID- 3669344 TI - [New therapeutic methods--technics, application, efficiency and problems- endoscopic lithotripsy. a) Mechanical lithotripsy]. PMID- 3669345 TI - [New therapeutic methods--technics, application, efficiency and problems- endoscopic lithotripsy. c) Endoscopic electrohydraulic lithotripsy]. PMID- 3669346 TI - [New therapeutic methods--technics, application, efficiency and problems- endoscopic lithotripsy. d) Lithotripsy using high-frequency electric current]. PMID- 3669347 TI - [New therapeutic methods--the technics, application, efficacy and problems- endoscopic biliary drainage. a) Percutaneous transhepatic biliary drainage]. PMID- 3669348 TI - [New therapeutic methods--technics, application, efficacy, and problems- endoscopic biliary drainage. b) Usefulness of endoscopic naso-biliary drainage]. PMID- 3669349 TI - [New therapeutic methods--technics, application, efficiency and problems- endoscopic biliary drainage. c) Application of endoscopic retrograde biliary drainage to therapy of cholelithiasis]. PMID- 3669350 TI - [New therapeutic methods--technics, application, efficacy and problems. Litholysis. a) Theory of litholysis and development of litholytic agents]. PMID- 3669351 TI - [New therapeutic methods--technics, application, efficacy and problems. Litholysis. b) Application, administration and clinical efficacy of oral litholytic agents]. PMID- 3669352 TI - [Hepatolithiasis. Classification of hepatolithiasis and its statistical distribution in Japan]. PMID- 3669353 TI - [Hepatolithiasis. Etiology of hepatolithiasis: cholestasis and bacterial infections]. PMID- 3669354 TI - [Hepatolithiasis. Endoscopic therapy of hepatolithiasis and prognosis]. PMID- 3669355 TI - [Hepatolithiasis. Biliary drainage of hepatolithiasis--with special reference to the efficacy of hepatic portojejunostomy]. PMID- 3669357 TI - [Cholelithiasis in the aged. Characteristics of cholelithiasis in the aged]. PMID- 3669356 TI - [Hepatolithiasis. Hepatectomy of hepatolithiasis]. PMID- 3669358 TI - [Cholelithiasis in the aged. Therapy of cholelithiasis in the aged with reference to complications and analysis of causes of death]. PMID- 3669359 TI - [Cholelithiasis in the aged. PTBD as a one of the therapeutic methods of cholelithiasis in the aged]. PMID- 3669360 TI - [Cholelithiasis in the aged. Use of surgical therapy in cholelithiasis in the aged]. PMID- 3669361 TI - [Cholelithiasis in the aged. Therapy of symptomless cholelithiasis in aged. a) Therapy from the standpoint of internal medicine]. PMID- 3669362 TI - [Cholelithiasis in the aged. Therapy of symptomless cholelithiasis in the aged. b) Therapy from the standpoint of the surgeons]. PMID- 3669363 TI - Analysis of false multiple primary cancers: Hiroshima Tumor Tissue Registry's experience. Hiroshima Tumor Tissue Registry, Acting Committee. AB - During the period 1978-84 a total of 34,422 cases with malignant tumors were accessed by the Hiroshima Tumor Tissue Registry. Of these, 3,136 (9.1%) were classified as having multiple primary cancers (MPC). A detailed review was conducted on 1,148 cases selected from the latter group, and 330 (29%) were found to have been falsely registered as having MPC. "False" MPC cases were classified into six major categories according to the type of error: Category I--invasions or metastases occurring at the same or adjacent site within three months of the primary tumor, misclassified as separate primaries; Category II--invasions or metastases occurring at the same or adjacent site more than three months of the primary tumor, misclassified as separate primaries; Category III--metastases to distant sites, misclassified as separate primaries; Category IV--tumors lacking a clear description of location, resulting in registrations as "false" MPC; Category V--tumors with revisions or corrections in their pathological diagnoses resulting in false MPC; Category VI--tumors with errors in coding and other operational procedures resulting in false MPC. The cases in Categories I, II and III together comprised 52% of all false MPC cases (18%, 23% and 11%, respectively). In many of these cases, it was difficult to reject the possibility of one tumor being a metastasis of the other. This suggests that specific criteria may help reduce the number of false MPC cases of these types. Cases in Categories IV, V and VI represented 24%, 14% and 9%, respectively, of all false MPC cases. Errors encountered in these cases may be prevented by the concentrated efforts of clinicians and hospital pathologists as well as by an improvement in the operation of the registry. PMID- 3669364 TI - The risk of a second primary cancer occurring in five-year survivors of an initial cancer. AB - Patients with a greater than five-year survival diagnosed with cancer of the stomach, colon, breast and uterus (included in situ) at the Kanagawa Cancer Center from 1963 to 1980 were studied for multiple primary cancers. They were followed up to December 31, 1985, for the occurrence of second primary cancers by means of a record linkage to the population-based cancer registry in Kanagawa Prefecture. The occurrence rate of total second primary cancers was 2.6% (76/2,977). Among the first primary cancer sites, the rate for cancer of the colon was highest: 5.3% (5/94), and the rate for women with cancer of the uterus lowest: 1.4% (16/1,146). The number of observed second primary cancers was compared with the expected number, which was calculated by the person-years method, to obtain an estimate of the risk. The relative risks (RR: observed: expected value) of women with cancer of the breast were significantly high for developing cancer of the colon (RR, 3.7), cancer of the opposite breast (RR, 3.9) and cancer of the ovary (RR, 5.8). Men with cancer of the stomach had a significant risk of developing cancer of the colon (RR, 3.3). It may be considered, at least in part, that some cancer patients, especially those with cancer of the breast, have a high risk of a second primary cancer occurring. These results may provide clues and information to the etiology of predisposition to and prevention of cancer. PMID- 3669365 TI - Establishment of cut off values for vanillylmandelic acid and homovanillic acid in 24-hr urine accumulation during mass screening for neuroblastoma. AB - The establishment of cut off values in vanillylmandelic acid (VMA) and homovanillic acid (HVA) in 24-hr urine specimens for the purpose of separating true positive cases from normal infants has been discussed. The specimens were collected at the time when thorough examinations under a mass screening programme for neuroblastoma were taking place, and data from 17 infants with neuroblastoma (patients) and 50 healthy infants (controls) have been employed. The function square root VMA2 + HVA2 = 34 (micrograms/mg of creatinine) separated the two groups with no overlapping cases. This function represents the distance from the origin of the VMA-HVA co-ordinates, and is thought to be one of the most reasonable discriminant methods when considering the distribution pattern of the data for normal cases and patients. PMID- 3669366 TI - A massive dose of vincristine. AB - An esophageal cancer patient with bilateral lungs and neck lymph nodes metastases received 24 mg of vincristine instead of vinblastine because of the similarity between the two names, and survived multiorgan derangement. Serious states of central and peripheral neuropathy with muscle atrophy, gastrointestinal disorder, bone marrow suppression and mucocutaneous involvement were all encountered. Although hypotension and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) were not observed as vincristine's side actions, toxicity to the myocardium, which has not been documented, was suggested in our case. These toxic impairments, however, subsided clinically within a month, except for paresthesia in the peripheral extremities. The effectiveness of the chemotherapy was remarkable against both the esophageal cancer and the metastatic lesions. No unintentional overdose of a drug, needless to say, should happen, and in order to minimize its possibility, it would be advisable for chemotherapy to be administered only by an experienced physician who is able to check the dose and concentration. PMID- 3669367 TI - An autopsy case of primary gastric choriocarcinoma. AB - An autopsy case of primary gastric choriocarcinoma in a 55-year-old male is presented. The tumor was diagnosed as choriocarcinoma of the stomach from a histological examination of biopsy specimens. The level of human chorionic gonadotropin (HCG) was significantly increased in the serum and urine. A histological examination of autopsy specimens showed the tumor of the stomach to be a pure choriocarcinoma composed of syncytiotrophoblasts and cytotrophoblasts with a mixture of eosinophilic necrotic tissues, but with no elements of adenocarcinoma. The tumor showed metastases and/or invasions to the liver, lungs, pancreas, omentum, pleura, peritoneum and lymph nodes. Positive immuno histochemical staining for the beta-subunit of HCG (HCG-beta) in the gastric tumor was demonstrated in the form of granular diffuse deposits in the cytoplasm of trophoblasts and predominated in syncytiotrophoblasts over transitional cells. Under electron microscopic observation, positive immunostaining for HCG-beta was observed in the perinuclear space, cisternae of the rough endoplasmic reticulum (RER) and secretory vesicles of syncytiotrophoblasts and transitional cells. PMID- 3669368 TI - A case of epithelioid hemangioendothelioma of the liver. AB - A case of epithelioid hemangioendothelioma of the liver is reported. Both immunohistochemical and electron-microscopic examinations revealed the neoplastic cells to share many characteristics with endothelial cells. We discuss and compare this rare tumor, which represents a low-grade sclerosing hemangiosarcoma of the liver, with its pulmonary counterpart, which is known as intravascular bronchioloalveolar tumor (IVBAT). PMID- 3669369 TI - [Laboratory methods in immunological serology--a prospective view]. PMID- 3669370 TI - [Diagnostic usefulness in the measurement of CRP by LPIA-300]. PMID- 3669371 TI - [An improved processing of turbidimetric immunoassay data by means of a personal computer system]. PMID- 3669372 TI - [Two-color analysis of lymphocyte surface markers by flow cytometry]. PMID- 3669373 TI - [Clinical application of immunoblotting to the detection of monoclonal immunoglobulins and Bence Jones protein]. PMID- 3669374 TI - [A sensitive enzyme immunoassay for immunoglobulins and antibodies to specific antigens--application for immunodeficiency and autoimmune thyroid disease]. PMID- 3669375 TI - [Interference of HCO-60 (solvent of vitamin K2) on the serum total lipid estimation]. PMID- 3669376 TI - [Detection of red cell antibodies using ELISA--quantitative measurement of anti-D antibodies]. PMID- 3669377 TI - [Effects of lead on glycosylated hemoglobin]. PMID- 3669378 TI - [Quantification of the follicle in simple adenoma of the thyroid]. PMID- 3669379 TI - [Utricular "endometrioid" carcinoma of the prostate]. PMID- 3669380 TI - [Somatosensory evoked potentials in Parkinson's disease and vascular parkinsonism]. PMID- 3669381 TI - [A study on precordial vibration. III. Isochronal mapping]. PMID- 3669382 TI - [Incidence and clinical features of an LDH subunit variant]. PMID- 3669383 TI - [Clinical preventive medicine in gastrointestinal diseases]. PMID- 3669384 TI - [Prevention of hepatitis B virus infection]. PMID- 3669386 TI - [Aging and immunology related clinical preventive medicine]. PMID- 3669385 TI - [Preventive aspects of coronary heart disease]. PMID- 3669387 TI - [Influence of various drugs on enzymatic assay of urinary polyamine]. PMID- 3669388 TI - [Enzyme-linked immunosorbent assay of DUPAN 2]. PMID- 3669389 TI - [Incidence of serum cholinesterase variants]. PMID- 3669390 TI - [Relationship between the ratio of alkaline phosphatase activity determined with PNPP or PP as substrates and alkaline phosphatase isozymes]. PMID- 3669391 TI - [A family of hemoglobinopathy detected with high performance liquid chromatography]. PMID- 3669392 TI - [Plasmid pattern analysis of methicillin-resistant Staphylococcus aureus and its application to hospital epidemiology]. PMID- 3669393 TI - [Comparison of the mucosal changes in the gallbladder with or without stone]. PMID- 3669394 TI - [Studies on the artifacts in ambulatory EEG system (Medidata M-300)]. PMID- 3669395 TI - [Melanotic schwannoma: a case report]. PMID- 3669396 TI - [Kyrle-like lesions in patients in hemodialysis, with special references to its correlation of trace elements in serum and hairs]. PMID- 3669398 TI - [Values of hypersensitivity test in patients with atopic dermatitis and normal healthy adults--normal values of serum IGE, IGG2, and IGG4]. PMID- 3669397 TI - [Reversibility of griseofulvin induced protoporphyria in the mice]. PMID- 3669399 TI - [An influence of phototoxic substances on the complement system. I. The effect of hematoporphyrin and exposure to metal halide lamps in complement hemolytic activity]. PMID- 3669400 TI - Interaction between human albumin polymers and the envelope polypeptide of hepatitis B virus (P31) containing the translation product of the pre-S2 region. AB - Two preparations of human serum albumin (Cohn fraction V), when subjected to high performance liquid chromatography, were found to contain albumin polymers with molecular sizes of 35 X 10(4) daltons or greater (breakthrough fraction), as well as tetramers, trimers and dimers. They bound to the envelope polypeptide of hepatitis B virus composed of translation products of the pre-S2 region and the S gene (P31), carrying the receptor for polymerized human serum albumin, with an activity increasing in parallel with the degree polymerization. PMID- 3669401 TI - Efficient encapsulation of water-soluble materials into small-sized liposomes. AB - A large proportion of the aqueous phase was encapsulated into small-sized liposomes with diameters less than 100 nm, when multilamellar liposomes, prepared by vortexing a lipid film at an extremely high concentration of lipids up to 512 mM, were subsequently rendered to small vesicles by sonication. Sixty percent of adriamycin (8.6 mM) and 39% of sucrose (50 mM) presented were respectively entrapped into the vesicles prepared with 256 mM lipids. The vesicles formed were quite stable and retained a major portion of the entrapped materials. This simple procedure may be useful for encapsulation of valuable, water-soluble materials into small-sized liposomes. PMID- 3669402 TI - Neuromuscular disorder in rabbit--a pathological study. AB - Rabbits affected by a neuromuscular disorder have been observed by light and electron microscopy. The presynaptic portion of the neuromuscular junction showed many changes such as depletion or reduction in synaptic vesicle population, degenerative changes in mitochondria. Intra-muscular axons showed few changes such as disorientation and ramification of neurofilaments. The muscle fibres showed some degenerated fibres and increased collagen around the muscle fibres. Intramuscular blood capillaries also showed proliferation of endothelial cells. PMID- 3669403 TI - [The effect of omeprazole on gastric acid secretion. The 1st report]. PMID- 3669404 TI - [Analysis of energy metabolism of the rabbit liver in obstructive jaundice using 31P magnetic resonance spectroscopy]. PMID- 3669405 TI - [Suppression of lymphocyte proliferation by serum lipoproteins in chronic liver diseases]. PMID- 3669406 TI - [Studies on a metabolite of tryptophan in liver damage]. PMID- 3669407 TI - [Magnetic resonance imaging (MRI) in diffuse liver diseases--comparison with CT]. PMID- 3669408 TI - [A study on the size of molecular aggregates formed by bile acid in human gallbladder bile: with special reference to a comparison of bile treated with chenodeoxycholic acid and with ursodeoxycholic acid]. PMID- 3669409 TI - [Pathogenesis of black stones--a study on the mechanism of polymerization of black pigment and precipitation of calcium carbonate]. PMID- 3669410 TI - [A case of ileocecal syndrome]. PMID- 3669411 TI - [A case of idiopathic portal hypertension with Cruveilhier-Baumgarten syndrome, complicated by nodular hyperplasia of the liver and chronic thyroiditis]. PMID- 3669412 TI - [A case of blue rubber bleb nevus syndrome with multiple hemangioma of the spleen and collateral circulation of the inferior mesenteric vein]. PMID- 3669413 TI - [Mechanism of acute gastric mucosal lesions--role of leukotrienes]. PMID- 3669414 TI - [Cell kinetic studies on biliary ductal mucosa by using anti-bromodeoxyuridine monoclonal antibody in patients with anomalous arrangement of the pancreatico biliary duct system]. PMID- 3669415 TI - [The caretaker-patient relationship and psychotic manifestations in the bedridden elderly]. PMID- 3669416 TI - [Research on hydroxyl radicals (.OH) in plasma under hyperbaric oxygen exposure]. PMID- 3669417 TI - [Behavior of 14C-diethylene glycol in rat and guinea pig]. PMID- 3669418 TI - [Respiratory illnesses in childhood and subsequent development of pulmonary function]. PMID- 3669419 TI - [A system for the simultaneous multiple measurement of opsonic activity using the luminol-dependent chemiluminescence technic. Part 2. The reproducibility of the inter-measurement and serum opsonic activities of inhabitants in a rural area of Oita prefecture]. PMID- 3669420 TI - [Changes in the lipid components in rats induced by methylmercury]. PMID- 3669421 TI - [Changes in length of stay of inpatients with National Health Insurance in S. City, Osaka]. PMID- 3669422 TI - [Manganese transfer from mothers to fetuses or sucklings during pregnancy and lactation]. PMID- 3669423 TI - [Study on the relationship between microwave dose and survival time]. PMID- 3669424 TI - [Enhancement of the sensitivity of the micronucleus test by calcium antagonist]. PMID- 3669425 TI - Electron microscopic study of striated fibers in human fibroblasts. AB - Fibroblasts in human conjunctiva were examined by electron microscopy. Their striated fibers were almost always associated with basal bodies or centrioles. The length and thickness of the striated fibers were variable. The average length was 0.48 +/- 0.38 (SD) micron; the maximum length was 2.1 microns. The average thickness was 62.3 +/- 26.4 (SD) nm; the maximum thickness was 157 nm. Each bundle of striated fibers consisted of several filaments of about 7 nm in diameter. The periodicity of the major crossband was 69.7 +/- 2.8 (SD) nm. At least six intraperiod subbands were seen between the electron-dense major bands. The functional significance of striated fibers was discussed. PMID- 3669426 TI - Quantitative measurement of upper eyelid movements. AB - A simple and noncontact method for recording upper eyelid movement by means of a solid state image sensor has been developed. Physiological parameters of blink and lid movements during gaze change were studied in 30 normal subjects. Maximum velocity against lid displacement was analyzed. Electromyography (EMG) of the levator palpebrae as well as orbicularis oculi muscles was conducted and vertical eye movement was recorded by electrooculography (EOG). The maximum lid velocity both for upward and downward gaze change was measured; it was always faster in the downward than in the upward gaze. The duration of lid movement during upward gaze change was about 70 msec longer than that of the vertical saccadic eye movement. By EMG, a pulse-step discharge has been well known to occur in the superior rectus muscle but it was never seen in the levator palpebrae muscle in the present observation. The maximum lid velocity of downward spontaneous blink showed two-phase distributions: phase 1 with an initial flat phase in small displacement and phase 2 with a steep phase in large displacement. By EMG, only the pretarsal portion of the orbicularis muscle discharged at the initial phase; preseptal as well as pretarsal orbicular muscle discharges were noted in the second phase. The simplicity of this technique would permit its wide clinical application. PMID- 3669427 TI - Conversion of 4-aminobutyraldehyde to gamma-aminobutyric acid in retina. AB - 4-Aminobutyraldehyde (ABAL) was shown to be converted to gamma-aminobutyric acid (GABA) in the rat retina in vivo as well as in vitro. The results suggest that ABAL can easily cross the blood-retinal barrier and be rapidly oxidized to GABA in the retina. The conversion of ABAL to GABA also occurred in retinas treated with kainic acid, which greatly reduced glutamic acid decarboxylase (GAD) activity. Therefore, it is suggested that the conversion in the retina is independent of the GAD pathway and may occur not only in GABAergic neurons but also in glia or photoreceptor cells. PMID- 3669428 TI - Posterior commissural connections of area pretectalis and neighboring structures in cat, with special reference to pupilloconstrictory pathway via posterior commissure. AB - The overall distribution of posterior commissural connections of the area pretectalis and the neighboring structures was studied in the cat, by the methods of anterograde fiber degeneration and retrograde axonal transport of horseradish peroxidase (HRP). After a localized lesion was made within the posterior commissure, dense degenerated terminals were distributed in the most rostral part of the nucleus pretectalis posterior, the nucleus of posterior commissure, the interstitial nucleus of Cajal, and the central tegmental field. A medium amount of degenerated terminals were observed in the nucleus pretectalis anterior (pars reticularis), the dorsal part of the periaqueductal grey at its most rostral levels, the caudolateral parts of the nucleus pretectalis posterior and the nucleus of optic tract, the H field of Forel, parts of the somatic cell columns of the oculomotor nucleus and the trochlear nucleus. A small amount of degenerated terminals were seen in the ventromedial part of the caudal periaqueductal grey, the ventral lateral geniculate nucleus and the zona incerta. However, the amount of degenerated terminals was very small in the nucleus pretectalis medialis and the nucleus pretectalis olivaris. Following an HRP (dissolved in 5% alkyl-phenol ethylene oxide) injection into the unilateral area pretectalis where fibers of the posterior commissure fan out, retrogradely labeled cells were observed in all of the above described (posterior commissural fiber recipient) regions of the pretectal and neighboring structures, with the exception of the somatic cell columns of the oculomotor nucleus and the trochlear nucleus. The number of labeled cells appeared roughly proportional to the amount of degenerated terminals of the posterior commissural fibers described above with the apparent exception of the nucleus pretectalis anterior, pars reticularis, where only a few labeled cells were identified. The findings were discussed with special reference to the pupilloconstrictory pathway via the posterior commissure. PMID- 3669429 TI - [Reorganization of public health services and regional problems in health care]. PMID- 3669430 TI - [Conditions surrounding public health nurses and their future problems]. PMID- 3669431 TI - [Accusation of the government policy in management of the National Railway System: a crisis in democracy at the Human Resources Center]. PMID- 3669432 TI - [Health care of the aged and the approach by public health nurses]. PMID- 3669433 TI - [Health problems of workers and public health nursing activities]. PMID- 3669434 TI - [Public health nursing for improved maternal and child health care]. PMID- 3669435 TI - [Area-specific approach to adult diseases]. PMID- 3669436 TI - [Cooperation between active middle-aged and aged population segment and public health nurses. A symposium. Activities at Nerima Ward, Tokyo]. PMID- 3669437 TI - [Management of the problem of senile patients]. PMID- 3669438 TI - [Conditions necessary for living: environmental pollution and our lives]. PMID- 3669439 TI - [Public health nursing activities with involvement of inhabitants--experiences at Bangladesh and England]. PMID- 3669440 TI - ["Eating" and "feeding"--nursing care in daily activities. (7) A meal time as a window of life activities]. PMID- 3669441 TI - [A survey on the living conditions of housewives at a land reclamation area]. PMID- 3669442 TI - [Regional public health nursing activities. 12. For the development of focal area activities: expansion of the activities]. PMID- 3669443 TI - [Assistance of families caring for senile patients who sought help at the geriatric psychiatric counseling service of a public health clinic--an example at Omiya Clinic, Saitama Prefecture]. PMID- 3669444 TI - [Conditions for the development of regional rehabilitation programs. Planning of a rehabilitation program at the Tama Clinic, Kawasaki-shi. 1. The development of the program and participation]. PMID- 3669445 TI - [Survey on regional rehabilitation services. Evaluation of planning and management of the services which determine the direction of regional rehabilitation programs]. PMID- 3669446 TI - [Approach to the improvement in public participation in mass screening of stomach cancer]. PMID- 3669447 TI - [Characteristics of the lives of the aged]. PMID- 3669448 TI - [Home oxygen therapy--selection criteria, prognosis and return to work]. PMID- 3669449 TI - [Indications of home oxygen therapy, treatment of acute exacerbation and reconditioning of home or social activities of patient with chronic respiratory failure]. PMID- 3669450 TI - [Management of acute exacerbation in patients on home oxygen therapy]. PMID- 3669451 TI - [At-home patient care of respiratory failure]. PMID- 3669452 TI - [Concentration in bronchial tissue of LMOX (1 g) after intravenous injection]. PMID- 3669454 TI - [Analysis of acoustic transmission of the respiratory system using white noise]. PMID- 3669453 TI - [Moment analysis of transit time in forced expiratory curve]. PMID- 3669455 TI - [A new oscillation method for measurement of respiratory impedance and its clinical utility]. PMID- 3669456 TI - [Relationship between the forced expiratory flow and tracheal sound]. PMID- 3669457 TI - [A case of malignant schwannoma of the posterior mediastinum]. PMID- 3669458 TI - [Bronchial asthma in respect to COPD]. PMID- 3669459 TI - [Chronic pulmonary emphysema]. PMID- 3669460 TI - [Study of diffuse panbronchiolitis and COPD]. PMID- 3669461 TI - [Chronic obstructive pulmonary disease seen among the previous workers in Okunojima poison gas factory]. PMID- 3669462 TI - Cricopharyngeal induced airways obstruction. PMID- 3669463 TI - [A case of bronchial asthma caused by cat hair with dual asthmatic responses]. PMID- 3669464 TI - [Diagnostic bronchofiberscopy in pulmonary diseases in the immunocompromised host]. PMID- 3669465 TI - [A case of adult respiratory distress syndrome associated with miliary tuberculosis]. PMID- 3669466 TI - [A case of primary alveolar hypoventilation syndrome]. PMID- 3669467 TI - [A case of endobronchial lipoma with peripheral organizing pneumonia]. PMID- 3669468 TI - [Electron microscopic observation of the nephrotoxicity in rats receiving cyclosporine]. PMID- 3669469 TI - [Distribution and phototoxicity of hematoporphyrin derivative in experimentally induced rat bladder tumors]. PMID- 3669470 TI - [Urinary diversion with Mainz pouch. Urinary continence by intussusception with seromuscular stripping]. PMID- 3669471 TI - [Studies of citrate metabolism in urolithiasis. 2--Influences of citrate compound administration on sequential excretion of urinary citrate and other substances related to stone formation in healthy controls]. PMID- 3669472 TI - [Radical nephrectomy for renal cell carcinoma--operative approach]. PMID- 3669473 TI - [Subrenal capsule assay--histological evaluation of chemotherapy responsiveness]. PMID- 3669474 TI - [Comparison of one stage and two stage urethroplasty in hypospadias]. PMID- 3669475 TI - [The clinical significance of tissue polypeptide antigen (TPA) in the serum, urine and tumor tissue of urologic cancer patients]. PMID- 3669476 TI - [Assessment of the single nephron function in the obstructed kidney by lissamine green injection method]. PMID- 3669477 TI - [Assessment of the proximal tubular function in the obstructed kidney using micropuncture technic]. PMID- 3669478 TI - [Combination therapy of hyperbaric oxygenation and Chinese herbs in asymptomatic hematuria]. PMID- 3669479 TI - [Scopolamine-N-butyl bromide loaded cystometry and its clinical significance]. PMID- 3669480 TI - [Ectopic opening of vas deferens into the prostatic utricle in two cases]. PMID- 3669481 TI - Clinical study of endoscopic therapy for the biliary tract lithiasis. PMID- 3669482 TI - Sequential changes of the autonomic nervous system in the development of cysteamine-induced duodenal ulcer, histochemical and quantitative studies. PMID- 3669483 TI - Reconstructive surgery in the treatment of hypopharyngeal cancer. PMID- 3669484 TI - Validity of the operational equation of the 14C-deoxyglucose method modified for changing arterial plasma glucose level. PMID- 3669485 TI - Uterine factors in infertility. PMID- 3669487 TI - [Reentrant tachycardia and atrial fibrillation in Wolff-Parkinson-White syndrome. V. Conversion of reentrant tachycardia into atrial fibrillation]. PMID- 3669486 TI - [Effectiveness of nifedipine in the emergency treatment of arterial hypertension]. PMID- 3669488 TI - [Evaluation of the possibilities of rapid hospital rehabilitation of patients with uncomplicated myocardial infarction. II. Clinical characteristics]. PMID- 3669489 TI - [The course of hospital physical rehabilitation after acute myocardial infarction in persons of advanced age]. PMID- 3669490 TI - [Electrocardiographic image and energy expenditure during selected daily activities in patients after myocardial infarction]. PMID- 3669491 TI - [Removal of an intracardiac electrode by the continuous traction method. A case report]. PMID- 3669492 TI - Renal response to metabolic alkalosis induced by isovolemic hemofiltration in the dog. AB - We describe a new model of chloride-depletion alkalosis (CDMA), in which the method of induction of alkalosis does not itself cause a direct alteration in sodium and fluid balance. We have used this model, which is based on hemofiltration techniques in the dog, to study the immediate response of the kidney to the induction of CDMA. Normal dogs maintained with a NaCl-free diet for several days underwent hemofiltration of 50 ml/kg over a 35 minute period. The hemofiltrate was replaced ml for ml with a solution containing sodium and potassium in the same concentrations as found in each animal's plasma water. In control animals, the replacement solution contained chloride and bicarbonate in the same ratio as in the plasma; in the experimental (CDMA) animals the replacement solution contained bicarbonate as the only anion. In the control group, the procedure of hemofiltration coupled with isovolemic replacement caused no appreciable changes in plasma composition, urinary excretion rates, GFR, or tubular handling of bicarbonate. In the CDMA group, 106 +/- 8.4 mEq of chloride were removed in exchange for bicarbonate. A marked metabolic alkalosis resulted, plasma bicarbonate concentration increasing from 21.9 +/- 0.6 to 33.3 +/- 0.6 mEq/liter. The hemofiltration procedure itself, by design, did not alter sodium or fluid balance. Nevertheless, cumulative urinary sodium excretion increased over 2.5 hours by 23.0 +/- 6.4 mEq. A natriuresis of this magnitude is equivalent to a loss of ECF volume of approximately 200 ml. GFR did not change significantly. The rate of tubular reabsorption of bicarbonate increased significantly from 1209 +/- 82 to 1559 +/- 148 mu Eq/min in CDMA animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3669493 TI - Effect of dietary lipids on renal function in rats with subtotal nephrectomy. AB - Female rats with 1-3/4 nephrectomy were divided in two groups and pair fed for five weeks diets differing in their linoleic acid content. Five weeks after subtotal nephrectomy, values for glomerular filtration rate and renal plasma flow were significantly higher and the values of blood pressure significantly lower in rats fed a diet rich in linoleic acid. Systolic blood pressure averaged 156 +/- 5.6 mm Hg in high and 215 +/- 8.1 mm Hg in low linoleic acid-fed rats. Differences in the values of blood pressure between the two groups were observed three weeks after subtotal renal ablation and persisted throughout the period of observation. Inulin clearance averaged 0.89 +/- 0.07 ml/min in the high and 0.44 +/- 0.05 ml/min in the low linoleic acid group. Protein excretion in the urine was significantly less in rats fed the high linoleic acid diet (36.9 +/- 4.4 mg/24 hr) than in those fed the low linoleic acid diet (90.1 +/- 12.5 mg/24 hr). The weight of the remnant kidney five weeks after subtotal renal ablation was greater in rats fed a low linoleic acid diet as compared to those fed a high linoleic acid diet (P less than 0.05). Glomerular lesions were more severe in rats fed a low linoleic acid diet than in those fed a high linoleic acid diet. Feeding high linoleic acid diets to normal and subtotally nephrectomized rats increased the content of linoleic and arachidonic acid in renal cortex and medulla.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3669494 TI - Cathepsin B and L in nephron segments of rats with puromycin aminonucleoside nephrosis. AB - The intralysosomal proteinases, cathepsins B and L, were measured in microdissected segments of rat nephrons following a single injection of puromycin aminonucleoside (PAN). Z-Phenylalanyl-arginine-7-amido-4-methylcoumarin served as substrate. Enzyme activities, proteinuria, creatinine clearance and renal morphology were determined at specific time intervals following induction of PAN nephrosis. During the first three days following PAN injection, enzyme activities in S2 and S3 segments, protein excretion, creatinine clearance and appearance of the renal parenchyma resembled control animals. The enzyme activity in S1 segments was slightly decreased, but returned to control levels at day six after injection. Days four through eight post-PAN injection were characterized by a dramatic increase in protein excretion and an increase in cathepsin B and L activity in S2 and S3 segments of the proximal tubule. During days 9 through 15 enzyme activity decreased significantly in S2 segments despite continued proteinuria. Overt necrosis and cell injury were seen in the proximal tubule and probably account for the decrease in proteolytic activity. After day 15 following PAN injection, the level of proteinuria decreased, restoration of cathepsin activities occurred and a histopathologic picture of healing was present. The data suggest a positive relationship exists between stimulation of cathepsin B and L activity in S2 and S3 segments of the proximal tubule and increased protein filtration in PAN nephrosis. The increased enzyme activity reflects enhancement of the proteolytic capacity of the lysosomal system that is necessary for increased protein catabolism. PMID- 3669495 TI - Serum apolipoprotein profile of patients with chronic renal failure. AB - Serum concentrations of apolipoproteins A-I, A-II, B, C-I, C-II, C-III and E were determined by electroimmunoassay in 56 patients with chronic renal failure (CRF) in the predialytic phase. The results were compared with those obtained in asymptomatic normolipidemic subjects, patients with type IV hyperlipoproteinemia, and patients with type II diabetes mellitus. CRF patients had reduced concentrations of ApoA-I and ApoA-II, normal levels of ApoB and ApoC-I, and increased concentrations of ApoC-II and, in particular, of ApoC-III. There was a significant reduction in the levels of ApoE, especially in male patients. In comparison with type IV, hyperlipoproteinemic patients, CRF patients had lower concentrations of ApoA-I, ApoA-II, ApoB, ApoC-I and, particularly, ApoE; there was no difference in ApoC-III levels reflecting the hypertriglyceridemia common to both disorders. Similar but less marked differences were also found in comparison with type II diabetics. The findings suggest that in CRF, the accumulation of ApoC-III-enriched lipoprotein particles accompanied by a moderate hypertriglyceridemia may be caused more probably by an impaired catabolism than overproduction of triglyceride-rich lipoproteins. CRF patients with vascular disease tended to have higher serum concentrations of triglycerides, cholesterol and ApoB and lower ApoA-I/ApoC-III and ApoA-I/ApoB ratios than patients without vascular disease. PMID- 3669496 TI - Lithium clearance during the paradoxical natriuresis of hypotonic expansion in man. AB - Tubular sodium handling in humans undergoing hypotonic expansion due to the administration of antidiuretic hormone was studied using the clearance of lithium as an index of distal filtrate and sodium delivery. Clearance studies were performed in the morning in eight normal subjects before and on the fourth day of intranasal I-desamino-8-D-arginine vasopressin (dDAVP) administration. Fluid intake was kept constant at 25 ml/kg body weight. After dDAVP body weight increased (2.5 +/- 0.4 kg), plasma sodium fell (from 143 +/- 1 to 128 +/- 5 mmol/liter) and a progressive natriuresis developed. Sodium balance remained negative up to the second clearance study, when the cumulative sodium loss amounted to 148 +/- 96 mmol. Plasma renin activity fell significantly, but plasma aldosterone did not. Inulin clearance rose from 110 +/- 14 to 135 +/- 23 ml/min and lithium clearance from 30.9 +/- 7.6 to 48.9 +/- 15.1 ml/min. Fractional reabsorption of uric acid, phosphate and calcium decreased. Together these changes suggest that the negative sodium balance in hypotonic expansion with dDAVP results from increased filtered sodium load, decreased fractional reabsorption in the proximal tubules, and increased distal delivery. Estimated fractional reabsorption in the distal nephron remained unaltered. The plasma concentration of lithium, of which 10.8 mmol was ingested on the eve of the clearance studies, was not lower during the dDAVP-clearance study. This indicates that the tubular adaptations mentioned are present intermittently, in particular during daytime. PMID- 3669497 TI - Role of growth hormone in the amino acid-induced acute rise in renal function in man. AB - To examine whether plasma growth hormone is necessary for the amino acid-induced rise in effective renal plasma flow (ERPF, PAH clearance) and GFR (inulin clearance), arginine HCl, 500 mg/kg, was infused for 30 minutes into eight normal and six growth hormone-deficient individuals. During infusion, ERPF increased in the normal and growth hormone-deficient subjects by 28.9 +/- 11.4 SD-% (P less than 0.01) and 46.5 +/- 14.4% (P less than 0.001). GFR rose by 23.7 +/- 5.9% (P less than 0.05) and 42.7 +/- 29.1% (P less than 0.001) in the two groups. Plasma growth hormone rose only in the normal subjects, while glucagon increased in both groups. Infusion of arginine HCl, 200 mg/kg, into normals increased ERPF and GFR without increasing plasma osmolality. Lower arginine doses essentially did not affect ERPF, GFR, growth hormone, or glucagon. Infusion of D-glucose into normals raised plasma osmolality as high as with arginine HCl, 500 mg/kg, but increased ERPF only slightly and not GFR; D-glucose infusion caused a delayed rise in growth hormone that was unassociated with an increase in ERPF or GFR. An infusion of ammonium chloride with sodium chloride, which provided an amount of chloride similar to the 500 mg/kg arginine HCl dose, did not change ERPF and GFR; this suggests that the chloride load did not cause the altered renal hemodynamics stimulated by arginine HCl. These findings indicate that neither normal plasma growth hormone levels nor a rise in growth hormone mediates the arginine-induced acute increase in ERPF or GFR. This effect is also not due to the osmolar load but could be caused by the rise in plasma glucagon. PMID- 3669499 TI - Kitasatosporia, a genus of the order Actinomycetales. PMID- 3669498 TI - Serum magnesium level and arterial calcification in end-stage renal disease. AB - In this paper we examine the relationship of serum levels of Ca, P, Ca X P, P/Mg, Ca X P/Mg, alkaline phosphatase, and iPTH to the development or regression of peripheral arterial calcifications (AC) in 44 patients with end-stage renal disease being treated by continuous ambulatory peritoneal dialysis (CAPD). The average follow-up time of this longitudinal study was 27 months (range 6-67 months). The patients were divided into two groups: Group A, those showing one or more increases of AC; and Group B, patients in whom AC either did not develop or decreased during the follow-up. There was no significant difference in serum Ca, P, Ca X P, alkaline phosphatase of iPTH between the two groups. However, serum Mg was significantly lower in Group A than in Group B (2.69 +/- 0.52 and 3.02 +/- 0.51 mg/dl, respectively, P less than 0.001), while the ratios P/Mg and Ca X P/Mg were significantly higher. Our observations suggest that in end-stage renal disease hypermagnesemia may retard the development of arterial calcifications. PMID- 3669500 TI - Taxonomic study of luminamicin-producing actinomycete strain OMR-59. PMID- 3669501 TI - Antitumor activity of a crude fucoidan fraction prepared from the roots of kelp (Laminaria species). PMID- 3669502 TI - [The rabbit P-like factor]. PMID- 3669503 TI - [Initial experiences with primary silicone oil administration into the vitreous cavity in complicated eye injuries]. AB - The authors report on five cases of severe perforating injury of the posterior segment which were initially treated by vitrectomy and subsequent filling of the vitreous cavity with silicone oil. The results so far have been satisfactory in all eyes. The advantages of the method (e.g., tamponade of retinal tears, facilitation of postoperative laser treatment) are emphasized and possible side effects are discussed. PMID- 3669504 TI - [Diplopia, enophthalmos and motility disorders in isolated orbital floor fractures]. AB - In cases of pure blow-out fracture with unequivocal clinical symptoms (limitation of movement of the globe, dislocation and/or enophthalmos) and confirmed X-ray findings, early surgery is the treatment of choice. In cases where the clinical findings are less pronounced, a "wait-and-see" policy, keeping the patient under observation, seems appropriate for the sake of avoiding surgical trauma. Coronal computerized tomography offers advantages in cases where the diagnosis is questionable. PMID- 3669505 TI - [Theory of the T-incision of the cornea]. AB - T-incisions are used for surgical correction of moderate corneal astigmatism. No theoretical models to explain the curvature changes have yet been described in the literature. This paper describes a biomechanical model intended to facilitate understanding of the effect of corneal flattening. The incisions cause the stress inside the untouched layers of the cornea to increase. Subsequently the strain also increases and so the curvature radius of the meridian perpendicular to the incision also increases. The calculated changes in the refractive power of the cornea are in good agreement with clinical data. The influence of the depth of the incision is explained quantitatively. Secondary parameters, such as the length of the incision and the size of the optical zone, are discussed. PMID- 3669506 TI - [Experimental studies of local therapy of Candida keratomycosis with amphotericin B]. AB - The efficiency of Amphotericin B drops was studied using a newly developed keratomycosis model (defined strain Candida albicans DSM 70010, which leads reproducibly to a corneal infection with descemetocele without prior local or systemic immunosuppression in the rabbit). Penetration of the drug (administered ten times a day) into the cornea and aqueous humor was only demonstrated after abrasion of the corneal epithelium. Three groups were studied: (I) therapy with abrasion, (II) therapy without abrasion, and (III) a control group. Both clinically (descemetocele or perforation, hypopyon) and with regard to microbiology (reculture of Candida) the results obtained in Group I were significantly better than those obtained in Group II (p less than 0.001). Repeated corneal abrasion is therefore recommended for treatment of Candida keratitis with Amphotericin B. PMID- 3669507 TI - [Strictly focal siderosis bulbi posterior]. AB - A 54-year-old white male with no history of trauma presented with subjective visual deterioration in the left eye. A choroidal lesion with brownish pigmentation and retinal detachment around it was found, located nasally of the optic disk. The lesion was clinically diagnosed as a malignant melanoma and the eye was therefore enucleated. Histologic examination revealed a strictly focal iron foreign body granuloma located intra- and subretinally, which had led to a localized siderosis as a result of connective-tissue encapsulation. It follows from this that an intramural iron foreign body must also be included in the differential diagnosis of malignant melanoma. The encapsulation of an iron foreign body located in the retina and choroid, with focally circumscribed ocular siderosis and glial overgrowth of the retinal defect can, in exceptional cases, justify a cautious approach toward splinters embedded in the posterior pole. PMID- 3669508 TI - [Subretinal cysticercosis]. AB - This paper communicates the history of a case of subretinal cysticercosis in the left eye of a 73-year-old female patient. The only subjective complaints were slightly blurred vision in the affected eye. Serological findings in the blood (Agar-Gel precipitation; IFAT; ELISA) and the aqueous humor were negative. However, according to the literature false-negative serological findings are not uncommon. A stool examination for worm eggs or tapeworm segments was also negative. The remaining lab findings, including hemogram and immunoelectrophoresis, were also normal. Neurocysticercosis was ruled out by clinical and roentgenologic (CCT) diagnosis. As the patient declined treatment with praziquantel, a modern treatment for tapeworm, photocoagulation of the cysticercus was performed at two sittings, first peripheral demarcation and subsequently central coagulation. PMID- 3669509 TI - [Determination of visual acuity using optokinetic nystagmus. A newly developed instrument based on Gunther's principle]. AB - The two most important methods used for objective determination of visual acuity are those of Ohm-von Romberg and Gunther. A newly developed instrument based on Gunther's principle is described which combines the advantages of both methods. Using a Leitz projector and a specially designed accessory unit, a constantly moving screen of dots measuring 64 X 64 cm is projected. The setting was standardized on the basis of 358 eyes with visual acuities ranging from finger counting to 1.0. The correlation between the measured distance (from screen to patient) at which an optokinetic nystagmus was just induced and visual acuity was r = 0.98 over the entire visual acuity range. The visual acuity to be expected can be read off from the diagrams or a table, with a scatter range of +/- 1 sigma, +/- 2 sigma, or +/- 3 sigma. The relevant literature is discussed. Replication of the accessory unit described can be recommended. PMID- 3669510 TI - [A tracker for ophthalmology]. AB - Real-time tracking of eye movements offers a solution to various problems in ophthalmology. Different types of image analysis and processing techniques is discussed and an advanced pattern recognition eye-tracking system has been developed; it can track a retinal target (in real time) under conditions typical for ophthalmologic examination and therapy. The sensor is a modified low-light video fundus camera. An example illustrates how a retinal target is automatically found again when it has been "lost". PMID- 3669511 TI - [Visual hand-space localization after idiopathic intracerebral hemorrhage. I. Provocation test]. PMID- 3669514 TI - [Evaluation of the efficiency of the central nervous system using the test of visual hand localization with regard to the prevention of hand injuries]. PMID- 3669513 TI - [Visual hand-space localization after idiopathic intracerebral hemorrhage. III. Examination of patients without changes in the visual field]. PMID- 3669512 TI - [Visual hand-space localization after idiopathic intracerebral hemorrhage. II. Examination of patients with visual field changes in both eyes]. PMID- 3669515 TI - [Effect of a magnetic field on visual space localization]. PMID- 3669516 TI - [Results of the treatment of strabismus in children in relation to a new statistical classification. I. The status of binocular vision]. PMID- 3669517 TI - [Results of the treatment of strabismus in children in relation to a new statistical classification. II. The status of visual acuity]. PMID- 3669518 TI - [Results of the treatment of strabismus in adults in relation to a new statistical classification. I. The status of binocular vision]. PMID- 3669519 TI - [Results of the treatment of strabismus in adults in relation to a new statistical classification. II. The status of visual acuity]. PMID- 3669520 TI - [A case of pseudoparetic strabismus]. PMID- 3669521 TI - [A case of strabismus after pterygium surgery]. PMID- 3669522 TI - [Current possibilities of electrophysiological diagnosis in relation to personal studies]. PMID- 3669523 TI - [Effect of cobalt on the distribution and composition of lipids in the retina and optic nerve of guinea pigs]. PMID- 3669524 TI - [Proceedings of the 15th Retinological Symposium. Poznan, 22-23 May 1986. II]. PMID- 3669525 TI - [Effect of ultrasound on the ultrastructure of frog retina]. PMID- 3669526 TI - [Fluorescein angiography of the rabbit fundus oculi]. PMID- 3669528 TI - [Direct glare in studies on visual evoked potentials]. PMID- 3669527 TI - [Proteins of the vitreous body. II. Biochemical analysis]. PMID- 3669529 TI - [Electrodiagnosis of retinitis pigmentosa in the light of our cases]. PMID- 3669530 TI - [Corticotherapy in the pre- and postoperative periods of retinal detachment]. PMID- 3669531 TI - [Ophthalmotlibotherapy in selected disorders of retinal circulation]. PMID- 3669532 TI - [Treatment of retrolental fibroplasia in children]. PMID- 3669533 TI - [Late results of laser coagulation in patients with diabetes mellitus]. PMID- 3669534 TI - [Comparison of late results of conservative treatment and laser coagulation of central serous chorioretinopathy]. PMID- 3669535 TI - [Use of SF6 in microsurgery of retinal detachment in children]. PMID- 3669536 TI - [A case of maculopathy caused by an optic disk pit]. PMID- 3669537 TI - [Adrenergic compounds and the intraocular pressure]. PMID- 3669538 TI - [Effect of prostaglandins and sympathomimetic amines on the production and chemical composition of the aqueous humor]. PMID- 3669539 TI - [Reaction of the retinal vascular system to measured physical exertion]. PMID- 3669540 TI - [Changes in the visual system of patients on long-term hemodialysis]. PMID- 3669541 TI - [Drusen of the optic disk in children in computerized tomography]. PMID- 3669542 TI - [Analysis of occupational injuries of the visual system in the 10-year experience of the Ophthalmological Department in Sosnowiec]. PMID- 3669543 TI - [Results of the treatment of blunt injuries of the eye causing intraocular hemorrhage in children hospitalized 1969-1984]. PMID- 3669544 TI - [Diagnosis and treatment of orbital rhabdomyosarcoma in children]. PMID- 3669545 TI - [Ocular form of Toxocara canis infection in children]. PMID- 3669546 TI - [Function of the visual system in traumatic cataract in the light of progress in its therapy]. PMID- 3669547 TI - [Lensectomy in the treatment of traumatic cataract in children]. PMID- 3669548 TI - [Late results of Cairns' trabeculectomy in the treatment of primary glaucoma]. PMID- 3669549 TI - [A case of ocular toxocariasis treated by xenon photocoagulation]. PMID- 3669550 TI - [A case of squamous cell carcinoma of the cornea]. PMID- 3669552 TI - [Trichomegalia (hyperciliosis)]. PMID- 3669551 TI - [Pierre Robin syndrome with congenital glaucoma and high myopia]. PMID- 3669553 TI - [Shock]. PMID- 3669554 TI - [Septic shock]. PMID- 3669555 TI - [Heart function and shock]. PMID- 3669556 TI - [Lung function in shock]. PMID- 3669557 TI - [Shock. Discussion on the subject of pathophysiology and pathomechanisms]. PMID- 3669559 TI - Hereditary angioedema and aortitis. AB - A 28-year-old male with hereditary angioedema died of an extensive stroke. Autopsy revealed cicatricial aortitis with narrowing of the coronary ostia, myocardial infarctions, and a left ventricular mural thrombus. There was neither acute inflammation of the aorta nor systemic vasculitis. A possible association of the aortitis with the hereditary angioedema is discussed. PMID- 3669558 TI - Effect of renal formic acid excretion on urinary calcium and ammonia concentrations. AB - Intragastrically given formic acid (300 mg/kg) caused high urinary formate concentrations in rabbits with continuously decreasing urinary pH up to 30 h after the dose despite the fact that the bulk of the formate in urine was excreted within 15 h. Urinary formic acid inversely correlated to urinary ammonia in 23 workers occupationally exposed to methanol or formic acid so that the delayed urinary acidification could have been caused by the effects of formate on renal ammonia genesis. The urinary excretion of calcium was linearly correlated to the formic acid excretion by the same subjects. The latter effect may have been caused by interferences with the tubular reabsorption mechanisms for the calcium ion. PMID- 3669560 TI - [Asthma attacks in low-dose preventive use of heparin in a male with femoral neck fracture and aortic aneurysm]. AB - Hypersensitivity reactions to heparin preparations with a wide spectrum of clinical manifestations have been reported frequently in the past, but are a rarity now. A 88 year old man was admitted for physical therapy of a collum femoris fracture. Treatment with a diuretic, Reserpine and Verapamil was continued. Chest x-ray revealed a large thoracic aortic aneurysm. From the 12th to the 18th day of low dose heparin prophylaxis with calcium heparin, 7500 U twice daily, at least eight attacks of asthma or cyanosis were observed, starting about two hours after heparin injection. The last attack began suddenly with wheezing, tachypnoea and cough and was associated with apprehension, a sudden blood pressure increase and severe cyanosis. Ventilation improved with oxygen and a beta 2-stimulator, but hypertension and cyanosis lasted for three hours. After discontinuation of heparin no further attacks occurred. Causes other then heparin could not be found. Despite the use of porcine mucosa heparin, avoidance of preservatives and use of low doses a hypersensitivity reaction occurred in our case. The delayed onset after preceding subcutaneous application as well as difficulties in separating the reaction from complications of underlying disease may delay heparin discontinuation. PMID- 3669561 TI - Monoclonal antibodies against rat brain protein kinase C. PMID- 3669562 TI - [Variants of the course and individual therapy of bronchial asthma]. PMID- 3669563 TI - [Herpes zoster in patients with hematologic diseases]. PMID- 3669564 TI - [Lymphosarcoma of the thyroid gland]. PMID- 3669565 TI - [Mammography in the diagnosis of breast diseases]. PMID- 3669566 TI - [2 cases of mucoviscidosis in adults]. PMID- 3669568 TI - [Differential diagnosis of neurocirculatory asthenia]. PMID- 3669567 TI - [Use of plasmapheresis in patients with mechanical jaundice as a complication of myocardial infarction]. PMID- 3669569 TI - [Use of corticosteroid preparations in dermatoses]. PMID- 3669570 TI - [Mechanism of compensation of left ventricular function in patients with acute myocardial infarction]. PMID- 3669571 TI - [Theory of the development of nonspecific ulcerative colitis (an attempt at establishing a model)]. PMID- 3669572 TI - [Changes in serum ceruloplasmin level in patients with acute myocardial infarction]. PMID- 3669574 TI - [Problem of classification of various forms of bronchial asthma]. PMID- 3669573 TI - [Changes in the levels of gonadotropic and sex hormones in men during post infarction rehabilitation]. PMID- 3669575 TI - [Interrelation between adenine/nucleotides and fatty acids in patients with rheumatic heart disease with cardiac insufficiency]. PMID- 3669576 TI - [Tuberculosis not recognized during patients' lives]. PMID- 3669577 TI - [Determining allergen-specific IgE in nasal secretion in the diagnosis of pollinosis]. PMID- 3669578 TI - [Chemiluminescence in determining the antiradical activity of the blood serum of patients with bronchial asthma]. PMID- 3669579 TI - [Respiratory disorders during night sleep in patients with chronic bronchitis]. PMID- 3669580 TI - [Outcome of destructive pneumonia treated in a hospital]. PMID- 3669581 TI - [Selective hypoaldosteronism after using heparin in patients with chronic glomerulonephritis]. PMID- 3669582 TI - [Complex radioisotope examination of patients with thyroid diseases]. PMID- 3669583 TI - [Errors in the diagnosis of leukemia]. PMID- 3669584 TI - Surgical treatment for upper gastric cancers. PMID- 3669585 TI - A comparison of crystallinity of calculi by X-ray diffraction line broadening analysis for bilateral and concurrent submandibular sialolithiasis. PMID- 3669586 TI - A benign cystic teratoma in the floor of the mouth of an infant--a case report. PMID- 3669587 TI - Assay for lipid peroxide content in mitochondria by the thiobarbituric acid reaction. PMID- 3669588 TI - A case of neurilemoma of the palate. PMID- 3669589 TI - Cardiac rhabdomyoma in a newborn infant--the diagnostic role of echocardiography. PMID- 3669590 TI - [Chronic bronchitis]. PMID- 3669591 TI - [Measures for the prevention of AIDS transmission]. PMID- 3669593 TI - [AIDS and the safety of blood and blood products. Recommendations by a group of experts]. PMID- 3669592 TI - [Psychosocial care of AIDS patients. A voluntary care giver in AIDS relief]. PMID- 3669594 TI - [Central venous and arterial puncture in intensive care and emergency patients. Puran catheter with retrograde valve]. PMID- 3669595 TI - [Cimetidine]. PMID- 3669596 TI - [Prick injuries of the fingers--small accident--big consequences]. PMID- 3669597 TI - Experimental diabetes in cats induced by partial pancreatectomy alone or combined with local injection of alloxan. AB - Experimental diabetes was produced in cats by partial pancreatectomy using a short and technically simple surgical procedure. Electrocautery was used to cauterize pancreatic blood vessels and seal free edges of remaining pancreatic tissue to prevent secretion of pancreatic enzymes into the peritoneal cavity. In a second group of animals, partial pancreatectomy was followed by local injection of alloxan into an arterial branch of the cranio-mesenteric artery. The combined procedure resulted in diabetes mellitus in 100% (8 of 8) animals as compared to only 70% (14 of 20) in those subjected to partial pancreatectomy alone. In addition, the alloxan-pancreatectomized cats had a reduced latency period prior to onset of chronic hyperglycemia (4.8 days compared to 19.3 days postoperatively in pancreatectomized cats). The diabetic cats were maintained in poor metabolic control (blood glucose approximately 300 mg/dl) by daily injections of low doses of long-acting insulin. Pancreatic enzyme supplementation was given by mouth. Weight changes and blood glucose levels were monitored carefully to maintain the health of the animals while keeping them in poor metabolic control. PMID- 3669598 TI - Rapid induction of vitamin A deficiency in rabbits. AB - Clinical and biochemical evidence of vitamin A deficiency was produced in rabbits as early as 4-5 weeks after weaning to a vitamin A deficient diet from dams maintained during lactation on the deficient diet. Mean serum retinol levels at the time of weaning for the deficient dams were 25 +/- 6 micrograms/dl compared with 74 +/- 8 micrograms/dl for the controls. Five weeks after weaning, 25% of pups fed the vitamin A deficient diet had ocular lesions characterized by the accumulation of sloughed epithelium on the cornea. At this time, mean serum values of the pups were 10 +/- 4 micrograms/dl for the deficient group and 73 +/- 8 micrograms/dl for the controls. Evidence of critically depleted liver stores was documented in the deficient rabbits by an elevated relative dose response test (54 +/- 18%) that did not occur in the control group (6 +/- 5%). Although food consumption was similar, weight gain was lower in the deficient group when compared to the control group. PMID- 3669599 TI - Tylosin concentrations in rat serum and lung tissue after administration in drinking water. AB - Tylosin has low in vitro minimum inhibitory concentrations against Mycoplasma pulmonis but levels attainable in rat serum or lung tissue have not been reported previously. Tylosin levels in rat serum and lung tissue were determined after administration of tylosin in the drinking water. Rats were given water mixed with a commercially available preparation of tylosin base, vitamins, and dextrose. Although the calculated amount of tylosin added to the water was intended to provide a concentration of 500 mg/L, the concentration attained was 70-79 mg/L and decreased rapidly with time. Bioassay of serum and lung tissue after 1-10 days of continuous medication revealed no detectable tylosin concentrations (less than 0.1 microgram/ml) in serum, while lung tissue from all treated rats contained tylosin (means = 10.69 +/- 2.66 micrograms/gm tissue, range = 3.93 to 18.14, n = 59). These concentrations are over ten times the reported in vitro minimum inhibitory concentrations against M. pulmonis which indicates that tylosin administration in drinking water may be useful in the treatment of M. pulmonis pneumonia in rats. PMID- 3669600 TI - Dichlorvos toxicity in the white-footed mouse (Peromyscus leucopus). AB - The organophosphate pesticide, dichlorvos (DDVP), is used commonly to control ectoparasites in laboratory rodents colonies. This compound is relatively nontoxic to Mus musculus at dosages several times the therapeutic level. However, usage of a similar therapeutic level in the white-footed mouse (Peromyscus leucopus) resulted in substantial mortality. To determine whether P. leucopus is more susceptible than M. musculus to the toxic effects of DDVP, both species were exposed to 0, 3 and 6 g of pelleted DDVP per cage. In a subsequent experiment, P. leucopus were exposed to 0 and 1 g of DDVP per cage. Mortality was not observed in M. musculus at any dosage level. P. leucopus exposed to 1, 3 and 6 g of DDVP exhibited mortalities of 3%, 20% and 53%, respectively. Mean serum cholinesterase in P. leucopus exposed to 3 and 6 g of DDVP was 0.35 and 0.21 U/ml as compared to 3.13 U/ml in unexposed mice. The analogous values for M. musculus were 1.60 and 0.79 U/ml while the level in unexposed mice was 6.79 U/ml. In the second experiment, mean serum cholinesterase in P. leucopus exposed to 1 g of DDVP was 0.32 U/ml as compared to 2.33 U/ml in unexposed mice. Histopathology revealed no lesions in the brain, liver or kidneys. The increased susceptibility of P. leucopus to the toxic effects of DDVP was related to the lowered serum cholinesterase. This indicates that DDVP should not be used for control of ectoparasites in P. leucopus. PMID- 3669601 TI - Reversal of ketamine/xylazine anesthesia in the rabbit with yohimbine. AB - Ketamine and xylazine used in combination have been shown to be effective, easily administered, cost efficient agents for surgical anesthesia in the rabbit. The effect of xylazine on the central nervous system has been shown to be mediated through alpha-2 adrenergic receptors. Yohimbine, an alpha-2 adrenergic antagonist has been shown to reverse xylazine induced depression and partially antagonize ketamine in other species. We evaluated the antagonistic effect of yohimbine on ketamine/xylazine anesthesia in the rabbit. Six New Zealand White rabbits were anesthetized with intramuscular ketamine (50 mg/kg) and xylazine (10 mg/kg) to establish baseline parameters including respiratory rate, heart rate, and palpebral, pedal and postural reflex activity. Fourteen days later each rabbit was subjected to the same anesthetic regimen followed 30 minutes later by the intravenous administration of yohimbine (0.2 mg/kg). The duration of anesthesia estimated by the time elapsed between the loss and return of the palpebral reflex was reduced in the yohimbine treated trial (means = 29.7 +/- 1.9 minutes) compared to the control trial (means = 67.0 +/- 13.5 minutes). The palpebral reflex returned within 5 minutes following yohimbine treatment. Our results indicated that yohimbine is an effective antagonist of ketamine/xylazine anesthesia in the rabbit. Yohimbine decreases anesthetic duration after intravenous administration and also may aid in the control of undesirable anesthetic effects and overdosage. PMID- 3669602 TI - Weibel-Palade bodies are not reliable ultrastructural markers for mouse endothelial cells. PMID- 3669603 TI - d-Limonene: an effective vasodilator for use in collecting rabbit blood. PMID- 3669604 TI - Streptococcus suis type 2 valvular endocarditis and sepsis combined with multiple enteric infections in a pig treated continuously with cyclosporine after experimental intestinal transplant. PMID- 3669605 TI - Pemphigus vulgaris in a baboon. PMID- 3669606 TI - Spontaneous hydrocephalus in baboons. PMID- 3669607 TI - Pentastomiasis in captive monkeys. PMID- 3669608 TI - Treatment of Trichosomoides crassicauda in laboratory rats using ivermectin. PMID- 3669609 TI - Chronic renal artery catheterization for infusion studies in the conscious rabbit. PMID- 3669610 TI - A simple system of feeding bottles for the study of zinc deficiency and ethanol consumption in the rat. PMID- 3669611 TI - Liver lobe torsion in a rabbit. PMID- 3669612 TI - Abstracts of scientific papers, platform and poster presentations. Thirty-eighth annual meeting, American Association for Laboratory Animal Science. Denver, CO, November 8-12, 1987. PMID- 3669613 TI - Coexpression of intermediate filament polypeptides in human fetal and adult tissues. AB - Tissues from human fetuses (12 to 14 weeks) were studied by using immunohistochemical methods, with special emphasis on coexpression of intermediate filaments. Well-characterized antibodies, monoclonal as well as polyclonal were used. Indirect immunoperoxidase staining disclosed simultaneous expression of cytokeratin and vimentin, or vimentin and desmin in several tissues, whereas some other tissues coexpressed three classes of intermediate filaments, i.e., cytokeratin, vimentin, and desmin. Coexpression of cytokeratin and vimentin was seen in immature tubules of the kidney localized in the blastema and in one case in a small area of the epithelium of the tongue. Coexpression of vimentin and desmin was found in stromal cells of the medulla of the kidney, in stromal cells of the decidua (maternal tissue) and in muscle cells in blood vessels of small intestine, kidney and decidua. Coexpression of cytokeratin, vimentin, and desmin was present in mesothelial cells of serosa, pleura and pericardium, in stroma of umbilical cord and placental villi, in muscle cells of small intestine, tongue, and heart, and in muscle cells of blood vessels of lung, heart, umbilical cord, and placental villi. Mesothelium and reactive submesothelial stroma cells also coexpressed three classes of intermediate filament polypeptides. In some cases, immunoperoxidase results were confirmed by double labeling immunofluorescence microscopy or by immunoblotting experiments. The results of this study indicate that coexpression of different types of intermediate filaments is a more general phenomenon in fetal tissues than previously realized and it also occurs in some reactive proliferative lesions in the adult. PMID- 3669614 TI - Comparison of chromogranins A, B, and secretogranin II in human adrenal medulla and pheochromocytoma. AB - Human phenochromocytomas were analyzed for the presence of chromogranins A and B and secretogranin II (chromogranin C). In immunohistochemistry, a positive staining of the tumor cells was observed for all three antigens. For immunoblotting, a method had to be developed which prevented proteolytic degradation of the antigens. Boiling homogenates of freeze-dried tissues achieved this and in addition, led to a significant enrichment of these secretory proteins. All three antigens could be identified in the tumor by immunoblotting. Chromogranin A and B were the major components present in about equal amounts. The relative concentration of all these antigens in the tumors was similar to those in adrenal medulla. A method involving high pressure liquid chromatography is presented which allows the separation of the human chromogranins/secretogranins. PMID- 3669615 TI - Gentamicin-induced loss of basolateral surface area of rat proximal convoluted tubules. AB - This study was performed to find the quantitative relationship between basolateral surface alterations of proximal convoluted tubules (PCT) and renal failure in 26 Fisher 344 rats receiving 20 mg/kg of gentamicin twice daily up to 28 days. They were sacrificed on day 14 (renal failure, 13 rats) and day 28 (recovering, 13 rats). Control rats were used for morphologic studies (19) and serum creatinine studies (6 of 19). PCTs (14th and 28th day) were graded as to severity with transmission electron microscopy into grades 1 (normal-mild injury), 2 (moderate injury) and 3 (severe injury) using brush border and basolateral surface alterations. Scanning electron microscopy confirmed these grades using kidney slices and isolated tubular cells. With scanning electron microscopy greater than 3400, PCTs were graded and counted from 14th and 28th day kidneys, day 14 (grade 1, 18%, grade 2, 22%, and grade 3, 60%), day 28 (grade 1, 89% grade 2, 4%, and grade 3, 7%). The basolateral surface contour lengths (BSCL) per length of underlying tubular basement membrane were measured using a computer assisted digitizer on transmission electron microscopy prints. Control PCTs had a mean BSCL of 268 microns, SD +/- 79, SE +/- 19 per 40 microns of tubular basement membrane. Likewise, the mean BSCL of grade 1 tubules measured 249 microns, SD +/- 87, SE +/- 21; the mean BSCL of grade 2 tubules was 125 microns, SD +/- 40, SE +/ 9 and grade 3 tubules BSCL was 90.5 the BSAI values showed that the 14th day rats had 28% of control BSAI and 28th day rats 80%. 2, grade 3, p less than 0.005). Squaring the mean BSCL of each group gave a basolateral surface area index (BSAI). Combining the percentage of the 3 grades of tubules of 14th and 28th day rats with the BSAI values showed that the 14th day rats had 28% of control BSAI and 28th day rats 80%. Mean serum creatinines (milligrams/deciliters) were: 14th day, 0.86; 28th day, 0.54; and control, 0.39. These data indicate loss of function correlates with lower BSAI (decreased basolateral surface area). PMID- 3669617 TI - Adolescent pregnancy and unfinished developmental tasks of childhood. AB - Adolescent pregnancy may occur when developmental needs have not been met adequately during earlier childhood stages. Reasons adolescents give for becoming pregnant may indicate which developmental needs were not met. Once developmental needs have been identified, professionals can help the adolescent and her child by tailoring interventions to fill gaps that occurred during earlier stages of development. This article explores the potential relationship between adolescent pregnancy and unfinished developmental tasks of childhood. Implications for intervention are addressed. PMID- 3669616 TI - L-azetidine-2-carboxylic acid retards lung growth and surfactant synthesis in fetal rats. AB - Maturation of the pulmonary epithelium during late fetal development is controlled at least in part by the underlying fibroblasts. To further investigate this cellular interdependence and the role of collagen in type 2 cell differentiation, we studied the effects of inhibiting fibroblast function in vivo by injecting the proline analog L-azetidine-2-carboxylic acid (LACA) to timed pregnant rats, and examining changes in cell proliferation and surfactant synthesis in fetal lungs. LACA (200 mg/kg) was injected twice daily for 2 days and rats were killed 2 days later at days 19, 20, 21, and 22 of gestation. Fetal lung weight and DNA content were about 50% of controls, hydroxyproline per dry weight was reduced and by electron microscopy, there appeared to be less fibrillar collagen in the lung. Autoradiography after [3H]thymidine pulse labeling showed reduced cell proliferation on days 19 and 20 mainly due to lower fibroblast growth with a smaller reduction in epithelial labeling. Lung development in LACA-treated rats was retarded; air sacs were slow to open, epithelial cells retained glycogen longer and fewer cells developed lamellar bodies compared with age-matched controls. There was a reduction in the incidence of epithelial-interstitial cell contacts at day 20 only. Measurements of disaturated phosphatidylcholine showed a 50% reduction per dry weight and a lower disaturated phosphatidylcholine/lipid ratio after LACA. The results indicate that LACA administration in vivo slows fibroblast growth and greatly reduces fibrillar collagen deposition with an accompanying reduction in pulmonary surfactant. This suggests that secreted matrix influences growth and differentiation of the alveolar epithelium. PMID- 3669618 TI - Three applications of the Role Delineation Project 1985 Curriculum Framework. AB - Colleges are beginning to use the Role Delineation Project Curriculum Framework for curricular reform at the graduate and undergraduate levels. This paper describes the efforts of three universities to revise their curricula based on the Framework. At Towson State University, it is being used with other national and state standards to assess health educators. At the University of Alabama at Birmingham, it provided the structure by which the faculty determined the competence of exiting health majors. At the University of Georgia, it was used in strategic planning and graduate education restructuring. The Framework, while lacking material in certain professional development areas, provides the structure for departments to begin the process of health education curricula reform. PMID- 3669619 TI - Celebrating 40 years of the Framingham Heart Study. AB - The 40th anniversary of the National Heart, Lung, and Blood Institute provided an opportunity to pay tribute to the Framingham Heart Study, the landmark epidemiological study that examined longitudinally the development of coronary heart disease in a general adult population. The Framingham Heart Study pioneered the concept that certain items, known eventually as risk factors, were associated with the development of heart disease. The concept of risk factors spawned a new generation of studies aimed at intervening to reduce the impact of risk factors on health. As part of its celebration of the 40th anniversary--and the 100th anniversary of the National Institutes of Health--the National Heart, Lung, and Blood Institute, sponsored poster and essay contests for Framingham, Mass., students to commemorate the event. This article recaps the history of the Framingham Heart Study, describes the poster and essay contests, and outlines current and future involvement of the NHLBI in school health research. PMID- 3669620 TI - Comprehensive prenatal care for pregnant teens. AB - Comprehensive teen-age pregnancy programs have endeavored to reduce associated morbidity and mortality. Positive results have been reported, but significant findings have been elusive. This article describes a rural program and compares the pregnancy outcomes of 60 matched nonparticipants. The study determined a relationship existed between participation in the program and maternal complications, birth weight, gestational age, Apgar score, and perinatal morbidity. Participants were matched perfectly on socioeconomic status and age, and near-perfectly on year of delivery. Subjects also were matched on ethnicity, marital status, and residence. Participation and fewer maternal complications of anemia, infections, and eclampsia were significantly related. Remaining dependent variables were not significantly related, but low birth weight (six vs. 11) and prematurity (six vs. nine) were lower for participants. Suggestions for researchers of teen pregnancy programs are included. PMID- 3669622 TI - A consumer health products contest. PMID- 3669621 TI - Schools, communicable disease, and the law. PMID- 3669623 TI - Enhancing the coping skills of mothers with learning disabled children. PMID- 3669625 TI - Review of occupational health and hygiene information resources in the United Kingdom. PMID- 3669624 TI - A study of naproxen sodium and ibuprofen in primary dysmenorrhoea. PMID- 3669626 TI - Employment of diabetics in a Post Office region. PMID- 3669627 TI - The limits of science in communication disorders. AB - Science is a powerful tool when it addresses the kinds of questions it was designed to answer, but there are also important questions in communication disorders that fall outside the limits of science. Three such areas are discussed: Questions concerning social and personal values, questions that call for logical rather than scientific endeavors, and questions that should not be posed because we already know the answers and would not be influenced by contrary findings. PMID- 3669628 TI - Effects of simulated conductive hearing loss on dichotic listening performance for digits. AB - This experiment assessed conditions under which simulated conductive hearing loss would affect performance on a digit dichotic test. Losses were simulated by insertion of EAR plugs, and each subject served as his/her own control. Performance for left ear plugged and right ear plugged conditions was compared with performance in a normal hearing condition (neither ear plugged). Conductive losses did not affect dichotic performance at test intensities 12 dB above the "knees" of monotic performance-intensity functions for the plugged ears (95% correct points) but did affect dichotic performance for some listeners at intensities that were within 8 dB of the monotic knees. PMID- 3669629 TI - An assessment of cognitive abilities in hearing and hearing-impaired preschool children. AB - There have been many investigations of cognitive development in older hearing impaired children, but few with preschool hearing-impaired children. The performance of 40 hearing and 40 hearing-impaired children of preschool age (2 1/2 to 5 1/2 years) was compared on five nonverbal cognitive tasks and three subtests from the Perceptual Performance subscale of the McCarthy Scales of Children's Abilities (1972). For this set of tasks there was a significant effect of age consistent with a developmental change. A one-way MANCOVA on all dependent measures with age as the covariate revealed no significant differences between the hearing-impaired and hearing children. The results suggest that despite a deficiency in language abilities, the cognitive development of young hearing impaired children is comparable to that of hearing children of the same age. PMID- 3669630 TI - Word knowledge acquisition in retarded children: a longitudinal study of acquisition of a complex linguistic structure. AB - The purpose of this 1-year longitudinal study was to investigate the acquisition of word knowledge by 18 retarded children. The words examined were relevant to the correct interpretation of sentences of the type "John is eager/easy to please." The interest was in how retarded children acquire the subcategorization features of these words. The study revealed that retarded children, like intellectually normal children, show great inconsistencies in their interpretations of specific words during an intermediate stage of performance on this linguistic structure; but the errors by retarded children, in contrast to those by intellectually normal children, were highly correlated with word frequency. The results are interpreted in representations. Interpretations based on gradual acquisition of word knowledge are contrasted with a reorganization theory, and a synthesis of the two views is given. Possible explanations for the finding that the retarded children nevertheless differed from intellectually normal children in the relation of their errors to word frequency are also given. PMID- 3669631 TI - Developmental influences in teaching language forms to individuals with developmental disabilities. AB - The purpose of this experiment was to test the assumption that the sequencing of language goals for individuals with developmental disabilities should be based on the normal developmental sequence. In a series of two studies, phonetic sounds and syntactic structures representing different levels of normal development were taught to individuals with developmental disabilities. The results showed that (a) the majority of earlier emerging forms were acquired in fewer trials, (b) there was never an instance when the later emerging form was acquired and the earlier emerging form was not, and (c) the majority of earlier emerging forms were correctly produced at higher levels than the later emerging forms during probe sessions conducted 6 months after training. The results are discussed in terms of their implications for the development of language curricula for individuals with developmental disabilities. PMID- 3669632 TI - Effectiveness of language intervention with the language/learning disabled. AB - This paper uses a meta-analytic procedure to assess the effectiveness of language intervention with the language/learning disabled. A total of 43 studies were coded and analyzed for design, subject, and treatment characteristics. A mean effect size (ES) of 1.041 was achieved suggesting that the average language disordered child moved from the 50th percentile to the 85th percentile as a result of language intervention. An analysis of the data for this study revealed several significant (p less than .05) ES differences for subject and treatment characteristics. The nature of the differences and their relationship to intervention are discussed. PMID- 3669633 TI - Electroacoustic calibration for sound field warble tone thresholds. AB - Walker, Dillon, and Byrne (1984) suggested reference equivalent threshold sound pressure levels (RETSPLs) for warble tones with specific modulation parameter values audited from a test position at the critical distance in a semireverberant sound field. This study evaluated these RETSPLs in two typical audiometric rooms and with typically encountered FM tones. Thresholds were measured under earphones and in two sound fields for 6-11 normal hearers at six test frequencies. Results indicated that there was a small but statistically significant difference between earphone and sound field thresholds in 4 of 24 comparisons. However, in both sound fields, 99% of the sound field thresholds were within 10 dB of the earphone thresholds. It is concluded that these RETSPLs are appropriate for electroacoustic calibration of sound field warble tones similar to those used in this study. PMID- 3669634 TI - Clinical application of two phonologically based treatment procedures. AB - Two phonological process-based treatment procedures were applied in an ongoing clinical program. Subjects were 4 children aged 3:1, 3:8, 4:1, and 5:1. Two subjects were assigned to a minimal pairs contrasting procedure, and 2 were assigned to a modified cycles procedure based on results of a detailed phonological analysis. All children demonstrated marked changes in their phonological systems as shown by the results of pretreatment and follow-up generalization probes. Correct production generalized to sounds affected by the treatment process that were not a focus of training. Correct production of untrained sounds lagged behind that of trained sounds for all subjects. Results support the hypothesis that articulation remediation is enhanced by treating phonological processes as well as the notion that the acquisition of phonology is a gradual process. Both treatment procedures used in this study were found to be effective and efficient, as evidenced by the elimination of up to three phonological processes within 2 1/2 months for each subject. PMID- 3669635 TI - Twitch response in the canine vocalis muscle. AB - The twitch response of the canine vocalis muscle was investigated through a series of experiments conducted in vitro. Samples of vocalis muscle were dissected and prepared from canine larynges a few minutes before death and kept in Krebs solution at a temperature of 37 +/- 1 degrees C and pH of 7.4 +/- 0.05. Field stimulation with parallel-plate silver electrodes was applied to study the twitch response of muscle samples. The peak tension and time course of isometric contraction of isolated muscle samples were measured electronically with a Cambridge Technology Dual Servo System (ergometer). Contraction time and 50% relaxation time of this muscle were measured for seven samples at various levels of strain. It was found that contraction time ranged between 22 and 32 ms and 50% relaxation time ranged between 17 and 37 ms. Results indicate that the vocalis muscle is a fast muscle capable of performing rapid maneuvers in support of changes in fundamental frequency. PMID- 3669636 TI - Formant frequencies of stuttered and fluent vowels. AB - The formant frequencies of 15 adult stutterers' fluent and disfluent vowels and the formant frequencies of stutterers' and nonstutterers' fluent vowels were compared in an F1-F2 vowel space and in a normalized F1-F2 vowel space. The results indicated that differences in formant frequencies observed between the stutterers' and nonstutterers' vowels can be accounted for by differences among the vocal tract dimensions of the talkers. In addition, no differences were found between the formant frequencies of the fluent and disfluent vowels produced by the stutterers. The overall pattern of these results indicates that, contrary to recent reports (Klich & May, 1982), stutterers do not exhibit significantly greater vowel centralization than nonstutterers. PMID- 3669637 TI - Vocal reaction times of stuttering subjects to tachistoscopically presented concrete and abstract words: a closer look at cerebral dominance and language processing. AB - The present study was an attempt to investigate further the issues pertaining to cerebral organization for visual language processing in the stuttering population. Employing a lexical decision task, vocal reaction times were obtained for a group of 14 stutterers to unilateral, tachistoscopically presented concrete and abstract words. Results of an analysis of variance showed that a significant interaction occurred between visual fields and stimuli. Posthoc tests showed that the right hemisphere was superior for analyzing the concrete words while the left hemisphere was responsible for processing the abstract items. Compared to past data from normal subjects, these findings were interpreted as suggesting that some form of linguistic competition may exist between the two hemispheres, possibly reflecting a disturbance in functional localization in the stuttering population. PMID- 3669638 TI - Auditory brainstem responses from graduates of an intensive care nursery: normal patterns of response. AB - Auditory brainstem responses (ABR) were obtained from graduates of an intensive care nursery (ICN) when those babies were in stable physiological states and ready for hospital discharge. Intensity ranged from ABR threshold to 80 dB nHL, and all recordings were made in a sound-isolated chamber. The data reviewed here are from 585 babies having presumably normal hearing, based upon bilateral ABR thresholds of 30 dB nHL or less. To insure that estimates of population statistics were not biased by high correlations between ears, only the data from the left ears were used in most analyses. Larger correlations were observed between conceptional age (CA) and ABR latencies than between either gestational age (GA) or chronological age (CHA) and the same latencies. Data were grouped into six CA groups for further analyses. Distributions of all response-component latencies were similar in shape and depended upon CA, showing orderly decreases in latency with increasing age. None of these distributions differed significantly from normal, and they were well fitted by normal ogives. Thus, accurate estimates of percentiles can be obtained from the means and standard deviations. The results indicate that it is important to take CA into account when evaluating ABR latencies. PMID- 3669640 TI - Influence of signal duration on the masking-level difference. AB - The effect of signal duration on the 500-Hz masking-level difference was studied in 4 subjects using an adaptive, two-interval, forced-choice method. SoNo, S pi No, and SoN pi thresholds for 13 signal durations between 2 and 100 ms were established in continuous broadband noise (36.2 dB pressure-spectrum level). The signals were synthesized and gated digitally with 1-ms rise-fall times. The SoNo threshold integration functions diverged from the S pi No or the SoN pi threshold integration functions as the signal duration was reduced from 100 ms to 6-10 ms. As the signal duration was reduced below 6-10 ms, however, the threshold integration functions for SoNo, S pi No, and SoN pi converged. The relationships among the threshold integration functions were reflected in the SoNo-S pi No and the SoNo-SoN pi masking-level differences that increased as the signal duration was reduced from 100 to 6-10 ms and then decreased as the signal duration was reduced below 6-10 ms. PMID- 3669639 TI - The role of coarticulatory effects in the perception of fricatives by children and adults. AB - Adult listeners are sensitive to the acoustic variations that result from a speaker's coarticulation (or coproduction) of phonetic segments. The present study charted the development of such sensitivity in young children by examining their responses to coarticulatory effects in fricative-vowel syllables. Children, at each of the ages 3, 4, 5, and 7 years, and adults identified tokens from a synthetic /sh/-/s/ continuum followed by one of four natural vocalic portions: /i/ and /u/, produced with transitions appropriate for either /sh/ or /s/. Children demonstrated larger shifts in fricative phoneme boundaries as a function of vocalic transition than did adults, but relatively smaller shifts as a function of vowel quality. Responses were less consistent for children than for adults, and differences between children and adults decreased as children increased in age. Overall, these results indicate that perceptual sensitivity to certain coarticulatory effects is present at as young as 3 years of age. Moreover, the decrease in the sensitivity to vocalic transitions with age suggests that, contrary to a commonly held view, the perceptual organization of speech may become more rather than less segmental as the child develops. PMID- 3669641 TI - Syntactic preservation in Alzheimer's disease. AB - Language ability of 20 patients with probable Alzheimer's disease (AD) was evaluated. Analysis of spontaneous speech revealed a normal range and frequency of syntactic constructions but poor lexical use. A writing task showed a similar divergence, with the ability to use syntactic cues significantly more intact than the ability to use semantic cues. The results are taken to indicate that syntactic ability is selectively preserved in AD. These findings are consistent with a modular theory of grammar and of mental functions more generally. A tentative explanation of these phenomena is proposed in which the overlearned and automatic nature of syntactic ability helps account for its resilience to cognitive dissolution and cortical degeneration. PMID- 3669642 TI - Age and speech breathing. AB - Thirty healthy men representing three widely different age groups (25, 50, and 75 years) were studied with respect to general respiratory function and speech breathing. Subdivisions of the lung volume were found to differ with age and most markedly so for measures of vital capacity and residual volume. Speech breathing also was found to differ with age and was characterized by differences in lung volume excursion, rib cage volume initiation, number of syllables per breath group, and lung volume expended per syllable. Age-related differences in general respiratory function and speech breathing are discussed in relation to possible underlying mechanisms. In addition, implications are drawn regarding the evaluation and management of individuals with speech breathing disorders. PMID- 3669643 TI - Verbal and perceptual analogical reasoning and proportional metaphor comprehension in young children. AB - In contrast to the common assumption that young children have little or no ability to reason by analogy or to comprehend proportional metaphors, the present study demonstrated that children as young as age 5 years have an emerging ability to solve both verbal and perceptual proportional analogy problems and to detect the meanings of proportional metaphoric sentences. These results were largely because the experimental tasks were designed to minimize the number of factors that would restrict the performance of young children. The results indicated that the years between 5 and 7 mark a steady improvement in analogical reasoning and proportional metaphor comprehension, but that children ages 5, 6, and 7 display a wide-ranging ability in these areas. It was also found that perceptual analogical reasoning was statistically related to verbal analogical reasoning and to proportional metaphor comprehension, and that perceptual analogical reasoning and proportional metaphor comprehension were both statistically related to receptive vocabulary development. PMID- 3669644 TI - Speech recognition threshold in noise: effects of hearing loss, frequency response, and speech materials. AB - Speech recognition threshold (SRT) was measured in quiet and in noise for normal hearing subjects and subjects with high-frequency sensorineural hearing loss. For the hearing-impaired subjects, SRT in quiet approximated the amount of hearing loss in the frequency region of importance for each of two sets of speech materials--spondees and monosyllables. With changes in frequency response of the stimulus delivery system, SRT shifted differentially for spondees and monosyllables. The speed, reliability, and apparent sensitivity of the SRT in quiet and noise to frequency response characteristics make it a potentially useful tool for hearing aid evaluation if speech materials appropriate to both the hearing loss configuration and the frequency response of amplification are chosen. PMID- 3669645 TI - Aerodynamic and myoelastic contributions to tracheoesophageal voice production. AB - Five laryngectomized, tracheoesophageal (TE) speakers completed a series of phonatory tasks developed to assess (a) aerodynamic and acoustic properties of TE voice and (b) aerodynamic and myoelastic contributions to the mediation of fundamental frequency change. These TE speakers' voices were characterized by increased trans-source airflow rates, comparable source driving pressures, and decreased airway resistances in comparison with standard esophageal speakers. TE speakers were capable of adjusting their voicing sources on a myoelastic basis to influence Fo change. This result, coupled with findings that confirm aerodynamic contributions to TE phonation, are interpreted to suggest that TE voice production should be regarded as an aerodynamic-myoelastic event. Findings are integrated with existing data to highlight fundamental differences among TE, esophageal, and normal voice production. PMID- 3669646 TI - The dissociation of SOAEs and tinnitus. AB - Spontaneous oto-acoustic emissions (SOAEs) were detected in 10 of 29 subjects with tinnitus. Because measures of the pitch of tinnitus are highly variable, the relation between the frequency composition of the tinnitus and the frequencies of SOAEs can not be known precisely. This raises the question of whether an observed SOAE could be proven to be the physical basis of an audible tinnitus of unspecified composition. To examine this question, subjects with both SOAEs and tinnitus participated in two demonstrations. First, while the tinnitus was reportedly masked by a high-frequency tone, the SOAE was unchanged. Second, while the SOAE was suppressed, the tinnitus was reportedly audible. Although masking and suppression are not equivalent operations, these findings make it likely that the SOAE and the tinnitus are independent phenomena, at least for these subjects. Additional evidence of the dissociation of SOAEs and tinnitus in these subjects is provided by data showing that suppression tuning curves for SOAEs are frequency-specific, whereas tones at any frequency are equally effective in masking the tinnitus. PMID- 3669647 TI - Further validation of the Speech Transmission Index (STI). AB - The present article further evaluates the accuracy of speech-recognition predictions made according to two forms of the Speech Transmission Index (STI) for normal-hearing listeners. The first portion of this article describes the application of the modified Speech Transmission Index (mSTI) to an extensive set of speech-recognition data. Performance of normal-hearing listeners on a nonsense syllable recognition task in 216 conditions involving different speech levels, background noise levels, reverberation times and filter passbands was found to be monotonically related to the mSTI. The second portion of this article describes a retrospective and prospective analysis of an extended sound-field version of the STI, referred to here as STIx. This extended STI considers many of the variables relevant to sound-field speech recognition, some of which are not incorporated in the mSTI. These variables include: (a) reverberation time; (b) speech level; (c) noise level; (d) talker-to-listener distance; (e) directivity of the speech source; and (f) directivity of the listener (eg., monaural vs. binaural listening). For both the retrospective and prospective analyses, speech recognition was found to vary monotonically with STIx. PMID- 3669648 TI - Movement timing in deaf and hearing speakers: comparison of phonetically heterogeneous syllable strings. AB - We review evidence suggesting that deaf speakers do not move their articulators toward the following open posture throughout closure and report results from a preliminary cinefluorographic study. Two prelingually deaf and two hearing speakers produced two different strings of alternating heterogeneous monosyllables as though speaking in time with a metronome (the so-called P-center task). Events traditionally associated with vowel production appeared evenly timed throughout the productions, and, in general, the deaf speakers performed similarly to the hearing speakers. We relate the results to Fowler's (1983) interpretation of the P-center phenomenon as an indicant of continuous vowel production. PMID- 3669649 TI - Perception of synthetic visual consonant-vowel articulations. AB - Synthetic speech-like articulations were presented to adult subjects via the visual modality, following the classic categorical perception experimental paradigm (Liberman, Harris, Hoffman, & Griffith, 1957). Animations were generated on a computer-based graphics system. Stimuli consisted of representations of the syllables /ba/, /va/, and /wa/; as well as 6 linearly interpolated intermediate stimuli between each of the possible exemplar pairs, resulting in three 8-item continua. Three sets of observations were obtained for these stimuli. First, for each continuum, labeling data were obtained in which the subject assigned one or the other exemplar label to each of the stimuli. Next, ABX discrimination data were obtained for each continuum. In the final task, subjects assigned a rating of one through nine to each animation indicating the extent to which it was like the exemplar syllables. Although the labeling functions showed rather abrupt transitions from one response category to the other, the peaks in the discrimination functions did not coincide with the category boundaries. Further, the mean rating functions were relatively linear, and the distribution of rating responses revealed unimodal distributions whose peak locations differed depending on the stimulus. PMID- 3669650 TI - Knowledge and attitudes of Memphis parochial school adolescents about the acquired immune deficiency syndrome. PMID- 3669651 TI - Retroperitoneal cyst in a 4-year-old child. A case report. PMID- 3669652 TI - Pruritus due to infected pancreatic duct catheter. PMID- 3669653 TI - Prevention and control of AIDS. An interim report. PMID- 3669654 TI - Renal hypertension following conservative management of blunt renal trauma. PMID- 3669655 TI - Health risk factors of Tennessee's teenagers. PMID- 3669656 TI - Excellent care--unexpected result. PMID- 3669657 TI - 11 beta-chloromethyl-[3H]estradiol-17 beta: a very high affinity, reversible ligand for the estrogen receptor. AB - It has been suggested that binding of 11 beta-chloromethyl estradiol (11 beta CME2) to the estrogen receptor is irreversible, since its complex with receptor fails to undergo exchange with estradiol (E2). To investigate this behavior directly, 11 beta-CME2 was prepared in high specific activity, tritium-labeled form: The binding of [3H]11 beta-CME2 to the estrogen receptor from lamb and rat uterus and MCF-7 human breast cancer cells was shown to be fully reversible; the 11 beta-CME2 complex with receptor, as well as that of a structural analog 11 beta-ethyl estradiol, however, do not dissociate or exchange with [3H]E2 over a 22 h period at 25 degrees C. By competitive or direct binding assays, the affinity of 11 beta-CME2 for the estrogen receptor can be estimated to be as much as 10- to 30-fold higher than that of E2. The complexes of estrogen receptor from MCF-7 cells with [3H]11 beta-CME2 and [3H]E2 show identical velocity sedimentation profiles on sucrose gradients, under conditions when the receptor is either a monomer of a dimer. Because of its very high affinity and unusual dissociation kinetics, [3H]11 beta-CME2 should be a very useful ligand for studies of estrogen receptor dynamics and in the assay of estrogen receptor concentrations in tumors and tissues. PMID- 3669658 TI - Antiprogesterone and antiglucocorticoid actions of RU 486 on rabbit mammary gland explant cultures. Evidence for a persistent inhibitory action of residual progesterone upon the mammary tissue. AB - The antiprogesterone and antiglucocorticoid compound RU 486 added to pregnant rabbit mammary gland explant cultures had no effect alone but significantly stimulated casein production in the presence of ovine prolactin (PRL) in a dose dependent manner. This stimulation was inhibited by progesterone (Pg) and the Pg agonist R5020. When the explants were cultured for 5 days with two changes of medium, to eliminate all steroids, and hormones added afterwards, the effect of PRL was potentiated, Pg was no longer inhibitory and RU 486 had no effect, RU 486 also could inhibit the stimulatory action of glucocorticoids added to the cultures along with PRL. The compound was able to displace [3H]dexamethasone and [3H]R 5020 from mammary gland glucocorticoid and Pg receptors respectively and proved to have a high relative binding affinity (RBA) for both receptors when compared with typical ligands for each receptor. The RBAs of RU 486 and the steroids used in this study to mammary gland glucocorticoid and Pg receptors correlated well with the ability of RU 486 to block their biological activities. These results demonstrate that RU 486 has both antiglucocorticoid and antiprogesterone activities in pregnant rabbit mammary glands as well as the existence of a strong inhibitory residual action of Pg in the gland that persists during the first 48 h of culture and that can be eliminated by RU 486 or after several days of culture with no hormones. PMID- 3669659 TI - Selective turnover of the essential fatty acid ester components of estradiol-17 beta lipoidal derivatives formed by human mammary cancer cells in culture. AB - The properties of fatty acyl coenzyme A: estradiol-17 beta acyl transferase in microsomes derived from pooled human mammary cancer tissue have been examined. A pH optimum of 5.5 was found and addition of long-chained fatty acyl CoAs increased estradiol-17 beta (E2) 17-monoacyl ester synthesis; the apparent Km for E2 being 8 microM when oleoyl CoA, linolenoyl CoA or palmitoyl CoA were employed. Testosterone, dehydroepiandrosterone, and 5-androsterone-3 beta, 17 beta-diol acted as competitive inhibitors with Ki values of 36, 36 and 46 microM, respectively. The composition of E2 fatty acyl esters (E2-L) formed by incubation of [3H]E2 with human mammary cancer tissue and human mammary cancer cell lines has been determined by HPLC. Although the composition of E2-L in estrogen receptor negative cell lines (MDA-MB-231 and MDA-MB-330) was generally similar to that found for MCF-7 cells (estrogen receptor positive) and pooled human mammary cancer tissue, the former cell lines contained a 3-fold higher relative concentration of E2-17 beta stearate. MCF-7 cells were exposed to 30 nM [3H]E2 and the composition of the isolated [3H]E2-L fraction studied at various time intervals. At 0.5 h, the intracellular concentration of E2-L was 1.8 +/- 0.4 (SEM) pmol/mg DNA which increased to values of 3.6 +/- 0.6 and 4.3 +/- 0.5 at 4 h and 16 h, respectively. In the subsequent 3 h following transfer to medium lacking [3H]E2, the concentration of E2-L declined to 3.7 +/- 0.3 pmol/mg DNA. The subfraction of E2-L composed of E2-17 beta arachidonate, linolenate and docosahexaenoate, was seen to decline in relative abundance after 0.5 h and to reach significantly lower relative levels at 16 h, and again in the 3 h period following estrogen withdrawal. The data suggests that these components, derived from essential fatty acids, are more metabolically active. This may then provide a new lead to link these novel estrogen derivatives with the established relationship between unsaturated fatty acids and an increased mammary cancer incidence. PMID- 3669660 TI - Effect of long term androgen removal on androgen-induced proliferation of seminal vesicle cells in adult mice. AB - Male mice were castrated on day 60 after birth; daily injections of testosterone propionate (TP, 4 micrograms/g b.wt) were started 1.2 or 6 months after the castration. The incorporation of 5-[125I]iodo-2'-deoxyuridine [( 125I]IdUrd) into the whole seminal vesicles was determined on various days after starting the TP injections as an index for proliferation. Although the peak of [125I]IdUrd uptake was observed 3 days after starting the TP injections in both short (1-2 months) and long (6 months) term castrated mice, the peak was significantly lower and the period of proliferation was longer in the long term group than in the short term group; the weights of seminal vesicles before TP injections were 6 and 10 mg in the long and short term groups, respectively. Although TP injections induced the proliferation of only epithelial cells in the short term group, the same treatment induced the proliferation of both epithelial and fibromuscular cells in the long term group. The deficient responsiveness to androgen of the seminal vesicle cells found in the long term castrated mice was completely recovered by TP pretreatment for 2 weeks. The present findings suggest that so-called imprinted cells in the mouse seminal vesicle induced by neonatal and prepubertal testicular androgens are very slowly lost at least in part by androgen removal for long periods such as more than 6 months in adult mice and that the loss is at least in part due to the death of fibromuscular cells, which is recovered rather quickly by androgen pretreatment. PMID- 3669662 TI - Validity of the calculation of non-sex hormone-binding globulin-bound estradiol from total testosterone, total estradiol and sex hormone-binding globulin concentrations in human serum. AB - Recent evidences indicate that biologically available serum testosterone (T) and estradiol (E2) include not only the free fractions but also most of the albumin bound fractions. These two serum T or E2 fractions constitute most of non-sex hormone-binding globulin (SHBG)-bound T or E2, respectively. It has been reported that the estimation of serum non-SHBG-bound T gives identical results when it is assayed experimentally or when it is calculated by a formula derived from the law of mass action assuming two binding systems (T-SHBG and T-albumin). In the present work, we have compared the results of the experimental measurement of non SHBG-bound E2 with the calculated value derived by an equation based on the law of mass action considering four binding systems (E2-SHBG, T-SHBG, E2-albumin, T albumin). It was found that the two estimations of non-SHBG-bound E2 correlated closely in normal men (r = 0.80), normal women (r = 0.90) and hirsute women (r = 0.98). When compared with a more complex calculation which includes 21 steroids and 3 binding proteins results also agreed closely. Values for the different T and E2 fractions in these groups of subjects are given. These calculations could be used, not only for clinical research, but also in clinical practice as an useful tool for evaluation of the sex hormone status of patients. PMID- 3669661 TI - The apparent molecular weight of androgen-binding protein (ABP) in the blood of immature rats differs from that of ABP in the epididymis. AB - When androgen-binding protein (ABP) in unfractionated immature (20-day old) male rat serum was covalently labeled with the site-specific photoaffinity ligand [3H]17 beta-hydroxy-4,6-androstadien-3-one and analyzed on 5.6% polyacrylamide tube gels containing SDS (SDS-PAGE), a protein of Mr 33,700 +/- 1200 was shown to be specifically labeled. Rat epididymal ABP from unfractionated cytosol analyzed under identical conditions exhibited two androgen-specific peaks of radioactivity, Mr 49,900 +/- 600 and Mr 44,100 +/- 800, which correspond to the previously described subunits of ABP. The apparent molecular weight differences between serum and epididymal ABP were further assessed on preparations of serum ABP that had been partially purified by chromatography on Affi-Gel blue (to remove albumin) and on Sephadex G-150 (to remove other proteins). When these preparations of ABP were photolabeled and analyzed by SDS-PAGE as above, two subunits of Mr 61,700 +/- 1300 and Mr 47,100 +/- 700 were resolved. Serum and epididymal ABP were further purified by androgen affinity chromatography. When these preparations were subjected to SDS-PAGE on slab gels containing 10% polyacrylamide and identified by fluorography of photolabeled ABP or by immunochemical localization following electrophoretic transfer to nitrocellulose, differences in the apparent molecular weight of ABP from the two sources persisted. Immunochemical localization studies on ABPs that had been desialylated with neuraminidase indicated that there was an increased mobility of the subunits, as one would anticipate from removal of carbohydrate. Differences in apparent molecular weight of ABPs from the two sources are likely due to differences in glycosylation. PMID- 3669663 TI - Chronic noise stress and dexamethasone administration on blood pressure elevation in the rat. AB - In order to evaluate the role of ACTH and corticosterone in the elevated blood pressure produced by chronic noise, we have studied the effect of dexamethasone administration on blood pressure. Adrenal response was measured by alterations in plasma corticosterone levels in two experimental groups (Dexamethasone treated rats, Dexamethasone-noise stressed rats) and compared with a Control and a Noise stressed group. Chronic noise stress with a frequency of 2640 Hz, power of 30 w and duration of 15 min daily was used for 30 consecutive days. Dexamethasone was administered by subcutaneous injection of 100 micrograms/100 g b.wt daily. Blood pressure was measured by an indirect tail cuff method and corticosterone levels by specific RIA. Dexamethasone administration decreases corticosterone levels but increases blood pressure. Dexamethasone-treated noise stressed rats show higher residual corticosterone levels and a more marked increase on blood pressure than rats treated with dexamethasone alone. Thus noise-stress and dexamethasone administration have opposing effects on corticosterone release and a synergistic effect on blood pressure elevation. PMID- 3669664 TI - Impaired pregnenolone biosynthesis in adrenal cortex mitochondria by adriamycin. AB - Adrenal cortex mitochondria isolated from mongrel dogs were incubated with cholesterol in the presence and absence of adriamycin (ADM). The capacity for cholesterol side chain cleavage was assessed by determining the pregnenolone yield. ADM behaves as an inhibitor of pregnenolone biosynthesis with a calculated IC50 of 110 microM. The inhibitory effect follows a dose-response relationship depending upon ADM concentration. PMID- 3669665 TI - Blood pressure and metabolic effects of 18-oxo-cortisol in sheep. AB - 18-Oxo-cortisol (18-oxo-F) has been isolated from the urine of subjects with primary aldosteronism. This study examines the pressor, mineralocorticoid and glucocorticoid effects of 18-oxo-F in conscious sheep--a well studied species for the assessment of the pressor effect of steroid hormones. 18-oxo-F (24 mg/day i.v. for 5 days, n = 3) increased mean arterial pressure MAP (64 +/- 2 mmHg control and 75 +/- 6 mmHg on day 5 P less than 0.001). There was no change in heart rate. Plasma [K+] decreased from a control of 4.3 +/- 0.1 mmol/l control to 2.9 +/- 0.3 mmol/l on day 5 (P less than 0.001). Urinary Na+ excretion decreased on the first infusion day (233 +/- 18 mmol/day control and 124 +/- 20 mmol/day on infusion day 1 P less than 0.001). Urinary K+ excretion was reduced on days 1, 4 and 5 of the infusion. Thus in sheep, 18-oxo-F increased blood pressure associated with in vivo evidence of mineralocorticoid activity. PMID- 3669666 TI - Nutritional dependence of the effect of estrogen on fat cell lipoprotein lipase. AB - We investigated the effects of ethynylestradiol (EE) at low dose (1.2 micrograms/day) injected s.c. for 10 days on lipoprotein lipase (LPL) in fat cells of female rats fed a standard diet (5% lipid, 49.5% glucid, 23.5% protein) as a function of the nutritional state. EE caused a 150% increase in LPL activity in the fed state, and a 65% decrease in the fasting state, resulting in a large increment in the physiological feeding-fasting difference. Feeding the rats a diet supplemented with 20% lard reversed the estrogen-dependent LPL increase in the fed state. Under all experimental conditions, EE caused a depletion of fat stores and an increase in plasma levels of triacyglycerol. PMID- 3669667 TI - Alcohol and self-disclosure: analyses of interpersonal behavior in male and female social drinkers. AB - We examined the effects of alcohol and expectations about drinking on self disclosure in male and female social drinkers. Consistent with cognitive social learning theory, these effects were shown to vary as a function of dose, expectations about alcohol consumption and gender-related social learning history. In men, alcohol increases self-disclosure, but only at a moderate blood alcohol level. Expectations emerged as a powerful influence on self-disclosure. Men who believed that they and their female partner were both intoxicated showed increased self-disclosure although no alcohol was consumed. Women who believed that they were intoxicated showed the opposite pattern of a decrease in self disclosure. Another gender difference was that moderate alcohol had no effect on women's self-disclosure. The self-awareness model of alcohol use failed to receive support. PMID- 3669668 TI - Comparisons of the cognitive functioning of familial and nonfamilial alcoholics. AB - Alcoholic men (N = 81) participating in a Veterans Administration inpatient program were classified using four different strategies to describe the extent of familial alcoholism. These classification schemes included: (1) a comparison of alcoholics with no familial alcoholism, parental alcoholism or alcoholism in other relatives, (2) a unilineal-bilineal approach, (3) a multigenerational approach and (4) an approach that quantified the degree of familial alcoholism. Comparisons were made of the performance of the different familial history groups on a series of neuropsychological tests. No differences in cognitive functioning were found using any of the four classification schemes. PMID- 3669669 TI - Family history of problem drinking among young male social drinkers: behavioral effects of alcohol. AB - Two experiments examined the behavioral effect of alcohol on male social drinkers aged 19-25, who differed in their family histories of problem drinking--21 reported a problem drinker in their immediate family (FH+) and 22 had no such family history (FH-). These groups did not differ in age, weight or absolute alcohol per kg of body weight typically consumed on social occasions. After drinking absolute alcohol (0.83 ml/kg), subjects performed bead stringing and hand steadiness tasks when their blood alcohol levels (BALs) averaged 63 mg/dl on the rising and the declining limb of the BAL curve. The experiments consistently demonstrated that FH+ individuals displayed a greater degree of impairment on the tasks. One of the experiments also explored subjective ratings of the effects of alcohol at matching BALs and found no significant group differences. The greater behavioral sensitivity to alcohol of FH+ subjects and their apparent absence of a concomitant enhanced perception of its effects were discussed as a potential component of their higher risk of developing problem drinking. PMID- 3669670 TI - One-month repeatability of alcohol metabolism, sensitivity and acute tolerance. AB - Subjects (N = 34) in the Colorado Alcohol Research on Twins and Adoptees (CARTA) were brought back between 30 and 60 days after their initial testing to be retested on all the CARTA procedures. As before, subjects were given a dose of alcohol (.8 g/kg of body weight) calculated to bring their blood alcohol level (BAL) to near 100 mg/dl. Additional doses were given at the end of each of the next 2 hours to maintain their BAL near peak for approximately 3 hours. Repeatability (test-retest correlation) for alcohol clearance rate was near 0, with repeatabilities between .40 and .55 for peak BAL, time-to-peak BAL, average session BAL and relative volume of alcohol distribution. Repeatabilities of prealcohol baseline scores were generally high (median, .71) for the CARTA battery of physiological, motor coordination, perceptual speed and reaction time measures, but were only low to moderate for sensitivity scores (median, .27) and acute tolerance scores (median, .25) calculated on these measures. There was some evidence that repeatabilities for alcohol metabolism, sensitivity and acute tolerance were lower for women than for men. PMID- 3669671 TI - Intoxication and self-orientations during alcohol use: an empirical assessment of the relationship and of its determinants among employed men and women. AB - Analysis of data from a survey of employed adults in Detroit indicates that frequency of intoxication is associated with a masculine self-orientation among men and a feminine self-orientation among women during alcohol use. The study calls attention to the importance of fathers' drinking, life events, social class relations and a generalized alienation from self, work and society for understanding frequency of intoxication and masculine and feminine orientations during alcohol use. A path analysis suggests that the men and women who become intoxicated may regain a sense of self and relationships to others that they do not have in sober everyday life. Implications for future research on heavy drinking and self-orientations during alcohol use are discussed. PMID- 3669672 TI - Stress, ethnic and distribution factors in a dichotomous response model of alcohol abuse. AB - An emerging methodology, the dichotomous response model, is applied to alcohol abuse. The model permits the systematic integration of events and factors from various theories of alcohol abuse as well as random influences to affect the outcome. Both the sociological and distribution of consumption hypotheses are drawn on to specify the factors influencing alcohol abuse. The empirical results based on data from Canada and the United States indicate that ethnic and stress factors strongly influence alcohol abuse. The stress variables include the rates of unemployment and divorce. The ethnic variables are the percentages of the population that are of African, French, Italian and Mexican ancestry. Distribution variables such as price, income and control measures were generally less important. PMID- 3669673 TI - Nurses' beliefs about the etiology and treatment of alcohol abuse: a national study. AB - The purpose of this study was to determine registered nurses' beliefs about alcoholism and alcoholics and to compare those beliefs with subjects' biographic and professional variables. A randomly selected national sample of 1026 registered nurses who are members of the American Nurses Association responded to a mailed survey that was designed to determine beliefs about the etiology and preferred treatment of alcohol abusers. Results showed that subjects had more positive beliefs toward alcohol abusers than was found in previous studies. In comparing nurses' beliefs with biographic and professional characteristics, it was found that those who had received their nursing education in hospital diploma programs and those with master's degrees had more positive beliefs about alcoholism than either baccalaureate prepared nurses or nurses with doctoral degrees. Female nurses more often expressed positive beliefs than did male nurses, and nurses working in rural hospitals were more positive than those in urban institutions. Age, length of time in nursing, clinical specialty, type of position, and size and type of institution, were unrelated to beliefs. PMID- 3669674 TI - Dose-related effects of alcohol among male alcoholics, problem drinkers and nonproblem drinkers. AB - Cognitive variables, such as expectancies regarding the usefulness of alcohol, have been receiving increased attention in recent years because these expected effects can influence decisions to drink and mediate responses to alcohol. In the present study, alcohol expectancies were assessed using the Alcohol Beliefs Scale, a measure that yields dose-related data on expected effects of alcohol. The subjects were male alcoholics, problem drinkers and nonproblem drinkers. The central finding was that drinker group membership and rated dose level interacted in predicting subjects' estimates of the usefulness of alcohol for them. On the "useful for feeling better" factor, the greatest benefit was expected from a moderate dose, particularly among alcoholics. On the "useful for relieving emotional distress" factor, usefulness ratings increased with dose, with alcoholics expecting the greatest rate of increase. A similar pattern was found for the "useful for feeling in charge" factor, except that the ratings for problem drinkers and alcoholics paralleled each other. These findings have implications for our efforts to understand drinkers' motivations to initiate and continue drinking. PMID- 3669675 TI - Beliefs about the effects of alcohol on self and others. AB - A questionnaire on beliefs about the effects of alcohol on the behavior of self and others was administered to a sample of college students and a sample from the general population. Respondents reported that alcohol effects are more likely to happen to others than to themselves, particularly for socially undesirable behaviors. Women reported a greater likelihood of behavioral impairment; men reported more aggressive behavior. Nondrinkers reported a greater likelihood of both positive and negative effects; heavier drinkers reported more pleasurable effects. PMID- 3669676 TI - Britain's Christmas Crusade against drinking and driving. AB - Great Britain's 1983 "Christmas Crusade" against drunken drivers, during which the police of England and Wales administered an average of 1350 breath tests daily, is discussed. Although not deliberately planned and organized, the campaign, fueled by press reports, was perceived by many observes to be a national organized deterrent effort. To test the hypothesis that the crusade reduced drunken driving, the index of total automobile crash-related fatalities was used in the analysis. Results showed that the index declined significantly during the month of the crusade, providing support for the hypothesis of deterrent effect. The experience of the Christmas Crusade reinforces the expectation that deterrent interventions involving highly publicized campaigns increasing the certainty of punishment for illegal behavior can be successful over a limited period of time. PMID- 3669678 TI - Reliability and validity of the MAST, Mortimer-Filkins Questionnaire and CAGE in DWI assessment. AB - The internal consistency reliability and criterion-related validity of the Michigan Alcoholism Screening Test (MAST) (N = 90), Mortimer-Filkins Questionnaire (MFQ) (N = 253) and CAGE (N = 375) were examined. Respondents were convicted of driving while intoxicated (DWI) and were assessed for the significance of their drinking problem at 34 DWI assessing agencies. Counselor decisions served as the criterion measure and were considered to be independent of the test scores. The finding revealed that counselors identified lower rates of problem drinking than are generally found to exist in this population. The MAST performance, although statistically impressive, was believed to be mediated by the low rate of counselor-identified problem drinkers. The MFQ, more moderate in its performance, shows promise for improvement based on recommended modifications. CAGE findings suggest little support for its use as a single index of problem drinking with this population. However, it would appear to be a statistical asset to the item pool of a more comprehensive screening inventory. The criterion used in the study did not provide a satisfactory range of problem drinking with which to evaluate the adequacy of these instruments as wide-range assessment inventories. The social-legal mandate to reduce the incidence of DWI will require not only more comprehensive definitions of problem drinking but more extensive study of repeat offenders for the identification of other subgroups as well. PMID- 3669677 TI - The Alcohol Expectancy Questionnaire: an instrument for the assessment of adolescent and adult alcohol expectancies. AB - Alcohol-related expectancies can influence the behavioral effects of alcohol and decisions regarding alcohol use. A standard measure of expectancies is needed for research and clinical work in the alcohol arena; the development and current status of the Alcohol Expectancy Questionnaire (AEQ) is summarized. The adolescent and adult forms of this instrument are designed to measure the degree to which individuals expect alcohol to produce a variety of general and specific effects. Research with the AEQ indicates a consistent relationship between alcohol expectancies and alcohol consumption, alcohol abuse and behavior while drinking. Data bearing on the psychometric properties and clinical and research utility of the AEQ are discussed. PMID- 3669679 TI - Social drinking and cognitive functioning in college students: a replication and reversibility study. AB - The purposes of this study were to replicate a previous study of the relationship between alcohol consumption and cognitive functioning in college students and to investigate the reversibility of negative effects of social drinking on cognitive functioning when randomly assigned subjects abstained from drinking for 2 weeks. The previous study was replicated by administering the same battery of neuropsychological tests to 170 subjects (103 women) during the first testing session. Like the original study, the present study demonstrated several significant predicted inverse relationships between drinking and cognitive performance, but specific relationships between various drinking and cognitive variables were not replicated. As in the original study, some significant nonpredicted relationships also occurred. At the end of the first testing session, subjects were randomly assigned either to abstain from drinking or to maintain their usual drinking patterns for 2 weeks. They were then administered a different neuropsychological battery designed to assess functions similar to the original battery. Consumption the previous 2 weeks was significantly lower in the abstain group than in the maintain group, but there were no significant differences in the predicted direction between groups on the cognitive variables. Several significant predicted inverse correlations between drinking variables and cognitive performance occurred, but some nonpredicted relationships occurred also. Problems and implications for research in social drinking are discussed. PMID- 3669680 TI - Cross-tolerance between morphine and ethanol and their antinociceptive effects. AB - Morphinization of mice (37.5 mg morphine) and rats (75 mg) with subcutaneously implanted pellets has resulted in tolerance to the antinociceptive effect of morphine, measured in the tail-immersion test. All animals also developed cross tolerance to the analgesic effects of ethanol (2.8 g/kg intraperitoneally for mice, per os for rats). These results suggest a commonality between morphine and ethanol antinociceptive action. PMID- 3669681 TI - The theory of sliding filament models for muscle contraction. I. The two-state model. AB - The mechanical and thermal properties of Huxley's 1957 sliding filament model for striated muscle contraction are reconsidered, with emphasis on general relationships between two-state models and muscle behaviour. New empirical forms for the rate functions f(x) and g(x) are proposed, which give an improved fit to experiments. A specific procedure, based on the shortening heat, for determining model parameters is described and applied to various choices of rate functions. The change in slope of the tension-velocity curve observed by Katz is shown to require at least one discontinuity in the binding rate f(x), and a general formula is given. The two-state model also gives a symmetric cusp in the ATP-rate vs velocity curve at v = 0. The theory is extended to time-varying situations and applied to transient responses following isometric activation by tetanus (including latency relaxation), and unloaded and after-loaded contractions. The early burst of heat production can also be fitted by assigning appropriate values to the heats of binding and dissociation. PMID- 3669682 TI - Transient response in a somatic shunt cable model for synaptic input activated at the terminal. AB - Rall's neuron model is extended by including a non-uniform time constant together with synaptic input modeled as a square step of conductance. An analytic solution (in series form) for the electrotonic potential is obtained. The major conclusion reached is that a lower somatic time constant attenuates the amplitude of the potential at the soma, brought about by the activation of a synapse located at the distal end of the dendritic cable in an initially polarized neuron. PMID- 3669683 TI - On Wright's mechanism for intergroup selection. AB - A haploid model of Wright's (1945) intergroup selection is described. Several approximate analyses as well as Monte Carlo simulation show that Wright's mechanism leads to powerful selection for group advantageous traits in the face of strong local selection against them. Intergroup selection is favored by small local subpopulation size and by high, not low, rates of immigration into local groups, although the dependence on migration rate is not strong. These results and others cast doubt on the primacy of genic selfishness as a tenet of Darwinian theory. PMID- 3669684 TI - Minimal energy foldings of eukaryotic mRNAs form a separate leader domain. AB - We have investigated the minimal energy foldings of 38 mature mRNAs, including the globin family, the insulins, the growth hormones and interleukin-2, and have compared these foldings with those of fully and partly randomised sequences. The mRNAs differ from the random sequences in that they form a separate leader hairpin of 40-60 nucleotides, with the initiation codon typically located downstream of this hairpin, followed by a main fold in which a region flanking the initiation codon is basepaired with the trailer: resulting in a close proximity of the 5' and 3' end of the mRNA. The formation of this conformation depends not only--or primarily--on the structure of the leader, but on both the leader and trailer sequence and their interaction with the coding sequence. Thus if, as the frequent occurrence of this pattern suggests, the secondary structure of the leader regions plays a role in the initiation of translation, possibly accounting for the specificity of initiation and the different translational efficiencies of various mRNAs, we expect that these features may be influenced both by leader and trailer mutants. PMID- 3669685 TI - Scaling of biological community structure: a systems approach to community complexity. AB - Local community dynamics are determined by the interaction of environmental variation and the biotic properties of communities. This interaction occurs on many spatial and temporal scales, hence the expectation is that community dynamics will be complex. Previous theoretical approaches to communities have assumed linear, near equilibrium dynamics. An alternative approach suggests that community dynamics are the result of the balance between energy use by the community and its tendency to move towards thermodynamic equilibrium, in this case extinction of all species in the community. Because this balance will be imprecise, community dynamics should be oscillatory. Furthermore, because energy use by a community can be broken down into a hierarchical set of processes occurring on different time scales, community dynamics should reflect multiple periodicities. The above theoretical treatment suggests that since community dynamics are scaled, a hierarchical observational approach should help resolve important aspects of community structure. This approach of scaling community observations provides a technique for evaluation of community responses to environmental change, including human induced perturbations. A thermodynamic approach to community dynamics can also provide the basis for new theoretical and empricial discoveries about biological communities. PMID- 3669686 TI - Diuretic activity of plants used for the treatment of urinary ailments in Guatemala. AB - Through ethnobotanical surveys in Guatemala, about 250 plants were identified for use in the treatment of urinary ailments. From 67 of these, aqueous extracts were prepared to investigate their oral diuretic activity in albino rats after a dose equivalent to 1 g/kg of dried plant material. The trials demonstrated that in 33 cases urinary excretion was not significantly increased (less than 90%), in 20 cases intermediate activity was seen (90-189%) and in 14 cases high diuretic activity was noted (greater than 189%). Control treatment increased urine output an average of 36% while 25 mg/kg hydrochlorothiazide treatment increased urine output by 286%. In a select group of the most used local plants, ethanol extracts were tested for their effect on urinary excretion of uric acid and electrolytes. Of these, three plants significantly increased uric acid excretion as did the reference drug, probenecid, 25 mg/kg. PMID- 3669687 TI - Anti-inflammatory studies on Polygonum glabrum. AB - Anti-inflammatory studies were conducted on a hot water decoction and on an ethanol extract of the stems of Polygonum glabrum. Effective anti-inflammatory activity was demonstrated against acute carrageenan-induced paw oedema, exudate and granuloma formation in the granuloma pouch test, acute and delayed reactions in formaldehyde arthritis, and acute primary and delayed secondary reactions in adjuvant-induced polyarthritis in albino rats. The acute toxicity in albino mice and 1-month studies on subacute toxicity in rats suggested a good margin of safety. The extract was more effective parenterally than by oral administration. PMID- 3669688 TI - The content of psychoactive phenylpropyl and phenylpentenyl khatamines in Catha edulis Forsk. of different origin. AB - Khat, the leaves of Catha edulis Forsk. (Celastraceae), is widely used as a stimulant in East Africa and the Arab Peninsula. Samples from the most important markets of Ethiopia, Kenya, North Yemen and Madagascar were analysed with high performance liquid chromatography (HPLC) concerning their khatamine content (phenylpropyl and phenylpentenylamines). The variability of khatamines depending on origin, type and quality is discussed. In many samples a good correlation between the amount of cathinone, the main CNS-active compound, and quality estimation (price) of dealers and consumers was found. PMID- 3669689 TI - Anti-Bacteroides fragilis substance from rhubarb. AB - Extracts of 178 Chinese herbs were screened for their antibacterial activity against Bacteroides fragilis a major anaerobic microorganism in the intestinal flora of humans. Only rhubarb root (Rheum officinale) was found to have significant activity and the purified active substance was identified as rhein. PMID- 3669690 TI - The medicinal plants of Gunung Leuser National Park, Indonesia. AB - This paper describes an ethnopharmacological study of two remote settlements in Indonesia. Interviews with practitioners of traditional medicine (dukuns) were carried out to determine the vernacular names of plants used for medicinal purposes. Parts used, methods of preparation and the medicinal uses of 158 species are presented in an inventory. Samples from several species are currently undergoing chemical analysis. PMID- 3669691 TI - Chemistry and pharmacology of a tertiary alkaloid from Strychnos trinervis root bark. AB - Bisnordihydrotoxiferine has been isolated as the major alkaloid from the root bark of Strychnos trinervis. This compound shows a wide antimicrobial spectrum against gram-positive, gram-negative and acid-fast microorganisms, filamentous and yeast-like fungi and also phytopathogenic microorganisms. Preliminary studies also reveal some cytotoxic activity in KB cells which was confirmed by tests against sarcoma 180 tumors. PMID- 3669693 TI - New frontiers and new barriers. PMID- 3669692 TI - Supplementary data on ritual enemas and snuffs in the western hemisphere. PMID- 3669694 TI - Recovery of the failing canine heart with biventricular support in a previously fatal experimental model. AB - Prolonged normothermic ischemia in the canine model is generally fatal with standard resuscitative techniques. To determine whether such myocardial injury is recoverable with biventricular support, we subjected 10 dogs to 45 minutes of ischemia at 37 degrees C. After ischemia, the animals were supported for 24 hours with biventricular assist with the centrifugal pump. During early reperfusion, none of the hearts could sustain a stable rhythm or blood pressure. Myocardial adenosine triphosphate concentration, expressed as micromoles per gram of heart protein, was dramatically reduced from a control of 31.5 +/- 2.4 to 14.6 +/- 2.9 (p less than 0.01 versus control), a 54% reduction. Ultrastructural analysis did not reveal the explosive cell swelling of irreversible cell injury. After 12 hours of biventricular assist, developed pressure partially recovered to 60.0 +/- 10 mm Hg (p less than 0.01 versus control) and maximal positive dP/dt measured 2,649 +/- 412 mm Hg/sec (p less than 0.01 versus control). Adenosine triphosphate concentration increased to 25.2 +/- 5.5 (p less than 0.01 versus control). Electron microscopic examination showed less chromatin clumping, no further mitochondrial distortion, and more abundant glycogen. After 24 hours of biventricular assist, cardiac output in the seven dogs successfully weaned from biventricular assist measured 3.6 +/- 0.6 L/min, developed pressure recovered to 76.3 +/- 8.9 mm Hg, and its first derivative recovered to 4,282 +/- 585 mm Hg/sec (all measurements not significant compared with control). Examination by an electron microscope revealed no severe mitochondrial injury. PMID- 3669695 TI - Extended cervical mediastinoscopy. A single staging procedure for bronchogenic carcinoma of the left upper lobe. AB - Despite a common misconception, bronchogenic carcinoma of the left upper lobe frequently metastasizes to lymph nodes not only in the anterior mediastinum (para aortic and subaortic) but also in the superior mediastinum. Anterior (parasternal) mediastinotomy can be used to assess only the former compartment. This procedure alone, if not done in conjunction with standard cervical mediastinoscopy, will fail to disclose technically unresectable N2 or N3 disease of the left upper lobe involving the superior mediastinum. We have developed a technique to explore and sample nodes from both regions by extending a standard cervical mediastinoscopy, eliminating the need for a second incision when the anterior mediastinal compartment requires assessment. We have prospectively analyzed the first 100 procedures that we performed. This technique has been found to be accurate and exceptionally safe with one superficial wound infection as the only complication. We can recommend this single staging procedure for preoperative assessment of bronchogenic carcinomas of the left upper lobe. PMID- 3669696 TI - A prospective evaluation of magnetic resonance imaging, computed tomography, and mediastinoscopy in the preoperative assessment of mediastinal node status in bronchogenic carcinoma. AB - Computed tomography, magnetic resonance imaging, chest roentgenography, and mediastinoscopy were compared prospectively as staging modalities to assess mediastinal node status in 84 patients with presumed operable bronchogenic carcinoma. Computed tomography was associated with a sensitivity of 71.0%, a specificity of 87.7% and an overall accuracy of 82.1%. Magnetic resonance imaging did not provide any advantage over computed tomography in the assessment of mediastinal node status. The accuracy of computed tomography was not dependent on cell type of the primary tumor. Although chest roentgenography had a sensitivity of 80.7%, the overall accuracy of 57.1% was unacceptably low. The sensitivity (87.1%), specificity (100%), positive (100%) and negative (93.0%) predictive values, and accuracy (95.2%) of mediastinoscopy exceeded those observed with all other modalities. We continue to recommend mediastinoscopy as the most accurate staging investigation in the routine management of patients with bronchogenic carcinoma. PMID- 3669697 TI - Implantable extra-aortic balloon assist powered by transformed fatigue-resistant skeletal muscle. AB - The hypothesis tested in this study was whether a skeletal muscle could be transformed to be fatigue resistant, to be used to power an implantable extra aortic balloon assist device, and therefore to provide dynamically significant cardiac assistance. Eight dogs underwent implantation of an Itrel pacemaker to stimulate the thoracodorsal nerve over 8 to 18 weeks and transform the latissimus dorsi muscle. Biopsies of these muscles confirmed near complete (up to 98%) transformation into fatigue-resistance type I muscle fibers, identified by the adenosinetriphosphatase histochemical stains. Biochemical assays showed conversion of myosin isoforms to that of myocardial V3 phenotype, decreased activity of anaerobic glycolytic marker, and increased activity of aerobic enzyme marker, which indicated greater resemblance of such muscle to the myocardial fibers. In four dogs, the optimal stimulation parameters of such muscles in response to a burst stimulator, which synchronizes and summates the muscle contraction, were studied and compared with the contralateral, nontransformed muscle. Fatigue tests confirmed the marked fatigue resistance of the transformed muscle. In four dogs, a 100 ml balloon was placed beneath the transformed latissimus dorsi muscle and connected to the thoracic aorta with a Dacron graft. By means of the optimal burst-stimulating parameters identified above, the latissimus dorsi muscle was stimulated to contract during diastole, compressing the balloon to achieve diastolic augmentation while allowing the balloon to fill during systole. A 39% increase (p less than 0.001) in the "subendocardial viability index" (diastolic pressure-time index/tension-time index) was obtained as calculated from the left ventricular and ascending aortic pressure tracings. We conclude that the skeletal muscle can be transformed to resemble myocardium, which can generate sufficient force to provide hemodynamically significant and clinically relevant counterpulsation. PMID- 3669698 TI - Oxygen consumption of chronically stimulated skeletal muscle. AB - The latissimus dorsi muscles of six dogs were made fatigue resistant by chronic electrical conditioning. Once the muscles were conditioned, oxygen consumption was measured during periods of exercise. The ratio of the tension developed to oxygen consumed during moderate stimulation (300 msec on) for the control and the electrically conditioned muscles was 16.3 +/- 3.5 and 36.5 +/- 6.7 kg-sec/ml oxygen, respectively. During intense stimulation (800 msec on) the ratio was 12.6 +/- 2.1 and 54.2 +/- 8.9 kg-sec/ml oxygen, respectively. Thus the conditioned muscle was able to develop and maintain tension with a considerably reduced oxygen expenditure. The increased efficiency of the conditioned muscle helps to explain its increased resistance to fatigue and the ability of pumping chambers constructed from electrically preconditioned skeletal muscle to perform sustained cardiac type work. PMID- 3669699 TI - Reconstruction of the left ventricle with autologous pericardium. AB - Autologous pericardium was used to reconstruct different parts of the left ventricle in 25 desperately ill patients. Fourteen patients had intractable sepsis resulting from infective endocarditis and myocardial abscess and 10 patients had noninfectious disorders. Of the patients with infections, 12 had valvular endocarditis with periannular abscess and three had interventricular septal abscess. The noninfected patients had acute rupture of the ventricular wall after mitral valve replacement (one patient) heavily calcified or surgically absent mitral anulus (three patients), or rupture of the interventricular septum after acute myocardial infarction (six patients). The interventricular septum, the posterior wall of the left ventricle, and the periannular areas were reconstructed by suturing appropriately tailored pericardial patches directly to the endocardium. In patients who also required valve replacement, the prosthetic valve was partially or completely secured to the pericardial patch. There were three operative deaths. All three patients were in either septic or cardiogenic shock before operation and in none of them was the death related to the pericardial patch. All 22 survivors have been observed from 3 to 34 months, an average of 14 months. There has been no case of patch dehiscence, patch aneurysm, prosthetic valve dehiscence, or recurrent endocarditis. Autologous pericardium appears to be safe for reconstruction of the left ventricle. It is easy to handle and problems with suture line bleeding are practically nonexistent. PMID- 3669700 TI - Brain microvascular function during cardiopulmonary bypass. AB - Emboli in the brain microvasculature may inhibit brain activity during cardiopulmonary bypass. Such hypothetical blockade, if confirmed, may be responsible for the reduction of cerebral metabolic rate for glucose observed in animals subjected to cardiopulmonary bypass. In previous studies of cerebral blood flow during bypass, brain microcirculation was not evaluated. In the present study in animals (pigs), reduction of the number of perfused capillaries was estimated by measurements of the capillary diffusion capacity for hydrophilic tracers of low permeability. Capillary diffusion capacity, cerebral blood flow, and cerebral metabolic rate for glucose were measured simultaneously by the integral method, different tracers being used with different circulation times. In eight animals subjected to normothermic cardiopulmonary bypass, and seven subjected to hypothermic bypass, cerebral blood flow, cerebral metabolic rate for glucose, and capillary diffusion capacity decreased significantly: cerebral blood flow from 63 to 43 ml/100 gm/min in normothermia and to 34 ml/100 gm/min in hypothermia and cerebral metabolic rate for glucose from 43.0 to 23.0 mumol/100 gm/min in normothermia and to 14.1 mumol/100 gm/min in hypothermia. The capillary diffusion capacity declined markedly from 0.15 to 0.03 ml/100 gm/min in normothermia but only to 0.08 ml/100 gm/min in hypothermia. We conclude that the decrease of cerebral metabolic rate for glucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass. PMID- 3669701 TI - Simultaneous implantation of St. Jude Medical aortic and mitral prostheses. AB - Since January 1980, 92 consecutive patients received St. Jude Medical aortic and mitral prostheses simultaneously. Mean age was 57.6 years (standard deviation 12.4); 14 were 70 years or older. Twenty-three had a previous cardiac operation and 22 had additional procedures performed at the time of double valve replacement. Before the operation 62% of the patients were in New York Heart Association functional class III and 29% were in class IV or required emergency operation. There were six (6.5%) deaths within 30 days. None of the hospital deaths were valve related; all occurred in patients who had additional risk concerns. Follow-up is 100% complete and ranges from 2 to 80 months, totaling 242 patient-years (mean 33.8 months). All except four hospital survivors reached class I or II and 40 patients (47%) remain asymptomatic. The actuarial survival rates are 82% at 1 year, 70% at 3 years, and 60% at 5 years. Causes of late death include heart failure (10), sudden, unexplained death (five), reoperation for coronary artery disease (one), noncardiac (four), and valve related (five). The linearized rate of fatal valve-related events is 2.1% pt-yr. A total of 22 valve related complications (including five fatal) occurred is 18 patients, for a linearized rate or incidence of 9.1%/pt-yr. Eleven thromboembolic episodes (rate 4.6%/pt-yr) occurred in nine patients; three of these (1.2%/pt-yr) were fatal. Thromboembolic and bleeding complications represented 64% of all valve-related complications. Four patients had six episodes of prosthetic valve endocarditis (incidence 2.5%/pt-yr), of which one (incidence 0.4%/pt-yr) was fatal. Paravalvular leak contributed to the fifth valve-related death. At 5 years, 83% of patients were free of thromboembolic complications; 94% were free of anticoagulant-related hemorrhage; and 71% were free of all valve-related complications. There are few comparable data for patients who have had simultaneous replacement of aortic and mitral valves with other mechanical prostheses. The total incidence of valve-related complications for patients with bioprostheses ranges between 3.9%/pt-yr and 10.4%/pt-yr and is similar to the 9.1%/pt-yr observed in the present series. The type of valve-related complication (thromboemboli and bleeding versus valve deterioration) is the principal difference between St. Jude Medical and bioprosthetic valves in patients who require simultaneous replacement of aortic and mitral valves. PMID- 3669702 TI - Repair of tricuspid valve insufficiency in patients undergoing double (aortic and mitral) valve replacement. Perioperative mortality and long-term (1 to 20 years) follow-up in 109 patients. AB - Between 1965 and 1984, 109 patients underwent simultaneous aortic and mitral valve replacement and tricuspid valve repair at the Mayo Clinic, with a perioperative mortality of 21%. The only variable predictive of perioperative mortality on multiple regression analysis was New York Heart Association class IV disability. The median follow-up was 5.6 years (range 1 to 20 years). Cumulative 5-, 10-, and 15-year survival rates in patients discharged from the hospital were 70% +/- 5%, 42% +/- 6%, and 33% +/- 7%. Multivariate analysis identified advanced age and class IV disability as significant predictors of poor survival. Five-year survival rates were similar in patients undergoing operation between 1965 and 1974 and after 1975, despite an increase in age and in the severity of preoperative symptoms in the recent group. Late mortality was due to sudden death in 38% of the patients, heart failure in 21%, reoperation in 5%, endocarditis in 2%, and thromboembolism and bleeding in 4%. Late complications included systemic emboli in 22% (embolism rate 4.5 events/100 patient-years), bleeding in 17%, reoperation in 14%, myocardial infarction in 8%, permanent pacemaker implantation in 5%, and infective endocarditis in 3%. Of 43% of the patients still alive, 79% are in class I or II. PMID- 3669703 TI - Protection of ischemic myocardium by exogenous phosphocreatine. I. Morphologic and phosphorus 31-nuclear magnetic resonance studies. AB - A phosphorus 31-nuclear magnetic resonance method was used to study the effect of exogenous phosphocreatine on the isolated perfused rat heart. The hearts were chemically arrested by St. Thomas' Hospital solution and made totally ischemic for 35 minutes at 37 degrees C. In the presence of phosphocreatine, 10 mmol/L, during ischemia, almost complete recovery of heart function and phosphocreatine content and 61% recovery of adenosine triphosphate content were observed after 30 minutes of postischemic reperfusion; in the control experiments without phosphocreatine, contractile function, intracellular phosphocreatine, and adenosine triphosphate contents were restored to 33%, 43%, and 26% of their normal values, respectively. Ultrastructural studies with a lanthanum tracer method showed remarkable protection of sarcolemma against ischemic injury by exogenous phosphocreatine at the level of the glycocalyx. PMID- 3669704 TI - Retained pacemaker leads. AB - Increasingly, functionless pacemaker leads are being abandoned in place because they cannot be safely removed. One hundred eighty-nine intact or partially removed pacemaker leads were abandoned in situ in 152 patients between Jan. 1, 1965, and Dec. 31, 1985. The leads, sometimes several leads in a single patient, were deemed uninfected at the time of abandonment in 137 patients and contaminated with Staphylococcus epidermidis in 15 patients. All of the contaminated leads have remained clinically uninfected during follow-up. One clean lead became infected early after implantation and the patient died after an open cardiac operation to remove that lead and an adjacent abandoned lead that was adherent to the subclavian vein. No other patient has had a late complication during follow-up to 256 months (mean 47.6). Properly managed abandonment of an uninfected lead can carry a very low complication rate. PMID- 3669705 TI - Tetralogy of Fallot with anomalous origin of left anterior descending coronary artery. Surgical options. AB - Anomalous origin of the left anterior descending coronary artery from the right coronary artery can interfere with the location of the usual ventriculotomy during repair of tetralogy of Fallot. The purpose of this study was to compare the results of two operative techniques: (1) a "tailored" right ventricular incision and outflow patch reconstruction and (2) placement of a conduit from the right ventricle to the main pulmonary artery. We reviewed the records of 416 patients who had complete repair of tetralogy of Fallot at the Mayo Clinic from 1973 through 1984. Twenty (5%) (median age 6.5 years) had anomalous origin of the left anterior descending coronary artery from the right coronary artery. Twelve of these patients had right ventricular outflow patch reconstruction, and eight had placement of a conduit from the right ventricle to the pulmonary artery. Three deaths occurred, all during hospitalization, two in the patch reconstruction group and one in the conduit group. The average reduction in right ventricular pressure postoperatively was slightly but not significantly greater for the conduit group. These data indicate that correction of tetralogy of Fallot with anomalous origin of the left anterior descending coronary artery can be done with either patch reconstruction or conduit placement. Selection of the more appropriate procedure depends on the exact location and degree of tortuosity of the anomalous artery and the level and severity of right ventricular outflow obstruction. PMID- 3669706 TI - Congenital esophagobronchial fistula in an adult. AB - Congenital esophagobronchial fistula occurring in infancy and childhood is a well recognized entity necessitating urgent surgical treatment. Persistence of such a communication into adulthood is rare and would seem possible only if the tract were small so that aspiration into the lung could be tolerated. The case of a 38 year-old woman is presented in this report who was cured of lifelong symptoms of aspiration by surgical division of a presumed congenital esophagobronchial fistula. PMID- 3669707 TI - Acute thrombosis of Starr-Edwards aortic prosthesis. AB - A case of acute valve thrombosis occurring in a Starr-Edwards aortic prosthesis during the immediate postoperative period is reported. This appears to be the first such case to be reported. PMID- 3669708 TI - Myocardial protection jacket for topical hypothermia. PMID- 3669709 TI - Reperfusion ventricular fibrillation and creatine kinase MB isoenzyme. PMID- 3669710 TI - Immunologic cell markers of peripheral blood and lymph node lymphocytes in chronic lymphocytic leukemia. AB - The immunologic phenotype of the lymphocytes of 100 patients with chronic lymphocytic leukaemia (CLL) was investigated. Peripheral blood lymphocytes (PBL) were examined in all cases; in 46 patients with lymphadenopathy, a lymph node was biopsied and the histologic and immunologic patterns were assessed: 24 had a lymphocytic-lymphoplasmocytoid histology and 22 the follicular variant of lymphocytic lymphoma (mantle zone lymphoma, MZL). For comparison, lymph node suspensions from 19 patients with non-leukemic centrocytic lymphoma (CCL) were also studied. Significant differences in the PBL immunologic features were found between stage O and stage I patients. The phenotype of the lymphocytes of patients with lymphocytic histology was similar to that of stage 0 CLL patients, whereas major differences were found between these patients and those with mantle zone histology. This enables these patients to be recognized easily on immunologic grounds. PMID- 3669711 TI - Long-term effects of cytostatic agents on the hemopoietic stroma: a comparison of four different assays. AB - We have compared four assays to detect hemopoietic stromal damage induced by various cytostatic agents in young (4-week old) and adult (12-week old) mice. These assays included: (a) quantitation of the hemopoietic stem cell content of subcutaneously implanted spleens and femurs, (b) quantitation of fibroblastic colony-forming units per femur and spleen, (c) quantitation of the growth of normal hemopoietic progenitor cells in irradiated cytostatic drug-treated mice, and (d) measurement of splenic hemopoietic stem cell accumulation in response to bacterial lipopolysaccharide-induced hemopoietic stress. Busulfan caused a short- and long-term hemopoietic stromal defect. However, the four assays used showed different kinetics and severity of the stromal damage. Cyclophosphamide treatment resulted in a short-term stromal damage which was repaired within one week to three months, depending on the assay used. Methotrexate and vincristine did not cause long-term stromal damage as measured by the four assays used, whereas a short-term splenic stromal damage was detected using the subcutaneous implantation technique. No significant differences in stromal sensitivity to drug treatment were observed between young and adult mice. The presented data suggest that the four assays used to study stromal integrity measure different components of the hemopoietic microenvironment, and indicate that the use of a single assay may well lead to erroneous interpretations. PMID- 3669712 TI - Getting to market: the scientific and legal climate for developing an AIDS vaccine. PMID- 3669713 TI - AIDS: legal and policy implications of the application of traditional disease control measures. PMID- 3669714 TI - AIDS: law and policy. PMID- 3669715 TI - Liability related to diagnosis and transmission of AIDS. PMID- 3669716 TI - AIDS and the criminal law. PMID- 3669717 TI - AIDS and the limits of discrimination law. PMID- 3669718 TI - Dynamic model for the development and testing of a tracheal prosthesis under preclinical conditions. AB - The development of a tracheal prosthesis was evaluated using in vivo data on mechanical loads in the natural organ. The application of in vivo loads to the explanted organ in a laboratory tester was shown to give information on the natural reaction forces of the organ. It is therefore possible to perform in vitro tests on various prosthesis prototypes under near-natural stress conditions and to adapt the prostheses accordingly before implantation. PMID- 3669719 TI - Cell seeding on microporous and solid polyurethane. AB - Cell coating with human embryonal fibroblasts was examined on solid (Plathurane UM 8300) and microporous (Tecoflex 80 A) polyurethane. Using measurements of cellular growth kinetics and adhesion strength it was found that the onset of cellular growth on the microporous material was delayed but that the vitality and adhesion strength of the cells were better than for the solid material. PMID- 3669720 TI - Porcine aortic versus bovine pericardial valves: a comparative study of unimplanted and from patient explanted bioprostheses. AB - This extensive morphological study (macroscopy, x-ray, histology, histochemistry and electron microscopy) compares two types of bioprosthetic valves, porcine aortic (PAV) and bovine pericardial (BPV) of various models, both unimplanted (five) and explanted (229). There were 197 PAV and 32 BPV explanted from the mitral, aortic and tricuspid positions, with a mean duration of implantation of 70.3 and 13.5 months, respectively. Within that material, a smaller, rather homogeneous, series of 11 Carpentier-Edwards PAV (CE) and 11 Ionescu-Shiley BPV (IS) explants (mean implantation period 53 and 49, mean patient-age 45 and 47 years) made the comparison of clinical and macroscopic features more valid. In the total series, the leading causes of failure were cuspal tear/perforation with calcification in the PAV group (64 per cent); non-calcified leaflet rupture (27 per cent) and infective endocarditis (27 per cent) in the BPV group. In the small series of CE PAV and IS PAV, the characteristic modes of failure were calcified juxta-commissural cusp rupture for CE and non-calcified leaflet rupture at the suture for IS. The most characteristic x-ray features were calcification of fibrous cords irradiating from the commissures and calcific nodules in the centre in PAV and large plaques extending from the commissures and leaflet base in all directions in BPV. The main microscopic features of leaflet degradation were: the soaked sponge phenomenon (loosening and plasma and fat insudation) and the nodular, protein-rich calcification, both centred in the spongiosa, in PAV explants; important macrophagic activity and destruction of collagenous structures at the outflow layer and along the suture of the leaflets, with preservation of the middle layer, and the intrinsic calcification of the deep collagenous bundles, in BPV explants. Those alterations and other features are discussed with reference to leaflet structure and design, haemodynamics and possible causal mechanisms. PMID- 3669721 TI - The in vitro function of 19-mm bioprosthetic heart valves in the aortic position. AB - 1. The new pericardial valves tested showed better hydrodynamic performance than the porcine and the St. Jude Medical mechanical valves. 2. The Ionescu-Shiley III valve exhibited the best hydrodynamic performance, with the least transvalvular energy loss. 3. Transvalvular energy loss shows that the major loss across the 19 mm valves occurs during the forward-flow phase. 4. Our data compares well with data from other in vitro tests performed using different test apparatus. 5. The pericardial bioprostheses, in particular, function well in the 19 mm size and therefore offer an alternative to the increased operative risk associated with valve over-sizing or orifice enlarging procedures. 6. The performance of the two porcine valves tested were comparable with each other. PMID- 3669722 TI - Portable and wearable artificial kidneys: introductory remarks. PMID- 3669723 TI - The bioartificial kidney: progress towards an ultrafiltration device with renal epithelial cells processing. AB - The combination of an ultrafiltration device with an exchanger whose semipermeable hollow fibres are covered with renal epithelial cells is proposed as a design for a bioartificial kidney. We first demonstrated that continuous ultrafiltration can be maintained for relatively long periods in the absence of anticoagulation. As a second step, we report here the feasibility of attaching and growing two lines of kidney epithelial cells (MDCK and LLC-PK1) on two different semipermeable materials, an acrylic copolymer and a polysulphone. Cells seeded on acrylic copolymer hollow fibres reach confluence within three weeks. Depending on the chemical and/or physical properties of the polymer, the cells show distinct differentiated morphology, which may influence their ability to perform specialized tasks. PMID- 3669724 TI - A pret-a-porter artificial kidney for treating severely ill patients. PMID- 3669725 TI - A portable artificial compact kidney: pack system. AB - To facilitate patients' movement, we developed a simplified portable haemodialysis system, using a sorbent cartridge (Organon Teknika) for regeneration of the dialysate. The whole system is in two parts: (1) a compact disposable container for dialysate recirculation with dialyser and blood and dialysate lines; (2) a dual functions circulatory assistance monitor. The pack system is easy to use: single-use; no water processing; no formalin processing; reliable for temporary use (because of its aluminium), providing excellent purification; compact and portable, it permits greater freedom for the patient, and with adequate dialysis. PMID- 3669726 TI - Evaluation of a readily-fabricated infusion device. AB - Drug delivery by controlled-release devices is used extensively in clinical practice and laboratory experiments. There are many external and implantable pumps available, but their cost is high and modification, when desired, to suit any special requirement is often difficult. We have tested a plastic infusion device fabricated from materials readily available in our research laboratory. The infusion device consists of a collapsible solution reservoir protected by a double jacket with vents to prevent the permeation of the volatile propellant contained in a rigid external casing. The flow moderator is a hollow glass-fibre, and flow rates as low as 100 microliter/h or less were maintained for an extended period without becoming occluded. In vivo tests on Wistar rats using a heparin solution demonstrate that controlled release of the anticoagulant was achieved, as indicated by the delay in the normal Lee-White clotting time. Since its size, service life and flow rate may be selected to suit the infusion requirement in an experiment, the device should be readily adaptable for the delivery of other drugs. PMID- 3669727 TI - Effects of magnesium on transient depolarizations and triggered activity induced by ouabain in guinea pig ventricular muscle. AB - Effects of Mg on transient depolarization (TD) and triggered activity (TA) induced by ouabain in guinea pig ventricular muscle were studied. Increased Mg concentrations (8-12 mM) suppressed the amplitude of TDs and prolonged the coupling intervals to the preceding action potential. Mg also increased the threshold of excitability for propagated action potentials and promptly terminated the otherwise sustained TA. The Mg-induced TA termination was due to both suppression of TDs and increases in the threshold of excitability, the latter appearing to take precedent. PMID- 3669728 TI - Alterations of electrolytes in serum and erythrocytes after myocardial infarction. AB - Electrolyte concentrations in serum and erythrocytes of 56 myocardial infarction (MI) patients and 50 patients having had an orthopedic operation or an accident were measured up to 2 weeks after the event. Several hours after the MI, considerable percentages of patients had had pathologically low serum concentrations of either K, Ca or Mg. In the erythrocytes of the Mi group, K was decreased and Ca increased during the entire period of investigation, whereas the serum electrolytes K and Ca had normalized by day 15, at which time only half of the patients with pathologically low serum Mg had reached the normal Mg range. By correlation analysis it was shown that the more the Ca concentration in the serum was decreased after MI, the less was the concentration of brain muscle creatine kinase. PMID- 3669729 TI - Magnesium attenuates methacholine-induced bronchoconstriction in asthmatics. AB - The effects of inhaled MgSO4 on methacholine bronchoprovocation test (BPT) were studied in 16 asthmatics in clinical remission (FEV1 greater than 80% of predicted). The patients performed methacholine BPT on two separate days, one day after saline, the other day after MgSO4 inhalation, in double-blind cross-over design. Spirometry was recorded on each test day before and 5 min after NaCl or MgSO4. Neither NaCl nor MgSO4 was found to have a significant effect on spirometric measurements. A significant inhibition of reactivity to methacholine was observed with an increase in log PD20 FEV1 from 1.31 +/- 0.11 inhalation units after NaCl to 1.56 +/- 0.11 inhalation units after MgSO4 (p less than 0.01). The most attractive hypothesis to explain the latter, is that Mg2+ might interfere with Ca2+ handling in the bronchial smooth muscle cells similar to that shown for other types of smooth muscle. PMID- 3669730 TI - Variable response of serum magnesium and total cholesterol to different magnesium intakes and exercise levels in rats. AB - Thirty-two Sprague-Dawley rats were divided into four groups: control, exercise, low-magnesium diet, and a combination of low-magnesium diet and exercise. The low magnesium diet contained 80 ppm of magnesium and the exercise consisted of 1-hour swim sessions, 5 days per week for 4 weeks. Serum magnesium was depressed and total cholesterol was elevated (p less than 0.05) in the low-magnesium diet, sedentary animals as compared to both sedentary and exercised rats fed a normal magnesium diet. The group on the combination of hypomagnesemic diet and exercise was not statistically different from the normal-diet group. It is concluded that exercise favorably affects the serum magnesium and cholesterol responses induced by a hypomagnesemic diet. There may be a threshold serum magnesium level to elicit the elevated cholesterol response, or other metabolic factors affected by exercise may modify the expected cholesterol response associated with deprivation or severe deficiency of dietary magnesium and related serum magnesium levels. PMID- 3669731 TI - Excretion, serum, bone and kidney levels of F in rats after a high single dose of F and Mg + F. AB - The aim of this study was to clarify the mechanisms by which Mg protects the organism against the acute toxic effects of F. A single dose of F (30 mg F/kg as NaF) was given to young rats by gastric gavage with or without a prior dose of Mg (as MgCl2) equivalent to the F dose given (groups MgF and F, respectively). Feces and urine, serum, femoral bone and kidney were sampled 24 h after the doses were administered. Mg given 30 min before fluoride did not modify elevation of the F content in serum or in femoral bone when each was measured 24 h after the F dose. Except for fecal excretion of F, Mg did not significantly influence F excretion. However, the mean renal content of calcium, which was highly elevated by F alone, was markedly less in the MgF group. The renal content of Mg was at almost the same level in the MgF group as in the controls. The antidotal effect of Mg against F toxicity cannot primarily be due to interference with the absorption of F. Prevention of the nephrocalcinotic effect of F by Mg appears to be a mechanism for reducing the acute toxic effects of F, but our results suggest that other tissue and intracellular mechanisms may be more decisive. PMID- 3669732 TI - Amiloride-sensitive net Mg2+ efflux from isolated perfused rat hearts. AB - Coronary blood vessels of isolated spontaneously beating rat hearts were perfused with an Mg2+-free solution at a rate of 3 ml/min. 1.5-ml fractions were sampled. Net Mg2+ efflux from heart muscle cells was measured by the increase of Mg2+ concentration in the perfusate. Addition of 0.3 microM isoproterenol to the perfusate resulted in a rapidly occurring transient Mg2+ efflux which was inhibited by amiloride. PMID- 3669733 TI - Bone marrow cytogenetics: the lineage of dividing cells changes during the first few hours in culture. AB - To determine changes in the cell lineages of metaphases karyotyped following different culture times, marrow from 11 healthy individuals was studied using a technique that allows simultaneous analysis of karyotype and cell lineage. Cell lineage was identified as erythroid by surface glycophorin A, granulocytic by Sudan black B and PM-81, and monocytic by lysozyme. Marrow examined sequentially showed granulocytic mitoses to initially decrease from a mean of 40% at 1.75 hr to 6% at 3.5 hr and then increase, being 46% by 6 hr and 82% after 1 day, and remain high for the 10 days studied. Erythroid mitoses were most frequent (mean, 72%) at 3.5 hr and then decreased rapidly, being 16% by 6 hr, 7% at 1 day, and absent thereafter. When granulocytic mitoses were least frequent, 20-36% of mitoses were also unreactive with glycophorin A. Double staining experiments to identify these cells found some to be monocytic, but most remained unidentified. The authors conclude that mitoses of different hematopoietic lineages predominate when normal marrow is studied cytogenetically at different times following aspiration, and that the major changes occur during the first 8 hours. These findings have importance for how cytogenetic studies are performed in leukemia. PMID- 3669734 TI - Expression of blood group A antigen during erythroid differentiation in A1 and A2 subjects. AB - The expression of blood group A antigen on marrow and blood cells from A1 and A2 subjects was investigated by the binding of Helix pomatia and Dolichos biflorus lectins using immunofluorescence. These two lectins stained BFU-E-derived colonies from A subjects in the early days of culture before the expression of glycophorin. The erythroid origin of these cells was ascertained by the coexpression of two other very early erythroid markers. In bone marrow, the ultrastructural immunogold method revealed that the entire erythroid lineage including proerythroblasts was labeled by HPA, whereas no staining was observed on granulomonocytic cells including myeloblasts. Platelets from A subjects were HPA-labeled and so were platelets from an O subject preincubated in A plasma. Megakaryocytes obtained in CFU-MK-derived colonies were weakly and heterogeneously labeled by the HPA lectin. Cultures from A1 and A2 subjects were the reflection of the genetic differences only when investigations were performed on mature erythroblasts. In contrast, the great majority of immature erythroblasts both from A2 and A1 subjects were equally labeled by both lectins; during further erythroid maturation, binding of both lectins markedly diminished only on A2 erythroblasts. When marrow erythroblasts were investigated at electron microscopic level, heterogeneity of labeling among all stages of maturation was clearly observed in A2 subjects, with staining stronger on immature than on mature erythroblasts. Therefore, the genetic differences between A1 and A2 subjects are revealed during terminal erythroid differentiation. PMID- 3669735 TI - Identification of two human phosphoproteins (dividin and IEF 59dl) that are first detected late in G1 near the G1/S transition border of the cell cycle. AB - Two-dimensional gel electrophoretic analysis (NEPHGE, IEF) of the [32P] orthophosphate-labeled proteins synthesized throughout the cell cycle of transformed human amnion cells (AMA) revealed two phosphoproteins (dividin, Mr = 54,000, pl = 8.4; IEF 59dl, Mr = 27,000, pl = 5.7) that are present mainly in S phase cells. These proteins are first detected at the end of G1, near the G1/S transition border, and their levels reach a maximum late in S-phase. Together with the previously identified nuclear protein cyclin, these phosphoproteins are likely candidates for proteins that may play a role in the regulation of the onset of DNA synthesis and cell division. PMID- 3669736 TI - Distribution of leukemia, lymphoma, and allied disease in parts of Great Britain: analysis by administrative districts and simulations of adjacencies. Leukaemia Research Fund 1984 Data Collection Group. AB - An analysis is presented of the distribution of cases of leukemia and allied disorders occurring in 151 administrative districts from England, Wales, and Scotland during 1984. The age-adjusted rates for certain conditions present an unusual pattern highlighting excessively high and low rates in parts of the country, some of which share contiguous boundaries. In particular, high rates for non-Hodgkin's lymphoma are found in rural Yorkshire districts, whereas leukemias and primary polycythemias are much more common in the Midland districts. PMID- 3669737 TI - Toward establishing a database of human protein information derived from the analysis of two-dimensional gels. PMID- 3669738 TI - Are two courses of chemotherapy required in phase II trials in acute leukemia? AB - In most phase II studies, patients must receive two courses of chemotherapy in order to be judged evaluable for response. We reviewed the experience with six different phase II drugs given to patients with acute leukemia and found that the requirement of a second course may be unnecessary. Administration of second courses do not transform "ineffective" drugs into effective drugs. Furthermore, second courses lead to enhanced toxicity. We conclude that future trials with phase II agents in acute leukemia should be limited to the administration of one course. PMID- 3669739 TI - Monoclonal antibodies specific for human platelet membrane glycoproteins bind to monocytes by focal absorption of platelet membrane fragments: an ultrastructural immunogold study. AB - The membrane labeling of monocytes by monoclonal antibodies directed against platelet glycoproteins Ib (AN51), IIb (Tab), IIIa (C17), IIb-IIIa complex (J15) and to antigens common to platelets and monocytes (anti-monocyte platelet antigen and FA6 152) has been investigated by an ultrastructural immunogold method. Only with FA6 152, which identifies a structure shared by erythroblasts, platelets, and monocytes, was labeling obtained on membranes of both platelets and monocytes from normal blood. With all the other monoclonal antibodies, platelets were highly labeled but monocytes lacked quantitatively significant label; however, focal microparticles which exhibited gold particles were adherent to the membrane of monocytes. This localized labeling, interpreted as resulting from the fragmentation of platelet membranes during monocyte isolation with adhesion of the fragments to monocyte surfaces, was verified by two approaches. First, double staining with C17 visualized by an anti-IgG coupled to 40 nm gold particles and MO2 recognizing exclusively a surface monocyte antigen, as visualized by an anti IgG coupled to 15 nm gold particles, was performed. The absence of colocalization of large and small gold particles either on monocytes or on microparticles confirmed the exclusive cell origin. Second, when analyzed by quantitative x-ray analysis, monocyte associated gold following C17 treatment was restricted to platelet pseudopods and fragments on whole mount spread cells. Finally, when monocytes were spread immediately after blood collection in the absence of sedimentation and centrifugation to prevent platelet activation, platelet rosetting was avoided and the number of microparticles markedly decreased. Thus, the attachment to monocyte membranes of microparticles originating from platelets may be confused with true labeling of monocytes by antibodies to platelet glycoproteins if analysis is limited to immunofluorescence. PMID- 3669740 TI - Childhood monosomy 7 syndrome: clinical and in vitro studies. AB - The clinical and cell growth characteristics of 11 children with monosomy 7 presenting as preleukemia (eight cases) or acute nonlymphoblastic leukemia (three cases) were studied. Anemia was common to all patients, with nine showing leukocytosis, seven thrombocytopenia, and one thrombocytosis. There was a striking predominance of males (M/F ratio, 10:1) and a young median age (3 years). Preleukemia evolved to acute nonlymphoblastic leukemia in five patients and to myelofibrosis in one. In vitro studies of bone marrow progenitor cells cultured in leukocyte feeder-stimulated agar revealed abnormal cell proliferative patterns, most often an increased number of small clusters, for all 11 subjects. The cells of some preleukemic patients showed increased growth even in the absence of an exogenous source of colony-stimulating factor, suggesting autonomous growth or possibly autocrine stimulation. Combination chemotherapy or bone marrow transplantation failed to induce complete remission in the seven patients who were treated. Our findings in these 11 cases confirm the poor prognosis of monosomy 7 presenting as preleukemia in children. The in vitro studies suggest an association between altered cell growth in vitro and clinical evolution to frank leukemia. PMID- 3669741 TI - Relation between cell cycle stage and the activity of DNA-synthesizing enzymes in cultured human lymphoblasts: investigations on cell fractions enriched according to cell cycle stages by way of centrifugal elutriation. AB - Undifferentiated human lymphoblasts (culture LS-2) were separated according to cell size during their exponential growth phase by way of centrifugal elutriation. The cell fractions thus obtained were characterized in terms of different cell cycle stages by flow cytometric measurement of their deoxyribonucleic acid (DNA histogram), the [3H]thymidine labeling index, and by determining the rate of [3H]thymidine incorporation. In these cell fractions the activities of thymidine kinase, thymidylate synthase, DNA polymerase, dihydrofolate reductase, methionine synthase, and hexokinase were determined. The results showed that all the enzymes investigated exhibited activities in all cell fractions. With the exception of DNA polymerase, all of the enzymes exhibited the lowest level of activity in the fraction containing the highest proportion of G0 + G1 phase cells (fraction 2); the activity of thymidine kinase was particularly low. This would suggest that thymidine kinase is not active in G0 + G1 phase cells and that the activity measured in fraction 2 is perhaps attributable to contamination of this fraction by S and G2 + M phase cells. PMID- 3669742 TI - Cytotoxicity and differentiating actions of adriamycin in WEHI-3B D+ leukemia cells. AB - The monomyelocytic leukemia WEHI-3B D+ can be induced to differentiate into mature granulocytes in suspension culture when exposed to 40 nM adriamycin. Treated cells underwent approximately two divisions prior to reaching plateau phase, with approximately 55% of the cell population expressing nitro blue tetrazolium positivity (NBT+) by day 3. Decreased cellular proliferation was paralleled by a progressive increase in morphologically mature granulocytic cells. Maturation was also characterized by a 4.4-fold increase in Fc receptors on the cell surface. An increase in the size of adriamycin-treated cells occurred and correlated with residency in the G2M phase of the cell cycle. Adriamycin induced NBT+ cells, which contained the highest levels of Fc receptors, were also found to reside in G2M. Adriamycin blocked cells in the G2M phase of the cell cycle by 8 hr (125% above control), and this arrest reached its maximum by 20 hr (194% above control). Concomitant with the block in the cell cycle was the commitment by these cells within 8 hr to the granulocytic pathway of differentiation. Fractionation of cells by centrifugal elutriation into enriched phases of the cell cycle was consistent with the hypothesis that induction of the differentiation program was initiated either in G1 or very late in the cell cycle. Immobilized adriamycin, which does not gain access to the cell interior, did not induce the maturation of WEHI-3B D+ cells, nor did it block their replication in a specific phase of the cell cycle; however, immobilized adriamycin was 30-fold more toxic to WEHI-3B D+ cells than free drug. Incubation of WEHI-3B D+ cells with the semisynthetic adriamycin analog N-trifluoroacetyl adriamycin-14-valerate (AD-32) resulted in approximately 50% of the cell population being NBT+ by day 3. The findings suggest that adriamycin must be able to enter cells to induce maturation, and that at least some portion of its toxicity is associated with an effect at the surface membrane. Furthermore, the results obtained with AD-32 imply that intercalation into DNA is not necessary for induction of the differentiated phenotype. PMID- 3669744 TI - Lineage infidelity or lineage promiscuity? PMID- 3669743 TI - Phenotypic and genotypic heterogeneity in large granular lymphocyte expansion. AB - The cellular heterogeneity of large granular lymphocyte expansions has been illustrated by the phenotypic and genotypic findings in five patients. In one patient whose circulating cells were CD2+, CD3-, CD5-, CD7+, CD8-, CD11+, Leu7+, CD16+, and displayed strong natural killer activity, no rearrangement of the T cell receptor beta-chain gene and T cell rearranging gene gamma was detected. The four other patients presented with neutropenia without overt lymphocytosis. In these patients the circulating lymphocytes expressed a predominant T cell phenotype CD2+, CD3+, CD5+, CD7+, CD8+, Leu7+. In three of them the presence of a T cell clone was demonstrated on the basis of a unique pattern of rearrangement of the T cell receptor beta-chain genes. PMID- 3669746 TI - LSA Medical Conference. Leukemia Society of America. Third national symposium. March 19-21, 1987, San Diego, California. Presentation synopses. PMID- 3669747 TI - Second International Workshop on Hairy Cell Leukemia. Kent, England, September 22 24, 1986. Proceedings. PMID- 3669745 TI - Monocyte esterase? A factor involved in the pathogenesis of lymphoproliferative neoplasia. AB - Monocyte esterase activity was studied in 1,000 doctor-attending patients with normal hematological indices and in 56 patients with non-Hodgkin's lymphoma (NHL) or B chronic lymphocytic leukemia (CLL). The incidence of esterase deficiency was significantly greater in the NHL-CLL patients (7.1%) than in the population group (1.7%; p less than 0.05). In the NHL-CLL group, study of the families showed the esterase deficiency to be a familial characteristic. We postulate that the presence of the anomaly may be either a factor predisposing to the development of the NHL or CLL or a factor indicating a predisposition to these disorders. PMID- 3669748 TI - Cytochemistry of tartrate-resistant acid phosphatase: 15 years' experience. AB - Tartrate-resistant acid phosphatase (T-AcP) has been used in the past 15 years as a specific test for the diagnosis of hairy cell leukemia (HCL). However, enzyme activity has been reported to be absent from the hairy cells of rare cases of HCL and to be present in the neoplastic cells of diseases other than HCL. In order to fully utilize T-AcP for the diagnosis of HCL, it is necessary to maximize the sensitivity and specificity of the staining method, to have adequate quality control to ensure technical and interpretative accuracy, and to prepare optimal cytologic and histologic materials for study. In blood, only the presence of cells with intense T-AcP activity is diagnostic of HCL (positive T-AcP test). In tissues other than blood, the presence of cells with intense enzyme activity may not be diagnostic for HCL; assessment of cell morphology and appreciation of the pattern of enzyme localization are also important. In studying the blood of over 1,000 patients, we have found a negative T-AcP test in two of 200 cases of HCL and a positive T-AcP test in three of 800 patients with diseases other than HCL. We believe that the T-AcP test, when performed and interpreted properly, is a useful diagnostic test for HCL. PMID- 3669749 TI - Unusual presentations and complications of hairy cell leukemia. AB - In a series of 116 patients with hairy cell leukemia at the Ohio State University, followed for over 20 years, several unusual presentations and complications were encountered. The awareness of these unusual findings might be of help to investigators in the prompt diagnosis and treatment of this disease. The patients presented had, at the time of initial diagnosis, spontaneous rupture of spleen, cryptococcal meningitis, massive splenomegaly with hairy cell infiltration with normal peripheral blood and bone marrow examination, and marked leukocytosis. Some patients developed unusual complications during the course of their illness, such as gastric submucosal infiltration by hairy cells with secondary protein-losing enteropathy, spinal cord compression with paralysis, esophageal perforation with fistula tract, and massive ascites and pleural effusion with typical hairy cells present in the ascitic and pleural fluid. PMID- 3669750 TI - Diagnosis and monitoring in patients with hairy cell leukemia using the monoclonal antibody anti-HC2. AB - Immunofluorescent staining of peripheral blood mononuclear cells with the monoclonal antibody anti-HC2 combined with phase microscopic examination identified leukemic hairy cells in nine of 13 patients (69%) evaluated at Memorial Hospital prior to treatment with recombinant alpha-interferon (rIFN alpha A). The remaining four patients required further studies of bone marrow or peripheral blood cytospin samples for diagnosis. In some cases a low percentage of cells staining with anti-HC2 could be significantly increased by depleting T cells from the sample using sheep red blood cell rosetting. These 13 patients represent a subgroup of patients treated on a phase II rIFN-alpha A study at Memorial Hospital. Ten patients (77%) achieved a partial response in a median of 128 days (range, 64-234). One patient achieved a minor response and two patients failed treatment. Nonhematologic toxicity, consisting of fever and malaise, was transient in all patients. Serial determinations of HC2-positive cells in the peripheral blood closely paralleled disease activity in the bone marrow in one patient treated for 4 years with various therapeutic modalities. The antibody anti-HC2 may play a significant role in the diagnosis and monitoring of hairy cell leukemia using peripheral blood sampling. PMID- 3669751 TI - Changes in hairy cells after alpha-interferon treatment as measured by flow cytometry. AB - Patients with hairy cell leukemia who responded to alpha-interferon (IFN-alpha) were compared to those who did not by examining their hairy cells throughout treatment. The examination of the cells by cytofluorography included the expression of surface antigens (such as B1, HLA, transferrin receptors, surface immunoglobulins, TAC), and cytofluorometric measurement of light scatter including forward (which correlates with cytoplasmic size and shape) and perpendicular (which correlates with nuclear size and shape) directions. Although the entire lymphocyte population from these patients was examined initially to look for changes in phenotype with treatment, in later studies an enriched leukemic population was examined and alterations in response to interferon treatment became more apparent. The monoclonal antibody M5 was used to enrich the hairy cell population via a panning technique. The enriched population contained greater than 90% tartrate-resistant acid phosphatase-positive hairy lymphocytes. By cytofluorographic analysis of these cells serially in four responding patients and one refractory, all of whom had been followed longer than 11 months, several observations were made: 1) leukemic cells from responding patients showed a rapid decline in the forward and perpendicular light scatter indicative of cell differentiation; 2) coexisting normal B cells showed no changes in the above features; and 3) leukemic cells exhibited a definite increase in the HLA antigen density and a slight decrease in transferrin receptors in responding patients but not in the refractory patient. The increase in HLA antigen expression by hairy cells indicates progression toward differentiation, and decrease in transferrin receptors correlates with growth reduction. These data indicate that the administration of IFN-alpha is associated with cellular changes toward differentiation. We can not exclude, however, the possibility of other actions of IFN-alpha in HCL as proposed by other investigators. PMID- 3669752 TI - Magnetic resonance imaging of bone marrow in hairy cell leukemia: correlation with clinical response to alpha-interferon. AB - Five patients with progressive hairy cell leukemia were treated with recombinant alpha 2-interferon and examined prospectively at 3-month intervals using serial bone marrow biopsies and magnetic resonance (MR) imaging. Pretreatment iliac crest marrow biopsies demonstrated hairy cell infiltration involving 30-90% of marrow cellularity. Concurrent pretreatment coronal images of the proximal femurs and pelvis using MR revealed extensive marrow involvement that varied in distribution from patchy to diffuse. At 6 months, all patients had responded to alpha 2-interferon with improvement in peripheral blood counts and decrease in lymphoid infiltration on marrow biopsy to 15-40%. Six-month follow-up MR scans demonstrated decreasing marrow leukemia infiltration and increasing marrow fat. MR bone marrow imaging appears useful in the initial diagnosis of hairy cell leukemia, for monitoring the response to treatment, and possibly for predicting relapse. PMID- 3669753 TI - Mid-term observations on the efficacy of alpha-interferon in hairy cell leukemia and status of the interferon system of patients in remission. AB - We summarize our experience using alpha-interferon (IFN-alpha) in the treatment of 93 patients with hairy cell leukemia. Both partially purified interferon and recombinant IFN-alpha produced over 85% response rate. Equal efficacy at 12 months of treatment was found for both types of IFN-alpha. However, continuation of treatment up to 24 months with partially purified IFN-alpha resulted in an increased number of complete remissions. An increase in the number of bone marrow's hairy cells occurred in 70-80% of the patients in whom a treatment was discontinued. Only 20% of the patients required reinitiation of treatment, and in all, reinduction of remission was readily obtained. Toxicity to IFN-alpha in patients with hairy cell leukemia was minimal. IFN-alpha production by patients in remission was studied. Only those patients in complete remission showed adequate IFN-alpha production. The role of endogenous IFN-alpha in the induction and sustenance of remission in hairy cell leukemia is discussed. PMID- 3669754 TI - The U.K. experience with human lymphoblastoid interferon in HCL: a report of the first 50 cases. AB - The results of treatment of the first 50 patients with hairy cell leukemia given human lymphoblastoid alpha-interferon (Wellferon) are presented. All patients, irrespective of previous splenectomy or splenomegaly showed evidence of response. Side effects were minor. Surface marker studies provided no clear indication of the mechanism of action of alpha-interferon. It is concluded that Wellferon is highly effective in this disease. PMID- 3669755 TI - Results of treating 53 hairy cell leukemia patients with alpha-interferon. AB - Fifty-three hairy cell leukemia patients were treated with low dose recombinant and natural alpha-interferon for 7 or 13 months with a marked improvement in peripheral blood and bone marrow findings. Our results suggest that daily injections have no advantage over three weekly injections, but longer treatment (12-13 months) is better than shorter treatment (6-7 months). The possibility of a relapse raises the issue of the place of splenectomy in the treatment strategy. Since the definition of remission and of relapse is based on the histological changes in the bone marrow, the necessity for the quantification of the hairy cell infiltration on bone marrow sections is stressed. PMID- 3669756 TI - The treatment of hairy cell leukemia with alpha 2b-interferon: experience with 27 patients treated more than one year. AB - Thirty-six patients with progressive hairy cell leukemia were treated with recombinant alpha 2b-interferon injected subcutaneously 2 X 10(6) IU/m2, three times a week. Twenty-seven patients completed 12 months of therapy and were randomized either to receive 6 months of continued interferon or to go off treatment. At the time of randomization, two patients had achieved a complete response, 22 a partial response, and three a minimal response. Three patients have relapsed, one while receiving interferon during the randomization period and two who were off therapy for 6 months. The outpatient regimen of interferon administration was well tolerated, with the principal acute toxicities being fever and an influenza-like syndrome and the major long-term toxicity being mild moderate fatigue. PMID- 3669757 TI - Human lymphoblastoid interferon for hairy cell leukemia: results from the Italian Cooperative Group. AB - Since April 1985, 82 patients with HCL entered a multicenter study using lymphoblastoid alpha-interferon; 51 (including 15 who failed splenectomy and 24 with substantial splenomegaly) enrolled before April 1986 are evaluated in this study. The patients were treated with 3 mega units daily subcutaneously until complete or partial response and were thereafter randomly allocated to a maintenance regime of 3 mega units/week or to observation only. Ten cases had a complete response, 18 a partial response, and 15 a minimal response. Two patients had no response, two interrupted therapy due to major toxicity (toxic hepatitis and thrombocytopenia), six died before completing 1 month of therapy of sepsis, and two died of myocardial infarction. In the two groups of splenectomized and nonsplenectomized patients the mean time to hemoglobin recovery was 8.5 and 6.5 weeks, respectively, the neutrophil count recovery was 6.5 and 9.3 weeks, and the time to platelet count recovery was 4.0 and 5.4 weeks, respectively. No significant differences in recovery time and response rate were observed between the two groups. In 31 out of 32 patients with substantial splenomegaly the spleen became either inpalpable (18) or significantly smaller (13). This study confirms the responsiveness of HCL to IFN in nonsplenectomized patients with high tumor burdens and is therefore recommended as a first-line therapy. PMID- 3669758 TI - Strategy for the treatment of hairy cell leukemia. AB - Both splenectomy and alpha-interferon are efficient treatments for hairy cell leukemia. Since interferon therapy seems to induce remissions of the disease, avoids the risks of surgery, and sustains the spleen, it should be discussed if this therapy may replace splenectomy as primary treatment for this disease. In order to make this decision the biologic relevance of complete remissions in hairy cell leukemia, the reliability of methods to confirm remission, the benefits and risks of both splenectomy and interferon therapy, and some aspects of the pathogenesis of the disease have to be considered. Based on our experimental and clinical results and data from other groups, we conclude that splenectomy should still be recommended as primary therapy in hairy cell leukemia provided that treatment is indicated and the patient is eligible for surgery. PMID- 3669759 TI - A prospective multicenter trial with human recombinant alpha 2c-interferon in hairy cell leukemia before and after splenectomy. AB - Our multicenter study on the treatment of hairy cell leukemia (HCL) started in December 1984 and the present data cover the time up to June 30, 1986. Ninety seven patients were enrolled. For induction of response daily doses (6 micrograms) of low dose human recombinant alpha 2c-interferon (arg) was chosen. Further dose reduction (3 micrograms) was possible for patients who improved within the first 3-4 weeks. Patients with known risk factors started at lower doses (0.6 microgram daily). As infections are known to be the main cause of death in HCL, splenectomy was not mandatory before treatment. Thirty-nine patients received treatment with interferon. Nevertheless, infections remained the major cause of death in the study. The protocol did not prevent fatal infections in nine of the 34 splenectomized patients. The regimen proved safe for all but one of the nonsplenectomized patients. According to this experience, new criteria are needed for the choice of primary treatment in HCL. In our opinion splenectomy should become restricted to selected cases. PMID- 3669760 TI - Changes in peripheral blood and bone marrow specimens during and after alpha 2b interferon therapy for hairy cell leukemia. AB - We studied changes in peripheral blood and bone marrow biopsy specimens obtained before, during, and after recombinant alpha 2b-interferon (IFN-alpha 2b) therapy in 25 patients with hairy cell leukemia. During therapy, only 1 patient showed no improvement in at least one of the parameters monitored. Granulocytopenia, thrombocytopenia, and monocytopenia resolved in 19/20, 14/15, and 17/18 patients, respectively. In 18/21 patients with Hb less than 12g/dl before treatment, the anemia became less severe. Hairy cells disappeared or decreased in numbers in the peripheral blood in all patients. In the bone marrow, numbers of hairy cells decreased and numbers of granulocytic, erythroid, and megakaryocytic cells increased usually within 3-6 months after the start of therapy. In no patient were hairy cells ever completely absent from the bone marrow. After cessation of IFN-alpha, the median Hb value, WBC, and platelet counts changed little for up to 12 months, but the absolute neutrophil count and absolute monocyte count decreased. Hairy cells reappeared in the peripheral blood of three patients. In the bone marrow the percentage of hairy cells increased, whereas the percentage of granulocytic and erythroid cells decreased. Neutrophil alkaline phosphatase (NAP) scores were abnormally high in 18/18 patients studied prior to IFN-alpha, but became normal in 17 of these during therapy and were normal in seven first studied during therapy. The median NAP score doubled by 3 months after cessation of therapy and was abnormal in 17/19 patients followed for 6 months. NAP score may be useful in predicting changes in the bone marrow in patients treated with IFN-alpha. We did not find any parameter in the pretherapy specimens that would have allowed us to predict individual response. PMID- 3669761 TI - Hairy cell leukemia: bone marrow changes following splenectomy and alpha interferon therapy. AB - Thirty hairy cell leukemia patients were evaluated repeatedly for their bone marrow (BM) histology. At the time of diagnosis, 18 (60%) had diffuse, 9 (30%) had interstitial, and 2 (10%) had a mixed (diffuse and interstitial) pattern of BM disease. The follow-up BM specimens were obtained at intervals of 3-24 months, and the follow-up observation period was 12-94 months. In patients who were nontreated or only splenectomized, no significant changes were observed except of a persistent megaloblastoid picture of the red cell series and an increase of BM fibrosis. In the alpha-interferon treated patients a complete disappearance of hairy cells was observed in one and a dramatic reduction in five. The hairy cell index was reduced from a mean of 0.8 before to 0.1 after alpha-interferon therapy; most patients displayed megaloblastoid erythropoiesis. In the complete responder features of myelodysplasia were present. PMID- 3669762 TI - Studies on the optimal dose and the mode of action of alpha-interferon in the treatment of hairy cell leukemia. AB - The therapeutic efficacy and side effects of alpha-2c-interferon (IFN-alpha 2c) treatment of hairy cell leukemia were compared between two different dose regimen: 10 patients received maximum tolerable doses of IFN-alpha 2c for 1 year (group A), and 11 patients received minimum doses of IFN-alpha 2c, which induced an optimal biological response (group B). Induction of neopterin excretion was chosen as the marker to define biological response and the dose of IFN-alpha 2c applied was on average only one tenth of that in group A cases. Average time of treatment in group B was 42 weeks. The data indicate that both dose levels are effective in the treatment of advanced hairy cell leukemia but that the low dose regimen is free of toxicity. Laboratory investigations on the mechanism of IFN mediated remission in HCL further revealed that hairy cells are resistant to lysis by IFN-alpha activated large granular lymphocytes and that improved natural killer function subsequent to IFN-alpha treatment in vivo is primarily due to the disappearance of leukemic hairy cells which dilute the natural killer effector cells. These findings support the view of a direct antitumor activity of IFN alpha as the main therapeutic principle. PMID- 3669763 TI - The beneficial effects of alpha-interferon in hairy cell leukemia are not attributable to NK cell-mediated cytotoxicity. AB - The natural killer (NK) activity of peripheral blood mononuclear cells against K562 targets was variable in 10 untreated patients with hairy cell leukemia and was inversely related to the number of hairy cells (HCs) present. After therapy with alpha-interferon (IFN-alpha) NK activity in vitro was equivalent to that of normal controls. It is suggested that the low activity often seen before treatment is attributable to dilution of NK cells by large numbers of inactive HCs and that this diluting effect is reduced as HCs disappear from the blood during IFN-alpha treatment. HCs was consistently resistant to NK lysis by normal or hairy cell leukemia allogeneic and autologous mononuclear cells, despite whether effector or target cells had been pretreated with IFN-alpha. Cold-target inhibition and direct binding experiments showed that HCs do not bind to NK effectors. It is therefore concluded that NK cells play no direct role in the progressive disappearance of HCs seen in patients receiving IFN-alpha. PMID- 3669764 TI - Saturation index of blood cell membrane fatty acids before and after IFN treatment in hairy cell leukemia. AB - Cells from the peripheral blood of 32 patients with hairy cell leukemia (HCL) were analyzed for cell membrane fatty acid composition. A consistent and significant change was found in the relative amounts of stearic and oleic acid components, which is expressed as the saturation index (SI), the ratio of stearic to oleic acid content. In all patients, SI was reduced in the erythrocytes, leukocytes, and platelets. On extended treatment with interferon, the hematological improvement was accompanied by an increase in SI. In two patients, one deteriorating after cessation of treatment and the other on a low maintenance dose of interferon, concurrent influenza infection induced temporary improvements in the blood cell counts, as well as increase in SI values. These results indicate that endogenous interferon can also be effective in inducing hematological and SI improvement in this disease. The relevance of low SI values and concomitant increase in membrane fluidity to the malignant transformation is discussed. It is proposed that one effect of interferon is to reduce the production of growth factors by reducing the malignant cell mass. PMID- 3669765 TI - Consensus resolution: proposed criteria for evaluation of response to treatment in hairy cell leukemia. PMID- 3669766 TI - Comments on editorial by G. Brown and co-workers: Stochastic or ordered lineage commitment during hemopoiesis? PMID- 3669767 TI - Individual clones of hemopoietic cells in murine long-term bone marrow culture. AB - Forty-seven individual hemopoietic cell clones bearing unique radiation markers were studied in long-term bone marrow cultures. Throughout cultivation clones appeared at different times, from 1 to 12 weeks after explantation, survived during 1-10 more weeks, and were characterized by marked variability in size. Usually, the number of metaphases peculiar to an individual clone rapidly increased, achieved maximum, and then underwent a decline. Cells of reliably disappearing clones were never seen again. The experimental results provide further evidence for the model of hemopoiesis by clonal succession. PMID- 3669768 TI - A randomized trial of high dose cyclophosphamide, vincristine, and prednisone plus or minus doxorubicin (CVP versus CAVP) with long-term follow-up in advanced non-Hodgkin's lymphoma. AB - Ninety-three stage III and IV patients with non-Hodgkin's lymphoma were randomized to either high dose CVP (cyclophosphamide 1500 mg/m2 i.v. day 1, vincristine 1.4 mg/m2 day 1, and prednisone 40 mg/m2 orally days 1-10) or high dose CAVP (cyclophosphamide 1000 mg/m2 i.v. day 1, doxorubicin 45 mg/m2 i.v. day 1, vincristine and prednisone as above). Overall, the complete response (CR) rates were similar (CVP 51%, CAVP 51%). Patients with the International Working Formulation diffuse large cell lymphoma had significantly higher CR with CAVP. No difference in CR duration was detected between the two regimens. CRs were durable with 68% of diffuse and 86% of diffuse large cell complete responders alive and disease free at 7 years. Survival was similar with both regimens except for patients with diffuse large cell lymphoma who survived longer with CAVP. Both regimens were equitoxic with neutropenia less than 1.0 x 10(9)/liter in 36% of courses, infections in 15% of courses, and fatal infections in three patients. These intermittent high dose cyclophosphamide equitoxic regimens produced durable responses. However, the doxorubicin-containing regimen is superior in diffuse large cell lymphoma. PMID- 3669769 TI - Human monoclonal antibodies--still much to learn. PMID- 3669770 TI - Relationship of factor-induced proliferation to respiratory status in marrow progenitor cells. AB - We have examined the respiratory status of murine and human marrow progenitor cells proliferating in response to growth factors. Proliferation of fresh marrow cells, which are almost entirely entering terminal differentiation, depends on oxidative phosphorylation as determined by oxygen uptake, lactic acid production, and effect of mitochondrial poisons which within minutes completely prevent incorporation of thymidine. However, marrow progenitors responding to growth factors in in vitro assays can proliferate in the presence of high concentrations of mitochondrial poisons, with mixed granulocyte/macrophage colonies being almost refractory to inhibition. We suggest that marrow anaerobiosis may have a physiological significance and may be of relevance to the aberrant respiration of leukemic cells which are considered to be derived from progenitor populations. PMID- 3669771 TI - Variables predicting response to high dose cytosine arabinoside therapy in patients with refractory acute leukemia. AB - The cytotoxic effect of cytosine arabinoside (ara-C) is presumably mediated by cytosine arabinoside 5'-triphosphate (ara-CTP). We tested for a correlation between intracellular ara-CTP pharmacokinetics and clinical response among 51 patients who received high dose ara-C (3 g/m2 at 12-hr intervals) as therapy for refractory acute leukemia. After accounting for pretreatment clinical variables that correlated with response, measurement of ara-CTP pharmacokinetics added significant prognostic information. This provides a rationale for manipulation of schedules of high dose ara-C administration in those patients whose pharmacokinetic characteristics are inconsistent with response to an every 12-hr schedule. PMID- 3669772 TI - Proto-oncogene expression in human normal bone marrow. AB - We and other investigators have previously reported our findings on oncogene expression in human leukemia in an attempt to study the possible involvement of these genes in the leukemic state. An important shortcoming of these studies has been the lack of information on the expression of these genes in normal hematopoietic cells. To address this question we analyzed both the transcript size and level of expression of six oncogenes in fresh hematopoietic cells obtained from hematologically normal individuals and compared the results to those found in fresh samples obtained from patients with various forms of leukemia (acute myelogenous leukemia, acute lymphocytic leukemia, and chronic myelogenous leukemia). We found low level expression of c-myc, c-myb, c-fes, and c-raf in normal bone marrow in sharp contrast to the high levels of expression found in some forms of leukemia. C-fos was highly expressed in both normal bone marrow and certain leukemias. We were unable to detect c-sis expression in our normal samples. With the exception of c-fes, there was no variation in transcript size when comparing normal and leukemic samples. Having defined the transcript sizes and levels of expression for these proto-oncogenes in normal hematopoietic cells, we know that aberrant transcript size for the genes we have studied is not a common event in leukemias. The levels of expression, however, vary widely between normal hematopoietic cells and leukemia as well as between different types of leukemia. PMID- 3669773 TI - Hemopoiesis on skin-derived fibroblasts in vitro. AB - Bone marrow fibroblasts have been shown to have a role in the support and regulation of hemopoiesis, both in vivo and in vitro. In this study we examine the ability of skin-derived fibroblasts to interact with hemopoiesis in vitro. Murine skin and bone marrow-derived fibroblasts were similar with respect to their abilities to support granulopoiesis and release colony-stimulating activity. Detailed analysis of skin fibroblast cultures 1 week after seeding with stromal cell-depleted bone marrow demonstrated that both multipotential hemopoietic stem cells and erythroid stem cells were maintained, while granulocyte/macrophage colony-forming units far exceeded inoculum values. Immunostaining demonstrated the presence of foci of T200 positive hemopoietic cells on the surface of the fibroblasts with less frequent scattered M1/70 and F4/80 positive macrophages. The majority of cells (greater than 90%) released from the stromal layer were of the granulocytic series. These findings demonstrate that the hemopoietic regulatory properties previously attributed to bone marrow-derived fibroblasts are not unique to fibroblasts derived from hemopoietic tissues. PMID- 3669774 TI - A rational and ethical approach to investigational therapy of acute leukemia. PMID- 3669775 TI - "Stem cell" activity in human peripheral blood. PMID- 3669776 TI - A myelodysplastic syndrome with eosinophilia associated with a break in the short arm of chromosome 16. AB - A case is reported of a young man with cardiomyopathy and myelodysplasia with bone marrow and peripheral blood eosinophilia. Cytogenetic investigation revealed a (5;16) (q33;p13) translocation. This is the first report of myelodysplasia with eosinophilia associated with a break in 16p13 alone, with no abnormality of 16q22. PMID- 3669777 TI - Cardiac rehabilitation in patients with severe ischemic left ventricular dysfunction. AB - Twenty patients who had had a myocardial infarction and who had a resting left ventricular ejection fraction of 25% or less participated in an 8-week outpatient supervised exercise and education program. No morbidity or mortality occurred during the program, and most patients achieved a substantial improvement in exercise capacity. During a follow-up interval of a mean of 29.7 +/- 13.0 months, four patients died, an annualized mortality of 8 +/- 4%. The outcome of cardiac rehabilitation was assessed 19.1 +/- 4.4 months after completion of the supervised program. Of the 16 survivors, all of whom had been fully employed before their most recent myocardial infarction, 9 (56%) had returned to full-time work, 6 (38%) were medically disabled, and 1 was retired (age 73 years) but fully active. Of the 16 survivors, 13 (81%) completed a questionnaire about their perceptions of their current quality of life. Of the 13 patients, 12 (92%) had continued to exercise regularly. Four patients (31%) reported the ability to perform all desired activities without symptoms, whereas nine patients (69%) noted some impairment in their functional capacity. Thus, in this group of patients with profound left ventricular dysfunction, the rehabilitation potential, as evidenced by return to productive employment and the ability to perform desired activities-including exercise training-was generally favorable. PMID- 3669778 TI - Osteolytic lesions in idiopathic myelofibrosis. AB - A case of idiopathic myelofibrosis with the unusual finding of osteolytic lesions is presented. Biopsies from the lesions showed proliferation of fibroblasts, megakaryocytes and myeloid cells. PMID- 3669779 TI - Phase I clinical and pharmacokinetic study of orally administered N4-palmitoyl-1 beta-D-arabinofuranosylcytosine. AB - A phase I study of N4-palmitoyl-1-beta-D-arabinofuranosylcytosine (PLAC) was conducted in 88 patients; 36 with solid tumors and 52 with hematological malignancies, using 2 different schedules. Schedule 1 employed a single oral administration and Schedule 2, 5-day consecutive daily oral administration. In Schedule 1, the daily dose was initiated with 1 mg kg-1 which was escalated up to 24 mg kg-1 according to the modified Fibonacci's method. Side effects included nausea, vomiting and skin rashes, but myelosuppression was not seen within this dose range. In Schedule 2, the daily dose was started with 1 mg kg-1 which was escalated up to 24 mg kg-1. Major side effects were nausea, vomiting and anorexia, and mild myelosuppression was noted at 12 mg kg-1 or more. The dose limiting toxicity was gastrointestinal toxicity, which appeared at 3.3 mg kg-1 or more and became frequent at 7 mg kg-1 or more. Pharmacokinetic study revealed that the plasma concentrations of PLAC and ara-C, obtained by the oral intake of 3.3 mg kg-1 or more of PLAC, were sufficient for these compounds to exert cytotoxic effects on various human leukemia cells in vitro. Based on these observations and plausible mechanism of action of PLAC, further clinical study should be carried out in a treatment schedule of considerably prolonged administration period with 3.3-6 mg kg-1 day-1 of PLAC. PMID- 3669780 TI - Specificity of fibrinopeptide A (FpA) as a marker for gastrointestinal cancers before and after surgery. AB - In 70 patients affected by gastrointestinal malignancies the plasma fibrinopeptide A (FpA) levels were assessed both before and at various intervals after the operation. At the same time other more commonly used tests of coagulation were carried out. In all the patients plasma FpA levels were shown to be variously elevated, so that they could give useful clues to the diagnosis, treatment, prognosis and follow-up of the gastrointestinal malignancies. In all the patients the coagulation tests fell into the normal ranges. However in the patients affected by recto-sigmoid adenocarcinoma an increase of circulating fibrin degradation products (FDPs) was observed which paralleled the increase of plasma FpA. In conclusion, in gastrointestinal malignancies the increase of plasma FpA levels suggests the cancer-induced start of the coagulation cascade. The assay of this peptide proves to be a reliable marker for these diseases. PMID- 3669781 TI - Influence of interferon on the growth of primary ovarian carcinoma cells in a semi-solid agar system: comparison with clinical effects of interferon therapy. AB - The sensitivity of primary human ovarian cancer cells to interferon (IFN) was studied in vitro by the use of a tumor cloning system in semi-solid agar. Tumor colonies were found in 37% (34/93) of the experiments with tumor cells from ascites and in 35% (6/17) of the experiments with solid tumors. The relative colony-forming ability could not be correlated to prior treatment. In 15 out of 18 patients the ascitic tumor cells were sensitive to IFN-alpha. Sensitivity was found in one test out of three with solid tumors. The sensitivity was dependent on the dose of IFN but could vary for the natural IFNs alpha and gamma. In seven patients the relation between in vitro and in vivo sensitivity of the tumor cells to IFN could be studied. Any correlation between in vitro and in vivo sensitivity could not be revealed in this small group of patients. PMID- 3669782 TI - Effect of microspheres in intra-arterial chemotherapy. A study of arterio-venous shunting and passage of a labelled marker. AB - Degradable starch microspheres (DSM) mixed and injected with a cytostatic drug might improve intra-arterial chemotherapy by increasing the local drug concentration. Several factors are of importance for an optimal effect of the microspheres, e.g. size and vascularity of the tumour, arterial blood flow and arterio-venous shunts. Therefore, the dose of DSM has to be individualized. A method for continuous monitoring of the effect of DSM was developed. A radiolabelled marker was injected intra-arterially mixed with DSM and mitomycin C. Two kinetic parameters--Passing Fraction and Marker Flow Rate--were found to be influenced by the microspheres and thus seemed to be useful for monitoring the DSM-treatment. Arterio-venous shunting was measured as passage of 99Tcm-labelled macroaggregated albumin through the liver to the lungs. Significant increase of shunting after injection of DSM was demonstrated in 15 out of 19 patients. Almost no effect of the microspheres was seen in patients with marked arterio-venous shunting or minimal reduction of the marker flow rate, but in others the passage of the labelled marker could generally be significantly reduced. PMID- 3669783 TI - [Prevalence of infections in a third-level medicosurgical hospital (I). Infections and risk factors]. PMID- 3669784 TI - [Prevalence of infections in a third-level medicosurgical hospital (II). Use of antibiotics]. PMID- 3669785 TI - [Intrahospital infection in an internal medicine service]. PMID- 3669786 TI - [Serum immunoglobulins in parenteral drug addicts]. PMID- 3669788 TI - [Autotransfusion]. PMID- 3669787 TI - [Intrahospital infections: do we prefer to describe them or do we want to prevent them?]. PMID- 3669789 TI - [Meningopolyneuritis as a manifestation of Lyme disease]. PMID- 3669790 TI - [Systemic vasculitis? No, scurvy]. PMID- 3669791 TI - [Spontaneous resolution of pituitary Cushing's syndrome]. PMID- 3669792 TI - [Infectious endocarditis in a patient with osteogenesis imperfecta]. PMID- 3669793 TI - [Statistical analysis of negative clinical tests of small samples]. PMID- 3669794 TI - [Adult respiratory distress syndrome and miliary tuberculosis]. PMID- 3669795 TI - [Adrenal insufficiency crisis after treatment with rifampicin]. PMID- 3669796 TI - [High environmental temperature and inhalation of chlorinated solvents]. PMID- 3669797 TI - [The patients' right to access to their clinical history]. PMID- 3669798 TI - [Thymostimulin in chronic hepatitis B virus infection]. PMID- 3669799 TI - [Sublingual clonidine in hypertensive crises]. PMID- 3669800 TI - [Treatment of meningococcal meningitis with fresh plasma in an individual with C7 deficiency]. PMID- 3669801 TI - [Evaluation of the effectiveness of bacteriologic studies in detecting Salmonella and Shigella in healthy persons under sanitary surveillance in Poland 1976-1985]. PMID- 3669802 TI - [Evaluation of the results of serologic studies of persons from a focus of Q fever]. PMID- 3669803 TI - [Biologic properties of Ureaplasma urealyticum and Mycoplasma hominis isolated from persons with inflammatory conditions of the urethra. I. A method of isolating Ureaplasma and Mycoplasma from human clinical specimens]. PMID- 3669804 TI - [Biologic properties of Ureaplasma urealyticum and Mycoplasma hominis isolated from persons with inflammatory conditions of the urethra. II. Occurrence of Ureaplasma urealyticum and Mycoplasma hominis in healthy men and in those with inflammatory conditions of the urethra and in their sexual partners]. PMID- 3669805 TI - [Improved quality of ambulatory health care of patients treated with oxygen for long period]. PMID- 3669806 TI - [Amatoxin analysis in mushroom poisoning]. PMID- 3669807 TI - [Dysplastic nevi--precursors of malignant melanoma?]. PMID- 3669808 TI - [Increased knowledge of the way cytostatics work has formed the basis of successful therapy]. PMID- 3669809 TI - [Alcohol-triggered acute renal failure]. PMID- 3669810 TI - [Port-A-Cath in prolonged biliary drainage as a practical alternative to a transcutaneous tube]. PMID- 3669811 TI - [Abdominal radiography in the diagnosis of adherent ileus with and without strangulation]. PMID- 3669812 TI - [Chloramphenicol resistance in acute epiglottitis--a growing problem in antibiotic therapy?]. PMID- 3669813 TI - [Patients with continent ileostomy can have a normal pregnancy and labor]. PMID- 3669814 TI - [Risk factors for coronary disease and premature death in women]. PMID- 3669815 TI - [Aseptic meningitis after treatment with ibuprofen]. PMID- 3669816 TI - [Weight loss by means of moderate cooling]. PMID- 3669817 TI - [Quality of life after rectal cancer surgery. A comparison between anterior resection and abdominoperineal rectum amputation]. PMID- 3669818 TI - [The B vitamin niacin and its potential role in cellular defense against DNA damage]. PMID- 3669819 TI - [Fiberoptic bronchoscopy--a possibility for the diagnosis of Pasteurella multocida pneumonia]. PMID- 3669820 TI - [Prenatal diagnosis of hemophilia A and hemophilia B by chorionic villi biopsy and DNA analysis]. PMID- 3669821 TI - [Hypothyroidism--easily overlooked in an elderly multisymptomatic patient]. PMID- 3669822 TI - [A warning against ear acupuncture used in the treatment of obesity]. PMID- 3669823 TI - [Transbronchial lung biopsy and bronchoalveolar lavage for the correct diagnosis in AIDS with lung infections]. PMID- 3669824 TI - [Surgery of metastases of differentiated thyroid cancers]. AB - 84 (19.5%) of 431 patients with differentiated thyroid cancer developed distant metastases in bone and parenchymal organs. 78% of primary bone metastases and only 21% of primary lung metastases were treated operatively. High survival rates of 33-60% at 5 years supported the necessity of surgical interventions primarily in bone metastases to prevent early morbidity due to pathological fractures. Even in case of questionable increase in survival rate surgery of metastases from differentiated thyroid carcinomas doubtlessly improves the quality of life in these patients. PMID- 3669826 TI - [Medical malpractice processes--and still no end?]. PMID- 3669825 TI - [Traumatic ruptures of the thoracic aorta]. AB - 1) Traumatic rupture of the thoracic aorta is most frequently caused by a traffic accident with deceleration. Approximately 80% of these patients die immediately. In 29 patients (1973-1986) reaching surgical treatment, all aortic lesions were located at the aortic isthmus (28 covered and 1 free rupture). 25 (86%) of them had serious associated injuries of the head, other thoracic or intraabdominal organs and/or the extremities. A seat belt could not prevent the deceleration injury of the aorta but reduced associated injuries of the head and the intraabdominal organs. 2) The widely accepted surgical rule that every diagnosed traumatic aortic rupture should have an immediate surgical repair is no longer acceptable. In all patients with a clinically and angiographically stable covered rupture of the aorta with serious associated injuries and symptoms of shock the surgical treatment of the aortic lesion should be undertaken with delayed emergency after some hours or several days. This changed surgical concept is based both on the rarity of secondary free rupture of the aortic lesion and on the chance to stabilize the circulatory condition by a primary shock treatment including the surgical elimination of other sources of blood loss. The group with such a delayed aortic vascular repair (n = 12) showed a remarkably improved outcome with reduced operative mortality and reduced risk of paraplegia (47% vs. 25% respectively 35% vs. ca. 10%). None of these patients with a delay up to 17 days for vascular repair developed a secondary free aortic rupture. Up to recently this risk has been obviously overestimated on the basis of earlier studies in the sixties. 3) The immediate repair of the aortic rupture with its high operative mortality and high rate of ischemic paraplegia can be restricted to a few exceptional cases with a secondary free rupture in the hospital. The transvenous DSA is the best approach for an early diagnosis and for the surgical decision to perform vascular repair immediately or with delay. PMID- 3669828 TI - [Vestibulocochlear anastomosis in the brain stem of the guinea pig. Preliminary report]. AB - A conspicuous fibre bundle running through the vestibular nuclear complex into the cochlear nucleus could be detected after tracing the superior vestibular nerve branch and the macula sacculi of the guinea pig with HRP (horseradish peroxidase). Considering certain electrophysiological findings, it is quite reasonable to believe that these fibres are indeed primary vestibular afferent fibres in synaptic contact with secondary cochlear neurons. PMID- 3669827 TI - [Autoradiography study of the uptake of 3H-2-deoxyglucose in the inner ear in normal and unilaterally sympathectomized albino rats]. AB - Using the autoradiographic technique for water-soluble substances, the uptake of 3H-2-deoxyglucose (2-DG) was measured in the inner ear tissue. The experiments were performed on 26 albino rats (22-27 days). 10 microCi/g b.w. of 2-DG were applied i.v. and the control group was immediately kept in the Camera silens in darkness. The main group was exposed to pink noise (50 Hz - 10 kHz of 60-110 dB). 8 unilaterally sympathectomised animals were exposed to pink noise of different intensity after 24h. The highest uptake of 2-DG independent of the intensity of noise was observed in the cochlear lateral wall (stria vasc., sp. lig., sp. prominentia) in the basal turn and decreased to the apical turn. The uptake in the lateral wall increased from 30-40 dB to 60dB and decreased from 60 to 80 dB exposure. The region of the inner hair cells was clearly marked by 80 dB. With increasing intensity of noise exposure, 2-DG uptake in the spiral ganglion increased continually. Unilateral sympathectomy did not result in any significant difference in the uptake of 2-DG. Therefore, the hypothesis that the decrease of 2-DG uptake in the lateral wall may be due to sympathico-adrenergic vasoconstriction is not verified by our results. PMID- 3669829 TI - [Histopathology of collagen fibers of the tympanic membrane]. AB - The lamina propria of the human tympanic membrane consists mainly of collagen fibres, but vessels and nerves can also be found as solitary elastic fibres. The pathologic alterations of the collagen fibres were examined by 47 biopsies of the tympanic membrane. These biopsies were taken in various middle ear diseases, and pathological changes were found in every case, ranging from clotting to chondral metaplasia; in one case a metaplasia into osseous tissue was found. No relationship was seen between the otoscopic findings and the severity of the pathological changes. PMID- 3669830 TI - [Nasal concentrations of fusafungin following administration of a dosage aerosol (Locabiosol)]. AB - Following investigations on content uniformity and of the drug content delivered per each dose from a pressurised aerosol (Locabiosol) the concentration of the locally acting antibiotic fusafungin was determined in nasal secretions of volunteers. Quantitative HPLC-assay of fusafungin was performed following the extraction of cotton swabs used to collect nasal secretions. The volume of the nasal secretions results from the mass difference of the swabs before and after application. The concentrations of fusafungin measured on 41 volunteers over a period of 3 hrs were evidently higher than the minimum inhibitory concentrations reported in literature. The results of controlled clinical studies of other authors are in agreement with these results. PMID- 3669831 TI - [Mechanisms of adaptation of breathing and swallowing coordination following partial laryngectomy]. AB - Integrated study of respiration and deglutition includes 48 healthy examinees and 30 patients after partial laryngectomy. Every act of swallowing is accompanied by a respiratory pause (swallow apnoea) which in healthy subjects lasts for approximately 0.7438 sec. In the patients after partial laryngectomy swallow apnoeas are significantly prolonged and last for approximately 1.2482 sec. Swallow apnoea is usually followed by expiration. This is observed in the majority of subjects, its function being the protection of the lower respiratory pathways. Besides the interaction between breathing and swallowing, synergism is also present, functioning as adaptive mechanism of the upper respiratory and gastrointestinal system. PMID- 3669832 TI - [Balloon method and water irrigation in thermal vestibular assessment. Electronystagmographic comparison of both methods]. AB - In cases of large central perforation of the eardrum, caloric test of the vestibular organ cannot be carried out by irrigation of the external auditory canal with water but must be done with a balloon instilled in the external auditory canal perfused with water. Caloric responses were registered by using water irrigation and balloon irrigation in 40 healthy persons. Nystagmographic registrations were analysed. Frequency, slow phase velocity and amplitude of nystagmus were measured. Cumulative percentage curves of the four caloric responses are drawn to compare the distribution of data in balloon and water irrigation (Figures 2-5). In addition, mean values and standard deviations of data and of difference in excitability related to the total excitability are recorded in table 1. Statistics (Wilcoxon test for matched pairs) reveals no significant differences in nystagmographic pattern of caloric reactions between water and balloon stimulation. It is concluded that in the caloric test of the vestibular organ balloon irrigation is equivalent to water irrigation. Balloon irrigation is more comfortable for the patient and easier to handle. PMID- 3669833 TI - [Intensity of the vestibulo-ocular reflex as a response to thermal labyrinth stimulation with water and air. Comparative studies of the stimulus intensity in thermal vestibular assessment in healthy probands]. AB - In 22 otoneurologically healthy subjects (44 ears) the response of the labyrinthine system to stimulation was studied for the method using water, standardized according to Mulch and Scherer (1980), and for our method of stimulation by air. The mean values of the speed of the slow phase and of the total amplitude of the vestibular nystagmus were significantly lower in case of air stimulation. If we consider each stimulus modality separately, the nystagmus parameters correlate significantly in the right-left comparison, and likewise the right predominant nystagmus with the left predominant nystagmus. However, on comparing the data measured for air stimulation and for water stimulation, no correlation could be established. The reason is thought to be an energetic one, since the method using air depends on heat capacity and heat transfer, whereas the method employing water depends on heat transfer only. Calculation shows that the energetic conditions of the method employing air are of the same order of magnitude as the roughly quantitative minimal rinse when filling the auditory meatus with water of moderate temperature. Hence, thermal stimulation of the labyrinthine system with air reacts very sensitively to changes in experimental conditions, so that all conditions must be strictly adhered to and standardised and the examination methods must be repeatable within narrow tolerance limits. On account of its low mean values and great susceptibility to variation, the method of air stimulation should be discouraged, especially in the assessment of patients who are suspected of suffering from a disease of the vestibulum auris. PMID- 3669834 TI - [Reconstruction of the skin in triple layer hypopharyngeal defects "in problem cases"]. PMID- 3669835 TI - Hearing results after cholesteatoma surgery: the Iowa experience. AB - This study compared the hearing outcome of canal-up and canal-down mastoidectomies for removal of cholesteatoma in 455 ears. An intact canal wall procedure was performed in 92 patients while the remainder (N = 363) underwent a canal-down operation. The hearing results for both procedures are dependent on the presence of the stapes superstructure. When the stapes superstructure was intact, 52% of the patients with canal-up operations had an air-bone gap of less than 20 dB. The corresponding figure for canal-down cases was 37%. When there was no stapes superstructure, 54% of the canal-up cases and 19% of the canal-down cases obtained a similar ABG closure. Preserving the posterior external auditory canal wall results in slightly better hearing function. However, when the stapes superstructure is intact, the difference in hearing function is not remarkable, and must be weighed against the potential for residual disease or recurrence associated with canal-up procedures. PMID- 3669836 TI - A vented laryngeal stent with phonatory and pressure relief capability. AB - This prototype vented laryngeal stent incorporates a dome-shaped, one-way valve that allows articulation of transmitted vibrations to produce speech, while preventing aspiration and not interfering with deglutition. The stent is placed endoscopically and is used in conjunction with a T-tube or a tracheostomy tube. The stent has been placed in seven patients for chronic aspiration, after partial laryngectomy, and with laryngotracheal reconstruction for stenosis. Aspiration pneumonia has not been seen in any patient after placement of the appropriate stent, with follow-up of 2 to 6 months. One patient's swallowing improved and none deteriorated. All patients were able to phonate with the stent in place. No significant long-term sequelae are apparent in three patients whose stents were removed after resolution of their primary diseases. PMID- 3669837 TI - Complications of endoscopic intranasal ethmoidectomy. AB - A consecutive series of 90 patients undergoing endoscopic intranasal ethmoidectomy was reviewed. There were 26 complications (29%) in 19 patients in this group. Eight complications (8%) including CSF leak, temporary blindness, and hemorrhage were considered major with the latter occurring most commonly. Synechiae were the most commonly occurring minor complications. Endoscopic nasal sinus surgery performed by inexperienced operators carries with it the same risks and complications as traditional intranasal sinus surgery. Any surgeon who does not routinely perform traditional intranasal ethmoidectomy should accrue endoscopic experience through appropriate didactic training and multiple cadaver dissections (akin to otologic training). PMID- 3669838 TI - Modified Lynch procedure for chronic frontal sinus diseases: rationale, technique, and long-term results. AB - The modified Lynch operation (Neel-Lake) differs in several ways from the operation described by Lynch. The operation begins with an intranasal anterior ethmoidectomy. The agger nasi cells are removed by curetting forward between the frontal process of the maxilla and the septum. The middle turbinate, normal appearing mucosa of the frontal-ethmoid complex, and frontal process of the superior maxilla are preserved. Bone removal is limited in most cases to the anterior floor of the frontal sinus, a portion of the lacrimal bone, and the bone over the anterior ethmoid cells. Another important difference is the use of soft, nonreactive material (thin Silastic sheeting) to stent the nasal-frontal passageway. Removal of all the mucosa of the frontal-ethmoid-sphenoid complex is unnecessary for a good postoperative result, and the remaining normal mucosa hastens the process of reepithelialization of the nasal-frontal duct. The patients in our original study group have been observed for a period of 5 to 20 years (mean, 13.5 years) after the surgical procedure. This is the longest period of follow-up for any group of patients reported in the literature. The incidence of failures increased from 7% (one duct) to 20% (3 of 15 ducts) after an additional 7 years of follow-up. PMID- 3669839 TI - Improvement of olfaction in laryngectomized patients with the larynx bypass. AB - Hyposmia following laryngectomy is an often recognized phenomenon. A larynx bypass device was used to determine whether this olfactory deficit could be reversed simply by restoring nasal airflow. Odorant detection thresholds and confusion matrix identification tests were administered to laryngectomy and normal comparison groups. Data on nasal airflow characteristics with and without the bypass were also analyzed. The results suggested that restoration of nasal airflow completely reversed the hyposmia for trigeminal nerve stimuli. However, the reversal of hyposmia was not complete for those odorants which primarily, if not exclusively, stimulate the olfactory nerve. This suggested that other factors may contribute to laryngectomy-induced hyposmia for olfatory nerve stimuli. Additionally, nasal airflow analysis revealed that confusion matrix identification scores were depedent upon inspiratory sniff flow rates with and without the larynx bypass. It is argued that rehabilitation for the laryngectomee should include efforts to restore and maintain preoperative olfactory acuity. PMID- 3669840 TI - The efficacy of myringotomy and ventilation tube insertion in middle-ear effusions in patients with nasopharyngeal carcinoma. AB - Myringotomy and insertion of a grommet are effective in the management of middle ear effusion resulting from nasopharyngeal carcinoma. The procedure was carried out in 46 ears in 30 patients, resulting in significant improvement of hearing. The complication rate of the operative procedure is not negligible in this group of patients, and it is higher if the patients had received radiotherapy at the time of operation. PMID- 3669841 TI - Epithelioid hemangioendothelioma (histiocytoid hemangioma) of the palate. AB - The first case of epithelioid hemangioendothelioma involving the oropharynx is described. A 25-year-old woman developed a mass on the palate which noted to enlarge during the first trimester of pregnancy. Biopsy revealed a cellular tumor initially considered to be of epithelial origin. Vascular differentiation of the tumor was confirmed, however, by positive lectin histochemistry for Ulex europaeus, by evidence of immunoreactivity for factor VIII-related antigen, and by ultrastructural identification of endothelial features. The patient remains free of tumor 21 months after complete excision. Because of the potential for misdiagnosis, epithelioid hemangioendothelioma should be considered in the differential diagnosis of oropharyngeal malignancies. The effect of pregnancy on the development and growth of vascular tumors such as epithelioid hemangioendothelioma remains uncertain. PMID- 3669842 TI - Tuberculous otitis media: a clinical record. AB - The clinical picture of tuberculous otitis media has changed since previously documented. In our series of 31 patients, it was found that severe conductive hearing loss, abundant pale granulations, and denuded malleus handle are constant findings and, in our opinion, are significant clinical features of the pathology. The disease can also manifest itself as an acute mastoiditis. As regards to investigations, bacteriology is considered as being unreliable. This is attributed to secondary organisms interfering with the growth of the tubercle bacillus, as well as the fastidious nature of the bacillus itself. We regard histology as the most reliable means of attaining a definitive diagnosis. Treatment was with a four drug antituberculous regime administered over 6 months. Streptomycin was excluded in all but one case due to its ototoxicity. We believe TB otitis media to be secondary to an established chronic otitis media in the majority of cases. PMID- 3669843 TI - Post-tonsillectomy bleeding: an evaluation of risk factors. AB - While tonsillectomy is usually a safe operation, it is always accompanied by the risk of immediate postoperative bleeding. Despite continued efforts to eliminate this problem, it remains a persistent risk. In reviewing 775 consecutive cases of tonsillectomy, immediate postoperative bleeding occurred in 21 (2.7%). Diagnostic, demographic, hematologic, hemodynamic and surgical management factors were evaluated. The role of local anesthesia for tonsillectomy was also examined. Postoperative bleeders were more likely to have abnormal preoperative clotting studies, greater elevations of their mean postoperative blood pressures, and unusual surgical indications. Local anesthetic cases were shorter, had less intraoperative bleeding and were not associated with greater postoperative bleeding. We conclude that local anesthesia is safe and efficient and that identifiable factors are associated with primary post-tonsillectomy bleeding. An awareness of these factors can help identify potential postoperative bleeders. PMID- 3669844 TI - Venturi jet ventilation for microlaryngoscopy: technique, complications, pitfalls. AB - Our experience with Venturi jet ventilation as the method of anesthesia in 872 cases of microlaryngeal surgery is presented. Our indications and exact technique are presented, as well as a review of our complications. Possible pitfalls and their avoidance are discussed. With attention to detail and good clinical judgement on the part of anesthesiologist and surgeon, Venturi jet ventilation can be safe and efficient with minimal complications. PMID- 3669845 TI - Temporalis muscle-galea flap in craniofacial reconstruction. AB - With the advent of increasing technological and surgical sophistication in craniofacial surgery, reconstructive efforts are challenged to provide a reliable means of compartmentalization. When dural integrity is compromised in the face of nasopharyngeal or paranasal communication, the risk of ascending infection and potential life-threatening meningitis mandate cranial and facial compartments, separated by sufficient and healthy soft tissues. This paper describes a method of providing pedicled soft tissue coverage and support for the contents of the anterior cranial fossa using a temporalis muscle-galea rotation flap. The vascularized myofascial tissues, capable of carrying skin and bone grafts, are well suited to cover and protect large areas of the skull base. Several cases are described to show the advantages and disadvantages of the technique. PMID- 3669846 TI - Laryngeal image biofeedback. AB - The proper treatment of many voice disorder patients includes modification of voice production. Laryngeal image biofeedback (LIB), a new technique to help selected patients modify vocal fold posture and thereby vocal production is described. The effectiveness of this technique as a learning tool is assessed in 20 subjects. PMID- 3669847 TI - Telescopic video-otoscopy using a compact home video color camera. AB - Our method of telescopic video-otoscopy using a telescope (Hopkins) and a compact home video camera is presented. Telescopic video-otoscopy is a most effective method of demonstrating and documenting the anatomy and pathology of the tympanic membrane, ear canal, and mastoid cavity. It is of considerable value for teaching, patient counseling, and making a permanent record. It obtains instantaneously a video print-out either in black-and-white or in color of video images of telescopic otoscopy. A simple and economical method of telescopic pneumatic otoscopy (pneumatic teleotoscopy) is also described. Telescopic video otoscopy combined with the use of a video printer is a useful addition to the clinical practice of otology. PMID- 3669848 TI - Removal of antral polyp through an extended nasoantral window. PMID- 3669850 TI - Flaps for cochlear implants. PMID- 3669849 TI - The use of a wire sling in anterior table fractures of the frontal sinus. PMID- 3669851 TI - Sterilization of endoscopic instruments. PMID- 3669852 TI - [Heterotopic gastric mucosa in the upper gastrointestinal tract: endoscopic incidence, appearance and clinical significance]. AB - Heterotopia is understood as the occurrence of locally atypical tissue. Heterotopic gastric mucosa may occur throughout the whole GI-tract. In an unselected series of upper GI-endoscopies 6.3% of heterotopic gastric mucosa could be detected. Main localisation was the upper esophagus with 70%, followed by the duodenal bulb with approximately 25%. In 86% histological proof of ectopic mucosa was possible. In the esophagus the lesion looks like a red spot, in the duodenal bulb in contrast more like polypoid formations without discoloration. In our experience there is no significant relation of heterotopic mucosa to clinical symptoms. The clinical significance of heterotopic gastric mucosa however may be underscored by its possible complications. PMID- 3669853 TI - [Diagnosis in malabsorption syndromes--which tests are really necessary?]. AB - The symptoms of the malabsorption syndrome are uniformly weight-loss, diarrhea and/or steatorrhea for which symptoms numerous etiological factors could be responsible: biliary and pancreatic diseases, inborn and acquired intestinal diseases, sequelae of operations (post-gastrectomy syndrome), metabolic and autoimmune diseases and several drugs. Accordingly, the spectrum diagnostic tools is rather broad and often confusing, comprising simple methods like measurement of faecal weight up to complicated radioactive or morphological techniques. In the present paper the available diagnostic procedures are grouped together and evaluated according to their importance, practicability and sensitivity in hospital and praxis. It turns out that simple laboratory techniques are sufficient for the majority of patients with malassimilation syndrome which have been specifically dealt with. However, in numerous cases a more detailed and specific diagnostic investigation is necessary in which single findings as a whole reflect the picture of the underlying disease. Only the knowledge of these rare investigational techniques will prompt the involved physician to transfer the patient with the unknown cause of malabsorption syndrome to a specialized medical centre. PMID- 3669854 TI - [Therapy of pain caused by gastrointestinal tumors]. AB - Therapy of pain induced by malignant diseases is an important task for any physician. A proper diagnosis is necessary for an adequate treatment. Pain in the bones can be treated successfully with peripherally acting analgesics such as acetylsalicylic acid, paracetamol or metamizole. On the other hand, certain tumors require local blockade as in cases with pancreatic or perianal tumors. If such a therapeutic approach is not possible or if pain is felt all over the body then centrally acting analgesics such as opiates are necessary. Opiates should be administered according to a tight schedule and not on demand. Combinations of certain analgesic drugs are often quite useful. Apart from their peripheral application opiates can also be administered epidurally or intrathecally which reduces the required dosage. PMID- 3669856 TI - Some legal aspects of angiography and interventative radiology. PMID- 3669855 TI - [Treatment guidelines in intestinal burns]. AB - Intestinal burns due to ingestion of acids or alkaline materials still put the physician in a difficult position because until now it is not possible to correlate the amount of ingested material to the extent of damage that can be expected. Furthermore, there are no objective criteria to determine the depth of the burn. Diagnosis is based on endoscopy. Mild, moderate and severe damage can be differentiated endoscopically. Mild and moderate burns are not operated upon primarily. Surgery is indicated with moderate burns whenever complications occur during intensive care treatment, and generally with severe corrosive burns. Operative management depends on intraoperative findings. PMID- 3669857 TI - Medico-legal aspects of the Bhopal tragedy. PMID- 3669858 TI - Drug and chemical blood level data 1986. PMID- 3669859 TI - Implantable cardiovascular devices: medico-legal aspects. PMID- 3669860 TI - WHO; guidelines for personnel involved in collection of skin smears in leprosy control programmes for the prevention and control of possible infection with HIV. PMID- 3669861 TI - A study of leprosy and other skin diseases in school children in the state of Amazonas, Brazil. PMID- 3669862 TI - Operational efficiency of leprosy clinics: a time-motion study. PMID- 3669864 TI - Buluba Leprosy Hospital, Uganda: a review of admissions, 1981-84. PMID- 3669863 TI - Blister calendar packs for the implementation of multiple drug therapy in DANIDA assisted leprosy control projects in India. Danish International Development Agency. PMID- 3669865 TI - Short-course multidrug therapy for leprosy patients in western Kenya. Preliminary communication. PMID- 3669866 TI - Periodontal findings in patients with leprosy. PMID- 3669867 TI - A loom for grass mat weaving in Tamil Nadu, south India. PMID- 3669869 TI - To get it done--it simply needs doing! The teaching of leprosy to medical students. PMID- 3669868 TI - The diagnostic efficiency of paramedical workers in leprosy. PMID- 3669870 TI - Effective prophylactic measures against accidental inoculation with live Mycobacterium leprae in laboratory and hospital workers. PMID- 3669871 TI - Myiasis in necrotic tissue of a leprosy patient. PMID- 3669872 TI - Multidrug therapy for paucibacillary leprosy: WHO regimen inadequate? PMID- 3669873 TI - Introduction of multidrug therapy: two points highlighted. PMID- 3669874 TI - [Psychosomatic medicine]. PMID- 3669875 TI - [Differentiation of the origin of microhematuria using microscopy]. PMID- 3669876 TI - [In vitro study of characteristics associated with the pathogenicity of strains of Yersinia enterocolitica]. PMID- 3669877 TI - [Interfascicular anastomosis of nerves using autologous transplants]. PMID- 3669878 TI - [Nephritis and hearing-loss in thrombocytopenia and macrothrombocytopathy]. PMID- 3669879 TI - [The Ellis-Van Creveld syndrome]. PMID- 3669880 TI - [Primary actinomycosis of the skin]. PMID- 3669881 TI - [Diagnosis and therapy of opiate coma]. PMID- 3669882 TI - [Cefotaxime in the therapy of purulent meningitis in childhood]. PMID- 3669883 TI - [Use of subclavian and internal jugular vein catheterization in hemodialysis and plasmapheresis]. PMID- 3669884 TI - [Yugoslav diabetology--1986]. PMID- 3669885 TI - [Study of the effects of cytostatic agents on human tumor tissue transplants under the renal capsule in mice]. PMID- 3669886 TI - [Campylobacter pyloridis--a possible etiologic agent in patients with chronic gastritis and peptic ulcer]. PMID- 3669887 TI - [Reoperation in lumbar disk hernia]. PMID- 3669888 TI - [Personal experience with difficulties in recognition of the epidural space]. PMID- 3669889 TI - [Extrinsic allergic alveolitis--bird fancier's disease]. PMID- 3669890 TI - [Toxic epidermal necrolysis (Lyell's syndrome) caused by allopurinol]. PMID- 3669891 TI - [The syndrome of pulmonary infiltration with eosinophilia]. PMID- 3669892 TI - [Gunshot injury of the trachea]. PMID- 3669893 TI - [Early cholecystectomy--therapy of choice in the treatment of acute cholecystitis]. PMID- 3669894 TI - [Aspergillosis of the maxillary sinus]. PMID- 3669895 TI - [The hospitalized child: his rights and our obligations]. PMID- 3669896 TI - [Gangliosides in planocellular carcinoma of the lung]. PMID- 3669897 TI - [The effect of anesthetics, sedatives and narcotics on intrahepatic and extrahepatic biliary kinetics]. PMID- 3669898 TI - [The significance of clinical and biochemical variables in the prognosis of multiple myeloma]. PMID- 3669899 TI - [Testing for arboviruses in the population of various African countries]. PMID- 3669900 TI - [Chronic eosinophilic pneumonia]. PMID- 3669901 TI - [Serologic diagnosis of infectious mononucleosis]. PMID- 3669902 TI - [Nonsurgical treatment of pulmonary valve stenosis using balloon valvuloplasty in children]. PMID- 3669903 TI - [The need for organization of a single specialized postgraduate course and program in experimental animal science in the medical and biological sciences in Yugoslavia]. PMID- 3669904 TI - [Yersinia enterocolitica: molecular biology aspects of virulence]. PMID- 3669905 TI - [Drug interaction with alcohol]. PMID- 3669906 TI - Radioiodinated 2'-iodospiperone: a new radioligand for in vivo dopamine receptor study. AB - In vivo dopamine receptor binding of the newly synthesized ligand, 125I-2' iodospiperone (125I-2'-ISP), was studied in mouse brain. The highest accumulation was found in the striatum. Analysis of the striatal homogenate showed the 125I-2' ISP to be metabolically stable. Furthermore, this striatal binding was saturable and displaced only by dopaminergic drugs. On the other hand, the accumulation in the cortex was as low as that of the cerebellum and uneffected by the administration of serotoninergic drugs and dopaminergic drugs; results assessed by macroautoradiographic studies. Thus, the newly synthesized 125I-2'-ISP presented high affinity for dopamine receptors in vivo and therefore, holds great potential for the in vivo dopamine receptor studies, provided 123I becomes readily available. PMID- 3669907 TI - Distribution of physostigmine and metabolites in brain subcellular fractions of the rat. AB - The distribution of 3H-physostigmine (Phy) has been studied in the rat brain subcellular fractions at various time intervals following i.v. injection. 3H-Phy or its metabolites rapidly accumulate into the cytoplasm of cells and penetrates the intracellular compartments. Kinetic studies of the subcellular distribution of radioactivity (RA) per gm of rat brain following i.v. injection of 3H-Phy show peak concentrations at 30 min in all subcellular fractions with the exception of mitochondria. In the mitochondrial fraction the RA levels continue to rise from 4682 +/- 875 DPM/gm at 5 min to 27474 +/- 2825 DPM/gm at 60 min (P less than .05). The cytosol contains the highest RA: 223341 +/- 21044 DPM/gm at 30 min which declined to 53475 +/- 3756 DPM/gm at 60 min. RA in synaptosome, microsomes and myelin increases from 5 to 30 min, and declines at 60 min. In vitro studies did not show a greater uptake of RA by the mitochondrial or synaptosomal fractions. The finding of relatively high concentrations of RA in the mitochondrial fraction at 60 min increases the likelihood that Phy or its metabolites could interfere with the physiological function of this organelle. PMID- 3669908 TI - The effect of propylbenzilylcholine mustard on contraction and radioligand binding parameters of muscarinic receptors in guinea pig ileum. AB - The receptor occupancy-biological effect relationship for muscarinic receptors in guinea pig ileal smooth muscle has been studied by comparison of radioligand binding and contractile response. Muscarinic receptors in homogenates of ileal smooth muscle were labeled with [3H]-1-Quinuclidinyl benzilate. Treatment with propylbenzilylcholine mustard (PrBCM), to inactivate irreversibly muscarinic receptors, caused a large dose dependent rightward shift of the dose-response curve to three agonistic furtrethonium derivatives with a concomitant decrease in maximal response. Using those data, the fraction of receptors remaining unoccupied (q-values) and "true affinity constants" (-log KA-values) were calculated. Exposure to 20 or 60 nM PrBCM for 15 minutes resulted in a 39% and a 61% reduction in specific [3H]-1-Quinuclidinyl benzilate binding sites respectively to be compared with a 62% and a 85% decrease expected from calculated q-values. KA-values for the methyl and ethyl derivative agreed well with the dissociation constants for the high affinity agonist sites determined from displacement of [3H-]-1-Quinuclidinyl benzilate. The KA-value for the propylfurtrethonium corresponds to the low affinity agonist dissociation constant. The fraction of receptors in the high affinity agonist state differs considerably for the three furtrethonium derivatives investigated. Neither the fraction of receptors in the high affinity agonist state, nor the ratio of dissociation constants for these states is affected by the alkylation of 85% of the functional muscarinic receptors. The inactivation of components of the effector system by PrBCM seems unlikely. PMID- 3669909 TI - Ethanol and nitrous oxide produce withdrawal-induced convulsions by similar mechanisms in mice. AB - Twenty generations of selective breeding were used to produce lines (strains) of mice which differ markedly from one another in ethanol physical dependence development as indexed by handling-induced convulsions (HIC) induced by withdrawal from ethanol. These withdrawal seizure prone (WSP) and withdrawal seizure resistant (WSR) selection lines now differ by over 10-fold in HIC scores after equivalent exposure to intoxicating levels of ethanol via inhalation. Since handling-induced convulsions can be readily elicited following withdrawal from nitrous oxide, we sought to determine if the very large differences in ethanol withdrawal-induced HIC bred into these selection lines would generalize to nitrous oxide. Following a 60 min exposure to 75% nitrous oxide (in O2), a greater than 10-fold difference in HIC scores, and a 2-fold difference in tremor incidence was seen upon withdrawal in WSP vs. WSR mice. These findings closely parallel those seen with ethanol, and demonstrate that a large degree of commonality exists in the genes and the mechanisms determining these withdrawal signs. HIC elicited by nitrous oxide withdrawal were readily suppressed by ethanol, and HIC elicited by ethanol withdrawal were promptly suppressed by 75% nitrous oxide in WSP mice. Nitrous oxide also suppressed HIC and tremor associated with nitrous oxide withdrawal. PMID- 3669910 TI - Tissue distribution of phenoxybenzamine in the rat. Lack of adipose tissue storage. AB - Rats were given the basic lipophilic drug, phenoxybenzamine, in single i.v. doses of 0.4 and 30 mg/kg. The drug was determined in plasma and 7 tissues by a new HPLC method. Adipose tissue reached peak levels after 30 minutes. At that time levels in heart, kidney, and brain were higher than in subcutaneous, epididymal, and mesenteric adipose tissues. The percentage metabolites in adipose tissue, kidney, and liver was 0, 88, and 96, respectively. Pretreatment with SKF 525-A inhibited metabolism and increased the tissue levels of unchanged drug, however, even under these conditions storage in adipose tissues did not occur, the adipose storage index being still less than unity. These results contradict findings of the 1950s which have been repeatedly reported in textbooks and reviews, but they confirm observations that basic drugs, even when highly lipophilic, are not being stored in adipose tissues. PMID- 3669911 TI - Ca2+ releasing effect of perezone on adrenal cortex mitochondria. AB - Ca2+ energy-coupled transport was analized in adrenal cortex mitochondria using the sesquiterpenic drug perezone. Perezone promotes Ca2+ efflux by inducing collapse of the membrane potential and oxidation of pyridine nucleotides. The effect of perezone on mitochondrial Ca2+ release follows a dose-response relationship and is dependent of the reduction of the drug. These data suggest that perezone may produce a cytotoxic effect through an impairment in Ca2+ homeostasis. PMID- 3669912 TI - Effects of alcohol feeding on androgen receptors in the rat pituitary gland. AB - Specific binding of testosterone-1 beta, 2 beta-3H by cytosol from anterior pituitary gland of alcohol-fed, isocaloric control, and castrated control and alcohol-fed rats with or without testosterone treatment has been investigated by charcoal assay. The number of androgen binding sites was significantly reduced in alcohol-fed rats (8 +/- 1.0 fmoles/mg cytosol protein), when compared to the isocaloric control value (13.2 +/- 2.1 fmoles/mg protein), with no significant change in Kd (0.7 +/- 0.14 nM). Castration significantly increased the number of receptor sites in control rats and when castrated control animals were treated with testosterone the binding sites were decreased to the intact control level. In contrast, castration or testosterone given to castrated alcohol-fed rats did not alter alcohol-induced reduction of the receptor sites. The binding affinity (Kd) is identical in all groups. The concentration of serum luteinizing hormone (LH) was significantly lower in alcohol-fed rats when compared to that of normal controls. An increased serum LH level with a decreased testosterone level was noted in castrated control rats. However, castration of alcohol-fed rats had little or no effects on the concentrations of LH and testosterone. Administration of testosterone suppressed castration-induced high LH in control rats but alcohol induced reduction of LH level was not altered by this treatment. These findings indicate that alcohol exerts a suppressive effect on the content of androgen receptors and secretory functions of gonadotropins in the pituitary gland. PMID- 3669913 TI - Visual pigments and retinoids in the Mongolian jird. AB - The visual cells, visual pigments and major retinoids of the Mongolian jird (Meriones unguiculatus) were examined. Light and electron microscope analyses show that these jirds had mainly rod photoreceptors. Octylglucoside extracts prepared from their retinas contained only rhodopsin with a maximum absorption at 497 nm and a concentration of 0.51 nmol per retina. Employing a standard method of high performance liquid chromatography (HPLC), the pigment epithelium from each eye was found to possess 0.52 nmol of retinyl palmitate (the most abundant form of retinyl ester) along with a small amount of retinol (0.02 nmol). Most of the retinoids in the body of these animals are stored in the liver, in the form of retinyl palmitate (1228.80 nmol per gram liver). As the Mongolian jird is small, inexpensive and readily available, this animal is a mammalian species suitable for the research of the biochemistry of retinoids and vision. PMID- 3669914 TI - Dietary restriction influence bile formation in aging rats. AB - Food restriction is one of the most effective interventions which increases the survival of rodents and influences a variety of physiologic and pathologic processes. Thus, we examined whether life-long caloric restriction would influence bile formation, one of the important hepatic functions. Female Sprague Dawley rats were subjected soon after weaning to a restricted diet (60% of the diet consumed by the rats fed ad libitum) and bile formation determined at 3.5, 12 and 24 months of age. Rats had their bile ducts cannulated under nembutal anesthesia and bile collected at 10 min. intervals. Bile flow rate decreased 35% between 3.5 and 24 months of age. This decrease was associated with a reduction of the bile acid dependent fraction of bile flow (BADF) up to 12 months of age, thereafter the bile acid independent fraction (BAIF) also decreased. Phospholipid and cholesterol secretion rates increased with age, but did not correlate with bile acid secretion. In rats fed the restricted diet, bile flow was about 20% higher at 3-5 months of age when compared with the ad libitum fed group. This bile flow rate remained constant until 24 months of age. The increased bile flow was attributed to higher BADF and BAIF. The phospholipid and cholesterol secretion followed that of bile acids. It thus appears that dietary restriction exerts a beneficial effect on the age related decline in bile formation. PMID- 3669915 TI - Low natural killer cytotoxicity in major depression. AB - Natural killer cell cytotoxicity was significantly lower in a group of hospitalized depressed men than in matched controls. The absolute number of neutrophils was increased in the depressed group, but the numbers of other cell types did not differ between groups. These findings further demonstrate that altered immunity is a biologic concomitant of affective disorders. PMID- 3669916 TI - Dichloroacetate derivatives. Metabolic effects and pharmacodynamics in normal rats. AB - Dichloroacetate (DCA) reduces blood glucose, lactate and lipids in diabetes or during fasting. Chronic use of DCA, however, is limited by toxicity, probably due in part to its rapid conversion to oxalate in vivo. In theory, therefore, DCA's efficacy may be retained and its toxicity minimized by controlling its rate of metabolism. We attempted to alter DCA pharmacokinetics and bioavailability by synthesizing various derivatives comprising DCA esters with polyols and DCA ionic complexes. Twenty-four hour fasted, nondiabetic rats received single, orogastric doses of saline (control) sodium DCA (100mg/kg) or the following derivatives (D1 4): the esters D1-D3: potassium tetra (dichloroacetyl) glucuronate (D1), inositol monophosphate-tetradichloroacetate (D2), inositol-hexadichloroacetate (D3) and inositol-hexa [N-methylnicotinate] hexadichloroacetate salt (D4). Each derivative was administered at a dose that would ultimately provide 100 mg/kg DCA as the anion. All derivatives were orally effective in significantly decreasing blood glucose and lactate. D4 exerted the most potent and long-lasting glucose- and lactate-lowering effects, yet increased plasma DCA concentrations less than an equivalent dose of the sodium salt. When administered to reverse light-cycled rats, D4 markedly inhibited the incorporation of tritiated water into cholesterol and triglycerides. We conclude that derivatives of DCA retain the biological activity of the parent compound, but may exhibit different pharmacokinetics. They may eventually prove useful in the treatment of diabetes mellitus, hyperlipidemia and lactic acidosis in man. PMID- 3669917 TI - Plasma from cirrhotic patients induces inotropic changes on cultured rat heart cells. AB - Cultured monolayers of newborn rat heart cells were perfused with plasma from patients with alcoholic liver cirrhosis. The results showed that cirrhotic plasma, when compared to control plasma, depressed contractility of beating cardiac cells. The in-vitro deleterious effects of plasma from cirrhotic subjects on cell cultures were neither related to hemodynamic parameters nor to the levels of plasmatic catecholamines. This study suggests the presence in the plasma of patients with alcoholic liver cirrhosis, of humoral factor(s) which cause depressive effects on rat heart cells in culture. PMID- 3669918 TI - Genetic variability in response to dietary calcium. AB - Supplemental dietary calcium has been shown to reduce blood pressure in spontaneously hypertensive rats while restricted calcium diets cause an elevation in blood pressure. This latter nutrient effect has been enhanced by modest sodium restriction and is associated with a reduction in serum ionized calcium concentration. To determine whether alterations of dietary calcium and sodium have a similar influence on blood pressure in genetically normotensive rats, Fisher 344, Wistar Furth, and ACI rats were fed either a low (0.1%) calcium, low (0.25%) sodium diet or normal (1.0%) calcium, normal sodium (0.45%) diet from 4 weeks of age through 29 weeks of age. Indirect measurements of systolic blood pressure showed that only the Fisher 344 rats consistently responded to the low calcium/low sodium diets with an elevation of blood pressure. There was considerable variation in serum electrolytes across strains in the normal diets but all three strains experienced a reduction in ionized calcium and an elevation in phosphorus and magnesium on the restricted diets. In the Fisher 344 rats there were significant (p less than .05) inverse correlations among systolic blood pressure and serum ionized and total calcium concentrations and positive correlations among systolic blood pressure, phosphorus, and magnesium. There was no significant correlation between serum electrolytes and blood pressure in the other two strains. The data indicate that there is genetic variability in the blood pressure response to alterations in dietary calcium and sodium. The pattern of change in serum electrolytes across strains suggests that diet-induced alterations of serum electrolytes, specifically calcium, are not necessarily predictive of a pressor response. It would appear that some other calcium sensitive physiological process involved in blood pressure regulation must respond differentially to calcium availability across strains. PMID- 3669919 TI - Trauma induced increases in plasma vasopressin and angiotensin II. AB - Previous investigators have shown that hypotension will cause an increase in plasma levels of both vasopressin and angiotensin II. Significant increases in peripheral resistance after thermal trauma suggested that a similar increase in plasma vasopressin and angiotensin II levels might occur under this condition. This possibility has been studied in the pentobarbital anesthetized dog. Peripheral resistance was calculated from measured cardiac output and mean arterial blood pressure. Vasopressin and angiotensin II levels were measured by radio-immunoassay. The results of this study showed that vasopressin plasma levels increase 4 to 6 fold 15 minutes after thermal trauma and remained elevated (3 to 4 fold) for at least 6 hours. Angiotensin II increased in a linear manner from 15 minutes to 6 hours post trauma. At 6 hours post trauma angiotensin II plasma levels were 4 times pretrauma levels. For the first 4 hours post trauma there was a positive correlation between the sum of vasopressin and angiotensin II plasma levels and the increase in peripheral resistance. These results suggest that the trauma induced increase in peripheral resistance is due to increases in plasma vasopressin and angiotensin II. PMID- 3669920 TI - Possible role of regional superoxide dismutase activity and lipid peroxide levels in cadmium neurotoxicity: in vivo and in vitro studies in growing rats. AB - Cd2+ (0.4 mg/kg) administration to growing rats (45 +/- 5 g) intraperitoneally, daily for 30 days was found to decrease the activity of superoxide dismutase (SOD) in all the brain regions, except hippocampus. The concentrations of lipid peroxides were significantly elevated in the cerebellum, cerebral cortex, corpus striatum and midbrain. A 100% inhibition in SOD activity was observed by 14 microM and 50 microM of Cd2+ in bovine blood and rat brain preparations, respectively. Cadmium-induced strong inhibitory effect on brain and purified bovine blood SOD suggested a direct effect of the metal on enzyme molecule. Furthermore, in vitro addition of a wide range of Cd2+ (1-100 microM) increased the rate of lipid peroxidation (LPO) reaction in fresh brain homogenate, however, did not affect boiled homogenate. The studies on LPO in reconstituted homogenate resulting from mixing of fresh and/or heated different subcellular fractions indicated the presence of some heat-labile Cd2+ -sensitive factor in 15000 x g pellet fraction. It is suggested that Cd2+ directly and indirectly through inhibition of SOD, increases the LPO of cell membranes and thus produces damage to the associated physiological functions leading to central nervous dysfunctions. PMID- 3669921 TI - Evidence of "cross-stressor"-induced adaptive gastric cytoprotection. AB - Rats were given 7 days pre-treatment with either water (p.o.), 1 h immobilization or 20% ethanol (p.o.) with or without concomitant indomethacin injection. Following the pre-treatment phase, rats from each pre-treatment group were exposed to either 3 h cold-restraint stress or to 100% ethanol p.o. Results indicated that immobilization and 20% ethanol pre-treatment significantly reduced both cold-restraint stress ulcer formation and 100% ethanol-induced ulcers. Indomethacin co-treatment attenuated the reduction of ulcer formation of both pretreatments. These results suggest that "cross-stressor" adaptive cytoprotection occurs. Indomethacin abolished these effects, implicating the involvement of endogenous prostaglandins in the mediation of "cross-stressor" induced gastric cytoprotection. PMID- 3669922 TI - Injection of noradrenaline into the hypothalamic paraventricular nucleus produces vigorous gnawing in satiated rats. AB - Single injections of noradrenaline (NA) into the hypothalamic paraventricular nucleus (PVN) initiate short bouts of eating in the rat. The effect of the injections of NA (40 nM) into the PVN on gnawing was studied in satiated male rats that had displayed a reliable eating response to NA. The NA injections produced numerous bouts of prolonged and vigorous gnawing of wood pieces shaped like food pellets. The gnawing response started 0.5-2 min after the injection of NA and lasted for 20-25 min. The results suggest that the increase in gnawing and eating evoked by NA might be related to facilitation of the oral responses, and a changed sensitivity to the food related stimuli, in addition to an intrinsic increase in appetite. PMID- 3669923 TI - Lipid composition and amino acid transport in a nystatin-resistant mutant of Aspergillus niger. AB - A nystatin-resistant mutant of Aspergillus niger has been isolated and used as a model system to study the effect of altered sterol levels on lipid composition, transport behavior and physical properties of membrane lipids. There is a decrease in the sterol to phospholipid ratio in the mutant compared to the wild type. Although there is no qualitative change in phospholipid composition, the mutant contains a higher amount of phosphatidylcholine and a lower amount of phosphatidylethanolamine compared to the wild type. The most significant change is the elevated level of linoleic acid in the mutant, concomitant with a decreased level of oleic acid. These adaptive changes to nystatin resistance are manifested in the altered thermotropic behavior of membrane lipids as studied by the steady-state fluorescence polarization technique. These changes are also associated with altered membrane permeability as evidenced by the change in Vmax values for uptake of some amino acids in the mutant compared to the wild type. PMID- 3669924 TI - Interaction of (n-3) and (n-6) fatty acids in desaturation and chain elongation of essential fatty acids in cultured glioma cells. AB - Recent research in various biological systems has revived interest in interactions between the (n-6) and (n-3) essential fatty acids. We have utilized cultured glioma cells to show that linolenic acid, 18:3(n-3), is rapidly desaturated and chain elongated; 20:5(n-3) is the major product and accumulates almost exclusively in phospholipids. We examined effects of various (n-6), (n-3), (n-9) and (n-7) fatty acids at 40 microM concentration on desaturation and chain elongation processes using [1-14C]18:3(n-3) as substrate. In general, monoenoic fatty acids were without effect. The (n-6) fatty acids (18:2, 18:3, 20:3, 20:4 and 22:4) had little effect on total product formed. There was a shift of labeled product to triacylglycerol, and in phospholipids, slightly enhanced conversion of 20:5 to 22:5 was evident. In contrast, 22:6(n-3) was inhibitory, whereas 20:3(n 3) and 20:5(n-3) had much less effect. At concentrations less than 75 microM, all acids were inhibitory. Most products were esterified to phosphatidylcholine, but phosphatidylethanolamine also contained a major portion of 20:5 and 22:5. We provide a condensed overview of how the (n-6) and (n-3) fatty acids interact to modify relative rates of desaturation and chain elongation, depending on the essential fatty acid precursor. Thus, the balance between these dietary acids can markedly influence enzymes providing crucial membrane components and substrates for biologically active oxygenated derivatives. PMID- 3669925 TI - Cholesterol autoxidation in phospholipid membrane bilayers. AB - Lipid peroxidation in unilamellar liposomes of known cholesterol-phospholipid composition was monitored under conditions of autoxidation or as induced by a superoxide radical generating system, gamma-irradiation or cumene hydroperoxide. Formation of cholesterol oxidation products was indexed to the level of lipid peroxidation. The major cholesterol oxidation products identified were 7-keto cholesterol, isomeric cholesterol 5,6-epoxides, isomeric 7-hydroperoxides and isomeric 3,7-cholestane diols. Other commonly encountered products included 3,5 cholestadiene-7-one and cholestane-3 beta, 5 alpha, 6 beta-triol. Superoxide dependent peroxidation required iron and produced a gradual increase in 7-keto cholesterol and cholesterol epoxides. Cholesterol oxidation was greatest in liposomes containing high proportions of unsaturated phospholipid to cholesterol (4:1 molar ratio), intermediate with low phospholipid to cholesterol ratios (2:1) and least in liposomes prepared with dipalmitoylphosphatidylcholine and cholesterol. This relationship held regardless of the oxidizing conditions used. Cumene hydroperoxide-dependent lipid peroxidation and/or more prolonged oxidations with other oxidizing systems yielded a variety of products where cholesterol-5 beta,6 beta-epoxide, 7-ketocholesterol and the 7-hydroperoxides were most consistently elevated. Oxyradical initiation of lipid peroxidation produced a pattern of cholesterol oxidation products distinguishable from the pattern derived by cumene hydroperoxide-dependent peroxidation. Our findings indicate that cholesterol autoxidation in biological membranes is modeled by the peroxide-induced oxidation of liposomes bearing unsaturated fatty acids and suggest that a number of cholesterol oxidation products are derived from peroxide dependent propagation reactions occurring in biomembranes. PMID- 3669926 TI - Liver subcellular fatty acid profiles of chicks fed diets containing hydrogenated fats and varying linoleate levels. AB - Day-old male broiler chickens were fed semipurified diets containing 5% lipid from one of four different lipid sources: corn oil (CO), partially hydrogenated soybean oil (HSBO), a spent restaurant grease (SRG) and a purified mixture of triolein, tripalmitin and tristearin (OPS). Diets CO and HSBO contained adequate amounts of linoleic acid, but diets SRG and OPS were deficient in linoleate. In addition, SRG and HSBO contained trans isomers of 16:1 and 18:1. The diets were fed for 3 wk to determine the effects of low linoleate levels and trans isomers on fatty acid profiles in liver microsomes, mitochondria and cytosol. Chicks fed HSBO had the highest body weights, while those fed SRG and OPS had the lowest. The incidence and severity of dermatitis were similar for all treatments. The proportions of linoleate and arachidonate in lipids from liver subcellular fractions were reduced significantly in chicks fed OPS and SRG; however, levels of 20:3 omega 9 were not increased. Feeding HSBO, which is high in both linoleate and linolenate, resulted in higher levels of 18:3 omega 3 and 20:5 omega 3 in liver subcellular fractions and lower levels of 20:4 omega 6 than those seen in chicks fed CO. The isomeric forms of 18:1 present in the partially hydrogenated fats (HSBO and SRG) appeared to be incorporated into the lipids of liver fractions. The results of this study show that dietary lipids influence fatty acid profiles of chick liver microsomes, mitochondria and cytosol. Decreases in linoleate and arachidonate in these organelles occur before overt essential fatty acid (EFA), deficiency signs in chicks fed EFA-deficient diets. PMID- 3669927 TI - Lipid composition of cultured B16 melanoma cell variants with different lung colonizing potential. AB - Lipid components influence several cell surface properties that are critical in different stages of the metastatic process. In this study, we examined whether the different lung-colonizing potential of B16-F1 and B16-F10 melanoma cells could be related to a characteristic lipid profile. The lipid analyses, carried out on the same cell cultures used for the assay of lung-colonizing potential, revealed characteristics in the lipid composition of both B16-F1 and B16-F10 melanoma cells that are common to other systems of malignant cells: a high level of 18:1 associated with low proportions of polyunsaturated fatty acids in phospholipids, accumulation of ether-linked lipids and absence of complex gangliosides. The two B16 melanoma variants differed significantly only with respect to ether-linked lipids, due to a higher level of alkyl-PC in B16-F10 than in B16-F1. PMID- 3669929 TI - Isolation and quantitation of lectins from vegetable oils. AB - The factor(s) responsible for the unexplained atherogenicity of peanut oil remain to be elucidated. To this end, we developed a technique to determine if lectin was present in the oil and to quantitate its concentration. This technique was applied to other vegetable oils including corn, soybean, and sunflower. Crude, unprocessed corn and soybean oils were also analyzed for lectin content. The crude oils contained from 858 to 2983 micrograms lectin per kg, while the refined oils contained 24 to 55 micrograms/kg of biologically active lectin. The identities of the isolated lectins were confirmed by electrophoresis on SDS polyacrylamide gels. The biological significance of the presence of lectin in these oils remains to be determined. PMID- 3669928 TI - [3H]cholesterol transfer from microemulsion particles of different sizes to human fibroblasts. AB - A new technique for preparing microemulsion particles of well-defined sizes and compositions is presented. Utilization of these microemulsions is advocated as lipoprotein models in studies of lipid transport and metabolism, rather than the currently used phospholipid-cholesterol vesicles. The emulsion particles consisted of egg phosphatidylcholine and cholesterol as surface lipids and cholesteryl oleate as core lipid. They were prepared by a combined injection and sonication technique and size-separated by a two-step procedure of gel filtration chromatography and density gradient centrifugation. By varying the ratios of core and surface material, particles covering a size range of 20-200 nm in diameter could be produced. The adequacy of these microemulsions as lipoprotein models was tested by studying the transfer of [3H]cholesterol and [14C]cholesterol oleate from the particles to cultured human fibroblasts. Up to a particle size of 100 nm, there was a slight increase of [3H]cholesterol transfer. The transfer of [14C]cholesteryl oleate was very slow, yet measurable. Studies of the exchangeability of cholesterol between the microemulsion core and surface phases indicated that all cholesterol can be transferred from microemulsions to cultured cells as a single pool. PMID- 3669930 TI - The activity and properties of a hepatic acid cholesteryl ester hydrolase obtained from rats of different age groups. AB - The activity of lysosomal acid cholesteryl ester hydrolase (acid CEH, EC 3.1.1.13) in rat liver was determined at 3, 5, 7, 10 and 20 wk following birth. The levels of acid CEH activity showed a marked decrease as rats grew older, whereas those of other lysosomal marker enzymes, such as acid phosphatase, beta glucuronidase and cathepsin B and D, showed only a slight decrease. On the other hand, acid CEH activity was detected in all subcellular fractions obtained from rat liver, but the enzyme activity in these fractions did not show the age related decrease observed in the lysosomal fraction. The results presented here suggest that the marked alteration of lysosomal acid CEH activity that accompanies aging may be related to its possible involvement in the regulation of cholesterol concentration in rat liver. PMID- 3669931 TI - A time-of-flight method of measuring flow velocity by magnetic resonance imaging. AB - A new time-of-flight method for direct imaging of flow velocities by magnetic resonance is presented. The technique uses selective exciting and refocusing RF pulses to selectively affect planes oriented in orthogonal directions in space, with the region of excitation perpendicular to the flow and the refocusing region parallel to and including the flow. The positions of the sources of the resulting spin echoes are imaged, showing a displacement equal to the product of the velocity and the echo time. These images clearly show the profile of the velocity distribution, both in laminar and nonlaminar flows. PMID- 3669932 TI - Motion artifacts in quantitative magnetic resonance imaging. AB - Several investigators have emphasized the potential value of quantitative relaxation times in the assessment of diseases. In performing such measurements using the spin-echo technique, we have encountered several anomalous results, whereby the intensity of the organ parenchyma on second-echo images is greater than on first echo images. This is most likely a result of respiratory motion, and it occurs only rarely. Several volunteers were studied before and after exercise to see if respiratory motion could reproduce the anomalous intensity reverse; a reversal of intensities in renal parenchyma was observed in two of five individuals. We conclude that respiratory motion artifacts will seriously limit quantitative magnetic resonance imaging of the upper abdomen if respiratory gating during imaging is not used. PMID- 3669933 TI - The perceived clinical value of NMR measurements on biopsy specimens. Part I. Interval estimates of diagnostic error rates and a note on an effect of the law of small numbers. AB - There are currently two conflicting views concerning the value of NMR measurements (in vivo and in vitro) of the proton T1 and T2 relaxation times in tissues, in discriminating between normal (Ca) and malignant (Ca) conditions. Damadian repeatedly asserted that a linear combination of these two measurements, the so-called malignancy index, can, "...discriminate between normal and cancer tissue on a case-by-case basis...considerably better than 90%" and thus "...the technique is now ready for use by pathologists as an adjunct to present methods of diagnosing malignancy." On the other hand, Hollis countered that, "Neither nmr nor any other method requiring surgical biopsy is likely to replace or even supplement the standard histopathological techniques." Part I of the present paper examines the relation between the first of these two views and the sample data presented in their support. Part I is a "cautionary tale" in which the procedures used by Koutcher to obtain point estimates of the misclassification rates from these data are shown to be incorrect. (These procedures are identical to those used two decades earlier by Ternberg in an advocacy of the diagnostic use of EPR measurements on biopsied tissues.) It is also shown that the interval estimates of the misclassification rates obtained from these data, which have not previously been reported, are large enough to embrace both views; these data are "user-friendly"--a characteristic of small samples. It is shown that, in accordance with the Tversky-Kahneman (1971) Law of Small Numbers, the disparity in the two views can be accounted for by, "...underestimates of the breadth of confidence intervals" (due to the small sample sizes) by each group. The appropriate statistical procedures for determining point and interval estimates of such misclassification rates are also described and illustrated with the Koutcher, data. Part II describes a Discriminant Analysis of these data. It is, of course, still possible that proton T1 and T2 measurements can be used to reliably distinguish between normal and malignant tissues since absence of evidence is not always evidence of absence for an effect. PMID- 3669934 TI - Tissue contrast enhancement: image reconstruction algorithm and selection of TI in inversion recovery MRI. AB - It is clearly demonstrated that the proper application of the inversion recovery imaging pulse sequence is dependent on the method of image reconstruction and the selection of TI for optimum tissue contrast. There are two methods of 2DFT image reconstruction of IR sequence time-domain raw data. The first is a modulus-image reconstruction algorithm (contrast-obliterating option), and the second is a phase-correction routine for reconstructing "phase-sensitive" true IR-images. The second option generates proper "in-phase" images, retains proper scale of contrast, but can invert the algebraic sign of image-values under certain conditions. A series of "phase-sensitive" and "modulus" reconstructed brain images, obtained with conventional and optimized new IR pulse sequences, are shown to demonstrate these effects. They illustrate the considerable advantages gained, in practical clinical situations, if one generates "phase-sensitive" true IR-images from IR-sequence raw data at optimum TI for tissue contrast enhancement. PMID- 3669935 TI - 1H MR spatially resolved spectroscopy of human tissues in situ. AB - SPAtially Resolved Spectroscopy (SPARS) has been developed as a method to obtain localized MR spectra in a whole body MRI system. It is based upon a combination of selective and non-selective pulses such that longitudinal magnetization is preserved in a particular volume of interest (VOI), whereas outside this volume the magnetization is dephased in the transversal plane. After this selection phase the spectrum of the VOI can be obtained after a single excitation pulse. In this respect it is similar to the VSE sequence as proposed by Aue et al. The difference is that even by using relatively large body and head coils the SPARS sequence requires much lower rf powers levels, such that it can be implemented on a whole body MRI system. PMID- 3669936 TI - Proton MR study of different types of experimental acute renal failure in rats. AB - Kidney cortical and medullary spin-lattice (T1) and spin-spin (T2) relaxation times were measured in several types of experimental acute renal failure in rats with a Bruker PC "Multispec." Gentamicin ARF was obtained after one i.p. injection of 100mg Gentamicin/kg BW/day for 8 days. Glycerol ARF: 24 hours after one i.m. injection of 10 ml 50% Glycerol/kg BW. Obstruction ARF: 3 days after complete ureteral ligation. Renal tissue total water content, hydration fraction, fraction bound, blood urea and creatinine were measured at the end of the experiments. Shortened T1 and prolonged T2 were found in both cortex and medulla in the Glycerol ARF group. Gentamicin renal toxicity and the non-functioning kidney with ureteral obstruction are characterized by significant prolongation of T1 and T2 in cortex, while the medullary T1 and T2 were prolonged only in obstruction ARF. The highest T1 and T2 were found in the obstructed non functioning kidney. The total water content decreased in the Glycerol ARF, increased in the obstruction and remain unchanged in Gentamicin ARF. The hydration fraction and the fraction bound changed significantly in the opposite direction with the total water content. Different profiles of renal cortical and medullary magnetic resonance properties found in several models of experimental ARF in rats indicate that MR properties may provide etiopathogenetic diagnostic possibilities. PMID- 3669937 TI - In vivo determination of 31P spin relaxation times (T1, T2, T1 rho) in rat leg muscle. Use of an off-axis solenoid coil. AB - A probe using a solenoid coil tilted 45 degrees off-axis has been used to study the 31P NMR relaxation characteristics of the resonances arising from phosphorus metabolites in rats in vivo. T1, T1 rho and T2 values have been determined for phosphocreatine and ATP in leg muscle. The ratio of 31P T1(1700ms) to T2(12ms) for ATP was in excess of 200:1 compared with a ratio of 5:1 for 1H T1:T2. Of major significance was the observation that T2 values for phosphocreatine (230ms) were markedly longer than T2 values for ATP (12ms). Thus by use of appropriate delay times in spin echo sequences ATP signals can be nulled, and discrete 31P imaging of phosphocreatine in muscle may be possible provided the overall signal to-noise is satisfactory. PMID- 3669938 TI - Errors in the assessment of the efficacy of MRI pulse sequences. AB - The effects of the echo delay TE on contrast in saturation recovery MRI have been analyzed both theoretically and with experimental brain scans. It is demonstrated that the influence of the TE values offered as minimal values by all major current equipment manufacturers is not insignificant, but produces a degree of T2 weighting that considerably degrades the useful contrast that could be obtained from T1 weighted studies. Consequently, conclusions drawn about the relative performances of T1 and T2 weighted sequences may be incorrect if based on saturation recovery images obtained with inappropriate echo times. PMID- 3669939 TI - Application of autoregressive modelling in magnetic resonance imaging to remove noise and truncation artifacts. AB - Magnetic resonance imaging data is conventionally reconstructed using two dimensional discrete Fourier transforms. However, there is growing interest in other types of spectral estimation which minimize noise and artifacts due to truncated data. This note presents preliminary results--showing the improvement obtainable using a modified autoregressive model, the Transient Error method. PMID- 3669940 TI - Agarose as a tissue equivalent phantom material for NMR imaging. AB - Phantoms for evaluation of nuclear magnetic resonance (NMR) imaging systems were made from water-based agarose gels, according to a standard procedure herein described. Copper sulfate (CuSO4) was included in the gels to further affect their proton relaxation characteristics. The proton relaxation rates of each batch of gel are dependent on the concentrations of agarose and copper ions in it, with T1 depending more on copper than on agarose, and T2 depending more strongly on agarose than on copper. The wide range of T1 and T2 which can be covered, and the stability and physical characteristics of the agarose gel material make it well-suited for phantom use. PMID- 3669941 TI - Diffuse fatty infiltration of the liver by magnetic resonance. PMID- 3669942 TI - Behavioral effects of exposure to nuclear magnetic resonance imaging: I. Open field behavior and passive avoidance learning in rats. AB - The effect of exposure to the magnetic and radio-frequency fields associated with Nuclear Magnetic Resonance Imaging (MRI) on two standard animal behavior tests, was examined in rats. In the first experiment male rats were given a baseline open-field test and 48 hrs later exposed for 22.5 min to a MRI procedure, a sham imaging procedure, or a control condition. Immediately after this exposure period a second open-field test was administered. All animals were given 4 more daily exposures to their respective treatment conditions and after the last exposure period a third open-field test was given. Analysis of open-field ambulation, rearing, and defecation responses indicated no significant effect of exposure to MRI on these behaviours. In a second experiment rats were conditioned in a step down passive avoidance task and then exposed for 23.2 min (48 hrs later) to MRI, sham imaging, or control conditions. Retention tests for the passive avoidance response were administered after the first and fifth daily exposure to the experimental treatment conditions. No significant effects of the treatment conditions on retention of the avoidance response were obtained and a third retention test 3 months after the second test, also failed to provide any evidence for treatment effects. These results fail to provide any evidence for short or long term behavioral changes in animals exposed to MRI. PMID- 3669943 TI - Behavioral effects of exposure to nuclear magnetic resonance imaging: II. Spatial memory tests. AB - In order to determine possible effects of exposure to nuclear magnetic resonance imaging (MRI) on cognitive processes, the performance of imaged, sham exposed, and control rats on a spatial memory task was examined. This particular task was chosen because, under some conditions, animals use the magnetic field as a compass when navigating. The rats were required to collect food from eight different locations before returning to an already chosen location. All three groups of rats achieved a high level of performance, and there were no differences between groups in any of the performance measures examined. These results indicate that the MRI procedure has no significant effect on spatial memory processes in rats. PMID- 3669944 TI - Significance of proton relaxation time measurement in brain edema, cerebral infarction and brain tumors. AB - We examined the proton relaxation times in vitro in various neurological diseases using experimental and clinical materials, and consequently obtained significant results for making a fundamental analysis of magnetic resonance imaging (MRI) as followings. 1) In the brain edema and cerebral infarction, T1 prolonged and T2 separated into two components, one fast and one slow. Prolongation of T1 referred to the volume of increased water in tissue. The slow component of T2 reflects both the volume and the content of increased edema fluid in tissue. 2) In the edematous brain tissue with the damaged Blood-Brain-Barrier (BBB), the slow component of T2 became shorter after the injection of Mn-EDTA. Paramagnetic ion could be used as an indicator to demonstrate the destruction of BBB in the brain. 3) After the i.v. injection of glycerol, the slow component of T2 became shorter in the edematous brain with the concomitant decrease of water content. The effects of therapeutic drug could be evaluated by the measurement of proton relaxation times. 4) Almost all tumor tissue showed a longer T1 and T2 values than the normal rat brain, and many of them showed two components in T2. It was difficult to determine the histology of tumor tissue by the relaxation time alone because of an overlap of T1 and T2 values occurred among various types of brain tumors. 5) In vivo T1 values of various brain tumor were calculated from the data of MRIs by zero-crossing method, and they were compared with the in vitro T1 values which were measured immediately after the surgical operation. Though the absolute value did not coincide with each other due to differences in magnetic field strength, the tendency of the changes was the same among all kinds of tumors. It is concluded that the fundamental analysis of proton relaxation times is essentially important not only for the study of pathophysiology in many diseases but also for the interpretation of clinical MRI. PMID- 3669945 TI - Molecular masking and unmasking of the paramagnetic effect of iron on the proton spin-lattice (T1) relaxation time in blood and blood clots. AB - The contribution of hemolysis, proteolysis and the paramagnetic effect of iron on the proton spin-lattice (T1) relaxation time in blood was examined. Hemolysis induced by sonication resulted in a significant (10%) increase in the T1 relaxation time of whole blood. Proteolysis in both sonicated and unsonicated whole blood samples eventually yielded T1 values which correlated well with the relaxation times of free iron in plasma or water at concentrations comparable to the concentration of iron in whole blood. It is concluded that proteolysis allows the iron atom to express its paramagnetic effect on water relaxation by gradually destroying the hydrophobic nature of the pocket in which iron resides on the hemoglobin molecule. The contribution of various blood components to the T1 relaxation of whole blood was also studied. The T1 values for packed erythrocytes, intact whole blood, sonicated whole blood, plasma and serum proved to be significantly different from each other. Serum was found to have a significantly (12%) longer T1 relaxation time than plasma. Packed clotted blood in vitro showed no change in the T1 time for at least 13 days while packed erythrocytes showed a shortening of T1 time after 6-8 days. PMID- 3669947 TI - On the thermoregulatory consequences of NMR imaging. AB - A simple model of physiological thermoregulation has been adapted to predict the thermoregulatory consequences of exposure to the nuclear magnetic resonance (NMR) imaging environment. Based on our knowledge of thermoregulatory processes and how heat is exchanged between a person and the environment, the model can predict physiological heat loss responses in real time as a function of selected ambient temperature (Ta), air movement (v), and rate of whole-body radiofrequency (RF) energy deposition (SAR). Assuming a criterion elevation in deep body temperature (delta Tco) of 0.6 degree C, Ta = 20 degrees C and v = 0.8 m/sec, a 70 kg patient could undergo an NMR exposure of infinite duration at SAR less than or equal to 5 W/kg. Lowering Ta or increasing v permits a rise in permissible SAR for a given delta Tco. More restrictive delta Tco criteria result in lower permissible SARs and shorter exposure durations. The limiting response under all conditions tested was found to be the rate of peripheral blood flow, although sweating played a significant role in preventing excessive delta Tco. Some guidance for the clinical application of the predictions is offered. PMID- 3669946 TI - Numerical T1 computation from NMR intensity ratios. AB - Two-point measurement of tissue T1 from NMR intensity ratios consists of forming an a priori ratio function describing a T1 dependence of the ratio R(T1) and computing T1 from an observed ratio Q by numerically solving R(T1)-Q = 0 or an equivalent equation. Impact of R(T1) designs on the numerical computation and dependence of relative speeds of three numerical methods on desired computational precisions q and on other factors are examined. All three methods begin with computing a table of R(T1) entries in uniform T1 steps (delta T1). In two iterative methods, a step containing the T1 root is looked up, and the precise T1 location within the step is pinpointed to within a q value by either linear interpolative (LI) or Newton-Raphson (NR) iteration. The third method simply consists of computing a large table of delta T1 = q for a mere "look-up" with no iterative search. All three methods require a monotonous R(T1) for uniformly effective computation over wide T1 ranges. Speeds of either iterative method for computing T1 images are expected to vary with delta T1 and q with unsharp speed maxima at delta T1 near 20, 6, and 2 ms for q = 10(-1), 10(-2), and 10(-3) ms, respectively. Either iterative method is suitable for both low- and high precision computations, the LI method being generally faster. The simple look-up is the fastest of the three for T1 image computation to low precisions of q greater than or equal to 1 ms, is likely the slowest for that to q = 0.1 ms, and is impractical for that to q less than or equal to 0.01 ms. PMID- 3669948 TI - 1H-NMR relaxation times and water compartmentalization in experimental tumor models. AB - The present studies were conducted with RIF-1, M5076 and Panc02 subcutaneous tumor models to assess the relationship between tissue-free water compartmentalization and observed tissue T1 and T2 changes at 10 MHz. Observed T1 was shown to correlate directly with total extracellular water and interstitial water volumes. T1 and T2 were also inversely related to intracellular water volumes. T1 and T2 decreases after dexamethasone treatment were, however, most closely correlated with changes in tumor extracellular water and not changes in cell or total water volumes. Studies to assess Gd-DTPA-dimeg dose dependent T1 and T2 modification in model serum protein solutions indicated that although the Gd concentration that reduced T2 by 50% was about 2.5 fold greater than that required to reduce T1 equally, the of the concentration dependent T1 and T2 modifications were similar. In studies with tumor models, the injected dose of Gd DTPA-dimeg that reduced T1 by 50% was inversely correlated with tumor extracellular water volumes. The slopes for dose dependent T1 modification in all tumors were similar and similar to that observed for model protein solutions. Gd DTPA-dimeg had a different effect on observed T2 values for the 3 tumor models. Exponential slopes were about twice that observed for T2 modification of serum protein solutions, and Gd-DTPA-dimeg doses that reduced observed tumor T2 ranged from 9 to 50 times that necessary to similarly reduce T1. The results from these studies indicate that the observed T1, for these tumors, was dominated by relaxation of water protons in interstitial water but that the observed T2 was most strongly influenced by proton relaxation in water compartments that were unavailable to the Gd labeled probe. PMID- 3669949 TI - Immunospecific NMR contrast agents. AB - Most NMR contrast agents suggested to date have been paramagnetic. These agents, which include the transition and lanthanide metal ions as well as stable organic free radicals, do not provide effective contrast at concentrations much below 1 mM. However, the use of macromolecular ferromagnetic and superparamagnetic particles provides, for the first time, an NMR relaxation agent that is effective at subnanomolar concentrations. Two different sized superparamagnetic particles have been coupled to monoclonal antibodies with high affinity for a neuroblastoma specific cell surface antigen. The specific binding of these particles, both in vivo and in vitro is demonstrated and the consequences for immunospecific NMR contrast are discussed. PMID- 3669950 TI - Reducing motion artifacts in two-dimensional Fourier transform imaging. AB - The effects of motion in two-dimensional Fourier transform imaging (2DFT) are considered. Specific calculations describing the case of periodic motion are presented. The results predict the commonly seen artifact of image replication, sometimes referred to as ghosting. Expressions for both position and amplitude of these ghosts are derived. Simulated examples illustrate the image degradation for pulsatile flow and in plane motion. Several methods of reducing motion artifacts are then suggested. These include: randomization of views, averaging views, matching repeat times to the respiratory period, hybrid imaging, ROPE and COPE. The latter two methods reorder the data acquisition to destroy the coherence of the motion. They do not increase the data acquisition time and promise to be part of the standard approach to remove motion artifacts. The final step in actually recovering ideal resolution can be accomplished by using a model of the motion and a generalized transform inversion technique. PMID- 3669951 TI - Medical records: medicolegal balm or bomb? PMID- 3669952 TI - Anesthesia for transurethral resection of the prostate (TURP). PMID- 3669953 TI - [A simplified multiple pressure monitoring system]. PMID- 3669954 TI - [Clinical experience with the inhalation agent isoflurane in children]. PMID- 3669955 TI - The cerebral circulatory effects of hypotension induced by adenosine and hemorrhage in dogs. PMID- 3669956 TI - Clinical experience of low-dose epidural morphine as a post-operative analgesic in patients undergoing hemorrhoidectomy. PMID- 3669957 TI - [Tension pneumocephalus during neurosurgery in the sitting position without nitrous oxide anesthesia--a report of two cases]. PMID- 3669958 TI - [Rhabdomyolysis with myoglobinuric acute renal failure following the use of succinylcholine chloride and enflurane in a mentally-retarded patient: a case report]. PMID- 3669959 TI - The fourth annual Medical Software Buyer's Guide. PMID- 3669960 TI - [Work of the dispensary department nurse in tuberculosis institutions in foci of tuberculosis infection]. PMID- 3669961 TI - [Organization of the nurse's work in the balneology room of a sanatorium preventorium]. PMID- 3669962 TI - [Symptomatic alcoholism in women and its role in the occurrence of law breaking]. PMID- 3669963 TI - [Current organizational problems of emergency care for the mentally ill in hospital departments and the role of the nurse in its realization]. PMID- 3669964 TI - [The responsibilities of the psychiatric duty nurse in the light of the modern methods of treating the mentally ill]. PMID- 3669966 TI - [Charcot-Marie-Tooth neural amyotrophy]. PMID- 3669965 TI - [Headache: the status of the problem and its treatment]. PMID- 3669967 TI - [Paresthesia of the oral mucosa]. PMID- 3669968 TI - [Chronic urethritis in women]. PMID- 3669969 TI - [Emergency medical care for patients with febrile hypertoxic schizophrenia]. PMID- 3669970 TI - [Diadynamotherapy in pediatrics]. PMID- 3669971 TI - [The child must live]. PMID- 3669972 TI - [Men's health]. PMID- 3669973 TI - [Drug addiction and toxicomania in the practice of the general nurse]. PMID- 3669974 TI - [Characteristics of the duodenal intubation of elderly subjects]. PMID- 3669975 TI - [Functional couch with switching device for electrocardiography]. PMID- 3669976 TI - [Injuries of the spine and spinal cord]. PMID- 3669977 TI - [Pathogenesis and treatment of brain edema in severe craniocerebral injury in children]. PMID- 3669978 TI - [Treatment of strabismus and amblyopia]. PMID- 3669979 TI - [Diseases of the optic nerve]. PMID- 3669980 TI - [Characteristics of the nurse's work in a laboratory studying external respiratory function in detecting bronchial obstruction]. PMID- 3669981 TI - [Safety technics and occupational hygiene in radiodiagnosis units]. PMID- 3669982 TI - [Emergency care for the mentally ill in a state of psychomotor excitation]. PMID- 3669983 TI - [Deontological and ethical questions in the work of the hospital nurse]. PMID- 3669984 TI - [Use of practice games for the training of nurses]. PMID- 3669985 TI - [Rehabilitative treatment of patients undergoing an operation for uterine myoma]. PMID- 3669986 TI - [Characteristics of the health status and the means for its restoration in children who are frequently ill]. PMID- 3669987 TI - Improving student learning during lectures. PMID- 3669988 TI - Project work in a medical course. PMID- 3669989 TI - Simulations in medical education: a review. PMID- 3669990 TI - Harvey: the impact of a cardiovascular teaching simulator on student skill acquisition. PMID- 3669991 TI - Nursing education. PMID- 3669992 TI - The use of application test, a novel type of problem-solving exercise as a tool of teaching and assessment of competence in medical biology. PMID- 3669993 TI - Qualifying exams for medical students: are both major finals and continuous assessment necessary? PMID- 3669995 TI - Construction of a learning/teaching module relating to the training of teachers in general practice: an example of international co-operation. PMID- 3669994 TI - Hypothesis: cognitive development of medical students is relevant for medical education. PMID- 3669997 TI - Knowledge which cannot be used is useless. PMID- 3669996 TI - The clinical tutor. PMID- 3669998 TI - A method of deriving definitions of specific medical competencies: a framework for curriculum planning and evaluation. PMID- 3669999 TI - Determinants in physiotherapy education. PMID- 3670000 TI - The analysis of medical curriculum. PMID- 3670001 TI - An evaluation of student satisfaction with professional skills teaching in an integrated medical school. PMID- 3670002 TI - The OSCE as a part of a systematic skills training approach. PMID- 3670003 TI - Vocational training for general practice in Dartford 1971-1982: an assessment. PMID- 3670005 TI - A philosophy for the day release course in vocational training. PMID- 3670004 TI - Printed material for patients with heart disease: are we really 'educating patients?'. PMID- 3670006 TI - [Fragments of gas dynamic parameters of pulsatile diffusion respiration]. AB - The fragments of the mathematical simulation of one of the present-day methods of artificial pulmonary ventilation (APV) are described. Some parameters of this APV method have been calculated on the basis of the anatomic and physiologic data and the gas dynamic methods. PMID- 3670007 TI - [Mass spectrometric determination of the gas content of blood]. AB - The operational principle of the new mass-spectroscopic device for determining the gas content in blood is based on extracting gases from blood samples into vacuum volume and measuring their content with mass spectrometer. The increased sensitivity and measurement accuracy are achieved by raising the pressure of gases during the process of freezing out the water vapors as well as by making use of calibrating gas. About 0.5-1.0 ml of blood are enough for the analysis. The low pressure in the extraction chamber favors complete removal of gases from the sample without using hemolyzing reagents. Besides O2 and CO2 it is possible to determine the content of other gases including narcotic and inert gases. PMID- 3670011 TI - [A digital meter for output and frequency of pulsatile pumps]. AB - The authors propose a digital meter of the pulsatile pump flow and frequency for artificial circulation of blood and pulmonary ventilation. The measurement of the above parameters is based on period-to-frequency inverse transformation and the stroke volume digital information per cycle of the pump function. The device is realized on the basis of the digital integral technique and provides visual control of the parameters with the required accuracy. PMID- 3670008 TI - [Electrical safety of endoscopic equipment]. AB - The article considers in detail the problems affecting the safety of the patients and the medical personnel during endoscopic examinations, gives practical recommendations both to the endoscope makers and users. PMID- 3670009 TI - [Optical characteristics of closed-type safety glasses]. AB - Measurements of spectral translucent coefficients of four types of protective spectacles with clean and tinted glasses were done using the C phi-46 spectrophotometer. Translucent coefficients were calculated according to a special programme in relation to the visibility factor curve. Vision acuity evaluation for the analysed spectacles is given. It was found that the change of vision acuity in relationship to the glass tinting degree does not directly depend on their translucent coefficient change. PMID- 3670010 TI - [Deodorant gaskets for colostomy patients]. AB - The results of the experiments for the objective evaluation on a model system of the protective effect of deodorant gaskets on colostomy patients are given. It has been determined that the deodorant capacity of the above gaskets is more than two times higher than that of its "washer filter" analog manufactured by the foreign "Coloplast" company. PMID- 3670012 TI - [Characteristics of a new ultrasonic apparatus for removing dental calculus]. AB - The use of piezoceramic transducers and high-efficiency ultrasonic oscillation system with replaceable working heads sharply decreased electric energy consumption, the dimensions and mass of the new "Ultradent" unit for odontolithic removal. PMID- 3670013 TI - [Radiation dose to patients and informativeness of the images obtained during eye examinations using x-ray computed tomography]. AB - Reducing the scanning time and the X-ray tube anode current to 80-100 mA is the main way of reducing the radiation dose without noticeably lowering the tomogram image quality in examination of the eye area using the USA QUAD-1 X-ray computer tomograph of the fourth generation. The optimum tube voltage is 140 kW. Narrowing the collimator slit and reducing the number of sections can also lower the total radiation dose, but these measures are less universal for they are determined by clinical situation. PMID- 3670014 TI - [Setting of work standards for electrical engineers engaged in the maintenance of medical equipment]. PMID- 3670015 TI - [Automated work station for an economist]. PMID- 3670016 TI - [A device for centering a gamma camera transducer]. AB - The device consists of the upper part of the gamma chamber pillar to which a rod is rigidly fastened with a disk of acrylic plastic moving freely on the opposite end. This disk is placed coaxially and is equal to the gamma chamber detector crystal. The device makes it possible to use ordinary medical couches covered with a porolone mattress when the gamma chamber detector is placed below. PMID- 3670017 TI - [A contact-free exposure meter for x-ray diagnostic equipment]. AB - The paper describes a digital apparatus capable of measuring the duration of X radiation within the range of 0.001-10.0 s with an error of 2%. The apparatus is used for exposure control in X-ray units having four- and six-pulse circuits. PMID- 3670018 TI - [An electrocardiographic synchronizer for the MV-9100 gamma camera]. PMID- 3670019 TI - [The NAPP-4 "Spironarkon-P" equipment for intermittent-flow inhalation anesthesia]. PMID- 3670020 TI - [The Cardiocomplex-05]. PMID- 3670021 TI - [Specialized medical tables]. PMID- 3670022 TI - [Specialized medical beds for children]. PMID- 3670023 TI - [Automated measurement of cardiac output during physical exercise using a rheographic method]. AB - The authors propose the methods of measuring the hemodynamic indices on the basis of the impedance rheoplethysmography, electrocardiometer and programming microcalculator. The use of the disk electrodes instead of the circular electrodes makes it possible to take measurements during physical tests, e.g. veloergometric tests. PMID- 3670024 TI - [Sexually transmitted diseases in tropical Africa]. PMID- 3670025 TI - [Management of sexually-transmitted diseases diagnosed in women in tropical Africa]. AB - Taking into account their own experience and very numerous recent publications, the authors proposed an easy protocol towards diagnosed S.T.D., in African woman. Diseases are classified according to symptomatology: clear infection in case of cervico-vaginitis, ulcerations (painful or not), tumural formations, and also during salpingitis or infertility. They particularly emphasize cervico-vaginitis manifestations which represent one visit out of three in Gynecology Departments. For each infection, they recall its symptomatology, diagnosis and efficient treatment. They strongly recommend to keep in mind, in Africa, multi-microbial associations. PMID- 3670026 TI - [Surgical pelviperitonitis and the African gynecologic complex]. AB - From the analysis of 28 records in the gynecological Department of the Hospital Principal in Dakar, all of them recording cases of pelviperitonitis having demanded a surgical intervention, it seems permissible to the authors to maintain the denomination, full of imagery, of "Gynecologic African Complex". They define it as appearing in a peculiar socio-economical environment (in Africa but also in the Third World) and characterised anatomically by an inflammatory pelviperitoneal syndrome presenting a large anatomic diversity. In the studied records, the authors sorted out 14 cases with an acute clinical aspect and 14 with a chronic one. These 28 cases represented 1.5% of the admissions and 5% of the operated patients in the gynecologic Department. The aspect "complex", linked with the polymorphism of the diagnosed lesions (among them 2 tubal tuberculosis, 1 peritoneal tuberculosis, 2 genital bilharziosis) and their frequent association, constitutes a surgical entity about which therapeutic tactics has to be adapted and reasonably mutilating. The concern of preservation must take into consideration future evolution of surgical consequences, genital and obstetrical future of women often young. PMID- 3670028 TI - [Syphilis in 1987]. AB - The author recalls the main features of primary-secondary syphilis observed nowadays under any climat. Still present and in more young people, syphilis is no longer the plague it was in the past centuries, thanks to a quick and efficient treatment: penicillin. In case of allergia, cyclines and erythromycin are used. Serological, reaginic and specific tests must be associated and quantitative. Qualitative serology exposed by crosses is obsolete and without possible interpretation. Modern American terminology of early syphilis has no other interest than the therapy which varies according to the stage of the disease. PMID- 3670027 TI - [Urethral stricture in Africa. Urologic complication of sexually transmitted diseases in the male in Africa]. AB - Urethral stricture is a very frequent and severe complication of sexually transmitted diseases in African male. It is very often largely sclerous and inflammatory as the patients come to consultation very late. Urethral repair techniques are analysed, so the principles of surgical procedure. When urethral stricture is brief and "catheterisable", and in case of recurrence, endoscopic dilatation or endoscopic internal urethrotomy must be performed in the first place. In the others cases, in order, we advise: free skin graft urethroplasty (Devine), pedicled vaginal urethroplasty (Kishev), scrotal flap urethroplasty (Blandy), and the two-stage urethroplasty. In fact this choice depends on the urethral and peri-urethral lesions and on the operator's practice. PMID- 3670029 TI - [Diarrhea and acquired immunodeficiency syndrome in the tropics (tropical AIDS). The place of digestive endoscopic examinations in diagnosing opportunistic infections]. AB - A.I.D.S. has revealed some parasitic, microbiotic, mycotic or viral diseases causing diarrhea or has given a revival of interest to them. So are Cryptosporidium, Isospora belli, Salmonella typhi murium, Cytomegalovirus. Some easy techniques lead to the diagnosis of some pathogenic agents, such as parasitologic diagnosis of Cryptosporidium. Some other pathogenic agents call for a biopsy in view of an histopathology test: it is the case of Cytomegalovirus of which the diagnosis is stated positively by the histological picture with virus intranuclear inclusions. Then, it is necessary to make clear the actual indications of digestive endoscopic scanning when confronted by a diarrhea of tropical A.I.D.S. PMID- 3670030 TI - [Risk of AIDS for the occasional traveler in Africa]. AB - The authors first point out the importance of A.I.D.S. in Africa; then they appreciate the risk of contamination for occasional traveller in Africa. They recall some epidemic features of tropical A.I.D.S., its originality suggesting some risk factors different from the ones faced in temperate countries. Importance of risk of heterosexual transmission is emphasized, as well as possible parenteral contamination in connection with the frequent use of disposable needles and syringes again utilized without preliminary sterilization. Taking into consideration all these possibilities, the authors expose some prophylactic advises intended for people travelling briefly in endemic zones. PMID- 3670031 TI - [Sexually transmitted diseases and community health services. I. Community diagnosis]. AB - The ambition of Community Health Services in the fight against Sexual Transmitted Diseases (S.T.D.) in developing countries is to enable the exposed population to benefit by cheap but also most efficient preventive and curative measures. This paper mentions and illustrates by examples the different stages of this approach. Community diagnosis identifies the groups and the areas at risk and determines their respective degree of priority, by confronting the epidemiological importance of S.T.D. with the chances of successful attempts to overcome it. The initial evaluation of the endemia is obtained thanks to pertinent epidemiological rates which are collected by a "sentinel notification system" in controlled collectivities or in the population in general. The feasibility of the operations is evaluated by leaning on logistical, psychological and political aspects so as to fix an order of priority. PMID- 3670032 TI - [Sexually transmitted diseases and community health services. II. Planning of the program]. AB - The ambition of Community Health Services in the fight against Sexual Transmitted Diseases (S.T.D.) in developing countries is to enable the exposed population to benefit by cheap but also most efficient preventive and curative measures. This paper mentions and illustrates by examples the different stages of this approach. The planification of the program fixes objectives for the target groups and the diseases in terms of efficiency and efficacy. To achieve these objectives, adaptable strategies must be chosen. The strategies of primary prevention (prophylaxis and education) and secondary prevention (screening and treatment) are examined as well as the principles which govern their choice. In addition, epidemiological surveillance and different criteria used during periodical evaluation of the program have to be planned. Arguments presenting the efficacy and the cost benefit of a program are the most able to convince some partners to finance a program against S.T.D. PMID- 3670033 TI - Free vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia. AB - Five patients with congenital pseudarthrosis of the tibia treated by a free vascularized fibular graft are described. Follow-up evaluation ranged from 15 to 81 months, with a mean of 40 months. Bony union was attained in three of five cases as determined roentgenographically. The remaining two cases failed to attain bony union. All cases except one, who was treated with a below-knee amputation, subsequently attained bony union. However, four cases had five fractures after bony union. We discussed unsolved problems regarding the free vascularized fibular graft and fracture after bony union. PMID- 3670034 TI - Sterilization reversals performed by fellows in training: what success rates can we reasonably expect? AB - To assess outcomes of sterilization reversal procedures performed by fellows in training, we retrospectively analyzed 44 women who had undergone this procedure at a large teaching institution. All women studied had been followed postoperatively for a minimum of 12 months. Sixty-five percent of patients became pregnant. Fifty-four percent of patients successfully delivered a term infant. Compared to results tallied by experienced microsurgeons, no significant differences in outcomes were noted. We conclude that clinically inexperienced microsurgeons can obtain reasonable success rates for sterilization reversal procedures by carefully following established microsurgical principles. PMID- 3670035 TI - Mural repair following obliteration of aneurysms: production of experimental aneurysms. AB - One hundred thirty-two experimental rat carotid artery aneurysms were produced using a variety of methods, in order to determine which of these approaches should be employed in the development of a satisfactory laboratory model. The gross appearance and pathomorphology of aneurysms created by vein pouch and partial arteriotomy methods most closely resembled those features reported in clinical intracranial aneurysms. PMID- 3670036 TI - Second toe transfer for thumb reconstruction in multiple digit amputations including thumb and basal joint. AB - Amputation of the thumb, including the basal joint, is a disabling injury that leaves limited reconstructive options. Three cases of multiple digit amputation including the thumb and basal joint are presented in which a second toe transfer was used to reconstruct the thumb. All patients have functional pinch with an average pinch strength of 27% of the opposite uninjured extremity. The average grip strength for two patients is 44% of the opposite hand. Average motion of the transfer at the MP, PIP, and DIP is 25 degrees, 37 degrees, and 9 degrees, respectively. Adduction and abduction are obtained, the degree depending on the site of proximal bony fixation. No patient has morbidity at the donor site and all are happy with their reconstruction. In selected cases we feel second toe transfer is an excellent choice to reconstruct the thumb amputated at a proximal level. PMID- 3670037 TI - The wraparound procedure for thumb and finger reconstruction. AB - Nineteen thumb and finger reconstructions were performed using the wraparound procedure; there were five early arterial failures. Thirteen of the 14 successful digital reconstructions were reviewed at an average of 26 months after surgery. There were complications related to the upper limb in seven patients, several of whom had more than one problem; these included radial skin breakdown (2), malrotation (2), and infection (2). One patient underwent late deletion for chronic infection following corrective osteotomy. Time until toe donor site healing averaged 2 months. We considered that cosmesis and function were good. Pinch grip averaged 48% of normal; sensibility returned in all patients--four regained protective sensation and the others attained two-point discrimination (average 9 mm). The wraparound procedure provides a cosmetically and functionally excellent method of thumb reconstruction for amputation distal to the metacarpophalangeal joint. PMID- 3670038 TI - Free neurovascular cutaneous toe pulp transfer for thumb reconstruction. AB - Free vascularized toe pulp transfer to the thumb is a technique to restore sensibility and durable soft tissue coverage to the thumb. This article reviews alternative techniques for coverage; the neurovascular anatomy of the great toe; and the technique of microvascular toe pulp transfer. Although the procedure is technically demanding, it provides excellent coverage with minimal donor morbidity. PMID- 3670039 TI - Neurovascular island skin flaps in the hand: functional and sensibility evaluations. AB - The value of neurovascular island skin flap transfers for digit tip surfacing has been evaluated in 13 patients. A computer assisted sensory evaluation was carried out on six of the patients. All patients were satisfied with the procedure. Sensory acuity did not appear to diminish with time and sensory misreference was not a major functional problem. We suggest that the neurovascular island flap, when available, is still an excellent procedure for restoration of useful digit tip sensibility. PMID- 3670040 TI - Dual innervated index to thumb cross finger or island flap reconstruction. AB - Partial volar amputations of the entire thumb pulp require soft tissue coverage that provides not only padding and protection for exposed bone and tendons, but also restoration of discriminative sensation. A modification of the radial sensory innervated cross finger flap from index to thumb is described, which includes separate reinnervation of the flap by repair of the dorsal sensory branch of the index radial digital nerve to the ulnar digital nerve of thumb. The anatomical basis for this flap is discussed and two example cases presented. Sensory reinnervation is rapid and does not require cortical reorientation. PMID- 3670041 TI - [Effect of short-term exposure to ash from electric power plants on histochemical reactions of succinate dehydrogenase and lactate dehydrogenase in the lungs of experimental animals]. AB - Histochemical studies of the activity of succinic dehydrogenase (SDH) and lactic dehydrogenase (LDH) in the pulmonary tissue of experimental animals which were given four coal ashes issued from different thermal-electric power stations: group VII--from the thermal-electric power station Siekierki (Warsaw), group VIII -from Wroclaw, group IX--from Leg (Cracow) and group XI--from Lodz, were carried out. In particular ash samples the content of trace elements and free silica was determined. The studies yield the following conclusions: 1. The activity of succinic dehydrogenase (SDH) and lactic dehydrogenase (LDH) was changed in the respiratory tract and pulmonary alveoli as a result of the electroenergetic ashes applied. 2. Changes in cytoenzymatic reactions of SDH and LDH vary with the type of ash applied. The greatest changes were found in group XI where the ashes contained almost doubled amount of such elements as Mn, Zn, Pb, Cu. 3. SDH exhibited a greater sensitivity to the effects of electroenergetic ashes, as compared to LDH. 4. Changes in the activity of the test SDH and LDH enzymes indicate disorders in oxydoreductory processes of cells. PMID- 3670042 TI - [Experimental studies of toxic effects of 1,3,5-trioxane and 1,3-dioxolane. I. Acute toxic effect]. AB - The problems arising from occupational exposure to 1,2,3-trioxane and 1,3 dioxolane made it necessary to carry out complex studies on that issue. This paper is focussed on systemic and local effects of those compounds. The studies involved: 1) Determination of acute systemic toxic effects following intragastric administration of the test compounds (DL50) and inhalatory exposure (CL50) using the Litchfield and Wilcoxon method as well as determination of medium lethal dose (MDLder) following dermal administration of the test compounds after Deichmann and Le Blanca, 2) Determination of the intensity of acute primarily irritating effects upon skin and eye using the Draize et al method, as well as irritating effects under repeated exposure, 3) Determination of allergic effects using the Magnusson and Kligman method, as modified by B. Krysiak. The DL50 and CL50 values for 1,3,5-trioxane and 1,3-dioxolane come to 8.5 g/kg m.c. and 5.8 g/kg m.c. respectively, and CL50 greater than 26000 mg/m3 and 87000 mg/m3 of air. Of those two compounds only 1,3-dioxolane may be absorbed through intact skin. However, the medium lethal dose MDLder coming to 15 g/kg b.w. in the rabbit implies that the rate of skin absorption for that compound is too low to induce a severe poisoning. Locally, the compounds exhibit irritating effects upon the eyeball and eye protective apparatus. As regards the irritating effectus upon skin, only 1,3 dioxolane induces skin irritation under repeated exposure. Under experimental conditions, no dermatitis related to oversensitivity was found. PMID- 3670043 TI - [A chromatographic method of analysis of mixtures of methylethyl ketone, n-butyl alcohol, xylene, ethylene glycol, ethylene glycol acetate, cyclohexanol, cyclohexanone and butyl glycol vapors in the air]. AB - A gas chromatographic method for the determination of the mixture of organic solvents in air has been developed. The optimum conditions of the separation of the mixture were obtained in the column packed with 10% UCON HB 2000 coated on Chromosorb W AW DMCS 80-100 mesh. The components of the mixture are collected on activated charcoal and desorbed with CS2. A quantitative analysis is made using methyl isobutyl ketone as an internal standard. The lowest detectable limit under proposed air sampling and analysis conditions is 0.1 TLV (threshold limit value) for each component of the mixture. PMID- 3670044 TI - [Mortality ratio in industrial cohort studies]. AB - Presented in the paper is a method of calculating and evaluating the statistical significance of one of the primary measures of mortality in industrial cohort studies--i.e. standardized mortality rate. As the standardized mortality rate is calculated basing on man-years of stay in cohort, thus the method of man-years calculation has been exemplified by two subjects. The methods have been illustrated by the results of studies carried out by the authors. PMID- 3670045 TI - [Incidence of cancer in relation to place of residence, social class and occupation]. AB - The variation in the incidence of cancer between geographic areas and socioeconomic classes is outlined. In many instances the differences in the incidence can be attributed to differences in life-style factors such as smoking, diet, sexual habits, and the reproductive history of women. The role of smoking as an explanator of the variation in the risk of lung cancer between occupational groups is emphasized. PMID- 3670046 TI - [Physical work capacity of women performing light and moderate tasks]. AB - The studies have been aimed at answering the question whether or not a slight difference in the energetic and physiologic expenditure of work performed for many years affects the level of workers' physical fitness. A hundred women performing light (seamstresses) and moderate (formers) work have been examined. The physical fitness has been determined by a submaximum effort test. It seems that a work that only slightly exceeds the moderate and light work limits when added to everyday non-occupational tasks, results in reduced fitness. PMID- 3670047 TI - Specificity of proto-oncogene amplification in human malignant diseases. AB - DNAs from 253 fresh human tumors of 38 different types were hybridized with 17 different oncogene probes. The analysis demonstrated unique associations between amplification of specific oncogenes and specific types of tumors. In a large number of cases it was determined that amplified oncogenes occurred in 10 to 20% of tumors with the following specific associations: c-myc in adenocarcinomas, squamous carcinomas and sarcomas but not hematologic malignancies; c-erbB2 in adenocarcinomas, particularly breast cancers; c-erbB1 in squamous carcinomas; N myc in neuroblastomas. A small number of cases suggested other specific associations: amplified c-myb in breast cancers; amplified c-ras-Ha and c-ras-Ki in ovarian carcinomas. In addition, there was a correlation between amplification of c-myc and the clinical stage of adenocarcinomas, and amplification of c-erbB2 and the clinical stage and lymph node involvement of breast cancers. PMID- 3670048 TI - Expression of genes transferred to haemopoietic stem cells by recombinant retroviruses. AB - We have compared several recombinant retroviruses carrying the selective marker NeoR for gene delivery to murine haemopoietic stem cells. Provirus content and expression was assessed in animals reconstituted with infected bone marrow cells. With viruses bearing only a NeoR gene, viral RNA was readily detectable both in spleen colonies and in the haemopoietic tissues of long-term reconstituted mice. Thus, the progeny of infected primitive multipotential cells are competent to express integrated proviruses. The level of expression was significantly greater for proviruses carrying a modified long terminal repeat in which the Moloney enhancer had been replaced with that from the myeloproliferative sarcoma virus. With viruses bearing the c-myc gene in addition to NeoR, however, no viral RNA could be detected in spleen colonies harbouring proviral inserts, even though these viruses are expressed in vitro within haemopoietic cells. The implications of these results for gene transfer to haemopoietic stem cells are discussed. PMID- 3670049 TI - Altering retrieval demands reverses the picture superiority effect. PMID- 3670050 TI - Constraints on effective pictorial and verbal elaboration. PMID- 3670051 TI - The influence of camera angle on comprehension and retention of pictorial events. PMID- 3670052 TI - Evidence for an anaphoric mechanism within syntactic processing: some reference relations defy semantic and pragmatic constraints. PMID- 3670053 TI - Surface and structural similarity in analogical transfer. PMID- 3670054 TI - The judgment of covariation between binary variables: some conditions that influence the process. PMID- 3670055 TI - Production, verification, and priming of multiplication facts. PMID- 3670056 TI - Recognition of multiple-item probes. PMID- 3670057 TI - Effects of varying modality, surface features, and retention interval on priming in word-fragment completion. PMID- 3670058 TI - Recognition failure of categorized words. PMID- 3670059 TI - Category representations and their implications for category structure. PMID- 3670060 TI - The role of causal connections in the retrieval of text. PMID- 3670061 TI - Individual differences in television comprehension. PMID- 3670062 TI - The spacing effect in 4- to 9-year-old children. PMID- 3670063 TI - Errors in short-term memory for good and poor readers. PMID- 3670064 TI - Ear of input as a determinant of pitch-memory interference. PMID- 3670065 TI - Psychiatric outpatient services, United States, 1983-84. PMID- 3670066 TI - Staffing of specialty mental health organizations, United States, 1984. PMID- 3670067 TI - Wizardry and "networkry". PMID- 3670068 TI - Attitudes toward deinstitutionalization: national survey of families of institutionalized persons with mental retardation. PMID- 3670069 TI - Tangible reinforcement plus social reinforcement versus social reinforcement alone in acquisition of toothbrushing skills. PMID- 3670070 TI - AAMD's 1983 Classification in Mental Retardation as utilized by state mental retardation/developmental disabilities agencies. PMID- 3670071 TI - Training adults with mental retardation to pay bills. PMID- 3670072 TI - Long-term hypertriglyceridemia and glucose intolerance in rats fed chronically an isocaloric sucrose-rich diet. AB - We have previously shown that short-term feeding [20 to 25 day induction period (IP)] normal rats a sucrose-rich diet (SRD) results in an increase of plasma (P), liver (L), and heart (H) triacylglycerol (TG) levels, accompanied by a drop in plasma postheparin total (T-TGL) and hepatic (H-TGL) triglyceride lipases activities, IV glucose intolerance (low Kg) and hyperinsulin responses both in vivo and in vitro, suggesting that a state of insulin resistance had developed. Since normalization of P-TG ensued in the medium term [40 to 55 day adaptation period (AP)] we decided to carry out a longitudinal, long-term (90 to 120 day) follow-up study to observe the dynamic behavior of the above metabolic and hormonal parameters as compared to the appropriate time course control rats were fed the standard chow (STD).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670073 TI - Plasma proline kinetics and the regulation of proline synthesis in man. AB - A quantitative exploration of the regulation of plasma proline concentration, proline oxidation, and proline endogenous biosynthesis was undertaken utilizing a 360-minute primed continuous infusion of L-[1-13C]proline and L-[methyl 2H3]leucine in healthy, postabsorptive young men. The response of proline metabolism to the intravenous administration of two physiologic rates of L proline, as well as the withdrawal of an L-proline infusion, were examined. The administration of L-proline at 20 mumol.kg-1.h-1 after an overnight fast resulted in a higher steady state plasma proline concentration, attained within 100 minutes, and this was associated with an increase in proline oxidation, from a baseline value of 10.9 to 16.1 mumol.kg-1.h-1 (P less than .01). Additionally, there was a decrease in proline endogenous synthesis from 15.8 (baseline) to 5.3 mumol.kg-1.h-1 (P less than .01). Administration of L-proline at 40 mumol.kg-1.h 1 after an overnight fast resulted again in a higher plasma steady state proline concentration, attained within 100 minutes and with an associated increase in proline oxidation from 13.1 to 20.0 mumol.kg-1.h-1 (P less than .01) and with a decrease in proline endogenous synthesis from 12.2 to -0.6 mumol.kg-1.h-1 (P less than 0.01). The withdrawal of L-proline after a 20 mumol.kg-1.h-1 infusion resulted in a lower plasma steady state proline level and this was accompanied by a decrease in proline oxidation from 21.2 to 18.2 mumol.kg-1.h-1 (P less than .05) and an increase in endogenous synthesis from 22.2 to 29.7 mumol.kg-1.h-1 (P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670074 TI - Plasma amino acid concentrations in normal adults ingesting aspartame and monosodium L-glutamate as part of a soup/beverage meal. AB - We tested the hypothesis that ingestion of monosodium L-glutamate with aspartame produces a marked increase in plasma glutamate and aspartate concentrations. Twelve normal adults (6 males, 6 females) ingested three different soup/beverage meals in a balanced Latin square design. One meal (A) provided no aspartame (APM) or monosodium L-glutamate (MSG); a second (B) provided 50 mg MSG/kg body weight; while the third (C) provided 50 mg MSG and 34 mg APM per kg body weight. Plasma glutamate (Glu) concentrations were not significantly affected by meal A but increased significantly after meals B and C (no significant difference between B and C). Plasma aspartate (Asp) concentrations were not significantly affected by meal A but increased significantly after meals B and C (values significantly higher after meal C than meal B). Plasma Glu + Asp concentrations were not significantly affected by meal A but increased significantly from a mean (+/- SD) baseline value of 5.64 +/- 2.62 mumol/dL to high mean values of 23.1 +/- 7.29 and 26.8 +/- 9.74 mumol/dL after ingestion of meals B and C, respectively (no significant difference between meals B and C). Similarly, the area under the plasma Glu + Asp concentration-time curve did not differ significantly between meals B and C (624 +/- 197 v 763 +/- 277 mumol/dL x min, respectively). Peak plasma Glu + Asp concentrations for each subject (ignoring time) were also examined. The mean peak plasma Glu + Asp concentrations were 7.39 +/- 2.77, 23.0 +/- 6.61, and 27.3 +/- 9.07 mumol/dL, respectively after meals A, B, and C. PMID- 3670076 TI - Peptide growth factors. Part B. PMID- 3670075 TI - Determinants of the uptake of very low density lipoprotein remnants by the perfused rat liver. AB - The receptor-mediated uptake of very low density lipoprotein (VLDL) remnants by the rat liver was studied. Livers were perfused with native 125I-VLDL remnants, radiolabeled apo E-deficient remnants, and radiolabeled remnants that contained reductively methylated apo B and unmodified apo E. The specific uptake of the apo E-deficient remnants was 20% of that for the native remnants, whereas the specific uptake of the remnants containing unreactive apo B was 78% of the control value. This suggests that the apo E of VLDL remnants is the principal ligand for binding to the receptor, and in the absence of apo E, apo B may participate in binding. This conclusion is supported by the finding that dimyristoyl phosphatidylcholine (DMPC)- apo E complexes were effective in competing for the hepatic uptake of 125I-VLDL remnants. The intracellular distribution of radioactivity was analyzed by Percoll density gradient centrifugation. At five minutes after perfusion, radioactivity was associated with the plasma membrane and lysosomal fractions, and at 30 minutes most of the radioactivity was associated with the lysosomal fraction. Binding and internalization of VLDL remnants was also directly visualized by electron microscopy. Internalization proceeded by coated pit-coated vesicle formation with subsequent delivery to lysosomes. Our findings demonstrate that the apo E of VLDL remnants mediates binding to the hepatic receptor and that the internalization and degradation of VLDL remnants is by a similar pathway to that previously described for LDL. PMID- 3670077 TI - Isolation and characterization of acidic and basic fibroblast growth factor. PMID- 3670078 TI - Purification and characterization of acidic fibroblast growth factor. PMID- 3670079 TI - A radioreceptor assay for platelet-derived growth factor. PMID- 3670080 TI - Assay of capillary endothelial cell migration. PMID- 3670081 TI - Spectrophotometric assay for the quantitation of cell migration in the Boyden chamber chemotaxis assay. AB - The method described here for the quantitation of cell migration in Boyden chambers is applicable to many cell types, especially connective tissue cells and endothelial cells. Currently, there are many groups working toward the isolation of chemotactic factors for these cells and this method would be useful for the large numbers of repetitive assays done during a purification. In our hands the assay is very reproducible and can be learned within a short time. The major problem with the assay is that the upper surface cells must be completely removed as well as any cellular debris containing dye. However, if the proper care is used in removing these cells, the results vary less than those obtained by counting cells directly. PMID- 3670082 TI - Identification of cell surface proteins sensitive to proteolysis by thrombin. PMID- 3670083 TI - Derivation of monoclonal antibody to nerve growth factor. PMID- 3670084 TI - PC12 pheochromocytoma cells: culture, nerve growth factor treatment, and experimental exploitation. PMID- 3670085 TI - Assay and isolation of glial growth factor from the bovine pituitary. PMID- 3670086 TI - Radioimmunoassay of transferrin receptor. PMID- 3670087 TI - Monoclonal antibodies to transferrin receptor and assay of their biological effects. PMID- 3670088 TI - Purification of human platelet-derived growth factor. PMID- 3670089 TI - Biological activity of human plasma copper-binding growth factor glycyl-L histidyl-L-lysine. PMID- 3670090 TI - Isolation of human erythropoietin with monoclonal antibodies. PMID- 3670091 TI - Large-scale procurement of erythropoietin-responsive erythroid cells: assay for biological activity of erythropoietin. PMID- 3670092 TI - Isolation of mitogen-specific nonproliferative variant cell lines. PMID- 3670093 TI - Use of variant cell lines and cell hybrids for the study of hormone and growth factor action. PMID- 3670094 TI - Kinetic analysis of cell growth factor-nutrient interactions. PMID- 3670095 TI - Purification of fibroblast-derived growth factor. PMID- 3670096 TI - Characterization of growth factor-modulated events regulating cellular proliferation. PMID- 3670097 TI - Measurement of growth factor-induced changes in intracellular pH. PMID- 3670099 TI - On clinically relevant differences and shifted null hypotheses. PMID- 3670098 TI - Analysis of two-way contingency tables: log-linear models and dual scaling. PMID- 3670100 TI - A stochastic model for the inheritance of the cancer proneness phenotype. PMID- 3670101 TI - Strategy for the promotion of medical informatics. PMID- 3670102 TI - Medical databases. PMID- 3670103 TI - Graphical access to medical expert systems: III. Design of a knowledge acquisition environment. PMID- 3670104 TI - Frequency of injury events in New Zealand compared with the available E-codes. PMID- 3670105 TI - Automated indexing of SNOMED statements into ICD. PMID- 3670106 TI - Dutch respelling rules for English and German medical word lists. PMID- 3670107 TI - Where should babies be born? PMID- 3670108 TI - Women's preferences for and satisfaction with current procedures in childbirth- findings from a national study. PMID- 3670109 TI - Surveying the opinions of midwives regarding the curriculum content of refresher courses. PMID- 3670110 TI - The prevention of the acid aspiration (Mendelson's) syndrome. A contribution to reduced maternal mortality. PMID- 3670111 TI - The effect of hypertension on glomerular structures and capillary permeability in passive Heymann glomerulonephritis. AB - In glomerulonephritic and normal kidneys hypertension has been shown to increase the urinary protein excretion and the thickness of the glomerular basement membrane and to reduce the glomerular filtration rate. We have studied the effect of desoxycorticosterone acetate (DOCA)-salt hypertension on the glomerular anatomy and function in normal control rats and rats with passive Heymann nephritis. Standard methods for measurements of glomerular filtration rate and urinary protein excretion were used and the results were correlated to morphometrical measurements in randomly selected glomeruli in all groups. In control rats, DOCA-salt hypertension increased the kidney weight (P less than 0.001), the glomerular volume (P less than 0.05), and the surface of peripheral glomerular basement membrane (P less than 0.01). The thickness of peripheral glomerular basement membrane and the length of glomerulary capillaries were not affected. In glomerulonephritic rats, DOCA-salt hypertension did not change the kidney weight and glomerular capillary diameter. The thickness of the peripheral basement membrane increased (P less than 0.05), while the length of glomerular capillaries and the surface of peripheral basement membrane were reduced (P less than 0.05). Glomerular filtration rate per unit peripheral basement membrane was not significantly different among the groups while protein excretion per unit peripheral basement membrane increased significantly both in the hypertensive and in the glomerulonephritic groups. The estimated hydraulic conductivity of the glomerular capillaries was reduced both in rats with DOCA-salt hypertension and glomerulonephritic rats with and without DOCA-salt hypertension. In conclusion, DOCA-salt hypertension seems to decrease hydraulic conductivity and increase protein excretion both in normal and in glomerulonephritic kidneys although the effect on glomerular morphology is different. PMID- 3670112 TI - Flow dynamics of human sickle erythrocytes in the mesenteric microcirculation of the exchange-transfused rat. AB - To analyze the microvascular rheology of sickle cells in an intact animal model, rats were isovolemically exchange transfused with human normal (hemoglobin AA) or sickle (hemoglobin SS) erythrocytes (blood group O) or autologous red cells under ambient conditions, and the effects of the heterologous or autologous cells on (a) hemodynamics and respiration, (b) blood gases, and (c) acid-base status of the recipients were determined. Exchange transfusion of rats with autologous red cells or hemoglobin AA or hemoglobin SS erythrocytes was associated with stable mean arterial blood pressure, central venous pressure, respiration rate, blood pH, pCO2, and pO2 during the experimental period, except for tachycardia among the group of rats that received HbSS cells. Arteriovenous oxygen content varied among the three groups of animals, but, nonetheless, suggested adequate tissue oxygen supply under the conditions of the study. Acid-base status also was similar in the three groups of rats. The exchange-transfused rats were utilized to investigate the flow dynamics of red cells in the mesenteric microcirculation by applying intravital microscopy. Time-averaged velocities of the autologous red cells in 16- to 30-microns (id) vessels ranged from 1.07 to 1.25 mm/sec in single unbranched arterioles with varying flux and wall shear rates. Time-averaged velocities of the HbAA cells in single 15- to 35-microns arterioles ranged from 1.16 to 1.24 mm/sec with wall shear rates similar to the estimates for the autologous cells. For both rat and human HbAA RBCs, the flow dynamics were indicative of normal shear-dependent and deformability characteristics of the cells under the flow conditions. Sickle cells exhibited time-averaged velocities of 0.384 to 0.452 mm/sec, lower wall shear rates in 10- to 35-microns single unbranched arterioles, and three times less volumetric flux. In some arterioles, sickle cells with high axial ratio and low deformability showed definite adhesion to the endothelial surface, residing at such sites for several seconds until dislodged by the force of flow. Within single unbranched vessels or at microvascular bifurcations, sickle elliptocytes and sickle echinocytes with low deformability and high axial ratio obstructed flow and exhibited residence times of 2 to 88 sec, thereby causing stasis. These data illustrate the microvascular flow behavior of sickle cells and demonstrate the rheological disequilibrium state that can result as sickle cells course through successive segments of the microcirculation. PMID- 3670113 TI - Analysis of vascular pattern and dimensions in arteriolar networks of the retractor muscle in young hamsters. AB - A quantitative analysis of the distribution of microvascular blood flow and oxygen delivery requires a detailed description of the vascular network geometry. The distributions of lengths and diameters were determined in terminal arteriolar networks of the cheek pouch retractor muscle of young (34 +/- 2 days) hamsters. We compared the Strahler centripetal vessel ordering scheme, which assigns lowest order to the capillaries and proceeds upstream toward the larger vessels, with the centrifugal ordering scheme, which begins with the input arteriole and proceeds downstream toward the capillaries. The terminal networks of the retractor muscle typically contain 2 to 4 Strahler orders and 2 to 6 centrifugal orders. The coefficients of variation of diameter and length are smaller for Strahler ordering than for centrifugal ordering. In addition, for Strahler ordering, we found that the sequence of number of vessels obeyed Horton's law. We have compared three different methods of calculating the bifurcation, diameter, and length ratios. As an alternative method for analyzing network topology, we also studied the distribution of the number of segments on each pathway from the inlet of a network to a capillary. The information obtained from this analysis is useful for the mathematical modeling of flow in the microvascular network. PMID- 3670114 TI - Junctional transfer of small molecules in cultured bovine brain microvascular endothelial cells and pericytes. AB - We have utilized cultures of bovine brain microvascular endothelial cells (MEC) and pericytes to study two aspects of intercellular relations in the microvasculature. First, the apparent contradiction between the reported demonstration of dye transfer between endothelial cells in capillaries and venules in rat omentum and the lack of ultrastructurally demonstrable interendothelial gap junctions in the same vessels in omentum, brain, and other tissues led us to examine this problem in vitro. MEC showed extensive transfer of both fluorescent dye (Lucifer yellow CH, 96% transfer incidence in primary culture) and radiolabeled uridine nucleotides (97%). Freeze-fracture replicas of MEC revealed both gap and tight junctions. These results demonstrate that MEC are capable of producing gap junctions and engaging in junctional communication in vitro. Second, we have examined the interaction of pericytes with MEC. Cultured pericytes showed gap junctions in freeze-fracture replicas, variable dye transfer (cell density dependent, 19-91%), and extensive nucleotide transfer (94%). While the incidence of dye transfer between MEC and pericytes was low (10-31%), nucleotide transfer between these cells was extensive (86-96%). The demonstration of junctional transfer between MEC and pericytes in vitro may be particularly significant considering the high frequency of junctional contact between these cells in vivo. These cultured cell models should help us to better understand the complex interactions of vessel wall cells in microvascular physiology and pathophysiology. PMID- 3670115 TI - Oxygen transport studies of normal and sickle red cell suspensions in artificial capillaries. AB - Oxygen transport from normal and sickle red cells was studied under known and carefully controlled conditions simulating the microcirculation. Oxygenated red cell suspensions became deoxygenated as they traversed silicone rubber artificial capillaries of 27 microns diameter. Oxygen saturation values of the flowing red cell suspensions were measured at several axial positions along the artificial capillary by use of a microspectrophotometric technique. Oxygen saturation decreased with increasing distance from the entrance of the artificial capillary and was influenced strongly by the flow rate. Under the same hematocrit and flow conditions, the rate of oxygen saturation decrease was significantly higher for the sickle red cells than that for the normal red cells. Similar results were obtained by use of a mathematical simulation of oxygen transport in the microcirculation for both normal and sickle red cells. Sickle red cells would be expected to have a higher diffusional resistance to oxygen transport than would normal red cells. However, the higher diffusional resistance is more than offset by the lower oxygen affinity of the sickle cells. The difference in oxygen affinity appears to account for the difference in oxygen transport rates between normal and sickle red cells. PMID- 3670116 TI - Mass transfer kinetics from blood to lymph in the mesenteric microcirculation studied by the fluorescent intravital microscope method. PMID- 3670118 TI - Digital video image-shearing device for continuous microvessel diameter measurement. AB - A modular video device for the measurement of vessel diameter by image shearing is presented. The shearing line may be positioned anywhere and at any angle within the video field. The device produces a standard video signal so that the resulting sheared image can be viewed on any CCTV monitor. PMID- 3670117 TI - Dilation of intracerebral arterioles in vitro by fatty acid contamination in bovine serum albumin. PMID- 3670119 TI - Keep singin' the Blues. PMID- 3670121 TI - A closer look at 1,137 liability cases closed. PMID- 3670120 TI - Premarital testing. PMID- 3670122 TI - Michigan doctors recovering in Alcoholics Anonymous. PMID- 3670123 TI - Supreme Court supports malpractice arbitration statute. PMID- 3670124 TI - A discussion: claims-made policies vs. occurrence. PMID- 3670125 TI - Activation of the human complement cascade by bacterial cell walls, peptidoglycans, water-soluble peptidoglycan components, and synthetic muramylpeptides--studies on active components and structural requirements. AB - Cell walls isolated from 29 strains of 24 gram-positive bacterial species, whose peptidoglycans belong to the group A type of Schleifer and Kandler's classification, with one exception (Arthrobacter sp.), were shown to activate the complement cascade in pooled fresh human serum mainly through the alternative pathway and partly through the classical one. The complement-activating effect of cell walls (5 species) possessing group B type peptidoglycan, except those of Corynebacterium insidiosum, was weaker than that of the walls with group A type peptidoglycan. Preparations of peptidoglycan isolated from cell walls of Staphylococcus aureus, Streptococcus pyogenes, and Lactobacillus plantarum also activated the alternative pathway of the complement cascade, but less effectively than the respective parent cell walls. A water-soluble "polymer" of peptidoglycan subunits (SEPS), which was prepared from Staphylococcus epidermidis peptidoglycans by treatment with a cross-bridge degrading endopeptidase, retained most of the complement-activating ability of the parent cell walls. A peptidoglycan "monomer," SEPS-M, which was obtained by hydrolysis of the glycan chain of SEPS with endo-N-acetylmuramidase to disaccharide units did not activate complement. In conformity with this finding, neither synthetic N-acetylmuramyl-L alanyl-D-isoglutamine (MDP) nor MDP-L-Lys-D-Ala activated the complement cascade. Among several lipophilic derivatives of MDP, 6-O-(3-hydroxy-3 docosylhexacosanoyl)-MDP-L-Lys-D-Ala (BH48-MDP-L-Lys-D-Ala) and 6-O-(2 tetradecylhexadecanoyl)-MDP (B30-MDP) were shown to activate complement through the alternative as well as the classical pathway and exclusively through the classical pathway, respectively. The finding that a D-isoasparagine analog of B30 MDP caused the same effect as the parent molecule strongly suggests that the activation of complement by B30-MDP is different from that caused by cell wall peptidoglycans and a water-soluble "polymer" of peptidoglycan subunits. PMID- 3670126 TI - The primary immune response of the green toad (Bufo viridis) to challenge with Crithidia fasciculata. AB - The primary immune response of the green toad (Bufo viridis) following immunization with Crithidia fasciculata choanomastigotes was studied. Lysins, agglutinins, and antibodies detectable by enzyme-linked immunosorbent assay (ELISA) were first detected in the sera of immunized animals one week after injection. The antibody titers increased to significant levels (P less than 0.01) and maximum values were reached seven weeks post-immunization. The stimulated immunoglobulins were antigen-specific, partially heat-labile, sensitive to the reducing agent dithiothreitol, possessed precipitin activity, effectively fixed complement and exhibited an electrophoretic mobility similar to the gamma globulins of human serum. On this basis, it is probable that the antibody produced during the primary response in green toads is high molecular weight IgM. Increases in serum lysozyme levels paralleled the rise of antibody titers. Overall, the lysozyme concentration increased two-fold compared to the appropriate controls. This is the first report of the immune response in amphibians to experimental injection with protozoan parasites and the use of the ELISA technique to detect antibodies in amphibian sera. PMID- 3670127 TI - Female ejaculation: its relationship to disturbances of erotic function. AB - It is hypothesised that function of the female prostate homologue in small girls may be associated with shame resulting in inhibition of erotic function and sexual disturbance. This inhibition may explain the great variation to be found in female sexual experience. PMID- 3670128 TI - Will treatment with digoxin antibody benefit pregnant patients with toxemia and elevated digoxin like factor? AB - Some pregnant patients with toxemia, especially those with thrombocytopenia, liver or renal dysfunction have elevated serum DLF (digoxin like factor). Since antidigoxin serum reduces the hypertension of DOCA hypertensive rats, it is proposed that antidigoxin antibodies be tried in the treatment of these select patients with toxemia of pregnancy. PMID- 3670129 TI - Alcohol satiety, hypertension and the renin-angiotensin system. AB - Evidence is presented which supports the hypothesis that the renin-angiotensin (r a) system regulates alcohol intake. Documented findings suggest that an elevated level of r-a activity represents a satiety signal which stops alcohol intake. The fact that alcohol itself is known to stimulate r-a activity suggests that its intake may in some sense be self-regulating and that levels of r-a activity below those which signal satiety may even be rewarding. The role of the r-a system in hypertension is also considered. The ability of alcohol to elevate r-a activity may be seen as a contributing factor to alcohol-induced hypertension because angiotensin is a potent pressor agent. Furthermore, the notion that lower levels of angiotensin may be rewarding permits the hypothesis that essential hypertension may, in part, be the result of a self-induced increase in endogenous angiotensin. This would explain the otherwise puzzling utility of the angiotensin converting enzyme inhibitors in the treatment of essential hypertension. PMID- 3670130 TI - The binding of DNA to water soluble carbodiimide modified proteins. AB - Bovine serum albumin and human serum transferrin modified by the water soluble carbodiimides N-ethyl-N'-(3-dimethyl propylamino) carbodiimide (CDI) or N-ethyl N'-(3-trimethyl propylammonium) carbodiimide (Me+CDI) to yield N-acylurea proteins bind pBR322 DNA reversibly showing electrostatic and non-electrostatic components in the binding energies (delta G overall). It is proposed that initially an electrostatic interaction arises from ion pair formation between the DNA phosphates and the N-acylurea entities. This is consolidated, in single stranded regions, by a second event in which it is suggested that the base guanine interacts with elements of the N-acylurea moieties through hydrogen bonding or a glyoxal-type addition. PMID- 3670131 TI - An alternative to the magic bullet paradigm for specific cancer therapy. AB - To improve on current cancer therapies, which attack cells on the basis of their proliferative tendencies, much effort has been devoted to a search for properties of tumor cells that are tumor-specific rather than proliferation specific. Evidence from molecular genetic studies suggests, however, that most tumors may lack such properties. An alternative approach to therapy is described that is based on a property known to characterize the majority of human tumors; viz., a monoclonal origin. The strategy requires the prophylactic induction in tissues of mosaicism for genes dictating sensitivity or resistance to chemotherapeutic agents, and exploits the observation that any clone of cells arising in a mosaic tissue must inevitably differ from some other cells in the mosaic. Recent advances in genetic technology imply that the strategy is likely to be testable soon in animals, and that it may significantly improve the results of cancer therapy when a technology safe and efficient enough for its human implementation becomes available. PMID- 3670132 TI - Autoantibodies--a mechanism of microdebridement. AB - Antibodies to foreign debris are generally beneficial because they speed inflammation and debridement of tissue. Intracellular components are debris if they reach extracellular space. If not rapidly debrided from extracellular space, intracellular components stimulate autoantibody production. If not debrided, cellular constituents like other foreign material can initiate a chronic tissue response. Antibodies will speed removal of debris if an effective microdebridement mechanism is present. This is their general biologic significance. If the patient has a defective microdebridement system as in lupus erythematosus or rheumatoid arthritis, the autoantibodies occur to large numbers of intracellular substances and accumulate and contribute to tissue damage. Tissue damage occurs and autoantibodies accumulate in lupus erythematosus and rheumatoid arthritis because of inadequate microdebridement. This should not detract from the fact that autoantibodies are a common secondary phenomenon which plays an important part in maintaining tissue microdebridement. PMID- 3670134 TI - For one crowded hour of glorious life. PMID- 3670133 TI - Type 2 diabetes. Primary vascular disorder with metabolic symptoms? AB - It is postulated that in the resting state insulin-dependent tissue uptake of glucose is limited by the rate of blood flow, capillary permeability, and the number of perfused capillaries in the skeletal muscles. A mathematical model, simulating these relations, is developed. According to this model, changes in the indicated parameters might cause type 2 diabetes. PMID- 3670135 TI - Pulmonary valve echocardiogram in the evaluation of pulmonary arterial hypertension in the presence of intracardiac shunts. PMID- 3670137 TI - Mass anxiety attack in a primary school. PMID- 3670136 TI - Supracondylar-condylar fractures of the femur. PMID- 3670138 TI - Dental status of the Penans along the Melinau and Terawan Rivers. Baram, Sarawak. PMID- 3670139 TI - Left atrial myxoma: three case reports. PMID- 3670140 TI - Marfan or marfanoid: a case study. PMID- 3670141 TI - Acute appendicitis in infants: a case report. PMID- 3670142 TI - Urological Service at the General Hospital, Kuala Terengganu. PMID- 3670143 TI - Management of voiding disorders in adult and paediatric patients. PMID- 3670144 TI - Correction of claw fingers in leprosy by the brand four-tailed tendon graft operation. PMID- 3670145 TI - Diagnostic and operative arthroscopy of the knee: report of 51 consecutive arthroscopies. PMID- 3670148 TI - Quality in health care. PMID- 3670146 TI - Infantile coxa vara. PMID- 3670147 TI - Fractured penis: two case reports. PMID- 3670149 TI - Quality assurance in health care. PMID- 3670150 TI - Perinatal mortality: selected data from a survey. PMID- 3670151 TI - Iron-deficiency anaemia and serum ferritin levels in Malaysian women. PMID- 3670152 TI - Tetanus and immunization: a six-year study. PMID- 3670153 TI - Dengue and dengue haemorrhagic fever outbreak in Lawas District, Sarawak, East Malaysia. PMID- 3670154 TI - Home haemodialysis in Malaysia. PMID- 3670155 TI - Career choice of final-year female medical students at Universiti Kebangsaan Malaysia (UKM). PMID- 3670156 TI - Psychoneurotic profiles of Universiti Kebangsaan Malaysia medical students. PMID- 3670157 TI - Acute appendicitis: pathology of 1,000 cases. PMID- 3670158 TI - Coital injuries of the vagina. PMID- 3670159 TI - Pseudomembranous colitis: local experience with 3 cases. PMID- 3670160 TI - Patency of the omphalomesenteric duct (enteroumbilical fistula): 2 case reports. PMID- 3670161 TI - Metastatic malignant schwannoma of orbit: a case report. PMID- 3670163 TI - Fallacy of clinical confirmatory signs in internal jugular catheterisation: a case report. PMID- 3670162 TI - Unicystic ameloblastoma: a new entity? PMID- 3670164 TI - Further evidence of analgesic nephropathy in Malaysia. PMID- 3670165 TI - "RSI": putting the epidemic to rest. PMID- 3670166 TI - The cot death enigma. PMID- 3670167 TI - After the Morling inquiry: the doctor as an expert witness. PMID- 3670168 TI - The implementation of the Cotton Report. PMID- 3670169 TI - Epidemiological aspects of "repetition strain injury" in Telecom Australia. AB - An epidemic of "repetition strain injury" ("RSI") in Telecom Australia is described. In the years 1981-1985, there have been 3976 reports of "RSI". The occupation that was most affected was that of telephonist, with 1886 reports and a rate of 343 per 1000 keyboard staff members over five years; among other occupations that were affected were clerical workers (1421 reports; rate, 284 per 1000 keyboard staff members); telegraphists (17 reports; rate, 34 per 1000 staff members); and process workers (235 reports; rate, 116 per 1000 staff members). Women accounted for 3330 (83%) of all reports; in the telephonist group, 27% of female and 20% of male staff members were affected (P less than 0.001); for women, younger staff members were more affected. There was a significant difference among states in the prevalence of "RSI" in telephonists. There was a high morbidity, and 644 (16%) subjects were affected for more than 26 weeks; the cost-effectiveness of treatment and rehabilitation varied appreciably among state administrations. The costs of the epidemic exceed $15 million, including $1.8 million in medical costs. Reasons for the rise and decline of the epidemic are discussed. PMID- 3670170 TI - Current mortality in the Australian petroleum industry: the healthy-worker effect and the influence of life-style factors. AB - A surveillance system, to monitor mortality and cancer morbidity on a continuing basis, has been established in the Australian petroleum industry. A baseline survey of 11,573 employees, by personal interview, was carried out in 1981-1983. By the end of June 1986, 33,712 person-years of observation in men had accrued, with 109 deaths. Standardized mortality ratios, with the Australian national death rates as reference, indicate that in terms of mortality from all causes and in mortality from the more common diseases, the death rates in this population are substantially lower than in the national population. Standardization was also carried out in the case of employed men, with data from contributors to the Commonwealth superannuation fund as reference, in order to provide a more appropriate contrast. The risks of tobacco smoking are demonstrated, as is the probable protective effect of mild-to-moderate alcohol consumption. The advantages to the occupational physician in being able to describe current mortality patterns, and in being able to delineate "at-risk" groups are discussed, particularly in the context of health promotion and other interventions. PMID- 3670171 TI - Comparison of panoramic and standard radiographic radiation exposures in the diagnosis of mandibular fractures. AB - Radiological examination of the maxillofacial region is required to confirm fractures and to identify lesions that are present in the jaws. The complex anatomy of the area necessitates multiple radiographic views with standard projections. The accuracy of diagnosis is at times suspect. An orthopantomogram, which is supplemented by a posteroanterior projection of the lower jaw where required, allows a more accurate diagnosis. This pilot study was designed to compare the radiation dosage that is delivered after a standard hospital series of films and an orthopantomogram. The results demonstrate the significant reduction in irradiation to patients who undergo orthopantomography. PMID- 3670172 TI - The failure of the "RSI" concept. PMID- 3670173 TI - "RSI": a model of social iatrogenesis. PMID- 3670174 TI - Playing dice with expert evidence: the lessons to emerge from Regina v. Chamberlain. PMID- 3670175 TI - Psychiatric aspects of regional pain syndrome. PMID- 3670176 TI - Haemoglobin levels in pregnancy in mothers whose infants died subsequently of sudden infant death syndrome. PMID- 3670177 TI - Suspected Mycobacterium ulcerans disease in Kiribati. PMID- 3670178 TI - Surgical management of chronic lymphoedema of the penis caused by a red-back spider. PMID- 3670180 TI - Breast-weight and industrial fatigue. PMID- 3670179 TI - Infringement of human rights and public health by a curfew in Namibia. PMID- 3670181 TI - Can aspirin act only in the enterohepatic circulation to inactivate platelets? PMID- 3670183 TI - Reflux nephropathy. PMID- 3670182 TI - Intrathecal baclofen for severe spasticity. PMID- 3670184 TI - Triamterene drug fever and hepatitis. PMID- 3670185 TI - Wheat starch and the gluten-free diet. PMID- 3670186 TI - Anorectal manometry. PMID- 3670187 TI - Sea-salt in Pritikin bread. PMID- 3670188 TI - Alcohol--a shared responsibility. PMID- 3670189 TI - Should postnatal patients be discharged home early? PMID- 3670190 TI - The move away from permanent colostomies in the treatment of anal carcinoma. PMID- 3670191 TI - Mortality from asthma in Western Australia. AB - From a cohort of all 5760 male and 4979 female patients who were admitted to WA hospitals and were discharged with a diagnosis of asthma between 1976 and 1980, 265 deaths in men and 189 deaths in women were identified by the end of 1982. The standardized mortality ratio (SMR) for all causes of death for this cohort was 1.6 for men (P less than 0.001) and 1.7 for women (P less than 0.001). Both sexes showed a significant increase in deaths that were attributable to asthma (SMR, 57.9), chronic airflow obstruction (SMR, 9.3) and ischaemic heart disease (SMR, 1.3). The excess death rates for asthma were observed in all age groups, but those for chronic airflow obstruction and ischaemic heart disease were present in older age groups only. These findings indicate that asthma remains a potentially fatal disease in the Australian community. The excess mortality ratios for chronic airflow obstruction that were observed in patients who were admitted to hospital with asthma also suggest that asthma may result in irreversible airflow obstruction. PMID- 3670192 TI - Recidivism in a cohort of young Australian drinking-drivers. AB - Four hundred and sixty-three men aged 18-25 years were referred to a counselling programme in 1975-1977, after their first conviction for an alcohol-related traffic offence. Records of the Victoria Police, and those of the Motor Registration Board, were searched for subsequent alcohol-related traffic offences up to February 1984. Those subjects who had left the State of Victoria or had died were identified, and a "survival" curve was constructed where survival implied freedom from reconviction for an alcohol-related traffic offence. By means of Cox's proportional hazards model, the rate ratios of a number of predictor variables of recidivism were calculated; those of significance were the number of drinks per week, social class, and a history of "family troubles with drinking". Reduction of alcohol consumption may be a more appropriate goal in programmes that are concerned with the counselling of young drinking-drivers than is attempted modification of the drinking-driving nexus. PMID- 3670193 TI - The Queensland "drinker" and the bad old, new Australia. AB - Queensland "drinkers" in rehabilitation units have been compared with their counterparts on Merseyside, England. Substantial differences were found between the two populations: more drinkers in Queensland were divorced or separated, fewer were employed and far fewer expected to return to their families after discharge from the units. Queensland families were reported as more often unaware of the drinking, more rejecting and less concerned. Where the drinker was still living with family members, they were less aware of alcohol-related physical symptoms and put less pressure on the drinker to eat properly. Information that was provided by Queensland family members about a drinker's eating behaviour could be interpreted as indicative of an optimistic response style. Underinvolvement and optimism are put forward as characteristics of Queensland families where one member is a problem drinker. These characteristics are likely to have an adverse effect on the resolution of problem drinking. PMID- 3670194 TI - An evaluation of planned early postnatal transfer home with nursing support. AB - A community-based programme of planned early postnatal transfer home with the continuity of hospital nursing care was instituted in a defined geographic area of the western suburbs of Sydney in 1983. Mothers were offered the option of discharge in 24-48 hours after delivery, with home visits by a hospital midwife, subject to certain medical and social criteria. An evaluation of the programme in terms of morbidity, psychosocial impact on the family and costs was undertaken. For evaluation, a quasi-experimental study of parallel groups was designed in preference to randomized selection as it was believed that the personal choice would be fundamental to the success of the scheme. A contemporary control group was achieved with volunteer mothers who opted for the traditional five- to seven day hospital stay. Studies of maternal response and the partner's response and adjustment were undertaken, including the administration of questionnaires that were designed to detect the presence of mild postnatal depression. No increased morbidity occurred in the early discharge group. The early discharge group performed more favourably on the questionnaire that was designed to measure their postpartum adjustment. Continued postnatal domiciliary surveillance reduces the risk that early neonatal pathological changes, especially jaundice, may be overlooked. PMID- 3670195 TI - Carcinoma of the anal canal. AB - During the period 1973 to 1982, 35 patients with carcinoma of the anal canal were seen at this hospital. The main form of treatment was abdominoperineal excision, unless specific contraindications to this procedure were present. Between 1982 and 1984, a further 18 such patients were seen; the primary method of treatment then was combination chemotherapy and radiotherapy. Abdominoperineal excision was reserved for those patients who failed to respond to therapy or whose carcinoma recurred during the period of follow-up. The over-all five-year survival rate for the first 35 patients was 50%; the actuarial disease-free survival at two years for those who went into complete remission was 78% in the 18 patients who were seen in the second part of the study. We conclude that conservative treatment by chemoradiation is of value in the management of anal carcinomas. PMID- 3670196 TI - A report on education in general practice? PMID- 3670197 TI - Post-traumatic stress disorder in Australia and New Zealand: a clinical review of the consequences of inescapable horror. AB - Over the last 20 years, much has been written on the morbidity that results from disasters. However, it is only since 1980 with the introduction of the "new" diagnostic category of "post-traumatic stress disorder" in the third edition of the Diagnostic and statistical manual of mental disorders of the American Psychiatric Association (DSM-III) that a specific diagnosis has become available for many of the victims of such disasters. While, as a condition, it has been recognized from antiquity, it has lacked official recognition in the nomenclature and has tended to be viewed, particularly between the end of World War II and the introduction of DSM-III, as a transient disorder. A description of the disorder is followed by a discussion of its relevance with particular reference to papers by Australian and New Zealand authors. PMID- 3670198 TI - Delayed onset sympathetic ophthalmia. AB - Three cases of sympathetic ophthalmia that occurred up to 62 years after an ocular injury are reported. Sympathetic ophthalmia occurred spontaneously in the first case, 62 years after a shot-gun pellet had penetrated one eye. In the other two cases, further surgery had been performed on previously-injured eyes. This was followed by a bilateral granulomatous panuveitis that developed within a week in one case and after seven years in the other case. The risk of elective surgery in eyes that are already at risk of sympathetic ophthalmia and the practical aspects of patient counselling are discussed. PMID- 3670199 TI - Aortic and coronary embolism of anaplastic small-cell carcinoma of the lung. AB - A case of macroscopic tumour embolism from an anaplastic small-cell carcinoma of the bronchus to the aortic bifurcation and the left main coronary artery is described. The emboli occluded both vessels and caused sudden death. To our knowledge, this is the first report of coronary embolism by this type of carcinoma. Previous reports of coronary embolism by lung tumours are reviewed briefly. PMID- 3670200 TI - Confidence trick. PMID- 3670201 TI - Death rates in asthmatic patients. PMID- 3670203 TI - Bilateral radial-nerve pressure palsy in chronic obstructive airways disease. PMID- 3670202 TI - Multiply-resistant Staphylococcus aureus in a hospital affected by industrial dispute. PMID- 3670204 TI - Stress-related illnesses. PMID- 3670206 TI - Atypical pneumonia. PMID- 3670207 TI - Non-ulcer dyspepsia and Campylobacter pylori gastritis: to treat or not to treat? PMID- 3670205 TI - Vancomycin-induced vasculitis. PMID- 3670208 TI - Lens implantation in cataract surgery. PMID- 3670209 TI - Spiramycin and coccidiosis. PMID- 3670210 TI - The AIDS epidemic. PMID- 3670211 TI - The dying declaration. PMID- 3670212 TI - Intracavernous injections for impotence. PMID- 3670213 TI - Mometasone--a new topical steroid. PMID- 3670214 TI - Botulinum toxin injection for ocular muscle disorders. PMID- 3670215 TI - [Eye color and hair color in children and adolescents in Vrsac]. PMID- 3670216 TI - [Use of Efudix in the therapy of condylomata acuminata]. PMID- 3670217 TI - [Salmonella sepsis caused by Salmonella virchow]. PMID- 3670218 TI - [Polyradiculoneuritis as a complication of viral encephalitis]. PMID- 3670219 TI - [Conservative therapy of Peyronie's disease using vitamin E]. PMID- 3670220 TI - [The daily timing of admission as one of the determinants of overloading in intensive coronary care units]. PMID- 3670221 TI - [Evolution of clinical signs and the late development of primary instability of the hip in children]. PMID- 3670222 TI - [The possible thyroid-suppressive effects of lithium]. PMID- 3670223 TI - [Evaluation of methods for the early diagnosis of pregnancy]. PMID- 3670224 TI - [Febrile convulsions in children today]. PMID- 3670225 TI - [Cytologic and histologic changes in the endometrium in users of intrauterine contraception having experienced bleeding]. PMID- 3670226 TI - Relative hyperphosphaturia in diabetic chronic renal failure: a protective factor of hyperparathyroidism. AB - Relative low serum levels of parathormone (PTH) and low incidence of secondary hyperparathyroidism have been reported in diabetic uremic patients. The pathogenesis of this reported resistance to uremic secondary hyperparathyroidism in diabetes remains controversial. We have measured the serum C-terminal parathormone (C-PTH) renal phosphorus threshold (TmPO4) and nephrogenous cyclic AMP (N-cCAMP), in 2-hour urine collection in 22 patients with diabetic nephropathy with moderate chronic renal failure and in 27 controls with similar creatinine clearance values (18.16 +/- 9.14 and and 19.1 +/- 8.47 ml/min). In spite of the lower levels of serum C-PTH (1.07 +/- 0.43 ng/ml) diabetic patients exhibited an increased phosphaturia (TmPO4: 1.97 +/- 0.9 mg/100 ml GFR) when compared with the control group (C-PTH: 2.01 +/- 1.17 mg/ml, and TmPO4: 2.5 +/- 0.7 ml GFR). When the C-PTH values were plotted against the logarithm of creatinine clearance values, both groups showed a significant linear relationship reflecting the progressive increase in PTH when GFR fell. This progressive parathyroid stimulus was also present in diabetic patients but in a lower intensity. We believe that increased phosphaturia in diabetics with moderate chronic renal failure may be a major factor in precluding the appearance of secondary hyperparathyroidism in these patients once they reach the dialysis and transplantation programs. PMID- 3670227 TI - Acute effects of salmon calcitonin in man include stimulation of the renin angiotensin-aldosterone system. AB - The present double-blind placebo-controlled cross-over study was designed to evaluate the renin-angiotensin-aldosterone system behavior after a short-term infusion of a pharmacological dose (100 MRC U) of salmon calcitonin. Overall, a significant increase in plasma renin activity, aldosterone and serum angiotensin converting enzyme was seen throughout. This effect may be, at least in part, due to the renal loss in sodium and calcium ions, while the increased kaliuresis could be interpreted as a consequence of the stimulation of aldosterone release. PMID- 3670228 TI - Renal handling of phosphate during extracellular volume expansion and parathyroid hormone administration. AB - To further examine the interaction between the phosphaturic effects of parathyroid hormone (PTH) and extracellular volume expansion (ECVE), clearance studies were performed in chronically and acutely parathyroidectomized (PTX) rats in three sets of experiments. In the first series, two groups of chronically PTX animals (groups 1 and 2) received a PTH infusion (2 U/h). In group 1 ECVE was superimposed on the PTH infusion, while the animals in group 2 received the hormone infusion alone. In the second series the following groups of chronically PTX rats were examined: volume expanded rats (groups 3 and 4) and control normovolemic rats (group 5). A PTH bolus (5 units) was added to group 3 while group 4 underwent volume expansion alone. The third series of experiments compared the response of acutely and chronically PTX rats given a submaximal dose of PTH (1 U/h) with additional ECVE (group 6) or undergoing submaximal ECVE with additional PTH (group 7). In the first set of experiments, the PTH-ECVE rats had a higher inulin clearance (CIn) and phosphate clearance (Cp) than the animals receiving the PTH alone. The maximal fractional excretion of phosphate (Cp/CIn) was similar in both groups. In the second set, GFR was similar in the normovolemic and the volume expanded animals. The two volume expanded groups had a higher Cp/CIn than the control normovolemic animals. The maximal Cp/CIn was 0.234 +/- 0.031 in the ECVE-PTH and 0.235 +/- 0.056 in the ECVE animals (p = NS). No significant difference could be detected during the whole experiment in any variable between the volume-expanded PTH-injected (ECVE-PTH) and ECVE only rats. Acutely and chronically PTX rats responded with a similar degree of phosphaturia after ECVE superimposed on PTH infusion or after PTH superimposed on ECVE. Acutely PTX rats, however, exhibited a significantly delayed response to exogenous PTH as compared to chronically PTX animals. There was no difference in the response to ECVE between the acute and chronically PTX rats. When chronically PTX rats were exposed to submaximal ECVE, the final Cp/CIn was less than after ECVE-PTH, PTH-ECVE or PTH. These findings show that in chronically PTX rats the phosphaturic response to PTX and ECVE is not additive under conditions of maximal stimulation by PTH or ECVE. Examination of acutely PTX animals and use of a different protocol of ECVE disclose a broader spectrum of phosphaturic responses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3670229 TI - Does the kidney 'escape' from the kaliuretic action of mineralocorticoids? AB - The purpose of this study was to determine if there are renal mechanisms which limit the magnitude of potassium loss during mineralocorticoid-induced hypokalemia. To study the renal effects of mineralocorticoids in vivo, the 'cortical distal nephron' transtubular [K] gradient (TTKG) was calculated by dividing the urine [K] by the urine to plasma osmolality ratio; this in turn was divided by the arterial plasma [K]. Hypokalemia (2.6 +/- 0.1 mM) was induced in rabbits by the daily administration of 5 mg deoxycorticosterone acetate (DOCA) for 9-13 days. Infusion of a K-free isotonic solution into these rabbits resulted in more severe hypokalemia (1.6 +/- 0.1 mM) and a TTKG of 4.3 +/- 0.3. The subsequent infusion of a 60-mM K-containing solution elevated the plasma [K] to 5.1 +/- 0.1 mM and was associated with a significant rise in the TTKG to 5.9 +/- 0.4 (p less than 0.05). A K-free solution was then infused to lower the plasma [K]; when the plasma [K] fell below 4 mM, the TTKG decreased to 4.4 +/- 0.3 (p less than 0.05), and was equal to the preinfusion value. Thus, DOCA-induced hypokalemia diminishes renal K excretion by two mechanisms: first, the lower value for the denominator of the TTKG (the plasma [K]) results in a lower luminal [K] at a given TTKG. Second, the TTKG fell during hypokalemia and thereby decreased the luminal [K] in the cortical distal nephron. Hence the urinary K excretion rate was diminished to a greater extent than that predicted from the fall in the plasma [K] despite continuing mineralocorticoid action. PMID- 3670230 TI - Abstracts of the 2nd biannual meeting of the American Society of Renal Biochemistry and Metabolism. May 24-26, 1987, Quebec City, Canada. PMID- 3670231 TI - [Study on breast feeding in an area of Campania with a prevalent rural-artisan economy]. PMID- 3670232 TI - [The first 48 hours of life of a child born to a mother undergoing hemodialysis treatment]. PMID- 3670233 TI - [Immediate prognosis and cause of death in newborn infants with birth weight less than or equal to 1500 g]. PMID- 3670234 TI - [Use of intra-atrial silicon catheters in children with malignant neoplasms]. PMID- 3670235 TI - [A family with strabismus and multiple signs of muscular involvement with onset in childhood: a new syndrome?]. PMID- 3670236 TI - [Insertion of trans-tympanic drainage in muco-gelatinous otitis in children]. PMID- 3670237 TI - [Infant feeding: trends in the last 20 years in the Turin area]. PMID- 3670238 TI - [Dietary habits and iron deficiency anemia in the first 15 months of life]. PMID- 3670239 TI - [Poisonings in children in Trieste (1975-85) and their variations]. PMID- 3670240 TI - [Kawasaki's disease in Sicily]. PMID- 3670241 TI - [Arterial hypertension and obesity in children of school age in Lazio. Study of 1907 children]. PMID- 3670242 TI - [Severe dysphagia and dyspnea caused by an ectopic hypertrophic thymus. Diagnosis and surgical therapy in a case favorably treated]. PMID- 3670243 TI - [Slow-release theophylline in recurrent bronchial asthma. Clearance of the drug and circadian variations in blood theophylline]. PMID- 3670244 TI - Mandatory HIV testing. PMID- 3670245 TI - Low-level radioactive waste. A report of the MMA Subcommittee on Environmental Health. PMID- 3670246 TI - New physician review process stresses intervention. PMID- 3670247 TI - Mandibular reconstruction using a free forearm flap. PMID- 3670248 TI - Ibuprofen-induced interstitial nephritis and the nephrotic syndrome. PMID- 3670249 TI - Peripartum cardiomyopathy: diagnosis and management. PMID- 3670250 TI - Repair of traumatic aneurysm of the pulmonary artery with arteriovenous fistula. PMID- 3670251 TI - Diet and arthritis. PMID- 3670252 TI - Risk management in practice. Maintaining defensible medical records (part two). PMID- 3670253 TI - Interpersonal constructs for nursing practice. PMID- 3670254 TI - Nurses' knowledge and attitudes about sexuality: report of a study. PMID- 3670255 TI - Experiential learning: the development of communication skills in a group therapy setting. PMID- 3670256 TI - The role of the teacher in self-directed learning. PMID- 3670257 TI - The nursing instructor and the teaching climate. PMID- 3670258 TI - Nurse education as social control. PMID- 3670259 TI - Plasma theophylline levels as related to toxicity in infants with severe chronic lung disease. PMID- 3670260 TI - Dopamine use in neonates. PMID- 3670261 TI - Use of fentanyl for sedation of mechanically ventilated neonates. PMID- 3670262 TI - Administration of i.v. medications in the NICU: the development of a procedure. PMID- 3670263 TI - Use of Retroset in the delivery of intravenous medications in the neonate. PMID- 3670265 TI - [Surgical certification system of the Japanese Society of Neurosurgery]. PMID- 3670264 TI - Theophylline: a closer look. PMID- 3670266 TI - [Studies on the absorption of elemental diets containing "small peptides" as a nitrogen source]. AB - Previous studies have shown that small peptides (di-or tri-peptide) are more rapidly and more evenly absorbed through the small intestine than free amino acid mixture of the same amino acid composition. Since a method to produce protein hydrolysate rich in di-or tri-peptide (SP) was developed, absorption studies were performed to ascertain if the SP shows superior efficiency in absorption to the free amino acid mixture (AA) and large peptide (LP) of the same amino acid composition. A practical elemental diet which contained SP as a nitrogen source, was made (SP-ED) and the absorption rates of nitrogen, carbohydrate and water were studied using dog Thiry-Vella loop in comparison with ED prepared with AA (AA-ED) or LP (LP-ED) with the same amino acid composition. The results are as follows: 1) Absorption rates of nitrogen and water in SP were higher than in AA and LP, when the osmolarities of these solutions were not adjusted to the same level. 2) When the osmolarities of the solutions were adjusted to the same level using mannitol, the absorption rate of nitrogen was still the highest in SP. 3) Nitrogen absorption rate was significantly higher in SP-ED than in AA-ED and LP ED and carbohydrates were absorbed to a significantly greater extent from the SP ED than from the AA-ED. These results indicate that small peptides are suitable for use as the nitrogen source for ED. PMID- 3670267 TI - [Urine levels of polyamine in patients with or without cancer]. AB - The urine levels of polyamine (total amount of putrescine, spermidine and cadaverine) were measured in patients with or without cancer by simple enzymatic assay method. In 148 control healthy adults, the urine levels of polyamine were 23.1 +/- 7.1 mumole/g. creatinine, whereas among 52 patients with benign diseases, the level in only 5 patients was slightly higher than normal level. The polyamine levels in 170 patients with cancer was 46.1 +/- 50.6 mumole/g. creatinine, which was about 2-times higher than normal level. In the patients with cancer of the stomach or the colon and rectum, the increase in polyamine level appeared to be correlated with the clinical stage of tumor. Following successful surgical resection of cancer, the polyamine level increased in one week transitorily after operation but gradually decreased to normal level within 5 weeks. Whereas following unsuccessful surgical resection of cancer, the polyamine value maintained high levels. The evidence suggests that the measurement of the urine level of polyamine is useful for the diagnosis of cancer or the clinical stage of tumor, and it will be helpful in the evaluation of therapeutic effects and prognosis. PMID- 3670268 TI - [Results of treatment of primary malignant tumor of the small intestine]. AB - The results of treatment of 40 cases of primary malignant tumor of the small intestine are reported. The malignant tumors included 14 leiomyosarcoma, 12 malignant lymphoma and 14 adenocarcinoma. Our standard treatment for these tumors was segmental resection of the small intestine with its mesentery including the regional lymph nodes and we used additional adjuvant chemotherapy for some cases of malignant lymphoma and adenocarcinoma. Curative resection was performed in 57.1% of leiomyosarcoma, 50.0% of malignant lymphoma and 61.5% of adenocarcinoma. Cumulative 5-year survival rates were leiomyosarcoma 21.4%, malignant lymphoma 53.0% and adenocarcinoma 43.3% respectively. Serosal infiltration, lymph node metastasis and operative curability proved to be the prognostic factors. In particular, the 5-year survival rate of patients on whom curative resection could be performed was significantly better for each tumor type than that of patients for whom this was not possible, the figures being leiomyosarcoma 40.0%, malignant lymphoma 83.3% and adenocarcinoma 83.3%. PMID- 3670269 TI - [Anatomical studies on the biliary tree of the caudate lobe using an endoscopic retrograde cholangiogram]. AB - The purpose of this study is to clarify positional relationship between the bile duct of the caudate lobe and the bile duct of the hepatic hilum through endoscopic retrograde cholangiogram (ERC). Until December 1984 all 100 ERC that met the following three conditions were studied which at Yachio Hospital. 1. The first cholangiogram. 2. Without obstructive jaundice. 3. No existence of lesion at the hepatic hilum. Bile duct of the caudate lobe were classified into 4 separate types: 1) Ducts from the cranialis of the right caudate lobe which pass via the inferior vena cava to the hepatic hilum named Blr, were confirmed in 32. 2) Ducts from the cranialis of the left caudate lobe to the hepatic hilum named Bl l s, were confirmed in 19. 3) Ducts from the left lateral part of the left caudate lobe to the hepatic hilum named Bl l i were confirmed in 37. 4) Ducts from the caudate process to the hepatic hilum named Blc, were confirmed in 5. One or more of the above bile ducts were confirmed in 53 cases. All four of the above were confirmed in only 2 cases out of 53 cases. Three were confirmed in 7 out of 53 cases, two were confirmed in 20 cases out of 53 cases and one was confirmed in 24 out of 53 cases. Studies for the bile duct of the caudate lobe have been conducted anatomically, but there has been no research by clinical examination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670270 TI - [Histological appearance of carcinoma of the upper bile duct and the mode of its spread]. AB - The histopathology of 34 resected cases of carcinoma of the upper bile duct was reviewed in relation to its mode of spread and prognosis of the patients. The patients with papillary adenocarcinoma showed 3-year survival rate of 75 percent which was better than those with carcinoma of other histologic types. There were no 2-year survivals in patients with poorly differentiated adenocarcinoma. Infiltration to the serosa of the bile duct and to the liver, lymph node metastasis, and venous, lymphatic or perineural invasion of carcinoma were thought to be important prognostic factors, since the chance for survival was definitely better for patients without those factors than with those factors. In four patients with papillary adenocarcinoma, no involvement of hepatic parenchyma and lymph node metastasis was found. Three of these patients had no cancer infiltration to the serosa of the bile duct. Most cases of poorly differentiated adenocarcinoma, in contrast, had positive and extensive association of those prognostic factors. Seventy-five percent of patients with papillary adenocarcinoma and only 22 percent of those with poorly differentiated adenocarcinoma were microscopically considered curable by resection. It is noteworthy that histological appearance of carcinoma may be valid as a fundamental factor to determine mode of spread of carcinoma of the upper bile duct and prognosis of the patients. PMID- 3670271 TI - [Erythrocyte calcium and pH levels during postoperative tetany following radical operations for thyroid cancer]. AB - To investigate the mechanism of postoperative tetany, erythrocyte calcium and pH were consecutively measured in 15 patients who underwent total removal and subsequent autotransplantation of parathyroid glands at the surgery for thyroid cancer. Of these, 8 patients presented tetany signs, but the other 7 patients had no symptoms. In the non-tetanized group, the concentration of erythrocyte calcium decreased by 33.2% and 46.0% on the 3rd and 5th postoperative day, respectively. On the other hand, it increased by 49.8% and 34.6%, respectively, in the tetanized group, showing a significantly different concentration between two groups. No significant differences were observed, however, in the serum calcium level at any time between two groups. The erythrocyte pH as well as the plasma pH in the tetanized group was significantly higher on the 3rd postoperative day, than that in the non-tetanized group. These results suggest the possibility that the elevated cellular calcium content is more closely linked with postoperative tetany than the serum calcium level, and that the elevated cellular pH as well as plasma pH is another causative factor in evoking tetany. PMID- 3670272 TI - [The comparative study of long-term results of surgical and medical treatment of post-infarction left ventricular aneurysm]. AB - Sixty-three patients of postinfarction left ventricular aneurysm (26 surgical cases and 37 medical cases) were analysed in the left ventricular performance, the survival rate, and the subjective complaints. In the surgical cases, the left ventricular performance improved significantly, but no significant changes were noted in the medical cases. The left ventricular function curves were inclined toward the upper left direction in the surgical cases. Whereas in the medical cases they were declined toward the lower right direction. No cardiac death occurred among the surgical cases, but it occurred in 8 patients, or 21.6% in the medical cases. Five year cumulative survival rate was 95.7% and adjusted survival rate was 100% in the surgical cases, but in the medical cases it was 80.7% and 86.8%, respectively. PMID- 3670273 TI - [A case of aneurysmal dilatation of a saphenous vein graft for subclavian aneurysm in a patient with Behcet disease]. AB - The autogenous saphenous vein is the preferred conduit for repair of occluded arteries in the limb and coronary arteries. The aneurysmal dilatation of the vein graft is a unusual complication in the long-term period. A case of aneurysmal formation of the vein graft for the subclavian aneurysm 5 years after grafting with classic Behcet disease was reported. The etiology of this rare complication and the special surgical problem were also discussed. PMID- 3670274 TI - [Successful management of abdominal aortic aneurysm due to bacterial infection: report of a case]. AB - A successful surgery of abdominal aortic aneurysm due to bacterial infection is described. The patient, 71-year-old man, had been suffering from high fever of unknown origin which had narrow escape with the several kinds of antibiotics about a month and more. During the antibiotic therapy in another hospital, he was diagnosed as an abdominal aortic aneurysm by whole body computed tomography. Immediately after the arrival to our hospital, digital subtraction angiography was done, and it showed a saccular aneurysm in the infrarenal abdominal aorta. Surgical removal of this aneurysm without opening of the aneurysmal wall was performed and the kitted dacron graft was used for aorto-biiliac anastomosis. The diagnosis of aneurysm due to bacterial infection was confirmed by bacteriological and pathological examinations. The patient in now surviving 17 months after operation. Abdominal aortic aneurysm due to bacterial infection is a serious disorder that generally carries grave prognosis. Complete removal of infected lesion without contamination and long-term follow-up with antibiotic chemotherapy are essential for this disease. PMID- 3670275 TI - [A case of myonephropathic metabolic syndrome treated with limb washout using a roller pump and cell saver]. AB - We operated on a 65 year old male for the saddle embolism presenting the signs of MNMS. Before the reperfusion of the ischemic limbs which were successfully embolectomized with the use of Fogarty catheter, we performed limb washout using roller pump and cell saver. The washout was done in the high flow and large volume by the roller pump. The red blood cells in the efflux were saved using cell saver and retransfused to the patient. The patient recovered without deterioration of MNMS. The limb washout was effective for the prevention of the deterioration of MNMS. PMID- 3670276 TI - Pharmacological properties of fluphenazine-mustard, an irreversible calmodulin antagonist. AB - We describe an improved synthesis and properties of fluphenazine-mustard, a potent phenothiazine having an alkylating chlorethylamine chain in its structure. The drug possesses anticalmodulin activity equivalent to the parent compound, but unlike fluphenazine dihydrochloride, the mustard derivative irreversibly antagonizes the ability of calmodulin to activate cyclic nucleotide phosphodiesterase. This property is partially calcium-dependent and can be overcome by coincubation with excess fluphenazine dihydrochloride. The compound irreversibly inactivated calmodulin when incubated with intact cells and caused single-stranded breakage of DNA. Fluphenazine-mustard possesses potent antiproliferative and cytotoxic properties against malignant cell lines that are likely to be mediated through both of these actions. PMID- 3670277 TI - Evidence for participation of lipid peroxidation and iron in diquat-induced hepatic necrosis in vivo. AB - The hepatic necrosis produced in Fischer-344 rats by diquat appears to be mediated by redox cycling of diquat with generation of reactive oxygen species. We have now tested the hypothesis that chelates of iron are important in the cytotoxicity of reactive oxygen species, possibly through initiating the cleavage of peroxyl bonds. Pretreatment with the iron chelator desferrioxamine, 0.24 mmol/kg intraperitoneally, attenuated the hepatic damage produced by diquat. No additional protection was provided by a second dose of desferrioxamine 2 hr after diquat or by administration of the iron chelator by a different route of administration (subcutaneously). Ferrous sulfate (0.36 mmol/kg, intraperitoneally) alone produced no hepatic injury, but when given 15 min before diquat, it potentiated hepatic injury and animal mortality. In contrast, biliary excretion of glutathione disulfide in response to administration of diquat was neither potentiated by pretreatment with FeSO4 nor diminished by pretreatment with desferrioxamine. The marked changes in hepatic injury produced by these pretreatments, without changes in glutathione disulfide production, indicate that shifts in thiol/disulfide equilibria are not likely to be initiating events in the pathogenesis of diquat-induced hepatic necrosis. Administration of a hepatotoxic dose of diquat quickly produced 5-fold stimulation of ethane and pentane expiration rates with return to control rates by 3 hr. Desferrioxamine markedly inhibited, and iron potentiated, hydrocarbon expiration in response to diquat. The parallel changes in diquat hepatic injury and ethane and pentane expiration rates in response to manipulation of iron availability suggest a possible causal role for Fenton chemistry and lipid peroxidation in diquat generated, reactive oxygen-mediated hepatic injury in vivo. PMID- 3670278 TI - Contribution of aniline metabolites to aniline-induced methemoglobinemia. AB - Methemoglobinemia after aniline and certain aniline derivatives is thought to be mediated by toxic metabolites formed during the hepatic clearance of the parent compounds. However, three aniline metabolites--phenylhydroxylamine, 2 aminophenol, and 4-aminophenol--catalyze methemoglobin formation in erythrocyte suspensions and, hence, could contribute to methemoglobin formation in vivo after aniline. To determine the relative contributions of these aniline metabolites to aniline-induced methemoglobinemia in rats, we determined time courses of methemoglobinemia in rat erythrocyte suspensions and in rats after treatment with 2- and 4-aminophenol, phenylhydroxylamine, and aniline. The relative potencies for methemoglobin production in vitro after phenylhydroxylamine, 2-aminophenol, and 4-aminophenol were about 10:5:1, based on both peak and area of the methemoglobin versus time curve. Approximate minimum concentrations for observable methemoglobin formation in vitro from these compounds were 20, 50, and 200 microM, respectively. Compared with the in vitro data, the relative potencies of the aminophenols for methemoglobinemia in rats after intraperitoneal injections were reduced with respect to phenylhydroxylamine (to 100:4:1, respectively), apparently as a result of rapid in vivo clearance of the aminophenols. Subsequent experiments, in which the time courses of the aniline metabolites were determined in blood after toxic doses of aniline, demonstrated that only phenylhydroxylamine (measured as phenylhydroxylamine + nitrosobenzene) accumulated to blood levels exceeding the minimum concentration required for methemoglobin production in vitro. In addition, blood levels of phenylhydroxylamine remained in the toxic range throughout most of the methemoglobinemic response after aniline treatment. These data are consistent with phenylhydroxylamine being the sole mediator of aniline-induced methemoglobinemia in these rats. PMID- 3670279 TI - The effects of 6-benzyl-1,3-benzodioxole derivatives on the alkylation of tubulin. AB - Derivatives of 6-benzyl-1,3-benzodioxole are known to bind to tubulin and inhibit tubulin polymerization. For a better understanding of the mechanism of action of the 6-benzyl-1,3-benzodioxole derivatives, we have examined their effect on the alkylation of tubulin sulfhydryls by iodo[14C]acetamide and N,N' ethylene(bis)iodoacetamide. We have found that the 6-benzyl-1,3-benzodioxole derivatives with an intact dioxole ring affect alkylation to an extent proportional to their ability to inhibit tubulin polymerization. Those derivatives with the strongest resemblance to podophyllotoxin have the weakest effects. However, derivatives with a disrupted dioxole ring show little or no ability to inhibit polymerization, but their effect on alkylation is directly related to the degree of resemblance they bear to the trimethoxy ring of podophyllotoxin. It thus appears that the relatively simple approach of using alkylating agents can generate a significant amount of information on the mechanism by which various drugs interact with tubulin. PMID- 3670280 TI - Interaction of a benzomorphan opiate with acetylcholinesterase and the nicotinic acetylcholine receptor. AB - The benzomorphan opiate, (-)N-allynormetazocine [(-)ANMC, (-)SKF10047], has been shown previously to bind two distinct sites on acetylcholine receptor (AChR)-rich membranes from Torpedo electroplaque. The low affinity site seems to correspond to the site for noncompetitive blockers on the AChR. The high affinity site, which can be photoaffinity labeled using UV irradiation, was distinct from this site. We show here, using a variety of techniques, that the high affinity binding site for (-)ANMC is on the acetylcholinesterase (AChE) associated with these membranes. The Triton X-100-solubilized peptide photolabeled with (-)[3H]ANMC co migrates with acetylcholinesterase activity on velocity sucrose gradient centrifugation and fast protein liquid chromatography. In addition, the labeled peptide cannot be precipitated with monoclonal or polyclonal antibodies raised against the nicotinic AChR but can be precipitated with anti-AChE antibodies. Localization of the binding site on AChE was confirmed by photolabeling of and reversible binding to the 11 S AChE purified from Torpedo californica. The binding and photolabeling had characteristics and affinity similar to those for the high affinity binding site in Torpedo electroplaque membranes. Competition studies with specific AChE inhibitors suggest that the binding site may be the catalytic site of the enzyme, which exists on the 66-kDa globular protein. The effect of (-) and (+)ANMC on AChE activity was also investigated. ANMC inhibited AChE activity at micromolar concentrations in a stereoselective fashion, with the (-)isomer exhibiting a 2-fold higher affinity than the (+) isomer. The inhibition was consistent with a competitive blockade of AChE activity. PMID- 3670281 TI - Xenobiotic metabolizing enzymes are not restricted to parenchymal cells in rat liver. AB - To characterize the distribution and inducibility of drug metabolizing enzymes within different hepatic cell populations, the activities of aminopyrine N demethylase, ethoxyresorufin O-deethylase, microsomal epoxide hydrolase and cytosolic glutathione transferase were measured in liver parenchymal, Kupffer, and endothelial cells isolated from untreated rats or rats pretreated with phenobarbital, 3-methylcholanthrene, or Aroclor 1254. Enzyme activities, measurable in all cases, were 2.3- to 5.7-fold higher in parenchymal cells than in Kupffer and endothelial cells. Phenobarbital increased aminopyrine N demethylase, microsomal epoxide hydrolase, and cytosolic glutathione transferase activities, whereas 3-methylcholanthrene enhanced ethoxyresorufin O-deethylase, epoxide hydrolase, and glutathione transferase activities in the three cell populations. Aroclor 1254 consistently induced each of the enzyme activities in parenchymal, Kupffer, and endothelial cells. Western blot analyses revealed clear differences in the expression of proteins immunologically related to cytochrome P 450 PB-1, and glutathione transferases B and X in parenchymal cells compared with the corresponding Kupffer and endothelial cells. In contrast, only minor differences between the cell types were apparent in the expression of cytochromes P-450 PB-4, P-450 MC1a, P-450 MC1b and microsomal epoxide hydrolase. These studies establish that oxidative and postoxidative drug metabolizing enzymes are not restricted to parenchymal cells: similar but distinguishable complements of these enzymes are also found in Kupffer and endothelial cells. PMID- 3670282 TI - Binding of 3H-estradiol-17 beta-(beta-D-glucuronide), a cholestatic organic anion, to rat liver plasma membranes. Evidence consonant with identification of organic anion carriers. AB - The binding of 3H-estradiol-17 beta(beta-D-glucuronide) (3H-E2 17G), a cholestatic organic anion, was examined in rat liver plasma membranes, and two saturable, specific binding sites were identified. The binding parameters are Kd1 = 3.9 X 10(-7) M, Bmax1 = 69 pmol/mg of protein; Kd2 = 4.90 X 10(-6) M, Bmax2 = 495 pmol/mg of protein according to Scatchard analysis of equilibrium experiments. Kinetic dissociation experiments showed that 3H-E2 17G binding was reversible and revealed two components. The dissociation rate constants did not vary with the method of dilution of radioligand, i.e., by "infinite" volume, or excess unlabeled ligand, ruling out the possibility of cooperativity. The rate of association of 3H-E2 17G binding was very rapid, so that maximal binding was reached within 15 sec at 4 degrees. Na+ was not required for binding and binding was not decreased in the presence of high osmolarity buffer (125 mM sucrose), indicating that transport into vesicles was not involved. The ability of a series of compounds to inhibit the binding of 3H-E2 17G was also examined. Taurocholate, cholate, taurodehydrocholate, and testosterone glucuronide were identified as ligands selective for the high affinity site (site 1). The A- and D-ring glucuronide conjugates of estradiol and estriol, bromosulfophthalein, dibromosulfophthalein, and the glucuronide conjugates of phenolphthalein, 4 methylumbelliferone, and menthol inhibited binding of 3H-E2 17G to both sites. Morphine glucuronide, estradiol, and glucuronic acid did not inhibit binding to either site. The substrate specificities of binding to the low affinity site (site 2) are consistent with data characterizing the transport of these substrates in hepatocytes and supports the postulate that site 2 represents a non bile acid organic anion carrier. Site 1 is postulated to represent a carrier shared by the bile acids and non-bile acid organic anions. PMID- 3670283 TI - Multiple carriers for uptake of [3H]estradiol-17 beta(beta-D-glucuronide) in isolated rat hepatocytes. AB - The transport of the cholestatic steroid glucuronide, 3H-estradiol-17 beta-(beta D-glucuronide) (E2 17G), was examined in isolated female rat hepatocytes over a broad substrate concentration range (0.1-100 microM). Two different carrier systems were identified with the following kinetic parameters: Km1 = 4.54 microM; Vmax1 = 0.149 nmol/min/mg protein; Km2 = 149 microM; Vmax2 = 0.641 nmol/min/mg protein. Taurocholate and testosterone glucuronide selectively and competitively inhibited [3H]-E2 17G uptake at the high affinity site. Ki values calculated for taurocholate (43 microM) and testosterone glucuronide (28 microM) indicated that these two inhibitors were relatively weak competitors for this E2 17G transport site. Conversely, E2 17G inhibited [3H]taurocholate uptake into isolated hepatocytes (Ki = 43 microM). Bromosulfophthalein (10 microM) inhibited uptake of 0.5-50 microM [3H]-E2 17G by 55-85%, whereas morphine glucuronide (100 microM) had no significant effect on uptake of [3H]-E2 17G at these concentrations. The effects of taurocholate, testosterone glucuronide, bromosulfophthalein, and morphine glucuronide on [3H]-E2 17G uptake into isolated rat hepatocytes correlated with the ability of these agents to inhibit binding of [3H]-E2 17G to specific sites in rat liver plasma membranes. These data support the postulate that the two [3H]-E2 17G binding sites identified in female rat liver plasma membranes represent two distinct organic anion carriers and indicate that the high affinity site for [3H]-E2 17G represents a carrier that is shared by organic anions and bile acids. PMID- 3670284 TI - Mechanism of S-(1,2-dichlorovinyl)-L-cysteine- and S-(1,2-dichlorovinyl)-L homocysteine-induced renal mitochondrial toxicity. AB - The mechanism by which the nephrotoxic S-conjugates S-(1,2-dichlorovinyl)-L cysteine (DCVC) and S-(1,2-dichlorovinyl)-L-homocysteine (DCVHC) produce toxicity in rat kidney mitochondria was studied by examining their effects on mitochondrial function, structural integrity, and metabolism. Both S-conjugates inhibited succinate-linked state 3 respiration and impaired the ability of mitochondria to retain Ca2+ and to generate a membrane potential; 30-60 min were required for maximal expression of these functional changes. Mitochondrial structure was damaged, as indicated by enhanced polyethylene glycol-induced shrinkage of matrix volume and by leakage of protein and malic dehydrogenase from the matrix; 60-120 min were required for maximal expression of these structural changes. Much shorter incubation times (15-30 min) were required for DCVC and DCVHC to decrease ATP concentrations, to alter the concentrations of several citric acid cycle intermediates, and to inhibit succinate:cytochrome c oxidoreductase and isocitrate dehydrogenase activities. Lipid peroxidation and oxidation of glutathione to glutathione disulfide also occurred. The relative time courses of these pathological changes indicate that the initial effects of DCVC and DCVHC in renal mitochondria are the inhibition of energy metabolism and the oxidation of glutathione. These changes then lead to alterations in mitochondrial function and ultimately to irreversible damage to mitochondrial structure. PMID- 3670285 TI - The effect of tunicamycin on Leishmania brasiliensis. Glycosylation and the cell surface components. AB - Culture conditions of Leishmania cells were developed to allow the study of the effect of tunicamycin (TM) on glycosylation and on the cell surface components. Leishmania incorporate [14C]-mannose and [35S]-methionine in vitro. The incorporation of [14C]-mannose is linear for 150 min and is inhibited by TM (2 micrograms/ml) in a time dependent effect which reaches a plateau of 45% inhibition at 36 h. Under the same experimental conditions [35S]-methionine incorporation into protein is slightly affected. This is reflected by an almost identical polypeptide pattern for TM treated and non-treated cells when analyzed on SDS-PAGE. On the contrary, strong differences were detected on the labeled compounds analyzed on SDS-PAGE followed by autoradiography when the precursor used was [14C]-mannose. A shift in the electrophoretic mobility of most of the glycopeptides synthesized in the presence of TM was observed, which is also reflected in the structure of the main Leishmania cell surface components. The findings are discussed in the light of biological implications. PMID- 3670286 TI - Non-random distribution of Alu-family repeats in human chromosomes. AB - A phage lambda recombinant clone containing at least 8 Alu-family repeats (AFRs) has been isolated from a human genomic library, and DNA from the phage was used as a probe for in situ hybridization on G-banded human metaphase chromosomes of healthy donors and leukemic patients. Some chromosome bands show prominent clusters of silver grains in all individuals examined: 1p34, 1q23, 2q21-22, 10p14, 11p14, 10q21 and 11q14. The data suggest non-random distribution of AFRs in the human genome. PMID- 3670287 TI - Two endogenous protein kinase activities in heterogeneous nuclear ribonucleoprotein particles (hnRNP). AB - Two protein kinase activities which differ in their catalytic activity towards endogenous and exogenous substrates have been detected and partially purified from heterogeneous nuclear ribonucleoprotein particles (hnRNP). PMID- 3670288 TI - Gamma-crystallins of the human eye lens: expression analysis of five members of the gene family. AB - While only two gamma-crystallins have been identified in the human eye lens, molecular studies indicate that the human gamma-crystallins are encoded in a multigene family comprising at least seven closely related members. Sequence analysis of five of these genes has suggested that three (gamma 1-2, G3, and G4) are potentially active, while two (G1 psi and G2 psi) correspond to closely related pseudogenes. Here we report on the detailed structure of a sixth gamma crystallin gene, G5, and our results obtained with transient expression assays to characterize both the promoter activity and translation products of five members of the gene family. We show that 5'-flanking sequences of G1 psi and G2 psi lacked detectable promoter activity, while the corresponding sequences of G3, G4, and G5 were able to direct high levels of expression of the bacterial chloramphenicol acetyltransferase gene in primary lens epithelia, but not in cultures of nonlens origin. Detailed sequence comparisons indicated that active genes contained several conserved sequence tracts 5' of the TATA box which may constitute functional elements of a lens-specific gamma-crystallin promoter. Expression of the gamma-crystallin coding sequences from the human metallothionein IIA promoter in nonlens cells facilitated characterization of the polypeptides encoded by individual gamma-genes and, in future studies, should permit comparison of these proteins with distinct gamma-crystallins in the human lens. PMID- 3670289 TI - Glucocorticoids selectively inhibit translation of ribosomal protein mRNAs in P1798 lymphosarcoma cells. AB - When P1798 murine lymphosarcoma cells are exposed to 10(-7) M dexamethasone, there is a dramatic inhibition of rRNA synthesis, which is completely reversible when the hormone is withdrawn. In the present experiments we examined whether dexamethasone treatment causes any alteration in the accumulation or utilization of mRNAs that encode ribosomal proteins (rp mRNAs). No effect on the accumulation of six different rp mRNAs was detected. However, the translation of five of six rp mRNAs was selectively inhibited in the presence of the hormone, as judged by a substantial decrease in ribosomal loading. Normal translation of rp mRNA was resumed within a few hours after hormone withdrawal. In untreated or fully recovered cells, the distribution of rp mRNAs between polyribosomes and free ribonucleoprotein is distinctly bimodal, suggesting that rp mRNAs are subject to a particular form of translational control in which they are either translationally inactive or fully loaded with ribosomes. A possible relationship between this mode of translational control and the selective suppression of rp mRNA translation by glucocorticoids is discussed. PMID- 3670290 TI - Mutations affecting assembly and stability of tubulin: evidence for a nonessential beta-tubulin in CHO cells. AB - Eight strains of Chinese hamster ovary (CHO) cells having an assembly-defective beta-tubulin were found among revertants of strain Cmd 4, a mutant with a conditional lethal mutation in a beta-tubulin gene (F. Cabral, M. E. Sobel, and M. M. Gottesman, Cell 20:29-36, 1980). The altered beta-tubulins in these strains have electrophoretically silent alterations or, in some cases, an increase or a decrease in apparent molecular weight based on their migration in two-dimensional gels. The identity of these variant proteins as beta-tubulin was confirmed by peptide mapping, which also revealed the loss of distinct methionine-containing peptides in the assembly-defective beta-tubulins of lower apparent molecular weight. The altered mobility of these beta-tubulin polypeptides was not the result of a posttranslational modification, since the altered species could be labeled in very short incubations with [35S]methionine and were found among in vitro-translated polypeptides by using purified mRNA. In at least one strain, an altered DNA restriction fragment could be demonstrated, suggesting that an alteration occurred in one of the structural genes for beta-tubulin. Assembly defective beta-tubulin was unstable and turned over with a half-life of only 1 to 2 h in exponentially growing cells. This rapid degradation of a tubulin gene product resulted in approximately 30% lower steady-state levels of both alpha- and beta-tubulin yet did not affect the growth rate of the cells or the distribution of the microtubules as judged by immunofluorescence microscopy. These results argue that CHO cells possess a beta-tubulin gene product that is not essential for survival. PMID- 3670291 TI - Binding of a cellular protein to the gibbon ape leukemia virus enhancer. AB - The gibbon ape leukemia virus (GALV) contains enhancer activity within its long terminal repeat. In the GALV Seato strain this activity resides in a 48-base-pair (bp) repeated element. We demonstrate the existence of a cellular protein which binds in this region of the Seato strain. A sensitive method for enriching protein-DNA complexes from crude extracts coupled with exonuclease and DNase footprint analysis revealed the specific binding of this protein to a 21-bp region within each repeated element. A 22-bp oligonucleotide fragment defined solely by the 21-bp footprint binds a protein in vitro and displays enhancer activity in vivo, suggesting that this protein is a major determinant of GALV enhancer activity. The protein is present in three cell lines which are positive for enhancer activity and is not detected in Jurkat cells, which are negative for enhancer activity. Only GALV long-terminal-repeat variants which support high levels of enhancer activity in vivo compete with this protein for specific binding in vitro, suggesting a potential role for the protein in determining enhancer activity. This protein binding is not inhibited by competition with heterologous retroviral enhancers, demonstrating that it is not a ubiquitous retroviral enhancer binding protein. PMID- 3670292 TI - High-efficiency transformation of mammalian cells by plasmid DNA. AB - We describe a simple calcium phosphate transfection protocol and neo marker vectors that achieve highly efficient transformation of mammalian cells. In this protocol, the calcium phosphate-DNA complex is formed gradually in the medium during incubation with cells and precipitates on the cells. The crucial factors for obtaining efficient transformation are the pH (6.95) of the buffer used for the calcium phosphate precipitation, the CO2 level (3%) during the incubation of the DNA with the cells, and the amount (20 to 30 micrograms) and the form (circular) of DNA. In sharp contrast to the results with circular DNA, linear DNA is almost inactive. Under these conditions, 50% of mouse L(A9) cells can be stably transformed with pcDneo, a simian virus 40-based neo (neomycin resistance) marker vector. The NIH3T3, C127, CV1, BHK, CHO, and HeLa cell lines were transformed at efficiencies of 10 to 50% with this vector and the neo marker incorporated pcD vectors that were used for the construction and transduction of cDNA expression libraries as well as for the expression of cloned cDNA in mammalian cells. PMID- 3670293 TI - Aplysia californica neurons express microinjected neuropeptide genes. AB - Neuropeptide genes are expressed in specific subsets of large polyploid neurons in Aplysia californica. We have defined the transcription initiation sites of three of these neuropeptide genes (the R14, L11, and ELH genes) and determined the nucleotide sequence of the promoter regions. The genes contain the usual eucaryotic promoter signals as well as other structures of potential regulatory importance, including inverted and direct repeats. The L11 and ELH genes, which are otherwise unrelated, have homology in the promoter regions, while the R14 promoter was distinct. When cloned plasmids were microinjected into Aplysia neurons in organ culture, transitions between supercoiled, relaxed circular, and linear DNAs occurred along with ligation into high-molecular-weight species. About 20% of the microinjected neurons expressed the genes. The promoter region of the R14 gene functioned in expression of the microinjected DNA in all cells studied. When both additional 5' and 3' sequences were included, the gene was specifically expressed only in R14, suggesting that the specificity of expression is generated by a multicomponent repression system. Finally, the R14 peptide could be expressed in L11, demonstrating that it is possible to alter the transmitter phenotype of these neurons by introduction of cloned genes. PMID- 3670295 TI - Site-specific demethylation and normal chromatin structure of the human dihydrofolate reductase gene promoter after transfection into CHO cells. AB - The effect of in vitro methylation on the function and chromatin structure of the human dihydrofolate reductase (DHFR) promoter linked to the DHFR coding sequences (minigene) was studied after DNA-mediated gene transfer into DHFR- CHO cells. Methylation of HhaI sites reduced the transforming frequency to about 10% of control, whereas methylation of HpaII sites had a less significant effect. The integrated genes were demethylated at specific sites in the promoter sequence, namely, HpaII sites around -57 base pairs from the major start site for transcription and HhaI sites around +9, +24, or both. All other HpaII or HhaI sites in the DHFR coding region or in the plasmid sequences remained consistently methylated. The DHFR minigene, after methylation with HhaI methylase, was also introduced without selection by cotransfection with pSV2neo and selection for neor clones in G418. Preferential demethylation of the same sites was observed even without selection for the DHFR+ phenotype. Analysis of the chromatin structure of the integrated minigene revealed characteristic proximal and distal hypersensitive regions of the promoter, as previously observed in human cells. Correctly initiated DHFR mRNA was detected in all of the transformants studied. These results suggest that formation of the characteristic chromatin structure is an intrinsic property of the DHFR promoter sequence and that demethylation of specific sites accompanies gene expression. PMID- 3670294 TI - Molecular cloning of gene sequences regulated by tumor promoters and mitogens through protein kinase C. AB - cDNA clones representing genes whose expression is modulated by treatment with mitogens and tumor promoters were isolated and characterized. TPA-S1 corresponds to an mRNA species whose abundance was increased markedly within 1 h of exposure to the tumor promoter 12-O-tetradecanoyl phorbol-13-acetate (TPA), and TPA-R1 represents an mRNA that was decreased in TPA-treated cells. The induction of TPA S1 was blocked by actinomycin D but was not affected by cycloheximide, and it was specific for phorbol esters with tumor-promoting activity. The role of protein kinase C in the induction of TPA-S1 is supported by the following lines of evidence. (i) Agents that activated protein kinase C (TPA, platelet-derived growth factor, and diacylglycerol) also increased TPA-S1 mRNA levels. (ii) A potent PKC inhibitor blocked the induction of TPA-S1. (iii) Down-regulation of PKC activity, by treatment of cells with TPA for 24 h, resulted in a loss of responsiveness to TPA-S1 induction by subsequent TPA treatment. DNA sequence analysis of TPA-S1 predicts a cysteine-rich, secreted protein with a molecular weight of 22.6 X 10(3) that exhibits homology with sequences representing a protein with human erythroid-potentiating activity and protease inhibitory activity. PMID- 3670296 TI - Developmental regulation of a novel repetitive protein of Trypanosoma brucei. AB - Trypanosoma brucei undergoes many morphological and biochemical changes during transformation from the bloodstream trypomastigote to the insect procyclic trypomastigote form. We cloned and determined the complete nucleotide sequence of a developmentally regulated cDNA. The corresponding mRNA was abundant in in vitro cultivated procyclics but absent in bloodstream forms. The trypanosome genome contains eight genes homologous to this cDNA, arranged as four unlinked pairs of tandem repeats. The longest open reading frame of the cDNA predicts a protein of 15 kilodaltons, the central portion of which consists of 29 tandem glutamate proline dipeptides. The repetitive region is preceded by an amino-terminal signal sequence and followed by a hydrophobic domain that could serve as a membrane anchor; the mRNA was found on membrane-bound polyribosomes. These results suggest that the protein is membrane associated. PMID- 3670297 TI - Expression of bcr and bcr-abl fusion transcripts in normal and leukemic cells. AB - The translocation of the c-abl oncogene from chromosome 9 to the bcr gene on chromosome 22 in cases of Philadelphia chromosome-positive chronic myelogenous leukemia (CML) generates an aberrant bcr-abl fusion transcript which may be intimately related to the pathogenesis of CML. Because factors controlling normal bcr expression might also be involved in the expression of this aberrant bcr-abl transcript, we studied the patterns of expression of the normal bcr gene in different cell types. We found that the normal bcr gene was expressed in many different types of human cells. Moreover, the bcr gene was evolutionarily conserved, and homologous bcr genomic sequences and RNA transcripts were readily detected in chick tissue. The highest level of bcr expression in chick tissue was in brain tissue, the lowest level was in liver tissue, and a truncated bcr mRNA was noted in chick testes. Normal bcr transcripts, in addition to the aberrant bcr-abl hybrid transcripts, have been found in all Philadelphia chromosome positive CML cells studied to date. Within a given CML sample, the relative amounts of normal bcr RNA and aberrant bcr-abl RNA were similar. In addition, the normal bcr and the aberrant bcr-abl hybrid transcripts demonstrated similarly prolonged half-lives compared with that of the normal abl-related transcripts in CML cells. These findings suggest that in CML cells, similar cellular mechanisms control the steady-state levels of both the normal bcr and the bcr-abl fusion RNAs. PMID- 3670298 TI - Primary processing of mammalian rRNA involves two adjacent cleavages and is not species specific. AB - The primary transcript of the mouse rRNA gene is rapidly processed at nucleotide approximately +650 both in vivo and in vitro. Using run-off transcription in a mouse cell extract as well as S1 nuclease and primer extension analysis of cellular RNA, we demonstrated that this primary processing actually results in the formation of two species of downstream RNA which differ in length by approximately 6 nucleotides, indicating the existence of two closely positioned alternative processing sites. The 200-base-pair region just 3' to the mouse processing site has a striking 80% sequence homology with a region of the human rRNA external transcribed spacer, and S1 nuclease analysis of human cellular RNA has demonstrated that an analogous rRNA processing occurs at the 5' border of the homologous human region. Unlike rDNA transcriptional initiation, however, the primary rRNA processing is not highly species specific, for the transcript of a chimeric gene containing the human processing region adjacent to a mouse rDNA promoter was synthesized and correctly processed in a mouse cell extract. This result confirms that mouse and human rRNA undergo a common primary processing event which is evidently directed by sequences within the 200-base-pair conserved sequence region. PMID- 3670299 TI - Control of thymidine kinase mRNA during the cell cycle. AB - To investigate the mechanism which controls the onset of DNA synthesis, we examined the regulation of thymidine kinase (TK) and its mRNA in the cell cycle. TK activity provides a useful marker for the onset of the S phase in mammalian cells. The present analysis of regulation of TK mRNA in BALB/c 3T3 cells showed that (i) the increase in TK activity depended on the availability of TK mRNA, (ii) the level of TK mRNA between G0 and S increased more than 20-fold, (iii) the rate of run-on TK transcription increased at most 2- to 4-fold between the G0 and S phases, (iv) the half-life of TK mRNA was greater than 8 to 12 h in the S and M phases and decreased as cells entered quiescence, (v) the TK mRNA increase was fully blocked by inhibition of protein synthesis by only 60%, (vi) this inhibition was completely effective for up to about 10 h following serum addition and progressively much less effective when the drugs were added later. These results suggest that the appearance of TK mRNA at the beginning of the S phase in serum-stimulated 3T3 cells is controlled not only by the rate of gene transcription but importantly also by the decreased rate of mRNA degradation. Similar mechanisms may be involved in regulation of the onset of DNA synthesis and the increase in TK mRNA since both are controlled in a manner consistent with a requirement for a labile protein. PMID- 3670300 TI - Identification of the principal promoter sequence of the c-H-ras transforming oncogene: deletion analysis of the 5'-flanking region by focus formation assay. AB - A number of deletion mutants were isolated, including 5', 3', and internal deletions in the 5'-flanking region of the human cellular oncogene related to the Harvey sarcoma virus (c-H-ras), and their transforming activities were examined in NIH 3T3 cells. DNA sequences which could not be detected without losing transforming activity were localized to a relatively short stretch upstream of the region which showed homology to the 5'-flanking region of v-H-ras oncogene. S1 nuclease analysis indicated that there were two clusters of mRNA start sites at positions that were about 1,371 and 1,298 base pairs upstream of the first coding ATG. The minimum region required for promoter function was estimated to be a 51-base-pair-long (or less) DNA segment. The promoter was GC rich (78%) and did not contain the consensus sequences that are usually observed in PolII-directed promoters but contained a GC box within which one of the mRNA start sites was included. In addition, two sets of positive and negative elements seemed to be located between the promoter and the protein-coding region, which appeared to influence positively and negatively, respectively, the efficiency of transformation with the c-H-ras oncogene. PMID- 3670301 TI - Levels of fos, ets2, and myb proto-oncogene RNAs correlate with segregation of chromosome 11 of normal cells and with suppression of tumorigenicity in human cell hybrids. AB - The tumorigenicity in nude mice of human carcinoma-derived D98AH2 (D98) cells is suppressed when cell hybrids are made by fusing these cells with normal human diploid cells. Selection for hybrids that have segregated chromosomes results in the recovery of tumorigenic segregants. These segregants have all lost at least one copy of chromosome 11 of the diploid cell parent. Earlier we found that the parental D98 cells had detectable levels of mRNA specific for 13 of 21 proto oncogenes examined. To determine if transregulation of proto-oncogenes by genes of the normal cell occurs in such hybrids, the steady-state levels of mRNA specific to 22 proto-oncogenes in the parental cells were compared with those of nontumorigenic D98 X human diploid hybrids as well as with those of their tumorigenic segregants and with the cells of the resulting tumors. The only chromosome consistently segregated in the latter was chromosome 11 of the diploid cell. fos and ets2 RNA levels and the amount of fos protein were consistently elevated in the segregants compared with amounts in the original hybrids. An unexpected finding was the inverse relationship for myb RNA that was barely detected in the parental D98 cells but was at least 10-fold elevated in hybrids that did not have segregated chromosomes compared with those that did. These patterns were evident in RNAs prepared from both subconfluent and confluent cell cultures. The findings suggest that genes of the normal cell parent can affect proto-oncogene expression. Whether the genes affecting fos, ets2, and myb RNA levels are on chromosome 11 and whether these alterations are causally related to the tumorigenic phenotype of the hybrid remain to be determined. PMID- 3670302 TI - The rat elastase I regulatory element is an enhancer that directs correct cell specificity and developmental onset of expression in transgenic mice. AB - A total of 134 base pairs of the 5' flanking sequence of the elastase I gene is sufficient and necessary to direct expression of the passive human growth hormone gene (hGH) to the exocrine pancreas. We demonstrate that this elastase I regulatory region contains a transcriptional enhancer which directs acinar cell specific expression in transgenic animals. The elastase I enhancer specifies correct expression of the linked hGH gene in an orientation- and position independent manner and can activate a heterologous promoter. The enhancer also directs the appropriate temporal activation of the hGH gene in the developing pancreas. Transcription is initiated correctly for the elastase I or hGH promoter, and the transcripts are correctly processed regardless of the enhancer position within or outside the fusion gene. The elastase I enhancer generates coincident DNase I-hypersensitive sites in pancreatic chromatin when moved 3 kilobases upstream or within the first intron of the hGH gene and when associated with the hGH promoter. PMID- 3670303 TI - Transcriptional activation of the glucose-regulated protein genes and their heterologous fusion genes by beta-mercaptoethanol. AB - The sulfhydryl-reducing agent beta-mercaptoethanol preferentially stimulates the synthesis of glucose-regulated proteins (GRPs) in mammalian cells. The rapid and large increase in GRPs is due to transcriptional activation of GRP94 and GRP78 genes, resulting in a rapid increase in the steady-state levels of GRP transcripts. From analysis of 5'-deletion mutants, the region of beta mercaptoethanol responsiveness in the GRP78 promoter was mapped within 450 nucleotides upstream of the TATA sequence. This same general region was demonstrated to be important for induction of the GRP78 gene by the calcium ionophore A23187, glucose starvation, and a temperature-sensitive mutation in a K12 cell line defective in protein glycosylation. PMID- 3670304 TI - Transient correction of genetic defects in cultured animal cells by introduction of functional proteins. AB - Material was introduced into cultures of cells by using the method of scrape loading, in which cells are simply rubbed from the surface of a plastic tissue culture dish by a rubber-tipped rod in the presence of a macromolecule of interest. The volume of solution introduced into cells was comparable to that generally injected in the direct microinjection method with glass capillaries, that is, about 50 to 100 fl per cell. Genetic defects (lack of hypoxanthine guanine phosphoribosyltransferase and thymidine kinase) in several cell lines were transiently corrected by scraping the cells in the presence of crude cell extracts prepared from wild-type cells. PMID- 3670305 TI - Mouse nerve growth factor gene: structure and expression. AB - The organization and biologically significant sequences of the entire mouse nerve growth factor (NGF) gene have been determined. The gene spans 45 kilobases and contains several small 5' exons. Transcription of the gene results in four different mRNA species, which can be accounted for by alternative splicing and independent initiation from two promoters. These transcripts encode proteins which have divergent N termini and the NGF moiety at their C termini. The levels of the various NGF transcripts have been determined in different tissues and throughout postnatal development. We have also examined the expression of these transcripts in the brain in response to specific early sensory deprivation. The results suggest that the expression of NGF mRNA during postnatal development is regulated independently of the formation of complex neural networks. PMID- 3670306 TI - Complex regulation of the muscle-specific contractile protein (troponin I) gene. AB - A cloned quail troponin I contractile protein gene, stably transfected into a mouse myogenic cell line, exhibits appropriate developmental activation and quantitative expression during myoblast differentiation. Deletion mutagenesis analyses reveal that the troponin I gene has two distinct cis regulatory elements required for its developmental expression, as measured by mRNA accumulation and nuclear runoff transcription assays. One element in the 5' flanking region is required for maximum quantitative expression, and a second larger regulatory element (1.5 kilobases) within the first intron is responsible for differentiation-specific transcription. The upstream region is highly sensitive to negative repression by interaction with pBR322 sequences. The larger intragenic region retains some activity when moved to the 5' and 3' flanking regions and when inverted but is maximally active in its native intragenic site. The concerted activities of these two regulatory regions produce a 100- to 200 fold transcriptional activation during myoblast differentiation. The conserved 5' exon-intron organization of troponin I and other contractile protein genes suggests a possible mechanism by which intragenic control elements coordinate contractile protein gene regulation during skeletal myogenesis. PMID- 3670307 TI - Accurate and efficient 3' processing of U2 small nuclear RNA precursor in a fractionated cytoplasmic extract. AB - The small nuclear RNAs U1, U2, U4, and U5 are cofactors in mRNA splicing and, like the pre-mRNAs with which they interact, are transcribed by RNA polymerase II. Also like mRNAs, mature U1 and U2 RNAs are generated by 3' processing of their primary transcripts. In this study we have investigated the in vitro processing of an SP6-transcribed human U2 RNA precursor, the 3' end of which matches that of authentic human U2 RNA precursor molecules. Although the SP6-U2 RNA precursor was efficiently processed in an ammonium sulfate-fractionated HeLa cytoplasmic S100 extract, the product RNA was unstable. Further purification of the processing activity on glycerol gradients resolved a 7S activity that nonspecifically cleaved all RNAs tested and a 15S activity that efficiently processed the 3' end of pre-U2 RNA. The 15S activity did not process the 3' end of a tRNA precursor molecule. As demonstrated by RNase protection, the processed 3' end of the SP6-U2 RNA maps to the same nucleotides as does mature HeLa U2 RNA. PMID- 3670308 TI - Molecular cloning and sequence of a cholesterol-repressible enzyme related to prenyltransferase in the isoprene biosynthetic pathway. AB - Differential hybridization and molecular cloning have been used to isolate CR39, a cDNA which hybridizes to a 1.2-kilobase (kb) mRNA in rat liver. The level of CR39 mRNA was increased seven- to ninefold over normal levels by dietary cholestyramine and mevinolin and decreased about fourfold compared with normal levels by cholesterol feeding or administration of mevalonate. Similar changes in the mRNA levels of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and HMG-CoA synthase were observed under the various conditions. In vitro translation of either CR39 hybrid selected RNA or 1.2-kb CR39 RNA generated by an SP6 in vitro transcription system produced a polypeptide of 39,000 daltons. As deduced from the nucleotide sequence of a full-length CR39 cDNA, the rat CR39 polypeptide contained 344 amino acids and had a molecular weight of 39,615. The predicted amino acid composition and submit molecular weight of the rat CR39 were very similar to those of prenyltransferases isolated from chicken, pig, and human. The sequence of amino acid residues 173 through 203 in the rat CR39 polypeptide showed that 17 out of 30 matched an active-site peptide of avian liver prenyltransferase. Thus, alterations in the rate of cholesterogenesis resulted in the coordinate regulation of three mRNAs encoding HMG-CoA reductase, HMG-CoA synthase, and CR39, the latter being tentatively identified as prenyltransferase. PMID- 3670309 TI - Identification and characterization of mRNAs regulated by nerve growth factor in PC12 cells. AB - Differential screening of cDNA libraries was used to detect and prepare probes for mRNAs that are regulated in PC12 rat pheochromocytoma cells by long-term (2 week) treatment with nerve growth factor (NGF). In response to NGF, PC12 cells change from a chromaffin cell-like to a sympathetic-neuron-like phenotype. Thus, one aim of this study was to identify NGF-regulated mRNAs that may be associated with the attainment of neuronal properties. Eight NGF-regulated mRNAs are described. Five of these increase 3- to 10-fold and three decrease 2- to 10-fold after long-term NGF exposure. Each mRNA was characterized with respect to the time course of the NGF response, regulation by agents other than NGF, and rat tissue distribution. Partial sequences of the cDNAs were used to search for homologies to known sequences. Homology analysis revealed that one mRNA (increased 10-fold) encodes the peptide thymosin beta 4 and a second mRNA (decreased 2-fold) encodes tyrosine hydroxylase. Another of the increased mRNAs was very abundant in sympathetic ganglia, barely detectable in brain and adrenals, and undetectable in all other tissues surveyed. One of the decreased mRNAs, by contrast, was very abundant in the adrenals and nearly absent in the sympathetic ganglia. With the exception of fibroblast growth factor, which is the only other agent known to mimic the differentiating effects of NGF on PC12 cells, none of the treatments tested (epidermal growth factor, insulin, dibutyryl cyclic AMP, dexamethasone, phorbol ester, and depolarization) reproduced the regulation observed with NGF. These and additional findings suggest that the NGF-regulated mRNAs may play roles in the establishment of the neuronal phenotype and that the probes described here will be useful to study the mechanism of action of NGF and the development and differentiation of neurons. PMID- 3670310 TI - Amount of RNA secondary structure required to induce an alternative splice. AB - We set up an alternative splicing system in vitro in which the relative amounts of two spliced RNAs, one containing and the other lacking a particular exon, were directly proportional to the length of an inverted repeat inserted into the flanking introns. We then used the system to measure the effect of intramolecular complementarity on alternative splicing in vivo. We found that an alternative splice was induced in vivo only when the introns contained more than approximately 50 nucleotides of perfect complementarity, that is, only when the secondary structure was much more stable than most if not all possible secondary structures in natural mRNA precursors. We showed further that intron insertions containing long complements to splice sites and a branch point inhibited splicing in vitro but not in vivo. These results raise the possibility that in cells most pre-mRNA secondary structures either are not maintained long enough to influence splicing choices, or never form at all. PMID- 3670311 TI - A Podospora anserina longevity mutant with a temperature-sensitive phenotype for senescence. AB - A Podospora anserina longevity mutant was identified with a temperature-sensitive phenotype for senescence. This mutant, termed TS1, grew for over 3 m at 27 degrees C, but when shifted to 34 degrees C, it underwent senescence between 10 and 18 cm. A previously described senescence-associated plasmid, alpha senDNA, derived from the mitochondrial genome, was not detected in TS1 at 27 degrees C but was present in senescent cultures at 34 degrees C. A similar result was observed in progeny strains obtained by crossing the TS1 mutant with a wild-type strain. Other mitochondrial excision-amplification DNAs in addition to alpha senDNA were also observed in the senescent cultures. Most were derived from a specific region of the mitochondrial genome. These results provide evidence that alpha senDNA is involved in TS1 senescence and suggest that this plasmid may play a role in the formation of other mitochondrial excision-amplification plasmids. PMID- 3670312 TI - Isolation and characterization of full-length functional cDNA clones for human carcinoembryonic antigen. AB - Carcinoembryonic antigen (CEA) expression is perhaps the most prevalent of phenotypic changes observed in human cancer cells. The molecular genetic basis of this phenomenon, however, is completely unknown. Twenty-seven CEA cDNA clones were isolated from a human colon adenocarcinoma cell line. Most of these clones are full length and consist of a number (usually three) of surprisingly similar long (534 base pairs) repeats between a 5' end of 520 base pairs and a 3' end with three different termination points. The predicted translation product of these clones consists of a processed signal sequence of 34 amino acids, an amino terminal sequence of 107 amino acids, which includes the known terminal amino acid sequence of CEA, three repeated domains of 178 amino acids each, and a membrane-anchoring domain of 27 amino acids, giving a total of 702 amino acids and a molecular weight of 72,813 for the mature protein. The repeated domains have conserved features, including the first 67 amino acids at their N termini and the presence of four cysteine residues. Comparisons with the amino acid sequences of other proteins reveals homology of the repeats with various members of the immunoglobulin supergene family, particularly the human T-cell receptor gamma chain. CEA cDNA clones in the SP-65 vector were shown to produce transcripts in vitro which could be translated in vitro to yield a protein of molecular weight 73,000 which in turn could be precipitated with CEA-specific antibodies. CEA cDNA clones were also inserted into an animal cell expression vector and introduced by transfection into mammalian cell lines. These transfectants produced a CEA-immunoprecipitable glycoprotein which could be visualized by immunofluorescence on the cell surface. PMID- 3670313 TI - Subnuclear associations of the v-myb oncogene product and actin are dependent on ionic strength during nuclear isolation. AB - The method used to isolate nuclei has a direct effect on the subnuclear association of the v-myb product, p48v-myb, and nuclear actin. Analysis of nuclei subjected to various isolation procedures showed that disruption of native nuclear structure during hypotonic treatment resulted in dissociation of p48v-myb from the nuclear matrix. PMID- 3670314 TI - One- and two-step transformations of rat thyroid epithelial cells by retroviral oncogenes. AB - A system of epithelial cells is described in which it is possible to study the number and the nature of genes capable of conferring the malignant phenotype. Two fully differentiated, hormone-responsive cell lines from rat thyroid glands are presented which are susceptible to one-step or two-step transformation upon infection with several murine acute retroviruses. After infection, both cell lines became independent from their thyrotropic hormone requirement for growth. However, complete transformation was achieved with one of the cell lines (FRTL-5 Cl 2), whereas the other cell line (PC Cl 3) failed to grow in agar and to give rise to tumors in vivo. The latter cell line was susceptible to complete transformation upon cooperation of the v-ras-Ha and the human c-myc oncogenes. PMID- 3670315 TI - [Causative relations between infections and allergies in obstructive respiratory tract diseases in childhood]. AB - Obstructive bronchitis of young babies and infants is most often caused by respiratory-syncytial (RS)- and parainfluenza viruses, to a certain extent by adenoviruses. In the school age-group rhinoviruses and to a smaller extent mycoplasma pneumoniae gain further importance. All the viruses may cause or deteriorate asthmatic attacks, as well as during common cold or on the basis of documented allergies. Proposed mechanisms of viral-infection-induced obstructive airway disease are distinct lesions of bronchial-epithelium, followed by enhanced allergen-resorption and sensitization of submucosal mast cells, establishing an allergy. Following epithelial discontinuation airway irritant receptors which are raised in sensitivity by viral toxins are exposed and stimulated. Via vago-vagal reflexes this leads to bronchoconstriction. Furthermore, in the development of bronchial hyperresponsiveness there may be participation of virus-induced blockage of adrenoceptors, basophilic and mast-cell release of mediators as well as induction of specific IgE antibodies against RS- and/or Para-influenza viruses. Viral airway infections are supposed to influence the immunological response of T-lymphocytes and probably macrophages selectively, e.g. to regulate IgE-antibody production. Especially in children with an atopic family history the RS-viruses cause obstructive airway disease. During acute respiratory-virus infections using electron microscopy marked pathological changes of bronchial epithelium can be demonstrated causing disturbance or even stopage of mucus transport. These changes are fully reversible within weeks after airway infection. Although there is no doubt about a causative relation between respiratory-tract infection and allergy, hardly any prediction for development of asthma bronchiale in later life, after having suffered from virus-induced obstructive airway disease early in life, can be made.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670316 TI - [Determination of the isoenzymes of alkaline phosphatase in serum and tissue homogenates with HPLC]. AB - We describe a new method for separating alkaline phosphatase isoenzymes by "high performance" liquid chromatography. Isoenzymes are chromatographed on the column (Mono Q HR 5/5, a strong anion-exchanger) with stepwise gradient elution. The isoenzymes originating from small intestine, bone, liver and bile were identified by use of tissue homogenates, pathological sera, and heat inactivation. One isoenzyme was identified in the homogenate of small intestine, two were identified in bone, and two in liver, and biliary and fragment isoenzymes in bile. There are indications that the first liver isoenzyme is derived from the cell membrane and the second liver isoenzyme from the cytosol. The biliary isoenzyme is considered to be a highly sensitive and specific indicator for cholestasis. We propose that the isoenzymes called "Fragmented Isoenzymes" which had been detected in liver homogenate and in bile fluid, represent catabolites of the various isoenzymes in serum. PMID- 3670317 TI - [Adult respiratory distress syndrome as a complication of infectious mononucleosis]. AB - We describe a three-year-old boy with clinical findings of infectious mononucleosis, but no serologic proof in the beginning of his disease. The subsequent course was complicated by fatal pulmonary complications compatible with an adult respiratory distress syndrome (ARDS). Repeat serologic tests for Epstein-Barr virus finally could confirm the diagnosis of infectious mononucleosis. Thus, ARDS has to be added to the possible rare causes of fulminant, fatal cases of infectious mononucleosis. PMID- 3670318 TI - [Therapy of bacterial meningitis 1985. Results of a survey throughout West Germany]. PMID- 3670319 TI - [A short repeat in the genome of the DNA sequences flanking bovine growth hormone genes]. AB - The phage clones containing a gene coding for bovine growth hormone were isolated from a bovine genomic library. Comparison of the 5' and 3' regions flanking the bovine growth hormone gene by Southern blot hybridization revealed that they share homology. Screening the bovine genomic library by nick-translated DNA fragment from 5' flanking region leads to conclusion that this sequence is present in 0.1% of clones. Each analysed clone carrying the sequence contains some copies of it. PMID- 3670320 TI - [Preparation and properties of the staphylococcal toxin causing the toxic shock syndrome]. AB - A method is proposed for isolation and purification of the staphylococcal toxin causing the toxic shock syndrome (TSS). The method includes three steps: aggregation of protein from the cultural filtrate of Staphylococcus aureus strain 1169 in the presence of 0.025% sodium hexametaphosphate at pH 3.0; gel filtration of the concentrated material on the sephadex G75; ion-exchange chromatography on DEAE 32 cellulose. The proposed method permits to obtain the purified biologically active preparation of toxin with the yield about 40%. The obtained preparations are homogeneous in polyacrylamide electrophoresis and as analyzed by immunochemical methods. The mol mass of the isolated protein is 24 kD, it is not immunologically identical to staphylococcal toxins A-D and is lethal for New Zealand white rabbits and chinchilla rabbits. Interferon inducing activity of the protein is identical to the one of staphylococcal enterotoxin type A. PMID- 3670321 TI - [Evolution of RNA-dependent RNA polymerases of positive riboviruses]. AB - A comparative analysis is presented of 24 known amino acid sequences of RNA dependent RNA polymerases of positive strand RNA viruses infecting animals, plants and bacteria. Using a newly proposed methodology of group alignment for weakly similar sequences, evolutionary conserved fragments of all these proteins were unambiguously aligned. A unique pattern (consensus) of 7 invariant amino acid residues was revealed which is absent from the sequences of other RNA and DNA polymerases and is thought to unequivocally identify the RNA-dependent RNA polymerases of positive strand RNA viruses. Based on the obtained alignment a tentative phylogenetic tree of viral RNA polymerases was constructed for the first time. The RNA-dependent RNA polymerases of positive strand RNA viruses are concluded to comprise a distinct family of evolutionary related proteins. PMID- 3670322 TI - DNA damage and repair in higher plants and their relation to genetic damage. PMID- 3670323 TI - Effects of G2 treatments with inhibitors of DNA synthesis and repair on chromosome damage induced by X-rays and chemical clastogens in root tips of Vicia faba. Comparison with corresponding effects in cultured human lymphocytes. AB - The frequencies of chromatid aberrations produced in roots of Vicia faba by clastogenic (chromosome-damaging) agents were strongly enhanced by exposing the root-tip cells to inhibitors of DNA synthesis during the G2 phase. Chromosome damage produced by both S-dependent (maleic hydrazide, methyl methanesulfonate, thio-TEPA) and S-independent (X-rays, streptonigrin) mechanisms was enhanced by the inhibitor treatments. The types of aberrations affected by the inhibitors were mainly chromatid gaps and breaks and isochromatid breaks of the non-union type. Most effective among the inhibitors tested were hydroxyurea (HU) and 5 fluorodeoxyuridine (FdUrd). Post-treatments with caffeine were effective in enhancing clastogen-induced chromosome damage when given during the S phase. All types of aberrations, exchanges as well as breaks, were enhanced by the post treatments. When given during the G2 phase, caffeine enhanced only the frequency of chromatid aberrations produced by X-rays. The enhancement was slight and obtained only when the cells were irradiated in the G2 phase and immediately post treated with caffeine. Clastogen-treated cultures of human lymphocytes responded to post-treatments with inhibitors of DNA synthesis in very much the same way as clastogen-treated root-tip cells of Vicia faba. Thus, the frequencies of chromatid gaps and breaks and isochromatid breaks of the non-union type were strongly enhanced by exposing clastogen-treated lymphocytes to inhibitors of DNA synthesis during the G2 phase. The efficiency of the inhibitors, however, varied considerably in the two materials. On the whole, the number of inhibitors capable of enhancing induced chromosome damage was much larger in lymphocytes than in bean root tips. Only HU was equally effective in both materials. The most striking difference between the two materials was found when caffeine was given as a post-treatment. Thus, in human lymphocytes the frequencies of chromatid aberrations induced by most clastogenic agents were strongly enhanced when caffeine was given during the G2 phase, but little affected by post-treatments with caffeine during the S phase. PMID- 3670324 TI - Interaction of the mutagenic metabolite of sodium azide, synthesized in vitro, with DNA of barley embryos. AB - The in vitro synthesized sodium azide mutagenic metabolite (azidoalanine) produced single-strand breaks and proteinase K-sensitive sites in isolated, germinating barley embryos. In contrast with sodium azide, the efficiency of DNA damage induction was lower, and both types of DNA lesions were totally or partially repaired in the course of subsequent 24 h incubation of the embryos. The mutagenic azide metabolite did not inhibit DNA replication, while azide did so even at doses which are not highly mutagenic. The metabolite labelled with 14C at the amino acid residue was taken up with a similar efficiency both into barley embryos germinating for 2 days and into cells of Salmonella typhimurium TA100. The majority of the radioactivity was incorporated into proteins, less into RNA and a negligible amount into DNA. PMID- 3670325 TI - Differential sensitivities of transformed and untransformed murine cell lines to DNA cross-linking agents relative to repair of O6-methylguanine. AB - Sensitivities of several murine cell strains to killing by the DNA cross-linking agents 1-(2-chloroethyl)-1-nitrosourea (CNU), cis-diamminedichloroplatinum (II) (Cis-Pt) and mitomycin C (MMC) were measured by post-treatment colony-formation. Virally-transformed murine cells were usually more sensitive to cell killing by these agents than were the parental 3T3 cell strains. The hypersensitivity to CNU of some virally-transformed murine cell strains correlated well with the reduced ability to repair O6-methylguanine (O6mGua), a phenomenon similar to that in human cells. The loss of ability to repair O6mGua, as well as the increased sensitivity of transformed strains to cell killing, may not be due to a mutation but rather due to a change of gene expression associated with transformation by viruses or activation of oncogenes. PMID- 3670326 TI - RecA-like activity in mammalian cell extracts of different origin. AB - The occurrence of a RecA-like activity similar to the one detected in the fibroblast cell line GM1492 derived from a patient suffering from the autosomal recessive disease Bloom's syndrome has been investigated in cell extracts of different origin. The formation of D-loop containing joint molecules from phi X174 RFI DNA and fragments of phi X174 single-stranded DNA by partially purified extracts was measured by a filter binding assay. The RecA-like activity, dependent on ATP and Mg2+, was detected at an elevated level only in the human and rodent cell lines, GM1492 and CHO respectively. The level of activity in DNA cellulose-purified cell extracts from these cell lines was 4-7-fold higher compared to normal human fibroblasts. Low levels of activity were also detected in extracts from two additional Bloom's syndrome fibroblast cell lines, Fanconi's anemia fibroblasts, virus- (Epstein-Barr virus, Simian virus 40) transformed human cells and human placenta. Cell extracts from rat testis, spleen and calf thymus were also of low activity. PMID- 3670327 TI - Reparative strand incision in saponin-permeabilized human fibroblasts. AB - The damage-directed strand incision step in the nucleotidyl DNA excision-repair pathway (NDERP) was characterized in quiescent monolayer cultures of human fibroblasts in which the plasma membrane was selectively permeabilized with saponin. When permeable normal human fibroblasts (NHF) were incubated in a DNA repair assay mixture lacking the deoxyribonucleoside triphosphate precursors, the numbers of UV-dependent DNA-strand breaks were increased by about 9-fold consistent with the uncoupling of incision from gap-filling DNA synthesis and ligation. In uncoupled NHF omission of ATP reduced the numbers of UV-dependent strand breaks by 84% confirming the requirement for ATP for reparative strand incision. Time-course experiments indicated that the maximum rate of strand incision occurred in the first 10 min of incubation of permeable cells and diminished to 16-28% of this rate between 30 and 60 min of incubation. The initial rate of incision in permeable NHF was estimated to be 20% of that seen in intact fibroblasts. Dose-response studies indicated an initial saturation of strand incision activity at fluences between 10 and 25 J/m2. In permeable group A xeroderma pigmentosum fibroblasts (XPA) few UV-dependent incisions were produced after 10-25 J/m2. In the xeroderma pigmentosum variant (XPV) strain that we studied, strand incisions saturated at a plateau level that was about twice that seen in the NHF strain suggesting the preservation of a higher level of incision activity after permeabilization. After fluences above 50 J/m2 additional strand incision was observed in all cell strains reflecting the activity of a damage dependent endodeoxyribonuclease that is independent of the NDERP. Saponin-treated fibroblasts were also permeable to pancreatic deoxyribonuclease I and the UV-DNA endonuclease from M. luteus indicating that these preparations may be used for in vitro complementation. PMID- 3670328 TI - Exogenous O6-methylguanine inhibits adduct removal and sensitizes human cells to killing by the chemical carcinogen N-methyl-N'-nitro-N-nitrosoguanidine. AB - We partially depleted the O6-methylguanine-DNA methyltransferase activity in four O6-methylguanine (O6-mGua) repair-proficient (Mer+) human cell strains with exogenous O6-mGua (2 mM for 3 h, a non-toxic regimen) and then challenged them with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). MT-partially depleted HT29 cells removed O6-mGua from DNA at about half the rate of control cells, while removal of 3-methyladenine was unaffected. In spite of partial depletion of MT, however, cell killing by MNNG in a colony-forming assay with HT29, A549, A498 or KD cells was not greatly affected. (This is in contrast to the dramatic potentiation of CNU cytotoxicity observed previously.) In an attempt to sensitize Mer+ strains to killing by MNNG, we treated cells with O6-mGua following MNNG exposure (0.4 mM for 4 days), in addition to the pre-MNNG treatment of 2 mM O6 mGua for 3 h. This sensitized KD and HT29 cells 2-fold to killing by MNNG, based on the dose at 10% survival, but did not sensitive Mer- A1336. However, post treatment alone was as effective as combined pre- and post-treatment in sensitizing KD cells to killing. Thus, when the O6-mGua post-treatment was begun, greater than 50% of O6-mGua was already removed from cell DNA. Our findings may be accounted for by at least two schemes, one in which nonlethal O6-mGua are removed from DNA rapidly, while potentially lethal O6-mGua are repaired later. The other scheme proposes that exogenous O6-mGua increases the lethality of a non O6-mGua lesion by reducing its repair both in Mer+ and Mer- cells. Both schemes are consistent with the hypothesis that O6-mGua may be a lethal DNA lesion in human cells. PMID- 3670330 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Publication No. 15. Alcohol as a mutagenic agent. Report of an ICPEMC expert group. PMID- 3670329 TI - The fate of 8-methoxypsoralen-photoinduced DNA interstrand crosslinks in Fanconi's anemia cells of defined genetic complementation groups. AB - The fate of 8-methoxypsoralen (8-MOP)-photoinduced DNA interstrand crosslinks was followed by alkaline elution in Fanconi's anemia (FA) fibroblasts belonging to complementation groups A (FA 150 and FA 402) and B (FA 145) in comparison to a normal (1 BR/3) and a heterozygote (F 311) cell line. Clonogenic cell survival to 8-MOP photoaddition was established in parallel for all cell lines. In comparison to normal cells, group A FA cells demonstrated a higher photosensitivity than group B cells (sensitivity index 2.3 and 1.5, respectively), the heterozygote cell line being only slightly more sensitive. FA cells from both groups A and B demonstrated an incision capacity of crosslinks, the kinetics and extent of which being, however, different from that of normal or heterozygote cells. The incision is slower in FA cells and, at 24 h of post-treatment incubation, the amount of crosslinks incised is clearly lower than that observed in normal cells for group A cells, whereas in group B cells incision approaches the level of normal cells. These results correlate with survival as well as with rates of DNA semi conservative synthesis after 8-MOP photoaddition. PMID- 3670331 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. Conclusions on the genotoxicity of alcohol and recommendations for further work. PMID- 3670332 TI - Methapyrilene is a genotoxic carcinogen: studies on methapyrilene and pyrilamine in the L5178Y/TK +/- mouse lymphoma assay. AB - Methapyrilene (MP), a sedating antihistamine, is a potent rat hepatocarcinogen which has been thought to be non-genotoxic on the basis of the negative results in a small number of short-term mutagenicity tests. The present studies show that MP is a moderately active mutagen in the L5178Y/TK +/-----TK-/- mouse lymphoma assay (MLA) in the presence of aroclor-induced rat-liver S9, and that it induces predominantly small-colony thymidine kinase-deficient (TK-/-) mutants of demonstrated chromosomal origin. 10 of 12 small colony TK-/- mutants analyzed by banded karyotype (230-band level of resolution) show aberrations to chromosome 11b, the known location of the single functional TK gene in these cells. The observed aberrations from nine of the mutants included insertions, deletions and translocations while the tenth mutant had highly rearranged, multiple copies of chromosome 11 segments. By varying the concentrations of the S9 protein and cofactors it was shown that our standard S9 composition was close to optimum for activating MP to a mutagen. The activity and stability of various lots of S9 prepared in-house or purchased from a contract laboratory revealed significant differences. The ability of 2 lots of in-house S9 to activate a standard concentration of MP increased rapidly over the first 4 weeks of liquid nitrogen storage then declined slowly over the next 16 weeks. Three separate lots of purchased S9 were essentially inactive for the first 2 weeks of liquid nitrogen storage then increased in activity thereafter; these were the only occasions in which MP was not mutagenic in our hands. The mutagenic activity of pyrilamine (PYR), a structurally related antihistamine which is far less carcinogenic in rats, but easily detected in short-term tests as being genotoxic, was also investigated in the MLA. PYR was slightly less mutagenic than MP over a comparable range of concentrations, and also induced predominantly small-colony mutants. These studies fail to adequately explain the great carcinogenic differences between these two compounds, but are consistent with the potent hepatocarcinogenicity of MP resulting through a mutagenic mechanism. PMID- 3670333 TI - Genotoxicity of analgesic compounds assessed by an in vitro micronucleus assay. AB - Several analgesic compounds and mixtures of analgesics were examined for both cytotoxicity and ability to induce chromosomal damage in the normal rat-kidney cell line NRK-49F. Chromosomal damage was assessed using an in vitro micronucleus assay. Of all the compounds tested, only N-hydroxyparacetamol caused a high degree of cell death at the concentrations used. 4 analgesic compounds were found to be inducers of micronuclei in NRK cells; in order of decreasing potency these were: N-hydroxyparacetamol, N-hydroxyphenacetin, caffeine and paracetamol. An aspirin, phenacetin, caffeine mixture (APC) failed to induce micronuclei above the background level, and a paracetamol-codeine combination did not increase the level of micronuclei induction above that induced by paracetamol alone. This report suggests paracetamol and some related compounds are capable of inducing chromosomal damage in mammalian cells in vitro, which is consistent with recent reports of a possible paracetamol-DNA interaction. PMID- 3670334 TI - Mutagenicity of instant coffee and its interaction with dimethylnitrosamine in the micronucleus test. AB - The mutagenicity of instant coffee and its interaction with dimethylnitrosamine (DMN) were examined in mice using the micronucleus test. Although neither a single nor multiple administration of instant coffee by gavage induced a significant rise in micronucleated cells over the dose range tested (100-2500 mg/kg), there was a tendency for the number of micronucleated cells to increase in a dose-related fashion. When coffee was administered with DMN, the difference in the frequency of micronucleated cells was small in comparison to a single treatment with DMN alone, thus indicating a lack of synergism between coffee and DMN. PMID- 3670335 TI - Effects of antimutagenic flavourings on SCEs induced by chemical mutagens in cultured Chinese hamster cells. AB - Effects of antimutagenic flavourings such as vanillin, ethylvanillin, anisaldehyde, cinnamaldehyde, coumarin and umbelliferone on the induction of SCEs by MMC were investigated in cultured Chinese hamster ovary cells. None of these 6 flavourings showed any SCE-inducing activity by themselves. However, an obvious increase in the frequencies of SCEs was observed when MMC-pretreated cells were cultured in the presence of each flavouring. All these compounds have either an alpha, beta-unsaturated carbonyl group or a carbonyl functionality neighbouring the phenyl group which may react with an enzyme SH-group and cause higher-order structure changes. SCE-enhancing effects of vanillin were further investigated on 6 other kinds of mutagens. Vanillin was also effective on SCEs induced by EMS, ENNG, ENU or MNU. On the other hand, MMS- or MNNG-induced SCEs were not influenced at all by vanillin. SCE-enhancing effects of vanillin seemed to be dependent on the quality of lesions in DNA. PMID- 3670336 TI - In vivo and in vitro cytogenetic damage induced by sodium nitrite. AB - The mutagenicity of sodium nitrite was assayed by in vivo and in vitro experiments. The in vivo experiments were carried out in male rats and mice intragastrically treated twice, with an interval of 24 h, with nitrite in doses of 1.72, 5.18, 15.55 and 46.66 mg/kg body weight and in male rabbits treated with the same doses of nitrite administered daily in drinking water for 3 months. Chromosomal aberration analysis was conducted in all 3 species of animals and micronucleus induction was only evaluated in mice. Nitrite induced increases in aberrant metaphases in all 3 species of animals. Likewise, in mice it induced increases of the numbers of micronucleated polychromatic erythrocytes and a light bone marrow depression. Neither in the increases of the numbers of chromosomal aberrations nor in that of micronuclei, were dose-related responses observed. The in vitro experiments were carried out on BSC-1 and HeLa cells grown in cultures with nitrite in doses of 0.265 and 0.530 mg/ml for 24 h. Both doses produced significant increases of the percentage of chromosomal aberrations but also without demonstration of positive dose-effect relationships. PMID- 3670337 TI - Factors that affect the sensitivity of the in vivo-in vitro hepatocyte DNA repair assay in the male rat. AB - Measurement of chemically induced DNA repair as unscheduled DNA synthesis (UDS) in rat hepatocytes following in vivo exposure has been shown to be a useful indicator of the genotoxicity of chemicals in rat liver. We have examined some of the parameters of this assay in an attempt to increase its sensitivity and reduce cytoplasmic backgrounds. Fischer-344 rats were treated with a low dose of a known positive chemical, water, or corn oil. Livers were perfused with a collagenase solution and isolated hepatocytes were incubated with [3H]thymidine (3H-TdR) followed by overnight incubation in unlabeled TdR, then cell fixation and washing. UDS was measured by quantitative autoradiographic grain-counting as net grains/nucleus (NG). Incubation in 3H-TdR ranging in age from 1 week to more than 12 months gave highly variable background (BKG) and NG counts and a slight overall decrease in NG when the 3H-TdR used was more than 4 months old. Control BKG was 3 times higher after 19 h than after 4 h of incubation in 3H-TdR, with little change in NG. Incubation in unlabeled TdR also reduced BKG significantly. Reduction of autoradiogram exposure from two to one week cut BKG in half without significantly reducing NG. A half-hour wash in fixative (1:3 acetic acid:ethanol) followed by two water washes was as effective in reducing BKG as three 10-min washes in fixative followed by 6 water washes, and resulted in better overall cell attachment. An examination of the distribution of historical control data shows that vehicle control animals never exceed zero NG. This suggests that any NG response greater than zero should be viewed as a possible positive response. PMID- 3670338 TI - Cytogenetic effects of 1-p-(3-methyltriazeno)benzoic acid potassium salt on human lymphocytes in vitro. AB - The triazene derivative 1-p-(3-methyltriazeno)benzoic acid potassium salt (MTBA) shows pharmacological properties similar to those of 5-(3,3-dimethyl-1 triazeno)imidazole-4-carboxamide (DTIC, trade name dacarbazine), which is known to induce antigenic modulation in tumor cells (xenogenization) and is currently used in cancer therapy. Mutagenic, teratogenic and cancerogenic properties of triazene derivatives have been demonstrated but there is no report on their possible clastogenicity. We describe here the in vitro cytogenetic effects of MTBA on human peripheral blood lymphocytes. The drug was tested at different culture times in a range of concentrations from 2 to 500 micrograms/ml. MTBA caused a dose-dependent increase in the frequency of chromosomal breaks. Different blood donors showed different sensitivity to the treatment. Cell proliferation, as evaluated by [3H]thymidine incorporation, was inhibited at the highest concentrations of the drug. These data might be relevant for comparison with in vivo effects of the drug in clinical trials and to investigate the possible relations between xenogenization induced by MTBA and its genetic and cytogenetic effects in human lymphocytes. PMID- 3670339 TI - Cytogenetic study of a group of workers exposed to thinner. AB - The frequency of sister-chromatid exchanges (SCE) was evaluated in a group of 24 workers exposed to thinner in a luminous advertisements factory and in three workshops for painting sheet metal in Mexico City. 50 metaphases for each exposed individual and each control were analysed; air samples of the working places were also studied; it was observed that among all the components of thinner, only benzene exceeded advisable limits. The cytogenetic data were subject to one-way analyses of variance indicating that no significant differences existed between both groups; also, there are no significant differences among workers with a long exposure time and those with fewer than 5 years of exposure. Nevertheless, use of tobacco increased significantly the SCE frequencies among the exposed group, but did not increase SCE in the control group. PMID- 3670340 TI - Sino-orbital and cerebral aspergillosis: cure with medical therapy. PMID- 3670341 TI - Evaluation of the skin retention time of imidazole derivatives. PMID- 3670342 TI - Uptake and esterification of arachidonic acid by trophozoites of Giardia lamblia. AB - Although trophozoites of Giardia lamblia have not been demonstrated to possess the capacity for synthesis of phospholipids, these protozoan parasites would be exposed to fatty acids within the human small intestine. We have evaluated the metabolic incorporation of arachidonic and palmitic acids by Giardia trophozoites. Trophozoites (2.25 X 10(6)) were incubated with 12 nM [3H]fatty acid for up to 60 min. Uptake of [3H]arachidonate by trophozoites was rapid, increasing from 37% at 1 min to 65% at 10 min. Uptake of palmitate was rapid but less extensive. In contrast to palmitate, almost all of the trophozoite associated [3H]arachidonate was esterified into phospholipids and neutral lipids. By 1 and 60 min 37% and 82% of [3H]arachidonate, respectively, were incorporated into phospholipids, including phosphatidylinositol and phosphatidylcholine. Peak incorporation of [3H]arachidonate into phosphatidylcholine (30 mmol [3H]fatty acid (mol phospholipid)-1) occurred at 60 min; whereas incorporation into the pool of phosphatidylinositol, which accounted for only 4% of trophozoite phospholipid, was maximal at 10 min (190 mmol [3H]fatty acid (mol phospholipid) 1) and declined significantly thereafter as arachidonic acid was released from phosphatidylinositol. Therefore, Giardia trophozoites not only utilize exogenous fatty acids in the formation of glycerolipids but also preferentially incorporate arachidonic acid into a metabolically active pool of phosphatidylinositol. PMID- 3670343 TI - Analysis of ecdysteroids in different developmental stages of Hymenolepis diminuta. AB - Prepatent and patent adult Hymenolepis diminuta from the intestines of rats, H. diminuta eggs recovered from the faeces of rats harbouring patent infections, and infective cysticercoids from the beetle intermediate host were analysed for free and conjugated ecdysteroids. Adult worms and eggs contained both free ecdysteroids and hydrolysable polar conjugated ecdysteroids, with comparatively large amounts of immunoreactive material also being detected following hydrolysis of the possible apolar conjugated ecdysteroid fraction. Free ecdysteroids were not detected in the cysticercoid sample. The concentration of free ecdysteroids in H. diminuta eggs was higher than that detected in the tissues of the adult worms. Ecdysone and 20-hydroxyecdysone were the major identified compounds of the free ecdysteroid fraction, whereas in the hydrolysed polar conjugated ecdysteroid fraction these two compounds were accompanied by 20,26-dihydroxyecdysone. The free ecdysteroid fraction also contained comparatively large amounts of unidentified immunoreactive material. PMID- 3670345 TI - Identity and tissue localization of free and conjugated ecdysteroids in adults of Dirofilaria immitis and Ascaris suum. AB - Adult males and females of the dog heartworm, Dirofilaria immitis, and of the swine parasite, Ascaris suum, were extracted, the free and polar conjugated ecdysteroid fractions separated and the latter hydrolysed enzymically. The ecdysteroids released by hydrolysis of the conjugates and the free hormones were analysed by radioimmunoassay, high-performance liquid chromatography on reversed phase and adsorption columns monitoring fractions by radioimmunoassay, and by gas liquid chromatography/mass spectrometry (selected ion monitoring). In both species, males and females contained free and polar conjugated ecdysteroids, with evidence for the presence primarily of ecdysone and 20-hydroxyecdysone together with smaller amounts of 20,26-dihydroxyecdysone. Males and females of both species were then dissected into body fluid, reproductive system, gut and remaining body wall compartments, the ecdysteroids extracted, fractionated and analysed by radioimmunoassay and high-performance liquid chromatography monitoring fractions by radioimmunoassay. The results for both sexes in the two species were similar and indicated that ecdysteroids were not detectable in body fluids and that free ecdysteroids occurred in the reproductive system and the body wall, whereas polar conjugated ecdysteroids were detected in the reproductive system and the gut; a minor portion of the free ecdysteroids in A. suum was also apparently present in the gut. Further localization of the ecdysteroids in the body wall of A. suum females suggested that negligible immunoreactivity was associated with the circumpharyngeal nerve ring. The possible significance of the results is discussed. PMID- 3670344 TI - Identification of two integral glycosomal membrane proteins in Trypanosoma brucei. AB - Glycosomal membranes of bloodstream form Trypanosoma brucei were purified to apparent homogeneity by sodium carbonate treatment and found to contain two major integral membrane proteins of 26 kDa (band 10) and 24 kDa (band 11). The procyclic-form glycosomal membranes isolated by the same procedure also resulted in a homogeneous preparation, but each piece of membrane thus purified was associated with an electron-dense granule. Procyclic membranes also contained primarily bands 10 and 11. These two proteins were selectively reduced by protease treatment of intact glycosomes, suggesting surface exposed domain(s) of the two proteins accessible to proteolytic digestion. They and band 8 protein also vanished in glycosomal lysates by apparent proteolysis, implying the presence of a specific protease which degrades the integral membrane proteins upon the loss of membrane integrity. The two proteins, hydrophobic in nature and apparently unglycosylated, have no known biological functions, but their possible involvement in translocating precursor proteins from the cytoplasm into the glycosome of T. brucei is postulated. PMID- 3670346 TI - Identification of immunodominant surface antigens of Eimeria acervulina sporozoites and merozoites. AB - Immunodominant surface antigens of Eimeria acervulina sporozoites and merozoites were identified by 125I-labeling and immunoblotting studies. Using these methodologies 60% of the immunodominant sporozoite antigens and 90% of the immunodominant merozoite antigens were observed to be 125I-surface labeled. However, several major 125I-labeled sporozoite and merozoite proteins did not represent prominent antigens as measured by immunoblotting. Immunodominant surface antigens were found over a wide size range for sporozoites (21-110 kDa) and for merozoites (20-250 kDa). In order to relate these findings to a 'natural' infection, two groups of 3-week old chickens were inoculated 5 times over a 2.5 week period with either a low or high dose of E. acervulina oocysts. The serum response to sporozoites and merozoites, indicated by enzyme-linked immunosorbent assay titers, was rapid; less than or equal to 7 days post-infection with 10(4) oocysts and less than or equal to 3 days with 10(5) oocysts. Many of the antigens identified by immunoblotting of sera from sporozoite- and merozoite-immunized animals were recognized by sera from both high dose and low dose E. acervulina infected chickens. Furthermore, the sporozoite and merozoite antigens could be grouped into those constituents which induced a serum response early or late in the infection. PMID- 3670347 TI - Protective antigen in the membranes of mouse erythrocytes infected with Plasmodium chabaudi. AB - A malarial antigen, Pc96, in the plasma membrane of erythrocytes infected with Plasmodium chabaudi has been identified. It is synthesized by the parasite and present during most of the growth stages of the intra-erythrocytic cycle as demonstrated by immunofluorescence. The antigen has a molecular weight of approximately 96,000. Monoclonal antibodies raised against this antigen were used to isolate the protein by affinity chromatography. Mice immunized with affinity purified Pc96 were partially protected against blood induced-P. chabaudi infection. This result indicates the existence of a protective antigen in the membranes of erythrocytes parasitized by a rodent malaria and encourages the search for analogous antigens in human malaria parasites as possible candidate molecules for malaria vaccination. PMID- 3670348 TI - Outbreak of severe hepatitis due to delta and hepatitis B viruses in parenteral drug abusers and their contacts. AB - We investigated an unusually large and severe outbreak of hepatitis B, primarily involving parenteral drug abusers and their sexual contacts, in Worcester, Massachusetts, over a 21-month period from 1983 to 1985. Of 135 patients with drug-related acute hepatitis B, 81 percent were parenteral drug abusers and 19 percent had sexual contact with drug abusers; 13 fulminant cases resulted in 11 deaths. Among the patients with hepatitis B, evidence of delta virus infection was found in 54 percent of drug abusers, 33 percent of their sexual contacts, and 9 percent of other patients with acute hepatitis B (P less than 0.001). Most of the delta infections (86 percent) were coinfections with hepatitis B virus; the balance were superinfections. Delta infection was strongly associated with fulminant hepatitis: 91 percent of patients with a fulminant outcome had delta infection, as compared with 45 percent of less severely ill drug abusers and their contacts (P = 0.0037). Alcohol, other drugs, and other hepatitis viruses could not be implicated as hepatotoxic cofactors for fulminant disease. This outbreak appeared to result from the concurrent spread of hepatitis B and delta viruses among new drug users. Control measures included the distribution to physicians of guidelines on prophylaxis in contacts of patients with hepatitis B, health education for drug abusers, and a hepatitis B vaccination program. Despite these efforts, the outbreak continued unabated until the number of new cases began to decline slowly in late 1986. PMID- 3670349 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 46-1987. A 31-year-old woman with secondary amenorrhea. PMID- 3670350 TI - Must we always use CPR? PMID- 3670351 TI - Alcohol and breast cancer. PMID- 3670352 TI - Aplastic anemia, malignant lymphoma, and the acquired immunodeficiency syndrome. PMID- 3670353 TI - Hymenoptera uvulitis. PMID- 3670354 TI - Sudden death in hypothyroidism. PMID- 3670355 TI - Drunk drivers and medical and social injury. AB - Alcohol-related traffic injuries are a major cause of death, pain, and suffering and a major contributor to health care costs in the United States. We reviewed the medical and legal consequences of 252 motor vehicle accidents involving drivers admitted to St. Mary's Hospital between 1981 and 1985, with particular attention to patients with a blood alcohol concentration equal to or above the legally defined threshold for intoxication (100 mg per deciliter). There were 84 such patients, with a median blood alcohol level of 218.5 mg per deciliter. Few of these patients were referred either to alcoholism-rehabilitation programs or to the courts for prosecution. We conclude that both drunk drivers and the population at large are poorly served by current medical and legal practices. Because denial of reality and prevarication are hallmarks of alcoholism, we make two recommendations. First, in order to encourage physicians to refer all injured patients with high blood alcohol concentrations to detoxification and rehabilitation programs, injury to intoxicated drivers should be made a reportable condition. Second, prosecution for driving under the influence of alcohol should be made easier by simplifying the procedures for providing the courts with blood alcohol measurements obtained as part of normal clinical care. Physicians must act in the interest of their patients. The two recommended changes in current practice would help provide a firm framework within which physicians could advise patients about appropriate treatment for alcoholism. If such steps are not taken or are ineffective, vigorous legal action should be encouraged, because society has the right to demand that innocent people not be endangered by intoxicated people who drive motor vehicles. PMID- 3670356 TI - Recuperating from spinal fusion. PMID- 3670357 TI - Psychiatric problems on the orthopaedic ward and the traction intolerance syndrome. PMID- 3670358 TI - Osteogenesis imperfecta: the 'brittle bone' syndrome. PMID- 3670359 TI - The care of infected wounds. PMID- 3670361 TI - [Job specification]. PMID- 3670360 TI - Incontinence: can drugs help? PMID- 3670362 TI - The management of patients with head injuries. Part three. PMID- 3670363 TI - Infections associated with orthopaedic surgery. PMID- 3670364 TI - [Diagnosis and management of scoliosis]. PMID- 3670365 TI - Squibb boosts Oxford pharmacology lab. PMID- 3670366 TI - Changes ahead for US policy on biotechnology regulations. PMID- 3670367 TI - What future now for Japanese biotechnology research? PMID- 3670368 TI - French AIDS campaign criticized as too soft by volunteer groups. PMID- 3670369 TI - California gives radiation-safety violations a short half-life. PMID- 3670370 TI - Animal models. PMID- 3670371 TI - Does the T-cell receptor bind to the MHC? PMID- 3670372 TI - Strand segregation or recombination. PMID- 3670373 TI - Migration rates of human populations from surname distributions. AB - Migration is an important factor in the biological evolution of human populations, and surnames provide one of the simplest records of identification. The distribution of surnames can supply quantitative information on the structure of human populations. Surnames considered as alleles of a gene transmitted only by the male line can be assumed to be neutral markers and therefore satisfy the expectations of the neutral theory of evolution, which is entirely described by random genetic drift, mutation and migration. As data on surnames are easier to collect than those from genes, the information yield is potentially increased, but the validity of the conclusions must be tested in actual samples. The purpose of this report is to compare the estimates of migration rates in Italy, as inferred by the surname distribution found in the telephone directories and other sources, with the corresponding estimates from official demographic sources. Our findings show that in these samples the ratio of surnames to individuals makes it possible to calculate reliable estimates of migration rates. PMID- 3670374 TI - Latent synaptic pathways revealed after tetanic stimulation in the hippocampus. AB - Synaptic plasticity may result from changes at existing synapses or from alterations in the number of functional synaptic connections. In the hippocampus excitatory synaptic strength is persistently enhanced after tetanic stimulation. Here we report that latent synaptic pathways may also become functional. Simultaneous intracellular recordings were made from pairs of CA3 pyramidal cells in slices from guinea pig hippocampus. After stimulating afferent fibres repetitively, polysynaptic excitatory pathways between previously unconnected cells became apparent. The efficacy of recurrent inhibitory circuits was also reduced. The loss of inhibitory control is of interest because latent excitatory pathways are revealed after pharmacological suppression of inhibition. This plasticity in local synaptic circuits leads to the emergence of synchronous firing in groups of CA3 cells. The formation of groups of associated cells and the ability of some cells to initiate synchronous firing in a larger cell group through recurrent pathways is reminiscent of several models of information storage and recall in the cortex. PMID- 3670375 TI - Corticofugal feedback influences the generation of length tuning in the visual pathway. AB - In the feline visual system, neurons exhibiting sensitivity to the length of a moving contour were first observed in the cortex and described as 'hypercomplex cells'. In these cells an increase in stimulus length beyond an optimal value leads to a rapid decline in response. This decline has been attributed to an intracortical inhibitory input which may be driven by layer VI cells with very long receptive fields. It is now clear, however, that cells in the dorsal lateral geniculate nucleus (dLGN), exhibit a degree of length tuning similar to that of cortical 'hypercomplex cells', suggesting that this response property could be generated subcortically. Alternatively, as the dLGN receives a massive corticofugal projection from layer VI cells in the visual cortex, it is possible that this input has a function in generating length tuning in the dLGN. We have investigated this issue by comparing the length tuning of dLGN cells with and without corticofugal feedback. The data show that corticofugal feedback makes a highly significant contribution to the length tuning of dLGN cells. This raises the possibility that length tuning is an emergent property of the geniculo cortical loop. PMID- 3670376 TI - Oestrogen and glucocorticoid responsive elements are closely related but distinct. AB - DNA sequences recognized by the glucocorticoid receptor are termed glucocorticoid responsive elements because of their stimulatory effect on transcription. An oligonucleotide of 15 base pairs having partial or perfect symmetry is necessary for glucocorticoid induction and this same oligonucleotide is surprisingly also recognized by the progesterone receptor. Here we define a palindromic sequence of 15 base pairs, modelled after a sequence element shared by the vitellogenin genes of frog and chicken, which confers oestrogen inducibility on a heterologous promoter and can be converted into a glucocorticoid-responsive element by substitution of one or two bases at homologous positions in the palindrome. Considered with the observation that the DNA-binding domains of steroid receptors are closely related, this finding demonstrates that the steroid-responsive elements constitute a family of related DNA sequences. PMID- 3670377 TI - AIDS drug gets green light. PMID- 3670378 TI - Bhopal aftermath re-assessed. PMID- 3670379 TI - Merck's new drug free to WHO for river blindness programme. PMID- 3670380 TI - Harvesting human embryos. PMID- 3670381 TI - When learning guides evolution. PMID- 3670382 TI - A darwinian theory of divorce. PMID- 3670383 TI - Ocean flux of Chernobyl fallout. PMID- 3670384 TI - Soviet science. Must the young carry all the weight? PMID- 3670385 TI - Molecular genetics: another refuge from Lysenko? PMID- 3670386 TI - Siberian genetics: putting Lysenko behind them. PMID- 3670387 TI - Chernobyl radionuclides in a Black Sea sediment trap. AB - The Chernobyl nuclear power station accident released large quantities of vaporized radionuclides, and, to a lesser extent, mechanically released small (less than 1-10 micron) aerosol particles. The total release of radioactivity is estimated to be out of the order of 1-2 x 10(18) Bq (3-5 x 10(7) Ci) not allowing for releases of the xenon and krypton gases. The 137Cs releases of 3.8 x 10(16) Bq from Chernobyl can be compared to 1.3 x 10(18) Bq 137Cs released due to atmospheric nuclear weapons testing. Chernobyl-derived radionuclides can be used as transient tracers to study physical and biogeochemical processes. Initial measurements of fallout Chernobyl radionuclides from a time-series sediment trap at 1,071 m during June-September 1986 in the southern Black Sea are presented. The specific activities of 137Cs, 144Ce and 106Ru in the trap samples (0.5-2, 4 12 and 6-13 Bq g-1) are independent of the particle flux while their relative activities reflect their rates of scavenging in the order Ce greater than Ru greater than Cs. PMID- 3670388 TI - Chernobyl nuclide record from a North Sea sediment trap. AB - Nuclides liberated by explosion and subsequent fire at Chernobyl No. 4 reactor on 26 April 1986, travelled to Western Europe with lower tropospheric air masses. They reached the northern Alps and Paris on 30 April, southern Great Britain on 2 May, the southern North Sea on 3 May, and the northern North Sea on 3 May and again on 8 May. Levels of deposited activity varied by a factor of 30 or more over distances less than 100 km because of variability of rainfall. A sediment trap deployed 222-m-deep in the North Sea off Bergen recorded the onset and magnitude of the deposition of Chernobyl nuclides. The trap collected 13 samples between 24 April and 21 September 1986. The flux of nuclides adsorbed to particles sinking from surface waters to sediments started less than ten days after contaminated air reached the site. Maximum specific activity occurred on 16 27 May for 137Cs, 134Cs, 106Ru and 103Ru, and on 8-20 June for 144Ce, 95Nb and 95Zr. The highest activity was found for 103Ru. The highest total specific activity of these nuclides in depositing sediments reached 670,000 Bq kg-1, and the highest total activity flux for one day amounted to 50 Bq m-2. PMID- 3670389 TI - Growth inhibition by protein kinase C late in mitogenesis. AB - The importance of alpha-thrombin in the clotting cascade is well-known, but it is also a potent mitogen. Like many other mitogens, thrombin causes receptor mediated activation of a phosphatidylinositol-specific phospholipase C (PLC), leading to the release of diacylglycerol and the subsequent activation of protein kinase C (refs 3-6). Protein kinase C is probably important in cell proliferation, as activation of this enzyme by phorbol esters promotes growth in many systems. Some growth factors have tyrosine kinase activity and function without activation of PLC or protein kinase C. In this report we show that alpha thrombin retains its mitogenicity in vascular smooth muscle cells depleted of protein kinase C. Phorbol-12-myristate-13-acetate (PMA) is found to be a potent growth inhibitor when added to vascular smooth muscle cells with alpha-thrombin. Moreover, growth inhibition is maximal when protein kinase C is activated 4 hours after exposure to thrombin, long after the completion of 'early events' induced by thrombin. Thus, PMA probes an event late in the G1 phase of the cell cycle or at the G1-S transition. PMID- 3670390 TI - Duplication and remoulding of tRNA genes during the evolutionary rearrangement of mitochondrial genomes. AB - During the evolution of sea urchins, a transfer RNA gene lost its tRNA function and became part of a protein-coding gene. This functional loss of a tRNA with specificity for one group of leucine codons (CUN, where N is any base) was accompanied by the gain of a new tRNA with that specificity. The new tRNA gene for CUN codons appears to have evolved by duplication and divergence from a tRNA gene specific for another group of leucine codons (UUR, where R is a purine). These proposals account for (1) the strong sequence resemblance between the modern tRNA genes for CUN and UUR codons in Paracentrotus, (2) the altered location of the CUN gene in mitochondrial DNA of this urchin, and (3) the persistence of a 72-base pair sequence containing a trace of the old CUN gene at its original location. The old CUN gene now codes for an extra 24 amino acids at the amino end of subunit 5 in NADH dehydrogenase. Besides giving clues about the mechanisms by which tRNA genes move during mitochondrial DNA evolution, this finding leads us to propose a pathway relating the arrangements of other genes in mitochondrial DNAs from four animal phyla. PMID- 3670391 TI - Cognition: connections and controversy. PMID- 3670393 TI - Celltech undeterred by crash of '87. PMID- 3670392 TI - What about protein polarity? PMID- 3670394 TI - Soviets admit improper committal to mental hospitals. PMID- 3670395 TI - Dwarfism in an adolescent from the Italian late Upper Palaeolithic. AB - There have been numerous reports of pathological conditions in the hominid fossils, but these have only involved trauma or age-related deterioration in the health of otherwise normal individuals. Here we describe a skeleton of a young male from Riparo del Romito in Calabria, dated to the Epi-Gravettian of southern Italy. The preserved skeletal elements show that this individual (Romito 2) had the skull and long-bone morphology consistent with a mesomelic form of dwarfism, most probably the autosomal recessive disorder acromesomelic dysplasia. Generally recognized at birth, persons with acromesomelic dysplasia usually have normal intelligence and are free of serious medical problems. However, growth deficiency is severe (adult height typically is 110-120 cm) and mobility at the elbows is restricted. These physical impairments would have greatly interfered with the individual's participation in subsistence activities and would have been a substantial handicap in a nomadic hunting and gathering group. Thus, besides being the earliest known case of dwarfism in the human record, this skeleton provides evidence of tolerance of, and care for, a severely deformed individual in the Palaeolithic. PMID- 3670396 TI - A gene affecting the specificity of the chemosensory neurons of Drosophila. AB - The sensilla on the proboscis and tarsi of Drosophila contain five neurons, four chemosensory and one mechanosensory. The sugar-sensitive neuron, designated S, carries independent acceptor sites for pyranose, furanose and trehalose. Two others, L1 and L2, respond to salts. The fourth neuron, W, is inhibited by salts and sugars, and is believed to mediate detection of water. We describe here a gene in which mutations alter the neurons in such a way that the S cell is excited by salts. As a result, the mutant flies are strongly attracted by NaCl at concentrations which are repellent to the wild type. To our knowledge, this is the first instance of a mutation which changes the specificity of the chemosensory neurons. PMID- 3670397 TI - Vitamin K-dependent blood coagulation proteins form hetero-dimers. AB - The later stages of the blood coagulation cascade are characterized by the presence of vitamin K-dependent proteins and their involvement in membrane-bound, multi-protein converting complexes with an essential requirement for calcium ions. Specific interactions between zymogens and activating enzymes have not yet been identified. Here we describe a crystallographic study of prothrombin fragment 1 (residues 1-156 of prothrombin) which indicates that vitamin K dependent coagulation proteins have specific association sites that allow them to form hetero-dimers. The calcium-induced formation of a hetero-dimer between fragment 1 and factor X is demonstrated by cross-linking. Such hetero-dimers of vitamin K-dependent proteins could be significant in the coagulation system. PMID- 3670398 TI - Synaptic physiology: inhibition by acidification? PMID- 3670399 TI - Plasma lipoproteins: teaching old dogmas new tricks. PMID- 3670400 TI - cDNA sequence of human apolipoprotein(a) is homologous to plasminogen. AB - Lipoprotein(a) is an LDL-like lipoprotein whose concentration in plasma is correlated with atherosclerosis. The characteristic protein component of lipoprotein(a) is apolipoprotein(a) which is disulphide-linked to apolipoprotein B-100. Sequencing of cloned human apolipoprotein(a) complementary DNA shows that it is very similar to human plasminogen. It contains a serine protease domain and two types of plasminogen-like kringle domains, one of which is present in 37 copies. PMID- 3670401 TI - Postsynaptic fall in intracellular pH induced by GABA-activated bicarbonate conductance. AB - Synaptic inhibition mediated by gamma-aminobutyric acid (GABA) is known to involve opening of receptor-gated chloride channels. Recent evidence indicates that these channels also show a significant permeability to the physiologically important bicarbonate anion. In all the excitable cells studied to date, the intracellular pH (pHi) is higher than would be predicted from a passive distribution of H+ ions, and consequently there is an outwardly directed electrochemical driving force for HCO3-. In the presence of CO2/HCO3- therefore, activation of GABA-gated channels could give rise to a significant efflux of bicarbonate, leading to a fall in postsynaptic pHi. We have examined the influence of GABA on pHi in crayfish skeletal muscle and we find that in the presence of CO2, GABA induces a dramatic fall in pHi which is coupled to an alkalosis at the extracellular surface. This fall in pHi and the extracellular alkalosis are attributable to a GABA-activated, picrotoxin-sensitive HCO3- conductance. In view of the sensitivity of ion channels and intracellular ion concentrations to changes in pHi, a GABA-induced postsynaptic acidosis could prove to be important in the modulation of inhibitory transmission. PMID- 3670402 TI - Retrograde transport by the microtubule-associated protein MAP 1C. AB - Microtubules are involved in several forms of intracellular motility, including mitosis and organelle movement. Fast axonal transport is a highly ordered form of organelle motility that operates in both the anterograde (outwards from the cell body) and retrograde (from the periphery towards the cell body) direction. Similar microtubule-associated movement is observed in non-neuronal cells, and might be involved in secretion, endocytosis and the positioning of organelles within the cell. Kinesin is a mechanochemical protein that produces force along microtubules in an anterograde direction. We recently found that the brain microtubule-associated protein MAP 1C (ref. 7) is a microtubule-activated ATPase and, like kinesin, can translocate microtubules in an in vitro assay for microtubule-associated motility. MAP 1C seemed to be related to the ciliary and flagellar ATPase, dynein, which is thought to produce force in a direction opposite to that observed for kinesin. Here we report that MAP 1C, in fact, acts in a direction opposite to kinesin, and has the properties of a retrograde translocator. PMID- 3670404 TI - New effort starts up to evaluate AIDS education in United States. PMID- 3670405 TI - AIDS virus cultured. PMID- 3670403 TI - Castration pleases bulls? PMID- 3670406 TI - DNA fingerprint ruling. PMID- 3670407 TI - UK compensates AIDS haemophiliacs. PMID- 3670409 TI - Battles on radiation safety. PMID- 3670408 TI - Potential carcinogens are under-regulated says OTA report. PMID- 3670410 TI - The structure of an oligo(dA).oligo(dT) tract and its biological implications. AB - Poly(dA).poly(dT) has unusual properties in that it cannot associate into nucleosomes and short, phased runs of it cause DNA bending. The crystal structure of a B-type DNA dodecamer containing a homopolymeric run of six A.T base pairs shows that this region possesses special structural features, including a system of bifurcated hydrogen bonds, which explains some of the properties of this simple homopolymer. PMID- 3670411 TI - Inhibition of mitosis by an antibody to the mitotic calcium transport system. AB - Calcium ions are important in the regulation of mitotic apparatus assembly and in the control of chromosome movement. Changes in intracellular free calcium concentration, [Ca2+]i are achieved by an intracellular calcium-transport system which is highly conserved in different cell types. A membrane-bound protein of relative molecular mass (Mr) 46,000 (46K) is part of this transport system and has been implicated in the regulation of the [Ca2+]i changes associated with the course of mitosis. A monoclonal antibody against this 46K protein inhibits Ca2+ uptake into isolated Ca2+-sequestering membranes and specifically labels membranes associated with the mitotic apparatus of sea urchin embryos. Here we investigate the relationship between the intracellular calcium transport system and mitosis by injection of this monoclonal antibody into living mitotic sea urchin embryos. We find that after injection the intracellular free calcium increases up to 10(-6) M, the mitotic apparatus is rapidly destroyed and the cell is irreversibly blocked in its development. PMID- 3670412 TI - Thrombosis induction by different carrageenans in rats and mice. PMID- 3670413 TI - [The family physician with a difficult-to-diagnose case]. PMID- 3670415 TI - [AIDS and pregnancy]. PMID- 3670414 TI - [Current developments in the drug treatment of cholesterol gallstones]. PMID- 3670416 TI - [Cervical lymph node metastasis of an unknown primary tumor]. PMID- 3670417 TI - [Brain infarct as a possible side effect of antihypertensive treatment]. PMID- 3670418 TI - [Possibilities and limitations of scintigraphy of the parathyroid glands]. PMID- 3670419 TI - [Treatment and abstaining policy for newborn infants with a poor prognosis for living]. PMID- 3670421 TI - [Minoxidil: hope for bald people?]. PMID- 3670422 TI - [Abdominal pain or acute abdomen]. PMID- 3670420 TI - [Medical ethics education in the United States and The Netherlands]. PMID- 3670423 TI - [Diagnosis and treatment of patients with liver metastases from colon carcinoma]. PMID- 3670424 TI - [Recurrent obstruction ileus caused by adhesions]. PMID- 3670425 TI - [The treatment of left-sided cardiac decompensation, hypertensive crisis and acute heart infarct with sodium nitroprusside]. PMID- 3670426 TI - [Acute cellulitis following gynecologic-obstetrical operations]. PMID- 3670427 TI - [Results of psychiatric interventions in patients with symptoms of a depressive nature, admitted to internal medicine departments]. PMID- 3670428 TI - [Methods of detection and treatment of liver metastases in the Western world]. PMID- 3670429 TI - [Management of pain, recommendations of the Public Health Council]. PMID- 3670430 TI - [Recommendations of the Public Health Council in relation to carefulness in euthanasia]. PMID- 3670431 TI - [Ischemic colitis]. PMID- 3670432 TI - [What can be done for mother and child in the case of irregular antibodies in pregnant Jehovah's Witnesses?]. PMID- 3670433 TI - [Drugs and therapeutic methods, an alternative approach]. PMID- 3670434 TI - [Phlebography in deep venous thrombosis; indications and methods]. PMID- 3670435 TI - [Drugs in hyperlipidemia]. PMID- 3670436 TI - [Blood pressure and serum lipids: a question of balancing]. PMID- 3670437 TI - [Diagnosis of cardiovascular diseases using electron spin resonance tomography]. PMID- 3670438 TI - [Initial experiences with iodine-121 implantation in 41 patients with prostatic carcinoma]. PMID- 3670440 TI - [Constipation in the elderly]. PMID- 3670439 TI - [Tympanoplasty using preserved tympanic membranes]. PMID- 3670441 TI - [Psychiatric diagnosis in 1986; on DSM-III and other developments]. PMID- 3670442 TI - [Psychological and sexual sequelae of uterus excision]. PMID- 3670443 TI - [2d-generation antidepressive agents]. PMID- 3670444 TI - [Clinical and neuropsychological symptoms of normal pressure hydrocephalus]. PMID- 3670445 TI - [Behcet's disease]. PMID- 3670446 TI - [Electron spin resonance tomography of the musculoskeletal system]. PMID- 3670447 TI - [Maternal mortality in The Netherlands and in various other west European countries]. PMID- 3670448 TI - [Mass screening for breast cancer: remaining questions]. PMID- 3670449 TI - [Gastroesophageal reflux disease--reflux esophagitis]. PMID- 3670450 TI - [International and regional differences in mortality from disorders (partially) preventable or treatable by medical care]. PMID- 3670451 TI - [Incidence of hospitalization for dementia in Rotterdam 1981-1985]. PMID- 3670453 TI - [Islam and human reproduction]. PMID- 3670452 TI - [Trans-esophageal echocardiographic study of the thoracic aorta]. PMID- 3670454 TI - [Splenectomy: from life-saving to life-threatening intervention]. PMID- 3670455 TI - [A patient with many physical symptoms: what to do and what not to do]. PMID- 3670456 TI - [The imperative character of medical technology and the significance of 'anticipated decision regret']. PMID- 3670457 TI - [Clinical and neuropsychological characteristics of normal pressure hydrocephalus]. PMID- 3670458 TI - [Myelodysplastic syndromes: a group of preleukemic disorders]. PMID- 3670459 TI - [Medications for cough]. PMID- 3670460 TI - [Primary tumors of the lung in patients with squamous cell carcinoma of the head and neck region: a challenge]. PMID- 3670461 TI - [Recommendations in aberrant findings of cytological studies of the cervix uteri]. PMID- 3670462 TI - [Retrograde endotracheal intubation using a catheter]. PMID- 3670463 TI - [Dog bites of the face]. PMID- 3670464 TI - [Disturbed lactose resorption in Rotterdam school children of various ethnic groups]. PMID- 3670465 TI - [Cave canem: fulminant course of septicemia following a dog bite]. PMID- 3670466 TI - [Career choice and entry in the job market by basic physicians from Maastricht]. PMID- 3670467 TI - Metamizole: a 100-year-old grief. PMID- 3670468 TI - [Wilkie's syndrome]. PMID- 3670469 TI - [How useful is screening in pregnancy?]. PMID- 3670470 TI - [Post-polio syndrome]. PMID- 3670471 TI - [The 12-minute walking test in patients with chronic respiratory disease. I. Relation to the results of lung function tests]. PMID- 3670472 TI - [The 12-minute walking test in patients with chronic respiratory disease. II. Walking in the laboratory and walking in daily life]. PMID- 3670473 TI - [Computerized tomography: a cost-saving study?]. PMID- 3670474 TI - [Extension of professional education for the family physician]. PMID- 3670475 TI - [Age-specific decrease in mortality in cervix carcinoma]. PMID- 3670477 TI - [Salivary calculi]. PMID- 3670476 TI - [Poikilothermy]. PMID- 3670478 TI - [Pancreatic enzyme preparations]. PMID- 3670479 TI - [Which benign breast disorders form a risk factor for breast carcinoma ?]. PMID- 3670480 TI - [The drug data bank of the KNMP (Royal Dutch Society for the Promotion of Pharmacology)]. PMID- 3670481 TI - [Status migrainosus, a separate variant of migraine?]. PMID- 3670482 TI - [Bile duct carcinoma in the liver hilus]. PMID- 3670483 TI - [Thrombosis of a mechanical heart valve prosthesis]. PMID- 3670485 TI - [Brain infarct as a possible side effect of blood pressure-lowering treatment]. PMID- 3670484 TI - [Hyperplasia of the squamous cell epithelium of the larynx; the importance of classification]. PMID- 3670486 TI - [The family physician with a problem]. PMID- 3670487 TI - [Medical ethics education in the United States and The Netherlands]. PMID- 3670488 TI - [Extensive soft-tissue sarcoma: a hopeless situation?]. PMID- 3670489 TI - [Smoking and pregnancy, a neglected health problem]. PMID- 3670490 TI - [Misunderstandings concerning bursae of the shoulder]. PMID- 3670491 TI - [The effects of smoking during pregnancy on the birth weight percentile]. PMID- 3670493 TI - [Recurrent obstruction ileus caused by adhesions]. PMID- 3670492 TI - [Iodine and goiter in The Netherlands]. PMID- 3670494 TI - [Immunothrombocytopenia in pregnancy]. PMID- 3670495 TI - [Tuberculostatic agents]. PMID- 3670496 TI - [Immunologic diseases with sex-linked heredity; current possibilities for prevention]. PMID- 3670497 TI - [Minor complaints in family medicine; alopecia areata]. PMID- 3670499 TI - [Role perception of physicians at general hospitals]. PMID- 3670498 TI - [Surgery of obstruction of the carotid artery; a retrospective study]. PMID- 3670500 TI - [Treatment and policy of abstaining in neonates with an infaust prognosis for living]. PMID- 3670501 TI - [Clinico-genetic aspects, early diagnosis and neurosurgical treatment of familial, intracranial aneurysm]. PMID- 3670502 TI - [Physical examination in diseases following return from (sub)tropical areas]. PMID- 3670503 TI - [Vasculitis: a spectrum of divergent disease pictures with a common pathogenesis]. PMID- 3670504 TI - [Treatment of the spastic pelvic floor syndrome using biofeedback]. PMID- 3670505 TI - [Frey's syndrome]. PMID- 3670506 TI - The biopsy. PMID- 3670507 TI - Gastric stromal tumors. PMID- 3670509 TI - Why are you in my room? PMID- 3670508 TI - Growth arrest following a minimally displaced distal femoral epiphyseal fracture. PMID- 3670510 TI - Artificial tanning. PMID- 3670511 TI - Cranial CT atrophy in multiple sclerosis--an aid to diagnosis. PMID- 3670512 TI - Cranial CT characteristics of low-density multiple sclerosis regions of sclerosis. PMID- 3670513 TI - Wordy surgery. PMID- 3670514 TI - [Primary malignant lymphoma of the central nervous system--an increasingly more frequent tumor]. PMID- 3670515 TI - [Study of long spinal pathways in amyotrophic lateral sclerosis. Electrophysiologic and clinical findings]. PMID- 3670516 TI - [Acute and chronic diseases in transmitted borreliosis by tick bite]. AB - We report on clinical and laboratory findings of 58 study patients with tick-bite burrelia burgdorferi-infection. In seven cases, chronic borreliosis like a tertiary metaluetic illness was recognized. All were treated either with high dose penicillin intravenously or tetracycline. Results of treatment and recommendations are given. PMID- 3670517 TI - [Chronic Borrelia disease of the central nervous system]. AB - A few years ago meningoradiculitis Garin-Bujadoux-Bannwarth (Bannwarth's syndrome) was discovered to be a neurological manifestation of Lyme disease transmitted by tick-bites and caused by Ixodes-ricinus-spirochaete (borrelia burgdorferi). Not enough attention is given to the fact that more serious and chronic disease of the central nervous system may be entailed. Two cases are reported in which detection of the borrelian-antibodies corroborated the diagnosis. After parenteral treatment with penicillin there was a drastic improvement in both patients. PMID- 3670518 TI - [10-year catamnesis of 10 patients with hemiplegia following total excision of a cerebral arteriovenous angioma]. PMID- 3670519 TI - [Extrapyramidal syndrome in idiopathic hemochromatosis. Significance of laboratory chemical, neurophysiologic and imaging procedures (CCT, MRT)]. AB - In any patient with unexplained basal ganglia symptoms or dementia, the possibility of idiopathic hemochromatosis (IHC) should be considered. The findings of magnetic resonance tomography, discussed in this case report, lead to the conclusion that IHC is very likely to induce these syndromes. This is of clinical importance as IHC can be successfully treated by phlebotomy. PMID- 3670520 TI - [Brain contusion and "fetal" cyst in the arachnoid space. Question of correlation and long-term course]. PMID- 3670521 TI - Hypoxanthine transport through the blood-brain barrier. AB - The unidirectional influx of hypoxanthine across cerebral capillaries, the anatomical locus of the blood-brain barrier, was measured with an in situ rat brain perfusion technique employing [3H]hypoxanthine. Hypoxanthine was transported across the blood-brain barrier by a saturable system with a one-half saturation concentration of approximately 0.4 mM. The permeability-surface area product was 3 X 10(-4) sec-1 with a hypoxanthine concentration of 0.02 microM in the perfusate. Adenine (4 mM) and uracil and theophylline (both 10 mM), but not inosine (10 mM) or leucine (1 mM), inhibited hypoxanthine transfer through the blood-brain barrier. Thus, hypoxanthine is transported through the blood-brain barrier by a high-capacity, saturable transport system with a half-saturation concentration about 100 times the plasma hypoxanthine concentration. Although involved in the transport hypoxanthine from blood into brain, this system is not powerful enough to transfer important quantities of hypoxanthine from blood into brain. PMID- 3670522 TI - Amino acid content in astroglial primary cultures from different brain regions during cultivation. AB - Free amino acids in astroglial primary cultures obtained from newborn rat cerebral cortex, striatum and hippocampus were analyzed and compared during cultivation. Glutamate and taurine exhibited the highest concentrations. Aspartate and glutamate showed the highest values after 1 and 3 weeks of cultivation with lower values after 2 weeks in culture, while taurine, beta alanine/hypotaurine and phosphoethanolamine showed the highest value after 2 weeks in culture. The non-neuroactive amino acids and gamma-aminobutyric acid were present at a low level and the former showed the lowest concentration at 2 weeks of cultivation. Astrocytes from the different regions did generally not differ with respect to amino acid content. We conclude that the morphological and biochemical maturation of glia in culture is accompanied with marked quantitative changes in amino acid pattern. PMID- 3670523 TI - Solubilization and purification of the Ni-stimulated arginine-vasopressin binding site of rat brain membranes. AB - Arginine vasopressin binding sites on rat brain membranes were solubilized and purified by affinity chromatography. Membrane protein solubilized with CHAPS bound arginine vasopressin (AVP) only in the presence of divalent cations. Specific binding to the solubilized tissue was maximally stimulated by Ni2+, and markedly stimulated by Co2+ (30% of maximal binding with Ni2+), Zn2+ (18%), and Fe2+ (11%), parallel to the effects of these ions on the binding of AVP to neural membranes. Binding to solubilized tissue was not stimulated by Mg2+, Cu2+, Mn2+, or Ca2+. In the presence of Ni2+, binding of AVP to solubilized tissue was reversible, and the dissociation constant (10.5 nM), pH optimum, and time course were virtually identical to those of the membrane-bound AVP binding site. Purification of solubilized AVP-binding proteins by affinity chromatography on AVP-sepharose followed by gel electrophoresis yielded a major band of 55 kdalton molecular weight when purified in the presence of 5 mM Mg2+, or a major band of 62 kdaltons when purified in the presence of 1-5 mM Ni2+ or 10 microM Zn2+. By means of a new binding assay involving conjugation of the 62 kdalton fraction to brain membranes, the extent of purification of AVP binding activity was 150-fold in the presence of Ni2+. We suggest that the 62 kdalton protein is a component of the Ni-stimulated AVP binding site. PMID- 3670524 TI - [Cobalt radioisotope teletherapy of patients with metastases to the brain]. AB - The results are presented of palliative telecobaltotherapy in patients with metastases to the brain. The patients received a dose of 30 Gy in 10 fractions during 2 weeks. Clinical improvement was achieved in 28 out of 33 treated patients (85%). The survival time after the completion of radiotherapy was from 1 to 15 months, mean 5 months. PMID- 3670525 TI - [A model of complex medical care of children with epilepsy]. PMID- 3670526 TI - [Prolactin in the blood serum of patients with multiple sclerosis]. AB - The authors determined in 1984 by radioimmunoassay (INEP kit) the serum prolactin concentration in 76 multiple sclerosis patients (33 males and 34 females) aged from 21 to 53 years, with disease duration from 2 to 30 years. The control group comprised 110 healthy subjects. Normal prolactin values were 150-750 mIU/ml in females and 150-500 mIU/ml in males. In about one-third of the patients raised prolactin level was found which failed to correlate with the age of the patients and with increased beta-endorphin level in them. The authors suppose that hyperprolactinaemia may be of importance in certain clinical signs of multiple sclerosis. Further investigations on prolactin are conducted with reference to the circadian rhythm of prolactin secretion and dynamic tests. PMID- 3670527 TI - [Comparative epidemiologic studies of multiple sclerosis and cancer of the large intestine in several provinces of western Poland]. AB - A trial was made of finding a correlation between the incidence and prevalence of multiple sclerosis and large bowel carcinoma in several microregions (communities and areas of the former counties). The following conclusions have been reached. No correlation was found between the incidence of multiple sclerosis and large bowel carcinoma in these studied areas. A positive correlation was demonstrated between the prevalence of multiple sclerosis and large bowel carcinoma in the areas corresponding to former counties but not in communities. Since the latter index is of much lower importance for the estimation of the frequency of malignant neoplasms there is no reason to assume the existence of one or several common aetiologic factors of multiple sclerosis and large bowel carcinoma determining local differences in the frequency of these diseases. PMID- 3670528 TI - [Various anthropologic characteristics of patients with myasthenia gravis]. AB - The anthropologic examination comprised: somatic measurements, cephalic measurements, determination of the pigmentation of the eyes and hair of women with myasthenia. The studied group was living in the towns of Lower Silesia and it included 47 myasthenic women and 67 healthy ones aged from 24 to 45 years. In 36 patients the HLA antigens were determined. The examination showed significant differences in the proportions of the body and head and in the pigmentation of eyes and hair between both these groups. The haplotypes HLA-B8, HLA-DR3 and HLA A1 were significantly more frequent in the group of patients. PMID- 3670529 TI - [Diagnostic value of dynamic zonography in contrast studies of the meningeal sac]. AB - In a material of 232 dynamic radiculosonographies their diagnostic value was analyzed in relation to the results of standard radiculography. Correct diagnosis of lumbar intervertebral disc prolapse was obtained in 61.6% of cases. The technique was found to be particularly useful in cases of abnormally shaped sacs. PMID- 3670530 TI - [Extent of fenestration in one-level operations for lateral herniation of the intervertebral disk of the lumbar segment of the spine]. AB - In the years 1969-1986 operations were carried out in 1650 cases of lateral prolapse of the lumbar nucleus pulposus at one level, they accounted for 75% of patients operated on for symptomatic sciatic pains. The operations were done in lateral recumbent position. In 29% of cases it was necessary to extend the typical fenestration by reducing the size of one or two halves of the vertebral arches, and in 12% of cases full hemilaminectomy was done. The most frequent cause of fenestration extension was narrow yellow ligament and massive broad vertebral arches at the level of the prolapsed nucleus, as well as congenital or acquired narrowing of the lateral recess of the vertebral canal. In only 4% of cases the necessity of fenestration extension was due to displacement of the free fragments of the prolapsed nucleus far from the intervertebral space or their falling into the meningeal sac. PMID- 3670532 TI - [Unilateral hyperostosis frontalis interna coexistent with cerebral angioma]. AB - The authors describe a rare case of coexistence of cerebral angioma with hyperostosis frontalis interna in a female patient aged 28 years, suffering from mental disturbances. The coexistence of these two diseases in one person caused considerable diagnostic and therapeutic difficulties. The described case points out that both these conditions may occur concomitantly. Another point of interest is the presence of hyperostosis frontalis interna in a young woman. PMID- 3670531 TI - [Paramyoclonus multiplex (Friedreich's disease)]. AB - The authors describe a case of benign myoclonic jerks in a man aged 45 years, followed-up during 3 years. The disease had a benign course and a tendency was observed for decreasing intensity of symptoms. Apart from disseminated myoclonic jerks and longer lasting muscle spasms no other neurological abnormalities were found. EMG demonstrated spontaneous and asynchronous discharges of groups of motor units corresponding to the observed myoaclonic jerks but no other pathological findings were elicited. Other laboratory investigations including CT of the brain gave normal results. Taking into account the onset and course of the disease, the objective state and the results of laboratory investigations a functional background of the disease could not be ruled out. PMID- 3670533 TI - [Cerebrospinal rhinorrhea in a tumor of the pituitary gland]. AB - The authors report a case of rhinorrhoea caused by a hypophyseal tumour. The clinical pattern and the result of CT of the head might suggest a non-neoplastic aetiology of the cerebrospinal fluid fistula, but intraoperative findings and histological examination made possible establishing of the cause of the rhinorrhoea which was most likely perforation of a cyst of the hypophyseal tumour into the subarachnoid space with secondary development of the empty sella syndrome with consequent fistula leading off the cerebrospinal fluid into the nose. PMID- 3670534 TI - [A clinical study on head injuries in the aged]. AB - We review 79 patients over 65 years old among 715 patients who underwent CT scans in the early period after head injuries, to study the characteristics of head injury in the aged. Among 79 aged patients, 24 developed posttraumatic subdural fluid collections, and in 13 of them chronic subdural hematomas developed subsequently. There were only three acute epidural hematomas. However, a high incidence of intracerebral lesions was noted, regardless of the presence of skull fracture. The pedestrian accident was the most frequent cause of head injury in the 36 aged patients admitted and the mortality rate of traffic accident in the aged was also highest. The relationship between Glasgow Coma Scale Score (GCS) on admission and the outcome was not parallel in the aged, because high GCS not rarely resulted in poor condition or death. Head injury is apt to occur and becomes severe in the aged pedestrian because of advancing carelessness and dull movements with age. The vulnerability of the brain to the injury and changes of intracranial environment in the aged tend to cause intracranial lesions much more than in the younger patients. Already-existing diseases and/or posttraumatic general complications also make clinical courses worse in the aged. It seems important for the improvement of the treatment that the characteristics described above are always taken into consideration throughout the period of the treatment in the aged, in order to eliminate worsening factors adequately. In addition, the social measures to cope with the suffering of the aged pedestrians from traffic accident should be considered and established in an aging society. PMID- 3670535 TI - [Sutureless method of micro-vascular anastomosis using low-energy Nd-YAG laser]. AB - Sutureless end-to-end anastomosis of rat common carotid artery was carried out, low energy Nd-YAG laser being used thereby. An intraluminal-intervascular splint, made of water-soluble poval, was used for precise adaptation of the intimas. Neither stay suture nor glue was required. The patency rate of the anastomosed vessels, 24 hours after operation, was as high as 91%. The vessels were confirmed to be likewise patent on the 7th and 30th postoperative day. Complications such as pseudoaneurysm formation or stenotic change, were negligible. The fusion of the anastomosis with Nd-YAG laser was histologically proved to be satisfactory and the result of tensile strength test was excellent. Temperature at the anastomotic site during laser irradiation was measured, optimal energy for anastomosis determined and possible mechanism of vascular fusion by laser beam postulated. The major advantages of the laser technique combined with poval splint, such as rapidity, consistency and no residual foreign body (thread or adhesive), are discussed. PMID- 3670536 TI - [Clinical effects of lipo-prostaglandin E1 in patients with delayed cerebral vasospasm]. AB - Prostaglandin (PG) E1 is a potent vasodilator on the peripheral vessels and also has an inhibitory action of platelet aggregation. Thus it is expected that PGE1 may be used for the treatment of cerebral vasospasm in aneurysmal subarachnoid hemorrhage. Lipo-PGE1, the lipid emulsified PGE1, is not destroyed in the lung, has much longer half life in the circulation than PGE1 which is rapidly inactivated in the lung. The effects of intravenous injection of lipo-PGE1 on the cerebral hemodynamics and the central conduction time (CCT) of the sensory evoked potential under vasospastic conditions has been studied in eight patients. All these 8 patients demonstrated severe angiographic vasospasm and signs of cerebral ischemia. The 15-20 micrograms of lipo-PGE1 was administered every eight hours for 5 to 7 days. Within 6 hours of the first lipo-PGE1 treatment, the regional cerebral blood flow (rCBF) and the CCT measurements were reported to document the effect of treatment. The average pretreatment of rCBF on the right anterior, middle and posterior cerebral artery were 46.6 +/- 6.8, 56.4 +/- 7.3 and 58.8 +/- 8.9 ml/100 g/min and on the left side were 52.1 +/- 9.2, 49.1 +/- 10.8 and 56.1 +/- 9.2 ml/100 g/min respectively. With treatment these flows increased to 53.0 +/- 6.9, 64.3 +/- 5.3 and 63.0 +/- 4.6 ml/100 g/min respectively on the right side and 60.8 +/- 9.4, 60.6 +/- 9.7 and 60.6 +/- 7.2 ml/100 g/min respectively on the left. The CCT also demonstrated the improvement from 6.36 msec to 6.21 msec by the initial PGE1 treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670537 TI - [Myelopathy caused by hypertrophy of the posterior longitudinal ligament (HPLL): case report]. AB - A case of myelopathy caused by hypertrophy of the posterior longitudinal ligament at the cervical spine is reported. A 71-year-old man was hospitalized with myelopathy with progressed during the last two months. Plain X-ray of the cervical spine revealed only mild spondylotic change. Myelography demonstrated completely blocked contrast medium at C4 to C5 vertebral height due to epidural mass. This epidural mass was localized ventral to the spinal cord from C3 to C5. CT scan revealed slightly high density area behind the vertebral body. On surgery, no evidence of disc fragment but only hypertrophied posterior longitudinal ligament which was removed was found to be a cause of cord compression. Excellent recovery of neurological symptoms after operation was obtained. On histological study, remarkable hypertrophy, edema, hyalinoid degeneration and a little calcification of the ligament was found, which did not show any evidence of new bone formation. HPLL was characterized by thickened and broad epidural mass in the ventral side of cervical cord with Hounsfield number of 90-156 on CT scan, which is not very easy to differentiate from metastatic epidural tumor. The cause of HPLL is not well elucidated, though, this may be a new category of compression myelopathy. PMID- 3670538 TI - [An autopsy case of syringomyelia associated with Chiari malformation and basilar impression]. AB - The authors report one autopsy case of syringomyelia associated with Chiari malformation and basilar impression. The pathogenesis of syringomyelia in our case is discussed. This 37-year-old man complained of progressive difficulty in swallowing and walking for two years. He had noticed dysarthria for six months before admission. (Examination) Neurological examination showed dysarthria, down beat nystagmus, disturbance of IXth nerve, Xth nerve and XIth nerve, and cerebellar ataxia. Deep tendon reflexes were hyperactive in the upper and lower extremities. Babinski's sign was positive bilaterally. Neuroradiological examination demonstrated basilar impression and Chiari malformation. (Operation) Suboccipital craniectomy and laminectomy of upper cervical vertebra were performed with dural plasty. Postoperatively he acquired some improvement, but soon after he was worse. He died of respiratory disturbance. (Postmortem examination) Though the central canal was obliterated at the C4 level, the syrinx extended from the C5 to Th7 level. From the C5 to C8, the syrinx was present in the areas of central gray matter, extending into the left dorsal horn, where it communicated with subarachnoid space. Furthermore, the abnormal vessels were noticeable around the syrinx. At the Th2 level, they were also shown in central grey matter where no syrinx existed. (Conclusion) The etiology of syringomyelia in our case was not explained by Gardner's hydrodynamic theory. We suggested that intramedullary abnormal vessels played an important part for the formation of the syringomyelia. PMID- 3670539 TI - [Traumatic arteriovenous fistula with feeders of the scalp, dura mater and pia mater: case report]. AB - A very rare case of 41-year-old male with symptomatic dural arteriovenous fistula which was detected after 22 years from receiving head injury is reported. This AVF had arterial blood supply of scalp, dural and pial origins. In the literature, only two similar cases have so far been reported. The draining veins were the superior sagittal sinus and the vein of Trolard, and a large vascular sac was seen in the pial vein. PMID- 3670540 TI - [CP angle meningioma presenting as hemifacial spasm]. AB - An interesting case of CP angle meningioma presenting with hemifacial spasm is reported. The patient was a 64-year-old woman with left hemifacial spasm of 18 years' duration which was the initial and the only symptom she had had for ten years until other signs and symptoms including tinnitus and hearing decrease on the left side, vertigo and left cerebellar disturbance occurred. Preoperative CT films showed an enhancing mass at the left CP angle. Operation was performed and the diagnosis of meningioma originating at the rostral edge of the jugular foramen was made. The tumor was extending from the lower cranial nerves up to the Vth nerve burring the VIIth, VIIIth, IXth, Xth, XIIth cranial nerves and vertebral artery within it and compressing the root exit zone of the VIIth nerve. It was totally removed by microsurgical techniques. Postoperative follow-up during eight months disclosed complete disappearance of hemifacial spasm. Residual neurological deficits were left hearing loss, mild facial weakness due to previous nerve blocks on the left side and slight hoarseness. But she was doing well as a housewife. So far, the authors have experienced with 1310 cases of microvascular decompression for hemifacial spasm and 730 cases for tic douloureux. There were only 4 cases (0.3%) in which a CP angle tumor was found in hemifacial spasm series, while in tic douloureux series as many as 79 tumor cases (10.8%) were found. A review of the literature revealed that hemifacial spasm due to CP angle meningioma was very rare, particularly as an initial symptom as in our case.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670541 TI - [Intraoperative liquid embolization of an arteriovenous malformation in the basal ganglia and thalamic region]. AB - Total three patients with arteriovenous malformation (AVM) in basal ganglia or thalamic region were treated by intraoperative liquid embolizations. These procedures were decided because of repeated hemorrhagic episodes. In the case with AVM in the head of the caudate nucleus which was fed by several anterior perforating arteries originated from anterior cerebral artery (A1 portion) and middle cerebral artery (M1 portion), frontotemporal craniotomy was performed. After the microsurgical dissection of these feeders, one of the feeders lenticulostriate artery, was cannulated with a small-caliber polyethylene catheter, 0.6 mm in outer diameter and 0.3 mm in inner diameter. A small amount of isobutyl 2-cyanoacrylate (IBCA) was injected through the catheter. Same procedure was carried out one month later. Postoperative angiograms revealed about 90% loss of AVM. In two cases with AVM which involved almost entire thalamus, subtemporal craniotomy was done. Feeding vessels which originated from posterior communicating artery and posterior cerebral artery (PCA) were carefully dissected under the operative microscope and one of them was prepared for cannulation with small catheter. When the small amount of IBCA was injected, proximal PCA and internal carotid artery were temporarily occluded. In both cases intraoperative embolization was carried out twice. Postoperative angiograms revealed that the size of AVM was decreased to 20% in one and 40% in the other. Although temporary postoperative deterioration of neurological deficits such as hemiparesis and visual disturbance was slightly noted in all cases, no hemorrhagic episode was experienced for 6 months, 1.5 and 2 years in each after embolization. PMID- 3670542 TI - [Diagnosis of a cystic lesion in the spinal cord--studies on delayed CT myelography and MRI]. AB - The collection of contrast medium within the spinal cord on delayed CT myelography generally indicates the presence of syringomyelia. We report the cases of cystic myelopathy with intramedullary contrast accumulation on delayed CT myelography. The purpose of this report is to compare MRI with delayed CT myelogram and to discuss the pathogenesis of the intramedullary contrast accumulation on delayed CT myelography. METHODS AND MATERIALS: Thirty patients with intramedullary contrast accumulation on delayed CT myelography were studied with High Resolution Computed Tomography (Siemens Somatom II) and Magnetic Resonance Imaging (MRI) (0.15T imager, Toshiba MRT 15A). MRI were routinely obtained in both axial plane and sagittal plane. Short spin-echo sequences (30 msec TE, 500 msec TR) were used. This series included 6 cases of cervical disc disease, 5 cases of Chiari malformation, 4 cases of lipomeningocele, 4 cases of adhesive arachnoiditis, 2 cases of thoracolumbar spondylosis, 2 cases of trauma, one case of spinal arachnoid cyst, one case of spinal epidural cyst, and 5 cases of idiopathic type. RESULTS: 1) In 17 out of the 30 patients (57%), the region corresponding to the region of contrast medium collection, which was visualized on delayed CT myelography, was seen as an area of the low signal intensity on MRI. In 11 cases out of 17, the syrinx cavity was confirmed at surgery. 2) In 13 cases, delayed CT myelogram showed collection of intramedullary contrast medium, but MRI failed to reveal an area of low signal intensity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670543 TI - [Treatment of craniofacial fractures]. AB - In the facial fractures, a large number of these patients also sustain a head injury. Neurosurgical care should be the first choice when an intracranial injury is associated. In such situation, suitable timing of the reduction of the facial fractures would be often missed and this would result in functional disturbance and deformities of the face. The present report concerns the early definitive treatment of the extensive craniofacial fractures. Operative procedure and its result are presented. We have surgically treated 100 cases with facial fractures during the past 7 years. Sixty-nine percent of these cases were injured in traffic accidents. The most common site, accounting for 72%, was the middle third of the face. Open reductions and internal fixations were performed within 10 days following the injury in all cases. Among 100 cases, 28 had associated intracranial injuries. Most of these cases were accompanied with frontobasal or zygomatic fractures. Twenty-four cases underwent craniotomy for acute intracranial hematomas, brain contusions, CSF rhinorrhea or optic nerve injuries. In 21 out of 24 cases, primary reconstruction of the fracture were performed at the time of craniotomy. Whether a primary reconstruction was available or not was determined according to the patient's general condition and the severity of the associated intracranial injury. In the extensive frontobasal injury, it is of the utmost importance to have a water-tight dural closure. Fractures involving the sinus were treated by exenteration of the sinus without packing to establish the pathway to the nasal cavity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670544 TI - [Experimental study of evoked potentials in predicting the reversibility of brain function following tentorial herniation]. AB - Brainstem auditory evoked potentials (BAEP), somatosensory evoked potentials (SEP) and EEG were recorded sequentially in cat with mass-induced intracranial hypertension in correlation with mass volume, intracranial pressure (ICP), systemic blood pressure (BP) and size of the pupils. 1) As the intracranial pressure was raised by expansion of a supratentorial epidural balloon, suppression of cortical SEP (CSEP) and pupillary abnormality appeared first, EEG, waves IV and III of BAEP and wave III of short latency SEP (SSEP) were suppressed in this order. 2) As far as wave IV of BAEP remained and decompression was started within 30 minutes after peaks of CSEP completely suppressed, changes in P1 and N1 of CSEP were reversible. 3) Further raising of ICP was followed by loss of waves IV and III of BAEP and wave III of SSEP in this order. Simultaneously with loss of wave III in SSEP, systemic blood pressure dropped rapidly. By immediate balloon deflation after disappearance of wave III of SSEP, animals recovered from hypotension, but hardly from suppression in EEG, CSEP and BAEP. 4) Preservation of wave IV of BAEP indicated good improvement of pupillary abnormality even after removal of compression. These results suggest that for the patient with disturbed consciousness caused by supratentorial mass lesion, decompressive procedure should be started before wave V of BAEP and brainstem components of SEP disappear. EP monitor seems to be useful clinical method for preventing irreversible change of the brain in patients with coma caused by supratentorial mass lesions. PMID- 3670545 TI - [Three cases of an intracranial wooden foreign body]. AB - Three cases of intracranial wooden foreign body are reported discussing the diagnostic and therapeutic problems. First case is a 50-year-old man. After drinking, he drove a bike and fell to the ground. On admission the wooden foreign body could not been detected in appearance. CT scan showed low density area similar to air in bilateral anterior horn of lateral ventricle. The patient was treated for traumatic pneumocephalus at first. Later, it proved that he was stabbed with a foreign body penetrating into the contralateral frontal lobe through the left nasal cavity. It was extracted by endonasal approach by otolaryngologist, fortunately without trouble. The foreign body was a branch of tree. The second case is an 18-year-old man. He was driving a car, and suffered injury. He was stabbed with a wooden stake penetrating into his left eye. Immediately, bifrontal craniotomy was performed and the stake was withdrawn carefully. Moreover bone fragments were removed. The third case is a 61-year-old man. When he cut the timber by chain saw, a piece of wood hit and stabbed his right eye directly. Immediately right front temporal craniotomy was performed. The piece of wood was withdrawn from the right eye, and pieces of glass, wood and bone fragments were evacuated. It is difficult to confirm intracranial foreign body accurately by means of only plain skull film and usual CT scans. It is necessary to utilize various function of CT scanner. For example, it is useful to know CT values or select measure mode with window width and level or make reconstruction image to sagittal or coronal section, and so on.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670546 TI - [Basal skull metastasis of stomach cancer presenting with Garcin's syndrome--a case report]. AB - A case of 57-year-old man with Garcin's syndrome is reported. By means of upper gastrointestinal endoscopy, this patient proved to have a stomach cancer. He noticed left trigeminal neuralgia for the first time in early Jan. 1986, and when he was referred to our department, his symptoms and signs of left cranial nerve palsy (from 5th to 12th, totally 8 nerves) were complete, although other neurological findings such as long tract signs, cerebellar signs, or papilledema were all negative. Although skull X-ray and basal skull tomography revealed neither bony deformity nor destruction, CT scan and angiography showed suspicious appearance of basal skull invasion of a certain mass. CSF examination revealed no malignant cells or abnormal protein, and sugar content. Exploratory craniotomy for tumor biopsy was performed. Histologically, the tumor had characteristics of anaplastic carcinoma. General survey revealed that he had a stomach cancer which was histologically the same as the basal skull tumor. His general condition became so serious that irradiation to the lesion was not indicated Among many papers reported about Garcin's syndrome, those of basal skull metastasis of stomach cancer are extremely rare. The authors discussed the lesion in comparison with meningeal carcinomatosis involving cranial nerves. PMID- 3670547 TI - [A case of interhemispheric glio-ependymal cyst in a newborn infant]. AB - An interhemispheric glio-ependymal cyst in a male neonate is reported. Neuroradiologically, the cyst, which had a septum like component within it, was located in the right frontoparietal interhemispheric and displaced the third and lateral ventricles. It had no communication with the ventricular system. As for anomalies associated with it, the total callosal agenesis and congenital hydrocephalus were revealed in CT scan. Angiogram suggested that polymicroglia accompanied with the cyst. It was confirmed that the cyst was divided into two parts by the septum during surgery. Microscopic examination showed that the cyst wall was composed of ependyma, connective tissue and glial cells. Choroid plexus component was also found in the septum. On the basis of the fact above, it was diagnosed interhemispheric glio-ependymal cyst. We believe that this interhemispheric cyst described above is a true cyst and differs morphologically and embryologically from the midline cyst which is produced with callosal agenesis and due to increased intraventricular pressure. In fact, the latter is an encystic third ventricle but not a true cyst. Both of them are, however, usually called interhemispheric cyst in the literature. We conclude that this case is appeared to be a true cyst because we can differentiate it from third ventricle by neuroradiological findings. We discussed nature of different interhemispheric cysts with callosal agenesis and suggested that recognition of the morphological relationship between the interhemispheric cysts and third ventricle was utmost important to make a correct diagnosis. PMID- 3670548 TI - [Growing aneurysm presenting with Weber's syndrome and obstructive hydrocephalus- a case report]. AB - A case with two cerebral aneurysms, in which one at the origin of the left superior cerebellar artery (SCA) grew and presented with Weber's syndrome and obstructive hydrocephalus, is reported. The patient was a 69-year-old female, who had severe headache and vomited. On admission, neck stiffness was recognized. CT scan showed findings of subarachnoid hemorrhage. Angiograms demonstrated two saccular aneurysms at the right middle cerebral artery (MCA) bifurcation and at the origin of the left SCA. Craniotomy and neck clipping of the aneurysm at the right MCA was performed. After discharge, left oculomotor palsy appeared and gradually progressed. Severe headache and right hemiparesis suddenly occurred two years after the first attack. On the second admission, CT scan revealed high density on the brain surface and a well enhanced round lesion at the left ambient cistern. Left vertebral angiogram demonstrated increase in size of the aneurysm at the left SCA. The patient was discharged after conservative therapy. Drowsiness and urinary incontinence appeared, and she was admitted for the third time three years after the first admission. CT scan showed an enhancing mass lesion sized 25 X 30 mm beside the left midbrain and obstructive hydrocephalus. The aneurysm at the SCA no longer seen on the left vertebral angiogram. V-P shunt was performed. Both Weber's syndrome and obstructive hydrocephalus in this case indicate an aneurysmal natural history, in which aneurysm becomes gigantic and thrombosed spontaneously. PMID- 3670550 TI - Effect of chronic alcohol consumption on the pregnant mare serum gonadotropin induced luteinizing hormone surge. AB - The studies reported in this paper were undertaken to investigate the effect of chronic (10 day) alcohol consumption on female pituitary-gonadal function. The immature female rat model treated with pregnant mare serum gonadotropin (PMSG) was used since it results in a highly reproducible luteinizing hormone (LH) surge and ovulation. Twenty-day-old female rats were placed on diets that were either (1) unrestricted (ad libitum); (2) contained 5% ethanol in a liquid diet, or (3) isocalorically pair-fed with the liquid diet to the ethanol group. After 10 days on their respective diets, the groups were subdivided and given either 8 IU of PMSG in 0.1 ml saline or 0.1 ml saline s.c. between 10.00 and 11.00 h. The animals were sacrificed by decapitation at 24, 48, 52, 54, 56, 58, 60 and 62 h after injection. Trunk blood was obtained for serum measurements of LH. The uteri were weighed and prepared for the histological study. In all dietary groups, serum LH levels were significantly higher in the PMSG-treated animals when compared to the saline controls at all time intervals with the exception of the alcohol 58-hour group. In the ad libitum animals, plasma LH concentrations were highest at 52 h following hormone administration. The serum LH concentrations were highest at 56 h after hormone administration in the pair-fed group and were significantly less than the ad libitum group at 52, 54, 56, and 58 h after PMSG stimulation. No significant plasma LH surge was observed in the alcohol group and the LH concentrations were significantly less than the pair-fed rats at 56 and 58 h after PMSG treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670549 TI - [Brain edema after surgery of lateral ventricle tumors]. AB - We reported five cases of lateral ventricle tumors all of which developed severe brain edema between 9 days and 8 years after surgery. Follow-up study with serial computed tomography before and after surgery were presented. Based on a review of the literature, a possible causal mechanism is suggested: 1) The cerebrospinal fluid diffuses into the white matter through the surgically damaged ependyma and caused severe postoperative edema; and 2) surgical blockade of the flow of cerebral interstitial fluid to drain into the fenestrated vessels of the choroid plexus and other periventricular areas caused severe postoperative edema. PMID- 3670551 TI - Central mechanisms of ethanol-induced adrenocortical response in selectively bred lines of mice. AB - Selectively bred long-sleep (LS) and short-sleep (SS) mice differ markedly in ethanol-induced adrenocortical response. Intracerebroventricular injections of saline elicited a 'stress-induced' adrenocortical response in both lines of mice, and intracerebroventricular infusions of noradrenergic and cholinergic compounds modulated ethanol-induced and stress-induced adrenocortical responses differentially in these mice. Clonidine, an alpha 2-adrenergic agonist, blocked ethanol-induced elevations in plasma corticosterone in a dose-dependent manner (1 and 10 micrograms) in LS mice; however, only the 10-micrograms dose of clonidine effectively antagonized this response in SS mice. Clonidine was less effective in blocking adrenocortical activity induced by stress than that induced by ethanol. Yohimbine, an alpha 2-adrenergic antagonist, induced a marked elevation in plasma corticosterone in LS mice but not in SS mice; however, this compound did not alter ethanol-induced adrenocortical responses in either line of mice. Yohimbine reversed the inhibitory effect of clonidine in ethanol-treated LS and SS mice. Phentolamine, a nonspecific alpha-adrenergic antagonist, and propranolol, a beta adrenergic antagonist at high doses (10 micrograms), produced slight increases in plasma corticosterone in LS mice only. Neither these compounds nor methoxamine, a nonspecific alpha-adrenergic agonist, altered the effect of ethanol on adrenocortical activity in LS or SS mice. Carbachol, a mixed muscarinic/nicotinic agonist, significantly increased adrenocortical response in both LS and SS mice and potentiated ethanol-induced elevation in plasma corticosterone in both lines of mice. However, atropine, a nonspecific muscarinic antagonist, or hexamethonium, a nicotinic antagonist, did not modify ethanol-induced elevations in plasma corticosterone in LS and SS mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670552 TI - Plasma prolactin levels in the inferior petrosal sinuses in various pituitary disorders during perihypophyseal phlebography. AB - The use of intercavernous sinus phlebography for the diagnosis and neurosurgical treatment of pituitary adenomas has enabled the collection of selective venous samplings of the inferior petrosal sinuses (IPSs), where prolactin (PRL) levels can be measured before the hormone becomes excessively diluted in the systemic circulation. In the present study, plasma PRL levels were studied in the right and/or left IPS and, simultaneously, in the peripheral circulation of: (1) normoprolactinemic patients affected with various pituitary disorders which required phlebographic procedures; (2) hyperprolactinemic patients with negative radiological and computed tomographic (CT) signs of pituitary adenomas and (3) adenomatous hyperprolactinemic patients. In the 17 normoprolactinemic patients, the plasma PRL concentration in the IPSs was significantly higher (3.5 times; p less than 0.01) than in the peripheral circulation. In the 11 hyperprolactinemic patients with negative radiological and CT signs of pituitary adenomas, the central gradient for PRL was significantly higher (2.8 times; p less than 0.05) than in the peripheral circulation. No significant difference was detected between PRL concentrations in the left and right IPSs. In the 11 adenomatous hyperprolactinemic patients, there was a significant (p less than 0.01) central gradient for PRL 3.8 times higher than in the peripheral circulation on the ipsilateral side of the tumor. Furthermore, the plasma PRL concentration in the ipsilateral IPS was significantly higher (3.4 times; p less than 0.05) than that in the contralateral sinus. In conclusion, the present study shows that a clear cut concentration gradient exists between plasma PRL levels in the IPSs and in the peripheral circulation of normoprolactinemic and hyperprolactinemic patients with negative radiological and CT signs of pituitary adenomas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670554 TI - Effects of preoptic microinjection of neurotensin on luteinizing hormone secretion in unanesthetized ovariectomized rats with or without estrogen priming. AB - Effects of microinjection of neurotensin (NT) in the medial preoptic area on luteinizing hormone (LH) release were examined in unanesthetized ovariectomized rats with or without estrogen priming. Microinjection of NT (100 ng) into the medial preoptic area of ovariectomized estrogen-primed rats significantly facilitated the circadian afternoon rise of LH secretion as compared to the hormone values in control animals microinjected with physiological saline. The timing of the afternoon LH rise was not altered by the peptide. In ovariectomized estrogen-unprimed rats, on the other hand, NT did not affect the existing pulsatile LH secretion nor induced an afternoon rise of the hormone secretion. These results show that NT can stimulate the preoptic LH release mechanism which undergoes the circadian clock under the influence of estrogen. PMID- 3670555 TI - Excitatory amino acid antagonists induce a phencyclidine-like catalepsy in pigeons: structure-activity studies. AB - The excitatory amino acid antagonists D,L-2-amino-5-phosphonovalerate (D,L-AP5), its isomers D-(-)-AP5 and L-(+)-AP5, D,L-2-amino-4-phosphonobutyrate (AP4), D,L-2 amino-7-phosphonoheptanoate (AP7), beta-D-aspartylaminomethylphosphonic acid (ASP AMP), cis-2,3-piperidinedicarboxylic acid (cis-PDA), and gamma-D glutamylaminomethylsulphonic acid (GAMS) were tested for their ability to produce a phencyclidine (PCP)-like catalepsy in pigeons when administered intracerebroventricularly. Each of the antagonists produced catalepsy, although L AP5, and the non-selective antagonists GAMS and cis-PDA, produced the effect only at toxic doses. The rank order of potency to produce catalepsy was AP7 greater than D-AP5 greater than D,L-AP5 greater than cis-PDA greater than ASP-AMP greater than AP4 greater than L-AP5 greater than GAMS; there was a strong positive correlation between this rank order of potency in vivo and the potency order of these compounds in vitro as NMDA antagonists. The antagonists did not displace significant amounts of [3H]N-[1-(2-thienyl)cyclohexyl]piperidine (a congener of phencyclidine) from its recognition site in the brain of pigeon. Thus, the PCP like catalepsy that is produced by the excitatory neurotransmission at NMDA preferring receptors that are distinct from, but related to, PCP receptors. The results strongly support the hypothesis that a reduction of neurotransmission at excitatory synapses, utilizing NMDA-preferring receptors, may underlie catalepsy in pigeons induced by PCP. PMID- 3670553 TI - Neural pathways involved in the photoperiodic control of reproductive physiology and behavior in female hamsters (Mesocricetus auratus). AB - Female hamsters received horizontal knife cuts to investigate the role of hypothalamic connections in the photoperiodic control of female reproductive functions. Knife cuts placed ventral to or through the paraventricular nucleus (PVN), but dorsal to the suprachiasmatic nucleus (SCN), prevented photoperiod induced acyclicity and uterine regression in animals maintained under a nonstimulatory photoperiod for 10 weeks. The animals were then ovariectomized and tested for lordosis behavior following subcutaneous injections of ovarian hormones to investigate the photoperiodic modulation of female sexual behavior. Animals exposed to a nonstimulatory photoperiod were less behaviorally sensitive to treatment with estradiol benzoate (EB) alone, but did not differ from animals maintained under a stimulatory photoperiod when EB was combined with progesterone. The effect of photoperiod and behavioral sensitivity to hormone replacement was independent of the surgical condition. The results are consistent with the hypothesis that dorsal projections from the SCN to the PVN mediate gonadal responses to short photoperiods. They also indicate that photoperiod induced changes in behavioral sensitivity to gonadal steroids may be mediated by neural pathways distinct from those that mediate the gonadal changes. PMID- 3670556 TI - Electrophysiological effects of phencyclidine in the medial prefrontal cortex of the rat. AB - The effects of local applications of phencyclidine (PCP) and dopamine (DA) on neurons of the medial prefrontal cortex were investigated using single unit recording techniques. The activity of the majority of cells in the deeper layers of the medial prefrontal cortex was depressed by both phencyclidine and DA, whereas increases, as well as decreases, in the firing rates were observed in cells located in the superficial cortical layers. The stereospecificity of the responses of deeper cells to phencyclidine was demonstrated using the enantiomers of 1-(-1-phenylcyclohexyl)-3-methylpiperidine (PCMP). Phencyclidine was found to be 1.5 times more potent than (+) PCMP and 3 times more potent than (-) PCMP. Finally, the DA receptor antagonist fluphenazine, blocked the phencyclidine elicited depressions of unit activity in the deep prefrontal cortex. Taken together, the data indicate that the DA-like effects of phencyclidine on neurons of the medial prefrontal cortex are mediated by DA receptors and provide pharmacological support for the idea that psychomotor stimulant drugs have specific actions on targets of the ventral tegmental area (A10) dopamine system. PMID- 3670557 TI - Effect of a cholecystokinin antagonist on some effects of diazepam. AB - Dose responses were evaluated for the effects of diazepam alone or together with the cholecystokinin receptor antagonist CR 1409 on pentetrazole-induced convulsions, motor performance and spontaneous motor activity. The results obtained showed that the cholecytokinin antagonist potentiated the effects of diazepam on motor performance and the anticonvulsant activity of diazepam, while it did not affect spontaneous motor activity. The data presented are consistent with a role for cholecystokinin in some effects of diazepam. PMID- 3670558 TI - Ontogeny of swimming behavior and brain catecholamine turnover in rats prenatally exposed to a mixture of 2,4-dichlorophenoxyacetic and 2,4,5 trichlorophenoxyacetic acids. AB - Rats exposed in utero on gestational days 6-15, to nonfetotoxic and grossly nonteratogenic mixtures (50 or 100 mg/kg) of 2,4-D/2,4,5-T as found in Agent Orange (but without significant contamination with 2,3,7,8 tetrachloro-p-dioxin) manifested subtle developmental neurotoxicity. Maturation of swimming behavior was significantly delayed on postnatal day 7 in both treatment groups. The concentration of norepinephrine (NE) in whole brain was significantly increased on postnatal day 15 in both treatment groups, whereas the concentration of dopamine (DA) was increased on postnatal day 15 at 100 mg/kg. The turnover and efflux rate constant of DA in whole brain were significantly reduced whereas the turnover time increased on postnatal day 3. The efflux rate constant for NE decreased and the turnover time increased significantly on postnatal day 15 at 100 mg/kg. These data indicate the value of ontogenic assessment following exposure to small doses, which result in functional alterations in the absence of overt toxic signs. PMID- 3670559 TI - Evidence for an extra-abdominal site of action for the 5-HT3 receptor antagonist BRL24924 in the inhibition of radiation-evoked emesis in the ferret. AB - Recent studies have implicated 5-HT3(5-HT-M) receptors in the genesis of retching and vomiting evoked by antineoplastic agents. Such receptors have so far only been located peripherally, notably on the vagus. Therefore, the effects of bilateral abdominal vagotomy and antagonism of 5-HT3 receptors have been investigated on retching and vomiting induced by radiation. The gastrokinetic substituted benzamide BRL24924, (Beecham Pharmaceuticals) which has 5-HT3 receptor antagonist properties, was used. Using the ferret, it was shown that whole body x-radiation produced retching and vomiting, which was most severe during the 30 min following irradiation, and continued for at least 90 min. Abdominal vagotomy almost totally abolished the retching and vomiting, occurring during the 30 min immediately after irradiation. The following 60 min period was similar to that of control animals. This would suggest that the emetic events can be divided into a vagally-dependent and independent phase. In a small dose, BRL 24924 mimicked abdominal vagtotomy, in a larger dose, it almost totally abolished the retching and vomiting throughout the entire 90 min period. These results suggest that 5-HT3 receptor antagonists are capable of ameliorating radiation induced retching and vomiting and that, while an important site of their action could be the abdominal vagi, other areas are probably also involved. PMID- 3670560 TI - 5-Hydroxytryptamine agonistic action of methysergide and the absence of supersensitivity to 5-HT agonists in spinal flexor reflexes in rats. AB - The intravenous administration of L-5-hydroxytryptophan (5-HTP), 5-methoxy-N,N dimethyltryptamine (5-MeODMT), p-chloroamphetamine (PCA), LSD and methysergide to acute spinal rats, transected at C1, stimulated the flexor reflexes induced by electrical stimulation applied to the skin of the toe. The enhancement produced by 5-HTP, 5-MeODMT and PCA, was not antagonized by the prior administration of a dose of LSD or methysergide, although the enhancement produced by 5-MeODMT, LSD and methysergide, but not that produced by 5-HTP and PCA, was antagonized by cyproheptadine. In rats treated with 5,6-dihydroxytryptamine (intracisternal administration, 2 weeks previously) supersensitivity was observed to the effects of 5-HTP, a precursor of 5-HT, while subsensitivity was observed for the effects of PCA, a releaser of 5-HT. However, no supersensitivity was observed for the effects of 5-MeODMT, LSD and methysergide. These results suggest that methysergide may have an agonistic action on the 5-HT receptors in spinal cord and that supersensitivity to 5-HTP in rats treated with 5,6-dihydroxytryptamine was due to the lack of uptake of 5-HT into terminals of descending 5-HT fibres or to the change in 5-HT receptors which were not sensitive to 5-MeODMT, LSD, methysergide or cyproheptadine. PMID- 3670561 TI - The effects of mazindol on local cerebral glucose utilization in rats. AB - The effects of mazindol (1 mg or 10 mg/animal, p.o.) on local cerebral utilization of glucose were studied by the quantitative autoradiographic [14C]2 deoxyglucose method in conscious adult male rats. Significant increases in local cerebral utilization of glucose were observed 2 hr after administration of 10 mg of mazindol in 10 out of 37 anatomically discrete regions examined. These 10 areas included regions rich in dopaminergic receptors (substantia nigra, globus pallidus), and also regions with few dopaminergic receptors (cerebral cortex, thalamus, cerebellum). Only the habenular nucleus showed a significant decrease in utilization of glucose induced by the administration of 10 mg of mazindol. No significant changes in local cerebral utilization of glucose were observed following the administration of 1 mg of mazindol. The fact that the pattern of utilization of glucose observed in this study resembled that produced by apomorphine, a putative dopaminergic agonist, indicates that the pharmacological effects of mazindol are related to the dopaminergic system. PMID- 3670562 TI - The effect of carbamazepine on the post-tetanic twitch tension in the diaphragm of the mouse. AB - The effects of carbamazepine (0.084-0.25 mM) on the post-tetanic potentiation of the twitch tension, were studied on the isolated phrenic nerve diaphragm preparation of the mouse. Carbamazepine decreased the post-tetanic potentiation of the twitch tension. The maximal depressant effect was found after higher frequencies and longer durations of stimulation. After repetitive stimulation, the amplitude of the endplate potential and the frequency of miniature endplate potentials were potentiated. Carbamazepine decreased the post-tetanic potentiation of the amplitude of endplate potential and the frequency of miniature endplate potentials. The directly-elicited muscle action potential was not affected when post-tetanic potentiation of the twitch tension was decreased. It is concluded that carbamazepine suppressed the post-tetanic potentiation of the indirectly-elicited twitch tension, mainly due to its pre-synaptic inhibitory effect. PMID- 3670563 TI - Pharmacological characteristics of tremor, rigidity and hypokinesia induced by reserpine in rat. AB - The experiments characterized the dose- and time-dependence of parkinsonian motor signs induced by reserpine in rats and a standardized system of manipulation of animals, evaluation of symptoms and analysis of data was devised. The assay procedure yielded no more than 0.5, 4.5 and 0.0% false positives with the evaluation of tremor, rigidity and hypokinesia, respectively. A dose-dependent and often complete blockade of all three signs was obtained with L-DOPA plus carbidopa (10:1) as well as with other classes of pharmacological agents that are used in the treatment of Parkinson's disease, i.e. direct or indirect dopamine (DA) agonists (amantadine, pergolide, lisuride) and inhibitors of monoamine oxidase (MAO) (clorgyline, pargyline, deprenyl, tranylcypromine). The inhibitor of the uptake of DA, nomifensine, and anticholinergics, 5-hydroxytryptamine (5 HT) antagonists, histamine antagonists and tricyclic antidepressants exerted little or no effect. The effects of putative agonists and antagonists at alpha 1- and alpha 2-adrenoceptors were also examined. Yohimbine blocked tremor and rigidity, but not hypokinesia, at 0.66 and 0.28 mg/kg, respectively. It is suggested that alpha-adrenergic mechanisms and, in particular, alpha 2 adrenoceptors, may be involved in reserpine-induced tremor and rigidity. Noradrenergic and dopaminergic systems can conceivably interact to progressively generate these different motor signs. PMID- 3670564 TI - Effects of salicylates and paracetamol compared to lidocaine on nerve conduction in vitro. AB - The effects of acetylsalicylic acid, salicylic acid, sodium salicylate and paracetamol on the compound action potentials of the isolated left phrenic nerve of the rat were observed, and compared to that of lidocaine. All drugs depressed the compound action potential in a reversible, dose-dependent way. Lidocaine (inhibition between 0.05 and 10 mM) was more potent than the other drugs and the depression occurred faster. The inhibitory effects of acetylsalicylic acid and salicylic acid were similar to each other (between 1 and 20 mM). Sodium salicylate was less potent (inhibition between 5 and 70 mM). These concentrations cover the plasma levels reported after therapeutic and toxic doses for the salicylates. Inhibition of nerve conduction may therefore contribute to the adverse nervous effects seen after intoxication with salicylates. In contrast, the observed concentrations for inhibition of the compound action potential caused by paracetamol (between 6.7 and 53 mM) were far greater than the plasma concentrations reported after therapeutic doses or after intoxication with paracetamol. Thus, the inhibition of the compound action potential, caused by paracetamol does not contribute to the therapeutic analgesic effects of paracetamol. PMID- 3670565 TI - Changes in the activity of GAD in the basal ganglia of the rat after striatal dopaminergic denervation. AB - The aim of this experiment was to study the effect of a unilateral lesion of the dopamine-containing nigro-striatal pathway, on the activity of glutamic acid decarboxilase (GAD) in different structures at two survival times: 4 and 8 weeks. The structures studied were the striatum and its output target areas, globus pallidus, entopeduncular nucleus and substantia nigra. Four weeks after the lesion, GAD activity was increased in the ipsilateral striatum, globus pallidus and substantia nigra. This effect was reversed at 8 weeks, when a decrease in enzyme activity was observed. These time related changes in enzyme activity reveal the presence of a physiological compensatory process. PMID- 3670566 TI - Oxytocin and arginine vasopressin stimulate steroid secretion by the isolated perfused rat adrenal gland. AB - Using the intact isolated perfused rat adrenal preparation we have shown for the first time a direct effect of oxytocin on adrenocortical steroid secretion. Oxytocin specifically stimulated aldosterone secretion in a dose-dependent manner with a threshold dose of 1 pmol. Arginine vasopressin was also shown to be a potent stimulus to aldosterone secretion and was additionally found to stimulate inner zone function. Using superfused adrenal cells, the effects of arginine vasopressin were only seen at 10,000 times higher doses than were effective in the intact perfused gland, and oxytocin had no effect at any dose. These results reinforce the hypothesis that tissue integrity is essential for full expression of steroidogenic control mechanisms. We conclude that oxytocin and vasopressin may play a role in the control of steroidogenesis. PMID- 3670567 TI - Elevation of arterial pressure in rats by two new vertebrate peptides FLFQPQRF NH2 and AGEGLSSPFWSLAAPQRF-NH2 which are immunoreactive to FMRF-NH2 antiserum. AB - We found that two recently characterized neuropeptides Phe-Leu-Phe-Gln-Pro-Gln Arg-Phe-NH2 (F-8-F-NH2) and Ala-Gly-Glu-Gly-Leu-Ser-Ser-Pro-Phe-Trp-Ser-Leu-Ala Ala-Pro-Gln-Arg-Phe-NH2 (A-18-F-NH2) elevate mean arterial blood pressure (MAP) in conscious, unrestrained rats. The pressor activities of both agents were attenuated, but not abolished, by prior treatment with guanethidine or prazosin. These results suggest that F-8-F-NH2 and A-18-F-NH2 elevate MAP in rats by potentiating the release of catecholamines and by mechanisms independent of catecholamine release. PMID- 3670568 TI - Oxytocin-induced facilitation of lordosis behaviour in rats is progesterone dependent. AB - Oxytocin was administered intracerebroventricularly to ovariectomized female rats and its effect on lordosis was examined. In Experiment 1a, oxytocin (0.17 mU in 4 microliters saline) failed to facilitate lordosis behaviour in animals primed acutely with 10 micrograms estradiol benzoate (EB) and 300 micrograms progesterone (P). In Experiment 1b, however, oxytocin significantly facilitated lordosis in animals primed acutely with 10 micrograms EB and 250 or 200 micrograms P. In Experiments 2a and 2b, oxytocin failed to facilitate lordosis in animals treated acutely with 10 micrograms EB, or chronically with 0.8 micrograms EB daily for eight days prior to testing. These results support the hypothesis that the facilitation of lordosis in ovariectomized rats by centrally administered oxytocin is progesterone-dependent. PMID- 3670569 TI - CCK 8 analgesia and hyperalgesia after intrathecal administration in the rat: comparison with CCK-related peptides. AB - The C-terminal octapeptide of cholecystokinin (CCK 8) was administered intrathecally to rats. Doses in the nanogram range produced weak but significant antinociception in the paw pressure test five minutes after injection whereas microgram doses of CCK 8 produced hyperalgesia. The CCK 8-induced analgesia or hyperalgesia was not seen in the tail flick test and was not associated with motor incapacitation or any other noticeable side effects. The C-terminal tetrapeptide of CCK (CCK 4) and pentagastrin were found to be ineffective in all tests but caerulein and molluscan cardioexcitatory neuropeptide (FMRF-amide), like CCK 8, produced antinociception in the paw pressure test. PMID- 3670570 TI - Structure-activity studies of C- and N-terminal fragments of cholecystokinin 26 33 in guinea pig isolated tissues. AB - In vitro structure-activity studies with cholecystokinin (CCK)/gastrin-related peptides, including C- and N-terminal fragments of CCK 26-33, were undertaken in guinea pig gallbladder and ileum. The general order of potency in both smooth muscle preparations is CCK 26-33 greater than CCK 1-33 greater than 27-33 much much greater than nonsulfated (NS) CCK 26-33 greater than pentagastrin greater than CCK 30-33. None of the CCK fragments exhibit antagonistic properties such as in guinea pig, rat and mouse pancreatic acinar cells and hog duodenum. These observations suggest the existence of CCK receptor sub-types in peripheral tissues. PMID- 3670571 TI - Cognition and adjustment after late and early operation for ruptured aneurysm. AB - Does early aneurysm operation, while lowering the overall management mortality, result in an unacceptable morbidity in terms of increased cognitive disturbances and psychosocial maladjustment? The present study evaluates quality of life, degree of cognitive dysfunction, and adjustment of 93 patients with satisfactory neurological recoveries after operations for ruptured supratentorial aneurysms. All patients had been in neurological Grades I to III (Hunt and Hess) after subarachnoid hemorrhage (SAH). Fifty-five patients were operated upon during the acute state, i.e., within 72 hours after bleeding (early surgery = ES), and 38 patients had been subjected to late surgery (LS), i.e., were operated on 9 days or more after SAH. Each patient was subjected to a clinical interview and a comprehensive neuropsychological investigation. The time interval between SAH and assessment varied between 12 and 103 months (mean, 56 months). The results confirm that there are indication of cognitive malfunctioning and psychosocial disturbances of varying severity and distribution in patients who have undergone LS. The pattern and distribution of sequelae after LS did not differ substantially from that in patients subjected to ES. The results offer strong support to the concept that remaining disturbances in cognition are mainly related to the impact of the initial hemorrhage per se. In patients with anterior communicating artery aneurysms, a larger decrease in tempo and perceptual vigilance was noted, suggesting that the subfrontal midline structures are particularly involved in processes demanding flexibility, attention, and capacity to adapt to novel demands in a perceptual situation. PMID- 3670572 TI - Common carotid occlusion for unclippable carotid aneurysms: an old but still effective operation. AB - We present a selected series of nine patients with unclippable internal carotid artery aneurysms to illustrate our current approach to this problem. Eight of the nine underwent common carotid ligation after preoperative angiographic evaluation. Tolerance to carotid occlusion was determined intraoperatively by awake examination, electroencephalogram (EEG) monitoring, and carotid stump pressure measurements. No patient developed a permanent deficit; seven of eight treated aneurysms have thrombosed. Our experience and review of the literature indicate that most ischemic complications after carotid ligation seem to be thromboembolic, rather than due to "low flow" from poor collateral circulation. For this reason, we have gradually come to favor common carotid (CCA) over internal carotid (ICA) occlusion in many of these patients. After CCA occlusion, the ICA frequently remains open and embolic complications are therefore less likely. An extracranial-intracranial bypass procedure is performed only in those patients with poor collateral circulation demonstrated by cross compression angiographic studies, by the development of new deficits during test occlusion, or by the appearance of EEG changes during test occlusion. We suggest that CCA ligation remains a useful alternative in the management of unclippable internal carotid aneurysms. PMID- 3670573 TI - Effects of intravascular volume expansion on cerebral blood flow in patients with ruptured cerebral aneurysms. AB - To clarify the effect of intravascular volume expansion on cerebral blood flow (CBF) in patients after subarachnoid hemorrhage (SAH), we performed 55 pairs of regional CBF measurements using the xenon-133 inhalation method before and after volume expansion in 35 patients with ruptured cerebral aneurysms. CBF was calculated as the hemispheric mean value of the initial slope index. To accomplish volume expansion, we transfused 500 ml of 5% human serum albumin in half an hour. After volume expansion with albumin, the hemoglobin value decreased significantly (P less than 0.005). Volume expansion did not change the mean arterial blood pressure. During the first 2 weeks after SAH, CBF decreased significantly after volume expansion (P less than 0.005). During the 3rd week after SAH and subsequently to the 4th week after SAH, volume expansion produced no change in CBF. In patients with symptomatic vasospasm, CBF decreased significantly after volume expansion (P less than 0.005). In patients without symptomatic vasospasm, volume expansion produced no change in CBF. The results of this study suggest that increasing the intravascular volume above normal by volume expansion does not increase CBF or reverse symptomatic vasospasm. PMID- 3670574 TI - Subarachnoid hemorrhage of unknown cause. AB - After the institution of computed tomography (CT), 814 cases of spontaneous subarachnoid hemorrhage (SAH) were treated during a period of 6 years and 9 months (April 1978 through December 1984). In 9 (22.0%) of 41 patients whose cause of SAH was not determined by the first four-vessel study (cerebral panangiography), ruptured aneurysms were found by repeated four-vessel study. Thus, of 814 cases, only 32 (3.9%) were diagnosed as cases of unknown etiology at discharge. The 32 cases were monitored by follow-up examination for 5 to 67 months (median, 27.1 months) after onset. No recurrence of SAH was reported, and all patients were rehabilitated except 2 who suffered terminal carcinoma. A third follow-up four-vessel study was performed 8 to 44 months (median, 22.0 months) after the second study in 14 of the 16 patients with SAH initially demonstrated by CT. In 1 of these cases, an aneurysm found 9 months after the initial SAH was treated surgically. Ultimately, 31 cases (3.8%) were diagnosed as cases of SAH of unknown cause. This incidence is low when compared with those in previous reports. Because of the strict examination schedule including repeated angiography, the incidence is lower and the prognosis is relatively favorable. PMID- 3670575 TI - Staged treatment of arteriovenous malformations of the brain. AB - Twenty-eight patients treated for arteriovenous malformations (AVMs) of the brain had staged therapy consisting of multiple surgical procedures or endovascular embolization followed by surgical treatment. There were 10 men and 18 women, aged 15 to 60 years (mean, 34 years). The clinical symptoms were those associated with intracranial hemorrhage in 13 patients, progressive neurological deficit not due to hemorrhage in 6, intractable headache in 5, and seizures in 4. Four groups were identified based upon the reason for staging therapy. Thirteen patients with large high flow AVMs (Group A) had staged treatment because of the risk of normal perfusion pressure breakthrough. The initial afferent artery occlusion was accomplished surgically in 9 patients and by endovascular embolization in 4. Postoperatively, no patient in this group had malignant cerebral edema or intracranial hemorrhage suggestive of normal perfusion pressure breakthrough, but 1 patient had an intraventricular hemorrhage after initial embolization. In 9 patients (Group B), the AVM had a complex multiple arterial supply that precluded resection from a single operative exposure. Seven had supratentorial AVMs, and 2 had AVMs of the posterior fossa. In 6 of these cases, the AVM was located in the midline and received bilateral arterial input. Six patients had staged surgical procedures, and 3 had an initial endovascular embolization followed by operation. Two patients had intracerebral hemorrhages, one after an initial surgical procedure and another after initial embolization. In 4 patients (Group C), the AVM had a major dural component that was treated separately from the parenchymal component. In 3 of these patients, embolization through the external carotid artery satisfactorily obliterated the dural component; in the remaining patient, a persistent internal carotid supply necessitated resection of the dural malformation. The parenchymal component was excised surgically in 2 patients. Two patients (Group D) had separate surgical procedures to treat an aneurysm associated with a parenchymal AVM. Overall, 19 of 28 patients had complete excision and 9 had partial obliteration of their AVMs. Late follow-up of 27 patients at a mean of 18.6 months showed that 16 patients were in excellent condition and 8 were in good condition. Three patients were in poor condition with debilitating neurological deficits. One patient had a delayed intracranial hemorrhage 22 months after incomplete obliteration of her AVM. Staged treatment of selected AVMs of the brain may avoid the occurrence of normal perfusion pressure breakthrough.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3670576 TI - Effects of angioplasty upon carotid sinus mechanical properties and blood pressure control in the dog. AB - The effects of vein patch angioplasty of the carotid sinus upon carotid sinus control of blood pressure and carotid sinus mechanical properties were studied in nine vagotomized dogs. Pressures in the isolated carotid sinuses were increased from 60 to 180 mm Hg in steps of 30 mm Hg, and the resulting reflex changes in mean aortic pressure were measured both before and after unilateral angioplasty. Angioplasty significantly decreased aortic pressure for carotid sinus pressures above 60 mm Hg, decreased the calculated carotid sinus reflex set point pressure, and increased the range of control of arterial blood pressure together with the maximal capacity of the arterial baroreceptors to effect vasoconstriction. In five dogs, concomitant changes in carotid sinus diameter were measured. From the latter, together with accompanying changes in sinus wall geometry, were calculated the tension-strain modulus of elasticity of the carotid sinus wall, together with the radial displacement of the media-adventitial junction. Calculated increases in the latter were consistent with the observed increased effectiveness of the carotid sinus baroreceptors after angioplasty. It was concluded that the modification of blood pressure and its control was predominantly due to the surgical exaggeration of normal carotid sinus geometry accompanied by modest changes in carotid sinus wall mechanical properties. PMID- 3670577 TI - Foraminal cervical herniated disc treated by anterior discoforaminotomy. AB - The authors report their experience with cervical foraminal disc herniation. The importance of the computed tomographic scan in its diagnosis is emphasized, and discoforaminotomy is described. PMID- 3670578 TI - T2 and T3 sympathetic ganglia in the adult human: a cadaver and clinical radiographic study and its clinical application. AB - The technique of percutaneous radiofrequency (RF) upper thoracic sympathectomy mandates an exact knowledge of the anatomical location of the sympathetic ganglia. Because conflicting descriptions are given in anatomy texts, we examined the T2 and T3 sympathetic ganglia in 48 sympathetic chains in adult cadavers to measure the exact location of the ganglia. Measurements were made relative to their distances (a) dorsal to the ventral surface of the vertebral body and (b) rostral or caudal to the midpoint of the vertebral body. Median locations of T2 and T3 ganglia were 17 to 20 mm dorsal to the ventral surface of the vertebral body and 2 mm rostral to the T1-T2 and T2-T3 vertebral bodies. The sympathetic chains lay lateral to and between the heads of the ribs at these levels. A clinical-radiographic correlation study of the sympatholytic effectiveness of various needle electrode placement sites during sympathectomy confirmed these findings. These data have been used to modify the technique of percutaneous RF sympathectomy. PMID- 3670579 TI - Intradural spinal lipomas. AB - Intradural spinal lipomas are rare, and their origin is unknown. Although the clinical presentation may not be distinctive, the neuroradiographic presentation is. Total excision is usually not possible, although subtotal resection is easily accomplished using an ultrasonic aspirator. PMID- 3670580 TI - Hydrosyringomyelia and its management in childhood. AB - Syringomyelia, once regarded as a degenerative disease of adults, is now recognized to be a disorder usually associated with the Chiari malformation and occurring in patients of all ages. We have reviewed 47 patients with syringomyelia treated on the Neurosurgical Service at the Hospital for Sick Children during the years 1977 to 1985. Twelve of these patients had a Chiari I malformation, 30 had a Chiari II malformation, and 5 had an acquired Chiari malformation. Thirty-one of these patients were treated by decompression of the Chiari malformation and plugging of the obex, 5 were treated by a simple posterior fossa decompression, 9 were treated by shunting of the syringomyelic cavity, and 2 were treated by a combined decompression of the posterior fossa and shunting of the syrinx. The Gardner procedure (decompression of the Chiari malformation and plugging of the obex) was the procedure most commonly used in managing our group of patients and resulted in improvement in over 70% of patients. PMID- 3670581 TI - Effect of high altitude on the visual evoked responses in humans on Mt. Everest. AB - Cerebral visual evoked potentials (VEPs) were collected over a 1-year period from the summer of 1983 through the summer of 1984 from 16 members of the American Ultima Thule Everest Expedition at sea level and at altitudes of 7,100 ft, 16,800 ft, and 21,300 ft. VEPs in response to 100 unilateral LED flashes were processed by a modified Nicolet CA-1000 computer of average transients with an analysis time of 250 ms and were recorded by an X-Y plotter. Readings of oxygen saturation, tetrapolar impedance pulmonary plethysmography, and clinical signs and symptoms of acute mountain sickness (AMS) were recorded. The latency of the major waves of the VEPs increased on initial arrival at higher altitude and returned toward base line over time with acclimatization. There were more acute latency changes in individuals who suffered from symptoms of AMS, which reversed with amelioration of symptoms. PMID- 3670582 TI - Comparative evaluation of intracranial epidermoid tumors with computed tomography and magnetic resonance imaging. AB - The diagnosis of intracranial epidermoid tumors with computed tomography (CT) is often difficult because of indistinct margins, close proximity to the skull base, and a density similar to that of cerebrospinal fluid (CSF). Recent experience with six histologically confirmed epidermoid tumors served to emphasize the value of magnetic resonance (MR) imaging in studying these lesions. MR images were obtained using varying spin echo and inversion recovery techniques with a 0.5 tesla superconducting magnet. CT with and without enhancement had been performed in each case. In Case 1, CT showed an ill-defined left cerebellopontine angle hypodensity. MR imaging clearly showed the presence of abnormal tissue at that location. Case 2 showed a CSF density mass in the right upper posterior fossa. MR imaging of that area showed a variegated signal of a mass extending supratentorially. CT of Case 3 showed a left medial middle fossa hypodensity with an enhancing rim. MR imaging showed a clearly extraaxial mass in that location. In Case 4, a diffuse cerebellar hemispheric hypodensity was observed on CT and was clearly demarcated by MR studies. A huge lesion, thought initially to be an arachnoid cyst on CT of Case 5, was seen on MR imaging to be a large, extraventricular mass displacing the temporal lobe. Finally, CT in Case 6 was suggestive of a poorly demarcated right cerebellopontine angle lesion, which was seen on MR images to be extraaxial, displacing the brain stem. Various MR images more clearly demonstrate the extent of abnormal tissue than CT of epidermoid tumors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670583 TI - Pituitary tumors composed of adenohypophysial adenoma and Rathke's cleft cyst elements: a clinicopathological study. AB - Nine cases of pituitary tumors composed of mixed tissue elements of adenohypophysial adenoma and Rathke's cleft cyst are reported. All cases were associated with hyperprolactinemia and were managed by transsphenoidal adenomectomy with good results. The clinical and pathological features are presented, and embryological pathogenesis for the occurrence of this unique association is discussed in connection with the high incidence of immunoreactive S-100 protein cells identified in tumor tissues. Patients with this kind of pituitary tumor can be managed in the same fashion as patients with other types of pituitary adenoma. PMID- 3670584 TI - Median nerve somatosensory evoked potentials as an indicator of ischemia in a case involving an aneurysm of the internal carotid artery. AB - We present a case report demonstrating that somatosensory evoked potentials (SEPs) suggested ischemia when an internal carotid aneurysm ruptured during surgical clipping. SEPs were also recorded from the contralateral cortex and subcortical and peripheral sites and remained unchanged. The use of multiple bilateral recording sites for SEP recording simplified the interpretation of acute changes. PMID- 3670585 TI - "Giant pneumoaneurysm" after combined internal carotid artery occlusion and extracranial-intracranial anastomosis. AB - A patient with a giant aneurysm of the internal carotid artery (ICA) was treated by combined ICA occlusion in the neck and superficial temporal artery to middle cerebral artery anastomosis. Six months after complete closure of the ICA, the patient had episodes of nasal discharge mixed with dark red, old blood. Computed tomographic scan demonstrated that the lumen of the giant aneurysm was filled with a large amount of air, which communicated with the nasal cavity. Not finding a similar case in the literature, we named this entity "giant pneumoaneurysm." After direct operation, the giant pneumoaneurysm collapsed. This unusual complication may be due to a decrease of blood supply to the aneurysmal wall through the vasa vasorum. PMID- 3670586 TI - Spinal extradural meningeal cysts that contain nerve fibers: case report. AB - We describe a case of extradural meningeal cysts of the lumbar spine that contain nerve fibers. These lesions are anatomically distinct from both perineurial and meningeal cysts. Drainage and suturing of the cyst walls to the dorsal dura mater was effective in relieving the clinical symptoms. PMID- 3670587 TI - Demonstration by magnetic resonance of symptomatic spinal epidural lipomatosis. AB - In patients with Cushing's syndrome or morbid obesity, excessive accumulation of fat in the hips, upper back, abdomen, and mediastinum is well known (1, 3, 7). Excessive deposition of fat in the epidural space is less common, but must be recognized as a potential cause of neurological deficit (1-8). We report a patient with iatrogenic Cushing's syndrome, in whom magnetic resonance imaging (MRI) established the specific diagnosis of spinal cord compression secondary to excess epidural fat. PMID- 3670588 TI - Preservation of the supraspinous ligament for spinal stenosis: a technical note. AB - Laminectomies and bilateral laminotomies for spinal stenosis have been performed over a period of 16 years at the Mercy Catholic Medical Center by preserving the supraspinous ligament along with the tips of the lumbar spines. More recently, this has been done utilizing a unilateral approach. This operation is technically feasible and with practice can be done routinely for extensive spine decompression, even for spinal tumor resection or spinal fusion. PMID- 3670589 TI - Unusual craniocerebral injuries by glass fragments. PMID- 3670590 TI - Rapid, spontaneous disappearance of acute subdural hematoma. PMID- 3670592 TI - Brain pH in severe head injury. PMID- 3670591 TI - Naloxone after spinal cord injury. PMID- 3670593 TI - Evidence for uptake and synthesis of 5-hydroxytryptamine by a subpopulation of intrinsic neurons in the guinea-pig heart. AB - Using an indirect immunofluorescence technique, a subpopulation of 5 hydroxytryptamine-like immunoreactive neurons was observed in cell cultures dissociated from the atria and interatrial septum of newborn guinea-pig heart maintained in fetal calf serum-supplemented medium. 5-Hydroxytryptamine has not been demonstrated in intracardiac neurons in situ, and since 5-hydroxytryptamine has been previously shown to be a constituent of fetal calf serum, the 5 hydroxytryptamine-like immunoreactivity seen in culture may have been the result of neuronal uptake of 5-hydroxytryptamine from the growth medium. This was examined by growing the cultures in a serum-free, hormone-supplemented, defined medium. Under these conditions, 5-hydroxytryptamine-like immunoreactive neurons were not present. When cultures were grown in hormone-supplemented, defined medium containing 10(-4) to 10(-6) M 5-hydroxytryptamine, some intracardiac neurons accumulated 5-hydroxytryptamine. This type of neuron also developed 5 hydroxytryptamine-like immunoreactivity after incubation with 5 X 10(-5) M 5 hydroxytryptophan, indicating that the subpopulation of intracardiac neurons which can take up exogenous 5-hydroxytryptamine can also synthesize it from 5 hydroxytryptophan. However, no 5-hydroxytryptamine-like immunoreactive neurons were observed after incubation with L-tryptophan, the other 5-hydroxytryptamine precursor molecule. Under all of the conditions described, some small, 5 hydroxytryptamine-like immunofluorescent cells, very similar to the catecholamine containing, small intensely fluorescent cells of the heart, were observed in culture. Bright, 5-hydroxytryptamine-like immunoreactive endothelial cells were seen only in cultures maintained in defined medium and loaded with 5 hydroxytryptamine. The present study shows that some intracardiac neurons are amine-handling, and also raises the possibility that 5-hydroxytryptamine is utilized as a neurotransmitter or neuromodulator by these neurons in the mammalian heart. Further, there is evidence to suggest that two populations of small intensely fluorescent cells, one containing 5-hydroxytryptamine, the other a catecholamine, are present in the heart; and to indicate that atrial endothelial cells can take up 5-hydroxytryptamine. PMID- 3670594 TI - The effects of excitotoxic lesions of the substantia innominata, ventral and dorsal globus pallidus on the acquisition and retention of a conditional visual discrimination: implications for cholinergic hypotheses of learning and memory. AB - The effects of ibotenic acid-induced lesions of the ventral pallidum/substantia innominata region, the dorsal pallidum or both on the acquisition and retention of a conditional visual discrimination have been studied in the rat. Lesions of the ventral pallidum and large lesions of the dorsal and ventral pallidum severely impaired both the acquisition and retention of the conditional discrimination. Dorsal pallidal lesions had similar, but less marked effects. The same lesions also impaired the retention of a passive avoidance task, but had no effect on a conditioned taste aversion. Neurobiological investigations revealed that the lesions destroyed cholinergic neurons in the magnocellular nucleus basalis and caused reductions in cortical choline acetyltransferase activity of about 30-40%. Tract-tracing experiments indicated that the lesions destroyed, in particular, cholinergic neurons projecting to the frontal dorsolateral cortex and also those projecting to more posterior cortex, but not the occipital lobes. Contingency analysis of the behavioural, neurochemical and neuroanatomical data indicated that those animals with the largest decreases in choline acetyltransferase activity, or the largest areas of neuronal loss in the ventral and dorsal globus pallidus, were most impaired in the retention of the conditional discrimination. The results do not, therefore, indicate a simple relationship between cholinergic neuronal loss and the retention of response rules essential for performance of the task ("reference memory"). The relevance of the results to cholinergic hypotheses of learning and memory is discussed. PMID- 3670595 TI - Delayed neurotoxicity of excitatory amino acids in vitro. AB - The acute neurotoxicity produced by glutamate and related excitatory amino acids is probably caused by depolarization leading to excessive anionic and cationic fluxes and osmotic lysis. Recently, a more delayed form of glutamate neurotoxicity, which is critically dependent upon calcium influx, has been described in cultured neocortex. We investigated this phenomenon in cultures of dispersed rat hippocampal neurons. When these cultures were briefly incubated with various excitatory amino acids in low extracellular chloride, there was no acute toxicity, but a gradual drop-out of neurons occurred over the next day. When calcium was removed from the extracellular medium during amino acid incubation, this late neuronal loss was not seen. Interestingly, blocking excitatory amino acid receptors in cultures after the amino acid exposure also prevented this delayed neuronal death. In addition, these treated cultures contained neurons with normal physiological properties, and had concentrations of adenosine triphosphate that were close to control values. The findings suggest an amino acid-induced calcium influx may elevate the release of endogenous excitatory transmitter, likely glutamate, and/or increase the sensitivity of these neurons to glutamate. These in vitro observations may partially explain the delayed neuronal loss seen in some pathological conditions affecting man. PMID- 3670596 TI - Neurotensin in the human brain. AB - The localization of neurotensin-immunoreactive sites in the adult human brain was investigated by the indirect immunoperoxidase method of Sternberger [Sternberger (1979) Immunocytochemistry. Wiley, New York]. Our results demonstrate a widespread, albeit uneven occurrence of neurotensin-immunoreactive cells and processes throughout the central nervous system. Immunoreactive cells are prominent in the medial hypothalamus and in various regions of the limbic system, including the amygdaloid body, septal area, bed nucleus of the stria terminalis and piriform cortex. A few cells were also found in the dorsal synencephalon, superior colliculus, periaqueductal grey and spinal trigeminal nucleus. The distribution of immunoreactive fibres corresponds well with that reported for rodents. Areas with the highest concentration of neurotensin-immunoreactive processes included all the areas where immunoreactive neurons were found and, in addition, periventricular thalamic nuclei, the sublenticular region, lateral parts of the brainstem reticular formation and the vagus-solitarius complex. Comparison mapping studies of melanin-containing neurons on sections treated with neurotensin antiserum revealed an anatomical relation between almost all the catecholaminergic cell clusters with peptide-containing fibres. PMID- 3670597 TI - Alterations in hippocampal extracellular amino acids and purine catabolites during limbic seizures induced by folate injections into the rabbit amygdala. AB - The effects on hippocampal extra- and intracellular amino acids of focal injection of folic acid into the amygdala in the rabbit were studied with brain dialysis. Folate seizures were accompanied by pronounced elevations of extracellular alanine and phosphoethanolamine. The increase of extracellular alanine was related to an enhanced level of this amino acid in total hippocampal tissue, whereas phosphoethanolamine was unaltered in tissue biopsies. Folate seizures did not significantly affect extracellular aspartate and extracellular glutamate was only slightly elevated (50-75% over baseline values). The tissue concentration of glutamate remained at control levels during the seizures and tissue aspartate was decreased by 28%. Extracellular glutamine decreased rapidly after folate injection with a concomitant increase of total hippocampal glutamine. Neither extra- nor intracellular taurine was affected by folate epilepsy. The experiments also encompassed measurements of the extracellular purine catabolites inosine, hypoxanthine and xanthine. Folic acid-induced epilepsy produced changes in these compounds indicative of moderately accelerated degradation of adenosine 5'-triphosphate. The findings support the view of glutamate as a mediator of epilepsy-related brain damage. It is, however, questionable if the small enhancement of extracellular glutamate is enough to provoke neuronal necrosis associated with folate epilepsy. PMID- 3670598 TI - Distribution of GABA-immunoreactive neurons in the thalamus of the squirrel monkey (Saimiri sciureus). AB - A light microscopic study of the cellular localization of GABA in the thalamus of the squirrel monkey (Saimiri sciureus) was undertaken by means of the indirect peroxidase-antiperoxidase method using a highly purified antiserum directed against GABA-glutaraldehyde-lysyl-protein conjugate. GABA-immunoreactive cell bodies and axon terminals were visualized in all thalamic nuclei in the squirrel monkey but their relative density varied from one nucleus to the other. At the level of the anterior nuclear group, GABA-positive cells and terminals abounded in the anterodorsal nucleus but were much less numerous in the anteromedial and anteroventral nuclei. In the nuclei of the ventral group, GABA-immunoreactive cells were found to be smaller and less numerous than nonimmunoreactive neurons. In the ventral anterior nucleus, GABA-positive neuronal profiles formed typical clusters, whereas they were more uniformly distributed in the posterior nuclei of the ventral group. In the intralaminar nuclei, GABA-immunoreactive cells and terminals abounded in the dorsal portion of the paracentral and centrolateral nuclei, whereas more caudally, GABA-positive terminals pervaded the entire parafascicular nucleus. In the mediodorsal nucleus, GABA-positive cell bodies and axon terminals formed typical clusters of various sizes scattered within the lateral parvocellular portion of the nucleus, while GABA-immunoreactive neuronal profiles were less numerous and more uniformly distributed in the medial portion of this structure. In the nuclei of the posterior group, GABA-immunoreactive neuronal profiles were uniformly distributed except in the pulvinar where they abounded in the inferior and oral parts but were scarce in the medial part. In the dorsal lateral geniculate nucleus, the magnocellular layers received the most massive GABA-positive innervation and contained the largest number of GABA immunoreactive cell bodies. In the ventral lateral geniculate nucleus, GABA positive cells occurred only ventrolaterally while GABA-immunoreactive terminals pervaded the entire structure. In the medial geniculate nucleus, GABA immunoreactive cell bodies and terminals abounded particularly within the ventromedial third of the structure. In the habenula, a few GABA-immunoreactive cell bodies and numerous GABA-positive terminals were scattered throughout the lateral habenular nucleus, whereas only a few GABA-immunoreactive terminals surrounded the closely packed unreactive cells in the medial habenular nucleus. In contrast to other thalamic nuclei all neurons in the reticular nucleus displayed GABA immunoreactivity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3670599 TI - In vivo measurement of [18F]fluorodeoxyglucose rate constants in rat brain by external coincidence counting. AB - The operational equation for the double-label deoxyglucose method described in the following paper requires the knowledge of the rate constants for transfer of fluorodeoxyglucose across the blood-brain barrier (K1* and K2*), and those for phosphorylation of fluorodeoxyglucose (K3*) and dephosphorylation of fluorodeoxyglucose-6-phosphate (k4*). These rate constants were determined in anesthetized rats by external coincidence counting. Radioactivity in parietal brain was measured for a 110 min experimental period after a bolus injection of 18F-labeled fluorodeoxyglucose. Apparent rate constants were obtained by fitting the resulting tissue radioactivity curves to the tissue radioactivity function of the deoxyglucose model modified to take into account the dephosphorylation of fluorodeoxyglucose-6-phosphate. The apparent fluorodeoxyglucose rate constants in rat brain are K1* = 0.195 ml g-1 min-1, k2* = 0.379 min-1, k3* = 0.088 min-1, and k4* = 0.009 min-1. PMID- 3670600 TI - Double-label autoradiographic deoxyglucose method for sequential measurement of regional cerebral glucose utilization. AB - A new double-label autoradiographic glucose analog method for the sequential measurement of altered regional cerebral metabolic rates for glucose in the same animal is presented. This method is based on the sequential injection of two boluses of glucose tracer labeled with two different isotopes (short-lived 18F and long-lived 3H, respectively). An operational equation is derived which allows the determination of glucose utilization for the time period before the injection of the second tracer; this equation corrects for accumulation and loss of the first tracer from the metabolic pool occurring after the injection of the second tracer. An error analysis of this operational equation is performed. The double label deoxyglucose method is validated in the primary somatosensory ("barrel") cortex of the anesthetized rat. Two different rows of whiskers were stimulated sequentially in each rat; the two periods of stimulation were each preceded by an injection of glucose tracer. After decapitation, dried brain slices were first exposed, in direct contact, to standard X-ray film and then to uncoated, "tritium sensitive" film. Results show that the double-label deoxyglucose method proposed in this paper allows the quantification and complete separation of glucose utilization patterns elicited by two different stimulations sequentially applied in the same animal. The double-label deoxyglucose is of potential usefulness in sensory physiology since it makes possible the separate mapping of regional cerebral glucose utilization patterns elicited by two sequentially applied sensory stimulations in the same animal. The method allows the quantification of a step-like change in regional cerebral glucose utilization in the same animal. It could be used to study the cerebral metabolic effects induced by neuropharmacological agents or surgical interventions applied during the experiment. Using each animal as its own control eliminates intersubject variability. Thus experimental cost and effort can be saved, and the reliability of the results obtained can be increased. PMID- 3670601 TI - Ultrastructural evidence for a functional unit between nerve fibers and type II cerebral mast cells in the cerebral vascular wall. AB - By histofluorescence microscopic examinations of pial arteries from rats and rabbits, we have observed that the routes of adrenergic fibers were apparently organized along successive sites of granular autofluorescent cells present in the adventitia. Subsequent electron microscopic studies showed that these cells were often situated in close apposition (80 to 200 nm) to the adventitial nerve bundles. The granular cells and nerve varicosities were frequently enclosed within the same basement membrane, with a membrane-to-membrane distance as small as 20 nm. However, no clear membrane differentiation was seen. These granular cells were identified histochemically by staining with Sudan Black, Oil Red O, Toluidine Blue, Alcian Blue, together with ultrastructural and pharmacological methods (48/80 compound and carbachol intracarotid infusions). The cells, many of which contained large amounts of lipids, showed morphological ultrastructural and pharmacological similarities to peripheral mast cells. Nerve bundles contained two types of varicosities: some of them degenerated after superior cervical ganglionectomy and were thus of sympathetic origin, whereas the others contained small clear vesicles (probably cholinergic) and/or large dense-cored vesicles (probably peptidergic). As we have shown that cholinomimetics induce exocytosis of these granular cells, the close relationship between these cells and the nerve fibers may indicate a neurogenic control of the cerebrovascular mast cell secretion. As these cells contain potent vasoactive substances, this relationship may be of importance in the genesis of physiological or pathological cerebrovascular events which are, as yet, poorly understood. PMID- 3670602 TI - Evidence that adenosine mediates the depression of spinal dorsal horn neurons induced by peripheral vibration in the cat. AB - Nociceptive neurons in the dorsal horn of the cat spinal cord are depressed by vibration applied to the ipsilateral hind limb. The present study investigated the pharmacological properties of this depression because of the possibility that it represents the neural basis at the spinal level for the analgesic effects of vibration in humans. Experiments were done in cats anesthetized with sodium pentobarbital and acutely spinalized at the first lumbar level. Extracellular recordings were made from nociceptive neurons in the lower lumbar segments. The depression of these neurons induced by vibration to the hindlimb was attenuated by administration of the P1-purinergic (adenosine) receptor antagonist, caffeine (20-60 mg/kg i.v.); the maximum attenuation was 100%. Effects of caffeine began within 2 min after the start of injection (1-3 min injection period), were greatest in the 10 min period after the end of injection and lasted for up to 2 hr. Importantly, another P1-purinergic receptor antagonist, which does not cross the blood-brain barrier, 8-sulphophenyltheophylline (8-16 mg/kg), had no effect on the depression when given intravenously (n = 5); however, when administered by iontophoresis 8-sulphophenyltheophylline blocked the depression in 2 of 6 units. Dipyridamole (1.0-2.0 mg/kg i.v.), an inhibitor of adenosine uptake, potentiated the depression in 2 of 5 cases. These results prompt us to suggest that depression induced by vibration may be mediated by adenosine via the activation of P1-purinergic receptors. On the other hand, the GABAA antagonist, bicuculline, failed to attenuate vibration-induced depression when administered either intravenously (0.2-0.4 mg/kg; n = 5) or by iontophoresis (n = 10) and the glycine antagonist, strychnine (0.2-0.6 mg/kg; n = 3) and the opiate antagonist, naloxone (0.1-0.4 mg/kg; n = 4) were similarly ineffective. These findings suggest that vibration-induced depression of these units occurs without involvement of bicuculline-sensitive GABA receptors, strychnine-sensitive glycine receptors and naloxone-sensitive opiate receptors. In view of the fact that vibration-induced depression is evoked synaptically, this study is the first to demonstrate in the central nervous system a synaptic response which is mediated by adenosine. In addition, we suggest that the analgesic effects of vibration in humans may be mediated at the spinal level by activation of P1-purinergic receptors. PMID- 3670603 TI - The development of the gracile nucleus in the rat: the time of ingrowth of ascending primary sensory fibres and effect of early deafferentation. AB - An investigation was carried out of the time of ingrowth of primary sensory fibres in the medulla and of their penetration into the gracile nucleus, and of the effect of an early loss of these fibres upon the development of the nucleus in rats. After injection of the conjugate horseradish peroxidase-wheat germ agglutinin in the hind limbs of fetuses, a bundle of labelled fibres was seen in close proximity of the gracile nucleus at embryonic day 17. However, fibres did not appear to leave the bundle until embryonic day 19, when they were seen to project ventrally and penetrate the nucleus which, on embryonic day 20 and thereafter, contained an increasing number of labelled fibres. Synaptic contacts within the gracile nucleus were found at all stages of the observation; the presynaptic processes consisted of an electron-lucent matrix which contained round vesicles. Although no mature glomeruli were observed, an occasional terminal appeared to be presynaptic to more than one process. After transection of the primary sensory afferents at embryonic day 18 and 19, no degeneration was seen within the gracile nucleus; degenerated boutons were occasionally seen after deafferentation at embryonic day 20 and became more numerous thereafter; nerve cells in various stages of degeneration could also be seen. Removal of primary afferents to the gracile nucleus at the time they reach the nucleus or soon after was followed by a severe loss of nerve cells and a reduced increment in size of the remaining ones. Moreover, the results of the present investigation show that penetration of primary sensory fibres into the gracile nucleus takes place approximately 2 days after they have been seen in the medulla and are in keeping with observations made in other pathways of the nervous system of the rat as well as in other animals. The findings that mature glomeruli, previously described in 1-day-old rats, are not present shortly before birth, suggest a fast rate of maturation of these synapses. PMID- 3670604 TI - The influence of some antidepressant drugs on the nuclear volume of rat cingular cortex cells in culture. AB - The changes in the volume of cell nuclei of the rat cingular cortex were investigated in culture after incubation with some antidepressant drugs. Two-week incubation of the cingular cortex culture with both tricyclic (desipramine, imipramine, amitryptyline) and non-tricyclic (mianserin) antidepressants in concentration of 3 X 10(-6) M resulted in a decrease of the volume of the cell nuclei. Because the size of the nucleus is regarded as a criterion of the cell metabolic activity, our results may point to a diminished activity of metabolic processes of the cells. PMID- 3670605 TI - Spatial buffering of potassium by retinal Muller (glial) cells of various morphologies calculated by a model. AB - In a previous study we found the morphometrical data of rabbit retinal Muller (radial glial) cells to vary greatly with their localization in various parts of the retina. The long cells of the central retina have thinner vitreal processes and smaller endfeet than the short cells of the retinal periphery. This configuration should impair the spatial buffering capacity of the central Muller cells for excess K+ ions. To test this hypothesis, we developed a simple modified model for the calculation of K+ clearance by spatial buffering, diffusion through the extracellular space, and co-operation of both processes. K+ clearance processes were demonstrated to depend greatly on the retinal geometry and Muller cell morphology in different parts of the retina. The efficiency of spatial buffering exhibited an obvious optimum for Muller cells of intermediate length, and decreased very steeply in longer cells. Some conclusions are drawn with respect to retinal physiology. In particular, it is suggested that very long and slender radial glia is unable to perform sufficient K+ clearance preventing long lasting extracellular [K+] elevations after neuronal activity. Such [K+] elevations could depolarize these glial cells so as to enforce their mitotic division. This mechanism might lead to the perinatal transformation of embryonic radial glia into adult multipolar glia when neuronal activity commences in CNS tissues thicker than the maximal effective length of radial glial cells. PMID- 3670606 TI - A quantitative study of anterograde and retrograde axonal transport of exogenous proteins in olfactory nerve C-fibers. AB - The pike olfactory nerve which consists of a homogeneous population of C-fibers of 0.25 micron diameter or less was used to study quantitatively both anterograde and retrograde axoplasmic transport of wheat germ agglutinin and horseradish peroxidase. It was found that even in these extremely thin axons anterograde and retrograde transport takes place. Activity distribution profiles (transport profiles) for retrograde transport were established and found to be similar to the typical profiles of anterograde transport as they consisted of a small rapidly moving peak and a saddle region followed by the bulk of the material which moved more slowly. Horseradish peroxidase activity profiles were obtained both after injection into the synaptic region and after injection into the perikaryal region. From these transport profiles a maximal velocity of 25 mm/d (19 degrees C) for the leading peak and of about 7 mm/d for the slower component could be determined. There is no significant difference between the velocities for anterograde and retrograde transport. In the case of wheat germ agglutinin, only injection into the synaptic region resulted in typical transport profiles (retrograde transport) with a peak and saddle region. The maximum velocities of retrograde transport were about the same as for horseradish peroxidase [26 mm/d and 7 mm/d (19 degrees C)]. The electron microscopic analysis of horseradish peroxidase revealed that after injection into the olfactory bulb it was taken up into the neurons where it was found mainly in multivesicular bodies (0.5 micron diameter). In longitudinal sections of the nerve similar but slightly more elongated organelles (diameter 0.25 micron, length 0.4 micron) were found in those segments in which the slowly moving bulk of the peroxidase activity was located. The number of these organelles decreased with distance from the site of injection. The horseradish peroxidase transported within the leading peak could not be assigned to specific structures although several electron microscopic histochemical methods were applied. It was concluded that anterograde and retrograde transport occur simultaneously in these axons, and that, therefore, even the large organelles, each of which almost fills the axon, must be able to pass each other. This would necessitate that the axons are able to transiently enlarge their diameter considerably. PMID- 3670607 TI - Effects of opioid peptides and naloxone on nervous tissue in culture. AB - It was shown that opioid peptides stimulate nervous tissue growth in culture in the rat, which manifests itself in augmented outgrowth of neurites from explants and in an increase in the number of glial and fibroblast-like cells in the growth zone. The effects of opioid peptides ([Leu]- and [Met]-enkephalins, beta- and gamma-endorphins and some synthetic analogues of [Leu]-enkephalin) on the growth of organotypic cultures of rat sympathetic and dorsal root ganglia and spinal cord were investigated. Neurite outgrowth, cell composition, and size of the growth zone as well as the dynamics of its formation were estimated. Changes in the survival of neurons in dorsal root ganglion cultures were determined. The experiments were performed with living cultures as well as with fixed preparations. In experiments with sympathetic ganglia, it was demonstrated that a significant growth-promoting effect is exerted by peptides taken at concentrations of 10(-8) M to 10(-14) M. Naloxone does not eliminate the effects of peptides, but stimulates the growth at 10(-5) M to 10(-7) M. Studies with spinal cord revealed that naloxone (10(-6) M) enhances the response to [Leu] enkephalin (10(-9) M). The survival of dorsal root ganglion neurons under the influence of a [leu]-enkephalin analog (10(-9) M) exceeds control values by approximately two to four times. Thus, opioid peptides were shown to exert a strong growth-promoting effect on nervous tissue in culture. This effect is dual: in neurons the peptides stimulate the outgrowth of neurites and their survival, while in glial cells they change the rate of their migration and, probably, their proliferation. It is suggested that opioid peptides, besides their already established functions, may play a role in the development and regeneration of nervous tissue. PMID- 3670608 TI - A model clinical neuroscience curriculum. AB - We have attempted to identify those attitudes, skills, and competencies in the clinical neurosciences that every graduating medical student should possess. Curricular guidelines are provided that may act as a model educational outline, to be adapted and utilized as individual circumstances dictate and resources permit. A universal, although not lockstep, curriculum emerges from these considerations. PMID- 3670609 TI - Lyme disease: cause of a treatable peripheral neuropathy. AB - Peripheral nerve dysfunction was demonstrated in 36% of patients with late Lyme disease. Of 36 patients evaluated, 14 had prominent limb paresthesias. Thirteen of these had neurophysiologic evidence of peripheral neuropathy; neurologic examinations were normal in most. Repeat testing following treatment documented rapid improvement in 11 of 12. We conclude that this neuropathy, which is quite different from the infrequent peripheral nerve syndromes previously described in this illness, is commonly present in late Lyme disease. This neuropathy presents with intermittent paresthesias without significant deficits on clinical examination and is reversible with appropriate antibiotic treatment. Neurophysiologic testing provides a useful diagnostic tool and an important measure of response to treatment. PMID- 3670610 TI - Transcranial Doppler in brain death. AB - Transcranial Doppler examinations (TCD) of 24 brain-dead adult patients demonstrated persistent movement of blood within the middle cerebral arteries in 21. The characteristic pattern of Doppler shift frequencies, seen in 14, was a sharply contoured, brief anterograde systolic envelope with reversed diastolic flow. Five others had variants of this pattern, and two had anterograde flow throughout the cardiac cycle, except at the end of diastole. This suggests that the internal carotid and proximal middle cerebral artery circulation remains patent, but distal resistance to flow in the brain is very high in the majority of brain-dead patients. Three other patients with absent brainstem reflexes but persistent EEG activity had normal TCD patterns. The characteristic pattern on TCD may be a useful ancillary finding in the diagnosis of brain death, and normal TCD patterns probably exclude the diagnosis. PMID- 3670611 TI - Perseveration in behavioral neurology. AB - We tested a new taxonomy of perseverative behavior consisting of three categories: (1) repetition of a previous response to a subsequent stimulus (recurrent), (2) inappropriate maintenance of a category of activity (stuck-in set), and (3) abnormal prolongation of a current activity (continuous). Three groups of neurologically impaired subjects (with aphasia, right hemisphere damage, and Parkinson's disease) were administered tests to elicit each category of perseveration. Patients with aphasia produced significantly more recurrent perseveration than did patients with right hemisphere damage or healthy controls. Stuck-in-set perseveration was associated with dopamine system dysfunction, and continuous perseveration with right hemisphere damage. We propose a theory of perseveration dependent on anatomic, neuropsychological, and pharmacologic factors related to cerebral dominance. According to this theory, disruption of specific anatomic and pharmacologic systems produces different forms of perseveration which, in turn, underlie particular neurobehavioral disorders. PMID- 3670612 TI - Basilar artery stenosis: middle and distal segments. AB - We report the clinical features and prognosis in nine patients with angiographically documented basilar artery stenosis of the middle and distal segments. Six patients had transient ischemic attacks (TIAs), and in two this was their only clinical manifestation. The TIAs in four patients included two or more of the following symptoms: dizziness, diplopia, perioral numbness, dysphagia, weakness, or loss of consciousness. Two other patients had isolated symptoms of transient dizziness and unilateral weakness. Seven patients had posterior circulation strokes, preceded by TIAs in four. Basilar artery occlusive disease can affect any segment of the artery. The short-term prognosis of middle and distal basilar artery stenosis was good especially when patients were treated with warfarin or platelet antiaggregants. PMID- 3670613 TI - Neuropsychological disturbances in hemiparkinson's disease. AB - Nine parkinsonian patients with main unilateral symptoms on the right side (RHP) and nine with symptoms on the left side (LHP) were assessed through a comprehensive neuropsychological battery. RHP performed at a lower level than LHP on the WAIS verbal subtests. Although both groups scored poorly on a test of frontal lobe functions, RHP performed significantly lower than LHP. On a line bisection task, LHP showed a mild left hemispatial neglect. In conclusion, mild but significant intergroup differences were observed, tending to correlate with predominantly hemispheric functional deficits. PMID- 3670614 TI - Dopamine agonist therapy for neglect in humans. AB - Lesions of ascending dopaminergic pathways induce neglect in animals. Apomorphine, a dopamine receptor agonist, decreases the magnitude of neglect in rats with cortical lesions. We treated two patients with 15 mg of bromocriptine daily for 3 to 4 weeks, one with chronic (longer than 6 months) and one with relatively more acute disabling neglect. Tests for neglect that significantly improved on therapy and worsened after its withdrawal included line, letter, and geometric figure cancellation tasks. Neither patient noted any untoward effects. Based on this open trial of dopamine agonist therapy in humans with neglect, larger controlled studies may be warranted. PMID- 3670615 TI - The use of the chemical shift of the phosphomonoester P-31 magnetic resonance peak for the determination of intracellular pH in the brains of neonates. AB - The use of the chemical shift of the phosphomonoester P-31 magnetic resonance peak for the determination of intracellular pH has been assessed for piglet and neonatal human brain in vivo. The chemical shift difference between resonance peaks corresponding to phosphoethanolamine and inorganic phosphate, compared with phosphocreatine, was determined for piglets and human neonates. Using in vitro pH titration data to calculate intracellular pH, it was found that pH values from the phosphoethanolamine peak (pH 6.84 to 6.80) were lower than pH estimates from the inorganic phosphate peak (pH 7.22 to 6.99). This difference suggests that phosphoethanolamine and inorganic phosphate may exist in different intracellular environments. Results are presented to demonstrate that the phosphomonoester peak may also be used to measure changes in intracellular pH associated with brain ischemia. PMID- 3670616 TI - Are there two forms of carnitine palmitoyltransferase in muscle? AB - Mitochondria were isolated from rat skeletal muscle, heart, and liver and from human skeletal muscle. The distribution of CPT I and CPT II was studied by measuring CPT activity and malonyl-CoA sensitivity before and after disruption of the mitochondria. Neither sonication, freezing and thawing, nor detergent treatment increased CPT activity in heart or skeletal muscle mitochondria, but these procedures did increase CPT activity in liver mitochondria. These results cannot be attributed to different kinetics of CPT I and II to palmitoyl-CoA or carnitine, or to different effects of electrolytes on CPT I and II. Sensitivity to inhibition by malonyl-CoA also failed to distinguish convincingly between CPT I and II in skeletal muscle. Because the presence of CPT I and II in muscle cannot be ascertained, the notion of a selective CPT I or II deficiency in muscle cannot be entertained. PMID- 3670617 TI - Acute ascending necrotizing myelopathy caused by herpes simplex virus type 2. AB - A 57-year-old diabetic man died of a rapidly ascending necrotizing myelitis. Autopsy results proved that the etiologic agent was herpes simplex virus type 2 (HSV2). The clinical findings, autopsy immunohistopathology, and electron microscopy suggest that either primary HSV2 infection or reactivation of HSV2 infection within dorsal root ganglia was followed by spread to the spinal cord. Viral infection of the CNS occurred by direct extension and led to death by involvement of the brainstem. Although there is only one previous report of HSV2 myelitis in the literature, our findings suggest that HSV2 might be a more common etiologic agent of necrotizing myelitis. Because CSF cultures are usually negative, viral inclusions are not usually seen, and morphologically identifiable virions are exquisitely rare, previous cases were probably descriptively diagnosed as acute ascending necrotizing myelitis without etiologic identification. PMID- 3670618 TI - Clinical significance of antibodies against peripheral nerve tissue in inflammatory polyneuropathy. AB - With the use of a mixed hemagglutination test (MHT), circulating antibodies against human peripheral nerve tissue (PNT) were found in 22 of 38 patients with Guillain-Barre syndrome (GBS) or chronic relapsing demyelinating inflammatory polyneuropathy (CR-DIP). The antibodies were found in only 1 of 34 patients with polyneuropathy of other origin, and in 3 of 32 patients without polyneuropathy. The presence of antibodies was related to response to intravenous gamma globulin treatment in CR-DIP patients. Antibodies against PNT may be pathogenic. PMID- 3670619 TI - Hyperornithinemia, hyperammonemia, and homocitrullinuria: case report and biochemical study. AB - Two siblings with hyperornithinemia, hyperammonemia, and homocitrullinuria are reported. The clinical picture included protein intolerance, mental retardation, seizures, and stuporous episodes. One patient had cerebellar ataxia, myoclonus, convulsive seizure, and muscular weakness in both legs. Isolated liver mitochondria in the patient revealed that ornithine transport and citrulline synthesis were decreased, but urea cycle enzymes and ornithine aminotransferase were normal. Ornithine metabolism was decreased in cultured skin fibroblasts. PMID- 3670621 TI - Multi-infarct PSP. PMID- 3670620 TI - Miliary metastasis to the brain: clinical and radiologic features. PMID- 3670622 TI - Paraquat and Parkinson's disease. PMID- 3670623 TI - Magnetic resonance imaging of brain tumors: application of gadolinium-DTPA and comparison to computed tomography. AB - In general, CT examinations still seem to be necessary for preoperative classification of brain masses. With increasing experience it should become clear whether sensitivity and specifity of MRI in the diagnosis of brain tumors can be further improved. Although much more work will be necessary in order to establish the optimal dose, timing, and pulse sequences when using Gd-DTPA, this study demonstrates that contrast changes due to Gd-DTPA can have clinical value. PMID- 3670624 TI - Magnetic resonance imaging in vascular malformations: studies with and without gadolinium-DTPA. AB - MRI and gadolinium-DTPA enhanced dynamic MRI increase the information available for and from diagnosis of vascular malformations since it appears possible to obtain nearly specific information about these lesions. Further investigations are needed with fast imaging, flow imaging, and MR substraction angiography to obtain information similar to that obtained by angiography and CT. The value of X ray CT for the diagnosis of vascular malformations seems to be inferior to MRI since MRI can delineate vessels and flow better and also allows direct multiplanar imaging. PMID- 3670625 TI - DNA-fluorescence-cytometry and prognosis (grading) of meningiomas--a study of 104 surgically removed tumors. AB - A total of 104 meningiomas of various histological types were examined microscopically and with flow fluorescence cytometry using the EBR staining technique and either an ICP 11 or an ICP 22 (PHYWE). Also tissue culture cells of 72 tumors were studied for their DNA content. There was a variable DNA distribution, which allowed a grading of malignancy according to a 3 or 4 grade scale. Useful information on the nature of a meningioma and its proliferative activity can be obtained during the surgical treatment. A majority of meningiomas show slowly proliferative DNA patterns typical for benign tumors. More than one third of the meningiomas show an intermediate configuration, probably associated with more or less semi-benign proliferative activity. 5.8% of our cases showed primary malignant tumors--except meningosarcomas. PMID- 3670626 TI - Diagnosis of neurinoma in the region of the jugular foramen--a case report. AB - Neurinomas in the region of the jugular foramen are extremely rare, are difficult to diagnose before surgery, and have seldom been described in the literature. The typical jugular foramen syndromes (Collet-Sicard syndrome, Vernet's paralysis) may be caused by many various disorders. The diagnostic problems are illustrated using one of our cases as an example. The differential diagnosis was made before surgery using currently available radiologic techniques. The tentative diagnosis "neurinoma of the hypoglossal nerve" was confirmed intraoperatively and histologically. PMID- 3670627 TI - Magnetic resonance imaging of postrepair-myelomeningocele--findings in 31 children and adolescents. AB - Magnetic resonance imaging has clearly demonstrated its efficacy in the diagnosis of pathological processes in the C.N.S. We examined 31 children who had undergone plastic closure of myelomeningocele a few days post partum. We could show that a high percentage of the patients (89%) presented the pathological anatomy of a tethered spinal cord; clinical symptoms of the tethered spinal cord syndrome, i.e. progressive neurological symptoms, however, are rarely observed. Possible revision of neurosurgical treatment of MMC is discussed. PMID- 3670628 TI - Magnetic resonance imaging of acute intracerebral hematomas: in vivo and in vitro studies. AB - The mechanisms causing unclear differentiation of ICH in the acute phase by MRI are discussed. The increase of the hemoglobin concentration in the hematoma, caused by loss of the plasma component directly after onset, is one of the reasons for the shortening of relaxation times. The clotting system is also responsible for this shortening. Thus, the hematoma reaches the same intensity as the brain in the acute stage. Although knowledge from our animal experiments, in vivo as well as in vitro, cannot be directly transferred to the human, such experiments are useful for the understanding of the pathomechanism influencing MR imaging. PMID- 3670629 TI - Noradrenergic innervation of the pineal gland--histochemical basis of scintigraphic imaging? AB - There is first evidence that the adult human pineal gland may be equipped with noradrenergic fibers as is the case in a variety of mammalian species. It therefore appears worthwhile to investigate the capacity of pineal noradrenergic nerves to take up 123I-MIBG, a prerequisite for scintigraphic imaging. PMID- 3670630 TI - [Echocardiographic parameters and cardiac angioscintigraphy: comparison and correlation in ischemic cardiopathy]. PMID- 3670631 TI - [Return to work after intervention of myocardial revascularization]. PMID- 3670632 TI - [Pharmacologic cardioversion of total arrhythmia caused by atrial fibrillation of recent onset. Factors influencing the therapeutic action of amiodarone administered intravenously]. PMID- 3670633 TI - [Correlations of symptoms and objective findings in dynamic electrocardiography by the Holter method: palpitations]. PMID- 3670634 TI - [Diagnostic efficiency of dynamic electrocardiographic monitoring by the Holter method in the study of patients with syncope or minor equivalents]. PMID- 3670635 TI - [Diverse incidence of disorders of cardiac rhythm in athletes and untrained youngsters]. PMID- 3670636 TI - [Spontaneous aorto-caval fistula, a rare complication of aneurysms of the abdominal aorta. Case contribution]. PMID- 3670637 TI - [The Microvel Hemashield prosthesis in aortoiliac reconstructions. Intraoperative evaluation and clinical results in a series of 40 consecutive cases]. PMID- 3670638 TI - [Computerized axial tomography in the preoperative evaluation of mediastinal lymph nodes (N2) of patients with bronchogenic carcinoma]. PMID- 3670639 TI - [Pure bronchial lipoma. Histogenetic and clinical considerations]. PMID- 3670640 TI - [Cimetidine and peptic ulcer surgery. Analysis of 708 operations before and after the introduction of the drug]. PMID- 3670641 TI - [Primary non-Hodgkin's lymphoma of the ileum: the role of surgery]. PMID- 3670642 TI - [Surgery of Crohn disease. Examination of the different trends disclosed in the international literature and personal cases]. PMID- 3670643 TI - [Appendicular mucocele]. PMID- 3670644 TI - [Complications of perforation of the gallbladder in emergency surgery. I. Biliary peritonitis]. PMID- 3670645 TI - [Complications of perforation of the gallbladder in emergency surgery. II. Biliary ileus; considerations on 21 cases]. PMID- 3670646 TI - [Possible relation between cholecystectomy and cancer of the colon]. PMID- 3670647 TI - [Carcinoma of the gallbladder. Contribution of 50 cases]. PMID- 3670648 TI - [Spontaneous gallbladder-cutaneous fistula]. PMID- 3670649 TI - [Risk of recurrent nerve lesions in thyroid surgery]. PMID- 3670650 TI - [Respiratory complications in acute pancreatitis and their treatment]. PMID- 3670651 TI - [Preoperative determination of TPA in colorectal neoplasms. Evaluation of a group consisting of 75 patients]. PMID- 3670652 TI - [Peripheral ulcers of the lower limbs with a venous basis. Criteria of treatment]. PMID- 3670653 TI - [Use of defibrotide in dystrophic lesions of the lower limb in the varico phlebitic syndrome]. PMID- 3670654 TI - [Total colectomy and ileo-anastomosis with and without ileal reservoir. Experimental study]. PMID- 3670655 TI - [Protective jejuno-ileal tube in the prevention of occlusive recurrences of the adhesion syndrome]. PMID- 3670656 TI - [Hyrtl's accessory hepatic artery during total gastrectomy with celiac-mesenteric lymphadenectomy]. PMID- 3670657 TI - [Immediate and remote problems following total pancreatectomy]. PMID- 3670658 TI - [Primary cancer of the gallbladder]. PMID- 3670659 TI - [Sequential revascularization bypass of the aorto-iliac-femoral axis]. PMID- 3670660 TI - [Analysis of the incidence of geriatric surgery. I. General evaluation]. PMID- 3670661 TI - [Thyrotropic response following hemithyroidectomy. Therapeutic implications]. PMID- 3670662 TI - [Inguinal hernia: contribution to its etiopathogenesis]. PMID- 3670663 TI - [Crural hernia permagna]. PMID- 3670664 TI - [Chlorhexidine gluconate in the treatment of subphrenic abscess and thoracic empyema]. PMID- 3670665 TI - [Progressive pneumoperitoneum in preparation for surgery of laparocele]. PMID- 3670666 TI - [Reconstruction of the breast following surgical ablation for cancer by the Patey method]. PMID- 3670667 TI - [A rare case of fibrosarcoma of the stomach]. PMID- 3670668 TI - [Obstructive syndrome of the superior vena cava caused by bronchogenic cyst. A clinical case]. PMID- 3670669 TI - [Effects of the oral administration of famotidine on gastric acid secretion and on basal and food-stimulated gastrin]. PMID- 3670670 TI - [Epidemiological findings on gastric and duodenal ulcer in the pre- and post cimetidine era. Study of 2,119 cases]. PMID- 3670672 TI - [Propranolol, hepatic encephalopathy and blood levels of ammonia in hepatic cirrhosis]. PMID- 3670671 TI - [Bile acids before and after administration of branched-chain amino acids in acute hepatitis]. PMID- 3670673 TI - [Changes in gastric emptying in patients with non-ulcerative gastropathy]. PMID- 3670674 TI - [Double-blind study of the effectiveness and tolerance of metoclopramide in the treatment of chronic constipation and diverticulosis of the colon]. PMID- 3670675 TI - [Prevention of deep venous thrombosis in digestive surgery]. PMID- 3670676 TI - [Medical therapy of deep venous thrombosis in digestive surgery]. PMID- 3670677 TI - [Surgical therapy of deep venous thrombosis in digestive surgery]. PMID- 3670678 TI - [Thrombectomy associated with in situ thrombolytic therapy with urokinase: a valid surgical procedure also in digestive surgery]. PMID- 3670679 TI - [Prevention of pulmonary embolism in gastroenterologic surgery]. PMID- 3670680 TI - [Preordained intervention]. PMID- 3670681 TI - [Collageno-vascular diseases and interstitial pulmonary fibrosis. An analysis of diagnostic tests]. AB - Collagenovascular diseases, particularly rheumatoid arthritis, LES and scleroderma frequently involve the lung. A group of 15 patients with collagen vasculopathies was analysed with a view to identifying the most suitable invasive and noninvasive tests for the diagnosis of the interstitial fibrosis of the lung that often accompanies such disorders. Among the noninvasive tests only the respiratory function tests (especially DLCO) are adequately sensitive, while chest X-rays, gallium scintigraphy of the lung and ACE are relatively unreliable. Bronchoalveolar lavage is often altered (though the intensity varies considerably) and transbronchial biopsy appears to be the ideal diagnostic examination. PMID- 3670682 TI - [Prevention of recurrent respiratory infections in adults]. AB - The authors compared the results obtained by using antibiotic therapy, vaccine, thymomodulin (a calf thymus acid lysate) and association of vaccine-thymomodulin in order to prevent acute infectious episodes in a group of 85 patients suffering with recurrent respiratory infections. The use of thymomodulin, alone and in association with vaccine, at the dose of 120 mg/die for 20 days/month during the period of observation (4 months), determined a higher reduction, (p less than 0.001) if compared with the other treatments, of the number and the duration of infectious episodes and moreover of the antibiotics' intake. Also the respiratory symptoms, and in particular the fits of coughing, showed an improvement. The pulmonary function indices and the laboratory parameters were unchanged in all groups studied. PMID- 3670683 TI - [Homeostasis of blood glucose and abuse of exogenous opiates: evaluation of fructosamine and glycosylated hemoglobin]. AB - The study was designed to assess glycaemic homeostasis in different situations of chronic stimulation of the opiate receptors by exogenous opiates. After an OGTT, levels of glycosylated haemoglobin (HbA1c) and serum fructosamine were measured in 3 groups of male drug addicts of comparable age. Group A consisted of 10 subjects undergoing substitution treatment with oral methadone. Group B consisted of 10 subjects addicted to intravenous injection of the syrup based methadone intended for oral administration. Group C consisted of 10 heroin addicts. Ten healthy subjects of the same age and sex were used as controls. Analysis of the results showed normal glucose tolerance in all groups with tendentially higher basal glycaemia levels in group B. HbA1c levels were significantly higher, though within normal limits, in group B than in either those receiving oral methadone (p less than 0.01) or the heroin addicts (p less than 0.01). The group B subjects also showed the highest fructosamine levels that were both well above normal limits and higher than those in the other groups in whom fructosamine levels were normal. The data therefore confirm normal glycaemia compensation in those taking oral methadone and in heroin addicts during the period considered. A new type of drug addiction involving the intravenous injection of methadone was also encountered. This produces an outstanding short-term change in glycaemic homeostasis and may well lead to future alterations in glucose tolerance. PMID- 3670684 TI - [Westphal-Strumpell disease. Description of a clinical case]. AB - A case of hepatolenticular degeneration with the clinical pattern of Westphal Strumpell disease is described. Diagnosis was based on clinical pattern, absence of hepatic impairment, typical biochemical abnormalities of copper metabolism and response (clinical and biochemical) to D-penicillamine. PMID- 3670685 TI - [Medical therapy of gastroesophageal reflux. Evaluation of the activity of clebopride by continuous intraluminal pH measurement]. AB - Seven female and three male outpatients (mean age 45, range 37-54), suffering from gastroesophageal reflux underwent therapy with clebopride, a new selective antidopaminergic agent. Before and after treatment (1 mg b.i.d. for ten days) 24 h-continuous monitoring of esophageal pH was done. Clebopride significantly lowered the number and the extension of gastroesophageal acid refluxes. PMID- 3670686 TI - [The combination of nifedipine and a low sodium diet with potassium supplement in the therapy of essential arterial hypertension]. AB - Moderate dietary sodium restriction with moderate dietary potassium supplementation was used in patients with essential hypertension who were treated with nifedipine retard by mouth every twelve hours. Combination therapy of this diet with the nifedipine retard produced a significantly greater decrease in both lying and standing blood pressure that with the drug alone. No noticeable side effects were observed. PMID- 3670687 TI - [Pilot clinical study on the use of a new nonsteroid anti-inflammatory drug (flunoxaprofen) in arthrosis pathology]. AB - Twenty-five patients (10 males and 15 females, mean age 56.5 years) suffering from osteoarthritis were admitted to a clinical trial in order to evaluate the efficacy and long-term tolerability of Flunoxaprofen, a new non-steroidal anti inflammatory compound. Flunoxaprofen 100 mg was given orally twice a day to the patients for a 60 days period. The variables involving the clinical effectiveness of Flunoxaprofen, especially pain and joint motion range, assessed every two weeks showed a considerable and progressive improvement of the symptoms all along the period of treatment. Blood chemistry, hematology and urinalysis, performed routinely on every patient concurrently with their pre-treatment and subsequent clinical assessments, showed the remarkable tolerability of the drug. PMID- 3670688 TI - [295 cases of brucellosis treated with minocycline]. AB - 295 cases of acute and subacute cases of brucellosis were treated with minocycline. It is concluded that because of its in vitro activity, its penetrability in macrophages and granulomas and its tolerance, minocycline is the antibiotic of choice for brucellosis. PMID- 3670689 TI - [Urinary NAG activity and diabetic microangiopathy]. AB - The behaviour of urinary NAG was monitored in diabetic patients some of whom presented more or less severe vascular alterations. The results showed a relationship between urinary NAG levels and the severity of the vascular condition (in fact the greatest NAG activity was found in patients with overt kidney damage). NAG may therefore reveal the existence of a vascular nephropathy that is still too slight to be identified by the standard non-invasive clinical examinations. PMID- 3670691 TI - [Evaluation of visual evoked potentials in chronic Parkinson disease patients]. AB - The P-100 latency of the evoked visual potentials in 20 cases of idiopathic Parkinson's disease were examined. As indicated in earlier studies, P-100 latency was significantly higher in Parkinson patients than in healthy controls. The hypotheses about the pathogenesis of such anomalies are then discussed. PMID- 3670690 TI - [Data on cellular subpopulations in bronchoalveolar lavage in silicosis and asbestosis patients. Case contribution]. AB - Data on the cytology of BAL performed on 8 silicosis and 5 asbestosis patients with different degrees of radiological profusion and functional impairment are examined. The prevalently neutrophilic alveolitis reported in the literature in these forms of pneumoconiosis is confirmed, while differences were found between the percentage of lymphocyte subpopulations in the two diseases. PMID- 3670693 TI - [Recurrence of pernicious anemia. Description of 2 cases]. AB - Two cases of pernicious anaemia both recurring after 14 years are examined. Both patients had voluntarily suspended parenteral vitamin-B12 intake a few months after their first hospitalisation. The earliest signs of B12 deficiency and the clinical and biological alterations arising during the recurrence are reviewed. PMID- 3670692 TI - [Follow-up of a sample of 536 meningiomas seen from 1958 to 1983]. AB - 536 meningioma cases were examined in order to assess incidence in terms of sex age, site and recurrences and to discover whether recurrence was related to the site, dimensions or histological features of the tumour. The data obtained indicate that in order to assess the biological behaviour of meningiomas, their histological features, accessibility and dimensions must be borne in mind. In fact benign tumours quickly recur if they are large or inaccessible. In contrast long-term recurrences are probably due to the presence of included cells as reported in the literature. PMID- 3670694 TI - [Fibromatosis of the mesenterium]. AB - A rare case of mesenteric fibromatosis observed in a 58 year old woman, repeatedly operated in the abdominal area, with a mesogastric-hypochondriac hard elastic mass, is presented. Being the cause of the affection still unknown, an abnormal proliferation of fibrous tissue induced from chemical-physical injuries is considered at the basis of the clinical entity. PMID- 3670695 TI - [Aplastic anemia and myelodysplasia: a not-always-easy distinction]. AB - The differential diagnosis between Myelodysplasia and Aplastic anaemia may be sometimes difficult, because clinical and morphological features may appear similar. Two cases, a Myelodysplastic syndrome with hypocellular and an Aplastic anaemia with hypercellular BM aspirates, are described in this report. Reciprocal connections between these two pathological entities, some biological aspects and the value of BM biopsy are also discussed. PMID- 3670696 TI - [Thrombopenia and cirrhosis. Study of 56 cases]. AB - Blood platelets were assayed in 56 cirrhosis patients divided into two groups: alcoholic cirrhosis (20 cases) and non-alcoholic cirrhosis (36 cases). Each group was also divided into two sub-groups: with and without clinical signs of portal hypertension. Low platelet counts were found in both groups (greater than 70%), the incidence being high in the sub-group with clinical signs of portal hypertension. Alcohol appeared to have no influence on the development of platelet insufficiency which was rather correlated with the severity of the hepatopathy, the presence of splenomegaly (splenic sequestration), immunological factors, (presence of circulating antiplatelet antibodies) and "consumption" phenomena (significant incidence of circulating FDP, and indicator of chronic Disseminated Intravascular Coagulation). PMID- 3670697 TI - [Evaluation of pharmacologic treatment associated with motor-activation therapy in the prevention of senile impairment]. AB - The study was designed to assess any changes in certain aspects of aging produced by combined drug (buflomedil) and motor activation therapy (MAT). The study was conducted on 3 selected groups of 10 women aged 60-74 years with initial signs of mental and physical senile impairment as revealed by appropriate psychometric and laboratories tests. The 3 groups (I: control, II: MAT, III: buflomedil + MAT) were given a series of cognitive, behavioural, affective and cardiovascular tests before and after the 6-month study. The results showed a deterioration in the parameters considered among the control group and a significant improvement especially in cardiovascular, affective and behavioural parameters as well as certain cognitive aspects (attention, mental state) in the group treated with MAT only. The combination of MAT and buflomedil had a positive influence on all parameters considered. In particular it acted extensively on the cognitive parameters. It is therefore concluded that the combination of MAT and drug treatment is a valid system for the prevention of senile impairment since it acts on the main biological, psychological and social aspects of the elderly patient. PMID- 3670698 TI - [Symphysis-fundus distance and fetal growth in pregnant diabetics of normal weight and obese]. PMID- 3670699 TI - [Maternal and fetal hemostasis during pregnancy and labor]. PMID- 3670700 TI - [Varices and pregnancy. Statistical evaluation]. PMID- 3670701 TI - [A case of cystic teratoma of the ovary. Its recognition using computerized axial tomography]. PMID- 3670702 TI - [Clinical considerations in an exceptional case of pregnancy with a voluminous fibromatous uterus]. PMID- 3670703 TI - [Characterization of the hormone dependence of breast neoplasms using mammography. Prospectives and limitations]. PMID- 3670704 TI - [Value of colposcopy in the diagnosis of uterine cervix tuberculosis]. PMID- 3670705 TI - [Pleasure in sexuality]. PMID- 3670706 TI - [Nosological classification of sideropenic anemia]. PMID- 3670707 TI - [Principles of the physiopathology of iron]. PMID- 3670708 TI - [Iron pathology in pregnancy]. PMID- 3670709 TI - [Iron pathology in non-pregnant women]. PMID- 3670710 TI - [Possibility of pharmacologic intervention in iron-deficiency pathology in pregnancy]. PMID- 3670711 TI - Septic shock: nursing implications of current medical research. PMID- 3670712 TI - Use of investigational drugs. PMID- 3670713 TI - Cost savings approach for justification of an i.v. therapy team. PMID- 3670714 TI - Stability of selected beta-lactam antibiotics stored in plastic syringes. PMID- 3670715 TI - The role of the i.v. team in a cardiac arrest code alert. PMID- 3670716 TI - Preferential loss of collaterals from goldfish retinal axons in the optic tract is delayed by tetrodotoxin. AB - Following optic nerve section (ONS) in goldfish, the right eye was repeatedly injected with tetrodotoxin (TTX) and the left eye with Ringer solution. At various survival periods after ONS, horseradish peroxidase (HRP) was applied to small groups of axons in dorsal or ventral retina in both eyes. Counts of labeled regenerating retinal axons show that 43 +/- 4.6% of regenerating axons course through the inappropriate brachium of the optic tract between 20 and 65 days after ONS. The amount of misrouted axons declines to 30 +/- 6.1% between 70 and 80 days after ONS. Under TTX blockade the reduction of misrouted axons is delayed but reaches 27 +/- 3.6% at 150 days after ONS. PMID- 3670717 TI - Electrophysiological evidence for adenosine receptors on astrocytes of cultured rat central nervous system. AB - The actions of adenosine, R-N6-phenylisopropyladenosine (R-PIA) and N (ethyl)carboxamidoadenosine (NECA) were tested on the membrane potential of astrocytes of cultured rat spinal cord and cerebellum. All 3 compounds hyperpolarized the majority of astrocytes studied. A considerable number of cells did, however, not respond to adenosine and its analogues, suggesting that only a certain type of astrocyte possesses adenosine receptors. The hyperpolarizations by adenosine, R-PIA and NECA were reversibly blocked by their antagonist 8 phenyltheophylline indicating that these compounds activate specific adenosine receptors. In agreement with biochemical and autoradiographic binding studies, our electrophysiological data strongly suggest the existence of adenosine receptors on astrocytes. PMID- 3670718 TI - The organization of nucleus tegmenti pedunculopontinus neurons projecting to basal ganglia and thalamus: a retrograde fluorescent double labeling study in the rat. AB - The organization of nucleus tegmenti pedunculopontinus (PPN) projections to the basal ganglia and thalamus was studied in the rat by using retrograde transport of fluorescent dyes. Fast blue was injected into the substantia nigra (SN) while Nuclear yellow was delivered to one of the following nuclei: globus pallidus (GP), entopeduncular nucleus, subthalamic nucleus (STN) or parafascicular nucleus of the thalamus. Retrogradely labeled cells were observed throughout the PPN without topographical arrangement. The cells labeled from the SN outnumbered those labeled from other structures. In all cases the majority of cells were single labeled and only a few cells double labeled from SN-GP or SN-STN were found. Labeled cells were either fusiform or multipolar in shape. These data suggest that distinct PPN cells project to their basal ganglia and thalamic targets without a prominent branched organization. PMID- 3670720 TI - Temporal requirements of associative short-term potentiation in CA1 neurons of rat hippocampus. AB - Temporal separation and juxtaposition of stimulations for the induction of associative short-term potentiation in the rat hippocampus were examined. A series of stimulations of stratum radiatum during brief tetanic stimulations of stratum oriens resulted in a short-term potentiation (of about 3 min duration) of stratum radiatum-induced CA1 population excitatory postsynaptic potential. Potentiation was evident when the stratum radiatum stimulus preceded the onset of the conditioning tetanus by no more than 50 ms, or followed by no more than 80 ms. These parameters closely resemble those found for associative long-term potentiation, suggesting the possibility of shared mechanisms for the induction of these two forms of potentiation. PMID- 3670719 TI - Motor activity and visually induced postural reactions during two-g and zero-g phases of parabolic flight. AB - Maintenance of an upright posture was measured in human subjects during increased and decreased gravitoinertial force phases of parabolic flight. Upright posture was maintained by tonic activity of the ankle joint extensor muscle (soleus) during the one-g or two-g phases. During the zero-g phase the same posture was maintained primarily by activity of the flexor muscle (tibialis). Downward and upward optokinetic stimulation induced strong postural reactions directed forwards and backwards, respectively. These reactions were accompanied by changes of motor activity of the flexor muscle. This suggests a rapid redistribution of motor programs between extensor and flexor muscles with an increase in visual input influence, and confirms results obtained during space flight. PMID- 3670721 TI - Inhibitory effects of 2-deoxytetronic acid, a putative endogenous satiety factor, on paraventricular neurons of rats, in vitro. AB - The endogenous sugar acid, 2-deoxytetronic acid (2-DTA) was investigated for its effects on activity of paraventricular nucleus (PVN) neurons in slice preparations from rats. 2-DTA dose-responsively inhibited the spontaneous activity of 23 of the 53 PVN neurons tested at concentrations of 10(-5) to 10(-2) M, and 2 were excited. The inhibitory responses were not due to osmotic changes by 2-DTA administration. The high concentration of 2-DTA needed to produce responses suggests that it acts as substrate for oxidative metabolism rather than as a neurotransmitter or neuromodulator in the suppression of feeding behavior. PMID- 3670722 TI - Unihemispheric slow-wave sleep in the Amazonian dolphin, Inia geoffrensis. AB - An electroencephalographic study of sleep in Amazonian dolphins, Inia geoffrensis, revealed that unihemispheric slow-wave sleep is the dominant sleep type in this species, as in the other two dolphin species that were studied earlier. PMID- 3670723 TI - The effect of chlorpromazine on monoamine levels in the rat cerebellum and hippocampus: a developmental study. AB - Acute and chronic alterations of the monoamine levels in the rat cerebellum and hippocampus after late prenatal and early postnatal administration of chlorpromazine, were examined using high performance liquid chromatography with electrochemical detection. During a critical phase of development (one week postnatal), chlorpromazine produced increased levels of both serotonin and dopamine in both brain regions. At 24 weeks postnatal, or 21 weeks after cessation of drug administration, the levels of all 3 monoamines were decreased in the cerebellum and increased in the hippocampus. The early disruption in the normal monoamine levels may be related to abnormal growth patterns observed in previous studies. PMID- 3670724 TI - The reaction of acetaldehyde with brain microtubular proteins: formation of stable adducts and inhibition of polymerization. AB - Stable adducts were formed by treatment of bovine brain microtubular proteins (MTP) with acetaldehyde, followed by gel filtration to remove excess acetaldehyde. The extent of stable adduct formation was determined using [14C]acetaldehyde and was correlated with acetaldehyde concentration and reaction time. Significant inhibition of MTP polymerization was observed at adduct concentrations of 0.6 mol acetaldehyde/mol tubulin dimer. The data suggest that repeated exposure of MTP to low concentrations of acetaldehyde, as would occur in the brain and other tissues of alcoholics, may inhibit MTP polymerization with neurological consequences. PMID- 3670725 TI - Ethanol enhances recurrent inhibition in the dentate gyrus of the hippocampus. AB - Intraperitoneal injection of ethanol (2 g/kg) substantially augmented recurrent inhibition in the dentate gyrus, as measured by population responses to paired pulse stimulation of the perforant path. In contrast, this dose of ethanol had no significant effect on singly evoked (or conditioning) population spikes. These data indicate that the increased recurrent inhibition by ethanol was not due to a generalized depressant effect, and suggests that at these doses and time points ethanol can selectively alter synaptic transmission in the hippocampus. PMID- 3670726 TI - Alterations in [3H]desmethylimipramine binding in the aged rat brain: an in vitro autoradiographic demonstration. AB - Using in vitro autoradiographic receptor binding, the present report provides a descriptive analysis of [3H]desmethylimipramine ([3H]DMI) binding in the aged rat brain. Small circular patches of intense [3H]DMI binding were present within the caudate nucleus in every aged brain examined. Occasionally, similar patches of label were present in restricted cortical regions of aged brains. Comparable patches of [3H]DMI binding were never observed in young brains used in these investigations. Additional evidence suggests that these age-dependent changes in [3H]DMI binding are anatomically restricted to the loci indicated above. PMID- 3670727 TI - Loss and recovery of acetylcholinesterase molecular forms in the fornix-lesioned rat hippocampus. AB - The loss and recovery of hippocampal acetylcholinesterase (AChE) molecular forms was studied following fornix lesions. Two weeks after lesioning, the G4 form, which constituted the majority (91%) of AChE activity in the unlesioned hippocampus, was significantly reduced (P less than 0.01) to levels 21% of those in the unlesioned hippocampus, suggesting that this form is probably presynaptic. Thirteen weeks after lesioning total hippocampal AChE activity had increased 3 fold relative to 2-week animals, with the majority of the recovery in total AChE activity being due to a significant (P less than 0.05) increase in the abundance of the G4 form to levels 340% of those at 2 weeks. The increase in the abundance of the G4 form, which appears to be a functionally important molecular form of AChE within the CNS, serves as a marker of the integrity of the newly formed hippocampal cholinergic synapses. PMID- 3670728 TI - Bright light phase shifts the human melatonin rhythm during the Antarctic winter. AB - In most species daily and seasonal changes in the light-dark cycle are the most important synchronisers (zeitgebers) of daily and seasonal rhythms. In humans only bright light (2500 lux) appears to be an effective circadian zeitgeber. Seasonal effects of light on human physiology have not been investigated. We have exploited the low intensity illumination of the Antarctic winter to investigate the effects of bright- or dim-light treatment for an hour in the morning and in the evening (a 'skeleton' 12.5-h day) for 6 weeks on the plasma melatonin rhythm, together with mood and a number of behavioural variables. In parallel seasonal changes in melatonin were observed. Melatonin is known to convey daylength information in photoperiodic seasonal breeders through characteristics of its night-time secretion profile. Bright-, but not dim-, light treatment in winter induced a marked phase advance of the melatonin rhythm, similar to that found in the summer, without marked effect on the other variables. Thus at least one human seasonal change appears to be light-dependent. PMID- 3670729 TI - Reactive microglia in patients with senile dementia of the Alzheimer type are positive for the histocompatibility glycoprotein HLA-DR. AB - HLA-DR is a class II cell surface glycoprotein of the human histocompatibility complex usually expressed on the surface of cells that are simultaneously presenting foreign antigen to T-lymphocytes. Using immunohistochemical procedures with two specific monoclonal antibodies to HLA-DR, HLA-DR-positive reactive microglia were found in gray matter throughout the cortex of postmortem brains of patients with senile dementia of the Alzheimer type (SDAT) and were particularly concentrated in the areas of senile plaque formation. Double immunostaining with antibodies to glial fibrillary acidic protein (GFAP) showed that the HLA-DR positive cells were different from the reactive astrocytes although the occasional positively staining giant astrocyte was also seen. Small numbers of resting microglia were HLA-DR-positive in white matter of both normal and SDAT brains. The SDAT cases also had reduced cortical choline acetyltransferase (ChAT) levels. In the 11 brains studied, the number of hippocampal HLA-DR-positive cells was positively correlated with the numbers of plaques and negatively correlated with average cortical ChAT. PMID- 3670730 TI - Alcohol consumption and blood-cerebrospinal fluid barrier dysfunction in man. AB - The cerebrospinal fluid (CSF)/serum albumin ratio has been used a marker for blood CSF barrier permeability in 116 normal patients. We attempted to correlate the CSF/serum albumin ratio with a number of clinically measurable parameters including alcohol consumption. Alcohol consumption had a significant effect on the blood-CSF barrier. Our data indicate that alcohol increases blood CSF barrier permeability in a dose-dependent manner. The measured values of parameters indirectly indicative of alcohol consumption, such as gamma glutamyltranspeptidase (gamma-GT) and erythrocyte mean corpuscular volume (MCV), were also correlated with enhanced blood-CSF barrier permeability. Although an apparent influence of age, body weight and sex on blood-CSF barrier permeability was observed, these correlations were not separable from the effect of alcohol consumption. PMID- 3670731 TI - Specific alterations in the levels of N-acetyl-aspartyl-glutamate in the nervous system of the dystrophic mouse. AB - Determinations of N-acetyl-aspartate (NAA) and N-acetyl-aspartyl-glutamate (NAAG) levels were obtained by ion-exchange HPLC from 10 regions of the male dystrophic mouse brain as well as from those of non-dystrophic littermate controls. Similar to previous studies in the rat, NAA levels in control mice were distributed rather uniformly while NAAG levels exhibited a pronounced rostrocaudal gradient, with highest levels found in the lumbar spinal cord. Contrary to a recent report, we found no significant alterations in gross brain or spinal cord levels of NAA. In contrast, levels of NAAG were substantially and differentially reduced in several regions of the dystrophic mouse nervous system. These results demonstrate a pathological dissociation between NAA and NAAG, whose levels are known to display differential regional, ontogenetic and phylogenetic patterns. In addition, they may represent an ability of neural tissue to differentially regulate their steady-state levels, if indeed they can be shown to be biosynthetically related. The pronounced and non-uniform NAAG reductions observed in the dystrophic CNS underscores recent suggestions of a role for the neuropeptide in central systems involved in the control of motor function. PMID- 3670732 TI - Distribution and morphology of abducens motoneurons innervating the lateral rectus and retractor bulbi muscles in the frog Rana ridibunda. AB - The distribution and morphology of the neurons innervating the lateral rectus and retractor bulbi muscles of the frog Rana ridibunda were studied by means of retrograde axonal transport of horseradish peroxidase (HRP). The neurons are located in the rhombencephalon in two distinct groups which lie dorsolateral and lateral to the fasciculus longitudinalis medialis and represent the main and accessory abducens nuclei, respectively. From HRP injections into the two muscles, it can be concluded that multipolar neurons located rostrally in the main abducens nucleus innervate the lateral rectus muscle. The retractor bulbi muscle receives its innervation from bipolar, fusiform neurons located in the caudal portion of the main abducens nucleus and throughout the rostrocaudal extent of the accessory abducens nucleus. PMID- 3670733 TI - Neural modulation of cutaneous differentiation: epidermal hyperplasia and precocious hair development following partial neuralectomy in opossum pups. AB - The original intent of the present study was to evaluate the compensatory response of the nervous system to areas of denervation. A portion of the spinal cord in the lumbosacral region of one-day opossum pups (Monodelphis domesticus) was removed by cauterization. This partial neuralectomy produced an expected compensatory response of neurons in the dorsal root ganglia, but in addition produced unexpected abnormalities of cutaneous differentiation. At 4-6 days following surgery, an increase in the thickness of the epidermis resembling glabrous palmar or plantar skin was seen. This hyperplastic epidermis appeared to be associated with an abnormally dense innervation of the dermis and epidermis. Eight days following partial neuralectomy most animals showed areas of precocious hair development. Nerve fibers were always seen in the dermis associated with these precocious hairs and were seen to penetrate the basal lamina in the region of the epidermal-hair shaft boundary. These results imply a critical role for afferent nerves in the normal development of the skin and its appendages. PMID- 3670734 TI - Differential retinal growth appears to be the primary factor producing the ganglion cell density gradient in the rat. AB - We have studied the distribution of retinal ganglion cells (RGCs) that had been retrogradely labelled from bilateral injections of horseradish peroxidase into the retino-recipient nuclei of albino rats aged from the 22nd postconceptional day (22PCD-day of birth) to adulthood. During the period in which most (85%) of the naturally occurring RGC loss takes place (22-26 PCD) the distribution of RGCs remains almost uniform. Between the 26 and 32PCD (11th postnatal day), the peak RGC density decreases by only 20% while the RGC density at the superior retinal periphery decreases by 80%. In the same period a centro-peripheral RGC density difference of 4:1 becomes apparent. We have interpreted these changes to be due to a phase of rapid differential retinal growth (with more growth occurring at the retinal periphery). Thereafter the reduction in RGC density (and presumably retinal growth) is more uniform resulting by adulthood in a centro-peripheral RGC density ratio of 5:1. PMID- 3670735 TI - Septal cholinergic neurons from postnatal rat can survive in the dissociate culture conditions in the presence of nerve growth factor. AB - The survival effect by nerve growth factor (NGF) on the cholinergic neurons of postnatal rat septal neurons in culture was examined. When the septal neurons from 10 to 12-day-old rats were cultured without NGF, the activities of choline acetyltransferase gradually decreased during the period of cultivation. The addition of NGF to the culture prevented the decline of activities. And, the number of acetylcholinesterase-positive neurons in culture with NGF was found to be more than that without NGF, after 5 days in culture. These results suggest that NGF promotes the survival of septal cholinergic neurons from postnatal rats in culture. PMID- 3670736 TI - The right choice for geriatric care. PMID- 3670737 TI - A new age for elderly care. PMID- 3670738 TI - Taking the stand for standards of care: the role of an expert witness. PMID- 3670739 TI - Primary nursing: panacea or problem? PMID- 3670740 TI - Head Start practicum--more than child's play. PMID- 3670742 TI - Regional campuses ease returning-to-school woes. PMID- 3670741 TI - Credit where credit is due: an honors program in nursing. PMID- 3670743 TI - Molecular size distribution of somatostatin-like immunoreactivity in the cerebroventricular fluid of neurosurgical patients. AB - The molecular size distribution of somatostatin-like immunoreactivity (SLI) in the cerebroventricular fluid of patients with Parkinson's disease, dystonic syndromes, multiple sclerosis, basal and midline tumors, epilepsy and pain syndromes was investigated by separation with a Sephadex G-50f column and subsequent radioimmunoassay of the eluate. Marked heterogeneity of SLI was observed in most of the pools investigated. The most conspicuous feature of the elution profiles was the preponderance of the peak coeluting with synthetic somatostatin-14, whereas the peaks comigrating with synthetic somatostatin-28 and attributable to precursor-like SLI represented only minor or trace amounts of total immunoreactivity. These findings are consistent with the greater biological activity of somatostatin-14 in the human central nervous system, whereas somatostatin-28 appears to represent the more active form in the pituitary and in the intestinal mucosa. Solely in the case of brain tumor patients, some differences could be seen, resulting in an approximately equal distribution of somatostatin-14 and somatostatin-28 in two pools of ventricular fluid and by the detection of a degradation product of somatostatin-14 in another one. These observations could be explained by a lowered barrier function as a consequence of increased intracranial pressure in case of brain tumors, which is well in accordance with a markedly elevated total protein content being a sign of a lowered barrier function. PMID- 3670744 TI - Olfactory input to the lateral hypothalamus of the old world monkey. AB - Responses of lateral hypothalamic neurons to 8 odors were studied in chronic unanesthetized old world monkeys (Macaca irus). Many neurons (54.5%) responded to a single odor only, and the number of neurons responding to 2, 3 and 4 odors decreased successively. No neuron responded to as many as 5 odors. Thus, the presence of olfactory input and a highly discriminative ability for odors were found in the lateral hypothalamic area (LHA). Neuronal responses to the same odors were also studied in the septum (Spt). In anesthetized old world monkeys, evoked potentials were recorded in the LHA and in areas of the Spt and the nucleus accumbens (Acc) during stimulation of the olfactory bulb (OB). When the Spt (and probably the Acc with it) was subsequently destroyed, OB-evoked potentials in the LHA disappeared. Next, by injecting horseradish peroxidase (HRP) into the LHA, an olfactory pathway to the LHA was examined. Labeled neurons were found mainly in the Spt and the Acc, and only partly in other areas. However, labeled neurons were scarcely found in the prepyriform (PPF)-entorhinal (ER) area or in the olfactory tubercle (OT). The present study thus shows that an olfactory pathway to the LHA passes through the Spt and probably also the Acc, but not through the PPF-ER areas nor through the OT in the old world monkey. PMID- 3670745 TI - Modulations of collicular visual responses by acoustic stimuli in rabbits. AB - This study analyzes the influences of an acoustic stimulus upon neuronal light responses of superficial layers of the superior colliculus in anesthetized and paralyzed rabbits. The results have revealed that even if visually-responsive cells fail to be excited by sound, the latter is still capable of modifying light evoked discharge. The influence may be "short-term" (the discharge rate recovers within 500 ms) or it may be "long-term" (the firing rate remains modified for several seconds). This audio-visual interaction depends upon several factors: the time of occurrence of both stimuli, the physical aspects of the visual target, the relative positions of the speaker and the visual receptive field, and finally, the sensitivity of the unit to movement direction. Data indicates that cells of the most dorsal (hence visual) layers of the superior colliculus are influenced by sound. It is concluded that the colliculus may use the sound as an additional cue to orientate the animal. Also, collicular cells could "memorize" for several seconds various features present in the environment. PMID- 3670746 TI - Cortically induced masticatory rhythm in masseter motoneurons after blocking inhibition by strychnine and tetanus toxin. AB - In the first series of experiments, we studied whether or not strychnine (STR) resistant inhibition of masseter motoneurons (MASS . MNS) was involved in their rhythmical inhibition that occurs during masticatory activity, induced by repetitive stimulation of the cortical masticatory area (CMA) in the cat. After systemic STR injection, repetitive CMA stimulation induced rhythmically alternating activity in the masseteric and anterior digastric nerves with a shorter cycle time than before STR-administration. The short-latency IPSPS in the MASS . MNS evoked by single shocks applied to the CMA were abolished. In contrast, repetitive CMA stimulation still induced a rhythmical alternation of EPSPS and IPSPS in the MASS . MNS, although the IPSPS were significantly reduced in amplitude. In the second series, we attempted to abolish the STR-resistant component of the rhythmical IPSP with tetanus toxin (TT). This was injected into one superficial masseter muscle of the guinea pig. In the majority of animals, repetitive CMA stimulation induced a tonic EMG superimposed by rhythmical bursts in the TT-intoxicated masseter muscle. Repetitive CMA stimulation induced a rhythmical sequence of EPSPS and superimposed spikes in the MASS . MNS innervating the TT-intoxicated masseter muscle in paralyzed guinea pigs. It was concluded that: (1) the cortically-evoked short-latency inhibition of MASS . MNS is STR-sensitive, as is part of the rhythmical inhibition during CMA-induced mastication; and (2) rhythmical inhibition is not essential for the central generation of the rhythmical activity in the MASS . MNS. PMID- 3670747 TI - Inhibitory effect of acupuncture on the finger flexion reflex induced by finger tip vibration. AB - The effect of acupuncture on finger flexion reflex, caused by mechanical vibration applied to the finger tip, was studied by using the cross-correlation function. A stainless steel acupuncture needle was inserted into the acupuncture point called "Wai-Kuan" for 10 min. Acupuncture inhibited the reflex and suppressed the two modes seen in the cross-correlogram between unitary EMG activity of the muscle flexor digitorum superficialis and finger tip vibration with random frequency. The recovery of the primary mode, which may be via the spinal monosynaptic reflex loop, was significantly earlier than the recovery of the secondary mode, which may be via the supraspinal reflex long loop. This suggests that the distinct inhibitory effect of acupuncture takes place on the reflex at spinal and supraspinal levels. PMID- 3670748 TI - Subfornical organ neurons act to enhance the activity of paraventricular vasopressin neurons in response to intravenous angiotensin II. AB - The effects of pretreatment of the angiotensin II (ANGII) antagonist, saralasin (Sar), in the subfornical organ (SFO) on intravenous ANGII-induced responses of the activity of phasically firing paraventricular nucleus (PVN) neurons (n = 23) antidromically identified as projecting to the posterior pituitary were examined in urethane-anesthetized rats. The activity of the majority (n = 18) of identified PVN neurons was excited by intravenously administered ANGII, whereas the remaining neurons (n = 5) were not affected. The excitatory responses (n = 13) to ANGII were prevented by pretreatment with Sar, but not by isotonic saline (n = 3), in the SFO. These results suggest that ANGII-sensitive SFO neurons may act to enhance the excitability of putative vasopressin (VP)-secreting neurons in the PVN in response to circulating ANGII. PMID- 3670749 TI - Haloperidol prevents the methamphetamine-induced apomorphine subsensitivity of dopamine metabolism in rat striatum. AB - Our previous experiment showed that the sensitivity of striatal dopaminergic metabolism to apomorphine was lowered after pretreating rats with methamphetamine. This study further demonstrated that haloperidol administered with methamphetamine prevented the effect of the methamphetamine pretreatment. Since gamma-butyrolactone was administered in combination with apomorphine so as to remove complications which might arise from the modification of impulse flow through the striatonigral feedback loop, it is possible that the observed effect of apomorphine upon striatal dopaminergic metabolism and its antagonism with haloperidol may be mediated by autoreceptors of dopaminergic axon terminals in rat striatum. PMID- 3670750 TI - Predicting effective contraceptive behavior in college females. AB - This article reports the results of a preliminary research project that explored the relationship between assertiveness, cognitive development and contraceptive behavior among single young women in their freshman and senior years at college. A total of 60 college women at a university health center volunteered to participate in this pilot study. They filled out three instruments: the Galassi College Self-Expression Scale (SES), the Measure of Intellectual Development (MID) tool and an author-developed sexuality questionnaire. Although there was a significant relationship between cognitive development and assertiveness, no significant relationships were found between cognitive development, assertiveness and use of effective contraception. Interesting descriptive characteristics were identified. Clinical implications are discussed. PMID- 3670751 TI - A timesaving guide to better patient teaching. PMID- 3670752 TI - Malpractice insurance: are you covered or not? PMID- 3670754 TI - Myths & facts about fever. PMID- 3670753 TI - In Lynne's eyes. PMID- 3670755 TI - Thyroid crisis. PMID- 3670756 TI - Responding quickly to tachydysrhythmias (continuing education credit). PMID- 3670757 TI - Did negligence cause this patient's fall? PMID- 3670758 TI - Supporting the mother and infant at risk of A.I.D.S. PMID- 3670759 TI - Why you are the answer to the nursing shortage. PMID- 3670760 TI - When your I.C.U. patient can't sleep. PMID- 3670761 TI - Perfecting the 3 steps of chest physiotherapy. PMID- 3670762 TI - Troubleshooting central line complications. PMID- 3670763 TI - Patient controlled analgesia: more than a machine. PMID- 3670764 TI - What's wrong with this patient? PMID- 3670765 TI - Investigating absent bowel sounds. PMID- 3670766 TI - Learning from the young. PMID- 3670767 TI - Psychiatric nursing. Defining alcohol abuse. PMID- 3670768 TI - Psychiatric nursing. Reflections on suicide. PMID- 3670769 TI - Nutritional problems in the cancer patients. PMID- 3670770 TI - Symptom control in the cancer patient. PMID- 3670771 TI - Patient education. PMID- 3670772 TI - Coping with cancer at home. PMID- 3670773 TI - Hodgkins disease: a personal account. PMID- 3670774 TI - Did someone mention empathy? PMID- 3670775 TI - Effect of cooking on the nitrate levels in vegetables. AB - The effects on the nitrate content of vegetables exposed to boiling in water for various lengths of time is described. Whilst certain cultivars show a steady decrease in nitrate levels, other varieties show an initial rise. The nitrate content of the cooking water used shows a sustained increase as the cooking time is extended. PMID- 3670776 TI - Legal significance of charting--Part II. PMID- 3670777 TI - Shift reports: using nursing diagnosis. PMID- 3670778 TI - Financial implications of an acuity-based periodic staff adjustment model. PMID- 3670779 TI - Developing patient outcomes as a quality measure of nursing care. PMID- 3670780 TI - Recognizing and responding to administrative incompetence. PMID- 3670781 TI - Making it work right for you: acuity recording and professional nursing care. PMID- 3670782 TI - The nurse manager and the art of Japanese management. PMID- 3670783 TI - Modified cyclical scheduling: a practical approach. PMID- 3670784 TI - Primary nursing revised. PMID- 3670785 TI - Changes in federal funding for health services: effects on nursing. PMID- 3670786 TI - Keeping the C-A-R-E in healthcare. PMID- 3670787 TI - Staff involvement in developing a nursing philosophy and the selection of a model for practice. PMID- 3670788 TI - Y-not? A Y concept of managing nursing promotions. PMID- 3670789 TI - Intermediate care--not a stepdown: an overview. PMID- 3670790 TI - Staff development...the buck stops here. PMID- 3670791 TI - To tier or not two tier. PMID- 3670792 TI - A mid-year legislative report. By OSMA Department of Legislation. PMID- 3670793 TI - Correlation between steroid hormone receptors and prognostic factors in human breast cancer. AB - Knowledge of the tumor content of estrogen (ER) and progesterone (PgR) receptors has proved to be of significant value in human breast cancer. Relative determinations were performed in 589 specimens in our laboratory. The positivity of ER and PgR is correlated with the patients' age at diagnosis, tumor size and relative grade. In particular, the significance of PgR versus ER status and the possible prognostic role of these receptors are investigated. PMID- 3670795 TI - Occult metastasis of rhabdomyosarcoma to lymph node with sinus pattern. AB - Light microscopy of sections from the paraaortic and pelvic lymph nodes of a patient revealed micrometastases with sinus pattern. The diagnosis of metastatic rhabdomyosarcoma was confirmed ultrastructurally by demonstration of actin filaments and Z bands. To our knowledge occult metastases of rhabdomyosarcoma with purely sinus pattern have not been reported previously and diagnosis might be difficult to establish clinically or pathologically. However, recognition of the lymph node involvement changes the clinical staging and therapeutic regimen of this disease. Therefore, rhabdomyosarcoma should be included in the differential diagnosis of lymphadenopathies with sinus pattern. The disorders causing sinus pattern in lymph nodes are briefly reviewed. PMID- 3670794 TI - Induction of cutaneous plasma cell tumor as a complication of adjuvant immunotherapy with methanol extraction residue of bacillus Calmette-Guerin. AB - Methanol extraction residue (MER), a cell wall fraction of bacillus Calmette Guerin, has been reported to exhibit immunomodulating properties which permit its successful use as an adjuvant of immunotherapy in cancer patients. Its beneficial immunostimulatory effects are generally thought to be due to nonspecific stimulation of cell-mediated immunity. Little attention has been focused on its humoral stimulating properties. A case is presented of a patient undergoing treatment with adjuvant immunotherapy with MER for malignant lymphoma who developed a cutaneous plasma cell tumor at the injection site of the drug. This complication may represent the result of enhanced humoral immunity induced by the MER treatment. The development of a cutaneous plasma cell tumor must be added to the list of known MER toxicities, and may constitute an indication for the discontinuation of treatment with this agent. PMID- 3670796 TI - In vitro studies of canine mammary tumors: influence of 17-beta-estradiol and progesterone on cell kinetics parameters. AB - Using an in vitro tritiated thymidine nuclear labeling followed by autoradiography, the effects of 17-beta-estradiol (E2) or progesterone (Pg) were studied in 30 canine mammary tumors that were incubated and hormonally stimulated in vitro. In 10 of these tumors, the synthetic (S) phase duration was also measured in absence or in presence of E2, by using a double labeling with tritiated thymidine. Our results demonstrate that E2, and, to a lesser degree, Pg can induce cell replication in both estrogen receptor-positive (ER+ PgR+) and estrogen receptor-negative (ER- PgR-) canine mammary tumors. The mitogenic effect of E2 may involve a shortening of the DNA S cell cycle phase. We have also found a significantly positive relationship between the estrogen and the progesterone receptor concentrations and the basal proliferation rate in these tumors, whereas no correlation was found between steroid receptor contents and the maximal level of stimulation achieved after E2 or Pg exposure. PMID- 3670797 TI - Enhanced cardiotoxicity in rabbits treated with verapamil and adriamycin. AB - Verapamil, a calcium channel blocker, reduces resistance of some tumors to Adriamycin by inhibiting Adriamycin efflux from resistant cells. This study shows that rabbits given 7 mg/kg of Adriamycin and 0.8 mg/kg of verapamil died earlier with functional and morphological cardiac abnormalities than rabbits given Adriamycin alone. Rabbits that were given verapamil and died peracutely had higher concentrations of Adriamycin in the myocardium. The relatively high dose of Adriamycin was expected to produce cardiotoxicity in rabbits within a matter of days. However, peracute death (within hours) in rabbits given the same dose of Adriamycin but with verapamil treatment was unexpected. These results suggest that combining Adriamycin with verapamil increases early cardiac toxicity. Therefore, clinical use of this combination should be approached cautiously until the interactions, including the possibility for enhanced normal tissue damage, are fully understood. PMID- 3670798 TI - Chemotherapeutic response of squamous cell carcinoma xenografts (subcutaneous and subrenal capsule assay). AB - Chemotherapeutic response of two squamous cell carcinoma xenograft lines (established from the primary and metastatic lesion of a tongue carcinoma) was studied using SC and SRC assays (as well as immunocompetent and -suppressed recipients in the latter assay). The two assays provided similar ranking of drugs, in the sense that in each instances two of the three (cyclophosphamide, 5 fluorouracil, vinblastine) most active agents were identical. The host response in immunocompetent recipients supports the need for histology to prove the proper quality of the implanted tumor tissue in order to be used for drug evaluation. PMID- 3670799 TI - Combined effects of pregnancy and Lewis lung carcinoma bearing upon essential metal tissue content in inbred mice. AB - The essential metal (Cu, Zn, Fe, Ca, Mg, Na and K) tissue content in Lewis-lung carcinoma-bearing mice was compared with that of pregnant mice as well as with controls and with mice both pregnant and cancerous. All comparisons were done on day 17 after inoculation/Impregnation on C57BL/6 age-matched female mice. Despite unchecked tumour growth and metastasizing ability, pregnancy effectively prevented the tissue-wasting effect of the tumour. The economy of all the essential metals studied followed practically the same pattern. The combined tumour-bearing and pregnancy situation was much closer to that of pregnancy than to the tumour-bearing alone, either at individual tissue concentration level or at that of the whole animal, in the maternal tissue and metal stores and tissue concentrations in front of the cachexic effect of tumour-bearing. Neither fetal nor tumour growth nor their metal content were impaired by the presence of the tumour/concepta. The maternal processes that allow for a higher fetal uptake of substrates seem to increase--at least in the case of iron--the ability of the tumour to accumulate some metals. PMID- 3670800 TI - Lens opacity meter: a new instrument to quantify lens opacity. AB - The lens opacity meter, a new instrument for quantifying the lens opacity, is described. The basic concept is the measurement of stray light produced by the lens. The measurement can be performed without dilating the pupil. A modulation of the light source renders the measurement insensitive to the surrounding light. The handling of the instrument is very simple. It is mounted on a slitlamp-like table. After adjusting the instrument to the eye, the measurement is initiated by depressing a console button. PMID- 3670802 TI - Microscope ocular fundus photography. AB - The ocular of any microscope may be used for the purpose of photography through the device if the camera utilizes the given optical conditions like an observer eye concerning aperture and focal length. PMID- 3670801 TI - Retinal venous-venous anastomoses and capillary aneurysms in juvenile glaucoma. AB - Two patients with juvenile glaucoma, a 12-year-old boy and a 22-year-old woman, were noted to have venous-venous anastomoses and capillary aneurysms of the retina. Their intraocular pressures had exceeded the diastolic pressure of the central retinal artery for months. Accompanying the successful surgical reduction of the intraocular pressures, these changes in the retinal vessels promptly reverted or disappeared. We consider that these capillary aneurysms and venous venous anastomoses are the sequelae of the prolonged elevation of the intraocular pressure. PMID- 3670803 TI - Multifocal pigment epithelial damages with serous retinal detachment in systemic lupus erythematosus. AB - We experienced 2 females with systemic lupus erythematosus (SLE) who developed serous retinal detachment in the posterior pole of both eyes in its active phase. Fluorescein angiography showed multifocal pigment epithelial damages with fluorescein leakage into the subretinal space. However, retinal hemorrhages or cotton-wool spots typical of SLE were not observed in their courses. PMID- 3670804 TI - Pathophysiology and prognosis of sudden deafness with special reference to the N1 latency. AB - Electrocochleography (ECochG) was performed in 84 patients with sudden deafness which were classified into 3 groups according to the ECochG findings, i.e. the unchanged N1 latency, the prolonged N1 latency and the absence of N1 response. The cause of hearing loss in the first group was thought to be strial, postsynaptic or mild cochlear damage and that in the second to be vascular, sensory or neural damage. The first group showed a better prognosis than those of the other two. PMID- 3670805 TI - Sonotubometric measurement of the eustachian tube function by means of band noise. A clinical view of the acoustic measurement of the eustachian tube. AB - The Eustachian tube is well known as an organ serving the ventilation and drainage of the tympanic cavity and mastoid. Ventilation is carried out by the opening and closing of the Eustachian tube accompanying swallowing movements. Until now there has been no instrument to quantify these motor activities of the tube necessary for its function as a ventilator. The author developed a generally applicable sonotubometer Model WIO-01 with the help of Siemens Hearing Institute K.K. for automatic measurement of the aforesaid tubal function with the use of 7 kHz full-octave band noise. In a sonotubometric trial with 32 adult female subjects, the duration of patency of the Eustachian tube was 288.5 +/- 1.38.5 ms, and the amplitude eliciting response was 16.4 +/- 8.3 dB. The positive response rate was 89.1%. In 89 children aged 4-12 years, a positive response was detected in 117 ears (61.9%). The mean duration of patency was 337.7 +/- 154.4 ms, and the amplitude 16.3 +/- 7.2 dB. It is physiological to have tubal opening and closing during natural swallowing. It is therefore important to understand the tubal function when dealing with tympanoplasty and diseases caused by tubal dysfunction. PMID- 3670806 TI - A prospective epidemiological study of secretory otitis media in young children related to the indoor environment. AB - To assess the influence of housing upon the middle ear status in young children in the form of secretory otitis media (SOM), 210 children not looked after in kindergarten or municipal day-care were investigated. Tympanometry was performed 6 times at 2-week intervals, and the parents filled in a questionnaire concerning housing conditions. In addition to the number of times the children had suffered from SOM, we evaluated long-lasting cases, and the frequency of common colds. Age affected all 3 parameters and sex 1, the boys having a larger number of long lasting episodes. As to housing factors, the type of housing was of importance, children living in flats being most apt to get SOM, and children on farms least, but this difference disappeared after a regression analysis. Both major and minor airing resulted in fewer cases of SOM than did average airing. Children with a history of allergy (but not of allergic rhinitis) caught colds more often than others. PMID- 3670807 TI - The pediatric lower extremity. PMID- 3670808 TI - [Clinico-radionuclide criteria of the course of fistulous forms of traumatic osteomyelitis]. PMID- 3670809 TI - [Experience with the treatment of suppurative infection of the long bones]. PMID- 3670810 TI - [Characteristics of the treatment of injuries of the pelvis and extremities in patients with combined and multiple trauma]. PMID- 3670811 TI - [Roentgeno-morphological characteristics of post-traumatic deformities in children]. PMID- 3670812 TI - [Complications of using a single-plate endocorrector]. PMID- 3670813 TI - [Transosseous osteosynthesis in the treatment of open fractures of long bones]. PMID- 3670814 TI - [Transosseous osteosynthesis of long bones in multiple and combined trauma]. PMID- 3670815 TI - [Biomechanical aspects of transosseous osteosynthesis in inveterate femoral fractures in children and adolescents]. PMID- 3670816 TI - [Vacuum-aspiration in the treatment of stab wounds of soft tissues]. PMID- 3670817 TI - [A method of surgical treatment of rupture of the pubic symphysis]. PMID- 3670818 TI - [Fixation of hip and crural bones in pelvic injuries associated with cranio cerebral and other injuries]. PMID- 3670819 TI - [A method of fixation of the hand during plastic surgery of crural soft tissues with Filatov's flap]. PMID- 3670820 TI - [Correction of experimental parietal diaphyseal defects of long bones with carbonic implants]. PMID- 3670821 TI - [Splint for skeletal traction in the treatment of injuries of the lower extremities]. PMID- 3670822 TI - [Prognosis of infectious complications in severe trauma]. PMID- 3670823 TI - [Crutch holder]. PMID- 3670824 TI - [Various problems of organization of medical services for patients with suppurative bone infection]. PMID- 3670825 TI - [Expert work capacity evaluation after the treatment of invalids with the sequelae of fractures of the crural bones and femur]. PMID- 3670826 TI - [Role of psychophysiological characteristics of sailors in the occurrence of injuries]. PMID- 3670827 TI - [Results of the discussion on the problem of early surgical treatment of children with congenital hip dislocation]. PMID- 3670828 TI - [Orthopedics-traumatology at the pediatric department should also be taught by orthopedists-traumatologists (results of the discussion)]. PMID- 3670829 TI - [Immobilized furazolidone in the treatment of suppurative open fractures]. PMID- 3670830 TI - [Functional treatment of diaphyseal fractures]. PMID- 3670831 TI - [Thermography of hand injuries]. PMID- 3670832 TI - [Timing of the surgical treatment of injuries of the locomotor system in patients with combined and multiple trauma]. PMID- 3670833 TI - [Restorative treatment and prosthesis of invalids with sequelae of leg injuries]. PMID- 3670834 TI - [Surgical treatment of patients with severe scoliosis and spinal cord compression syndrome]. PMID- 3670835 TI - [Diagnostic value of myeloscintigraphy in kyphoscoliosis complicated by spinal cord disorders]. PMID- 3670836 TI - [Preoperative correction in surgical treatment of scoliosis in adolescents]. PMID- 3670837 TI - [Role of spine mobilization in increasing the corrective potential of the Rodnianskii-Gupalov endocorrector (experimental study)]. PMID- 3670838 TI - [Causes of failures of the surgical treatment of lumbar osteochondrosis and analysis of the results of reoperation]. PMID- 3670839 TI - [Scientific analysis of medical publications and possible ways of improving their style and structure]. PMID- 3670840 TI - [Functional treatment of central hip dislocations]. PMID- 3670841 TI - [Methods of studying sensation disorders after injuries of the median and ulnar nerves]. PMID- 3670843 TI - [Medico-social aspects of alcoholic trauma]. PMID- 3670842 TI - [Partial gigantism]. PMID- 3670844 TI - [Use of cold in the treatment of injuries of the locomotor system]. PMID- 3670845 TI - [Study of regional hemodynamics in fractures]. PMID- 3670846 TI - [The role of an antibiotic therapy group in a hospital]. PMID- 3670847 TI - [A new surgical solution in cancer of the posterior meso-hypopharynx involving the esophagus]. PMID- 3670848 TI - [Antibiotic policies: control of antibiotic usage]. PMID- 3670849 TI - [Pre- and postoperative clinical and electrodiagnostic studies in 150 surgically treated cases of carpal tunnel syndrome]. PMID- 3670850 TI - [Importance of childhood blood lipid tests in the prevention of arteriosclerosis]. PMID- 3670851 TI - [Transplantation of the human aortic valve (homotransplantation) in the surgical correction of complex congenital heart defects]. PMID- 3670852 TI - [Diagnostic value of bone scintigraphy and roentgen examination in the detection of bone involvement in malignant lymphomas]. PMID- 3670853 TI - [Age-related changes in the mineral content of the lumbar vertebrae and femoral neck in the healthy female population of Hungary]. PMID- 3670854 TI - [The state of electromyography and electroneurography in Hungary]. PMID- 3670855 TI - [Hypercalcemia syndrome associated with solid tumors and hematologic diseases]. PMID- 3670857 TI - [In defense of medical terminology]. PMID- 3670856 TI - [Epidemiologic study of immunopathological diseases in a population sample from Hajdu-Bihar County]. PMID- 3670858 TI - [Perspectives of urological training]. PMID- 3670859 TI - [Intestinal-vesical fistulas of inflammatory origin]. PMID- 3670860 TI - [High rate of suicidal risk of the elderly in Budapest]. PMID- 3670861 TI - [Retained balloon catheter]. PMID- 3670863 TI - Choosing a computer for the medical office. The Health Care Group. PMID- 3670862 TI - Perforation of the appendix: a cause for concern. PMID- 3670864 TI - Psychiatric care for children with spinal injuries. PMID- 3670865 TI - The scarlet letter. PMID- 3670866 TI - Screening for psychiatric morbidity. The pattern of psychological illness and premorbid characteristics in four chronic pain populations. AB - Three hundred and seventy-eight patients from 4 chronic pain populations have been examined by self-assessment questionnaire methods to estimate the amount of psychiatric morbidity present. Using the General Health Questionnaire-28 scaled version (GHQ-28) the findings for probable psychiatric illness by clinic were: for anaesthetists' pain clinics serving a mixed urban and rural population--37%; for an oral medicine facial pain clinic--30%; for a rural hospital pain clinic- 37%; and for a psychiatrists' pain assessment and treatment service--51%. These findings demonstrate the effects of selection upon the psychiatric characteristics of different pain populations. On the subscales of the General Health Questionnaire the psychiatric clinic patients were significantly more depressed than those in the other 3 groups (P less than 0.001) and also showed more social dysfunction (P less than 0.001). On the Irritability/Depression and Anxiety Questionnaire (IDA), depression and inward irritability were higher in the psychiatric clinic patients (P less than 0.001) but the amount of anxiety did not differ by clinic or by diagnosis (P greater than 0.05). These findings are taken to indicate that the extent of somatic complaints and anxiety does not differentiate the majority of pain patients in pain services with psychological illness from others attending for treatment. However, in the patients who have definite psychological symptoms, depression, social dysfunction and irritability provide a characteristic pattern. The psychiatric clinic patients were demonstrably more introverted or obessional on the Hysteroid/Obsessoid Questionnaire (HOQ) than those in other clinics. Childhood experience as seen by the patients did not differ by clinic or diagnosis and did not correlate significantly with personality as measured by the HOQ. It did correlate very significantly with measures of the current mood represented by the IDA. This effect was relatively weak, permitting the inference that the major portion of those psychological abnormalities which were found to be present was related to other factors such as the occurrence of painful lesions. PMID- 3670867 TI - Family morbidity in chronic pain patients. AB - Family morbidity in chronic pain patients could indicate genetic vulnerability to depressive spectrum disorders or presence of pain behaviour models. Assessment of family morbidity is an area of chronic pain research which has been neglected. In the present study, the frequency and nature of the family psychiatric morbidity of 203 consecutive chronic pain patients has been assessed and compared with that of 140 non-pain psychiatric patients. 30% of chronic pain patients and 33.6% of non-pain psychiatric patients had family psychiatric morbidity. The commonest illness in families of pain patients were found to be alcoholism, psychosomatic disorders and chronic pain. Schizophrenia and affective disorders were reported significantly more often in families of non-pain patients. 53% of psychogenic pain disorder patients had a positive family morbidity. Alcoholism among male relatives, and chronic pain and hypertension more often among female relatives, was another significant observation. No significant difference was found between chronic pain patients with and without family morbidity with regard to socio demographic variables and clinical diagnosis. PMID- 3670868 TI - Management of injection pain in children. AB - Researchers have come to understand a great deal about pain mechanisms, especially in the past 30 years. This understanding has spawned the development of a number of psychological pain control strategies which have been extensively assessed for use with adults. Less is known about pain control strategies in children. The purpose of this study was to assess the value of 2 cognitive strategies (suggestion and music distraction) in reducing pain in children. Two hundred children, aged 4.5-6.5 years, receiving routine immunization injections were randomly assigned to one of the intervention groups in this factorial study. The groups were designated as: distraction, distraction with suggestion, suggestion and control. Subjects reported their pain using a 4-point pain scale. Distraction was found to significantly decrease pain whereas suggestion did not. Combining suggestion and distraction did not further enhance pain relief compared to use of distraction alone. Age was found to be an important determinant of the success of distraction. Furthermore, age was found to be related to amount of pain reported by children regardless of type of treatment. The results of this study support the use of music distraction in the reduction of injection pain in children. PMID- 3670869 TI - IASP taxonomy of chronic pain syndromes: preliminary assessment of reliability. AB - Communication and consequently advancement of knowledge in understanding and treatment of chronic pain has been hindered by the absence of a taxonomy of chronic pain syndromes. Recently the IASP Subcommittee on Taxonomy proposed a classification method based on a multiaxial system. In the present study the interjudge reliability of 2 of the 5 axes, body location and presumed etiology are evaluated. Overall, axis I demonstrated good reliability, however, the reliability of several categories contained within this axis were low enough to suggest minor changes to this axis may increase its clinical utility. Axis V was found to have only fair reliability and many of the categories comprising this axis were demonstrated to have reliabilities that are not clinically acceptable. The implications of these results for future development and refinement of the IASP taxonomy are discussed. PMID- 3670870 TI - The short-form McGill Pain Questionnaire. AB - A short form of the McGill Pain Questionnaire (SF-MPQ) has been developed. The main component of the SF-MPQ consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate or 3 = severe. Three pain scores are derived from the sum of the intensity rank values of the words chosen for sensory, affective and total descriptors. The SF-MPQ also includes the Present Pain Intensity (PPI) index of the standard MPQ and a visual analogue scale (VAS). The SF-MPQ scores obtained from patients in post-surgical and obstetrical wards and physiotherapy and dental departments were compared to the scores obtained with the standard MPQ. The correlations were consistently high and significant. The SF-MPQ was also shown to be sufficiently sensitive to demonstrate differences due to treatment at statistical levels comparable to those obtained with the standard form. The SF-MPQ shows promise as a useful tool in situations in which the standard MPQ takes too long to administer, yet qualitative information is desired and the PPI and VAS are inadequate. PMID- 3670871 TI - P-A-I-N: a four-cluster MMPI typology for chronic pain. AB - A 4-cluster empirically derived MMPI typology for chronic pain sufferers has been demonstrated by combining the results of 10 investigative teams. These MMPI 'types' have been labeled P-A-I-N and appear to have important clinical and demographic correlates. Type P is the most 'psychopathological' looking as nearly all scales are usually elevated. Type P patients are extreme in their claims of physical illness, psychological distress and social maladaptation. Demographic correlates include poor education, high rates of unemployment, and limited household income. Type A is defined by a 'conversion V' on the 'neurotic' triad scales. It has no unique correlates. Type I has elevations on all of the neurotic triad scales and on no others. Type I patients appear to be the most physically infirm with multiple surgeries and hospitalizations. They may not improve physical status with treatment, but appear to benefit psychologically. Type N profiles are 'normal' in that no scale, except perhaps scale K, is often elevated. Type N patients are moderate in their claims of ill health, often are better educated and employed, and appear to respond well to treatment. Classification rules have been proposed to allow patient-typing without a computer. Use of these rules should allow programmatic research into treatment/type interactions even in the ordinary clinical setting. The typology appears well enough established to allow for prospective studies to test theoretical hypotheses drawn from the literature base. PMID- 3670872 TI - Lymphomatous meningitis presenting as atypical cluster headache. AB - We report a woman who developed atypical cluster headache as the first manifestation of trigeminal dysfunction from leptomeningeal lymphoma. Progression to a complete trigeminal neuropathy led to resolution of her pain. The role of the trigeminal nerve in the expression of the signs and symptoms of cluster headache is discussed. PMID- 3670873 TI - Recurrent abdominal pain in children and the endogenous opiates: a brief hypothesis. AB - The aetiology of recurrent abdominal pain in children (RAP) remains unclear. Some features of this syndrome suggest that an opiate-like mechanism may be involved. The evidence for this is reviewed, and it is hypothesised that RAP may result from a differential gastrointestinal response to stress mediated by the endogenous opiate system. PMID- 3670874 TI - Diffuse noxious inhibitory controls (DNICs): psychophysical evidence in man for intersegmental suppression of noxious heat perception by cold pressor pain. AB - Counterirritation, the phenomenon of one painful stimulus reducing pain caused by a second noxious stimulus, has been recognized clinically for decades. Recently a physiological mechanism to explain counterirritation was described and termed diffuse noxious inhibitory controls (DNICs). Nevertheless, few psychophysical studies have examined systematically the effects of a noxious conditioning stimulus on pain perception. The present study examined the perception of painful heat stimuli on the face before, during and after the subject submerged a hand in painfully cold water (5 degrees C) for 5 min (cold pressor pain). We found that the subjects' ratings of the heat stimuli were significantly, although not completely, reduced during the cold pressor pain; this attenuation of pain perception continued after the noxious conditioning stimulus was withdrawn. Similarly, the pain threshold was significantly increased from 45.7 degrees C to 47.3 degrees C while the hand was in cold water and this threshold remained elevated after the cold water was terminated. Since DNICs have been found to completely and selectively inhibit the activity of only one type of pain transmission neuron (wide dynamic range), our data suggest that these neurons are involved in the perception of pain intensity. However, the persistence of residual pain perception in the presence of noxious conditioning stimuli indicates the importance of other nociceptive pathways. PMID- 3670875 TI - Skeletal muscle stiffness and pain following eccentric exercise of the elbow flexors. AB - Stiffness and pain occurring after eccentric exercise have been studied in human elbow flexor muscles. Increased muscle stiffness and flexion deformities of the elbow developed immediately after the exercise and were greatest 1-4 days later. Muscle tenderness and pain experienced during elbow extension developed more slowly but were both maximal at the same time as the muscle stiffness. EMG recordings at times when there was pain and flexion deformity showed the biceps to be electrically silent. This demonstrates that the pain was not due to sustained electrical activity in the muscle and the flexion was a consequence of shortening of non-contractile elements, presumably the connective tissue. It is suggested that some response to damaged connective tissue may cause increased mechanical sensitivity of muscle receptors which, in turn, gives rise to pain when the muscle is stretched or pressed. PMID- 3670876 TI - Discrimination between intensity and affective pain descriptors: a psychophysiological evaluation. AB - The current study utilized a differential classical conditioning paradigm to test subjects' abilities to autonomically differentiate between pain descriptors that had previously been designated as belonging to the intensity or affective dimensions of pain perception. Twenty-one subjects were first tested for differences in spontaneous skin conductance responses (SCRs) and possible habituation to visual presentations of 23 intensity or affective pain descriptors. The classical conditioning procedure consisted of 46 12-sec visual trials. Each of the 23 pain descriptors was presented twice to each subject. Results indicated no differences in spontaneous SCR to intensity or affective descriptors and a clear habituation of response across trials. Results also indicated that the utilization of a differential classical conditioning paradigm produced an overall difference in SCR to the two sets of pain descriptors. The intensity-conditioned subjects demonstrated greater SC responsivity (P less than 0.0004) to intensity-related descriptors than to affective descriptors, and affective-conditioned subjects displayed greater skin conductance responsivity (P less than 0.0004) to affective pain descriptors than to pain intensity descriptors. These results provide psychophysiological support for a multidimensional conceptualization of pain and suggest the utility of classically conditioned autonomic responses in the further development and refinement of verbal pain descriptor scales. PMID- 3670877 TI - CSF and plasma morphine concentrations in cancer patients during chronic epidural morphine therapy and its relation to pain relief. AB - Seventeen patients with advanced cancer pain, treated with chronic epidural morphine, were studied. Minimum plasma and CSF morphine concentrations (CSSmin) were determined at pharmacokinetic steady state. A linear relationship was found between epidural morphine dose and concentrations obtained in plasma (r = 0.92) as well as CSF (r = 0.90). The line for best fit was much steeper for CSF than for plasma. The CSF/plasma concentration gradient of morphine at CSSmin was 132 +/- 31 (mean +/- S.E.M.). Large interindividual variations of morphine concentrations in CSF were found. It is suggested that the variations are due to substantial differences in transdural morphine diffusion between individuals. No correlation was found between pain relief, evaluated with a visual analog scale, and CSF morphine concentrations at pharmacokinetic steady state, when calculated in 9 patients. Mean duration of treatment was 104 days (range 14-366) and the daily dose was increased from 18 +/- 2 to 87 +/- 31 mg/day (mean +/- S.E.M.). A total of 39 epidural catheters were inserted in 14 patients. The catheters were patent for 2-223 days with a mean of 38 days. When re-examined later during treatment, 2 out of 8 patients demonstrated decreased CSF morphine concentrations in spite of increased doses given. One patient with extremely high dose demand is reported on separately and data supporting the concept of a combined spinal and systemic brain morphine effect in such cases are presented. Side effects were not a major problem but the possibility of infectious complications should be considered during chronic epidural morphine therapy. PMID- 3670878 TI - Modifications of [3H]imipramine binding sites in platelets of chronic pain patients treated with mianserin. AB - Tritiated imipramine binding to whole platelets was measured in 16 chronic pain patients who were free from major depression, and in a control group. The maximum binding was significantly lower in chronic pain patients than in the control group, whereas the binding affinity was not significantly different. Twelve patients were treated with mianserin for 21 days; this produced a significant improvement in the mean scores for pain (evaluated with the McGill Questionnaire) and depressive symptoms (assessed with the Zung Self-Rating Scale). The improvement in both types of symptom was accompanied by a significant mean increase in the density of the [3H]imipramine binding sites without modifications in the values of the constant of affinity. All the patients who responded well to treatment (N = 8) had a family history of depressive spectrum disorders (DSD), while none of those who failed to respond had a first degree relative with DSD. PMID- 3670879 TI - Cerebrospinal fluid and plasma pharmacokinetics of morphine infusions in pediatric cancer patients and rhesus monkeys. AB - The cerebrospinal fluid (CSF) and plasma pharmacokinetics of morphine administered as a continuous infusion were studied in pediatric cancer patients and in monkeys with implanted Ommaya reservoirs. In monkeys administered a constant infusion of 0.15 mg morphine sulfate/kg/h, morphine steady-state plasma and CSF concentrations were 84.4 +/- 20.0 ng/ml and 25.3 +/- 4.9 ng/ml, respectively, for a CSF:plasma ratio of 0.30 +/- 0.05. For comparison, the monkeys also received morphine as an intravenous bolus at a dose of 0.45 mg morphine sulfate/kg. The CSF:plasma area under the concentration-time curve (AUC) ratio was 0.40 +/- 0.07, similar to that seen with continuous infusion. Morphine pharmacokinetics were also studied in cancer patients administered long-term infusions of morphine sulfate over a wide dosage range (0.04-31 mg/kg/h). The steady-state plasma concentration of morphine was linearly related to the infusion rate although variability was noted. The average clearance value was 23 ml/min/kg which is at the upper end of the estimates reported for morphine clearance using bolus administration. No evidence for morphine accumulation using long-term administration was observed. A limited number of CSF samples obtained by lumbar puncture showed comparable CSF and plasma concentrations of unbound morphine assuming morphine is approximately 30% bound in human plasma. PMID- 3670880 TI - Subcutaneous formalin-induced activity of dorsal horn neurones in the rat: differential response to an intrathecal opiate administered pre or post formalin. AB - Many studies of pain and nociception use short-lasting acute stimuli which may have limited relevance to prolonged or chronic pain states. Using extracellular single-unit recording in the dorsal horn of the rat lumbar spinal cord the present study examines the response of neurones to a long-lasting nociceptive stimulus, i.e., 50 microliter 5% formalin injected into the corresponding receptive field in the ipsilateral hind paw, and modulation of this response by an opioid. Formalin produced a distinct biphasic excitatory response in all convergent neurones tested; an immediate acute or phasic peak of neuronal firing (mean maximum 22 spikes/sec) 0-10 min post injection, and a second more prolonged tonic excitatory response (mean maximum 12 spikes/sec) over a period 20-65 min after formalin. Cells only activated by innocuous stimuli were not excited by formalin indicating the involvement of C fibre afferents in the excitatory response of convergent neurones to formalin. Both the biphasic nature and the time course of the neuronal response are similar to those observed in behavioural studies. Intrathecal DAGO (Tyr-D-AlaGlyMePheGly-ol), a potent and selective mu opioid receptor agonist, applied 20 min prior to formalin completely inhibited both peaks of excitation. Co-administration of intrathecal naloxone with the agonist restored the biphasic response. By contrast, when the administration of naloxone was delayed to 2 min post formalin so that inhibition of the first peak by DAGO pretreatment occurred, there was no subsequent second peak of activity although antagonism of the opioid would have occurred. When DAGO was applied 2 min post formalin so the initial acute response occurred, the inhibitory effect of the agonist on the second peak was far less. Thus the relative ability of DAGO to modulate the biphasic excitatory response of cells to formalin depends on whether the agonist is administered prior to or after the formalin and the appearance of the second peak may depend on the presence of the first. These results are discussed in light of the role of these neurones in nociception, opioid effects and changes in neural systems following peripheral stimuli. PMID- 3670881 TI - The effect of temporal parameters on subjective sensations evoked by electrical tooth stimulation. AB - The effect of stimulus duration and frequency on subjective sensations evoked by electrical tooth stimulation was studied in 12 subjects. The sensory responses were classified using 5 equi-sensation categories (perception threshold, prepain, pain threshold, moderate pain, intense pain). Both continuously increasing and randomised stimuli were applied. A comparison was made with the activation thresholds of intradental A- and C-fibres in the cat. The mean threshold of intradental A-fibres was lower than the perception threshold at all pulse durations. Perception threshold decreased with increasing stimulus frequency. Current intensities which evoked prepain at a stimulus frequency of 1 Hz were rated as pain at 20 Hz. At supraliminal pain levels the effects of summation were more marked. High-frequency stimulation produced intense pain sensations at intensities well below the activation thresholds of pulpal C-fibres in the cat. We conclude that both perception and pain thresholds and supraliminal pain are modified by temporal summation, and that activation of different pulpal fibre populations is not responsible for production of prepain and pain sensations. PMID- 3670882 TI - Contrasting thermal sensitivity of spontaneously active A- and C-fibers in experimental nerve-end neuromas. AB - Injured afferent A- and C-fibers ending in experimental neuromas in the rat sciatic nerve generate a substantial spontaneous discharge. We show that for individual axons the rate and percent incidence of spontaneous discharge are sensitive to neuroma temperature. Within the range of 14-43 degrees C, firing rate of all of the myelinated fibers examined increased as temperature rose, and decreased as temperature fell. For fibers with a tonic rhythmic discharge pattern, Q10 averaged 1.64 at 34-42 degrees C. Some fibers that were initially silent began to fire as the neuroma was warmed, and some fibers active at baseline temperature fell silent when the neuroma was cooled. Unmyelinated fibers behaved quite differently, showing either no response to temperature changes (44% of fibers sampled), or an increase in discharge rate upon cooling (56%). These effects are probably not secondary to vascular changes, but rather reflect thermal sensitivity of the ectopic neuroma impulse generator sites. This thermal sensitivity may account for the aggravation of phantom limb pain and other neuralgias during cold weather (i.e., post-traumatic cold intolerance). PMID- 3670883 TI - Rapid transneuronal destruction following peripheral nerve transection in the medullary dorsal horn is enhanced by strychnine, picrotoxin and bicuculline. AB - The effects of systemic administration of strychnine (1 mg/kg), picrotoxin (0.5 mg/kg) and bicuculline (2 mg/kg) on acute transsynaptic destruction of medullary dorsal horn neurons following transection of the inferior alveolar nerve were assessed in rats. Single intraperitoneal injections of the above drugs were given without, 1 min before or 1 min after the nerve transection. The effect of transection without drug administration was also examined. Eighteen hours after nerve transection without drug, approximately 7 dark neurons were found in a single toluidine blue stained 1 micron section of the rostral medullary dorsal horn ipsilateral to the nerve transection. Administration of the drugs 1 min before the nerve transection significantly increased the number of dark neurons in a single section to about 17 (strychnine), 46 (picrotoxin) and 20 (bicuculline). These dark neurons were found mainly in the dorsal half of medullary dorsal horn. Delivery of any of the drugs 1 min after the nerve transection did not increase the number of dark neurons. The data thus indicate that the transneuronal effect of transection of the nerve was enhanced by antagonism of glycinergic and GABAergic inhibition of dorsal horn neurons. In view of the short latency and duration of transsynaptic destructive activity, a massive injury discharge of primary afferent neurons and the subsequent release of excitatory neurotransmitters appear to be the direct cause of convulsant enhanced rapid transsynaptic destruction which follows the peripheral nerve transection. PMID- 3670884 TI - The McGill Pain Questionnaire constructed for the Dutch language (MPQ-DV). Preliminary data concerning reliability and validity. AB - The Dutch version of the McGill Pain Questionnaire was composed mainly by following R. Melzack's methodological design. The recommendations of the Finnish research team were considered and integrated. In the first phase as wide an inventory of pain descriptions as possible was drawn up. In the second phase, these pain descriptions were categorized by pain experts and students according to quality aspects. In the third phase the pain descriptions were judged according to intensity aspect as well by pain experts, by students and by pain patients. Finally a fourth phase was set up to obtain insight into the reliability and validity of the McGill Pain Questionnaire - Dutch Version (MPQ DV). PMID- 3670885 TI - Nursing research in the clinical area: getting started. PMID- 3670886 TI - Research collaboration between staff nurses and a university professor. PMID- 3670887 TI - How to read a research article. PMID- 3670889 TI - Osteoarthritis in the primary health care setting. PMID- 3670888 TI - Patient-controlled analgesia: rationale, attributes, and essential factors (continuing education credit). PMID- 3670890 TI - Charting--the dreaded dilemma. PMID- 3670891 TI - Fractured femur with internal fixation. PMID- 3670892 TI - Why nursing research? PMID- 3670893 TI - Use of species-specific DNA probes for detection and identification of trypanosome infection in tsetse flies. AB - Species- and subspecies-specific trypanosome DNA hybridization probes have been employed in the detection and identification of trypanosome infections in Glossina morsitans centralis. Several ways of sample preparation including the use of tsetse organ suspensions, proboscides and dissected midguts, as well as tsetse abdominal content touch-blots were explored. The results of hybridization of radio-isotope-labelled species-specific DNA probes to tsetse samples indicated that it was possible to detect trypanosomes in the organs where parasite development is known to characteristically occur for each subgenus. Duplicate slot-blots of samples prepared from midguts of tsetse infected with 2 strains of T. congolense and from non-infected fly controls show that it is not only possible to detect infection in tsetse but also to identify the strain of parasite present in a sample after hybridization with the DNA probes specific for each strain. The results, obtained after hybridization of sequential abdominal touch-blots from the same fly with the DNA probe specific for one strain of T. congolense, indicated that at least 8 positive signals can be observed after an overnight exposure. Because of their simplicity and potentially low cost, the techniques described here would be appealing for screening large numbers of tsetse samples from the field for the presence of any trypanosome residing in the guts or proboscis of the vector. In addition, the possibility of doing multiple touch-blots from the same fly gives the opportunity of detecting mixed trypanosome infections in the vector. PMID- 3670894 TI - Regulation of mouse colony abundance by Heligmosomoides polygyrus. AB - Despite the ubiquitous presence of parasites, parasitism has not been considered among the list of regulatory factors in animal populations until recently. A detailed long-term study on the impact of the direct life-cycle nematode Heligmosomoides polygyrus on a breeding population of laboratory mice provides a clear example of the ability of helminths to regulate host abundance. In the absence of the parasite, the mouse population equilibrated at a density of 320 mice/m2 as a result of density-dependent effects on recruitment. When the parasite was added and transmission was maintained at high levels, infected mouse populations equilibrated at densities of less than 18 mice/m2. Reduced rates of parasite transmission and elimination of the parasite from the system both resulted in an increase in mouse density. These results have implications for both ecology and parasitology as they demonstrate a potentially important but often ignored component of host populations that may well influence host abundance and community structure. PMID- 3670895 TI - The epidemiology of Ostertagia ostertagi and other gastrointestinal nematodes of cattle in Louisiana. AB - The epidemiology of Ostertagia ostertagi and other gastrointestinal nematodes in yearling beef cattle was examined in each of 2 successive years. During each year 50 head of newly weaned beef calves were given a single dose of thiabendazole and then placed on experimental pastures. Twenty-four of the animals were designated for monthly slaughter (n = 2) and analysis of worm population characteristics and 25 were designated for blood and faecal collection and for weighing. Parasite free tracer calves were grazed alongside the yearling cattle each month (n = 2) throughout the 2 years and were also slaughtered for analysis of worm populations. Faecal egg counts, plasma pepsinogen determinations, herbage larval counts, and animal liveweight changes were recorded monthly. Results of this work substantiated previous observations on seasonal changes of populations of the different nematode genera, but greater continuity and definition of patterns was possible in the present work. Ostertagia ostertagi was the predominant nematode present. While minimal numbers of inhibited larvae were observed from autumn into winter, most of the population was adult at this time. Acquisition of inhibition prone larvae begins in late winter and peak numbers are acquired between March and June. Little transmission of O. ostertagi occurs between June and September. Trichostrongylus axei had a similar seasonal prevalence to O. ostertagi. A major difference in the 2 years was in the pattern of maturation of inhibited larvae. This occurred early, during May 1981, following below average temperatures in May and above average rainfall in May and June. Overt type II disease was not associated with a smaller level of maturation in autumn 1982. In contrast, maturation of large burdens of inhibited larvae did not occur until autumn 1982 following a protracted period of dry and hot weather from spring. Acute type II disease was observed in autumn 1982. Reasons for the differences in maturation pattern, based on worm counts from yearling cattle and tracer calves and association of these with faecal egg counts, herbage larval counts, clinical condition, and liveweight changes are discussed. PMID- 3670896 TI - The relationship between the density of Fasciola hepatica miracidia and the net rate of miracidial infections in Lymnaea truncatula. AB - Experimental studies on the dynamics of infection of Lymnaea truncatula by the miracidia of Fasciola hepatica show that there is a linear relationship between the net rate of attachment of miracidia to snail epithelium and the density of infective stages. The probability of a snail remaining uninfected after exposure to a single miracidium varies with the size class of the snail. Under the conditions of the experiment (temperature, 15 degrees C; exposure period, 30 min; water volume, 8 ml), the probability was 0.46-0.48, 0.27-0.26 and 0.13-0.19 for snail size classes, 0.5-2.9, 3.0-5.9 and 6.0-8.9 mm respectively. PMID- 3670897 TI - Fasciola hepatica in vitro: increased susceptibility to fasciolicides in a defined serum-free medium. AB - The cidal properties of some phenolic, halogenated diphenyl, salicylanilide, benzimidazole and diaminophenoxyalkane anthelmintics, against 6-week-old worms of Fasciola hepatica were assessed in vitro. In a conventional fluke culture medium containing RPMI 1640, supplemented with serum with or without rabbit erythrocytes or pink-ghosts, only the halogenated diphenyl and salicylanilide compounds showed activity at concentrations equal to or less than 100 microM. However, when basal, serum and cell-free RPMI 1640 was used, all compounds other than diamphenethide were highly active, their minimum lethal concentrations being some 25-125 times lower under these conditions. The inclusion of rabbit liver microsomes in the basal culture medium resulted in diamphenethide exhibiting cidal activity equivalent to that seen when its free-amine active metabolite was assayed. The possibility that the activity of many of these compounds was masked in vitro because of their serum binding properties is discussed. Recommendations are made that in vitro screens for new fasciolicides should be carried out in serum-free medium and that additional replicates containing mammalian liver microsomes and liver cytosolic extracts be included as means for the metabolic activation of certain otherwise undetectable prodrugs. PMID- 3670898 TI - Destruction of Leishmania mexicana amazonensis amastigotes by leucine methyl ester: protection by other amino acid esters. AB - L-Amino acid esters, such as leucine methyl ester (Leu-OMe) can destroy intracellular as well as isolated amastigotes of Leishmania mexicana amazonensis by a mechanism which may involve ester hydrolysis by parasite enzymes. We show here that several other esters prevented the killing of the amastigotes by Leu OMe. Destruction of Leishmania within macrophages in culture was assessed microscopically and viability of isolated parasites was monitored by reduction of the tetrazolium MTT. The main features of the protective effect were similar for intracellular and for isolated amastigotes. Thus, (i) effective prevention of parasite killing required that the protective ester be present in the medium prior to and during exposure of infected cells or parasites to Leu-OMe; (ii) the same esters protected intracellular and isolated Leishmania against damage by Leu OMe. Ranks of protective activity, as determined on isolated amastigotes were: Gly-OBz greater than Tyr-OMe greater than Ile-OMe greater than Met-OMe greater than Val-OMe greater than Ala-OMe greater than Gly-OMe greater than D-Leu-OMe; (iii) several esters were inactive in both systems (Leu-OBz, Trp-OMe and Phe OMe). Protective activity was associated with leishmanicidal (e.g. Gly-OBz, Tyr OMe) as well as with non-leishmanicidal (e.g. Ile-OMe, Val-OMe) esters. The results are compatible with the hypothesis that protective esters inhibit the activity of parasite enzyme(s) which hydrolyse Leu-OMe. PMID- 3670899 TI - The mode of action of some benzimidazole drugs on Trichinella spiralis. AB - In an attempt to find possible targets for benzimidazole action in muscle-stage larvae of Trichinella spiralis, the effects of mebendazole and thiabendazole were tested in vivo by oral treatment of infested mice and in vitro by including these anthelmintics in an adequate maintenance medium containing decapsulated larvae. The effects of the anthelmintics on succinate dehydrogenase and fumarate reductase activities, measured in the mitochondrial fraction obtained from the in vivo- or in vitro-treated larvae showed that only thiabendazole causes significant inhibition of fumarate reductase activity. On the other hand, measurements of free glucose, glycogen reserves and soluble protein in the treated larvae indicate that in vivo, mebendazole and thiabendazole clearly diminish free glucose levels, although in vitro only mebendazole produces the same diminution. Both the glycogen and protein contents of the larvae remained unchanged after treatment in vivo or in vitro. The importance of these findings with regard to a possible site of action for mebendazole and thiabendazole is discussed. PMID- 3670900 TI - Echinococcus granulosus: specificity of amino acid transport systems in protoscoleces. AB - Protoscoleces of Echinococcus granulosus absorb the L-amino acids proline, methionine, leucine, alanine, serine, phenylalanine, lysine and glutamic acid by a combination of mediated transport and diffusion. All eight amino acids were accumulated against a concentration gradient. Comparison of Kt and Vmax values suggests that a low affinity for a particular compound is compensated for by a relatively larger number of transport sites for that compound. Four systems serve for the transport of the eight substrates studied: 2 for neutral (EgN1, EgN2) and 1 each for acidic (EgA) and basic (EgB) amino acids. All eight amino acids are incorporated into protein to varying degrees and substantial portions of absorbed L-alanine and L-methionine are metabolized into other compounds. PMID- 3670901 TI - Fatty acid and cholesterol synthesis in mice infected with the tapeworm Hymenolepis microstoma. AB - Infection with Hymenolepis microstoma significantly affected the lipid metabolism of young male Balb/C mice. Infection increased the rates of hepatic fatty acid and cholesterol synthesis and cholesterol synthesis by the gut. Decreases were recorded in testicular fatty acid synthesis and in the weights of testes and white epididymal adipose tissue. Plasma glucose decreased rapidly during infection. The observed changes in lipogenesis could not be attributed to changes in food intake or body temperature. The changes are discussed in relation to nutritional interactions between host and parasite and the possible effects on host hormone levels. The presence of newly synthesized fatty acid in H. microstoma is also reported. PMID- 3670902 TI - Evidence against the hypothesis that metacestodes of Hymenolepis diminuta inhibit corpora allata functioning in the intermediate host, Tenebrio molitor. AB - Several of the pathophysiological responses made by the beetle Tenebrio molitor, when infected with metacestodes of Hymenolepis diminuta, may be attributed to a parasite-induced reduction in host juvenile hormone titre. It has been suggested that production of this hormone by the corpora allata may be inhibited in parasitized insects. This hypothesis was tested using an in vitro radiochemical assay to compare the biosynthesis of juvenile hormone by single pairs of corpora allata taken from mated 12- and 15-day-old infected and control female insects. The results demonstrate, however, that there was no difference in hormone production associated with metacestode infection. Other possible mechanisms for parasite interference in this host endocrine system are discussed. PMID- 3670903 TI - Differences in biological characteristics of two strains of the cestode Hymenolepis diminuta. AB - Biological characteristics of infectivity, growth rate and fecundity of Hymenolepis diminuta isolated from wild Rattus rattus in Japan were compared with parasites of Texas origin maintained for several generations in this and many other laboratories in laboratory bred Rattus norvegicus. The timing of development and maturation was similar in parasites from both sources, but the mean parasite dry weight was less and the mean egg production lower in Japanese parasites in both single and multiple infections. The differences persisted over 10 weeks in single infections, and were unaffected by rat strain. In all experiments there was much greater variation and heterogeneity in the biological characteristics of the Japanese parasites. It was concluded that the Texas parasites were better adapted to R. norvegicus and in the course of adaptation had become more homogeneous, and that the difference between the parasite strains had a complex genetic basis. Some Japanese parasites of the early isolated generations failed to produce normal eggs, but the proportion of these decreased in later generations. However, selected individual Japanese parasites whose egg production was equal to that of parasites of Texas origin did not produce offspring of larger mean size or higher mean fecundity, and heterogeneity of these characteristics was maintained. In the intermediate host, the mean number of cysticercoids of the Japanese isolate per beetle was higher than that of the Texas strain in Tribolium confusum but lower in Tenebrio molitor. The greater heterogeneity exhibited by Japanese parasites and the genetic basis of the strain difference are discussed with particular reference to geographical isolation, differences in definitive hosts and co-evolution of wild and laboratory host and parasite populations. PMID- 3670904 TI - Are sex, age at diagnosis, or mode of presentation prognostic factors for cystic fibrosis? AB - Data on 622 patients with cystic fibrosis born in Victoria, Australia from 1955 to 1980 and on 344 surviving patients in the care of a specialist clinic on June 30, 1983 were analyzed for factors associated with better survival and a less rapid progress of lung disease. Presentation with predominantly gastrointestinal symptoms, other than meconium ileus, was associated with an improved prognosis, whereas presentation with predominantly respiratory symptoms was associated with a worse prognosis. While infants diagnosed before the age of 6 months as a result of routine testing because of a family history of the disease seemed to have less rapid progress of lung disease, their ultimate survival did not seem to be better than that of patients presenting symptomatically after the newborn period. The sex of the patients did not appear to have prognostic significance. Age at diagnosis did not affect rate of progress of lung disease or survival when infants dying within 6 months of birth were excluded. There was a close association between the extent of lung disease at diagnosis and current lung disease. Failure to reverse extensive disease at diagnosis or deterioration of lung disease in the first year after diagnosis was associated with a less favourable course. PMID- 3670905 TI - Pulmonary mechanics in normal infants and young children during first 5 years of life. AB - To characterize lung function in young children we measured lung compliance and pulmonary conductance in 40 normal infants and children ranging in age from the newborn period to 5 years. Inspiratory and expiratory flow was measured by a pneumotachograph, esophageal pressure through a water-filled feeding tube, and functional residual capacity (FRC) by a N2 washout technique. The esophageal pressure change per breath [(mean +/- SD) 7.3 +/- 1.4 cm H2O] and specific compliance (75 +/- 13 ml/cm H2O/L-FRC) did not change with growth. Specific conductance was high (0.60 L/s/cm H2O/L-FRC) in preterm infants, decreasing rapidly with initial growth but minimally beyond 10 kg of body weight, and stabilizing at 0.10 L/s/cm H2O/L-FRC. During the age period studied, compliance increased approximately x 25 whereas conductance only rose five-fold. The changes in compliance and conductance were well correlated to FRC, body weight, and length. These findings suggest that in the last trimester of pregnancy the airways are already well developed and postnatal lung growth occurs mainly by formation of new alveoli, leading to a proportional increase in FRC and lung compliance. Postnatally, conductance increases much more slowly than FRC, resulting in a rapid drop in specific conductance. PMID- 3670906 TI - Recovery from hypopnea in preterm lambs: effects of breathing air or oxygen. AB - The aim of this study was to determine if resuscitation from hypopnea when breathing oxygen resulted in a slower recovery than that seen when breathing room air. Hyperoxia, in preterm human neonates and lambs, decreases minute ventilation (Vl), but no study has shown this effect during recovery from apnea or hypopnea, a common clinical setting. Thus, recovery from hypopnea was studied in eight unanesthesized preterm lambs, breathing spontaneously via an endotracheal tube placed into a tracheostomy. Hypopnea, defined here as a decrease in Vl from baseline greater than 50%, was induced by instillation of distilled water onto the larynx. After a baseline 30 sec when Vl, heart rate, and arterial blood gas were measured, a standard hypopnea stimulus was given over 30 sec. The lambs then breathed air or oxygen during a 2-min recovery period, which started with 15 sec of artificial ventilation. The degree of recovery at 2 min was less in the oxygen (O2) breathing group: Vl (ml/kg/min) = 381 +/- 27 in air and 270 +/- 18 in O2, P less than 0.01; pH = 7.38 +/- 0.005 in air and 7.34 +/- 0.008 in O2, P less than 0.01; arterial carbon dioxide tension (PaCO2, mmHg) = 45.0 +/- 1.3 in air and 49 +/- 1.3 in O2, P less than 0.01; base excess = 2.1 +/- 0.6 in air and 1.1 +/- 0.5 oxygen, P less than 0.01. By 2 min a return to baseline values of Vl, pH, and PaCO2 was noted only in the air breathing group, where the arterial oxygen tension also returned to normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670907 TI - Effect of pulmonary hypertension on lung compliance in newborn lambs. AB - We studied the effects of increased pulmonary arterial pressure and vascular resistance on lung compliance in 12 anesthetized newborn lambs. Lung compliance was unaffected by large changes in pulmonary artery pressure and pulmonary vascular resistance (80% increase) that were induced by either hypoxia or acidosis. We conclude that contraction of the pulmonary vascular smooth muscle in normal newborn lambs does not affect the stiffness of the lung in the parenchymal regions undergoing volume change during ventilation. PMID- 3670908 TI - Lung growth and maturation in experimental oligohydramnios in the rat. AB - On day 16 of gestation the amniotic sacs of either the right or left uterine horns of timed-pregnant Sprague-Dawley rats were punctured with a 20-gauge needle. The fetuses of the opposite horn served as controls. On day 21 of gestation (1 day prior to natural delivery), the fetuses were delivered by Cesarean section. Amniotic sac puncture resulted in a significant loss of amniotic fluid. Fetal growth retardation occurred. Lung growth was specifically retarded, as indicated by significantly reduced lung weight to body weight ratios and lung volume to body weight ratios following amniotic sac puncture. There appeared to be no effect on the structural units of the lung, since no differences between control and experimental fetal lungs were observed in terms of deoxyribonucleic acid, nonconnective tissue protein, total phospholipid, and disaturated phosphatidylcholine per gm dry lung weight. The ratios of disaturated phosphatidylcholine to total phospholipid and nonconnective tissue protein to deoxyribonucleic acid were unchanged. The volume proportions of saccular air, saccular wall, bronchial and bronchiolar air and nonparenchyma, peripheral airspace size, and surface-to-volume ratio were also unchanged. Thus loss of amniotic fluid significantly affected lung growth, more than it affected overall body growth, without having an effect on lung maturation. PMID- 3670909 TI - Pneumothorax: new manifestation of Chlamydia trachomatis infection in infancy. PMID- 3670910 TI - Bronchoscopic evaluation of airway obstruction in campomelic dysplasia. AB - Campomelic dysplasia is a generalized disorder of cartilaginous growth and development, leading to early death from pulmonary insufficiency. We describe the airway dynamics as observed bronchoscopically in two affected infants. Both infants demonstrated anatomic compromise of the upper airway and diffuse laryngotracheobronchomalacia. Additionally, both had a characteristically small, bell-shaped thoracic cage. The abnormal airway dynamics produced serious inspiratory and expiratory obstruction in these infants and, in combination with the restrictive chest wall defect, led rapidly to the development of respiratory failure. While palliative procedures such as tracheostomy may temporarily improve airway dynamics, future respiratory tract insults may prove fatal. PMID- 3670911 TI - Fourth Conference on High Frequency Ventilation of Infants. April 8-11, 1987, Snowbird Ski Resort, Utah. Abstracts. PMID- 3670912 TI - [Effect of vibramycin on the regeneration of the intestinal epithelium in rats]. PMID- 3670913 TI - [Pentagastrin and glucagon as factors accelerating epithelial regeneration in ileal segments subjected to desquamation after administration of vibramycin]. PMID- 3670914 TI - [Morphological and morphometric studies of disorders of regeneration and differentiation of intestinal epithelium in animals receiving vibramycin and enterohormones (glucagon and pentagastrin)]. PMID- 3670915 TI - [Rotavirus as a cause of acute diarrhea in infants]. PMID- 3670916 TI - [Oculoauriculovertebral syndrome (Goldenhar syndrome) associated with Hirschsprung disease]. PMID- 3670917 TI - [Hyperargininemia. Clinical aspects and molecular basis of the defect]. PMID- 3670918 TI - [Changes in the indicators of phagocytosis and leukergia in children with bronchial asthma]. PMID- 3670919 TI - [Changes in IgG, IgA and IgM levels in children with bronchial asthma in relation to the clinical course and treatment with adrenal cortex hormones]. PMID- 3670921 TI - [Dynamics of physical development in neglected celiac disease]. PMID- 3670920 TI - [Bacterial flora of the respiratory system of newborn infants with acute respiratory tract infections 1973-1974 and 1983-1984]. PMID- 3670922 TI - ["Latent" celiac disease or merely short stature?]. PMID- 3670923 TI - [Staphylococcal septicemia with severe course and hematogenic osteomyelitis in children]. PMID- 3670925 TI - [The problem of the quality of life of children]. PMID- 3670924 TI - [A case of staphylococcal septicemia with extremely severe course in a 14-year old girl]. PMID- 3670926 TI - [A simplified scale for determining gestational age of sick and healthy newborn infants]. PMID- 3670927 TI - [Characteristics of the non-protein nitrogen fraction of human and cow's milk]. PMID- 3670928 TI - [Effect of Lasolvan on the course of respiratory distress syndrome in newborn infants]. PMID- 3670929 TI - [Evaluation of the clinical course and the results of treatment of septicemia in newborn infants delivered by cesarean section]. PMID- 3670930 TI - [Clinical observations of septicemia in infants and older children hospitalized at the Children's Hospital 1978-1984]. PMID- 3670931 TI - [Clinical picture of congenital toxoplasmosis in children hospitalized at the Neonatal Department of the Institute of Pediatrics, Medical Academy, in Lublin]. PMID- 3670932 TI - [Thymic aplasia--Digeorge syndrome]. PMID- 3670933 TI - [Chronic anemia in a newborn infant due to fetomaternal transfusion]. PMID- 3670934 TI - [Suppurative peritonitis following appendicitis in a premature infant with a birth weight of 1000 g]. PMID- 3670935 TI - [A case of osteogenesis imperfecta congenita in a 3-week-old infant]. PMID- 3670936 TI - [Perinatal hypoxic-ischemic encephalopathies]. PMID- 3670937 TI - In situ management of confirmed central venous catheter-related bacteremia. AB - Thirty-one patients with suspected central venous catheter-related bacteremia were evaluated with comparative quantitative cultures of central venous and peripheral blood specimens. Using criteria developed from studies in bacteremic animals, 19 patients were confirmed to have catheter-related bacteremia. Antibiotic therapy was administered through the catheter (in situ therapy) in 17 of those patients to evaluate the feasibility of treating patients with true central venous catheter-related bacteremias without catheter removal. Bacteremia was successfully eradicated in 11 of 17 patients (65%), allowing 7 patients to retain their catheter a median of 157 days. This study validates the use of comparative quantitative blood cultures in the diagnosis of catheter-related bacteremia and indicates that in situ therapy is a rational alternative to catheter removal in patients with catheter-related bacteremia. PMID- 3670938 TI - Variability of tobramycin pharmacokinetics in cystic fibrosis. AB - This study determined the extent and impact of tobramycin pharmacokinetic variability in cystic fibrosis patients. Twenty patients were hospitalized twice and the tobramycin half-life, volume of distribution and clearance were determined during Weeks 1 and 2 of both admissions. A difference (P less than 0.05) existed between Weeks 1 and 2 of each admission, but not between admissions, for the clearance and half-life. No difference existed between weeks or admissions for the volume of distribution. No significant correlations existed between weeks within an admission for the half-life and clearance. There was a significant correlation for the volume of distribution between Weeks 1 and 2 of the second admission but not for the first admission. The percents of coefficient of variation and ranges were large. With dosing regimens derived from previously determined factors, "within admission" predicted peaks and troughs would result in 60 and 35% of patients outside the therapeutic range for Admissions 1 and 2, respectively. "Between admission" predictions would result in 65 and 75% of patients outside the therapeutic range. We conclude that considerable variability exists and recommend weekly determinations of serum concentrations and dosing adjustments. PMID- 3670939 TI - Pneumococcal sacroiliitis in an infant. PMID- 3670940 TI - Seroepidemiologic study on influenza A (H1N1) virus infection among school children after an "antigenic shift" from A (H3N2) to a (H1N1) in Kukuoka of southern Japan in 1978. PMID- 3670941 TI - High prevalence of human immunodeficiency virus infection in children with thalassemia exposed to blood imported from the United States. PMID- 3670942 TI - Increased prevalence of strongly positive tuberculin skin reactions in children from a desert agricultural community in Israel. PMID- 3670943 TI - Cost for intravenous immunoglobulin in children can vary 25% by packaging alone. PMID- 3670944 TI - Nosocomial meningitis caused by multiply resistant Pseudomonas cepacia. PMID- 3670945 TI - Treatment of chlamydial conjunctivitis. PMID- 3670946 TI - Aminopenicillin prophylaxis of recurrent otitis media. PMID- 3670947 TI - Neonatal tetanus: potential for elimination in the world. PMID- 3670948 TI - Clinical manifestations of epidemic neonatal listeriosis. AB - We report the broad spectrum of clinical manifestations in 23 infants with positive cultures for Listeria monocytogenes who were treated in our hospital during a recent epidemic. The majority of infants (70%) were preterm and none was small for gestational age. Thirteen (56%) had respiratory distress at birth with evidence of congenital pneumonia. Four of the 5 deaths occurred among these infants. Four infants considered healthy after resuscitation developed fever and lethargy within 36 hours after birth. Only one of these infants had evidence of pneumonia. We conclude that congenital pneumonia with respiratory distress at birth is the major cause of mortality and morbidity from L. monocytogenes infection in the neonate. PMID- 3670949 TI - Invasive bacterial disease in childhood: efficacy of oral antibiotic therapy following short course parenteral therapy in non-central nervous system infections. AB - Recommendations vary considerably for duration of parenteral therapy of common bacteremic infections in children. To assess the efficacy of the current standard of practice by private pediatric practitioners in Portland, OR, we reviewed hospital and clinic records of children older than 6 months of age with non central nervous system bacteremic disease due to Haemophilus influenzae type b, Streptococcus pneumoniae, Neisseria meningitidis and Group A Streptococcus during 1981 to 1984. Diagnoses were: cellulitis (buccal/periorbital), 21; bacteremia without focus, 17; epiglottitis, 13; pneumonia, 7; and other, 4. The average duration (range) of fever (greater than 37.9 degrees C) was 1.8 days (0.5 to 21 days), that of parenteral therapy was 2.9 days (0 to 10 days) and that of oral therapy was 9.5 days (4 to 42 days). No complications of inadequate therapy assessed by clinical or microbiologic failure were reported in study patients. Our review suggests that in a private practice where compliance and accessibility of medical care are good, parenteral therapy for non-central nervous system bacteremic disease need be continued only until the child is afebrile for 24 to 48 hours; outpatient oral therapy should be provided to complete a 10- to 14-day total course of antibiotics. A lumbar puncture should be performed in bacteremic children to rule out occult meningitis. PMID- 3670950 TI - Vertical transmission of Ureaplasma urealyticum in full term infants. AB - Ureaplasma urealyticum is a common inhabitant of the urogenital tract of pregnant women. Although colonization of newborn infants with U. urealyticum has been documented previously, the actual rate of vertical transmission has not been determined. Cervical cultures for U. urealyticum were performed on 1315 pregnant women on admission to the labor suite. A positive culture was found in 810 (62%). Eye, nasopharyngeal and/or throat, vaginal and rectal cultures were obtained in the first 5 days of life from 132 full term infants born to mothers colonized with U. urealyticum. Fifty-nine infants (45%) had at least one culture site positive for U. urealyticum (eye, 4%; nasopharynx 24%; throat, 16%; vagina, 53%; and rectum, 9%). None of the infants had evidence of disease caused by U. urealyticum during the nursery stay. Vertical transmission was not affected by the method of delivery. However, among the vaginally delivered infants, rupture of membranes greater than 1 hour correlated with an increased rate of vertical transmission of U. urealyticum (52%) compared with rupture of membranes less than or equal to 1 hour (22%) (P less than 0.05). Because vertical transmission of U. urealyticum occurs frequently, caution must be exercised when attributing disease to U. urealyticum based solely on positive cultures of mucosal surfaces. PMID- 3670951 TI - Malabsorption of oral antibiotics in humans and rats with giardiasis. AB - We observed unexplained treatment failures in 13 patients with serious infections and apparent incidental giardiasis. Antibiotic concentrations were assayed in the serum from patients before initiating anti-Giardia therapy and again 2 to 3 weeks after therapy. The peak serum concentrations of antibiotics were higher after treatment for giardiasis. The rat model of giardiasis was used to examine the hypothesis that oral antibiotics are malabsorbed during Giardia lamblia infection. Twenty-eight-day-old Sprague-Dawley rats were fed amoxicillin (50 mg/kg/dose), ampicillin (50 mg/kg/dose), cefaclor (50 mg/kg/dose), cephalexin (50 mg/kg/dose), erythromycin (50 mg/kg/dose), penicillin V (50 mg/kg/dose) or sulfamethoxazole (20 mg/kg/dose) and sera were assayed for antibiotics at 1, 2, 4, 6 and 12 hours after therapy. The same rats were fed 10(5) G. lamblia cysts on 4 consecutive days. On Day 7 of infection the rats were fed the same antibiotic and sera were assayed for antibiotics at 1, 2, 4, 6 and 12 hours after therapy. The mean peak serum concentrations for all drugs except sulfamethoxazole were significantly higher in the rats before infection with G. lamblia. These data suggest that oral antibiotic therapy maybe compromised by decreased absorption in the presence of giardiasis. PMID- 3670952 TI - Measles vaccine failure after documented seroconversion. PMID- 3670953 TI - Group C streptococcal infections. PMID- 3670954 TI - Tuberculous peritonitis in an adolescent female. PMID- 3670955 TI - Pediatric acquired immunodeficiency syndrome in Italy: a health problem correlated with drug abuse. PMID- 3670956 TI - Neonatal meningitis caused by Ureaplasma urealyticum. PMID- 3670957 TI - Meningococcal infection and complement deficiency. PMID- 3670958 TI - Central nervous system toxoplasmosis. PMID- 3670959 TI - Behavioral changes after amoxicillin-clavulanate. PMID- 3670960 TI - Staphylococcal scalded skin syndrome. PMID- 3670961 TI - Cardiorespiratory arrests temporally associated with injection of intravenous ampicillin in infants: investigation of a suspected cluster. AB - In August 1985, the FDA received reports of infants who had cardiorespiratory arrests associated with a widely used IV ampicillin product. The events occurred during July and August 1985 in three hospitals located in different parts of the United States. To assess the possibility of a product defect, an epidemiologic investigation was undertaken to determine whether the suspect ampicillin product was associated with an excess number of serious adverse events among infants in 1985. Because complete ampicillin brand information was unavailable for two of the three hospitals, a nonconcurrent cohort study was conducted to test whether the proportion of serious adverse events among infants who were hospitalized between July 1 and Aug 23, 1985, and exposed to any brand of IV ampicillin was different from the proportion of serious adverse events among infants who were hospitalized during the same time in 1984 and exposed to IV ampicillin. No statistically significant difference was found. A follow-up incidence density study at the hospital for which complete ampicillin brand information was known determined that the suspect ampicillin product was not associated with an increased number of serious adverse events in 1985. No common lots of the suspect ampicillin product were identified at the three hospitals. It was concluded that the suspect ampicillin product was not the cause of the cluster of serious adverse events observed among infants in July and August 1985 based on epidemiologic findings. PMID- 3670962 TI - Tin ear syndrome: rotational acceleration in pediatric head injuries. AB - An array of signs pathognomonic of child abuse is described for three young children. The eponym "tin ear syndrome" describes distinct unilateral ear bruising, radiographic evidence of ipisilateral cerebral edema with obliteration of the basilar cisterns, and hemorrhagic retinopathy. Rotational acceleration produced by blunt trauma to the ear is shown to be a necessary and sufficient cause for the production of this syndrome. An approximate value of 4,670 radians/s2 produced by a force of 309 to 347 N (70 to 80 lb) results in shear stress and tearing of the subdural veins, loss of cortical vasomotor tone, cerebral hyperemia, herniation, and death. Past history and environmental circumstances implicated child abuse in every case. PMID- 3670963 TI - Moderately elevated blood lead levels: effects on neuropsychologic functioning in children. AB - Investigations of moderately elevated lead levels and children's cognitive functioning have yielded conflicting results, although studies showing no effects used measures of limited sensitivity and breadth. In this study, a comprehensive neuropsychologic battery was used to determine whether deficits would be revealed. An experimental group of 15 children with a past history of moderately elevated lead levels, but subsequently without increased lead levels for at least a year, were compared with a control group matched by residential area, socioeconomic status, parental IQ, age, and gender. The experimental groups' performance was lower on the battery overall and on measures of motor skill, memory, language, advanced spatial functions, and concentration. The results suggest that exposure to moderately elevated lead levels exerts significant and nontransient effects on cognitive functions. PMID- 3670964 TI - Underdosing of acetaminophen by parents. AB - The parents of 96 young children seen in an inner-city walk-in clinic for perceived or measured "fever" were asked about their management of the symptom. Eighty-eight (92%) administered acetaminophen, and of these, 67% gave less than the usual recommended dose of 10 to 15 mg/kg per dose. Underdosing was most commonly noted in the younger, lighter patient population. Of the parents who gave an acetaminophen elixer preparation (160 mg/5 mL), 26% measured the dose with the 0.8-mL dropper intended for use with the infant drops preparation (80 mg/0.8 mL), resulting in significant underdosing of acetaminophen (2.3 +/- 1.3 mg/kg per dose). Health care professionals should specifically inquire about the details of acetaminophen administration when discussing antipyresis with parents. PMID- 3670965 TI - A catch in the Reye. AB - Twenty-six cases of Reye syndrome from The Children's Hospital, Camperdown, Australia, occurring between 1973 and 1982 were reviewed. Of these, 20 cases met the US Public Health Service Centers for Disease Control criteria for the diagnosis of Reye syndrome. Aspirin or salicylate ingestion had occurred in only one of the 20 cases (5%), and paracetamol (acetaminophen) had been administered in only six of the cases (30%). Pathologic confirmation of the diagnosis of Reye syndrome was accomplished in 90% of the cases. The incidence of Reye syndrome in New South Wales, Australia, is estimated from this study to be approximately nine cases per 1 million children compared with recent US data of ten to 20 cases per 1 million children and three to seven cases per 1 million children in Great Britain. The mortality for these Reye syndrome cases in Australia was 45% as compared with a 32% case-fatality rate in the United States. In Australia, the pediatric usage of aspirin has been extremely low for the past 25 years (less than 1% of total dosage units sold), with paracetamol (acetaminophen) dominating the pediatric analgesic and antipyretic market. Reye syndrome may be disappearing from Australia despite a total lack of association with salicylates or aspirin ingestion, since there were no cases found at The Children's Hospital in 1983, 1984, or 1985. PMID- 3670966 TI - Pediatricians' perceptions of mentally retarded individuals. AB - Three hundred randomly selected members of the American Academy of Pediatrics were surveyed to determine their perceptions of mildly, moderately, and severely mentally retarded individuals. For each of the three categories of mental retardation, pediatricians completed the Prognostic Beliefs Scale which consisted of 27 functional capabilities and choices of residential and vocational placement. Of the 169 (56%) questionnaires returned, 142 (47%) were available for analysis. The pediatricians' perceptions were different for mildly, moderately, and severely retarded individuals. Most pediatricians believed mildly retarded individuals could do all but tasks requiring judgment, could function in unskilled competitive employment, and were likely to live in their own apartments. They believed that those with moderate retardation were limited in their capacity to simple and supervised tasks, could function in sheltered workshops, and were likely to live in group-home settings. They believed that severely retarded individuals were restricted to simple feeding tasks and following one-stage commands, were not capable of any productive employment, and would most likely live in institutions. Pediatric expectations and prognostications for placements were significantly lower than those of other professionals caring for mentally retarded individuals. PMID- 3670967 TI - Sleep problems in early childhood: continuities, predictive factors, and behavioral correlates. AB - A longitudinal study, based on interviews with 308 middle-class, preponderantly white mothers, provided an opportunity to evaluate the continuity, predictive factors, and behavioral correlates of sleep problems in young children. When their children were 8 months old, 10% of the mothers reported that their babies woke three or more times per night, 8% reported that the babies took an hour or more to settle after waking, 5% complained that their own sleep was severely disrupted by the child, and 18% reported at least one of these problems. At 3 years of age, 29% of the children had difficulty getting to bed and/or falling asleep or staying asleep. Of children with a sleep problem at 8 months of age, 41% still had a problem at 3 years of age, whereas only 26% of children without a problem at 8 months of age had a problem at 3 years of age (P less than .001). Among children with sleep problems at 8 months of age, mothers' depressed feelings were the only measured demographic or psychosocial factor associated with persistent sleep problems (P = .02). A separate analysis indicated that these depressed feelings did not appear to be a consequence of the child's sleep problem. Future studies should evaluate how maternal depression interacts with other factors to result in persistent sleep problems. Children with persistent sleep problems were more likely to have behavior problems, especially tantrums (P less than .02) and behavior management problems (P less than .01), than were children without persistent sleep problems (P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670968 TI - Defecation dynamics and behavior profiles in encopretic children. AB - The social competence and behavioral profiles of 38 encopretic children were evaluated, and the social competence and behavioral ratings were correlated with physiologic abnormalities found during anorectal manometric and EMG evaluation and with treatment outcome. When defecation was studied, 66% of encopretic children were not able to defecate rectal balloons and 63% were not able to relax the external anal sphincter during defecation attempts. Total social competence and behavior problem scores were not different for boys able and unable to defecate balloons. Total social competence scores were significantly lower in girls unable to defecate balloons than in those able to (P less than .006), whereas behavior problem scores were similar in girls able to and unable to defecate. We found that persistence of encopresis at 6-month and 12-month follow up was not related to the social competence (P greater than .2) or behavioral scores (P greater than .2) but was significantly related to the inability to defecate (P less than .01) and to the inability to relax the external sphincter during defecation attempts (P less than .03). PMID- 3670969 TI - Vitamin E levels in premature infants during and after intravenous multivitamin supplementation. AB - Serum vitamin E levels were measured in 19 infants weighing 1.0 to 1.5 kg, in 16 infants weighing less than 1 kg who received 65% of a vial (4.6 mg of vitamin E) of multivitamins (MVI Pediatric) daily, and in another group of 16 infants weighing less than 1 kg who received 30% of a vial (2.1 mg of vitamin E) daily. Supplementation was started within 12 hours of birth. Serum vitamin E levels were also measured after supplementation was discontinued in infants who had received 65% of a vial daily. Vitamin E sufficiency (levels equal to or greater than 0.5 mg/dL) was attained after 48 hours of supplementation in all infants receiving 65% of a vial daily and after 72 hours of supplementation in all infants receiving 30% of a vial daily. Vitamin E sufficiency was not maintained in all infants receiving 30% of a vial daily. Of the infants weighing less than 1 kg who received 65% of a vial daily, 31% had serum levels greater than 3.5 mg/dL, whereas no infant weighing less than 1 kg who received 30% of a vial daily had a level greater than 3.5 mg/dL (P less than .05). Of the infants weighing less than 1 kg who received 30% of a vial daily, 56% had levels less than 1 mg/dL v 6% of infants less than 1 kg who received 65% of a vial daily (P less than .01). Vitamin E levels decreased after MVI Pediatric supplementation with 65% of a vial was discontinued (P less than .05). After MVI Pediatric was discontinued, some infants became vitamin E insufficient. PMID- 3670970 TI - Prone and supine positioning effects on energy expenditure and behavior of low birth weight neonates. AB - The effect of body position (supine v prone) on energy expenditure and behavior of 42 healthy low birth weight (920 to 1,760 g) infants was evaluated in 66 studies. Each infant was randomly assigned to the supine or prone position for the first three-hour epoch; the position was reversed for the second three-hour epoch. The difference in energy expenditure and the percentage of time in active sleep, quiet sleep, and wakefulness between the two positions was computed. The median difference (supine minus prone) in overall energy expenditure between positions was +3.1 kcal/kg/d (interquartile range 0.6 to 6.5; P less than .001). When only periods of active sleep were analyzed, the median difference in energy expenditure remained significant, the supine position being higher than prone by +2.6 kcal/kg/d (interquartile range 0.1 to 4.8; P less than .001). In the supine position, the time awake was 5.7% higher (interquartile range 1.8 to 17.4; P less than .001) than in the prone position. The percentage of time in active sleep was not significantly different between the positions, hence quiet sleep decreased in the supine position. In summary, when low birth weight infants are changed from the supine to the prone position, energy expenditure decreases, time spent in quiet sleep increases, and time spent awake decreases. These data suggest that prone is the position of choice for the low birth weight infant. PMID- 3670971 TI - Are venous circulatory abnormalities important in the pathogenesis of hemorrhagic and/or ischemic cerebral injury? AB - The venous circulatory changes in 12 intubated premature infants with fluctuations or elevations in arterial BP were studied. The objectives of the study were to determine whether important alterations in venous pressure occur in infants with fluctuations in arterial BP or with elevations in arterial BP associated with suctioning. Venous and arterial catheters were present in all infants. Perfusion pressure was derived from the difference between mean arterial BP and venous pressure. At rest, minimal change in arterial BP, venous pressure, and perfusion pressure was observed. Elevations in arterial BP were accompanied by pronounced changes in venous pressure. However, because the magnitude and the direction of the changes in venous pressure were not consistent, pronounced changes in perfusion pressure resulted. Fluctuations in arterial BP were associated with fluctuations in venous pressure, which also resulted in pronounced and continuous alterations in perfusion pressure. Induced muscle paralysis in two infants obliterated the changes in arterial BP, venous pressure, and perfusion pressure associated with suctioning. These data demonstrate that marked venous circulatory changes accompany common arterial circulatory abnormalities; such alterations on the venous side of the circulation may be important in the pathogenesis of neonatal hemorrhagic and/or ischemic injury. PMID- 3670972 TI - Buffy coat transfusions in neutropenic neonates with presumed sepsis: a prospective, randomized trial. AB - Neonatal sepsis, accompanied by neutropenia, is associated with a high mortality. To determine whether granulocyte transfusions improve the survival of critically ill neutropenic infants, we prospectively randomized 25 infants to transfusion and nontransfusion groups, matching for birth weight (less than or equal to 1,500 g or greater than 1,500 g). Infants with necrotizing enterocolitis were randomized separately. Neutropenia was established by two successive absolute neutrophil counts less than or equal to 1,500 cells prior to randomization. The transfusion (n = 12) and nontransfusion (n = 13) groups did not differ with respect to clinical or hematologic characteristics. In 23 of 25, bone marrow aspirations were performed to determine the percentage of neutrophil storage pool. Granulocyte transfusions of buffy coats from single units of whole blood (0.1 to 0.9 X 10(9) polymorphonuclear leukocytes per kilogram) were given daily until the absolute neutrophil count increased to more than 1,500/microL. Only five infants, mostly those with necrotizing enterocolitis, required more than one transfusion. A circulating immature to total neutrophil ratio (I:T) greater than or equal to 0.80 was not predictive of an infant with a neutrophil storage pool less than or equal to 7%, and neither an I:T less than 0.80 nor a neutrophil storage pool greater than 7% were predictive of survival. Granulocyte transfusions did not improve survival when either comparing the whole group, those 17 infants with cultures positive for bacteria or viruses, the 19 infants with a circulating I:T greater than or equal to 0.80, or the nine infants with a neutrophil storage pool less than or equal to 7%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3670973 TI - Haemophilus influenzae type b vaccine: use in the pediatric population. AB - To assess the use of the Haemophilus influenzae type b vaccine and the attitudes of health professionals regarding its use in the pediatric population, we conducted a study of community clinics, health department clinics, university based teaching clinics, and private practice groups in the state of Texas. Whereas 59.6% of the private practice groups and 57.1% of the university-based teaching clinics administered the vaccine to more than 75% of their eligible children, 72.7% of community clinics and 81.7% of health department clinics never administered the vaccine to their eligible children. Likewise, whereas 100% of the university-based teaching clinics and 95.7% of the private practice groups had the vaccine available to their patients, only 22.7% of the community clinics and 15.5% of the health department clinics did so. The two most common reasons given by health professionals concerning the nonuse of the vaccine were nonavailability and high cost of the vaccine. Our findings suggest that a large segment of eligible children do not have access to this important vaccine and that children who depend on community and health department clinics for their routine health care are particularly affected in this regard. Strategies identified to increase the use of the vaccine include providing vaccine free of charge, increasing patient awareness of the vaccine benefits, and passing mandatory state laws requiring vaccine administration before day-care enrollment. PMID- 3670974 TI - Preparing residents for the Doctor Denver. PMID- 3670975 TI - Self-inflicted disease and the pediatrician. PMID- 3670976 TI - Granulocyte transfusions in neonates with presumed sepsis. PMID- 3670977 TI - American Academy of Pediatrics Committee on Infectious Diseases: Personal and family history of seizures and measles immunization. PMID- 3670978 TI - American Academy of Pediatrics Committee on Infectious Diseases: Family history of convulsions in candidates for immunization with pertussis-containing vaccines (diphtheria, tetanus, pertussis). PMID- 3670979 TI - American Academy of Pediatrics, American Thyroid Association: Newborn screening for congenital hypothyroidism: recommended guidelines. PMID- 3670980 TI - American Academy of Pediatrics Committee on Children with Disabilities: Pediatrician's role in development and implementation of an individual education plan. PMID- 3670981 TI - American Academy of Pediatrics Committee on Children with Disabilities, Committee on Drugs: Medication for children with an attention deficit disorder. PMID- 3670982 TI - Pediatrics and poverty. PMID- 3670983 TI - Tocopherol efficacy and retinopathy of prematurity. PMID- 3670984 TI - Larger numbers needed. PMID- 3670985 TI - Care of uncircumcised penis. PMID- 3670986 TI - Transcutaneous arterial oxygen tension and retrolental fibroplasia. PMID- 3670987 TI - Cardiovascular risk factors from birth to 7 years of age: the Bogalusa Heart Study. Design and participation. AB - Cardiovascular risk factor variables were examined in a cohort of 440 infants from birth through 7 years of age. Anthropometric measures, BP, serum lipid and lipoprotein values, and dietary intake data were obtained according to detailed protocols. Various quality controls to ensure the collection of valid and reliable data were instituted. Participation remained high throughout the study with 80% of the children examined at 6 months and 60% at 7 years of age. Rates were slightly higher for black than for white children. Children born in the private hospital were more likely to continue in the study than children born in the charity hospital. Children of parents examined when the child was 2 years of age were more likely to be examined during the preschool phases, but parental examination was not related to child examination when the child was 7 years of age. As in studies of school-aged children, measurement errors were lowest for height, weight, and serum total cholesterol. Measurement errors for BP were highest at the younger ages, particularly for diastolic BP. Examination of a newborn cohort throughout time affords the opportunity to study early development of relationships and tracking of cardiovascular risk factors. PMID- 3670988 TI - Cardiovascular risk factors from birth to 7 years of age: the Bogalusa Heart Study. Tracking of body composition variables. AB - Height, weight, and skinfold measurements were obtained on a cohort of 447 children from birth (weight) or 6 months of age (height and skinfold) and monitored yearly thereafter until 7 years of age. At age 7 years, 250 remained for follow-up screening. A significant degree of tracking was found for all variables from age 1 to age 7 years. Height and weight tracked most strongly (age 1- to 7-year correlations = .42 and .44, respectively), whereas skinfold tracked somewhat lower (.28). Earlier levels of each anthropometric variable were the best predictor of later levels of that parameter. Implications for early detection and treatment of growth abnormalities are discussed. PMID- 3670989 TI - Cardiovascular risk factors from birth to 7 years of age: the Bogalusa Heart Study. Blood pressure. AB - BP was measured in 440 children followed longitudinally from birth to 7 years of age in Bogalusa, LA. Levels, trends, and determinants of BP were evaluated in this newborn cohort. Both systolic and diastolic BP levels remained relatively constant between the ages of 6 months and 7 years. BP levels varied between the different instruments, and differences were also noted between measures obtained using the same instrument before and after venipuncture. White children were noted to have slightly higher levels of systolic and diastolic BP pressure at 6 months and 1 year of age, even after adjustment for body size. Significant prediction of year 7 BP rank occurred as early as 6 months of age for systolic and at 1 year of age for diastolic BP levels. Body size was inconsistently related to BP levels from ages 6 months through 4 years, but the relationship was stronger and more consistent with changes in body size. Of interest is the relatively constant levels of indirect BP during this period of rapid growth, as measured by currently available instruments. These data emphasize the importance of cardiovascular risk factor measurement during early life and of the need to improve methods of indirect BP measurement in infancy. PMID- 3670990 TI - Cardiovascular risk factors from birth to 7 years of age: the Bogalusa Heart Study. Dietary intakes. AB - Dietary patterns and racial differences in nutrient intake were observed in children 6 months to 4 years of age in the Bogalusa Heart Study. Even in this sample of young children, the composition of the intakes of the majority of children was not compatible with prudent recommendations of less than 35% and 10% of energy from total and saturated fat, respectively. Mean cholesterol intake of the 4-year-old children (390 mg) was approximately one half of the average daily adult levels. The polyunsaturated to saturated fatty acid ratio ranged from 0.41 to 0.53 and sucrose to starch ratio from 1.32 to 1.57, reflecting a high saturated fat and sucrose intake. White children had greater intakes of sucrose than black children; however, total fat and cholesterol intakes were greater in black children. Gender differences were noted among the 2, 3, and 4-year-old children: energy, sugar, and starch intakes were greater in boys, and cholesterol intake per 1,000 kcal was greater in girls. Mean intakes per 1,000 kcal in Bogalusa were higher for fat and carbohydrate and lower for protein than reported in the Second Health and Nutrition Examination Survey. However, when the National Research Council recommended dietary allowances for protein and energy are used for comparison, a more than adequate intake was noted in these children. The data found in this newborn-infant cohort contribute information regarding the early development of dietary habits that likely influence eating behavior in later childhood and adolescence. PMID- 3670991 TI - Cardiovascular risk factors from birth to 7 years of age: the Bogalusa Heart Study. Predictive value of parental measures in determining cardiovascular risk factor variables in early life. AB - Parent-child associations of height, weight, subscapular skinfold thickness, blood pressure, and serum lipids and lipoproteins were observed in a cohort of 440 infants and their parents in Bogalusa, LA. The infants were examined according to a standardized protocol six times from birth to 7 years of age, and the parents were examined when the child was 2 years old. Regression analyses were performed with the value of the cardiovascular risk factor variable for the child as the dependent variable and race, sex of child, and either mother's value, father's value, or both mother's and father's values as the independent variables. The most significant relationship between parents and their children was for height (P less than .005 at all ages of the child) and weight (P less than .05 from age 1 year for father's regression coefficient and at all ages for mother's regression coefficient). Regression coefficients for parental serum lipids and lipoproteins tended to increase with the child's age. Child-father regression coefficients and child-mother regression coefficients were generally significant (P less than .05) after age 2 years for total cholesterol. Less association was noted for triglycerides and lipoproteins. Parental diastolic BP was a poor predictor of children's values; the regression coefficients for systolic BP were higher and more significant. The longitudinal nature of this cohort study allows for examination of the changing patterns of familial association with aging and may provide insight as to the best age for examining children for cardiovascular risk factors to determine their relative risk for heart disease. PMID- 3670992 TI - [Blood levels of medium-weight molecules in children with various degrees of toxemia in measles and its complications]. PMID- 3670993 TI - [Changes in the internal organs of children with cranio-cerebral injuries]. PMID- 3670994 TI - [Characteristics of cerebral and peripheral circulation disorders in children with sequelae of acute cranio-cerebral trauma]. PMID- 3670995 TI - [Acid phosphatase activity of the cylindrical epithelium of the respiratory tract in healthy children]. PMID- 3670996 TI - [Correlation between hemodynamics and pulmonary ventilation in children after surgical treatment of bronchiectasis]. PMID- 3670997 TI - [Processes of carbohydrate absorption in children with food allergy]. PMID- 3670998 TI - [Hydroxyproline and somatotropic hormone in children of mothers with diabetes mellitus]. PMID- 3670999 TI - [Differences between correlations of immunologic parameters in healthy adolescent girls and boys]. PMID- 3671000 TI - [Hepatitis B virus markers in children with diabetes mellitus]. PMID- 3671001 TI - [Immune complexes and immunologic reactivity in children with diabetes mellitus and obesity]. PMID- 3671002 TI - [Value of studying circulating immune complexes (CIC-PEG 280) in juvenile rheumatoid arthritis]. PMID- 3671003 TI - [Immunocorrective effect of T-activin in children with hypoplastic anemia]. PMID- 3671004 TI - [Characteristics of the course of acute respiratory viral infections in children with various degrees of lipid peroxidation in lymphocytes]. PMID- 3671005 TI - [Status of lipid peroxidation and the antioxidative system in children with cerebral palsy]. PMID- 3671006 TI - [Objectives with regard to improving children's health in Siberia]. PMID- 3671007 TI - [Autonomic dysregulation and diagnostic value of thermography in children with chronic diseases of the gastrointestinal tract]. PMID- 3671008 TI - [Calculation of the specific resistance of the blood in improving the accuracy of the tetrapolar transthoracic rheoplethysmography method]. PMID- 3671009 TI - [Errors in the clinical diagnosis of arthritis in children]. PMID- 3671010 TI - [Errors in the diagnosis of foreign bodies in the respiratory tract and esophagus]. PMID- 3671011 TI - [Effect of the therapy of thyrotoxicosis on the status of the reproductive system of girls with diffuse toxic goiter]. PMID- 3671012 TI - [Characteristics of the development of children of alcoholic mothers]. PMID- 3671013 TI - [Krabbe's globoid-cell leukodystrophy (report of 2 cases of the disease in brothers)]. PMID- 3671014 TI - [Familial congenital hypoplastic thrombocytopenic purpura associated with developmental defects of the bones]. PMID- 3671015 TI - [A case of effective treatment of Lyell's syndrome using hemosorption]. PMID- 3671016 TI - [Possibility of spontaneous arrest of hemorrhage after splenic trauma in children]. PMID- 3671017 TI - The effect of droperidol on the ST-T segment of the ECG. AB - It is generally accepted that droperidol as a dopaminergic blocking agent has some influence on heart function. Therefore, a study was performed to investigate the effect of droperidol on the so-called ischaemic ST-T segment depression in the ECG. Droperidol treatment 0.1 mg/kg b.w. in a single i.m. injection was performed in 30 patients 21 women and 9 men, aged 15-55 years producing marked ST T depression in at least two conventional leads, at rest. Droperidol had a beneficial effect in the majority of patients, i.e. the ST-T segment inversion had normalized in 23%, and improved in 30%. It is concluded that droperidol abolishes the ST-T alteration produced by dopaminergic mechanism. PMID- 3671018 TI - Experience with 131I-therapy. Hyperthyroidism in old age. AB - Retrospective clinical studies of 211 thyreotoxic patients having received 131I therapy were performed and processed by computer. The patients' mean age was 58 years, the male-female ratio 7.1 to 1. The incidence of symptoms and associated diseases was in agreement with data in the literature. Of the clinical symptoms, weight loss, weakness, fatigability, a fine tremor, decompensation and nervousness, called attention to the condition. Of the ECG changes, an absolute arrhythmia of atrial fibrillation and extrasystole may be indicative of hyperthyroidism. Clinically, there is an essential difference between juvenile and old-age thyrotoxicosis. Differences could also be noted between patients with toxic adenoma and those with non-toxic one. Toxic adenoma patients were more advanced in age and the female-male ratio was higher than in non-toxic cases. Absolute arrhythmia of atrial fibrillation, extrasystole, repolarization disorders, diabetes, hypertension and arteriocardiosclerosis occurred more often, while ophthalmopathy and immune disease were less frequent. The clinical picture may raise the suspicion of old-age thyrotoxicosis. Following laboratory diagnosis, treatment should be administered without delay. PMID- 3671019 TI - Pancreatic and intestinal growth-promoting effect of truncal vagotomy in the rat. AB - The effect of chronic subdiaphragmatic truncal vagotomy was investigated on body weight gain, food intake pattern, and also on intestinal and pancreatic growth, in adult rats. Two sham-operated groups, the one fed ad libitum, the other pair fed with the vagotomized rats, served as controls. Body weight of vagotomized rats decreased in the first 5 postoperative days, due to hypophagia. Then, body weight increased as food intake reached the presurgery level. The rats were killed after 34 days of vagotomy. A moderate pancreatic and intestinal hypertrophy was observed in the vagotomized rats, while the tissue weight of and the DNA and protein contents in the colon and the oxyntic and antral areas of the stomach did not change compared to controls. The mechanism of the intestinal and pancreatic hypertrophy is unknown; several humoral and nervous factors may be involved in it. PMID- 3671020 TI - Efficient recognition of adverse drug reactions. AB - The author discusses the possibility of detection of adverse drug effects. Two methods of data collection are compared: the "side effect oriented" and the "change oriented" method. Well-known and new adverse effect may be detected with greater probability by the described "change-oriented" method. The important role of ward doctors in data collection is emphasized. The method is considered suitable for carrying out both drug trials and intensive drug monitoring. PMID- 3671021 TI - Haemostatic alterations in lymphomas and tumours. AB - Disturbances of blood coagulation often occur in various malignancies. Deep vein thrombosis or pulmonary embolism often precedes the manifestation of a solid tumour. Chemotherapy, irradiation, surgery, infections are the triggering factors of a blood clotting abnormality. In the present paper the plasmatic clotting factors and platelet functions were studied in patient with solid tumour and with lymphoma. The most characteristic findings were: ethanol positivity, increased fibrinogen level, decreased euglobulin lysis, impairment of platelet functions. In solid tumours the signs of hypercoagulability were more expressed, in non Hodgkin lymphomas the platelet functions were decreased. These data were in good correlation with data in the literature: in tumours and lymphomas an activation of blood clotting and platelets can be observed. PMID- 3671022 TI - Activation of haemostasis by combined chemotherapy. AB - Haemostasis was studied in 26 patients with malignant non-Hodgkin lymphoma and 19 patients with solid tumours before, and for four days after combined chemotherapy. After treatment an activation of haemostasis was observed in both groups, especially on the 1st and 2nd days. Activation was more expressed in the lymphoma group. This manifested with an increased fibrinogen level, positivity of the ethanol test, a prolongation of thrombin time, an increase of euglobulin lysis and of some platelet functions. Prothrombin and AT III activity decreased as signs of consumption. Thromboembolic events were in the lymphoma group in connection with combined chemotherapy. Thus for preventing the activation of haemostasis we suggest a low-dose subcutaneous heparin treatment for 4 days, beginning 2 h before cytostatic therapy. PMID- 3671023 TI - [Microcytogenetics: a new view of genetics]. PMID- 3671024 TI - [Medical treatment of neonatal chylous ascites: apropos of a case]. AB - We report a case of congenital neonatal chylous ascites successfully managed by diet therapy with medium chain triglycerides. There was a rapid decrease in the lipid content of the ascitic fluid which preceded the clinical response. PMID- 3671025 TI - [A radio-endoscopic case: Barrett esophagus in children]. AB - The authors report a case of Barrett's oesophagus in a child. This observation is characterized by the extent of the lesion which is of three types of metaplasic epithelium usually seen in this disease (fundic, cardial and intestinal tissue); the difficulties in differential diagnosis from uncomplicated hiatal hernia justify radiological and endoscopical examinations with multiple biopsies. The discussion centers on the risk of malignant transformation with its therapeutical consequences and the long term follow-up of such patients. PMID- 3671026 TI - [Brachymetapodies: diagnostic and therapeutic aspects. Apropos of 3 cases]. AB - The authors present 3 cases of brachymetapody (or "hereditary type E brachydactyly"). These conditions are defined by an abnormal shortness of some metacarpals and metatarsals, sometimes associated with other malformations and short stature. The feet may require a surgical correction with different alternatives, adapted to the type of malformations: lengthening of the short rays if they are the least numerous, shortening of one single "long" ray. Surgical indications depend upon pain, more than upon aesthetic considerations. In one of the reported cases, bilateral shortening osteotomy of the first metatarsal and proximal phalanx was performed. PMID- 3671027 TI - [Risk factors of prematurity related life style. Apropos of INSERM surveys in the Rhone-Alpes area]. AB - Based on INSERM epidemiological surveys, the authors study the risk of prematurity related to the maternal way of life. The prematurity rate is higher in women younger than 20 years, in women of foreign overseas origin, in unmarried women living in couple or alone, and in women of low socio-economic classes. Work during pregnancy is not in itself a risk factor as women at home present a higher prematurity rate than women at work. However, the strenuous working conditions, which concern about 20% of pregnant women at work, lead to a higher prematurity rate. Other factors such as smoking, alcohol consumption, travelling and housework are studied. The role of psychological modifications linked to pregnancy is discussed, particularly in women who do not present any medical factor. From these data, suggestions are made in order to improve prematurity prevention. PMID- 3671028 TI - [Experience in health education of children by televised messages]. AB - A questionnaire was submitted to 394 school children aged from 9 to 12 years following a short campaign of health education using televised advertisements. Slides with a drawing and a brief comment were used and broadcasted on a regional TV network. The results of the survey showed that there is still an important need for health education among children to which television can effectively contribute. PMID- 3671029 TI - [Apropos of a familial case of adrenoleukodystrophy related to X chromosome diagnosed prenatally]. AB - The juvenile type of adrenoleukodystrophy is a X linked genetic disorder involving the central nervous system and the adrenal cortex. It is associated with an abnormal metabolism of saturated very long chain fatty acids. The basic defect remains unknown and there is presently no effective treatment. The authors report a familial observation which illustrates the efficacy of the techniques of identification of heterozygote females carriers and of prenatal diagnosis from trophoblast biopsy. PMID- 3671030 TI - [Severe hyperthermia syndrome in the infant. Apropos of 11 cases]. AB - The authors report a retrospective study of 11 cases of malignant hyperthermia. The mean age of the patients was 5 months and 3 weeks. Clinical features included severe hyperthermia (greater than 41 degrees C), seizures, coma, collapse, rhabdomyolysis, acute renal failure and functional renal failure. Three infants died. Four patients presented neurological damages. Four recovered fully. The authors discuss the difficulties of diagnosis, the nosological position and the pathophysiology of this syndrome. PMID- 3671031 TI - [Urinary tract infections in children. Status in a pediatric hospital and sensitivity of bacterial strains to amoxycillin-clavulanic acid combination]. AB - Three hundred bacterial strains from positive urine cultures were isolated over a 10 months period in paediatric hospitalized and out-patients. In addition to commonly used antibiotics, each strain was tested for amoxycillin-clavulanic acid (Augmentin, Beecham) susceptibility. This antibiotic, which is a potent inhibitor of bacterial beta lactamases, may be of interest in the treatment of urinary tract infections because of its pharmacokinetics and activity. The antibacterial activity of amoxycillin and Augmentin against Enterobacteriaceae with special reference to Escherichia coli was compared. The resistance phenotype of Enterobacteriaceae to amoxycillin, carbenicillin and cephalothin allows to anticipate the nature of the beta-lactamase produced by a particular strain, and infer the activity of Augmentin. The overall activity of Augmentin should be interpreted taking into account the resistance phenotypes. In our study, Augmentin was active against 90% of E. coli strains, almost all Proteus mirabilis and vulgaris strains but 9 out of 24 Klebsiella strains were resistant. Augmentin had no activity against nosocomial Enterobacteriaceae, nor against Pseudomonas aeruginosa. On the other hand, its activity was of interest against penicillinase producing Staphylococcus. Our results confirm the interest of Augmentin as a preferential treatment of urinary tract infections in children. PMID- 3671032 TI - [Health survey of the maternal and child population at an Afghan refugees' camp in Pakistan]. AB - A survey on maternal and child health was conducted in the Afghan refugees' camp of Kot-Chandana in Pakistan (109,000 people). Neonatal and infant mortalities were respectively 21% and 78%. The vaccination rate was low. Nevertheless, malnutrition and malaria were relatively unfrequent. This survey showed that the health conditions in the Kot Chandara camp differed appreciably from those in other refugees camps. The authors emphasize the need for health evaluation in all refugees camps before to conducting a mass health campaign. PMID- 3671033 TI - Spatial frequency and selective attention to spatial location. AB - The effect of spatial attention on the detectability of gratings of different spatial frequency was measured using a probe technique. Three experiments are reported in which the detectability of full-field probe gratings was measured while subjects analyzed stimuli presented in either the central or the peripheral visual field. Selective attention to peripheral stimuli produced a facilitation at low frequencies and a decrement at high frequencies. These effects disappeared under forced-choice presentation. PMID- 3671034 TI - Use of central and peripheral optical flow in stance and locomotion in young walkers. AB - Young walkers (up to 5 years of age) were presented with optical flow in a moving room. Flow was global or was restricted to either the center or the periphery of the visible optic array. On standing trials the response rate was greatest when peripheral flow was available. The availability of central flow had a smaller effect on standing, and the younger children showed greater response rates to frontal flow than did the older ones. There was a strong negative correlation between age and response rate for all conditions. Flow also affected stability during locomotion. Response rate was again related to the location of the available flow. It is concluded that children show the same relative sensitivity for flow in the periphery of the dynamic structure of the optic array as has been observed in adults, but that this differentiation of different areas of optical structure is not yet fully developed when children learn to stand. PMID- 3671035 TI - The perception of continuous curves in dot stimuli. AB - Two categorisation experiments are reported in which the perceptual phenomenon that some simple arrays of discrete dots appear as a continuous curve whereas others are perceived as an angular contour or as consisting of separate groups of dots was investigated. Triplets of dots were presented in the first experiment, and complete or incomplete regular dot polygons (ie dots positioned on the vertices of imaginary regular polygons) in the second. In both experiments the perception of a curve versus an angle was determined mainly by the relative orientations of the dots, ie by the angles between successive virtual lines, whereas the lengths of the virtual lines had relatively little influence. In experiment 2 the number of displayed dots was shown to be a second independent factor for perceiving continuity. These results are in agreement with results from experiments on dipole textures discrimination, and suggest the psychological existence and importance of virtual lines in the visual processing of dot stimuli. PMID- 3671036 TI - Circular vection as a function of foreground-background relationships. AB - It has previously been reported that illusory self-rotation (circular vection) is most effectively induced by the more distant of two moving displays. Experiments are reported in which the relative effectiveness of two superimposed displays in generating circular vection as a function of (i) the separation in depth between them, (ii) their perceived relative distances, and (iii) which display was in the plane of focus was investigated. Circular vection was governed by the motion of the display that was perceived to be the more distant, even when it was actually nearer. However, actual or perceived distance was found to be not the crucial factor in circular vection because even when the distance between the two displays was virtually zero, vection was controlled by the display perceived to be in the background. When the displays were well separated in depth, vection was not affected by whether the near or the far display was in the plane of focus, nor by which display was fixed or pursued by the eyes. PMID- 3671037 TI - Perceived path of oblique motion: horizontal-vertical and stimulus-orientation effects. AB - Subjects adjusted the path of moving stimuli to produce apparent slopes of 45 degrees with respect to horizontal. The stimulus was either a single moving dot or a vertical or horizontal bar. In separate experiments either the stimuli were tracked or fixation was maintained on a stationary fixation target positioned 8 deg to the right of the center of stimulus motion. In both experiments the selected path slopes were in general more horizontal than 45 degrees. This pattern indicates that subjects overestimate the vertical component of motion along an oblique path, and is interpreted as a manifestation of the spatial anisometropy generally termed the 'horizontal-vertical illusion'. Additionally, paths selected for horizontal bars were more vertical than those for vertical bars. This finding is interpreted in the context of a previous report of the influence of stimulus orientation on perceived velocity. PMID- 3671038 TI - The Goldmeier effect in adults and children: environmental, retinal, and phenomenal influences on judgments of visual symmetry. AB - Adults judge that patterns symmetrical about the vertical axis are more similar to standard patterns symmetrical about both major orthogonal axes than are patterns which are symmetrical only about the horizontal axis (the Goldmeier effect). Thus, symmetry about the vertical axis is more salient for adults than symmetry about the horizontal axis. Two experiments are reported in which subjects from three age groups (preschool, 8 years old, and adult) were given Goldmeier problems under different conditions. In experiment 1 three head-tilt conditions were used (0 degrees, 45 degrees, 90 degrees); in experiment 2 there were four conditions defined by head orientation (0 degrees, 90 degrees) and phenomenal instructions (top of figure at 0 degrees or at 90 degrees). In both experiments, increasing head tilt from 0 degrees decreased the consistency with which the environmentally vertical pattern was chosen. Noncorrespondence between the three spatial frameworks (environmental, retinal, and phenomenal) failed to produce biases in favor of either retinal-egocentric or phenomenal systems. For rotated adult subjects in experiment 2, 0 degrees phenomenal instructions strengthened an environmental bias, and 90 degrees phenomenal instructions shifted responses toward a retinal bias. These findings provide strong refutation of explanations for symmetry perception that are based solely upon the anatomical symmetry of the visual system. The data also fail to support arguments for environmental or phenomenal frameworks as singular influences. The results are best explained in terms of failure of constancy mechanisms to coordinate environmental and retinal information as a function of degree of head rotation and stimulus complexity. PMID- 3671039 TI - Sensitivity to changes in size and velocity in young and elderly observers. AB - Thresholds for detection of change of size and for detection of change of velocity were measured in young and elderly observers. No differences in thresholds between these subject groups were found at the fovea or in more peripheral retina. The results indicate a degree of functional redundancy in the peripheral retina of elderly subjects, even though there is evidence of reduced numbers of functional photoreceptors in the periphery. PMID- 3671040 TI - Visual reaction time and high-speed ball games. AB - Laboratory measures of visual reaction time suggest that some aspects of high speed ball games such as cricket are 'impossible' because there is insufficient time for the player to respond to unpredictable movements of the ball. Given the success with which some people perform these supposedly impossible acts, it has been assumed by some commentators that laboratory measures of reaction time are not applicable to skilled performers. An analysis of high-speed film of international cricketers batting on a specially prepared pitch which produced unpredictable movement of the ball is reported, and it is shown that, when batting, highly skilled professional cricketers show reaction times of around 200 ms, times similar to those found in traditional laboratory studies. Furthermore, professional cricketers take roughly as long as casual players to pick up ball flight information from film of bowlers. These two sets of results suggest that the dramatic contrast between the ability of skilled and unskilled sportsmen to act on the basis of visual information does not lie in differences in the speed of operation of the perceptual system. It lies in the organisation of the motor system that uses the output of the perceptual system. PMID- 3671041 TI - The perception of time in scale model environments. AB - It has been claimed that when subjects observe differently-scaled model environments their experience of temporal duration is compressed relative to standard clock time in the same proportion as the scale of the model being observed. A series of experiments is reported in which subjects made judgements of duration while observing model environments of different scale. In each experiment, two similar model environments of different scale were presented. Three different kinds of model were used: scale model railways, sitting-room models, and abstract nonrepresentional models. Despite considerable individual variability, significant effects were obtained. Smaller scale was, up to a point, related to a compression of subjective time relative to clock time, although the effect was nowhere near as great as that previously reported. Also, when scale was reduced beyond a certain point the effect on judgements of duration was eliminated, or even reversed. It is suggested that the effect of time compression is related to differences in the density of the information to be processed in environments of different scale, and that there may be an optimum value for information density related both to the scale and to the type of environment. PMID- 3671042 TI - Observations on stroboscopic induced motion. AB - Subject-relative explanations of motion induction state that induced motion is the result of a misperceived shift of the median plane of the visual field of the subject. This theory does not require relative motion of the spot and frame, in the classical spot-and-frame condition, only asymmetrical stimulation. Three experiments are reported in which stroboscopic induced motion was investigated. The experimental arrangement was unconventional in that the induced object (spot) was presented only during the interstimulus interval between the exposures of the inducing object (frame). This allowed differentiation of the duration of the induced movement and that of the inducing one. In the first experiment it was demonstrated that perception of induced motion depends upon the duration of the interstimulus interval between the presentations of the inducing frame. In the second experiment it was shown that the perceived velocity of the induced movement can be different from that of the inducing one and depends on the duration of exposure of the induced object. In the third experiment a stimulus display was created in which the apparent displacement of an object and its induced motion are incongruous. The results are incompatible with subject relative displacement as the sole determining factor of motion induction and they present some difficulties for the hypothesis that induced motion is the result of the apportionment of the objective displacement of the frame. PMID- 3671043 TI - Stereokinesis with moving visual phantoms. AB - When a flat pattern composed of a solid ellipse with two symmetrical semirings (corresponding to the visible parts of a contour ellipse whose major axis is perpendicular to that of the solid ellipse) is slowly rotated in the frontoparallel plane, a compelling three-dimensional impression occurs. Subjects report seeing an egg-shaped object that is inserted into a circular ring: the two objects move solidly into three-dimensional space and a moving visual phantom is generated so that the ring appears completed by an illusory curved bar in the region closest to the observer during rotation. A number of variations of this illusion are presented. It is shown that stereokinetic phantoms (i) maintain the shape of the inducing elements; (ii) appear only after the stereokinetic transformation has taken place; and (iii) depend on the organization of the three dimensional percept as a whole. Relations between stereokinetic phantoms and other completion phenomena are presented and discussed. PMID- 3671044 TI - The effects of display and observer strategy variables on Bourdon assimilation illusions. AB - When a solid (filled-in) triangle is mirror-reflected about its vertex such that one angle arm and its reflection form a straight edge, this straight edge appears as a chevron bent in the direction of the other sides of the triangles, an effect directionally opposite to the well-known tilt illusion that occurs with outline angles. It has been proposed that these negative solid-angle illusions (assimilation effects) which occur in dual-angle (Bourdon-type) displays result from a failure to discriminate between the test (judged) edges and the bisectors of the solid angles. In dual-angle outline displays, near-zero effects have been attributed to the availability of collinearity cues. These hypotheses were tested in two experiments in which cues to collinearity were reduced by inserting gaps between the angles and in which collinearity information was increased by adding thick 'necks' to the displays. The results are consistent with predictions and implicate not only the nature of the angle display, but also the way in which observers perform the matching task in the production of assimilation effects. PMID- 3671045 TI - Spatial frequency and selective attention to local and global information. AB - Probe methods were used to investigate whether the distribution of attention to the local or the global structure of a stimulus affects the detectability of different spatial frequencies. Four experiments are reported in which the detectability of threshold probe gratings of different spatial frequencies was measured while subjects analyzed either the local or the global information from a display. A relative shift in the detectability of low and high frequencies was observed. Low frequencies were facilitated during global processing and/or high frequencies were facilitated during local processing. PMID- 3671046 TI - Depth without disparity in random-dot stereograms. PMID- 3671047 TI - Focused auditory attention and frequency selectivity. PMID- 3671049 TI - Maximum-likelihood psychometric procedures in two-alternative forced-choice: evaluation and recommendations. PMID- 3671048 TI - Threshold models of temporal-order judgments evaluated by a ternary response task. PMID- 3671050 TI - On cross-modal similarity: perceiving temporal patterns by hearing, touch, and vision. PMID- 3671052 TI - Perceptual-motor coordination and prism adaptation during locomotion: a control for head posture contributions. PMID- 3671051 TI - The detectability, discriminability, and perceived magnitude of painful electrical shock. PMID- 3671053 TI - Observers' sensitivity to dynamic anomalies in collisions. PMID- 3671054 TI - Contingency and the McCollough effect. PMID- 3671055 TI - On the theory of Weber fractions. PMID- 3671056 TI - Movement of attentional focus across the visual field: a critical look at the evidence. PMID- 3671057 TI - [Treatment of TIA]. PMID- 3671058 TI - [The social situation of ostomy patient]. PMID- 3671059 TI - [Vasculitis in children]. PMID- 3671060 TI - Known viruses, new dangers. PMID- 3671061 TI - [Withhold treatment, but never care]. PMID- 3671062 TI - [Scandinavian undergraduate education in medical ethics]. PMID- 3671063 TI - [Microcomputers in the hospital sector]. PMID- 3671064 TI - A role for exon sequences in alternative splicing of the human fibronectin gene. AB - Exon EDIIIA of the fibronectin (Fn) gene is alternatively spliced via pathways which either skip or include the whole exon in the messenger RNA (mRNA). We have investigated the role of EDIIIA exon sequences in the human Fn gene in determining alternative splicing of this exon during transient expression of alpha globin/Fn minigene hybrids in HeLa cells. We demonstrate that a DNA sequence of 81bp within the central region of exon EDIIIA is required for alternative splicing during processing of the primary transcript to generate both EDIIIA+ and EDIIIA- mRNA's. Furthermore, alternative splicing of EDIIIA only occurs when this sequence is present in the correct orientation since when it is in antisense orientation splicing always occurs via exon-skipping generating EDIIIA- mRNA. PMID- 3671065 TI - Sequence-specific recognition, photocrosslinking and cleavage of the DNA double helix by an oligo-[alpha]-thymidylate covalently linked to an azidoproflavine derivative. AB - A 3-azidoproflavine derivative was covalently linked to the 5'-end of an octathymidylate synthesized with the [alpha]-anomers of the nucleoside. Two target nucleic acids were used for this substituted oligo-[alpha]-thymidylate: a 27-mer single-stranded DNA fragment containing an octadeoxyadenylate sequence and a 27-mer duplex containing eight contiguous A.T base pairs with all adenines on the same strand. Upon visible light irradiation the octa-[alpha]-thymidylate was photocrosslinked to the single-stranded 27-mer. Chain breaks were induced at the crosslinked sites upon piperidine treatment. From the location of the cleavage sites on the 27-mer sequence it was concluded that a triple helix was formed by the azidoproflavine-substituted oligo-[alpha]-thymidylate with its complementary oligodeoxyadenylate sequence. When the 27-mer duplex was used as a substrate cleavage sites were observed on both strands after piperidine treatment of the irradiated sample. They were located at well defined positions which indicated that the octathymidylate was bound to the (dA)8.(dT)8 sequence in parallel orientation with respect to the (dA)8-containing strand. Specific binding of the [alpha]-octathymidylate involved local triple strand formation with the duplex (dA)8.(dT)8 sequence. This result shows that it is possible to synthesize sequence-specific molecules which specifically bind oligopurine-oligopyrimidine sequences in double-stranded DNA via recognition of the major groove hydrogen bonding sites of the purines. PMID- 3671066 TI - Purification in an active form of the phage phi 29 protein p4 that controls the viral late transcription. AB - The phage phi 29 protein p4, that controls viral late transcription, was highly purified from Escherichia coli cells harbouring a gene 4-containing plasmid. This protein, representing about 6% of the total cellular protein, was obtained in a highly purified form. The protein was characterized as p4 by amino acid analysis and NH2-terminal sequence determination. The purified protein was active in an in vitro transcription assay, allowing specific initiation of transcription at the phi 29 A3 late promoter in the presence of Bacillus subtilis sigma 43-RNA polymerase holoenzyme. PMID- 3671067 TI - Adenine specific DNA chemical sequencing reaction. AB - Reaction of DNA with K2PdCl4 at pH 2.0 followed by a piperidine workup produces specific cleavage at adenine (A) residues. Product analysis revealed the K2PdCl4 reaction involves selective depurination at adenine, affording an excision reaction analogous to the other chemical DNA sequencing reactions. Adenine residues methylated at the exocyclic amine (N6) react with lower efficiency than unmethylated adenine in an identical sequence. This simple protocol specific for A may be a useful addition to current chemical sequencing reactions. PMID- 3671068 TI - Deduced products of C4-dicarboxylate transport regulatory genes of Rhizobium leguminosarum are homologous to nitrogen regulatory gene products. AB - We have sequenced two genes dctB and dctD required for the activation of the C4 dicarboxylate transport structural gene dctA in free-living Rhizobium leguminosarum. The hydropathic profile of the dctB gene product (DctB) suggested that its N-terminal region may be located in the periplasm and its C-terminal region in the cytoplasm. The C-terminal region of DctB was strongly conserved with similar regions of the products of several regulatory genes that may act as environmental sensors, including ntrB, envZ, virA, phoR, cpxA, and phoM. The N terminal domains of the products of several regulatory genes thought to be transcriptional activators, including ntrC, ompR, virG, phoB and sfrA. In addition, the central and C-terminal regions of DctD were strongly conserved with the products of ntrC and nifA, transcriptional activators that require the alternate sigma factor rpoN (ntrA) as co-activator. The central region of DctD also contained a potential ATP-binding domain. These results are consistent with recent results that show that rpoN product is required for dctA activation, and suggest that DctB plus DctD-mediated transcriptional activation of dctA may be mechanistically similar to NtrB plus NtrC-mediated activation of glnA in E. coli. PMID- 3671069 TI - Inosine.adenine base pairs in a B-DNA duplex. AB - The structure of the synthetic deoxydodecamer d(C-G-C-I-A-A-T-T-A-G-C-G) has been determined by single crystal X-ray diffraction techniques at 2.5A resolution. The refinement converged with a crystallographic residual, R = 0.19 and the location of 64 solvent molecules. The sequence crystallises as a B-DNA helix with 10 Watson-Crick base-pairs (4 A.T. and 6 G.C) and 2 inosine.adenine (I.A) pairs. The present work shows that in the purine.purine base-pairs the adenine adopts syn orientation with respect to the furanose moiety while the inosine is in the trans (anti) orientation. Two hydrogen bonds link the I.A. base-pair, one between N 1(I) and N-7(A), the other between O-6(I) and N-6(A). This bulky purine.purine base-pair is incorporated in the double helix at two positions with little distortion of either local or global conformation. The pairing observed in this study is presented as a model for I.A base-pairs in RNA codon-anticodon interactions and may help explain the thermodynamic stability of inosine containing base-pairs. Conformational parameters and base stacking interactions are presented and where appropriate compared with those of the native compound, d(C-G-C-G-A-A-T-T-C-G-C-G) and with other studies of oligonucleotides containing purine.purine base-pairs. PMID- 3671070 TI - An abasic site in DNA. Solution conformation determined by proton NMR and molecular mechanics calculations. AB - We have determined the three-dimensional structure of a non-selfcomplementary nonanucleotide duplex which contains an abasic (apyrimidinic) site in the centre, i.e. a deoxyribose residue opposite an adenosine. The majority of the base and sugar proton resonances were assigned by NOESY, COSY and 2DQF spectra in D2O and H2O. We have measured the initial slope of buildup of NOEs in NOESY spectra at very short mixing times (25 to 50 ms), and from these were able to establish interproton distances for the central part of the duplex. We propose a different strategy for proton-proton distance determinations which takes into account the observed variations in correlation times for particular proton-proton vectors. A set of 31 measured interproton distances was incorporated into the refinement of the oligonucleotide structure by molecular mechanics calculations. Two structures were obtained which retain all aspects of a classical B DNA in which the unpaired adenine and the abasic deoxyribose lie inside the helix. We observe that the non hydrogen bonded adenine is held well in the helix, the Tm of this base being the same as that of the A.T base pairs in the same duplex. PMID- 3671071 TI - A long polypyrimidine/polypurine tract induces an altered DNA conformation on the 3' coding region of the adjacent myosin heavy chain gene. AB - A long (147 base pairs), natural A.T rich polypyrimidine/polypurine tract has been found 55 base pairs downstream of a chicken embryonic myosin heavy chain (MHC) gene. Analysis at the nucleotide level of nicks induced by S1 and Neurospora crassa nucleases indicate that this long interrupted polypyrimidine/polypurine tract exists in an alternate DNA structure in vitro at pH 4.5 and pH 7.5 in both supercoiled and linear plasmid DNA. The polypyrimidine/polypurine tract induces this alternate structure upon at least 200 base pairs of its 5' flanking DNA, and thus extends into the 3' coding and non-coding regions of the neighboring MHC gene. The different nicking patterns induced by the nucleases S1 and N. crassa on each strand of this alternate structure suggests that the polypyrimidine/polypurine tract may form heteronomous DNA. When this long polypyrimidine/polypurine tract is present in a supercoiled plasmid at low pH, a new and as yet undefined S1 hypersensitive DNA alteration was detected near the center of this tract. PMID- 3671072 TI - Chromatin structures: dissecting their mixed patterns in nuclease digests. AB - Four separate features could be distinguished in Fe-DNAase-1 digestions of human lymphoblast nuclei: a di-nucleosomal (2N) repeat, a mono-nucleosomal (1N) repeat, a component of "random" DNA, and triple splitting of major peaks. The random component is major, is unlikely to be completely artifactual, and is what would be expected from the face to face layering model of Subirana et. al., (1). The 2N pattern appeared to be associated with compact, metaphase-type chromatin, whereas the 1N pattern was associated with more exposed chromatin. These two modes are explained in terms of orderly back-to-back folding of zig-zag nucleofilaments, and face-to-face folding respectively. Hybridization studies indicated that the centromeric classes of repetitive DNA had the same digestion spectra as the major interspersed classes of repetitive DNA, and DNA enriched in transcriptionally active sequences. It is suggested that current coil models are all inadequate explanations of higher order chromatin packing. PMID- 3671073 TI - Complete nucleotide sequence of the fast-twitch isoform of chicken skeletal muscle alpha-tropomyosin. PMID- 3671074 TI - The complete amino acid sequence of an HMG-like protein isolated from the macronucleus of Tetrahymena. PMID- 3671075 TI - Detection of transcribed amplified DNA sequences by a modification of the method of DNA renaturation in an agarose gel. PMID- 3671076 TI - Luciferase reporter gene cassettes for plant gene expression studies. PMID- 3671077 TI - Complete nucleotide sequence of the gene encoding a glycinin A2B1a subunit precursor of soybean. PMID- 3671078 TI - A rapid method for the preparation of multiple samples of eucaryotic DNA. PMID- 3671079 TI - A cell type specific factor recognizes the rat thyroglobulin promoter. AB - We have fused a 900 base pair long DNA segment containing the transcriptional start site of the rat thyroglobulin (Tg) gene to the bacterial gene for chloramphenicol acetyltransferase (cat). The fusion gene has been introduced into three different cell lines derived from the rat thyroid gland and into a rat liver cell line. Expression of the fusion gene was detected only in the one thyroid cell line that is able to express the endogenous Tg gene. The minimum DNA sequence required for the cell type specific expression was determined by deletion analysis; it extends 170 nucleotides upstream of the transcription initiation site. The Tg promoter contains a readily detectable binding sites for a factor present in salt extracts of thyroid cell nuclei. This binding site is not recognized by the nuclear extracts of any other cell type that we have tested, suggesting that it may help mediate the cell type specific expression of the Tg gene. PMID- 3671080 TI - The stability of oligodeoxyribonucleotide duplexes containing degenerate bases. AB - Oligodeoxyribonucleotides containing N4-methoxycytosine (mo4C), N4-methoxy-5 methylcytosine (mo4m5C) and other base-analogues were synthesised and used to compare the stabilities of duplexes containing mo4C.A and mo4C.G base pairs with those containing normal and mismatch pairs. The Tm values and other thermodynamic parameters are recorded. The otherwise identical duplexes containing a mo4C.A and a mo4C.G base pair have closely similar stabilities to each other and to the corresponding duplexes containing normal base pairs, considerably greater than the stabilities of those containing mismatch pairs. Corresponding observations are recorded in dot-blot experiments using M13 cloned DNA carrying an insert complementary to the oligonucleotides; approximate Td values are given. PMID- 3671081 TI - Expression of a beta thalassemia gene with abnormal splicing. AB - Expression of a cloned human beta thalassemia gene with a single base change at position 5 of IVS 1 has been analyzed 48 hours after transfer of the gene into HeLa cells (transient expression). Little or no normal beta globin mRNA accumulates in the presence of the abnormal beta gene in contrast to significantly more normal beta mRNA produced with other mutations at this same position. By contrast, large amounts of an abnormal beta globin mRNA are present; this is due to the use of a cryptic 5' splice site in exon 1 rather than the normal 5' splice site of IVS 1. The results indicate the variability of the effect on RNA splicing of different single base defects within IVS. PMID- 3671082 TI - Effects of the antitumor drug VP16 (etoposide) on the archaebacterial Halobacterium GRB 1.7 kb plasmid in vivo. AB - The topoprofile of 1.7 kb plasmids from the archaebacterium Halobacterium GRB was analysed from cells growing with or without VP16 (etoposide). This drug interferes with the breakage-reunion reaction of eukaryotic DNA topoisomerase II by inhibiting the ligase activity of this enzyme. Addition of VP16 to the culture medium of Halobacterium GRB cells results in the introduction of single- and double-strand DNA breaks in part of the plasmid population, with proteins covalently associated at their 5' ends. While some of the remaining covalently closed circular DNA molecules are relaxed, VP16 treatment also gives rise to the production of positively supercoiled 1.7 kb plasmids. In contrast to adriamycin, VP16 does not intercalate into the 1.7 kb plasmid DNA in vivo. These results suggest that the VP16 target in halobacteria is a DNA topoisomerase II. Three major cleavage sites were detected on the 1.7 kb plasmid after VP16 treatment in vivo. PMID- 3671083 TI - Plant expression signals of the Agrobacterium T-cyt gene. AB - Within the 5' and 3' non-coding regions of the T-cyt gene from the octopine T-DNA of Agrobacterium tumefaciens sequences required for expression of this gene in plant cells were identified by deletion mutagenesis. The results show that 184 bp of the 5' non-coding region and 270 bp of the 3' non-coding region are sufficient for wild-type expression. Within the 5' non-coding region two essential expression signals were identified: (1.) an activator element located between 185 and -129 with respect to the ATG start codon and (2.) one out of two TATA boxes. Deletions of the activator element or the two TATA boxes resulted in nonfunctional genes. Deletion of the upstream TATA box and both putative CAAT boxes did not significantly affect expression. Within the 3' non-coding region, the polyadenylation box most distal to the stop codon was not essential for expression, but sequences more upstream, including a second polyadenylation box were found to be required for wild-type expression. PMID- 3671084 TI - Effects of mutations in the TATA box region of the Agrobacterium T-cyt gene on its transcription in plant tissues. AB - We have generated mutations in the promoter region of the octopine type cytokinin gene of Agrobacterium tumefaciens, and studied their effects on mRNA formation in different plant species. The promoter region of this gene contains several putative TATA boxes. Phenotypic expression and Northern blot hybridization showed that TATA boxes are essential for expression, but that one TATA box leads to wild type transcript levels. Analysis of the 5' ends of T-cyt transcripts by primer extension using RNA from T-cyt gene transformed tobacco shoots revealed two major cap site clusters and one minor cap site. TATA box consensus sequences can be found approximately 30 bp upstream from each cap site cluster. Deletion of a TATA box results in loss of the corresponding cap sites. An insertion of 7 bp between the right TATA box and corresponding cap sites results in a shift of the position of the cap sites, so that the original distance of TATA box to cap sites is conserved as much as possible. PMID- 3671085 TI - Large numbers of random point and cluster mutations within the adenovirus VA I gene allow characterization of sequences required for efficient transcription. AB - We have isolated clones with well over 100 randomly dispersed point mutations distributed throughout the 5' half of chemically synthesized adenovirus type 2 VA I genes. In addition, we have isolated clusters of mutations targeted to the regions corresponding to the A and B block consensus sequences of eukaryotic tRNA and adenovirus VA genes. In vitro analyses of these constructs have allowed us to survey in detail the importance of DNA sequence to transcriptional efficiency. Our analyses demonstrate that certain constructs with radically substituted A block regions can be transcribed efficiently. In contrast, there is little tolerance for variation in the sequence within the B block region. We propose that the B block sequence should be R-G-A/T-T-C-R-A-N-N-C for optimal transcriptional efficiency of the VA I gene in mammalian cells. PMID- 3671086 TI - Guanine modification during chemical DNA synthesis. AB - Base modification during solid-phase phosphoramidite synthesis of oligodeoxynucleotides has been investigated. We have discovered chemical modification that converts dG and dG-containing oligomers to a fluorescent form. This modification has been linked to N,N-dimethylaminopyridine (DMAP), an acylation catalyst, which can displace phosphate triester adducts at the 6 position of guanine. Further, we have found that this fluorescent intermediate can be converted in ammonium hydroxide solution to 2,6 diaminopurine deoxyribonucleoside (2,6 DAP), a potentially mutagenic nucleoside analog. We have shown that N-methylimidazole (NMI) in place of DMAP eliminates the fluorescent species and reduces 2,6 DAP contamination. PMID- 3671087 TI - Characterization of the effects on ovalbumin mRNA of aminomethyl trimethylpsoralen photoreaction with hen oviduct mRNA. AB - We have described the reaction of 4'-aminomethyl-4,5',8-trimethylpsoralen (AMT) with hen oviduct mRNA and have investigated the specific effects of AMT photoaddition on ovalbumin mRNA which constitutes 60-70% of oviduct mRNA. The photoreaction of AMT with hen oviduct mRNA appeared to occur in two phases - a rapid monoaddition followed by a slower conversion of monoadducts to diadducts (i.e. crosslinking). Both nondenaturing and denaturing gel electrophoresis revealed a photoreaction time dependent increase in ovalbumin mRNA electrophoretic mobility indicating the formation of a progressively more compact molecular structure. Identical analysis of photoreacted rabbit globin mRNA revealed no change in electrophoretic mobility suggesting that AMT was stabilizing the AU rich secondary structure of ovalbumin mRNA but having no similar effect on the relatively GC rich secondary structure of globin mRNA. Ovalbumin-specific DNA primer extension was used to demonstrate the selective and secondary structure specific photoaddition of AMT to uracil bases at the 5' end of ovalbumin mRNA. PMID- 3671088 TI - Sequence of figwort mosaic virus DNA (caulimovirus group). AB - The nucleotide sequence of an infectious clone of figwort mosaic virus (FMV) was determined using the dideoxynucleotide chain termination method. The double stranded DNA genome (7743 base pairs) contained eight open reading frames (ORFs), seven of which corresponded approximately in size and location to the ORFs found in the genome of cauliflower mosaic virus (CaMV) and carnation etched ring virus (CERV). ORFs I and V of FMV demonstrated the highest degrees of nucleotide and amino acid sequence homology with the equivalent coding regions of CaMV and CERV. Regions II, III and IV showed somewhat less homology with the analogous regions of CaMV and CERV, and ORF VI showed homology with the corresponding gene of CaMV and CERV in only a short segment near the middle of the putative gene product. A 16 nucleotide sequence, complementary to the 3' terminus of methionine initiator tRNA (tRNAimet) and presumed to be the primer binding site for initiation of reverse transcription to produce minus strand DNA, was found in the FMV genome near the discontinuity in the minus strand. Sequences near the three interruptions in the plus strand of FMV DNA bear strong resemblance to similarly located sequences of 3 other caulimoviruses and are inferred to be initiation sites for second strand DNA synthesis. Additional conserved sequences in the small and large intergenic regions are pointed out including a highly conserved 35 bp sequence that occurs in the latter region. PMID- 3671089 TI - Synthesis and physical characterization of DNA fragments containing N4 methylcytosine and 5-methylcytosine. AB - The synthesis of N4-methyl-2'-deoxycytidine and its fully protected mononucleotide, suitable for the oligonucleotide synthesis by phosphotriester method is described. A set of octanucleotides - d(CGCGCGCG), d(CG5mCGCGCG), d(CG4mCGCGCG) and dodecanucleotides - d(GGACCCGGGTCC), d(GGA5mCCCGGGTCC), d(GGA4mCCCGGGTCC) has been synthesized in a solution. Physical characterization of the oligonucleotide duplexes by means of UV and CD spectrometry provides the evidence that 4mC similarly to 5mC favours the B--greater than Z transition, although both of these methylated cytosines inhibit the B--greater than A conformational change. N4-Methylcytosine in contrast to 5-methylcytosine reduces the DNA double helix thermal stability. PMID- 3671090 TI - Selective catalysis of A.T base pair proton exchange in DNA complexes: imino proton NMR analysis. AB - Polyaromatic molecules with amino chain substituents, upon binding with DNA, selectively catalyze exchange of the A.T base pair protons with bulk water protons. The amine-catalyzed exchange is mediated by compounds which are A.T and G.C base sequence specific, intercalators, and outside binders. A mechanism for the selective exchange, involving transient opening and closing of individual A.T base pairs in the duplex, is discussed. PMID- 3671092 TI - Isolation and characterization of an alphoid DNA sequence recently amplified on human chromosome 3. PMID- 3671091 TI - Computer modelling of DNA structures involved in chromosome maintenance. AB - Sequence-dependent DNA bending of synthetic and natural molecules was studied by computer analysis. Modelling of synthetic oligonucleotides and of 107 kb of natural sequences gave results which closely resembled published electrophoretic data, demonstrating the powerful predictive capacity of the procedure. The analysis was extended to the study of DNA structures involved in chromosome maintenance. Centromeric DNAs from yeast were found to have sequences in their functional elements which cause them to be unusually straight. Autonomous replicating sequences were found to have two structural domains, one consisting of unusually straight sequences surrounding the consensus and the other of bending elements in flanking DNA. In addition to a structural homology, centromeric and autonomous replicating sequences share common sequence elements. These observations show that computer modelling of natural sequences is a viable approach to the study of the biological implications of alternative DNA structures. PMID- 3671093 TI - Nucleotide sequence of a mouse tRNA gene cluster. PMID- 3671094 TI - Sequence of human 5-aminolevulinate synthase cDNA. PMID- 3671095 TI - A rapid method for Bal31 deletion analysis. PMID- 3671096 TI - Sequence of the Kluyveromyces lactis URA3 gene. PMID- 3671097 TI - Impaired oxidation of carbon-labeled galactose by alcoholic or diabetic liver in vivo. AB - Because of the organ and enzyme specificity of the metabolism of galactose, evaluation of various kinds of liver disease can be done by measuring the formation of labeled breath CO2 from carbon-labeled galactose in vivo. As shown earlier with uniformly 14C- or 13C-labeled galactose, a further study of alcoholic cirrhotic patients and controls with cheaper 1-14C-galactose indicates a superior discriminatory value of this test compared with common liver function tests. The oxidation test is easier to perform and more acceptable to patients than the standard galactose tolerance blood test. Output of 14CO2 showed slight correlations with serum albumin and 99mTc-sulfur colloid scan grade, but not with other function tests (SGOT, alkaline phosphatase, bilirubin). Comparison with five-year clinical outcome (two groups: with or without known liver-related death) in 29 of 43 total cirrhotic patients (U-14C or 1-14C-galactose) showed a low (75% probability) significance of prognosis for the galactose oxidation test, but none for any of the other tests. A two-part test of oxidation of 14C galactose (with and without an acute dose of ethanol) in 19 possibly or likely alcoholic (but non-cirrhotic) persons indicated, by correlation with other liver function tests and drinking history, some possibly enhanced sensitivity of the two-part versus the single test for recognizing early liver damage. A preliminary study of the single galactose oxidation test in 7 patients with Type II diabetes suggests moderate impairment of oxidation, which might be applied to evaluate the hepatic disorder in diabetes. PMID- 3671098 TI - Accuracy and reproducibility of the assessment of the global ejection fraction using 195mAu and a single-crystal digital gamma camera: influence of collimator design. AB - A sequence of RAO first-pass studies (first with 99mTc and then twice with 195mAu) was performed in 18 normal volunteers and in 12 CAD patients using two different types of collimator for medium energy: a standard collimator (MEMS) and a special high-sensitivity collimator (MEHS). The following data were compared: the peak count rate, the net LV end-diastolic counts and the LVEF. Using MEMS the end-diastolic counts acquired were so low (12% of 99mTc average value) that EF standard deviation had a mean value of 0.061 (range 0.045-0.081). With MEHS the following results were obtained: 1. the peak count rate and LV net end-diastolic counts with 195mAu were 55% and 50% respectively, of 99mTc values; 2. a good correlation was shown between LVEF values either with 99mTc and 195mAu (r = .97), or with 195mAu sequential studies (r = .98). PMID- 3671099 TI - Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease--comparison with 201Tl myocardial perfusion scintigraphy. AB - Using 123I-omega-heptadecanoic acid (HDA) and 201Tl, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination half-life was 26.1 +/ 3.6 min, whereas the patients with MVP had a mean value of 25.0 +/- 6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31% and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201Tl showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201Tl, presumably due to ischemia based on small vessel disease or abnormalities of cellular metabolism. PMID- 3671100 TI - [Radionuclide ventriculography--a noninvasive method of diagnosis and quantification of tricuspid valve insufficiency]. AB - The diagnosis of tricuspid regurgitation (TR) is difficult to make by simple clinical methods or by invasive techniques. Contrast echocardiography and Doppler echocardiography have improved diagnostic results, but a golden standard is still not available. Radionuclide ventriculography (RNV) is a well-established method for the detection and quantification of a volume load on the left ventricle: the regurgitation fraction can simply be derived from the regurgitant index as the ratio of enddiastolic-endsystolic count-rate differences between the left and right ventricle. In left heart valvular regurgitation a regurgitant index exceeding the upper normal limit can be expected. This study was performed to evaluate the diagnostic accuracy of an abnormally low regurgitant index in detecting TR, which is accompanied by an isolated volume load on the right ventricle. A series of 33 patients with TR on physical examination and cardiac catheterization underwent RNV and was compared with 48 patients with right ventricular enlargement or pressure load on the right ventricle. In addition, the specificity of the method was evaluated in 470 consecutive patients with various forms of heart disease. In 18 out of 20 subjects with isolated TR a regurgitant index below the lower normal limit was found. The remaining 2 cases with minor TR had a regurgitant index within the normal range, which is 0.89 to 1.97 in this laboratory. In patients with additional volume load on the left ventricle, the sensitivity of the method was found to be low, as could be expected from the principle of the method. The time-activity curve over the liver was usually in phase with that recorded over the atria in subjects with TR. Therefore, the additional examination of a region of interest over the liver was particularly useful in these patients with concomitant aortic or mitral valve regurgitation. None of the 48 patients with right ventricular enlargement or pressure load on the right ventricle had a falsely positive result. A total of 17 out of 470 consecutive patients had a regurgitant index below the normal range; left ventricular function was severely impaired in 9 of these patients. The remaining subjects had a regurgitant index slightly below the lower normal limit. In conclusion, RNV has a high sensitivity in the diagnosis of TR in patients without left heart valvular regurgitation and a high specificity in patients without severely impaired left ventricular function and without left-to-right shunt through an atrial septal defect.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3671101 TI - [Experimental animal model for late post-radiation reaction of the large intestine]. PMID- 3671103 TI - [Pathogenesis and radiobiology of late post-radiation reactions in healthy tissues. II. Role of the volume factor and fractionated dose]. PMID- 3671102 TI - [Pathogenesis and radiobiology of late post-radiation reactions in healthy tissues. I. The concept of target cells and functional units and serial and parallel functional connections]. PMID- 3671105 TI - [Evaluation of the possibility of permanent cure of patients with breast cancer without metastases to the lymph nodes]. PMID- 3671104 TI - [Infection as a complication of the treatment of neoplasms of the hematological and lymphatic systems]. PMID- 3671106 TI - [Malignant neoplasm mortality among men occupationally exposed to asbestos dust]. PMID- 3671107 TI - [Evaluation of programs of health education regarding neoplasms in Lublin schools]. PMID- 3671109 TI - ANA delegates should reconsider their decision. PMID- 3671110 TI - Second opinion. PMID- 3671108 TI - [Usefulness of determining C-reactive protein levels for monitoring the patients with ovarian cancer]. PMID- 3671111 TI - The interface of ethics and politics in nursing. PMID- 3671112 TI - Directors of nursing service: how well prepared are they? PMID- 3671113 TI - Nursing and health care in India. PMID- 3671114 TI - A window of opportunity. PMID- 3671115 TI - Keeping the focus on nursing. AB - Keeping the curriculum focused on nursing will take the best efforts of nursing educators, administrators, and practitioners. Nursing knowledge based on systematic study has expanded and is now developing more quickly than ever. This, along with the recognized need for general education courses in the curriculum, has helped nursing move into the mainstream of higher education. New approaches to curriculum organization and to teaching nursing should be considered in the effort to provide the best possible education. The many advances made by nursing education and practice in the past century now challenge us to consider curriculum changes that could significantly alter our traditional approaches. PMID- 3671116 TI - Research preparation for undergraduates. PMID- 3671117 TI - The simulated clinical laboratory. PMID- 3671118 TI - Refusing unsafe work assignments. PMID- 3671119 TI - The time of our lives. PMID- 3671120 TI - Toward self-integration: the recovery process of chemically dependent nurses. AB - This qualitative field research explored and described the process of recovery for chemically dependent nurses. Data collection methods included participant observation in a chemically dependent nurses' self-help group for one year and in depth interviews with 20 chemically dependent nurses who were in the process of recovery. Data analysis was done according to the grounded theory methods. In accordance with this method, a substantive theory was proposed that viewed the recovery process as a move from self-annihilation to self-integration. Stages and phases of self-integration are presented. PMID- 3671121 TI - Use of nursing practice research findings. AB - Fourteen nursing research findings that meet the Conduct and Utilization of Research in Nursing (CURN) Project (1982) criteria for clinical use were identified from research journals and CURN publications. Data collected from 216 practicing nurses in small, medium, and large hospitals were analyzed to determine their awareness of, persuasion about, and use of the findings. The majority of nurses were aware of the average innovation, were persuaded about it, and used the average innovation at least sometimes. Use of the innovations had no relationship to hospital policies or procedures concerning the nursing research findings. PMID- 3671122 TI - Menopausal stage, current life change, attitude toward women's roles, and perceived health status. AB - The impact of menopausal stage, current life change, and attitude toward traditional women's role on perceived health status was studied in 249 women 40 to 55 years of age. Instruments included the Life Experiences Survey (LES), Index of Sex Role Orientation (ISRO), and the Perceived Health Status (PHS). The relationship between menopausal stage and PHS was inverse and significant, though small. That between the LES score and PHS was inverse and significant. No direct, significant relationship between the ISRO score and PHS was observed. Multiple regression analysis accounted for 15% of variance in PHS. PMID- 3671123 TI - Diagnostic reasoning strategies of nurses and nursing students. AB - This study described and compared the cognitive strategies of diagnostic reasoning used by junior nursing students (n = 15), senior nursing students (n = 13), and practicing nurses (n = 15). Verbal responses to three videotaped vignettes provided the data. Findings suggested that diagnostic reasoning processes of both nurses and nursing students can be described by a general model developed from studies of physicians. Subjects activated diagnostic hypotheses early in the encounter and used systematic information gathering to rule in and rule out hypotheses. With increased levels of knowledge and experience, there was a trend toward more systematic data acquisition and greater accuracy in diagnosis. The number of hypotheses activated, the earliness with which they were activated, and their diagnostic accuracy were task-specific components of the process, but selection of data-acquisition strategies appeared to be more generalizable across cases. PMID- 3671124 TI - Footwear practices and operating room contamination. AB - The extent of bacterial transfer into the clean confines of the operating room (OR) was studied by comparing the use of protective footwear (i.e., polypropylene shoe covers and OR restricted shoes) with unprotected street shoes over a 5-week period. The study was divided into two experimental times: (a) early morning (disinfected floor) and (b) midmorning (dirty floor). Data obtained from the early morning experiment showed that OR restricted shoes and shoe covers transferred fewer bacteria onto the disinfected study area than unprotected street shoes; similar findings were obtained from the midmorning experiment for shoe covers, but not for OR restricted shoes. A comparison of changes in bacterial counts obtained from OR restricted shoes and shoe covers worn from the changing room through a common corridor to the disinfected study area did not differ significantly from OR restricted shoes and shoe covers that were put on immediately before walking through the study area at both experimental times. Overall results indicated that protective footwear may act to reduce bacterial contamination on OR floors. PMID- 3671126 TI - Work stress, hardiness, and burnout among hospital staff nurses. AB - The question of whether personality hardiness moderates the impact of job stressors on burnout was studied in 107 registered staff nurses from an urban, community hospital who responded to a self-administered questionnaire. Consistent with previous research, burnout was significantly associated with higher levels of perceived job stress and lower levels of personality hardiness. Hierarchical multiple regression analyses further indicated that work stressors (particularly stress due to workload) and hardiness were significant additive rather than interactive predictors of burnout. That is, hardiness had beneficial main effects in reducing burnout, but did not appear to prevent high levels of job stress from leading to high levels of burnout. PMID- 3671125 TI - Nurses' responses to do-not-resuscitate orders in the neonatal intensive care unit. AB - A statewide survey of nurses in perinatal centers was conducted to assess the prevalence of do-not-resuscitate (DNR) policies in neonatal intensive care units (NICUs) and to examine factors influencing nurses in those centers in their compliance with DNR orders. Three nurses in each of 10 perinatal centers were asked to complete a questionnaire on DNR policies and nurses' compliance and to respond to four hypothetical clinical situations. Eighteen of the 27 responding nurses reported the existence of a DNR policy. Factors affecting compliance with DNR orders were agreement that the infant should not be resuscitated (n = 24) or respect for the parents' wishes (n = 19). Nurses' intention to resuscitate despite a DNR order varied, depending on the description of the infant. Multiple regression analyses showed that subjective norms (beta = .41 to .82) rather than attitudes (beta = .17 to .39) exerted a more powerful influence on nurses' decisions not to resuscitate. PMID- 3671127 TI - Remembering the peer in peer review. PMID- 3671128 TI - Perceived self-care agency: a LISREL factor analysis of Bickel and Hanson's questionnaire. AB - The psychometric properties of Bickel and Hanson's Perceived Self-Care Agency Questionnaire (PSCAQ) (Hanson, 1981) were examined using a LISREL confirmatory factor analysis approach. Questionnaires were distributed to a convenience sample of 575 noninstitutionalized adults in northwestern Ohio; 462 questionnaires (80%) were returned. Findings indicated that the factor structure of the PSCAQ is significantly different from that described by Bickel (1982) and does not appear to conform to the expected self-care power component structure. These findings call into question the construct validity of the PSCAQ as a measure of self-care agency in non-institutionalized adults. It should be used only with extreme caution, if at all, for testing the self-care deficit theory. PMID- 3671129 TI - Gynecologic age: prediction in adolescent female research. PMID- 3671130 TI - [Umbilical cord IgE: a test for sensitivity, specificity and predictive value of atopy?]. AB - Total IgE cord serum levels were measured in 200 newborns in the Hospital of Viadana-Bozzolo and familial allergic conditions were investigated in all the cases. In a 6 month follow up study attention was focused on the development of atopic symptoms. The sensibility, specificity and predictive value of the total IgE cord serum levels are discussed and the introducing of preventive measures in the at risk newborns is also questioned. PMID- 3671131 TI - [Self care in celiac disease]. AB - The need for patients with coeliac disease to be introduced to a self-management program is well established. This program frequently raises some problems for young patients in relation to social condition and personal habits, and to the life and culture of their community. Data from a questionnaire given to 62 young patients show a strong interest in self-management and in periodic meetings. Some problems usually arise only on early adolescence (12/15 years). PMID- 3671132 TI - [Therapy with plasmapheresis and lymphoplasmapheresis combined with immunosuppressive agents in 2 cases of intractable juvenile rheumatoid arthritis]. AB - Two cases of JRA refractory to NSAID' steroids and long-acting drugs were successfully treated with plasmapheresis and combined lympho- and plasma apheresis respectively. Case 1. A 8 year old female child who had been suffering from systemic JRA for 6 years received a course of three plasmapheresis followed by a 6 month cycle of azathioprine. Clinical and laboratory remission was promptly achieved and is still present after 18 months. Case 2. A 12-year old boy affected by poliarticular JRA received a course of 4 plasmapheresis followed by a 6 month cycle with azathioprine. The opportunity of performing plasma or lymphoplasmapheresis reinforced by immunosuppressive drugs such as azathioprine or methotrexate at low doses in refractory cases of JRA is discussed. PMID- 3671133 TI - [Mucha-Habermann disease. Description of a case in childhood]. AB - The authors report a case of Mucha-Habermann disease in childhood. Mucha Habermann disease is not a very well known, though not infrequent, disease. It is characterized by recurrent erythematous-papular-vesicular skin lesions associated with arthralgia or arthritis or large joints. Prognosis is generally favourable although an evolution towards Pityriasis Lichenoides Chronica and/or Mycosis Fungoides is possible. There are not specific laboratory findings for this form. Diagnosis is essentially based on histology showing an immunopathogenetic vasculitis. At the present time there is not a safe therapy for the disease; there are however indications for the use of Erythromycin and we followed these in our therapy with positive results. PMID- 3671134 TI - [Ring chromosome 4 in twins]. AB - A case of ring chromosome 4 in an eleven months old male child with severe mental retardation, microcephaly and craniofacial anomalies is described. The karyotype was: 46,XY, r(4) p16----q35). The patient shows only few elements of the Wolf syndrome, whose phenotype is observed in most of the other cases with analogue karyotype. PMID- 3671135 TI - [Clinical aspects (especially nephropathologic) and genetic counseling in tuberous sclerosis. Presentation of a case with polycystic kidney]. AB - Tuberous sclerosis (TS) represents a relatively frequent inherited disorder of the skin and neurological tissues. Defects of other organs may also be present, but subjects differ significantly in their individual involvement. Usually, white leaf - shaped macules, even though most subtle, are the first precocious sign of the disease in young patients. Other signs tend to appear when the patient grows older. Visceral disorders include renal angiomyolipomata; clinical behavior of these solid tumors is almost always benign. Sometimes the renal lesions present themselves as polycystic kidneys, and may be the earliest sign and the only manifestation of TS, such as the case here described. This unusual form of renal involvement may be a severe potential complication of TS for the possible blood hypertension, recurrent urinary sepsis and chronic renal failure. It is of the utmost importance to search for the classical stigmata of TS in any patient who has cystic renal enlargement as only apparent abnormality. Careful inquiry into the family history cannot be overemphasized. The authors believe that, failing availability of adequate therapy for TS, the role in genetic counseling is to provide as much informations as possible to enable the involved family to make an intelligent decision about future children. PMID- 3671136 TI - [Leri-Weill syndrome (dyschondrosteosis). Description of 2 clinical cases]. AB - We describe two children with Leri-Weill syndrome (Dyschondrosteosis), one of which showed the clinical features at very early age. Stature was moderately reduced in both, due to shortening of the bones of the legs. Furthermore were evident in them the clinical and radiological features of the propositus and of their affected parents are described. The problems concerning the early recognizing of the disease and the genetic inheritance are discussed. PMID- 3671137 TI - Dose-related effects of nebulized metaproterenol in asthmatic children. AB - The dose-related effects of inhaled 5% metaproterenol solution in asthmatic children between the ages of six and 12 years with acute bronchospasm were evaluated. Tests included FEV1.0, FEF25-75, and PEFR. For entry into the study, subjects were required to have an FEV1.0 or an FEF25-75 less than 80% of the child's predicted normal value based on height and race. Sixty children were randomly assigned in double-blind fashion to receive one of four different doses of 5% metaproterenol inhalant solution: 0.0 ml (placebo), 0.1 ml, 0.2 ml, or 0.3 ml. Drug efficacy was assessed by spirometry using a DeVilbiss Surveyor I spirometer. Spirometry was performed prior to inhalation of the test dose (baseline) and four times after inhalation: immediately after and 15, 30, and 60 minutes after inhalation. Patients in the three treated groups had significantly higher peak post-dose FEV1.0 and FEF25-75 than the placebo group but were not significantly different from one another. There was a significant relationship between dose and incidence of side effects. These results suggest that 0.1 ml (5 mg) of nebulized metaproterenol may provide as much bronchodilatation as higher doses with fewer side effects. PMID- 3671138 TI - Computerized tomography in hemophiliacs with head trauma. AB - Intracranial hemorrhage secondary to head trauma is a major cause of morbidity and mortality in patients with bleeding disorders. Indications for head computerized tomographic scanning (CT scan) on patients with bleeding disorders who sustain head trauma are not well established. We retrospectively reviewed the medical records and head CT scan results of 21 patients with bleeding disorders. Five patients had more than one episode of head trauma. The severity of head trauma per episode was classified according to objective clinical findings as minor in 12 episodes, moderate in 12, and severe in four. In three of four patients with severe head trauma, the CT scan showed evidence of intracranial hemorrhage. In this series, all 17 patients with 24 episodes of moderate or minor head trauma had normal head CT scans. We conclude that a larger prospective study is needed to further evaluate the diagnostic value of head CT scan in hemophilia patients with minor or moderate head trauma, as defined in this study. PMID- 3671139 TI - Chest pain secondary to cocaine use. AB - Chest pain in adolescents and younger children is most often benign, and cardiac causes are rare. We present a 16-year-old with chest pain temporally related to cocaine use and discuss the relationship between cocaine use and acute myocardial infarction that has been seen in the adult population. Pediatricians and emergency physicians should consider cocaine abuse in the evaluation of an adolescent with chest pain. PMID- 3671140 TI - Acute headache in childhood: a case of sphenoid sinusitis. AB - A case of sphenoid sinusitis is presented. This case exemplifies the need to consider sinusitis in the differential diagnosis of severe headache, even without the accompanying signs and symptoms of sinusitis. The clinical, presentation, diagnostic work-up, potential complications, and treatment of sphenoid sinusitis are reviewed. PMID- 3671141 TI - Hypokalemia following fresh-water submersion injuries. PMID- 3671142 TI - Unexpected vaginal sperm in two sexual abuse victims. AB - A careful forensic examination of the sexually abused child may reveal evidence of male ejaculation if this had occurred in the recent past. Two cases of the unexpected presence of vaginal sperm in prepubertal children are presented. The techniques of sperm and acid phosphatase collection are discussed. Sperm and/or other seminal products should be sought in victims of recent assault, in preverbal or nonverbal children, in victims with signs or symptoms of recent penetration, or in any case where the recency of sexual contact is unknown or uncertain. PMID- 3671143 TI - Methemoglobinemia in two children: disparate etiology and treatment. PMID- 3671145 TI - The physician's deposition: preparation and testimony of the medical malpractice defendant. PMID- 3671144 TI - Severe methemoglobinemia induced by a topical teething preparation. PMID- 3671146 TI - Acute respiratory distress with cyanosis. PMID- 3671147 TI - Initial management of adolescent overdoses. PMID- 3671148 TI - Pediatric venous cutdowns: utility in emergency situations. PMID- 3671149 TI - Atracurium or vecuronium for rapid sequence endotracheal intubation. PMID- 3671150 TI - [Arterial hypertension in elderly patients]. PMID- 3671151 TI - [Clinical course of infectious diseases in patients over 60]. PMID- 3671152 TI - [Pattern of blood flow velocity in the branchial artery as an indicator of the aging process in the vascular system]. PMID- 3671153 TI - [Dynamics of anxiety states in middle-aged and elderly persons]. PMID- 3671154 TI - [Changes in internal body temperature after physical exertion under heat discomfort conditions as a parameter of biological age]. PMID- 3671155 TI - [Chronic subdural hematoma in patients over 70]. PMID- 3671156 TI - [Secretion of gastrin, pancreatic polypeptide and glucagon in persons with simple obesity]. PMID- 3671157 TI - [Incidence of diabetes mellitus among the adult population of Lodz]. PMID- 3671158 TI - [Rate of sodium transport through cell membranes and the sodium level in the granulocytes of patients with increased body weight and arterial hypertension and in those with normal blood pressure]. PMID- 3671159 TI - [The sanatorium as a promoter of health and health education]. PMID- 3671160 TI - [Effect of physical exercise conducted in sanatoria on serum levels of selected hormones in patients with ischemic heart disease]. PMID- 3671161 TI - [Interpretation of ST-segment depression in the exercise electrocardiogram of patients with coronary insufficiency]. PMID- 3671162 TI - [Use of adenosine triphosphate in the diagnosis of short PQ interval]. PMID- 3671163 TI - [Transesophageal stimulation of the heart in patients with pre-excitation syndromes]. PMID- 3671164 TI - [Various immunological phenomena in pregnancy]. PMID- 3671165 TI - [Test for pregnancy and labor risks in women with congenital heart defects]. PMID- 3671166 TI - [Motherhood after treatment of hyperthyroidism with I-131]. PMID- 3671167 TI - [Positive serological tests for toxoplasmosis and abortions]. PMID- 3671168 TI - [Iron, copper, ceruloplasmin and selected hematological indicators in the blood of women in the third trimester of pregnancy]. PMID- 3671169 TI - ["Periclimacteric" hypertension]. PMID- 3671170 TI - [Health status and resumption of professional work after myocardial infarction]. PMID- 3671171 TI - [Exercise electrocardiogram in patients after myocardial infarction: a 12-year observation]. PMID- 3671172 TI - [Serum manganese level during the acute stage of myocardial infarction]. PMID- 3671173 TI - [Value of polycardiographic examinations in the prevention of post-radiation cardiac damage after radiotherapy]. PMID- 3671174 TI - [Adenosine triphosphate in the diagnosis and treatment of paroxysmal supraventricular tachycardia]. PMID- 3671175 TI - [Sexual problems of patients after myocardial infarction]. PMID- 3671176 TI - [Poisonous insect bites (data of the Toxicology Clinic and the Institute of Forensic Medicine, Medical Academy, in Cracow)]. PMID- 3671177 TI - [Combined effect of the allergen and thymus extract (TFX) in the desensitization of patients with hay fever]. PMID- 3671178 TI - [Postoperative intensive care of patients after surgical treatment of aortic coarctation]. PMID- 3671179 TI - [Problems in the treatment of patients with implanted heart valves]. PMID- 3671180 TI - [Rare cause of hypokalemia (Westphal's syndrome)]. PMID- 3671181 TI - [Health policies with regard to decreasing cardiovascular disease mortality rate]. PMID- 3671182 TI - [Blood coagulation disorders in extracorporeal circulation]. PMID- 3671183 TI - [Activation of blood platelets and the plasma coagulation system in patients with chronic uremia]. PMID- 3671184 TI - [Congenital complement 2 deficiency in a patient with systemic lupus erythematosus with a severe course]. PMID- 3671185 TI - [An alphabet of hematologic ideographic signs and its use in a computer program assisting the interpretation of microscopic images of the peripheral blood and bone marrow]. PMID- 3671186 TI - Interactions of ketamine, naloxone and morphine in the rat. AB - The effect of naloxone on the ketamine-induced anesthesia and analgesia, and the development of tolerance to ketamine and the cross-tolerance to morphine (measured by an analgesic effect) were investigated in the rat. Ketamine produced a dose-dependent analgesia. Naloxone, 1 mg/kg, significantly inhibited analgesia induced by ketamine, 100 mg/kg, but even in a dose of 4 mg/kg it did not affect the duration of anesthesia. A chronic administration of ketamine (100 mg/kg twice a day (b.i.d.) for 7 days) resulted in the development of tolerance to analgesic effects of ketamine. The analgesic action of morphine was attenuated in rats receiving ketamine chronically, while the analgesic effects of ketamine were significantly potentiated in morphine-dependent rats. Ketamine, 25 mg/kg, significantly attenuated the withdrawal signs evoked by naloxone in morphine dependent rats. The results corroborate the suggestion about the participation of the central opioid neurotransmission in the mechanism of ketamine action. PMID- 3671187 TI - Naloxone and lithium interaction on the levels of homovanillic acid in the rat brain. AB - The effects of long term (10 days) treatment of lithium and naloxone on HVA levels of striatum, hypothalamus and frontal cortex in rats were investigated. Lithium (400 mg/l in drinking water) itself had no effect on HVA levels of any region. Naloxone (2 mg/kg) treatment caused significant increases in the levels of HVA in hypothalamus and striatum and lithium cotreatment prevented the effect of naloxone. Neither of those were observed in the frontal cortical region. PMID- 3671188 TI - Tolerance to diazepam-induced avoidance depression in mice. AB - The disrupting action on avoidance responses, exerted by diazepam given during shuttle-box training (5 mg/kg before each session), was abolished by a pretreatment with the drug (5 mg/kg) for five days. Similarly, avoidance depression, produced by diazepam in trained mice, was prevented by a pretreatment with five daily doses and was attenuated by previous administration of three daily injections or even of a single dose of the drug. The results demonstrate that tolerance rapidly develops to diazepam-induced avoidance depression, as to other behavioral actions of benzodiazepines. PMID- 3671190 TI - Modalities of chemotherapy and endocrine therapy for growth inhibition of androgen-stimulated mouse carcinoma (Shionogi carcinoma 115). AB - Effects of chemotherapy and endocrine therapy applied individually or in combination on growth of an androgen-stimulated mouse tumor, Shionogi carcinoma 115 (SC 115), were examined. In the present study cyclophosphamide and castration were used as chemo- and endocrine therapy, respectively, and simultaneous combination of these two treatments was found to be the most effective in inhibiting tumor growth. When comparing the effect of castration alone with that of injection of cyclophosphamide alone, the former retarded the tumor growth more efficiently, but relapse occurred in both instances. Injection of cyclophosphamide to the relapsed tumor after castration caused a marked effect when compared with the effect of the drug on the untreated or the chemotherapy relapsed tumors. Castration caused a retardation of growth in the chemotherapy relapsed tumor, but the survival period was shorter than that observed in the mice that received castration followed by injection of cyclophosphamide. From these results, it was concluded that castration followed by chemotherapy was the preferred order among sequential treatments for the SC 115; however, the optimal treatment was produced by simultaneous combination of chemotherapy plus castration. PMID- 3671189 TI - Synthesis and anticonvulsant properties of N-methylpyridyl derivatives of m- and p-bromophenylsuccinimides. AB - The reaction of m- or p-bromophenylsuccinic acids with 2-aminomethylpyridines yielded respective N-methylpyridylimides 1-8. Only compounds 1 and 6 show anticonvulsant activity in the pentetrazole and electric seizures tests, but their therapeutic index is inferior to that of ethosuximide and valproic acid. PMID- 3671191 TI - Transplantable human prostatic carcinoma (PC-82) in athymic nude mice: I. Hormone dependence and the concentration of androgens in plasma and tumor tissue. AB - This paper is the first part of a series of three describing a number of observations made on the PC-82 human prostatic carcinoma, xenografted into nude mice. The previously described androgen-dependence, one of the main properties of this tumor, has been the subject of subsequent studies. The impact of hormonal manipulation on the growth of the tumor and on plasma and tissue concentrations of androgens is discussed in this first part of the series. The great variability of plasma testosterone (T) levels in intact male mice (range: 1-90 nmol/liter) has been levelled out by the use of T-containing Silastic implants, resulting in levels ranging from 18 to 35 nmol/liter. Moreover, this route of administration also facilitated hormonal manipulation of tumor bearing mice. Androgen withdrawal from male mice with growing PC-82 tumors caused 80% tumor regression at ten weeks after androgen deprivation; the decline of the tumor volume followed a biphasic course. Delayed androgen substitution in castrated male mice grafted with PC-82 30 days before resulted in growth of the tumor tissue. This indicates that cells do not die and keep the capability to respond to androgens. It was concluded that the growth of the PC-82 tumor is not compatible with plasma T levels lower than 1 nmol/liter. Variable concentrations of endogenous T and dihydrotestosterone (DHT) were detected in total homogenates of PC-82 tumor tissue. Androgen withdrawal from T-implanted, tumor-bearing female mice caused a rapid reduction (90% within one day) of the tissue-T and a slower decline (up to 90% within seven to ten days) of tissue-DHT concentrations. PMID- 3671192 TI - How did you get into it? Medicine, that is. PMID- 3671193 TI - Neonatal loss. What can be done to ease parents' grief. AB - Healthcare professionals have an important role in helping grieving parents cope with a neonatal loss. Physicians need to be professionally prepared to deal with such a situation, which includes knowing how to refer the parents to community support systems and anticipating and being prepared for a variety of emotional responses. Suggestions based on personal experience are offered for dealing with bereaved parents during this complex and difficult time. PMID- 3671194 TI - Common seasonal and environmental allergens. AB - House dust represents a complex mixture of individual, clinically important allergens that includes insects, danders, and pollens. Characterization and standardization of each of these allergens will provide significant advancement in our understanding and treatment of allergic respiratory disease. PMID- 3671195 TI - Why should physicians recognize compulsive gambling? AB - Compulsive gambling, which was recently recognized as a separate and primary illness, is a chronic disease that has as one of its facets poor impulse control. The illness is likely to be encountered by primary care physicians who look for it. A complete history, focusing on the destructive impact of gambling on the person's ability to function, and physical examination, including a search for coexisting cardiovascular disease and alcohol or substance abuse, are recommended for these patients. Diagnostic criteria have been described and shown in table form, as have therapeutic options. This condition is treatable, and the earlier it is discovered, the less damage will be done to the psychological, emotional, social, and financial well-being of the patient. PMID- 3671196 TI - Is compulsive gambling really a disease? PMID- 3671198 TI - How to remove tightly adherent gauze from open wounds. PMID- 3671197 TI - Orthostatic hypotension caused by headache therapy. PMID- 3671200 TI - Teach humanities to doctors? Says who? PMID- 3671199 TI - Unproven arthritis remedies. How to approach the problem. AB - The traditional medical model (ie, history taking, physical examination, diagnosis, and treatment) is not sufficient in the management of chronic diseases such as arthritis. The complex social interactions that lead patients toward and away from traditional medical treatment must be recognized and addressed. Physicians need to acknowledge the likelihood that their patients may use unproven arthritis remedies and to make an effort to reduce the problem. Clinical research on the use of unproven remedies is needed, especially as it relates to complex physician-patient interactions. A good patient-physician relationship remains the basis of good clinical medicine and increases the likelihood of patient compliance. PMID- 3671201 TI - Another warning about electric shock for snakebite. PMID- 3671202 TI - Anorexia nervosa. PMID- 3671203 TI - Individualized hypertension therapy. PMID- 3671204 TI - Pyoderma gangrenosum in an elderly woman. Course marked by extensive morbidity. AB - A case of extensive medical and functional morbidity in an elderly patient during treatment of pyoderma gangrenosum is described. Pyoderma gangrenosum is an uncommon cause of ulcerative skin lesions often involving areas of skin trauma about the lower extremity. Because of the possibility of underlying disease and the special treatment requirements, the condition must be differentiated from other, more common causes of skin ulceration. Treatment includes local care, systemic corticosteroid therapy, and control of any underlying disease. Pyoderma gangrenosum serves as a model for the interactions of various types of morbidity in the healthcare of the elderly. PMID- 3671205 TI - Dispirited doctors. PMID- 3671206 TI - Headache from video display terminals. PMID- 3671207 TI - Body water phenomenon is intriguing. PMID- 3671208 TI - Accurate blood pressure measurement. PMID- 3671209 TI - Overwhelming infections in trauma. AB - Following trauma, wound contamination with aerobic and/or anaerobic bacteria should always be suspected. Treatment with antibacterial antibiotics should begin immediately in the emergency room, particularly for those patients with fractures. Patients with serious trauma are best treated by a team of specialists including general surgeons, orthopedists, infectious disease specialists, and intensive care specialists. The author recommends transport of seriously injured patients to major hospitals specializing in the care of trauma. Particularly when gas gangrene secondary to clostridial infection is suspected, the patient should be moved to a major trauma center with the capability for hyperbaric oxygen therapy. PMID- 3671210 TI - Neurologic syndromes from repetitive trauma at work. AB - Overuse syndrome and peripheral nerve entrapment syndromes arise in work situations in which the body is stressed beyond its limits by cumulative, repetitive trauma. These syndromes arise in some nonwork situations as well. When such an injury occurs, prompt diagnosis, treatment, and retraining aid in returning the employee to work. Prevention, of course, is the ultimate goal. This can be accomplished with close attention to basic ergonomic principles, from the design of work stations to the use of proper body mechanics. PMID- 3671211 TI - Total shoulder replacement. Exciting progress in a rapidly developing field. PMID- 3671212 TI - Eating disorders. AB - Anorexia nervosa and bulimia nervosa present special challenges for physicians. Considerable skill and flexibility, as well as a collaborative spirit, are required to address the important physical, psychological, and social dimensions of these eating disorders. The ideal treatment is an individualized program designed to (1) eliminate the multifaceted effects of a body weight driven well below the biologic set point, (2) develop self-esteem, including a healthy attitude toward the body, and (3) strengthen those aspects of the individual and the family that orient the patient to health instead of illness. PMID- 3671213 TI - Halting the spread of AIDS. PMID- 3671214 TI - Noninvasive device achieves penile rigidity. PMID- 3671215 TI - Preventing sudden cardiac death. AB - The syndrome of sudden cardiac death, which claims the lives of hundreds of thousands of Americans each year, is usually caused by ventricular tachycardia or fibrillation. Electrophysiologic testing is now being used to prevent recurrence of this syndrome in successfully resuscitated persons. With this procedure, antiarrhythmic drugs are assessed in terms of their ability to prevent induction of sustained ventricular tachyarrhythmias, rather than their ability to merely suppress ventricular premature beats. In medically unresponsive patients, an automatic cardioverter-defibrillator can be implanted to provide maximal protection from sudden cardiac death caused by ventricular tachyarrhythmias. PMID- 3671216 TI - When renal colic is really malingering. AB - Renal colic malingerers feign symptoms of pain and hematuria, usually to obtain parenteral narcotics. These patients must be identified early to minimize waste of time and supplies by emergency department staff. However, they often use clever ploys to avoid undergoing diagnostic procedures that would unmask them and cut off their drug supply. These malingerers must be differentiated from patients with somatization disorders and those with hard-to-diagnose renal disease, which further complicates their detection. Fortunately, the informed physician can usually suspect the truth early and take steps to reach the proper "diagnosis." PMID- 3671217 TI - Pruritus ani. AB - Management of pruritus ani rests on a few basic principles. The first and foremost is to listen to the patient and accept how uncomfortable and even disabling this common disorder can be. Such causes as parasites, diarrhea, trauma, hemorrhoids, and fistulas must be accurately diagnosed and treated. Contributing factors, such as poor hygiene or, paradoxically, too vigorous cleansing, must be corrected. Certain foods, such as spices and citrus fruits, need to be eliminated from the diet. Use of all over-the-counter preparations, cleaning pads, and solutions except water must be stopped. Finally, a mild steroid cream should be prescribed on a temporary basis, and the patient should be reexamined in two to three weeks. In the vast majority of cases, the physician will have a very happy and appreciative patient. PMID- 3671218 TI - Anal fissures and fistulas. AB - Thorough understanding of the pathophysiology of anal fissures and fistulas is essential for the physician treating these conditions. An acute fissure often heals in a month with conservative management; long-standing disease is relieved by lateral internal sphincterotomy. An acute fistulous abscess must be drained by unroofing the abscess rather than by simple incision, which fosters recurrence. Chronic fistula in ano requires fistulotomy, which can be done with a local anesthetic. Fistulas with multiple external orifices should be treated by a specialist in rectal surgery. PMID- 3671219 TI - Hemorrhoids. AB - Hemorrhoids often may be relieved by relatively simple medical management. When this fails, a number of office procedures are available, including rubber band ligation, which is most widely used. Surgical therapy is still useful and preferred for patients with large third-degree or fourth-degree hemorrhoids; cryotherapy is no longer a popular alternative with either patients or physicians. More experience is needed with infrared photocoagulation. Studies of laser hemorrhoidectomy have not been sufficient to assess its role in the treatment of hemorrhoidal disease. PMID- 3671220 TI - Eurotherapeutics II. Proceedings of a conference on recent developments in drug and therapeutic strategies in internal medicine. Eastbourne, UK, 30-31 May 1986. PMID- 3671221 TI - Non-palpable breast lesions: out-patient needle localization and biopsy. AB - One hundred and nine patients undergoing out-patient needle localization and biopsy of non-palpable breast lesions were studied. Six patients with carcinoma were detected, 5 of them qualifying as minimal carcinoma. Thirty five patients with proliferative fibrocystic breast disease in need of careful follow-up were identified. While the number of patients with carcinoma was low, the early stage of their disease justifies continued use of the procedure. Doing the procedure on an out-patient basis has been shown by others to provide a substantial reduction in cost. Our results suggest that the out-patient setting does not affect the morbidity or mortality of the procedure. PMID- 3671222 TI - Pyogenic infection and rheumatoid arthritis. AB - Ten episodes of severe pyogenic infection occurring in nine patients with rheumatoid arthritis are reported. There was a wide range of presenting features including pyoarthrosis in 7 episodes. Three cases presented with meningitis, bacterial endocarditis and probable multiple abscesses respectively. Infection was caused by Staphylococcus aureus in 7 episodes and by Staphylococcus epidermidis, Streptococcus pneumoniae and beta-haemolytic Streptococcus in each of one episode. Three infective episodes were fatal. Pyogenic, especially staphylococcal, infection should be considered in patients with rheumatoid arthritis with unexplained illness with or without sudden deterioration in joint symptoms. It is important to recognize and treat infection rapidly. PMID- 3671223 TI - Idiopathic oedema and diuretics. AB - Diuretic abuse has been invoked as the cause of idiopathic oedema. In this study, eight patients with idiopathic oedema were studied. Symptoms and weight variation continued despite the proven absence of diuretics in seven of them as determined by urinary chromatograms. Idiopathic oedema cannot therefore be attributed to diuretic use alone. PMID- 3671224 TI - Exposure of the wound--a safe economy in the NHS. PMID- 3671225 TI - Post-traumatic diabetes insipidus combined with primary polydipsia. AB - We describe a case of diabetes insipidus after head injury in which thirst persisted despite treatment with DDAVP and normal plasma osmolality. Symptoms were only completely relieved when plasma osmolality was below 270 mosmol/kg. We believe that this might have been due to hypothalamic injury causing resetting of the thirst osmostat. To our knowledge, this type of primary polydipsia has not been described before in association with diabetes insipidus following head injury. PMID- 3671226 TI - Chylothorax after high translumbar aortography. PMID- 3671227 TI - Lumbosacral plexopathy due to dermoid cyst of the greater omentum. AB - We describe the case of a 66 year old woman with a lumbosacral plexopathy secondary to the compression produced by a dermoid cyst of the omentum, a complication not previously reported. PMID- 3671228 TI - Gastric cancer following highly selective vagotomy. AB - A case of gastric cancer occurring seven years after a highly selective vagotomy is described. This operation may not be the appropriate choice for the surgical treatment of gastric ulcers and H2 blockers should be used with caution in these patients. PMID- 3671229 TI - Strangulated Spigelian hernia. AB - Spigelian herniae rarely present as emergencies. There have been two cases requiring emergency surgery at this hospital within the last 5 years, representing 2.4% of all abdominal wall herniae requiring urgent treatment for strangulation. PMID- 3671230 TI - Prostatic involvement in Wegener's granulomatosis. AB - Prostatic involvement is an unusual complication of Wegener's granulomatosis. We report two cases with this complication and emphasize the importance of recognizing this manifestation in diagnosis and management of the disease condition. PMID- 3671231 TI - Psychosis with propranolol: still not recognized? AB - A 21 year old male developed hallucinations, personality change and severe depression following an increase in oral propranolol administration at recommended dosage levels. The symptoms improved markedly on stopping the drug. Without provocation, the patient developed further symptoms, mainly depressive, with marked suicidal impulses. Again, this quickly settled. The case identifies the need for careful observation of patients with psychiatric side effects from propranolol, following discontinuation of the drug. PMID- 3671232 TI - A report of acute overdosage of the anti-serotonergic drug pizotifen. AB - An acute overdosage of 30 mg of pizotifen causing a pyrexial illness is reported. The clinical features suggest that the effects of overdosage are principally due to the anticholinergic activity of this drug. Resolution of symptoms occurred after 10 hours, without specific therapy. PMID- 3671233 TI - Medical education 2000. PMID- 3671234 TI - Radioiodine therapy in thyrotoxicosis. PMID- 3671235 TI - Leaking aortic aneurysm. PMID- 3671236 TI - Fatal hyperparathyroid crisis. AB - A case of hyperparathyroid crisis presenting with a serum calcium level of 7.6 mmol/l is presented. The rarity and importance of recognizing the condition early is emphasized. PMID- 3671237 TI - Normal pressure hydrocephalus presenting as Parkinson's syndrome. AB - Although extrapyramidal features in normal pressure hydrocephalus (NPH) are not uncommon, presentations with Parkinson's syndrome as the predominant feature are rare and may give rise to diagnostic difficulties. Failure of patients with parkinsonism to respond to therapy, should alert one to the possibility of NPH. PMID- 3671238 TI - Pancytopenia and folate deficiency in alcoholics. AB - Three alcoholic patients are reported who presented with pancytopenia and macrocytosis due to acute folate deficiency. While folate deficiency is a common finding in alcohol abusers due to abnormalities in diet, intestinal absorption, internal metabolism and excretion, this life-threatening complication has not been well documented. PMID- 3671239 TI - Temporary sequential atrioventricular pacing in myocardial infarction. AB - The loss of atrial contraction can seriously impair cardiac output when complete heart block follows myocardial infarction. We describe two cases in which temporary sequential atrioventricular pacing was lifesaving. The pacemaker used was a previously explanted internal pacemaker. By avoiding the need for an expensive dedicated temporary pacemaker this technique may be more widely applied. PMID- 3671240 TI - Bilateral submandibular gland lymphoma in Sjogren's syndrome. AB - Salivary gland lymphoma is associated with Sjogren's syndrome. A case of bilateral submandibular gland and sublingual gland lymphoma, arising in Sjogren's syndrome, is presented. A lymphoma involving more than one salivary gland may occur in Sjogren's syndrome, and there is an increased risk of developing an extrasalivary lymphoma. PMID- 3671241 TI - Acute pancreatitis and non-Hodgkin's lymphoma. AB - We report two patients presenting with acute pancreatitis, the aetiology of which was subsequently proven to be non-Hodgkin's lymphoma. Histological confirmation of tumour-associated pancreatitis is essential so that appropriate therapy can be planned. PMID- 3671242 TI - Amyloid myopathy and myeloma: response to treatment. AB - A 57 year old female presented with an amyloid myopathy in association with lambda light chain myeloma. Treatment with melphalan and prednisolone resulted in remission of both myeloma and myopathy. PMID- 3671243 TI - Metastatic teratoma from a regressed impalpable testicular primary. AB - A young man presented with a perineal tumour which despite intensive investigation, remained of unknown origin and required radical excision. It was subsequently shown to be a metastasis from a primary regressed testicular teratoma. It is important to exclude a testicular origin in these patients wherever possible because such tumours are often chemosensitive. PMID- 3671244 TI - Ileal carcinoma and tuberculous ileitis. AB - A 76 year old woman presented with abdominal pain and weight loss. At laparotomy she was found to have an adenocarcinoma of the ileum arising in a segment of tuberculous ileitis. The possible significance of this association is discussed. PMID- 3671245 TI - ERCP in late post-traumatic biliary fistula. AB - A case is described in which a huge subcapsular bile collection due to biliary fistula presented late after hepatic trauma and in which ERCP indicated the diagnosis. PMID- 3671246 TI - The management of severe hypercalcaemia. PMID- 3671247 TI - Stab injury--the experience of an East London Hospital 1978-1983. AB - A retrospective review of 201 patients with stab wounds admitted to an East London Hospital over a period of six years was performed. There was no striking increase in the annual incidence of these injuries over the period reviewed. The majority of patients were young males who arrived at the Accident and Emergency Department after 1800 h on a Friday, Saturday, or Sunday and had consumed alcohol prior to admission. There were 47 abdominal injuries (23%), 69 thoracic (34%), 51 limb injuries (25%) and 34 injuries involving the head and neck (17%). Forty patients (20%) had injuries involving more than one site. Abdominal stabbings were managed by a selective approach resulting in 28 laparotomies of which only 2 (7%) were negative. Evisceration of small bowel or omentum was always associated with significant intraperitoneal injury. PMID- 3671248 TI - Herpes zoster and its neurological complications. AB - Ninety-three Chinese patients with cutaneous herpes zoster were seen during a 4 year period. Thoracic zoster occurred most commonly, followed by ophthalmic, cervical and lumbosacral zoster. Neurological complications were present in eleven patients (11.8%), the commonest being Ramsay-Hunt syndrome and segmental limb paresis. The clinical picture, pathogenesis, treatment and outcome of segmental limb paresis, myelitis and delayed contralateral hemiparesis following zoster ophthalmicus are discussed. Nine immunocompromised patients received intravenous adenine arabinoside (vidarabine) or acycloguanosine (acyclovir), and no cutaneous or visceral spread occurred in these patients. PMID- 3671249 TI - Reduced plasma high-density lipoprotein and increased platelet activity in arterial versus venous blood. AB - Plasma lipid and lipoprotein pattern and platelet activity were studied in blood samples derived from veins and arteries of 10 healthy male subjects. A significant reduction in plasma high-density lipoprotein (HDL) cholesterol, triglyceride and protein levels, as well as in plasma apolipoprotein A-I, was found when lipoproteins were derived from arterial blood in comparison to venous blood. All other lipoproteins were not significantly changed. Platelet activity measured as plasma beta-thromboglobulin levels and as collagen-induced platelet aggregation and 14C-serotonin release in platelet-rich plasma was markedly elevated when platelets were derived from arterial blood. Since reduced plasma HDL concentration and platelet activation are known risk factors for atherosclerosis, our study may suggest a further explanation for the presence of atherosclerotic lesions in arteries but not in veins. PMID- 3671250 TI - Comparison of nifedipine, prazosin and hydralazine added to treatment of hypertensive patients uncontrolled by thiazide diuretic plus beta-blocker. AB - In 93 patients with hypertension uncontrolled by bendrofluazide 5 mg plus atenolol 100 mg daily, the effects of adding nifedipine (up to 60 mg/day, n = 31), prazosin (up to 20 mg/day, n = 31), or hydralazine (up to 200 mg/day, n = 31) were compared in a 6 month open random parallel group study. The three drugs did not differ significantly as regards antihypertensive effect, withdrawal rate, total number of side effects, or effect on serum biochemical variables. The pattern of side-effects differed. Headache, flushing and oedema were common with nifedipine, tiredness and drowsiness with prazosin, and headache with hydralazine. Nifedipine is an acceptable third-line antihypertensive drug which may have some advantage over hydralazine and prazosin. PMID- 3671251 TI - Acute mountain sickness. PMID- 3671252 TI - Acute mountain sickness. A symposium. Birmingham, 20 September 1985. Proceedings. PMID- 3671253 TI - The BMRES 1984 Medical Research Expedition to the Himalayas. AB - Twenty-one subjects formed a trekking expedition to study the effects of acetazolamide on exercise performance and acclimatization at high altitude. Subjects were randomized to acetazolamide or placebo on a double blind basis. During ascent to and stay for 6 nights at 4846 m studies were carried out on blood gases, 2,3 diphosphoglycerate (2,3 DPG), proteinuria, exercise testing, intestinal absorption, purine metabolism and changes in body composition. The results showed beneficial effects of acetazolamide on exercise performance and preservation of muscle mass. PMID- 3671254 TI - The ventilatory response to hypoxia: how much is good for a mountaineer? AB - Methods for measuring the ventilatory response to hypoxia (HVR) are reviewed. The criteria for success as a high altitude mountaineer are defined as freedom from acute mountain sickness (AMS) and ability to perform well at extreme altitude. The evidence for a brisk HVR being protective against AMS and associated with successful high altitude performance is reviewed. The contrary evidence of blunted HVR in high altitude residence and some elite climbers is discussed. The effect of a brisk HVR in producing periodic breathing when asleep at altitude is noted. It seems that there is an optimum HVR for different circumstances and peoples. A brisk HVR is a benefit in lowlanders going to altitude for the first time whereas a blunted HVR is appropriate for high altitude residents and possibly for very experienced elite climbers. PMID- 3671255 TI - Intestinal absorption at high altitude. AB - Three tests of small intestinal function were performed at 3100 m and 4846 m to seek evidence of malabsorption of high altitude. Xylose tolerance did not change in 11 subjects but, in three who ascended to 5600 m, one-hour xylose levels were significantly lower. The results of an oxalate loading test did not suggest significant fat malabsorption. A direct fat absorption test using chylomicron levels after ingestion of 100 g fat showed significantly increased levels at high altitude. We conclude that there is no evidence of malabsorption up to 4846 m. PMID- 3671257 TI - The effect of acetazolamide on breath holding at high altitude. AB - The effect of altitude and acetazolamide on breath holding was studied in 20 individuals. Breath holding time was reduced progressively during ascent. There was an additional reduction in the acetazolamide group at low but not at high altitude. The initial difference between the two groups may have been related to a lower CSF pH when on acetazolamide. At high altitude the finding of similar breath holding times in the two groups may have been due to acclimatization in the placebo group. PMID- 3671256 TI - Blood lactate changes during exercise at high altitude. AB - Blood lactate concentrations were measured in 18 normal subjects at the end of an exercise test designed to maintain heart rate at 85% of maximum for 15 minutes. Blood lactate concentrations were reduced at high altitude (4846 m) and correlated positively with basal pH and negatively with basal Pa,O2 levels. Blood lactate concentrations tended to be lower in those subjects on acetazolamide but were not correlated with the severity of acute mountain sickness or with the workload of the exercise test. We conclude that the pH changes are probably the most significant factor in reducing lactate concentrations. PMID- 3671258 TI - Hepatic metastasis from intracranial meningioma. AB - A 38 year old man presented with a hepatic mass which biopsy showed to be a metastasis from an intracranial meningioma. The meningioma originally followed cranial radiotherapy. Previous reports of extracranial metastases are reviewed. PMID- 3671259 TI - Recurrent hyperparathyroidism: a study of 3 cases with evaluation of some pathogenetic and clinical aspects. AB - Three patients with recurrent hyperparathyroidism (15, 8 and 3 years respectively, after the first operation) are described in order to establish the causes and define the clinical characteristics of the disease. The observation that in the present series recurrent hyperparathyroidism was associated either with an adenoma (two cases) or a carcinoma (one case), appears to stress the possibility of the pathological involvement of one gland even though recurrent hyperparathyroidism should be considered due to the chronic extrinsic stimulation of the parathyroid glands. The severity of the clinical and metabolic picture observed at the time of the first diagnosis and/or at the time of recurrence together with the simultaneous presence of bone and stone disease in the patients described is of particular interest. The cases reported underline the importance of carrying out careful metabolic investigations in patients with hyperparathyroidism not only before but also for a prolonged period of time after operation. PMID- 3671260 TI - Macrocytic anaemia due to copper deficiency in a patient with late onset hypogammaglobulinaemia. AB - Very few cases of acquired severe copper deficiency have been described. The principal effects are haematological, but the precise abnormalities are uncertain due to the possible association of other deficiencies. A case of isolated severe copper deficiency associated with late onset hypogammaglobulinaemia is reported in which the chief findings were macrocytic anaemia, neutropenia and a decrease in mean platelet volume. All these abnormalities resolved when copper therapy was instituted and recurred when the medication was stopped. PMID- 3671261 TI - Acute post-streptococcal glomerulonephritis followed shortly by acute rheumatic fever. AB - A 16 year old girl with post-streptococcal glomerulonephritis developed acute rheumatic fever 19 days afterwards. Previous publications on concurrent post streptococcal glomerulonephritis and acute rheumatic fever are reviewed. PMID- 3671262 TI - Slow-release potassium and perforation of Meckel's diverticulum. AB - A case of peritonitis following perforation of gastric-type mucosa in a Meckel's diverticulum is described. At laparotomy a wax core of a combined diuretic-slow release potassium preparation was found extruding through the perforation and a further pellet was found free in the peritoneal cavity. Intestinal perforation due to potassium-containing drugs is recognized and led to the development of enteric-coated and slow-release delivery systems. The association of perforation of Meckel's diverticulum with a slow-release potassium perforation has not previously been described. PMID- 3671263 TI - Chronic perianal fistula: beware of rectal duplication. AB - A child with cystic duplication of the rectum containing ectopic duodenal mucosa and aberrant pancreatic tissue presenting as a chronic perianal fistula is reported. The duplication was removed by subtotal excision of the cyst along with mucosal sleeve resection from the common septum with the rectal wall. PMID- 3671264 TI - Carcinoma of the colon presenting with dyspepsia. AB - Three patients with upper abdominal symptoms responding to anti-ulcer medication are reported who had negative upper gastrointestinal endoscopies. Subsequent barium enemas showed that each of the patients had either a carcinoma of the transverse colon or caecum. Investigation of the colon should be considered in all such cases. PMID- 3671265 TI - Epithelioid sarcoma presenting as the reflex sympathetic dystrophy syndrome. AB - A case of reflex sympathetic dystrophy caused by an epithelioid sarcoma is presented. This is the first report of a local peripheral tumour associated with the reflex sympathetic dystrophy syndrome. PMID- 3671266 TI - Factors influencing mortality from infective endocarditis in two district general hospitals. AB - Factors influencing mortality were studied in 92 consecutive cases of infective endocarditis admitted to two district general hospitals between January 1975 and April 1982. Thirty two patients died, an overall mortality of 35%, 13 patients died before diagnosis and 19 despite aggressive antimicrobial therapy. Bactericidal antibiotic levels were monitored in 39 cases but these did not appear to influence outcome. Mortality was lowest for Streptococcus viridans infection (15%) but rose to 50% for infections with S. faecalis and other less common organisms. Most deaths were in patients over 50. Cardiac failure on admission was a poor predictor of mortality, although this was the principal cause of death during treatment (14 cases). Eight patients had emergency valve replacement and 3 died post-operatively. When the diagnosis was missed during life (13 cases) arterial embolus was a common presenting feature (46%). Classical signs of endocarditis, other than pyrexia, were absent. A cardiac murmur (always mitral incompetence) was noted in only 6 cases and considered to be insignificant. PMID- 3671267 TI - Impaired splenic function in systemic amyloidosis. AB - In four cases of biopsy proven amyloidosis there was evidence of impaired splenic function. All had absent or grossly reduced splenic uptake on colloid isotope scans and three had haematological changes consistent with hyposplenism. Poor splenic function with a normal sized or enlarged spleen may be a clue to underlying amyloid. PMID- 3671268 TI - Cyanotic tetralogy of Fallot in a 77 year old man. AB - We report the clinical details of a 77 year old man with classical tetralogy of Fallot. The patient had clubbing and cyanosis at birth, and exertional squatting in childhood. He was asymptomatic as an adult until the seventh decade, when he developed biventricular failure and had an episode of bacterial endocarditis. He finally died of cerebral infarction and bronchopneumonia following abdominal surgery. In spite of investigations, the diagnosis was not made in life, but only discovered at post-mortem. A persistent ductus arteriosus was also found. Increased pulmonary blood flow via the ductus is believed to have facilitated this patient's unusual longevity. PMID- 3671269 TI - Hemlock water dropwort poisoning. AB - Severe plant poisoning is relatively uncommon in adults. We report two adults who ingested hemlock water dropwort roots, having mistaken them for wild parsnip. One developed prolonged convulsions, severe metabolic acidosis and respiratory distress requiring mechanical ventilation. The toxin--oenanthotoxin--was detected in the gastric aspirate and measured by high performance liquid chromatography. PMID- 3671271 TI - Haematoma of liver. PMID- 3671270 TI - Missed Addisonian crisis in surgical wards. AB - Three women were admitted to the surgical wards with acute gastro-intestinal symptoms and despite good clinical (pigmentation, hypotension) and biochemical (hyponatraemia, acidosis) evidence of Addisonian crisis had unnecessary investigations with delay in the diagnosis and appropriate management of this medical emergency. Clinicians should take careful note of the typical electrolyte upset seen in Addisonian crisis. PMID- 3671272 TI - Hyperventilation and Raynaud's disease. AB - A 42 year old woman with long standing Raynaud's disease, unresponsive to medical and surgical treatment, was noted to have a typical history of the hyperventilation syndrome. Rewarming of the hands following cold challenge was markedly prolonged in the presence of hypocapnia. It is suggested that hyperventilation may have an aetiological role in maintaining digital artery spasm in Raynaud's disease, which would benefit from recognition and treatment. PMID- 3671273 TI - Lymphomatoid granulomatosis mimicking bronchial carcinoma. AB - This report concerns a patient with lymphomatoid granulomatosis who presented with multiple ulcerated skin nodules, a solitary pulmonary mass and a cerebral mass. Biopsies taken from the skin and lung lesion showed necrotic tissue only. This combination of physical signs and the initial non-specific histological changes suggested a diagnosis of primary bronchial carcinoma with secondary spread. However, the subsequent temporary improvement and a further histological examination enabled a diagnosis of lymphomatoid granulomatosis to be made and this was confirmed at post-mortem. This report emphasizes the difficulty in obtaining diagnostic material in lymphomatoid granulomatosis and highlights the need to consider this diagnosis in a patient with suspected carcinoma when biopsy material shows necrotic tissue only. PMID- 3671274 TI - Primary pulmonary artery sarcoma: intra-operative similarity to pulmonary embolus. AB - An infarcted right lower lobe, thought to be due to a thrombotic pulmonary embolus, was resected in a 48 year old man. Subsequent examination of the lobe unexpectedly showed the infarction to be secondary to a primary sarcoma of the pulmonary artery. PMID- 3671275 TI - Amiodarone-induced pulmonary toxicity mimicking metastatic lung disease. AB - A 65 year old man developed atrial arrhythmias secondary to a congestive cardiomyopathy which were resistant to quinidine and disopyramide. Amiodarone controlled the paroxysmal atrial tachycardia but 4 months after starting the drug he developed increasing dyspnoea and radiological changes highly suggestive of metastatic lung disease. Lung biopsy showed change of drug-induced pneumonitis and 4 months after stopping amiodarone his symptoms resolved and the chest X-ray had cleared. Amiodarone may cause pulmonary toxicity mimicking metastatic lung disease. PMID- 3671276 TI - Jervell and Lange-Nielsen syndrome in a middle aged patient. AB - A case of Jervell and Lange-Nielsen syndrome is reported in a 50 year old woman presenting with repeated ventricular tachycardia terminating fatally. The case is interesting in view of the fact that this syndrome has not previously been reported in a middle-aged patient. PMID- 3671277 TI - A life-threatening respiratory complication of gastro-oesophageal reflux in a patient with tetraplegia. AB - Recurrent attacks of life-threatening dyspnoea and choking occurred in a patient with tetraplegia. Conventional investigations for gastro-oesophageal reflux were normal, but 24-hour oesophageal pH recording revealed gross reflux in association with an attack of dyspnoea. Surgical correction of the reflux abolished the attacks. The possibility of autonomic dysreflexia as the mechanism linking reflux and respiratory symptoms in this patient is discussed. PMID- 3671278 TI - Isolated hepatic tuberculosis with scrofuloderma. AB - A case of isolated hepatic tuberculosis with tubercular involvement of the overlying skin is described. The combination does not appear to have been previously described. PMID- 3671279 TI - Isolated colonic tuberculosis. AB - Two cases of isolated colonic tuberculosis are reported, and recent literature on this field is reviewed. Isolated colonic tuberculosis is defined as a tuberculosis which exists in the colon except for ileocaecum, without focus in any other organ. The morphological changes are tuberculous granulation primarily located to the submucosa layer of the colon with smooth surfaces of both mucous and serous membrane. Its clinical features are atypical, just like those on X-ray examination, and even on frozen biopsy, it may sometimes be misdiagnosed. The treatment of choice is resecting the diseased segment of colon combined with anti tuberculosis therapy. PMID- 3671280 TI - Counsel. PMID- 3671281 TI - Management of an acute abdomen following high-dose cytosine arabinoside. PMID- 3671282 TI - Egg production efficiency in dwarf lines selected for high and low body weight as influenced by feed restriction. AB - Hens from dwarf Single Comb White Leghorn lines selected for four generations for high (H) and low (L) body weight (BW) plus randombred controls (C), sixty birds per line, were placed in cages at 18 wk of age and randomly assigned to either a full-fed (FF) or restricted-fed (R) (10 percent less than FF group) treatment. Birds received a layer ration having 16% protein and 2,816 kcal/kg metabolizable energy. Water was provided ad libitum. Individual BW and egg weights (EW) were obtained, and daily feed intake (DFI), egg production (EP), performance efficiency (PE) [egg mass (EM) per BW], and feed efficiency (FE) [EM/DFI] were calculated for 28-day periods from 18 to 41 wk of age. There were significant line, treatment, and age effects and line by age interactions for BW, EW, EM, DFI, and PE; FE was significantly influenced by age. There were significant treatment by age interactions for BW, DFI, and FE. Feed intake, BW, and EW were greatest for FFH hens and increased in all lines with age. Maximum EM occurred during 30 to 33 wk for RH and RL hens, during 34 to 37 wk for FFH, and during 38 to 41 wk for FFL. Maximum PE occurred during peak EP. Maximum FE for FFH and FFL occurred during 26 to 29 wk and during 30 to 33 wk for RH and RL. Data for C hens were intermediate to the other lines. Feed efficiency was improved by restriction for L hens from 26 to 33 wk and for H hens from 26 to 33 wk and for H hens from 26 to 41 wk of age. PMID- 3671283 TI - Parabiosis between avian embryos selected for high and low competences of the graft-versus-host reaction. AB - Parabiosis of chicken embryos was conducted to determine if changes in immunological competences could occur by parabiosis between lines of chickens selected for high (H) and low (L) graft-versus-host reaction (GVHR). Eggs of the B9B9 genotype from the H line (H-B9B9) were parabiosed to eggs of the B11B11 from the L line (L-B11B11) and also the H-B11B11 were parabiosed to the L-B9B9. There were significant differences in hatchability between the line-genotype groups. The percentage of blood chimerism of parabionts showed also significant genetic differences. Chimerism was the highest in the H-B11B11 birds and the lowest in the L-B11B11. All chimeric parabionts showed immunological tolerance and almost all nonchimeric parabionts did not. Immunological competence was measured by splenomegaly index (SI) based on GVHR. The SI value of parabionts changed in the direction of the SI value of the partner. The SI value of chimeric parabionts differed significantly from those of nonchimeric parabionts and controls. Antibody response to bovine serum albumin was tested only for the H-B11B11. Antibody titers of parabionts were significantly lower than those of controls. PMID- 3671284 TI - Response of growth-selected Japanese quail lines to tannin levels in grain sorghum diets with suboptimal protein. AB - Growth of selected lines of Japanese quail fed grain sorghum diets was evaluated. Suboptimal protein levels (23 and 25%) were used in conjunction with two varieties of sorghum differing in tannin content (.02 vs. 6.06%). Chicks of three related lines of quail differing in growth rates and mature body sizes were fed the diets from 0 to 28 days of age. Growth was significantly reduced (14 and 6%) by substitution of high tannin sorghum for low tannin sorghum in the 23 and 25% protein diets, respectively. No line X diet interaction was observed. PMID- 3671285 TI - Evaluation of two commercial broiler male lines differing in efficiency of feed utilization. AB - Factors potentially influencing feed conversion were studied in two lines of broilers known to differ in efficiency of feed utilization. When fed diets differing in energy, line by diet interactions were seldom significant and line effects were greater than those between diets. Chicks from the more efficient line had less plumage cover, less fat, and spent more time sitting than those from the less efficient line. These data imply that improved feed conversion is a function of several traits. PMID- 3671286 TI - Relationships between dietary protein, dietary energy, rearing environment, and nutrient utilization by broiler breeder pullets. AB - The relationship between dietary energy and protein and their interaction with method of restriction and environment were studied. In Experiment 1, two isocaloric diets (2750 kcal/kg) formulated to contain either 13.5% or 15.5% protein were fed to broiler breeder pullets from hatching through 21 weeks of age. There were no significant differences in body weight due to dietary protein but chicks fed the 13.5% protein ration did require a significantly greater quantity of feed to produce an equivalent body weight. Sexual maturity, peak egg production, and egg size were not affected by the level of dietary protein but total egg production was significantly decreased in pullets fed the 13.5% protein diet. In Experiment 2, 2970 kcal/kg ration containing 15.5% protein was fed to pullets that were reared under two different lighting environments, natural daylength or 24 hr light for the first 7 days and 8 hr light per day thereafter. Pullets housed in the controlled environment and reared on an every-other-day restriction program had significantly improved feed utilization compared with similarly restricted birds kept under natural light. Environmental effects on feed utilization were not as great in the every day restriction treatment. Chicks exposed to natural daylight and fed 15.5% protein diets had similar caloric efficiencies (kcal/g) at 15 weeks of age in both experiments despite dietary density differences of 220 kcal/kg. This supports a hypothesis that above some minimal level of protein intake, caloric intake has the greatest control over body weight gain in restricted pullets, particularly where every-other-day feeding is used during part of the growing period. PMID- 3671287 TI - Parental effects on performance of broiler chicken progenies. AB - Mortality among broiler progeny from a meat-type parent population, consisting of four maternal genotypes (two normal and two dwarf) mated with two normal paternal genotypes (White and Gold) and fed three different breeder diets was not significantly (P greater than .05) affected by genotypes or parental dietary treatments. Body weights of male and female progenies from matings with White males were significantly (P less than .05) heavier at both 21 and 42 days than those sired by Gold males but progeny sired by Gold males exhibited the best feed conversion. The progeny from normal hens were heavier, had a better feed conversion up to 21 days, and yielded higher monetary returns than those from dwarf hens. Parental diets had no significant effect on progeny weights, feed conversion, or monetary returns. A low magnitude first-order interaction, involving paternal and maternal genotypes, occurred for feed conversion and monetary returns. PMID- 3671288 TI - Toxicity of Diplodia maydis to broilers, ducklings, and laying chicken hens. AB - The toxicity of corn culture material of Diplodia maydis to ducklings, chicken broilers, and laying hens was investigated. Screening trials in ducklings using a 50% dietary concentration of D. maydis culture material showed that thirteen out of sixteen isolates obtained from different corn samples from South Africa as well as ones from the US and Argentina were highly toxigenic. Culture material of two isolates added as 20, 10, and 5% of the diet also proved to be toxic in ducklings. Incorporation of D. maydis culture material of two different South African isolates at 5%, 2% and 1% dietary concentrations in broilers resulted in significantly poorer weight gains. These isolates, both capable of inducing diplodiosis in ruminants and both acutely toxic in ducklings, nevertheless differed significantly in their toxigenic effect in broilers. Feeding of 5% culture material to laying hens for 7 days resulted in a drastic (43%) drop in egg production. Even at a .5% dietary level, egg production as well as egg weights of laying hens were significantly reduced. These results show that the regular and widespread occurrence of D. maydis in South African corn may be of economic importance in the poultry industry. PMID- 3671289 TI - Efficacy of cysteine in replacing methionine in the immune responses of broiler chicks. AB - Two trials were conducted to compare the effects of supplements of methionine and cysteine on the growth and immune responses of broiler chicks fed corn-soy diets. The basal diet contained 21% crude protein, 3,255 kcal metabolizable energy/kg diet, .35% methionine, .37% cysteine, and .13% choline. Additions to the basal diet were methionine (.063, .25, .85, and 1.45%), or cysteine (.203%), or a combination of methionine (.063%) and cysteine (.153%). Total antibody and 2 mercaptoethanol-resistant antibodies, immunoglobulin G (IgG), were determined in chicks inoculated intraperitoneally at 14 days of age and serially bled at 4, 7, and 10 days postinoculation. Thymus-derived (T)-cell-dependent in vivo mitogen response to phytohemagglutinin-P (PHA-P) was assessed via wing web swelling. The methionine requirement for growth (0 to 3 wk of age) was found to be no more than .413% of the diet (.35% in the basal diet plus .063% added). Addition of 1.45% methionine to the basal diet resulted in significant depression (P less than .05) in growth. The antibody responses generally peaked at 7 days postprimary inoculation. Both methionine and cystine supplementation at low levels resulted in improvement in the cell mediated PHA-P responses as well as in the IgG (T-cell dependent) responses. High supplemental methionine (1.45%), however, caused significant (P less than .05) depressions in both responses. Equimolar additions of methionine and cysteine (16.8 mmol/kg diet) showed that cysteine was about 84 and 70% as efficacious as methionine in the IgG and the PHA-P stimulation (PHA I), respectively, in healthy chicks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671291 TI - Altered metabolism of carotenoids during aflatoxicosis in young chickens. AB - Young chickens were fed from hatching until 3 weeks of age with a white corn-soy diet (containing 1.36 micrograms total carotenoids per gram of diet) amended with a commercial preparation of lutein, a dihydroxycarotenoid, to supply 25 micrograms free lutein per gram diet. The diet which also contained 0, 1, 2, 4, or 8 micrograms aflatoxin per gram of diet was fed to four groups of ten chickens per aflatoxin treatment until they were 3 weeks old. Aflatoxin had no effect on the partial acylation of free lutein to lutein monoester that occurs in the jejunal contents of normal birds but it decreased significantly (P less than .05) the conversion of free lutein to lutein diester. Aflatoxin reduced up to 35% the lutein (94% free alcohol) content of the jejunal mucosa and the serum lutein (99% free alcohol) was reduced by up to 70%. Aflatoxin caused a slight (25%) decrease in the free lutein content of liver while increasing the monoester content 3.5 fold and the diester content 10-fold. This sequestering of lutein in the liver in esterified forms poorly transported to the integument presumably contributes to the poor pigmentation during aflatoxicosis. The forms of lutein in the toe web were diester (66%0, free alcohol (26%), and monoester (8%) and their sensitivity to aflatoxin followed the same order. These data offer clear, unequivocal proof that aflatoxin can cause poor pigmentation in birds, presumably by interfering with the absorption, transport, and deposition of carotenoids. PMID- 3671290 TI - Enhanced immune responses in broiler chicks fed methionine-supplemented diets. AB - Effects of feeding supplementary methionine and choline on broiler growth and immunity were examined by supplementing a corn-soybean diet that contained 21% crude protein, 3,255 kcal metabolizable energy/kg diet, .35% methionine, .37% cystine, and .13% choline. Methionine (.063, .125, .25%) and choline (.125, .25%) were dietary variables. Sulfate (.055%) was added either alone or along with methionine (.125 or .25%) and choline (.125%). In one study, the .25% methionine diet was supplemented with .121% betaine. Sodium and chloride levels were constant in all the diets. Feed and distilled water were supplied ad libitum. Total antibodies, immunoglobulin (Ig) G (2-mercaptoethanol-resistant antibodies) and IgM (2-mercaptoethanol-sensitive antibodies) were determined in 3-wk-old chicks inoculated intraperitoneally with sheep red blood cells. The thymus derived (T)-cell-dependent in vivo mitogen response to phytohemagglutinin-P (PHA P) was assessed via wing web swelling. The methionine requirement for growth (0 to 3 wk of age) was approximately .413% of the diet (.35% in the basal diet plus .063% added). Supplementation of the basal diet with .125% choline stimulated growth to the same extent as did the extra .063% of methionine. Addition of .055% sulfate with .125% choline did not improve the ability of the latter to spare methionine. Supplemental methionine resulted in significant (P less than .05) dose-related increases in total antibody, IgG, and response to the mitogen PHA-P, but not in IgM. There were no effects of choline on the immune variables studied. These results suggest that methionine is required for select components of the antibody response, which effect might be related to T-cell help. PMID- 3671292 TI - Growth characteristics, protein synthesis, and protein degradation in muscles from fast and slow-growing chickens. AB - Developmental changes in muscle growth were studied in Single Comb White Leghorn (SCWL) and broiler-type (B) chickens. The extensor digiti communus (EDC) and ulnaris lateralis (UL) muscles were chosen for study because these muscles can be maintained in vitro, permitting the direct measurement of the fractional rate of protein synthesis (FSR) and the fractional rate of degradation (FDR). These muscles were removed from chicks at 1, 5, 10, and 20 days of age. Muscles for B were heavier, grew at a faster rate, and had greater fractional rates of growth than muscles from SCWL. Muscle protein concentrations were similar for SCWL and B. The deoxyribonucleic acid (DNA) concentrations were greater in EDC muscles from SCWL than B at all time periods. Concentrations of DNA were greater in UL muscles from SCWL than B after Day 1. The FSR and FDR were measured in muscles incubated in vitro. At 9 days of age, FSR in broiler and SCWL chicks was not significantly different in either muscle. The FDR was 12 and 19% lower in broiler EDC and UL muscles, respectively, demonstrating that broiler EDC and UL muscles accrete protein at a greater rate and more efficiently than SCWL muscles because of a slower rate of protein degradation. The FSR and FDR were also compared in B and SCWL chicks of 8 and 11 days, respectively, with equal DNA unit sizes. The FSR in B was 27 and 13% greater in EDC and UL muscles, respectively, demonstrating that protein synthesis per nucleus is greater in B chicks. PMID- 3671293 TI - Effect of dietary fructose on broiler chick performance. AB - The effect of feeding various levels of dietary fructose, furnished by high fructose corn syrup (HFCS), to broiler-type chicks housed in Petersime batteries was studied in two experiments. In experiment 1, HFCS was added to a corn-soybean meal basal diet at levels of 0, 5, 10, and 15%. In Experiment 2, HFCS was added to the diet at levels of 0, 2, 4, 6, and 15%. In both experiments diets were isocaloric and isonitrogenous. In Experiment 1, chicks fed HFCS consumed more feed (P less than or equal to .05) and grew more rapidly (P less than or equal to .05) than chicks fed the control diet. No differences in the feed to gain ratio were observed among treatments. Feeding HFCS resulted in non-significantly higher liver weight and percent liver lipid. Values for kidney weights and plasma uric acid were higher (P less than or equal to .05) in chicks fed 15% HFCS. In Experiment 2, adding 4, 6, and 15% HFCS resulted in more rapid growth (P less than or equal to .05). No significant differences were observed in feed intake and kidney weights. Chicks fed the 15% HFCS diet had heavier (P less than or equal to .05) livers. PMID- 3671294 TI - Effect of a high fat diet fed prior to or at sexual maturity on egg weight. AB - This study compared the effects of a low fat, high carbohydrate diet with a high fat diet fed prior to or at the onset of egg production on initial egg weight. Commercial egg-type pullets were assigned to one of three dietary regimens: 1) the control (CON), a low fat, high carbohydrate diet, 2) a high fat (HF) diet containing eight parts of fat, and 3) the high carbohydrate diet provided prelay and the high fat diet during the production period (CHO-HF). The carbohydrate prelay and laying diets contained .990 and .943% fat and had a calculated metabolizable energy (ME) value of 2,831 and 2,697 kcal/kg, respectively. The high fat prelay and laying diets contained 8.959 and 8.484% fat with a calculated ME value of 3,202 and 3,032 kcal/kg, respectively. The first 60 eggs produced by each pullet were collected and weighed. At Egg 60, no significant differences were seen in body weight and abdominal adipose tissue. The CON treatment had a significantly greater liver weight, liver lipid content, and ovary weight than the HF or CHO-HF treatments. The CON and HF treatments had a similar hen-day egg production (HDP). The CHO-HF treatment was slow to adjust to the high fat diet and that may have caused the lower HDP that was seen for this treatment. No indication of a failure to adjust to the high fat diet was noted for the HF treatment. Additionally, a high fat diet resulted in higher egg weights.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671295 TI - Secretion of egg white proteins in primary cultured oviduct cells of laying Japanese quail (Coturnix coturnix japonica). AB - Oviduct (magnum) cells of laying Japanese quails (Coturnix coturnix japonica) were isolated after digestion of the magnum portion by collagenase and dispase and cultured in Dulbecco's modified Eagle medium (DME) supplemented with 10% fetal calf serum. The cultured cells formed a monolayer. Immunoperoxidase staining with antiovalbumin and anticonalbumin antibodies elucidated that more than 90% of the total population of the cells contained ovalbumin and conalbumin within the cytoplasm. The result shows that the cultured cells are composed mainly of tubular gland cells. Cells secreted ovalbumin and conalbumin continuously for several days. Secretion of these egg white proteins was confirmed to be inhibited by colchicine and vinblastine, which means that the microtubular system is involved in the secretion pathway of the proteins, as is widely accepted. Tunicamycin, an inhibitor of glycosylation of proteins, blocked the glycosylation of nascent ovalbumin molecules at a concentration of 5 micrograms/mL in the medium. However, immunoreactive ovalbumin was secreted under these conditions, without being glycosylated. This suggests that the carbohydrate moiety of ovalbumin is not essential for the secretion of ovalbumin. The secretion of ovalbumin was inhibited by brefeldin A, which is supposed to inhibit the transport of proteins from the rough endoplasmic reticulum to the Golgi apparatus. The present method of cultivating egg white-secreting cells will be useful in investigations of mechanisms and regulation of the synthesis and secretion of egg white proteins in birds. PMID- 3671296 TI - Food intake response of genetically selected high and low-weight line cockerels to plasma infusions from fasted fowl. AB - Two experiments were conducted to determine if food intake of free-feeding chickens could be affected by infusions of plasma from fasted fowl. In the first experiment, chickens from two lines genetically selected for high or low body weight were infused intrahepatically with plasma collected from free-fed and fasted individuals from each line. Food intake of low-weight line birds was increased significantly by infusions of plasma from fasted high-weight line chickens when compared to food intake of low-weight line birds receiving plasma from free-fed low-weight line chickens. Food consumption in high-weight line birds was unaffected by any of the plasma treatments. In the second experiment, plasma from free-fed and fasted high-weight line chickens was infused intrahepatically into Single Comb White Leghorn cockerels. Again the birds receiving the plasma from the fasted fowl consumed significantly more food than those infused with plasma from free-fed fowl. The results of these experiments suggest that some property of plasma from fasted birds stimulates appetite. Selection for increased body weight may have intensified this hunger factor in high weight fowl. PMID- 3671297 TI - Ionostatic control of food intake in the domestic fowl. AB - It has been suggested that there is ionostatic control of food intake in which calcium, acting in the hypothalamus, alters food intake. This study was conducted to determine the effects of intracerebroventricular (ICV) injections of calcium on food and water intake in both broiler and Leghorn cockerels. The ICV injection of 50, 100, or 150 mM CaCl2 had no significant affect on food or water intake in Leghorn cockerels. In broilers, the ICV injection of 50 mM CaCl2 significantly increased food intake. This effect appeared to be due to Ca++ as equivalent amounts of Cl- given as NaCl had no effect on food intake nor did isosmotic solutions of NaCl. The effect of Ca++ on water intake in broilers is equivocal as it increased water intake in one experiment while decreasing it in another. Whereas these results support the hypothesis of a role for calcium in food intake regulation in broilers, they do not support the existence of a specific ionostatic control mechanism. PMID- 3671298 TI - Relationship of biotin deposition in turkey eggs to dietary biotin and biotin binding proteins. AB - The biotin and biotin-binding protein contents of egg yolk, egg albumen, and hen plasma were determined on eight groups of four turkey hens each that had been fed diets ranging from less than 10 to 3,475 micrograms available biotin per kilogram. Biotin deposition in the yolk was strongly dependent upon available dietary biotin below 100 micrograms/kg. Between 100 and 1,000 micrograms/kg the amount of biotin deposited in the yolk increased slightly and was directly related to and limited by a biotin-binding protein that transferred biotin from the plasma to the yolk. Over the entire dietary range, biotin deposition in yolk was proportional to the total biotin concentration in the plasma. In contrast, biotin deposition in the albumen, which was proportional to dietary biotin, increased several-fold over a very narrow range of plasma biotin concentration (56 to 62 micrograms/L). When dietary available biotin exceeded 160 micrograms/kg, there was more biotin deposited in the albumen than in the yolk. Although the concentration of unbound biotin in plasma is low, it appears to be the component of plasma biotin that is rapidly scavenged by avidin in the oviduct. It seems likely that avidin-bound biotin is available to the turkey embryo. PMID- 3671299 TI - Therapeutic drug monitoring. PMID- 3671300 TI - Using private pathology services. PMID- 3671302 TI - Geriatrics and the new diploma. PMID- 3671301 TI - The nature of psychiatric emergencies. PMID- 3671303 TI - Growing old in Britain. PMID- 3671304 TI - Chemical pathology and the family doctor. PMID- 3671305 TI - Best use of the haematology laboratory service. PMID- 3671306 TI - Use of the microbiology laboratory in clinical practice. PMID- 3671307 TI - The value of immunological tests in general practice. PMID- 3671308 TI - Who controls prescribing? A personal view. PMID- 3671309 TI - Antiseptic sprays and nipple trauma. PMID- 3671310 TI - Alternative medicine. PMID- 3671311 TI - Acupuncture. PMID- 3671312 TI - Osteopathy. PMID- 3671314 TI - Clinical ecology. PMID- 3671313 TI - Healing and spirituality. PMID- 3671315 TI - Violent patients in general practice. PMID- 3671316 TI - 'Falling all over the place'. PMID- 3671317 TI - Stopping smoking. Do nicotine chewing-gum and postal encouragement add to doctors' advice. PMID- 3671318 TI - Gynaecology in 1997. PMID- 3671319 TI - Hepatitis A. PMID- 3671320 TI - Asthma management. PMID- 3671321 TI - Failure to diagnose acute myocardial infarction. PMID- 3671322 TI - Vulval skin changes. PMID- 3671323 TI - The benefits and snags of job-sharing. PMID- 3671324 TI - Effect of anticonvulsant drugs on (35S)t-butylbicyclophosphorothionate binding in vitro and ex vivo. AB - Using several concentrations of eight anticonvulsant drugs in clinical use (carbamazepine, clonazepam, phenytoin, phenobarbital, ethosuximide, primidone, sodium valproate, and D,L-gamma-vinyl GABA), we studied their abilities in vitro to displace (35S)t-butylbicyclophosphorothionate (35S-TBPS) from its binding site in a homogenate of rat brain. Thereafter ethosuximide (150 mg/kg), phenobarbital (30 mg/kg), clonazepam (0.3 mg/kg), or phenytoin (100 mg/kg) was injected intraperitoneally into rats for 16-20 days; and the effect of drug administration on 35S-TBPS binding was studied in the cortex and hippocampus ex vivo. Phenobarbital (100 microM, P less than 0.001), ethosuximide (500 microM, P less than 0.001), and phenytoin (40 microM, P less than 0.001) decreased the specific 35S-TBPS binding in vitro by 10-16%. After drug administration of phenobarbital (concentration in plasma 168 microM), the number of binding sites decreased and the binding affinity (P less than 0.05) in the cortex increased. Other anticonvulsants did not modulate 35S-TBPS binding in vitro at the concentration analogous to therapeutic plasma levels or ex vivo at the dose used. These results suggest that the use of phenobarbital may modulate the TBPS binding site, but the role of the present findings in the anticonvulsant action of phenobarbital needs to be further studied. PMID- 3671326 TI - The effect of isosorbide dinitrate on the arterial vascular bed: a dose response study in dogs. AB - Isosorbide dinitrate (ISDN) was infused stepwise intraarterially into the left hindlimb (5.7-364.8 micrograms/kg/min.) into six dogs. The mean local vascular resistance was decreased by 32% in the left hindlimb after a dose of up to 91.2 micrograms/kg/min. corresponding to a 1.6-fold increase in the left femoral artery blood flow, without significant changes in the control limb or central haemodynamics. The muscular blood flow in the adductor magnus muscle obtained by the Xenon washout technique remained unchanged in 6 of 7 other dogs at ISDN infusion rates of 91.2 micrograms/kg/min., indicating that the increase in femoral artery blood flow was not a consequence of increased muscular blood flow. The arterio-venous extraction fraction of radioactive microspheres was lower in the experimental leg during ISDN infusion when compared with the control leg, suggesting that AV-shunts are opened during ISDN infusion. In addition to the well-known effect on preload, the present results confirm that ISDN also acts on afterload. Thus, ISDN may be classified as a mixed agent acting on both pre- and afterload which is in agreement with some previous studies. PMID- 3671325 TI - Effect of corticosteroids on muscarinic receptors on cultured myocardial cells. AB - Rat myocardial cells in tissue culture were utilized to investigate modulation by corticosteroids on muscarinic receptor affinity. Competition binding experiments between tritiated quinuclidinyl benzilate and carbachol were performed on the muscarinic receptor both on whole cells and on a crude membrane preparation from cultured myocardial cells. Hydrocortisone was shown to promote a transition of the high affinity site of the muscarinic receptor towards super-high affinity. This was analogous with the effect of divalent ions. The affinity shift was detectable after 6 hr exposure to 0.1 microgram/ml of hydrocortisone in the tissue culture dishes but was abolished by concomitant incubation with a protein synthesis inhibitor (10 microM puromycin). The response on agonist binding of Gpp(NH)p in the presence of manganese ions was altered indicating that the adenylate cyclase-coupled muscarinic receptor nucleotide binding protein was modulated. No effects of corticosteroid exposure were noted on phosphatidyl inositol turnover. PMID- 3671327 TI - Age related decrease in the density of dopamine D1 and D2 receptors in corpus striatum of rats. AB - The densities (Bmax) and apparent dissociation constants (Kd) of D1 and D2 receptors in striatum and of 5-HT2 receptors in cortex of rats aged 1, 3, 7 and 12 months have been determined using 3H-SCH 23390, 3H-spiperone and 3H ketanserin, respectively, as ligands. No changes in Kd's were seen. The density of D1 receptors decreases continuously from 1 month, attaining approximately 65% at 12 months of age. The density of D2 receptors increases slightly from 1 to 3 months, followed by a decrease until 12 months of age, where the level is approximately 80% of the 1 month value. The rise D2 receptor density is less apparent when calculated on a protein basis due to a concomitant increase in protein content of corpus striatum. The ratio between D1 and D2 receptors remains constant, approximately 4.2, from 1 to 12 months of age. The density of 5-HT2 receptors decreased from 1 to 7 months and remained at this level also after 12 months. PMID- 3671328 TI - Studies on laxatives: biliary and urinary excretion in rats given danthron by intravenous infusion or gastric intubation. AB - Rats were infused with danthron (I) at doses of 0.48, 2.2 and 5.8 mumol/100 g body weight, or given 12 mumol/100 g with gastric tube. TLC of bile and urine demonstrated a number of metabolites, at both administration routes. These included I monosulphate (II) and -glucuronide (III), two other phase 2 metabolites which behaved as the corresponding diconjugates, and several phase 1 metabolites (IV) in conjugated form. IV as a group were estimated by photometry of hydrolysed samples, using I as a reference. Danthron conjugates as a group were determined in such samples by a specific method for I. Moreover, II and III were determined individually in unhydrolysed specimens. Following infusion, about 80% of the danthron conjugates in bile were excreted after 1 hour; the dose fractions found after 5 hours represented about 20%, 30%, and 40% at the low, intermediate and high dose level, respectively. The corresponding fractions in urine were 16%, 12% and 10%, giving rise to bile:urine excretion ratios of 1.3, 2.7 and 4.0, respectively. This change in excretion pattern was associated with changes in metabolite muster, which involved a decrease in the balance of IV:I conjugates, as well as an increase in III:II ratio. IV was more abundantly present in bile than in urine, and showed a more sustained excretion than the I conjugates. By intragastric administration, the cumulated excretion (bile + urine) of I conjugates were only 6%, 8% and 5% of dose, in three consecutive 6 hours' periods (0-6, 6-12 and 12-18 hours after dosing). The bile:urine excretion ratios seemed to decrease with time, as did the III:II ratio.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671329 TI - Laxative potency and acute toxicity of some anthraquinone derivatives, senna extracts and fractions of senna extracts. AB - This paper investigates the laxative effect and acute toxicity of certain fractions of senna extracts in mice. The same tests were also carried out with several pure anthraquinone derivatives common in senna pods. The results show that the laxative and toxic components of senna pods and senna extracts can be separated. The most potent laxative components, sennosides A + B and Fraction V (relative potencies 1 and 0.9 respectively), have the lowest toxicity (relative intravenous toxicities 1 and less than 1). Fractions with very low laxative activity (rhein-8-glucoside and Fraction IV, relative potencies 0.56 and 0.05) have the highest acute toxicity (relative toxicities 10 and 32 respectively). PMID- 3671331 TI - Resistance to acute nephrotoxicity induced by cadmium-metallothionein dependence on pretreatment with cadmium chloride. AB - Three groups of rats (B-D) were given various daily doses of CdCl2 (0.5-2 mg Cd/kg) continuously or in intervals during time periods of 1-8 weeks. Another group of animals (A) were kept untreated. At the end of the period, selected subgroups of groups A-D were given a single subcutaneous injection of 109Cd metallothionein (109CdMT) 0.05 or 0.4 mg Cd/kg ("challenge dose"). Subsequently, urinary creatinine, protein, Cd, 109Cd and MT and kidney cortex Cd, 109Cd and MT were determined. In group A (no long term pretreatment), an increased proteinuria was observed after the rats had received the lower of the challenge doses of 109CdMT, and an even greater increase after the higher challenge dose of 109CdMT. No such increase appeared in group B, C and D (repeatedly pretreated with CdCl2) at either of the challenge doses. Higher metallothionein concentrations in kidney cortex observed in the pretreated groups constitute a plausible explanation of the protective effects of pretreatment against the development of increased proteinuria after challenge dosing. It is likely that increasing Cd concentrations, gradually accumulating in the renal cortex (22-226 micrograms/g wet wt.) as a result of the pretreatment, served to induce the synthesis of metallothionein in the renal cortical cells, thus making them resistant to the challenge from 109CdMT. PMID- 3671332 TI - Dopamine D2 receptor binding in striatal membranes of rat lines selected for differences in alcohol-related behaviours. AB - The specific binding of 3H-spiperone to striatal membranes was compared within two pairs of rat lines produced by selective breeding for either differences in voluntary alcohol consumption or for differences in acute ethanol-induced motor impairment. Although a significant difference was found between the alcohol preferring rats and alcohol-avoiding rat lines, the estimate for the Bmax value was only slightly lower in naive alcohol-preferring rats. The small magnitude of the difference suggests it is unimportant for the genetically-determined differences in alcohol preference. No significant differences were found in the estimates for their Kd values. There were no significant differences for either the Bmax and Kd values between the alcohol-sensitive and alcohol-insensitive rat lines, which suggests that striatal dopaminergic D2 receptors are not involved in the genetically-determined factors influencing sensitivity to alcohol (and also barbital and lorazepam). PMID- 3671330 TI - The actions of nifedipine and nisoldipine on the contractile activity of human coronary arteries and human cardiac tissue in vitro. AB - We have studied the action of nifedipine and nisoldipine on the contractile activity of human isolated coronary arteries and human isolated auricular and ventricular muscles. Nisoldipine depressed dose dependently the spontaneous rhythmic contractions displayed by the coronary artery preparations and at 1 nM abolished these contractions. Nisoldipine was twenty times more potent than nifedipine as an inhibitor of increase in tone induced by depolarization (100 mM K+). The rhythmic activity induced by serotonin (10 microM) was about five times more sensitive to nisoldipine than to nifedipine. In both auricular and ventricular preparations, isoprenaline evoked an increase in the rate of force development and in the rate of relaxation. Nifedipine was five times (ventricular muscles) and ten times (auricular muscles) more potent than nisoldipine as a negative inotropic agent. The present observations in human isolated preparations indicate that nisoldipine shows a higher vascular selectivity than nifedipine. PMID- 3671333 TI - Prenatal diagnosis of chromosomal abnormalities from chorionic biopsy samples: improved success rate using a modified direct method. AB - Several methods for fetal chromosome analysis using chorionic biopsy samples were compared. A modified direct method for culturing villi was considered to be the method of choice and details are presented of 186 pregnancies tested prenatally. The success rate in obtaining a fetal karyotype with the direct method was 93 per cent. The fetal loss rate in the prenatal series was 4.3 per cent and congenital abnormalities in the babies already born did not differ from the expected incidence. PMID- 3671334 TI - Prenatal diagnosis of hereditary elliptocytosis with molecular defect of spectrin. AB - Hereditary elliptocytosis (HE) is, in the heterozygous state, a common mild congenital hemolytic disease. In contrast, homozygous elliptocytosis is a severe transfusion-dependent hemolytic anemia. The major determinant of red cell membrane shape and stability is a two-dimensional proteinaceous meshwork named membrane skeleton. Spectrin, the most important protein of the membrane skeleton, is basically a heterodimer composed of alpha and beta chains. Within the membrane, spectrin dimers self-associate to form tetramers. In type I HE spectrin dimer self-association is defective and an excess of spectrin dimer is present in the patient's red cell membranes. The defective self-association is often correlated with an abnormality of the spectrin alpha chain which is depicted by limited tryptic digest of spectrin. In a family previously studied by us (Dhermy et al., 1984), the search for a spectrin defect in the red cells of the fetus of the pregnant mother was indicated for the following reasons: the diagnosis of heterozygous type I HE with the same spectrin variant had been made in the mother as well as in the father. Moreover, homozygous HE had been recognized in one of the children born two years previously with a persistent and severe transfusion dependent hemolytic anemia. Preliminary studies of normal fetal erythrocytes at twenty weeks gestation have shown that fetal and adult spectrin molecules are identical. The results obtained in the fetus at risk allowed us to diagnose type I HE (though elliptocytes were not present in the blood) for the following reasons: (i) erythrocyte deformability was decreased (ii) spectrin self association was defective with an excess of dimer species in the membrane (iii) limited tryptic digest of spectrin showed the same abnormal pattern as seen in the heterozygous mother, with a decrease in the 80,000-dalton peptide and a concomitant increase in the 74,000-dalton peptide. The heterozygous state, strongly suspected on the tryptic digest pattern of fetal spectrin, was confirmed when the mother gave birth to a baby who did not have hemolytic anemia during the first 18 months of life. PMID- 3671335 TI - Experience with first trimester prenatal diagnosis of Menkes disease. AB - We have performed 28 first trimester diagnoses for Menkes disease in 27 high risk pregnancies by direct copper measurement on chorionic villi (c.v.) Two male fetuses were found to be affected because of significantly increased copper content. In one male fetus a slightly increased copper content was observed indicating an exogenous copper contamination of the sample. This view was supported by normal results observed after abortion. Three out of 15 diagnostic c.v. samples with a female karyotype showed increased copper levels. In two of these cases, part of the copper content might have been released from the cannulae used for these particular biopsies. Histochemical visualization of copper accumulation in fixed chorionic villi of two affected fetuses and one female fetus was observed. [64Cu]-uptake studies have been performed on 11 diagnostic and 10 control c.v. samples. As the control samples in some cases were found to incorporate more [64Cu] than the corresponding diagnostic sample, this method cannot at present be used for diagnosis. Compiled results on newborn females gave evidence that two carriers expressed the paternal X-chromosome, and two carriers expressed the maternal X-chromosome in in chorionic villi. PMID- 3671336 TI - Prenatal diagnosis of 45,X/46,XY mosaicism in a fetus with asymmetric gonadal dysgenesis. AB - An 18 week abortus had been prenatally diagnosed as a 45,X/46,XY mosaic. The fetus was a phenotypic male with glandular hypospadias, a horseshoe kidney and asymmetric gonadal dysgenesis. This case represents a rare instance of prenatally diagnosed 45,X/46,XY mosaicism with an abnormal phenotype. PMID- 3671337 TI - Light microscopic visualization of peroxisomes and plasmalogens in first trimester chorionic villi. AB - Peroxisomes and their metabolites the plasmalogens were visualized in chorionic villi by quick and simple procedures. Villi were stained and mounted in toto, and can also be embedded. These methods may contribute to early prenatal diagnosis of peroxisomal disorders (Zellweger syndrome, neonatal adrenoleukodystrophy, infantile Refsum's disease a.o.). PMID- 3671338 TI - Chorionic villus sampling and acceptance rate of prenatal diagnosis. AB - In this paper, we compared the acceptance rate of fetal diagnosis for beta thalassemia in three group of couples of Sardinian descent; the first counselled before DNA analysis was available, the second presenting after DNA analysis was introduced but too late for chorionic villus sampling and thus monitored by amniocyte DNA analysis and the third presenting within the first trimester after DNA analysis was introduced and thus in time for trophoblast DNA analysis. A higher proportion of couples from the latter group opted for fetal testing as compared to the 1st and 2nd group. These results indicate that in this population, introduction of 1st trimester diagnosis made prenatal testing acceptable to practically all counselled couples at risk. PMID- 3671339 TI - [Temporal follow-up of pulmonary Wegener's granulomatosis]. PMID- 3671340 TI - [Diffuse hemangioma of the peripelvic fatty tissue of the kidney]. PMID- 3671341 TI - [Unusual findings in the adventitia of the aorta following rheumatic fever]. PMID- 3671342 TI - [Mitral valve atresia with premature closure of the foramen ovale, right-sided levo-atriocardinal vein and thrombosis of the left atrium]. PMID- 3671343 TI - Hypoplastic left heart syndrome: options for the infant and the family. PMID- 3671344 TI - Effect of volume and temperature of injectate on thermodilution cardiac output measurement using an open system of injection. PMID- 3671345 TI - Sepsis indicators in acute pancreatitis. PMID- 3671346 TI - Sepsis indicators in acute pancreatitis. AB - Twenty-one routine clinical and laboratory data in 161 patients with necrotizing pancreatitis (NP) undergoing surgical treatment were analyzed. The necrotic tissue at operation was bacterially infected in 41% of the patients. The goal of the study was to evaluate whether there was any special clinical feature in cases of an infection. The parameters were recorded during 48 h after admission as well as during 48 h before operation, and the frequencies submitted to both a univariate and a multivariate analysis (logistic regression model). In the period after admission, patients with infected necrosis significantly more often had a rectal temperature greater than 38.5 degrees C (p = 0.001). Before operation (i.e., after maximum conservative treatment), four findings were significantly related to an infection: rectal temperature greater than 38.5 degrees C, base excess greater than -4 mmol/L, hematocrit less than 35% (all p = 0.0001), and paO2 less than 60 mm Hg (p = 0.001). The multivariate analysis, which calculates and quantifies the mutual influence of factors, showed a combination of three findings (rectal temperature greater than 38.5 degrees C, base excess greater than -4 mmol/L, and hematocrit less than 35%) to be related to necrosis infection before operation. All three criteria in a patient imply a probability of infection of 83%. It is noteworthy that the sepsis indicators were equally distributed in patients with focal, extended, or subtotal/total infected necrosis, but correlated with the necrosis extent in sterile necrotizing pancreatitis. Moreover, all parameters not related to the pancreatic infection [e.g., hyperglycemia, hypocalcemia, rise of lactic dehydrogenase (LDH), and the white blood cell count] correlated with the three necrosis categories. PMID- 3671347 TI - Aging and pancreatic exocrine function: studies in conscious male rats. AB - Changes in pancreatic exocrine function in young (6- and 12-month-old) and old (24- to 27-month-old) male Fischer (F-344) rats were examined. Rats were prepared with cannulae draining bile and pancreatic juice separately and with duodenal and right jugular vein cannulae. Experiments were conducted between the third and the seventh postoperative day in conscious rats. Bile and pancreatic juice were returned to the intestine during both the recovery period and between experiments. Pancreatic responses to endogenous [bile-pancreatic juice (BPJ) diversion from the intestine] and exogenous stimulation [0.086, 0.432, and 1.728 nmol/kg secretin and 0.033, 0.167, and 0.667 nmol/kg cholecystokinin-octapeptide (CCK-8)] were determined. Basal secretions of fluid, bicarbonate, and protein were not affected by aging. The pancreatic responses of fluid and bicarbonate secretion to BPJ diversion or secretin were unaffected by aging. However, the increment of protein secretion in response to BPJ diversion and the largest dose of CCK-8 was attenuated in old rats. It appears the duct cell function is hardly affected by aging, but that the reserve capacity for protein secretion in response to stimulation may decrease in old rats. PMID- 3671348 TI - Secretion of pancreatic lipase and colipase from rat pancreas. AB - Rat pancreatic juice was collected from female, anesthetized Sprague-Dawley rats (200-250 g) during basal secretion and after 45-min intravenous infusion for secretin or secretin with cholecystokinin (CCK). The volume of secretion was measured as well as activity of lipase and colipase. It was shown that the basal secretion of pancreatic juice gave a colipase/lipase (C/L) ratio of about 0.5. Stimulation with secretin or addition of CCK to secretin gave a C/L ratio between 0.4 and 0.6. This was not significantly different from the ratio found in basal secretion. The secretion of lipase and colipase from isolated pancreatic acini was also found to parallel a C/L ratio equal to 0.6 in the basal release and to a ratio between 0.5 and 0.6 after stimulation with CCK, secretin, or carbachol. The total activity ratio of C/L in the pancreas was equal to 0.97. It is concluded that lipase and colipase are secreted in parallel both in vivo and in vitro. The reason for a lower ratio of C/L in the secreted juice compared to the C/L ratio of pancreatic gland is not known. PMID- 3671349 TI - In vitro evidence for genetic predisposition in some human pancreatic adenocarcinoma. AB - A numerical alteration in chromosome complement in human dermal fibroblast cultures, hyperdiploidy with a normal occurrence of tetraploidy (IVH) has been reported to be associated with some hereditary single tumors, including pancreatic adenocarcinoma (PaCa). The incidence of IVH was compared in cultures derived from 34 PaCa patients and 39 clinically normal subjects without a family tumor history by three assay systems: (a) percentage of numerically altered metaphases in chromosome preparations (MA); (b) percentage of cells from high density, stationary cultures with a DNA index (DI) greater than 1 (FCMs); (c) percentage of cells with a DI greater than 2 from cultures of cells undergoing division (FCMd). The last two measurements were obtained by flow cytometric measurement of propidium idodide (PI) stained cells. Concordance was observed between the three assays. There was a linear relationship between the percentage of hyperdiploid metaphases assayed in the chromosome preparation and the percentage of cells with a DI greater than 1 by FCMs and a DI greater than 2 by FCMd. IVH was considered to be present (IVH+) by the MA technique if the percentage of numerically altered metaphases was over 4% exclusive of tetraploids, by the FCMs technique if DI greater than 1 was greater than 10%, and by FCMd if DI greater than 2 was greater than 7%. The assayed group could be divided into two IVH groups on the basis of all three assays, individually or collectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671351 TI - Neutrophil responsiveness to chemoattractant tripeptide in rheumatoid arthritis. AB - Neutrophils isolated from medication-free rheumatoid arthritis (RA) patients were assayed for responsiveness to the bacterial chemoattractant tripeptide formyl methionyl-leucyl-phenylalanine (f-Met-Leu-Phe). Rheumatoid arthritis neutrophil preparations contained significantly lower percentages of rapidly migrating cells. This relative hyporesponsiveness of RA neutrophils was related to impaired sensing of chemotactic gradients. Rheumatoid neutrophil abnormalities in sensing of and responding to chemotactic gradients were not associated with resting or f Met-Leu-Phe-induced changes in arachidonic acid metabolism. PMID- 3671350 TI - Pure pancreatic juice collection over 24 consecutive hours. AB - We collected pure pancreatic juice during an entire day and examined pancreatic secretory changes induced by ordinary meals in a male patient having an external drainage of the main pancreatic duct. The ingestion of breakfast, lunch, and dinner each caused a marked increase in pancreatic secretion above basal levels. The increase in both bicarbonate and protein output was very prolonged. The highest secretory outputs induced by meals were slightly higher than those produced by exogenous administration of submaximal doses of secretin and cerulein. The profile and magnitude of bicarbonate and protein secretion were similar. PMID- 3671352 TI - 5 alpha-reductase activity in rat adipose tissue. AB - We measured the 5 alpha-reductase activity in isolated cell preparations of rat adipose tissue using the formation of [3H]dihydrotestosterone from [3H]testosterone as an endpoint. Stromal cells were prepared from the epididymal fat pad, perinephric fat, and subcutaneous fat of male rats and from perinephric fat of female rats. Adipocytes were prepared from the epididymal fat pad and perinephric fat of male rats. Stromal cells from the epididymal fat pad and perinephric fat contained greater 5 alpha-reductase activity than did the adipocytes from these depots. Stromal cells from the epididymal fat pad contained greater activity than those from perinephric and subcutaneous depots. Perinephric stromal cells from female rats were slightly more active than those from male rats. Estradiol (10(-8) M), when added to the medium, caused a 90% decrease in 5 alpha-reductase activity. Aromatase activity was minimal, several orders of magnitude less than 5 alpha-reductase activity in each tissue studied. PMID- 3671353 TI - Changes in ethanol concentration during incubation in multiwell tissue culture trays. AB - Ethanol can have direct effects in tissue culture and is often used as a solvent. Analysis of these effects will require a precise knowledge of the concentration over time in the particular system employed. We measured the disappearance rate of ethanol from multiwell culture trays (open system) containing single or multiple concentrations of ethanol over a 48-hr time period. The ethanol concentration was also measured at 72 hr in stoppered Erlenmeyer flasks (closed system). In multiwell culture trays, 1 and 0.3% ethanol (V/V) evaporated with a t1/2 of 6 to 12 hr. Media containing no ethanol but adjacent to wells with 1% ethanol accumulated ethanol with a peak of 0.2% at 12 hr. The evaporation of 0.3% ethanol was slower from wells adjacent to those containing 1% ethanol. At 72 hr, stoppered Erlenmeyer flasks, which originally contained 1% ethanol, still had a concentration of 0.85%. Since both evaporation and transfer can occur in an open system, it is necessary to specify precise conditions or measure concentrations in such systems. Alternatively, a closed system in which the concentration of ethanol is maintained can be employed. PMID- 3671354 TI - Bromocryptine prevents the decline in tuberoinfundibular neuronal release of dopamine after removal of chronic estrogen treatment. AB - Prolonged exposure to estradiol 17-beta (E2) in rats has been shown to decrease dopamine (DA) synthesis in and release from tuberoinfundibular dopaminergic (TIDA) neurons in Fischer 344 rats. The objective of the present study was to determine whether inhibition of the E2-induced increase in anterior pituitary (AP) weight and prolactin (PRL) secretion by concomitant administration of the dopaminergic agonist, bromocryptine, could prevent the decrease in TIDA neuronal function produced by chronic E2 administration. TIDA neuronal function was evaluated by in vitro superfusion and electrical stimulation of median eminence (ME) tissue after allowing for accumulation of [3H]dopamine (DA). The effect of chronic E2 and/or bromocryptine treatment on catecholamine content in tuberohypophyseal neurons in the neurointermediate lobe was also measured to determine whether increased pituitary size possibly damaged the tuberohypophyseal neurons. Treatment with E2 for 30 days significantly increased AP weight, serum PRL concentration, and AP PRL and DNA content over values in non-E2-treated controls. When bromocryptine was injected daily during E2 treatment, bromocryptine completely inhibited the E2-induced increase in serum PRL and AP DNA content, and AP weight was only moderately increased. The evoked release of 3H at the end of the 30-day E2 treatment was reduced during electrical stimulation and there was no augmented release of 3H from the ME tissue after 10 microM nomifensine infusion in E2-treated rats and in rats given both bromocryptine and E2. However, neurointermediate lobe DA content was diminished only in E2-treated rats and not in animals given bromocryptine together with E2. When all treatments were discontinued for 30 days, animals previously given only E2 showed sustained increases in AP weight, serum PRL levels, and AP PRL and DNA content, but reduced stimulation-evoked release of 3H, absence of response to nomifensine, and reduced neurointermediate lobe DA and norepinephrine content when compared with values in non-E2-treated controls. After withdrawal of E2 treatment for 30 days, animals previously given bromocryptine and E2 together were not different from control animals in any of the parameters measured. These results suggest that the decline in TIDA neuronal release of DA induced by chronic E2 treatment was at least partly exerted via the marked hyperprolactinemia and/or by compression of the medial basal hypothalamus by the enlarged AP. PMID- 3671355 TI - Neurogenic pulmonary edema in a pulmonary normotensive model. AB - In the present study our aim was to determine whether or not neurogenic pulmonary edema would develop from a brief pulse of intracranial pressure (ICP) in the absence of any obvious pulmonary hypertension. There were three groups of cats: sham-operated controls, ICP only, and ICP plus variable occlusion of the pulmonary artery. Partial occlusion of the pulmonary artery was carried out by placing a ligature around the pulmonary trunk and mechanically constricting the artery to maintain pulmonary arterial pressure (PAP) and left atrial pressure (LAP) at pre-ICP levels. In sham-operated animals the extravascular lung water/blood free dry weight ratio (EVLW/BFDW) was 3.26 +/- 0.07 and broncho alveolar lavage (BAL) protein, 6.49 +/- 0.62 mg/g lung. ICP-only caused a rise in PAP, left atrial pressure, and EVLW/BFDW to 3.67 +/- 0.08 (P less than 0.05). ICP with partial occlusion of the pulmonary artery prevented any rise in PAP or LAP while EVLW/BFDW rose to 3.67 +/- 0.10 (P less than 0.05) and BAL protein was 8.37 +/- 1.27 mg/g lung. Our results show that EVLW/BFDW can increase with neurogenic pulmonary edema in cats in the absence of an obvious increase in pulmonary arterial or left atrial pressure. PMID- 3671356 TI - Sexual differences in the expression of copper deficiency in rats. AB - The present investigation was undertaken to establish whether the severity of copper deficiency in rats fed diets containing fructose is affected by the presence and type of endogenous sex hormones. Intact and castrated male rats and intact and ovariectomized females were fed from weaning a copper-deficient diet (0.6 ppm) containing 62% fructose for 8 weeks. Regardless of castration, male rats were anemic, exhibited heart hypertrophy, and died of the deficiency. However, castration ameliorated the anemia and delayed the mortality. In contrast, none of the females died of the deficiency. It is suggested that in addition to the sex of the animal, levels of testosterone in the male may also play a role in the severity of copper deficiency. PMID- 3671357 TI - Glucocorticoid-induced glycogen increases in extensor digitorum longus and soleus grafts in the rat. AB - The purpose of the present study was to compare dexamethasone-induced glycogen increases in normal EDL and SOL muscles with that in free muscle grafts. Glycogen in mature EDL and SOL grafts in the rat equalled control concentrations irrespective of whether the graft was a nerve-intact (NI), nerve-crushed (NC), reimplanted, or cross-transplanted graft. The grafts also possessed the glycogen regulatory mechanisms to respond to the glucocorticoid dexamethasone (DEX), which increases muscle glycogen. The increase in glycogen induced by DEX in the EDL and SOL grafts resembled that of the EDL and SOL muscles, respectively, whether the grafted muscle was originally an EDL or SOL. DEX induced an approximate twofold increase in glycogen concentration in control muscles and nerve-intact SOL grafts, and a smaller but significant increase in all other free grafts. Nerve crushing prior to grafting resulted in no significant change in muscle weight, glycogen concentration, or DEX-induced glycogen increase in these grafts. The data suggest that skeletal muscle grafts are qualitatively similar to normal muscles in terms of metabolic responsiveness to hormones. Leaving the nerve intact during grafting quantitatively enhances the graft's hormonal sensitivity but the technique of nerve crushing prior to grafting has no such effect. PMID- 3671358 TI - The effect of dimethyl sulfoxide on cholesterol and bile acid metabolism in rats. AB - The effect of DMSO on cholesterol and bile acid metabolism was studied in rats. Male Sprague-Dawley rats were randomly assigned to one of two groups and given either tap water or 2% DMSO (v/v) in tap water to drink for 9 days. Both food (stock rat diet) and water were available ad libitum. Animals in both groups gained weight equally throughout the study. They also had similar liver weights (g/100 g body wt) at the end of the study (control: 5.0 +/- 0.1 (N = 6) vs DMSO: 4.9 +/- 0.1 (N = 6]. The activity of hepatic cholesterol 7 alpha-hydroxylase (pmole/mg/min), the rate-limiting enzyme of bile acid biosynthesis, was significantly (P less than 0.005) reduced in the treated animals (control: 9.7 +/ 1.0 (N = 6) vs DMSO: 4.3 +/- 0.7 (N = 6)). Plasma cholesterol (mg/dl) was significantly (P less than 0.005) elevated in the treated animals (control: 90 +/ 3 (N = 6) vs DMSO: 107 +/- 4 (N = 6)), a finding consistent with the reduced CH 7 alpha hydroxylase activity in this group. DMSO treatment did not affect either microsomal cholesterol content or hepatic glutathione content. Thus, this study has shown that DMSO treatment per se can affect cholesterol and bile acid metabolism. However, the precise mechanisms whereby DMSO exerts the observed effects are not known. PMID- 3671359 TI - Regional differences in cardiac myocyte dimensions and number in Sprague-Dawley rats from different suppliers. AB - Previous experiments conducted in this laboratory have indicated that adult Sprague-Dawley rats obtained from Holtzman Company (H) have hearts that are significantly larger than those obtained from Charles River (CR). To investigate potential differences in cell size and number, isolated myocytes were prepared by retrograde coronary perfusion with collagenase. Cell volume (V) was measured with a Coulter Channelyzer, cell length (L) was measured directly, and cross-sectional area (CSA) was calculated from V/L. Cell number was calculated using data from isolated cells and whole-sectioned tissue. Although V for left and right ventricular myocytes was similar in CR and H rats, myocytes from CR tended to be shorter in L (P less than 0.001), but larger in CSA (N.S.) than myocytes obtained from H rats. In both H and CR, left ventricular V and CSA were greater (P less than 0.01) in endomyocardium than epimyocardium and middle myocardium. Values for V and CSA of right ventricular myocytes were less (P less than 0.01) than those from left ventricles in both H and CR. Hearts from H had 19% more myocytes than those from CR (P less than 0.05). Values for cellular dimensions from CR generally showed less variability than those from H. We conclude that significant regional differences in myocyte size are present in rats from both H and CR. Hearts from H rats have significantly more myocytes than those from weight matched CR rats. Therefore, investigators should be aware that differences in heart weight and myocyte number can be found in rats of the same strain, but obtained from different suppliers. PMID- 3671360 TI - Immunocytochemical evidence for methylation of the inactive X chromosome in human fetal oogonia. AB - The state of DNA methylation of the X chromosomes of human interphase oogonia from a 46,XX and a 46,XX/47,XXX fetus at 17 weeks of gestation was tested immunocytochemically with an antibody to 5-methylcytosine (5MeC). Of 1637 oogonial nuclei from the 46,XX fetal ovary, 313 (19.1%) contained Barr bodies, of which 93.6% were positive for 5MeC. Of 1780 oogonia from the 46,XX/47,XXX fetus 327 (18.4%) contained Barr bodies; 175 oogonia had one Barr body and 152 had two. Of the single Barr bodies 145 (82.8%) had positive 5MeC reaction product. Of the 152 oogonia from the XXX line, 97 (63.8%) had positive 5MeC on both Barr bodies, 35 (23%) had one positive and one negative, and 20 (13.1%) had no product on either Barr body. This immunocytochemical evidence supports the hypothesis that the DNA of the inactive X-chromosome of the human 17-week gestation oogonium is methylated. PMID- 3671361 TI - GH binding to liver in young and old female rats: relation to somatomedin-C secretion. AB - Age-related changes in binding of 125I-bovine GH to liver membrane fractions were measured in female Long-Evans rats 2, 6, 12 and 20 months of age. Specific GH binding did not change between 2 and 6 months of age but increased significantly at 12 and 20 months of age. Scatchard analysis showed that the plots were curvilinear and consisted of high- and low-affinity binding sites. The age related increases in binding sites were mainly due to an increase in number of low-affinity binding sites. Serum somatomedin-C (SM-C) levels in 20-month-old rats were about half those in the 6-month-old rats. Twice daily injections of ovine GH (2 mg/kg body wt) for 7 days depressed liver GH binding and increased serum SM-C levels in 19-month-old female rats, but had no effect on GH binding in 2-month-old female rats. These results suggest that the increase in liver GH binding sites and the decrease in SM-C secretion are associated with our previously reported decrease in GH secretion in old female rats. PMID- 3671362 TI - Antagonism by nalmefene of systemic and intrathecal morphine-induced analgesia in mice. AB - Nalmefene is an orally active opiate antagonist structurally related to naloxone and naltrexone. In this study using two different strains of mice (Swiss Cox and ICR), the antagonist activity of nalmefene given subcutaneously (sc) was quantified by determination of the apparent pA2 values against the antinociceptive activity (tail flick and hot plate tests) of morphine given sc or intrathecally (lumbar spinal cord). The apparent pA2 values (constrained to a slope of -1) were 8.06 (7.79-8.33) in Swiss Cox mice and 7.81 (7.62-8.00) in ICR mice in the tail flick test with sc morphine. These values were larger than the corresponding value for naloxone in ICR mice, 7.35 (7.10-7.60). The hot plate test provided similar results: the apparent pA2 values for nalmefene with sc morphine were 8.14 (7.89-8.39) in Swiss Cox mice and 7.81 (7.65-7.97) in ICR mice, values which were different from naloxone 7.33 (7.23-7.42) in ICR mice. Apparent pA2 values for nalmefene with intrathecal morphine were not different from those for naloxone in the tail flick test. Thus, these sets of results suggest that it may be worthwhile to further determine whether systemic nalmefene might possibly possess an advantage over naloxone in antagonizing systemic side effects of morphine arising from local spinal morphine administration. PMID- 3671363 TI - Purification of glomerulopressin. AB - The present investigation was undertaken to attempt the purification of glomerulopressin. Isolated rat livers were perfused with Krebs-Ringer bicarbonate, and the perfusate was concentrated at reduced pressure, extracted with n-butanol, and subjected to thin-layer chromatography (TLC) with different solvent systems. For monodimensional TLC, (a) acetic acid or (b) chloroform/methanol/formic acid (65:30:5, v/v) was used. For bidimensional TLC solvent (b) was used as the first mobile phase and as the second mobile phase three different solvent systems were employed as follows: ethyl acetate/n butanol/formic acid (40:57:3; v/v), pyridine/methanol/formic acid (50:49:1, v/v), and acetic acid/n-butanol/water (5:50:10, v/v). The activity of the spots viewed under uv light was studied in three different biological assays: increase of the glomerular pressure index (GPI) in the toad and of the glomerular filtration rate (GFR) in the rat and increase of the tonic tension contraction in the rat stomach strip (TTC). In monodimensional TLC developed with system (a), three spots were detected, and with system (b), seven spots were observed. The biological activity of these seven spots was studied. Only the substance showing Rf 0.47 was active. This Rf 0.47 spot subjected to bidimensional TLC with the three different solvent systems moved in the second direction as only one spot. To confirm whether the Rf 0.47 spot was composed by only one substance, reverse-phase HPLC was performed in a Waters radial compression unit using three different elution systems and in a Hewlett-Packard model equipped with an ultrasphere ODS column. With these different HPLC columns and elution systems, only one peak was observed. This is the first attempt to purify a substance showing a biological activity similar to that of glomerulopressin. PMID- 3671364 TI - Asialoorosomucoid hepatobiliary transport is unaltered by the loss of liver asialoglycoprotein receptors in aged rats. AB - The hepatobiliary transport of asialoorosomucoid (ASOR) was examined in aging male Fischer 344 rats. The time course of transport of 125I-ASOR from blood to bile was identical in both senescent and young adult rats. Peak secretion occurred at approximately 35 minutes after injection via the femoral vein. Total secretion of radiolabeled ASOR (3.6% of injected dose), bile secretion and rate of secretion of radiolabeled ligand (approximately 2% of administered dose/hr/gm bile/liver) were not significantly different for the two age groups. Determination of the binding capacity for 125I-ASOR with liver plasma membrane enriched preparations showed the membranes from old animals capable of binding approximately 50% less radiolabeled ligand as the young adult animals. Analysis of the distribution of 125I-ASOR autoradiographic grains along the liver lobule indicated extensive uptake of ligand in Zone 2 and 3 cells in senescent animals, whereas uptake in young rats was essentially limited to Zone 1 parenchymal cells. These results indicate that, contrary to the age-related loss of hepatic receptors for dimeric IgA and the concomitant reduction in hepatobiliary secretion of IgA, loss of ASOR binding capacity on liver plasma membranes from old animals is not reflected in diminished hepatobiliary secretion of ASOR. The loss of ASOR binding capacity is offset by the recruitment of Zone 2 and 3 hepatocytes along the liver lobule. This result suggests that hepatic metabolism and hepatobiliary secretion of macromolecules which exhibit a lobular gradient of uptake (e.g. ASOR) will be relatively less affected by loss of receptors compared to ligands which do not display such a gradient (e.g. IgA). PMID- 3671366 TI - Wound assessment. PMID- 3671365 TI - Respecting clients' dignity. PMID- 3671367 TI - When a nurse is the patient. PMID- 3671368 TI - Problems in i.v. therapy. 2. Inflammation, pyrexia, tachycardia and rigors. PMID- 3671369 TI - MRSA: methods of prevention and control. PMID- 3671370 TI - Preventing coronary heart disease. PMID- 3671371 TI - Anorexia bulimia. PMID- 3671373 TI - Courses for enrolled nurses to convert to first level (registered) nurses. PMID- 3671372 TI - Radiation and the nurse. PMID- 3671374 TI - Partnership with patients? PMID- 3671375 TI - Priorities in wound management: Part 2. PMID- 3671376 TI - Problems in i.v. therapy 2. Inflammation, pyrexia, tachycardia and rigors. PMID- 3671377 TI - Prostaglandins in clinical research. Proceedings of the 3rd International Symposium on Prostaglandins. Bad Ischl, Austria, September 16-20, 1986. PMID- 3671378 TI - Trapidil derivative AR 12463 lowers blood pressure and thromboxane formation in spontaneously hypertensive rats. PMID- 3671379 TI - Experimental variables affecting thromboxane B2 formation in human whole blood. PMID- 3671380 TI - Thromboxane concentrations in arterial blood of cigarette smokers and hypertensive subjects. PMID- 3671381 TI - Relevance of thromboxane-prostacyclin balance for cardiac rhythm disturbances. PMID- 3671382 TI - Effect of irradiation on thromboxane and platelet sensitivity in-vivo in patients with cervical cancer. PMID- 3671383 TI - Actions of platelet-activating factor in the coronary circulation of the guinea pig in vitro. PMID- 3671384 TI - Influence of hypoxia on spontaneous aggregation and TXA2 formation of human blood platelets. PMID- 3671385 TI - Synergism between a phosphodiesterase inhibitor and modulators of thromboxane formation on thrombin-induced sudden death in rabbits. PMID- 3671386 TI - Thromboxane and 6-oxo-PGF1 alpha in the plasma of patients with diabetes type I and II. PMID- 3671387 TI - Inhibition of platelet 5-HT secretion and of 5-HT induced vasoconstriction by paracetamol. PMID- 3671388 TI - Inhibition of leukotriene formation as a mode of action of gastroprotective drugs. PMID- 3671389 TI - Beneficial effect of prostaglandin E1 on smooth muscle cell proliferation. PMID- 3671390 TI - Studies on pharmacokinetics, platelet function and fibrinolytic activity under various prostaglandin E1 infusion regimens. PMID- 3671391 TI - Effects of cold test on arterial flow and vascular reactivity at the calf, before and after inhibition of prostaglandins synthesis, in young healthy subjects. PMID- 3671392 TI - Two years follow-up Cottbus reinfarction study with 30 and 60 mg acetylsalicylic acid. PMID- 3671393 TI - Effect of thromboxane A2-synthetase inhibitor OKY-046 and evening primrose oil (Efamol) on mercuric chloride induced autoimmune glomerulonephritis in Brown Norway rats. PMID- 3671394 TI - Hypothesis: dietary (N-3)-fatty acids prolong gestation in human beings. PMID- 3671395 TI - Physiological relevance of the formation of 15-hydroxy derivative from dihomogammalinolenic acid in human platelets. PMID- 3671396 TI - Effects of indomethacin or verapamil on dialysis induced leucopenia and hypoxia in the unstressed sheep. PMID- 3671397 TI - Advances in cancer control. The war on cancer--15 years of progress. Proceedings of the fourth annual meeting. Washington, D.C., April 2-6, 1986. PMID- 3671398 TI - Smoking policy at the worksite: employee reactions to policy changes. PMID- 3671399 TI - Cancer education and screening in the workplace: the corporate perspective. PMID- 3671400 TI - A survey of current health screening practices for chemotherapy handlers. PMID- 3671401 TI - Process and impact evaluation of a cancer program for older people. PMID- 3671402 TI - Free breast cancer screening utilization and results. PMID- 3671403 TI - A cancer patient survey to help determine psychosocial needs, design, and implement meaningful interventions. PMID- 3671404 TI - Comparative methodologies for the community distribution of a cancer risk assessment form. PMID- 3671405 TI - Marketing cancer information to under-utilizing communities: an intervention and control study of a newspaper feature. PMID- 3671406 TI - Quality assurance in hospice care. PMID- 3671408 TI - Evaluation of the impact of a CCOP program in a low population density area of Montana. PMID- 3671407 TI - Current and future cancer control activities in cancer programs in the United States. PMID- 3671409 TI - The management of breast cancer in a community: the impact of the CCOP in Fresno, California. PMID- 3671410 TI - Impact of a competitive health care environment on the viability of multi hospital cancer control programs: 1986 and beyond. PMID- 3671411 TI - The importance of multi hospital linkages for oncological cancer control services to the rural hospital: an administrative perspective. PMID- 3671412 TI - The impact on reducing referrals of cancer patients to out-of-region hospitals resulting from the implementation of a multi hospital regional cancer control program. PMID- 3671413 TI - Life after CHOP: when a community cares about cancer care. PMID- 3671414 TI - Cancer etiology, management, and outcome: does it matter who you are? PMID- 3671415 TI - A community-wide breast self-exam education program. PMID- 3671416 TI - Mitoxantrone salvage in heavily pretreated advanced breast cancer. PMID- 3671417 TI - Antiemetic effects of metoclopramide (M) continuous infusion (CI): safety, efficacy, patient preference, and cost reduction. PMID- 3671418 TI - The war against cancer. PMID- 3671419 TI - In search of new cancer chemopreventative agents. PMID- 3671420 TI - Issues impacting on acceptance and compliance in a community based colorectal screening program. PMID- 3671421 TI - Innovative approach to alter fatalistic misconceptions in a high cancer mortality community. PMID- 3671422 TI - Worker perceptions and actions toward cancer control in the workplace: an analysis of baseline data. PMID- 3671423 TI - Worksite smoking cessation: a test of two programs. PMID- 3671424 TI - Extracellular protein phosphorylation systems in the regulation of cellular responsiveness. AB - In cells which store ATP within secretory vesicles and release it by exocytosis upon cell stimulation, extracellular protein phosphorylation systems may play an important role in cellular activation and intercellular communication. Secretion of ATP has been well documented in three cell types: neurons, chromaffin cells of the adrenal medulla and platelets. In each of these cell types we have found extracellular protein phosphorylation systems and surface proteins phosphorylated by extracellular ATP. Two types of extracellular protein kinases have been detected: a membrane bound ecto-protein kinase and a soluble, secreted exo protein kinase. The ecto-protein kinase has properties consistent with involvement in the feedback regulation of cellular activation. The secreted protein kinase can phosphorylate proteins of the extracellular matrix and surface proteins of target cells, and thus may serve as an enzyme with the role of first messenger in cell-cell communication. PMID- 3671425 TI - H1 histone phosphorylation, cell cycle progression and chromatin structure. PMID- 3671426 TI - Second messenger diacylglycerols and analogs: metabolic fate in cell culture. PMID- 3671427 TI - Regulation of protein kinase C by activators, Ca2+, and phosphorylation. PMID- 3671428 TI - Dynamic reciprocity: how do extracellular matrix and hormones direct gene expression? AB - Using mouse mammary epithelial cells (MME) as a model, we show that extracellular matrix (ECM) plays a fundamental role in the maintenance of tissue-specific function in culture. The ECM affects both the level of mRNA and the rates of synthesis and secretion of milk proteins. Casein gene expression by primary mammary epithelial cells and cell strains is controlled by both ECM and lactogenic hormones (insulin, hydrocortisone and prolactin). In the case of transferrin, the major iron-binding protein of mouse milk, the ECM rather than prolactin, appears to modulate the level of its mRNA. We further show that both ECM and lactogenic hormones influence cell shape and polarity of mammary epithelial cells. The data are consistent with a model of "Dynamic Reciprocity" (Bissell et al. 1982) where the ECM is postulated to exert an influence on gene expression via transmembrane proteins and cytoskeletal components. Cytoskeleton, in turn, is associated with polyribosomes, affecting mRNA stability and rates of protein synthesis, and with the nuclear matrix, affecting mRNA processing and, possibly, rates of transcription. We postulate that hormones and ECM act synergistically to complete the 'reciprocity' loop. PMID- 3671429 TI - The protein composition and morphology of the nuclear matrix-intermediate filament scaffold reflect cell type. PMID- 3671430 TI - [The stability of parenteral lipid emulsions following thermal and mechanical pressure in the Sudan red test as a single test method]. PMID- 3671432 TI - [The direct compression of gelatin hydrolysates. Evaluation of the influence on compressability of crystalline lactose by extensiometric measurement]. PMID- 3671431 TI - [The effect of polyvinylpyrrolidone on locomotor hyperactivity in mice induced by ephedrine and amphetamine]. PMID- 3671433 TI - Cardiac glycosides encapsulated into phosphatidylcholine liposomes: incorporation ratio and membrane localization. PMID- 3671434 TI - Influence of surfactant on the properties of granules and tablets containing sodium calcium alginate. PMID- 3671435 TI - Simultaneous capillary gas chromatographic determination of guaifenesin, dextromethorphan and diphenhydramine in cough-cold syrup. PMID- 3671436 TI - Effect of new biologically active polypeptides on dihexadecyl phosphate vesicles. AB - Effect of new biologically active polypeptides on hexadecyl phosphate vesicles. The effect that monomeric and trimeric chemotactic peptides may have on the permeation of DHP vesicles was studied by means of electronic absorption spectroscopy. The results show that attaching covalently two or more of the same chemotactic peptides to a suitable carrier molecule produced changes in the permeation of DHP vesicles that deviate from simple additivity rule. Thus a parallelism between the biological potency of the peptides and DHP permeation exists. PMID- 3671437 TI - Different cholinergic pathways are involved in the improvement induced by CCK-8 and by ACTH-(1-24) in massive acute hemorrhage, in rats. AB - Cholecystokinin octapeptide (CCK-8) (20 micrograms/kg i.v.) and tetracosactide [ACTH-(1-24)] (160 micrograms/kg i.v.) restore blood pressure and allow rats subjected to otherwise invariably fatal acute hemorrhage to survive. Atropine sulphate (2-8 mg/kg i.p.), which crosses the blood-brain barrier, dose dependently prevents this effect both in the case of ACTH-(1-24) and in that of CCK-8. On the other hand, atropine methyl bromide (2-8 mg/kg i.p.), which does not cross the blood-brain barrier, prevents the effect in the case of CCK-8, but not in that of ACTH-(1-24). These data suggest that a cholinergic mechanism is involved in the anti-shock effect of both ACTH-(1-24) and CCK-8, though the sites of action appear to be in the CNS, in the case of ACTH-(1-24), and outside the CNS, in that of CCK-8. PMID- 3671438 TI - Studies in the field of pyridazine compounds. Part 21. Structural studies on 6-H pyrimido[1,2-b]-1,2,4-triazolopyridazines. AB - The structure of 7,8-dihydro-6H-pyrimido [1,2-b]-1,2,4-triazolo [3,4-f] pyridazine (2a) was confirmed by 1H and 13C NMR spectroscopy and by preparation of the isomeric [5,1-f] pyridazine 3. Some derivatives of 6H-pyrimido [1,2-b] 1,2,4,-triazolo [3,4-f]pyridazine were prepared. Compounds 2a, 2b and 9a showed a positive inotropic effect. PMID- 3671439 TI - [Drug transport through artificial lipoid membranes. 21. Ion pair transport with alkyl salicylic acids]. AB - Using hexylsalicylic acid it was demonstrated that alkylated derivatives of salicylic acid are able to increase partition and transport of ionized basic drugs across lipophilic membranes. The influence of different donor concentrations on the relation of transport was studied by means of pholedrine in combination with hexylsalicylic acid. In order to explain the mechanism of the ion-pair-transport experiments were carried out which show beside the mentioned increase of transport the occurrence of a countertransport of protons and lithium ions, respectively. The lipophilic counterion hexylsalicylate acts inside of this mechanism as a carrier for the ionized drugs. PMID- 3671440 TI - [Drug liberation from floating capsules in the rotating-flask solubility tester]. AB - In this communication, a report is presented on the drug liberation from so called floating capsules (with 10 and 15 mg diazepam) and from several other comparable oral and rectal drug dosage forms in the rotating flask model (Resotest-System). None of the commercially available preparations exhibits any availability problem. The rotating flask was suitable and appears as superior over the official dissolution apparatuses with regard to the testing of drug dosage forms that float on the surface of the dissolution medium. PMID- 3671441 TI - In vitro release and in vivo absorption of nitrofurantoin and nalidixic acid from ethylcellulose microcapsules. AB - Ethylcellulose was used as an efficient retarding material to prepare nitrofurantoin or nalidixic acid microcapsules. The dissolution rates of the different preparations have found to increase in alkaline rather than in acidic media. Considerable retardation in the rate and extent of release from 2:1, 1:1 and 1:2 drug-polymer ratios were observed as compared with those of the plain drugs. Absorption study in man proved that formulations containing 2:1 ratios have delayed urinary excretion rates by 2 h, however, the total cumulative amounts excreted from all samples remained almost constant. Man volunteers administered the 2:1 drug-polymer microcapsules did not suffer gastric irritation, usually produced after three consecutive d from taking the plain drugs. Experiments in male albino rats showed that the coated drugs did not produce gastric hemorrhage seen with the same doses of the uncoated ones. PMID- 3671442 TI - Studies on the release of drugs from O/W emulsion ointments using the mathematical interpretations. Part 3: Kinetic approach. AB - Kinetic models describing the drug release process from oil-in-water (O/W) emulsions through artificial membranes have been proposed. It has been shown that the kinetic approach appears to be useful in analysis of this problem. PMID- 3671443 TI - [Development of combined inulin/p-aminohippuric acid (PAH) slow release implantation tablets for clearance determination in awake rats]. AB - A new method has been developed for the simultaneous measurement of Inulin and PAH clearance in small laboratory animals (rats). An implantable Inulin/p aminohippuric-acid matrix-retard tablet based on Eudragit was tested with the purpose to estimate renal clearances. Sufficiently high serum and urine levels of both substances can thus be maintained up to 12-48 hours. The advantage of the method is that it can be used for renal clearance tests in small conscious animals, able to move freely within their cages without serious handling stress. PMID- 3671444 TI - Influence of vehicle on antimicrobial efficiency of topical dosage forms of chloramphenicol. AB - Antimicrobial efficiency of chloramphenicol incorporated into ambiphilic emulsion bases was investigated, and it was shown that the efficiency was several times greater than the efficiency of a comercially available lipophilic dosage form. The efficiency was especially pronounced when the samples with a higher aqueous phase content and of a lower viscosity were used. All ambiphilic preparations were stable when stored at 4 degrees C for 6 months, and when storage time was prolonged up to 1 year the most stable formulations were those which were prepared with a mixture of Tagat S and Tegin M. PMID- 3671445 TI - [The effect of intrahepatic cholestasis in pregnancy on various forms of cytochrome P-450-dependent biotransformation reactions]. AB - The elimination of caffeine from plasma and the excretion of the main metabolites of metamizol (noramidopyrinemethanesulphonate sodium) into the urine were determined in healthy pregnant women (weeks 30-38 of pregnancy) and in patients with intrahepatic cholestasis in pregnancy (weeks 28-39 of pregnancy). From the elimination velocity of these model substances conclusions concerning the activity of 3-methylcholanthrene (caffeine elimination) and phenobarbital inducible isoenzymes (metamizol elimination) of cytochrome P-450 are drawn. Patients with intrahepatic cholestasis in pregnancy (t1/2 = 15.8 +/- 1.8 h) eliminate caffeine more slowly than healthy pregnant women (t1/2 = 11.0 +/- 0.8 h) at this stage of pregnancy. The excretion of the metabolites of metamizol is only in tendency diminished in patients with intrahepatic cholestasis. The influence of the intrahepatic cholestasis on the cytochrome P-450 isoenzymes investigated differs in degree. PMID- 3671446 TI - Synthesis and metabolic disposition of 14C-centperazine in rats. AB - The metabolic disposition of [2-14C]-centperazine (1; 3-ethyl-8-methyl-1,3,8 triazabicyclo[4.4.0]decan-2-one) following an injection of 5 mg/kg dose was studied in male albino rats. During the initial period of 45-60 min, a very rapid fall in blood level of radioactivity was noticed. Thereafter the rate of fall of blood radiocarbon went on decreasing but did not attain linearity even upto 24 h. The drug was found to be fairly distributed in all the tissues attaining highest concentration in most of them within 30 min. In 24 h, about 83.5% of the administered drug was eliminated from the body, of which 21.3% was recovered from the faeces and 61.1% from the urine. The 14CO2 accountes for only 1% of the total dose. The drug exhibited significant binding with all the tissues examined. The brain and muscle showed highest and lowest activity, respectively. PMID- 3671447 TI - [The effect of trapidil and the trapidil derivative AR 12463 on blood pressure and thromboxane formation in spontaneously hypertensive rats]. AB - The trapidil derivative AR 12463 has a much more stronger inhibiting effect than trapidil on different atherosclerotic parameters of the cell cultures obtained from normal intima and fatty streaks of human aorta, on thromboxane (TX) formation and on the aggregation of human platelets in vitro, and on the activity of phosphodiesterase. In addition to these present results, AR 12463 reduced significantly the mean arterial blood pressure of spontaneously hypertensive rats (at a dosage of 20 mg/kg/d administered orally for 2 weeks) in contrast to the same dosage of trapidil. Simultaneously, TX formation is significantly reduced in serum by 48% in aorta thoracica by 29%, and in aorta abdominalis by 19%. Due to these properties, AR 12463 seems to be suitable for a therapeutic and prophylactic strategy in chronic ischemic diseases. PMID- 3671448 TI - Effects of lectin I from mistletoe (ML I) and its isolated A and B chains on human mononuclear cells: mitogenic activity and lymphokine release. AB - The interaction of lectin I from mistletoe (Viscum album) (ML I) and its isolated A and B chains with mononuclear cells from healthy human donors was investigated with respect to proliferation capacity (mitogenicity) and monokine/lymphokine factor (MSF) production. The factor produced was studied by means of the electrophoretic mobility inhibition assay using guinea pig macrophages as indicator cells. ML I and its B chain exhibited comparable inhibitory effects on the proliferation of mononuclear cells (MNC, lymphocytes) that differed in quantity only. After 72 h the tritiated thymidine incorporation had diminished in comparison to the control over a concentration range from 10(-7) to 10(-11) mol/l (ML I) or from 3 X 10(-7) to 3 X 10(-9) mol/l (B chain), respectively. The ML I was about 30 times more active than the B chain. Moreover, MSF production could be substantiated for the B chain at a concentration of 3 X 10(-8) mol/l. In contrast to the B chain, the A chain stimulated the MNC to blastogenic transformation at concentrations of 3 X 10(-8) and 3 X 10(-9) mol/l. The stimulation index was much lower than after PHA stimulation. The same concentrations induced the production of lymphokine (MSF). The lymphokine activity on the indicator cells could be inhibited by L-fucose. Perhaps both cytotoxicity and lymphocyte stimulation are important for anti-tumor activity after application in vivo. PMID- 3671449 TI - [N-acyl-derivatives of amino alcohols with antiarrhythmic action]. PMID- 3671450 TI - HPLC Determination of the synthetic thrombin inhibitor N alpha-(2 naphthylsulfonylglycyl)-4-amidinophenylalanine piperidide in biological material. PMID- 3671451 TI - [Determination of 6-mercaptopurine in human plasma with HPLC]. PMID- 3671452 TI - [The effect of pore structure of drug-containing bead polymerizates on drug liberation behavior]. PMID- 3671453 TI - The effect of bilateral adrenal demedullation on blood pressure and heart rate of spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats. PMID- 3671454 TI - Release of plasminogen activator by molsidomine and its active metabolite SIN-1. PMID- 3671455 TI - Synthesis of thiazole derivatives with positive inotropic effect. AB - Thiazole derivatives with potential positive inotropic effect were synthesized. The highest activity (medium positive inotropic effect) was exhibited by ethyl 2 (2-hydroxyethylamino)-4-phenylthiazole-5-carboxylate (3b) of which several derivatives have been prepared. Among these derivatives only those which could presumably easily removed in the living organism to give 3b exhibited a medium positive inotropic effect (6, 8b). It was assumed that the effect of 3b had a beta-agonist character. PMID- 3671456 TI - Evaluation of some benzenesulphonylhydrazones of aryl aldehydes and ketones as antiepileptic agents. AB - Benzaldehyde benzenesulphonamide was shown to have comparable anticonvulsant activity to valproic acid in the maximal electroshock seizure test. Molecular modification of this compound was developed principally to explore whether a correlation between planarity and anticonvulsant activity could be discerned. The interplanar angle (theta) between an aryl ring and the adjacent azomethine group of some representative compounds was measured by electronic absorption spectroscopy. However, the structural alterations of benzaldehyde benzenesulphonamide undertaken in this work led to compounds bereft of anticonvulsant activity. PMID- 3671457 TI - Synthesis and antimycotic activity of some benzyloxyimino compounds. AB - Some benzyloxyimio compounds, related to oxiconazole and having a 1H-indole or 1H benzimidazole moiety, have been synthesized and tested in vitro for their antimycotic activity against Candida tropicalis and C. albicans. The most active was showed to be 0-(2,4-dichlorobenzyl)-1-benzyl-5-nitro-1H-benzimidazole-2 carboxaldehyd e oxime (MIC: 25 micrograms/ml against both microorganisms). A structural feature important for the biological activity of the series appears to be presence of a benzimidazole nucleus substituted by an electron withdrawing group. PMID- 3671458 TI - Selective solid-phase extraction of mexiletine from human serum prior to its GLC analysis. AB - A rapid and sensitive method for the GLC determination of mexiletine in human serum is described. The liquid-liquid extraction was replaced by the solid-phase extraction procedure for sample preparation using Separcol SI C 18 cartridges. The two-step elution of the cartridges after serum application was used-first with 50% acetonitrile in water for eluting endogenous compounds from serum, then with methanol to displace purified mexiletine. The recovery by this procedure was 83.6%. This selective solid-phase extraction offers an acceptable alternative to liquid extraction, and in combination with GLC-FID analysis is suitable for clinical pharmacokinetic studies of mexiletine. PMID- 3671459 TI - [The effect of ion pair formation on the pharmacokinetics of drugs. 2. The effect of hexylsalicylic acid on the pharmacokinetics of quinine]. AB - The influence of the hexylsalicylic acid (2) on the pharmacokinetic of the quinine (1), was studied using rabbits. It could be observed that after i.v. application the mean resistance time (MRT) of 1 was increased by means of ion pair-formation with 2. But the AUC of 1 was not influenced. After rectal application of the combination 1/2 an acceleration of the 1 absorption could be pointed out. The kinetic parameters of 2 were not increased significantly if 1 was applicated simultaneously. PMID- 3671460 TI - The influence of propranolol and glucagon on the pharmacokinetics of antipyrine and sodium salicylate. AB - Propranolol (1) decreases hepatic blood flow and glucagon (2) exerts an opposite effect on hepatic circulation. The effects of these drugs on the pharmacokinetics of phenazone (3; antipyrine)-a compound with low coefficient of hepatic extraction, and sodium salicylate (4) that is highly extracted by liver, were studied on rabbits. It was shown that changes in the pharmacokinetics of 3 and 4 in the presence of 1 or 2, seemed to be interactions between these drugs in the haemodynamic phase. PMID- 3671461 TI - [Experimental results of the optimization of external prednisolone therapy]. AB - The initial steps of any topical therapy are characterized by the degree of liberation of the agent from the ointment base and their penetration into different skin layers. A high percentage of the topically applied prednisolone does not penetrate into the skin and may be removed from the skin surface even after some time. By altering the functional structure of the horny layer and considerably increase of prednisolone liberation from ointment bases urea is a effective penetration promotor also for prednisolone. The increased prednisolone penetration into human skin from urea containing ointment correspond with the degree of blanching results by vasoconstriction test under in vivo conditions. The resulting penetration optimation of prednisolone has two possible applications in topical therapy: an increased therapeutic effect for a given prednisolone concentration and a given therapeutic effect could be obtained with a reduced prednisolone concentration. PMID- 3671462 TI - [Improved synthesis of the highly active cholecystokinin sequence succinyl Tyr (OSO3-)-Met-Gly-Trp-Asp-Phe-NH2]. PMID- 3671463 TI - On the conformational structure of bipyridine cardiotonics. PMID- 3671464 TI - Isn't it easier to obtain metoprolol tartrate in the form of gastrointestinal diffusion system than the oral osmotic system form? PMID- 3671465 TI - Microcapsules of sage oil: essential oils content and antimicrobial activity. PMID- 3671466 TI - [The effect of calcium channel blockers and some reference substance on the effectiveness of anticonvulsants in maximal electroshock in the mouse]. PMID- 3671467 TI - [The action of new quaternary iminium compounds against selected bacteria and fungi]. PMID- 3671468 TI - The effect of the chemical character of certain penicillins on the resistance of the beta-lactam group in their molecules. Part 5: Kinetics of thermal decomposition in solid state. AB - The decomposition rate at elevated temperature was studied of the following penicillins: ampicillin trihydrate (1), 6-aminopenicillanic acid (2; 6-APA), amoxicillin trihydrate (3), piperacillin (4), amoxicillin sodium (5), azlocillin sodium (6), mezlocillin sodium monohydrate (7) and azidocillin sodium (8). The pattern of decomposition was found to comply with the first-order reaction. The thermal stability of the compounds at 25 degrees C increased in accordance with the sequence 1 less than 2 less than 3 much less than 6 less than 5 less than 8 less then 7 much less than 4, which was connected with the hydrophilic and lipophilic properties of these penicillins. An isokinetic enthalpy-entrophy correlation was demonstrated. The calculated beta value was 420 K. PMID- 3671469 TI - [A new experimental design for the in vitro evaluation of drug absorption in topical forms. 1. Design and model calculation]. AB - An in-vitro model is presented which consists on several membrane Layers. The penetration of drugs from the ointment bases into these membrane Layers is observed. By combination of different membranes this system can be varied. In model calculations the resulting conditions are demonstrated. PMID- 3671470 TI - Microencapsulation of potassium chloride with mastic. AB - The present investigation deals with the microencapsulation of potassium chloride with mastic. Spherical potassium chloride crystals with a mean particle diameter of approximately 450 microns were used. It could be shown that with a layer of mastic wall material thicker than 21 microns the release of potassium chloride in the in vitro test can be controlled for more than 6 h. The thickness of the wall material over the tested range of 21 to 33 microns has only a limited effect on the kinetics of release of potassium chloride. Increasing the thickness of the layer from 21 to 33 microns merely leads to a reduction of about another 10% in the amount of drug released in 6 h. PMID- 3671471 TI - [Preparations of acetylsalicylic acid sustained-release tablets on hydrophilic matrix forms]. AB - The aim of this study was to prepare a tablet with acetylsalicylic acid based on hydrophilic matrix form by means of polyvinyl alcohol. The liberation was carried out with the column dissolution-rate method. In contrast to other studies, the percentage of the cumulative liberation is decreased by increasing the drug concentration. Acetylsalicylic acid caused a decrease of the wetting and the rate of swelling. PMID- 3671472 TI - [Possibilities for the in vitro evaluation of bioavailability. 5. Compact peroral agents with basic drugs]. AB - Lipophilic, basic drugs can be transported across lipoid-membrane even if the part of the substance being not ionized in the solution is very low. Therefore the resorption model can be used for the control of drugs containing the substances as salts. In the case of 4 substances no differences could be found concerning half transport time between the aqueous solutions and the drugs. PMID- 3671473 TI - [Development and characterization of skin-protective dermatologic preparations. 3. Determination of the protective action of hydrophobic and hydrophilic compounds]. PMID- 3671474 TI - Release kinetics of potassium aspartate in polyvinyl chloride matrix formulation. AB - The authors prepared potassium aspartate matrix tablets in combination with polyvinyl chloride. The physical parameters were measured and the dissolution rates were determined. During the in vitro release rate experiments, it was determined that the dissolution kinetics obey both zero order and Higuchi diffusion model order kinetics. PMID- 3671475 TI - Vitamin D and its metabolites in the pollen of pine. Part 5: Steroid hormones in the pollen of pine species. AB - Unconjugated vitamin D and its metabolites were investigated in the pollen of Pinus nigra Ar. and Pinus sylvestris L. by TLC, HPLC and competitive radiochemical determination of 25-hydroxycholecalciferol (25-OHD3). It was found that vitamin D (D2, D3) was present in the pollen in amounts about 2 micrograms/10 g and 25-OHD3, 24,25-dihydroxycholecalciferol [24,25-(OH)2D3] and 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] between 0.1 and 3 micrograms/10 g of pollen, dependent on pollen species and methods. PMID- 3671476 TI - Potential antineoplastics--1-substituted thiocarbamoyl-3,5-disubstituted pyrazoles. PMID- 3671478 TI - Colorimetric determination of pentoxiverine citrate in some pharmaceutical preparations. PMID- 3671477 TI - A facile spectrophotometric method for the determination of antimony(III) antibilharzial compounds based on the formation of molybdenum blue. PMID- 3671479 TI - [Separation of heptacain hydrochloride metabolites with HPLC]. PMID- 3671480 TI - Effect of the dosage of Ac-Di-Sol and Plasvita TSM on the properties of tablets. PMID- 3671481 TI - [The effect of ionizable lipids on the permeation behavior of lipid-collodion membranes]. PMID- 3671482 TI - Progesterone receptor of adult rabbit lung. AB - Properties of progestin binding sites in adult male rabbit lung cytosol were analyzed using [3H] promegestone ([3H]R5020). At concentrations of 0.05-10 nM, [3H]R5020 bound to two saturable sites with differing affinities: a high affinity site (Kd = 0.34 nM, Bmax = 57 fmol/mg protein) and a moderate affinity site (Kd = 60 nM, Bmax = 540 fmol/mg protein). [3H]R5020 binding, under conditions selected to favor binding to the high affinity site, was reversible, protease-sensitive and inhibited in a concentration-dependent manner by steroids with the following order of potency: R5020 greater than norgestrel greater than norethindrone greater than progesterone greater than norethindrone acetate greater than norethynodrel greater than deoxycorticosterone greater than lynestrenol greater than quingestanol greater than testosterone greater than 17 beta-estradiol greater than cortisol. Upon sucrose density gradient ultracentrifugation analysis, a peak of [3H]R5020 binding activity was observed in the 6-7S region in the absence of KCl and in the 3-4S region in the presence of KCl. The progestin binding activity of adult male rabbit lung cytosol thus possesses those characteristics conventionally accorded to a hormone receptor and suggests that lung tissue may be progesterone-responsive. PMID- 3671483 TI - Parathion toxicity in relation to liver microsomal oxidases, lipid composition and fluidity. AB - Rats were injected intraperitoneally with phenobarbital (PB) and 3 methylcholanthrene (MC), 80 and 20 mg/kg, respectively, for 3 consecutive days and then administered threshold lethal dose of the organophosphorus insecticide, parathion, 10 mg/kg i.p. to compare its toxicity in these, with those fed high fat, diet (HFD-50% saturated fat, and normal diet (ND-10% saturated fat) for 30 days. Hepatic microsomes of these four groups of rats without the parathion administration were also analysed to evaluate toxicity and metabolism of the insecticide in relation to some physico-chemical changes in microsomal membranes. Results showed that in comparison to ND, all three pretreatments (PB, MC and HFD) significantly decreased parathion toxicity, increased microsomal oxidase activity and elevated microsomal cholesterol/phospholipid ratio. However, microsomal cytochrome P-450 was significantly raised only in PB and MC, and microsomal fluidity was significantly raised only in MC, as measured by DPH-fluorescence polarization technique. PMID- 3671484 TI - Effect of ethanol on the rat gastrointestinal cholinergic enzymes. AB - Male Sprague-Dawley rats weighing between 180 and 220 g and maintained under controlled lighting and temperature conditions were used in this experiment. Animals were given ethanol (3 g/kg, p.o.) 24 h after fasting. One group was given ethanol at 10.00 h (light phase) and the other at 22.00 h (dark phase). One hour later, the treated animals with their proper controls were sacrificed and the mucosa of the stomach, duodenum, ileum and colon were separated and assayed for choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) activities. Data obtained indicate that the administration of ethanol resulted in significant decline (p less than 0.01) in ChAT activity in the stomach and the colon during the light phase. A significant increase (p less than 0.01) in ChAT activity was also noted in the ileum during the dark phase. There was a significant decrease (p less than 0.01) in AChE activity in the stomach during the dark phase. The administration of ethanol also resulted in a significant decline in AChE activity (p less than 0.05) in the duodenum and the colon (p less than 0.01). The results obtained indicate that the gastrointestinal changes caused by ethanol administration may be related to changes in the cholinergic enzymes of the mucosa of the gastrointestinal tract. PMID- 3671486 TI - Kindling models and antikindling effects of mood normalizers. AB - In animal experiments, kindling designates the appearances of increasing EEG and behavioral responses when an initially ineffective stimulus on certain cerebral areas is repeated (Goddard et al., 1969). Its development occurs in association with increasing duration and spread over the major part of the brain of electric afterdischarges. This process may lead to critical changes in behavior. Kindling can be caused by electric stimulation or pharmacological inducement. The nature of the behavioral response varies with that of the stimuli, so different types of kindling have been described, constituting animal models notably for epileptogenesis. Their psychiatric interest stems from evidence of an inhibiting effect of certain substances, such as carbamazepine or phenytoin, which are effective in the treatment of both epilepsy and mental disorders, but this effect is also found for lithium (Post et al., 1982, 1984). Applied to the development of periodic psychoses, kindling models would account for certain unexplained clinical data and precisely explain the mechanisms and the specific action of various mood normalizers. PMID- 3671487 TI - Towards a neuropsychological model of lithium action. AB - Very few models exist to explain the mechanism of prophylactic action of lithium salts in a differentiated and comprehensive way. Our own efforts in the past were mainly directed at the mental and neurophysiological effects of lithium. In the present contribution, a psychological model is proposed, and it is discussed whether the psychological and the neurophysiological approaches can be combined with each other, or rather whether interfaces between them can be postulated. This psychological model was developed together with D. Kropf and defines "pathologic" and "normal" as two distinct qualities which--due to classic logical arguments--cannot be deduced from each other. On the contrary, it must be assumed that the specific "pathologic", i.e. manic or depressive processes, already exist in subtle or rudimentary form in the premorbid experience and behaviour. The specific quality of these premorbid processes is described as a "weakness of structurizing". The paper discusses how and when lithium can interfere with these premorbid processes. This interference is related to prophylactic efficacy, but can also be considered a sort of early treatment. Empirically, longterm lithium treatment may lead to slightly restricted information processing. Evidence for such an action is gained from psychological experiments on the effects of lithium on visual perception as well as from the recent re-evaluation of EEG-data obtained in lithium-treated healthy volunteers. It is emphasized that such effects are not unidirectional, but differential depending on the specific predrug or premorbid pattern of the investigated processes. PMID- 3671485 TI - Psychophysiological aspects of depressive syndromes. AB - Compared to 30 healthy controls, 59 drug free patients with primary major depression exhibited significantly higher rates of heart beat, respiration, and eye blinking; longer simple and associative reaction times; fewer spontaneous fluctuations of skin resistance, a lower salivation rate, a faster habituation rate of skin resistance orienting response, and a smaller CNV area in the EEG. Skin resistance level, speech pause time, N1P2 amplitudes of acoustically evoked potentials and the postimperative negative variation (PINV) in the EEG did not differ between groups. All deviations are nosologically unspecific; they can be regarded as signs of overarousal, as deficits, or as the result of protective inhibition. In all subjects the investigation was repeated twice, while the patients were treated with either amitriptyline or oxaprotiline, repetition of measurement influenced several variables, but most patient/control differences remained unaffected--irrespective of the drug applied. PMID- 3671488 TI - Lithium: clinical study by brain electrical activity mapping. A case report. AB - One of the axes of research in our department is oriented on the study of the action of psychotropic drugs on the Central Nervous System by the means of the non invasive and direct techniques of cerebral imagery. First approach: EEG mapping In depressive states, the modification of nocturnal wakefulness states observed under lithium therapy begins to be well known. However, under lithium monotherapy, few diurnal studies have been performed. EEG mapping, based on a protocol and a strict methodology, could represent an interesting technique to approach the mechanisms of lithium action in psychopathological states concerned by this type of therapy. Second approach: Nuclear Magnetic Resonance (NMR) We studied the manic-depressive states in man before and after chronic administration of lithium salts. This research is performed in fundamental molecular studies, in vitro, and from modification of certain parameters in protonic NMR imagery that can be observed in these pathological states. We are participating in a research program and we preliminarily present: 1. the study by protonic NMR of the in vitro interaction between the lithium ion and water which is free or bound to the total cerebral tissue of rats (acute intravenous treatment by Li+ in different doses and at different times of tissular penetration). 2. the study by lithium NMR of the in vitro kinetics of the erythrocyte's lithium penetration in man, for the plasmatic concentrations (acute intravenous dose) considered as therapeutic in manic-depressive states. These measures performed by spectroscopic NMR are coupled with a classical dosage of lithium made with a flame spectrophotometer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671489 TI - Early physiological effects of lithium treatment: electrooculographic and adaptometric findings in patients with affective and schizoaffective psychoses. AB - Electrooculography allows to measure the fundocorneal potential, a standing potential of the eye, under the conditions of light and dark adaptation. The results are expressed as the so-called Arden ratio. As was demon-strated by others in healthy volunteers, the Arden ratio, on the average, de-creases under Lithium treatment. However, in individual cases it can also remain unchanged or even rise. We have performed electrooculographic and adaptometric examinations in ten patients with affective disorders (DSM-III, 296. XX) and schizoaffective psychoses (DSM-III, 295.70). The criteria for the assignment of patients to lithium treatment were derived from a study by Angst. Arden ratios were determined six times, respectively, before lithium application and after a therapeutic lithium serum level (0.6-0.8 mmol/l) had been reached (cf. 5). The values observed during lithium treatment were significantly lower than those measured before lithium application. Dark adaptation, as measured using an adaptometer according to Goldmann-Weekers, was disturbed under lithium. The potential predictor function of these findings with regard to the lithium response is being investigated by means of a prospective study. PMID- 3671490 TI - Contralateral eye movements and alpha reactivity of lithium patients in recognition tasks. AB - For the purpose of analyzing memory deficits in patients on lithium therapy the Psychological Labor (E. Opgenoorth et al.) and Lithium Department (R. Wolf et al.) studied not only psychological performance but also biosignals of elementary complexity (characteristic values of eye movements as a reaction to simple light stimuli) and of higher complexity, i.e. those which accompany the cognitive processing of information. Recall and recognition performance for incidentally learned word and picture items was tested in 14 patients receiving lithium treatment. Simultaneously registered EEG (O1-Cz and O2-Cz) and lateral eye movements (LEM) were analyzed with reference to different stimuli. Absolute alpha power and relative event-related desynchronization (ERD) show differences in EEG reactivity between healthy individuals and lithium patients demonstrated by differences in the amplitudes. LEM are characterized by a slight delay of the peaks. PMID- 3671491 TI - Auditory evoked potentials and response to lithium prophylaxis. AB - Auditory evoked potentials were recorded in 28 euthymic patients with affective psychosis who had received lithium prophylaxis for at least 5 years. Binaural clicks at 4 intensities were presented in randomized order via headphones. Potentials were recorded from Cz, C3, and C4 referenced to linked mastoid electrodes. N1-P2 amplitudes, N1 and P2 latencies, and the slope of the amplitude/stimulus intensity function (ASF) were determined in each patient. The patients were divided into responders and nonresponders on the basis of whether or not they had been hospitalized for treatment of relapses during the last 5 years of lithium prophylaxis. The ASF was steeper for all leads in responders than in nonresponders. In addition, N1 latencies were shorter for all leads in responders than in nonresponders. Age played a role in the differences observed between responders and nonresponders for ASF, but not for N1 latencies. PMID- 3671493 TI - Mood-independent aberrancies of word responses and action of lithium on their repetition in manic depressed illness. AB - Following a preceding study, two samples of patients, one French (N = 20) and one American (N = 29), from two affective disorders clinics, were given free word association tests consisting of two successive presentations of the same list of stimulus words separated by a 15 minute interval. On the one hand, commonness of word responses was not affected by changes of mood, and consequently aberrancies in associative processes may be a trait of persons with bipolar affective disorders. On the other hand, repetition of responses was directly correlated with lithium concentration in plasma, which allowed a prediction of the success of lithium therapy. PMID- 3671492 TI - Effects on the patterns of melatonin and cortisol in cluster headache of a single administration of lithium at 7.00 p.m. daily over one week: a preliminary report. AB - Cluster headache represents a primary headache disorder. The major characteristics of cluster headache are the seasonal frequency and the occurrence of symptoms during night time. A significant decrease in nocturnal melatonin levels and an advanced phase associated with a shift in cortisol acrophase has been described. The effect of lithium on nocturnal melatonin and cortisol secretion was examined in the present study. Preliminary results indicate that Lithium delaises rhythms in cluster head-ache. PMID- 3671494 TI - Compliance with long-term lithium treatment in major affective disorders. AB - Compliance with long-term lithium treatment was studied retrospectively in 73 patients suffering from major affective disorders. It was assessed during the first two years treatment by monitoring plasma lithium levels every 6 weeks. 5 patients stopped the lithium treatment before the first two years were up. Of the 68 remaining patients, only 32 (47%) were thought to be complying perfectly. Most of the failures with lithium (11 patients out of 15) were observed in non compliant patients. The main factors accounting for non-compliance were a low intellectual level, cognitive deficit, affective relapses and traits of personality disorders; on the other hand, neither the age nor the sex of the patients, nor the polarity, the severity or the duration of the affective disorders, nor the modalities or side effects of the treatment seemed to have any bearing on compliance. PMID- 3671495 TI - Electron dose distributions in experimental phantoms: a comparison with 2D pencil beam calculations. AB - Dose distributions were measured and computed within inhomogeneous phantoms irradiated with beams of electrons having initial energies of 10 and 18 MeV. The measurements were made with a small p-type silicon diode and the calculations were performed using the pencil beam algorithm developed originally at the M D Anderson Hospital (MDAH). This algorithm, which is available commercially on many radiotherapy planning computers, is based on the Fermi-Eyges theory of electron transport. The phantoms used in this work were composed of water into which two- and three-dimensional inhomogeneities of aluminum and air (embedded in wax) were introduced. This was done in order to simulate the small bones and the air cavities encountered clinically in radiation therapy of the chest wall or neck. Our intent was to test the adequacy of the two-dimensional implementation of the pencil beam approach. The agreement between measured and computed doses is very good for inhomogeneities which are essentially two-dimensional but discrepancies as large as 40% were observed for more complex three-dimensional inhomogeneities. We can only trace the discrepancies to the complex interplay of numerous approximations in the Fermi-Eyges theory of multiple scattering and its adaptation for practical computer-aided radiotherapy planning. PMID- 3671496 TI - Measurements of dose distributions in small beams of 6 MV x-rays. AB - Dose distributions produced by small circular beams of 6 MV x-rays have been measured using ionisation chambers of small active volume. Specific quantities measured include tissue maximum ratios (TMR), total scatter correction factors (St), collimator scatter correction factors (Sc) and off-axis ratios (OAR). Field sizes ranged from 12.5 to 30 mm diameter, and were defined by machined auxiliary collimators with the movable jaws set for a 4 cm x 4 cm field size. Due to the lack of complete lateral electronic equilibrium for these small fields, the accuracy of the measurements was also investigated. This was accomplished by studying dose response as a function of detector size. Uncertainties of 2.5% were observed for the central axis dose in the 12.5 mm field when measuring with an ionisation chamber with a diameter of 3.5 mm. The total scatter correction factor exhibits a strong field size dependence for fields below 20 mm diameter, while the collimator scatter correction factor is constant and is defined by the setting of the movable jaws. Off-axis ratio measurements show larger dose gradients at the beam edges than those achieved with conventional collimator systems. Corrected profiles measured with an ionisation chamber are compared with measurements made with photographic film and LiF thermoluminescent dosemeters. PMID- 3671497 TI - General specifications for silicon semiconductors for use in radiation dosimetry. AB - Silicon semiconductor detectors used in radiation dosimetry have different properties, just as e.g. ionisation chambers, affecting the interaction of radiation with matter in the vicinity of the sensitive volume of the detector, e.g. wall materials, and also the collection of the charges liberated in the detector by the radiation. The charge collection depends on impurities, lattice imperfections and other properties of the semiconductor crystal. In this paper the relevant parameters of a silicon semiconductor detector intended for dosimetry are reviewed. The influence of doping material, doping level, various effects of radiation damage, mechanical construction, detector size, statistical noise and connection to the electrometer is discussed. PMID- 3671498 TI - Diagnostic x-ray spectra measurements using a silicon surface barrier detector. AB - A silicon surface barrier detector is used to analyse diagnostic x-ray spectra. This detector, usually employed to detect charged particles, has a very low efficiency for x-ray. This characteristic is advantageous in overcoming experimental problems caused by the high fluence rates typical of diagnostic x ray beams. The pulse height distribution obtained with silicon surface barrier detectors is very different from the true photon spectra because of the presence of escaped Compton photons and the fact that detection efficiency falls abruptly when photon energy increases. A detailed analysis of the spurious effects involved in detection is made by applying a Monte Carlo method. A stripping procedure is described for implementation on a personal computer. The validity of this method is finally tested by comparison with the experimental results obtained with a Ge detector. The spectra obtained with the Si detector are in fairly good agreement with the analogous spectra measured with a Ge detector. The advantages of using Si as opposed to Ge detectors in x-ray spectrometry can be summarised as: its simplicity of use, its greater economy for use in routine diagnostic x-ray spectroscopy and the possibility that the stripping procedure can be implemented on a personal computer. PMID- 3671499 TI - Phantom equivalent thicknesses in diagnostic radiology. AB - Some measurements in diagnostic radiology must be done with phantoms. The most frequently used phantoms are water, plexiglass, aluminium and copper. It is interesting to know the equivalent thicknesses between these phantoms in order to be able to relate these values to real anatomical organs of known thicknesses. The use of antiscatter grids, the choice of intensifier screens, the beam size and in general the scattering parameters considerably change the equivalent thicknesses. Many situations have been simulated by the Monte Carlo method and equivalent thicknesses are presented. PMID- 3671500 TI - Intensity of the flash associated with laser-induced plasma in the eye. AB - A bright flash of light is emitted by the plasma formed at the focus of an ophthalmic Nd: YAG laser. The purpose of this investigation is to determine whether the plasma flash constitutes a hazard to the operator. The intensity of the flash at the slit lamp eyepiece was measured and the experimentally derived value was verified by independent calculation. For hazard assessment purposes, the concept of a spectrally weighted maximum permissible exposure (MPE) is described in the paper. Based on the MPE and our measurements and calculations our conclusion is that viewing the flash in a patient's eye through the microscope would not be considered hazardous to the operator. In contrast, during technical procedures, targets in air are used to produce a plasma and in this situation eye protection is recommended when viewing the flash through the microscope. PMID- 3671502 TI - Phantom materials for photon-scattering measurements. PMID- 3671501 TI - The relative significance of trabecular and cortical bone density as a diagnostic index for osteoporosis. AB - The density of the distal radius in the non-dominant forearm was measured non invasively by Compton spectrometry in 234 post-menopausal women. The density of the trabecular tissue was determined almost independently from that of cortical tissue by horizontal and vertical scanning of the bone. It was found that the lower the density of the trabecular bone, the greater the difference between the density of the cortical and trabecular bone. As osteoporosis progresses, trabecular bone density in the distal radius seems to decrease faster than that of compact bone. Hence the severity of the disease is best determined by measuring the density of trabecular bone. PMID- 3671503 TI - A simple radiation beam position monitor. PMID- 3671504 TI - Statistical errors in 'Texture analysis in radionuclide tomographic liver imaging'. PMID- 3671505 TI - Functional outcomes after hip fracture. AB - The ability to achieve independent ambulation after hip fracture, orthopedic stabilization, and subsequent rehabilitation was studied in 65 inpatients in a specialized geriatric rehabilitation center. The association of 10 factors with the ability to achieve independent ambulation was measured by Kendall's tau B analysis and a two-tailed t test. The 10 factors were sex, age, surgical technique, side of fracture, site of fracture, presence of previous fracture, presence of lower extremity contractures, strength of hip abductor muscles, number of visits to physical therapy, and number of days from surgery to discharge from physical therapy. Measurements were taken at discharge from physical therapy, at 60 days after surgery, and one year after surgery. Fifty four (83%) of the 65 patients reached independent ambulation at some time between the date of surgery and one year later. At one year after surgery, only 4 of the 65 patients had died. The variables of age, lower extremity contractures, strength of the affected hip abductor muscles, type of surgical technique, number of visits to physical therapy, and number of days from surgery to discharge were associated with independence in ambulation. PMID- 3671506 TI - Toe-touch test. A measure of its validity. AB - The primary purpose of this study was to investigate the relationships between the vertical fingertip-floor distance (FFD) and the hip and vertebral components of trunk flexion during the toe-touch test. Measurements were taken from lateral photographs of each subject standing in the erect and maximally flexed positions. The subjects were healthy young men (n = 16) and women (n = 17). The mean FFD was 3 cm below floor level (-3 cm) with a standard deviation of 8 cm. Reliability of this measure was indicated by a test-retest correlation coefficient of .97. The FFD was a measure of both trunk (r = -.85) and hip flexion (r = -.79), but not of vertebral flexion (r = .10). At maximum trunk flexion, therefore, FFD is mainly a measure of the extensibility of the hamstring muscles that limit hip flexion when the knees remain extended. The toe-touch test was determined to be unsuitable for monitoring the effect of a treatment regimen to improve vertebral mobility because the partial correlation coefficient between vertebral flexion and FFD was -.64 (p less than .01), with the effect of hip flexion held constant. Although this correlation is significant, it means that less than half of the variation in FFD can be explained by changes in vertebral mobility. For this group of young adults, no significant correlations existed between the FFD and limb length and abdominal girth at maximum trunk flexion. PMID- 3671507 TI - Functional changes during acute rehabilitation in patients with stroke. AB - The purpose of this study was to analyze functional change levels and determine Spearman rank order correlation coefficients about information gleaned from physical therapy discharge notes for a group of 212 patients with stroke who received physical therapy during an acute rehabilitation stay. Functional changes were determined in the categories of wheelchair skills, transfer ability, bed (mat) mobility, and ambulation. Comparisons also were made between a subgroup of the most severely involved patients and a subgroup of the least involved patients. The correlations between these functional changes and days of physical therapy were determined. Four conclusions were deduced: 1) All patients improved functionally after a stroke, 2) the improvement was related to the amount of time spent in physical therapy, 3) the more severely involved patients exhibited a greater relationship between functional gains and days spent in physical therapy than the least involved patients, and 4) the least involved patients exhibited the most gains in function. The implications of these findings were discussed. PMID- 3671508 TI - Bicycle ergometer and electromyographic feedback for treatment of muscle imbalance in patients with spastic hemiparesis. Suggestion from the field. PMID- 3671509 TI - Muscle pressure effects on motoneuron excitability. A special communication. AB - The purpose of this communication is to report on the analysis of the effects of muscle pressure on altering motoneuron excitability. Motoneuron excitability was assessed by measuring changes in the H-reflex in 30 neurologically healthy individuals. The results indicate that muscle pressure is excitatory, but of such low intensity as to be of dubious therapeutic benefit. Methodological limitations specific to muscle pressure stimulation limit the interpretation of our results. These limitations are discussed, and a suggestion is made for an alternative approach to evaluate the effects of muscle pressure on motoneuron excitability. PMID- 3671510 TI - The 1987 presidential address. Toward a profession of substance. PMID- 3671511 TI - Twenty-second Mary McMillan lecture. PMID- 3671512 TI - Chemistry of singlet oxygen--48. Isolation and structure of the primary product of photooxygenation of 3,5-di-t-butyl catechol. PMID- 3671513 TI - Different photoinactivation mechanisms in Propionibacterium acnes for near ultraviolet and visible light. PMID- 3671514 TI - An animal model of solar-aged skin: histological, physical, and visible changes in UV-irradiated hairless mouse skin. PMID- 3671515 TI - Verdins: new photosensitizers for photodynamic therapy. PMID- 3671516 TI - Propranolol, a beta-adrenergic antagonist, retards response to MSH in skin of Anolis carolinensis. AB - Lacking sympathetic innervation, the skin of A. carolinensis, an iguanid lizard, darkens within minutes in response to circulating melanocyte stimulating hormone (MSH) or beta adrenergic agonists such as epinephrine (EPI). This change is produced by dispersion of melanin from a perinculear position within dermal melanophores into superficial dendritic processes. These melanophores possess alpha-2 and beta-2 adrenergic as well as MSH receptors except in a patch of skin behind the eye, the eyespot, which lacks alpha receptors. Activation of beta or MSH receptors leads to stimulation of adenyl cyclase whereas alpha stimulation inhibits the enzyme to override the others. In a series of trials, injection of saline or propranolol was followed after 30 minutes by saline, EPI, or MSH. Propranolol inhibited chromatophore response to EPI. It also, unexpectedly, retarded the response to MSH, increasing latency to eyespot formation and body color change as well as the duration of darkening for both. Alteration of MSH response by a beta blocker could be explained by linkage of both adrenergic receptors and the MSH receptor to a common adenyl cyclase molecule to form a functional unit in the membrane of the melanophore. PMID- 3671517 TI - Sex differences in magnetic field inhibition of morphine-induced responses of wild deer mice, Peromyscus maniculatus triangularis. AB - An exposure for 60 min to a 0.5 Hz weak rotating magnetic field (1.5-90 G) reduced the day-time locomotory and analgesic effects of morphine (10 mg/kg) in a wild population of deer mice. Peromyscus maniculatus triangularis. Females displayed significantly lower levels of morphine-induced responses and sensitivity to the inhibitory effects of the magnetic fields than did the males. These responses indicate that there are sex differences in the effects of weak magnetic fields on the opiate-mediated responses of a wild rodent, with males being more responsive to the magnetic stimuli than females. PMID- 3671518 TI - Carbohydrate taste preferences in rats: glucose, sucrose, maltose, fructose and polycose compared. AB - The taste preferences of adult female rats for solutions of five different carbohydrates were evaluated using brief (3-min) two-bottle preference tests. At the lowest concentration tested (0.03 molar) the order of preference was Polycose greater than maltose greater than sucrose greater than glucose = fructose. Whereas at the highest concentrations tested (0.5 or 1.0 molar) the preference order was sucrose greater than maltose greater than or equal to Polycose greater than glucose greater than fructose. Thus, at low concentrations starch-derived polysaccharides (Polycose) are more palatable to rats than are sugars. These findings are consistent with the hypothesis that rats have separate taste receptors for sugars and for starch-derived polysaccharides. The fact that maltose is the most preferred sugar at low concentrations is attributed to its stimulation of "polysaccharide" taste receptors. PMID- 3671519 TI - The effect of subcutaneous administration of delta sleep-inducing peptide (DSIP) on some parameters of sleep in the cat. AB - Delta sleep inducing peptide (DSIP) significantly increases deep-slow-wave sleep (DSWS) of cats after subcutaneous (SC) injection. Cats (n = 8) were SC injected with DSIP (120 nmol.kg-1) prior to polygraphic recording of EEG combined with electro-oculography, EOG) and electromyography (EMG) for 8 hours. DSIP was found to significantly increase slow-waves (delta sleep) in the sleep EEG. There was a tendency to reduced waking time and a prolongation of slow wave sleep time, and a shortening of sleep onset and REM sleep latencies but the differences from control (Ringer injection) were not statistically significant. There was no change in the amount of REM sleep. These findings support the belief that DSIP can increase sleep wave activity when administered by peripheral route. PMID- 3671520 TI - Central and peripheral injection of quaternary antagonist, SR58002C, reduces drinking. AB - Earlier research has demonstrated that opioid involvement in drinking is primarily mediated centrally [8,10]. Drinking is attenuated by the centrally and peripherally active opioid antagonists naloxone and naltrexone in doses as low as 1.0 mg/kg, but not by the quaternary forms of these antagonists [4]. Peripherally administered quaternary forms of these antagonists fail to suppress drinking in doses as high as 10 mg/kg. We generated dose-response curves for centrally and peripherally administered SR58002C, a "newer" quaternary opioid antagonist purported to have high peripheral selectivity, on drinking in 23.5 hr water deprived rats. SR58002C was administered both intracerebroventricularly (ICV, 0, 10, 40 and 80 micrograms/rat) and intraperitoneally (IP, 0, 10, 40 and 80 mg/kg). Doses of SR58002C above 10 mg/kg IP or 10 micrograms ICV significantly reduced drinking in comparison to controls. However, SR58002C appears to be less potent than quaternary naltrexone in suppressing drinking after ICV administration. PMID- 3671521 TI - Hunger and satiety: a multidimensional assessment of responses to caloric loads. AB - The assessment of hunger in human subjects is complicated by the variety of response systems involved. In the present study, hunger was tracked by subjective, physiological and behavioural responses after identical-tasting high or low calorie preloads. The contribution of nutritional and psychological factors was evaluated by giving half the subjects false information about the caloric content of the preload. Ten women took part, with all subjects participating in each experimental condition and a control condition, in counter balanced order. The results showed that ratings of hunger symptoms, preferred foods, global hunger and satiety in the inter-meal interval were sensitive both to deprivation effects and to differences in the energy content of the preload. No effects of the psychological manipulation (beliefs about caloric content) were observed. At the test meal two hours later, all the subjective responses converged on a single point and physiological and behavioural responses likewise failed to discriminate the different preload conditions. The results are discussed in terms of a loosely-coupled multidimensional model of hunger. PMID- 3671522 TI - Activity and reproductive state in the hamster: independent control by social stimuli and a circadian pacemaker. AB - Entrainment of circadian rhythms by social communication between male and female Syrian hamsters (Mesocricetus auratus) was tested by recording the wheel-running activity of pairs kept in the same cage but separated by a wire mesh barrier. Before pairing, males and females were synchronized to light/dark cycles that were 180 degrees out of phase, and at the time of pairing the hamsters were placed into constant darkness (DD). The activity rhythms of males and females housed in a cage alone (isolated) were also recorded. The freerunning periods of paired and isolated hamsters were not different over six weeks in DD, and no phase-shifts of the paired animals' rhythms were seen, indicating that the close proximity of a hamster of the opposite sex had no effect on the timing of the other's activity/rest rhythm. This was not due to a lack of communication between the paired males and females. Males showed four-day cycles in the amount and distribution of activity which corresponded to the estrous cycle of the female, and regression of the reproductive system which occurred in the isolated hamsters was delayed in both the paired males and females. Despite the fact that locomotor activity and reproduction are each regulated in part by a circadian pacemaker, social stimuli can affect both of these without influencing the circadian pacemaker that underlies the activity/rest rhythm. PMID- 3671523 TI - Actions of progestins on estrous behaviour in female rats. AB - The present study evaluated the facilitative actions of progesterone and the synthetic progestin R 5020 on estrous responsiveness in ovariectomized, estrogen primed female rats. The dose-response and time-response characteristics of the behavior facilitating actions of both progesterone and R 5020 were measured. The threshold doses for the facilitation of estrous behavior in estrogen-primed female rats were 1 microgram of R 5020 and 100 micrograms of progesterone. These doses of progestins facilitated estrous responsiveness with a similar time course that approached maximum at one hour. To examine the possible mechanism(s) of action of each progestin the synthetic progestin antagonist RU 38486 was used. The inhibitory effects of RU 38486 on estrous behavior facilitated by a threshold dose of progesterone or R 5020 were found to be almost identical. RU 38486 (5 mg) administered 1 hr prior to progesterone or R 5020 suppressed lordosis behavior by 44% and 47% respectively. These results suggest that progesterone and R 5020 facilitate estrous responsiveness through the same mechanism. PMID- 3671524 TI - Adrenalectomy and dexamethasone differentially affect postswim antinociception in mice selectively bred for high and low stress-induced analgesia. AB - The effects of dexamethasone and naloxone on analgesia induced by swimming (3 min, 20 degrees C) were studied in the 6th and 7th generations of adrenalectomized and intact mice selectively bred for high (HA) and low (LA) postswim analgesia. Swim-induced analgesia in intact HA animals was significantly reduced by naloxone and dexamethasone while in LA mice these two compounds were ineffective. Naloxone ability to reverse adrenalectomy-caused swim analgesia increase was much greater in HA than in LA mice. In both intact and adrenalectomized HA animals dexamethasone and naloxone decreased postswim analgesia to the level observed in LA mice. It is suggested that selective breeding for high and low swim analgesia modified the extent of pituitary-adrenal axis involvement in the generation of stress-induced analgesia. PMID- 3671525 TI - Lateralization in male rats and dopaminergic system: evidence of right-side population bias. AB - Recent studies have reported population right-biased lateralization in rats, although with low percentages (between 54-59%). The present study investigated the spatial preference of rats in an electrified T-maze during successive days and the influence of ascending dopaminergic systems using apomorphine, a dopamine agonist, as well as ipsilateral and contralateral lesions on the side preference. Results showed a marked right-biased lateralization at both individual and population levels (85.71% of the rats presented a behavioral asymmetry, being 80% right-biased and 20% left-biased within the lateralized group). Also, the results suggest that there is a presynaptic dominance in the contralateral dopaminergic system to the spatial preference in the T-maze and postsynaptic dominance in the ipsilateral side. PMID- 3671526 TI - Effects of food restriction during concurrent lactation and pregnancy in the rat. AB - The ability of rat dams to cope with food restriction as well as a concurrent lactation and pregnancy was examined by varying the duration, time of onset and severity of the food restriction schedule. Groups of females impregnated in the postpartum estrus and nursing 8 pups were either allowed to feed ad lib, given 60% of an ad lib ration from days 1-7, 1-14, 8-14 or 15-21 postpartum or 40% of an ad lib ration from days 1-7. Food restriction regimens that extended through the estimated time of implantation for females nursing 8 pups (days 1-14 and 8 14) resulted in a prolongation of pregnancy. Food restriction in the first week postpartum did not result in a prolongation of pregnancy and did not affect the number of females carrying the pregnancy to term. Dams food restricted in the third week postpartum had pregnancies of the same length as ad lib females but a smaller proportion of this group gave birth to a second litter. PMID- 3671527 TI - Epileptogenesis is associated with heightened arousal responses in fish. AB - Intramuscular injection of sodium penicillin in roach (Rutilus rutilus) caused delayed habituation of arousal responses to repeated presentation of the onset of illumination or of a 'tap' stimulus. Topical application of aluminum hydroxide to the telencephalon of roach had a similar effect but was shown, also, to induce electroencephalographic seizures, in which the EEG amplitude was elevated from 4 20 times its normal level. Both treatments caused intermittent, abnormal 'weaving' behaviour and sporadic, violent, uncoordinated motor activity. In goldfish, Carassius auratus, topical application of aluminum hydroxide also caused delayed habituation of quantitatively measured, cardiac arousal responses to a moving shadow stimulus, compared to controls. This delayed habituation was, however, largely a result of the elevated magnitude of these arousal responses. The results are discussed in relation to brain mechanisms normally operative during arousal which may be hyperactive in epilepsy. PMID- 3671528 TI - Dorso-ventral variation in the attenuating effect of lateral hypothalamic stimulation on the switch-off response elicited from the mesencephalic central gray area. AB - Previous experiments have shown that the lateral hypothalamus (LH) is a heterogeneous structure with respect to self-stimulation and aversion. Specifically it has been reported that stimulation of the dorsal LH region entails consequences which are both more rewarding and more aversive than those due to ventral LH stimulation [5, 7, 8, 16, 18]. The aim of the present study was to compare the effects of electrical stimulation applied to either the dorsal or the ventral regions of the LH on the switch-off response elicited by activation of the dorsal part of the mesencephalic central gray area (CG). This experiment was performed using BALB/c mice. The results obtained show that whatever the LH site, hypothalamic stimulation reduces the aversive effects of CG stimulation; however, ventral LH activation was more effective than the dorsal one. In addition, a close relationship was observed between the tolerance in regard to LH stimulation alone, and the tolerance in regard to combined CG/LH stimulation. These data suggest that the more marked aversive consequences of dorsal LH stimulation represent a limiting factor for the attenuating effect on CG escape responding. PMID- 3671529 TI - Hypothalamic temperature and the 22 kHz vocalization of the male rat. AB - Following ejaculation the male rat emits a 22 kHz vocalization that has been hypothesized to play a communicative role. We found previously that this vocalization is often accompanied by rapid and selective hypothalamic cooling, and we hypothesized that the vocalization or, more precisely, the thoracic laryngeal maneuver underlying the vocalization, is primarily a thermoregulatory behavior. Accordingly, one prediction made herein was that heating the brain of the isolated male, through the infusion of prostaglandin E2, would be accompanied by the vocalization. Another was that cooling the brain of the copulating male through the injection of sodium salicylate would significantly reduce the post ejaculatory vocalization. Both predictions were confirmed. PMID- 3671530 TI - Effects of adaptation and cross-adaptation to common ions on sourness intensity. AB - The effects of self and cross-adaptation of acetic acid and HCl solutions on the perception of sourness, were investigated using a filter paper method. In contrast to acetic acid and to pH-buffered acetic acid solutions, self-adaptation could not be obtained with HCl. In fact the sourness of the HCl test-stimulus after adaptation to HCl was increased compared to the sourness obtained with the unadapted tongue. Such a sourness potentiation was also observed with acetic acid and buffered acetic acid solutions after adaptation to distilled water. The results suggest that the reception process eliciting the sour taste of H+ ions and of undissociated acids are different and probably independent. PMID- 3671531 TI - Prenatal stress reduces estradiol-induced prolactin release in male and female rats. AB - Prenatal stress is a potent disruptor of the normal course of sexual differentiation, affecting both males and females. In the present study, we wished to examine a sexually dimorphic endocrine response, estradiol (E2)-induced prolactin (Prl) release, in prenatally-stressed (P-S) males and females. Sprague Dawley female rats were timed-mated (+ sperm = Day 1). From gestation days 15-22 one group of females was subjected to a thrice-daily regimen of heat and restraint stress (0830, 1230, and 1630 hr) consisting of placing the rats into a Plexiglas restraint tube over which were poised two 100 W floodlights. Control females remained undisturbed throughout pregnancy. At parturition all offspring were cross-fostered to untreated, recently-parturient dams and weaned at 25 days of age. Separate groups of P-S and Control males and females were gonadectomized and, for males, paired testes weights and body weights were recorded. Four days later the animals were implanted with Silastic capsules containing E2, and fitted with intra-atrial cannulae. The following day, blood samples were taken at 0900, 1300, 1500, and 1700 hr for a total of five days. Beginning with the 1700 hr sample on Day 2, and with the exception of the 1500 hr sample on Day 3, P-S males had significantly lower plasma Prl values than Control males through Day 4, and at the 1500 hr sample on Day 5. Moreover, at no point did P-S males exhibit a significant daily afternoon increase in Prl values, whereas Control males did so on Days 2 and 4.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671532 TI - Scent marking and the maintenance of dominant/subordinate status in male golden hamsters. AB - Since it is thought that flank marking communicates dominance status, experiments were designed to look at changes in aggression and flank marking behaviors in pairs of male hamsters with intact flank glands (Experiment One) or when one (Experiment Two) or both (Experiment Three) members of a pair had their flank glands surgically removed. In Experiment One the dominant members of twelve pairs of hamsters had a mean daily frequency of flank marks that was over two-fold greater than their subordinate partners, F(1,11) = 17.59, p less than 0.001. Over the course of five consecutive daily tests there was a significant decrease in the aggression index of both the dominant, t(44) = 4.49, p less than 0.01, and subordinate, t(44) = 3.33, p less than 0.01, hamsters. Accompanying the decrease in aggression was a significant increase in the flank marking of both dominant, t(44) = 7.8, p less than 0.01, and subordinate, t(44) = 3.59, p less than 0.01, hamsters. In Experiment Two, six out of eleven flank glandectomized hamsters were dominant over their sham operated partners while the remaining five were subordinate. Unlike Experiment One there was no significant difference in the flank marking between dominant and subordinate hamsters, in fact, in seven pairs the subordinate hamsters flank marked more than their dominant partners. In Experiment Three both hamsters had their flank glands removed, and as in Experiment Two, there was no significant difference in flank marking between dominant and subordinate hamsters, neither was there any significant change in their aggression and flank marking behaviors over the course of the five test periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671533 TI - Silent ovulation in rhesus monkeys (M. mulatta): dissociation of hormonal and behavioral states. AB - Ovarian hormone levels were monitored in rhesus monkeys during the breeding and non-breeding seasons. Ovulation (as inferred from progesterone levels in blood serum in excess of 1.5 ng/ml) was most frequent in the breeding season but was absent only during the month of August. Summer (non-breeding season) ovulations were more frequently "silent," or without heterosexual behavior, than were winter ovulations. This finding suggested that estradiol stimulation may cause different behavioral responses at different times of the year. To test this hypothesis, ovariectomized females were treated with subcutaneously implanted estradiol capsules at different times within and outside the normal breeding season. In either season, treatment with estradiol resulted in increased female-to-female sexual behavior. Only during the breeding season, however, did the estradiol treated ovariectomized females interact sexually with males. Although males copulated with both estradiol-treated and gonadally intact, untreated females during the breeding season, their rate of copulation with the intact females was higher. The results suggest that: (1) Some female rhesus monkeys displaying strictly seasonal breeding behavior continue to have luteal activity indicative of ovulation in May, June and July, (2) Summer ovulatory cycles are rarely accompanied by sexual behavior, (3) Estradiol treatment of ovariectomized females induces female-to-female sexual behavior both in the breeding and non-breeding seasons, and (4) Males are less responsive to the presence of estrogen-stimulated females in the non-breeding season than in the breeding season. PMID- 3671535 TI - Increase in body weight of spontaneously hypertensive rats (SHR) under prolonged behavioral stimulation. AB - We noticed that during 44 weeks of exposure to a number of behavioral tests (such as assessments of emotionality, locomotion, short term memory and visual discrimination learning) the body weight of spontaneously hypertensive rats (SHR) increased above that of normotensive controls (NT). To determine whether this difference was related to "behavioral stimulation" resulting from different testing situations and accompanying handling, body weights were recorded in other SHR and NT groups not subjected to any experiment (unstimulated). Stimulated SHR were significantly heavier than rats from other subgroups (unstimulated SHR as well as stimulated and unstimulated NT rats) which did not differ from one another. The first significant difference appeared after 7 weeks of behavioral training (18th week of life). Several weeks later, and continuing for the duration of study, stimulated SHR were approximately 12% heavier than the other 3 groups. No effect of behavioral testing on blood pressure was seen in either strain. PMID- 3671534 TI - Early weaning effects on voluntary ethanol consumption and stress responsivity in rats. AB - The present study examined the effect of early maternal deprivation (early weaning) on voluntary ethanol consumption and responses to cold-immobilization stress in adult rats. Rats were weaned at 16 and 21 days of age and housed individually with food and water ad lib until they reached 190 +/- 5 g at which time half of the animals from each group were exposed to increasing concentrations (3 to 9%) of ethanol in a free choice with water every alternate day. Following acquisition of ethanol drinking, animals were provided with water and ethanol (9%) daily for eight days. At the end of this period, animals were divided into stressed and non-stressed groups. Stressed animals were exposed to cold immobilization stress for 3 hr. Results showed that the early-weaned animals consumed significantly more ethanol as compared to normal-weaned animals. Stomach pathology data revealed little ulcer formation in water-only groups. However, normal-weaned/ethanol-exposed animals exhibited significantly more severe ulcers when compared to all other water- or ethanol-exposed groups. We suggest that early maternal deprivation may predispose animals to increased ethanol consumption as adults. Stress ulcer susceptibility in these animals was likely influenced by interactions among the effects of early weaning, ethanol intake and handling and needs further clarification. PMID- 3671536 TI - Developmental, sexual and reproductive differences in habituation shown by the guppy (Poecilia reticulata). AB - Behavioural arousal responses of guppies (Poecilia reticulata) were observed to repeated presentation of 2 seconds increased illumination at 30 second intervals. Habituation of responses occurred more rapidly in males than in females and habituation in females was related to their reproductive state. Exposure of gravid females for 8 days to a daily series of stimuli resulted in their young having enhanced habituation postnatally. The results are discussed in relation to developmental and possible hormonal influences on arousal and its habituation in fish. PMID- 3671537 TI - Social structure and plasma corticosterone level in female albino mice. AB - Five week old female albino mice were grouped two, three, four and five per cage. Social rank was established by observation according to eight parameters. Social structure in caged female laboratory mice is dependent on the number of animals per cage. Blood samples taken from each animal showed a significantly lower corticosterone level in the plasma of dominant female albino mice compared with their subdominant social partners. PMID- 3671538 TI - Competitive behavior in male rats: aggression and success enhanced by medial hypothalamic lesions as well as by testosterone implants. AB - Castrated male hooded rats were given electrolytic lesions of the medial hypothalamus or sham lesions. Another group of castrated rats was implanted subcutaneously with bilateral testosterone-filled Silastic capsules or empty capsules. Lesioned animals with a high defensiveness (reactivity) score toward the experimenter were each placed in a cage with a sham-lesioned animal of a similar weight. Animals with testosterone implants were likewise housed with an animal of similar weight without a testosterone implant. Following a period of adaptation to a 23-hr water deprivation schedule, each pair of rats was given daily competition tests on each of 6 days. During the tests, a single water spout was placed in the cage for a 4-min period. The spout was surrounded by a plastic ring which prevented more than one animal from drinking at any time. Access to an unencumbered water spout was present following the competition test for 1-hr each day. Rats with medial hypothalamic lesions displayed more aggression than sham lesioned rats during the competition tests and were able to spend more time drinking. Rats with testosterone implants were more successful in maintaining access to the spout but did not consistently display more aggression than their cagemates without testosterone implants. The aggression of the lesioned rats was defensive while that of animals with testosterone implants corresponded to intermale social aggression. These results demonstrate that a competitive situation can elicit intermale social aggression mediated by testosterone and defensiveness induced by medial hypothalamic lesions. PMID- 3671539 TI - Lordosis behavior in males of two inbred strains of guinea pig. AB - The lordosis behavior of male guinea pigs from inbred strains 2 and 13 was examined. Significantly more isolated gonadally intact males of strain 2 than strain 13 displayed lordosis. Castration did not decrease the display of lordosis. In castrated strain 2 males, those which showed lordosis did not have higher plasma androgen, estrone or estradiol levels than those which did not show lordosis. They also did not differ hormonally from ovariectomized strain 2 females even though strain 2 females never showed lordosis without hormone replacement. Although the lordosis shown by strain 2 males was not related to endogenous gonadal hormone levels, estradiol benzoate (EB) administration facilitated lordosis. EB had no clear effect on lordosis in strain 13 males. Progesterone after EB priming had no further facilitative effect in males of either strain. These results indicate that lordosis is more readily elicited from strain 2 than strain 13 males. Furthermore, lordosis in strain 2 males is not dependent upon gonadal hormones for its display although it is facilitated by EB (but not progesterone). PMID- 3671540 TI - Effects of early separation of young rats from the mother on their open-field behavior. AB - Changes were studied in the open-field behavior of young rats prematurely separated from their mothers at different ages. Premature separation from the mother on days 15 and 18 of life increased their fear or emotional behavior, as measured by the amount of defecation and locomotor activity. The changes in rats' open-field behavior were due to the absence of the mother rather than to an inadequate food supply after the day of separation. PMID- 3671541 TI - Reproductive state and motor activity in female ferrets. AB - The pattern of motor activity in female ferrets (Mustela putorius furo) housed in cages mounted upon rocker platforms was followed under conditions of short-(8 hr) and long-(16 hr) day illumination. A distinct diurnal rhythm was evident that remained unchanged after lesioning of the anterior hypothalamus. The level of activity did not differ between animals kept under short days and long days, between anoestrous and oestrous females, or during the development or waning of oestrus. Ovariectomy did not affect the pattern of activity. These findings are at variance with those of a previous study where wheel-running activity was followed and oestrous females found to be more active than anoestrous ferrets. PMID- 3671543 TI - Effects of postoperative environment on recovery of function after fimbria-fornix transection in the rat. AB - We have previously found that rats given dorsal hippocampus lesions show reduced deficits on maze learning, spontaneous alternation and extinction tasks when housed postoperatively in an "enriched" as opposed to an "impoverished" environment. In contrast, postoperative enriched conditions were ineffective in rats given bilateral entorhinal cortex lesions. In this study, we examined whether postoperative differential housing would reduce the impairment in radial maze performance induced by fimbria-fornix transections. Significant interactions were found between lesion state and housing condition for the total number of errors made, the number of errors on the first eight arms visited and for the number of arms visited before the first error in an 8-arm maze. The interaction was due to the fact that, in sham-operated rats, isolated ones made more errors than enriched counterparts whereas, in rats with lesions, enriched ones showed no improvement of performance in comparison to isolated counterparts. These data suggest that the integrity of fimbria-fornix pathways is an important factor for the expression of facilitated maze performance in intact enriched rats and in enriched rats with hippocampal system damage. PMID- 3671542 TI - Rat strain comparisons on drug and sleep sensitive behaviors. AB - Rat swimming behaviors have been productive in both sleep research and neuropharmacology. In this report, both of these areas are addressed in the context of inbred strain effects. Thirty-two rats from three stocks were tested in a seven day, repeated measures design. Each rat swam for 5 min each day in shallow 25 degrees C water. There were significant differences between inbred stocks on two measures which can be related to both REM sleep deprivation and adrenergic drug effects. Nonsignificant strain differences were found on two other behaviors which also lack significance under REM sleep deprivation and atropine sulfate treatments. It is concluded that there may be differential stress affecting the treatment-sensitive and the change-resistant behaviors. PMID- 3671544 TI - Attractivity of male rats induced by estradiol and progesterone. AB - From the present study it appears that castrated male rats can be made attractive to intact males by estradiol benzoate plus progesterone (EB + P). For the determination of attractivity a residential plus-maze was used in which the resident male could choose between the company of the experimental male and that of an ovariectomized female with or without EB + P. In one experiment the males were castrated in adulthood; these animals were less attractive than the ovariectomized females with a similar hormone treatment. In a second experiment it was found that males that had been castrated at birth were as attractive as the ovariectomized females, after treatment with EB + P. These findings indicate that the attractivity that can be induced by EP + P in gonadectomized adult rats is somewhat but not wholly reduced if androgen is present during the neonatal period. PMID- 3671545 TI - Opposed locomotor asymmetries following lesions of the medial and lateral substantia nigra pars compacta or pars reticulata in the rat. AB - In animals with lesions in the medial or lateral portions of the substantia nigra pars compacta (SNC) amphetamine produces circling in opposite directions. The present study examined the relationships between lesion site and the direction of circling using glyoxylic acid histofluorescence to visualize DA cells. Lesions were produced by 6-hydroxydopamine (2-6 micrograms) or 0.05% ascorbate injected into the SN. After lesions in the medial SNC, amphetamine caused rats to circle ipsiversive to the lesion while after lateral SNC lesions rats circled contraversively. When the lesion extended to the middle of the SNC, or deeper into the SN pars reticulata (SNR), the direction of circling was unpredictable. When the damage produced by the cannula track and ascorbate injection was in the lateral SNR animals circled ipsiversively while medial SNR damage led to contraversive circling. Thus the medial and lateral SN, and the pars compacta and pars reticulata, are functionally antagonistic. This four way division of the SN is consistent with the topographic mapping of SNC to striatum and striatum to SNR. PMID- 3671546 TI - Effects of a selective alpha 1-adrenoceptor agonist, methoxamine, on sexual behavior and penile reflexes. AB - Methoxamine, an adrenergic agonist with selectivity for the alpha 1-adrenoceptor, when administered intraperitoneally 10 minutes prior to mating tests (1 to 5 mg/kg), effected reductions in the ejaculatory threshold, evidenced by a decrease in the number of intromissions preceding ejaculation. In mounting tests after penile anesthetization, a test which specifically assesses sexual motivation, 3 mg/kg methoxamine was without a stimulatory effect. Further, in penile reflex tests (ex copula) 1 mg/kg methoxamine was without effect, whereas 5 mg/kg decreased the number of erections, cups and flips per test, and increased the incidence of seminal emission. These data indicate a facilitation of the ejaculatory mechanism, both in and ex copula, coupled with an inhibition of erectile responses for moderate doses of methoxamine. Treatment of male rats with the alpha 2-adrenoceptor agonist clonidine (0.25 mg/kg, IP, five minutes pretest) drastically reduced the number of animals exhibiting intromissive and ejaculatory behavior in mating tests. This suppressive effect of clonidine was not prevented by prior treatment with methoxamine (3 mg/kg, 10 minutes pretest and five minutes preclonidine). Further, ST-91, a polar analog of clonidine which does not readily enter the central nervous system, was without effect on male sexual behavior. Since (1) the effects of methoxamine administration are not of similar quality or magnitude to those reported earlier after yohimbine, an alpha 2-adrenoceptor antagonist, (2) since concurrent stimulation of alpha 1- (by methoxamine) and alpha 2- (by clonidine) adrenoceptors is followed by a suppression of sexual behavior similar to that seen after clonidine alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671547 TI - Oral lesions in the chicken: behavioural responses following nociceptive stimulation. AB - The behaviour of normal birds and birds with ulcerated buccal lesions was described following oral stimulation with Acetylcholine chloride (ACh) and Bradykinin (BK). Both groups of birds showed normal oral behaviour but a number of birds with oral lesions showed a behaviour pattern which had been previously seen in our laboratory following nociceptive stimulation. The birds remained motionless in a crouch-like stance with the head pulled into the body and a significantly reduced number of alert head movements. The onset and duration of this immobility response was compared with reports of pain in humans in the blister-base test using similar concentrations of ACh and BK. It was concluded that nocifensive responses of the chicken fulfil many of the requirements for the definition of pain in animals. PMID- 3671548 TI - Behavioral lateralization in the T-maze and monoaminergic brain asymmetries. AB - Recently we have reported a marked rat lateralization in the T-maze choice. The present study examines the relationship between the ascending monoaminergic systems and the T-maze behavioral asymmetry. There were no significant differences for serotonin or norepinephrine between the T-maze preferred and non preferred brain sides in the s. nigra, ventral tegmental area, striatum, acumbens, frontal lobe or hippocampus. Only in the hippocampus was dopamine concentration significantly greater for the brain site ipsilateral to the T-maze choice side. Previously, we reported that both apomorphine, a dopamine receptor agonist, and 6-hydroxydopamine lesion in the medial forebrain bundle of the catecholaminergic neurons affect the T-maze asymmetry; we therefore suggested that the T-maze choice could be related with the ascending dopaminergic systems. The present data strongly support this hypothesis and suggest that the DA cells involved in the spatial asymmetry in the T-maze are included in the dopaminergic mesohippocampal system. PMID- 3671549 TI - Use of the radial maze in studies of phencyclidine and other drugs of abuse. AB - Effects of drugs known to disrupt performance in an 8-arm radial maze are reported in terms of changes caused in the pattern of arm entry. Phencyclidine (PCP) and N-allyl-N-normetazocine (SKF-10,047) alter the pattern of arm entry in a way which distinguishes their actions from those of scopolamine and certain serotonergic agonists. The apparent rank order of potencies for causing this effect is (+)SKF-10,047 greater than PCP greater than (-)SKF-10,047. Results of previous radial maze studies evaluating the interactions of clonidine and verapamil with PCP are summarized. Data are reported which indicate that the ability of verapamil to potentiate PCP's behavioral effects stems from an alteration of the pharmacokinetics of PCP; when verapamil (20 mg/kg, IP) was administered 15 minutes before [3H]PCP (40 microCi/kg, IP), brain levels of tritium were increased by 154 to 225 percent. Finally, possible advantages of using a 4-arm radial maze in studies of PCP and related drugs are discussed. PMID- 3671550 TI - Blood levels of 1,8-cineole and locomotor activity of mice after inhalation and oral administration of rosemary oil. PMID- 3671551 TI - Investigation of the anti-tumor action of eupatoriopicrin against the Lewis lung tumour. PMID- 3671552 TI - Effects of cirsimaritin, a flavone isolated from Artemisia judaica, on isolated guinea-pig ileum. PMID- 3671553 TI - A uterine relaxant compound from Zingiber cassumunar. PMID- 3671554 TI - Preliminary study of phenolic glycosides from Origanum majorana; quantitative estimation of arbutin; cytotoxic activity of hydroquinone. PMID- 3671555 TI - Analysis and processing of Chinese herbal drugs; VI. The study of Angelicae radix. PMID- 3671556 TI - Studies on medicinal plants in Paraguay; studies on "Romero"; Part 1. PMID- 3671557 TI - Electrical injury mechanisms: dynamics of the thermal response. AB - The thermal response of the human upper extremity to large electric currents was examined using an axisymmetric unidimensional model containing bone, skeletal muscle, fat, and skin in coaxial cylindrical geometry. Appropriate thermal and electrical properties were assigned to each tissue, and the tissue response to joule heating was determined by a finite-element numerical technique. We found that when the tissues are electrically in parallel, skeletal muscle sustained the largest temperature rise and then heated adjacent tissues. Thus, when bone is not in series with other tissues, joule heating of bone is unlikely to be responsible for thermal damage to adjacent tissue. In addition, the effect of tissue perfusion on the thermal response was found to be essential for rapid cooling of the centrally located tissues. PMID- 3671558 TI - Electrical injury mechanisms: electrical breakdown of cell membranes. AB - Electric fields are capable of damaging cells through both thermal and nonthermal mechanisms. While joule heating is generally recognized to mediate tissue injury in electrical trauma, the possible role of electrical breakdown of cell membranes has not been thoroughly considered. Evidence is presented suggestive that in many instances of electrical trauma the local electrical field is of sufficient magnitude to cause electrical breakdown of cell membranes and cell lysis. In theory, large cells such as muscle and nerve cells are more vulnerable to electrical breakdown. To illustrate the significance of cell size and orientation, a geometrically simple model of an elongated cell is analyzed. PMID- 3671559 TI - Lacrimal gland involvement in zygomaticofrontal fracture sites. AB - Injury to the lacrimal gland following fracture of the zygomatic complex is a rare occurrence. Recently, we have observed three cases of herniation of the lacrimal gland between the diastased frontal and zygomatic bone ends. We present these cases, postulate a mechanism for this phenomenon, and advocate open reduction and internal fixation in the primary management of severe distraction. PMID- 3671560 TI - Surgical anatomy of the mimic muscle system and the facial nerve: importance for reconstructive and aesthetic surgery. AB - Mimic muscles are arranged in four layers regarding their origins, and these four layers should be considered when muscle tissue is added or lifted. All mimic muscles are built up by parallel fibers. Mean values of length, width, and thickness of the three lip elevators have been determined. These data might be of importance when dealing with this muscle system, which appears rather different from all other muscles in the human. The individual muscles receive their innervating facial nerve branches from their deeper surface when they belong to the superficial (first, second, or third) layer and from outside when they lie in the deepest (fourth) layer. Nerve branches communicate at least four times before innervating their respective muscles. PMID- 3671561 TI - Mammographic changes following reduction mammaplasty. AB - Mammographic findings after reduction mammaplasty may be similar to those seen with carcinoma. A knowledge of the expected mammographic alterations would be helpful in differentiating postoperative changes from those seen with carcinoma of the breast. Accordingly, the clinical records and mammograms of patients who underwent reduction mammaplasty at the Dartmouth-Hitchcock Medical Center between March of 1977 and July of 1985 were analyzed. Forty-two patients had at least one mammographic examination following reduction mammaplasty. Periareolar soft-tissue changes and inferior pole alterations were present in almost all examinations of patients during the first 6 months after operation, but they decreased during the next few years. Asymmetrical densities were present in approximately half the patients throughout the follow-up period but decreased in degree. Parenchymal calcifications occurred later; few x-rays showed these calcifications during the first year, but 50 percent were apparent after 2 years. Evidence of fat necrosis occurred in approximately 10 percent. Four patients had biopsies for suspicious densities. Chronic inflammation and inclusion cyst were reported. We believe that changes after reduction mammaplasty are predictable and can usually be differentiated from those associated with cancer. PMID- 3671562 TI - The psychological contribution of nipple addition in breast reconstruction. AB - Two groups of consecutive patients from two different plastic surgical practice populations were evaluated to determine psychosocial differences between those who underwent nipple-areola reconstruction in addition to breast reconstruction (N = 33) versus those who did not undergo nipple-areola reconstruction in addition to breast reconstruction (N = 26). Psychological assessment consisted of a standardized symptom inventory (Brief Symptom Inventory) and a specially designed self-report questionnaire investigating reactions unique to surgeries for breast cancer and breast reconstruction. Both groups were equivalent sociodemographically, with the exception of age, where the nipple-added group was significantly younger (P = 0.035) than the nipple-not-added group. The nipple added group reported significantly greater satisfaction with breast reconstruction with regard to overall satisfaction (P = 0.004), satisfaction with size (P = 0.02), satisfaction with softness (P = 0.0004), sexual sensitivity (P = 0.006), and satisfaction with nude appearance (P = 0.02). Of the nine scales of clinical symptomatology on the Brief Symptom Inventory, the nipple-added group showed more increased symptoms on seven of the nine. The nipple-added group was significantly higher on two of these scales, namely, paranoid ideation (P = 0.009) and anxiety (P = 0.03). PMID- 3671563 TI - Regional differences in the skin blood flow at various sites of the body studied by xenon 133. AB - Normal skin blood flow was measured by the xenon 133 clearance method at different anatomic sites of the body and the following results were obtained. First, the skin blood flow of the face and anterior chest was significantly greater than that of the deltoid region (P less than 0.01). The skin blood flow of the dorsal side of the hand and foot was significantly lower than that of the deltoid region (P less than 0.01). A tendency was observed for the skin blood flow to decrease gradually from the upper part of the body to the lower part of the body. For example, the ratio of the highest value at the face to the lowest value at the dorsal side of the foot was about 2.5:1, indicating a remarkable difference among the various sites of the body. The skin blood flow at the dorsum of the hand was significantly higher by about 25.4 percent than that of the foot (P less than 0.01). Second, the skin blood flow at the left side of the deltoid region was higher by about 5 percent than that of the right side (P less than 0.01). Bilateral comparison of the skin blood flow at the dorsal side of the hand and foot showed that the values were almost the same on the left and right. PMID- 3671564 TI - Reality in plastic surgery: a plea for complete disclosure of results. PMID- 3671565 TI - Scalp infections in black children: think kerion. AB - Treatment of tinea capitis consists of a 5-week course of griseofulvin. A 1-week course of a systemic corticosteroid may be considered in addition to griseofulvin therapy to accelerate the subsidence of inflammation in kerion lesions. Kerion is an inflammatory form of tinea capitis which may progress rapidly into a fulminant infection if untreated. This case report underscores the need for prompt recognition and appropriate treatment of this disorder. PMID- 3671566 TI - Salvage of infected expanded scalp without loss of flap length. AB - This case presents the dilemma of a scalp infection emerging at the conclusion of soft-tissue expansion. Basic principles of wound infection would dictate that the foreign body (the inflatable prosthesis) be removed and that the infection be treated before inset of the flap. The prevention of possible loss of flap length due to skin contraction during treatment of the infection was avoided by stretching the flap over the intact scalp temporarily, thus maintaining its expanded status. PMID- 3671568 TI - Skull molding caps: an adjunct to craniosynostosis surgery. AB - External cranial vault molding using dynamic splinting is an adjunct to surgery in the treatment of craniosynostosis skull deformities. The skull molding cap not only maintains desired skull form, but also provides further active molding to normalize skull shape. Dynamic skull remodeling from these devices occurs primarily by translational movements of bone. Traction and compression result in bony repositioning which allows further reshaping as the osteoblasts and osteoclasts respond to these stresses. Three basic designs have been described. In practice, each one must be modified to meet individual needs, and adaptations are made according to established principles of dynamic splinting. PMID- 3671567 TI - Unilateral athelia with a subcutaneous dermoid cyst. AB - A case of unilateral athelia with a subcutaneous dermoid cyst in the area in question is reported. The histologic features of the cyst wall suggest that it is derived from a base in the nipple-areola complex. Dozens of cases of congenital absence of the breast have been reported, some of them associated with congenital anhidrotic ectodermal dysplasia, others with additional musculoskeletal abnormalities, and still others normal in other respects. But to our knowledge, the combination of athelia and corresponding subcutaneous dermoid cyst has not been reported. PMID- 3671569 TI - Sympathetic dystrophy. PMID- 3671570 TI - Survival of transferred intestine after interruption of blood supply. PMID- 3671571 TI - An i.v. cannula stent for ear piercing. PMID- 3671572 TI - Advertising by plastic surgeons. PMID- 3671573 TI - Absorbable gelatin film: a useful carrier for intranasal grafts. PMID- 3671574 TI - Authoritis: a preliminary report. PMID- 3671575 TI - Hidradenitis suppurativa. PMID- 3671576 TI - Silver nitrate for skin marking. PMID- 3671577 TI - Survival of flaps and grafts. PMID- 3671579 TI - Update on allergy. PMID- 3671578 TI - AIDS and dermabrasion. PMID- 3671580 TI - Allergens. AB - The environment contains a huge array of allergens, primarily proteins or glycoproteins, to which the atopic individual may become sensitized. In situations of high exposure and highly reactive substances, even nonatopic individuals may develop allergic antibodies. The individual's response depends on the underlying immune responsiveness, the dosage, frequency, route, and possibly the chemical nature of the allergen. Most allergenic sources contain multiple allergenic determinants, as demonstrated by characterization of pollen and mold extracts. Major allergens are acidic proteins with weights in the 20,000 to 40,000 dalton range, and pIs in the 4 to 6 range. Minor allergens may be larger or smaller and either acidic or basic. These conclusions are based on the isolation of a relatively small number of allergens. Cross-reactivity data, especially with the pollens, are useful in the rational formulation of immunotherapy extracts. Considering the wealth of allergenic pollens, information available to date is very scanty. Data on molds, epidermals, and mites are even more preliminary or conflicting. As further research proceeds on purifying and characterizing allergens, a number of these questions and conflicts will be resolved. PMID- 3671581 TI - Insect sting allergy. AB - Hymenoptera venom is a well recognized cause of allergic reactions. These allergic reactions are common and may at times be life threatening. Precautions such as avoidance and the possession (and use) of epinephrine can decrease the incidence and severity of such reactions. Venom immunotherapy is the treatment of choice in those patients who have had systemic allergic reactions and are shown to be vespid allergic by skin testing. PMID- 3671582 TI - [Plasma amitriptyline levels and its therapeutic effect in endogenous depression]. PMID- 3671584 TI - [Social isolation of mentally ill persons exemplified by 2 patients (mother and daughter)]. PMID- 3671583 TI - [Synergistic effect of lithium and thymoleptics in endogenous depression]. PMID- 3671585 TI - [Psychiatric health services in Finland]. PMID- 3671586 TI - [Evaluation of sexual and seminalogic activities in patients treated for epilepsy]. PMID- 3671587 TI - [Educational influence of families of schizophrenic patients treated at the State Institute of Psychiatry with regard to the patients' health and social needs]. PMID- 3671588 TI - [Everyday psychiatry--a contribution to the hermeneutics of diagnostic and therapeutic clinical practice]. AB - The relations between diagnostic and therapeutic practice and the events of everyday life are investigated in a two-fold regard. The first view is directed towards the signification of "psychiatry" and of the psychiatric view-points in the everyday life of society; the second view is the experience of everyday life inside psychiatric institutions. Under both aspects an interest in the development and the both aspects an interest in the development and the process of mental illness is pursued, which is also an interest in correct diagnostic insight and in promoting therapeutic consequence that positively influences the process. PMID- 3671589 TI - [Effect of the hodja (magic healer) on Turkish psychiatric patients in West Germany--an evaluation of clinical examples]. AB - Turkish magic healers called hodjas are working in West-Germany today. Our knowledge about their influence on Turkish patients is poor. They are consulted at least from patients with psychogenous diseases. The degree and the multiple dimensions of their influence and the possibility for the doctor to master the conflicting cultural identity of these patients is demonstrated on the base of four clinical case-histories. PMID- 3671590 TI - [A communications theory approach to the mechanisms of development of psychiatric disorders exemplified by foreign workers]. AB - This article is intended as a contribution towards interpreting the development of psychiatric symptoms as a final result of disturbed processes of communication. We should like to point out that the importance of communication for normal and abnormal behaviour has been established both from the viewpoints of sociopsychology and family therapy as well as of cognition psychology and psychophysiology. The present study is limited to the presentation of clinical aspects, but it should be pointed out that a systematic phase concept of treatment can be developed via an integration of psychophysiological research studies on this subject; however, we have not gone into this possibility in detail in the present study. PMID- 3671591 TI - [Client-centered self-experience groups in male alcohol-dependent patients]. AB - 104 group sessions with 59 male alcoholics were classified under 9 themes. At the beginning of self-experience sessions, all patients looked back to their drinking history. 8 patients reported mere facts, whereas 51 patients expressed their emotional involvement. Drinking style and themes of self-experience could not be definitely correlated. There was a statistical tendency for alcoholics with loss of control (Gamma-alcoholics) to describe themselves as craving for adventure, as men who tend to live according to their momentary needs whenever possible. Alcoholics with inability to abstain (Delta-alcoholics) describe themselves more often than Gamma-alcoholics as passive hangers-on, as persons who tend to drink as others do, who do not worry much about their alcohol intake, who become aware, by somatic and social consequences, that they cannot go on living as before. These results were compared to results found in research literature. It is astonishing that so little work has been done to find out the themes presented by alcoholics in the course of self-experience. PMID- 3671593 TI - Size and cognitive development in the early preschool years. PMID- 3671592 TI - [Day clinic treatment of substance-dependent patients]. AB - The authors are of the opinion that not enough use is being made of the possibility to treat patients suffering from various kinds of dependence, in special day hospitals or departments. Two different models are reported: briefly, the possibility of day hospital treatment instead of inpatient care, and in detail the type of treatment practised in Bremen following short-term inpatient treatment. The article describes the indications for admission, course of treatment, and handling of relapses, as well as the results of catamnestic follow up questioning. The results encourage continuation of day hospital facilities and their increased utilisation. PMID- 3671594 TI - Neuropsychological deficit and learning disability in children with psychiatric disorders: a preliminary report. PMID- 3671595 TI - Depression and health behavior of adolescents. PMID- 3671596 TI - Smoking control in a hospital setting: a nonsmoking canteen eating area. PMID- 3671597 TI - Intrafamily communication and familial environment. PMID- 3671598 TI - Cognitive styles of school-age children showing attention deficit disorders with hyperactivity. PMID- 3671599 TI - Agreement among different measurements of type A behavior in adolescents and young adults. PMID- 3671600 TI - Expression of anger: its relationship to assertion and social desirability among college women. PMID- 3671601 TI - Validation of the Sociomoral Reflection Objective Measure--Short Form. PMID- 3671602 TI - Classical conditioning with suitable controls in the classroom: a refinement. PMID- 3671603 TI - Drugs used by students: caffeine, tobacco, marihuana, cocaine and alcohol. PMID- 3671604 TI - Differences in adolescents' self-esteem across cultures. PMID- 3671605 TI - When an AIDS child enters the classroom: moral-psychological research questions. PMID- 3671606 TI - Benefits of marriage for reducing risk of violent death from suicide and homicide for white and nonwhite persons: generalizing Gove's findings. PMID- 3671607 TI - Some health-risk benefits of behavioral weight-loss treatments. PMID- 3671608 TI - Symbol use by developmentally disabled children. PMID- 3671610 TI - Nonmedical management of intractible hiccups: a brief review of the literature. PMID- 3671609 TI - Suicide and homicide at Easter. PMID- 3671611 TI - History and validities of the Serkownek subscales for MMPI scales 5 and 0. PMID- 3671612 TI - Psychological distress and well-being in Hare Krishnas. PMID- 3671613 TI - Experiences of forgiveness in physicians whose medical treatment was not successful. PMID- 3671614 TI - On using public media for prevention of rape. PMID- 3671615 TI - Somatomotor thresholds in the New Zealand albino rabbit in response to paraorbital electric shock. PMID- 3671616 TI - Comparative analysis of the 'good moments' in rational-emotive and experiential psychotherapies. PMID- 3671617 TI - 1986 Stanford-Binet abbreviated forms. PMID- 3671618 TI - Classification of psychopathology according to a scientific (psychology and psychiatry) and an artistic (film noir) perspective. PMID- 3671619 TI - Human circadian patterns of memory processes: chronopsychology of rates of forgetting, a rhythmometric study. PMID- 3671620 TI - Children's oral hygiene: spot checks and contingency management are equivalent. PMID- 3671621 TI - Comments on "The orthogonality of extraversion and neuroticism scales". PMID- 3671622 TI - Short-term memory for two meaningful stories and self-report on the adult Eysenck Personality Questionnaire. PMID- 3671624 TI - Differentiation of genuine suicide notes. PMID- 3671623 TI - Comments on the orthogonality of extraversion and neuroticism scales of the Eysenck Personality Inventory. PMID- 3671625 TI - Test-retest reliability of Battle's Depression Inventory for Children. PMID- 3671626 TI - Relation of depression to anger and hostility constructs. PMID- 3671627 TI - Elementary teachers' cognitive and affective perceptions of exceptional children. PMID- 3671629 TI - Visual attention: race models for selection from multielement displays. PMID- 3671628 TI - Different trends in perceptual pattern microgenesis as a function of the spatial range of local brightness averaging. Towards an empirical method for the differentiation between global and local levels of form as related to processing in real time. PMID- 3671630 TI - Is attention allocation sensitive to word informativeness? PMID- 3671631 TI - Loci of phonological effects in the lexical access of words written in a shallow orthography. PMID- 3671632 TI - Visual discrimination and response programming. PMID- 3671633 TI - Personality and risk of cancer: 20-year follow-up of the Western Electric Study. AB - Psychologic depression as measured by the Minnesota Multiphasic Personality Inventory (MMPI) in a cohort of 2018 middle-aged men employed at the Western Electric Company in 1957-1958 was positively associated with 20-year incidence and mortality from cancer. The association with incidence was apparent only during the first 10 years of follow-up, but the association with mortality was observed for the full 20 years of follow-up. The association persisted after adjustment for age, number of cigarettes smoked, alcohol intake, occupational status, family history of cancer, body mass index, and serum cholesterol. The association did not appear to be stronger for one type of cancer than another, but the power of this study to detect differences among types of cancer was limited by small numbers. However, the association did appear to be stronger with risk of fatal cancer than with total incidence. No association was noted between other variables measured by the MMPI or Cattell 16 Personality Factor Inventory and subsequent incidence or mortality from cancer. Specifically, the data did not support the hypothesis that psychologic repression, as measured by Welsh R scale in the MMPI, would be associated with risk of cancer. These results are consistent with previously reported results that have suggested that psychologic depression might promote the development and spread of malignant neoplasms. PMID- 3671634 TI - Suspiciousness, health, and mortality: a follow-up study of 500 older adults. AB - Scores on Factor L of the 16 PF, a measure of suspiciousness that is closely related to the Cook and Medley hostility scale, predicted survival in a sample of 500 older men and women during a follow-up of approximately 15 years. Those individuals with scores indicating higher levels of suspiciousness had greater mortality risk. This association remained significant after controlling for age, sex, physician's ratings of functional health, smoking, cholesterol, and alcohol intake. In addition, Factor L was associated with physician's ratings of health at the initiation of follow-up. These findings add to the weight of evidence that implicates a set of negative interpersonal attitudes in the domain of hostility, anger, cynicism, and mistrust as a prospective marker of individuals at risk for adverse health outcomes. PMID- 3671635 TI - Psychometric properties of component and global measures of structured interview assessed type A behavior in a population sample. AB - Structured interview (SI) assessments of global and component Type A behavior were conducted in a general population sample of 903 respondents. Correlations among all the measures were positive and significant. A factor analysis revealed that the common component variance was explained by a single underlying factor. Interrater reliabilities were approximately 0.5 to 0.7 for the individual components and 0.8 for both the SI global Type A and a second global measure that was assigned independently by assessors who did the component scoring. Prediction of the SI-assessed global measure from the components accounted for 56% of the variance, and prediction of the second global measure from the components accounted for about 83% of the variance. Implications of the psychometric properties of the SI component and global measures of Type A behavior for future research are discussed. PMID- 3671636 TI - Responses to illness and health in chronic pain patients and healthy adults. AB - Although it is clear that health care utilization rates differ among individuals, what is not so obvious is the explanation for the variation in illness responses, nor is it known whether responses to illness are consistent or predictable. This pilot study compared responses to common symptoms and health maintenance activities in 1) healthy subjects with no medical visits in the previous year, 2) patients with chronic headaches with high medical utilization who remained functional at work and home, and 3) patients with nonmalignant chronic pain who were seriously dysfunctional in work and home responsibilities. The chronic pain samples differed primarily in level of functioning with similar outpatient utilization levels; they reported greatly differing response tendencies to common symptoms, with the more functional group endorsing numerous self-help strategies along with medical care seeking. The dysfunctional pain patients responded consistently with only one illness behavior: they went to the doctor. Among all three groups, the severely impaired individuals were most likely to say that they made special efforts to maintain their health; however, there was no single pro health activity they engaged in more than the other groups. There appear to be attitudinal as well as behavioral differences in response to health and illness issues between these groups of high and low utilizers and, within the high utilizer group, between those who are more or less impaired by their pain. PMID- 3671637 TI - The diagnosis of major depression in renal dialysis patients. AB - Controversy exists regarding the frequency of depression in renal dialysis patients. We have assessed an unselected sample of 99 dialysis patients using the Diagnostic Interview Schedule (DIS). A current Major Depressive Episode (MDE) was diagnosed in 8.1% of the sample, one-half of whom had a past history of MDE. An additional 12.1% had only a past history of depression. In contrast to patients with no affective disorder, characteristics of patients with a current MDE included the following: a history of previous MDE; female sex; duration of dialysis less than or equal to 24 months; a younger mean age; solitary living arrangements; and unemployment. The following DSM-III criteria distinguished patients with MDE from those with no affective disorder: depressed mood or loss of interest; feelings of worthlessness or excessive guilt; anorexia and weight loss; and slowed or mixed-up thoughts. DSM-III criteria that were common in the entire sample but not useful in distinguishing patients with MDE included loss of energy, insomnia, and decreased sexual interest. These results indicate that some DSM-III criteria are common in dialysis patients and therefore do not distinguish major depression, whereas other DSM-III criteria are more specific for MDE. Further, it is possible that the prevalence of MDE is greater in dialysis patients than in the general population. PMID- 3671638 TI - Factors associated with the use of psychiatric consultations in short-term general hospitals. AB - A significant number of patients in general hospitals suffer from psychiatric distress or illness, but not all receive psychiatric consultation. This study examined several potential predictors of such consultation. These included patient characteristics (age, sex, race, insurance, disease stage, and number of medical diagnoses), characteristics of hospital stay (number of procedures, other consultations, length of stay, discharge destination), hospital characteristics (size, percent occupancy, teaching status, presence of a psychiatric unit, type of control), and community characteristics (region, urban/rural setting). Data were derived from a national sample of 327 hospitals. Parallel analyses using stepwise logistic regression were carried out across four samples: patients determined at discharge to have been hospitalized for diabetes, hip fracture, chronic obstructive pulmonary disease, and coronary artery bypass surgery. Results show a wide variation in the use of psychiatric consultations across different subgroups. Longer lengths of stay, urban setting. Northeast region, younger patient age, and other consultations were the most consistent predictors of the probability of psychiatric consultation. These variations may reflect differences in the need for consultation, differential recognition of these needs by providers, or differential availability of psychiatric consultation services. Moreover, they may have implications for equity and/or quality of hospital care. PMID- 3671639 TI - Chronic stress and immunity in family caregivers of Alzheimer's disease victims. AB - Although acute stress has been associated with transient immunosuppression, little is known about the immunologic consequences of chronic stress in humans. In order to investigate possible health-related consequences of a long-term stressor, we obtained blood samples for immunologic and nutritional analyses and psychologic data from 34 family caregivers of Alzheimer's disease (AD) victims and 34 sociodemographically matched comparison subjects. Family caregivers for AD victims were more distressed than comparison subjects without similar responsibilities. Greater impairment in the AD victim was associated with greater distress and loneliness in caregivers. Caregivers had significantly lower percentages of total T lymphocytes and helper T lymphocytes than did comparison subjects, as well as significantly lower helper-suppressor cell ratios; caregivers also had significantly higher antibody titers to Epstein-Barr virus than did comparison subjects, presumably reflecting poorer cellular immune system control of the latent virus in caregivers. The percentages of natural killer cells and suppressor T lymphocytes did not differ significantly. These data suggest that chronically stressed AD family caregivers do not show immunologic or psychologic adaptation to the level of their well-matched age peers. PMID- 3671640 TI - Respiratory airway changes in response to suggestion in normal individuals. AB - Thirty normal individuals were told they were inhaling a substance that would either cause breathing difficulty (N = 15) or not affect breathing (N = 15). Total respiratory resistance was measured prior to and during inhalation. In reality, the subjects inhaled no substance; inhalation consisted of breathing normally into a respiratory resistance recorder. Individuals who received the former suggestion exhibited increased total respiratory resistance during inhalation, whereas individuals who received the latter suggestion did not. These observations demonstrated that the ability of suggestion to affect the respiratory airway is not limited to asthmatic individuals. PMID- 3671641 TI - [Anorexia nervosa with initial manifestations in adulthood--differences from anorexia nervosa in puberty and therapeutic consequences]. PMID- 3671642 TI - [Anorexia nervosa and bulimia--a multidimensional inpatient psychotherapy]. PMID- 3671643 TI - [Psychopathologic aspects of disordered eating behavior in females. I--On the significance and function of body image and its determinants]. PMID- 3671644 TI - [Psychopathologic aspects of disordered eating behavior in females. II--Self assessed attractiveness, chronic self-control in eating and loss of control]. PMID- 3671645 TI - [Concept of integrative inpatient-ambulatory therapy in patients with anorexia nervosa: a revised therapeutic approach]. PMID- 3671646 TI - [Description of pain, complaints and depression in patients with chronic headache syndromes]. PMID- 3671647 TI - [Consultation behavior of psychosomatic patients following inpatient psychotherapy: effect of treatment]. PMID- 3671648 TI - [An empirical study of the phenomenon of the negative attitude to the birth control pill]. PMID- 3671650 TI - Housing and respiratory disease. PMID- 3671649 TI - [The patient's wish for treatment--exemplified by inpatient psychotherapy]. PMID- 3671651 TI - The changing pattern of foodborne disease in England and Wales. PMID- 3671652 TI - Parkinson's disease from a patient's point of view. PMID- 3671653 TI - Prevention of neck injuries playing rugby. PMID- 3671655 TI - My student elective: 'serving God and the people in Zambia'. PMID- 3671654 TI - What has become of public health? Past patterns and future prospects in England, Ontario and Quebec. PMID- 3671656 TI - Early experiences in the treatment of acute diarrhoea with oral rehydration therapy at the University of Port Harcourt Teaching Hospital, Nigeria. PMID- 3671657 TI - The interpretation and medical management of complex arrhythmias in the newborn infant. AB - The clinical history, long term follow-up, and the surface electrocardiographic interpretation of four newborn infants with different arrhythmias are described. The arrhythmias discussed are: supraventricular tachycardia involving an accessory atrioventricular nodal bypass tract (Kent fibers), ectopic atrial tachycardia, atrioventricular nodal reentrant tachycardia, and ventricular tachycardia associated with congenital prolonged QT syndrome. Echocardiographic examination completed the evaluation in these newborns. A cardiac tumor was found in one infant and an aneurysm of the atrial septum was observed in two. Pharmacological therapy was successful in each newborn infant. PMID- 3671658 TI - Fine needle thyroid aspiration: university hospital experience. AB - Fine needle thyroid aspiration (FNTA) as a diagnostic tool of thyroid disease was started at the University District Hospital (UDH) in 1983. FNTA was performed in 54 willing patients from December 1984 through December 1985. If no medical contraindications existed, thyroid surgery was recommended in order to assess diagnostic accuracy. Surgery was done in 34 (63%) patients; while not in 20:3 for medical reasons, 2 lost to follow-up, 3 refused, 7 had inappropriate FNTA, and 5 for unknown reasons. None had complications to FNTA. Cytology was classified as Class O: inadequate; Class 1: benign; Class 2: indeterminate; and Class 3: malignant. "Non-benign" cytology was obtained in 14 patients: 7 indeterminate (class 2) and 7 malignant (class 3). Four of these had carcinoma confirmed by surgery. Of the 19 with benign FNTA (class 1) only one has thyroid carcinoma. One patient had inadequate sample (Class O). The sensitivity was 80%, specificity 65%, and diagnostic accuracy 67%. All these statistical values are within the range reported in fifteen reviewed series. Thus, FNTA at UDH had a diagnostic value comparable to that described in the literature. It may be utilized as a safe, reliable tool complementary to clinical data in order to reduce the amount of unnecessary thyroid surgery, carry out earlier diagnoses of malignant nodules and increase the yield of carcinoma among those operated. PMID- 3671659 TI - Cholesterol and dominance rank in the Cayo Santiago macaques. AB - The relationship between serum total cholesterol (STC) and social dominance rank was investigated in adult (greater than or equal to 5 year old) males of a single, naturally-formed free-ranging troop of rhesus monkeys (Macaca mulatta) on Cayo Santiago, Puerto Rico. Dominance rank, age and body weight were not correlated with STC, nor was rank correlated with age or body weight. The mean (+/- 1 SD) STC was 154.0 +/- 27.0 mg/dl. Seven of the 34 males sampled had STC levels (189.1 +/- 4.3 mg/dl) greater than 1 SD above the mean for all males. These monkeys did not differ significantly in age or body weight from each other or the remaining males in the study, but 5 of the 7 monkeys with high STC were high-ranking in the group and 7 of 8 monkeys with STC (115.6 +/- 5.8 mg/dl) 1 SD or more below the mean for all males were low-ranking. The difference was significant (p less than .05, Fisher's Exact Test). PMID- 3671660 TI - A profile of knowledge and attitudes toward tobacco usage of first and fourth year medical students at the University of Puerto Rico. AB - A questionnaire entitled "Attitude toward tobacco usage among health professionals in Puerto Rico" was administered to medical students completing their first and fourth years respectively at the University of Puerto Rico Medical School. Percent of each group currently smoking was found to be 18.5 and 10.8 with an average of 24.2% and 13.5% for 1st and 4th year male students and 9.1% and 3.2% for 1st and 4th year female students. A trend toward beginning smoking at an earlier age was noted as compared to a survey taken 20 years ago. Both groups demonstrated adequate knowledge of the risks and consequences of smoking, however, 4th year students had a wider awareness of smoking hazards. Attitude toward tobacco was highly dependent upon the smoking status of the respondent with non smokers being predictably more strongly opposed to tobacco usage. Although cultural differences exist between Puerto Rican and mainland health professionals, they both share similar knowledge and attitudes toward tobacco usage. PMID- 3671661 TI - Age and the metabolism of drugs. PMID- 3671662 TI - Renal failure in the elderly. AB - A pilot study recording the incidence, management and outcome of renal failure in elderly patients presenting to three geriatric units in a six-month period is described. A total of 4001 patients were admitted during this time and 273 patients were considered to have renal failure at presentation (criteria, plasma urea level greater than or equal to 17 mmol/l and/or creatinine level greater than or equal to 160 mumol/l). In 151 patients (55 per cent) the cause was pre renal and this form of renal failure had a good prognosis; over 60 per cent recovered and increasing age did not affect prognosis adversely. Ninety-six patients (35 per cent) had intrinsic renal disease which was commoner in younger patients and had a mortality rate of 48 per cent. In the majority of patients renal failure was mild, only 24 per cent having a urea level greater than 31 mmol/land/or creatinine level greater than 400 mumol/l. PMID- 3671663 TI - Molecular forms of porphobilinogen deaminase in acute intermittent porphyria. A study by Western immunoblotting. AB - Acute intermittent porphyria is an inborn error of haem synthesis which is transmitted as a dominant character with variable phenotypic expression. The disorder is caused by a partial deficiency of porphobilinogen deaminase in all tissues so far studied. The nature of the enzymatic deficiency of porphobilinogen deaminase in haemolysates from patients with acute intermittent porphyria was examined by the use of monospecific antibody probes. In affected heterozygotes from three British pedigrees of diverse ancestry, the catalytic deficiency of porphobilinogen deaminase was accompanied by diminished enzyme protein, as determined by radial immunodiffusion. No evidence of functionally attenuated enzyme was demonstrable by kinetic studies. The molecular forms of the residual enzyme were investigated in red cell extracts and in lysed preparations of reticulocytes by a sensitive Western blotting procedure. This revealed the presence of reduced amounts of porphobilinogen deaminase polypeptide co-migrating with wild type enzyme (Mr approximately 40,000), and no evidence of variant forms in situ. The studies show that porphobilinogen deaminase deficiency in acute intermittent porphyria is commonly associated with a CRM-phenotype. The residual activity under these circumstances is thus related to expression of a single normal allele, since sensitive techniques detected neither aberrant nor degraded forms of the enzyme in erythroid tissues. PMID- 3671665 TI - Oestradiol levels in diabetic men with and without a previous myocardial infarction. AB - Elevated oestradiol levels have been found in men with a previous myocardial infarction and it has been suggested that hyperoestrogenaemia may explain partly the increased risk of coronary heart disease in diabetes mellitus. Therefore we have measured concentrations of oestradiol and testosterone (the main substrate for oestradiol) in a group of diabetic men with a previous myocardial infarction (n = 15), a matched group of diabetic men without overt cardiovascular disease (n = 13) and a group of healthy, non-diabetic men (n = 15). The diabetics had elevated oestradiol levels (p less than 0.03) despite lower testosterone levels (p less than 0.02) compared with control subjects. In the diabetic patients, a correlation between oestradiol and testosterone was found (r = 0.55, p less than 0.02) which suggested that the elevated oestradiol levels were only partly derived from the aromatization of testosterone. There were no differences in oestradiol or testosterone levels between the two diabetic groups. This study has shown that endogenous hyperoestrogenaemia is a consistent finding in diabetic men, irrespective of whether they have or have not sustained a previous myocardial infarction. The source of the raised oestradiol levels is uncertain. It is unclear whether hyperoestrogenaemia can be regarded as a risk for myocardial infarction in diabetic men. PMID- 3671664 TI - Male hypogonadism--a non-specific consequence of illness. AB - Depressed thyroid hormone levels are commonly found in sick patients. Low serum testosterone concentrations have also been described in men suffering from a number of illnesses. To investigate whether this might be a non-specific marker of illness, various endocrine parameters were measured in 30 male patients in a general medical ward. Patients were suffering from a wide spectrum of medical disorders and were not receiving drugs known to affect endocrine function. Results were compared with a healthy age-matched control group. Serum testosterone concentrations (mean +/- SE) were low in the patient group (8.9 +/- 1.1 vs. 18.2 +/- 1.4 nmol/l, p less than 0.001), correlated significantly with serum T3 levels but were not related to prognosis. Half the patients had testosterone levels below the normal control range. Changes in testosterone concentrations could not be explained on the basis of binding protein changes, hyperprolactinaemia or depressed pituitary secretion of gonadotrophins. Depression of serum testosterone concentrations is a non-specific marker of illness. PMID- 3671666 TI - [Serum bile acids in cirrhosis: correlation with liver function parameters and with the severity of the disease]. AB - The aim of this paper is to evaluate the relationships among the increase of serum bile acids (SBA) and other common liver function tests in subjects with liver cirrhosis. Our results show that SBA levels are well-correlated with the seriousness of the disease (classified according to Child's criteria), and with the presence of ascites, of oesophageal varices, of hepatic encephalopathy and with the gamma-globulin level. SBA also appear to be well-correlated with total bilirubinemia, and, at a lower extent, with cholesterolemia and albuminemia; no significant linear correlation was found among SBA and cholestasis (alkaline phosphatase, gamma-glutamyl-transpeptidase) or cytolysis (transaminases) indexes. In conclusion, the SBA increase in liver cirrhosis without evidence of cholestasis (as in our patients) seems to be related to liver cell reuptake disturbances and to the presence of porto-systemic shunts, with consequent alterations in entero-hepatic bile salt recirculation. PMID- 3671667 TI - Relationship between triglyceride levels and high-density-lipoprotein cholesterol and phospholipid content. PMID- 3671668 TI - [Urinary tract infections: observations on 19,021 patients hospitalized in Sassari Province]. AB - We report the results of a study carried out upon samples of urine from 19,021 patients in various departments of medical school in Sassari and in the hospitals of Alghero and Ozieri. The 34.7% of samples examined proved to be positive. Among these we isolated Escherichia coli (32%), Proteus spp. (24%), Staphylococcus (12%), Klebsiella-Enterobacter-Serratia (KES) spp. (9%), Pseudomonas spp. (5%). We found microbic associations in 11% of cases. We also studied the sensitivity of microorganisms to various chemoantibiotics, and the efficacy of therapy on 964 patients. In the various checks made, the results point out a persisting positivity (53%). E. coli strains show a major sensitivity to the various antibiotics (aminoglycosides, quinolones, cephalosporins, etc.); Proteus spp. and KES are less sensitive; Pseudomonas spp. strains are very resistant and respond mainly to norfloxacin and ceftazidime. PMID- 3671669 TI - Reduced/oxidized glutathione ratio in aging human red cells. PMID- 3671670 TI - [Research on staphylococcal enterotoxin B by dot immunobinding assay (DIB). Preliminary observations]. AB - A recently developed immunoenzymatic technique, the Dot Immunobinding assay (DIB), has been applied to the rapid detection of staphylococcal enterotoxin B in filtered culture supernatants. The test has been shown to be highly sensitive and specific, easy to perform and rapid (only 4 hours). The use of nitrocellulose paper as the solid phase allows the exact standardization of the amount of antigen employed and it avoids the overnight incubation usually necessary with the conventional enzyme-linked immunosorbent assay (ELISA). PMID- 3671671 TI - [Macro-CK type 1: a methodological study approach and its clinical significance]. AB - Description of an analytical procedure in order to show the atypical-CK carriers that simulate an abnormal raising of CK-MB circulating levels in dosages for immune inhibition. This procedure was applied to two samples taken from patients of such a type, immune form neoplastic and cardiac pathology. A systematic dosage of a "real" MB isoenzyme is desirable in all the cases of very raised CK-MB activity. PMID- 3671672 TI - [Diagnostic study of 5 cases of allergic asthma due to sensitization to silk allergens in textile workers from the Prato area]. AB - Five cases of allergic asthma due to sensitivity to silk allergens have been studied. All the patients worked in the Prato textile industry. The presence of specific antibodies against extracts of silk has been shown by the direct RAST and confirmed by the indirect RAST. The onset of the symptoms, with regard to the various stages in the processing of silk, leads one to assume that the allergen involved is sericin. PMID- 3671673 TI - [Automatic enzymatic determination of urea nitrogen]. AB - Six BUN kits available on the market, applied on selective chemistry analyzer, shown acceptable accuracy, good stability and linearity, "borderline" within-day and among-day standard deviations. The cause is investigated, particularly in the dispenser of the analyzer for delivering samples and reagents. PMID- 3671674 TI - [Gamma- and UV-induced DNA synthesis in neurons of the rat neocortex]. AB - Nuclear DNA synthesis in neocortex neurons of neonatal 14- and 60-day rats after in vitro irradiation of isolated sections was estimated by the incorporation of a labeled precursor into DNA. gamma- and UV-radiation increased the rate of DNA synthesis in the cells of animals of all studied age groups. However, the level of the UV-induced synthesis sharply dropped during the postnatal ontogenesis while gamma-radiation-induced synthesis decreased slightly. The peculiarities revealed in the repair DNA synthesis seem to be influenced by the process of postnatal differentiation of a neuron accompanied by the nucleosome length shortening and the decrease in the DNA-polymerase alpha content. PMID- 3671676 TI - [Changes in the structure of lymphocyte chromatin after irradiation with He-Ne laser]. AB - The cytofluorometric method was used to study changes occurring in the chromatin structure of lymphocytes during the first few hours following irradiation of lymphocytes with He-Ne-laser (lambda = 632.8 nm) of 28-112 J/m2. The changes were similar to those caused by PHA that is: the increase in acridine-orange binding to DNA during the first 45-90 min, its fall to the control level in 3-4 h and the subsequent increase. PMID- 3671675 TI - [Changes in the secondary structure of collagen after gamma-irradiation in an aqueous solution]. AB - The conformation of calf skin collagen at the secondary structure level changed after 60Co-gamma-radiation with doses ranging from 50 to 1,000 Gy in aerated aqueous solutions and in the presence of N2 and N2O. Despiralization of collagen at a dose of 1,000 Gy reached 90% in N2O, 70% in N2, and 60% in the aerated solution. The radiochemical yield of the despiralized collagen molecules was 0.007 mol/100 eV owing to OH(.). The presence of radioprotective agents upon irradiation of collagen solutions diminished considerably the injury to its secondary structure. PMID- 3671677 TI - [Quinoid radiotoxins in the blood of gamma-irradiated dogs]. AB - Quinoid radiotoxins were found in the peripheral blood 3-4 h following gamma irradiation of dogs with doses of 5.76 Gy. The authors developed a simple method of isolation and purification of quinoid radiotoxins and specified their physicochemical and biological characteristics. PMID- 3671678 TI - [Effect of interferon on the yield of chromosome aberrations in cultured human lymphocytes irradiated with fast neutrons]. AB - A study was made of the influence of leucocytic interferon on the yield of chromosome aberrations in a human lymphocyte culture after irradiation of cells with fast neutrons (0.85 MeV) at the G0- and G1-stages. It was shown that in cells treated with interferon (50 UE/ml) prior to irradiation the total yield of aberrations and of some of their types was invariable as compared to the irradiated control. PMID- 3671679 TI - [Effect of hypoxic cell sensitizer metronidazole on the radiation reaction of clonogenic cells from solid tumors]. AB - The clonogenic capacity of cells from peripheral and central zones of solid NKLy tumors of mice treated with metronidazole, a sensitizer of hypoxic cells, and with a mixture of metronidazole and radiation was studied by cloning in diffusion chambers. The cytotoxic effect of metronidazole was only noted during the prolonged interaction with cells under acute hypoxia that was observed in central tumor zones. Metronidazole increased by more than two times the radiosensitivity of cells from the central zones of the tumor and did not influence the radiation response of cells from the peripheral zones. Metronidazole was shown to inhibit the repair of potentially lethal radiation damages. PMID- 3671680 TI - [Changes in the clonogenic ability of solid tumor cells during combined exposure to hyperthermia and irradiation]. AB - A study was made of the clonogenic capacity of cells from central and peripheral zones of NKLy solid tumors of mice after heating up to 42 degrees C and after the combined effect of hyperthermia and local irradiation of the tumor. Hyperthermia markedly increased the rate of radiation death of cell populations from central tumor zones, having low oxygen tension, and had no effect on radiosensitivity of cells from peripheral well oxygenated zones. In heated tumors, the repair of potentially lethal radiation damages to cells from the peripheral zones was inhibited while in conventional irradiation conditions these damages could be restored. PMID- 3671681 TI - [Changes in synapses after gamma-irradiation of the rat head]. AB - High reactivity and, at the same time, flexibility of interneuronal contacts were observed after exposure of rat head to 2-100 Gy radiation. At high doses (200-400 Gy) radiation-induced changes played a major role in the development of the cerebral form of radiation sickness. A complete asynapsis is probably one of the causes of the animals death "under the ray" (irradiation of the head with a dose of 1000 Gy). PMID- 3671682 TI - [Effect of therapeutic administration of purine derivatives on the life span of irradiated animals]. AB - Purine derivatives, meradine and ethimizole, are shown to exert a therapeutic effect with respect to survival of rats exposed to 4 Gy radiation. Distinctions in the death rate between the exposed rats and rats treated with meradine and ethimizole are manifested 1 month following irradiation, i. e. at the time of clinical recovery of the exposed body. The preparations used at other te terms are uneffective. It is suggested that purine derivatives increase the regeneration and compensation of radiation lesions at the time of clinical recovery reducing an irreversible component of radiation damage. PMID- 3671683 TI - [Effect of the radioprotector adeturon on radiation injury in mice with Lewis carcinoma of the lung]. AB - A study was made of the radioprotective effect of Adeturon, a protective agent obtained in Bulgaria, on mice with Luis lung tumors exposed to fractionated radiation. The effect of the radioprotector on a radiation-induced injury to normal tissue was estimated by the number of leucocytes in the peripheral blood and its count, cellularity of bone marrow and spleen and the mass of the latter, and by the number of exogenous and endogenous CFUs. A pronounced radioprotective effect of Adeturon was implemented through maintaining or normalizing the indices under study impaired by tumor inoculation or irradiation. PMID- 3671684 TI - [Quantitative analysis of neurological effects after cranio-caudal gamma irradiation of rats]. AB - A study was made of the frequency and duration of neurological disorders after cranio-caudal irradiation of rats with doses of 7.5-500 Gy delivered to the head. As the mean effective dose increased the neurological disorders occurred in the following order: tremor, rotatory movements hyperkinesia, opisthotonos, and convulsions. The neurophysiological disorders observed were subjected to a pathophysiological analysis. PMID- 3671685 TI - [Neuroeffects of prolonged exposure to microwaves: systemic, neuronal and electron microscope study]. AB - Cats were kept in the electromagnetic field (2375 mHz, 500 microW/cm2) for 200 h. A functional disorder was noted in the neuronal activity of the studied brain formations associated with a physical injury to axo-dendritic synapses involved in the promotion of the morphological relationship between the brain departments. PMID- 3671686 TI - [Absorption of 241Am in the gastrointestinal tract]. AB - In experiments with rats a study was made of a number of factors influencing the resorption of 241Am from the gastrointestinal tract (GIT). The resorption of 241Am from GIT was found to be 120-245 times more intensive in neonatal rats, during the first 21 days after birth (a milk diet), than in adult animals. A milk diet for adult rats produced a 5-fold increase in the resorption of 241Am from GIT. The additional administration of digestive enzymes, as a homogenate from pancreas and small intestine, produced a 7--9-fold increase in the rate of 241Am resorption from GIT. PMID- 3671687 TI - [The level of aberrant lymphocytes in the blood of rats and duration of survival after radionuclide incorporation]. AB - There is a positive correlation between the number of aberrant lymphocytes in the experimental rat blood, 24 h following the administration of 45Ca, 131I, 131I together with 90Sr, and 45Ca together with 137Cs, and the life span of exposed animals. It is suggested that the cytogenetic index should be used in the prognosis of the radionuclide-induced life span shortening. PMID- 3671688 TI - [Combined effect of interferon inducers, radiosensitizing and antineoplastic agents on solid tumors]. AB - In experiments with mice bearing solid sarcoma 37 a study was conducted on the combined effect of radiation and inductors of endogenous interferon synthesis (IEIS), together with hyperthermia or together with an alkylating and carbomoilating agent, dimethinur. The effect was estimated by the tumor growth coefficient and by the number of animals with the regressed tumors. Po I. polyC was not shown to influence the efficiency of hyperthermia combined with radiation; dextransulphate and tiloron increased the radiosensitizing effect of hyperthermia. Dimethinur aggravated the effect of radiation, but with IEIS used together with dimethynur and radiation, the response of the tumor increased insignificantly as compared to the effect of IEIS together with radiation. PMID- 3671689 TI - [Combined effect of normobaric hyperoxia and vibration on the radiosensitivity of animals]. AB - In experiments with hybrid mice (CBA X C57B1)F1 and F2(CBWA), a study was made of the combined effect of normobaric hyperoxia and vibration on sensitivity of the organism to gamma-radiation. A single and protracted (for 5 days, daily) vibration before irradiation aggravated acute radiation sickness. A modifying effect of hyperoxia on the development of the intestinal form of radiation sickness was the same as that observed under the effect of vibration. In the experiments with tetrahybrids, the combined effect of the two factors aggravated drastically the intestinal syndrome of acute radiation sickness (DMF = 1.24). PMID- 3671690 TI - Ionising radiation regulations: how to apply them in the department. PMID- 3671691 TI - Meeting the need for clinical instruction. PMID- 3671692 TI - The radiographer and the frontline diagnosis. PMID- 3671693 TI - Silver recovery trial. PMID- 3671694 TI - Student and staff selection. PMID- 3671695 TI - Epidurography. PMID- 3671696 TI - The place of the professions supplementary to medicine in the future National Health Service. PMID- 3671697 TI - The case for continuing education. PMID- 3671698 TI - Os odontoideum. PMID- 3671699 TI - Quality assurance in diagnostic radiography: are we using it correctly and what is its future? AB - In this paper the author aims to instigate discussion on the manner in which we, as a profession, currently approach and perform quality assurance. To what use we put the results and the way in which quality assurance should progress in the future. It is based mainly on his experience as radiographic service manager of an eight-roomed x-ray department with responsibility for the radiographic services for one of the centres of the DHSS breast cancer early detection project. PMID- 3671700 TI - Basic life support and training: an update. AB - In recent years there has been a move, led by the Resuscitation Council (UK), to standardise resuscitation methods. The Council's recommendations constitute a code of practice (supported by the Health and Safety Executive) and both voluntary and professional organisations are aligning their procedures. As radiographers are already trained in these basic skills, the following article simply outlines the standard procedure for emergency first-aid resuscitation, discusses the importance of training, and will act as a useful reminder to all departments. PMID- 3671701 TI - Urinary diversion: a new angle? PMID- 3671702 TI - Three dimensional cranio-facial reformations. PMID- 3671703 TI - An unusual presentation of bronchial carcinoma. PMID- 3671704 TI - Computerised tomography of hydatid disease. PMID- 3671706 TI - Diagnostic imaging in bone disease. PMID- 3671705 TI - Applications of the graphical mode in dynamic CT studies of the brain. PMID- 3671707 TI - An approach to primary bone tumors. AB - This article is designed to provide the busy, practicing physician with the essential information needed to approach the patient with a primary bone tumor. An algorithm provides a suitable method of assessing most patients with bone tumors, recognizing slight modification is necessary in each case. Following this approach should allow successful accomplishment of the therapeutic triad: (1) do not "over-treat" a benign bone tumor, (2) do not "under-treat" a malignant bone tumor, and (3) do not misdirect the biopsy approach to the lesion so as to convert a more conservative operation into a more radical operation. PMID- 3671708 TI - The diabetic foot. AB - Disorders of the foot are a common and disabling problem among diabetic patients. Often the most difficult problem radiographically is to differentiate infection from neuropathic change. This article reviews the radiographic features and imaging approach to patients with diabetic foot disorders, with specific reference to both conventional and advanced imaging modalities. PMID- 3671709 TI - Unique musculoskeletal trauma. AB - Pelvic and lower extremity insufficiency fracture in the osteoporotic individual, an approach to posttraumatic wrist instabilities, and certain upper and lower extremity pediatric fractures are discussed. The case material concentrates upon the clinical/radiographic recognition of subtle trauma and the multimodality approach to these unique traumatic musculoskeletal conditions. The impact that computed tomography has had on some of these traumatic conditions also is presented. PMID- 3671710 TI - The normal and abnormal growth plate. AB - Skeletal growth is a dynamic process. A knowledge of the structure and function of the normal growth plate is essential in order to understand the pathophysiology of abnormal skeletal growth in various diseases. In this well illustrated article, the authors provide a radiographic classification of abnormal growth plates and discuss mechanisms that lead to growth plate abnormalities. PMID- 3671711 TI - Skeletal metastases. AB - This article discusses the role of imaging in the evaluation of patients with known or suspected malignancies. The radionuclide skeletal scintigram is the most sensitive imaging method for screening the skeleton for metastatic disease but is inherently nonspecific. Standard radiography provides useful correlative information and often confirms the presence of malignancy when characteristic lytic or blastic lesions are seen. Newer modalities such as CT and MR do not have a primary role in detecting skeletal metastases but may reveal lesions incidentally. PMID- 3671712 TI - Interventional radiology in appendicular skeletal trauma. AB - Embolotherapy for extremity vascular injuries is a relatively new, effective, and safe treatment modality in selected patients. The resultant hemostasis decreases the morbidity or even mortality that can result from uncontrolled hemorrhage. In addition, surgery may be postponed until the patient is stabilized, or avoided altogether. Prompt diagnosis of vascular injury and embolization when indicated also contributes to the proper management of associated osseous and soft tissue injuries. PMID- 3671713 TI - Rheumatoid and seronegative arthropathies of the foot. AB - The foot is often involved in rheumatoid arthritis and its seronegative variants. This article presents an overview of the subject and highlights the various distinguishing features of these arthritic disorders in the foot. PMID- 3671714 TI - [Radiologic diagnosis of salivary gland diseases]. PMID- 3671715 TI - [Present status and place of sialography]. AB - Roentgenography without contrast media and sialography, as well as the basic facts concerning the radiodiagnostic of the salivary gland, are all discussed with regard to the most current equipment, examination techniques, the positioning of patients, and the problems involved in contrast media. The technique used in more than 4,000 sialograms is recommended. The diagnostic value of this method is illustrated by means of representative patient series: sialolithiasis, inflammatory disorders, and tumors. The limitations of the method are demonstrated and complementary examinations shown. PMID- 3671716 TI - [Computed tomography and diagnosis of salivary gland diseases]. AB - A study was carried out to compare routine sialography and combination sialo-CT. The results in 36 patients with afflictions of the parotid and submandibular region are discussed. In addition to tumors, regarded as primary indications, inflammatory disorders were also considered. The diagnosis made by routine sialography is regularly confirmed by computed sialography (CTS), which is often an important complementary means. Visualization of the deep parotid lobe and parapharyngeal space (third plane) is very important for making the diagnosis and planning therapy. PMID- 3671717 TI - [Foramina parietalia permagna]. AB - We report a patient who presented with the foramina parietalia permagna feature. This harmless malformation of the skull has already been described long ago but is rare and fairly unknown. Therefore, it may present problems concerning differential diagnosis. To our knowledge our case is the first to be illustrated and analyzed by cerebral computed tomography. PMID- 3671718 TI - [A holder for plain x-ray visualization of ulnar, volar and radial injuries of the capsule and ligaments of the basal thumb joint. A hyperextensometer for the determination of the ligamentous laxity of the index finger basal joint]. AB - We have constructed a device for standardized radiodiagnostics of ulnar, volar, and radial capsulo-ligamentous lesions of the basal thumb joint. Used as hyperextensometer at the basal joint of the index finger, the device is of equal value in the diagnosis of ligamentous laxity. PMID- 3671719 TI - [A heating pad for x-ray examination tables]. PMID- 3671720 TI - [Myoma of the uterus? Osteochondroma]. PMID- 3671722 TI - [Cost/need relations in medicine. Reuse of re-sterilized intravascular catheters]. AB - The costs of catheters in a university radiology department are listed and the reasons for re-sterilization of catheters discussed. Questionnaires have been sent to 17 German university radiology departments. Thirteen of them routinely re sterilize catheter material. The advantages and complications of catheter re-use are discussed. PMID- 3671721 TI - [Reuse of angiography catheters. Results and discussion of the present state of knowledge]. AB - The re-use of angiographic catheters after cleansing and sterilization with ethylene oxide has received increasing attention, primarily because of cost considerations. However, there are various risks in this common practice, mainly because the principles of maintenance are neglected. Experimental findings on cleansing, sterilization, and mechanical safety are discussed, leading to the conclusion that re-use of disposable catheters is possible only under certain circumstances. PMID- 3671723 TI - [Spontaneous infarct of the omentum majus: visualization by computed tomography]. AB - In a case report, idiopathic segmental infarction of the greater omentum is demonstrated for the first time by means of computed tomography. This rare disease of unknown etiology can mimic the clinical presentation of acute appendicitis or cholecystitis. PMID- 3671724 TI - [An unusual cause of mechanical ileus]. AB - A patient with the signs of mechanical ileus is reported. Past history of dilated cardiomyopathy with atrial fibrillation and the recent occlusion of the left renal artery suggested arterial mesenteric embolism. Celiacography ruled out mesenteric thromboembolism and vigorous enemas resulted in the delivery of the foreign bodies causing the mechanical ileus: 2 "10-Pfennig" coins. PMID- 3671725 TI - [Professional errors in radiology]. AB - As medico-legal statistics show, compared with other branches of medicine, cases of liability of the radiologist or his assistants are relatively rare. The duty to exercise due care as set out in 6 of the Austrian penal code or 276 of the German civil code also provides a basic rule of law for radiology. Due to the risk inherent in the investigation, incidents during angiography cannot be totally excluded. It is therefore of the utmost importance that all steps be taken with regard to staff, equipment and drugs to deal with any complications and incidents that may arise. The courts of law require the employer to produce the strongest exonerating evidence to prove that the duty to exercise due care in the selection and supervision of the assistants has been duly fulfilled. For the practical execution of radiological investigations of the digestive tract, the radiologist's technical assistant is also responsible; her liability when performing an irrigation is particularly great, as perforation of the intestine is often lethal. The introduction of the rectal tube into the vagina by mistake, with resultant injury or death of the patient, will regularly lead to conviction under penal law. PMID- 3671726 TI - [Kidney tumor? Focal IgA nephritis]. PMID- 3671727 TI - [Tertiary structure of immunoglobulins]. PMID- 3671728 TI - [The data management system at cell bank]. PMID- 3671729 TI - [Lysophospholipase]. PMID- 3671731 TI - Abstracts of the meeting: The role of platelet-activating factors in the immune response. Paris, France, June 25 and 26, 1987. PMID- 3671730 TI - Constriction of cat coronary arteries by synthetic thromboxane A2 and its antagonism. AB - Synthetic thromboxane A2 (TxA2S) induced rapid, concentration-dependent constriction of isolated perfused cat coronary arteries. Its potency was approximately 30 times that of the prostaglandin endoperoxide, PGH2. Pinane thromboxane A2 (PTA2), BM-13.505 and SQ-29,548, compounds previously shown to antagonize the effects of stable prostaglandin endoperoxide analogs, inhibited the constriction induced by TxA2S in a concentration-dependent fashion. These experiments provide further evidence that the oxetane structure proposed for TxA2 is correct and show that compounds that inhibit the effects of prostaglandin endoperoxides also antagonize the effects of TxA2. PMID- 3671732 TI - The effect of acetylsalicylic acid and indomethacin on the catecholamine- and oxytocin-induced contractility and prostaglandin (6-keto-PGF1 alpha, PGF2 alpha) production of human pregnant myometrial strips. AB - The effects of acetylsalicylic acid (ASA) and indomethacin (IND) on the epinephrine and oxytocin stimulated contractility and prostaglandin (6-keto-PGF1 alpha, PGF2 alpha) production of superfused myometrial strips from the pregnant human uterus at term are reported. Without preincubation in ASA or IND epinephrine dose-dependently (10 ng/ml to 1 microgram/ml) stimulated the contractility and significantly increased the PG-release of the myometrial strips. The epinephrine induced increase in contractility was correlated to a higher increase in PGF2a production and a decreased 6-keto-PGF1 alpha/PGF2 alpha ratio (5.4 to 1.8). Superfusion of oxytocin increased myometrial contractions and PGF2 alpha release according to dose (3-12 microU/ml). However, 6-keto-PGF1 alpha production was not affected by oxytocin. Myometrial strips preincubated with ASA (100 micrograms/ml) or IND (10 micrograms/ml) demonstrated little spontaneous activity and the PG production was below the detection limit of the RIA. The stimulating effect of epinephrine and oxytocin on the contractility and PGF2 alpha release of the myometrial strips was inhibited significantly. During continuous superfusion of the ASA and IND preincubated myometrial strips with Tyrode's solution the inhibitory effect on spontaneous, epinephrine-, and oxytocin-stimulated contractility and PGF2 alpha release gradually declined over a period of 2 hours. This decrease of the inhibitory effect was more significant in ASA preincubated specimens. Our results demonstrate that spontaneous, epinephrine-, and oxytocin-stimulated contractility and PG release of human myometrial strips can be inhibited by ASA and IND and that this inhibitory effect is reversible. Furthermore our results suggest that in pregnant human myometrium the inhibition of PGF2 alpha production by ASA and IND is more pronounced than that of 6-keto-PGF1 alpha (PGI2). PMID- 3671733 TI - Azathioprine-induced in vitro inhibition of prostaglandin E2 production by rabbit retina. AB - Although much work exists concerning the clinical and immunosuppressive effects of azathioprine, little is known of the mechanism of action of this drug. The present study reports that azathioprine at the concentrations of 0.1 and 0.05 micrograms/ml causes a significant suppression of in vitro prostaglandin E2 production by rabbit retinas. However, at concentrations below (0.01 microgram/ml) or above (1,10 micrograms/ml) azathioprine was not inhibitory effect. These results suggest a dose-dependent inhibitory effect of azathioprine on prostaglandin E2 production. PMID- 3671734 TI - Stimulatory and inhibitory effects of prostaglandins on the gonadotropin sensitive adenylate cyclase in the monkey corpus luteum. AB - Detailed analysis of the action of prostaglandins (PGs) on the corpus luteum in primate species is very limited. In this study we examined the response of the adenylate cyclase system to PGs in homogenates prepared from the corpus luteum of rhesus monkeys at midluteal phase of the menstrual cycle. The conversion of [alpha 32p] ATP to [32p] cyclic AMP (cAMP) was assessed in the absence (control activity; 50 microM GTP) and presence of various concentrations of seven PGs and arachidonic acid, either alone or in combination with 250 nM hCG. Cyclic AMP production increased up to three-fold in the presence of PGD2, PGE2, PGI2 or PGF2 alpha; however PGA2, PGB2, 13, 14-dihydro-15-keto PGE2 and arachidonic acid alone did not alter cAMP levels. In dose-response studies, adenylate cyclase was 10 and 100-fold more sensitive to PGD2 (Vmax at 1 X 10(-5) M) than to PGE2 or to PGI2 and PGF2 alpha, respectively. Activity in the presence of hCG plus either PGD2, PGE2, PGI2 or PGF2 alpha did not differ from that for hCG (or the PG) alone. In contrast, addition of PGA2 or arachidonate inhibited (p less than 0.05) hCG stimulated cAMP production by 50 and 100 percent. We conclude that the gonadotropin-sensitive adenylate cyclase of the macaque corpus luteum is also modulated by several PGs. These factors may either mimic (e.g., PGD2, PGE2, PGI2) or suppress (PGA2) gonadotropin-stimulated cAMP production and possibly cAMP mediated events in luteal cells. PMID- 3671735 TI - [Scintigraphic evaluation of osteoarticular changes in simple psoriasis]. PMID- 3671737 TI - [Epidemiological chronicle]. PMID- 3671736 TI - [Diagnosis and surgical treatment of spinocellular carcinoma of the skin]. PMID- 3671738 TI - [Communicable diseases in Poland 1985]. PMID- 3671739 TI - [Diarrhea in infants under 2 years of age--1985]. PMID- 3671740 TI - [Infectious mononucleosis 1985]. PMID- 3671741 TI - [Scabies 1985]. PMID- 3671742 TI - [Rabies 1985]. PMID- 3671743 TI - [Brucellosis 1985]. PMID- 3671744 TI - [The epizootiological situation with regard to animal brucellosis in Poland 1985]. PMID- 3671745 TI - [Toxoplasmosis 1985]. PMID- 3671746 TI - [Trichinosis 1985]. PMID- 3671747 TI - [Intestinal parasites 1985]. PMID- 3671748 TI - [Whooping cough 1985]. PMID- 3671749 TI - [Scarlet fever 1985]. PMID- 3671750 TI - [Epidemic parotitis 1985]. PMID- 3671751 TI - [Influenza 1985]. PMID- 3671752 TI - [Rubella 1985]. PMID- 3671753 TI - [Cerebrospinal meningitis and encephalitis 1985]. PMID- 3671754 TI - [Salmonellosis 1985]. PMID- 3671755 TI - [Food poisoning 1985]. PMID- 3671756 TI - [Botulism 1985]. PMID- 3671757 TI - [Measles 1985]. PMID- 3671758 TI - [Viral hepatitis 1985]. PMID- 3671759 TI - [Tetanus 1985]. PMID- 3671760 TI - Is stimulus structure in the mind's eye? An examination of dimensional structure in iconic memory. PMID- 3671761 TI - Exploring the visuo-spatial scratch pad. PMID- 3671763 TI - The representation of depth in children's drawings of a table. PMID- 3671762 TI - The effects of literacy on the recognition of dichotic words. PMID- 3671764 TI - Morphological errors in acquired dyslexia: a case of mistaken identity. PMID- 3671765 TI - The influence of premovement visual information on manual aiming. PMID- 3671766 TI - Identity matching and oddity learning in patients with moderate to severe Alzheimer-type dementia. PMID- 3671767 TI - Medullary breast carcinoma: the role of radiotherapy as primary treatment. AB - The results are reported of a selected series of 41 patients with medullary carcinoma of the breast, treated with primary radiotherapy with (24 patients) or without (17 patients) adjuvant chemotherapy. Complete responses to radiotherapy occurred with moderate doses (67% of the patients had a complete response after a dose of 55-60 Gy) and were increased by the addition of an irradiation boost. The 6-year actuarial free of local recurrence survival, metastase-free survival and survival rates were 86, 83, and 83%, respectively. The 6-year actuarial probability of living with breast preserved was 72%. Recurrences and survivals were not influenced by the tumor size or clinical axillary node status. Adjuvant chemotherapy had no effect on the rate of recurrence or survival. PMID- 3671768 TI - Prognostic significance of residual disease after radiation therapy of stage III breast cancer. AB - 239 Consecutive women with stage III carcinoma of the breast were treated by primary radiation therapy (RT) from 1977 to 1985. The response rate was 89%, the 5-year survival 40% and the local-regional tumor control (LTC) 59%. For the 27 non-responders, postirradiation chemotherapy was initiated but they died within 3 years. 105 Patients were subjected to mastectomy and axillary dissection after RT. In 107 cases, the RT was not followed by surgery. Systemic treatment consisted of hormonal therapy in both groups. The RT plus surgery group had better survival rate, 58% vs. 35% at 5 years. However, the incidence of less favorable cases was higher in the RT alone group. Histological findings in the operated group are analysed to determine prognostic significance of residual disease. No residual or only damaged microscopic disease was found in the breast in 36% of the cases. The axillary lymph nodes (ALN) were free of disease in 42% of the women. Patients with negative ALN after RT had significantly better 5-year survival (82% vs. 43%) and LTC (85% vs. 60%) rates. Decreased chest wall recurrence rate was associated with no residual or damaged microscopic disease in the breast (5% vs. 21%). The disease-free ALN were more common after 50-80 Gy telecobalt than after 40-50 Gy kV irradiation (51% vs. 33%). Primary tumor size (phi less than 5 cm vs. phi greater than 5 cm) had no significant impact on histological findings or on prognosis. Residual disease is mainly a marker of tumor-host relationship which indicates the biological aggressiveness of the disease. PMID- 3671769 TI - Squamous cell carcinoma of the tonsillar area treated with radical irradiation. AB - This is an analysis of 136 patients treated with radiation therapy alone (104) or in conjunction with planned neck dissection (32) for squamous cell carcinoma of the tonsillar area between October 1964 and August 1983. All patients have a 2 year follow-up and 94 (69%) have a minimum 5-year follow-up. Patients were excluded from analysis of disease control at the primary site and/or neck if they died within 2 years of treatment with that site continuously disease-free. All patients were treated with continuous-course irradiation; those treated with the planned split-course technique are not included. Once-a-day fractionation was used in 105 patients and twice-a-day fractionation in 31 patients. External beam alone was used in 93 patients, and external beam followed by a radium needle implant boost to the primary site was employed in 43 patients. Rates of initial local control with irradiation and ultimate local control after surgical salvage of irradiation failures are as follows: T1, 10/12 (83%) and 12/12; T2, 36/46 (78%) and 41/46 (89%); T3, 28/39 (72%) and 28/39 (72%); T4, 5/16 (31%) and 5/16 (31%). Local control data are also presented as a function of tumor site within the tonsillar area, total dose, dose per fraction, and external beam alone versus external beam plus radium needle implant. The 5-year determinate survival rates by modified AJCC stage are as follows: I, 3/3; II, 13/14; III, 14/17; IVA, 6/14; and IVB, 4/19. PMID- 3671770 TI - Irradiation of murine lip mucosa in combination with 5-fluorouracil, administered by single dose injection or continuous infusion. AB - The possible interaction of 5-fluorouracil (5-FU) and irradiation on mouse lip mucosa was studied, with special interest for the influence of the route of administration of the drug, either by single intraperitoneal (i.p.) injection or by 7 days continuous subcutaneous infusion. Apart from the possible modification by the drug of radiation-induced damage to the lip mucosa assessment was made of the systemic toxicity. No modification of the radiosensitivity of mouse lip mucosa nor of its repair capacity was observed with the use of 5-FU given either by i.p. injection or by continuous infusion. However, the combination of 5-FU and irradiation resulted in an increased systemic toxicity which was only seen when 5 FU was administered by an i.p. injection in close timing with irradiation. It is suggested that this increased systemic toxicity is caused by the combined effects of irradiation and 5-FU on the alimentary tract, although we could not demonstrate the mechanism of it. PMID- 3671771 TI - Effect of decreasing the dose rate of irradiation on the mouse lip mucosa. Comparison with fractionated irradiations. AB - The effect of continuous irradiation, delivered at five different dose rates (642, 76.8, 14.1, 2.9 and 1.5 Gy.h-1), has been investigated using the mouse lip mucosa. There was a striking dose rate effect (DRE) below 14.1 Gy.h-1 while above this dose rate the DRE was relatively small. No DRE was observed between irradiations delivered at 642 and 76.8 Gy.h-1. A comparison was made with the previously published results of high dose rate (84 Gy.h-1) fractionated irradiation (2, 4, 10 and 20 fractions). For both types of irradiation treatment an alpha/beta value of 7.4 Gy and a half-time for repair of 47 min was derived. PMID- 3671772 TI - Interaction of cis-diamminedichloroplatinum and renal irradiation on renal function in the young and adult rat. AB - The interaction between single low doses of cis-diamminedichloroplatinum(II) (c DDP) and renal irradiation (7.5, 10, 12.5 Gy) on renal function and systolic blood pressure (SBP) was investigated in young (3-4 weeks old, BW 45-65 g) and adult rats (over 12 weeks old, BW 230-290 g). The glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), plasma creatinine, urea and SBP were measured over 24 weeks. Changes in ERPF, plasma creatinine and urea concentrations paralleled GFR changes, but tended to be less pronounced. In young rats, BW and GFR were 10-20% below control values after c-DDP administration (5 mg/kg BW). Irradiation caused a dose-dependent drop in GFR, starting 4 weeks after irradiation in young rats. When c-DDP was given immediately after irradiation to the young rats, the loss of renal function was more pronounced than after either treatment modality alone. Dose-effect curves for a greater than 25% reduction of the GFR relative to controls (ml/min) after 24 weeks gave an ED50 of 9.8 Gy for irradiation alone and 4.6 Gy for irradiation followed by c DDP. After correction for the drug effect, dose-effect curves were similar for renal irradiation given alone or followed by c-DDP administration in young rats. In adult rats, c-DDP (2.5 mg/kg BW) or irradiation alone did not significantly alter renal function during the follow-up period. Only 12.5 Gy in combination with c-DDP, caused a significant reduction in GFR after 16 weeks in adult rats. In adult rats data were too limited for probit analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671773 TI - Experimental irradiation of the rat ureter: the effects of field size and the presence of contrast medium on incidence and latency of hydronephrosis. AB - Following X-irradiation of a 1.5 cm length of rat ureter, hydronephrosis developed after doses down to 10 Gy. The estimated ED50 was 11.8 Gy. In the dose range 37.4 Gy to 17.5 Gy there was a significant increase in latency with decreasing dose, but at lower doses the latency did not increase further. Reducing the length of ureter irradiated to 0.5 cm or 0.8 cm caused a decrease in incidence of hydronephrosis and longer latency periods. The ED50 for rats irradiated to 0.5 cm of ureter was 29.6 Gy. The possibility that secondary radiation produced as a result of interaction between X-radiation and iodinated contrast medium might affect the radiation induction of hydronephrosis was investigated. No difference was found between groups of rats irradiated with or without injection of contrast media. PMID- 3671774 TI - The radioprotective effect of N-acetylcysteine in thorax irradiation of mice. PMID- 3671775 TI - Radiotherapy of prostate carcinoma: results of treatment and complications. AB - During October 1974 and December 1981, 204 patients with a localized prostate carcinoma were treated by radiotherapy. One hundred and eighty two patients were suitable for this evaluation. The minimal time of follow-up was 30 months, the mean time 54 months. All patients had a split-course radiotherapy starting by equally weighted opposed pelvic fields with daily doses between 1.8 and 2 Gy, a rest period of 6-7 days and a total dose between 60 and 70 Gy. The overall survival rates (actuarial) for all patients were 64% after 5 years and 55% after 8 years. Several prognostic factors were evaluated. The main factor was tumor grading, the 5 year survival rates fall off from 81% for G1, 65% for G2 to 40% for G3. Split according to T-categories, 5 year survival rates were 73% in T1, 74% in T2, 59% in T3, and 50% in T4. When using the American staging system, we found 75% in stage B and 59% in stage C. There was no statistically significant influence of age and dose on survival, but a clear trend for better survival with higher doses. 36.8% of all patients relapsed, 79% of them developed only distant metastases. Comparing grading and appearance of distant metastases, we found 58% in the group of G3 tumors. There was no influence of transurethral resection (TUR) on survival. Side effects were observed frequently, but mostly mild and transient, late effects were rare. PMID- 3671776 TI - What is nursing--more than glue! PMID- 3671777 TI - The Labour Agentry Scale: psychometric properties of an instrument measuring control during childbirth. AB - Psychometric and field studies are reported concerning the development and assessment of the Labour Agentry Scale, an instrument measuring expectancies and experiences of personal control during childbirth. Factor analysis yielded evidence that it is a unifactorial scale, with factor loadings between 0.36 and 0.85. Dual-scaling techniques corroborated the results of factor analysis and provided evidence that few differences exist between antepartum and postpartum samples' responses to individual items. Field studies yielded evidence of an inverse relationship between anxiety and control, as well as evidence of construct validity. For example, subjects who had spontaneous, unmedicated births had the highest Labour Agentry Scale scores. PMID- 3671778 TI - Validation of an instrument to measure exercise of self-care agency. AB - The purpose of this study was to examine the reliability and construct validity of Kearney and Fleischer's (1979) Exercise of Self-Care Agency Scale. The Self Directed Learning Readiness Scale (SDLRS) (Guglielmino, 1977) was used to test construct validity. Subjects consisted of 62 post-basic nursing students and 57 adult diabetic patients. The results showed significant correlations between the scales for both groups. However, the relationship was stronger for the student group (r = .505) than for the patient group (r = .302). The Exercise of Self Control Agency Scale was significantly correlated with all eight factors of the SDLRS for the student group and with only three factors for the patient group. Split-half reliability for the former scale was similar for both groups (r = .78 and .74); test-retest reliability was lower for the patient group (r = .55) than for the student group (r = .76). PMID- 3671779 TI - Body temperature in elderly surgical patients. AB - Body temperatures of 37 elderly surgical patients with fractured hips were measured using tympanic membrane probes. Comparisons were made between patients having the usual body coverings, eight were hypothermic as compared with one of 16 patients with extra body coverings. Temperatures were significantly different between groups intraoperatively (p less than .001) and in the recovery room p less than .002) where the lowest temperatures were recorded. Anxiolytics given preoperatively had a significant negative relationship with lower body temperatures. Careful monitoring of temperatures and extra coverings are recommended for elderly hip fractured patients perioperatively. PMID- 3671780 TI - Perceptions and attitudes toward nursing impairment. AB - Perceptions and attitudes toward nursing impairment held by 1,047 registered nurses were examined. Factor analysis of the 32 Likert-type items in an original survey questionnaire revealed an underlying structure of nine dimensions characterizing attitudes toward impairment. Analyses of variance and covariance gave evidence that supervisors were more likely than staff nurses to perceive a need for disciplinary action in responding to cases of nursing impairment; staff nurses were more likely to view impairment as treatable. Significant differences were found among attitudes toward drug abuse, alcohol abuse, and emotional distress as forms of impairment. PMID- 3671781 TI - Spirituality and well-being in terminally ill hospitalized adults. AB - Initial research into the significance of spirituality among terminally ill adults was extended. Two hypotheses were examined using three groups of 100 adults matched on age, gender, education, and religious background: a) Terminally ill hospitalized adults indicate a greater spiritual perspective than nonterminally ill hospitalized adults and healthy nonhospitalized adults. b) Spiritual perspective is positively related to well-being among terminally ill hospitalized adults. All 300 participants completed the Spiritual Perspective Scale, Index of Well-Being, and other information. Planned comparisons analysis results supported the first hypothesis; low but significant correlation lent support to the second hypothesis. Differences among groups on recent change in spiritual views also were examined; a significantly larger number of terminally ill adults indicated a change toward increased spirituality than did nonterminally ill or healthy adults. PMID- 3671782 TI - Women's causal explanations of divorce: relationships to self-esteem and emotional distress. AB - The relationships of women's self-esteem and emotional distress to their causal explanations of divorce were investigated. Thirty-six women ending a first marriage were interviewed using the Tennessee Self-Concept Scale (Fitts, 1965), the Ireton Personal Inventory (Ireton, 1980), and the Women's Attributions to Divorce Questionnaire. Self-esteem was associated with causal explanations characterized as internal, whereas emotional distress was related to causal explanations characterized as internal, stable, and global. The relationships occurred only in women who perceived themselves as being unable to prevent the marriage from ending. The findings support the learned helplessness model for predicting emotional distress and provide nurses with information useful in assessing mental health. PMID- 3671783 TI - Peptide YY interacts with secretin and duodenal acidification to inhibit gastric acid secretion. AB - Previous studies have indicated that plasma levels of peptide YY (PYY) increase significantly after a meal. The purpose of this study was to characterize the interaction of PYY and secretin in the inhibition of gastric acid secretion, and to determine whether PYY can influence acid-induced inhibition of gastric acid secretion in conscious dogs. I.v. administration of PYY at 200 pmol/kg/h inhibited pentagastrin (1 microgram/kg/h)-stimulated gastric acid output (P less than 0.05). PYY further augmented i.v. secretin-induced inhibition of pentagastrin-stimulated gastric acid output by 32 +/- 7%, and intraduodenal hydrochloric acid-induced inhibition of pentagastrin-stimulated gastric acid output by 40 +/- 12%. The mean integrated release of secretin response to duodenal acidification (3.9 +/- 1.0 ng-[0-60] min/ml) was not affected by PYY (3.3 +/- 0.9 ng-[0-60] min/ml). The present study demonstrates that PYY can interact with secretin and duodenal acidification in an additive fashion to inhibit pentagastrin-stimulated gastric acid secretion. Our results suggest that several hormones that are released postprandially can interact with each other to inhibit gastric acid secretion. PMID- 3671784 TI - Identification and distribution of immunoreactive peptide YY in the human, canine, and murine gastrointestinal tracts: species-related antibody recognition differences. AB - A radioimmunoassay using two antisera (antibody 80 and antibody 213) from rabbits immunized with porcine peptide YY has been characterized for both sensitivity and specificity. To determine the distribution of peptide YY in the gut, fresh tissue specimens from the human and canine gut were separated into mucosal-submucosal and muscularis externa layers by microdissection. These tissues and transmural specimens from murine gut were acid-extracted and neutralized, followed by radioimmunoassay using each antiserum. Immunoreactive peptide YY in canine and murine gut was present in similar concentration and distribution using each antiserum, with highest concentrations in the mucosal-submucosal layer of the descending colon. Using antibody 213, immunoreactive peptide YY throughout the human gut was measured only at the lower detection limit of the radioimmunoassay. By contrast, using antibody 80, peptide YY in human gut was present in a distribution similar to canine and murine gut. Using antibody 80, one major immunoreactive species was identified with C18 reverse-phase high-performance liquid chromatography in extracts of human, canine, and murine colon. These results suggest species-related antibody recognition differences. The similar concentrations of peptide YY in canine and murine gut determined with the two antisera are consistent with the hypothesis that the amino acid sequences of canine and murine peptide YY are similar to porcine peptide YY. Using antibody 213, the low concentrations of immunoreactive peptide YY found in human gut are consistent with the hypothesis that human and porcine peptide YY have different amino acid sequences. Antisera prepared by immunization with porcine PYY must therefore be carefully characterized prior to studies using human sera or human tissue extracts. PMID- 3671785 TI - Effects of nonapeptide antagonists on oxytocin- and arginine-vasopressin-induced analgesia in mice. AB - Several peptides, including arginine-vasopressin (AVP), neurotensin, and substance P, produce analgesia that is not mediated by opiate systems. Using the hot plate test, we studied the analgesic effects of intracisternal (i.c.) administration of various doses of the nonapeptide oxytocin (OXY) in Swiss Webster mice. We found that OXY (1-4 micrograms) significantly increased the latency of animals to jump or lick their paws after placement on a hot plate. This effect was not blocked by naloxone pretreatment, which suggests that it is not opiate dependent. Using the hot plate test, we confirmed that AVP (1 and 4 micrograms) also produces analgesia. We then studied the analgesia produced by OXY and by AVP using 3 nonapeptide analogues with antagonist properties: [Pen1, LpMePhe2, Thr4, Orn8]OXY (PLMPTO-OXY) that has anti-oxytocic properties in the uterine contraction assay, d(CH2)5Tyr(Me)AVP(dTM-AVP) which antagonizes the antidiuretic properties of AVP and d(CH2)5D-Ile2,Abu4-AVP (dIA-AVP) which antagonizes the vasopressor effects of AVP. Simultaneous administration of PLMPTO OXY completely blocked the analgesia produced by OXY whereas the antidiuretic antagonist dIA-AVP partially blocked OXY-induced analgesia and dTM-AVP had no effect. None of the antagonists used blocked AVP-induced analgesia. We concluded that the neural systems mediating the analgesic effects of i.c. OXY differ from those for AVP. PMID- 3671787 TI - Abstracts of the 7th national scientific meeting of the Bayliss and Starling Society. 28-29 September 1987, Belfast, Northern Ireland. PMID- 3671788 TI - [Data processing system of personnel exposure with personal computer]. AB - This paper describes a software package that manages personnel exposure data with a personal computer. The exposure data is automatically transferred to the computer through a floppy disk supplied by film badge service companies. The computer processes data of about 4000 persons who belong to the 11 facilities and prints out the reports on the distribution of personal exposure level. This system made it possible for the radiation protection division to rapidly investigate the actual situation of occupational exposure with less laborious works. PMID- 3671786 TI - Mechanism of neurotensin depolarization of rabbit colonic smooth muscle. AB - The aims of this study were (1) to measure the effect of neurotensin on the membrane potential of circular muscle of the distal colon of the rabbit and (2) to determine the mechanism by which neurotensin affects the membrane potential of this tissue. The membrane potential was measured with microelectrodes placed intracellularly and the double sucrose gap. Neurotensin (10(-11) M to 10(-7) M) dose-dependently decreased the membrane potential. The maximum decrease in membrane potential occurred with 10(-9) M neurotensin. The ED50 of neurotensin depolarization of the membrane potential was 0.87 +/- 0.33 X 10(-10) M. The frequency of the slow waves was unchanged after neurotensin. The voltage response to a constant current pulse decreased as the concentration of neurotensin increased. The amplitude of the voltage response after a 0.6 microA current pulse decreased by 6 +/- 0.5 mV after neurotensin (10(-7) M) compared to the Krebs control (P less than 0.05). Decreasing the [Na+]o to 0-23 mM did not affect the decrease in membrane potential after neurotensin. However, perfusion with a test solution containing no added Ca2+ or verapamil (10(-5) M) inhibited neurotensin depolarization of the tissue. Evidence was found that neurotensin depolarizes colonic circular smooth muscle, and the decrease in membrane potential is associated with an increase in conductance which is dependent on influx of Ca2+. PMID- 3671789 TI - [The reactor accident at Chernobyl': identification of radionuclides in fallout in Niigata City]. AB - The fallout caused by the accident of Chernobyl' nuclear reactor has been monitored in Niigata City (April 30-June 3, 1986). Twelve nuclides (131I, 132I, 129Te, 129mTe, 132Te, 134Cs, 136Cs, 137Cs, 103Ru, 99mTc, 140La, 140Ba) were identified in aerosol samples. The same nuclides plus 7Be were identified in rain water. Gaseous and particle-bound 131I were separately trapped on a glass filter and a charcoal filter, respectively. Results indicate 50-60% of atmospheric 131I is gaseous and the rest is particle-bound. Chloroform extraction of rain-water revealed that 40-60% of 131I in the rain-water sample exists in the form of IO3- and 131IO3- (131IO4-)/131I- seemed to increase with the lapse of time after the accident. PMID- 3671790 TI - [Influence of nuclear reactor accident at Chernobyl' on the environmental radioactivity in Toyama]. AB - The environmental radioactivity caused by the reactor accident at Chernobyl' was investigated from May 7 to May 31 of 1986 in Toyama. Measurement of radioactivities in airborne particles, rain water, drinking water, milk, and mugwort are carried out by gamma-ray spectrometry (pure Ge detector; ORTEC GMX 23195). Ten different nuclides (103Ru, 106Ru, 131I, 132Te-I, 134Cs, 136Cs, 137Cs, 140Ba-La) are identified from samples of airborne particles. In the air samples, a maximum radioactivity concentration of each nuclide is observed on 13th May 1986. The time of the reactor shut-down and the flux of thermal neutron at the reactor were calculated from 131I/132I and 137Cs/134Cs ratio. The exposure dose in Toyama by this accident is given as follows: internal exposure; [thyroid] adult-59 microSv, child-140 microSv, baby-130 microSv, [total body] adult-0.2 microSv, child, baby-0.4 microSv, external exposure; 7 microSv, effective dose equivalent; adult-9 microSv, child-12 Sv, baby-11 microSv. PMID- 3671791 TI - [A new evaporation procedure for monitoring of iodine-125 in liquid waste]. AB - A simplified monitoring method of 125I in liquid waste was devised. The waste water of 200 cm3 was taken on a Saran (polyvinylidene chloride) film covering a stainless steel vat. A stable iodine (20 mg) and sodium hydroxide (1 mmol) was added. The water was evaporated using an infra-red lamp. After heating to dryness, the Saran film was folded and transferred into a polyethylene tube. The radioactivity of 125I was counted with a well type NaI(Tl) scintillation counter. When a multi-channel analyzer was available for counting, an absolute decay rate of 125I was calculated with single and sum photo-peak counts. The radioactivity of 125I counted by a single-channel counter must be corrected with the counting efficiency of about 55%, with a special emphasis of a self absorption of photons. The recovery of 125I for concentrations below the permissible level was more than 98%. PMID- 3671792 TI - [Trends of irradiated foods in Japan and the world]. PMID- 3671793 TI - [Handling manual for brachytherapy sources. IV. Manual of safety use in brachytherapy]. PMID- 3671794 TI - [Analysis of the diagnostic efficacy of magnetic resonance tomography]. AB - During a preliminary 10-month clinical experience using MRI, 731 patients have been studied, almost 50% for brain and spine pathology. From 62% (skeletal studies) to 73% (brain and spine studies) of the patients underwent MRI after CT or US studies. While 75% of the MRI brain and spine examinations have been performed due to precise clinical indications, respectively 77% and 80% of the examinations at the level of bone joints and soft tissues and body have been selected on the basis of clinical research programs. Three percent of the patients could not complete the examination because of claustrophobia. MRI gave more diagnostic informations than CT or US in 67% (brain and spine studies), 41% (bone joint and soft tissue studies) and 33% (body studies) of the cases. On the contrary MRI has been less diagnostic than CT or US respectively in 9%, 12% and 11% of the cases. Furthermore in 18% of the patients studied for brain or spine pathology, MRI showed lesions not demonstrated by CT. The requests for routine neuroradiologic studies makes it necessary to have at least one MRI unit per 500,000 people. PMID- 3671795 TI - [Clinical applications of an instrument of resistive-type magnetic resonance of new design]. AB - In Magnetic Resonance, resistive magnets give a poorer image quality than superconductive magnets, due to the lower magnetic field strength, uniformity and stability of resistive magnets. However, recent developments in resistive magnet technology have improved the field strength, as well as its uniformity and stability. The aim of this paper is to report the preliminary results of a new resistive magnet based on a iron core technology with transverse field orientation, operating at 0.38 T. The clinical experience based on about 200 studies of the brain, spinal cord, cervical, thoracic, lumbo-sacral spine, heart, abdomen and joints was promising in most clinical applications with results comparable to those of superconductive magnets with a similar field strength. PMID- 3671796 TI - [The hyperostotic knee]. AB - Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder characterized by bone proliferation of spinal and extraspinal structures. Frequently, extraspinal manifestations may occur before the involvement of the spine. These alterations are so common and characteristic that they should be included in the diagnostic criteria for DISH. The patella is one of the most commonly involved sites. The knee of 48 patients affected by DISH, according to Resnick's diagnostic criteria, were subjected to systematic, radiographic and xerographic studies. The most characteristic radiographic patterns are: thickening of the anterior margin of the patella (81.1%); ossifying enthesopathy of supero-anterior margin of patella (68.7%); periosteal new bone formation on the tibial insertion of the cruciate ligaments (47.8%); presence of fabella (41.%); presence of megafabella (22.9%), which may come near the posterior profile of the femur. Changes are usually symmetrical in DISH: entheseal abnormalities mostly involve the antero-superior margin of the patella, whereas in osteoarthritis, osteophytes are found on the postero-superior margin. In the lateral view enthesophytes at the bone attachment of the cruciate ligaments are oriented inside the joint space; on the contrary, osteophytes are always oriented outside the joint space. Radiographic manifestations of the fabella are similar to those observed in osteoarthritis, and so they cannot be utilized in the differential diagnosis of these diseases. PMID- 3671797 TI - [Radiological assessment of Crohn disease]. AB - Fifty-eight consecutive cases of patients affected by Crohn's disease, with ileum (23/58), colon (10/58) and ileo-colic (25/58) involvement were studied. A good overall sensitivity was reached by the radiological procedures employed (barium meal, barium enema, enteroclysis). Enteroclysis is proposed as a second-step method for the study of ileum involvement, because it provides a quite precise assessment of disease stage and extent. Some criteria for a rational use of current radiological procedures in the follow-up of both surgically and medically treated patients are proposed. Moreover it is suggested that better coordination of anatomo-radiological and clinical aspects could improve the therapeutic approach and prognostic judgement in such cases. PMID- 3671798 TI - [Computerized tomography in renal injuries]. AB - CT scans were performed on 25 patients suspected of sustaining renal trauma. The utility of CT in both detecting renal damage and appraising the gravity of injuries was assessed. Nowadays, in fact, nephrectomy is reserved for lesions devastating the kidney parenchyma or rupturing the renal pedicle; so it is very important to identify both the kind of lesions, and the extent of the damage, for the purposes of a better planned therapeutic approach. CT does both, being more accurate than urography in the detection of renal fractures, intra or extraparenchymal hematomas and contrast media extravasation. Urography very often shows aspecific lesion patterns and sometimes it is also falsely negative. In the present series CT was more reliable than angiography itself, particularly in the diagnosis of extra-renal hematic collections, contrast media extravasation and injuries to the other abdominal organs. Although CT may arouse the suspicion of and sometimes correctly diagnose vascular lesions, such as renal infarction, angiography remains the choice examination in the study of vascular lesions, thanks to its characteristic and unmistakable images. PMID- 3671799 TI - [Computerized tomography in Peyronie's disease. Clinico-radiological comparison]. AB - The diagnostic capabilities of Computed Tomography (CT) in the study of Peyronie's disease are assessed. Twenty-four patients, with different symptoms and a variety of findings on physical examination (from normal to large painful plaques), were studied with third-generation CT equipment. CT defined the normal pattern of the albuginea, as a hyperdense (ranging from 80 to 100 HU) thin and regular line on the periphery of the corpora cavernosa. Pathologic features such as irregularities, disruptions and calcifications of the tunica can be identified; irregularities are shown as circumscribed zones of hyper or hypodensity, disruptions as small or large areas of complete absence of the thin regular line of albuginea. Calcifications are identified as hyperdense nodular or plaquelike areas of 200-300 HU. When physical examination and CT patterns are compared, the reliability of the method is revealed. It provides an accurate definition of the albugineal lesions, imaging all abnormalities detected on physical examination and demonstrating additional, non-palpable and doubtful lesions. Physical examination and CT findings concurred in 19 cases (79%), whereas disagreement was observed in 5 (12%). In 3 cases CT showed calcified plaques not revealed on physical examination; in 2 cases the plaques revealed by palpation were not confirmed by CT. Furthermore there may be a connection between CT aspects of the albuginea and the hystological findings in the disease: irregularities could represent the early stage, interruptions the mid-stage and calcifications irreversible final abnormalities. CT, being a non-traumatic, harmless diagnostic method, improves the clinical evaluation of the patient and can facilitate the choice of the most suitable therapeutic modalities, as well as the follow-up of their results. PMID- 3671800 TI - Diagnostic and prognostic role of infrared thermography. AB - A series of 469 breast cancer studied by physical examination (PE), mammography (M) and infrared thermography (TH) is discussed. Follow-up was performed up to 5 years later. The poor diagnostic role of TH is proven for the low sensitivity in the total series (0.47) and, particularly, in T1 cancers (0.26). TH does not increase significantly the cumulative sensitivity (0.98 vs. 0.97 in the total series). Its limited advantage is offset by the great number of useless biopsies due to TH false positive. A correlation between TH pattern and prognosis is evident only when TH is considered independently from other reliable prognostic indicators such as the T or N categories. If survival curves are stratified by T or N or if a multivariate analysis based on TH, T and N variables is performed, all correlations between TH pattern and prognosis disappear; for this reason the use of TH as a prognostic indicator in the clinical practice is disregarded. PMID- 3671801 TI - [The Chernobyl accident. Evaluation of the doses absorbed by the thyroid gland in children of a mountain community from the measurement of I131 retained activity]. AB - I131 thyroid uptake after the Chernobyl's accident was sampled in a Val Pellice school. Children were grouped according to sex, age and area of residence. The procedure used in collecting data and calculating the transformation coefficients from activity counts by computer simulation is analysed, as are the errors and sensitivity of the method. The activities were then converted into doses using an intake model. The dose levels identified are lower than the estimates based on the measurement of environmental matrices. Statistical analysis revealed certain subgroups with significantly different levels of absorption: particularly groups accustomed to a different diet or living in particular areas. PMID- 3671802 TI - [Results of radiotherapy in the treatment of 218 carcinomas of the tonsillar area]. AB - After a brief review of the literature, the results of the treatment by radiation therapy in 218 patients with tonsillar region carcinoma are reported. The patients were treated at the Turin University Radiotherapy Department (131 cases) and at the Radiotherapy Department of the Ospedale Maggiore, Novara (87 cases) from 1976 through 1984. The series included 29 T1, 88 T2, 64 T3 and 37 T4; 86 patients (40%) were N0. Only 49 patients were stages I and II (1/4 of the total). The local control (T) rate at the end of therapy was 63.5% for the overall series (139/218) ranging from 100% in T1, 72.6% T2, 54.6% T3 to 30% T4; the regional control (N) for patients with cervical lymphadenopathy was 66% (88/132). The overall 5-year survival was 38%; the 5-year disease-free survival was 35%. The 5 year survival according to T-stage was 52% for limited cases (T1-T2) in comparison to 22% for advanced ones (T3-T4). The 5-year survival for N0 stage was 55%; when neck nodes were present (N # 0) the survival was 29% after 5 years. Complications included 6 cases of trismus and 2 osteonecroses of the mandible. Second primary malignant diseases were seen in 17 cases (7.8%). The most common cause of death was failure in primary tumour control (80% of cases). In this series the results of radiotherapy of early stage tonsillar carcinomas are quite good; patients with large tumour masses fare less satisfactorily. Better results should be obtained in the future by identifying prognostic factors, monitoring potential causes of treatment failure and optimizing the radiotherapeutic treatment plan and technique. PMID- 3671803 TI - [Concomitant therapy with cisplatin and radiotherapy in locally advanced tumors of the cervico-facial area]. AB - Nineteen patients with locally advanced head and neck cancer were treated from November 1983 to January 1986 with standard loco-regional Radiotherapy: 2 Gy for 5 days/week up to a total dose of 70 Gy and simultaneous Cisplatinum 20 mg/m2 weekly. All patients achieved a response: 10 (52%) obtained a complete remission (CR) and 9 (48%) a partial remission (PR). Four of 9 patients in PR after chemoradiotherapy were disease-free after radical resection of the residual masses, while another patient was completely cured after second-line chemotherapy. The overall CR was then 79% (15/19). The results were analyzed according to the nodal status and showed that: 92% (11/12) of patients with initial nodal involvement (N1-2) achieved a CR and 75% of them were disease-free after a median follow-up of 23+ months, while only 57% (4/7) of patients with advanced nodal involvement (N3) obtained a CR (p greater than 0.05; NS) and 28% (2/7) of them were alive without evidence of disease (p less than 0.05) after 4+ and 30+ months. Toxicity was moderate: nausea and vomiting (grade 2-3) occurred in about 50% of patients, mucosal toxicity (grade 1-2) in 58%. Myelosuppression was negligible. No patient developed renal failure. Weekly cisplatinum administration during radiotherapy deserves further study especially in the management of patients with advanced primary tumor and minimal lymph node involvement. PMID- 3671804 TI - [Radiotherapy of carcinoma of the glottis in the initial stage]. AB - The control of early glottic cancer is equally satisfactory with either surgical resection or radiation therapy; this last method gives the patient good functional results. During the period from 1/1978 to 12/1985, 73 patients with early glottic carcinoma (T1 N0 M0) were treated in the Institute of Radiotherapy L. Galvani, University of Bologna; 45 were stage T1a (tumour limited to one vocal cord) and 28 were stage T1b (tumour of both vocal cords or involving anterior commissure); radiation treatment utilised a 60Co machine and 5 x 5 cm fields; the median dose was 67.2 Gy (range 50-76) with conventional fractionation. Ten patients had local recurrence; the median time of recurrence was 13.4 months; 9/10 were treated by surgery and 2/10 died, so the overall control by radiotherapy with surgery in reserve was 100% in T1a tumours and 90.6% in T1b ones. The 5-years disease free survival rate was 93.1% in T1a tumours and 69% in T1b; lesions involving anterior commissure had the worst prognosis, independent of the dose and time-dose factor (3/10 recurrences in the group treated with TDF less than 110 and 4/18 recurrences in the group with TDF more than 110). PMID- 3671805 TI - [Effect of Eimeria falciformis infection on the development of toxoplasmosis in mice]. AB - White mice previously infected with 10(2), 10(3) or 10(4) Eimeria falciformis oocysts on days 0, 5, 10 or 30 were inoculated per os with 10(1), 10(2), 10(3) or 10(4) Toxoplasma oocysts. While the results obtained for mice with higher Toxoplasma inocula were consistent, animals with 10(1) and 10(2) oocysts previous inoculation with Eimeria showed important differences related with those infected only with Toxoplasma. For example, survival time was higher in animals infected with both parasites, especially if inoculated with Eimeria 30 days before Toxoplasma infection. Furthermore the number of T. gondii cysts found in the animals previously infected with Eimeria was lower compared with mice inoculated with Toxoplasma only. Body weight of mice infected with Toxoplasma previous infection with Eimeria was almost normal in relation to those infected only with Toxoplasma, indicating a probable pathological effect due to the parasite, more evident in "non immunized" mice. PMID- 3671806 TI - [Ultrastructure of the Ranvier's nodes in myelinated nerve fibers of the shrimp Penaeus]. AB - From a comparative point of view the axonal cytology and the ultrastructure of Ranvier nodes in non-giant myelinated fibers of the shrimp Penaeus are described. PMID- 3671807 TI - Purification and some properties of hemagglutinating protein mutina from bushmaster Lachesis muta snake venom. AB - Lachesis muta snake venom induced aggregation of bromelain sensitized human erythrocytes at a concentration of 1 mg/ml. The hemagglutinating protein was purified by DEAE-Sephadex A-50 column chromatography. Polyacrylamide gel electrophoresis revealed at least three bands, whereas SDS electrophoresis in the presence of 2-mercaptoethanol showed a single one. Isoelectric focusing revealed hemagglutinating activity in the range of pH 3-8. The maximum peak (mutina) at pH 5.5. This fraction was active in agglutinating human RBC of types A, B, O Rh (+) and B, O Rh (-). One mM EDTA and 1 mM Ca++ did not alter the agglutinating time significantly. Lactose and inositol inhibited the agglutination of A, B, O Rh (+) and B, O Rh (-) human RBC. The present study showed the non specificity of the hemagglutinating activity of mutina. It was also shown that mutina is a non mitogenic protein. PMID- 3671808 TI - Rat macrophage activity against Toxoplasma gondii studied by electron microscopy. AB - An electron microscope model was used to study the effect of rat peritoneal macrophages on Toxoplasma gondii. 10(7) tachyzoites were injected i.p. in 30 days old rats. After 1, 2, 4, 8 and 24 h peritoneal exudate was withdrawn and infected phagocytic cells were prepared for electronic microscope studies. Toxoplasma organisms inside of rat macrophages showed remarkable lesions such as vacuolization and organisms were totally lysed inside of macrophages of more than 8 h infection rats. The results confirm at molecular level, the importance of rat macrophages in the natural adaptation of this rodent to T. gondii. PMID- 3671809 TI - [Morphological changes induced by ampicillin in Campylobacter]. AB - Morphologic changes in Campylobacter fetus ssp. jejuni were evaluated as cultivated on thioglycollute broth, containing minimum of 0.1, 1.3 and 10 Ampicillin minimal inhibitory concentration (MIC). During the first four hours of incubation, no changes occurred in the presence of 0.1 MIC; but with the rest of the ampicillin doses, even at the first hour, a proportion larger than 5% of filament-policurved forms was found, and it increased with the incubation time. The greatest number of altered bacteria was found with the use of 10 MIC. No other morphologic changes were observed. PMID- 3671811 TI - Acquisition of generalized telephone use by students with moderate and severe mental retardation. AB - This study examines the effects of one approach for selecting teaching examples on the development of generalized telephone skills with moderately and severely mentally retarded high school students. Four subjects were taught to make and receive telephone calls within a counterbalanced multiple baseline design. The primary dependent variable was generalization of telephone skills to nontrained telephone situations in home, school, and community settings. Results document the effectiveness and efficiency of the training approach. An eighteen-month validation assessment also shows that telephone use continued as a regular part of each student's lifestyle. The instructional implications of these results are discussed as well as methodological implications for applied research on generalization. PMID- 3671810 TI - Naltrexone in treatment of self injurious behavior: a clinical study. AB - It has been suggested that the parenteral opiate antagonist, naloxone, might ameliorate self-injurious behavior. However, clinical studies have had conflicting results. We have evaluated whether a potent oral opiate antagonist, naltrexone, is effective in the treatment of this condition. The study was conducted on two young, profoundly mentally retarded adults, who exhibited intractable self-injurious behavior. A double-blind, placebo-controlled, within subject-withdrawal design was utilized. One subject was studied for 12 weeks and the other one for 18 weeks. No measurable effects on the self-injurious behavior were observed. PMID- 3671812 TI - Wyatt v. Stickney: a consent decree. AB - On September 22, 1986, Judge Myron Thompson issued a consent decree in the Wyatt v. Stickney litigation. The settlement occurred 14 years after Judge Frank M. Johnson, Jr. rendered his landmark decision in this case. The consent decree included termination of the court's active supervision of the state's mental health system, termination of the receivership, and termination of the court monitor's powers. The state agreed to adhere to Wyatt standards, maintain Title XIX accreditation, continue deinstitutionalization efforts, and develop an internal advocacy and quality assurance program. Mechanisms are also to be put in place to apprise the plaintiffs' attorneys of progress in these efforts. PMID- 3671813 TI - Stimulus manipulation versus delayed feedback for teaching missing minuend problems to difficult-to-teach students. AB - The present study evaluated two procedures, Stimulus Manipulation and Delay Feedback Only, for teaching difficult-to-teach students to solve missing minuend problems (i.e., missing number problems starting with a minus sign). The Stimulus Manipulation procedure was directed at establishing the target skill with a minimum of errors. The training consisted of three phases of several steps each. The first phase was designed to establish a nonnumerical response to a prompt, the shape of which was gradually transformed into the final discriminative stimulus. The second phase was designed to extend the control of this stimulus to the numerical operations and to eliminate all supplementary stimuli. The third phase gradually eliminated the originally trained nonnumerical responses. The Delayed Feedback Only procedure included no stimulus manipulation and consisted of the experimenter giving only delayed right.wrong feedback on the solutions. The data indicate that both procedures resulted in all (N = 4) subjects (a) learning to solve the target problems, (b) generalizing this skill to similar, more advanced problems, and (c) maintaining it over multiple intervals of several consecutive weeks. However, systematic differences in error rate and long-term retention across training methods were observed, favoring the Stimulus Manipulation procedure. PMID- 3671815 TI - Referential first mention in narratives by mildly mentally retarded adults. AB - Referential first mentions in narrative reports of a short film by 40 mildly mentally retarded adults and 20 nonretarded adults were compared. The mentally retarded sample included equal numbers of male and female, and black and white speakers. The mentally retarded speakers made significantly fewer first mentions and significantly more errors in the form of the first mentions than did nonretarded speakers. A pattern of better performance by black males than by other mentally retarded speakers was found. It is suggested that task difficulty and incomplete mastery of the use of definite and indefinite forms for encoding old and new information, rather than some global type of egocentrism, accounted for the poorer performance by mentally retarded speakers. PMID- 3671814 TI - A comparison of time delay and system of least prompts in teaching object identification. AB - This study is a comparison of two response prompting procedures: Progressive time delay and system of least prompts. Three students with severe handicaps were each taught to identify eight functional objects, four objects with each prompting procedure. The procedures were compared in terms of effectiveness (establishing criterion level correct responding) and efficiency, (sessions and trials to criterion, errors to criterion, and the number of minutes of direct instructional time). A combination of two concurrently operating multiple probe designs (Parallel Treatments Design) in which extraneous variables were counterbalanced across sessions was employed. An analysis of the results indicates that both prompting procedures were effective in establishing correct responding at criterion levels, but the time delay procedure required fewer sessions, trials, and errors to criterion, and fewer minutes of direct instruction time than did the system of least prompts. Issues for further comparative research are discussed. PMID- 3671816 TI - A comparison of external and self-instructional teaching formats with mentally retarded adults in a vocational training setting. AB - A theory recently proposed by Whitman postulates that self-instructional training procedures should have special utility for low ability individuals. Although past studies have shown that self-instructional training programs can be employed to improve the performance of mentally retarded individuals in work situations, research has not examined whether this training format is superior to external instruction. To test Whitman's theory, mentally retarded adults were taught to perform a complex sequencing task through one of two training formats: self instruction or external instruction. Performance was evaluated through the examination of accuracy measures obtained during training, maintenance, and generalization assessments. Results indicated that participants receiving self instructional training were able to achieve and sustain a higher level of performance than participants receiving external instruction. While self instructionally trained subjects also showed superior performance on the generalization assessment, these results were not statistically significant. Secondary analyses revealed that higher ability participants, self instructionally trained participants, and participants who reached criterion on the training and generalization tasks self-verbalized more frequently during the various assessments. In contrast to prediction, there was no significant difference in the length of time required to train individuals in the two instructional groups. PMID- 3671817 TI - Use of the partial-sequential withdrawal design to assess maintenance of mentally retarded adults' acquired meal preparation skills. AB - This study is presented as a follow-up to an earlier fully-controlled acquisition study in which three mentally retarded adults had acquired the ability to use sequenced picture recipe cards to prepare breakfast and dinner meals. Immediately following the acquisition demonstration, instructional components and trainers were partially-sequentially withdrawn. Reliable self-reports from the subjects and their mentally retarded roommates were established prior to trainer withdrawal. The demonstrated self-report method provided a means to assess performance following the withdrawal of trainers. Performance was maintained during a 10 month period. PMID- 3671818 TI - Use of the alternating treatments design as a strategy for empirically determining language training approaches with mentally retarded children. AB - The present study was conducted as a practical demonstration of the potential utility of the alternating treatments design (ATD) in determining the most efficacious language training approach with mentally retarded children. Two subjects were chosen who used single words to communicate but who did not combine words to form sentences. Two sentence triads consisting of four words each and rated as equivalent in difficulty were trained. Each triad had one sentence trained using oral speech methods, a second trained using total communication methods, and a third sentence trained using a "modified" total communication approach. Each training procedure involved chaining sentence parts, reinforcement, and prompting. Oral methods involved presenting vocal stimuli and requiring vocal responses. Total communication methods involved presenting vocal and signed stimuli and requiring vocal and signed responses. The "modified" total communication approach also involved presenting vocal and signed stimuli, but required only vocal responses. For the initial sentence triad with each child, an alternating treatments design was used to determine the relative efficacy of the three language training methods. This approach was repeated with a second sentence triad for each child using a multiprobe technique within a multiple baseline design. Results were consistent within each subject but differed across subjects, with one child benefitting most from total communication methods and the other benefitting most from oral speech methods. Results were discussed in terms of the utility of the alternating treatments design as a potentially useful aid to traditional decision-making in the selection of language training strategies commonly employed with mentally retarded children. PMID- 3671819 TI - Sensory reinforcement of head turning with nonambulatory, profoundly mentally retarded persons. AB - Two experiments examined the reinforcing value of response contingent sensory events consisting of combinations of visual, auditory, and vibratory stimulation. Ten nonambulatory, profoundly mentally retarded individuals participated in these studies. Four different stimulus combinations were required to achieve operant conditioning of head turning responses in 6 participants. These sensory reinforcers included 5-s simultaneous presentations of picture, music, and vibration (N = 2), picture and music (N = 2), picture and vibration (N = 1), and picture alone (N = 1). These results indicate that systematically varying a multimodal sensory event is a fruitful procedure for identifying positive reinforcers for nonambulatory, profoundly mentally retarded persons. PMID- 3671820 TI - General case simulation instruction and the establishment and maintenance of work performance. AB - This study was conducted to determine whether general case simulation instruction on selected job task sequences and teaching examples, which sampled the range of stimulus/response variation encountered in two community jobs, resulted in the generalized performance of specific community job requirements by four young adults with severe handicaps. A multiple baseline across subjects and behaviors design was used to assess subject performance in simulation instruction, on concurrent and subsequent actual job probes, and in actual job instruction. Data indicated that simulation instruction on two representative teaching examples for each of two job task sequences resulted in concurrent generalized performance on six response examples for each task sequence, and in subsequent improvements in job entry skills which were maintained and extended during actual job instruction and instructor withdrawal phases. Results are discussed in terms of potential uses and misuses of general case simulations of community job skills. PMID- 3671821 TI - Caregiver perceptions of psychotropic medication in residential facilities. AB - Direct caregivers (designated as "psychopaedic nurses" in New Zealand) in two public residential facilities were surveyed regarding their perceptions, opinions, and knowledge of psychotropic drugs. Of 276 individuals contacted, 227 (82%) returned usable questionnaires. The results indicated that unit supervisors (charge nurses) and unit doctors were perceived as wielding most influence on decisions regarding psychotropic drugs, whereas caregivers based outside residential units were seen as having little influence. Aggressive/destructive behavior and, to a smaller extent, self-injurious behavior were seen as the most likely problem behaviors to lead to medication use. Subjective measures were generally favored for assessing drug effects although, in a hypothetical "ideal" situation, nurses gave increasing priority to more objective indices. Endorsement of behavior modification as an alternative to pharmacotherapy was generally high. A large majority of these caregivers (85%) expressed dissatisfaction with their training concerning psychotropic drugs. Finally, data were presented on drug topics about which respondents wanted to learn more and about changes they wished to see instated in their facilities. Our principal conclusion was that these data indicate a need for more education on a variety of social, pharmacological, and behavioral issues as they relate to medication use. PMID- 3671822 TI - Introducing EMR children to arithmetical operations: a program involving pictorial problems and distinctive-feature prompts. AB - This study assessed a program involving distinctive-feature prompts for teaching four EMR children to use the appropriate arithmetical operations (addition, subtraction, multiplication, and division) in the presence of multicomponent pictorial problems. The prompts highlighted critical features of the problems and cued the operations implied. The operations were computed by means of pocket calculators adapted to the response requirements. Training was carried out according to a modified multiple-probe design. Data indicate that the program was effective in establishing the use of operations with all subjects. This behavior was also displayed on problems portraying actions not included in training. The findings are discussed in terms of distinctive-feature prompting, orienting responses, and self-cueing. Attention is given to the generalization of responding across problems, and to educational implications of the program. PMID- 3671823 TI - [Anthropometric parameters in male Chilean adolescents of median-high socioeconomic level]. PMID- 3671824 TI - [Growth and development of children of adolescents of middle-low socioeconomic class. II: 30 months of life]. PMID- 3671825 TI - [Some clinical characteristics of patients with growth retardation]. PMID- 3671826 TI - [Barr chromatin: analysis of its current value]. PMID- 3671827 TI - [Early detection of congenital hypothyroidism]. PMID- 3671828 TI - [FG syndrome: report of 4 cases with agenesis of the corpus callosum]. PMID- 3671830 TI - [Chromatin-positive gonadal dysgenesis]. PMID- 3671829 TI - [Ambiguous sex with a 45,X/45,X,t(Y;14) chromosomal constitution]. PMID- 3671831 TI - [Trisomy 8 mosaicism: 46,XX/47,XX+8]. PMID- 3671832 TI - [Twins with autism and mental retardation associated with balanced (7;20) chromosomal translocation]. PMID- 3671833 TI - [Familial selective deficiency of somatotropin]. PMID- 3671834 TI - [Thrombocytopenia and radial aplasia of benign course in identical twins]. PMID- 3671835 TI - [Hyperinsulinism in newborn infants]. PMID- 3671836 TI - [Escobar syndrome]. PMID- 3671837 TI - [Rud's syndrome]. PMID- 3671838 TI - [Hyperthyroidism and choreoathetosis]. PMID- 3671840 TI - [Posttransfusion hepatitis]. PMID- 3671839 TI - [Lesch-Nyhan disease]. PMID- 3671841 TI - [Clinical relevance of monitoring the plasma levels of theophylline]. PMID- 3671842 TI - [Prevalence of Cryptosporidium oocysts in fecal samples sent for routine microbiologic study at a general hospital in Madrid]. PMID- 3671843 TI - [Non-Hodgkin's lymphomas: presentation of 129 cases]. PMID- 3671844 TI - [Reflex sympathetic dystrophy syndrome caused by phenobarbitol]. PMID- 3671845 TI - [Tests of sensitivity to cytostatics: can they contribute to treating cancer in a more rational form?]. PMID- 3671846 TI - [Reform of primary care as seen by patients: a study of user complaints]. PMID- 3671847 TI - [Pulmonary hemorrhage caused by the interaction of acenocoumarin and sodium diclofenac]. PMID- 3671848 TI - [Non-secreting myeloma: a different prognosis?]. PMID- 3671849 TI - [Inappropriate secretion of antidiuretic hormone syndrome. Does an idiopathic form exist?]. PMID- 3671850 TI - [Mediterranean boutonneuse fever in Mallorca]. PMID- 3671851 TI - [Hodgkin's lymphoma and positive anti-HIV antibodies]. PMID- 3671852 TI - [Listeria monocytogenes spontaneous peritonitis of the cirrhotic patient]. PMID- 3671853 TI - [A better life for the elderly. A joint meeting of ADELF-IEA. 13-14 November 1986. Proceedings]. PMID- 3671854 TI - Demographic aspects of population aging in developed countries. AB - There has been a dramatic growth of the elderly (aged 60+) population in the developed countries since 1950. By the year 2000, roughly 20% of the population in these countries will belong to the aged. Women far outnumber men among the elderly due to differential mortality trends between the sexes. Male life expectancy at age 60 varies from 19.1 years in Japan to 14.6 years in Hungary. Among females, the range is from 23.2 years (Canada) to 18.4 years (Romania). Mortality rates have declined dramatically in several countries since 1970 due primarily to declines in death rates from ischaemic heart disease and stroke. PMID- 3671855 TI - Changes in the healthfulness of life of the elderly population: an empirical approach. AB - This paper presents an empirical approach to measuring the healthfulness of life of the elderly population. It discusses information related to trends in disability-free and quality-adjusted life expectancy in the context of the current debate concerning prospects for a possible future compression of morbidity. Trends in each of the components underlying health expectancy are examined: survivorship and remaining life expectancy in each state of health, rates of institutionalization, as well as incidence of disability and prevalence of activity restriction in the household population. The effects on health expectancy of changes in these components are noted. PMID- 3671856 TI - [Locomotor and cardiorespiratory impairments after retirement in relation to certain occupational exposures during working life]. AB - The relationships between locomotor and cardiorespiratory impairments and occupational exposures during working life were examined, using a sample of 627 retired persons in the greater Paris area. Among men, there was a significant statistical association between carrying heavy weights and locomotor impairment. There were also significant associations between exposure to toxic products, tiring postures and vibrations and cardiorespiratory impairment among men. Concerning women, associations between exposure to dust and tiring postures during working life and cardiorespiratory impairment were observed. These results were obtained after adjusting for age, socio-professional status, tobacco use, living alone and after adjusting also for the other occupational exposures. These results are compatible with the hypothesis of long-term effects of occupational exposures on the principal health characteristics of the aged. PMID- 3671858 TI - [Visual defects of aging and their consequences]. AB - Visual impairments have a preeminent place in gerontology because they are a constant feature of the aging process. The impairments are manifested through both normal and pathologic phenomena. Individual, professional and social consequences of these impairments are many: An individual's personal activities are affected, but also his profession, and his participation in the life of the community, his capacity to drive an automobile safely-or merely to get about in his own home. PMID- 3671857 TI - [Nosologic framework of mental deterioration in aged subjects. From clinical practice to epidemiology]. AB - The difficulty of defining a precise nosologic framework for mental decline is linked, on the one hand, to the contradictions surrounding the term normalcy as age increases, and, on the other, to the fact that mental decline has been mired for years under a term that must be definitively proscribed: "psycho compartmental disorders of senescence". In this catch-all++ proscribed: "psycho compartmental disorders of senescence". In this catch++-all it is, in fact, essential to identify diseases whose nature, prognosis and, above all, therapeutic approaches differ fundamentally one from the other; to confuse them is to risk dramatic consequences. Standardization of diagnostic criteria through the combined use of clinical data, the DSM III classification, scored tests (MMS, Hachinsky, etc.), as well as scannography, presently makes it possible to arrive at the diagnosis of dementia with reasonable accuracy. This standardization++ has its limits and is not necessarily useful in atypical cases. It is nevertheless an indispensable tool for epidemiological studies and therapeutic trials. PMID- 3671859 TI - [Blockage of health care pathways]. AB - The social welfare policy, adopted in the 1970s, of devising ways to help the aged to remain in their homes and adapting institutions to the problems of the very old was instituted without being integrated into the incentive programs of such other sectors as public health and housing. The result has been a patchwork of services and centers whose organization, financing, and allowances are fragmented among a multitude of agencies. In addition, there is an imbalance of resources among the different sectors providing medical care and social welfare assistance. This makes for substantial difficulties in coordinating the activities of service providers and in financing some of the services. Moreover, inflexibility is apparent in adjusting types of services to varied and evolving needs. These problems explain the gaps, disjointed character of care, and faulty guidance in the system of distributing assistance that constitute so many blockages of the pathways used by the elderly. Such blockages cannot be usefully examined by analyzing the overall system, but must be studied at local points of convergence among clients, services and institutions. Such research is presently being conducted by the Concerted Action Committee of the European Community's Health Service Research. PMID- 3671860 TI - Characteristics of elderly people receiving home-help in three regions of France. AB - This study examined the allocation of home-help to the elderly using survey data collected on 3153 elderly respondents living at home in Haute-Normandie, Lille, and Ile-de-France. The samples of respondents were stratified by age, sex and area of residence, and were randomly selected from the electoral registers. The analysis identified 399 elderly people "in need": of home-help - living alone with disability. Of these, only 21% received home help. Of 174 home help recipients, 49% were "in need", and they received 52% of the volume (hours) of help allocated. The pattern of allocation varied regionally. PMID- 3671861 TI - [Study of the factors associated with the inability to perform household tasks among aged persons on the Ile-de-France. Application to the sub-regional planning of home-help services]. AB - The aim of this paper is to present the preliminary results of a planning project in the area of health and social services for the elderly, which makes it possible to estimate the number of persons likely to seek help from such services at the administrative area levels with decisional powers. This involves identifying predictors of disability from raw data routinely available in the census and at various administrative area levels, the municipality being the preferred level. From the epidemiological data collected at the regional level, an indicator of disability has been constructed. Initially, those factors possibly associated with disabilities were identified by regrouping the variables in four dimensions (discriminant analysis): socio-economic, physical environment, human environment, local administrative area environment (district data from census, medical-social services offered in the area, ect.). Subsequently, a logistic regression made it feasible to calculate the coefficients attached to these predictors of disability. In our sample, sex, age and level of housing amenities in the dwelling place appear to be predictors of disability. The application of the coefficients obtained at the region level--by means of an epidemiological approach to distributions by sex, age and dwelling amenities characterizing a municipality or group of municipalities (territorial approach)- enabled us to estimate the number of persons 65 and over likely to seek help from home-assistance services at whatever administrative area level chosen. In certain of its quantitative aspects, this mixed approach (individual and area) helps in determining need, the first step in the planning process. PMID- 3671862 TI - Pathways into and through services for the elderly in Europe: a research design. AB - Services for the elderly fall short of demand in all European countries. Resources are clearly inadequate. But are they most effectively used? This contribution presents the research design being used to study these questions in eight countries of the European Community. It postulates that shortage of shortage of services is aggravated by fragmentation between organisations and professions, by associated inflexibility in planning, transfer of resources and adaptation to changing needs, and by over-concentration of resources and influence upon medical and residential institutions. The study involves the observation of cohorts of patients/clients entering and passing through the health and social services and the relationship between this experience and the expectations of the clients, their relatives and their service providers. The key question is how far structural features of each health and social service system facilitate or hinder the effective delivery of care. Methodological problems of cross-national research are discussed. PMID- 3671863 TI - [Bacteriological aspects of 64 cases of severe pneumonia seen in a respiratory intensive care unit]. AB - We report on the bacterial aspects of 64 cases of severe pneumonia in an intensive care over a two year period, excluding cases occurring during artificial ventilation. In all the cases, the grave respiratory and haemodynamic signs, the blood gas and radiological findings justified admission of these patients to an intensive care unit. Specimens for bacteriology, virology and parasitology enabled a precise microbiological diagnosis 43 times (63%); in 44% of these diagnosis the possibility of the protected specimens (trans-tracheal, protected brushing) were confirmed by another specimen (pleural or blood). The germs identified were: Streptococcus pneumoniae (13), Staphylococcus aureus (9), Haemophilus influenzae (6), other gram negatives (12), Mycoplasma pneumoniae (1), Koch's bacillus (1), Aspergillus fumigatus, Cytomegalovirus, Myxovirus, Pneumocystis carinii (5). Twenty eight patients died of whom eight had marrow failure following chemotherapy; amongst the non-leukopenic patients an analysis of the records allowed certain presumptions as to the causative organism according to the patients mode of referral and immune state. The prognosis of these pneumonias remains serious in spite of improved bacteriological diagnosis, above all in the elderly, poorly nourished or with marrow aplasia. PMID- 3671864 TI - [Demonstration of a correlation between the degree of pigmentation and the power of inactivation of isoniazid in man]. AB - In a group of 153 white subjects treated for tubercle, individual determinations were made of: a) The power of inactivation of isoniazid. b) The degree of pigmentation (iris, skin, hair) assessed by a weighted pigmented index of the iris. A statistical study of the results shows the clear existence of a narrow positive correlation between these two characters, such that the more pigmented a subject is, the greater is the chance of rapid inactivation of isoniazid. An attempt at a biochemical explanation is proposed. The results in the world literature (Japanese, Swedish, American) are in keeping with these observations. Thus, weakly pigmented tuberculous patients are potentially a new group at risk from anti-TB drugs. PMID- 3671865 TI - [Chylothorax caused by thrombosis of the superior vena cava in Behcet's disease]. AB - The occurrence of chylothorax due to thrombosis of the subclavicular venous drainage is reported. This occurred in a young adult with previously undiagnosed Behcet's disease which had been developing over three years. Venous thromboses during the course of Behcet's disease are extremely frequent and are currently one of the diagnostic criteria. When these thromboses involve the central veins, in particularly the superior vena cava or one of its branches a chylothorax is possible due to blockage of the lymphatic circulation and may be a grave complication, given its location. PMID- 3671867 TI - [Osteolysis of the astragalus and retractile opacity of the right lung]. PMID- 3671866 TI - [Pulmonary localization of Kaposi's sarcoma]. AB - The authors describe a case of a 61 year old man suffering from Kaposi's sarcoma with pulmonary involvement associated with a hairy cell leukaemia. The numerous associations with Kaposi's sarcoma are reviewed and the circumstances of the unexpected appearance of this disease, placing it in the group of opportunistic diseases. The prognosis is totally different according to whether it is an isolated Kaposi's sarcoma without visceral localisation or to a form with polyvisceral involvement and associated with another neoplasm or immunodepression. PMID- 3671868 TI - Lupus clients assisting one another: a model for supportive services. PMID- 3671869 TI - Group exercise: a nursing therapy in Parkinson's disease. PMID- 3671870 TI - Accidental falls in a rehabilitation setting. PMID- 3671871 TI - The rehabilitation client: considerations for home care. PMID- 3671872 TI - A new approach to an old problem. PMID- 3671873 TI - Portable ventilation. PMID- 3671874 TI - Immunopotentiating activity of a nucleotide derivative, heptaminol AMP amidate (HAA) in mice and spontaneously hypertensive rats (SHR). AB - The immunopotentiating activity of heptaminol AMP amidate (HAA), a new derivative of 5'-AMP, was examined in experimental animals. Anti-SRBC PFC activity and antibody titer values augmented for both of single and 4 days consecutive administrations in ICR male mice. The dose of 10 mg/kg was found to cause the maximum enhancement. In spontaneously hypertensive rats, with a state of immunosuppression, 10 days consecutive administrations of HAA at the dose of 10 mg/kg was found to increase significantly the anti-SRBC PFC and antibody titer values. From these results, it is tempting to suggest that HAA may possess an immunopotentiating activity. PMID- 3671875 TI - Effects of oral aluminum administration on perinatal and postnatal development in rats. AB - Aluminum nitrate was administered by gavage to four groups of pregnant Sprague Dawley rats from the 14th day of gestation through 21 days of lactation at doses of 0, 180, 360 and 720 mg/kg/day. These doses did not produce overt fetotoxic effects. However, the growth of the offspring was significantly less from birth and during all the period of lactation for the higher doses of aluminum nitrate. Although very few toxic effects could be observed for the 180 mg/kg/day group (or 13 mg Al/kg/day), this quantity is similar to the amounts ingested by some people in special medical treatment (10 mg Al/kg/day). Therefore, it would seem that high amounts of aluminum should not be ingested during the periods of gestation. PMID- 3671876 TI - An acute study on the relative gastro-intestinal absorption of a novel form of calcium ascorbate. AB - Several functions of L-ascorbic acid (vitamin C) have been suggested in addition to its role in the prevention of scurvy. Consequently, a controversy has arisen over the daily intake of the vitamin which will afford maximum benefits. Rapid cellular uptake and delayed renal excretion of ascorbic acid would be conducive to providing optimum cellular concentration for biochemical activity. ESTER-C (patent pending), a complex consisting of L-ascorbic acid and Ca++, has been recently developed by Inter-Cal Corporation (421 Miller Road, Prescott, AZ 86301). It has been proposed that the structure of ESTER-C may render it more readily absorbed and less rapidly excreted than the acid or salt form of the vitamin. To test this hypothesis, ESTER-C and L-ascorbic acid were administered to two groups of rats. Blood was sampled at 20, 40, 80, 160 and 240 minutes and plasma analyzed for ascorbic acid. As urine appeared in collection cups, it was tested qualitatively for the presence of ascorbic acid. The plasma concentration of ascorbic acid was higher in ESTER-C treated rats at 20, 40 and 80 minutes than in rats given L-ascorbic acid. Ascorbic acid was detected in the urine of animals administered ESTER-C later than in those treated with L-ascorbic acid. These results support the hypothesis that ESTER-C is absorbed more readily and excreted less rapidly than L-ascorbic acid. PMID- 3671877 TI - Bremazocine-induced urination in rats of different sizes. AB - The increased urine output after injection of the kappa agonist bremazocine was determined in rats of various body weights. Rats of all sizes were sensitive to the diuretic effect of bremazocine. The total diuretic effect was greater in heavier animals. The urine output plateaued between 4-5 ml/100 g body weight irrespective of body weight at the higher doses of bremazocine. PMID- 3671878 TI - Effect of propranolol on progression of chronic renal disease in partially nephrectomized rats. AB - The effect of propranolol, a beta adrenergic receptor blocking agent, on the progression of renal dysfunction in three-quarters nephrectomized adult male Sprague-Dawley rats was studied. Beginning four weeks after partial nephrectomy (week 0), rats received either 50 mg/kg propranolol (Group I) or distilled water (Group II) daily by gavage for 12 weeks. Renal function was measured by 24 hour urinary protein excretion, water intake, urine output, plasma creatinine, and plasma urea nitrogen at weeks -4, 0, 4, 8, and 12. Mean systolic blood pressure was measured by the tail cuff method. At the end of 12 weeks, rats were euthanatized, and remnant kidneys examined histologically. Group II rats were significantly (p less than 0.05) proteinuric compared to Group I rats at weeks 8 and 12. Mean systolic blood pressures of Group II rats were significantly greater (p less than 0.05) than group I rats on week 8. Both groups became significantly hypertensive (p less than 0.05) compared to week 0 values by week 12. Group II had significant (p less than 0.05) polyuria, polydipsia, and elevated plasma creatinine and urea nitrogen compared to Group I at week 12. Groups I and II could not be distinguished on the basis of renal histologic rank (p = 0.104). We conclude that propranolol attenuated the progression of chronic renal disease in this model. PMID- 3671879 TI - Epicardial application of capsaicin causes tachycardia and pressor effect in guinea pigs. AB - Topical application of picomoles of capsaicin (CAP) to the surface of the left ventricle (epicardial application) of anesthetized guinea pigs evoked dose dependent increases of heart rate and of mean arterial blood pressure. The pressor responses to epicardial application of CAP were inhibited by systemic administration of pentolinium or a mixture of phentolamine and propranolol whereas only the mixture of phentolamine and propranolol attenuated the tachycardia. The pressor and heart rate responses to epicardial CAP were not modified by acute bilateral vagotomy or prior systemic treatment of animals with atropine, indomethacin, naloxone or a mixture of mepyramine and cimetidine, but both responses were markedly reduced by prior chronic treatment of guinea pigs with CAP or by prior epicardial application of lidocaine. Altogether these results suggest that the pressor effects caused by epicardial application of CAP in anesthetized guinea pigs are reflex in nature and likely to be due to stimulation by CAP of cardiac, sympathetic, CAP-sensitive, sensory nerve endings, whereas the tachycardia caused by epicardial CAP might be mediated by local noradrenaline release (and subsequent cardiac beta adrenoceptor activation) from cardiac, sympathetic, postganglionic nerve fibers and/or terminals. PMID- 3671880 TI - Selective inhibition by dantrolene of caffeine-induced catecholamine release from perfused dog adrenals. AB - Effects of dantrolene sodium on catecholamine (CA) release from the perfused dog adrenal medulla was investigated in relation to it's therapeutic action on malignant hyperthermia (MH), in which CAs would play a significant pathophysiological role. Acetylcholine (ACh)-induced CA release was not affected, whereas caffeine-induced CA release was inhibited by dantrolene in a dose dependent manner (84% inhibition at 10 microM). Dantrolene had no effect on the CA release induced by lasalocid or Na+ deprivation. On the other hand halothane inhibited ACh-induced CA release markedly, Na+ deprivation-induced CA release slightly, but not caffeine-induced CA release at all. The results indicate that dantrolene selectively inhibit caffeine-induced CA release, and that the therapeutic action of dantrolene on MH would be, at least in part, due to inhibition of abnormal release of Ca2+ in the adrenal medullary cells. PMID- 3671881 TI - Theophylline disposition during acute and chronic hypoxia in the conscious dog. AB - It has been reported in experimental models that acute hypoxia reduced the activity of the hepatic cytochrome P-450. The objective of the present study was to investigate in conscious dogs whether acute and chronic hypoxia will influence the disposition of theophylline. To this purpose 6 beagle dogs received 8 mg/kg i.v. of theophylline while breathing air, after acute hypoxia (PaO2 of 48.5 +/- 0.3 mmHg) and after 96 hours of hypoxia. Theophylline and metabolites, 3 methylxanthine and 1,3-dimethyluric acid, were assayed by HPLC. Theophylline volume of distribution, while breathing air, was 0.51 +/- 0.03 L/kg and was not affected by hypoxia. Theophylline metabolic and renal clearances were 1.53 +/- 0.24 and 0.18 +/- 0.04 mL/min/kg and remained constant when the dogs were hypoxic. The urinary recovery of theophylline and metabolites was not affected by acute or chronic hypoxia. It is concluded, that in the dog hypoxia does not affect the disposition of theophylline. PMID- 3671882 TI - Dose response studies of gentamicin nephrotoxicity in rats with experimental renal dysfunction. III. Effects of dosage adjustment method. AB - Previous studies indicate that while Sprague-Dawley (SD) rats with pre-existing renal insufficiency were resistant to gentamicin nephrotoxicity, beagle dogs with renal dysfunction were sensitive. In this study the effects of gentamicin dose reduction method on nephrotoxicity were investigated in subtotally (approx. 65%) nephrectomized (Nx) SD rats. Thirty SD rats were assigned as controls (Ctrls, n = 10) or Nx (n = 20). All rats received gentamicin for 7 days. Nx rats received either a decreased dose, fixed interval (FI) or increased interval, fixed dose (FD) regimen to compensate for prior renal insufficiency. Pre- and post-dosing serum creatinine and urea nitrogen (SCr, SUN), adjusted SCr and SUN ([postdosing predosing]/predosing), histopathologic scores and single-dose pharmacokinetic parameters were determined in all rats. Adjusted SCr and Sun values, as well as histopathology scores were consistently greater in FI rats than in FD rats. Additionally, FI rats had significantly greater predicted trough gentamicin levels than Ctrl or FD rats. The relatively lower nephrotoxicity in the FD regimen in rats agrees with results previously reported in dogs, thus indicating that the method of dose reduction in patients with compromised renal function may be a significant factor in lowering nephrotoxic potential. In addition, the subtotal Nx rat may thus be a valuable and economical model for assessing the nephrotoxicity of different drug dosage regimens in pre-existing renal disease. PMID- 3671883 TI - Effects of indomethacin and cold-stress on gastric acid secretion and ulceration. The effects of anti-acid secretory agents in rats. AB - Gastric ulcerations induced in rats by a combination of indomethacin and cold stress (5 +/- 1 degrees C) for 6 hr were more severe than those induced by indomethacin or cold-stress alone. The acidity of gastric juice was increased in rats treated with indomethacin plus cold-stressed. Histamine H2 receptor antagonists, (H+-K+) ATPase inhibitors and prostaglandins inhibited gastric ulcer formation in indomethacin plus cold-stress treated rats, whereas anticholinergics aggravated the ulceration. The indomethacin plus cold-stress induced acid secretion was inhibited by cimetidine and omeprazole in pylorus-ligated rats. Atropine had less effect on the increase in acidity than cimetidine and omeprazole. These findings indicate that the ulcer formation in indomethacin plus cold-stress treated rats is related the increased in acidity of gastric juice. This gastric ulcer model may be useful for evaluating antiulcer agents. PMID- 3671884 TI - Renal effects of prednisolone in the chicken. AB - The effects of prednisolone on renal tubular transport of organic ions, urine flow and glomerular filtration rate were studied using the Sperber preparation in chickens. Low infusion rates of 1 and 5 nmole/min prednisolone slightly enhanced organic ion excretion. At higher infusion rates up to 1,000 nmol/min, no change in organic ion transport was observed. Urine flow and glomerular filtration rate increased at prednisolone infusion rates of 50 nmole/min and higher, independent of changes in renal blood flow. PMID- 3671885 TI - Effect of several amino acid phosphonates and related compounds on rat brain aminopeptidases. AB - N-Terminal sodium phosphonate derivatives Na3O3PCH2CONHR (R-Leu, Phe, or Tyr) and Na3O3PCH2CONHR-R (R-R = Leu-Phe, Phe-Leu, Phe-Phe, and Phe-Tyr) were synthesized. All showed no activity toward a soluble rat brain aminopeptidase. We could not prepare the corresponding N-2-phosphono-2,2-diphenylacetyl compounds (Na3O3PC(C6H5)2CONHR) by the same Arbusov reaction. Little or no inhibition was obtained with the N-(2-hydroxy-2,2-diphenylacetyl derivatives HOC(C6H5)2CONHR (R = Leu, Phe, Trp, or Tyr). The best inhibitory responses were given by the N-(2 halogeno-2,2-diphenylacetyl mono- and dipeptides (Br/Cl)C(C6H5)2CONH Phe and (Br/Cl)C(C6H5)2CONHR-R (R-R = Leu,Leu, Leu-Phe, Phe-Gly, Phe-Leu, or Phe-Phe), respectively. PMID- 3671886 TI - The effect of omega-phosphono-alpha-aminocarboxylic acids on seizures and brain amino acid levels in E1 mice. AB - The omega-phosphono-alpha-aminocarboxylic acids, e.g., 2-amino-5 phosphonopentanoate and 2-amino-7-phosphonoheptanoate, are known to act as potent and selective antagonists at N-methyl-D-aspartate receptors and to have a pronounced anticonvulsant action on a variety of animal models of epilepsy. In the present study, the effects of these omega-phosphono-alpha-aminocarboxylic acids on E1 mice were investigated. These mice are inbred mutant epileptic mice, which are highly susceptible to convulsive seizures upon throwing stimulation. 2 Amino-3-phosphonopropionate injected intraventricularly (at a dose of 1.04 mumol) had a marked anticonvulsant action, but at a lower dose (0.1 mumol), it induced running fits. 2-Amino-4-phosphonobutyrate induced transitory excitation just after the injection, followed by sedation. 2-Amino-5-phosphonopentanoate induced marked behavioral sedation. 2-Amino-6-phosphonohexanoate induced tonic-clonic convulsions and epileptic discharges in electroencephalograms. 2-Amino-7 phosphonoheptanoate showed a strong anticonvulsant action at a dose of 1.27 mumol, but it induced myoclonic seizures at a lower dose. Amino acid analyses of E1 mouse brain showed that 2-amino-3-phosphonopropionate increased the glutamine level, 2-amino-4-phosphonobutyrate decreased the aspartic acid level, 2-amino-5 phosphonopentanoate decreased the glutamic acid level, 2-amino-6 phosphonohexanoate decreased the glutamic acid, glutamine, gamma-aminobutyric acid, glycine and alanine levels, and 2-amino-7-phosphonoheptanoate decreased the glutamic acid label 1 hour after their injection. These findings suggest that the effects of omega-phosphono-alpha-aminocarboxylic acids on the E1 mouse brain are multiple and complicated, depending on the numbers of their carbon chain. PMID- 3671887 TI - Cytochrome P450-dependent alkoxyphenoxazone dealkylase activities in lung microsomes from untreated and beta-naphthoflavone-treated rats: effect of in vitro inhibitors. AB - The reactivities of four alkoxyphenoxazone derivatives toward cytochrome P450 dependent monooxygenase activity were studied in lung microsomes from control and beta-naphthoflavone (BNF)-treated rats. Ethoxyphenoxazone (EtOPh)- and methoxyphenoxazone (MeOPh)-dealkylases were induced by beta NF (16- and 3.9-fold respectively), whereas benzyloxyphenoxazone (BzOPh)- and pentoxyphenoxazone (PeOPh)-dealkylase activities were unchanged after pre-treatment with beta NF. The specific activities of BzOPh'ase from control- and beta NF-treated rats and EtOPh'ase from beta NF-treated rats were sufficiently high (214-560 pmoles resorufin per min per mg protein) for routine biochemical studies. Each differed in its sensitivity toward the in vitro inhibitors, alpha-naphthoflavone (ANF) and metyrapone (MP). In lung microsomes from beta NF-treated rats the I50 (MP) = 7.6 X 10(-5) M for EtOPh'ase and 1.0 X 10(-6) M for BzOPh'ase. I50 (ANF) = 3.8 X 10( 8) M for EtOPh'ase. I50 (ANF) for BzOPh'ase could not be determined; at the highest concentration of ANF (10(-3) M), 50% inhibition was not observed. The presence of high levels of two distinct forms of lung microsomal P450-dependent alkoxyphenoxazone dealkylases, BzOPh'ase from untreated and beta NF-treated rats and EtOPh'ase from beta NF-treated rats, will be useful for studies on specific P450-xenobiotic interactions in rat pulmonary tissue. PMID- 3671888 TI - Immunoassay detection of drugs in horses. I. Particle concentration fluoroimmunoassay detection of fentanyl and its congeners. AB - We investigated the use of particle concentration fluorescence immunoassay (PCFIA) as a technique for drug detection in racing horses. The test was constructed from an antiserum to a carboxyfentanyl-BSA conjugate and carboxyfentanyl linked to b-Phycoerythrin. Using these reagents and a PCFIA apparatus levels of fentanyl as low as 0.1 ng/ml could be detected by the assay. In addition, cross-reactivity studies on this assay showed that the anti-serum cross-reacted well with carfentanil, sufentanil and the methylated analogs of fentanyl. We therefore evaluated the ability of these agents to produce pharmacological effects in the horse and the ability of this test to detect pharmacologically significant doses of this drug in racing horses. All of these agents produced good locomotor responses in horses at doses of between 0.1 and 10 micrograms/kg. Of these agents, carfentanyl was the most potent followed by 3 methylfentanyl, sufentanyl, alpha-methylfentanyl, and fentanyl. Similarly, when these agents were administered to horses at doses sufficient to produce a pharmacological response, all produced sufficient inhibition of fluorescence in the PCFIA system to enable their detection in post-race urines from these horses. Since PCFIA is a much faster technique than radioimmunoassay, is of approximately similar sensitivity, and requires much less instrumentation we concluded that this technique holds considerable promise as an equine drug testing technique. PMID- 3671889 TI - Strain differences in susceptibility to the embryotoxic effects of aminopyrine in mice. AB - Embryotoxic effects induced by aminopyrine were studied in two inbred strains of mice, C57BL/6N and DBA/2N. Aminopyrine was given by subcutaneous injection at a dose of 200 mg/kg on day 7, 8 and 9 of gestation. In both strains, aminopyrine induced malformations such as omphalocele, club foot and kinky tail were observed, but the incidence of malformations was significantly higher in C57BL/6N than in DBA/2N. Maternal plasma levels of aminopyrine and its metabolites were significantly higher in C57BL/6N, compared to DBA/2N. Further, reciprocal crosses between these two strains were used to clarify whether the maternal or fetal genotype is more important in aminopyrine-induced embryotoxicity. F1 hybrid embryos developing in C57BL/6N or DBA/2N mothers were as resistant as inbred DBA/2N. These results suggest that strain differences in susceptibility to aminopyrine may depend on fetal genotype rather than maternal factors. PMID- 3671890 TI - Laryngeal effects on respiratory pressures and timing in rabbits: role of the vagi. AB - Tidal breathing through a tracheostomy and through the larynx were compared in two groups of rabbits. Ten control and fourteen rabbits with chronically vagally denervated lungs were anaesthetized and spontaneously breathing. Inspiratory and expiratory tracheal pressure and timing components of respiratory pattern were measured in both groups of animals before and after carotid sinus/body denervation and cervical vagotomy. Breathing through the larynx significantly increased the inspiratory pressure and, to a lesser degree, affected expiratory pressure in both groups of animals and changed the respiratory timing by prolongation of TI and shortening of TE. Our results indicate that the larynx prominently influences pressures within the lower respiratory tract but its effect on the pattern of breathing is confined only to animals with an intact lung innervation. PMID- 3671891 TI - Ambroxol increases the choline but not fatty acid incorporation into lung phospholipids in experimental lung disorders. AB - Ambroxol, a drug capable of elevating the phospholipid content in healthy rabbit lungs, was tested on two models of experimental lung injury, lung changes in sepsis induced by a peritonitis and in bromcarbamide intoxication. The phospholipid content of the lungs and the synthesis of the individual phospholipids phosphatidylcholine (PC) and sphingomyeline were measured in vitro by incubation of lung slices with labeled phospholipid precursors. Influenced by the drug, the phospholipid content increases to 132% in the peritonitis experiments and to 111% in the bromcarbamide experiments. The peritonitis experiments show the increase in phospholipid synthesis to result from an enhanced choline incorporation into PC up to 192% and into sphingomyeline up to 630%. The values for the bromcarbamide experiments are 411% for PC and 485% for sphingomyeline, respectively. There was no statistically significant difference in the incorporation of fatty acids in the treated and untreated animals. We conclude that ambroxol possibly stimulates the phospholipid synthesis in injured lungs by stimulating the choline phosphatcytidyltransferase, but not the incorporation of fatty acids into PC in those lungs. These findings may be important to the surfactant system of the lung consisting mainly of PC. PMID- 3671892 TI - Inspiratory impedance during histamine-induced bronchoconstriction in patients with bronchial asthma. AB - Histamine inhalation provocation tests were performed in 18 asymptomatic asthmatic patients with progressively increasing doses of a pressurized aerosol of histamine phosphate. Forced expiratory volume in 1 s (FEV1), total neuromuscular output, assessed by mouth occlusion pressure (P0.1), mean inspiratory flow (VT/Ti), and the P0.1/(VT/Ti) ratio, which represents an index of effective inspiratory impedance of the respiratory system, were measured. With histamine, compared to control, FEV1 decreased and P0.1/(VT/Ti) increased (p less than 0.01 for both). After bronchoconstriction was reversed by administration of a beta 2-agonist bronchodilator (fenoterol), a significant decrease in P0.1/(VT/Ti) (p less than 0.001) and a significant increase in FEV1 (p less than 0.01) were noted as compared to histamine. With histamine, change in P0.1/(VT/Ti) was found to be related to its pre-histamine value (p less than 0.01). Furthermore, with histamine and fenoterol, changes in P0.1/(VT/Ti) and concurrent changes in FEV1 were found to be significantly related (p less than 0.001). From these data we calculated that the P0.1/(VT/Ti) ratio provides a useful tool in the clinical assessment of histamine-induced bronchospasm. PMID- 3671893 TI - Once-daily dosing of a new ultrasustained-release theophylline preparation. AB - Theophylline plasma levels and profiles were evaluated in patients with chronic obstructive pulmonary disease during once-daily dosing of an ultrasustained release theophylline preparation (Theo-1; capsules filled with microgranules containing 400 mg anhydrous theophylline). In a first study, 6 patients received a single morning dose of 800 mg (a) in the fasting state, and (b) with a protein fat-rich breakfast in a random order, and the systemic theophylline availability was evaluated for 48 h. No significant differences were found either in Cmax (a: 7.0 +/- 3.2 micrograms/ml; b: 7.6 +/- 2.6 micrograms/ml), or in Tmax (a: 11.7 +/- 6.1 h; b: 10.2 +/- 3.6 h). Elimination half-life was in a 11.4 +/- 4.4 h and in b 12.9 +/- 4.8 h (p less than 0.05). In a second study, the steady-state theophylline levels were measured during a 24-hour dosage interval on day 8 after intake of 800 mg at 8 a.m. in 16 patients and at 8 p.m. in 11 patients. Plateau shaped plasma concentration-time curves were obtained, with small fluctuations between the peak (Cmax) and trough (Cmin) levels: [100(Cmax-Cmin)/Cmin] was 83 +/ 40% after morning dose, and 54 +/- 26% after evening dose (p less than 0.05). Cmax was 12 +/- 5 and 11 +/- 4 micrograms/ml, respectively (NS). Tmax was 9 +/- 3 and 11 +/- 3 h, respectively (NS). The FDA fluctuation for the 37 patients was 48 +/- 20%. In a third study, the dose-plasma concentration relationship was evaluated in steady state in 6 patients receiving 400, 800 and 1,200 mg for 3 days each. The trough plasma concentrations were 2.6 +/- 0.9, 6.2 +/- 2.1 and 10.2 +/- 3.1 micrograms/ml, respectively. Six hours after drug intake the plasma levels were 5.0 +/- 1.6, 10.6 +/- 2.5 and 15.4 +/- 4.2 micrograms/ml, respectively; and 12 h after drug intake, 4.9 +/- 1.4, 11.6 +/- 2.4 and 14.5 +/- 3.7 micrograms/ml, respectively. In conclusion, we found in these studies that with once-daily dosing of the ultrasustained-release preparation Theo-1, plateau shaped 24-hour theophylline plasma levels could be achieved. The relationship between daily dosage and theophylline plasma levels was linear intraindividually but showed an important interindividual variation. No consistent interference by food intake was found and no serious side effects occurred within therapeutic plasma levels. PMID- 3671894 TI - Diagnosis of a case of lipoid pneumonia by bronchoalveolar lavage. AB - Exogenous lipoid pneumonia (ELP) was diagnosed by bronchoalveolar lavage (BAL) in a 57-year-old woman with a long history of using oily nose drops. Since clinical and roentgenological presentations are nonspecific, BAL, along with specific staining of recovered alveolar macrophages, represents a safe alternative to more invasive diagnostic procedures whenever a diagnosis of ELP is suspected. PMID- 3671895 TI - Specificity of pulmonary vascular lesions in primary pulmonary hypertension. A reappraisal. AB - The type and distribution of pulmonary vascular lesions in 23 cases of primary pulmonary hypertension were reviewed. 15 cases were classified as plexogenic arteriopathy. The remaining cases displayed thromboembolic lesions. All cases showed a predominance of eccentric intimal lesions. In the plexogenic group, mixed concentric and eccentric intimal fibrosis coexisted. Therefore, in the present study, we propose an objective descriptive approach to the diagnosis of hypertensive pulmonary vascular disease, to correlate morphology and function. PMID- 3671896 TI - Nifedipine attenuates acute hypoxic pulmonary vasoconstriction in patients with chronic obstructive pulmonary disease. AB - The calcium channel blocker nifedipine was administered to patients with chronic obstructive pulmonary disease (COPD) to determine its efficiency as a pulmonary vasodilator. Since nifedipine has been shown to decrease elevated pulmonary artery pressures in patients with hypoxic pulmonary hypertension, we hypothesized that nifedipine would attenuate acute hypoxic pulmonary vasoconstriction in patients without pulmonary hypertension. We studied 11 clinically stable patients with mild to moderate COPD and normal pulmonary artery pressures using a randomized single-blind cross-over design. The patients were studied before and after nifedipine (20 mg) or placebo, given sublingually, at room air and subsequently during inhalation of a hypoxic gas mixture containing 13% O2, 5% CO2 and 72% N2. During normoxia, nifedipine significantly increased cardiac index from 4.2 +/- 0.3 to 4.9 +/- 0.5 liters/min/m2 (p less than 0.05) and the coefficient of oxygen delivery from 4.15 +/- 0.3 to 4.91 +/- 0.5 (p less than 0.05), whereas placebo treatment did not. During isocapnic hypoxia, a significant increase in mean pulmonary artery pressure (from 15.7 +/- 0.7 to 24.4 +/- 1.2 mm Hg; p less than 0.005) and mean pulmonary vascular resistance index (from 2.6 +/- 0.3 to 4.2 +/- 0.5 mm Hg; p less than 0.005) could be observed. Pretreatment with nifedipine significantly attenuated the hypoxia-induced increase in mean pulmonary artery pressure by 53% and of the mean pulmonary vascular resistance index by 50%. This was accomplished without significant changes in systemic arterial pressure and in the systemic vascular resistance index. Thus, nifedipine acutely dilates the constricted vascular bed associated with hypoxia in these patients with COPD. PMID- 3671897 TI - Influence of extreme hypercapnia on respiratory motor nerve activity in cats. AB - Sedative drugs have been found to depress the respiratory activity of upper airway muscles more than that of the diaphragm. To determine whether CO2 at narcotic levels has a similar action, we recorded phrenic and hypoglossal nerve activities in decerebrate, vagotomized, paralyzed cats. T5 or T6 external intercostal nerve activity was also recorded in some animals. End-tidal CO2 concentration was raised progressively to over 30% or until depression of nerve activity was apparent. Respiratory frequency was reduced by severe hypercapnia in most cats. Hypoglossal nerve activity was consistently decreased more than that of the phrenic nerve. In most cases intercostal nerve activity was also more susceptible than phrenic nerve activity to hypercapnic depression. The results indicate that CO2 at narcotic levels interferes both with the central pattern generator for breathing movements and with the expression of the pattern in specific motor nerves. PMID- 3671898 TI - Comparison of the response of diaphragm and upper airway dilating muscle activity in sleeping cats. AB - The steady state and transient effects of hyperoxic hypercapnia on the electromyographic activities of the genioglossus (GG), posterior cricoarytenoid (PCA), and diaphragm (D) were studied in cats instrumented with chronically implanted electrodes during non-rapid eye movement sleep. Hypercapnia (inhalation of 3.4 and 7.4% CO2 in O2) increased the phasic electrical activity occurring during inspiration of all three muscles. Activities of the PCA and D increased in a parallel fashion with increasing CO2. The GG responded to steady state CO2 inhalation alinearly, with larger increases in activity occurring when CO2 was raised from 3.4 to 7.4% than when CO2 was increased from 0 to 3.4%. When gas mixtures containing CO2 were given, the GG reached its new steady state level more slowly than the D or PCA, and when CO2 was rapidly removed from the inspired gas mixture, the GG attained its steady state sooner than the D. These results suggest that in sleeping cats, hypercapnia does not affect either transient or steady state responses of the GG in the same way as the D or the PCA. These differences seem to be explained largely by different threshold characteristics of hypoglossal and phrenic neurons. PMID- 3671900 TI - Differences in respiratory patterns after acute and chronic pulmonary denervation. AB - The role of pulmonary vagal information in the control of respiratory patterns was assessed in awake and anaesthetised rats in which pulmonary denervation was effected by bilateral cervical vagotomy or by right cervical vagotomy combined with left pneumonectomy or left intrathoracic vagotomy. Acute denervation led to increases of tidal volume (VT), inspiratory duration (TI) and expiratory duration (TE) in both awake and halothane anaesthetised animals; in awake rats the increase of TE rapidly subsided. Chronic pulmonary denervation produced markedly smaller increases of VT and TI and no change of TE from control values. In hypercapnia, awake animals with combined pneumonectomy and vagotomy consistently increased respiratory frequency by reductions in TI and TE; awake animals with combined intrathoracic and cervical vagotomy showed no increase in f because decreases in TI offset increases in TE; in anaesthetised rats with acute bilateral cervical vagotomy there was a consistent fall in respiratory frequency due to an expiratory pause. The results demonstrate that (1) the role of vagal activity in the production of respiratory patterns is unlikely to be accounted for solely in terms of influences arising from pulmonary stretch receptors; (2) vagal influences of TE are transitory; (3) under halothane anaesthesia hypercapnia induces an expiratory pause; and (4) the combination of pneumonectomy with contralateral vagotomy makes possible studies in awake rats although pulmonary denervation is less complete than with bilateral intrathoracic vagotomy. PMID- 3671899 TI - Propranolol blocks metabolic rate increase but not ventilatory acclimatization to 4300 m. AB - Previously, we found resting metabolic rate increased at high altitude but the mechanism and consequences of this increase were unclear. We sought to test the role of beta-sympathetic activation for increasing metabolic rate and the contribution of an increase in metabolic rate to raising total ventilation at altitude. Following baseline studies at sea level, two groups of six healthy male subjects received either placebo or propranolol (80 mg/8 h) for 3 days prior to ascent to Pikes Peak (4300 m) where treatment was continued for 15 days. O2 consumption increased in placebo-treated subjects with a rise of 20 +/- 5% (X +/- SEM) on day 1 and no change 0 +/- 7% in propranolol-treated subjects (difference between groups, P less than 0.05). The increase in total ventilation upon ascent was 28 +/- 2% in the placebo group vs 9 +/- 7% in the propranolol group (P less than 0.05) and was correlated with metabolic rate in individual subjects. Decreasing end-tidal PCO2, taken as an index of ventilatory acclimatization, was similar in both groups. Thus, beta-sympathetic activation appears to increase metabolic rate upon ascent to high altitude and lead to a proportionate elevation in total ventilation but does not alter ventilatory acclimatization. PMID- 3671901 TI - The effect of shape and position of the oxygen equilibrium curve on extraction and ventilation requirement in fishes. AB - The effects of haemoglobin-oxygen affinity and of cooperativity in oxygen binding on the oxygen extraction and ventilation requirement in fish are analysed using the mathematical model of Malte and Weber (1985). It is shown that a high affinity may allow a substantial reduction in ventilatory requirement and that optimal O2 uptake depends on a delicate balance between affinity and cooperativity. Using P50 and nH values from the literature, the oxygen extraction values predicted by the model for carp and rainbow trout coincide neatly with the values found for these species, indicating that the differences in oxygen extraction are a direct result of different blood oxygen binding properties. PMID- 3671902 TI - Reticulocytosis, increased mean red cell volume, and greater blood viscosity in altitude susceptible compared to altitude resistant rats. AB - We have identified two strains (H and M) of Sprague-Dawley rat with markedly different susceptibilities and cardiopulmonary responses to chronic hypobaria. To further characterize factors responsible for these differing cardiopulmonary responses to chronic hypobaria, the present study examined differences in hematologic responses between the strains and assessed the contribution of differences in blood viscosity to differences in pulmonary vascular resistance. Following a 4-5 week exposure to simulated high altitude (0.5 atm), hemoglobin, hematocrit, mean red cell volume, and reticulocyte count were all increased in the susceptible H compared to the resistant M rats, whereas red blood cell counts were similar. Sea level controls manifested no differences. Blood viscosity, measured in a capillary viscometer, was 53% greater in chronically hypoxic H than in M rats, and plasma viscosities were similar. Blood from high altitude H rats increased pulmonary vascular resistance more than blood from high altitude M rats when perfused into lungs isolated from high altitude rats of either strain. In conclusion, high altitude H rats have an increased population of immature red cells, leading to a greater mean red cell volume and hematocrit than in high altitude M rats. These hematologic differences contribute to the the increased blood viscosity and greater pulmonary vascular resistance of H compared to M rats after 4 weeks' high altitude exposure. PMID- 3671903 TI - Oxygen deficit-oxygen debt relationships in ponies during submaximal treadmill exercise. AB - The O2 deficit-O2 debt relationship in ponies was examined at two levels of treadmill exercise. Five healthy ponies exercised for 8 min at two work rates (WR):(1) 50 m/min at 6% grade and (2) 70 m/min at 12% grade. The O2 deficit and O2 debt were calculated using open-circuit measurement of pulmonary gas exchange during the transition from rest to steady-state exercise and during recovery from exercise. The O2 deficit was significantly lower (P less than 0.05) than the O2 debt at each of the two work rates. The means (+/- SEM) for the deficit and the O2 debt, respectively, in liters were: (1) low WR = 0.45 +/- 0.12; 0.92 +/- 0.13; high WR = 1.03 +/- 0.20; 1.62 +/- 0.12. Given the observation that the O2 deficit and the O2 debt are generally equal in humans during exercise below the anaerobic threshold, these findings suggest a species difference in the O2 deficit-O2 debt relationship. It is hypothesized that the difference in O2 deficit between man and pony is related to faster VO2 kinetics for the on-transient of exercise which involves a more rapid increase in cardiac output coupled with a release of splenic stored erythrocytes. PMID- 3671904 TI - Effects of intravenous atropine on static P-V curves of the lung in normal man. AB - In eight normal subjects we studied the effects of intravenous (i.v.) injection of 2 mg atropine sulfate on the static lung recoil pressure-volume (PV) curves, plethysmographic airway resistance (Raw), and maximum expiratory flow rates (Vmax). In addition, we determined the influence of atropine injection in esophageal elastance (Ees) by measuring the esophageal pressure with an esophageal balloon containing five different volumes (0.5 to 4 ml) of air and by calculating the change in esophageal pressure per unit change in balloon volume (delta Pes/delta Vb). This procedure allowed us to obtain static lung recoil pressure (Pst(1] at a balloon volume extrapolated to zero, thus avoiding the interference of changes in esophageal tone following atropine administration with the measurement of Pst(1). After vagal blockade with atropine, Pst(1) significantly decreased with a shift to the left of PV curves, Raw decreased, and Vmax increased mainly at lower lung volumes. Ees also decreased with parasympathetic blockade. We interpret these findings to indicate that inhibition of vagal tone results in dilatation of large and small airways, and also in the relaxation of smooth muscle in terminal lung units. PMID- 3671905 TI - Sarcoidosis in the UK and in France. A permanent challenge. PMID- 3671906 TI - Cutaneous pathology. PMID- 3671907 TI - The pigmented spindle cell tumor of Reed: an underdiagnosed lesion. AB - The pigmented spindle cell tumor is a distinct benign melanocytic lesion with characteristic clinical and histopathologic features. Until recently, it has been poorly documented in the literature and is frequently misdiagnosed as malignant melanoma. On the basis of 40 personal cases of pigmented spindle cell tumor, the clinical and pathologic features of the lesion and its differential diagnosis will be discussed. PMID- 3671908 TI - Squamous cell carcinoma of the larynx in young adults. AB - Clinical and pathologic features of squamous cell carcinoma in 33 young adults (19 to 34 years) are presented. The most important difference between these patients and older subjects with squamous cell carcinoma of the larynx is the female preponderance in the young. Sixty percent were smokers but no other predisposing factors were uncovered. Histologic grade of malignancy had no impact on prognosis but, as it is with any head and neck site, the most important prognostic predictor is clinical stage. PMID- 3671909 TI - Head and neck pathology. PMID- 3671910 TI - Potpourri. PMID- 3671912 TI - Rapid office methods for the diagnosis of streptococcal tonsillitis--reliability and impact on patient management. PMID- 3671911 TI - Flow cytometry of transitional cell carcinoma of the urinary bladder: influence of prior local therapy. AB - A review of acridine-orange DNA and RNA flow cytometry (FCM) histograms of 249 bladder irrigation specimens from 129 patients with a previous history of transitional cell carcinoma (TCC) reveals that aneuploidy and tetraploidy (greater than 10% of total cell population) are reliable markers to detect the presence of bladder tumor in patients treated by surgical resection of tumor only. Tetraploidy is unreliable when the patient received intravesical chemotherapy or radiation therapy but aneuploidy remains accurate. A comparison of the reliability of FCM compared with cytology indicates an overall lower sensitivity and specificity for FCM (respectively, 52% and 73%) as opposed to cytology (respectively, 62% and 92%). Sensitivity is improved and raised to 77% if FCM and cytology are used in conjunction and reaches 82% in patients treated by surgery only and 88% in those who received radiation therapy. The lowest sensitivity and specificity obtained with FCM are in patients treated by intravesical chemotherapy (respectively, 44% and 58%) and the highest are in those treated by surgery without additional therapy (56% and 83%). This study demonstrates that FCM criteria for diagnosis of TCC of urinary bladder on bladder irrigation specimens depends on patient's treatment history. It also indicates that sensitivity and specificity of cytology to detect bladder tumor are superior to those obtained with FCM but both methods may be considerably improved if they are used in conjunction. PMID- 3671913 TI - Radioactive iodine treatment of hyperthyroidism. PMID- 3671914 TI - Inter-observer variation on registration of signals of cancer. AB - Previous studies have dealt with the role of seven warning signals of cancer in public health education and cancer diagnostics in general practice. Registrations of warning signals from medical records have some inconveniences common to most retrospective record studies. In the present inter-observer variation study it is found that agreement is good for warning signals in cancer patients when the warning signal has a probable connection with the disease. In control patients, and for more incidentally occurring warning signals in cancer patients, agreement is not so good. It seems that reproducible registrations from records are possible when there is a precise definition of what to look for and the data are relevant to the patient's disease. This study stresses the importance of good record keeping in medical practice. PMID- 3671915 TI - The value of warning signals of cancer in general practice. AB - Seven warning signals of cancer are poor diagnostic indicators of cancer, but for some patients awareness of warning signals may help reducing diagnostic delay. The usefulness of warning signals recorded by general practitioners at consultation is evaluated for a group of 80 patients who developed cancer 0-18 months after the consultation. Warning signals of cancer were recorded at the consultations in 20 cancer patients and in 13 matched control patients. For three cancer patients the warning signal was considered not related to the cancer. Recognition of warning signals related to the cancer disease was considered useful for nine out of 17 patients, somewhat useful for five and hardly useful at all for three patients. PMID- 3671917 TI - Intervention studies among elderly people. AB - There are not many reports of Nordic intervention studies on the health and medical care of the elderly. Nevertheless much knowledge about old age is available and should be applied in practice under controlled conditions. In this overview article the authors present some experience from four of the Nordic countries to encourage further intervention studies, and focus some important aspects to be taken into consideration. PMID- 3671916 TI - Prevalence of subjectively experienced symptoms in a population sample of women with special reference to women with arterial hypertension. AB - Women, participants in a population study and representative of middle-aged women in the general population, were asked to complete a questionnaire containing 30 questions about prevalence or absence of 30 specified complaints during the last three months prior to the investigation. As a whole, complaints were common. E.g. more than 30% reported sleep disturbances, 40% general fatigue and 40% depressive symptoms. There were some differences between the different age groups studied with respect to different complaints but the total number of stated complaints were similar in the different ages. A special analysis was made concerning antihypertensive drugs and blood pressure levels. The most obvious finding with respect to these variables was that symptoms were common in women with low blood pressure (below 120 mmHg). PMID- 3671918 TI - Caries risk children in the Danish child dental service. AB - The purpose of the investigation was 1) to describe the progression and pattern of dental caries among Danish school children with high caries experience in relation to comparable groups of children with low or moderate levels of caries, and 2) to study the possibilities of early identification of risk children from information on caries experience in the mixed dentition. Longitudinal data from the Public Child Dental Service in a representative Danish municipality were used. Data on caries among children have been collected each year according to the standardized Danish recording system. In 1983/84, about 10% of the children with a high level of caries (H-group), and 10% with a low level of caries (L group) were selected from all school children at grade 2 (n = 595), grade 5 (n = 658), and grade 8 (n = 631). Gradual increments of caries were observed for all three cohorts of H-groups. On average, caries on mesial and distal surfaces accounted for one fifth of the total caries experience in the permanent teeth and, in particular, molars were affected. In the primary dentition, caries on occlusal and on smooth surfaces accounted each for 40% of the caries experience. Caries in primary molars was dominating. Attempts were made to identify caries risk children at grade 8 from information on caries severity zone or from total caries experience at grade 1. Low values of predictive power were obtained. Therefore the relevance of sociomedical and sociological methods in the child dental service should be studied. PMID- 3671919 TI - Value of thyroid follow-up registers. AB - In this study from a county in southern Sweden 269 of 271 patients (99.3%) treated with radioiodine for hyperthyroidism over a two-year period were followed up five years later. The routine procedures at hospital clinics and primary health care centres were studied. A high number of toxic multinodular goitre (n = 113; 42.0%) and toxic adenoma (n = 76; 28.3%) emerged, 80 patients (29.7%) had toxic diffuse goitre (Graves's disease). During the five-year follow-up the cumulative incidence of hypothyroidism in the various goitre groups was 10.7%, 23.9%, and 57.5% respectively. Altogether 76 patients (28.3%) were diagnosed hypothyroid. Nine patients were lost to regular follow-up; elevated TSH and low or normal T4-concentrations were found in two of them. We propose a register system to enable detection of thyroid dysfunction after radioiodine treatment and other thyroid patients in primary health care. PMID- 3671920 TI - Obstacles to progress in science: a la recherche des faits perdus. PMID- 3671921 TI - Usefulness of regional bone measurements in patients with osteoporotic fractures. PMID- 3671922 TI - [Correlation between osteoporosis and arthritis]. PMID- 3671923 TI - [Role of endogenous calcitonin in postmenopausal osteoporosis]. PMID- 3671924 TI - [Hormone treatment in menopause and the prevention of osteoporosis]. PMID- 3671925 TI - [Diphosphonates in the treatment of Paget's disease of bone]. PMID- 3671926 TI - [Radioimmunologic determination of parathyroid hormone]. PMID- 3671927 TI - Tumor products and the hypercalcemia of malignancy. PMID- 3671928 TI - [Phosphocalcium metabolism in granulomatous diseases]. PMID- 3671930 TI - [Parathyroid surgery in renal osteodystrophy]. PMID- 3671929 TI - [Proximal tubular acidosis associated with deficiency osteomalacia in adults]. PMID- 3671931 TI - [Medico-psychological studies in alcoholism]. PMID- 3671933 TI - [Balloon valvuloplasty--future treatment of choice in heart valve stenosis?]. PMID- 3671932 TI - [A rare cause of jaundice: bilio-biliary fistula]. PMID- 3671934 TI - [Red-colored lesion of the iris, polylymphadenopathy]. PMID- 3671935 TI - [A case from practice (88). Patient A. G., born 29 April 1972]. PMID- 3671936 TI - [Shockwave lithotripsy in the treatment of urinary calculi]. PMID- 3671937 TI - [Miliary tuberculosis in autopsy material]. PMID- 3671938 TI - [Current diagnostic imaging of the temporomandibular joint. 1: Pathomorphology of the temporomandibular joint and technics of tomographic studies]. PMID- 3671939 TI - [Abdominal pain and melena]. PMID- 3671940 TI - [Environmental pollution and pregnancy]. PMID- 3671941 TI - [Exogenous light protection]. PMID- 3671942 TI - [Therapeutic depigmentation agents]. PMID- 3671943 TI - [Respiration-dependent chest pain, cough, fever]. PMID- 3671944 TI - [A case from practice (90). Patient: Mr. T. A. M., born 1952, teacher]. PMID- 3671945 TI - [Current diagnostic imaging of the temporomandibular joint. 2. Demonstration of the diagnostic potential of computerized tomography with selected case examples]. PMID- 3671947 TI - [A case from practice (91). Patient: Mr. K.N.R., chemist, born 7 January 1946]. PMID- 3671946 TI - [Reye's syndrome in Switzerland]. PMID- 3671948 TI - [Environmental epidemiology]. PMID- 3671949 TI - [Diagnosis and therapy of depression in the elderly]. PMID- 3671950 TI - [Bone pain, spontaneous fractures, muscle weakness]. PMID- 3671951 TI - [A case from practice (92). Patient: Mr. E. R., born 1948, day laborer]. PMID- 3671952 TI - [Preventive medicine aspects of jogging: an epidemiologic study of 4300 participants of a 16-km race]. PMID- 3671953 TI - [Painful knee, fever]. PMID- 3671955 TI - [Werner's syndrome. Clinical and radiologic manifestations. Apropos of 2 new cases]. AB - In this work we present two cases of Werner's Syndrome. Its typical manifestations, the clinical and radiological aspects and diagnostic criteria are mainly commented. PMID- 3671954 TI - [Disseminated Mycobacterium africanum infection]. AB - A case of disseminated Mycobacterium africanum infection in a 28 years old black male with no known causes of immunosuppression and resident in Spain 2 years prior to his symptomatology is described. In addition, the characteristics of Mycobacterium africanum and its capacity to produce pathology in man are discussed as is its proper treatment leading to satisfactory cure. PMID- 3671956 TI - [Testicular torsion: review of 42 cases]. AB - Forty two cases of Testicular Torsion in children aged under 9 are presented. Diagnosis and therapy are discussed; an accurate and prompt diagnosis is emphasized on to decide on the proper surgical correction to achieve testes preservation. PMID- 3671957 TI - [The physician in relation to the existential vacuum of his patients]. PMID- 3671958 TI - [Laryngeal apnea]. AB - The apneic laryngeal chemoreflex (QRL), elicited by water on the vocal cords and the reflex by mechanical stimulation (MRL) has been compared in dog. The response decrease with naloxone at a 400 micrograms.kg-1, suggesting that the reflex inhibition depends on endogenous opioids of the respiratory centre. PMID- 3671959 TI - [Prevalence of dental caries in a coastal zone of Granada]. AB - In the present study, the problem of caries and its actual state in a seaside region of Granada is analyzed. 1.001 aged 5 to 15 scholars from three towns- Motril, Itrabo and Molvizar--were studied. In the descriptive survey, the prevalence of the illness by CO, CAOD, CAOS and CAOM epidemiologic indexes is registered, and also its distribution by place, age and sex. A general 1.45 CO, global 1.22 CAOD, 1.36 total CAOS and 0.94 CAOM were estimated. The relation of sweets taken out of the eating time, buccodental hygiene degree and fluorization drinking water levels with caries are studied in the analitic part. Straight connection was observed of sweets consuming to the total of caries (in both temporary and permanent teeth). A significant clear correlation was also observed between the levels of fluor and the prevalence of caries in temporary teeth, which was higher than in permanent teeth. PMID- 3671960 TI - [Acute myocardial infarction in patients over 65 years of age]. AB - Three hundred and ten patients, 129 under sixty-five years (group A) and 181 over this age (group B), were studied to determine the clinical differences between young and elderly patients with acute myocardial infarction. Women were significantly more present in group A and heavy smokers in group B. Hypertension, although not significantly, was more frequent among the elderly. Serial ECG and enzyme determinations followed the same classic pattern in both groups. Age did not influence neither the localization of the infarction nor the incidence of subendocardial infarction. Young patients remained more often in functional class I, whereas class IV was twofold more frequent among the older. First and second degree A-V block were equally present in the two groups, while third degree A-V block was significantly more frequent in patients over 65. Finally, as expected, in-hospital mortality was significantly higher (34% vs 16% p less than 0.001) among the older patients. PMID- 3671961 TI - [In vivo location of the cortical language areas (correlation between anatomy, x ray computed tomography and magnetic resonance imaging)]. AB - Cortical language areas were identified by CT scan or NMR imaging, using planes of horizontal sections parallel to the orbitomeatal plane and therefore indirectly to the bicommissural plane. Sections 45 and 50 mm above the bicommissural plane pass electively through temporal structures i.e. the posterior part of T1 and T2, while sections at 60 and 70 mm pass through the angular gyrus and supramarginal gyrus. PMID- 3671962 TI - [Intellectual and mood disorders in multiple sclerosis]. AB - Reports of frequency and interpretation of intellectual and mood disorders differ in multiple sclerosis (MS). Forty-one patients with MS defined according to MacAlpine's criteria were evaluated by psychometric tests (WAIS) and neuropsychologic examinations (study of language, gnosic and praxic activities, dynamic gestural organization, memory and learning) together with, in 24 of them, the AMDP psychopathologic rating scale. Intellectual disorders were noted in 65 p. 100 of patients. Although more frequent in severe and chronic forms they were nevertheless of early onset since more than a half of the patients with onset of disease less than 5 years ago were affected. Their semiology was fairly homogeneous, combining disturbances of dynamic gestural organization (decomposition or simplification) and memory and learning deficiencies without anomalies of instrumental functions or usual psychometric mental deterioration. Application of the AMDP scale failed to reveal any psychotic type of disorders. Mood disturbances were predominant, affecting 60 p. 100 of the subpopulation studied (24 cases) and combining, in an unexpected manner: dysphoria, euphoria and depression. Only euphoria appeared to be correlated with intellectual disorders. Frequency of both intellectual and mood disorders was similar to that reported in other series published. The relative homogeneity of semiology, seen by the correlation between the different disturbances (decomposition and simplification, plateau learning curve and euphoria) and the unusual grouping of these effects, is suggestive of their organic basis. In addition, signs and symptoms resemble the neuropsychological expression of frontal lobe lesions and certain lesions of central grey nuclei.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3671963 TI - [Ataxic hemiparesis caused by a thalamic lacuna]. AB - A 64 year old man was admitted for an ataxic hemiparesis. Magnetic resonance imaging (MRI) suggested a lacunar infarct. The lesion was located in the postero lateral part of the contralateral thalamus, sparing the internal capsule. PMID- 3671964 TI - [Magnetic resonance imaging in a case of paramedian mesencephalic infarction]. AB - A case of paramedian midbrain infarction was studied by magnetic resonance imaging. The clinical syndrome included a paralysis of the oculomotor nerve sparing the pupil and cerebellar disorders of the opposite side. MRI disclosed a cylindrical infarction in the paramedian midbrain tegmentum. PMID- 3671965 TI - [Neuropsychic side effects of bromocriptine in Parkinson's disease]. AB - The clinical characteristics of psychiatric side effects of bromocriptine in patients with Parkinson's disease were studied in 12 cases. The clinical picture was characterized by hallucinations and delirium. Daily doses of bromocriptine (more than 30 mg daily), not duration of the disease or pretreatment with levodopa or previous psychiatric diseases, appeared to be the most important causal factor. PMID- 3671966 TI - [Chronic unilateral distal juvenile muscular atrophy localized to the upper extremity (Hirayama type). A European case]. AB - A 40 year-old Frenchman had had for 12 years, an amyotrophy of one upper limb. Clinical features were similar to those previously reported in Japan and India i.e. atrophy limited to one hand and forearm, with mild functional discomfort, and slow progression for 2 years after which the disorder did not progress. Electromyography showed disturbances of anterior horn cell type. The cause of this syndrome is unknown, no pathological case has yet been reported. The prognosis appears to be good. PMID- 3671968 TI - [Transparietal needle biopsy of pulmonary lesions with an image intensification system. Apropos of 82 biopsies]. AB - We report the results of 82 needle biopsies of pulmonary nodules, using a fine screw needle. Owing to the very small diameter of the needle (0.8 mm), very few complications were observed (minor pneumothorax 13%, major pneumothorax 2.5%). The screw needle provided samples adequate for both cytological and histological examination. Forty-eight out of 53 cancers were diagnosed by this method (sensitivity 83%, specificity 100%). PMID- 3671967 TI - [Sleep apnea syndrome combined with an anatomical obstruction of the upper airways]. AB - In patients with sleep apnoea syndrome abnormalities of the upper airways may play a major role in the genesis of apnoea. Three cases are presented which illustrate the part played by hypertrophy of the tonsils in a child and by stenosis of the pharynx in an adult and of the larynx in another adult. All three patients were cured by surgical correction of these abnormalities. The physiopathology of alveolar hypoventilation, present in one of the three patients, is discussed in relation to the effects of pure oxygen inhalation on the patient's ventilation. PMID- 3671969 TI - [Severe neurologic complications secondary to poisoning by slow-release theophylline]. AB - Three cases of severe slow-release theophylline toxicity (plasma theophylline levels above 30 mg/l) in patients with severe chronic pulmonary disease are reported. Seizures were noted in all patients, and one had tachyarrhythmia. Two of the patients died. Several factors were present which may have impaired theophylline clearance, leading to toxic plasma levels. The mortality rate of theophylline intoxication being high, the initial doses should be sufficiently low to minimize the risk of adverse affects, and the best way to prevent theophylline toxicity is to monitor plasma concentrations. A management of patients with theophylline overdosage is suggested: oral administration of activated charcoal is the primary therapeutic measure; haemoperfusion or haemodialysis should be considered only in patients in whom conservative measures have failed. PMID- 3671970 TI - [Use of helium and oxygen mixtures in status asthmaticus]. AB - Four patients in status asthmaticus and with alveolar hypoventilation were given a helium-oxygen (He-O2) mixture to breathe during 4 hours. Clinical improvement and return to normal of arterial blood gas levels were rapid and dramatic in all patients. The He-O2 mixture, which is a low density gas, causes a reduction in pulmonary resistance and an improvement in overall alveolar ventilation. PMID- 3671971 TI - [Primary alveolar hypoventilation. Clinical aspects and diagnostic problems. Apropos of a case]. AB - Primary alveolar hypoventilation is a rare syndrome of unknown origin, characterized by a dysfunction of the automatic respiratory pattern in spite of normal lungs and in the absence of mechanical ventilatory defects. A reduction of the ventilatory response to CO2 is regularly found, and cardiac failure is common. The differential diagnosis mainly concerns the sleep apnoea syndrome. The usual treatments have little effectiveness. PMID- 3671972 TI - [Contribution of pulmonary gallium scintigraphy to the diagnosis of pulmonary tuberculosis]. AB - Radioisotope scanning of the lungs with gallium 67 was performed in 13 patients whose radiological images were suggestive of pulmonary tuberculosis. The purpose of the study was to assess the value of that method as a complement to bacteriology in active pulmonary tuberculosis. Provided the lung tissue is not totally destroyed, gallium 67 is strongly taken up by the tuberculous lesions. However, scanning cannot be regarded as a routine examination, as it is costly and delivers a non-negligible dose of radiations. All it can do is to serve as a guide for more invasive investigations. PMID- 3671973 TI - [Possibilities of training for marathon races after myocardial infarction]. AB - The arguments against participation in marathon races after myocardial infarction are critically discussed. It can be demonstrated that most patients undergoing post-infarction rehabilitation have the physiological characteristics required to complete the necessary training. However, psychological and social considerations reduce the potential candidates to 33-50% of a typical sample, and only 1 or 2% of these would accept the demands of such an intensive training. So far, we are encouraged by the safety of marathon races for patients who are well trained and closely monitored. In addition, the influence of the training programme on smoking, serum lipid levels and heart work seems to be impressive. Participants are much less depressed, and a growing enthusiasm can be perceived in those of their colleagues who have a lesser reserve of cardiac function. PMID- 3671974 TI - [Isolated pulmonary lymphoma in a patient with acquired immunodeficiency syndrome]. AB - We report the case of a male patient with AIDS who had been hospitalized for various opportunistic infections, from which he recovered, and was readmitted on account of a round opacity in the lower lobe of his right lung. There was no evidence of extrapulmonary pathology. Transtracheal aspiration, alveolar lavage and transbronchial biopsy failed to identify the lesion. Lung biopsy after thoracotomy resulted in a diagnosis of malignant lymphoma type B with anti-IgA and anti-kappa antibodies. Despite chemotherapy the patient died within one month, the lymphoma having spread to both lungs. PMID- 3671975 TI - [Epidemiologic aspects of extrauterine pregnancy and therapeutic approach. Apropos of 200 cases in a continuous series]. AB - The study of 200 files has enabled to define a few epidemiological aspects of ectopic pregnancy: large frequency of this pregnancy with ectopic location, for 42 births, in an average, occurrence in young women, between 25 and 35 years, hypofertile, nulli or primiparous, importance of utero-adnexal infections and their sequelae, found in 50% of the cases, and linked to the increase of sexually transmissible diseases and the frequency of voluntary interruptions of pregnancy, importance also of histological lesions of the isthmo-interstitial segment of the tube. The different therapeutic approaches are presented: the authors explain the reasons for a deliberately conservative therapy (in 82% of the cases) without compromising the maternal prognosis: absence of anatomical abnormality justifying the excision of the tube, or, often bilateral anatomical lesions requiring a subsequent radiological work-up, and a secondary treatment. Finally, desire of another pregnancy in a population which is infertile, most of the time, and of which the mean age is 28 years. PMID- 3671976 TI - [Severe jaundice during pregnancy]. AB - Severe jaundice during pregnancy is exceptional; it rapidly compromises the maternal and fetal prognosis. The series of seven cases presented in this study (3 acute viral hepatitis, 3 acute steatosis of pregnancy, one uncertain diagnosis), demonstrates the rapid evolution and the major repercussion on the pregnancy (5 premature deliveries, four fetal deaths in 8 children). No maternal death occurred but the complications were practically constant (4 severe haemorrhages, 3 acute renal insufficiencies, one encephalopathy with convulsions). This study permits also to emphasize the difficulty of the diagnosis in the acute phase: laboratory tests are often not very significant and the needle biopsy of the liver is usually contra-indicated; a liver scan (3 cases) may be an interesting alternative. The treatment requires a collaboration between obstetrician and anesthetist. The obstetrical management rests on the condition of the fetus and the etiology since the current tendency is to deal rapidly with the pregnancy, in the presence of an Acute Steatosis. PMID- 3671977 TI - [Examination of condylomatous lesions of the uterine cervix in 468 anatomic specimens. Retrospective study]. AB - On the basis of 468 anatomical specimens, we intended to look for histological signs of an HPV (human papilloma virus) infestation. This study has enabled to calculate the true incidence of this pathology, to correlate the histo-clinical aspects as well as the association severe lesions-condylomatous lesions. Our conclusions confirm the close connection between viral lesions and malignant pathology of the cervix. PMID- 3671978 TI - [When should one operate on polyps of the isthmo-interstitial portion of the fallopian tube?]. AB - The authors analyze the diagnosis and the results of the treatment of 43 patients presenting simple polyps of the isthmo-interstitial segment of the tube with at least a 2 years follow-up. The study was carried out between 1980 and 1983. It was a prospective, non-randomized study. They conclude that the medical treatment, which gives excellent results, is advantageous. Microsurgical treatment (reimplantation or isthmo-ostial anastomosis) is only used after failure of the medical treatment. PMID- 3671979 TI - [Clonidine and emergency treatment of hypertension in pregnant women]. PMID- 3671980 TI - [Role of immunological mechanisms in the production of cardiac post-streptococcal sequelae]. PMID- 3671982 TI - [Rehabilitation nurses]. PMID- 3671981 TI - [Observations related to a series of recent cases of boutonneuse fever recorded in this country]. PMID- 3671983 TI - [One is often in need of somebody smaller than oneself]. PMID- 3671984 TI - [An attempt at objective evaluation]. PMID- 3671985 TI - [Understanding epidemiology. 3]. PMID- 3671986 TI - [Nurses of the Sports Medicine Center]. PMID- 3671987 TI - [At the surgical unit, the team, the management]. PMID- 3671988 TI - [Biliary lithiasis: current therapeutic therapies]. PMID- 3671990 TI - The nature of the onset of rheumatoid arthritis: a reassessment. AB - A total of 300 consecutive patients referred to a tertiary-care center and fulfilling the American Rheumatism Association criteria for definite-classical rheumatoid arthritis, (with a mean disease-duration of 10.3 +/- 9 years) were studied by structured interview and medical record review. The type of onset (rapid or insidious), type of joint involved (small, medium, large or combined joints) and pattern of joint involvement (monarticular, pauciarticular or polyarticular) at onset, and the interval between the first symptom and development of established disease were determined from the interview (based on the patient's memory). The onset was rapid in 46%. Initial involvement occurred in small joints in 31%, medium joints in 16%, large joints in 28% and combined sites in 25%. The pattern of joint involvement at onset was monarticular in 21%, pauciarticular in 44% and polyarticular in 35%. The time for disease to become established was less than 1 month in 25%, 1-6 months in 35%, 6-12 months in 14% and over 1 year in 26%. The monarticular pattern of onset was associated with slower development of established disease than the other patterns of joint involvement; polyarticular disease tended to be associated with polyarticular onset; involvement of large joints was associated with pauciarticular onset. PMID- 3671989 TI - The synthesis of hyaluronic acid by human synovial fibroblasts is influenced by the nature of the hyaluronate in the extracellular environment. AB - Various cell lines of human synovial fibroblasts derived from synovium obtained at the time of biopsy or total joint-replacement surgery have been established. The synthesis of 3H-labelled hyaluronic acid (HA) in these cells has been determined, and the effects of adding HA of varying molecular size to the cultured cells examined. The results obtained clearly show that the in vitro synthesis of HA by these cells is influenced by the concentration and molecular weight (MW) of the HA in their extracellular environment. Synovial fibroblasts derived from an osteoarthritic joint demonstrated the most marked response on exposure to exogenous HA, showing a stimulation of HA synthesis with preparations of weight-average molecular weight (Mw) greater than 5 X 10(5) in a concentration dependent manner. HA preparations with Mw less than 5 X 10(5) showed little or no effect except at high concentrations where a suppression of biosynthesis was observed. A model to explain these findings is proposed. PMID- 3671991 TI - Adult onset Still's disease in North India. A report on six patients. AB - Six patients suffering from adult onset of Still's disease were seen over a 10 year period. Contrary to expectations, complications of deformative arthritis (two patients), amyloidosis (one patient), uveitis (one patient) and chronic granulomatous liver disease (one patient) were observed during follow-up. One patient succumbed due to iatrogenic causes; autopsy showed that the pathological changes, like the clinical features, were non-specific. Four patients responded to aspirin and indomethacin; two required corticosteroids. PMID- 3671992 TI - Anorexia nervosa in a patient with systemic lupus erythematosus. AB - Anorexia nervosa has not been described in patients with systemic lupus erythematosus (SLE). The case of a patient with SLE who developed the classical features of anorexia nervosa is described. Although an impressive interplay between psychosocial and cultural factors was present, the possibility that this syndrome was produced by active CNS vasculitis remained. PMID- 3671993 TI - Treatment of Weber-Christian panniculitis with cyclosporine A. PMID- 3671994 TI - Analysis of the genes for transferrin, transferrin receptor as well as H and L subunits of ferritin in idiopathic hemochromatosis. AB - In the attempt to define the abnormalities responsible for the severe iron overload found in patients with idiopathic hemochromatosis (IH) we analyzed, in 8 patients with IH and in 7 normal subjects, by using specific cDNA probes, the genes coding for the main iron-related proteins, i.e., transferrin, transferrin receptor, as well as H and L subunits of ferritin. In all the patients tested all the probes failed to evidentiate rearranged bands with any of the restriction enzymes employed. These findings suggest the absence of gross structural alterations of the genes examined. The lack of polymorphic sites recognized by the restriction enzymes employed in this study within or around the genes examined does not allow to associate a specific gene with the disease. PMID- 3671995 TI - Cryptic hepatitis B virus replication during prednisone therapy in type B chronic active hepatitis. AB - Hepatitis B virus (HBV) replicating in patients with serum hepatitis B surface antigen and antibody to hepatitis B e antigen (cryptic HBV replication) can be detected by a spot hybridization technique for serum HBV-DNA and by immunoperoxidase staining of hepatitis B core antigen in the liver. These methods allowed us to study the effects of chronic (13 to 82, mean 30 months) administration of low doses (10 or 15 mg/day) of prednisone to 17 patients with chronic active hepatitis and cryptic HBV replication. Liver biopsies performed before treatment demonstrated that 1 to 50% (mean 12%) of the liver cells were infected. After therapy, infected cells had disappeared in 5 (29%), were considerably reduced in 9 (53%) and remained unchanged in 3 (18%) patients. The mean percentage of infected cells in the liver biopsies performed at the end of the follow-up was 3.2 +/- 5.5% (p less than 0.005). Serum HBV-DNA was present in 12 of 13 and in 5 of 12 patients investigated before treatment and at the end of the study, respectively. Five patients harboring HBV in the liver developed cirrhosis during treatment. Our data indicate that, despite steroid therapy, HBV replication either ceased or was decreased in two thirds of the patients, while in no case it flared-up. The rise of cirrhosis was not prevented by this type of therapy. PMID- 3671996 TI - IgA antibodies to dietary antigens in liver cirrhosis. AB - Antibodies to dietary antigens (ovalbumin, beta-lactoglobulin, casein) have been detected by a micro-ELISA test in 47-50% of serum samples from patients with alcoholic liver cirrhosis, in 27-36% with non-alcoholic cirrhosis (HBV-related, autoimmune and primary biliary) and in 50-70% of cirrhotic patients with portacaval shunt. Dietary antibodies were mainly confined to the IgA class (90%). In patients with chronic active hepatitis dietary antibodies showed a low positivity (11%), similar to that of subjects with alcohol abuse without liver injury and of healthy subjects. Dietary antibodies were significantly associated with portal hypertension (evaluated on the presence of esophageal varices and/or ascites) both in alcoholic and non-alcoholic cirrhosis. The absence of dietary antibodies in the duodenal juice of cirrhotic patients positive for serum antibodies confirms that the intestinal mucosa is normal or slightly altered in liver cirrhosis. Unlike cirrhotics, untreated celiac patients showed a high prevalence of dietary antibodies also in the duodenal juice (55%). PMID- 3671997 TI - Prevalence of duodenal and jejunal lesions in dermatitis herpetiformis. AB - Sixty-eight patients with dermatitis herpetiformis underwent jejunal suction biopsies and/or multiple endoscopic duodenal biopsies to evaluate the incidence of small bowel mucosal atrophy and to compare the diagnostic yield of the two methods. Small bowel function tests were also performed to evaluate the extent of functional impairment. Small bowel lesions were observed in 89.4% of jejunal suction biopsies and in 100% of endoscopic duodenal biopsies. Of the 10 patients who underwent both procedures, one had lesions only in the duodenum, one had more severe lesions in the duodenum than in the jejunum, while the remaining 8 patients showed identical lesions at both sites. The 1-h blood d-xylose test after a dose of 5 g proved more sensitive than xylosuria or serum folic acid assay in detecting subclinical malabsorption. Finally, histological features of gluten-sensitive enteropathy can be found in nearly 100% of patients with dermatitis herpetiformis. Upper gastrointestinal endoscopy with duodenal biopsies is at least as sensitive as jejunal suction biopsy in assessing small bowel involvement in dermatitis herpetiformis. PMID- 3671998 TI - Sudden increase of plasma fibrinopeptide A levels after induced abortion. AB - Plasma fibrinopeptide A levels were studied before and after abortion induced during the first trimester of pregnancy. Fibrinopeptide A levels were significantly increased 15 min after the induced abortion, and returned to preoperative values 2h later. This finding suggests that thrombotic activity is transiently increased immediately after the induced abortion. Activation of the clotting factors during the induced abortion appears to be important in controlling uterine hemorrhage. PMID- 3671999 TI - Nasal changes following immersion in chlorinated water. AB - Ten swimmers had rhinomanometry, mucociliary clearance time and lung function tests performed pre and post swimming in a chlorinated swimming pool. No evidence of nasal irritation or adverse effects on nasal function were obtained. PMID- 3672000 TI - Nasal resistance to respiratory airflow: a plethysmographic alternative to the face mask. AB - Nasal airflow resistances were measured simultaneously by face mask and "head out" body plethysmograph and compared. Computer averaging of transnasal pressure and flow signals digitized at 50Hz during 5 breath sequences was employed to determine a ratio of pressure to flow as an index of nasal resistance to breathing. The mean value of ten plethysmograph measurements differed by only 2.0% from that of ten face mask measurements which were made simultaneously. Coefficients of variation of plethysmograph resistance measurements averaged less than 6% in twenty subjects (ten measurements/subject) aged 7-68 years over an intersubject resistance range of 1 to 7 cms H2O/l/sec (0.1-0.7 Pa/cm3/sec). Voluntarily altered minute ventilations from 8-28 l/min in a subject at rest increased this variation to 10%. The "head-out" body plethysmograph is a versatile and reliable instrument for assessment of nasal respiratory airflow resistance. PMID- 3672001 TI - Relationship between nasal patency and clearance. AB - Nasal airway patency and nasal clearance were measured bilaterally on six different test days in ten subjects. Nasal patency was evaluated using anterior rhinomanometry and clearance was measured using a dyed saccharin method. The results showed large intra- and inter-subject variances in the clearance times. Clearance times determined by the saccharin taste method were shorter than those determined by the dye method, but these measures were positively correlated. Also, the mean clearance rate was directly related to the mean nasal conductance. In seven of ten subjects, the clearance rate for a given side of the nasal passage was relatively faster when that side was the more patent. These results suggest that the clearance rate is a function of the patency of the nasal passage and may also exhibit alternating cyclic fluctuations. PMID- 3672002 TI - Occupational formaldehyde exposure and the nasal mucosa. AB - This study was undertaken to evaluate the possible cytotoxic effect of formaldehyde on the nasal mucosa in man. 38 men with an average age of 38 years and average exposure time of 10.5 years were studied. They were exposed to formaldehyde when processing laminae. All men passed a medical examination and a nasal biopsy. The histological findings were scored, 0-8, according to a system proposed by Torjussen. The findings were compared with a non-exposed reference group of 25 men (mean age 35 years). 35% of the exposed were smokers compared to 48% of the nonexposed. The average histological score was 2.8 for the exposed versus 1.8 for the non-exposed (p less than 0.05, Wilcoxon). The more common findings in the exposed were loss of cilia, goblet cell hyperplasia and squamous metaplasia. In four cases (11%) there was a mild dysplasia. Smoking had a slight modifying effect on the histological picture. The results indicate that the suspected precancerous findings in animal studies after exposure to formaldehyde might be present in workers exposed to formaldehyde at relatively low levels. PMID- 3672003 TI - Is endonasal insufflation of xenon133 a fiable functional assessment of nasal cavities? AB - The ventilation of nasal cavities has been examined according to the method of Bisschop et al. (1983). The test was performed on 32 healthy volunteers, free of symptoms with normal standard X-rays of their sinuses. Half-times of the wash-out curves were calculated and adopted as a measure of ventilation. For sitting persons these values were lower than other authors reported, the values in sitting or lying persons were comparable. We did not find a significant difference between values of sitting or lying We did not find a significant difference between values of sitting or lying persons. There was no significant difference neither in the half-times obtained in persons with normal clinical background and persons with septal deviations. The experiment was not optimally reproducable. PMID- 3672004 TI - The role of maxillar morphology in the development of pathological septal deformities. AB - As a rule some kinds of nasal septum deformities are more frequently found in subjects whose maxilla has more or less stressed morphological irregularities than in those with a normally shaped maxilla. The subjects with asymmetry between the nasal floor levels (the right and left side) show heavier septal damages than others. It means that a regularly shaped maxilla as well as a symmetric nasal floor serve like a fuse against the more severe deformations after nasal trauma. In this paper we have made a classification of the septal pathological deformities. PMID- 3672005 TI - Ethmoidal nerve and artery block in endonasal sinusectomy. PMID- 3672006 TI - Carcinogenetic action of the implant of acrylic tabs in ozena. PMID- 3672007 TI - International Symposium on Multiple Sclerosis. Invited lectures and posters. PMID- 3672008 TI - Advanced detection of viral nucleic acids in the central nervous system: a progress report. AB - A progress report. We have helped to standardize an advanced in situ hybridization technology to detect viral nucleic sequences in formalin fixed paraffin embedded brain tissue with high sensitivity and specificity as well as good preservation of cytomorphology. It is our belief that if the inflammation in the multiple sclerosis central nervous system is associated with persistent virus this technique should reveal it. Technical reasons are given why we are continuing to search for measles virus in multiple sclerosis brain tissue. PMID- 3672009 TI - The role of spinal cord MRI in the diagnosis of multiple sclerosis. AB - In this study we evaluated the effectiveness of high field thin slice surface coil MRI in demonstrating MS plaques in the cervical and upper thoracic spinal cord. MRI seems to be in our experience a sensitive indicator of spinal cord involvement in patients suffering from MS. PMID- 3672010 TI - Multimodal evoked potentials and CSF findings in the diagnosis of multiple sclerosis. AB - A group of 30 patients classified on clinical grounds as having definite (N = 16) or probable MS (N = 14) according to McAlpine's criteria, has been studied using multimodal recordings of evoked potentials (visual, auditory, and somatosensory) and examination of the cerebrospinal fluid (CSF) for oligoclonal bands and Link's Index. Evoked potentials examination proved extremely sensitive in discovering asymptomatic lesions of the central nervous system. CSF data, in particular the presence of oligoclonal bands, had a high sensitivity for MS. According to these electrophysiologic and immunologic results, we have reclassified our patients in conformity with the diagnostic criteria proposed by Bartel. The combination of electrophysiological and CSF data, together with common clinical criteria, led to greater diagnostic accuracy, making it possible to reclassify most patients previously considered to have probable MS as having definite MS. PMID- 3672011 TI - Cerebrospinal fluid (CSF) parameters and clinical course of multiple sclerosis. AB - The separate correlations among CSF and clinical parameters (mononuclear cell count, assay of intrathecal IgG synthesis, assessment of blood-brain barrier permselectivity to albumin and alpha 2-macroglobulin, detection of oligoclonal intrathecal IgG isoelectric spectro-type; age, disease duration, disability, number of bouts) were investigated by multiple linear regression in 100 multiple sclerosis patients subdivided according to the course and the phase of the disease. Results indicate that the complexity of the oligoclonal CSF IgG isoelectric spectrotype increases, but the overall amount of intrathecal IgG synthesis decreases with increasing number of bouts or disease duration in relapsing remitting and in progressive courses respectively. The CSF mononuclear pleocytosis was low in progressive forms, and it appeared to be linked to the intrathecal IgG synthesis changes. The IgG synthesis rate was proportional to CSF pleocytosis, but a negative correlation between pleocytosis and complexity of CSF IgG spectrotype was found. About 40% of patients had a blood-brain barrier damage. The increased permeability to albumin was related to the number of previous bouts, whereas the CSF pleocytosis seemed to be accompanied by a loss of barrier selectivity to large serum molecules. High CSF IgG index, high mononuclear cell count and low number of prominent oligoclonal CSF IgG fractions characterize the less active or short-lasting disease. Low CSF IgG index with numerous, faint, abnormal IgG CSF bands, low mononuclear cell number and increased barrier permeability to albumin are associated with long-lasting or steady progressive disease. PMID- 3672012 TI - Evolution and severity markers in 233 MS patients. AB - Clinical data of 233 patients (202 definite and 31 probable MS) have been examined in relation to the following prognostic indicators: sex, age at onset, pousse frequency, interval between the first two relapses, initial symptomatology. Regression analysis technique and covariate analysis have been used versus the latest Expanded Disability Status Scale of each patients. Onset at younger age and a longer interval between the first two episodes have resulted statistically significant for a more favourable prognosis. The shift from a remitting toward a progressive course appears to happen within the first five years in 60% of the cases. PMID- 3672013 TI - The alterations of the synovial membrane in rheumatoid arthritis treated with corticosteroids. AB - Sections of synovial tissue removed from patients with rheumatoid arthritis treated, for a long period of time or a brief period of time or not at all, with corticosteroids were examined for the incidence of histopathologic changes. Comparison of the quantification of these changes in the differently treated groups revealed that prolonged administration of corticosteroids had an inhibiting effect on the occurrence of lymphocytes and histiocytes in inflammatory infiltrates as well as on the hypertrophy of synoviocytes, on the proliferation both of fibroblasts and fibrocytes, and on the formation of villi and collagen fibers. PMID- 3672015 TI - [Radiographic study of the rheumatoid hand and etiopathogenic mechanisms of deformities. Apropos of 100 cases]. AB - X-rays of the hands and wrists of 100 patients suffering from rheumatoid arthritis (RA) were compared to those of 65 control subjects matched for age and sex. Osteoarticular destruction was assessed using Larsen's index and by carpal bone deformities; ulnar deviation of the fingers (UDF) and radial deviation of carpal bones (RDC). No significant asymmetry of lesions in the right or left hands can be demonstrated, whatever the subsets of patients and osteoarticular manifestations studied. After a one year course, there is no significant difference between patients and control subjects. Only the index of carpal deformity is significantly high and the clinical course progresses between 1 and 5 years (p = 0.02). The difference becomes significant for UDF (p less than 0.01) after the disease evolves for 5 to 10 yrs. UDF is correlated with carpal osteoarticular lesions (p = 0.01) and metacarpophalangeal lesions (MCP). Different osteoarticular lesions of the hand are correlated with each other. The close correlation between UDF and RDC and MCP involvement has been confirmed by various statistical tests. Comparison of seropositive and seronegative patients with RA only reveals a more marked disturbance of MCP in the seropositive patients. Various methods of assessing osteoarticular deformities and joint destruction are discussed. Finally, the etiopathogenic mechanisms causing deformities of the hand in RA were studied, and the authors reviewed the importance of the initial involvement of soft tissues and therapeutic implications whereby prevention of disease extension using prompt local therapy is recommended. PMID- 3672014 TI - [Monocytic arthritis. Study of their clinical significance apropos of 43 cases]. AB - The clinical significance of synovial monocytosis (greater than 50 p. cent) of inflammatory fluids (greater than 1,000 elements per mm3) was studied retrospectively in 43 patients. An accurate diagnosis was made 35 times: rheumatoid polyarthritis (13 cases), lupus disease (1 case), Gougerot-Sjogren syndrome (1 case), isolated infantile monoarthritis (1 case), sarcoidosis (1 case), seronegative spondylo-arthropathy (3 cases), microcrystalline arthritis (5 cases) arthritis revealing a blood disease (2 cases), idiopathic "lymphocytic" arthritis (3 cases), eosinophilic pseudo-allergenic arthritis (2 cases), aseptic osteonecrosis of the medial condyle (1 case), femoro-patellar arthrosis (1 case). Among the 8 other patient for whom no diagnosis was made, 6 had a spontaneously resolving acute affection, evoking the possibility of a viral etiology. PMID- 3672016 TI - [Postero-lateral arthrodeses in spondylolisthesis and lumbosacral disk arthroses. Study of 11 cases with follow-ups exceeding 5 years]. AB - The retrospective study of 111 patients having undergone a postero-lateral arthrodesis for lumbar disc degeneration or spondylolisthesis has enabled to evaluate functional results according to the clinical criteria of Stauffer and Coventry with a mean follow-up of 9.5 years, and to examine among clinical and socio-professional elements, X-rays data and technical conditions of the graft, those which seem to influence in a statistically significant fashion the quality of the results. The long term result was estimated satisfactory (very good and average) for 70% of spondylolisthesis, and stable in time; 3/4 of the patients resumed work, after rehabilitation 2 out of 3 times. Concerning disk arthroses, we have observed 50% of satisfactory results, with degradation of average results one year after surgery occurring 4 out of 10 times, most often more than 5 years after the graft; 58% of the patients resumed work, half of them after rehabilitation. 25 complications were noted and they all evolved favorably. Among factors capable of influencing the quality of the result, no statistically significant influence was found concerning the pre-operative site of the pain, the possible past history of spine surgery, a pre-operative risk profession for the spine, a pre-operative inter-apophyseal arthrosis, the number of levels grafted and a possible associated discal curettage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3672017 TI - [Malignant lymphoma with centrofollicular cells associated with pseudomyelomatous lytic bone lesions]. AB - The authors report on 3 cases of malignant lymphoma associated with well-defined lytic lesions of the skull and limbs that were identical to lesions observed in patients with multiple myeloma. In two patients, subcutaneous nodules were found opposite the site of bone lysis. Histologic examination diagnosed centrofollicular cell malignant lymphoma in all 3 cases. The exceptional nature of such lesions in patients with malignant lymphoma is discussed in connection with literature data. The suggested physiopathologic mechanism is secretion of an "osteoclast activation factor" (OAF) by malignant lymphoid B cells. PMID- 3672018 TI - [The gouty patella. Microradiographic and microscopic study]. PMID- 3672019 TI - [Campylobacter fetus bursitis of the elbow]. PMID- 3672020 TI - [The significance of risk factors in the primary prevention of ischemic heart disease]. PMID- 3672021 TI - [Manifestation of an electrically nonhomogeneous conductor and an eccentric source on the distribution of electrical voltage in a model of circular laminar electrical fields and in the potentials in Wilson's central terminal]. PMID- 3672022 TI - [Does the creation of an arteriovenous fistula effect the hemodynamics in patients with chronic renal failure?]. PMID- 3672023 TI - [Treatment of Goodpasture's syndrome]. PMID- 3672024 TI - The effect of beta 1-adrenoceptor blockade on cardiac output and organ blood flow in conscious rats. AB - The acute effects of the beta 1-adrenoceptor inhibition by atenolol were investigated on conscious rats. Cardiac output and organ blood flow were measured by 15-microns radiolabelled microspheres during control and 20 min after administration of atenolol (1 mg/kg body wt). Arterial blood pressure and heart rate were measured continuously. Arterial blood gases and pH were determined immediately after the two microsphere injections and arterial blood samplings. The mean arterial blood pressure fell significantly shortly after the injection of atenolol and was reduced by 9% (p less than 0.02) after 20 min. Heart rate fell by 17% (p less than 0.05). The total peripheral vascular resistance increased by 25% (p less than 0.05). At the same time the arterial acid-base chemistry remained unaltered from the control. The cardiac output fell by 24% (p less than 0.05). Blood flow fell to all organs and tissues (0-67%) except to the brain, adrenals, liver, ears and diaphragm. The greatest decrease was seen in perfusion of the adipose tissue (67%) and of the spleen (60%), indicating that the blood flow to these organs are normally highly influenced by beta 1 adrenoceptor stimulation. The estimated work load of the heart was reduced by 20% which correlated well to a reduction of myocardial blood flow to the same degree. PMID- 3672026 TI - Reliability of transcutaneous oxygen tension (TcPO2) measurements in elderly normal subjects. AB - This study was conducted to evaluate the reliability of TcPO2 measurements in a well characterized group of 10 elderly normal subjects with an age distribution typical for the population with peripheral vascular disease (PVD) and amputation. The TcPO2 values were obtained on three separate occasions at 2-week intervals at seven anatomic sites commonly measured in patients with PVD. The TcPO2 values were comparable to those previously reported for similar sites in normal elderly subjects. Measurement to measurement variation averaged 1.1 kPa (8 mmHg) for a coefficient of variation (CV) of 14.4%. Confidence intervals ranging from 2.1 kPa (16 mmHg) above a single TcPO2 value to 2.1 kPa (16 mmHg) below were necessary to contain the true value 95% of the time. While TcPO2 measurement is assuming an important role in the evaluation of disease states in both paediatric and adult medicine, our observations emphasize the importance of using such measurements as an adjunct in clinical decision making and not basing such decisions on a single TcPO2 value alone. The size of the confidence intervals can be reduced substantially for a given site by taking the mean of two or more TcPO2 measurements taken at separate times. PMID- 3672025 TI - A simple isotopic assay method for human serum phospholipase A2 activity. AB - An assay using 2-(1-14C)palmitoyl-labelled dipalmitoyl phosphatidylcholine substrate for the determination of serum phospholipase A2 (PLA2) activity is described and validated. The rapid determination of the enzyme activity is enabled by a simple liquid-liquid partition system to replace the laborious thin layer chromatography used in earlier studies. The PLA2 activity of human pancreatic juice was used for the optimization of the assay. Interference by serum phospholipids can be avoided by using 10 microliter aliquots of serum in the assay, whereas larger amounts caused a progressive inhibition of the enzyme activity. Virtually no enzyme activity is determined in serum from normal healthy subjects (range from 1.2 to 3.0 IU/l). In acute haemorrhagic pancreatitis the PLA2 activity is markedly elevated (range from 10.7 to 42.0 IU/l). Due to the simple extraction of the reaction products the results can be obtained the same day. Therefore, the assay can conveniently be used for the rapid clinical identification of subjects with acute haemorrhagic pancreatitis. PMID- 3672027 TI - Deconjugation of bile salts: does it occur outside the contents of the intestinal tract in the rat? AB - Several different methods have been applied to measure the extent of bile salt deconjugation (deamidation), if any, outside the gastro-intestinal tract of the rat. A breath test has been applied to the rat using peroral or intravenous administration of cholyl-glycine-1-14C. Results for normal rats have been compared with rats with a continuous recirculation of bile to a tail vein. Bile salts labelled with 2,4-3H in the sterol moiety and conjugated with glycine-1-14C have been infused in rats and recirculated via a bile duct tail-vein shunt. The 3H:14C ratio in the bile has been used as an indication of deconjugation. In these experiments the radioactivity pattern of the bile salts has been determined after thin-layer chromatography. Different labelled bile salts have also been infused intraperitoneally and the composition of bile secreted through bile fistulae studied. In none of these experiments, in which the gastro-intestinal content was bypassed and a return of bile salts to the liver in the physiological range ensured, was any deconjugation of glycine-conjugated bile salts observed. When the liver, however, was stressed by anaesthesia and the intraportal infusion of deoxycholyl-2,4-3H-glycine in unphysiological levels, deconjugation occurred as indicated by the appearance in bile of labelled taurine conjugates. In these rats the dose of deoxycholylglycine was clearly toxic as evidenced by partial or complete cholestasis and eventually death of the animal. PMID- 3672028 TI - Deconjugation of glycine-amidated bile salts does not occur in germfree rats. AB - After oral administration to germfree rats of cholyl-glycine-1-14C, deoxycholyl glycine-1-14C and nor-ursocholyl-glycine-1-14C no significant amounts of 14CO2 are expired. This indicates that these bile salts are not significantly deamidated under physiological conditions in the rat organism outside the gastro intestinal tract. PMID- 3672029 TI - Methodological aspects of breath hydrogen (H2) analysis. Evaluation of a H2 monitor and interpretation of the breath H2 test. AB - The reliability of end-expiratory hydrogen (H2) breath tests were assessed and the significance of some important pitfalls were studied, using a compact, rapid H2-monitor with electrochemical cells. The H2 response was shown to be linear and stable. The reproducibility of the breath collection technique was determined in 20 patients following ingestion of lactulose. The increment between consecutive means of duplicate samples indicative of a significant rise of H2 concentration never exceeded 10 p.p.m., the mean coefficient of variation of the duplicate samples was below 5%. Fasting H2 levels were studied in 10 healthy adults during a 4-month period and they showed very marked inter- and intra-individual variability (16% above 40 p.p.m.). Initial peaks (early, short-lived H2 rises unrelated to carbohydrate malabsorption) were identified in 25% of the breath tests (in 4% above 20 p.p.m). It is concluded that the technique used for interval sampling of end-expiratory breath samples for H2 concentration gives reliable results. The biological significance of H2 concentration increments can only be evaluated if the limitations of the technical procedures and the individual ability to produce H2 is known. PMID- 3672031 TI - The association between calcium and acetoacetate, 3-hydroxybutyrate, pyruvate and lactate as determined by potentiometry. Determination of concentrational complexity constants in watery solutions at physiological conditions. AB - The complex binding of calcium to acetoacetate, 3-hydroxybutyrate, lactate and pyruvate was studied under physiological temperature and ionic strength by potentiometric measurement of the calcium ion activity. The limiting conductances of the complex-forming anions were measured to make a proper correction for the analytical error due to the liquid junction potential between the test solution and the salt bridge solution of the reference electrode. The calcium activity measurements indicate a 1:1 binding ratio of calcium and the anions. The concentrational complexity constants at physiological ionic strength of calcium and acetoacetate, 3-hydroxybutyrate, lactate and pyruvate are 8.8, 4.0, 11.6 and 6.3 1/mol, respectively, and the limiting conductances of the anions are 4.5, 3.8, and 5.2 X 10(-3) S.m2/mol, respectively. The thermodynamical complexity constants, which are based on ion activities, are about three times higher than the concentrational complexity constants. The possible role of the various complexes in lactic acidosis and ketoacidosis is discussed, and it is concluded that under merely moderate lactic acidosis the quantitatively most important of the low-molecular weight calcium complexes is the calcium-lactate complex. PMID- 3672030 TI - Increased myocardial performance following acute hyperglycaemia in insulin dependent diabetic patients. A consequence of increased peripheral blood flow? AB - Cardiac function during acute hyperglycaemia was investigated by means of echocardiography in eight insulin-dependent (type 1) diabetic patients without microvascular or cardiac disease. Blood glucose was raised from 5.1 +/- 0.8 to 13.0 +/- 0.9 mmol/l for 1 h and then to 20.1 +/- 1.2 mmol/l for 1 h. A saline control study was performed to obtain an equal amount of plasma volume expansion. The left ventricular end-diastolic diameter increased significantly in both studies, however, significantly more following glucose infusion (3.3% at blood glucose of 13.0 mmol/l, 5.4% at blood glucose of 20.1 mmol/l versus 2.7% after both saline infusions). At the blood glucose level of 20.1 mmol/l, fractional shortening of the left ventricle and cardiac output were increased as compared with the baseline level and the level during moderate hyperglycaemia, and also increased compared with values of non-diabetics. In conclusion acute hyperglycaemia is followed by increased myocardial performance, probably as a consequence of increased peripheral blood flow. PMID- 3672032 TI - A comparison between concentrations of free erythrocyte protoporphyrin and serum ferritin during development of iron deficiency by phlebotomy in polycythaemia vera patients. AB - Therapeutic venesection for polycythaemia vera (PV) produces iron deficiency. If iron supplementation is avoided, the frequency of venesections can be kept lower than if iron is given. This is the standard treatment for PV in our department, and this model for iron deficiency was used to compare serum ferritin, free erythrocyte protoporphyrin (FEP), serum iron and transferrin as indicators of iron deficiency. Eleven patients with PV were studied on a total of 90 occasions. Five patients were followed from normal iron status to iron deficiency, the other six were iron deficient at the start of the study. Serum ferritin and FEP became abnormal approximately simultaneously during the development of iron deficiency, serum ferritin in all patients, FEP in 8 out of 11 patients. There was a correlation between the two in all specimens (r = 0.75, p less than 0.001), but serum ferritin showed fewer false negative results. Serum transferrin alone was elevated only in 25% of the patients, and serum iron, although mostly subnormal, was rather inconsistent. It is concluded that serum ferritin and FEP can both be used to diagnose iron deficiency during venesection treatment of PV, whereas serum iron and transferrin are of little value. PMID- 3672033 TI - Prediction of myocardial infarct size from early serum myoglobin observations. AB - Different possibilities to predict infarct size were analysed. The basic method was the fitting of a mathematical model to serial serum myoglobin concentration values from the very early phase of infarction. Correlation was performed with infarct size estimated from the complete serum curves of 53 patients. An observation period up to and including the serum peak value (on the average 6.8 h after onset) was required in order to give a well-determined value of infarct size. A correlation coefficient of r = 0.85 (n = 38) was then obtained. The serum peak concentration value of myoglobin correlated even better (r = 0.89). The initial slope of the serum curve (obtained on the average 4.3 h after onset of symptoms) also correlated well to infarct size (r = 0.80; n = 53). In conclusion, estimation of infarct size appears to be as good with the serum peak value of myoglobin as with model-based parameters. The most useful measure for early prediction of infarct size could be the initial slope of the serum curve. PMID- 3672034 TI - Lecithin: cholesterol acyltransferase in liver disease. AB - Lecithin: cholesterol acyltransferase (LCAT) activity in patients with liver disease has been found to be either normal or lower than normal, but no information on LCAT mass in these patients is available. In this study, LCAT mass concentration together with LCAT activity and cholesterol esterification rate were measured in the plasma of 19 patients with cholestatic liver disease and 21 patients with non-cholestatic liver disease. The LCAT mass in plasma correlated positively with serum albumin (r = 0.69, p less than 0.001) and pre-albumin (r = 0.77, p less than 0.001) and negatively with serum bilirubin (r = -0.42, p less than 0.01) and bile salts (r = -0.43, p less than 0.01), thus reflecting the severity of liver disease and liver protein synthesizing capacity. In plasma, LCAT mass concentration also correlated well with LCAT activity (r = 0.88, p less than 0.001) and cholesterol esterification rate (r = 0.73, p less than 0.001), thereby indicating that the decrease of LCAT activity and cholesterol esterification rate in liver disease is primarily a function of decreased LCAT mass. PMID- 3672035 TI - Production of an amino acid sequence-specific antiserum against human amyloid A (AA) and serum amyloid A (SAA) protein. AB - The hydrophilic nonapeptide Ser-Asp-Ala-Arg-Glu-Asn-Ile-Gln-Arg, identical with residues 59-67 of human amyloid protein A (AA) and serum amyloid protein A (SAA), was covalently bound via its carboxyl-terminal end to the carrier-protein keyhole limpet haemocyanin. The complex was injected subcutaneously into ten rabbits. All rabbits produced antisera which, unabsorbed, were specific for AA and SAA. The antisera and their isolated peptide specific antibodies were performance-tested and found to be excellent for demonstration of AA and SAA in immunoblotting and immunohistochemical techniques but unsuitable for immunoprecipitation. Since it is difficult to produce AA- and SAA-specific antisera by procedures earlier described and commercial supplies of good such reagents are unavailable, the easy production of sequence-specific such antisera will facilitate more extended studies of the corresponding antigens for diagnostic and scientific purposes. PMID- 3672036 TI - Retention and variability of hydrogen (H2) samples stored in plastic syringes. AB - The utility of two brands of 20 ml plastic syringes for storage of hydrogen (H2) samples as obtained in H2 breath tests were studied. Plastipak syringes were found to be significantly better with regard to the stability of the H2 concentration and the variability between the H2 samples. Storage of the H2 samples in Plastipak syringes at 5 degrees C significantly improved the H2 retention, whereas refrigeration of H2 samples stored in Once syringes did not reduce H2 loss. Storage of H2 samples in refrigerated plastic syringes is efficient and reliable for several days if syringes with minimal sample variation are used. PMID- 3672037 TI - In man, only activity fronts that originate in the stomach correlate with motilin peaks. AB - We have tested the hypothesis that the imperfect correlation between the occurrence of plasma motilin peaks and the migrating motor complex (MMC) is related to the site of origin of the MMC. Gastric and small-intestinal motor activity was recorded manometrically in 16 normal subjects after an overnight fast. Blood samples were taken every 10 min and assayed for motilin. Fifty MMCs were recorded: 29 (58%) originated in the antrum and 21 (42%) in the small intestine. For gastric MMCs a motilin peak (45 +/- 5 pM) was found 10 min before the occurrence of the MMC in the duodenum. For intestinal MMCs no peak could be demonstrated. On an individual basis 27 of the 29 gastric activity fronts were associated with a motilin peak, versus 5 out of 21 intestinal MMCs. It is concluded that in man only gastric activity fronts are associated with plasma motilin peaks. Apparently, motilin is only involved in the regulation of the MMCs originating from the stomach. PMID- 3672038 TI - Motilin response to a glucose load aberrant in smokers. AB - Smoking is known to influence the blood glucose response to an oral glucose load, possibly by altering the gut motility. Because the peptide hormone motilin might be involved in the regulation of the gastric emptying pattern, we studied 12 heavy smokers and 9 non-smokers after an overnight fast and tobacco abstinence. After an oral glucose load non-smokers showed falling serum motilin levels, as expected, whereas the smokers had initially increasing values. We conclude that smoking affects the gastrointestinal tract, not only during acute nicotine exposure but also chronically. PMID- 3672039 TI - Faecal osmolality and electrolyte concentrations in chronic diarrhoea: do they provide diagnostic clues? AB - Osmolality, pH, and electrolyte concentrations in faecal fluid were measured in 23 patients referred to our department because of diarrhoeal disorders. The aim of the study was to ascertain whether such measurements could provide valuable diagnostic information in patients with diarrhoea. The patients were studied on a fat-restricted diet (70 g fat/day) and during fasting. Osmolality, pH, and concentrations of electrolytes in faecal water showed wide variations but were within normal ranges in most of the patients. The patients were grouped into secretory and osmotic diarrhoea on the basis of: 1) current assumptions on the pathogenesis of diarrhoea in different disorders; 2) persistence versus resolution of diarrhoea during fasting (resolution = decrease of stool mass to less than 200 g/24 h); and 3) an osmotic gap (measured osmolality -2 X (Na + K]. The accordance between these three ways of grouping was very incomplete. It is concluded that measurements of faecal fluid osmolality and electrolyte concentrations are of little value as diagnostic procedures in chronic diarrhoea. Determination of the osmotic gap and/or of the decrease of stool mass during fasting may help to elucidate the pathogenesis of diarrhoea in different disorders but does not seem diagnostically useful. Three patients turned out to be laxative abusers, and laxative ingestion should always be considered in chronic unsettled diarrhoea. PMID- 3672040 TI - Psychologic aspects of flatulent dyspepsia. AB - Psychologic and social factors have been implicated in the aetiology of dyspepsia. In this study these factors were investigated in relation to flatulent dyspepsia, a symptom complex that has traditionally been associated with gallbladder disease. Subjects completed the Middlesex Hospital Questionnaire and the Life Events Inventory and were interviewed in detail, using a semi-structured format. Three groups of patients with flatulent dyspepsia--those with and without gallbladder disease and post-cholecystectomy--all had significantly more associated somatic symptoms than non-dyspeptic subjects with gallbladder disease or normal controls, thus indicating greater emotional upset amongst dyspeptic patients. There was little evidence that symptoms were related to stressful life events. PMID- 3672041 TI - Colorectal adenomas: morphologic features and the risk of developing metachronous adenomas and carcinomas in the colorectum. AB - The morphologic features of 307 colorectal adenomas among 159 patients are reviewed. Most adenomas (66.4%) were located in the sigmoid colon and the rectum, and the percentage decreased proximally to the right colon. The 307 adenomas comprised 244 (79.5%) tubular, 41 (13.3%) tubulovillous, and 22 (7.2%) villous adenomas. The epithelial dysplasia was graded as mild in 260 (84.7%) adenomas, moderate in 33 (10.7%), and severe in 14 (4.6%). The percentage of severe dysplasia was greater in villous adenomas than in tubular adenomas (p less than 0.05) and correlated with the increasing size (greater than 5 mm) of the adenomas (p less than 0.01). The risk of metachronous adenomas could be evaluated among 56 patients, 34 men and 22 women with a history of removed adenoma(s). Fourteen of 56 patients (25%) with 6:1 male to female ratio developed 18 new adenomas, after an average of 34.3 months (range, from 12 to 88 months). Eleven of the 14 patients had multiple adenomas at the initial examination. In addition, a carcinoma of the rectum was found in one male patient. Of the 48 patients, 17 men and 31 women, operated on for colorectal cancer 16 patients (34%) with 1.3:1 male to female ratio had 40 new adenomas after an average of 51.8 months (range, 12 to 252 months) after the surgical excision of their carcinomas. One patient had a recurrent carcinoma at the site of the anastomosis 22 months after anterior resection of his carcinoma. Our data suggest that a history of colorectal carcinoma, multiple adenomas, and male sex predict a higher risk of having future colorectal tumours. PMID- 3672042 TI - A new method for measurement of the electrical potential difference across the stomach wall. Clinical evaluation of the gastric mucosal integrity. AB - PD, the electrical potential difference across the gastric mucosa, is a variable used frequently in experimental studies. Existing methods for PD measurements are, however, unstable, and variations in the pH of the gastric juice causes liquid junction potentials between gastric juice and the PD measuring probe. A new PD measuring system has been developed with high stability, easy handling, and correction for the liquid junction potentials. PD was measured between a stomach microelectrode and an intravenous reference electrode connected to a millivoltmeter. pH was measured by an intragastric microelectrode. The liquid junction potential was calculated by using the pH measured in the gastric juice and the Henderson equation and was then subtracted from the measured PD to provide a better approximation of the PD across the mucosa. The liquid junction potential calculated as stated above correlated with the liquid junction potential calculated from precise ion determinations made in gastric juice samples (y = x; r = 0.92; p less than 0.05). The reliability of the PD measuring system was tested in vitro and in vivo and was satisfactory. In conclusion, a new, reliable, and easily applied method for gastric PD measurements corrected for the liquid junction potential between gastric juice and the PD measuring probe has been developed. PMID- 3672043 TI - Plasma levels of cholecystokinin (CCK-8 and CCK-33-39) in response to feeding and during pregnancy in dogs. AB - A method for measuring plasma cholecystokinin (CCK) levels in dogs which enables separate determination of small (CCK-8) and large (CCK-33-39) molecular forms by using reversed-phase high-performance liquid chromatography before radioimmunoassay is presented. Basal levels of CCK averaged 1.8 pM and rose to 4.6 pM 60 min after feeding. The ratio between small and large molecular forms was 1:1 in basal samples but 3:1 and 1:2 in samples collected 10 and 60 min after feeding, respectively. In pregnant dogs basal CCK levels were significantly increased (5 pM) and equally distributed for CCK-8 and CCK-33-39. PMID- 3672044 TI - Decreased incidences of intestinal and diffuse types of gastric carcinoma in Finland during a 20-year period. AB - The incidence of gastric carcinoma (GCA) has decreased throughout the world. This decrease is attributed to a decline in incidence of the intestinal type of GCA (IGCA), whereas the diffuse (DGCA) type of GCA is considered to be endemic in nature and more stable in incidence. In the present study we have estimated how much the incidences of IGCA and DGCA have decreased in percentage in Finland from 1952-61 to 1972-81. Our calculations are based on the Finnish Cancer Registry data of new GCA cases, on population statistics in Finland, and on the percentage distribution of GCA subtypes in three consecutive samples of GCA patients collected in the time periods 1952-61 (reference series) and 1972-81 (two separate samples: series A and B). The samples totaled 1837 GCA cases. We calculated that the incidence of IGCA had decreased from 1952-61 to 1972-81 by 62 71% (reference series versus series A - reference series versus series B) among men and by 69-70% among women. Correspondingly, the incidence of DGCA was calculated to have decreased by 30-39% among men and 37-42% among women. We conclude that not only has the incidence of IGCA decreased in percentage approximately twice as much as the incidence of DGCA but DGCA has also distinctly decreased in incidence in Finland from 1952-61 to 1972-81. PMID- 3672045 TI - Transit time in ulcerative proctitis. AB - Whole-gut transit time was measured by the time taken for an orally administered dose of brilliant blue dye to disappear from the stool in 20 patients with ulcerative proctitis and in 20 age- and sex-matched controls. Ten of the patients had active, and 10 inactive disease. The dye usually appeared in the stool with the next bowel movement after ingestion in both patients and controls; however, the time at which the dye disappeared from the stool (transit time) was prolonged to 76.1 h in the patients, compared with 50.2 h in the controls (p less than 0.01). This delay occurred both in patients with active disease at 70.5 h (p less than 0.05) and in those with inactive disease at 81.8 h (p less than 0.05). This prolongation of transit time may be relevant to both the pathogenesis and treatment of ulcerative proctitis. PMID- 3672046 TI - Is duodenal ulcer really a psychosomatic disease? A population-based case-control study. AB - Risk factors for prepyloric and duodenal ulcer were analysed by means of a questionnaire in 132 patients and 132 population controls, pairwise matched for age and sex. Several factors associated with a lower socioeconomic status, such as short education, low income and low housing standard, and a job characterized by low satisfaction, low demands, and low autonomy, were more prevalent among the patients. The odds ratio (OR) with 95% confidence limits (CL) in smokers versus non-smokers was 2.9 (CL, 1.7-5.0). A trend emerged in relation to the daily number of cigarettes, with an OR of 4.1 (CL, 2.2-7.5) for those smoking more than 10 cigarettes. The risk of having peptic ulcer disease was virtually unrelated to other psychiatric and somatic morbidity, to marital status, personal worries, type-A behaviour, experience of a hectic or psychologically demanding job, and to consumption of coffee, alcohol, and drugs. Our data lend no support to the concept that peptic ulcer disease is a disorder related to psychologic stress. Causative agents other than smoking should probably be sought among factors characterizing the life style of low socioeconomic classes. PMID- 3672048 TI - Epidemiology and immunity to tetanus in Sweden. AB - An investigation of tetanus antitoxin titres in the Swedish population was carried out in 1985. In Sweden, primary vaccination against tetanus has consisted of 3 doses at intervals of 4-6 weeks, beginning in the 2nd or 3rd month of life. A booster dose is offered to school children at 8-10 years of age. Three levels of antitoxin concentration (0.01, 0.05 and 0.1 U/ml) are used to demonstrate different titre levels. The interpretation is based on the premise that a serum level of 0.01 U/ml is sufficient to protect the subject against clinical tetanus. A protective titre level (greater than 0.01 U/ml) was found in 98-99% of children and young adults. A rapid decrease in the number of children with high titres (0.05-0.1 U/ml) was observed after the age of 1 and was very low in the 4-5-year old children. An increase in the number with titres of 0.05 and 0.1 U/ml was seen after the booster dose given at school. A protective level was detected in all 21 30-year-old men and in 94% of the women, in 94% of 31-50-year-old men and in 73% of the women in the same age group. 70% of 31-40-year-old men reached antitoxin concentrations of 0.1 U/ml, and 38% of the 41-50-year-olds. The corresponding figures for women were 22% and 16% respectively. In people over 60 years, 80% of the men and 56% of the women reached protective levels of antibodies. PMID- 3672047 TI - Antimicrobial therapy and case fatality in meningococcal disease. AB - The effect of different initial antimicrobial treatments on the case fatality rate (CFR) was evaluated in 112 consecutive patients with meningococcal disease. The overall CFR was 9.8%. 85 patients received initial therapy with chloramphenicol in addition to benzylpenicillin or other antimicrobials, and 27 patients benzylpenicillin or other antimicrobials without chloramphenicol. Patients treated with chloramphenicol had a lower CFR than those not given chloramphenicol (5% vs. 26%; p = 0.004). However, severely ill patients were treated more often with penicillins, and adjustment for the severity of disease on admission to hospital demonstrated that this difference in favour of chloramphenicol was slight and nonsignificant (p = 0.58). High doses of benzylpenicillin and no chloramphenicol were also associated with a higher CFR than low doses. However, the difference was not significant (p = 0.22). More extensive studies should be carried out to evaluate the effect of benzylpenicillin doses and chloramphenicol on the outcome of meningococcal disease. PMID- 3672049 TI - Epidemiology of tetanus in Denmark 1920-1982. AB - Tetanus is still a major health problem in developing countries and still occurs in countries with a high medical standard. To guide planning of future prophylactic programs, incidence and mortality from tetanus in Denmark previous and present prophylactic efforts have been studied. Incidence and mortality from neonatal tetanus decreased in the thirties probably consequently to social and hygienic improvement, and a very marked decrease coincided with the introduction of vaccination against tetanus in 1947. Since 1970 no case of neonatal tetanus has been observed. Mortality from non-neonatal tetanus was reduced markedly in 2 steps, coinciding with an increased use of tetanus antitoxin around 1930 and the introduction of vaccination respectively. The effect of routine vaccination in childhood from 1950 was especially prominent. Tetanus in childhood is now nearly eradicated. A survey of all hospitalized cases of tetanus 1978-1982 showed that the majority of patients were incompletely or never vaccinated, but 10% had a history of complete vaccination. The majority of cases developed from minor posttraumatic lesions, of which only 41% had been professionally treated, and 13% developed from non-traumatic lesions. It is concluded that vaccination programs offering continuous protection are needed for a complete eradication of tetanus. Fatality remains high, in the present series 9.4%, and is mostly due to cardiovascular manifestations. PMID- 3672050 TI - Determination of tetanus and diphtheria antitoxin content in dried samples of capillary blood: a convenient method applied to infants. AB - To assess the effect of vaccination of infants against tetanus and diphtheria capillary blood was drawn from 51 randomly selected healthy infants 2 years of age. The blood was applied directly to filter paper. In the laboratory the blood dots were eluted in phosphate buffered saline for 2 h at room temperature yielding 100% recovery of antitoxin activity. Serum volume in the blood dots was determined by calculation of dot area or by measuring albumin content in the eluted samples by means of rocket immunoelectrophoresis. These approaches were found to be equally applicable. Concentration of antitoxin to tetanus and diphtheria was assessed with ELISA and in vitro toxin neutralization assay respectively. Mean diphtheria antitoxin concentration was 0.53 IU/ml, and mean tetanus antitoxin concentration 4.1 IU/ml. Low initial immune response to diphtheria vaccination may be responsible for the risk among school children to have antitoxin concentration below protective level (reported elsewhere). In environments where diphtheria is disappearing a lowered vaccination response may be expected. PMID- 3672051 TI - Successful treatment of typhoid fever in children with parenteral ceftriaxone. AB - Eight children, seriously ill with bacteriologically proven Salmonella typhi septicemia, were successfully treated with a single daily intramuscular injection of 2 g ceftriaxone given for 5-7 days. All children improved clinically within 48 h of starting therapy and all except 1 became afebrile within 5 days. None relapsed during the 4-week follow-up study. PMID- 3672052 TI - Short-term nalidixic acid plus sodium citrate in acute lower urinary tract infection. AB - Low-dose nalidixic acid (0.66 g) in combination with 4 g of sodium citrate (NAC) was evaluated in acute lower UTI. In college-age females (n = 24) given NAC every 8 h for 3 days the nalidixic acid (NA) susceptible infecting strain was eradicated in 100% of the patients and recurrence during the 1 month follow-up period occurred in 1 case (5%) classified as relapse. In a following study the corresponding rates in general practice (GP) patients (n = 71) were 90% and 17%, respectively, irrespective of treatment with NAC every 12 h for 3 days or 5 days. The failures observed in GP were due to persistence of (or immediate reinfection by) the original infecting strain (4%) or its NA resistant mutant (6%). Emergence of NA resistance was associated with high age of the patient and a high incidence of NA resistant mutants in the infecting Escherichia coli strain. NA susceptible failure and recurrence during follow-up occurred primarily in younger GP patients. The recurrences were equally often classified as relapse (6 cases) as reinfection (5 cases). About 20% of the patients reported rather innocuous transient side effects of NAC and interruption of medication occurred in 1 case (0.6%). PMID- 3672053 TI - Infective aortitis due to Brucella melitensis. AB - Infective aneurysms caused by Brucella sp. are extremely rare. B. suis and B. abortus have been implicated in a few cases but to our knowledge, B. melitensis has not been reported as a cause of mycotic aneurysm of the abdominal aorta. We here report the first case of this described in the English literature. The patient was successfully treated with resection of the infected aneurysm, placement of an axillo-bifemoral graft, and prolonged antibiotic treatment (doxycycline and streptomycin). Extended antimicrobial therapy and extra anatomical bypass grafting procedures are advisable in the management of brucella infections of the abdominal aorta. PMID- 3672054 TI - Arterial occlusion due to Listeria meningoencephalitis in an immunocompromised boy. AB - Sequential CAT scan studies of the brain were performed in a 7-year-old boy with Listeria monocytogenes serotype 1 meningoencephalitis. The infection occurred while he was receiving maintenance chemotherapy for T-cell non-Hodgkin lymphoma. A lesion in the right hemisphere during the infection resulted in an excessive enlargement of the right ventricle 10 months later, most probably caused by arterial occlusion. PMID- 3672055 TI - Similarities and differences in mothers' and fathers' grief following the death of an infant. PMID- 3672056 TI - Anxiety and vulnerability in parents following the death of an infant. PMID- 3672057 TI - Hormonal and psychological effects of examination stress. PMID- 3672058 TI - Emotional and autonomic responses to visual traumatic stimuli. PMID- 3672059 TI - [Local immune reaction in human intestinal spirochetosis]. AB - The pathogenetic and clinical importance of intestinal spirochaetes in man is still unresolved. In 12 patients mainly presenting with mild diarrhoea, light and electron microscopy demonstrated massive spirochaetal infestation of the colonic mucosa (spirochaetosis). There were several hitherto unreported features: spirochaetes adhered not only to the surface epithelium of the intestine but were also present within epithelial cells and subepithelial macrophages; many partially degranulated mast cells were noted within the epithelium; there was a marked increase of IgE plasma cells within the lamina propria. In control biopsies intraepithelial mast cells were absent and IgE cells occurred only sporadically. Penetration of the microorganisms into the intestinal mucosa may be responsible for this unusual immune response. Spirochaetes, symptoms and findings disappeared after antibiotic therapy. The authors therefore suggest that intestinal spirochaetosis can cause clinical symptoms in man, and that spirochaetes should not invariably be considered harmless commensals. PMID- 3672060 TI - [Cellular immunoreactivity in chronic alcoholics with and without liver disease]. AB - To evaluate the influence of chronic alcohol consumption on the cellular immune system in man, we investigated the immune response to seven intradermally applied common antigens and in vitro stimulation of peripheral lymphocytes by Phytohemagglutinin A and concanavalin A in chronic alcoholics with (n = 15) and without (n = 15) liver disease. The results suggest that the diminished cellular immune response in chronic alcoholics is not primarily a direct sequel to alcohol consumption; it is more likely that the impaired immune response is linked to severity of the liver damage itself and to malnutrition. PMID- 3672061 TI - [Clinical study and gastroscopy of biliary gastritis following gastric resection and Roux-en-Y anastomosis]. AB - Between 1981 and 1985, seven patients (mean age 44 years) underwent surgery for benign gastroduodenal ulcer in the Department of Surgery. Cantonal Hospital, Fribourg, Switzerland. Surgical indications were a double subcardial and prepyloric ulcer recurring after medical treatment, a duodenal and jejunal anastomotic ulcer after gastroenterostomy, two duodenal ulcers which recurred after vagotomy, and three perforated ulcers (subcardial, prepyloric, duodenal). All patients underwent two-thirds gastrectomy with a Roux-en-Y loop. Clinical investigations and gastroscopy were performed 1-5 years postoperatively. Clinical results were excellent in 5 cases (Visick 1), good in one (Visick 2), and moderate in one (Visick 3). Symptoms and signs associated with biliary gastritis were found as follows: vomiting 1 patient; epigastric pain 1 patient; weight loss 1 patient; anemia 1 patient. No bile staining was seen in any patient. Gastric biopsy demonstrated a normal mucosa in 2 patients and gastritis in 5 patients. Roux-en-Y gastrectomy gives satisfactory results in certain benign gastroduodenal ulcer situations. Perianastomotic and gastric stump gastritis may exist without biliary reflux. PMID- 3672062 TI - [Carcinoma of Vater's ampulla and precursor states]. AB - Treatment of periampullar carcinoma is known to be more rewarding than that of the cancer of pancreas. Operative mortality however remains high, and five-year survivors are a minority. Diagnosis of precancerous lesions should improve the prevention of these tumours. We review our ten-year experience, in which 16 periampullary carcinomas were operated on in patients aged between 45 and 90 years (average 69). 10 Whipple and 3 local resections, and 3 by-pass procedures were performed. Two patients died during the first two postoperative weeks, after a Whipple and a by-pass procedure respectively. Survival after the Whipple operations averaged 35 months (3 patients are still alive up to 60 months later) and 9.9 months after the other procedures. All the histologic specimens were reviewed for lesions such as adenomatous polyps or epithelial dysplasias coexisting with carcinoma. We found such associations in 3 biopsies or local excisions and in 4 pancreaticoduodenal resections. These findings confirm that periampullar carcinoma is preceded in a significant number of cases by pre malignant conditions. It is hoped that awareness of this fact will make possible early diagnosis and treatment. PMID- 3672063 TI - [Nutritional profile of patients with cancer of the pancreas]. AB - A case control study was carried out in the Geneva area from 1976 to 1980 to determine correlation between cancer of the pancreas and nutrition. The controls were randomly selected from the general population and 88 patients with pancreatic cancer were interviewed on their food habits by two experienced dietitians. Bias may always be suggested, but even Anglo-Saxon workers are increasingly adopting this method. Comparison between patients with pancreatic cancer and controls revealed different alimentary habits. Consumption of beer (2.9 times higher risk), of butter (2.1 times) and pasta (2.5 times) considerably increases the risk, whereas margarine, fruit and fresh vegetables are associated with a significant reduction of risk. PMID- 3672064 TI - [Aorto-esophageal fistula: late complications following aortic graft implantation]. AB - Aorto-esophageal fistula is a rare complication after repair of thoracic aortic aneurysm. In a review of the literature only 3 cases have been found. A fourth case is reported which was diagnosed preoperatively by endoscopy. PMID- 3672065 TI - [Diagnostic value of blood TSH levels in seriously ill patients]. AB - Undetectable serum TSH values measured by immunoradiometric methods are highly suggestive of hyperthyroidism. However, serum TSH levels can also be very low in severely ill patients and in this case thyroid disease can be ruled out by thyroid hormone measurements. The authors have determined the frequency of low thyroid hormone values and of low serum TSH measurements in hospitalized patients. They investigated 276 euthyroid patients, 21 of whom were found to have decreased values for serum total T4 and free T4 index (FTI). Serum TSH was below the lower limit of detection (less than 0.2 mU/l) in 4 of these 21 patients (19%) and normal in 17 others. Serum TSH measurements are therefore considered more reliable than thyroid hormone measurements in ruling out primary hypothyroidism. Interestingly, serum TSH was also found to be unmeasurable in 7 of 248 patients with normal total serum T4 and FTI (3%). An unmeasurable TSH value is therefore not synonymous with low T4 in sick patients, which indicates that both measurements are needed in this category of patients. Data are also included on 7 patients with high serum total T4 and FTI but still normal serum T3, in whom as measurable serum TSH concentration rules out hyperthyroidism. PMID- 3672066 TI - [A prospective study of 776 cases of acute non-traumatic abdominal pain. Acute appendicitis and its diagnosis]. AB - 776 patients seen in our emergency ward with abdominal pain for less than one week duration were prospectively analysed. In 49% of these patients no cause was found and 19% had acute appendicitis. Among 180 appendectomized patients, 147 (82%) had acute appendicitis whereas 33 (18%) had no inflammation of the appendix. Clinical presentation with a pain duration of less than 36 hours, steady abdominal pain, guarding in the right iliac fossa and a white cell count above 12,000/mm3 (12 g/l) were the best criteria for prediction of acute appendicitis versus a normal appendix. Perforated appendicitis was found in 18% of the patients with acute appendicitis but in only one patient for whom appendectomy had been deferred on the grounds of atypical presentation. Thus, in most cases, the perforation was preexistent to admission. We therefore recommended a 24-48-hour observation period for patients with uncertain diagnosis. Rates of normal appendices and perforated appendices of about 20% seem to be difficult to improve upon. PMID- 3672067 TI - [Study of gallbladder emptying using 99m Tc-HIDA in acalculous cholecystopathy]. AB - So-called acalculous gallbladder disease is an ill-defined entity, mainly seen in young women, which could be due to a motility disorder of the biliary tract. Seven young women with relapsing pain in the right upper quadrant of the abdomen or in the epigastrium, with cholesterol crystals in the bile and with normal sonographic and radiologic findings as well as normal gastroscopy, were investigated by hepato-biliary scintigraphy with 99mTc-HIDA. This first group was compared with a second group of 6 young women suffering from irritable colon, and with a third group of 6 asymptomatic control subjects. The half emptying-time of the gallbladder after cholecystokinin injection was 104.36 +/- 43.93 minutes in the first group, 17.92 +/- 23.57 minutes in the second and 20.42 +/- 23.67 minutes in the third group (p less than 0.005). After 6 weeks of ursodeoxycholic acid treatment, regression of pain and a significant reduction in the half emptying-time from 104.36 +/- 43.93 to 74.35 +/- 52.79 minutes (p less than 0.01) was observed in the first group. These results, which need to be confirmed by further studies, show that in acalculous gallbladder disease there is a delay in gallbladder emptying which could explain the formation of cholesterol crystals by bile stasis as described by various authors. PMID- 3672068 TI - [Erosive gastritis: an aggravating cause of anemia in patients treated for chronic renal insufficiency]. AB - Anemia is one of the commonest and most serious complications of chronic renal failure. The causes are multiple, while gastrointestinal blood loss is often unrecognized. Eleven hemodialyzed patients underwent esogastroduodenoscopy (OGD) to investigate anemia requiring transfusion of 4 or more blood units in a 6-month period. The same investigator performed all the endoscopies using the following scores: 0 = no lesions, 1 = focal red appearance of the mucosa, 2 = bleeding of the mucosa due to the gastroscope, 3 = erosive lesions, and 4 = presence of ulcers. Patients with a score of 1 or more were treated with ranitidine in a dose of 150-300 mg daily for 6 months. The need for transfusions before and after OGD was compared. The results were as follows: 8 of 11 patients had a score of 1-3, 1 patient scored 4 and 2 patients had no lesions. After 6 months' treatment with ranitidine no differences in hematocrit values were noted but the need for transfusions was significantly reduced (8.6 +/- 1.4 blood units before OGD vs. 4.9 +/- 1.3 blood units in the 6 months following OGD). It is concluded that minimal lesions of the esogastroduodenal mucosa are very common in hemodialyzed patients and ranitidine treatment could reduce the need for blood transfusions in these patients. PMID- 3672069 TI - [On the article "Mortality from cancer of the nose and paranasal sinuses in Swiss cabinetmakers" Minder]. PMID- 3672070 TI - [Clinical aspects of hyperthyroidism in areas of different supplies of iodine. Results of a European prospective study]. AB - Clinical aspects of 924 unselected patients with hyperthyroidism from 17 thyroid centres of 6 European countries were investigated in a prospective study for exactly 1 year. Serum samples were centrally assayed for thyroid hormones, thyroid autoantibodies and TSH-binding inhibiting immunoglobulins (TBII), and urine samples for iodine. 26 items of information per patient were computerized and evaluated. Forming 2 groups from iodine-deficient areas (IDA) and iodine sufficient (ISA) according to the urinary iodine, it was possible to elucidate some characteristics independently of local factors. The most important findings were: 1. Three types of hyperthyroidism were described: Graves' disease was defined as hyperthyroidism with eye symptoms and/or the presence of measurable TBII; autonomous adenomas were defined by a single hot nodule in the thyroid scan; the remainder included TBII negative hyperthyroid patients as well as non immunogenic forms of hyperthyroidism (toxic multinodular goiter and other multifocal autonomies). These were termed "non-classifiable" patients. Graves' patients, representing an average of 60% of the patients, have an age peak between 40 and 49 years; they are 10 years younger than unclassified hyperthyroid patients and 20 years younger than patients with autonomous adenoma, who represented 9.2% of the patients. Surprisingly, there was no difference in the prevalence of Graves' disease between IDA and ISA. 2. An unexpectedly high rate of 10.5% of hyperthyroid patients (Graves' disease 8.5%, non-Graves' disease 14.2%) had no goiter, a figure increasing in the elderly to almost 17%. In IDA the thyroid was larger and the goiter more often nodular than in ISA. IDA are characterized by significantly higher rates (11.3%) of autonomous adenoma than ISA (3.2%). 3. 59.4% of 507 patients with Graves' disease had eye symptoms, 44.6% of at least grade II or higher using the Werner classification. There was no difference between patients from ISA and IDA. We found unilateral ophthalmopathy in 6.7% of Graves' patients. 4. The median iodine excretion was calculated from urinary iodine after exclusion of values over 250 micrograms iodine/g creatinine, arbitrarily defined as iodine contamination. In IDA the median iodine excretion was 63.6, and in ISA 105 micrograms/g of creatinine. 5. Surprisingly, proven iodine contamination was as frequent in IDA (14.5%) as in ISA (15.2%). In the survey protocol, however, this was noticed less often by physicians in ISA.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3672071 TI - [Massive and small pulmonary embolisms in intensive care units]. AB - Over one fifth of patients hospitalized for massive pulmonary embolism die within the first few hours. The threatening load on the right ventricle can be reduced by early detection of embolism and immediate start to treatment. 53 patients treated for pulmonary embolism in our intensive care unit from 1982-1984 were divided into groups of 34 patients with massive embolism (occlusion 50% and/or circulatory shock) and 16 patients with small embolism. In 3 additional patients the embolism was detected only at autopsy. Patient's history and first clinical workup, together with special investigations and hemodynamics, allowed differentiation between massive and small embolism. Regarding treatment, patients with pulmonary embolism and circulatory shock were immediately embolectomized surgically. The other patients with massive embolism were treated by early fibrinolysis, with strict attention to any contraindications. These fibrinolyzed patients had fewer complications during the subsequent hospital course. A total of 8 patients with massive embolism and 2 patients with small embolism died during the same hospital stay. Where history and clinical findings prompt suspicion of massive pulmonary embolism a rather aggressive diagnostic procedure is indicated, since rapid reopening of the pulmonary circuit, to reduce the load on the right ventricle, may be life-saving. PMID- 3672073 TI - [Suspicion of bone tumor: planning of the biopsy from the pathologist's viewpoint]. AB - Suspicion of a neoplastic lesion of bone presents particular problems for both clinicians and pathologists. In most cases biopsy will be planned and should be performed as for a malignant lesion. The material obtained must be representative as well as qualitatively and quantitatively adequate. X-ray data, intraoperative findings, and histopathologic results constitute the three prime sources of information on which diagnosis and prognosis are based; these condition the therapeutic modalities which must be elaborated in each case by a multidisciplinary approach. PMID- 3672072 TI - [Septicemia due to tuberculosis in HIV infection]. AB - A 27-year old female HIV-positive patient developed septic tuberculosis, with mycobacterium tuberculosis typus humanus repeatedly found not only in sputum, bronchial secretion, blood and faeces but also in biopsy material from the liver. Although standard therapy with Pyrazinamid, Rifampicin and INH had to be replaced at times by Ethambutol or Streptomycin respectively, there was a surprisingly fast clinical and bacteriological improvement. Establishment of the diagnosis AIDS requires not only HIV-infection but also the occurrence of opportunistic infections. The latter include, according to the definition given by CDC, atypical mycobacteriosis, but not tuberculosis. Tuberculosis, however, is increasingly seen in HIV-infected patients. This observation allows us to question whether mycobacterium tuberculosis typus humanus should not be included in the list of opportunistic agents in AIDS. We conclude that in HIV infection the possibility of atypical and typical mycobacteriosis has to be taken into consideration. On the other hand, in tuberculosis patients at risk from AIDS the possibility of infection with HIV has to be considered. Tuberculin reactivity in HIV infected subjects is frequently missing and therefore can not be used for diagnosis. HIV-positive patients may require prophylactic treatment with INH, but BCG vaccination is strictly contraindicated. With early combination therapy continued for at least nine months, the prognosis may be good. PMID- 3672074 TI - [Does tobacco abstinence in patients with chronic bronchial obstruction make sense?]. AB - In 60 patients with advanced COPD, lung function was studied retrospectively at the beginning and end of a 12 to 175 months' test period. 25 patients continued to smoke 5 or more cigarettes daily (smokers). The other 35 patients were ex smokers or smoked only 1 to 4 cigarettes daily during the trial (non-smokers). In the heavy smoker group FEV1 diminished much more rapidly than in the non-smoking group (p less than 0.01). We observed a significant dose-response ratio between the number of cigarettes smoked and the decrease in FEV1 (r = 0.27, p less than 0.025). No causes other than smoking were found for the fall in FEV1: age, weight, place of residence, profession, sputum evaluation and inhalation therapy were statistically equal in the non-smoking and the smoking group. However, one unexpected result was that more non-smokers had had long term treatment with steroids than smokers. This may mean that non-smokers have better compliance or that there is a subgroup more sensitive to COPD who thus take more steroids and are more inclined to stop smoking than a less sensitive population. The question remains open. PMID- 3672075 TI - [Renal function after administration of angiotensin-converting enzyme inhibitors]. AB - Angiotensin converting enzyme (ACE) inhibitors are widely used today for the management of hypertension and congestive heart failure. These agents inhibit angiotensin II synthesis. In some particular circumstances they may be responsible for deterioration of renal function, e.g. in hypertensive patients with bilateral renal artery stenosis or with stenosis of the artery supplying a single kidney, or in patients with severe congestive heart failure or marked nephroangiosclerosis. In these patients renal perfusion pressure may become too low to maintain adequate glomerular filtration as there remains no angiotensin II to increase the tone of the efferent arteriole. In high risk patients it is therefore recommended that serum creatinine be checked after initiating therapy with an ACE inhibitor. PMID- 3672076 TI - [Mitral annular calcification in dialysis patients]. AB - Degenerative mitral anular calcifications (MAC) are most often found between the posterior mitral anulus and the left ventricular posterior wall. In advanced stages they may encircle the mitral valve and thus involve the insertion of the anterior mitral leaflet and the posterior part of the aortic root. They are usually found only after the age of 70. Among 33 patients on chronic dialysis for renal failure who were investigated by echocardiography (2-D and m-mode) we found an MAC incidence of 55% but no cases among a control population of the same age and sex (p less than 0.001). The diameter of the calcification exceeded 5 mm in 9 cases out of 18. Four of these calcifications extended in a circular fashion around the mitral valve. Additional significantly associated echocardiographic features included dilatation of the left atrium and sclerosis of the aortic root and valve. Furthermore, 12 patients with MAC had dysfunction of the mitral valve (p less than 0.05), viz. 10 isolated mitral valve regurgitations and 2 mitral stenosis, combined with regurgitation. The patients with MAC were older than those without MAC, their mean duration of dialysis was longer and parathormone level higher. The incidence of mitral anular calcifications is much higher among patients on chronic dialysis. The clinical significance of these calcifications lies primarily in the consequent dysfunction of the mitral valve. PMID- 3672078 TI - [Preliminary results of burn treatment using an autograft of cultured epidermis]. AB - Transplantation of autologous cultured epidermal sheets is a recent advance in the treatment of burn patients. A small skin biopsy is sufficient to produce large epidermal sheets within 3 weeks which provide transplants to cover extensive burn wounds. First clinical experience with this method is described. PMID- 3672077 TI - [Plasma perfusion in life-threatening exogenous poisoning]. AB - Since 1984 30 patients with severe exogenous intoxications have been treated by plasma perfusion. This method has advantages compared to other instrumental detoxification techniques, especially hemoperfusion; i.e. no loss of blood cells, no necessity for systemic anticoagulation and no blockage of the adsorber by thrombus. The plasma, which was obtained by plasma separation, perfused the respective adsorber (activated charcoal, resin). After "purification" the plasma was returned to the patient. The mean perfused plasma volume amounted to 3800 ml per patient and per treatment cycle. 27 of the 30 patients were treated successfully. The observed toxokinetic data confirmed the effectiveness of plasma perfusion in the elimination of toxic substances. PMID- 3672079 TI - [Successful treatment of anemia in hemolysis patients using recombinant human erythropoietin. Maintenance dosage and serum concentration]. AB - Recombinant human erythropoietin (r-huEpo) was administered i.v. to eight anemic patients on hemodialysis in increasing doses 3 times a week. 7 out of 8 patients showed an increase in hemoglobin level by 2 g/dl over the baseline of 7.9 +/- 0.8 g/dl after a mean period of 8 +/- 2 weeks. During treatment a cumulative dose of 692 +/- 358 IU/kgBW erythropoietin was given. Before the rise in hemoglobin, reticulocytes increased from 1.6 +/- 0.7% initially to 5 +/- 1.6%. The serum ferritin concentration decreased from 426 (range 19-1223) to 250 (5-707) micrograms/l. No side effects were observed. Mean blood pressure before dialysis increased slightly from 125 mmHg to 137 mmHg systolic, and diastolic pressure from 75 to 80 mmHg. Maintenance doses to maintain hemoglobin values between 10 und 12 g/dl varied from 2 X 72 IU/kgBW to 3 X 168 IU/kgBW per week. Measurement of serum levels of erythropoietin by radioimmunoassay showed deficiency of the hormone in the patients with chronic renal failure: before treatment mean serum values were 4 +/- 6.4 mU/ml and during maintenance doses with r-huEpo 33.7 +/- 8.1 mU/ml, which is within normal ranges related to hematocrit. These data show erythropoietin to be effective in ameliorating anemia during hemodialysis treatment. PMID- 3672080 TI - [Ventriculo-peritoneal cerebrospinal fluid drainage in the treatment of hydrocephalus]. AB - From January 1980 to December 1984 67 patients with hydrocephalus were treated with v-p shunts at the University Hospital, Berne. 61.2% had obstructive hydrocephalus and 38.3% communicating hydrocephalus. They were followed up for 2 to 6 years. Apart from clinical examination, computerized tomography was the single most important procedure for diagnostic purposes as well as for follow-up. This was not true in the case of communicating hydrocephali treated with an antisiphon device. 8 patients had serious early complications, with two fatal cases. There were not late complications. 90% of the clinical symptoms were improved or cured. V-p shunt is a technically simple and clinically effective operation, but in view of a complication rate of 12% the indication requires critical assessment. PMID- 3672081 TI - [67th annual meeting of the Swiss Society of Pneumology and the Swiss Union Against Tuberculosis and Lung Diseases. Geneva, 10-11 April 1987. Proceedings]. PMID- 3672082 TI - [Justification of the TNM classification system in lung carcinoma]. AB - The clinical TNM classification system allows improved exchange of information, is an aid in tumor staging and establishing treatment schedules, assists in assessing prognosis and forms the basis of cancer registration. New elements in the last edition of classifications are stage T4, which means a tumor invading the mediastinum, the heart, the great vessels, the trachea, the esophagus, vertebral bodies, the carina or the pleural space, and stage N3, which includes mediastinal, contralateral hilar, scalene and supraclavicular lymph node metastases. Both stages rule out surgical treatment. Mediastinoscopy is advised in the case of lymph nodes in thoracic CAT of greater than or equal to 1.5 cm diameter. There is evidence that most peritumoral infiltrations consist in T lymphocytes, presenting the host's immunological reaction against tumor tissue. In the context of tumor staging such phenomena may be of prognostic significance. PMID- 3672083 TI - [Establishment of T3 (T4) in the TNM classification of lung cancer]. AB - The diagnosis of T3 (T4) extension of a lung tumor according to the TNM classification system means that the patient has reached stage 3 with a very poor prognosis. To establish the exact extent of a tumor standard chest X-rays, tomograms and even CT scan may not suffice, and, depending on the situation, endoscopy, ultrasonography, NMR or diagnostic pneumothorax should be employed. Extension T4, corresponding to malignant pleural effusion, which has been added recently (1987) to the UICC classification, may require thoracocentesis, pleural biopsy or even pleuroscopy. PMID- 3672084 TI - [Staging of pulmonary cancer, establishment of M1]. AB - The rapid and widespread development of imaging techniques during the last decade has markedly modified the previous algorithms used in the staging of pulmonary carcinoma, particularly M0/M1 in the TNM classification and the directives of the American Thoracic Society. Sensitivity and specificity of each method are reviewed according to the most frequent metastatic sites of bronchopulmonary carcinoma. Presently, CT is the most efficient technique for detection and display of metastases of the contralateral lung, brain, adrenal glands and retroperitoneal lymph nodes. Ultrasound is equal or even slightly superior to CT for the detection of liver metastases. The superiority of magnetic resonance imaging (MRI) over CT in the detection of brain metastases has already been demonstrated. The results of MRI using fast sequences have recently been demonstrated for imaging of thoracic, abdominal and bone metastases, but confirmation of these first results by prospective studies is needed. Skeletal survey is still obtained by radioisotope scanning. PMID- 3672085 TI - [Evaluation of the extension of bronchial carcinoma: strategy proposals]. AB - The diagnostic approach in a patient with lung cancer should be oriented according to the mode of presentation of the disease. The first step includes history and clinical examination of the patient, and frontal and lateral chest X ray, before histological typing of the tumor. The various diagnostic methods are selected according to localization of the mass in the thorax, and staging procedures are determined by the type of the tumor and the possible therapies available. The complexity of the problems surrounding patients with lung cancer mean that the general practitioner should seek the opinion of the chest specialist early rather than late in the pretherapeutic evaluation. PMID- 3672086 TI - [Trends in and distribution of lung cancer in Switzerland]. AB - Recent trends in lung cancer mortality in Switzerland and the distribution of this cancer by districts, linguistic regions, and occupations are described. In 1985 7.5% of male deaths were due to the disease; female lung cancer is increasing (male-female ratio of deaths 1985: 5.9;in the age-class 35-44: 1.5). From 1970 to 1980, lung cancer became more frequent in the French-speaking area than in the rest of Switzerland. The geographic distribution shows a correlation with population density (chiefly in the over 65 age group) and there were high rates in agglomerations such as Basle and in some peripheral regions. The impact of smoking and occupational/environmental factors on the distribution of lung cancer by regions and occupations is discussed. PMID- 3672087 TI - [Effect of Broncho-Vaxom on serum IgE and IgG levels in patients with bronchial asthma and chronic obstructive lung disease. A placebo-controlled double-blind study]. AB - In a double-blind study of 33 patients with bronchial asthma or chronic obstructive pulmonary disease, of whom 17 had proven atopies, the results showed a distinct diminution of the mean IgE level in the atopic patients at the end of 1-month treatment with Broncho-Vaxom, though not attaining statistical significance (trend with p less than 0.10), compared to a slight increase under placebo. Simultaneously the mean IgG level increased slightly in the atopic patients under Broncho-Vaxom and remained stable in the patients under placebo (p less than 0.10). The IgE and IgG values of the non-atopic patients in both treatment groups remained practically unchanged. Considering the small number of patients in each group, and the clear tendency towards a diminution of the IgE level, it may be concluded that the administration of Broncho-Vaxom to atopic patients does not lead to an increased IgE level but, on the contrary, seems rather to favour a decrease. PMID- 3672088 TI - [Realities in the diagnosis of bronchial carcinoma in clinical and general practice]. AB - In 100 patients with lung cancer the diagnostic procedure, results of clinical staging and therapeutic sequelae were analysed retrospectively and compared to a similar group of patients 10 years previously. During the 10 years' interval there was a remarkable shortening of the time between the onset of symptoms and the diagnosis, from 20 weeks to the present 10 weeks. Despite this acceleration the number of patients undergoing curative surgical resection increased only from 15 to 17%. Inoperability was still due to general condition in 14%, impaired lung function in 7%, advanced tumor stages with metastasis in 52% and local inoperability in 10%. Of the 77 patients with specific tumor related symptoms only 18 were in the prognostically favourable stage I, whereas in the asymptomatic group early stage I was observed in 13 out of 23 patients. We conclude that an improvement in early detection of lung cancer may be achieved by periodical screening of the high risk population, rather than by focusing on the onset of the first symptoms. PMID- 3672090 TI - [Health behavior and social inequality in the Swiss population. Results from the SOMIPOPS study (Sociomedical Model Indicators of the Population of Switzerland)]. AB - In the context of the first representative Swiss national health survey, the relationship between social inequality and health behavior was assessed in 3419 Swiss citizens. Social inequality was measured by an indicator model including occupational position and education. Utilization of preventive services was better among women than men, a trend not dependent on social class. Women of lower social position and education used cervical screening services less often. Unskilled men made less use of preventive services offered. Health behavior was better in women than in men, independently of social class. Working women had significantly worse health attitudes than housewives. Among males, unskilled workers' and white collar employees' consumption of alcohol and tobacco was highest. In both sexes overweight was highly correlated with a low occupational position and low educational level. PMID- 3672089 TI - [Ceftriaxone, a cephalosporin with high hepatic elimination. Evaluation of its biliary clearance in man. Therapeutic value]. AB - The biliary elimination of ceftriaxone, a cephalosporin derivative, was quantitatively studied in man with the help of high pressure liquid chromatography (HPLC). In 6 healthy volunteers a mean peak concentration of 565 +/- 347 (SEM) micrograms/ml was observed in the aspirated duodenal fluid within the first hour after i.v. administration of 2 g ceftriaxone, and 1.4 +/- 0.5% of the dose was recovered during the 4 hours investigation period. In 10 cholecystectomized patients provided with a T-drain, the biliary concentration peak (1078 +/- 158 micrograms/ml) was reached within 1 hour after administration and the total 24 hours recovery amounted to 9.5 +/- 2.9% of the dose given. In 12 patients undergoing cholecystectomy, serum, and choledochal (CB) and gallbladder bile (GB) were peroperatively collected 1 hour after i.v. administration of 2 g ceftriaxone; the respective concentrations were: 199 +/- 10 (serum), 5259 +/- 1085 (CB), and 4533 +/- 809 (GB) micrograms/ml. These data point to excellent biliary elimination of ceftriaxone compared with the other beta-lactams previously studied, and afford evidence of its high therapeutic potential in biliary tract infections. PMID- 3672092 TI - [Recent advances in the physiological study of blood circulation of the nasal cavity]. PMID- 3672091 TI - [Experiences in the diagnosis of lower respiratory tract infection using a double sheathed brush catheter]. AB - Specimens from the lower airways were taken by protected brush catheter during 54 fiberoptic bronchoscopies for quantitative microbiological analysis. This technique allows uncontaminated sampling of lower airway secretion. The chance of identifying a bacterial pathogen in patients who have already been treated with antibiotics was less than 10%. The method is cumbersome, and it is important not only to culture but also to quantify the bacteria. The microbiological results thus obtained have influenced clinical decision-making in only a few patients. PMID- 3672093 TI - [Conconi's test, the 5 x 200 m test, and the anaerobic threshold in swimming]. PMID- 3672094 TI - [Conconi's test and the anaerobic threshold]. PMID- 3672095 TI - [Skating and compartment syndrome in a cross-country skier]. PMID- 3672096 TI - [Late results following conservative treatment of fibulo-talar ligament lesions using the Aircast splint]. PMID- 3672097 TI - [Electrolyte volume homeostasis, the sympathetic nervous system and circulatory reactions in swimmers. Comparison of highly-trained and untrained swimmers]. PMID- 3672098 TI - Cytoplasmic effect on gene function in Xenopus laevis. AB - The pigmentation gene of Xenopus laevis is dominant and that of albino aP mutant recessive. Heterologous haploid hybrids are produced by UV inactivation of the egg nuclei during second polar body formation in the mutant sperm-fertilized Xenopus eggs. During development of these hybrids, melanin appeared in the eye and melanophores in the skin at stages comparable to those of the wild type, but much earlier than in the albino mutant. The number and intensity of pigment cells are intermediate between the black Xenopus and albino mutant. While a number of pigment cells remain in the hybrids, those in the albino eventually degenerate. Therefore, the development and maintenance of pigmentation in heterologous hybrids are contributed by Xenopus cytoplasm. Tadpole tail-tips were squashed and stained for chromosome counting. The results show that Xenopus and mutants are diploid (36 chromosomes) and heterologous haploid hybrids have 18 chromosomes. PMID- 3672099 TI - Heat-stable DNA polymerase I large fragment resolves hairpin structure in DNA sequencing. AB - A heat-stable large fragment was obtained by subtilisin digestion of DNA polymerase, prepared from Bacillus stearothermophilus. The dideoxy sequencing method, combined with the use of M13 vector has proved to be the most powerful one for obtaining the sequences of large genomes. However, the hairpin structure formed along the single-stranded DNA template often prevents the DNA polymerase from moving on, with the result that no sequence information can be obtained. The heat-stable large fragment that we have obtained has proved to be the most active at 65 degrees C. When the sequencing reaction was carried out at this temperature, the hairpin structure was resolved and the sequencing gels obtained were satisfactory. PMID- 3672100 TI - The complete nucleotide sequence of the cloned DNA of hepatitis B virus subtype adr in pADR-1. AB - The complete nucleotide sequence of the cloned hepatitis B virus DNA subtype adr in pADR-1 was determined by Maxam and Gilbert's method. It is 3215 base pairs in size, which is 27 bp longer than the sequence of the adr pHBr330, as reported by Ono et al. The nucleotide difference between pADR-1 and adr pHBr330 is about 2% while those between pADR-1 and adw as well as ayw are 9.3% and 9.7% respectively. In this paper, the heterogeneity and homogeneity of the S gene, the C gene and the other coding regions in pADR-1 and in the other subtypes are compared and discussed. PMID- 3672101 TI - Establishment and characterization of a cell line HR-8348 derived from human poorly differentiated adenocarcinoma of rectum. AB - A human rectal poorly-differentiated adenocarcinoma cell line HR-8348 is established from the surgically removed tumor mass of a male adult patient. The cell doubling time is 36.05 h. The mitotic index is 44.5%. The cells are all of epithelial type and mostly of polygonal shape. Electron microscopic examination shows malignant nuclei with enlarged nucleoli; there are abundant microvilli and some secretory granules. The plating efficiency in soft agar is 12.9%. In PHA (1 microgram/ml), the cells show obvious agglutination. Chromosomal analysis reveals a mode of 70 chromosomes per cell, with a marker chromosome. CEA in cells is detected positively both qualitatively and quantitatively. Hetero-transplantation of the cells to nude mice shows that the tumor mass has the same morphology as the original mass from the patient, with Alcian blue positive material in the cytoplasm. Repeated detection for mycoplasma contamination shows negative. PMID- 3672102 TI - The effect of upstream sequences to initiator on the expression of gene coding for hepatitis B core antigen. AB - The nucleotide sequences of cloned adw hepatitis B core antigens (HBcAg) which have different levels of expression have been determined by dideoxy chain terminating method. The results indicate that the different levels of gene expression is primarily due to the different structures of upstream sequences before the initiator of HBcAg genes. The hepatitis B core gene in the low expressed clone forms a secondary structure before the initiator. This secondary structure has been removed by Bal-31 exonuclease in the high-expressed clone and half of the structure removed in the mid-expressed clone. It is apparent that the transcription/translation of the hepatitis B core gene is somehow blocked because of the secondary structure. Therefore, the amount of HBcAg synthesized in E. coli is dramatically reduced. PMID- 3672103 TI - Human immunodeficiency virus infection in homosexual men. PMID- 3672104 TI - Haemophilia, blood products and HIV infection. AB - Between 1979 and 1984, many haemophiliacs in the UK were exposed to the human immunodeficiency virus (HIV) by transfusion of blood products, in particular clotting factor concentrates, especially those imported from the USA. In the UK 1025 haemophiliacs are HIV-antibody-positive, of whom 75 are in Scotland. Thirty one UK haemophiliacs have developed the Acquired Immune Deficiency Syndrome (AIDS), of whom 23 have died. The clinical progress of HIV infection appears similar in haemophiliacs and in other risk groups, except that Kaposi's sarcoma is rare. There is evidence that transfusion of blood products is immunosuppressive in the absence of HIV antibody. Blood donor selection and heat treatment of clotting factor concentrates were introduced from 1985, and so far these measures appear to have largely prevented new HIV infection in haemophiliacs. Meanwhile a tragic toll of iatrogenic disease and death continues to increase. PMID- 3672105 TI - Virology of HIV testing. PMID- 3672106 TI - Counselling in HIV infection. AB - HIV infection and AIDS have focused attention on counselling as a major and integral part of the total clinical care of HIV seropositive and AIDS patients. There is, as yet, no cure for HIV infection and treatment is of the symptoms as they appear. This combined with the lack of knowledge of how the infection may progress has led to a very great uncertainty for the patients, their families, their sexual partners and the staff who are looking after them. For the haemophiliac patient here has been the additional problem of having been clearly identified as one of the AIDS risk groups resulting in many haemophiliacs being reluctant to disclose that they have haemophilia. The question of confidentiality, of the worried well, of the responses of others and of counselling for family and partners are also discussed. PMID- 3672107 TI - HIV infection and adoption in Scotland. PMID- 3672108 TI - Life assurance, HIV seropositivity and haemophilia. PMID- 3672109 TI - Thrombocytopaenia as the presenting feature of persistent generalised lymphadenopathy (PGL) in a one-year-old. AB - A one-year-old child who presented with thrombocytopaenia was found to be HIV positive and has now developed persistent generalised lymphadenopathy (PGL). PMID- 3672110 TI - Brittle books and journals. PMID- 3672111 TI - Africa begins to face up to AIDS. PMID- 3672112 TI - One AIDS problem or two? PMID- 3672113 TI - Merck donates drug for river blindness. PMID- 3672114 TI - Chemistry in the image of biology. PMID- 3672115 TI - Chernobyl: a radiobiological perspective. PMID- 3672116 TI - Teaching reasoning. AB - Twentieth-century psychologists have been pessimistic about teaching reasoning, prevailing opinion suggesting that people may possess only domain-specific rules, rather than abstract rules; this would mean that training a rule in one domain would not produce generalization to other domains. Alternatively, it was thought that people might possess abstract rules (such as logical ones) but that these are induced developmentally through self-discovery methods and cannot be trained. Research suggests a much more optimistic view: even brief formal training in inferential rules may enhance their use for reasoning about everyday life events. Previous theorists may have been mistaken about trainability, in part because they misidentified the kind of rules that people use naturally. PMID- 3672117 TI - Actin polymerization and ATP hydrolysis. AB - F-actin is the major component of muscle thin filaments and, more generally, of the microfilaments of the dynamic, multifunctional cytoskeletal systems of nonmuscle eukaryotic cells. Polymeric F-actin is formed by reversible noncovalent self-association of monomeric G-actin. To understand the dynamics of microfilament systems in cells, the dynamics of polymerization of pure actin must be understood. The following model has emerged from recent work. During the polymerization process, adenosine 5'-triphosphate (ATP) that is bound to G-actin is hydrolyzed to adenosine 5'-diphosphate (ADP) that is bound to F-actin. The hydrolysis reaction occurs on the F-actin subsequent to the polymerization reaction in two steps: cleavage of ATP followed by the slower release of inorganic phosphate (Pi). As a result, at high rates of filament growth a transient cap of ATP-actin subunits exists at the ends of elongating filaments, and at steady state a stabilizing cap of ADP.Pi-actin subunits exists at the barbed ends of filaments. Cleavage of ATP results in a highly stable filament with bound ADP.Pi, and release of Pi destabilizes the filament. Thus these two steps of the hydrolytic reaction provide potential mechanisms for regulating the monomer-polymer transition. PMID- 3672118 TI - Immunochemical proof that a novel rearranging gene encodes the T cell receptor delta subunit. AB - The T cell receptor (TCR) delta protein is expressed as part of a heterodimer with TCR gamma, in association with the CD3 polypeptides on a subset of functional peripheral blood T lymphocytes, thymocytes, and certain leukemic T cell lines. A monoclonal antibody directed against TCR delta was produced that binds specifically to the surface of several TCR gamma delta cell lines and immunoprecipitates the TCR gamma delta as a heterodimer from Triton X-100 detergent lysates and also immunoprecipitates the TCR delta subunit alone after chain separation. A candidate human TCR delta complementary DNA clone (IDP2 O 240/38), reported in a companion paper, was isolated by the subtractive library approach from a TCR gamma delta cell line. This complementary DNA clone was used to direct the synthesis of a polypeptide that is specifically recognized by the monoclonal antibody to TCR delta. This complementary DNA clone thus corresponds to the gene that encodes the TCR delta subunit. PMID- 3672119 TI - The adenovirus major late transcription factor activates the rat gamma-fibrinogen promoter. AB - The major late transcription factor (MLTF) is a 46-kilodalton polypeptide that specifically binds to and activates transcription from the major late promoter of adenovirus. The presence of this promoter-specific transcription factor in uninfected HeLa cell extracts suggests that MLTF is also involved in the transcription of cellular genes. This report demonstrates that MLTF specifically stimulates transcription of the rat gamma-fibrinogen gene through a high-affinity binding site. Stimulation of transcription by MLTF was not dependent on the exact position of the MLTF binding site with respect either to the transcription initiation site or to adjacent promoter elements. These results suggest that one of the cellular functions of MLTF is to control gamma-fibrinogen gene expression. PMID- 3672120 TI - Safety of DOE reactors questioned. PMID- 3672121 TI - Doctors square off on employee drug testing. PMID- 3672122 TI - Yale takes action against psychiatrists for financial improprieties. PMID- 3672123 TI - New look at health in developing nations. PMID- 3672124 TI - Dynamics of automatic and controlled visual attention. AB - The time course of attention was experimentally observed using two kinds of stimuli: a cue to begin attending or to shift attention, and a stimulus to be attended. Precise measurements of the time course of attention show that it consists of two partially concurrent processes: a fast, effortless, automatic process that records the cue and its neighboring events; and a slower, effortful, controlled process that records the stimulus to be attended and its neighboring events. PMID- 3672125 TI - New routes to early memories. AB - Stimulation of one side of the olfactory system during training with odor-milk pairings in neonatal rats results in their ability to recall an odor memory by using the trained but not the untrained side of the brain. In 12-day-old rats, olfactory learning can be recalled by stimulation of either the trained or untrained side. The development of bilateral recall reflects the maturation of olfactory commissural pathways that provide access to the olfactory memory stored on the contralateral side. Furthermore, the commissural pathways need not be present at the time of memory formation but can establish new and specific access to already existing olfactory memories. PMID- 3672126 TI - A novel thyroid hormone receptor encoded by a cDNA clone from a human testis library. AB - The c-erbA gene belongs to a multigene family that encodes transcriptional regulatory proteins including the v-erbA oncogene product, steroid hormone receptors, and the vitamin D3 receptor. A v-erbA DNA probe encoding the DNA binding region of the v-erbA protein was used to screen a human complementary DNA testis library. One of the clones isolated, erbA-T-1, was found to encode a 490 amino acid protein (erbA-T). The erbA-T polypeptide shows high homology with the proteins encoded by both the chicken c-erbA and the human c-erbA-beta genes but is most closely related to the chicken gene. The chicken c-erbA and the human c erbA-beta genes encode high-affinity receptors for thyroid hormone, and here it is shown that the erbA-T protein binds specifically to 3,5,3'-triiodo-L-thyronine with a dissociation constant of 3.8 +/- 0.2 x 10(-10) M. These data imply that more than one thyroid hormone receptor exists in humans and that these receptors might have different tissue- and gene-activating specificities. PMID- 3672128 TI - Scientists and lawyers look at fraud in science. PMID- 3672127 TI - A nerve growth factor-induced gene encodes a possible transcriptional regulatory factor. AB - Nerve growth factor (NGF) is a trophic agent that promotes the outgrowth of nerve fibers from sympathetic and sensory ganglia. The neuronal differentiation stimulated by this hormone was examined in the NGF-responsive cell line PC12. Differential hybridization was used to screen a complementary DNA library constructed from PC12 cells treated with NGF and cycloheximide. One of the complementary DNA clones that was rapidly induced by NGF was found to have a nucleotide sequence that predicts a 54-kilodalton protein with homology to transcriptional regulatory proteins. This clone, NGFI-A, contains three tandemly repeated copies of the 28- to 30-amino acid "zinc finger" domain present in Xenopus laevis TFIIIA and other DNA-binding proteins. It also contains another highly conserved unit of eight amino acids that is repeated at least 11 times. The NGFI-A gene is expressed at relatively high levels in the brain, lung, and superior cervical ganglion of the adult rat. PMID- 3672129 TI - Continuing education for blue-collar workers. PMID- 3672130 TI - Animal regulations: so far, so good. PMID- 3672131 TI - Duke's Heart Center in bureaucratic jam. PMID- 3672132 TI - Networks nix contraceptives ad. PMID- 3672133 TI - Imaging technique passes muster. PMID- 3672134 TI - NIH celebrates 100. PMID- 3672135 TI - Structurally distinct, stage-specific ribosomes occur in Plasmodium. AB - Two structurally distinct nuclear genes code for cytoplasmic small subunit ribosomal RNA's in the parasite Plasmodium berghei. Stable transcripts from one of the ribosomal RNA genes are found almost exclusively in those stages of the life cycle that develop in the mosquito. When the parasite infects the mammalian host, transcripts from the second gene become the predominant small subunit ribosomal RNA species. PMID- 3672136 TI - Environmental correlates of food chain length. AB - In 113 community food webs from natural communities, the average and maximal lengths of food chains are independent of primary productivity, contrary to the hypothesis that longer food chains should arise when more energy is available at their base. Environmental variability alone also does not appear to constrain average or maximal chain length. Environments that are three dimensional or solid, however, such as a forest canopy or the water column of the open ocean, have distinctly longer food chains than environments that are two dimensional or flat, such as a grassland or lake bottom. PMID- 3672137 TI - [Role of hippocampal acetylcholine-sensitive neurons in different stages of nictitating membrane conditioning of rabbits]. PMID- 3672138 TI - [The role of the globus pallidus (GP) and nucleus accumbens (NAc) in the control of avoidance conditioning of rats]. PMID- 3672139 TI - [Inspiratory-facilitated effects due to electrical stimulation of the nucleus raphe dorsalis in rabbits]. PMID- 3672140 TI - [Effect of gastrin injected into the lateral hypothalamus on gastric acid secretion in rats]. PMID- 3672141 TI - [Effect of estrogen or progestogen injection on serum gastrin levels and gastric acid secretion of ovariectomized rats]. PMID- 3672142 TI - [Micro- and ultra-structure of the leg muscle of the spider Lycosa singriensis]. PMID- 3672143 TI - [Resetting of the baroreceptor reflex by electroacupuncture in conscious rabbits]. PMID- 3672144 TI - Barriers to physician-nurse collegiality: an anthropological perspective. AB - This paper discusses social and cultural factors that impede collegial interaction of physicians and nurses. While physicians encourage a form of 'team work' in which nurses are subordinate, nurses seek mutual collegiality with physicians. This phenomenon is apparent in various degrees between all educational categories of nurses and physicians. We suggest that nurse expectations of status enhancement through increased knowledge and skill--the nurse practitioner model--fail to consider the deeply rooted structures of hierarchy, in particular gender hierarchy, that pervades medical care. Physician nurse collegiality does offer benefits to patients; to achieve it nurses must devise methods to alter these structural barriers. PMID- 3672145 TI - Progress towards achieving health for all New Zealanders by the year 2000. AB - New Zealand has been faced in recent years with a serious failure to maintain its relative position, in comparison to other OECD countries, in its social, economic and health status indicators. Although health costs so far have been successfully controlled, through a largely capitation funded service, its health organisational problems are typical of developed countries including major problems of equity and efficiency. Despite these problems some important recent initiatives give optimism for future health improvement. These include the spread of the service concept through service development groups and moves towards decentralisation through area health boards. Population-based funding of hospital and area health boards, supplemented with service planning guidelines, has proved to be an important lever for change. Maori health initiatives are beginning to show the way to improving the status of this disadvantaged section of society and perhaps for other New Zealanders as well. Important issues yet to be faced include establishing an effective central organisation for the health services, education and training for leadership and a more central place for the still largely fragmented and isolated primary health care services. PMID- 3672146 TI - Health care institutions in a regional network: a longitudinal case study of inter-organizing. AB - This is a second article reporting on the functioning of a regional federation in the Dutch health care field. It is a heterogeneous federation of health care delivery institutions (clinical, ambulatory, and primary care) within a geographical area of about 250,000 inhabitants. The first article on this subject, published in this journal in 1981, dealt with the facilities and obstacles during the founding process of the federation and with the problems concerning the making of a policy program (Soc. Sci. Med. 15A, 41-48, 1981). That was about five years after the inception of the federation and it seemed both possible and fruitful to carry out further evaluation of this particular case. A content analysis of all the 41 meetings of the federation could be performed on the agendas, minutes and other relevant documents. The results of this analysis, taken together with a substantial amount of information gathered by participant observation during these sessions, gave rise to certain conclusions and interpretations. They concerned the numbers and kinds of subjects discussed, the changes in their composition over the years, the varying amount of energy put into the development of the federation's organization, the evolution of the federation's task and its effectiveness in preparing regional plans for health care provision. The results of the analysis seemed to encourage this approach to regionalization. Developments during the most recent period, since 1982, will be described in a third article. Although in a legislative sense this year was important, the related enactment processes went on very slowly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3672148 TI - Why do people go to the doctor? Sex differences in the correlates of GP consultation. AB - This study explores the variables associated with consultation behaviour within the NHS of 256 men and women aged 16-45 and registered with one GP. The focus is on long term effects rather than on the immediate precipitants of a consultation and hence the dependent variable is the one year consultation rate. The predictor variables include predisposing, enabling and need factors. It is found that not only do women consult more often than men but also the correlates of primary care utilisation differ between the sexes. Health status (need) and social role factors (including parenthood and marital status) are found to be more important for men, while psychological predisposition is of greater significance among women in this setting. The implications of the findings are discussed. PMID- 3672147 TI - [Avoidable mortality in Belgium]. AB - The concept of avoidable mortality leads to an attempt at using specific mortality rates as output measures of health services. The analysis covered 43 Belgian districts between the years 1974 and 1978. Two Belgian areas were compared along a dimension defined by two axes of a correspondence factor analysis: Flanders which is associated with low SMR of avoidable mortality and Wallonia which has high rates. The persistence of high mortality in Wallonia was confirmed. Factorial scores for each district were used as indexes for geographical heterogeneity. Variations in these indices, including patient consultation rates and technical medical procedures, remained even after adjustment for socio-economic differences. PMID- 3672149 TI - Swedish physicians' perspectives on work and the medical care system--II: The cases of child and maternal health physicians. AB - This paper reports the results of focused interviews with child health and maternal health physicians in the public ambulatory care sector of a large Swedish city to describe (1) the organization of their work activities, (2) their perspectives on their work, and (3) their perspectives on the medical care system. Child health physicians (who were attached to a major teaching hospital) practiced in child health clinics for preschoolers and school health clinics. Each physician covered several such settings. Maternal health physicians were attached to local hospitals and practiced full time in maternal health centers. Child health physicians described their work in terms of preventive care, patient care, integration of ambulatory and hospital services, and technological sophistication; they described the system in terms of quality of care, quality of diagnosis and treatment, adequacy of resources, and distribution of services. Maternal health physicians described work in terms of a biophysical orientation, practice independence, relations with hospitals and other specialists, and dependence on nurses; they described the system in terms of technological sophistication, ambulatory and hospital care, and problems of other specialties. Both were more positive about both work and the system than were district general practitioners, and some interpretation is offered. PMID- 3672151 TI - [Bladder catheterization and closed drainage]. PMID- 3672150 TI - [Angiotensin-converting enzyme inhibitors]. PMID- 3672152 TI - [Dietary treatment of hyperlipoproteinemia]. PMID- 3672153 TI - [Drug treatment of hyperlipoproteinemia]. PMID- 3672154 TI - [Hyperlipoproteinemia. A case report]. PMID- 3672155 TI - [Blood lipid disorders]. PMID- 3672156 TI - [Ideal nutrition with special reference to lipids]. PMID- 3672157 TI - [Lipoproteins]. PMID- 3672158 TI - [An asthmatic crisis: why?]. PMID- 3672159 TI - [Personnel staffing and scheduling]. PMID- 3672161 TI - [Penicillins: groups G and M]. PMID- 3672160 TI - [Hyperlipoproteinemias]. PMID- 3672162 TI - [Implantable chamber for intravenous perfusion. Perfusion technics]. PMID- 3672163 TI - [The phenomenon of professional burnout in oncologic nurses. Ways of psychological intervention. Report of a roundtable conference]. PMID- 3672164 TI - [Sterile feeding of an aplastic child]. PMID- 3672165 TI - [Nutritional surveillance in pediatric hematology]. PMID- 3672166 TI - [Blood products]. PMID- 3672167 TI - [The nurse and the transfusion procedure. management of blood products]. PMID- 3672168 TI - [Modalities of transfusion surveillance]. PMID- 3672169 TI - [AIDS]. PMID- 3672170 TI - [The "donor-receiver" relationship. A current topic]. PMID- 3672171 TI - [Bladder rehabilitation and adaptation in intermediate stay patients]. PMID- 3672172 TI - [A description of apprenticeship. Improving the integration of apprentices]. PMID- 3672173 TI - [Maternity leave. Educational leave (2)]. PMID- 3672174 TI - [Therapeutic development in hemato-oncology]. PMID- 3672175 TI - [Drug screening using sequential detection in thin-layer chromatography]. PMID- 3672176 TI - [Our initial results using the isoelectric focusing method in the practice of forensic medicine]. PMID- 3672177 TI - Polarisation fluoroimmunoassay for quinine in serum and urine. AB - The development and validation of a polarisation fluoroimmunoassay for the antimalarial drug quinine is described. The assay is performed either by sequential addition of the reagents or by a single-reagent technique whereby the tracer and antibodies are premixed. Serum samples require pepsin digestion prior to assay while urine specimens are assayed directly. The reliability criteria of the assay are satisfactory and no cross-reaction is detected with quinidine (the optical isomer of quinine) or with common antimalarial drugs. The assay was applied to the measurement of quinine in urine specimens obtained from a single dose pharmacokinetic study and the results correlated with those of the benzene extraction fluorescence method for quinine measurement. PMID- 3672178 TI - The host-parasite relationship between the Saudi Arabian Schistosoma mansoni and its intermediate and definitive hosts. 1. S. mansoni and its local snail host Biomphalaria arabica. AB - The infectivity of miracidia of the Saudi Arabian isolate of S. mansoni in Bi. arabica was found to be influenced by such factors as miracidial dose, water temperature and salinity. The pre-patent period of S. mansoni in Bi. arabica was 30 to 33 days. Miracidial dose had no effect on the mortality of snails during the pre-patent period. The infection rate increased as the miracidial dose was increased. However, cercarial production was highest in snails exposed to 1 miracidium each and decreased as the miracidial dose was increased. Water temperature during exposure had an influence on the mortality, infection rate and cercarial production in Bi. arabica exposed to S. mansoni miracidia. The infection rate was highest in snails exposed at 28 degrees and 34 degrees C. No infection of Bi. arabica occurred at the temperature of 10 degrees C. The number of cercariae per snail per day was highest in snails exposed to miracidia at 34 degrees C. It was demonstrated that salinity had an influence on the infection of Bi. arabica with miracidia of S. mansoni. The infection rate in snails decreased as the salinity increased up to 4,500 mg/l, above which no infection occurred. The daily pattern of cercarial emergence was rhythmic, whereby 94.7% of the total daily production was released within 6 h from infected Bi. arabica, with a peak between 11 a.m. and 1 p.m. PMID- 3672179 TI - Renal plasma flow in rhesus monkeys infected with Plasmodium knowlesi. AB - Renal plasma flow was studied in six rhesus monkeys before and during infection with Plasmodium knowlesi using 125I-sodium orthoiodohippurate (125I-OIH) as a tracer. The mean renal plasma flow and the rate constant from the intravascular compartment to the kidneys were significantly reduced in the infected monkeys. As both intravascular and extravascular compartments were slightly but not significantly elevated, which resulted in the prolonged mean transit time of 125I OIH in monkeys infected with P. knowlesi. The parasitemia showed a reverse relationship with the renal plasma flow and a direct relationship with the mean transit time. These findings indicated that the renal plasma flow in the infected monkeys was depressed in proportion to the number of P. knowlesi parasites. The mechanism of reduced renal plasma flow was probably due to renal vasoconstriction. PMID- 3672180 TI - Serodiagnosis of parasitic infections by ELISA with different antigens. AB - An enzyme-linked immunosorbent assay is described in which four antibodies (amoebiasis, schistosomiasis, echinococcosis and filariasis) can be tested at once. Because of the sensitivity, specificity, reproducibility and practicability this test system can be recommended as a quantitative routine test. PMID- 3672181 TI - Survey of intestinal parasites on Palawan, Philippines. AB - A biomedical survey for intestinal parasites was conducted in Napsan on the island of Palawan, Philippines in September 1986. A total of 353 stool specimens were obtained from 155 males and 198 females ranging in age from 1 1/2 months to 70 years. Ascaris lumbricoides, 34.8%, hookworm 34.8% and Trichuris trichiura 25.2% were the most common helminths encountered, while Entamoeba coli 27.7% and Endolinax nana 22.2% were the common protozoans. This study demonstrated a 7-13% higher overall prevalence of intestinal parasites among the population on Palawan compared to previous studies in the rural Philippines. PMID- 3672182 TI - Albendazole in the treatment of strongyloidiasis. AB - Albendazole was used to treat 30 patients with Strongyloides stercoralis infections. There were 21 males and 9 females, 13 to 68 years of age, who were divided into two groups of 11 and 19, respectively. Repeated pre- and post treatment stool examinations were done by simple direct smear and formalin-ether concentration, and larval quantitations were done by the Stoll and Sasa's technique. Group I patients were given albendazole in dosages of 400 mg/day in divided doses for 3 days. Group II patients were given similar dosages, but were treated again 7 days later on the same schedule. Patients in Group I were followed for 14 days and those in Group II for 30 days. The cure rates were 73% for Group I and 100% for Group II. Side effects were minimal and transient. Albendazole is recommended for the treatment of strongyloidiasis in dosages of 400 mg/day in divided doses for 3 days with treatment repeated one week later. PMID- 3672183 TI - Comparative study of different doses of mebendazole in hookworm infection. AB - Sixty six children (40 males, 26 females) aged from 4 to 14 years with hookworm infection were treated with mebendazole. Thirty one and 35 children were treated with mebendazole 300 mg single dose and 600 mg conventional regimen respectively. Stool examination by Kato-Katz technique were done for 3 consecutive days before treatment and on day 14-16, 21-23 after treatment. The cure rate with 300 mg mebendazole was 16.1% with 90.9% egg reduction while 600 mg mebendazole gave 91.4% cure rate with 99.5% egg reduction. No side effects were observed in all children. Four hundred and six adult worms were identified, 99% were Necator Americanus, 0.5% Ancylostoma duodenale and 0.5% Ancylostoma ceylanicum. PMID- 3672184 TI - A brief report on Gnathostoma spinigerum specimens obtained from human cases. AB - A total of 23 gnathostome specimens different stages from the Hospital for Tropical Diseases, other general hospitals and medical clinics in Bangkok metropolitan area and central Thailand were identified as G. spinigerum. The various stages were as follows: Five advanced third-stage larvae (22.0%) of various sizes; 2.20-3.50 mm X 0.40-0.63 mm were removed from the skin, mucous membrane and the eyeball, of which the smallest measured 2.20 X 0.40 mm. Fourteen immature worms of both sexes were from the skin and mucous membrane, one spontaneously voided in the urine. The sizes varied from 4.63-9.35 mm X 0.60- 1.05 mm (8 male worms), and 3.83-16.25 mm. X 0.83-1.0 mm (6 female worms). All these immature worms had 8 rows of complete cephalic-hooklets with the exception of two with 6 and 7 rows of complete cephalic-hooklets. Four mature males size ranged from 9.9-12.5 mm X 1.0-1.25 mm. The smallest was removed from the abdominal skin of a newly born 7-day old baby evidently the case was prenatally transmitted. PMID- 3672185 TI - Cryptosporidiosis in Siriraj Hospital, Bangkok, Thailand. AB - During January to July 1986, 1,500 fecal specimens from out and in-patients attending Siriraj Hospital, Bangkok were examined for Cryptosporidium oocysts by modified acid fast technique. Eight were found to be positive. The prevalence of cryptosporidiosis was 3.7% in children with acute diarrhoea. Medical records of the patients showed that the main clinical presentation was acute diarrhoea with fever for one to 7 days duration. Stool examinations and cultures revealed no white blood cells or parasites or other enteropathogenic bacteria. All recovered within two weeks. The study suggest that Cryptosporidium is a relatively common nonviral cause of acute diarrhoea in young children and routine laboratory study to detect Cryptosporidium may be justified. PMID- 3672186 TI - Scanning electron microscopy of adult Echinostoma malayanum. AB - Scanning electron microscopy observations of E. malayanum adult obtained from small intestines of infected rats was made. The number of collar spines were 41. The features observed were a pair of corner spines (3 oral and 2 aboral) total 10; a pair of lateral collar spines (10 spines each side); total 20; dorsal collar spines (5 oral and 6 aboral) total 11. Sensory papillae were found more densely situated on the circumoral disc around the oral sucker and on the ventral sucker. Other sensory organs, dome shaped, found only on the circumoral disc. The scales appear mainly on the ventral surface. The microvilli are present on the tegument where the scales occur, while the other part of dorsal side had pitted tegument. PMID- 3672187 TI - Studies on growth and distribution of Angiostrongylus cantonensis larvae in Ampullarium canaliculatus. AB - The intramolluscan development of Angiostrongylus cantonensis larvae in Ampullarium canaliculatus, a fresh-water migrant snail which multiplies in tremendous rate in Taiwan, was followed for 28 consecutive days in this study. The snails were infected with first stage larvae of A. cantonensis and groups of three snails were sacrificed daily to study various larval stages in different organs. A. cantonensis larvae were found in all snails examined. During the first four days, they were obtained only from the digestive tract. Mouth is thus suggested as the primary route of natural infection. The first molt was observed on the fifth day of infection, and the second molt, the 12th day. Molting occurred in almost all kinds of organs examined. Studies on tissue tropism showed that the predilection site of A. cantonensis in this freshwater snail was headfoot region. Relatively few larvae were found in visceral organs including liver, heart, and ovary. Most parasites, 62.1%, recovered on the 28th day of infection were third-stage larvae. PMID- 3672188 TI - The natural first intermediate host of Paragonimus in Thailand. PMID- 3672189 TI - [Postoperative mechanical intestinal obstruction]. PMID- 3672190 TI - [Treatment of trophic ulcers of the lower extremities with celiase]. PMID- 3672191 TI - [Laser therapy of osteoarthrosis]. PMID- 3672192 TI - [Kallikrein-kinin system and prostaglandin levels in the blood in interruption of pregnancy in the 2d trimester]. PMID- 3672194 TI - [Active surgical treatment of suppurative-inflammatory diseases of the soft tissues of diabetes mellitus patients]. PMID- 3672193 TI - [Effect of alcohol on clinico-metabolic indices in ischemic heart disease]. PMID- 3672195 TI - [Dynamics of the concentration of free phenol in patients with diffuse peritonitis and pancreatic necrosis]. PMID- 3672196 TI - [Anemic coma in Addison-Biermer disease]. PMID- 3672197 TI - [Physiologic activity of blood plasma in cerebral dyshemias]. PMID- 3672198 TI - [Impaired absorption and digestion of fat in acute intestinal infections]. PMID- 3672199 TI - [Effect of continuous ultraviolet radiation on red cell indices]. PMID- 3672200 TI - [Integral approach to the prevention of non-infectious diseases]. PMID- 3672201 TI - [Modern roentgenology in the overall diagnostic process]. PMID- 3672202 TI - [Results of combined treatment of cancer of the stomach using cryogenic therapy]. PMID- 3672203 TI - [Pigmentation and melanoma of the skin, possibility of laser treatment]. PMID- 3672204 TI - [Prevention of vascular diseases of the brain complicating hypertension in industrial enterprises]. PMID- 3672205 TI - [Dispensary care of pollinosis patients in a system of specialized allergologic services]. PMID- 3672206 TI - [Conservative treatment of patients with myocardial infarcts complicated by rupture of the interventricular septum]. PMID- 3672207 TI - [Effect of alcohol on cerebral hemodynamics (clinico-rheographic correlation)]. PMID- 3672208 TI - [Features of traumatologic care in alcoholic intoxication]. PMID- 3672209 TI - [Dynamics of laboratory indices in myocardial infarction]. PMID- 3672210 TI - [Transient disorders of cerebral circulation in hypertension]. PMID- 3672211 TI - [Urgent cytologic examination of the lymph nodes during conservative surgery in cancer of the breast]. PMID- 3672212 TI - [Early diagnosis of primary melanoma of the skin]. PMID- 3672213 TI - [Contractile capacity of the myocardium in neurocirculatory dystonia]. PMID- 3672214 TI - [Resection of a horseshoe kidney]. PMID- 3672215 TI - [Treatment of chemical burns of the esophagus with applications of medical glue MK-8 through an endoscope]. PMID- 3672216 TI - [Indomethacin in salmonellosis and food poisoning]. PMID- 3672217 TI - [Errors and complications of medical care in combined and multiple injuries at the pre-hospital stage]. PMID- 3672218 TI - [Combined endoscopic methods in the diagnosis and treatment of acute cholecystitis complicated by choledocholithiasis]. PMID- 3672219 TI - [Immunogenesis of acute complications of gastroduodenal ulcers]. PMID- 3672220 TI - [National program for oral hydration in diarrhea, 1983-1986. Evaluation and perspectives]. PMID- 3672221 TI - [Migration and health: notes on an interdisciplinary field of research]. PMID- 3672222 TI - [Evaluation of health needs]. PMID- 3672223 TI - [Malnutrition in marginal rural areas of the Republic of Mexico: epidemiology and control programs]. PMID- 3672224 TI - [Cancer mortality among Mexican women]. PMID- 3672225 TI - [Epidemiology of cancer in the population served by the Mexican Institute of Social Security]. PMID- 3672227 TI - [Epidemiology of suicide and attempted suicide in the decade from 1971 to 1980 in Mexico]. PMID- 3672226 TI - [Regional analysis of drug use in the student population of Mexico]. PMID- 3672228 TI - [Prevention of nuclear warfare as a public health responsibility]. PMID- 3672229 TI - [Simulation of screening for cervical carcinoma as a means of selecting a program for early detection]. PMID- 3672231 TI - [The significance of cerebrospinal fluid cytology in the differential diagnosis and prognosis of purulent meningitis]. PMID- 3672230 TI - [The biosynthetic human growth hormone (Somatonorm) in the treatment of children with growth hormone deficiency]. PMID- 3672232 TI - [Modern approach to the diagnosis and therapy of hemolytic disease of the newborn]. PMID- 3672233 TI - [Biliary ileus--preoperative diagnosis]. PMID- 3672234 TI - [Use of computers in medicine]. PMID- 3672235 TI - [Microanatomic study of hippocampal arteries in man]. PMID- 3672236 TI - [Hepatobiliary scintigraphy]. PMID- 3672237 TI - [Parkinson's disease--incorrect diagnosis]. PMID- 3672238 TI - [The blink reflex in vascular lesions of the brain stem]. PMID- 3672239 TI - [Differential diagnosis of diaphragmatic eventration and liver echinococcosis]. PMID- 3672240 TI - [Respiratory center activity in excessively obese persons]. PMID- 3672241 TI - [Functional status of the lungs in children in the town of Bor who have been exposed to the effects of industrial air pollution]. PMID- 3672242 TI - [Gastroesophageal reflux--diagnostic value of scintigraphic methods]. PMID- 3672243 TI - [Primary hyperparathyroidism--analysis of 38 patients]. PMID- 3672245 TI - [Causes of short stature in children]. PMID- 3672244 TI - [Clinical and serologic diagnosis of trichinosis in people from an endemic area near Sabac]. PMID- 3672246 TI - [The etiology of hypothalamic diabetes insipidus in children]. PMID- 3672247 TI - [Intraoperative injuries of the bile ducts]. PMID- 3672248 TI - [Early diagnosis of malignant tumors of the glottis]. PMID- 3672249 TI - [Benign growths in the larynx]. PMID- 3672250 TI - [Use of laryngomicroscopy in adults]. PMID- 3672251 TI - [Biodegradation of polymers. I. Changes in the mechanical properties of polyethylene insulation of cardiostimulation electrodes after long-term implantation in the human body]. PMID- 3672252 TI - [Biodegradation of polymers. II. Changes in the mechanical properties and network density of silicone insulation in cardiostimulation electrodes after long-term implantation in the human body]. PMID- 3672253 TI - [The function of the gastroesophageal junction in an experiment]. PMID- 3672254 TI - [Anaerobic mediastinitis--a serious surgical problem]. PMID- 3672255 TI - [Carcinoma of the major duodenal papilla (Vater's)]. PMID- 3672256 TI - [Use of nasobiliary drainage in the treatment of biliary diseases]. PMID- 3672257 TI - [Liver metastases in colorectal carcinoma]. PMID- 3672258 TI - [The accessory gallbladder as a surgical finding]. PMID- 3672259 TI - [Perforation of the colon as a cause of acute abdomen]. PMID- 3672260 TI - [Open dislocation fractures of the talocrural joint]. PMID- 3672261 TI - [Bilateral rerupture of the tendon of the quadriceps muscle of the thigh]. PMID- 3672262 TI - Sun induced skin damage--where do we stand. PMID- 3672263 TI - Uneasy bedfellows. PMID- 3672264 TI - The pregnant epileptic. PMID- 3672265 TI - Clothes make the doctor. PMID- 3672266 TI - Are we too concerned with means in the statistical analysis of clinical research? PMID- 3672267 TI - Malignant breast tumours at Coronation Hospital, Johannesburg. A 10-year review. AB - A review of malignant breast tumours at Coronation Hospital has highlighted their frequency in younger women and their biologically aggressive nature. Inadequate patient compliance with follow-up makes routine use of conservative treatment modalities hazardous. PMID- 3672268 TI - Hypertension management in a Cape Peninsula coloured community. A retrospective medium-term assessment. AB - A retrospective study of the records of a large hypertension clinic at a primary care centre was carried out for the period 1975-1984. A total of 250 patients were selected from a systemic 1-in-2 sample. The objectives were to establish the degree of control, compare the use of a large arm blood pressure (BP) cuff with a standard one, and determine the prevalence of associated diseases and the cost of drug therapy. The mean systolic BP was 163.2 mmHg, with 45% of patients having a systolic BP below 160 mmHg. The mean diastolic BP was 101.2 mmHg with 13% of patients having a diastolic BP below 95 mmHg. The majority of patients were overweight and the large BP cuff was found to be useful. PMID- 3672269 TI - Treatment of acute self-poisoning in a respiratory intensive care unit. A 5-year review. AB - A study of 103 cases of drug-related suicide attempts admitted to the Respiratory Intensive Care Unit, Groote Schuur Hospital, over a 5-year period (1980-1984) was carried out. This group constituted 4.8% of all patients admitted to this hospital with acute self-poisoning. The majority of patients made an uneventful recovery (survival rate 91.7%). No association was found between initial admission status and ultimate recovery. Haemoperfusion was useful in treating patients with severe barbiturate poisoning. PMID- 3672270 TI - Pneumatoceles as a complication of paraffin pneumonia. AB - Paraffin pneumonia is a common form of poisoning, but pneumatoceles are an uncommon complication. This is a report of 6 patients who developed pneumatoceles after the ingestion of paraffin. These children's ages varied from under 18 months to 4 years; they were clinically more ill and were hospitalised longer than those who did not develop pneumatoceles. The pneumatoceles were discovered at the earliest on day 6 and, although extensive and in 2 cases bilateral, caused no clinical impairment of respiratory function. The pneumatoceles appear to resolve spontaneously but this may take more than 200 days. PMID- 3672271 TI - Surgical management of patients with hyperhidrosis. AB - Eighteen patients with hyperhidrosis affecting different anatomical areas were treated with a variety of surgical methods. Bilateral axillary gland excision is an appropriate and cosmetically acceptable method of treating axillary hyperhidrosis (11 patients). Bilateral supraclavicular cervical sympathectomy was performed for excessive sweating of the hands (7 patients). Bilateral lumbar sympathectomy was necessary in only 3 patients with excessive sweating of the feet. When perineal hyperhidrosis is present, the first lumbar ganglia must be excised. Transaxillary, transpleural sympathectomy, removing the first to fourth thoracic ganglia, is successful in treating failures of sweat gland excision or troublesome sweating of hands and axillae. PMID- 3672273 TI - Urethral prolapse in children--alternative management. AB - After a brief discussion of urethral prolapse in children, the results of local application of conjugated oestrogen cream in 5 patients are discussed. It is suggested that this should be the primary management. PMID- 3672272 TI - [The effect of 30% N2O on the general hemodynamics of patients with heart valve lesions]. AB - The effect of 50% N2O on the general haemodynamics of patients with heart valve lesions was evaluated. The addition of N2O to oxygen before cardiopulmonary bypass was associated with a decrease in the cardiac output from 3.60 +/- 0.23 to 3.04 +/- 0.17 l.min-1/m2 (P less than 0.001) although the filling pressure of the left ventricle remained constant and right ventricle preload was increased from 8.18 +/- 0.99 to 9.85 +/- 1.14 mmHg (P less than 0.05). Because the systemic blood pressure fell after N2O was added, the decrease in cardiac output is interpreted as representing a decrease in myocardial contractility. The changes in the inverse relationship between arterial blood pressure and stroke volume also support the concept that N2O suppresses myocardial contractility. PMID- 3672274 TI - Outcome of treatment at a psycho-educational day unit for young children. AB - The outcome of treatment at the psychiatric day centre of the Red Cross War Memorial Children's Hospital in Cape Town is described. Forty-five children were followed up for 2-6 years after discharge--12 were asymptomatic, 22 moderately improved and 11 unimproved. Possible means of improving outcome are discussed. PMID- 3672276 TI - Epidemiological research methods. Part VI. Planning a research project. PMID- 3672275 TI - Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part IV. Respiratory diseases. AB - Respiratory diseases are major causes of death in South Africa. The reported mortality rates (MRs) for: (i) pneumonia and influenza; (ii) chronic obstructive lung disease and allied conditions; (iii) pulmonary tuberculosis; and (iv) carcinoma of the lung and bronchus over a 5-year period are examined in relation to age, sex, ethnic group and year. Such data have not previously been reported in South Africa. MRs for all respiratory diseases (except lung carcinoma) were substantially higher in coloureds than in whites or Asians. In each ethnic group and for each disease category, MRs for males were higher than for females, especially in those over the age of 24 years. For all, except lung carcinoma, MRs were highest at the extremes of life. Changes in respiratory disease MRs over the 5-year period were examined by calculating the age standardised MRs for each condition in each of the 5 years. There was a clear decline in the MR for pneumonia over this period in all groups. The MR for chronic obstructive pulmonary disease rose in all groups, except Asian females. Similarly, the MR for carcinoma increased in all groups, except white females. The MR for tuberculosis was highest in coloured males (10 times greater than in Asian males and 100 times greater than in white females). The pattern of respiratory disease MRs in white South Africans is very similar to that in the USA, whereas in coloureds MRs for infectious diseases remain high and are added to by the burden of cigarette smoking-related deaths. PMID- 3672278 TI - Malignant melanoma in a child. A case report. AB - The rare occurrence of malignant melanoma in a child is reported. Differentiation on histopathological grounds between this tumour and the more common juvenile melanoma may be difficult, but this important distinction should be possible in almost all cases. PMID- 3672277 TI - Lethal cardiac conduction defects in Emery-Dreifuss muscular dystrophy. AB - Significant cardiac conduction defects were a prominent feature of a kindred suffering from Emery-Dreifuss muscular dystrophy and 3 affected males were treated by insertion of permanent cardiac pacemakers. Because of the rarity of this disorder and for the sake of further phenotype delineation, results of clinical, genetic and biochemical investigations of the affected males and obligate carrier females are presented and discussed. PMID- 3672279 TI - Hydatidiform mole with a coexistent live fetus. A case report. AB - A patient with a hydatidiform mole and coexistent live fetus is presented. This rare phenomenon occurs in 0.005-0.01% of all pregnancies. Correct antenatal diagnosis can be made with ultrasonography in conjunction with the presence of low human placental lactogen and raised beta-human chorionic gonadotrophin levels. PMID- 3672281 TI - Heart disease and food. PMID- 3672280 TI - Pulmonary cysticercosis. A case report. AB - Pulmonary cysticercosis is an extremely rare manifestation of a rather common disease which occurs primarily in developing countries. A patient suffering from a very heavy infestation of Taenia solium larvae is described. Histological examination of biopsy specimens of several of the numerous subcutaneous nodules confirmed the diagnosis. All the lesions, including the pulmonary nodules, regressed rapidly after appropriate treatment. PMID- 3672282 TI - Ketoconazole induced hepatitis. PMID- 3672283 TI - Metacarpal thickness in South African population. PMID- 3672284 TI - Remarks by the Commissioner of Social Security. PMID- 3672285 TI - Social workers in health care management: the move to leadership. PMID- 3672286 TI - Social workers in health care management: the move to leadership. The study: purpose and method. PMID- 3672287 TI - Alternatives and options: the transition from social work director to hospital administrator. PMID- 3672288 TI - Social work as a preparation for health care administration. PMID- 3672289 TI - Social workers in health care management: the move to leadership. Findings and implications. PMID- 3672290 TI - Social worker to hospital administrator. PMID- 3672291 TI - Social workers in health care management: the move to leadership. Pathway to administration. PMID- 3672292 TI - The social worker as leader. PMID- 3672293 TI - Social workers in health care management: the move to leadership. Reflections on a journey. PMID- 3672294 TI - Social work and hospital administration. PMID- 3672295 TI - Social workers in health care management: the move to leadership. Administration: getting the right things done. PMID- 3672296 TI - The social worker as manager in health care settings: an experiential view. PMID- 3672297 TI - Philosophical perspective on social work administration. PMID- 3672298 TI - Congenital atresia of the vagina. AB - The correction of an absent vagina requires the creation of a canal either by surgical means or by the intermittent pressure technique of Frank. Both methods have drawbacks and, in our experience, it is difficult to persuade a patient to use a vaginal dilator alone, accurately and conscientiously for long enough to give a good result. A simple surgical alternative is described which gives good anatomic and functional results with minimal morbidity. It combines the positive features of the traditional McIndoe approach and the Frank method of vaginal development. The results of a study of 24 patients with vaginal agenesis confirmed that the condition is usually part of the Rokitansky-Kuester-Hauser syndrome with an absent or rudimentary uterus and tubes but normally functional ovaries (21 patients). There were three instances of testicular feminization with an XY karyotype, and the results of orchidectomy performed upon these patients after puberty showed the classical histologic findings. The uterus and tubes were absent. Since 1976, the new isograft technique has been performed upon 11 patients with excellent results and no complications. PMID- 3672300 TI - Surgical treatment of patients with hour glass shaped or ruptured membranes prior to the twenty-fifth week of gestation. AB - The surgical technique of cervical cerclage in patients with bulging membranes prior to the twenty-fourth week of gestation is described. Of the 11 patients, ten had viable births. Ten of the 11 patients had spontaneous rupture of their membranes, lasting from two and one-half to 14 weeks. The only adverse effects of rupture of membranes were preterm labor and fetal growth retardation. PMID- 3672299 TI - A high plasma prostaglandin to thromboxane ratio protects against renal ischemia. AB - Pretreatment with the thromboxane synthase inhibitor OKY-046 but not the cyclo oxygenase inhibitor ibuprofen protects against ischemia-induced acute tubular necrosis. However, ibuprofen together with the vasodilating agent prostaglandin E1 is protective. This suggests that a high prostaglandin to thromboxane ratio is the major factor operative in preventing tubular necrosis, the subject of this study. Rats that had unilateral nephrectomy (n = 60) with the exception of rats that had sham operations (n = 8) underwent 45 minutes of left renal pedicle clamping. Thirty minutes before the operation, the rats received either a saline solution or a thromboxane synthase inhibitor that was given intravenously. The inhibitors OKY-046 (2 milligrams per kilogram, n = 10), UK38485 (1 milligram per kilogram, n = 9) and U63357A (10 milligrams per kilogram, n = 10) were given as a single bolus while the inhibitor CGS13080 (0.1 milligram per kilogram, n = 9, and 1.0 milligram per kilogram, n = 7) was given by constant infusion and continued for 60 minutes after reperfusion. With saline solution therapy, five minutes after reperfusion, thromboxane B2 increased from 154 to 2,537 picograms per milliliter (p less than 0.00001) and 6-keto-prostaglandin F1 alpha increased from 51 to 266 picograms per milliliter (p less than 0.004). At 24 hours, the creatinine level increased from 0.5 to 2.8 milligrams per deciliter (p less than 0.00001). Only OKY-046 yielded a creatinine level at 24 hours of 1.2 milligrams per deciliter, a value lower than that for those in the saline solution control group (p less than 0.002). Furthermore, OKY-046 led to the highest prostaglandin to thromboxane ratio (p less than 0.035). The five other ratios which occurred after drug therapy were inversely related to the decrease in the creatinine value (r = -0.93, p less than 0.02). Histologically, OKY-046 was the only thromboxane synthase inhibitor to prevent acute tubular necrosis (p less than 0.05). Results show that a high prostaglandin to thromboxane ratio protects against acute tubular necrosis. PMID- 3672301 TI - The use of vascular clips to minimize blood loss in colpourethropexy. AB - A serious intraoperative and postoperative complication associated with colpourethropexy as described by Burch and Tanagho and others is hemorrhage. We performed the Tanagho modification of the Burch procedure in 13 patients, as the sole procedure in the treatment of genuine stress incontinence. Vascular clips were used to circumscribe the fat overlying the anterior part of the vaginal wall, thereby allowing en bloc resection of the vascular fat pad. Suspensory sutures of 1-0 Vicryl (polyglactin 910) were placed; no retroperitoneal drains were used. The blood loss was estimated to be less than 50 milliliters in ten instances and less than 75 milliliters in three. The average hospital stay was 4.2 days. All of the patients were given antibiotic prophylaxis and were discharged home with suprapubic drainage of the bladder. There were no intraoperative or postoperative complications. Thus, one of the serious complications of colpourethropexy can be avoided by using vascular clips to facilitate the removal of the periurethral and paravesical fat from the anterior part of the vaginal wall. PMID- 3672302 TI - Gallstones and uterine fibroids. AB - In a series published in 1961, an unusual frequency of hysterectomies for uterine leiomyomas (fibroids) was reported in women with gallstones. The purpose of this study was to confirm the association between gallstones and uterine leiomyomas with a patient control study and to investigate its physiopathologic basis comparing the cholesterol saturation of bile in women with gallstones, in women with leiomyomas but no gallstones and in those in the control group with no gallstones or leiomyomas. Patients admitted to the surgical department have, routinely, echography of the gallbladder before and manual exploration of the pelvic floor during surgical intervention. For the first part of the study, we collected information concerning the diagnosis of leiomyomas from the operating room registers and about the diagnosis of gallstones from the clinical records. In 1982, 42 of 139 women operated upon consecutively for gallstones and five of 69 operated upon for other diseases of the gastrointestinal tract had leiomyomas, a statistically significant difference (chi-square test, p less than 0.001). This difference persisted stratifying women with gallstones and those in the control group for age. In the second part of the study, we examined the bile collected at duodenal drainage after gallbladder stimulation with cholecystokinin, in 11 young women with radiolucent gallstones (echography and cholecystography), in ten women with leiomyomas (gynecologic examination and pelvic echography) but no gallstones (echography) and in 11 women with no leiomyomas (gynecologic examination or pelvic echography) or gallstones (echography). Cholesterol, phospholipids and total bile acids in the biliary tract were analyzed with standardized enzymatic methods. The cholesterol saturation index of the biliary tract was higher in patients with leiomyomas than in those in the control group (Wilcoxon rank sum test, p less than 0.01) and similar to that of women with radiolucent gallstones. These data suggest that gallstones and leiomyomas are associated diseases, probably sharing a common cause. PMID- 3672303 TI - The fiberoptic choledochoscope in the operative management of pancreatic pseudocysts. PMID- 3672304 TI - Fasciotomy of the upper extremity in the patient with trauma. PMID- 3672305 TI - Retrograde dissection of the adnexa in residual ovary syndrome. AB - Injuries to the ureter in the course of gynecologic procedures can occur frequently. The usual histologic signs and symptoms of peri-oophoritis, adhesion and distorted anatomy encountered with residual ovaries make their ablation hazardous to the surrounding structures and the ureter in particular. A method is described and illustrated to facilitate surgical extirpation and render the procedure safe. PMID- 3672306 TI - Modified posterior approach for right adrenalectomy. AB - I use this approach for all patients with primary hyperaldosteronism due to a right adenoma. In addition, the approach has been used for other functioning and nonfunctioning adrenal lesions less than 6 centimeters in size, if there is no anatomic or biochemical evidence of a malignant lesion. This approach is not recommended for patients with pheochromocytoma, carcinoma of the adrenal gland or lesions of the adrenal gland greater than 6 centimeters. PMID- 3672307 TI - Immediate endoscopic placement of long intestinal tube in partial obstruction of the small intestine. AB - A technique that allows for endoscopic placement of a long intestinal tube with an inflatable balloon well beyond the pylorus is described. This procedure has been successful in 24 patients; is well tolerated; removes air and fluid from the stomach, duodenum and upper part of the jejunum, and can be performed in less than 45 minutes. It uses equipment that is standard in all hospitals and can be performed by anyone experienced in performing endoscopy of the upper part of the gastrointestinal tract. It is safe, easy to perform and improves the efficacy of long tube decompression and, therefore, can be recommended in properly selected patients, with partial obstruction of the small intestine. PMID- 3672309 TI - A new alternative to diverting double barreled ileostomy. AB - A new diverting ileostomy is described which avoids the attendant problems associated with the previously described "loop ileostomy," and other described ileostomies used in conjunction with ileoanal pull-through procedures. The ileostomy result is a functionally superior stoma, similar to that of the standard Brooke ileostomy, and requires only a local exploration for takedown. Initial experience with the procedure has been uniformly excellent and would support wider use of the "close loop" double barreled ileostomy. PMID- 3672308 TI - Needlepoint teeth for jaws of vascular surgical clamps. AB - A vascular surgical clamp is described which has a single row of needlepoint teeth for the jaws. In our experience, the use of fine round and pointed teeth seems to afford less trauma and greater control of the vessel. PMID- 3672310 TI - A technique for reimplantation of the visceral artery during repair of thoracoabdominal aneurysm. PMID- 3672311 TI - Local management in primary breast cancer. Our experience of 331 cases. AB - The peroperative exploration of axillary content gave wrong result from the stage of axillary nodes in every fourth case compared with the final result of axillary evacuation. There were no locoregional recurrences in stage I-patients irradiated after mastectomy. In postoperatively irradiated stage II-patients there were locoregional recurrences in 2.5% of cases, which was 1/8 of recurrences of patients not irradiated postoperatively. PMID- 3672312 TI - [Preoperative short-term irradiation in rectal cancer]. AB - From 1979 through 1983, 78 patients underwent short-term preirradiation before primary operation for rectal carcinoma at the Medical Radiation Institute of Tubingen. A hyperfractionated total dose of 16 Gy was applied within a maximum time of 36 hours in four fractions of 4 Gy each. Surgery was performed at the last irradiation day. The medium observation time of the total group of patients was five years and three months, at least 40 months. The local recurrence rate of all patients followed up is 9% (7/78), for stage Dukes A it is 6% (2/32), for stage Dukes B 0%(0/25), for stage Dukes C 27% (3/11), and for stage Dukes D 20% (2/10). In the group of 68 patients showing no metastases at the moment of surgery, the rate of formation of remote metastases amounts to 21%, in stage Dukes A to 13% (4/32), in stage Dukes B to 24% (6/25), and in stage Dukes C to 36% (4/11). The relapse-free survival during the follow-up period is 66% (45/68), for stage Dukes A 69% (22/32), for stage Dukes B 68% (17/25), and for stage Dukes C 55% (6/11). There were no acute or late radiogenic complications. Compared to publications about cases treated only by surgery, the present preirradiated patient's group shows a considerable lower local recurrence rate and an increased relapse-free survival rate. These improved treatment results are probably due to preoperative irradiation. The incidence of perioperative complications was not increased by preoperative irradiation. PMID- 3672313 TI - [Combination of interstitial hyperthermia and afterloading therapy at a high dosage rate]. AB - The study was supposed to develop a method allowing to combine interstitial hyperthermia with high dose rate afterloading therapy. For hyperthermia, metallic hollow needles, which are also used in brachytherapy, are connected with the RF source by a computer-controlled relay switch. The temperature is measured by thermistors incorporated into the needles. Several heating methods are investigated in a homogenous phantom and compared by means of the experimentally determined temperature/time evolutions and isotherms (in a stationary state). PMID- 3672314 TI - Quantitative evaluation of radiotherapy treatment planning using CT image. AB - A method of computerized optimization system of radiotherapy treatment planning is presented. For the optimization of treatment planning, it is highly desirable to evaluate treatment planning quantitatively corresponding to a set of three dimensional criteria. For this purpose, we introduce a set of criteria using some parameters defined as three-dimensional extension of those of ICRU report 29. The development of computer software has become feasible for clinical use of our criteria. This paper described some preliminary results of our criteria which was applied to some clinical cases. Our method was proved applicable to any type of treatment plannings, and the optimization of treatment plannings will surely be realized through our criteria. PMID- 3672315 TI - [Systematic research on the dose distribution in mantle field irradiation with Co60 gamma radiation in the Alderson phantom]. AB - A mantle field is localized according to the patient's data in an inhomogenous Alderson phantom. After having established the irradiation scheme, the dose distributions measured in the Alderson phantom are compared with those measured and calculated in an homogenous water phantom. The possible side effects of this irradiation technique can be assessed on the basis of the radiation exposure of heart, lung and spinal marrow. The dose differences found on the central ray are within the margin of error amounting to 5 to 10% which is indicated in the calculation program. In case of a total reference dose of 40 Gy, the radiation exposures of heart and lung do not reach the tolerance limit. A spinal marrow dose of 50 Gy is found in the upper neck marrow. In case of an exact therapy planning, a sufficient dose can be directed to the Waldeyer's tonsillar ring. PMID- 3672316 TI - [Effect of actinomycin D on the survival and recovery capacity of irradiated connective tissue cells in the Chinese hamster]. AB - Simultaneous treatment of Chinese hamster fibroblasts with Actinomycin D and gamma rays under normal aerobic conditions leads to radiosensitization. In contrast to Actinomycin D pretreatment, modification to the effect of radiation is drug dose dependent in the case of post-treatment. No effect of Actinomycin D upon the shape of the radiation cell survival curve is seen under hypoxic conditions. Recovery from radiation damage in split dose experiments is not influenced by the drug. PMID- 3672317 TI - Regrowth, tumor cell proliferation and morphological alterations of the adenocarcinoma EO 771 following a single dose of 30 Gy 60Co gamma-rays. AB - The effect of irradiation with 30 Gy 60Co gamma-rays on the adenocarcinoma EO 771 has been studied by simultaneously evaluating the effect on tumor growth, on tumor cell proliferation and on the histological structure of the tumor. Inspite of a drastic decrease of tumor cell density by a factor of 2 within one day after irradiation there is practically no tumor regression but only a growth delay lasting about five to six days. The lack of decrease in tumor volume is due to hemorrhages and interstitial oedemas. Regrowth of the tumor starting after about five days concomitantly with the removal of necrotic tissue is followed by a second wave of growth delay. Following the release of the G2 block of the cells tumor cell proliferation is reduced to about half the normal proliferative activity for further three days. Tumor cell proliferation reaches its maximum about eight days after irradiation and then decreases again although higher proliferative activity should be expected comparing the size of the tumor with that in untreated animals. The proliferative activity is much higher in the tumor periphery than in the center suggesting that radiation damage is more rapidly compensated in the tumor periphery. These studies confirm that tumor volume changes are not representative for radiation effects but that there are many processes as damage to the vascular system or the tumor bed effect that influence the effect of irradiation on the tumor. PMID- 3672318 TI - The treatment of perforated diverticulitis by one-stage intracolonic bypass procedure. AB - The one-stage intracolonic bypass procedure prevents gastrointestinal secretions and fecal content from coming in contact with an anastomotic site without interrupting the intraluminal continuity of the fecal flow from proximal to distal colon. This can be achieved by the intraluminal implantation of a soft, pliable tube above the anastomotic site. Previous clinical and experimental data have indicated that the intracolonic bypass procedure can protect an anastomosis in the presence of maximal colonic loading, gross dehiscences, or fecal peritonitis. This report presents 28 patients with perforated diverticulitis, all of whom were treated by one-stage intracolonic bypass procedures. Ten of the 28 patients had peritonitis, and 18 had pericolic abscesses. Results indicate no deaths and no anastomotic leakages. Three patients (10.7%) had a complicated postoperative course. One patient with fecal peritonitis had prolonged ileus and a pulmonary effusion, and one had a myocardial infarction. Both of these patients responded to medical therapy. Another patient had a wound infection. The hospital stay ranged from 10 to 18 postoperative days. All patients passed the tubes spontaneously 2 to 3 weeks after operation. The one-stage intracolonic bypass procedure can be recommended as a viable alternative to the two- or three-stage procedures commonly used for perforated diverticulitis. PMID- 3672319 TI - Plasma amino acid clearance as an indicator of hepatic function and high-energy phosphate in hepatic ischemia. AB - A major function of the liver is to maintain normal levels of plasma amino acids. This function may depend in part on tissue levels of high-energy phosphate. Experiments were performed in adult mongrel dogs to assess the relationship between plasma amino acid clearance (PAAC) and tissue high-energy phosphate after 90 minutes of warm hepatic ischemia. In addition, when PAAC was assessed in the anhepatic dog, PAAC fell to low levels after hepatectomy. After 90 minutes of warm ischemia, both tissue adenosine triphosphate (ATP) and PAAC fell to low levels, with PAAC similar to those levels observed in anhepatic dogs. Recovery of ATP and PAAC progressed over a 48-hour period but did not reach control values. Mortality rate was 33% in a group of 12 animals at 48 hours after ischemia. At 24 hours after ischemia, total free plasma amino acid levels were significantly higher in those animals that were dying as compared with those that were surviving (4352 mumol/L versus 2850 mumol/L; p less than 0.05). There was a strong correlation between PAAC and ATP (r = 0.81). PAAC appears to be an indicator of hepatic functional recovery and tissue ATP levels after ischemia. PMID- 3672320 TI - Central venous dialysis access: experience with a dual-lumen, silicone rubber catheter. AB - The central venous dialysis catheter has gained wide acceptance for short-term hemodialysis with the realization of the need to spare peripheral extremity vessels for the creation of more durable internal arteriovenous fistulas. The Hemocath (Quinton Instrument Co., Seattle, Wash.), a soft, silicone rubber, double-lumen central venous dialysis catheter, was introduced as a permanent access device in 1984. A prospective evaluation of 53 catheters placed in 51 patients over a 9-month period is presented. Forty-nine catheters were placed for temporary access and four were placed for permanent access. All 53 catheters were discontinued after functioning an average of 63.9 days (range, 5 to 324 days). No major complications occurred during insertion or on dialysis. One catheter fragmented during removal and was retrieved in the operating room. Infection led to the removal of 17 catheters (34.7%). Thrombosis occurred in 11 catheters and was the cause of removal in two (4.1%). Excluding the two catheters that functioned at the time of the patient's deaths and those placed for permanent access, 91.5% of the catheters performed successfully as temporary accesses devices until permanent access sites were available for use. The catheter provided reliable, relatively safe, and easily maintained central venous access for hemodialysis. PMID- 3672321 TI - Endotoxemia in burn patients: levels of circulating endotoxins are related to burn size. AB - With use of a quantitative limulus assay, the levels of circulating endotoxins were examined in a population of burn patients with injuries covering 1% to 88% of the total body surface area (TBSA). In cases in which the injury was less than 20% TBSA, the increases in endotoxins were only 35% as compared with those of normal controls. As the extent of injury increased, the levels of endotoxins also increased: burns between 21% and 40% TBSA showed average increases of over 350% and burns in excess of 40% showed increases of 500%. The relationship between burn size and total endotoxin burden was significant (p = less than 0.01). Time course studies indicated that in most cases, peak endotoxin levels occurred 3 to 4 days after injury. The data also showed that there was no relationship between the age of the patient and the extent of the endotoxin increase. PMID- 3672322 TI - Regimen for improved effectiveness of intermittent pneumatic compression in deep venous thrombosis prophylaxis. AB - The incidence of deep venous thrombosis (DVT) was assessed in a series of 78 patients undergoing major surgical operations to compare the prophylactic effectiveness of intermittent sequential pneumatic compression alone with the simultaneous use of graduated compression stockings and intermittent sequential pneumatic compression. The diagnosis of DVT was determined with the I-125 fibrinogen-uptake test, Doppler ultrasound, maximum venous outflow by strain gauge plethysmography, and contrast venography. The incidence of DVT in nonstockinged legs was 9% while that in the stockinged legs was 1%. The simultaneous use of graduated elastic compression stockings and intermittent pneumatic compression is more effective than pneumatic compression alone in the prevention of postoperative DVT. PMID- 3672324 TI - Electrohydraulic lithotripsy of intrahepatic stones during choledochoscopy. AB - In two patients, electrohydraulic lithotripsy was used under direct vision during choledochoscopy to fragment intrahepatic calculi above bile duct strictures, which were difficult to remove by ordinary choledochoscopic methods. Choledochoscopy was performed after dilation of a percutaneous transhepatic tract in one patient and after intubation of the subcutaneous blind jejunal limb of a previous Roux-en-Y intrahepatic cholangiojejunostomy in the other. Both patients were treated without any complications. Electrohydraulic lithotripsy during choledochoscopy is a safe and effective method to fragment stones and facilitate their removal. PMID- 3672323 TI - The technique of segmental mastectomy (lumpectomy) and axillary dissection: A syllabus from the National Surgical Adjuvant Breast Project workshops. AB - Surveys conducted by the American College of Surgeons indicate an increasing trend toward the treatment of primary breast cancer by segmental mastectomy and radiotherapy. This operation has never been formally taught in training programs, and scant standard descriptive material exists. The National Surgical Adjuvant Breast Project conducted a series of workshops to develop guidelines for the performance of the operation. The essential points are (1) pathologic control of margins to ensure complete surgical excision, (2) surgical principles of complete tumor excision, (3) attention to optimum cosmetic results, and (4) axillary dissection for accurate staging and regional control of the disease. This article summarizes the recommendations made at those workshops. PMID- 3672325 TI - Topical ibuprofen decreases early postburn edema. AB - We determined the effect of topically applied ibuprofen on formation of second degree burn edema and prostanoid production, a possible causative factor. Six adult sheep were given second-degree burns on both flanks with water at 80 degrees C while they were under general anesthesia. Lymph (QL), draining the flank areas, was used to monitor edema formation and prostanoid production. A 5% ibuprofen cream was applied at 2 and 5 hours after the burn and full-thickness biopsy specimens of burned hide were obtained at 8 hours for determination of water content. The QL increased sixfold in nontreated and 2.5 times in treated burn tissue. The lymph/plasma (L/P) protein ratio increased from 0.4 to 0.58 in both sides. Lymph TxB2 was increased from baseline of 200 pg/ml to 500 +/- 100 and 310 +/- 90 pg/ml in untreated and treated sides, respectively. Lymph 6-keto PGF1 alpha increased from a baseline of 50 +/- 10 to 150 +/- 40 and 90 +/- 80 pg/ml in untreated and treated sides. The difference between PG content of lymph in treated and untreated sides was significant. Plasma prostanoids, except for a transient early rise, remained at preburn baseline. Lymph ibuprofen content on the treated side rose to 1.9 +/- 0.8 mcg/ml with no detectable plasma level. Water content of hide increased from a control value of 74 +/- 2% to 84 +/- 2% in untreated burn, while the value in the treated side was 76 +/- 4%, a significant difference between the two sides. We conclude that topically applied ibuprofen decreases both local edema and prostanoid production in burn tissue without altering systemic production. PMID- 3672326 TI - The effect of complete burn wound excision and closure on postburn oxygen consumption. AB - We determined the effect of complete excision and closure of the burn wound on the postburn increase in oxygen consumption. Twelve sheep were given a 15% of total body surface full-thickness burn and were monitored for 7 days. By the third day, a 50% increase in O2 consumption, VO2, was noted, as was a significant increase in cardiac index and decrease in mixed venous PO2, compared to baseline. The hypermetabolic process persisted for the 7-day pre-excision period. On the seventh postburn day all sheep were anesthetized for 2 hours with halothane and placed on positive pressure ventilation, and then one half of these sheep underwent excision and closure. During anesthesia, VO2 decreased to 76 +/- 15 ml/min/M2, a value significantly lower than even the preburn awake baseline of 122 +/- 14 ml/min/M2 and the 7-day postburn value of 180 +/- 18 ml/min/M2. Quantitative cultures, before excision, revealed the wounds to be noninfected (less than 10(5) organisms per gram). In six animals, the burns were totally excised to fascia and closed with full-thickness defatted hide from other sheep obtained at the same time under sterile conditions. In these animals, the VO2 returned to preburn baseline by 24 hours postexcision and remained there for the 3-day postexcision study period. In the other six burned sheep, the 15% full thickness burns remained. The hypermetabolic state returned to the 7-day postburn level on return to the awake state and persisted for the remainder of the study. We conclude that complete excision and wound closure can reverse the postburn increase in O2 consumption. PMID- 3672327 TI - Pancreatic abscess due to infected hydatid disease. AB - A 35-year-old man sought treatment for acute epigastric pain, mild jaundice, and high fever. The patient was alcoholic and had been treated for a week in another hospital, at which time the clinical findings and indirect laboratory test indicated an attack of acute pancreatitis. At admission to the surgical intensive care unit of Aretaieon Hospital, the patient was in a septic condition; a computed tomographic scan of the upper abdomen revealed an abscess at the head of the pancreas. Surgical exploration showed an infected hydatid cyst at the head of the pancreas and pancreatic edema. The cyst was evacuated and drained, which resulted in formation of an external pancreatic fistula. Fistulography showed a communication of the residual cavity with the main pancreatic duct. The patient was begun on a regimen of somatostatin infusion, and the fistula closed within 3 days. The patient was discharged on the sixteenth postoperative day and has remained in good health for a year. PMID- 3672328 TI - Multiple enteroliths in a chronically obstructed duodenal loop after Roux-en-Y biliary diversion. AB - A case of chronic mechanical obstruction of the duodenal loop due to stricturing of the enteroenterostomy after diversion following a Polya gastrectomy for bile reflux gastritis is reported. The dilated loop contained several hundred enteroliths. The clinical and chemical evidence strongly supports the view that the enteroliths were formed in the intestinal loop. This complication of Roux-en Y reconstruction has not previously been recognized. PMID- 3672329 TI - Vascular graft seeding. PMID- 3672330 TI - [Executive Board. Reactions to new needs for saving run from shock to bitterness]. PMID- 3672331 TI - [Blood transfusion. Indications for blood transfusion have changed]. PMID- 3672332 TI - [Guidelines for home nurses' regulations]. PMID- 3672333 TI - [Children's health. 28. Families with young children often miss the closer family contact]. PMID- 3672334 TI - [Politicians should announce consequences of cutbacks themselves]. PMID- 3672336 TI - [Alternative treatment. Integrated medicine is treatment seen from a holistic human viewpoint]. PMID- 3672335 TI - [Community Hospital: current occupational developments requires more nurses. Interview by Lars Peter Bergqvist]. PMID- 3672337 TI - [Pediatrics. Health visitors prepare research on colic in infants]. PMID- 3672338 TI - [Nurses can directly or indirectly cooperate with capital punishment]. PMID- 3672339 TI - [Blood transfusion. Transfusion of own blood can prevent complications]. PMID- 3672340 TI - [Danish Nursing Council. Necessary insight of representatives' working conditions]. PMID- 3672341 TI - [Children's health. 29. Musical stimulation important for child's complete development]. PMID- 3672342 TI - [Optimal development among nurse representatives]. PMID- 3672343 TI - [Nursing records from partially open to completely open]. PMID- 3672344 TI - [Role of the teaching of phthisiology in raising the quality of the training of the general practitioner]. AB - The teaching of a cycle of phthisiological pulmonology to undergraduates should be based on the principle of the retention of knowledge of phthisiology. In the 4th and 6th year great emphasis should be placed on the clinical signs of tuberculosis and the physician's role in the detection of tuberculosis. PMID- 3672345 TI - [Hyperlipoproteinemic arthritis]. PMID- 3672346 TI - [Effect of hereditary predisposition on gastric secretion and acidity in healthy persons]. PMID- 3672347 TI - [Experience in using different oral rehydration solutions for treating acute intestinal infections]. PMID- 3672348 TI - [Clinical picture and diagnosis of primary tuberculosis in adults today]. PMID- 3672349 TI - [The course of tuberculous meningitis in adults today]. PMID- 3672350 TI - [Diabetes mellitus in pulmonary tuberculosis patients]. PMID- 3672351 TI - [Markers of hepatitis B virus in chronic liver diseases]. PMID- 3672352 TI - [Drowning in chlorinated water with the development of the near drowning syndrome]. PMID- 3672353 TI - [Effect of hyperbaric oxygenation on the disease course and blood coagulation function in patients with acute viral hepatitis]. AB - The paper is concerned with an analysis of clinico-biochemical indices and 14 parameters of the plasmatic and platelet links of hemostasis in 29 patients with acute virus hepatitis of a varying degree of severity treated by hyperbaric oxygenation and in 40 controls. HBO made a modulating effect on most indices of hemocoagulation and fibrinolysis bringing them nearer to a certain standard which was optimum for a certain stage and degree of AVH. Probable mechanisms of the HBO effect on various indices of homeostasis in AVH and clinico-pathogenetic importance of the state of hemocoagulation against a background of HBO-therapy were discussed. PMID- 3672354 TI - [Morphological characteristics of the manifestation of chronic hepatitis and cirrhosis of viral etiology in chronic alcoholics]. PMID- 3672355 TI - [Serum lipid spectrum of patients with protracted viral hepatitis A who abuse alcohol]. PMID- 3672356 TI - [Results and outlook in infectious disease control]. PMID- 3672357 TI - [Effect of alcohol consumption and hepatobiliary pathology on morbidity with temporary loss of work capacity among workers of a brewery]. AB - Among brewery workers diseases of the hepatobiliary system are more common in persons directly engaged in the field of production and regularly consuming liquor and beer. Chronic liver and biliary tract diseases contribute to an increase in morbidity with temporary loss of working capacity, prolong the period of treatment, on the whole, and in traumatic diseases in particular. Expenditure on temporary loss of working capacity per 1 patient among those consuming liquor was 32.8% higher than that among abstainers, and in the presence of hepatobiliary pathology 70% higher than in persons without it. PMID- 3672359 TI - [Diagnostic problems of infectious-toxic shock in acute pneumonia patients at the prehospital stage]. AB - An infective-toxic shock, one of the earliest complications of acute pneumonia, is now rarely recognized at the prehospital stage. Its hypodiagnosis resulted mainly from inadequate patients' examination, underestimation of the signs of a shock or their incorrect interpretation, and insufficient knowledge of physicians of a possibility of its development in this disease. PMID- 3672358 TI - [Acquired immunodeficiency syndrome (a clinical case)]. PMID- 3672360 TI - [Diagnostic significance of opportunistic bacteria in acute intestinal infections]. AB - A study was made of the rate of the cultivation of opportunistic bacteria (OB) from the feces of different groups of patients, normal persons and those examined in accordance with epidemic indications as well as of serological modulations in autogenous strains of the bacteria. The rate of the cultivation of the different types of OB in the different groups, in inpatients and outpatients, and the character of the serological modulations in them depending on the OB type and the group under examination were different. Evolution in the specific composition of OB over the recent 20 years is demonstrated. The principles of evaluating the diagnostic importance of OB cultivated from the feces of patients and normal persons are worded. Five possible versions of the diagnostic interpretation of OB demonstration in human feces are presented. PMID- 3672361 TI - [A variant in integrating the activities of therapeutic and tuberculosis control services]. AB - The author finds it appropriate to take advantage of antituberculous sanatoria for secondary prevention of various diseases during annual mass screening of population with account of pathomorphosis of tuberculosis. PMID- 3672362 TI - [Effect of chronic nonspecific lung diseases on the detectability and course of tuberculosis]. AB - Chronic nonspecific diseases of the respiratory organs frequently develop after clinical cure of tuberculosis, particularly in persons with ample residual changes which, in their turn, contribute to the development of a recurrence of tuberculosis. Recurrences were mainly detected during consultations in medical institutions. Therefore improved work with patients of the 7th registration group in antituberculous centers as well as with patients with chronic nonspecific diseases of the respiratory organs in the general medical network will contribute to a decrease in the number of tuberculosis recurrences or their earlier detection. PMID- 3672363 TI - [Lung diffusion capacity of pulmonary tuberculosis patients]. AB - DLCO, DL/VA, Dm and Vc, lung volumes, capacities and values of a curve representing flux-forced expiration volume relationships were investigated in 159 patients with focal, infiltrative, disseminated and fibrocavernous tuberculosis. A decrease in DLCO was observed in half of the patients with disseminated and fibrocavernous tuberculosis and in less than one/fifth of the patients with focal and infiltrative tuberculosis. The leading factor of a decrease in DLCO in the patients with disseminated and fibrocavernous tuberculosis was the reduction of the lung respiratory surface resulting from a decrease in the effective alveolar volume; the leading factor in infiltrative tuberculosis was a decrease in alveolocapillary membrane permeability. In focal tuberculosis the importance of the above factors in DLCO reduction was approximately the same. PMID- 3672364 TI - [Clinical x-ray characteristics of recurrent tuberculosis of the bronchopulmonary system in patients with chronic respiratory diseases]. AB - X-ray and clinical features of tuberculosis combined with lingering pneumonia were studied in 110 patients of the 7th group of dispensary registration suffering from chronic diseases of the respiratory organs. Tuberculosis recurrences in this group of patients had a torpid course, specific changes were slowly reversed, noticeable fibrosis was formed on their site. Thorough x-ray tomographic investigation not only of the pneumonia zone but also of the zone of posttubercular changes was conducted at the onset and end of pneumonia therapy to exclude tuberculosis reactivation. Frequent exacerbations of chronic diseases of the respiratory organs including complications in the form of lingering pneumonia in patients with posttubercular changes can mask early stages of tuberculosis reactivation. PMID- 3672365 TI - [Antioxidants--effective pathogenetic agents in the combined therapy of pulmonary tuberculosis]. AB - The use of anti-oxidants (alpha-tocopherol and sodium thiosulphate in multimodality therapy of patients with infiltrative pulmonary tuberculosis raised therapeutic efficacy promoting elimination of signs of tuberculous intoxication, the onset of bacteria elimination, disintegration cavity closing, and a decrease in the frequency of residual changes. The advantage of alpha-tocopherol was shown in its administration to patients with infiltrative tuberculosis with the prevailing productive tissue reactions. alpha-tocopherol prevented the occurrence of noticeable respiratory insufficiency contributing to its elimination in patients with fibrocavernous tuberculosis. PMID- 3672367 TI - [Risk factors for the development of early relapse in pulmonary tuberculosis after chemotherapy]. PMID- 3672366 TI - [Pharmacokinetic bases for the drug-free prevention of drug-induced hepatitis in pulmonary tuberculosis patients]. AB - The causes and frequency of occurrence of toxic hepatitides determined by isoniazid and rifampicin, were analysed in 551 patients with primary tuberculosis detected by clinical pharmacological methods. The intravenous mode of drug administration was shown to be indicated for prevention of isoniazid hepatitides in patients with a fast type of acetylation. Doses and methods of therapy with isoniazid and streptomycin leading to their high concentrations in the patients' body should be avoided to prevent liver affection with rifampicin. Since rifampicin hepatitides develop in persons with a slow type of acetylation, rifampicin and isoniazid with streptomycin should be injected with a 6-hour interval to prevent them. PMID- 3672369 TI - [Mental functions (memory and attention) and their dynamics during the use of sinusoidal modulated currents by the electrosleep method on patients in the early recovery period following operations on the intracranial arteries]. AB - Clinicopsychological studies on memory and attention functions with the help of psychological tests in 34 patients in an early rehabilitation period after operations on cerebral vessels have shown the efficacy of a new method of therapy with sinusoidal modulated currents based on electric sleep methods contributing to the regression of focal neurological symptomatology and improvement of memory and attention functions. PMID- 3672368 TI - [Effect of fructose-1,6-diphosphate and trental on the erythrocyte aggregating capacity in ischemic heart disease]. AB - It was shown that fructose-1.6-diphosphate was capable of marked suppression of the aggregation power of the blood erythrocytes of patients with acute myocardial infarction and angina of effort. The antiaggregation effect of the drug was dose related and enhanced with an increase in the time of its contact with erythrocytes. The antiaggregation effect of pentoxifylline was not of distinct dose-related nature. Its antiaggregation power did not considerably depend on the time of incubation with erythrocytes. PMID- 3672370 TI - Subcellular effects of experimental oligohydramnios on the developing rat limb. AB - In the rat, the development of the limb bud can be impaired by amniotic puncture. Selective haemorrhages are observed within 1 hour of the treatment. An ultrastructural analysis was undertaken to uncover the cytological changes associated with these haemorrhages. The earliest effect of oligohydramnios is the appearance of a periendothelial oedema which separates the mesodermal cellular processes from the endothelial basal lamina. The loosening of the latter and the distortion of the endothelial cells occur almost simultaneously. Subsequent damage of the mesodermal cells ensues, the ectoderm and the preskeletal condensations remaining unaffected. Only general damage of the embryo affecting all tissues will lead to the complete necrosis of the limb bud and even to foetal death. The great variability of skeletal defects observed in amniocentesis syndrome can be accounted for by the higher resistance of the differentiating cells to a decrease in blood supply. PMID- 3672371 TI - Migration and proliferation of primordial germ cells in the rat. AB - Information about early primordial germ cell (PGC) formation and migration in rats is lacking. In utero developed and in vitro cultivated whole rat embryos were studied on days 10-13 postcoitum (p.c.). The development of the PGCs was investigated in serial sections stained for alkaline phosphatase activity. On postcoital day 10, PGCs were found in the invaginating visceral yolk sac endoderm and at the base of the allantois. At day 11 p.c. PGCs were mostly found in the ventral and lateral gut wall or in the mesenchyme between the gut and the future genital ridges. At day 12 p.c. most of the PGCs (94%) could be localised in the mesenchyme or in the future genital ridges. On postcoital day 13 almost all PGCs had reached the now-well-developed genital ridges. Quantitative measurements showed an increase in the number of PGCs from 84 at day 10 p.c. up to 2,768 at day 13 p.c. Only slight differences were found between in vivo and in vitro embryos with respect to the number of PGCs and their developmental pattern. The in vitro culture of whole rat embryos enables the discrimination between the effects of indirect (maternal) and direct action of PGC-toxic agents. PMID- 3672372 TI - Cardiovascular malformations induced by bromodeoxyuridine in the chick embryo. AB - For the study of morphogenesis and early embryonic development, 5 bromodeoxyuridine (BUdR), a halogenated analogue of thymidine, is incorporated into replicating DNA and serves as a valuable tool. To study the teratogenicity of BUdR on the developing chick cardiovascular system, we topically administered graded doses of BUdR (32.6-325.6 nmol) in ovo during Hamburger-Hamilton stages 15 to 16. We also administered to a parallel group of embryos corresponding nanomole doses of thymidine during identical stages of development. In the thymidine treated group, survival rates and cardiovascular anomaly rates did not differ statistically from those in the chick Ringer's control group. Both survival rates and cardiovascular anomaly rates in the BudR-treated group were dose-responsive. Among 78 embryos with cardiovascular anomalies induced by BUdR, vascular malformations were found in 96%. These anomalies included interruption of the right fourth aortic arch, absence or hypoplasia of the right and/or left sixth aortic arch, and persistence of the left fourth aortic arch. Interruption of the right fourth aortic arch was always associated with intracardiac anomalies. Intracardiac anomalies were found in 54% of the embryos; these included ventricular septal defect, double outlet right ventricle, and persistent truncus arteriosus. Subclavian artery malformations were noted in 95% of the embryos. Possible mechanisms for BUdR-induced malformations in the cardiovascular system of the chick are discussed. PMID- 3672373 TI - Reduction of uterine blood flow by phenylephrine, an alpha-adrenergic agonist, in the day 11 pregnant rat: relationship to potentiation of acetazolamide teratogenesis. AB - We have demonstrated previously that phenylephrine, a selective postsynaptic alpha-1-adrenergic agonist, significantly potentiates the incidence of acetazolamide-induced right forelimb ectrodactyly in a dose-response manner. As reported herein, phenylephrine also decreases maternal uterine blood flow in a dose-response manner as measured by radioactive microsphere methodology. At the potentiative dose of 12.5 mg/kg phenylephrine decreases uterine blood flow by 86.8% when compared to control. In turn, pretreatment with prazosin, a selective postsynaptic alpha-1-adrenergic antagonist, prevents this large decrease in uterine blood flow and abolishes the potentiation of acetazolamide teratogenesis by phenylephrine. Although the effects of acetazolamide or acetazolamide + phenylephrine on uterine blood flow were not measured the data suggest a correlation between decreased uterine blood flow and potentiation of acetazolamide teratogenesis. PMID- 3672374 TI - Response to Teratology Society statement about the risks of excessive doses of vitamin A. PMID- 3672375 TI - Cytotoxic effects of ethylene glycol monomethyl ether in the forelimb bud of the mouse embryo. AB - The role of cytotoxicity in digital maldevelopment in CD-1 mouse embryos was examined following dosage with ethylene glycol monomethyl ether (EGME) on gestation day (gd) 11. Patterns of cell necrosis in the forelimb buds of embryos collected from dams given EGME orally at doses of 100, 250 or 350 mg/kg were characterized by staining with Nile blue A. Cell death was induced in the mesenchymal tissue and to some extent in the limb bud ectoderm, including the apical ectodermal ridge in a dose-related manner. The area of preaxial physiological cell necrosis was enlarged by EGME, and the shape of the limb buds was altered 24 hr after treatment. Preaxial tissue and the predigital chondrocyte condensations were reduced or missing following 250 and 350 mg EGME per 1 kg. Light and electron microscope evaluations of forelimb buds revealed the presence of phagocytic vacuoles and condensed, fragmented cytoplasm, which indicate cytotoxicity, as early as 2 hr following EGME, a maximum effect being observed 6 hr after the dose was administered. Although the severity of the cytotoxic response appeared to be dose-related, comparison with the incidence of digital malformations in near-term fetuses indicates that the loss of mesenchymal tissue is partially compensated for as formation of the limb progresses. PMID- 3672376 TI - Ovarian follicular cell hyperplasia in fetal mice treated transplacentally with ethinyl estradiol. AB - The occurrence of follicular cell hyperplasia was studied by light and electron microscopy in fetal mouse ovaries exposed to ethinyl estradiol (EE) from day 11 through day 17 of pregnancy. Pregnant mice were given EE in olive oil (0.02, or 0.2 mg/kg of body weight) and were sacrificed on day 18. The female fetuses were examined for ovarian histogenesis. Follicular cell hyperplasia was detected in both of the experimental groups, but the incidence was statistically significant only in fetuses exposed to 0.2 mg/kg of EE. Light and electron microscopic observations of the ovaries showed that the hyperplasia was located in the medullary region, and the follicular cells showed pleomorphism. Accumulation of abundant lipid droplets, enlarged rough endoplasmic reticulum with granular material, dense bodies, and vague masses of fibrous structures were seen in the cytoplasm. These morphological observations indicate that hyperplasia of follicular cells in fetal mouse ovaries at term can be induced by prenatal treatment with EE. PMID- 3672377 TI - Fate of adriamycin-induced dilated renal pelvis in the fetal rat: functional and morphological effects in the offspring. AB - Previously we reported that gestational exposure to Adriamycin, an anthracycline antibiotic used in the treatment of neoplasms, reduced renal function in the neonatal rat, and we suggested that alterations in the development of the renal papilla might be responsible for the dysfunction. In this study we exposed groups of Sprague-Dawley rats to 0, 1.0, 1.25, or 1.5 mg/kg of Adriamycin on gestation days 10-12, a period previously shown to be effective in altering postnatal renal function with this compound. Offspring were evaluated at several developmental periods in order to 1) precisely define the morphological status of the urogenital system in Adriamycin-treated offspring; 2) replicate the finding of a decreased renal concentrating ability in the neonates; 3) determine the transience/permanence of any morphological effect; and 4) correlate any permanent alterations in urogenital morphology with our indicator of neonatal functional competence. Maternal Adriamycin treatment induced alterations in the development of the renal papilla that persisted well into the postnatal life of the offspring. The first appearance of the morphological alteration occurred in the absence of other general indicators of developmental toxicity such as growth retardation. The determination of the ultimate fate and functional consequences of the structural alterations required postnatal evaluations of the renal system. Finally, a relatively simple test of renal function in the neonate proved to be predictive of the permanence of the morphological effect, and the absolute test result showed a strong correlation with the incidence of the morphological effect in the overall population. PMID- 3672378 TI - Father's drinking and infant birth weight: report of an association. AB - Parents' drinking in the month prior to conception was ascertained for 377 infants born to members of a health maintenance organization. If the father had an average of two or more drinks daily, or had at least five drinks on one occasion, a decrease of 137 gm in infant birth weight was predicted, by means of regression analysis. This result was independent of maternal drinking, although infants whose mothers were regular drinkers weighed less at birth. The lower mean birth weights of infants of regular-drinking fathers was not due to parents' smoking, maternal use of caffeine, marijuana, or other drugs, or 21 other measured variables. This is the first report of an association in humans between father's drinking prior to conception and decreased infant birth weight. However, interpretation of this finding is difficult because the biological mechanisms that might underlie it are obscure. PMID- 3672379 TI - Amyoplasia congenita-like condition and maternal malathion exposure. AB - This report concerns an amyoplasia-like condition in a case with maternal exposure to malathion during the 11th to 12th week of pregnancy. Malathion is an agent acting on the neuromuscular system. The possibility of a causal association is discussed. PMID- 3672380 TI - Pathogenesis of median facial clefts in mice treated with methotrexate. AB - Methotrexate (MTX), administered as a single 20 mg/kg intraperitoneal dose to C57Bl/6J mice on their 9th day of pregnancy results in high incidences of median facial clefts in the surviving gestational-day-18 fetuses. We have shown the presence of dilated and congested blood vessels in the frontonasal prominences (FNP) of embryos from treated mothers as early as 3 hours following drug administration. Within 24 hours, large vascular blebs are located in the FNP and the neural tubes appear somewhat distended. By 32 hours after treatment, distention of the neural tube is marked while blebs have become less evident. Subsequent to these changes, FNP mesenchymal deficiency as well as neural tube distention lead to the formation of median facial clefts. It is hypothesized that, as with a number of other teratogenic agents (especially hypoxia), initial fluid imbalance is the primary teratogenic insult. PMID- 3672381 TI - Neuronal degeneration caused by ethylenethiourea in neuronal monocell layers in vitro and in fetal rat brain in vivo. AB - The monocell layers, containing a mixture of neuronal and non-neuronal (primarily glial) cells, were obtained by growing cells dissociated from trypsinized fetal brains of 19-day pregnant rats under optimum conditions. Ethylenethiourea (ETU), at greater than or equal to .5 mM concentrations, caused in monocell layers in vitro a necrosis of neuronal cells and a marked depression in the formation of neurites and fascicles without any noticeable change in the non-neuronal cells. In the in vivo study, ETU orally administered as a single 30 or 45 mg/kg dose to rats on day 19 of pregnancy was found to induce necrosis of neuroblasts in the fetal CNS after 18 and 24 hours of dosing and a high incidence of hydrocephalus in postnatal pups at both doses. In an in vivo/in vitro experiment, rat fetal brains from 19-day pregnant dams which had previously been dosed with 80 or 120 mg ETU/kg were trypsinized and then dissociated into a cell suspension in a nutrient medium. The total number of viable cells in the suspension was significantly reduced compared to the number in the control suspension. The test suspension with cell density adjusted to that in the control suspension grew into monocell layers manifesting a marked decreased population of neuronal cells with a concomitantly increased population of non-neuronal cells. It was concluded that the target of ETU action was most likely the neuronal cells rather than the organization of nervous tissue per se. PMID- 3672382 TI - Evaluation of the embryotoxic potential of ten chemicals in the whole mouse embryo culture. AB - Ten widely different chemicals, actinomycin D, mithramycin, podophyllotoxin, vincristine sulfate, triaziquone, chlorambucil, mercaptopurine riboside, methyl mercaptopurine riboside, dimethylsulfoxide, and L-lysine were tested in the whole mouse embryo culture system. The highest concentration was always the concentration that induced 100% lethality (ELC100). The lowest concentration varied from 1/2 to 1/10 of the ELC100. The chemicals that had the most noxious effect on embryonic growth and differentiation were actinomycin D, triaziquone, and mercaptopurine riboside. Podophyllotoxin, methyl-mercaptopurine riboside, and L-lysine were the less embryotoxic. As a whole, no significant discrepancies were observed between the results and the teratological data obtained from the literature. These observations support the assumption that the whole murine embryo culture system can give valuable information on the teratogenicity of chemicals. PMID- 3672383 TI - Child sexual abuse: recognition and response. PMID- 3672384 TI - The treatment of obstructive sleep apnea. PMID- 3672385 TI - Spontaneous rupture of the distal esophagus--Boerhaave's syndrome. PMID- 3672386 TI - Zinc deficiency in a breast-fed infant. PMID- 3672387 TI - Reye's syndrome and juvenile rheumatoid arthritis: a case report in Texas. PMID- 3672388 TI - Child sexual abuse. PMID- 3672389 TI - Senator Bentsen on catastrophic coverage. PMID- 3672390 TI - Legislature adds new life to organ donation, transplantation. PMID- 3672391 TI - Teenage childbearing trends in Texas. PMID- 3672393 TI - Texas Cancer Plan designed to control cancer. PMID- 3672392 TI - Postconcussive syndrome: an overview. PMID- 3672395 TI - Physician deaths: an analysis of the JAMA obituaries. PMID- 3672394 TI - Priapism--a medical emergency. PMID- 3672396 TI - Texas Cancer Plan: current profile and future directions. PMID- 3672397 TI - Wrap-up, Part II: 70th legislature postmortem. PMID- 3672398 TI - "Mbotay, pasi wapi?" ("Hello, where does it hurt?"). PMID- 3672400 TI - Techniques for improving your practice development. PMID- 3672399 TI - Peer review update--new tools and requirements. PMID- 3672401 TI - Oncology guidelines report. Legislative Task Force on Cancer in Texas. PMID- 3672402 TI - Urologic cancer. Urologic Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672403 TI - Pediatric cancers. Pediatric Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672404 TI - Head and neck cancer. Head and Neck Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672405 TI - Colorectal cancer. Colorectal Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672406 TI - Gynecologic cancer. Gynecologic Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672407 TI - Hematology-oncology. Hematology-Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672408 TI - Lung cancer. Lung Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672409 TI - Breast cancer. Breast Oncology Workgroup, Legislative Task Force on Cancer in Texas. PMID- 3672410 TI - [Self medication in Switzerland]. PMID- 3672411 TI - [Drug treatment of hyperlipidemia]. PMID- 3672412 TI - [Choice of cardiac antiarrhythmia agents]. PMID- 3672413 TI - [Active instruction in small groups adapted to patients with intermittent claudication]. PMID- 3672414 TI - [Indications for surgical reconstruction in arterial occlusive diseases of the lower limbs]. PMID- 3672415 TI - [Outcome after major amputation of the lower limb in patients with vascular diseases]. PMID- 3672416 TI - [Aneurysms of the abdominal aorta]. PMID- 3672417 TI - [The diabetic foot from the surgical viewpoint. I. General medicine viewpoints]. PMID- 3672418 TI - Electroimmunochemical characterization of endothelial cell proteins: antigenic relationship with platelet and erythrocyte membrane proteins. AB - Human endothelial cells isolated from umbilical cords and cultured in primary cultures were solubilized in Triton X-100 and examined by crossed immunoelectrophoresis using rabbit antiserum against endothelial cells. Endogeneous labelling of the endothelial cell proteins with 35S-methionine or 14C mannose followed by crossed immunoelectrophoresis and autoradiography revealed about 30 or 8 immunoprecipitates, respectively. Antigenic relationship between endothelial cell proteins and proteins in human platelets or erythrocyte membranes was demonstrated by use of the corresponding antisera and by antigen addition experiments. One of the endothelial cell proteins cross-reacted with antiserum against erythrocyte membranes and showed a partial antigenic identity reaction with the band 3 protein complex of erythrocyte membranes. The same protein showed antigenic relationship also with a platelet protein. In addition, endothelial cells contain at least 7 proteins antigenically related to platelet proteins, of which at least 5 were labelled with 14C-mannose and thus were glycoproteins. Three of these glycoproteins were antigenically related to proteins from isolated platelet membranes and three were related to the release products obtained after thrombin treatment of platelets. The present study demonstrated numerous platelet and endothelial cell proteins that were antigenically related, more than previously anticipated. PMID- 3672419 TI - Identification of a glycoprotein III a dimer in polyacrylamide gel separations of human platelet membranes. AB - Membrane glycoproteins IIb and IIIa play a major role in human blood platelet aggregation. The absence or the severe reduction of these two membrane glycoproteins, as observed in platelets of Glanzmann's thrombasthenic patients, is related to a lack of platelet aggregation. Separation of Glanzmann's thrombasthenic platelet samples by two-dimensional polyacrylamide O'Farrell gels show the absence of a high and several low molecular mass glycoproteins, in addition to the loss of glycoproteins IIb and IIIa (McGregor J. L. et al. Eur. J. Biochem. 1981; 116: 379-388). The aim of this study was to identify the nature of the high molecular mass component, absent in thrombasthenic platelets. A high molecular mass glycoprotein (200 kDa), present in two-dimensional SDS polyacrylamide O-Farrell gel separations, was recognized by a monoclonal antibody (MP37) directed against glycoprotein IIIa. Moreover, the tryptic peptide map of this high molecular mass glycoprotein was nearly identical to that of glycoprotein IIIa. These results indicate that this high molecular mass glycoprotein present in SDS-polyacrylamide gels is a dimer of glycoprotein IIIa. This work raises the possibility that the high molecular mass glycoprotein, absent in two-dimensional O'Farrell gel separations of thrombasthenic platelets, is a dimer of glycoprotein IIIa. PMID- 3672420 TI - The basement membrane underlying the vascular endothelium is not thrombogenic: in vivo and in vitro studies with rabbit and human tissue. AB - Studies examining the interaction of platelets with exposed subendothelium in vivo have reported conflicting results. To examine possible explanations for the apparently discrepant findings, we measured the platelet reactivity of subendothelium prepared by a number of methods both in vivo and in vitro. In addition, we examined the possibility that 13-hydroxyoctadecadinoic acid (13 HODE), an endothelial cell-derived chemorepellant, modulates the reactivity of the subendothelium to platelets. In vivo, the subendothelium of segments of rabbit carotid arteries was exposed by removing the endothelial cells by air perfusion or by balloon catheter stripping. Platelet accumulation onto the de endothelialized segments was assessed by 3H-radioactivity uptake, using 3H adenine-labelled platelets, and by scanning electron microscopy. In vitro, 3H adenine-labelled platelet adhesion was measured onto plain plastic discs and onto plastic discs coated with the following purified basement membrane components: collagens type I, III, IV, V, laminin, or fibronectin. In addition, 3H-adenine labelled platelet adhesion was measured onto plastic discs covered with human endothelial cells or onto the basement membrane underlying the endothelial cells. In vivo, there was marked 3H-platelet accumulation onto the balloon catheter carotid arteries one hour after injury. In contrast, there was no platelet accumulation onto the subendothelium of carotid arteries de-endothelialized by air perfusion. These differences were confirmed by scanning electron microscopy. Transmission electron microscopic examination demonstrated that the extracellular matrix was intact following the air perfusion injury whereas the majority of it was removed by the balloon catheter injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3672421 TI - Plasma kallikrein-kinin system in patients with uncomplicated sepsis and septic shock--comparison with cardiogenic shock. AB - Alterations of the kallikrein-kinin system consistent with activation and increased consumption have been reported in septic patients and it has been suggested that this activation could contribute to the development of septic shock. The aim of this work was to confirm these alterations in septic patients and to investigate the possible existence of similar changes in subjects developing cardiogenic shock secondary to myocardial infarction as a model of non septic shock. Patients with septic shock, especially in fatal cases, showed a highly significant decrease in levels of factor XII, prekallikrein, high molecular weight kininogen (HMW-kininogen), alpha 2-macroglobulin (alpha 2-M) and antithrombin III (AT-III). C1-esterase inhibitor (C1-INH) activity was increased in uncomplicated sepsis but came back to normal or was slightly decreased in septic shock. Components and inhibitors of the kallikrein-kinin system were within normal limits in patients with cardiogenic shock. Our findings support the idea of a contribution of the kallikrein-kinin system to the development of septic shock though this system does not seem to play a significant role in the pathogenesis of cardiogenic shock or seem to be altered as a consequence of it. PMID- 3672422 TI - The platelet volume distribution: a signature of the prethrombotic state in coronary heart disease? AB - A coronary care unit population of 175 consecutive patients was studied. A clinical diagnosis of acute myocardial infarction was made in 103 cases (MI group) while 72 had chest pain, ECG indications of myocardial ischaemia, but no other clinical signs of acute myocardial infarction (control group). Based on bivariate Gaussian statistics the MI group could be divided in two groups, with respect to the platelet parameters of count and volume. The majority (65%) had large mean platelet volume and low count, while the remainder were indistinguishable from the control group. Patients with a large mean platelet volume also had significantly different volume distributions when assessed for volume dispersion, asymmetry and convexity. It is argued that this platelet volume distribution provides a signature for the prethrombotic state in ischaemic heart disease. Identification of such a platelet signature in a patient with coronary artery disease may allow appropriate prophylactic action to be taken and reduce the risk of subsequent acute myocardial infarction. PMID- 3672423 TI - The use of monoclonal antibodies to human platelet membrane glycoprotein IIb-IIIa to quantitate platelet deposition on artificial surfaces. AB - A new technique is described to quantitate platelet deposition in vitro on artificial surfaces, based on a surface phase radioimmunoassay using the monoclonal antibody 6C9, directed specifically against the membrane glycoprotein complex IIb-IIIa of human platelets. Results correlate in linear fashion with those obtained using 111Indium labeled platelets. The method offers particular advantages for the measurement of platelet deposition in whole blood, since platelet separation, washing and labeling procedures are eliminated, together with the ensuing possible selection of platelet populations. In vitro perfusion is performed in glass capillaries of precisely defined diameter (0.80 or 0.56 mm i.d.). Blood flow is laminar and accurately controlled over wall shear rates ranging from venous to capillary (50-4,000 s-1). Using glass capillaries precoated with purified human albumin or fibrinogen or bovine collagen, platelet deposition from suspensions of washed human platelets in Tyrode's-albumin buffer in the presence of a 40% hematocrit is (platelets/mm2): 11,000 (albumin), 78,000 (fibrinogen) and 306,000 (collagen) after 5 min perfusion at 2,000 s-1. In heparin, citrate or hirudin anticoagulated whole blood, surfaces are passivated, probably by albumin adsorption from plasma (platelets/mm2): 400 (albumin), 3,600 (fibrinogen) and 48,000 (collagen) after 5 min perfusion in the presence of 13 mM citrate. PMID- 3672424 TI - The response of megakaryocytes with processes to thrombin. AB - The response of megakaryocytes to thrombin (1-10 U/ml) has been examined by time lapse cinemicrography and electron microscopy. The study was confined to mature megakaryocytes which had developed processes following incubation in vitro. The initial response of all cells was to undergo retraction of processes, behaviour thought to be linked with the depolymerization of microtubules which extend longitudinally through the processes. The majority of cells completely withdrew their processes, but about 30% responded differently and underwent only limited retraction, followed by secretion. Analysis of time-lapse film showed that processes from the latter group of cells had formed attachments with the coverslip prior to exposure to thrombin. Within the partially retracted processes of these cells, secretory granules were found to be clustered centripetally and enveloped by a microfilamentous structure in the form of a cylinder. Vacuoles appeared, some of which were located outside the microfilamentous structure. Microtubules were present, but many appeared disorientated. The shape of the microfilamentous structure suggests that the cytoplasm is not organized into putative platelets at the time of process formation. PMID- 3672425 TI - Increased aggregation and secretion responses of human platelets when loaded with the calcium fluorescent probes quin2 and fura-2. AB - Incorporation into human platelets of the calcium fluorescent indicators quin2 or fura-2 at low concentrations used to measure intracellular free calcium leads to the potentiation of the effects of agonists on platelets. This was shown by increased aggregatory and secretory responses of quin2 or fura-2 loaded platelets after stimulation with ADP, PAF and with low concentrations of thrombin, collagen, the endoperoxide analog U-46619 and the calcium ionophore A 23187. Quin2 and fura-2 mediated platelet sensitisation could be due to altered arachidonic acid metabolism since it was inhibited by prior treatment with the cyclooxygenase inhibitor acetylsalicylate. In contrast, platelets loaded with higher concentrations of calcium chelators exhibited diminished aggregation responses to all aggregating agents. This latter effect was accompanied by increased fluidity of the platelet plasma membrane bilayer and by the exposure of a new pool of membranes to the outer surface of platelets, as monitored with trimethyl-ammonium-diphenylhexatriene (TMA-DPH) in platelets loaded with the non fluorescent calcium probe analog MAPT. In contrast, low concentrations of quin2 did not potentiate shape change of platelets activated with ADP. Thus, shape change and aggregation can be influenced separately by intracellular Ca2+ chelators. We conclude that platelet responses are altered by the incorporation of intracellular calcium chelators at concentrations used to monitor intracellular calcium changes. PMID- 3672426 TI - Effect of dipyridamole on spontaneous platelet aggregation in whole blood decreases with the time after venepuncture: evidence for the role of ADP. AB - Spontaneous platelet aggregation (SPA) was studied in human whole blood at 3, 5, 10, 20, 30, 40, and 60 minutes after venepuncture. Using a whole blood platelet counter, SPA was quantified by measuring the fall in single platelet count upon rollermixing aliquots of citrated blood at 37 degrees C. The extent of SPA increased with the time after venepuncture, with a correlation coefficient of 0.819. The inhibitory effect of dipyridamole (Dipy) on SPA was studied: (a) 10 microM at each time interval; (b) 0.5-100 microM at 3 and 30 minutes and (c) 15 microM in combination with 100 microM adenosine, 8 microM 2-chloroadenosine (2Clad, an ADP receptor blocker) and 50 microM aspirin. There was a rapid decrease in the inhibitory effect of Dipy with the time after venepuncture; the correlation coefficient was -0.533. At all the concentrations studied, Dipy was more effective at 3 minutes than at 30 minutes after venepuncture. A combination of Dipy with adenosine, 2ClAd or aspirin was a more effective inhibitor of SPA than either drug alone. However, when 15 microM Dipy and 10 microM Ad were added together, the inhibitory effect of Dipy was not increased significantly, suggesting that Dipy inhibits platelet aggregation independent of Ad. The increase in SPA with the time after venepuncture was abolished when blood was taken directly into the anticoagulant containing 5 microM 2ClAd. It is suggested that ADP released from the red blood cells is responsible for the increased platelet aggregability with the time after venepuncture and makes a serious contribution to the artifacts of in vitro platelet function studies. PMID- 3672427 TI - Possible role of fibrinogen in the aggregation of white blood cells. AB - In order to verify whether leukocyte aggregation correlated with aggregation of other cellular elements during inflammation, we examined the state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood and red cell aggregation. Correlation was found to be significant as was the correlation between LAA and fibrinogen, and with the fibrin/fibrinogen degradation products concentration during various inflammatory states. In vitro leukocyte aggregation was decreased when the cells were suspended in autologous heat defibrinogenated plasma as compared to cells suspended in autologous native plasma. Heat aggregated fibrinogen but not native fibrinogen caused leukocyte aggregation in vitro. Finally, Arvin defibrinogenation in rabbits reduced the state of LAA in endotoxinemic rabbits. Integrating all this information, we assume that fibrinogen participates not only in the aggregation phenomena of red cells and platelets, but also in those of leukocytes. PMID- 3672428 TI - Relationship between fibrinopeptide A and fibrinogen/fibrin fragment E in thromboembolism, DIC and various non-thromboembolic diseases. AB - Increased fibrinopeptide A (FPA) levels have been reported in various non thrombotic disorders, including cancer, acute myocardial infarction, liver cirrhosis and collagen vascular diseases. To investigate the significance of these findings, the present study combined the radioimmunoassay of FPA with that of fibrinogen/fibrin degradation fragment E (FgE) in the aforementioned disorders and compared the results with those observed in healthy subjects as well as in patients with thromboembolism and overt disseminated intravascular coagulation (DIC). Mean FPA and FgE in malignancy were 6.3 and 305 ng/ml, in myocardial infarction 5.6 and 98 ng/ml, in liver cirrhosis 2.7 and 132 ng/ml and in collagen vascular diseases 5.6 and 142 ng/ml. All these values were significantly higher than in healthy controls (mean FPA 1.6 ng/ml, mean FgE 49 ng/ml) but significantly lower than in thromboembolism (mean FPA 10.7 ng/ml, mean FgE 639 ng/ml). and DIC (mean FPA 22.0 ng/ml, mean FgE 1041 ng/ml). The overall correlation between FPA and FgE was highly significant. However, different disorders showed peculiar patterns in FPA, FgE and fibrinogen levels. In malignancy, a definite increase of FPA, FgE and plasma fibrinogen levels was observed. This finding probably indicates a compensated state of (intra- or extravascular) fibrin formation and lysis. Acute myocardial infarction was characterized by a high FPA to FgE ratio, which is interpreted to reflect acute thrombin generation and fibrin formation. FPA in cirrhosis was only marginally elevated with most single values within the normal range, indicating that intravascular coagulation was infrequent and unimportant in quantitative terms. PMID- 3672429 TI - Antithrombotic and bleeding effects of a new synthetic direct thrombin inhibitor and of standard heparin in the rabbit. AB - This study reports on the anticoagulant, antithrombotic and bleeding effects of a new synthetic direct thrombin inhibitor (SDTI) in comparison with standard heparin (SH). The anticoagulant effect was determined with the thrombin clotting time (TCT) and the activated partial thromboplastin time (APTT). SDTI was more potent than SH in prolonging the TCT, but as potent as SH in prolonging the APTT. The antithrombotic effect was determined using a modified Wessler model in the rabbit, either 30 min after a continuous IV infusion of increasing doses or at various times after a single SC injection (20 mg/kg). After continuous IV infusion of 187 micrograms/kg/h of SDTI and of 60 micrograms/kg/h of SH, significant thrombus prevention effects were obtained (59 and 57% respectively). Increasing the dose of SDTI up to 3000 micrograms/kg/h did not significantly improve the antithrombotic effect. After SC injection, a significant antithrombotic effect was observed for 12 h with SDTI but for more than 24 h with SH. The bleeding effect was studied using the rabbit ear model 15 min after a continuous infusion of 7.5 and 15 mg/kg/h: the amounts of blood loss were dose dependent and comparable for SDTI and SH. These studies also indicated that SDTI possesses a considerable shorter half-life in comparison with SH. Accordingly, the ex vivo concentrations generated after continuous IV infusion or SC injection of the same dose were higher for SH than for the SDTI. PMID- 3672430 TI - Platelet adhesion to native collagens involves proteoglycans and may be a two step process. AB - Adhesion of rat blood platelets to native rat tail collagen fibrils was studied in the electron microscope under conditions that preserved collagen-associated proteoglycans (CAPG). The CAPG molecules were aligned in chain-like configurations that encircled the fibrils with a 65 nm period; they appeared to coat the fibrils completely and extended 60-100 nm away from the fibril. The initial platelet-fibril contact occurred between the platelet glycocalyx and the CAPG of the fibrils i.e. between two surfaces with net-negative charges. When close contact was established between the fibril surface proper and the platelet membrane, CAPG were not identified in the area of contact, and the collagen platelet distance was reduced to a approximately 10-12 nm wide gap traversed by delicate links in register with fibril periodicities. PMID- 3672431 TI - Acute cardiovascular collapse during intravenous vitamin K1 injection. PMID- 3672432 TI - Concurrent hepatitis B, delta and human immunodeficiency virus infection in hemophiliacs. PMID- 3672433 TI - Dermatan sulfate in pharmaceutical heparins. PMID- 3672434 TI - Acquired alpha-2 anti-plasmin deficiency secondary to amyloidosis. PMID- 3672435 TI - Unusual properties of platelet shape in coronary and cerebral artery disease. AB - Platelet shape was examined in freshly fixed whole blood, using phase contrast microscopy, from 7 patients post-myocardial infarction, 9 patients undergoing elective angiography for the investigation of angina, and 17 patients with stroke. Platelet shape was abnormal in 29/33 patients and in 20 of them the distribution of platelet shape did not resemble that produced by known platelet activators, by venipuncture techniques known to produce platelet activation, nor by shearing platelet-rich plasma. In particular, the proportion of spherical platelets is too high relative to the proportion of smooth discoid shaped platelets. Addition of platelet-poor plasma from a patient post-myocardial infarction to normal platelet-rich plasma did not reproduce the abnormality in platelet shape. In contrast, for patients post-myocardial infarction platelet shape was normal in platelet-rich plasma, but the platelets were hypersensitive to ADP-induced aggregation. Incubation of citrated whole blood at 37 degrees C resulted in an incomplete disappearance of the spherical platelets suggesting that the abnormal distribution of platelet shape consists of both a reversible and a more persistent abnormality. The reversible portion of the platelet shape abnormality seen in patients with stroke and coronary artery disease may be related to venipuncture-induced platelet activation; however, the nature of the persistent abnormality in platelet shape is presently unknown. PMID- 3672436 TI - Interaction of antithrombin III and thrombin-antithrombin III complex with cultured aortic endothelial cells. AB - The binding of antithrombin III, thrombin, thrombin-antithrombin III complex to endothelial cells was investigated. While the rate of the binding of thrombin to these cells was very rapid, that of antithrombin III was relatively slow and the thrombin-antithrombin III complex was intermediate. Binding kinetics indicated that antithrombin III, like thrombin, showed high affinity to endothelial cells; with a Kd of 3 X 10(-8) M and with 5 X 10(4) binding sites per cell. The dissociation of the inhibitor molecule was also rapid, i.e., approximately 70% bound antithrombin III was released in 2 minutes. Heparin, in a 100-fold molar excess to antithrombin III, or the modification of lysine residues of the inhibitor involved in the interaction with heparin, did not influence the association of antithrombin III with endothelial cells. In addition, antithrombin III did not compete with thrombin blocked in its active center for binding to endothelial cells. It is suggested that the binding sites of endothelial cells are different for thrombin and antithrombin III, and antithrombin III does not bind to these cells through its heparin binding domain. PMID- 3672437 TI - Changes in fibrinolysis in the intensive care patient. AB - Critically ill patients have been described as having blood coagulation abnormalities that predispose to bleeding and thrombosis. We have studied plasminogen activators, alpha 2-antiplasmin, X-oligomers fibrin fragments, fibronectin, antithrombin III, fibrinogen, platelets, kaolin-cephalin clotting time and prothrombin time on admission to the intensive care unit and sequentially after 24 and 48 hours in 39 adult patients: ARDS (n = 6), trauma (n = 12), sepsis (n = 8) and a miscellanea (n = 13). A decrease in plasminogen activators associated with an increase in X-oligomers, the earliest form of cross linked fibrin degradation products, indicate that fibrin deposition and the consumption of components of fibrinolysis is a widespread condition in the ICU patients. Low fibronectin levels were related to prognosis. These findings suggest that critically ill patients must be evaluated in respect to fibrinolysis and supported when necessary with prophylactic treatment. PMID- 3672438 TI - Heparin degradation in the endothelial cells. AB - We analyzed the molecular weight distribution of (125I) heparin fractions bound or internalized by human endothelial cells, using gel permeation chromatography. Our results showed that high molecular weight heparin chains are selectively bound and internalized by endothelial cells. Endocytosis is followed by depolymerization of internalized heparin. Chloroquine prevented depolymerization of internalized heparin, indicating that lysosomal enzymes are involved in this process. Degradation of high molecular weight heparin chains by endothelial cells may contribute to the inactivation of the drug, especially as concerns the antifactor IIa activity. PMID- 3672439 TI - Effect of leupeptin on platelet aggregation, fibrin formation and amidolysis induced by thrombin. PMID- 3672440 TI - [Do medical students receive sufficient training in resuscitation, emergency medicine and intensive care?]. PMID- 3672441 TI - [Core curriculum in practical procedures in emergency medicine. Have local hospitals the responsibility for both undergraduate and graduate medical education?]. PMID- 3672442 TI - [Assisted circulation after open heart surgery. Temporary, closed-chest ventricular bypass]. PMID- 3672443 TI - [Spontaneous pneumothorax. Drainage therapy]. PMID- 3672444 TI - [Spontaneous pneumothorax. Symptoms with and without chronic obstructive lung disease]. PMID- 3672446 TI - [Chlamydia trachomatis. Screening of pregnant women]. PMID- 3672445 TI - [Chlamydia trachomatis in induced abortion]. PMID- 3672447 TI - [Self-monitoring of peak expiratory flow (PEF)]. PMID- 3672448 TI - [A psychiatric information system 1983-1985. Patients registered by psychiatrists in private practice and clinical psychologists in Oslo]. PMID- 3672449 TI - [Registration of gas flow through a thoracic drain. A new method for treating pneumothorax]. PMID- 3672450 TI - [Radial keratotomy]. PMID- 3672451 TI - [Violent patients in a nursing home]. PMID- 3672452 TI - [Severe head injuries. Experiences from Vestfold 1982-85]. PMID- 3672453 TI - [Soccer injuries and artificial turf]. PMID- 3672454 TI - [The hypermobility syndrome]. PMID- 3672455 TI - [Group therapy in a psychiatric emergency department]. PMID- 3672456 TI - [Acute pancreatitis. Treatment with continuous infusion of marcaine]. PMID- 3672457 TI - [Is spontaneous regression of cancer dependent on immunology?]. PMID- 3672458 TI - [Dry chemistry in primary health service]. PMID- 3672459 TI - [Practical management of head injuries]. PMID- 3672460 TI - [Patients with alcohol problems. Early identification and intervention in general practice]. PMID- 3672461 TI - [Health and fertility in relation to production. Stress and its interaction with resistance]. AB - Stressors, environmental factors which stress animals, can influence the resistance capability of the animals. Adrenal hormones play a significant role, through the modulating of many functions of leucocytes and immune competent cells by glucocorticosteroids. There are indications that immune competent cells can produce a number of hormone-like substances. It is suggested that there is a complex relationship between the immune and endocrine systems. It may later appear that both of these must be considered as parts of an integrated system. PMID- 3672462 TI - [Pathogen supply modified by environment and stage of production]. AB - Animal health status depends on the capability of the animals to resist the infection pressure of micro-organisms in the environment. This balance between resistance and infection pressure is very strongly influenced by farm and housing conditions. The infection pressure in the environment of the pigs is greatly reduced by good hygiene in the supply of feed and water, employment of the 'all in - all out' system with effective cleaning and disinfection between groups, and constant air change related to the age and weight of the animals. The resistance of the pigs is favourably influenced by a good vaccination strategy and a comfortable housing climate. Disease outbreaks are clearly reduced in houses with small separated compartments, consistent use of the 'all in-all out' system, and very high standard of climate control directed towards the requirements of the animals in each compartment. PMID- 3672463 TI - [What are the cause and therapy of ear necrosis in swine?]. PMID- 3672465 TI - [Behavior and welfare of veal calves in individual crates and in group pens]. AB - Criticisms passed by society regarding the welfare of veal calves in individual crates induced the development of an alternative, more friendly to animals: housing in groups of five calves fed from buckets and given small amounts of roughage. The pros and cons of individual and group housing with regard to the behaviour of the calves are discussed in the present paper, and particular attention is paid to 'preputial sucking', an important behavioural problem in group pens. In addition, a number of data on production aspects in each housing system is presented. PMID- 3672464 TI - [Wound healing and wound irrigation in cesarean section of cattle]. AB - Calves were delivered by Caesarean section in 128 cases during the early months of 1984. All animals were allocated alternately to a trial group and a group of controls. When the peritoneum and transverse muscle had been sutured, the wounds of the animals in the trial group were irrigated and washed with 300 ml. of Betadine (10 per cent of PVP-iodine in water). This was followed by closure of the wound. The animals of the group of controls were not treated. The procedure was performed in ninety-four primiparae (73 per cent) and thirty-four multiparae (27 per cent). The indication for Caesarean section consisted in fetal oversize in 119 cases (93 per cent). Eight calves (6 per cent) were stillborn or died immediately post partum. The proportion of animals in which the placentae were retained, was 9 per cent. Two animals died from peritonitis and intra-abdominal haemorrhage respectively. Irrigation of the wound did not have any effect on the number of wound infections (Table 3). Wound infection occurred in nineteen animals (15 per cent). The operations were performed by six veterinary surgeons (Table 4). The trial group and group of controls treated by each veterinarian did not differ essentially as regards wound healing. PMID- 3672466 TI - [Identification and prevention of meat poisoning]. AB - In this contribution to a series 'Papers of Yesterday and Today' a retrospective review of developments in the identification and control of meat 'poisoning' defined as infections and intoxications following the ingestion of bacteriologically unsound meat and meat products is presented. Starting from two classical Dutch papers, viz. by H. J. H. Stempel (1891) and K. Hoefnagel (1899) illustrating the knowledge of meat 'poisoning' acquired in the nineties of the 19th century, developments in the field of bacteriological research on meats and the resulting efforts to manage meat 'poisoning' are summarised. Attention is paid to the role of Dutch veterinarians in investigations on the aetiology of meat infections resulting in the adoption of legal meat inspection in 1922 and the ensuing reduction in the occurrence of mass outbreaks of meat poisoning. However, despite marked improvement of the standard of hygiene in the food industry in general and expert monitoring of meat production lines by veterinarians in particular, infections and intoxications transmitted by meat and meat products are still quite prevalent. Essentially, their management can only be achieved by strict adherence to Good Manufacturing Practices (GMP) throughout animal husbandry, slaughter, distribution and storage, termed longitudinally integrated safety assurance. Professional monitoring by an up-to-date meat inspection system, however, continues to be indispensable in the prevention of food-borne infections and intoxications. Some recommendations are made for effective intervention in the infection cycle of food-transmitted pathogens originating from the high infection pressure on slaughter lines, resulting from contamination acquired at previous stages of the animal production chain. PMID- 3672467 TI - [Health and fertility in relation to production. Climate and health in young farm animals]. AB - In animals, the climatic factor of environmental temperature causes specific physiological adaptations dependant on the nature and duration of the 'stressor'. The absolute temperature appears to be of less importance in influencing animal health than the extent of deviation from the thermoneutral zone. The difficulty experienced by animals in maintaining thermoregulation affects the immunological response and possibly also resistance. In the literature, the duration and type of changes involved are not always clearly stated. This may explain why the reactions to cold and warmth are not always identical. Also, the reactions which partly influence resistance are sometimes not compatible with climatic stress. Further research is needed for improved understanding of the relationship between the resistance of the animal and the duration and extent of climatic stress. PMID- 3672468 TI - [Housing and health of farm animals]. AB - Data on the relationship between housing systems and health in farm animals are relatively scarce. In dairy cattle and poultry, for which special housing systems are dominant in the Netherlands, no important new figures are available. In veal calves, the group housing system is being investigated. Preliminary results indicate that there are many problems in the first 6 to 8 weeks. More research has been done on pigs. It is now clear that the floor system is important not only with respect to leg and claw problems; the morbidity and mortality of pigs in pens with (partly) slatted floors is higher than in the Danish (straw) systems. PMID- 3672469 TI - [Stomach dilatation-stomach torsion syndrome: a 'new' clinical picture in sows?]. AB - Increased mortality occurred among sows in a pig-breeding unit during a few months. It was concluded that gastric torsion was one of the causes of death. This disease is becoming increasingly important in large intensive units, also in the Netherlands. Little is so far known of the origin of this syndrome. The feeding system and the quality of the food (fine-grained feed, contamination by toxic agents) could be a factor in the pathogenesis. Closer investigation of this economic problem would appear to be advisable. PMID- 3672470 TI - [Fertility in relation to production in dairy cattle]. AB - A review of the relationship between fertility of production in dairy cattle is presented. At farm level almost no relationship was found, except that farms in the lowest production class had lower fertility rates. Within farms there was a weak antagonistic relationship. Better dairy cows were first presented slightly later and needed more inseminations to achieve pregnancy. The genetic capacities for production and fertility appear, especially in the first lactation, to be negatively related. In older animals, the relationship was absent or even slightly positive. Animals with a lower productive capacity are generally culled earlier for fertility problems than high-producing animals. Thus a negative relationship between production and fertility can always be established. In selection experiments on milk production, no adverse effects on the fertility of young animals were observed. The effects at older ages were negative, but small. PMID- 3672471 TI - [An example of BVD infection from practice]. PMID- 3672472 TI - [Coughing cows at pasture]. PMID- 3672473 TI - [The development of our professional society in increasing quality standards for animal products]. PMID- 3672474 TI - [Breeding and managing of large-hindquarter cattle]. PMID- 3672475 TI - [Studies in the field of tick-borne blood parasites]. AB - A review of 'piroplasmosis' (a collective name tick-borne protozoan forms of disease of the blood (babesiasis, theileriasis) as well as rickettsial forms (anaplasmosis), written by De Blieck and published in 1916, is compared with the present state of our knowledge. Considerable progress has been made in classifying the causative agents. Moreover, the situation in the Netherlands has become much clearer. However, as regards the situation in the tropics, progress in control is rather limited and these forms of disease continue to be of major economic importance. The use of ascaricides is becoming increasingly confronted with problems and, in particular conditions, the use of cattle characterised by a considerable genetically acquired ability to produce an immune response to ticks is growing. In addition, it is hoped that it will be possible to immunise animals both against ticks and against tick-borne disease using characterised antigens produced by modern biotechnological methods in the future. Finally, a warning note is sounded that the active role of the faculty of veterinary science in the field of tropical veterinary medicine could well be reduced in the near future as a result of economies and changes of structure. PMID- 3672476 TI - [Lethal effects of various antimicrobial agents and clinically usable alternatives in rabbits and rodents]. AB - The lethal effects of antibiotics which may be observed in rabbits and some rodent species are reviewed. A selection of antibiotics and chemotherapeutic agents and their respective dosages are referred to, which may be used therapeutically in these animals. Suggestions are made for the treatment of enterocolitis induced by antibiotics in rabbits. PMID- 3672477 TI - [Fatal ovarian hemorrhage in 2 donor cows following embryo transplantation]. PMID- 3672478 TI - [Experimental dogs: a need for improvement in housing]. PMID- 3672479 TI - [A cat with recurrent hematuria]. PMID- 3672480 TI - [Veterinary Chief Inspection for Public Health. Rabies in bats]. PMID- 3672481 TI - [Specialization, a desired development?]. PMID- 3672482 TI - [Pediatric anesthesiology]. AB - Paediatric anaesthesia varies from anaesthesia administered to the adult. No one would now doubt the value of paediatrics as a separate specialty- but what of its various branches? In the instance of anaesthesia it is believed that a very good case indeed can be made for a distinct specialty, because in paediatric anaesthesia the infant's needs are fundamentally different from those of the adult. It is not simply a question of adjusting doses or the parameters of ventilation to a scale related to weight or surface area. The anatomy, physiology, biochemistry, pharmacology and pathology of the infant generally and of the neonate in particular differ greatly from those of the adult. Each type of surgery has its special problems, and again these are different when applied to the infant. In this paper a few of the differences with their implications on anaesthetic practice are emphasized. Last but not least the psychological responses of infants and children of various ages to anaesthesia are explained. PMID- 3672483 TI - [Prenatal diagnosis and therapeutic intervention]. AB - Experience in fetal invasive therapeutic procedures is currently nearly entirely based on animal experimental research. Structural defects in the human fetus which are potentially amenable to intrauterine surgical treatment are obstructive uropathy, hydrocephaly and diaphragmatic hernia. The results from closed procedures such as shunting of urine or CNS fluid to the amniotic fluid compartment under ultrasound monitoring is as yet not very encouraging. This is partly determined by technical inadequacies, and partly due to insufficient information available on the possible presence of associated anomalies and functional aspects of the affected organ systems. The risks of invasive procedures for the mother and in particular the fetus must be weighed up against the advantages for the fetus if surgery has been successful. It seems that the development of open surgical procedures will determine the future of fetal surgery. PMID- 3672484 TI - [Craniofacial surgery]. AB - A craniofacial team is functioning since 15 years in Sophia's Children Hospital and Dijkzigt Hospital. An intensive-care unit and a anaesthesist specialised in children is imperative for proper functioning of the team. An overview of the most common Craniofacial malformation is given, the operative technique of craniosynostosis described and the complications discussed. PMID- 3672485 TI - [Developments in management of esophageal atresia]. AB - The results of treatment of oesophageal atresia show that attentiveness and knowledge of the referring paediatrician concerning diagnostics, preoperative care and transport, together with concentration of high-standard care and specific experience in centres for paediatric surgery, can lead to a substantial decrease in morbidity and mortality. Between 1955 and 1968 a total of 193 children have been operated for oesophageal atresia. Mortality has declined from 51% in the period 1955-1969 to 10% in the timespan 1980-1986. Mortality is almost solely determined by additional congenital malformations, in which congenital heartdefects form the major cause. Management of oesophageal atresia seems to have evolved to a routine-procedure. New trends in paediatric surgery pose new sorts of specific problems, that require attention. PMID- 3672486 TI - [Gastroesophageal reflux]. AB - Gastro-oesophageal reflux (GER) in children, causes sometimes aspecific symptoms in children. Not only in the case of regurgitation but also in respiratory problems or even in the 'near missed' - Sudden Infant Death Syndrome GER is to be considered. The most important method of investigation is pH-monitoring during 24 hours preceded by a barium meal and followed by endoscopy, in most cases. Operative treatment is necessary for a hiatal hernia, or after failure of conservative treatment of an oesophagitis. In mentally retarded children, who continue to vomit, a fundoplication can be necessary to improve general care. PMID- 3672487 TI - [Short bowel syndrome]. AB - The short bowel syndrome is a clinical picture, consisting of malabsorption and failure to thrive, in consequence of a resection of more than 50% of the small bowel, with or without resection of a part of the colon. The etiology, pathophysiology, treatment and natural history are discussed, as well as complications and ultimate prognosis. A review of the literature and own retrospective investigation prove, that after an extensive small bowel resection in the neonatal period, normal stools, growth and development can occur in 1-3 years. In the first, postoperative period however, these patients suffer from considerable malabsorption, deficiencies of vitamins and trace elements, as well as complications of total parenteral nutrition and recurrent infections. PMID- 3672488 TI - [Anorectal abnormalities]. AB - An insight in the genesis of anorectal abnormality, combined with a painstaking diagnostic examination leading to a justifiable, well-considered therapeutic procedure, may spell hope and better prospects to approximately 35 children that are born with this abnormality in The Netherlands each year. Subsequently, the function of the anorectoplasty has to be evaluated at regular check-ups. Coupled with a sound understanding of the defaecation mechanism, this should lead to uniformity in the treatment and sustenance of a child with anorectal abnormality, which will reduce the burden of this handicap for both parents and child to a minimum. PMID- 3672489 TI - Association of HLA-Bw65 with two major complotypes. AB - The association between the HLA-B14 subtypes Bw64 and Bw65 and complement allotypes (C2, Bf and C4) was investigated in both population and family studies. Bf, C4A and C4B allotyping was performed on 37 Bw64 and 35 Bw65 positive unrelated Welsh/English subjects. Sixteen HLA-Bw65 bearing haplotypes were characterized for HLA-ABC, DR and DQ antigens and complement allotypes, including C2. The findings of the population study suggested that the complement haplotype associated with Bw64 is BfS, C4A2, C4B2. The population and family studies revealed two major complement haplotypes associated with HLA-Bw65: (i) C2C, BfF, C4A3, C4A1 - often associated with HLA-A3, Cw8 and DRw13, and (ii) C2C, BfS, C4A2, C4B2 - often associated with HLA-Aw33, Cw8 and DR1 or with A28, Cw8 and DRw13. The HLA-Bw65 bearing haplotypes of three families carried a C4B2B1 duplication of the C4B locus. In these families three C4B gene products were identified in the Bw65 positive members using an anti-C4B monoclonal antibody. It is suggested that most, if not all, HLA-Bw65 bearing haplotypes may possess a C4B locus duplication. PMID- 3672490 TI - Immunization of normal human splenocytes in vitro to produce human monoclonal antibodies to cellular antigens. AB - We have obtained human monoclonal antibodies to polymorphic cell surface determinants by immunizing normal human splenecytomy in vitro to allogeneic cells. Splenocytes from young patients undergoing splenectomy secondary to traumatic injury are separated into T and B lymphocyte populations. The T lymphocytes are irradiated with 1500 rad to selectively inactivate T suppressors. Responder T and B cells are then recombined at a 1:1 ratio. Maximal IgM and IgG production is obtained when pokeweed mitogen and irradiated stimulator cells are added to the cultures. Stimulator cell specific antibody levels peak at day 7 of in vitro immunization, and fall thereafter. Fusion of the immunized splenocytes to a human fusion partner as early as day 4 results in hybridomas secreting antibodies to cellular antigens. Transformation by EBV, expansion and fusion of the immunized cell line also yield hybridomas secreting stimulator cell specific antibody. PMID- 3672491 TI - HLA-DR factors associated with postpartum hypothyroidism: an early manifestation of Hashimoto's thyroiditis? AB - Thirty-three Danish women selected from a prospective study of postpartum thyroiditis were HLA-DR typed. All women had positive titers of antimicrosomal antibodies, and 20 women developed thyroid dysfunction after delivery. DR5 and the phenotype 4.5 were significantly increased in the whole group (p less than 0.001) and strongly associated to hypothyroidism (p less than 0.01), whereas DR3 was insignificantly increased in thyrotoxic women. It is concluded that postpartum hypothyroidism is an autoimmune disorder and may be an early manifestation of Hashimoto's thyroiditis. PMID- 3672492 TI - Production of an HLA-DRw13 antibody in a DRw14 positive multiparous woman. AB - A lymphocytotoxic HLA-DR alloantiserum (Ma159) which reacts with DR7, DR5 and DRw13 positive lymphocytes is described. It was non-cytotoxic against 27 DRw14 positive subjects and was not absorbed by DRw14 positive cells. The antiserum was produced by pregnancy alone in a DR4, DRw14 positive woman whose husband possesses DR7 and DRw13. Absorption and titration studies suggested that the antiserum contains separate antibodies directed towards DR7, DRw13 and a determinant shared by DR5 and DRw13. The implications of finding a specific anti DRw13 antiserum and its production in a donor positive for the alternative subdivision of DRw6 are discussed. PMID- 3672493 TI - A genetic study of Behcet's disease in Taiwan Chinese. AB - The frequency of HLA-A, B and C antigen in 53 patients and HLA-DR, DQ and Dn antigen in 31 patients of Behcet's disease was studied. All patients were Chinese, and diagnosis was made according to the Japanese Research Committee on Behcet's disease. A significantly increased incidence of HLA-B51 (P less than 0.001) and a significantly decreased incidence of HLA-B16 (P less than 0.01) was found. No significant difference was found in HLA-DR, DQ and DN antigens. PMID- 3672495 TI - Absence of linkage between familial hypocalciuric hypercalcaemia and the major histocompatibility system. PMID- 3672494 TI - HLA and C4 in subacute sclerosing panencephalitis. AB - The frequencies of HLA-A, B, C, DR and DQ antigens were studied in 63 Japanese patients with subacute sclerosing panencephalitis (SSPE). The results could not confirm the statistical association between SSPE and HLA antigens. In addition, the allele frequencies of complement components C4, C2 and BF were determined in the 20 haplotypes with 10 unrelated SSPE patients. A significant association of C4A QO with SSPE in Caucasians was not found in Japanese. PMID- 3672496 TI - [Technological procedures in intensive care; nurse's role?]. PMID- 3672497 TI - [Primary health care: by all for all]. PMID- 3672498 TI - [This is how nurses can feel ... de-identification]. PMID- 3672499 TI - [Problems of nurses in the relationship with colleagues, physicians and patients]. PMID- 3672500 TI - [Work problems--role for nursing management]. PMID- 3672501 TI - [Health care and nursing in Japan]. PMID- 3672502 TI - [Medical information for nurses. Guillain-Barre syndrome]. PMID- 3672503 TI - A simple spectrophotometric method for the determination of thrombin activity. AB - The activity of thrombin in commercial preparations was measured by an easy, precise spectrophotometric method that allows determination of thrombin activity in dilute solutions more accurately than other methods hitherto used. The method can also be used to compare fibrinogen content in plasma samples. PMID- 3672504 TI - A spectrophotometric method for the standardization of thromboplastin clot promoting activity. AB - A simple spectrophotometric method for the quantitating of the clot promoting activity of thromboplastin in commercial preparations was developed. Thromboplastin activities were proportional to the maximum rate of clot formation. This was calculated from curves of absorption change during the coagulation of plasma coagulation control. The clot-promoting effects of thromboplastin in commercial preparations varied widely when assayed by this method. PMID- 3672505 TI - Daily variation of blood pressure in patients with Cushing's syndrome. AB - The circadian rhythm of blood pressure (BP) was compared between patients with Cushing's syndrome and those with essential hypertension. In patients with essential hypertension, clear nocturnal falls in systolic and diastolic BP and heart rate (HR) were observed, and there was a positive correlation between HR and systolic or diastolic BP. On the other hand, in patients with Cushing's syndrome, there was no nocturnal fall in BP and instead a rise in some cases. In all cases with Cushing's syndrome there was a nocturnal fall in HR, and consequently no significant correlation between HR and BP in these patients. The present results imply that the normal circadian rhythm of blood pressure may be regulated at least in part by the hypothalamo-pituitary-adrenal system. PMID- 3672506 TI - Pontine urine storage center in the dog. AB - Electrical stimulation of the presumptive pontine urine storage center, areas ventral to and/or lateral to the pontine micturition center, elicited an increase in threshold volume at which reflex micturition occurred in response to bladder filling with physiological saline, suggesting a facilitatory effect on the urine storage function. The electrolytic lesions made in the stimulated areas were histologically identified to distribute at the nucleus reticularis pontis oralis, Kolliker-Fuse nucleus and subcoeruleus. These nucleus seemed to work as a pontine urine storage center and to perform a reciprocal action with the pontine micturition center. PMID- 3672507 TI - Health care's future shock: an update. PMID- 3672508 TI - Pricing hospital services. PMID- 3672509 TI - Pricing hospital services. Developing a cost base for pricing. PMID- 3672510 TI - Pricing hospital services. Global pricing strategies. PMID- 3672511 TI - Pricing hospital services. Evaluating existing rate structures. PMID- 3672512 TI - Pricing surgical services. PMID- 3672513 TI - Pricing hospital services. Case study: procedure cost determination. PMID- 3672514 TI - The effect of immunosuppressants and adoptive transfer in monocrotaline pyrrole pneumotoxicity. AB - Monocrotaline pyrrole (MCTP) is a pyrrolizidine alkaloid that causes pulmonary vascular injury and pulmonary hypertension in rats. The lesions in lungs of MCTP treated rats are similar to those occurring in humans with primary pulmonary hypertension. Thus, the MCTP-treated rat is a good animal model for this disease. The mechanisms by which MCTP causes lung injury are unknown. The character of the pulmonary lesions and the delay in onset of the injury after a single low dose of MCTP suggest that immune mechanisms may be important in the pathogenesis. Accordingly, rats were treated with MCTP and the immunosuppressants antilymphocyte serum (ALS) or cyclosporin A (CyA). Neither ALS nor CyA completely protected rats from the injury due to MCTP. Several series of experiments also were undertaken to assess the effect of lymphocytes adoptively transferred from MCTP-treated donor rats into MCTP-treated recipient rats. Adoptive transfer of lymphocytes did not decrease the onset time of the injury or increase the severity of lesions due to MCTP in the recipients. These results indicate that immune mechanisms are probably not involved in MCTP-induced pulmonary injury. PMID- 3672515 TI - Kinetic constants for the inhibition of eel and rabbit brain acetylcholinesterase by some organophosphates and carbamates of military significance. AB - The kinetics of the inhibition of eel and rabbit brain acetylcholinesterase by a number of organophosphates and carbamates has been studied. Five organophosphates (tabun, sarin, soman, GF, and VX) and two carbamates (neostigmine and physostigmine) were used. Small but significant differences have been found between the two enzyme preparations in both the dissociation constant and the rate constants for the irreversible step. The values of k2 ranged from 0.56 to 1.08 sec-1 for the eel enzyme and 0.19 to 0.73 sec-1 for the rabbit enzyme. Kd varied from 0.3 to 24.5 microM for the eel and 0.3 to 9.3 microM for the rabbit enzyme. The similarity between the enzymes is remarkable considering the differences in the species of origin. PMID- 3672516 TI - Involvement of thromboxane in injury to isolated rat lungs perfused with phorbol myristate acetate in the presence and absence of neutrophils. AB - In a previous study, we demonstrated that a non-toxic concentration of phorbol myristate acetate (PMA) produced edema in isolated rat lungs which were coperfused with neutrophils (PMN). In this study, we examined whether prostaglandins or thromboxane were responsible for increases in pressure and/or edema in this preparation. In lungs perfused with PMA (14 ng/ml) and PMN (1 X 10(8], significantly greater amounts of thromboxane B2 (TxB2) and 6-keto prostaglandin F1 alpha (6-keto-PGF1 alpha) were produced than in controls. Relative lung weights and increases in perfusion pressure correlated with concentrations of TxB2 and 6-keto-PGF1 alpha that were produced. Indomethacin (10 microM) or Dazmegrel (10 microM) retarded the increase in perfusion pressure and prevented the increase in relative lung weight induced by PMA and PMN. When lungs were perfused with a high concentration of PMA (57 ng/ml) in the absence of added PMN, lungs also become edematous. Compared to controls, concentrations of TxB2 and 6-keto-PGF1 alpha were elevated in media collected from this preparation. As with lungs perfused with PMN and PMA, increases in pressure and relative weights of lungs perfused with PMA (57 ng/ml) correlated with the concentrations of TxB2 that were detected in perfusion media. Although indomethacin (10 microM) and Dazmegrel (50 microM) retarded the increase in perfusion pressure in this preparation, they only partially attenuated the increase in lung weight. These results suggest that, depending on the concentration, PMA can produce lung injury via different mechanisms. Thromboxane does not seem to be required for the genesis of edema induced by a high concentration of PMA in the absence of perfused neutrophils; however, it appears to play an obligatory role in the pathogenesis of edema induced by a low concentration of PMA in the presence of PMN. PMID- 3672517 TI - Electrophysiological changes in the primary sensory neuron following subchronic soman and sarin: alterations in sensory receptor function. AB - Cats were administered soman or sarin either in a single high dose (1 mg/kg) with pretreatment or in multiple sublethal doses to determine whether these potent organophosphorus agents could produce a delayed neurotoxicity and what, if any, pathophysiological changes occurred in peripheral sensory receptors. Neither soman nor sarin, when administered as a single high dose, produced a delayed neurotoxicity as observed behaviorally for up to 60 days. There were also no observable signs of delayed neurotoxicity when these agents were administered in multiple doses. Functional tests of proprioceptors and mechanoreceptors were performed on the cats which received multiple sublethal doses of either soman or sarin. It was found that the discharge rates of muscle spindle primary endings were depressed while the discharge rates of secondary endings were facilitated following the administration of either soman or sarin. The discharge rates of slowly adapting type 1 mechanoreceptors were also depressed. The total number of identified mechanoreceptors was reduced in both the soman- and sarin-treated animals. Conduction velocities of several of the muscle spindle and mechanoreceptor afferents were significantly decreased. The alterations in muscle spindle function may be due to changes in the muscle resulting from acetylcholinesterase inhibition. Another explanation for the changes in both muscle spindle and mechanoreceptor function may be the direct effect of the organophosphorus agents on the afferents themselves, thus altering their excitability. PMID- 3672518 TI - Study of factors influencing the in vivo methylation of inorganic arsenic in rats. AB - Previous studies have shown that several factors may influence the methylation of inorganic arsenic by rat liver in vitro (Buchet and Lauwerys, 1985). The present study attempts to assess the relevance of these observations in vivo. Like man, rat inactivates inorganic arsenic by methylation to monomethylarsonic (MMA) and dimethylarsinic (DMA) acids which are excreted in urine along with unchanged inorganic arsenic (Asi). The administration of S-adenosylmethionine alone or in association with reduced (GSH) or oxidized glutathione or acetylcysteine and the increase of hepatic GSH level by butylated hydroxytoluene pretreatment do not stimulate the urinary excretion of the methylated arsenic metabolites following a challenge dose of inorganic arsenic. Conversely a reduction of the hepatic GSH level by phorone pretreatment greatly modifies the metabolism of inorganic arsenic in vivo. A reduction exceeding 90% of the control value leads to a decreased urinary excretion of MMA and DMA and an increased urinary excretion of inorganic arsenic. This is also associated with an increased accumulation of inorganic arsenic in the liver. This suggests that a drastic reduction of GSH level in liver not only impairs the methylation of inorganic arsenic but also impairs its biliary excretion. When GSH depletion is less severe, the total amount of arsenic excreted in urine after a challenge dose of NaAsO2 is not significantly different from that found in unpretreated animals but the proportion of the three metabolic forms is different: MMA is reduced whereas Asi and DMA tend to increase. These changes resemble those found in patients with liver insufficiency (J.P. Buchet, A. Geubel, S. Pauwels, P. Mahieu, and R. Lauwerys (1984). The influence of liver disease on the methylation of arsenite in humans. Arch. Toxicol. 55, 151-154). Long-term pretreatment of rats with CCl4 slightly reduces the amount of MMA and DMA excreted in urine following a challenge dose of inorganic arsenic. This effect may result from a reduction of GSH transferase activity by CCl4. This study demonstrates the important role of liver GSH in the metabolism of inorganic arsenic in vivo. PMID- 3672519 TI - Paraquat-induced cytoskeletal injury in cultured cells. AB - Although the redox cycling of paraquat (PQ) and the resultant "activated oxygen" generation are important in toxicity development, the intracellular events leading to cell injury remain unclear. To understand the mechanism of PQ-induced cell injury, we have studied the effects of PQ on DNA synthesis, cell proliferation, the cytoskeletal organization, particularly microtubules (MT) and microfilaments (MF), and the synthesis and composition of cytoskeletal proteins in mouse 3T3 cells. PQ treatment produced a dose-dependent inhibition of DNA synthesis and cell growth. Exposure of cells to PQ (313 microM, 20 hr) resulted in MT aggregation and bundling as well as MF redistribution in the perinuclear area as revealed by fluorescence microscopy. Although this PQ dose inhibited DNA synthesis by 95%, it caused only a 22% decrease in protein synthesis of the cytoskeletal fraction. Higher doses of PQ (1250 microM, 20 hr) caused (a) dramatic thinning out and loss of MT and (b) marked loss of MF cables and the appearance of numerous pine needle-like structures much finer and shorter than normal MF. Under these conditions, the synthesis of cytoskeletal proteins was decreased by about 83%. Further analysis of the cytoskeletal fraction from PQ treated cells by sodium dodecyl sulfate gel electrophoresis showed (a) that tubulin was greatly diminished, in agreement with microscopic observations; (b) that two new protein bands appeared; and (c) another protein band which was also reduced considerably. These results indicate that the PQ-induced dose-dependent cytoskeletal injury may be important to the mechanism of cytotoxicity of this herbicide. PMID- 3672521 TI - Fate of cadmium in rat renal tubules: a microinjection study. AB - 109Cd was injected into the lumen of superficial proximal or distal tubules of rat kidneys, and recovery in the pelvic urine from the ipsilateral kidney was measured. Fractional recovery of labeled inulin always exceeded 90%. About 70% of injected inorganic Cd (CdCl2) was taken up by the epithelium of proximal tubules, while more than 90% of the injected amount was recovered after distal microinjection. The proximal fractional Cd uptake of a 1:1 (molar) Cd-L-cysteine complex was 82%, but was below 60% for a 5-10:1 molar ratio of cysteine:Cd. The chelate Cd-pentetic acid was recovered in final urine nearly quantitatively after proximal or distal microinjection. Fractional uptake of 109Cd from a Cd metallothionein (Mt) complex, following proximal microinjection, ranged between 17 (Cd-Mt 0.19 mM) and 8% (Cd-Mt 1.5 mM). It is concluded that luminal Cd uptake by the tubular epithelium depends markedly on the chemical form of Cd and, when present, occurs mostly or exclusively in proximal tubules. PMID- 3672520 TI - Modulation of p,p'-DDT-induced tremor by catecholaminergic agents. AB - p,p'-DDT (1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane; 75 mg/kg) or corn oil was administered po to male Fischer 344N rats. Tremor was quantified 8 hr later by spectral analysis of whole body movements. The effect of sc injection of pharmacological challenges on the spectral profile of body movements was determined. The alpha antagonist phenoxybenzamine decreased the intensity of movements over most of the power spectra in animals exposed to DDT, but decreased spectral power only at lower frequencies in control subjects. The alpha-1 antagonist prazosin had similar effects in animals given DDT. The alpha-2 antagonist yohimbine and the beta antagonist propranolol produced lethality and increased the intensity of movements in animals administered DDT, without significantly affecting control animals. The alpha-2 agonist clonidine decreased the spectral profile over a wide range of frequencies in animals exposed to DDT, while depressing the spectral power of control animals only at higher frequencies. The dopamine antagonist haloperidol increased the intensity of movements in DDT-treated animals, without altering the spectral profile of controls. The dopamine agonist apomorphine induced stereotypy in control animals, but failed to significantly alter the power spectra in subjects given DDT. These data suggest a facilitatory and inhibitory role, respectively, for alpha-1 and alpha-2 receptors in the modulation of DDT-induced tremor. Dopamine and beta receptors may be involved in the tonic inhibition of tremor produced by DDT. PMID- 3672522 TI - Effect of age on the toxicity and metabolism of ethylene glycol monobutyl ether (2-butoxyethanol) in rats. AB - Heavy production as well as the diversity of 2-butoxyethanol (BE) uses, which include preparation of products intended for household uses, pose a high risk of human exposure to BE. The current studies were designed to investigate the acute toxicity of BE and to evaluate the effect of age on BE-induced toxicity in F344 male rats. Data presented in this report show that BE causes severe acute hemolytic anemia resulting in significant increases in the concentration of free plasma hemoglobin. Secondary to the hemolytic effects, BE also caused hemoglobinuria as well as histopathologic changes in the liver and kidney. These effects of BE were dose- and time-dependent. Further, both the hemolytic effects and the secondary effects of BE were age dependent with older rats being more sensitive than younger rats. The metabolic basis of the greater susceptibility of older rats to BE-induced toxicity was investigated by comparing BE metabolism in adult (9- to 13-week-old) and young (4- to 5-week-old) rats. These studies revealed that there was a significantly higher portion of the administered dose eliminated by young rats as CO2 as compared to that eliminated by older rats. Similarly, a significantly higher portion of the administered dose was excreted in the urine of young rats. HPLC analysis of the urinary metabolites of BE in adult and young rats showed that the ratio of butoxyacetic acid (BAA)/BE glucuronide + BE - sulfate (previously thought to reflect an activation/detoxification index of BE; see text) was significantly higher in older rats. We currently believe that the increase in the activation/detoxification index in older rats is caused by decreased degradation of BAA to CO2 (as evident by the lower percentage of the dose excreted as CO2 by older rats) and by depressed urinary excretion of BAA (as evident from the lower percentage of the dose excreted in the urine of older rats. PMID- 3672523 TI - Inhibition of central nervous system aromatase activity: a mechanism for fenarimol-induced infertility in the male rat. AB - Fenarimol (alpha-(2-chlorophenyl)-alpha(4-chlorophenyl)-5-pyrimidine-methanol), a pyrimidine carbinol agricultural fungicide, was previously reported to cause a dose-related decrease in fertility in rats (K. S. Hirsch, E. R. Adams, D. G. Hoffman, J. K. Markham, and N. V. Owen (1986), Toxicol. Appl. Pharmacol. 86, 391 399). Based on the results of a number of reproduction studies (K. S. Hirsch, E. R. Adams, D. G. Hoffman, J. K. Markham, and N. V. Owen (1986), Toxicol. Appl. Pharmacol. 86, 391-399), the infertility appeared to be associated with an impairment of male sexual behavior. When [14C]fenarimol was administered to the dam, high concentrations of radioactivity were observed in the neonatal hypothalamus, which functions in the development and subsequent expression of male sexual behavior. In the present studies fenarimol exhibited neither antiandrogenic nor antiestrogenic activities. The compound did, however, prevent the increase in nuclear estrogen receptors in the brain which normally occurs in the male during the early postnatal period. These results suggested that fenarimol might be acting to inhibit estrogen biosynthesis (via the aromatase enzyme complex) within the central nervous system. [3H]Testosterone was administered to neonatal rats, and the tritiated metabolites were isolated. Testosterone and dihydrotestosterone (17 beta-hydroxy-5 alpha-androstan-3-one) concentrations were similar in all treatment groups. Tritiated estrogens were detected in the brain cell nuclei from control neonates but not in neonates exposed to fenarimol. Fenarimol was also observed to inhibit rat ovarian aromatase activity in vitro. These data indicate that the decrease in male sexual behavior and the infertility associated with exposure to fenarimol were, most likely, due to inhibition of aromatase activity within the central nervous system. PMID- 3672524 TI - Teratogenic effects of polychlorinated dibenzofurans in combination in C57BL/6N mice. AB - Polychlorinated dibenzofurans (PCDFs) are highly toxic environmental contaminants which have been involved in several incidents of human poisoning. Two congeners, 2,3,4,7,8-pentachlorodibenzofuran (4-PeCDF) and 1,2,3,4,7,8 hexachlorodibenzofuran (HCDF), have been shown to persist in the tissues of victims of accidental ingestion from Japan and Taiwan. The teratogenicity of these compounds, both alone and in combination, was assessed in C57BL/6N mice. Pregnant mice were treated with 10 ml/kg corn oil containing no PCDFs, 4-PeCDF (0 30 micrograms/kg), HCDF (0-300 micrograms/kg), or a combination of the two on gestation Days 10-13, followed by necropsy on gestation Day 18. Maternal and fetal toxicity were assessed and selected soft tissues were examined for abnormalities. Both chemicals caused hydronephrosis and cleft palate in the absence of any overt toxicity. Hydronephrosis occurred at doses approximately fivefold lower than those causing cleft palate. The combination of 4-PeCDF and HCDF was additive for terata based on responses predicted by probit analysis. In addition, the combination of 2,3,4,5,3',4'-hexachlorobiphenyl (0-60 mg/kg), a structurally related compound also present in PCDF poisoning victims, and 4-PeCDF appears additive. Thus, these chemicals, which cause toxic effects similar to those of 2,3,7,8-tetrachlorodibenzo-p-dioxin, are additive in the induction of fetal anomalies in the mouse. PMID- 3672526 TI - A biochemical basis for 1,2-dibromo-3-chloropropane-induced male infertility: inhibition of sperm mitochondrial electron transport activity. AB - A rapid decrease in male fertility in laboratory animals exposed to 1,2-dibromo-3 chloropropane (DBCP) has been suggested to be due, in part, to a postglycolytic inhibition of sperm carbohydrate metabolism. The present studies were performed to identify the specific site of DBCP-induced inhibition of intermediary metabolism. 14CO2 generation by epididymal sperm, isolated from Fischer 344 rats, was measured using radiolabeled tricarboxylic acid (TCA) cycle intermediates: acetyl CoA, citrate, alpha-ketoglutarate, and succinate. There was 0-28% inhibition of CO2 generation after addition of 0.5 mM DBCP and 81-98% inhibition with 3 mM DBCP, with all four substrates. The activities of alpha-ketoglutarate dehydrogenase, pyruvate dehydrogenase, malate dehydrogenase, and lactate dehydrogenase were not inhibited by DBCP. Since the DBCP-induced inhibition of metabolism of different substrates to CO2 was similar, and since DBCP did not inhibit enzyme activities of glycolysis or the TCA cycle, a common site of inhibition was suspected. In evaluations of mitochondrial electron transport chain activity, DBCP (3 mM) inhibited oxygen consumption resulting from metabolism of endogenous substrates plus alpha-ketoglutarate or malate by about 80%. When succinate, an FAD-dependent oxidation, was used as a substrate, oxygen consumption was not inhibited by DBCP. It is concluded that DBCP inhibits sperm carbohydrate metabolism at the NADH dehydrogenase step in the mitochondrial electron transport chain. PMID- 3672525 TI - Intestinal absorption of trichloroethylene in dogs. AB - In order to examine the intestinal absorption of trichloroethylene (TRI), we developed the intestinal circulation system of dogs and administered TRI solution at three concentrations (0.1, 0.25 and 0.5%) to the three parts of the intestinal tract (jejunum, ileum, and colon) of the operated dogs. We measured TRI and its metabolites, free-trichloroethanol, trichloroacetic acid, and conjugated trichloroethanol, in serum or blood, urine, bile and circulating solutions. The absorption rates of TRI from the intestine were 50-70% of the administered volume of TRI 2 hr after administration in all groups, and all parts of intestine readily absorbed TRI. Moreover, there were no significant differences in the absorption rates of TRI and water between the jejunum and ileum, and ileum and colon, respectively. The excretion rates of TRI and its metabolites in urine and bile were very low (0.1-0.4%) compared with the volume of absorbed TRI from the intestine 2 hr after administration in all groups. The high degree of absorption of TRI should be considered when threshold limits for TRI in the drinking water, the surface water, and the ground water are established. PMID- 3672527 TI - Assessment of potential aluminum chelators in an octanol/aqueous system and in the aluminum-loaded rabbit. AB - Aluminum (Al) solubilization from Al borate and its distribution in an octanol/aqueous system (Do/w) were determined in the absence and presence of 12 potential Al chelators. Citrate, N,N'-bis-(2-hydroxybenzyl)ethylenediamine- N,N' diacetic acid (HBED), cyclohexane-1,2-diaminotetraacetic acid (CDTA), diethylenetriaminepentaacetic acid (DTPA), nitrilotriacetic acid (NTA), desferrioxamine, and ethylenediamine-N,N'-bis(2-dihydroxyphenylacetic acid) (EDDHA) were 55 to over 100% efficient in solubilizing equimolar amounts of Al. Tetracycline, EDTA, and 2,3-dihydroxybenzoic acid (DHBA) were less than 20% efficient. 1,4-Dioxane and fluoride were ineffective. The Do/w of Al averaged 0.005. The Do/w of the Al.chelator complex was generally less than that of Al, except for HBED and tetracycline (0.04 and 0.96, respectively). The Do/w of DHBA, desferrioxamine, EDDHA, and HBED were not influenced by Al, but tetracycline became more lipophilic. These compounds were tested for their ability to increase urinary Al excretion in Al-loaded rabbits. Chelators were given po weekly beginning 2 weeks after Al loading. Urine was obtained hourly from 3 hr prior to 6 hr after chelator administration and analyzed for Al. Fluoride and tetracycline (450 and 4500 mumol/kg) and citrate, NTA, EDTA, CDTA, DTPA, DHBA, HBED, and 1,4 dioxane (150 and 1500 mumol/kg) were ineffective. Following HBED administration, some of the Al-loaded rabbits died, presumably due to redistribution of Al within the rabbit. Following DTPA administration, some of the Al-loaded rabbits died, presumably due to DTPA. Oral EDDHA (1500 mumol/kg) significantly increased urinary Al excretion. EDDHA and desferrioxamine (150 mumol/kg) were administered by po, sc, and iv routes and were found to have comparable potency. The in vitro results may explain some of the in vivo findings. The in vitro methods may be useful to screen out compounds with no chelation potential. EDDHA-like compounds may have potential as alternatives to desferrioxamine in the prevention or treatment of Al accumulation and Al-induced toxicity. PMID- 3672528 TI - The effect of pretreatment with 2,3,7,8-tetrachlorodibenzo-p-dioxin on the hepatic metabolism of 2,4,5-trichlorophenoxyacetate (2,4,5-T) and 2,4 dichlorophenoxyacetate (2,4,-D). PMID- 3672529 TI - Colchicine as an investigative tool in neurobiology. AB - Neurotoxicants are being used with increasing frequency in neurobiology as investigative tools to study the structure and function of the nervous system. Colchicine administered directly into the hippocampus produces preferential destruction of dentate gyrus granule cells and mossy fibers and affects conditioned behavior. Studies from our laboratory have demonstrated the dose- and time-dependent loss of dentate gyrus granule cells and stimulation of motor activity following intradentate administration of colchicine. Preferential degeneration of pyramidal cells and other morphological changes observable at the light microscopic level were not seen in colchicine-treated rats. Other studies showed that intradentate colchicine produces specific damage to granule cells in both the dorsal and ventral hippocampus and that this damage is associated with depletion of dynorphin, a neuropeptide preferentially localized in the granule cells and mossy fibers of the hippocampus. Finally, it was noted that there are compensatory changes in the nervous system following treatment with colchicine and that the behavioral effects of colchicine can be modified by factors such as handling. One potentially important compensatory change occurring after intradentate colchicine is an alteration in cholinergic function. Pharmacological studies suggest that colchicine-treated rats may be less sensitive to the behavioral effects of scopolamine. These experiments support the conclusion that given at the appropriate dose into the hippocampus, colchicine may be a useful investigative tool to study the function of the dentate gyrus granule cells and mossy fibers, as well as the compensatory changes in the nervous system that follow chemical-induced neurodegeneration. PMID- 3672530 TI - Effects of inhaled cholinesterase inhibitors on bronchial tonus and on plasma and erythrocyte acetylcholine esterase activity in rats. AB - Young adult male and female Wistar rats were inhalationally exposed head-only for 1 or 4 h to different anticholinesterase aerosols. The compounds tested were dichlorvos, fenamiphos, methamidophos, parathion, a pyrimidine thiophosphate and the carbamate propoxur. These compounds are direct or indirect inhibitors of cholinesterase activity. Immediately after termination of exposure to the compounds, the rats were anesthetized with barbiturate and subjected to pulmonary function tests. An acetylcholine provocation test was performed to correlate the effect of the cholinesterase inhibition and lung resistance. The results basically revealed that by inhalation exposure bronchoconstriction in the absence of acetylcholine provocation did not occur at toxicologically significant doses of the pesticides. An increase in lung resistance was observed only after provocation. However, measurements of plasma cholinesterase activity proved to be more sensitive than the provocation test. With regard to their diagnostic value, the results of the reported study may be summarized as follows (beginning with the most sensitive parameter): plasma cholinesterase activity depression greater than or equal to acetylcholine-induced bronchoconstriction greater than or equal to cholinergic symptoms greater than erythrocyte cholinesterase activity depression greater than pulmonary resistance without acetylcholine provocation. PMID- 3672531 TI - Morphology and release of lysozyme following exposure of rabbit lung macrophages to nickel or cadmium in vitro. AB - Lung macrophages lavaged from 7 rabbits were incubated with 0, 3, 6, 12 and 24 micrograms/ml of nickel as NiCl2 and macrophages from 4 rabbits were incubated with 0, 0.1, 1, 3 and 6 micrograms/ml of cadmium as CdCl2. After 2 days lysozyme activity in the medium in which the macrophages were cultivated, was estimated using a technique with agar plates prepared with heat-killed Micrococcus lysodeikticus. Macrophage morphology was examined by scanning and transmission electron microscopy. For nickel there was a dose-related inverse relationship between the lysozyme activity and concentration of nickel. Many macrophages exposed to the higher nickel concentrations had a rounded form and, thus, the surface area of each cell which came in contact with the glass appeared to be less than that for control macrophages. There was, however, no increase in the number of macrophages detached from their glass support. Cadmium exposure did not influence lysozyme levels of activity, in spite of morphological indications of cell toxicity. From the present study we conclude that the decreased lysozyme activity seen previously in vivo after nickel inhalation is likely to be due to a direct effect of nickel ions on macrophages and that the increased lysozyme activity seen in vivo after cadmium inhalation is probably a secondary effect, subsequent to inflammation. PMID- 3672532 TI - Developmental toxicity of EDS recycle solvent and fuel oil. AB - Direct coal liquefaction is one of several technologies currently under development as alternative means to produce liquid fuels. Relatively high levels of polycyclic aromatic hydrocarbons are present in distillate fractions boiling above approximately 370 degrees C. Coal-derived liquids containing substantial amounts of material from this boiling range were genotoxic in in vitro tests and carcinogenic in mouse skin. Some of the liquids were also teratogenic in rodents. The present report describes studies which assessed the potential effects of 2 coal-derived liquids, recycle solvent (nominal boiling range 200-427 degrees C) and an experimental industrial fuel oil (nominal boiling range 204-538 degrees C) on prenatal development in the rat. The test materials were produced by the EDS direct coal liquefaction process and contained substantial amounts of material boiling above 370 degrees C. Test materials were administered by gavage to pregnant female Sprague-Dawley rats from days 6 to 19 of gestation (G). Animals were sacrificed on day 20G and the uterine contents were removed and examined. Results of both studies were similar. The number of live fetuses declined in a dose-related manner, and there was evidence of intrauterine growth retardation in fetuses which survived to day 20G. Statistically significant effects were noted at doses which did not appear to be maternally toxic. The frequency of malformation was not significantly elevated in either study; however, a thorough evaluation of this endpoint was precluded by embryo lethality at the high doses. It was apparent that both of the EDS liquids examined affected prenatal survival and growth. However, in contrast to studies of other coal-derived liquids, there was no evidence of teratogenic effects at non-toxic doses. PMID- 3672533 TI - A statistical test for synergism of two cell growth inhibitors. AB - Interaction of 2 inhibitors of cell growth can be detected by measuring the inhibiting effect of the 2 drugs separately and in combination. A control group is used as the basis for each comparison. We discuss a method for the statistical analysis of such measurements, when the basic observation is the number of cells harvested from a treated culture. PMID- 3672534 TI - Biochemical effects on combined gases of nitrogen dioxide and ozone. I. Species differences of lipid peroxides and phospholipids in lungs. AB - In the present study, changes of lipid peroxides, phospholipids and antioxidant levels in lungs of 4 animal species exposed to the combined gases of NO2 and O3 were compared. Male mice, hamsters, rats and guinea pigs were used. Lipid peroxides were increased significantly in the lungs of mice and guinea pigs exposed to the combined gases, but not in hamsters and rats. Changes of alpha tocopherol (VE) contents were slight. On the other hand, non-protein sulfhydryl (NPSH) contents were increased strikingly, especially in hamsters, but were not increased in guinea pigs. Phosphatidylcholine (PC) contents were increased and phosphatidylethanolamine (PE) contents were decreased by the exposure to the combined gases, with the order guinea pig greater than mouse greater than rat. In hamsters no changes were seen. The changes of fatty acid composition in guinea pigs and mice were marked, the increases of palmitate and palmitolate and the decreases of polyunsaturated fatty acid were especially characteristic. These changes in phospholipid class and fatty acid composition may be a "a kind of adaptation phenomenon" to avoid further lipid peroxidation. On the other hand, the changes in hamsters and rats were small. The results show the existence of species differences in lipid peroxide formation by exposure to the combined gases of NO2 and O3. They were found to be related to the contents of antioxidants and the compositions of phospholipids and their fatty acids. PMID- 3672535 TI - Assessment of the potential reproductive and subchronic toxicity of EDS coal liquids in Sprague-Dawley rats. AB - The EDS direct coal liquefaction process is one of several methods of producing liquid fuels from coal which have reached the pilot or demonstration stage of development. Relatively high levels of polycyclic aromatic hydrocarbons are present in distillate fractions boiling above approximately 370 degrees C, and unrefined coal-derived liquids which contain substantial amounts of material from this boiling range are relatively potent dermal carcinogens. Because coal-derived liquids containing high boiling (i.e., greater than 370 degrees C) material may pose a variety of toxic hazards, efforts have been made to evaluate the potential effects on biological endpoints other than cancer. The present studies assessed the potential for reproductive and subchronic toxicity following repeated oral administration of 2 coal-derived liquids, recycle solvent and fuel oil, which contained substantial amounts of high boiling material. Few biologically important differences were found in any of the experimental parameters. In the reproductive toxicity study, frequency of fertilization and implantation, mean number of live births, fraction of litter surviving through the lactation period and mean weight gain of the litters during the lactation period were not affected by treatment; in addition, there was no evidence of increased frequency of malformation. In the subchronic toxicity study, weight gain was reduced in animals from the high dose groups, but was not significantly different from controls. Liver weights were significantly elevated, but there was no microscopic evidence of pathologic changes. Erythrocyte counts, hemoglobin levels and hematocrits were significantly reduced suggesting a tendency towards anemia. These findings suggested that repeated exposure to EDS recycle solvent and fuel oil at levels of up to 0.5 g/kg per day had no detectable effect on reproductive capacity or performance and did not induce substantial systemic toxicity. PMID- 3672536 TI - Skin effects of trichothecenes and their amelioration by decontamination. AB - The ability of trichothecenes, in particular T2 toxin (T2), to cause irritant effects on the skin has been investigated in laboratory rodents and rabbits. Quantitatively, T2 was found to be highly potent in this respect, causing irritant reactions on rat skin at contamination densities of less than 1 microgram.cm-2. The first appearance of skin effects was delayed for approximately 6 h after application, irrespective of the dose applied. Similarly, variation in solvent or injection into or beneath the skin failed to accelerate the onset of the irritant reaction. An aqueous soap solution was largely effective in removing low doses of T2 from the skin, but was ineffective in removing larger doses. However, washing the contaminated skin with polyethylene glycol 300 was very effective at removing even large doses of T2 from the skin. The macrocyclic trichothecene verrucarin A was of comparable irritancy to T2 on rat skin. Diacetoxyscirpenol and nivalenol were less potent. PMID- 3672537 TI - Examination of the reproductive effects of tricresyl phosphate administered to Long-Evans rats. AB - Tricresyl phosphate (TCP) is used commercially as a plasticizer and a flame retardant. The reproductive effects of TCP (less than 9.0% TOCP) were examined. Male Long-Evans rats received 0, 100, or 200 mg/kg and females received 0, 200, or 400 mg/gk TCP in corn oil by gavage. The 100 mg/kg TCP males were mated with 200 mg/kg TCP females, and 200 mg/kg TCP males were bred with 400 mg/kg TCP females. Males were dosed for 56 days and females for 14 days prior to breeding and throughout the 10-day breeding period. Following breeding, the males were necropsied and evaluated for sperm parameters and reproductive tract histopathology. Females were dosed throughout gestation and lactation. Pups and adult females were necropsied on postnatal day 21. Sperm concentration, motility, and progressive movement were decreased for 200 mg/kg dose group males. A dose dependent increase in abnormal sperm morphology was observed for males in both TCP dose groups. The percent of sperm-positive females per group was unchanged, but the number of females delivering live young was severely decreased by TCP exposure. Litter size and pup viability were decreased in the 400 mg/kg dose group. Pup body weight and developmental landmarks were unaffected by TCP exposure. Histopathologic changes were observed in the testes and epididymides of male rats and in the ovaries of female rats exposed to TCP. PMID- 3672538 TI - Acute tabun toxicity; biochemical and histochemical consequences in brain and skeletal muscles of rat. AB - Male Sprague-Dawley rats injected s.c. with an acute non-lethal dose (200 micrograms/kg) of ethyl N,N-dimethylphosphoramidocyanidate (tabun) showed onset of hypercholinergic activity within 10-15 min. The maximal severity of toxicity signs was evident within 0.5-1 h and persisted for 6 h. Except for mild tremors no overt toxicity signs were evident after 24 h. Within 1 h a dramatic decline of acetylcholinesterase (AChE) activity occurred in all the brain structures (less than 3%) and skeletal muscles (less than 10% in soleus and hemi-diaphragm; and 32% in extensor digitorum longus (EDL)). No significant recovery was seen up to 48-72 h. Within 7 days rats became free of toxicity signs and AChE activity had recovered to about 40% in brain structures (except cortex, 14%) and 65-70% in skeletal muscles. Within 1 h the 16 S molecular form of AChE located at the neuromuscular junction was most severely inhibited in soleus, followed by hemi diaphragm and least in the EDL, and had fully recovered in all the muscles when examined after day 7. Muscle fiber necrosis developed within 1-3 h in soleus and hemi-diaphragm and after a delay of 24 h in EDL. The highest number of necrotic lesions in all muscles was seen at 72 h with the hemi-diaphragm maximally affected and EDL the least. To determine detoxification of tabun by non-specific binding, the activity of butyrylcholinesterase (BuChE) and carboxylesterase (CarbE) was measured. The inhibition and recovery pattern of BuChE activity was quite similar to that of AChE, except that the rate of recovery was more rapid. Within 1 h the remaining activity of CarbE was 10% in plasma, about 30% in brain structures, and 79% in liver; recovery was complete within 7 days. The inhibition of BuChE and CarbE can serve as a protective mechanism against tabun toxicity by reducing the amount available for AChE inhibition. The prolonged AChE inhibition in muscle and brain may indicate storage of tabun and delayed release from non enzymic sites. Since tabun is a cyanophosphorus compound, the toxic effects from the released cyanide (CN) could be another reason for the delayed recovery after tabun. PMID- 3672540 TI - Effects of sodium fluoride on uptake of T-2 mycotoxin in cultured cells. AB - We examined the effect of sodium fluoride on uptake of tritium-labeled T-2 toxin (molecules of toxin/cell) in Chinese hamster ovary (CHO) and African green monkey kidney (VERO) cells. Correlations were made to temperature (22 and 37 degrees C) and toxin concentration (0.001 and 0.01 microgram/ml) over time (0-180 min). As expected, toxin uptake increased in both cell types with increasing time and temperature. VERO cells exhibited significant (P less than 0.05) increases in the rate (i.e. slope) of toxin uptake under all parameters, while the rate of toxin uptake in both cell types was generally greater at 37 degrees C compared to 22 degrees C. The rate of equilibrium was affected by both temperature and sodium fluoride. At 37 degrees C toxin uptake plateaued by 30 min in the presence of sodium fluoride. At 22 degrees C the rate of toxin uptake was slower, with or without sodium fluoride present. Statistical analysis of individual time points along the curve demonstrated that sodium fluoride significantly increased cell associated toxin at most time points. Analysis of the slopes of uptake curves from 0 to 20 min indicated significant (P less than 0.05) differences in the rates of T-2 uptake in both cell types and toxin doses in the presence of sodium fluoride. The increase in toxin uptake in the presence of sodium fluoride was not due to altered cell membrane permeability caused by sodium fluoride. This study demonstrates that sodium fluoride significantly increases cell-associated T-2 toxin and the rate of toxin uptake in two cultured cell lines. PMID- 3672539 TI - Effects of various pretreatments on the acute nephrotoxic potential of styrene in Fischer-344 rats. AB - The effects of various inducers and inhibitors of hepatic microsomal mixed function oxidase (MFO) system and diethylmaleate treatment on styrene-induced acute nephrotoxicity in male Fischer-344 rats were studied. Groups of rats were pretreated with either 3-methylcholanthrene (15 mg/kg, i.p., 3 days), or phenobarbital (80 mg/kg, i.p., 3 days), or SKF525-A (50 mg/kg, i.p., 1 h), or piperonyl butoxide (300 mg/kg, i.p., 2 h), or diethylmaleate (400 mg/kg, i.p., 90 min) prior to an i.p. administration of styrene (0, 0.6 and 0.9 g/kg) in corn oil. The uptake of p-aminohippurate (PAH) by renal cortical slices, the morphology of renal cortices, as well as urinary excretion of N-acetyl-beta-D glucosaminidase (NAG) and gamma-glutamyl transpeptidase (gamma-GT) of control and pretreated rats were examined 24 h after styrene. The inducers and inhibitors of MFO system failed to modify further the acute nephrotoxicity of styrene. On the other hand, diethylmaleate pretreatment not only reduced further the uptake of PAH, but also produced further significant increase in the urinary excretion of NAG and gamma-GT observed at the higher dose of styrene. Similarly, ultrastructural studies showed a moderate increase in the severity of kidney damage induced at the higher dose of styrene due to pretreatment with diethylmaleate. These data suggest that tissue glutathione concentrations and hence, corresponding conjugating activity might be important determinants of styrene nephrotoxicity. The results further indicate that a metabolic activation system not involving certain cytochrome P-450 might be responsible in styrene induced nephrotoxicity. PMID- 3672541 TI - Ability of a polyvalent antivenom to neutralize the venom of Lachesis muta melanocephala, a new Costa Rican subspecies of the bushmaster. AB - Several toxic and enzymatic activities of the venom of L. m. melanocephala were studied. This venom has many similarities with that of L. m. stenophrys, although there are quantitative differences in venom activities, as well as in the immunodiffusion patterns of these venoms when reacted against polyvalent antivenom. This antivenom was tested for its ability to neutralize a series of toxic and enzymatic effects of L. m. melanocephala venom. A new method to study myonecrosis, based on the quantitation of residual creatine kinase in injected muscle, was used. Antivenom was highly effective in neutralizing lethal, hemorrhagic, myotoxic, edema-forming, defibrinating, caseinolytic and fibrinolytic activities when venom and antivenom were incubated prior to the test or, in the case of edema-forming activity, when antivenom was administered before venom injection. On the other hand, when antivenom was injected i.v. at different time intervals after venom injection neutralization of lethality was good, although neutralization of local effects, i.e. hemorrhage and edema, was poor. These results indicate that polyvalent antivenom contains antibodies capable of neutralizing toxic and enzymatic activities of L. m. melanocephala venom. Moreover, the partial inability of antivenom to neutralize local effects when administered after venom injection is probably due to the rapid development of these effects once venom is injected. PMID- 3672542 TI - Purification of contracture-inducing insect toxins from Buthinae scorpion venoms by immunoaffinity and high pressure liquid chromatography. AB - A method of rapid and selective detection and purification of contracture inducing insect toxins from Buthinae scorpion venoms is described in this paper. It consists of two main steps: the first one is specific as it uses immunoaffinity chromatography with antibodies against Androctonus australis Hector IT; the second, reverse phase high pressure liquid chromatography, allows the final separation of the different toxins present in each of the three venoms studied. Two, three and four insect toxins have been purified, respectively, from the venoms of Androctonus australis Hector, Buthus occitanus mardochei and Leiurus quinquestriatus quinquestriatus. This work demonstrates that, in Buthinae venoms, contracture-inducing insect toxins antigenically related to AaH IT, the first one purified, constitute the most important and, in some cases, the only toxins present. PMID- 3672543 TI - Effects of drugs and metabolic inhibitors on the acute toxicity of T-2 toxin in mice. AB - The antidotal effects of antiinflammatory agents, inhibitors of bioamine syntheses, an opioid antagonist and other pharmacological agents on lethal toxicity, leukocytosis and ear inflammation, were investigated in mice subcutaneously administered or topically exposed to T-2 toxin, a trichothecene mycotoxin of Fusarium species. The acute lethal toxicity of T-2 toxin was reduced by administration of the steroidal anti-inflammatory agents, prednisolone and dexamethasone, and prolongation of survival times was demonstrated with an antihistaminic agent, diphenhydramine, and an opioid antagonist, naloxone. Prednisolone also antagonized leukocytosis and the increment of ear weight caused by T-2 toxin. These findings suggest that the action site(s) of steroidal anti inflammatory agents is involved in the development of the toxic actions of T-2 toxin, and the implications of the results with bioamines and opioids are also discussed. PMID- 3672544 TI - Characterization of a metallo-proteinase from Bothrops asper (terciopelo) snake venom. AB - Metalloproteinase from the venom of Bothrops asper (proteinase G) is a glycoprotein with 1% neutral hexose and 3.5 moles of sialic acid per mole of protein. It hydrolyses a number of protein substrates such as casein, hemoglobin, gelatin and fibrinogen, whose alpha chain is degraded preferentially. The pH optimum of hydrolysis of casein is approximately 9.5. The protease is devoid of hemorraghic, esterolytic and amidolytic activities. The proteolytic activity of the enzyme increases by about 20% in the presence of 0.2 mM Ca2+ and Mg2+. Among the other ions tested, only Cd2+ and Fe2+ markedly decreased its activity. EDTA and cysteine are also strong inhibitors. In the presence of Ca2+ and EDTA, Zn2+ ions restored 50% of the activity. The amino acid composition shows fewer acidic residues than in related proteinases from other snake venoms. PMID- 3672545 TI - Resistance of California ground squirrels (Spermophilus beecheyi) to the venom of the northern Pacific rattlesnake (Crotalus viridis oreganus): a study of adaptive variation. AB - Recent studies have documented natural resistance to snake venom in a number of diverse mammalian species. The present paper documents for the first time variation in such resistance within one single species, the California ground squirrel (Spermophilus beecheyi). This species is a frequent prey of the northern Pacific rattlesnake (Crotalus viridis oreganus) in certain habitats. Venom resistance was tested directly in two populations of ground squirrels by injection of 1-40 mg/kg venom doses. One population was obtained from a habitat with a high rattlesnake density; the other population came from a rattlesnake free habitat. Dramatic differences in the response to venom between these populations were manifested, based on a variety of criteria, such as mortality, necrosis and healing time. Resistance to venom was also examined by LD50 tests in groups of mice pre-injected with ground squirrel sera from three rattlesnake adapted California populations and a non-adapted Arctic population (S. parryii) from snake-free central Alaska. The California ground squirrel sera were 3.3-5.3 times more effective in the in vivo neutralization of venom than the sera from Arctic ground squirrels. Moreover, the level of protection by the sera as reflected by the LD50 values was highly correlated (P less than 0.005) with the level of in vitro squirrel serum-venom binding as quantified by radioimmunoassay (RIA). A subsequent RIA revealed that binding levels of sera from 14 California ground squirrel populations correlated significantly (P less than 0.025) with local rattlesnakes densities; i.e. sera pools from populations sympatric with rattlesnakes exhibited the highest binding, whereas populations living in habitats where rattlesnakes are rare or absent typically exhibited the lowest binding levels, several of which approximated the Arctic control. Taken together, these results demonstrate intraspecific variation that is probably the result of differential natural selection due to northern Pacific rattlesnakes. This intraspecific variation should be taken into consideration when testing for natural resistance in wild-caught species. PMID- 3672546 TI - LD50 determination: objections to the method of Beccari as modified by Molinengo. AB - The efficiency of the method of Beccari as modified by Molinengo is compared with the sequential technique of Dixon and Mood. It is concluded that the sequential technique is less constrained, gives estimates that are less disperse and is simpler to analyze statistically than the regression of Beccari-Molinengo. Both techniques are comparable in the number of animals required, as well as in the time invested in each assay. PMID- 3672547 TI - Some biochemical characteristics and cell membrane actions of a toxic phospholipase A2 isolated from the venom of the pit viper Agkistrodon halys (Pallas). AB - A toxic component (AgTx) from the venom of Agkistrodon halys (Pallas) was isolated using DEAE-cellulose DE11 and CM-Sephadex C50 column chromatography and finally purified to homogeneity by FPLC on a MonoQ column. The toxin is a neutral (pI 6.9) single chain polypeptide with a mol. wt of 14,000 and an amino acid composition (123 residues) roughly similar to that of notexin. AgTx was found to have phospholipase A2 activity which was dependent on calcium and stimulated by sodium deoxycholate. The toxin caused efflux of 2-deoxy-(1-3H)-glucose-6 phosphate (a cell membrane integrity probe) as well as of [3H]acetylcholine from rat brain synaptosomes. No cell membrane damage was induced by AgTx on cultured N1E 115 neuroblastoma cells and chick myotube cultures. The LD50 ws 150 micrograms/kg (i.p.) in mice. The main symptom observed was respiratory paralysis. The results obtained show that AgTx can be classified as a toxic phospholipase A2 with a presynaptic site of action. PMID- 3672548 TI - T-2 toxin induced changes in liver and serum enzymes of rats. AB - The effects on liver and serum enzymes of feeding a single dose (2 mg/kg) and daily doses (0.75 mg/kg) of T-2 toxin were studied in young male rats. Sample times were 8, 16 and 24 hr for single dose administration and 7, 14 and 21 days for daily dose administration. T-2 toxin in single and daily doses significantly reduced activities of hepatic glutamate pyruvate transaminase (GPT) and alkaline and acid phosphatases at all the sampling periods. In both feeding trials, levels of serum GPT increased, while that of acid and alkaline phosphatases significantly decreased at all the sampling times. This study indicates that the liver is affected by feeding T-2 toxin to rats. PMID- 3672549 TI - A low molecular weight protein with antimicrobial activity in the cutaneous 'venom' of the yellow-bellied toad (Bombina variegata pachypus). AB - The cutaneous 'venom' was collected from dorsal skin fragments of the yellow bellied toad Bombina variegata pachypus by means of stimulation with noradrenaline. Light and electron microscope observations gave evidence that the 'venom' corresponds to the secretory products of both serous gland types (i.e. with small or large granules) characteristic of this genus, which had discharged their contents upon stimulation. The serous 'venom', when tested for antimicrobial activity, inhibited the growth of several bacterial strains. Heat treatment, dialysis, protease digestion and SDS-PAGE electrophoresis showed that the antimicrobial activity was thermostable and associated with a low molecular weight protein. This protein was purified and homogeneity determined by CM cellulose chromatography and SDS-PAGE electrophoresis. The purified protein has a molecular weight of 6700, displays antibacterial properties and appears different from the antimicrobially active peptides previously isolated from the 'venom' of the toad. PMID- 3672550 TI - Comparison of the toxicity of methylcyclopentadienyl manganese tricarbonyl with that of its two major metabolites. AB - Pneumotoxicity and lethality resulting from administration of methylcyclopentadienyl manganese tricarbonyl (MMT) and its 2 major metabolites in rats were compared. Following i.p. injection, MMT was found to have an LD50 value of 12.1 mg/kg. Neither of the metabolites appeared to have significant acute toxicity even when doses as high as 250 mg/kg were given. This impressive difference in toxicity may be due in part to changes in solubility of the metabolites, allowing for (1) decreased distribution into the central nervous system, coupled with (2) a more rapid excretion rate. This suggests that the oxidative metabolism of MMT that results in the formation of these metabolites is an important detoxifying pathway. PMID- 3672551 TI - 2,2'-Dichlorodiethyl sulfide (sulfur mustard) decreases NAD+ levels in human leukocytes. AB - 2,2'-Dichlorodiethyl sulfide (sulfur mustard, HD) extensively alkylates DNA in a concentration-dependent manner in many cell types. We have proposed a biochemical hypothesis that explains HD-induced injury by linking DNA alkylation and DNA breaks with activation of poly(ADP-ribose) polymerase, resulting in depletion of cellular NAD+. This hypothesis was tested by treating human leukocytes with HD to determine whether NAD+ depletion occurred as predicted. These cells demonstrated a decrease in NAD+ levels which was dependent on both concentration of HD and time after exposure. Inhibitors of poly(ADP-ribose) polymerase or substrates for NAD+ synthesis were able to prevent the HD-induced NAD+ decrease. PMID- 3672552 TI - The turnover of radiolabeled nuclear proteins in rats exposed to environmental and chemical stress. AB - Exposure to a 12 h light/12 h dark (L/D) cycle for 1 month, followed by reversal to a 12 h D/12 h L (D/L) cycle stimulated within 18 h the incorporation of [3H]leucine and [32P]orthophosphoric acid into new proteins (130-25 kDa) in the G0 phase of the cell cycle of the non-regenerating and regenerating rat liver as observed in two-dimensional gel autoradiograms. Six additional proteins from the rat submaxillary gland (130-20 kDa) revealed labeling with 32P within 3 h following combined administration of isoproterenol and sodium arsenite. Labeling disappeared within 7 days for all stressed proteins. PMID- 3672553 TI - Studies of nephrotoxicity due to mixed exposure to styrene and toluene. AB - Adult male Sprague-Dawley rats were treated simultaneously with 4 mmol styrene per kg i.p., twice a day at an interval of 4 h, and 10 mmol toluene per kg once a day, 5 days a week for 4 consecutive weeks. After the last day of treatment, the rats were placed in metabolism cages for collection of urines for 24 h and then were sacrificed. Such mixed exposure produced significant increases in the urinary excretion of gamma-glutamyl transpeptidase, glucose and proteins as compared to those with either solvent alone. An increase, but not significant, in the urinary excretion of N-acetyl-beta-D-glucosaminidase was also noticed due to such exposure. Electron microscopic examination of renal cortex 24 h after the mixed exposure showed the appearance of many vacuoles of various sizes surrounded by a single membrane, which were not seen in rats treated with either styrene or toluene alone. Metabolism studies showed only a significant increase in the urinary excretion of hippuric acid due to mixed exposure. These data indicate that under certain conditions, mixed subchronic exposure to styrene and toluene may have the potential to increase further the nephrotoxic response as compared to that of either solvent alone. PMID- 3672554 TI - The effect of carboxylesterase inhibition on interspecies differences in soman toxicity. AB - Subcutaneous administration of 2 mg/kg cresylbenzodioxaphosphorin oxide (CBDP) produced complete inhibition of carboxylesterase activity in plasma and lung of mice, rats, guinea pigs and rabbits, without inhibition of acetylcholinesterase activity in either brain or diaphragm. This CBDP treatment also reduced the subcutaneous soman LD50 in these species by 48-90% in comparison to the soman LD50 in control animals. The interspecies differences in the soman LD50 values that were seen in control animals were absent in CBDP-treated animals. The soman LD50 values in control animals were 125 micrograms/kg (mouse), 116 micrograms/kg (rat), 32.3 micrograms/kg (guinea pig) and 22.8 micrograms/kg (rabbit), whereas the soman LD50 values in CBDP-treated animals from these species were clustered in a narrow dose range (11.8-15.6 micrograms/kg) and were not significantly different. This suggests that the amount of CBDP-sensitive carboxylesterase available for detoxification of soman in each species may be an important determinant of interspecies differences in soman toxicity. PMID- 3672555 TI - Dibutyl phthalate: maternal effects versus fetotoxicity. AB - Dibutyl phthalate (DBP), a plasticizer, is a teratogen in mice and rabbits but produces fetal loss in the rat. Long-term dosing studies indicating reduced fertility in the rat suggested a maternal effect of the compound. The decidual cell response (DCR) and pregnant rats were used to examine whether DBP affects maternal physiological parameters independent of the compound's fetotoxic effect. DBP has no effect on the DCR, pregnant uterine weight, number of implantation sites, ovarian weight, or serum progesterone concentration during early pregnancy or pseudopregnancy. These data show that short-term dosing with DBP has no direct maternal effect in the rat and suggest that the viability of preimplantation embryos is not compromised. PMID- 3672556 TI - Chemical form-dependent induction of hepatic zinc-thionein by arsenic administration and effect of co-administered selenium in mice. AB - Four arsenic compounds (m-arsenite, arsenate, methylarsonate (MMA), and dimethylarsinate (DMA) were administered to mice, either orally or by intraperitoneal injection, and the amounts of induced hepatic zinc-thionein (Zn Th) were determined to investigate the chemical form dependency in metallothionein induction by arsenic. Several mice died within 24 h following intraperitoneal injection. The toxicity estimated from the lethality was in the order of m-arsenite greater than arsenate much greater than DMA approximately equal to MMA. Although all 4 arsenic compounds more or less induced Zn-Th following intraperitoneal injection, the dose of inorganic arsenic compounds observed to cause induction was one order lower than that of organic arsenic compounds. The induction of hepatic Zn-Th was also observed following oral administration, and inorganic arsenic compounds were again found to be more effective inducers via this route. To study the interactions of m-arsenite and selenite with regard to the amounts of Zn-Th induced, the two compounds were co administered intraperitoneally. The amount of hepatic Zn-Th induced by the co administration was one-fifth of that observed after selenite administration, and was almost the same as that after m-arsenite injection. Namely, when co administered m-arsenite had the effect of lowering the level of Zn-Th induced following selenite administration, but the converse phenomenon was not observed. PMID- 3672557 TI - Oral Zn-DTPA treatment reduces cadmium absorption and retention in rats. AB - This work was performed to evaluate the possibility of using early oral diethylenetriaminepentaacetate (DTPA) therapy for decreasing absorption and retention of cadmium. Albino rats (6 days and 6 weeks old) were used. 115mCd was administered orally. Zn-DTPA was also given orally (3.64 mmol/kg) immediately after 115mCd and 24 h thereafter. Radioactivity in body and organs was determined 6 days later. In sucklings this treatment decreased whole body and gut retention 7-9 times and kidney and liver retention 2-3 times. In older rats it decreased whole body, gut and organ retention 4-5 times. This finding deserves attention since it is generally believed that DTPA is not indicated for early treatment, i.e. while the toxic metals or radionuclides are still in the gastrointestinal tract. PMID- 3672558 TI - Hepatotoxicity of acetaldehyde in rats. AB - The ability of acetaldehyde to initiate hepatotoxicity as evidenced by enzyme leakage, hepatic fat accumulation and histological alterations was studied in rats. Neither oral nor intraperitoneal treatment with acetaldehyde had any hepatotoxic effect, even following aldehyde dehydrogenase inhibition by disulfiram. This is probably due to the inability of exogenously added acetaldehyde to penetrate liver cell membranes. In contrast, acetaldehyde derived metabolically from ethanol was capable of inducing moderate hepatotoxicity when it accumulated upon pretreatment with disulfiram. Acetaldehyde may thus be partly responsible for alcohol-induced liver damage. PMID- 3672559 TI - Oral kinetics and bioavailability of the cholinesterase reactivator HI-6 after administration of 2 different formulations of tablets to dogs. AB - A one-compartment open model with first-order absorption was used for comparing new oral formulations of the potent acetylcholinesterase reactivating oxime HI-6. Although mean peak plasma levels did not differ between retard and conventional tablets (21.38 and 20.74 mumol/l), the time for reaching peak levels was significantly longer (5.5 h) with retard than with conventional tablets (2.86 h). Among other pharmacokinetic estimates only absorption half-lives and areas under the concentration-time curve (AUC) were significantly different (P less than 0.05). The AUC with retard tablets was 8.07% and that of conventional tablets 5.42% of intravenous AUC, indicating low bioavailability of oral HI-6 formulations. Potential therapeutic use of HI-6 requires, therefore, further investigations in order to improve its gastrointestinal absorption. PMID- 3672560 TI - Effects of PUVA therapy on skin surface lipids: skin surface lipid peroxidation in psoriasis vulgaris and its biological significance. AB - PUVA therapy (Psoralen + UVA irradiation) is an effective mode of photochemotherapy for psoriasis vulgaris. The biological significance of PUVA therapy for psoriasis vulgaris has mainly been considered to be based on DNA, especially the formation of DNA crosslinks between complementary DNA stands. On the other hand, we have already reported that skin surface lipids were oxidized by UVA irradiation in vitro and this reaction was enhanced in the presence of 8 methoxy-psoralen by a singlet oxygen mechanism. Keeping this in mind, we conducted an experiment to determine whether lipid peroxide can be formed in skin surface lipids following systemic PUVA therapy in psoriasis patients and the following results were obtained: 1) a marked increase of lipid peroxide values in skin surface lipids occurred following PUVA therapy; and 2) the amount of squalene in skin surface lipids was decreased by this treatment. These results indicate that skin surface lipids can be oxidized by PUVA therapy in vivo and this lipid peroxidation on the skin surface may be related to the effects of PUVA therapy on psoriasis vulgaris. PMID- 3672561 TI - A clinical trial of removal of bilirubin in blood by Evaflux-2A. AB - We performed both free and albumin-bound bilirubin removal therapy using the Evaflux-2A and evaluated its clinical effects. The removal rates of total bilirubin in the first and second sessions were 31.4%, and 31.0%, respectively. Our clinical data suggested that plasma exchange using Evaflux-2A and an albumin added electrolyte solution as the substitute fluid was useful in the treatment of hyperbilirubinemia. PMID- 3672562 TI - Unexpected 10-year survival after removal of a huge bladder tumor. AB - It is reported that a patient has survived in a tumor-free condition for 10 years since the removal from the bladder of a huge tumor, which was as large as child's head. This case had a very poor prognosis due to the histopathological diagnosis of Grade IV transitional cell carcinoma and adhesion to the ileum. The tumor was surgically removed in a combination of partial resection of the bladder and the ileum. PMID- 3672563 TI - Plasma antithrombin III, alpha 2-plasmin inhibitor and plasminogen activities in cases of various liver diseases. AB - alpha 2-PI, a coagulation factor, and AT III and PLG, fibrinolytic factors, are all glycoproteins synthesized in the liver, and their half-lives are as short as two to three days. Therefore, we assumed that determination of their plasma activities would be meaningful as a liver function test. We determined these three factors in 900 patients with various liver diseases and investigated their relation to serum biochemical data and differences in their activities among the diseases. Parameters in which all three factors were significantly correlated (magnitude of gamma greater than or equal to 0.5) were serum ALB, CHE and PT, indicating that the factors were suitable for the examination of liver function, particularly its reserve capacity. The activities of the three factors were significantly decreased (p less than 0.001) in the presence of acute hepatitis, chronic active hepatitis, fulminant hepatitis and liver cirrhosis. Compared with patients with compensated liver cirrhosis, those with decompensated liver cirrhosis exhibited significant decreases in the three factors. Among chronic hepatitis cases, the active type showed a more significant decrease in ATIII alone than the inactive type. These results indicate that determination of the three factors is very useful for the differential diagnosis and follow-up study of various liver diseases. PMID- 3672564 TI - Immunological effects of arsenic compounds on mouse spleen cells in vitro. AB - Immunological effects of arsenic compounds on mouse spleen cells in vitro were examined. Three kinds of arsenic compounds: sodium arsenite, sodium arsenate and dimethyl arsenic acid, at high doses, suppressed the plaque-forming cell response to sheep erythrocytes and the proliferative response to mitogens, whereas at low doses they enhanced both responses. And each of arsenic compounds differs in strengths at which the modulation effects on both responses were exerted. The strength was comparable to general toxicity of arsenic compounds. PMID- 3672565 TI - Intellectual impairment in Parkinson's disease--correlation with cerebral cortical blood flow. AB - A contribution of cerebral cortical damage to the development of intellectual impairment in patients with Parkinson's disease (PD) has been suspected. We studied the relationship between intellectual impairment and cerebral cortical blood flow in 28 treated idiopathic parkinsonian patients. Mean IQ score as evaluated by applying the Suzuki-Binet test in patients with PD was 70.7 (+/- 12.7) and 78.6% of the patients showed abnormal score (below 80). The intellectual deficits were characterized by impairment of memory and abstract thinking, and showed a significant correlation with the severity of motor symptoms. Mean hemispheric cortical blood flow measured by using the 133xenon intravenous injection technique in patients with PD was significantly lower than that for 18 age-matched controls. Prefrontal cortical blood flow in PD was also significantly reduced compared with that in age-matched controls, showing a partial loss of hyperfrontal pattern. However, there was no significant correlation between IQ score and either mean hemispheric cortical blood flow or prefrontal cortical blood flow values. These results suggest that, although the patients with PD demonstrated a high prevalence of intellectual impairment, the impairment is not necessarily of cortical origin. PMID- 3672566 TI - Propylene glycol pharmacokinetics and effects after intravenous infusion in humans. AB - Knowledge of the pharmacokinetics of propylene glycol (PG) is scarce, though it is used in a number of preparations for intravenous use. Although systemic toxicity appears to be uncommon, PG has been reported to cause lactic acidosis and other adverse effects. We describe a rapid gas chromatographic assay method for PG and the plasma pharmacokinetics after intravenous administration to six patients on nine occasions. The pharmacokinetics were nonlinear, based on a saturable clearance. The apparent first-order half-life was 2.3 +/- 0.7 h. There was no evidence of lactic acidosis, hemolysis, or increase in osmolality at 3-15 g/m2 PG infused over periods of 4 h. PMID- 3672567 TI - Influence of gender on the disposition of cefotaxime and desacetylcefotaxime. AB - The pharmacokinetics of cefotaxime and desacetylcefotaxime were evaluated in 11 female and 13 male subjects with end-stage renal disease. Subjects received single 1- or 2-g intravenous doses of cefotaxime sodium. Serum, urine, and dialysate concentrations of cefotaxime and desacetylcefotaxime were determined using high performance liquid chromatography. The results indicate that gender has no clinically significant influence on the disposition of cefotaxime or its active metabolite desacetylcefotaxime. PMID- 3672568 TI - Comparison of the pharmacokinetics of AMSA and AMSA-lactate in patients with acute nonlymphoblastic leukemia. AB - A pharmacokinetic study was performed in 13 adult patients with acute nonlymphoblastic leukemia to compare two formulations of 4'-(9-acridinylamino) methanesulphone-m-ansidide (AMSA): the original formulation, AMSA-NCL, and a water-soluble lyophilized formulation, AMSA-lactate (Bristol Myers, Syracuse, N.Y. USA). Initially, the patients received either AMSA-NCL or AMSA-lactate, 75 90 mg/m2 daily, for 3-7 days as a 1-h infusion. Eight patients subsequently crossed over to receive the other formulation. Plasma samples for drug determination were collected during the first 3 days. A new method for determination of AMSA is described. Acidified plasma samples containing an internal standard were extracted with hexane, then made alkaline, whereafter, AMSA was extracted with ethylacetate. Extracts were reconstituted in absolute ethanol and analyzed by high-pressure liquid chromatography (HPLC) using a reverse-phase C-18 column and UV detection at 254 nm. There were no clear differences in clinical effects and toxicity between the two formulations. Patients with the highest total area under the drug concentration-versus-time curves (AUCs) for plasma concentrations versus time had significantly lower nadir for white blood cell count, suggesting a relation between plasma levels and bone marrow toxicity for AMSA. The pharmacokinetics showed a biphasic elimination for both formulations. The mean terminal elimination half-life of AMSA-NCL and AMSA lactate was 7.1 and 6.3 h, respectively, and the mean volume of distribution was 105 and 99 L/m2, respectively. No significant differences in the pharmacokinetics comparing days 1 and 3 were seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3672569 TI - Altered protein binding of disopyramide in plasma from patients with cancer and with inflammatory disease. AB - Protein binding of disopyramide (D) was studied in eight patients with cancer, seven with inflammatory diseases, and seven healthy subjects. Plasma samples containing concentrations of 0.2-12.0 micrograms/ml were ultrafiltered, and the free fractions were measured with fluorescence polarization immunoassay. The mean free fractions at D concentrations ranging from 1.0 to 6.0 micrograms/ml were significantly less in patients with cancer (p less than 0.01) and those with inflammatory diseases (p less than 0.05) than in healthy subjects. Patients with cancer had a greater (p less than 0.05) D binding than those with inflammatory diseases. A multiple regression analysis revealed a significant contribution of plasma alpha 1-acid glycoprotein (AAG) (r = -0.79, p less than 0.01), but not of albumin (r = -0.096), to the overall variability in D binding at 3.0 micrograms/ml. The mean capacity constant in the two patient groups was similar, but significantly (p less than 0.01) greater than in the healthy group. Nonspecific D binding was greater in cancer patients (p less than 0.01) compared to the other two groups. Our results suggest that (a) therapeutic range of D measured as total drug concentration in patients with cancer and with inflammatory diseases would be greater than previously thought, and (b) unidentified component(s) (other than AAG and albumin) might contribute to the greater D binding in cancer patients compared to other study groups. PMID- 3672570 TI - Theophylline clearance during and after mild upper respiratory infection. AB - Theophylline clearance was estimated by a single-sample technique in 19 subjects with acute clinical respiratory infections. Mean (+/- SD) theophylline clearance during acute illness was 0.044 +/- 0.011 L X h-1 X kg-1 compared to 0.043 +/- 0.012 L X h-1 X kg-1 1 month later. In a subset of five subjects, single-sample clearance estimates were not different from standard multi-sample clearance estimates. Mild upper respiratory infection does not appear to alter theophylline clearance in adults. PMID- 3672571 TI - Changes in lignocaine disposition during long-term infusion in patients with acute ventricular arrhythmias. AB - Lignocaine disposition was studied in 30 patients with acute ventricular arrhythmias. Serum concentrations of lignocaine, its metabolites Monoethylglycine xylidide (MEGX) and glycine xylidide (GX), and alpha 1-acid glycoprotein (AAG) were analyzed during and after a 48-h lignocaine infusion. AAG concentrations tended to rise in patients with acute myocardial infarction (AMI), leading to binding of the drug in plasma. Lignocaine clearance was estimated at various times during the infusion using a Bayesian parameter estimation program and was found to decline over the course of the infusion. There was a significant reduction in clearance based on estimates obtained at the end of the infusion compared with estimates obtained during the first 0-5 h. Clearance was reduced both in patients who had an AMI and those who did not. Multiple linear regression analysis of the clearance data revealed that these changes could be described by a linear function of time and AAG concentration. These findings suggest that other factors in addition to protein binding changes may influence lignocaine disposition during long-term infusion. PMID- 3672573 TI - Serum concentrations of carbamazepine and its epoxide and diol metabolites in epileptic patients: the influence of dose and comedication. AB - The influence of carbamazepine (CBZ) dose, CBZ preparation used, comedication (phenobarbital, phenytoin, primidone, valproate), and factors such as age, weight, and sex on the concentration of CBZ and its metabolites carbamazepine 10,11-epoxide (CBZ-epoxide) and 10,11-dihydro-10,11-dihydroxy-carbamazepine (CBZ diol) in serum was investigated. A non-linear regression analysis using the data of 609 patients shows that other anti-epileptic drugs can influence the metabolism of CBZ in various ways. The mean serum concentration of CBZ is lower when the drug is given in combination with phenytoin (59.4%), primidone (58.2%), phenobarbital (65.7%), and valproate (83.0%) than when CBZ is given alone (100%), whereas the mean concentration of CBZ-epoxide is increased by valproate (144.8%), by primidone (118.5%), and by a combination of the latter (167.4%). The CBZ-diol concentrations are also increased during concomitant treatment with the other antiepileptic drugs. Our results indicate a nonlinear relationship between the CBZ dose and the CBZ concentration, but a linear relationship between the CBZ dose and the CBZ-diol concentration. PMID- 3672572 TI - Serum lidocaine concentrations following application to the oropharynx: effects of cimetidine. AB - Solutions of lidocaine hydrochloride are widely used for anesthesia of the oropharynx and respiratory tract prior to endoscopic procedures. It is commonly believed that this route of administration is not associated with clinically significant systemic absorption of the drug, and large doses of topical lidocaine are routinely used in this setting. Serious adverse effects, including seizures, occasionally occur. The extent of absorption of lidocaine from the oropharynx was studied in eight healthy volunteers. Wide variation in serum lidocaine concentrations was observed. A 14-fold range of peak lidocaine concentrations occurred following identical, accurately metered doses of a lidocaine aerosol spray preparation. The effects of cimetidine on lidocaine pharmacokinetics were also studied. Therapeutic doses of oral cimetidine significantly increased the area under the lidocaine time-concentration curve (p = 0.019), but no effect on the terminal-phase elimination rate constant was observed. Serum concentrations of alpha 1-acid glycoprotein, a major binding protein of lidocaine, were significantly elevated following cimetidine (p = 0.030). Maximum lidocaine concentration, time to reach maximum concentration, and mean residence time of lidocaine were unchanged following cimetidine. These observations suggest an effect of cimetidine on the volume of distribution of lidocaine. Because of the wide variability in lidocaine pharmacokinetics and the potentially serious nature of adverse reactions, caution is advised in the use of topical lidocaine solutions in "standard" doses. PMID- 3672574 TI - Utilization of Km for phenytoin dosage after folate addition to patient regimen. AB - Phenytoin decreases serum and red blood cell folates in 50% of the patients on the anticonvulsant. The supplementation of folic acid changes the disposition of phenytoin, a drug that exhibits Michaelis-Menten kinetics. In a retrospective study at the Veterans Administration Medical Center, seven adult male folate deficient epileptic patients on phenytoin alone and compliant with the anticonvulsant were supplemented with 1 mg oral folic acid. Before and after the addition of the vitamin, Vmax and Km were calculated for phenytoin. With folic acid, the total serum phenytoin concentration decreased significantly by an average of 22.6 +/- 13.0%. The Km decreased significantly from 6.7 +/- 1.1 to 4.1 +/- 1.5 micrograms/ml. The Vmax remained unchanged. It is hypothesized that folic acid is a cofactor in the metabolism of phenytoin. A cofactor would be expected to alter the affinity (Km) of the enzymes for phenytoin with no change in the liver's total capacity (Vmax) to metabolize phenytoin. This retrospective study in seven male epileptic patients is a convincing argument for the hypothesis. PMID- 3672575 TI - Positive impact of a therapeutic drug-monitoring program on total aminoglycoside dose and cost of hospitalization. AB - A prospective evaluation was undertaken to assess the impact of an aminoglycoside therapeutic drug-monitoring (TDM) program on the total dose of aminoglycoside antibiotics, the duration of therapy, the number of serum concentrations determined, the length of hospital stay, and the potential cost reduction in 221 patients with proven or suspected gram-negative infections. The patients were allocated to a group that received individualized aminoglycoside doses (study) or to a group that did not (control). The mean total dose of gentamicin or tobramycin per patient course of therapy was 1,258 mg in the study group and 1,981 mg in the control group (p less than 0.0001). The mean duration of therapy was 5.9 and 10.3 days per patient in the study and control group, respectively (p less than 0.0001). The mean length of hospital stay was 8.4 days in the study group and 11.8 days for the control (p less than 0.005). The type and site of infection, number of serum concentration determinations, and mortality were not statistically different for the groups. These data indicate that a TDM program can markedly reduce the total dose of aminoglycoside, which can potentially reduce tissue accumulation and toxicity. In addition, the hospital costs were $725 less per patient in the study group, which would produce a savings of approximately $640,000 per year at our institution. PMID- 3672576 TI - An evaluation of a clinical pharmacokinetic service for serum digoxin levels. AB - The appropriateness of requests by physicians for serum digoxin measurements (SDMs) and the appropriateness of responses by physicians to a reported SDM were evaluated with and without the contribution of a pharmacy-based clinical pharmacokinetic service (CPS). Also, for each patient, the difference between dosage regimens that had been established by means of SDMs and those regimens that would have been estimated by the method of Dobbs et al. was analyzed. This prospective evaluation involved two 3-week phases and included inpatients. During phase I the CPS was intact, while during phase II it was discontinued. There was a significant increase from phase I (23.4%) to phase II (36.4%) in the rate of inappropriate action or inaction with respect to requesting SDMs. There was also a significant increase from 9.7 to 24.6% in the rate of inappropriate dosage adjustments in response to a reported SDM. There was a statistically significant difference between the digoxin dosages estimated by the method of Dobbs et al. and the actual dosage regimen established with SDMs. The disparity between the CPS approach and the Dobb et al. method was such that 23.4% of digoxin dosage regimens determined with the guidance of SDMs did not result in an estimated steady-state level within the therapeutic range when those regimens were applied to the Dobbs et al. method. Thus, the pharmacy-based CPS improved the appropriateness of physician utilization of SDMs. Also, sole use of the Dobbs et al. method as an example of a noninvasive approach to digoxin dosing is not a reasonable alternative in a tertiary care institution. PMID- 3672577 TI - Comparative evaluation of equilibrium dialysis methods employing biological and artificial membranes for the determination of protein binding of drugs. AB - The goal of the study was to investigate comparatively the performance of the conventional equilibrium dialysis method using artificial membranes (AED) and an alternative equilibrium dialysis method employing biological membranes of red blood cells (BED). The following criteria were employed for an assessment of the two methods: (a) mean estimate of the fraction of drug unbound in plasma, (b) precision, and (c) time required for establishing equilibrium dialysis. For this purpose, plasma protein binding data by AED and BED obtained for several compounds in our laboratory were employed. In addition, suitable results of further compounds on the plasma protein binding by AED and on the partitioning in red cell buffer and plasma systems were collected from the literature, allowing a calculation of the plasma protein binding by BED. Plasma protein binding values by AED and BED were available for a total of 22 nonelectrolytic and electrolytic compounds, including the entire possible range of binding values. Plots of the mean plasma unbound fractions as obtained by AED and BED for the compounds studied could be fitted by a straight line with slope and intercept not significantly different from unity and zero, respectively. Also, the precision of the two methods appeared to be similar. However, the times required to reach equilibrium dialysis were significantly different: With BED and AED, this time span ranged between 2 and 45 and 180 and 960 min, respectively. These results indicate that overall the BED method offers a significant advantage over the AED procedure: It is less time consuming and hence possibly more reliable. PMID- 3672578 TI - Determination of clonazepam in serum by high performance liquid chromatography. AB - A simple, specific, and sensitive high-performance liquid chromatography (HPLC) method has been developed for the routine monitoring in serum of the benzodiazepine anticonvulsant, clonazepam. Serum spiked with internal standard, methylclonazepam, was vortex-mixed for 1 min with chloroform at an alkaline pH. The evaporated extract was dissolved in the HPLC mobile phase consisting of sodium phosphate buffer, acetonitrile, and methanol. Analytics were resolved at ambient temperature on a 5-micron Supelcosil LC-PCN column (150 X 4.6 mm) equipped with a guard column. Flow rate was 2.0 ml/min, and monitoring was at 306 nm. The calibration curve was linear from 2 to 200 ng/ml. This method provides selectivity and sensitivity with a precision of 3.5%, average recovery of 99%, and no interference from 42 commonly administered drugs. PMID- 3672579 TI - Electrochemical detection of benperidol in serum for drug monitoring in humans. AB - A high-pressure liquid chromatographic (HPLC) method for the serum assay of benperidol is described. One ml of serum is required for a single estimation. The method involves a simple and rapid extraction step (BondElut columns), HPLC separation (C8 10-mu column), and electrochemical detection (+0.65 V). Haloperidol is used as internal standard. On the basis of this procedure, recovery (93-97%) and reproducibility (intra-assay and inter-assay coefficients of variation less than 9%) are satisfactory. The detection limit is 0.2 ng/ml of serum. After therapeutic doses, trough serum levels ranged from 3.8 to 12 ng/ml in five patients. PMID- 3672580 TI - Routine methods in toxicology and therapeutic drug monitoring by high performance liquid chromatography. II. A rapid microscale method for determination of chloramphenicol in blood and cerebrospinal fluid. AB - A highly sensitive, specific method for determining chloramphenicol levels in human blood plasma and cerebrospinal fluid is described. The method uses high performance liquid chromatography for the analysis, requires minimal quantities of patient specimen, and thus is suitable for use in newborn and pediatric patients. The method described in this article is specifically developed for routine use in laboratories engaged in therapeutic drug monitoring. It has advantages over other methods because it is less time consuming and can be used with commercially available controls. PMID- 3672581 TI - Reversed-phase high-performance liquid chromatography determination of cyclosporin in human blood. AB - A high-performance liquid chromatographic (HPLC) method for determination of cyclosporin A (CyA) in blood, using cyclosporin D (CyD) as internal standard, is described. The method is specific, precise, reproducible, accurate, and isocratic, and it requires no derivatization. It is more rapid than previously described methods. Its detection limit is 25 ng/ml, suitable for quantitation of the drug at clinically observed concentrations. No interference was found by any of the other commonly coadministered drugs tested. Comparison of measurements in patients' blood with radioimmunoassay (RIA) results showed lower estimates by the chromatographic technique. Because measurements of the drug in blood banks spiked with pure CyA were similar with the two techniques, the nonspecificity of RIA, probably related to cyclosporin metabolites, was demonstrated. Because the chromatographic technique is simple, it should be preferred to RIA in therapeutic drug monitoring. PMID- 3672582 TI - Therapeutic monitoring of chlorpromazine. IV: Comparison of a new high performance liquid chromatographic method with radioimmunoassays for parent drug and some of its major metabolites. AB - A new high-performance liquid chromatographic (HPLC) procedure for the simultaneous determination of chlorpromazine and its six metabolites, namely, 7 hydroxy-chlorpromazine, N-monodesmethyl-chlorpromazine, 7-hydroxy-N-monodesmethyl chlorpromazine, chlorpromazine-sulfoxide, chlorpromazine N-oxide, and N monodesmethyl-chlorpromazine-sulfoxide, in plasma was developed and compared with four radioimmunoassay (RIA) procedures that measured separately chlorpromazine, 7 hydroxy-chlorpromazine, chlorpromazine-sulfoxide, and chlorpromazine N-oxide. The results of this study for the determination of plasma levels in four healthy volunteers given a 100-mg single oral dose of chlorpromazine hydrochloride demonstrated that in some cases, strong correlations could be found between the plasma levels determined by the HPLC and RIA procedures, whereas in other cases, there was a lack of strong correlation. The discrepancies observed were not only due to nonspecificity of the immunoassay procedures employed, but also to a lack of rigorous specificity of the HPLC procedure in plasma samples from dosed humans. These findings clearly indicate that even a chemical method of analysis, such as HPLC, has its limitations in its application to multianalyte analysis, as is the case with drugs like chlorpromazine. PMID- 3672583 TI - Effect of thymic humoral factor (THF) on hemopoiesis in neonatally thymectomized mice. PMID- 3672584 TI - [The price of survival]. PMID- 3672585 TI - [Perspective on continued development in geriatrics]. AB - The Health Department (WVC) has given the National Hospital Institute (NZI) the task to conduct a study with respect to geriatric wards in general hospitals. In the final report of the NZI the recommendation was made to officially acknowledge clinical geriatrics in general hospitals as a function. Geriatric wards as well as geriatric policlinics are necessary in every region. In this article the researchers advise to apply the insights and experiences of geriatric wards and policlinics to other wards in general hospitals, especially wards where many elderly patients stay. The function and position of clinical geriatrics need to be specified in relation to other institutions for the care of the elderly and in particular to nursing homes. In the Netherlands the nursing homes also have a rehabilitation function. So a more permanent dialogue is necessary between clinical geriatrics and other institutions. PMID- 3672586 TI - [Households in the reduction stage of the housing market. Analysis of behavior and prospects for the year 2000]. AB - The aging of the Dutch population will lead to a larger demand for housing for the elderly. But this is not the only effect the aging population will have on the housing market. Till the year 2000 the group of households in the reduction stage will grow substantially. These households experience a reduction in size because children leave their parents' home or one of the partners dies. These households behave quite differently on the housing market than younger households. Simulation models have been developed to analyse both growth and composition of the group of older households and their behaviour on the housing market till the year 2000. The result show that the housing needs of the elderly in the future differ widely from those of the present cohorts. PMID- 3672587 TI - [Nursing home problems in a large city. A report from practice]. AB - At the moment The Hague has the oldest population of all Dutch cities. In the years to come this will continue to be so. Even though the permitted permillage for nursing home beds for the three major cities in Holland is already higher than for other cities, the permitted permillage for the number of beds in The Hague is even higher. Nevertheless, at this moment The Hague is facing a huge problem in placing patients with irreversible demential disorders. PMID- 3672588 TI - [Clinical observation: a nursing home function? Comments on the article 'Clinical observation in a nursing home']. PMID- 3672589 TI - Outpatient endoscopy: the nurse's role. PMID- 3672590 TI - Meet the challenge: become a continuing educator. PMID- 3672591 TI - Operating at maximum efficiency. PMID- 3672592 TI - A realistic approach to nursing management. PMID- 3672593 TI - The making of a nose. PMID- 3672594 TI - Using a problem solving approach. PMID- 3672595 TI - From nursing with love. PMID- 3672596 TI - Hepatitis B: the facts made simple. PMID- 3672597 TI - RGN BA! (Registered Graduate Nurse). PMID- 3672598 TI - In the best tradition. PMID- 3672599 TI - Vox non pop. Uniforms: barrier to infection--or patients? PMID- 3672600 TI - Nursing as one solution to the nation's health care problems. PMID- 3672601 TI - Appropriate quality in health care. PMID- 3672602 TI - Cost control: a surgeon's perspective. PMID- 3672603 TI - A Presidential forum on health issues. Remarks by the President. PMID- 3672604 TI - The ethics of medicine: the challenges of reconstruction. PMID- 3672606 TI - Segmental small intestinal allografts in the dog. I. Morphological and functional indices of rejection. AB - Fourteen dogs received an orthotopically vascularized allograft of a 100-cm length of terminal ileum as a Thiry-Vella segment. Absorption, motility, myoelectrical activity and morphology of the allograft were studied to determine the most reliable indices of rejection. The earliest histological evidence of rejection occurred at a mean of 6.2 +/- 0.9 days and was coincident with significant deterioration in the absorption of water, alanine, lauric acid, sodium, and glucose. Intestinal motility did not decrease until 7-8 days after transplantation, and intestinal myoelectrical activity was unchanged for a further 2-3 days, by which time graft necrosis was imminent. Reduced intestinal motility occurs only after rejection is established, and is therefore of little use as an index of rejection, while recording intestinal myoelectrical activity is valueless and serves only to confirm graft death. Decreased intestinal absorption of water, sodium, glucose, alanine, and lauric acid are present as early as the first changes in mucosal histology and are useful indices of rejection of intestinal allografts. PMID- 3672605 TI - Total orthotopic small bowel transplantation with cyclosporine. AB - The efficacy of immunosuppression including intravenous cyclosporine was assessed in a dog model of total orthotopic small bowel transplantation. Without immunosuppression, allografted animals died before the thirteenth postoperative day. Cyclosporine and prednisone therapy afforded a sixfold increase in survival of allografted animals. Bowel preparation, such as ex-vivo irradiation, treatment of the donor animal with antithymocyte globulin (ATG), or bowel preservation, did not appear to affect survival. However, a preliminary study of combination therapy using azathioprine, ATG, prednisone, and cyclosporine indicated that there were fewer early deaths as compared with other groups. Histologically, allografted bowel showed various degrees of mucosal change to which poorer nutritional aspects were attributed. "Intestinal death" caused by rejection was considered to be the principal cause of death in animals with advanced mucosal changes, in particular those who were long-term survivors. However, other debilitating factors (e.g., superimposed infection, endotoxemia, or possibly graft-versus-host reaction) may be present in nonsurvivors demonstrating fewer pathological changes in the graft. PMID- 3672607 TI - Segmental small intestinal allografts. II. Inadequate function with cyclosporine immunosuppression: evidence of a protein-losing enteropathy. AB - Terminal ileum was autografted (24 dogs) or allografted (18 dogs) as a 100-cm Thiry-Vella segment, and absorption, motility, and histology were studied. Dogs with allografts were given cyclosporine (CsA) 20 mg/kg/day. At a second operation 5 to 6 weeks after transplantation continuity of the nontransplanted intestine with the Thiry-Vella segment was restored. At a third operation 3 months after autografting, all the non-transplanted small intestine was excised. All technically successful autografts survived indefinitely, and the dogs weights were maintained at 88 +/- 0.6% (mean +/- SE) of preoperative weights by absorption from the autografted intestine. Administration of cyclosporine to dogs with intestinal autografts produced a reversible impairment of intestinal absorption. Dogs with allografts survived 63.3 +/- 15.5 days (mean +/- SE). Death within 9 weeks of transplantation was from peritonitis secondary to graft rejection. Death in long survivors was a consequence of inadequate intestinal absorption. In the first 4 weeks after transplantation absorption and motility of allografted Thiry-Vella segments was comparable to the intestinal autografts but allografts showed evidence of a protein losing enteropathy. Large volumes of high protein-content fluid were lost from the allografted Thiry-Vella segments, and dogs with allografts became hypoalbuminemic. PMID- 3672609 TI - The abrogation of thyroid allograft rejection by culture in acid medium. PMID- 3672608 TI - Retardation of renal growth and ornithine decarboxylase activity by cyclosporine after uninephrectomy in rats. AB - Renal transplantation or a partial reduction in renal mass prompts compensatory growth of the kidney, an event that appears to be stimulated by a circulating substance, the purported renotropic factor. This factor may stimulate synthesis of renal polyamines by induction of the rate-limiting enzyme in polyamine metabolism, ornithine decarboxylase. Cyclosporine has been shown to attenuate induction of renal ornithine decarboxylase activity in response to other tropic hormones, such as prolactin, thyroxine, and dexamethasone. These studies were undertaken to evaluate the effects of cyclosporine on induction of renal ornithine decarboxylase activity and growth in response to the serum renotropic factor. Rats were given either 15.0 or 25.0 mg/kg/day or cyclosporine for six days following removal of one kidney. The growth of the remaining kidney was reduced by cyclosporine treatment compared with pair-fed, vehicle-treated control animals. Administration of 25.0 mg/kg/day of cyclosporine also reduced the activity of ornithine decarboxylase in the growing kidney. We conclude that cyclosporine imposes a limitation on the ability of the kidney to grow in response to a reduction in renal mass in rats. The mechanisms of this effect may relate to a blunting of the induction of renal ornithine decarboxylase activity in response to the renotropic factor. PMID- 3672610 TI - Protective effect of lipo-prostaglandin E1 on post-ischemic renal failure. PMID- 3672611 TI - Beneficial effects of calcium antagonist pretreatment and albumin infusion on cyclosporine A-induced impairment of kidney microcirculation in mice. PMID- 3672612 TI - Absorption of vitamin A after orthotopic small bowel transplantation: evidence for the development of graft adaptation to lipid metabolism. PMID- 3672613 TI - Hand transplantation in baboons. PMID- 3672614 TI - Brain death, triiodothyronine depletion, and inhibition of oxidative phosphorylation: relevance to management of organ donors. PMID- 3672615 TI - Inability to maintain adenine nucleotide levels by cold storage in ischemically damaged and control kidneys. PMID- 3672617 TI - A new perfusion tube for multiple organ procurement. PMID- 3672616 TI - Evaluation of intracellular energy status during liver preservation by 31P-NMR spectroscopy. PMID- 3672618 TI - Cyclosporine-induced cholestasis: inhibition of bile acid secretion is caused by the parental molecule. PMID- 3672619 TI - Physiologic and hormonal changes in experimentally induced brain dead dogs. PMID- 3672620 TI - The effect of ketanserin during pulsatile hypothermic perfusion of canine kidneys. PMID- 3672621 TI - Grafting of allogeneic cultured epidermis does not induce anti-HLA immunization. PMID- 3672623 TI - Pathology of pulmonary hypertension. PMID- 3672622 TI - Histologic changes in atrophic spleens of mice treated with cyclosporine A. PMID- 3672624 TI - Small bowel transplantation in the rat: a new technique. PMID- 3672626 TI - Cytopathology for the tropical doctor. PMID- 3672625 TI - World blindness--a challenge to all doctors. PMID- 3672627 TI - Essential drug list in a rural hospital. Does it have any influence on drug prescription? PMID- 3672628 TI - Minimizing unnecessary X-ray examinations. PMID- 3672629 TI - Bladder stone in rural Nepal. PMID- 3672630 TI - Dialysis in the Third World. PMID- 3672631 TI - Treatment of chronic osteomyelitis with gentamicin-PMMA beads. A prospective study in Nepal. PMID- 3672632 TI - Diagnosis of primary open angle glaucoma by doctors and medical auxiliaries. PMID- 3672633 TI - Onchocerciasis and pregnancy. Traditional beliefs of Yoruba women in Nigeria. PMID- 3672634 TI - Labour ward management. PMID- 3672635 TI - Home-made jelly duplicator. PMID- 3672636 TI - [Quantitative evaluation of ultrastructural restructuring in the adrenal cortex of rats under stress]. AB - Quantitative and qualitative analysis has revealed that submicroscopic changes of the rat adrenal cortex in dynamics of the stress reaction examined at the level of "functional element" which combines basic structural components of the parenchyma and stroma are of the polyphase character and agree with data from the biochemical analysis of 11-OCS in blood plasma. At the stage of exhaustion of the stress reaction (72 hours of immobilization) the ultrastructure of the adrenal cortex testifies to the preservation of functional reserves in the secretory cells. PMID- 3672637 TI - [Reproductive kinetics of differentiating chondrocytes in normal states and in exposure to lead acetate]. AB - Parameters of the mitotic cycle of chondrocytes in the skeletal extremities of the rat foetuses were estimated in various experiments with 3H-thymidine. Lead acetate entering the organism during the gestation period influenced the mitotic cycle duration, increasing it at the expense of a presynthetic phase. A change in the proliferation rates delayed the bones' growth and affected the morphological structure of the forming epiphyseal cartilage. PMID- 3672638 TI - [Incidence of familial longevity among the population of the Ukrainian SSR]. AB - The genealogical method was used to study the family longevity in 220 individuals aged 80 and older in the Ukrainian SSR. The family longevity rate and total index are found to increase with the age of individuals examined. These indices in most cases are higher in men than in women and can be used as genetic markers to estimate the potential longevity. PMID- 3672639 TI - [Levels of DNA and sex chromatin bodies in the myocyte nuclei of different sections of the human heart]. AB - Nuclei of ventricular, atrial and atrioventricular node myocytes of normal and hypertrophied human heart were studied on squash preparations and on 12 micron sections after the Feulgen staining. The cytophotometric DNA measurements have shown a distinction in the degree of polyploidization of nuclei in different heart compartments. In contrast to ventricular and atrial myocardia, in which polyploid nuclei predominate, the conduction system myocytes contain 77-88% of diploid nuclei. A correlation between DNA content and the number of sex chromatin bodies was observed for myocyte nuclei from all the compartments under investigation. PMID- 3672640 TI - [Role of multipolar mitoses in the proliferation of multinucleate cells induced by cytochalasin B]. AB - A prolonged action of cytochalasin B results in the formation of numerous multipolar mitoses (26%) in Chinese hamster cell cultures. The transition to multipolar mitoses in the presence of cytochalasin B is not accompanied by K mitotic delay. It is shown that a multipolar mitosis without cytoplasmic division is one of the main causes of multinucleation development in cytochalasin B treated cultures. After stopping the drug action the cytochalasin B-induced multinucleate cells continue to divide by multipolar mitosis. In this case it completes with cytokinesis and, probably, leads to a decrease in the number of nuclei per cell. The origin of multipolar mitotic apparatus after the action of cytochalasin B is discussed in addition to the role of multipolar mitosis in formation and proliferation of multinucleate cells. PMID- 3672642 TI - [Growth-stimulating effect of UF-irradiated blood. I. The radiation dose dependence of the initial growth potencies of blood and of the functional state of the target cells]. AB - UV irradiation (UVI) of donor blood in the apparatus used in hospitals of the USSR with the therapeutic aim of autotransfusion of UV-irradiated blood (AUVIB), results in an increase of connective tissue cell growth potency: being added into culture media the supernatants of irradiated blood stimulate DNA-synthetic and proliferative activity of cultured human embryonic cells. The high activity of cells persists for about 2 days. The effect is great with low initial levels of cell proliferative activity. In this case the effect is maximum (about 125% of the control). It is suggested that the above effect may be involved in the mechanism of stimulation of regeneration processes in the organism after AUVIB. PMID- 3672641 TI - [Cell populations of transplantable murine tumors of various degrees of histogenesis during their proliferation in the anterior chamber]. AB - Six transplantable murine tumors of different histogenesis were investigated after transplantation to subcutaneous connective tissue (SCT) and the eye anterior chamber (EAC). Cell morphology was studied using light microscopy. DNA contents in the nuclei of tumor cells were investigated with flow cytometry technique. LDH isoenzymes were studied using electrophoresis in polyacrylamide gel. In the case of tumors with near diploid modal class, a redistribution of LDH isoenzyme activity and an increase in morphological differentiation level were obtained. In the case of tumors with modal class differing from the diploid one, a morphological structure changes were revealed, but there were no differences in LDH isoenzyme activity. The data obtained show that the capability of increasing morphological and biochemical differentiation level after cultivation in the EAC of murine transplantable tumors remains even on the late stages of progression in tumors of different histogenesis with near diploid value of modal class. PMID- 3672643 TI - [Differentiation of Leishmania in culture]. AB - During their cultivation on diphasic medium Leishmania donovani, L. major and L. gymnodactyli pass through the regular differentiation within the promastigote stage of the life cycle that involves a gradual change of the four main morphological forms: 1) extremely basophilic, short, wide, actively dividing cells; 2) lightening longer forms with pointed posterior ends; 3) long, cigar shaped uniformly light specimens with the clear nucleus in the central or posterior position and distinct karyosome; 4) small narrow nearly non-basophilic cells with a long compact nucleus and a rather large kinetoplast. The latter are similar, on the one hand, to the final stage of Leishmania development in Phlebotomus and, on the other hand, to metacyclic forms of Trypanosoma cruzi infective for the vertebrate host. PMID- 3672644 TI - [Recovery from thermal damage of mammalian cells fixed by treatment with a hypertonic sodium chloride solution]. AB - The survival of Chinese hamster cell V79-4 after hyperthermic treatment (42 degrees C, 40 minutes) in the exponential growth phase considerably increases with the duration of holding them in the growth medium at 37 degrees C before hypertonic salt treatment (1.5 M NaCl, 15 minutes). The experimental data are interpreted as a recovery of mammalian cells from thermal lesions, whose lethal action manifests itself at high salt concentrations. PMID- 3672645 TI - [A scanning cytophotometer for the analysis of closely contiguous objects]. AB - A measuring complex including microscope-photometer and computer is described to be used for scanning of a sample inside of an arbitrary contour. The complex is supplied with a television channel for simultaneous control of the sample and photometric diaphragm, and also with a manual manipulator for setting the boundaries of the informational zone. At the end of scanning the cytophotometric and morphometric data are registered. PMID- 3672646 TI - [5th National Congress of Experimental and Clinical Oncology. Ancona, 18-21 October 1987. Abstracts]. PMID- 3672647 TI - [19th National Symposium of the Italian Cancer Society. Ancona, 18-21 October 1987. Abstracts]. PMID- 3672648 TI - [13th scientific meeting of the Italian Association of Medical Oncology. Ancona, 18-21 October 1987. Abstracts]. PMID- 3672649 TI - Seadragon VI: a 7-day saturation dive at 31 ATA. PMID- 3672650 TI - Seadragon VI: a 7-day dry saturation dive at 31 ATA. I. Objectives, design, and scope. AB - Seadragon VI dive was designed to determine the effects on humans of a prolonged exposure to a 31 ATA, dry helium-oxygen environment. The specific objectives were to study a) circadian changes in renal-endocrine function, including a comprehensive characterization of nocturia; b) cardiovascular-endocrine responses to a 90 degree tilt; c) erythrocyte functions, including intracellular organic phosphates and the Donnan ratio for chloride; and d) blood enzyme profiles. The experiment was conducted over a period of 30 d in September and October 1984 at the Japan Marine Science and Technology Center, Yokosuka. Following a 5-d predive control period at 1 ATA in air, 4 male divers spent 7 d at 31 ATA in a helium oxygen environment, and then returned to 1 ATA air after 12 d of decompression. They stayed an additional 3 d inside the chamber for postdive control measurements. The chamber temperature was maintained at 27-28 degrees C during pre- and postdive periods, 31-32 degrees C at 31 ATA, and 28-31 degrees C during decompression. At 31 ATA, PO2 and PCO2 of the chamber gas were maintained at approximately 225 and 2 mmHg, respectively. In this introductory paper, physical and physiologic characteristics of individual subjects, the major daily activity schedule, daily caloric intake, and the scope of investigation are presented. PMID- 3672652 TI - Seadragon VI: a 7-day dry saturation dive at 31 ATA. IV. Circadian analysis of body temperature and renal functions. AB - Circadian rhythms of body temperature and daytime rhythms of urine flow and urinary excretion of electrolytes were investigated in 4 male subjects before, during, and after a 7-d stay in a dry heliox 31 ATA environment. The chamber temperature was maintained at about 28 degrees C during pre- and postdive 1 ATA periods and was raised to 31.5 degrees C at 31 ATA. The circadian rhythm of the rectal temperature, as analyzed by the cosinor fitting method, showed the same mesor (the mean level of fluctuation) and the amplitude at 31 and 1 ATA. However, a reversible phase shift was noted at 31 ATA in which the acrophase shifted to 1435 h at 31 ATA from 1540 h (predive) or 1610 h (postdive) at 1 ATA. This shift was attributed to an early rise of rectal temperature during night at 31 ATA. A similar phase shift was observed at 31 ATA for the skin temperature of the forehead, a region not covered by clothing or blanket. The daytime rhythms of urinary excretion of water, Na, Cl, urea, and total osmotic substances were similar, with the acrophase at 1300-1500 h at both 1 and 31 ATA. On the other hand, the daytime rhythm for urinary excretion of K, which was similar to the above at 1 ATA, disappeared at 31 ATA. The urinary excretion of endogenous creatinine remained constant during both daytime and nighttime at both 1 and 31 ATA. These results suggest that exposure to 31 ATA may alter the underlying pattern of circadian or daytime rhythms for thermoregulatory and certain renal functions. PMID- 3672651 TI - Seadragon VI: a 7-day dry saturation dive at 31 ATA. II. Characteristics of diuresis and nocturia. AB - Four male divers were exposed to a dry, 31 ATA, He-O2 environment for 7 d (Seadragon VI). Urine was collected diurnally (0700-2200 h) and nocturnally (2200 0700 h) before (predive 1 ATA air), during, and after (decompression and postdive 1 ATA air) exposure to 31 ATA. A typical hyperbaric diuresis associated with a reduction in urine osmolality was observed in the face of a constant creatinine clearance. A significant increase (P less than 0.05) in osmolal clearance (COSM) was observed with concomitant decrease (P less than 0.05) in negative free water clearance, indicating that the diuresis has both osmotic and free water components. Although urine flow increased at pressure during both day and night, its magnitude was twofold greater at night as compared to daytime. Moreover, the diurnal diuresis was entirely due to an increase in free water excretion, whereas the nocturnal diuresis was largely due to an increased COSM. These results indicate that hyperbaric diuresis is induced by inhibition of tubular reabsorption of free water during daytime and of certain solutes during the night. Approximately 80% of the nocturnal increase in the excretion of osmotic substances was accounted for by Na, K, Cl, and urea. PMID- 3672654 TI - Seadragon VI: a 7-day dry saturation dive at 31 ATA. VII. Erythrocyte functions. AB - Organic phosphates and the Donnan ratio (cell to plasma Cl ratio) were measured in man during a dry saturation dive to 31 ATA for 7 d. 2,3-DPG increased significantly with a concomitant decrease in ATP and the molar ratios of ATP and ADP on Day 5 at 31 ATA (P less than 0.05). Inorganic phosphate did not change during the dive. The Donnan ratio was relatively high at 31 ATA and the value was significantly different on Day 3 at 31 ATA (0.731 at 1 ATA vs. 0.895 at 31 ATA, P less than 0.05). This suggests a rise in intracellular pH, resulting from a change in the net charge of hemoglobin. It is speculated that an increase in oxygen affinity of hemoglobin occurs during the early phase at 31 ATA and is followed by an increase in 2,3-DPG in response to the resulting tissue hypoxia. PMID- 3672653 TI - Seadragon VI: a 7-day saturation dive at 31 ATA. V. Cardiovascular responses to a 90 degree body tilt. AB - Cardiovascular deconditioning (CD) has been reported to occur in weightlessness, bed rest, and head-out water immersion. An expanded intrathoracic blood volume results, at least initially, in all these diverse conditions. Subjects in hyperbaric environments exhibit cephalad redistribution of blood volume, which also occurs in weightlessness, bed rest, and head-out water immersion. This physiologic similarity led us to suspect that CD may also occur as a consequence of hyperbaric exposure. We examined this possibility in 3 young male subjects during a 7-d dry saturation dive at 31 ATA. Changes in blood pressure, heart rate, and stroke volume were measured before and during 15 min of the 90 degree body tilt. These changes, expressed either singly or in combination, provided indications of CD during and immediately after hyperbaric exposure. One of the principal indicators of CD was the inability to exert adequate vasoconstriction. In addition, 1 subject fainted during hyperbaric exposure, whereas no such episode occurred before or after the exposure. These findings suggest that inappropriate orthostatic reflexes may be evoked by hyperbaria and reduced physical activity over the period of confinement. It should be noted, however, that CD was already evident within 24 h of hyperbaric exposure, suggesting that the initial phase of CD was unrelated to physical confinement. We postulate that CD occurs during hyperbaric exposure as an expression of cardiovascular and neurohumoral adaptation to an expanded central blood volume with a reduced total blood volume. PMID- 3672655 TI - Seadragon VI: a 7-day dry saturation dive at 31 ATA. VIII. Plasma enzyme profiles. AB - This report summarizes serum profiles of liver enzymes of divers during 2 dry saturation dives to 31 ATA. In both dives, serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), and alkaline phosphatase were significantly elevated at 31 ATA when compared to predive control levels. SGPT and SGOT levels returned to control levels during the postdive period. These data provide strong evidence for compromised liver function at high pressure and are consistent with similar observations in other saturation dives. The reason for the parenchymal dysfunction at high pressure remains unknown. PMID- 3672656 TI - Tubular embryonal remnants in the human spermatic cord. AB - The spermatic cords (SCs) obtained from: (a) autopsies of 67 adults and 50 children; (b) 3 fetuses; (c) 12 surgical specimens from 9 adults and 3 children with testicular tumors, and (d) 26 surgical specimens (14 adults and 12 children) with diagnosis of SC cysts, were studied by light microscopy. The histological study revealed the occurrence of tubular embryonal remnants (TERs) in 19 autopsied adults, 14 autopsied children, 3 fetuses, 2 surgical specimens (1 adult and 1 child) owing to testicular tumors, and 6 surgical specimens with diagnosis of SC cysts. The TERs were found in the low, middle or high thirds of the SC and consisted of a cuboidal or columnar, often ciliated epithelium surrounded by connective tissue. In the 3 fetuses and in 3 autopsied children renal glomeruli were found in close relation with the TERs. In 2 cases of SCs showing cysts and TERs both structures contained spermatozoa. The histological pattern of the TERs suggest that they are wolffian derivatives which might give rise to SC cysts. PMID- 3672657 TI - Effect of distension on function and nervous ultrastructure in the canine urinary bladder. AB - Canine bladders were distended for 4 h at 100 cm H2O to study the effects of distension on bladder function and structure. A micturition study was performed before overstretching, immediately after distension and 5 days after it. Bladder function was impaired immediately after distension, compliance and residual urine were increased and the maximum pressure during voiding decreased. The function returned to normal after 5 days. Overstretching caused diffuse or focal submucosal haemorrhages, only rarely fibrosis or necrosis of bladder wall. Electron microscopic changes of the bladder peripheral nerves were slight, the consistent finding being oedema in areas of outer mesoaxons and between cytoplasmic processes of Schwann cells. This change was sometimes accompanied by a rupture of the surrounding basement membrane. Axonal lysis was observed in one case. It is concluded that these anatomical changes, although found at the moment of functional recovery, may be linked to impaired conductivity of nerves in the bladder wall causing, at least partly, its impaired function. This may further decrease bladder instability and after urinary retention cause prolonged micturition problems. Functional recovery occurs, however, quite rapidly in healthy bladders. PMID- 3672658 TI - Staging of bladder carcinoma by magnetic resonance imaging. A preliminary report. AB - Magnetic resonance imaging (MRI) of bladder carcinoma was performed in 10 patients who subsequently underwent operations for tumor staging. MRI was performed with a 0.1 T resistive magnetic resonance unit. Images were obtained in the transverse, coronal and sagittal directions with different repetition and echo times. Simultaneously, computed tomography (CT) was performed in 9 of the 10 patients. The accuracy of MRI and CT staging was then evaluated by comparison with the staging from pathologic diagnosis. All of the tumors, which were 2.3-6.3 cm in diameter, were readily depicted by both imaging techniques. The overall accuracy of MRI staging for the 10 patients in whom staging had been pathologically confirmed was 90%, while the accuracy of CT staging for the 9 patients was 55%. Although no statistically significant differences in accuracy between CT and MRI staging can be established on the basis of the above results because of the small number of patients included in this study, MRI appears to be a very useful modality for staging bladder carcinoma. PMID- 3672659 TI - Late results of complementary specific immunostimulation in metastatic prostate carcinoma. AB - Calculation of the 5-year actuarial survival reveals a clear superiority of a combination of estrogenic hormone therapy with specific immunostimulation as compared to hormone therapy alone. The aim of this investigation was to show that specific immunostimulation complementary to estrogenic hormone therapy can substantially improve the results of the latter. Because of the appreciable side effects of estrogens, we have abandoned them as basic therapy. Today, we combine specific immunotherapy with RH-LH analogs and androgen receptor blockers and hope to attain further improvement of the actuarial survival in metastatic prostate carcinoma. PMID- 3672660 TI - Evidence for a defect in urinary concentrating ability in primary aldosteronism and its reversal by adrenal surgery. AB - Of 15 patients with primary aldosteronism, 7 had idiopathic adrenal hyperplasia (IHA) and 8 had aldosterone-producing adenoma (APA). In order to determine any renal problems involved in the treatment, the renal clearance of these patients was analyzed and the results compared with those obtained from 12 patients with essential hypertension. With water diuresis or under antidiuresis status, levels of urine volume, Cosm and CH2O in patients with APA were greater (p less than 0.05-p less than 0.001) than those of patients with essential hypertension, while the fractional tubular sodium delivery of the former patients was lower than that of the latter patients (p less than 0.001 or less than 0.05). A similar tendency was observed in clearance studies in patients with IHA, although to a lesser extent. Adrenal surgery for patients with APA normalized these values, but administration of trilostane (3 beta-hydrosteroid dehydrogenase inhibitor) to patients with IHA failed to improve these values. These results indicate that impaired urinary concentrating ability as well as reduced urinary diluting capability is a common feature of primary aldosteronism. Such impaired renal function was improved only in patients with APA after adrenal surgery. PMID- 3672661 TI - [Simple rapid test with carbonate/nitroprusside for the semiquantitative determination of cysteine in the urine--possible use for control of ascorbic acid therapy in cystine urolithiasis]. AB - In this paper a method of semiquantitative cysteine determination is presented, which is based on the formation of a red cysteine-Na-nitroprusside salt. The method is a suitable rapid test for checking the process of ascorbic acid therapy in cystinuria and cystine urolithiasis patients. It guarantees acceptable reproducibility of values and can be easily carried out in every clinicochemical laboratory. With the K2CO3/nitroprusside test described and an additional cystine rapid test (Ni2+/S2O4(2-) tablet reagency) a separate semiquantitative differentiation of cysteine and cystine in fresh (!) urine is possible. PMID- 3672662 TI - Severe thrombocytopenia due to apalcillin. AB - Whereas impaired platelet aggregation is a well-known complication of penicillin usage, thrombocytopenia rarely occurs. We present the first case of apalcillin induced thrombocytopenia and review the literature about this uncommon adverse effect of penicillins. PMID- 3672664 TI - Controversies in urologic oncology. PMID- 3672663 TI - Unusual metastases of renal cell carcinoma. AB - The case of a 55-year-old white male with recurrent metastases in the oral cavity and maxillary sinuses, as well as other organs, is presented. Local excision of the lesions, hormonal treatment and palliative measures for other metastases were used. The patient is alive 10 years after the initial diagnosis. PMID- 3672665 TI - A trial of the in vitro sensitivity test of anti-cancer drugs using primary cultured urogenital cancer cells. AB - An in vitro chemosensitivity test was applied to clinical specimens of urogenital cancer tissues obtained at operation. Incorporation of 3H-leucine into primary cultured cells 24 h after treatment with cytotoxic drugs was used as an index for cell viability. Primary cell culture was performed using specimens obtained from 37 patients including 20 with transitional cell carcinoma, 15 with renal cell carcinoma and 2 with testicular cancer. Primary cell growth was achieved in 27 (73%) out of 37 specimens and 10 were tested for chemosensitivity. Each specimen of the tumor revealed different sensitivity to drugs, and results of quadruplicate tests for each specimen were identical. It was concluded that the present method of measuring incorporation of radioactivity using urogenital cancer cells primarily cultured in microtiter plate is practically applicable to an in vitro chemosensitivity test. PMID- 3672666 TI - Urothelial carcinogenesis and portocaval anastomosis in the rat. AB - Portacaval anastomoses were performed in the rat to study urothelial carcinogenesis in this model and the promoting effect of dietary tryptophan. We were unable to produce any urothelial cancers or premalignant changes; some animals formed uric acid stones and developed papillary hyperplasia in the bladder. We conclude that the initiating carcinogen is likely to be exogenous and may be dietary in those experiments that have produced urothelial cancers. PMID- 3672668 TI - Large fibres in urinary calculi--promoters of stone formation. AB - Large fibres (phi 10-20 microns, length up to 5,000 microns) are sometimes imbedded in urinary calculi. It may be that these fibres can catch sediment particles and promote stone growth. By scanning electron microscopy the morphology of the fibres was studied as well as the relationship of the fibres with crystalline stone components. The reported findings suggest that the fibres are possibly formed in the tubuli as the result of an hitherto unknown defect. PMID- 3672667 TI - ABH isoantigens, histology and DNA ploidy in 36 consecutive patients with transitional cell bladder cancer. Status of tumor and biopsies taken from visually normal urothelium. AB - Tumors and biopsies from visibly normal urothelium in 36 consecutive patients with transitional cell bladder carcinoma were analysed for histological pathology, DNA ploidy and ABH isoantigens. Tumor isoantigen deletion correlated strongly with malignant histology (p = 0.016) and aneuploidy (p = 0.005). In 4/12 patients with ABH isoantigens present on the tumor, and in 6/8 with isoantigens absent, isoantigen changes were found in normal looking urothelium, usually with normal histology and ploidy. It was concluded that the ABH isoantigen change was an early event in bladder carcinoma. PMID- 3672669 TI - Calcium oxalate precipitation in urine following T.U.R. with glycine as irrigation fluid. AB - Precipitation of calcium oxalate was studied in a group of ten patients who underwent transurethral prostatectomy with glycine irrigation. Post operatively all patients showed hyperoxaluria; 60% with oxaluria higher than 10 times the critical concentration of calcium oxalate in urine. Other factors, known to favour crystallogenesis were modified during the same period: low urinary output, relative hypercalciuria and uraturia and hypomagnesuria. Thus, conditions for intraluminal precipitation of calcium oxalate were present post operatively. We suggest the use of a xanthine oxidase inhibitor to prevent hyperoxaluria. PMID- 3672670 TI - An assessment of a collagen/vicryl composite membrane to repair defects of the urinary bladder in rabbits. AB - Collagen/vicryl (Polyglactin) composite membrane has been used to repair full thickness defects in the urinary bladder of rabbits. The material has been shown to be biodegradable, prevent leakage of urine, and is readily replaced by collagenous scar tissue lined with a urothelium. Regeneration of smooth muscle has been observed in the repair area of some animals. The results suggest that such a material may well be of use to urologists wishing to augment contracted bladders or in the repair of bladder fistulae in human subjects, thereby avoiding the use of bowel or other material e.g. omentum. PMID- 3672671 TI - The use of a biodegradable collagen/vicryl composite membrane to repair partial nephrectomy in rabbits. AB - A composite membrane produced from collagen and vicryl mesh has been used to cover the kidney surface following partial nephrectomy in rabbits. The membrane readily held sutures, gave satisfactory haemostasis, and prevented leakage of urine. The experiments showed that the prosthesis biodegraded in less than twenty weeks. The only observed long-term effect of the material was thickening of the renal capsule. The results indicate that this membrane may be a suitable reparative material for use in traumatised kidneys in humans. PMID- 3672673 TI - Areas for safe percutaneous nephrocentesis--a study of practical anatomy. AB - The safest percutaneous nephrocentesis route is through the posterolateral aspect of the kidney. From study of 160 kidneys from adults at autopsy, we conclude that the most favorable nephrocentesis area is the lower major renal calyx and its minor calyces or the upper minor calyces. We believe that the lateral aspect of the middle calyces may be an area for safe nephrocentesis. PMID- 3672672 TI - Microsurgical anastomosis of vas deferens by a telescopic technique. AB - A telescopic microsurgical anastomosis of the vas deferens was performed on 24 rats. Sequential histological examination demonstrated mucosal healing in 7 days. Healing was complete in 21 days, and tubal patency was confirmed by histology in 100% of the cases. PMID- 3672674 TI - Excretion of urinary Tamm-Horsfall glycoprotein in girls with recurrent urinary tract infections. AB - Tamm-Horsfall glycoprotein (THG) might constitute a bacteria-fixing mucus which contributes to the non-immunological anti-infectious mechanisms of the lower urinary tract. To evaluate the role of THG in girls with idiopathic recurrent lower urinary tract infections, the THG excretion and concentration in 24-h urine were measured by a radial immunodiffusion method in 16 patients with a median age of 9 years and in 14 healthy age-matched girls. The results showed no significant differences in the THG excretion or concentration between the patients and the controls. Transiently decreased THG excretion rates as well as functional changes in the ability and/or capacity to trap bacteria, however, may leave girls periodically prone to colonization of the bladder. Thus, further studies are warranted to evaluate the importance of THG in the bladder defence mechanism. PMID- 3672675 TI - Radical prostatectomy for stage D1 prostate cancer. Prognostic variables and results of treatment. AB - Surgical extirpation of the primary tumor together with the involved regional nodes has been considered ineffective treatment for locally disseminated prostatic carcinoma. We retrospectively reviewed our experience with 42 patients with Stage D1 disease who underwent radical prostatectomy and bilateral pelvic lymphadenectomy and who had a follow-up of one to thirteen years (mean 5 years). The following variables affecting survival and tumor progression were analyzed: (1) tumor grade and local extent; (2) number of positive lymph nodes, and (3) adjuvant therapy. The overall five- and ten-year survival was 79.5 per cent and 28 per cent compared with the expected survival of an age-matched control group of 88 per cent and 28 per cent, respectively. The degree of tumor differentiation had no effect on prognosis, but local tumor bulk and the number of involved lymph nodes significantly changed the disease progression and survival rate. Patients with low local tumor bulk and one positive node survived as long as the age matched male population group. Our data suggest that radical prostatectomy may represent a valuable treatment in selected patients with Stage D1 prostate carcinoma. PMID- 3672676 TI - Experience with Gleason histopathologic grading of prostatic cancer in Japan. AB - Histologic characteristics of prostate cancer in Japan were evaluated in a retrospective analysis of 267 cases. These specimens were graded by the Gleason histopathologic grading system, and the proportional distribution of histologic features and the death rate were compared with those of Gleason's results in the literature. The system demonstrates significant correlation with mortality rates for each grade group in our cases, and it was also found that the death rates as obtained by our figures were comparable to those of Gleason in each category. The results help to provide the basis for future comparative multinational trials of prostate cancer. PMID- 3672677 TI - Urologic manifestations of AIDS. AB - A retrospective analysis of 60 patients with Acquired Immune Deficiency Syndrome (AIDS) seen between 1981-1985 was performed to determine the genitourinary manifestations of this disease. Twenty-two per cent were found to have significant proteinuria, while 7 per cent had nephrotic syndrome which was associated with an extremely rapid demise. Renal insufficiency occurred in 27 per cent and renal biopsy results, when abnormal, revealed focal and segmental glomerulosclerosis. Pyuria was found in 52 per cent of patients, and urinary tract infections occurred in 20 per cent. Atypical pathogens including Candida, Salmonella, Acinetobacter calcoaticus, and cytomegalovirus were encountered. PMID- 3672678 TI - Long-term catheter-associated bacteriuria: species at low concentration. AB - Polymicrobial bacteriuria in patients with long-term (greater than or equal to 30 days) indwelling urethral catheters is common and is associated with potentially serious acute and long-term complications. The dynamics of organisms at low concentration (less than 10(5) cfu/mL) in this setting has not been well characterized; however, in patients with short-term catheters organisms initially present at low concentration (less than 10(5) cfu/mL) usually grow to high concentration (greater than or equal to 10(5) cfu/mL). At the time of catheter replacement for 7 long-term catheterized patients who were not receiving antibiotics, we identified all species at greater than or equal to 10(2) cfu/mL in fresh urine aspirated from the old indwelling catheter and the new sterile replacement catheter and then determined which of these species were present at high concentration two weeks later. A total of thirty-seven species, nineteen at high and eighteen at low concentration were detected in either the old or the new catheters. Eighteen of the nineteen initially detected at high concentration but only one of the eighteen initially detected at low concentration (p less than 0.001) were present at high concentration two weeks later. In patients with long term indwelling urethral catheters, the number and multiplicity of species causing bacteriuria at low concentration rival that of species at high concentration; however, species at low concentration usually do not grow to high concentration in the presence of other species at high concentration. PMID- 3672679 TI - Caval extension of renal cell carcinoma. Results of surgical treatment. AB - Twenty-eight patients with renal cell carcinoma extending to the vena cava underwent surgical treatment consisting of radical nephrectomy and removal of tumor thrombus, which was at the level of the renal veins in 23 cases, the hepatic veins in 4, and extending above the diaphragm in 1 case. In 7 patients lymph nodes were invaded, and 8 had both positive nodes and extrarenal tumor diffusion discovered at surgery. The mean survival was 41.7 months for patients with only venous extension of the tumor, 16 months for patients with positive nodes, and 10.2 months for those with both nodal and extrarenal tumor diffusion. PMID- 3672680 TI - Relationship of blood groups and bladder cancer. A retrospective study. AB - A retrospective study to evaluate the relationship of blood groups of 96 patients with transitional cell carcinoma of the bladder in Israeli population, reports that patients with blood group O had higher grade tumors and higher recurrence rates than the other blood groups, without a difference in the mortality rates. PMID- 3672681 TI - Xanthogranulomatous pyelonephritis in children. AB - We report on a child with xanthogranulomatous pyelonephritis--an uncommon entity in children. A review of the literature revealed that in only 18 per cent was the diagnosis made correctly preoperatively. In children the disease is of a focal nature rather than a diffuse one, suggesting that possibly radical surgery would be less necessary for adequate treatment. PMID- 3672682 TI - Neonatal urinary ascites secondary to ureteropelvic junction obstruction. AB - A case of neonatal urinary ascites resulting from a ureteropelvic junction obstruction in a solitary kidney is reported. This is an uncommon cause of urinary ascites in the newborn, reported but once heretofore. PMID- 3672683 TI - Measurement of renal pelvis pressures during endourologic procedures. AB - Twenty-five kidneys underwent nephrostomy puncture with placement of a pigtail catheter into an upper pole calyx for manometric recording during nephroscopy without a working sheath and with an Amplatz sheath with and without a Rutner adapter. Intrarenal pressures remained below 16 cm of water (H2O) at all times with the Amplatz sheath with or without a Rutner adapter, whereas without a sheath the pressures ranged from 15 to 31 cm H2O (i.e., pressures associated with significant pyelovenous and pyelosinus backflow). Similar results were obtained in monitoring intrarenal pressures during clinical procedures. A working sheath should be utilized for all percutaneous nephroscopic procedures to minimize the incidence of pyelovenous and pyelosinus backflow as well as of perirenal extravasation of the irrigation solution. Even with a wide-lumen ureteral catheter in place, drainage via the ureter is not sufficient to maintain the intrapelvic pressure in the physiologic range. PMID- 3672684 TI - Ureteroscopy under local anesthesia. AB - Ureteroscopy has been performed with local anesthesia with and without sedation in 30 patients. Flexible endoscopes were used in 18, rigid endoscopes alone in 7, and rigid and flexible instruments in 5 patients. The flexible instruments ranged in size from 4F to 10F, while rigid instruments were 10F to 12F. Although most procedures were diagnostic, calculi were removed from the distal ureter in 4 patients and from the midureter in 1 patient. Ultrasonic lithotripsy was utilized in 1 patient. The success and tolerance of flexible or distal rigid ureteroscopy with local anesthesia permits its recommendation in carefully selected patients. PMID- 3672685 TI - Relationship between testicular volume and presence of varicocele. A comparative study. AB - The varicocele, present in many of the male partners of infertile couples continues to generate controversy, particularly as related to its diagnosis and pathophysiology. The purpose of our study was to determine the relationship between testicular volume and the presence or absence of a varicocele. Testicular volume was determined by the use of an orchiometer; the presence of a varicocele was determined by palpation during a Valsalva maneuver. The patients utilized in the study were those seen in our Andrology and General Urology Clinics; 291 patients with varicoceles and 83 control patients (no evidence of varicocele) were used. The left (mean = 21.4 mL) and right (mean = 23.4 mL) testicular volumes of patients with a varicocele were significantly reduced compared with that of the control group (left, mean = 23.4 mL; right, mean = 26.2 mL; p = 0.0041 and p = 0.002, respectively). The testicular volume corrected on the basis of the body mass (V/m2) also was significantly reduced in the varicocele group compared with controls (left p = 0.007; right p = 0.001). Reduced testicular volume relative to body size may be detected prior to actual demonstration of the stress pattern and the presence of a varicocele, and may be useful in early diagnosis. It is suggested that measurement of testicular volume may be a useful adjunct to routine examination of the infertile male. PMID- 3672686 TI - Cutaneous metastases from transitional cell carcinoma of bladder. AB - Cutaneous metastases from transitional cell carcinoma of the bladder is a rare occurrence. We report on a patient in whom multiple cutaneous metastases developed five months after radical surgery. PMID- 3672687 TI - Fracture of Hydroflex penile implant. PMID- 3672688 TI - Bladder carcinoma with Werner syndrome. AB - Werner syndrome is a rapid premature aging disease and is considered chromosomal instability syndrome, occasionally associated with malignancy. Urologic malignancy associated with this syndrome is unusual. Herein we report a case of Werner syndrome with urinary bladder carcinoma. PMID- 3672689 TI - Alternative to catheter guide after transurethral resection of prostate. PMID- 3672690 TI - Correlation of heterogeneity index score (HIS) of DNA content in bladder cancer recurrence. AB - Automated flow cytometry (FCM) has been used to monitor the effects of therapy and progression of human bladder carcinoma. We have previously reported a computer-based model which has shown a correlation to relative mean DNA content in cell populations analyzed by FCM. Two patients with superficial transitional cell carcinoma of the bladder were followed for several months. Using FCM the patients' tissue samples were examined and heterogeneity index scores (HIS) were determined. Both cases had recurrence. The first patient has increased in grade with a respective increase in HIS within four months (grade I----II, HIS 27.2--- 80.8). The second patient also has recurrence in three months both times with a grade I tumor and a score of 106.2. High scores reflect large aneuploid populations which have shown to recur. Since such a correlation exists HIS may not only offer a more objective technique with quantitative results to monitor patients but possibly can distinguish the degree of tumor malignancy. PMID- 3672691 TI - CT diagnosis of unsuspected von Hippel-Lindau disease. AB - Von Hippel-Lindau disease is a hereditary disorder with complex, multi-organ involvement including retinal, central nervous system, and abdominal manifestations. We report a case of clinically unsuspected von Hippel-Lindau disease identified during computed tomography (CT) evaluation of a renal mass. The CT demonstration of a coexisting pancreatic tumor and renal cell carcinoma suggested the correct diagnosis of von Hippel-Lindau disease, which was subsequently confirmed. This case reemphasizes the value of preoperative assessment of renal tumors by CT. The finding of coexisting renal and pancreatic tumors should stimulate the search for further evidence of von Hippel-Lindau disease. PMID- 3672693 TI - "Window operation" for hydrocele. PMID- 3672692 TI - Intraoperative Polaroid roentgenograms. AB - The introduction of a new Polaroid film (TPX) prompted an evaluation of all Polaroid films that are available, and a comparison with Kodak Xomat film was done both in the experimental mode and the clinical situation. Type TPX shows excellent definition but is still an experimental film. All the other Polaroid films (Types 52, 57, and TPX 10 x 8) produce images in twenty seconds. This is really the only advantage over the conventional Kodak X-Omat KS film processed as an x-ray film. PMID- 3672694 TI - Pain and Small-Carrion prosthesis. PMID- 3672695 TI - Urinary frequency in children. PMID- 3672696 TI - [Comparative evaluation of the possible postoperative astigmatism in using different shapes of cataract incision]. PMID- 3672697 TI - [Binocular function and aniseikonia in artiphakia]. PMID- 3672698 TI - [A method for the surgical treatment of patients with open-angle glaucoma]. PMID- 3672699 TI - [Retinal changes in primary glaucoma patients]. PMID- 3672700 TI - [Clinico-morphological parallels in lamellar keratectomy with biological protection of the tissue bed]. PMID- 3672701 TI - [Scleral filling operation in high retinal detachment with posterior pole ruptures]. PMID- 3672702 TI - [A method for removing foreign bodies from the anterior chamber (an experimental study)]. PMID- 3672703 TI - [Lasers with various radiation parameters in ophthalmic oncology]. PMID- 3672704 TI - [Results in the use of various cataract extraction methods with simultaneous vitrectomy in patients with proliferative diabetic retinopathy]. PMID- 3672705 TI - [Lekozim in the treatment of the vitreoretinal traction syndrome in proliferative diabetic retinopathy]. PMID- 3672706 TI - [Antioxidant activity of pharmaceutical preparations used for treating eye diseases]. PMID- 3672707 TI - [Intraocular lenses: the changing indications for their implantation in the United States of America]. PMID- 3672708 TI - [Stimulation of the oxidative-reductive enzymes of the corneal system in traumatic lesions (an experimental study)]. PMID- 3672709 TI - [Characteristics of lipid peroxidation in the vitreous body during hemorrhage]. PMID- 3672710 TI - [Ophthalmic biometric parameters of infants in the perinatal period]. PMID- 3672711 TI - [Aspherical eyes in preschool children]. PMID- 3672712 TI - [Experimental verification of an operation for revascularization of the posterior pole of the eye]. PMID- 3672713 TI - [Structure of eye morbidity in hospitalized patients at the National Institute of Eye Diseases of the Democratic Republic of Afghanistan]. PMID- 3672714 TI - [Toxic-allergic reactions from the use of gentamycin in ophthalmologic practice]. PMID- 3672716 TI - [Allergic granulomatous inflammation of the conjunctiva]. PMID- 3672715 TI - [Stenosis of the internal carotid artery with unusual ophthalmologic symptoms]. PMID- 3672717 TI - [Use of a radial flap of the forearm in plastic and reconstructive surgery of the extremities]. AB - A detailed characteristic of the ways of using fascio-cutaneous, osteo-cutaneous and muscular-cutaneous flaps disposed in the basin of the radial vascular bundle is given on the basis of an experience with 18 operations. Non-free plasty by an island flap on a peripheral vascular pedicle was used in 13 patients. Free plasty with microvascular anastomoses was used in 4 patients. In 16 of the 17 patients a complete take of the flap took place. PMID- 3672718 TI - [Formation of a flap for plastic surgery of defects of the crural skin]. PMID- 3672719 TI - [Repair of bone defects with a polymer material]. AB - Experimental investigations and results of 76 clinical observations of patients with endoprostheses made of Acryloxide enabled the authors to support grounds for using the compositional polymer material Acryloxide for the substitution of defects formed after resections for neoplasms. PMID- 3672720 TI - [Anomalies of ureteral orifices simulating diseases of the abdominal organs]. AB - The ectopy of the ureter orifices and ureterocele are always followed by either mechanical or dynamic obstruction of the ureter and obstructive pyelonephritis. These anomalies are periodically accompanied by abdominal pains which make their appearance during an attack of acute pyelonephritis. These abdominal pains can be erroneously taken for symptoms of appendicitis or intestinal obstruction and the patients are subjected to appendectomy or laparotomy by mistake. The erroneous appendectomy or laparotomy were fulfilled in 47 of 201 patients with ectopy of ureter orifices and ectopic ureterocele which were observed by the authors. The differentiation of genesis of abdominal pains may be more exact with the help of chromocystoscopy, excretory urography and isotopic renography. PMID- 3672721 TI - [Treatment of acute bilateral suppurative lung diseases complicated by pyopneumothorax]. AB - An analysis of the complex treatment of 33 patients with acute bilateral suppurative diseases of the lungs complicated by pneumothorax has been made. It has been proved that early pleurectomy with resection of the lung is possible in a number of patients with such a pathology. Indications to surgery were established and a comparative analysis of conservative and surgical methods was made. PMID- 3672722 TI - [Errors and complications in the treatment of fractures of the forearm bones in children]. PMID- 3672723 TI - [Latent anaerobic gas infection]. PMID- 3672724 TI - [Embolization of adrenal arteries in the combined treatment of Cushing's syndrome]. PMID- 3672725 TI - [A safety doser for intra-arterial infusions]. PMID- 3672726 TI - [Sterilization of fibrogastroduodenoscopes]. PMID- 3672727 TI - [Surgical treatment of diffuse toxic goiter associated with autoimmune thyroiditis]. AB - An experience of the clinic with the surgical treatment of diffuse toxic goiter associated with autoimmune thyroiditis for the recent 16 years has been generalized based upon 258 observations. Long-term results followed in 73.6% of the patients show that an improved method of operation thought to be less radical gives good results. An immune depressive effect of the operation was noted. The investigation facilitates positive solution of the problem of the expediency of the surgical treatment of the complicated form of toxic goiter having indications for surgery. PMID- 3672728 TI - [Malignant stomach ulcer]. AB - The authors present data of the clinical X-ray and morphological diagnostics of malignant gastric ulcers revealed in 96 patients. The total number of patients with gastric ulcer operated upon was 642. The morphological findings may serve the only reliable criterium of malignancy. Results of the operative treatment of such a malignant ulcer of the stomach are dependent on the spread of malignant invasion in the gastric wall. Treatment of patients with the involved mucosa only gave 5-year survival in 89.5%. Spread of the malignant invasion throughout the whole thickness of the gastric wall--50.0%. In patients with metastases into lymph nodes (independent of the invasion into the gastric wall) 5-year survival made up 29.4%. PMID- 3672729 TI - [Duration of temporary disability of patients after selective proximal vagotomy]. AB - The investigation of factual terms of temporary invalidity after selective proximal vagotomy without draining operations of the stomach in a number of regions of the Ukrainian SSR has shown their considerable variability (56.4 +/- 13.8 days). Under observation were 178 patients. It has been established that normal indices of homeostasis, functions of the gastro-intestinal tract, regeneration of the postoperative scar and recovery of their physical labour capacity is taking place during 30-33 days. Criteria for the determination of terms of temporary invalidity after selective proximal vagotomy for the ulcer disease of the duodenum have been elaborated. PMID- 3672730 TI - [Hemosorption in the treatment of endogenous toxemia in acute pancreatitis]. AB - One of important components of endogenous intoxication in acute pancreatitis is considered to be middle-mass molecules possessing high toxicity. Hemosorption improves results of complex therapy and reduces postoperative lethality by 10% at an average. The positive effect of hemosorption in focal pancreanecrosis is associated with sorption of lipase, trypsin, middle-mass molecules and other metabolites. In total pancreanecroses the effect of hemosorption was minimal. In hemosorption on the sorbent SKN the oxygenation and regional heparinization of the sorbent is indicated. PMID- 3672731 TI - [Chronic cardiac insufficiency at the decompensation stage and the surgical treatment of mitral stenosis]. AB - A classification of chronic heart failure was made on the material of surgical treatment of 290 patients with rheumatic mitral heart defect with prevailing stenosis. Three stages of chronic heart failure at the decompensation stage were found: I--unstable removable; II--stable removable; III--stable not completely removable. In the Ist stage the authors recommend operations by both closed and open techniques; in the IInd stage closed methods are thought to be preferable (open operations may be used in single cases); in the IIIrd stage only closed methods are possible. PMID- 3672732 TI - [Delayed occlusion of the pancreatic duct]. AB - Seventy six delayed occlusions of the main pancreatic duct were fulfilled during the period from 1978 to 1985. No severe complications or lethal outcomes due to performing a delayed occlusion of the duct were noted. PMID- 3672733 TI - [Surgical tactics in appendicular infiltrates]. AB - The article generalizes and analyzes specific results of conservative and operative treatment of 133 patients with appendicular infiltrate. Immediate results were studied and they were taken as a basis for recommendations on the surgical tactics in appendicular infiltrate and periappendicular abscesses. PMID- 3672734 TI - [Surgical treatment of patients with diffuse forms of peritonitis]. AB - Under analysis are results of treatment of 178 patients with diffuse forms of peritonitis for 2 periods. In the 1st period only one-step sanitation, drainage of the abdominal cavity and naso-gastral aspiration of the gastric content were performed. Lethality was 24.4%. In the 2nd period in the reactive phase of peritonitis a one-step sanitation, naso-gastral aspiration were performed, in the toxic and terminal periods--fractional peritoneal lavage and decompression of the intestines through ceco- and ileostomy. Lethality was 6.3%. PMID- 3672735 TI - [Fistulous atresia of the distal part of the rectum in adults]. AB - Based on an analysis of the surgical treatment of 19 adult patients with atresia of the anal canal with a fistula into the vagina or perineum, not operated for this disease in their childhood the author has established specific indications for their treatment. The adequate choice of the method of operation with special reference to anatomical features of the developmental defect and complications resulting from its long existence is responsible for success of the treatment. PMID- 3672736 TI - [Liposarcoma of the retroperitoneal space]. AB - Date of an examination of 60 patients with liposarcomas of the retroperitoneal space aged from 40 to 60 are presented, women comprised 62%, men 38%. Operative treatment was undertaken in 48 patients (96%), radical operation--in 82%, palliative operations--in 14%. Recurrent tumors were revealed in 33 patients (66%), metastases--in 8%. Most frequent recidivations were noted in myxoid liposarcomas. A complete removal of the recurrent tumor was made in 72% of the cases. Out of 50 patients with liposarcomas 54.2% of the patients survived 5 or more years after the operation, in the myxoid variant--72.3%, in polymorphocellular form--23.1%. PMID- 3672737 TI - [Indications for preventive axillary lymphadenectomy in melanoma of the skin of the upper extremity]. AB - Based upon clinico-morphological analyses of data of 79 patients with primary melanomas of the upper extremity skin the authors have found 3 risk factors of the regional metastasing process. It was shown that in patients having these risk factors there is 50% higher probability of regional metastases of melanomas which may be taken as indications for performing prophylactic axillary lymphadenectomy in such patients. PMID- 3672739 TI - [Surgical treatment of recurrences of varicose veins of the lower extremities]. AB - Operations for recurrent varicosities were made in 48 patients. Extravasal correction of the femoral vein valves, dissection of the popliteal vein aneurysms and ligation of the communicatory veins were also performed in addition to the extirpation of dilated subcutaneous veins. PMID- 3672738 TI - [Substantiation of the extent of surgery in varicose veins of the lower extremities]. AB - The authors have distinguished 2 forms of the varicose disease of lower extremities determining the volume of surgical operation. Since the "simple" form is characterized only by incompetent valves of the superficial veins, the radical veinectomy is thought to be a sufficient operation and gives a complete recovery of the adequate venous return. In patients with the 2nd form of the varicose disease the radical veinectomy only is not the optimal operative intervention. Ligation of incompetent perforated crus veins by super- or subfascial methods is indicated to such patients. PMID- 3672740 TI - [Evaluation of the dynamics of serum immunoglobulins in suppurative surgical diseases and severe trauma]. AB - Serum immunoglobulins G, A, M were studied along with a parallel investigation of the laboratory indicators of the destructive-inflammatory process and other indices of organism reactivity in 378 patients with acute and chronic pyo inflammatory diseases and a critical mechanical trauma. Such an approach allowed an objective substantiation of the dynamics of serum immunoglobulins to be given. They may be recommended as prognostic criteria for the selection of curative tactics and assessment of quality of the surgical and conservative treatment. PMID- 3672741 TI - [Treatment of chronic hematogenic osteomyelitis of the spine using extrafocal fixation equipment]. AB - An experience with the treatment of 27 patients with hematogenic osteomyelitis of the spine is presented. Seventeen of the patients have completed the treatment and began working, 7 patients are invalids of the II or III groups, 3 patients still continue their treatment. PMID- 3672742 TI - [Benign tumors of the lungs]. PMID- 3672744 TI - [Osteomyelitis of the rib as a cause of intrapleural hemorrhage]. PMID- 3672743 TI - [Granulomatous thymoma]. PMID- 3672745 TI - [Emptying function of the stomach after selective proximal vagotomy]. PMID- 3672746 TI - [Disorders of gastric emptying after resection of the stomach with a terminal lateral gastroduodenal anastomosis]. PMID- 3672747 TI - [Spontaneous internal biliary fistula]. PMID- 3672749 TI - [Extensive cyst of the pancreas]. PMID- 3672748 TI - [Internal drainage of the pancreatic duct]. PMID- 3672750 TI - [Meckel's diverticulum as a cause of acute obstruction of the small intestine]. PMID- 3672751 TI - [Injury of the right deep bent iliac artery in the etiology of acute appendicitis]. PMID- 3672752 TI - [Endoscopic diagnosis and treatment of adenoma of the large intestine]. PMID- 3672753 TI - [Use of a photoelectric device in the diagnosis of spinal osteomyelitis]. PMID- 3672754 TI - [Antimicrobial polymers in reconstructive vascular surgery]. PMID- 3672755 TI - [Raynaud's phenomenon]. PMID- 3672756 TI - [Treatment of frostbite]. AB - The article shows that treatment of frostbites in a special medium with controlled temperature and humidity makes the time of treatment shorter and prevents complications characteristic of such a trauma. The main purpose of such exposures of the injured areas is to achieve mummification and to make the operation as early as possible. The mummification of the soft tissues began within 5-8 days after trauma. Chemical necrectomy was possible on the 7th-9th days, followed by autodermoplasty on the 2nd day. PMID- 3672757 TI - [Treatment of metadiaphyseal fractures of the forearm bones in children]. PMID- 3672758 TI - [Combined and multiple fractures in traffic accidents]. PMID- 3672759 TI - [Injuries of the pancreas, portal vein and liver]. PMID- 3672760 TI - [Treatment of hypospadias in children]. AB - To straighten the penis in truncal, scrotal and perineal forms of hypospadias is expedient to use the proposed method. Fixation of the penis should be performed with the help of a correcting splint. An analysis of results of urethroplasty by different methods has shown an indisputable advantage of the Landerer method modified by Rusakov. PMID- 3672761 TI - [Mediastinal cyst associated with a spinal cord cyst in a child]. PMID- 3672762 TI - [Spontaneous rupture of the stomach in a child with scoliosis]. PMID- 3672763 TI - [Traumatic torsion of the greater omentum in children]. PMID- 3672764 TI - [Right-sided traumatic diaphragmatic hernia in a child]. PMID- 3672765 TI - [Treitz's hernia]. PMID- 3672766 TI - [A cyst of the common bile duct in a child]. PMID- 3672767 TI - [Diagnostic errors and inadequate therapeutic tactics in tumors of the large intestines]. AB - The authors observed 21 patients after previous non-radical treatment in other medical institutions. The age of the patients was from 38 to 80. Radical operations were performed on all the patients during relaparotomies. The authors make a conclusion that choice of a rational surgical and curative tactics in colonic tumors was determined individually with special reference to the general state of the patient, careful assessment of the degree of local spread of the tumor. A dogmatic approach is thought to be inadmissible. PMID- 3672768 TI - [The use of preserved photomodified autoblood for the prevention of thromboembolic complications in surgical interventions on the small pelvis]. AB - The method of UV irradiation of autoblood followed by infusion in the early postoperative period was used in 109 patients subjected to various operative interventions on the small pelvis organs. It was established that the infusion of autologous photomodified blood allowed to avoid postoperative thromboembolic complications. PMID- 3672769 TI - [The use of UV irradiated autoblood for the prevention and treatment of pulmonary complications after operations on organs of the abdominal cavity]. AB - The authors have made an analysis of incidence of postoperative pneumonias in 285 patients aged from 60 to 83 after operation on the abdominal organs. The use of reinfusion of the UV irradiated blood in the complex of prophylactic measures for prevention of postoperative pneumonias resulted in 2 times less amount of such complications. PMID- 3672770 TI - [Surgical treatment of mediastinal tumors and cysts]. AB - The authors have analysed the diagnostics, clinical course and surgical measures in mediastinal neoplasms in 196 patients from 4 months to 72 years of age. Operations were performed in 84.7% of the patients, lethality was 1.8%. Postoperative complications were noted in 4.6% of the patients. The authors find it expedient to remove small mediastinal new formations in patients with an asymptomatic clinical course of the disease due to the danger of their future growth and resulting problems concerned with their excision. A detailed examination and surgical treatment of such patients should be performed in thoracal departments. PMID- 3672771 TI - [A method of dislocation of mesoperitoneally disposed portions of the large intestine]. AB - In order to decrease the amount of postoperative complications by means of preventing alterations of blood circulation and of the transplant function a method of dislocation of mesoperitoneally disposed portions of the colon has been developed and introduced into practice which consisted in the formation of the mesenterium preventing a bend and trauma of the vascular pedicle. The method was used in 63 patients with idiopathic megadolichocolon. In 80% of the patients there were no complications in the early and postoperative period. PMID- 3672772 TI - [The tendon hook]. PMID- 3672773 TI - [Medical-work capacity examination of patients with chronic empyema of the pleura after pulmonectomy]. AB - Treatment and analysis of immediate results were described in 269 patients with chronic empyema of the pleura as well as their long-term results in 207 of them. Under consideration were main criteria of the examination of labor capacity in such patients. It was shown that the establishment of the phase of "compensation at the limit" (IIa degree of pulmonary insufficiency) and subcompensation (IIb degree of pulmonary insufficiency) allowed more exact evaluation of the degree of compensatory processes of respiratory organs in patients after operation and the degree of loss of their working capacity. PMID- 3672774 TI - [Prevention of hepatitis B in the surgical clinic]. AB - The introduction of prophylactics of hepatitis B in surgical departments results in 2 times lower growth of HBsAg carriers among medical men. The main prophylactic measures consist in an analysis of the donor blood and HBsAg examination of surgical patients, treatment of HBsAg carriers as acutely contagious persons, centralized sterilization of medical instruments and individual protection of the personnel. PMID- 3672775 TI - [Features of the surgical treatment of postbulbar ulcers of the duodenum]. AB - The article describes main principles of the operative treatment of 42 patients with postbulbar ulcers. Choice of the surgical method was individualized: resection for the "exclusion" was used in 25 patients, gastric resection with the excision of the ulcer--in 11 patients, organ preserving operations--in 5 patients. The operations made for the "exclusion" gave most favourable immediate and long-term results. Technical details of the operations are described. PMID- 3672776 TI - [The role of fibrocholedochoscopy in the complex intraoperative diagnosis of diseases of the bile ducts]. AB - The method of fibrocholedochoscopy was used by the authors in 622 patients with diseases of the bile ducts. Bile duct stones were detected in 91.4% of the patients. Scarry alterations of the common bile duct wall and Vater's papilla were found in 21.1%. Cholangitis of various degrees were diagnosed in 98% of the patients. The authors propose to make fibrocholedochoscopy parallel with other modern methods of the intraoperative diagnostics in patients with a pathology of the bile ducts. PMID- 3672777 TI - [Determination of the input and output volume of the right ventricle based on cineangiocardiography data]. AB - The authors have developed a method of separate determination of the volumes of the input and output portions of the right ventricle by findings of cineangiocardiography made in two projections. The volume of the input portion had been shown to be 1,23 times as great as that of the output portion. A comparison of measurements of the volumes of the input and output portions and the total right ventricle as a whole will reveal their participation in the compensation of congenital and acquired heart diseases. PMID- 3672778 TI - [Intraoperative contact biomicroscopy as a method of assessing disorders of microcirculation in ileus of the small intestine]. AB - The article describes an experience with visual microscopic assessment of disturbances of microcirculation in the small intestine in various forms of acute ileus. The assessment of microcirculation in the small intestine wall with the help of a microscope facilitates more objective establishment of indications for the resection of ischemic portions and drainage of the intestine by intubation. This method of direct assessment of microcirculation disturbances in the intestine is a promising one and requires further development. PMID- 3672779 TI - [Tactics in the remote period in acute appendicitis complicated by an appendicular infiltrate and abscess]. AB - Based upon an analysis of long-term results of treatment of 99 patients after appendicular infiltrate and abscess the authors made a conclusion that young and middle-aged patients with this disease have indications for operation in the early period--within 2-3 weeks after resolution of the infiltrate. In elderly and senile patients, especially those with a pronounced concomitant pathology, planned operations should be refrained. PMID- 3672780 TI - [Immediate and long-term results of endarterectomies in atherosclerotic occlusions of the abdominal aorta and iliac arteries]. AB - An analysis of the clinical material evidences a sufficiently high efficiency of endarterectomy even in spread occlusions of the aorto-femoral segments of atherosclerotic etiology with the absence of atheromatosis and calcinosis of the arteries. Good and satisfactory immediate results were obtained in 89.4% of the patients, long-term results in 52.8% and with regard to reoperations--in 67.5% of the patients. PMID- 3672781 TI - [Diagnostic value of thermography in diseases of the vessels of the lower extremities]. AB - The thermographic examinations of 430 patients with different diseases of the lower extremity vessels have confirmed the diagnostic value of thermography. The method was shown to give the objective assessment of alterations in blood circulation of the lower extremity resulting from a pathological process. It may be widely used for diagnosis and control of treatment of vascular diseases. PMID- 3672782 TI - [Embolization of the hepatic artery and decompression of the portal system in liver cirrhosis complicated by hemorrhage]. PMID- 3672783 TI - [Complications of foreign bodies in the intestines]. PMID- 3672784 TI - [A non-standard organ-preserving operation in recurrent nephrolithiasis]. PMID- 3672785 TI - [Operations on inguinal hernias with displacement of the spermatic cord into subcutaneous fat]. PMID- 3672786 TI - [Relapsing nodular nonsuppurative panniculitis (Pfeiffer-Weber-Christian disease)]. PMID- 3672787 TI - [Congenital acro-osteolysis as a cause of trophic ulcers of the extremities]. PMID- 3672788 TI - [Rheological properties of the blood in patients with chest and abdominal injuries in the postoperative period]. AB - Examinations made in 30 patients with a trauma of the chest and abdomen have shown the alterations in blood rheology resulting from the trauma and blood loss to be persistent and often to make progress in the postoperative period. In purulent complications there appear secondary alterations of blood rheology which acquire a lingering character. The syndrome of decreased viscosity of blood is a dangerous disturbance of microcirculation since it is due to the activation of blood cell structures against the background of elevated utilization of hemostasis factors and requires a purposeful therapy. PMID- 3672789 TI - [Control and correction of tissue respiration in an injured extremity with posttraumatic changes in blood circulation]. AB - An examination of ABB constants of the capillary blood in dynamics in 45 patients with posttraumatic alterations of the blood circulation has shown a correlation between them and the degree of disturbances of tissue respiration. Results of experiments in animals point to an improvement of tissue respiration as a response to the administration of methylene blue to the ischemic extremity. The methylene blue along with other drugs improving the microcirculation and tissue respiration was used in 4 patients and resulted in its normalization and prevented ischemic contracture. PMID- 3672790 TI - [Sorption detoxication in the treatment of open fractures of the extremities complicated by purulent infection]. AB - The article describes the authors' experience with the treatment of open diaphyseal and intra-articular fractures of bones of the upper and lower extremities complicated by purulent infection, in 126 patients sorption methods being used (hemosorption, enterosorption, application of sorbents on the wounds). Results of the treatment were studied in 120 patients within the period from 1 year to 6 years. Good results were obtained in 44 patients (36.7%), satisfactory- in 60 patients (50%), unsatisfactory--in 16 patients (13.3%). PMID- 3672791 TI - [Immediate risk of mitral valve prostheses after a previous closed mitral commissurotomy]. AB - Two groups of patients (30 patients each) operated and reoperated upon for rheumatic mitral valve failure were compared by different parameters. The authors consider that risk of reoperations on the mitral valve is dependent upon the critical initial state of such patients and upon technical problems in maximum cardiolysis. PMID- 3672792 TI - [Treatment of a patient with a heart wound twelve hours after trauma]. PMID- 3672793 TI - [A thoraco-abdominal knife wound during labor]. PMID- 3672794 TI - [Reoperations on the lungs in children]. AB - On the basis of an experience with 24 reoperations on the lungs in children at late terms, indications have been developed for such operations and for their volume. A rational complex of treatment in the period of preoperative management was determined. Technical and tactical errors occupied the main place in the structure of causes resulting in reoperations. Recovery was achieved in all the 24 patients. PMID- 3672795 TI - [Results of treatment of newborn infants with diaphragmatic hernias]. AB - The article generalizes an experience with the treatment of 91 newborns with diaphragmatic hernias for the period from 1955 to 1985. The diagnostics has improved and greater amount of newborns were admitted to the clinic within the first day after birth. The frequency and character of postoperative complications were analyzed as well as causes of their appearance and effective measures for their prevention and structure of lethality. The tactics of resuscitation both before and after operation has been changed: the artificial ventilation of the lungs was performed without a positive pressure at the end of the expiration with the use of Tubarin and infusion of Dopamine. Lethality was 2 times reduced. PMID- 3672796 TI - [Specific features of postoperative infusion therapy depending on kidney function in newborn infants with developmental defects]. AB - Results of examination of partial functions of the kidneys in 113 newborns have shown the reaction of the kidneys on a surgical aggression to be dependent on the age and stage of the postoperative period. The reaction manifests itself by renal economy of water and electrolytes on the 1-3 days after operation followed later by the osmotic dilution of urine and lower reabsorption of sodium and potassium. The maximum amount of sodium admissible for administration in the postoperative period has been established with special reference to age. PMID- 3672797 TI - [Methods of plasty in meningocele in children]. AB - The authors describe their original method of fascio-aponeurotic plasty of the bone defect in meningocele in children. The method was used in 25 children and gave positive results. PMID- 3672798 TI - [Incarceration of traumatic diaphragmatic hernia in children]. PMID- 3672799 TI - [Macrohamartoma of the liver in a 6-year-old child]. PMID- 3672800 TI - [Urethral injuries in children]. PMID- 3672801 TI - Bone marrow response in cattle with chronic dermatitis caused by Psoroptes ovis. AB - Six Hereford heifer calves were infested with Psoroptes ovis and compared to six uninfested control calves. Infested calves developed severe exudative dermatitis which covered 100% of the body surface by 7 weeks after infestation. They developed moderate nonregenerative anemia, decreased numbers of neutrophils and lymphocytes, and increased plasma protein and fibrinogen concentrations. Sternal marrow core biopsies taken 7 weeks after infestation were 75 to 90% cellular, while cores from uninfested calves were 10 to 20% cellular. Comparison of myelograms between the two groups of calves revealed increased M:E ratio, myelocyte and metamyelocyte hyperplasia with depletion of mature neutrophils and eosinophils in the P. ovis-infested calves. It was concluded that P. ovis infested calves develop myeloid hyperplasia and that mange-related neutropenia is not due to bone marrow suppression by a mite or scab-associated toxin. PMID- 3672802 TI - Hematology in the regressive phase of bovine psoroptic scabies. AB - Hereford calves were infested with Psoroptes ovis. Hemograms were evaluated weekly for 7 weeks during progressively extensive dermatitis and compared to uninfested control calves. Calves were treated with ivermectin and weekly hemograms were compared for 4 weeks during regression of clinical disease. They developed extensive dermatitis and marked decreases in total white blood cells, neutrophils, and lymphocytes. Infested calves also had moderate anemia, increased plasma proteins, and increased plasma fibrinogen. Some calves developed marked eosinophilia. Within 1 week after ivermectin treatment, nearly all hematologic parameters returned or began to return to normal values, even though scabs remained on the calves at 4 weeks. Peak eosinophilia in calves which responded occurred 1 to 2 weeks after treatment. The findings indicate that most of the hematologic changes occurring with psoroptic scabies in cattle are associated with living mites and not with toxic substances in the scab on the skin surface. PMID- 3672803 TI - Disseminated intravascular coagulation in "Hitra disease" (hemorrhagic syndrome) in farmed Atlantic salmon. AB - Necropsy findings in adult salmon with subclinical "Hitra disease" (hemorrhagic syndrome) varied from negligible to hemorrhagic diathesis with generalized edema. By light microscopy, minute vessels were dilated, arterioles had mural necrosis, and thrombi were present. Occlusions consisted of fused erythrocytes and fibrin. Ultrastructurally, endothelial nuclei were pyknotic with condensed chromatin. The cytoplasm contained numerous laminar structures and electron-dense particles. Damaged erythrocytes adhered to the degenerated endothelium, and coalesced erythrocytes had formed mural thrombi or filled the vascular lumen. Microthrombi were frequently seen. There were no thrombocytes in the thrombi, which consisted of erythrocytes or reticulocytes. Clinically healthy farmed salmon parr showed the same disorders as did adults, but to a far lesser degree. Wild salmon parr had normal microvasculature. Results indicate that disseminated intravascular coagulation (DIC) occurs in "Hitra disease" in farmed Atlantic salmon. PMID- 3672805 TI - 3-Methylindole-induced nasal mucosal damage in mice. AB - 3-Methylindole (3MI) damages nasal olfactory epithelium in mice. Lesions were studied histologically from 30 minutes to 28 days after intraperitoneal injection of 400 mg 3MI/kg. Cellular swelling was apparent in olfactory epithelium by 6 hours after injection of 3MI, while respiratory epithelium was normal. Necrosis of olfactory epithelium and subepithelial glands was diffuse by 48 hours. Subsequent ulceration resulted in epithelial hyperplasia, squamous metaplasia, fibroplasia, and ossification. Partially occlusive intranasal fibrous and osseous tissue persisted through 28 days after 3MI injection. PMID- 3672804 TI - Sphingomyelin lipidosis in a cat. AB - A 7-month-old Balinese cat with progressive neurological dysfunction had histopathological lesions of brain, liver, kidney, spleen, and lung consistent with a lysosomal storage disease. Ultrastructural examination revealed lysosomal hypertrophy with membranous inclusions. Hepatic sphingomyelin and cholesterol were elevated 10 times normal, and total phospholipids were increased 3.6 fold. Sphingomyelinase activity measured with 14C labeled sphingomyelin at pH 5.0 was virtually absent in brain and liver. Other lysosomal hydrolase activities were normal or elevated. Clinical, morphological, and biochemical findings suggest that this cat had sphingomyelin lipidosis similar to human Niemann-Pick disease type A, and that feline sphingomyelin lipidosis provides another model of human lysosomal storage disease. PMID- 3672806 TI - Ultrastructural pathology of Bordetella avium infection in turkeys. AB - One-day-old turkeys were infected intranasally with Bordetella avium, and tracheas were examined by scanning and transmission electron microscopy at 1 to 5 weeks post-inoculation (PI). The predominant ultrastructural lesions were progressive loss of ciliated epithelium with replacement by nonciliated cells, bacterial colonization of ciliated cells, membrane-bound crystalline inclusions in cytoplasma of epithelial cells, depletion of mucous granules, and distortion of tracheal rings and the mucosal surface. Tracheal surface exudates consisted of mucus, necrotic cells, heterophils, and fibrin. Ciliated cells were replaced by immature cuboidal cells characterized by abundant rough endoplasmic reticulum with small numbers of electron-dense mucous granules in the apical cytoplasm. Bacterial surfaces were rough and contained numerous pleomorphic, knob-like structures, 20-50 nm in diameter. Other changes included enlarged mucosal gland openings, cell extrusion marks, pleomorphic microvilli, and cells with small numbers of short cilia. PMID- 3672807 TI - Pathology of Campylobacter jejuni abortion in sheep. AB - Campylobacter jejuni was inoculated intravenously into pregnant ewes on gestation days 114 and 123 to reproduce ovine abortion. All ewes aborted 7-12 days post inoculation. High numbers of C. jejuni were isolated from ewe tissues (caruncle, bile, cecal feces), fetal tissues, and placenta. C. jejuni colonies were identified in caruncles and placenta by light microscopy and immunoperoxidase techniques. Histologically, inoculated ewes had a severe purulent endometritis with vasculitis. Placentas from inoculated ewes and field cases showed necrosis and purulent inflammation; however, placentas from inoculated ewes had large numbers of bacterial colonies compared to few bacteria found in field cases. Histologically, only one fetus from the inoculated ewes showed lesions (purulent bronchopneumonia), whereas all fetuses from field cases had a distinct bronchopneumonia, and one fetus showed multifocal hepatic necrosis. These results suggest that C. jejuni (serotypes Penner 1 and Lior 2) is an important abortifacient organism for sheep. PMID- 3672808 TI - Histopathologic and electron microscopic studies on the acute toxicity of ochratoxin A in rats. AB - Ochratoxin A was given by gavage to male rats. Moribund and dead animals were necropsied, and the surviving rats, including the controls, were killed 48 hours after dosing. Many of the principal rats were moribund, or began dying, within 12 to 24 hours after dosing. Lesions suggestive of disseminated intravascular coagulation were seen by light microscopy as early as 12 hours after dosing; fibrin deposits were in the spleen, brain choroid plexus, glomerular capillaries, liver, and heart. Renal tubular nephrosis, hepatic and lymphoid necrosis, and necrotic enteritis with villous atrophy were also seen. Electron microscopy demonstrated fibrin strands mixed with degranulated platelets, necrotic leukocytes, and swollen endothelial cells in glomerular capillaries. Myocardial changes included focal supercontracted sarcomeres adjacent to intercalated disks. Swollen sarcolemma, lysed myofibrils and fragmented Z-bands with interstitial edema, vascular thrombosis, and endothelial damage were also seen. The acute pathologic changes induced by ochratoxin A in the intestine, liver, and lymphoid tissues were more obvious than the tubular nephrosis, and the development of a disseminated intravascular coagulation-like syndrome with myocardial changes was a complicating factor. PMID- 3672809 TI - Early histopathologic and ultrastructural alterations in femorotibial joints of partial medial meniscectomized guinea pigs. AB - The articular cartilage from femorotibial joints of partial medial meniscectomized male guinea pigs was evaluated at 24, 48, 72, and 96 hours post surgery to determine the sequential histopathologic and ultrastructural alterations. At 24 hours post-surgery, histopathologic alterations were in the superficial and middle layers and consisted of degeneration and necrosis of chondrocytes and minimal decreased intensity of toluidine blue matrix staining. Changes in chondrocytes and matrix became progressively more extensive 48 hours after surgery. Ultrastructurally, the changes in the superficial matrix appeared to be the result of loss of the fine granular material interspersed between collagen fibers. At 72 and 96 hours post-surgery, chondrocyte loss was extensive and surface fibrillation was seen. These findings suggested that chondrocyte death was the initial important event which led to progressive severe cartilage degeneration in this model. PMID- 3672810 TI - Progressive chronic osteoarthritis in femorotibial joints of partial medial meniscectomized guinea pigs. AB - The sequential histopathologic alterations in femorotibial joints of partial meniscectomized male and female guinea pigs were evaluated at 1, 2, 3, 6, and 12 weeks post-surgery. Foci of moderate to severe cartilage degeneration were present in the medial tibial plateau and femoral condyle of the operated leg by 1 week post-surgery. At 2 weeks post-surgery, the cartilage degeneration in the operated legs was more extensive and there was evidence of early chondrophyte formation on the medial side of either the femur or tibia in three animals. Changes were progressively more severe at 3, 6, and 12 weeks. Focal areas of minimal to mild cartilage degeneration were in the medial tibial plateau of the contralateral nonoperated leg in some animals at 3 weeks post-surgery and in all animals at 12 weeks post-surgery. Changes in the contralateral leg of meniscectomized guinea pigs have not been described previously. Since cartilage degeneration was often severe by 1 week post-surgery, the model has limited utility for testing agents designed to modify the degenerative process in the operated leg. Milder, more slowly progressive lesions in the contralateral leg may be amenable to therapeutic intervention. PMID- 3672812 TI - Multiple osteochondromas with evidence of malignant transformation in a cat. PMID- 3672811 TI - Acute Ehrlichia platys infection in the dog. AB - Ten dogs were inoculated with Ehrlichia platys (E. platys) from an acutely infected dog. Two dogs were necropsied on each of days 7, 14, 21, 28, and 35 post inoculation, and tissues were collected and either fixed in formalin or frozen for light microscopic examination of lesions or E. platys antigen localization in tissues. Serum antibody titers to E. platys and serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase activities were also determined. The significant light microscopic findings were lymph node follicular hyperplasia and crescent-shaped hemorrhages in the splenic periarteriolar lymphoid sheaths beginning day 7 post-inoculation. There was significant megakaryocyte hyperplasia of bone marrow on days 28 and 35 post-inoculation. Ehrlichia platys antigen was in macrophages at 14 days post-inoculation which corresponded to the initial decline in platelet numbers. Initial thrombocytopenia and splenic crescent-shaped hemorrhages were temporally related, however the degree of lesion development and prominence were not related to subsequent platelet numbers. PMID- 3672813 TI - Ultrastructure of the liver in pigs with experimental African swine fever. PMID- 3672814 TI - Solar elastosis with squamous cell carcinoma in two horses. PMID- 3672815 TI - Peritoneal mesothelioma in a rabbit. PMID- 3672816 TI - Arteriolosclerosis in a cat. PMID- 3672817 TI - Prostaglandins on the farm. PMID- 3672818 TI - Code of practice for using prostaglandins in cattle and pigs. PMID- 3672819 TI - Possible sulphadiazine-trimethoprim induced polyarthritis. PMID- 3672820 TI - Diarrhoea associated with Clostridium difficile. PMID- 3672821 TI - Unusual sequelae to discospondylosis in a boxer. PMID- 3672822 TI - Necrotic stomatitis/nephrosis syndrome in Zimbabwe. PMID- 3672823 TI - Alternative treatment. PMID- 3672824 TI - Ivermectin for use in fish. PMID- 3672826 TI - Dearth of veterinary surgeons. PMID- 3672825 TI - Orf in man--a treatment? PMID- 3672827 TI - Prevalence of chlamydia, toxoplasma, toxocara and ringworm in farm cats in south west England. AB - The prevalence of infection with Chlamydia psittaci, Toxoplasma gondii, Toxocara cati and Microsporum canis was examined in 51 cats on 22 sheep farms in the Bristol area. Serum antibody to C psittaci and T gondii was present in 45 per cent and 47 per cent of cats, respectively. At the time of sampling C psittaci was isolated from 6 per cent of the cats, T cati was identified in 63 per cent of faecal samples but neither T gondii nor M canis was isolated. When examined according to the farm of origin, 22.7 per cent of farms had cat populations with no evidence of infection with C psittaci or T gondii. Of the remainder, 45.5 per cent supported cat populations with evidence of both infections and 31.8 per cent had evidence of T gondii infection alone. None of the farms had cat populations with evidence of C psittaci infection alone. Two of the cats infected with C psittaci were excreting viable organisms in the faeces. The possible significance of this to the epidemiology of ovine enzootic abortion is discussed. PMID- 3672828 TI - A method for estimating the age of coenuri of Taenia multiceps recovered from the brains of sheep. AB - The age of coenurus metacestodes from the brains of sheep has been estimated by counting the average number of scolices in each cluster on the coenurus wall and relating it to a calculated regression line derived from an examination of cysts of known age. The method has been applied to 17 natural infections and its value is discussed. PMID- 3672829 TI - An outbreak of ringworm in sheep in Ireland caused by Trichophyton verrucosum. AB - An outbreak of ringworm in sheep in Ireland caused by Trichophyton verrucosum is described. The flock consisted of 110 sheep and two separate groups within the flock were affected. Eleven of the first group of 23 sheep and five of the second group of 25 sheep showed lesions. Contact with infected cattle and fomites contaminated by the cattle are believed to have caused the outbreak. An excellent response was obtained in both infected groups by treatment with griseofulvin at a dose rate of 7.5 mg/kg daily for seven days. PMID- 3672830 TI - Factors affecting the survival of Campylobacter jejuni in relation to immersion scalding of poultry. AB - Potential measures for reducing the survival of campylobacters during commercial scalding of poultry have been evaluated in a series of laboratory trials. At 50 degrees C, the lower temperature limit of commercial scalding, raising the pH of a buffered heating medium from 6.0 to 9.0 markedly increased the heat sensitivity of Campylobacter jejuni but the effect was largely nullified in the presence of 1 per cent 'organic material' (50:50 horse blood and milk). Either in the presence or absence of organic material a more rapid rate of kill was observed at 60 degrees C and it was again enhanced by raising the pH to 9.0. Use of a mild detergent at a concentration of 1000 ppm had little effect on the survival of C jejuni at 50 degrees C, but the addition of a cationic quaternary ammonium product at 50 to 100 ppm was highly effective in enhancing the rate of kill, even in the presence of organic material. It is suggested that such products should be evaluated in commercial scalding systems as a possible means of preventing the spread of campylobacters and other organisms of significance to public health. PMID- 3672832 TI - Copper poisoning in Angora goats. PMID- 3672831 TI - Feline struvite urolithiasis: factors affecting urine pH may be more important than magnesium levels in food. AB - Eighteen male cats were fed either a canned complete diet or a commercially available dry pelleted diet or the same dry diet containing 1.6 per cent ammonium chloride. The daily food and water intake of four of these cats was measured. Urine samples were taken at random and the pH and the presence of struvite crystals in their sediment estimated. In some samples in which the pH was less than 7.0, and struvite crystals were absent, the pH was increased to 7.0 and any sediment was examined for struvite. No spontaneous struvite was seen in urine samples (pH 5.8) from cats fed the canned complete diet but when its pH was raised to 7.0, 46 per cent of these samples showed struvite. Cats fed the dry pelleted diet had urine of higher pH (7.55) and 78 per cent of the samples contained struvite crystals. Cats fed this diet supplemented with ammonium chloride had a urine pH of 5.97 and only 9 per cent contained struvite crystals but when the pH was adjusted to 7.0 all the samples showed struvite crystals. Energy intake was similar on all three diets but the intake of dry matter was greater on the dry diets. Liquid water intake was greater on the dry diets but total water intake was greatest on the canned complete diet. The intake of magnesium, calcium and phosphate was greater on the dry diets. It is concluded that urine pH is a more important controller of struvite precipitation than mineral intake. PMID- 3672833 TI - Isolation of Ehrlichia risticii, the causative agent of Potomac horse fever, from the fetus of an experimentally infected mare. PMID- 3672834 TI - Haemorrhagic syndrome in pigs. PMID- 3672835 TI - Schistosomus reflexus. PMID- 3672836 TI - VAT on motoring expenses. PMID- 3672837 TI - Effects of a nine-month endurance training programme on muscle composition in the horse. AB - Muscle biopsy samples were collected from the middle gluteal muscle of seven horses undergoing a nine-month endurance training programme. Samples were collected before the programme began and again after three, six and nine months of training. A fifth sample was collected three months after training ceased. Serial muscle sections were reacted histochemically for myosin adenosine triphosphatase after either acid (pH 4.3 and 4.6) or alkaline (pH 10.3) pre incubation, and muscle fibres identified as type I, IIA, IIB or IIC. The oxidative capacity of individual fibres was assessed, using the reduced nicotinamide dinucleotide tetrazolium reductase stain, and the number of intermyofibrillar capillaries adjacent to each fibre was counted after staining, using the alpha-amylase periodic acid Schiff technique. Biochemical analyses involved the fluorometric measurement of the enzymes citrate synthase, 3-hydroxy acyl CoA dehydrogenase and lactate dehydrogenase as markers of end terminal oxidative, beta oxidative and glycolytic potential, respectively. There was an increase in the percentage of type IIB fibres having high nicotinamide dinucleotide tetrazolium reductase staining after three months training. This increase persisted throughout the period of training and during the period without training. There was an increase in the number of capillaries adjacent to type IIB fibres after six and nine months training. These had returned to near pre-training numbers after three months without training. There were increases in the activities of citrate synthase and 3-hydroxy acyl CoA dehydrogenase after three months training. The activities of both enzymes continued to rise throughout training and the highest activities were attained after nine months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3672838 TI - Malignant catarrhal fever in Pere David's deer. PMID- 3672839 TI - Haemoglobinuria in eperythrozoon infected sheep. PMID- 3672840 TI - Time of release of oxfendazole from an oxfendazole pulse-release bolus. PMID- 3672841 TI - Wooldridge memorial lecture. The professions in today's society. PMID- 3672842 TI - Hepatitis in German shepherd pups. PMID- 3672843 TI - Peripheral neuropathy in diabetic bitch. PMID- 3672844 TI - Prolonged gestation in a mare following surgery. PMID- 3672845 TI - Prostaglandin reaction. PMID- 3672846 TI - Possible potentiated sulphonamide-associated fatality in an anaesthetised horse. PMID- 3672847 TI - PML vaccines. PMID- 3672848 TI - Salinomycin poisoning in horses. AB - Six cases of accidental salinomycin poisoning in horses are described. The horses were fed a contaminated ration and presented clinical signs which were extremely varied in nature and severity. However, the range of signs, including anorexia, colic, weakness and ataxia bore similarities to those described in horses poisoned with the related ionophore monensin. Other similarities became apparent in serum biochemical profiles of the clinical cases. Although ionophore toxicity is rarely reported in horses they appear to be particularly susceptible, and it should therefore be considered as a differential diagnosis of digestive upsets or locomotory disorders at establishments where ionophore-treated feeds are used therapeutically in other species. PMID- 3672849 TI - Survey of libraries in veterinary practice. AB - Responses were received to a survey of practice libraries, from 537 practices. The average practice library contained between 11 and 30 books and one or two journals. Between 50 pounds and 100 pounds was spent on books each year. Practitioners wished they had more time to read and that the literature was orientated towards practice. PMID- 3672850 TI - Role of houseflies (Musca domestica) in the epidemiology of Streptococcus suis type 2. PMID- 3672851 TI - Laminitis in beef bulls. PMID- 3672852 TI - Heat stroke in a dog. PMID- 3672853 TI - Adverse reactions to dichlorophen in cats. PMID- 3672854 TI - In Practice quiz: sweet-itch. PMID- 3672855 TI - Indurative lymphocytic mastitis in sheep after experimental infection with maedivisna virus. AB - In order to provide further evidence for the association of an indurative lymphocytic mastitis in sheep with MVV (maedi-visna virus) infection, an experimental study was performed. Fourteen MVV-free pregnant ewes, 2 years of age, were divided into two groups. Eight were intravenously inoculated with MVV (strain ZZV-1050); six ewes served as sham-inoculated controls. Post-mortem examinations were carried out at 8, 16 and 28 months. After 8 months, the 3 infected ewes had indurated udders with extensive lymphoid proliferation around lactiferous ducts and in the acinar tissue. The ducts were often partially obliterated. After 16 months, one of the two infected ewes suffered from indurative lymphocytic mastitis. The other was free of specific udder lesions. After 28 months only one of three infected ewes had mild lymphocytic infiltration in the udder. None of the controls, two in each post-mortem session, had lesions typical of this form of mastitis. The lesions were most severe 8 months after infection. At 16 and 28 months lesions were of a lesser degree or were absent. The lung lesions in the infected ewes 8 months after inoculation were similar to the changes in the udder regarding the lymphoid accumulation, although the proliferation around bronchial tree and blood vessels was less pronounced. After 16 and 28 months all infected ewes had peribronchial and perivascular lymphocytic infiltration though of a lesser degree than after 8 months. From these results it is concluded that in addition to the lung and brain lesions MVV infections may cause a specific indurative lymphocytic mastitis. PMID- 3672856 TI - Lung and pleural lesions of veal calves at slaughter and their relationship with carcass weight. AB - At slaughter the lungs of 2138 veal calves (13 transport groups, mainly from different farms) were examined. Lung and pleural lesions were classified by degree of extension and pathomorphological features, and the accompanying carcass weights were measured. Seventeen percent of the calves had extensive lung lesions, extensive pleural lesions or both, and their mean carcass weight was reduced by 4.3 kg (p less than 0.05). The percentage of calves with extensive lesions varied between transport groups from 4% to 33%. All pleural lesions were adhesive. Most lung lesions (93%) were classified as cuffing/exudative pneumonia. Slaughterhouse inspection of lungs can be used as a non-clinical parameter of respiratory disease in veal calves. PMID- 3672857 TI - Some pharmacokinetic data about furaltadone and nitrofurazone administered orally to preruminant calves. AB - A single oral dosage of furaltadone and nitrofurazone (14.0 mg/kg) to 5 preruminant calves (in a cross-over trial) revealed mean maximum plasma concentration of 2.5 and 3.5 microgram/ml, respectively, at approximately 3 h after administration. The final elimination half-lives of furaltadone and nitrofurazone were 2.5 and 5 h, respectively. Urinary recovery of these two nitrofurans in 3 calves revealed approximately 2% of the orally administered dose. The renal clearance of the unbound drugs did not differ (for both drugs approximately 0.42 ml/min/kg); furaltadone clearance was strongly related to urine flow. PMID- 3672858 TI - Behavioural problems in dogs. Problems, diagnoses, therapeutic measures and results in 133 patients. AB - The treatment of 133 dogs with behavioural problems is reviewed. The problems most frequently presented concerned aggressive behaviour and/or fear (agonistic behaviour). The combination of problems of dominance and problem behaviour stimulating conditioning (PBSC) was a diagnosis made significantly more often than others. The owner's inability to control the dog appeared to be associated primarily with aggression, but also with fear, in the dog. In aggression as well as in fear, reinstatement of the appropriate ranking order was the usual goal of therapy. In cases of aggression the results of treatment were considered good or fair in 42 percent of the cases, moderate in 11, and bad in 41 percent of the cases. In those involving fear, the results were good or fair in 52 percent of the cases, moderate in 15, and bad in 25 percent. Hence treatment was only moderately successful. This reflects the need for more reliable and valid knowledge about symptoms, diagnostic methods and therapeutic possibilities. PMID- 3672859 TI - Bilirubin metabolism in canine hepatobiliary and haemolytic disease. AB - The kinetics of unconjugated 3H-bilirubin are described in 25 healthy dogs and 35 dogs with spontaneous hepatobiliary or haemolytic disease, using a two compartment model. The bilirubin production rates from erythrocyte degradation (PE), ineffective erythropoiesis (PI) and catabolism of hepatic haemoproteins (PL), were derived from the incorporation of 14C-glycine into haemoglobin and stercobilin. These combined measurements permitted an integral survey of bilirubin metabolism in health and disease. The concentration of unconjugated bilirubin in plasma and its fraction of total bilirubin levels were similar in hepatic and haemolytic disorders. This was explained by the highly increased bilirubin production rates in both types of disease. In addition, the hepatic bilirubin clearance was severely impaired in fulminant hepatitis and in cirrhosis, and moderately decreased in the other hepatobiliary diseases and in primary haemolysis. The erythrocyte lifespan was reduced in all animals but one. In addition to haemolysis, the contribution of PI and PL was variable, and in two dogs PL was the principle source of highly increased bilirubin production rates. These data indicate that the concentration of unconjugated bilirubin in plasma or its fraction of total pigments is unreliable in the discrimination of canine hepatobiliary disease from haemolytic disorders. PMID- 3672860 TI - Advances in companion animal medicine and surgery. Papers from a meeting on "Regulatory Peptides and Diseases of Companion Animals". September 10-12, 1986, Utrecht. PMID- 3672861 TI - Radiocardiography in dogs with atrial fibrillation. AB - In 54 of 99 dogs with atrial fibrillation heart function was examined scintigraphically. Data on the ejection fraction (EF), end-diastolic volume (EDV) and regurgitation fraction (RF) are presented. Of these animals 37 had a seriously decreased EF (less than 30%) with a more or less normal RF value, whereas a smaller group (17) had a moderately decreased EF (but greater than or equal to 30%) and a seriously increased RF value. In both groups the EDV was increased. PMID- 3672862 TI - General and local [corrected] aetiologic factors in canine osteochondrosis. AB - Observations based on necropsy findings in 89 dogs with osteochondrosis are presented. Osteochondrosis was most common in the elbow joint, followed by the shoulder joint, the stifle and the hock joint. There were 59 male and 30 female dogs, and the mean age was 2 years. The high frequency of bilateral lesions and the occurrence of osteochondrosis in more than one pair of joints in 25 of the 89 dogs indicates that general factors are important. The various manifestations of osteochondrosis and their frequency are reported. Various local factors believed to be important for the occurrence of the lesions within the joints are also considered. PMID- 3672863 TI - Comparison of blood glucose concentrations measured by enzymatic and reflectance photometric methods in fasting piglets. AB - During a metabolic study of 22 fasting newborn piglets, blood glucose concentrations were measured by enzymatic and reflectance photometric methods. Use of the reflectance photometer is an accurate method of determining blood glucose levels even in hypoglycaemic range. In addition, the minimal quantity of blood needed for measurement allows the use of the same newborn piglets in longitudinal studies in which samples must be taken frequently. PMID- 3672864 TI - The taxonomic status of Rhodococcus equi. AB - The species Corynebacterium equi was proposed for strains isolated from foals suffering from purulent pneumonia. The taxon has had a confused history and is currently listed under both Corynebacterium and Rhodococcus in the Approved Lists of Bacterial Names. Data from modern taxonomic studies indicate that Corynebacterium equi Magnusson 1923 should be reduced to a synonym of Rhodococcus equi (Magnusson) Goodfellow and Alderson 1980. Rhodococcus equi has repeatedly been shown to be a good species on the basis of chemical, molecular biological, numerical phenetic and serological data. Improved methods are needed to differentiate Rhodococcus equi from closely related species of Rhodococcus. PMID- 3672865 TI - Ecology of Rhodococcus equi in horses and their environment on horse-breeding farms. AB - Quantitative culture of R. equi in the feces of dams and foals, in the air of the stalls and in the soil of the paddocks was carried out on three horse-breeding farms during the foaling season. The isolation rates of R. equi from the feces of dams from the 3 farms suddenly increased to approximately 80% at the end of March, when the snow in the paddocks finished melting, and remained at that level during April and May. The mean number of R. equi and the isolation rate of R. equi from the feces of dams on the farms were investigated for 5 weeks before and 5 weeks after delivery. During the 10 weeks, there were no differences in the isolation rate or in the mean number of R. equi from the feces of dams. R. equi was first isolated from the feces of the foals born in February and the middle of March at 3-4 weeks of age, on the other hand, it was first isolated from the feces of foals born in the end of March and April at 1-2 weeks of age. The number of R. equi in the soil collected from the paddocks used by dams during the winter was approximately 10(2)-10(4) g-1 of soil during the experiment. R. equi was isolated from the air in the stalls at the end of March and the number of R. equi in the air increased particularly on dry and windy days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3672866 TI - The ecology of Rhodococcus equi and physicochemical influences on growth. AB - Growth of Rhodococcus equi was studied in vitro. Optimal growth occurred under aerobic conditions between pH 7.0 and 8.5, at 30 degrees C. R. equi survived better in a neutral soil (pH 7.3) than it did in two acid soils (pH less than 5.5). It grew substantially better in soils enriched with faeces than in soils alone. Simple organic acids in horse dung, especially acetate and propionate, appear to be important in supporting growth of R. equi in the environment. The ecology of R. equi can be best explained by an environmental cycle allowing its proliferation in dung, influenced by management, grazing behaviour and prevailing climatic conditions. Preventive measures should be aimed at reducing or avoiding focal areas of faecal contamination in the environment. PMID- 3672867 TI - Rhodococcus equi in fecal and environmental samples from Kansas horse farms. AB - Horse farms in Kansas were surveyed for the incidence of Rhodococcus equi. Fecal specimens and soil or cobweb samples were collected from each farm and cultured on selective media. One control farm (with no history of R. equi infection), one farm which had an outbreak 3 and 4 years previously and 2 farms which had R. equi infected foals that season were surveyed. In addition, fecal samples from 21 horses hospitalized in the Kansas State University Veterinary Hospital were cultured. There was no significant difference in the incidence of R. equi in fecal samples from the 2 farms with recent disease problems. The farm with a history of disease had a significantly higher percentage of positive fecal cultures than the 2 farms with a more recent history of disease. Neither ration composition nor sex of the horses appeared to affect the fecal culture results. Fecal samples from 2 birds on 1 farm were positive for R. equi. PMID- 3672868 TI - Experimental infection of mice with Rhodococcus equi: differences in virulence between strains. AB - The growth kinetics in outbred mice of clinical and environmental isolates of Rhodococcus equi were followed by serial bacterial enumeration of organ homogenates. Clinical isolates multiplied until Day 4 before being progressively cleared, but could still be recovered from the liver at 3-4 weeks post-infection. Intravenous inoculation of clinical strains was associated with histopathological responses very similar to those elicited by intravenous infection with various facultative intracellular parasites. Whereas lesions in mice and foals at 7-9 days following respiratory infection are those of severe bronchopneumonia with massive consolidation, a week later the patterns of host response have diverged as the murine lesions resolve. The type strain, NCTC 1621 and 4-6 environmental isolates were eliminated without prior multiplication and these strains caused negligible lesions. The two environmental strains which behaved as the clinical strains were recovered from a stud with an R. equi problem. No association of colonial morphology of R. equi with virulence was apparent. PMID- 3672869 TI - Dynamics of equi-factor antibodies in sera of foals kept on farms with differing histories of Rhodococcus equi pneumonia. AB - The occurrence of equi-factor antibodies in sera of mares and their foals was studied on two horse breeding farms, one of which (Farm A) had a positive and the other (farm B) a negative history of R. equi infection of foals. The equi-factor neutralization (EFN) and the reverse Elek-Ouchterlony (REO) precipitation were used as assays. On Farm A, 25 mares positive in both tests (EFN+ REO+) and 25 mares negative in both tests (EFN- REO-) was chosen. On Farm B, a group of 25 EFN REO+ mares and a group of 25 EFN- REO- mares were studied. The first serum samplings in mares were 1 week ante partum and the subsequent samplings in both mares and foals were in the first week after birth and at the end of every month of the foals' age up to 6 months, with further samplings at 8 and 12 months. A higher number of seropositive foals was found on Farm A, but the difference between Farms A and B was not significant. The smallest number, with the lowest titres, was among the foals of EFN- REO+ dams. The number of foals positive in the REO test was higher than in the EFN test. The onset of EFN positivity was found in foals on both farms in the first month of their age, always culminating in the third and fourth months in titres varying between 1:64 and 1:2048, after which time it fell until it disappeared altogether or reached values of 1:4. The results showed the widespread nature of subclinical infection with R. equi on horse farms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3672870 TI - Rhodococcus equi: equine neutrophil chemiluminescent and bactericidal responses to opsonizing antibody. AB - The opsonic capacity of serum containing R. equi-specific antibody was compared with antibody-deficient sera using luminol-dependent chemilumenscence (LDCL) and bactericidal assays. These assays incorporated peripheral blood polymorphonuclear neutrophilic leukocytes (PMNL) exposed to R. equi opsonized with neonatal equine pre-colostral serum (control) or serum from foals with R. equi infections (principal). All sera were complement inactivated at 56 degrees C for 30 min. Bacteria were obtained from the lung of a foal with R. equi pneumonia. Neutrophils were obtained from one adult horse for LDCL and another for bactericidal assays. Chemiluminescence of PMNL exposed to R. equi opsonized with control or principal sera was measured in a liquid scintillation counter. Mean peak LDCL within 1 h was significantly (P less than 0.01) higher with principal sera (2.4 X 10(5) cpm) than with control sera (0.018 X 10(5) cpm). A radioisotope bactericidal assay was used to determine the effect of control or principal sera on PMNL capacity to kill R. equi. Mean peak percent kill of R. equi by PMNL within 2 h was significantly (P less than 0.01) higher with principal sera (95.2%) than with control sera (54.6%). Enzyme-linked immunosorbent assay (ELISA) values for R. equi-specific antibody were determined on all sera. Mean ELISA values were significantly (P less than 0.01) higher for principal sera (71.8) than for controls (0.0). This investigation documents the presence and biological effectiveness of opsonic activity in complement-inactivated sera from foals with R. equi infections and R. equi-specific antibody. PMID- 3672871 TI - The interaction of Rhodococcus equi and foal neutrophils in vitro. AB - Polymorphonuclear neutrophil leukocytes (PMNL) from 8 healthy foals (2-14 weeks of age) and 2 foals with bacterial pneumonia were separated from whole blood using a 2 step Percoll gradient. Purified PMNL were tested for bactericidal function against Rhodococcus equi and Staphylococcus aureus in the presence of normal horse serum. The percentage uptake after a 15-min pre-incubation of PMNL and bacteria was also calculated. Ultrastructural examination of the interaction of R. equi and normal foal PMNL was performed after 15 min incubation. Results indicated that foal PMNL effectively phagocytose and destroy R. equi and S. aureus in the presence of normal horse serum. The mean percent uptake for R. equi was 99.3 +/- 0.4% and for S. aureus 99.9 +/- 0.1%. Further, 97.8 +/- 0.1% ingested R. equi and 98.4 +/- 0.1% ingested S. aureus were destroyed in the 15 min incubation period. Over the 3-h incubation, 91.9% of remaining R. equi were killed, but only 49.2 +/- 31.9% of S. aureus (P less than 0.01). Total bactericidal effect of foal PMNL, however, was 99.3 +/- 0.4% against R. equi and 99.9 +/- 0.1% against S. aureus. The percentage uptake and total bactericidal efficacy of neutrophils from sick foals was greater than 95%. Ultrastructural examination of the PMNL-R. equi interaction after 15 min incubation revealed phagocytosis of the bacteria and morphologic changes consistent with neutrophil degranulation. This study suggests that a defect in PMNL bactericidal capability is not likely to be a contributing factor in the pathogenesis of R. equi pneumonia in foals. PMID- 3672872 TI - Electron microscopic investigation of intracellular events after ingestion of Rhodococcus equi by foal alveolar macrophages. AB - It has been suggested that R. equi causes pulmonary disease in foals by persisting within the lung as a facultative intracellular parasite of alveolar macrophages. This paper describes an ultrastructural study of the intracellular events after ingestion of R. equi by foal alveolar macrophages, in an attempt to determine the mechanism of intracellular survival of R. equi. Secondary lysosomes of alveolar macrophages recovered from foals by bronchoalveolar lavage were labelled with electron-dense ferritin, and the cells were challenged with either viable or formalin-killed R. equi. After 0-, 3-, 8- or 24-h incubation, the cells were fixed and processed for electron microscopy. There was no evidence of phagosome-lysosome fusion after ingestion of either viable or non-viable R. equi by foal alveolar macrophages. Rhodococcus equi persisted and multiplied within dilated phagosomes, which were often lined by elongate microvillous structures. After 24-h incubation, 75% of the ingested bacteria were still structurally intact. Macrophages with ingested viable R. equi were irreversibly damaged and released intracellular bacteria into the surrounding medium. These data confirm that R. equi is a facultative intracellular parasite of foal alveolar macrophages and is able to persist and multiply within the phagosome, apparently inhibiting phagosome-lysosome fusion by some as yet unknown mechanism. PMID- 3672873 TI - Interaction of Rhodococcus equi with phagocytic cells from R. equi-exposed and non-exposed foals. AB - The interaction of Rhodococcus equi with alveolar macrophages from adult horses, foals experimentally exposed to R. equi (sensitized foals) and non-exposed foals was studied using in vitro bactericidal assays, cytochemical staining and transmission electron microscopy. It was demonstrated that R. equi is a facultative intracellular parasite, able to survive and multiply within the alveolar macrophages of the host by interfering with phagosome-lysosome fusion. Opsonization of R. equi with antibody against capsular components was associated with increased phagosome-lysosome fusion and significantly enhanced (P less than 0.05) killing of the organism by alveolar macrophages from non-exposed foals. Macrophages from non-exposed foals were able to ingest the non-opsonized organism, but unable to kill greater than 65% of the infective dose by 6 h post exposure. Alveolar macrophages from sensitized foals behaved as adult macrophages, able to kill greater than 95% of the infective dose by 6 h. Lymphocyte factors, derived by in vitro incubation of sensitized peripheral blood lymphocytes with R. equi surface antigens, enhanced macrophage bactericidal activity. Macrophages from non-exposed foals incubated in the presence of the lymphocyte factors had a 50% increase in killing of R. equi, while sensitized macrophages incubated with lymphocyte factors had a greater than 100% increase in killing capacity. PMID- 3672874 TI - Humoral immune response of foals to experimental infection with Rhodococcus equi. AB - Humoral immune response to Rhodococcus equi in experimentally infected foals was studied with the enzyme-linked immunosorbent assay (ELISA) method. Class-specific antibodies were measured by ELISA in the sera of foals after intratracheal or oral inoculation with R. equi ATCC 6939 or T 48 and in the lung washings of a foal after intratracheal inoculation or of normal horses. After intratracheal or oral inoculation with R. equi, serum antibodies were first detected in immunoglobulin G (IgG) followed by IgM and IgA classes, but significant levels of IgM and IgA developed only in the foal infected intratracheally with R. equi T 48. Only the foal infected intratracheally with T 48 developed pneumonia. Anti-R. equi IgG and IgA antibodies appeared in lung washings of the intratracheally infected foal. There were differences in the antibody response to R. equi among the intratracheally infected foals, the orally infected foal and the naturally infected foal. These results suggest that the humoral immune response to R. equi may be affected by the type of R. equi strain and the route and extent of R. equi exposure. PMID- 3672875 TI - Rhodococcus equi pneumonia in 48 foals: response to antimicrobial therapy. AB - Case records of 48 foals with pneumonia due to Rhodococcus equi were reviewed. Twenty of the 48 foals survived and 28 died or were euthanized. There was no significant difference between the survivors and non-survivors in the age of onset of illness, duration of illness prior to admission, the mean white blood cell (WBC) count, or the mean plasma fibrinogen content. All foals had R. equi isolated from a tracheobronchial aspirate or lung specimens obtained at necropsy. All organisms were susceptible in vitro (Kirby-Bauer) to erythromycin and gentamicin. Susceptibilities to other drugs were: trimethoprim-sulfamethoxazole (88%), tetracycline (87%), chloramphenicol (83%); 97% were resistant to cephalothin and 83% to penicillin. Thirteen of the 20 surviving foals were treated with erythromycin and/or rifampin. A decline in mortality rate was observed with the introduction of the combination of erythromycin and rifampin. None of the 17 foals treated with penicillin and gentamicin survived. Chronic, active, non-septic synovitis was confirmed in 17 foals. These foals had joint distension with mild or no apparent lameness. PMID- 3672876 TI - [Current trends of scientific and technical progress in roentgenology]. PMID- 3672877 TI - [X-ray diagnosis of pulmonary edema in myocardial infarct]. PMID- 3672878 TI - [X-ray diagnosis of duodenal rupture in closed abdominal trauma]. PMID- 3672879 TI - [General principles of emergency x-ray diagnosis in resuscitation departments and intensive care units]. PMID- 3672880 TI - [X-ray characteristics of posttraumatic deformities of the upper and middle third of the face]. PMID- 3672881 TI - [Computed tomography in the diagnosis of eye and orbital injuries]. PMID- 3672882 TI - [X-ray characteristics of the vascular network of fragments of a doubly fractured long bone]. PMID- 3672883 TI - [Lymph outflow in the extremities of patients with posttraumatic osteomyelitis of the leg based on lymphographic data]. PMID- 3672884 TI - [Post-diploma education of roentgenologists in the new era]. PMID- 3672885 TI - [Deutschlander's disease as a microtraumatic injury of the metatarsal bones]. PMID- 3672886 TI - [Side reactions and complications in intravenous urography]. PMID- 3672887 TI - [X-ray diagnosis of lymphogenous disseminated tuberculosis of the lungs]. PMID- 3672888 TI - [X-ray semeiotics of aortic coarctation in children under 1 year of age]. PMID- 3672889 TI - [Clinical and x-ray characteristics of chondroblastoma of the bone]. PMID- 3672890 TI - [Difficulties and failures in superselective catheterization of the left testicular vein with varicocele]. PMID- 3672891 TI - [Rare cases of foreign bodies in the bronchi]. PMID- 3672892 TI - [Case report of arterial embolization of the kidney in secondary hemorrhage]. PMID- 3672893 TI - Mitogenic reactivity of mononuclear cells isolated from thymus, spleen and umbilical cord blood of pig foetuses. AB - The in vitro mitogenic reactivity of mononuclear cells from the thymus, spleen and umbilical cord blood of Danish Landrace pig foetuses ranging in gestational age (GA) from 48 to 112 days was monitored by means of a microculture lymphocyte transformation test (LTT). Dose-response profiles for concanavalin A (Con A), pokeweed mitogen (PWM) and leucoagglutinin (LAG) were set up for the various age groups and the results showed that the onset and development of mitogenic reactivity in the pig foetus is age-related. The results indicate the occurrence of mitogen responsive cells in the thymus and cord blood at 48 days GA and in the spleen at 54 days but statistically significant reactivity (p less than 0.01) for the various tissues could only be demonstrated at later stages of gestation. Thymus cells from all foetuses ranging in GA from 54 to 112 days exhibited significant reactivity to Con A, PWM and LAG. While the first detectable definite response of spleen cells was seen at 60 days GA when 50% of the foetuses exhibited significant reactivity to the 3 mitogens, spleen cells from all foetuses beyond that age responded significantly. Cord blood cells from only 50% of the foetuses of 60 and 70 days GA responded significantly to Con A and PWM but after this stage, cord blood cells from all foetuses did. The first significant response of cord blood cells to LAG was seen at 70 days GA but only in 50% of the foetuses and it was not until 100 days GA that significant reactivity to LAG was detected in all foetuses. PMID- 3672894 TI - Suppression of humoral immunity in chickens with carrageenans. AB - Carrageenans (CGN), sulphated polygalactans, have been reported to be cytotoxic for macrophages in vitro. On this basis, the effect of the 3 major CGN types on humoral immune responses in chickens was investigated. Carrageenan had no effect on body and lymphoid organ weights. Histologically, CGN produced a significant proliferation of reticuloendothelial cells in liver and spleen, but no changes were observed in lymphocyte populations of the bursa of Fabricius, thymus, or spleen. Intracoelomic pretreatment with high doses of CGN induced a marked suppression of primary responses to sheep red blood cells (SRBC) given by the same route. However, if SRBC were injected intravenously into chickens already treated intracoelomically with CGN, no evidence of suppression was demonstrated. Antibody responses to Brucella abortus (BA), a T-independent antigen, were not affected by intracoelomic treatment with CGN. Intravenous pretreatment with CGN did not alter antibody responses to SRBC and BA given by the same route. PMID- 3672895 TI - Importance of the hour of sampling in the lymphoblastic transformation assay of sheep peripheral blood lymphocytes. AB - This paper describes the effect of the nycthemeral cycle on the lymphocyte response of sheep to different mitogens (PHA, Con A and PWM). A considerable decline in the lymphocyte response was evident in the afternoon and early in the morning in all 6 animals tested. Three peak responses were identified during a 24 hour study period, at 14.00 h, 24.00 h and 08.00 h. The results presented here suggest that this variation in lymphocyte response is a meaningful difference in the response ability of individual lymphocytes. Factors affecting the number of leukocytes and the proportion of different types of lymphocytes in peripheral blood might be the essential causes of variation. To obtain an accurate indication of an individual's immunocompetence, it is important to make a preliminary determination of the optimal hour for sampling. If this is not possible, all the samples must be taken at the same hour on each test day, in order to make significant comparisons. PMID- 3672896 TI - Assays and activities of glycosidic enzymes in bovine peripheral blood leukocytes. AB - Methods are described for the quantitative measurement of N-acetyl-beta-D glucosaminidase, alpha-mannosidase and beta-glucuronidase in peripheral blood leukocytes of the bovine. Enzyme kinetics and stability were determined. Activities of the glycosidases in polymorphonuclear leukocytes and mononuclear leukocytes were determined using the optimized assays. Polymorphonuclear leukocytes had greater activities of N-acetyl-beta-D-glucosaminidase and alpha mannosidase, and similar levels of beta-glucuronidase, when compared to mononuclear leukocytes. PMID- 3672897 TI - Lysosomal enzymes in bovine mammary leukocytes during the nonlactating period. AB - Leukocytes from mammary secretions in dairy cows were collected during the nonlactating and postpartum periods. Differential cell counts, viability and activity of peroxidase, N-acetyl-beta-D-glucosaminidase (NAGase, beta glucuronidase and alpha-mannosidase in cells were determined. Cell viability (trypan blue exclusion) was 75-80% during most of the nonlactating period, but declined to 45-50% by parturition. Polymorphonuclear neutrophils (PMN) predominated during the first week of involution, after which macrophages were the predominant cell type. Peroxidase activity in leukocytes from mammary secretions was high in early involution, probably reflecting the predominant peroxidase-containing PMN. Peroxidase activity declined through the remaining nonlactating and postpartum periods. The activity of NAGase was variable in early involution, then increased to a peak during the mid-nonlactating period, before declining prior to parturition. Activity of beta-glucuronidase generally was unchanged during the nonlactating period, although NAGase and beta-glucuronidase activities were significantly and positively correlated throughout the period studied. Activity of alpha-mannosidase changed in a manner similar to peroxidase activity. PMID- 3672898 TI - Pharmacokinetics of streptomycin with particular reference to its distribution in plasma, milk and uterine fluid of she-buffaloes. AB - The study elucidated the pharmacokinetics of streptomycin in healthy lactating she-buffaloes after a single intramuscular (IM) injection (10 mg/kg). The drug attained its peak concentrations of 24.39 +/- 2.67, 0.45 +/- 0.05 and 5.06 +/- 0.18 micrograms/ml at 1, 4 and 1 hour in plasma, milk and uterine fluid respectively. Calculations based on the assumption of a 2-compartment model gave a plasma t1/2 (beta) of 4.01 +/- 0.44 h and an apparent volume of distribution [Vd(area)] of 0.47 +/- 0.06 1/kg. The drug was detectable in the plasma, milk and uterine fluid for 30, 8 and 12 hours, respectively. A therapeutic concentration of the drug was maintained for 6 to 7 hours in the plasma and for around 1 hour only in the uterine fluid. However, a therapeutic level could not be achieved in milk at any time. The results suggest that the drug can be used clinically by the IM route against streptomycin susceptible systemic infections but not those in the uterus and mammary gland. PMID- 3672899 TI - Studies on the neuromuscular junction with a special preference to nicotinic receptors in normal delivering cows and cows suffering from parturient paresis. AB - Acetylcholine synthesizing (ACh-s) activity, and binding of 3H-alpha-bungarotoxin (3H-Btx) and 3H-d-tubocurarine (3H-TC) were analysed in gluteus media muscle from normal cows and from cows suffering from parturient paresis, both at parturition and 3 months later. At parturition, the ACh-s activity was 50% lower in the muscle of paretic cows than in non-paretic cows. No difference was found in the number of 3H-Btx and 3H-TC binding sites at parturition, while 3 months after parturition the numbers of 3H-TC and 3H-Btx binding sites were significantly higher in normal than in paretic cows. These significant differences in the number of receptors and a possible underlying receptor regulation defect might be a plausible etiological factor for the disease parturient paresis. PMID- 3672900 TI - An evaluation of milk temperature measurement for detecting oestrus in dairy cattle. I. Factors affecting measurement of milk temperature. AB - The paper reports the development of an electronic system of milk temperature measurement and the results of investigations into the influence of milk yield, milk flow and ambient temperature on milk temperature. The milk and body temperatures of randomly selected multiparous Friesian cows were recorded at afternoon milkings. Temperature was measured by bead thermistors housed in perspex probes from which a digital read-out with an accuracy of +/- 0.1 degree C was obtained. Milk temperature was measured at four sites: the short milk tube (SMT), claw piece (CT), and the beginning (BLT) and end of the long milk tube (ELT) with readings being taken every 30 s from the commencement of milking. Body temperature measured with a probe in the vagina (VT) 38.85 +/- 0.02 degrees C) was significantly higher than milk temperature at any of the four sites although a significant positive correlation existed between milk and body temperature. Milk temperature measured at each site decreased with distance from the cows (SMT: 38.64 +/- 0.03 degrees C, ELT: 37.92 +/- 0.04 degrees C). The difference between body and milk temperature was greatest in cows in which milk flow rates were below average (less than 1.37 kg/min) and/or milk yields were below average (less than 7.82 kg/milking). Milk temperature sites SMT and CT were least affected by variation in milk yield or flow, and showed the closest relationship between maximum milk temperature and body temperature. Milk temperature measurement was most reliable when taken during the full flow of milk. PMID- 3672901 TI - An evaluation of milk temperature measurement for detecting oestrus in dairy cattle. II. Variations in body and milk temperature associated with oestrus. AB - Vaginal and milk temperatures were measured at each milking in 15 post-partum Friesian cows showing recurrent oestrous cycles for a total of 33 oestruses. A significant increase (P less than 0.001) in both vaginal and milk temperature of 0.29 +/- 0.05 degrees C was shown between the milking prior to oestrus and the milking when oestrus occurred. Cows were divided into 3 groups: showing either a definite temperature rise (27% of cases), a limited temperature rise (60%) or no temperature change (13%) associated with oestrus. Various methods of analysis were investigated to determine the usefulness of the milk temperature data for oestrus prediction. The optimum compromise of high oestrus detection rate (73.3 +/- 16%) and lowest percentage of false positives (10.8 +/- 3.0%) was based on a temperature rise on the day of oestrus of greater than or equal to 0.2 degrees C over the corresponding mean temperature of the preceding three days. These rates suggest the measurement of milk temperature is less useful for oestrus prediction than some earlier reports have indicated. PMID- 3672902 TI - [Electron microscopic methods for the rapid diagnosis of Q fever in animals]. AB - Methods have been worked out for the electron-microscopic diagnosis of Q-fever. A characteristic feature with them is the use of clinical, pathological, and experimental material that is investigated through negative contrast and ultra thin sections for the detection of rickettsial cells and inclusions. It is underlined that the methods referred to are readily applicable, economic, highly effective, and hazardless. They are described for the first time and could be adopted into the diagnostic and epizootiologic practice as well as in experimental investigations. PMID- 3672903 TI - [Drug resistance and virulence of Staphylococcus aureus strains isolated from cows with endometritis]. AB - A study was carried out on the drug resistance as associated with the virulence of Staphylococcus aureus strains isolated from cows with endometritis. Hirota's method was employed to ascertain that resistance to penicillin, erythromycin, neomycin, and kanamycin was governed by plasmids. It was found at the same time that, fairly often, with the elimination of some of the resistant markers the virulence of the strain variants also dropped. However, these two properties did not correlate with each other. PMID- 3672904 TI - [Effect of a chromatographically purified bile secretion on the blood protein levels in hens]. AB - The injection of chromatographically purified biliary fraction from broiler birds, rich in bile acids, led to a dependable drop of serum proteins in chickens. Treatment of the latter with a bile sample from swine, obtained in a similar way (the reaction for bile acids being negative) did not lead to essential changes in the content of plasma colloids. Results showed that bile acids were of definite importance as regards the blood level of proteins and the redistribution of proteins in the body with the individual species of animals. PMID- 3672905 TI - [Cytological research on the vaginal mucosa in cows with estrous cycle disorders]. AB - Cytologic investigations were carried out of a total of 140 cows with regard to the vaginal mucosa in the event of disturbed functions in the course of the sexual cycle: hypofunction of the ovaries (71 animals), persisting yellow bodies (34 animals), and estral and postestral cases of metrorrhagia (35 animals). Chamov's trichromatic method was employed to stain the smears and Veznik's cytogramme method--to carry out the recordings. It was found that in the case of ovarian hypofunction the mixed type of cell pictures prevailed (47.8 per cent), followed by the estrogenic type (39.4 per cent), and the progesterone type (12.6 per cent). In the case of persisting corpora lutea the mixed type of cell picture prevailed too--64.7 per cent, while the estrogenic and progesterone types were 17.6 per cent. Featuring in the postestral and estral metrorrhagia was the estrogenic type of cell picture (51.4 per cent), while the mixed type accounted for 45.7 per cent of the cases, and the progesterone one--for 2.8 per cent. It is suggested to use the cytovaginal method in combination with the routinely employed clinical and laboratory tests for the overall evaluation of the condition of the genital system in cows. PMID- 3672906 TI - [Epizootiology, prevention and control of salmonellosis in swine]. AB - Microbiologic studies were carried out in 1981-1985 with a total of 25,561 samples--12,878 were cadavers and viscera, 574 were fetuses, 6,208 were swabs of rectal samples. 844 were feces, 4,096 were washings, 493--feed samples, etc. A number of prophylaxis and control programmes were tested under productional conditions with the use of drugs and vaccinations with a live and a killed autovaccine. Salmonella organisms were isolated as follows: 9.05% from cadavers, 2.5% from fecal samples, 1.35% from rectal swabs, 1.2% from washings from the environment, 0.6% from feed samples--all belonging to 19 serologic types. Greatest importance was shown to have S. cholerae suis, which was epizootically specific for swine, however, the part played by var. america also grew as compared to var. kunzendorf. With the exception of several sporadic cases all other serologic types of Salmonellae were isolated from carriers, rectal and fecal samples, and others. In the event of swine salmonellosis under productional conditions better results were obtained with the use of drugs. Both morbidity and mortality rate dropped twice as low with animals treated with a live vaccine once, and with a killed autovaccine four times. Suggested is a prophylactic and control program, following a definite pattern in dealing with swine salmonellosis in enzootic foci, with the use of complex measures. PMID- 3672907 TI - [The exchange of animals in the form of embryos]. AB - The results are given of transplantation work with cattle embryos from Czechoslovakia. The embryos were taken in the stage of morula or blastocyst, frozen and stored for one to ten months. Following thawing they were transplanted via surgical methods to local, estrus-synchronized recipient heifers at the Ruzhevo Konare village, Plovdiv district. A calf was born to each of six of the recipients, while two heifers that were inseminated seven days prior to transplantation yielded twins. It was considered to be the result of both the embryo-transplantation and the fertilization of own ova. Discussed are the opportunities and advantages of long-term storage and shipping of animals in the form of frozen embryos. PMID- 3672908 TI - [Erythrocyte lipid peroxidation as a diagnostic test in supplying pigs, lambs and chickens with vitamin E]. AB - Experiments with pigs, lambs, sheep, and birds, carried out under various conditions of feeding (with or without supplement or treatment with vitamin E) revealed that the study of the peroxide resistance of erythrocyte lipids could render useful information on the supply of animals with vitamin E. The study of peroxide resistance was shown to be much more accessible than the available chemical methods, and had better reproducibility. This new approach took good consideration of the biologic activity of vitamin E, and was fairly suitable to be employed as a screening diagnostic method. The interpretation of results should take into account the occasional peroxidizing effect produced by heavy metals. With sheep the normal values of erythrocyte lipid peroxidation were 40.3 +/- 1.86; with cattle they were 60.0 +/- 3.2; with pigs--63.7 +/- 3.56; with young birds--64.6 +/- 2.35; and with hen layers--72.8 +/- 4.39. PMID- 3672909 TI - [Enzymatic activity of ceruloplasmin in gamma-irradiated lambs]. AB - Studied were the changes in the concentration of ceruloplasmin through altering its oxidase activity in the blood serum by gamma treatment, using a 60Co source at the rate of 3 Gy and dose power of 0.68 Gy/min-1. The oxidase activity of the enzyme was determined colorimetrically with an o-dianisidine substrate. The concentration of ceruloplasmin rose from 34 E/l prior to irradiation to 129 E/l following treatment. The analyses were carried out immediately before using gamma rays and at the 30th min, at the 15th and 40th hour, and on the 10th, 17th, and 30th day after that. By the 30th day the ceruloplasmin level was found to drop up to 90 E/l. The serum proteins also changed their values following treatment. Albumin and gamma-globulins dropped from 52.3 to 43.2 per cent and from 20.1 to 13.1 per cent, respectively. Alfa-1 rose from 8.5 to 9.8 per cent, alfa-2 globulins--from 13.0 to 17.7 per cent, and beta-globulins--from 6.0 to 15.1 per cent. Alfa-2 globulins were shown to follow the same pattern of rising as ceruloplasmin and serum copper. As a result of the irradiation disease that developed after treatment a paraclinical picture of an acute inflammatory process set in. PMID- 3672910 TI - [Paraclinical indices in experimental damage to the renal parenchyma]. AB - A model was developed of the experimental injury of kidney parenchyma with the use of potassium bichromate with six calves. Studied was the activity of ChE, LAP, ALD, APh, GOT, GPT, OKT, and guanase as well as the level of blood sugar, calcium, and inorganic phosphorus. It was found that ALD, ChE, and LAP formed a good enzyme constellation to follow up the functional status of the kidney parenchyma. The results obtained needed further clinical processing. PMID- 3672911 TI - [Effect of anticoccidial preparations in the prevention of coccidiosis in turkeys caused by Eimeria adenoides]. AB - Studied was the anticoccidial activity of the preparations monensin, salinomycin, lassalocid, lerbek, arpocox, and chimcoccid in the prevention of coccidiosis in turkey poults infected with Eimeria adenoeides. A total of 80 turkey poults were used. The prophylactic effect produced by the coccidiostatics was recorded as judged by the anticoccidial index, the liveweight at the beginning and at the end of the experiment, the amount of food intake, and the index of feed conversion. Best effect was produced by chimcoccid which was to be preferred to the other preparation in the prophylaxis of turkey cocidiosis. Comparatively good results were likewise obtained with the use of lerbek, followed by salinomycin and arpocox. Monensin and lassalocid ranked last. PMID- 3672912 TI - [Chemical composition of the meat of emergency-slaughtered calves]. AB - Studied was the chemical composition of musculus longissimus dorsi and the liver of 16 emergency-slaughtered calves, affected with bronchopneumonia, along with 10 normal calves used as controls. Special attention was paid to the content of water, fats, ashes, total and extractive and protein nitrogen, and the amount of essential amino acids (tryptophane) and nonessential (hydroxyproline) proteins. It was demonstrated that the sampled muscle tissue of the diseased calves had higher content of water (1.81 per cent) and lower content of fats (1.68 per cent) and caloric value (16.11 Kcal) as against the values of the same indices for the analogous muscle of normal calves (P less than 0.001). No essential differences (P greater than 0.05) were found in the average values of the crude protein, the essential and nonessential proteins and their ratio in the tissues sampled from the forcedly slaughtered calves as compared to the controls. PMID- 3672913 TI - [Histological and electron microscopic research on pale, soft, watery and pale, soft pork]. AB - Histologic and electron-microscopic studies were carried out on pale-soft exudative (PSE) and pale-soft (PS) swine meat taken from musculus longissimus thoracis et lumborum. PSE meat was shown to have more strongly manifested morphologic changes. Histologically, with some of the samples there were 'gigantic fibers', their dia exceeding several tens of times the dia of fibers taken from control animals. The electron microscopy with some of the samples revealed a strong deformation of the myofibrils (extensions alternating with narrowings), broader Z-bands, loss of striation in the anisotropic zones, confluence of myofibrils in individual portions, granular destruction or fragmentation of sarcoplasm with swollen or disrupted mitochondria in it, strongly disrupted or destructed Z-bands, lysed or hyperchromic nuclei of the fibers, etc. In PS meat the same ultrastructural changes were observed, although they were less strongly manifested. With such meat some of the samples showed total destruction of the Z-bands, which had led to the full separation of sarcomeres (a phenomenon observed for the first time). These results constitute a contribution to the knowledge of the mechanism through which the PSE meat phenomenon occurs and the evaluation of such meat for consumption. PMID- 3672914 TI - [Drug resistance of bacterial strains isolated from sows with the clinical picture of mastitis-metritis-agalactia]. AB - The disk method with Ericson and Bauer's solid nutrient media were employed to ascertain the drug resistance of a total of 54 strains of Escherichia coli, 25 strains of Staphylococcus aureus, 11 strains of Streptococcus pyogenes, 7 strains of Corynebacterium pyogenes, 7 strains of Streptococcus uberis, 2 strains of Streptococcus agalactiae, and 1 strain of Streptococcus disgalactiae isolated from utero-cervical exudate and milk samples of sows with clinical symptoms of mastitis-metritis-agalactia (MMA). It was found that gentamycin only suppressed 100 per cent of the strains. So far as the other chemotherapeutic agents were concerned the organisms showed a varying extent of resistance. After determining the sensitivity of the strains to drugs two groups of pigs (from which the strains referred to were isolated) were subject to treatment. All 20 sows of the first group were treated with oxytocin only, while the 446 animals of the second group were treated with gentamycin in combination with oxytocin. It was found that effective therapy in the case of MMA was impossible with the application of preparations on the base of the hind lobe of the pituitary only. It is necessary to use chemotherapeutic means tow which the isolated organisms are susceptible. PMID- 3672915 TI - [Etiology of salmonellosis in swine raised commercially]. AB - A total of 25,561 samples from swine (cadavers, internal organs, rectal swabs, feed, and washings of premises) were investigated microbiologically over the 1981 1985 period via routinely employed methods for the isolation and typing of Salmonella organisms, following the Kauffmann-White pattern. Tested was the susceptibility of 411 strains by the disk-diffusion method, using drugs of the general practice, and the results were recorded after Bauer. In 5.32 per cent of the samples 19 Salmonella serotypes of the B. C. D, and E groups were isolated. Greatest in the etiology of salmonelloses was still the relative share of S. cholerae suis (85.22%), represented by the two-phase var. america and the autochthonous var. kunzendorf. Second ranked S. typhimurium--5.14%, followed by S. agona--2.20%, S. menden--1.25%, S. thompson--1.18%, S. derby--1.10%, S. bovis morbificans--0.81%, and others. A change was ascertained in the serotypes isolated from pigs with regard to the exotic types. Sensitive to gentamycin proved 89.9%, to chloramphenicol--79.1%, to carbenicillin--71%, to kanamycin- 70%, etc; 75% were resistant to ampicillin, 54.6%--to streptomycin, 51.3%--to tetracycline, and 33.8%--to furazolidone. PMID- 3672916 TI - [Pharmacological research on ophthalmic drug lamellae containing gentamycin sulfate in laboratory and agricultural animals]. AB - The in vitro and in vivo solubility of ocular drug lamellae, containing 1.5 and 3 mg gentamycin sulphate, was followed up. It was found that those that contained lower amount of the antibiotic disintegrated in the eyes of rabbits, lambs, and sheep for 30-40 minutes, while lamellae having 3 mg gentamycin disintegrated for 45-50 minutes. It is stated that such ocular lamellae are well tolerated by the conjunctiva of the animal species referred to. With the application of one lamella with 3 mg gentamycin sulphate therapeutic concentrations of the antibiotic in the lacrimal secretion are found up to the 24 th hour with cows, sheep, and lambs, and up to the 48h hour with rabbits. PMID- 3672917 TI - [Subchronic toxicity of apramycin in pigs]. AB - Use was made of four groups of six pigs each, weighing 40 to 50 kg to follow up the toxicity of Pharmachim's apramycin in the form of water-soluble powder of apramycin sulfate, given at the rate of (nil), 300, 500, and 1,000 mg per liter of drinking water in the course of 35 days. It was found that such treatment did not lead to changes in the general status of the animals. On the contrary, apramycin sulfate stimulated growth and improved feed conversion. In concentrations of up to 300 mg/l the preparation did not produce an essential effect on the clinico-laboratory indices, and did not lead to toxic alterations of the viscera. In concentrations of 500 and 1,000 mg/l and extending the period to more than 15 days an occasional drop of the percent of lobular neutrophilic leukocytes and rise of the percent of lymphocytes in the blood might occur. This could lead to dystrophic processes in the liver and to negligible changes of the same character in both the kidneys and the heart. PMID- 3672918 TI - [Clinico-biochemical and hematological studies in acute monensin poisoning in swine]. AB - Investigations were carried out with pigs divided into four groups and treated with monensin-Na at rates of 20, 30, and 50 mg/kg, once only, through a nose pharyngeal tube. The total change in the clinical status was followed up. Most characteristic were found to be the changes setting in with the posture and locomotive apparatus--prolonged lying, pareses, etc. Blood was checked in the dynamic course of the disease at the 4th and the 24th hour as well as on the 6th day following monensin-Na treatment. The amount of haemoglobin and the erythrocyte count rose in the early stage of intoxication, and came back to normal after the 24 th hour. Leukocytosis with neutrophilia was also found. The serum level of selenium, calcium, vitamins A, B1, and C dropped substantially, while that of phosphorus and magnesium rose. The morphologic changes were found to be localized in the parenchymal organs and in the skeletal muscles. Featuring were diffuse hyperaemia, haemorrhages, granular degeneration, and focal necrosis. PMID- 3672919 TI - [Hygienic research on meat-dressing shops and enterprises]. AB - Observations were made on the hygiene state of the meat-conditioning departments and enterprises of 13 meat-dressing combines. Both qualitative and quantitative investigations were carried out with regard to 9 bacteriologic indexes. The result of studies on a total of 1,042 samples of washings taken from equipment, working tools, machines, working milieu, and hands and aprons of workers prior to beginning work showed that in case all regulations of cleaning, washing, and disinfection were observed the residual microflora, and, more specifically organisms that were of interest from a sanitary point of view were lowered to minimum counts. No pathogenic Staphylococcus and Salmonella organisms were isolated. It was found that during work the count of indicative organisms considerably rose. No pathogenic staphylococci were isolated. In one case only were there Salmonella typhimurium organisms on the surface of a circular saw for carcass cutting. The overall bacteriologic investigation of a total of 137 samples of minced meat and meat balls and other products prepared with such meat revealed that the average counts of various organisms ranged as follows: aerobic mesophiles--3,653 830/g, and coliforms--31,748/g; Escherichia coli organisms were demonstrated in 10.22 per cent of the cases, B. proteus--in 1.46 per cent, and pathogenic staphylococci--in 3.65 per cent of the samples. None of the samples, weighing 25 g each showed the presence of Salmonellae. No correlative dependence was found between the coli titer and the coli index of the products. PMID- 3672920 TI - [Effect of the gas composition of the air on the growth of broilers]. AB - Comparative investigations were carried out with the gas composition of air and the productivity of broilers raised in cells and on deep litter in the region of Northeast Bulgaria. The buildings were sized 75 X 15 X 3.8 m. The air exchange in them was effected through mechanical ventilation at lowered pressure, after the pattern 'from above--sideways'. As many as 17.3 birds/m2, when deep litter was used, and 28.6 birds/m2, when cells were used, were housed in the buildings for raising up to the age of 56 days. The content of harmful gases, such as ammonia, hydrogen sulfide, and carbon dioxide was determined at 14-day intervals at 3 sites in the buildings. The body mass of broilers, raised after the two methods, was followed up on the 14th, 28th, 42nd, and 56th day of age. The number of birds and the live mass produced per square meter of floor area in the various seasons of the year were calculated at the end of the fattening periods. It was found that by the end of fattening on deep litter the concentration of ammonia varied around the upper admissible threshold, while with fattening in cells it was within the standard range. With cell raising of broilers the live mass produced per 1 m2 of flooring was 50.5 to 83.6 per cent more as compared with the live mass produced on deep litter. The total broiler produce with cell raising over the 4 seasons was 63.3 per cent, on an average, more than that with the use of deep litter. PMID- 3672921 TI - [Enzyme constellation in cows of the Simmental crossbreed and Black Pied breed during the dry period and lactation]. AB - Studied was the enzyme constellation, resp., activity of alkaline phosphatase (AP), glutamate-oxaloacetic transaminase (GOT), glutamate-pyruvate transaminase (GPT), aldolase (ALD), leucin-aminopeptidase (LAP), cholinesterase (CE), creatine phosphokinase (CPK), lactate dehydrogenase (LDH), ornithine carbamoyltransferase (OCT), and guanase (G) in a total of 360 clinically normal and lactating and dry cows of the Black-and-White and Simmental crossbreeds. Characteristic quantitative changes were found with GOT, GPT, ALD, LDH, and CPK both over the dry period and over the entire period of lactation. The activity of LAP, AP, OCT, and G was not influenced by the functional status of the animals. In the course of the analyses there were changes in the serum ALD, CE, and GOT, associated with the breed. The enzymes referred to were studied with a view to establishing their normal parameters needed for the practice as the base to demonstrate preclinical disturbances in individual organs and tissues of the cows during pregnancy and the puerperium. PMID- 3672922 TI - [Experimentally induced aflatoxicosis in broilers]. AB - Aflatoxicosis was induced under experimental conditions in two groups of broiler birds fed in the course of the entire fattening period upon feed, containing 0,250 and 0,600 ppm aflatoxin. Dependable changes were established in the investigated haematological and biochemical indices. There was a drop of the body weight and an increase in the feed to gain ratio. Pathologic changes were recorded in the liver. PMID- 3672923 TI - [Effect of a yeast preparation on the blood indices of swine]. AB - Studied was the effect of a preparation of yeasts of the Saccharomyces cerevisiae species, obtained by the authors, on the fattening of pigs. Some blood parameters, characterizing the physiologic status of the animals, were followed up to ascertain the effect of the preparation of the animals' body. Determined was the activity of the serum enzymes aspartate-aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (AP) as well as the erythrocyte and leukocyte counts, the concentration of haemoglobin, the haematocrit value, and the differential white blood picture. Results of the biochemical investigations with the activity of AST, ALT, and AP showed that the yeast preparation most probably raised the biologic value of the dietary plant protein, which resulted in more intense growth at lower feed intake. Investigations on the blood indices referred to confirmed that all was normal with the test animals. PMID- 3672925 TI - [Comparative trial of the action of coccidiocidal drug agents to control coccidiosis in turkeys due to Eimeria adenoeides]. AB - Tested was the effect of the anticoccidial agents ESB3, trimedin, Coccistop, and Coccibio used in the control of Eimeria adenoeides infection in turkeys. The experiment made use of a total of 130 turkey poults of the Beltsville White breed, divided into 13 groups of 10 birds each. The drugs were applied at different hours following infection that corresponded to the various phases of the endogenic development of the parasite. Best results were obtained with the use of ESB3 and of the Bulgarian preparation trimedin. Weaker was the effect produced with the administration of the other two preparations, which was explained by the weaker suppression of E. adeneoides in the process of gametogony. PMID- 3672924 TI - [Antibacterial activity of chlorquinaldol esters and 2-styryl-substituted derivatives]. AB - Studied was the bacteriostatic activity of a total of 17 new esters and replaced 2-styryl derivatives of chlorquinaldol. Determined were also the lowest concentrations that suppressed the growth of organisms. Some of the compounds showed higher activity and broader spectrum of antibacterial qualities, mainly against Escherichia coli, Salmonella gallinarum, and Salmonella cholerae suis as compared to the initial therapeutic preparation chlorquinaldol. It was found that the presence of chlorine atoms either in the second or in the second and fourth place in the benzene nucleus of the esters studied, the presence of a NO2-group in the third place of the same nucleus, and the presence of an extranuclear hydroxyacetyl remainder in the ester grouping could lead to a rise of the antibacterial activity. The presence of an F atom in the second and third place of the benzene nucleus of the sterile grouping also raised the activity of these compounds. PMID- 3672926 TI - [Pathomorphological research on chlamydial abortion in sheep]. AB - Serologic and morphologic studies were carried out with ewes and aborted fetuses, respectively, with regard to the Chlamydial infection in the flocks of some farms. The complement-fixation test was employed to examine a total of 656 blood serum samples. It was found that 20.2 per cent of these contained Chlamydial antibodies. Abortions were established with 6 to 8 per cent of the sheep in each flock. Material was sampled from 35 aborted fetuses. Featuring in the gross lesions of the fetal placenta in Chlamydial abortions were the wheat-bran type of whitish coatings on the surface. Characteristic histologic findings were desquamation, necroses, lympho-leukocytic infiltrations, and the partial deposits of calcium salts. Definite diagnostic value with the aborted fetuses were shown to have the lympho-histiocytic proliferations in the liver, adrenal glands, kidneys, lungs as well as the reticuloendothelial hyperplasia with the presence of gigantic cells of Langhans type in the mesenterial lymph nodes. PMID- 3672927 TI - E1B functions of type C adenoviruses play a role in the complementation of blocked adenovirus type 12 DNA replication and late gene transcription in hamster cells. AB - Adenovirus type 12 (Ad12) DNA cannot replicate in hamster cells and the late Ad12 genes cannot be expressed. It has been demonstrated previously that these defects can be at least partly overcome by coinfection of hamster cells with Ad12 and wild-type adenovirus type 2 (Ad2) or type 5 (Ad5) or by superinfection of Ad2- or Ad5-transformed cells with Ad12. These transformed cell lines carry in an integrated form and constitutively express the E1 region of Ad2 or Ad5. The compensation in Ad12 DNA replication and late gene transcription does not, however, lead to the assembly of intact Ad12 virions. In the present study, it has been demonstrated that the complementing functions in the Ad5 genome, which can effect Ad12 DNA replication and late transcription in hamster cells, reside predominantly but not exclusively in the E1B region. A supporting role in the E1A region is likely. These conclusions have been adduced from the results of double infection experiments using Ad12 and deletion mutants of Ad5. Inside the E1B region of Ad5 DNA, the complementing functions have not yet been precisely located. Although late Ad12 messenger RNAs are synthesized in Ad12 and Ad5 coinfected hamster cells, most of the late structural Ad12 proteins are not made or are made in minimal amounts, and consequently virions are not assembled. It is necessary to investigate whether hamster cells also exhibit a translational block vis a vis the expression of late Ad12-specific mRNAs. The data presented here also demonstrate that Ad12 functions can effectively complement E1A or to a lesser extent E1B deletions in the Ad5 genome in hamster cells. Upon coinfection with Ad12 and deletion mutants of Ad5 in either the E1A or the E1B region, Ad5 DNA and late proteins are synthesized, although Ad5 E1A or E1B functions cannot complement the deficient late Ad12 protein synthesis in hamster cells. PMID- 3672928 TI - The nucleotide sequence of a geminivirus from Digitaria sanguinalis. AB - The encapsidated single-stranded circular DNA of a geminivirus isolated from Digitaria sanguinalis has been sequenced. The data obtained are consistent with there being one DNA circle of 2701 nucleotides. Comparison of the nucleotide sequence with those of maize streak virus (MSV) and wheat dwarf virus showed 64 and 47% DNA homology, respectively. The sequence has four potential coding regions for proteins of greater than 10 kDa, two in the viral (+) sense and two in the complementary (-) sense. Each of these potential coding regions has a highly homologous counterpart among the seven open reading frames previously described for MSV. Virion DNA contained, in addition to the circular single stranded DNA, a population of small DNA molecules similar to those associated with MSV particles. A comparison with MSV DNA of the region complementary to these small DNA molecules revealed conserved sequences, which may have a role in defining the limits of these primer-like molecules. PMID- 3672929 TI - On the molecular mechanism of DNA translocation during in vitro packaging of bacteriophage T3 DNA. AB - The process of packaging of bacteriophage T3 DNA in a defined in vitro system can be separated into two stages: formation of a precursor complex (50 S complex) in the presence of adenosine-5'-O-(3'-thiotriphosphate) (ATP-gamma-S) and subsequent translocation of DNA into the head by the addition of ATP. Packaged DNA exits when DNA translocation is interrupted by the addition of ATP-gamma-S (M. Shibata, H. Fujisawa, and T. Minagawa, 1987, Virology, in press; M. Shibata, H. Fujisawa, and T. Minagawa, 1987, J. Mol. Biol., in press). The in vitro system packaged nicked and cross-linked DNAs but did not package single-stranded DNA. DNA packaging was inhibited by intercalating reagents such as ethidium bromide, acridine orange, and 4',6-diamino-2-phenylindole dihydrochloride. The inhibitory effect was proportional to the ability of intercalating agents to unwind DNA. Ethidium bromide did not inhibit the formation of 50 S complex but blocked translocation of DNA into and out of the capsid. DNA packaging was inhibited by actinomycin D and distamycin A which bind to the minor groove of the DNA helix. From these results, we conclude that DNA packaging mechanism utilizes the exterior structure of duplex DNA for translocating the DNA into the capsid. PMID- 3672930 TI - Structure of the M2 protein gene of sonchus yellow net virus. AB - The nucleotide sequence of the gene immediately following the nucleocapsid protein gene of sonchus yellow net virus (SYNV), a plant rhabdovirus, is presented. Serological reactions of SYNV proteins with antibodies elicited by a fusion protein constructed from the sequenced gene indicate that this gene encodes an SYNV structural protein designated M2. The 5' end of the M2 protein mRNA appears to correspond to position 1700 relative to the 3' end of SYNV RNA, because an extension product that maps to this position was synthesized by reverse transcription of polyadenylated [poly(A)+] RNA from infected tobacco that had been primed with an SYNV-specific oligodeoxyribonucleotide. The 3' end of the gene encoding the M2 protein is defined by a recombinant DNA plasmid derived from poly(A)+ RNA from SYNV-infected plants. This plasmid contains an insert with a 3' terminal region corresponding to a uridylate-rich sequence present at positions 2832 to 2836 on SYNV genomic (g) RNA. These data thus suggest that the M2 protein mRNA is 1132 nucleotides (NT) long, excluding the poly(A) tail, and consists of a 50-NT untranslated 5' region, a 1035-NT open reading frame (ORF), and a 47-NT untranslated 3'region. The ORF is capable of encoding a 345-amino acid protein with a calculated molecular weight of 38,332. A small region of the M2 protein appears to have some similarity to the phosphoproteins of other rhabdoviruses. An identical 14-NT region occurs at the two sequenced gene junctions on SYNV gRNA and shares homology with regions separating the genes of some animal rhabdoviruses. PMID- 3672931 TI - Differential interaction of reovirus type 3 with sialylated receptor components on animal cells. AB - In this report we study the interaction of reovirus type 3 Dearing (RV3) with vertebrate erythrocytes whose membrane glycoconjugates differ in the degree and position of O-acetylation of their sialic acid (NeuAc) residues. Binding to erythrocytes required the presence of NeuAc on cellular glycoconjugates, since pretreatment with sialidase (neuraminidase) abolished hemagglutination by RV3. Furthermore, we found that RV3 binds efficiently to and hemagglutinates all erythrocyte preparations possessing exclusively NeuAc, or a mixture of NeuAc and 4-O-acetyl-NeuAc (4-O-Ac-NeuAc), but poorly to erythrocytes bearing a mixture of 9-O-Ac-NeuAc and NeuAc, suggesting that RV3 binds preferentially to NeuAc containing glycoconjugates. To gain further evidence for this hypothesis we treated chicken erythrocytes with influenza C virus neuraminate, 9-O acetylesterase, to convert their 9-O-Ac-NeuAc residues to NeuAc. When hemagglutination assays were carried out on these cells, we observed a 16-fold increase in the hemagglutination titer for RV3 compared to untreated cells. When we treated bovine submaxillary mucin (BSM) with influenza C virus, we observed a dramatic increase in its potency as an inhibitor of RV3 hemagglutination. Concomitant with this, the 9-O-Ac-NeuAc residues on BSM were converted to NeuAc. Taken together and in conjunction with a previous report (A. F. Pacitti and J. R. Gentsch, 1987, J. Virol. 61 1407-1415), these results suggest that the virion attachment protein exhibits a strong preference for NeuAc over 9-O-Ac-NeuAc as a receptor component on erythrocytes. PMID- 3672932 TI - Sequence of the dengue-1 virus genome in the region encoding the three structural proteins and the major nonstructural protein NS1. AB - Sequence results are presented for a 3745-nucleotide region at the 5' end of the dengue type-1 virus (DEN-1) genome. The strain characterized is a Western Pacific isolate from Nauru Island. The sequenced region contains the beginning of a continuous open reading frame which specifies the capsid (C), membrane (M), and envelope (E) structural proteins and the nonstructural protein NS1. The sequences are compared with corresponding segments for seven other flaviviruses, including two of the three remaining dengue serotypes, DEN-2 and DEN-4. The results show the DEN-1 genome size and organization to be similar to those of other characterized flaviviruses and that major features of the individual proteins are conserved. It is of special interest that comparisons of the E glycoprotein sequences between the dengue serotypes (DEN-1, -2, -4) reveal only moderately greater sequence relatedness (63-68%) than occurs in comparisons of DEN-1 with five other flaviviruses (46-54%). For the other structural proteins, C and M, the relatedness values are 59-74% for comparisons between DEN-1 and the other dengue serotypes and 31-45% for comparisons between DEN-1 and the five other flaviviruses. PMID- 3672934 TI - [Baculovirus vector]. PMID- 3672933 TI - Mechanisms of rabies virus neutralization by glycoprotein-specific monoclonal antibodies. AB - Incubation of radiolabeled rabies virus with neutralizing monoclonal antibodies (MAbs) resulted in complete neutralization of the virus but only partial inhibition of virus binding to, and internalization by, BHK cells. Several of the neutralizing MAbs were capable of preventing infection after virus adsorption to cells; up to 30% of the bound virus was released when cells containing adsorbed virus were incubated with these MAbs at 4 degrees, indicating that the release of bound virus accounts only in part for the neutralization of adsorbed virus. To study the mechanism of neutralization of cell-bound virus, temperature shift experiments were carried out to follow the fate of neutralized cell-adsorbed virus at 37 degrees. Treatment of infected cells with each of the tested neutralizing MAbs had no effect on virus uptake at 37 degrees and the MAbs were endocytosed together with the virus; however, the ability of some of the MAbs to neutralize cell-adsorbed rabies virus correlated with the fusion inhibition activity of these MAbs. We hypothesize from these data that these MAbs neutralize rabies virus by inhibiting the intraendosomal acid-catalyzed fusion step that leads to virus uncoating. PMID- 3672935 TI - [Early interaction of the flavivirus West Nile virus with mouse macrophage cell line P 388D1: pH-dependent fusion between the virus particles and cell membranes]. PMID- 3672936 TI - [An adeno-associated virus vector]. PMID- 3672937 TI - [Cauliflower mosaic virus: a prospective virus vector for higher plants]. PMID- 3672938 TI - The Supplement on Aging to the 1984 National Health Interview Survey. PMID- 3672939 TI - Plan and operation of the NHANES I Epidemiologic Followup Study: 1982-84. PMID- 3672940 TI - Comparability of diagnostic data. Coded by the 8th and 9th Revisions of the International Classification of Diseases. PMID- 3672941 TI - [10 years' experience with hemoperfusion in the treatment of acute poisoning- clinical analysis of 122 patients]. PMID- 3672942 TI - [Possible utilization of the favorable effects of bee pollen in patients with chronic renal insufficiency]. PMID- 3672943 TI - [Long-term study of patients after resection of a left ventricular aneurysm]. PMID- 3672944 TI - [Intracardiac masses in clinical cardiology]. PMID- 3672945 TI - [Changes in the peripheral vascular circulation in patients with borderline hypertension]. PMID- 3672946 TI - [The effect of smoking on lipid levels in the heart muscle]. PMID- 3672947 TI - [Diabetes and myocardial infarct. The significance of the blood sugar level on admission]. PMID- 3672948 TI - [Cricopharyngeal dysphagia of non-tumoral origin in the aged. Radiographic diagnosis]. PMID- 3672949 TI - [Diabetes mellitus and myocardial infarct--its course and therapy]. PMID- 3672950 TI - [Regular dialysis therapy in the 80s of the 20th century--progress or stagnation?]. PMID- 3672951 TI - [Dyslipoproteinemia as a causative factor in atherogenesis and its diagnosis]. PMID- 3672952 TI - [Autonomous adenoma of the thyroid gland and radioiodine therapy]. PMID- 3672953 TI - [The asymptomatic carrier state of viral hepatitis B]. PMID- 3672954 TI - [Malignant lymphogranuloma and pericarditis]. PMID- 3672955 TI - [The sorption capability of Hemasorb, a hemoperfusion column made in Czechoslovakia, in toxicologic conditions]. PMID- 3672956 TI - [Acute tetrachloroethylene poisoning successfully treated with repeated hemoperfusion]. PMID- 3672957 TI - [Sympathoadrenal hypertension in a patient with the Rokitansky-Kuster-Hauser syndrome and oligophrenia]. PMID- 3672959 TI - [The making of the troop physician]. PMID- 3672958 TI - [Myocardial infarct in young women with systemic lupus erythematosus]. PMID- 3672960 TI - [Network model for planning research work]. PMID- 3672961 TI - [Optimal regimens for high-frequency jet ventilation of the lungs]. PMID- 3672962 TI - [On guard for the health of sailors]. PMID- 3672963 TI - [Importance of studying the bronchoalveolar washing in the diagnosis of lung diseases]. PMID- 3672964 TI - [Experience in conducting epidemic-control measures in a focus of intestinal infections with a water mechanism of transmission]. PMID- 3672965 TI - [Method for the statistical treatment of morbidity indices using a programmable microcalculator]. PMID- 3672966 TI - [Methods of calculating the noise load on the human body]. PMID- 3672967 TI - [Methodological principles for determining the normative values of circulatory indices]. PMID- 3672968 TI - [Prevention of injuries on board ship]. PMID- 3672969 TI - [Aerosol drug preparations]. PMID- 3672970 TI - [Risk factors in acute pneumonia]. PMID- 3672971 TI - [Subcapsular injuries of the liver]. PMID- 3672972 TI - [Ophthalmic pruritus]. PMID- 3672973 TI - [Sulfide balneotherapy combined with local hyperbaric oxygenation in arteriosclerosis obliterans of the lower extremities]. PMID- 3672974 TI - [Use of thermography in the diagnosis of foot mycoses]. PMID- 3672975 TI - [Characteristics of foot mycoses in a hot climate]. PMID- 3672977 TI - [The scientific and technical creativity of young military physicians (2)]. PMID- 3672976 TI - [The status of body nonspecific resistance and humoral immunity in tobacco smoking]. PMID- 3672978 TI - [Medical care for the victims of combined injuries from nuclear weapons]. PMID- 3672979 TI - [Organization of emergency ENT care in a troop unit]. PMID- 3672980 TI - [Organization of emergency care in a polyclinic]. PMID- 3672981 TI - [Automatic accounting for deficiencies in therapeutic and diagnostic work]. PMID- 3672982 TI - [Effectiveness of sulfur-containing radioprotectors under various conditions of radiation exposure]. PMID- 3672983 TI - [Clinico-immunological research in the practice of the laboratory departments of large hospitals]. PMID- 3672984 TI - [Information value of immunological follow-up tests in the thymalin treatment of pyodermatitis patients]. PMID- 3672985 TI - [Timely questions of military medical expertise today]. PMID- 3672986 TI - [A unified classification of closed craniocerebral injury]. PMID- 3672987 TI - [Treatment of pulmonary thromboembolism]. PMID- 3672988 TI - [Endocrine metabolic changes during adaptation to high temperature]. PMID- 3672989 TI - [Restoration of the occupational work capacity in flight personnel]. PMID- 3672990 TI - [Means of improving the selection and medical examination of Navy specialists]. PMID- 3672991 TI - [Work experience of a nonstaff x-ray office]. PMID- 3672992 TI - [Diagnosis and treatment of spontaneous pneumothorax]. PMID- 3672993 TI - [Treatment of habitual dislocation of the shoulder]. PMID- 3672994 TI - [Diagnostic and treatment problems in pulmonary sequestration]. PMID- 3672995 TI - [Late results of surgical treatment by resection and hemisection in chronic periodontitis and parodontitis]. PMID- 3672997 TI - [Prevention of climatopathic and balneological reactions during sanatorium and health resort treatment]. PMID- 3672996 TI - [Litholytic therapy of gallstones]. PMID- 3672998 TI - [Medical aspects of anti-alcohol propaganda in the Navy]. PMID- 3672999 TI - [Polymers for public health]. PMID- 3673000 TI - [Etiology of chronic nonspecific urethritis]. PMID- 3673001 TI - [Treatment of mechanical injuries associated with burns]. PMID- 3673002 TI - [The physical loading of military paramedics during the removal of wounded from the front lines]. PMID- 3673003 TI - [Risk activities for injuries in the soldier]. PMID- 3673004 TI - [Isthmoplasty in the surgical treatment of aortic coarctation]. PMID- 3673005 TI - [Treatment of brain metastasis in primary bronchogenic carcinoma]. PMID- 3673006 TI - [Dynamic renal scintigraphy using 99mTc-MDP in the detection of urinary obstruction in patients with prostatic carcinoma]. PMID- 3673008 TI - [The importance of early endoscopy in corrosive injuries of the esophagus and stomach]. PMID- 3673009 TI - [Acute diarrhea caused by rotaviruses]. PMID- 3673010 TI - [Mixed cryoglobulinemia with severe neurologic complications]. PMID- 3673007 TI - [Levels of cortisol in the blood of schizophrenic patients during neuroleptic therapy]. PMID- 3673011 TI - [Psychiatric problems among the troops]. PMID- 3673012 TI - [The role of soy protein in the diet therapy of patients with ischemic heart disease]. AB - The dynamics of blood lipid values, activity of the kallikrein-kinin system and immunologic responsiveness were studied in coronary patients (males aged 43-56 years) who had survived myocardial infarction, during dietotherapy with rations in which 2/3, 1/3 and 1/2 protein were sequentially substituted for soybean protein. The hypocholesterolemic action of soybean protein correlated with its content in the ration, the kallikrein and prekallikrein levels in the blood serum rose simultaneously with a tendency to decrease in the tryptic and to increase in the inhibitory activity of the blood, positive shifts in the cellular immunity were recorded in the patients followed up during dietotherapy. PMID- 3673013 TI - [Zinc and silicon metabolism in highly trained athletes during heavy exercise]. AB - Trained male athletes were under study. It was found that under the effect of physical stress during the contest in ski race (30 and 50 km) the increase of the zink and silicon levels in the blood plasma correlated with their decrease in the blood cells. A positive zink and silicon equilibrium was observed in the athletes on the day of rest before the contest. Excretion of zinc and especially of silicon through the kidneys and intestine drastically grew on the day of the contest. On the day of rest following the high muscular stress the loss of trace elements appreciably lowered, however, it was higher than that before the contest. The authors recommend the following doses of the trace elements for highly trained athletes: zink--20-25 mg/day, silicon--30-35 mg/day. PMID- 3673014 TI - [The use of urinary nitrogen indices for the evaluation and prognosis of protein nutrition in man]. AB - In a group of similar subjects correlation has been revealed between the level of protein intake and nitrogen indices of urine assayed in the portion of urine taken on an empty stomach. The nitrogen indices of urine: creatinine N/total N, creatinine N/urea N, creatinine N/amine N, urea N/total N proved to be the most informative criteria of protein nutrition. It was found that the indices studied could be used as signs of providing the group of subjects with protein and for prognosing the protein nutrition level by the simulation of linear regression, using the methods of the random process theory. PMID- 3673015 TI - [The role of amino acids in the regulation of gastric secretion]. AB - The experiments conducted on dogs have demonstrated that amino acids entering blood increase the maximum response of gastric glands to pentagastrin 2-3-fold, to histamine by 20-25%. The test on rats has revealed varying concentrations of amino acids when they are passing through the liver: a half of certain amino acids (lysine, glycine, proline etc.) is retained in the liver, other (cystine) increase their concentration in the hepatic vein as compared to that in the portal vein, whereas amino acids with ramified carbon chain are insignificantly retained by the liver. The data obtained have evidenced an important role of amino acids in the third intestinal phase of gastric secretion during protein food intake and in the modulating of gastric secretion under conditions of mixed food intake. PMID- 3673016 TI - [Effect of the type of nutrition on the dynamics and stages of morphological changes in the liver during experimental N-nitrosodiethylamine carcinogenesis]. AB - The time course of the development of morphological changes was studied in the liver of rats given intraperitoneal injections of nitrosodiethylamine (NDEA) in a dose of 130 mg/kg, weekly, during 9 weeks, in the presence of full value hypocalorific (70% calorific value of the ration received by the control group), and hypercalorific (130% calorific value) nutrition. Four stages were distinguished in the development of the pathologic process under a chronic action of NDEA: I-alternative, II-alternative-proliferative, III--proliferative tumorigenic, and IV--the stage of malignant growth. No matter what character of nutrition was, continuous NDEA administration induced the development of neoplasms in the liver 120 days after the commencement of the injections. The frequency of tumorigenesis rose significantly when NDEA was injected in the presence of hypo- or hypercalorific rations. PMID- 3673017 TI - [Effect of vitamin A deficiency on surfactants and enzymes of xenobiotic metabolism in the rat lung]. AB - Experiments were conducted on 128 male rats kept on a retinol-deprived diet during 12-14 weeks, that resulted in vitamin A deficiency. The content of phospholipids, total lipids, proteins and the activity of esterase, glutamate dehydrogenase, catalase, glutathione-S-transferase, aldehyde dehydrogenase and aldehyde oxidase were assayed in the bronchoalveolar lavage fluid, in homogenates and microsomes of the lungs. The content of phospholipids in the bronchoalveolar lavage fluid was reduced up to 63.9%, as compared to that in the control rats, while the protein content was unchanged. The levels of phospholipids, total lipids and protein rose in the homogenates and microsomes of the lungs. Esterase activity decreased up to 38.6% of the control level, catalase--up to 73.2%, glutamate dehydrogenase--up to 79%. There was a tendency to decrease in glutathione-S-transferase activity, while aldehyde dehydrogenase and aldehyde oxidase activities remained unchanged. It is suggested that the disorders in the enzymatic activity and lipid content in the surfactant can be responsible for the changes in the xenobiotic biotransformation and for the rise in xenobiotic toxicity. PMID- 3673018 TI - [Modifying effect of nutrition on the mutagenic activity of phosphorus and fluorine compounds]. AB - The test animals were fed with low-grade food during 2-5 months under conditions of acute and chronic action of hydrogen phosphide and hydrogen fluoride induced by inhalation, that resulted in the pronounced impairment of the chromosomal apparatus of the bone marrow cells in the rats. A principal possibility has been established of modification of the hydrogen phosphide and hydrogen fluoride cytogenetic effect by the alimentary action. In particular, it has been found that the effect is significantly higher when the rats are fed with a low-grade ration than under conditions of balanced nutrition. PMID- 3673019 TI - [Turnover of hexosamines in the lens and glycoproteins in the blood of rats given a xylose-containing diet]. AB - To elucidate the action of xylose admixtures during the biotechnological production of monosaccharides, rats were given rations containing xylose that comprised 2.10 and 20% of the total amount of carbohydrates. Hexosamines of the lens and general blood globulin fraction were isolated and their turnover was investigated. The activity of glucoso-6-phosphate dehydrogenase, and the content of reduced and oxidized glutathione were assayed in the eyes and red blood cells. The content of xylose was determined in the plasma, eyes and red blood cells. Xylose inclusion into the ration of rats induced a pronounced increase in the half-life of hexosamines in the lens. The general blood globulin fraction turnover was unchanged. The activity of glucoso-6-phosphate dehydrogenase and the amount of total and reduced glutathione in red blood cells were decreased. Xylose content in the eyes and red blood cells was unchanged, while in the plasma it rose proportionally to the increase of its amount in the ration. PMID- 3673020 TI - [Substantiation of daily permissible levels of cadmium intake with food]. AB - A chronic experiment was conducted in rats which were given cadmium in doses 100, 10 and 1 microgram/kg (as salt or in the metadolized form) with food, daily, during 6 months. Biochemical studies were based on the parameters characterizing the functions of the liver, kidneys, gastro-intestinal tract, pancreas, CNS, prostate (in males). Pathomorphological investigations were made at the end of the experiment. No significant differences were recorded in the action on the body of metabolized cadmium and cadmium salt. Cadmium in a dose of 100 micrograms/kg induced the development of anemia, renal insufficiency, suppression of the activity of digestive enzymes and dystrophic changes in the liver, kidneys and testes. Cadmium in a dose of 1 microgram/kg proved to be inactive, and it is recommended as a daily safe dose of cadmium intake with food. PMID- 3673021 TI - [Methodological approach to evaluating the nutrition (nutritional status) of preschool and school-age children]. PMID- 3673022 TI - [A rare case of food poisoning]. PMID- 3673023 TI - [Differences in the gene structure of the matrix protein and hemagglutinin in remantadine-resistant and -sensitive variants of the influenza virus type A FPV]. AB - The oligonucleotide mapping technique and RNA-RNA hybridization revealed structural differences between the HA- and M-protein genes of two variants of influenza A FPV, remantadine-sensitive and remantadine-resistant ones. A quantitative estimation of the structural divergence of the two influenza FPV pairs of genes was carried out. The possible functional role of the differences in the structure of the HA- and M-protein genes of the two FPV variants is discussed. PMID- 3673024 TI - [Analysis of equine influenza H3N8 viruses]. PMID- 3673025 TI - [Glycosylated and nonglycosylated proteins of the tick-borne encephalitis virus synthesized in continuous pig embryonic kidney cells]. AB - Synthesis of virus-specific proteins p93, p79, p69, p53, p47, p34, p24, p23, p21, p18, p15, p13, and p12 of which p53 and p13 are analogues of virion proteins V3 (E) and V2 (C) occurs in continuous pig embryo kidney (PEK) cells infected with tick-borne encephalitis virus. The third structural protein, p8 (V1, M) is found in virions but not in the cells. Treatment of the cells with cycloheximide and hypertonic NaCl solution, virtually depressing the radioactive label incorporation into PEK cell proteins, also inhibits the synthesis of virus specific proteins p69, p21, p15, and p12. Protein p53 is present in the cells in glycosylated and nonglycosylated forms differing in electrophoretic mobility. Intensive glycosylation of not only p53 protein but also of proteins p47 and p21 was observed, and poor glycosylation of proteins p93, p79, and p69. PMID- 3673026 TI - [Comparative characteristics of the pathogenicity of 2 viruses of the family Rhabdoviridae for monkeys]. AB - Pathogenic properties of two viruses, Sowgrass and Barur, of the Rhabdoviridae family, isolated in different geographical zones were studied comparatively in green monkeys. These viruses showed different pathogenicity for monkeys by the intracerebral and subcutaneous routes of inoculation. Sowgrass virus had no manifest pathogenicity for monkeys, whereas Barur virus caused death of the animals in 5-6 days after intracerebral inoculation with typical localization of lesions in the brain. Subcutaneous inoculation of the animals produced no fatalities; slight lesions in organs and production of virus-neutralizing antibodies in the blood were observed. PMID- 3673027 TI - [Virological and serological diagnosis of influenza using the passive hemagglutination and passive hemagglutination inhibition tests]. PMID- 3673028 TI - [125I-antibodies to the HBs-antigen produced by different methods of adding the isotope]. PMID- 3673029 TI - [Clinical and hemodynamic characteristics of patients with an aortic valve defect before the implanting of an aortic valve prosthesis]. AB - The clinical and hemodynamic characteristics, perioperative and early postoperative results were studied in 38 patients with aortic valve prosthesis in order to determine the indications for surgical treatment in isolated aortic valvular disease. The basic factors determining the need for surgical treatment are: severity of the aortic lesion--stenosis and/or incompetence, degree of the harmful action of the aortic valvular disease on the left ventricle (clinical data for left ventricular failure; hypertrophy and dilatation--telediastolic volume greater than 300 ml/m2, telesystolic volume greater than or equal to 50 ml/m2; myocardial lesion; hemodynamic data for left ventricular dysfunction) and functional class of the patients. Most of the patients were with severe aortic incompetence and/or aortic stenosis and considerably diminished functional capacity. Only few patients had a low degree valvular lesion but they also showed some of the signs of its harmful action on the left ventricle. PMID- 3673030 TI - [Early diastolic changes in patients with unstable angina pectoris]. AB - The length of the time intervals of the early diastole was studied by the method of Alvares and Goodwin in 30 patients with unstable angina pectoris by means of simultaneous recordings of M-type echocardiogram, ACG,PCG and ECG before and after medicamentous treatment (beta blockers, nitrites with prolonged action, calcium antagonists). The control group was of 33 healthy men. The isovolumetric relaxation period was greatly prolonged in the patients and the active aspiration period was shortened (p less than 0.001). At the end of hospital treatment the interrelations between these two periods changed--the isovolumetric relaxation period shortened (p less than 0.001) and the active aspiration period lengthened (p less than 0.01) without change of the total period of fast relaxation. The slow relaxation period during the time of fast filling and the total fast filling period before and after treatment did not differ from those of the control group. The changes of the time intervals are probably related to the diminished compliance due to myocardial ischemia. The dynamic changes in the course of medicamentous treatment of unstable angina pectoris reflect the lowered restriction of left ventricular filling. PMID- 3673031 TI - [Effect of Pharmachim's cimetidine preparation in 200- and 1000-mg ampules on the gastric secretion of duodenal ulcer patients]. AB - Gastric secretion was studied in 30 patients with duodenal ulcer. The trial was carried out in the following way: the patients were divided into two groups of 10 patients each. To the first group of 10 patients on the first day of the examination pentagastrin test was performed by subcutaneous application of Acignost (GDR) in a dose of 6 micrograms/kg body mass; on the second day the same dose of Acignost was injected with simultaneous i. v. application of 200 mg of Cimetidin-Pharmachim. To the second group of 10 patients on the first day pentagastrin test was also performed but on the second day the same dose of Acignost was injected together with 1000 mg of Cimetidin. The i. v. application of 200 mg and 1000 mg of Cimetidin-Pharmachim inhibits significantly the gastric secretion and acid production in patients with duodenal ulcer stimulated by Acignost. The inhibiting action of Cimetidin begins 30 minutes after its application and lasts more than an hour and is better expressed by injecting of 1,000 mg than of 200 mg Cimetidin-Pharmachim. Cimetidin-Pharmachim for parenteral application exerts a strong inhibiting action on gastric secretion and acid production. Its use is recommended for everyday practice since its efficacy equals that of the English drug Tagamet (Smith Kline) for parenteral application. PMID- 3673032 TI - [A more efficient method of gastric intubation]. AB - A self time-regulating aspiration device is presented. The device is a combination of a buffer container and a gastric tube and provides improved gastric intubation, gives more accurate results, has a high reliability of exploitation and there is no need of constant personal attendance. PMID- 3673033 TI - [Gastric secretion and acidity in elderly patients with duodenal peptic ulcer]. AB - 46 patients over 60 years of age suffering from duodenal ulcer, 36 young patients with duodenal ulcer and 36 healthy aged persons (control group) have been examined after maximal pentagastrin stimulation. The results revealed that the aged patients with duodenal ulcer have significantly lower gastric secretion and acidity (BVO--87.7 +/- 36.8 ml/h, MVO--220.0 +/- 52.8 ml/h, BAO--4.23 +/- 2.63 mmol/h, MAO--25.43 +/- 8.39 mmol/h, PAO--30.34 +/- 12.09 mmol/h) than the young patients with duodenal ulcer (p less than 0.01-0.001). The volume of gastric secretion and the degree of acidity of the aged patients with duodenal ulcer are significantly above the reference value (BVO--71.6 +/- 19.5 ml/h, MVO--174.8 +/- 34.9 ml/h, BAO--1.84 +/- 0.96 mmol/h, MAO--16.58 +/- 4.02 mmol/h, PAO--20.73 +/- 3.08 mmol/l) of the control group of healthy aged persons (p less than 0.02 0.001). The suggestion is put forward that the differences in gastric secretion and acidity between the patients and the healthy persons above 60 years of age are one of the basic factors for development and/or persistence of the ulcerous process in old age. PMID- 3673034 TI - [Clinico-diagnostic, therapeutic and prognostic studies of Wilson-Konovalov disease. The results of 25 years' experience]. AB - The author's 25 years experience in clinical, diagnostic, therapeutic and prognostic study of 24 patients with Wilson-Konovalov's disease (hepatilenticular degeneration) is presented. The great diagnostic importance of copper metabolism (plasma copper level, urine copper), plasma ceruloplasmin concentration, histochemical and quantitative determination of copper in liver cells (after a liver biopsy) is pointed out. These are of special importance in young patients (under 25 years) and in children with chronic parenchymal liver disease. In 1/4 of the patients the early stage of the disease resembled chronic active hepatitis (predominantly liver type of the disease). The basic therapeutic drug is D penicillamine hydrochloride and when it is not tolerated the drug Trien may be used. Very good therapeutic results and considerable improvement of prognosis, social and working rehabilitation of the patients have been achieved. The preconditions for good therapeutic and prognostic results are the early discovery, exact diagnosis and prolonged purposeful pathogenetic treatment (chelatory and hepatoprotective). Zinc sulfate and potassium sulfide are only secondary therapeutic means in patients with hepatolenticular degeneration. PMID- 3673035 TI - [Determination of the effectiveness of plasma exchange in kidney diseases by a biological test]. AB - Plasma toxicity and plasma exchange efficacy were studied in two groups of patients: I gr.--8 patients with various degree of disturbed renal function who did not need hemodialysis treatment; II gr.--9 patients treated by periodic hemodialysis. A biologic toxicity test was used together with the clinical, immunologic and biochemical indices as a criterion for plasma exchange efficacy. The test gives direct information for the total plasma toxicity which is of great advantage and helps in the decision for another plasma exchange. PMID- 3673036 TI - [Improving the diagnostic potentials of isotope nephrography with 131I-hippuran]. AB - In order to eliminate the false positive and the false negative results in the control isotopic nephrographic examinations due to the minute diuresis determination of the difference between the time of appearance of T-maximum of both kidneys is recommended. When the earlier (respectively the later) appearance of T max. is due to improved (or deteriorated) renal function the difference between the two T max. increases (or decreases). When the change in the time of appearance of the two T max. is due to the minute diuresis the difference between them remains unchanged. PMID- 3673037 TI - [Carbohydrate metabolic disorders in porphyria cutanea tarda]. AB - The frequency of diabetes mellitus was studied in all 150 registered patients suffering from porphyria cutanea tarda in Bulgaria. To 63 of the patients an oral glucose tolerance test was performed according to the criteria of the Diabetic Committee of the WHO (1979). Diabetes mellitus was found in 9 patients--6% which is considerably above the mean frequency of diabetes in this country which is about 1%. In 4 patients diabetes mellitus developed before the onset of porphyria, in 2 patients it developed after the onset of porphyria and in 3 patients the two diseases developed simultaneously. The glucose tolerance test showed lowered tolerance in 8 patients (12.7%) and 5 of them reacted with increased insulin response. 35 patients (55.5%) presented increased insulin response. The data of the study suggest that all patients suffering from porphyria cutanea tarda should be examined for disturbed carbohydrate metabolism. PMID- 3673038 TI - [Case report of Gaucher's disease]. AB - The case of a 42 years old man suffering from Gaucher's disease is reported. The primary diagnosis was liver cirrhosis based on echographic and scintigraphic examinations. The following signs were found: thrombocytopenia, slight hemolysis, shortened life of the erythrocytes with considerable sequestration in the spleen, abnormal flocculation tests, increased acid phosphatase. The X-ray examination revealed irregularly oval light spots with different size and form and well cut outlines in the skull and a zone of bone resorption in the right shoulder joint. The liver needle biopsy showed parenchymal infiltration with Gaucher's cells. The above mentioned deviations and the family heredity of the patients suggested the diagnosis of an adult form of Gaucher's disease. The fibroplastic changes in the liver including formation of septa led to the suggestion of a link between Gaucher's disease and liver cirrhosis. PMID- 3673039 TI - [Bronchospasm in the Stein-Leventhal syndrome]. AB - A female patient with Stein--Leventhal syndrome has been followed up for six years. The course of the disease was characterized by attacks of bronchial obstruction markedly related to the menstrual cycle. The patient was seen before during and after normal pregnancy and normal delivery. The bronchial spasm was resistant to the ordinary antiasthmatic treatment but responded well to progesterone treatment. The role of the female sex hormones in the pathogenesis and clinical characteristics of bronchial asthma is discussed. The bronchospasm in this particular case is accepted as a clinical manifestation of the basic disease. The case is presented because of the diagnostic difficulties and the clinical masks of allergic pulmonary diseases--bronchial asthma, asthmatic bronchitis, etc. in Stein--Leventhal syndrome wrongly and ineffectively treated. PMID- 3673040 TI - [Association of Ebstein's disease and aortic coarctation]. AB - The rare case of a 58 years old male patient with a combination of Ebstein's disease and coarctation of the aorta is reported. The patient presented and died with manifestations of cardiac and respiratory failure. The post mortem examination revealed the combination of Ebstein's disease and coarctation of the aorta. The analysis of the clinical and paraclinical data points to an atypical course of the disease probably due to the opposite hemodynamic characteristics of the two congenital heart diseases. PMID- 3673042 TI - International nursing research for knowledge development. PMID- 3673041 TI - [Malignant hemopathies combined with latent tuberculosis (a report of 2 cases)]. AB - Two cases of a combination of a malignant blood disease with latent tuberculosis are presented. One of the patients was with acute leukemia and the other one was with non-Hodgkin's malignant lymphoma (Lymphosarcoma). The blood disease dominated the clinical picture and determined the severity of the course and the lethal outcome. The post mortem examination revealed hepatosplenic form of miliary tuberculosis in both patients. In one of the patients caseous tuberculosis of the bronchopulmonary, peribronchial and periportal lymph nodes was found, too. The tuberculous process had a latent course without characteristic manifestations but it also led to worsening of the patients' condition. PMID- 3673043 TI - Perception of time among Japanese inpatients. PMID- 3673044 TI - Rural Zimbabwean Shona women. Illness concepts and behavior. PMID- 3673045 TI - Traditional birth attendants in Sierra Leone. Key providers of maternal and child health care in West Africa. PMID- 3673046 TI - Role of the woman patient and fear of the pelvic examination. PMID- 3673047 TI - Symptoms reported by Arab-American patients on the Cornell Medical Index (CMI). PMID- 3673048 TI - International collaboration in research: forces and constraints--by leaders from Thailand, People's Republic of China, Japan, and Brazil. PMID- 3673049 TI - Ethical issues in nursing research. International nursing research. PMID- 3673050 TI - Doing international nursing research. PMID- 3673051 TI - Computer applications for qualitative analysis. PMID- 3673052 TI - Massive hepatic haemangioma. PMID- 3673053 TI - Electrical injury and cataracts--an unusual case. PMID- 3673054 TI - Obturation obstruction in a cocaine smuggler. PMID- 3673055 TI - Acid ingestion causing pyloric obstruction. PMID- 3673056 TI - Screening for breast cancer saves lives. PMID- 3673057 TI - Feeding practices of infants, and beliefs of mothers in Western Jamaica. PMID- 3673058 TI - Proportion of time used productively by staff in Jamaica's primary health care services. PMID- 3673060 TI - Completed suicide in Barbados. PMID- 3673059 TI - Risk factors for carcinoma of the uterine cervix in Jamaican women. PMID- 3673061 TI - Toxicity of the hyperglycaemic-inducing extract of the annatto (Bixa orellana) in the dog. PMID- 3673062 TI - Evaluation of the first 300 patients treated at an outpatient center for male sexual dysfunction. AB - A comprehensive multidisciplinary evaluation was carried out on 300 outpatients seen consecutively at a specialized impotence center. Psychologic evaluation was coupled with the use of contemporary diagnostic modalities. Nocturnal penile tumescence testing, penile vascular studies, pharmacologic diagnostic testing and dynamic infusion cavernosography have been used advantageously. In addition to psychologic counseling for all treatment categories, treatment alternatives have included hormonal and pharmacologic agents and penile prosthetic implantations. PMID- 3673063 TI - On reducing health care costs. PMID- 3673064 TI - Duodenal ulcer disease--lessons from history. PMID- 3673065 TI - Bacterial meningitis in the 1980s, or one drug or many? PMID- 3673067 TI - Overuse of health resources by penicillin-sensitive children. PMID- 3673066 TI - Catheter-related thrombophlebitis of the superior vena cava caused by Candida glabrata. PMID- 3673068 TI - Primary care--does it have a future? PMID- 3673069 TI - Where is the pathologist? PMID- 3673070 TI - Insects in the operating room. PMID- 3673071 TI - Reflex sympathetic dystrophy syndrome. Diagnosis and management. PMID- 3673072 TI - How physicians can improve patients' participation and maintenance in self-care. AB - A protocol for the stepped education and support of patients is derived from the cumulative experience of more than 200 clinical trials of patient education and behavioral change interventions. The recommended procedure entails assessing a patient's educational needs by asking a sequence of "diagnostic" questions to assure patient motivation, skill and resources and to reinforce adherence to the prescribed medical regimen or life-style modifications. The sequence of questions and interventions is also designed to minimize a physician's time commitment and to maximize the medical benefit to the patient. PMID- 3673073 TI - Pelvic fullness, urgency and frequency following lymphadenectomy. Pelvic lymphocele. PMID- 3673075 TI - [Echocardiographic evaluation of left ventricular function in patients with primary arterial hypertension]. PMID- 3673074 TI - Endoscopic sclerotherapy for esophageal varices. PMID- 3673076 TI - [Ambulatory cardiological care of pregnant women with heart diseases]. PMID- 3673077 TI - [A case of argyria after peroral treatment of peptic ulcer with silver albuminate]. PMID- 3673078 TI - [A case of Prader-Willi syndrome with tubular acidosis and partial ocular albinism]. PMID- 3673079 TI - [Lymph node form of acquired toxoplasmosis in a 12-year-old girl]. PMID- 3673080 TI - [Difficulties in the diagnosis of celiac disease]. PMID- 3673081 TI - [Early post-infarction rehabilitation (experiences of 5-years' activity of the Department of Cardiological Rehabilitation)]. PMID- 3673082 TI - [Hemodynamic evaluation of the results of surgical treatment of advanced mitral valve disease]. PMID- 3673083 TI - [Neurological reactions in infectious mononucleosis]. PMID- 3673084 TI - [Use of verapamil in the treatment of migraine]. PMID- 3673085 TI - [Myxoma of the left atrium simulating bacterial endocarditis]. PMID- 3673086 TI - [Diagnostic problems in solitary plasmacytoma]. PMID- 3673087 TI - [Traumatic diaphragmatic hernia in a patient with multiple injuries]. PMID- 3673088 TI - [Diagnosis of lymphoma of the digestive tract]. PMID- 3673089 TI - [Abdominal actinomycosis]. PMID- 3673091 TI - [Guidelines for the prevention of atherosclerosis]. PMID- 3673090 TI - [Eosinophilic granuloma of the bones in multiple sites]. PMID- 3673092 TI - [A 58-year-old type-II diabetic patient with severe insulin resistance]. PMID- 3673093 TI - [Nonspecific urethritis]. AB - The multiple etiology of non-gonorrhoic urethritis has been extensively investigated in the last few years. It has thus become possible to diagnose the separate forms and consequently treat them with a greater degree of accuracy and specificity. For exact diagnosis multiple and time consuming examinations are often necessary. Sometimes this can only be done in highly specialized laboratories. Among the agents triggering such an infection Chlamydia (30.9% of the cases of non-gonorrhoic urethritis), as well as mycoplasma, ureaplasma, anaerobic bacteria and herpes simplex viruses have gained particular significance. Whereas these infections very rarely lead to complications by ascension in men they can result in unpleasant and severe disease in women (salpingitis, infertility, newborn infection). PMID- 3673094 TI - [Radiation exposure and radiation risk in our environment]. AB - The extent of radiation exposure of the population of central Europe will be described by natural sources, by medical application and exposure by nuclear power facilities with special emphasis of the accident in Chernobyl. It will be shown, how the assessment of the various exposures can be standardized. Especially the risk for cancer and genetic diseases should be taken into account. The consequences for optimal radiation protection will be discussed. PMID- 3673095 TI - [Atypical mycobacterioses. Unusual pathogens of increasing significance]. AB - Atypical mycobacteria may cause pulmonary diseases - similar to tuberculosis - as well as infections of the lymph nodes, the skin and other organs. But only if several cultures from sputum or biopsy specimen have been positive and Mycobacterium tuberculosis has been excluded, these species can be noted as the pathogenetic agents. The course of disease mostly times appears uncharacteristic, the manifestations remind of chronic tuberculosis. The majority of patients with atypical mycobacterioses belong to the group with reduced host resistance (like AIDS, immunosuppression, malignancy). The outcome and prognosis without special treatment are deleterious. Because of the difference in the susceptibility of atypical mycobacteria to antituberculotic drugs a successful chemotherapy only can be made according to the analysis of resistance behaviour. PMID- 3673096 TI - [Rapid transesophageal and transvenous atrial stimulation]. AB - Rapid atrial stimulation (RAS) is a very effective method of treatment of paroxysmal supraventricular tachycardia (PSVT). Substained AV nodal reentrant PSVT could not be terminated by administration of different antiarrhythmic drugs in 19 patients. Transesophageal pacing was performed in 10 patients successfully in 2 patients following verapamil intravenous administration. In the remaining 7 patients in whom this procedure failed the PSVT could be terminated by transvenous RAS - in 3 patients following the intravenous injection of verapamil. PMID- 3673097 TI - [Waste disposal from medical practices and laboratories]. AB - The major part of wastes from medical practices can be classified as refuse without any further consideration or it can be used for recycling. However, certain waste products need a specific treatment; most of all, there are waste products that are infectious or that could mechanically cause injuries due to their design. The amount of infectious wastes that could be established in our waste-separation-model was extremely small and therefore, can easily be added to the refuse after adequate disinfection. Only practitioners themselves can decide on the spot which wastes need or not need to be disinfected. PMID- 3673098 TI - [Endoscopic diagnosis and therapy of benign stenosis of Vater's papilla]. AB - Out of 921 endoscopic papillotomies (EPT) 110 (12%) were performed in patients with benign stenosis of the papilla of Vater. Among these patients were 96 after cholecystectomy and 14 with gallbladder in situ. The diagnostic aspects of the stenosis of papilla and the complications of EPT were investigated on the basis of these patients. The dilation of the bile ducts is not a specific criteria for the diagnosis of papilla-stenosis. Dilatation could develop after cholecystectomy despite the normal sphincter pressure. The complication rate in patients with stenosis of papilla of Vater is increased (13.6%) in comparison with the patients with biliary stones (8.8%). This can be account for the increased number of haemorrhage and cholangitis. PMID- 3673099 TI - [Acute hepatitis in Lyme borreliosis]. AB - The clinical feature of an acute hepatitis within a tick-borne meningopolyneuritis Garin-Bujadoux-Bannwarth is described by means of a given case and the etiological context is being discussed. PMID- 3673100 TI - [Treatment of aluminum-induced osteopathy with desferrioxamine in dialysis dependent renal failure]. AB - Presenting two patients on long-term dialysis with marked osteopathy due to aluminium intoxication we described the symptoms, pathogenesis and therapy of the disease. Two patients were treated with the chelating agent desferrioxamine which lead to a striking improvement in clinical symptoms and removal of aluminium from bone. Osteopathy due to aluminium intoxication is refractory to Vitamin D and its metabolites. Using reversed osmosis in dialysis the high aluminium levels in bone result mainly from the long-term use of phosphate binders. Therapy of choice is the treatment with desferrioxamine. PMID- 3673101 TI - The prevention of arterial collaterals after repeated temporary blockade of the hepatic artery in pigs. PMID- 3673102 TI - Internal bile duct injuries. PMID- 3673103 TI - Truncal vagotomy as it affects parietal cell multiplication. PMID- 3673104 TI - International nutrition in health and disease. PMID- 3673105 TI - The trend of the nutritional status of the Korean, 1969-1984. PMID- 3673106 TI - Some food and nutrition problems in developing countries with special reference to Sudan. PMID- 3673107 TI - A QSAR study of the acute toxicity of some industrial organic chemicals to goldfish. Narcosis, electrophile and proelectrophile mechanisms. AB - 1. A baseline toxicity QSAR model was derived for the 24-h LC50 to the goldfish, Carassius auratus. 2. The QSAR-predicted LC50 values for six epoxide derivatives were 2.8-985 times greater than measured. The excess toxicity of these epoxides and other compounds was ascribed to an electrophile molecular mechanism involving SN2 reaction with sulphydryl and other neucleophile groups present in enzymes and other biological macromolecules. 3. The excess toxicities of allyl alcohol and pentaerythritol triallyl ether were interpreted in terms of proelectrophile mechanisms. For the latter compound, this involves a monooxygenase-mediated free radical proton abstraction to a stable allyl radical. The allyl-free radical can undergo enzymic free radical hydroxylation to afford the corresponding acetal, which on decomposition yields the Michael acceptor electrophile acrolein. PMID- 3673108 TI - Studies on the metabolism of Inabenfide (a new plant growth regulator) in rats. I. Characterization of metabolites in rats. AB - 1. The metabolism of 4'-chloro-2'-(alpha-hydroxybenzyl) isonicotinanilide (Inabenfide, IBF) was studied in the rat. After intraperitoneal administration of IBF to rats, eight metabolites were detected in urine by g.l.c.-mass spectrometry and a stable isotope technique. 2. The major metabolites were hydroxylated IBF, and minor metabolites were dihydrodiol IBF, methylated catechol IBF, IBF ketone, IBF N-oxide and an amine derivative. 3. Of these metabolites, IBF ketone was produced by oxidation of the carbinol between the benzene rings, which is an interesting metabolite since similar oxidation between benzene rings is not well known. 4. Metabolism involving an NIH shift of chlorine and an epoxide-diol pathway for IBF are presented. PMID- 3673109 TI - Pharmacokinetics of T-2 tetraol, a urinary metabolite of the trichothecene mycotoxin, T-2 toxin, in dog. AB - 1. The urinary metabolites of T-2 toxin were identified and analysed quantitatively after i.v. administration to dogs. 2. A new routine assay for T-2 tetraol was developed and a pharmacokinetic study was carried out on this final hydrolytic metabolite of T-2 toxin. T-2 tetraol was excreted in urine for 2-3 days. Its 'sigma minus' plot demonstrated a significantly longer apparent half life than its precursors (T-2 toxin and HT-2 toxin). This fact was explained by extraplasma binding causing prolongation of the metabolism and excretion of T-2 toxin metabolites. 3. The urinary metabolites of T-2 toxin were: HT-2 toxin, T-2 triol and T-2 tetraol. The metabolites were excreted in free and conjugated forms. In two dogs T-2 toxin was found in the urine in an amount which accounts for 3.2 and 16% of the administered dose respectively. The cumulative amount of the identified metabolites and toxins formed in the urine ranged from 9.7 to 17.3% in four dogs and 44.7% in one dog. PMID- 3673110 TI - Induction of microsomal enzymes in rat liver by oxcarbazepine, 10,11-dihydro-10 hydroxy-carbamazepine and carbamazepine. AB - 1. The effects of the new anti-epileptic drug, oxcarbazepine, its major metabolite in man, 10,11-dihydro-10-hydroxy-carbamazepine, and carbamazepine, on hepatic microsomal enzyme activities have been studied in rats after repeated administration of equimolar doses. 2. All three compounds caused a qualitatively similar induction of the mono-oxygenase system, the greatest increase being observed in the activity of 4-nitroanisole O-demethylase. Oxcarbazepine is as potent as carbamazepine, while 10,11-dihydro-10-hydroxy-carbamazepine is a weak inducer. 3. The observation that oxcarbazepine is a potent inducer in rats but not in man is explained by the species differences in its metabolism. PMID- 3673111 TI - The metabolism of dimethylamphetamine in rat and man. AB - 1. Urinary metabolites of dimethylamphetamine after oral administration to rat and healthy human volunteers have been studied. 2. Six metabolites and unchanged drug were detected in rat urine and the same metabolites except p hydroxyamphetamine were found in human urine. The major metabolite was dimethylamphetamine N-oxide in both cases, and methamphetamine and amphetamine were also excreted as minor metabolites. 3. Metabolites excreted in three days after administration of the drug to rat amounted to about 57% of the dose and those after administration to man, 53-56%. PMID- 3673112 TI - Fate of TR-2, the hepatic metabolite of the tremorgenic mycotoxin verruculogen, in sheep. AB - 1. Verruculogen is eliminated in bile after transformation to TR-2, only a trace of which was excreted as such in faeces of sheep given verruculogen per os. Negligible TR-2 was present free in urine; no glucuronide was found. 2. An isomer of TR-2, a minor component of the bile of sheep given verruculogen, has been defined by 1H-n.m.r. spectroscopy and the isomerism involves the disposition of the two adjacent hydroxyl groups with a concomitant change in the conformation of the ring adjacent to the indole. 3. 14C-TR-2, added to the perfusate of isolated rat liver, was excreted unchanged in the bile, implying no significant loss of any biliary TR-2 subject to enterohepatic recycling in vivo. 4. 14C-TR-2 incubated anaerobically in sheep ileum contents was 95% transformed into more polar metabolites, the majority of the radiolabelled metabolites isolated being water soluble. 5. The principal fate of biliary TR-2 is as a metabolic substrate for the intestinal microflora. PMID- 3673114 TI - Identification in in vivo acetylation pathway for N-dealkylated metabolites of doxylamine in humans. AB - 1. Metabolites of doxylamine in human urine were separated by g.l.c. and h.p.l.c. and tentatively identified by their mass spectrometric behaviour. 2. N Desmethyldoxylamine, N,N-didesmethyldoxylamine and their N-acetyl conjugates were identified. This is believed to be the first report of acetylation in vivo of primary and secondary aliphatic amines in man. PMID- 3673113 TI - Studies on the metabolism of aristolochic acids I and II. AB - 1. After oral administration of aristolochic acid I (AAI) and aristolochic acid II (AAII) to rats, the following metabolites were isolated from the urine and their structures elucidated: aristolactam I, aristolactam Ia, aristolochic acid Ia, aristolic acid I and 3,4-methylenedioxy-8-hydroxy-1-phenanthrenecarboxylic acid (metabolites of AAI); or aristolactam Ia, aristolactam II and 3,4 methylenedioxy-1-phenanthrenecarboxylic acid (metabolites of AAII). A further metabolite of AAII having a lactam structure has not yet been isolated in pure form. 2. The metabolic pathways have been elucidated by administration of various metabolites. 3. The principal metabolite of AAI in rats was aristolactam Ia; 46% of the dose was excreted in the urine in form of this metabolite and 37% in the faeces. The other substances were minor metabolites. Those metabolites of AAII whose structures have been elucidated were minor metabolites; the largest proportion consisted of aristolactam II, which accounted for 4.6% in the urine and 8.9% in the faeces. 4. The mouse was the only animal which had the same metabolite patterns of AAI and AAII as those found in the rat. Not all the metabolites listed above were found in urine from guinea pigs, rabbits, dogs and man. PMID- 3673115 TI - [Incidence of lung fibrosis in Hungary]. AB - Epidemiological data of patients with lung fibrosis being registered in dispensaries are demonstrated. Three groups of fibrosis patients are registered: lung fibrosis of known origin, lung fibrosis associated with systemic disease and lung fibrosis of unknown origin. In 1984 prevalence was 22.7/100,000. Incidence was the lowest in systemic diseases and the highest in lung fibrosis of unknown origin. PMID- 3673116 TI - [Diagnostic score in heart sarcoidosis]. AB - Basis of the score is the empirical valuation of clinical and cardiac functional parameters. The degree of probability shall enable the applier either to temporize and conclude therapeutic steps or considering the diagnostic stage to add additional examinations in order to confirm the supposition. The importance of this diagnostic and therapeutic management rests on the vital danger to patients with heart sarcoidosis. We arranged the score according to the clinical significance intentionally applying strict standards mainly with regard to the differential diagnosis of the coronary heart disease. Due to our results the myocardial biopsy seems to be unnecessary. PMID- 3673117 TI - [Chronic pneumonia in a cohort of a thoracic surgery department]. AB - Report on 78 cases of chronic pneumonia which underwent surgical treatment between 1959 and 1985. In 52 cases previous to operation a tumor was diagnosed or suspected (in 20 cases cytologically or histologically, and in 32 cases clinically, by x-ray or by endoscopy). The frequency and correlation of x-ray and endoscopic findings, problems of preoperative diagnostics, surgical methods and postoperative course are described. PMID- 3673118 TI - [Antibody formation in the blood and respiratory tract secretions following one time and repeat immunization with an inactivated influenza vaccine]. AB - Eighty nine volunteers were under study. They were immunized by inactivated vaccine from influenza viruses A(H1N1)+A(H3N2) one time or every year during 4 to 6 years. Vaccine in dosage of 0.2 ml was applied intracutaneously. Under detailed clinical study deflections of health were not over standard. Accumulation of antibodies was determined to immunogens of the vaccine and to virus A/Leningrad/X/83(H3N2), which was in epidemic circulation 3 years later. Intensity of relative increase of antibodies with repeated immunization was 1.5 to 2 times lower. Maximum concentrations of antibodies were found in a week after vaccination. Immunization didn't cause change of titres of secretory antibodies and concentration of immunoglobulin isotopes G, M, A and E in sera and secretions. PMID- 3673119 TI - Lung cancer growing around a silicotic nodule. AB - The authors report on a patient, working for 17 years in ceramic industry, in whom simple silicosis was revealed in 1977. In 1985 the disease progressed and a nodule-like opacity in the left upper lung lobe was detected. After one year of further progression cavitation was found. Suspected cancer was confirmed cytologically by discovering epidermoid cancer cells in the lavage from the growing around the silicotic nodule. Lobectomy was performed, the postoperative course being without complications. PMID- 3673120 TI - [Paragonimiasis of the lung]. AB - Paragonimiasis results from infection with a trematode worm, P. Westermani or, less commonly, one of the many of the other Paragonimus species (for instance: Paragonimus africanus). It usually affects the lung with manifestation of chronic cough, hemoptysis and roentgenographic infiltrates, alterations that can be difficult to distinguish from the lesions of tuberculosis. The diagnosis is established by the finding of Paragonimus eggs in the sputum or stool. On the basis of a case report on pulmonary paragonimiasis characterised by some peculiarities in a Congolese the clinical and roentgenological as well as the pathological features of pulmonary paragonimiasis are shortly described. The importance of this parasitosis is emphasized because of increasing migration of people from endemic areas to European countries. PMID- 3673121 TI - [Intrapulmonary percussion--a secretolytic treatment method]. AB - Intrapulmonary percussion means the utilization of high-frequency ventilation as therapeutic and secretolytic principle. It succeeded by modification of the BIRD Mark 8 to realize an effective secretolytic treatment. The value of this method will be explained by 3 cases. PMID- 3673122 TI - [Nuclear trace microfilter--a test for the filtration of fibrous dust particles from fluids]. AB - Nuclear track microfilters produced in GDR were effective in separation of fibrous dust particles out of fluids. Further use of nuclear track microfilters in the field of research is planned. PMID- 3673123 TI - [Oscillation method in respiratory function diagnosis of adults--integration and optimizing possibilities. 3. The phase angle]. AB - The importance of the phase angle in oscillatory measurements of resistance depends on the presence or absence of an endobronchial obstruction. In case there is an obstruction, a negative phase angle is first of all an expression of the low compliance of the larger airways and points to an underestimation of the real flow resistance. If there is no obstruction one can state facts about the peripheral compliance, in particular taking into consideration the dependence of the phase signal on actual lung volume. It is recommended to supply the basic ventilation tests with an additional determination of a second angle (beta) from the inspiratory part of the psi/V-curve. That allows to separate normal persons and patients with lung fibrosis and emphysema. PMID- 3673124 TI - [Report on the 59th meeting of the Working Group on the Pathophysiology of Breathing of the Society of Pathological and Clinical Physiology of East Germany and the Society of Bronchopneumonology and Tuberculosis of East Germany. Karl Marx-Stadt, 27 March 1985. Abstracts]. PMID- 3673125 TI - [Diagnostic bronchoscopy--mycologic and bacteriologic findings]. AB - The authors studied the findings of mycotic and bacterial agents in the lower air passages of 122 patients with lung disease examined by bronchoscopy. The series represents a current profile of patients investigated at the Department of tuberculosis and respiratory diseases, Pardubice hospital within 17 months of the years 1982-1983. Bronchial swabs were compared with the findings in the swabs of the throat taken immediately before the endoscopic examination. Yeast organisms were isolated from the bronchi of 12 patients, and from the throats of 50 subjects examined. Amongst the agents isolated, Candida albicans showed the highest frequency of occurrence (68.0%). Isolation of Aspergillus fumigatus from the bronchi revealed pulmonary mycetoma in one case. Pathogenic and potentially pathogenic bacterial flora was isolated from the bronchial swabs in 40 subjects examined. A total of 47.5% findings belonged to patients suffering from inflammatory disease of the lower air passages. Isolations of Mycobacterium tuberculosis from the bronchial swabs of three subjects examined, where other cultivation examinations gave negative results, are considered by the authors as a contribution to the differential diagnosis in infiltrative disease of the lung. The value of examination of directed swabs at bronchoscopy by culture, the problems of contamination and the reliability of the results obtained are discussed. PMID- 3673126 TI - [Chemiluminescent measurements of alveolar macrophages in sarcoidosis patients]. AB - The phagocytic activity of alveolar macrophages (AM) in a group of patients with stage I, stage II and stage III pulmonary sarcoidosis (gradation according to Wurm) has been investigated. Additionally a classification in different forms of the course of sarcoidosis was made (acute = Loefgren's syndrome, latent = primary chronic, and relapses). Patients with other lung diseases and healthy subjects were recruited as control group. The phagocytic activity (stimulation with opsonized yeast cell wall particles) of AM, which were isolated by bronchoalveolar lavage, was determined by means of chemiluminescence (CL) measuring using lucigenin and luminol, respectively, as amplifiers. The investigations showed that the lucigenin-dependent yeast cell wall-induced CL of AM in patients with sarcoidosis is significantly increased in comparison to the control group. No significant changes of the luminol-dependent CL of AM from sarcoidosis patients could be detected. The lucigenin-dependent CL-response of AM is obviously an indicator of the intensity of the alveolitis and thus of the activity of the pathological process in sarcoidosis. The results suggest that in pulmonary sarcoidosis there is a hyperreactive AM/lymphocytes-system. PMID- 3673127 TI - [Initial results with x-ray absorption spectrometry in lung fibrosis]. AB - Biopsies from 68 patients suffering from interstitial lung disease were examined with regard to minerals using Energy Dispersive X-Ray Analysis (EDXA). In 31 patients a higher portion of minerals or elements were found as pigments. The interpretation of these findings is difficult. If there is a professional exposition and a reaction of the lung parenchyma the findings could be of clinical value. PMID- 3673128 TI - [Tuberculous pneumonia, complicated by tuberculosis of the middle ear]. AB - The authors report on a rare localization of tuberculosis in a young foreigner. Tuberculous otitis media developed secondarily via Eustachian tube in far advanced pulmonary tuberculosis. Anti-tuberculous chemotherapy resulted in recovery. Even in the present favourable epidemiological situation of tuberculosis the possibility of tuberculous otitis media should be considered in patients under care because of advanced tuberculosis of different localization. PMID- 3673129 TI - [A case report of actinomycosis of the lung]. AB - This is the report about a case of the infrequently observed actinomycosis of the lung from the clinical-surgical and pathological-anatomical standpoint. Considering existing publications the picture of the disease is described with this case. In consequence of misinterpretation of clinical-cytological and histological findings and of the picture of the disease during seven months of the postoperative phase a progressive generalized actinomycosis developed. The problems and causes of the error are discussed, also the possibilities to recognize this disease. The difficulties in giving a diagnosis are shown. The protracted illness could be cured in spite of the late start of appropriate therapy. PMID- 3673130 TI - [Application of ICP spectrometry for analysis of multiple elements in biological material]. PMID- 3673131 TI - [Report on the 5th European Conference on Sarcoidosis and other Granulomatous Disorders. 27-30 August 1986, Vienna, Austria]. PMID- 3673132 TI - [Report on the 60th meeting of the Working Group on the Pathophysiology of Breathing of the East German Society of Pathological and Clinical Physiology and of the East German Society of Bronchopneumonology and Tuberculosis. Berlin-Buch, 24 September 1985. Abstracts]. PMID- 3673133 TI - [Physiologic frequency adaptation of cardiac pacemakers using systolic time intervals]. AB - Of the parameters in consideration for control of physiological rate responsive pacing special interest is directed to stroke volume. In search of indirect parameters which are correlated to stroke volume it is demonstrated on principle that systolic time intervals could be used. From the relation ejection time versus pre-ejection time (LVET/PEP) which is known for its correlation to stroke volume a simple algorithm is derived which is based on the realization that PEP is related to the reciprocal of cardiac output. First investigations with patients demonstrated the possibility of the computation of heart rate from PEP only, with good physiological significance. PMID- 3673134 TI - [Arrhythmogenic effects of anti-arrhythmia agents]. AB - Arrhythmogenic effects appear in 5-22% of all patients. On the basis of a literary investigation on 11,547 patients with 1,114 proarrhythmic effects and of 21 own observations mechanisms, risks and diagnostics of this dangerous side effect are demonstrated. In most cases patients with severe functional disturbances of the heart and known ventricular tachyarrhythmias are affected. Not infrequently a prolonged QT-internal is found. An accumulation of the known arrhythmias or an appearance of new disturbed rhythms, frequently Torsade de pointes, may occur. Holter-ECG and programmed stimulation are suited for recognition, which are together to be applied in malignant tachyarrhythmias. The prophylaxis deals with a careful indication, aimed selection of the antiarrhythmic drugs and a subtile control of therapy in the first days after the beginning of the therapy and after every increase of dosage. PMID- 3673135 TI - [Kidney function and behavior of blood pressure in short-term diabetic patients. A follow-up study 1982-1986]. AB - In 1982 there were increased creatinine values in 24.9 per cent (n = 344) of 1,380 investigated short-term diabetics of a closed territory. The course of disease of these 344 cases was followed in a follow-up-study. None of the patients had come to dialysis treatment. 32.3 per cent had died until 1986. In no case uremia caused the death. Hypertonias had a significant higher creatinine level than normotoniacs. The creatinine rise was on a higher level with the hypertoniacs. In 1982 the frequency of hypertension in the group of the died patients was with 65.8 per cent significant higher than in the group of the 1986 still living patients (32.9 per cent). PMID- 3673136 TI - [Catamnestic studies of the significance of synovial membrane needle biopsy for the diagnosis of rheumatic disease]. AB - By means of a catamnestic study diagnostic evidence, number of complications and examination-conditioned stress of the patient caused by needle biopsy of the synovial membrane were tested. 4-11 years after a blind biopsy of the synovial membrane carried out on account of rheumatological indication 80 patients (48 males, 32 females) were examined and the results of the preliminary examination and the secondary examination were compared with the findings of the needle biopsy of the synovial membrane. While the needle biopsy of the synovial membrane in rheumatoid arthritis has a high diagnostic value in comparison to clinical and paraclinical findings, in the histomorphological ascertainment of the uric arthritis the catamnestic study shows the limits of the method due to place depending differences of the findings of the crystalline deposit in the synovial membrane. The number of complications of the investigation technique was insignificant and had no influence on the duration of the inability to work. As a highly specialised diagnostic method the blind biopsy of the synovial membrane may contribute to the clarification of problem cases in institutions with rheumatological profile without possibility of arthroscopy. PMID- 3673137 TI - [Pathology of primary inflammatory and primary degenerative changes in joints]. AB - The author describes, from a general pathological viewpoint, the primary inflammatory arthropathies (arthritic diseases) and the primary degenerative arthropathies (arthroses), basing himself on a description of the joint as a complex open system consisting primarily of the highly vascularized synovial membrane, the synovial fluid and the hyaline articular cartilage. In the case of arthritis the primary lesion occurs in the synovial membrane. Different quantitative and qualitative morphological findings are obtained depending on the causes and duration of the disease and the pathomechanisms involved and, more specifically, on the involvement, or otherwise, of immunological mechanisms in the pathogenesis of arthritis. A classification of arthritic diseases following this concept is proposed. In the case of arthroses the primary lesion occurs in the non-vascularized hyaline cartilage. The latter reacts basically with metabolic disturbances which, from a morphological viewpoint, manifest themselves as degeneration and finally lead to cartilage necrosis. A distinction is made between primary arthrosis and secondary arthroses of known etiology. The close metabolic interaction of the synovial membrane and articular cartilage is the reason why, depending on the duration of the disease, arthritis develops into secondary arthrosis and the latter into secondary arthritis. PMID- 3673138 TI - [Inflammatory and degenerative joint diseases. 8th annual meeting of the East German Society of Rheumatology]. PMID- 3673139 TI - [Biomechanical aspects of human joints]. AB - The value of biomechanical studies of human joints is illustrated. The investigation of stiffness of joints has suggested that subjective stiffness is more likely to be related to limitation of movement of a joint than to increased physical stiffness. A knee analyser has been constructed to measure ligamentous and meniscal damage. Ligament replacement has been successfully achieved in the pig and in man by using a woven polyester tube. The load-bearing function of the menisci has been clearly demonstrated, explaining a relationship found in studies of parachutists and physical education teachers between meniscectomy and osteoarthrosis of the knee. The biomechanical reasons for a partial meniscectomy in the treatment of a bucket-handle tear have been shown. Support for the Leeds biomechanical hypothesis for the development of osteoarthrosis has been provided from mechanical studies of cartilage at the patello-femoral joint and at the ankle. PMID- 3673140 TI - [Pathophysiologic aspects of inflammatory and degenerative joint diseases]. AB - Authors describe the physiological particularities of components of articular system (cartilage, synovialis, synovia, subchondral bone, ligamentous and neuromuscular apparatus). The essential resultant pathophysiological pattern in rheumatoid arthritis and osteoarthritis are demonstrated. Differences between temporary attendant synovitis in osteoarthritis and rheumatoid arthritis are pointed out. PMID- 3673141 TI - [Microbiologic aspects of inflammatory joint diseases]. AB - Regarding of microbiological aspects of arthritis three forms of joint diseases are under investigation: the septic arthritis, the reactive arthritis and the Rheumatoid Arthritis. In 95% of patients with septic arthritis microorganisms as causative agents responsible for the disease are described: Staphylococci, Streptococci, some gram-negative bacteria. By an haematogenic route of infection predominantly patients with immunosuppressive therapy are altered. In newborns and children septic arthritis is to observe more rarely. A reactive arthritis is a postinfectious sterile process in dependence on an infection occurred at an earlier time. As etiologic agents Yersinia, Enterobacteriaceae and Campylobacter have been discovered. 80% of the patients suffering such a reactive arthritis are carrier of the HLA-B27 system. The etiology of the Rheumatoid Arthritis is an open, unanswered problem. Of importance are: immunogenetic conditions, autoimmune phenomena, endocrinologic, dietetic and psychologic factors as well as bacteria and viruses as causative agents: cocci, bacilli, Diphteroids, endoparasitic bacteria (Listeria, L-forms, Mycoplasma, Chlamydiae), viruses (Adeno-, Mumps-, Measles-, ECHO-, Coxsackie-A- and B-, Hepatitis-, Cytomegalo-, Para-influenza-, Retro-, Parvo- and Rubella viruses). In the last years the EBV is of interest covering the question of a distinct virus persistence in tissues and the adequate limiting factors. Perhaps a defect of the hu-IFN-gamma-system might be of immunopathological and clinical significance. PMID- 3673142 TI - [The primary inflamed and primary degeneratively changed joint from the viewpoint of physical therapy]. AB - The author emphasizes the interdisciplinary approach that is necessary to rheumatic arthropathies. The pain, inflammation and disturbance of movement must be seen as requiring physiotherapy, while a degree of differentiation is necessary in thermotherapy. PMID- 3673143 TI - [Surgical treatment of patients with rheumatoid diseases]. AB - The selection of surgery methods in the treatment of rheumatism, and the success one can expect, depends on the stage of the disease and the location of the affected joint(s). A distinction is made between preventive methods (synovectomy, tenosynovectomy, tenotomy, relocation or lengthening of tendons, capsulotomy) and reconstructive/corrective operations (corrective osteotomy, arthrodesis, plastic arthrectomy, alloarthroplasty). The author also points to the limits of operative therapy, especially as regards social rehabilitation. The accent in rheumatism orthopedics should gradually shift toward early preventive operation. PMID- 3673144 TI - [Characteristics of chronic joint diseases in childhood and adolescence]. AB - After dealing briefly with aspects of nomenclature and classification, the author describes the multifarious picture presented by juvenile chronic arthropathies (JCA). Special emphasis is given to the way in which these differ from adult arthropathies, including the clinical syndromes, paraclinical findings, complications, sequels and social integration of patients. A short reference is made to the Morbus Kashin-Beck in view of similarities to JCA polyarthritis. PMID- 3673145 TI - [Osmotic equilibrium between the intestinal lumen and blood of the growing rat without increase in the fluid content of portal vein blood]. AB - In rats weighting 230-280 g, the resistance, the protein, and the electrolyte concentration of portal vein blood were measured continuously. At constant electrolyte concentration (Cel) resistance was a true measure of hematocrit. Protein concentration (Cprot) was monitored refractometrically in a continuous stream of filtered plasma. The changes brought about by intraduodenal and intragastric injections of water were studied. For comparison, equal amounts (0.5 1% of body weight) of isotonic NaCl were instilled intraduodenally. Water led in all experiments to an immediate and steep but variable drop of Cel within a minute without an accompanying drop of Cprot. The drop of Cprot was delayed by 1.4-2.6 min. The delay was even greater when a small increase of Cprot by 65 mg/dl took place. No such delay occurred when saline was given. After this initial phase, the course of Cprot and hct curves was identical for both fluids. Using these two parameters as independent indicators of volume, similar values for blood volume increase were calculated from their final change. The result suggests that in the gut, osmotic equilibration has priority over fluid transport. PMID- 3673146 TI - [Does prolonging the test period improve screening for colorectal cancer?]. AB - Prolongation of Haemoccult-screening from 3 to 6 days in 3540 out-patients resulted in a rise of the positivity rate from 4.1 to 6.75%. This was accompanied by an increase of the detection rate by 10% in cancers and 25% in large adenomas. The predictive value of a positive test for colorectal neoplasia (carcinoma and large polyps together) dropped from 26.7 to 20.9%. More data are needed before general recommendation for change from the standard 3-day-test period can be given. PMID- 3673147 TI - [Commentary on an abstract. Effects of metoclopramide and domperidone on azygous venous blood flow in patients with cirrhosis and portal hypertension]. PMID- 3673148 TI - European Intestinal Transport Group. 8th meeting, Sept. 30th-Oct. 3rd, 1987, Schloss Seggau-Austria. Abstracts. PMID- 3673149 TI - Method for vascularized lymph nodes transplantation in rats. AB - In our study a microsurgical technique for vascularized mesenterial lymph nodes transplantation is presented. The methodical investigation was performed on outbred Wistar rat strain. Observation in light microscopy and vascular bed examination followed up to the fourth day after operation proved the existence of good preserved lymphatic tissue with sufficient blood circulation. PMID- 3673150 TI - [Assessment of the interface reaction of endosseous implanted bio-sinterceramics by electron probe microanalysis]. AB - The electron ray microanalysis (ESMA) showed an intimate bone-implant-compound already 4 weeks postoperatively. This compound was detectable in all sinter variants after 78 weeks. An area with changed material contrast was prepared on the surface of the implant with an extent of 45-55 micron until the 24th week and over 100 micron after 78 weeks. A surface stratum relatively rich in calcium and absolutely rich in phosphorus was formed in the immediate contact to the regenerated bone opposite to the implant nucleolus. This stratum had an approximate consistent extent of 20-35 micron from the 12th week. The relative intensity of the stratum rich in calcium and phosphorus corresponded to that of the bone around the implant. The stabilization of the reactive surface stratum can become assumed by that. PMID- 3673151 TI - [Use of the excimer laser in experimental laser angioplasty]. AB - XeCl-excimer laser produce pulsed far uv-light (wave length lambda = 308 nm). Biophysical effects were studied on arteriosclerotic human cadaver aortic and coronary vessels. Ablative photodecomposition results in cleanliness of the incisions with minimal thermal side effects. PMID- 3673153 TI - [Antibodies in drug allergy can bind to cytochrome P-450]. PMID- 3673152 TI - [Oxygen supply and oxygen uptake by skeletal muscle in acute arterial circulatory disorders--an experimental study in the dog]. AB - The oxygen supply and the oxygen uptake of the ischemic skeletal muscle were defined in rest and by loading in experimental studies in dog. About 72% of the supplied arterial oxygen was taken up from the ischemic skeletal muscle in rest in opposite to 84.7% by loading. Therewith the authors found an essential higher value as supposed in literature so far. The absolute value of the oxygen uptake of the normally circulated skeletal muscle with 0.14 ml O2/min/100 g is small in contrast to the highly differentiated parenchymatous organs. An adaptation to an anaerobic metabolism is assumed by the authors in case of falling below the critical boundary value of 0.1 ml O2/min/100 g in skeletal muscle. PMID- 3673154 TI - [Erectile dysfunction: a multidisciplinary approach]. AB - In 1985, a multidisciplinary investigation was carried out on 134 patients suffering from erectile dysfunction (mean age 37.5 years). The study comprised medical and sexual history, physical examination, laboratory tests, psychological interview and psychometrics, nocturnal penile-tumescence (NPT) measurements, bulbocavernosus-reflex (BCR) latency, and penile Doppler sonography. If indicated, we performed additional autoinjection of the corpus cavernosum (CCAT) with vasoactive agents, dynamic cavernosography, and bilateral selective pudendal arteriography. Thus we found an organic cause in 85% of the cases, revealing a vascular disease in 76%. PMID- 3673155 TI - [The nitrazine yellow test. A simple clinical method for diagnosing epidermal wound healing]. AB - Nitrazine yellow test has proved successful in determining toxic degenerative hand eczema. Additionally, it may be regarded as helpful in the quantitative registration of kinetic data on epidermal wound healing. PMID- 3673156 TI - [Prurigo diseases]. AB - The term "prurigo" is universally used in dermatology. But, up to now, no definition of this term has been generally accepted. The "classic" description of the "urticarial papules" as the primary skin eruptions of prurigo is not correct, for these papules do not show any momentary edema but a persistent cellular infiltration. In the past, some authors already pointed out that the histologic structure of such papules looks very much like that of the characteristic papulovesicles in eczema--especially those in atopic dermatitis. The various forms of the prurigo nodes secondarily develop in case of the coincidence of three main factors: (1) the particular cutaneous response to repeated irritation (especially in autosomally dominant ichthyosis simplex), (2) reduced threshold for or constitutional disposition to pruritus (especially in atopy), and (3) internal (e.g. intestinal disorders) or external (e.g. insect bites) triggers. Probably none of the prurigo diseases represents a nosologic entity. PMID- 3673157 TI - [Chloroquine--therapy of atopic dermatitis]. AB - In 1984 and 1985, 62 patients suffering from atopic dermatitis were systemically treated with chloroquine for 3 to 6 months. In 46 of the patients, the therapy resulted in significant improvement, so that all systemic or topical treatment with glucocorticoids could be discontinued. 8 patients revealed moderate improvement, which did not allow the discontinuation of topical glucocorticoids. 6 patients showed adverse reactions, which forced us to stop therapy with chloroquine. 2 patients broke off therapy because of side effects. PMID- 3673158 TI - [Clinical aspects of blue nevus and its variants]. AB - In a 5-years' study, we investigated the correlation between clinical and histological diagnoses of blue nevi. In 24.7% of the cases, the clinical diagnosis turned out to be false; blue nevus was mostly confused with nevomelanocytic nevus (11.2%). Malignant melanoma was the primary differential diagnosis in 13 out of 89 cases. Differentiation of the histological subtypes identified 76.4% of the tumors as common blue nevi and 15.7% as cellular blue nevi. The remaining 7.9% were combined nevi. The average age of the patients with blue nevi at the time of excision was lower than that of the patients suffering from malignant melanoma during the same observation period. Comparison of the distribution of 89 blue nevi with 196 malignant melanomas revealed the different preferred areas of these tumors. We briefly refer to related dermal melanocytoses, such as Mongolian spot and Ota's nevus. PMID- 3673159 TI - [Skin changes in an acute attack of polyarthritis--Aschoff's nodules and rheumatic granulomas]. AB - Exanthematous skin eruptions in an acute attack of polyarthritis histologically showed Aschoff's nodules or rheumatic granulomas, which are usually found in the myocardium but not in the skin. PMID- 3673160 TI - [Importance of programmed ventricular stimulation in patients with ventricular salvos]. AB - The yield of programmed ventricular stimulation in asymptomatic patients with documented ventricular salvoes is not definitely known. Therefore, we retrospectively evaluated the data of 57 patients in whom ventricular salvoes had been observed, either during resting ECG or 24-hour ECG monitoring, and who had been studied using programmed ventricular stimulation. Of these patients, 63% were male, with a mean age of 49 years. 28% had coronary artery disease, 21% dilated cardiomyopathy, 16% mitral valve prolapse, 9% hypertrophic cardiomyopathy, 9% valvular heart disease and 14% had no structural heart disease. Using a maximum of two premature ventricular extrastimuli during programmed ventricular stimulation, sustained ventricular tachycardia or ventricular fibrillation was induced in nine patients (16%). In 30 patients (53%) nonsustained ventricular tachycardia was induced (3-35 ventricular echo beats), in 18 patients only one to two ventricular echo beats could be induced. In 8/16 patients (50%) with coronary artery disease, sustained ventricular tachycardia/ventricular fibrillation could be induced. Mean left ventricular ejection fraction did not differ between patients with inducible sustained ventricular tachyarrhythmia and those with inducible non-sustained ventricular tachycardia or those with a normal result during programmed ventricular stimulation. 33 patients were treated with antiarrhythmic drugs; the efficacy of antiarrhythmic therapy was either controlled by "serial electrophysiologic testing" in four patients, or by repeated 24-hour long-term ECG in 29 patients. During a mean follow-up period of 31 +/- 24 months five patients died, two of them suddenly. None of the remaining patients had experienced a symptomatic sustained ventricular tachycardia or a syncope.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673161 TI - [Prevention of effort-induced ventricular arrhythmia using verapamil]. AB - In this study prophylactic antiarrhythmic effects of verapamil on exercise induced ventricular arrhythmias were evaluated in a total of 22 patients. All patients displayed frequent and/or complex ventricular arrhythmias during repeated exercise tests under control conditions. After two control exercise tests, all patients were treated with 120 mg verapamil given every 8 h orally for 4 days. On the 3rd and 4th day of treatment the exercise tests were repeated. The results were that verapamil caused a significant reduction in the incidence and severity of exercise-induced ventricular arrhythmias in 13 out of 22 patients. In patients with concomitant significant ST-segment depression, a prophylactic action could be demonstrated in nine out of ten cases. The antiarrhythmic effect was independent of changes in heart rate. In patients with myocardial ischaemia, a reduction in myocardial oxygen consumption and direct electrophysiological effects (suppression of the "slow response" and/or an increase in the resting potential of the "depressed fast response") can be discussed as mechanisms of action. Also, a suppression of "triggered activity" or a direct inhibition of adrenergic effects must be considered. According to our results and the literature, calcium antagonists (verapamil type) proved to be suitable drugs for the treatment of exercise-induced ventricular arrhythmias, particularly in patients with concomitant myocardial ischaemia. PMID- 3673162 TI - [Electrophysiologic and hemodynamic effects of the new anti-arrhythmia agent diprafenone]. AB - Diprafenone is a new antiarrhythmic agent currently under clinical investigation, with close chemical similarity to propafenone. In this study, the electrophysiological and haemodynamic effects of the compound were investigated both in animals, by experiment, and in man. Diprafenone produces a dose-dependent prolongation of conduction in all parts of the conducting system. Lengthening of PQ-time is more pronounced than prolongation of QRS. The atrial and ventricular refractory periods are also significantly prolonged. There are no significant changes in the QT-time. Heart rate and aortic pressure are slightly decreased. The electrophysiological and haemodynamic profile of Diprafenone is similar to propafenone with respect to a dominant local anaesthetic activity and an additional beta-sympatholytic effect. However, with respect to the dose needed, the efficacy of the new drug appears to be significantly stronger. Diprafenone can be considered an effective antiarrhythmic drug for the treatment of supraventricular and ventricular tachyarrhythmias. PMID- 3673163 TI - [Treatment of chronic ventricular arrhythmias with the new class Ic anti arrhythmia agent diprafenon--results of long-term therapy]. AB - Diprafenone is a new antiarrhythmic drug with a dominant local anaesthetic action and an additional beta-sympathicolytic activity. In this study, the results of long-term treatment (8 months on average) obtained from 27 patients with chronic ventricular arrhythmias are reported. Before diprafenone, all patients were treated unsuccessfully with flecainide, propafenone, sotalol, combined sotalol/flecainide and sotalol/propafenone, and another two to six antiarrhythmic agents. Following diprafenone (300-600 mg/24 h), a substantial reduction in arrhythmic activity (greater than or equal to 80%; Lown classification less than or equal to II) was achieved in 21 cases. In 12 patients, side effects (fatigue, headache, blurred vision, dizziness and heartburn) were apparent. Diprafenone had to be discontinued in five patients, because of these side effects. At dosages greater than or equal to 450 mg/24 h, the PQ interval was significantly lengthened, and QRS duration prolonged. In one patient, an AV block III degree developed. In another case, SGOT and SGPT increased significantly; this increase was reversed after the drug was discontinued. Despite these side effects, further clinical evaluation of the compound seems promising, as the antiarrhythmic potency of diprafenone is very strong and superior to that of propafenone with respect to the required doses. PMID- 3673164 TI - [Relation between hemodynamics and ventricular arrhythmia in patients with heart valve diseases]. AB - The incidence and severity of ventricular arrhythmias were compared with hemodynamic findings of cardiac catheterization, in 160 patients with mitral and aortic valve disease. All patients underwent right and left heart catheterization, as well as M-mode and 2D-echocardiography, and 24-hour ambulatory electrocardiographic monitoring. Out of 160 patients, 68 had mitral valve disease and 92 had aortic valve disease. In mitral regurgitation the degree and frequency of ventricular arrhythmias showed a positive correlation to the degree of regurgitation (rs = 0.44, rs = 0.56, respectively) and a negative correlation to left ventricular ejection fraction (rs = -0.49, rs = -0.57) and to cardiac index (rs = 0.48, rs = 0.53). In aortic valve disease the incidence and severity of ventricular arrhythmias were not related to the type of valve lesion, to the transvalvular pressure gradient nor to the degree of regurgitation. In aortic stenosis, the degree of arrhythmia showed a negative correlation to left ventricular ejection fraction (rs = 0.55) and a positive correlation to left ventricular endsystolic volume index (rs = 0.40) and to peak systolic left ventricular wall stress (rs = 0.59). In aortic regurgitation the number of ventricular arrhythmias showed a negative correlation to left ventricular ejection fraction (rs = -0.43) and a positive correlation to left ventricular endsystolic volume index (rs = 0.43) and to peak systolic left ventricular wall stress (rs = 0.37). These data demonstrate that the incidence and severity of ventricular arrhythmias, in patients with aortic valve disease and mitral regurgitation, are strongly associated with the impairment of left ventricular function. PMID- 3673165 TI - [Comparison of Doppler echocardiographic methods of determining cardiac minute volume]. AB - In 40 patients without valvular disease, cardiac output was determined by pulsed Doppler echocardiography and thermodilution simultaneously. The sample volume was located in the center of the mitral valve ring, at the tips of the mitral leaflets and in the left ventricular outflow tract, directly proximal to the aortic valve leaflets. Circular cross-sectional areas of the mitral valve ring, aortic ring and bulbus of the aorta were calculated from the M-mode and two dimensional echocardiographic diameters. The mitral orifice was assumed to be an ellipse with varying short axes, determined as the mean diastolic leaflet separation in the M-mode and a constant long axis, derived from the maximal mitral orifice area or mitral ring diameter. Cardiac output was calculated by multiplying time-velocity integrals with different areas and heart rate. Cardiac output, measured by the thermodilution technique, ranged from 4.0 l/min to 10.2 l/min. Cardiac output determined by the different Doppler methods correlated significantly with the thermodilution measurements. Cardiac output measurements in the left ventricular outflow tract provided the best correlation coefficient (0.93) and a standard error of the estimate of 0.589 l/min, when the circular flow area was derived from the M-mode echo of the aortic ring.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673166 TI - [Right ventricular endomyocardial fibrosis]. AB - The clinical course, non-invasive and invasive diagnostic findings from a 50-year old patient with endomyocardial fibrosis are reported. The patient died in cardiogenic shock. In Europe, endomyocardial fibrosis is a rare event. An exclusively right ventricular involvement is a seldom manifestation. The clinical, echocardiographic and computed tomographic features are diagnostic; therefore a satisfactory differentiation from other cardiac disorders with restrictive hemodynamic signs is possible. An echodense mass as cavity obliteration, with predominantly apical localization, was present at echocardiography; the computed tomography showed a hypodense area instead of the right ventricular cavity. PMID- 3673167 TI - [Treatment of hypertrophic cardiomyopathy with nifedipine and propranolol in combination]. AB - Fifteen patients (14 males and 1 female) with hypertrophic cardiomyopathy, ranging from 22 to 67 years of age (mean: 45.5 years) were treated with oral nifedipine and propranolol for 6 to 24 (mean: 18) months. Twelve of the patients had been pretreated with a mean oral dose of 560 mg verapamil for 60 to 93 (mean 78.5) months, showing slight subjective and objective improvement. Treatment with nifedipine and propranolol was terminated in five cases, due to deterioration or side effects after 6 and 12 months, respectively. During combined therapy, two patients reported improvement, whereas in five cases there was no change and eight patients reported deterioration. There was no change in the Sokolow index. The radiologically determined heart volume increased in 10 out of 15 patients and in the total group from 887 +/- 214 to 938 +/- 248 ml/1.73 m2. Echocardiographic measurements showed a significant increase in left atrial diameter from 40.0 +/- 9 to 44.0 +/- 11 mm, whereas ventricular wall thickness remained unchanged. Thus, high-dose verapamil therapy seems superior to nifedipine-propranolol therapy in patients with hypertrophic cardiomyopathy. PMID- 3673168 TI - [The atrial pacemaker as therapy in sinus node disease: retrospective analysis of complications and rate of survival]. AB - The implantation of an atrial pacing device represents an established mode of therapy for bradycardia in sinus node dysfunction. However, controversial views remain concerning the safety of this type of pacing. To investigate this, we retrospectively analysed data from 81 patients, all of whom received an AAI pacing device between 1972 and 1984. Complete AV-block developed in two out of 81 patients (cumulative incidence after 10 years was 5 +/- 3%). Atrial fibrillation developed in three out of 81 patients (cumulative incidence after 10 years was 10 +/- 5%). Lead-related complications were strongly related to the type of lead tip and the mode of fixation. The overall incidence of lead-related problems was 20 +/- 5% after 5 years and 38 +/- 12% after 10 years. 82 +/- 6% of patients survived the first 5 years, 52 +/- 14% survived for 10 years. The 5 years' survival rate was not different from that of the normal population. From this we conclude that atrial pacing can be safely done with an AAI system as long as there are no signs of an AV-block. Atrial fibrillation develops less often on AAI pacing than on VVI pacing. The risk of developing an AV-block seems rather low. PMID- 3673169 TI - [Therapy refractory sinus tachycardia following polytrauma]. AB - The course of a 20-year-old patient with head injury and fractures of the ribs is reported, in whom sinus tachycardia has now persisted for three years. Antiarrhythmic treatment with calcium antagonists, beta-blocking agents and digitalis did not reduce the rate of the tachycardia. Contusio cordis, as well as different mechanisms of arrhythmias after cerebral trauma are discussed. PMID- 3673170 TI - [Abstracts of the autumn meeting of the German Society for Cardiovascular Research. 1-3 October 1987, Freiburg. Sudden cardiac death. Lysis therapy in acute myocardial infarct. Improved technics in cardiology]. PMID- 3673171 TI - [Indications and results of the surgical treatment of distal intra-articular humeral fractures in the elderly]. AB - In this paper we review 16 patients with closed intercondylar fractures of the distal end of the humerus that had open reduction and internal fixation. All patients were older than 60 years of age. Using the classification system of Muller et al. 6 fractures were classified as type C2 and 10 fractures as type C3. The surgical procedures and the types of internal fixation of the fractures allowed early postoperative mobilisation (3rd postoperative day). A rating scale modified according to Cassebaum was used for the results. At a mean follow-up of 4.2 years 3 patients were rated as excellent 9 as good and 2 as fair. No severe complications were registered. PMID- 3673172 TI - [Talocrural angle and ankle joint mobility in Germans and Japanese]. AB - 1980 Kramer and Gudat introduced the talo crural angle, which provides exact measurement of the mobility of the ankle joint. In field studies in Germany we found a greater range of mobility in female compared with male persons. With advancing age range of mobility decreased in both sex. Same examinations in Japan were performed to determine influence of genetic and way of life pattern. PMID- 3673173 TI - [Significance of nuclear magnetic tomography in the diagnosis of lumbar disk displacements]. AB - In a prospective study we determined the validity of MRI (Magnetic Resonance Imaging) in lumbar disc herniations. MRI and CT were compared in 34 patients who underwent operation and 8 patients who underwent discography and intradiscal injection. By this study we determined the validity of CT and MRI being more than 90%. PMID- 3673174 TI - [Autologous transfusion in scoliosis operations: preoperative autologous blood donations and intraoperative mechanical autotransfusion]. AB - Autologous transfusion was used to reduce the high demand for blood accompanied with scoliosis surgery. Half of the blood loss could be saved by intraoperative autotransfusion (35 patients). This resulted in a corresponding reduction in homologous transfusion. An elimination of the need for homologous blood could be achieved only by the combination of preoperative blood donation and intraoperative autotransfusion (37 patients). With freezing the predeposit blood was independent of storage time and autologous plasma was available. Thus, the risks of transfusion can be avoided. PMID- 3673175 TI - [Experiences with ventral stabilization in vertebral metastases in the area of the thoracic and lumbar spine]. AB - 43 cases of tumor resection followed by ventral stabilisation are reported in 42 patients with metastases in the spine. Indications for surgery were beginning or incomplete transversal lesion of the spinal cord, bedrest for at least 3 weeks, unsusceible pain caused by instability, or unsuccessful conservative and radiotherapeutic treatment. 46.5% of the cases can be rated as good considering the time of survival and life quality, 18.5% can be judged as a partial success. 7 patients hat to be reoperated in the same level, most of them because of local recurrence. Complications occurred in 40% of the cases. These operations should be performed by a "term of specialists". Postoperative treatment with isotope-, hormone- or radiotherapy is decisive to obtain good results. PMID- 3673176 TI - [Meniscus signals in vibration arthrography]. AB - The technique of vibration arthrography (VAG) permits the non-invasive evaluation of internal derangements of the knee. Using the computer-assisted recording and analysis equipment which has previously been described, a major survey was conducted into the signal patterns present in subjects with symptomatic knee joints. Two hundred and forty-seven patients were examined, and all of these subsequently underwent arthroscopy. One hundred and seventy-two patients were demonstrated arthroscopically to have a meniscal lesion and 150 of these gave characteristic meniscal signals. This paper discusses the vibration signal patterns associated with the various types of meniscal tear and the effect of surgery on the meniscal signal. The overall accuracy of vibration arthrography in the diagnosis of meniscal pathology was 86%. In many cases, not only could the site of a meniscal tear be determined, but the type of tear could be diagnosed with reasonable accuracy. PMID- 3673177 TI - [Transposition of the medial meniscus as an anterior cruciate ligament replacement in animal experiments]. AB - In 24 rabbits the anterior cruciate ligament was resected and replaced with the medial meniscus. The posterior and middle part of the meniscus was dissected from the capsule. The anterior horn remained in biological fixation. The posterior horn was fixed with a wire under tension and placed in a drill hole through the lateral femoral condyle. After 6 weeks, 3 months and 6 months the ligamentous replacement was examined. Colour and strength of the transplanted meniscus was related to tension of the cruciate ligament replacement. The transformation in ligamentous tissue could be shown histologically. According to tensile strength in the cruciate ligament fibrous cartilage tissue was replaced by parallel collagenous tissue. The intraarticular surface of the new ligament was covered with a layer of synovial cells. Boney insertion showed collagen fibers inserted in new bone formation. Metaplasia of fibrous cartilage tissue into ligamentous structures is possible under tensile strength. Autologous menisci should be preserved whenever possible. In the future allogenic menisci wight be used for cruciate ligament replacement. PMID- 3673178 TI - [Optimization of the spiral drill for use in medicine]. AB - Cutting tools are used in medicine a long time ago. Varying mechanical and thermal damage to bone tissue results from using cutting tools. These are often commented in the literature, but there is hardly any systematic studies of optimization of cutting tools. This present study was initiated in an attempt to improve the drill bit geometry and machining conditions. The study includes the thermal damage of bone and the soft-tissue injury, especially beyond the bone, by drilling of bone. The result of this study is a new drill bit geometry, which reduces the time of drilling. Thus lower temperature rises and less danger of thermal damage are achieved. It is easy to center and to start the cut with this new drill. The physical effort of the surgeon is substantially lessened. The danger of the soft-tissue injury can be disregarded. Optimized practice in medicine is gained by avoiding thermal and mechanical damage. PMID- 3673179 TI - [Pes valgoplanus in Friedreich and Charcot-Marie-Tooth-Hoffmann disease]. AB - An increasingly severe hollow foot deformity is typical of Friedreich's hereditary ataxia and Charcot-Marie-Tooth's progressive muscular atrophy. However, on the basis of personal observations it has been found that in infancy, patients with either of these diseases may have an extreme pes valgoplanus. The retrospective analysis presented here is intended to draw attention to this possibility and to point out that these diseases should also be taken into consideration in the differential diagnosis of the cause of a pes valgoplanus. PMID- 3673180 TI - [Frontal talus cleft--talus bipartitus]. AB - To our knowledge, only three patients with a frontal split of the talus have been reported so far. We report on a sixteen year old patient who had some discomfort and restriction of movement in the ankle joint. X-ray examination showed an articular link between the ankle and subtalar joint. As regards the etiology, trauma, avascular necrosis, accessory bones and abnormal ossification were not evident. With respect to the phylogenesis of the foot skeleton, the frontal split of the talus may represent an atavistic malformation of the human foot. This is in contrast to the current hypothesis of a duplicated ossification in the talus. PMID- 3673181 TI - [Complex indications in surgery of the lumbar spinal canal]. AB - Opinions on the treatment of disc herniation are very controversial and the results reported vary, very much indeed. Most often, one decided--and still decides--to excise the disc herniation in conjunction with hemilaminotomy or flavectomy; this method having been carried out from 1974 to 1983 on 598 patients, at the department of Orthopaedic Surgery, Balgrist, of the University of Zurich. A follow-up of over 400 patients has proved to be very informative: whereas very good or good clinical results can be reported in 73.6% of such cases with disc herniation, alone, these not having undergone operation before, similar results were only found in 27.2% of those who had also been suffering from additional causes of lumbalgia like a relatively narrow spinal canal, spondylolisthesis, spondylolysis or nearthrosis for instance. This finding is of paramount importance when attempting to improve the overall results. It is very necessary to separate the complex cases from the "simple" disc herniation ones. At the same time, those patients suffering from lumbalgia due not only to a herniated disc but also to other additional causes arising from alterations to the lumbar spinal canal must be judged and treated differentially. The present follow-up permits conclusions and considerations correspondingly. PMID- 3673182 TI - [Paraplegia caused by vertebral compression fractures in senile osteoporosis]. AB - Paraplegia followed spontaneous deformed osteoporotic spine is very rare. Our own 3 cases treated conservatively in two and operatively in one with success and 11 cases reported in the literatures were analyzed. All patients were recovered from paraplegia. One patient was died one and a half year after the recovery of her paralytic episode. Thorough autopsy study of this patient showed no organic lesion in the regarded spinal cord due to such kind of spine deformity. PMID- 3673183 TI - [Use of electronic data processing in larger orthopedic clinics. Results of a survey]. AB - In a survey of 93 orthopedic clinics or departments conducted in 1985, concerning the use of data processing systems, a total of 64 replies were received. These were not yet affected by the new Federal (German) Hospital Tariffs Regulations and therefore reflect the actual needs of the institutions in question. There is a clear trend toward using data processing for scientific purposes. Data processing systems were already in use in 42 institutions. There are hardly any differences between university clinics and non-university establishments. It is significant that among the key systems used in orthopedic medicine, ICD9 plays a completely subordinate role. This is seen as proof that ICD9 is inadequate for orthopedic purposes. Attention is drawn to a simple diagnostic key used by the Oskar-Helene-Heim. The author also comments on the problems of special documentation departments. PMID- 3673184 TI - [Commentary on the article "Is the mechanical traction of the cervical spine still acceptable?" by R. Dorian ]. AB - Referring to literature Dorian reported on severe complications after apparative traction of the cervical vertebral column up to cross-sectional paralysis and sudden death during treatment. Based on these reports he presents a list of contraindications which comprises nearly all diseases of the cervical vertebral column. The author summarizes his statements claiming that the apparative traction at no means can be a routine method because of it's inherent extreme risks. The comment in hand states that none of the complications claimed have been exemplified by the author in the original paper. Neither authors are named in the text, nor such complications are mentioned in the papers cited in the publication index. A request to the author for completion of literature proofs remained negative. Such complications were also not encountered by 36 orthopedic surgeons in practice who together survey 375 years of treatment with this method. On the contrary a corresponding inquiry yielded that in opposition to the statement of Dorian the apparative traction of the cervical vertebral column is indeed a widely spread standard method in orthopedic practice. The incidents claimed are also unknown to various experts an to importers of traction devices neither from their own experience nor from the literature. Consequently none of the essential statements in Dorian's contribution is proven and therefore the conclusions are unallowable. PMID- 3673185 TI - [Spatial orientation of the facies patellaris femoris]. AB - The present article reports on the geometrical conditions of the physiological movement of the patella. The geometrical shape of 18 femoral condyles and patella sliding areas was investigated in order to describe basic data for the design of endoprostheses. Surface and direction of the facies patellaris femoris were determined by means of radiographic, mechanical and optical measurements. The curvature of the deepest patella sliding groove proves a constant correlation with the dorsal condylar curvature. In the frontal plane the lowest points of the sliding area run with a dispersion of +/- 4 degrees to the vertical line related to the transverse tangent on the dorsal condylar surface. Considering deviations of leg alignment the measures come close to an angle of about 0 degrees. So the direction of the patella sliding groove differs from the normal valgus position of the distal femur. Therefore in artificial knee replacement a lateral tilt of the patella sliding groove should not be propagated as 'physiological'. PMID- 3673186 TI - [Intraoperative fatal fat and bone marrow embolism of the lung in implantation of a hip endoprosthesis with polymethylmethacrylate bone cement]. AB - We report on an intraoperative lethal fat embolism and bone marrow embolism of the lung caused by implantation of hip endoprosthesis using acrylic bone cement. Autopsy revealed massive fat embolism of the lung and multiple bone marrow emboli within branches of the pulmonary arteries. It is concluded that there is a close relationship between implantation of hip endoprosthesis and death because fat embolism and bone marrow embolism was the only available evidence on post mortem examination. PMID- 3673187 TI - [Initial results of the surgical treatment of scoliosis with the Cotrel and Dubousset CD instruments]. AB - At the Orthopaedic University Hospital Muenster 50 patients were surgically treated according to the Cotrel and Dubousset technique from June 1985 to October 1986. An outstanding characteristic of this method is the three-dimensional correction of the curve without exclusive application of distraction or transverse forces, bringing about excellent stability. By means of this operation an average preoperative angle of 63.4 degrees could be diminished to 33.9 degrees, meaning a gain of correction of 46.5%. Complications occurred essentially due to insufficient experience with this technique in the first patients operated on. After sufficient training this procedure is as practicable as the Harrington technique. PMID- 3673188 TI - [Pseudomeningocele following lumbar intervertebral disk surgery]. AB - Pseudomeningoceles have been observed several times after closed traumatic injuries of the cervical plexus resulting in avulsion of the nerve roots. Following lumbar puncture or lumbar disc operation meningoceles are seldom occurring events. The first report of perineural cysts causing sciatic pain was made by Bancroft (1) in 1941. Since that time about 50 cases have been reviewed by the literature (10, 11). In this paper we report another case of an iatrogenic pseudomeningocele developed following surgical treatment for herniated lumbar disc attempting to outline their clinical and radiological findings. PMID- 3673189 TI - [Treatment of Scheuermann's disease with the active-passive Gschwend erection corset]. AB - In a retrospective study of 31 patients we give a report about the experience with the Geschwend-brace in the therapy of acute M. Scheuermann. The indication for therapy with this brace was given if there was no possibility to stop the progression of the kyphosis by intensive physiotherapy. During the whole time of therapy the brace could not be removed by the patients. Within a follow-up of 24 month in average after the end of brace treatment, we saw a permanent correction of kyphosis of 18 degrees in 22 patients (71%). In 2 patients there was no change of kyphosis and in 7 patients (22%) we saw a progression of 7 degrees. An erection of the wedge-shaped vertebrae we couldn't see in our patients. Permanent correction of kyphosis by Gschwend-brace could be achieved by starting the therapy early, long enough time of treatment about 1,5-2 years and a good compliance. PMID- 3673190 TI - [Resection of the acromial and sternal end of the clavicle]. AB - The causes of complaints in the acromioclavicular joint include arthrosis after dislocation of the joint, metastases, polyarthritis, tuberculosis, or hyperparathyroidism. Some causes have not yet been identified. If conservative therapy is unsuccessful the condition may be treated by resection of the acromial end of the clavicular, as first described by Gurd and Mumford. The present paper reports the results obtained in 22 patients who were followed up. Complete freedom from pain was achieved in 59% of the cases and improvement in 23.7%, while in 13.6% the results had to be classified as unchanged or poor. An analysis of these results admits the conclusion that with restricted indication and in particular in post-traumatic conditions, it is certainly possible to achieve results which make this technically simple procedure the treatment of choice in arthrosis of the acromioclavicular joint; this is borne out by the literature. In much rarer cases, changes in the sternoclavicular joint have to be surgically treated. Here also, the majority of cases are post-traumatic changes, and here again most of them are conditions following anterior luxation. Analogously to resection at the acromial end of the clavicula, a resection at its sternal end may also produce successful results. With reference to three of the authors' own cases, the clinical picture is considered and the results are presented and discussed; however, since the various surgical techniques cannot be compared, a final evaluation is only possible to a limited extent. PMID- 3673191 TI - [5 years' experiences with the Gersthof polyethylene peg-anchored acetabulum]. AB - The acetabular socket "Model Gersthof" is a spheric polyethylene component which can be anchored cement-free by means of three symmetrically arranged pegs at the outside. Between July 1979 and October 1986, 1316 implants of cement-free sockets were performed at our own department. The evaluation of the socket was based on the criterium of radiological instability (= aseptic loosening). After five years of observation, this design-oriented evaluation of success shows a survival of 92% +/- 2.9%. PMID- 3673192 TI - [Nuclear magnetic resonance tomography of meniscus lesions]. AB - In magnetic resonance imaging (MR) the use of suitable surface coils combined with high resolution makes it possible to obtain differentiated information on the condition of the menisci. In particular, the course and extent of cracks, degenerative changes, and the attachment zones of the menisci can be assessed. This paper describes MR and clinical findings in 58 patients and compares them with those in seven healthy subjects. PMID- 3673193 TI - [Idiopathic talus necrosis in an infant]. AB - A case of a spontaneous osteonecrosis of the talus in a 22 months old girl is reported. Under treatment in a non-weight-bearing leg brace the talus recovered without remaining deformities. Osteomyelitis, tumors, neurogenic arthropathy and traumatic origin were taken into diagnostic consideration, but could be excluded by clinical, radiological and laboratory examinations. According to our knowledge an idiopathic osteonecrosis of the talus occurring in an infant of 22 months has never been reported before. PMID- 3673194 TI - [Results of the follow-up of Ludloff open hip repositions and closed repositions in congenital hip dislocations]. AB - Three combinations of therapy of CDH (closed and open reduction, with and without foregoing so called "functional" conservative treatment, and with and without retention in the frog position) have been evaluated among 82 children with 100 dislocated hips. They had been operated on 71 times by Ludloffs open reduction and 29 times by gentle closed reduction in anaesthesia. If following a test-x-ray in 130 degrees flexion of the hips and 50 degrees of abduction no spontaneous reduction occurs, an attempt at careful closed reduction under anaesthesia seems to be justified. If it is not successful with lack of a deep position of the head, an immediate open reduction after Ludloff with retention in hip flexion of about 130 degrees and slight abduction was in our hands less frequently followed by an avascular necrosis of the femoral head than following conservative treatment. The latter and the inhuman frog position are according to our statistics probably more responsible for the avascular necroses than the open reduction as such. Every treatment of CDH has to be evaluated in regard to the frequency of irreversible avascular necrosis of the femoral head. PMID- 3673195 TI - [Results of the follow-up of varus osteotomy in Perthes disease with reference to the hip value]. AB - A total of 89 patients with 105 hip joints affected by Perthes' disease at Catterall's stages II to IV, which had been treated by varus osteotomy, were re examined clinically and radiologically between two and ten years after surgery. The clinical and subjective results of treatment were generally good. The best clinical and radiologic results were found in patients who contracted the disease before the age of seven and in whom necrosis was not yet at an advanced stage. The results in children who did not undergo treatment until after the age of eight and those with the disease at Catterall's stage IV were significantly poorer as far as arthrotic deformation of the hip joint was concerned. Radiologic evaluation of the hips examined, with regard to severity of arthrosis, epiphyseal index, and hip value show that the hip value is the best means of distinguishing prearthrotically deformed hip joints from normal findings. For example, at the time of follow-up severe prearthrotic changes were found in 40 of 105 hip joints when the hip values were analyzed. Therefore, in cases of Perthes' disease also, the hip value is of special importance in prognostic counseling of patients as regards the extent to which the hip joint can be subjected to stress either at work or in sports. PMID- 3673196 TI - [Value of scintigraphy in aseptic loosening of cemented and cement-free hip endoprostheses]. AB - Scintigraphic findings in 24 cemented and 25 cement-free prostheses were compared to determine the information value of scintigraphy in the diagnosis of loosening of total hip replacements. The scintigraphic findings were evaluated on the basis of specificity (indicates the percentage of complaint-free hips in which the scan is also negative) and sensitivity (indicates the percentage of clinically loosened hips in which the scan is also positive) in relation to the clinical diagnosis. For the cemented prostheses, the specificity value was 58% and the sensitivity 66%. The figures for the cemented prostheses were 15% and 83% respectively. On the basis of the authors' results it may be inferred that for cemented hip replacements the scan represents a valuable supplement to clinical and radiologic diagnosis. For the cement-free type of prostheses used by the authors, neither the scan nor radiology are suitable for diagnosing loosening; with these prostheses the findings obtained by clinical examination are the most reliable. PMID- 3673197 TI - [Three-dimensional computerized tomography of diseases of the bones and joints]. AB - Three-dimensional CT (3-DCT) surface reconstructions were generated in 157 patients with various disorders of the musculoskeletal system. Whereas generating the 3-D display of ligaments, tendons, intervertebral discs and nerve roots was difficult and time-consuming, the comprehension of complex abnormalities of bony structures was easier than with two-dimensional CT. 3-DCT was particularly useful in the preoperative planning of hip and spine surgeries while it also simplified the intraoperative orientation. 3-DCT proved to be a useful diagnostic method supplementing axial computed tomography. PMID- 3673198 TI - [Optimizing instrument geometry of oscillating saws for use in medicine]. AB - The sawing of bones is an often employed method in separating bones for osteotomies. In the application of reciprocating saw blades appear various risks for like thermal and mechanical damage of the bone delaying the healing process. In order to avoid such risks the geometry of sawing tools has to be optimized. Important demands are an easy handling of the reciprocating saw blades, shortening of the cutting time, reduction of temperature and an accurate to measurement and form guideway of the sawing tool. In this paper a newly optimized geometry of tool is established fulfilling the above-mentioned demands and avoiding bone damage by application of tools. PMID- 3673199 TI - [Bilateral spontaneous femoral neck fracture in chronic alcoholism and liver cirrhosis]. AB - One case of a double-time, bilateral spontaneous fracture of the femoral neck as a result of a hepatogenic osteopathy is reported. The other reasons for spontaneous fractures are shortly mentioned, the osteopathy in chronic liver disease is examined more closely. PMID- 3673201 TI - Vaccines for respiratory disease in cattle. AB - Respiratory disease is one of the most serious disease complexes affecting beef cattle production. For example, it is claimed to cost the UK industry about 70 million pounds per year. It is usually associated with young cattle and can occur in a variety of situations. It is a good example of multifactorial disease in that its aetiology involves both infection by a variety of microorganisms and a number of environmental factors. Several distinct syndromes occur and a number of microorganisms are thought to be important including the bacteria Pasteurella haemolytica type A1, P. multocida, Haemophilus somnus, Corynebacterium pyogenes, Mycoplasma bovis and M. dispar. Of the viruses, bovine herpes virus 1 (BHV1) and respiratory syncytial virus (RSV) are known to be important, the former also causing the specific syndrome, infectious bovine rhinotracheitis (IBR) in addition to its involvement in the pneumonia complex. Other viruses of possible importance include para-influenza 3 (Pi3), adenoviruses, bovine viral diarrhoea (BVD) virus, coronavirus and rhinovirus. PMID- 3673200 TI - [Stress fractures of the femur and tibia 8 years after corrective osteotomy with a plate]. AB - Stress fractures of the low extremities 8 years after correcting osteotomy with plate fixation are described and critically valued in 2 cases. As both legs were operated bilaterally, technical faults could be demonstrated in comparison. The alternative treatment with the dynamic system of osteosyntheses by interlocking nailing is the solution of the biological and biomechanical problems and leeds to a physiological bone consolidation. PMID- 3673202 TI - Measles immunization in children with human immunodeficiency virus infection. PMID- 3673203 TI - Safety and immunogenicity of a new heat-inactivated hepatitis B virus vaccine in adult recipients. AB - A new heat inactivated HBV vaccine has been evaluated for safety and immunogenicity in 203 adult recipients. The vaccine was found to be safe and highly immunogenic. Three doses of 3 micrograms given at 0, 1 and 6 months, resulted in 96% seroconversion. Three doses of 3 micrograms given at 0, 1 and 2 months produced, more rapidly, seroconversion in 92% of those immunized. Antibody to a pre-S determinant developed in four of six subjects tested. PMID- 3673204 TI - Multicentre dose range study of a yeast-derived hepatitis B vaccine. AB - Healthy young adult volunteers, 778 in number, without HBV markers were randomly distributed into groups and administered different lots of a yeast-derived hepatitis B vaccine (YDV) at different dose levels or a commercial plasma-derived vaccine (PDV), according to a 0, 1, 2, 12-month vaccination schedule. The YDV proved to be safe and well tolerated, even when partly purified lots were given. Reactions were mild and transient, comparable to those observed after PDV. One month after three YDV doses, 0-7% of subjects overall had failed to seroconvert; all those evaluated one month after the booster dose had seroconverted. No significant difference was found between the two vaccine types as far as seroconversion rates were concerned. Geometric mean anti-HBs levels following three vaccine doses were higher in seroconverters of the PDV groups. However, a booster dose of YDV resulted in high anti-HBs levels in all groups varying from 11,474 to 51,404 IU l-1 (purified YDV lot), 4915 to 18,832 IU l-1 (partly purified YDV lots) and 11,008 to 15,805 IU l-1 (PDV lots). Of seroconverters to the purified lots of YDV 93% attained 1000 IU l-1 after the booster dose, thus ensuring protection for a number of years. Dose-response studies provided a basis for the selection of 20 micrograms of highly purified YDV as the standard dose. PMID- 3673205 TI - Further observations on the stability of cholera vaccine at different temperatures. AB - The stability of cholera vaccine samples held at 4-8 and 20-25 degrees C for 2 1/2 years was studied with regard to the number of organisms, total nitrogen content and relative antigenicity. After this length of time, the percentage loss in the number of organisms averaged 10.7 at 4-8 degrees C and 22.7 at 20-25 degrees C. The maximum loss in number of organisms took place during the first six months and in the next two years there was very little loss in the number of organisms. The total nitrogen content after 2 1/2 years remained almost unaltered at these temperatures. All the ten samples had acceptable relative antigenicity for both the Inaba and Ogawa serotypes after exposure at 4-8 degrees C for 2 1/2 years, while at 20-25 degrees C only two samples for the Inaba serotype and one sample for the Ogawa serotype retained antigenicity within acceptable limits after the same time. The loss of antigenicity after 2 1/2 years at 20-25 degrees C in comparison with antigenicity at 4-8 degrees C ranged from 41.5 to 83.1% (mean 61.9%) for the Inaba serotype and from 47.3 to 80.3% (mean 65.1%) for the Ogawa serotype. From this study on the cholera vaccine manufactured at the Central Research Institute, Kasauli, it is concluded that the shelf life of cholera vaccine may be increased from 18 months to at least 24 months, when the vaccine is stored under refrigeration. PMID- 3673206 TI - Hepatitis B vaccination in healthy Chinese adults with low dose regimens. AB - Three hundred seronegative healthy Chinese adults were divided randomly into three groups to receive 5, 2 and 1 micrograms of Pasteur's hepatitis B vaccine on a four dose schedule. No difference between the three groups was observed in the antibody to hepatitis B surface antigen (anti-HBs) response rate (96, 92 and 94%, respectively) a month following the fourth dose of vaccination. Young vaccinees had a faster and higher anti-HBs response than older ones. There was no difference in antibody response rate by sex. This study shows a good immunogenic effect for low dose hepatitis B vaccine in Chinese adults. The use of low dose (1 microgram) hepatitis B vaccine in susceptible adults would make mass hepatitis B vaccination more economically feasible. PMID- 3673207 TI - Pre-exposure studies with purified chick embryo cell culture rabies vaccine and human diploid cell vaccine: serological and clinical responses in man. AB - Clinical reactions and neutralizing antibody responses to six pre-exposure regimens of purified chick embryo cell culture rabies vaccine (PCECV) and human diploid cell strain rabies vaccine (HDCSV) were studied in 177 volunteers. Antibody kinetics, height of the response and persistence of antibody over two years were virtually identical after PCECV and HDCSV. An antibody response was detected in all subjects on day 14 when the highest titres were found after two intramuscular (i.m.) 1.0 ml doses of a schedule of immunization on days 0, 7 and 21. In comparison, a schedule of immunization on days 0, 28 and 56 ultimately evoked the highest titres 21 days after the final injection, but antibody persisted equally well over two years with either schedule. Neutralizing antibody titres were lower after intradermal (i.d.) vaccination with 0.1 ml compared to 1.0 ml i.m. on days 0, 7 and 21, but when given on days 0, 28 and 56 the responses were comparable. Three subjects with a personal or family history of atopy developed urticarial lesions after PCECV. Both vaccines were otherwise well tolerated. PMID- 3673209 TI - Characterization of a double avirulent mutant of rabies virus and its potency as a vaccine, live or inactivated. AB - A strain bearing two mutations which abolish the virulence for adult animals after intracerebral or intramuscular inoculation has been constructed from the CVS strain of rabies virus. This apathogenic phenotype is stable after three successive passages of the double mutant in suckling mice brain. Trials of vaccination performed on mice in parallel with the double mutant and CVS both inactivated with beta-propiolactone indicate that the mutant is at least as efficient as CVS. This strain has also been found to be efficient as a live virus vaccine. PMID- 3673208 TI - Synergistic teratogenic effect produced in mice by whole cell pertussis vaccine. AB - Pertussis whole cell bacterial vaccine was injected in mice during early pregnancy to disclose any teratogenic effect on the brain of the fetuses. Cytochalasin D by itself induced exencephaly in a dose dependent way in fetal mice. When pregnant mice received a single injection of pertussis vaccine on day 8 of gestation and a subteratogenic dose of cytochalasin D on days 8, 9 and 10 of gestation a synergistic teratogenic action of pertussis vaccine and cytochalasin D in mice was observed. When autopsy was performed after a further 9 to 10 days a significant number of brain malformations was found. In order to analyse which component in the vaccine might be responsible for the co-teratogenic effect, purified pertussis components, pertussis toxin and filamentous haemagglutinin were used in combination with cytochalasin D, but no malformations occurred. The same results were obtained by using diphtheria-tetanus-polio (DiTePol) vaccine and acellular pertussis component vaccine, whereas the use of whole cell typhoid vaccine resulted in a high rate of fetuses with exencephalies. Experiments with purified Bordetella pertussis and Escherichia coli lipopolysaccharides indicated that lipopolysaccharides in whole cell pertussis vaccine as well as in typhoid vaccine were the factors causing teratogenicity in fetal mice. PMID- 3673211 TI - Diagnostic strategies for palpable and nonpalpable lesions of the breast. PMID- 3673210 TI - Screening for breast cancer in Virginia. PMID- 3673212 TI - Current choices in treatment of primary breast cancer. PMID- 3673213 TI - Adjuvant therapy of breast cancer. PMID- 3673214 TI - AIDS: politics and pussyfooting. PMID- 3673216 TI - [Role of peroxisomal enzymes and lipid peroxidation in the pathogenesis of alcoholic cardiomyopathy]. PMID- 3673215 TI - [Aminopeptidases and their inhibitors]. PMID- 3673218 TI - [Progress in clinical enzymology: the problems of standardization and automation]. PMID- 3673217 TI - [Enzymatic characteristics of hepatoma]. PMID- 3673219 TI - [Enzymes of the blood kallikrein-kinin system in the diagnosis of the degree of severity of acute lung damage and the correction of its changes by hemosorption]. PMID- 3673220 TI - [The role of enzymes of amino acid and lipid metabolism in Leptospira metabolism]. PMID- 3673221 TI - [Use of immobilization and chemical modification methods for research on subunit interactions in alpha-ketoglutarate dehydrogenase]. PMID- 3673222 TI - [Mental activities and the organization of brain processes]. PMID- 3673223 TI - [Correlation of the physiological and the mental in human higher nervous activity]. PMID- 3673224 TI - [Neuronal mechanisms of conditioned reflex activity in monkeys]. PMID- 3673225 TI - [The hippocampus--the monoaminergic system of the brain for sensory reinforcement]. PMID- 3673226 TI - [Role of reinforcement as a system-generating factor in shaping the purposeful behavior of animals]. PMID- 3673227 TI - [Clinico-mathematical classification of acute blood circulation disorders]. PMID- 3673228 TI - [Changes in the cardiac diastole in acute and chronic energy deficiency]. PMID- 3673230 TI - [Principal methodological problems of the experimental pathology of higher nervous activity]. PMID- 3673229 TI - [State of the myocardium in cardiac insufficiency in patients with ischemic heart disease]. PMID- 3673231 TI - [Prevention of cardiac insufficiency in acute myocardial infarct]. PMID- 3673232 TI - [Clinical and morpho-biochemical aspects of chronic cardiac insufficiency in patients with acquired heart disease]. PMID- 3673233 TI - [Cardiovascular insufficiency in children]. PMID- 3673234 TI - [Recent peripheral vasodilators in the treatment of cardiac insufficiency]. PMID- 3673235 TI - [Diagnosis and means of optimizing the treatment of congestive heart failure]. PMID- 3673236 TI - [Pharmacodynamics, pharmacokinetics and side effects of cardiac glycosides]. PMID- 3673237 TI - [Surgical treatment of cardiac rhythm disorders complicated by acute and chronic circulatory disorders]. PMID- 3673238 TI - [Cellular immunity in psoriatic arthritis patients]. PMID- 3673239 TI - [The function of skin adrenoreceptors in psoriasis patients]. PMID- 3673240 TI - [Acid phosphatase distribution in the epidermis in psoriasis (an electron microscopy-histochemical study)]. PMID- 3673242 TI - [Experience with the photochemotherapy of psoriasis combined with hyperbaric oxygenation]. PMID- 3673241 TI - [The role of neutrophils in the pathogenesis of psoriasis and the effect of T activin on them]. PMID- 3673243 TI - [Lipid peroxidation and the blood antioxidant activity in psoriasis]. PMID- 3673244 TI - [Venous circulation and microcirculatory processes in psoriasis and eczema patients]. PMID- 3673245 TI - [Immunological reactivity of psoriasis patients with hypersensitivity to bacteria]. PMID- 3673246 TI - [Circadian rhythm of urinary catecholamine excretion in psoriasis patients]. PMID- 3673247 TI - [Experience in treating psoriasis patients by plasmapheresis]. PMID- 3673248 TI - [Photochemotherapy with the external use of psoberan in psoriasis patients]. PMID- 3673249 TI - [Clinical characteristics and the combined differential treatment of psoriasis patients]. PMID- 3673250 TI - [The psychoemotional status of psoriasis patients]. PMID- 3673251 TI - [Combination of psoriasis and Hailey-Hailey disease]. PMID- 3673252 TI - [Combination of focal scleroderma and psoriasis]. PMID- 3673253 TI - [Multiple skin cancer in a patient with psoriasis and lymphogranulomatosis]. PMID- 3673254 TI - [Trends and prospects in the development of the physiology of higher nervous activity]. PMID- 3673255 TI - [The role of feedback in the dynamics of functional asymmetry of brain hemispheres in man]. AB - Reaction time, number of correct evaluations of time microintervals, and P300 wave were studied in healthy adult subjects. The role is shown of feedback stimuli in training of a subject to discriminate short intervals and in changes of interhemispheric functional relations. These relations change in the course of training as a result of lateralized activation of the left hemisphere. Training with informative feedback is more efficient in the left hemisphere. The right hemisphere in lesser extent than the left one is subject to correcting influence of the feedback. In this sense the former is more autonomous. PMID- 3673256 TI - [Gnostic micronet of cortical neurons]. PMID- 3673257 TI - [Alpha-rhythm of the EEG in directed attention]. AB - Degree of manifestation and synchronization of rhythmic alpha-range components in various cortical areas was studied in healthy adult subjects in conditions of controlled computer experiment by spectral-correlation method of EEG analysis during directed attention previous to discrimination of tactile, auditory and visual stimuli. The obtained results show that in preparation for discrimination of heteromodal stimuli, specific reconstructions take place of alpha-range electrical activity determined by signal modality. These changes are expressed in a local increase of the degree of synchronization of alpha oscillations in those projection and associative brain areas which are connected with the analysis of the given stimuli. Functional significance of these reconstructions is seen in the fact that they are significantly more expressed at correct recognition. A hypothesis is suggested about participation of the alpha-range in neurophysiological mechanisms of directed attention. PMID- 3673258 TI - [Characteristics of the formation of conditioned defense reactions in monkeys in a primatological chair]. AB - Rate of reactions in motor conditioned electro-defensive reflexes and different kinds of internal inhibition, such as acute extinction, differentiation and delay with different retardations, were studied on monkeys in primatological chair. Specificity in formation of conditioned reactions was studied with simultaneous recording of vegetative (respiration and heart rate) and motor conditioned reactions. It has been established, that forming of vegetative and motor components of defensive reflex does not proceed synchronously. At first (2-4 trials) vegetative reactions appear, such as increase of heart and respiration rates. Conditioned motor reactions (legs' jerks) appear later, after 4-9 trials. It has been shown that in monkeys in the primatological chair we have a possibility to form all kinds of negative conditioned defensive reactions: acute extinction, differentiation, delay. Formation of delay inhibition with retardation of 90 s leads to neurotic disorders. But they last only for short periods and disappear after breaks in work. The obtained data are discussed from evolutionary point of view, with a comparative study of specificity of higher nervous activity formation among lower organized vertebrates and with consideration of processes of excitation and inhibition in evolution. PMID- 3673259 TI - [Organization of early forms of kitten behavior after partial oral deprivation]. AB - Study of development of early forms of behaviour was carried out on intact kittens of the first month of life, who endured in 5 days age uni- and bilateral sections of the lingual nerve, and on shame-operated and undernourished animals. It was shown that bilateral deafferentation caused significant disturbance of alimentary behaviour at the stage of sucking, manifested in disturbance of natural sucking and appearance of shame sucking, i.e. rhythmic sucking movement without nipple grasping. At the one-month age, in conditions of artificial feeding, natural sucking in operated animals was restored and the shame one disappeared. Bilateral section of the lingual nerve led to acceleration of ripening of sensory and motor systems and accelerated development of homing, exploratory and playing behaviour. Possible role is discussed of sensory trigeminal nuclei neurones in organization of normal patterned sucking and at limited sensory inflow. It is suggested that elimination of sensory input developing in the norm earlier than others, changes natural terms of other channels development, what accelerates the change of early behaviour forms. PMID- 3673260 TI - [Changes in the behavioral and biochemical effects of cerulein, an analog of cholecystokinin octapeptide, after prolonged administration of haloperidol]. AB - In experiments on male mice and rats, long-term haloperidol administration (0.25 mg/kg twice a day during 15 days) significantly changed behavioural effects of caerulein, an agonist of CCK-8 receptors. As a rule, the effects of caerulein were reduced or inverted; only long-term antagonism with amphetamine motor excitation in rats increased after the cessation of haloperidol administration. The decrease or inversion of caerulein's effects was connected with reduction of high-affinity dopamine2- and low-affinity CCK-8 receptors' density, reflecting the inhibition of some interneurons' activity in subcortical forebrain structures after haloperidol treatment. A more pronounced inhibition of dopamine's release by caerulein was the reason for the increased antiamphetamine action after long term haloperidol treatment. It seems possible that both above mechanisms are involved in the antipsychotic action of haloperidol. PMID- 3673261 TI - [Hemisphere asymmetry of motor-feeding behavior of mice in a multi-alternative symmetrical maze]. AB - The behaviour of mice of BALB/c line was studied in a symmetrical multialternative Y-maze: their motor, alimentary and investigating activities as well as spatial-motor asymmetry. In animals with inactivated left hemisphere, as compared to intact ones, the motor and alimentary activities were lowered, and the investigating one augmented. Instead of the weak left-side asymmetry a distinct left-side preference appeared of most Y-maze sections, and right-side preference for approaches to the feeders. Elimination of the right hemisphere did not change the motor activity; the alimentary one decreased and the investigating one augmented, but less than during inactivation of the left hemisphere. On the whole, the right-side asymmetry appeared for all sections. According to all parameters studied, the influence of the left hemisphere on animal behaviour was more expressive and diverse. Spatial preference is formed with participation of influences of both hemispheres. The differences between them are more qualitative than quantitative. PMID- 3673262 TI - [The role of inhibition processes in the development of functional properties of neurons of the vibrissa projection area in the cat somatosensory cortex]. AB - The paper deals with the contribution of intracortical inhibitory processes to the organization of receptive fields in the vibrissae projection area of the somatosensory cortex. Inhibition blockade by means of microelectrophoretic application of picrotoxin and bicucullin was shown to lead to a loss of directional sensitivity of neurones. Activation of inhibition at remote glutamate application led to opposite changes: the neurones became directionally sensitive, and dependence was found between the spatial localization of activated neurones and the character of changes of detector parameters. Inhibitory processes caused by natural afferent stimulation led to similar changes of functional characteristics of neurones. PMID- 3673263 TI - [Conditioned reflexes in rats after 5-minute arrest of blood circulation]. AB - Neurological recovery and conditioned activity were studied in rats resuscitated after five-minute circulation cessation caused by intrathoracal clamp of the heart vascular bundle. The dynamics of disappearance of neurological deficit was evaluated according a scale of 19 parameters of the general state of animals where number 100 meant the death of the brain and number 0 meant recovery. In the course of 8 months after resuscitation, in reanimated rats and simultaneously in intact (control) ones, an alimentary instrumental conditioned reflex was elaborated and then changed to a defensive one; passive and acute extinction of both reflexes was also carried out. In most of the rats the neurological recovery was completed rapidly within 3-4 hours. In reanimated animals, both instrumental conditioned reflexes were acquired in the same way as in the intact rats. Quantitative evaluation of the dynamics of conditioning and extinction allowed to see that elaboration of the alimentary reflex in reanimated rats proceeded faster and its change to the defensive one, and acute extinction of both kinds of conditioned reflexes went slower than in intact animals. A conclusion is drawn that even a short-term circulation cessation compatible with complete and rapid compensation of visible neurological disorders causes long-term disturbances of conditioned activity manifested in weakening of inhibitory processes. PMID- 3673264 TI - [Brain biopotentials associated with decision on the choice of reaction]. PMID- 3673265 TI - [Structural organization of natural sleep in man after different levels of motor activity]. PMID- 3673266 TI - [Analysis of cardiac activity during solution of a logical problem at different stages of ontogenesis]. PMID- 3673267 TI - [The use of pattern recognition in EEG data for the diagnosis of epilepsy in children]. PMID- 3673268 TI - [Effect of pyrroxan on the behavioral and neurohormonal manifestations of emotional stress in monkeys]. PMID- 3673269 TI - [Analysis of neuronal activity in the cat motor cortex during a timed feeding reflex]. PMID- 3673270 TI - [Relation between the hierarchical structure of the population and learning characteristics in random-bred albino rats and Dull Tryon rats]. PMID- 3673271 TI - [Development and preservation of conditioned defensive reflexes in rats subjected to an oxygen-free medium in the early postnatal period]. PMID- 3673272 TI - [Impulse activity of amygdala neurons in freely moving rats during predatory aggression and feeding behavior]. PMID- 3673273 TI - [Characteristics of propagation of the wave of depression in the rat cerebral cortex in the late post-resuscitation period]. PMID- 3673274 TI - [Habituation of command neurons after administration of a vasopressin analog in the snail]. PMID- 3673275 TI - [A discriminator for the visual detection of impulses of specific form]. PMID- 3673276 TI - [A microprocessor system for recording and analysis of intraspecies behavior of primates]. PMID- 3673277 TI - [Insufficient cerebrospinal shunt systems in childhood caused by body growth. A problem solved?]. AB - Causes for operative revisions of CSF shunting systems are displacement of the distal catheter from the heart or the peritoneal cavity due to the patient's growth. This takes place in 40-50% of all revisions. Median time for the first revision is 2 years post implantation. Preliminary experience with a simple peritoneal "reserve" catheter lead us to expect that the revisions may eventually become redundant: the catheter is normally inserted 10 cm into the abdominal cavity and then fixed to the peritoneum. About 20 cm of a catheter tubing are coiled in a spiral line inside a silicone bag placed subcutaneously in the abdominal wall. As the child grows, the catheter uncoils, and this uncoiling may be observed radiologically. PMID- 3673278 TI - Oesophageal anastomosis without bougienage in isolated atresia--do the segments really grow while waiting? AB - Four cases of isolated oesophageal atresia, in which a successful oesophageal anastomosis was achieved without bouginage, are reported. The anastomoses were performed at ages from one month to three and a half months. No certain growth of the segments could be observed. However, in the cases, where the operation was performed after a longer waiting period, the lower segment was surprisingly thick walled, which made the anastomosis possible. A single Livaditis myotomy was required in three cases and a double myotomy in one. All patients needed Nissen's fundoplication because of gastro-oesophageal reflux, which caused stricturation of the anastomosis and oesophagitis. After the follow-up period of 1.3 to 2.5 years, two patients had an excellent result, one patient a fair result and one patient had died of his severe cardiac anomaly associated with Down's syndrome. PMID- 3673279 TI - [Esophageal replacement with resorbable vicryl tubes--an animal experiment study]. AB - In order to study a novel resorbable oesophageal prosthesis, four centimetres of cervical oesophagus were replaced by a Vicryl tube in 26 dogs with an average weight of 16.9 kg. The implants were removed after 2, 4, 8 days and after 2, 4, 6, 8 and 10 weeks. 19% of the animals died; not counting three dogs which were sacrificed earlier than planned, the overall lethality was 8%. Dehiscences occurred in 75%, of which 2/3 closed spontaneously within the first 10 days. Stenoses developed in 87%. All dogs had difficulty in swallowing. A fibrous tube with complete epithelial lining formed around the prosthesis within two weeks. Following this the prosthesis was lifted off and expelled per vias naturales. PMID- 3673280 TI - [Pathogenesis of chest wall abnormalities--electron microscopy studies and trace element analysis of rib cartilage]. AB - In 71 patients with chest deformity (Group B) and in 43 patients who underwent thoracotomy due to heart disease (Group BN), cartilage of the ribs was removed intraoperatively. Analyses of trace elements showed a highly significant decrease in zinc, coupled with a significant increase in magnesium and calcium in Group B. Electron microscope studies in the cartilage of patients with chest deformity revealed chondrocytes with a normal structure only in some parts, but many degenerative altered chondrocytes with vacuoles of fat and osmiophilic depositions, as well as atypical fibrils and so-called "long-spacing collagen". PMID- 3673281 TI - [Quantitative determination of LP-X in the differential diagnosis and treatment of direct hyperbilirubinemia in infancy]. AB - Quantitative measurements of serum concentrations of LP-X were performed in 45 newborn and infants. The changes of LP-X concentrations before and after a 2-3 weeks' course of cholestyramine therapy differentiated extrahepatic biliary atresia (n = 6) from other causes of neonatal liver disease with a sensitivity of 100%, a specificity of 78.6 to 84.6% and an efficiency of 81.3 to 86.7%. The efficiency was decreased in children with alcoholic stools (75-80%). Cholestyramine treatment of 3-7 days did not allow to diagnose all children with extrahepatic biliary atresia. However, the test was superior to a combination of single measurements of LP-X and GGT. The changes of LP-X concentrations in serum were influenced by the individual course of the disease but not by the synthetic function of the liver (as indicated by CHE activities) or by parenteral nutrition or bacterial infections. LP-X was a valuable parameter in the management of cholestyramine therapy in infants with liver diseases. PMID- 3673282 TI - Clinical and manometric assessment of anorectal function after Martin's operation. AB - Anorectal function after Martin's operation for total colonic aganglionosis was assessed in five patients by clinical and manometric studies. One year after operation the frequency of bowel movements decreased to three times a day, and the stools became semi-formed. Anorectal manometry showed decreasing anal resting pressure and anorectal pressure difference one month after the operation. However, these values became gradually normal. Rectal compliance increased as bowel function improved clinically. These results show that increasing rectal compliance and normalisation of stools by adequate absorption of intestinal fluid are important factors in the improvement of faecal continence after Martin's operation. PMID- 3673283 TI - [Autologous transfusion of blood deep frozen in the interim in childhood]. AB - In the report we describe a method of reducing the number of transfusions of heterologous blood in patients with a surgical correction of chest walls. In 71 children between 2 and 17 years of age, 10-15% of total blood volume were withdrawn 3-4 weeks before the operation, deep frozen and thawed at the appropriate time to be ready for retransfusion. This arrangement reduced the need of heterologous blood significantly from 18.6% (prior to the introduction of the method) to 4.2%. PMID- 3673284 TI - [Intermittent peritoneal lavage following generalized peritonitis in the neonatal period and infancy]. AB - Between 1981 and 1985, 15 neonates and young infants, who suffered from severe putrid or faecal peritonitis due to perforation of the gastrointestinal tract, were treated by intermittent postoperative peritoneal lavage. During the operation 2 to 4 drains were inserted into the peritoneal cavity. Immediately after operation peritoneal lavage was started with 20 ml/kg body weight Ringer or peritoneal dialysis solution. Inflow of the solution was done during a 20 minutes period. The solution then remained in the peritoneal cavity for another 20 min., before the 20 min. outflow was started (tidal-like rhythm). We did not use antibiotics or antiseptics in addition to the saline fluid to prevent damage to the tissue and adhesions of the bowel. Serum electrolytes, blood urea and body temperature can be changed by variation of the solution. After the operation the patients must remain in the intensive care unit. Accurate and detailed documentation of the balance of the inflow and outflow is very important. Five of the fifteen treated infants died due to additional malformations and complications following sepsis. All of them were premature with necrotising enterocolitis. Our experience with intermittent peritoneal lavage in selected patients suggest to use it in the management of infants with severe peritonitis due to perforation of the intestine. PMID- 3673285 TI - [Results following surgical treatment of ligament ruptures of the ankle joint in children]. AB - A follow-up study was done in 49 children one to five years after surgical repair of traumatic rupture of the fibular ligaments of the ankle joint. Surgery has been performed when the unstable ankle joint showed radiologically a difference in the supinatory subluxation of more than 7 degrees in comparison to the opposite side. 30 children were free of complaints and showed identical stability of both ankle joints. Further eleven patients had minor complaints but the ankle joints were stable, clinically and radiologically. Four patients without complaints had a slightly differing weakness of the ankle joint. Further four patients had substantial complaints. Three of them also showed radiologically instability of the joint. Ruptures of the fibular ligament in childhood are not infrequent. Early operative treatment obviously gives better results when compared with those of conservative plaster cast therapy. The radiologically confirmed difference in supinatory subluxation of the traumatised ankle joint in comparison to the other side provides an excellent parameter for the indication to surgery. PMID- 3673286 TI - Basal-cell carcinoma of the lower lid in a 27-month-old child. AB - Basal-cell carcinoma of the skin is rare in childhood. An unusual case of a 27 month-old girl is described, in whom basal-cell carcinoma afflicted the left lower lid without predisposing cutaneous diseases. The lesion appeared as a naevus, four months before consultation; it developed rapidly and was ulcerated. Treatment was achieved by surgical excision of the lesion. No report of such a young child could be found in the literature. PMID- 3673287 TI - Congenital cystic adenomatoid malformation of the lung: an unusual presentation. AB - A case of congenital cystic adenomatoid malformation of the lung is described in a twelve-year-old boy presenting with signs and symptoms of a tension pneumothorax. PMID- 3673288 TI - [Arthritis following post-traumatic pancreatitis with subsequent pseudocyst in children]. AB - The authors report on a nine-year-old boy who presented with arthritic complaints at the wrists and joints of the feet 6 weeks after posttraumatic pancreatitis with development of a pseudocyst. These complaints subsided only after spontaneous voiding of the contents of the cyst into the abdominal cavity. The pathogenesis, diagnosis and surgical indication in posttraumatic pancreatic pseudocysts are discussed. PMID- 3673289 TI - [Behcet syndrome in childhood]. AB - Behcet's syndrome represents a multisystemic disease with vasculitic changes. It manifests mainly with oral and genital ulceration, ocular involvement mostly uveitis and typical skin lesions. Further symptoms can develop: arthritis, gastrointestinal signs, thrombophlebitis and neurologic disturbances. The disease can start already in childhood and follows a chronic recurrent course. Diagnosis is often delayed by a long interval between manifestation of each of the several symptoms. In this regard diagnostic criteria which consider clinical findings have proved helpful. Courses of Behcet's syndrome in three juvenile patients whose disease started in childhood are demonstrated and discussed together with experience from the literature. PMID- 3673290 TI - [Diagnostic and prognostic significance of serologic studies in Yersinia arthritis]. AB - Commonly-used serological methods for the determination of Yersinia antibodies are based on the presence of agglutinins, which are frequently absent or of low titer when arthritis begins. Stool cultures are usually negative at that time, so many Yersinia infections are underdiagnosed. On the other hand, significant agglutinin titers, of diagnostic value, become frequently minimised because of cross reactivity with Yersinia and other gram-negative bacteria. With the immunoblot-technique, using specific virulence-associated antigens and the detection of class-specific antibodies, clear statements are possible about whether there is a recent or an old Yersinia infection. As Yersinia arthritis may have an acute start and a protracted course over months, an exact diagnosis is essential for therapy and prognosis, as well as for answering the question of whether there is acute exacerbation of a preexisting rheumatoid illness of an additional infectious arthritis. PMID- 3673291 TI - [Psychogenesis of rheumatoid arthritis--what do we really know?]. AB - Empirical studies concerning the psychogenesis of rheumatoid arthritis are critically reviewed. Alexander's thesis that patients' suppressed aggressive impulses lead to increased muscle tension and hence to articular lesions has not thus far been given sufficient empirical support; there is not much evidence that people with rheumatoid arthritis show specific personality features, either. Human studies have not yet clearly demonstrated a connection between stressful life events and the onset or exacerbation of the disease; animal studies, in which the influence of stress on the development of rheumatoid symptoms was examined experimentally, have not yielded unambiguous results. However, these somewhat disappointing findings should not lead to the premature conclusion that psychological factors play no part in the development of rheumatoid arthritis. PMID- 3673292 TI - [Halothane intubation anesthesia during controlled respiration in ferrets]. PMID- 3673293 TI - [Pentobarbital sleeping time for the pharmacogenetic differentiation of inbred rat strains]. PMID- 3673294 TI - [Morphologic changes in the lungs of rats after death]. PMID- 3673295 TI - [Excretion urography in guinea pigs]. PMID- 3673296 TI - [Utilization of C14-labeled cellulose in conventional, germ-free and defined associated rats]. PMID- 3673297 TI - Homocytotropic antibodies of the multimammate rat, Mastomys natalensis. Demonstration and characterization of 2 types classified as IgE and IgG3. PMID- 3673298 TI - Normal development of behaviour in rabbits. PMID- 3673299 TI - Intranasal electrocoagulation in rats. PMID- 3673300 TI - [Effects of immobilization with ketamine on the peripheral blood parameters of cats]. PMID- 3673301 TI - Spontaneous tumours of the seminal vesicles in male Han:NMRI mice. PMID- 3673302 TI - [Progress in the treatment of colonic cancers: early detection]. AB - A parallelism was found to exist in cases of colon carcinoma between the number of affected lymph nodes and the chance of survival. Prognostication is possible by means of Dukes classification and the TNM system. Prospects of therapy can be improved by early detection of the tumour proper and of precancerous lesions. Colonoscopy is recommended as the optional diagnostic method, which applies equally to postoperative follow-up. PMID- 3673303 TI - [Surgical therapy of rectal cancer]. AB - Surgical excision of rectum carcinoma by amputation, resection or locally delimited excision has remained to be the optional curative approach to carcinoma of any position, severity, type and phase. Low-dose heparinisation, oral intestinal washing, and perioperative application of antibiotics have retained their established positions in the run-op to surgical action. The value of perioperative radiotherapy is still unelucidated. Chemotherapy has so far failed to produce a safe adjuvant effect. The age limit to curative intervention is continuously moved upwards. Resection is more often chosen than other approaches. Safely established knowledge is likely to suggest that the atumorous aboral safety zone may be reduced to 2 cm, provided that the perirectal lymphatic channels are severed at equal level. Anastomosis in cases of deeper anterior removal can often be sutured only by staplers. There is a growing number of situations in which the approach can be taken without preceding colostomy. Transanal and transsphincteral access routes are available for locally delimited tumour excision. Postoperative lethality has been continuously lowered and is now below five per cent. Reported in this paper are the authors' own results over the past decade. PMID- 3673304 TI - [CEA determination in the follow-up of colorectal cancers]. AB - CEA follow-up checks of 135 patients with colorectal carcinoma are described in a retrospective analysis. Unambiguous correlations were found to exist between clinical tumour staging and CEA findings in the context of both primary findings and recurrences and metastasation. Typical courses are described of 107 patients who received curative treatment. An assessment is made of the value of CEA determination in postoperative follow-up. PMID- 3673305 TI - [Acute intestinal occlusion caused by invagination of a sigmoid cancer]. PMID- 3673306 TI - [Benign tumors of the small intestine]. PMID- 3673307 TI - [Extraperitoneal perforation of the rectum following roentgen contrast enema]. PMID- 3673308 TI - [Transplantation of gastrointestinal tumors to immunodeficient nude mice as an in vivo model of tumor biology]. AB - Serial transplantation of ten different types of tumours, both primary tumours and their metastases, to 170 nude mice was conducted for biological analysis of human gastro-intestinal carcinomas, with particular reference being made to the aspect of tumour growth. The types transplanted included seven colorectal carcinomas, one oesophageal carcinoma, one gastric lymphoma, and two gastric carcinomas.--Tumour growth was quantitatively monitored by means of a standardised measuring method and was statistically evaluated. The qualitative aspects of tumour growth were micromorphologically investigated. Tumour transplants were allowed to reach a defined size and were then retransplanted within the nude mouse system, with up to six tumour passages being conducted. The investigations were evaluated, with particular reference being made to comparison between primary tumours, on the one hand, and their metastases, on the other.- The average primary tumour take rate amounted to 83 per cent and was generally higher for metastatic tumours. Statistically significant findings were obtained to the effect of growth of metastases which was faster than that of their own primary tumours (p 0.05), where as no qualitative differentiation between primary tumour and metastases was possible on the basis of the micromorphological aspect. Growth of metastases. PMID- 3673309 TI - [Performance evaluation (validation) of diagnosis]. AB - A theoretical account is given of methods for validation of diagnostic procedures, with reference being made to literature quoted in surgical journals. Wider use of those methods is recommended to ensure more economy, effectiveness, and higher scientific standards in every-day routine. PMID- 3673310 TI - [Penetrating chest injuries--an indication for early thoracotomy]. AB - Indication for thoracotomy is undisputed in cases of gaping wounds with massive haemorrhage. However, discrete stab and gunshot wounds may quite often conceal imminent pericardial tamponade. Three quarters of all penetrating thorax injuries are located in or close to the cardiac silhouette. When it comes to patients with circulatory conditions of good stability, management of superficial wounds may cost valuable time and cause delay to thorough revision of the cardiac injury which usually would be possible without extracorporeal circulation. Success of that revision may then be limited due to tamponade-related impairment of cerebral perfusion and subsequent ischaemic brain damage. The risk implied in early exploratory thoracotomy was found to be low, as compared to the risk emanating from pericardial tamponade in cases of stab wounds in the cardiac region. Hence, early thoracotomy is generally indicated and should be generously decided to handle penetrating wounds of the chest. Superiority of early thoracotomy in handling penetrating thorax injuries is demonstrated in this paper by six of the authors' own patients. While relief of cardiac tamponade is possible by pericardiocentesis, immediate and safe restoration of blood volume through a central vein or the right atrium, control of haemorrhage, and definite repair of the cardiac defect can be achieved only by thoracotomy. PMID- 3673311 TI - [Lezius nailing under controversy? Experiences with Lezius-Herzer curved nailing in 1,062 pertrochanteric femoral fractures]. AB - Curved nailing according to Lezius and Herzer was applied to 700 of 1,062 cases of pertrochanteric fractures of the femur at the Surgical Department of the "Carl Gustav Carus" Medical Academy, Dresden, between 1964 and 1985. Complications are described, and results are generally compared with other surgical techniques used to handle pertrochanteric fractures of the femur. Lezius nailing, when compared to other methods, has proved to be a simple and reliable approach, primarily under the aspect of geriatric traumatology, and should be used on a much wider scale. PMID- 3673312 TI - [Middle-hand and finger fractures]. AB - An account is given in this paper of 299 metacarpal and phalangeal fractures. Cases of that kind have a negative impact on the absence-for-illness record in national economy. Careful conservative therapy based on clear-cut concepts and unambiguous indications for surgery are considered necessary for the purpose of shortening absence periods. Conservative treatment still is applied to most of all phalangeal fractures (94 per cent); while less than 25 per cent of all metacarpal fractures are successfully handled by surgery. PMID- 3673313 TI - [Ambulatory surgery in orthopedics]. AB - Growing importance is being assumed by orthopaedic outpatient surgery. An account is given in this paper of advantages, obstacles, prerequisites, surgical indications, preparations for surgical intervention, and anaesthesia. Close cooperation between the clinical and outpatient departments has proved to ensure smooth transition in patient care from one sector to another in the case of complications. PMID- 3673314 TI - [Replantation of upper limb segments. Case reports from a large health care clinic]. PMID- 3673315 TI - [Intraneural ganglion of the peroneal nerve]. PMID- 3673316 TI - [Effect of defined body stress in pregnancy on the functional values of the maternal cardiovascular system and fetal heart rate]. AB - Four healthy women are subjected to a defined physical training in the 22nd and 34th weeks of pregnancy. Systolic and diastolic blood pressures, maternal heart rate, respiratory quotient, oxygen pulse, tension-time index and oxygen partial pressure are determined. In addition, the fetal heart sounds are registered in the 34th week of pregnancy. Normal levels of cardiorespiratory function can be detected in three patients. Fetal heart rate is likewise unremarkable. A considerable rise in blood pressure during exercise in one women only and, moreover, two accelerations of a duration of 6 to 7 minutes and a frequency of 200 beats per minute are recorded on the fetal cardiogram. The influence of physical training on uteroplacental circulation during pregnancy is discussed considering the results reported in the pertinent literature. PMID- 3673317 TI - [Effect of hypertensive gestosis on the condition of the fetus]. AB - In a retrospective study fetal risk was investigated in 138 pregnant women with hypertensive gestosis was investigated by means of selected parameters. We used the patho-physiologic classification and divided the patients in the groups of preeclampsia and chronic hypertension. By this it is possible to show in preeclampsia a larger shore of premature infants and a latent deficient fetal development. There is no significant difference of the average duration of pregnancy between the two groups. The gestosis symptoms of hypertension and proteinuria show differences with regard to their pathogenetic value. Correlative analyses between blood pressure values and proteinuria show predominantly inverse relations to pregnancy duration, birth weight of the newborn and pH-values in the umbilical artery post partum. On the other hand, they cannot be demonstrated in chronic hypertension. The results are being discussed in connection with possibly occurring differences of cardiocirculatory parameters and uteroplacental perfusion in either group of gestosis. PMID- 3673318 TI - [Effect of caffeine on the contractility of the fetal heart muscle]. AB - The caffeine-induced changes in contractility of early human fetal hearts obtained from termination of pregnancy and surviving in nutrient solution was studied. Three concentrations of caffeine (0.01; 0.1 and 1 mMol/l) were applied. In the presence of caffeine there was a significant age- and concentration dependent increase in the contractility of fetal hearts. On the basis of this positive inotropic and the previously observed tachycardiac effect of caffeine the authors call attention to the potential harmful effect of the drug on the fetal heart. PMID- 3673319 TI - [Hysterectomy within the scope of cesarean section]. AB - In this paper 19 cases of caesarean hysterectomy were analysed with regard to indications, choosing the method of operation, post-surgery procedure and management in cases of surgical complications. In period 1975-1985 in Ist Clinic of Obstetrics and Gynecology in Bytom we had 2,961 sections. Caesarean hysterectomy occurred in 0.07% of normal deliveries and in 0.64% of caesarean sections. The most frequent indication for caesarean section followed hysterectomy was placenta praevia (28%) and the most frequent indication for hysterectomy was atony and coagulopathy (32%). In all cases a total abdominal hysterectomy has been made. Mortality rate was 10.5% and the most frequent complications were lesions of urinary bladder (10.5%). The results obtained have been compared with the data from world literature. PMID- 3673320 TI - [Detection of the early pregnancy factor (EPF) in the serum of patients with questionable pregnancy]. AB - The early pregnancy factor (EPF) has been detected in sera of 24 women with a doubtful pregnancy by means of the rosette inhibition test using a horse antihuman lymphocyte serum. In all sera of women with an intact early pregnancy the EPF was found, furthermore in a pregnancy ending as abortion and two cases of an Arias Stella phenomenon. In non-pregnant patients the EPF was not detectable with exception of two patients under medication and one patient suffering from dysmenorrhea membranacea. PMID- 3673321 TI - [Overlap behaviour as a cell-biology characteristic of cultivated ovarian cancer cells]. AB - The in vitro growth behaviour of ovarian cancer cells is investigated regarding its ability to characterize this tumor biologically. Out of 60 patients suffering from ovarian cancer with different extension and histologic types 79 in vitro cell cultures were cultivated from either tumor biopsies, ascites or pleura effusions. The overlap index of each culture is calculated by the ratio of actually observed to as a maximum expected nuclear overlaps and is compared to parameters being acknowledged characterization of ovarian carcinomas. Correlations were found between overlap behaviour and other typical parameters such as histologic type, grading, and tumor staging. Beside some other parameters nuclear overlap index seems to be appropriate for characterization of neoplastic ovarian tumors. PMID- 3673322 TI - [Free amino acids in normal and carcinomatous ovarian tissue in correlation with serum level--tumor diagnostic possibilities]. AB - Free amino acids were investigated in samples of normal and carcinomatous ovarian tissues by amino analyser AAA 881 (Mikrotechna, Praha). The level of amino acids in cancer tissue was 2.5-5 times higher than in normal ovarian tissue. There was no difference in serum amino acid levels of patients with benign ovarian tumours and healthy women. Significant differences of free amino acid level were found in cancer patients in correlation to normal female persons. It is possible to use these alterations for tumour diagnosis. PMID- 3673323 TI - [Free serum amino acids in patients with tumors of different sites--tumor-induced imbalances]. AB - We analysed 10 free serum amino acids of altogether 8 different malignant organ localisations before therapy and compared this with reference levels. We investigated asparaginic acid, glutaminic acid, glycine, alanine, valine, methionine, leucine, isoleucine, tyrosine and phenylalanine. All investigated amino acids with the exception of methionine show an elevated level compared to normal one. After successful therapy the elevated levels returned to normal ones and could be found increased in recurrent diseases. The analysis of amino acids in serum is a good method in therapeutic monitoring. PMID- 3673324 TI - [DNA in koilocytotic dysplasia of the cervix uteri, cytophotometric studies]. AB - In koilocytotic dysplasia of the uterine cervix the DNA content in squamous cells was quantitated by cytophotometry in histological preparations stained according to Feulgen. Three patterns of DNA distribution in the squamous cells were found. In type one (21.4%) the cells had DNA content in the diploid and paradiploid zone of the histogram. In type two (35.7%) cells with triploid and tetraploid DNA values were found, but with a conspicuous modal class of cells. In type three no modal class cells were found (42.9%). The quantitative DNA changes in squamous cells show that some of the HPV induced alterations may be regarded as precancerous. PMID- 3673325 TI - [A case of stromatosis uteri]. AB - A report given about a case of stromatosis uteri. The age of the patient was 42 years. This illness can be interpreted as a favourable form of sarcoma uteri. An intensive follow up is necessary following operative therapy. PMID- 3673326 TI - [Grawitz tumor in pregnancy]. AB - One case of adenocarcinoma of the kidney during pregnancy has been demonstrated. PMID- 3673327 TI - [Principles in prevention, early detection, treatment and after care of endometrial cancer]. AB - The paper is the summary of a workshop and contains guidelines for prophylaxis, early detection, treatment and follow-up of endometrial cancer recommended by the Central Institute of Cancer Research as well as the Medical Associations of the German Democratic Republic. PMID- 3673328 TI - [Possibilities and evaluation of the use of tumor markers in gynecologic oncology. 1. Biochemical parameters]. AB - There can be not doubt that a knowledge of cancer diagnosis is becoming of increasing importance throughout all medicine disciplines. Neoplastic disorders are usually related with the incidence of heterologic molecules, so called tumor markers. The authors present in this paper a selection of these substances which are able to announce malignant growth in gynaecologic oncology. They give recommendations in favour of practice. PMID- 3673329 TI - A comparison of live and formalised leptospiral microscopic agglutination test. AB - The sensitivity and reliability of a formalised leptospiral antigen battery was compared with a smaller battery of live leptospiral antigens with 152 human sera positive for leptospirosis. There was good concurrence of results between the formalised and live antigens, however the live battery did fail to detect some positive sera where the antibody level was low. The formalised antigens were more sensitive than the live (P less than 0.001) and more reliable in the detection of early leptospiral infection, but the live antigens were more specific in the determination of probable infecting serogroup. PMID- 3673330 TI - Lectin mediated adhesion of Streptococcus pneumoniae and its specific inhibition in vitro and in vivo. AB - According to our hypothesis, bacterial lectins play an important role in the organotropy of infectious diseases which is analogous to the metastasis of tumor cells. As a model for proving this, we investigated the specific lectin of Streptococcus pneumoniae, which has N-acetyl-D-glucosamine/D-galactose (GlcNAc Gal) specificity. In vitro, after incubation with Streptococcus pneumoniae, cryotome sections of various organs from Balb/c-mice showed remarkable quantitative differences of bacterial adhesion to the organ cells. Whereas lungs and meninges were closely settled with bacteria, attachment to other organs (e.g. liver, spleen, brain) was lacking. In vitro lectin-blocking by GlcNAc completely prevented the adherence of Streptococcus pneumoniae to lungs and meninges. Other non-related carbohydrates (e.g. D-mannose, D-xylose) showed no effect. During in vivo experiments with Balb/c-mice, intratracheal application of Streptococcus pneumoniae led to a diffuse settlement of the lung. However, bacterial lectin blocking with intratracheal GlcNAc administration completely inhibited adhesion to the organ cells of the lung. Therefore blocking of bacterial adhesins with competitive specific monosaccharides can completely prevent bacterial adhesion processes, a fact, which opens therapeutical aspects. PMID- 3673331 TI - Determination of aspoxicillin (TA-058) by high-performance liquid chromatography. Stability at different temperatures. AB - A rapid and sensitive HPLC-method has been developed for the determination of serum concentrations of aspoxicillin (TA-058), a new semisynthetic beta-lactam antibiotic. Aspoxicillin was chromatographed with a phosphate buffer/methanol (92:8 v/v) mobile phase and a C-18 reversed phase column and was detected at a wavelength of 220 nm. The stability of aspoxicillin in serum and buffer at different temperatures was studied over a time period of 3 months. Furthermore, the degradation of aspoxicillin versus piperacillin was determined in serum and buffer at 37 degrees C. Aspoxicillin remains stable only at -70 degrees C whereas degradation has been observed at -20 degrees C and 4 degrees C. At 37 degrees C, 20% of aspoxicillin is degraded in serum within 24 h whereas piperacillin is completely degraded under the same conditions. PMID- 3673332 TI - Prevalence of staphylococcal zoonosis in pyogenic skin infections. AB - S. aureus aetiology was found in 76.47% of the 102 pyoderma cases under study, with a high frequency of incidence in children below 5 years of age. The majority of the S. aureus isolates was nontypable (50.0%) and among the typable strains, phage group-III (31.0%), Group-I (20.7%) and a mixed phage group (34.5%) were predominant. 28.2% of the isolates were S. aureus var. bovis and 2.6% were S. aureus var. canis subgroups. Zoonoses in staphylococcal pyogenic skin infections were proved in 9 of the cases, which showed the history of direct animal contact supported by the isolation of S. aureus of animal host origin. Dogs, cattle and poultry were found to be the most important reservoirs transmitting S. aureus to humans, with folliculitis, furunculosis, impetigo as the frequent clinical manifestations. PMID- 3673333 TI - Isolation of influenza A viruses from migratory waterfowls in San-in District, Western Japan in winters of 1980-1982. AB - In the two winters of 1980-1982, we surveyed migratory waterfowl of some species staying in San-in District, Western Japan for influenza virus at a few stations. From November 1980 to April 1981, only two strains of influenza virus, H13N1 and H11N6 subtypes, were isolated from 465 fecal samples from pintails but none from 255 samples from whistling swans nor from 625 black-tailed gulls. From November 1981 to March 1982, 17 viruses were isolated from 1156 fecal samples. Fourteen viruses, 10 H7N3, 2 H1N6 and 2 H3N8, were isolated from 459 feces samples from whistling swans. Two viruses, H13N3 and H13N6 subtypes, were isolated from 425 fecal samples from black-tailed gulls. A strain belonging to H1N3 subtype was isolated from 30 feces samples from mallards but no virus was isolated from 242 samples from pintails. PMID- 3673334 TI - Staphylococcus aureus strains of the 94/96 complex isolated in the German Democratic Republic: incidence and discrimination of strain clones. AB - The incidence of S. aureus with a phage pattern of 94/96 rose from 9% in 1979 to 18% in 1985. The frequency of occurrence not only increased among isolates from inpatients and outpatients but also among those from healthy carriers. All of the 504 investigated strains of different origin exhibited a uniform pattern of biochemical characteristics. In each of 40 investigated strains, a plasmid with a molecular mass of 16 Md was found. Elimination experiments indicated that these plasmids determined resistance to penicillin and/or cadmium. Resistance to chloramphenicol was found to be determined by plasmids of 2.0 Md, resistance to oxytetracycline by plasmids of 2.7 Md. Clones could be discriminated by means of 7 experimental phages. The application of these phages for typing strains from infections in hospitals is demonstrated. PMID- 3673335 TI - Serotyping of Plesiomonas shigelloides strains with our own antigenic scheme. An attempted epidemiological study. AB - Thirty-four O and 19 H sera were used to test 169 strains of Plesiomonas shigelloides from several countries of three continents. The most frequent O serovar was O17 (O antigen identical with Shigella sonnei phase I) which occurred in the OH serovar combinations: O17:c, O17:d and O17:f. Some OH serovars were represented by a single strain; others, despite the small number of strains in hand, were evidently ubiquitous, having been isolated in mutually distant countries or at long time intervals. The source of our strains was most often human stools, diarrhoeal or collected at preventive examinations during epidemiological and ecological investigations, the droppings of animals (dogs, cats, pigs, sewer rats, water birds) and surface, sewer or aquarium water. The usefulness of serotyping in epidemiological investigation in the patients' environment was confirmed by a finding of two different serovars in one of our patients and her cat. PMID- 3673336 TI - Colonization with genital mycoplasmas in pregnant women and their neonates and birth weight. AB - The colonization by genital mycoplasmas of mothers and their newborn infants was examined in 114 pregnant women and their 84 neonates. Urine and cervical swabs were taken from the pregnant women in the last trimester, and urine from the neonates within six days after birth. Ureaplasma urealyticum was found in 73.7% of the pregnant women and in 17.9% of the neonates. Mycoplasma hominis was isolated in 8.8% of the material from the pregnant women and in 1.2% of that from the neonates. The isolation rate of U. urealyticum from newborn girls was significantly higher than that from newborn boys (p less than 0.01). There was no correlation between the germ density in the urine of the pregnant women and that of the neonates. The urine of the neonates harboured as many U. urealyticum as that of the adults. The frequency of colonization by mycoplasmas in the pregnant women or the neonates was not related to the duration of gestation or the babies' birth weight. PMID- 3673337 TI - Oncolysis by Clostridium oncolyticum M55 and subsequent enzymatic determination of sialic acid in serum. AB - Since the discovery of the "Clostridium tetani phenomenon", various apathogenic clostridia have been used for tumour lysis. Experiments have been conducted to achieve a tumour diagnosis using radiolabelled antibodies to clostridia. In addition, a method has been described that distinguishes, with variable success, between healthy and tumour-carrying animals by means of hemagglutination. The method outlined here uses the fact that malignant cells produce a multitude of sialic acid compounds which lie on the cell membrane and are also connected to the lipid layer of the tumour cell membrane. The apathogenic Clostridium oncolyticum M55 only germinates and multiplies in the malignant tumour tissue. Thus; bacterial hydrolases can enter the tumour tissue and lead to oncolysis. Subsequently the glycocompounds which can be detected by means of an enzymatic determination of the concentration of neuraminic acid (one of the sialic acids) in the serum are washed out into the peripheral blood. We observed these processes in mice in the Ehrlich ascites solid carcinoma and in the Lewis lung carcinoma. Using this method it was possible to detect tumour growth at an early stage with impressive accuracy. The Lewis lung carcinoma which secretes only small amounts of sialic acid glycocompounds cannot be distinguished from the control group by determination of sialic acid concentration. It was possible to detect a 52% increase in the amount of sialic acid after administration of spores of clostridia. This method makes it possible to increase the tumour marker sialic acid through manipulation of the tumour, using apathogenic clostridia, and to measure of sialic acid concentration as an indicator of the metabolic products of the tumour. PMID- 3673338 TI - Production of bacteriocin-like agents of Budvicia aquatica and "Pragia fontium". AB - In cultures of 9 budvicia aquatica and 5 "Pragia fontium" strains production of distinct bacteriocin-like agents was proved. It is suggested to call them aquaticins and fonticins. They display strain specific antibacterial activities towards both genera; however, they are not active towards Escherichia coli or Shigella sonnei indicators. Their inhibition zones are conspicuously narrow (turbid or clear). Their spontaneous production may be enhanced by UV-induction of producing bacteria. They are readily set free into the medium; no intracellular accumulation occurs. With only one exception, they are trypsin resistant and remarkably heat-sensitive, being damaged at 45 degrees C to 55 degrees C. All these results suggest that aquaticins and fonticins are of corpuscular character. This assumption was proved true by electron microscopic observation of one of the fonticins: this resembles contracted tails of bacteriophage T4. PMID- 3673340 TI - Serological typing of reference strains and clinical isolates of Streptococcus mutans by agglutination reactions and/or radioimmunoassay. AB - Rabbit antisera were prepared against eight different serotypes of Streptococcus mutans. After absorption with heterologous serotype strains the antisera were able to distinguish 21 reference strains of different serotypes of S. mutans by simple agglutination reactions and radioimmunoassay, both using intact whole cells. The reference serotypes a, b, d and g were differentiated by specific agglutination using the corresponding monospecific antiserum. Strains of serotypes c, e, f and h were discriminated by differential agglutination using anti-c, anti-e, anti-f or anti-h serum respectively, but the antisera cross reacted slightly with other serotype strains. Using these antisera a total of 261 clinical isolates of S. mutans from human dental plaques were serotyped by agglutination reactions, in addition to which radioimmunoassay and the classical immunodiffusion tests in agar were also used in some cases. The results were quite consistent in the three methods. The predominant strain was of serotype c (187), followed by serotype f (28), g (10), d (5), e (4) and b (1). 26 strains were untypable and there were no serotype a or h strains. PMID- 3673339 TI - Methodological aspects of a serodiagnostic Clostridium tumour test--experience with spontaneous canine tumours. AB - The paper describes the development of appropriate antigen and method combinations for the microbiological cancer test using the non-oncolysing strain Clostridium butyricum CNRZ 528 in dogs with spontaneous tumours. The diagnostic rod antibodies could be determined quantitatively by the complement fixation test if a short-time warm fixation and a long-time cold fixation procedure were combined in separate runs and if two different antigens, a rod corpuscular antigen and a rod surface antigen, were used. Since complement-fixing antibodies were not always detected in cases of malignant tumours, we additionally used the passive haemagglutination method after pre-absorbing the sera with cross-reacting clostridial antigens. The efficiency of the microbiological cancer test could not be substantially increased, however, by the method combination the reliability of the evaluation of low seropositive titres was improved. PMID- 3673341 TI - Identification of anaerobic bacteria using high-performance liquid chromatography. AB - 20 species of the genera Clostridium, Bacteroides, Fusobacterium and the type strains of Peptostreptococcus anaerobius, Peptococcus asaccharolyticus, Veillonella parvula and Propionibacterium acnes were examined for the production of volatile (VFA) and nonvolatile (NVFA) short-chain fatty acids using high performance liquid chromatography (HPLC) with a column for organic acids (Aminex HPX-87H). 10 min are needed for sample preparation and the VFA and NVFA were detected simultaneously in a single chromatographic run. The total time required to run each chromatogram was approximately 60 min. With regard to the production of short-chain fatty acids in culture media it was possible to identify the species of the genera rapidly and clearly. The results illustrate the role of HPLC in determinating short-chain fatty acid products as an additional means for rapid differentiation between closely related anaerobic bacterial species. The aim of the method developed is to establish a complete automatization for the identification of anaerobic bacteria using an automatic sampling system and a microprocessor-controlled chromatography unit. PMID- 3673342 TI - The influence of various bacteria on the cecal mucosa of monoflora chickens infected with Eimeria tenella. A scanning electron microscopic study. AB - Monoflora chickens were established at the age of 2 days by an oral inoculation of one of six species of bacteria (Lactobacillus acidophilus, Bifidobacterium thermophilum, Bacteroides vulgatus, Clostridium perfringens, Escherichia coli, or Streptococcus faecalis). Two days later the chickens were infected with Eimeria tenella (5 X 10(4) oocytes per bird). There were four groups: uninfected birds as controls, the birds infected with either bacteria or E. tenella alone, and the birds infected with bacteria and E. tenella. As observed under the scanning electron microscope (SEM) seven days after E. tenella infection, damage of the cecal mucosa in all groups infected with bacteria + E. tenella was more severe than in that infected with E. tenella alone. Most severe damage to the cecal mucosa was found in the birds infected with either C. perfringens or B. thermophilum combined with E. tenella. PMID- 3673343 TI - Induction of human neutrophils chemotaxis by staphylococcal lipase. AB - Influence of highly purified staphylococcal lipase on chemotactic activity of human polymorphonuclear leukocytes (PMN), has been studied. Staphylococcal lipase exhibited both chemotactic and chemokinetic properties. Chemotactic response was stimulated at concentration as low as 10(-9) M and was dose-dependent. Pretreatment of PMN with lipase, strongly enhanced chemotactic response toward casein. At the same time, spontaneous migration of these PMN was inhibited. It has been demonstrated that staphylococcal lipase binds to the leukocyte surface. Several possible mechanisms of lipase-induced chemotactic response of human PMN are discussed. PMID- 3673344 TI - Uptake of selected antibacterial agents in Mycobacterium avium. AB - The antibacterial action of 64 drugs against Mycobacterium avium ATCC 15769 was screened in Middlebrook 7H9 liquid medium. The most active drugs were ansamycin, rifampicin, clofazimine, and pristinamycin. The antibacterial action of the selected drugs was confirmed by testing clinical isolates on Middlebrook 7H10 agar medium. The antibacterial actions were not related with the hydrophobicities and molecular weights of the drugs. However, all the active drugs were highly hydrophobic molecules of low polarity. These drugs dissolved into the lipids forming the outer layers of the bacterial envelope and they appeared to interact with the surface amphiphils. PMID- 3673345 TI - Modifying effects of pH and temperature on (14C)erythromycin uptake into Staphylococcus aureus--relation to antimicrobial activity. AB - The uptake of (14C)erythromycin into Staphylococcus aureus was investigated by use of a rapid centrifugation method. Erythromycin uptake was saturable with time and with increasing erythromycin concentrations (apparent uptake constant Km = 6.0 x 10(-7) moles/l). Inhibitors of glycolysis, respiration and oxidative phosphorylation did not influence the uptake process but uptake was decreased by reducing temperature. Increases of erythromycin uptake, decreases of half life times of the uptake reaction and a log dose linked to enhancement of antimicrobial activity were seen with alkaline pH levels of the incubation medium. The experimental data conform well with the concept of non ionic diffusion. The high affinity of erythromycin to the intracellular ribosomal target site probably generates the driving force of uptake and the unionized antibiotic obviously represents the antimicrobially active molecular form. PMID- 3673346 TI - Abstracts of papers presented at the 40th meeting of the Deutsche Gesellschaft fur Hygiene und Mikrobiologie, Bochum, October 2-5, 1985. PMID- 3673347 TI - Abstracts of papers presented at the 12th meeting of the Deutsche Gesellschaft fur Parasitologie e. V., Wien, 23.-25.4.1986. PMID- 3673348 TI - DNA pattern in choroid plexus papillomas. AB - Report on Feulgen-cytophotometric DNA studies of 8 choroid plexus papillomas. 7 tumours reveal distinct diploid stemlines in their karyogram. One tumour with oncocytic transformation exhibits a stemline in the triploid stage. These findings reflect the DNA pattern of a benign euploid neoplasm of the there investigated tumours. PMID- 3673349 TI - Apoplectic course of meningiomas. AB - The authors present 5 cases of meningiomas producing apoplectic symptoms, which appeared among 196 meningeal tumors operated upon from 1969 to 1983. In 4 cases the illness simulated acute cerebral ischaemia, the fifth patient presented twice subarachnoid haemorrhage. The authors discuss possible mechanisms of apoplectic course of meningiomas. PMID- 3673350 TI - Single unit potential amplitude in relation to the conduction velocity in frog and human. AB - The single unit potential amplitude increases with the conduction velocity. The absolute value of the potential amplitude depends on the conditions of the actual preparation. Since the conduction velocity is correlated to the nerve fibre size the large single unit potentials represent thick, fast conducting nerve fibres. In cases where the single unit potential activity is so high, that it is difficult to measure conduction velocities or of it is recorded only with one electrode pair, rough information about conduction velocities and classes of nerve fibres can be obtained from the single unit potential amplitudes. PMID- 3673351 TI - Acute aneurysmal haemorrhage presenting as space occupying subdural haematoma. AB - With this report on 3 cases of subarachnoid haemorrhage presenting like a space occupying acute subdural haematoma the authors want to remind clinicians of the danger of overlooking an intracranial aneurysm in cases of acute subdural haematomas, when relying diagnostically only on CT findings. Frequency and possible mechanism of this phenomenon is discussed taking into account data from the literature. In any acute subdural haematoma without clear traumatic aetiology or with symptoms and signs in the history which could indicate the possibility of a subarachnoid haemorrhage should angiography be done. PMID- 3673353 TI - [A paper clip as an inexpensive replacement for microclips in end-to-side anastomoses]. PMID- 3673352 TI - Mixed gliomas. Their clinical course and results of surgery. AB - 43 cases of mixed gliomas (oligoastrocytomas) selected out of 505 supratentorial glial tumors were reviewed. 26 tumors were designated grade I and 17 as grade II. In 29 tumors two glial components occurred in about equal amounts whereas there was oligodendrocytes predominance in 11 cases and astrocytes preponderated only in 3 cases. 56% of the patients were male and 44% female. The mean age at the time of diagnosis was 45.6 years. There were 9 postoperative deaths and the result of surgery was poor in 6 cases. In the remaining 28 cases the immediate result was good or fair. There was a distinct tendency showed by the tumors with oligodendroglial cells predominance to involve the basal ganglia or contralateral hemisphere. As a corollary, these tumors had worse prognosis than the others. There was no difference in the result of surgery comparing grade I and II tumors. The average postoperative survival period was 47 months and the mean life span after the appearance of the first symptoms was 5.5 years. We failed to find the significance of divading tumors into grade I and II categories when applied to survival period. PMID- 3673354 TI - [Aneurysm surgery in relation to secondary intracranial findings]. AB - In 116 patients operated on because of aneurysms we found 125 aneurysms, one convexity meningioma, and one A. V. supratentorial angioma. In 9 patients (8%) more than one aneurysm were found. In 8 patients there were double aneurysms and on one case 4 aneurysms, 18 of these 20 aneurysms were clipped. If these were situated on the same side they were treated simultaneously. If they were situated on two sides, the aneurysms were clipped in two surgical interventions. In 2 patients one of the two aneurysms remained untreated. Two interventions were also carried out for the combination aneurysm/tumor. After clipping the aneurysm, the meningioma was removed after an appropriate interval. PMID- 3673355 TI - [Recurrent cystic "hypophyseal abscess"]. AB - A report is given on a primary hypophyseal abscess with an acute chiasmal syndrome, the only case among 426 hypophyseal interventions. In spite of two pterional exposures a relapse occurred, so that in the third operation a transethmoideo-sphenoid access was chosen. In this procedure--as the method of choice--a drainage into the paranasal sinuses is reached. The genesis is discussed on the basis of the histological findings, assuming differential diagnostically a Rathke's cyst as the starting point. PMID- 3673356 TI - [Nuclear magnetic resonance imaging in the area of the cranial base]. AB - Short TR (time repetition) and TE (time echo) images usually display pathologic structures unsatisfactorily. Tumors appear larger in MR than in computer tomography (CT). Additional examinations with intensive x-ray exposure are not necessary, as the better soft tissue contrast in MR allows for a distinct demarcation of the pathologic structure. T2-weighted images of brain stem angioma and pinealoma are not better than T1-weighted images. In the skull-base area, the sagittal plane best displays the anatomical-pathological relationship. The second plane is necessary for three-dimensional demarcation. On the second plane, the use of identical sequences is helpful, as the optical comparison of light intensity in pathologic tissue is easier. PMID- 3673357 TI - Some aspects of measuring intracranial pressure. AB - The problem of measurement of intracranial pressure in the epidural space is discussed in the light of the authors' own experience. Three forms of transducers have been used consecutively: (1) a capsular form which slides into the epidural space, (2) a screw-shaped form, fixed firmly in a burr hole and (3) a cylindrical tape, designed to be fixed in a burr hole with the aid of a protective socket. The zero point may be adjusted during measurement. The merits and disadvantages of these three types of transducer, as well as the practical problems connected with their use are discussed. PMID- 3673358 TI - [Psychologic adjustment process following high cervical spine paralysis and its support by a bedside reading apparatus]. AB - The process of psychological adjustment, which has to go on after high levelled lesions of the cervical spinal cord, passes through several phases. It needs a lot of empathy, plenty of time for confidential talks and psychological knowledge as well as an individualizing cooperation between the several levels and stages of combined treatment during rehabilitation. We could give this process a considerable advance by a (half-) automatic bedside-projection of belletristic literature, which can be continuously read on a screen from long film strips by means of a modified Pentacon system. The introduction of this new object in life proved a good support for the threatened personality of those badly handicapped patients. PMID- 3673359 TI - [Surgical management of perinatal damage of the brachial plexus]. AB - The etiology of the plexus brachialis palsy is in generally well known. The dimensions of clinical signs is correlating with the severeness of the birth trauma and therefore with the degree of morphological damage, as well. In our remained after conservative therapy in 5% a severe lesion of the plexus. An improvement of motorical functions could be observed. The paper presents 5 cases with severe plexus brachialis lesions which had been operated on and gives a look to the postoperative results. PMID- 3673360 TI - Three observations of familial incidence of the central nervous system neoplasms. AB - The authors report of 3 observations of the familiar incidence of the central nervous system neoplasms. In the first case it was brain astrocytoma in 2 brothers, in the second case is was man with the meningioma of falx cerebri and his sister with capillary hemangioma of the cerebellum, in the third case it was a woman with astrocytoma of the left temporal lobe and her brother with medulloblastoma. The authors are of the opinion that it was only coincidence in all three cases. PMID- 3673361 TI - [Experimental studies on the effect of chronic aerogenous toxic gas burden of suckling pigs with different ammonia concentrations. II. The reaction of cellular and humoral infection defense mechanisms of NH3-exposed suckling pigs under the conditions of an experimental Pasteurella multocida infection with and without thermomotor stress]. PMID- 3673362 TI - Liquid versus dry feeding in weaned piglets: the influence on small intestinal morphology. PMID- 3673363 TI - [Experimental studies on the effect of a chronic aerogenous toxic gas burden of suckling pigs with different ammonia concentrations. 3. Light and electron microscopic studies on the pathology and pathogenesis of chronic aerogenous ammonia damage to the respiratory apparatus of the piglet]. PMID- 3673364 TI - [Experimental infection with Leishmania in the dog: clinical, pathologic, parasitologic and serologic findings]. PMID- 3673365 TI - [The effect of the paramunity inducer PIND-ORF on the flight performance of healthy and sick carrier pigeons (Columba livia Gmel., 1789, var. dom.)]. PMID- 3673366 TI - 27-nm virus particles found in the faeces of a cat with vomiting and diarrhoea. PMID- 3673367 TI - [Mechanisms of the initiation of lipid peroxidation in the synaptosomes of marine teleosts]. AB - The initial rates of NAD- and NADPH-dependent enzymic and Fe+-ascorbic acid dependent nonenzymic lipid peroxidation have been measured in synaptosomes from the brain of 4 teleost species. The rates of peroxidation were compared with lipid composition and fatty acid composition of total lipids in order to reveal factors accounting for the intensity of peroxidation in the excitable membranes from the brain of ectotherms. The data obtained indicate that the rates of enzymic lipid peroxidation do not correlate with lipid and fatty acid compositions, depending on the efficiency of production of oxygen in the active form by pyridine nucleotide-dependent enzymic systems. Activation of lipid peroxidation during adaptation of animals to the environment may be considered as one of the mechanisms which account for compensatory changes in fatty acid composition of the membrane lipids. PMID- 3673368 TI - [Immunochemical properties of erythrocyte-specific histone H5 in salmonid fishes]. AB - Comparative studies have been made on the immunochemical properties of histone H5 in Salmonidae species. High degree of homology between these histones and H5 histone from Oncorhynchus tschawytscha was demonstrated by microcomplement fixation. Properties of H5 histones in fish and birds are discussed. PMID- 3673369 TI - [Rhythmic activity of the endbrain in the carp evoked by adequate visual stimulation]. AB - In acute experiments on immobilized carps, under dark adaptation conditions, studies have been made on the electrical activity of the telencephalon and midbrain tectum. It was found that in the latter photostimulation evokes local rhythmic activity which includes fast (30-50 Hz) phasic (200-300 ms) and slow (8 14 Hz) tonic (up to 3-4 s) components. High rhythm of this activity may be observed only in "healthy" preparations, coinciding with on-rhythm in the midbrain tectum. Low rhythm does not depend on the presence of rhythmic activity in the tectum. Various aspects of the development of the thalamo-telencephalic system in vertebrates are discussed. PMID- 3673370 TI - [Spectral analysis of the cardiac rhythm of fishes]. AB - Spectral analysis of the rhythmograms in the cod Gadus morhua callarias, plaice Pleuronectes platessa, herring Clupea harengus membras and trout Salmo gairdneri revealed complex wave structure of their cardiac rhythm. In all the species investigated, slow (0.01-0.06 Hz), intermediate (0.06-0.25 Hz) and fast (0.25-0.5 Hz) waves were recorded. It is suggested that the wave structure of cardiac rhythm reflects rather complicated relationships between functional systems regulating cardiac activity. PMID- 3673371 TI - [Role of motor activity in the development of hypothyroid rat pups]. AB - Studies have been made on the role of the thyroid in the development of rats. In the first group of experiments, newborn rat received within a month mercazolyl which inhibits the activity of the thyroid; in animals of the second group, mercazolyl injections were combined with cold exposures which stimulated motor activity in animals. It was found that hypothyroid rats in both groups exhibit retardation of growth as compared to normal animals. However, retardation is less significant in animals of the second group, as it is indicated by smaller changes in the protein content and total mass of skeletal muscles. PMID- 3673373 TI - [Interaction of reversible inhibitors with the cholinesterase of the squid Berryteuthis magister from different areas of the Bering Sea]. AB - Studies have been made of the interaction of 13 onium reversible inhibitors with cholinesterase from the visual ganglia of the squid B. magister from various habitats (Kurile Islands, Olyutorsk-Navarin and Navarin-Alaskan regions). In some of the cases, differences were found between the enzymes from various specimens with respect to values of the generalized inhibitor constant (which is a measure of inhibitor effectiveness) and the pattern of inhibition. These data reveal intraspecific polymorphism in B. magister from the Bering Sea. PMID- 3673372 TI - [Holotoxin content in the tissues of the holothurian Stichopus japonicus at different seasons of the year and their effect on oocyte maturation]. AB - Seasonal variations and distribution of holotoxins in tissues of the sea cucumber Stichopus japonicus have been studied. It was shown that holotoxin content in the ovaries is higher than that in other organs during the breeding season. In the course of a year, the amount of glycosides in other holothurian organs changed a little. It has been found out that high concentrations of glycosides inhibit oocyte maturation in the holothurian Stichopus japonicus. PMID- 3673374 TI - [Age-related characteristics of the effect of deafferentation of the mandible on the metabolism of sulfate, citrate, phosphorus and calcium in the bones]. AB - Mineral metabolism in the bones of 1- and 3-month rats reacts to a different extent to cutting the lower alveolar nerve. After deafferentation of the lower jaw, the decrease in the intensity of incorporation of the intraperitoneally injected [3-14C]-citrate and [35S]-sulphate in the bones is more significant in 1 month animals as compared to that in older ones. Deafferentation increased utilization of Na2H32PO4 and 45CaCl2 in the bones of younger rats, but decreased incorporation of 32P and remained unchanged incorporation of 45Ca in 3-month animals. PMID- 3673375 TI - [Adaptive-compensatory processes in the small intestine of young rats]. PMID- 3673376 TI - [Possible role of urinary beta-glucuronidase and proteins in regulating the physiological activity of androgen-dependent pheromones in the house mouse Mus musculus L]. PMID- 3673377 TI - [Immunogenicity of Yersinia pestis grown on nutrient media at 28 and 37 degrees C]. AB - The immunogenicity of Y. pestis strain EV, grown in yeast-casein medium, yeast medium with Hottinger digest and yeast medium with sunflower-seed protein at 28 degrees C and 37 degrees C, for guinea pigs and white mice has been studied. As revealed in this study, these media ensure the formation of highly immunogenic populations of Y. pestis strain EV and, therefore, can be used for growing Y. pestis vaccine strains. Considerable fluctuations in the content of such highly protective antigen as fraction 1 do not affect the immunogenicity of live cultures of Y. pestis strain EV. This is due to the leveling of differences in the content of this antigen in the process of the multiplication of these bacteria in laboratory animals. PMID- 3673378 TI - [Changes in the functional activity of the liver cells in rabbits during a bacterial infection]. AB - In the process of the development of bacterial infections, the activity of marker enzymes in the membrane structure of liver cells has been studied in rabbits by biochemical and electron-histochemical methods. The results of these studies have shown that, simultaneously with the progressing course of cell pathology and inhibition of the function of mitochondria, microsomes and peroxisomes, the lysosomes activate for the realization of the protective function formed in the course of evolution. At the same time the excessive labilization of lysosomal membranes facilitates the development of cell pathology, which is confirmed by the accumulation of residual bodies in the cytoplasm. PMID- 3673379 TI - [Morphological properties of erythrocytes and their deformability in cerebral circulatory disorders in patients with arterial hypertension]. AB - Using a scanning electron microscope, the authors examined changes in the shape of erythrocytes (E) in 85 patients with impaired cerebral circulation (ICC). Parallelly 48 patients were studied for the deformity and osmotic resistance of E. The control group consisted of 17 healthy individuals. The data obtained suggest significant alterations in the shape and functional properties of E in patients with ICC which correlated with parameters of blood viscosity and E aggregation. The degree of changes was determined by the duration of the underlying vascular disease, recurrent episodes of ICC and their severity. PMID- 3673380 TI - [Ultrastructure of the substantia nigra in schizophrenia]. AB - The compact portion of the substantia nigra containing dopamine neurons was studied at autopsy in schizophrenics and in a control group. Neurons presented pathological inclusions composed of electron dense material in the form of parallel rows of microstructures which were not observed in the control. It is postulated that they originate from microtubules in neuronal bodies and neurofilaments in neuronal processes. The authors revealed dystrophic-destructive changes in axon terminals in synapses on spikes, dendrites of variable diameters and the neuronal soma with hyperproduction of the membranous structures and reduction in the size of the active zone of synapses. Membranous structures were also detected both inside and outside myelin fibers. The data obtained are suggestive of a peculiar dystrophic process in neurons related probably to protein metabolic disorder and dystrophic-destructive changes in afferent systems of one of the dopamine areas of the brain. PMID- 3673381 TI - [BB creatine phosphokinase activity of the brain structures of mentally healthy persons and schizophrenics]. AB - Creatine phosphokinase (CPK) activity has been determined in certain brain structures of schizophrenics and control subjects. It has been found that CPK activity in different structures of the normal human brain is heterogeneous, being the maximal in the occipital cortex (2.80 U/mg of protein) and thalamus (1.87 U/mg of protein) and the minimal in the temporal cortex (0.30 U/mg). In schizophrenic patients, CPK activity was significantly depressed (by 80-90%, P less than 0.001) in the occipital cortex and thalamus, as well as in the substantia nigra, limbic cortex and grey tuber (P less than 0.001) but remaining unaltered in the frontal, temporal and parietal cortex. It has been demonstrated that decrease in CPK activity does not depend on the post-mortem interval, sex and age of those examined or the psychotropic therapy conducted but appears to be related to a pathological process in the nervous tissue. PMID- 3673382 TI - [Action of haloperidol on the ultrastructure of areas of the dopaminergic system of the brain]. AB - The ultrastructure of the olfactory tubercle was investigated in patients receiving prolonged (3-weeks-long) treatment with low doses (0.1 mg/kg) of haloperidol. This therapy was mostly associated with changes in the neuronal processes and glial cells. It has been found that ultrastructural rearrangement in neurons of the olfactory tubercle is functional in nature which indicates the change in the efficacy of synaptic transmission and in metabolic processes. It is postulated that chronic administration of low doses of haloperidol induces adaptive alterations mediated by DA receptor block. PMID- 3673383 TI - [Characteristics of the action of tetrapeptidamide on the body in short- and long term administration]. AB - It has been elucidated that the structures of the motor system of the rabbit and rat brain undergo significant alterations in monoamine metabolism 30 min after the administration of the synthetic enkephalin analogue Tyr-D-Ala-Gly-Phe-NH2 and in acetylcholinesterase activity and protein metabolism on the 3rd-6th day. It i suggested that a prolonged tetrapeptidamine-induced change in the motor functions may be due to a specific response on the part of the corticosubcortical structures of the motor systems. PMID- 3673384 TI - [Pathogenetic role of the abstinence syndrome in the development of alcoholic encephalopathy (morpho-immunological research)]. AB - In 219 male rats receiving for 8 months 10% ethanol solution instead of water either constantly or with multiple periods of discontinuation, the authors studied the morphological and immunological parameters in the period of the development of alcoholic encephalopathy and abstinence syndrome. Examination of the rat brain revealed chronic hemodynamic disorders and dystrophic-destructive changes in parenchymatous elements with superimposition of acute changes in the early stage of abstinence. Acute changes in the brain were attended by considerable disturbance of protein metabolism in neurons expressed in an altered rate of 3H-leucin inclusion. The development of acute morphological alterations in the brain tissue during abstinence was accompanied by the appearance of anticerebral antibodies in the blood of the animals. The obtained results represent new quantitative data on metabolic disorders of neuronal proteins and new immunologic data related to experimental alcoholic encephalopathy at different stages of abstinence. This evidence contributes to the understanding of the pathogenetic role of abstinence in the development of alcoholic encephalopathy. PMID- 3673385 TI - [Comparative clinico-psychological research on asthenic and sthenic remissions in attack-like schizophrenia]. AB - Using a clinico-psychological approach, personality changes have been studied in 40 patients with attack-like schizophrenia presenting asthenic (n = 22) or sthenic (n = 18) types of remissions. The common regularities have been identified, namely personality alterations of a superficial level with the preservation of "the nucleus of personality". In an asthenic type of remission the defect is total and all the main components of the personality are involved. This variant of schizophrenic defect is distinguished by impairment of the motivational-stimulating component of mental activity without reduction in its other components (exhaustion, fatigue, etc.) characteristic of asthenic syndromes of other etiology. In a sthenic type of remission personality changes are partial. PMID- 3673386 TI - [Linguo-statistical indices of speech production of schizophrenics]. AB - Using a linguostatistical method of examination, the author analyzed texts produced by 19 patients with the delirious syndrome, 20 patients with the hallucinational-delirious syndrome and 112 healthy subjects. On the basis of protocols in which those examined gave written definitions of 10 notions, 3 frequency alphabetic lists have been made up for each group of the patients and normal individuals. It has been established that verbosity, vagueness of definition and inadequate differentiation of the main and secondary signs are objectively manifested in the schizophrenic patients in an increase of a relative richness of vocabulary and of the proportion of rarely used words. Redistribution of parts of speech expressed in diminution of the proportion of verbs because of the predominance of pronouns and adverbs is explained by a reduced ability to formulate utterances, probably due to autism. PMID- 3673387 TI - [The place of psychological correction in the process of rehabilitating schizophrenics]. AB - Psychological correction as a well organized system of psychological impacts is one of the main components of the process of social and psychological rehabilitation of mental patients. Psychological correction is particularly important in the organization of rehabilitational work with schizophrenic patients because of disorders of social behaviour typical of such patients. According to the findings of the study on spontaneous adaptation in schizophrenic patients, the following tasks have been set up to optimize social behaviour with the help of psychocorrective methods: the search for intact structures in the emotional-motivational sphere, purposeful formation of social behaviour, and the search for the individual social niche. Psychological correction in patients with slowly progressive schizophrenia is constructed in the form of a diagnostic corrective complex consisting of experimental-psychological techniques aimed at determining individual psychological characteristics of patients and a wider range of techniques of psychological impact including both individual and group forms of psychological corrective work. PMID- 3673388 TI - [Experimental psychological research on the level of pretensions in alcoholics taking the sex factor into account]. AB - An experimental psychological study has involved 50 males and 53 females with Stage I-II alcoholism during their first hospitalization. The studied patients presented an extravert-neurotic type of personality degradation. Abnormalities of motivational activity in an experimental situation of choice were characterized by a very low level of pretensions in male alcoholics and the maximum level of pretensions in female alcoholics. An analysis of intellectual productivity of the patients has indicated a low intellectual output and inability of the rational utilization of the intellectual potential. In view of the heterogeneity of affective disturbances in men and women, the author recommends a differential psychotherapeutical approach to alcoholic patients of different sex. PMID- 3673389 TI - [The importance of psychological research in the system of rehabilitating epileptics]. AB - The authors consider the results of the psychological analysis of individual characteristics of intellectual and mnemonic activity, of emotional response, behaviour and the system of relations determined with the help of 10 experimental psychological techniques in 239 epileptic patients with a variable clinical picture of the disease in the process of their rehabilitation. The data obtained by the psychologist are correlated with the assessment of mental disorders by both the patient himself and the doctor. A conclusion is made that the psychological diagnosis is more accurate and its results may be used as an important criterion in the process of rehabilitation of epileptic patients. PMID- 3673390 TI - [The attitude of the mentally ill patient to hospitalization and to treatment and recovery procedures of the rehabilitation department]. AB - The attitude of the patient to hospitalization and therapeutic procedures employed in the rehabilitation department has been investigated in a series of 87 mental patients. The orientation of the patient with regard to participation in the therapeutic process has been found to correlate with the patient's mental activity and emotional-volitional potential as well as with his empathic properties and attitude to hospitalization. The patient's attitude toward hospitalization was related to the structure of his attitudes toward specific types of rehabilitation procedures. Two general therapeutic orientations of mental patients characterized by their attitude toward admission to a rehabilitation department as toward "institutionalization" or "rehabilitation" have been determined. PMID- 3673391 TI - [The extent of the concept and the diagnostic criteria of psychopathy based on catamnestic data. I. The spectrum of psychopathic disorders. II. Organic pathology and psychopathy]. AB - A study covering 277 psychopathic patients has been aimed at specifying the notion of psychopathy as well as the criteria of its diagnosis with the help of follow-up findings. Psychopathies are considered as a transient status of protracted adaptation due to retardation of the pubertal period. The study of "true" psychopathy has demonstrated that psychic disturbances are transitory and determined typologically by manifestations of neurosis or neurotic development. Persistent and prolonged psychopathy-like disturbances (n = 233) are referred to groups of other diseases.A total of 118 psychopathic patients have been subjected to a prolonged follow-up. The findings obtained have demonstrated a variety of organic cerebral diseases from traumatic encephalopathy to oligophrenia. The authors raise a question as to the validity of the generally accepted criteria of psychopathy in the framework of the so-called "organic psychopathy". A suggestion is put forward that abuse of the diagnosis of psychopathy in organic diseases of the central nervous system leads to the erroneous therapeutic strategy and corresponding social restrictions. PMID- 3673392 TI - [Clinical genealogical research on hysterical psychopathy]. AB - Thirty probands with the diagnosis of hysterical psychopathy were studied using clinical and genealogic techniques. An analysis of the obtained data made with the help of modern geneticomathematical methods identified a significant correlation between the type of psychopathy in probands and the corresponding type of personality disorders in the first-kin relatives of the probands. The calculated rate of heredity in relation to the risk of hysterical pathology manifestation (in the framework of quasi-permanent multifactor model) (79.9%) suggests that the formation of hysterical psychopathy is to a considerable degree determined by genetic mechanisms. PMID- 3673393 TI - [Criteria for the long-term prognosis of epilepsy occurring with psychotic disorders]. AB - On the basis of analysis of 450 epileptic cases the authors have established positive correlations between the suspected ethological factors (endogenic predisposition in the form of epileptoid personality characteristics in relatives, alcoholism in parents, birth-related traumas, the history of intracranial infections at the early stages of ontogenesis) and the main structural dynamic manifestations of the disease in delayed periods. The above factors have been frequently associated with an unfavourable course of the disease, largely characterized by catatonic disturbances, and have been less common in patients with torpid and mixed patterns of the disease. The form of the psychosis course (transitory, paroxysmal and chronic) is poorly correlated with epilepsy progression. PMID- 3673394 TI - [The hippocampus in patients with different forms of senile dementia]. AB - Using cytoarchitectonic and quantitative techniques the hippocampus and dentate fascia of the adult human brain were studied in normal subjects and in patients with senile dementia and Alzheimer's disease. The examination elucidated the peculiarity of the hippocampal structures, identified characteristics of the changes in the structural organization of the hippocampus and dentate fascia and established the severest atrophy in the H2 field of the hippocampus and a dramatic narrowing of the width of the dentate fascia. The data obtained are analyzed. PMID- 3673395 TI - [Structural organization of subcortical-stem formations of the human brain during aging]. AB - Using "Videoplan" apparatus manufactured by "Reihert" (Austria) the authors studied qualitative and quantitative cytoarchitectonic characteristics of the ventral posterolateral nucleus of the thalamus, individual reticular nuclei of the pontomesencephalic fissure, Meynert's nucleus and locus coeruleus in senile dementia (simple-type) and Alzheimer's disease in comparison with their structure in normal subjects of various age (from 30 to 90 years). Examination of 20 microns thin sections stained after Nissl has revealed both qualitative and quantitative cytoarchitectonic changes (a reduction in the area of the profile fields of neurons) which were more pronounced, along with cholinergic Meynert's nucleus, in the serotoninergic nuclei of the fissure and particularly in patients with Alzheimer's disease in whom they were far more expressed than in those with senile dementia. PMID- 3673396 TI - [Isolation and morphological study of the purified fraction of paired tangle filaments of the brain in Alzheimer's disease]. PMID- 3673397 TI - [Angioarchitectonics of the cerebral cortex in senile dementia as the basis of hemodynamic disorders]. AB - Using Klosovsky's technique and scanning electron microscopy, the authors studied the angioarchitectonics of the cerebral cortex in 3 patients with senile dementia and in mentally normal age-matched individuals. Senile dementia was associated with characteristic loop- and spiral-shaped changes in vascular trunks. Possible causes of these phenomena and their relationship to the cerebral blood flow is discussed. PMID- 3673398 TI - [Hypo- and hyperdiagnosis of senile dementia and Alzheimer's disease in psychiatric practice]. AB - A total of 714 brains from patients of predominantly advanced age who died in mental (n = 546) and somatic (n = 168) institutions have been examined macro- and microscopically. It has been found on the basis of accurate postmortem verification of Alzheimer's disease (AD) and senile dementia (SD) that in 20% of cases psychiatrists erroneously diagnose feeblemindedness in old age and in about the same proportion of cases they fail to diagnose the actual disease (most often AD and SD). The author has revealed a marked hyperdiagnosis of hypophrenias of vascular genesis at the expense of AD and SD whose rates are obviously underreported and which play a greater role in gerontopsychiatric practice than is generally accepted. PMID- 3673399 TI - [Structural transformations of the intima of arteries of the human pia mater in atherosclerosis]. AB - Using scanning and transmission microscopy, the structural transformations of the internal coating of the pial arteries have been investigated in patients with atherosclerosis (grade I+). The examination has revealed marked changes in the intima expressed in variable degree disorganization of the microrelief of the luminal surface of the vessels (diminution in the height and disappearance of the folds, their inadequate orientation, formation of spherical protrusions and crater-like cavities) and in transformations of the structural organization of the endothelium and subendothelial layer (intensification of pinocytosis, impairment of the integrity of intercellular contacts, lipidosis of endothelial cells, subendothelial edema). PMID- 3673400 TI - [Compression spectral analysis of the EEG of patients with occlusive diseases of the main vessels of the head]. AB - The authors have examined 37 patients with occlusive lesions of the main vessels of the head using electroencephalogram and compression spectral analysis of the EEG findings. A group of patients with the predominant damage to the carotid and vertebral arteries has been identified on the basis of angiographic data. It has been shown that alterations in the bioelectrical activity of the brain are determined by hemodynamic disturbances in patients with transient disorders of the cerebral circulation and circulatory encephalopathy. In patients with acute impairments of the cerebral circulation, the nature of the EEG and spectrogram depends primarily on localization of the ischemic focus. The quantitative parameters of changes in the bioelectrical activity of the brain in different groups of patients are outlined. PMID- 3673401 TI - [A program of electromyographic study of suspected latent pyramidal insufficiency]. AB - One hundred patients with suspected latent pyramidal insufficiency associated with cerebral and upper spinal abnormalities of varying nature were studied using a special scheme of electromyographic examination. The latter included: assessment of the ratio of curves of tension-time of the central and motor responses of the muscles of the calf and the musculi pedis, determination of the severity of "low frequency depression" of the H-reflex of the musculus gastrocnemius as well as of the main characteristics of the late potential of the musculi plantaris. The electrophysiological signs of the subclinical stage of the pyramidal syndrome were detected in 47% of cases. PMID- 3673402 TI - [Humoral immunity in subjects with a history of tick-borne encephalitis]. AB - A total of 137 patients with a history of focal and meningeal forms of tick-borne encephalitis (TBE) were examined in the period from 1 to 7 years after the acute stage of the disease. In their examination the authors used hemagglutination inhibition test in the acute and the long-term periods and neutralization test in the late periods. Antibodies to the TBE virus were detected in individuals living in the western region of TBE prevalence (Latvian SSR). The results of the clinical and immunological investigation help to obtain a more comprehensive understanding of the peculiarities of TBE pathogenesis, the stability of the post disease immunity, as well as to solve more successfully the questions of immunoprophylaxis and medical expert examination of the patients. PMID- 3673404 TI - [State of cerebral and systemic blood circulation in patients with the initial manifestations of circulatory encephalopathy]. AB - Parameters of the cerebral and systemic circulation were studied with the help of rheoencephalography in 119 patients with initial circulatory encephalopathy secondary to atherosclerosis (50 patients aged 45 to 59 years; 69, 60 to 74 years). Fifty-six healthy subjects served as a control group. The data obtained confirm the development of combined cardio-cerebrovascular insufficiency already at the initial stage of the disease and indicate the necessity of a comprehensive approach to the assessment of the function of two circulatory systems at an early stage of cerebrovascular pathology. PMID- 3673403 TI - [Biochemical factors in the pathogenesis of autonomic crises]. AB - Twenty-six neurotic patients with psychovegetative syndromes and eight healthy subjects were studied for the following vegetative and biological parameters: heart rate, respiration rate, skin galvanic reflex (SGR), and blood levels of lactic acid (LA) and pyruvic acid (PA). The examination was carried out under normal conditions and after exercise. It was found that the patients were more reactive to exercise as compared to the healthy subjects with regard to both vegetative (respiration rate, heart rate) and biochemical parameters (LA, PA). The maximal reactivity was observed to be associated with a considerable degree of emotional stress revealed by the test of comprehensive study of personality. PMID- 3673405 TI - [Method of evaluating the clinical status of patients during rehabilitation from the sequelae of stroke]. AB - The authors propose the methodology of the comprehensive assessment of the status of patients with cerebral stroke consequences which is based on the total score evaluation of the most informative clinical signs with due regard to their relative significance. PMID- 3673406 TI - [Characteristics of the fatal outcome in acute cerebrovascular disorders]. AB - Recent decades have seen a steady growth of the mortality rate related to cerebrovascular disorders. Age-matched mortality rates from this pathology are higher among men as compared to women. The main complications leading to death of patients with cerebrovascular disorders are oedema and dislocation of the brain (50.0%) and pneumonia (34.1%). The system of medical provision to patients with this pathology needs further improvement. Thus, only 26.5% of the patients who died of acute impairment of the cerebral blood circulation had been examined by neuropathologists at the polyclinic. The index of erroneous diagnosis (the number of erroneous diagnoses per 100 correct ones) is 38 at the prehospital and 11.6 at the inpatient stage. PMID- 3673407 TI - [Clinical expert classification of chronic cerebrovascular insufficiency]. AB - Basing on the results of an analysis and systematization of the findings of comprehensive examination of 519 patients the authors identified complexes of characteristic criteria which have served as the basis for creating a classification of chronic insufficiency of cerebral circulation (CICC) developing in cases of cerebral atherosclerosis, essential hypertension, and their combination. With regard to the stage of CICC and expert significance of either clinical manifestations of this disorder in relation to different types of professions a working scheme of medical expert examination of patients' working capacity is proposed. PMID- 3673408 TI - [Clinical picture and differential diagnosis of the pseudo-stroke syndrome in urgent somatic pathology]. AB - A clinical and pathomorphological examination has covered 206 subjects who died due to various urgent somatic abnormalities (myocardial infarction, pulmonary thromboembolism, pneumonia, etc.) whose clinical picture was largely characterized by general cerebral and focal neurological symptoms. To denote the aforementioned conditions, the term "pseudo-stroke" has been utilized. Pathomorphological examination of the brain has revealed multiple cysts in the hemispheres and brain stem in 40.8%, single cysts in 17.0% and no focal damage to the cerebral matter in 42.2% of cases. On the basis of a retrospective analysis of neurological manifestations of the pseudo-stroke syndrome in urgent somatic abnormalities, the authors have identified the regularities of its course, criteria of differential diagnosis, and possible pathogenetic mechanisms of the development of the above conditions. PMID- 3673409 TI - [Effect of cavinton and sulfocamphocain on systemic and cerebral hemodynamics in patients with early forms of cerebrovascular diseases]. AB - In a study involving 33 patients with initial manifestations of inadequate cerebral blood supply and in 22 patients with transient disorders of the cerebral circulation in the presence of atherosclerosis (n = 45) and atherosclerosis with arterial hypertension (n = 8) the authors studied the effect of intravenous administration of cavinton in combination with sulfocamphocain on the clinical manifestations and on the systemic (using the method of Evans' dilution) and cerebral (using Doppler ultrasonography) hemodynamics. It has been demonstrated that both a single intravenous administration of cavinton in conjunction with sulfocamphocain and a course of treatment with these drugs reduce the volume of the circulating blood, lower the stroke and cardiac indices, increase the linear velocity of blood flow along the carotid and vertebral arteries, and decrease neurological symptomatology. The authors discuss the questions related to indications for the administration of cavinton in combination with sulfocamphocain to patients with inadequate cerebral blood supply and transient disorders of the cerebral circulation. PMID- 3673410 TI - [Blood content of the vertebrobasilar basin during experimental trauma of the cervical portion of the spine]. AB - The author measured the blood content of the vertebrobasilar bed in rats with a cervical trauma induced by backward bending and simultaneous rotation of the neck. The blood content of the vessels was found to undergo a phasic reduction at both the cerebral and spinal levels depending on the duration of the posttraumatic period. It was demonstrated that a neuro-reflectory spasm of the extracranial portion of the vertebral arteries is the cause underlying the development and evolution of the above changes in the circulation system in the given injury. PMID- 3673411 TI - [Treatment of radicular syndromes of lumbar osteochondrosis using peridural infusions of drugs]. AB - A total of 107 patients with radicular syndromes of lumbar osteochondrosis were treated with epidural infusions of ganglefen (54 patients), rumalon (43 patients) and morphine (10 patients) following an unsuccessful prolonged in- and out patient treatment with the conventional methods. The therapy involved infusion into the lumbar epidural space of 2 ml of 1.5% solution of ganglefen in 20 ml of physiological saline or 0.5% solution of procaine, 1 ml of rumalon in 20 ml of isotonic saline and 4-8 mg of morphine in 10 ml of physiological saline. The number of epidural infusions varied from 1 to 5. A positive effect was obtained in 72.9% of the patients 24 hours after the first epidural infusion and in 90.6% of the patients after the full course of treatment. In the control group of patients (n = 100) treated with epidural infusions of procaine, vitamin B12, lidase, and steroid hormones the results were 57.9% and 76.9% respectively. The difference was statistically significant (p less than 0.05). PMID- 3673412 TI - [Effect of a series of vasoactive drugs on the compensatory adaptive processes of the brain during acute experimental cerebral venous stasis]. AB - In 120 rats with acute intracranial venous congestion the authors investigated the influence of some vasoactive drugs on compensatory-adaptive processes in the brain. They studied reactions of the nerve cells, pericellular and perivascular edema, and vessels to the administration of cavinton, trental, xanthinol nicotinate, troxevasin, and euphyllin. It has been demonstrated that vasoactive drugs have a varying influence on the compensatory processes in the brain. Thus, cavinton and trental significantly improve the venous outflow from the cranial cavity, sharply reduce cerebral edema, and stimulate reparative processes. Xanthinol nicotinate deteriorates compensatory-adaptive reactions, troxevasin exerts a favourable effect at an early stage, euphyllin acts in a biphasic mode. PMID- 3673413 TI - [Neurologic manifestations of the Marfan syndrome]. AB - Examination of 37 patients with Marfan's syndrome has revealed acute disorders of the cerebral circulation, aneurysms of the spinal vessels, varicose spinal veins, myopathy-like syndrome, atlantal semiluxation, spondylolisthesis, epilepsy and cephalgia. The data of additional examinations conducted in patients with Marfan's syndrome with and without neurological symptomatology are presented. The questions concerning the prevention, pathogenesis and therapy of neurological disturbances associated with Marfan's syndrome are considered. PMID- 3673414 TI - [Current problems of gerontopsychiatric epidemiology and organization of gerontopsychiatric care]. AB - A wide-scale programme of gerontopsychiatric epidemiological research using various mutually supportive methodological approaches (analysis of the statistics and examination of representative samples of the general population and of the group of registered patients) has made it possible to obtain the maximally complete picture of the mental health of elderly patients residing at a limited area of a large industrial city. It has been found that among the elderly patients registered at mental institutions there is an ever growing number of patients with endogenic psychoses while individuals with age-related diseases proper constitute only a comparatively small portion. Thus, schizophrenia has accounted for 43.5% of all cases. Ratio of patients with psychotic and non psychotic disturbances at this age constitutes 3.8:1. PMID- 3673415 TI - [International study of schizophrenia based on a WHO program. Purposes and methods of the study]. AB - The authors report on a new transcultural investigation of schizophrenia in the framework of the WHO programme which involved 13 research centres from 10 countries and was aimed at identifying the prevalence, clinical manifestations and regularities of the course of schizophrenia in different countries. The authors discuss methodological requirements to the conduction of large-scale clinical and epidemiological cross-cultural studies and analyze the methodological experience of the current WHO programme. PMID- 3673416 TI - [International study of schizophrenia based on a WHO program. Comparative characteristics of the data]. AB - The author compared cases of primary schizophrenia in ten countries. In analyzing the data the author used criteria of the ICD-9 and computerized diagnosis of the CATEGO. The differences revealed between the developed and developing countries concerned acute or chronic manifestations of schizophrenia, its clinical form and frequency of individual symptoms. The computer-aided diagnosis of cases failed to identify any discrete subgroup of schizophrenia, which seems to refute the theory of heterogeneity of this disease. PMID- 3673417 TI - [International study of schizophrenia based on a WHO program. Incidence of schizophrenia]. AB - The article presents data on the incidence of schizophrenia in one of the Moscow districts, which are compared with the findings obtained in 7 centres in different countries which used the same procedure of the investigation. Differences in the rate of morbidity between different countries were detected only when a broad diagnostic approach was employed, there being no such difference when narrow diagnostic criteria of schizophrenia were used, which indicates poor correlation between cultural factors and the development of schizophrenia with first-rank symptoms. The use of traditional clinical symptomatology has made it possible to reveal that the rate of different syndromes of manifest schizophrenia depends on sex and age. PMID- 3673418 TI - [Clinico-epidemiologic characteristics of non-hospitalized schizophrenic patients]. AB - On the basis of the material from three psychoneurological outpatient centres in Moscow the author has identified 581 schizophrenic patients without a history of hospitalization at mental institutions. It has been established that the proportion of these patients constituting 10.6 per cent from the total number of schizophrenic patients increases with time at the expense of slowly progressive forms. At the same time there is some tendency toward increase among nonhospitalized schizophrenic patients in cases with apparent manifestations of psychosis. Along with clinical factors influencing the structure of patient population without a history of hospitalization the author has identified other factors that may reduce or increase the number of these patients (the organizational structure of mental care, psychopharmacotherapy, social factors, etc.). PMID- 3673419 TI - [Prognosis in the social and occupational adaptation of patients with slowly progressive schizophrenia]. AB - A series of 190 patients with slowly progressive schizophrenia have been examined with the aim of studying the prognosis of their social and occupational adaptation. The authors have analyzed the dynamics of the mental status and adaptation over years. Criteria of the prognosis of social and occupational adaptation have been identified. The adaptive behaviour and prognosis in patients with slowly progressive schizophrenia have been found to depend on the type of the personality abnormality in the premorbid period, age at the disease onset, its pattern, and clinical characteristics of the active period of the disease. PMID- 3673420 TI - [Epidemiologic aspect of the problem of the disability of schizophrenic patients (incidence, chronogenic dynamics, risk factors)]. AB - Epidemiological aspects of disability have been studied in a random sample of schizophrenics living in three Moscow districts. It has been found that 39.4% of schizophrenic patients (44.2% of the patients in the productive age) are disabled due to the underlying disease. The past 20 years have seen a trend toward a decrease in the disability rate; the difference between the number of the disabled reported 20 years ago and today is 5.5%, being fully accounted for by paroxysmal forms of schizophrenia. It has been ascertained that the decision as to the patient's disability following medical examination of his or her working ability depends not only on the severity of the patient's clinical status, but also on the patient's sex. Thus, if patients with an equally grave disease are considered, women are more frequently given the status of disability which is explained by the fact that their involvement in household chores is much greater than that of males. PMID- 3673421 TI - [Comparative clinico-genetic analysis of slowly progressive and manifest forms of schizophrenia]. AB - Using modern genetico-mathematical methods (genetico-correlational analysis), the author made a comparative analysis of the findings from a clinico-genealogic study of two groups of probands--with torpid schizophrenia (192 families) and with manifest forms of schizophrenia (365 families). The results obtained confirm the validity of the clinical differentiation of torpid schizophrenia as one of relatively independent forms of schizophrenia. PMID- 3673422 TI - [Correlation of the clinical manifestations of schizophrenia with the constitutionally morphologic type of the patient]. AB - Using clinical and anthropometrical methods involving the determination of discrete somatotypic groups in accordance with the Reese-Aisenk Habitus index, the authors examined 1064 schizophrenic patients. Each constitutional morphological type was characterized by specific premorbid personality features, duration and patterns of the initial period, as well as by manifest syndromes, variants of the time-course of the process and deficiency types. The process was especially acute in people with pyknic build while the severity of negative disturbances increased from the pyknic pole toward the asthenic one. The normosthenic somatotype was most frequently related to monomorphic productive disorders. The constitutional morphophenotype is considered as an important parameter with regard to the early prognosis of the time-course of schizophrenia. PMID- 3673424 TI - [Specialized aid to patients with borderline neuropsychic disorders]. PMID- 3673423 TI - [Antioxidant capacity of the blood serum of schizophrenic patients in relation to brain tissue as an index of its neurotropic activity]. AB - The authors have proposed a method of determining the neurotropic activity of the blood serum, which is based on the ability of cytotoxic anticerebral antibodies to intensify the processes of lipid peroxidation in the homogenate of the rat brain. Sera of the overwhelming majority of the 175 schizophrenics studied showed neurotropic activity. At the stage of exacerbation patients with different forms of schizophrenia showed identical neurotropic activity while at the stage of remission this activity was significantly different as compared with both the value characteristic of the exacerbation stage and the control one. PMID- 3673425 TI - [Prophylaxis of brain edema in neurosurgical operations]. AB - Rational surgical approaches providing for preservation of the arteries and veins of the brain and minimal mechanical damage to it during the removal of tumors, the use of adequate anesthesia which prevents the development of vegetative reactions of central origin, and postoperative correction of the patients' condition under clinical and physiological control allow the development of cerebral edema to be prevented. Experience in the management of 1,447 patients with intracranial, mainly extracerebral, tumors showed that postoperative lethality can be reduced from 27.0 to 4.3%. PMID- 3673426 TI - [Acute lung edema after injury of the medulla oblongata (experimental study)]. AB - In determining the role of medulla oblongata in the development of central edema of the lungs it was established that in rats edema develops regularly 1 hr 37 min +/- 17 min following damage to the caudomedian parts of the vagus nerve dorsal nuclei. Damage to the rostral part of the nucleus, its complete removal, destruction of adjacent structures are not attended by the development of lung edema but, on the contrary, reduce the amount of water in the lungs. The caudal, median, and rostral parts of the dorsal nuclei as well as the nuclei of the reticular formation are evidently a system regulating water balance in the lungs. PMID- 3673427 TI - [Dynamics of the cerebrospinal fluid and elastic properties of the cerebrospinal system (a bolus technic)]. AB - The theoretical aspects of employing the infusion methods of examination of CSF time course and viscoresilient properties of the cerebrospinal system (CSS) are discussed. The general formula of changes in the time of intracranial pressure (TIP) after a load is given. Dog experiments showed this formula to reflect sufficiently exactly the behavior of the CSS in a TIP range of 24 to 40 cm H2O. Analysis of the data in the literature and the results of the author's studies allows the conclusion that determination of CSF resorption resistance by the method of infusion under constant pressure with subsequent calculation of the CSS resilience gradient from the curve of TIP reduction makes it possible to avoid the disadvantages of the bolus technique. PMID- 3673428 TI - [Long-term results of the surgical treatment of parasagittal meningiomas]. AB - The article analyses the late results of surgical treatment of 123 patients with parasagittal meningiomas of various localization along the superior sagittal sinus (SSS) and falx cerebri (FC). Invalidism of patients after operations for meningiomas of the middle third of the sagittal line is still high because of stable motor defects. The results of operations for SSS resection without restoration of venous outflow of the hemisphere are poorer. Recurrences of the disease were revealed in one fourth of patients in different periods after surgery. The possibility of rehabilitation of the patient after an operation for recurrences of the tumor considerably reduces with each subsequent recurrence. PMID- 3673429 TI - [Possibilities of quantitative criteria of the effectiveness of treatment of glial brain tumors]. AB - The authors suggest a quantitative criterion for evaluating the efficacy of radiotherapy in patients with glial tumors of the brain. Three types of course followed by the disease are distinguished: regressive, progressive, and undulating. The use of the quantitative criterion made it possible to detect patients with individual increased sensitivity to macrofractional radiotherapy and to come to the decision on the expediency of conducting the next series of irradiation in each concrete case. PMID- 3673430 TI - [Monstro-cellular sarcoma of the brain]. AB - The peculiar features of the histological structure of monstrocellular sarcoma of the brain are discussed on the grounds of morphological study of 14 cases. It is shown that the tumor arises in the adventitial cells of the cerebral blood vessels, which is evidence in favor of its mesenchymal origin. PMID- 3673431 TI - [Involvement of the subcortical structures in children with cranio-cerebral injuries]. AB - From experience in the management of 12 cases the authors discuss the clinical picture and pathogenesis of a special form of craniocerebral trauma in children which is characterized by isolated affection of the subcortical ganglia, internal capsule, and the thalamus in the area supplied by the perforating branches of the middle cerebral artery. PMID- 3673432 TI - [Neuropsychological studies in the surgery of epilepsy]. AB - Comparison of the findings of neuropsychological examination with the EEG pattern, the results of psychopathological examination, and the character of the paroxysms showed the high informativeness of standardized neuropsychological diagnostic methods in determining the location of the dominant epileptic focus and predicting the outcomes of surgical treatment of patients with epilepsy as well as the transient character of possible disorders of high cortical functions caused by surgical interventions. PMID- 3673433 TI - [Convex intracranial chondroma]. PMID- 3673434 TI - [Syringomyelia associated with cerebrospinal rhinorrhea]. PMID- 3673435 TI - Calculations of the conformational properties of acyclonucleosides. Part I. Stable conformations of acyclovir. AB - Conformational properties of te antiherpes agent acyclovir (acycloguanosine, ACG) were calculated using molecular mechanics approximation. Eighty two different stable conformations have been determined. The large number of local minima of the total enery, and small differences between them, point to the marked flexibility of the acyclic chain. The barrier to rotation around N9-C1 bond was calculated and found to be asymmetric (the lower equals 17 kJ/mol, the higher 63 kJ/mol). An energetic preference for the compact from of ACG was demonstrated. A comparison of the calculated conformations with the crystallographic structures is presented. PMID- 3673436 TI - Sugar ring conformations of guanine nucleosides by proton nuclear magnetic resonance. AB - Proton NMR studies at 250 MHz showed that ribofuranosyl and 2-deoxyribofuranosyl derivatives of N2-(p-n-butylphenyl)guanine (BuPG) favored the C2'-endo (S) sugar pucker and the gg exocyclic group rotamer, although less so than guanosine and 2' deoxyguanosine themselves. The correlation calculated between C3'-endo (N) and gg conformational states in these compounds may result from destabilization of syn glycosidic bond conformers by the bulky N2 substituent. Results for a bis(ribofuranosyl) derivative of BuPG showed a strong correlation between N and gg states in both sugar rings, suggesting that both rings are anti and are stabilized by intramolecular hydrogen bonding between C3'-O and H8. PMID- 3673437 TI - Electrochemical study of the reduction of toyocamycin and sangivamycin in aqueous media. AB - The redox behaviour of two antibiotics, toyocamycin and sangivamycin, structurally related pyrrolopyrimidine nucleosides, and their reduction products in buffered aqueous media, have been examined by direct current polarography and cyclic voltammetry. Both compounds exhibit one 3-electron polarographic wave in the pH range 1-6. Macroscale electrolysis at the crest of the polarographic wave was followed electrochemically and by UV spectroscopy. The photochemical transformation of the reduction products on UV irradiation has been examined. It was found that the reduction of both compounds occurs in the pyrimidine ring, leading to two reduction products. One of these (lambda max = 306 nm) is photochemically reversible to the parent compound. PMID- 3673438 TI - Stabilization of human prostate acid phosphatase by cross-linking with diimidoesters. AB - 1. Modification of dimeric human prostate acid phosphatase (EC 3.1.3.2) by diimidoesters leads to the formation of water-soluble preparations of high enzymatic activity, resistant to denaturing agents. 2. Monomeric, dimeric, trimeric and tetrameric species were found in SDS-polyacrylamide gel electrophoresis of the phosphatase cross-linked with dimethyl-suberimidate, and dimeric, trimeric and tetrameric enzymatically active species on thin-layer Sephadex 200 gel filtration. This molecular pattern evidenced formation of the inter-subunit covalent linkages. All molecular forms are immunoreactive against the polyclonal rabbit anti-phosphatase antibodies. 3. The catalytic properties of the modified phosphatase are almost the same as those of the native enzyme. Differences in the optical properties between the modified and the native enzymes point to slight conformational transitions in the modified enzyme. PMID- 3673439 TI - Thermochemistry of aqueous solutions of alkylated nucleic acid bases. VI. Enthalpies of hydration of 2-alkyl-9-methyladenines. AB - Enthalpies of solution in water, delta H0sol, and vant'Hoff enthalpies of sublimation, delta H0subl, were determined experimentally for a number of crystalline 2-alkyl derivatives of 9-methyladenine: m2(2,9)Ade, e2m9Ade, pr2m9Ade and but2m9Ade. Standard enthalpies of hydration, delta H0hydr derived from these data were corrected for the calculated cavity terms, delta H0cav, to yield enthalpies of interaction, delta H0int, of the solutes with their hydration shells. The apparent residual contribution of alkyl groups, R, to the enthalpy of interaction delta delta H0int (R) was found to increase linearly with the number of CH2 groups added upon alkyl substitution, whereas this contribution calculated per unit area of the water-accessible molecular surface, SB, of alkyl residues delta delta H0int (R): delta SB(R) appeared constant over the whole series of the compounds investigated. This indicates that alkyl groups substituted at the C(2) carbon atom of the adenine contribute additively to the van der Waals' part of the enthalpy of interaction and do not affect the electrostatic part of the energy of interaction of the solutes with their hydration shells. PMID- 3673440 TI - On tautomerism of the cytosine molecule. AB - Tautomerism of the cytosine molecule is discussed in connection with recent experimental matrix-isolation infrared spectroscopic measurements and recent ab initio calculations of relative stabilities of tautomers and of IR spectra for different tautomeric forms of the compound. Experimental IR spectra in the N-H and O-H stretching regions and in the C = O stretching region are presented for cytosine and for its several derivatives considered as model compounds. This experimental evidence, as well as the quantum-mechanical calculations (including both electron correlation and zero-point vibrational contributions), clearly indicate that two tautomers of cytosine, i.e. the amino-hydroxy and amino-oxo forms with the hydrogen atom at the N(1) position, exist in equilibrium when the cytosine molecule is isolated in an inert environment. The effect of the environment on the relative stabilities of several tautomers is also discussed briefly. PMID- 3673441 TI - Energy relationships between ATP synthesis and K+ gradients in cultured glial derived cell line. AB - In C6 astrocytoma cells respiring with glucose, 40% of the total production of ATP was provided by glycolysis. Anaerobiosis in the presence of glucose, reduced ATP synthesis by approximately 50%, increased lactate production by 30% and caused a 3-fold decline in [creatine phosphate]/[creatine] and consequently [ATP]free[ADP]free. There was no change in [K+]i which suggests that glycolytic production of ATP provides sufficient energy to ensure normal operation of the Na+/K+ pump. In the absence of glucose, [creatine phosphate]/[creatine] declined to less than 0.1 in 15 min and there was a loss of K+ from cells. A comparison of delta GATP and delta GNa,K under aerobic conditions with and without glucose, showed the former to be larger by 1 - 2 kcal. However, under O2-limited, glucose restricted conditions delta GATP fell below the level necessary to maintain operation of the Na+/K+ pump and led to a collapse in ionic gradients. PMID- 3673442 TI - The ability of DNA polymerase beta to synthesize DNA beyond the gap with displacement of the non-replicated strand. AB - Study was made of the ability of calf thymus DNA polymerases alpha and beta to replicate templates containing a small gap. It was found that during extensive replication of activated DNA or synthetic template.primers or specially prepared circular DNA containing a small gap, catalyzed by DNA polymerase alpha, the levels of incorporated nucleotides corresponded to the amounts of the single stranded fraction of these templates. In contrast, in the reaction catalyzed by DNA polymerase beta the amounts of products were several times greater. The ability to synthesize the product in a great excess was a specific feature of the latter enzyme. An analysis of the gap-filling products by sucrose gradient centrifugation, gel electrophoresis and Southern hybridization showed that, contrary to DNA polymerase alpha, DNA polymerase beta exhibited the ability to synthesize DNA not only within but also beyond the gap. The "net" DNA product is complementary to the template strand. It is suggested that DNA was synthesized beyond the gap by displacement of the non-replicated strand. PMID- 3673443 TI - Diastereomers of thymidine 3'-O-(methanephosphonothioate): synthesis, absolute configuration and reaction with 3'-methoxyacetylthymidine under conditions of triester approach to oligonucleotide synthesis. AB - Diastereomers of the title compound were obtained and absolute configuration was assigned by means of stereochemical correlation. Their reaction with 3'-O methoxyacetylthymidine in the presence of triisopropylbenzenesulphonyl (4-nitro) triazole is neither chemo- nor stereo-selective and leads to diastereomeric pairs of dithymidyl (3',5')methanephosphonate and -methanephosphonothioate. Obtained results are discussed in terms of mechanism of activation of phosphodiesters under conditions known as "phosphotriester approach to oligonucleotide synthesis". PMID- 3673444 TI - Prediction of the beta Bp crystallin dimer structure by the complementary surfaces (CS) method. AB - The method of searching for complementary surfaces of proteins was used to evaluate the modes of beta Bp crystallin autoassociation. The dimer structure of beta Bp is predicted and characterized. PMID- 3673445 TI - Age-related antigenic changes in human aortic elastin. PMID- 3673446 TI - Liver histology in chronic metribuzin poisoning of the guinea-pig. AB - Forty male guinea-pigs weighing 400-600 g, 8 months old, were given metribuzin directly into the gastric lumen over a period of 30 days (20 animals) or 90 days (20 animals), 6 times a week. The intoxicated animals showed congestion and obliteration of the trabecular structure of the liver. Acidophilic and vacuolar degeneration of the liver cells with signs of necrosis were also observed. Histochemical tests revealed a poorer staining for glycogen and succinic dehydrogenase and intensification of the alkaline and acid phosphatases reaction. The above findings indicate a progressive degeneration due to metribuzin of different organelles of the liver cells including nuclei, mitochondria, lysosomes, microvilli and the cytoplasm. PMID- 3673447 TI - Contraction induced by antibodies to paramyosin in glycerinated fibers of Barnacle giant muscle in an ATP-deficient medium: a possible function of paramyosin. AB - Glycerinated giant muscle fibers of the barnacle Balanus rostratus in an ATP deficient solution respond to antibodies to paramyosin (aPM) by an isometric tension development followed by an immediate spontaneous relaxation. The aPM presence does not affect the subsequent contraction and relaxation of the fibers in suitable ATP-containing media. The effects of ATP and aPM present together in a contracting medium are additive. The aPM effect is caused assumedly by a sudden shortening of some highly elastic connecting filaments which are linked in a stretched and strained state to the thick filament by its paramyosin, aPM dissociates this link. Possible specific functions of paramyosin in various types of muscles are discussed. PMID- 3673448 TI - Comparative antioxidant enzyme study in freshwater fishes. II. Distribution of antioxidant enzymes and lipid peroxidation in omnivorous fish organs. AB - Comparative studies were performed on the activities of superoxide dismutases, catalase and glutathione peroxidase in organ homogenates from three omnivorous fishes, the barbel, crucian carp and common carp. The lipid peroxidation and protein contents of organ homogenates were also compared. These comparative measurements primarily provide control values for subsequent toxicological examinations. The highest total superoxide dismutase activities were found in the liver or roe, kidney, heart and spleen in every cases. The antioxidant enzyme activities and other studied parameters of the organ homogenates partly appear to depend on the feeding mode, but are rather characteristic of the fish variety. PMID- 3673449 TI - Syntheses of (S)-(+)-trihexyphenidyl hydrochloride and (S)-(+)-procyclidine hydrochloride, two anticholinergics, using (S)-(-)-3-cyclohexyl-3-hydroxy-3 phenylpropanoic acid as chiral synthon. AB - The absolute configuration of the more active (-)-enantiomer of the anticholinergic trihexyphenidyl hydrochloride has been established as (R) by syntheses of (S)-(+)-procyclidine hydrochloride, whose absolute configuration has been established previously, and (S)-(+)-trihexyphenidyl hydrochloride from the same chiral building block, viz. (S)-(-)-cyclohexyl-3-hydroxy-3-phenylpropanoic acid. Both enantiomers of this chiral synthon were prepared by optical resolution of the corresponding racemate, employing (R)- and (S)-1-phenylethylamine, respectively, as resolving agents. PMID- 3673450 TI - Antibiotic consumption and faecal bacterial susceptibility in surgical in patients. AB - A one-day prevalence study of resistance of faecal bacteria to 19 antibacterial agents was performed in 144 surgical inpatients. Most of the drug-resistant isolates were of aerobic and anaerobic species commonly seen in infections, which indicates that surveys of faecal flora can yield rapid information on local patterns of drug resistance in pathogens relevant to abdominal infection. In faecal bacteria the drug resistance pattern only weakly reflected the local antibiotic consumption. The amount of administered aminoglycosides was relatively small, and no gentamicin-resistant aerobes were found. Absence of resistance was found also for some of the newer agents not yet in clinical use (aztreonam, latamoxef, norfloxacin), but not for others (ceftazidime, ceftriaxone). Despite heavy use of fosfomycin and metronidazole, resistance had not emerged among aerobic and anaerobic bacteria, respectively. Imipenem was unique in inhibiting growth of all aerobic and anaerobic faecal bacteria, in the studied patients with the single exception of a strain of Enterobacter. PMID- 3673451 TI - Trends in civilian vascular trauma during 30 years. A Swedish perspective. AB - Vascular injuries operated on during a 30-year period (1955-1984) were analyzed. There has been significant increase of such injuries, particularly the iatrogenic types. The total incidence per 100,000 population and year rose from 11.0 to 26.6. Various angiographic and catheterization techniques were responsible for the iatrogenic increase. The noniatrogenic vascular injuries not infrequently were part of multiple trauma, with fractures and a variety of penetrating wounds. Numerous operative techniques were used, increasingly with reconstructive surgery. The mortality rate did not change in the study period, but the rate of amputations and of various long-term sequelae diminished. PMID- 3673452 TI - Acute appendicitis and plasma concentration of serotonin. AB - The concentration of serotonin in platelet-poor plasma was measured with a radioenzymatic method in 31 patients prior to operation for suspected acute appendicitis. The serotonin determinations were made without knowledge of the peroperative or histologic findings. Appendicitis was found in 20 patients, nine of whom had elevated plasma serotonin level, giving 45% sensitivity for the test. Of the 11 patients with normal appendix, only one had increased plasma serotonin, giving 91% specificity. The predictive value of normal serotonin level was 48% and that of elevated serotonin level was 90%. No correlation was found between duration of appendicitis symptoms and plasma serotonin concentration. Other diseases did not influence the serotonin level. PMID- 3673453 TI - Crohn's disease limited to the vermiform appendix. AB - Thirteen cases of Crohn's disease confined to the vermiform appendix were seen during a 12-year period. They constituted 16.9% of patients with primary resection of the bowel for Crohn's disease in the same period, but only 0.4% of the cases of acute appendicitis. In 10 of the 13 cases there was marked fibrous thickening of the appendiceal wall, and in 11 there were epithelioid cell granulomas. Appendectomy was performed in all cases. None had postoperative fistula or later manifestations of the disease within the observation time averaging 6.3 years. The recurrence rate was previously believed to approach that of recurrence after resection in other parts of the intestines. Collective review of this and three other relatively large case series gave an estimated recurrence rate of 3.5%. We conclude that in Crohn's disease initially confined to the appendix the course appears to be indolent. PMID- 3673454 TI - Long-term effects on bacterial sensitivity patterns of preoperative antibiotic prophylaxis in colorectal surgery. AB - Since 1973, when doxycycline was introduced as peroperative prophylaxis in elective colorectal surgery at Malmo General Hospital, Sweden, there has been an unchanged and low rate (8-12%) of septic complications in colonic surgery. For treating postoperative infections ampicillin, cefuroxime and piperacillin have been used since 1973, 1980 and 1982 respectively. The sensitivity pattern of E. coli and Klebsiella against these four antibiotics used for prophylaxis and treatment has been followed for the past five years and only minor changes have occurred through the period. However, a lower frequency of antibiotic resistance was recorded for bacteria isolated peroperatively than postoperatively after colorectal surgery or from infection sites from other patients presumably mostly due to selection caused by antibiotics used within the hospital. Due to the good clinical outcome and seemingly lack of development of antibiotic resistance in peroperative isolates, doxycycline still remains a choice for prophylaxis in bowel surgery. PMID- 3673455 TI - The prognostic significance of DNA content in carcinoma of the rectum and rectosigmoid. AB - Using cytofluorometric single-cell DNA analysis, the pattern of nuclear DNA content was determined in preoperative biopsies from 166 unselected primary adenocarcinomas of the rectum or rectosigmoid. The pattern was aneuploid (AN) in 125 (75%) of the tumours, was aneuploid (AN) in 125 (75%) of the tumours, near diploid with aneuploid cells (ND-anc) in 26 (16%) and near-diploid (ND) in 15 (9%). The DNA content was not related to tumour stage or degree of differentiation. The clinical course tended to be more favourable in patients with ND tumour than in those with AN or ND-anc pattern. The nuclear DNA content in rectal carcinoma thus can be estimated in preoperative biopsies, and the pattern may serve as a prognostic parameter. PMID- 3673456 TI - Thromboangiitis obliterans affecting the upper extremity in a woman. Case report. AB - A rare case of thromboangiitis obliterans is reported, with involvement of the left brachial and axillary artery and signs of median-nerve denervation in a 42 year-old woman following long affection of the right popliteal artery. Arterial reconstruction of the upper extremity was beneficial when the patient stopped smoking. The histologic changes distinguished the condition from atherosclerosis. PMID- 3673457 TI - Pulsatile cervical swelling (dilated carotid artery) associated with persistent primitive trigeminal artery. Case report. AB - A 39-year-old woman was admitted to the department of surgery due to a left-sided pulsatile cervical swelling. Angiography showed that the pulsatile swelling was due to enlargement of the internal carotid artery, and revealed a persistent left sided primitive trigeminal artery. The clinical significance of this persistent carotid-basilar anastomosis is reviewed, and its possible pathogenetic relationship with the pulsatile cervical swelling is discussed. PMID- 3673458 TI - Gastric pseudolymphoma. Case report. AB - Gastric pseudolymphoma (GPL) is a rare entity which closely mimicks malignant lymphoma. Controversy still exists concerning the risk of malignant transformation. In this report a case of GPL occurring 8 years after a gastric resection due to duodenal ulcer is described. The patient has been followed for more than 10 years with annually performed upper GI endoscopies. The histological and endoscopic findings are described. PMID- 3673459 TI - Bronchobiliary fistula in chronic pancreatitis. Case report. AB - Bronchobiliary fistulas are rare. One aetiological cause is biliary obstruction with secondary suppuration and subsequent hepatic and subphrenic abscesses. Only a few cases of bronchobiliary fistulas in patients with chronic pancreatitis have been reported and we record another case. A 47-year-old white male, with chronic alcohol-induced pancreatitis who had earlier undergone several laparotomies related to this disease, was admitted with a hepatic abscess. Drainage was not successful. The patient developed bilioptysis and a bronchobiliary fistula was diagnosed. The fistulous tract was demonstrated using PTC as well as bronchography. Laparotomy was performed and the fistulous tract was excised. The hepaticoduodenal ligament was completely obstructed by the inflamed pancreatic gland. An earlier but now obstructed cholecystojejunostomy was revised. This case was complicated by episodes of severe gastrointestinal bleeding probably caused by thrombosis of the portal vein and local varices around the gallbladder and common duct. PMID- 3673460 TI - Rupture of an aortic aneurysm into the renal vein presenting as a left-sided varicocoele. Case report. AB - We report a case of aorto-left renal vein fistula secondary to an aortic aneurysm presenting with flank pain, a left-sided varicocoele and microscopic haematuria. These symptoms and signs should alert the clinician to this rare complication of abdominal aortic aneurysm. PMID- 3673461 TI - Fine needle aspiration cytology of a large cell calcifying Sertoli cell tumor of the testis. AB - A case of a large cell calcifying Sertoli cell tumor (LCCSCT) of the testis in a 7-year-old boy is presented. Fine needle aspiration (FNA) cytologic smears showed large polygonal tumor cells with abundant finely granular or vacuolated eosinophilic cytoplasm and eccentric nuclei with one distinct nucleolus. A variable amount of amorphous calcification was a constant feature. The light microscopic and ultrastructural features of the tumor cells supported a Sertoli cell origin of the tumor. This tumor is found frequently associated with complex endocrine disorders and usually has a benign course. This case, which appears to be the first such case diagnosed by FNA cytology, shows the efficacy of FNA cytology in the presurgical evaluation of testicular masses. PMID- 3673462 TI - Fine needle aspiration cytologic diagnosis of ganglioneuroblastoma. AB - Two children with ganglioneuroblastomas in different locations underwent fine needle aspiration (FNA). Clinically, the tumor in the presacral area was diagnosed as a benign teratoma and the retroperitoneal tumor as a neuroblastoma. Both tumors were correctly diagnosed preoperatively as ganglioneuroblastomas by FNA cytology. The smears showed the characteristic Homer-Wright rosettes, ganglion cells and fibrillar material. PMID- 3673463 TI - Fine needle aspiration cytology of the thyroid, 1980 to 1986. AB - An experience with approximately 6,300 fine needle aspirations of the thyroid was reviewed. The cytologic results were negative in 65% of the aspirates, suspicious for malignancy in 11%, positive for malignancy in 4% and nondiagnostic in 20%. Sensitivity in 382 cases of known malignancy was 98%, and the specificity of a positive cytologic report for malignancy was 99%. Repeat aspiration on initially nondiagnostic cases produced diagnostic results in more than half of the cases. The major limitation of the technique seems to be the lack of specificity in the group whose results are suspicious for malignancy, in large part due to an inability to separate cellular follicular or Hurthle-cell adenomas from follicular or Hurthle-cell carcinomas. The protocols for obtaining and processing the aspirates are briefly summarized. PMID- 3673464 TI - Papillary carcinoma of the thyroid gland. Analysis of 94 cases with preoperative fine needle aspiration cytologic examination. AB - From 1979 to 1983, 94 papillary carcinomas of the thyroid gland were examined histologically in our institute after a preoperative cytologic examination. Material for cytologic examination was obtained using fine needle aspiration (FNA) biopsy. Eighty-five (90.4%) of the 94 examined cytologic smears were representative. Among these 85 cases suspicion for malignancy or malignancy itself was found in 64 cases (75.3%). The remaining 21 smears, classified as cytologically not as suspect for malignancy, were reclassified and the previous diagnosis had to be revised in one case. In the other 20 cases no clue for malignancy could be demonstrated even after reexamination. In the 85 cases with representative cytologic findings, tumor size was determined on surgical material, in order to establish how many carcinomas with a diameter less than 3 cm could not be reached by FNA biopsy. Except for one case, all carcinomas with negative preoperative cytologic findings had a diameter less than or equal to 3 cm. The question arising is the possibility of improving the accuracy of FNA biopsy in tumor detection within cold nodules of the thyroid by combined use of scintigraphy and ultrasound-guided FNA biopsy. PMID- 3673465 TI - The role of fine needle aspiration biopsy cytology in the evaluation of the clinically solitary thyroid nodule. AB - The imputation that a clinically solitary nodule is a suspicious sign of carcinoma has been the cause of too many surgical procedures as well as the subject of much controversy. This study evaluated the effectiveness of fine needle aspiration (FNA) biopsy cytology in diagnosing the uninodular goiters in 286 patients who presented with clinically solitary nodules. The final diagnoses in these cases included carcinoma (4.7%), adenoma (6.3%), autonomous nodule (11.0%), colloid goiter (45.8%), colloid cyst (17.4%) and chronic thyroiditis (13.4%). The proportion of patients with cancer in this group was the same as in patients with multinodular and diffuse goiters. These findings call attention to (1) the fact that any thyroid disease may appear as a uninodular goiter and (2) the frequency with which lymphocytic thyroiditis was cytologically diagnosed, even in cases with negative antibody titers. The cytologic diagnosis of benign disease has contributed to a reduction in the number of unnecessary surgical procedures; only 24.1% of our patients with uninodular goiters underwent surgery. PMID- 3673466 TI - A critical evaluation of bronchoalveolar lavage. Criteria for identifying unsatisfactory specimens. AB - In a multicenter, city-wide study of the use of bronchoalveolar lavage for the evaluation of diffuse interstitial lung diseases, the occurrence of specimens unsuitable for analysis was evaluated. Using a standardized bronchoscopy technique, 26 physicians obtained 1,588 lavage specimens from 787 patients over a 52-month period. After transport to and processing in one laboratory using standardized procedures, all specimens were interpreted by one pathologist. Specimens were considered unsatisfactory if they contained: (1) a paucity of alveolar macrophages (i.e., less than ten alveolar macrophages/high-power field), (2) excessive numbers of airway-derived cells (i.e., more than the alveolar macrophages present), (3) a mucopurulent exudate, (4) cells altered by degeneration or (5) laboratory artifacts. Using these criteria, 30.4% of the specimens were considered unsuitable for analysis. There were no significant differences in the frequency of unsatisfactory specimens among participating physicians and institutions or between smoking and nonsmoking patients. Appraisal of alveolar inflammatory and immune effector cells in bronchoalveolar lavage specimens from patients with interstitial lung disease should include an assessment for contamination from airways proximal to the terminal bronchioles before conclusions are drawn about the activity of alveolar inflammation. PMID- 3673467 TI - The effects of cytocentrifugation on differential cell counts in samples obtained by bronchoalveolar lavage. AB - Quantification of the differential cell count and total number of cells recovered from the lower respiratory tract by bronchoalveolar lavage is a valuable technique for the diagnostic study of interstitial lung diseases. To examine the effect on the cell counts of different methods of processing the lavage fluid, two comparisons were performed. First, two methods of differential cell counting were compared using 28 fluids. One count was performed in a Malassez hemocytometer after incubation of the living cells with neutral red for five minutes at room temperature; large cells and some small cells that had incorporated neutral red were identified as macrophages. Another count was performed on cytocentrifuge preparations made using the Shandon Cytospin I and Cytospin II and stained by the May-Grunwald-Giemsa method. The percentage of cells identified as lymphocytes was significantly lower on the cytocentrifuge preparations than with the Malassez hemocytometer. In the second study, the differential cell counts on smears prepared by the two types of cytocentrifuge (Cytospin I and Cytospin II) were compared for 32 bronchoalveolar lavage fluids. The percentage of small cells (especially lymphocytes) was lower on preparations made with the Cytospin I than on those made with the Cytospin II, but the difference was not significant. The results indicate that (1) cytocentrifugation of bronchoalveolar lavage fluids does result in a significant loss of small cells, especially lymphocytes, and (2) this loss is not significantly lessened by the use of the Cytospin II. PMID- 3673468 TI - Use of tartaric acid resistance of beta-glucuronidase for the characterization of cancer cells in pleural effusions. AB - Tartaric acid was shown to have an inhibiting effect on beta-glucuronidase staining in mesothelial cells and macrophages but not in malignant cells in pleural effusions. Staining for beta-glucuronidase with tartaric acid inhibition is thus suggested for the differentiation of cancer cells from mesothelial cells and macrophages in effusions. PMID- 3673469 TI - Crystalline deposits in ascites in a case of cryoglobulinemia. AB - Crystalline inclusions were observed on routine cytologic studies of ascitic fluid from a patient with exudative ascites of undetermined cause. These inclusions were polymorphic, but frequently appeared as slender needles. They were seen most often in histiocytes and, less frequently, in mesothelial cells and plasma cells. Extracellular crystals were also seen. The crystals were also present in biopsy specimens of peritoneum, liver and bone marrow. Special studies by polarizing light microscopy, cytochemistry, electron microscopy and immunocytochemistry suggested that the crystals were most probably immunoglobulins synthesized by plasma cells. Some were excreted extracellularly and phagocytized by histiocytes. Further studies indicated that the patient had an indolent plasma-cell dyscrasia, resulting in excessive production of a monoclonal immunoglobulin. The immunoglobulin may have crystallized and become deposited in tissues, inciting chronic inflammatory changes. Massive deposits of crystals in the peritoneum, with the resultant inflammatory reaction, was possibly the cause of the formation of ascites. PMID- 3673470 TI - Casts or fibers? An observation in urinary cytology. PMID- 3673471 TI - Cytology "in black and white". PMID- 3673472 TI - Abstracts. Scientific session of the 35th annual meeting of the American Society of Cytology. New Orleans, Louisiana, November 4-8, 1987. PMID- 3673473 TI - Innovations in the statistical analysis of twin studies. AB - Advances in computer technology have made possible a greater sophistication in the statistical analysis of pedigree data, however this is not necessarily manifest by fitting more comprehensive causative models. Planned twin and family studies measure numerous explanatory variables, including perhaps genetic and DNA marker information status on all pedigree members, and the cohabitation of all pairs of individuals. A statistical analysis should examine the contribution of these measured factors on individual means, and in explaining the variation and covariation between individuals, concurrently with the postulated effect of unmeasured factors such as polygenes. We present two models that meet this requirement: the Multivariate Normal Model for Pedigree Analysis for quantitative traits, and a Log-Linear Model for Binary Pedigree Data. For both models, important issues are examination of fit, detection of outlier pedigrees and outlier individuals, and critical examination of the model assumptions. Procedures for fulfilling these needs and examples of modelling are discussed. PMID- 3673474 TI - Constrained maximum likelihood analysis of familial resemblance of twins and their parents. AB - When the univariate twin design is extended by including parents of twins, it is possible to assess additive genetic effects in the presence of assortative mating and genotype-environment correlation, the effects of parental influence, as well as the extent of residual shared environmental influences. The analysis of data obtained in such an extended twin design can be carried out by means of constrained maximum likelihood confirmatory factor analysis. Specifically, the structural model underlying this design can be represented as a LISREL model with nonlinear constraints. This representation offers the possibility to consider extended multivariate twin designs involving common genetic and environmental factors. The proposed method will be illustrated with applications to simulated and real data. PMID- 3673475 TI - The analysis of marital interaction in cross-sectional twin data. AB - The effects on twin data of social interaction between spouses is examined. When social interaction leads to an increase in marital resemblance (eg through reciprocal imitation), the variance of married individuals is increased, compared to the variance of unmarried individuals. Furthermore, the expected correlations between concordant married twin pairs will be lower than the expected correlations between concordant unmarried twin pairs, with the discordant twin correlations being intermediate in value. It is therefore possible, in principle, to detect the effects of marital interaction without using either longitudinal data or data on spouse pairs. However, to be detectable in twin data, marital interaction must be strong, or must exhibit marked asymmetry of effects between males and females. Genotype x environment interaction can also produce heterogeneity of correlation between concordant married, discordant, and concordant unmarried twin pairs, when genetic and environmental effects interact with marital status. However, this will usually produce increased estimates of the genetic component of variance in unmarried twins, whereas marital interaction produces increased genetic variance in married twins. PMID- 3673476 TI - Prospects for detecting genotype X environment interactions in twins with breast cancer. AB - We consider a study of MZ and DZ twin pairs ascertained because one or both twins have a disease. Genotypes at a major locus are known and putative environmental risk factors have been measured for all individuals. The power of the study to estimate the effect on liability of the measured and residual genetic and environmental effects (Gm, Gr, Em, Er) and all two-way interactions between them (except Gr X Er) is estimated by simulation. If liabilities can be indexed on a continuous scale (eg, blood pressure as an index of liability to hypertension), then a study of 600 MZ and 600 DZ pairs would have sufficient power to detect quite subtle interaction effects, even if ascertainment is greatly biased toward MZ twins. If liabilities cannot be measured and only affection status is known, then the power of the study would be much lower, although not impracticably so. There appears to be no advantage in augmenting the twins with a sample of control individuals who have been drawn at random from the population regardless of disease status, at least for the case we have considered in which the disease threshold on the liability scale is assumed to be known without error. The argument is developed in terms of the utility of the design for research into breast cancer. PMID- 3673477 TI - Spectral analysis of twin time series designs. AB - The genetic analysis of physiological time series has to accommodate the presence of autocorrelation. This can be accomplished by means of orthogonal transformation of the series, thus enabling the use of standard genetic analysis techniques for the sequence of uncorrelated transforms. In view of the oscillatory character which typifies various physiological time series, it is customary to invoke spectral techniques for the analysis of these series. It can be shown that spectral analysis is an orthogonal transformation that asymptotically resembles principal component analysis. Consequently, standard genetic analysis methods for the uncorrelated spectral transforms may be used. This approach will be illustrated with simulated and real (heart rate) data for univariate twin time series. Furthermore, it will be indicated that the proposed analysis can be readily generalized to multivariate time series. PMID- 3673478 TI - The Vietnam Era Twin (VET) Registry: method of construction. AB - A Vietnam Era (1964-1975) Twin Registry of American male-male veterans born between 1939 and 1955 has been developed to provide a study sample for research evaluating the impact of Vietnam service on the medical and psychosocial aspects of health. In preparation for developing the Registry, several alternative sources of twins and methods for identifying twins were investigated. A computerized database of veterans discharged from the military after 1967 was selected as the source because it contains about 50% of the total Vietnam era veteran population, is reasonably unbiased, and provides a feasible method for identifying twins. Twins were identified using an algorithm which involved matching entries on the database for same last name, different first name, same date of birth, and similar social security number. Twin status was confirmed by review of military records. The registry, now complete, is composed of 7,400 twin pairs. It will be an important resource for future research projects. PMID- 3673479 TI - The Vietnam Era Twin (VET) Registry: ascertainment bias. AB - An examination of ascertainment bias in identification of twin pairs in the Vietnam Era Twin Registry has been conducted. A complete listing of all male-male Vietnam era veteran twin pairs born in Connecticut between 1939 and 1955 was obtained (N = 150). An attempt was made to match these pairs with a listing of Vietnam era veteran twin pairs derived from the United States Department of Defense's Defense Manpower Data Center (DMDC) computer files. The results indicate that the DMDC files identified only 46.7% of the 150 Connecticut born Vietnam era veteran pairs. Statistically significant differences (P less than 0.05) between pairs found on the DMDC files and Connecticut veteran pairs missing from the DMDC files are observed for the following variables: a) year of discharge from military service, b) total length of active military service, c) branch of service, and d) foreign service. No consistent pattern of bias is observed for factors related to the physical and psychosocial health of veteran pairs. The implications of the ascertainment biases in the Vietnam Era Twin Registry are discussed. PMID- 3673481 TI - [Studies on glycosylated protein during pregnancy with glyc affin system]. PMID- 3673480 TI - Design and sampling considerations, response rates, and representativeness in a Finnish Twin Family Study. AB - Kinships composed of twin parents, their spouses and children, offer a robust and flexible sampling design for research in genetic epidemiology. Families-of-twins designs circumvent some of the sampling problems that arise when independent data sets are combined, and these designs provide unique evaluations of maternal influences, assortative mating and X-linkage. Unfortunately, empirical studies of families of twin parents have been limited by relatively small samples and by the self-selection biases intrinsic in ascertainment of families from volunteer twin registries. A large and representative cohort of monozygotic and dizygotic twin parents, drawn from a population-based twin registry, provides the optimal sampling frame for twin-family research. This paper reviews the sampling considerations underlying the initial family study based on the Finnish Twin Cohort and evaluates the representativeness of the sampled twins. Spouses and adult children (over 18 years) of 236 pairs of twins, about equally divided by gender and zygosity, were evaluated by a postal questionnaire. Individual response rates exceeded 86% and in 464 of the 472 nuclear families (98.3%), at last one member of the twin's family completed the questionnaire. The sampled twins, selected for fecundity to maximize statistical power of the obtained data, were broadly representative of non-selected twins drawn from the Cohort, with whom they were matched on age, gender, and zygosity. Such results suggest that the Finnish Cohort has excellent potential for extended twin-family research designs. PMID- 3673482 TI - [Clinical study on the disturbances in calcium and bone disease: renal osteodystrophy in patients with chronic renal failure]. PMID- 3673483 TI - Guidelines for medical-nursing responsibilities. PMID- 3673484 TI - "The worried well". PMID- 3673485 TI - Beyond audit--quality assurance studies and projects. PMID- 3673486 TI - Joint academic/clinical appointments: a Canadian perspective. PMID- 3673487 TI - Strategies that will pay for higher education. PMID- 3673488 TI - Politically speaking: what is media watch? PMID- 3673489 TI - The image of the nurse: a nursing perspective. PMID- 3673490 TI - Acute atypical psychosis following a right hemisphere stroke. AB - An acute atypical psychotic episode characterized by hallucinations and delusions suddenly developed in a 63-year-old right-handed male following an extensive right hemisphere infarction in the carotid artery distribution. While hallucinations were visual, tactile and auditory, delusions were associated with specific neurologic defects (anosognostic phenomenon, reduplication for place, body-parts and objects and confabulation). Distractibility, inappropriate sexual behavior, agitation or seizures were lacking. This case supports the presumption that the right hemisphere damage plays a major role in the genesis of organic psychotic episodes. PMID- 3673491 TI - [Flunarizine in epilepsy. Evaluation of a 4-month supplementary treatment in patients resistant to treatment with existing antiepileptics]. AB - Twenty patients affected with a form of epilepsy resistant to treatment received 10 to 20 mg of flunarizine per day in addition to the anti-epileptic medication. The majority of the patients suffered from partial epilepsy with or without secondary generalization. The flunarizine treatment was evaluated after four months. On the whole, flunarizine was well tolerated. The number of attacks was reduced by 50% or more in half the patients. PMID- 3673492 TI - Electrophysiological (EEG, BAEP, VEP) study in patients with beta-thalassemia major. AB - Twenty-four patients affected by beta-thalassemia major were studied by means of combined EEG, VEP and BAEP recordings. All the subjects were treated with regular blood transfusions and chelating therapy (DFO). An elevated incidence of EEG abnormalities (70.8%) consisting of diffused slow waves and/or diffused small sharp spikes was seen. VEP P100 latency was abnormally prolonged in eight patients (33.3%). Furthermore, a voltage increase of N75-P100 (29%) and P100-N145 (33.3%) VEP components was observed. Mean latency and voltage values were significantly increased when compared with those of a control group. No BAEP alterations were observed. No correlations were found between electrophysiological data, serum ferritin levels and transfusional treatment duration. The possible mechanisms involved in provoking such electrophysiological abnormalities are discussed. PMID- 3673493 TI - [Internuclear ophthalmoplegia and non-paralytic pontine exotropia]. AB - The authors discuss internuclear ophthalmoplegia associated with non-paralytic pontine exotropia of the contralateral eye. Impairment of the posterior oculogyric tract in its protuberantial segment, resulting in oculographic signs of alteration in the contralateral continuation. Seems to be responsible for the exotropia. PMID- 3673494 TI - On some myopathies with oculomotor involvement. AB - The conditions under discussion are the oculopharyngeal muscular dystrophy, the various forms of centronuclear myopathies and a variant of the multiminicore disease, namely the pleocore disease. For each of these disorders, the main clinical (including the involvement of the extraocular muscles) and histopathological features are illustrated using already reported or unpublished personal observations. The accent will essentially be laid on the lack of specificity of the clinical symptoms in congenital myopathies and on the difficulties to identify specific histological characteristics. PMID- 3673495 TI - Hemiballism. Clinico-pathological conference. AB - A case of left hemiballism is presented. Besides multiple lacunar infarcts an haemorrhage in the contralateral subthalamic nucleus is shown. A short review of the literature is given with special attention to the etiology and the therapy. PMID- 3673496 TI - Hereditary cystatin C (gamma-trace) amyloid angiopathy of the CNS causing cerebral hemorrhage. AB - Hereditary CNS amyloid angiopathy occurring in Icelanders is the first human disorder known to be caused by deposition of cystatin C amyloid fibrils in the walls of the brain arteries leading to single or or multiple strokes with fatal outcome. One or more affected members have been verified by histological examination in 8 families containing 127 affected. These originated from the same geographic area. Abnormally low value of cystatin C found in the cerebrospinal fluid of those affected can be used to support or make diagnosis of this disease, also in asymptomatic relatives. By amino acid sequence analysis the amyloid fibrils in the patients are found to be a variant of cystatin C (gamma-trace), a major cysteine proteinase inhibitor. The variant protein has an amino acid substitution (glutamine for leucine) at position 58 in the amyloid molecule. It is postulated that a point mutation has occurred leading to production of amyloidogenic protein causing the disorder. PMID- 3673497 TI - Familial centronuclear myopathy: a clinical and pathological study. AB - A congenital myotubular myopathy in a family is presented. An elderly woman, her daughter and her granddaughter showed the characteristic clinical and histological pattern of the disease. It is still a matter of debate whether the disease is of myopathic or neuropathic origin. The similarity of the muscle fibre with a myotube of the fetus might point towards an arrest of the maturation after 20th week of gestation perhaps caused by a lack of a trophic factor from the motor nerve. PMID- 3673498 TI - Vascular dementia due to cardiac arrhythmias and systemic hypotension. AB - Among 133 consecutive patients with the clinical diagnosis of vascular dementia there were 6 patients (4.5%) in whom dementia was judged to be associated with cerebral hypoperfusion due to cardiac arrhythmias and systemic hypotension. Patients with cardio-pulmonary arrest and resuscitation were excluded from this series. Our findings suggest that cerebral hypoperfusion is not an uncommon mechanism to contribute to the evolution of vascular dementia in the elderly. Besides arrhythmias, also hypovolaemia caused by diuretics medication might have been a contributory factor to hypoperfusion. It is evident that cerebral hypoperfusion is the predominant mechanism responsible for vascular dementia in some cases. It may be a contributing factor also in many cases of multi-infarct dementia. Thus, besides dementia after cardio-pulmonary arrest, vascular dementia of the haemodynamic type as a separate clinical entity is open to discussion. PMID- 3673499 TI - Experience of microsurgical compared with conventional technique in lumbar disc operations. AB - Experiences gained from the first 56 patients operated upon for lumbar disc herniation by the microsurgical technique in our clinic are presented. The results are compared with those of conventional operations performed by the author and a senior colleague. Compared with the traditional operation the microsurgical approach meant a shorter duration of operation, less bleeding during surgery, less post-operative wound pain, a shorter post-operative stay in hospital and return to work within half the usual time. Six months after operation 96% of the patients treated by the microsurgical technique were relieved of their root pain and 89% were free from low back pain. The corresponding figures at follow-up 3.6 years post-operatively were 89% and 80% respectively. Compared with the results of the present and previous series of conventional operations, this means a high degree of success. Restitution of pre operative neurological impairment was complete in 90% of the patients at 6 months. There were no haemorrhagic complications, infections or increased neurological disturbances following microsurgery. Microanatomical examinations revealed capsule formation around prolapsed sequestra with time and adherence to the nerve root, which are considered to be foreign body reactions. In conclusion, microsurgery has proven to be a safe, non-traumatic procedure in the removal of lumbar disc herniations, with very good long-term results. PMID- 3673500 TI - Ideomotor apraxia: a study of initial severity. AB - This study investigated whether there are predictors for initial severity of ideomotor apraxia (IMA) in focal left-hemisphere vascular patients. One hundred and twenty-nine subjects were examined between 15 and 30 days post-onset. Twenty five patients with bilateral lesions were also studied in order to delineate the role of the right hemisphere. Other neuropsychological variables (i.e., token test, progressive matrices and oral apraxia scores) and size of the lesion were included in the experimental design. The main results were that a) token test, progressive matrices, oral apraxia scores, and lesion size correlate significantly with IMA, and b) that the presence of a second lesion in the right hemisphere is not found to have any significant effect on initial severity of IMA. PMID- 3673501 TI - Fasciculations during wakefulness and sleep. AB - Fasciculation potentials were quantitated during wakefulness (W) and the different sleep stages in 10 patients affected by motor neuron disease. Compared to W, no statistically significant variation was present in fasciculations during any sleep stage. Fasciculations remain unaffected by the decrease in central nervous system excitability which occurs during sleep. PMID- 3673502 TI - Electrophysiological study of the peripheral and central neurotoxic effect of cis platin. AB - We describe clinical and electrophysiological findings in 8 patients with tumors of germ cell origin before and after treatment with high-dose cisplatin (800-1400 mg) combined with etoposide and bleomycin. All patients developed clinical or electrophysiological signs, or both, of a peripheral sensory neuropathy. One had in addition clinical and electrophysiological signs of CNS involvement, and 2 had a central conduction defect revealed by auditory stimulation. PMID- 3673503 TI - Responses of intracranial pressure (ICP) produced by stimulating the pressor area in the brainstem at various levels of blood pressure and ICP in cats. AB - An increase in intracranial pressure (ICP) was produced by stimulating brainstem pressor sites in cats anesthetized with alpha-chloralose. The ICP responses were augmented by lowering prestimulus BP and reduced by elevating prestimulus BP. In contrast, stimulus-induced pressor response of BP showed no consistent correlation to prestimulus BP. When the mean amplitude of stimulus-induced ICP responses at the control prestimulus ICP (within 18 mmHg) was plotted against the mean of the prestimulus BP levels for each site examined, the sites were classified into 2 groups by the regression line; sites generating a marked ICP response above the line and those generating a small ICP response on and under the line. The former sites were located in the paramedian region of the reticular formation including nuclei parvocellularis and gigantocellularis. The latter sites scattered throughout the brainstem pressor area. The ICP response at the former sites was markedly increased at an elevated prestimulus ICP. The peak ICP response at 30-50 mmHg of prestimulus ICP was 70-100 mmHg, similar to plateau waves. The ratio of ICP response size to BP response size was negatively correlated to prestimulus BP and the regression line was 2-5 times steeper at an elevated prestimulus ICP (18-60 mmHg) than at the control ICP. On the other hand, the negative relation between the response ratio and the BP for the latter sites produced no such change at the increased prestimulus ICP. These findings suggest that the ICP response is produced primarily by neurogenic intracranial vasodilation, which works most effectively at moderately decreased cerebral perfusion pressure. This mechanism may be involved in a series of events that results in plateau waves. PMID- 3673504 TI - A special type of senile plaque, possibly an initial stage. AB - It is customary to distinguish "primitive", "classic" and "compact" ("burned out") senile plaques in Alzheimer's disease and senile dementia of the Alzheimer type (SDAT). Primitive plaques are characterized by altered neurites without accumulation of amyloid, classic plaques by an amyloid core surrounded by altered neurites and compact plaques by amyloid without pathological neurites. Here we describe a further type of plaque in which no amyloid or obviously altered neurites could be found by light microscopy with appropriate stains. This type of plaque was found mainly in the lateral entorhinal region and could be recognized by a slightly more intense staining and an altered texture of the neuropil in a spherical area having the same size as an early or mature plaque (100-150 microns in diameter). In non-serial paraffin sections (3-4 microns thick), a dark, silver positive cell measuring 10-12 microns in diameter was found in the center of 49 out of 400 such plaques (about 12%), which is the expected frequency if one assumes that every plaque contains such a cell and measures itself about 125 microns. In fact, the reconstruction of 15 plaques (from four different patients) by means of serial sections demonstrated the presence of a central cell in each of them suggesting that this cell is an essential component of this plaque type. The central cell did not react with antibodies against cells of the mononuclear phagocyte lineage, such as alpha-1-antichymotrypsin, alpha-1-antitrypsin, leucocyte common antigen and lysozyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673505 TI - Epithelial properties of pleomorphic xanthoastrocytomas determined in ultrastructural and immunohistochemical studies. AB - Three cases of pleomorphic xanthoastrocytoma (PXA), one of which showed anaplastic evolution, are described. In all three the PXA tumors were well circumscribed and could be totally removed. Light-microscopically, pleomorphic tumor cells clustered gregariously and often formed alveolar structures. Electron microscopy revealed various epithelial properties, such as junctions and interdigitations between apposing tumor cells, and prominent basal laminae surrounding tumor nests. The circumscribed growth of PXA, as contrasted with an infiltrative growth of usual astrocytoma, can be attributed to the cellular cohesion based on the epithelial properties of the tumor cells. In the third patient, tumor recurred 6 months postoperatively. Although the recurrent tumor retained the alveolar structures, pleomorphism and various degenerative features of the tumor cells diminished with advance in the proliferative activities. PMID- 3673507 TI - Induction of synchronized relapses in SJL/J mice with chronic relapsing experimental allergic encephalomyelitis. AB - Chronic relapsing experimental allergic encephalomyelitis (CR-EAE) was induced in SJL/J mice by two injections of encephalitogenic emulsion. The majority of mice developed multiple relapses from day 22 to day 367 post injection. To induce synchronized relapses a third injection of the encephalitogenic emulsion was given. Almost all mice that received the third injection developed an acute, synchronized relapse with severe clinical signs within 7 to 11 days. Histologically, there was no difference between the lesions in the spontaneous versus the precipitated relapse. CR-EAE in SJL/J mice modified with the third injection offers an advantage of a reproducible and well-timed acute relapse, which allows precise dissection of the immunological events governing spontaneous relapses in chronic EAE. PMID- 3673506 TI - Experimental allergic myositis: strain 13 guinea pig immunised with rabbit myosin B fraction. AB - Of 32 guinea pigs (Hartley and strain 13), 20 were immunised with whole muscle homogenate, microsome or myosin B fraction of rabbit skeletal muscle with Freund's complete adjuvant (FCA); the purified myosin fraction was also used as an antigen in four animals at a concentration lower than other antigens; four were injected with normal saline and FCA; other four had no injection. Five histological changes, namely necrosis, phagocytosis, central nuclei, inflammation and vacuoles, in the quadriceps femoris muscle were compared by quantitative analysis. The group immunised with myosin B fraction showed necrosis, phagocytosis and inflammation more frequently than those immunised with other preparations (p less than 0.05). The changes were more frequent in the strain 13 than in Hartley (p less than 0.05). PMID- 3673508 TI - Growth fraction in human brain tumors defined by the monoclonal antibody Ki-67. AB - The monoclonal antibody Ki-67, which reacts with cells in the active part of the cell cycle, was used to evaluate immunocytochemically the growth fraction in 22 primary brain neoplasms. The percentage of labelled cells reflected the histological grade of malignancy of each neoplasms. High percentage of Ki-67 positive cells were observed in one choroid plexus carcinoma (60%), one primary melanoma of meninges (40%), three medulloblastomas (40%-50%), one anaplastic astrocytoma and six glioblastomas (10%-40%). One ependymoma had 7% positive cells. Rare positive cells (1%) were present in one pilocytic astrocytoma and one ganglioglioma. Except one negative case, the meningiomas (five cases) had values of positivity ranging from 1% to 6%. Two acoustic schwannomas were negative. These results suggest that immunocytochemical staining with the Ki-67 may be a useful method for measuring the growth fraction in brain neoplasms. PMID- 3673509 TI - Selective kainic acid lesions in cultured explants of rat hippocampus. AB - The influence of the excitotoxin kainic acid (KA) on cultivated explants of rat hippocampus was investigated. Addition of 3 microM KA to the culture medium over 24-48 h induced a destruction of the pyramidal cells in the CA3 region, whereas the CA1 pyramidal cells and the granule cells were left undamaged. Higher concentrations (10-100 microM) of KA destroyed also the latter cell groups. The selectivity of the KA lesion at 3 microM was further indicated by the fact that the acetylcholinesterase-positive neurons in the hippocampus were not destroyed through KA administration and that the stereoisomer dihydrokainic acid was ineffective in inducing lesions. Application of tetrodotoxin did not protect the CA3 pyramidal cells from KA lesion, whereas gamma-glutamylaminomethylsulphonic acid (GAMS) only offered a very small, statistically not significant, protection. Baclofen protected the cultures slightly from KA lesions but not when added together with GAMS. Possible mechanisms responsible for the KA lesions in these cultures are discussed. PMID- 3673510 TI - Simultaneous visualization of vascular permeability change and leukocyte egress in the central nervous system during autoimmune encephalomyelitis. AB - An unresolved issue in the study of demyelinating disease is whether blood-brain barrier damage is dependent upon the migration of inflammatory cells into the central nervous system (CNS). In a study of experimental autoimmune encephalomyelitis (EAE) in rabbits, a freeze-dried, paraffin-embedded tissue technique was exploited to enable (1) the immobilization of intravenously injected sodium fluorescein tracer, as an index of vascular permeability; and (2) an effective labeling by monoclonal antibodies of both T-lymphocytes and mononuclear phagocytes in "unfixed" neural tissue. Using these newly combined methods, evidence was found that increased vascular permeability in the CNS during EAE occurs concomitantly with, and not prior to, infiltration by mononuclear phagocytes. PMID- 3673511 TI - Congenital hypo- and hypermyelination neuropathy. Two cases. AB - Two young patients were referred recently to the authors for investigation of a peroneal atrophy syndrome. Since the first symptoms were observed in infancy, a congenital hypomyelination neuropathy was suspected, and superficial peroneal nerve biopsies were taken. Signs of severe and widespread demyelination/remyelination were observed. These features appeared morphologically similar to those observed in the globular or tomaculous neuropathies. The mechanism of the hypermyelination is discussed. PMID- 3673512 TI - Cerebellar hemispheric agenesis. AB - A case report is reported of bilateral cerebellar hemispheric agenesis which was associated with secondary degeneration of cerebellofugal and cerebellopetal tracts. Somatotopic correlations between the cerebellar and the medullary olive lesions were obvious: preserved dorsal accessory olives pattern correlated with the spared vermis and normal medial accessory olives with the spared flocculi. Cerebellopetal degeneration was more difficult to analyse. The relation of cerebellar agenesis with basal ganglia abnormalities and microcephaly is discussed. PMID- 3673514 TI - Mitochondrial angiopathy in cerebral blood vessels of mitochondrial encephalomyopathy. AB - We studied cerebral blood vessels of two autopsied patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). All the main cerebral arteries in the proximal portion at the brain base and more distal portion at the cortical surface, as well as within the brain parenchyma were examined by electron microscopy. There was a striking increase in number of mitochondria in the smooth muscle and endothelial cells, which were most prominent in the pial arterioles and small arteries up to 250 micron in diameter and less frequent and severe in the larger pial arteries and intracerebral arterioles and small arteries. These vascular changes have not hitherto been described in MELAS, or in other disorders affecting blood vessels of the brain and other organs. It is suggested that the vascular changes are caused by primary mitochondrial dysfunction in the vascular smooth muscle and endothelial cells of the brain and that they constitute the pathogenic base of the brain lesions and their unusual distribution pattern in MELAS. PMID- 3673513 TI - Histopathological criteria for progressive dementia disorders: clinical pathological correlation and classification by multivariate data analysis. AB - Autopsied brains from 55 patients with dementia between 59-95 years of age (mean age 77.9 +/- 8.1 years) and 19 non-demented individuals between 46-91 years of age (mean age 74.3 +/- 10.5 years) were examined to establish histopathological criteria for normal ageing, primary degenerative [Alzheimer's disease (AD)/senile dementia of Alzheimer type (SDAT)] and vascular (multi-infarct) dementia (MID) disorders. Senile/neuritic plaques, neurofibrillary tangles, microscopic infarcts and perivascular serum protein deposits were quantified in the frontal lobe (Brodmann area 10) and in the hippocampus. The demented patients were classified according to the DSM-III criteria into AD/SDAT and MID. Operationally defined histopathological criteria for dementias, based on the degree/amount of the histopathological changes seen in aged non-demented patients, were postulated. The demented patients were clearly separable into three histopathological types, namely AD/SDAT, MID and AD-MID, the dementia type where both the degenerative and the vascular changes are coexistent in greater extent than are seen in the non demented individuals. Using general clinical, gross neuroanatomical and histopathological data three separate dementia classes, namely AD/SDAT, MID and AD-MID, were visualized in two-dimensional space by multivariate data analysis. This analysis revealed that the pathology in the AD-MID patients was not merely a linear combination of the pathology in AD/SDAT and MID, indicating that AD-MID might represent a dementia type of its own. The clinical diagnosis for AD/SDAT and MID was certain in only half of the AD/SDAT and one third of the MID cases when evaluated histopathologically and by multivariate data analysis. AD/SDAT, MID and AD-MID were histopathologically diagnosed in 49%, 24% and 27%, respectively, of all the dementia cases studied. Opposite correlation between the number of tangles, plaques and the patient age in non-demented and AD/SDAT cases were observed, indicating that the pathogenesis of tangles and plaques in the two groups of patients might be different and that AD/SDAT might not be a form of an exaggerated ageing process. PMID- 3673515 TI - Cellular reactions to implantation of a microdialysis tube in the rat hippocampus. AB - Microdialysis tubes, used for measurements of extracellular neurotransmitter concentrations, were implanted in rat dorsal hippocampus to study the adjacent tissue reaction. The brain was examined 1-60 days after the implantation. Within the first 2 days, normal neuropil and only occasional hemorrhage surrounded the microdialysis tube. Three days following the implantation astrocytes close to the dialysis tube, hypertrophied. Hypertrophic astrocyte processes invaded the spongy fiber wall. There was no increase in the number of astrocytes. Fourteen days after the fiber insertion layers of reticulin-positive fibers separated astrocytes and the remaining neuropil from the fiber wall. Late tissue changes (1 and 2 months) consisted of collagen deposits and occasional granuloma formation. These results can be used to predict the optimal time for commencing microdialysis after the fiber implantation. PMID- 3673516 TI - Neuroanatomical anomalies in autoimmune mice. AB - The cerebral cortex was examined for signs of pathology in the NZB, BXSB, and MRL autoimmune strains of mice, crosses among these strains, and control mice. Previously, we reported that 20% of NZB mice had ectopic collections of neurons in layer I of the cortex. In this study we replicated this finding in the NZB, and extended it to the BXSB strain, and BXSB/NZB and MRL/NZB hybrids. The MRL strain, however, did not have a large number of individuals with brain anomalies. Thus, a number of autoimmune mice strains and hybrids develop brain anomalies, although at least one autoimmune strain does not. We suggest that in certain autoimmune strains maternal autoantibodies cross the placenta and damage the developing fetal brain, and that these strains may be useful experimental models for studying the development of brain anomalies seen in the dyslexic human. PMID- 3673517 TI - Cell kinetics of the malignant evolution of meningothelial meningioma. AB - A meningotheliomatous meningioma occurred in the right parietal parasagittal region of a 43-year-old woman. A total excision was carried out. Three years and 9 months later, one parasagittal and two falx tumors in close proximity recurred and were excised. The falx tumors showed the features of an anaplastic transitional meningioma with increased mitoses. The falx meningioma recurred locally and repeatedly, despite radiation therapy and chemoimmunotherapy. She died 7 years and 8 months after the onset. At autopsy, the tumor was found to have metastasized via the cerebrospinal fluid to the spinal cord and pituitary stalk. Extracranial metastases were not evident. At the fourth craniotomy, bromodeoxyuridine (BrdU) was administered intravenously to label tumor cells in the S phase of the cell cycle. The BrdU-labeled cells accounted for 9.0%; they are usually less than 1% in benign meningiomas. Meningothelial meningiomas with a high labeling index recur rapidly, even after Simpson's grade 2 removal, and treatment for a malignant meningioma should be instituted. PMID- 3673518 TI - Blood-brain barrier leakage and brain edema in stroke-prone spontaneously hypertensive rats. Effect of chronic sympathectomy and low protein/high salt diet. AB - Brain edema associated with severe chronic hypertension was studied in stroke prone spontaneously hypertensive rats (SHRSP), 5 to 9 months of age. Blood-brain barrier (BBB) leakage sites and intracerebral spreading pathways for plasma proteins were delineated by an intravenously (i.v.) injected exogenous dye tracer (Evans blue), known to form a complex with albumin in blood, and by immunohistochemical visualization of extravasated endogenous plasma proteins. The tissue content of edema fluid was estimated by measuring the specific gravity of selected brain regions, stained or unstained by the tracer dye, on a bromobenzene kerosene gradient column. Multifocal BBB leakage sites were macroscopically detected within the cerebral cortex and the deep gray matter after i.v. circulation of Evans blue-albumin for 30 min. After 24 h of i.v. circulation the dye tracer had spread not only locally in the gray matter but also into the adjacent white matter, where it was widely distributed. Immunohistochemically visualized plasma proteins showed similar distribution. Unilateral superior cervical ganglionectomy performed at 4 weeks of age neither increased the incidence of major BBB opening to Evans blue-albumin nor altered the specific gravity of the ipsilateral cerebral hemisphere in grown-up SHRSP, furthermore, the blood pressure remained unchanged. The lack of significant effect on BBB function may possibly be attributed to the extensive reinnervation of the cerebral arteries, verified in the grown-up SHRSP using the Falck-Hillarp fluorescence method for visualization of catecholaminergic nerve fibers. In SHRSP raised on a low-protein and high-salt diet the mean arterial blood pressure was 212 mm Hg compared to 195 mm Hg in controls (P less than 0.05) and the incidence of BBB opening was 72% compared to 25% in controls (P less than 0.05). After 24 h of i.v. circulation of Evans blue-albumin, brain regions stained by the dye tracer showed significantly reduced specific gravity (P less than 0.001), while unstained regions had normal values. Thus the brain edema fluid spread, as revealed by specific gravity measurements, corresponded to the intracerebral distribution of extravasated plasma proteins. PMID- 3673519 TI - Two cases of agenesis of the vermis of cerebellum, with fusion of the dentate nuclei and cerebellar hemispheres. AB - Two cases are reported of the rare anatomical abnormality of fusion of the cerebellar hemispheres with agenesis of the vermis. The cases are the more unusual since they show prolonged survival and the absence of other major fusion abnormalities in the nervous system. PMID- 3673520 TI - Megacolon in third-phase malrotation with delayed migration and degeneration of intramural ganglionic cells and nerves. AB - A woman of 36 was admitted to hospital because of griping abdominal pain which occurred especially during the night when turning in bed. She had a history of constipation and bloating since birth. Irrigoscopy revealed megacolon extending from the middle of the transverse colon to the rectum. A rectal biopsy excluded Hirschsprung's disease. When surgery was performed, megacolon combined with malrotation of the colon was found, only the ascending colon being attached to the abdominal wall. Hemicolectomy was performed. In the megacolon, a cropolith, the size of a foetal head, was found which along with malrotation of the large intestine had caused the woman's symptoms. The nerve supply of the ascending colon was normal but in the megacolon there was evidence of delayed migration of ganglion nerve cells and varying degrees of degeneration of ganglion nerve cells and intraganglionic nerve fibres. Malrotation of the colon associated with megacolon and delayed migration of ganglion nerve cells and degeneration of nerve elements has not been reported previously. PMID- 3673522 TI - Nasu-Hakola's disease (membranous lipodystrophy). AB - An autopsy case of Nasu-Hakola's disease (membranous lipodystrophy) is reported. A 43-year-old Japanese man, whose parents were not consanguineous, had been suffering from frequent long bone fractures since the age of 10. Neuropsychiatric symptoms, which were characterized by euphoria, disturbance of attention and dementia, appeared at his thirties and generalized and/or localized seizures and apallial syndrome at the later stage. The neuropathology revealed diffuse leukoencephalopathy of the cerebrum. The peculiar aspects in this case were membranocystic changes in the lungs [Yagishita et al. Virchows Arch [A] 408:211 217 (1985)], diffuse degeneration of the cerebral cortex, chiefly in frontal and temporal lobes, and many axonal spheroids throughout the cerebral cortex. The ultrastructure of spheroids in the cerebral cortex demonstrated aggregations of mitochondria, dense bodies and minute concentric bodies and a small amount of neurofilaments. PMID- 3673521 TI - Mitochondrial encephalomyopathy. A variant with heart failure and liver steatosis. AB - We report the clinical and autopsy findings in a young man of 18 with a chronic progressive disorder comprised of lactic acidosis, mental deterioration, and epileptic seizures which were sometimes accompanied by stroke-like episodes with transient hemiparesis and cortical blindness. He died of congestive heart failure. The autopsy showed lesions of the gray matter of the brain. Both the putamen and parieto-occipital cortex showed loss of neurons and proliferation of macrophages, astrocytes and vessels. There was marked loss of neurons in the inferior olives, and slight reduction of the number of Purkinje cells. Skeletal muscle studies revealed ragged-red fibers and structurally abnormal mitochondria. The heart was enlarged: accumulations of mitochondria occurred in the muscle fibers. The liver exhibited marked fatty degeneration. Biochemical analyses showed normal activities of pyruvate dehydrogenase in thrombocytes, pyruvate carboxylase in lymphocytes, biotinidase in serum as well as succinate dehydrogenase and cytochrome c oxidase. The features of this disorder differ in many respects from cases of mitochondrial encephalomyopathy previously reported and cannot be assigned to any specific disease entity. PMID- 3673524 TI - Staphylococcal adherence to chicken cartilage. AB - Immature chicken cartilage was incubated in a Staphylococcus aureus suspension and then washed. Scanning electron microscopy and radiolabel measurements showed increased adherence to cartilage with increasing bacterial concentration. Preheating of the bacteria did not reduce the adherence property, but trypsin treatment did. PMID- 3673523 TI - Ultrastructural alterations of neuronal cells in a brain stem ganglioglioma. AB - A brain stem ganglioglioma in a 9-year-old female was examined ultrastructurally. The constituent neuronal (ganglion) cells displayed various ultrastructural features of neuronal degeneration including Hirano, Lafora and zebra bodies, inclusion-like aggregates of neurofilaments and large dilatations of rough endoplasmic reticulum. Although similar observations have been reported in peripheral neuronal tumors, this is the first reported occurrence in ganglioglioma, an uncommon tumor in the central nervous system. The coincidence of these alterations in the present tumor appeared to be of great interest, however, their exact etiology remained uncertain. PMID- 3673525 TI - Tissue vitality in septic gonitis. 99mTc-DPD scintimetry in puppies. AB - After a single intraarticular injection of 10(9) Staphylococcus aureus in 12 puppies, septic arthritis developed in all the experimental knees after 48 hours. A considerable variability in scintigraphic appearance was observed. The juxtaarticular growth plates showed either unchanged or slightly decreased uptake except in 1 dog exhibiting a definite increase in tracer uptake. The epiphyseal uptake showed no consistent pattern. The intraarticular pressure of the arthritic joints increased significantly, but was not related to the tracer uptake pattern. We conclude that delayed joint scintigraphy as a single investigation in early septic arthritis does not provide diagnostic information and may be misleading. PMID- 3673527 TI - Fixation of trochanteric hip fractures. A cadaver study of static and dynamic loading. AB - Human cadaveric femora were subjected to static and uniaxial dynamic load applied on the femoral head by a simulator. By two transducer-mounted aluminium rings attached to the bone, the static and the dynamic load causing an elastic deformation of 1 mm in the trochanteric region was assessed. A trochanteric fracture was then produced and stabilized by one of three fixation devices, after which the test was repeated. The unfractured femora had the most rigid appearance (static load, 25.9 KN/mm; dynamic load, 33.1 KN/mm). Of the fractured and stabilized specimens, the Jewett nail-plate gave the most rigid fixation (static load, 5.4 KN/mm; dynamic load, 11.5 KN/mm). The least rigid femora were those stabilized by the dynamic Nolok (static, 4.7 KN/mm; dynamic, 9.2 KN/mm) and Hansson (static, 3.2 KN/mm; dynamic 6.1 KN/mm) telescoping devices. Because of the viscoelastic properties of bone, the load applied in a hip simulator should be dynamic; otherwise, the ability of the device to withstand in vivo loading might be underestimated. PMID- 3673526 TI - Cefuroxime prophylaxis in trochanteric hip fracture operations. AB - In a double-blind randomized study of antibiotic prophylaxis in trochanteric fractures operated on with a nail and plate, a 24-hour intravenous administration of cefuroxime 0.75 grams thrice daily (Group B) was compared with the previous regimen of cefuroxime for 24 hours plus 6 days of oral cephalexin (Group A). In each group, 56 (Group A) and 65 (Group B) patients could be evaluated. One deep infection occurred in Group B with growth of Staphylococcus aureus, and another 4 patients had discharge and cultures of which 2 showed S. aureus. In Group A, 6 patients had signs of an infection, and in 3 patients cultures were taken but were negative. There were no differences between the groups. We concluded that the prophylaxis time need not be longer than 3 days. PMID- 3673528 TI - Changes in bone-mass after tibial shaft fracture. AB - We studied 20 patients who had suffered tibial shaft fractures 30 months previously. The bone-mineral content in diaphyseal and metaphyseal bone of the femur and tibia was determined by photon absorptiometry. There was a moderate, but significant, deficit of bone-mineral in metaphyseal bone at the knee and distal tibia. This loss was, however, far smaller than that previously reported. Persisting bone-mineral changes in diaphyseal bone were insignificant except in the fracture area where there was a 28 per cent increase. This may indicate that bone may, under some circumstances, locally increase in strength after remodelling of the fracture. PMID- 3673529 TI - The interrelationship of past and present fractures of the forearm and hand. AB - We analyzed 366 consecutive patients treated for low-energy trauma fractures below the elbow who had a history of previous fractures below the elbow. Patients with previous metacarpal or finger fractures were liable to have subsequent hand fractures of the ipsilateral side. Healed Colles' fractures appeared to confer a relative protection against refracture. Only one fifth of subsequent Colles' fractures were ipsilateral to the previous injury. PMID- 3673530 TI - Scintigraphy in nontraumatic femoral head necrosis. AB - We performed serial 99mTc-MDP bone scintigraphy of nontraumatic femoral head necrosis in 14 hips of 10 patients. The uptake of isotope was decreased in the very early stage, and either variable or increased at the stage when symptoms appeared. A variable uptake changed to increased uptake in 3 of 10 patients, but there was no hip in which an increased uptake changed to a variable uptake. No relationship was demonstrated between the scintigraphic appearance of the femoral head and the pain and function of the hip. PMID- 3673532 TI - Presence of macrophages at the bone-cement interface of stable hip arthroplasty components. AB - The bone cement interface of four clinically stable hip-joint prosthetic components was examined histologically for the presence of macrophages using routine staining and a histochemical technique for acid phosphatase. Macrophages were found in the absence of wear debris in all four cases. Because these cells are capable of bone resorption, their presence at a well-fixed interface must give cause for concern. PMID- 3673531 TI - Bone repair inhibited by indomethacin. Effects on bone metabolism and strength of rabbit osteotomies. AB - We measured mineral content, maximum bending strength, and regional blood flow after tibial osteotomy fixed with a small metal plate in 38 rabbits. Half of the animals were treated with indomethacin (10 mg/kg/day) while the other half served as controls. After 2 and 6 weeks, the bone mineral content and maximum bending strength were lower in the indomethacin group when compared with the controls. Compared with the controls, the blood flow at the osteotomy site was decreased after 2 weeks and increased after 6 weeks in the indomethacin-treated animals. Inhibition of blood flow increase by indomethacin medication in the early period following osteotomy, as well as retarded bone healing, are probably caused by inhibition of the inflammatory reaction. PMID- 3673533 TI - Hyperflexion sprain of the cervical spine. Follow-up of 45 cases. AB - A long-term follow-up study of a series of 45 consecutive patients with a hyperflexion sprain causing anterior subluxation of the cervical spine shows that conservative management is successful in more than 50 per cent of children and adults. In patients under 16 years of age, usually with involvement of the C2-C4 level, kyphosis may persist for months, but later realignment is common. Primary surgical treatment should be restricted to children with a kyphotic angulation of more than 20 degrees. In adults with injuries commonly at the C4-C7 level, the failure rate of conservative management indicates that primary surgical treatment should be preferred unless kyphotic angulation is less than 10 degrees. Kyphosis may progress during conservative management and may even result in unilateral interlocking. However, none of the patients with a persisting kyphotic angulation had neck complaints. Neurologic involvement when present was mild and reversible. Posterior wiring and fusion may entail inadvertent inclusion of adjacent segments without, however, causing major residual symptoms. PMID- 3673534 TI - Forefoot amputation in rheumatoid arthritis. AB - Five patients with long-standing rheumatoid arthritis underwent transmetatarsal amputation. Operative indications were severe pain on walking, marked deformity of the forefoot, and no effect of conservative treatment. After a median follow up time of 7 (1-12) years, 4 patients had no pain, all patients could wear normal shoes, and the gait was significantly improved without imbalance. PMID- 3673535 TI - Metatarsal osteotomy in rheumatoid arthritis. AB - Thirty-eight feet in 28 patients with rheumatoid forefoot deformity were operated on with a proximal valgus osteotomy of the first metatarsal bone to reduce splaying of the forefoot. Each patient also underwent additional surgical procedures for associated conditions of the forefoot. The mean follow-up period was 3.7 years. Both the entire forefoot and the medial border of the foot were substantially improved in all but 2 cases. Residual symptoms were slightly more pronounced in the anterior footpad and the lesser toes (5 cases). A proximal valgus osteotomy of the first metatarsal bone, performed in combination with other surgical procedures, affords a good correction of the rheumatoid foot deformity with long-term improvement. PMID- 3673536 TI - Mobility of the ankle mortise. A roentgen stereophotogrammetric analysis. AB - In 7 adult volunteers, a roentgen stereophotogrammetric technique was used to analyze the tibiofibular relationship during active unloaded movements of the ankle. The greatest movements were observed during plantar to dorsiflexion with an average widening of the ankle mortise of 1.0 mm and an average dorsal translation of the fibula of 0.9 mm. No significant rotation of the fibula could be revealed. PMID- 3673537 TI - Development of the olecranon bursa. An anatomic cadaver study. AB - Anatomic dissection of the elbows of 63 cadavers selected at random were performed in an attempt to find out whether the incidental disparity of olecranon bursitis between children and adults might be explained by anatomic differences. The volume of the bursae was determined by syringes used for methylene blue injections. There were no olecranon bursae in children under the age of 7 years; the volume of the bursae increased with age; and the bursa was usually larger on the right, i.e., the common dominant side. The formation of the bursae in late childhood can explain the low incidence of olecranon bursitis in children. PMID- 3673538 TI - Silicone implant arthroplasty in Kienbock's disease. AB - Fifty-five patients with malacia of the carpal lunate treated by Swanson's silicone implant arthroplasty were reexamined. The follow-up period averaged 3 years. The operation had a favorable effect on pain, but the range of motion and the grip strength remained impaired. Arthrosis progressed in half the cases, and there were five dislocations of the implant and 11 cases of cystic changes of carpal bone. PMID- 3673540 TI - Irreducible posterolateral elbow dislocation. A case report. AB - It is extremely rare that a posterolateral elbow dislocation resists closed reduction. The condition is characterized by the presence of a prominent radial head that is caught in a buttonhole tear of the lateral collateral ligament and capsule. PMID- 3673539 TI - Synovial chondromatosis of the shoulder. A case report. PMID- 3673542 TI - Popliteal aneurysm after plate osteosynthesis. A case report. AB - A false aneurysm of the popliteal artery caused acute ischemic symptoms 23 years after plate osteosynthesis of a distal femoral fracture. The protruding tip of a screw was found in the center of the aneurysmal sac. PMID- 3673541 TI - A case of phalangeal lengthening. AB - A severely shortened and deformed index finger--due to osteomyelitis of the middle phalanx--of a 12-year-old boy was lengthened by using a Kessler distraction device. Distraction for 2 weeks followed by interposition of a 15-mm bone graft resulted in a stable painless finger of normal length. PMID- 3673543 TI - A case of superior dislocation of the patella. AB - A 56-year-old woman with arthrosis of the knee sustained a fixed superior dislocation of the patella from a minor trauma. Closed reduction was performed. Only 3 other cases have been found reported in the literature. PMID- 3673544 TI - Intradural lumbar disc protrusion. A case report. AB - We report a rare case of intradural lumbar disc protrusion describing a specific myelographic appearance that may help in preoperative diagnosis. Most of these patients present with acute sciatica and neurologic deficit. Preoperative awareness and diagnosis is of importance because the extruded disc protrusion lies intrathecally and must be specifically looked for and removed from its intradural position. PMID- 3673545 TI - Avulsion of the triceps tendon in secondary hyperparathyroidism. A case report. AB - We report a case of avulsion of the triceps brachii tendon in a patient with secondary hyperparathyroidism due to hemodialysis. A convulsion led to a stress rupture of the tendon, already weakened by degenerative changes. After surgical repair the patient regained nearly normal range of motion and strength. PMID- 3673546 TI - Neuropathic osteonecrosis of the knee in childhood. Two cases of myelomeningocele. AB - Two girls, aged 11 and 7 years, with myelomeningocele had osteonecrosis in the lateral tibial epiphysis and in the medial femoral condyle, respectively. Both girls suffered from sensory impairment of the affected area and presented with warmth and swelling of the knee. No signs of infection were found. The necroses seen in radiographs were confirmed by biopsy and 99mTc-MDP scintigraphy. The lesions showed only little tendency to heal, and rather severe growth disturbances developed despite treatment in long leg calipers. One of the girls was unable to walk because of the loss of muscular power during the long period of bracing. PMID- 3673547 TI - Proceedings of the Scandinavian Orthopedic Association 43rd assembly. Trondheim, Norway, June 11-14, 1986. Part III. Abstracts. PMID- 3673548 TI - Proceedings of the Netherlands Orthopaedic Society. Breda, January 23-24, 1987. Abstracts. PMID- 3673549 TI - Persistence of synaptic bodies in saccular hair cells of senescent mice. AB - The morphology of the afferent synapse in type I (HCI) and type II (HCII) saccular hair cells was compared in juvenile and very old C57BL/6NNia mice. Normal membrane specializations and normal synaptic body (SB) form and organization were found to continue well beyond the expected life span. Although SB were found less frequently in HCI than in HCII, they were as readily found in old saccules as in juveniles. The elongated rod was the most common form in HCI and the spheroid was the most common in HCII. Large clusters of SB (greater than 5), found in both juvenile and old saccules, were unique to HCI. SB in HCII were generally found singly. A range of forms, including hollow and striated dense bodies, also occurred in both juvenile and very old saccules. Singular or clustered SB were found free in the cytoplasm as well as engaged at the membrane. No SB were seen at sites other than nerve terminal appositions. In rare instances a SB was observed engaged at a site that appeared to be opposite an efferent fiber. PMID- 3673550 TI - Ultrastructure of the stria vascularis and Reissner's membrane in experimental hydrops. AB - A time-sequence study was made of the early ultrastructural changes of the stria vascularis and Reissner's membrane in the guinea pig after obliteration of the endolymphatic sac and duct. Pathological alterations of both the stria vascularis and Reissner's membrane were found to start in the apex of the cochlea. The morphological changes of the stria vascularis were characterized by an increase of vesicles in the marginal cells and by intercellular edema, followed by vacuolization and atrophy of marginal and intermediate cells. In Reissner's membrane extensive gaps in the mesothelial cell layer were observed together with intracellular pathology of the epithelial cells. The significance of these ultrastructural changes in the stria vascularis and Reissner's membrane with regard to the pathophysiology of the endolymphatic hydrops is discussed. PMID- 3673551 TI - A scanning electron microscopic study of cochlear changes in iron-deficient rats. AB - The effects of iron deficiency on the cochlea were studied in growing rats fed with a basic iron-deficient diet for 80 days. The electrophysiological changes (auditory thresholds raised more than 15 dB) were observed in 47% of the cochleas of iron-deficient rats. When these organs of Corti were examined by scanning electron microscopy, abnormalities of outer or inner hair cells were found, as follows: (1) fusion and torsion of the stereocilia, (2) coalescence of adjacent stereocilia in the same row, (3) loss of sensory hair stiffness, and (4) loss of stereocilia. Within each lesion, the neighbouring supporting cells and their microvilli showed no damage. The findings indicate that cochlear impairment can be induced by iron deficiency. The peroxidative mechanisms responsible for the lesions of stereocilia in iron deficiency are discussed. PMID- 3673552 TI - Myocardial activity during noise exposure. AB - The present investigation was performed to study coronary blood flow along with other indices of cardiac activity in subjects exposed to short-term noise. The study was carried out on 10 normal-hearing individuals suffering from Variant Angina of Prinzmetal. The acoustic stimuli consisted of 100 dB (A) broad-band noise, lasting 30 s. The following parameters were examined: ECG (D1, D2 and D3) and heart-rate by means of electrocardiographic recording, left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP) and dP/dT max by means of arterial catheterization, and coronary blood flow by means of the thermodilution method. The results, statistically evaluated by means of multiple comparison test and t-test, did not reveal any significant modifications in the ECG traces, LVEDP, or dP/dT max. The transitory and moderate variations of LVSP and heart rate were not reflected in coronary blood flow, which remained unchanged during and after noise exposure. PMID- 3673553 TI - Acute acoustic trauma. AB - Acute acoustic trauma is a clinical condition with immediate persistent hearing loss after impulse or blast wave noise. This condition is not well recognized in occupational medicine and probably not even in otolaryngology. We report 52 cases of acute acoustic trauma including information concerning the traumatic event. Most cases occurred within military service and in the shipbuilding industry. Except for immediate hearing loss, many patients experienced tinnitus and some pain and hyperacusis. Relatively few patients report immediately. Most patients have been met by a nihilistic approach to therapy, in most cases due to the fact that patients report long after the trauma. The aim of the report is to focus attention on this clinical condition, since there is some indication that the final outcome may improve if patients are taken care of and treated early. PMID- 3673554 TI - Cochlear blood flow in relation to age in normotensive and spontaneously hypertensive rats. AB - Cochlear blood flow was studied with the microsphere method in young and old normotensive and spontaneously hypertensive rats. The young animals were 3-6 months old and the old ones 18-24 months. The cochlear blood flow in young rats was 1.64 microliter/min/cochlea for the normotensive and 1.51 for the spontaneously hypertensive rats. In the old rats, the cochlear blood flow rates were 1.40 and 1.29 microliter/min/cochlea, respectively. The differences were not significant between the age groups, nor between the normotensive and spontaneously hypertensive rats. However, there was a tendency towards lower cochlear blood flow with increasing age, especially among the spontaneously hypertensive rats. The difference between young normotensive and old spontaneously hypertensive rats was significant (p less than 0.05). The group of old hypertensive rats was also the only one with evident morphological changes in the organ of Corti. PMID- 3673555 TI - The influence of pregnancy on the eustachian tube function in rats. AB - Textbooks of otorhinolaryngology usually report that one-third of women diagnosed for patulous Eustachian tube (tuba aperta) are pregnant or on estrogenic therapy. To investigate whether the opening of the Eustachian tube (ET) can be facilitated experimentally during pregnancy, the ET opening function of 14 pregnant rats was compared with that of 14 nonpregnant controls. The air pressure at which the ET opened (the pressure opening level, Pol) when air is injected into the middle ear, and the pressures maintaining open ET during continued air injection were measured. The Pol was lower in the pregnant rats, whereas there was no difference in pressures between the two groups during open ET. The differences between Pol and the pressures during open ET were smaller in the pregnant rats than in the controls. It was furthermore demonstrated in 2 rats that, after instillation of a surface tension lowering substance in the middle ear, the Pol was reduced markedly, whereas the effect on the pressure during open ET was less pronounced. It is concluded that pregnancy facilitates opening of the ET in rats and it is suggested that it is done by reducing the surface tension of the ET secretion. PMID- 3673556 TI - Influence of altered middle ear pressure on cochlear microphonics. AB - Patients with otitis media with effusion often have impaired hearing loss caused by bone conduction. Among several possible causes for this hearing loss, the influence of middle ear pressure upon hearing was examined. Cochlear microphonics (CM) of guinea pigs were recorded under positive or negative pressure created simultaneously in the middle ear and in the external ear canal. CM was recorded from each turn (basal, second, third and apical). Whereas under negative pressure CM decreased suddenly but soon became stable, under positive pressure CM normalized gradually after the initial drop. Thus, in the stable state, CM amplitude was low under negative pressure but was slightly subnormal under positive pressure. One possible explanation is that perilymphatic efflux appears to cause such recovery of CM under positive pressure. it is postulated that perilymphatic inflow does not seem to occur under negative pressure, since CM and perilymphatic pressure were stable. PMID- 3673557 TI - Cochlear blood flow in noise-damaged ears. AB - Cochlear blood flow was measured in rats with a known noise-induced hearing loss, using the microsphere technique. The animals were exposed to simulated industrial noise for 3 months. The rats were divided into four groups: young and old; normotensive (N) and spontaneously hypertensive (SH). The mean values of the cochlear blood flows were compared with those of rats from matched groups not exposed to noise. The mean cochlear blood flow in the noise-exposed groups was lower than in the non-exposed groups. The decrease in cochlear blood flow was significant for all groups except young SH rats and was more pronounced in the older age group. Cochleas from the groups of old N and SH rats were investigated in the scanning electron microscope. Extensive changes were far more common in SH than in N rats. PMID- 3673558 TI - Surgical treatment of chronic middle ear disease. 1. Myringoplasty and tympanoplasty. AB - Results of myringoplasty or tympanoplasty were evaluated in 225 ears followed for at least one year after surgery. Repair of the tympanic membrane with an underlay connective tissue graft (fascia in 90%) was successful in 97% of the ears. One late perforation developed 3 years postoperatively. The average postoperative air bone gap was 4.8 dB in 88 cases of myringoplasty, the series including three ears with a rigid footplate. Rigid incus and malleus should not be mobilized but subjected to resection and reconstruction. Poor tubal function caused adhesive changes in one ear (1%). In tympanoplasty the average postoperative air-bone gap was 11.3 dB in 100 ears with stapes present and 20.6 dB in 36 ears with only the footplate remaining. Of the 137 tympanoplasty ears, 10 (7%) showed prominent adhesive changes. In 36 ears with cholesteatoma there was one recurrence 3 years later (3%). An air-bone gap of less than 20 dB was postoperatively noted in 94% of the ears undergoing myringoplasty and in 69% of the ears undergoing tympanoplasty. PMID- 3673559 TI - X-ray microanalytic studies on developing otoconia. AB - The onset of otoconial development in the macula utriculi in CBA/CBA mice occurs on the fifteenth and sixteenth gestational days. Our study was concentrated on the early secretion of calcium in the areas of otoconial formation. The epithelial origin of otoconia is documented. Protrusions from supporting cells in the utricular and saccular epithelia contain very large quantities of calcium in addition to the normal cytoplasmic content of elements. The cell protrusions have an elemental composition clearly differing from that of otoconia as well as from neighbouring utricular cells with protrusions. A directed flow of calcium to developing otoconia from the supporting cells of the maculae is suggested. PMID- 3673560 TI - Smooth pursuit in senescence. Effects of target acceleration and velocity. AB - Smooth pursuit responses to sinusoidal and triangular waveform targets were investigated in elderly and middle-aged subjects. The middle-aged pursued triangular targets with significantly lower gain than sinusoidal targets. In the elderly, pursuit gain was significantly lower than in the middle-aged under all target conditions. When all smooth eye movements at a constant frequency were correlated with varying target velocity, pursuit gain was uniformly reduced in the elderly, irrespective of target velocity up to 63 degrees/s or accelerations up to 395 degrees/s2. Within these limits, the steady-state gain of pursuit was depressed. At higher target accelerations having the same velocity range, smooth pursuit velocities were further reduced in the elderly. Senescent tracking is depressed by involvement of the steady-state gain element of the pursuit system at low target accelerations and by acceleration saturation at higher demands. PMID- 3673561 TI - Human optokinetic afternystagmus. Is the fast component of OKAN decay due to smooth pursuit? AB - Eye movement after-effects subsequent to pursuit of a single LED target were studied in human subjects to test the hypothesis that constant velocity pursuit activates a velocity storage system in the neuronal pathway. The temporal characteristics of observed after-effects fall within those predicted from the Robinson model of eyeball mechanics, indicating that neuronal integration was not a factor. PMID- 3673562 TI - Oscillopsia of peripheral vestibular origin. Central and cervical compensatory mechanisms. AB - Eight patients with absent vestibular function categorized into four grades according to the disability they suffered from oscillopsia have been studied with a view to correlating its severity with the development of gaze stabilizing compensatory mechanisms. Eye movements were recorded while the following sinusoidal rotational stimuli were delivered: 1) trunk on head oscillation in the dark (COR); 2) head on trunk oscillation in the dark; 3) head on trunk and whole body (head and trunk) oscillation in the light in the presence of optic fixation. The COR was potentiated in all the patients regardless of their clinical status. Velocity gains (peak slow phase eye velocity/peak head velocity) during whole body rotation were significantly lower than head on trunk gains in the light in the better compensated patients. Since in the absence of vestibular function whole body rotation involves only the otokinetic system (OKN), this finding implies a depression of the OKN in these patients which can be corrected during head on trunk movements by virtue of a dynamic input from the neck. The results suggest that the processes of recovery from oscillopsia are dependent, in the main, upon the development of central mechanisms by means of which undesirable image movement across the retina is perceptually suppressed. Depression of OKN may be secondary to this perceptual rearrangement. PMID- 3673563 TI - Effects of exercise on nasal resistance and nasal blood flow. AB - Nasal resistance and nasal blood flow were measured consecutively before exercise, immediately after exercise, 5, 10, 15, 20, 25, and 30 minutes after exercise in 11 normal subjects and 18 patients with perennial allergic rhinitis. Nasal resistance was measured by Nihon-Koden Rhinorheograph MRP 2100, and nasal blood flow was measured by Periflux PF2, a laser doppler flowmeter. 77% of unilateral nasal cavities in normal subjects and 75% of unilateral cavities in patients with allergic rhinitis showed a decrease of both nasal resistance and nasal blood flow immediately after exercise. However, rates of changes in nasal resistance and in nasal blood flow were not correlated with each other. In the latter period after exercise, there was a discrepancy between nasal resistance and nasal blood flow. A laser doppler flowmeter is considered to measure blood flow in the superficial part of the nasal mucosa. Based upon our results, an intensive stimulus such as exercise seems to induce vasoconstriction in the superficial part as well as in the deeper part of the nasal mucosa. However, it is also suggested that the vessels in the various parts of the nasal mucosa don't always respond in the same way. PMID- 3673564 TI - Encapsulated nerve structures in the human vocal cord. An electronmicroscopic study. AB - Encapsulated nerve structures which contain abundant axon terminals between dense collagen fibres are found in the intermuscular connective tissue of m. vocalis and the subepithelium of the cartilaginous part of the human vocal cord. Axon terminals are either partly surrounded by or lack the Schwann sheath. They directly face to the basal lamina and collagen fibres and together represent the receptors of mechanical stimuli. The location of these nerve structures in the vocal cord may indicate that they serve to detect its degree of rigidity. Encapsulated nerve structures in m. vocalis contain a striated muscle fibre. The termination of this fibre within the capsule resembles that of the Golgi tendon organ. Since the encapsulated nerve structures are located near the termination of muscle fibres in the vocal ligament, they may serve to detect the tension of muscle fibres which pull on the vocal cord during vibration of the vocal mucosa. Encapsulated nerve structures in the cartilaginous part of vocal cord are located in the submucosa where they are covered by thick stratified squamous epithelium with papilla. These regions often contact each other in the state of full adduction of the arytenoid cartilages. Therefore the encapsulated nerve structures may detect the bilateral contact of the vocal cord when the glottis is closed. PMID- 3673565 TI - DNA cytophotometry of acinic cell carcinoma and its relation to prognosis. AB - Single-cell DNA cytophotometry has been assessed on histological sections or aspiration biopsy smears from 13 parotid acinic cell carcinomas and has been related to prognosis. The minimal follow-up was 6 years. Six ACC were well differentiated and seven moderately well differentiated. The modal DNA values of all tumours examined were in the diploid area. The number of nuclei above 2.5C DNA, expressing proliferative ability or aneuploidy, was low. A difference, too small to be of value for prognostic purposes, was found between the non-recurrent tumours (6%) and the metastasizing tumours (16%). The DNA levels measured in the present tumour material correspond to the concept of ACC as being a well differentiated neoplasm. The nuclear DNA pattern of these tumours would seem to be of minor prognostic significance with regard to survival time and/or potential for metastasis. PMID- 3673566 TI - S-phase fractions and DNA-ploidy of oropharyngeal squamous epithelium carcinomas compared with histologic grade, stage, response to chemotherapy and survival. AB - DNA-ploidy and the percentage of S-phase fractions in 55 primary oropharyngeal squamous epithelium carcinomas were measured by DNA-Flow Cytometry (FCM). The data were compared with the histologic grade, the stage and the response of the tumours to cytostatic chemotherapy. A significant correlation was found between the histologic grade and the mean percentage of S-phase fractions (p less than 0.01). No correlation could be found between the FCM measurement data and the tumour stage. Carcinomas with an amount from 4.0 to 10.4% S-phase fractions responded to chemotherapy by complete remission, and those with 10.0 to 13.3% S phase fractions by partial remission. The group of non-responders could be subdivided into two subgroups: non-responders with low amounts of S-phase fractions (1.1-3.9%), and non-responders with very high amounts of S-phase fractions (11.6-16.6%). FCM data, histologic and clinical prognostic factors were summed up to a prognostic score. The number of score points showed a significant correlation to the length of survival in months after diagnosis of the tumour (p less than 0.00001). FCM may be used as an additional diagnostic tool for a better biological characterization of the neoplastic tissue, especially as an aid for grading, prediction of the response to chemotherapy and the length of survival. PMID- 3673567 TI - Cervical vertigo. Diagnostic and semiological problem with special emphasis upon "cervical nystagmus". AB - There is a strong evidence that vertigo can be produced by cervical disturbance, either via the neck-proprioceptor, or via the vascular supply by the vertebral artery. However, it is very difficult to confirm the cervical origin of the vertigo in a particular patient. "Cervical nystagmus" has been proposed as a diagnostic clue. But critical analysis, discussed in this paper, has raised doubt about its reliability. The most know type, the neck torsion nystagmus, appears to be in fact a "normal" cervico-ocular reflex. Its inconstancy and low gain makes that it is only present in 50% of the subjects. Reduced vestibular input as well as enhanced cervical proprioceptive input favour its appearance. In this way the presence of NTN is suggestive for a cervical component but doesn't mean that the vertigo is cervical. Correlation with other cervical data is needed to conclude to a "cervical component" in the vertigo. PMID- 3673568 TI - [One-day surgery in an ENT practice]. AB - The one-day surgery is not a new concept, but has become more frequent during the last years. Medical, psychosocial and especially economical reasons are the basis of this evolution. These different reasons having been analyzed, this evolution is illustrated by a personal experience and statistical data of the last ten years. Advantages and possible complications of the ambulatory surgery in our specialty are then discussed. PMID- 3673569 TI - [Role of ORL in the treatment of sleep apnea syndromes]. AB - Over the past few years, the criteria defining the sleep apnea syndrome have been well delineated. This syndrome is a common affliction whose pathophysiology is usually indicative of an obstacle in the upper respiratory tract. The authors describe seven mostly serious cases, with cardiovascular and hemodynamic repercussions, that benefited from ORL surgery (uvulo-palato-pharyngoplasty and/or tonsillotomy). In each case, the consequences of this simple surgery were excellent, resulting in a sharp attenuation of the symptoms or their disappearance. In conclusion, the authors insist on the preponderant role that can be played by the ear, nose and throat specialist, both in the selection of these patients and in their treatment. PMID- 3673570 TI - [A new medical therapeutic approach to cholesteatoma. 5-fluorouracil in local treatment]. AB - The use of applied 5-Fluorouracil is effective in the treatment of cholesteatoma. The authors described the limits of this technique. PMID- 3673571 TI - [The zinc sulfate overload test in patients suffering from tinnitus associated with low serum zinc. Preliminary report]. AB - This work studies the efficiency of the zinc overloading in the treatment of patients suffering from tinnitus with hypozincemia. The authors have positive results about 52% of cases: in 15% there was a good amelioration and in 37% there was a little but significant amelioration of their symptoms. The authors have also found on that this type treatment with zinc of overloading is more efficient in males than in females. It is also more efficient in types of tinnitus of a continuous character than in other types. PMID- 3673572 TI - Passive transfer of experimental allergic encephalomyelitis with lymphocytes collected from brains of immunized guinea pigs. AB - Lymphocytes were collected from the brains of guinea pigs immunized with syngeneic spinal cord emulsified in complete Freund's adjuvant. Sixteen to 32 X 10(6) lymphocytes were inoculated into the vein of each inbred guinea pig (NIH 13). Recipient animals without clinical signs of experimental allergic encephalomyelitis (EAE) were sacrificed 20 days later. Some of the recipients had perivascular infiltrates of a large number of mononuclear cells mostly in choroid plexus and meninges of the brain and spinal cord. Demyelination, which was not so intense, was also observed in the vicinity of the perivascular infiltrates. Thus, the lymphocytes from the brain as well as lymph node and spleen were clear to have the ability to transfer EAE. PMID- 3673573 TI - Collagen-producing mesothelial cells in adriamycin-induced pleuritis in rat. Microautoradiographic study utilizing tritiated proline. AB - By the microautoradiographic method using 3H-proline, collagen production by mesothelial cells was investigated in adriamycin-induced pleuritis in rats. In subpleural granulation tissue formed at 4 to 7 days after the intrapleural injection of adriamycin, proliferating fibroblasts and primitive mesenchymal cells were most intensely labeled, and abundant deposition of collagen and acid mucopolysaccharides were demonstrated about these cells. It is thus concluded that these subpleural mesenchymal cells are mainly responsible for the fibrosing process. Labeling was also observed in some reactive mesothelial cells and macrophages free-floating in the pleural exudate. Several ultrastructural differences between labeled mesothelial cells floating in the fluid and lining the pleural surface were confirmed, suggesting a change in ability to synthesize collagen during mesothelial desquamation. It seems likely that these labeled mononuclear cells in the effusion, attached to the pleural wound surface, support fibrosis performed by underlying collagen-synthesizing mesenchymal cells. Pleural fibrosis disappeared by 10 days, when mesothelial regeneration was almost complete. Probably this change may be due to fibrinolytic activity caused by regenerative mesothelial cells derived from subpleural mesenchymal cells. PMID- 3673574 TI - Alagille's syndrome. A case with a hamartomatous nodule of the liver. AB - A male case of Alagille's syndrome associated with a hamartomatous nodule of the liver is described. The patient developed jaundice soon after birth, and was diagnosed as the syndrome with signs such as paucity of the intrahepatic bile ducts, pulmonary stenosis and embryotoxon in the cornea at 15 years of age. The liver was examined in recurrent biopsies and other tests. However, no evidence of liver cirrhosis was confirmed until his 15th year. The patient died of hepatic dysfunction when he was 17 years old. At autopsy, a large hamartomatous nodule was found in the liver showing biliary cirrhosis. Morphology of the nodule resembled that of focal nodular hyperplasia. Abnormalities of the large vessels were noted around the liver. Vascular abnormalities were also seen in the mass. The relation of these vascular abnormalities to etiological background of the syndrome and occurrence of the nodular lesion is discussed. PMID- 3673575 TI - Osteoclast-like giant cell tumor of the liver. AB - A 66-year-old male with osteoclast-like giant cell tumor of the liver that arose in the non-cirrhotic liver is presented. The liver tests were almost normal, and plasma levels of alpha-fetoprotein and carcinoembryonic antigen were within normal limits. The findings of liver scan by 99mTc phytate, celiac angiography, and CT scans are described for the first time for this rare neoplasm, showing a large, unresectable liver tumor. Histologically, the tumor mainly consisted of osteoclast-like giant cells and mononuclear cells, which were focally arranged in a vaguely trabecular pattern and sarcomatous pattern. By an electromicroscopic study, however, no definitive evidence was obtained whether it arose from epithelial cells or nonepithelial cells. Various clinicopathological features were described and compared with previously reported cases including two cases arising in the liver. PMID- 3673576 TI - Bilateral ovarian hemangiomas associated with diffuse hemangioendotheliomatosis: a case report. AB - A patient who had disseminated vascular tumors involving the bilateral ovaries, bilateral lungs and pleura, pericardium, and mediastinum is reported. The tumors were histologically of the capillary, and partly the cavernous, type of hemangioma. However, endothelial cell growth was prominent in some areas, especially in the lung, and the histology of the lung tumor resembled epithelioid hemangioendothelioma or intravascular bronchiolo-alveolar tumor (IVBAT). In the endocardium of the right atrium, an endothelial tumorous projection was observed, and there were tiny foci of tumor cell nests in the abdominal venous wall. Small lymphangiomas were also found in the subcapsular region of the spleen. These findings suggest that there had been an abnormal proliferation of systemic endothelial cells and that tumors of endothelial cell origin with diverse histological patterns developed with this condition as a background. The autopsy finding of fibrin thrombi in multiple organs as well as laboratory data including thrombocytopenia suggest that this case belongs to the "Kasabach-Merritt syndrome." PMID- 3673577 TI - Delayed posttraumatic ischemic stricture of the small intestine. A clinicopathologic study of four cases. AB - Three men and one woman with delayed posttraumatic ischemic stricture of the small intestine were studied, clinicopathologically. Three sustained trauma in traffic accidents, and the other one was injured at a workshop. The chief signs and symptoms were repeatedly occurring incomplete intestinal obstruction. The interval between operation and trauma ranged from 1.5 to 14 months, with a mean of 4 months. The lesions were present in the jejunum 150 cm distant from the ligament of Treitz in one, and in the terminal ileum in three. Shallow ulcers, transmural inflammation, fibromusculosis, and neovascularity in the submucosa, as well as siderophages and foreign body reaction in the subserosa were evident, microscopically. The associated deeper ulcers proximal to the strictures in three were considered to have been induced by ischemic plus mechanical factors. PMID- 3673578 TI - Flucloxacillin in chronic leg ulcers. Penetration of flucloxacillin into chronic leg ulcer exudate and the effect on the bacteria. AB - The penetration of flucloxacillin into ulcer exudate was investigated in six patients with chronic leg ulcers. The flucloxacillin dosage used was 1 g orally three times daily for three days, and the serum and exudate concentrations were measured repeatedly during a 10 h-period following the first and the seventh dose. All the ulcers were contaminated with (S. aureus) Staphylococcus aureus either in pure culture (three ulcers) or in culture mixed with Gram-negative bacteria (three ulcers). Bacterial counting in the ulcers was performed twice before and twice during the antibiotic treatment. The flucloxacillin concentrations measured in the ulcer exudate were found to be lower than the corresponding serum concentrations. However, the exudate concentrations were found to be above the minimum inhibitory concentration (MIC) for the contaminating S. aureus during an average of 7 h after each dose, and the number of S. aureus during the treatment period was reduced to less than 0.01% of the initial number. The Gram-negative bacteria were not susceptible to flucloxacillin. The number of these bacteria decreased before flucloxacillin treatment but increased again during treatment, probably owing to the changed conditions in the ulcers following the marked decrease in the number of S. aureus. PMID- 3673579 TI - Streptococcus suis infections in Danish pigs and experimental infection with Streptococcus suis serotype 7. AB - During a two-year period, Streptococcus suis serotypes 1-8 were isolated from 108 pigs examined at the laboratory. S. suis serotypes 2 and 7 represented 75% of the isolates. S. suis serotype 7 was isolated more frequently than reported from other countries, and mostly from piglets less than 3 weeks of age. Experimental inoculation of 7-day-old piglets with S. suis serotype 7 provoked severe illness within a week in 6 out of 7 animals. By bacteriological and pathological examination it was found that S. suis serotype 7 was pathogenic to piglets, giving rise to septicemia with predilection for joints, serous membranes and meninges. PMID- 3673580 TI - Immunological relation between serum antibodies against pneumolysin and against streptolysin O. AB - The immunological relation between serum antibodies to pneumolysin and to streptolysin O was studied in patients with pneumococcal pneumonia (n = 40), patients with infections due to beta-haemolytic streptococci (n = 35), healthy human controls (n = 60) and in rabbits immunized with pneumolysin. There was no correlation between anti-pneumolysin and anti-streptolysin O titers (r = -0.279). The distribution of anti-pneumolysin titers in patients with high anti streptolysin O titers did not differ from healthy controls. However, there was a tendency to increased or rising anti-streptolysin O titers in patients with pneumococcal infection. Antibodies obtained during pneumococcal infection might thus give false-positive reactions in the streptolysin O neutralization test. Serum antibodies to streptolysin O do not cross-react with pneumolysin in an ELISA. The pneumolysin ELISA for detection of pneumococcal disease will therefore not be disturbed by false-positive reactions due to antibodies directed against beta-haemolytic streptococci. PMID- 3673581 TI - Crossed immunoelectrophoretic analysis of Flavobacterium meningosepticum and allied Flavobacterium taxa. AB - A total of 55 different antigens were demonstrated in pooled lysate of six Flavobacterium meningosepticum strains by crossed immunoelectrophoresis against homologous rabbit antibody. The six strains used represented the two DNA relatedness groups within this species. All 52 strains of F. meningosepticum investigated were found to cross-react with 53 to 55 of these F. meningosepticum reference antigens. Using this F. meningosepticum reference system, cross reactions between the F. meningosepticum reference antigen and antigens from representatives of other Flavobacterium taxa were also investigated. A positive correlation was demonstrated between the number of cross-reacting antigens and the taxonomic relatedness of the investigated taxa as determined by other classification methods, including DNA-DNA hybridization. The crossed immunoelectrophoretic techniques were not useful in differentiating the two main DNA groups of F. meningosepticum. PMID- 3673582 TI - Evaluation of two vacuum bottle blood culture media--supplemented peptone broth and brain heart infusion broth. AB - A new blood culture medium (brain heart infusion broth) (BHI) from Terumo was compared with a commonly used blood culture medium, supplemented peptone broth (Becton Dickinson) (SPB). Blood from patients with suspected bacteraemia was simultaneously cultured in the two media, approximately five ml of blood in each bottle. Both bottles were incubated aerobically at 37 degrees C for 7 days. A total of 3724 paired blood cultures (sets) were processed. Altogether 340 (9.1%) of the blood culture sets were positive. Of these, 233 were positive in both media, 51 in the SPB medium only and 56 in the BHI medium only. Despite the similar overall results, Streptococcus spp. and anaerobic bacteria were detected more frequently in the SPB bottles and Enterobacteriaceae more frequently in the BHI bottles. PMID- 3673583 TI - Experimental pneumococcus infection in mice: comparative in vitro and in vivo effect of cefuroxime, cefotaxime and ceftriaxone. AB - In a mouse model using intraperitoneal inoculation of Streptococcus pneumoniae type 3, the 50% effective dose, ED50, after single doses one hour post inoculation was considerably lower for ceftriaxone (CRO) than for cefuroxime (CXM) and cefotaxime (CTX), in spite of the same minimal inhibitory concentration, MIC, of 0.02 mcg/ml against the pneumococcus for all 3 drugs. The bactericidal activity as measured by time-kill curves was similar for the 3 drugs, as was the post-antibiotic effect in vitro. Protein binding in mouse serum was considerably higher for CRO (87%) than for both CTX (35%) and CXM (15%), respectively. Of pharmacokinetic parameters investigated on doses equal to the ED50s, the time the serum antibiotic concentration remained above the MIC (delta T(MIC)) was the factor that varied the least among 3 drugs. Therefore, the superior in vivo effect for CRO is not due to higher intrinsic activity against the pathogen but to the long serum-elimination half-life resulting in an extended delta T(MIC), probably related to the high serum protein binding. PMID- 3673584 TI - Interaction between beta-lactam antibiotics and gentamicin against Streptococcus pneumoniae in vitro and in vivo. AB - In vitro synergy was demonstrated for each of the beta-lactam antibiotics, penicillin, ampicillin, piperacillin and cefuroxime, respectively, in combination with gentamicin, by the time-kill method within 6 h. The combination of the beta lactam antibiotics with gentamicin as compared to therapy with each drug alone was investigated by the mouse-protection test after intraperitoneal inoculation of the pneumococcus. Antibiotics were administered sc one h after inoculation. Three sub-therapeutic doses calculated on the basis of the 50% effective doses for each antibiotic were given individually or in combination (beta-lactam + gentamicin) by a factorial design, in order to study all possible dose combinations. Penicillin, piperacillin, or cefuroxime in combination with gentamicin were significantly superior to either drug administered individually. Ampicillin + gentamicin was significantly superior to gentamicin alone but not to ampicillin alone. With combination therapy, survival of mice correlated significantly with increasing gentamicin doses but was independent of the size of the dose of beta-lactam antibiotics. PMID- 3673585 TI - Antibiotics and human monocyte function. I. Chemotaxis. AB - The influence of thirteen commonly used antibacterial drugs on the chemotactic responsiveness of human blood monocytes in vitro was investigated. Tetracyklin, trimethoprim and fusidic acid at high concentrations produced a significant inhibition of the monocyte response, whereas normal therapeutic concentrations produced insignificant inhibition. Benzylpenicillin, ampicillin, tobramycin, chloramphenicol, metronidazole, rifampicin, clindamycin, sulfametoxazole, cefotaxime and ofloxacin did not alter monocyte migration. From these observations it can be expected that at normal dosages none of the tested drugs will affect monocyte chemotaxis in vivo. PMID- 3673586 TI - Biochemical characterization of nine oral small-sized spirochete strains containing one endoflagellum from each cell-end. AB - The purpose of the present investigation was to establish a biochemical characterization of oral spirochetes containing one endoflagellum from each cell end. Nine spirochete strains were isolated from subgingival plaque with pocket depth greater than 6 mm. The following metabolic capabilities were examined: fermentation of 16 different carbohydrates, hydrolysis of urea, gelatin and esculin, and production of indol and H2S. Furthermore activities of the following categories of enzymes were examined: proteases, peptidases, lipases, glycosidases, phosphatases, and mucopolysaccharadases. The tests and analyses were routinely carried out with cultures in the early stationary phase of growth. Of the examined metabolic capabilities eleven of the 21 characters were identical for all strains. Only the fermentation of some of the carbohydrates varied between the strains. All strains were identical regarding the examined enzymes. The following enzyme activities were found: acid and alkaline phosphatase, C-4 (butyrate)-, and C-8 (caprylate)-lipases, peptidases, hyaluronidase, and chondroitinsulfatase. The findings are compared with earlier observations for the same spirochete morphotype and with small-sized spirochetes containing two endoflagella from each cell-end. PMID- 3673587 TI - Septicemia with Agrobacterium species from a permanent vena cephalica catheter. A case report. AB - A case of Agrobacterium septicemia is reported in a 47-year-old woman with disseminated adenomcarcinoma mammae and a permanent vena cephalica catheter. PMID- 3673588 TI - Inhibition of in vitro lysozyme release from human granulocytes and monocytes by non-steroidal anti-inflammatory agents. AB - A selective zymosan-induced release of lysozyme from freshly prepared human blood granulocytes and monocytes was inhibited by indomethacin, sulindac, piroxicam and ibuprofen. This effect was slightly more marked for granulocytes than for monocytes. Salicylic acid, acetylsalicylic acid and naproxen, even at high concentrations, did not inhibit the enzyme release from either cell type. Since all these nonsteroidal anti-inflammatory agents are cyclooxygenase inhibitors, these findings suggest that lysozyme release is independent of prostaglandin biosynthesis. PMID- 3673589 TI - Rheumatoid factors in psoriatic scale, serum and circulating immune complexes detected by an isotype-specific ELISA. AB - An isotype-specific ELISA for detection of rheumatoid factors (RFs) is described. The assay utilizes rabbit anti-albumin IgG bound to albumin as solid phase reactant (test wells). RF-activity was expressed as the difference in reaction between test wells and wells containing F(ab')2-fragments of the rabbit IgG bound to albumin. The activity correlated well with the conventional Waaler agglutination test on sera that showed a positive Waaler titre, but several sera that were negative by the Waaler test were positive for RF of IgG isotype by the ELISA-test. The method was applied on specimens from psoriatic patients, and RFs of IgG- and IgA isotype were demonstrated in serum immune complexes from all the psoriatic patients examined. IgG- and IgA-RF was also demonstrated in extracts from psoriatic scale, and RFs in scale were demonstrated independently of free rheumatoid factor activity in serum. PMID- 3673590 TI - [Instrumental possibilities of the standardization of complex plant preparations, paramedications]. PMID- 3673591 TI - Some phytochemical characteristics of Juglans regia L. PMID- 3673592 TI - [Chemical and pharmacological study of propolis samples from various locations]. PMID- 3673594 TI - GC/MS investigation of the essential oils Rosmarinus officinalis L. PMID- 3673593 TI - [Analysis of chemical substances in Viola tricolor L]. PMID- 3673595 TI - Presence of carlina oxide in plants of Hungary. Stabilization and antimicrobial effect. PMID- 3673596 TI - [Chemical study of Scrophulariaceae species]. PMID- 3673597 TI - Effect of piracetam and of standardized ginseng extract on the electroconvulsive shock-induced memory disturbances in "step-down" passive avoidance. AB - The effects of piracetam and standardized Ginseng extract (G115) on the memory impairing action of electroconvulsive shock were investigated in experiments on albino rats. The changes in the memory were traced using the "step-down" conditioned reflex method of passive avoidance with negative reinforcement. Piracetam, administered in a dose of 600 mg/kg i.p. for 5 days prior to the beginning of the training sessions, completely eliminated the electroshock induced retrograde amnesia in memory tests, as well as on the 3rd and 24th hour after the end of the training session. Standardized ginseng extract, administered in a dose of 30 mg/kg orally for 10 days prior to the beginning of the training session, markedly tended to eliminate the memory-impairing effect of electroconvulsive shock. The role of the serotoninergic neurotransmitter system for the protective effects of piracetam and of standardized ginseng extract on retrograde amnesia induced by electroconvulsive shock is investigated on the basis of earlier experiments. PMID- 3673598 TI - Extracellular potential field of unmyelinated active axons. AB - Experimental and model investigations were carried out on the extracellular action potentials and potential fields of some unmyelinated axons: the medial and the lateral giant axons of Lumbriscus terrestris and small unmyelinated axons (nerve fibres of group C). Close to the membrane the extracellular action potentials are similar in shape to the second space derivative of the intracellular action potentials--they are triphasic in case of intracellular action potential with depolarization after-potential, having four phases in case of intracellular action potentials with hyperpolarization after-potential. Upon increasing the radial distance, the amplitudes of the different phases of the extracellular action potentials decrease at a different rate, while their maxima are shifted, which results in considerable changes in their shape. PMID- 3673599 TI - The effects of orchidectomy and testosterone replacement therapy on plasma and brain oxytocin in normal rats. AB - In male rats, two-week orchidectomy induced a significant increase in the pituitary content of oxytocin-immunoreactivity and a significant fall in its hypothalamic concentration, without detectable changes in plasma. Testosterone replacement therapy in castrated animals abolished the stimulant effect of orchidectomy on pituitary accumulation of oxytocin. The present study demonstrates an inhibitory effect of testicular androgens on oxytocin release. These results and previous observations suggest that the neurohypophysial hormone oxytocin may play a role in male reproductive system. PMID- 3673600 TI - Determination of the threshold of simultaneity and temporal order using the "step ladder" method. AB - The article considers the sensitivity of the mechanisms for perceiving simultaneity and temporal order. A method similar to the psychophysical "staircase" method is used for determining the thresholds of the perception of simultaneity and temporal order. The simultaneity and temporal order thresholds are measured for two levels of visual adaptation of the subjects. Two clearly distinguishable thresholds are established: simultaneity threshold and temporal order threshold. The threshold values for simultaneity and temporal order are preserved, irrespective of the adaptation level, which suggests that the general illumination does not affect the mechanisms for perceiving simultaneity and temporal order. PMID- 3673601 TI - The hemolytic effect of copper complexes with different ligands. AB - The effect of Cu(II) and Cu(II) complexes/Cu(II)(cimetidine)2 Cu(II)(glycine) and Cu(II)(glycine)2/on the rat and human erythrocytes was studied. Time- and dose dependence of the Cu(II) complexes-induced hemolysis, oxidation of hemoglobin and formation of precipitates of denaturated hemoglobin were established. The hemolytic effect of Cu(II)complexes was abolished by strong complexons of Cu(II) and by physiological concentrations of albumin and histidine. The hemolysis greatly decreased in the presence of chelator of Cu(I) and superoxide dismutase, which suggested oxi-reduction transitions and participation of superoxide in the process. The results are considered with the view to clarifying the differences in the stability and reaction ability of the different complexes, the possibility of their parenteral application. PMID- 3673602 TI - Optimization of the source derivations from the scalp surface. AB - The selectivity of source derivations (SD) is computer-calucla ted using different combinations of electrodes and different interelectrode differences, with a view to the optimization of the method. For this purpose, the method described by Nunez and Katznelson (1981) is used to calculate surfaces in the brain tissue from the points of which a single current source will determine the same potential in a given point on the scalp surface. The lines of these surfaces are given for different planes. The calculations show that the selectivity increases with the decrease of the interelectrode distances, as well as when more electrodes are used. With a small number of electrodes for SD and especially when one central and two lateral electrodes are used, there exist brain areas in which the generators cause a potential with opposite sign on the scalp surface. PMID- 3673603 TI - 17th Congress of the Polish Physiological Society. September 15-18, 1987. Abstracts of lectures and communications. PMID- 3673604 TI - Effects of ischaemia on leakage of albumin in rabbit kidneys. AB - The effect of ischaemia on the leakage of proteins across the vessel walls in rabbit kidneys was studied. The leakage of proteins was estimated from the distribution space of labelled albumin. Various methods to calculate the vascular volume yielding the true extravascular leakage were tested. The most reliable method appeared to be to use the same tracer (131I-albumin, 125I-albumin) for both estimating the leakage and the intravascular volume. One hour of ischaemia induced a drastic increase in the extravasation of proteins in the cortex and outer zone of the medulla but not in the inner zone. PMID- 3673605 TI - Effect of decreased oxygen availability on NADH and lactate contents in human skeletal muscle during exercise. AB - Eight men cycled for 5 min at 120 +/- 6 W (mean +/- SE) at which O2 uptake was 50% of its maximal normoxic value, breathing room air (21% O2; normoxia) on one occasion and 11% O2 in N2 (respiratory hypoxia/hypoxic--Resp. Hx.) on the other. Biopsies were taken from the quadriceps femoris muscle. Oxygen uptake during exercise was not significantly different between Resp. Hx (1.59 +/- 0.08 1 min-1) and normoxia (1.55 +/- 0.08 1 min-1). At rest, muscle lactate was the same under both conditions but was four times higher after Resp. Hx (33.2 +/- 5.2 mmol kg-1 dry wt) than normoxic cycling (8.6 +/- 1.0 mmol kg-1 dry wt; P less than 0.01). The muscle lactate/pyruvate (which is proportional to cytosolic NADH/NAD) was significantly higher after Resp. Hx.(76 +/- 19) than after normoxic cycling (26 +/- 2; P less than 0.05). At rest, analytically determined NADH averaged 0.14 +/- 0.02 mmol kg-1 dry wt under both conditions. However, exercise during Resp. Hx. resulted in a significantly higher NADH content (0.17 +/- 0.01) than exercise during normoxia (0.12 +/- 0.01; P less than 0.01). Indirect evidence indicates that the difference in muscle NADH reflects a difference in the mitochondrial redox state (Sahlin & Katz 1986). The increased muscle NADH during Resp. Hx. therefore indicates a relative lack of O2 at the cellular level (muscle hypoxia). It is suggested that the increased lactate production during Resp. Hx. is a consequence of the cellular adaptation to muscle hypoxia (i.e. increases in cytosolic ADP, AMP, Pi and NADH). PMID- 3673606 TI - Mechanical jumping power in young athletes. AB - Mechanical jumping power was determined for 286 young male athletes representing six sports events and ranging in calendar and skeletal ages from 8.8 to 17.1 and from 7.8 to 18.1 years, respectively. The subjects performed successive maximal vertical jumps on a contact mat for 30 s. The number of jumps and their cumulative flight time after 15 and 30 s were used for calculations of mechanical power. The jumping performances of the young athletes were found to be reproducible from the age of 10-12 years in respect to the angular displacement of the knee and duration of contact. Absolute mechanical power, as well as power related to body weight, increased with calendar and skeletal ages. Of the anthropometric characteristics, the circumference of the thigh and body weight showed the highest correlation with mechanical power; subjects with the greatest thigh circumference and body weight having the lowest mechanical power. The subjects were divided into 'power' (track and field, gymnastics) and 'endurance' (skiing, orienteering) groups. The former reached higher mechanical power values than the latter. Mechanical power for the second 15-s jumping period was on average 4.7% lower than for the first. The events did not differ from each other in respect of the decrease in power. PMID- 3673607 TI - Effects of acetylcholine and atropine, respectively, on spontaneous contractions of the isolated colonic circular smooth muscle in the rat. PMID- 3673608 TI - A comparative study of the pain-relieving effect of laser treatment and acupuncture. PMID- 3673609 TI - Mitotic activity of duodenal crypt cells in the young fieldfare (Turdus pilaris). PMID- 3673610 TI - Vago-vagal activation of naloxone-sensitive non-adrenergic, non-cholinergic jejunal contractions in the anaesthetized cat. AB - Experiments were performed on chloralose-anaesthetized cats, pretreated with guanethidine and with ligated adrenals and sectioned splanchnic nerves. The animals were paralysed and artificially ventilated. Jejunal motility was recorded by an intraluminal balloon, as volume changes at a constant pressure. Cervical or abdominal vagal afferent stimulation was performed before and after the administration of atropine. In both circumstances jejunal contractions were elicited. The latency of onset and the duration of the responses were significantly shorter before than after atropine. Strength-duration and frequency response relationships, respectively, did not differ significantly prior and subsequent to atropine. Naloxone (0.05-0.5 mg kg-1 i.v.) blocked these reflexly induced atropine-resistant jejunal contractions, as did section of the contralateral vagus. Possible mechanisms of action of these putative opioid receptor-mediated neurogenic effects are discussed. The present study demonstrates that non-adrenergic, non-cholinergic, naloxone-sensitive jejunal contractions can be elicited as a vago-vagal reflex, where the receptive field seems to be located within the abdominal cavity. PMID- 3673611 TI - The effect of progesterone and its metabolites on the interictal epileptiform discharge in the cat's cerebral cortex. AB - The antiepileptic effect of progesterone, 5-alpha-pregnane-3,20-dione, 3-alpha hydroxy-5-alpha-pregnane-20-one, and 3-alpha-hydroxy-5-beta-pregnane-20-one were tested in an experimental animal model, and compared with the effect of clonazepam. The steroids were dissolved in serum from ovariectomized cats. Ovariectomized adult cats were used and spontaneous epileptic discharges were generated by placing small pieces of penicillin-soaked filter papers on the ipsi and contralateral cerebral cortex. The frequency and amplitude of the interictal epileptiform spikes were recorded, and analysed in a computer. The changes in frequency and amplitudes were calculated. The drugs were infused during 20-s periods into one cerebral hemisphere via the ipsilateral lingual artery with speeds of 1.1, 3.4 and 6.3 ml min-1. A penicillin focus on the contralateral hemisphere served as a simultaneous control. Progesterone and clonazepam showed similar inhibitory effects on epileptiform interictal spiking (median reduction of spike frequency 21%, cf. Table I). The 5-alpha-pregnane-3, 20-dione was generally less potent than progesterone (median reduction 9%) and the 5-alpha- and 5-beta-pregnanolones were two to three times more potent than progesterone (54-66% reduction). The latency of the inhibitory effect was 4-10 s measured from the entrance of the infusion into the lingual artery. The depression lasted 10-20 min. It is concluded that the pregnanolones have strong antiepileptic properties. The rapid onset of effect indicates that the steroids may interact with the neuronal function at the membrane or synaptic levels. PMID- 3673612 TI - Ultrastructure of pancreatic duct cells at secretory rest and during secretin dependent NaHCO3 secretion. AB - The study was undertaken to identify possible ultrastructural changes occurring in pancreatic duct cells in relation to secretin-dependent NaHCO3 secretion, Pancreatic biopsies were obtained for examination, following in situ glutaraldehyde fixation from four groups of anaesthetized, young pigs. In the resting state, pancreatic duct cell cytoplasm was found to contain multiple vesicles of approximately 0.2 micron diameter. Elevation of systemic arterial PCO2 to 11.1 (10.6-11.6) kPa increased the number of vesicles per unit volume of resting cells by approximately 250%. During secretin-dependent NaHCO3 secretion, the duct cell cytoplasm was devoid of vesicles. Following cessation of secretin dependent NaHCO3 secretion, cytoplasmic vesicles reappeared. The observed changes in the population of cytoplasmic vesicles in pancreatic duct cells may be causally related to the exocrine secretion of NaHCO3. PMID- 3673613 TI - Appropriate and inappropriate hypothalamic cold thermosensitivity in Willow ptarmigan. AB - Hypothalamic thermosensitivity has been investigated in conscious Willow Ptarmigan (Lagopus lagopus lagopus) provided with chronically implanted hypothalamic perfusion thermodes. The birds were exposed to either cold (Ta - 10 degrees C) or warm (Ta + 25 degrees C) ambient conditions while hypothalamic temperature (Thy) was clamped for periods of 20 min at different set levels between 28 degrees C and 43 degrees C. The responses of the animals to hypothalamic thermal stimulation were classified by comparing them with those normally found in mammals. At Ta - 10 degrees C hypothalamic heating inhibited ongoing shivering, causing a fall in body-core temperature (Tc) (appropriate mammalian-like response). Strong levels of hypothalamic cooling (Thy less than 34.0 degrees C) also caused a fall in Tc due to inhibition of shivering (inappropriate mammalian-like response). However, weaker levels of hypothalamic cooling (Thy 34-36 degrees C), facilitated ongoing shivering, resulting in small increases in Tc (appropriate mammalian-like response). At Ta + 25 degrees C hypothalamic heating facilitated ongoing panting while weak (Thy 38 degrees C) levels of hypothalamic cooling inhibited ongoing panting (both mammalian-like responses). The observation of a weak mammalian-like cold hypothalamic thermosensitivity in Willow Ptarmigan indicates that these birds possess some specific cold thermosensors in the hypothalamic region. This finding suggests that hypothalamic temperature dependence in birds and mammals is fundamentally similar. PMID- 3673614 TI - Blood-to-tissue transport of albumin in rat fibrosarcomas at two different implantation sites. AB - Albumin clearance and blood flow were measured in normal tissues and in fibrosarcomas by means of a multiple tracer method in intact male rats. Sarcomas implanted in testes had higher albumin clearances than the same tumours implanted in skeletal muscle, 59 and 26 microliters min-1 per 100 g, respectively. Albumin extraction (defined as the ratio of albumin clearance to plasma flow) was found to be 1 x 10(-4) - 14 x 10(-4) in normal tissues. Fibrosarcomas in muscle showed high extractions (24 x 10(-4)), especially in the central portions (96 x 10(-4)), where the extraction was similar to that in tumours implanted in the testes (111 x 10(-4)). The high albumin extraction in poorly perfused central parts of the muscle-implanted tumours and in the similarly insufficiently perfused testicular sarcomas is probably due to an increased endothelial permeability of the exchange vessels and not to an increased capillary exchange surface area compared with the better-perfused peripheral parts of the muscle-implanted tumours. The latter tissue also had a high albumin clearance, however, in the range of that of maximally dilated skeletal muscle vasculature, possibly reflecting a large functional capillary surface area. PMID- 3673615 TI - Parotid salivary flow in response to mechanical and gustatory stimulation in man. AB - To examine further the role of the oral receptors in the masticatory-salivary reflex, a study with eight subjects was performed. The influence on mean parotid salivation of combined alterations in frequency and force of chewing and length of the chewing object was evaluated by group comparison. Salivary flow rate was recorded using a sensitive micromanometer, and the frequency (12, 60 and 90 cycles min-1) and force of chewing (10 and 40% of maximum) were controlled by a metronome and masseter muscle EMG, respectively. The maximum instantaneous flow and the latency of the masticatory-salivary reflex were examined in three subjects. For comparison with mean salivation rate during chewing, gustatory stimulation was performed with 0.5 or 5.0% citric acid. The masticatory-salivary reflex was mainly ipsilateral, and depended upon having an object between the teeth. Salivation increased with increases in frequency and force of chewing and with the number of teeth involved, each parameter of chewing having the greatest influence when increased from a low level of action. The salivation response to chewing showed two phases; the first, presumably due to contraction of the myoepithelial cells, had a latency of 0.2-0.4 s, while the second phase occurred about 1 s later. Our results support the hypothesis that the periodontal mechanoreceptors have a major role in the parotid response to chewing. Application of 0.5 and 5.0% citric acid on the back of the tongue induced dose dependent parotid secretions, significantly higher than those of chewing. A negative correlation was found between the maximum fluid outputs during chewing and 5.0% citric acid stimulation. PMID- 3673616 TI - Polyamine metabolism in rat parotid gland after duct ligation. AB - Parotid ducts were ligated unilaterally in rats for periods from 6 h to 5 months. A slight increase in gland weight was observed during the first 24 h; thereafter, the weight gradually fell, being less than 50% of controls at 5 months. The activity of the putrescine-forming enzyme, ornithine decarboxylase (ODC), increased with peak values by 3 days and 3 weeks. However, the putrescine content had already reached its highest value by 24 h. A notably marked reduction of spermidine and spermine contents was observed by 1 day after ligation and throughout the whole time of observation. The results suggest that an inverse polyamine metabolism occurred, that is, spermine converts to spermidine which in turn converts to putrescine. PMID- 3673617 TI - Fatigue and endurance of lower extremity muscles in relation to running velocity at OBLA in male orienteers. AB - At three occasions during a year, the ratio of contractional work (output)/integrated electromyographic activity (input), that is, CW/iEMG, was measured during repetitive maximum isokinetic manoeuvres for m. quadriceps and m. triceps surae in male elite orienteers. Running velocity at the onset of blood lactate accumulation (VOBLA), which was considered as a measure of running performance, and maximal oxygen uptake (VO2max) were analysed at each test. Type and amount of training were continuously registered. For m. quadriceps there was a decline in CW/iEMG during the first 30 manoeuvres, followed by an unchanged plateau level. In contrast, m. triceps surae showed a plateau level of virtually unaltered CW/iEMG ratio from the start to the end of the experiment. The differences might be explained by structural causes, but also by local muscle adaptation to training. The plateau level of CW/iEMG of m. quadriceps was positively correlated to VO2max. An increase in the plateau level of CW/iEMG was found for both tested muscle groups after the winter training period (mainly low intensity road running) when both VOBLA and VO2OBLA increased. During the competition period (mainly high intensity forest running), the whole group increased while some orienteers lowered their VOBLA. During this period, no changes in the plateau level of CW/iEMG of any muscle group or in VO2OBLA occurred. The changes in the plateau level of CW/iEMG might express local muscle adaptations to changes in running technique and aerobic/anaerobic demands during low intensity road running versus high intensity forest running. PMID- 3673618 TI - Adaptations to changing speed in human locomotion: speed of transition between walking and running. AB - The transition speed between walking and running was determined in 18 healthy males (23-38 years) of various statures (range of leg length 0.86-1.09 m) during acceleration and deceleration of different magnitudes (0.05-0.11 ms-2) on a motor driven treadmill. The speed of the treadmill belt and the duration of the stance phases of each foot were recorded. A transition step was identified and the speed of transition was taken as the average speed value of the stance phase of that step. The overall mean value for the transition speed was 1.88 m s-1 (range 1.30 2.55). Deceleration resulted in a somewhat lower speed of transition than acceleration. There was a tendency towards increasing values for transition speed with increasing leg length. This could partly be explained by differences in natural frequency. The reasons for the switch between walking and running at a speed which is not extreme for either mode of progression are unclear. The subjective feeling that a transition will lead to a more comfortable situation might be based on previous experience combined with information from peripheral receptors and activity in central networks controlling locomotion. PMID- 3673619 TI - Respiratory modulation of shivering intensity in the pigeon. AB - Respiration and shivering were measured in unanaesthetized, cold-exposed pigeons using pneumotachography and electromyography, respectively. The instantaneous intensity of shivering in the pectoral muscle varied in phase with respiration. Power spectral analysis showed that the main frequency components of respiration and demodulated EMG coincided exactly. The intensity of shivering was highest during end-expiration and lowest at end-inspiration. This was confirmed by cross correlation analysis of respiration and demodulated EMG. The absolute level of modulation remained constant (c. 10 microV peak-to-peak) despite changes in the general intensity of shivering. On the other hand, the relative depth of modulation was highest during incipient shivering. These facts indicate that only a part of the motor units recruited for shivering is susceptible to respiratory modulation and that this part is first recruited during incipient shivering. Inhalation of 5% CO2 did not affect the interaction between respiration and shivering although respiration frequency varied from 25 to 60 min-1. Thus, pulmonary chemoreceptors do not mediate this effect. It is suggested that the interaction between respiration and shivering occurs directly in the CNS. The question whether the interaction is adaptive for the animal or merely reflects a common evolutionary history of the underlying neural circuits is discussed. PMID- 3673620 TI - Neural control of electrogenic transport in the rat jejunum; interaction between intramural and adrenergic mechanisms. AB - The aim of the study was to test the hypothesis that extrinsic adrenergic neurons modulate electrogenic ion transport in the jejunum by inhibition of intramural secretory nerve activity. Isolated pieces of rat jejunum were mounted in the Ussing chamber. Noradrenaline (NA) was released from sympathetic nerve endings in the tissue by electrical stimulation of the mesenteric nerves or by the indirect sympathomimetic agent tyramine. Intramural neurons were activated by electrical field stimulation (EFS). Mesenteric nerve stimulation induced a frequency-related decrease in the transepithelial potential difference (PD) and short circuit current (SCC), effects which were abolished by the alpha-adrenergic antagonist phentolamine. A similar response was induced by the serosal application of tyramine and by exogenous NA. Tetrodotoxin (TTX), a nerve conduction inhibitor, had no significant effect on the response to NA, but attenuated the response to tyramine. Both NA and tyramine markedly attenuated the secretory response to EFS, but there was no significant effect of catecholamines on the secretory response to serosal theophylline. The results suggest at least two mechanisms behind the adrenergic modulation of electrogenic chloride secretion: (I) a ganglionic or presynaptic modulation of secretory nerve activity via innervated alpha receptors, and (2) a modulation at the level of the enterocytes via non innervated alpha-receptors. The latter effect does not seem to be mediated by the cAMP system. PMID- 3673622 TI - A new method for continuous recording of oviductal pressure variations in unrestrained gilts. AB - A new method using two intraluminally placed ultra-miniature pressure sensors placed in the same isthmus of the oviduct has been developed for continuous monitoring of oviductal pressure variations during the oestrous cycle in unrestrained gilts. Each test animal was followed for 48 h during which recordings were made at frequent intervals. By using two points of registration, directions of pressure waves could be determined. This technique allows for the determination of the base pressure in the oviduct and how it varies during the oestrous cycle. Effects of different stimuli and the effect of narcosis on oviductal activity can also be directly studied. PMID- 3673621 TI - Low potency of Ca antagonists in smooth muscle from different levels of the respiratory tract. AB - Respiratory smooth muscle at different levels of the respiratory tract was isolated from rabbit, rat and guinea-pig and incubated with the Ca antagonists, verapamil, D-600, felodipine, and nifedipine. There was no effect of the Ca antagonists when added on top of an already developed contraction. When added before the contractile agent at high concentrations (10-100 microM) the Ca antagonists reduced the contractions. Lanthanum (2 mM) was considerably more effective to prevent contractions than the Ca antagonists. Preparations from the trachea and bronchus responded in all animals, whereas the third generation bronchus from rat and guinea-pig failed to contract and that from rabbit showed very weak contractions. The failure to contract was not specific for the agonist, as depolarization with isotonic potassium solution (124 mM) did not evoke contractions either. Microscopic investigation showed well-developed smooth muscle in the trachea and main bronchus of the rat, whereas the muscle of the third generation bronchus was inhomogenous with scattered groups of muscle cells. PMID- 3673623 TI - Possible reflection of intracellular calcium binding in the divergent pattern of relaxation in rat and rabbit uterus. AB - The mechanical responses to potassium of the rabbit and rat uterus were different. The force of a potassium-induced contracture showed a rapid decline in the rabbit uterus, whereas it was fully maintained for a long period in the rat uterus. The increase in 45Ca influx following exposure to high KCl was substantial and similar (0.3 mmol kg-1) in both rat and rabbit uterus. Calcium uptake in post nuclear supernatant (PNS) from the rat myometrium was significantly lower than that from the rabbit myometrium in both the rate and capacity of uptake. This uptake was reduced to about 10% in the presence of sodium azide in PNS from both rat and rabbit myometria. Both the rate and capacity of calcium uptake by mitochondria isolated from PNS of rat myometrium were considerably lower than that by rabbit myometrial mitochondria. Microsomes isolated from rat and rabbit PNS had very low capacity for calcium uptake compared with mitochondria. No difference was found in the rate or the capacity of uptake between the rat and the rabbit myometrial microsomes. The data support the argument for a role of mitochondria in myometrial relaxation and further provide evidence for a considerable species difference in calcium uptake by myometrial mitochondria. PMID- 3673624 TI - [Pharmacological studies of the central effects of new ethylguanidine, imidazolidine and imidazolidinone-2 derivatives]. PMID- 3673625 TI - [Amides of 7-theophyllineacetic acid with antiarrhythmic action]. PMID- 3673626 TI - [Synthesis and pharmacological studies on new guanidine derivatives of 1,5 diazabicyclo(5.3.0)decane and 1,5-diazabicyclo(5.4.0) undecane]. PMID- 3673627 TI - [Biopharmaceutical evaluation of the rectal administration of mefenamic acid. IV. Biological availability of mefenamic acid on the base of polyoxyethylene glycol with the addition of polysorbates]. PMID- 3673628 TI - The borderline of depression. 8th annual forum of the Belgian College of Neuropsychopharmacology and Biological Psychiatry (BCNBP). Gand, 6 December 1985. Proceedings. PMID- 3673629 TI - The psychopharmacology of borderline personality disorders. AB - DSM-III borderline personality disorder defines a group of patients who are characterised by impulsivity and unpredictable behaviour, inappropriate aggression, intense and unstable relationships and are often associated with repeated suicidal behaviour. A substantial body of research has established an association between disturbance of serotonin and also dopamine and suicidal behaviour in depression. A similar relationship is also seen in studies of personality disorders which suggests the association is not specific to depression. A placebo controlled study of low dose flupenthixol has been shown to significantly reduce subsequent suicidal behaviour in patients with personality disorders without depression or schizophrenia. Evidence points to a biological basis for suicidal behaviour and borderline personality disorder and possibly of pharmacotherapy. PMID- 3673630 TI - Assessing depression in elderly patients. AB - Late onset depression often appears similar to depression in younger persons. However, it may present a diagnostic challenge to the clinician because of its atypical expression in the aged. For example, it may be characterized by cognitive impairment, neurotic symptoms, prominent anxiety, somatization, and high bodily concern. Since depressive disorders are not always obvious to the observer, they are perhaps the most poorly recognized and therefore untreated psychiatric disturbances in the aged. PMID- 3673631 TI - The significance of sleep physiological disturbances in depression. AB - Since the discovery of the antidepressant effects of interventions in the sleep wake cycle, a number of hypotheses have emerged according to which disturbances in sleep physiology are not merely expressions but essential components of the pathophysiology of depression. Three hypotheses are presented, the "Phase advance", the "S-deficiency" and the "ACh-hypersensitivity" hypotheses. They explain the therapeutic effects of total, partial and selective sleep deprivation as consequences of the normalization of disturbed sleep regulation. The question is dealt with whether there are indications that the hypothesized sleep regulatory disturbances exist and whether there is a relationship between the effects of sleep deprivation on sleep regulation and clinical state. None of the hypotheses is totally supported, none can be fully rejected. PMID- 3673632 TI - Psychological correlates of the dexamethasone suppression test response and of the shortened REM sleep latency in depressed outpatients. AB - The overlap between REM sleep latency and DST response was investigated in a group of 117 mildly depressed outpatients. No significant correlation between these two biological markers could be evidenced. The MMPI profile of the DST suppressors was clearly different from the non-suppressors' profile indicating a more severe clinical condition at that moment. REM sleep latency did not contribute to the psychological and clinical subtyping of this depressive sample. PMID- 3673633 TI - [Endocrinological and neurophysiological modifications in a case of atropinic delusional state]. AB - In this case report, we observed a delirium probably owing to toxic effects of homatropine eye drops. We reproduced this syndrome and we reversed it with physostigmine salicylate as an antidote. We observed a decrease of cortisol at 9.00 a.m. and impairment of regional cerebral blood flow with increase in the previous right side. The unusual susceptibility of this patient to the anticholinergic effect of homatropine is perhaps related to a preexisting mild cognitive defect possibly related to a cholinergic neurotransmitter deficit. PMID- 3673634 TI - Psychiatric service within primary care. Mode of organization and influence on admission-rates to a mental hospital. AB - The organization of a psychiatric specialist service integrated in primary care is described. One of the aims was to replace admissions to the mental hospital with consultation and treatment within primary care. An 18% reduction of admissions was achieved over a 2-year period. The staff at the local mental hospital to a large extent controlled the number of admissions. Lack of cooperation from part of the staff made a greater reduction of admissions difficult. It is argued that in order to achieve a true shift from institutional to community psychiatry, the use of the hospital beds should be monitored from the community level. PMID- 3673635 TI - Early subjective reactions predicting the outcome of hospital treatment in depressive patients. AB - Early statements by 41 depressive inpatients about a subjective change in their condition and about their attitude to proposed treatment were examined. These statements, made on the day after admission, were found to correlate with the outcome of the treatment. It was found that early subjective reactions can indicate to some extent, not only the result of hospital treatment for depressive symptoms, but also the outcome measured by objective and subjective criteria, after a 3 to 4 month follow-up. PMID- 3673636 TI - Prolactin response to dexamethasone: a study on normal controls and depressed patients. AB - Pre- and post-dexamethasone prolactin and cortisol levels of 40 endogenous and non-endogenous depressive patients and of 20 controls were studied. Dexamethasone had a suppressive effect on prolactin levels, which was expressed more in normal controls and in non-endogenous depressive patients than in endogenous depression. A "prolactin suppression test" by dexamethasone was constructed and provided comparable results to the usual DST. However, it failed to be a specific marker for endogenous depression. There are close relationships between various endocrine axes, which might be altered in depression. PMID- 3673637 TI - Positive and negative symptoms of schizophrenia and linguistic performance. AB - Selected subjects from a group of first onset schizophrenics (aged under 30 years) were taken from a previous study and placed in one of two groups depending upon whether they had exclusively positive symptoms (n = 9) or a mixture of positive and negative symptoms (n = 9). Their linguistic profiles were compared with those of a group of controls (n = 10) matched for educational attainment and parental social class. Both groups of schizophrenics had significantly lower integrity scores, suggesting that they made more syntactic and semantic errors. Those patients who presented with negative symptoms tended to have speech of lower syntactic complexity than the other two groups, although the difference just failed to reach statistical significance. It is suggested that syntactic and semantic errors are state dependent features associated with positive symptoms, whereas low syntactic complexity may be a more enduring feature associated with the presence of negative symptoms. PMID- 3673638 TI - Evaluation of 294 psychiatric consultations involving in-patients above 70 years of age in somatic departments in a university hospital. AB - The integrated geropsychiatric service of the Psychiatric Department of the University Hospital in Linkoping consists of an observation ward, a day unit and an out-patient unit. One of the main tasks of the last-mentioned unit is to provide geropsychiatric consultations for in-patients in the non-psychiatric departments of the hospital. During the first 2 years from October 1982 to October 1984 300 consultations were performed. The consultations included registration of social, medical and psychiatric data, a psychiatric examination, discussions with the staff and a psychiatric report. Out of the total number of 300 consultations 294 could be evaluated completely. They comprised 247 individuals. The evaluation was performed after the first 2 years by screening the patients' psychiatric records and reports and by computer-analysis of 89 variables covering medical as well as social data. The patients' mean age was 78 years and 52% were treated in the Department of Internal Medicine. Fifty-three percent had had previous psychiatric contacts. Many were suffering from serious somatic diseases and 22% from depressive states. Only 9% showed no signs of psychiatric disorders. Twenty-three percent of the patients were transferred to the geropsychiatric observation ward or day unit and only 3% were recommended to be certified and transferred to a mental hospital. Pertinent findings are discussed in the light of international data on geropsychiatric consultations and liaison psychiatry. The study shows the importance of providing special geropsychiatric consultations for in-patients in somatic departments as a part of an integrated geropsychiatric service. PMID- 3673639 TI - The maternity blues: exploration of a psychological hypothesis. AB - Previous studies of the maternity blues have failed to identify a consistent factor discriminating between the group of women who experienced the phenomenon and those who did not. The present study hypothesized that the maternity blues are a hormonally-assisted grief reaction which will occur predominantly in women whose antenatal expectation of baby or delivery fails to be fulfilled by the reality events. The hypothesis was tested in a prospective study of 89 women. The phenomenology of the blues was not found to be associated with the hypothesized sense of disappointment or anti-climax despite many womens' experiences falling short of expectation. Rather, the most powerful predictor of the blues was a sense of "pessimism" in late pregnancy which was actually fulfilled by postpartum reality. In addition, the triad comprising of severity of pre-menstrual tension, unplanned pregnancy and consideration given to elective termination in early pregnancy was associated with increased incidence of the blues. PMID- 3673641 TI - Phases on the way to alcoholism in female psychiatric patients. AB - Sixty-four female alcoholic psychiatric patients were interviewed with a semistructured clinical interview and the standardized interviews: SADS and SSP. The drinking histories were classified into two pre-alcoholic phases: the sporadic and the regular drinking phases; and two alcoholic phases: the escalating and the established phases. Age of abuse, the presence of major depression, schizophrenic psychosis, borderline and schizotypal personality disorder, primary or secondary abuse, number of alcoholic partners, attribution of causes of abuse, and marital state were related to one or several phases. Age of first drink, social class, alcoholism in parents and drug abuse were not. The study demonstrates the diversity of pathways to alcoholism in women, and shows the importance of studying different phases separately. A subgroup with "rapid changes" to a high, stable abuse was characterized by a high frequency of major depression and relationship problems. PMID- 3673640 TI - Markers for vulnerability to psychopathology: temperament traits associated with platelet MAO activity. AB - The functional linkage between platelet MAO activity and psychopathology was explored by analyzing temperamental correlates in 40 male subjects by means of scales from the Eysenck Personality Questionnaire (EPQ), the Zuckerman Sensation Seeking Inventory, and the Karolinska Scales of Personality (KSP). Linear correlations were found with two sensation seeking scales, replicating earlier findings. However, nonlinear correlations predominated. Subjects with intermediate platelet MAO activity had higher scores in conformity scales and lower scores in anxiety and hostility scales than low and high MAO subgroups. Low MAO subjects showed a pattern of higher scores in KSP Impulsiveness, EPQ Neuroticism, and KSP Somatic Anxiety and Irritability and lower scores in KSP Socialization, in line with personality profiles found in alcoholics, psychopaths, and suicide attempters who also tend to have low platelet MAO activity. High MAO subjects scored lower in sensation seeking and conformity scales and higher in KSP Psychasthenia, Muscular Tension and Suspicion scales, consistent with clinical links between high platelet MAO activity and anxiety and paranoia. PMID- 3673642 TI - Lithium: long-term effects on the kidney. IV. Renal lithium clearance. AB - Renal lithium clearance was investigated in 44 patients treated with lithium for an average of 8 years as part of a functional-morphological follow-up study including a kidney biopsy. The average renal lithium clearance was 0.36 ml/s (= 21.6 ml/min). A significant correlation with age, sex and glomerular filtration rate was seen, whereas no significant relationship with urine volume, lithium treatment regimen and histopathological biopsy variables was found. The results were compared with the same renal functional tests obtained from a control group consisting of 26 patients with affective disorders never treated with lithium. The control group had a lower urine output, but no significant difference in lithium clearance was observed. In conclusion, renal lithium clearance is a specific investigation, which may provide valuable baseline information on glomerulo-tubular function in patients before and during prophylactic lithium treatment. PMID- 3673643 TI - Ventricular enlargement and neuropsychological testing in schizophrenia. AB - The Ventricular Brain Ratio was computed in a group of 42 young chronic schizophrenics (age range: 17-45). The patients also completed a battery of neuropsychological tests: four WAIS subscales, the Benton test and the Trail Making Test. Although patients as a whole showed the expected ventricular enlargement and neuropsychological impairment when compared to control groups, no correlation was found between the two measures. These results are inconsistent with previous work on the same topic that hypothesized the association of both parameters. Some tentative explanations for these conflicting results are given. PMID- 3673644 TI - Why do some psychiatric patients somatize? AB - A study was made of a series of 139 outpatients referred by the medical and surgical services of a general hospital for evaluation by the psychiatry unit. In accordance with established criteria, this population was divided into somatizers (56) and non-somatizers (75), and the socio-demographic and clinical characteristics of both groups were comparatively analyzed. The results show that the group of somatizers was younger, had more histrionic personality traits and more stress factors related with alterations in interpersonal relationships or death or disease of relatives. It is emphasized that somatization is poorly known by psychiatrists--whose diagnostic criteria practically omit these aspects--and by other physicians, in spite of its importance and frequency. PMID- 3673645 TI - First-admission rates and marital status of schizophrenics. AB - All patients who were first-admitted to Danish psychiatric institutions in the calendar years 1970, 1973, 1976, 1979, and 1982 and who were diagnosed as schizophrenics at least once within a 2-year period of observation from the first day of the first admission are followed up by means of the nation-wide Danish Psychiatric Register (totally 1,175 males and 665 females). Sex and age specific first-admission rates of schizophrenia show that the difference between male and female rates especially appears in the age group 15-24 years. In this age group the peak incidence is found for both sexes, also if the patients only diagnosed as schizophrenics at a later admission are included. The ratio of male to female incidence rates are not changed by inclusion of the latter patients. A higher frequency of married or formerly married patients is found among the schizophrenics who were diagnosed late in the course of treatment than among those who were so at first-admission. This might be a manifestation of a less severe symptomatology which could explain the tendency to hesitate in diagnosing patients as schizophrenics. PMID- 3673647 TI - Lithium therapy in China: 6 years later. PMID- 3673646 TI - Disappearance of tardive dyskinesia during catatonic stupor. AB - A 61-year-old man diagnosed as having catatonic schizophrenia was treated with neuroleptics for many years. From 1983 he showed tardive dyskinesia on trunk and limbs as well as orofacial dyskinesia. In September 1985 he displayed a catatonic stupor several times. With the outbreak of the stupor the dyskinesia disappeared and vice varsa. This finding induces the hypothesis that the dopaminergic system is suppressed during catatonic stupor in such a way that tardive dyskinesia is no longer visible. PMID- 3673648 TI - Stressors and aetiology of depression: a comment on Hallstrom, March 11, 1987. PMID- 3673649 TI - Thrombocyte monoamine oxidase activity and personality traits in women with severe premenstrual syndrome. AB - Women with premenstrual syndrome (PMS) of such severity that they actively had sought medical attention for their symptoms were compared with healthy female students with regard to platelet MAO activity and temperamental correlates by means of the Karolinska Scales of Personality (KSP), scales from the Eysenck Personality Questionnaire (EPQ) and Eysenck's IVE inventory. The women with PMS were divided into two groups; irritability and depression as predominating symptom. No variation in platelet MAO was found during the menstrual cycle, either in patients or in controls. Both PMS groups had significantly lower platelet MAO activity than the controls. There was no difference between the two groups with PMS. Also with regard to personality traits there were considerable differences between the females with PMS and the controls. There were few differences between the two groups of PMS patients. Thus, the patients scored significantly higher as regards somatic anxiety, muscular tension, indirect aggression, verbal aggression and neuroticism and lower as regards socialization than the controls. PMID- 3673650 TI - Acoustic analysis of speech variables during depression and after improvement. AB - Speech recordings were made of 16 depressed patients during depression and after clinical improvement. The recordings were analyzed using a computer program which extracts acoustic parameters from the fundamental frequency contour of the voice. The percent pause time, the standard deviation of the voice fundamental frequency distribution, the standard deviation of the rate of change of the voice fundamental frequency and the average speed of voice change were found to correlate to the clinical state of the patient. The mean fundamental frequency, the total reading time and the average rate of change of the voice fundamental frequency did not differ between the depressed and the improved group. The acoustic measures were more strongly correlated to the clinical state of the patient as measured by global depression scores than to single depressive symptoms such as retardation or agitation. PMID- 3673651 TI - An empirical comparison of three different borderline concepts. AB - Forty-six inpatients were independently diagnosed according to the DSM-III concept of borderline personality disorder, the diagnostic interview for borderlines (DIB) and the concept of borderline personality organization, which is linked to Kernbergs structural interview. The interviews were videotaped. Satisfactory inter-rater reliability was demonstrated for the DIB, which furthermore showed high sensitivity and specificity in identifying patients with a clinical DSM-III diagnosis of borderline personality disorder from patients with a other personality disorders or schizophrenic disorders. Discriminant features, demographic profile and earlier treatment history for the patients with a borderline personality disorder are described and discussed. The structural interviews were scored according to a specified format. Inter-rater reliability was satisfactory but not too impressive. Borderline personality organization turned out to be a very broad concept and only half of the patients within this concept received a syndrome diagnosis of borderline personality disorder. A general conclusion was that borderline personality organization should not be considered as a diagnostic entity but rather as a different diagnostic dimension representing an intermediate level of personality structure. PMID- 3673652 TI - Age and duration of illness as predictors of ventricular brain ratio (VBR) size in chronic schizophrenic patients. A stepwise regression analysis study. AB - The CT scans of 18 chronic schizophrenic patients and 17 controls were evaluated for Ventricular Brain Ratio (VBR) size. A trend for the patient group to have larger VBR than controls was present but did not reach statistical significance at the 5% level. Age was found to be an important correlate of VBR within the patient group but not among controls. In a stepwise multiple-regression model age, among other independent variables, can account for 47% of VBR variance in schizophrenic patients. Linear regression analysis did not reveal significant association between VBR and age in control subjects. PMID- 3673653 TI - Psychopathology and accidental injuries. AB - One hundred and twelve adults admitted to a surgical ward due to accidental injuries were studied. Thirty-seven percent had a psychiatric disorder on admission (DSM-III axis I) and 21% had a personality disorder (axis 2). Substance abuse and dependence and antisocial personality disorders were most frequent. Eighteen percent were definitely distressed when injured. Persons with a personality disorder were distressed significantly more often and had sustained clinically more severe injuries. No support could be found for a hypothesis of accidental injuries being the result of hidden or unconscious self-destructive tendencies, and only one patient was injured in a suicide attempt. Defense Mechanism Test applied to a subgroup of 20 patients suggested that high perceptual defense may be related to injury occurrence in patients at fault for the accident. PMID- 3673654 TI - Depressed mood and reality disturbance correlate with decreased nocturnal melatonin in depressed patients. AB - The authors measured serum samples of melatonin at 11:00 p.m. in 28 patients suffering from major depression. Melatonin secretion was inversely correlated with the depressed mood and reality disturbance factors of the Hamilton Depression Scale. These results are consistent with previous reports of low melatonin syndrome in a subgroup of depressed patients. PMID- 3673655 TI - Neuropsychiatric studies in a family with presenile dementia different from Alzheimer and Pick disease. AB - We have studied a family in which 14 persons among 73 are or have been suffering from presenile dementia. Post mortem examination showed atrophy but no sign of any known demential syndrome. Cerebral blood flow measured in the late stage of disease was low, but with no characteristic pattern in flow distribution. In one patient in the initial stage of disease, the cerebral blood flow was unexpectedly increased. The patients with presenile dementia in this family did not reveal pathological signs of any known demential syndrome and showed CBF-changes not earlier reported. Moreover, contrary to widely held views we have evidence that dementia may be connected to a high blood flow at least in the initial state. An increased blood flow was also seen in seven of ten well functioning first degree relatives, in some cases along with cerebral atrophy and/or psychological tests with signs of dementia. Are these people going to develop manifest dementia later in life? PMID- 3673656 TI - Psychotic homicides in Copenhagen from 1959 to 1983. AB - During the years from 1959 to 1983, 263 Copenhagen defendants of homicide underwent a psychiatric examination for the court. Twenty-three percent of the defendants were held to be psychotic at the time of the crime. The psychotic defendants differed from the non-psychotic by being older, less often substance abusing and by choosing victims inside their families. It is discussed whether a reduction in the available number of psychiatric beds could be a contributional reason for the increase in especially the number of schizophrenic defendants. About one third of all defendants were by the examining psychiatrists found in need of a sanction different from ordinary punishment; furthermore, a tendency towards sanctions of treatment instead of just placement in a psychiatric hospital was documented and is discussed. The increasing demand of capacity for forensic, psychiatric patients is mentioned. PMID- 3673657 TI - Onset of functional psychoses in later middle age. Social-psychiatric considerations. AB - The onset of functional psychosis occurring in later middle age (45-64 years) was studied by comparing the life situation and personal history of 74 Turku patients admitted to the mental hospital for the first time with the corresponding information obtained for randomly selected controls of the same age and of the same sex. The annual first admission rate of functional psychoses was 81 per 100,000; there was no difference between men and women. The rate was highest in unmarried individuals and lowest in married individuals (167 vs. 56 per 100,000). Measured by many different indicators, the patients' prepsychotic social development had been clearly poorer than that of the controls during the corresponding period. Almost all patients had had a precipitating life change during the last 5 years preceding the onset of psychosis. Objective losses had occurred more often in the group of affective psychoses than in the other diagnostic groups. In the case of childhood losses, on the other hand, there were no difference between patients and controls or between the diagnostic groups. PMID- 3673658 TI - Differences between alcoholic and non alcoholic female psychiatric patients. AB - Sixty-four consecutive DSM-III alcoholic female psychiatric patients (A-group) were compared with 65 non alcoholic women from the same psychiatric units. The A women more often had nervous sisters. They were younger at the first intercourse, had had more frequent intercourses during the last year, more often had a poor relationship with their children. They had had more heterosexual partners, living together relationships and divorces, and had more often a dependent adult relationship. The mean age of the first nervous symptoms and of coming to psychiatry was significantly lower in the A-group, and they had more suicidal attempts and criminality. During childhood, adolescence and adult age, they reacted more often to losses with acting out and alcohol abuse. Nervous problems and close contact difficulties seem to have manifested themselves mostly before the alcohol abuse was established. PMID- 3673659 TI - Clinical course and outcome of delusional psychosis. AB - The purpose of the study was to examine first-admitted patients with delusional psychosis meaning functional psychosis with paranoid symptoms with respect to clinical course and outcome. The index population comprised 88 patients. At discharge from first admission the patients were classified according to ICD-8 and DSM-III. According to both diagnostic classifications the majority of the patients did not belong to either of the two major psychotic groups, schizophrenia or affective psychosis. During the 2-year observation period half of the patients took psychotropic drugs continuously, and almost half of the patients experienced one or more relapses. One third of the patients were readmitted, and in average the patients stayed in the hospital for 4 months during the observation period including the time of index admission. At follow-up half of the patients revealed positive psychotic symptoms, while two thirds were moderately or severely impaired because of psychotic illness or personality dysfunction. It is concluded that the present aftercare treatment is insufficient to prevent relapse and psychotic symptoms. In consequence of this the existence of delusions at first admission to hospital because of functional psychosis seems for many to predict an unfavourable course and outcome. Further study will search for clinical and social predictors of course and outcome in patients with delusional psychosis. PMID- 3673661 TI - Short stature as a possible etiological factor in anorexia nervosa. AB - The 21st case of concurrence of anorexia nervosa (AN) and gonadal dysgenesis (GD) or Turners syndrome is presented together with two more cases of AN in girls of short stature, but with normal chromosomes. The concurrence of AN and GD in the Danish population over a 10 year period is found not to be beyond the expected frequency. The possibility of low stature as such as an etiologic factor in AN is presented on the background of three cases. The same hypothesis has been suggested previously, but we cannot support the view of short stature as a common condition in AN patients premorbidly. PMID- 3673660 TI - The effect of tricyclic antidepressants on stress-induced heart rate changes in panic disorder patients. AB - Eight panic disorder patients participated in a double-blind placebo-controlled infusion study designed to induce panic-anxiety in the laboratory both before and after treatment with tricyclic antidepressants. Pre-infusion heart rates for the first infusion were significantly higher than baseline both before and after treatment. The delta increase in pre-infusion heart rates from baseline and the ratios of pre-infusion heart rates to baseline values were not significantly different between before and after treatment conditions indicating similar levels of arousal during the two pre-infusion periods, while the pre-infusion anxiety ratings after treatment were significantly lower. PMID- 3673662 TI - Decreasing rates of diagnoses of schizophrenia in Denmark. PMID- 3673663 TI - Factor VII-phospholipid complex in male survivors of acute myocardial infarction. AB - The presence of an activated form of coagulation factor VII--a factor VII phospholipid complex--in male survivors of myocardial infarction is described. The level of this complex did not correlate with age or level of conventional risk factor score, but showed a highly significant positive correlation with serum triglycerides in all the subgroups as well as in the whole study population (r = 0.88, p less than 0.0001). Measurement of this form of activated factor VII may constitute a simple and promising method for additional screening of men at risk for cardiovascular disease. PMID- 3673664 TI - Cardiac arrest in Stockholm with special reference to the ambulance organization. AB - During a one-year period all patients with cardiac arrest (CA) taken care of by three ambulances were studied. An incidence of 110 cardiac arrests/100,000 inhabitants/year was found. The majority of CAs affected the elderly and occurred during the day in their homes. The majority of CAs were witnessed but cardiopulmonary resuscitation (CPR) had been initiated by bystanders in only a few cases. The ambulance arrived within a mean time of 7.7 +/- 4.0 min. Forty eight per cent of the CA patients showed ventricular tachycardia or ventricular fibrillation (VT/VF) on ambulance arrival. Patients with a prolonged ambulance delay showed a lower incidence of VT/VF than patients with a short delay. Patients in whom CPR had been initiated by bystanders showed a significantly higher incidence of VT/VF (67%) than unattended patients (45%). Bystander CPR was furthermore associated with an increased incidence of VT/VF in patients with prolonged ambulance delay. VT/VF was present at the time when the ambulance arrived in 86% of the CA patients who had received CPR from a bystander and were reached within 8 min by the ambulance. PMID- 3673665 TI - Prognosis and clinical follow-up of patients resuscitated from out-of hospital cardiac arrest. AB - A new organization has been formed in which ambulance personnel have been trained to recognize ventricular tachycardia and ventricular fibrillation (VF) and to defibrillate. Cardiac arrest (CA) occurred in 307 patients and 140 were defibrillated. Twenty-eight patients were resuscitated and admitted for further hospital care. A previous history of ischaemic heart disease was found in 24 patients. Twenty-two of the patients admitted were found to have VF, two asystole and four other rhythms. All 11 survivors regained circulation at the site of the CA. At the time of admission all but one of the patients were unconscious and one long-time survivor remained unconscious until the 5th day following admission. Seventeen patients died while still in hospital. In 16 cases a diagnosis of acute myocardial infarction was established, a further six had VF without evidence of acute myocardial infarction and six had other diagnoses. Ten out of the 11 survivors were still alive six months after discharge. Only one case of recurrent VF was seen during a median follow-up period of 16 months. Prolonged coma, especially in combination with convulsions, was associated with a poor prognosis, while early return of circulation was significantly more common among survivors. Ongoing medication with beta-blockers, a high QRS rate on admission and VF without proof of any acute myocardial infarction were also found to be more common in survivors. PMID- 3673666 TI - Vasospastic angina assessed by hyperventilation-thallium-201 myocardial scintigraphy. AB - The response to prolonged hyperventilation (HVT) was evaluated by electrocardiography (HVT-ECG) and thallium-201 myocardial scintigraphy (HVT-Tl Sc) in 40 patients suspected of vasospastic angina. Both tests showed ischaemic changes in 16 patients and no changes in 20 patients. Two patients had abnormal HVT-ECG and normal HVT-Tl-Sc, and the reverse combination was found in two patients. Prolonged HVT was performed in 14 patients during coronary angiography (CAG). Nine developed transient total or subtotal occlusion in one of the major coronary arteries, all of whom had ischaemic HVT-ECG and eight had abnormal HVT Tl-Sc. In the five patients without spasm at CAG four had normal HVT-ECG and all five normal HVT-Tl-Sc. Our data suggest that HVT-ECG and HVT-Tl-Sc have essentially the same sensitivity and specificity in detecting vasospastic angina. PMID- 3673667 TI - Autonomic neuropathy in type I diabetes: influence of duration and other diabetic complications. AB - To evaluate the influence of duration on the development of autonomic neuropathy (AN) a group of type I diabetic patients (n = 58) who had been diagnosed between the ages of 15 and 25 years was investigated. The duration of diabetes varied from 2 months to 30 years (mean 13 years). AN tests included a deep breathing test (E/I ratio) and an orthostatic test on tilt table (acceleration and brake indices) and the results were corrected for age. A clear correlation between AN test and duration of diabetes was shown only for the E/I ratio (r = -0.44, p less than 0.001). On the other hand, deteriorations in the brake index were unrelated to the duration of diabetes and occurred early; 35% of the patients with a duration of 10 years or less showed an abnormal brake index. Autonomic test deviations were related to other diabetic complications. The E/I ratio and the acceleration index were especially low in patients with retinopathy as well as in patients with symptoms of AN if combined with peripheral neuropathy (PN). The brake index was low in patients with symptoms of AN independent of PN. PMID- 3673668 TI - Appropriate replacement dose of thyroxine in primary hypothyroidism. AB - An ultrasensitive thyrotropin (TSH) assay was used to determine how many of 65 patients with primary hypothyroidism on thyroxine (T4) replacement therapy had suppressed serum TSH. In 13 patients (20%) TSH levels less than or equal to 0.1 mIU/l were found, indicating an overdose of thyroxine. After correction of the dose, 48 patients had normal TSH values. Their mean dose of thyroxine was 119 micrograms/24 hours, and the appropriate replacement dose tended to decline with advancing age. The serum level of thyroid hormones during replacement therapy with thyroxine very imperfectly reflected serum TSH values. It is concluded that overdose of thyroxine is common when suppressed serum TSH is used as an end point. Biochemical follow-up of replacement therapy with thyroxine in primary hypothyroidism therefore requires the use of an ultrasensitive TSH assay in order to detect such suppression. Serum levels of thyroxine or triiodothyronine (T3) during thyroxine therapy are poor indicators of pituitary TSH secretion and are therefore not useful as parameters of adequate thyroxine dosage. PMID- 3673669 TI - Hydroxyurea treatment of myeloproliferative disorders. Macro-megaloblastic blood and bone marrow changes. AB - Blood and bone marrow changes induced by continuous low-dose hydroxyurea treatment are described. A linear increase in mean red cell volume was observed after onset of therapy. The entire normocyte population was replaced by abnormally large erythrocytes within 150 days. The bone marrow morphology changed in megaloblastic direction. Bone marrow iron stores and number of sideroblasts increased, findings compatible with ineffective erythropoiesis. Serum folate and cobalamin levels remained normal. These morphologic changes might cause confusion when examining blood or bone marrow samples from patients treated with hydroxyurea. PMID- 3673670 TI - Antibiotic treatment of Staphylococcus aureus endocarditis. A review of 119 cases. AB - Clinical and bacteriological information of Staphylococcus aureus endocarditis was reviewed in 119 cases from all over Denmark. Overall mortality was 71%. Survival correlated with antistaphylococcal treatment, short duration from onset of infection to start of treatment, and long duration of treatment. In spite of relevant treatment, mortality was significantly lower in cases infected with penicillin-susceptible strains than when penicillin-resistant strains were isolated. There were no differences in the effect of various anti-staphylococcal treatment regimens; in particular, there were no differences in mortality with regard to beta-lactam antibiotics alone as compared to beta-lactam antibiotics in combination with aminoglycosides. However, embolic manifestations occurred more often after start of treatment with combination therapy than with beta-lactam antibiotics alone. PMID- 3673671 TI - Factors limiting physical working capacity in predialytic uraemic patients. AB - The exercise capacity of 20 predialytic uraemic patients (mean age 43 +/- 12 years) was studied prospectively. Nine of these patients were examined twice in a longitudinal study. The maximal working capacity, measured by standardized exercise test on a bicycle ergometer, averaged 74 +/- 19% of the expected normal. Normal exercise ECG were registered in 16 out of 20 patients. Total hemoglobin/kg body weight (THb) was 67 +/- 16% of the expected normal and serum parathyroid hormone concentration (PTH) was 39 +/- 39 micrograms/l (normal range 0.5-1.5). Partial correlation showed a correlation between exercise capacity and PTH (p less than 0.05). In the longitudinal study the decrease in steady state exercise capacity was correlated to the decrease in THb (p less than 0.05), but not to the increase in PTH. In conclusion, patients with predialytic uraemia have a reduced maximal working capacity, due to several possible factors one of which is a reduced THb. Ischaemic heart disease seems to be of minor importance. PMID- 3673672 TI - Perforated peptic ulcer--a complication in acute salicylate intoxication. AB - A patient with perforated peptic ulcer following acute salicylate intoxication is presented. The patient had reversible renal failure requiring dialysis therapy, but no abdominal symptoms were noticed until six days after arrival. At this time haematemesis and melaena were observed. Symptoms and objective findings were vague, but further investigations revealed a perforated prepyloric ulcer, which was successfully treated with cimetidine, The delay from intoxication to symptoms has previously been described and might be due to the analgetic properties of salicylates. PMID- 3673673 TI - In search of paintings influence on time judgement. AB - The influence of paintings on short time interval perception was studied. Three methods for time estimation were tested: direct scaling and two modifications of the method of reproduction ? with and without simultaneous presentation of the painting whose duration was, reproduced. The results show that short time interval perception is influenced by such complex stimuli as paintings. The motor reproduction with simultaneous presentation of the visual stimulus was the most effective in revealing the influence of paintings on short time interval perception. PMID- 3673674 TI - The use of rotating checkerboard patterns in the treatment of amblyopia. AB - Sixty-four amblyopic children (mean age 7.5 years, age range 4-12 years) were subjected to treatment using slowly rotating patterns of different spatial frequencies. In 20 amblyopes square-wave gratings (spatial frequencies 0.26-16.84 c/deg), in 44 checkerboard-patterned structures (spatial frequencies 0.04-5.2 c/deg) were used for stimulation. The mean improvement of the distance visual acuity was significantly higher in the checkerboard-stimulated group (3.59 equidistant optotype lines) than in the grating-stimulated group (2.71). As the highest spatial frequency of the checkerboards was substantially lower than of gratings, the results cannot be explained in terms of optical qualities of the stimulating patterns. Other factors, such as short-term occlusion, accomplishment of demanding visuomotor tasks and the quality of cooperation and attentiveness of the patients are considered to be more important for the success of treatment. PMID- 3673675 TI - Environmental temperature and maternal behavior in Rattus norvegicus. AB - In 14 female rats the daily duration of selected patterns of maternal behavior was registered for 10 successive days (from the 4th till the 13th day postpartum) for 180 min each day. On certain days the home cages of 7 females (experimental group) were cooled for 8 h, while the remaining 7 females constituted a control group. During the days of cooling the experimental females devoted to the care- giving behavior much more time than during the days without cooling. The drop in temperature influenced the intensity of maternal behavior not only in the early postpartum days, but also on the following days, and that behavior altered repeatedly according to temperature changes. The behavioral responses of females to the actual temperature changes emerge during the first 90 min of cooling. The results indicate that in the course of one maternal cycle the intensity of care giving activities can be modified many times and relatively quickly, according to temperature changes. PMID- 3673676 TI - Ventral tegmental area lesions differentially affect responses controlled by CS US contiguity and response-reinforcer contingency in the rat. AB - Rats with electrolytic lesions of the ventral tegmental area (VTA, n = 32), or sham lesions (n = 32), were tested in four behavioral paradigms in a shuttlebox. The paradigms were designed to assess the motivational influence of CS-US contiguity and response-reinforcer contingency. The VTA lesion increased the number of shuttle responses in the paradigms involving contiguity between a warning signal and a shock, without affecting responses controlled by the contingency between shuttling and shock avoidance. Escape latency was reduced by the lesion, but the general locomotor activity of the rats was not increased.The data suggest that the VTA normally acts to inhibit behavior motivated by classically conditioned fear. The results are discussed in terms of the hypothesis that the dopaminergic projection from the VTA to the nucleus accumbens plays a role in the inhibition of emotionally motivated motor responses. PMID- 3673677 TI - Toward the problem of physical and semantic component of the form during eye scanning. AB - In subjects inspecting random polygonal shapes eye movements were recorded by means of a corneal reflection technique and computer processed. Eye fixations were mostly located around angles. Distribution of fixations over different angles was unhomogenous. Angular rotation changed both semantic meaning of the shapes and the eye fixation distribution. Sequential Markov dependence was found only in cases when semantic interpretation of the shapes was reported by the subjects and was absent when the shapes were perceived as meaning-less geometrical patterns. PMID- 3673678 TI - CT-findings in haemorrhages from aneurysms of the anterior communicating artery: correlation with angiography and clinical course. AB - CT findings, angiography and clinical course were analyzed in a series of 31 patients with a recent subarachnoid haemorrhage (SAH) from an aneurysm of the anterior communicating artery (ACoAA). It is shown that 3 types of bleedings can be distinguished according to the CT findings. In the first group (52%), suffering a mild or moderate bleeding into the basal cisterns and/or the cisterna lamina terminalis, the aneurysm mostly points downwards and is orientated straight in the midline, the Hunt and Hess Grade at admission is I or II and the prognosis following early surgery is good. In the second group (29%), the aneurysm mostly is orientated towards one side, additional bleeding occurs into the gyrus rectus and the mediobasal frontal lobe, they are in HH Grade II and III and the prognosis following surgery also is relatively good. In group three (19%) however, the aneurysm points upwards, they present with severe bleeding into the cisterna lamina terminalis, the cavum septum pellucidum and rupture into the putamen, hypothalamus and the ventricle. In this group, the HH grade at admission is IV or V and the prognosis is extremely unfavourable. It is concluded, that this classification may be used for decision on early surgery. PMID- 3673679 TI - CT-findings in cystic meningiomas. AB - Cystic meningiomas are rare, about 10% occurring in children. Only 61 cases have been reported in the literature. Based on 6 of our own cases and the reports in the literature typical CT-findings are described and differentiating features from other cystic mass lesions discussed. If a tumour on CT shows a cystic component, is smoothly outlined, enhances markedly and is attached to the dura, then a preoperative diagnosis of cystic meningioma should be taken into account. This holds especially true if the patient is a child. PMID- 3673680 TI - Co-existence of abdominal aortic aneurysms and intracranial aneurysms. AB - The occurrence of abdominal aortic aneurysms (AAAs) and intracranial aneurysms (IAs) in the same patient and in the same family was studied among 89 patients with AAAs and 485 patients with IAs. Among the AAA-patients two had IAs themselves and five had IAs in the family, whereas three IA-patients had AAAs themselves and eight had AAAs in the family. Moreover, one of the patients with both AAA and IA had a blood relative with AAA, and in six of the families with both types of aneurysms there were more than two subjects with aneurysms. The results indicate, that AAAs and IAs may have a common aetiologic factor. PMID- 3673681 TI - Brainstem auditory evoked response and vestibulo-ocular reflex in severe head injury patients. A prospective study of 60 cases. AB - Brainstem auditory evoked response (BAER) performed in 60 serious head injury patients, over the last two year period at All India Institute of Medical Sciences, New Delhi have been analysed, to correlate the findings with ultimate outcome. All patients included in this study were unconscious, not following any command at the time of initial evaluation, mostly within 48 hours of injury. Repeat studies were performed in surviving patients. Computerized cranial tomography was performed to establish the nature of the intracranial pathology. The clinical status and cold caloric responses were recorded in all. The patients were followed up for 1 to 24 months. Three patients had extradural haematoma, 2 patients had subdural haematoma and 30 patients had intracerebral contusion/haematoma. Brain oedema was recorded in 14 cases. BAER was normal in 32 patients and 26 of them had good recovery (81%). Three patients with normal BAER died. Abnormal BAER was recorded in 21 patients and only 50% of them had good recovery and 25% of them died. In 7 patients BAER was absent and only 2 (29%) had a good recovery. Thus 48 out of 60 patients (66%) had a good recovery and 11 (18%) died. When compared to cold caloric response, 87% patients with normal caloric response had a good recovery and 5 out of 6 patients with absent caloric response died and remaining 1 left in a vegetative state. Thus the caloric response is at least as good a prognostic factor as BAER. PMID- 3673682 TI - Internal neurolysis or ligament division only in carpal tunnel syndrome. II. A 3 year follow-up with an evaluation of various neurophysiological parameters for diagnosis. AB - 48 patients with clinical and neurophysiological signs of carpal tunnel syndrome were randomized to any of two operative methods: Internal neurolysis of the median nerve with a microsurgical technique, or simple division of the carpal ligament (flexor retinaculum). After a minimum follow-up period of 3 years 81% of the patients did not report any complaints at all, and all patients considered themselves improved after operation. There was no difference between the operation groups. Therefore there seems to be no justification to perform the more difficult procedure of internal microsurgical neurolysis for treatment of the carpal tunnel syndrome. A study of the neurophysiological parameters before and after restitution showed the highest sensitivity (91%) for the sensory conduction velocity, and the highest specificity for motor distal latency and sensory distal latency (83 and 75% resp.). PMID- 3673684 TI - Prevention of neuroma formation by Neodym Yag laser--experimental observations. AB - The influence of Laser radiation on neuroma formation was investigated in rat sciatic nerves. Peripheral nerve trunks were divided by focused Neodym Yag Laser and compared with those transected by microscissors. The nerves were re-exposed at different time intervals up to 240 days after initial operation. True neuroma formation could not be observed after laser transection. Sharp division resulted in widespread amputation neuromas consisting of regenerating axons and connective tissue. Neodym Yag laser radiation by its scattering effect may cause deep coagulation necrosis and thrombosis of vasa nervorum thus sealing the dome of the divided nerve trunk. The formation of amputation neuromas may be suppressed by laser application. PMID- 3673683 TI - Observer variability in assessment of angiographic vasospasm after aneurysmal subarachnoid haemorrhage. AB - In clinical practice and in many reported studies about incidences and time courses of vasospasm the angiographic spasms are judged by eye without clear definition of vessel narrowings. To evaluate the reliability of this diagnostic method two experienced neuroradiologists and two experienced neurosurgeons independently in two sessions, examined 30 carotid angiograms performed after an aneurysmal subarachnoid haemorrhage. The intra- and inter-observer agreements for the absent/present and localization diagnosis of vasospasm were calculated by means of Kappa statistics. Kappa values for both intra- and inter-observer agreement showed great variability and in general most of the agreements were not much better than chance expected agreement. The diagnostic method of judging angiographic vasospasm by eye without clear-cut definitions of vessels narrowings is unreliable and should not be used in the future, neither in clinical practice nor in research. PMID- 3673685 TI - The study of the effect of human chorionic gonadotrophic (HCG) hormone on the survival of adrenal medulla transplant in brain. Preliminary study. AB - Autologous adrenal cortex was completely dissected off the medulla using microdissection. The adrenal medulla tissue was transplanted to the lateral ventricle in twenty-one adult rats. Group A consisting of ten animals received 200 units of HCG per 100 gram body weight daily for one week and then on every alternate day for seven weeks. The remaining rats (group B) served as control. After eight weeks the brains were removed and a volumetric study was done using histological sections. High pressure liquid chromatography (HPLC) with electrochemical detection for catecholamine assay of the graft was also undertaken. The graft survival in group A was significantly higher (p less than 0.005) than group B. The level of norepinephrine was significantly higher in group A while dopamine was higher in group B. The higher volume of graft tissue in group A suggests that HCG may help in increased survival and growth of the transplanted tissue. Higher levels of norepinephrine in group A would suggest a tendency for such grafts to be active to a greater extent with the treatment of HCG. PMID- 3673687 TI - The midline supra-orbital approach, using a large single free bone flap. Technical note. AB - Surgical access to the anterior frontal region of the skull base is facilitated by the removal of a fronto-orbital bone flap. This technique was first described as a two-step procedure by Cophignon. We recently devised a simplified one-step approach in which a single bifrontal supra-orbital bone flap is removed. This report is a technical description and resume of our experiences. PMID- 3673686 TI - A rare case of Maffucci's syndrome combined with tuberculum sellae enchondroma, pituitary adenoma and thyroid adenoma. AB - Maffucci's syndrome is a rare, congenital mesodermal dysplasia combined with dyschondroplasia and haemangiomatosis, and there are only about 150 reported cases. This syndrome is often combined with other neoplasms. Our case was associated with goitre, enchondroma of the tuberculum sellae and pituitary adenoma; the latter brought about disturbance of vision. Including ours, four cases of Maffucci's syndrome associated with pituitary adenoma are found in the literature. In the case of Maffucci's syndrome, it is necessary to examine associated disease as well as associated pituitary adenoma and skull base enchondroma, similar to the correlation of von Recklinghausen's disease with acoustic neurinoma. PMID- 3673688 TI - Extradural haematoma of the posterior fossa. Twelve years experiences with CT scan. AB - 18 cases of an extradural haematoma of the posterior fossa (EDHPF) are presented and the clinical and radiological findings are demonstrated. The onset of symptoms was acute in 10 patients and subacute in the other 8 patients. The overall mortality was 22%, but only acute course patients died (40%). All subacute cases survived. The most important factors influencing mortality were the level of consciousness immediately before the operation and the presence of hydrocephalus prior to surgery. Other coexisting intracranial lesions had no influence on mortality but on the quality of survival. Compared with the literature there is a certain decrease in mortality in the subacute course patients since the introduction of computed tomography. PMID- 3673689 TI - Cranio-cerebral erosion (growing fracture of the skull in children). Part I. Pathology. AB - Seventeen cases of cranio-cerebral erosion were subjected to detailed histopathological study in order to get a better insight into the pathogenesis of this lesion. It was found that the bone and brain at the site and edge of the defect show not only evidence of damage at the time of initial injury, but also of "active" progressive damage months and years later. The possible causes for continuing damage to the brain and bone are discussed. PMID- 3673690 TI - DNA and prognosis of meningiomas: a comparative cytological and fluorescence cytophotometrical study of 71 tumours. AB - DNA analysis in meningiomas was performed using flow-fluorescence cytometry in 71 tumours. Three subcategories of rather small, medium-sized or clearly abnormal growth activities were evident in each of the fibroblastic, transitional and syncytial tumour types. These categories reflected grades 1, 2 or 3 of malignancy on a four-grade scale in which the primary fibroscarcomas of the meninges are grade 4. Richly vascularized (haemangioblastic) meningiomas of our series comprised only two subcategories: these included 7 tumours with slight signs of proliferation and 1 with increased growth, probably indicating a propensity to recur. Tumours of grades 2 and 3 have a tendency to recur, which is probably due more to their biological behaviour than to the efficiency of the surgical treatment. The most variable patterns of DNA distribution are detected in the so called "anaplastic" meningiomas: some of them are microscopically polymorphous blastomas but show unimodal diploid karyograms, whereas the proliferative indizes, ranging between 1 to 15, were obviously indicative for slow-growing benign tumours. The majority of polymorphous and anaplastic meningiomas, however, are characterized by a rather abnormal tetraploidy or aneu/polyploidy not uncommon in a relapse. The corresponding DNA distribution was demonstrated in a recurrent papillomatous meningioma in agreement with its dubious histological prognosis. PMID- 3673691 TI - Stable-xenon-CT: effects of xenon inhalation on EEG and cardio-respiratory parameters in the human. AB - The effects of inhalation of a 33% Xenon-O2 mixture over a period of 5 minutes on EEG and cardio-respiratory parameters were studied in 18 human volunteers. This dosage is similar to that used clinically in Xenon-CT studies. In 4 cases no EEG power change was observed during the study. In the 14 other subjects EEG variations were seen. The most prominent change was an increase in beta EEG power. No change was observed in theta and delta EEG power. The findings seem to correlate with the early induction (excitation) phase of an anaesthetic. Hyperventilation was observed before the study and increased during the Xenon inhalation. Blood pressure remained stable while the heart rate tended to decrease a little. All these changes disappeared rapidly following the termination of the Xenon inhalation. The effects are minimal and should not reduce the clinical value of CBF measurement using the Xenon-CT method. PMID- 3673692 TI - Clinical study of brain retraction in different approaches and diseases. AB - Pressure of brain retraction was measured with a strain gauge spatula in 31 cases of 21 tumours and 10 aneurysms. They were operated on via different approaches: subfrontal (10 cases), interhemispheric (5), subtemporal (7) and suboccipital (9). The patients' age ranged from 11 to 74 years (average 50). The recorded data were averaged for every 5 minutes and divided into two groups: the first was data taken in the initial stage during the approach to the lesions, and the second were those taken during procedures at and around the lesion. Significant difference in the pressure among different approaches was found in the tumour group approached by the subtemporal route compared with other routes (p less than 0.005). The retraction pressures in the tumour cases were higher during the approach (31 +/- 15.5 torr) than during the main procedure (12 +/- 9.2 torr) (p less than 0.025). On the other hand, the pressures in the aneurysm cases were the reverse, being lower during the approach (22 +/- 15.2 torr) than during the main procedure (38 +/- 17.7 torr) (p less than 0.01). Early-stage operations for aneurysm required a higher retraction pressure than delayed operations. PMID- 3673693 TI - The influence of the profile of brain retractors on regional cerebral blood flow in the rat. AB - Self-retaining brain retractors with different profiles have been constructed in order to decrease the risk of cerebral ischaemia during intracranial operations. Flat retractors are more easy to handle than curved, because the flat retractors can be bent into the desirable shape. To estimate the regional cerebral blood flow (rCBF) using retractors with three different profiles (flat, flat with rounded edges and curved) autoradiography with carbon-14 (14C) iodoantipyrine was performed in rats. After craniotomy over the parietal cortex lead weights with the three different profiles corresponding to 20 mm Hg of brain retractor pressure (BRP) were placed on the cortex for 15 minutes. rCBF (average values) in cortex beneath the flat retractors was 80 ml/100 gm/min (n = 10), for flat ones with rounded edges 90 ml/100 gm/min (n = 5) and for the curved retractors 75 ml/100 gm/min (n = 5). The differences were not significant. Even with a BRP of 30 mm Hg no differences were observed between flat (n = 3) and curved (n = 3) weights. In control animals craniotomy showed no influence on the rCBF (n = 3). No further risk for ischaemic nerve cell damage could be demonstrated by using the most easily-handled retractors, the flat ones, instead of those more or less curved. PMID- 3673694 TI - A practical technique for continuous monitoring of cerebral tissue pressure in neurosurgical patients. Preliminary results. AB - A new technique for continuous monitoring of cerebral tissue pressure is presented. It is based on a new type of piecoresistive microtransducer with low baseline and temperature drifts. In 7 patients cerebral tissue pressure and ventricular fluid pressure were recorded simultaneously. Comparison of these two different pressures showed extremely good correlation with coefficients always better than 0.95. Due to another type of pulsewave cerebral tissue pressure was constantly 4 to 12 mm Hg lower than ventricular fluid pressure. Routine use of cerebral tissue monitoring in 12 neurosurgical patients with brain tumours postoperatively showed good clinical correlation of cerebral tissue pressure without any additional complications. The authors recommend continuous monitoring of cerebral tissue pressure as a safe and simple method of intracranial pressure monitoring in neurosurgery. PMID- 3673695 TI - Protective effect of experimental subarachnoid hemorrhage on sodium dehydrocholate-induced blood-brain barrier disruption. PMID- 3673696 TI - Evolution of criteria for determination of brain death in Japan. AB - In 1974, the Japanese EEG Society's Ad Hoc Committee on Brain Death published criteria for determining brain death only in cases of acute gross primary brain lesions. In 1983, a new brain death study group was organized to re-evaluate these criteria. During a 6-month period from March 1, 1984, 217 neurosurgical and neurological clinics and emergency services throughout Japan reported 718 brain deaths caused not only by primary lesions but also by secondary brain lesions and diagnosed as such on the basis of the 1974 criteria excluding the condition of "abrupt fall of blood pressure followed by persistent hypotension". The data derived from the 718 cases in this collaborative study were pooled and analyzed, and it became known that the 1974 criteria still are generally reliable. Some changes have been made, however, and new criteria for determination of brain death adopted. PMID- 3673698 TI - Fifth annual meeting, the Society for the Advancement of Contraception (SAC). Caracas, Venezuela, October 5-8, 1987. Abstracts. PMID- 3673697 TI - Results of surgical treatment in patients with arachnoid cysts. AB - A retrospective study of 35 patients operated upon for arachnoid cysts during the last 10 years was carried out. In 19 patients treated by craniotomy, membrane resection and drainage into the basal cisterns, clinical improvement could be noted in 13 cases. Correspondingly on the CT-controls the cysts were found to have disappeared in two cases and were reduced in size in seven patients. In 11 patients, however, who were initially treated by a shunting procedure, seven patients became free of symptoms. Postoperative CT-controls showed in three cases a significant reduction of the size of the cyst, which remained unchanged in two other cases. In five patients with the combination of a nonspace-occupying arachnoid cyst and subdural effusions, drainage of the latter only was sufficient to relieve the clinical symptoms. The prominent findings were the high complication rate of the primary or secondary shunting procedures (48%), as well as the close correlation between the clinical outcome and the postoperative CT controls. PMID- 3673699 TI - Uterine geometry by Wing Sound and hysterography versus direct measurements. AB - Selecting an IUD that fits the uterine dimensions is believed to be a keystone in improving IUD performance. This study included 15 women admitted for hysterectomy with no gross pelvic pathology distorting the uterine cavity and no contraindication to hysterography. Before hysterectomy the uterine cavity dimensions were measured using the Wing Sound II device and hysterography. After hysterectomy, direct measurements of the same dimensions were performed. The correlation between the Wing Sound II device measurements and those obtained by the direct method was highly significant except for the fundal transverse dimension where the correlation was moderately significant. On the other hand, hysterography measurements had a moderately significant correlation with those obtained by the direct method, except for the fundal transverse dimensions and the total uterine length where the correlation was insignificant. The Wing Sound II device is a simple, safe and accurate tool for studying uterine geometry on an outpatient basis. PMID- 3673701 TI - Proceedings of the twenty-sixth Symposium on Regulation of Enzyme Activity and Synthesis in Normal and Neoplastic Tissues. Indianapolis, Indiana, September 29 and 30, 1986. PMID- 3673700 TI - Efficacy of two insertions of 100-minute releasing quinacrine hydrochloride pellets for non-surgical female sterilization. AB - Extensive research has been undertaken to develop a simple method of non-surgical female sterilization. Zipper and associates identified quinacrine hydrochloride as a drug likely to produce tubal occlusion when placed into the uterus. Zipper's early work with a solution of quinacrine led to the development of quinacrine pellets, a delivery system that was designed to bring the quinacrine into prolonged contact with the tubal ostia through extended uterine retention. Three transcervical uterine insertions of 10-minute releasing quinacrine hydrochloride pellets performed at monthly intervals have produced a 12-month pregnancy rate of 3.3 per 100 women. The ultimate goal is to develop an effective, single insertion procedure, but the performance of the quinacrine pellets in occluding tubes has necessitated more than one insertion. FHI developed a 100-minute extended release pellet system with the expectation that more prolonged drug exposure would produce a higher rate of tubal closure. A study of the 100-minute releasing pellet system has been conducted in Santiago, Chile. Two monthly insertions in 112 women has resulted in a 12-month pregnancy rate of 2.0 per 100 women. Postprocedure problems occurring within the first year were reported by 13% of the women; most were minor and transitory. PMID- 3673702 TI - Specific multisubstrate adduct inhibitors of aminopropyltransferases and their effect on polyamine biosynthesis in cultured cells. AB - We have designed and synthesized multisubstrate adduct inhibitors for each of the three enzymes in the polyamine biosynthetic pathway (equation 1). The specific aminopropyltransferase inhibitors AdoDATO (2b) and AdoDATAD (2d) have been used to study the effects of specific polyamine depletion on cell growth. As shown in Table 2, these compounds effectively modulate the biosynthesis of Spd and Spm in vitro. However, tight regulation of the biosynthetic and degradative pathways results in little or no change in total polyamine levels in the presence of a single inhibitor (Table 2). Further studies with these aminopropyltransferase inhibitors in combination with other specific inhibitors of polyamine biosynthesis or degradation (e.g. DFMO) should shed light on the mechanism(s) underlying this tight biological regulation. PMID- 3673703 TI - Demonstration of multiple regulatory factors for purified human leukocyte 5 lipoxygenase. AB - The human leukocyte 5-lipoxygenase is a unique enzyme in its class because of its involvement in the synthesis of the biologically active leukotrienes. Furthermore, unlike most other lipoxygenases, this enzyme requires multiple stimulatory factors for maximal activity. These include Ca2+, ATP, and three non dialyzable cellular components, two cytosolic, and one membrane-associated. The mechanism of action of these factors is not yet well understood; however, a Ca2+ dependent association of the enzyme and one of the cytosolic factors with the membrane has been demonstrated. These findings suggest that stimulation of the leukocyte, resulting in an increased intracellular Ca2+ concentration, may result in the translocation of the enzyme and the factor to a membrane site, thereby facilitating the interaction of these two proteins with other enzymes involved in the 20:4 metabolic cascade. The development of a better understanding of these processes should not only help to define the biochemical basis for the regulation of leukotriene formation, but should also yield valuable information concerning the more general aspects of stimulus-response coupling in the leukocyte. PMID- 3673704 TI - Platinum-folate compounds: synthesis, properties and biological activity. AB - Cis-diamminediaquaplatinum(II)-ion, the biologically active form of the anticancer agent Cisplatin, reacted readily with tetrahydrofolate at pH 7 and 37 degrees C to produce a stable complex. The reaction was monitored spectrophotometrically by the change in absorbance maximum from 298 nm (tetrahydrofolate) to 275 nm (complex); occurrence of isobestic points at 282 and 327 nm indicated that a single product was formed. Purity of platinum tetrahydrofolate, after isolation in ca. 70% yield, was established by TLC and HPLC. Elemental analysis, absorbance spectra at various pH values and nmr spectra provided evidence that the diammine platinum moiety was bridged across the N-5 and N-10 positions of tetrahydrofolate. Complexation also occurred with 5 methyltetrahydrofolate, 5-formyltetrahydrofolate, Methotrexate and aminopterin, but not with folate or 7,8-dihydrofolate. Biological implications of these observations have been investigated. Intracellular folates in L1210 cells have been identified and quantitated via reverse phase HPLC (C18 column; tetrabutylammonium phosphate as the pairing ion) and changes in the levels of these compounds, after exposure of cells to Cisplatin, have been measured. Platinum derivatives of tetrahydrofolate or other reduced folates were not found, but there was a decrease in the level of 5,10-methenyltetrahydrofolate, accompanied by an increase in 5-formyl and 10-formyltetrahydrofolate (and perhaps tetrahydrofolate). The chemical interaction of the diaqua form of Cisplatin with Methotrexate resulted in decreased uptake of the latter by L1210 cells. The platinum complex of tetrahydrofolate was a reasonably good inhibitor (Ki = 4 microM) of L1210 dihydrofolate reductase and of the folate transport system (50% inhibition at ca. 200 microM) of L1210 cells. PMID- 3673705 TI - Hormones, glutathione status and protein S-thiolation. AB - The formation of mixed disulfides between proteins and glutathione has been discussed as a potentially interesting metabolic signal. The S-thiolation of proteins with glutathione has been observed in several systems in vitro. We have correlated the increase in glutathione disulfide (GSSG) with the amount of protein mixed disulfides. The methodological aspects are briefly presented; normal values for protSSG are about 20-30 nmol per g wet weight of liver. Several processes have been related to changes in the thiol redox state. The stimulation of flux through the pentose phosphate pathway during the metabolism of t-butyl hydroperoxide is presented, and the increase in cellular activity of glucose-6 phosphate dehydrogenase is correlated with the increase in the level of protSSG. Hormonal stimulation of GSH efflux from the liver by vasopressin or by alpha adrenergic agonists such as phenylephrine or epinephrine is presented and discussed in relation to physiological states of peripheral (non hepatic) GSH utilization. Preliminary work relates the release of GSH to the perturbations in thiol redox state in inflammation and in exercise. PMID- 3673706 TI - Unfolding of nucleosome core induced by phosphatidylserine. AB - The main experimental findings on the actual presence of lipids among the minor chromatin components are revised and discussed especially in the light of the reported effects that exogenous lipids induce in DNA and RNA synthesis by using purified templates. Moreover, all the available evidence of the influence of phospholipid liposomes on the activities and structure of isolated nuclei are reported. In order to further clarify the possible mechanism by which phospholipids could affect gene expression, the modifications at the nucleosome core level have been investigated by means of IAF staining and electron microscopy. The results obtained indicate that the increased transcriptional activity induced by PS MLV in isolated nuclei requires both the removal of histone H1, which causes the unfolding of the solenoid into the nucleosome fiber configuration of the chromatin, and the subsequent splitting of the H3 dimer. This latter process, monitored by IAF accessibility to H3 in isolated nucleosomes incubated with PS, causes the transition from the nucleosome to the lexosome structure, which is the configuration favoring the activity of RNA polymerases. PMID- 3673707 TI - Biochemical pharmacology and experimental chemotherapy studies with guanine-7 oxide, a novel purine antibiotic. AB - 1. Guanine-7-oxide is a novel purine antibiotic produced by a Streptomyces species, ATCC 39364. 2. Guanine-7-oxide is cytotoxic to murine and human leukemia cells in vitro at sub-micromolar concentrations. Murine and human carcinoma cells are much less sensitive. 3. Guanine-7-oxide has significant in vivo antitumor activity, particularly against the intraperitoneal and subcutaneous L1210 leukemia systems. 4. Guanine-7-oxide, at highly cytotoxic concentrations, has little effect on biosynthesis of RNA and DNA. 5. There is preliminary evidence for an early effect of guanine-7-oxide on cellular protein synthesis. 6. Guanine, guanosine and hypoxanthine protect cells from the cytotoxicity of guanine-7 oxide. 7. Activation of guanine-7-oxide requires the presence of the enzyme hypoxanthine-guanine phosphoribosyltransferase in the target cells. 8. Cytotoxic concentrations of guanine-7-oxide do not cause depletion of cellular guanine nucleotides during a two hr incubation period. 9. Guanine-7-oxide is converted within mouse and human cells to a metabolite with chromatographic mobility corresponding to a ribonucleoside 5'-triphosphate. PMID- 3673708 TI - Chemical characterization of phosphoribosylamine, a substrate for newly discovered trifunctional protein containing glycineamide ribonucleotide synthetase activity. AB - PRA has been characterized for the first time using 13C-NMR spectroscopy. Incubation of [1-13C]ribose-5-phosphate with NH3 results in the production of 38:62 alpha:beta anomeric mixture of PRA, alpha,beta ribose-5-phosphate and variable amounts of dimeric materials. NMR studies at various pHs allowed determination of the pH independent Kequi = 0.95 +/- 0.14 M-1 for this reaction. In addition, using magnetization transfer NMR methodology the rate of conversion of alpha to beta PRA was determined to be 44 sec-1 at 37 degrees C (pH 8.0). The rates of formation (from ribose-5-phosphate and NH3) and degradation of PRA were also measured using E. coli GAR synthetase (recently cloned, overproduced and purified to homogeneity) as a trap. Determination of these rates allowed an independent and accurate measurement of Kequi = 2.7 M-1. In addition, in close agreement with early studies of Nierlich and Magasanik, the half life of PRA at 37 degrees C and pH 7.5 was determined to be 35 sec. Characterization of the chemical stability of PRA and Kequi for ribose-5-phosphate, NH3 with PRA will now allow detailed kinetic analysis of the newly discovered trifunctional protein containing GAR synthetase activity in addition to AIR synthetase and GAR transformylase activities. Comparison of the properties of the 110 kd GAR synthetase and an independently isolated 54 kd GAR synthetase are reported. Experiments are underway to investigate the possibility that unstable intermediates such as PRA are not released into solution, but that the transfer is mediated by specific protein-protein interactions between GAR synthetase and PRPP amidotransferase. PMID- 3673709 TI - Salvage pathways as targets of chemotherapy. AB - This paper discussed the significance of the activities of purine and pyrimidine salvage enzymes in cancer cells and the targeting against them of chemotherapy. 1. The activities of salvage enzymes in the rat liver were orders of magnitude higher than those of the rate-limiting enzymes of de novo biosynthesis. A similar relationship was observed in rat hepatomas of different growth rates and in primary colon carcinoma in human. 2. The concentrations of nucleosides and nucleobases were measured in plasma, liver and hepatoma 3924A in the rat. The freeze-clamp method was required to determine the concentrations of these precursors in rat liver and hepatoma in a reliable and precise fashion because ischemia markedly altered the concentrations of nucleosides, nucleobases and, as shown earlier, nucleotides in these tissues. The results indicated that the liver markedly concentrated the purine precursors, hypoxanthine, guanine and adenine, but not thymidine, which was one-third that of the plasma. Uridine and deoxycytidine occurred in the same concentration as in plasma, but cytidine was 3 fold higher in liver. In the hepatoma in comparison to the liver the concentrations of the nucleosides and bases were altered and for some of the changes the enzymic differences between liver and hepatoma appeared to be accountable. 3. Kinetic parameters for purine and pyrimidine synthetic enzymes and for the substrates and co-factors were determined in liver and hepatoma 3924A. When enzymic activities were calculated at the tissue steady-state concentrations of the various ligands, the activities of the salvage enzymes were markedly higher than those of the rate-limiting enzymes. 4. Hepatoma cells were highly sensitive to the action of the transport inhibitor, dipyridamole, in lag and log phases. However, plateau phase cells lost their sensitivity to dipyridamole. 5. Amphotericin B rendered plateau phase cells sensitive to the inhibitory action of dipyridamole for the incorporation of thymidine. 6. Amphotericin B enhanced cytotoxicity of dipyridamole in hepatoma and human colon cancer HT-29 cells. 7. In these studies we discovered the decreased responsiveness to dipyridamole of plateau phase cells and the ability of amphotericin B to restore the sensitivity. Moreover, dipyridamole and amphotericin B were synergistic in their cytotoxic action in rat hepatoma cells and human colon cancer cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3673710 TI - Regulation of liver metabolism by the hepatic nerves. AB - In the isolated rat liver perfused as usual via the portal vein, joint electrical stimulation of the nerve fibers around the artery and the portal vein in the liver hilus increased glucose output, shifted lactate uptake to output, decreased urea and glutamine formation as well as ammonia uptake, reduced ketone body production, lowered oxygen uptake and reduced perfusion flow simultaneously changing the intrahepatic flow distribution; it was accompanied by an overflow of noradrenaline into the hepatic vein. All effects were mediated predominantly via alpha-receptors; they were dependent on extracellular calcium. In livers perfused both via the artery and the portal vein, separate stimulation of the plexus at the common hepatic artery or at the portal vein caused similar effects on glucose and lactate balance and on perfusion flow. Arterial stimulation caused the higher metabolic responses and alterations not only in arterial but also 'transhepaticly' in portal flow, and conversely, portal flow elicited the smaller metabolic responses and alterations in both portal and 'transhepaticly' arterial flow. If sympathetic nerve actions were blocked using alpha- and beta antagonists, the resulting parasympathetic stimulation increased glucose uptake in the presence of insulin and antagonized the glucagon stimulated glucose release, both alone and more strongly in the presence of insulin. The sympathetic nerves may act directly at the parenchymal cells or indirectly via an overflow of neurotransmitter from the vasculature into the sinusoids or via hemodynamic changes. Experiments with the smooth muscle relaxant sodium nitroprusside and with retrograde flow indicate that neither hemodynamic changes nor noradrenaline overflow from the vasculature can play a major role in the mechanism of action of sympathetic liver nerves on glucose and lactate metabolism. Comparative studies with perfused livers of rats, guinea pigs and tupaias are in line with the view that in the rat the sympathetic nerves act via contacts with only a few periportal hepatocytes, from where the signal is propagated through gap junctions, while in guinea pig and tupaia the nerves act via contacts with almost all parenchymal cells. Sympathetic nerve stimulation of the perfused rat liver caused an increase in the activity of glycogen phosphorylase and a decrease of glycogen synthase, but left the activity of pyruvate kinase unaltered; fructose 2,6-bisphosphate and cAMP were only slightly enhanced.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3673712 TI - Oxygen transport to tissue IX. Proceedings of an ISOTT meeting. International Society on Oxygen Transport to Tissue. July 27-30, 1986, Cambridge, United Kingdom. PMID- 3673711 TI - Morphometric analysis of sparse capillary networks. AB - Two methods were used to assess the heterogeneity of capillary supply to muscles of widely differing metabolic capacity and fibre size. Using the method of capillary domains (DOM; Hoofd et al., 1985) and the closest-individual method (CI; Kayar et al., 1981) radii of Kroghian cylinders (R) can be calculated, and the heterogeneity of their lognormal distribution represented by the logarithmic standard deviation (Log SD). Both methods yield similar values for mean R in a tissue. DOM is more direct and quicker than CI, and may be particularly useful in the analysis of capillary oxygen supply during functional hypertrophy and in muscle regeneration where a broad distribution of fibre areas may be found. Despite a 500-fold range of capillary density, to a minimum of 20 capillaries mm 2, heterogeneity of capillary supply was similar in all muscles, indicating a functionally homologous spatial distribution. The relationship between number of fibres overlapped by a capillary domain, and domain area has zero correlation in most tissues but shows a negative trend in fish fast muscle, reflecting hyperplastic and hypertrophic growth. Capillary/fibre ratio is inappropriate for sparse networks whereas the cumulative fraction of domains vs fibre area shows a strong correlation, suggesting that maximal oxygen supply to muscle fibres is not restricted to contiguous capillaries, but also involves those remote from the fibre surface. PMID- 3673713 TI - Highly polymerized human haemoglobin as an oxygen-carrying blood substitute. PMID- 3673714 TI - Oxygen boundary crossing probabilities. AB - The probability that an oxygen particle will reach a time dependent boundary is required in oxygen transport studies involving solution methods based on probability considerations. A Volterra integral equation is presented, the solution of which gives directly the boundary crossing probability density function. The boundary crossing probability is the probability that the oxygen particle will reach a boundary within a specified time interval. When the motion of the oxygen particle may be described as strongly Markovian, then the Volterra integral equation can be rewritten as a generalized Abel equation, the solution of which has been widely studied. PMID- 3673715 TI - In vivo recruitment of mitochondrial VO2: test of current models using tissue data. PMID- 3673716 TI - A comparison of a four wavelength analysis and multicomponent wavelength analysis applied to determination of haemoglobin saturation. PMID- 3673717 TI - Time courses of erythrocytic oxygenation in capillaries of the lung: lower and upper bounds on red cell transit times. PMID- 3673718 TI - Diffusion pathways in oxygen supply of cardiac muscle. PMID- 3673719 TI - Simulation of the point spread function for light in tissue by a Monte Carlo method. AB - We have been able by a Monte Carlo technique to generate the point spread function (PSF) for light in tissue for a generalized range of tissue characteristics. We have demonstrated that these can be described by an equation containing a gaussian, diffusion and exponential term. The PSF equation will allow one to estimate the limits of spatial resolution achievable with near infrared (NIR) imaging systems, and may be used in image deconvolution algorithms. Additionally an equation has been derived describing the average photon pathlength through the tissue. Finally, the light transmission and reflection (backscattering) have been illustrated as functions of scattering and absorption coefficients. These results can be used in attempting to quantify data from non-invasive NIR spectroscopy systems. PMID- 3673720 TI - Use of Adair four-step kinetics in mathematical simulation of oxygen transport in the microcirculation. AB - The Adair four-step kinetic model for the reactions of haemoglobin and oxygen recognizes five haemoglobin species, corresponding to deoxyhaemoglobin and one species for each level of oxygenation of the four haem groups. Thus, an oxygen transport problem involves a system of five simultaneous non-linear partial differential equations for diffusion with chemical reaction. This mathematical complexity has impeded application of the Adair model despite its theoretical advantages over the one-step model often used in practice. The Adair kinetic model has been incorporated into a simulation of microcirculatory oxygen transport. The results show that the usual one-step kinetic model is inaccurate in comparison with the Adair model. However, an empirical modification can be made to the one-step model to ensure compatibility with the equilibrium curve. This modified one-step kinetic model (the VRC model) is much more tractable mathematically than the Adair model. In the physiological range of fluxes, the VRC kinetic model appears to be of sufficient accuracy for most purposes, and the mathematical complexity of the Adair model is not required. PMID- 3673721 TI - Arterial obstruction induced by PAF-acether (1-O-alkyl-sn-glycero-3 phosphocholine). PMID- 3673722 TI - Role of hypoxia and acetylcholine in the regulation of cerebral blood flow. PMID- 3673723 TI - Adaptation to hypoxia. AB - Many biochemical changes occur during acclimation to altitude. Some appear to be deleterious, but the increase in cytochrome-P 450 and the changes in the endoplasmic reticulum seem to be beneficial. The latter changes could reduce the capillary to oxidase gradient to compensate for the lower capillary oxygen tensions. The possibility of accelerating acclimation to hypoxia by using drugs which produce similar changes is being explored. PMID- 3673724 TI - Changes in the endoplasmic reticulum following exposure to hypoxia. PMID- 3673725 TI - Cerebral microcirculatory changes during exposure to hypoxia. AB - Changes in the red blood cell content of the cat cerebral cortical vessels were monitored using reflecting light during a decrease in PIO2. The following observations were made: 1) the capillary bed red blood cell content increased during hypoxia prior to the arteriole response at an arterial oxygen tension of 52.0 mmHg; 2) at arterial oxygen tensions below 52 mmHg the red blood cell content increased in all vessels simultaneously; 3) as the PIO2 decreased, the increase in red blood cell content occurred earlier in all vessels. Capillaries, therefore, can respond to hypoxia independently of the arteriole in cat cerebral cortical tissue. PMID- 3673726 TI - Metabolic, ionic and electrical activities during and after incomplete or complete cerebral ischaemia in the Mongolian gerbil. PMID- 3673727 TI - Determination of cerebral cortical capillary blood volume from mean transit time analysis. PMID- 3673728 TI - Simultaneous measurement of haemoglobin oxygenation of brain and skeletal muscle of rat in vivo by near-infrared spectrophotometry. PMID- 3673729 TI - Non-invasive near-infrared measurements of human arm tissues in vivo. PMID- 3673730 TI - The effect of intracellular oxygen concentration on ventricular fibrillation in perfused rat heart. PMID- 3673732 TI - Dynamic structure of phospholipid bilayers on the path for oxygen diffusion in the ox lung. AB - The dynamic properties of the phospholipid bilayer of cell membranes were studied with a nanosecond fluorometer to obtain information on the microstructure of the path for oxygen diffusion in the ox lung. The viscosity in membranes of pneumocytes, endothelial cells from pulmonary artery, and erythrocytes was 47, 54 and 162 mPa . sec respectively. The wobbling angle representing the oscillation of phospholipid molecules was 47, 44 and 38 degrees, respectively. PMID- 3673731 TI - Comparison of intracellular PO2 and conditions for blood-tissue O2 transport in heart and working red skeletal muscle. AB - 1. Neither anoxic nor hypoxic cells were found in epicardium of anaesthetized dogs, cats, rabbits and rats despite heterogeneity of flow (Wieringa et al., 1982) and haematocrit (Honig et al., in press) in the coronary capillary network. 2. Median PO2 in unstressed dog heart and cat heart are 4.8 and 5.2 torr, respectively. These values are close to the P50 of the oxymyoglobin dissociation curve, and well above PcritO2. 3. A dense, interconnected capillary network and high capillary haematocrit appear essential to achieve high O2 extraction at flows characteristic of maximally working myocardium. 4. Mb promotes O2 transport in myocardium by: a) maximizing the driving force for transcapillary diffusion, b) minimizing spatial variability in PmbO2, c) facilitating O2 diffusion in myocytes and, d) permitting close capillary packing without a diffusion shunt for O2. 5. The O2 conductance of the red cell-capillary system is a major determinant of O2 mass transfer in red muscle. PMID- 3673733 TI - Effects of temperature on oxygen transfer conductance of human red blood cells. AB - The influence of temperature (varied from 37 to 7 degrees C; average pH = 7.4) on the kinetics of O2 uptake and release by human red blood cells under stopped-flow conditions was investigated by double-beam spectrophotometry. The kinetics were characterized by the specific transfer conductance for O2, G. The temperature coefficient of G, Q10(G), for O2 uptake averaged 1.17, and activation energy, Ea(G) = 2.9 kcal/mol O2. The average values for O2 release were: Q10(G) = 1.30, and Ea(G) = 4.8 kcal/mol O2. The G values for release of O2 from oxyhaemoglobin solution, Gsol, yielded Q10(Gsol) = 2.06, Ea(Gsol) = 13.4 kcal/mol O2. Comparison of these Q10 and Ea values with those for diffusion of O2 and haemoglobin in aqueous media leads to the conclusion that the kinetics of O2 uptake and release by red blood cells in the stopped-flow condition is mainly limited by diffusion of O2 and haemoglobin in the red cell interior and by diffusion of O2 in the medium, and to a lesser degree by chemical reaction kinetics. PMID- 3673734 TI - Oxygen tension and sperm migration in the female bed bug. PMID- 3673735 TI - Surfactant in pulmonary oxygen toxicity. PMID- 3673736 TI - The microphotometric determination of the variability of oxygen saturation of erythrocytes lying within rouleaux. AB - It was found that by using nonlinear multicomponent analysis with the spectra of oxygenated and deoxygenated haemoglobin as basic spectra the mean O2 saturation of 2 to 3 red cells lying in a rouleau could be determined with an accuracy of 0.5 - 1.0%. At the same PO2 and PCO2 distinct differences in O2 saturation were found in different red cells; for 50% of the saturation values the differences were in the range +/- 1.5%, for 30% of the values, the differences were in the range of +/- 3% and 15% lay in the range of +/- 4.5%. Only 5% of saturation differences were larger than 4.6%. These differences are so large that they have to be considered in calculations of the PO2 from O2 saturation measurements. PMID- 3673737 TI - Acute respiratory failure induced by tracheal instillation of xanthine oxidase, its prevention and therapy by exogenous surfactant instillation. PMID- 3673738 TI - Survival time of rats exposed to different high oxygen pressures after administration of perfluorochemicals. PMID- 3673739 TI - Effect of antioxidants on the biochemical response in the oxygen-exposed rat. PMID- 3673740 TI - Tumour blood flow following local ultrasound heating computed from thermal clearance curves. AB - Thermal clearance curves following termination of ultrasound-induced hyperthermia in human mammary carcinomas implanted into the flanks of nude rats were studied. They were found to be monoexponential in form, both with and without blood flow. From the difference between the inverse time constants with and without flow, the tumour blood flow rate could be calculated. Blood flow was found to increase with very short exposure times at the therapeutic hyperthermia temperature and subsequently decrease as the exposure time increased. A higher therapeutic hyperthermia temperature augmented this effect. PMID- 3673741 TI - Oxygen consuming regions in EMT60/Ro multicellular tumour spheroids determined by nonlinear regression analysis of experimental PO2 profiles. PMID- 3673742 TI - Oxygen consumption rate of tumour cells as a function of their proliferative status. AB - The oxygen consumption rate (QO2) of EMT6/Ro-cells cultured as monolayers was investigated as a function of their proliferative status. The transition of these cells from the exponential to the plateau growth phase was associated with a continuous decrease in QO2 per single cell. This decrease can partially be attributed to a corresponding decline in cellular volume. In addition, the QO2 per cell volume was also reduced during the passage of the cells through the growth phase described. The results lead to the conclusion that a reduction in cellular volume and factors which are still unknown may contribute to the metabolic changes observed. PMID- 3673743 TI - Blood flow, vascular resistance and oxygen availability in malignant tumours upon intravenous flunarizine. AB - Tumour blood flow, an important determinant of the efficacy of presently available nonsurgical cancer treatments, significantly increased following a single I.V. injection of the calcium antagonist flunarizine. At a dose of 1 mg/kg, tumour blood flow increased approximately by 28% without a significant change in mean arterial blood pressure. The flow increase was paralleled by a similar improvement of the O2 availability to the cancer cells. The data suggest that flunarizine may provide a means of improving delivery of antineoplastic agents to tumours. Furthermore, flunarizine may also enhance the effectiveness of irradiation by increasing tumour oxygenation. PMID- 3673744 TI - Quantitative relations between gas exchange parameters including contact time at rest and during treadmill exercise. PMID- 3673745 TI - A versatile and sensitive method for measuring oxygen. AB - Oxygen dependence of the lifetime of the excited triplet state of phosphorescent molecules can be used to measure the oxygen concentration in aqueous media. These measurements are insensitive to much of the optical interference that limits the usefulness of measurements based on the oxygen dependent quenching of luminescence intensity. The measurements also extend to significantly lower oxygen concentrations than are normally attainable using oxygen electrodes. The phosphorescence lifetimes can be accurately measured from a few microseconds to seconds, permitting a wide dynamic range of oxygen concentration measurements. With currently available probes, for example, it is possible to make continuous measurement of oxygen concentrations from 10(-4) M to 10(-8) M in a single experiment. PMID- 3673746 TI - Prophylaxis and treatment of myocardial ischaemia by haemodilution with fluorocarbon emulsions. PMID- 3673748 TI - Continuous transcutaneous monitoring. PMID- 3673747 TI - Emulsified perfluorochemicals as physiological oxygen-transport fluids: assessment of a novel formulation. PMID- 3673749 TI - Effectiveness of combined transcutaneous PO2/PCO2 monitoring of newborns. PMID- 3673750 TI - Incidence and severity of retinopathy in low birth weight infants monitored by TCPO2. AB - The incidence and severity of retinopathy of prematurity (ROP) were studied in 561 survivors of low birth weight infants (LBWIs) weighing under 2,000g. They were the survivors out of 604 LBWIs admitted to Okayama National Hospital during the five years from January 1981 to December 1985. The tcPO2 of all the LBWIs on the respirator or under oxygen administration was monitored using an Oxymonitor SM 361. The upper limit of tcPO2 was maintained between 50 to 80 torr. The ophthalmologic funduscopy was continued until 12 months of age. The early active stages of ROP were recorded by "the International Classification 1984". The cicatricial change of retina was classified by the criteria of the Joint Committee for the Study of Retrolental Fibroplasia in Japan. In the survivors, 55 cases of active ROP were found. (Stage 1:29 cases, 2:17, 3:9, and 4:0) In the survivors, 27 cases of cicatricial ROP were found, (Grade I:27 cases, II:0, III:0, IV:0) None of them developed blinding retinopathy. Neither the artificial ventilation nor the duration of oxygen administration influenced the incidence of ROP with statistical significance. The incidence and severity of ROP in this study seems to be one of the lowest among those hitherto published. Though our study is not a controlled one, it can be concluded that tcPO2 monitoring eliminates the blinding ROP. PMID- 3673751 TI - Transcutaneous oxygen monitoring and retinopathy of prematurity. AB - This study was performed to determine whether the use of continuous tcPO2 monitoring could reduce the incidence of ROP in preterm infants receiving oxygen therapy. Two hundred and ninety-six infants with birth weights less than or equal to 1300 grams were randomly assigned to a continuous monitoring (CM) or a standard care (SC) group. CM infants had tcPO2 monitored continuously as long as they required supplemental oxygen while SC infants had tcPO2 monitored only during the more acute state of their illness. Management of both groups was otherwise identical. One hundred and one of 148 infants in the CM and 113 of 148 patients in the SC groups survived. Mean birth weights and gestational age were similar in both groups. Duration of mechanical ventilation and oxygen therapy was also similar. The overall incidence of ROP was 51% in the CM and 59% in the SC group. As birth weight for infants greater than or equal to 1000 grams increased a higher risk for developing ROP was noted in the SC group. Four infants in the CM and 5 in the SC group developed cicatricial ROP. These results suggest that continuous tcPO2 monitoring may reduce the incidence of ROP in infants with birth weights greater than 1000 grams, but not in the smaller infants in whom this complication occurs more frequently and is more severe. PMID- 3673752 TI - Transcutaneous PO2 and PCO2 during surfactant therapy in newborn infants with idiopathic respiratory distress syndrome. AB - We conclude that surfactant treatment in newborn infants with IRDS results in decrease in TcPO2 and an increase in TcPO2 within minutes. The surfactant treatment procedure used in this study was not associated with hypoxemia. During surfactant treatment monitoring of TcPO2 and TcPCO2 is absolutely necessary. PMID- 3673753 TI - Continuous fetal acid-base assessment during labour by tc-pCO2 monitoring. PMID- 3673754 TI - Microvascular dynamics during acute asphyxia in chronically prepared fetal sheep near term. PMID- 3673755 TI - Pulse oximetry: physical principles, technical realization and present limitations. AB - Oximetry for continuous patient monitoring has evolved to a mature technology that is clinically useful. Technologic limitations, however, still exist and there is need to develop more reliable, less expensive systems that will allow new applications such as fetal and home infant and adult monitoring. Although it is not possible to fully monitor patient blood gas status with a single variable, pulse oximetry provides an important view of the blood oxygen content that can be combined with other monitoring methods to more fully characterize patient status. PMID- 3673756 TI - Pulse oximetry--an alternative to transcutaneous PO2 in sick newborns. AB - In summary, the pulse oximeter provides a reliable, continuous assessment of oxygenation in newborn infants. Its rapid response time and ease of use make it a practical device for use on all sick newborns. To avoid hyperoxia it should be used in conjunction with arterial blood gas measurements and we recommend a high SaO2 alarm of 92% in infants with predominantly fetal hemoglobin. Finally, it is an improved way of monitoring oxygenation in very immature infants and in infants with bronchopulmonary dysplasia. PMID- 3673757 TI - Application of the Ohmeda Biox 3700 Pulse Oximeter to neonatal oxygen monitoring. PMID- 3673758 TI - Pulse oximetry and transcutaneous oxygen tension for detection of hypoxemia in critically ill infants and children. AB - We tested the performance of transcutaneous oxygen monitoring (TcPO2) and pulse oximetry (tcSaO2) in detecting hypoxia in critically ill neonatal and pediatric patients. In 54 patients (178 data sets) with a mean age of 2.4 years (range 1 to 19 years), arterial saturation (SaO2) ranged from 9.5 to 100%, and arterial oxygen tension (PaO2) from 16.4 to 128 mmHg. Linear correlation analysis of pulse oximetry vs measured SaO2 revealed an r value of 0.95 (p less than 0.001) with an equation of y = 21.1 + 0.749x, while PaO2 vs tcPO2 showed a correlation coefficient of r = 0.95 (p less than 0.001) with an equation of y = -1.04 + 0.876x. The mean difference between measured SaO2 and tcSaO2 was -2.74 +/- 7.69% (range +14 to - 29%) and the mean difference between PaO2 and tcPO2 was +7.43 +/- 8.57 mmHg (range -14 to +49 mmHg). Pulse oximetry was reliable at values above 65%, but was inaccurate and overestimated the arterial SaO2 at lower values. TcPO2 tended to underestimate the arterial value with increasing PaO2. Pulse oximetry had the best sensitivity to specificity ratio for hypoxia between 65 and 90% SaO2; for tcPO2 the best results were obtained between 35 and 55 mmHg PaO2. PMID- 3673759 TI - Is pulse oximetry reliable in detecting hyperoxemia in the neonate? AB - We tested the hypothesis that hyperoxemia defined as arterial PO2 above 12 kPa can be detected by pulse oximetry using 95% oxygen saturation as the upper limit. Thirty artificially ventilated neonates with an indwelling arterial catheter were studied registrating transcutaneous oxygen saturation (Ohmeda Biox 3700 Pulse Oximeter) and transcutaneous PO2 continuously during a 4-hour period and measuring arterial oxygen saturation and PO2 intermittently. 46 episodes of arterial hyperoxemia were observed. Pulse oximetry had a sensitivity of 30%, detecting 14 of these 46 hyperoxemic episodes, and a specificity of 93%. The accuracy for separating hyperoxemia from normoxemia by pulse oximetry could be improved by shifting the cut-off point from 95% to 92%. With this optimal cut-off point sensitivity was 70% and specificity 62%. We conclude that pulse oximetry is not reliable for detection of hyperoxemia. PMID- 3673760 TI - Comparison between transcutaneous PO2 and pulse oximetry for monitoring O2 treatment in newborns. AB - 213 paired tcpO2/paO2-data and 186 paired tcSO2/SaO2-data measured in 25 newborns (10 term, 15 prematures) were compared. The correlation coefficient for tcpO2/paO2 was 0.796, for tcSO2/SaO2 0.944. Sensitivity for discriminating between normo- and hypoxemia (paO2 less than 50 torr) was 82% for the tcpO2- and 88% for the tcSO2-method. Positive predictive values for discriminating between normo- and hypoxemia were 88% for both methods. Sensitivity for discrimination between normo- and hyperoxemia (paO2 greater than 100 torr) was 85% for the tcpO2 and 100% for the tcSO2-method. Positive predictive values for the discrimination between normo- and hyperoxemia were 58% and 25% for tcpO2- and tcSO2 respectively. Pulse oximetry proved to be less cumbersome than the tcpO2-method. However, as tcpO2, it could not be used in some very immature newborns and in those with circulatory instability. In conclusion, these preliminary results show a similar discrimination between normoxemia and hypo-hyperoxemia for both methods. A better sensitivity of pulse oximetry for hyperoxemia is counteracted by a lesser positive predictive value. PMID- 3673761 TI - The accuracy of the pulse oximeter in neonates. AB - The Nellcor pulse oximeter was studied in 16 newborn infants. The transcutaneous oxygen saturation (TCSaO2) was compared to both fractional saturation and functional saturation. TCSaO2 was found to be closer to fractional SaO2. 95% prediction intervals were established for the estimation of arterial oxygen saturation (SaO2) from TCSaO2. At a pulse oximeter reading of 85% to 90%, SaO2 could be as low as 83% and as high as 98%. PMID- 3673762 TI - Pulse oximetry and transcutaneous oxygen tension in hypoxemic neonates and infants with bronchopulmonary dysplasia. AB - The reliability of pulse oximetry and transcutaneous oxygen tension (tcPO2) was investigated in hypoxemic neonates and older infants with chronic hypoxemia due to bronchopulmonary dysplasia (BPD). It was found that during severe hypoxemia (tcPO2 less than 40 mmHg and saturation less than 80%) pulse oximetry showed a better correlation with arterial saturation than tcPO2 with arterial oxygen tension. During mild hypoxemia and normoxemia (tcPO2 40-90 mmHg and saturation 80 95%) tcPO2 and pulse oximetry both showed a good correlation with arterial values. Above 95% saturation and a corresponding tcPO2 of 70-120 mmHg, the correlation between arterial and transcutaneous PO2 was better than that between pulse oximetric and arterial saturation. Computer recording and analysis of tcPO2 and pulse oximetry improves the quality of both noninvasive oxygenation parameters in older infants with BPD. PMID- 3673763 TI - Control of pedicle and microvascular tissue transfer by photometric reflection oximetry. PMID- 3673764 TI - Growth and development of transcutaneous monitoring in the U.S.A.--1978-1986. AB - Surface blood gas monitoring is an invaluable clinical technique. It is, unfortunately, subject to many errors unless carefully carried out. This can be done by clinicians. Clinicians, however, cannot be responsible for the cumulative effects of changes in the electrodes made by manufacturers. Before a modified electrode is approved for use its accuracy under clinical conditions and at high arterial PO2 tensions has to be established. In America this has not and is not being done. The F.D.A. met in December, 1986, to consider this problem. Recommendations are expected to be published in 1987. In any new regulations similar but not identical requirements for accuracy should be demanded from pulse oximeters, as these devices have their own unique limitations under hyperoxic and hypoxic conditions. PMID- 3673765 TI - Comparison of in-vivo response times between pulse oximetry and transcutaneous PO2 monitoring. PMID- 3673766 TI - Capillary blood pressure. AB - Human capillary blood pressure may be measured directly in nailfold capillaries of the fingers and toes. By applying servonulling pressure measuring techniques rapid fluctuations in capillary pressure may be recorded, opening the way to a greater understanding of capillary pressure control in health and disease. The estimation of mean pressure which may be accomplished manometrically is of value in determining the mechanism of oedema, identifying the site of raised peripheral resistance in disease states, evaluating the effects of vasoactive drugs on peripheral resistance, and investigating haemodynamic abnormalities associated with microangiopathies. Capillary pulse waveform analysis, made possible by servonulling techniques and computer analysis has already revealed important changes in hypertension. PMID- 3673767 TI - Microvasculatory evaluation of vasospastic syndromes. PMID- 3673768 TI - Infrared fluorescence videomicroscopy with indocyanine green (Cardiogreen). AB - After intravenous injection indocyanine green binds almost completely to the plasma proteins and may be detected in the skin capillaries by an infrared sensitive fluorescence videomicroscopy system. The technique opens a way to measure full capillary diameter and dimension of the plasma layer in an almost atraumatic way. PMID- 3673769 TI - The use of the Hellige Oxymonitor to study skin blood flow changes. AB - Transcutaneous oxygen tension is a flow related parameter. Detailed analysis of the physiology and physical chemistry of oxygen consumption and diffusion indicates that tcPO2 is not proportional to skin blood flow. Measurement of tcPO2 at 37 degrees C allows changes in skin blood flow to be clearly demonstrated and is of use in many areas of clinical medicine. Transcutaneous oxygen tension recorded using a polarographic oxygen electrode depends on skin blood flow, skin respiration, arterial oxygen concentration, temperature, skin and electrode permeability and the oxygen consumption of the electrode. Applying clearance principles, the relationship between blood flow, respiration and the difference between arterial and venous oxygen concentrations is well established. This has long been used to measure cardiac output, since the other three parameters are readily determined. Arterial saturation is normally greater than 95% of maximum in subjects without lung disease and it may thus be considered to be constant. Tissue respiration is independent of oxygen concentration when PO2 exceeds 2 mm Hg. If skin respiration is invariant at constant temperature, when the tissue oxygen tension exceeds 2 mm Hg, then blood flow is inversely proportional to the difference in concentration between arterial and venous blood. It has recently been directly shown that the inference that tissue respiration is independent of tissue blood flow is accurate. Correcting for the oxyhaemoglobin dissociation curve and for the deviation from zero order respiration kinetics when tissue PO2 less than 2 mm Hg, the relationship between venous oxygen tension and blood flow at 37 degrees C is shown when arterial oxygen concentration is constant (Figure 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673770 TI - Estimated peripheral blood flow in premature newborn infants. PMID- 3673771 TI - Skin blood flow calculations from transcutaneous gas pressure measurements. PMID- 3673772 TI - Estimation of the determinants of transcutaneous oxygen tension using a dynamic computer model. AB - A dynamic model for oxygen transport within the outer layers of the skin and a tcPO2 sensor has been developed. By comparing model simulations with clinical measurements from adults, it is possible to analyze some of the physiologic and physical determinants of the tcPO2 measurement. The results indicate that the permeability of the epidermis is a significant parameter when using a microcathode sensor. Using this model, the values obtained for normalized stratum papillare blood flow and metabolic oxygen consumption of the dermis are higher than those seen for other models. PMID- 3673773 TI - Quality and safety aspects in the development and fabrication of transcutaneous sensors. AB - The safe and reliable application of transcutaneous sensors requires their construction and fabrication to be embedded in a system of external regulation and internal rules. PMID- 3673774 TI - A new system for tcPO2 long-term monitoring using a two-electrode sensor with alternating heating. PMID- 3673775 TI - A novel approach for an ECG electrode integrated into a transcutaneous sensor. AB - The integration of an ECG-electrode into a common transcutaneous sensor allows simple handling and leads to a reduction of the physiological stress of pre-term infants. Furthermore it may allow future replacement of an invasive method to measure the ECG under labour by a non-invasive one. PMID- 3673776 TI - Microelectronic sensors for simultaneous measurement of PO2 and pH. AB - Sensors capable of simultaneous measurement of pH and PO2 in an aqueous solution have been fabricated in planar form using microelectronic technology. Separate potentiometric metal-metal oxide pH and three electrode amperemetric PO2 sensors have been fabricated together on a silicon chip with active surface of 2 x 3 mm. Rhodium-rhodium oxide electrodes operating in a cyclic voltammetry mode have also been studied and show sensitivity to both pH and PO2 in different regions of the voltage swept curve. PMID- 3673777 TI - A modified electrode ring for use in transcutaneous measurement of PO2. PMID- 3673778 TI - History, status and future of pulse oximetry. PMID- 3673779 TI - Multichannel recording and analysis of physiological data using a personal computer. AB - A flexible data acquisition system was designed for an Apple IIe computer. For implementation, we used a microcomputer capable of recording 4 channels simultaneously with a selectable sample rate; this information was saved on a floppy disc and the recordings could be evaluated later. This evaluation is accomplished by reproducing the analog signals on display and calculating a histogram after deleting artefacts in the signal. PMID- 3673780 TI - Continuous non-invasive beat-by-beat blood pressure (B.P.) measurement in the newborn. AB - Intermittent measurement of blood pressure (BP) is frequently performed in newborn babies under intensive care using an inflatable cuff encircling either the arm or leg. This paper describes work aimed at achieving continuous beat-by beat measurement of the arterial pressure waveform by means of a finger cuff, the pressure of which is controlled by a feedback arrangement utilising a photoplethysmograph. Preliminary results are encouraging, but improvements to cuff design are still needed. PMID- 3673781 TI - The relative accuracy of three transcutaneous dual electrodes at 45 degrees C in adults. AB - Measurements made by transcutaneous electrodes can be compared with arterial blood gases in several different ways. The relationship between them is commonly expressed by a linear regression equation, and a correlation coefficient, r, calculated. However calculation of the bias and the precision of transcutaneous electrode readings is more helpful in clinical practice. The differences between the two methods are explained by comparing the relationship of three transcutaneous dual electrodes to endtidal gases in adults. PMID- 3673782 TI - The measurement of TcPO2 and TcPCO2 in newborn infants at 44 degrees C, 42 degrees C and 37 degrees C after initial heating to 44 degrees C. AB - Prolonged measurement of the transcutaneous O2 and CO2 tension at an electrode temperature of 44 to 45 degrees C often causes a second degree burn of the underlying skin. To avoid this, we compared the readings at 44 degrees C, 42 degrees C and 37 degrees C, after 2 hours pre-heating of the skin by the electrodes at 44 degrees C. In order to eliminate the electrodes' own temperature coefficients, electrodes with a built-in temperature correction were used. The changes observed therefore represent changes in the O2 and CO2 tension in the skin. The obtained values were compared to repeated arterial samples. We found that the TcPO2 and TcPCO2 values obtained at 42 degrees C and 37 degrees C were lower than those obtained at 44 degrees C, but when corrected for the in vivo temperature coefficients previously found by us the TcPO2 values at 42 were quite similar to the 44 degrees C values, whereas the 37 degrees values remained lower. TcPCO2 values at 44, 42 and 37 degrees were all similar. The temperature coefficient of PO2 was calculated to be 0.044 +/- 0.008 and for TcPCO2 as 0.049 +/- 0.007. PMID- 3673783 TI - Drift in vivo of transcutaneous dual electrodes. AB - TcPO2 and tcPCO2 monitoring is widely used but the in vitro drift of the new combined sensors is unknown. We tested the in vivo stability of 3 such electrodes in six adults, compared to nasal endtidal values from a mass spectrometer. Each electrode was remembraned within 5 days and had a 2 point dry gas calibration at 45 degrees C before fixing to the subjects' right arms. TcPO2, tcPCO2 and endtidal values were averaged over four minutes after 30 minutes equilibration, and then at seven subsequent 20 minute intervals. We observed that (1) Endtidal values remained stable (2) tcPCO2 differed from baseline by less than 3 torr (3) tcPO2 rose significantly in all three electrodes by an average of 16 to 21% and, (4) in vivo drift greatly exceeded separately determined in vitro changes. We discuss the possible explanations for the observed results, and conclude that skin permeability changes may play an important role. In the light of the large in vivo tcPO2 drift, transcutaneous dual electrodes are not reliable trend indicators of blood gases in adults. PMID- 3673784 TI - Evaluation of single sensor transcutaneous measurement of PO2 and PCO2 in the neonate. AB - A single combined transcutaneous sensor for PO2 and PCO2 was evaluated in a neonatal intensive care unit. The values obtained with the combined sensor were compared with the values obtained with two separate electrodes monitoring respectively PO2 and PCO2. Adequate correlations were found. The combined sensor represents an improvement on individual electrodes as it spares available skin surface and needs less handling. PMID- 3673785 TI - Computing the oxygen status of the blood from heated skin pO2. PMID- 3673786 TI - Transcutaneous oxygen tension during exercise in patients with pulmonary emphysema. AB - Transcutaneous PO2 (tcPO2) and arterial PO2 (PaO2) were compared during exercise in six patients with pulmonary emphysema. For calibration purposes, the tcPO2 electrode was first attached to the skin and after stabilisation its reading was adjusted to correspond to the PO2 of an initial arterial blood sample. It was shown that tcPO2 measurement could follow accurately the rapid changes in PaO2 occurring during exercise. Sixty-eight paired comparisons of PaO2 and tcPO2 were available and the regression equation was given by: tcPO2 (mmHg) = 0.98 PaO2 + 0.7 (correlation coefficient, 0.985; 95% confidence limits, 5.7 mmHg). PMID- 3673787 TI - The effect of inhaled bronchoconstrictors on transcutaneous gas tensions in normal adult subjects. AB - The administration of histamine and leukotriene D4 (LTD4) by nebulised aerosol in logarithmically increasing doses to normal subjects resulted in significant bronchoconstriction. Transcutaneous oxygen tension (tcPO2) was monitored during and after the bronchial challenge tests. Following histamine challenge there was significant hypoxaemia in all subjects (mean fall in tcPO2, 20 mmHg). However, following LTD4 administration, there was a small and insignificant fall in tcPO2. Transcutaneous carbon dioxide tension (tcPCO2) was also monitored throughout bronchial challenge, but showed no significant change. We suggest that the hypoxaemia following histamine challenge was due to increased ventilation/perfusion (V/Q) mismatching in the lung induced by histamine deposition. PMID- 3673788 TI - In vivo calibration of a transcutaneous oxygen electrode in adult patients. AB - Transcutaneous oxygen tension (tcPO2) has been compared with arterial oxygen tension (PaO2 in 14 haemodynamically stable patients in an intensive care unit. Two calibration methods have been compared: (1) "In vitro" calibration, a two point calibration procedure carried out before attachment to the skin. (2) "In vivo" calibration, calibration using a single arterial sample, to recalibrate the upper point after attachment of the electrode to the skin and stabilisation of the electrical output. After "in vitro" calibration the regression equation was given by tcPO2 (mmHg) = 0.58 PaO2 + 13.4 (95% confidence limits +/- 19.6). After "in vivo" calibration, the regression equation for 55 comparisons over the range 50 to 120 mmHg was given by: tcPO2 (mmHg) = 0.98 PaO2 + 1.6 (95% confidence limits +/- 6.6). The "in vivo" calibration method therefore allows a close estimate of PaO2 to be made from tcPO2 values in adult patients providing strict operating criteria observed. PMID- 3673789 TI - Inflammation and transcutaneous measurement of oxygen pressure in dermatology. AB - In this study the influence of local inflammation on tcPO2 values at different electrode temperatures has been investigated. The measurements were performed on UV-erythema, contact dermatitis and other inflammatory reactions of the skin. Different types of inflammation and different degrees of damage can lead to very different reactions in the microcirculation and this will have an effect on the tcPO2 levels. PMID- 3673790 TI - Diagnostic assessment of diabetic microangiopathy by tcPO2 stimulation tests. AB - Transcutaneous PO2 measurements at 37 degrees C can recognize and quantify diabetic microangiopathy if suitable stimulation tests are used. The following parameters are of practical importance: resting PO2, postocclusive PO2, rubefacient-induced PO2 and 45 degrees C heating PO2. Patients with diabetic microangiopathy show diminished PO2 values in rubefacient-induced PO2 and 45 degrees C heating PO2. The former ist probably related to endothelial-cell function disturbances and the letter to organic vessel wall changes. Thus, a quantitative and differentiated picture of microangiopathy can be obtained in each individual patient. PMID- 3673791 TI - Transcutaneous blood gases and sleep apnea profile in healthy preterm infants during early infancy. AB - Studying the development of transcutaneous blood gas levels (tcpO2 and tcpCO2) and the sleep apnea profile in relation to sleep states in normal preterm infants between 36 and 52 weeks postconceptual age we found a dynamic increase in tcpO2 during regular breathing (without apnea) and a steady decrease in tcpCO2 during both regular and periodic breathing. The mean tcpO2 of periodic breathing, however, persistently remained well below the corresponding level found during regular breathing. It is suggested that in normal preterm infants there is a continued maturational adjustment of autonomic respiratory control up to 3 months post term and, furthermore, that periodic breathing may persistently be associated with a relative hypoxemia. PMID- 3673793 TI - Otology today. 2nd international workshop. Riva del Garda, April 1-5, 1986. Proceedings. PMID- 3673792 TI - Transcutaneous monitoring as trigger for therapy of hypoxemia during sleep. AB - Based on results on central chemosensitivity in cats, paired stimuli were applied for therapy to infants with central respiratory insufficiency of various degrees. An unspecific respiratory stimulus, e.g. light for 1 s, was followed by a jet of either O2 or 2% CO2 in O2 for 1.5 s. The unspecific and the chemical stimuli were interspaced by 0.5 s. The combined stimulation was repeated every 10 s. The program was triggered by using threshold values of transcutaneous pO2. In infants with intratrachial tubes or tracheostoma we used the end tidal pCO2 for triggering the stimulation. The method could prevent hypoxemia during sleep in non-ventilated subjects with sleep apnea syndromes or in infants with severe hypoxemia during sleep after being rescued from Sudden Infant Death Syndrome (SIDS). In patients with Ondine's Curse Syndrome (OCS) with its CO2 insensitivity, paired stimuli were used in order to condition the chemical function of the respiratory system. Polysomnograms from 310 clinically healthy infants including healthy siblings of SIDS victims revealed instability of arterial pO2 and low CO2 sensitivity during sleep within the second month and the fourth to ninth month of life, respectively. These data challenge the described method as a potential preventive or therapeutic measure to defeat SIDS and sleep apnea syndromes in conjunction with disturbed chemical regulation of respiration. PMID- 3673794 TI - State of the art of otology. PMID- 3673795 TI - Current method of stapes surgery. PMID- 3673796 TI - Modification of intact canal wall technique in the treatment of cholesteatoma. PMID- 3673797 TI - Closed tympanoplasty and recurrent cholesteatoma. Long-term results. PMID- 3673798 TI - New concepts regarding the volume flow of endolymph and perilymph. PMID- 3673799 TI - Surgical treatment of cholesteatoma in children. PMID- 3673800 TI - On the wall-down tympanoplasty. PMID- 3673801 TI - Pitfalls of ossiculoplasty. PMID- 3673802 TI - Labyrinthine fistulae in cholesteatoma. PMID- 3673803 TI - Transplantation of nasal mucosa into the middle ear for the treatment of adhesive otitis media. PMID- 3673804 TI - Cholesteatomas of the temporal bone invading the posterior and middle fossa. PMID- 3673805 TI - Indications for surgery in sudden sensorineural hearing loss. PMID- 3673806 TI - The problem of the facial nerve in acoustic neuroma surgery. PMID- 3673807 TI - Techniques for facial rehabilitation by temporalis muscle transposition. PMID- 3673808 TI - Surgical reconstruction of the auricle. PMID- 3673810 TI - New developments in hearing aid technology. PMID- 3673809 TI - Clinical rehabilitation of the deaf. PMID- 3673811 TI - Computer-assisted hearing-aid evaluation and fitting program. PMID- 3673812 TI - Rehabilitation of the deaf with cochlear implants. PMID- 3673813 TI - Development of the INERAID artificial ear. PMID- 3673814 TI - The partially implantable middle ear implant, case reports. AB - The partially implantable middle ear implant (MEI) is clinically useful for bilateral deafness when it is applied to the mixed deafness with a bone conduction threshold of 20-40 dB. Two out of five successful cases are reported. It should be noted that 1.5 years have passed without changes for the first successful implantation. The next step for application of the MEI to more cases is discussed. PMID- 3673815 TI - The inorganic component of otosclerotic footplates. PMID- 3673816 TI - Surgical pathology of the ear. PMID- 3673817 TI - Laser interferometry with human temporal bones. PMID- 3673818 TI - Observation of the eustachian tube in pediatric cases with acquired cholesteatoma. PMID- 3673819 TI - CT densitometry in otosclerosis. PMID- 3673820 TI - Role of amino acids in the inner ear with special reference to tectorial membrane. PMID- 3673821 TI - Endoscopy of the eustachian tube. PMID- 3673822 TI - Recent advances in hearing screening. PMID- 3673823 TI - Otoneurology today. PMID- 3673824 TI - Perceptual audiometry: a new dimension in the audiological field. PMID- 3673825 TI - Audiologic diagnosis of central versus VIII nerve and cochlear auditory impairment. PMID- 3673826 TI - Forensic evaluation of noise-induced hearing loss. PMID- 3673827 TI - Childhood deafness today. PMID- 3673828 TI - New pathogenetic and therapeutic aspects of Meniere's disease. PMID- 3673829 TI - Subfascial lifting. AB - The authors demonstrate by anatomical dissection that inaccuracies made by classical anatomists have worried plastic surgeons for many years. They demonstrate that continuity between the parotid fascia and the fibrous platysma has not been recognized. In addition, anatomists in the past have not been aware that the platysma is a unique type of fasciomuscular layer because in contrast to conventional anatomical opinions, the platysma has no bony attachment to the mandible. PMID- 3673830 TI - Compound implant to project the nasal tip. AB - Use of a compound implant to project the nasal tip in cases of thick skin, a depressed or slightly descending tip, and a minimal bony hump is reported. This implant gives shape and projection, is easy to obtain, and is well tolerated by the organism. It is made of a strip of septal cartilage or silastic; the anterior end is covered by a portion of alar cartilage. There is a low percentage of complications with this technique. PMID- 3673831 TI - Dissatisfaction among women with "thunder thighs" undergoing closed aspirative lipoplasty. AB - In our practice, we have uncovered a small series of female patients with "thunder thighs" who were dissatisfied with results of closed aspirative lipoplasty. The common problem appears to be unrealistic expectations. These patients expected a change in body habitus. This article reiterates the need for careful patient selection and preoperative information of what the procedure can and cannot accomplish. PMID- 3673832 TI - Diabetes mellitus and exercise. AB - The study deals with the subject of exercise in diabetic patients, with particular emphasis on acute physical stress in type--I and type--II diabetics. The principal task was to define metabolic changes as they occur in the diabetic subjected to acute stress induced by exercise, in comparison with non-diabetics; metabolic changes during prolonged stress as well as during the period of rest; and finally, to propose, on the basis of authors' experimental results and detailed literature research, appropriate rules of procedure for prescriptive exercise for the individual patient. There were 120 subjects divided into 8 groups. Using primarily a bicycle ergometer, the members of the individual groups were subjected to physical stress of various intensity and duration. A detailed analysis of each subject's metabolic response was performed, involving an assessment of 35 physiological and biochemical parameters, with main focus on determining biochemical changes. The study results are presented in detail both with respect to the metabolic response to a given stress in individual groups and comparatively for individual parameters with regard to specific stress rates and groups. Significant differences were found in the metabolic responses concerning the following parameters: acid-base balance, potassium, triglycerols, glucose, cholesterol, FFA, free glycerol, lactate, uric acid. On the basis of the results of experimental measurements, the following algorithm has been designed for prescribing exercise to diabetics: appropriate motivation; determination of the type of exercise; determination of the intensity of exercise; determination of the duration of exercise; respecting related contraindications and complications. A conclusion has been made that provided all possible risks and contraindications as well as prescription guidelines are respected, exercise is to be considered one of the basic principles of diabetes management. PMID- 3673833 TI - [Primary hyperparathyroidism in 23 cases]. AB - Twenty-three cases of primary hyperparathyroidism were experienced at Wakayama Medical College Hospital and affiliated hospitals between January, 1969 and December 1985. Histopathological findings were adenoma in 22 cases, hyperplasia in 1 case. On the clinical diagnosis of this disease, the most sensitive laboratory test was serum calcium level, which was elevated in 21 patients (91%), and in 87.8% of all samples measured. Serum ionized calcium and phosphorus were also sensitive measures. The positive rate of serum PTH was 67% in 18 cases. Tl chloride scintigraphy identified preoperatively the site of the adenomas in 8 out of 10 cases, and computed tomography in 10 out of 15 cases. Both methods are non invasive, and are beneficial for the preoperative examination of the localization of parathyroid adenoma. After parathyroidectomy, serum calcium and ionized calcium levels recovered rapidly within the normal limit in 12 hours. On the other hand, serum phosphorus level increased gradually up to the normal limit in about 1 week. PMID- 3673834 TI - [Operative fiberoptic nephroureteroscope--removal of renal and upper ureteral stones]. AB - Two types of operative fiberoptic nephroureteroscopes were developed with the cooperation of the Olympus Optical Company mainly to remove the upper urinary tract calculi. Removal of the renal and upper ureteral stones was attempted in nine cases. The ureter was dilated with olive tip, balloon and Teflon dilators alone or in combination. The combination of balloon and Teflon dilators seemed the most promising. As a result of ureteral dilation, operative fiberoptic nephroureteroscopes, 4.5 mm and 3.5 mm in diameter, could be passed into the ureter in all the cases and the stones could be visualized clearly. Four of the 7 upper ureteral stones and 1 of the 2 pelvic stones could be removed. The success ratio was 56%. The method of stone removal still requires improvement. At present, application of the operative fiberoptic nephroureteroscope is indicated for upper ureteral and renal stones less than 1.0 cm in diameter. With the improved techniques of stone removal using this fiberscope, the indications of extracorporeal shock-wave lithotripsy or percutaneous nephrolithotripsy will probably be greatly reduced in the near future. PMID- 3673836 TI - [Uroepithelial tumors of the upper urinary tract following bladder cancer]. AB - Five hundred and nineteen patients with primary bladder cancer were treated between January, 1969 and December, 1984, 12 of whom had developed upper urothelial tumors. These patients had received various transurethral treatment for the primary bladder lesions, except for one patient who had undergone total cystectomy and ileal conduit diversion. Overall incidence of patients with upper urinary tract tumors following bladder cancer was 2.3%. The incidence of patients with treated bladder tumors (13.2%) for dye workers was higher than that for the general population (1.1%). The interval between initial treatment of the bladder tumor and diagnosis of the upper tract tumor ranged from 7 to 170 months (mean 70 months). The incidence of upper tract tumors increased with the passage of time. We conclude that the occurrence of upper urinary tract tumors following primary bladder cancers is promoted by nonspecific chemical irritants against the urothelium already made unstable by certain urinary chemical carcinogens. PMID- 3673835 TI - [Effect of selective intra-arterial infusion of OK-432 against renal cell cancers]. AB - In 8 cases of operable renal cancer, selective intraarterial infusion of the streptococcal preparation, OK-432 was performed and its cytocidal effects on the surgical specimens, which were removed on the 8th day after infusion, were investigated histopathologically with immunological parameters of the peripheral blood. The histopathological study revealed a high grade of sinus histiocytosis of the renal pedicle lymph nodes, but the anti-tumor effect on renal tumors was not so marked in any of the 8 cases. OK-Ia-positive lymphoid cells of peripheral blood were increased significantly and Con-A stimulation index of blastogenesis was lowered without any change in the PHA stimulation index after the OK-432 infusion. No serious complications of the selective intraarterial infusion were experienced except for high fever (less than 38 degrees C). In conclusion, OK-432 selective intraarterial infusion was an effective method for improving regional and systemic immunoactivity, but the cytocidal effect against tumor cells could not be confirmed histopathologically. PMID- 3673837 TI - [Viscus perforation as an unusual complication of Politano-Leadbetter ureteral reimplantation]. AB - Unusual complications of the Politano-Leadbetter ureteral reimplantation technique are reported in four ureters in three children with primary vesicoureteral reflux (VUR). These ureters were found to pass through an adjacent intraperitoneal viscus including the sigmoid colon, ileum or broad ligament. This complication occurred in 0.48% of the Politano-Leadbetter antireflux operations for primary VUR. Viscus perforation occurred only in children with a relatively high grade VUR. The prognoses of the hydroureter after ureteric reimplantation or ureterolysis, were good in all cases. Although there are several advantages in the transvesical procedure of the original Politano-Leadbetter method, we should not hesitate to go extravesically if there are difficulties in mobilizing the ureter or inducing it into the vesical cavity. PMID- 3673838 TI - [Clinical studies on 179 cases of prostatic cancer]. AB - Between 1971 and 1984, 179 patients with prostatic cancer were admitted to our Hospital. These cases were studied retrospectively. The greatest number of patients were in their seventies. The patients ranged from 55 to 90 years old with an average age of 72.4 years. The most common symptoms were dysuria, urinary retention, pollakisuria and macrohematuria. About 76% of the chief complaints were related to urinary tract obstruction. There were 64 (35.8%), 21 (11.7%), 38 (21.2%) and 56 (31.3%) cases of stage A, B, C and D, respectively. Prostatic cancer was confirmed histopathologically at transurethral resection in 146 patients, transrectal needle biopsy in 25 patients, open prostatectomy in 3 patients, autopsy in 4 patients, and cryosurgery in 1 patient. The 1-, 3-, and 5 year actual survival rates of 162 cases were 89, 70 and 55%, respectively. The 5 year actual survival rate of stage A, B, C, and D was 72, 67, 55 and 34%, respectively. The 5-year actual survival rate for the cases treated with and without anti-androgen therapy was 72% and 73% for stage A, 66% and 75% for stage B, 58% and 44% for stage C and 37% and 12% for stage D, respectively. The cases treated with anti-androgen therapy was divided into the low dose (diethylstilbestrol less than 300 mg/day or hexestrol less than 30 mg/day) and high dose (diethylstilbestrol greater than or equal to 300 mg/day or hexestrol greater than or equal to 30 mg/day) groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673839 TI - [Response criteria for prostatic cancer treated by chemotherapy or antiandrogenic therapy]. AB - The efficacy of cytotoxic agents in the treatment of prostatic cancer is difficult to evaluate because objective, measurable lesions, such as lung, liver, skin, subcutaneous and nodal metastasis are often not found. However, most of the patients with advanced prostatic cancer have bone involvement and elevated serum acid-phosphatase in addition to the primary tumor. Exact clinical trials on such cases, especially phase II studies can not be performed without appropriate evaluations of these three parameters. The criteria of these three parameters offered by various study groups are reviewed and the relevant response criteria are proposed. A stable category was thought to be useful to evaluate the efficacy on the patients with progressing disease. In our proposal, overall assessment of response involves all objective parameters including these three parameters as well as both measurable and unmeasurable disease described in the WHO handbook for reporting results of cancer treatment. PMID- 3673840 TI - [Blood access puncture point pseudoaneurysms in two hemodialysis patients]. AB - This is a report of blood access puncture point pseudoaneurysms which occurred in two hemodialysis patients. Case 1: A 58-year-old male had been undergoing hemodialysis treatment since June, 1975. In January, 1981 a subcutaneous mass had developed at the blood access puncture point above the previously superficialized left femoral artery. An operation was performed in February, 1981 and the mass was dissected. The same artery has been used since the operation for blood access without any problems. The dimensions of the egg-shaped dissected mass were 3.5 X 4 X 2.5 cm. A histological diagnosis of the wall of the mass showed that it was a pseudoaneurysm. Case 2: A 48-year-old female had been undergoing hemodialysis treatment since September, 1983. The left basilic vein, connected to the brachial artery, has been used for blood access. In April, 1984, a subcutaneous mass had developed at the blood access puncture point and an operation was performed within a few days. Operative findings revealed that the mass was a capsulized infected hematoma with a smooth but extremely thin and easily ruptured surface, and the section of the basilic vein surrounded by the mass showed evidence of necrotic change due to compression. The brachial artery was resutured at the region where it was previously connected to the basilic vein without disturbance of arterial blood flow. In July, 1985, an operation was performed in which a new blood access was constructed in the left thigh by superficializing the femoral artery and connecting its side to the end of the saphenous vein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673841 TI - [Bilateral renal cell carcinoma associated with von Hippel-Lindau disease]. AB - A 52-year-old man was referred to the department of neurosurgery of our hospital for evaluation of left occipital pain on September 27, 1982. Brain CT and arteriography showed midcerebellar tumor and an operation was performed on October 7, 1982. Histopathologically, the tumor was hemangioblastoma (solid type). His whole-body CT showed bilateral multiple renal tumors but no angioma retinae were found. Angiography revealed that the lesions were bilateral multiple (more than 20) renal tumors, bilateral adrenal tumors and left retroaortic renal vein. The patient underwent bilateral radical nephrectomy and lymphadenectomy on December 15, 1982. Renal cell carcinoma (grade II greater than III) with adrenal and left renal vein involvement were noted on the pathologic specimen. Postoperatively, he received supplement therapy with hydrocortisone and hemodialysis, but died of bleeding from the recurrent hemangioblastoma on July 7, 1983. PMID- 3673842 TI - [A case of fibrosarcoma of the kidney extending into the inferior vena cava]. AB - A case of fibrosarcoma of the kidney extending into the inferior vena cava with intraoperative development of massive neoplastic pulmonary emboli is reported. A 38-year-old man was admitted to our hospital because of right renal tumor with gross hematuria, right flank pain and abdominal tumor. Inferior venacavograms and computerized tomography demonstrated almost total occlusion of the abdominal part of the vena cava by tumor thrombi. No signs of inferior vena caval involvement were present. Intraoperative pulmonary neoplastic emboli suddenly occurred after right nephrectomy was performed. Immediately, pulmonary thrombectomy was performed with extra-corporeal circulation. Postoperatively, pulse, blood pressure and ventilation were stable, but the patient remained unconscious and neurologic signs gradually deteriorated. Computerized tomography of the brain showed diffuse brain edema and infarctions. The patient died of cardiopulmonary insufficiency with multiple pulmonary metastasis 8 months postoperatively. We emphasize the risk of fragmentation and migration of the tumor thrombi during surgical treatment of neoplasm of the kidney invading the inferior vena cava. PMID- 3673843 TI - [A case of webbed penis]. AB - A case of webbed penis is reported. This case is believed to be the fourth case in Japan and was treated by dorsal incision. PMID- 3673844 TI - [A case of serous papillary adenocarcinoma of the ovary initially suspected to be a uretero-vaginal fistula]. AB - A case of serous papillary adenocarcinoma of the ovary initially suspected to be an uretero-vaginal fistula is reported. The patient was a 57-year-old female with the complaint of urinary leakage from the vagina. Because she had undergone a supravaginal hysterectomy for myoma uteri 10 years earlier, a uretero-vaginal fistula was initially suspected. However, the fistula was not recognized from the findings of excretory and retrograde pyelographies. Chemical analysis of the vaginal discharge was similar to serum rather than urine. Gynecological examination showed the presence of an ovarian tumor. Right oophorectomy and extirpation of remaining cervix combined with partial resection of rectum was performed. From the pathological finding that the tumor consisted of serous papillary adenocarcinoma, the vaginal discharge was confirmed to originate from the tumor. Ovarian tumors with serous discharge from the vagina seem to be very rare. PMID- 3673845 TI - [A case of intra-arterial infusion chemotherapy using the vascular-access-port]. AB - For the treatment of progressive bladder tumors, intraarterial infusion chemotherapy has been performed extensively with satisfactory results. However, we have experienced various cases not only in which side effects of the infusion drug appeared, but also in which treatment had to be discontinued because of infections and flexuous caused by the intraarterial infusion catheter. In this study, intraarterial infusion chemotherapy was done using the vascular-access port (VAP) which is an access implanted in the body devised to improve the fault of the intraarterial catheter exposed outside of the body. PMID- 3673846 TI - International Association of Asthmology. XII World Congress of Asthmology. 25-29 October 1987, Barcelona (Spain). Abstracts. PMID- 3673847 TI - MASA's tentative AIDS policy. PMID- 3673849 TI - Senior medical students in Guatemala. PMID- 3673848 TI - The unmentionable, charity care. PMID- 3673850 TI - The liver and pregnancy. PMID- 3673851 TI - Reporting of congenital malformations on Alabama birth certificates. PMID- 3673852 TI - Sovietizing American medicine? PMID- 3673853 TI - Programs and services for the deaf in the United States. III. Supportive and rehabilitative programs and services. PMID- 3673854 TI - Programs and services for the deaf in the United States. IV. Research programs and services. PMID- 3673855 TI - Teacher characteristics and the degree to which teachers incorporate features of English in their sign communication with hearing impaired students. PMID- 3673857 TI - Caption decoders: expanding options for hearing impaired children and adults. PMID- 3673856 TI - Words spoken by teachers to primary-level classes of deaf children. PMID- 3673858 TI - Programs and services for the deaf in the United States. II. Educational programs and services. PMID- 3673859 TI - Infantile apnea and home monitoring devices. PMID- 3673860 TI - Pediatric burns. AB - Burns are the second most common cause of death in childhood. More than half of pediatric burns are partial-thickness scald burns; the majority occur in the kitchen. Generally, minor burns may be treated on an outpatient basis, while moderate burns are treated in a community hospital. Children with major burns should be transferred to a regional burn unit as soon as possible after stabilization, provision of fluids and, if necessary, intubation. PMID- 3673861 TI - Fitz-Hugh-Curtis syndrome. AB - The Fitz-Hugh-Curtis syndrome consists of right upper quadrant abdominal pain, perihepatitis and genital tract infection. Neisseria gonorrhoeae and Chlamydia trachomatis have been identified as causative agents. This syndrome frequently mimics other diseases and typically occurs in sexually active young women. A high index of suspicion is essential for early diagnosis. Laparoscopy may be indicated for diagnosis and for lysis of adhesions. PMID- 3673862 TI - Long-term effects of unresolved sexual trauma. AB - Rape and child sexual abuse are common in our society, and the incidence is increasing. A variety of presenting complaints in adults may be signals of unresolved, remote sexual trauma. These include memory problems, confusion, impulsive or self-injurious behavior, unexplained somatic complaints and many others. Family physicians attentive to such signals can assist in relieving the toxic secret. PMID- 3673863 TI - Depression in Southeast Asian refugees. AB - Depressive illness is common among Southeast Asian refugees. Classic vegetative symptoms seem to cross cultural boundaries and have been found in all ethnic groups studied. A migration history is important for eliciting information about the flight experience and the current living situation. Symptomatic treatment, combined with an abbreviated form of psychotherapy, is effective for many patients. PMID- 3673864 TI - A new approach to stroke management. AB - Stroke incidence has declined in recent decades, largely as a result of risk factor management rather than any stroke-specific therapy. Despite improved diagnostic techniques, aggressive management of transient ischemic attack and asymptomatic carotid disease has proved to be costly and of questionable benefit. The emphasis in the clinical approach to stroke should shift to acute intervention and "cerebral resuscitation." PMID- 3673865 TI - Cryptosporidiosis. AB - In the United States, the four groups at high risk of cryptosporidiosis are animal handlers, foreign travelers, children in day care centers and immunocompromised patients, including those with acquired immunodeficiency syndrome. In immunocompetent patients, the sporadic diarrheal illness is self limited. Diagnosis is made by the identification of Cryptosporidium oocysts in stool specimens, but these parasites are easily overlooked and may be confused with yeast. At present, there is no specific therapy for this infection. PMID- 3673866 TI - Croup syndrome. AB - Spasmodic croup has a sudden onset, almost always at night, and usually responds well to humidification. Laryngotracheobronchitis is the most common form of the croup syndrome; children with this disease generally do well, although some require hospitalization and intubation. Bacterial tracheitis may mimic severe laryngotracheobronchitis; diagnosis is usually established during visualization of the airway. Epiglottitis is rare but is often life-threatening. PMID- 3673867 TI - Cocaine and sudden death. AB - Victims of cocaine are seen increasingly often in physicians' offices and emergency departments. Sudden death in previously healthy individuals may be due to massive overdose. As law enforcement becomes more active in the pursuit of drug dealers, "body stuffing"--the ingestion of large quantities of cocaine or other drugs in a panic situation to avoid arrest--is occurring more frequently. PMID- 3673868 TI - Herpes zoster as a sign of AIDS-related complex. AB - Herpes zoster has recently been reported in young patients with risk factors for AIDS. In high-risk patients under age 55, herpes may be the first manifestation of AIDS or AIDS-related complex. Dissemination of zoster does not appear to be greatly increased in this group, but corticosteroid therapy should be withheld. PMID- 3673869 TI - Therapeutic potential of Ampligen. PMID- 3673870 TI - Fat embolism. PMID- 3673872 TI - Pro sports and smokeless tobacco. PMID- 3673871 TI - Granulocytes in the CSF. PMID- 3673873 TI - Family ties. PMID- 3673874 TI - Relationship between Tl-201, Tc-99m (Sn) pyrophosphate and F-18 2-deoxyglucose uptake in ischemically injured dog myocardium. AB - We have previously demonstrated that enhanced glucose utilization in reperfused myocardium as assessed by F-18 2-deoxyglucose (FDG) and positron tomography predicts functional recovery. In this study, we compared segmental uptake of F-18 FDG with that of Tl-201 and Tc-99m (Sn) pyrophosphate (Tc-99m PPi) as conventional markers of tissue viability in seven dogs after a 3-hour intracoronary balloon occlusion and 20 hours of reperfusion. Myocardial blood flow was determined with microspheres. Regional retention fractions were calculated from tracer tissue concentrations, the arterial input function, and blood flow. Ischemic injury was assessed by triphenyltetrazolium chloride (TTC) staining and histologic analysis. At 24 hours, blood flow was 22% lower in reperfused than in control myocardium (p less than 0.05). Uptake of Tl-201 was related linearly to blood flow (r = 0.92), while glucose utilization and Tc-99m PPi were 2.9 (p less than 0.01) and 4.7 (p less than 0.05) times higher in reperfused than in control myocardium. Retention fractions of Tc-99m PPi increased with the degree of ischemic injury, while F-18 FDG uptake was highest in segments with mild cell injury. Thus, in ischemically injured myocardium, Tl 201 primarily reflects blood flow. F-18 FDG as a marker of glucose utilization identifies ischemically injured but viable tissue. The admixture of necrotic cells can be determined with Tc-99m PPi. Our results indicate that a dual tracer approach might best characterize the presence and extent of reversibly and of irreversibly injured tissue in a given myocardial region. PMID- 3673875 TI - Regional differences in postischemic recovery in the stunned canine myocardium. AB - To determine if differences exist in the degree of ischemic damage and in postischemic recovery when different coronary arteries are occluded and reperfused, 40 barbital-anesthetized dogs were subjected to brief 15-minute periods of coronary artery occlusion followed by 3 hours of reperfusion ("stunned" myocardium) of the left anterior descending (LAD) or the left circumflex (LCX) coronary arteries. Myocardial segment shortening (%SS) in the subendocardium of nonischemic and ischemic reperfused areas was measured by sonomicrometry, and regional myocardial blood flow was measured by radioactive microspheres. Transmural tissue biopsies were taken at the end of reperfusion for the measurement of adenine nucleotides and total tissue water content. Arterial and local coronary venous blood samples were collected during preocclusion, during occlusion, and at 30 and 180 minutes of reperfusion for determination of blood oxygen content and oxygen consumption in the ischemic area. During occlusion, subendocardial blood flow (LAD flow = 0.11 +/- 0.02; LCX flow = 0.15 +/- 0.04 ml/min/gm), myocardial oxygen consumption (LAD = 2.4 +/- 0.7; LCX = 2.7 +/- 0.7 ml/min/100 gm), and areas of the left ventricle at risk (LAD = 27.4 +/- 2.3%; LCX = 32.4 +/- 2.4) were similar in both groups, thus indicating equivalent degrees of ischemia. There were no differences between groups in hemodynamics throughout the experiment or in the loss of myocardial high-energy phosphates or increase in total tissue water in the ischemic reperfused area at 3 hours of reperfusion. There was a significantly greater loss (p less than 0.05) of systolic wall function during LAD versus LCX occlusion and a greater recovery of segment function from 5 minutes throughout 1 hour of reperfusion after LCX occlusion (p less than 0.05), with no difference in %SS at 2 and 3 hours following reperfusion. Thus, although similar changes occurred in blood flow, metabolite parameters, tissue edema, wall function, and overall hemodynamics when either the LAD or LCX perfusion territories were occluded and reperfused, the loss of systolic wall function and recovery of segment shortening were more variable after regional stunning of the LCX perfusion bed. These data suggest that evaluation of pharmacologic or surgical interventions to improve postischemic functional recovery may be more reliably performed when the LAD coronary artery is the vessel occluded. PMID- 3673876 TI - Angiographic and angioscopic observations of the arterial luminal changes induced by vasospasm. AB - Angiography and angioscopy were used to examine arterial luminal changes induced by experimental vasospasm. The right common carotid artery of the dog was perfused with Krebs-Henseleit solution at a constant pressure, 3,4 diaminopyridine (DAP), a selective potassium channel blocker was applied on the adventitia, and the luminal changes were observed with angiography and angioscopy. Angiographically vasospasm (defined as a reduction in the internal diameter to less than 50% of the control value) was always induced by the topical application of 5 X 10(-1) mol/L DAP. The internal diameter decreased to 25% +/- 7% (mean +/- standard error, n = 6) 15 minutes after the application. The vasospasms propagated 2.7 +/- 0.6 and 1.1 +/- 0.3 cm downstream and upstream, respectively. Angioscopy showed that the lumen narrowed gradually and concentrically. Perfusion of the artery during vasospasm for 15 minutes with a backflow of blood from the contralateral artery resulted in thrombosis at the spastic segment. The results indicate that carotid vasospasm can be constantly induced by DAP, thrombosis occurs in the spastic artery, and angioscopy is useful for serial observation of the luminal changes induced by vasospasm. PMID- 3673877 TI - High-risk subgroups of patients with non-Q wave myocardial infarction based on direction and severity of ST segment deviation. AB - To determine the significance of the direction of ST segment deviation on admission of patients who evolved non-Q wave myocardial infarction (MI), 97 patients with initial ST segment depression were compared to 207 patients with initial ST segment elevation. Patients with ST segment depression developed smaller infarcts than those with ST segment elevation (creatine kinase MB isoenzyme 8.2 vs 13.3 gmEq/m2, p less than 0.002), but had a lower left ventricular ejection fraction on admission (44% vs 51%, p less than 0.001), more in-hospital complications, and a higher cumulative 1-year mortality (29% vs 11%, p less than 0.001) that could be accounted for by an excess of adverse baseline characteristics. Although a severity index (combining magnitude and extent of the initial ST segment deviation) was not useful for discriminating prognosis of patients with non-Q wave MI who presented with ST segment depression, it was useful in identifying a subgroup of patients with ST segment elevation with an adverse prognosis. The poor outcome of patients with non-Q wave MI presenting with either ST segment depression or severe ST segment elevation on admission suggests that patients in these subgroups should receive close surveillance and should possibly be considered for aggressive therapy. PMID- 3673878 TI - ST segment changes in exercise body surface mapping after myocardial infarction in patients with isolated left anterior descending coronary artery disease. AB - To investigate the clinical significance of exercise-induced ST segment elevation and ST segment depression after myocardial infarction (MI), we performed 87-lead ECG mapping after previous anterior infarction in 24 patients with isolated left anterior descending coronary artery disease before and 1.5 minutes after treadmill exercise. Thirteen patients showed ST segment elevation only, seven patients showed both ST segment elevation and depression, and four patients showed ST segment depression only. ST segment elevation most frequently occurred in the left anterior chest leads corresponding to the QS area, and ST segment depression developed in the left lower chest and left lower back leads. There was good correlation between the number of lead points showing ST segment elevation (nSTe) after exercise and the number of lead points showing QS waves (nQS) before exercise (r = 0.65). nSTe was also correlated with the asynergy index (r = 0.43). These findings suggest that ST segment elevation is mainly the result of aggravation of wall motion abnormalities of the infarcted myocardium. Body surface distribution of ST segment depression was similar to that in effort angina pectoris without MI. We conclude that exercise-induced ST segment depression in MI mainly reflects the ischemia of the surviving myocardium of small infarcts or the peripheral area of large infarcts. PMID- 3673879 TI - Computer versus visual analysis of exercise thallium-201 images: a critical appraisal in 325 patients with chest pain. AB - Although computer-aided analysis of planar thallium images has been previously reported to be superior to visual analysis, a segment-by-segment comparison of all thallium variables (presence of initial defect, presence of redistribution, and presence of abnormal lung:heart thallium ratio) has not been performed with the use of both methods. In the present study, such a comparison was performed to determine which thallium variable(s) are superior, when the computer method is used. In addition, both methods were compared to determine their correlations with the angiographic extent of coronary artery disease (no disease, or one vessel disease vs multivessel, or left main disease) and the occurrence of future events (cardiac-related death or nonfatal myocardial infarction). Computer-aided analysis was superior to visual analysis (an average of three independent blinded observers) for detection of coronary disease because: (1) it was more specific for detecting initial defects despite having the same sensitivity (89.6% vs 91.0%, p = NS) and (2) it was more sensitive for detecting redistribution in the territory of a stenosed vessel (68% vs 46%, p less than 0.001). However, absolute myocardial clearance of thallium had very poor specificity compared to visually assessed redistribution. Only when segmental clearance was considered abnormal on a relative basis (if it was slower by 98% or more than the fastest clearing segment in the heart) did abnormal clearance achieve the same specificity (99%) and a better sensitivity (60% vs 48%, p less than 0.01) than visual analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673880 TI - The prognostic value of the changes in the mode of ventricular tachycardia induction noted during therapy with a marked reduction of ventricular ectopic activity. AB - The prognostic significance of changes in the mode of induction of ventricular tachycardia (VT) noted during therapy was studied in 49 patients with sustained VT or ventricular fibrillation. Before treatment, all patients had inducible sustained VT by programmed stimulation (one to three extrastimuli) and frequent (greater than or equal to 30/hr) ventricular premature complexes (VPCs). On the discharge regimen, VT was no longer inducible by programmed stimulation in 22 patients (group 1). Twenty-seven patients (group 2) with persistent induction of VT despite extensive serial drug testings were discharged on a regimen that resulted in a marked reduction of VPCs on Holter monitoring (greater than or equal to 50% reduction of VPCs, greater than or equal to 90% reduction of couplets, and abolition of nonsustained VT). The modes of induction at baseline and on the discharge regimen were compared in each patient in group 2. Induction of VT was more difficult, requiring more aggressive stimulation protocol in 5 of 27 patients, unchanged in 14 patients, and easier in 8 patients. The duration of follow-up was 20 +/- 13 months (mean +/- SD). Arrhythmia-free survival rates at 6, 12, 18, and 24 months were 95%, 89%, 82%, and 73% in group 1, 92%, 84%, 75%, and 75% in group 2, 93%, 83%, 77%, and 69% in 27 patients with noninducibility or harder induction, and 95%, 90%, 79%, and 79% in 22 patients with the same or easier induction, respectively. The differences were not significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673881 TI - A prospective comparison of continuous wave versus high pulse repetition frequency Doppler echocardiography for quantifying transvalvular pressure gradients in adults with aortic stenosis. AB - To evaluate the relative accuracy of continuous wave (CW) and high pulse repetition frequency (HPRF) Doppler for estimating aortic transvalvular pressure gradients, Doppler examinations with both devices were obtained in 87 consecutive patients with aortic valve disease. Thirty-seven (43%) also underwent catheterization and direct determination of the pressure gradient. The correlation between CW Doppler and catheterization measurements was high (r = 0.91) and significantly superior to HPRF Doppler (r = 0.72; p less than 0.005). Disparities between the Doppler measurements predominantly occurred in patients with gradients exceeding 50 mm Hg in whom underestimation by the HPRF instrument was frequent. These data suggest that continuous wave Doppler is the preferred modality for the estimation of transvalvular pressure gradients in adult patients with moderate or severe aortic stenosis. PMID- 3673882 TI - Noninvasive evaluation of mid-left ventricular obstruction by two-dimensional and Doppler echocardiography and color flow Doppler echocardiography. AB - Three patients with midventricular obstruction resulting from three different pathophysiologic mechanisms and differing anatomic bases for the development of obstruction are presented. In the first patient, a membrane-like structure appeared to cause some fixed obstruction, but a superimposed dynamic component to the obstruction was also evident. Papillary muscle hypertrophy with approximation of the papillary muscles during systole was the mechanism in the second patient. In the third patient, apical infarction with hyperdynamic contraction of the mid- and basal portions of the myocardium appeared to be the pathophysiologic mechanism. Color flow Doppler echocardiography was particularly useful in localizing the site of obstruction and allowed further evaluations by pulsed and continuous-wave Doppler techniques to precisely determine pressure gradients. PMID- 3673883 TI - Aneurysm of the sinus of Valsalva: a roentgenologic study of 105 Chinese patients. AB - Of 105 cases of lesions of the sinus of Valsalva found over a 25-year period at the Shanghai Chest Hospital, 90 were ruptured sinuses or sinus aneurysms and 15 were unruptured aneurysms. The cases were classified roentgenologically according to the method of Sakakibara and Konno: 64.5% were type I, 23.7% type II, 1.1% type IIIv, 6.4% type IIIa, 1.1% type IIIa + v, and 3.2% type IV. A new and simplified method of classification has been devised in the Shanghai Chest Hospital and shows the highest incidence to be the type of aneurysm of the sinus of Valsalva associated with ventricular septal defect. On aortography three types of morphologic changes--aneurysmal formation, enlargement of the sinus with no definite aneurysm, and sinus rupture with no enlargement or aneurysmal formation- are observed. Angiographically, shunting from ruptured sinus or sinus aneurysm begins in middiastole and gradually increases to end diastole. Aortic insufficiency, if present, usually begins in early diastole and extends over the whole diastolic phase in a decrescendo fashion. Special attention should be paid to the differentiation between ruptured sinus of Valsalva with or without aneurysmal formation and ventricular septal defect with aortic insufficiency. PMID- 3673884 TI - Left ventricular systolic circular index: an echocardiographic measure of transseptal pressure ratio. AB - An echocardiographic index of left ventricular (LV) short axis circularity can be defined by the equation: left ventricular systolic circularity index (LVSCI) = 4 pi(LV area) X 100/(LV perimeter). This index was measured from two-dimensional echocardiograms in 98 children (ages 1 day to 19 years) with congenital heart disease, and results were compared to right ventricular/left ventricular peak systolic pressure ratios (RVP/LVP) determined at cardiac catheterization. LVSCI was also computed in 50 children without cardiovascular or pulmonary disease to define the normal range. A short axis image of the left ventricle at the level of the papillary muscles was obtained from the left parasternal position. Area and perimeter were determined by computer planimetry of the LV endocardium at end systole. LVSCI was measured from three consecutive beats and averaged. In the normal group all values of LVSCI exceeded 93% (mean 96%). In the group with congenital heart disease RVP/LVP correlated exponentially with LVSCI: RVP/LVP = e2.6-0.04 LVSCI; with r = 0.88, SEE = 0.39, and p less than 0.001. If patients with suprasystemic right ventricular pressures (RVP/LVP greater than 1.2) are excluded, there is a linear correlation between RVP/LVP and LVSCI: RVP/LVP = 2.3 0.021 LVSCI; with r = 0.80, SEE = 0.14, and p less than 0.001. LVSCI could distinguish between patients with normal, mildly elevated, moderately elevated, and severely elevated RVP/LVP. We conclude that LVSCI is a readily determined parameter that is independent of age or body size and predicts RVP/LVP in children with congenital heart disease. PMID- 3673885 TI - A comparison of traditional wall motion assessment and quantitative shape analysis: a new method for characterizing left ventricular function in humans. AB - To forego the need to arbitrarily choose coordinate, reference, and indexing systems and to make other assumptions mandated by traditional methods of measuring wall motion, a technique of regional function analysis based on shape characteristics and pattern recognition was developed. The method is based on curvature analysis, a fundamental shape parameter, and is adaptive to the complex geometry of cineangiographic ventricular images. Quantitative shape parameters were compared to a standard method of regional function analysis (center-line method) in 130 patients. Quantitative shape and wall motion indexes showed a positive correlation over a broad range of normal and abnormal function (r = 0.748, p less than 0.001). Overall sensitivity and specificity for categorization of regional function were not statistically different for either technique. Within regions, however, shape criteria were more specific in categorizing inferior zones than anterior zones and were more often abnormal in the presence of mild regional abnormalities that were not located in the apical region. In conclusion, shape analysis and pattern recognition techniques can be used to forego dependence on the numerous assumptions and approximations required by traditional wall motion techniques, while providing performance characteristics that are similar to, and in some instances better than, traditional approaches. Incorporation of shape information in assessments of regional function provides a more comprehensive evaluation that includes the important visual cues used by experienced observers or "experts." PMID- 3673886 TI - Diastolic time in congestive heart failure. AB - Diastolic perfusion time is an important determinant of coronary blood flow and subendocardial perfusion. It has been proposed that subendocardial ischemia may exacerbate and perpetuate left ventricular dysfunction in congestive heart failure. Diastolic perfusion time in relation to heart rate was analyzed in 29 digitalized (group 1) and 12 nondigitalized patients (group 2) with heart failure and in 58 normal control subjects. In group 1 there was a strong negative exponential correlation (r = -0.85) and in group 2 a strong negative logarithmic correlation (r = -0.95) between heart rate and diastolic time; both regressions differed significantly from normal control. There was a 9% increase of diastolic time at a heart rate of 60 bpm in group 1 and a 7% increase in group 2 (both p less than 0.05) compared with normal subjects. The curves intersected the regression line of normal subjects at a heart rate of 98 bpm in group 1 and 93 bpm in group 2. At 120 bpm there was a 10% decrease in diastolic time for both groups with heart failure (both p less than 0.05). Changes in diastolic perfusion time relative to heart rate are more pronounced in congestive heart failure such that at faster heart rates this relationship may further impede subendocardial blood flow. PMID- 3673887 TI - Trends in cardiovascular risk factors in an urban black population, 1973-74 to 1985: the Minnesota Heart Survey. AB - Cardiovascular disease mortality rates have fallen dramatically in blacks in the United States. To determine whether this may be due to a decline in cardiovascular risk factors, we compared risk factors in a 1985 urban black population, ages 35 to 69, with those obtained in blacks of the same area in 1973 74. Age-adjusted mean body mass and the prevalence of overweight increased significantly over the 12-year period in both men and women. Mean systolic blood pressures declined significantly in both sexes, diastolic blood pressure declined significantly in men, and the proportion of men and women hypertensives on medication and under control increased. The overall prevalence of cigarette smoking changed very little, but the proportion of heavy smokers decreased significantly in men. No significant changes occurred in resting heart rate. Concurrently with these risk factor trends, age-adjusted heart disease mortality rates in area blacks fell 27% between 1968-73 and 1979-84, and stroke mortality fell 58%. Changing risk factors may be contributing to declining cardiovascular mortality rates in blacks. However, overweight seems to be a worsening problem. PMID- 3673888 TI - Percutaneous coronary angioscopy in patients with ischemic heart disease. AB - Percutaneous transluminal coronary angioscopy was performed during routine coronary angiography in seven patients and during PTCA in one patient with ischemic heart disease. A flexible fiberscope with an external diameter of 1.4 mm was introduced through an 8F or 9F guiding catheter used for PTCA into the coronary arteries. Warmed saline solution (15 to 20 ml) was injected through the guiding catheter into the coronary arteries for replacement of blood. Twenty-one of the 31 coronary segments were visualized and photographed on color cinefilms. The lumen of the atherosclerotic segment showed narrowing with smooth surface or with spiral folds. PTCA caused dilatation of the stenosed segment with scattered thin thrombi. These findings indicate the usefulness of angioscopy to observe luminal changes in the coronary arteries of patients with ischemic heart disease. PMID- 3673889 TI - Double-balloon valvuloplasty of tricuspid stenosis. PMID- 3673890 TI - Rupture of tricuspid valve papillary muscle during balloon pulmonary valvuloplasty. PMID- 3673891 TI - Ruptured sinus of Valsalva aneurysm in childhood. PMID- 3673892 TI - Hypoplasia of the left coronary artery complicated by reversible myocardial ischemia in a newborn. PMID- 3673893 TI - Aortic origin of the right pulmonary artery in an adult: successful surgical correction. PMID- 3673894 TI - Left atrial appendage aneurysm with associated anomalous pulmonary venous drainage. PMID- 3673895 TI - Effect of papaverine administration on myocardial echocontrast distribution. PMID- 3673896 TI - Biventricular cavity obliteration by metastatic malignant melanoma: role of magnetic resonance imaging in the diagnosis. PMID- 3673897 TI - Localization of slow conduction in a ventricular tachycardia circuit: implications for catheter ablation. PMID- 3673898 TI - Pulmonary embolism and thrombophlebitis in the United States, 1970-1985. PMID- 3673899 TI - A symposium: new approaches to cardiovascular therapy. March 5-8, 1987, Palm Beach, Florida. Proceedings. PMID- 3673900 TI - Clinical consequences of age-related impairments in vascular compliance. AB - Advancing age is associated with progressive reductions in the vascular distensibility of major vessels. Two clinically relevant consequences of physiologically impaired arterial compliance of aging, increased systolic blood pressure and decreased carotid arterial baroreflex sensitivity, are discussed. While arterial thickening and stiffening with age are associated with increased systolic blood pressure, diastolic blood pressure is generally stable or even decreases slightly with advancing age. Thus, the prevalence of isolated systolic hypertension increases dramatically with age. This long-neglected abnormality has recently attracted attention, and the view that systolic hypertension is harmless and its treatment fraught with a high incidence of serious adverse effects has now been shown to be myth. Several studies indicate substantial risk associated with isolated systolic hypertension, especially with regard to increasing prevalence of stroke. A recent multicenter trial has shown that systolic blood pressure can be safely lowered with low doses of thiazide diuretics. Currently, a National Institutes of Health sponsored multicenter trial aims to determine whether treatment of isolated systolic hypertension is associated with reduced risk. Age-related impairments in baroreflex sensitivity reduce the capacity of normal elderly persons to increase the heart rate in response to hypotensive stress and contribute to the increased prevalence with advancing age of orthostatic hypotension. This must be taken into account in the design of pharmacologic treatment regimens in older persons. PMID- 3673901 TI - Day-to-day variability of myocardial ischemic episodes in coronary artery disease. AB - Twenty patients with chronic stable angina pectoris, proved coronary artery disease, positive treadmill stress test response, and at least 2 episodes of ischemia per day underwent 72 hours of Holter monitoring during daily activities. During this period they had 389 ischemic episodes: 104 (27%) symptomatic and 285 (73%) silent. Marked variability was observed between patients in the number of ischemic episodes (range 2 to 15 per day, mean 6.5), duration of ischemia (range 6 to 419 minutes/day, mean 76.5), maximal ST depression (range 1 to 6 mm, mean 3.4) and heart rate at the beginning of ST depression (range 75 to 105 beat/min, mean 91). The day-to-day variability in individual patients between the different days in the number of ischemic episodes was 36%, in duration 51%, and in maximal degree of ST depression 31%. Only 9% variability was noted in heart rate at the beginning of ST depression. Similar day-to-day variability in individual patients was noted in the symptomatic and silent episodes. For clinical purposes of evaluation of ischemia during daily activities, 1 day of monitoring appears to be sufficient because within the first day, 78% of the maximal number of ischemic episodes, 64% of their duration, and 84% of the maximal degree of ST depression were detected. However, for evaluation of anti-ischemic drugs at least 2 monitoring days are required. PMID- 3673902 TI - Clinical and angiographic features of coronary artery disease after chest irradiation. AB - Coronary artery disease (CAD) developed in 15 patients at a mean of 16 years (range 3 to 29) after chest irradiation. The mean dose of radiation was 42 +/- 7 grays; irradiation was performed for Hodgkin's disease in 9 patients, lymphoma in 2, breast carcinoma in 3 and cystic hygroma in 1 patient. Mean age was 48 years (range 26 to 63) at diagnosis of CAD; 4 patients were younger than 35 years. Nine were women. Ten presented with angina, 3 with acute myocardial infarction, 1 patient with syncope and 1 with dyspnea. Twelve had no more than 2 risk factors of atherosclerosis. At coronary angiography, 8 had at least 50% diameter narrowing of the left main coronary artery and 4 had severe ostial stenosis of the right coronary artery. Eight patients also had valvular heart disease, 4 pericardial disease and 4 complete heart block. Mean left ventricular ejection fraction was 67 +/- 11% (range 53 to 80%). Nine had undergone coronary artery bypass grafting, but surgery was difficult or impossible in 3 because of severe mediastinal and pericardial fibrosis. Radiation-associated CAD is characterized by a high incidence of left main and right ostial coronary disease and often occurs in women with relatively few conventional risk factors for CAD. PMID- 3673903 TI - Utility of ambulatory electrocardiography in detecting pacemaker dysfunction in the early postimplantation period. AB - The value of ambulatory electrocardiography (AECG) in detecting pacemaker dysfunction before hospital discharge was assessed in 100 patients a mean of 1.2 days after pacemaker implantation. The incidence of permanent pacemaker dysfunction detected by AECG in the early postimplantation period, the frequency that pacemaker dysfunction detected by AECG was not detected by telemetric monitoring and the frequency that results of AECG led to pacemaker reprogramming before hospital discharge were determined. AECG detected at least 1 type of pacemaker dysfunction in 35% of patients and routine telemetry identified the abnormality in only 8% (p less than 0.001). Pacemaker dysfunction occurred in 42% of patients with dual-chamber devices and 27% of those with single-chamber devices (difference not significant). In the 35 patients who had pacemaker malfunction, a total of 50 instances of pacemaker dysfunction were detected. Failure of atrial capture occurred in 2% of patients, failure of atrial sensing in 9%, failure of atrial output in 1%, failure of ventricular capture in 8%, failure of ventricular sensing in 14%, failure of ventricular output due to myopotential inhibition in 11% and pacemaker-mediated tachycardia in 5%. The results of the AECG led to a clinical intervention in 22 patients (pacemaker reprogramming in 21 patients and lead repositioning in 1 patient) in whom no pacemaker dysfunction was suspected on the basis of telemetry or clinical symptoms. In conclusion, AECG provides additional benefit beyond that of routine telemetry monitoring in identifying pacemaker dysfunction in the early period after implantation. PMID- 3673904 TI - Relation between ventricular premature complexes and sudden cardiac death in apparently healthy men. AB - The association between ventricular premature complexes (VPCs) detected on a rest 2-minute lead I electrocardiographic rhythm strip and sudden cardiac death (SCD), occurring within 1 hour of onset of symptoms, was evaluated in a prospective study of 15,637 apparently healthy white men, aged 35 to 57 years, at the first screening examination (1973 to 1975) to determine eligibility for the Multiple Risk Factor Intervention Trial in Minneapolis/St. Paul, Minnesota. The prevalence of any VPC was 4.4% (681 of 15,637). Over an average follow-up period of 7.5 years, a total of 381 deaths occurred. Of these, 34% (131 of 381) were ascribed to coronary artery disease (CAD) and 31% of the CAD deaths (41 of 131) occurred suddenly. The presence of any VPC was associated with a significantly higher risk for SCD (adjusted relative risk = 3.0; p less than 0.025). On the other hand, the presence of any VPC was not associated with any significant increase in the risk of non-SCD or of total deaths from CAD (adjusted relative risk = 1.0 and 1.6, respectively). When VPC characteristics such as frequency (2 or more uniform VPCs every 2 minutes) and complexity (multiforms, pairs, runs, R-on-T) were examined, those with frequent or complex VPCs were at a significantly increased risk of SCD (adjusted relative risk = 4.2; p less than 0.005), whereas for non-SCD no significant increase in risk was found (adjusted relative risk = 1.6; p = 0.28).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673905 TI - A transcardiac lead system for identification and termination of supraventricular and ventricular tachycardia. AB - The value of a transcardiac lead system (coronary sinus to right ventricular apex) to record atrial and ventricular electrical activity and its pacing capabilities was assessed in 20 patients with a variety of tachycardias (atrial tachycardia in 3 patients, atrial flutter in 4, intranodal tachycardia in 6, circus movement tachycardia using an accessory pathway in 1 patient, and ventricular tachycardia in 9). The transcardiac lead invariably showed both atrial and ventricular electrical activity during sinus rhythm and tachycardias, allowing application of the same criteria as used when analyzing cardiac rhythm on the surface electrocardiogram. Atrial complexes had a mean amplitude of 4.2 mV during sinus rhythm and varied from 3.0 to 4.1 mV during the different types of tachycardia. Ventricular complexes had a mean amplitude of 9.8 mV during sinus rhythm, 13.8 mV during supraventricular tachycardia and 16.1 mV during ventricular tachycardia. The duration of the QRS complex on the transcardiac lead was equal to the duration of the QRS complex on the surface electrocardiogram during tachycardias with a small or wide QRS complex. By varying the intensity of current delivered through the transcardiac lead, only right ventricular pacing (mean current intensity 1.2 +/- 0.4 mA) or simultaneous atrioventricular pacing (mean current intensity 4.7 +/- 3.3 mA) could be achieved. Termination of all episodes of tachycardia was achieved with either ventricular pacing or simultaneous atrioventricular pacing. This transcardiac lead system allows clear identification of atrial and ventricular events, is suitable for tachycardia analysis using simple surface electrocardiographic algorithms and allows pacing termination of a variety of tachycardias. PMID- 3673906 TI - Temporary pacemaker use during coronary arteriography. AB - The risk of life-threatening ventricular arrhythmias complicating coronary angiography is reportedly increased in patients in whom temporary righ ventricular pacemakers are used. Placement of the temporary pacing electrode in the right atrium or vena cava during angiography theoretically removes from the vulnerable ventricle a source of mechanically or electrically induced ventricular arrhythmias. This hypothesis was evaluated in 7,648 consecutive patients who underwent cardiac catheterization with selective coronary angiography, including 103 with life-threatening ventricular arrhythmic complications. The prevalence of ventricular arrhythmias was 6.4 times greater in patients with temporary pacemakers than in those without (7% vs 1.1%, respectively, p less than 0.001). Analysis of 369 cardiac catheterizations concurrently using temporary pacemakers revealed a greater than 4-fold decrease in the frequency of ventricular arrhythmias when the pacing electrodes were located in the right atrium or vena cava rather than the right ventricle (2% vs 9%, respectively, p less than 0.01). No significant difference in indications for temporary pacing could be distinguished between the groups based on location of the pacing electrode or occurrence of ventricular arrhythmias. These findings confirm that there is an increased risk of ionic contrast agent-induced ventricular arrhythmias in patients with chronic underlying conduction disturbances undergoing coronary angiography with concurrent right ventricular temporary pacemakers. This risk can be significantly decreased by placing the pacing electrode in the right atrium or vena cava. PMID- 3673907 TI - Success of chronic defibrillation and the role of antiarrhythmic drugs with the automatic implantable cardioverter/defibrillator. AB - Because the automatic internal cardioverter defibrillator's long-term ability to reduce arrhythmic mortality in patients with ventricular tachycardia/fibrillation is unknown, it is important to determine whether the threshold for defibrillation changes over time. Serial defibrillation thresholds were measured in 23 patients over a mean replacement time of 24.8 +/- 7.5 months. In all cases the lead system was a superior vena cava coil to a left ventricular epicardial patch. The defibrillation threshold for the entire group increased from 12.3 +/- 4.7 J to 16.9 +/- 5.9 J (p less than 0.05). Striking increases in the defibrillation threshold were seen in the subgroup of patients taking amiodarone (from 10.9 +/- 4.3 J at implantation to 20.0 +/- 4.7 J at replacement, p less than 0.05). Defibrillation threshold decreased in patients taking no antiarrhythmic drugs or taking class I agents. Thus, the increase in mean defibrillation threshold was the result of an increase in the patients taking amiodarone. These data suggest that at initial implantation lead systems associated with the lowest defibrillation threshold should be used and the defibrillation threshold should be measured at generator change to guarantee an adequate margin of safety. PMID- 3673908 TI - Influence of underlying coronary artery disease on the natural history and prognosis of exercise-induced left bundle branch block. AB - The long-term prognosis of exercise-induced left bundle branch block (BBB) in patients with and without underlying coronary artery disease (CAD) was examined by following 15 patients (7 with normal coronary arteries and 8 with CAD) for an average of 6.6 years (range 2.2 to 11.2). Over the follow-up interval, permanent left BBB developed in 8 of the 15 patients. Seven of these 8 had underlying CAD, compared to 0 of 6 patients with normal coronary arteries and normal left ventricular function (p less than 0.002). In 1 patient with normal coronary arteries and a left ventricular ejection fraction of 0.34, permanent left BBB developed. During follow-up, 4 patients died; 3 had significant CAD and 1 had depressed left ventricular function. In no patient did high-grade atrioventricular block develop and no patient required pacing. Thus, development of permanent left BBB in patients with exercise-induced left BBB is related to presence or absence of underlying CAD or myocardial disease. When left BBB is found in the absence of underlying heart disease, there does not tend to be progression of the conduction disturbance and the prognosis is excellent. PMID- 3673909 TI - Value of programmed ventricular stimulation in presumed carotid sinus syndrome. AB - This study determines the results of programmed stimulation in patients with syncope or near-syncope presumed to have the carotid sinus syndrome based on the finding of carotid sinus hypersensitivity and the absence of any other apparent cause for syncope or near-syncope after clinical evaluation. Fourteen patients had coronary artery disease, 1 had dilated cardiomyopathy and 18 patients did not have structural heart disease. Programmed simulation was performed at 2 basic drive cycle lengths and 2 right ventricular sites with 1 to 3 extrastimuli. Sustained unimorphic ventricular tachycardia (VT) was induced in 5 of 15 patients who had structural heart disease, and in none of the 18 patients who did not (p less than 0.05). Polymorphic VT or ventricular fibrillation (VF) was induced in 5 of 15 patients (33%) who had structural heart disease, and in 5 of 18 patients (27%) who did not (p greater than 0.05). Patients who had inducible unimorphic VT were treated with antiarrhythmic drugs that suppressed the induction of VT, and 4 of 5 patients also received a pacemaker; no patient had a recurrence of syncope during follow-up. Patients who had inducible polymorphic VT and VF (n = 10) or no inducible VT (n = 18) received treatment directed at only carotid sinus syndrome. Two patients with inducible VT or VF and 1 patient without inducible VT had recurrent syncope during follow-up, but none had cardiac arrest or died suddenly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673910 TI - Electrical thermal angioplasty: catheter design features, in vitro tissue ablation studies and in vivo experimental findings. AB - A prototype electrical thermal tip catheter has been developed for ablation of atherosclerotic plaques. The operating principle is based on establishing an electric arc between a central electrode and the inside of an enclosing metallic tip to convert electrical energy to thermal energy. The metal tip catheter can be heated rapidly and boils water in a saline bath with less than 1 W of power. In vitro studies, using human atherosclerotic aortic segments, demonstrated that effective tissue ablation required more power in saline than in air (more than 9 W vs less than 1 W). The rate of tissue ablation varied with the amount of power delivered and the catheter tip pressure against tissue. In a saline field, 2-mm thickness aortic wall segments were consistently perforated in 3 seconds when 15 W of power and 20 g/mm2 of pressure were applied. Using an atherosclerotic rabbit, in vivo electrical thermal angioplasty (3 W of power for 10-second treatment sequences) was performed in obstructed iliofemoral vessels after mechanical recanalization was attempted. Of the 7 vessels that were more than 50% narrowed (compared with contiguous normal vessel diameter), mechanical recanalization was effective in only 1, but thermal angioplasty resulting in an increased lumen diameter was successful in 6 others. The recanalized segments were 8 to 10 cm; gross morphologic and histologic examination of recanalized vessels demonstrated little or no thermal injury. In addition, significant cholesterol-laden plaques remained in the vessel lumen, which appeared to have been compressed and displaced laterally.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3673911 TI - Components of left ventricular dysfunction discriminated noninvasively beat by beat. AB - Disturbed left ventricular contractility and synchrony were studied noninvasively beat by beat with simultaneous systolic time intervals and acceleration ballistocardiograms during quiet respiration. Thirty-six measures per beat, reduced to 7 by appropriate statistical methods, produced a linear discriminant function, based on a split training sample of 15 normal men (258 beats) and 9 men (149 beats) with proved myocardial infarctions. Validation tests on an independent set classified 89% of the beats from 12 tested normal subjects as "normal" and 96% of the beats from 6 tested men who had had infarction as "coronary-like," a physiologic, not etiologic, classification. In 14 hypertensive patients with no history or findings of coronary artery disease, 8 had 72 to 100% coronary-like beats per subject, suggesting unrecognized coronary artery disease, the cumulative effect of hypertension, or both. This method may help identify hypertensive patients at greater risk. Factor analysis found 4 discrete groups of the 7 discriminant variables that function together. Despite beat-to-beat variations due to respiration, myocardial dysfunction (when present) and individual differences, dysfunctional beats can be identified by these methods. They may also be applied to other multivariate data to extract the maximal information despite complex interactions. PMID- 3673912 TI - The effects of glucose on myocardial substrate utilization in acute myocardial infarction or angina pectoris. AB - Infusion of glucose-insulin-potassium during acute myocardial infarction has favorable clinical and hemodynamic effects, presumably as a result of decreased myocardial utilization of free fatty acids. In 14 patients with coronary artery disease, hypertonic glucose (a bolus of 10 g followed by infusion of a 30% glucose solution at a constant rate of 10 mg/kg/min) was infused and arterial and coronary sinus levels of glucose, lactate and free fatty acids were measured before and after 15 and 30 minutes of infusion. Arterial glucose and lactate levels increased significantly after glucose infusion, whereas free fatty acid levels decreased significantly. Modest but significant correlations also existed between glucose arterial levels and the arterial-coronary sinus glucose difference (r = 0.53, p less than 0.001); arterial lactate and the arterial coronary sinus lactate difference (r = 0.35, p less than 0.01); arterial free fatty acids; and the arterial-coronary sinus free fatty acid difference (r = 0.62, p less than 0.001). These results with a hypertonic glucose infusion are similar to those reported after infusion of glucose-insulin-potassium without the potential for harmful adverse effects from infusions of insulin or potassium. Therefore, infusion of hypertonic glucose may be beneficial in patients with coronary artery disease. Further work is necessary to study its effects in different subgroups of patients with coronary artery disease. PMID- 3673913 TI - Effectiveness of amiodarone on ventricular arrhythmias during and after acute myocardial infarction. AB - A randomized, placebo-controlled study examined the effect of amiodarone on the incidence of ventricular arrhythmias after acute myocardial infarction (AMI). Two hundred patients with AMI were randomized to receive amiodarone, 200 mg every 8 hours for 1 month, followed by 200 mg/day, or placebo, starting 48 hours after the onset of chest pain. Twenty-four-hour Holter monitoring was performed on day 1, repeated after 8 days and subsequently at 3-month intervals. One hundred seventy-two patients were followed for 6 to 42 months and monitor data were available at 6 to 9 months in 129 patients. Amiodarone was well tolerated, with no serious side effects; 12 patients were withdrawn from therapy. At 6 to 9 months more than 1 ventricular premature complex per hour was present in 3 of the 59 amiodarone-treated patients (5%) and 24 of the 70 placebo-treated patients (34%) (p less than 0.02). Complex arrhythmias (multifocal, early cycle, repetitive, bigeminy, trigeminy or ventricular tachycardia) were present in 5 of 59 of the amiodarone-treated patients (8%) and 20 of 70 placebo-treated patients (28%) (p less than 0.005). Sixteen patients in the amiodarone group and 11 in the placebo group died (difference not significant). Thus, amiodarone can reduce the frequency and complexity of ventricular arrhythmias after AMI, but it is unlikely that this will result in a substantial beneficial effect on post-AMI mortality risk. PMID- 3673914 TI - Prognosis in survivors of acute myocardial infarction occurring at age 70 years or older. AB - To identify prognostic factors in elderly persons who have survived acute myocardial infarction, 113 patients, aged 70 to 91 years (median 76), were followed for an average of 122 months (range 94 to 170). Eighty-four patients died, 61 (73%) from coronary artery disease. Overall mortality rates were 20.4% at 1 year, 30.1% at 2 years, 31.9% at 3 years, 45.1% at 4 years, 51.3% at 5 years and 69% at 10 years. Almost half (44%) of all deaths from coronary causes occurred in the first 2 years. Univariate analysis of 21 historical and clinical variables found several of prognostic significance: age, prior myocardial infarction, previous diastolic hypertension, history of diabetes mellitus, history of heart failure, presence of rales above the scapula, ventricular gallop, Killip class, cardiomegaly on admission chest x-ray and prescribing digitalis or diuretic at discharge. When these prognostic factors were entered into multivariate analysis, only Killip class (p less than 0.001) emerged as an independent predictor of survival. PMID- 3673915 TI - Efficacy of propranolol therapy after acute myocardial infarction related to coronary arterial anatomy and left ventricular function. AB - The effect of the beta-adrenergic blocking agent propranolol on morbidity and mortality risk after acute myocardial infarction was studied relative to coronary anatomy and left ventricular (LV) ejection fraction in a subset of 406 patients participating in a randomized study of 3,837 patients in the Beta Blocker Heart Attack Trial (BHAT). Median follow-up for this subset of patients was 28 months. The mortality rate was 2% (2 of 100) in patients with 2- and 3-vessel coronary artery disease taking propranolol and 10% (12 of 126) in those taking placebo (p less than 0.02). In patients with 2- and 3-vessel coronary artery disease with decreased LV function (defined as ejection fraction less than 50%), no patient taking propranolol died, whereas 17% (7 of 42) taking placebo died (p less than 0.04). The salutary effect of propranolol on mortality in the larger BHAT after acute myocardial infarction also was evident in this population studied in regard to their coronary and LV anatomy and function. PMID- 3673916 TI - Cardiac morphologic observations after operative closure of acquired ventricular septal defect during acute myocardial infarction: analysis of 16 necropsy patients. AB - Certain cardiac morphologic findings are described in 16 necropsy patients having operative closure of an acquired ventricular septal defect (VSD) during acute myocardial infarction (AMI). Of the 16 patients, 6 were women (mean age 69 +/- 7 years) and 10 were men (mean age 60 +/- 11 years). The AMI associated with the VSD was the first coronary event in 13 patients (81%). At least 6 patients had a history of systemic hypertension. Conduction disturbances were diagnosed by electrocardiogram in 5 patients (31%). The median interval from the onset of the AMI to death was 11 days, and from the onset of the AMI to operative closure of the VSD, 4 days. Eight patients died in the operating room or within 2 hours of operation. Coronary artery bypass grafting was performed simultaneously with the VSD closure in 7 patients. Death was attributed to unsuccessful VSD closure in 5 patients, to inadequate left ventricular cavity after resection of necrotic myocardium in 5 patients and to inadequate viable left ventricular myocardium in 4 patients. Heart weights were increased in 14 patients (88%). The AMI associated with the VSD was anterior in 9 patients and posterior (inferior) in 7. Healed myocardial infarcts were present in 3 patients. All 16 patients had severe (greater than 75% in cross-sectional area) narrowing of 1 or more of the 4 major epicardial coronary arteries. PMID- 3673917 TI - Diagnostic implications for myocardial ischemia of the circadian variation of the onset of chest pain. AB - To determine whether the occurrence of chest pain is randomly distributed during the day and to study whether the time of onset is useful in discriminating among causes of chest pain, patients older than 30 years who presented to 7 emergency departments with a chief complaint of chest pain unexplained by trauma or chest x ray abnormalities were studied. A total of 7,759 patients presented during the study period; of these, 3,990 presented within 6 hours of the onset of pain and were included in the primary analysis. Chest pain caused by acute myocardial infarction, unstable angina pectoris and stable angina pectoris was more likely to begin during the period from 6 AM to noon than would be expected if the onset were uniformly distributed during the day (relative risks 1.15, 1.29 and 1.32, respectively), but chest pain that was caused by nonischemic cardiac causes and by noncardiac causes was also more likely to begin during the same time period (relative risks 1.28 and 1.17). Although chest pain from coronary arterial causes had a distinct circadian variation, the time of onset of pain was not a helpful criterion for determining the cause of chest pain. PMID- 3673919 TI - Pulmonary acinus: geometry and morphometry of the peripheral airway system in rat and rabbit. AB - The geometry and morphometry of intraacinar airways in rat and rabbit lungs were studied from silicone rubber casts. Acini, defined as the complex of alveolated airways distal to the "terminal" bronchiole, were trimmed off the bronchial tree. In both species, the acinar volume followed a log-normal distribution over a range in size of one order of magnitude. At an inflation level of 60% total lung capacity, their mean volume was 1.86 mm3 in the rat and 3.46 mm3 in the rabbit. On a representative sample of acini of different volumes, the branching pattern was characterized as irregular dichotomy, and the segment length and inner and outer diameters were measured. The average acinus had a mean of six generations in the rat and seven in the rabbit. Both showed a decrease in segment length and inner diameter with each generation. The mean longitudinal pathway length--that is, the distance from the initial acinar segment to the terminal sacs--was found to depend on the cube root of the acinar volume in both species. It was calculated at 1.46 and 1.95 mm for rat and rabbit, respectively. PMID- 3673918 TI - Brain sizes, surfaces, and neuronal sizes of the cortex cerebri: a stereological investigation of man and his variability and a comparison with some mammals (primates, whales, marsupials, insectivores, and one elephant). AB - This study deals with the stereological estimation of macroscopic sizes of brain and cortex, i.e., volume, surface, and folding, and of microscopic neuronal sizes, i.e., density, mean size, size distribution, and number of neurons. The results show that the degree of variability in man amounts to about 15%. A decrease in volume of the different gray structures can be observed in man after the age of 65 years. The surface, folding index, and length of convolution do not alter with aging. The comparison with mammals of various sizes allows the conclusion that there is a high correlation to brain size for nearly all macroscopic values. Man and elephant, however, have a cortical surface which is, in comparison with whales, relatively small. In contrast, whales have very small cortices compared with man. At the cytoarchitectonic level, the neuronal density has a correlation to brain size. Contrary to other mammals, the primates and man have a high fraction of small granular neurons, especially in layer 4. The assumption that the number of cortical neurons beneath a given surface area of cortex is the same in all mammals cannot be verified, especially in those with large brains. The allometric connection between brain size and parameters is not valid for all measurements (e.g., thickness of cortex, mean size of neurons, perikaryal size distribution, and glial density). Yet some other measurements are well correlated. PMID- 3673920 TI - Schmidt-Lanterman clefts: a morphometric study in human sural nerve. AB - In the human sural nerve, large myelinated fibers contained 35 Schmidt-Lanterman (SL) clefts per mm, and small myelinated fibers contained only eight SL clefts per mm. The incidence of SL clefts is linearly related to myelin thickness. The SL clefts extended over 13 micron in large and over 9 micron in small fibers, the total extent of the SL region amounting to nearly 50% of internodal length in large and to 6% in small fibers. In the SL region, the fiber diameter was 6% larger than outside this region, and the axon was 17% smaller in large and 28% smaller in small fibers. The paranodal-nodal region occupied less than 2% of internodal length in large fibers and 6.5% in small fibers; in the nodal region the axon diameter was reduced by 40-50%. PMID- 3673921 TI - Passage of microspheres through vessels of normal and split hydronephrotic rat kidneys. AB - Microspheres (15 micron) were injected intracardially in rats. By means of in vivo microscopy of the split hydronephrotic kidney microcirculation, the passage of microspheres through renal blood vessels was analyzed. Additionally, three sets of experiments were conducted, one consisting of rats with normal kidneys, one of rats with hydronephrotic kidneys, and one of rats with hydronephrotic kidneys under vasodilation. In vivo microscopic as well as histological studies show that the passage of 15-micron microspheres is dependent on the postinjection interval. Microspheres are capable of locally dilating preglomerular vessels and moving towards the glomeruli. Therefore, estimates of preglomerular vessel diameters with microsphere experiments ought to be controlled by intravital microscopy. PMID- 3673922 TI - 1987 McCollum award lecture. Kinetics of human amino acid metabolism: nutritional implications and some lessons. AB - Clinical nutrition is an integrative science with the ultimate purpose of defining in quantitative terms the characteristics of an optimum nutritional intake in relation to a defined level of nutritional health. Thus, to achieve major progress in our field of clinical nutrition, data from the molecular, subcellular, cellular, and organ levels need to be exploited and considered in reference to the whole organism; this requires that we identify important unanswered questions for this latter and more complex, hierarchical level of biological organization and then pursue the answers with the aid of techniques and approaches used in and concepts emerging from all areas of modern biology. In relation to this, the present overview of some of the studies that my colleagues, my students, and I have conducted was meant to emphasize that there is considerable merit in attempting to explore the integrative aspects of the physiology and biochemistry of human nutrient metabolism, specifically of amino acids, with the aid of stable-isotope probes. Recognition of the importance of the phosphorylation and dephosphorylation of cellular proteins as a major regulatory process and of the regulation of leucine oxidation through changes in the activity of the branched-chain 2-Oxo acid dehydrogenase complex via a reversible phosphorylation catalyzed by a specific branched-chain dehydrogenase kinase and phosphatase is indeed exciting new knowledge. Following from this, Espinal et al state: "The activity of the complex determines the rate of degradation and the dietary requirement for branched-chain amino acids." However, the physiological situation cannot be appreciated simply in these terms because we showed that the rate of oxidation of leucine depends upon the tissue availability of the amino acid. Furthermore, our studies revealed that the regulation of leucine oxidation in the intact human appears to be achieved through biochemical mechanisms that are linked to the host's nutritional requirements. These observations and interpretations would not have emerged by considering only the enzymology of branched-chain amino acid metabolism; this underscores the value of exploring, through use of safe noninvasive tracer techniques, the communication of amino acid metabolism among different systems and how these systems might interplay to influence the nutritional needs of the individual. This recalls Fishman's advice: "Physiology has a special role to play here, for after probing the submicroscopic, life is left behind. It is physiology's responsibility to put together the lifeless pieces of the molecular biologist into living systems."(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3673923 TI - Carnitine in human polymorphonuclear leukocytes, mononuclear cells, and platelets. AB - We tried to study the distribution of carnitine in human blood. Total carnitine (free plus acylcarnitine) was determined in red blood cells, polymorphonuclear leukocytes, mononuclear cells, platelets, and plasma from 15 apparently healthy adults. We did not find carnitine in red blood cells but found it in significant amounts in polymorphonuclear leukocytes and mononuclear cells, 52.2 +/- 16.9 and 41.9 +/- 9.3 mumol/10(9) cells (mean +/- 1 SD), respectively. We also found that platelets contain carnitine in small amounts, 49.0 +/- 8.4 nmol/10(9) cells. In plasma the carnitine concentration was 51.5 +/- 3.3 mumol/L. We conclude that blood carnitine is localized mainly in polymorphonuclear leukocytes and mononuclear cells (83% of whole-blood carnitine). PMID- 3673924 TI - Interpretation of Z-score anthropometric indicators derived from the international growth reference. AB - The WHO international growth reference was reviewed to identify characteristics that might affect the interpretation of anthropometric indicators derived from it. Discontinuities were found at the junction point of the two distinct data sets from which the reference curves are derived. Also, the Z-score derived percentile curves for weight-for-age and weight-for-height did not join due to differences in the variances of the two portions of the reference. Empirically an examination of data from international nutrition surveys revealed an artifactual drop in the prevalence of low height-for-age, low weight-for-height, and high weight-for-height at age 2 y, which is due substantially to these discontinuities rather than to intrinsic changes in nutritional status with age. Strategies are discussed for the interpretation of anthropometric indicators in light of these characteristics of the international reference. PMID- 3673925 TI - Zinc and pregnancy outcome. AB - Total zinc needs during the last half of human pregnancy may be approximately 2.6 mg absorbed Zn/d. Adaptations in Zn utilization during pregnancy may help meet those needs. Possible adaptations include an increase in Zn absorption, reduced endogenous Zn loss, redistribution of tissue Zn, and an efficient maternal-fetal Zn transfer. A decline in circulating Zn concentration begins early in pregnancy and continues to term. The effect of gestational stage on circulating Zn should be incorporated into standards for serum Zn of pregnant women. Low maternal serum Zn levels have been associated with pregnancy-induced hypertension, abnormal parturition, and congenital anomalies. In studies done to date, Zn supplementation of 15-45 mg/d failed to improve pregnancy outcome except for a possible reduction in the incidence of a dysfunctional labor pattern. The relationship between Zn status and pregnancy outcome remains an open question. PMID- 3673926 TI - Whole-body protein turnover in adult hemodialysis patients as measured by 13C leucine. AB - Muscle wasting may occur in patients with chronic renal failure (CRF). To determine whether this is due to a decrease in the synthesis or an increase in the breakdown of muscle protein, we evaluated postabsorptive whole-body protein breakdown, oxidation, and synthesis rates at steady state during a primed, continuous infusion of 13C-leucine. This was done in seven subjects on chronic maintenance hemodialysis (MHD) and in seven normal control subjects. The protein breakdown rate in MHD was not different from that in controls (103 +/- 19 and 106 +/- 19 mumol leucine.kg-1.h-1, respectively). In MHD, however, the protein oxidation rate was 43% greater than that in controls (20 +/- 6 and 14 +/- 4 mumol leucine.kg-1.h-1, p less than 0.05), whereas net protein synthesis was less (p less than 0.05). Reduced net synthesis and increased oxidation rates of protein in the postabsorptive state may therefore contribute to the muscle-wasting syndrome in patients with CRF. PMID- 3673927 TI - Polysiloxane: potential noncaloric fat substitute; effects on body composition of obese Zucker rats. AB - Phenylmethylpolysiloxane (PS), a noncaloric, nonabsorbable liquid oil, was studied for effects on body comparison as fat substitute in the diet. Two groups of female obese Zucker rats were fed either a control low-fat (LF) or an experimental diet containing PS (22% wt/wt) incorporated into LF. Two additional groups were fed either PS or cellulose (CE) in diet providing equivalent caloric dilution. Rats on PS lost weight whereas LF control rats gained. Dissectible fat and adipocyte size of PS were smaller than those of LF. Food intake, body water, and adipocyte number did not differ between PS and LF. Body protein on PS increased only in proportion to weight. When both diets were diluted, PS animals lost more weight than CE controls despite similar food intakes, suggesting absorption of calorigenic substances derived from partial digestion of CE but not PS by intestinal microflora. Obese rats did not compensate for caloric dilution with PS. PMID- 3673928 TI - Biochemical indices of human vitamin C status. AB - Biochemical indicators of ascorbic acid (AA) status were studied in eleven young adult males fed the same AA deficient diet for 14 wk in a live-in metabolic unit. Supplements of AA were added to the diet to give AA-intake periods of 65 mg/d (2 wk), 5 mg/d (4 wk), 605 mg/d (3 wk), 5 mg/d (4 wk), 605 mg/d (4 d), and 65 mg/d (3 d). Blood plasma, erythrocyte, and leukocyte AA levels all reflected AA intake, however, plasma AA showed less variability than red cell AA levels and was considerably easier to determine than leukocyte AA. Plasma AA values less than 0.40 mg/dL (23 mumol/L) reflected marginal AA status. The daily AA intake calculated to maintain plasma AA levels of at least 0.4 mg/dL (23 mumol/L) in healthy young men was 41 mg. The average AA intake estimated to maximize the total body pool was 138 mg/d. Urine and salivary AA levels were not useful indicators of AA status because urinary AA levels did not discriminate well between adequate and deficient AA intakes and salivary AA levels did not consistently reflect AA intake. PMID- 3673929 TI - Mild vitamin A deficiency and childhood morbidity--an Indian experience. AB - Over 1500 preschool urban Indian children were followed weekly for morbidity from 12 to 18 mo. Examination for mild xerophthalmia (Bitot's spots and night blindness) was done initially and at 6 and 12 mo. Children with mild xerophthalmia at the start of a 6-mo interval developed respiratory disease in the interval twice as often as children with normal eyes at the start of the interval. No association was found between mild xerophthalmia and incidence of diarrhea. PMID- 3673931 TI - Folic acid: effect on zinc absorption in humans and in the rat. AB - The effect of folic acid on zinc absorption and utilization was studied in humans and in rats. Serum Zn response curves after a 25-mg oral dose of Zn was measured for 4 h with and without 10 mg folic acid. The increase in serum Zn expressed as AUC (area under the curve) was 57 mumol/L for Zn alone and 65 mumol/L with folate. Zn intragastric intubation experiments with rats showed that adding 4.4 or 176 micrograms of folate to test meals containing 13 micrograms Zn did not affect the bioavailability of Zn as measured by the retention of 65Zn by the liver and kidney. A 3-wk feeding test carried out with diets containing either 6 or 12 mg Zn/kg diet showed that adding either 2 or 160 mg of folic acid had no effect on growth or Zn uptake by the femur. These results do not indicate any inhibition of Zn utilization by folic acid. PMID- 3673930 TI - Flavin catabolites: identification and quantitation in human urine. AB - Riboflavin is the primary flavin excreted in human urine but significant amounts of 7 alpha-hydroxyriboflavin and lesser amounts of 8 alpha-hydroxyriboflavin are present and reflect tissue microsomal oxidations. A newly found flavin catabolite of an 8 alpha-sulfonyl type may reflect intake and/or turnover of such thioether linked flavin as occurs in monoamine oxidase. Additionally, lesser amounts of 10 hydroxyethylflavin (indicative of intestinal microbial action on the vitamin) and traces of lumiflavin (arising from photodecomposition) constitute part of the remaining flavin, which acutely reflects level of intake. PMID- 3673932 TI - Screening test for iron overload. AB - It is presently estimated that 2-3/10(3) people living in the United States are homozygous for the iron-loading gene and are thereby susceptible to severe iron overload. The complications of this disorder can be prevented if recognized in the asymptomatic precirrhotic stage. We have developed a simple, inexpensive screening method for its early laboratory detection based on the fact that one of the earliest laboratory manifestations of hemochromatosis is a reduction in unsaturated iron-binding capacity. The sequential addition of a small measured quantity of saturating iron and bathophenanthroline disulfonate will result in color with highly saturated but not with normal sera. This screening test almost completely differentiated between 40 normal individuals and 40 patients with iron overload (as defined by a transferrin saturation greater than 55%). The test provides a cost-effective method for screening large segments of the population to detect this genetic disorder. PMID- 3673933 TI - Nonradioisotopic method for measuring iron absorption from a Gambian meal. AB - Iron absorption from a typical Gambian meal of rice with groundnut sauce was measured by the fecal balance technique in nonanemic adult males with 58Fe as an extrinsic label and neutron activation analysis and compared with ferrous sulphate. Gambian men had a higher efficiency of absorption than UK volunteers but the availability of the food Fe was approximately half that of ferrous sulphate in both groups of subjects. PMID- 3673934 TI - Discriminant biochemical markers for evaluating the nutritional status of elderly patients in long-term care. AB - To determine the most discriminant serum markers of protein-energy status in elderly patients, we performed a discriminant analysis of 85 subjects grouped according to triceps skinfold and midarm circumference values as compared with reference percentiles. Results indicated that neither the classic serum indices of nutritional assessment nor retinol-binding protein can predict undernutrition. However, creatinine, urea, carotene, complement C3, and prealbumin included in a function enabled high discrimination between groups: 68% of subjects in 0-5th percentile for triceps skinfold and 75% of subjects in 0-5th percentile for midarm circumference are correctly predicted. Lower serum concentration was found in the lower anthropometric percentiles except for serum carotene, which showed an inverse relation not explained by diet. We found that nutritional alterations exist in hospitalized elderly patients. We emphasize the importance of considering several biochemical markers for detection of mal-nutrition and the pertinency of further exploration of serum carotene profiles in undernourished elderly patients. PMID- 3673935 TI - Medium-chain triglyceride storage in adipose tissue of orally fed infants. PMID- 3673936 TI - Folates in human milk. PMID- 3673937 TI - Stature as body conductor length for whole-body resistance. PMID- 3673938 TI - Importance of previous nutritional status. PMID- 3673939 TI - Immunohistochemical characteristics of proliferative and metaplastic lesions in bronchial mucosa. AB - To elucidate the characteristics of metaplastic changes of bronchial mucosa, the distribution of four epithelial antigens and two subtypes of enolases was studied immunohistochemically. The authors classified the metaplastic changes into three types: basal cell hyperplasia, stratification, and squamous metaplasia. Secretory component (SC) was detected in all lesions with stratification and in three of ten lesions of squamous metaplasia. Epithelial membrane antigen (EMA) was localized not only on the luminal surfaces but also among the stratified layers of metaplastic epithelium. No carcinoembryonic antigen (CEA) was detectable in normal epithelium, whereas almost all metaplastic lesions had both nonspecific cross-reacting antigen (NCA) and CEA immunoreactivity. In normal mucosa, basal cells were strongly positive for alpha-enolase but negative for gamma-enolase, and columnar cells expressed both enolases. In areas of metaplasia, alpha-enolase was present throughout the layer, but gamma-enolase was absent. These immunohistochemical findings suggest that metaplastic squamous epithelial cells have glandular differentiation and that several biochemical and metabolic aberrations occur during the process of metaplasia. PMID- 3673940 TI - Detection of DNA abnormalities by flow cytometry in cells from cerebrospinal fluid. AB - To evaluate the diagnostic utility of flow cytometry (FCM) as compared to cytology, DNA and RNA content of cells were measured in 233 samples of cerebrospinal fluid (CSF) from 147 patients with solid tumors or lymphomas and 17 controls with nonmalignant disorders. All control specimens were normal. Twenty eight samples were abnormal: 20 showed an aneuploid peak and 8 an increased number of cells with DNA content in the S and G2M phases of the cell cycle. Of these 28, cytologic results were positive in 18, suspicious in 3, and negative in 7. All but one of the suspicious and negative cases had confirmatory laboratory and/or radiographic evidence of leptomeningeal metastasis within one week of FCM examination. Cytologic results were positive in eight samples negative by FCM. Compared with cytology, the sensitivity of FCM was 69% and the specificity 95%. Abnormal DNA content by FCM can be a useful adjunct to cytologic examination. PMID- 3673941 TI - Abnormalities of blood coagulation tests in patients with cancer. AB - Routine blood coagulation tests were performed on 431 consecutive patients enrolled in a study of the role of anticoagulation in cancer treatment (VA Cooperative Study #75). Two hundred sixteen control patients were treated with standard therapy, and 215 patients were treated with standard therapy plus sodium warfarin. At the time of entry into the study, the most common abnormalities were elevated fibrinogen levels, platelet counts, and fibrinopeptide A levels. Serial studies demonstrated a steady increase in platelet count and fibrinogen levels before death. Anticoagulation lowered FPA levels but had no significant effect on fibrinogen levels, platelet counts, or euglobulin clot lysis times. An unexpected finding was a dramatic increase in fibrin split product levels after institution of anticoagulation (means +/- SEM = 42.6 +/- 116.4 vs. 2.9 +/- 7.0 mg/L in control subjects; P less than 0.02). This study supports the presence of subclinical activation of blood coagulation in most patients with cancer. Moreover, the preferential activation of fibrinolysis in anticoagulated patients suggests a role for a vitamin K-dependent factor(s) in the regulation of fibrinolysis in patients with cancer. PMID- 3673942 TI - A clinical evaluation of the Cobas Fara clinical chemistry analyzer for some routine serum enzymes and glucose. AB - The authors evaluated the Cobas FARA centrifugal analyzer with respect to pipetting precision and accuracy, instrument temperature, spectrophotometric response, and analytic performance for the assay of five serum enzymes and glucose. Spectrophotometric response, temperature response, pipetting precision, and accuracy were satisfactory. However, sufficient time must be allowed for cuvet contents to reach a stable temperature before measurements are made. Total day-to-day imprecision (within plus between run) was less than 5% (coefficient of variation) for aspartate and alanine aminotransferases (AST; Enzyme Commission classification number [EC] EC 2.6.1.1; and ALT; EC 2.6.1.2); alkaline phosphatase (AP; EC 3.1.3.1); gamma-glutamyltransferase (GGT; EC 2.3.1.2); lactate dehydrogenase (LD; EC 1.1.1.17); creatine kinase (CK; EC 2.7.3.1); and glucose assays. Results compare well with those obtained with other current clinical chemistry analyzers; correlation coefficients were greater than 0.993. Sample-to sample carryover was negligible, and method linearity was satisfactory for all tests. PMID- 3673943 TI - Low-grade fibromyxoid sarcoma. A report of two metastasizing neoplasms having a deceptively benign appearance. AB - Two deceptively benign-appearing, unclassifiable but very similar fibromyxoid sarcomas characterized histologically by bland, innocuous-appearing fibroblastic cells and a swirling, whorled growth pattern are presented. The tumors both occurred in women in their late twenties and were located in the soft tissues of the scapular area and the axillary-chest wall area, respectively. Lung metastases developed in both cases; one patient died 94 months after excision of the primary neoplasm, whereas the other was alive at 82 months. The designation "low-grade fibromyxoid sarcoma" is suggested for these tumors. PMID- 3673944 TI - Leukemic blasts detected by the Technicon H-1 blood cell counter. AB - The authors studied the usefulness of the flagging system of the Technicon H-1 Cell Counter using samples from 45 patients with acute leukemia, 24 with acute lymphoblastic leukemia (ALL), and 21 with acute nonlymphoblastic leukemia (ANLL). Results by the automated method were compared with those by the eye-count method. Four out of 24 specimens were falsely negative; no false positive results were found. For ANLL specimens, there were no false positives or negatives. When 1% or more of the cells were blasts by the eye-count method, the automated system almost always flagged the sample. The results suggested that the flagging system programmed in the H-1 is useful for the diagnosis and follow-up of leukemia. PMID- 3673945 TI - Performance characteristics of Bull's multirule algorithm for the quality control of multichannel hematology analyzers. AB - The multirule quality control procedure for interpreting Bull's moving averages, proposed by Levy and colleagues (Am J Clin Pathol 1986; 85: 719-721.), has been evaluated by computer simulation with the use of the approach of Cembrowski and Westgard (Am J Clin Pathol 1985; 83: 337-345.). With this procedure, a batch of patient specimens is rejected if either of two criteria are satisfied: (1) the Bull's mean of one of the red blood cell indices is outside its 3% limits, or (2) the average of three consecutive Bull's means is outside its 2% limits. Power function curves were used to summarize the performance of the multirule approach and demonstrated error-detection capabilities that are superior to the more common implementation of Bull's algorithm using 3% limits for single Bull's means. The increased error detection achieved by the multirule procedure allows shifts in hemoglobin and mean corpuscular volume to be more readily detected but also results in the detection of small shifts in red blood cell count. A modified multirule procedure was also tested and was found to be ineffective. The authors recommend the multirule of Levy and colleagues but caution that its use may result in the detection of small shifts in the red blood cell count. PMID- 3673946 TI - A neoplasm with pancreatic and hepatocellular differentiation presenting with subcutaneous fat necrosis. AB - A neoplasm demonstrating both pancreatic and hepatic phenotypes is described. The tumor, from a 53-year-old woman with the syndrome of subcutaneous fat necrosis and arthropathy, was studied histologically, immunohistochemically, ultrastructurally, and biochemically. The clinical features of this case can be explained by the production of large amounts of lipase by the tumor. The hepatocellular properties of the tumor included characteristic morphology and the synthesis of catalase. The pancreatic properties of the tumor included the production of pancreatic lipase. This neoplasm would appear to be analogous to animal models in which the transdifferentiation of pancreatic acinar cells and hepatocytes has been demonstrated. Although the bulk of the tumor was present in the liver, the authors believe the tumor arose from the pancreas. The distinction between differentiation and site of origin of tumors is discussed. PMID- 3673947 TI - Cerebral cysticercosis in a 22-month-old infant. AB - A case of cerebral cysticercosis is described in a 22-month-old infant from northern California who presented with a right-sided focal seizure. Unusual features were her young age; a single, enlarging, frontoparietal mass lesion; and apparent lack of history of exposure to an endemic area. PMID- 3673948 TI - Desirable standards for hematology tests: a proposal. AB - Few analytic goals have been proposed for hematology tests, and these are based upon subjective clinical opinions. It is proposed that the current consensus strategies for delineating analytic goals in clinical chemistry can be validly used in the other disciplines of clinical pathology. Goals for imprecision are best based upon average intraindividual biologic variation; such goals are more stringent than those previously published. There are many cogent reasons that justify the goal for inaccuracy of no bias. In consequence, goals for imprecision should be viewed as goals for total laboratory error. Further experimental work on biologic variation is required to develop a wider range of goals for hematology and coagulation tests, if these strategies are considered worthy of adoption. PMID- 3673949 TI - Megatrends in pathology practice: implications for residency training. Ninth Conference for pathology residency program directors--a summary. AB - The participants at the Ninth Conference for Pathology Residency Program Directors clearly identified the important trends, the problems, and the opportunities now confronted by the specialty of pathology. Equally important, the speakers identified changes that should be incorporated into residency programs if we are to provide the training and education for practice in a changing medical environment. Evaluations of the program by the participants indicated it had been a valuable conference and it should be maintained as a part of each annual American Society of Clinical Pathologists/College of American Pathologists Fall Meeting. PMID- 3673950 TI - Primary prevention of behavior problems in Mexican-American children. AB - A primary prevention program, the Houston Parent-Child Development Center, directed towards infants and their parents, has effectively reduced the frequency of behavior problems for these children 5 to 8 years after the program's completion. Teacher ratings showed significantly fewer acting-out, aggressive behaviors for program children. Ratings of classroom behaviors found program children significantly less hostile and more considerate than control boys. This appears to be the first primary prevention program to have demonstrated effectiveness in reducing behavior problems over such a long time. PMID- 3673951 TI - Teacher ratings of children's problem and competence behaviors: normative and parametric characteristics. AB - Teacher-rated adjustment differences among young elementary school children from (a) a recent sample and a 1974 cohort, and (b) urban/suburban, male/female, and grade-level subgroups were examined. A problem behavior checklist (Classroom Adjustment Rating Scale) and a school competence measure (Health Resources Inventory) for 974 children from 5 urban and 5 suburban schools were completed by 101 first- to fourth-grade teachers. Children from the more current cohort were rated as significantly more maladjusted than those from the earlier sample on 8 of 10 adjustment variables. In the recent sample, girls and suburban children evidenced a greater number of school competencies and fewer problem behaviors than boys and urban children, respectively. The implications of these findings for the future use of the teacher rating scales are discussed. PMID- 3673952 TI - Sex differences in professional help seeking among adult black Americans. AB - This paper provides baseline data on sex differences in the use of professional help for serious personal problems in a nationally representative sample of adult black Americans. Bivariate analyses revealed that women had higher levels of psychological distress and were significantly more likely to seek professional help than were men. They were also more likely to utilize physicians and social service agencies. The relationship of gender to these help resources remained significant even when the effects of problem severity and differential problem definition were taken into account. Controlling for income, however, eliminated the sex difference for social services use but not for physician use. PMID- 3673953 TI - Divorcing mothers and social support: testing the specificity of buffering effects. AB - The circumstances under which social support buffers the negative effects of stress have been a subject of much research. The hypothesis that social support is effective only when it matches the needs elicited by particular stressors was studied in a sample of divorcing mothers. Predictions were made regarding which types of support (Parenting, Emotional, and Tangible) would buffer the effects of Parenting, Social, and Tangible stress on depressive symptoms and on general psychological distress of divorcing mothers. Results did not support the specificity of social support buffering effects, though the stress and support scales often showed direct relationships to criterion measures. Implications were discussed for the assessment of support with multiple models, for future research designs, and for planning prevention programs to meet the needs of divorcing mothers. PMID- 3673954 TI - Professional involvement in self-help groups for parents of high-risk newborns. AB - Patterns of professional involvement and control in self-help groups were studied through a questionnaire completed by representatives of 63 self-help groups for parents of high-risk newborns located throughout the United States. Results indicated that when professionals began a group, they were likely to continue to maintain control over it. Groups controlled by professionals were more likely to utilize professional counseling as a form of support and less likely to provide outreach services to parents following hospital discharge of their infants. Group stability, growth, and innovation were associated with more consultation between parents and professionals in the planning process. PMID- 3673955 TI - Negative implications of fragmented public perspectives toward local alcohol programs. AB - Strengthening local alcohol programs so as to emphasize primary prevention is an active concern among mental health professionals; yet interventions intended to achieve this aim have produced only modest shifts in program orientation in most communities. An analysis of data obtained from those active in local affairs in a small community, using Q-sort techniques, suggested that contrasting perspectives toward alcohol abuse as a social problem may stand as an unseen barrier to relevant change. PMID- 3673956 TI - Citizen participation in police crisis intervention activities. AB - A naturalistic experiment tested the proposition that police time could be saved in nondangerous crisis intervention calls through the use of citizen participants. Results showed that police officers who used citizen intervention spent less time per call than officers who did not. However, police time was not saved in family disturbance calls. Family disturbance control group calls were rated by police as having a higher degree of physical danger present than other calls. PMID- 3673957 TI - Race differences in professional help seeking. AB - Using data from two national surveys, findings from this research indicated that blacks were more likely than whites to seek help from mental health professionals, particularly for economic and physical health problems. Blacks also sought help more often than whites from other sources of professional help, such as teachers, lawyers, social workers and emergency rooms. On the other hand, whites were more likely to seek help from medical sources for all types of problems, and from clergy members. PMID- 3673959 TI - Transfusion-associated HIV infection in a neonate from a seronegative donor. PMID- 3673958 TI - The self-help clearinghouse concept: an evaluation of one program and its implications for policy and practice. AB - Many clearinghouses have been organized within the last decade to promote mutual aid and to provide referral information about self-help groups to potential members. Few of the assumptions that underpin the operation of these programs have been evaluated, however. This paper presents an evaluation of the Self-Help Information Service, a clearinghouse integrated with a generic information and referral service. The results were generally positive with respect to operator and consumer satisfaction, community responsiveness, and the system's capacity to undertake numerous service and research functions. They also pointed up several changes that might be made to improve the system's impact. It is concluded that a new practice specialty might be developed within a clearinghouse context, and that the clearinghouse concept might serve as one cornerstone of a funding policy that supports the self-help approach. PMID- 3673960 TI - Microbiology of intra-abdominal abscesses in children. PMID- 3673961 TI - Scarring retinopathy of prematurity. PMID- 3673962 TI - Antenatal hypoxia and IQ values. PMID- 3673963 TI - The pediatric residency program of the future. III. Modifying pediatric residency training programs. PMID- 3673964 TI - The pediatrician and the innocent heart murmur. PMID- 3673965 TI - Impact of maternal drug dependency on birth weight and head circumference of offspring. AB - The impact of maternal opiate dependency on birth weight and head circumference of offspring was studied in 150 mother-infant pairs and 150 controls. Mean birth weight and head circumference of drug-dependent offspring were reduced symmetrically compared with drug-free controls of similar socioeconomic status. Although mean gestational ages and rates of prematurity were similar, intrauterine growth retardation occurred in 20% of passively addicted infants vs 4% of controls. A longer period of methadone maintenance was associated with longer gestation and increased birth weight, while higher methadone dosages were associated with higher birth weights and larger head circumferences. Smoking was associated with reduced birth weight by an average of 160 g per pack of cigarettes smoked per day; longer duration of smoking was associated with reductions in both birth weight and head circumference. These data suggest therapeutic strategies to improve these fetal growth characteristics and perhaps improve neurobehavioral outcome of drug-dependent newborns. PMID- 3673967 TI - The clinical course and echocardiographic features of Marfan's syndrome in childhood. AB - The clinical and echocardiographic manifestations in 25 patients with Marfan's syndrome diagnosed during infancy and childhood (mean [+/- SD] age, 8.1 +/- 4.8 years; range 0 to 16 years) were evaluated. Twenty-one patients (84%) had a midsystolic click, 11 patients (44%) had mitral regurgitation (MR), and five patients (20%) had combined MR and aortic regurgitation (AR). Echocardiography demonstrated mitral valve prolapse in all 25 patients, aortic root dilatation in 20 patients (80%), AR in seven patients (28%), and aortic aneurysm in five patients (20%). During the follow-up period (mean, 5 +/- 4.5 years), progressive AR and aortic aneurysm were documented in four patients, progressive MR in three patients, and progressive aortic root dilatation in two patients. Five patients (22%) died during the follow-up period. Among patients with a positive family history of Marfan's syndrome, MR was less frequent as compared with sporadic cases (29.4% vs 75%, respectively). Progressive cardiovascular involvement was more frequent among patients diagnosed before 10 years of age compared with those diagnosed later (60% vs 12.5%, respectively). Cardiovascular involvement was a common feature of childhood Marfan's syndrome, causing significant morbidity and mortality. Sporadic cases and children diagnosed before 10 years of age represented a particularly high-risk group. PMID- 3673966 TI - A new hypospadias-mental retardation syndrome in three brothers. AB - Three brothers had a syndrome of hypospadias and mental retardation in association with microcephaly, craniofacial dysmorphism, joint laxity, and beaked nails. No other family members were affected, and this previously undelineated condition appears to be inherited in either an autosomal recessive or X-linked recessive mode. PMID- 3673968 TI - Endemic, multiply resistant Staphylococcus aureus in a pediatric population. Clinical description and risk factors. AB - During a seven-year period, 38 children acquired multiply resistant Staphylococcus aureus (MRSA) after admission to a pediatric service. Eighteen children were thought to be colonized. Twenty-three infectious episodes occurred in the remaining 20 children. Infections included endocarditis (n = 2), pneumonia (n = 8), burn infection (n = 1), postoperative wound infection (n = 6), intra abdominal abscess (n = 1), catheter sepsis (n = 2), urinary tract infection (n = 1), conjunctivitis (n = 1), and central nervous system shunt infection (n = 1). When patients infected with MRSA were compared by multivariate analysis with control subjects matched for age and unit of admission, patients with MRSA were hospitalized longer, underwent more surgical procedures, received more intravenous alimentation, and were more likely to require a tracheostomy; no correlation was found with administration of antibiotics. Twenty-six of the 34 discharged patients remained colonized with MRSA. Mortality in the infected patients was 20% (4/20), with a 38% (3/8) mortality rate for MRSA pneumonia. PMID- 3673969 TI - Parenting and the pediatrician. PMID- 3673970 TI - Therapy in short children with subnormal integrated concentrations of growth hormone. AB - We evaluated the effect of growth hormone (GH) therapy on the posttreatment growth of 11 poorly growing children who had normal GH response to provocative stimuli but subnormal integrated concentrations of GH. Patients received 0.1 U/kg of GH three times per week. Their mean (+/- SD) growth rate increased from 3.3 +/ 1.0 cm/y before treatment to 6.5 +/- 1.4 cm/y after eight months of treatment. The growth rates of five patients declined to below 4.5 cm/y four months after treatment. Three of these patients resumed GH therapy and again responded with increased growth velocity (8.0 +/- 1.2 cm/y). After therapy, the growth rate of five remaining patients continued to be greater than 4.5 cm/y (6.8 +/- 1.4 cm/y). Two of these patients had entered puberty and their posttreatment growth rate might have been due to a pubertal growth spurt. The three prepubertal patients in this group had a gradual decline in growth velocity to 3.8 +/- 1.0 cm/y by the end of 12 posttreatment months. We conclude that maintenance of normal growth in patients with this pattern of GH deficiency is dependent on GH replacement therapy. PMID- 3673971 TI - Capillary and venous bilirubin values. Are they really different? AB - We measured total serum bilirubin values in paired capillary and venous samples from 79 untreated jaundiced newborn infants (group 1) and in 29 infants who were receiving phototherapy (group 2). While bilirubin values from the two sites correlated significantly for both groups, capillary samples underestimated venous bilirubin values when the latter exceeded 170 mumol/L (10 mg/dL) (mean and 95% confidence limits: group 1, -15.1 mumol/L [-0.9 mg/dL] and -24.7 to -5.5 mumol/L [-1 to -0.3 mg/dL]; group 2, -10.3 mumol/L [-0.6 mg/dL] and -17.1 to -3.4 mumol/L [-1 to -0.2 mg/dL]). Furthermore, capillary samples underestimated venous bilirubin levels by more than 17 mumol/L (1 mg/dL) in eight of 16 group 1 patients and five of 18 group 2 patients when venous bilirubin values exceeded 170 mumol/L (10 mg/dL). Lower capillary values at higher bilirubin levels might be due to the influence of environmental light. As clinical treatment decisions may be made on the basis of differences in serum bilirubin level of about 17 mumol/L (1 mg/dL) and as capillary samples may underestimate venous bilirubin levels by a similar amount, it may be prudent to measure venous rather than capillary bilirubin levels when the total serum bilirubin level exceeds 170 mumol/L (10 mg/dL). PMID- 3673972 TI - Recognition of coarctation of the aorta. A continuing challenge for the primary care physician. AB - Coarctation of the aorta (CoA) in its classic form presents with characteristic and distinctive physical findings. However, in our survey less than one third of 106 consecutive patients in whom CoA was ultimately diagnosed had the correct diagnosis made by the referring physician. Our survey suggests that in asymptomatic infants and children, an incomplete physical examination explains the diagnostic failure. However, in infants presenting with heart failure, the diagnostic signs of CoA may be obscured and more difficult to recognize even when specifically sought. This survey reaffirms the need for specific physical examination techniques in all infants and children to facilitate early recognition of CoA; these include the palpation of pulses and proper measurement of blood pressure. PMID- 3673973 TI - Investigation of pediatric hypertension. Use of a tailored protocol. AB - Using a comprehensive protocol, the efficacy of simple clinical data, including history, physical examination, and urinalysis, in the discrimination of essential or secondary hypertension was investigated by a review of 103 patients, aged 2 weeks to 18 years, consecutively referred for investigation. Essential hypertension (55/103 mm Hg) was the most common diagnosis, even in infancy, whereas various renal disorders formed the next most common diagnostic category (21/103 mm Hg). Family history and the presence of "fixed" vs "labile" hypertension were of no value in detecting secondary hypertension. Urinalysis was useful in detecting inflammatory renal lesions but not structural disorders of the kidney. This study emphasizes the need for thorough investigation, including renal imaging, of asymptomatic hypertensive children and suggests a useful protocol to achieve this end. PMID- 3673974 TI - Serum beta-carotene, retinol, and alpha-tocopherol levels during mineral oil therapy for constipation. AB - Twenty-five children with chronic constipation underwent serial monitoring of serum beta-carotene, retinol (vitamin A1), and alpha-tocopherol (vitamin E) levels during mineral oil therapy. Mineral oil was administered between meals. Patients were monitored for up to four months of therapy. Mean serum beta carotene levels fell from 1.0 +/- 0.5 mumol/L (55.7 +/- 26.0 micrograms/dL) to 0.7 +/- 0.4 mumol/L (35.9 +/- 22.1 micrograms/dL) after the first month of mineral oil therapy and remained depressed throughout the remainder of the study. Serum alpha-tocopherol levels remained unchanged throughout the observation period. There was a modest increase in serum retinol levels during the study, especially after three months (from 1.48 +/- 0.84 mumol/L [42.3 +/- 24.1 micrograms/dL] to 2.22 +/- 0.77 mumol/L [63.5 +/- 22.1 micrograms/dL]). We conclude that while a short course of mineral oil can induce a reduction in the serum level of beta-carotene, the treatment has no adverse effect on serum levels of retinol and alpha-tocopherol. PMID- 3673975 TI - Is medical therapy effective for regional lymphadenitis following BCG vaccination? AB - We describe 120 patients with regional lymphadenitis following intradermal BCG vaccination. Seventy-eight of the patients were given medical therapy to prevent drainage and suppuration, and 42 patients were followed up without such treatment. The medical therapy group is divided into three subgroups: 36 were given erythromycin stearate, 21 isoniazid, and 21 isoniazid plus rifampin. No statistical difference in the incidence of spontaneous drainage and suppuration was found between the "no therapy" and the "medical therapy" groups. No significant superiority of any specific therapy was shown. If lymphadenitis develops rapidly (in two months), the incidence of spontaneous drainage and suppuration is significantly higher than in patients with slowly developing lesions. Total surgical excision is recommended to prevent spontaneous drainage and chronic suppuration in these rapidly evolving instances. PMID- 3673976 TI - Hemophilia presenting with intracranial hemorrhage. An approach to the infant with intracranial bleeding and coagulopathy. AB - Intracranial hemorrhage (ICH) in the newborn or young infant is an uncommon presenting manifestation of hemophilia. Its occurrence is almost always preceded by mild-to-moderate head trauma, unlike adult hemophiliacs in whom ICH occurs without prior head injury in 50% of cases. The bleeding event may follow a minor complication of labor or delivery (eg, prolonged second-stage labor or the use of forceps). Recent experience at our institution, a major tertiary care children's hospital, indicates that the diagnosis of hemophilia is often overlooked in a young infant presenting with ICH, a history of perinatal or postnatal head injury, and a prolonged activated partial thromboplastin time (PTT). Three young infants with hemophilia (two moderate cases and one severe case) presented with head trauma and were later found to have factor VIII deficiency. Despite prolongation of the preoperative PTT in each case, hemophilia was not considered before neurosurgery was performed. In one case, PTT prolongation was ascribed to tissue thromboplastin-induced intravascular coagulation. There was one death secondary to overwhelming intraventricular hemorrhage and iatrogenic bacterial ventriculitis. Some specific diagnostic and therapeutic recommendations are provided to assist the clinician in evaluating a child with ICH and a prolonged PTT who is in need of immediate neurosurgery. PMID- 3673977 TI - Early detection of congenital cardiovascular malformations in infancy. AB - In an ongoing population-based study of congenital cardiovascular malformations in the Baltimore-Washington, DC, area, 1527 affected infants were ascertained from multiple sources during the years 1981 to 1984. Ninety-eight percent were evaluated at a regional pediatric cardiology center. Among the unreferred cases, in which the cardiac defect was diagnosed only at autopsy, most infants died in the first week of life and had associated problems, such as low birth weight, major noncardiac malformations, or other life-threatening illnesses, but a few infants with potentially remediable heart disease escaped clinical detection. Until preventive measures become available, reduction of infant mortality due to congenital cardiovascular malformations will continue to depend on early recognition of signs of serious heart disease in infants and on effective community-wide use of specialized cardiac services. PMID- 3673978 TI - Antidiuretic hormone excess in infant botulism. AB - Two infants developed evidence of antidiuretic hormone excess as a complication of infant botulism. Neither child received mechanical ventilatory support before the development of hyponatremia, serum hyposmolality, and urinary hyperosmolality. Both infants responded to fluid-intake restriction. The appearance of hyponatremia in an infant with botulism should suggest antidiuretic hormone excess. The recognition of this entity will lead to its appropriate management with fluid-intake restriction. PMID- 3673979 TI - Teenage suicide in King County, Washington. I. Rates of suicide for 26 years. AB - The population-adjusted rate of teenage suicide in King County, Washington, was reviewed for the 26 years from 1959 to 1984. For the entire period, the rate did not change significantly. An abrupt change did occur during the middle of this period, but, for reasons discussed in the text, this may well represent a change in procedures and philosophy of death certification rather than a real change in rate. Reasons for the apparent discrepancy with national statistics are discussed. PMID- 3673980 TI - Teenage suicide in King County, Washington. II. Comparison with adult suicides. AB - The 25 teenage suicides that occurred in King County, Washington, during 1983 and 1984 were compared with the 158 adult suicides that occurred during 1984. The comparison included the following features: sex, race, declaration of intent, motive, method, isolation, alcohol or drug intoxication at the time of death, prior suicide threats and attempts, counseling history and diagnosis, and family history of suicide. For the teens, we also queried school or employment status, anxiety-producing experiences, symptoms of depression, marital history of the parents, and number and order of siblings. PMID- 3673981 TI - Diffuse axonal injury by assault. AB - A case of diffuse axonal injury (DAI) by assault is reported. The majority of DAI cases documented have been due to traffic accidents and some due to falls from height. DAI is caused by angular or rotational acceleration of the victim's head. The condition is common and is the second most important head injury after subdural hematoma with regard to death. Its clinical picture is characterized by immediate and prolonged coma or demented state. Because of the subtle nature of histological changes in DAI, awareness and intentional search for the lesion is essential. The triad of DAI is as follows: focal lesions (hemorrhages and/or lacerations) in the corpus callosum and brain stem, and microscopic demonstration of axonal damage--retraction balls. The concept of DAI will elucidate and enhance the understanding of many head trauma cases. PMID- 3673982 TI - A study of fatal strangulation cases in Varanasi (India). AB - Strangulation is one of the oldest and widely used methods of committing murder in the Indian subcontinent. It is usually carried out by constricting the neck either with the hands, elbow, or other parts of body or by ligature, stick, and the like. In this paper we report a study of 26 cases of fatal strangulation occurring in the district of Varanasi (India) during 1982-1983 and analyze their epidemiological, medicolegal, and forensic pathological aspects. The paper also projects the mentality of perpetrators who, after strangling their victims, tried to hide the crime by disposing of the dead bodies by burning, burying, hanging, throwing them into water, or concealing them in distant places in most of the cases. PMID- 3673983 TI - All-terrain vehicles. Dangerous at any speed. AB - A study of fatalities arising from the operation of all-terrain recreational-type vehicles was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida for the 5-year period, 1981-1985. A total of 11 cases were collected and are presented. A discussion examines the risk factors responsible for the fatalities--namely, youthful impetuosity, carelessness, and ethanol use. It is recommended that people in all locales realize the problems associated with such vehicle usage. It is hoped that activists in all countries prevail upon their legislative representatives to enact laws to curtail use of this type of vehicle, and hence save lives. PMID- 3673984 TI - Tumbling abrasions. Injuries from ricocheting bullets. AB - Atypical entrance gunshot wounds may be produced by deflected or ricocheting bullets. One special type of atypical entrance wound involves abrasion of the skin at a site that is remote from the point of dermal penetration. These remote abrasions, termed "tumbling abrasions," are produced by bullets that tumble after impact with an intermediate target. Three cases of tumbling abrasions are presented. PMID- 3673985 TI - Homicidal poisoning. A dying modality of lethal violence? AB - Review of the experience of the Cuyahoga County (Cleveland, Ohio and its suburbs) Coroner's Office with homicidal poisonings over the past 3 1/2 decades reveals that this modality of felony homicides constitutes but a tiny fraction of the total case load and small percentages of overall homicides and drug- and chemical caused deaths of all types. These findings are representative of selected medicolegal establishments across the country, as well as in the United States as a whole. Precise definition of the several types of felonious homicidal poisonings is suggested in the interest of clarity and accuracy of statistical data. PMID- 3673986 TI - Sulfuric acid poisoning. AB - Deliberate ingestion of a corrosive acid is an unusual manner of death. Sulfuric acid, often used in electrical industry, chemical laboratories, and agriculture, is fatal at a dosage of 3.5-7.0 ml. The mortality rate is quite high, with only 35% recovery rate. Poisoning by sulfuric acid resembles other mineral acids in that the esophagus is more commonly spared while coagulative necrosis of the stomach is often apparent. A case involving the ingestion of sulfuric acid by a patient with a history of chronic psychiatric illness is presented. The pathological, clinical, and toxicological aspects of this case are discussed. PMID- 3673987 TI - Homicide as a cause of the sudden infant death syndrome. AB - The homicidal asphyxiation of a 10 1/2-month-old male infant and the attempted asphyxiation of his 4-month-old sibling, documented by parental confession, is presented as evidence that murder may sometimes be mistaken as sudden infant death syndrome (SIDS). A review of the literature of the relationship between murder and SIDS deaths reveals the suspicions of some physicians but few published cases; this reflects not only the difficulties of making a determination of murder by suffocation, since no injuries may be present, but also a lack of awareness among physicians who must evaluate infant deaths. It is recommended that murder should be considered in the differential diagnosis of sudden, unexpected death in infants and that the autopsy should include full-body x-rays and at least an initial look at the social history of the child. PMID- 3673988 TI - Homicidal death following blunt trauma in a vulnerable host, with secondary infections including local tetanus. AB - An uncommon type of homicide resulted from complications of an ordinarily nonfatal injury after a 59-year-old obese, hypertensive, diabetic man was struck in the face with a two-by-four, sustaining a grossly contaminated laceration. It was cleaned and sutured primarily, and a tetanus booster was given. On the fourth hospital day there was evidence of anerobic wound cellulitis, including Clostridium tetani. The wound was surgically debrided, but 2 days later the patient developed local tetanus. Only then was it discovered that he had never been immunized against tetanus. He did not develop systemic tetanus, but 2 days later he died with bronchopneumonia and sepsis. The assailant was indicted for involuntary manslaughter, but after a contentious trial he pleaded "no contest" to a reduced charge. The decedent was a vulnerable host, his contaminated facial laceration initiating an unbroken course of events that led to his death. PMID- 3673989 TI - Rolled up to death. An unusual autoerotic fatality. AB - Recently, an unusual case of autoerotic death in which a man died of hypoxia after having enclosed himself in plastic was reported in this Journal (1). We present a second case showing many similarities to the one published previously. PMID- 3673990 TI - Sudden, unexpected death due to massive, nontraumatic intra-abdominal hemorrhage in association with cirrhosis of the liver. AB - Hemoperitoneum is usually due to rupture, laceration, or perforation of a blood vessel or organ. The author describes three deaths due to massive intra-abdominal hemorrhage, all in alcoholics with cirrhosis of the liver, in which no source for the bleeding was found. One of the three individuals, who was briefly hospitalized, showed evidence of a disseminated intravascular coagulopathy (DIC). In the author's opinion, this is the most likely cause of the intra-abdominal hemorrhage in the two other cases and is related to the cirrhosis of the liver. PMID- 3673991 TI - Liver regeneration factor detected in human serum after partial hepatectomy. AB - We obtained blood sera from patients before and after partial hepatectomy, and estimated the activities of the sera in promoting DNA synthesis in a primary culture of rat hepatocytes. The stimulating activity in portal serum from patients without any postoperative complications increased significantly after liver resection; that in portal serum from patients with complications did not. The amount of stimulatory factor transported to the liver, calculated by use of the stimulating activity in portal serum and the portal blood flow, increased after partial hepatectomy. The maximum amount was correlated to the resection ratio (p less than 0.05) and seemed to be correlated to the increase in liver volume. These results suggest that a stimulatory factor or factors are present in portal serum after partial hepatectomy and that such a factor and portal blood flow are important in liver regeneration after surgery. PMID- 3673992 TI - The effects of endoscopic sclerotherapy combined with transhepatic variceal obliteration on portal hemodynamics. AB - We studied the effects of endoscopic sclerotherapy with transhepatic variceal obliteration on portal hemodynamics in 20 patients with cirrhosis (six with a spontaneous splenorenal shunt and 14 without it). Portal venous flow 1 month after combined therapy (measured by pulsed Doppler flowmeter) was significantly increased compared with that before therapy (n = 20, 843 +/- 339 vs. 669 +/- 253 ml/min, p less than 0.001). Portal vein catheterization and portal venous flow measurement were repeated 18 months after therapy in eight patients without a splenorenal shunt before therapy and in two patients with a splenorenal shunt before therapy. Two of the former developed a splenorenal shunt. In these 10 patients, portal venous flow before, one month, and 18 months after therapy was 617 +/- 219, 784 +/- 227, and 720 +/- 224 ml/min, respectively, and in 8 of 10 patients the portal venous flow at 18 months remained similar to the values at one month. Portal vein pressures were not significantly elevated 18 months after therapy (35.4 +/- 6.4 vs. 33.6 +/- 5.1 cm H2O) and the mean portal vein pressure change was 2.75 cm H2O (range -6 to +7.5 cm H2O). To summarize, portal venous flow was significantly increased one month after combined sclerotherapy in cirrhotics, the portal venous flow at 18 months remained similar to the values at 1 month in most patients, and the change in portal vein pressure after therapy was small. PMID- 3673993 TI - Metoclopramide-induced normalization of impaired gastric emptying in spinal cord injury. AB - In a partial, two-way crossover study of gastric emptying (GE) in spinal cord injury (SCI), fasted, healthy, unmedicated male volunteers were given a 99mTc labeled liquid meal on two occasions. Metoclopramide (10 mg) was administered intravenously to each subject before the second evaluation of GE. We used single and multiexponential models with linear and nonlinear least-squares regression techniques to study the time-course of the disappearance of 99mTc from the stomach. The GE pattern in all subjects was most accurately characterized by nonlinear analysis (NONLIN) and consisted of two components, an initial adynamic phase and a phase of rapid emptying. The GE t1/2 of a liquid meal decreased from 106.6 +/- 58.3 min (mean +/- SD) in all SCI subjects (quadriplegic plus paraplegic) prior to treatment to 21.6 +/- 8.2 min after the intravenous administration of metoclopramide (p less than 0.006). Significant correlations between GE t1/2 and injury duration (yr) or level of spinal injury were observed. Impaired gastric emptying in SCI can be pharmacologically modified by metoclopramide to resemble a normal gastric emptying profile. Metoclopramide altered gastric emptying in SCI may be expected to result in changes in the therapeutic efficacy of orally administered drugs when drug absorption is dependent on gastric motility or emptying efficiency. PMID- 3673994 TI - Campylobacter pylori and non-ulcer dyspepsia. AB - Non-ulcer dyspepsia (NUD) is a poorly understood syndrome often present in association with gastritis. Among patients undergoing gastroscopy, some with NUD have a gastric mucosa colonized by the campylobacter-like organism, Campylobacter pylori. We therefore studied prospectively 55 consecutive patients with NUD and 15 normal controls to determine the prevalence of C. pylori organisms, and to investigate their association with histological gastritis, macroscopic evidence of gastritis, sex, smoking, alcohol consumption, and dyspeptic symptoms. We found a 45.4% prevalence in NUD patients which was statistically significantly higher than the 13.33% prevalence in the control group (p less than 0.05). We also found a close association between C. pylori and microscopic evidence of gastritis (p less than 0.001), male sex (p less than 0.001), and postprandial bloating (p less than 0.05). We did not find any significant association between C. pylori and macroscopic evidence of gastritis, smoking, alcohol consumption and other dyspeptic symptoms. Our findings suggest that C. pylori may play a pathogenic role in NUD. PMID- 3673995 TI - Acute cholecystitis complicating unrelated disease: etiological considerations. AB - The phenomenon of acute cholecystitis complicating an unrelated operation has been reported with increasing frequency, and may be preceded by a variety of operative procedures and a lack of previous biliary tract symptoms. Among eight such patients treated by us, seven developed acute cholecystitis postoperatively, and in one it was discovered during operation for bleeding duodenal ulcer. Two patients had undergone wide excision of the breast; two, highly selective vagotomy; one, nephrolithotomy; one, truncal vagotomy and gastroenterostomy; and one, left hemicolectomy and colostomy. In three patients, urgent cholecystectomy was performed, and four were treated conservatively with subsequent elective cholecystectomy. Histopathological studies revealed acute and chronic cholecystitis in all eight patients and cholelithiasis in four. One patient died in septic shock. Numerous contributing factors have been suggested, including hypovolemia and biliary stasis, as well as the presence of stones. It would appear that chronic cholecystitis or other biliary pathology, as found in our eight patients, is a major factor in the development of this manifestation. PMID- 3673996 TI - Wide local excision as an alternative treatment for periampullary carcinoma. AB - Wide excision of periampullary carcinoma is associated with low operative morbidity and mortality, but its effect on long-term survival, compared with that of pancreaticoduodenal resection, is controversial. Five patients with periampullary carcinoma were treated with wide local excision as a definitive procedure. There was no operative death, and four patients survived for two or more years following the operation. These patients are presented and the literature is reviewed. PMID- 3673997 TI - Improved palliation of a respiratory-esophageal fistula with a cuffed esophageal prosthesis. AB - We report a case in which a traditional prosthesis failed to seal a malignant respiratory-esophageal fistula. Removal of the prosthesis and replacement with a new type with an inflatable cuff provided palliation, and allowed the patient to leave the hospital. The cuffed prosthesis provides a custom fit which should seal fistulous tracts of any shape or size, without causing tissue necrosis. PMID- 3673998 TI - Multiple squamous papillomas of the esophagus associated with Goltz syndrome. AB - A 30-yr-old white female with a history of focal dermal hypoplasia (Goltz syndrome), chronic gastroesophageal reflux, and dysphagia was found to have, by barium esophagram and esophagogastroduodenoscopy, multiple 2- to 3-mm papillary projections in the distal esophagus and an esophageal stricture. Biopsy of these lesions revealed squamous papillomas and a benign stricture. Although chronic irritation from gastroesophageal reflux has been suggested as a possible etiology of acquired esophageal papillomas, the previous association of congenital papillomas of the oral mucosa in Goltz syndrome suggests that the multiple papillomas in this patient are congenital in origin. PMID- 3673999 TI - Defective hepatic anion transport in variegate porphyria. AB - A 29-yr-old man with neurological symptoms that included tremor, dysarthria, and loss of consciousness was diagnosed as having variegate porphyria, because of increased urinary excretion of delta-aminolevulinic acid, porphobilinogen, uroporphyrin, and coproporphyrin, and increased fecal uro-, copro-, and protoporphyrins. He showed marked retention of indocyanine green (R15 min: 53% 78%) and bromosulfophthalein (R45 min: 24%-10%) as well. The kinetic analysis revealed that both hepatic uptake and hepatic excretion were decreased for both dyes. Results of other liver function tests were unremarkable except for intermittent hyperbilirubinemia (0.7-3.3 mg/100 ml), of which the ratio of conjugated and unconjugated fraction was between 0.7 and 1.2. Binding of serum protein and indocyanine green or bromosulfophthalein was normal. An angiographic and scintigraphic study of the liver was normal. A minimal deposition of hemosiderin pigment was found in liver biopsy specimen without other abnormalities. Deposition of porphyrin was not present in the liver. Plasma exchange and erythrocytapheresis did not show any beneficial effects on the clinical and laboratory abnormalities of the patient. A possible relationship between variegate porphyria and defective hepatic anion transport is discussed. PMID- 3674000 TI - Congenital absence of the gallbladder and cystic duct: nonoperative diagnosis. AB - A case of congenital absence of the gallbladder and cystic duct diagnosed by nonoperative means is presented. Hitherto, confident diagnosis of this condition during life required laparotomy. Improved hepatobiliary imaging techniques now enable diagnosis without resort to surgical intervention. PMID- 3674001 TI - Localized pseudomembranous colitis simulating carcinoma of the cecum. AB - A 76-yr-old woman complained of right lower quadrant abdominal pain, nausea, and fever. There was no history of antibiotic therapy or preceding diarrhea. At laparotomy, a cecal lesion simulating a tumor was found with an otherwise normal colon. Right hemicolectomy was performed. Pathological examination showed pseudomembranous colitis confined to the cecum. It is suggested that pseudomembranous colitis unrelated to prior exposure to antimicrobial agents can occur without diarrhea, and may be a localized process mimicking colonic carcinoma. PMID- 3674002 TI - Sclerosing cholangitis associated with chronic cryptosporidiosis in a child with a congenital immunodeficiency disorder. AB - Primary sclerosing cholangitis (PSC) in children is a rare and incurable disorder of unknown etiology. We report an immunodeficient child with chronic cryptosporidiosis of the biliary tract leading to clinical, pathological, and radiographic findings consistent with PSC. This case documents the ability of Cryptosporidium to disseminate to extraintestinal organs, and suggests that chronic cryptosporidial infection of the biliary tract may be one etiological mechanism producing sclerosing cholangitis in immunodeficient children. The increased incidence of PSC in immunodeficient children may in part be due to their inability to resolve infections of the biliary tract, which may result in sclerosing cholangitis mimicking PSC. We submit that an aggressive diagnostic workup should be performed to rule out an infectious etiology of sclerosing cholangitis in immunodeficient patients who have findings of PSC, because specific chemotherapy against the infecting organism would potentially arrest progressive biliary obliteration. PMID- 3674003 TI - Impaired antioxidant defense in hemoglobin E-containing erythrocytes: a mechanism protective against malaria? AB - Red blood cell (RBC) antioxidant defense was investigated in eight individuals with hemoglobin E (Six EE and two E-B(+) thalassemia) and compared to that in six individuals with thalassemia and ten normal subjects. Individuals with hemoglobin E had increased incubated Heinz body formation (68% +/- 18%; p less than 0.001) compared to normal and thalassemic RBC (10% +/- 2% and 11% +/- 5%, respectively). Stimulated pentose phosphate shunt activity was increased in the thalassemic and decreased in the hemoglobin E RBC as compared to normal. The 2,3 diphosphoglycerate (DPG) content of the EE RBC was increased to 5.59 +/- 0.69 mumol/ml RBC as compared to normal (4.51 +/- 0.77; p less than 0.001). In the EE RBC, there was a direct correlation between Heinz body formation and DPG content (r = 0.73). Ascorbic and dehydroascorbic acid (0.1 and 1.0 mM) were able to decrease the degree of Heinz body formation in the hemoglobin E RBC. Ascorbic acid (0.1 mM) prolonged the response of the pentose shunt. Thus impaired antioxidant defense may account for the persistence of the hemoglobin E gene in areas where malaria is endemic. Oxidant medications should be used with caution in individuals of Southeast Asian origin. PMID- 3674004 TI - Association in cis of beta +-thalassemia and hemoglobin S. AB - A Moroccan woman was investigated because of a typical beta-thalassemia trait associated with a low-percentage (11%) hemoglobin (Hb) variant. The beta thalassemia trait was manifested by a microcytosis, a high HbA2 (above 6%), and an increase of the alpha/beta biosynthetic ratio (1.31). The variant was identified to HbS by amino acid analysis of the abnormal peptide (beta T1) and by DNA mapping with Sau I (Mst II) restriction endonuclease. No additional amino acid substitution was recorded in the beta s-chain. The reduction of beta-globin synthesis occurred exclusively at the expense of the beta s-chain. These results are consistent with the existence of a beta s mutation and a beta +-thalassemia in cis. PMID- 3674005 TI - Partial deficiency of protein 4.1 in hereditary elliptocytosis. AB - Protein 4.1, an important component of the red cell membrane skeleton, was quantitated relative to protein 3 after sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) of membranes isolated from red cells of members of 14 kindreds with hereditary elliptocytosis (HE) who reside in South Africa. A partial deficiency of protein 4.1 (mean 30% reduction) was inherited in autosomal dominant fashion in five white kindreds giving a frequency of 0.36 of HE families studied. Immunoblots of membrane proteins separated by SDS-PAGE and probed with a monoclonal antibody to protein 4.1 did not reveal any proteolytic fragments in the 4.1-deficient subjects that could account for the reduction of this protein. These studies draw attention to the relatively high frequency of this condition as a cause of HE in white subjects in this country. PMID- 3674006 TI - Excess HLA antigens after transfusion of sickle cell patient with AIDS. AB - A woman with sickle cell-hemoglobin C disease developed the acquired immunodeficiency syndrome (AIDS), possibly as the result of blood transfusions administered 4 years earlier. Three months after subsequent transfusions, she had excess HLA-A and DR antigens (triplets) on her circulating lymphocytes. Three of her first-degree relatives were HLA-typed, and none had excess antigens. Family studies also indicated that the patient had at least one HLA-A antigen that was probably not inherited. These findings suggest the possibility that transient hemopoietic engraftment can occur in transfused sickle cell patients with AIDS. PMID- 3674007 TI - Corticosteroid-responsive pure red cell aplasia in chronic lymphatic leukemia. AB - Acquired pure red cell aplasia characterized by selective failure of erythropoiesis was seen in a 37-yr-old female patient with a diagnosis of chronic lymphatic leukemia (CLL). Though different immunosuppressive therapies have been tried in the past with variable response, there has been no case report of such favorable response to corticosteroids alone. We report this rare and unusual case of PRCA associated with CLL who responded to steroid therapy. PMID- 3674008 TI - Effects of acetate and bicarbonate dialysate on left ventricular performance. AB - Whether bicarbonate dialysis (BiHD) improves left ventricular (LV) function more than acetate dialysis (AcHD) and whether AcHD exerts a negative inotropic effect remains controversial. To address this question, the LV contractile responses to both dialysate buffers were tested in six stable chronic dialysis patients not taking any cardiac or antihypertensive medicines. The patients were studied with echocardiography before and after an isovolemic dialysis (no weight change) with either buffer, and neither heart rate nor blood pressure were significantly altered during either procedure. The patients were studied at three different filling volumes so that LV function curves could be constructed. Both dialysates were associated with comparable and significant changes in LV end systolic volume (AcHD, 55 +/- 5 to 49 +/- 5 mL, P less than .001; BiHD, 56 +/- 5 to 49.5 +/- 5 mL, P less than .001), stroke volume (AcHD, 88 +/- 7 to 97 +/- 5 mL, P less than .01; BiHD, 89 +/- 7 to 97 +/- mL, P less than .05), and LV ejection fraction (AcHD, 60 +/- 7% to 65 +/- 8%, P less than .05; BiHD, 60 +/- 3 to 67 +/- 2%, P less than .001). In addition, the mean velocity of circumferential fiber shortening (VCF), an index of ventricular contractility, also increased significantly after dialysis with both dialysates (AcHD, .96 +/- .08 to 1.20 +/- .15, P less than .001; BiHD, .93 +/- .09 to 1.29 +/- .11, P less than .001). Finally, both dialysates were associated with upward shifts in the LV function curve of a similar magnitude.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674009 TI - Hernias: a frequent complication in children treated with continuous peritoneal dialysis. AB - The course of 93 children, treated with continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) over a total of 1,819 months, was evaluated retrospectively regarding hernia development. Thirty-seven patients (40%) developed 60 hernias (one per 30 patient-months), of which 36 were ventral, 7 umbilical, 14 inguinal, and 3 scrotal. Hernia occurrence was inversely correlated to patient's age and duration of CAPD/CCPD. The rate of hernia development was highest within the first 3 months following initiation of CAPD/CCPD with a subsequent rapid decrease. The dialysate inflow volume was not related to hernia development. The only complication due to the presence of a hernia was one episode of incarceration of the small bowel that required immediate surgical intervention. Surgical repair was the treatment performed in 75% of the cases. The remaining hernias were managed with volume reduction, conversion from CAPD to CCPD, or discontinuation of the daytime dialysate dwell in patients undergoing CCPD. Our observations suggest that hernia development is a frequent complication in children treated with CAPD/CCPD. PMID- 3674011 TI - Rhabdomyolysis and acute renal failure associated with pyloric stenosis. AB - Rhabdomyolysis and acute tubular necrosis (ATN) are described in a patient with pyloric stenosis in whom severe hypokalemia developed due to repetitive vomiting. Furthermore, the importance of hypokalemia in the development of acute renal failure is emphasized. PMID- 3674010 TI - Fungal peritonitis during continuous ambulatory peritoneal dialysis: a report of 17 cases. AB - Seventeen cases of fungal peritonitis and one case of Nocardia asteroides peritonitis were observed in 141 patients during the first 5 years of our continuous ambulatory peritoneal dialysis program (CAPD). Fungal peritonitis accounted for 7% of the episodes of peritonitis observed in this interval. There were eight deaths associated with fungal peritonitis. In only three instances could factors predisposing to fungal peritonitis be identified. We were unable to predict who would develop fungal peritonitis by analysis of nutritional, demographic, or technical factors associated with the dialysis procedure. The diagnosis of fungal peritonitis was easily established using routine blood agar culture techniques. Successful management of these patients included prompt removal of the Tenckhoff catheter and intravenous (IV) administration of amphotericin. PMID- 3674012 TI - Transient paralysis of upper extremity after percutaneous cannulation of the subclavian vein for hemodialysis. AB - Two cases of transient paralysis of upper extremity after percutaneous cannulation of the subclavian vein for hemodialysis are presented for the first time. Large amounts of lidocaine used, together with its deep and too lateral administration are responsible for development of this transient complication. PMID- 3674013 TI - Striking elevation of serum IgA, IgA-containing immune complexes, and IgA rheumatoid factor in clinically silent dermatitis herpetiformis. AB - We describe a patient with dermatitis herpetiformis with immunoglobulin A (IgA) containing circulating immune complexes and IgA rheumatoid factor who presented with acute renal insufficiency; a renal biopsy specimen showed IgA nephropathy. The renal function and proteinuria spontaneously returned to normal despite markedly elevated levels of IgA-containing circulating immune complexes, IgA rheumatoid factor, and IgA antibodies to some environmental antigens. IgA1 was the predominant subclass. IgA2-containing immune complexes and IgM rheumatoid factor were not detected. Cultures of peripheral blood mononuclear cells produced increased quantities of IgA and IgA rheumatoid factor spontaneously and after pokeweed mitogen stimulation. These data indicate that renal function can improve and remain normal despite the presence of increased levels of IgA-containing circulating immune complexes and IgA rheumatoid factor. PMID- 3674014 TI - Nephrotic syndrome associated with chronic persistent hepatitis B in an HIV antibody positive patient. AB - Several renal diseases have been reported to complicate both hepatitis B and human immunodeficiency virus infection. Establishing the exact renal diagnosis in patients with multiple viral infections requires renal biopsy. Exposure to human immunodeficiency virus may not determine renal histopathology. Although exact prognosis depends on a definitive diagnosis, treatment options may be limited in the face of several viral infections and concurrent exposure to human immunodeficiency virus. PMID- 3674015 TI - Medullary cystic disease: an inherited form of autoimmune interstitial nephritis? PMID- 3674016 TI - Case report of congo red-negative amyloidosis-like glomerulopathy. PMID- 3674017 TI - Induction of sister chromatid exchanges at common fragile sites. AB - Experiments were performed to gain further insight into chromosome structure and behavior at common fragile sites by testing the hypothesis that gaps at these sites predispose to intrachromosomal recombination as measured by sister chromatid exchanges (SCEs). Human lymphocytes were concurrently treated with aphidicolin, for determination of fragile site expression, and with 5-bromodeoxy uridine, for SCE analysis. Aphidicolin induced chromosome gaps nonrandomly, with the great majority of gaps occurring at common fragile sites. On average, 66% of gaps were accompanied by an SCE at the site of the lesion. Analysis of two specific common fragile sites at 3p14 and 16q23 showed the same pattern; that is, on average 70% of gaps at these sites were accompanied by an SCE. These results show that common fragile sites are hot spots not only for chromosomal lesions such as gaps but also for SCE formation. PMID- 3674019 TI - Methods old and new for analyzing occupational cohort data. AB - The person-years approach to analyzing mortality data from occupational cohorts was introduced in the midtwentieth century. It cross-classifies all observed deaths and observation times into cells, computes the number of expected deaths for each cell based on referenced mortality rates, and then examines the ratio of total number of observed deaths to total number of expected deaths (the standardized mortality ratio). The maximum likelihood method of statistical inference was developed in the early twentieth century. However, only recently has it been applied to the analysis of occupational cohort data. When so applied, it provides estimates of measures of association between exposures and disease by maximizing the probability of the observed data. This paper shows how recent developments in the use of this tool justify and extend the person-years approach. In particular, problems with the standardized mortality ratio cited in the literature are shown to result from reliance on assumptions that are inappropriate for the data at hand. Methods for testing these assumptions are described. The discussion is illustrated with examples from occupational cohort studies of lung cancer. PMID- 3674018 TI - Evolutionary implications of the human aldolase-A, -B, -C, and -pseudogene chromosome locations. AB - The aldolase genes represent an ancient gene family with tissue-specific isozymic forms expressed only in vertebrates. The chromosomal locations of the aldolase genes provide insight into their tissue-specific and developmentally regulated expression and evolution. DNA probes for the human aldolase-A and -C genes and for an aldolase pseudogene were used to quantify and map the aldolase loci in the haploid human genome. Genomic hybridization of restriction fragments determined that all the aldolase genes exist in single copy in the haploid human genome. Spot-blot analysis of sorted chromosomes mapped human aldolase A to chromosome 16, aldolase C to chromosome 17, the pseudogene to chromosome 10; it previously had mapped the aldolase-B gene to chromosome 9. All loci are unlinked and located on to two pairs of morphologically similar chromosomes, a situation consistent with tetraploidization during isozymic and vertebrate evolution. Sequence comparisons of expressed and flanking regions support this conclusion. These locations on similar chromosome pairs correctly predicted that the aldolase pseudogene arose when sequences from the aldolase-A gene were inserted into the homologous aldolase location on chromosome 10. PMID- 3674020 TI - Exposure assessment for occupational epidemiology. AB - Exposure evaluation for epidemiology has special requirements, which can be derived from the pharmacological processes that determine the exposure-effect relationship. Since environmental concentrations of toxic agents typically are highly variable over time, the tissue concentrations they produce will vary over time, and consequently the level of effects will also vary over time. A general, six-step approach is proposed for developing an exposure assessment for an epidemiologic study. This approach uses pharmacologic models to guide the choice of exposure measurement parameters and to guide the epidemiologic data analysis. The approach is illustrated for evaluations of reversible airway effects of ozone and irreversible pulmonary effects of a mixed silica dust. Effect indices are introduced as a means of quantifying the temporal interrelationships of the exposure profiles and the pharmacologic models. These indices have advantages over both dose indices and simple dose-outcome models. PMID- 3674021 TI - Health effects of pesticides: a review of epidemiologic research from the perspective of developing nations. AB - Acute poisoning among pesticide applicators is still a prominent health hazard in rural areas in developing countries, but published reports are very rare. Registration analysis and descriptive study are helpful in giving guidance for orientation and evaluation of preventive strategies and measures. Data and material from China show that, in circumstances with a well organized grass-roots level network of primary health care services, poisoning episodes can be prevented through dissemination of information of hazards and provision of prevention training courses. Among pesticide manufacturing workers, especially manual packers of organophosphorus insecticides, there is suggestive evidence of subacute poisoning resulting from continuous low-level exposure. Chronic delayed neuropathy has, rarely, been reported. Further study of the cause of subacute poisoning now requires analytical rather than descriptive investigations. There is still no solid documentation of an association of excess human cancer and the use of chlorinated hydrocarbon insecticides. Phenoxyacetic and chlorophenol herbicides recently have been widely studied for causation of soft tissue sarcoma, non-Hodgkin's leukemia, and lymphoma. Although the evidence at present indicates a positive association, discrepancies in findings and resultant controversy require further study. Epidemiological surveys on the harmful effect of DBCP are quite instructive. Investigations in exposed populations verified and extended the observation in animals as infertility and gender ratio change in the next generation. Adverse reproductive effects of a number of pesticides, particularly birth defects resulting from pesticides (other than those already documented for organomercurials), require further study. PMID- 3674022 TI - Prevalence of byssinosis and respiratory symptoms among spinners in Sudanese cotton mills. AB - Byssinosis, other respiratory symptoms, and ventilatory capacity were investigated in 186 male spinners in two Sudanese textile mills located in Khartoum and Hassaheisa. The prevalence of byssinosis was 37% among Khartoum spinners where coarse cotton was processed, significantly higher (p less than 0.01) than the 1% found among Hassaheisa spinners, where fine cotton was used. The prevalence of chronic bronchitis was 29% in Khartoum and 2% in Hassaheisa spinners. A significant reduction in forced expiratory volumes (FEV1 after a shift) was observed in spinners of both factories. Our findings provide evidence that very low rates or absence of byssinosis, related respiratory symptoms, and significant functional abnormalities (FEV1) in the late stages of cotton yarn processing all depend on the quality of cotton used and low levels of cotton dust concentration. PMID- 3674024 TI - Mortality among workers at a butadiene facility. AB - Several studies of styrene-butadiene rubber (SBR) workers have reported excess cancers at various sites; however, little could be concluded concerning specific etiologic agents because of the multiple exposures encountered by these groups. The current study examined cause-specific mortality in a cohort of 2,586 male workers employed for at least 6 months between 1943 and 1979 in a butadiene manufacturing plant that supplied butadiene to two SBR plants. Standardized mortality ratios were calculated using national (NSMR) and local (LSMR) comparison populations. The all-cause NSMR was 80 (p less than 0.05) and the all cancer NSMR was 84; the corresponding LSMRs were 96 and 76 (p less than 0.05). No significant excesses were observed for any cause of death except lymphosarcoma and reticulum cell sarcoma (NSMR = 235). When the cohort was subdivided into routine, nonroutine, and low-exposure groups, the SMRs were consistently elevated for this cause of death in all three groups. However, direct comparisons between each of the two exposure groups and the low-exposure group were inconsistent. This suggests butadiene may not be responsible for the excess, but the association deserves close attention in future studies. PMID- 3674023 TI - Prevention of work-related injuries and diseases: lessons from experience with ionizing radiation. AB - Almost immediately after the discovery of the Roentgen ray, in 1895, radiation injuries of various kinds began to be encountered in early X-ray workers, radium handlers, radiologists, and exposed patients. The injuries, which were predominantly acute reactions resulting from the killing of cells in affected tissues, were found to be preventable merely by keeping exposures below relevant threshold levels. By the middle of the twentieth century, however, it was realized that thresholds might not exist for certain effects of ionizing radiation, such as mutagenic, carcinogenic, and teratogenic effects. The risks of such effects in workers and other populations exposed to low-level radiation have thus been of increasing concern in recent years. The scientific basis for assessing such risks and the principles that have evolved for their control have important implications for occupational and environmental health in general. PMID- 3674025 TI - Angioedema and urticaria as acute and late phase reactions to zinc fume exposure, with associated metal fume fever-like symptoms. AB - IgE-mediated acute and late phase reactions associated with occupational metal fume exposure are rare compared with the more common metal fume fever. The latter is a common acute industrial disease caused by inhalation of oxides of metals, especially zinc. It is a flu-like illness and is thought to be self-limited. This article describes the first case, to my knowledge, of an immediate and a late phase reaction (urticaria and angioedema) to zinc fumes, associated with a metal fume fever-like reaction. Hives and angioedema developed immediately and in a delayed fashion in a 34-year-old man after he had welded zinc at his job. There also was an associated metal fume fever-like reaction. The relationship was proved by a challenge test done at home. The patient has been asymptomatic since using complete protective measures while welding zinc. Possible immunologic mechanisms are discussed. PMID- 3674026 TI - Cause-specific mortality among male chemical workers. AB - Cause specific mortality was surveyed among 37,682 male employees with three or more days of service between 1940 and 1982 at the Midland or Bay City, Michigan, locations of Dow Chemical USA. Vital status was ascertained through 1982 for 97.5% of the cohort members, and death certificates were obtained for 97.1% of the 7,751 decedents. Comparisons of observed mortality with expected levels based on any of three general population groups (US, Michigan, or seven local counties) consistently demonstrated lower mortality in the cohort from each of the major causes of death, including total malignant neoplasms. Unique among hourly employees was significant excess mortality in the categories of cancer of other lymphatic tissue, and motor vehicle accidents, and both hourly and salaried nonexempt employees experienced significantly higher mortality from other and ill defined cancers. The influence of duration of employment and age at and period of hire were explored with the Mantel-Haenszel method as adapted for a cohort study. Results were evaluated both including and excluding the mortality experience of subsets of employees with past exposure to known human carcinogens (arsenic, asbestos, bis-chloromethyl ether, benzene, organic dyes, and vinyl chloride). The use of the general mortality survey in monitoring whether or not there are major health problems among the employees and in setting research priorities is emphasized. PMID- 3674027 TI - Monitoring of zinc protoporphyrin levels in blood following occupational lead exposure. AB - The value of measurements of zinc protoporphyrin in blood (ZPP) in the surveillance of workers occupationally exposed to lead has been studied. From a group of referents, consisting of 1,088 men and 511 women, it has been established that the normal mean ZPP is in the region of 25 micrograms/100 ml, and only rarely do values exceed 45 micrograms/100 ml. The higher ZPP values are frequently associated with low blood hemoglobin concentrations and appear to be manifestations of an iron-deficiency anemia. Women have higher ZPP values than men; smoking has no influence. Measurements of ZPP and blood lead concentration (PbB) have been made every other month for 2.5 years on a group of around 200 men and 40 women exposed to lead in a storage battery factory. The mean ZPP of the group throughout the period was 70.9 micrograms/100 ml blood, and a linear relation between log ZPP and PbB in the PbB range of 10-80 micrograms/100 ml has been established. ZPP thresholds in the control of excessive occupational lead exposure, and the economic advantage of ZPP measurements over PbB, are discussed. PMID- 3674028 TI - Past exposure to asbestos among active railroad workers. AB - Before the transition from steam- to diesel-powered locomotives during the 1950s certain railroad workers had the opportunity for significant occupational exposure to asbestos. Past studies have demonstrated that older workers with jobs associated with the repair of steam locomotives had the most exposure. To determine the prevalence of currently employed railroad workers with past asbestos exposure we surveyed 514 white male employees of an active US railroad by mail questionnaire. Twenty-one percent (50/242) of the workers 50 years old or greater had likely asbestos exposure compared to 3% (9/275) of the workers 49 years old or less (p less than .001). Fifteen (30%) of the 50 older workers with likely asbestos exposure had current job titles no longer suggestive of past exposure. The duration of exposure of these older active workers was short, (median = 3 years; range, 6 months to 15 years). A history of past asbestos exposure may still be obtained among active railroad workers with past railroad shop employment. PMID- 3674029 TI - Assessing the feasibility of retrospective cohort studies. AB - While most epidemiologic cohort studies are preceded by some sort of feasibility study, details of such prior investigations are rarely reported. Yet it is during such feasibility studies that critical decisions are made, such as site selection and definition of exposure. Here we present the details on one such feasibility study, conducted to determine the possibility of a cohort mortality study of workers exposed to ethylene oxide. Issues discussed include methods for estimating sample size and power, for estimating levels of exposure, and for assessing the adequacy of personnel records. PMID- 3674030 TI - Blood histamine levels in cotton-dust exposed workers in a textile mill of Ahmedabad. AB - Blood histamine levels were measured by the bioassay of histamine (on an isolated strip of guinea pig ileum) in workers exposed to cotton dust in a textile mill in Ahmedabad. Byssinotic subjects showed very high levels of blood histamine as compared to nonbyssinotic and control subjects. The blood histamine levels were not well correlated to the dust concentrations or duration of exposure but rather to the day of the week (ie, first, second, third, etc., after weekend break) on which the samples were collected. The blood histamine levels were high on the first day of the work week, when byssinotics complained most of their symptoms. PMID- 3674031 TI - Selecting clindamycin dosage regimens. PMID- 3674032 TI - Visual incompatibility of dacarbazine and heparin. PMID- 3674033 TI - Inaccurate acquisition costs for hospital-reconstituted cefazolin sodium injection. PMID- 3674034 TI - Liquid-filled capsules not reliable sources of pediatric doses. PMID- 3674035 TI - Practicing director should direct practice. PMID- 3674036 TI - Formulary system versus formulary, "the book". PMID- 3674037 TI - Allow no harm. PMID- 3674039 TI - Hospital diversification: case studies of pharmacy involvement. Hamot Health Systems, Inc. PMID- 3674038 TI - Group purchasing: vendor selection. AB - Ways that purchasing groups assess pharmaceutical vendors and products are discussed. The size of the purchasing group affects the process of screening vendors, with small groups tending to accommodate familiar vendors and large groups protecting themselves from an excessive number of prospective suppliers. Large groups usually have more resources to conduct in-depth screening. It may be necessary to organize subgroups to deal with the various aspects of the selection process; one subgroup might solicit and organize data relative to vendor selection. The sequencing of the selection process is critical: Product pricing should be considered after the vendor has cleared the quality and bioequivalence screens. Factors to consider when choosing a vendor are discussed. Because of the vast amount of information that is generated by the group's screening process, the group should develop tools to categorize and evaluate the data, including vendor quality profiles and bioequivalence screens. Some groups have established a probationary period before making a commitment to volume buying so that the group and the vendor can assess the other's value. A defined evaluation process informs the purchasing group's various publics--members, vendors, and competitors -of the group's quality assurance standards, thereby facilitating the vendor selection process. PMID- 3674040 TI - Hospital diversification: case studies of pharmacy involvement. Thomas Jefferson University Hospital. PMID- 3674041 TI - Hospital diversification: case studies of pharmacy involvement. New England Medical Center. PMID- 3674042 TI - Hospital diversification: case studies of pharmacy involvement. St. John's Hospital. PMID- 3674043 TI - Pharmacy: a profession in transition or a transitory profession? AB - Areas in pharmacy that are in transition are described, and ways to prevent the perception of pharmacy as a transitory profession are detailed. Pharmacy has adapted itself over the past 75 years to changes in the health-care system and in societal demands of the profession. The evolution of pharmacy functions has included drug product preparation, establishment of standards, drug distribution, and clinical pharmacy. The profession is continuing to change in reaction to economic and social forces. Hospital pharmacy flourished when it shifted from a profit to a cost center because pharmacy practice researchers documented the contribution of clinical pharmacy to patient care and because hospital pharmacy administrators developed sound management procedures to maintain efficient inventories. Current controversies in pharmacy practice are discussed, including pharmacist prescribing, physician dispensing, and therapeutic substitution. These terms inadequately describe the concepts, especially when they are taken out of context of the total health-care process involving a physician-pharmacist team. Because of the success of this teamwork in acute-care institutions, ambulatory pharmaceutical services should involve cooperative activities of pharmacists in professional service administrative organizations (PSAOs) and physicians in independent practice associations. The cost-effectiveness of PSAOs is discussed. Marketing of drug products is changing as the physician-pharmacist interaction becomes integral to the drug therapy decision-making process. Drug distribution should not be viewed as less professional than clinical activities. Although the pharmacy profession is reorienting itself toward patient care and the rational use of drugs in society, it must maintain its authority over the drug distribution system. PMID- 3674044 TI - Multidimensional work sampling to evaluate the effects of computerization in an outpatient pharmacy. AB - The effectiveness of multidimensional work sampling versus direct observation in evaluating the effects of computerization in an outpatient pharmacy was studied. A direct-entry, self-reporting method of multidimensional work sampling was used to measure and compare the relative times spent on various tasks before and after computerization in the outpatient pharmacy of a 475-bed teaching hospital. Analysis of variance was used to evaluate differences in the types of functions performed, differences in functions among the five employees (two pharmacists, one pharmacy intern, and two technicians), and differences in functions on a week to-week basis. Data obtained by multidimensional work sampling were compared with data obtained by direct observation to determine the level of agreement between the two methods. Also, a time clock method was used to measure and compare the time required for prescription processing before and after computerization. After computerization, the percentage of time spent on some clerical tasks decreased by 26.7%, but this decrease was offset by a significant increase of 27.7% in the percentage of time spent entering information into the computer. Time spent on clinical tasks did not change significantly. A significant difference among employees was found in the percentage of time spent on clinical functions. The differences in time spent on clinical or clerical functions from week to week were not significant. The time to process a set of prescriptions increased after computerization, primarily because of the time needed to enter information into the computer. However, computerization enabled the generation of patient profiles. Multidimensional work sampling is an accurate method of work measurement that may be more useful than direct observation in capturing clinical functions. PMID- 3674045 TI - Effect of a pharmacy-based cost-containment program on cimetidine costs and use. AB - A program developed by the University of California at San Diego Medical Center to curb over-prescribing of cimetidine is described. Guidelines for cimetidine use were approved in September 1985. Pharmacists undertook physician education and enforced the guidelines by monitoring patients through a specially designed documentation form. When use of cimetidine was not in compliance with the guidelines, the pharmacists contacted the physicians to recommend changes. Use of cimetidine hydrochloride injection declined 49% between September 30 and December 6, 1985. Extrapolated to an entire year, this reduction would result in cost savings of +12,000 to +16,000. However, after pharmacists stopped enforcing the guidelines in December 1985, use of cimetidine hydrochloride injection gradually increased to near control levels. In February 1986, the review of patients receiving cimetidine was reinstituted, resulting in another decline in use. Periodic review and reinforcement by pharmacists appear necessary to ensure that cimetidine continues to be prescribed appropriately. PMID- 3674046 TI - Factors influencing prices offered to pharmaceutical purchasing groups. AB - Purchasing-group characteristics that influence pharmaceutical-vendor pricing are discussed. A questionnaire about pricing practices and a self-addressed stamped envelope were mailed to bid managers of vendors in November 1985. The bid managers' attitudes toward the effect of various characteristics of purchasing groups on prices was determined by calculating the mean response to each of a group of four questions about pricing practices. Of the 269 questionnaires distributed, 161 (59.8%) were returned. Of these, 115 were usable. Three vendor groups were established from demographic information: Pharmaceutical Manufacturers Association members (44.3%), generic manufacturers (13.9%), and wholesalers (41.7%). Bid managers agreed that the following characteristics would influence lower prices: single group membership, market conditions, group size, adherence to contracts, and volume commitment; they disagreed that the time of year during which bid solicitations are conducted would affect prices. Further studies are needed to correlate actual pricing practices and the opinions of vendors regarding factors influencing pricing. PMID- 3674047 TI - Personnel requirements of a poison information center. AB - Time use by poison information specialists at a poison information center was assessed to determine personnel requirements. To justify the current staff complement, to develop a formula for calculating future needs, and to monitor staff use, a time-use study was conducted by professional management engineers over 8 days in a 24-day period. Equal time was spent during each of three work shifts (0700-1500, 1500-2300, 2300-0700). Of 11 poison information specialists, 9 worked during the study period. Activity was divided into direct (handling poison information calls) and indirect (follow-up calls, quality assurance, continuing education, etc.) categories. Time study calculations for direct activity were based on 324 actual exposure calls. The average time to receive and document an initial poison exposure call was 8.7 minutes (range, 6.6-11.1 minutes). Indirect activity related to those calls averaged 12.9 minutes (range, 5.8-20.7 minutes), for a total of 21.6 minutes per call (87.3% of an eight-hour work shift). Nonproductive activity accounted for 12.7% of the time. Based on a mean (+/- S.D.) daily exposure volume of 104.7 +/- 1.35 calls, it was determined that 5.4 full-time equivalents per day were necessary to respond to an average day's call volume. At this center, the workload management study provided a sound basis for assessing current staffing needs and for justifying future changes in staffing based on actual call volume. PMID- 3674048 TI - Health-care marketing. PMID- 3674049 TI - Evidence that multiple risk factors for coronary artery disease exist in persons with abnormal glucose tolerance. AB - Multiple risk factors for coronary artery disease were determined in 50 healthy, non-diabetic persons with an oral glucose tolerance test result that could not be classified as normal by current criteria and 50 sex-, age-, and weight-matched persons with normal oral glucose tolerance. The results indicated that persons with abnormal oral glucose tolerance were hyperinsulinemic, as well as hypercholesterolemic and hypertriglyceridemic. In addition, patients with abnormal results in glucose tolerance tests had significantly elevated systolic blood pressure and heart rates. These data suggest that a cluster of risk factors for coronary artery disease exists in non-diabetic persons with abnormal oral glucose tolerance. PMID- 3674050 TI - Native valve endocarditis due to coagulase-negative staphylococci. Clinical and microbiologic features. AB - Twenty-one patients with native valve endocarditis caused by coagulase-negative staphylococci were studied; 14 had pre-existing valvular or congenital heart disease. Although commonly subacute in presentation, complications of endocarditis were frequent: arterial emboli in five patients, new electrocardiographic conduction system abnormalities in nine, congestive heart failure in eight, annular or myocardial abscesses in five, and disruption of valve leaflets in three. Cures were achieved in 10 of 12 patients treated medically and seven of nine treated surgically. In microbiologic studies of 16 coagulase-negative staphylococci from patients with endocarditis, only eight were identified as Staphylococcus epidermidis. All isolates were susceptible to vancomycin. Antibiotic resistance (methicillin, four isolates; gentamicin, two isolates; rifampin, one isolate) was usually associated with nosocomial acquisition of endocarditis. Rather than representing contamination, coagulase negative staphylococci in blood cultures may indicate life-threatening endocarditis. However, with careful attention to the selection of antibiotics for therapy and to the occurrence of heart failure due to intracardiac complications, treatment of this form of endocarditis is frequently successful. Organisms must always be tested for cryptic resistance to beta-lactam antibiotics. Valve replacement may be required frequently. PMID- 3674051 TI - Infective endocarditis: clinical features in young and elderly patients. AB - The elderly constitute an increasing percentage of patients with infective endocarditis. The disease manifestations and outcomes in 53 episodes of endocarditis in patients over the age of 60 were reviewed and compared with 55 episodes of endocarditis in patients less than 40 years of age and 46 episodes of endocarditis in patients aged 40 to 60. The percentage of cases caused by staphylococci and streptococci were roughly equal in all groups. Enterococci, Streptococcus bovis, and coagulase-negative staphylococci were more common in the elderly. In the elderly, invasive vascular procedures were the most common source of infection. Endocarditis acquired nosocomially accounted for 23 percent of all episodes in older patients. The elderly reported fewer symptoms and showed a diminished febrile response. Errors in diagnosis were noted in 68 percent of elderly patients, and a delay in initiating appropriate therapy was more common in this age group. The mortality rate was significantly higher in the elderly (45.3 percent) than in the middle-aged (32.6 percent) and young (9.1 percent). Endocarditis in elderly patients is often nosocomially acquired, is difficult to diagnose, and is associated with a higher mortality than noted in younger patients. PMID- 3674052 TI - Isolated clinical syndrome of primary aldosteronism in four patients with adrenocortical carcinoma. AB - Adrenocortical carcinoma is a rare disorder that can be revealed by an isolated syndrome of mineralocorticoid excess. In a retrospective study of 137 patients referred to our hypertension clinic in the past 10 years for primary aldosteronism, four cases of adrenocortical carcinoma were identified. The clinical presentation of these patients was similar to that of patients with Conn's adenoma, but preoperatively, malignant tumoral primary aldosteronism was suspected because of profound hypokalemia, marked elevation in plasma aldosterone levels, and enlarged size and weight of an heterogenous adrenal tumor with internal calcifications. Malignancy was confirmed by the histologic features. No prognostic criteria could be established and two patients died despite specific surgery, which was performed in all cases. More recent developments in the use of mitotane led to the addition of adrenocorticolytic therapy in the remaining two patients, who are still alive at the time of this report. PMID- 3674054 TI - Septic bursitis in immunocompromised patients. AB - A retrospective analysis of 29 patients with septic bursitis was undertaken to ascertain if immunocompromised patients differed in their clinical presentations, type of organisms cultured, and outcome when compared with their non immunocompromised cohorts. Thirty episodes of septic bursitis occurred in 29 patients, 43 percent of which occurred in immunocompromised patients. Despite similar clinical presentations, the bursae of immunocompromised patients took three times longer to sterilize and had a much higher bursal white blood cell count when compared with the bursae of non-immunocompromised patients. The bacteriologic spectrum was essentially identical in both groups; there were no cases in which gram-negative organisms were recovered from infected bursae. No cases of septic bursitis were seen in neutropenic patients. The most common factors contributing to an immunocompromised state were alcoholism or steroid therapy. A successful resolution of septic bursitis was seen in all the patients in the immunocompromised groups. PMID- 3674053 TI - Lipoprotein analyses in varying degrees of glucose tolerance. Comparison between non-insulin-dependent diabetic, impaired glucose tolerant, and control populations. AB - Atherosclerosis is the major cause of death in diabetic patients. Lipoproteins and lipids are frequently altered in non-insulin-dependent diabetes. These lipoprotein alterations are of interest because of their possible role in the origin of the accelerated atherosclerosis found in diabetes. Because of the link between lipoproteins and diabetes, serum lipids and lipoproteins were measured in 215 middle-aged patients (107 female, 108 male) with varying degrees of glucose tolerance: control subjects, subjects with impaired glucose tolerance (IGT), and patients with non-insulin-dependent diabetes mellitus (NIDDM). In male subjects, levels of fasting total triglycerides were significantly greater in those with NIDDM compared with control subjects. In female subjects, fasting total cholesterol levels were significantly greater in NIDDM compared with IGT. Both high-density lipoprotein (HDL) cholesterol and HDL2 cholesterol values were significantly lower in both sexes with NIDDM compared with control subjects. Low density lipoprotein (LDL) cholesterol levels were elevated in the male subjects with IGT. No differences in HDL cholesterol or its subfractions were seen in both sexes with IGT compared with control subjects. Bivariate analyses showed that the reduced HDL cholesterol and HDL subfraction levels were most closely associated with both total triglycerides and weight. This study shows that reduced HDL cholesterol and HDL2 cholesterol levels occur in NIDDM, whereas persons with "impaired glucose tolerance" do not have the dramatic alterations in HDL levels. PMID- 3674055 TI - Flow-volume loop changes reflecting respiratory muscle weakness in chronic neuromuscular disorders. AB - In order to identify the changes in pulmonary function and in the flow-volume loop due to respiratory muscle weakness, two groups of 10 nonsmokers with stable, chronic neuromuscular disease but without respiratory symptoms were studied: one without (Group 1) and one with (Group 2) respiratory muscle weakness as assessed by measurement of maximal static inspiratory and expiratory pressures. In Group 1, pulmonary function was normal except for increased ratio of one-second forced expiratory volume to forced vital capacity and forced expiratory flow at 25 to 75 percent forced vital capacity, which may reflect increased elastic lung recoil. Group 2 had mild volume restriction, appropriate for the degree of respiratory muscle weakness, and reduced inspiratory and expiratory flow rates. Pulmonary function was significantly more disturbed in Group 2 than in Group 1, and correlated well with maximal static inspiratory and expiratory pressures. Analysis of the flow-volume loop configuration revealed that four parameters describing effort-dependent portions were significantly related to maximal static inspiratory pressure and maximal static expiratory pressure. These parameters were peak expiratory flow, the slope of the ascending limb of the maximal expiratory curve, a drop of forced expiratory flow near residual volume, and forced inspiratory flow at 50 percent of vital capacity. A flow-volume loop score obtained from these four parameters was significantly higher in Group 2 than in Group 1 (2.8 +/- 1.03 versus 1.1 +/- 1.37; p less than 0.01). A flow-volume loop score of 2 or more had 80 percent specificity and 90 percent sensitivity in predicting respiratory muscle weakness in these patients with chronic neuromuscular disease. These data suggest that sensitive assessment of the flow volume loop configuration as part of routine pulmonary function testing may help to suspect and identify respiratory muscle weakness. PMID- 3674056 TI - Prognosis of noncardiac medical patients receiving mechanical ventilation in a veterans hospital. AB - In order to determine prognostic factors in noncardiac medical patients treated by mechanical ventilation in a Veterans Administration hospital, 78 patient records were reviewed. Disease severity was scored by the Acute Physiology and Chronic Health Evaluation (APACHE) II system. Physicians' prior impressions of prognostic factors were compared with the actual results of this study. Most patients were middle-aged men with respiratory diseases. Fifty-nine patients (76 percent) died in the hospital. Survivors of hospitalization and nonsurvivors had similar age, diagnoses, emergency intubations, duration of ventilation, and pH and oxygen tension after 24 hours of ventilation. However, only one of 31 patients with a serum albumin level of 2.5 g/dl or less at the initiation of mechanical ventilation survived (p less than 0.001). Of 24 patients requiring a fractional inspired oxygen concentration greater than 50 percent at 24 hours, none survived (p less than 0.005). At all APACHE II scores, the mortality rates documented in this study were higher than predicted. Physicians overestimated the impact of several variables, including age and presence of pneumonia, on mortality. At the San Francisco Veterans Administration Medical Center, a low serum albumin level may aid in the decision whether to begin mechanical ventilation, and a high fractional inspired oxygen concentration at 24 hours may aid in the decision regarding further aggressive care. These findings need to be validated in other patients before being applied. Conversely, certain older patients, and those undergoing emergency intubation or intubation for a prolonged time, may have as good a prognosis as patients without these factors. PMID- 3674057 TI - Diagnostic and prognostic implications of recurrences in patients with syncope. AB - The incidence and the diagnostic and prognostic implications of recurrences in 433 patients enrolled in a prospective syncope study are reported. Over a mean follow-up of 30 months, 146 patients had recurrent syncope. Patients with an initial diagnosis of a cardiovascular cause of syncope had a recurrence rate of 31 percent, patients with a noncardiovascular cause had a recurrence rate of 36 percent, and patients with syncope of unknown origin had a recurrence rate of 43 percent at three years (these differences were not significant; the minimum for any two-way comparison was p greater than or equal to 0.11). In eight of the 191 patients in whom a cause of syncope could not be found on initial evaluation, a diagnosis was assigned in follow-up after recurrent syncope. Recurrences led to major morbidity in eight of 146 patients (5 percent) and minor trauma in 10 patients (7 percent). Using recurrence as a time-dependent variable in the Cox models, it was found that this variable was not a significant predictor of overall mortality or sudden death. It is concluded that recurrences are common in patients with syncope, but new diagnosis are rarely established on the basis of evaluation of recurrences. Recurrences are not predictors of mortality or sudden death. PMID- 3674058 TI - Spectrum of endocrine abnormalities associated with acanthosis nigricans. AB - Acanthosis nigricans is a marker for disorders of insulin action, endocrine abnormalities, and cancer of internal organs. To evaluate the clinical significance of this marker the systemic alterations and clinical features of 26 patients with acanthosis nigricans seen at two institutions were reviewed. Most subjects affected by acanthosis nigricans were female (20 patients), Caucasian (22 patients), in the third decade of life (13 patients), and overweight (24 patients greater than 120 percent ideal body weight). Gonadal disease, present in 17 patients, was expressed as polycystic ovary syndrome (11 cases), disorders of prolactin secretion (two cases, one with polycystic ovary syndrome), streak gonads (one case), and hypogonadism of the male (four cases). Thyroid disease and tinea versicolor were present in four patients each. Three patients were receiving insulin therapy for diabetes mellitus, and in two additional patients diabetes mellitus was detected during the diagnostic workup. All patients had elevated fasting insulin levels; most of them also had an exaggerated insulin response to a glucose load. Two of 18 patients tested had antibodies against the insulin receptor in the circulation. Skin biopsy of acanthosis nigricans lesions from all 26 patients showed a typical pattern of hyperkeratosis, acanthosis, and epidermal papillomatosis. Colloidal iron staining showed glycosaminoglycan infiltration of the papillary dermis (21 of 21 cases), consisting mainly of hyaluronic acid. It is concluded that: (1) hyperinsulinenemia and local dermal glycosaminoglycan deposition are regular features in acanthosis nigricans and (2) patients with acanthosis nigricans should be screened for diabetes mellitus, gonadal disease, and hypothyroidism. PMID- 3674059 TI - Treatment of idiopathic mixed cryoglobulinemia with alpha interferon. AB - Seven patients with type II idiopathic mixed cryoglobulinemia were treated with recombinant human leukocyte interferon (alpha interferon). In all of them, a conspicuous reduction of circulating cryoglobulins was noted, together with a definite, remarkable improvement of the clinical pattern. The immunologic parameters (natural killer cell activity and phagocytosis, among others) improved as well; side effects were usually mild and transient. Increases in the cryoglobulin level occurred in a few cases, but they were at least partly sensitive to readministration of alpha interferon treatment. The favorable results obtained in these cases of idiopathic cryoglobulinemia seem to be consistent and prolonged. PMID- 3674061 TI - An outlier theory of cancer curability. Tumor cell differentiation as a therapeutic goal. AB - Combinations of cytotoxic agents that cure a substantial percentage of patients with several childhood and adult malignancies are much less efficacious for the majority of solid tumors. Standard approaches for curability that rely solely on the concept of cytotoxicity may not be applicable for most epithelial and mesenchymal solid malignancies. Differentiation may play a more important role in cancer cure than heretofore suspected. Clinical and experimental evidence supports further investigation into models of inducing tumor cell differentiation. The question of why such models could predict for curative modalities of treatment is discussed. PMID- 3674060 TI - Cerebral infarction from non-bacterial thrombotic endocarditis. Clinical and pathological study including the effects of anticoagulation. AB - The clinical and pathologic findings in 42 autopsy proved cases of cerebral infarction from cancer-associated non-bacterial thrombotic endocarditis were reviewed. Carcinoma of the lung was the most common malignancy. Most patients had disseminated cancer, but in six patients, the condition was stable or in remission, and six patients had localized cancer; two patients were not known to have cancer until neurologic symptoms developed. Neurologic symptoms were focal, suggesting stroke in 18; diffuse, suggesting metabolic encephalopathy in nine; and mixed in five. Neurologic signs were often the only evidence of thromboembolism. The definitive diagnostic test was cerebral angiography showing multiple arterial occlusions. Anticoagulation with heparin appeared to help some patients and did not promote brain hemorrhage. Early diagnosis and vigorous treatment of non-bacterial endocarditis may prevent severe neurologic disability. PMID- 3674062 TI - Graves' disease with thyrotoxicosis following subacute thyroiditis. AB - Two patients are described who manifested the sequential occurrence of Graves' disease and subacute thyroiditis. The literature on this very unusual event is reviewed and speculation is offered on a possible mechanism linking thyroiditis to activation of Graves' disease in susceptible persons. PMID- 3674063 TI - Patients with primary hypothyroidism presenting as prolactinomas. AB - Hyperprolactinemia can occur in patients with primary hypothyroidism. Two women with hypothyroidism who had elevated serum prolactin levels, galactorrhea, amenorrhea, and pituitary computed tomographic scans that demonstrated the presence of "pituitary tumors" were recently evaluated. It was believed that they had prolactinomas, and they were referred for possible surgery. An elevated serum thyroid-stimulating hormone level, however, suggested that they had primary hypothyroidism and probably pituitary enlargement secondary to pituitary hyperplasia. Detailed evaluation of thyroid-stimulating hormone and prolactin secretion was performed. These studies revealed several abnormalities in dopamine prolactin interactions; however, the primary event responsible for the hyperprolactinemia is unclear. These women were given thyroxine therapy, and subsequent radiologic and endocrine studies documented resolution of their "pseudotumors" and normalization of the serum thyroxine and prolactin levels. Hence, thyroid-stimulating hormone levels should be measured in all patients presenting with a suspected prolactinoma so that any hypothyroidism that is noted is not presumed to be due to secondary hypothyroidism from tumor involvement of the pituitary. PMID- 3674064 TI - Localization of ectopic pheochromocytomas by magnetic resonance imaging. AB - Magnetic resonance imaging (MRI) was utilized to localize ectopic pheochromocytomas in two patients. In both cases, MRI proved superior to computed tomography. Differentiation from surrounding tissue was excellent. MRI permits spatial localization and by assessment of signal contrast intensity provides a suggestion as to the characteristics of the tumor without the use of invasive procedures or intravenous injections. MRI should be considered as an alternative to computed tomography when evaluating patients with a suspected pheochromocytoma. PMID- 3674065 TI - Pheochromocytoma, polycythemia, and venous thrombosis. AB - Polycythemia is rarely associated with pheochromocytoma. A patient with a 22-year history of malignant pheochromocytoma is presented in whom major complications developed as a result of long-standing polycythemia, apparently due to secretion of erythropoietin by the tumors. Despite attempts to reduce tumor burden by surgery, chemotherapy, and large doses of I-131-metaiodobenzylguanidine, polycythemia persisted. Extensive venous thrombosis developed requiring hospitalization and anticoagulation. Thus, polycythemia itself may be a cause of major morbidity in patients with pheochromocytoma, and prophylactic measures may be warranted. Review of the 130 patients with benign and malignant pheochromocytoma studied since the introduction of I-131-metaiodobenzylguanidine in 1980 revealed another six patients with hematocrits over 50 but only one had a hematocrit greater than 55 and required regular phlebotomy. In contrast, anemia (hematocrit less than 35) due to variety of causes was present in 18 cases. PMID- 3674066 TI - Vaccine-associated poliomyelitis in a household contact with Netherton's syndrome receiving long-term steroid therapy. AB - Paralytic poliomyelitis developed in a man 51 days after his two-month-old daughter received her first dose of trivalent live oral poliovirus vaccine. The patient was receiving long-term glucocorticosteroid therapy (tapered to 12.5 mg per day for the eight months prior to his poliomyelitis) for Netherton's syndrome, a congenital syndrome characterized by bamboo-like hair, hyperkeratotic and hyperhidrotic skin, and multiple allergies. The patient was ventilator dependent and quadriplegic throughout most of his hospital stay and died in the hospital 10 months after the onset of paralysis. "Vaccine-like" type 3 poliovirus was isolated from a stool specimen and his serum showed a significant rise in neutralizing antibody titer against type 3 virus. This case report represents the first documented case of vaccine-associated poliomyelitis in a household contact receiving glucocorticosteroids, although evidence of immunosuppression was not documented. Nevertheless, the case reinforces current recommendations not to administer oral poliovirus vaccine to persons known to be immune deficient or suppressed or to normal persons with close contacts known to be immune deficient or suppressed. PMID- 3674067 TI - Staphylococcus aureus septicemia mimicking fulminant Rocky Mountain spotted fever. AB - Septicemia due to Staphylococcus aureus can be a difficult diagnosis to make early in its presentation. This report illustrates a case that mimicked fulminant Rocky Mountain spotted fever in a patient with no other medical problems that might predispose her to the development of staphylococcal sepsis. Epidemiology, cerebrospinal fluid characteristics, and early biopsy of skin lesions are emphasized as important factors leading to early diagnosis and definitive treatment. PMID- 3674068 TI - Prophylaxis of endocarditis. PMID- 3674069 TI - Screening for alcohol abuse using the CAGE questionnaire. PMID- 3674070 TI - Spontaneous remission of metastatic paraganglioma. PMID- 3674071 TI - Spontaneous Candida albicans meningitis in a patient with the acquired immune deficiency syndrome. PMID- 3674072 TI - Cardiac myonecrosis and monoamine oxidase inhibitor therapy. PMID- 3674073 TI - Hypothermia associated with terminal liver failure. PMID- 3674074 TI - Penile vein thrombosis: a patient with a lumpy penis. PMID- 3674076 TI - Correction: catheter-related sepsis. PMID- 3674075 TI - Drug company-sponsored symposia: pros and cons. PMID- 3674077 TI - Asymptomatic bacteriuria in the elderly. PMID- 3674078 TI - Treatment of calcinosis universalis with low-dose warfarin. PMID- 3674079 TI - Diagnostic value of zinc levels in pleural effusions. PMID- 3674080 TI - Cryptococcal mediastinitis mimicking lymphoma in the acquired immune deficiency syndrome. PMID- 3674081 TI - Spontaneous regression of a prolactin-producing pituitary adenoma during pregnancy. PMID- 3674082 TI - Osteomyelitis of the clavicle as complication of infected subclavian vein catheter. PMID- 3674083 TI - Volume expansion versus pericardiocentesis in low-pressure cardiac tamponade. PMID- 3674084 TI - Vitamin D toxicity in patients with renal failure. PMID- 3674085 TI - Ileocecal tuberculosis in a patient with the acquired immune deficiency syndrome. PMID- 3674086 TI - Pyoderma gangrenosum versus acute febrile neutrophilic dermatosis (Sweet's syndrome) PMID- 3674087 TI - Cardiac pheochromocytoma. PMID- 3674088 TI - Human immunodeficiency virus-associated meningitis. Clinical course and correlations. AB - Fourteen patients infected with human immunodeficiency virus (HIV) had a lymphocytic pleocytosis unexplained by secondary pathogens or neoplasms. Three men had prior diagnoses of Kaposi's sarcoma; none had acquired immune deficiency syndrome-defining opportunistic infections. Two patterns of illness were observed. Seven men had an acute, self-limited illness that was often accompanied by meningeal findings. The other seven had chronic headaches without signs of meningeal irritation and had less marked abnormalities of cerebrospinal fluid (CSF) cell count and protein. Encephalopathy was a finding in only one of 14 patients. In four of five CSF specimens studied, HIV was recovered. HIV has been associated with acute meningitis at the time of seroconversion and can apparently also cause sporadic episodes of acute or chronic meningitis in patients with prior infection and relatively preserved immune function. Both the clinical presentation with predominant headache rather than encephalopathy and the presence of CSF inflammation differentiate this syndrome from other HIV-related neurologic complications. PMID- 3674090 TI - Analysis of continuous ambulatory peritoneal dialysis-related Pseudomonas aeruginosa infections. AB - The outcomes of all continuous ambulatory peritoneal dialysis-related infections due to Pseudomonas aeruginosa (n = 33) were analyzed and compared with the outcomes of infections due to all other microorganisms (n = 663) over a seven year period. There were 16 catheter infections (exit site or tunnel infection or both), seven episodes of peritonitis, and 10 episodes of catheter infections associated with peritonitis due to P. aeruginosa. Catheters were removed in 58 percent (19 of 33) of the infections due to P. aeruginosa, but in only 16 percent (104 of 663) of the infections due to other organisms (p less than 0.01). All P. aeruginosa catheter infections associated with P. aeruginosa peritonitis resulted in catheter loss. P. aeruginosa catheter infections not associated with peritonitis also often did not resolve with antibiotic therapy (nine of 16 or 56 percent of catheters removed compared with 42 of 317 or 13 percent of catheters removed for other organisms, p less than 0.01). However, P. aeruginosa peritonitis episodes that were not associated with a catheter infection were no more likely to result in catheter loss than were peritonitis episodes due to other organisms (one of seven compared with 37 of 256, 14 percent for both). It is concluded that catheter infections due to P. aeruginosa with or without associated peritonitis usually require catheter removal. Conversely, P. aeruginosa peritonitis without a catheter infection often does not require catheter removal. PMID- 3674089 TI - Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital. AB - Strictly enforced formulary restrictions for aminoglycosides, cephalosporins, and a vancomycin group generated combined savings of $2.61 (p less than 0.0046) per antibiotic day and $34,597 (p less than 0.0003) per month. Even after some cost increases (not significant) in new and other antibiotics, the program saved $1.33 (p less than 0.0175) per antibiotic day and $24,620 (p less than 0.0311) per month for all antibiotics. The pharmacy's 1985 average cost per antibiotic day and its monthly expenditures were $18.45 and $199,003, respectively. In the months following the formulary restrictions, no significant detrimental changes occurred in hospital length of stay or mortality. A retrospective analysis of 322 patients with bacteremia treated before and after the onset of the controls revealed that antibiotics were more appropriately used afterwards. PMID- 3674091 TI - Acute neurologic and psychiatric complications associated with cocaine abuse. AB - This report reviewed 996 emergency room visits and 279 hospital admissions of patients with complications of cocaine abuse seen at the San Francisco General Hospital between 1979 and 1986. In 143 cases, acute neurologic or psychiatric symptoms were the primary complaint, and case-notes provided sufficient detail for analysis. The major neurologic complications included one or more seizures (n = 29), focal neurologic symptoms or signs (12), headache (10), and transient loss of consciousness (six). Psychiatric disturbances included agitation, anxiety, or depression (33), psychosis and paranoia (24), and suicidal ideation (18). The most serious consequences were found in patients with prolonged seizures or strokes, those who jumped out of buildings, and those who attempted suicide by overdosing with other drugs. There was no correlation between the appearance of complications and the reported route of administration, the amount of cocaine used, or prior experience with cocaine. The number of patients who are seeking hospital attention for these or related complaints appears to be rising substantially. Cocaine abuse, regardless of the use pattern, is associated with a variety of potentially severe neurologic and psychiatric complications. PMID- 3674092 TI - Sex hormones and coronary artery disease. AB - Previous investigators have found an increased risk of coronary heart disease in men with high levels of circulating estrogens. To elucidate further this relationship, a case-control study of atherosclerotic coronary artery disease (ASCAD) and sex hormones was undertaken in male patients. Hormone levels in men with severe ASCAD documented at angiography were compared with those in men found to be virtually free from disease and with those in a group of control subjects without signs or symptoms of ASCAD. Significantly lower total testosterone levels were observed among men with severe ASCAD compared with either control group; the free testosterone level was significantly lower than in angiographically disease free control subjects. The same pattern of hormone levels persisted after control of covariates. Epidemiologic analysis demonstrated a fivefold decrease in risk for severe ASCAD between the lowest and the highest quartile of total testosterone. No overall pattern of association was seen between ASCAD and free or total estrogens. PMID- 3674093 TI - Induction and circumvention of nitrate tolerance applying different dosage intervals. AB - There is increasing evidence that constant nitrate plasma levels, as induced by at least three-times-daily ingestions of isosorbide dinitrate in sustained release form, lead to an attenuation or even complete loss of the anti-ischemic effects (nitrate tolerance). Therefore, the dependence of tolerance development on dosage intervals according to once-daily and twice-daily ingestions was assessed. Tablets of isosorbide dinitrate (80 mg) in sustained-release form were administered once-daily at 8 A.M. (dosage interval 24 hours) or twice-daily at 8 A.M. and 8 P.M. (dosage interval 12 hours), as well as at 8 A.M. and 2 P.M., respectively (maximal dosage interval 18 hours). A total of 34 patients with angiographically proven coronary artery disease, a history of stable, exercise dependent angina pectoris, and a reproducible, exercise-induced ST-segment depression of at least 0.15 mV (1.5 mm), who initially showed a response to 80 mg of isosorbide dinitrate, were enrolled. The anti-ischemic effects of isosorbide dinitrate on exercise-induced ischemia were objectively determined by the measurement of exercise-induced ST-segment depression before as well as two, six, and 12 hours after the ingestion at the first and the 15th day of the studies. Since the dosage interval of 12 hours resulted in constant plasma levels, the initially beneficial anti-ischemic effects of isosorbide dinitrate were considerably attenuated after two weeks of treatment. In contrast, the once-daily regimen with its intermittent peaks and valleys of nitrate plasma levels showed identical anti-ischemic effects at the 15th day as compared with the first day. Ingestions at 8 A.M. and 2 P.M. also circumvented the development of nitrate tolerance, however, combined with an even more pronounced anti-ischemic effect after 12 hours as compared with the once-daily regimen. Thus, the circumvention of nitrate tolerance requires a daily "nitrate-poor" interval. The best compromise between a maximal possible anti-ischemic effect and the circumvention of tolerance development was found for the "eccentric" dosage regimen in which the tablets were ingested in the morning and early afternoon. PMID- 3674094 TI - Long-term follow-up of patients with lupus nephritis. A study based on the classification of the World Health Organization. AB - The long-term course of 56 patients with systemic lupus erythematosus who had precisely defined renal histology and carefully assessed clinical status at the time of their initial renal biopsy prior to 1976 was evaluated and analyzed by life-table analysis. The average length of follow-up has now been greater than 10 years since initial biopsy. Patients with mesangial lesions (World Health Organization [WHO] classes IIA and IIB) had a more favorable renal and patient survival at five and 10 years than did patients in the other WHO classes (III, IV, and V). Individual renal histologic features of activity and chronicity when combined into an activity index and a chronicity index did not significantly predict renal survival in this population, nor did the presence of hypertension or renal dysfunction at the time of the initial renal biopsy significantly influence renal or patient survival. Patients with the nephrotic syndrome at initial biopsy had a poorer renal survival than did patients without the nephrotic syndrome. However, patients who experienced a remission of the nephrotic syndrome fared better in terms of both renal and patient survival than did those patients without a remission. By life-table analysis, patient survival was significantly better for patients in whom biopsy was performed after 1973 than for those in whom biopsy was performed prior to that time despite similar clinical features and WHO histology in each group interval. Our data suggest that improved survival for patients in recent studies may relate to better supportive care and more selective use of immunosuppressive therapy in patients with milder forms of lupus nephritis. PMID- 3674095 TI - Long-term effects of hydralazine on ventilation and blood gas values in patients with chronic obstructive pulmonary disease and pulmonary hypertension. AB - Hydralazine has been shown to increase minute ventilation, alveolar ventilation, and arterial partial pressure of oxygen (PaO2) after short-term administration in patients with chronic obstructive pulmonary disease and pulmonary hypertension. The effects of orally administered hydralazine on ventilation and blood gas values were evaluated after six to 18 months of treatment in 10 male patients who had demonstrated an increase in minute ventilation after 24 hours of treatment. Hydralazine was administered at a dose of 200 mg per day during the initial 24 hours and in doses ranging from 40 mg per day to 200 mg per day during long-term therapy. Following 24 hours of treatment, a statistically significant increase in minute ventilation, alveolar ventilation, and PaO2, and reduction in arterial partial pressure of carbon dioxide (PaCO2) were seen both at rest and during exercise. After six to 18 months of hydralazine therapy, the increase in minute ventilation at rest persisted when compared with the pre-hydralazine value (15.3 +/- 1.3 liters/minute versus 13.1 +/- 1.1 liters/minute; p less than 0.05). The improvement in PaO2 at rest continued relative to the pre-hydralazine value (70.9 +/- 3.2 mm Hg versus 65.1 +/- 3.0 mm Hg, p less than 0.05) as did the PaO2 during exercise (60.3 +/- 3.5 mm Hg versus 53.3 +/- 2.0 mm Hg; p less than 0.05). The reduction in PaCO2 at rest persisted compared with the pre-hydralazine value (41.2 +/- 2.4 mm Hg versus 47.0 +/- 3.0 mm Hg; p less than 0.05) as did the PaCO2 during exercise (44.0 +/- 2.8 mm Hg versus 48.0 +/- 2.8 mm Hg; p less than 0.05). No significant changes in minute ventilation, PaO2, or PaCO2 were seen at rest or during exercise, when re-measured after six to 18 months in an age- and sex matched control group of 10 patients who did not receive hydralazine. These results demonstrate that the short-term effects of hydralazine on ventilation and blood gas values persisted after six to 18 months of treatment in this sample of patients, some of whom received doses less than 200 mg per day. PMID- 3674096 TI - Elevated pyruvate kinase activity in patients with hemolytic anemia due to red cell pyruvate kinase "deficiency". AB - Two patients with non-spherocytic hemolytic anemia were found to have elevated red blood cell pyruvate kinase activities commensurate with the decreased mean red cell age, but the residual pyruvate kinase had marked kinetic abnormalities. Accumulation of metabolic intermediates before pyruvate kinase and reduced levels of activity of the red blood cells of the parents of both patients supported the diagnosis of an inherited abnormal pyruvate kinase causing hemolytic anemia. Although it was observed in two unrelated persons, review of enzyme assays performed on the red blood cells of 651 patients with hereditary non-spherocytic hemolytic anemia suggests that this occurrence is rare. PMID- 3674097 TI - Clinical assessment of extracellular fluid volume in hyponatremia. AB - Assessment of the status of extracellular fluid volume is important in evaluating the cause and selecting appropriate therapy for hyponatremic disorders. Since the sensitivity and specificity of clinical assessment of extracellular fluid volume status in hyponatremic states remain unknown, 58 non-edematous patients with serum sodium less than 130 meq/liter were prospectively evaluated. Patients were judged to be either normovolemic (no response of serum sodium to saline infusion) or hypovolemic (saline infusion significantly corrected hyponatremia). Hypovolemic patients had significantly higher plasma renin activity (5.0 +/- 1.5 versus 2.5 +/- 0.5 ng/ml per three hours, p less than 0.05) and norepinephrine (1,054 +/- 252 versus 519 +/- 55 pg/ml, p less than 0.05) concentrations than did normovolemic patients. Clinical assessment correctly identified only 47 percent of hypovolemic patients and 48 percent of normovolemic patients. Thus, clinical assessment was of limited sensitivity and specificity in identifying extracellular fluid volume status in these hyponatremic patients. However, the concentration of sodium in a spot urine sample clearly separated hypovolemic (mean UNa = 18.4 +/- 3.1 meq/liter) from normovolemic (mean UNa = 72 +/- 3.7 meq/liter, p less than 0.001) hyponatremic patients. PMID- 3674098 TI - Specific effects of sedative/hypnotic drugs in the treatment of incapacitating chronic insomnia. PMID- 3674099 TI - Evaluation of intern performance by medical inpatients. AB - Patients, as the recipients of medical care, have a unique and crucial perspective from which to judge the performance of physicians. In this study, 27 interns (postgraduate year 1 residents) were evaluated by a sample of 212 medical inpatients at two university-affiliated hospitals using a previously validated questionnaire constructed from patients' comments. Patients were generally very satisfied with the performance of their interns and valued traditional clinical skills and interpersonal skills equally. The most important and characteristic attributes of the interns as rated by patients were demonstrating personal concern, skill in treating disease, providing information about findings, preparation for impending events, availability, manner of communication, trust, and comforting and listening skills. Encouraging mutuality by the interns was not often done and was not believed to be particularly important by patients. Older patients and whites were more satisfied with their interns, whereas college educated, employed, and male patients were less satisfied. Implications of the findings for understanding and teaching about the physician-patient relationship are discussed. PMID- 3674101 TI - Nephropathic cystinosis with central nervous system involvement. AB - Nephropathic cystinosis is associated with end-stage renal failure, retinal damage, and hypothyroidism. Patients may now survive past the first decade of life with the use of dialysis and renal transplantation. Examination of a 24-year old woman with this disorder revealed ovarian failure, mildly abnormal results on a glucose tolerance test, intermittent confusion, short-term memory loss, and cerebral atrophy on computerized axial tomography. Autopsy examination at age 25 years revealed cystine storage in multiple tissues including the atrophic ovaries, pancreatic islet cells, the aorta, and the brain. Dysfunction of multiple organ systems may develop in patients with cystinosis who survive into adulthood. This emphasizes the need for a systemic therapy for cystinosis. PMID- 3674100 TI - Strongyloides stercoralis hyperinfection in a patient with the acquired immune deficiency syndrome. AB - Severe infections with Strongyloides stercoralis occur in immunocompromised patients. Strongyloides hyperinfection syndrome complicated by gram-negative bacteremia and meningitis in a bisexual man with the acquired immune deficiency syndrome (AIDS) is described. Increased awareness of this infection, which may also be sexually transmitted, is recommended when caring for patients with AIDS who are homosexual, or have resided in areas endemic for strongyloidiasis. Multiple stool examinations should be performed routinely for such patients. Examination of sputum for the parasite is recommended if pneumonia is present. Prompt diagnosis and therapy are essential for prevention of fatal dissemination. PMID- 3674102 TI - Treatment of torsades de pointes with esophageal atrial pacing. AB - A 65-year-old woman presented with new onset atrial fibrillation. Medical therapy with digoxin and quinidine was not effective in controlling the arrhythmia. Subsequently, complications developed including a stroke and torsades de pointes. The arrhythmia was successfully controlled by overdrive suppression by esophageal pacing. This case illustrates the usefulness of esophageal pacing and how it may be applied in emergencies when transvenous pacing cannot be readily performed outside the intensive care unit setting. PMID- 3674103 TI - Giant invasive prolactinomas. AB - Two of the largest prolactinomas ever documented that have been followed for nine and 10 years, respectively, demonstrate how aggressive prolactinomas may become and how difficult invasive prolactinomas are to treat. One of these prolactinomas invaded both internal auditory canals and simultaneously grew inferiorly, reducing the bony support of the skull and necessitating the patient to utilize both hands to hold his head up. The second patient's prolactinoma invaded the sphenoidal, ethmoidal, and cavernous sinuses. Both of these patients had neurosurgical debulking of their tumors followed by radiation therapy. Neither patient's prolactin levels decreased significantly during their first five years post-surgically, at which time bromocriptine was added. Since then, there has been a gradual lowering of serum prolactin levels and a decrease in the size of these tumors. These cases demonstrate that prolonged treatment and very large doses of bromocriptine may be necessary for tumor reduction in patients with invasive prolactinomas. PMID- 3674104 TI - Individual variation and specific cognitive deficits in the fra(X) syndrome. AB - Mental retardation has been associated with fra(X) but comprehensive psychological evaluation has rarely been applied to 2 major behavioral questions 1) the extent of individual variation in IQ among fra(X) males and the possibility of some fra(X) males being of normal IQ; and 2) whether there is a depression in general IQ or whether specific abilities are impaired. The problems of developing an effective battery of tests for assessing fra(X) are discussed. These questions were examined in 54 individuals, comprising fra(X) males, their obligate carrier mothers and those sisters shown to have the fra(X). Among noninstitutionalised males nonverbal IQ as measured on a Block Design test ranged from 100 to 0, and vocabulary scores while generally higher, ranged from 79-33. The males scored low on a digit span memory task, while performance on a memory of objects task was adequate. Despite lower overall scores, a similar pattern and variability emerged in institutionalised males. Daughters were extremely variable in performance and the mothers performed much better, supporting the view that women who have children are a selected subset of fra(X) syndrome individuals. The performance of one male is discussed in detail. His vocabulary and nonverbal IQ scores were normal, despite his having other specific cognitive deficits. The pattern of abilities and behavior seen in fra(X) may result in an overestimation of intelligence and underestimation of penetrance when based on clinical impressions rather than formal psychological assessment. The implications of this for molecular and for population genetic approaches to fra(X) are discussed. PMID- 3674105 TI - X-linked laterality sequence: situs inversus, complex cardiac defects, splenic defects. AB - The association of abdominal situs inversus, complex cardiac defects, and alterations in development of the spleen represents a developmental field complex with variable expression of altered laterality. Familial and inherited cases documenting respectively autosomal recessive and dominant inheritance have been reported. We report on the first family in which X-linked recessive inheritance of this defect has been documented. PMID- 3674106 TI - Cognitive variability in the fragile X syndrome. PMID- 3674107 TI - Syndrome of osteopetrosis and muscular degeneration associated with cerebro-oculo facio-skeletal changes. AB - We describe an infant with cerebro-oculo-facio-skeletal manifestations, radiologic and pathologic findings of osteopetrosis, and severe myopathic degeneration proven on histopathologic study of muscles. The muscle changes appear to be part of the pathogenetic process in this syndrome and the cause of the flexion contractures present at birth. Real-time ultrasonography may prove a useful tool in prenatal diagnosis of this syndrome. PMID- 3674108 TI - Apparent Apert syndrome with polydactyly: rare pleiotropic manifestation or new syndrome? AB - Two patients are described with a syndrome which resembles Apert syndrome with polydactyly of hands and feet. This association is apparently rare and we think that this may represent a distinct syndrome separate from Apert syndrome. PMID- 3674109 TI - Recurrence risks in the presence of single gene susceptibility to environmental agents. AB - Investigators often attribute the 2-5% sibling recurrence risks of common congenital malformations to a multifactional/threshold model (MFT) mechanism. However, most studies fail to address adequately the role of specific environmental factors and their interaction with genetic factors in recurrence risks. We consider the effects of a hypothetical environmental agent on recurrence risks in the presence of a single gene-mediated differential susceptibility. It can be shown that recurrence risks increase with increasing population exposure frequency to the agent and the strength of gene-environment interaction (relative risk among susceptible genotypes). However, they are usually much lower than expected on the basis of simple Mendelian segregation. Moreover, recurrence risks decline considerably between 1st, 2nd, and 3rd degree relatives, especially for recessive traits. Because single gene-mediated differential susceptibility can mimic the MFT model in many instances, family studies of malformations (and other common diseases) could be more rewarding if they incorporate in their design and analyses specific environmental exposures affecting disease risk. PMID- 3674110 TI - Decreased cell viability of fibroblasts from two patients with a ring chromosome: an in vitro reflection of growth failure? AB - We found decreased cell viability in fibroblast cultures from two patients, one with ring chromosome 4, the other with ring chromosome 15, who had severe somatic retardation. Cell viability was studied with the trypan blue exclusion assay, and in comparison with matched control cells was found to be 72.0 vs. 93.1%, and 79.8 vs 90.2%, respectively. Cloning efficiency of fibroblasts from the patient with ring chromosome 15 was also decreased (12.3 vs. 25.7%). It is suggested that the decreased cell viability is due to a continuous production of hypomodal cells, a process related to the ring structure per se, and perhaps responsible for the severe somatic retardation frequently observed in patients with a ring chromosome. PMID- 3674111 TI - Chromosomal mosaicism of trisomy 7 restricted to chorionic villi. PMID- 3674113 TI - Familial situs inversus and congenital heart defects. PMID- 3674112 TI - Multiple benign circumferential skin creases on limbs--a congenital anomaly existing from the beginning of mankind. PMID- 3674114 TI - Normal high-resolution karyotypes in three patients with the Holt-Oram syndrome. PMID- 3674115 TI - A genetic follow-up study of 64 patients with the Pierre Robin complex. AB - A genetic follow-up study has been performed of 64 infants who were diagnosed as having Pierre Robin complex over a 23-year period in South Australia. Patients and their families were contacted, family history was obtained, and physical examinations were performed with an aim to detect heterogeneity and establish recurrence risks. In 16 deceased patients, detailed autopsy reports allowed the conclusion that 12 (70%) had an underlying syndrome. Twelve of the 47 living patients (26%) were diagnosed as having an underlying syndrome, the most common of which was Stickler syndrome (6 cases). In most cases separation of syndromic cases from the nonsyndromic cases was possible in the neonatal period. In the 34 patients without an underlying syndrome, study of pregnancy and birth details did not reveal any distinctive etiologic factors. There was no recurrence in sibs of this group of patients with nonsyndromic Pierre Robin complex. PMID- 3674116 TI - Familial Prader-Willi syndrome with apparently normal chromosomes. AB - We report on 4 sibs (2F, 2M) with Prader-Willi syndrome (PWS). Diagnosis was made clinically on the basis of history, behavior, and physical findings in 3 of the sibs. The other child had died at age 10 months with a history and clinical findings typical of first phase of PWS. Results of chromosome studies on the parents and surviving sibs were normal. The implications of this unusual familial occurrence for our understanding of PWS are discussed. PMID- 3674117 TI - Clinical heterogeneity associated with deletions in the long arm of chromosome 15: report of 3 new cases and their possible genetic significance. AB - Deletions, duplications, and rearrangements of the long arm of chromosome 15 are frequently associated with the clinical diagnosis of the Prader-Willi syndrome. However, a number of other clinical entities have also been associated with similar, if not identical, cytogenetic defects, arguing for clinical heterogeneity associated with abnormalities in this region of chromosome 15. We present 3 patients who all appear to have deletions in 15q11-15q12, such as described for many patients with Prader-Willi syndrome; however, none of these patients has classical clinical features of the Prader-Willi syndrome. The first patient is a child with Williams syndrome, the second, Angelman (Happy Puppet) syndrome, and the third is a child with hypotonia of infancy, obesity, and developmental delay, but who does not meet specific diagnostic criteria for the Prader-Willi syndrome. It is proposed that different molecular abnormalities involving specific points or segments along the long arm of chromosome 15 might account for the clinical diversity seen among these and other patients. PMID- 3674118 TI - Atypical phenotype associated with deletion (15) (pter----q11::q13----qter). AB - We report on a 10-year-old boy with an interstitial deletion within the region of bands 15q11----q13. Authors have associated the manifestation of the Prader-Willi syndrome (PWS) with variable deletions involving the bands q11----q13. Our patient had atypical manifestations not usually associated with PWS, ie, normal stature, proportionally sized hands and feet, normal genitalia, and was nonambulatory and severely mentally retarded. This case emphasized the clinical diversity seen in proximal 15q deletions in the region considered to be correlated with the PWS. PMID- 3674119 TI - Recurrence risk in Prader-Willi syndrome. PMID- 3674120 TI - Diprosopus with associated malformations: report of two cases. AB - We report on two patients with craniofacial duplication and anencephaly. In addition to these anomalies, one patient showed vertebral fusion and diaphragmatic hernia, and the other one presented cheilognathopalatoschisis. PMID- 3674121 TI - Lessons from conjoined twins. PMID- 3674122 TI - Monozygosity and holoprosencephaly: cleavage disorders of the "midline field". PMID- 3674123 TI - Two million a day is not chicken feed. PMID- 3674124 TI - "Why bother about flu shots?". PMID- 3674125 TI - Using restraint. PMID- 3674126 TI - Hyperglycemia at dawn. PMID- 3674127 TI - Lung cancer. Tobaccoism in America. PMID- 3674128 TI - Lung cancer. The diagnostic workup. PMID- 3674129 TI - Lung cancer. Teaching, counseling, and caring. PMID- 3674130 TI - Too poor to pay: the scandal of patient dumping. PMID- 3674131 TI - Miami: keeping cool in a health care war. PMID- 3674132 TI - Speaking out. Who are the working poor? PMID- 3674133 TI - Just between friends. PMID- 3674134 TI - Myocardial contusion: the hidden menace in blunt chest trauma. PMID- 3674135 TI - West by Southwest: AJN JobFocus. PMID- 3674137 TI - How well do you use power? PMID- 3674136 TI - PCA vs. regular IM injections for severe postop pain. PMID- 3674138 TI - Tracking the cost of home care. PMID- 3674139 TI - The holiday cheese ball. PMID- 3674140 TI - Nifedipine: effects on fetal and maternal hemodynamics in pregnant sheep. AB - We investigated the effects of nifedipine, a calcium entry blocker, on the fetal and maternal circulation. Nifedipine was administered intravenously for 30 minutes to chronically instrumented pregnant ewes. Infusion of 5 micrograms.kg 1.min-1 resulted in a 30% to 50% increase in total and regional fetal cerebral blood flow to the brain stem, watershed, and subcortical regions (p less than 0.05), without a significant change in fetal oxygenation or cardiac output. Infusion of 10 micrograms.kg-1.min-1 decreased uterine blood flow by 21% (p less than 0.001) and fetal arterial oxygen content by 15% (p less than 0.01), with no further increase in fetal cerebral blood flow. Maternal arterial pressure decreased and heart rate increased (p less than 0.001) without variation of arterial blood gases. Significant plasma levels of nifedipine were detected in the fetal and maternal circulations. In view of the potential adverse effects on the fetus, further studies are needed before nifedipine is considered for use in human pregnancy. PMID- 3674141 TI - Absence of clomiphene and/or active metabolites in blood of clomiphene citrate treated patients during organogenesis: determination by radioreceptor assay. PMID- 3674142 TI - Spontaneous fetal seizures in utero. PMID- 3674143 TI - Human ovarian oxytocin and steroid hormones. PMID- 3674144 TI - Teen pregnancies. PMID- 3674145 TI - Hypertensive diseases of pregnancy: nulliparity, primiparity, multiparity, and gravidity. PMID- 3674146 TI - Pemphigus in pregnancy: a reevaluation of fetal risk. PMID- 3674147 TI - The cause of uterine softening in pregnancy. PMID- 3674148 TI - Intrapartum electronic fetal monitoring efficacy. PMID- 3674149 TI - Previous cesarean delivery and trial of labor. PMID- 3674150 TI - HELLP syndrome. PMID- 3674151 TI - Risk scoring for preterm labor: where do we go from here? AB - Risk scoring systems based on traditional demographic, social, and medical factors have limited use, especially in certain populations. Newer approaches, including frequent cervical examinations, periodic outpatient monitoring for contractions, extensive daily monitoring at home for contractions in very high risk persons, and identification and reduction of modifiable behavioral risks, offer promise. PMID- 3674152 TI - Presidential address of Association of Professors of Gynecology and Obstetrics. PMID- 3674153 TI - Cord serum bromide concentration: variation and lack of association with pregnancy outcome. AB - Excessive maternal bromide exposure during pregnancy from drugs and occupation have been reported to have adverse effects on the fetus and newborn, including central nervous system depression at birth and possible teratogenicity. To define further fetal bromide exposure during pregnancy, we determined the cord serum bromide concentration in 1267 newborn babies born in Rochester, New York, during the 6-month period from January 1, 1984 to June 30, 1984. There was a normal distribution of the cord serum bromide concentration values (mean +/- SD = 8.6 +/ 2.6 mg/L; range 3.1 to 28.5 mg/L). The highest concentration was still significantly below the minimal bromide concentration associated with toxic effects (720 mg/L). There was no association between the cord serum bromide concentration and indices of fetal health including Apgar scores, presence of congenital malformations, and neonatal disposition. No mothers were taking significant amounts of bromide-containing drugs during pregnancy. The second highest cord serum bromide concentration (21.4 mg/L) was in a woman who was an amateur photographer and developed her own film, which required her to use chemicals containing bromide. Our results indicate that excessive fetal bromide exposure is rare and probably occurs only in the setting of maternal use of bromide-containing drugs or occupational exposure during pregnancy. PMID- 3674154 TI - A pregnant woman with a high level of naturally occurring immunoglobulin M antibodies to Toxoplasma gondii. AB - A pregnant woman diagnosed as positive for immunoglobulin M antibodies to Toxoplasma gondii did not have a subsequent rise of specific immunoglobulin G antibodies until delivery. The antibodies were therefore considered as naturally occurring immunoglobulin M antibodies. The baby was completely normal without any clinical and serologic signs suggestive of congenital toxoplasmosis. PMID- 3674155 TI - The umbilical cord twist: origin, direction, and relevance. AB - The purpose of this study was to evaluate the origin, direction, and relevance of the umbilical cord twist. We initially hypothesized that the direction of the helix or twist of the human umbilical cord at birth correlated with the eventual handedness of the child. Among 2801 singleton placentas in this study, only 5% had no twist, and the left twist outnumbered the right twist by 7 to 1, a ratio that is strikingly similar to the predominance of right-handed persons to non right-handed persons in the general population. Forty-five 3- and 4-year-old children with previously documented cord twists were evaluated with respect to hand preference and performance. The direction of the cord twist was independent of the handedness of the child as well as the mother. We have documented an increased incidence of absent twist and right twist in association with single umbilical artery, suggesting that the impetus for the cord twist is independent on hemodynamic forces in the umbilical cord itself. We further document an increased incidence of absent twist among intrauterine fetal deaths and twins, suggesting that decreased fetal movement can impede the forces leading to normal twisting of the umbilical cord. Absence of cord twist may be associated with adverse prognosis. PMID- 3674156 TI - Indicators of perinatal asphyxia. AB - Creatinine phosphokinase and its isoenzymes (myocardial-specific MB and brain specific BB) are elevated in the presence of specific tissue injury. The value of this serum marker as an objective indicator of perinatal asphyxia was studied. Forty-nine patients with gestational ages ranging from 36 to 42 weeks were prospectively studied. Patients who by interpretation of the fetal heart rate tracing alone were diagnosed as having fetal distress demonstrated significantly lower pH (p = 0.001) and base excess (p less than 0.0001) in umbilical venous blood. Umbilical venous cord MB (p less than 0.05) and BB (p less than 0.01) were increased in this group. Abnormal fetal heart rate patterns correlate well with acid-base abnormalities and elevated creatinine phosphokinase values. These tests may demonstrate more efficient and improved indicators of tissue injury and damage from perinatal asphyxia than clinical observation alone. PMID- 3674157 TI - Umbilical cord blood pH and Apgar scores as an index of neonatal health. AB - In an effort to determine the clinical usefulness of Apgar scoring and cord pH in neonatal management, specimens of umbilical cord blood were obtained after 257 of 329 consecutive deliveries at a community-based hospital. A notable number of babies who were born in a vigorous state were in fact acidotic (umbilical arterial pH greater than 1 SD below mean). Seventy-two percent of acidotic babies had an Apgar score greater than 7 at 1 minute, and 92% had an Apgar score greater than 7 at 5 minutes. Correlation coefficients of Apgar scores at 1 and 5 minutes and arterial pH with the health status of newborn infants were poor. A chi 2 analysis of arterial pH and Apgar scores at 1 and 5 minutes indicated that a larger number of sick babies had an Apgar score less than 7 and acidosis than expected by pure chance. However, the sensitivity values of the Apgar score at 1 minute (0.48) and 5 minutes (0.24) and the arterial pH (0.40) for predicting sick children limit the clinical usefulness of these tests. While technically feasible in a community hospital, routine cord pH measurements add little to neonatal evaluation and management. PMID- 3674158 TI - Cervical endometriosis: facilitated diagnosis by fine needle aspiration cytologic testing. AB - Regarded as infrequent, endometriosis of the cervix probably occurs more commonly than is generally realized. The lesion's apparent rarity may be ascribed to limited awareness of the clinical appearance, combined with technical difficulty in obtaining suitable biopsy material for confirmation. A consequence of previous cervical trauma, endometriosis of the cervix can be expected to increase in incidence with more widespread use of invasive cervical procedures. Clinical recognition and tissue confirmation thus become essential. This paper refocuses attention on cervical endometriosis by documenting the clinical, colposcopic, and histopathologic findings in 16 cases seen at a single colposcopy clinic over a 6 month period. Diagnosis in these patients was facilitated and improved by fine needle aspiration cytologic testing. This technique, not previously used for documentation of endometriosis in this location, is outlined in detail, together with a full description and illustration of the cytologic features. PMID- 3674159 TI - A novel Y/13 familial translocation. AB - A novel Y/13 translocation was discovered in a female fetus during amniocentesis. The familial translocation is present in a phenotypically normal female sibling and in the father who also possesses a pericentric inversion. Karyotype of the father is 46,XY,-13,+der(13)t(Y;13)(q12;p12),inv(22)(p13q12.1). PMID- 3674160 TI - Validity of intrapartum diagnosis of fetal thrombocytopenia. AB - Performing a platelet count in fetal scalp blood was hitherto the only method to predict whether the infant of a mother with idiopathic thrombocytopenic purpura will be thrombocytopenic. Fifteen such cases are reported. Falsely low platelet counts were found in almost half of these fetal scalp samples. In two patients this could have altered the obstetric management. PMID- 3674161 TI - Fetal assessment based on fetal biophysical profile scoring: experience in 19,221 referred high-risk pregnancies. II. An analysis of false-negative fetal deaths. AB - The incidence of false-negative fetal death, which is defined as stillbirth unrelated to major anomaly or alloimmunization occurring after a last normal fetal biophysical score, was determined in 19,221 referred high-risk pregnancies. The calculated rate of fetal death after a last normal test was 0.726/1000 (14 deaths), which remained relatively constant despite a progressive increase in tests and patients studied. We conclude that a normal fetal biophysical profile score confers a high probability of perinatal survival. PMID- 3674162 TI - Acute oligohydramnios in postdate pregnancy. AB - The evaluation of amniotic fluid volume plays a major role in antepartum fetal surveillance. Although the definition of diminished amniotic fluid volume varies, this sign is considered by itself an indication for intervention in the near-term fetus. The interval of testing is predicated on the concept that amniotic fluid volume diminishes slowly (unquantified) as a result of developing hypoxia. We present six postterm pregnancies in which amniotic fluid volume diminished abruptly over 24 hours. Although one fetus died, the three babies delivered by cesarean section and the two babies delivered after a 2-day labor did well, despite obvious postmaturity syndrome, meconium staining, and variable decelerations. Apgar scores in the survivors were above 8, and pH results failed to confirm hypoxia. These data suggest the need to better understand the mechanisms regulating amniotic fluid volume. PMID- 3674163 TI - Preterm birth at 23 to 26 weeks' gestation: is active obstetric management justified? AB - To determine if active perinatal management was justified in preterm deliveries at less than or equal to 26 weeks' gestation, the outcome (survival and short- and long-term morbidity) of 43 infants (group I) born between 23 and 26 weeks' gestation was compared with that of 17 infants (group II) born at 27 weeks' gestation. Of the 12 surviving infants in group I (survival 28%), 11 were ventilated (median = 50 days), eight had moderate to severe bronchopulmonary dysplasia, and four had mild retrolental fibroplasia. At follow-up, two infants had physical disabilities with moderate to severe functional impairment, one had a minor disability, and nine had normal neurodevelopment. In contrast, of the 13 surviving infants in group II (survival 76%), nine were ventilated (median = 8 days), six had moderate to severe bronchopulmonary dysplasia, and six had mild RLF. At follow-up, one infant had a physical disability with moderate to severe functional impairment, four had minor disabilities, and eight had normal development. Perinatal factors that positively influenced survival in the two groups combined included active perinatal management, antenatal steroids, female sex, and absence of clinical chorioamnionitis and asphyxia. Although group I infants had a significantly higher mortality rate (p less than 0.05) and required a longer duration of ventilation (p less than 0.05), no differences in the incidence of postnatal complications or long-term morbidity at 2 to 4 years of age were evident between the two groups. PMID- 3674164 TI - Inhibitory effect of quinidine on plasma pseudocholinesterase activity in pregnant women. AB - The effect of quinidine at therapeutic and subtherapeutic concentrations on pseudocholinesterase activity in the plasma of 16 normal pregnant women was studied. The mean plasma pseudocholinesterase activity in the absence of quinidine (control) was 0.67 +/- 0.11 U/ml. The mean pseudocholinesterase activity in the presence of quinidine at concentrations of 0.5, 1.0, 2.0, and 5.0 micrograms/ml 0.48 +/- 0.09, 0.38 +/- 0.09, 0.29 +/- 0.10, and 0.19 +/- 0.09 U/ml, respectively. At therapeutic concentrations needed to treat cardiac arrhythmias (2 to 5 micrograms/ml), quinidine inhibited pseudocholinesterase activity by 60% to 70%. All the plasma samples had a normal dibucaine number (78 to 85). We recommend caution when succinylcholine and/or ester-type local anesthetics are used in pregnant women receiving quinidine. PMID- 3674165 TI - Pregnancy in Henoch-Schonlein purpura. AB - A 22-year-old white woman with Henoch-Schonlein purpura was treated with frequent plasmapheresis for increased severity of the disease activity during pregnancy. Hypertension, azotemia, and placental dysfunction were not observed. A healthy infant was delivered by cesarean section, and evidence of vasculitis was not detected in the placenta. PMID- 3674166 TI - Racial differences in survival of women with endometrial cancer. AB - The hypothesis that white women with endometrial cancer survive longer than black women with this disease was evaluated in a retrospective analysis of a population based, prospective cohort study. All female residents of metropolitan Atlanta with a first diagnosis of primary endometrial cancer from 1978 through 1982 were eligible for inclusion. The 628 white and 105 black women were followed up through June 1984 to determine survivorship. Race was evaluated as a prognostic factor with univariate, multivariate, and excess death rate analyses. Overall, an estimated 89.2% of whites and 61.6% of blacks survived 3 years from the time of diagnosis. Although black women tended to have more advanced disease at the time of diagnosis and a higher proportion of undifferentiated malignancies, the racial difference in survival persisted after adjustment for these factors. When initial therapy was considered, race remained a significant prognostic determinant among women who did not receive radiation therapy. PMID- 3674167 TI - Colposcopic evaluation of abnormal Papanicolaou smears in pregnancy. AB - Colposcopy was used to examine 401 pregnant patients with cytologic or clinical abnormalities of the cervix to determine if routine biopsy could be safely omitted except where the colposcopic impression was one of possible invasive carcinoma. A comparison of the antepartum colposcopic impressions with the postpartum histologic diagnosis revealed agreement to within one degree in 87% of patients, with 3% of patients showing a more advanced lesion than that anticipated. Only 2% of patients showed a progression of cytologic abnormalities at postpartum examination; 39% showed marked improvement. Four of nine patients with invasive carcinoma were diagnosed at antepartum colposcopy, with an additional two patients recognized as having invasive cancer at the postpartum colposcopic examination. The omission of routine biopsy is less than ideal if only one antepartum colposcopy is performed, since a considerable period of time may elapse before the patient is seen again postpartum. Those situations in which it may be omitted, together with guidelines for the management of pregnant patients with abnormal cervical cytologic findings, are presented. PMID- 3674168 TI - Acute effects of exercise on plasma catecholamines in sedentary and athletic women with normal and abnormal menses. AB - Norepinephrine plays a role in the regulation of luteinizing hormone secretion and may therefore be involved in the etiology of exercise-induced menstrual dysfunction. This study evaluated both intraexercise and postexercise responses of epinephrine, norepinephrine, and dopamine in sedentary women and women runners with normal and abnormal menstruation. Five eumenorrheic nonrunners and five eumenorrheic, four oligomenorrheic, and five amenorrheic runners were evaluated on 2 consecutive days. On day 1, the women cycled on a bicycle ergometer against an increasing work load until exhaustion, and on day 2, the women underwent a submaximal exercise regimen. Serial blood draws were taken at specified time intervals during intraexercise and postexercise periods on both days. The data collected during exercise for all groups showed that epinephrine and norepinephrine had a sixfold to sevenfold rise on day 1 and had a threefold rise on day 2. Dopamine increased twofold during both exercise protocols. On day 1 norepinephrine displayed a significantly higher percentage change from baseline to peak levels for oligomenorrheic and amenorrheic runners than for eumenorrheic runners and sedentary women. This latter finding is consistent with the hypothesis that periodic marked elevations in norepinephrine levels during maximal exercise may interfere with pulsatile luteinizing hormone release and hence may play a role in the occurrence of menstrual dysfunction in women runners. PMID- 3674169 TI - Configuration of the prepubertal hymen. AB - Anatomically descriptive terms are required when one is asked to comment on the hymen of the sexually abused prepubertal child. Action descriptive terms such as virginal or ruptured relay no objective information. Biologic hymenal configurations can be loosely categorized by the amount and distribution of hymenal tissue surrounding the vaginal introitus: The terms fimbriated, circumferential, and posterior rim are proposed. Descriptions of 124 prepubertal hymens are presented, with discussion focusing on biologic configurations and the impact of trauma and hormones. PMID- 3674170 TI - Magnesium and zinc status during the menstrual cycle. AB - The effect of menstrual cycle phases on the indexes of magnesium and zinc status was assessed in five normally menstruating women. Plasma concentrations of magnesium and zinc and the magnesium and zinc content of red blood cells and peripheral blood mononuclear cells were measured for 3 or 5 days per week during three menstrual cycles. The cycles were divided into four phases: menses, follicular, ovulatory, and luteal. Plasma magnesium concentrations were highest during menses and then gradually declined, reaching the lowest point during the ovulatory phase. This was followed by a rise during the luteal phase. Plasma zinc concentrations were higher during menses and the follicular phase and then dropped during the ovulatory and luteal phases. Both the magnesium and zinc content of red blood cells and mononuclear cells remained constant over the course of the study and did not change significantly as a function of cycle phase. This study provides evidence that plasma magnesium and zinc concentrations fluctuate during the menstrual cycle in a phase-related fashion in normally menstruating women. Whether these changes are hormonally mediated or reflect metabolic changes will require further study. PMID- 3674171 TI - Partial hydatidiform moles: deoxyribonucleic acid content and course. AB - Partial moles are either diploid (46 chromosomes) or triploid (69 chromosomes). In 35 cases ploidy was measured by flow cytometry for nuclear deoxyribonucleic acid quantitation, indicating approximate chromosome number. Six of the 35 were triploid (17%) and the balance was diploid (83%). No complications occurred in the triploid group, while five of 25 (20%) diploid cases with evaluable follow-up had nonfatal sequelae. Complications included persistent mole treated by recurettage and four cases requiring chemotherapy (human chorionic gonadotropin titer plateau, clinical metastasis, overt choriocarcinoma, and placental site trophoblastic tumor). A combined morphologic and genetic classification of partial moles is recommended for identification and risk assessment. Deoxyribonucleic acid cell cycle fractions of the diploid partial moles may be helpful in the identification of patients at high risk for complications. A proliferation index greater than 3.6 separated the cases with sequelae from most of the uncomplicated cases (sensitivity 100%, specificity 95%). PMID- 3674172 TI - Correlation between chlamydia infection and clinical evaluation, vaginal wet smear, and cervical swab test in female adolescents. AB - Vaginal wet smear, endocervical swab test, gynecologic examination, and history were investigated in 148 healthy female adolescents. Cultures for Chlamydia trachomatis were obtained from all patients. The overall prevalence was 19/148 (13%). No significant correlation was found between chlamydia infection and any of the parameters investigated in the wet smear. Results of swab test or history showed no discrimination between young women with cultures positive for C. trachomatis and those with cultures negative for C. trachomatis. Chlamydia was found in 32% of patients when the gynecologic examination showed signs of infection and in 10% when no signs of infection were seen (p less than 0.025). Thirteen of the 19 (70%) adolescents with chlamydia infections had no signs of infection. We conclude that neither swab test, vaginal wet smear, nor the history of the patient can give conclusive evidence of a chlamydial infection. Detection of C. trachomatis in this population can be done only by culture or other specific methods. PMID- 3674173 TI - Evaluation of 1-deamino-[D-Tyr(Oethyl)2, Thr4, Orn8] vasotocin, an oxytocin antagonist, in animal models of uterine contractility and preterm labor: a new tocolytic agent. AB - We attempted to characterize the ability of a new oxytocin derivative, 1 deamino[D-Tyr(Oethyl)2,Thr4,Orn8] vasotocin (ORF 22164), to antagonize the action of oxytocin in several in vitro and in vivo animal models of uterine hyperactivity. In these studies, the derivative was found to be a specific competitive inhibitor of oxytocin-induced contractions of pregnant guinea pig uterus in vitro. In addition, its intravenous administration induced a dose dependent inhibition of oxytocin-induced uterine contractions in situ. Finally, like ritodrine, the drug induced a dose-dependent delay of ongoing labor in rats. These results suggest that 1-deamino-[D-Tyr(Oethyl)2,Thr4,Orn8] vasotocin, unlike ritodrine, is a potent and specific antagonist of oxytocin-induced uterine contractions and thus may have potential clinical utility in the treatment of preterm labor. PMID- 3674174 TI - Stereotypic behavioral response of rat fetuses to acute hypoxia is altered by maternal alcohol consumption. AB - Transient compression of the umbilical cord has been implicated as a potential cause of unexplained brain damage and/or fetal death. We induced acute fetal hypoxia by compressing the umbilical cord of the fetal rat with a microvascular clamp. Direct observation of fetal behavior immediately after cord compression identified a three-phase behavioral response to acute hypoxia, consisting of an initial suppression in motor activity, a brief period of hyperactivity, and a secondary suppression of movement. All three phases occurred in less than 2 minutes from the onset of hypoxia. The stereotypic hypoxic response of rat fetuses may be adaptive as a means of removing mechanical sources of umbilical cord compression. Among fetuses exposed to alcohol in utero, the response to hypoxia was diminished in intensity and duration. Because of their altered hypoxic response, alcohol-exposed fetuses may therefore be at greater risk from transient cord compression in utero. PMID- 3674175 TI - Effects of norepinephrine on lung fluid flow rate in the chronically catheterized fetal lamb. AB - The influence of norepinephrine on lung fluid flow rate was studied in seven chronically catheterized fetal lambs. Lung fluid was collected through a catheter inserted into the fetal trachea. In six experiments, continuous saline solution infusion for 1 hour followed by equivolumnar norepinephrine (3.0 micrograms/min) for 1 hour via the fetal jugular vein was carried out. In three additional experiments (two fetuses), a 3.0 mg intravenous bolus of propranolol was administered before norepinephrine infusion. Saline solution infusion did not influence the lung fluid flow rate or fetal biophysical and biochemical parameters. Norepinephrine increased fetal blood pressure by 22% and decreased lung fluid flow by 45% from control values. Lung fluid flow rate recovered within 2 hours after the end of the norepinephrine infusion. Pretreatment with propranolol did not alter the results. In addition to previous reports that demonstrated beta-sympathomimetic agonist-enhanced reabsorption of lung fluid from fetal alveolar epithelial cells, our present results suggest that a reduction in fetal lung fluid secretion may be implemented as well through stimulation of alpha-sympathomimetic receptor sites in the pulmonary vasculature. PMID- 3674176 TI - Characteristics of the electromyogram recorded from the mesometrium of the pregnant ewe from 106 days' gestation to delivery: similarities with and differences from the electromyogram obtained from the myometrium. AB - Electromyographic recordings from 12 pregnant sheep were analyzed in four gestational age groups (106 to 115, 116 to 125, 126 to 135, and 136 to 145 days) and by the day of delivery. Mesometrial electromyographic activity was present in all animals studied. Contracture activity was synchronous in both mesometrium and myometrium. The frequency distribution of electromyographic events of different duration in the mesometrium was qualitatively identical to that recorded from the myometrium. The frequency of events less than 180 seconds was greater in the myometrium, while no difference was observed in contracture frequency. Mean contracture duration in myometrium and mesometrium shortened as gestation progressed (p less than 0.01), and was of significantly shorter duration on the day of delivery when compared with all gestational age intervals (p less than 0.05). Except at 135 to 145 days' gestation and at the day of delivery, myometrial contractures were of significantly longer duration than mesometrial contractures. The presence of the endometrium and fetal membranes in the pregnant ewe may stimulate the myometrium, and account for the difference observed. In vivo recording of mesometrial electromyographic activity may provide an opportunity to study the paracrine regulation of myometrial activity. PMID- 3674177 TI - International symposium on contraception. October 28, 1986, Singapore. PMID- 3674178 TI - Contraception: an overview. AB - In this century, paramount progress has been made in many areas of medicine, not least in the field of contraception, with landmarks such as the introduction of intrauterine contraceptive devices (IUDs), hormonal contraceptives (OCs), and laparoscopic sterilization. The general optimism of the 1960s about overcoming the problems of global overpopulation with these new tools has subsequently been replaced by growing concern about the risks of contraception in general and of OCs especially. It was not before the 1980s that the benefit-risk balance of hormonal contraception turned out to be much more favorable than was formerly suspected. The wide variation from country to country in the prevalence of contraceptive methods has economic, political, religious, sociological, educational, and legal rather than medical reasons. Former misjudgments have led to a ban on valuable tools such as the sequential regimen or the use of 17 acetoxyprogestogen analogues as components in OCs, or to a ban on the licensing of depot progestogens in some countries but not in others. The recent decision of U.S. firms to cease production and sale of IUDs for legal reasons is unique and hopefully will not be imitated elsewhere. Just after the introduction of oral contraception, tremendous inventive dynamics led to the discovery of several new contraceptive principles. Most of these have reached the stage of clinical application and are being used satisfactorily, at least in some parts of the world. Later contraceptive concepts are still in the stage of experimentation and no breakthrough appears to be directly ahead. If contraception means more than just meeting individual wants--if it is also to be an instrument for handling the increasing problems of overpopulation--then much more must be done to deepen our knowledge of reproductive physiology, to popularize efficient means of contraception, and to make them available to everyone. Otherwise, all efforts to improve health standards throughout the world according to the "WHO Global Strategy for Health for All by the Year 2000" will be in vain. PMID- 3674179 TI - Hormonal contraception: benefits versus risks. AB - Epidemiologic studies, chiefly in English and U.S. populations, have generated concern regarding cardiovascular hazards associated with the use of oral contraceptives (OCs). A detailed analysis of these data suggests, however, that such studies have serious methodologic flaws. For example, the clinical diagnosis of deep vein thrombosis may be incorrect up to 50% of the time, rendering statistical analysis meaningless. The known cardiovascular risks of cigarette smoking may be amplified by OC use, but nonsmokers probably do not have an increased risk. Further, a number of studies in developing-world countries do not yield evidence of increased cardiovascular risks of OC use. Abnormal levels of serum lipids appear to affect cardiovascular (that is, myocardial infarction) risks in Western populations. Whether normalization of these levels improves the outlook is not entirely certain. The hormonal components of OCs are known to affect serum lipids, raising concern about possible long-term consequences. Newer low-dose OC formulations (such as triphasics) do not cause changes in serum lipids and therefore eliminate this putative risk. PMID- 3674180 TI - Positional changes in the vasculature of the optic disk in glaucoma. AB - We analyzed 34 sets of optic disk photographs from 19 patients with glaucoma who had been followed up for ten years to evaluate changes in the position of the vasculature of the optic disks over time. Each photograph was analyzed by an image analyzer's edge-defining program for optic disk analysis and by three experienced clinicians. Image analysis of the blood vessels in 16 optic disks showed positional centrifugal shifts. The clinicians consistently noted changes in the appearance of seven optic disks. The difference between the results obtained using the image analyzer and those obtained by clinical observation was significant (P less than .05). PMID- 3674181 TI - Extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy in patients with glaucoma. AB - We reviewed 75 consecutive cases of extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy in 69 patients with glaucoma. The mean preoperative intraocular pressure was 19.3 mm Hg on an average of 2.3 glaucoma medications. Visual acuity improved in 58 eyes (77%) at two months, with an average improvement of 3.3 and 3.6 lines at two and 12 months, respectively. Of the 75 eyes, 49 (65%) achieved a visual acuity of 20/40 or better; three patients (4%) had further deterioration in vision at the completion of follow-up because of progressive glaucoma or macular disease. Postoperatively, the average intraocular pressure was 3.8 and 3.0 mm Hg lower than the preoperative level at two and 12 months (P less than .001) on 0.63 and 0.79 glaucoma medications, respectively. However, 27 (36%) of the 75 eyes had a recorded intraocular pressure greater than 30 mm Hg and 30 (40%) had a pressure 7 mm Hg or more above their preoperative level during the first six months after surgery. Despite improved long-term control of intraocular pressure, detectable conjunctival filtering blebs were present in only 31 (41%) of 75 eyes at two months and in seven (12%) of 56 eyes at 12 months. Hyphema occurred in 34 (45%) of the cases. PMID- 3674182 TI - Clinical patterns of corneal epithelial wound healing. AB - We studied the reepithelialization of corneal abrasions in 21 patients. All abrasions, irrespective of the nature of injury, followed a consistent pattern during reepithelialization. Three to six convex leading fronts of migrating epithelial sheets developed along the circumference of the defect and progressed toward the center. Neighboring fronts met along their sides, resulting in the formation of various geometric shapes. In the final stage of the healing process a contact line shaped like a "Y" or two "Y's" placed with their long axes end to end was seen where the advancing fronts of migrating epithelial sheets met. The rate of healing of the abrasions was determined by measuring the area of the abrasions at daily intervals from serial photographs. The area of the epithelial defects decreased exponentially with time, indicating a constant rate of epithelial cell migration. PMID- 3674183 TI - Topical fibronectin in the treatment of persistent corneal epithelial defects and trophic ulcers. AB - Six patients with persistent corneal epithelial defects that failed to improve with standard therapy were treated with topical fibronectin in a phase I uncontrolled trial. Fibronectin was purified from autologous plasma by affinity chromatography and administered topically, 0.5 mg/ml five times a day, for three weeks. Complete reepithelialization was achieved in five patients: three healed three to 17 days after initiation of treatment while two healed one to two weeks after discontinuation of topical fibronectin. No side effects were observed. Over a follow-up period of three to 18 months, two recurrences were noted. PMID- 3674184 TI - Neodymium-YAG laser posterior capsulotomy for the treatment of aphakic and pseudophakic pupillary block. AB - We examined five patients who developed pupillary block after extracapsular cataract extraction. One of the patients also had a posterior chamber intraocular lens implanted at the time of cataract operation. In all five patients, pupillary block was promptly relieved by Nd:YAG laser posterior capsulotomy. PMID- 3674185 TI - A model for predicting the site of paraxial retinal lesions secondary to "coaxial" operating microscope illumination systems. AB - We measured a 15 +/- 2-mm displacement of the illuminating element of the coaxial operating microscope from the true optical center of the microscope. We further calculated the displacement of the image of the illuminating element of the operating microscope on the retina of the simplified schematic eye and found that the "coaxial" operating microscope would focus the light between 1.3 and 1.8 mm superior to the fovea of the eye, depending on the theoretical refractive status of the simplified eye. Actual measurements on a simulated retina (35-mm camera) confirmed the calculated displacements. The deviation varied with eye tilt and microscope position. We also found that the maneuvers commonly used by anterior segment surgeons of tilting the microscope and rotating the eye downward tended to displace the image of the illuminating element closer to the fovea, increasing the chance for symptomatic retinal damage. A combination of such maneuvers may reduce the potential for clinically significant retinal phototoxicity by displacing the light further inferior to the fovea. PMID- 3674186 TI - The relation of rhodopsin and scotopic sensitivity in choroideremia. AB - We examined two patients who had clinical characteristics typical of choroideremia using psychophysical and reflection retinal densitometric techniques. In the dark-adapted state, sensitivity was more compromised than would be predicted on the basis of the modest losses of rhodopsin. In the dark adapted state, studies of spatial and temporal summation suggested that postreceptoral processes are similar to normal. The kinetics of rhodopsin regeneration after bleaching exposures were abnormal in some retinal regions. PMID- 3674188 TI - A simple simulated eye for use in tonometry training. PMID- 3674187 TI - Ocular pigmented spots and eyelid myxomas. AB - Ophthalmic abnormalities are part of a recently recognized syndrome that includes myxomas, spotty pigmentation, and endocrine overactivity. The complex is familial with mendelian dominant mode of inheritance. The 63 patients (27 males and 36 females) we have identified with this complex had the following ophthalmic abnormalities: facial and eyelid lentigines in 44 patients (70%); pigmented lesions on the caruncle or conjunctival semilunar fold in 17 patients (27%); and eyelid myxomas in ten patients (16%). Because these findings usually preceded the most serious component of the syndrome, cardiac myxoma, early recognition of their significance is important. PMID- 3674189 TI - Peripheral corneal ulceration in a patient with AIDS-related complex. PMID- 3674190 TI - Iris melanoma with extensive corneal invasion and metastases. PMID- 3674191 TI - Peters' anomaly in a father and son. PMID- 3674192 TI - Mountain travel and intraocular gas bubbles. PMID- 3674193 TI - Protein C deficiency associated with vitreous hemorrhage in a neonate. PMID- 3674194 TI - A simple device for holding ophthalmic prisms. PMID- 3674195 TI - Acute posterior multifocal placoid pigment epitheliopathy with unilateral retinal lesions and bilateral disk edema. PMID- 3674196 TI - Ocular signs of cocaine intoxication in neonates. PMID- 3674197 TI - Oculocardiac reflex during manipulation of adjustable sutures after strabismus surgery. PMID- 3674198 TI - Vitrectomy surgery in proliferative sickle retinopathy. PMID- 3674199 TI - Long-term results of scleral reinforcement surgery. PMID- 3674200 TI - Posterior ischemic optic neuropathy during general surgery. PMID- 3674201 TI - Direct examination vs culture of biopsy specimens for the diagnosis of keratomycosis. PMID- 3674202 TI - Pentoxifylline enhancement of defective neutrophil function and host defense in neonatal mice. AB - Decreased neutrophil (PMN) chemotaxis is thought to contribute to the increased morbidity and mortality from infection in newborn infants. Pentoxifylline, a methylxanthine, has previously been shown to augment PMN chemotaxis in vitro. The authors therefore investigated the effects of pentoxifylline on 1) in vitro PMN chemotaxis, 2) in vivo leukocyte accumulation, and 3) protection against Staphylococcus aureus infection in newborn mice. Using a modified Boyden chamber system, they demonstrated that pentoxifylline significantly enhanced neonatal PMN chemotaxis in a dose-dependent manner. Additionally, pentoxifylline was found to increase PMN accumulation in vivo in a proteose peptone-induced peritonitis model. Finally, the survival rate in experimentally induced S aureus infection was 51% in neonatal mice given pentoxifylline, compared with 17% in a control (nonpentoxifylline) group (P less than 0.01). These data demonstrate pentoxifylline modulation of PMN migration and enhancement of host defense against bacterial infection. PMID- 3674203 TI - Spasm of small coronary arteries and ischemic myocardial injury induced by hypothalamic stimulation in the rat. AB - Electrical stimulation of the lateral hypothalamus resulted in electrocardiographic evidence of acute myocardial ischemia in 35% of normal adult rats under anesthesia. Mean arterial blood pressure was also elevated. Study of vascular corrosion casts disclosed that spasm of smaller branches of the coronary circulation, rather than the major epicardial arteries, was the main cause of the ischemic response. The histologic changes of the same experimental treatment in a separate group of animals revealed multiple focal areas of tissue damage throughout the myocardium, which were quantitatively assessed. The results may be relevant for the clinical problem of various forms of ischemic heart disease in which little evidence is found for organic (atherosclerosis) or dynamic (spasm) stenosis involving the major coronary arteries. PMID- 3674204 TI - Histochemical detection of lipid peroxidation in the liver of bromobenzene poisoned mice. AB - The possibility of detecting lipid peroxidation histochemically was investigated in liver tissue in vivo, in conditions in which the process has been demonstrated by biochemical methods. The technique was based on the detection of aldehyde functions with the use of the Schiff's reagent. The study was carried out on bromobenzene-intoxicated mice, which generally exhibit levels of lipid peroxidation considerably higher than those observed in the case of other hepatotoxins. Liver sections from control animals were unstainable by the reagent, while sections from bromobenzene-poisoned mice showed a purple stain of various intensity, unhomogeneously distributed, sometimes with a mediolobular localization. Microphotometric measurements were performed at 565 nm by means of a computer-controlled microscope photometer. The ratios of Schiff-positive area relative to total section area, as well as the total extinctions referred to 100 sq mu of the sections, showed a high correlation with the corresponding hepatic contents of malonic dialdehyde, chosen as biochemical index of lipid peroxidation. In vitro studies in which liver sections were incubated in the presence of NADPH-Fe2+, showed a Schiff positivity which increased with the incubation time, confirming the reliability of the histochemical method. Another procedure, based on the use of 2-OH-3-naphtoic acid hydrazide coupled with fast blue B, was also developed and proved to be possibly more sensitive than Schiff's reagent in the detection of lipid peroxidation in liver tissue. PMID- 3674206 TI - Late-onset paranoid disorder. AB - While the onset of paranoid states in the geriatric population has received some attention, recent research results on such proposed etiological factors as sensory impairments, cognitive decline, and pre-existing schizophrenia-spectrum pathologies remain equivocal. The authors present an alternative hypothesis positioning the interaction of pre-existing narcissistic personality features with unique aspects of the aging process. Case studies and innovative treatment strategies are discussed. PMID- 3674205 TI - Anti-Fx1A induces association of Heymann nephritis antigens with microfilaments of cultured glomerular visceral epithelial cells. AB - Binding of anti-Fx1A to Heymann nephritis antigens (HA) on rat glomerular epithelial cells (GECs) in culture leads to capping and disappearance of antigens from the cell surface. This process may contribute to the formation of glomerular subepithelial immune deposits in vivo. The authors differentially extracted GECs to determine whether HA redistribution is mediated by cytoskeletal components. Observations were made by phase-contrast and immunofluorescence microscopy on primary and passaged GECs in monolayer culture and by spectrofluorimetry on GECs in suspension. GEC-bound sheep anti-Fx1A IgG was detected by fluoresceinated anti sheep IgG. Microfilaments were identified by rhodamine-phalloidin staining of F actin. After cross-linking HA on GECs by anti-Fx1A IgG at 0 C, GECs remained polygonal in shape and had diffuse granular IgG staining of their plasma membranes. Treatment of GECs at 0 C with hypotonic buffer containing 0.5% Triton X-100 produced microfilament-rich cytoskeletons that retained the shape of unextracted GECs. Further incubation with DNase I at 37 C removed microfilaments (mean fluorescence declined by 90%) and resulted in the rounding of cytoskeletons. After Triton X-100 treatment, 85% of initial GEC-bound anti-Fx1A IgG remained, but only 29% remained after DNase I. In contrast to intact IgG, detergent-extraction resulted in the complete loss of GEC-bound anti-Fx1A Fab'. Anti-Fx1A IgG did not bind to GECs pretreated with Triton X-100. Thus, cross linking of HA by anti-Fx1A converts HA from a detergent-soluble, membrane associated form to an insoluble, cytoskeleton-bound form. Attachment of cross linked HA to the cytoskeleton is mediated by microfilaments. PMID- 3674207 TI - Moving forward with deinstitutionalization: lessons of an ethical policy analysis. AB - The formulation, implementation, and evaluation of public policies do not typically include formal ethical analysis. Reconceptualizing from an ethical standpoint the historical and contemporary dilemmas created by the deinstitutionalization policy underscores the need for attention to distributive justice and respect for individuals in developing programs for the chronically mentally ill and in selecting and measuring successful outcomes. PMID- 3674208 TI - Residential instability: a perspective on system imbalance. AB - In an exploration of residential instability and recidivism in chronic mental patients, 215 psychiatric admissions were followed for a year after the initial episode. In addition to an unusually high incidence of residential mobility, a relationship between mobility and number of hospitalizations was evident, as were isolation, disruptive family situations, and homelessness. The needed response of the mental health system is discussed. PMID- 3674209 TI - Inflicted and noninflicted injuries: differences in child and familial characteristics. AB - Clinicians involved in child protection work are frequently confronted with decisions as to whether a child's injury is inflicted or accidental. This study examines child, parental, familial, and environmental characteristics in a group of 25 abused children compared to a group of 90 children with accidents. Significant differences and commonalities are discussed. PMID- 3674210 TI - Depression and academic achievement among Indochinese refugee unaccompanied minors in ethnic and nonethnic placements. AB - Unaccompanied Indochinese refugee adolescents resettled in the United States with ethnic foster families were significantly less depressed and had higher grade point averages than those in foster care with Caucasian families or in group homes. The ongoing presence of an adult of similar ethnicity to the adolescent appeared to mitigate against the stress of adaptation to a new country. PMID- 3674211 TI - Measuring children's coping. AB - Using a transactional model of stress and coping, a measure of children's coping is offered and applied in a semi-structured interview in which specific coping styles are assessed. Data from 176 school-age children yielded findings on age and gender differences along with other preliminary suggestions of the validity of the instrument. PMID- 3674212 TI - Family system and individual child correlates of sibling behavior. AB - In this study of the connections between marital adjustment and sibling behavior, the best predictor of younger siblings' prosocial behavior was found to be low interparental conflict. Older siblings' prosocial behavior was most associated with the mothers' marital adjustment. Younger siblings' agonistic behavior was related to marital adjustment and to the older children's activity level. PMID- 3674213 TI - Downward comparison and coping with serious medical problems. AB - Correlates of selective comparisons by mothers of high-risk infants and individuals with rheumatoid arthritis showed that mothers were especially likely to make downward comparisons. Arthritis patients making downward comparisons were rated by their health care providers as more positively adjusted, independent of actual severity of illness. Implications for support providers are discussed. PMID- 3674214 TI - Treatment of the nonpsychotic chronic patient: a problem of interactive fit. AB - Nonpsychotic chronic adult patients are troublesome, not only because of their psychosocial dysfunction, cognitive and affective impairments, and behavioral problems, but also because they fail the expectations and values of health care providers. The concept of interactive fit is proposed to facilitate the therapeutic process between patient and provider. Stages of treatment are described, together with guidelines for clinicians. PMID- 3674215 TI - Long-term effects of divorce on children: a developmental vulnerability model. AB - Research and clinical work with children of divorce have focused primarily on parental separation as a traumatic event and its effects on children as a crisis situation. The present paper, based on clinical experience, considers potential long-term problems of these children in key developmental areas: handling anger and aggression, separation-individuation, and gender identity. Implications for prevention and service delivery are presented. PMID- 3674216 TI - Safeguards and the therapeutic window. A group treatment strategy for adult incest survivors. AB - A group treatment model for adult incest survivors is presented. It has been designed to take into account the traumatic nature and sequelae of abuse experiences. Based on the Stress Response Syndrome, the model emphasizes use of a "therapeutic window" as a clinical guide and includes protective interventions, clinical timing issues, and prominent themes relevant to these survivors. PMID- 3674217 TI - Support sources of adolescents in families adopting older children. AB - The social supports of adolescents in families adopting school-aged children are explored. The perception of support provided by parents was related to severity of problems experienced with the new adoptee. Findings suggest that mothers, more than fathers or friends, are pivotal in adolescents' support systems following such adoptions. PMID- 3674218 TI - Sexual identity and confusion. PMID- 3674219 TI - Day care follow-up. PMID- 3674220 TI - Reeducative treatment of female genuine stress incontinence. AB - Three-months re-education treatment of genuine stress incontinence was given to 26 female outpatients: 22 patients completed the treatment programme and 4 interrupted it for various reasons. The aims of the treatment were both to correct compensatory habits that patients used to conceal or reduce leakage accidents and to give specific education and strengthening of pelvic floor muscles. All patients who completed the three-months treatment definitely improved and 7 were cured. Accordingly a marked reduction or absence of weekly incontinence episodes as well as a reduction of the daily frequency of micturition was observed. On vaginal palpation a clear-cut improvement of pubococcygeous muscle contractility was detectable. Urethral closure pressure profilometry showed significant improvement of functional urethral profile length at rest and of maximal urethral closure present both at rest and during maximal voluntary contraction of the pelvic floor muscles. Micturition cystourethrography, repeated in 15 patients at the end of the treatment, showed a clear-cut improvement of bladder neck suspension defects in all but 2 patients. Follow-up assessments showed that the clinical effects were long-lasting. Possible mechanisms of this re-educative technique are discussed. PMID- 3674221 TI - Influence of caffeine on force and EMG in rested and fatigued muscle. AB - At present, it is unclear how caffeine induced alterations in neuromuscular function might affect force production and EMG signal characteristics during isometric exercise. These data suggest that acute caffeine ingestion (7 mg/kg) has no significant effect on force production during a maximal isometric hand grip contraction or endurance during a sustained submaximal contraction. Further, maximal motor unit activation, the relationship between submaximal motor unit activation and subsequent force production, and frequency content of the EMG signal were not significantly altered following caffeine ingestion. These results indicate that although caffeine may be a potential ergogenic aid for some activities, its ingestion may not improve performance in activities requiring strength and/or short-term endurance. PMID- 3674222 TI - The GPEP report on undergraduate medical education. Implications for rehabilitation medicine. Association of American Medical Colleges, panel on the General Professional Education of the Physician. AB - The Association of American Medical College's project panel on the General Professional Education of the Physician (GPEP) and College Preparation for Medicine and its working groups appear to share many values with professionals involved in rehabilitation medicine. The GPEP report stresses that learning about disability or functional status, chronic illness and its impact on the individual, his family and the community, and developing the ability to work as a team with other health professionals are important elements in the education of all physicians. PMID- 3674224 TI - Abused to abuser: antecedents of socially deviant behaviors. AB - The authors interviewed 34 young people who had been sexually abused as children 6 or 8 years after the abuse had occurred and compared them with 34 control subjects who had not been abused. They also compared subjects who had been abused for less than 1 year with those who had been abused for more than 1 year. The findings suggest a link between childhood sexual abuse and later drug abuse, juvenile delinquency, and criminal behavior. The authors explore the effects of pretrauma factors of previous childhood physical abuse and parental modeling of aggression and the postdisclosure factors of social and family blaming. PMID- 3674223 TI - Childhood sexual and physical abuse as factors in adult psychiatric illness. AB - Using objective measures, the authors found a high rate of childhood sexual and physical abuse in a sample of 66 female psychiatric inpatients. Childhood abuse experiences were correlated with severity of adult psychiatric symptoms. The authors explore the usefulness of adult psychological symptoms, diagnoses, and prescribed medications as factors in the identification of patients who have histories of early sexual and physical abuse. PMID- 3674225 TI - Conceptual and methodological issues in the comparison of inpatient psychiatric facilities. AB - The authors compared the length of stay of acute admission patients at a mental health center and a nearby state hospital. The two facilities had significantly different length of stay distributions; the mean was not an adequate index to describe these patterns. Despite careful matching, patients at the state hospital were more disabled. Different patient characteristics were associated with length of stay at the two facilities, and these were also characteristics on which the patient populations differed at admission. The authors conclude that comparisons of hospitals, for example, on mean or median length of stay can be misleading unless the different functions, policies, and constraints of the facilities are taken into account. PMID- 3674226 TI - Long-term hospital treatment of borderline patients: a descriptive outcome study. AB - The authors report a prospective 2-year outcome study of 40 inpatients with severe personality disorders who were treated on a specialized long-term unit for patients with "borderline conditions." Treatment goals included improving interpersonal relationships and facilitating a lasting discharge from the hospital. Data were collected at admission, discharge, and 1 and 2 years after discharge. The data reflect change from admission to follow-up in impulsivity, psychotherapy, and social adjustment. Mediating effects of length of stay on outcome are discussed. PMID- 3674227 TI - Perceptual and cognitive abnormalities in bulimia. AB - The authors compared 55 bulimic subjects and 55 normal control subjects using the Beck Depression Inventory, a new scale designed to detect cognitive distortions (the Bulimia Cognitive Distortion Scale), and several perceptual and attitudinal measures of body image. There were significant differences between the bulimic and control groups on all measures except estimates of face width. These findings are discussed in terms of a multifactorial theory of the psychopathogenesis of bulimia. PMID- 3674228 TI - The evolving subspecialization of psychiatry: implications for the profession. AB - Psychiatry is likely to evolve into a number of subspecialty areas, paralleling developments in other medical specialties. These changes are impelled both from within psychiatry, where the rapid increase in knowledge and skills makes mastery of the entire field by any one practitioner less possible, and from without, related to new expectations for psychiatric services from referral sources and patients, increasing competition by other physicians and nonphysician mental health care providers, and shifting reimbursement patterns. The authors discuss the advantages and disadvantages of subspecialization as well as implications for psychiatric practitioners and training programs. PMID- 3674229 TI - Progress in the classification of functional psychoses. AB - The three most widely used diagnostic systems in American psychiatry--the Feighner criteria, the Research Diagnostic Criteria, and DSM-III--appeared sequentially at 4-year intervals. The fact that the latter two systems each incorporated changes in essentially all diagnostic categories implied progress toward greater validity; however, this assumption has rarely been tested directly. To do this, the authors applied each of these three systems to 98 consecutively admitted patients with nonmanic psychoses. Although family history and 6-month follow-up data strongly supported the validity of diagnostic distinctions made in each of the three systems, they did not show increments in validity with successively developed criteria sets. PMID- 3674230 TI - Reports of childhood incest and current behavior of chronically hospitalized psychotic women. AB - Of the female patients (N = 26) on a state hospital unit who remained chronically institutionalized and actively psychotic despite psychopharmacologic and psychosocial treatment, 12 (46%) reported histories of childhood incest. These 12 patients were more likely than the others to engage socially with ward staff. A higher proportion had sexual delusions, affective symptoms, substance abuse, suspected organicity, and major mental problems, and they spent more time in seclusion than other patients. The authors acknowledge the difficulty of assessing the accuracy of reports of incest. They discuss the implications of a possible relationship between incest and severe, intractable psychotic disorder. PMID- 3674232 TI - Platelet MAO activity in geriatric patients with depression and dementia. AB - The authors studied platelet MAO activity in psychiatrically hospitalized geriatric patients with depression and dementia. Platelet MAO activity was higher in demented patients with and without depression and in depressed patients with reversible dementia than in nondemented depressed patients. The data suggest that abnormally high platelet MAO activity may reflect a predisposition to the development of a dementia syndrome. PMID- 3674231 TI - A comparison of the Diagnostic Interview Schedule and clinical diagnosis. AB - The Diagnostic Interview Schedule (DIS) was administered to 220 psychiatric patients by lay interviewers. Kappas for agreement between DIS and chart diagnoses ranged from .39 to -.03 and averaged .14 for 13 diagnostic categories. Agreement was best for affective, obsessive-compulsive, and schizophrenic disorders and was poorest for phobias where patients overemphasized fears. The authors suggest that clinician evaluation of information collected by the DIS is important, especially in diagnosing individual cases. PMID- 3674233 TI - The use of DSM-III axis III in recording physical illness in psychiatric patients. AB - The randomly selected charts of 50 discharged psychiatric inpatients were reviewed for documentation of medical illness and DSM-III axis III diagnoses. Twenty-eight percent of the patients had had medical symptoms, 56% had had medical findings, 36% had had laboratory findings, and 60% had been given axis III diagnoses. In at least seven cases, the medical findings were poorly reflected in the final axis III diagnosis. In no case did the record indicate that medical factors were viewed as the cause of a patient's immediate psychiatric syndrome. PMID- 3674234 TI - Effects of sugar and aspartame on aggression and activity in children. AB - Habitual sugar consumption and behavior following challenge by sugar and aspartame were studied in 30 preschool boys. The 18 subjects whose parents considered them sugar reactive had more disruptive behavior problems at baseline than the other 12 subjects. Habitual sugar consumption correlated only with duration of aggression against property in alleged responders. Double-blind crossover challenges with aspartame, saccharin, sucrose, and glucose produced no significant effect on aggression or observers' ratings of behavior. Lower actometer counts followed the trials of aspartame, but the difference was not apparent to observers. It is unlikely that sugar and aspartame are clinically significant causes of disruptive behavior. PMID- 3674235 TI - Relationship of serum TSH concentration and antithyroid antibodies to diagnosis and DST response in psychiatric inpatients. AB - Basal serum TSH concentration, antithyroid antibody titers, and DST response were evaluated in 124 psychiatric patients with affective symptoms. DST nonsuppressors were more likely than DST suppressors to have thyroid abnormalities. PMID- 3674236 TI - Clonazepam in the treatment of chronic schizophrenia. PMID- 3674237 TI - Eating Attitudes Test scores of patients with obsessive-compulsive disorder. PMID- 3674238 TI - Antiandrogen treatment of aberrant sexual activity. PMID- 3674239 TI - Postural hypotension with syncope possibly precipitated by trazodone. PMID- 3674240 TI - Hypomania induced by sertraline, a new serotonin reuptake inhibitor. PMID- 3674242 TI - Comments on review of brief psychotherapies. PMID- 3674241 TI - Homophobia among physicians and nurses treating AIDS patients. PMID- 3674243 TI - Russian roulette and suicide. PMID- 3674244 TI - Transitional day hospitalization. PMID- 3674245 TI - Poetry and psychopathology. PMID- 3674246 TI - The national score card: deaths from RDS/HMD. PMID- 3674247 TI - New to the Journal from NCHS. PMID- 3674248 TI - Foster home care for the frail elderly as an alternative to nursing home care: an experimental evaluation. AB - This paper describes a program (Community Care Program) in which some elderly hospital patients who were candidates for nursing home placement were placed in foster homes. Caregivers were carefully trained and supervised. A total of 112 elderly inpatients were randomly assigned to placement in a nursing home or a foster care home. Patients and caregivers were interviewed at 3, 6, 9, and 12 months after placement. Community Care Program patients were more likely to maintain or improve ADL (activities of daily living) and mental status scores. They also had better nursing outcomes and were more likely to get out of the house than were nursing home patients. Nursing home patients had higher life satisfaction, and participated in more social and recreational activities. The Community Care Program was 17 per cent less costly than nursing home care. The results suggest that foster care may be a viable alternative for a segment of the nursing home population. PMID- 3674249 TI - Trends in mortality caused by respiratory distress syndrome in the United States, 1969-83. AB - Using United States vital statistical data we examined trends in infant deaths from Respiratory Distress Syndrome/Hyaline Membrane Disease (RDS/HMD) for 1969 to 1983, by race and age at death. In order to improve comparability of diagnosis across two revisions of the International Classification of Diseases, deaths from RDS/HMD were ascertained using both underlying and associated causes of death. These data document a 2 per cent per year increase in infant mortality attributed to RDS/HMD for all races during interval I (1969-73) followed by 9 per cent per year decreases during intervals II (1974-78) and III (1979-83). However, there was a marked difference between Whites and Blacks in these trends. In the White population, RDS/HMD infant mortality increased by 2.2 per cent per year in interval I but then decreased by 10.5 per cent per year in interval II and 8.9 per cent per year in interval III. Among Blacks, on the other hand, the initial increase in RDS/HMD mortality was steeper (5.2 per cent per year) and the subsequent decreases were less (6.3 per cent per year and 8.0 per cent per year). As a result, the Black-White ratio in infant mortality attributed to RDS/HMD increased from 1.32 in 1969-73, to 1.59 in 1974-78 and to 1.72 in 1979-83. The proportion of RDS/HMD deaths that occurred in the postneonatal period increased from 1.1 per cent in interval I to 3.6 per cent in interval II to 5.0 per cent in interval III.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674250 TI - Effect of government and commercial warnings on reducing prescription misuse: the case of propoxyphene. AB - We analyzed trends in prescribing and overdose deaths related to propoxyphene (e.g., Darvon) before and after a 1978-80 informational campaign carried out by the US Food and Drug Administration and the drug's manufacturer through mailed warnings, face-to-face education of prescribers, press releases, and labeling changes. The goals included a reduction in propoxyphene use with alcohol or other CNS depressants, reduced prescribing of refills, and cessation of prescribing for patients at risk of abuse and misuse (suicide). We conducted time-series analyses of nationwide propoxyphene use data 1974-83 and analyzed data on drug overdose death rates covering a combined population of about 83 million. Segmented regression methods were used to determine if the informational program was associated with changes in trends of prescribing or overdose deaths. Comparison drug series were analyzed to control for other secular trends in prescribing. Nationwide propoxyphene use during the warnings continued a pre-existing decline of about 8 per cent per year, but this decline halted after the warnings. The no refill recommendation had no impact on refill rates. The risk of overdose death per propoxyphene prescription filled has remained about constant since 1979. Sharper declines in misuse of such drugs will require stronger, more sustained regulatory or educational measures. PMID- 3674251 TI - Fatal occupational injuries of women, Texas 1975-84. AB - A review of Texas death certificates for 1975-84 identified 348 cases of fatal occupational injuries of civilian females. Homicides accounted for 53 per cent and motor vehicle-related injuries accounted for 26 per cent of the deaths. Injuries from firearms caused 70 per cent of the homicides. One hundred thirty three deaths occurred to women employed in the retail trade industry; of these, 77 per cent resulted from homicide. Women workers in gasoline service stations, food-bakery-and-dairy stores, and eating-and-drinking places had especially high risks of homicide. Texas female heavy-truck drivers had the highest fatal-injury rate, with motor-vehicle-related injuries causing 89 per cent of their deaths. These results indicate that effective strategies to prevent fatal occupational injuries of Texas women will need to address the problems of workplace violence and the hazards posed by motor vehicles. PMID- 3674252 TI - Computerized surveillance of errors in newborn screening practice. AB - We describe the use and early results of the Oregon Public Health Laboratory computer to monitor hospital and practitioner compliance with state newborn screening recommendations. The system tracks five major categories of screening practice in which 21 types of errors affecting screening test quality have been identified. Our initial pilot study examined computer generated data for 23,717 specimens submitted by 116 Oregon birthing facilities over a four-month period. Results show that 58.3 per cent of newborn screening specimens were submitted incorrectly according to current state recommendations. PMID- 3674253 TI - Summary measures of occupational history: a comparison of latest occupation and industry with usual occupation and industry. AB - The utility of using latest occupational information as a summary of work history is assessed by comparing it to usual occupation and industry. We analyzed 5,734 complete occupational histories obtained by telephone interview as part of an ongoing occupational cancer surveillance study. Of these, 73.6 per cent reported the same usual occupation as latest occupation and 76.6 per cent the same usual industry as latest industry. Differences in match rates by race and sex, occupation and industry titles and categories suggest that bias may result in studies using latest occupation or industry as a summary measure of occupational exposures. PMID- 3674254 TI - Women's leadership status in the American Public Health Association. AB - Content analyses of the official printed programs for the 1973 and 1983 annual meetings of the American Public Health Association were used to compare the proportion of men and women serving as officers of the Association, members of the Executive Board, section representatives to the APHA Governing Council, and officers of section councils. The findings suggest substantial progress for women in gaining access to APHA leadership, despite continued underrepresentation in several of the Association's highest offices. PMID- 3674255 TI - Depressive symptoms and substance use among adolescent binge eaters and purgers: a defined population study. AB - We surveyed 646 tenth grade females in Northern California to assess the prevalence of binge eating and purging behaviors. Of these, 10.3 per cent met study criteria for bulimia and an additional 10.4 per cent reported purging behaviors for weight control. Bulimics and purgers were heavier, had greater triceps and subscapular skinfold thicknesses, and reported higher rates of drunkenness, marijuana use, cigarette use, and greater levels of depressive symptomatology. PMID- 3674256 TI - Health status of Ethiopian refugees in the United States. AB - The health status of 239 Ethiopian refugees in the United States was evaluated. Over 70 per cent were males 15-30 years old. Positive PPDs (purified protein derivative of tuberculin) were observed in 72 per cent and 3.4 per cent had abnormal chest x-rays. One patient had active tuberculosis. Other laboratory abnormalities included: intestinal parasites (36.7 per cent), anemia (14.9 per cent), eosinophilia (14 per cent), positive syphilis serology (7.5 per cent), and hepatitis B surface antigenemia (9.4 per cent). The most prevalent intestinal parasites were Giardia lamblia, Trichuris trichiura, and Schistosoma mansoni. PMID- 3674257 TI - The scope of diabetes in the United States population. PMID- 3674258 TI - A fox in the chicken coop? Epidemiologic surveillance of medical care. PMID- 3674259 TI - On HIV transmission in homosexual/bisexual men. PMID- 3674260 TI - Seriousness of AIDS and screening. PMID- 3674261 TI - Cesarean section rates in Italy. PMID- 3674262 TI - Antigens of human trophoblast: trophoblast-lymphocyte cross-reactive antigens on platelets. AB - Human and rabbit antibodies to trophoblast-lymphocyte cross-reactive (TLX) antigens were employed in an enzyme-linked immunosorbent assay (ELISA) to identify and characterize the TLX alloantigen system on human platelets. Neither washing nor extraction in chaotrope or acid altered platelet TLX. The antigen was significantly changed by pronase and trypsin digestion, but Folch extraction yielded antigen in the hydrophilic interface, suggesting carbohydrate. Rabbit antibodies prepared to HLA-negative human syncytiotrophoblast TLX antigens were shown by platelet ELISA to have the same specificity and similar allotypy as anti TLX antibodies from secondary (2 degrees) spontaneously aborting women. Patients with normal pregnancies before becoming 2 degrees aborters had both IgG and IgM antibodies to TLX. Anti-TLX in patients who never had a normal pregnancy were predominantly IgG. ELISA reactions performed with different concentrations of protein in the buffers detected anti-TLX activity in buffers containing high protein concentrations. This has been observed in studies of blocking antibodies in graft-versus-host disease and immune responses to tumor cells. Platelet TLX offers a new genetic and immunological approach to study similarities of the host parasite relationships in pregnancy, transplantation, and cancer. PMID- 3674263 TI - Investigation of the expression of amnion antigens by spiral arteries in human utero-placental tissues. AB - Two monoclonal antibodies raised against human amnion, GB3 and GB5, were used in an indirect immunoperoxidase method to investigate the expression of amnion antigens by spiral arteries in pregnant and nonpregnant uterine tissues. GB3 showed focal reactivity with occasional spiral arteries in the placental bed throughout pregnancy, but no GB3-staining was observed in nonpregnant endometrium. In contrast, GB5 showed bandlike circumferential reactivity with spiral arteries at all gestational ages examined. GB5-positivity showed no relation to the presence of endovascular or perivascular trophoblast. In nonpregnant endometrium, GB5 labeled rare spiral arteries. However, in a premenstrual specimen showing pseudodecidual change, there was circumferential reactivity with GB5 resembling that in pregnancy. The reaction patterns of GB3 or GB5 were not similar to those for two other basement-membrane components, fibronectin and type IV collagen. The results suggest that expression of the GB5 antigen may in part be regulated by hormones. PMID- 3674264 TI - The role of spermine in the cytotoxic effects of seminal plasma. PMID- 3674265 TI - The biomechanics of lateral knee bracing. Part I: Response of the valgus restraints to loading. AB - To better understand the role of preventive knee braces in injury prevention, a biomechanical study using fresh frozen cadaveric knees (N = 18) was conducted. Ligament tensions and joint displacements were measured at static, nondestructive valgus forces as well as low-rate destructive forces. After quantifying and establishing individual ligament contributions to valgus restraining function, knees were then braced with two different laterally applied preventive braces, the McDavid Knee Guard and the Omni Anderson Knee Stabler. The effects of lateral bracing were analyzed according to valgus force, joint line opening, and ligament tensions. Valgus applied forces, with or without braces, consistently produced medial collateral ligament (MCL) disruptions at ligament tensions surprisingly higher than the anterior cruciate ligament (ACL) and higher than or equal to the posterior cruciate ligament (PCL). Although large joint displacements were necessary for complete ligament failure, bundle disruption in the MCL, ACL, and PCL was noted at much smaller joint openings. In Part I of this study, no significant protection could be documented with the two preventive braces used. Also, four potentially adverse effects were noted: MCL preload, center axis shift, premature joint line contact, and brace slippage. PMID- 3674266 TI - The biomechanics of lateral knee bracing. Part II: Impact response of the braced knee. AB - In Part I of our study on lateral knee bracing, we evaluated brace effectiveness using cadaveric knees and two commercially available braces (McDavid and Omni). The results indicated that for low-rate dynamic valgus loading, neither brace provided significant protection against MCL injury. Also, four potentially adverse effects were noted. The goals in Part II were to: 1) determine the clinical significance of brace induced MCL preload; 2) define the functional character of an "ideal" brace; 3) design and validate a surrogate knee model for testing brace effectiveness; and 4) determine brace performance under impact loading using the surrogate knee and six commercially available brace types (manufactured by DonJoy, McDavid, Mueller, Omni Scientific, Stromgren-Scott, and Tru-Fit). Knee braces, modified to measure varus/valgus bending force, were used to determine MCL preload effects in 13 human volunteers. An anatomically correct surrogate knee model, instrumented to measure ligament/tendon tension and medial joint opening, was developed and validated using information from our previous cadaver studies and results of analyses on the effects of high strain rates (100% versus 1000% strain/sec) on MCL failure. Over 500 impact tests were performed on the surrogate knee in unbraced versus braced conditions. Tests were conducted for three impactor masses, two flexion angles, and free or constrained limb positions. Impact safety factors (ISF) were calculated for each test condition and brace type. An ISF of 1.50 (MCL load reduction of 30%) was considered significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674267 TI - Anterior cruciate ligament repairs in world class skiers. AB - From 1979 to 1984, 27 skiers who were either present or past members of the United States Ski Team or professional skiers had 30 ACL tears that were repaired primarily. Only two of the repairs were augmented with autogenous patellar tendon grafts. Five patients had complete knee dislocations, including tears of both cruciate ligaments. Nineteen patients had a concomitant extraarticular iliotibial band tenodesis. Twenty-seven knees (24 patients) were followed an average of 57.6 months postoperatively. Recreational skiing was resumed at 5.4 months on average, and in ski racing and pivot-requiring sports all but three patients resumed participation at an average of 9.1 months. In 78% of the knees there was pain free function. Mild pain was reported in 19%, the majority of which (4/5) was related to vigorous activity. Of the total, only two knees were reported to have a sensation of giving way. On clinical examination 85% (23/27) had normal pivot shift examination with no evidence of abnormal motion. Four percent (1/27) had a 1+ test and 11% (3/27) had "glides." Arthrometer measurements revealed an average of 7.76 mm anterior displacement with 20 pounds of force on the knee with an ACL repair as compared to 5.56 mm on the uninjured knee. The laxity measurements of knees with repaired ACLs fell within the range reported for uninjured knees in the normal population. Five patients had reinjuries to the ACL at an average time of 28 months postoperatively, with two of five undergoing rerepair. Only one patient had an iliotibial band tenodesis to supplement the original ACL repair.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674268 TI - Biomechanical comparison of stimulated and nonstimulated skeletal muscle pulled to failure. AB - We compared the biomechanical properties of passive and stimulated muscle rapidly lengthened to failure in an experimental animal model. The mechanical parameters compared were force to tear, change in length to tear, site of failure, and energy absorbed by the muscle-tendon unit before failure. Paired comparisons were made between 1) muscles stimulated at 64 Hz (tetanic stimulation) and passive (no stimulation) muscles, 2) muscles stimulated at 16 Hz (wave-summated stimulation) and passive muscles, and 3) muscles stimulated at 64 Hz and at 16 Hz. Both tetanically stimulated and wave-summation contracted muscles required a greater force to tear (at 64 Hz, 12.86 N more, P less than 0.0004; and at 16 Hz, 17.79 N more, P less than 0.003) than their nonstimulated controls, while there was no statistical difference in failure force between muscles stimulated at 16 Hz and 64 Hz. The energy absorbed was statistically greater for the stimulated muscles than for the passive muscles in Groups 1 and 2 (at 64 Hz, 100% more, P less than 0.0003; and 16 Hz, 88% more, P less than 0.0002). In Group 3, the tetanically contracted muscle-tendon units absorbed 18% more energy than the wave-summated stimulated muscles (P less than 0.01). All muscles tore at the distal musculotendinous junction, and there was no difference in the length increase at tear between muscles in each group. These findings may lead to enhanced understanding of the mechanism and physiology of muscle strain injuries. PMID- 3674269 TI - Graft tension in anterior cruciate ligament reconstruction. An in vivo study in dogs. AB - The purpose of this study was to examine the effect of initial tensioning on the outcome of reconstruction of the ACL. The ACLs of 15 adult mongrel dogs were excised and reconstructed. In the first five dogs, the ACLs of both knees were reconstructed using the medial one-third of the patellar tendon. The graft was fixed under a tension of 1 N (0.22 pounds) in one knee and 39 N (8.8 pounds) in the opposite knee. In the remainder of the dogs, the reconstructions were augmented with Dacron prostheses. Tensioning of both graft components in the augmented reconstructions was either with 1 N in one knee and 39 N in the contralateral knee or disproportionate tensions of 1 N and 39 N applied to the autogenous material and to the prosthesis. Sacrifice was 3 months postsurgery and results were examined with microangiography/history and mechanical testing. In the reconstructions with the patellar tendon alone, the biologic study showed poor vascularity and focal myxoid degeneration within the graft pretensioned with a load of 39 N. In the augmented reconstructions, the knees in which both graft materials were fixed with 1 N tension showed the strongest and stiffest reconstruction at 3 months. The study suggests that minimal tension should be applied to the graft materials during surgical reconstruction of the ACL. PMID- 3674270 TI - Prophylactic knee bracing. AB - Six studies to determine the effectiveness of prophylactic knee braces in preventing medial collateral ligament (MCL) injury in football are compared. Criteria useful in evaluating studies are discussed, such as the probability of confounding factors, bias in selecting cases and controls, and variations in defining injury and exposure. Cost, as well as some ethical issues associated with mandated use are discussed. While four of these studies found a reduction in MCL injuries associated with using a brace, two of them reported increases. No consensus arises from these studies, conflicting results as well as methodological problems in some make it impossible to state with assurance the role of prophylactic knee bracing in football at this time. PMID- 3674271 TI - The percutaneous lateral retinacular release. AB - This study reviews 34 of 37 original patients who were reviewed in 1981 after previously undergoing percutaneous lateral retinacular release. Short-term satisfactory results regarding reduction of pain and prevention of dislocation were maintained on this second followup (average, 48 months). With this increase in postoperative time, patients with recurrent subluxation developed an increase in patellar slipping. Patients with chondromalacia and degenerative joint disease are less suited for long-term treatment. Long-term problems occurred in 1 of 34 patients (3%). PMID- 3674272 TI - Strength training for prepubescent males: is it safe? AB - This study examined the safety of one type of strength training for prepubescent males. Eighteen males (average age, 8.3 +/- 1.2 years) participated in a 45 min/session, three session/week, 14 week supervised strength training program with an attendance rate of 91.5%. Concentric work was done almost exclusively. KinCom analysis showed significant strength gain in this group (P less than 0.05), while an age, sex, and activity matched control group did not gain strength. Safety was evaluated by injury surveillance, blood pressure and heart rate monitoring, scintigraphy, and creatine phosphokinase measurement. Effects on growth and development, flexibility, and motor performance were also investigated, as these are factors with an impact on sports injury occurrence. Results showed that in the short term, supervised concentric strength training results in a low injury rate and does not adversely affect bone, muscle, or epiphyses; nor does it adversely affect growth, development, flexibility, or motor performance. As the safety question is multifaceted, this should not lead to the conclusion that strength training for prepubescents is uniformly safe. Further research is needed. PMID- 3674273 TI - Evaluation of patella viability after disruption of the arterial circulation. AB - Fifty patients whose surgical approach violated the arterial geniculate circulation to the patella were evaluated to determine the subsequent effect on patella viability. Comparative postoperative radionuclide scans in 100 knees, 50 control and 50 surgical, revealed an avascular insult in only 7 knees (14%). It appears that the intratendinous circulation described by Bjorkstrom and Goldie protects the patella from an avascular insult in the presence of geniculate arterial disruption. PMID- 3674274 TI - Soccer injuries in Saudi Arabia. AB - Soccer injuries which were seen at the King Fahd University Hospital over a period of 12 months were analyzed. The majority of the patients were under 20 years of age. Two-thirds of the injuries involved soft tissue, while those to the bone and joint comprised one-third. The lower extremity was involved in 59%. Sixteen percent of the injuries were considered severe enough to require inpatient treatment. We feel the high incidence of injuries can be reduced by better guidance and coaching at school and other training levels. At present, these patients are seen in the emergency room of our hospital and subsequently in the orthopaedic and fracture clinics. A specialized sports injury clinic staffed with medical and paramedical personnel with special interest in sports medicine would enable early and effective treatment returning athletes to play without undue delay. PMID- 3674275 TI - Trabecular bone density and menstrual function in women runners. AB - Osteoporosis results in decreased bone mineral mass and reduced trabecular bone density. Although its etiology remains unknown, studies have revealed differential changes in the bone mineral densities of postmenopausal women, anorexic women, and amenorrheic female athletes. Correlations have also been made between estrogen deficiency and osteoporosis in both premenopausal and postmenopausal women. In order to examine the possibility of osteopenia, a group of 36 female runners between the ages of 15 and 44 years were evaluated for bone mineral density, menstrual function, and dietary habits. Serum calcium, phosphorus, and parathyroid hormone (PTH) levels were also determined for each participant, as were complete blood counts. Using dual photon absorptiometry, all participants underwent a 20 minute scan of the lumbar spine with specificity to the L1-14 vertebrae. The 36 subjects included 19 oligomenorrheic and 17 eumenorrheic women. Results of bone density analyses revealed that the oligomenorrheic runners had significantly lower calibrated bone mineral density (CBMD) than their eumenorrheic counterparts (P less than or equal to 0.01). Likewise, the PTH levels of the oligomenorrheic runners were also significantly lower (P less than or equal to 0.01). Analysis of dietary logs revealed no significant differences between the dietary habits, the calcium intake, or the caloric intake of the two groups. The data from this study indicate that there is a relationship between reduced serum PTH levels and the oligomenorrheic state. The loss of the protective effect of estrogen in the oligomenorrheic runners possibly contributed to their reduced bone mineral densities and could be a contributing factor in osteopenia. PMID- 3674276 TI - The physiologic effects of eight weeks of aerobic dance with and without hand held weights. AB - There are few reports concerning the physiologic alterations that occur following a specified period of aerobic dance. Further, no data exist to describe the physiologic changes or potential risk associated with using hand-held weights during aerobic dance. The purpose of this study was to determine the changes in maximum oxygen uptake (VO2max) and body composition following 8 weeks of aerobic dance using hand-held weights (Heavyhands, AMF, Jefferson, IA). Twenty-eight college females volunteered for the study. All subjects were given a preoxygen and postoxygen uptake (VO2 max) treadmill test. Body composition was measured by taking the sum of five skinfold sites and determining the percent change following training. Subjects were randomly assigned to a hand-held weight or nonhand-held weight group. No significant differences (P less than 0.05) existed between groups for VO2 max and body composition after 8 weeks of training. However, a significant improvement (P less than 0.05) in VO2 max was found within the hand-held weight (37.7 to 42.6) and in the nonhand-held weight group (36.5 to 41.9). Complaints from subjects included transient aches and pains in the shoulder area during the first 3 weeks as a result of hand-held weight use. These findings suggest that hand-held weights may be used safely but do not increase the work load sufficiently above that of aerobic dance alone to significantly modify VO2 max or body composition. PMID- 3674277 TI - Subluxation of the peroneal tendons within the peroneal tendon sheath. A case report. PMID- 3674278 TI - Ruptured triceps in a powerlifter presenting as cubital tunnel syndrome. A case report. PMID- 3674280 TI - An electromyographic analysis of the elbow in pitching. PMID- 3674279 TI - Septic arthritis. A case report. PMID- 3674281 TI - Weight loss without dietary restriction: efficacy of different forms of aerobic exercise. PMID- 3674282 TI - Familial visceral myopathy. Evidence of diffuse involvement of intestinal smooth muscle. AB - We report the histologic and ultrastructural findings on two sisters with familial visceral myopathy who presented with acquired megacolon that necessitated subtotal colectomy. Both patients were mentally retarded and had repeated episodes of constipation and fecal impaction. Each presented near the age of 30 with massive dilatation of the colon and without clinical evidence of small intestinal involvement. Histologic abnormalities primarily involved smooth muscle and included marked nuclear enlargement and irregularity, interstitial fibrosis, and cytoplasmic vacuolation. These changes were most severe in the muscularis propria, but similar abnormalities were found in the muscularis mucosae and blood vessels. In the most advanced stages, collagen had completely replaced the muscularis propria, with extreme thinning of the intestinal wall. Abnormalities were noted in all segments of the colon and the appendix, but there was little correlation between severity of involvement and the segment examined. This study not only confirms the variable nature of morphologic changes in familial visceral myopathy, but also provides evidence of more extensive involvement of intestinal smooth muscle than has been previously reported. PMID- 3674283 TI - Papillary cystic tumor of the pancreas. An analysis of cellular differentiation by electron microscopy and immunohistochemistry. AB - Three cases of clinically benign pancreatic papillary cystic tumors in young female patients were studied by immunohistochemistry and electron microscopy in order to define the cellular nature of this type of neoplasm. Two of the tumors showed focal cytokeratin- and desmoplakin-positivity as evidence of focal epithelial differentiation, while the tumor cells were in all cases positive for vimentin--the intermediate filament protein typical of (but not specific for) mesenchymal cells. Electron microscopy showed some cell-cell junctions, but there was no evidence of acinar or islet cell differentiation. The tumors were at least focally positive for neuron-specific enolase, and small clusters of polypeptide hormone immunoreactive cells were present in all cases (glucagon 3/3, somatostatin 2/3, insulin 2/3). However, the tumors were negative for synaptophysin and neurofilament proteins, unlike most islet cell tumors. Trypsin and chymotrypsin immunoreactivity was found in all tumors, but because many nonpancreatic carcinomas were also positive, we doubt whether these two enzyme proteins can act as specific markers for pancreatic acinar cell differentiation. Two of the tumors that were studied immunohistochemically for the presence of nuclear estrogen receptors, were negative. Therefore no proof of the suggested hormone dependence of this tumor could be obtained. We conclude that papillary cystic tumor is a neoplasm of primitive pancreatic epithelial cells, that may exhibit focal endocrine cell differentiation. PMID- 3674284 TI - Acute megakaryocytic leukemia with myeloid/monocytic differentiation. AB - Acute megakaryocytic leukemia is a rare form of acute nonlymphocytic leukemia that occurs with increased frequency in patients with Down's syndrome. Herein, we report a child with Down's syndrome who presented with a large retroperitoneal mass due to acute megakaryocytic leukemia. Immunohistochemical stains of the tumor cells also demonstrated evidence of myeloid/monocytic differentiation, with positivity for alpha-1-antitrypsin, alpha-1-chymotrypsin, and lysozyme. The significance of this phenotypic heterogeneity is unclear and awaits further studies of similar cases. PMID- 3674285 TI - Unusual intestinal talcosis. AB - A case of intestinal talcosis in a 46-year-old man is reported. At the age of 27, the patient was treated for pulmonary tuberculosis with tablets containing talc (183 g talc per 2,670 g total drug intake) over a period of 28 months. Eighteen years later, the patient was hospitalized for abdominal pain that remained refractory to antacids; he subsequently underwent a right hemicolectomy. Light microscopic examination revealed a prominent fibrosis of the intestinal wall in which birefringent particles were demonstrated by polarized light. Using energy dispersive spectroscopy, an analysis of these particles showed that they were predominantly composed of silicon and magnesium as well as small amounts of phosphorus, sulphur, calcium, and iron--the spectrum typically associated with talc. We believe that the source of this talc is the tablets ingested by the patient during prior antituberculosis therapy. PMID- 3674286 TI - Wegener's granulomatosis presenting with massive pulmonary hemorrhage and capillaritis. AB - The typical lesions of Wegener's granulomatosis in the lung consist of necrotizing granulomatous inflammation associated with a necrotizing vasculitis. We report an unusual case in which massive pulmonary hemorrhage was the initial manifestation. An open-lung biopsy showed intraalveolar hemorrhage and a necrotizing capillaritis, but no granulomas and no vasculitis involving arteries or veins. The diagnosis of Wegener's granulomatosis was established only at autopsy, when necrotizing granulomas and vasculitis were found. This case emphasizes that Wegener's granulomatosis should be considered in the differential diagnosis of pulmonary hemorrhage and necrotizing capillaritis. PMID- 3674287 TI - Lymphoepithelial cyst of the pancreas. AB - A rare cystic lesion of the pancreas is reported. Morphologically, this unilocular cyst was filled with keratin material and lined by mature, keratinizing squamous epithelium; it was surrounded by lymphoid tissue and also focally by pancreatic tissue. Clinically, the lesion was associated with diarrhea and abdominal pain, both of which promptly disappeared after its removal. Although the histogenesis of this lesion is not known, it can be histologically differentiated from other pancreatic and retroperitoneal cysts. We propose the name "lymphoepithelial cyst" for this lesion and note that only one similar case has been described previously. PMID- 3674288 TI - Breast sarcoma. PMID- 3674289 TI - Collagenous spherulosis. PMID- 3674290 TI - What is surgery? PMID- 3674291 TI - Of mentors and academic responsibility. PMID- 3674292 TI - Final diagnosis by fine-needle aspiration biopsy for definitive operation in breast cancer. AB - This work has been based on 15 years experience with more than 10,000 needle aspiration biopsies of the breast. Fine-needle aspiration biopsy was used in place of open breast biopsy for definitive operation in breast cancer. Our experience with 2,623 aspiration biopsies over a 3 year period has been reviewed. There was a total of 323 cancers, of which 257 (80 percent) were unequivocally diagnosed by fine-needle aspiration biopsy. Definitive operation was performed in 244 of these patients (95 percent) without open biopsy. Thirteen had an excisional biopsy before definitive operation at the request of the referring physician. The sensitivity was 80 percent and the specificity was 98 percent. There were no false-positive diagnoses. The positive predictive value was 100 percent. False-negative diagnoses were made in 9 percent of the patients, half of whom had nonpalpable carcinomas. Our experience shows that fine-needle aspiration biopsy is accurate in the diagnosis of breast cancer, and when the finding is positive, it can be used for definitive breast operation, eliminating the need for open biopsy. A management algorithm has also been presented herein. PMID- 3674293 TI - Some questions concerning the routine use of aspiration cytologic study in the definitive diagnosis of breast lesions. PMID- 3674294 TI - An improved system for surgical excision of needle-localized nonpalpable breast lesions. AB - A technique for improved localization and surgical excision of nonpalpable breast lesions is described. The method employs an atraumatic outer stiffening cannula which is available in a variety of lengths and eliminates several of the technical difficulties encountered during these procedures. Successful initial excision of over 50 consecutive nonpalpable breast lesions has been obtained with this technique. PMID- 3674295 TI - Prevention of wound infection after elective colorectal resection. AB - Various operative wound handling techniques have been proposed to prevent wound infections after elective colorectal resection, including pelvic drains, wound wicks, topical antibiotics, and subcutaneous drains. Review of 243 consecutive elective colorectal resections performed between 1977 and 1983, in which 64 percent of the patients had significant underlying medical problems, 27 percent were over age 70, and 45 percent had concomitant abdominal procedures, revealed that consistent application of a uniform perioperative protocol emphasizing aseptic and antiseptic techniques minimizes wound and anastomotic infectious complications. Simple wound closure in this setting is sufficient to prevent incisional wound infections. PMID- 3674296 TI - Testimony has its merits! PMID- 3674297 TI - Proximal pancreatectomy: a comparison of electrocautery and contact and noncontact Nd:YAG laser techniques in the dog. AB - Proximal pancreatectomy with duodenal preservation is technically difficult. It has often been performed experimentally in pancreatic transplantation studies. Preservation of the pancreaticoduodenal vessels and duodenum provides an excellent method of testing various operative techniques in pancreatic surgery which may lead to further clinical applications. The present study has compared the conventional noncontact Nd:YAG laser technique with electrocautery and a new contact Nd:YAG laser technique for proximal pancreatectomy. There were five dogs in each group, and the pancreatic duct was left open to drain into the abdominal cavity after pancreatic transection in all of the animals. Resection with the contact laser caused significantly less blood loss (109 +/- 74 ml) than the noncontact laser (228 +/- 81 ml), (p less than 0.05). A greater number of ligatures were used in the noncontact laser group (11 +/- 3 ligatures) as compared with the electrocautery group (2.2 +/- 1.6 ligatures) and the contact laser group (5.2 +/- 2.8 ligatures), (p less than 0.005). Noncontact laser and electrocautery resection techniques resulted in necrotizing pancreatitis and death in two animals. The new contact laser system provides a safe and effective method of performing pancreatic surgery. PMID- 3674298 TI - Sexual function after resection for rectal cancer. AB - Major rectal operation, that is, abdominoperineal or anterior resection, for cancer frequently damages the autonomic pelvic nerve supply with resultant sexual dysfunction. The anatomic characteristics and function of the autonomic nervous system in the pelvis has been reviewed. Sexual function after rectal excision for cancer was studied in 25 male patients who were less than 60 years of age and exhibited normal sexual activity preoperatively. Of nine patients who had abdominoperineal resection, four were impotent and two reported no ejaculation with normal potency postoperatively. Of 4 patients who had high anterior resection, only 1 reported no ejaculation, whereas of 12 patients with low anterior resection, 4 were impotent and 3 reported no ejaculation. A higher incidence of sexual dysfunction was noted after abdominoperineal resection compared with after anterior resection (66 percent and 50 percent, respectively). However, the incidence after low and very low anterior resection was comparable with that after abdominoperineal resection (58 percent and 66 percent, respectively). Advanced patient age and very low resection were the two main factors effecting sexual dysfunction after major rectal operation. Although we believe that careful operative technique might reduce the incidence of sexual disturbances attributable to sympathetic fiber damage, avoidance of parasympathetic damage during operation cannot be accomplished because the most likely site of injury, namely the periprostatic plexus, is usually within the operative field, the exception being cases in which the tumor is small, thus allowing preservation of the rectoprostatic fascia. PMID- 3674299 TI - The long-term fate of the gallbladder after endoscopic sphincterotomy. Complete follow-up study of 122 patients. AB - One hundred twenty-two patients with common bile duct stones and intact gallbladders underwent endoscopic sphincterotomy without cholecystectomy and were followed for 6 months to 9 years (mean 3 years). Nineteen patients died from unrelated causes. One hundred of 103 surviving patients (97 percent) were asymptomatic, whereas 3 had complaints. Acute cholecystitis did not occur in 91 patients without gallstones, whereas it did occur in 5 of 31 patients (16 percent) with gallstones (25 patients) or nonvisualization of the gallbladder (6 patients). Two patients in the former subgroup had formation of new gallstones. We conclude that cholecystectomy should be advocated whenever possible in patients with gallstones or nonvisualization of the gallbladder after endoscopic sphincterotomy due to the high incidence of acute cholecystitis in this subgroup and that operation is not necessary in patients without gallstones; however, one should be aware of possible formation of new stones in the gallbladder. PMID- 3674300 TI - Diagnostic and prognostic problems in early gastric cancer. AB - Although common in Japan, early gastric cancer is rarely seen in Western countries and generally accounts for only 7 to 10 percent of all gastric malignancies. Eleven patients with early gastric cancer seen over a 10 year period have been reviewed for clinical and pathologic features, method of diagnosis, treatment, and prognosis. The symptoms usually consisted of vague epigastric pain or dyspepsia, but anorexia, weight loss, anemia, and hypoalbuminemia were not commonly seen. Barium meal examination was not helpful in the diagnosis in 50 percent of the patients. The diagnosis was made by endoscopic biopsy of abnormal areas of the stomach, although in 6 of 11 patients, there was no macroscopic suspicion of malignancy. All patients were treated by surgical resection. The tumor was confined to the mucosa in five patients and had infiltrated the submucosa in six patients. The lymph nodes were free of tumor in every patient. At last follow-up, seven patients had survived more than 5 years after operation and were well, although recurrent tumors developed in two patients 3 and 4 years postoperatively but were detected early by endoscopic surveillance. Early gastric cancer has a good prognosis after surgical resection, but the symptoms are vague and the diagnostic tests can be misleading. A vigorous approach to investigation, treatment, and follow-up is necessary to achieve satisfactory results. PMID- 3674301 TI - Effect of sleep deprivation on the performance of surgical residents. AB - Surgical residents were tested under sleep-deprived and nonsleep-deprived conditions. Three performance domains were tested: factual recall, the ability to concentrate, and manual dexterity. Sleep deprivation was defined as less than 3 hours of sleep in a 24 hour period. A randomized, repeated measures design was used. Split-plot analysis of variances was used to analyze the mean scores, and it revealed that there were no significant differences in performance in the sleep-deprived condition compared with performance in the nonsleep-deprived condition in any of the three domains tested. Moderate sleep deprivation appeared to be well tolerated by the surgical residents studied in this investigation. PMID- 3674302 TI - Management of soft-tissue infections of the upper extremity in parenteral drug abusers. AB - Management of extensive soft-tissue infections of the upper extremity in 23 parenteral drug abusers was reviewed. Bacterial cultures most often revealed oral flora, including streptococcal species in 77 percent of patients and anaerobes in 59 percent. Staph. aureus was present in only one patient. Ninety percent of the organisms were sensitive to penicillin and 98 percent to first-generation cephalosporins. Blood culture specimens, obtained at admission, were negative in 15 patients. All patients responded well to operative debridement, excision of involved veins, and local wound care. Surgical debridement is the mainstay of therapy. We believe that intravenous antibiotic therapy with a first-generation cephalosporin should be used in the acute phase for control of surrounding cellulitis and prevention of bacteremia. PMID- 3674303 TI - Cranial nerve injuries during carotid endarterectomy. AB - Our experience with patients undergoing carotid endarterectomy over a 10 year period has been retrospectively reviewed. Nerve injuries were detected by reviewing postoperative progress and clinic notes. One hundred twenty-nine procedures were performed on 112 patients, 12 of whom (9.3 percent) sustained major nerve injuries. These included five vagal nerve injuries causing ipsilateral vocal cord paralysis and hoarseness, four injuries of the marginal mandibular nerve, and three injuries of the hypoglossal nerve. Evidence of nerve dysfunction was not present preoperatively. None of the patients with nerve injury sustained a stroke as a result of carotid operation. Vocal cord paralysis was documented by indirect laryngoscopy. The incidence of cranial nerve injury during carotid endarterectomy appears to be higher than expected, particularly if asymptomatic patients are investigated; however, most injuries are transient and result not from transection but from trauma during dissection, retraction, and clamping of the vessels. The pertinent anatomy and techniques for preventing these injuries have been reviewed. PMID- 3674305 TI - [Does life-prolonging therapy exist? 2d meeting on anesthesiology, oxyology and resuscitation (1). Roissy, 9-10 October 1986. Proceedings]. PMID- 3674306 TI - [Life-prolonging therapy: an outdated subject]. PMID- 3674304 TI - Percutaneous endoscopic gastrostomy and jejunostomy by a single pass of the endoscope. AB - A modified Gauderer-Ponsky technique of percutaneous endoscopic gastrostomy has been described. The major advantage is elimination of a second insertion of the endoscope, as well as unnecessary traversing of the esophagus by snares and strings. The result achieved is equal to what has been achieved with the original technique, but the single-pass technique is more expeditious and less uncomfortable for the patient. In addition, it can easily be modified to insert both draining gastrostomy and feeding jejunostomy tubes at the same time, using only one pass of the endoscope. PMID- 3674307 TI - [Does life-prolonging treatment exist?]. PMID- 3674308 TI - [Prolonging treatment in an incurable disease: Duchenne's muscular dystrophy]. PMID- 3674309 TI - [Early respiratory assistance by nasal route in Duchenne's muscular dystrophy]. PMID- 3674310 TI - [Treatment of bilateral pelvi-crural gangrene with arthritis of the hip in extensive bedsores of paraplegics (review of 21 cases)]. PMID- 3674311 TI - [Does life-prolonging treatment exist in emergency medicine? Emergency medical aid services and emergency and resuscitation mobile services in cardiorespiratory arrest. A national survey]. PMID- 3674312 TI - [The seriousness of suicide attempts and the death wish]. PMID- 3674313 TI - [The obligation to use available means in resuscitation: does life-prolonging treatment exist?]. PMID- 3674314 TI - [The place of minor abdominal cesarean section (sectio parva) in obstetrical practice]. PMID- 3674315 TI - [Reproductive problems in female workers exposed to the chronic action of microdoses of chemical substances]. PMID- 3674316 TI - [Harmful action of indomethacin on the fetus]. PMID- 3674317 TI - [Our experience in treating spontaneous abortions using the preparation Supradyn N]. PMID- 3674319 TI - [Concentration of the trace element zinc in the maternal serum in cases of fetal anomalies]. PMID- 3674318 TI - [Changes in the serum levels of selenium, zinc, copper, iron and magnesium during pregnancy]. PMID- 3674320 TI - [Importance of magnesium in preventing late pregnancy toxicoses (pre-eclampsia) (preliminary report)]. PMID- 3674321 TI - [Endothelial desquamation in pregnant diabetics]. PMID- 3674322 TI - [Advanced maternal age and fetal macrosomia]. PMID- 3674323 TI - [Incidence of the HBsAg carrier state among pregnant women and its effect on newborn infants. I. The incidence of the HBsAg carrier state among pregnant women in different provinces of Bulgaria]. PMID- 3674324 TI - [Level of immunoglobulins G, A and M in the milk of puerperae with mastitis]. PMID- 3674325 TI - [Initial impressions from using the new oral antimycotic Nizoral]. PMID- 3674326 TI - [Morphological findings during gynecologic operations on women before and after the age of 60]. PMID- 3674327 TI - [Importance of tumor markers for the diagnosis of ovarian carcinoma]. PMID- 3674328 TI - [Treatment of male infertility in idiopathic varicocele by high resection of the vena testicularis interna using Ivanissevich's method]. PMID- 3674329 TI - [Simultaneous presence in utero of 2 intrauterine contraceptive pessaries inserted consecutively]. PMID- 3674330 TI - [New model intrauterine contraceptive pessary--the Copper T 380 Ag]. PMID- 3674331 TI - Coronary artery embolism following cancer chemotherapy. AB - A 16-year-old patient underwent partial gastrectomy for leiomyosarcoma of the stomach. Following resection, he received combination chemotherapy that included Adriamycin and dimethyltriazenoimidazole carboxamide (DTIC), with the cumulative Adriamycin dose being 405 mg/m2. The patient was subsequently treated with vincristine, actinomycin D, and cyclophosphamide. Six hours after receiving his fourth dose of cyclophosphamide, the patient developed signs and symptoms of acute anterior wall myocardial infarction. Although he recovered from this initial cardiac event, he subsequently experienced several additional episodes of vascular occlusion involving the cerebral, femoral, coronary, and pulmonary arteries. Cardiac catheterization demonstrated all coronary arteries to be normal. Both ventricles were hypokinetic, and bilateral mural thrombi were demonstrated; these were the presumed source of the embolic phenomena. To our knowledge, this is the first description of repeated coronary artery embolization following cancer chemotherapy in a patient without evidence of preexisting cardiac abnormalities. PMID- 3674332 TI - Reversibility of splenic function by transfusion in two young adults with sickle cell anemia. AB - A level of circulating "pitted" or vesiculated red blood cells higher than 3.5% was recently reported in studies in the Cooperative Study of Sickle Cell Disease to correlate with splenic dysfunction as shown by spleen scans. Reversal of splenic dysfunction by transfusion in children with sickle cell anemia (SS disease) is known to occur in the young child. We report two older patients with homozygous sickle cell disease, aged 17 and 21 years, whose spleen function, as measured by pit count, was restored to normal range after transfusion. PMID- 3674334 TI - Alcoholism--a glimmer of hope. PMID- 3674333 TI - In vitro megakaryocytopoiesis in children with acute idiopathic thrombocytopenic purpura. AB - Idiopathic thrombocytopenic purpura (ITP) of childhood is a disorder characterized by a history of previous viral illness followed by acute onset of low circulating platelet count with present or increased megakaryocytes in the bone marrow. The majority of children recover a normal platelet count within 6 months to 1 year after onset of the disease. To better understand the regulation of megakaryocytopoiesis in this disorder, we studied nine patients with childhood ITP with the plasma clot colony assay in vitro for megakaryocyte colony forming units (CFU-Mk). Mononuclear bone marrow cells from some of the patients with ITP contained greater numbers of CFU-Mk and greater numbers of cells per colony than mononuclear bone marrow cells from healthy adult volunteers (p less than 0.026) when the cultures contained no added megakaryocyte colony-stimulating activity (Mk-CSA). The serum from patients with ITP did not stimulate in vitro megakaryocytopoiesis from healthy adult volunteers' bone marrow mononuclear cells above baseline values. These findings are consistent with the hypothesis that a decrease in bone marrow megakaryocytes is needed for Mk-CSA production. Alternatively, Mk-CSA is consumed by active megakaryocytopoiesis in the bone marrow. PMID- 3674335 TI - Health care for Alaska--continuing the commitment. PMID- 3674336 TI - [Morphometric study of the intrapetrosal route of the facial nerve]. PMID- 3674337 TI - [Preliminary study of high-frequency audiometry]. PMID- 3674338 TI - [Middle ear tumor associated with craniosynostosis. Apropos of a case]. PMID- 3674339 TI - [A new surgical technic for the treatment of bilateral abductor paralysis of the larynx]. PMID- 3674340 TI - [Topical treatment of otorrheas. Risks and indications]. PMID- 3674341 TI - [Inverted nasosinusal adenoid papilloma]. PMID- 3674342 TI - [Value of simultaneous bilateral thermal stimulation of the labyrinth]. PMID- 3674343 TI - Tracheal tubes in neuroanaesthesia. Nylon reinforced latex rubber tracheal tubes. AB - An exercise in quality assurance during neuroanaesthetic procedures identified uncontrolled re-use of armoured latex rubber tracheal tubes as a risk factor associated with equipment failure. We recommend that such tubes should be used once only. Alternatively, tubes made from more stable materials, such as polyvinyl chloride and silicone rubber, are available for clinical evaluation. PMID- 3674344 TI - Nerve blocks for hip surgery. PMID- 3674345 TI - Repeated use of halothane. PMID- 3674347 TI - A test for breathing systems. PMID- 3674346 TI - Nomenclature of circle absorption breathing systems. PMID- 3674348 TI - Shelf-life of sodium citrate (0.3M) PMID- 3674349 TI - Pain-free intravenous injections. PMID- 3674350 TI - Unexpected difficult intubation. PMID- 3674351 TI - Beta blockade and nitroprusside. PMID- 3674352 TI - Epidural lavage for extensive epidural suppuration. PMID- 3674353 TI - Postoperative complications of dystrophia myotonica. PMID- 3674354 TI - Down the tube. PMID- 3674355 TI - Suxamethonium in myasthenia gravis. AB - The effects of suxamethonium 1.0 and 0.5 mg/kg were studied in myasthenic patients. Resistance was not encountered at the 1.0 mg/kg dose but was seen at the lower dose. A non-depolarising type of block developed in patients in both groups. However, recovery from the non-depolarising block was not prolonged beyond the requirements of surgery. The neurophysiological basis for, and clinical implications of these findings are discussed. PMID- 3674356 TI - Intercostal catheterisation. An alternative approach to the paravertebral space. AB - Twenty-one patients scheduled to undergo thoracotomy or median sternotomy had intercostal catheters inserted pre-operatively. During thoracotomy, under direct vision, the spread of 20 ml of a solution containing bupivacaine and methylene blue was followed. In most cases the spread involved one or two intercostal spaces. However, in all but one patient, dye spread medially to the paravertebral space where it then spread in both caudad and cephalad directions to reach between two and five vertebrae. In three cases, dye was seen crossing the anterior surface of the vertebrae to reach the contralateral aspect. It is concluded that a major component of dermatomal block during intercostal catheterisations may be secondary to paravertebral spread. PMID- 3674357 TI - A red patient: immunological reaction to glycine? AB - A case of immunological adverse reaction to the commonly used bladder irrigation fluid, glycine, is reported, with discussion of the immunological investigations and possible significance of the results. PMID- 3674358 TI - Removal of a giant ovarian cyst. Anaesthetic and intensive care management. AB - Excision of a giant ovarian cyst may be associated with considerable mortality. Problems stem from the size of the cyst and the emaciated state of the patient. We describe a case in which the patient's pre-operative nutritional and psychological state required attention. Gradual pre-operative drainage of a cyst weighing 113 kg was carried out successfully. The main problems intra-operatively stemmed from copious blood loss and the duration of surgery. Postoperatively, ventilatory inadequacy occurred and was probably caused by altered mechanics of ventilation, postoperative pain and pulmonary oedema. We suggest ways in which the management of such cases might be improved. PMID- 3674359 TI - Ketamine infusion. Its use as a sedative, inotrope and bronchodilator in a critically ill patient. AB - A patient with acute lymphatic leukaemia developed a bilateral fulminating Pseudomonas aeruginosa pneumonia and required controlled ventilation of the lungs. Marked agitation, hypotension and bronchospasm unresponsive to conventional bronchodilators presented a therapeutic challenge. A continuous intravenous infusion of midazolam failed to provide adequate sedation. A continuous intravenous infusion of ketamine resulted in better sedation, an increase in arterial pressure and a diminution of bronchospasm. The clinical improvement was maintained for the 5 days during which ketamine was infused. Plasma concentrations of ketamine and its metabolites are reported. PMID- 3674360 TI - Upper limb sympathetic blockade following intercostal nerve blocks. AB - A case of transient sympathetic block of the arm following percutaneous intercostal nerve injections is described and the possible aetiology discussed. PMID- 3674361 TI - Carcinoid syndrome and intravenous cyproheptadine. AB - The anaesthetic management of a patient with the carcinoid syndrome is reported. Important cardiovascular complications occurred immediately after tracheal intubation and during manipulation of metastases. Hypertensive crises were controlled with intravenous cyproheptadine, although hypotension and drowsiness were observed due to its use. PMID- 3674362 TI - A differential pulse polarographic serum protein assay. AB - Human serum and albumin show a differential pulse polarographic band near -0.6 V. For sufficiently dilute solutions (less than 7 micrograms/ml) at pH 7.0, the polarographic response is linearly related to the solution concentration. At pH 12.6 a near-linear response to 70 micrograms/ml is obtained, but sample equilibration time is slow. The polarographic assay for total serum protein using bovine serum albumin (BSA) to generate a standard curve gave a correlation coefficient of 0.89. The cellular constituents of whole blood do not interfere. The correlation with BSA does not hold for protease-digested serum or albumin. PMID- 3674363 TI - Kinetic analysis of the fluorescence reaction of histamine with orthophthalaldehyde. AB - Histamine reacts with orthophthalaldehyde (OPA) in an alkaline medium to form an unstable fluorescent adduct (Fbase). Acidification of the solution gives a stable adduct (Facid). In order to elucidate the mechanism of this fluorescence reaction, a kinetic study of this reaction was carried out. Although Fbase was believed to be the precursor of Facid, it was shown not to be the precursor of Facid owing to the effects of the reaction time in an alkaline medium and OPA concentration on the yields of Fbase and Facid. The kinetic analysis of the formation and degradation of Fbase revealed the pathway of the fluorescence reaction. On the basis of the results obtained in this study, the mechanism of the fluorescence reaction is proposed. PMID- 3674364 TI - Fluorometric high-performance liquid chromatography of N-acetyl- and N glycolylneuraminic acids and its application to their microdetermination in human and animal sera, glycoproteins, and glycolipids. AB - A simple, rapid, and highly sensitive high-performance liquid chromatographic method is described for the determination of N-acetyl- and N-glycolylneuraminic acids in human and animal sera, glycoproteins, and glycolipids. The neuraminic acids, released by acid hydrolysis of these biological samples, are converted in dilute sulfuric acid with 1,2-diamino-4,5-methylene-dioxybenzene, a fluorogenic reagent for alpha-keto acids, to highly fluorescent derivatives. The derivatives are separated within 12 min on a reversed-phase column (Radial-Pak cartridge C18) with an isocratic elution and detected fluorometrically. The detection limits are 25 fmol (7.7 pg) for N-acetylneuraminic acid and 23 fmol (7.5 pg) for N glycolylneuraminic acid in a 10-microliter injection volume at a signal-to-noise ratio of 2. This method permits precise determination of the neuraminic acids in 5 microliter of human and animal sera or in 0.25-2.5 micrograms of glycoproteins and glycolipids. PMID- 3674365 TI - Tandem mass spectrometric determination of 11-dehydrothromboxane B2, an index metabolite of thromboxane B2 in plasma and urine. AB - 11-Dehydrothromboxane B2 is one of the major enzymatic metabolites of thromboxane B2 (TXB2), a biologically inactive product of thromboxane A2. The short half-life of thromboxane A2 and ex vivo production of thromboxane B2 by platelet activation make these prostanoid metabolites inappropriate as indices of systemic thromboxane biosynthesis, whereas 11-dehydro-TXB2 has been shown to reflect the release of thromboxane A2 in the human blood circulation. Analysis of 11-dehydro TXB2 in plasma and urine was performed by gas chromatography-mass spectrometry mass spectrometry using the chemically synthesized tetradeuterated compound as an internal standard. The high selectivity of triple-stage quadrupole mass spectrometry (tandem mass spectrometry) considerably facilitates sample purification as compared to single quadrupole mass spectrometric determination. Plasma concentrations in five healthy male volunteers were in the range 0.8-2.5 pg/ml. Urinary excretion of 11-dehydro-TXB2 was higher than that of 2,3-dinor TXB2: 1.2 +/- 0.36 micrograms/24 h vs 0.53 +/- 0.33 micrograms/24 h (n = 5). Thus 11-dehydro-TXB2 appears at present to be the best index metabolite of systemic TXA2 activity in plasma as well as in urine. PMID- 3674366 TI - A miniaturized method for multiple and inexpensive electrophoreses on polyacrylamide slab gels. AB - The design, construction, and use of a simple inexpensive system for multiple slab gel electrophoreses are described. Each gel slab is cooled from both sides by an electrode buffer. The electrophoresis time of each gel can be easily controlled independently from the others in the set. Because this set is very simple, it was completely handmade by the author. Depending on the purpose for which the set is to be used, its size, thickness, and shape can be changed. PMID- 3674367 TI - Fast method for two-dimensional electrophoresis of proteins from biological samples. AB - The method for two-dimensional gel electrophoresis of J. Klose and M. Feller [(1981) Electrophoresis 2, 12-24] has been simplified by reducing the thickness of the gels from 3.5 to 1.1 mm for isoelectric focusing gels and from 3.5 to 0.84 mm for sodium dodecyl sulfate slab gels. Thin gels need less reagents and smaller sample volumes. Cooling of the thin gels during electrophoresis is more effective, which allows the use of higher electric power. Therefore, less time is required for an electrophoretic run (approx 4 h). The resolution increases due to the smaller size of the spots. The time required for staining the gels is reduced from at least 3 days to about 1 h. The method has been tested with a protein sample from the filamentous fungus Fusarium solani. PMID- 3674368 TI - Homogeneous chicken heart mitochondrial creatine kinase purified by dye-ligand and transition-state analog-affinity chromatography. AB - A method for the preparation of homogeneous mitochondrial creatine kinase from chicken heart is presented. The two-column procedure, which can be completed in 2 days, uses Procion red dye and transition-state analog-affinity chromatography. The transition-state analog-affinity chromatographic system utilizes an ADP hexane-agarose column in conjunction with the transition-state analog complex originally developed by E. J. Milner-White and D. C. Watts (1971, Biochem, J. 122, 727-740) composed of KNO3, MgCl2, creatine, and ADP. The enzyme is a dimer composed of 2 Mr 43,000 subunits. The sequence of the first N-terminal 20 amino acids shows that the enzyme is different from the cytosolic isozymes but similar to human mitochondrial creatine kinase. The enzyme has an extinction coefficient of epsilon 280 nm = 2.22 +/- 0.10 ml X mg-1 X cm-1 and a maximum velocity of 200 IU/ml at pH 7.0. The kinetic constants for the chicken heart mitochondrial isozyme are comparable to values for the canine and human heart isozyme. PMID- 3674369 TI - The identification of serum tuftsin by reverse-phase high-performance liquid chromatography and mass spectrometry. AB - We describe for the first time a method for unambiguously identifying the phagocytic stimulating tetrapeptide tuftsin from trypsinized human serum. The method consists of separating serum tuftsin by reverse-phase (RP)-HPLC, collecting HPLC fractions corresponding to the synthetic tuftsin retention time, and then subjecting those fractions to mass spectrometry/mass spectrometry (MS/MS) analysis, which provides optimal molecular specificity to the measurement. Although quantification was not the goal, it was estimated that the amount of tuftsin found by RP-HPLC and MS/MS was in the hundreds of nanograms per milliliter. PMID- 3674370 TI - Linear multidimensional liquid chromatography in the preparative scale purification of calmodulin from brain extract. AB - Rapid preparative scale purification of calmodulin from crude bovine brain extract is achieved in a single chromatographic run by physically coupling two different liquid chromatography columns which employ different separation mechanisms. In this case columns packed with newly commercialized 40-microns silica-based hydrophobic interaction and 5-microns micron silica-based weak anion exchange chromatography media were used. The only sample preparation required for conducting this purification procedure is the addition of salt to the crude brain supernatant to promote the initial binding of calmodulin to the hydrophobic interaction chromatography media. Chromatography carried out on such linear arrangements of columns has been referred to as linear multidimensional liquid chromatography. PMID- 3674371 TI - Column purification of adenovirus cores. AB - A simple and efficient technique for purifying adenoviral chromatin (nucleoprotein cores) with Sephacryl S-1000 is described. This method is significantly faster than previous methods and gives a higher degree of purity with an increased recovery of the nucleoprotein. In addition, the structural integrity of the cores is maintained. PMID- 3674372 TI - Spectropolarimetric determination of the guanine-cytosine content of DNA. AB - A circular dichroism technique for the determination of DNA base composition in terms of the guanine-cytosine content has been developed. A linear relationship between the ratio of ellipticities at 260 and 280 nm (theta 260/theta 280) and base composition of DNA is obtained in citrate-phosphate buffer, pH 3.0 at 20 degrees C. The DNA base composition obtained with this method is not only highly reproducible but is also the fastest method reported. PMID- 3674373 TI - Detection of biotinylated DNA probes by using Eu-labeled streptavidin and time resolved fluorometry. AB - Europium has been used as a label in immunoassays as it can be measured with high sensitivity by means of time-resolved fluorometry. Here we have used streptavidin labeled with europium chelates in the detection of adenovirus type 2 DNA bound to microtiter wells after hybridization with a biotinylated probe. The method gave quantitative results and a sensitivity of about 10 pg of the specific DNA. PMID- 3674374 TI - Purification of alpha-toxin from Staphylococcus aureus and application to cell permeabilization. AB - Crude alpha-toxin was produced by Staphylococcus aureus, strain Wood 46. The amount of exotoxin was monitored during growth and all subsequent purification steps by determination of its hemolytic activity against rabbit erythrocytes. The culture supernatant was treated with ammonium sulfate (75% saturation). The resulting precipitate was dialyzed and subjected to cation-exchange chromatography. The fractions containing the hemolytic activity were further purified by gel chromatography. The final product was enriched by a factor of 8.5 compared to the crude toxin. In sodium dodecyl sulfate-polyacrylamide gel electrophoresis the purified toxin exhibited one major band. It caused the release of 86Rb+ and ATP from rat insulinoma (RIN A2) as well as pheochromocytoma cells (PC12) in culture, indicating efficient permeabilization of their plasma membranes for small molecules. PMID- 3674375 TI - An enzymatic colorimetric assay of calcium-dependent phospholipases A. AB - In this paper we describe a new method for the assay of calcium-dependent phospholipases A. In this method released fatty acids are quantitated by an enzymatic colorimetric reagent kit which is commercially available. We have tested the applicability of this assay with enzymes from porcine pancreas (phospholipase A2), snake venom (phospholipase A2), and Rhizopus arrhizus (a lipase with phospholipase A1-like activity) as well as with a phospholipase A2 activity of bovine seminal vesicle fluid. We conclude that the kit procedure is a convenient, rapid and sensitive endpoint assay for calcium-dependent phospholipases A. PMID- 3674376 TI - Measurement of branched-chain ketoacids in plasma by high-performance liquid chromatography. AB - Branched-chain ketoacids were isolated from plasma or serum samples by acidification, passage through a cationic exchange resin, ether extraction, and extraction of the ether layer with phosphate buffer. The recovery of 2-[1 14C]ketoisocaproate taken through these procedures averaged 95 +/- 3%. Branched chain ketoacids were measured by high-performance liquid chromatography using a single mobile phase (sodium phosphate:acetonitrile). In normal human subjects, mean +/- SD fasting levels of 2-ketoisocaproate, 2-keto-3-methylvalerate, and 2 ketoisovalerate were 29 +/- 8, 18 +/- 4, and 12 +/- 3 microM, respectively. In normal rats, slightly different results were found: 24 +/- 10, 19 +/- 7 and 17 +/ 6 microM, respectively. In both species, levels of each ketoacid expressed as fractions of total branched-chain ketoacids were much less variable. PMID- 3674377 TI - Elimination of CoASH interference from acetyl-CoA cycling assay by maleic anhydride. AB - A method for the removal of CoASH from tissue extracts by maleic anhydride is described. It eliminates CoASH interference in the acetyl-CoA cycling assay using phosphotransacetylase and citrate synthase. Maleyl-CoA thioether does not hydrolyze under the conditions of the assay and allows a reduction in the number of blank samples during acetyl-CoA determination. The levels of acetyl-CoA in whole rat brain, isolated synaptosomes, and mitochondria were found to be 61, 8.6, and 31.3 pmol/mg of protein, respectively. PMID- 3674378 TI - An azophenolic colorimetric reagent for use in enzyme-linked immunosorbent assays. AB - A colorimetric reagent, 4-(4'-nitro-2'-methylsulfonylphenylazo)phenyl phosphate (NMPP), has been shown to be an effective substrate of alkaline phosphatase. NMPP and p-nitrophenyl phosphate were applied in comparative studies using enzyme immunoassays for the detection of viral antigens and antiviral antibodies. The new substrate exhibited similar, or even higher, sensitivity than p-nitrophenyl phosphate depending on the substrate concentrations used. Positive and negative reactions were easier to define, even without cumbersome equipment. The enzyme reaction was terminated by the uncompetitive inhibitor, theophylline. PMID- 3674379 TI - Acid-labile sulfide and zero-valence sulfur in plant extracts containing chlorophyll and ionic detergents. AB - Two methods for analysis of acid-labile sulfide and zero-valence sulfur in plant extracts containing chlorophyll as well as ionic and/or nonionic detergents are presented. Both methods are based on the conversion of sulfide into methylene blue. In the first method an ethyl acetate extraction step is used to remove chlorophyll and its degradation products which otherwise prevent spectrophotometric quantitation of methylene blue. The second assay method employs 35S-labeled plant extracts. This method, which involves thin-layer chromatography and autoradiography, is potentially more sensitive than the spectrophotometric assay in detecting acid-labile sulfide and zero-valence sulfur. PMID- 3674380 TI - Reversed-phase and hydrophobic-interaction high-performance liquid chromatography of elapid cardiotoxins. AB - The separation of proteins by hydrophobic-interaction HPLC and reversed-phase HPLC depends upon differences in the hydrophobicity of accessible surface groups. The elution order of a group of snake venom cardiotoxins was found to vary between these two HPLC methods. Circular dichroism spectroscopy showed that the eluant acetonitrile-trifluoroacetic acid used for reversed-phase HPLC altered the conformation of the toxins, whereas the salt-buffer eluting medium used for hydrophobic-interaction HPLC did not affect toxin conformation. The retention times of cardiotoxins on reversed-phase HPLC are therefore influenced by their conformational instability in the eluting medium which causes partial or complete unfolding. Hydrophobic interaction is clearly the preferred method with which to correlate the "surface hydrophobicity" of cardiotoxins and their biological effects. PMID- 3674381 TI - Introduction of 5'-terminal functional groups into synthetic oligonucleotides for selective immobilization. AB - Oligodeoxyribonucleotides terminating in a 5'-primary amine group are synthesized using solid-phase supported phosphoramidite chemistry. The 5'-terminal amine group in the deprotected oligomers is further derivatized with either succinic anhydride to give 5'-carboxylic acid or with dithiobis(succinimidylpropionate) followed by treatment with dithioerythritol to produce 5'-thiol-terminated oligonucleotides. The 5'-thiol-terminated oligonucleotides are selectively immobilized on solid supports containing either p-chloromercuribenzoate or 2,2' dithiobis(5-nitropyridine) activated thiol groups. PMID- 3674382 TI - A radiometric assay for phenylethanolamine N-methyltransferase and catechol O methyltransferase in a single tissue sample: application to rat hypothalamic nuclei, pineal gland, and heart. AB - A simple and highly sensitive method for simultaneous assay of phenylethanolamine N-methyltransferase (PNMT) and catechol O-methyltransferase (COMT) is described. These enzymes are determined in a single tissue homogenate using S-[methyl-3H] adenosyl-L-methionine as methyl donor and sequentially incubating with the substrates phenylethanolamine and epinephrine. The radioactive products of the enzymatic reactions, N-methylphenylethanolamine and metanephrine, are extracted and then separated by thin-layer chromatography. The identity of the reaction products has been established chromatographically and the conditions for both enzymatic reactions in the assay procedure have been defined. Measurement of PNMT activity in the rat pineal gland or in minute fragments of other tissues (e.g., brain nuclei) has not been possible using previously described methods. Activities of PNMT and COMT in the rat pineal gland, various hypothalamic nuclei, and the auricular and ventricular myocardia are herein reported. PMID- 3674383 TI - Radiometric assay for cytochrome P-450-catalyzed progesterone 16 alpha hydroxylation and determination of an apparent isotope effect. AB - In the course of studies on the oxygenation of steroids by purified P-450 cytochromes, particularly rabbit liver microsomal cytochrome P-450 form 3b, a rapid and reliable radiometric assay has been devised for progesterone 16 alpha hydroxylation. In view of the lack of a commercially available, suitably tritiated substrate, [1,2,6,7,16,17-3H]progesterone was treated with alkali to remove the label from potential hydroxylation sites other than the 16 alpha position. The resulting [1,7,16-3H]progesterone was added to a reconstituted enzyme system containing cytochrome P-450 form 3b, NADPH-cytochrome P-450 reductase, and NADPH, and the rate of 16 alpha-hydroxylation was measured by the formation of 3H2O. This reaction was shown to be linear with respect to time and to the cytochrome P-450 concentration. An apparent tritium isotope effect of 2.1 was observed by comparison of the rates of formation of tritium oxide and 16 alpha-hydroxyprogesterone, and the magnitude of the isotope effect was confirmed by an isotope competition assay in which a mixture of [1,7,16-3H]progesterone and [4-14C]progesterone was employed. PMID- 3674384 TI - Oxidation product(s) in acetaldehyde reacts with NAD(P)H and interferes with assay of alcohol dehydrogenase. AB - A decrease in absorbance at 340 nm, at rates similar to those obtained with alcohol dehydrogenases in routine assays, occurred when NADH or NADPH was mixed with acetaldehyde that had been exposed to air for various durations. NAD(P)H was apparently oxidized by interfering substance(s) present in acetaldehyde. Reagent grade acetaldehyde from newly opened bottles as well as acetaldehyde redistilled under strictly O2-free conditions contained minimal amounts of NAD(P)H-reacting substance(s). Redistillation under poor anaerobic conditions or in air increased the amount of NAD(P)H-reacting substance(s) in redistilled acetaldehyde. NADPH reacted at a higher rate than NADH with the interfering substance(s) in Tris-Cl buffer at pH 7.5. Also, the reaction was faster in Tris buffer than in phosphate buffer at pH 7.5. The NAD(P)H-oxidizing reaction may not be apparent when the nominal concentration of acetaldehyde used was below 5 mM, but the measured ethanol dehydrogenase activity could be significantly lower with acetaldehyde containing a measurable level of interfering substance(s). This study suggests that acetaldehyde is most easily tested with NADPH for the presence of a significant level of interfering substance(s) and that redistillation, if necessary, must be performed under strictly O2-free conditions. PMID- 3674385 TI - Spectrophotometric determination of oxidized and reduced pyridine nucleotides in erythrocytes using a single extraction procedure. AB - Several methods are available for the extraction and quantitation of oxidized and reduced pyridine nucleotides in erythrocytes. Enzymatic methods, however, are complicated by the presence of hemoglobin, which causes oxidation of NADH and NADPH during extraction. Although hemoglobin-mediated oxidation can be prevented by the addition of reducing agents, these interfere with spectrophotometric cycling assays for these nucleotides. Therefore, we have developed a method for determining oxidized and reduced NAD and NADP in human erythrocytes using a single extract. Our extraction method eliminates the need for reducing agents and thus allows the use of a spectrophotometric cycling assay. Using this method, we obtained full recovery of all added nucleotides with both normal and reticulocyte enriched red blood cells. Our method is suitable for the determination of NAD+, NADH, NADP+, and NADPH in normal human erythrocytes and in red cells from patients with hemolytic anemia with a higher proportion of reticulocytes. PMID- 3674386 TI - Systematic fractionation of oligosaccharides of human immunoglobulin G by serial affinity chromatography on immobilized lectin columns. AB - Human immunoglobulin G is known to contain 16 different biantennary complex-type asparagine-linked sugar chains, each of which occurs in a nonsialylated, monosialylated, or disialylated form. These oligosaccharides can be separated into 14 fractions by sequential affinity chromatography with Aleuria aurantia lectin (AAL)-Sepharose, RCA120-WG003, and E4-phytohemagglutinin-agarose columns. Twelve of them were found to contain a single oligosaccharide, while the fraction which passed through all three columns was shown to contain two oligosaccharides, GlcNAc beta 1----2Man alpha 1----6(+/- GlcNAc beta 1----4) (GlcNAc beta 1----2Man alpha 1----3)Man beta 1----4GlcNAc beta 1----4GlcNAcOT. The fraction, which bound to the AAL-Sepharose column and passed through the remaining two lectin columns, also contained two oligosaccharides, GlcNAc beta 1----2Man alpha 1----6(+/- GlcNAc beta 1----4) (GlcNAc beta 1----2Man alpha 1----3)Man beta 1----4GlcNAc beta 1----4 (Fuc alpha 1----6)GlcNAcOT. These results indicated that serial affinity chromatography with the three lectin columns can be used effectively to detect changes in the sugar chains of IgG resulting from diseases such as rheumatoid arthritis. PMID- 3674387 TI - An enzyme immunoassay for the quantitation of dihydropteridine reductase. AB - A competitive, enzyme-linked immunosorbent assay for the quantitative determination of dihydropteridine reductase (DHPR) is described. This highly sensitive method can determine the content of DHPR protein in tissue preparations independently of the enzymatic activity of the protein molecule. The method involves initial incubation of samples containing soluble enzyme in microtiter plates coated with purified goat antibodies to rat DHPR and further incubation with DHPR conjugated to alkaline phosphatase. The assay is used to study the ontogeny of DHPR in rat liver. PMID- 3674388 TI - A new colorimetric method for determination of creatine phosphokinase. AB - A new colorimetric method has been developed for the determination of creatine phosphokinase (CPK). This method is based on the reaction of creatine, formed enzymatically from creatine phosphate and ADP, with p-nitrophenylglyoxal (PNPG) under alkaline conditions to produce a colored product which absorbs maximally at 480 nm. At 25 degrees C the reaction was complete after 10 min in 0.1 M sodium pyrophosphate, pH 12, containing 0.15 M sodium ascorbate. The colored product was stable for at least 24 h and obeyed Beer's law in the range 0.005-0.05 mM creatine. The color reaction was used to determine the activity of CPK in serum and tissue extracts. The results obtained by this method agreed well with the results obtained by other available methods for CPK determination. However, the PNPG method was more rapid and more sensitive than other colorimetric methods and required a single chromogenic reagent. PMID- 3674389 TI - Crosslinked concanavalin A-O-(diethylaminoethyl)-cellulose--an affinity medium for concanavalin A-interacting glycoproteins. AB - When concanavalin A (Con A) is reacted with a low concentration of glutaraldehyde, the product formed strongly binds to DEAE-cellulose. Thus, the resultant material can be used as an affinity medium for those glycoproteins which interact with Con A. This affinity medium is easy to prepare, has a capacity comparable to that of similar commercially available affinity media, and is stable for up to at least 6 months. PMID- 3674390 TI - A new tritium-release assay for 25-hydroxyvitamin D-1 alpha-hydroxylase. AB - A new, rapid assay for 1 alpha-hydroxylase has been developed using 25-hydroxy-[1 alpha-3H]vitamin D3 as the substrate. Using the solubilized and reconstituted chick 1 alpha-hydroxylase, conversion of this substrate to 1,25-dihydroxyvitamin D3 causes the release of tritium into the aqueous medium. This 3H2O can be easily separated from the labeled substrate by passing the reaction mixture through a reverse-phase silica cartridge. The release of tritium is stereospecific as evidenced by the lack of 3H2O formed when 25-hydroxy-[1 beta-3H]vitamin D3 is used as the substrate. In parallel reactions containing the 25-hydroxy-[26,27 3H]vitamin D3 substrate, production of labeled 1,25-dihydroxyvitamin D3 was assessed by extraction and high-performance liquid chromatography and found to agree very closely with the amount of 3H2O produced from 25-hydroxy-[1 alpha 3H]vitamin D3, validating the accuracy of the new assay. Finally, a major advantage of the tritium-release assay for 1 alpha-hydroxylase is that the results are not affected by further metabolism of the 1,25-dihydroxyvitamin D formed in the incubations. PMID- 3674391 TI - Sample preparation for gas chromatography with electron capture detection: determination of total and free thyroxin in serum. AB - Relatively clean gas chromatography with electron capture detection (GC-ECD) chromatograms are obtained for both total and free thyroxin (T4) in serum by improving sample preparation. This is based on establishing a sequence of steps that cumulatively overcome two classes of interference: those present in the initial sample and those introduced by the procedure. The main source for the latter contaminants is the derivatization step, a problem that was largely overcome by employing HPLC after this step. Also it is helpful to use ion exchange columns early in the procedure under fast-flow conditions with intermediate flows of air to speed up and enhance their reliability. The work establishes some guidelines for future applications of GC-ECD to the determination of sub-nanogram analytes requiring derivatization, an area in which GC-ECD has been remiss in the past. As a side benefit, total T4 in serum is determined by HPLC for the first time with uv detection. PMID- 3674392 TI - Synthesis and structure determination of [8(-13)C]guanosine 5'-diphosphate. AB - A combined chemical and enzymatic synthesis of [8(-13)C]guanosine 5'-diphosphate (GDP) from H13COOH is described. About 35 mg nucleotide was obtained from 500 mg H13COOH. Analysis of the [8(-13)C]GDP by negative ion fast atom bombardment mass spectrometry and by 13C NMR confirmed that one atom of 13C was incorporated at the 8-position of the guanine ring at 90 +/- 10% enrichment. The chemical shift of the C(8) was 140.2 ppm downfield from internal trimethylsilylpropionate at neutral pH and room temperature, with a spin-spin coupling 1J(13C(8)-H(8] of 217 Hz and a 3J(13C(8)-H(1'] of 3.9 Hz. PMID- 3674393 TI - High-performance analytical applications of immobilized metal ion affinity chromatography. AB - The separation of three sets of standard protein mixtures on a high-performance immobilized metal ion affinity chromatography (HP-IMAC) column by elution with linear gradients of imidazole is described. The affinity of the test proteins for the immobilized metal ions follows the order Cu2+ greater than Ni2+ greater than Zn2+. The iminodiacetic acid-Cu2+ column gives the best resolution of all three protein mixtures and is the only immobilized metal ion column that can be used for elution of absorbed proteins with a decreasing pH gradient. An application of HP-IMAC for the separation of monoclonal IgG from mouse ascites fluid is also outlined. This versatile separation method is thus suitable for both analytical and preparative separations of proteins and peptides resulting in high recoveries and good reproducibility. The leakage of immobilized metal ions from the TSK gel chelate-5PW is apparent if the column is eluted by buffers containing low concentrations of (i) glycine or (ii) primary amines at round neutral pH. Considerable amounts of immobilized Zn2+ and Ni2+ ions also leak from the column by washing with buffers of pH 4.5 or lower. However, all three immobilized metal ions are stable toward exposure to low concentrations of imidazole (up to 50 mM) in phosphate buffers between pH 6.5 and 8.0. Adsorbed proteins could thus be eluted conveniently by using linear gradients of imidazole to give reproducible results. Moreover, this elution procedure made it possible to use the IMAC columns for repeated runs without the need for regeneration and recharging of the columns with fresh metal ions after each use. PMID- 3674394 TI - Fluorescence-detected circular dichroism studies of serum albumins. AB - Multidimensional fluorescence-detected circular dichroism (FDCD) is used to investigate the binding of bilirubin to four mammalian serum albumins. It is shown that the complexes formed with the albumins have distinctly different FDCD spectra. The effect of the pH-dependent transition from basic to acidic conditions on the complexes is examined. The binding of warfarin to albumin is also presented to demonstrate the general analytical utility of the multidimensional FDCD measurement for biochemical analysis. PMID- 3674395 TI - An enzymatic method for the assay of serum argininosuccinate lyase. AB - A rapid enzymatic method was developed for the assay of serum argininosuccinate lyase (ASAL: EC 4.3.2.1) which is a useful marker enzyme for diagnosis of parenchymal liver diseases. Fumarate, liberated from argininosuccinate in the lyase-mediated reaction, was converted to pyruvate via L-malate by the actions of fumarase and malic enzyme in the presence of NADP+. The NADPH formed was then oxidized with a diaphorase-resazurin system to give a highly fluorescent resorufin. All the enzymatic reactions proceeded continuously in 0.1 M Tris-HCl buffer (pH 7.5) and allowed direct assay of ASAL in serum by monitoring the increase in the fluorescence intensity due to resorufin. The method is rapid and sensitive; only 50 microliter of serum is required. This method was used to detect increases in the activities in sera from patients with liver diseases. PMID- 3674396 TI - A water-soluble, monitorable peptide and protein crosslinking agent. AB - A novel, freely water-soluble, heterobifunctional crosslinking reagent, N maleimido-6-aminocaproyl ester of 1-hydroxy-2-nitro-4-benzenesulfonic acid (mal sac-HNSA), was synthesized and used for conjugation of sulfhydryl (cysteine) containing peptides to carrier proteins. Reaction with amino groups releases the dianion phenolate, HNSA, which allows convenient spectrophotometric quantitation of the reaction in progress. Since mal-sac-HNSA is completely water soluble, its concentration can be adjusted to maximize the rate of amine reaction and to minimize hydrolysis. Conjugates of peptides to appropriate carriers have elicited peptide-specific antibody and did not elicit detectable antibody specific to the crosslink. PMID- 3674397 TI - Colorimetric-detected DNA sequencing. AB - A sensitive, colorimetric method for visualizing the band pattern of DNA sequencing reaction is described. The enzymatic incorporation of radioactive nucleotides commonly used for the band detection is replaced by biotin conjugated to the 5'-terminus of a synthetic oligonucleotide by chemical synthesis. The oligonucleotide so labeled is used as a primer for dideoxy DNA sequencing in a primer extension reaction. The products of the sequencing reactions are analyzed on a denaturing polyacrylamide gel using the direct blotting electrophoresis technique. This technique makes it possible to transfer the band pattern during the electrophoresis onto an immobilizing matrix, on which it is made visible by an enzymatic reaction in less than 3 h. This biotin-based detection method is so sensitive that the sequencing reactions can be performed under the same conditions and concentrations as those for the radioactive detection. PMID- 3674398 TI - Decoloration and solubilization of plant tissue prior to determination of 3H, 14C, and 35S by liquid scintillation. AB - A method is described for the decoloration and partial solubilization of plant tissue with 2% sodium hypochlorite. Following treatment of the digest with ammonia, the samples are suitable for the determination of 3H, 14C, and 35S by liquid scintillation counting. The color quenching is negligible and counting efficiencies are high: 30-40% for 3H and 90-95% for 14C. PMID- 3674399 TI - A kinetic, chromatographic method for studying protein hydrodynamic behavior. AB - A chromatographic method based on "split-peak" behavior was described for the determination of the coefficient of mass transfer of proteins on small reversed phase columns. The coefficient of mass transfer was found to be a linear function of the protein translational diffusion coefficient and inversely proportional to the square of the support particle diameter, as predicted by chromatographic theory. As an example of the practical application of this method for the measurement of protein diffusion coefficients, the denaturation of bovine serum albumin with decreasing solution pH was followed by measuring the change in the coefficient of mass transfer. A major advantage of this method was that the results were not affected by the interaction of the protein with the stationary phase. PMID- 3674400 TI - Analysis of glycated amino acids by high-performance liquid chromatography of phenylthiocarbamyl derivatives. AB - A method has been developed for the analysis of hexitolamino acids formed by acid catalyzed hydrolysis of nonenzymatically glycated proteins that have been treated with sodium borohydride. The hexitolamino acids are converted into phenylthiocarbamyl (PTC) derivatives which are analyzed by reverse-phase HPLC. The PTC derivatives of N alpha-hexitolamino acids behave like lactones, migrating on the column more slowly than the corresponding PTC-amino acids. The PTC derivatives of N epsilon-glucitol- and N epsilon-mannitol-lysine are probably free acids, since they migrate faster than PTC-lysine. The method, which can be used to determine the degree of glycation of N-terminal and lysyl residues, has been applied successfully to human hemoglobin, serum albumin, and ocular lens proteins. PMID- 3674401 TI - Separation by high-performance liquid chromatography of penicillins with C4 to C10 aliphatic side chains. AB - A suitable and rapid method for the simultaneous determination of different aliphatic penicillins is described. Butyryl-, pentanoyl-, hexanoyl-, heptanoyl-, octanoyl-, nonanoyl- and decanoylpenicillin can be completely separated by high performance liquid chromatography using an isocratic elution mode (50 mM H2KPO4, pH 5.0:methanol, 45:55 v/v). Under these conditions, retention times for C4 to C10 aliphatic side-chain penicillins were 2.5, 2.8, 4.1, 5.8, 8.9, 15.3, and 28.2 min. The benzylpenicillin retention time was 3.3 min. PMID- 3674402 TI - An automated assay for adenylate cyclase using reversed-phase high-performance liquid chromatography. AB - An automated high-performance liquid chromatographic method for the assay of 3',5'-cyclic AMP was developed using octylsilica. Total analysis time was 10.1 min, with cAMP eluting at 3 min. As little as 10 pmol of cyclic AMP could be detected by absorption at 260 nm. Peak height and area were linearly related to cyclic AMP concentration over at least two orders of magnitude. The analytical procedure gave good results in the assay of crude microsomal preparations of adenylate cyclase from both bovine brain and sea urchin eggs. The method was used to demonstrate that sea urchin adenylate cyclase is a Ca2+-activated enzyme. PMID- 3674403 TI - Coupled-enzyme and direct assays for uroporphyrinogen III synthase activity in human erythrocytes and cultured lymphoblasts. Enzymatic diagnosis of heterozygotes and homozygotes with congenital erythropoietic porphyria. AB - Rapid and reproducible assays for uroporphyrinogen III synthase (URO-S; EC 4.2.1.75) have been developed and used to determine the enzymatic activity in human erythrocytes and cultured lymphoid cells. In the coupled-enzyme assay, porphobilinogen was first converted to hydroxymethylbilane, the natural substrate for URO-S, by hydroxymethylbilane synthase which was conveniently obtained from heat-treated erythrocyte lysates. In the direct assay, synthetic hydroxymethylbilane was used as substrate. In both assays, the uroporphyrinogen reaction products were oxidized to their respective uroporphyrin isomers, which were then resolved and quantitated by reversed-phase high-pressure liquid chromatography. Both assays were optimized for pH, substrate concentration, and linearity with time and protein concentration. The mean URO-S activities in normal human erythrocyte lysates determined by the coupled-enzyme and direct assays were 7.41 +/- 1.35 and 7.64 +/- 1.73 units/mg protein, respectively. In normal human cultured lymphoid cells, the mean activities were 13.7 +/- 1.39 and 17.6 +/- 1.15 units/mg protein for the coupled-enzyme and direct assays, respectively. In four families with congenital erythropoietic porphyria, both assays reliably identified the markedly decreased URO-S activities in erythrocytes and cultured lymphoid cells from affected homozygotes and the half normal activities in these sources from obligate heterozygotes. The coupled enzyme assay was easier to perform and was suited for clinical diagnostic assays and for monitoring enzyme purification procedures, while the direct assay, which required substrate preparation and technical dexterity, was best for kinetic studies of URO-S. PMID- 3674404 TI - Assay and properties of N-acetylglucosamine-6-phosphate deacetylase from rat liver. AB - A single-vial assay has been developed for N-acetylglucosamine-6-phosphate deacetylase, in which [3H]acetate released from 3H-acetyl-labeled substrate is measured in a biphasic liquid scintillation counting system after acidification of the reaction mixture. The deacetylase was partially purified from rat liver, and some of its properties were determined. Chromatography on a calibrated Sepharose CL-6B column indicated a molecular weight of 345,000. The Km for the substrate at pH 8.0 was 0.3 mM. Glucosamine 6-phosphate and glucose 6-phosphate inhibited the enzyme, whereas N-acetylgalactosamine, N-acetylglucosamine, N acetylglucosamine 1-phosphate, and glucosamine 1-phosphate were without effect. The effects of several divalent cations were also examined. Under the conditions tested, Ca2+, Mg2+, and Ba2+ had essentially no effect, whereas Mn2+, Ni2+, and Cu2+ were inhibitory and Co2+ stimulated activity at low concentrations but inhibited above 5 mM. An increase in the ionic strength of the reaction mixture to 0.3 M decreased the activity by 40%. PMID- 3674405 TI - Use of a chemiluminescence detector for quantitation of nitric oxide produced in assays of denitrifying enzymes. AB - We have developed a closed-flow system that continuously sweeps away gases evolved in enzyme assay mixtures into a commercially available oxides of nitrogen (NOx) analyzer for the quantitation of any nitric oxide present in these gases. The system enabled us to study both the stoichiometry and the kinetics of NO production by a copper-containing nitrite reductase (EC 1.7.99.3) purified from Achromobacter cycloclastes IAM 1013. In addition to its much greater sensitivity in comparison with standard gas chromatographic (GC) techniques, the method offers the advantage that NO, a very reactive free radical, is immediately swept away and quantitated, obviating the necessity for periodic manipulations and disturbances of the reaction mixture characteristic of other GC quantitations. The characteristics of the system are discussed and its utility in studies of the kinetics and stoichiometry of NO production from nitrite is confirmed by comparison with results obtained using manometric and GC techniques. PMID- 3674406 TI - Simultaneous determination of psychosine and cerebrosides. AB - A new method was developed for the simultaneous determination of psychosine and cerebrosides in tissues. Total lipids extracted from the tissues were treated with [3H]acetic anhydride in toluene-methanol. Known amounts of nonradioactive N acetylpsychosine were added to the reaction product and then subjected to mild alkaline methanolysis. After the product was washed, it was fractionated by silica gel column chromatography and the fraction containing glycolipids was benzoylated. The benzoylated product was finally fractionated on TLC. The amounts of benzoylated derivatives of nonhydroxy- and hydroxycerebrosides and N acetylpsychosine were determined using a scanning densitometer. The amounts of psychosine in tissues were calculated from the radioactivity in the spot of N acetylpsychosine and the recovery of added carrier N-acetylpsychosine. This method allowed us to determine 5 to 1000 pmol of psychosine and 1 to 20 nmol of cerebrosides in peripheral nerves and other tissues of the twitcher mouse as well as transfected Schwann cells derived from the sciatic nerves. PMID- 3674407 TI - Iodinated derivatives of the hormone avian pancreatic polypeptide. AB - Reaction of avian pancreatic polypeptide with an iodine monochloride reagent at both pH 4 and pH 7.5 results in the differential modification of the four tyrosine residues in this peptide hormone. A total of 19 distinct iodinated derivatives were isolated by reverse-phase high-performance liquid chromatography, and their sites of iodination were characterized by both tryptic mapping and leucine aminopeptidase techniques coupled with HPLC. The pH 4 reaction produced 16 derivatives which, overall, represented substantial iodination at each tyrosine residue, whereas the pH 7.5 reaction was more directed, producing only 7 derivatives. Iodination at the C-terminal tyrosineamide 36 predominated at both pH values, and diiodo-Tyr 36 was found in the majority of the pH 7.5 derivatives. The relative of the four tyrosine residues with ICl were as follows: at pH 7.5, Tyr 36 much greater than Tyr 21 much greater than Tyr 27 greater than Tyr 7; at pH 4, Tyr 36 greater than Tyr 27 greater than Tyr 7 greater than Tyr 21. PMID- 3674408 TI - A continuous fluorescence assay for lecithin cholesterol acyltransferase. AB - A continuous fluorescence assay was adapted to the measurement of the phospholipase reaction of lecithin cholesterol acyltransferase (LCAT). The fluorescent phospholipid 1-acyl-2-(N-4-nitrobenzo-2-oxa-1,3-diazole)aminocaproyl phosphatidylcholine (C6-NBD-PC) in micelle form reacted with LCAT to yield NBD caproic acid, resulting in up to 5-fold increases in fluorescence in 30 min. The reaction rates were optimal in mixtures containing 0.1 M NaCl and 4 mM beta mercaptoethanol at 37 degrees C. Apolipoprotein A-I did not activate the enzyme and bovine serum albumin bound monomeric substrate and interfered with the fluorescence assay. Under similar reaction conditions, bee venom phospholipase A2 was almost 100-fold more reactive than LCAT. PMID- 3674409 TI - A colorimetric assay for alpha-hydroxynitrile lyase. AB - A colorimetric assay for alpha-hydroxynitrile lyase which utilizes acetone cyanohydrin as a substrate is described. The assay is based on measurement of the HCN formed when the lyase catalyzes the dissociation of acetone cyanohydrin. The procedure was devised for use with the optically inactive acetone cyanohydrin but will be applicable to enzymes utilizing other cyanohydrins. PMID- 3674410 TI - Elution countercurrent distribution. AB - The single withdrawal technique, here called elution countercurrent distribution, was applied for the first time on aqueous two-phase systems. The modifications necessary for elution countercurrent distribution of a thin-layer countercurrent distribution apparatus are described. The results from a test run with sulfuric acid showed good agreement between the experimental and the theoretical curves for elution countercurrent distribution. Thylakoid membrane vesicles from spinach chloroplasts were subjected to the elution countercurrent distribution. A gradient of NaCl in the eluting upper phase was used to elute the different fractions in order of their affinity for the moving upper phase. Inside-out thylakoid vesicles were resolved into two major and several minor fractions having different chlorophyll a/b ratios. Sonicated inside-out thylacoid vesicles were resolved into at least five different fractions with different chlorophyll a/b ratios. An increased resolution is obtained with elution countercurrent distribution compared to the fundamental process. PMID- 3674411 TI - A method for the production of highly specific polyclonal antibodies. AB - Two polyclonal antibodies directed against paramyosin and tropomyosin from Owenia fusiformis (a marine polychete annelid) were obtained using a new method of immunization. After purification by two-dimensional gel electrophoresis, proteins were transferred onto a nitrocellulose sheet using the Western blot technique. The proteins bound to their cellulose support were injected into rabbits without Freund's adjuvant and without solubilization of nitrocellulose with dimethyl sulfoxide. Highly specific polyclonal antibodies were generated. PMID- 3674412 TI - Glycosphingolipid glycosyltransferase assay using sephadex G-50 chromatography in aqueous phase. AB - An assay method for glycosphingolipid glycosyltransferase activity using simple Sephadex G-50 gel permeation chromatography in an aqueous solvent has been developed. An acceptor glycosphingolipid and a donor radioactive nucleotide sugar were incubated with an enzyme source. The reaction mixture was loaded onto a Sephadex G-50 column previously equilibrated with 0.3% (w/v) Triton X-100, 0.1 M sodium chloride, and 0.02% (w/v) sodium azide. The radiolabeled reaction product was eluted by the same solvent in the excluded volume and was collected directly into a liquid scintillation vial, separated from other radioactive compounds. This assay method was utilized to determine the activity of cytidine 5' monophosphate-N-acetylneuraminic acid:GM3 ganglioside sialyltransferase, which catalyzes the synthesis of GD3 ganglioside, and proved to be as reliable and sensitive as previously published assay procedures. In addition, this assay can be carried out in less time and is simpler than previously reported procedures. PMID- 3674413 TI - An enzyme-linked immunoassay for lipoprotein lipase. AB - Polyclonal antibodies against bovine milk lipoprotein lipase (LPL) were used to generate an enzyme-linked immunosorbent assay (ELISA) for rat LPL. The antibodies to LPL were affinity purified on bovine LPL columns and were shown to be specific for LPL by immunoprecipitation and enzyme inhibition. The solid-phase ELISA was sensitive from 1.0 to 20 ng/ml of LPL and paralleled enzyme activity. Denatured rat LPL showed the same LPL mass as undenatured samples, allowing LPL mass to be quantitated effectively in a variety of rat tissue extracts. PMID- 3674414 TI - Preparation of cell envelopes of large numbers of individual bacterial strains with the use of an automatic cell disruptor. AB - Analysis of the cell envelopes of large numbers of bacterial strains is used for the epidemiological and taxonomic investigation of clinical, veterinarian, and ecological isolates. Isolation of cell envelopes requires lysis of the bacteria. We developed an apparatus to disrupt bacterial cells of 200 different isolates in suspension by ultrasonication automatically. It is composed of modified standard laboratory equipment (fraction collector, cooling unit, pump), a standard ultrasonifier, and a newly designed control unit, which includes a sampler. This apparatus was applied to the analysis of cell envelope proteins of 96 Haemophilus influenzae strains on sodium dodecyl sulfate-polyacrylamide gel electrophoresis within 3 days after the first culture. PMID- 3674415 TI - Quantitative immunochromatographic analysis: theory and application to theophylline immunoassay. AB - The development of an immunochromatographic technique suitable for rapid analysis of biological fluids is described. Quasi-one-dimensional antibody lattices specific for theophylline were constructed by packing Sepharose beads conjugated with specific antibody into specially designed narrow capillary tubes. The design of these capillary columns was such that they would subtract a preset threshold quantity of antigen (label and analyte) from the total amount presented. Labeled antigen, which appeared in the flowthrough, could then be used to precisely quantitate the analyte present. The ideal format would permit very precise subtraction of 100% of the available antigen up to the threshold amount and none of the remainder. The microcolumn described here comes close to this ideal behavior through the attainment of very high ratios of bound/free antigen. The elevated bound/free ratio could be explained by theoretical analysis of the effect on equilibria of the high antibody concentration in this quasi-one dimensional system. Lattices containing anti-theophylline antibodies were used to develop a competitive enzyme immunoassay for theophylline which demonstrated a dose-response that was closely similar to that predicted by theoretical treatment. The entire assay procedure was performed in less than 30 min and demonstrated a sensitivity limit of approximately 20 ng/ml. Preliminary studies on clinical serum samples suggest that this assay has potential for the routine analysis of biological fluids. PMID- 3674416 TI - A solid-phase method for the quantitation of protein in the presence of sodium dodecyl sulfate and other interfering substances. AB - We describe a simple assay for small amounts of protein that is insensitive to sodium dodecyl sulfate (SDS) or many common interfering substances including Tris and reducing sugars. For this reason, it is particularly useful in the analysis of protein content of samples prior to SDS electrophoresis. The assay consists of the following steps: (i) absorption of protein to nitrocellulose; (ii) fixation of the bound protein with methanol; (iii) staining of the bound protein with amido black; and (iv) elution and spectrophotometric measurement of the bound dye. The assay is sensitive to as little as 0.5 microgram of protein in 1 microliter of solution. Although SDS does not interfere appreciably with measurement, Nonidet-P40 does. PMID- 3674417 TI - Trace enrichment of biological folates on solid-phase adsorption cartridges and analysis by high-pressure liquid chromatography. AB - A procedure involving solid-phase adsorption on bonded silica has been developed for trace enrichment and selective recovery of folate monoglutamates from liver tissue. A variety of reverse-phase (ethyl, octyl, octadecyl, phenyl) and anion exchange (aminopropyl, quaternary amine, primary/secondary amine) cartridges were tested for their potential to adsorb and elute folate monoglutamates from standard solutions (50 nmol each of H4-pteroylglutamic acid (H4PteGlu), 5-CHO H4PteGlu, 10-CHO-H4PteGlu, PteGlu, and 5-CH3-H4PteGlu). Quantitative recoveries were obtained from aminopropyl (-NH2) and all reverse-phase cartridges. For the analyses of rat liver folates, 20 ml of clear supernatant obtained from 5 g of tissue was treated with conjugase, which released folate monoglutamates from endogenous stores. Folate monoglutamates were then separated from nonfolate material by selective adsorption and recovery from -NH2 extraction cartridges. The procedure also provided a 10-fold concentrate, which allowed direct analysis by HPLC, using C-18 reverse-phase ion-pair columns coupled with uv detection (290 nm). Experiments with standard folates (n = 3) mixed with liver tissue and carried through the extraction, incubation, and trace-enrichment steps showed the following recoveries: 10-CHO-H4PteGlu, 55 +/- 5.0%; H4PteGlu, 80 +/- 5.0%; 5-CHO H4PteGlu, 123 +/- 12.0%; and 5-CH3-H4PteGlu, 89 +/- 3.0%. Endogenous compositions of liver folates (n = 5) were as follows: 10-CHO-H4PteGlu, 1.03 +/- 0.3 nmol/g (6.7%); H4PteGlu, 5.70 +/- 1.0 (36.4%); 5-CHO-H4Pte Glu, 1.34 +/- 0.4 (8.7%); and 5-CH3-H4PteGlu, 7.34 +/- 1.2 (48.0%). Chromatographic peaks were identified by their retention times and by comparing their spectral profiles (obtained by a diode array detector) with respective pure folates. We found trace enrichment of biological folates on solid-phase extraction cartridges to be rapid and quantitative. The method allowed, for the first time, direct analysis of tissue folates by HPLC/uv methods. PMID- 3674418 TI - Postcolumn fluorometric detection system for liquid chromatographic analysis of amino and imino acids using o-phthalaldehyde/N-acetyl-L-cysteine reagent. AB - A high-performance liquid chromatographic system for the determination of amino acid and imino acid was developed using a two-step reaction with sodium hypochlorite and o-phthalaldehyde/N-acetyl-L-cysteine (OPTA/AcCys) reagent. This reagent improved the sensitivity in the analysis of proline presumably because the fluorophore is more stable to hypochlorite which has been used for the oxidative cleavage of the imino linkage. The use of OPTA/AcCys facilitated the detection of imino acids at the same concentration level as that of amino acids. The detection limit for all the amino and imino acids was a few picomoles. This detection system, together with cation-exchange chromatographic separation, was applied to the determination of amino and imino acids in biological samples. PMID- 3674419 TI - Membrane open-system cell for oxygen consumption measurement. AB - A membrane-diffusion cell for oxygen uptake measurements in an open system is described. Polarographic oxygen measurements with a Clark electrode are combined with simultaneous pH and absorbance or fluorescence determinations. Examples of its use are given and discussed, including experiments on mitochondrial respiration. Advantages of this cell are analyzed and comparisons are made with other open-system respirographs. PMID- 3674420 TI - A confidence interval for mutant frequency in assays using microtiter wells. AB - Previous attempts to derive a confidence interval for the estimated mutant fraction in assays using microtiter wells have not considered the variance introduced by the early growth and dilution steps. We derive a confidence interval that includes these sources of variability. PMID- 3674422 TI - Power programmed field-flow fractionation: a new program form for improved uniformity of fractionating power. PMID- 3674421 TI - Fast atom bombardment mass spectrometry for the determination of zinc stable isotopes in biological samples. PMID- 3674423 TI - Factor analysis and Kalman filter studies of severely overlapped amino acid derivatives in thin-layer chromatography. PMID- 3674424 TI - Residue levels of ethyl carbamate in wines and spirits by gas chromatography and mass spectrometry/mass spectrometry. PMID- 3674425 TI - Simultaneous determination of selenite and trimethylselenonium ions in urine by anion exchange chromatography and molecular neutron activation analysis. PMID- 3674426 TI - Extraction of low molecular weight polynuclear aromatic hydrocarbons from ashes of coal-operated power plants. PMID- 3674427 TI - Catalytic oxidation of reduced nicotinamide adenine dinucleotide at hexacyanoferrate-modified nickel electrodes. PMID- 3674428 TI - Potentiometric biosensor for riboflavin based on the use of aporiboflavin-binding protein. PMID- 3674429 TI - Evaluation of differential-pulse anodic stripping voltammetry at mercury-coated carbon fiber electrodes. Comparison to analogous measurements at rotating disk electrodes. PMID- 3674430 TI - Anodic behavior of the antineoplastic agent amethopterin at a mercury electrode and its determination in body fluids by liquid chromatography with indirect anodic polarographic detection. PMID- 3674431 TI - Bicarbonate-sensitive electrode based on planar thin membrane technology. PMID- 3674432 TI - Surface-enhanced Raman spectrometry of organophosphorus chemical agents. PMID- 3674433 TI - Determination of boron in biological tissues by inductively coupled plasma atomic emission spectrometry. PMID- 3674434 TI - Multivariate analysis applied to near-infrared spectra of milk. PMID- 3674436 TI - Controlled-growth mercury drop electrode. PMID- 3674435 TI - Self-training, self-optimizing expert system for interpretation of the infrared spectra of environmental mixtures. PMID- 3674437 TI - Determination of iodine in foods by cathodic stripping voltammetry. PMID- 3674438 TI - Construction and comparison of open tubular reactors for postcolumn reaction detection in liquid chromatography. PMID- 3674439 TI - Biosensors: potentiometric and amperometric. PMID- 3674441 TI - Immobilized enzyme kinetic study of D-glucose mutarotation by flow injection analysis. PMID- 3674440 TI - Enrichment of enantiomers and other isomers with aqueous liquid membranes containing cyclodextrin carriers. PMID- 3674442 TI - Chlorinated derivatives of dibenzo-p-dioxin and related compounds for use as reference compounds in method development and environmental toxicology. PMID- 3674443 TI - Electrochemical preconcentration of metals using mercury film electrodes followed by electrothermal vaporization into an inductively coupled plasma and determination by atomic emission spectrometry. PMID- 3674444 TI - Effect of phase length on column selectivity for the separation of polycyclic aromatic hydrocarbons by reversed-phase liquid chromatography. PMID- 3674445 TI - Transient response of an enzyme electrode sensor for glucose. PMID- 3674446 TI - Continuous monitoring of ambient ammonia with a membrane-electrode-based detector. PMID- 3674447 TI - Optimizing the optical configuration for light-pipe gas chromatography/Fourier transform infrared spectrometry interfaces. PMID- 3674448 TI - Evaluation of an improved single-beam gas chromatography/Fourier transform infrared interface for environmental analysis. PMID- 3674449 TI - Direct coupling of open-tubular liquid chromatography with mass spectrometry. PMID- 3674450 TI - Preparation and evaluation of slurry-packed capillary columns for normal-phase liquid chromatography. PMID- 3674451 TI - [Craniofacial growth under the influence of the blood supply. 6. Metric studies of the skull]. AB - Cephalometric data show that the distances spanning several skull bones also have the highest growth rates. No sexual dimorphism can be observed in the skulls of animals that are six weeks old; such differences do not appear until after the fourth month of life. Allometric studies reveal a relative narrowing of the neurocranium and a relative broadening of the rostrum and zygomatic arch. The broadening of the zygomatic arch complex is related to the postnatal development of the masseter muscle. Vector analysis is used to demonstrate the growth activities of the different parts of the skull. Local changes in the bone during growth was observed in the regions of muscle origin and attachment. PMID- 3674452 TI - Growth control of neurocranial height of the rat skull. AB - In the present study the skulls of 36 experimentally bipedal adult male rats are compared with those of 47 adult male control rats, with particular attention to the relation length, width and height respectively of the neurocranium to brain size. It was shown that, on average, the neurocranium of bipedal rats was reduced in length and increased in height, while its width was unchanged. With respect to brain size the 2 groups were similar. It is postulated that the increase of height might be considered as a compensation for the loss of space due to the decreased length. The neurocranial height is the dimension in which adaptation to the space demands of the brain is realised. These adaptations are, therefore, controlled by a local epigenetic factor, viz. brain size. PMID- 3674453 TI - [Biomechanical regularities of hard tissues in the human]. AB - The interrelationship between acting forces and hard tissues of living beings is demonstrated on the basis of some examples. They give evidence that the structure of hard tissues is oriented toward higher pressure tensions. It is also demonstrated that living hard tissues react differently to mechanical impulses than liveless matter. It is also stressed that the science of statics is insufficient to explain the laws and reactions of living hard tissues. PMID- 3674454 TI - An anatomical investigation on the muscles of the pelvic outlet in crab-eating monkey (Macaca irus) and Japanese monkey (Macaca fuscata) with special reference to their nerve supply. AB - For a fuller understanding of the nerve supply to the muscles of the pelvic outlet in man, 4 pelvic-halves of crab-eating monkeys and 6 pelvic-halves of Japanese monkeys were minutely dissected. 1) The composition of the pudendal plexus tends to be limited to 2 segments, S1 and S2. 2) If we consider the origin of the nerves, the pudendal plexus is divided into 2, the first or medial and the second or lateral parts. From the first part arise the pelvic splanchnic nerves, the nerve to the iliopubocaudalis and the nerve to the ischiocaudalis. From the second part the dorsal nerve of the penis or clitoris, the perineal nerve and the inferior rectal nerve originate. 3) A laminate arrangement exists among the 3 nerves from the first part at their origin; the pelvic splanchnic nerves are situated ventrally, and the nerve to the ischiocaudalis dorsally, with the nerve to the iliopubocaudalis in between. No obvious laminate arrangement exists among the 3 nerves from the second part. 4) The part of the iliopubocaudalis, contiguous with the rectal wall but without attaching to it, has no branches of supply from the perineal nerve and the inferior rectal nerve. 5) A detailed discussion of our findings in relation to man, is given below. PMID- 3674455 TI - A comparative SEM-study on the teeth of 10 anuran species. AB - Teeth of 10 anuran species have been investigated by means of scanning electron microscopy (SEM). Generally a great variability of the structure of dentine crowns and the zone of division was noted not only between the single species, but also within one species on the same dentigerous bone. 4 species (Hyla cinerea, Rana ridibunda, R. hosei, Ptychadena spec.) mostly have more or less bladed bicuspid and clearly divided teeth corresponding to the "Lissamphibia" pattern. 2 species (Xenopus laevis, X. spec.) exhibit conical spike-like teeth with a trace of a dividing zone similar to those observed in late stage larvae of Urodela. One species (Ceratophrys cranwelli) shows undivided bladed monocuspid teeth. It is assumed that the 2 species of Dendrobatidae (Dendrobates tricolor, D. anthonyi) examined have no zone of division. Its occurrence in Gastrotheca riobambae and in the few juvenile D. tricolor available is still doubtful. Results are discussed regarding the variability of tooth structures (dentine crown, zone of division, pedicel) and the occurrence of 2 types of monocuspid teeth in the Amphibia as well as its possible bearing upon phylogeny and systematics of this group. PMID- 3674456 TI - Non-secretory neuronal elements in the bovine pituitary intermediate lobe. AB - The bovine pituitary intermediate lobe was studied by light microscopy after staining with a modified Bodian procedure. The study revealed a number of dissimilar intermediate lobe elements characteristic of mature and immature cells found in the adult and embryonic central nervous system and ganglia. In this study the elements are referred to as non-secretory neuronal elements. The elements, forming part of the parenchyma, have multiple processes which distribute themselves throughout the lobe. The typical secretory intermediate lobe cells have only a slight affinity for the Bodian stain. The intermediate lobe basophilic staining secretory cells and the neuronal elements maintain their general differences in appearance and possibly their function. Since the intermediate lobe in bovine is rather avascular and neuronal elements are usually associated with blood vessels, these elements may be involved in certain mechanisms yet unknown. It is possible that the elements provide common precursor proteins that reach the secretory intermediate lobe cells through their dendritic branches. In addition, the non-secretory neuronal elements may be directly involved in the spike potentials recorded from the lobe as well as in stimulus secretion coupling. This study does not treat the function of the neural elements at this time, but directs attention strictly to their presence in the intermediate lobe of the bovine pituitary gland. PMID- 3674457 TI - Prenatal development of subepithelial vasculature related to appearance of ruminal papillae in the bovine rumen. AB - The mucosal surface of the fetal bovine rumen was studied with ruminal papillae standing at an interval of 400 microns on an average with a slight increase in distance from each other during gestation. Nevertheless, the overall area of the inner surface of the rumen was greatly increased with fetal age, suggesting a successive development of new ruminal papillae appearing at the sites among older ones. In the 3rd month of gestation, the subepithelial microvasculature consisted into 2 layers (adluminal and submucosal) of capillary networks with anastomoses between them. Junctional sites of the adluminal capillary and the anastomosing ramus were gradually elevated by extension of the ramus to form hairpin-like, and later papilla-like, capillary projections in the lamina propria. These projections further pushed the surface epithelium up and formed the cores of the ruminal papillae. The number of capillary projections, regardless of their sizes, in the lamina propria always exceeded that of ruminal papillae at any time of gestational period. Therefore, it seems that the successive formation of new ruminal papillae is preceded by the formation of subepithelial capillary projections in the lamina propria. PMID- 3674458 TI - Dissociation of muscle cells from the bony fish heart. AB - A method for dissociating myocardial cells from the bony fish heart is presented. Beating hearts of Pleuronectes platessa were perfused by an aerated medium containing 0.1% collagenase and 0.1% hyaluronidase. After 60 min, the hearts were quite soft and easy to dissociate. The cardiac muscle cells were then collected on Nucleopore membranes, and their surface structure was revealed by scanning electron microscopy. PMID- 3674459 TI - Development of the connective tissue in the digestive tract of the larval and metamorphosing Xenopus laevis. AB - Developmental changes, until the completion of metamorphosis, of the connective tissue of the digestive tract in the South African clawed frog Xenopus laevis were examined by light and scanning electron microscopy. During the pre- and prometamorphosis (stages 50 through 59) the layer of connective tissue was prominent in the typhlosole, while that in the rest of the intestine and stomach remained very thin. Most of the connective tissue cells were fibroblasts and were concentrated mainly in the typhlosole, the boundaries of which were distinct. In the anterior part of the typhlosole just behind the stomach, the layers of connective tissue and muscle were the thickest and the boundary between these 2 layers was obscure. Although the mitotic cells of the connective tissue were rare, if any, and no migrating cells were observed on the surface of the connective tissue, the connective tissue of the intestine gradually increased in cell number during the pre- and prometamorphosis. In the stomach, on the other hand, there was no such increase. At the beginning of the metamorphic climax (stages 60 and/or 61), the layer of connective tissue suddenly became thick in both the stomach and the intestine. The boundaries of the typhlosole became less distinct. Mitotic index of the connective tissue became high, and its cells dramatically increased in number and contained many undifferentiated mesenchyme like cells. In the stomach, these connective tissue cells invaded the glands of the larval epithelium into just below the surface epithelium and mitotic index of the entire stomach epithelium increased. In the intestine, in contrast, mitotic epithelial cells were localized in the islets which invaginated into the connective tissue and later formed the adult epithelium. With the growth of islets, the intestinal folds were formed as straight rows and, after stage 63, were modified into a zigzag pattern and had mitotic cells localized in the troughs of folds. The present results indicate that dramatic changes of the connective tissue of both the stomach and the intestine occur at the beginning of the metamorphic climax, concomitantly with those of the epithelium. Moreover, the results also show that, before the climax, even when there were no indications of metamorphic changes in the epithelium, cells of the connective tissue gradually increased in number in the intestine (but not in the stomach). It is also suggested that the muscle cells of the typhlosole just behind the stomach may participate in this gradual increase of connective tissue cells. PMID- 3674460 TI - [Craniofacial growth modified by blood supply. 8. Discussion of normal cranial growth of the rat]. AB - The dimensions of the skull and the dry weight of the skull bones show definite sexual dimorphism. The dynamics of the growth in the skull dimensions and their vectorial presentation show that skull growth in Rattus norvegicus BERKENHOUT is most rapid between the 42nd d and the 4th month of life. This phase is followed by a phase of localized bone growth, which persists up to an age of 300 d. The faster growth of the viscerocranium leads to changes in the proportions of the skull. The relative positions of viscerocranium and mandible and the higher relative position of the dentures are similar to principle to those seen in man. Finally, the morphogenetic effect of the temporalis muscle together with that of the brain in the shaping of the skull are discussed. PMID- 3674461 TI - Halothane: cause or cure for arrhythmias? PMID- 3674462 TI - Actions of halothane on the electrical activity of Purkinje fibers derived from normal and infarcted canine hearts. AB - The effects of 0.39 mM halothane (approx. 1.1 vol%) on the action potentials of proximal (false tendon) and distal (apical) left ventricular Purkinje fibers were compared in analogous in vitro preparations derived from normal dogs and animals surviving 1 day following acute myocardial infarction. In ten noninfarcted hearts, halothane reduced regional differences in repolarization by decreasing action potential duration (APD90, mean +/- SE) in proximal fibers from 300 +/- 7 to 277 +/- 6 msec (P less than or equal to 0.01) without decreasing APD90 in distal fibers (control 240 +/- 4 msec, halothane 249 +/- 5 msec). In ten infarcted hearts, halothane accentuated pathologic differences in repolarization by decreasing APD90 in the non-ischemic proximal fibers from 311 +/- 8 to 287 +/- 7 msec (P less than or equal to 0.01), while increasing APD90 in the ischemic distal fibers from 375 +/- 15 to 406 +/- 18 msec (P less than or equal to 0.01). Halothane also decreased the overshoot from 32.9 +/- 1.0 to 28.4 +/- 0.8 m V (P less than or equal to 0.01) and Vmax from 356 +/- 28 to 300 +/- 22 V/s (P less than or equal to 0.05) in ischemic fibers. In seven infarcts evaluated by extrastimulus techniques, halothane slowed the conduction of premature impulses and prolonged refractoriness, while, in five of the seven hearts, it reversibly increased the range of coupling intervals which induced probable reentrant responses. In a separate study of seven infarcts, halothane decreased the rate of spontaneous activity originating in the ischemic region. It is concluded that halothane facilitates the occurrence of re-entry while inhibiting the initiation of abnormal impulses in the in vitro canine infarction model. PMID- 3674463 TI - The association isoflurane-verapamil causes regional left-ventricular dyssynchrony in the dog. AB - In ten dogs anesthetized with 1% inspired isoflurane, the effect of low-dose verapamil on global and regional myocardial function was studied. The administration of verapamil resulted in no change in heart rate or blood pressure, but left ventricular stroke work, peak power, LV dP/dt max, and aortic blood acceleration were significantly reduced, while coronary blood flow remained unchanged. End-diastolic length increased in territory supplied by both left anterior descending (LAD) and left circumflex (LC) artery, but a significant decrease in systolic shortening occurred in the LAD segment only. Dyssynchrony of wall motion, characterized by post-systolic shortening, accompanied in three animals by a small amount of systolic lengthening, appeared with the administration of verapamil and was more pronounced in the LAD segment. Such patterns of wall motion have usually been attributed to myocardial ischemia. In the absence of significant reduction in coronary blood flow, and in the presence of a delay in onset of shortening and lengthening, these patterns of wall motion are more likely to reflect dyssynchrony of regional function than ischemia. PMID- 3674465 TI - Halothane metabolism in cirrhotic rats. AB - A rat model was used to determine whether the metabolism of halothane is changed in the presence of cirrhosis and whether exacerbation of liver dysfunction is correlated with such a change. Cirrhosis was produced by gavaging enzyme-induced male Wistar rats with carbon tetrachloride in corn oil once weekly for 12 weeks. Control rats received corn oil only. After a 3-week period without treatment, blood and urine were collected from each rat for determination of background levels of inorganic fluoride, bromide, and trifluoroacetic acid (halothane metabolites) and for assessment of liver function. Rats were then anesthetized with 1.05% halothane in 50% oxygen for 3 h. Following anesthesia, serial blood and urine samples were taken to monitor halothane metabolism and liver function. No differences were observed between cirrhotic and non-cirrhotic rats in serum levels and urinary excretion of halothane metabolites. However, serum levels of SGOT and SGPT were significantly increased about 1.5-fold in the noncirrhotic group and about 2.5-fold in the cirrhotic group after anesthesia. The increased levels observed in the cirrhotic group were significantly greater than in the noncirrhotic group. The results imply that the exacerbation of liver dysfunction after halothane anesthesia is most likely related to an indirect effect, such as change in liver blood flow, rather than to toxic metabolites. PMID- 3674464 TI - Effects of halothane on myocardial high-energy phosphate metabolism and intracellular pH utilizing 31P NMR spectroscopy. AB - Utilizing 31phosphorus nuclear magnetic resonance (NMR) spectroscopy, the authors tested the two hypotheses that the negative inotropic action of halothane is the result of: 1) myocardial intracellular acidosis, and 2) a decrease in myocardial high-energy phosphates. In isolated, paced, Langendorff-perfused rabbit hearts, halothane (1.5 vol %) dissolved in the coronary perfusate produced a 48 +/- 2% decrease (P less than 0.01) in left ventricular developed pressure. In contrast, halothane administration had no significant effect on myocardial intracellular pH (7.18 +/- 0.04 at control vs 7.21 +/- 0.02 during halothane). Halothane exposure decreased (P less than 0.01) the forward rate constant of the creatine kinase reaction by 32 +/- 6%, as measured using saturation transfer NMR, suggesting a decline in the rate of high-energy phosphate metabolism. This was further indicated by a concomitant decrease (P less than 0.05) in myocardial oxygen consumption (20 +/- 5%). During the halothane-induced reduction in left ventricular developed pressure, only small decreases in the myocardial steady state concentrations of phosphocreatine (7 +/- 1%; P less than 0.01) and beta ATP (12 +/- 4%; P less than 0.05), and an increase in Pi (18 +/- 6%; P less than 0.05) were observed. However, similar changes in steady-state high-energy phosphate metabolites were also measured in time-control hearts not exposed to halothane. These results indicate that the negative inotropic action of halothane is not mediated by myocardial intracellular acidosis. Moreover, these findings do not support the concept that the negative inotropic action of halothane is the result of a reduction in myocardial high-energy phosphates. PMID- 3674466 TI - Effects of isoflurane and halothane on coronary vascular resistance and collateral myocardial blood flow: their capacity to induce coronary steal. AB - Some coronary vasodilators, paradoxically, may endanger patients with coronary artery disease by causing "coronary steal." To determine the capacity of isoflurane and halothane to cause coronary steal, the authors studied their effects on coronary vascular resistance (CVR), diastolic coronary artery pressure, and collateral myocardial blood flow. Using ameroid constrictors, chronic occlusions of the left anterior descending (LAD) coronary artery were created in ten dogs. Six to eight weeks after implantation, the dogs were anesthetized with fentanyl and pentobarbital, and a stenosis was created on the circumflex (Cx) coronary artery. Isoflurane and halothane were each administered in doses of 0.5 and 1.5 MAC. Diastolic aortic pressure was held constant. Using small catheters in the circumflex and LAD coronary arteries, the authors measured diastolic coronary artery pressures. Collateral myocardial blood flow was measured by the microsphere method. In this model, halothane and isoflurane minimally affect CVR. The maximum change in CVR, which was found during 1.5 MAC isoflurane, was -8% (not significant). Diastolic coronary pressures distal to the Cx stenosis (54.5 +/- 11.5 mmHg) and distal to the LAD occlusion (44.5 +/- 5.2 mmHg) did not change significantly with either isoflurane or halothane. Transmural collateral blood flow distal to the LAD occlusion (0.51 +/- 0.11 cc.g 1.min-1) was unaltered by either drug. There was no evidence of coronary steal. Epicardial ECG S-T segments showed no evidence of ischemia. The finding of minimal direct effects of halothane and isoflurane on CVR, diastolic coronary pressure, and collateral myocardial blood flow suggest that, under the conditions of this study, neither agent, when used as an adjuvant to high-dose narcotic anesthesia, is likely to cause myocardial ischemia by a coronary "steal" mechanism. PMID- 3674467 TI - Depth of halothane anesthesia potentiates citrate-induced ionized hypocalcemia and adverse cardiovascular events in dogs. AB - The purpose of this study was to determine if depth of halothane anesthesia contributed to the adverse cardiovascular effects of citrate-induced ionized hypocalcemia. Six mongrel dogs were monitored with arterial, central venous, and pulmonary artery flow-directed catheters. Measured end-tidal halothane assured a constant depth of anesthesia, while controlled ventilation and arterial blood gas analysis provided constant acid-base status. Each dog received sodium citrate (USP Fenwal) equivalent to fresh frozen plasma, 1.0 ml.kg-1.min-1, during both deep (D) and light (L) halothane anesthesia. Three dogs received the infusion during L halothane anesthesia first; after a 1-h stabilization period (2.5 h after first infusion) they received a second equivalent infusion during D halothane anesthesia. Three other dogs were studied first with D, then with L halothane. Mean expired halothane (+/- SEM) for group D was 1.52 +/- 0.08%, for group L, 0.85 +/- 0.07%. Significantly greater adverse cardiovascular effects were seen during D halothane anesthesia; four of the six dogs that received citrate during D halothane anesthesia required cessation of the infusion or suffered cardiac arrest. All six infusions during L halothane anesthesia were tolerated. In both groups, significant reductions in ionized calcium [Ca++] (P less than 0.0001) and mean arterial pressure (MAP) (P less than 0.005) were observed; greater reductions in both parameters occurred in group D (P less than 0.0036-0.0005). In group D, but not in group L, cardiac output was depressed compared to baseline (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674468 TI - Effects of information feedback and pulse oximetry on the incidence of anesthesia complications. AB - No standard outcome measures exist to evaluate the effect of interventions intended to improve the quality of anesthesia care. The authors established a clinically practical definition of outcome, and used it to assess the effect of feedback of information about complications and the effect of pulse oximetry on the rate and severity of important anesthesia-related problems encountered in the operating room (OR) and recovery room (RR). On admission to the RR, the patient's anesthetist documented Recovery-Room-Impact Events (RRIE), defined as an "unanticipated, undesirable, possibly anesthesia-related effect that required intervention, was pertinent to recovery-room care, and did or could cause at least moderate morbidity." Following a control period with no feedback of data, intense feedback of grouped (anonymous) RRIE rates was provided. Later, pulse oximeters were introduced to all anesthetizing locations. Among 12,088 patients (71% of all RR admissions), 18% had at least one RRIE in the OR or RR. The most common RRIEs were hypotension (4.4%), arrhythmia (3.9%), hypertension (1.5%), intubation difficulties (0.8%), hypoventilation (0.8%), and hypovolemia (0.6%). Feedback of information produced no demonstrable change in the rate of RRIEs. Although significantly fewer patients experienced RRIEs (15.6% vs. 12.4%, P less than 0.0001), hypotensive RRIEs (5.2% vs. 3.8%, P = 0.0003), and hypovolemic RRIEs (0.88% vs. 0.42%, P = 0.0017) following the introduction of pulse oximetry in the OR, confounding factors prevent establishment of a cause-and-effect relationship. Quality assurance may require more direct intervention and individual feedback to be effective. Still, the RRIE measure requires minimal effort at low cost and encourages improved transmission of information at the time of admission to recovery-room care. PMID- 3674469 TI - Reduction of tonic ribcage muscle activity by anesthesia with thiopental. AB - Surface electromyograms were recorded from the scalene, sternomastoid, and parasternal intercostal muscles in 16 supine premedicated adult patients before, during, and after the induction of anesthesia with thiopental and after the administration of succinylcholine. Muscle activity was measured as the rectified, integrated signal, and expressed as a percentage of the activity detected during a maximal inspiration. Activity was found in the scalene and sternomastoid muscles of all patients, and in the intercostal muscles of 13. This activity was more commonly tonic, and, at end-expiration, it was 7%, 6%, and 5% of the activity that could be generated by a maximal inspiration, for the scalene, sternomastoid, and intercostal muscles, respectively. In all subjects, this activity was markedly reduced or abolished by the administration of thiopental, to 0.7%, 0.6%, and 0.6%, respectively. There was no tonic activity in these muscles during spontaneous respiration after induction of anesthesia. It is suggested that the reduction of tonic inspiratory activity in these muscles may contribute to the reduction in functional residual capacity associated with anesthesia. PMID- 3674470 TI - Hepatic oxygen supply during halothane or isoflurane anesthesia in guinea pigs. AB - The present study was designed to determine changes in hepatic oxygen supply in guinea pigs during halothane or isoflurane anesthesia. Twenty-seven guinea pigs were randomly divided into three equal groups: control (no anesthesia) group, and animals anesthetized with halothane or isoflurane to decrease mean arterial pressure (MAP) by 50%. Hepatic arterial blood flow (HABF) and portal blood flow (PBF), as well as arterial and portal venous blood oxygen content, were determined in awake animals (stage I, baseline values), and during anesthesia (stage II). HABF was found to be extremely low (0.04 ml.min-1.g-1) during both stages of observation in the control (no anesthesia) group, as well as during stage I (awake) in animals treated with halothane or isoflurane. Equal degrees of arterial hypotension during halothane and isoflurane anesthesia were accompanied by decreased HABF during halothane (37%), but no significant change in HABF during isoflurane anesthesia. PBF decreased significantly in both experimental groups; however, the decrease was more prominent during halothane than during isoflurane anesthesia (57% vs. 23%). The observed hepatic circulatory changes led to a 65% decrease in hepatic oxygen delivery during halothane, but only a 34% decrease during isoflurane anesthesia. The present study does not exclude the possibility that liver damage in the guinea pig model is related to the reductive metabolism of halothane or any other mechanism. However, the extremely low HABF and a prominent reduction in both HABF and PBF during halothane anesthesia may be responsible for hepatic damage observed in the guinea pig model. PMID- 3674471 TI - Specific bradycardic agents, a new therapeutic modality for anesthesiology: hemodynamic effects of UL-FS 49 and propranolol in conscious and isoflurane anesthetized dogs. AB - A "specific bradycardic agent" has direct negative chronotropic actions without producing other systemic or coronary hemodynamic alterations. UL-FS 49, a recently synthesized structural analog of verapamil without classical slow channel calcium blocking activity, is proposed as such an agent. The purpose of this investigation was to characterize the hemodynamic and electrocardiographic actions of UL-FS 49 (0.25, 0.50, and 1.0 mg/kg) and compare its effects with those of propranolol (0.25, 0.50, and 1.0 mg/kg) in conscious or isoflurane anesthetized (with and without neuromuscular blockade by pancuronium) chronically instrumented dogs. In six groups, comprising 52 experiments, UL-FS 49 was found to be more efficacious than propranolol in reducing heart rate, although this agent did not block the hemodynamic response to isoproterenol. UL-FS 49 produced 45-50% reductions in heart rate in dogs with isoflurane-induced tachycardia as compared to 15 and 30% reductions following propranolol. Furthermore, few other hemodynamic alterations were produced by UL-FS 49 indicating the remarkable specificity of this drug for reducing heart rate. A "specific bradycardic agent" such as UL-FS 49 may be useful clinically during the perioperative period. Such a drug may be especially advantageous for patients with documented or suspected ischemic heart disease, those who cannot tolerate the side effects of beta adrenergic blockade, as well as patients requiring a greater reduction in heart rate than can be obtained with beta adrenergic receptor antagonists. PMID- 3674472 TI - The pharmacokinetics of atracurium isomers in vitro and in humans. AB - Atracurium is a mixture of ten isomers. By high-performance liquid chromatography, using acidified methanol as the mobile phase and silica support, it was separated into its three geometrical isomer groups, cis-cis, cis-trans, and trans-trans, which contain three, four, and three isomers, respectively. The clinically available form of atracurium was made up of 58% cis-cis, 36% cis trans, and 6% trans-trans isomers. In buffered saline, pH 7.4, at 37 degrees C, the half-lives of the three isomer groups were 57.1 +/- 0.9, 59.7 +/- 0.9, and 66.4 +/- 2.7 min, respectively, for the cis-cis, cis-trans, and trans-trans groups. In whole blood, under similar conditions, the three groups showed different behavior. The cis-cis group broke down in a monoexponential manner with a half-life of 23.3 +/- 2.8 min. The cis-trans group showed bi-exponential breakdown with a rapid phase of 2.3 +/- 0.4 min and a slow phase of 22.1 +/- 2.9 min. The trans-trans group decayed rapidly, but, because of the low concentration of this group in the mixture, kinetic parameters could not be obtained. In eight patients, the mean elimination half-life and apparent clearance of the cis-cis group were 20.6 +/- 1.5 min and 5.3 +/- 0.4 ml.kg-1.min-1, respectively. For the cis-trans group, the apparent elimination half-life and clearance were 17.7 +/- 1.8 min and 9.0 +/- 1.0 ml.kg-1.min-1, but these figures require care in interpretation, as this isomer group contains isomers of widely varying rates of decomposition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674473 TI - Margin of safety in positioning modern double-lumen endotracheal tubes. AB - The authors have defined the margin of safety in positioning a double-lumen tube as the length of tracheobronchial tree over which it may be moved or positioned without obstructing a conducting airway. The purpose of this study was to measure the margin of safety in positioning three modern double-lumen tubes (Mallinkrodt [Broncho-Cath], Rusch [Endobronchial tubes], and Sheridan [Broncho-Trach]). The margin of safety in positioning a: 1) left-sided double-lumen tube (all manufacturers) is the length of the left mainstem bronchus minus the length from the proximal margin of the left cuff to left lumen tip; 2) Mallinkrodt right sided double-lumen tube is the length of the right mainstem bronchus minus the length of the right cuff; and 3) Rusch right-sided double-lumen tube is the length of the right upper lobe ventilation slot minus the diameter of the right upper lobe. The length of the right and left mainstem bronchi were measured by in vivo fiberoptic bronchoscopy (n = 69), in fresh cadavers (n = 42), and in lung casts (n = 55), and the diameter of the right upper lobe bronchus was measured in lung casts (n = 55). The average +/- SD male left and right mainstem bronchial lengths were 49 +/- 8 and 19 +/- 6 mm, respectively, the average +/- SD female left and right mainstem bronchial lengths were 44 +/- 7 and 15 +/- 5 mm, respectively, the average right upper lobe bronchial diameter was 11 mm, the proximal left cuff to left lumen tip distance was 30 mm, the length of the Mallinkrodt right cuff was 10 mm, and the length of the Rusch right upper lobe ventilation slot was 15 mm. The average margin of safety in positioning left sided double-lumen tubes ranged 16-19 mm for the different manufacturers. The average margin of safety in positioning Mallinkrodt right-sided double-lumen tubes was 8 mm, and the margin of safety in positioning Rusch right-sided double lumen tubes ranged 1-4 mm, depending on French size. The authors concluded that left-sided double-lumen tubes are much preferable to right-sided double-lumen tubes because they have a much greater positioning margin of safety, and that proper confirmation of proper position of either a left- or right-sided double lumen tube should be aided by fiberoptic bronchoscopy, because the absolute distances that constitute the margin of safety are extremely small. PMID- 3674474 TI - The influence of a right-to-left cardiac shunt on lidocaine pharmacokinetics. AB - The pharmacokinetics of lidocaine were studied in 1-2-month-old lambs with surgically created, intracardiac right-to-left shunts (RLS) and in age-matched control lambs. Shunts were prepared by anastomosing the pulmonary artery to the left atrial appendage to achieve arterial oxygen saturation of 65-75%. Catheters were implanted both in the right atrium for drug infusion and in the ascending aorta for blood sampling. Lidocaine, 1 mg/kg, injected as a rapid bolus, or 12 mg/kg, injected as a continuous infusion over 15 min, was delivered into the right atrium. Serial samples of arterial blood were obtained every 2.5 s for 1 min following the bolus injection and up to 4 h following the continuous infusion. Samples were analyzed for lidocaine by gas chromatography. Peak arterial whole blood concentration of lidocaine in the shunted animals was 37.0 +/- 2.1 micrograms/ml compared to 21.1 +/- 0.1 microgram/ml in the control animals; P less than .01. The peak arterial concentrations during the lidocaine infusion were 12.6 +/- 3.5 micrograms/ml in the RLS and 5.8 +/- 1.5 micrograms/ml in the controls. Total body clearance of lidocaine was decreased in the shunted animals to 30.7 +/- 13.2 ml.kg-1.min-1 from 68.1 +/- 12.1 ml.kg-1.min-1 in the control animals; P less than .001. The steady-state volume of distribution was also decreased in the shunted animals, 1.0 +/- 0.2 l/kg versus 2.0 +/- 0.7 l/kg in the controls; P less than .02. To induce convulsions 4.75 +/- 0.46 mg/kg of lidocaine was required in the shunted animals and 7.37 +/- 0.44 mg/kg in the control animals (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674475 TI - A new laryngoscope blade to overcome pharyngeal obstruction. AB - A new laryngoscope blade has been designed for emergency visualization of the pharynx and larynx when the pharyngeal space is restricted. The blade incorporates a 7-cm tube in the distal portion and an intraluminal light source protected from obstruction. It attaches to standard battery-powered light handles, making it practical for emergency use. The new blade has been tested on dogs and used successfully in 12 patients with edematous pharynges and in one patient with a bleeding pharyngeal tumor, where standard non-tubular blades failed to produce a view of the larynx. PMID- 3674476 TI - Opisthotonus during exposure to isoflurane, enflurane, and halothane in mice. AB - Some strains of mice, in whom anesthesia was induced with 1.2% isoflurane in air, developed episodes of intense opisthotonus, lasting 1-2 min. Occasionally, opisthotonus also occurred transiently on emergence from isoflurane anesthesia. The incidence of opisthotonus upon anesthetic induction varied with the strain of mice studied, and was particularly high (nearly 80%) in the ddN and YBR/Ki strains. A significantly lower incidence of opisthotonus was observed in all 14 strains studied when 2.0% enflurane was used. One percent halothane did not produce opisthotonus in any strain of mice except one animal of the YBR/Ki strain, and, in this situation, it occurred only on emergence. These results suggest that, in some strains of mice, induction of anesthesia with isoflurane may apparently excite (disinhibit) the central nervous system more intensely than does anesthesia with enflurane or halothane. PMID- 3674477 TI - A modified Pitot tube for the accurate measurement of tidal volume in children. AB - A device using modification of a Pitot tube has been designed for measurement of tidal volume in infants and small children. Its accuracy was compared both n vitro and n vivo to that of a calibrated pneumotachograph (Fleish #1) designed for a similar flow range. In vitro measurement of air flow with the modified Pitot tube (MPT) was within 5% of the pneumotachograph readings over a range of 1 60 l/min. Similar accuracy was found with measurement of tidal volumes from 20 ml to 1 l, delivered by a calibrated volume-cycled ventilator using a variety of inspiratory flow rates. Tidal volume measurements with the MPT were compared to the pneumotachograph using helium, oxygen, carbon dioxide, and a range of nitrous oxide/oxygen mixtures. A manual control was incorporated into the MPT electronics to allow direct measurements of tidal volume with different nitrous oxide/oxygen concentrations. In vivo, the insertion of the MPT into the patient circuit caused no apparent changes in ventilatory parameters in children under 20 kg. Measurement of tidal volumes with the MPT agreed to within 8% of pneumotachograph readings. The low dead space (1.5 cc) and light weight (12 gm) of the MPT confer advantages over the pneumotachograph (15 ml dead space and a weight of 90 gm) for routine use in pediatric anesthesia. PMID- 3674478 TI - Stability of sevoflurane in soda lime. AB - Stability of halogenated volatile anesthetic is important because of the potential toxicity associated with the breakdown products. The authors enclosed 100 ml of gas containing sevoflurane with 100 g of soda lime in a 581-ml flask for periods up to 24 h. The rate of degradation of sevoflurane by soda lime was several-fold greater than previously reported, and the degradation was temperature-dependent. At 22 degrees C, soda lime degraded 6.5% of the sevoflurane per hour. The rate increased by 1.6% per hour per degree rise in temperature, reaching 57.4% degradation per hour at 54 degrees C. In contrast, isoflurane was not degraded by soda lime. Halothane did not degrade at 22 degrees C or 37 degrees C, but did degrade (2.2% per hour) at 54 degrees C. PMID- 3674479 TI - The incidence and neonatal effects of maternal hypotension during epidural anesthesia for cesarean section. PMID- 3674480 TI - Metabolic responses to tourniquet release in children. PMID- 3674481 TI - The effect of a second dose of succinylcholine on cardiac rate and rhythm following induction of anesthesia with etomidate or midazolam. PMID- 3674482 TI - Intrapleural bupivacaine--a kinetic and dynamic evaluation. PMID- 3674483 TI - Anesthesia for children undergoing craniospinal radiotherapy. PMID- 3674484 TI - Craniotomy for tumor in a patient with a bronchopleural fistula: anesthetic considerations. PMID- 3674485 TI - Disulfiram-like reaction associated with carmofur after celiac plexus alcohol block. PMID- 3674486 TI - Continuous intrapleural infusion of bupivacaine for analgesia after thoracotomy. PMID- 3674487 TI - Perianesthetic intracranial hemorrhage in preterm neonates. PMID- 3674488 TI - Venous embolism during craniectomy in supine infants. PMID- 3674489 TI - Ligneous tracheobronchitis: an unusual cause of airway obstruction. PMID- 3674490 TI - Intraoperative re-expansion pulmonary edema. PMID- 3674491 TI - Unexpected focal neurologic deficit on emergence from anesthesia: a report of three cases. PMID- 3674492 TI - Effects of fentanyl anesthesia on visual evoked potentials in humans. PMID- 3674493 TI - Falsely normal saturation reading with the pulse oximeter. PMID- 3674494 TI - Stellate ganglion block: normal saline as placebo. PMID- 3674495 TI - Hemodynamic changes during total knee replacement surgery with total condylar prosthesis. PMID- 3674496 TI - The use of ventilation/perfusion lung scans to predict oxygenation during one lung anesthesia. PMID- 3674497 TI - Exacerbated spinal neurologic deficit during sedation of a patient with cervical spondylosis. PMID- 3674498 TI - Accidental injection of epidural methohexital. PMID- 3674499 TI - Sensitivity of the adductor pollicis and diaphragm muscles to atracurium in a hemiplegic patient. PMID- 3674500 TI - An unusual reaction to preoperative metoclopramide. PMID- 3674501 TI - Acute rhabdomyolysis following halothane anesthesia without succinylcholine. PMID- 3674502 TI - Effect of quinidine on plasma cholinesterase activity and succinylcholine neuromuscular blockade. PMID- 3674503 TI - The correct position of the head and neck for rapid sequence induction. PMID- 3674504 TI - Ketamine addiction. PMID- 3674505 TI - Economic impact of low-flow anesthesia. PMID- 3674506 TI - Ambient light affects pulse oximeters. PMID- 3674507 TI - Reusing the Nellcor pulse probe: clarification. PMID- 3674508 TI - A simple method to determine pulmonary capillary pressure. PMID- 3674509 TI - Clonidine reduces halothane MAC in rats. PMID- 3674510 TI - Bronchial intubation in children: does the tube bevel determine the side of intubation? PMID- 3674511 TI - [Effect of general anesthesia and its components on lipid peroxidation in vitro and in vivo]. PMID- 3674512 TI - [Effect of general anesthesia using ketamine and hexenal and surgical trauma on the humoral immune response]. PMID- 3674513 TI - [Immune response in cancer patients after surgery under combined drug and electric anesthesia]. PMID- 3674514 TI - [Automation of the calculation of medical parameters using the Elektronika-B3-21 microcomputer]. PMID- 3674515 TI - [Improved method of calculating central hemodynamic indices based on rheographic data]. PMID- 3674516 TI - [Polarographic method of evaluating the severity of neonatal asphyxia]. PMID- 3674517 TI - [Significance of lung closing volume in assessing ventilatory function in the early postoperative period]. PMID- 3674518 TI - [Prevention and treatment of shock lung in patients with massive blood loss and trauma following resuscitation]. PMID- 3674519 TI - [Respiratory insufficiency in nervous system diseases]. PMID- 3674520 TI - [Use of high-frequency jet ventilation of the lungs in intensive care]. PMID- 3674521 TI - [Use of computers in an intensive care unit]. PMID- 3674522 TI - [Correction of the immunologic status of patients with encephalopathies in critical states requiring resuscitation]. PMID- 3674524 TI - [Changes in central hemodynamics and the effect of transfusion therapy during surgical treatment of patients with mechanical jaundice]. PMID- 3674523 TI - [Platelet aggregation following surgery of acute gastroduodenal ulcer hemorrhage]. PMID- 3674525 TI - [Combined effect of blood factor C-26 and polyethylene oxide on hemodynamics]. PMID- 3674526 TI - [Pulmonary artery embolism following catheterization of the subclavian vein]. PMID- 3674527 TI - [Comparative evaluation of different types of premedication in cesarean section]. PMID- 3674528 TI - [Ultraviolet irradiation of the blood in the complex therapy of septic complications of critical states]. PMID- 3674529 TI - [Determination of the degree of surgical and anesthesiologic risk to children]. PMID- 3674530 TI - [Hemosorption as a basis for detoxication therapy in acute poisoning]. PMID- 3674531 TI - [Means of correcting the position of a subclavian catheter displaced into the internal jugular vein]. PMID- 3674532 TI - [Stereo-ultrastructure of erythrocytes from patients with congenital cyanotic heart disease following artificial circulation and vitamin E therapy]. PMID- 3674533 TI - [Bypass from the ascending thoracic aorta to the abdominal aorta in a case of coarctation between the left carotid artery and the left subclavian artery]. PMID- 3674535 TI - [Atherosclerotic occlusive disease of the lower limbs in young patients: clinical experience]. PMID- 3674534 TI - [Bilateral fibromuscular dysplasia of the carotid arteries treated surgically: description of a case]. PMID- 3674536 TI - Reuse of disposable medical devices in Canadian hospitals. AB - A survey of all Canadian hospitals was undertaken in 1986 to determine the extent of the reuse of disposable medical devices meant for "single use only." It was found that 41% of hospitals regularly reused disposable medical devices, and reuse was significantly higher in hospitals with more than 200 beds. Only 38% of hospitals that regularly reused had written procedures for reuse, and 32% indicated a mechanism for determining the number of times a device was reused. Cost analysis studies had been undertaken by only 29% of regular reusers, and items of respiratory therapy equipment were the most commonly reused devices. PMID- 3674537 TI - Measles (rubeola) infection in a hospital setting. AB - Although acquisition of measles infection in medical facilities is well documented, hospital outbreaks have been rare. During a recent community measles epidemic, one patient and four employees of the Mary Hitchcock Memorial Hospital developed the disease. Two of the employees were born before 1956, the year recommended by the Centers for Disease Control as an appropriate cutoff year for routine measles vaccination. Screening of 456 hospital employees for measles immunity demonstrated a 5% incidence of susceptibility in 135 individuals born between 1950 and 1956. This experience demonstrates the significant potential for the spread of a community measles outbreak into the hospital setting. Because of the high transmissibility of this disease and its potentially serious consequences in hospitalized patients, we suggest that all hospital employees born after 1950 who have significant patient contact should have documented immunity against measles. PMID- 3674538 TI - Varicella in hospital personnel: a challenge for the infection control practitioner. AB - Five unrelated cases of chickenpox (varicella) occurred in a 1-month period involving one physician, two house staff members, one medical student, and a nursing assistant at a large Veterans Administration medical center. This required immediate identification of susceptible employees and patients to prevent transmission to other personnel and patients. Negative history is not a reliable predictor of susceptibility. Of the fifty contacts reporting negative histories, only five persons (10%) were actually negative by antibody testing. No secondary cases of varicella occurred. These incidents suggested that more rapid prescreening of key hospital personnel with negative histories who have direct patient contact might be helpful in identifying susceptible employees in the future. PMID- 3674539 TI - The infection control practitioner as investigator of clinical phenomena. PMID- 3674540 TI - Decade of progress: decade of change. The future is now! PMID- 3674541 TI - Staphylococcus aureus bacteremia. PMID- 3674542 TI - [New epidemiologic markers of Klebsiella oxytoca strains isolated from nosocomial infections]. AB - In addition to capsular antigen typing and biotyping (sorbose, d-tartrate, dulcitol), the epidemiology of Klebsiella oxytoca can be improved by new biochemical characterization. The authors propose to determine tetrathionate reductase activity, D-melezitose fermentation and brown pigment production onto a mineral gluconate-ferric citrate medium. In order to assess the value of these new markers, several hospital epidemiological surveys were performed in France and Spain (112 strains studied). PMID- 3674543 TI - [Concentration of serum IGD in monoclonal gammopathies]. AB - Serum immunoglobulin levels IgG, IgA, IgM were assayed by laser-nephelometry and IgD by a liquid phase radio-immunoassay in 133 patients with monoclonal gammopathy. Our result show that IgD concentration decrease in parallel with polyclonal immunoglobulin levels. We observe a decrease of IgD level, more pronounced in malignant gammopathy in which the polyclonal immunoglobulin levels are usually low. PMID- 3674544 TI - [Thyroid biological evaluation: critical study]. AB - Laboratory tests to assess thyroid gland function have changed considerably over the past few years, with the development of techniques allowing for the direct routine determination of unbound thyroid hormones (tri and tetra-iodothyronine), the "ultra-sensitive" assay of serum concentrations of TSH (thyroid-stimulating hormone) and finally, the radioimmunological assay of anti TSH-receptor antibodies. In our study, which excluded patients having an excess of iodine or who had serious disease of an organ other than the thyroid, we assessed the impact of these parameters respectively on various disease categories. An innovation has been made in that anti TSH-receptor antibody assay is now possible in everyday practice while up to the present this was only possible in the hospital setting and with a limited number of cases: this titer is important as a classification parameter in diagnosing Grave's disease and has prognostic importance to monitor treatment of patients suffering from this disorder. The "ultrasensitive" version of measuring thyrotropic hormone requires a new strategy: TSH assessment becomes the first-line diagnosis test to evaluate thyroid function because it differentiates from control subjects, as well as patients with hyper ou hypothyroidism who are not receiving therapy. In other cases, dosing of the free hormones T3 and T4 remains a vital supplementary test. PMID- 3674545 TI - [Description and performance of a flow cytometry apparatus: the EPICS]. AB - This is a report on our experience with the EPICS C (Coultronics) cytometric flux apparatus, a screening cell analyzer, employing a laser ray (2 or 5 watts); we obtained good results to analyze immunologically-tagged mononuclear blood cells with or without prior separation: for rhythm, repeatability, and contamination. The EPICS C machine proved to be effective to study the cell cycle using lymphoblastic cells, epithelial cells and cells from a breast cancer. Several screening trials were carried out with fluorescent ball bearings of various sizes; the quality of screening (purity and yield) appear optimal at a speed ranging from 500 to 1,000 bearings per second, using three parameters: the logarithm of green fluorescence, the integral function of green fluorescence, the diffraction of light to small angles. Thus, if results obtained for this analysis are entirely satisfactory, the screening function remains limited because it is slow. PMID- 3674546 TI - Meeting of the Societies. Belgian Society of Clinical Chemistry. IIIrd International Symposium. Brugge, October 24-26, 1985. Human infertility. Second part. PMID- 3674547 TI - Evaluation of five commercially available direct radio-immunoassays for the determination of 17 beta-estradiol in serum for the hormonal monitoring of ovarian stimulation. AB - Five direct radio-immunoassay kits for the dosage of 17 beta-estradiol were assessed for their usefulness to monitor the serum values of 17 beta-estradiol in stimulated and natural ovarian cycles. Prerequisites included a turn-around time of 4 hours for an assay of 100 tubes and a range extended to at least 2,000 ng/l. The following parameters were evaluated: characteristics of the standard curve, sensitivity, precision profile, within- and between-assay precision, analytical drift and linearity. We found that the five tested methods are technically suitable to monitor serum 17 beta-estradiol in stimulated cycles but they all lack precision for low 17 beta-estradiol levels as seen in the early follicular phase of natural cycles. PMID- 3674548 TI - Radio-immunoassay of salivary progesterone for monitoring ovarian function in female infertility. AB - Fifty-two women, aged from 25 to 41 years, with infertility due to chronic anovulation were admitted to the study together with 36 age-matched controls with proven ovulatory cycles. Paired plasma (3 ml) and whole unstimulated saliva (10 ml) samples were collected over a 30 day period, starting from the first day of a menstrual bleeding, in patients, and throughout the menstrual cycle, in controls. Salivary progesterone levels, measured in women with infertility, ranged from undetectable values to 16 pmol/l during the first, and from 36 to 98 pmol/l during the second half of the monitoring period. In eugonadal women the steroid levels ranged from 34 to 46 pmol/l and from 96 to 780 pmol/l during the follicular and luteal phases, respectively. The saliva/plasma progesterone ratio ranged from 0.58 to 2.71 p. cent and a good correlation between salivary and plasma levels was found at each time of monitoring. Many (86 p. cent) of patients, which were randomly allocated to a low- or high-dose epimestrol administration schedule, appeared to be sensitive to the drug, achieving, after therapy, salivary progesterone levels which were within the range of controls. Since correct assessment of luteal function in basal conditions and during therapy requires multiple steroid measurements, and since saliva can be obtained by non-invasive techniques, salivary assays represent an attractive alternative to plasma ones for monitoring ovarian activity, also during specific treatment. PMID- 3674549 TI - Pregnancies without corpus luteum rescue. AB - Four beginning pregnancies after cycles with ovarian stimulation are described. Due to a delay of implantation no rescue of the corpus luteum occurred. At first the cycles ended with menstruation, negative serum hCG and normal low serum steroid hormone concentrations. A new stimulation was started and subsequently terminated as soon as the pregnancies were detected. There was no progesterone production in all these four cases during the first 9-13 days of pregnancy. Induced by the renewed stimulation new follicular development was noticed in three patients, followed by ovulation during pregnancy. Two clinical pregnancies were the result, one with good further evolution and delivery, and one aborted at 10 weeks after the first menstrual period. The other two pregnancies ended with preclinical abortions. PMID- 3674550 TI - Cryopreservation of in vitro cultured mouse preimplantation embryos. AB - We investigated two different freezing protocols on mouse embryos that were either grown in vivo or were grown in vitro for a certain period. Our results confirm that an extended in vitro culture period makes the embryo more susceptible for injury due to freezing and thawing. Furthermore when freezing two cell mouse embryos we could observe that this early stage is more dependent on optimal cryopreservation protocol parameters than later stages. PMID- 3674551 TI - First trimester prenatal diagnosis of lysosomal storage disease. Study of alpha-L fucosidase isoenzyme patterns in fetal and maternal tissue. AB - The normal range of activities of 6 lysosomal enzymes was determined in extracts of chorionic villi samples obtained by a rigid forceps in the first trimester of pregnancy. These activities were compared to those in villi obtained after abortion and in cultured amniotic fluid cells and fibroblasts. For five of the six enzymes tested, the data suggest that first trimester prenatal diagnosis should be possible and reliable. For the sixth enzyme, alpha-L-fucosidase, where on occasion very low activities were found, the results obtained on fresh chorionic villi have to be interpreted with extreme caution. Considerable lysosomal enzyme activities were also found in maternal decidua. Therefore, extreme care must be taken in the preparation of chorionic villi for prenatal diagnosis of lysosomal disorders since even small amounts of maternal tissue could lead to misdiagnosis. This study has allowed us to monitor 2 pregnancies at risk for lysosomal storage disease. Differences in the isoenzyme pattern of alpha L-fucosidase were found in chorionic villi and maternal decidua. Although further studies are required, this observation could lead to the development of immuno biochemical methods to evaluate the purity of chorionic villi used for prenatal diagnosis. PMID- 3674552 TI - [French Society of Clinical Biology. The vitamin A Commission. Determination of blood retinol by liquid chromatography (Document C, stage 3)]. PMID- 3674553 TI - Pneumonia in pigs induced by intranasal challenge exposure with pseudorabies virus and Pasteurella multocida. AB - The interaction between pseudorabies virus (PRV) and Pasteurella multocida was investigated to determine whether single or combined infections result in pneumonia in 6- to 7-week-old pigs. The effect of the PRV-P multocida challenge exposure on feed consumption, rate of gain, and extent of pneumonic lesions appeared dependent on the PRV dose; however, pneumonic lesions were of bacterial pneumonia. Pigs inoculated with a virulent strain of PRV plus P multocida developed severe pneumonia, whereas pigs given PRV only did not develop pneumonia. Modified-live PRV vaccine had no effect on the occurrence of pneumonia. Average daily gain was most depressed in pigs given the highest dose of virulent PRV plus P multocida. PMID- 3674554 TI - In vitro sensitization and stimulation of bovine lymphocytes with encapsulated or nonencapsulated Smith strain of Staphylococcus aureus. AB - An in vitro immunization procedure was developed, whereby bovine blood and mammary gland lymphocytes were isolated, and their blastogenic responses (measured by [3H]thymidine uptake) to sensitization and subsequent stimulation with selected antigens were determined. Capsular extracts of Staphylococcus aureus, encapsulated S aureus, and nonencapsulated S aureus were used as test antigens. Differences were observed between kinetics of the secondary response to encapsulated and nonencapsulated S aureus. The secondary response to nonencapsulated S aureus peaked in 48 hours, whereas the secondary response to the encapsulated S aureus peaked in 72 hours. The delayed peak response to encapsulated S aureus was observed only when encapsulated S aureus was used for sensitization of lymphocytes, regardless of whether the encapsulated or nonencapsulated strain was used for stimulation. Sensitization of lymphocytes with the nonencapsulated strain and stimulation with the encapsulated strain did not alter the kinetics of the secondary response of cells sensitized with the nonencapsulated strain. Seemingly, T and B cells were responsive to in vitro immunization with S aureus antigens. PMID- 3674555 TI - Mechanism and isotypes involved in passive immunoglobulin transfer to the newborn alpaca (Lama pacos). AB - Crias, newborn alpacas (Lama pacos), that were almost agammaglobulinemic at birth had a 70% increase in total serum proteins within 24 hours largely because of absorption of gamma globulins from colostrum. Immunoglobulin G was the isotype in highest concentration in colostrum and in serum from 24-hour-old crias. The serum IgG concentration of 10 crias increased linearly (r = 0.97) from a mean of 0.3 mg/ml (+/- 0.1 SD) for serum collected before crias suckled to a maximal mean of 30.1 mg/ml (+/- 8.1 SD) at 24 hours. The 24-hour concentration decreased by half in 10 days. Immunoglobulin M also was absorbed from colostrum and increased linearly (r = 0.99) from a mean of 0.5 mg/ml (+/- 0.1 SD) for serum collected before crias suckled to a maximal mean of 4.2 mg/ml (+/- 2.2 SD) 24 hours after birth. The 24-hour serum concentration of IgM decreased by half in 7 days. Therefore, on a weight basis, 7 times more IgG than IgM was transferred to crias; IgG accounted for greater than 85% of the passively transferred proteins in serum of 24-hour-old crias. Absorption of functional antibodies of IgG and IgM isotypes from colostrum of immunized dams by crias also was demonstrated. Immunoglobulin G and IgM antibody titers to chicken RBC increased linearly to maximal geometric mean titers of 1,139 and 843, respectively, 24 hours after birth. The 24-hour IgG and IgM antibody titers decreased by half in 6 and 3.8 days, respectively. Purified alpaca IgG had a molecular mass of 166 kilodaltons, a predominant gamma mobility, and an extinction coefficient of 14.1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674556 TI - Failure of passive immunoglobulin transfer: a major determinant of mortality in newborn alpacas (Lama pacos). AB - Failure of passive transfer (FPT) of immunoglobulin from colostrum was demonstrated as a major determinant of mortality in newborn alpacas (Lama pacos; crias). Serum IgG concentrations of dying crias were significantly (P less than 0.0001) lower than were serum IgG concentrations of crias that lived. Of 82 crias, 10 (12%) died within 1 month of age, and 7 of these had 0 to 9 mg of IgG/ml of serum at 48 hours after birth; 5 of the 7 had evidence of infectious diseases. The serum IgG concentrations of the remaining dead crias were 12, 13, and 20 mg/ml. On the basis of serum IgG concentrations of crias that died in the first month, FPT was defined as a 48-hour serum IgG concentration less than 9 mg/ml, which was greater than 2 SD below the 48-hour mean of clinically normal crias. Using this definition, the prevalence of FPT in the 82 crias studied was 9%. Corroborative evidence of the relationship between FPT and mortality was obtained from a retrospective study of 21 dead crias. The postmortem serum IgG concentration of 5 crias that died 2 to 10 days after birth ranged from less than 1 to 3 mg/ml; all were greater than 2 SD below the mean of age matched clinically normal crias. The range of serum IgG concentration was 2.2 to 21 mg/ml in 8 crias that died 11 to 20 days after birth; serum IgG concentration in 1 cria was greater than 2 SD below the normal mean, and 6 were greater than 1 SD below the normal mean.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674557 TI - Histochemical morphologic features of growth cartilages in long bones of pigs of various ages. AB - Growth cartilages were obtained from humeri, femora, and ulnae of 31 pigs between 1 and 169 days old. On the basis of stain uptake and distribution, distinct layers were identified in articular-epiphyseal cartilage complexes and growth plates. The laminated appearance was dependent on stain uptake by territorial and interterritorial matrices and was more distinct in pigs greater than 15 days old. There was morphologic heterogeneity, which probably represented a functional heterogeneity, among chondrocytes in all layers and zones of both types of growth cartilage. The laminar appearance of growth cartilages and the distribution of different types of cells were similar for all pigs in each age category and for all sites. PMID- 3674558 TI - Neurophysiologic maps of cutaneous innervation of the hind limb of sheep. AB - The area of skin supplied by afferent fibers in a peripheral nerve is called the cutaneous area (CA) of that nerve. The CA of hind limb nerves that were responsive to movement of wool/hairs were mapped neurophysiologically in 25 barbiturate-anesthetized sheep. The CA of the dorsal cutaneous branches of the caudal lumbar spinal nerves and of the sacral spinal nerves extended over the lateral aspect of the thigh. The CA of the lateral cutaneous femoral nerve was restricted to the stifle region, that of the saphenous nerve did not reach the digits, that of the deep peroneal nerve lay between the 3rd and 4th digits, and that of the lateral plantar nerve was confined to the lateral aspect of the 4th digit. The CA of the superficial peroneal nerve enveloped the dorsal, medial, and lateral aspects of the distal portions of the hind limb. In some sheep, the boundaries of the CA of the superficial peroneal nerve were juxtaposed caudally in such way that the medial plantar nerve did not have an autonomous zone. Differences in sizes of the CA resulted in corresponding differences in the overlap between adjacent CA and concomitant differences in the sizes of autonomous zones. PMID- 3674559 TI - Effects of acute pancreatitis on circulating lipids in dogs. AB - Effects of acute pancreatitis on circulating lipids in dogs were evaluated by comparing the serum cholesterol and triglyceride concentrations and plasma lipoprotein electrophoretic patterns of 4 dogs with experimentally induced pancreatitis (EIP), 2 (healthy) sham-operated control (SOC) dogs, and 4 dogs with naturally acquired pancreatitis (NAP) with the concentrations and patterns of 23 healthy, nonoperated control (HNC) dogs. Blood samples were collected once from HNC dogs, 1 to 3 times during the course of the disease in dogs with NAP, and prior to and at 6, 12, 24, 48, 72, and 96 hours after induction of pancreatitis in dogs with EIP or after the sham operation in the SOC dogs. The dogs with EIP did not have turbid serum and did not develop hypercholesterolemia or hypertriglyceridemia. Three of the dogs with NAP had turbid serum and hypertriglyceridemia, and 3 had hypercholesterolemia. The electrophoretic tracings of HNC dogs had predominant alpha-1 peaks and small beta peaks; 2 of the HNC dogs also had small alpha-2 peaks. The tracings of dogs with EIP were similar to those of HNC dogs until 48 to 72 hours after induction of pancreatitis, when dogs with EIP developed increased beta lipoproteins, decreased alpha-1 lipoproteins, and movement of lipoproteins into the alpha-2 zone. The tracings of SOC dogs were similar to those of HNC dogs at all times. Compared with HNC dogs, dogs with NAP all had increased beta lipoproteins, and 2 had decreased alpha-2 lipoproteins. Two dogs with NAP had additional lipoprotein alterations, unlike any seen in dogs with EIP. PMID- 3674560 TI - Relationship of cheek tooth abrasion to fluoride-induced permanent incisor lesions in livestock. AB - Teeth from cattle, sheep, and horses that ingested various fluoride intakes and teeth from field studies of these species plus deer, elk, and bison were examined for abnormalities. Approximately 99,000 animals in 322 herds were examined for fluorosis. From field studies, 988 cattle of various ages and with different degrees of dental fluorosis were slaughtered and necropsied. The severity of fluoride-induced mottling, hypoplasia, and abnormal abrasion of paired permanent incisor teeth was correlated with abrasion of premolar and molar (cheek) teeth that form and mineralize at approximately the same age. Severe irregular wear of cheek teeth impaired mastication and resulted in poor utilization of feed and unthriftiness. Excessive amounts of fluoride during tooth formation and mineralization induce characteristic dental changes. Offspring from the fluoride affected animals did not have discernible fluoride-induced lesions in the deciduous teeth. PMID- 3674561 TI - Systemic distribution of blood flow in ponies during 1.45%, 1.96%, and 2.39% end tidal isoflurane-O2 anesthesia. AB - Effects of 1.1, 1.5, and 1.8 minimal alveolar concentration (MAC) isoflurane-O2 (1.45%, 1.96%, and 2.39% end-tidal isoflurane, respectively) anesthesia on cardiac output, blood pressure, and blood flow to the brain, thyroid glands, adrenal glands, kidneys, and splanchnic organs were examined in 9 healthy isocapnic adult ponies. Tissue blood flows were studied using 15-micron diameter radionuclide-labeled microspheres that were injected into the left ventricle, and comparisons were made with data obtained from ponies in the conscious state. Isoflurane anesthesia caused dose-related reduction in cardiac output and arterial blood pressure, but total peripheral resistance was not significantly altered (P greater than 0.05). In the brain, vasodilation occurred with exposure to isoflurane that peaked at 1.5 MAC. Vasodilation was more pronounced in the cerebellum, pons, and medulla, compared with that in the cerebrum. Perfusion increased in cerebellar gray, as well as white, matter. However, in the cerebrum, blood flow increased in the white matter, whereas it decreased in caudate nuclei and was similar to value in the cortex of awake ponies. In thyroid glands and pancreas, intense vasoconstriction occurred during isoflurane anesthesia which caused precipitous reduction in blood flow in these organs. By contrast, adrenal gland blood flow was not affected during the 3 levels of isoflurane anesthesia because vasodilation occurred. The renal blood flow registered dose-dependent reductions during isoflurane-O2 anesthesia, but renal vasoconstriction occurred only during the deepest level (1.8 MAC) of anesthesia. Although the small intestine and and colon blood flow decreased with each concentration of isoflurane, the splenic blood flow remained unaffected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674562 TI - Effect of ranitidine on gastric acid secretion in young male horses. AB - Gastric cannulas were placed surgically in 5 young male horses. After a 2-week recovery period, horses were studied once a week. Horses were fasted for 24 hours, and gastric fluid output was collected for 5 continuous hours. Volumes were recorded every 15 minutes, and pH and hydrogen ion concentration were determined in an aliquot from each period. In 10 basal experiments, using 5 horses, volume, pH, and hydrogen ion concentration were continuously variable. Mean acid output was 45.1 +/- 2.02 microEq/15 min/kg (mean +/- SEM). In 6 experiments, using 3 horses, 0.5 mg of ranitidine/kg of body weight, given as an IV bolus after a 1-hour basal collection, significantly (P less than 0.02) inhibited hourly total acid output for 4 hours, but did not significantly change pH. The cannulation technique was done without complications, and horses tolerated the cannula for several months. Seemingly, the horse has a continuously variable gastric acid secretion, and histamine type-2 receptors have a role in this process. PMID- 3674563 TI - Listeriosis in diacetoxyscirpenol-treated mice. AB - Mice were treated with the trichothecene mycotoxin diacetoxyscirpenol (DAS) and subsequently were inoculated intraperitoneally with Listeria monocytogenes. The effect of the mycotoxin on the course of the infection was monitored by observing the resultant mortality and the bacterial content of the spleens from inoculated mice. Mice given 3 mg of DAS/kg of body weight, PO, at days -2 and -1 before inoculation had increased mortality and splenic Listeria counts. In these mice, thymus weights were reduced, and lymphocytes were depleted from the thymus cortex and from splenic lymphoid follicles and periarteriolar lymphoid sheaths. A single dose of 4 mg of DAS/kg given on day 6 before challenge exposure did not affect mortality compared with that in nontreated controls. Mice treated with DAS and subsequently inoculated with Listeria had significantly (P = 0.006) increased neutrophil populations compared with Listeria-infected control mice. PMID- 3674565 TI - Spinal-evoked potentials in dogs with acute compressive thoracolumbar spinal cord disease. AB - Spinal evoked potentials (SpEP) were recorded on an electromyograph from electrodes placed percutaneously in the ligamentum flava at the lumbosacral junction and between the 10th and 11th thoracic vertebrae following tibial nerve stimulation in 31 anesthetized dogs with acute compressive spinal cord injuries. The neurologic status of each dog was determined by clinical examination before SpEP recordings, and the neurologic status was monitored for 2 months in dogs that had surgical or conservative treatment. Two months after spinal injury, the response to treatment (outcome) of each dog was evaluated and graded as favorable (ambulatory and urinary continent) or unfavorable (nonambulatory, urinary incontinent, or euthanatized with confirmation of myelomalacia). Onset latencies, conduction velocities, amplitudes and durations of the wave forms, and the ratio of conduction velocity to combined durations of the first positive (P1) and first negative (N1) waves (CV/DPN index) were determined and were compared with reference data from clinically normal (control) dogs. Single SpEP recordings were of value in determining the prognosis for recovery. Significant differences were not found in the L7-S1 recordings between the reference (control) and spinal injury groups. Analysis of data from the T10-11 recordings indicated significant differences between the reference and spinal injury groups and between the favorable and unfavorable outcome groups within the spinal injury group. A CV/DPN index was less than 30 in dogs with unfavorable outcomes and greater than 30 in dogs with favorable outcomes. Stepwise discriminant analysis of data from the spinal injury group predicted outcome correctly in all dogs. PMID- 3674564 TI - Monensin toxicosis in swine: potentiation by tiamulin administration and ameliorative effect of treatment with selenium and/or vitamin E. AB - Modulation of acute monensin toxicosis in swine was evaluated in 2 studies. In study 1, 56 weanling male pigs were allotted to 14 groups of 4 each. Pigs in 7 groups were given tiamulin in the drinking water (to supply 7.7 mg/kg of body weight/day) for 3 days before and for 2 days after monensin administration. Monensin was given as a single oral dose (at 0, 7.5, 15, 25, 50, 75, or 100 mg/kg) to pigs in groups with or without tiamulin exposure. Prominent acute clinical signs of monensin toxicosis (hypermetria, hind limb ataxia, paresis, knuckling of hind limbs, and recumbency) developed by 2 to 6 hours after dosing in pigs given 15 or 25 mg of monensin/kg with tiamulin exposure, but not in pigs given the 15 or 25 mg of monensin/kg without tiamulin exposure. Also, the extent of monensin-induced skeletal muscle damage at 4 days after monensin dosing was enhanced in pigs given 7.5, 15, or 25 mg of monensin/kg and exposed to tiamulin. In study 2, 48 weanling male pigs were allotted to 8 groups of 6 each. Four groups of pigs were given 20 mg of monensin/kg orally, and 4 groups were given 100 mg of monensin/kg orally. For each monensin dose, a group was treated 24 hours before monensin administration with (i) selenium (Se)-vitamin E preparation, 0.25 mg of Se and 68 IU of d-alpha-tocopheryl acetate (vitamin E)/kg, IM; (ii) vitamin E only, 68 IU of d-alpha-tocopheryl acetate/kg; (iii) Se only, 0.25 mg of Se/kg; or (iv) vehicle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674566 TI - Load compensation: a strategic approach. PMID- 3674567 TI - To seek, find, and yet fail. PMID- 3674568 TI - Standardization of spirometry. PMID- 3674569 TI - Developmental changes in the ventilatory response of the newborn to added airway resistance. AB - Postnatal development of the steady-state response to inspiratory resistive loading was studied in eight 48-hour-old and seven 24-day-old tracheostomized monkeys. The newborn subjects did not maintain minute ventilation (Vl) with increasing loads of from 2 to 6 times baseline respiratory resistance, whereas the older subjects kept Vl constant when challenged by the same added resistances. The response patterns in both groups were characterized by a prolongation of Tl and Tl/Ttot, a reduction of respiratory frequency, and increases in airway occlusion pressure and respiratory work output. Apart from Vl, tidal volume (VT) was the only other ventilatory variable that differed significantly between age groups during loading. Arterial CO2 and O2 did not change from baseline in either group during loading, indicating that both age groups defended blood gas values equally well. The increases in occlusion pressures, inspiratory work output, and the maintenance of PaCO2 in the newborns indicated the presence of load compensatory mechanisms despite the fact that Vl was not strictly defended. PMID- 3674570 TI - Evaluation of the use of an oxygen conservation device in long-term oxygen therapy. AB - An oxygen-conserving delivery system employing a flow reducing oxygen pendant (OP) cannula was evaluated during home use for oxygen savings, cost reduction, and patient acceptance. Twenty-one male outpatients receiving home oxygen from liquid systems by conventional nasal cannula (NC) were fitted with OP and followed for 1 month. Oxyhemoglobin saturations (SaO2) were successfully maintained with a threefold reduction in mean O2 flow rate from 1.45 to 0.46 L/min. Exercise testing demonstrated no change between the 2 systems in either degree of desaturation or duration of exercise. Because the same benefit was achieved at lower O2 flow with the OP, 14 patients were able to utilize their O2 for longer periods of time without refilling their portable liquid units. Liquid O2 use per patient was reduced from 200 pounds/month with NC to 135 pounds/month with OP. In 12 patients who reported full compliance during the study period; a net savings of $141/month/patient was realized. However, 9 of the 21 patients stopped using the OP before completing the study. Patient evaluations of the OP identified several factors leading to poor compliance, including bulkiness and/or poor fit (16 patients), ear discomfort (8 patients), nasal discomfort (6 patients), and required nasal breathing (6 patients). While significant savings were achieved with OP, problems with patient acceptance may limit its practicality, particularly in continuous use situations. The primary benefit of the OP may be in extending the range of portable oxygen systems. PMID- 3674571 TI - Sternomastoid muscle function and fatigue in breathless patients with severe respiratory disease. AB - In patients with severe respiratory disease, the work of breathing is increased and the respiratory muscles, particularly those of inspiration, may become fatigued. Hitherto, there has been little information on the incidence of respiratory muscle fatigue in acutely breathless patients. We studied 34 patients with severe respiratory disease on admission to hospital when they were most breathless, and then, if possible, 7 to 14 days later after recovery for evidence of sternomastoid muscle fatigue or increased fatigability. Frequency/force curves, numerically expressed as the 20:50 ratio, were carried out in all patients on admission. Three of the 34 patients had evidence of low frequency fatigue (i.e., greater than 15% reduction in 20:50 ratio) in the sternomastoid muscle on admission when first studied (mean +/- SEM 20:50 ratio, 56.3 +/- 1.2%; n = 3). The mean 20:50 ratio in the remaining 31 patients on admission was 75.7 +/- 1.6% (n = 31) compared with 77.8 +/- 1.4% (n = 25) when symptomatically better (p less than 0.05). The mean 20:50 ratio on admission was also significantly lower than the mean 20:50 ratio in a group of age- and sex-matched normal control subjects (i.e., 78.5 +/- 1.4%, n = 25; p less than 0.05). Twenty five patients were studied completely both on admission and recovery, including a fatigability test that involved the performance of 50 fatiguing head lifts with measurements of the 20:50 ratio 10 and 60 min later. Sternomastoid muscle fatigability was significantly increased on admission when the patients were most breathless, compared with recovery when they were less breathless (p less than 0.001 at both 10 and 60 min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674572 TI - Small airways disease in patients without chronic air-flow limitation. AB - We measured airway diameter and quantitated airway pathology scores in respiratory bronchioles (RB) and membranous bronchioles (MB) in 37 patients undergoing resection for solitary pulmonary nodules. The patients had FEV1 greater than 75% of the predicted. Measurements of FEV1, nitrogen washout curve (delta N2/L), closing volume as a percentage of vital capacity (CV/VC%), and maximal flow at 50% of VC (V50) were made prior to surgery. There were 22 smokers and 15 nonsmokers. There were more MB per cm2 of tissue than RB (0.74 versus 1.02). The mean internal diameter for MB was 0.55 +/- 0.27 mm; for RB it was 0.47 +/- 0.15 mm. There were more MB greater than 1.0 mm in internal diameter than RB greater than 1.0 mm, and the mean diameter of MB was less than that noted in autopsy specimens. The total pathology scores for all airways were less than those found in Caucasian populations. Pathology scores were higher for MB than for RB, except for pigment deposition. Inflammation scores were higher in patients with FEV1 less than 100% predicted both for RB (p less than 0.05) and for MB (p less than 0.05). FEV1 values correlated with goblet cell metaplasia scores (p less than 0.05) for MB and with fibrosis (p less than 0.05), pigment deposition (p less than 0.05), and intraluminal macrophages (p less than 0.05) for RB. Tests specific for small airways (delta N2/L, V50, CV/VC%) did not correlate with the pathology scores. PMID- 3674573 TI - Symptomatic bronchoconstriction after short-term inhalation of sulfur dioxide. AB - We studied the relationship between duration and concentration of exposure in SO2 induced bronchoconstriction in 8 asthmatic subjects. On separate days, we administered SO2 in humidified air through a mouthpiece at 2 concentrations (0.5 and 1.0 ppm) for 3 time periods (1, 3, and 5 min) during eucapnic hyperpnea (60 L/min). Humidified air was administered for 5 min as a control. Bronchoconstriction was assessed by measurement of specific airway resistance (SRaw). The magnitude of the bronchoconstrictor response to both concentrations of SO2 increased progressively over the 3 time periods studied. The mean (+/- SE) increase in SRaw (in L x cm H2O/L/s) and percent increase above baseline (in parentheses) after each exposure to SO2 were as follows: 2.5 +/- 0.3 (34%) after 0.5 ppm for 1 min; 7.5 +/- 4.7 (93%) after 1.0 ppm for 1 min; 13 +/- 3.2 (173%) after 0.5 ppm for 3 min; 31.4 +/- 7.4 (395%) after 1.0 ppm for 3 min; 19.6 +/- 4.0 (234%) after 0.5 ppm for 5 min; 44.1 +/- 9.8 (580%) after 1.0 ppm for 5 min; 3.5 +/- 1.5 (46%) after humidified air for 5 min. For the group, the increases in SRaw caused by inhalation of both concentrations of SO2 for 1 min were small. However, 2 of 8 subjects did develop large increases in SRaw and chest tightness after inhalation of 1.0 ppm for 1 min. Seven of 8 subjects developed wheezing, chest tightness, or dyspnea and used an inhaled bronchodilator after inhalation of 0.5 ppm for 3 and 5 min and 1.0 ppm for 3 minutes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674574 TI - The roles of pH and ionic species in sulfur dioxide- and sulfite-induced bronchoconstriction. AB - Sulfur dioxide (SO2) and sulfites are well-described causes of bronchoconstriction in persons with asthma that are chemically related and, therefore, may share a common mechanism of action. When either sulfur species dissolves in aqueous solutions, a pH-dependent equilibrium is established predominantly among bisulfite ion (HSO3-), sulfite ion (SO3=), and SO2. In addition, hydrogen ions may be released. To assess the relative bronchoconstricting potencies of these chemical forms and the role of acidity caused by the release of hydrogen ions in SO2- and sulfite-induced bronchoconstriction, we administered to 10 asthmatic subjects nebulized sodium sulfite (Na2SO3) solutions at pH 9 containing 95% sulfite, at pH 6.6 containing 80% bisulfite, and at pH 4 containing 99% bisulfite but greater than an order of magnitude more SO2 than the pH 6.6 solutions. Subjects inhaled increasing concentrations of aerosolized Na2SO3 at each pH during 1 min of tidal breathing. Subjects also breathed buffered acetic acid aerosols with the same acidity of the pH 4 Na2SO3 solutions to control for the airway effects of acid aerosols. To assess sensitivity to SO2 gas, subjects inhaled increasing concentrations of SO2 during eucapneic hyperpnea. Bronchoconstrictor response was assessed by measuring specific airway resistance (SRaw) before and after each challenge. Nine of the 10 subjects developed bronchoconstriction after inhaling the Na2SO3 aerosols at all 3 levels of pH and the SO2 gas. The mean concentration of Na2SO3 solution calculated to increase SRaw by 100% above baseline was significantly different (p less than 0.01) at the various levels of pH: pH 4 (0.17 mg/ml) less than pH 6.6 (0.49 mg/ml) less than pH 9 (2.10 mg/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674575 TI - Replicated dose-response study of sulfur dioxide effects in normal, atopic, and asthmatic volunteers. AB - To help assess respiratory health risks from sulfur dioxide (SO2) air pollution, we studied 24 normal, 21 atopic, 16 minimal/mild asthmatic, and 24 moderate/severe, medication-dependent asthmatic subjects classified according to history, lung function, allergy skin tests, serum IgE level, and airway reactivity to methacholine. All were exposed in a chamber (21 degrees C, 50% humidity) to 0.0, 0.2, 0.4, and 0.6 ppm SO2 in random order at 1-wk intervals; then exposures were repeated to test consistency of response. The 1-h exposures included three 10-min exercise periods (ventilation approximately 40 L/min). Physiologic response was measured early (approximately 15 min) and late (approximately 55 min) in exposure. Symptoms were evaluated during exposure and for 1 wk afterward. Normal and most atopic subjects showed little response at these SO2 levels. A few atopic subjects and many asthmatics developed bronchoconstriction and respiratory symptoms, but most were able to maintain their exercise. Effects were not markedly different between early and late measurements, nor between the first and second round of studies; however, late and second-round responses appeared slightly more favorable. No statistically significant effect of SO2 on symptoms was found 1 day or 1 wk after exposure. Minimal/mild asthmatics showed, on the average, slight responses at 0.0 ppm (attributable to exercise) and increasing responses at increasing SO2 concentrations. Moderate/severe asthmatics reacted more at 0.0 ppm, but their increments in response with increasing SO2 concentration were roughly similar to those of minimal/mild asthmatics. Thus, responses to SO2 per se were not strongly dependent on clinical severity of asthma, nor on SO2 exposure history during previous weeks. PMID- 3674577 TI - The effects of ozone and nitrogen dioxide on pulmonary function in healthy and in asthmatic adolescents. AB - The aim of this project was to investigate whether well-characterized asthmatic adolescent subjects were more sensitive to the inhaled effects of oxidant pollutants than were well-characterized healthy adolescent subjects. Ten healthy and 10 asthmatic subjects inhaled via a mouth-piece 0.12 or 0.18 ppm of ozone (O3) or nitrogen dioxide (NO2) or clean air for 30 min at rest followed by 10 min during moderate exercise (32.5 L/min) on a treadmill. The following pulmonary functional values were measured before and after exposure: peak flow, total respiratory resistance (RT), maximal flow at 50 and 75% of expired VC, and FEV1. After exercise exposure to 0.18 ppm O3, statistically significant increases were seen in RT in asthmatic and healthy adolescent subjects. No consistent changes were seen in either group after NO2 exposure. Also, no significant differences in response to oxidant pollutants between the 2 groups could be demonstrated. It was concluded that neither group was consistently sensitive to these pollutants. PMID- 3674576 TI - Muscarinic M1 receptors mediate the increase in pulmonary resistance during vagus nerve stimulation in dogs. AB - The physiologic roles of the 2 muscarinic receptors (M1 and M2) in the vagal control of pulmonary resistance were studied by comparing the effects of pirenzepine (PZ, M1-blocker), gallamine (GAL, M2-blocker), and atropine (AT, M1- and M2-blocker) on the increase in pulmonary resistance (RL) and on the reduction in heart rate (HR) during bilateral cervical vagus nerve stimulation in 18 anesthetized (chloralose and urethane) and paralyzed (vecuronium) dogs. PZ, AT, and GAL all inhibited the reduction in HR during vagus nerve stimulation, although the inhibition required relatively high doses of PZ and GAL. AT and PZ inhibited the increase in RL during vagus nerve stimulation. The ratio of the dose needed to inhibit by 50% the HR response to the dose needed to inhibit by 50% the RL response was approximately 45:1 for PZ, 12:1 for AT, and less than 0.4:1 for GAL. Thus, compared with AT, PZ is a more selective blocker of vagally induced increases in RL, indicating that M1 receptors are present in the airway smooth muscle of intact anesthetized dogs. In the same dose range as that which caused the inhibition of the HR response, GAL had no consistent effect on the increase in RL during vagus nerve stimulation, indicating that M2 receptors do not mediate the increase in RL in intact anesthetized dogs. PMID- 3674578 TI - Airway responsiveness to intravenous and inhaled acetylcholine in the guinea pig after cigarette smoke exposure. AB - Exposure of conscious guinea pigs to cigarette smoke results in bronchial hyperresponsiveness. To examine the mechanisms involved, we measured airway responses to increasing doses of intravenous or inhaled acetylcholine in guinea pigs exposed to cigarette smoke (n = 20) or to air (n = 20). After exposure the guinea pigs were anesthetized, paralyzed, and studied in a pressure-sensitive body plethysmograph while ventilated through a tracheostomy. Two and 6 puffs of an aerosol of increasing concentrations (0.05 to 500 micrograms/ml) of acetylcholine were delivered via the tracheostomy. Intravenous acetylcholine was delivered in boluses of 0.1 ml of increasing concentrations (0.5 to 50,000 micrograms/ml) via a catheter in an external jugular vein. Pulmonary resistance (RL), dynamic compliance (Cdyn), and heart rate (HR) were measured at baseline (after aerosolized or intravenous saline) and after each dose of acetylcholine. The peak responses to both inhaled and intravenous acetylcholine were rapid in onset (less than 15 s), short-lived (3 to 4 breaths), and were noncumulative. The baseline RL, Cdyn, and HR were not different in the smoke and air exposure groups. In the intravenous acetylcholine group, there were no differences in RL, Cdyn, and HR responses between the air and smoke exposure groups. In the inhaled acetylcholine group, the dose-response curve was shifted to the left (p less than 0.05) and reached a higher maximal response (p less than 0.01) after smoke exposure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674579 TI - Theophylline absorption from two sustained-release products. Implications for therapeutic drug monitoring. AB - Theophylline absorption from 2 sustained-release theophylline (S-RT) formulations was examined over 2 consecutive days during continuous therapy in 8 clinically stable hospitalized patients with moderate to severe asthma. Theo-24, a formulation intended for once-daily dosing, produced larger fluctuations in serum theophylline concentration (STC) than did twice-daily Theo-Dur (214 +/- 106% versus 89 +/- 33%, p less than 0.02). Bioavailability for both formulations was essentially complete over 2 consecutive study days (95 +/- 22% and 87 +/- 8% for Theo-Dur versus 88 +/- 21% and 87 +/- 24% for Theo-24 on Days 1 and 2, respectively). The time of maximal STC (Tmax) and minimal STC (Tmin) over a 24-h period were relatively predictable for Theo-24 with Tmax 6 to 14 h postdose, and Tmin occurring at the time of dose. However, only Tmax (4 to 10 h post-A.M. dose) was predictable for Theo-Dur. The mean maximal STC over a 24-h period (Cmax) for Theo-Dur was 13.9 (range, 8.9 to 20.7 micrograms/ml), whereas the mean 6-h post AM dose STC was 13.0 (range, 8.0 to 20.7 micrograms/ml), indicating that the STC at this 6-h time point represents a very close estimate of the true Cmax. Similarly, the mean Cmax for Theo-24 was 14.5 (range, 6.2-20.4 micrograms/ml), and the mean 10-h post-dose STC was 13.7 (range, 3.6 to 20.4 micrograms/ml), suggesting that this time point approximates the true Cmax.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674580 TI - Inhaled corticosteroids reduce the severity of bronchial hyperresponsiveness in asthma but oral theophylline does not. AB - In a double-blind crossover study, we compared the relative effects of inhaled beclomethasone dipropionate (BDP) 800 micrograms per day and oral theophylline on the severity of bronchial hyperresponsiveness (BHR) to histamine. Daily doses of theophylline were sufficient to keep serum levels between 55 and 110 mumol/L. The subjects were 26 patients with severe asthma whose symptoms were inadequately controlled by regular treatment with inhaled salbutamol. The severity of BHR improved within 3 wk in the group treated with BDP, whereas no change occurred in the group treated with theophylline. There were no significant changes in FEV1 in either group during the study. When BDP was changed to theophylline there was a deterioration in BHR. Aerosol steroids, rather than theophylline, are the treatment of choice when reduction in the severity of BHR is the aim of treatment in patients with severe asthma. PMID- 3674581 TI - Tuberculosis screening in alcoholics and drug addicts. AB - To ascertain the value of screening for tuberculosis in the New York City (NYC) alcoholic and drug abusing welfare population, 2,641 clients were interviewed, and 970 (36.7%) of them met preestablished criteria for alcohol or drug abuse. The prevalence of active tuberculosis was 0.91%, which is 28 times the age matched NYC rate. Screening only those persons with a positive PPD and a cough substantially increased the yield of active tuberculosis to 7.2%, or 225 times the NYC rate. The prevalence of a positive tuberculin skin test was 32.4%, or 1.5 times greater than the age-matched NYC rate. Treatment or prophylaxis for tuberculosis was required in 128 or 13.2% of the screened population. Seventy thousand NYC welfare clients are routinely evaluated for medical illness each year. This study predicts that in 1 yr this subpopulation could yield 239 clients with active tuberculosis and 3,181 requiring INH prophylaxis. Screening for tuberculosis in the alcoholic and drug abusing welfare clients is therefore urgently recommended. PMID- 3674582 TI - Evidence of a selective major vascular marginal pool of lymphocytes in the lung. AB - The size and mobilization of the pulmonary vascular pool of lymphocytes was studied in young pigs. Blood lymphocytes, labeled in vitro with a fluorescent dye, were injected either intravenously or into the left heart. Comparable high numbers of lymphocytes were found in the lung after 30 min, demonstrating a specific homing of lymphocytes to the lung vascular bed. When the left lung was perfused with a cell-free medium for as long as 4 h in vitro, a continuous venous release of lymphocytes was found that resulted in about 1.5 x 10(9) lymphocytes and 5.7 x 10(6)/min leukocytes. Peripheral blood lymphocytes were labeled with 51Cr in vitro and injected intravenously. Fifteen minutes or 1 day later the lungs were perfused, and the release of cell-bound radioactivity was measured. The data indicate the existence of a large intravascular pulmonary lymphocyte pool. The sequestration of lymphocytes in the lung in many lymphocyte migration studies is not a removal of effete cells but a physiologic phenomenon. PMID- 3674583 TI - The adult respiratory distress syndrome. Cell populations and soluble mediators in the air spaces of patients at high risk. AB - In order to better understand the modulation of polymorphonuclear neutrophil influx into the lung during the development of the adult respiratory distress syndrome (ARDS), we evaluated bronchoalveolar lavage fluids from control subjects (n = 9), patients at high risk of developing ARDS (n = 12), and patients with ARDS (n = 11) for cellular and protein content and capacity to promote neutrophil adhesion to tissue culture plastic. Analysis of the lavage fluids from high risk patients and patients with ARDS showed an 8- to 10-fold increase in the total number of cells, an increase in the percentage of neutrophils present (control subjects = 1 +/- 0.4%, high risk = 53 +/- 8%, ARDS = 70 +/- 7%), and a 10- to 40 fold increase in protein content. The adherence of normal neutrophils to plastic surfaces after pretreatment with either concentrated lavage fluid, ultrafiltrates of BALF, or plasma samples was determined to evaluate the neutrophil adherence promoting activity of each. Lavage fluid from high risk patients and patients with ARDS promoted an approximate 3-fold increase in neutrophil adherence when compared with control lavage fluid. Neutrophil adhesion-promoting activity of the plasma and lavage filtrates (mw less than 500 daltons) was not significantly different from that of control subjects. The adherence-promoting activity found in ARDS lavage was stable at 56 degrees C for 30 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674584 TI - Pulmonary vascular tone improves pulmonary gas exchange in the adult respiratory distress syndrome. AB - Hemodynamics, blood gases, lung mechanics, and the distributions of ventilation perfusion ratios (VA/Q) were studied before and after iv diltiazem, 0.5 mg/kg over 30 min, in 6 patients with pulmonary hypertension secondary to the adult respiratory distress syndrome (ARDS) ventilated with 7 to 20 cm H2O positive end expiratory pressure (PEEP). Diltiazem decreased systemic and pulmonary arterial pressures without changes in cardiac output and in filling pressures of the heart, and with a slowing of heart rate. Pulmonary vascular resistances decreased from 401 +/- 59 to 329 +/- 58 dyne.s.cm-5.m2 (mean +/- SEM), p less than 0.01. Arterial Po2 decreased from 87 +/- 10 to 80 +/- 11 mm Hg (p less than 0.02) without changes in arterial PCO2, mixed venous PO2, and O2 consumption. Lung compliance and airway resistances did not change. Diltiazem increased true shunt from 23 +/- 5 to 30 +/- 7% of total blood flow (p less than 0.02) without other modification in the pattern of VA/Q distribution as measured by the multiple inert gas elimination technique. These results suggest that pulmonary vascular tone contributes to the maintenance of VA/Q matching in patients with ARDS. PMID- 3674585 TI - Crack lung: pulmonary disease caused by cocaine abuse. AB - A patient developed 3 separate episodes of fever, transient pulmonary infiltrates, and bronchospasm after inhalation of cocaine. The illness was associated with eosinophilia, pruritus, and an elevated IgE level, indicating an immunologic pathogenetic mechanism. This is a complication of cocaine abuse not previously reported. PMID- 3674586 TI - Late relapse of desquamative interstitial pneumonia. AB - Late relapse in desquamative interstitial pneumonia (DIP) is poorly documented. We describe 2 cases of relapse after 7 and 12 yr of therapeutic remission. Lung biopsies taken initially and at the time of relapse showed very similar appearances on both occasions, with little increase in fibrosis in the second sample. Patients with DIP in remission should be followed indefinitely. PMID- 3674587 TI - Ventilatory muscle dysfunction in patients with bilateral idiopathic diaphragmatic paralysis: reversal by intermittent external negative pressure ventilation. AB - Bilateral idiopathic diaphragmatic paralysis (BIDP) may result in progressive ventilatory failure. To test the hypothesis that this is in part due to dysfunction of overtaxed inspiratory muscles, we studied 3 patients with BIDP before and after 2, 5, and 18 wk of daily intermittent external surface negative pressure ventilation (ENPV). The patients were evaluated using a zero to 10 functional score (FS) that graded dyspnea, orthopnea, capacity to perform activities of daily living, and ability to work. Pleural (Ppl), abdominal (Pab), and transdiaphragmatic (Pdi) pressures were used as an index of respiratory muscle function. All patients improved their functional score (FS increased 2, 6, and 6, respectively) and their pressure generating ability (Pplmax increased -18, -37, and -46 cm H2O, respectively). Forced vital capacity and functional residual capacity increased in the 2 patients ventilated for longer than 2 wk. These results indicate that ventilatory muscle dysfunction may result from chronic increased work of the inspiratory muscles and that it may improve after periods of intermittent ENPV. This may occur as early as 2 wk after initiation of therapy. PMID- 3674588 TI - Inhalation of road dust by human subjects. AB - We measured pneumomagnetic field strength (PMFS) in 42 healthy control subjects living in districts of Northern Japan with low levels of road dust pollution and in 39 healthy subjects living in areas with high levels of road dust pollution. Suspended road dust produced by studded tires increases from 30 micrograms/m3 during the summer season to levels as high as 400 micrograms/m3 during the snow season in the downtown areas of Sendai, Japan. Road dust retained in the lungs, containing 3% iron, was magnetized from the surface of the chest wall, and PMFS was measured. Three to 5 sequential PMFS measurements were made in each subject in March and October of 1984 and 1985, and in March 1986. The PMFS in control subjects in March 1984 was 37 +/- 14 pico-Tesla (mean +/- SD) and did not significantly differ from the PMFS in October 1984 or that in March 1985. In March 1984, the PMFS of the subjects in highly polluted areas was 95 +/- 100 pico Tesla (mean +/- SD) and was significantly higher than that of control subjects (p less than 0.01) and subsequently decreased in March 1985 and in March 1986, corresponding to a decrease in suspended road dust brought about by a campaign to eliminate the use of studded tires. Our findings suggest that some road dust caused by studded tires is retained in the lungs. PMID- 3674589 TI - Standardization of spirometry--1987 update. Statement of the American Thoracic Society. PMID- 3674590 TI - Single breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique. Statement of the American Thoracic Society. PMID- 3674591 TI - Predicting the lung cancer risk of domestic passive smoking. PMID- 3674592 TI - Nomenclature of mycobacterial disease. PMID- 3674593 TI - Mycobacterium malmoense: mycobacteriologic concerns. PMID- 3674594 TI - Nosocomial pneumonia and sinusitis in intubated intensive care unit patients. PMID- 3674595 TI - Does the histologic appearance at the margin of resection affect the postoperative recurrence rate in Crohn's disease? AB - Is there a role for radical surgery in the management of Crohn's disease or is it feasable to perform limited resections without increasing the risk of recurrence? Fifty eight patients with Crohn's disease underwent resection with subsequent anastomosis. A follow-up of at least 3 years (range, 3-15 years) was undertaken in all cases. All resected specimens at primary surgery were reviewed by one gastrointestinal pathologist to evaluate, retrospectively, the influence of residual microscopic disease at resectional margins on recurrence rate. No statistically significant difference was reported between patients with involved margins and those without such findings as to recurrence rate, interval between primary surgery and reoperation at site of recurrent disease. This review does not provide evidence for adverse influence of residual microscopic disease at the margins of resection. Therefore, limited resection of macroscopically diseased bowel is recommended. One must bear in mind the high rate of recurrence with the necessity of reresection. PMID- 3674596 TI - Nonoperative management of splenic injuries in adults: an alternative in selected patients. AB - Between November 1979 and September 1984, ten adults with documented traumatic injuries of the spleen were treated nonoperatively at The Johns Hopkins Medical Institutions. The mechanisms of injury varied from assaults with a blunt object to a low-velocity motor vehicle accident. Diagnosis was confirmed in all with computed tomography of the abdomen. Seven patients were successfully managed nonoperatively. The hospital course in these seven patients was uncomplicated with a mean hospital stay of 10 days. Three patients underwent splenectomy after failure of nonoperative management; two operations were performed semielectively and one as an emergent procedure. In the latter patient, the diagnosis of splenic rupture was made 7 days after the injury and was not suspected on initial presentation. The limited experience suggests that adults selected for nonoperative management should fulfill certain criteria that include 1) rapid hemodynamic stabilization after fluid resuscitation, 2) lack of other serious intra-abdominal injuries, 3) lack of extra-abdominal trauma that requires a prolonged general anesthetic or that results in an altered state of consciousness, and 4) progressive symptomatic improvement early during the hospitalization. Patients involved in high-speed motor vehicle accidents should not be considered as candidates because of the high prevalence of other serious injuries. From these guidelines, the results support the concept of nonoperative management of selected adults with splenic injury. PMID- 3674597 TI - Incidental appendectomy with cholecystectomy: is the increased risk justified? AB - To evaluate the advisability of incidental appendectomy relative to patient age, a retrospective chart review of 905 patients undergoing elective cholecystectomy between 1979 and 1983 was undertaken. A total 377 of these patients underwent incidental appendectomy. The overall complication rate in the two groups was the same. Wound infection occurred in 1.5 per cent of patients undergoing cholecystectomy alone, compared with 3.7 per cent in those patients undergoing incidental appendectomy as well. Patients over the age of 50 who underwent incidental appendectomy had a wound infection rate of 5.9 per cent, compared with 0.9 per cent in those patients over 50 who underwent cholecystectomy alone, a difference found to be statistically significant (P less than .05). Therefore, incidental appendectomy cannot be recommended for patients over the age of 50. PMID- 3674598 TI - Choledochoscopy in prevention of retained common bile duct stones. AB - More than 150,000 patients undergo exploration of the common bile duct each year in the United States, and approximately 10 per cent of these patients are later found to have retained common bile duct stones. The usual recommended procedure to decrease the incidence of retained calculi is a more complete exploration of the common duct at time of initial operation. It is thought that the incidence of retained common bile duct stones can be decreased and almost eliminated with proper use of the flexible choledochoscope following intraoperative cystic duct cholangiogram. The technical aspects of choledochoscopy are reviewed and experience with its use in 102 cases between July 1978 and October 1985 is reported. There were no residual stones in the span of the study using the flexible choledochoscope as a routine procedure in common bile duct exploration. PMID- 3674599 TI - The role of percutaneous transhepatic internal biliary drainage in preoperative patients. AB - Routine percutaneous transhepatic drainage (PTD) has been recommended for minimizing morbidity after operations for obstructive jaundice. This approach assumes that early complications of PTD are rare or insignificant. It has also been suggested that internal (transsphincteric) drainage is superior to external drainage. To assess its safety, a consecutive series of 18 patients in whom PTD was performed prior to definitive operations for obstructive jaundice was reviewed. Internal biliary drainage was attempted in every instance. The biliary system was successfully cannulated in 100 per cent and the drainage catheter was passed into the duodenum in 16 patients (88%). Five patients (28%) had serious complications of PTD requiring emergency operations; three died. Complications after internal PTD were no rarer or less serious than those after transhepatic cholangiography without drainage. We recommend early surgical exploration once the site of complete biliary obstruction is demonstrated by cholangiography. PMID- 3674600 TI - Perianal suppuration: results of treatment. AB - Perianal suppuration (PAS) is a common surgical problem that is frequently treated inadequately. A series of 101 patients with PAS was reviewed. Thirty-six patients had a history of PAS. Fifty patients had drainage of a perianal abscess; six patients developed fistulas in ano and in two recurrent abscess developed (total, 16%). Thirty-six patients had fistulotomy for established anal fistula: three patients (8%) had recurrent fistulas. Fifteen patients had single-stage drainage of abscess and fistulotomy, and none had recurrent or residual PAS. All patients ultimately achieved healing. These results illustrate the fact that satisfactory results in the treatment of PAS can be obtained by surgeons if established principles of treatment are observed. PMID- 3674601 TI - The malpositioned Greenfield filter: lessons learned. AB - It is essential that a malpositioned Greenfield filter be recognized as such immediately. Three of the 21 Greenfield filters inserted in the current study were malpositioned. One was placed in the right renal vein, one in the right common iliac vein, and another in the right inferior vena cava in a patient with caval duplication and left ileofemoral thrombosis. A review of the postprocedure radiographs was performed. It was found that two of the three malpositioned filters were at an appropriate vertebral level, and, therefore, this single criteria was inadequate to judge proper filter positioning. A more reliable parameter was the maximal diameter of the open legs of the filter. The mean diameter of the legs in the correctly positioned filters was 29.9 mm compared with 19.0 mm for the malpositioned filters. The authors recommend that the diameter of the filter legs be measured on all postprocedure radiographs. If this diameter is not 30 +/- 4 mm (two standard deviations), then malposition of the filter should be suspected, regardless of the vertebral level at which the filter lies. PMID- 3674602 TI - Role of antibiotic prophylaxis in surgery for nonperforated appendicitis. AB - This report examines the efficacy of preoperative antibiotics in cases of nonperforated appendicitis. The charts of 61 patients who had an operative and pathologic diagnosis of acute nonperforated appendicitis were reviewed. Thirty one patients received preoperative cephalosporins, and in one patient (3.2%) a subsequent wound infection developed. Of 30 patients who did not receive preoperative antibiotics, four (13.2%) patients developed septic complications. The difference in postoperative septic complications between these groups is not statistically significant (P = .3310). Preoperative prophylaxis with cephalosporins in cases of nonperforated appendicitis is not indicated. PMID- 3674603 TI - Reconstruction of full-thickness defects of the cheek in cancer surgery. AB - Two techniques are presented that can be used for reconstruction of full thickness defects of the cheek. Defects involving a small area of mucosa can be reconstructed with an anteriorly based neck-pectoral skin flap in combination with primary closure of the mucosa. Defects involving a large part of the mucosa can be managed with a deltopectoral flap in combination with a pectoralis major myocutaneous flap. The two techniques have been applied with satisfactory results in a group of patients with neoplasms of the cheek. PMID- 3674604 TI - Liver abscess. Review of a 12-year experience. AB - Experience with liver abscess was reviewed to determine whether new trends in treatment have altered clinical outcome. Thirty-one cases of liver abscess were identified from 1973 to 1985. In this group there were ten deaths for a mortality rate of 32 per cent; the primary disease accounted for seven deaths. Significant predictors of liver abscess mortality were multiple abscesses, elevated bilirubin levels, and underlying disease. Percutaneous drainage was effective in three of four patients and should be attempted before operative intervention in selected patients. PMID- 3674605 TI - Rapid diagnosis of Candida sepsis in surgical patients. AB - Systemic candidiasis, an increasingly common disease, is associated with an extremely high mortality. Because of toxicity associated with amphotericin B therapy, clinicians are reluctant to initiate therapy until the presence of candidiasis is conclusively demonstrated. Using culture methods, such proof may not be forthcoming or may be available only late in the course of the disease. During the last 17 months, a new antigen latex agglutination test for candidiasis has been evaluated. Results indicate that this new test allows early, accurate diagnosis of the disease. In 36 consecutive cases of culture-proven candidiasis in surgical patients, the test was found to be 94.4 per cent sensitive and 100 per cent specific. On the basis of these findings initiation of amphotericin B therapy in patients with a positive Candida antigen titer is recommended. PMID- 3674606 TI - Device to aid in exposure for liver resections. PMID- 3674607 TI - Technique for placement of peritoneovenous shunts in presence of abdominal adhesions. AB - Abdominal adhesions may cause kinking of the peritoneal limb of peritoneovenous shunts during placement. Use of a stylet in the peritoneal limb can facilitate placement and avoid kinking that could lead to shunt dysfunction. PMID- 3674608 TI - The superior laryngeal nerve in thyroidectomy. AB - In a clinical prospective study, three cases of superior laryngeal nerve injury were detected after 54 classical high ligations of the superior thyroid artery. On the contrary no injury of the nerve was noted in 227 cases in which the technique of separate ligation of the superior thyroid artery's branches was used. Voice changes secondary to thyroid gland operations, without injury to the recurrent laryngeal nerve, are commonly attributed to laryngeal trauma or tracheitis. This view does not seem to be entirely true, because voice changes can follow injury to the external branch of the superior laryngeal nerve. The current study was undertaken to give a better insight to the problem on injury to the external branch of the superior laryngeal nerve during superior thyroid artery ligation and to evaluate for this purpose a technique of separate ligation of the superior thyroid artery's branches during thyroidectomy. PMID- 3674609 TI - Endoscopic sphincterotomy and removal of pancreatic duct stones. AB - Chronic pancreatitis may be associated with pancreatic duct dilatation and ductal stones. Such stones are undoubtedly the result of chronic pancreatitis and stasis within the ductal system and may themselves serve to exacerbate ductal obstruction and recurrent episodes of pancreatitis. Endoscopic sphincterotomy has been used to relieve common duct obstruction secondary to biliary stones. This report suggests that sphincterotomy may also be used to approach selected patients who have pancreatic duct stones and recurrent pancreatitis. The technique involves a preliminary ERCP followed by standard endoscopic sphincterotomy with the papillatome positioned in the bile duct. A balloon catheter is then directed into the pancreatic duct orifice to extract ductal calculi. Although the main duct may be cleared, side branches are more difficult, and perhaps unnecessary, to clear. This method has provided relief of pain in a limited series of patients and may mark the beginning of a more aggressive approach to pancreatic endoscopy. PMID- 3674610 TI - Synthesis of new N-alkyl-2-mercapto-1-octylamines and respective disulfides. AB - Four new N-alkyl-2-mercapto-1-octylamine hydrochlorides were synthesized via the reaction of 1,2-epithio-octane with corresponding amines following by conversion to the hydrochlorides. The disulfides were obtained by oxidation of the respective thiols. Upon biological assay of the products for activity against infection by Schistosoma mansoni, only 2,2'-dithiobis(N-isobutyl-1-octylamine) exhibited activity. PMID- 3674611 TI - [Degradation of the insecticide parathion in soil]. AB - Degradation of the insecticide Parathion in four types of soil from the Northeast of Brazil has been studied using radiometric techniques. In all the soil samples, sterilized or not, metabolites were detected with Rf values of 0.00 and 0.17 respectively--Silica Gel 60 F254 tlc plates (Merck); solvent system: hexane acetone (4:1, v/v)--. However, 14CO2 was formed only with the non-sterilized soils and this was independent of the use or not of organic fertilizer. These results suggest that the two metabolites, mentioned above, are formed by a predominantly non-biological pathway, where as the formation of carbon dioxide requires the participation of the microbial flora of the soil. Analysis of the interaction of 14C-Parathion with soils shows that the extent of degradation of this insecticide is modified by adsorption on the soil particles. PMID- 3674612 TI - [Effects of atrial paroxysmal tachycardia, experimentally induced, on renal function in the dog]. PMID- 3674613 TI - [Acute disseminated cryptococcosis disclosing AIDS]. PMID- 3674614 TI - [Pulmonary arterial hypertension disclosing liver cirrhosis]. PMID- 3674615 TI - [Current prognosis of multiple myeloma with renal failure]. PMID- 3674616 TI - [Role of bone scintigraphy in small tumors of the breast (T less than 2-3 cm). Preliminary results]. PMID- 3674618 TI - [Pulmonary nocardiosis with acute development. 2 cases diagnosed by bronchial fiberscopy. Cure under treatment]. PMID- 3674619 TI - [Clinical and immunological abnormalities in heroin addicts with anti-HIV antibodies]. PMID- 3674617 TI - [Chronic nasofacial ulceration disclosing muco-cutaneous leishmaniasis]. PMID- 3674620 TI - [Systematic psychiatry or 35 years of hospital clinical research]. AB - In an ere in which man is beginning to master and make his way into the various systems which surround him (atom, cosmic exploration, organ transplant, genetic manipulations...), a clinical practice which would remain centered on the various forms and apparent characteristics of psychic dysfunctioning, has become anachronical. Since 35 years, the author has been trying to introduce gradually within psychiatry, specific processes which would confer to it more scientific status. The disentanglement from traditional clinical practice, made easier by the fact of working in the open department of a general hospital as well as the perfecting of an adequate method structurating observation with modern logical mathematic notions, enabled him to elaborate a new clinical psychiatry, open to present techniques and more strict interdisciplinary research. The chronological account of the steps which have been taken allows a simplified synthesis of this new psychiatry. PMID- 3674621 TI - [Mental disorders caused by hypothalamic hamartomas. Apropos of a case report]. PMID- 3674622 TI - ["The creation of man". Paranoid graphic-pictorial production]. PMID- 3674623 TI - [Manic-depressive psychosis and transmission of Glanzmann-Naegeli thrombasthenia]. PMID- 3674624 TI - [The dexamethasone test today. Results in 68 depressed patients]. PMID- 3674625 TI - [The dexamethasone test today. Discussion, critique and reflexions on the place and significance of the test in psychiatry]. PMID- 3674626 TI - [A language for the psychotic deaf and their families]. AB - Deafness and psychosis are two, among the processus of recoiling from the world, where the human being's incommunicability is in question. The extreme pathology which associates them forces to establish links for the first contact with the deaf and psychotic child. Hearing means more than what the ears filter. The denial or forclosure of the uttered words is part of a psychological deafness among families and doctors. The child also plays the sense of hearing. PMID- 3674627 TI - [Accounting failures in public officials or notaries. Medico-legal approach]. AB - Considering 11 cases of psychiatric expert reports in criminal cases, the author's aim is to describe the criminological aspects of offences by notaries, mainly swindle and breach of trust. It appears that can be found in this professional category, personality types already described for "closely acquainted", or business crooks, as well as four obviously pathological cases, coming within the provisions of article 64 of the criminal code. Beyond the fact that there is a specific pre-criminal situation: dealing with contracts, assets, funds etc... the authors notices in several cases a discrepancy between the weak and immature personality of some notaries and the importance of the office with which they are entrusted. Thus the requirement of ability and sufficient professional qualification was not always met. The authors would be interested in further similar observations, to confirm or infirm their conclusions. PMID- 3674628 TI - [Diagnosis and taxonomy of periodical psychosis]. AB - The concept and taxonomy of periodic psychosis still remains in controversy for the past 100 years. In China, it was first reported by Ji, and thereafter various rinds of terminology and views were given by different authors. In the presentation, clinical investigation and follow up were carried out in 62 cases. In many of these cases, the so-called "periodic psychosis" or "phasophrenia" was early clinical features of schizophrenia or manic-depression. In those cases with apparent symptoms and signs of diencephalic function, differential diagnosis should be carried out from organic brain syndrome. In a small number of cases, their clinical manifestations, conforming to previous diagnostic criteria, might be an uncommon syndrome. It was concluded by the authors that until now periodic could be considered only as a clinical syndrome rather than a disease entity. PMID- 3674629 TI - [Forgetting learning]. PMID- 3674630 TI - [Treatment of opiate weaning by clonidine in prison (evaluation based on 36 patients)]. AB - The authors have used Clonidine for withdrawal from opiates of prisoners. About detoxification of 36 men entering into prison and published studies, they show that Clonidine is an efficacy and safe treatment. Clonidine induced hypotensia is not considered problematic. PMID- 3674631 TI - [The wordless story from institution obsession to hysteria passion]. AB - Silence and immobility: mutism and catatonia, this patient gives nothing to to hear, he gives to see. Could the catatonia concept, usually used for schizophrenic psychosis and primitively described by Kahlbaum in 1874, be used for neurosis? PMID- 3674632 TI - [Giant cell tumors of maxilla]. AB - Ten cases of giant cell tumor of maxilla are reported, the patients being children or young adults and of principally female sex. In three cases another affection was associated: Recklinghausen's disease, Francescatti syndrome and hyperthyroidism of adenomatous origin. Histology of all tumors was similar: giant cells, fibroblastic tissue and numerous vessels: the course was benign in all cases with frequent recurrences but no metastases. The pathology of these tumors is still the subject of wide debate, although research is extensive in this field: electron microscopy, histoenzymology, monoclonal antibodies are some aspects studied but results have sofar failed to elucidate the true nature and histoprognosis of these tumors. PMID- 3674633 TI - [Functional surgery in cancer of the laryngeal vestibule. Apropos of 149 cases treated at the Institut Gustave-Roussy]. AB - Functional surgery for treatment of 149 cases of cancer of vestibule of larynx admitted to the Institut Gustave-Roussy, Paris, included 92 supraglottic horizontal laryngectomies and 57 reconstructive subtotal laryngectomies with crico-hyoidopexy. General selection criteria for performing subtotal laryngectomy were very strict: local criteria included tumor of vestibule with possible extension to ventricle, to an arytenoid cartilage or to the HTE space, and regional criteria, more particularly, required absence of any palpable gland or mobile gland of less than 2.5 cm. This rigorous selection explains excellent carcinologic results: 90.8% survival after 5 years following subtotal laryngectomy as against 37.9% after supraglottic horizontal laryngectomy, equivalent to a survival rate for all cases of cancer of vestibule of larynx treated by functional surgery of 65% at 3 years and 58% at 5 years. PMID- 3674634 TI - [Cancer of the valleculal and laryngeal vestibule treated by supraglottic horizontal laryngectomy. Apropos of 173 surgically treated cases at the Institut Gustave-Roussy]. AB - The authors make a report on a series of 173 supraglottal horizontal laryngectomies carried out from 1970 to 1984 at the Gustave-Roussy Institute of Villejuif. After recalling of operability conditions and tackling characteristics of this series are quoted variants required from tumours localisations diversity and importance of extension. Then are treated clinical and anatomo-pathological classification as briefly surgeries results. This work is specially concerning in survival by analysing different topographical clinical and histological criteria. Survival of 173 patients, having gone through an supra-glottal laryngectomy is 45.5% at 3 years and 31.3% at 5 years. At least, reasons of failure are analysed. This kind of partial surgery caring of voice, should be proposed to patients affected by vallecula or epiglottis carcinomas as regards of good functional and improved carcinological results. PMID- 3674635 TI - [Frontal anterior laryngectomy with sliding epiglottoplasty. Tucker's operation. Indications. Technic and results]. PMID- 3674636 TI - [Reconstructive laryngectomies. Technical and functional aspects]. AB - Technical aspects are described of the reconstructive laryngectomy used between 1982 and 1986 to treat 59 patients with endolaryngeal epidermoid carcinoma. Both "conservative" techniques (Tucker's laryngectomy, total endolaryngeal functional evidement) and "non-conservative" techniques (cricohyoidopexy, cricohyoidoepiglottopexy, cricobasiglossopexy) as well as their functional outcome are described. Results of surgical review of endolaryngeal spaces (paraglottic space, hyothyroepiglottic space) are analyzed for each method, and a schema for their use proposed. PMID- 3674637 TI - [Extracartilaginous glottectomy. Operative technic, indications and results]. AB - Cancer developing on a chronic laryngitis or bilateral superficial cancer of vocal cords still pose management problems to surgeons. Double cordectomy presents the inconvenience of opening the larynx in the median line and the need for insertion of a dilating piece removed during a second stage. These disadvantages can be avoided by an extracartilaginous glottectomy by median opening of thyroid cartilage, monoblock ablation of both vocal cords and immediate closure of larynx by lowering of ventricular bands. A wide larynx is obtained with a loud but veiled voice. PMID- 3674638 TI - [Ossiculoplasty. Trial of comparison of different mountings]. AB - Functional results of tympanoplasty are partly dependent on the ossiculoplasty phase. Based on results of 331 operations using the closed technique, statistical differences were evaluated between several classical ossicular buildings carried out essentially with homograft ossicles. The study involved assessment of postoperative audiograms practised under identical conditions, patients with anatomical failure being excluded. In type II cases, the different drum to stapes mountings tried gave better results than "malleus to stapes" mountings. In type III cases the difference was not significant. In all cases, results were significantly better when ossiculoplasty was performed during the second look. PMID- 3674639 TI - [Use of coral implants in maxillofacial and otorhinolaryngologic surgery]. AB - The coral, as bio-compatible implant, has been used in several indications: in Otology: for ossicular chain and external auditory canal reconstruction. In Maxillo-facial surgery: for orbital floor, maxillary sinus and jawbone reconstruction. The first results of this study are favorable but coral resorption might be prevent by a careful sealing of the implant deep under the surface layer. PMID- 3674641 TI - [Lyme disease, an infectious cause of facial paralysis. Apropos of a case]. AB - A case of facial palsy first unilateral then bilateral, due to Lyme disease, is reported. This disease, transmitted by ticks, is caused by a spirochete (Borrelia burgdorferi) known as the etiologic agent since 1982. PMID- 3674640 TI - [Surgery of the tip of nose. Which approach to choose?]. AB - The indications of the different surgical approaches of the alar cartilages for a rational nasal tip correction are given on the basis of their respective advantages and disadvantages. PMID- 3674643 TI - Acquired subglottic stenosis in children. AB - Subglottic stenosis is a disorder characterized by narrowing of the airway below the glottis or apposing edges of the true vocal cords. In a broad definition, the term may be used to describe airway compromise in the regions of the larynx or the trachea or both. In children, the stenosis is usually due to scar formation secondary to prolonged airway intubation, rather than to external trauma. The location and extent of the stenosis are highly variable; consequently, corrective measures need to be selected to suit the individual problem. In the present series of children, conservative treatment was adequate for lesser degrees of stenosis; those with more severe scarring required external laryngeal surgery. The preoperative evaluation and treatment plans are reviewed. PMID- 3674642 TI - Histochemical study of posterior cricoarytenoid muscle reinnervation by a nerve muscle pedicle in the cat. AB - Reinnervation of the posterior cricoarytenoid (PCA) muscle with a nerve-muscle pedicle (NMP) has been proposed for patients with bilateral abductor vocal cord paralysis. Since its success has been controversial, a glycogen depletion histochemical technique was used to examine reinnervation. An ansa cervicalis NMP was implanted into the denervated PCA in nine cats. Eight months later, vocal cord activity was evaluated. The NMP nerve was stimulated extensively in seven cats (experimental group). Optical densities of NMP-supplied PCA muscle fibers from experimental and control groups were compared to detect differences in glycogen content. The results demonstrated quantitative evidence of reinnervation in two experimental animals. Electrical stimulation of the NMP produced abduction in one of these two animals, but was never observed during spontaneous respiration or airway occlusion. These observations indicate that reinnervation can occur but abduction requires electrical stimulation. The NMP technique may be more successful with an electrical pacer. PMID- 3674644 TI - Phonatory effects of thyroid cartilage fractures. AB - Blunt trauma can cause a wide range of injuries to the cartilaginous framework of the larynx. The severity of injury that is required to cause a permanent disorder of vocal function if left untreated has not been defined. A study using excised canine and human larynges was undertaken to identify the effects of minimal displacement or malalignment in simulated thyroid cartilage fractures on selected voice production measurements. These fractures were found to cause changes in glottal configuration sufficient to affect glottal resistance as well as amplitude and noise content of the voice signal produced by each larynx. Therefore, relatively minor injuries of the thyroid cartilage may cause potentially serious disorders of phonation. PMID- 3674645 TI - Congenital laryngeal anomalies associated with tracheal agenesis. AB - Forty-eight cases of tracheal agenesis have been reported to date. Previous authors have studied gross postmortem laryngeal specimens. Of 37 cases wherein laryngeal findings were mentioned, only 14 were reported to be abnormal. This report details two more cases of tracheal agenesis and includes a detailed histopathologic study of the laryngeal anomalies by serial horizontal section. Although one of these specimens appeared normal at autopsy, both were found to have several abnormalities when studied microscopically in horizontal section. Both have an elliptical cricoid cartilage, an abnormality originally discovered by one of us (G.F.T.) using the same technique. PMID- 3674646 TI - Adjunctive measures for successful laryngotracheal reconstruction. AB - The field of reconstructive surgery of the laryngotracheal complex has been the object of considerable enthusiasm in recent years. New surgical techniques, better surgical tools, and improved diagnostic skills all have contributed to a more confident approach to severe laryngotracheal stenosis. Just as the surgeon's judgment is crucial for a successful primary laryngotracheal reconstruction, so are his or her skill and judgment vitally important in managing the various problems that frequently are found following reconstructive surgery of the larynx and trachea. These problems, although seemingly minor, may prevent successful decannulation if not managed appropriately. This paper discusses the various problems that have been encountered while achieving decannulation following laryngotracheal reconstruction. An approach to such frustrating problems as suprastomal collapse, granulation tissue, and the inability to decannulate are presented. PMID- 3674647 TI - Correlation of tumor volume with local control in laryngeal carcinoma treated by radiotherapy. AB - An analysis of 37 patients with laryngeal carcinoma (T2 or greater) treated with radical radiotherapy, with surgery reserved for failure, was performed to determine if tumor volume, alone or in association with other prognostic factors, accurately predicted the probability of local control. Patient records were reviewed retrospectively and the following data extracted: age, sex, laryngeal region and number of sites involved by tumor, T and N categories, and success or failure of radiotherapy. Tumor volume for each patient was calculated from pretreatment computed tomograms by summing the products of the cross-sectional tumor area on each CT cut and the interval in millimeters between sequential CT cuts. The mean tumor volume for patients failing radiotherapy was 21.8 cm3, and the mean volume for patients primarily controlled by radiotherapy was 8.86 cm3. Tumor volume significantly predicted disease-free interval (p = .045) and outcome with radiotherapy (p = .02). The study suggests that tumor volume is a significant factor in determining the outcome of primary radiotherapy in advanced laryngeal carcinoma. PMID- 3674648 TI - Telescopic endolaryngeal surgery. AB - Magnification for endolaryngeal visualization, biopsy, and removal of benign lesions and carcinoma in situ is achieved using a telescope inserted in stripping type forceps. The combined telescope and forceps are passed easily through any standard laryngoscope with a holder. Excellent visualization is achieved through the telescope, which can be provided with 0 degree, 30 degree, or 70 degree optics. In most circumstances, these instruments obviate the use of the operating microscope, being simpler and just as exact. The field of vision, however, is smaller. The instruments are also ideal for cervical tracheoscopy and mediastinoscopy. PMID- 3674649 TI - Unusual pharyngeal lesion causing dysphagia. AB - A 58-year-old man was evaluated for a 42-year complaint of a pharyngeal foreign body sensation whenever he ate. Examination revealed normal anatomy at rest but diffuse hypopharyngeal distension with Valsalva's maneuver. His past history was remarkable for an infectious illness, possibly diphtheria. We speculate that this unusual case most likely represents a postdiphtheritic selective pharyngeal paralysis and present his case, radiographic findings, and a discussion of the differential diagnosis. PMID- 3674650 TI - Vocal nodules in children. AB - We reviewed 27 pediatric patients who had vocal nodules removed surgically in a 5 year period. Age of operation, duration of symptoms, indications for operation, and the results of removal are analyzed. The techniques of laryngoscopic assessment with telescopes and of microsurgical removal are described in detail. The 27 children had 53 nodules removed. Almost all had normal or improved voices as judged by the parents' answers to a written questionnaire. From the results of this series, microsurgical removal of vocal nodules in children is justified in selected patients. PMID- 3674651 TI - Phonatory airflow analysis in patients with laryngeal disease. AB - Phonatory airflow was recorded in 150 patients with various laryngeal diseases and in 60 persons with normal voices. All subjects produced several sustained vowels at different loudness levels. Disturbances of voice due to laryngeal disease may be manifested as variations of mean flow (DC), alternating flow (AC), or as a variation in the amplitude of the frequency components of the airflow signal (frequency spectra). The quantification of airflow characteristics is important if the clinician is to have a better understanding of laryngeal disease. Furthermore, preoperative and postoperative analysis can serve to document therapeutic effectiveness. PMID- 3674652 TI - Laser resection for early oral cavity cancer. Results and complications. AB - Laser excision of early selected cancers of the oral cavity and pharynx is a well accepted and reported treatment. Postoperative radiation therapy is employed in patients with unfavorable pathologic findings and in patients expected to have a high recurrence and metastatic rate. In most patients the combination of laser excision and postoperative radiation therapy is well tolerated and results in satisfactory healing, excellent tumor control, and high-level posttreatment function. This report discusses the treatment and results in 28 patients treated for early cancer of the oral cavity and pharynx. The local control rate of 77% compares favorably with the reported results following either conventional or laser excision of these lesions. The overall complication rate was 39%, with a 25% rate for patients not receiving postoperative radiation therapy, and a 58% complication rate for patients treated with postoperative radiation. PMID- 3674653 TI - Management of patients with long-term tracheotomies and aspiration. AB - The purpose of this study was to develop a management protocol for patients with long-term tracheotomies and aspiration, in order to develop clinical criteria for extubation and reduction of aspiration-related complications. We studied 39 patients with tracheotomies in place for over 3 months, 28 of whom completed management. Patients were classified according to degree of impairment and managed with the aims of avoiding aspiration and performing extubation whenever feasible. Criteria for choosing various management strategies are presented. PMID- 3674654 TI - Conradi-Hunerman syndrome. Case report. AB - Conradi-Hunerman syndrome, a variant of chondrodysplasia punctata, rarely presents with primary manifestations relevant to the head and neck surgeon. Usually, the disease is evidenced by malformation of the extremities, cataracts, cutaneous lesions, and an unusual facies. We have followed a child with Conradi Hunerman syndrome for 7 years whose primary manifestation of the disease is respiratory compromise secondary to calcification of the laryngotracheobronchial tree. In addition, he has a conductive hearing loss thought to be secondary to ossicular chain fixation. PMID- 3674655 TI - Human speech development for an implantable artificial larynx. AB - An electromagnetic artificial larynx was implanted in two volunteer laryngectomees. Both patients were able to communicate well, but the voice quality still needed improving. Therefore, in this investigation, listener judgments were obtained of 22 different sound sources with a view to incorporating the preferred speech sound in a new version of the device. Electroglottograms were used as sound sources in a speech synthesizer and sentences were produced with different voice qualities for judgmental tests. The results of the listening tests showed a distinct preference for waveforms corresponding to a long completely open phase, a very brief completely closed phase, and an abrupt closing gesture. The optimum acoustic characteristics for the device will be used by electrical engineers to manufacture a new version of the artificial larynx with an improved voice quality. PMID- 3674656 TI - Selection of video cameras for stroboscopic videolaryngoscopy. AB - Stroboscopic evaluation for the analysis of laryngeal function and disease has been reemphasized recently and its routine clinical use recommended. Many have found, however, that it is not always possible to obtain consistently satisfactory video images of stroboscopic laryngoscopy. The problem is related to the low intensity of the xenon light source during stroboscopy. The authors have tried many different video cameras available, along with the Bruel & Kjaer Rhino Larynx Stroboscope type 4914, and two types of endoscopes (flexible and rigid). The cameras included 1) single tube camera, 2) single chip metal oxide semiconductors (MOS) solid-state camera, 3) single chip charge-coupled devices (CCD) solid-state camera, 4) three-tube camera, and 5) three-chip CCD camera. Currently available video cameras and their adaptability for stroboscopic videolaryngoscopy are discussed. PMID- 3674657 TI - Vocal function following hemilaryngectomy. AB - Vocal function following hemilaryngectomy was investigated in 54 cases in which a superiorly based sternohyoid muscle flap was used for glottic reconstruction. Four types of material were employed for covering the muscle flap: hypopharyngeal mucosa, lip mucosa, thyroid perichondrium, and island cervical skin flap. The vocal function varied greatly from individual to individual; however, the following tendencies were observed in many cases: 1) the glottis did not close completely; 2) supraglottic structures (false fold, arytenoid region, and epiglottis) were hyperfunctional and vibrated instead of or together with the unaffected vocal fold; 3) vibrations of the laryngeal structures were irregular; 4) maximum phonation time was short; 5) mean airflow rate was high; 6) fundamental frequency and intensity ranges of phonation were limited; 7) the voice was rough, breathy, and/or strained; and 8) cases with poor vocal function were most frequent in the skin flap group and least frequent in the lip mucosa group. PMID- 3674658 TI - Vocal ligametry. Update. AB - In 1983, a report was made concerning experience with a technique of vocal ligament tightening in certain cases of dysphonia due to the ligament's stretching or lengthening. Since that time, efforts to measure the relative slackness or loss of tension of the vocal ligament have been partially successful. This report addresses the topics of consent forms; review of the local board of human procedures; and technical problems of instrument design, fabrication, and calibration. A large data base will be needed before true usefulness can be derived from these efforts. The author hopes to stimulate other workers in the field of phonosurgery to parallel these efforts and explore a field that is still relatively uncharted. PMID- 3674659 TI - Side effects and toxicity of interferon in the treatment of recurrent respiratory papillomatosis. AB - Twenty-six patients with recurrent respiratory papillomatosis have received interferon administered according to one or more of five experimental protocols currently ongoing or completed at the University of Iowa. Short-term side effects following interferon administration were common and included fever, headache, chills, fatigue, myalgias, and nausea. Two patients experienced neurotoxicity manifested as somnolence, confusion, or petit mal type or grand mal type seizures. Preliminary data show evidence for some growth retardation in patients receiving long-term interferon therapy. Laboratory evidence of toxicity in the form of decreased WBC, RBC, and platelet counts occurred in five patients, and increased liver enzymes occurred in 16 patients. Neither cardiovascular nor renal toxicity was noted. PMID- 3674661 TI - Myxomas of soft tissues and the facial skeleton. AB - Myxomas in the head and neck may be intraosseous or in soft tissues. In each site, their microscopic appearance and biologic activity are similar. Recurrences of myxomas are more the consequence of incomplete excision than intrinsic aggressiveness. PMID- 3674660 TI - Nasopharyngeal carcinoma: the Dana-Farber Cancer Institute experience with 24 patients treated with induction chemotherapy and radiotherapy. AB - Nasopharyngeal carcinoma traditionally has been treated with radiotherapy alone. Although the probability of cure for patients with stage I and II nasopharyngeal carcinoma is high, the probability of cure for patients with stage III and IV disease is poor because of a higher rate of local-regional and distant failure. Between February 1981 and August 1986, 24 patients with previously untreated, stage IV nasopharyngeal carcinoma were treated with two to four monthly courses of cisplatin-based combination chemotherapy prior to radiotherapy. A response to induction chemotherapy was recorded in 75% of patients (29% complete response and 46% partial) prior to radiotherapy. By actuarial estimate with a median follow-up of 42 months, the 2-year failure-free survival for all patients was 57%. In conclusion, induction chemotherapy has significant activity in nasopharyngeal carcinoma. The toxicity of this approach, as well as the influence of initial histopathology and response to chemotherapy on survival, will be discussed. PMID- 3674662 TI - Computed tomography of the ethmoid labyrinth. PMID- 3674663 TI - [Origin of macular amyloidosis. Apropos of 160 cases]. AB - This study is based on clinical findings in 160 patients with skin-limited amyloidosis: 151 macular, 8 biphasic and 1 lichen amyloidosis. 82.5 p. 100 of the patients were women and 17.5 p. 100 were men. 95 p. 100 of the patches were located in the back and 64 p. 100 in the suprascapular region. No less than 88 p. 100 of the patients had pruritus on the patches or on other sites. 75 p. 100 had allergic diseases or a history of allergy, and 45 p. 100 had non-allergic pruriginous diseases. Signs of scratching were noted in most of the patients. The principal causes of pruritus were dermographism, photodermatitis and dermatitis. Macular amyloidosis is now considered as secondary to scratching motivated by pruriginous diseases and not as a primary condition as hitherto described. The term "scratch amyloidosis" is proposed for macular and lichenoid amyloidosis, and the existence of a "preamyloidotic" histological stage is described. PMID- 3674664 TI - [Prevention of decubitus ulcer by an elastomere matrix cushion]. AB - We have measured and compared the mechanical properties of the skin, muscles and of a cushion designed to prevent bedsores. The mechanical properties of the tested material are intermediate to those of skin and muscles. They permit an even and optimal distribution of the pressures on the skin. PMID- 3674665 TI - [Clinical and mycological study of 11 cases of genitopubic trichosporosis nodosa (white piedra)]. AB - Piedra (stone in Spanish) is the name given to a trichomycosis characterized by the formation of nodules resembling small stones. There are two varieties of the disease, depending on the colour of the nodules: white piedra and black piedra. Black piedra sharply differs from white piedra on three main scores: a) the causative agent is a black filamentous and sexed dematicious fungus, Piedraia hortai; b) the disease exclusively affects the scalp, and c) the geographical distribution of human black piedra is limited to tropical and subtropical areas (South America, South-East Asia). White piedra has a different aetiology, being caused by an asexual fungus, Trichosporon beigeli. The genus Trichosporon (Behrend, 1890) and the species T. beigeli (Vuillemin, 1902) were created from a case of piedra of the moustache. White piedra may involve hairy regions other than the scalp, such as the beard and moustache, less frequently the armpits, eyebrows, eyelashes and pubic hair. The disease has been observed in all continents, except Africa, and under all climates, although it is exceptionally found in cold areas (two indigenous cases in Finland). The observatio princeps of white piedra (on a false chignon) was published in 1865 by Beigel, in London. In France, only three cases, all concerning the moustache, were reported at the very beginning of this century No other case has been published in that country in the east 80 years. T. beigeli is a common saprophyte in nature. It has been found in soil, water, fruit, rotten vegetables, sawdust, as well as in man (skin, skin appendages, mucosae) and in animals (mammals, insects, mussels).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674666 TI - [Nevus (hamartoma) of the musculus arrector pili]. PMID- 3674667 TI - [Squamous cell epithelioma on a leg ulcer in Werner's syndrome]. PMID- 3674668 TI - [Mesotherapy and cutaneous mycobacteriosis caused by Mycobacterium fortuitum: alternative medicine at risk]. PMID- 3674669 TI - [Photochemotherapy of eyelid lesions]. PMID- 3674670 TI - [Reynolds' syndrome: the combination of scleroderma of CREST syndrome type and primary biliary cirrhosis]. PMID- 3674671 TI - [Dowling-Degos disease]. PMID- 3674672 TI - Concerning the article "Acrokerato-elastoidosis. Apropos of 2 cases". PMID- 3674673 TI - [A case for diagnosis: palmoplantar macular erythema]. PMID- 3674674 TI - [External photoprotective agents. Evaluation methods and practical use]. PMID- 3674675 TI - [Virology and pediatrics]. PMID- 3674676 TI - [Methods of virologic diagnosis]. PMID- 3674677 TI - [Viruses responsible for respiratory infections in pediatrics. Evaluation of 3,480 nasal aspirates performed in children over a 6-year period]. PMID- 3674678 TI - [Value of smectite in the treatment of esophagitis in infants]. PMID- 3674680 TI - Aneurysm jig for anastomosis technique. AB - A new jig is described which enables the technique for abdominal aortic aneurysm to be taught and practiced as it is performed by arterial surgeons at the present time. The aneurysm jig enables a plastic simulated aortic aneurysm to be opened as at operation to allow the inlaying of a Dacron tube sutured into place with continuous sutures. PMID- 3674679 TI - War injuries treated under primitive circumstances: experiences in an Ugandan mission hospital. AB - Due to political instability in many Third World countries doctors in simply equipped rural hospitals are sometimes confronted with war injuries. In those situations sending patients to specialized centres is often impossible. We studied a series of 100 consecutive patients with missile injuries treated during 1982/3 in an Ugandan mission hospital. Out of these 87 were available for sufficient follow-up, 11 disappeared before completing the treatment, and two died. The results are reported. It is concluded that many cases of missile injuries, except the most serious thoraco-abdominal lesions and major neurovascular problems, can be managed satisfactorily in rural hospitals with basic facilities only, provided sound surgical principles are observed, particularly wound treatment in two stages. PMID- 3674682 TI - Thoracic outlet compression syndrome: the lack of reliability of its clinical assessment. AB - Four manoeuvres advocated for the assessment of thoracic outlet compression were performed on 64 randomly chosen volunteers. Although only 17% had any symptoms of thoracic outlet compression, 58% had a positive result in at least one of the manoeuvres. Only 2% were positive for more than two manoeuvres. We suggest this low specificity devalues these tests in clinical practice. We were unable to correlate our clinical results with the findings of digital photoplethysmography. PMID- 3674681 TI - 'False feet': an alternative to expensive surgical shoes. AB - A method of 'equalising' unequal sized and shaped feet to allow the use of normal shoes of equal size, and permit the purchase of a 'pair' of shoes is described. This makes available a greater choice of normal styles and colours for patients with deformed and unequal feet. It is contrasted with the provision of custom made surgical shoes and the purchase of two pairs of unequal size shop shoes. The patients and their parents were pleased with the results and the cost savings were considerable. PMID- 3674683 TI - Use of pedicled omentum in oesophagogastric anastomosis: analysis of 100 cases. AB - According to reports from our country, leakage occurs in about 5% of oesophagogastric anastomoses despite the numerous improvements in operative techniques, including methods of anastomosis in recent years. From October 1979 to May 1984, 128 cases of oesophageal or gastric cardiac cancer were operated on, and pedicled omentum was used to reinforce the oesophagogastric anastomosis in 100 cases, without any postoperative anastomotic leakage. PMID- 3674684 TI - Day case arthroscopy and arthroscopic surgery of the knee. AB - A Day Case Unit was opened at Wexham Park Hospital in October 1985 and this paper describes the first year's experience in arthroscopy and arthroscopic surgery. Ninety nine knees in 96 patients were examined. The predominant diagnoses were lesions of the medial meniscus (33%), ruptures of the anterior cruciate ligament (30%) and lesions of the lateral meniscus (20%). Fourteen knees (14%) were normal. There was one postoperative infection, 3 patients had troublesome effusions and one patient developed a synovial fistula. Two patients required overnight admission. The waiting list was reduced from 14.7 weeks to 3.0 weeks. The advantages and limitations of this technique is discussed. PMID- 3674685 TI - Airway resuscitation packs for nurses: a recommendation for their withdrawal. AB - Approximately one third of our hospitals appear to issue airway resuscitation packs (ARPs) to nurses responsible for the care of postanaesthetic and comatose patients. These packs contain instruments intended for use in overcoming airway obstruction. One hundred and eight nurses replied to a questionnaire designed to identify their knowledge of the instruments. The results indicate that nurses entrusted with ARPs were almost totally unfamiliar with the instruments and their application. The authors recommend the universal withdrawal of ARPs and suggest that nurses and doctors are taught to recognise airway obstruction and to manage it with simple manoeuvres not involving instrumentation. PMID- 3674686 TI - British Association of Clinical Anatomists. Abstracts of papers. 5 June 1986, Aylesbury, Bucks. PMID- 3674688 TI - Pitfalls in the assessment of dysphagia by fibreoptic oesophagogastroscopy. PMID- 3674687 TI - Is a drip necessary for a cholecystectomy? PMID- 3674689 TI - Awareness during bronchoscopy. PMID- 3674690 TI - The surgical treatment of a pharyngeal pouch: inversion or excision? PMID- 3674691 TI - The surgical management of pancreatic abscess. PMID- 3674692 TI - Recurrence rates following local anesthetic day case inguinal hernia repair by junior surgeons in a district general hospital. PMID- 3674693 TI - Surgical audit in a district general hospital: a stimulus for improving patient care. PMID- 3674694 TI - [Normal anatomy of the female pelvis in magnetic resonance imaging]. PMID- 3674695 TI - [Value of magnetic resonance imaging in gynecologic pelvic pathology]. PMID- 3674696 TI - [Value and limitations of x-ray computed tomography in secreting adrenal masses in adults. Apropos of 56 cases]. PMID- 3674697 TI - [Embolization of symptomatic dorsal vertebral hemangioma with Adamkiewicz's artery arising at the same level]. PMID- 3674698 TI - [X-ray computed tomographic diagnosis of congenital dermal fistulae of the glabella and occipital tuberosity with dermoid or epidermoid cyst]. PMID- 3674699 TI - [Fistulography combined with x-ray computed tomography in the evaluation of the extent of congenital dermoid fistulae of the nose. Apropos of 3 cases]. PMID- 3674700 TI - [Uncommon hypertrophy of a displaced xyphoid appendix]. PMID- 3674701 TI - [10 years' results of anastomoses of the left internal mammary artery to the anterior interventricular artery. Angiographic and radionuclide control]. PMID- 3674702 TI - [Role of the anatomo-pathologist specialist in the morphological evaluation of explanted valve bioprostheses]. PMID- 3674703 TI - [Traumatic rupture of 3 supra-aortic trunks at the level of aortic arch. Apropos of a case treated with success in 2 stages]. PMID- 3674705 TI - [Thermal cartography after antegrade cardioplegia in patients with coronary disease. Clinical experimentation]. PMID- 3674704 TI - [Autotransfusion in cardiac surgery. Value of red blood cell washing in operations with high hemorrhagic risk]. PMID- 3674706 TI - [Automation of a circulatory assistance device]. PMID- 3674707 TI - [Use of a biological fibrin adhesive in the surgical treatment of acute dissections of the ascending aorta]. PMID- 3674708 TI - [Pulmonary lymphangiomyomatosis. Apropos of 6 cases]. PMID- 3674709 TI - [Value of pulmonary angiography in the evaluation of the operability of lung cancers]. PMID- 3674711 TI - [Survival of surgically treated bronchial cancer. Proposal for modifying the surgical TNM code and stages]. PMID- 3674710 TI - [Result of surgery of primary non-anaplastic bronchial cancer. Critical analysis of survival]. PMID- 3674712 TI - [Respiratory course following pneumonectomy. Apropos of 224 cases]. PMID- 3674713 TI - [Cancers of the upper respiratory and digestive tracts and bronchial cancers: metastases or multiples lesions. Our 5-year therapeutic results]. PMID- 3674714 TI - [Inflammatory tracheal stenoses. Therapeutic approach and results. Apropos of 120 cases]. PMID- 3674715 TI - [Tracheobronchial tears caused by Carlens' tube]. PMID- 3674716 TI - [Wide resection of a pulsatile metastatic tumor of the manubrium sterni. Reconstruction by sliding clip splints]. PMID- 3674717 TI - [Comparison between the ambulatory and occasional determination of the blood pressure]. AB - In this study, we have attempted to determine the link between the occasional measurement of the blood pressure with an Hg sphygmomanometer and the ambulatory pressure, considering different recording periods during the nyctemer. The mean values of the period 8-10 A.M. and more generally of the diurnal period (7 am-10 pm) are close to the values occasionally observed, contrary to the night values and the values of the entire 24 hours. The heart frequency is always well correlated to the mean ambulatory frequency, for the entire period studied. The systolic and mean arterial pressure are also well correlated. On the contrary, there is no meaning when the diurnal period (7 am-10 pm) is reduced to the period of diurnal activity (7 am-7 pm). There is a very strong correlation between the values of the systolic, diastolic, and mean pressures observed during 24 hours and the morning period (8-10 am), giving the impression that this period could be a good reflection of the ambulatory blood pressure of the 24 h. PMID- 3674718 TI - [Popliteal venous aneurysm. Apropos of 3 cases]. AB - The popliteal venous aneurysm is a rare cause of recurrent phlebitis and pulmonary embolus. In reference to 3 personal cases, their etiology, their role in the occurrence of phlebitis, the place of phlebography and vascular sonotomography respectively, are discussed. The treatment is essentially surgical. PMID- 3674719 TI - [Auricular fibrillation: a cause of reversible myocardiopathy]. AB - A chronic supraventricular tachycardia may alone be responsible for a picture of severe congestive cardiac insufficiency, which is totally reversible after return to a sinus rhythm. The two cases reported here emphasize this particular fact, the physiopathology of which still remains unknown. There is also a prognostic advantage to such cases: in the presence of a congestive cardiopathy with atrial fibrillation, apparently idiopathic, it is important to try to obtain a sinus rhythm and to study from a distance the left ventricular performance indexes which may return to normal after regularization of the rhythm. PMID- 3674721 TI - Myocardial contractile force and catecholamines in patients undergoing open-heart surgery. PMID- 3674720 TI - Early endocarditis following open-heart surgery--importance of surgical treatment. AB - Nine cases of proven early form of endocarditis occurred after open-heart surgery. Eight of these occurred after valve surgery with an incidence 0.7% while one complicated correction of Fallot's tetralogy. Sternal wound infection preceeded endocarditis in two cases and respiratory tract infection in one case. In these three patients, the infection was caused by the same bacteria as the subsequent postoperative endocarditis. In only one patient were there no signs of infection during the immediate postoperative course. A new cardiac murmur suggesting prosthetic malfunction was a clear indication for early reoperation in five patients; four of them survived. In one patient with a paravalvular leakage the decision to operate was delayed with fatal outcome. Generally, in patients without signs of prosthetic valve malfunction or other prosthetic complication the indication and timing of surgery is problematic. In our series the antibiotic therapy was continued over two months in three patients. Two of them died while the third patient was operated on successfully. PMID- 3674722 TI - Factors contributing to subphrenic abscess. AB - Between 1969 and 1982 11 primary (without previous surgery) and 38 secondary (postoperative) subphrenic abscesses were treated out of total 20800 operations. The patients had on an average more than 4 risk factors. Causes contributing to the formation of secondary abscesses were a difficult operation in 42%, deficiencies in surgical technique in 26%, operative contamination in 21% and peritonitis in 13% of the cases. Clear problems in the primary operation were found in 23 of 38 patients and in 6 of 7 patients who died with a later secondary abscess. It seems probable that subphrenic abscesses are more likely to develop in high risk patients after a difficult and/or contaminated operation. PMID- 3674723 TI - Treatment of rectal prolapse. A clinical study of 50 consecutive patients. AB - The results of surgical treatment of rectal prolapse in 50 consecutive adult patients were evaluated. The mean age of the patients was 51.8 +/- 15.9 years. 8 of the patients were males. 13 of the patients had recurrent prolapse after operations performed earlier elsewhere. There were 4 types of operations: Delorme's mucosal sleeve resection (n = 21), perineal rectosigmoidectomy (n = 7), low anterior resection (n = 12) and abdominal rectopexy (n = 10). There was no operative mortality. The main postoperative complications were perforation or stricture of the rectum in the Delorme group and ileus and anastomotic complications in the low anterior resection group. The frequency of postoperative complications was clearly highest in the low anterior resection group (67%). Follow-up examination was performed 5.2 +/- 3.9 years postoperatively. The recurrence rate of prolapse was highest after perineal operations. Fecal incontinence was almost always associated with recurrence of prolapse and its incidence increased with reoperation. In conclusion, abdominal rectopexy was superior to other forms of operation in the treatment of rectal prolapse. Successfull correction of rectal prolapse does not necessarily rule out the need for later surgery for faecal incontinence. PMID- 3674724 TI - Endoscopic sphincterotomy in poor-risk patients. AB - During the period February 1981--February 1986 101 poor-risk patients with common bile duct stones were treated with EST (endoscopic sphincterotomy). 51 of the patients had no previous gallbladder surgery. The first year 7 complications occurred among 11 patients, including 3 deaths. The following four years we had a total of 8 complications among 90 patients, including 1 death. The complications consisted of: Bleeding needing transfusion (n = 5), pancreatitis (n = 5), cholangitis (n = 2), perforation (n = 2), impaction of the Dormia basket (n = 1). Fourty-five patients were discharged without cholecystectomy. Two patients later underwent elective cholecystectomy. Four patients developed symptoms requiring cholecystectomy. The remaining 39 patients have not required any further treatment for their gallstone disease. This study demonstrates that EST in experienced hands is a safe and effective method even in extremely poor-risk patients and that EST might be used as the sole treatment of common bile duct stones in this type of patients without previous cholecystectomy. The few complications are mostly mild and can be managed conservatively. PMID- 3674725 TI - Prosthetic implants in bone metastases of the lower limb. PMID- 3674727 TI - Outcome of operative treatment in fresh lateral clavicular fracture. AB - 23 fresh type II (Neer 1963) lateral clavicular fractures, were treated operatively. In 19 cases fixation was done with two Kirschner wires, in four cases plating was performed. The coracoclavicular ligament was left unsutured. The average follow-up period was 4.5 (1-12) years. In 22 cases out of 23 the subjective outcome was good or satisfactory. 22 fractures united and there were few complications. PMID- 3674726 TI - Prevention of fat embolism syndrome in patients with femoral fractures--immediate or delayed operative fixation? AB - From January 1976 until August 1980, femoral fractures in our department were initially stabilized with tibial traction and fixed operatively after 4-7 days. From August 1980 the fractures were treated with immediate operative fixation. In this retrospective study, we compared the incidence of fat embolism syndrome in 106 patients treated with delayed operative fixation to the incidence in 114 patients treated with immediate operative fixation. Eleven patients (10.4%) developed fat embolism syndrome in the group treated with delayed fixation, compared with two patients (1.8%) in the immediate osteosynthesis group (p less than 0.02). We concluded that early operative fixation of femoral fractures seems beneficial for the prevention of fat embolism syndrome. PMID- 3674728 TI - Alum irrigation in the treatment of severe haemorrhage from the bladder. AB - Ten patients in whom severe haemorrhage from the bladder persisted after clot evacuation and fulguration were treated by continuous irrigation with 1% alum solution. Bleeding ceased in 8 patients, and was temporary in only one of these cases. In 2 patients with thrombocytopaenia the treatment failed. No side effects were noticed. Serum aluminium level was measured in one patient and the value was normal. PMID- 3674729 TI - Serum sex hormone concentrations in adolescent secondary amenorrhoea. AB - The hormone concentrations of 17 amenorrhoeic adolescent girls, with no apparent environmental factor associated with the secondary amenorrhoea, were evaluated. 28 regularly menstruating adolescent girls served as controls. The clinical characteristics of both groups were similar, except that the amenorrhoeic girls showed clinical signs of androgenicity significantly more often than the regularly menstruating group. The concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, oestradiol, progesterone, testosterone, androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were determined in weekly blood specimens from the amenorrhoeic girls and during one menstrual cycle from the regularly menstruating girls. The amenorrhoeic girls had significantly higher concentrations of LH, androstenedione and free testosterone than the regularly menstruating girls. The LH/FSH ratio was significantly higher in the amenorrhoeic group than in the control group. The SHBG concentrations were significantly lower in the amenorrhoeic group than in the regularly menstruating group. Evaluation of the clinical signs of androgenicity combined with LH and androgen measurements seems important in the investigation of adolescent menstrual disorders. PMID- 3674730 TI - Environmental legionella--should we search for it? PMID- 3674731 TI - Serum protein binding of phenytoin, diazepam and propranolol in age-related decrease in renal function. AB - The serum protein binding of phenytoin, diazepam and propranolol was investigated in vitro in 32 elderly people with an age-related decrease in renal function by a pressure ultrafiltration method at 37 degrees C. The mean age of the patients was 88 +/- 1 years (mean +/- SE), and their mean 51Cr-EDTA clearance 46 +/- 4 ml/min. The main reason for hospitalization of these patients was their age. The free fraction of phenytoin correlated negatively with the serum albumin concentration, and that of propranolol with the alpha 1-acid glycoprotein (alpha 1-AGP) concentration. The free fraction of diazepam did not correlate with either of these binding proteins. In stepwise multiple regression analysis, the most significant variable for phenytoin free fraction was serum albumin concentration, with the serum urea concentration coming in second place. For the diazepam free fraction, the only significant variable was the serum urea level, although in the correlation matrix the correlation with creatinine was also significant. When the effect of serum albumin level was corrected mathematically, the urea level was the best determinant in regression analysis for both the phenytoin and diazepam free fractions. It can be concluded that an age-dependent decrease in renal function increases the free fraction of phenytoin and diazepam and is, together with hypoalbuminaemia, responsible for the increased free fraction of these drugs in the elderly. For propranolol the only important factor is the serum alpha 1 acid glycoprotein concentration. PMID- 3674732 TI - Occurrence of and microbiological findings in postoperative infections following open-heart surgery. Effect on mortality and hospital stay. AB - A prospective study of postoperative infectious complications after open-heart surgery was carried out in 885 patients. A total 200 postoperative infections occurred in 173 patients, an overall incidence was 19.5%. The mortality rate was 0.8%. The incidence of sternal wound infections was 7.7% (superficial 6.3% and deep 1.4%) and of leg wound infections 11.4%. Superficial sternal wound infections were associated with septicaemia in 10.7% and deep sternal wound infections in 33.3%. The leg wound infections caused no blood culture positive septicaemia. The incidence of urinary tract infections was 4.6% while respiratory tract infections occurred in only 2.5%. Early prosthetic valve endocarditis occurred in only one patient (0.3%). Staphylococcus aureus and epidermidis were the two bacteria most frequently cultured from sternal wound infections (82.4%), while gram-negative bacteria alone were seldom found (5.9%). In leg wound infections the incidence of gram-negative bacteria was greater (17.3%). Although E. coli was the causative agent in 37% of postoperative urinary tract infections the incidence of infection by the classical hospital-acquired organisms (klebsiella and pseudomonas) was also high (32%). Postoperative infections caused an average prolongation of hospital stay of 8 days. The increase was shortest for urinary tract infections (5 days) and longest in patients with postoperative mediastinitis (28 days). PMID- 3674733 TI - Serum sex hormone levels in adolescent girls with polymenorrhoea. AB - The hormone levels of 13 polymenorrhoeic adolescent girls were evaluated. Twenty eight adolescent girls with regular menstruation served as controls. Serum concentrations of luteinizing hormone, follicle-stimulating hormone, prolactin, oestradiol, progesterone, testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulphate, and sex hormone binding-globulin were determined in blood samples obtained over one menstrual cycle. In girls with polymenorrhoea the frequency of ovulation was significantly lower than in the control group as estimated on the basis of the progesterone level five days before the onset of menstruation. Low progesterone and oestradiol levels during the late part of the cycle were the main abnormalities of polymenorrhoeic adolescent girls. No differences in the other hormonal parameters were found. The duration of menstrual bleeding was similar in both groups. PMID- 3674734 TI - Comparison of echocardiographic and radionuclide methods with contrast angiography assessment of left ventricular function--response to isometric exercise in subjects without definite heart disease. AB - In order to study the validity of non-invasive assessment of left ventricular response to isometric exercise, 21 subjects with chest pain, but without any cardiac abnormalities performed an isometric handgrip test during cardiac catheterization, M-mode echocardiography and radionuclide angiography. Fourteen of the subjects were suitable for comparison of all the three methods. In response to handgrip exercise the ejection fraction (EF) remained unchanged in contrast angiography (68 +/- 9% at rest; 68 +/- 9% during exercise) and echocardiography (74 +/- 4% at rest; 74 +/- 5% during exercise), but showed a small increase on radionuclide angiography (from 57 +/- 5% to 60 +/- 7% (p less than 0.01). Individual changes in ejection fraction during the handgrip exercise had a reasonable correlation between contrast angiography and radionuclide angiography (r = 0.63, p less than 0.01). In order to validate the reproducibility of M-mode echocardiography and radionuclide angiography, the haemodynamic and left ventricular responses during two consecutive handgrip tests were compared in eight subjects. No significant differences were seen in the haemodynamic responses or between the changes in ejection fraction or fractional shortening in the two tests. Thus, in subjects without heart disease the non invasively determined results of the left ventricular response to the handgrip exercise were similar to those obtained invasively and could be reliably reproduced. PMID- 3674735 TI - Nonenzymatic glycosylation of proteins. II. Does glycosylation of low density lipoproteins affect lipid composition of erythrocyte membranes? AB - The degree of nonenzymatic glycosylation of low density lipoprotein (LDL) and lipid composition of LDL as well as of erythrocyte membrane ghosts was investigated in order to determine the possible relationship of LDL glycosylation and lipid metabolism disorders. Three groups of juveniles attending outpatient clinic: diabetics without associated conditions, diabetics with background retinopathy and control healthy subjects were selected for our study. Anisotropy measurements and chemical determinations revealed that enhanced LDL glycation in diabetics (20.6 +/- 1.5 in uncomplicated diabetic subjects and 21.4 +/- 1.0 in retinopathic patients versus 18.1 +/- 1.9 controls) corroborated significantly with membrane cholesterol: phospholipid ratio (r = 0.695), LDL cholesterol (r = 0.720) and membrane rigidization (r = 0.504). Moreover, the elevation of LDL glycation, significance of which was established by nonparametric variance analysis (p less than 0.01), was considerably correlated with total plasma cholesterol (r = 0.743). The possibility that chemical modification of LDL by glucose might induce the altered cholesterol metabolism and distribution was suggested. PMID- 3674736 TI - Distribution of thyroid diseases and evaluation of laboratory parameters used in their diagnosis. AB - A retrospective rationalization of commonly performed tests and procedures for the assessment of patients with suspected thyroid disease was attempted. The final diagnosis, in 392 consecutive new referrals to a central thyroid clinic, was primarily established by combined criteria of clinical/scintigraphic/cytopathologic findings. Detailed statistical analysis and evaluation of the accumulated data have demonstrated that: (a) only 15.8% of patients exhibited measurable thyrometabolic disturbances, thus indicating a rather limited scope for the application of laboratory tests in screening for thyroid diseases; (b) the measurement of serum total thyroxine with the thyroid hormone uptake test and the derivation of the free thyroxine index constitute, at present, the most appropriate initial in vitro laboratory procedure for assessing thyrometabolic function; and (c) recently available innovative methods for estimating serum levels of free thyroid hormones have no advantages over established assays. PMID- 3674737 TI - Special issue on immunodeficiencies. PMID- 3674738 TI - Histogenesis of subcutaneous malignant tumors resulting from nickel subsulfide implantation. AB - Tumors are described which have been produced by subcutaneous (s.c.) implantation of nickel subsulfide (Ni3S2) in 00 gelatin capsules in the left axillary region of Fischer 344 rats. This is in contradistinction to previous accounts where intramuscular (i.m.) or, in a few cases, subcapsular testicular implantation sites have been used. The advantages of the s.c. route are discussed, including the removal of the difficulties of distinguishing degenerating and regenerating striated muscle cells from tumor cells. The s.c. induced tumors were transplanted as far as the F6 generation, in some cases. Cells from tumor transplanted as far as the F3 generation were grown in tissue culture and then reimplanted s.c. Cytology of the tumors remained remarkably constant in all tumors, even after serial transplants and culture. A characteristic storiform pattern, with two major cell types -myofibroblasts and histiocyte-like cells, was seen. The question of pluripotential cell origin is discussed. The striking similarity of appearance to human malignant fibrous histiocytoma is noted; however, in view of the somewhat controversial origin of the human tumor, the simple designation, "nickel-induced malignant tumor of pluripotential origin", is preferred. The use of this model with its demonstrated ability to reproduce characteristic appearances seems to be valuable for the study of soft tissue sarcomas. PMID- 3674739 TI - A solid phase urease-linked cellular immunosorbent assay for circulating polymorphonuclear binding immunoglobulin. AB - A cellular enzyme linked immunosorbent assay (CELISA) is reported for the detection of circulating polymorphonuclear granulocyte binding immunoglobulin (PBG) in patients' sera. The assay features a solid phase microtiter method in which the enzyme urease is fixed to the antihuman globulin conjugate reagent and uses 0.25 percent glutaraldehyde fixed normal human polymorphonuclear neutrophils (PMNs) as target cells. The assay gave positive results in four of 13 (31 percent) cases of idiopathic neutropenia in which an autoimmune etiology was suspected and one typical case of isoimmune neonatal neutropenia. In a group of 15 patients receiving multiple blood transfusions for chronic anemia, five (33 percent) showed significantly higher levels (p less than 0.001) of PBG than non transfused normal donors. The PBG-CELISA appears potentially useful for the detection of autoimmune and isoimmune PMN antibodies and PMN binding IgG immune complexes. PMID- 3674740 TI - Observations on the electrophoretic and immunoelectrophoretic appearance of the prealbumin region in biological fluids. AB - Variations in the level of prealbumin in serum and spinal fluid were noted on routine electrophoresis. Low serum levels were associated with infection, liver disorders, and malignant disease, whereas high levels were seen in inflammatory disorders. A high spinal fluid prealbumin was noted in a young child with a disseminated medulloblastoma. A second arc with prealbumin mobility was seen on immunoelectrophoresis of one urine specimen and four sera from patients with varied pathologies. Sixteen duplicated arcs were seen in the spinal fluid of patients with neoplastic disorders, multiple sclerosis, suspected multiple sclerosis, epilepsy, cerebellar and cerebral atrophy, and chronic renal failure. PMID- 3674741 TI - Effects of oral salt load on arginine-vasopressin secretion in normal subjects. AB - Arginine-vasopressin (AVP) plays an important role in regulating water balance in humans. Its secretion is under control of several mechanisms, some of which are not completely understood. The purpose of the present study was to evaluate the effects of an acute oral salt load on AVP secretion in normal subjects. Six normal volunteers received 350 mEq of NaCl per os. Pulmonary capillary wedge pressure and right atrial pressure, plasma AVP, plasma sodium and potassium concentration, plasma osmolality, hematocrit, urinary sodium and potassium excretion, and urinary flow were measured at baseline and every 30 minutes for two hours after the salt load. Hemodynamics as well as urinary sodium and potassium excretion did not change over the study. Ninety minutes after the salt load, plasma AVP increased from the basal value of 6.0 +/- 0.9 pg per ml to 10.1 +/- 1.2 pg per ml (mean +/- SE, p less than 0.005) and a significant reduction in diuresis of about 50% was observed. However, plasma osmolality and plasma sodium concentration increased significantly only 120 min after the salt load, from the initial value of 277.7 +/- 2.2 mOsm per kg and 145.3 +/- 1.4 mEq per 1 (mean +/- SE) to 284.8 +/- 2.5 mOsm per kg and 148.7 +/- 1.5 mEq per 1, respectively (p less than 0.01). Ninety minutes after the salt load, no correlation was found between plasma osmolality and plasma AVP concentration, indicating that AVP secretion was independent of changes in systemic blood osmolality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674742 TI - [Scintigraphy and esophageal pH measurement in adults with gastroesophageal reflux]. AB - Thirty-seven adults with gastroesophageal reflux were explored by gastroesophageal scintigraphy and pH monitoring (three hours postprandial). Scintigraphy was less frequently positive than pH test in gastroesophageal reflux (81% versus 57%) with a significant difference. It is suggested that postprandial pH monitoring is reliable in the initial assessment of symptomatic gastroesophageal reflux. PMID- 3674743 TI - [Peroperative radiotherapy in cancer of the pancreas]. AB - 7 patients presenting with unresected (6 cases) or resected (1 case) cancer of the pancreas were treated peroperatively by radiotherapy. Tumors were treated with 15 to 20 Gy delivered by a particle accelerator. There were no post operative complications. Three patients who were experiencing pain before radiotherapy no longer had pain after radiotherapy and this effect was maintained. Five patients died during the follow-up period after 5 to 10 months. Two patients are still alive after 4 and 9 months' follow-up. This experience with peroperative radiotherapy should be continued. PMID- 3674744 TI - [Malignant degeneration of Menetrier disease]. AB - Gastric cancer was found in a patient in whom Menetrier's disease had been diagnosed 18 months before. In Menetrier's disease, incidence of cancer is as high as 14% of cases. But in only 5 cases of literature including the present one, has the time sequence been clearly documented. Metachronous tumours may be found 1 to 5 years after giant hypertrophic gastritis has been diagnozed. Such data make medical management, including anti-secretory drugs and periodic endoscopic survey, hazardous. We suggest that in documented Menetrier's disease elective total gastrectomy should still be considered as a treatment of choice. PMID- 3674745 TI - [Apparently superficial epidermoid cancer of the esophagus: value of radiotherapy and electrocoagulation]. AB - A 77 years old man has been treated by roentgenotherapy for an epidermoid carcinoma of the esophagus. The lesion extended from 24 to 37 cm of the arcades and did not modify roentgenographically the contraction of the muscular layer. This cancer has been heralded by inhalations when swallowing. An error of focusing of radiotherapy resulted in an under irradiation of the upper segment of the esophagus. At the same level a recurrency of the lesions has been treated by electrocoagulation under fibroscopy. The palliation was good but it did not prevent multiple recurrences. The remainder of the esophagus which received 60 Grays has been cured during the three years of follow-up. A second patient has a asymptomatic microcarcinoma at 32 cm. seemingly superficial and was cured by 60 Grays after a follow-up of seven years. External roentgenotherapy is compared to surgery and the use of local treatments as electrocoagulation, laser therapy and intraluminal roentgentherapy are discussed. PMID- 3674746 TI - [Neuropsychiatric effects of ranitidine. Apropos of 2 cases]. PMID- 3674747 TI - Localization of MIC5 to the region between HPRT and G6PD on the human X chromosome. AB - The X-linked gene, MIC5, encodes a human cell-surface antigen, R1. We have assigned MIC5 to the region between HPRT and G6PD on the long arm of the X chromosome. Regional localization was based on the pattern of reactivity of the R1 monoclonal antibody with human-rodent somatic cell hybrids which contained different fragments of the human X chromosome. PMID- 3674748 TI - The effect of recombination between the X and Y chromosomes of mammals. AB - Recent molecular analysis has proved the hypothesis that parts of the human sex chromosomes are homologous and can recombine in male meiosis. The biological consequences of this recombination have been investigated by considering the joint effect of neutral mutation and random genetic drift on a locus that is closely linked to the non-homologous segments of the sex chromosomes, but which recombines with them in an appreciable frequency. Our model predicts that, in the absence of selection, allelic differentiation between genes carried on the X and on the Y chromosomes will develop only if the recombination rate is of the same order of magnitude as the mutation rate or smaller. Similarly, a mutation favourable in males but disadvantageous in females will increase in frequency on the Y chromosomes, while remaining rare on the X chromosomes, only if the recombination rate is smaller than the fitness advantage of the mutation. The X and Y chromosomes are, thus, not expected to show any genetic differentiation for almost all of their homologous parts. Divergence will occur only for loci that very rarely recombine between the sex chromosomes. PMID- 3674749 TI - Expected genetic drift and observed gene variation in a small isolated human population. AB - Data on the gene frequencies of four blood groups and six polymorphic erythrocyte enzymes were collected in a small population of the Northern Apennines (municipality of Zeri, Tuscany, Italy), whose civic records are available from 1866 on. Starting from the assumption that the mean gene frequencies of large populations of the neighbouring regions may represent a good estimate of the frequencies of the 'mother population' of the isolate, an observed value of the standardized ('Wahlund') variance of gene frequencies was computed and found to be 0.0131. The expected value of the same variance, due to random drift, has been computed on the basis of an evaluation of the immigration to the isolate, drawn from the marriage register of the municipality: this value was 0.0103. PMID- 3674750 TI - Linkage between the loci for peptidase D and cytochrome P-450 (CYP1) on chromosome 19. AB - Families segregating for PEPD have been investigated for linkage between PEPD and CYP1. The results provide evidence for close linkage between PEPD and CYP1 in males. PMID- 3674751 TI - Genetic heterogeneity of X-linked mental retardation with fragile X. Association of tight linkage to factor IX and incomplete penetrance in males. AB - X-linked mental retardation with fragile X or Martin-Bell Syndrome (MBS) is a frequent cause of mental retardation. So far segregation analysis of MBS in pedigrees ascertained by different, incomplete criteria has produced results, difficult to interpret, which suggest genetic complexity (Sherman et al. 1985). Biochemical and cell biological studies have failed to provide an assay for genetic heterogeneity in MBS and linkage analysis is the only available method. Such analysis, however, is complicated by the incomplete penetrance of the disease in males and the variable penetrance and expression of the defect in heterozygous females. We have used a new approach to test the heterogeneity of recombination between MBS and the coagulation factor IX gene or the anonymous probe 52A in a group of nine families who have sought genetic counselling at Guy's Hospital. We find that both our families alone and our families plus apparently complete samples of pedigrees reported in the literature, separate into two groups: one tightly and one loosely linked to factor IX. In the combined family sample these represent respectively 0.3 and 0.7 of the total and show recombination fractions of 0.0-0.15 and 0.25-0.5. Furthermore, the families with non-penetrant carrier males show tighter linkage to factor IX than the others, thus confirming the suggestion of a systematic difference among MBS families in the recombination between the disease and the factor IX locus. By contrast, no significant differences were found in the recombination between 52A and factor IX in the two groups of MBS families or in these families versus those with Hunter syndrome examined in our laboratory. The causes of the linkage heterogeneity we describe are not known. At least two alternatives can be considered: The existence of two MBS loci or differences in the recombination between a single MBS locus and the factor IX gene. The association between incomplete penetrance and tight linkage to factor IX as well as the discontinuous variation in recombination fraction we have observed seem to favour the former alternative. PMID- 3674752 TI - The human alpha 2(IV) collagen gene, COL4A2, is syntenic with the alpha 1(IV) gene, COL4A1, on chromosome 13. AB - We have previously assigned the gene for the alpha 1 chain of type IV collagen to chromosome 13. In this report we show that the gene coding for the second chain of this heterotrimer is on the same chromosome. This is the first example of the genes for both chains of one collagen molecule being syntenic. PMID- 3674753 TI - The structural gene for lecithin:cholesterol acyl transferase (LCAT) maps to 16q22. AB - We have used a cDNA clone for human lecithin:cholesterol acyl transferase (LCAT) and Southern blotting techniques to identify the human LCAT gene in DNA from a series of rodent X human somatic cell hybrids. Our results are compatible with the location of the gene on human chromosome 16, and this has been confirmed using in situ hybridization of the LCAT cDNA to human metaphase chromosomes. These results confirm the earlier studies on LCAT-deficient patients, indicating that the structural gene for LCAT is on human chromosome 16q22. PMID- 3674754 TI - Physical mapping of genes and sequences at the end of the human X chromosome short arm. AB - Human-rodent somatic cell hybrids containing deleted and translocated human X chromosomes have been used to map genes and sequences in and around the pseudoautosomal region. The following order was found: (DXS69, DXS70, DXS143) (DXS31, STS)-MIC2. This order is consistent with the known inheritance patterns of DXS31, STS and MIC2. Assuming that the translocations and deletions we have studied are not complex rearrangements, we conclude that the pseudoautosomal region consists of less than 5 X 10(6) bp of DNA. PMID- 3674755 TI - The human placental alkaline phosphatase gene and related sequences map to chromosome 2 band q37. AB - A human placental alkaline phosphatase (PLAP) cDNA was isolated from a lambda gt 10 library of the cell line HEp-2. Southern blots probed with a fragment of the cDNA clone showed that the human genome may contain more than one PLAP-related sequence. The PLAP probe showed person-to-person variation in banding pattern with a number of enzymes. Using a panel of human/rodent somatic cell hybrids the PLAP sequences were mapped to chromosome 2. In situ hybridization confirmed this assignment and localized the gene(s) to chromosome 2 band q37. PMID- 3674756 TI - Localization of the oncogene c-erbA2 to human chromosome 3. AB - The human c-erbA1 gene has been previously mapped to chromosome 17. We have now mapped c-erbA2 to the short arm of chromosome 3, using a human genomic probe in Southern analysis of DNA from a panel of human/mouse somatic cell hybrids. In situ hybridization using the same probe on metaphase chromosomes has enabled fine chromosome mapping of c-erbA2 to the chromosome region 3p21-pter. PMID- 3674757 TI - The effect of non-random migration on genetic differences between populations. AB - Models of genetic population structure generally assume that emigrants from each local group are drawn at random from the set of individuals born there. We show that small violations of this assumption can have disproportionately large effects on genetic population structure, and we introduce a statistical method for measuring this effect. PMID- 3674758 TI - Major discrepancies between results obtained with two different methods for evaluating DNA damage: alkaline elution and alkaline unwinding. Possible explanations. AB - The fluorometric assay of DNA alkaline unwinding, developed by Birnboim and Jevcak (Cancer Res 41: 1889-1892, 1981) was applied to rat liver DNA, after treatment in vivo. N-nitrosodimethylamine, for which DNA damage in rat liver has been extensively investigated, was tested as a standard compound. The results were in complete agreement (both in terms of damage and repair) with data from the literature and with our own results obtained with other methods of detecting DNA alkaline fragmentation. Sensitivity was also of the same order of that of usual methods, with the effect of 0.3 mg/Kg of N-nitrosodimethylamine being detectable. Other DNA damaging carcinogens such as 1,2-dimethylhydrazine, 2 naphthylamine and dacarbazine were also correctly detected. Compounds like nitrofurantoin, benzoin and caprolactam, which appeared clearly positive with the alkaline elution technique, but for which genotoxicity and carcinogenicity are doubtful (nitrofurantoin) or most likely negative (benzoin and caprolactam), gave negative results with this method. This is also in agreement with previous results, observed using a different approach to measuring DNA unwinding. On the basis of these and other observations, we suggest that, under certain conditions, the alkaline elution technique is perhaps not only sensitive to DNA breaks but also to changes in chromatin conformation. Unwinding methods could be more specific in the detection of DNA fragmentations. PMID- 3674759 TI - Rhythmic fluctuations of CEA serum levels in breast cancer patients. AB - Hourly blood sampling for CEA determination was performed in metastatic breast cancer patients before and during medical treatment. Rhythmic fluctuations of marker concentrations could be detected. These oscillations seemed to be independent of the localisation of metastases and the kind of treatment. No relation between cortisol or prolactin and CEA levels became apparent. PMID- 3674760 TI - Mitoxantrone combined with vincristine, cyclophosphamide and fluorouracil for advanced breast cancer. A study of short-term response rate. AB - 50 patients with advanced breast cancer were treated with the combination of Mitoxantrone 10mg/m2 IV day 2, 5-Fluorouracil 400mg/m2 IV and Cyclophosphamide 300mg/m2 IV day 3, 4, 5, 6 of each monthly cycle. 49 patients are evaluable for toxicity and 47 for efficacy after three months of treatment. Hematologic toxicity was substantial and dose-limiting, with one toxic death early in the trial. Other toxicities were moderate and manageable in this short-term study. The response rate after three cycles was 53% +/- 14% with 4 complete remissions, 21 partial remissions, 16 stable disease and 6 progressions. Using the fixed response rate hypothesis of Gehan generalised by Lee and Wesley, with an expected response rate of 60% consistent with the reported response rate of advanced breast cancer to Adriamycin containing regimens, we conclude that the combination studied is not less efficient for the induction of remissions in advanced breast cancer than comparable combinations with Adriamycin. As there is now substantial experimental and clinical evidence of reduced toxicity, mainly on the cardiac muscle, of Mitoxantrone as compared to Adriamycin, we feel that the routine substitution of the latter by the former in chemotherapy for advanced breast cancer is justifiable. PMID- 3674761 TI - Effect of gallium at two phases of the CA 755 tumour growth. AB - GaCl3 efficiency was evaluated for mice mammary adenocarcinoma Ca-755 separately at two stages of tumour growth: the exponential and plateau phase. Two modalities of drug administration were evaluated: once only and twice a day for five days. Comparisons were made with the efficiency observed when saline liquid and cyclophosphamide were used. The comparisons between tumour shrinkages were carried out by non-parametric tests. GaCl3 was more often efficient for tumours at the exponential phase than for those at the plateau phase of growth. GaCl3 always appeared less efficient than cyclophosphamide. The treatment schedule did not result in any significant alteration of tumour regression. PMID- 3674762 TI - Differentiated DNA analysis in relation to steroid receptor status, grading, and staging in human breast cancer. AB - Flow cytometric DNA analysis was performed in 100 cases of human breast cancer. Using a category system of six ploidy groups, ploidy status was distributed as follows: The majority of the neoplasias were either diploid (45%), hyperdiploid (21%), or tetraploid (15%), whereas the remaining marginal ploidy groups, i.e. hypodiploid (4%), hypertetraploid (9%), and multiploid (6%) were less frequent. In an attempt to evaluate the prognostic significance of DNA content, ploidy status was correlated with steroid hormone receptor status, histopathological grade, and TNM data. The higher incidence of negative estrogen and progestin receptor status and higher histopathological grade in hyperdiploid malignancies was significantly different from the prognostically more favorable positive receptor status and lower grade in diploid tumors. Tetraploid neoplasias statistically resembled the latter group with respect to both parameters. As far as TNM data are concerned, tendencies towards less favorable staging were observed in hyperdiploid as compared to diploid and tetraploid tumors. A definite statement of the prognostic significance of the marginal ploidy groups cannot be made at present. In order to characterize diploid malignancies more closely, proliferative activity expressed by %S-phase was analyzed. Steroid receptor status of diploid tumors exhibiting more than 6% S-phase did not differ statistically from that of hyperdiploid neoplasias. In contrast, diploid tumors expressing less than 6% S-phase closely resembled tetraploid ones. Our data emphasize the prognostic significance of differentiated DNA analysis. PMID- 3674763 TI - Flow cytometric DNA analysis of normal and cancerous human endometrium and cytological-histopathological correlations. AB - The DNA content in individual cells from 112 histopathologically normal endometria and from 222 malignant endometrial tumors was measured using flow cytometry. In the normal endometrial cases only single DNA peaks were found, all in the diploid region, and the range of DNA index values was used for defining the limits for diploid tumor cases. In most cases with aneuploid cell populations, an additional peak was found in the normal diploid region. However, combined cytological and histopathological analysis showed that a majority of these diploid cells were to be considered as tumor cells. Aneuploid cell populations were found in 43% of malignant endometria; in the remaining endometrial carcinomas, the flow cytometrical findings showed no differences compared to those of benign tissue. Flow cytometry in this respect did not prove useful as a diagnostic screening method. Ploidy aberrations were correlated to histopathology. Aneuploidy was more common (62%) in poorly differentiated tumors than in highly/moderately differentiated tumors (29%). Two or more aneuploid cell populations were found in 6% of the cases. No difference in aneuploidy was found between FIGO stage I and II (36% and 34%), but aneuploidy was more frequent in stage IV (86%). In normal endometria the fraction of cells with DNA content corresponding to S-phase (S-fraction) was 9.7% on average in the proliferative phase and 6.2% in the secretory phase. In well and moderately differentiated diploid tumors the S-fraction was about the same (8.8% and 9.2%), but in poorly differentiated tumors it was significantly higher (12-16.5%). PMID- 3674764 TI - Prognostic value of flow cytometrical DNA measurements in stage I-II endometrial carcinoma: correlations with steroid receptor concentration, tumor myometrial invasion, and degree of differentiation. AB - The prognostic value of flow cytometric DNA measurements of individual tumor cells was studied in 166 patients with endometrial carcinoma stage I-II. Follow up time was 1-46 months and 110 patients were followed for more than 2 years. Three different ways of estimating DNA ploidy were evaluated, and the use of normal endometria in defining diploidy was considered the best. DNA-ploidy had a much more marked prognostic value in terms of 2-year recurrence-free survival than other known prognostic parameters, such as degree of differentiation, range of myometrial invasion and estradiol and progesterone receptor concentrations. The proliferative activity as determined by DNA flow cytometrical analysis was not correlated with prognosis. PMID- 3674765 TI - Enhancing effect of lonidamine on the inhibition of mitochondrial respiration by adriamycin. AB - Pretreatment of rat liver mitochondria with lonidamine (LND), 1-(2,4 dichlorobenzyl)-1 H-indazol-3-carboxylic acid, increases their susceptibility to respiratory inhibition by adriamycin (ADM). Because LND does not inhibit the rate of oxygen consumption at the concentrations used, its potentiating effect may be exerted by favoring the interaction of ADM molecules with their sites in the inner mitochondrial membrane. LND does not modify the permeability on the inner membrane for large molecules. However, its enhancing effect can be ascribed to a modified permeability of the outer mitochondrial membrane which may represent a barrier for ADM entry. PMID- 3674766 TI - S-phase rate as a predictor of early recurrences in carcinoma of the uterine cervix. AB - Flow cytometric measurements of ploidy level and S-phase rate were performed in a prospective study of 165 patients with cervical squamous cell carcinoma. Patients were followed-up for 24 months after initial treatment. There was no significant difference in recurrence rate between patients with peri-diploid tumors (1.8c 2.2c) and aneuploid tumors. The S-phase rate (evaluable in 133 cases), which previously has been studied only occasionally in cervical carcinomas, was correlated with early relapses. Significantly more relapses were found in tumors with S-phase rates greater than or equal to 20% than among tumors with S-phase rates less than 20% (chi 2 = 9.54, p less than 0.01). A higher relapse rate among tumors with S-phase rates greater than or equal to 20% was found even after taking staging into consideration (Cochran-Mantel-Haenszel test, p less than 0.01). Thus, besides staging, evaluation of the S-phase rate yielded additional prognostic information. PMID- 3674767 TI - Isolation and characterization of the glutathione-elliptinium conjugate in human urine. AB - In a cancer patient given 100 mg/m2 elliptinium by intravenous infusion, the glutathione conjugate was found in urine. This metabolite was isolated after ion exchange treatment and high performance liquid chromatography. Its structure was assessed by fast-atom bombardment mass spectrometry and comparison with an authentic sample. PMID- 3674768 TI - Serum, urine and peritoneal fluid levels of 5-FU following intraperitoneal administration. AB - Seven patients with advanced colon cancer, refractory to conventional chemotherapy, and malignant disease confined to the intra-abdominal space received a total of 24 consecutive courses of ip 5-Fluorouracil (5-FU). 5-FU 1000 mg was administered in 2 L of warm (37 degrees C) dialysate daily for five consecutive days every 28 days. 5-FU concentrations in serum, peritoneal fluid and urine were measured by high pressure liquid chromatography (HPLC). The mean disappearance half-life of 5-FU from the peritoneal fluid was 1.6 hours with a mean permeability area product (PA) of 22.4 ml/min. The mean peritoneal AUC was 450 +/- 165 times greater than the mean serum AUC. Ip 5-FU treatment is well tolerated, can be safely administered on an outpatient basis and produces a significant pharmacological advantage over conventional routes of administration. PMID- 3674769 TI - Influence of a growing ascitic tumor in mice on the distribution of injected 65Zn: role of the quantity of zinc administered. AB - 65-Zinc distribution was studied in different organs of either healthy mice or mice bearing an ascitic tumor. This study clearly showed that zinc distribution differs between healthy and tumoral mice. Moreover, zinc distribution in the different organs of the mice is modified by the quantity administered. PMID- 3674770 TI - Biological features and in vitro chemosensitivity of a new model of human melanoma. AB - The M14 human melanoma cell line was characterized either for some biological features in vitro and in vivo or for responsiveness to a panel of anti-tumor agents of clinical interest. The results of our study show that the M14 cells in culture resemble the in vivo melanomas both biologically and functionally, thus suggesting the usefulness of employing this line as a preclinical model for cancer treatment studies. PMID- 3674771 TI - Effect of PSK on prohibited immunity of splenectomized mice. AB - The effect of PSK (Krestine, an anti-tumor drug prepared from Coriolus versicolor) on splenectomized experimental animals was investigated. Splenectomy was performed on both a tumor-free control group and a tumor-bearing group. The administration of PSK on the splenectomized control group significantly increased the immune state of the host. In the case of the tumor-bearing group, administration of PSK resulted in restoration of the immune function as observed in the control group. Recovery of the immunological function was accelerated when tumor-bearing animals were splenectomized at the terminal stage. The results suggest that the immunomodulating effects of PSK developed at the time of the splenectomy resulted in anticancer activity. PMID- 3674772 TI - The influence of physical activity in 1,2 dimethylhydrazine induced colon carcinogenesis in the rat. AB - Recent epidemiologic findings indicate that relative risk of colon cancer is augmented with increasing proportion of time spent on sedentary occupations, and reduced with occupations requiring high levels of work-related physical activity. Therefore, the influence of exercise on experimental colon carcinogenesis was investigated. Spontaneous running wheel activity was related to incidence of 1,2 dimethylhydrazine (DMH) colon tumor induction. Colon tumor incidence was significantly reduced in animals that were allowed spontaneous wheel activity throughout the period of DMH tumor induction vs standard housed controls (p less than 0.05), indicating that, in the rat, physical activity protects against colon tumorigenesis. Further comparisons reveal a mild positive association (p = 0.07) between activity and incidence of tumors in the left colon. These results are in accord with epidemiologic findings indicating reduced colon cancer risk with increased physical activity. Possible mechanisms for the protective influence of physical activity on tumorigenesis include reduction in fecal pH, body weight and increased antioxidant enzyme activity. To the extent that epidemiologic associations between colon cancer and activity are inclusive of the multidimensional nature of physical activity, animal models such as that utilized in this experiment can be utilized for investigating the etiologic potential, or strength of association in variables that have been epidemiologically associated with colon cancer risk. PMID- 3674773 TI - Permanent alterations induced in plasma prolactin and estrogen receptor concentration in benign and malignant tissue of women who started oral contraceptive use at an early age. AB - In 65 young women undergoing curettage for benign uterine disorders a significant relationship was found between early oral contraceptive use (starting age less than 25 years) and a high ratio of ln plasma prolactin versus ln estrogen receptor concentration of the uterine mucosae (p less than 0.047, Mann-Whitneys U test). Year of birth, age at menarche, age at first full term pregnancy, parity, menstrual cycle phase and duration of oral contraceptive use could not explain the results. Because similar results have previously been found for breast cancer patients using plasma prolactin and breast tumour estrogen receptor concentration, the findings indicate that early oral contraceptive use permanently alters plasma prolactin levels and estrogen receptor concentration, both in benign uterine tissue and in malignant breast tumours. PMID- 3674774 TI - The occurrence of estrogen and progestin receptors and anti-estrogen binding sites (AEBS) in canine non-Hodgkin's lymphomas. AB - In the present study the occurrence of estrogen and progestin receptors in the lymphoid tissue of 20 canine non-Hodgkin's Lymphoma patients was investigated. Lesions in all dogs were histologically classified according to criteria used in human patients. No progestin receptors could be demonstrated. Estrogen receptors were found only in the cytosol of two canine lymphomas. Antiestrogen binding sites were present in all 18 cases examined (range 37-356, median 110 fmol/mg protein). No correlation with age, sex or histological classification was found. A pilot study was carried out in five of these dogs that were negative for estrogen receptors and positive for antiestrogen binding sites. These dogs were treated with the antiestrogen tamoxifen (20-30 mg/day) for 2-3 weeks, but the treatment had no apparent effect. It was concluded that if antiestrogens do play a role in the treatment of non-Hodgkin's lymphoma in the dog, it is most likely not by means of antiestrogen binding sites. PMID- 3674775 TI - Decreased rat rhabdomyosarcoma pulmonary metastases in response to a low methionine diet. AB - Many Experimental and human tumor cell lines have been previously described as being dependent upon exogenous methionine for their in vitro proliferation. The rationale of the experiments described herein was to decrease the in vivo growth of malignant tumors by reducing the exogenous methionine available in diets fed to Wistar AG rats bearing the highly metastatic rhabdomyosarcoma, RMS-J1. The methionine content in the diet was reduced either by replacing casein (diet 1) with soybean protein (diet 4), or by lowering the amount of soybean protein in the diet (from 23 g/100 g to 12 g/100g) (diet 5), or by using a crystalline amino acid-defined mixture as the source of protein (diet 7). In the latter diet homocysteine replaced methionine and allowed the survival of the animals. Diet 4 significantly reduced the mean number of lung metastases without affecting the primary tumor growth. Treatment of RMS-J1 bearing rats with diet 5 led to the decrease of pulmonary invasion (78 and 21 median lung metastases, respectively, in control and treated groups). This diminished metastatic dissemination resulted from the reduced methionine consumption: the lowered casein content in diet 3 (10 g/100 g) as compared to diet 1 (23 g) did not alter primary tumor growth or the amplitude of lung invasion. Moreover, the addition of methionine to diet 5 prevented the diminution of the median number of lung metastases. Replacement of methionine with homocysteine in the crystalline amino acid-defined mixture (diet 7) fed to RMS-J1 bearing rats led to a limited retardation of primary tumor growth (less than 10%) and to a significant decrease in pulmonary invasion: the median number of pulmonary metastases was 28 and 9 for control and treated rats respectively. PMID- 3674776 TI - Pathogenesis of Burkitt's lymphoma in children. AB - The reason that the classical African type of Burkitt's lymphoma often occurs in children is still not well understood. Several data published during the last months have, however shed some light on this phenomenon. PMID- 3674777 TI - Abstracts of 35th meeting of the European Tissue Culture Society (ETCS) and 25th meeting of the Cell Tissue and Organ Culture Study Group (CTOC). 20-24 September 1987, Athens, Greece. PMID- 3674778 TI - Double-membraned vesicles and their possible role in the ontogeny of microbodies of Basidiobolus haptosporus. AB - A concomitant but transient occurrence of large numbers of double-membraned vesicles with immature, culturally induced microbodies was demonstrated in thin sections of Basidiobolus haptosporus soon after transfer of the fungus to a defined medium containing xanthine or its catabolites as the sole source of nitrogen. Double-membraned vesicles were rapidly formed as derivatives of endoplasmic cisternae later to occur free in the cytoplasm, often as the most predominant cytoplasmic inclusion. Densitometric measurements revealed that heavy metal-binding cytoplasmic constituents were concentrated within the vesicular lumen. Most of the double-membraned vesicles appeared to undergo degeneration; they were rare to absent in thin sections of older cells. At times, double membraned vesicles were seen connected to newly formed microbodies in a manner suggesting ontogenic relationships. The outer vesicular membrane was continuous with the single limiting membrane of the microbody via a short tubule. We interpret these observations as empirical ultrastructural evidence to suggest that some double-membraned vesicles become specialized and function as precursor inclusions in the biogenesis of new microbody populations committed to purine salvage. PMID- 3674779 TI - [Description of 23 cellulolytic or non-cellulolytic clostridia isolated from a marine milieu]. AB - Twenty-three obligately anaerobic mesophilic bacteria were isolated from marine environments. The isolates were rod-shaped, spore-forming bacteria and were placed in the genus Clostridium. They could be divided into three groups: 9 non cellulolytic strains which used cellobiose as sole energy and carbon source; 6 pseudo-cellulolytic strains which fermented carboxymethyl-cellulose but degraded cellulose very slowly, and 8 cellulolytic bacteria. The morphological, physiological and biochemical characteristics indicated that, except for one strain which could be identified with C. aminovalerium and three strains which resembled C. sphenoides, these marine clostridia did not correspond to any previously described species. PMID- 3674780 TI - Antimycobacterial spectrum of colistin (polymixin E). AB - Minimal inhibitory concentrations and minimal bactericidal concentrations of colistin (polymyxin E) were determined for the type strains of fifteen mycobacterial species. Colistin was found to be active against pathogenic species Mycobacterium xenopi, M. intracellulare, M. tuberculosis, M. fortuitum and also against the rapidly growing, non-pathogenic species M. phlei and M. smegmatis. The discriminatory potential of susceptibility to colistin as a test was investigated on 25 strains of the M. fortuitum/M. chelonei complex, and also on 11 strains of the M. avium/M. intracellulare complex. The experimental data indicated the potential of colistin susceptibility testing for discriminating M. fortuitum from M. chelonei. PMID- 3674781 TI - [Bacillus gordonae sp. nov., a new species belonging to the second morphological group, degrading various aromatic compounds]. AB - Thirty strains were isolated from pasteurized soil samples by enrichment culture in aerobiosis at 32 degrees C in a minimal medium containing one of the following compounds as sole source of carbon and energy: quinate, p-hydroxybenzoate, phthalate, isophthalate or trimellitate. These bacteria were rods (0.8 X 2-7 micron), motile by peritrichous flagella. Endospores were oval (1.4-1.8 X 2 micron) and distinctly swelled the sporangia. The Gram reaction was variable but the Gram type was positive. Colonies were smaller on peptone (0.4%) agar than on minimal salts-glucose (0.2%) agar. The following characters were always present: growth in the presence of lysozyme, cytochrome c oxidase, catalase, nitrate assimilation, urease, amylase and L-glutamate dehydrogenase. The cells contained glycogen. In anaerobiosis, glucose was not fermented and nitrate was not used as a respiratory acceptor of electrons. Of 215 substrates tested, 31 (including 9 aromatic compounds) were used as sole carbon and energy sources by all 30 strains, and 38 substrates (including 13 aromatic compounds) were used by only some of them; 146 substrates (including 49 aromatic compounds) were not used by any of the 30 strains. No amino acid could be used as sole carbon and energy source. Numerical analysis of the 30 strains showed an aggregate cluster made of 5 phena. The mean G + C content of the DNA was 55 +/- 0.6 mol %. The described bacteria are clearly different from the 2 known species of the second morphological group which cannot ferment carbohydrates: Bacillus brevis and B. azotoformans. Strain Q1 (ATCC 29948) is the holotype of Bacillus gordonae sp. nov. PMID- 3674782 TI - [Evaluation of an experimental animal model allowing the study of the cecal microflora in the hamster, antagonistic to clostridium difficile]. AB - The purpose of this study was the development and evaluation of an experimental model allowing the investigation of hamster anti-Clostridium difficile coecal microflora. The existence of this "barrier" was verified in conventional hamsters. Such hamster coecal flora was then orally transferred to C3H germ-free mice. In such animals, the "barrier effect" was maintained. After treatment with erythromycin, the colonization resistance was always maintained; despite two subsequent processes, dilutions of coecal contents (10(-2] and subsequent heating of this fluid (70 degrees C, 10 min), the inhibitory activity against C. difficile was partially maintained (10(4) UFC/g faeces). The isolation of anaerobic strains implicated in colonization resistance will next be carried out in an anaerobic chamber using this microflora. PMID- 3674783 TI - [The Leafhopper Neoaliturus haematoceps (Mulsant & Rey) is a vector of Spiroplasma citri in the Mediterranean]. AB - Among the many leafhoppers which we have collected and identified in Morocco, Turkey, Syria and France (Corsica), only the species Neoaliturus haematoceps was found to be infected with Spiroplasma citri. In Syria, this leafhopper was encountered on ornamental stock plants (Matthiola incana L.) in the Oronte valley, and on Salsola kali L., a wild Chenopodiacae of the semi-arid regions of the coastal area. In Corsica, we found it on wild stock plants (Matthiola sinuata R.Br.) of the oriental coast and on bush plants. A breeding of this leafhopper was initiated, and we demonstrated that it was able to acquire S. citri from infected periwinkles, multiply the organisms in its body and transmit them to healthy plants. This leafhopper can also be infected after injection of S. citri. The leafhoppers thus inoculated can transmit the spiroplasma very efficiently to healthy plants. This is the first report of the transmission of S. citri by Neoaliturus haematoceps both after acquisition on a diseased plant and after injection. PMID- 3674784 TI - [Treatment of renal calculi with extracorporeal lithotripsy. Experience of the Urology Service at Rennes. Preliminary report on 134 patients]. AB - The results of 134 patients who underwent 150 treatments with the EDAP lithotriptor are reported. The first patients were treated with a frequency of 150 Hz under general anesthesia, with a success rate of 64%. In order to decrease the pain induced by the shocks waves, the frequency was lowered (20 Hz and 10 Hz), so that treatment could be performed under neuroleptic analgesia. The success rate was respectively 84% and 90%. A second treatment was required in 11% of the patients and 9% have undergone auxiliary endoscopic manoeuvres preoperatively. Morbidity was extremely low with only 3% of ureteral obstruction. The gradual reduction of anesthesia constitutes an advance in lowered morbidity and costs; in addition, the possibility to repeat the treatments makes the management of complex lithiasis easier. PMID- 3674785 TI - [A new hypothesis on the natural history of bladder cancer based on the study of tumor DNA levels by flow cytometry]. AB - 72 bladder tumors were studied for nuclear DNA content with flow cytometry. A bimodal DNA profile was present in 33 of them (45%). The following findings concerning the aneuploid second peak of these 33 tumors are remarkable. Aneuploid peak DNA index distribution is discontinuous: there is no peak below 1.5 nor between 2.3 and 2.7. Aneuploid peak importance (second peak cell percentage versus all tumor cells in the same sample) increases when its DNA index decreases from 2.0 to 1.5 = this percentage is on average 45% for a DNA index of 2.0 and increases to 75% when DNA index decreases to 1.5. Aneuploid peak mitotic activity increases when DNA index decreases from 2.0 to 1.5 = the percentage of S G2 M cells of the aneuploid peak is in the range of 15% for a DNA index of 2.0 and in the range of 22% for a DNA index of 1.5. These findings are in favor of a dynamics in bladder cancer natural history. Tumors are supposed to share the same clonal evolution, in 3 stages. First stage: transformed tumor cell DNA profile is unimodal with a DNA index in the region of 1; second stage: due to chromosomic non-dysjunction during mitosis, a second peak appears with a DNA index of 2. Third stage: DNA index of this aneuploid second peak progressively decreases from 2 to 1.5 as a consequence of non vital chromosomes loss by tumor cells. It is suggested that DNA index as defined by flow cytometry does not have an absolute prognostic value per se, but in combination with tumors mitotic activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3674786 TI - [Lymphography with lymph node puncture biopsy. A reliable procedure for assessing the lymphatic spread of bladder tumors]. AB - 119 patients with bladder tumors of category Ta, Tis, T4, considered for radical treatment because of local conditions were studied by pedal lymphography (LAG) and percutaneous fine needle aspiration biopsy (FNA). 41% had a positive LAG. Adequate material was obtained for FNA in 94% of the patients. Of 70 patients with normal LAG none had a positive FNA; only 36% of those with a positive LAG had a positive FN. The high rate of positive LAG with negative FNA is attributed to inflammatory changes due to previous transurethral resection. Radical lymphadenectomy (LND) was done in 64 patients of whom 54 had a negative FNA. In this group, 8 (17%) had a positive LND. There was no mortality and morbidity was mild. LAG with FNA has a role in the pre-operative staging of bladder carcinoma. PMID- 3674787 TI - [Value of the stop-test in the diagnosis of detrusor hyperactivity. Concept of the isometric zone. Preliminary study of 30 cases]. AB - The authors propose a new pathophysiological and diagnostic approach to detrusor hyperactivity by the study of the isometric pressure obtained during the stop test. This test consists of the sudden interruption of micturition by voluntary contraction of the striated urethral sphincter, resulting in sudden contraction of the bladder against the closed sphincter. This isometric contraction is equal to 20 to 30 cm of water. The increase in the pressure (delta P) between the basal micturition pressure and the absolute value of the isometric pressure (P iso) reflects the contractile force of the detrusor. The progressive return to the basal micturition pressure reflects the relaxation of the detrusor, which is the sum of visco-elastic properties and the mechanisms of cortico-sub-cortical neurological inhibition. Calculation of the isometric area (delta P X T/2), where T represents the time taken to return to the initial pressure, allows cases of central neurological hyperactivity (isometric area always greater than 100) to be distinguished from cases of detrusor hyperactivity of mechanical origin (isometric area less than 80). These data have been confirmed in a series of 30 patients. PMID- 3674788 TI - [Infiltrating cancer of the bladder with lymph node invasion: is total cystectomy justified?]. AB - In order to assess the potential benefits of radical cystectomy in bladder cancer associated with pelvic lymph node metastasis, a retrospective study compared 2 groups of patients with T2-T3 N+ bladder cancer: 10 treated by radical cystectomy and 14 treated conservatively once the diagnosis of nodal metastasis had been established by fine needle node aspiration or lymphadenectomy. The survival rates were identical in both groups: 80% of the patients died within 2 years, 60% during the first year after diagnosis, mainly due to distant metastasis. No patient in the conservative arm required salvage cystectomy because of local progression. It is concluded that radical cystectomy is of little benefit in T2 T3 N+ bladder cancer, a disease which is no longer amenable to purely local treatment. PMID- 3674789 TI - [How I perform the Mathieu technic in the treatment of anterior penile hypospadias]. AB - The Mathieu operation, used for distal penile hypospadias repair, gives excellent, not only functional, but also cosmetic results. Some modifications have still bettered these results and reduced post-operative restraints: use of very fine (PDS 6 X 0) resorb suture-thread, reconstruction of prepuce, only 48 hours cathetering. The child is operated after 2 years of age. This technique gives unrivalled cosmetic results by restoring in most cases a normal appearing penis. In hypospadias operated for first time, the fistula rate is about 10 per cent. These fistulas are repaired later with a new 24-hours hospital stay. PMID- 3674790 TI - [Treatment of complicated urethroceles in women by resection of the protruding dome]. AB - Vaginal marsupialization appear the safest treatment of complicated urethroceles. PMID- 3674791 TI - [Hemangiopericytoma of the ureter]. AB - This report of a case of an exceedingly rare ureteral tumor, i.e. hemangiopericytoma, provides the opportunity for a discussion of the nature, prognosis and management of this lesion. PMID- 3674792 TI - [Percutaneous renal surgery apart from calculi. Current possibilities and limitations]. AB - The purpose of this study is to describe the technical modalities and to evaluate the results of percutaneous renal surgery for ureteropelvic stenosis, pyelocaliceal diverticula, renal cysts and urothelial tumors of the kidney. Based on a review of literature and although the number of the reported cases is limited, the results indicate a great deal of variability in the success of these technics depending on the pathology. PMID- 3674793 TI - [Treatment of intradiverticular pyelocaliceal stones]. AB - Nine patients with symptomatic intradiverticular stones have been treated, 3 by open surgery (excluded cavity and abscess formation) and 6 by endoscopy. When possible (4 cases), direct puncture of the diverticular cavity seems to be much simpler and more effective than indirect intrarenal access. The percutaneous approach constitutes a valuable alternative to open surgery in the treatment of symptomatic intra-diverticular stones, although secondary obliteration of the cavity is not always obtained, which leaves a potential risk of long term recurrent stones. PMID- 3674794 TI - [Acquired stenosis of the upper urinary tract after percutaneous nephrolithotomy]. AB - The authors present two well documented cases of extensive acquired stenosis of the infra-pelvic upper urinary tract following percutaneous nephrolithotomy. This type of complication appears to be exceptional as, by combining the series of two centres, it represents only two cases out of more than five hundred cases treated. The delay in appearance is of the order of six months. The more or less complex nature of the procedure does not appear to be responsible. It is difficult to determine the exact mechanism fo this complication: several hypotheses are proposed. A few rare cases have been reported in the literature without raising any particular attention. These complications required difficult reconstructive surgery with a good result in both cases. Although these complications seem to be difficult to prevent, they should be systematically detected by ultrasonography at two months and at six months to avoid delay in the diagnosis of functional renal exclusion. PMID- 3674795 TI - Effects of oral physostigmine in Alzheimer's disease. AB - Previous studies of oral physostigmine in the treatment of Alzheimer's disease have: (1) assumed physostigmine is effective only in mildly affected patients; (2) relied on an initial "dose-finding" phase to determine the most effective dose and excluded nonresponders; and (3) primarily assessed memory. We examined the response of 22 patients to six different daily dosages of oral physostigmine, using selective reminding tests that were administered twice daily. Nine patients had a "best" dose/day (mode = 13 mg/day), which was used in a subsequent double blind crossover study. The other 13 were given the highest tolerated dose. The selective reminding test and a full neuropsychological battery were given during the drug and placebo periods. As a group, the 22 patients improved significantly on the Wechsler Adult Intelligence Scale-Revised Digit Symbol subtest and a shape cancellation task (p less than 0.05). Nine patients showed improved performance on the selective reminding test during physostigmine treatment, and 9 showed no response; 4 patients performed better during placebo treatment. Dose finding did not help in predicting response in the crossover study; only 2 of the 9 who showed improvement had a best dose. Dementia severity did not predict crossover response. This suggests that: (1) physostigmine as administered had no pronounced effect on memory in Alzheimer's disease; (2) oral physostigmine produces no greater benefits on memory in mildly than in moderately demented patients; (3) response in a dose-finding phase does not predict response in double-blind crossover; and (4) Digit Symbol and cancellation tasks may be more sensitive than memory tests to the effects of oral physostigmine. PMID- 3674796 TI - Acute ischemia causes axonal stasis, swelling, attenuation, and secondary demyelination. AB - Microsphere embolization of rat sciatic nerve capillaries results in a central fascicular ischemic core. Twenty-four hours after microembolization, the pathological alterations along the length of 55 myelinated fibers were reconstructed by computer imaging of 2,000 serial semi-thin epoxy sections of a tissue block that extended from just above and into an ischemic core. From proximal to distal, the typical sequence of pathological alterations was: normal- --swollen dark axons + thin myelin or demyelination----attenuated axons----axon cytolysis (46 fibers) or normal axons (9 fibers). Because organelle accumulation and axonal swelling were the earliest and most proximal pathological lesions, we infer that regional hypoxia causes axonal stasis as a primary event. Demyelination was found in fibers showing swollen dark and attenuated axons. These findings suggest that axons are selectively vulnerable to acute ischemia and that, depending on severity, the fibers either undergo axonal degeneration or transitory structural alterations without axonal degeneration, the latter consisting of axonal changes and secondary demyelination. PMID- 3674797 TI - Risk factors for ischemic stroke: a prospective study in Rochester, Minnesota. AB - A cohort of 1,804 residents of Rochester, Minnesota, who were at least 50 years old, free of stroke, and who underwent examination at the Mayo Clinic in 1960, was followed for 13 years. During this period, there were 110 first ischemic strokes and 616 deaths without stroke. The time of onset, if available, or the time of diagnosis of potential risk factors was determined for all patients during the study and was used to construct a proportional hazards model of time to occurrence of stroke with time-dependent risk factors. The model included 8 risk factors (2 fixed and 6 time-dependent). For these, the individual relative risks are: 1.6 for age (per 10 years), 2.0 for males, 4.0 for definite hypertension, 3.9 for transient ischemic attacks, 2.2 for hypertensive heart disease, 2.2 for coronary heart disease, 1.7 for congestive heart failure, and 1.7 for diabetes mellitus. Atrial fibrillation was not a significant risk factor using time-dependent multivariate analysis. PMID- 3674798 TI - Hippocampal neuron loss in temporal lobe epilepsy: correlation with early childhood convulsions. AB - Hippocampal neuron densities in three areas (H1 zone, end folium, and dentate gyrus) were counted in each of 32 temporal lobectomy excision specimens using the technique of Mouritzen Dam. The association between severe neuronal loss in all three areas and early childhood convulsions that were prolonged and/or lateralized was highly significant. Lesser degrees of neuron loss in H1 and/or end folium were common and were not associated with early childhood convulsions, but were most often found in older patients with a particularly long history of epilepsy. PMID- 3674799 TI - Magnetic resonance imaging in temporal lobe epilepsy: pathological correlations. AB - A retrospective single-blind study assessing the value of magnetic resonance imaging (MRI) in 48 patients treated surgically for temporal lobe epilepsy was carried out. The imaging findings were correlated with the surgical findings in all cases. Abnormal MRI signals were detected in 34 of 48 (71%) epileptic patients and in 3 of 48 (6.2%) normal or disease control subjects. Twelve patients had structural foreign-tissue lesions, all detected by MRI. Of 14 patients with severe gliosis of the neocortex and/or mesial temporal structures, 11 had abnormal MRI scans. In patients with mild or moderate gliosis of mesial temporal structures, 6 of 12 had abnormal MRI scans. These results indicate that MRI is a sensitive technique for localizing foreign-tissue lesions, mesial temporal sclerosis, and gliosis in patients with intractable temporal lobe seizures. PMID- 3674800 TI - Localization of magnetic interictal discharges in temporal lobe epilepsy. AB - Three young adults with intractable complex partial seizures were studied by electroencephalography, magnetoencephalography, and electrocorticography. Interictal electroencephalographic (EEG) spikes for each patient were grouped according to their morphological characteristics and distribution across channels. Mapping of simultaneously recorded magnetoencephalographic signals produced dipolar patterns from which the three-dimensional locations of equivalent current dipoles were calculated, whereas the mapping of EEG spikes showed single regions of electronegativity. The magnetic spikes were localized to the anterotemporal lobe, and the EEG spikes were localized somewhat anterior or posterior to the magnetic spikes. The magnetoencephalographic findings corresponded well with intraoperative electrocorticographic and depth-electrode findings of discharging areas located over the lateral temporal lobe and on the basal and mesial surfaces of the temporal cortex. PMID- 3674801 TI - Effect of levodopa treatment on contrast sensitivity in Parkinson's disease. AB - We studied contrast sensitivity function in 10 parkinsonian patients before and after levodopa treatment. Pretreatment contrast sensitivity function was abnormal in 16 of the 20 eyes. After treatment, only high-frequency loss was observed in 6 eyes. All other types of deficit disappeared under treatment. These changes of contrast sensitivity function following treatment suggest that dopamine is a functional transmitter in the visual pathways. PMID- 3674802 TI - Experimental hemiplegia in the monkey: basal ganglia glucose activity during recovery. AB - Unilateral ablation of cerebral cortical areas 4 and 6 of Brodmann in the macaque monkey results in a dense contralateral hemiplegia that recovers partially with time. During the phase of dense hemiplegia, the local cerebral metabolic rate for glucose (lCMRGlc) is decreased significantly in the caudate nucleus, putamen, globus pallidus, subthalamic nucleus, substantia nigra, and red nucleus of the hemisphere ipsilateral to the lesion. In the present study, lCMRGlc in the basal ganglia was studied during the phase of partial recovery of motor activity. lCMRGlc was partially restored, and the greatest degree of restoration occurred in structures with direct connections to the cerebral cortex (caudate nucleus, putamen, subthalamic nucleus, substantia nigra, and red nucleus). Restoration was least in structures that do not receive direct connections from the cerebral cortex (the internal and external segments of the globus pallidus). The findings support the hypothesis that corticofugal activity accounts for a substantial degree of functional recovery. PMID- 3674803 TI - Search for antibodies to galactocerebroside in the serum and cerebrospinal fluid in human demyelinating disorders. AB - To determine if galactocerebroside (GalC) is a target antigen in the human demyelinating disorders multiple sclerosis, Guillain-Barre syndrome, and chronic demyelinating inflammatory polyneuropathy, we examined the serum and cerebrospinal fluid from patients with these disorders and from control subjects using four assay systems. In none of these assays could we detect significant differences in anti-GalC antibody titer between patients with demyelinating diseases and normal subjects or patients with other neurological disorders. Our data suggest that there is no humoral immune response to GalC in human demyelinating disorders. PMID- 3674804 TI - Chronic muscle weakness caused by Borrelia burgdorferi meningoradiculitis. AB - A 19-year-old man developed chronic weakness of the lower limbs as the predominant manifestation of Borrelia burgdorferi infection of the nervous system. Spirochetes were demonstrated in the cerebrospinal fluid. The condition resolved following intravenous penicillin treatment. PMID- 3674805 TI - Clinical heterogeneity in autosomal dominant myopathies. PMID- 3674806 TI - HIV seropositivity in Guillain-Barre syndrome. PMID- 3674807 TI - Seizures induced by orgasm. PMID- 3674808 TI - Severe myotonia relieved by nifedipine. PMID- 3674809 TI - Cerebrovascular disease and systemic lupus erythematosus. PMID- 3674810 TI - [Contact lens optics in diagnosis and therapy]. PMID- 3674811 TI - [Ophthalmoscopy]. PMID- 3674812 TI - [Ergonomics of the operating microscope]. PMID- 3674813 TI - [Choice and optimal use of instrumentation in ophthalmology. Current questions]. PMID- 3674814 TI - [Vision disorder case finding]. PMID- 3674815 TI - [2d round table discussion: Choice and optimal use of instrumentation in ophthalmology]. PMID- 3674816 TI - [Retinal detachment in pseudophakia]. PMID- 3674817 TI - [Subjective refractometry]. PMID- 3674818 TI - [Cataract surgery using pars plana phacoemulsification, vitrectomy]. PMID- 3674819 TI - [Current technology in vitrectomy]. PMID- 3674820 TI - [Ophthalmologic manifestations of arterial hypertension]. PMID- 3674821 TI - [When and how should one operate on primary closed-angle glaucoma?]. PMID- 3674822 TI - [Financing of equipment in ophthalmology]. PMID- 3674823 TI - [4th round table discussion: Choice and optimal use of instrumentation in ophthalmology]. PMID- 3674824 TI - [Objective refractometry]. PMID- 3674825 TI - [The choice of eyeglass lenses in modern life]. PMID- 3674826 TI - [1st round table discussion: Choice and optimal use of instrumentation in ophthalmology]. PMID- 3674827 TI - [The slit lamp or ocular biomicroscopy]. PMID- 3674828 TI - Genetic studies on resistant and susceptibility genes controlling the mouse cornea to infection with Pseudomonas aeruginosa. PMID- 3674829 TI - [The main trends in the area of the pharmacokinetic study of chemotherapeutic agents]. AB - Development of rational antibiotic dosing is mainly limited by the absence of a clear conception of the minimum efficient concentration. Studies on antimicrobial effect kinetics in dynamic models in vitro simulating pharmacokinetic profiles observed in humans markedly promote the problem solution. Such an approach enabled one to reveal a relationship between duration or intensity of the antibiotic effect and the area under the concentration/time curve. This relationship depends on the antibiotic pharmacokinetic profile. It is advisable to evaluate antibiotic efficacy against microorganisms by the minimum efficient area under the concentration/time curve and not by the antibiotic minimum efficient concentration. Thus, it is possible to estimate simultaneous contribution of two factors to the antimicrobial effect: drug concentration and exposure time. PMID- 3674830 TI - [The main stages in the pharmacokinetic research on new substances]. AB - The main stages in studying pharmacokinetics of new drugs are discussed. They include: development of a micromethod for determining drugs in biological objects, estimation of drug stability in biological objects on storage, evaluation of drug distribution coefficients, investigation of drug solubility rate, drug binding to plasma proteins and erythrocytes, studying of drug metabolism in vitro and in vivo, investigation of drug kinetics in test tissues after single and repeated administrations, estimation of drug bioavailability, investigation of drug excretion and distribution in organs and tissues, determination of concentration-effect relationships in test tissues and studying of drug pharmacokinetics in models simulating pathological processes. PMID- 3674831 TI - [Model and model-independent methods of describing pharmacokinetics: the advantages, drawbacks and interrelationship]. AB - A system for classification of the main quantitative approaches used in describing drug pharmacokinetics is proposed. The basis of the system is occupied by the systemic approach ignoring a detailed picture of the processes observed in the organism with participation of drugs and providing only integral description of such processes by parameters not depending on the concrete structure of the model. The second level is represented by stochastic models which also ignore the process detailed mechanism but provide concrete definition of the drug retention time frequency and distribution. The upper level is occupied by structural models (compartment and physiological) fixating a priori the concrete picture of the drug mass transfer in the organism which is more or less close to the real one. Interrelation of the three levels is analyzed. Definitions of the main model independent pharmacokinetic parameters such as total clearance, apparent volume distribution and mean retention time of the drug molecules in the organism are presented. A relationship between the drug concentration profile in blood and the drug retention time density distribution was developed. This relationship is the ground of the stochastic pharmacokinetic models. PMID- 3674832 TI - [Problems of the relationship of the therapeutic effect and the concentration of drugs in the blood]. AB - Certain approaches to analysis of the drug concentration-response relationship based on the mechanism of the effect realization and the results of their clinical trials are discussed. The studies are exemplified by a model for quantitative analysis of the concentration-response relationship developed for diuretics and by the results of the clinical trial of the principle of the maximum providing prediction of the steady-state level of the drugs in blood and estimation of the drug effect. PMID- 3674833 TI - [Antibiotic pharmacokinetics in rats with an infected inflammation]. AB - Penetration of antibiotics into infected inflammation foci depended on the level of their binding to serum proteins. Low binding ampicillin provided the highest levels of the free antibiotic in both serum and the inflammation foci. At the same time coefficients of antibiotic penetration into purulent infiltrates and infected tissues were close and amounted approximately to 70-80 per cent. Antibiotic elimination from the infection foci was retarded as compared to that from serum. PMID- 3674834 TI - [Effect of the conditions for culturing Aureobasidium pullulans D-By Arnaud (1910) on the physicochemical characteristics of aubazidan]. AB - Physicochemical characteristics of several aubazidan lots were studied. It was shown that the polysaccharide drug consisted of three fractions. This means that aubazidan is a polydisperse polymer. The polysaccharide structure and properties such as solubility, velocity and optical parameters markedly depended on the cultivation conditions of the organism producing aubazidan. This could be due to different activity of the enzyme responsible for synthesis of the aubazidan molecule. PMID- 3674835 TI - [Action of thomicide on bacterial cells. The membranotropic activity of thomicide]. AB - It was shown that a combined drug thomicide impaired permeability of cell membranes in Micrococcus luteus 2665 and Staphylococcus aureus 209P inducing production of substances with the absorption maxima at 260 nm. Active lysis of the M. luteus 2665 protoplasts under the action of thomicide used in a dose of at least 60 micrograms per 1 mg of the protoplast proteins was observed. Thomicide inhibited oxidation of the substrates by intact cells of the staphylococci and micrococci. Respiration of the micrococcal protoplasts was inhibited by thomicide in concentrations inducing lysis of the protoplasts. Impairment of function and the state of the membranes of the bacterial cells (production of compounds with the absorption maxima at 260 nm, protoplast lysis and respiration inhibition) was recorded at thomicide concentrations lower than the bactericidal ones. The membranotropic activity of thomicide was associated with thermostable component of the complex. PMID- 3674836 TI - [Current status and prospects for antibiotic use in agriculture]. PMID- 3674837 TI - [Eremomycin--a new antibiotic from the cyclic glycopeptide group]. AB - Eremomycin, a novel antibiotic belonging to the group of cyclic glycopeptides is produced by an actinomycete designated INA-238. Biosynthesis, isolation, physico chemical and biological properties of the antibiotic are described. Eremomycin is shown to be close to vancomycin. However, by its chromatographic and electrophoretic mobility, presence of chlorine in the antibiotic molecule and optic characteristics eremomycin differs from vancomycin. Eremomycin is less toxic than vancomycin whereas its chemotherapeutic activity in treatment of infections caused by gram-positive organisms is higher. PMID- 3674838 TI - [Comparison of the sensitivity of Rhodococcus rubropertinctus R, S and M variants to antibiotic action]. AB - Comparison of sensitivity of 63 clones of R, S and M variants of Rhodococcus rubropertinctus 104 to 6 antibiotics showed that sensitivity of the variants was similar only to erythromycin. Their sensitivity to penicillin, streptomycin, chlortetracycline, rifampicin and actinomycin C was different. Still, they preserved similar regularity: M cells were the most sensitive and R cells were the most resistant. There was a 1.5-3 fold difference in sensitivity of R and M variants to the antibiotics. The number and rate of chlortetracycline absorption by R cells were lower than those of S and especially M cells which must condition their higher resistance to the antibiotic. PMID- 3674840 TI - [Rheological research in creating antibiotic hydrogels]. AB - Experimental design was used in studying the effect of certain qualitative factors on rheological properties of antibiotic hydrogels. It was shown that water solubility of antibiotics and the procedure of their addition to gel bases were important in developing hydrogels. Scanning electron microscopy was used in comparative analysis of antibiotic hydrogels. PMID- 3674839 TI - [Intracellular ATP content and nonactin biosynthesis]. AB - The effect of potassium orthophosphate on growth of the mycelium, its ATP contents and biosynthesis of the macrotetrolide antibiotic nonactin by Str. chrysomallus var. macrotetrolidi was studied. Direct dependence of the ATP contents in the mycelium on the amount of the phosphate added to the medium and consumed by the developing actinomycete was shown. Changes in the intracellular content of ATP depended also on the mycelium age. It was characterized by two peaks. Hemin was detected in the actinomycete mycelium. Its levels were sufficiently high and depended on the mycelium age and cultivation conditions, in particular on the phosphate content in the medium. Higher levels of nonactin biosynthesis were characteristic of the mycelium with lower contents of ATP, proteins and hemin. Intensive production of the antibiotic proceeded at the background of decreasing levels of ATP in the mycelium. PMID- 3674841 TI - [Bacterial antilysozyme activity and its regulation by antibiotics]. AB - The effect of subinhibitory doses of 25 antibiotics on the antilysozyme property of enterobacteria considered as a marker of their persistence was studied. This provided dividing the antibiotics into 3 groups: antibiotics increasing the bacterial capacity for lysozyme degradation, antibiotics indifferent with respect to this property and antibiotics decreasing it. Decreasing of the Salmonella antilysozyme activity by gentamicin under experimental conditions promoted suppression of the bacteria parasitism in Hep-2 cells. Clinical and laboratory studies on the effect of antibiotic therapy under the control of the time course of the antilysozyme property of the pathogen in patients with acute dysentery, pyelonephritis and inflammatory processes in the female genitalia showed that the use of the antibiotics increasing this property in the pathogen was not advisable which was confirmed by the absence of significant clinical improvement in the patients and necessity of prolonging the sanative period. PMID- 3674842 TI - [Complications and their elimination during the rapid intravenous administration of rifampicin in an experiment]. AB - Reaction to rapid intravenous administration (RIA) of rifampicin in a dose of 10 mg/kg was studied on 173 healthy dogs. Immediately after the first RIA of rifampicin there were observed vomiting and ataxia of various levels in 5.2 per cent of the animals. After the drug administration their arterial pressure (AP) lowered to 50-60 mm Hg. By the 9th-11th minute it restored to the initial level. A collapse-like condition was recorded immediately after rifampicin RIA in 2.3 per cent of the dogs with marked decreasing of their AP up to 15-20 mm Hg. Its restoration to the initial level was slow and required 35-40 min. It was noted that after the third consecutive RIA of rifampicin the observed reaction disappeared. Probably this was due to adaptation of the host to rifampicin intravenous injections. Mezaton is an efficient agent rapidly arresting the reaction within 1-3 min. PMID- 3674843 TI - Pulmonary disposition of roxithromycin (RU 28965), a new macrolide antibiotic. AB - The penetration of roxithromycin (RU 28965), an ether oxime derivative of erythromycin, into the cells and fluid lining the epithelial surface of the lower respiratory tract was studied by performing fiber-optic bronchoscopy with bronchoalveolar lavage on eight patients who had received roxithromycin at 300 mg perorally every 12 h for 5 days. The apparent volume of epithelial lining fluid recovered by bronchoalveolar lavage was determined by using urea as an endogenous marker. There was a significant relationship (r = 0.75; P less than 0.02) between roxithromycin levels in plasma and epithelial lining fluid, with a correlation whose slope suggested that the level of drug penetration into the lining fluid was 0.2. Concentrations of the antibiotic in cells recovered by bronchoalveolar lavage (21 +/- 10 micrograms/ml) were 2 and 10 times higher than in plasma (11.4 +/- 5.7 micrograms/ml) and epithelial lining fluid (2.0 +/- 1.7 micrograms/ml), respectively. Thus, when administered perorally in humans, roxithromycin is markedly accumulated by resident alveolar macrophages in concentrations largely exceeding the MBCs of the drug for most facultative intracellular pathogens including Legionella pneumophila, despite low concentrations in the epithelial lining fluid. PMID- 3674844 TI - Pharmacokinetics and tolerance of desciclovir, a prodrug of acyclovir, in healthy human volunteers. AB - Because of the incomplete absorption of acyclovir (ACV) when given orally in humans, efforts have been made to develop a prodrug of ACV that would be better absorbed from the gastrointestinal tract and then converted in vivo to ACV. One such compound, desciclovir (DCV), is converted to acyclovir in vivo by xanthine oxidase. We gave each of 13 healthy volunteers 250 mg (about 3.25 mg/kg of body weight) of DCV orally thrice daily for 10 days, collected serial plasma and urine specimens, and measured DCV and ACV concentrations. The absorption of DCV was at least 75%, and almost two-thirds of the administered oral dose was recovered in the urine as ACV. Peak ACV levels in plasma were about 5 micrograms/ml and were reached in less than 1 h. The levels of ACV achieved in plasma were of the same magnitude as those reported for subjects given intravenous ACV at a dose of 2.5 mg/kg and approximately 10-fold higher than levels attained after administration of 200 mg of oral ACV every 4 h as measured in previous studies. The half-life of DCV was 0.85 +/- 0.16 h, compared with 2.6 +/- 0.5 h for ACV, indicating rapid conversion of DCV to ACV. There was no substantial increase in ACV levels in plasma on day 11 compared with day 2. No serious or consistent adverse effects were noted. In particular, the creatinine level in serum did not significantly rise in any subject and remained within the normal range in all. PMID- 3674845 TI - Relationship between cefamandole and cefuroxime activity against oxacillin resistant Staphylococcus epidermidis and oxacillin resistance phenotype. AB - The activity of cefamandole and cefuroxime against oxacillin-resistant staphylococcus epidermidis was studied in vitro to determine whether there was any relationship between oxacillin resistance phenotypes and cephalosporin activity. Oxacillin resistance phenotypes were determined by efficiency-of plating studies on Mueller-Hinton agar containing oxacillin, with and without NaCl, and incubated at 30 and 35 degrees C. On the basis of MIC and MBC determinations, cefamandole was more active than cefuroxime against oxacillin resistant S. epidermidis. Although temperature had minimal effect on the activity of either cefamandole or cefuroxime, NaCl significantly decreased the activity of cefuroxime but not of cefamandole. Neither cephalosporin consistently produced greater than or equal to 99.9% bactericidal activity within 24 h in timed killing curve studies. No consistent relationship was observed between cefamandole or cefuroxime activity and oxacillin resistance phenotype. PMID- 3674846 TI - Comparison of relative susceptibilities of Candida species to three antifungal agents as determined by unstandardized methods. AB - Three groups of isolates, each comprising four isolates of Candida species, were selected for their diversity of susceptibilities to amphotericin B, flucytosine, or ketoconazole. The isolates were distributed in duplicate and in blinded fashion to three laboratories where a total of eight procedures were performed for each drug. From the decoded results, intralaboratory variability among replicate determinations was found usually to fall within a fourfold range. Interlaboratory variation, however, was 16-fold or greater for all isolates, ranging to 50,000-fold differences for some isolates. Relative susceptibilities of isolates within each method could be determined in 11 of the 24 drug-method combinations and agreed with the reference rank order in all but one instance. Our findings underscore the lack of agreement among laboratories for the susceptibility testing of yeasts but indicate that such differences could likely be resolved by standardization without loss of clinical value. PMID- 3674847 TI - Antifungal activity of the allylamine derivative terbinafine in vitro. AB - Terbinafine, an allylamine derivative, represents the most effective of this new chemical class of antimycotic compounds. Under in vitro conditions, terbinafine proved to be highly active against dermatophytes (MIC range, 0.001 to 0.01 microgram/ml), aspergilli (MIC range, 0.05 to 1.56 micrograms/ml), and Sporothrix schenckii (MIC range, 0.1 to 0.4 microgram/ml) and also exerted good activity against yeasts (MIC range, 0.1 to greater than 100 micrograms/ml). The growth of Malassezia furfur was inhibited also (MIC range, 0.2 to 0.8 microgram/ml). Terbinafine displays a primary fungicidal action against dermatophytes, other filamentous fungi, and S. schenckii. The type of action against yeasts is species dependent and can be primarily fungicidal (Candida parapsilosis) or fungistatic (Candida albicans). The in vitro activity of terbinafine is pH dependent and rises with increasing pH value. PMID- 3674848 TI - Interactions of ciprofloxacin with clindamycin, metronidazole, cefoxitin, cefotaxime, and mezlocillin against gram-positive and gram-negative anaerobic bacteria. AB - A total of 598 clinical isolates of anaerobic bacteria were tested against ciprofloxacin by the agar dilution technique with 10(5) CFU on Wilkins-Chalgren medium. Selected strains representative of the six major genera of anaerobes relatively resistant to the quinolones were tested for interactions with ciprofloxacin in combination with clindamycin, metronidazole, cefoxitin, cefotaxime, or mezlocillin by using a checkerboard agar dilution technique. Cefotaxime-ciprofloxacin and clindamycin-ciprofloxacin were the most effective combinations, with 16% of all isolates and 44% of the Bacteroides fragilis group isolates responding synergistically to the former combination and 9% of all isolates and 37% of Peptostreptococcus isolates responding synergistically to the latter. Occasional synergy was seen with all other antibiotic combinations except for metronidazole-ciprofloxacin. Likewise, synergism was seen with all groups of anaerobes except for Fusobacterium species. Antagonistic interactions were observed only with a Peptostreptococcus intermedius strain tested against clindamycin-ciprofloxacin. These data suggest that combinations of ciprofloxacin with these agents may be useful for certain resistant anaerobic infections. PMID- 3674850 TI - In vitro synergistic activity between bismuth subcitrate and various antimicrobial agents against Campylobacter pyloridis (C. pylori). AB - The in vitro interactions between bismuth subcitrate and a variety of antimicrobial agents against 12 Campylobacter pyloridis (C. pylori) isolates were studied by the agar dilution checkerboard technique. The combination of bismuth subcitrate with the older quinolone, oxolinic acid, produced synergistic activity against all strains. This observation, however, could not be extended to the (aryl) fluoroquinolones, norfloxacin, ofloxacin, and difloxacin, since synergy was rare or absent when bismuth subcitrate was combined with these antibiotics. Among the other antimicrobial agents tested, rifampin and the beta-lactams frequently showed showed MICs for C. pyloridis similar to those of bismuth subcitrate. PMID- 3674849 TI - Univariate and multivariate analyses of risk factors predisposing to auditory toxicity in patients receiving aminoglycosides. AB - Risk factors predisposing to auditory toxicity of aminoglycosides were analyzed from records of 187 patients enrolled in three prospective randomized trials comparing the toxicity of netilmicin, tobramycin, and amikacin. Patients were eligible if they received three or more days of therapy and at least two serial audiograms were available. The overall auditory toxicity rate was 9.6% (18 of 187). Auditory toxicity was detected in 4.4, 10.8, and 23.5% of patients given netilmicin, tobramycin, and amikacin, respectively (P = 0.05). In the univariate analysis, patients who developed auditory toxicity were significantly older (P = 0.01) and had a significantly higher (P = 0.04) percentage of trough levels of netilmicin or tobramycin above 2 mg/liter or amikacin above 5 mg/liter. In the final logistic regression model, only age was retained as independently influencing the development of auditory toxicity (P less than 0.00001). Conversely, factors that did not add significantly to the prediction of auditory toxicity were aminoglycoside serum levels, total aminoglycoside dose, duration of therapy, sex, peak temperature, presence of bacteremia, shock, liver cirrhosis, dehydration, previous otic pathology or renal failure, and development of renal toxicity. At least in certain populations, age is the most important predisposing factor for the development of auditory toxicity in patients receiving aminoglycosides. PMID- 3674851 TI - Comparative trial of cefuroxime axetil in recurrent urinary tract infections illustrating importance of 6-week follow-up. AB - Women with recurrent urinary tract infections treated with cefuroxime axetil (500 or 250 mg twice daily) for 7 days had a higher relapse rate when tested 6 weeks after the start of treatment than those given amoxycillin (250 mg three times daily). The poor performance of cefuroxime axetil is explained by variable bioavailability. PMID- 3674852 TI - Single- and combination-antibiotic therapy for experimental endocarditis caused by methicillin-resistant Staphylococcus aureus. AB - The efficacy of fosfomycin in combination with vancomycin or gentamicin was evaluated in experimental endocarditis caused by methicillin-resistant Staphylococcus aureus. After 5 days of therapy, both combinations proved to be highly effective since all rabbits had sterile vegetations. PMID- 3674853 TI - Priming of influenza mRNA transcription is inhibited in CHO cells treated with the methylation inhibitor, neplanocin A. AB - Chinese hamster ovary cells were pretreated with Neplanocin A, a potent inhibitor of RNA methylation. Analysis of polyadenylated RNA from treated cells by high pressure liquid chromatography revealed marked decreases of 2'-O-methylation within mRNA cap structures and of internal N6-methyladenosine residues. In these Neplanocin A-treated cells, influenza viral mRNA accumulation was virtually abolished. Cellular RNA from Neplanocin A-treated cells was substantially less efficient than RNA from control cells in priming cell-free influenza transcription reactions. These results suggest that the observed inhibition of influenza virus replication is due at least in part to impaired recognition of undermethylated cellular mRNA cap structures by the influenza polymerase complex. PMID- 3674854 TI - Detection of HBV-DNA in liver biopsy and serum: its significance in the selection of hepatitis B patients for antiviral therapy. AB - We have characterized the hepatitis B virus state in liver and serum of 38 HBsAg positive chronic hepatitis patients (chronic active hepatitis (CAH), 19; chronic persistent hepatitis (CPH), 7; cirrhosis, 11; 'normal' carrier, 1) and 21 HBsAg negative patients. Episomal HBV-DNA in liver, without detectable integrated HBV DNA sequences, concomitant with HBV-DNA in serum was found in 19 HBeAg-positive patients (CAH, 16; CPH, 1; cirrhosis, 2). Integrated sequences were detected in 13 HBsAg-positive HBeAg-negative patients (CAH, 1; CPH, 5; cirrhosis, 7) and in 1 HBsAg-negative patient. Episomal HBV-DNA and integrated HBV-DNA sequences were observed simultaneously in 1 HBsAg-positive HBeAg-negative CPH patient and in 4 HBsAg-positive cirrhosis patients (2 HBeAg-positive, 2 HBeAg-negative). The presence of HBcAg immunofluorescence corresponded well with that of episomal HBV DNA. Antiviral therapy is advised for HBsAg-positive chronic hepatitis patients with episomal HBV-DNA, irrespective of the presence of integrated sequences. Since the presence of episomal HBV-DNA in liver is not always accompanied by the presence of serum HBV-DNA, procedures for the selection and evaluation of patients for antiviral therapy should be extended by characterization of the HBV DNA state in liver biopsies. PMID- 3674855 TI - Differences in virulence within the species Bacteroides gingivalis. AB - In order to gain insight into the relative importance of several virulence factors of Bacteroides gingivalis, 8 strains with a varying virulence were studied. The virulence of B. gingivalis was determined in a mouse model. Strains HG 66, HG 76 and HG 184 were very virulent causing phlegmonous abscesses with lesions and necrosis. The strains HG 405 and HG 462 caused phlegomonous abscesses with pus. Strains HG 91, HG 94 and HG 185 were less virulent and induced gravity abscesses. In vitro strains HG 66, HG 76 and HG 184 induced low amounts of chemiluminescence by polymorphonuclear leucocytes. All other strains including HG 405 and HG 462 caused a relatively high chemiluminescence. Most strains displayed a high sensitivity to the bactericidal activity of fresh serum except for the highly virulent strains HG 66, HG 76 and HG 184. No differences in extracellular proteolytic activity on Azocoll, production of volatile fatty acids and ammonia were found between the B. gingivalis strains studied. In conclusion, differences in virulence were shown within the species B. gingivalis; the relative importance of several virulence factors was investigated. PMID- 3674856 TI - Sporobolomyces inositophilus, a new species of ballistosporous yeast isolated from a dead leaf of Sasa sp. in Japan. AB - A new species of ballistosporous yeast, Sporobolomyces inositophilus was isolated from a dead leaf of Sasa sp. collected at a mountain in Japan. This yeast is assumed to have a close relationship to Sporobolomyces singularis since it produces bilaterally symmetrical ballistospores and pale-coloured colonies and resembles Sporobolomyces singularis in these respects. These two species differ from typical species of Sporobolomyces and seem to constitute a natural taxonomic group. PMID- 3674858 TI - Nursing diagnoses challenged. PMID- 3674857 TI - Enrichment of subgingival microflora on human serum leading to accumulation of Bacteroides species, Peptostreptococci and Fusobacteria. AB - This study was undertaken to identify ecological factors that favour opportunistic pathogenic species in the subgingival microflora. In a first approach, human serum as a substitute for gingival exudate, was used for batch wise enrichment of subgingival plaque. The microflora resulting after 5-6 enrichment steps consisted of black-pigmented and non-black-pigmented Bacteroides species, Peptostreptococcus micros and Fusobacterium nucleatum as the main organisms. It is noted that the same group of species was found to be enriched independent upon the origin of the subgingival plaque sample. It was suggested that these organisms are favoured by the increased flow of gingival exudate during inflammation. The consortium of organisms was capable of selective degradation of serum (glyco-)proteins. Four different types of degradation occurred. After a prolonged period of growth complete degradation of immunoglobulins, haptoglobin, transferrin and complement C3c was observed. Partial degradation of immunoglobulins, haptoglobin, transferrin, albumin, alpha 1-antitrypsin and complement C3c and C4 was generally observed after 48 h of growth. Besides, immunoglobulin protease activity yielding Fc and Fab fragments was found. The consortium was also capable of consuming carbohydrate side-chains as indicated by an altered electrophoretic mobility of the serum glycoproteins. PMID- 3674859 TI - The nurse shortage. A brief opinion survey. PMID- 3674860 TI - One nurse's view of the nurse shortage. PMID- 3674861 TI - A manager's dilemma. Balancing job anxiety and personal stress. PMID- 3674862 TI - Perioperative documentation. Integrating nursing diagnoses on the patient record. AB - The perioperative record maintains accurate communication between the OR and the postoperative care nurse. For example, the nurse can easily verify the type and placement of a drain by checking the area labeled "Potential for infection." The check-off format also makes the information consistent and easy-to-read, and the nurse does not have to decipher any handwriting. Another advantage of this format is that it is easy to retrieve data for nursing research. It is also suitable for computerization. PMID- 3674863 TI - Orthopedic orientation. A guide for new nurses. PMID- 3674864 TI - Proposed recommended practices. Preoperative skin preparation. AORN Recommended Practices Subcommittee of the TPCC. PMID- 3674865 TI - Occupational Safety and Health Administration to address health care workers' exposure to AIDS. PMID- 3674866 TI - Central dispatch system coordinates surgical attendants' activities. PMID- 3674867 TI - Laser surgery for allergic rhinitis. PMID- 3674868 TI - Cases involving ulnar nerve injuries demonstrate precautions nurses can and should take. PMID- 3674869 TI - Biodegradation of DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane] by the white rot fungus Phanerochaete chrysosporium. AB - Extensive biodegradation of 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT) by the white rot fungus Phanerochaete chrysosporium was demonstrated by disappearance and mineralization of [14C]DDT in nutrient nitrogen-deficient cultures. Mass balance studies demonstrated the formation of polar and water soluble metabolites during degradation. Hexane-extractable metabolites identified by gas chromatography-mass spectrometry included 1,1,-dichloro-2,2-bis(4 chlorophenyl)ethane (DDD), 2,2,2-trichloro-1,1-bis(4-chlorophenyl)ethanol (dicofol), 2,2-dichloro-1,1-bis(4-chlorophenyl)ethanol (FW-152), and 4,4' dichlorobenzophenone (DBP). DDD was the first metabolite observed; it appeared after 3 days of incubation and disappeared from culture upon continued incubation. This, as well as the fact that [14C]dicofol was mineralized, demonstrates that intermediates formed during DDT degradation are also metabolized. These results demonstrate that the pathway for DDT degradation in P. chrysosporium is clearly different from the major pathway proposed for microbial or environmental degradation of DDT. Like P. chrysosporium ME-446 and BKM-F-1767, the white rot fungi Pleurotus ostreatus, Phellinus weirii, and Polyporus versicolor also mineralized DDT. PMID- 3674870 TI - Effect of hydrophobicity of utilization of peptides by ruminal bacteria in vitro. AB - When mixed ruminal bacteria were incubated with a pancreatic casein hydrolysate and free amino acids of a similar composition, rates of ammonia production were much greater for peptides than for amino acids. The pancreatic digest of casein was then fractionated with 90% isopropyl alcohol. Hydrophobic peptides which dissolved in alcohol contained an abundance of phenolic and aliphatic amino acids, while the hydrophilic peptides which were precipitated by alcohol contained a large proportion of the highly charged amino acids. The Km values of the mixed ruminal bacteria for each fraction were similar (0.88 versus 0.98 g/liter), but the Vmax of the hydrophilic peptides was more than twice that of the hydrophobic peptides (18 versus 39 mg of NH3 per g of bacterial protein per h). Pure cultures of ruminal bacteria had a similar preference for hydrophilic peptides and likewise utilized peptides at a faster rate than free amino acids. Since peptide degradation rates differed greatly, hydrophobicity is likely to influence the composition of amino acids passing unfermented to the lower gut of ruminant animals. PMID- 3674871 TI - Enzymatic methylation of sulfide, selenide, and organic thiols by Tetrahymena thermophila. AB - Cell extracts from the ciliate Tetrahymena thermophila catalyzed the S adenosylmethionine-dependent methylation of sulfide. The product of the reaction, methanethiol, was detected by a radiometric assay and by a gas-chromatographic assay coupled to a sulfur-selective chemiluminescence detector. Extracts also catalyzed the methylation of selenide, and the product was shown by gas chromatography-mass spectrometry to be methaneselenol. The sulfide and selenide methyltransferase activities copurified with the aromatic thiol methyltransferase previously characterized from this organism (A.-M. Drotar and R. Fall, Pestic. Biochem. Physiol. 25:396-406, 1986), but heat inactivation experiments suggested the involvement of distinct sulfide and selenide methyltransferases. Short-term toxicity tests were carried out for sulfide, selenide, and their methylated derivatives; the monomethylated forms were somewhat more toxic than the nonmethylated or dimethylated compounds. Cell suspensions of T. thermophila exposed to sulfide, methanethiol, or their selenium analogs emitted methylated derivatives into the headspace. These results suggest that this freshwater protozoan is capable of the stepwise methylation of sulfide and selenide, leading to the release of volatile methylated sulfur or selenium gases. PMID- 3674872 TI - Isolation of a Pseudomonas stutzeri strain that degrades o-xylene. AB - A Pseudomonas stutzeri strain capable of growing on o-xylene was isolated from enrichment cultures. The organism grew on 2,3- and 3,4-dimethylphenol but not on 2-methylbenzyl alcohol, o-tolualdehyde, or o-toluate. P. stutzeri was not able to utilize m-xylene, p-xylene, or 1,2,4-trimethylbenzene, but growth was observed in the presence of the corresponding alcohols and acids. From the Pseudomonas cultures supplied with o-xylene, 2,3-dimethylphenol was isolated and identified. When resting P. stutzeri cells were incubated with 2,3-dimethylphenol, the reaction mixture turned greenish yellow and showed spectral properties identical to those of the 3,4-dimethylcatechol meta ring fission product. Catechol 2,3 oxygenase was induced by growth on o-xylene or on 2,3- or 3,4-dimethylphenol. The suggested hypothesis is that the first metabolic steps of growth on o-xylene involve the direct oxygenation of the aromatic nucleus, followed by meta pathway reactions. PMID- 3674873 TI - New selective and differential medium for Vibrio cholerae and Vibrio vulnificus. AB - Thiosulfate-citrate-bile salts-sucrose agar has been routinely used for the isolation of pathogenic vibrios, although its selectivity for Vibrio cholerae and Vibrio vulnificus is inadequate. Therefore, a new plating medium, cellobiose polymyxin B-colistin agar, was developed for the isolation of these two species. Cellobiose-polymyxin B-colistin agar demonstrated a significant advantage over other media designed for the isolation or differentiation of vibrios: of both the 136 strains representing 19 Vibrio species and the marine isolates of the genera Pseudomonas, Flavobacterium, and Photobacterium, only V. vulnificus and V. cholerae were able to grow. Furthermore, the fermentation of cellobiose by V. vulnificus allowed for the easy differentiation of these two species. This medium offers significant potential as a selective and differential medium for these two pathogenic vibrios. PMID- 3674874 TI - A selective medium for enumeration and recovery of Pseudomonas cepacia biotypes from soil. AB - TB-T medium provides a high degree of selectivity for and detection of Pseudomonas cepacia biotypes upon initial plating from soil. TB-T medium consists of a basal medium with glucose as the sole carbon source and asparagine as the sole nitrogen source. The selectivity of TB-T medium is based on the combination of trypan blue (TB) and tetracycline (T) (pH 5.5). On TB-T medium, 216 of 300 isolates (72%) from five different soil types were identified as P. cepacia. The remaining 28% were facultative organisms that could be separated readily from P. cepacia by anaerobic glucose fermentation and by their inability to grow at 41 degrees C. Molds were controlled on low soil dilutions by adding crystal violet, nystatin, or both. Elimination of either ingredient or elevation of the pH to 7.5 resulted in a pronounced loss of selectivity. The efficiency of recovery varied considerably among P. cepacia strains but was high enough for some strains (76 to 86%) to permit quantitative studies. TB-T medium combines a defined formulation with high selectivity and allows recovery of P. cepacia biotypes from low soil dilutions (10(1) to 10(3)). PMID- 3674875 TI - Drag reduction by Acinetobacter calcoaceticus BD4. AB - The encapsulated bacterium Acinetobacter calcoaceticus BD4 at a density of 3.6 X 10(9) cells per ml reduced the friction of turbulent water in a narrow pipe by 55%. This drag reduction was due to the tightly bound polysaccharide capsules (0.4 mg per ml) of culture. Capsule-deficient mutants of BD4 failed to reduce drag. The cell-bound polysaccharide demonstrated a threefold-higher drag-reducing activity than the polymer which was free in solution. PMID- 3674876 TI - Purification of long-chain acyl-CoA hydrolase from bovine heart microsomes and regulation of activity by lysophospholipids. AB - Long-chain acyl-CoA hydrolase (EC 3.1.2.2) has been purified 12,000-fold from bovine heart muscle microsomes by extraction with Miranol detergent, followed by column chromatography on Reactive Blue agarose and DEAE-cellulose. The purified enzyme was nearly homogeneous on polyacrylamide gel electrophoresis and had a molecular weight of 41,000 in the presence of dodecyl sulfate. The specificity and kinetic properties of the enzyme were studied using several acyl-CoA derivatives as potential substrates. The enzyme showed a wide degree of specificity with little dependence on either the fatty acyl chain length or the degree of unsaturation of the acyl group. The kinetic properties were in accord with the Michaelis-Menten equation under most conditions, although high concentrations of substrates generally inhibited the enzyme. Arachidonoyl-CoA, which was the most effective substrate, had a Km value of 0.4 microM and a Vmax value of 6.0 mumol min-1 mg-1. The enzyme was strongly and specifically inhibited by constants of 16 and 30 nM, respectively. Other lysolipids and detergents such as deoxycholate and Triton X-100 were weak inhibitors. These properties and others distinguish this enzyme from other acyl-CoA hydrolases and support the idea that lysophospholipids may be important in vivo in the regulation of lipid metabolism. PMID- 3674877 TI - III6NeuAcLc4Cer in human SW1116 colorectal carcinoma cells: a possible oncofetal antigen that is not dependent on Lewis gene expression. AB - Monospecific rabbit antibodies directed against the human milk sialyloligosaccharides III6NeuAcLcOse4 (sialyltetrasaccharide b), IV3NeuAcLcOse4 (sialyltetrasaccharide a), and IV6NeuAcnLc4Ose (sialyltetrasaccharide c) were used to detect their homologous haptens as gangliosides or ganglioside-derived sialyloligosaccharides from the human colorectal carcinoma cell line SW1116. III6NeuAcLc4Cer was first detected in human meconium [P. A. Prieto and D. F. Smith (1985) Arch. Biochem. Biophys. 241, 281-289], and its presence in a total ganglioside fraction of SW1116 cells together with its absence from a total lipid extract of normal human intestinal mucosa are consistent with III6NeuAcLc4Cer being a tumor-associated oncofetal antigen. IV3NeuAcLc4Cer, a ganglioside in human meconium [P. A. Prieto and D. F. Smith (1986) Arch. Biochem. Biophys. 249, 243-253], was also detected in SW1116 cells; an observation that is consistent with its being the immediate precursor to the sialyl-Lea ganglioside in SW1116 cells. Specific antisera against sialylated type 1 oligosaccharide chains whose expression is independent of the Lewis gene fucosyltransferase may be useful diagnostic reagents for oncofetal, carbohydrate antigens. PMID- 3674878 TI - Permeability of ammonia and amines in Rhodobacter sphaeroides and Bacillus firmus. AB - Permeabilities of uncharged ammonia (NH3), methylamine (CH3NH2), and ethylamine (CH3CH2NH2) in the gram-negative phototrophic bacterium Rhodobacter sphaeroides were measured directly in cells grown heterotrophically under aerobic conditions. The permeability of NH3 was 2.55 +/- 0.73 microns s-1 (n = 20), but the permeabilities of CH3NH2 (MA) and CH3CH2NH2 (EA) were higher, PMA = 17.8 +/- 2.8 microns s-1 (n = 50), PEA = 24.7 +/- 3.9 microns s-1 (n = 44). The relative permeabilities of amines were also determined from their effect on the pH gradient across the cell membrane at alkaline external pH. In aerobically grown R. sphaeroides, both techniques indicated that the permeability of CH3CH2NH2 was about 30% greater than that of CH3NH2 but that the permeability of NH3 was only about 1/5 that of CH3NH2. The relative permeabilities of NH3 (A) and CH3NH2 were different in R. sphaeroides cells grown under three different physiological conditions: (a) cells grown aerobically with ammonium sulfate (PA/PMA about 0.20), (b) cells grown anaerobically with ammonium sulfate as their nitrogen source (PA/PMA about 0.29), and (c) diazotrophic cells (PA/PMA about 0.38). NH3 was also found to be only about 1/3 as permeable as CH3NH2 in the alkalophilic gram-positive bacterium Bacillus firmus. The findings that permeability properties of NH3 and CH3NH2 are very different in different bacteria and vary according to the conditions under which the organism is grown need to be taken into account in the interpretation of experiments where [14C]methylamine is used as an ammonia analog. PMID- 3674879 TI - Effects of urea and trimethylamine-N-oxide on enzyme activity and stability. AB - The interactions of urea, trimethylamine-N-oxide (TMAO), and related solutes on a number of enzymes were examined. Urea inhibited enzymatic activity and accelerated the thermal inactivation of catalase, whereas TMAO activated some enzymes but inhibited others. The effects of urea and of TMAO, whether parallel or in opposition, were exerted independently. Thus, in those cases where TMAO increases enzymatic activity, it did so to the same relative degree, whether or not urea was present. TMAO markedly decreased the rate of thermal inactivation of catalase, indicating that it does favor compact protein structures. The assumption that TMAO factors compaction of protein structure, whereas urea has the contrary effect, does not lead to the expectation that TMAO must always oppose the effect of urea on enzymatic activity, since the most compact form of an enzyme may not always be the most active form. PMID- 3674880 TI - Toxicity of S-pentachlorobutadienyl-L-cysteine studied with isolated rat renal cortical mitochondria. AB - The subcellular mechanism of alkenyl halide S-conjugate-induced nephrotoxicity was studied in mitochondria isolated from rat kidney cortex in vitro using the cysteine conjugate of hexachloro-1,3-butadiene, i.e., S-pentachlorobutadienyl-L cysteine (PCBC) as a model substrate. Respiring mitochondria exposed to various concentrations of PCBC exhibited a dose-dependent loss of ability to retain calcium. This phenomenon was associated with a sudden collapse of the mitochondrial membrane potential. PCBC caused a slow nonenzymatic depletion of mitochondrial glutathione. This was not due to oxidation or formation of mixed disulfides, and was efficiently counteracted by preincubation with aminooxyacetic acid, an inhibitor of cysteine-conjugate beta-lyase activity. PCBC inhibited state 3 respiration in the presence of succinate as substrate, which indicates that the activity of succinate dehydrogenase was affected. Thus, the present data confirm that impairment of mitochondrial function is a feature of nephrotoxicity mediated by alkenyl halide S-conjugates. We suggest a pathway involving interaction of beta-lyase-dependent reactive metabolite with the mitochondrial inner membrane, loss of membrane potential, disturbance of Ca2+ homeostasis, and subsequent respiratory insufficiency as a mechanism for renal tubular cytotoxicity. PMID- 3674881 TI - Free-radical chain oxidation of rat red blood cells by molecular oxygen and its inhibition by alpha-tocopherol. AB - The oxidation of rat red blood cells (RBC) by molecular oxygen was performed in an aqueous suspension with an azo compound as a free-radical initiator. The RBC were oxidized at a constant rate by a free-radical chain mechanism, resulting in hemolysis. The extent of hemolysis was proportional to the concentration of free radical. alpha-Tocopherol in RBC membranes suppressed the oxidation and hemolysis to produce an induction period. Tocopherol was constantly consumed during the induction period, and hemolysis developed when tocopherol concentrations fell below a critically low level. Among the membrane lipids, phosphatidylethanolamine, phosphatidylserine, and arachidonic acids were predominantly oxidized in the absence of tocopherol. In the presence of tocopherol, however, such lipid changes were suppressed during a 120-min incubation even when hemolysis started. Membrane proteins as well as lipids were oxidized. The formation of proteins with high molecular weight and concomitant decrease of the low-molecular-weight proteins were observed on gel electrophoresis with the onset of hemolysis. This study clearly showed the damage of RBC membranes caused by oxygen radical attack from outside of the membranes, and suggested that membrane tocopherol even below a critically low level could suppress lipid oxidation but that it could not prevent protein oxidation and hemolysis. PMID- 3674882 TI - Structures of the carbohydrate moieties of human prostatic acid phosphatase elucidated by H1 nuclear magnetic resonance spectroscopy. AB - The structures of the oligosaccharides comprising the carbohydrate moieties of human prostatic acid phosphatase were elucidated by 1H NMR spectroscopy. Homogeneous enzyme was digested with Pronase P, and three asparagine-linked carbohydrate moieties were obtained upon fractionation of the digest using a concanavalin A-Sepharose affinity column. One fraction did not bind to the column, while the portion that did bind was separated into two fractions by elution with two concentrations of mannose. The high-resolution 1H NMR spectra for the three fractions were recorded at 470 MHz. From these data, the structures were deduced to be high mannose, partially sialylated and fucosylated biantennary complex, and fucosylated, partially sialylated triantennary complex oligosaccharides. No O-linked carbohydrate moiety was detected, although the possible presence of small O-linked oligosaccharides cannot be completely discounted from these data. PMID- 3674883 TI - Rats fed prolonged high protein diets show an increase in nitrogen metabolism and liver megamitochondria. AB - Rats were fed diets containing 20, 50 and 80% protein for 14 months. The urea excreted by the rats fed diets containing 50 and 80% protein when compared to rats fed diets containing 20% protein increased ca. 2- and 3-fold, respectively, in ca. 2 days; this increase was maintained essentially unchanged through the experimental period. The serum levels of urea increased 2.5- and 4-fold, respectively, in the first days and were also maintained during the experiment. Glutamate dehydrogenase activity of liver remained unchanged. The five urea cycle enzymes increased with respect to the control values. Orotic acid excretion increased as well as orotidylate decarboxylase and orotate phosphoribosyltransferase, but aspartate transcarbamylase did not. The key amino acids involved in the urea and pyrimidine pathways in liver were also measured; aspartic and glutamic acids and citrulline were increased, and ornithine and arginine did not change with the higher protein intake. In general, no differences were observed between animals fed 50 and 80% protein in their diets. Protein synthesis did not increase with the increase of protein content of the diet. Stereological analysis of ultrathin sections showed that the high protein diet induced a significant increment in the volumetric density, numerical density and size of hepatocyte mitochondria. Moreover, the presence of giant mitochondria, a hundred times larger than normal, was also observed in some periportal hepatocytes of rats fed the 80% protein diet. PMID- 3674884 TI - Degradation of rat hepatic cytochrome P-450 heme by 3,5-dicarbethoxy-2,6-dimethyl 4-ethyl-1,4-dihydropyridine to irreversibly bound protein adducts. AB - Administration of 3,5-dicarbethoxy-2,6-dimethyl-4-ethyl-1,4-dihydropyridine (DDEP) (a structural analog of the dihydropyridine Ca2+ antagonists) to untreated, phenobarbital-, or dexamethasone-pretreated rats results in time dependent losses of hepatic cytochrome P-450 content. Functional markers for various cytochrome P-450 isozymes have permitted the identification of P-450h, P 450 PB-1/k, and P-450p as the isozymes inactivated preferentially by the drug. DDEP-mediated cytochrome P-450 destruction may be reproduced in vitro, is most prominent after pretreatment of rats with dexamethasone, pregnenolone 16 alpha carbonitrile or phenobarbital, and is blocked by triacetyloleandomycin. These findings together with the observation that DDEP markedly inactivates hepatic 2 beta- and 6 beta-testosterone hydroxylase and erythromycin N-demethylase tend to indict the steroid-inducible P-450p isozyme as a key protagonist in this event. The precise mechanism of such DDEP-mediated P-450p heme destruction is unclear, but involves prosthetic heme alkylation of the apocytochrome at its active site in what appears to be a novel mechanism-based "suicide" inactivation. Such inactivation appears to involve fragmentation of the heme to reactive metabolites that irreversibly bind to the protein, but the chemical structure of the heme protein adducts is yet to be established. Intriguingly, such DDEP-mediated P-450p destruction in vivo also results in accelerated loss of immunochemically detectable apocytochrome P-450p. It remains to be determined whether or not this loss is due to enhanced proteolysis triggered by the structural modification of the apocytochrome. PMID- 3674885 TI - Biochemical and biophysical comparison of two mucins from human submandibular sublingual saliva. AB - A high-molecular-weight mucin-glycoprotein (MG1) was isolated from human submandibular-sublingual saliva and was comprised of 14.9% protein, 29.0% N acetylglucosamine, 9.4% N-acetylgalactosamine, 10.5% fucose, 24.2% galactose, 0.9% mannose, 4.0% N-acetylneuraminic acid, and 7.0% sulfate. Carbohydrate units were O-glycosidically linked and ranged in size from 4 to 16 residues. The biophysical properties of MG1 were compared to those of a smaller mucin (MG2) also isolated from submandibular-sublingual saliva. Fluorescence spectroscopy demonstrated that MG1 bound both 1-anilino-8-naphthalenesulfonate (ANS) and N phenyl-1-naphthylamine (NPNA) in stable hydrophobic binding sites (melting temperature, 47 +/- 2 degrees C), whereas MG2 did not bind these hydrophobic probes. These hydrophobic domains occurred on nonglycosylated or naked portions of MG1 since Pronase treatment eliminated ANS binding. Reduction of disulfide bridges in MG1 increased the number of available hydrophobic binding sites. High ionic strength (0 to 2 M NaCl) had no effect on ligand binding, whereas lowering pH (9 to 2) increased ANS binding without affecting NPNA complexation. Circular dichroism (CD) data suggested that MG1's carbohydrate chains dominated its spectrum. In contrast, the peptide backbone dominated the CD spectrum of MG2. Collectively, the results of this study indicate that human submandibular sublingual saliva contains two structurally distinct mucins. PMID- 3674886 TI - Fourier transform infrared study of proteins with parallel beta-chains. AB - Deconvolved and second derivative Fourier transform infrared spectra of the proteins flavodoxin and triosephosphate isomerase have been obtained in the 1600 to 1700 cm-1 (amide I) region. To our knowledge these results provide the first experimental infrared data on proteins with parallel beta-chains. Characteristic absorption bands for the parallel beta-segments are observed at 1626-1639 cm-1 (strong) and close to 1675 cm-1 (weak). Previous theoretical studies based on hypothetical models with large, regular beta-sheets had suggested bands close to 1650 and 1666 cm-1. Our new assignments were confirmed by band area measurements, which yield conformational information in good agreement with results from X-ray diffraction data. The spectra were compared with corresponding spectra of concanavalin A and carboxypeptidase A. The first contains only antiparallel beta segments, the second "mixed" beta-segments, with some strands lying antiparallel and others parallel. None of the observed amide I band frequencies assigned to parallel beta-chains occurs in the 1650 cm-1 region associated with helical segments. PMID- 3674887 TI - Study of the components of reverse cholesterol transport in lecithin:cholesterol acyltransferase deficiency. AB - Enzymatic and lipid transfer reactions involved in reverse cholesterol transport were studied in healthy and lecithin:cholesterol acyltransferase (LCAT), deficient subjects. Fasting plasma samples obtained from each individual were labeled with [3H]cholesterol and subsequently fractionated by gel chromatography. The radioactivity patterns obtained corresponded to the elution volumes of the three major ultracentrifugally isolated lipoprotein classes (very low density lipoproteins (VLDL), low density lipoproteins (LDL), and high density lipoproteins (HDL)). In healthy subjects, the LCAT activity was consistently found in association with the higher molecular weight portion of HDL. Similar observations were made when exogenous purified LCAT was added to the LCAT deficient plasma prior to chromatography. Incubation of the plasma samples at 37 degrees C resulted in significant reduction of unesterified cholesterol (FC) and an increase in esterified cholesterol (CE). Comparison of the data of FC and CE mass measurements of the lipoprotein fractions from normal and LCAT-deficient plasma indicates that: (i) In normal plasma, most of the FC for the LCAT reaction originates from LDL even when large amounts of FC are available from VLDL. (ii) The LCAT reaction takes place on the surface of HDL. (iii) The product of the LCAT reaction (CE) may be transferred to either VLDL or LDL although VLDL appears to be the preferred acceptor when present in sufficient amounts. (iv) CE transfer from HDL to lower density lipoproteins is at least partially impaired in LCAT deficient patients. Additional studies using triglyceride-rich lipoproteins indicated that neither the capacity to accept CE from HDL nor the lower CE transfer activity were responsible for the decreased amount of CE transferred to VLDL and chylomicrons in LCAT-deficient plasma. PMID- 3674888 TI - Regulation of pea mitochondrial pyruvate dehydrogenase complex activity: inhibition of ATP-dependent inactivation. AB - In contrast to the pyruvate dehydrogenase complex (PDC) from animal mitochondria, our in situ and in vitro studies indicate that the ATP:ADP ratio has little or no effect in regulating the mitochondrial pyruvate dehydrogenase complex from green pea seedlings. Pyruvate was a competitive inhibitor of ATP-dependent inactivation (Ki = 59 microM), while the PDC had a Km for pyruvate of microM. Thiamine pyrophosphate, the coenzyme for the pyruvate dehydrogenase (PDH) component of the complex, did not inhibit ATP-dependent inactivation when used alone but it enhanced inhibition by pyruvate. As such, thiamine pyrophosphate was a competitive inhibitor (Ki = 130 nM) of ATP-dependent inactivation. A model is proposed for the pyruvate plus thiamine pyrophosphate inhibition of ATP-dependent inactivation of the pyruvate dehydrogenase complex in which pyruvate exerts its inhibition of inactivation by altering or protecting the protein substrate from phosphorylation and not by directly inhibiting PDH kinase. PMID- 3674889 TI - Stabilizing influence of calcium and magnesium ions on the decameric structure of chiton hemocyanins. AB - The stabilizing effects of Ca2+ and Mg2+ ions on the decameric structure of hemocyanins from two representative chitons, Stenoplax conspicua and Mopalia muscosa were investigated by light-scattering molecular weight measurements, ultracentrifugation, absorbance, and circular dichroism methods. The dissociation profiles at any given pH resulting from the decrease in divalent ion concentration, investigated at a fixed protein concentration of 0.1 g.liter-1, could be fitted by a decamer-to-dimer-to monomer scheme of subunit dissociation. The initial decline in the light-scattering molecular weight curves required one or two apparent binding sites per hemocyanin dimer formed as intermediate dissociation product, with apparent dissociation constants (kD,2) for Ca2+ ions of 0.7 to 7 X 10(-4) M, not very different from the value of 2.5 X 10(-4) M obtained by Makino by equilibrium dialysis for the hemocyanin of the opistobranch, Dolabella auricularia. The binding of Mg2+ ion to S. conspicua and M. muscosa hemocyanins appears to be both weaker than the binding of Ca2+ and more pH dependent, with kD,2 values ranging from the 3 X 10(-4) to 4 X 10(-2) M at pH 8.5 to 9.5. The dissociation the decameric hemocyanin species (sedimentation coefficient ca. 60 S) is also observed in the ultracentrifugation with the initial appearance of 18-20 S dimers, followed by a shift in equilibrium to monomeric species of lower sedimentation rates of 11-12 S as the divalent ion concentration is reduced below 1 X 10(-4) M Ca2+ and Mg2+. The dissociation of dimers to monomers in the second step of the reaction is characterized by one or two binding sites per subunit and a somewhat stronger affinity for divalent ions, indicated by apparent dissociation constants (kD,1) of 0.7 X 10(-4) to 3 X 10(-3) M. Circular dichroism and absorbance measurements at 222 and 346 nm suggest no significant changes in the conformation of the hemocyanin subunits produced by the different stages of subunit dissociation. PMID- 3674890 TI - Isozyme specificity of testosterone 7 alpha-hydroxylation in rat hepatic microsomes: is cytochrome P-450a the sole catalyst? AB - In the present study we show that monospecific antibody against cytochrome P-450a completely inhibits testosterone 7 alpha-hydroxylation in hepatic microsomes of untreated male or female rats or rats of either sex treated with dexamethasone. These data are in contrast with those of K. Nagata et al. (1987, J. Biol. Chem. 262, 2787-2793) who recently reported that an antibody prepared against cytochrome P-450a completely inhibited testosterone 7 alpha-hydroxylase activity in microsomes from untreated or 3-methylcholanthrene-treated rats but only inhibited 50% of the activity in microsomes from dexamethasone-treated rats. They proposed that dexamethasone treatment of rats induced another testosterone 7 alpha-hydroxylase in rat liver. The discrepancy in the two sets of data was due, at least in part, to the use of a chromatography system by Nagata et al. that is incapable of resolving a number of testosterone metabolites. Dexamethasone treatment of rats leads to a marked increase in the production of several testosterone metabolites, including 15 beta-hydroxytestosterone which is cochromatographic with 7 alpha-hydroxytestosterone in their chromatography system. Our results indicate that cytochrome P-450a accounts for all of the testosterone 7 alpha-hydroxylase activity in microsomes from dexamethasone treated rats, and that testosterone 7 alpha-hydroxylation continues to be a useful marker for monitoring cytochrome P-450a in rat hepatic microsomes. PMID- 3674891 TI - [Significance of tumor markers in the treatment of cancer: hematologic malignancy]. AB - Hematologic malignancies, such as acute leukemia and malignant lymphoma. Respond well to cancer chemotherapy. Therefore, it is important to monitor the state of response to chemotherapy as well as to determine the complete disappearance of the tumor and to predict early detection of recurrence in routine clinical work by estimation of tumor marker levels. Although changes in the levels of paraprotein in multiple myeloma have been utilized for monitoring the responsiveness to chemotherapy, since the amounts of paraprotein are directly proportional to the number of myeloma cells, in other hematologic malignancies there are no tumor markers for monitoring the clinical course, for detecting the presence of minimal residual disease, or for predicting disease recurrence. In the future it is expected that developments in biotechnology create a large number of reagents including 'oncogene'-related markers or 'oncogene' products for application to the diagnosis and treatment of cancer patients. PMID- 3674892 TI - [Combination chemotherapy of cyclophosphamide, adriamycin and cisplatin in advanced urothelial cancer]. AB - Sixteen patients with advanced evaluable urothelial cancer were treated with a chemotherapy regimen of cyclophosphamide, adriamycin and cisplatin (CAP). Cisplatin 50 mg/m2 and adriamycin 30 mg/m2 were given on the first day and cyclophosphamide 200 mg/m2 was given from the second to the fifth day. This course was repeated every 3 weeks. The objective response rate was 25% (4 of 16 patients), with 1 patient achieving complete remission. The survival time of responders was longer than that of nonresponders, although the difference was not significant (generalized Wilcoxon method). As side effects, nausea with vomiting (43.8%), renal dysfunction (6.3%), anemia (12.5%), leucopenia (12.5%), thrombocytopenia (25.0%), alopecia (68.8%), heart failure (6.3%) and peripheral neuropathy (6.3%) were noticed. One patient died of sepsis due to agranulocytosis and another died suddenly of heart failure. PMID- 3674893 TI - [Clinical evaluation of cisplatin in children with malignant solid tumors. Pediatric Cisplatin Study Group]. AB - A cooperative multicenter clinical study on cisplatin in children with malignant solid tumors was conducted in seventeen institutions. Of 63 children entered into the study, 18 patients were treated with cisplatin alone, 33 with a VCAP regimen (VCR, CPA, ADM and CDDP) and 12 with other combination regimens. The numbers of evaluable patients were 14, 27 and 7, respectively. Response rates for neuroblastoma were 37.5% (3/8) with cisplatin alone and 79.2% (19/24) for the VCAP regimen. Major adverse effects were gastrointestinal symptoms, bone marrow suppression and renal impairment. Hearing difficulty, electrolyte imbalance and transient elevation of transaminase were also observed. However, these adverse effects were within a tolerable range of severity. The results of this study demonstrate that cisplatin is a useful drug in the treatment of neuroblastoma. PMID- 3674894 TI - [Ifosfamide, cisplatin, adriamycin combination chemotherapy in gynecologic cancer]. AB - Thirteen patients with gynecologic cancer were treated with ifosfamide (2 g X 5), cisplatin (70 mg/m2) and adriamycin (20 mg/m2) combination chemotherapy. The response rate of 7 evaluable patients was 43%, with a median duration of survival of 14 months. Six patients with non-measurable disease are currently free from disease with a median duration of survival of 18 months. This combination caused reversible myelosuppression. No hemorrhagic cystitis was observed. PMID- 3674895 TI - [Cis-diamminedichloroplatinum(II) chemotherapy in advanced pancreatic carcinoma]. AB - The effect of cis-diamminedichloro platinum (II) (CDDP) was evaluated in 14 patients with advanced pancreatic carcinoma. Prior chemotherapy was done in 7 cases and the remaining 7 were fresh cases. The drug was given at a dose of 80 mg/m2 I.V. every 3 weeks, with hydration and mannitol diuresis. Four cases out of 14 showed no change, while the remaining 10 cases showed progressive disease. The response rate was 0%. Most of the patients who showed myelosuppression had received prior chemotherapy. Non-hematologic toxicity occurred in 9 patients (64%) and consisted of nausea in 9, vomiting in 7 and anorexia in 9. Values of serum creatinine and BUN were transiently elevated. PMID- 3674896 TI - [Subrenal capsule (SRC) assay as a chemosensitivity test (IV)--Evaluation of the SRC assay method as a system for growing implanted tumor-xenografts]. AB - Using tumor specimens of human cancer serially transplanted in nude mice, we examined fundamentally the subrenal capsule assay method in order to improve the subrenal space as an area where implanted tumor-xenografts persistently grow. Host reaction in immunocompetent mice treated with cyclosporin A (CsA) (60 mg/kg subcutaneously, daily) was suppressed almost completely, and tumor-xenografts persistently grew similarly to those implanted under the renal capsule of BALB/c nu/nu mice. CsA treatment, 30 mg/kg given subcutaneously; daily, or 60 mg/kg subcutaneously; every other day, could not suppress the host reaction. Bredinin treatment, 200 mg/kg subcutaneously; every other day, or 100 mg/kg subcutaneously; daily, could not suppress the host reaction also, and tumor xenografts implanted under the renal capsule were rejected. PMID- 3674897 TI - [Phase II study of 590-S (1-phthalidyl-5-fluorouracil) in patients with gastrointestinal cancer. Tokyo Cancer Chemotherapy Cooperative Group]. AB - 590-S is a new masked compound of 5-fluorouracil, the antimetabolic antitumor agent of the fluorinated pyrimidine group. The safe dose for the phase II study was determined during the phase I study to be 600 mg/m2/day, equivalent to 900 mg/body/day. The phase II study involving 24 institutions was performed for the treatment of gastro-intestinal cancer. A daily dose of 900 mg was given 3 times a day after meals for more than 4 weeks. The number of registered cases was 32 with stomach cancer, 17 with colo-rectal cancer and 8 with others. 4 of the 23 completed cases with stomach cancer were judged as PR, and the response rate was 19.0%. No response was found in the cases with colo-rectal cancer. Slight side effects were observed in 14 of the 44 evaluable cases. Most of these were gastro intestinal disorders. PMID- 3674898 TI - [The combined effect of cisplatin and caffeine on human sarcoma cells in vitro]. AB - The combined effect of cisplatin and caffeine which was reported to inhibit post replication of DNA repair, were studied on two kinds of cultured human sarcoma cells. Cell kinetics during drug administration were analysed by flow cytometry. As the result, it was found that the combination of cisplatin with caffeine showed a synergistic effect on the sarcoma cells. Cisplatin alone caused S and G2 accumulation on DNA histograms. The growth inhibition rate was enhanced when the S and G2 accumulation was reduced by caffeine. In both cases, nuclear fragmentation was frequently observed with a light and fluorescent microscope. This fundamental study implied that caffeine would be one of useful synergistic drugs in the chemotherapy of sarcoma. PMID- 3674899 TI - [A case of recurrent gastric cancer successfully treated with a combination of cisplatin and carmofur]. AB - A 51-year-old man with recurrent gastric cancer was treated by combined administration of Cisplatin and Carmofur. The target sites were the abdominal lymph nodes and the area of invasion to the stomach. Cisplatin (50 mg/body/day) was given for 3 days, while Carmofur (400-800 mg/body/day) was administered daily in 1 course. After 1 course of administration, the target tumor was reduced in size and the therapy was continued. A complete response was confirmed by upper gastrointestinal roentgenography, endoscopy and echography after 8 courses of Cisplatin administration. The patient has survived for 2 years 6 months in a state of CR. This case suggests that a combination therapy of Cisplatin and Fluoropyrimidine derivatives might be effective for gastric cancer. PMID- 3674900 TI - [Clinical effects of bestrabucil (KM2210) in bladder cancer]. PMID- 3674901 TI - [Treatment of myelodysplastic syndrome with alfacalcidol]. PMID- 3674902 TI - The importance of the basic classifications of skin flaps. PMID- 3674903 TI - Cyclosporine and male-pattern alopecia. PMID- 3674904 TI - In vitro release of minoxidil from topical formulations. PMID- 3674905 TI - Acute neutrophilic dermatosis associated with hydralazine-induced lupus. PMID- 3674906 TI - Atopic dermatitis exacerbated by inhalant allergens. PMID- 3674907 TI - Favorable effects of plasma factor XIII on lower esophageal sphincter pressure of progressive systemic sclerosis. PMID- 3674908 TI - Acanthosis nigricans of the forehead and fingers associated with hyperinsulinemia. PMID- 3674909 TI - Evaluation of oral minoxidil in the treatment of alopecia areata. AB - A dose-response effect has previously been demonstrated in topical minoxidil treatment of alopecia areata. Limitations in minoxidil solubility and percutaneous absorption have impaired the development of more effective topical therapy. Oral minoxidil (5 mg every 12 hours), a dose demonstrated to be relatively well tolerated if a 2-g sodium diet is strictly followed, was given to 65 patients with severe, treatment-resistant alopecia areata in an attempt to bypass the limitations of topical treatment and increase efficacy. Although hair regrowth progressed more rapidly and was more extensive with oral than topical 5% minoxidil, cosmetic response was seen only in 18% of the patients. Neither serum nor tissue levels of minoxidil correlated with response. These findings suggest that improved preparations of topical minoxidil, when used as a single therapeutic agent, are unlikely to be cosmetically effective in the majority of patients with severe alopecia areata. PMID- 3674910 TI - Malignant disseminated porokeratosis. AB - A patient has been observed with a distinct form of disseminated porokeratosis. During the course of his disease, he developed changes in the porokeratosis lesions that included cellular atypia, dysplasia, and invasive squamous cell carcinoma. One of the squamous cell carcinomas produced regional and disseminated metastases, resulting in the death of the patient. Although malignancy has been previously described in the various types of porokeratosis, this is the first report of disseminated metastases and death in any form of this disease. PMID- 3674911 TI - Unilateral pruritus after a stroke. AB - A patient with unilateral pruritus after a stroke is described. The neural pathways of pruritus and the role of the central nervous system in the initiation and modulation of the itch sensation are discussed. Pathways between the cerebral cortex and the medulla may play important roles in the sensation of pruritus. PMID- 3674912 TI - Cutaneous ulcers in sarcoidosis. AB - We treated four patients with multisystem sarcoidosis and skin ulceration. Their cases are compared with those of patients previously described in the literature. Treatment for ulcerative sarcoid is also discussed. PMID- 3674913 TI - Ichthyosis induced by cholesterol-lowering drugs. Implications for epidermal cholesterol homeostasis. AB - Ichthyosis and other disorders of cornification may occur as side effects of treatment with several hypocholesterolemic agents. Recent progress in understanding of the functional role of lipids in stratum corneum provides a new pathophysiologic basis for these earlier clinical observations. In stratum corneum, lipids are segregated within intercellular membranes, where they appear to regulate permeability barrier function and desquamation. Cholesterol is an important constituent of these membranes and may be essential to both of these functions. Perturbation of barrier function induces cholesterologenesis locally within the epidermis. Polar sterol metabolites, such as cholesterol sulfate, may also regulate epidermal sterologenesis under normal or pathologic circumstances. Cholesterol homeostasis may also modulate desquamation. For example, hairless mice fed azacosterol hydrochloride (20,25-diazacholesterol) develop a generalized scaling disorder without loss of barrier function. In these mice, total stratum corneum sterol content is markedly decreased, and topical or systemic repletion with cholesterol can correct the scaling abnormalities. PMID- 3674914 TI - Regulation of copper metabolism in the mottled mouse. AB - Menkes' kinky-hair syndrome is an X-linked recessive neurodegenerative and connective-tissue disorder, with decreased serum copper and ceruloplasmin-copper oxidase concentrations and tissue-specific increases in copper content. Clinical manifestations can be related to relative copper deficiency and reduced activity of cuproenzymes in multiple organs. An animal model is provided by mice hemizygous for mutant alleles, such as the blotchy allele, at the X-linked mottled locus. This locus may be homologous in mouse and man. The basic defect is unknown but has been thought to reside in the regulation of the function or synthesis of metallothioneins. In the blotchy mouse and in cultured skin fibroblasts derived therefrom, we showed that the mutation specifically affects the metabolism of copper and not other trace metals. Excessive accumulation and abnormal (reduced) exit kinetics were demonstrated for copper but not for the related trace metals cadmium and zinc. While metallothionein-I messenger RNA (mRNA) concentrations were elevated in blotchy fibroblasts, the elevations in metallothionein-I mRNA in response to metallothionein inducers (cadmium, copper) were similar in blotchy and control cells. Further, metallothionein-I mRNA levels were indistinguishable in mutant and control fibroblasts containing equivalent intracellular copper concentrations. Finally, metallothionein-I mRNA content was not elevated in blotchy kidneys at early developmental stages, before storage of excessive copper. The aggregate data suggest that the basic defect in the blotchy mouse--and, by analogy, in Menkes' syndrome--does not reside in defective modulation of metallothionein function and does not cause abnormal regulation of metallothionein synthesis. PMID- 3674915 TI - Acquired localized pigmentation. Primary localized cutaneous amyloidosis (PLCA). PMID- 3674916 TI - Hyperplastic reaction developing within a tattoo. Granulomatous tattoo reaction, probably to mercuric sulfide (cinnabar). PMID- 3674917 TI - Facial papules and nodules, thyroid goiter, and acral keratoses. Cowden's disease. PMID- 3674918 TI - Pruritic white papules in a pregnant woman. Sarcoidosis. PMID- 3674919 TI - Nocturnal cough in asthma. AB - The timing of nocturnal cough and its association with change in ambient temperature was documented in 11 asthmatic children, median age 5.1 years, while they were receiving continuous prophylaxis. Studies were performed in their homes on three nights. A voice activated system with electronic time signal recorded coughing. Ambient temperature was recorded every five minutes throughout the night on a Grant Squirrel data logger. Ten children coughed on 27 nights with a median of six bouts of coughing a night (range 0-272). The cough rate in the two hours after going to bed was significantly higher than the cough rate in the middle of the night (2-4 am or 4-6 am). Peak coughing times were 7-9 pm and 6-8 am. The room temperature was lowest between 5 and 7 am. There were no significant differences between cough rates during periods of rapid temperature change (more than 1 degree C an hour). The timing of nocturnal cough observed in this study differed from the known basophase of circadian cycles described for adults and children. PMID- 3674920 TI - Reduced incidence of tuberculosis by prophylactic chemotherapy in subjects showing strong reactions to tuberculin testing. AB - The introduction of chemoprophylaxis with rifampicin and isoniazid in 1981 significantly reduced the incidence of tuberculosis. Between 1978 and 1981 children accounted for 136 of 642 notified cases, and this was reduced to 55 of 418 between 1982 and 1986. This effect was most obvious among children from the Indian subcontinent who comprised 80.2% of the children treated. The incidence among white children was not affected. Few side effects occurred and only two of 339 (0.6%) later developed clinical tuberculosis. Chemoprophylaxis plays an important part in the management of tuberculosis in a district with a high incidence of the disease. PMID- 3674921 TI - Blood spot glucocorticoid concentrations in ill preterm infants. AB - The adrenocortical response to stress was studied longitudinally in 10 ill preterm infants using measurements of cortisol and 170H-progesterone concentrations in filter paper blood spots. Mean cortisol and 170H-progesterone concentrations reached a peak of 2200 nmol/l and 65 nmol/l, respectively, between the third and fifth days of life. These concentrations far exceeded those observed in older children and adults subjected to stress as a result of surgery. Further pulses of endogenous cortisol production of 4000 nmol/l or more occurred in association with clinical complications such as intraventricular haemorrhage. These results indicate that infants undergoing intensive care are unduly stressed. Consideration should be given to providing enough sedation and appropriate analgesia for ill preterm infants during painful procedures such as insertion of venous cannulae and arterial puncture. PMID- 3674922 TI - Effects of birth weight, gestational age, and maternal obstetric history on birth prevalence of cerebral palsy. AB - A register of children with cerebral palsy born to mothers resident in the Mersey region from 1966 to 1977 was compiled from health service records. Frequency distributions and prevalences of birth weight and gestational age differed for those with hemiplegia, diplegia, and quadriplegia. In particular, the children with diplegia showed a bimodal frequency distribution. Children of normal birth weight with diplegia had a higher prevalence of severe mental retardation than those of low birth weight. These differences may be due to survival bias and may not be of aetiological importance. Furthermore, the mothers of diplegic infants had a significantly higher proportion of spontaneous abortions, stillbirths, and low birthweight infants in their obstetric history. This suggests that prenatal factors predominate in the aetiology of diplegia. PMID- 3674923 TI - Mental development in congenital hypothyroidism after neonatal screening. PMID- 3674924 TI - Unorthodox allergy procedures. PMID- 3674925 TI - Case conferences for child abuse. PMID- 3674926 TI - Carbon monoxide production in ventilated premature infants weighing less than 1500 g. AB - Mean pulmonary excretion rate of carbon monoxide in 13 premature babies on ventilators was significantly higher (p less than 0.001) than that of 19 healthy infants born at full term. This correlated with carboxyhaemoglobin concentrations in blood, indicating that the premature infants on ventilators produced abnormally large amounts of bilirubin. PMID- 3674927 TI - Early congenital syphilis and severe haematological disturbance. AB - The early clinical signs and symptoms of congenital syphilis are diverse but, if undiagnosed, signs of the disease may subside until the late stigmata appear. We report a case that illustrates that the haematological signs and symptoms may be so severe as to mimic a diagnosis of leukaemia or disseminated malignant disease. PMID- 3674928 TI - Post-streptococcal glomerulonephritis in Hong Kong. AB - Of 74 paediatric inpatients with acute glomerulonephritis, 58 (78%) had a raised (greater than 1/200) antistreptolysin O titre. Serum C3 concentration was low in 73, but returned to normal within six weeks. Streptococcal infection remains the commonest cause of acute nephritis in children in Hong Kong, possibly due to overcrowded living conditions. PMID- 3674929 TI - Trends in birth prevalence of cerebral palsy. PMID- 3674930 TI - Prediction and management of nocturnal hypoglycaemia in diabetes. PMID- 3674931 TI - Baby walkers...time to take a stand? PMID- 3674932 TI - Vasoactivity of the major intracranial arteries in newborn infants. PMID- 3674933 TI - Interaction between chloramphenicol and acetaminophen. PMID- 3674934 TI - Neonatal typhoid fever. PMID- 3674935 TI - Incidences of childhood coeliac diseases and transient gluten intolerance move discrepantly in UK and Sweden. PMID- 3674936 TI - Screening for squint and poor vision. PMID- 3674937 TI - Top up transfusions in neonates. PMID- 3674938 TI - Environmental neonatology. PMID- 3674939 TI - When not to do a lumbar puncture. PMID- 3674940 TI - Steroid scare. PMID- 3674941 TI - Monitoring oxygen in the newborn: saturation or partial pressure? PMID- 3674942 TI - Pulse oximeter and transcutaneous arterial oxygen measurements in neonatal and paediatric intensive care. AB - Pulse oximeter (SaO2P) measurements were compared with direct arterial line oxygen saturation (SaO2) from co-oximeters in 92 instances in 43 patients, and with arterial line oxygen measurements (PaO2) in 169 instances in 81 patients. The mean (SD) absolute difference between SaO2P and SaO2 was 2.6% (2.4) after attempt to correct for the co-oximeter falsely measuring a proportion of fetal haemoglobin as carboxy haemoglobin. For 19 infants and children greater than or equal to 5 months old, who have very little fetal haemoglobin, the mean (SD) absolute difference of 27 comparisons was 1.8% (2.1). Comparison of SaO2P and PaO2 measurements in 46 instances when PaO2 was less than 6.67 kPa showed SaO2 to be less than 90% on 40 occasions. In 24 instances when PaO2 was greater than or equal to 13.3 kPa the SaO2P was greater than or equal to 98% on 22 occasions. In 23 infants undergoing neonatal intensive care, transcutaneous oxygen monitors were compared with arterial PO2 measurements in 60 instances. The mean (SD) absolute difference between PaO2 and transcutaneous oxygen measurements was 1.60 kPa (1.73). Ten of the 60 comparisons had differences greater than 2.67 kPa and three greater than 5.33 kPa (maximum 8.40 kPa). Pulse oximetry is a clinically useful technique for managing oxygenation but further studies are needed to confirm its safety in premature infants at risk of retinopathy of prematurity. PMID- 3674943 TI - Bone mineral content in bronchopulmonary dysplasia. AB - Fourteen preterm infants who developed bronchopulmonary dysplasia diagnosed radiologically were compared with a group of similar infants who did not. The two groups were of comparable maturity and birth weight. The clinical histories indicated that those infants with bronchopulmonary dysplasia had had longer periods of supplemental oxygen, more frequent treatment with dexamethasone, and a higher mean total dosage of frusemide. Bone mineral content in the mid-forearm was measured by photon absorptiometry at or near the postconceptional age of 40 weeks in all cases; no significant difference was found between the two groups, although both were severely undermineralised when compared with infants born at full term. In both groups mean daily calcium intake (about 70 mg/kg/day) was about half the daily intrauterine accretion of calcium. PMID- 3674944 TI - Validity of forced expiratory flow volume loops in neonates. AB - It is claimed that suddenly squeezing a newborn baby's trunk with a pressure of 3 4 kPa produces a flow volume curve that can be used to measure the function of the small airways. If the squeeze is applied during expiration rather than at the end of inspiration, however, anomalous results may be obtained. One possible explanation is that the babies are limiting expiratory flow by making inspiratory efforts in response to the applied external pressure. The response of 10 healthy term neonates to forced expiration was studied by using an oesophageal balloon. The squeeze was provided by an inflatable jacket, and measurements of oesophageal pressure and jacket pressure were recorded, as well as flow and volume changes at the mouth. Two hundred and twenty one squeezes were performed at different points in the respiratory cycle. In 188 squeezes an inspiratory effort was evident before the oesophageal pressure reached a plateau (mean time to peak pressure = 155 ms). For the remaining squeezes a plateau pressure was associated with closure or narrowing of the upper airway in most of the babies. When the squeeze was applied at low lung volumes the inspiratory effort was significantly earlier and stronger than around end inspiration. Thus a baby makes a reflex inspiratory response to chest compression that may interfere with the measurement of airway function when this technique is used. PMID- 3674945 TI - Morbidity after percutaneous liver biopsy. AB - The safety of percutaneous liver biopsy with a 1.2 mm Menghini needle in infants aged one year or less was investigated. One hundred and eighty four procedures performed from 1975 to 1985 were reviewed. There were no deaths or major complications within 48 hours associated with the procedure. In five instances specific complications occurred: a drop in haemoglobin concentration (three), transient hypotension (one), and haematoma at the biopsy site (one). The result of liver biopsy was diagnostic in 83% of cases, compatible with unspecified metabolic disease in 8%, and normal or not diagnostic in 9%. This study suggests that percutaneous liver biopsy can be performed with relative safety in small infants if coagulation is normal and there are no major contraindications, and the results yield important diagnostic information which cannot be obtained using less invasive procedures. PMID- 3674946 TI - Human milk and preterm formula compared for effects on growth and metabolism. AB - Metabolic tolerance to a 'premature formula' feed was studied in a group of small immature infants, mean (SD) gestation 27.8 (1.4) weeks. Ten infants weighing 880 1295 g at the time of the study were fed on SMA low birthweight formula for a mean (SD) of 23.5 (5.5) days and were compared with 10 who were fed on expressed breast milk for 25.8 (6.1) days. The infants were well matched for weight, gestation, and postnatal age at the time of the study and were receiving full enteral feeds. They were investigated by balance techniques and plasma sampling on at least two occasions. Ten larger infants weighing 1330-1740 g and being fed on the same formula feed were also studied as an additional control group. Formula fed infants retained more nitrogen and gained weight faster. Plasma phosphorus concentrations were higher in the group fed on the formula feed, and alkaline phosphatase activity was lower. There were no significant differences in plasma concentrations of urea, electrolytes, or albumin or in acid base status. Taurine and arginine concentrations were higher in the group being breast fed, but there were no other significant differences in plasma amino acids, and no toxic concentrations occurred after either feed. The results of this study show that this formula (and presumably other feeds of similar composition) seem to be metabolically safe for the smallest infants. PMID- 3674948 TI - Sudden infant death syndrome in south east Scotland. AB - Three hundred and fifty eight infants from south east Scotland who died suddenly were classified into four groups. Categories for these groups ranged from where a definite cause of death had been recorded to where no explanation had been provided and no associated disorder was discovered (SIDS). Our results supported the view that there are few differences in the history of cases certified as SIDS and other cases reported as dying suddenly but with an explanation. Groups that most closely matched the SIDS definition employed were reported to be healthier throughout life and freer from illness in the 48 hours before death. From the findings of this study the 'true' SIDS group did not appear as an 'at risk' population. The study group as a whole was not marked by social deprivation, poor mothering, or less privileged families. The importance of intensive investigation, including postmortem examination was emphasised, as misdiagnosis may give a 'falsely' inflated picture of the incidence of the syndrome and could cause unnecessary anxiety. PMID- 3674949 TI - Pulse oximetry in preterm infants. AB - One hundred and twenty five measurements of arterial oxygen saturation (Stcao2) obtained with a transcutaneous pulse oximeter were compared with direct arterial oxygen tension (Pao2) in 13 preterm infants with predominantly fetal haemoglobin. Stcao2 of 86-92% corresponded to Pao2 of 5-13 kPa. Stcao2 above 92%, however, was sometimes associated with Pao2 above 13 kPa. PMID- 3674947 TI - Recent trends in the incidence of multiple births and associated mortality. AB - The overall incidence of multiple births in England and Wales, which had been declining since the early 1950s, started to increase in the early 1980s in all age groups except for women under 20. This followed a rise in the incidence of triplet and higher order multiple births which had started in the late 1970s. Analyses of data for births between 1978 and 1983 showed that while stillbirth, perinatal, neonatal, and post-neonatal mortalities among multiple births fell considerably, they remained consistently higher than those for singleton births. Differences in the distribution of birth weight do not wholly explain these differences. Analyses of certified causes of stillbirth and death are difficult to interpret because a considerable proportion were attributed to 'multiple pregnancy'. PMID- 3674950 TI - Seasonal variation of glycosylated haemoglobin. AB - Retrospective analysis of glycosylated haemoglobin concentrations in a diabetic outpatient clinic over three and a half years showed a small seasonal variation in the mean value with a peak in mid February and a nadir in mid August. PMID- 3674951 TI - Penicillin resistant pneumococcal peritonitis in nephrotic syndrome. AB - Two infants with nephrotic syndrome who developed penicillin resistant pneumococcal peritonitis while receiving penicillin chemoprophylaxis are reported and the problems associated with prophylaxis against pneumococcal infection discussed. It is suggested that penicillin prophylaxis may be hazardous in an environment in which penicillin resistant pneumococci are prevalent. PMID- 3674952 TI - Infant feeding and atopy. AB - Parents of 457 5 year olds from a previous study of infant feeding and eczema in the first year of life were questioned about subsequent atopy. No association was found with early breast or bottle feeding. Family history was important. Parental recall of first year eczema was often inaccurate. PMID- 3674953 TI - Type V hyperlipoproteinaemia in neonates. AB - A boy investigated for neonatal jaundice was noted to have lipaemic serum and was subsequently shown to have type V hyperlipoproteinaemia. Dietary treatment was maintained for five years and he followed a typical clinical course. Circumstantial evidence suggested an autosomal recessive inheritance pattern. PMID- 3674954 TI - Light transmission of phototherapy eyeshields. AB - Twelve types of phototherapy eyeshields showed peak light transmission of less than 0.1%, and none transmitted greater than 0.04% light in the 460 nm spectral region. Commercial eyeshields offered no advantage over locally made ones. The choice of shield may be less important than how it is secured over the infant's eyes. PMID- 3674955 TI - Varioliform gastritis and campylobacter-like organisms. PMID- 3674956 TI - Haemorrhagic disease and vitamin K. PMID- 3674957 TI - Synthesis of cysteinylphenol, cysteaminylphenol, and related compounds, and in vivo evaluation of antimelanoma effect. AB - Phenolic and catecholic compounds were synthesized, by combination with cysteine or cysteamine through thioether bond, and their antimelanoma and melanocytotoxic effects were evaluated. Among nine compounds tested, 4-S-cysteaminylphenol (CAP) resulted in an increase in the life span (% ILS) of melanoma-bearing mice and in the growth inhibition (% GI) of melanoma tissue. 4-S-Cysteinylphenol (CP) and its methyl ester form also showed some increase in % GI. The 2-S-isomers of CP and CAP and diphenolic derivatives of CP did not show any significant antimelanoma effect. In addition, the s.c. injection of 4-S-CAP and 4-S-CP, in particular 4-S CAP, caused the depigmentation of black hair which was manifested by loss of functioning melanocytes, as seen under light microscopy. The 4-S-CAP appears to provide a basis for development of a new class of antimelanoma and melanocytotoxic agents that are more stable than catecholic compounds, which have been most widely utilized as a source of rational chemotherapy for malignant melanoma. PMID- 3674958 TI - Glycoconjugate biosynthesis in human epidermis. AB - Epidermal glycoconjugates synthesized by skin slices in media containing radiolabelled sugars were analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. A large proportion of the epidermal glycoconjugates were soluble in 10% (w/v) trichloroacetic acid. In addition to glycolipids and glycosaminoglycans, the acid-soluble fraction contained glycoproteins, a group of which (mol. wt. 70,000-160,000) were highly glycosylated and particularly rich in fucose. Analysis of the glycosaminoglycans by cellulose acetate electrophoresis combined with specific enzymic and nitrous acid degradation studies revealed that hyaluronic acid (73%) and heparan sulphate (18%) were the main components. PMID- 3674959 TI - Evaluation of a method for measuring the sustainable rate of sebaceous wax ester secretion. AB - Sebaceous wax ester secretion rates were measured in six subjects on six occasions each, using absorption into bentonite clay and analysis of the collected lipid by quantitative thin-layer chromatography. On each occasion eight samples were collected, four from the left and four from the right side of the forehead in four successive intervals. The first two intervals, which totaled 14 h, were intended to deplete the follicular reservoir of sebum so that a constant rate of absorption could be obtained during the third and fourth intervals, which were 3 h each. Thin-layer analysis of each sample was done in triplicate. The data were examined using analysis of variance techniques to determine the reproducibility of the measurement method and to identify possible sources of variability. The intraclass correlation coefficient (rI) for all 432 post depletion determinations was 0.80. The reproducibility was considerably better for three of the subjects (rI = 0.93) than for the other three (rI = 0.75). Variability within the latter three subjects did not seem to be attributable to lack of reproducibility in the thin-layer analysis. Real biological variability also seems unlikely considering the holocrine mechanism of sebum secretion. Therefore, the variability probably arises from non-representative collection of sebum into the bentonite absorbent. PMID- 3674960 TI - Lipid fluidity of human and guinea-pig epidermal cells: temperature dependence in comparison to nonepidermal cells. PMID- 3674961 TI - A new apparatus to measure rate of desquamation using dansyl chloride fluorescence. PMID- 3674963 TI - Distribution of skin surface pH on the forehead and cheek of adults. AB - The skin surface pH on the forehead and cheek of 574 men and women aged 18-95 was measured. No differences were found between men and women regarding forehead and cheek pH distribution. The group over the age of 80 showed higher pH values on both the forehead and the cheek. In 89% of the subjects measured, the skin surface pH on the cheek was higher than that on the forehead. The central 90%, i.e., the "representative range", for the population below the age of 80 is between 4.0-5.5 on the forehead and between 4.2-5.9 on the cheek. PMID- 3674962 TI - Neutrophil locomotion and serum chemotactic and chemokinetic activities in pustulosis palmoplantaris compared with psoriasis. AB - Twenty patients with palmoplantar pustulosis (PPP) and 21 patients with psoriasis were compared with respect to the chemotactic response and random migration of their neutrophils (PMNs) and to the chemotactic and chemokinetic activities of their serum. The Boyden chamber technique was used. Compared with the reference group, the PPP neutrophils showed a significant decrease in random migration (p = 0.036) and chemotactic response to casein (p = 0.031), but not to zymosan activated serum. The psoriasis PMNs had normal chemotactic response, but decreased random migration (p = 0.001). The chemokinetic effects of serum from PPP and psoriatic patients on normal neutrophils were increased (for PPP, p = 0.019 and for psoriasis p = 0.024). The chemokinetic activity of the heated sera was decreased and inversely correlated to the serum level of IgA in both disorders (PPP, p = 0.021; psoriasis, p = 0.013). The chemotactic activity of serum on normal PMNs was decreased in both conditions (PPP, p = 0.001; psoriasis, p = 0.047); this was due to the presence of chemotactic factor inhibitors in 34% of the sera. It seems likely that the high chemokinetic effect of serum both from the PPP and from the psoriasis patients compensates for the slightly low or normal migratory activity of neutrophils from these patients. PMID- 3674964 TI - Effect of hexadecane on protein kinase C of pig epidermis. AB - The application of hexadecane on animals skin induces hyperkeratinization and hyperplasia of the epidermis, however, the initial mechanisms of the epidermal cell proliferation and keratinization by hexadecane stimulation remains unknown. Protein kinase C is reported to be one of the critical enzymes involved in proliferation and differentiation of various cells and tissues. Therefore we investigated the effects of hexadecane on protein kinase C in pig epidermis. Protein kinase C activity of the pig skin increased 10 min after topical application of hexadecane to the back of the pig, normalized at 30 min, and subsequently kept falling for 24 h. In studying hexadecane dropped on floating sliced pig skin in Krebs buffer, similar results were obtained for the short term. Immediately after the hexadecane treatment, protein kinase C activity was not altered as compared with that of the untreated skin. Thus, the alteration of the protein kinase C activity after the hexadecane treatment is not due to the direct effect of hexadecane on the enzyme, but is due to other as yet unknown mechanisms of epidermal cell kinetics in response to hexadecane stimulation. We discuss the mechanisms of protein kinase C activity alteration upon treatment with hexadecane. PMID- 3674965 TI - The -SH and SS positive components in dermal connective tissues: a study by N-(7 dimethylamino-4-methyl-3-coumarinyl) maleimide (DACM) stain. AB - Although -SH and SS positive components in dermal connective tissue have been observed by N-(7-dimethylamino-4-methyl-3-coumarinyl) maleimide (DACM) stain, their nature is as yet unknown. In our study, we stained several organs such as human skin, rabbit aorta, auricle, and trachea using DACM stain, and studied the distribution of -SH groups and SS linkages among the elastic fibers in those organs. In the dermis of human skin, a moderately strong fluorescence by both -SH and SS stain was present all over the layer, especially in the lower half among collagen fibers in a fine linear or wavy pattern, and a fluorescence ascending vertically from the lower papillary dermis toward the epidermis was also observed. In rabbit aorta, a strong fluorescence by both -SH and SS stain was observed on well-developed elastic fibers. In the matrix of rabbit elastic cartilage, a strong reticular fluorescence by both -SH and SS stain was present. On the other hand, in rabbit hyaline cartilage, no -SH fluorescence was present on any components of the cartilage. However, though a diffuse moderate fluorescence for SS linkages was observed in the matrix, there was no reticular fluorescence such as that seen in the elastic cartilage. These results suggest that the -SH and SS components observed in the dermis by DACM stain are in fact elastic fibers, more precisely, "elastic tissue microfibrils". PMID- 3674966 TI - Nuclear morphometry of nodular malignant melanomas and benign nevocytic nevi. PMID- 3674967 TI - Endothelial cytotoxic activity (ECA) in sera of patients with livedo racemosa generalisata Ehrmann. PMID- 3674968 TI - Trichilemmoid carcinoma-derived cells produce a growth factor for fibroblasts and reveal fibroblast chemotactic activity. PMID- 3674969 TI - The intraepidermal sweat-duct unit is derived from cells of the dermal sweat duct: direct evidence obtained from epithelial allografts. PMID- 3674970 TI - Monitoring of aldicarb residues in Long Island, New York potable wells. PMID- 3674971 TI - Transport of organic contaminants in groundwater: gas chromatography model to forecast the significance as applied to aldicarb sulfone residues. PMID- 3674972 TI - Selenium in aquatic organisms from subsurface agricultural drainage water, San Joaquin Valley, California. PMID- 3674973 TI - Genotoxic properties of municipal wastewaters in Ohio. PMID- 3674974 TI - Simultaneous multiple species testing: acute toxicity of 13 chemicals to 12 diverse freshwater amphibian, fish, and invertebrate families. PMID- 3674975 TI - Dynamics of metal accumulation in the grasshopper Chorthippus brunneus in contaminated grasslands. PMID- 3674976 TI - Modifying effects of supplemental selenium and sulfur on cadmium toxicity in rats. PMID- 3674977 TI - Short-term and long-term uptake of zinc by the mussel, Mytilus edulis: a study in individual variability. PMID- 3674978 TI - Effects of environmental parameters on the elimination of cadmium by eastern oysters, Crassostrea virginica. PMID- 3674979 TI - Effects of paraquat on reproduction and mortality in two generations of mice. PMID- 3674980 TI - Biochemical alterations induced by citrinin in cultured kidney epithelial cell systems. PMID- 3674981 TI - DNA polymerase activities in human placenta. AB - Activities of DNA polymerase alpha and beta were assayed in crude extracts prepared from human placenta. Polymerase alpha activity was high in early pregnancy but low during the 2nd trimester. Polymerase beta activity did not change significantly with gestational weeks. The increase in polymerase alpha activity in early pregnancy may be closely related to mitosis at the time of placental formation; there might also be some type of accelerating factor for polymerase in early pregnancy. PMID- 3674982 TI - Oxytocin levels in maternal and fetal plasma, amniotic fluid, and neonatal plasma and urine. AB - Oxytocin was measured in maternal and fetal plasma, amniotic fluid and neonatal plasma and urine using a specific radioimmunoassay, following extraction procedures with Florisil. Maternal oxytocin levels rose progressively with advancing gestation, but there were no significant differences between oxytocin levels around the onset of labor. No diurnal rhythm of oxytocin was evident in maternal plasma during the third trimester. Maternal and umbilical plasma oxytocin levels at spontaneous delivery were significantly higher than those at elective cesarean section. Maternal oxytocin levels in four cases of post-term delivery were lower than those during normal late pregnancy; all four cases experienced uterine inertia. All amniotic fluid samples had detectable oxytocin levels and there were no significant differences between oxytocin levels in the second trimester and those in the third trimester. Oxytocin levels in neonatal urine were higher than levels in amniotic fluid and lower than in the umbilical artery. Neonatal plasma oxytocin levels gradually decreased and oxytocin levels of 7-day-old infants were significantly lower than those in the umbilical artery, but higher than those in adults. In conclusion, it appears that maternal oxytocin levels may not be involved in triggering the onset of labor but may play a role in the maintenance and reinforcement of labor. PMID- 3674983 TI - Placental protein 10 (PP10) in singleton and twin pregnancy complicated by pre eclampsia. AB - Circulating levels of placental protein 10 (PP10) were measured by radioimmunoassay in 140 women with normal singleton pregnancy (140 samples), in 6 women with normal twin pregnancy (15 samples) and in 35 pregnant women with pre eclampsia (51 samples from singleton pregnancies and 7 samples from twin pregnancies) between 24 and 40 weeks. In singleton pregnancies with pre eclampsia, the levels were lower than normal (P less than 0.01). In twin pregnancy the circulating PP10 levels were not significantly affected. These results suggest that changes in placental function are reflected in the circulating PP10 levels. PMID- 3674984 TI - Pregnancies following conservative treatment of malignant ovarian tumors. AB - Sixteen patients with malignant ovarian tumors were treated conservatively; 1 had a serous cystadenoma of low potential malignancy; 6 had a mucinous cystadenoma of low potential malignancy; 2 had a pure dysgerminoma; 2 had a mature solid teratoma; 3 had a mucinous cystadenocarcinoma; and 2 had an endodermal sinus tumor. Postoperative chemotherapy was given in 12 cases and 1 patient with a pure dysgerminoma had radiotherapy. Eighteen pregnancies occurred in 13 patients. One full-term and one 8 month premature infant died in utero, and 2 infants had malformations; the other 14 infants are all well. The patient with moderately differentiated mucinous cystadenocarcinoma who delivered a premature infant and 2 patients with endodermal sinus tumors died of recurrence. PMID- 3674985 TI - Abortion caused by electrical current. AB - A case of electrical accident in a pregnant woman at 9 weeks of gestation is described. No fetal heart activity was noted immediately after the injury, and spontaneous abortion occurred two days later. PMID- 3674986 TI - The relation between saliva estriol levels in pregnancy and infant birth weight. AB - Specimens of saliva were obtained from 106 women with normal pregnancies and from 42 women, whose children turned out to small for dates (birthweight below the 10th centile). Saliva estriol was highly significantly (P less than 0.0001) decreased in the group with a newborn with a birthweight below the 10th centile (500 +/- 340 ng/ml, mean +/- SD) when compared with the group with infants whose birthweight was over the 10th centile (813 +/- 449 ng/ml). Estriol determination in saliva seems to be a simple, non invasive method of aiding the detection of fetal growth retardation. PMID- 3674987 TI - [A surgical model for a new concept of implantable artificial kidney]. PMID- 3674988 TI - [Renal hemangioma]. PMID- 3674989 TI - [Pelvic lipomatosis. Diagnosis using computerized tomography]. PMID- 3674990 TI - [Primary hyperplasia of the adrenal medulla: precursor stages of pheochromocytomas?]. PMID- 3674991 TI - [Eosinophilic cystitis]. PMID- 3674992 TI - [Rectal bladder. Evaluation of its tolerance]. PMID- 3674993 TI - [Experimental lithogenesis using glyoxylic acid]. PMID- 3674994 TI - [Bilateral renal carcinoma disclosed by pulmonary metastasis]. PMID- 3674995 TI - [Treatment of idiopathic hydrocele by intravaginal injection of tetracycline]. PMID- 3674996 TI - CAPD in the treatment of refractory congestive heart failure. PMID- 3674997 TI - Self-care dialysis in Japan. PMID- 3674998 TI - Dialysis in a developing country: overcoming problems. PMID- 3674999 TI - Canada's health care system and its impact on nephrology nursing. PMID- 3675000 TI - Nursing education in Europe and treatment modalities of ESRD. PMID- 3675001 TI - Tracking problems. PMID- 3675002 TI - Evaluation of a diagnostic category: potential for infection in renal failure (continuing education credit). PMID- 3675003 TI - Towards independence: an alternative technique for drawing up Sandimmune. PMID- 3675004 TI - Chronic hemodialysis client pregnancy. PMID- 3675005 TI - The codependent dialysis nurse. PMID- 3675006 TI - Chemical analysis of whole saliva in Sjogren's syndrome. AB - In some studies, but not in all, abnormally high concentrations of salivary Na+, K+, and IgA have been found in patients with Sjogren's syndrome (SS). The lack of agreement between various reports might be due to the different ways in which saliva was collected. Some analysed stimulated parotid or whole saliva, whereas others used unstimulated saliva. In this study, therefore, the rate of flow and Na+, K+, and IgA levels in unstimulated and stimulated whole saliva in normals and in rheumatoids with and without SS have been determined. The results confirmed significantly raised levels of Na+, K+, and IgA in unstimulated whole saliva in SS. In response to stimulation there was marked decrease in Na+, K+, and IgA levels, whereas normally, as shown by the other two groups, there is an increase in Na+, no change in K+, and a mild decrease in IgA. As a result, the differences between SS and normals became much less significant (K+, IgA) or were even completely obliterated (Na+). The abnormal response of SS to stimulation may be partially explained by the initially low rate of flow and by the extremely high IgA levels. Thus chemical analysis of unstimulated whole saliva is much more sensitive than analysis of stimulated whole saliva in the detection of salivary gland involvement in SS. PMID- 3675007 TI - Renal findings in rheumatoid arthritis: clinical aspects of 132 necropsies. AB - Renal abnormalities in 132 necropsied patients with rheumatoid arthritis were studied. Clinical findings before death included extra-articular manifestations of the disease (86% of patients), systemic vasculitis (6%), and uraemia (23%). Necropsy findings included nephrosclerosis (90%), systemic vasculitis (14%) with kidney involvement in 8%, amyloidosis (11%), membranous glomerulopathy (8%), and focal glomerular disease (8%). Association with clinical data suggests that both rheumatoid and non-rheumatoid disease may play a part in the cause of these abnormalities. PMID- 3675008 TI - Comparison of phenytoin and gold as second line drugs in rheumatoid arthritis. AB - Phenytoin has known immunosuppressive properties, and a recent pilot study has indicated that it may have a second line effect in rheumatoid arthritis (RA). To evaluate this role 60 patients with active RA were randomly allocated to receive either oral phenytoin or intramuscular gold. The two treatment groups were comparable at the outset (Mann-Whitney U test). Twenty four patients completed 24 weeks of therapy in each group and no unexpected side effects were encountered. All variables except haemoglobin (Hb) improved significantly in the gold group while in the phenytoin group significant improvement was limited to articular index, erythrocyte sedimentation rate (ESR), and Hb. Between group comparison (Mann-Whitney) at week 24 showed a significant advantage of gold over phenytoin for pain score and morning stiffness. Thus phenytoin appears to exert a less potent second line effect than gold and is unusual in influencing laboratory indicators of disease activity more than clinical variables. This is likely to limit its usefulness as a second line drug in RA. PMID- 3675009 TI - A system of canals in semilunar menisci. AB - Semilunar menisci of young calves, and infants and young children were examined with the scanning electron microscope and the light microscope. Canal-like structures were noted opening onto the surface of the menisci. After filling the joints with Indian ink, ink was noted within canal-like structures deep in the substance of the tissue. The canals may play a part in the transport of fluid within the meniscus, or may carry nutrients from the synovial fluid or the blood vessels to the avascular sections of the meniscus. PMID- 3675010 TI - Shoulder disorders in the elderly (a hospital study). AB - One hundred acute geriatric inpatients were assessed to investigate the prevalence of shoulder disorders; 21 had symptoms due to shoulder disease. Conditions included supraspinatus tendinitis (five), chronic rotator cuff rupture (seven), frozen shoulder (two), glenohumeral osteoarthritis (two), apatite related shoulder arthritis (one), stroke related shoulder disease (six). (Some patients had more than one shoulder condition.) The last group included painful stiff shoulders (three), glenohumeral subluxation (two), and acute shoulder-hand syndrome (one). Patients with rotator cuff rupture had bilateral disease. Only three patients had sought medical attention for their symptoms. The common occurrence of these conditions has possible implications for rehabilitation, and medical awareness is required as few may volunteer symptoms. A community based study is needed to assess the prevalence in the elderly population. PMID- 3675011 TI - Experimental autoimmune arthritis in mice. I. Homologous type II collagen is responsible for self-perpetuating chronic polyarthritis. AB - Immunisation with heterologous type II collagen (CII) induces arthritis in mice of the DBA/1 strain, which is genetically susceptible to this disease. To develop an experimental model of autoimmunity more adequate for the study of human rheumatoid arthritis (RA), DBA/1 mice were injected with 100 micrograms of native CII that had been purified from mouse xiphoid cartilage. About six weeks later the animals developed a chronic progressive polyarthritis involving the four paws but mainly confined to interphalangeal and metatarsophalangeal joints. The evolution of the disease fluctuated between remissions and exacerbations. The initial lesions assessed by clinical observations were more severe when the disease occurred early than in the case of late onset. Interestingly, the incidence of arthritis was clearly preponderant in males, and, moreover, the few female mice which developed arthritis had mild disease states with lower arthritic scores than the males. Varying levels of autoantibodies against mouse CII were found in the sera of immunised animals, regardless of the development of arthritis. These data indicate that the injection of homologous CII into mice caused a polyarthritis that is clinically closer to the human RA than the disease induced with heterologous CII and therefore will represent a useful tool for the study of the self-perpetuating mechanisms that characterise RA. PMID- 3675012 TI - Sjogren's syndrome and fibrosing alveolitis complicated by pulmonary lymphoma. AB - The case of a middle aged woman who presented with fibrosing alveolitis, in her mid-forties, followed by a sicca syndrome and who subsequently developed a pulmonary lymphoma (B cell) while receiving azathioprine therapy is recorded. Of interest was the absence of polyclonal B cell activation, e.g., production of rheumatoid factor, hypergammaglobulinaemia, high titre antinuclear antibodies or antibodies to extractable nuclear antigens (ENA) during most of her illness. Persistently raised IgM levels and low IgA levels were demonstrated. The relevance of azathioprine to development of the lymphoma is discussed. PMID- 3675013 TI - Giant cell arteritis of the skin simulating erythema nodosum. AB - Cutaneous involvement in giant cell arteritis is quite uncommon. A patient is described who presented with pretibial skin lesions clinically indistinguishable from erythema nodosum which, on biopsy, showed subcutaneous pannicular giant cell vasculitis. Cutaneous manifestations of giant cell arteritis are subsequently reviewed. PMID- 3675014 TI - Pseudoseptic pseudogout in progressive pseudorheumatoid arthritis of childhood. AB - Progressive pseudorheumatoid arthritis of childhood is an uncommon arthropathy of unknown aetiology, which is related to spondyloepiphyseal dysplasia tarda. Previous reports have noted the absence of joint inflammation in this disease. An adult is described here with this arthropathy, who developed episodic acute inflammatory arthritis that mimicked septic arthritis, but proved to be pseudogout. The relation between pseudogout and progressive pseudorheumatoid arthritis of childhood is discussed. PMID- 3675015 TI - Heating rheumatoid knees to an intra-articular temperature of 42.1 degrees C. PMID- 3675016 TI - Enthesopathy index in ankylosing spondylitis. PMID- 3675017 TI - Atlantoaxial subluxation and spinal cord compression in psoriatic arthropathy. PMID- 3675018 TI - Immunoglobulin A and C reactive protein levels in ankylosing spondylitis. PMID- 3675019 TI - Nutrition after vertical banded gastroplasty. AB - The authors assessed the nutritional status of 60 morbidly obese patients by determining body composition, using multiple isotope dilution at 13.6 +/- 0.4 months following operation. Body weight was followed for an additional 12.3 +/- 0.8 months. Twenty-four patients lost more than 25% of their preoperative weight and were within 30% of ideal weight (a "good" result). At 1 year they had lost 41.4 +/- 1.8% of preoperative weight and the body mass index (BMI) decreased from 46.7 +/- 1.2 to 27.0 +/- 0.6 kg/m2. Despite rapid weight loss, malnutrition did not develop and their body composition became indistinguishable from that of normally nourished volunteers. Twenty-nine patients had a "satisfactory" result with more than 25% weight loss but were not within 30% of ideal. Their weight decreased by 34.8 +/- 1.0% as their BMI decreased from 55.4 +/- 1.2 to 36.0 +/- 0.8 kg/m2. Seven patients lost less than 25% of their preoperative weight (an "unsatisfactory" result). Malnutrition did not develop in any patient. In the authors' experience, in contrast to other weight reducing operations, vertical banded gastroplasty (VBG) results in rapid weight loss without the concomitant development of malnutrition even in patients who return to normal weight. PMID- 3675020 TI - Parietal cell vagotomy as an emergency procedure for bleeding peptic ulcer. AB - Twenty-three selected patients presenting with massive bleeding from peptic ulcers underwent emergency parietal cell vagotomy (PCV). Nineteen patients had a duodenal ulcer, two a prepyloric ulcer, and one a gastric ulcer. The patients were studied retrospectively with regard to postoperative mortality and morbidity, early rebleeding, and recurrent ulceration. Two patients (9%) died after operation, one of rebleeding. No others suffered rebleeding. One further patient had major respiratory complications and 14 others developed minor complications. The remaining 21 patients were followed for between 2 and 72 months. Two patients (10%) developed recurrent ulcers. The authors conclude that parietal cell vagotomy may be used as an emergency operation for bleeding peptic ulcer in selected cases with an acceptably low mortality, rebleeding rate, and incidence of recurrent ulceration. PMID- 3675021 TI - Physiologic assessment of the four commonly performed endorectal pullthroughs. AB - The popularity of the endorectal pullthrough for the treatment of benign mucosal diseases of the rectum has created a controversy regarding the need for a reservoir. The four currently advocated procedures, the straight endorectal anastomosis, the J pouch, the S pouch, and the lateral isoperistaltic ileal reservoir were evaluated in a puppy model with four animals in each experimental group. Measurement of rectal capacitance showed that all groups achieved 80-85% of control values at 6 months after surgery. Intestinal transit time decreased by one-half in all groups. Stool consistency, stool culture, water, and electrolyte absorption did not show any statistical superiority of one group over another. Stool frequency varied widely at 6 months; 10 stools per 8-hour period were counted in the lateral reservoir group versus 25 with the J pouches, and 16 with the straight and S groups. Stool frequency did not correlate with transit time, stool consistency, or rectal capacitance. Barium enemas showed that straight pullthroughs more closely resembled the measurements of the normal animal's endorectal canal. Based on these studies, there appears to be no advantage to adding a reservoir to the endorectal pullthrough. PMID- 3675022 TI - Coloanal anastomosis in the management of benign and malignant rectal disease. AB - The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence. PMID- 3675024 TI - A prospective study of vein patch angioplasty during carotid endarterectomy. Three-year results for 801 patients and 917 operations. AB - From 1983 through 1985, 801 consecutive patients (mean age: 66 years) underwent 917 primary carotid endarterectomies at the Cleveland Clinic. Conventional arteriotomy closure was performed during 483 operations, while patch angioplasty using a distal segment of saphenous vein was employed in 434. Preoperative risk factors, surgical management, and antiplatelet therapy were equivalent in the vein patch (VP) and nonpatch (NP) groups. Early results were evaluated by intravenous angiography (DSA) in 715 patients (89%), and 332 reconstructions (36%) have been reassessed by objective imaging during a mean follow-up interval of 21 months. Ischemic strokes occurred after 18 (1.9%) of the 917 procedures (0.7% VP, 3.1% NP; p = 0.0084), and symptomatic (N = 9) or unsuspected (N = 8) thrombosis of the internal carotid artery was confirmed by neck exploration or routine DSA after 1.9% of all operations (0.5% VP, 3.1% NP; p = 0.0027). Only ten patients (1.2%) have required reoperations for severe recurrent lesions, but the cumulative 3-year incidence of new defects (greater than or equal to 30% stenosis) documented by objective studies in the VP and NP groups was 9% and 31%, respectively (p = 0.0066). These results strongly suggest that VP angioplasty enhances the safety and durability of carotid endarterectomy. PMID- 3675023 TI - Magnetic resonance imaging for detection of arterial and venous occlusion in canine muscle flaps and bowel segments. AB - Magnetic resonance imaging (MRI) was performed on 16 muscle flaps and eight jejunal segments in dogs to assess its usefulness in detecting vascular occlusion. Arterial or venous occlusion was carried out in 11 muscles and six bowel segments, with the remaining sham flaps serving as controls. Imaging was performed over 2 hours using a spin echo pulse sequence with T2 weighting. Arterial occlusions in muscles resulted in T2 values 15-30% higher than controls, while venous occlusion produced T2 values 55-75% higher than controls. Differences became significant (p less than 0.05) at 10 minutes after venous occlusion and at 35 minutes after arterial occlusion. Differences between occluded and control bowel segments, although demonstrating a similar trend, failed to reach statistical significance in this preliminary study. The authors conclude that magnetic resonance imaging may be a valuable method for early detection of venous and arterial occlusion in muscle flaps. Further study may also demonstrate this technique to be useful in the diagnosis of ischemic bowel. PMID- 3675025 TI - Pulmonary hypertension and leukosequestration after lower torso ischemia. AB - Ischemia stimulates thromboxane (Tx) synthesis. This study tests the hypothesis that the cardiopulmonary dysfunction that may follow aortic declamping is related to Tx. Anesthetized dogs (N = 15) were subjected to 4 hours of infrarenal aortic cross-clamping. In untreated control animals (N = 7), plasma levels of TxB2 rose from 654 +/- 74 pg/mL to 1238 +/- 585 pg/mL at 5 min (p less than 0.05), and to 3174 +/- 912 pg/mL 3 hours after declamping (p less than 0.05). Mean pulmonary artery pressure (MPAP) rose 5 min after declamping from 13 +/- 2 mmHg to 21 +/- 2 mmHg (p less than 0.05). Cardiac Index (CI) declined during ischemia from 181 +/- 30 mL/kg.min to 128 +/- 16 mL/min.kg (p less than 0.05), and to 80 +/- 8 mL/min.kg after 4 hours of reperfusion (p less than 0.05). Platelet counts declined but platelets labeled with In 111 did not accumulate in the lungs, whereas quantitative counts of polymorphonuclear leukocytes (PMN) in the lungs 4 hours after declamping yielded 213 +/- 33 PMN/25 high power fields (HPF) in dependent areas of the lung and 153 +/- 26 PMN/25 HPF in nondependent areas. The wet/dry weight ratio of the lungs was not elevated, although foci of proteinaceous exudate and PMNs in alveoli were noted. Another group of dogs (N = 8) were pretreated by random choice with the Tx synthase inhibitor OKY-046 2 mg/kg IV every 2 hours, which led to: lower TxB2 levels at baseline 95 +/- 35 pg/mL (p less than 0.05), 5 min after ischemia 140 +/- 93 pg/mL and after 3 hours of reperfusion 122 +/- 36 (p less than 0.05); lower MPAP, 16 +/- 2 mmHg (p less than 0.05); higher CI throughout (p less than 0.05); normal histology and reduced pulmonary PMN sequestration both in dependent 127 +/- 15 PMN/25 HPF and nondependent areas of the lungs 95 +/- 11 PMN/25 HPF (p less than 0.05). In animals undergoing sham ischemia (N = 3), levels of TxB2 and cardiopulmonary function remained unchanged from baseline. There were 150 PMN/25 HPF in dependent and 85 PMN/25 HPF in nondependent lung areas. The results indicate that ischemia generated Tx mediates a rise in MPAP, a fall in CI, and PMN entrapment in the lungs. PMID- 3675026 TI - PTFE grafts for hemodialysis access. Techniques for insertion and management of complications. AB - In a series of 602 procedures, over 90% of primary forearm insertions of PTFE grafts between the radial artery and a cubital vein were possible. Thrombosis of the graft, which was invariably due to venous outflow obstruction, was the most common complication encountered. Revision of the venous anastomosis was not necessary in about one-third of the thrombosed grafts if a size 3 coronary dilator could be passed and the augmentation test was satisfactory. For revisions, creation of a new venous anastomosis using a jump graft was preferred over patch angioplasty or venous endarterectomy. Crossing the elbow for this purpose did not adversely affect graft patency. The incidence of aneurysm formation and infection was 16% and 35%, respectively. Infections involving the graft were managed by drainage, antibiotics, and bypass of the infected portion. Immediate bypass and delayed bypass were equally effective. About one-half of the infected grafts were salvaged by these techniques. The most common organism was Staphylococcus aureus. With a combination of the techniques outlined above, the service life of individual PTFE grafts can be extended. Two-year access patency in this series was 77%. PMID- 3675027 TI - Fibrin in peritonitis. PMID- 3675028 TI - Jejunal interposition for benign esophageal disease. PMID- 3675029 TI - A method to improve accuracy of central venous catheter placement. PMID- 3675030 TI - Patients with alcoholic cirrhosis and cholelithiasis. PMID- 3675031 TI - Efflux of 3H-thymidine by erythrocytes from mice infected with Trypanosoma brucei brucei. AB - Erythrocytes from mice infected with Trypanosoma brucei brucei showed a higher rate of efflux of labelled thymidine than did control erythrocytes from uninfected mice (0.56 +/- 0.10 and 0.38 +/- 0.06 mumole min-1 ml-1 packed cells respectively). Efflux of the nucleoside from erythrocytes of normal and infected mice were inhibited to the same extent by a specific nucleoside transport inhibitor, nitrobenzylthioinosine. Enumeration of nitrobenzylthioinosine binding sites on the erythrocytes showed that both have similar numbers of sites (6.2-6.6 X 10(3) sites/erythrocyte). It is concluded that the membrane permeability of the erythrocytes from infected mice was affected by the trypanosome in such a way as to enhance the purine nucleoside transport capacity. This may result in an increased supply of vital purine bases and nucleosides to trypanosomes which depend on their hosts for these nutrients. PMID- 3675032 TI - Concurrent human infection with Leishmania donovani and Leishmania braziliensis braziliensis. AB - In the suburban district of Campo Grande, Municipality of Rio de Janeiro (Brazil) cases of both Leishmania domovani and L. b. braziliensis infections occur. In March 1982 we examined a white male child, five years old, with fever, weight loss and distended abdomen, symptoms said to have started three months before. After the first month a papular lesion appeared on his forehead, rapidly increasing in size and becoming ulcerated: Parasites were isolated from both the ulcer and the bone marrow by culturing in BHI-agar with rabbit blood and a liquid overlay of modified LIT medium. Using the techniques of zymodeme analysis, schizodeme analysis and serodeme analysis using monoclonal antibodies, the parasite from the ulcer was identified as L. b. braziliensis and that from the bone marrow as L. donovani. This seems to be the first described case of concurrent infection of man with a visceral and cutaneous Leishmania. It indicates that, at least in humans, a previous infection with L. donovani does not protect against L. b. braziliensis. This result has important implications for the development of vaccines against leishmaniases. PMID- 3675033 TI - Chemotherapy of experimental echinococcosis in mice. AB - Mebendazole and flubendazole, administered in food at 500 ppm for 14 consecutive days, had a marked effect on one-year-old hydatid cysts of Echinococcus granulosus in mice infected with protoscolices of human origin. In both treated groups most of the cysts were collapsed compared with none in the controls. A small number of apparently viable cysts was observed in both mebendazole and flubendazole treated mice. Histological examination of collapsed cysts revealed necrosis and limited inflammatory infiltration, but in one intact cyst a normal germinal layer was present. The body weight decrease of the treated mice, as the cysts collapsed, was interpreted as an excellent indicator of drug efficacy. Drug related side effects were not observed. PMID- 3675034 TI - Response of laboratory-adapted human hookworm and other nematodes to ivermectin. AB - The activity of ivermectin was examined in Necator americanus, a human hookworm, adapted to the laboratory hamster. A dose of 30 mg kg-1 X 1 or 10 mg kg-1 X 2 was required for complete clearance of pre-adult N. americanus; however, hamsters carrying adult N. americanus were completely cured of infection by doses of 15 mg kg-1 or 7.5 mg kg-1 X 2. The doses of ivermectin required for complete elimination of N. americanus were much higher than those reported for other intestinal nematodes. The probable reasons for these higher doses are discussed. Tests were also carried out with other rodent parasites, namely Nematospiroides dubius, Strongyloides ratti and Trichuris muris. Doses as low as 0.3 mg kg-1 X 1 completely eliminated adult N. dubius from mice, whereas++ S. ratti needed a repeated dose (0.3 mg kg-1 X 2). None of the mice was cured of T. muris infection even at doses of 10 mg kg-1 X 2, although some degree of cure was apparent at the toxic dose. It thus appears that ivermectin is in no way superior in its activity against N. americanus and T. muris than the existing anthelmintics. PMID- 3675035 TI - Prevalence of intestinal parasitic infections in Riyadh district, Saudi Arabia. AB - A total of 23,516 stool specimens collected from patients attending three medical centres in Riyadh, Saudi Arabia, were examined for intestinal parasites. Of these 5737 (24.4%) were positive. Entamoeba histolytica (8.8%) and Giardia lamblia (6.3%) were the commonest parasites found, and in the age group of one to 15 years. Giardia was found in 14.8% of males and 11.9% of females. Other intestinal parasites present included Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, Hymeolepis nana. Ancylostoma duodenale, Enterobius vermicularis. Taenia saginata and Schistosoma hematotium. PMID- 3675036 TI - Malumfashi Endemic Diseases Research Project XXI. Some aspects of the collection of demographic data. AB - This paper considers some of the procedures used and problems encountered in the collection of demographic data for a large-scale medical project: the Endemic Diseases Research Project at Malumfashi in northern Nigeria, 1974-1979. 43,216 people were enumerated and a subset of 26,100 were visited monthly for one year for the purpose of registration of vital events. The majority of problems encountered are relevant to similar studies in developing countries. Some difficulties cannot be avoided, but it is considered helpful to identify them. Other situations, however, deserve particular attention, such as the development of adequate on-site data-checking mechanisms, as these are areas in which future programmes could benefit from the experience of the demographic studies in Malumfashi. More effort still needs to be put into the improvement of data collection methods themselves. PMID- 3675037 TI - A test for blood in haematophagous insects and its application to apparent blood feeding in insectivorous Ceratopogonidae (Diptera). AB - A method is described to confirm the presence of blood in fixed haematophagous insects. It was used to establish that the dark gut contents of individuals of five genera of insectivorous midges (Ceratopogonidae) was not blood. PMID- 3675038 TI - A method for the purification of Leishmania promastigotes from infected phlebotomine sandflies. AB - We describe a method for the purification of Leishmania promastigotes, isolated from infected sandflies (Lutzomyia longipalpis) using a discontinuous density centrifugation gradient (Percoll/Homem). The sandflies, infected seven days previously with Leishmania donovani chagasi or Leishmania mexicana mexicana from culture, were homogenized and centrifuged on a Percoll discontinuous gradient. Five interface bands were formed, and most of the promastigotes settled out at the interface between the (30% and 40%) Percoll concentrations. An extraction of 3.5 x 10(4) promastigotes from 90 female flies was achieved using this technique. PMID- 3675039 TI - Congenital neuro-ophthalmic toxoplasmosis in the mouse. AB - Clinical examination of the eyes of mice with congenital toxoplasmosis provided a good indication of the extent of underlying histopathological damage in the eye, but was of little value for predicting neuropathological severity. Furthermore, the dye-test titre was not related either to the degree of ocular damage or to the severity of brain damage. PMID- 3675040 TI - Echinococcosis in Libya. I. Prevalence of Echinococcus granulosus in dogs with particular reference to the role of the dog in Libyan society. AB - Of 151 dogs examined in 14 localities in Libya, 42 (27.81%) were infected with Echinococcus granulosus. The prevalence of the worms was generally higher in the coastal areas. Infections were light (1-200 worms) in 24 of the infected dogs, medium (201-1000 worms) in ten and high (over 1000 worms) in eight. The maximum number of worms was 12,821, recorded in a four-year-old dog. Infection rates differed with age: 12.5% in dogs aged up to one year, 36.6% for one to two years, 19.3% for two to three years, 44.2% for three to four years and 14.3% for dogs aged over five years. The role of dogs in Libyan society is discussed. PMID- 3675041 TI - Echinococcosis in Libya. II. Prevalence of hydatidosis (Echinococcus granulosus) in sheep. AB - The incidence and geographical distribution of hydatidosis was examined in sheep from ten localities in Libya. A total of 402 cases of hydatid disease (7.85%) were confirmed in a total of 5118 sheep examined; 12.74% of adult sheep were infected, but only 0.29% of lambs. The liver was the organ most commonly infected (97.26% of all infections), followed by the lungs (58.70%), kidneys (1.76%), spleen (0.74%) and heart, mesentery and muscles (0.24% each). The intensity of infection varied from one to more than ten fertile or sterile cysts. Infections were light in 43.73% of livers and 47.03% of lungs, medium in 33.24% of livers and 42.79% of lungs, heavy in 13.55% of livers and 7.62% of lungs, and very heavy in 9.96% of livers and 2.54% of lungs. A total of 73.13% of the infections were found to be fertile, 18.90% sterile and 7.96% both sterile and partly calcified. Lung hydatids tended to be more fertile than liver cysts. PMID- 3675042 TI - The prevalence and epidemiology of cestodes in dogs in Clwyd, Wales. II. Hunting dogs. AB - Studies of a foxhound pack and gundog kennel in Clwyd, Wales showed 47 of 162 foxhounds (29%) and six of 25 gundogs (24%) to be infested with cestodes. Taeniia species were found in both groups, T. hydatigena being most common. Echinococcus granulosus and Dipylidium caninum were found in hounds only. The husbandry of the dogs was investigated and close relationships were found between diet, worming procedures and cestode infestation. These dogs play an important role in disseminating cestode eggs in the environment. Recommendations for control of the problem are made. Foxhounds and other hunting dogs play a particularly important role in the life-cycle of cestodes because their diet frequently includes uncooked carcasses and because they hunt over large areas of countryside, facilitating the widespread dissemination of infective eggs. PMID- 3675043 TI - Onchocerciasis in Plateau State of Nigeria. II. The prevalence among residents around the Assob River area. AB - A study of the prevalence of human onchocerciasis in eight villages around the Assob River in Jos Plateau, Nigeria, was undertaken between October 1983 and March 1985 using the skin-snip method. A total of 1673 individuals were examined. One hundred and eighty five (11.06%) had microfilariae of Onchocerca volvulus in their skin biopsies, and of these infected people, five (2.7%) were blind. The highest prevalence rate recorded was in Ngwan Madaki, where 51 (26.3%) of the 194 people examined were infected. The lowest percentage prevalence was recorded in Dogon Fili with four (1.95%) of the 205 people examined being positive. The proportion of infected people increased with age; and onchocercal lesions were significantly more common in older than in younger persons (P less than 0.05). There was no significant difference between infection rates in males and females (P greater than 0.05), although the overall percentage infection and the numbers of onchocercal lesions were higher in males than in females. PMID- 3675044 TI - Parasites of stray dogs in the Rabat region, Morocco. AB - Eighteen parasites were identified from 57 stray dogs from the urban and rural areas of Rabat. The prevalence of the species of parasites was: Ctenocephalides (C. canis, C. felis) 94.7%, Rhipicephalus sanguineus 68.5%, Linguatula serrata, Babesia canis, Isospora canis each 3.5%, Toxocara canis 7%, Dirofilaria immitis, Taenia hydatigena, T. pisiformis each 12.3%, Dipetalonema dracunculoides 10.5%, Ancylostoma caninum 17.5% Echinococcus granulosus 22.8%, Toxascaris leonina 33.3%, Dipylidium caninum 40.4%, Spirocerca lupi 54.5%, Unicinaria stenocephala 79%. Multiple infections (two to nine parasites) were seen in 56 dogs. T. canis was present only in dogs younger than one year of age. D. immitis, D. dracunculoides, T. hydatigena and T. pisiformis occurred only in animals older than one year. A. caninum, U. stenocephala, S. lupi, D. immitis were more common in males than females. E. granulosus was never detected in urban dogs. PMID- 3675045 TI - Endemic Paragonimus infection in upper Igwun Basin, Nigeria: a preliminary report on a renewed outbreak. AB - In a 24-month longitudinal study on a renewed outbreak of Paragonimus infection in Igwun Basin, Nigeria 1973 individuals were examined. A total of 332 (16.8%) individuals were found infected with Paragonimus uterobilateralis. There was evidence of increasing annual prevalence rates from 15.0% in 1983 to 16.7% in 1984, and 18.7% in 1985. Infection was present in all age groups, with prevalence of 18.9% in males and 14.5% in females. 12.3% of the infections were of high intensity, over 100 eggs in 5 ml of sputum; 20.5% were moderate infections, 50 100 eggs in 5 ml of sputum; the remaining 67.2% were of low intensity, less than 50 eggs in 5 ml of sputum. The increasing annual prevalence rates and intensity of infection resulted from increased crab consumption. The commonest crab was Sudanautes africanus, whose population and level of infection with metacercariae showed seasonal fluctuations with peaks during the dry season months. There was evidence that snails of the genus Melania are involved in the transmission of P. uterobilateralis in the area. PMID- 3675046 TI - Antimalarial interaction with ferriprotoporphyrin IX monomer and its relationship to activity of the blood schizontocides. PMID- 3675047 TI - Experimental murine infection with the diffuse cutaneous leishmaniasis strain, Isabel. AB - Infection with the Isabel strain of Leishmania has been followed in several inbred strains of mice over an extended period. The mouse strains segregate into three major types with respect to susceptibility to infection: BALB/c, BALB.B and SWR/J are susceptible; DBA/1J is intermediate; and C57BL/6, C57BL/10, DBA/2J and B10.D2 are resistant. Infections with other leishmanial strains have been well characterized in the BALB/c mice. Therefore, BALB/c mice were selected for extended studies. Progression of the disease was assessed by the following parameters: (1) numbers of parasites isolated from various tissues including footpad lesions, spleens, and lymph nodes and (2) the presence of metastatic lesions. This model should prove valuable in the study of the early immunological events in leishmaniasis. PMID- 3675048 TI - Adenosquamous carcinoma and the biology of lung cancer. PMID- 3675049 TI - Thoracic surgery manpower: the fourth manpower study of thoracic surgery: 1985 report of the Ad Hoc Committee on Manpower of The American Association for Thoracic Surgery and The Society of Thoracic Surgeons. AB - Responding to a survey about their practice in 1985, 2,969 (70%) Board-certified thoracic surgeons provided data that were compared with data from manpower surveys in 1980 and 1976. (table; see text) Thoracic surgeons were most active between ages 35 and 54 years when they accomplished 61% of all general thoracic and 85% of cardiac operations. Surgeons older than 50 years performed significantly more general thoracic operations than younger surgeons, and the younger group performed significantly more cardiac operations than their older counterparts. Solo practice continued to decline. In smaller referral areas, the number of general thoracic procedures per surgeon increased, but the number of cardiac operations have decreased compared with 1980. Overall, general thoracic and cardiac operations increased, but peripheral vascular procedures and pacemaker insertions decreased in almost all nine census regions. Fewer general thoracic and cardiac operations were performed per thoracic surgeon in the western United States than in central and eastern regions. In response to questions about work load, 55% believed that their clinical activity was satisfactory, 42% operated too little, and 3% operated too much. The 363 non Thoracic Board-certified surgeons who responded performed 14% of general thoracic and 8% of cardiac surgery in 1985. During the first half of the 1980s, our specialty certified an average of 134 thoracic surgeons annually, which is higher than the 120 surgeons per year estimated to meet the projected demand. PMID- 3675050 TI - Adenosquamous lung carcinoma: clinical characteristics, treatment, and prognosis. AB - Adenosquamous carcinoma of the lung is a rare and poorly described entity. At the University of Chicago between 1974 and 1985, 2.3% (20/873) of patients with lung cancer had well-differentiated adenosquamous carcinoma. As in non-small cell lung cancer, patients with Stage I disease were amenable to operation with 60% (3/5) free from disease between one and six years postoperatively. However, Stage II adenosquamous carcinoma (14 patients) exhibited highly aggressive behavior with rapid progression of disease (mean interval, 2.1 months). Despite combinations of surgery (6 patients), chemotherapy (6 patients, one response), and radiotherapy (10 patients, no response), median survival for patients with Stage III adenosquamous carcinoma was 5.0 months, worse than that for Stage III small cell cancer (9.6 months), adenocarcinoma (9.0 months), and squamous cancer (7.8 months). PMID- 3675051 TI - Myocardial adenosine triphosphate content as a measure of metabolic and functional myocardial protection in children undergoing cardiac operation. AB - In an effort to quantitate the metabolic and functional response to global myocardial ischemia as a prelude to specific interventions to improve myocardial protection in children, the following data were collected. Twenty children (age, 1.16 +/- 0.3 years) underwent repair of congenital intracardiac malformations using aortic cross-clamping and cold potassium cardioplegia (ischemic time, 56.1 +/- 4.5 minutes). Metabolic protection was assessed by measuring the myocardial adenosine triphosphate (ATP) content by microbioluminescence. Before and after ischemia 10-mg myocardial samples were obtained from the left ventricular apex using a Tru-cut biopsy needle. In 15 patients, postoperative ventricular function was measured by radionuclide ventriculography at 72 to 96 hours following operation. Five of 6 patients with a postischemic ATP level less than 40% of control (26.3 +/- 2.8) had a left ventricular ejection fraction (EF) lower than 55% (50.3 +/- 2.3). Seven of 9 patients with an ATP level greater than 40% of the preischemic level (98.0 +/- 14.4) had a normal EF (61.8 +/- 2.9; p less than 0.04). Two other patients with postischemic ATP levels lower than 40% of control died of low cardiac output and had no postoperative ventricular function studies. Thus, of 7 patients with postischemic ATP levels lower than 40% of preischemic levels, 2 died and 5 had depressed left ventricular function. These data support the concept that low postischemic ATP levels correlate with death or poor postoperative ventricular function, and indicate that this variable will be useful to assess future improvements in myocardial protection during pediatric cardiac operations. PMID- 3675052 TI - Exercise tolerance test in lung cancer patients: the relationship between exercise capacity and postthoracotomy hospital mortality. AB - To evaluate the significance of the blood lactate threshold as a predictor of postthoracotomy hospital mortality resulting from pulmonary complications, a 3 minute incremental exercise test was administered to 33 lung cancer patients who underwent thoracotomy between October, 1981, and May, 1984. The oxygen consumption/body surface area at an arterial lactate level of 20 mg/dl (VO2/BSA at La-20) was adopted as the blood lactate threshold. Age and pulmonary function parameters such as forced expiratory volume in one second (FEV1)/body surface area (BSA), FEV1/forced vital capacity, diffusing capacity for the carbon monoxide/lung volume, and maximum ventilatory volume/BSA revealed significant differences between patients with postthoracotomy pulmonary complications and those without such complications. However, there was no difference in pulmonary function test results between the surviving and deceased patients. In contrast, although VO2/BSA at La-20 did not differ between the patients with and without pulmonary complications, it differed significantly between the surviving and deceased patients. We concluded that postthoracotomy pulmonary complications depended on the severity of preoperatively associated pulmonary function disorders and that the blood lactate threshold expressed by VO2/BSA at La-20 was an important indicator of the risk of hospital mortality. PMID- 3675053 TI - Bronchogenic cysts above and below the diaphragm: report of eight cases. AB - Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum. Although typically asymptomatic, infection or compression of adjacent structures may become prominent. Surgical excision is recommended to establish diagnosis, alleviate symptoms if present, and prevent future complications. We report our recent experience with bronchogenic cysts including 7 located within the mediastinum and a rare instance of a cyst below the diaphragm. PMID- 3675054 TI - Preoperative evaluation of the thoracic aorta using MRI and angiography. AB - The ability of ECG-gated magnetic resonance imaging (MRI) to evaluate disease of the thoracic aorta compared with angiography was prospectively assessed in 28 patients. MRI identified abnormalities in all patients, with confirmation at operation in 22 (79%) and by angiography alone in all 28. In 20 of the patients, MRI correctly diagnosed 20 of 21 aneurysms of the thoracic aorta (6 dissecting, 4 saccular, 10 fusiform), but 1 surgically proven fusiform aneurysm was categorized as an enlarged aortic dissection based on both MRI and angiographic findings. One dissection and 1 fusiform aneurysm were shown by MRI only. Coarctation of the aorta was identified in 4 patients. Ascending aortic enlargement and left ventricular hypertrophy were identified by MRI in 4 patients with aortic stenosis. In 7 patients (25%), MRI provided additional important information not shown by angiography and in 1 patient, the MRI findings resulted in a change in the surgical approach. In 14 of 28 patients (50%), angiography was necessary for definitive preoperative evaluation of the aortic valve, the coronary arteries, or the brachiocephalic vessels. MRI was a useful noninvasive supplement to angiography for the preoperative assessment of thoracic aortic disease. PMID- 3675055 TI - Infection prophylaxis in pulmonary surgery: a randomized prospective study. AB - A prospective randomized study to evaluate the efficacy of antibiotic prophylaxis against postoperative infections was carried out on 120 patients undergoing pulmonary operations. The patients were randomized into two groups of 60 patients each. One group received doxycycline (deoxytetracycline) prophylaxis for five days, and the other received cefuroxime (a second-generation cephalosporin) for one day. The groups were comparable with regard to age, sex, common risk factors, diagnosis, and operative procedures. A reduction in the infection rate was noted in the cefuroxime group (10/60) compared with the doxycycline group (19/60), but the difference was not statistically significant (p = 0.055). In major infections (empyema and pneumonia) there was no difference between the groups (4/60 in the cefuroxime group and 5/60 in the doxycycline group), but a significant (p less than 0.05) reduction was noted in minor infections (6/56 and 14/55, respectively) such as lower respiratory tract infections and prolonged fever. There were no wound infections in the two study groups. There were significantly (p less than 0.05) fewer postoperative fever reactions (axillary temperature greater than 37.5 degrees C) in the cefuroxime group (30/60) compared with the doxycycline group (44/60). Both antibiotics were effective in preventing wound infections, but cefuroxime may also be beneficial in preventing minor respiratory infections. The bactericidal effect of cefuroxime may explain this finding. PMID- 3675056 TI - Indications and techniques for midline approach to aortic coarctation in infants and children. AB - A variety of techniques have been described for the repair of aortic coarctation. Most of these use operative exposure through a left thoracotomy. There are, however, instances when a median sternotomy provides a more versatile approach and allows for equally acceptable repair. Twelve patients (age, 2 days to 16 years) with coarctation of the aorta serve to illustrate the value of the technique. All but 3 patients were under 3 years old. Five patients had repair of coarctation combined with repair of other congenital cardiac anomalies (atrial and ventricular septal defects, 2 patients; atrial septal defects, 2 patients; and valvular aortic stenosis, 1 patient). Six patients had complicated recurrences of previously repaired coarctations and 1 patient had a primary coarctation that involved the aortic arch. All repairs were accomplished through a median sternotomy with the use of cardiopulmonary bypass and periods of (1) total circulatory arrest (6 patients); (2) reduced flow (4 patients); or (3) normal flow with multiple sites of arterial inflow (2 patients). All patients did well with no operative mortalities and no sequelae to date (8 weeks to 4 years). Examples of various techniques are provided to demonstrate the flexibility obtainable with this method. Median sternotomy can provide a viable approach to difficult problems involving coarctation of the aorta. PMID- 3675057 TI - Bubble oxygenation and cardiotomy suction impair the host defense during cardiopulmonary bypass: a study in dogs. AB - Decreased complement levels and impairment of polymorphonuclear leukocyte function increase the risk of infection during cardiopulmonary bypass (CPB). The effects of different types of oxygenator and of blood suction on this natural humoral and cellular host defense mechanism were investigated in dogs undergoing CPB during sham open-heart operations. Airborne contamination of the wound area and the CPB circuit was performed by aerosolizing Staphylococcus aureus. A membrane oxygenator in the CPB circuit maintained a normal host defense mechanism. The use of cardiotomy suction during CPB with this type of oxygenator affected the host defense to some extent. The use of a bubble oxygenator in the CPB circuit together with cardiotomy suction seriously impaired the host defense. Postoperatively bacteremia developed in no dogs in the membrane oxygenator group, whereas 8 of 15 dogs in the bubble oxygenator group had a positive blood culture for the indicator microorganism. We conclude that the use of a membrane oxygenator is helpful to maintain the host defense. Attention has to be paid to reduce the deleterious effects of cardiotomy suction. PMID- 3675058 TI - Aortic origin of right pulmonary artery: successful surgical correction in three consecutive patients. AB - Over a period of four years (1981 through 1984), 3 infants with aortic origin of the right pulmonary artery were seen in our surgical unit. Two infants had a persistent ductus arteriosus, which arose from the left subclavian artery in 1 of them who also had a right-sided aortic arch. There were no other associated abnormalities. Preoperative diagnosis was established by echocardiography in 2 infants. Anatomical surgical correction was undertaken in all 3 infants under cardiopulmonary bypass. There were no operative deaths. One child required reoperation at 15 months for anastomotic stenosis. All 3 children were well two to five years postoperatively with scintillographic evidence of normal ventilation and perfusion. Our experience indicates that this rare but severe congenital cardiac anomaly is easily diagnosed by echocardiography, and confirms that it is eminently amenable to surgical correction. PMID- 3675059 TI - The Blalock-Taussig shunt in infants: standard versus modified. AB - In recent years, the modified Blalock-Taussig shunt--a polytetrafluoroethylene graft from the subclavian artery to the pulmonary artery--has been preferred over the standard shunt by some surgeons because (1) it requires less dissection and (2) length of native vessels is not critical. From January, 1979, to June, 1985, we operated on 51 infants less than 1 year of age, including 26 less than 1 week of age, to palliate severe complex cyanotic congenital cardiac malformations. Twenty-four modified Blalock-Taussig shunts and 29 standard Blalock-Taussig shunts were created. The groups were concurrent. We reviewed all available cineangiograms and measured branch pulmonary and subclavian arteries. Pulmonary artery index was not different preoperatively in patients given a modified versus a standard Blalock-Taussig shunt (144 +/- 118 and 118 +/- 59 mm2/m2, respectively), but it was greater postoperatively in patients with a modified shunt (431 +/- 188 and 189 +/- 106 mm2/m2) (p = 0.07). Distortion of the pulmonary artery occurred less often after a modified Blalock-Taussig shunt (4/11) than a standard Blalock-Taussig shunt (6/8) (p = 0.06), though none of the distortions was severe. Early and late shunt failure occurred less often with a modified shunt (5/24) than with a standard shunt (15/29) (p less than 0.05). The modified Blalock-Taussig shunt had advantages over the standard Blalock-Taussig shunt in our series: pulmonary artery growth was greater, distortion of pulmonary arteries was less commonly seen, and shunt failure occurred less often. Thus, in infants, we believe the modified Blalock-Taussig shunt should be considered a reasonable alternative to the standard Blalock-Taussig shunt. PMID- 3675060 TI - Persistent left superior vena cava causing subdivided left atrium: diagnosis, embryological implications, and surgical management. AB - A 3-month-old infant is described in whom a persistent left superior vena cava impinged on the posterior wall of the left atrium, producing a subdivided left atrium with left-to-right shunting and congestive heart failure. To our knowledge, this anomaly has not previously been reported. The preoperative diagnosis, surgical management, and embryological implications are discussed. PMID- 3675061 TI - Acquired left ventricular to coronary sinus fistula: an unusual complication of acute myocardial infarction. AB - Anatomical complications of myocardial infarction include ventricular septal defect and mitral regurgitation. Another unusual complication of myocardial infarction is described, and its diagnosis and surgical management are discussed. PMID- 3675062 TI - Bovine pericardium: a source of pulmonary venous obstruction in the Mustard procedure. AB - Following Mustard's popularization of the intraatrial baffle procedure for transposition of the great arteries, debate has persisted regarding the ideal materials to use. Reports of xenograft (i.e., bovine pericardium) as a suitable prosthetic material made it an appealing choice. We report our recent experience with 2 patients in whom bovine pericardium was used for atrial augmentation, with subsequent pulmonary venous obstruction. For this reason, we have abandoned this material as an acceptable prosthetic in the Mustard procedure. PMID- 3675064 TI - Electrocautery for dissection of implantable defibrillator leads. PMID- 3675063 TI - An easy and safe technique for ventricular septal defect closure in hearts with atrioventricular discordant connection and dextrocardia. AB - When ventricular septal defect exists in hearts with atrioventricular discordant connection and dextrocardia, closure of the defect can most easily be accomplished by exposure through the left atrium and retracted tricuspid valve leaflets. This approach provides good visualization of all aspects of the defect and keeps the suture line away from the conduction tissue, thus reducing the possibility of iatrogenic heart block. PMID- 3675065 TI - Legionnaires' disease. PMID- 3675066 TI - Adenosine triphosphate levels in human spermatozoa. AB - ATP levels in human spermatozoa have been positively correlated with good motility. This has given rise to the impression that good ATP levels per se are related to good motility, i.e., the higher the ATP level, the better the motility and fertilizing potential. There was no direct correlation between motility percentage, forward progression, viability percentage, and ATP levels (when expressed per 1 million spermatozoa) in the general population. This finding was not unexpected since other factors, such as defects of the microtubules and viscosity of the semen, could affect the motility in some patients. However, when semen from individual patients was assessed, the motility percent, viability, and ATP concentration decreased by comparable levels over a 4-h period postejaculation. Semen samples with normal counts of spermatozoa (greater than 20 X 10(6)/ml) had higher levels of ATP than samples from patients with oligozoospermia. Spermatozoa from patients whose semen contained less than 0.60 X 10(-2) nmol ATP/1 million spermatozoa showed a rapid drop in motility over a 4-h period compared with semen samples where the motility remained above 10% motile over this period, the latter samples having ATP levels averaging 3.30 X 10(-2) nmol/1 million spermatozoa. PMID- 3675067 TI - In vitro behavior of human nonfertile semen in isoosmotic and hyperosmotic media. AB - High-ionic-strength media are known to favor rapid capacitation and acrosome reaction of spermatozoa in vitro. The influence of isoosmolar (N-BWW) and hyperosmolar (H-BWW) media on the percent motility, forward progression, and zona free hamster egg penetration has been investigated for 148 semen from patients consulting for male or idiopathic sterility. After 15 h of incubation, the hyperosmotic medium had no significant detrimental effect on the percent motility of spermatozoa, although the forward progression was better maintained in the isoosmolar medium. In general egg penetration was increased when spermatozoa were treated with the hypertonic medium, and in particular 5 patients whose semen showed no penetration when treated with N-BWW scored greater than 12% when treated with H-BWW. For the 23 subjects who had an IVF at the same period, a good agreement with zona-free egg penetration was found in 70% of the cases. PMID- 3675068 TI - Effect of inhibin on testosterone metabolism by rat ventral prostate in vitro. AB - Conversion of radiolabeled testosterone to 5 alpha-dihydrotestosterone (5 alpha DHT) was determined in the rat ventral prostate in vitro, and the effect of inhibin on this conversion was demonstrated. The data revealed that the reduction of testosterone to 5 alpha-DHT was inhibited in a dose-related manner in the presence of inhibin as compared with the basal reduction. The percentage of testosterone reduced per 10-mg tissue also showed a similar trend. The ratio of radioactive counts for DHT and testosterone was also minimum at the highest dose of inhibin used. Inhibin can thus modulate the conversion of testosterone to 5 alpha-DHT in the rat ventral prostate, and therefore can autocrine-paracrine function can be attributed to the prostate. PMID- 3675069 TI - Protection of spermatogenesis during cancer chemotherapy. AB - The ability of androgen pretreatment in adult Wistar rats to protect the spermatogonial stem cells from one or two doses of the cytotoxic procarbazine (PCB) was investigated. Survival of stem cells was assessed by a tubule regeneration assay. Ten weeks' pretreatment of the rats with 200 mm2 silastic implants containing testosterone resulted in significant protection of the spermatogonial stem cells from PCB-induced damage. Androgen-pretreated rats given a single dose of 200 mg/kg PCB demonstrated 86% tubule regeneration as opposed to 41% in rats pretreated with cholesterol. Similar values were obtained when the PCB dose was given as two weekly fractions of 100 mg/kg. The protective effect of androgen is present from the time of the initial challenge with the cytotoxic drug. PMID- 3675070 TI - Sialic acid in purified human sperm. AB - Sialic acid levels of human sperm were estimated using newly developed sperm purification procedure (inner column method). This was used to estimate net sialic acid content of forward motile sperm of normal morphology without any contamination of the seminal plasma, other cellular components, and immature or abnormal sperm. The sialic acid content in purified sperm was approximately 40% of that in the washed (dilution-washing method) sperm. It is suggested that biochemical properties of human sperm should be reevaluated using the inner column purification procedure. PMID- 3675071 TI - Relationship between the sperm penetration assay and other tests of sperm function. AB - Semen from 88 men of infertile couples and 33 fertile donors differed in seminal fluid analysis (sperm density and motility) (SFA) as well as in the penetration of hamster ova (SPA) and bovine cervical mucus (MPT). In the fertile group, significantly more subjects had adequate SFA, SPA, or MPT results than in the infertile group. When the two groups were subdivided into those with normal or those with abnormal SFA, no differences were noted in SPA, MPT, or postcoital test (PCT) scores. The SFA parameter most consistently reflected in the results of the SPA, MPT, and PCT was sperm density. This was most evident when the SFA was poor. The worst prognosticator of fertility was the SFA, with 30% of the fertile donors having an abnormal SFA. The worst prognosticator of infertility was the MPT, with 79% of the patients penetrating in the fertile range. The SPA was a significantly better predictor than either the SFA or MPT. SPA and MPT results were positively correlated only in the overall infertile group. The SPA, MPT, and PCT measure sperm qualities distinct from those revealed by the SFA, and from each other, and in combination provide the best assessment of fertility. PMID- 3675072 TI - Improvement in semen quality using glass bead column. AB - Fertilizing ability of semen requires the presence of viable and motile spermatozoa whose surface-membrane integrity is maintained. Male infertility is often the result of these variables being suboptimal. Various in vitro methods have been reported that separate good-quality spermatozoa from such ejaculates. In this study we describe a simple procedure that uses a column of glass beads to separate spermatozoa from poor quality semen. The filtered spermatozoa have significantly better progressive motility and viability and also have enhanced fertilizing capacity. Such a method may have clinical use for semen preparation prior to intrauterine insemination and in vitro fertilization. It may also have a role in the assessment of semen to determine fertilization potential and hence provide prognostic information to infertile couples. PMID- 3675073 TI - Sexual function after bilateral retroperitoneal lymph node dissection for nonseminomatous testicular cancer. AB - This study concerns the sexual functions of 101 patients who had undergone bilateral retroperitoneal lymph node dissection for stage I or II nonseminomatous testicular cancer between 1969 and 1982. All patients were without evidence of disease after at least 4 years of follow-up. Antegrade ejaculation was present in 12 patients, while 89 patients experienced "dry ejaculation." Urine collected after intercourse or masturbation from 75 patients with dry ejaculation showed retrograde ejaculation in 55 and lack of ejaculatory emission into the urethra in 20 patients. Regarding other sexual functions, 17 patients had a diminished sexual desire (especially those patients who had received radiotherapy), 12 experienced difficulty reaching organism, and 6 complained of erectile dysfunction. The incidence of a contralateral hydrocele developing after retroperitoneal lymph node dissection seems to correlate with ligation of the contralateral spermatic vessels and their lymphatics. A review of the literature is presented comparing the types of dissection with the incidence of sexual disorders after retroperitoneal lymph node dissection. Since preserving normal ejaculation and fertility is important, a modified or unilateral retroperitoneal lymph node dissection, when required, is advocated. In patients, with stage I disease the therapy may be limited to an orchiectomy without lymph node dissection. In patients with retroperitoneal lymph node metastases combination chemotherapy with cisplatin and tumor excision gives good results. Patients with true retrograde ejaculation can be treated with alpha-sympathomimetic drugs such as imipramine HCl, and thus be offered the chance of fatherhood by coitus. PMID- 3675075 TI - [Structure of the total health test and its relationship with various factors. Study in a work environment]. PMID- 3675074 TI - Molecular biology of androgen action in genital hypoplasia associated with congenital growth hormone deficiency: a "transitory androgen insensitivity syndrome"? AB - Androgen receptor analyses of foreskin homogenate from a boy with congenital growth hormone deficiency revealed at age 1 and 3 years a decreased number of cytosolic binding sites for testosterone (T) and dihydrotestosterone (DHT), compared with controls of similar age. Nuclear T receptor was not detectable at age 1 but showed abnormal high-binding capacity at age 3 years. Nuclear DHT receptor was within normal limits at both age 1 and 3 years. Receptor affinities were normal. Maximum reaction velocity of tissue-specific androgen 5 alpha reductase A5R was decreased at age 1 year but within the normal range at age 3 years. Stretched penile length was below the third percentile at age 1 and increased to a 25th percentile at age 3 years, respectively. As the receptor and A5R data seem to indicate a "catch-up" growth, i.e., normalization of the external genitalia, we therefore postulate a "transitory" course of an androgen insensitivity in this particular patient. PMID- 3675076 TI - [Are magnesium determinations in postmortem material useful in the detection of hypomagnesemia and chronic alcoholism in the framework of forensic autopsies?]. PMID- 3675077 TI - [Graphic technics for epidemiologic surveillance. Evolution of perinatal mortality in the 9 provinces of Belgium 1972-1980]. PMID- 3675078 TI - [Acute ethylene oxide poisoning. Apropos of 5 cases]. PMID- 3675079 TI - Effects of perfluorochemical emulsion components on human albumin binding of warfarin. AB - Warfarin binding by human albumin (HSA) is altered in the presence of a perfluorochemical (PFC) emulsion. To determine which PFC emulsion component(s) was responsible for these changes, the effects of the components on this interaction were determined. Fluorescence titrations and ultrafiltration were used to monitor the effects of the components on HSA binding of 2 and 10 micrograms/ml warfarin at room temperature. Component concentrations ranged up to that present in the emulsion except for yolk phospholipids which have limited buffer solubility. For solubility reasons, oleic acid and phospholipids were studied in the presence of pluronic F-68. At 0.5% HSA pluronic F-68 caused a significant displacement of bound warfarin, while glycerol had little effect on warfarin binding. At concentrations of 20% of that in the PFC emulsion oleic acid with pluronic F-68 caused a significant increase in warfarin binding. This was followed by a very large displacement of bound warfarin at the emulsion concentrations of oleic acid and pluronic F-68. The phospholipid component had no specific effect on warfarin binding. A combination of the 4 components had an effect very similar to that of only oleic acid with pluronic F-68. At 2% HSA the combined components caused an increase in warfarin binding while at 4% HSA the combined components had little, if any, effect on warfarin binding. Thus, changes in HSA binding of warfarin in the presence of a PFC emulsion can be attributed to the oleic acid and, to a smaller degree, pluronic F-68 components of the emulsion. PMID- 3675080 TI - A comparison of the cardiac and vasodilatory effects of some calcium entry blockers in perfused isolated guinea-pig hearts. AB - The chronotropic, inotropic and coronary vasodilator actions of several calcium entry blockers have been compared in isolated guinea-pig hearts. Following the subdivision of calcium entry blockers as proposed by Spedding (1985), we have studied nifedipine (dihydropyridine) (group I), verapamil (phenylalkylamine) and diltiazem (benzothiazepine) (group II), flunarizine and lidoflazine (both diphenylalkylamines) as well as bepridil (group III). Moreover, the effect of the calcium entry blockers upon the calcium induced inotropic response was assessed. All calcium entry blockers displayed a clear negative inotropic, negative chronotropic and coronary vasodilating effect. The order of potency for the negative inotropic, coronary dilator and negative chronotropic actions of the calcium entry blockers was, for inotropy: nifedipine greater than verapamil greater than flunarizine = bepridil greater than lidoflazine greater than diltiazem, for coronary flow: nifedipine greater than verapamil greater than lidoflazine = flunarizine greater than diltiazem greater than bepridil, for chronotropy: nifedipine greater than verapamil greater than lidoflazine greater than flunarizine greater than diltiazem greater than bepridil. With respect to the cardiac parameters, the diphenylalkylamines were more potent in their action than described previously by other authors. Equi-effective doses with respect to the negative inotropic effect of the calcium entry blockers studied also displayed the same effectiveness upon calcium-induced inotropic responses. This suggests that the negative inotropic effect of the calcium entry blockers investigated is the result of a calcium antagonistic effect without the contribution of other actions of these drugs. However, the different potency orders for the coronary dilator and negative chronotropic actions of the calcium entry blockers and the differences in maximum for coronary dilator effects suggest that other mechanisms (such as calmodulin antagonism, adenosine uptake inhibition and sodium channel blockade), may contribute to these effects. PMID- 3675081 TI - Comparative effects of oxodipine and nifedipine in the isolated guinea-pig heart. AB - The electromechanical effects of 2 dihydropyridines, oxodipine (OXD) and nifedipine, were compared on isolated guinea-pig atrial and ventricular muscle fibres. Intracardiac conduction times were measured in the Langendorff-perfused guinea-pig heart. On isolated atria OXD and nifedipine produced a dose-dependent decrease in rate and amplitude of contractions, the negative inotropic effect being accompanied by a shortening of the time to peak tension and time for total contraction. In both atrial and ventricular muscle fibres OXD and nifedipine shortened the duration of the action potential without altering the resting membrane potential and the Vmax and amplitude of phase 0. OXD also decreased the amplitude and Vmax and shortened the duration of the slow action potentials and decreased the amplitude of the slow contractions elicited by isoprenaline in K depolarized papillary muscle fibres. In the Langendorff-perfused heart OXD and nifedipine slowed the conduction through the A-V node at concentrations at which it had no effect on intraatrial and intraventricular conduction times. The depression on A-V conduction was more marked with nifedipine than with OXD. All these results indicate that in the guinea-pig heart OXD, a new dihydropyridine, exhibit a potent and selective inhibition of Ca influx via the slow inward current. PMID- 3675082 TI - The effect of the calcium antagonist gallopamil on arrhythmias and enzyme release in rat hearts with coronary ligation and reperfusion. AB - In intact rats, as well as in isolated perfused rat hearts, the calcium antagonist gallopamil reduced the severity of ischemic and reperfusion-induced arrhythmias. The effective doses, or concentrations, respectively, lay near the border to those producing atrioventricular block. The antiarrhythmic action was connected with a negative chronotropic effect, but was independent of the coronary vasodilating effect of the drug. Coronary occlusion, and especially reperfusion of the ischemic myocardium, led to the release of the enzyme creatine kinase (CK) from isolated hearts, and to the increase of the serum CK activity in intact rats. Gallopamil significantly reduced the reperfusion-induced enzyme release in isolated hearts. In intact rats the serum CK activities were higher in the presence of gallopamil, than without the drug. It is shown that gallopamil itself releases CK from the heart. This effect interferes with the action which gallopamil has on the enzyme release due to myocardial ischemia or reperfusion, respectively. PMID- 3675083 TI - Reversal by hypothermia of vasodilator-induced tachycardia in anesthetized rats. AB - The normal cardiovascular response to hydralazine in urethane-anesthetized rats, i.e. hypotension and tachycardia, was changed to hypotension and bradycardia if the body temperature of the animals was not maintained constant by external heating, but was allowed to decrease spontaneously throughout the experiment. A similar phenomenon was observed with diazoxide. In rats maintained at a rectal temperature of 31 degrees C, hydralazine bradycardia was partially blocked by a low dose of atropine and was reversed to tachycardia by a high dose of this agent; mecamylamine failed to influence heart rate lowering in this condition. Heart rate responses in unheated animals to acetylcholine and isopropylarterenol were respectively potentiated and depressed when compared to responses in heated rats. These findings suggest that cold-induced reciprocal changes in reactivity of cardiac muscarinic and beta-adrenoceptors may be responsible for reversal of hydralazine or diazoxide tachycardia in urethane-anesthetized hypothermic rats. As a result, cardiac stimulation by the sympatho-adrenal discharge induced by hypotension is inhibited, while cardiac depression which is apparently also induced by hypotension, is facilitated. It is speculated that vasopressin, released as a consequence of the blood pressure fall, could be this negative chronotropic factor. PMID- 3675084 TI - The subtype of serotonin (5-HT) receptors in the rat pulmonary artery. AB - Serotonin (5-HT) and some alpha-agonists induced a marked contraction of ring segments of the rat pulmonary artery. Phenylephrine and 5-HT caused maximum contractions in the artery amounting to 91% and 66%, respectively, of the maximum effect of noradrenaline. Clonidine failed to induce contractions in the artery. The alpha 1-adrenoceptor blocker prazosin (1 X 10(-6)M) and alpha 2-adrenoceptor blocker yohimbine (5 X 10(-7)M) did not antagonize 5-HT-induced contractions. However 5-HT2 receptor antagonists ketanserin (3 X 10(-9)-1 X 10(-7)M), mianserin (3 X 10(-9)-1 X 10(-7)M) and pizotifen (3 X 10(-9)-1 X 10(-7)M) competitively antagonized 5-HT-induced contractions in the tissue studied, whereas the antagonist methysergide (5 X 10(-10)-1 X 10(-7)M) caused a noncompetitive antagonism. The pA2 values for ketanserin (8.98), mianserin (9.1) and pizotifen (9.14) against 5-HT were not different from the values obtained in other tissues which were shown to contain 5-HT2 receptors. The results suggest that 5-HT receptors in rat main pulmonary artery are of the 5-HT2 subtype. PMID- 3675085 TI - Influence of clonazepam on electrocorticographic changes induced by metrazol in rats during ontogenesis. AB - The action of clonazepam (CZP) pretreatment on metrazol-induced ECoG phenomena was studied in Wistar albino rats. ECoG was recorded in acute experiments in male rats 7, 12, 18, 25 and 90 days old (N = 162). CZP (0.1 or 0.02 mg/kg) was injected i.p. 10 min prior to the start of repetitive administration of metrazol (PTZ, 20 mg/kg i.p. every 5 min). Latencies of the first signs of PTZ action, of the rhythmic metrazol activity, of the first ictal activity and of the generalized seizure were measured. CZP exhibited a dose-related effect against ECoG signs elicited by PTZ. A statistically significant increase in latencies was observed with the dose of 0.1 mg/kg in 18 day old and older animals. The 0.1 mg/kg dose of CZP also completely blocked generalized ictal activity in 7 day old rats. In adult animals, CZP pretreatment led to the appearance of partial seizures, a phenomenon never seen in controls. The development of CZP effects corresponds to the maturation of benzodiazepine binding sites. PMID- 3675086 TI - Effects of estradiol benzoate on apomorphine-induced pecking behavior in the pigeon. AB - Clinical and laboratory observations suggested an interaction between sex hormones and dopaminergic functions. Estrogens are reported to exert dual effects on dopaminergic system(s). In the apomorphine-induced pecking behavior model in the pigeon, acute administration of estradiol benzoate (5, 10, 20 mg/kg) significantly reduced the total pecking counts, indicating an antidopaminergic effect. Other sex steroids, testosterone and progesterone were found to be ineffective. Chronic administration of low dose estradiol benzoate (20 micrograms/kg/day) resulted in an increase in total pecking counts elicited by a single dose of apomorphine administration, revealing an increased sensitivity in dopaminergic functions. PMID- 3675087 TI - Stimulation by trifluoperazine of p-aminohippurate accumulation in rat kidney cortical slices. AB - The effects of trifluoperazine and another phenothiazine, chlorpromazine, on p aminohippurate (PAH) transport in rat kidney cortical slices were examined. Increasing concentrations of trifluoperazine up to 0.1 mM progressively stimulated PAH accumulation in the slices, but a higher concentration of trifluoperazine (0.3 mM) did not cause stimulation. Chlorpromazine also had biphasic effects on PAH accumulation. Both drugs had biphasic effects on hypotonic hemolysis as well, i.e., they protected the erythrocytes at low concentrations, and lysed them at high ones. The effect of trifluoperazine and chlorpromazine on the kinetics of PAH accumulation was to increase Vmax, while the apparent Km remained constant. The efflux of PAH from the slices was significantly decreased by these antipsychotic drugs. The stimulation by trifluoperazine of PAH accumulation was blocked by tetraethylammonium. These results suggest that the antipsychotic drug, when taken up or adsorbed by the slices, stimulates PAH accumulation and that such stimulation may arise at least in part because of membrane stabilization. PMID- 3675089 TI - Venous thromboembolism and malignancy. PMID- 3675088 TI - Protective effects of oximes HI-6 and PAM-2 applied by osmotic minipumps in quinalphos-poisoned rats. AB - Protective and reactivating effects of oximes HI-6 and PAM-2, combined with atropine and diazepam, were investigated in quinalphos-poisoned rats. In protective experiments, atropine and diazepam decreased acute toxicity of the insecticide 3.3 times. Later administration of a single injection of oximes led to further improvement of protective indexes which were 1.45 (PAM-2) and 1.52 (HI 6) times larger. Plasma HI-6 concentrations below 1 microgram/ml, continuously maintained by osmotic minipumps and supported by a single administration of atropine and diazepam, protected animals from 18.6 LD50 of quinalphos, while its higher concentrations (ranging from 1 to 5.4 micrograms/ml) provided markedly better protection (up to 72 LD50). Corresponding plasma PAM-2 concentrations were even more effective in overcoming toxic effects of quinalphos. PAM-2 concentrations, continuously maintained in plasma, were distinctly better in protecting and reactivating peripheral cholinesterase activity than corresponding HI-6 concentrations in the case of quinalphos poisoning. On the basis of our findings we suggest that continuous maintenance of low oxime concentrations is preferred to single oxime administration in the therapy of organophosphate intoxications. PMID- 3675090 TI - Deep venous thrombosis and pulmonary embolism. Risk of subsequent malignant neoplasms. AB - We conducted a noncurrent prospective study of all Olmsted County, Minnesota, residents who had had a lower-extremity venogram, pulmonary angiogram, or lung scan performed because of suspicion of deep venous thrombosis or pulmonary emboli. One hundred thirteen cancer-free patients were followed for 386 person years from the date of procedure. Nine subsequent cancers were observed compared with 4.5 expected (relative risk, 2.0; 95% confidence interval, 0.9 to 3.8), using total cancer incidence rates for the Rochester, Minn, population. Five hundred seventeen cancer-free controls were followed for 2072 person-years. Twenty subsequent cancers were observed compared with 11.6 expected, yielding a relative risk of 1.7 (95% confidence interval, 1.1 to 2.7). When cases and controls were compared directly, no statistically significant difference in cancer-free survival was found. PMID- 3675091 TI - Serum lipoprotein in active rheumatoid arthritis and other chronic inflammatory arthritides. I. Relativity to inflammatory activity. AB - Lipoprotein metabolism was investigated in 69 patients with untreated active rheumatoid arthritis (n = 48) and in seronegative spondylarthropathies (n = 21). The patients had high inflammatory activity as measured by erythrocyte sedimentation rate and C-reactive protein (CRP). Serum cholesterol and cholesterol levels in the very-low-density lipoprotein (VLDL), low-density lipoprotein, and high-density lipoprotein fractions were reduced by 20% to 30% compared with healthy controls; and triglyceride levels in VLDL and high-density lipoprotein were reduced by 10% to 30%. There were significant correlations between the inflammatory activity and certain lipoprotein lipids, ie, between CRP and VLDL triglycerides, VLDL cholesterol, and serum triglycerides. The fractional elimination rate (K2) measured by an intravenous fat tolerance test was 30% higher in the patients than in the controls despite reduced tissue lipoprotein lipase activities. There was correlation between CRP and the K2 value. These findings suggest that it is the degree of inflammatory activity that governs the altered lipoprotein metabolism in untreated active chronic inflammatory arthritides. The relationships between CRP and VLDL and between CRP and K2 suggest that the VLDL particles may be altered by inflammatory process, and that the increased elimination may take place through the "scavenger pathway." PMID- 3675092 TI - Serum lipoprotein in active rheumatoid arthritis and other chronic inflammatory arthritides. II. Effects of anti-inflammatory and disease-modifying drug treatment. AB - Serum lipids and lipoprotein patterns were prospectively analyzed in 33 previously untreated patients with active chronic inflammatory arthritides during different anti-inflammatory and disease-modifying drug regimens. Before treatment the lipoprotein pattern was characterized by low cholesterol concentrations in all lipoprotein fractions and low triglyceride concentrations in the very-low density lipoprotein fraction as well as in the high-density lipoprotein fraction. During treatment with prednisolone combined with azathioprine or cyclophosphamide (n = 10), a reduction of the disease activity was achieved and the lipoprotein pattern was normalized; similar results were noted in a small group of patients (n = 4) treated with prednisolone alone while nonsteroidal anti-inflammatory drug therapy (n = 9) neither significantly affected the lipoprotein pattern nor the inflammatory activity measured by the acute-phase reactants. The long-term treatment with penicillamine (n = 4) and chloroquine (n = 6) induced both a clinical remission of the disease and a reduction of the inflammatory activity. The lipoprotein concentrations started to reverse to the normal values during penicillamine treatment. In contrast, in the chloroquine-treated group the alterations in lipoprotein lipid concentrations were further pronounced, ie, the cholesterol and triglyceride concentrations in serum and the very-low-density lipoprotein fraction decreased. PMID- 3675093 TI - Psychological, social, and somatic prognostic indicators in old patients undergoing long-term dialysis. AB - We prospectively studied the influence of 29 demographic, social, psychological, and somatic factors on survival of 78 patients over age 70 years receiving long term dialysis. Three years after the prospective evaluation, 54% of the patients had died. Only four factors, all psychosocial, were prognostically important. The patients who survived rated higher on the Karnofsky scale (85 vs 78 points), gained less weight between dialyses (1.5 vs 1.9 kg), more often underwent home dialysis (44% vs 21%), and less often wished for transplantation (28% vs 57%). In stepwise and multiple regression analysis, home dialysis and Karnofsky scale resulted in best fit. No somatic variable predicted outcome. Thirty-one patients were reinterviewed three years later. At that time, more patients were depressed and had a lower income, fewer wanted a transplant, and five had lost their living companion. There was a decrease in the number of patients who cooked their own meals, spent time outdoors, went to church, or had hobbies. Activity on the Karnofsky scale decreased from 87 to 84 points. The home dialysis patients' perceived health decreased from 3.9 to 3.4 points. Our study shows that psychosocial, but not somatic variables, are prognostically important in survival of older patients undergoing dialysis, and there is a measurable decline in these variables during a three-year follow-up period. PMID- 3675094 TI - Transfusion and long-term hemodialysis. AB - We analyzed the transfusion practice at a large regional renal dialysis center. More than half of all long-term dialysis patients received at least one transfusion annually, and the average transfused patient received 10 U of blood. A review of data on 318 dialysis patients over one year showed there is a sizable group (15.0%) who require greater than ten transfusions of blood. This group of intensely transfused dialysis (ITD) patients account for a disproportionate 67% of all units transfused. The majority of these patients (73%) were women, which may have been related to the relatively small proportion (12.5%) of women undergoing dialysis who were treated with synthetic androgens. These ITD patients were older and underwent dialysis longer than others in the population studied. One year mortality in the ITD group was 27%; more than twice that of the entire group (12.8%). A retrospective examination of transfusion practice in the five years preceding the present study showed that the number of transfusion recipients was essentially a constant fraction of the dialysis population. However, there was a significant trend to less intense transfusion of each transfused patient. Most of the ITD group had significant iron overload, and attending physicians indicated that concern about transfusion related hemosiderosis outranked other reasons including acquired immunodeficiency syndrome, that would account for the more conservative transfusion practice of recent years. PMID- 3675095 TI - Osteoporosis unmasked by hyperthyroidism in a young man with osteogenesis imperfecta. AB - A young man presented with a vertebral fracture and generalized osteopenia that was initially attributed to coexisting hyperthyroidism. However, the rarity of fractures in young men with hyperthyroidism and the finding of blue sclerae led to the diagnosis of osteogenesis imperfecta. Since vertebral fractures are uncommon in young men with osteogenesis imperfecta, we postulate that the combined effects of the two disorders contributed to his clinical presentation. PMID- 3675096 TI - What is the clinical significance of bone loss in primary hyperparathyroidism? AB - To help determine the clinical significance of the bone loss associated with primary hyperparathyroidism, we studied the prevalence of vertebral fractures in a group of patients with this disorder. From a registry of parathyroidectomies, 206 cases were reviewed, and lateral chest roentgenograms were studied for the presence of fractures. All roentgenograms were interpreted by two of the investigators who were "blinded" to diagnoses. Comparisons of readings were made that assured interrater agreement. A group of patients who underwent cholecystectomy served as controls. Studied in a logistic regression analysis model, controlling for the effects of age, sex, and race, primary hyperparathyroidism was found to be significantly associated with vertebral fractures. Subgroup analyses performed on the patients with hyperparathyroidism failed to identify specific biochemical or clinical markers associated with fractures. Our results suggest that the bone loss of primary hyperparathyroidism is clinically significant, leading not only to decreased bone densities but also to an increased prevalence of fractures. PMID- 3675097 TI - The diagnostic value of the medical history. Perceptions of internal medicine physicians. AB - We investigated the perceptions of 71 internal medicine faculty and residents regarding the diagnostic value of the medical history and other attitudes toward the medical interview. Physicians perceive the medical history as having much higher value in diagnosis than either the physical examination or laboratory/radiography information (mean scores, 5.76, 2.41, and 2.49, respectively). The perceptions of the importance of the physician-patient relationship were significantly correlated with the diagnostic value of the history. There was also a strong relationship between the perceived value of the history and preferences for more skilled interviewing responses, as measured by the Helping Relationship Inventory. Contrary to expectations, the perceptions of residents toward the diagnostic value of the patient's history increased significantly over the course of training (5.00 to 6.00). We conclude that despite the increasing emphasis on diagnostic technology, internal medicine residents and faculty continue to view the patient's history as the preeminent source of diagnostic information. Physician attitudes toward the physician patient relationship and toward the medical interview may contribute to the diagnostic value of the history. PMID- 3675098 TI - Influence of spirometry and chest roentgenography on the management of pulmonary outpatients. AB - Spirometry and chest roentgenography are frequently employed to evaluate patients with respiratory problems. To determine their impact on the management of outpatients with lung disease, both tests were performed on 100 consecutive patients (40 men and 60 women; mean age, 52 +/- 15 years) who returned for reevaluation 16 +/- 9 weeks after their previous clinic visit. Patients with obstructive (n = 45), restrictive (n = 35), and mixed (n = 20) lung diseases were initially assessed by history and physical examination and classified clinically as improved, stable, or worse. A clinical management plan (CMP) was formulated based on this initial evaluation. Changes in the proposed CMP due to spirographic or roentgenographic results were then noted. None of the 19 patients who were clinically improved and only two (3%) of the 64 clinically stable patients had a change in CMP. In contrast, five (29%) of the 17 patients whose conditions deteriorated clinically had their proposed CMP modified after review of the spirograms and roentgenograms. Therapy was intensified in three of the seven patients whose CMPs were modified, while in the other four, treatment was withheld because results of both tests were unchanged. These results indicate that routine spirograms and chest films have little influence on the CMP of clinically stable patients. However, unexpected roentgenographic and spirometric findings frequently alter the management of the individual whose condition has clinically deteriorated. PMID- 3675099 TI - Ambulatory blood pressure monitoring in patients with panic disorder. AB - To assess possible changes in blood pressure and heart rate associated with panic attacks, we performed automatic ambulatory blood pressure monitoring in 12 newly diagnosed, drug-free, and normotensive (casual blood pressure, less than 140/90 mm Hg) medical patients recently diagnosed with panic disorder. Detailed journals were designed for the study to assess the timing and symptoms of the panic attacks and the levels of activity. Systolic blood pressure increased by 27 +/- 9 mm Hg during the hour of the panic attack compared with the hour immediately prior to the episode of anxiety, while diastolic blood pressure increased by 5 +/ 2 mm Hg. The ambulatory heart rate increased by 14 +/- 6 beats per minute during the hour of panic attack vs the hour immediately prior to the attack. There was a strong relationship between the increase in heart rate and increase in systolic blood pressure. These data confirm that normotensive patients with panic disorder have episodically hypertensive blood pressure readings associated with an increase in heart rate; these hemodynamic alterations appear to be secondary to their panic attacks and not to increased physical activity. However, despite these episodic "hypertensive" periods, the mean ambulatory blood pressures remain within the normotensive range. PMID- 3675100 TI - A diagnostic fourth-year performance assessment. AB - The University of Massachusetts Medical Center, Worcester, attempted to develop a standardized, performance-based test battery aimed directly at assessing the critical aspects of clinical competence required for graduation from medical school. The battery used a blend of standardized patient-based and written test materials and was designed to yield a profile of scores, providing a "diagnosis" of student strengths and weaknesses on a skill-by-skill basis. Results indicate that a stable, reproducible assessment of clinical skills can be achieved in a one- to two-day test battery, depending on the specific skills measured. The resulting score profile provides faculty with important information about the clinical competence of students that is not readily available from other sources, thus improving the breadth and accuracy of student assessment. A long-term goal is that performance-based testing techniques will be incorporated into the licensure process to evaluate clinical skills and ensure the competence of graduating physicians. PMID- 3675101 TI - Influence of age at onset on the duration of treatment in idiopathic adult polymyositis and dermatomyositis. AB - Twenty-five patients with adult idiopathic dermatomyositis/polymyositis were followed for 59 +/- 39.3 months from initiation of therapy. Forty-two percent of the patients were able to discontinue prednisone therapy after 56 +/- 33 months of therapy and remained disease free for 34 +/- 35.2 months after discontinuing therapy. The mean dose of prednisone in 14 patients being treated at the end of the follow-up period was 16.0 mg. A positive correlation between age at diagnosis and duration of therapy was noted, but not with the creatine kinase value at diagnosis. Sex and dermal involvement were also not associated with treatment duration. All seven patients who received immunosuppressants continued to receive treatment during the follow-up period. PMID- 3675102 TI - Pernicious anemia in Latin Americans is not a disease of the elderly. AB - Pernicious anemia is widely regarded as a disease of the elderly. However, it is expressed differently in black women, among the most striking differences being their younger age at presentation of the disease compared with whites. We now compared 92 Latin-American patients with 115 white and 100 black patients to see if similar age differences occur in other racial groups. Latin-American men and women were both significantly younger than white men and women, and were similar in age to blacks. Only 21% of Latin-American patients were 70 years of age or older, compared with 49% of whites. It is apparent that pernicious anemia is indeed predominantly a disease of the elderly in whites but that this is not the case in other racial groups. PMID- 3675103 TI - Prospects for an emergency department-based adult immunization program. AB - Immunization of adults has been deficient in the United States. According to interviews conducted during their visits to an emergency room, only 20.1% of 350 patients who fit into high-risk categories for immunization had heard of pneumococcal vaccine, whereas 82.7% had heard of influenza vaccine. Only 8.6% and 47.8%, respectively, had ever been given pneumococcal or influenza vaccine. Previous pneumococcal vaccination was six times more common (10.3% vs 1.6%) and prior influenza vaccination twice as common (52.7% vs 25.4%) in the respondents who could identify a primary care provider or clinic than in those who could not. Of the patients who had not received a specific vaccine, about 60% indicated that they would take pneumococcal or influenza vaccine if it was offered while they were in the emergency room setting. Offering vaccine in an emergency room setting promises to complement other approaches to immunizing adults at high risk for complications of influenza and pneumococcal infections. PMID- 3675104 TI - Risk of developing complete heart block during bedside pulmonary artery catheterization in patients with left bundle-branch block. AB - We examined the incidence of complete heart block (CHB) as a complication of pulmonary artery catheterization with balloon-tipped, flow-directed catheters in patients with left bundle-branch block (LBBB). The study group included 47 consecutive critically ill patients with LBBB in the medical intensive care and coronary care units, who underwent a total of 82 pulmonary artery catheterizations. Twenty-six patients had an acute myocardial infarction, 34 patients had severe congestive heart failure (Killip class III or class IV), and 15 patients died during their hospitalization. Thirty patients had an old LBBB (more than one month in age), nine patients had a new LBBB, and the age of the LBBB was indeterminate in eight patients. There were five episodes of CHB in the group of patients with old LBBB. However, none of these episodes were related to the pulmonary artery catheterization, since CHB occurred either prior to catheterization (one case) or from one to 16 days after the pulmonary artery catheter had been removed (four cases). There were no episodes of CHB related to the pulmonary artery catheterization procedure in the patients with either old LBBB or indeterminate-aged LBBB. There were two episodes of CHB in patients with new LBBB. In both patients, the CHB occurred one day after the pulmonary artery catheter had been inserted. In both patients, CHB developed after episodes of ventricular tachycardia that eventually resulted in their deaths. Although it is unlikely, we could not rule out the possibility that the CHB was related to the presence of the pulmonary artery catheter. We conclude that the incidence of CHB complicating pulmonary artery catheterization with balloon-tipped, flow-directed catheters in critically ill patients with old or indeterminate-aged LBBB is extremely low. Therefore, we do not recommend the routine placement of a temporary transvenous pacemaker in all patients with LBBB prior to pulmonary artery catheterization. PMID- 3675105 TI - Gouty arthritis of the axial skeleton including the sacroiliac joints. AB - We treated a 62-year-old man with intermittent polyarthritis whose neck pain was prominent. Progressive deformities, limited neck motion, and the appearance of subcutaneous nodules prompted his admission to the hospital. The diagnosis of gout was established; the erosive and destructive changes in C6-7 were believed to be due to gout as well. Cervical spine involvement, although rare, can occur in gout. PMID- 3675106 TI - Technetium Tc 99m diphosphonate bone scan. False-normal findings in elderly patients with hematogenous vertebral osteomyelitis. AB - Hematogenous osteomyelitis is usually diagnosed by an abnormal technetium Tc 99m diphosphonate bone scan in symptomatic patients who have positive blood cultures. False-normal 99mTc bone scans have been described recently in neonates with biopsy-proved osteomyelitis. This phenomenon seems to be extremely rare in adults. Two elderly patients with hematogenous vertebral osteomyelitis had normal technetium Tc 99m diphosphonate bone scans when first evaluated. In both cases the bone scans became abnormal four to six weeks after onset of symptoms and two to four weeks after the initial normal results of the study. When suggested by the clinical picture, hematogenous osteomyelitis cannot be ruled out by a normal 99mTc bone scan at any age. Gallium scan, computed tomographic scan, or bone biopsy can be helpful in such cases. PMID- 3675107 TI - Tuberculosis. Missed opportunities. AB - The incidence of tuberculosis in the United States appears to be rising, most likely because of the introduction of the human immunodeficiency virus, and other factors such as outbreaks among the homeless and immigration of infected people from other countries. Because diagnosis and treatment of tuberculosis has shifted from specialized centers to the community, it is important that primary care physicians recognize and properly manage early forms of the disease. Several patients are described for whom an early diagnosis was not made, resulting in serious morbidity for the patients and risk of spread of disease to contacts. PMID- 3675108 TI - Pseudohyperphosphatemia and dysproteinemia. AB - We report the case of a patient with IgG multiple myeloma and pseudohyperphosphatemia, and the case of another patient in whom unexplained hyperphosphatemia led to the diagnosis of monoclonal gammopathy. The pseudohyperphosphatemia was due to the interference of monoclonal immunoglobulins with the phosphomolybdate colorimetric assay for phosphorus determination widely in use with some automated systems. Ultrafiltration of these patients' serum samples resulted in normalization of the elevated phosphorus values. Knowledge of this phenomenon may obviate confusion, unnecessary testing, and expenditure. It may also provide clinicians with a clue as to the presence of a dysproteinemia. PMID- 3675109 TI - Lingual thyroid. Diagnosis and treatment. AB - We describe four patients who presented with a lingual thyroid condition (three females and one male, aged between 7 and 22 years). Only the male patient was symptomatic with mild dysphagia and hemoptysis. The diagnosis was suspected in three patients, and was confirmed by iodine 123 or 131 scanning in all patients and by a computed tomographic scan in the one patient studied. The patient with dysphagia received a 10-mCl therapeutic dose of iodine 131 before thyroxine replacement was started. The diagnosis and management of lingual thyroid is discussed. All patients need lifelong thyroxine suppression. Unenhanced computed tomographic scans have a diagnostic appearance due to the iodine content of the ectopic thyroid tissue. PMID- 3675110 TI - Tetracyclines in therapy of Mycobacterium marinum infections. PMID- 3675111 TI - Silent amebic liver abscess. PMID- 3675112 TI - Predictors of bone marrow metastases. PMID- 3675113 TI - Anaerobic degradation of phenol by pure cultures of newly isolated denitrifying pseudomonads. AB - From various oxic or anoxic habitats several strains of bacteria were isolated which in the absence of molecular oxygen oxidized phenol to CO2 with nitrate as the terminal electron acceptor. All strains grew in defined mineral salts medium; two of them were further characterized. The bacteria were facultatively anaerobic Gram-negative rods; metabolism was strictly oxidative with molecular oxygen, nitrate, or nitrite as electron acceptor. The isolates were tentatively identified as pseudomonads. Besides phenol many other benzene derivatives like cresols or aromatic acids were anaerobically oxidized in the presence of nitrate. While benzoate or 4-hydroxybenzoate was degraded both anaerobically and aerobically, phenol was oxidized under anaerobic conditions only. Reduced alicyclic compounds were not degraded. Preliminary evidence is presented that the first reaction in anaerobic phenol oxidation is phenol carboxylation to 4 hydroxybenzoate. PMID- 3675114 TI - Changes in the electrolyte composition of caprine foetal fluids during different stages of gestation. PMID- 3675115 TI - Properties of fructose-1,6-biphosphatase of fetal and adult goat liver. PMID- 3675116 TI - Properties of phosphoenolpyruvate carboxykinase of goat liver. PMID- 3675117 TI - [Physiopathologic data on the action of selected fungicides and herbicides in carp]. PMID- 3675118 TI - [Radioimmunologic determination of cortisol in serum or plasma of cattle, swine and sheep]. PMID- 3675119 TI - Pathogenesis of Pasteurella multocida in experimentally infected rabbits. PMID- 3675120 TI - [Levels of hemoglobin in the blood and of glucose, lactate and free fatty acids in blood plasma from stillborn piglets of various birth weights]. PMID- 3675121 TI - [Automated heart rate analysis in swine using the EMG 666 B computer]. PMID- 3675122 TI - Physico-chemical factors affecting glutathione concentration in bovine and bubaline semen. PMID- 3675123 TI - Study into phosphorylated intermediates in the bovine and bubaline bull spermatozoa. PMID- 3675124 TI - Ascorbic acid concentration in bovine and bubaline semen. PMID- 3675125 TI - [Experimental Yersinia enterocolitica infection in calves with reference to the effect of sulfamerazine]. PMID- 3675126 TI - [The use of infrared spectroscopy of liver biopsies for the diagnosis of liver damage in cattle]. PMID- 3675127 TI - [The effect of chronic ammonia exposure on the histomorphologic structure of the respiratory tract and the clearance capacity of the lungs of rats. 2. Results of histomorphologic structural changes of the respiratory tract of rats after exposure to ammonia]. PMID- 3675128 TI - Further evidence for dementia of the prefrontal type in schizophrenia? A controlled study of teaching the Wisconsin Card Sorting Test. AB - Recent physiological and cognitive studies of schizophrenia have implicated dysfunction of prefrontal cortex as a possible explanation for some of the disabling intellectual and social aspects of the disorder. To investigate the potential reversibility of cognitive deficits and the role of state variables, eg, attention and motivation, three groups of patients with schizophrenia were administered the Wisconsin Card Sorting Test on six consecutive occasions. Two of the groups received incremental information on how to do the test, including explicit card-by-card instruction. The third group served as a control. Regardless of the degree of instruction, patients who could not do the test could not learn it. The deficit did not appear generalized, as patients were able to learn word lists on the Selective Reminding memory test and were not globally demented on the Mini-Mental State Examination. These data suggest that prefrontal type cognitive deficits in schizophrenia may be more profound than is generally appreciated. PMID- 3675129 TI - White matter reduction in the parahippocampal gyrus of patients with schizophrenia. PMID- 3675130 TI - Y's, kappa's, p's and q's. PMID- 3675131 TI - A linkage study of panic disorder. AB - We tested for linkage between panic disorder and a battery of 29 genetic markers in 26 families. Linkage between panic disorder and 18 of the marker loci could be excluded at a recombination fraction of 0.00, nine at a recombination fraction of 0.05, and four at a recombination fraction of 0.10. The 18 loci are distributed over ten chromosomes. One locus was suggestive of linkage. The maximum lod score for alpha-haptoglobin was 2.27 at a recombination fraction of 0.0, representing odds in favor of linkage of 186.1. alpha-Haptoglobin has been mapped to chromosome 16q22. The results demonstrate that linkage studies of psychiatric disorders can yield informative results by identifying tentative linkages that merit further investigation and by excluding regions of the genome from future linkage searches. PMID- 3675132 TI - Decreased epinephrine in familial alcoholism. Initial findings. AB - Stress-induced epinephrine release, measured in urine, was less in a group of 17 nonalcoholic adoptee probands, aged 18 to 36 years, with alcoholic biologic relatives than in 12 similar controls with no alcoholic relatives. This result is similar to previous observations of small stress-induced epinephrine release in humans with aggressive or hyperactive character traits. Resting epinephrine levels and epinephrine released by alcohol in soft drink were also lower in our probands than in controls. Familial alcoholism might be associated with a trait of globally decreased epinephrine responsiveness. PMID- 3675133 TI - Plasma cortisol levels following ethanol in sons of alcoholics and controls. AB - We used the pattern of change in plasma cortisol level following ethanol challenges to help characterize differences in response to alcohol in sons of alcoholics and controls. Thirty healthy, drinking young adult sons of alcoholics were matched with 30 sons of nonalcoholics on demography, drug use, and alcohol use histories. Each was tested on three occasions, when he received, in random order, placebo, 0.75 mL/kg of ethanol, and 1.1 mL/kg of ethanol. Subsequent blood samples for cortisol determinations were obtained every 30 minutes over the next four hours. The sons of alcoholics, at higher risk for the future development of alcoholism, demonstrated lower cortisol levels after drinking. The data are consistent with our prior measures of self-reported feelings of intoxication and family group differences in ethanol-induced decrements in performance. PMID- 3675135 TI - The effects of dieting and weight loss on neuroendocrine responses to tryptophan, clonidine, and apomorphine in volunteers. Important implications for neuroendocrine investigations in depression. AB - The increases in the growth hormone (GH) level following intravenous infusion of the 5-hydroxytryptamine precursor tryptophan, the alpha 2-adrenoceptor agonist clonidine hydrochloride, and subcutaneous injection of the dopamine agonist apomorphine hydrochloride were determined in volunteers before and in the third week of a weight-reducing diet (1200 kcal/d). The increases in the prolactin level following intravenous infusion of tryptophan and in response to protirelin were also determined. In male subjects, the GH responses to tryptophan and apomorphine were markedly increased by dieting; while also significantly increased, the GH responses to clonidine were much less affected. Female subjects showed similar trends in the GH responses to tryptophan and clonidine. In male subjects, prolactin responses to tryptophan and protirelin were not increased by dieting. In females, the prolactin response to protirelin was similarly not increased, but the prolactin response to tryptophan was markedly enhanced. These results are relevant to the use of neuroendocrine tests in depression. In addition, they suggest different effects of weight loss on neurotransmitter function in men and women. PMID- 3675134 TI - Serotonergic responsivity in obsessive-compulsive disorder. Comparison of patients and healthy controls. AB - To examine the "serotonin hypothesis" of obsessive-compulsive disorder (OCD), we studied the behavioral and neuroendocrine effects of metachlorophenylpiperazine (mCPP), a serotonergic agonist, in patients with OCD and healthy controls. Twelve patients and 20 controls were given a single dose of 0.5 mg/kg of mCPP, administered orally under double-blind, placebo-controlled, random-assignment conditions. Following mCPP, but not following placebo, patients with OCD experienced a transient but marked exacerbation of obsessive-compulsive symptoms. Moreover, compared with healthy controls, patients exhibited greater other behavioral (but not endocrinologic or thermal) changes after mCPP. These findings are consistent with a special role for the neurotransmitter serotonin in OCD psychopathology. PMID- 3675136 TI - Neuroendocrine responses to intravenous tryptophan in major depression. AB - The increases in plasma levels of prolactin (PRL) and growth hormone (GH) following intravenous administration of the 5-hydroxytryptamine precursor tryptophan (100 mg/kg) were assessed in 30 depressed patients and 30 control subjects. In depressed patients who lost less than 10 lb, PRL responses were significantly reduced compared with controls. In contrast, the PRL responses of patients with weight loss exceeding 10 lb were significantly greater than those of either controls or the other depressed patients. Growth hormone responses to tryptophan were significantly decreased in patients who lost less than 10 lb. Prolactin, but not GH, responses correlated significantly with the postdexamethasone plasma cortisol concentration; however, an apparent relationship between GH and PRL responses and suicidal behavior was probably due to the common factor of weight loss. The results suggest that depressed patients have different types of abnormal 5-hydroxytryptamine-mediated neuroendocrine responses that correlate with the presence or absence of severe weight loss and cortisol hypersecretion. Further investigations are needed to establish if these abnormalities are central to the depressive disorder or have implications for treatment response. PMID- 3675137 TI - Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans. AB - This study utilized psychophysiologic techniques to assess emotional arousal during imagery of psychologically traumatic experiences. All subjects were medication-free Vietnam combat veterans, classified on the basis of DSM-III-R criteria into groups with posttraumatic stress disorder (PTSD, n = 18) and no mental disorder (control, n = 15), which did not differ in extent of combat or in the judged severity of the traumatic experiences reported. "Scripts" describing each subject's combat experiences as well as other experiences were read to them in the laboratory, and they were instructed to imagine the events the scripts portrayed, while heart rate, skin conductance, and frontalis electromyogram were recorded. The PTSD subjects' physiologic responses to their combat scripts were markedly higher than the controls'. The combined physiologic variables identified PTSD subjects with a specificity of 100% and a sensitivity of 61%. The results demonstrate exaggerated physiologic arousal during recollection of traumatic experiences in PTSD. PMID- 3675138 TI - Sleep deprivation as a probe in the elderly. AB - Decreased slow-wave sleep (SWS) and sleep continuity are major effects of healthy aging and of associated psychopathological states. Using sleep deprivation, we studied the extent to which age- and psychopathology-related sleep "decay" is reversible in aged normal, depressed, and demented subjects. Depression or probable Alzheimer's dementia compromised the augmentation of sleep continuity and SWS seen in healthy elderly following sleep deprivation. Rapid eye movement (REM) latency decreased during recovery sleep in the controls but increased in both patient groups. Compared with demented patients, depressed elderly had greater severity of sleep continuity disturbance both before and after sleep deprivation, a more protracted course of recovery sleep, and increased slow-wave density in the second non-REM (NREM) sleep period (during recovery). The REM sleep time was diminished in dementia compared with depression both at baseline and during recovery sleep. These differential effects of age, health, and neuropsychiatric disease on recovery from sleep loss are relevant to recovery or reversal theories of sleep and have implications for daytime well-being in the elderly. PMID- 3675139 TI - Progressive neuropsychologic impairment and hypoxemia. Relationship in chronic obstructive pulmonary disease. AB - In previous work we showed that patients with chronic obstructive pulmonary disease (COPD) suffered decrements in neuropsychologic functioning suggestive of organic mental disturbance. This study combined data from two multicenter clinical trials to explore the nature and possible determinants of such neuropsychologic change. Three groups of patients with COPD whose hypoxemia was mild (N = 86), moderate (N = 155), or severe (N = 61) were compared with age- and education-matched nonpatients (N = 99). The rate of neuropsychologic deficit rose from 27% in mild hypoxemia to 61% in severe hypoxemia. Various neuropsychologic abilities declined at different rates, suggesting differential vulnerability of neuropsychologic functions to progress of COPD. Multivariate analyses revealed a consistent significant relationship between degree of hypoxemia and neuropsychologic impairment, but the amount of shared variance was small (7%). Increasing age and lower education were also associated with impairment. PMID- 3675140 TI - Quantification of polyethylene glycol precipitable circulating immune complex from carcinoma of cervix patients. AB - Changes in the level of circulating immune complexes (CIC) among Indian patients with untreated and treated squamous cell carcinoma of cervix and its correlation with the progression of the disease were studied. The quantitative determination of CIC was performed by precipitating the complex with 3% polyethylene glycol (PEG) and assaying the total protein content in the precipitate. The CIC level in serum was observed to increase gradually with the progression of the disease in CaCx and in stage III of the disease the CIC content was found to be more than double of the level obtained in normal healthy individual. The augmented CIC level in patients was found to reduce to normal levels after an interval of 104 weeks of surgery and 16 weeks of radiotherapy. PMID- 3675141 TI - Histochemical and ultrastructural study of human colon preneoplastic stages. AB - Fine structure and function are closely related in the cells of the different tissues. For this reason a comparative study combining histochemical techniques and scanning electron microscopy can result a potentially useful tool in the search for cell markers of preneoplastic stages of the colon mucosa. With this purpose, samples of normal colon mucosa, adenomatous polyps and adenocarcinomas obtained by colonoscopy were studied by histochemical techniques for the detection of epithelial mucosubstances and by scanning electron microscopy. Differences were shown in the architectural arrangement of the colon epithelium between the normal mucosa, the adenocarcinoma and the polyps studied, while between tubular an tubulovillous adenomas no marked differential ultrastructural features were found. Acid mucosubstances distribution pattern showed that sialomucin predominated in the colon mucosa harboring a carcinoma and in the tubulo-villous polyps as well as in the mucosa remote from adenocarcinoma and from the two cases of familial polyposis coli histologically considered as tubulo villous adenomas. On the other hand tubular adenomas and normal mucosa showed a predominance of sulfomucin. PMID- 3675142 TI - [Thoughts on a mathematical understanding of the growth of experimental tumors]. AB - A contribution by Krug and Taubert concerning the mathematical approximation of Ehrlich ascites tumor growth using logit transformation of the logistic function followed by an approximation of the prefinal decline of the cell number gives rise to further contemplations. The authors aimed at a rather simple method to be realised with programmable pocket computers. A proposal offered by Dr. Krug lead the author to further investigations into the problem in question. As one possibility the sigmoidal function is replaced by a special form of the Janoschek function whilst the multiplicative descending exponential function mainly responsible for the prefinal stage is given a more flexible character. As a result the ascending phase is only slightly altered whereas the stage of decline shows different behaviour partly due to the few and scattering input data for this branch of the growth curve. By this method linear deviations are reduced by about a quarter in the example treated. PMID- 3675143 TI - [Subtotal distal gastrectomy in antral carcinoma: following Billroth I or II?]. AB - In 1976, the National Cancer Registry of the GDR registered 488 cases with radical distal gastrectomy for carcinoma of the gastric antrum. 78.7% of them were treated with Billroth-II and 21.3% with Billroth-I. There were no striking differences regarding the postoperative lethality with 15.1% and 14.4% respectively. With 31.2% and 29.0% the 5-year survival was similar for both surgical methods, too. These results indicate the possibility of performing the Billroth-I-gastrectomy in distal gastric cancer if the principles of surgical oncology are carefully observed. PMID- 3675145 TI - Report on studies completed in 1985 within the frame of the CMEA-Programme "Malignant neoplasias" and the status of introducing them into the practice of health service. Council for Mutual Economic Assistance. PMID- 3675144 TI - [Postoperative fever and prognosis in breast cancer]. AB - Retrospectively 378 patients with primary cancer of all stages, treated between 1975 and 1982 were studied again after an interval of at least 3 years. During this time 75 (19.8%) tumor recurrences were observed; in 47 cases (12.4%) distant metastases and in 28 cases (7.4%) local recurrences. Fever was defined as body temperature above 37.5 degrees C from the second postoperative day onward. Postoperative fever occurred in 45% of the patients; stage I 41%, stage II 45%, stage III 59% and stage IV 50%. Considering tumor recurrence there was a fever frequency of 69%, irrespective of stage, which in stage III reached 86% in cases with distant metastases and even 100% in cases with local recurrence. In comparison fever frequency in patients without evidence of recurrence was 36% to 40%. The relative risk of recurrence after postoperative fever increases significantly: in stage II 2.4 times and in stage III 10.6 times. Analysis of postoperative fever revealed, that short drainage time below 6 days and volumes of drained fluid below 400 ml were prognostically infavorable, while wound complications were not associated with an increased risk of tumor recurrence. PMID- 3675146 TI - Progress report on the ASHI/CAP Histocompatibility Survey Program, 1981-1986. AB - Two histocompatibility testing surveys were conducted over a five-year period by the American Society for Histocompatibility and Immunogenetics and the College of American Pathologists. More than 200 laboratories participated in the HS survey, which consisted of four shipments of cells and serum samples to be tested for ABO type, HLA-A and -B types, antibody identification, and lymphocytotoxicity crossmatching. About 100 laboratories participated in the DR survey, which consisted of four annual shipments to be tested for HLA-DR and -DQ types, antibody identification, and crossmatching. The results of the analysis of the HLA-typing results showed high consistency (generally greater than 90%) among laboratories in the definition of most recognized HLA antigens. In contrast, the HLA antibody screening was generally less consistent between laboratories. On the basis of 90% or greater consensus among participants, it was possible to develop a performance grading system. PMID- 3675147 TI - Impact of Systeme International conversion on laboratory information systems. AB - As laboratories in the United States convert to reporting test results in Systeme International (SI) units, certain requirements will be placed on laboratory computers. Old and new results must be related to different reference ranges. Interpretive reporting and reflexive testing algorithms must be updated to the new units. Reporting in minimum increments is worthwhile, regardless of the SI conversion timetable. On the other hand, dual reporting is not advisable, as it would clutter reports and increase the cost and complexity of SI conversion, without yielding benefits. Results should be converted to SI units at the instrument, not by the computer. The Greek mu (mu) may be represented as u. Conversion graphs can be printed on the unused reverse side of report forms. The most important factors in the success of conversion to SI reporting will be thorough education of those reading the reports, and coordination of the conversion process within each locality. PMID- 3675148 TI - Revised nomenclature for tests of thyroid hormones and thyroid-related proteins in serum. PMID- 3675149 TI - Red blood cell volume distributions and the diagnosis of anemia. Help or hindrance? PMID- 3675150 TI - Interventional cardiology. A new frontier for pathology. PMID- 3675151 TI - New parameters in erythrocyte counting. Value of histograms. AB - In this report we rate a new, third-generation automated hematology system (Technicon Instruments H-1) that can furnish a full range of values, including erythrocyte parameters and a leukocyte differential count. Particular attention is focused on erythrocyte morphometric parameters, including measurement of cell size and hemoglobin content on a cell-by-cell basis. We assess the usefulness of new parameters derived from these measurements, such as mean corpuscular volume and red blood cell distribution width, which characterize cell size, and mean corpuscular hemoglobin concentration, and hemoglobin distribution width, which characterize cell hemoglobinization in evaluating normal and abnormal subjects. The value of these parameters in classifying anemias is assessed in our patient population that includes those with iron deficiency anemias and thalassemias, as well as other forms of anemia. PMID- 3675152 TI - Automated three-part leukocyte differential counts in the preoperative evaluation of ambulatory surgery patients. AB - The clinical value of the Coulter S-Plus V three-part leukocyte differential cell count in the preoperative evaluation of 295 patients scheduled for ambulatory surgery was examined. Ninety-five percent of the specimens could be processed by the instrument without further review. Only 11 specimens had abnormal manual differential cell counts. Of these, all but three were detected using a combination of S-Plus V-generated flags and preset laboratory criteria. There were 16 cases with red blood cell morphologic abnormalities, eight of which were not associated with specimens referred for complete manual differential cell count. In none of these 11 unreferred cases was the undetected abnormality of clinical significance relative to the patient's upcoming surgery. The use of the S-Plus V three-part differential in this patient population can result in a significant cost savings without adversely affecting patient care. PMID- 3675153 TI - Spontaneous atherosclerotic plaque and obstruction of distal anastomosis in femoral artery. Comparative morphologic study. AB - The morphology of unaffected intima, atherosclerotic plaque, and postoperative obstructions of the distal anastomosis of the human femoral artery was studied by light and immunofluorescence microscopy. It was established that a focal thickening at the site of the distal anastomosis is identical with an atherosclerotic plaque in structure and localization of certain extracellular matrix components. A distinctive feature of the intimal thickening at the site of the distal anastomosis is the presence of an organized thrombus. These data suggest that obstruction of the distal anastomosis occurs due to the development of an atherosclerotic plaque complicated by an organized thrombus. PMID- 3675154 TI - Atresia of left coronary ostium and left main coronary artery. AB - An uncommon coronary anomaly incidentally found at autopsy of a 76-year-old woman is reported. There was no history of cardiovascular symptoms or clinical signs of ischemic heart disease. The autopsy disclosed that the patient had no left coronary ostium and that the left main coronary artery was atretic. However, the rest of the left coronary system, including the left anterior descending coronary artery and the left circumflex coronary artery, were intact in their normal positions. Arterial flow to the left coronary system was supplied by a dilated collateral vessel that originated from the right main coronary artery and coursed between the right ventricular infundibulum and the aorta. Our case suggests that atresia of the left coronary ostium and the left main coronary artery, often associated with death at an early age, may also be compatible with symptom-free longevity. Moreover, attention is focused on the nomenclature of single coronary anomalies. PMID- 3675155 TI - Intravenous leiomyoma with intracardiac extension causing sudden death. AB - A 43-year-old woman with a three-year history of syncope is described. No cause for her symptoms was discovered until a postmortem examination revealed an intravenous leiomyoma within the left renal vein that extended to the right ventricle of the heart. A review of the literature is presented. PMID- 3675156 TI - Pulmonary involvement in giant cell arteritis. AB - While clinically suspected in some cases, pulmonary lesions in giant cell arteritis have rarely been described pathologically. We report the findings at autopsy in an elderly woman with typical giant cell arteritis. In addition to inflammation of temporal and other major systemic vessels, large- and medium sized pulmonary arteries showed focal necrosis as well as medial granulomatous inflammation. These findings, as well as a review of previous clinical and pathologic reports, emphasize that the disease can affect the lungs and may rarely be a significant cause of morbidity. PMID- 3675157 TI - Epithelioid leiomyosarcoma of the small intestine with oncocytic change. AB - We describe a 53-year-old woman who was found to have a large, ulcerated duodenal mass that on histologic examination was determined to be an epithelioid leiomyosarcoma and on ultrastructural studies contained a prominent component of cells with oncocytic change. To our knowledge, the findings in this case are unique, and on review of the literature, no similar cases of oncocytic change in smooth-muscle neoplasms of the gastrointestinal tract were found. PMID- 3675158 TI - [Ring transformation of pyrrolidine-enaminothiones to 4,5-dihydro-6H-thieno[2,3 c]azepines]. PMID- 3675159 TI - [Bicycloalkanol nitrates]. PMID- 3675160 TI - Influence of derivatisation of the hydroxy groups in 1,1-bis-(4-hydroxyphenyl)-2 phenylbut-1-ene on estradiol receptor affinity and mammary tumor inhibiting properties. PMID- 3675161 TI - [The in vitro N-oxygenation of N-tert.alkyl-substituted benzamidine]. PMID- 3675162 TI - [Degradation reactions of oral antidiabetics. 3. On the reactions of arylsulfonylureas with carbodiimides]. PMID- 3675163 TI - CaM-inhibitory actions of Ca antagonists. PMID- 3675164 TI - [Barbituric acid derivatives. 37. Racemates and enantiomers of barbiturates with a basic side chain on nitrogen]. PMID- 3675165 TI - [Antiaggregatory and anticoagulant effects of oligoamines. 4. N,N' Bisarylalkylalkanediamines]. PMID- 3675166 TI - [Tumor inhibiting beta-aminoketones]. PMID- 3675167 TI - [Barbituric acid derivatives. 38. Enantio-specific synthesis for enantiomers of barbiturates with a basic side chain on nitrogen]. PMID- 3675168 TI - Selective enzymatic transformation of lanatoside A. PMID- 3675169 TI - [Perhydropyrrolo [2,1-b] thiazolones: synthesis and study of their chemical and pharmacologic properties]. PMID- 3675170 TI - [Barbituric acid derivatives. 39. Study of the central nervous action of enantiomers of barbiturates with a basic side chain at the nitrogen atom]. PMID- 3675171 TI - [Antiaggregatory and anticoagulant effects of oligoamines. 5. Alicyclic di- and triamines]. PMID- 3675172 TI - [Thiophene as a structural element of physiologically active compounds. 16. Thienoisoxazoles by substitution at the oxime nitrogen]. PMID- 3675173 TI - Gait abnormalities in hemiplegia: their correction by ankle-foot orthoses. AB - Hemiparetic gait is characterized by slow speed and poorly coordinated movements. Because the values of gait parameters vary with changes in speed, the slow speed that is typical of hemiparetic gait necessitates applying controls for the influence of speed when comparing hemiparetic and able-bodied persons. Gait kinetics and kinematics were measured in seven hemiparetic and seven able-bodied adults to compare their gait patterns at similar speeds and to assess the effectiveness of ankle-foot orthoses which were double-stopped in 5 degrees of dorsiflexion or 5 degrees of plantarflexion. Hemiparetic persons ambulating without the orthoses had a shorter step length, longer duration stance, and shorter duration swing than normal. They displayed greater than normal flexion of the affected hip during midstance, which, by putting the center of mass farther in front of the knee, may explain the increased knee extension moment due to vertical force. Affected hip adduction during single support was less in hemiparetic persons than in able-bodied persons, indicating a decreased lateral shift to the paretic side. During the swing phase, the affected limbs of hemiparetic persons were in less knee flexion and less dorsiflexion than normal, necessitating circumduction to achieve toe clearance. Ankle-foot orthoses increased walking speed to normalize heelstrike duration through use of an optimally adjusted plantarflexion stop. An improperly adjusted orthosis may produce an exaggerated knee flexion moment resulting in knee instability. PMID- 3675174 TI - Antidepressant drug treatment for poststroke depression: retrospective study. AB - The records of 60 patients evaluated psychiatrically for major depression after stroke were reviewed retrospectively. Forty-two patients were treated with one of several "cyclic" antidepressant drugs, and 18 received no drug treatment. Objective ratings, based on current standard criteria for "major depression" (DSM III), were used to establish degree of depression at initial evaluation and within six weeks after the start of treatment. Overall, improvement in depression was no greater in treated than in untreated patients. However, a subgroup (40%) of drug-treated patients was identified with a substantial (greater than or equal to 40%) improvement in depression ratings. Only three (17%) untreated patients showed a comparable improvement within a similar time period. Eighteen (43%) of the drug-treated patients experienced minor side effects (especially mild sedation), but only three (7%) experienced major side effects that required cessation of treatment. The degree of initial depression was not correlated with the degree of motor or functional disability among patients. These results suggest that antidepressants may constitute safe and effective treatment for some patients with poststroke depression, and further studies of the pathophysiology and treatment of this disorder are indicated. PMID- 3675175 TI - Gait performance of hemiparetic stroke patients: selected variables. AB - This study was designed to determine if specific variables measured routinely at a rehabilitation center were predictors of gait performance of hemiparetic stroke patients. Nine predictor and four gait measures were taken. Of the five predictor variables hypothesized to be significantly correlated with a gait measurement, four were correlated with at least two gait measures (balance, weight-bearing ratio, motor control, and normalized strength of paretic lower limbs). Four gait measures (speed, cadence, independence, and appearance) were all significantly correlated with one another. Stepwise multiple regressions indicated that motor control and balance were the best predictors of gait performance. The results provide guidance as to which predictor variables might be important in assessing stroke patients. The results also provide some guidance for identifying appropriate targets for treatment intervention with hemiparetic stroke patients. PMID- 3675176 TI - Shoulder subluxation in hemiplegia: a radiologic correlational study. AB - A tridimensional (3-D) x-ray method of evaluation of the shoulder was contrasted with six clinical and radiologic techniques used to evaluate shoulder subluxation, in 50 hemiplegic subjects. The 3-D evaluation is obtained through a mathematical computation associating two x-rays of the same shoulder, one taken at 0 degree (anteroposterior) and the other at a 45 degrees oblique view. A vector is thus obtained quantifying the separation from the apex of the humeral head to the inferior border of the glenoid fossa. The Y component (cephalocaudal) of this vector is used to represent the inferior displacement of the humeral head. The six other techniques of evaluation were: a) palpation, or the number of finger breadths inserted between the acromial process and the head of the humerus; b) anthropometry, or the distance between the acromial process and the lateral epicondyle of the humerus; c) templates, or the use of four schemas representing different degrees of separation of the humeral head from the glenoid fossa; d) a measure of the relation of the center of the humeral head to the center of the glenoid fossa; e) the vertical distance between the center of the humeral head and the center of the glenoid fossa; and f) the vertical distance between the apex of the humeral head and the inferior border of the glenoid fossa. Correlation coefficients contrasting the 3-D x-ray technique and the six other measures ranged from .738 to .995. The high level of precision and reliability of the 3-D measure indirectly validated the other measurement techniques. PMID- 3675177 TI - Rotation of the scapula and shoulder subluxation in hemiplegia. AB - Inferior subluxation of the shoulder in hemiplegia was measured using a tridimensional (3-D) x-ray technique. This technique gave the true vertical distance separating the apex of the humeral head and the inferior margin of the glenoid cavity. Both shoulders of each subject were evaluated and the difference used as a measure of subluxation. This measure was then compared to the orientation of the scapula relative to the vertical, to the abduction, and to the relative abduction of the arm. Relative abduction is defined as the angle between the humerus and the glenoid fossa. It has been suggested that these factors are associated with inferior subluxation in hemiplegia. Results of this study of 50 volunteer stroke patients indicated that the affected and nonaffected shoulders were different (subluxed) in terms of the vertical position of the humerus vis-a vis the scapula. The orientation of the glenoid cavities was also different, the subluxed one facing less downward. The angle of abduction of the arm of the affected side was significantly greater than on the nonaffected side, but the relative abduction of the arm was on the same order of magnitude for both sides. There was no significant relationship between the orientation of the scapula and the severity of the subluxation. The abduction of the humerus was weakly (r = .24) related to the subluxation, which partly explained the weak association found between the relative abduction of the arm and the subluxation. It was concluded that the position of the scapula and the relative abduction of the arm cannot be considered important factors in the occurrence of inferior subluxation in hemiplegia. PMID- 3675178 TI - Protein C abnormalities in spinal cord injured patients with end-stage renal disease. AB - Patients with chronic spinal cord injury (SCI) and end-stage renal disease (ESRD) exhibit antithrombin III deficiency and several other coagulation abnormalities. In view of increasing recognition of protein C (PC) as an important, naturally occurring anticoagulant and fibrinolytic factor, we studied plasma PC in this population. PC antigen concentration and its anticoagulant activity were measured in nine SCI men with ESRD maintained on hemodialysis and in a control group of ten normal able-bodied men. The results showed a significant increase in PC anticoagulant activity in the SCI group. Consequently, the ratio of the PC activity to its concentration, which is a measure of the functional integrity of PC molecule, was markedly depressed. These findings are indicative of the presence of inactive or abnormal PC in SCI-ESRD patients and may suggest its in vivo activation. The combination of impaired PC activity shown in this study, with previously demonstrated antithrombin III deficiency and other coagulation abnormalities, is suggestive of a hypercoagulable state. PMID- 3675179 TI - H-reflex: optimum location of recording electrodes. AB - The Hoffmann (H) reflex was measured from a grid of 31 locations on the calves of 20 healthy volunteers. In 17 cases the maximum amplitude of response was found at a site more distal than at the conventional midcalf recording location. Three quarters of the distance between the popliteal crease and the flare of the medial malleolus, the waveform was found most consistently triphasic. At this site the latency was, on the average, 1.4msec longer than at the midcalf location. These results may be related to the more distal origin of the H-reflex dipole when compared to the M (motor) wave or T (tendon) reflex response, and indicate that a distal recording site is preferred if the H-reflex per se is to be assessed. PMID- 3675180 TI - Paraparesis in a child with a herniated thoracic disc. AB - Herniated thoracic disc after minor trauma, causing paraparesis in an 11-year-old boy, proved difficult to diagnose. Myelogram and computer tomography of the thoracic spine appeared normal, but magnetic resonance imaging demonstrated a small herniation at T4-T5. Disc material adherent to the dura was found at laminectomy. The child made progressive recovery preoperatively and postoperatively and was able to ambulate in parallel bars with a left knee-ankle foot orthorsis at the time of discharge from the hospital. PMID- 3675181 TI - Violence in Playboy magazine: a longitudinal analysis. AB - This paper analyzes the amount of violence in cartoons and pictorials from January 1954, through December 1983 in Playboy magazine. Inasmuch as the Attorney General's Commission on Pornography and Obscenity has focused upon magazines such as Playboy as potentially harmful to society because of the violence merged with sex, such an analysis is appropriate at this time. Each cartoon and pictorial for each issue of Playboy for the 30-year-period was examined for violent depictions. The average number of violent cartoons for the 30-year-period was 6.92/year or 0.58/issue. The average number of violent pictorials was less with an average of 1.89/year or 0.16/issue. The ratio of violent cartoons or pictorials to the total number of cartoons or pictorials was small. The ratio of violent cartoons to all cartoons was 25.2/1000 and for violent pictorials to all pictorials it was 8.6/1000. Moreover, the ratio of violent cartoons to total pages was 2.86/1000 and for violent pictorials 0.78/1000 pages. Although the overall number and ratio of violent cartoons and pictorials in Playboy over the 30-year-period examined was rare, a major question addressed was whether the amount of violence was increasing. Rather than a linear relation, a curvilinear relationship was observed with the amount of violence on the decrease in recent years. Although the effects of violence in sexual material is still being debated, those who argue for greater censorship of magazines such as Playboy because of its depictions of violence need a new rationale to justify their position. PMID- 3675182 TI - A comparison of volumetric and circumferential measures of penile erection. AB - Objective measurements of sexual arousal in men most commonly involve monitoring changes in penile size. Although changes in circumference are most often used, volumetric changes have been reported to be more sensitive and thus more effective. Six men volunteered to observe an erotic videotape while circumferential and volumetric changes of their penises were recorded. The two measures were significantly correlated (r = .68) but the volumetric device was more difficult to use, displayed considerably more artifacts, and was not more sensitive than a mercury-in-rubber strain gauge. PMID- 3675183 TI - Adherence to recommendations and improvement over time in men with erectile dysfunction. AB - Men with erectile problems seen for a comprehensive urology-department-based medical and psychological evaluation were sent questionnaires 2 to 3 years later. A representative sample of 99 (52%) responded. The majority (51%) has taken no action and reported that their sexual function was no better. Patients were more likely to comply with a recommendation for sex therapy than with one for a penile prosthesis. This was related to their attitude towards mental health professionals. These findings suggest the need for more knowledge of patient psychology and expectations. PMID- 3675184 TI - Sexual anxiety and female sexual arousal: a comparison of arousal during sexual anxiety stimuli and sexual pleasure stimuli. AB - Sexual arousal occurring during sexual anxiety stimuli was compared to sexual arousal occurring during sexual pleasure stimuli in 19 sexually functional women. Stimuli were individualized narratives based on descriptions given by each subject. Sexual arousal was measured by monitoring vaginal blood flow with a vaginal photoplethysmograph. Results showed significant increases in vaginal blood flow in response to both sexual anxiety and sexual pleasure. However, increases in the pleasure condition were significantly greater than those in the anxiety condition. Analysis of the blood flow across time showed a significant linear increasing trend in the pleasure condition and a lack of such a trend in the anxiety condition. PMID- 3675185 TI - The occurrence of atypical sexual experience among various female patient groups. AB - Clinical interviews with the use of a standard examination format were used to determine sexually atypical experiences in 373 women. The women were divided into three groups. Group 1: 167 women in fertile marriages, Group 2: 102 patients with sexual dysfunctions, Group 3: 104 patients of psychiatric outpatient clinics. Of these, 190 (50.9%) had encountered indecent exposure at least once; 76 women (20.4%) were the victims of attempted rape or rape; 60 women (16.1%) were sexually abused by an adult male prior to menarche; 36 women (9.6%) acknowledged homosexual contacts. Patients with a sexual dysfunction had been the object of sexual abuse in childhood significantly more often than women in the other groups. PMID- 3675186 TI - The psychophysiological nature of premature ejaculation. AB - The hypothesis that premature ejaculators (PEs) are less able than non-premature ejaculators (NPEs) to evaluate accurately their level of physiologically determined sexual arousal was tested. Twenty-six men (13 PEs and 13 NPEs) viewed a variety of videotaped vignettes, some of which were excerpts from sexually explicit films. Concurrent subjective (self-report) and objective (plethysmograph) ratings of sexual arousal were taken. Data revealed that both the PEs and NPEs were equally accurate in assessing their level of physiological sexual arousal. These results and those from a sexual history questionnaire were used to evaluate several hypotheses regarding the nature and etiology of premature ejaculation. PMID- 3675187 TI - At last--worldwide agreement on the staging of cancer. PMID- 3675188 TI - Metastases in small lymph nodes from colon cancer. AB - Lymph node metastases are important determinants in the prognosis of primary colorectal cancer. Although it has been established that enlarged, palpable lymph nodes contain metastases in less than half of the cases, no definitive data concerning the incidence of metastases in lymph nodes measuring 5 mm or less are available. We treated the surgical specimens of 52 consecutive patients who had colon cancer with a lymph node clearance technique at the Roswell Park Memorial Institute, Buffalo. We found 2699 lymph nodes in the 52 specimens, with a mean of 52 lymph nodes per specimen (range, five to 151). Sixty-four lymph nodes were found with metastases in 21 (40%) of the 52 patients. Fifty-nine of 64 of the lymph nodes were reexamined and remeasured. Thirty-nine lymph node metastases measured less than 5 mm, 13 were between 5 and 10 mm, and eight were larger than 10 mm. We concluded that lymph node metastases in colon cancer occur most frequently in lymph nodes measuring less than 5 mm (small lymph nodes). The use of lymph node clearing techniques in surgical specimens improves detection of small lymph node metastases and thereby diminishes understaging. PMID- 3675189 TI - The value of colonoscopic surveillance after curative resection for colorectal cancer or synchronous adenomatous polyps. AB - Between 1975 and 1984, 270 patients underwent a potentially curative resection for colorectal carcinoma. One hundred eighty-eight patients (70%) underwent preoperative colonoscopy, of which 129 patients (69%) were followed up with at least two postoperative colonoscopies. In 91 patients (70%), preoperative colonoscopy revealed no synchronous adenomatous polyps or cancer. Synchronous adenomatous polyps were found in 35 patients (27%), and three patients (2.3%) had a synchronous invasive cancer. Nineteen (54%) of the 35 patients with synchronous adenomatous polyps developed metachronous adenomatous polyps during the follow-up period compared with 24 (26%) of 91 patients without synchronous adenomatous polyps. The median interval to the development of metachronous adenomatous polyps was 19 months, and all of these polyps were 1 cm or less in size. Patients with synchronous adenomatous polyps less than 30 cm from the primary lesion (68%) developed metachronous polyps more often than did patients whose synchronous adenomatous polyps were more than 30 cm from the primary lesion (37%). Preoperative colonoscopy is important for determining synchronous pathology and identifying patients at risk for metachronous polyps. PMID- 3675190 TI - The prognostic significance of natural killer cytotoxicity in patients with colorectal cancer. AB - We evaluate the prognostic significance of preoperative natural killer (NK) cytotoxicity for K562 cells and its relationship to other prognostic factors in 102 patients with colorectal cancer who underwent curative resections between February 1984 and February 1985. The 18 patients who had recurrences within two years of surgery had significantly higher numbers of preoperative peripheral blood suppressor/cytotoxic and NK cells and significantly lower preoperative NK cytotoxicity than disease-free patients. Low preoperative NK cytotoxicity was predictive of recurrence independent of age, sex, hematocrit, procedure, blood loss, duration of surgery, Dukes' stage, specimen length, tumor size, tumor differentiation, and post-operative therapy. Low levels of in vitro NK-cell cytotoxicity may identify a subgroup of patients at high risk for recurrence. PMID- 3675191 TI - Enhancement of tumor blood flow and tumoricidal effect of doxorubicin by intraportal epinephrine in experimental liver metastasis. AB - Laser Doppler capillary perfusion monitoring was performed in 25 Sprague-Dawley rats with solitary intrahepatic implants of Walker carcinosarcomas. Doses of intraportal epinephrine from 1 to 10 micrograms produced an immediate rise in capillary blood flow, reaching peak levels by 16 s. The increased flow lasted an average of 57 s. Because epinephrine selectively increased tumor blood flow, studies were performed to determine if enhancement of the chemotherapeutic effect of doxorubicin could be achieved. Forty-two rats with seven-day hepatic implants were treated sequentially with intraportal epinephrine (10 micrograms) and doxorubicin hydrochloride (10 mg/kg) or doxorubicin alone. After only two courses of chemotherapy, a significant difference in necrosis and cell viability was obtained in those animals treated with epinephrine intraportally prior to doxorubicin infusion. Enhancement of the tumoricidal effect of chemotherapy can be achieved by manipulating the blood flow to developing tumors pharmacologically. PMID- 3675192 TI - Reliability of implantable central venous access devices in patients with cancer. AB - We reviewed complications requiring removal of Hickman catheters (HCs) and implantable central venous access devices (ICVADs) in patients with cancer over a 30-month period. The study was unique in the sense that patients chose which system would be inserted, unless continuous infusion was anticipated. A total of 115 systems were inserted in 102 patients. Forty-four HCs were inserted in 34 patients (total system days, 8533 [mean, 194 days]); 71 ICVADs were inserted in 68 patients (total system days, 18,681 [mean, 263 days]). Complications required removal in 38.6% of HCs and 18.3% of ICVADs. Complication rates were one in 501 days in the HC group and one in 1450 days in the ICVAD group. Although 15 systems were removed for suspected infection, closer analysis revealed that bacteremia ultimately found to be unrelated to the catheter resulted in premature removal in many cases. The catheter tip was located high in the superior vena cava or in the subclavian vein in all systems removed due to thrombosis. Miscellaneous complications in HCs included dislodgment and catheter embolism. The increased longevity, lower complication rate, and decreased maintenance requirements in the use of ICVADs support their superiority over HCs in the treatment of patients with cancer. PMID- 3675194 TI - Estrogen receptor protein of breast cancer in patients with positive nodes. High recurrence rates in the postmenopausal estrogen receptor-negative group. AB - In 448 patients with positive axillary lymph nodes who were treated with mastectomy at Memorial Sloan-Kettering Cancer Center, New York, from 1973 to 1978, estrogen receptor (ER) status was associated with survival. With a median follow-up of 75 months, significant differences were noted in the 288 postmenopausal patients; ER-positive patients had better six-year disease-free survival than ER-negative patients (60% vs 45%), as well as better overall survival. These differences were true in subgroups with one to three and four or more involved nodes. The addition of adjuvant systemic therapy had no significant effect on either ER-positive or ER-negative patients. The need for new imaginative systemic programs in the subgroup of ER-negative postmenopausal patients with breast cancer with positive nodes is apparent. PMID- 3675193 TI - Challenges in the treatment of childhood fibromatosis. AB - Between 1968 and 1985, we treated 20 children for fibromatosis (also called desmoid tumor and aggressive fibromatosis). The primary sites included head and neck (seven patients), extremity (seven patients), and trunk (six patients). Lesions ranged from 3 to 18 cm in diameter. The tumors were smaller than 5 cm in 13 patients, and in seven patients they were larger than 5 cm. A total resection was not feasible in any of the patients with lesions larger than 5 cm. Ten of the 11 patients treated with wide local resection, in whom the margins were clearly negative or close, remained free of disease for six to 16 years. Nine patients required additional treatment with radiotherapy (nine patients) and chemotherapy (five patients). Two died of local disease progression. In the remaining seven children, the disease was controlled. We describe our strategies for managing this disease in a pediatric population. PMID- 3675195 TI - Hyperthermic pelvic isolation-perfusion in the treatment of refractory pelvic cancer. AB - Hyperthermic isolation-perfusion (I-P) was used to treat 27 patients with refractory pelvic cancer. All patients except one achieved pelvic isolation as manifested by selective pelvic heating and by pharmacologic monitoring. Patient response was good, with rapid pain relief in 75% and tumor control as detected by physical examination, computed tomographic scan, and decline in carcinoembryonic antigen levels. Pelvic drug exposure averaged 7.8 times that of systemic drug exposure. Of the 20 patients with recurrent rectal adenocarcinoma, one complete response (duration, eight months), seven partial responses (average duration, greater than or equal to 10 months), four patients with stable disease (average duration, greater than or equal to 12 months), and five with disease progression were observed. Three patients could not be evaluated due to late deaths as a consequence of their disease. There were two postoperative deaths in the remaining seven patients, one due to drug toxicity and one due to probable cardiac arrhythmia. Pelvic I-P has evolved with the avoidance of laparotomy and increased drug dose. We conclude that hyperthermic I-P for pelvic cancer is a safe, effective procedure and an excellent therapeutic option for patients with persistent pelvic cancer. PMID- 3675196 TI - Inflammatory breast carcinoma. Effective multimodal approach. AB - Twenty-two patients with inflammatory breast carcinoma received preoperative chemotherapy consisting of weekly administration of cyclophosphamide, doxorubicin hydrochloride, fluorouracil, and vincristine sulfate for six weeks. Postoperative therapy consisted of 22 weeks of biweekly administration of these drugs. Regional radiotherapeutic consolidation followed chemotherapy. Nineteen patients completed therapy. Twelve of these patients remain disease free (median, 15 months; range, four to 32 months). Median disease-free survival for all 22 patients is 13 months or more (range, zero to 32 months). Median overall survival is 18 months or more (range, one to 33 months). This regimen compares favorably with prolonged adjuvant and maintenance chemotherapy for inflammatory breast carcinoma. PMID- 3675198 TI - Prognosis for recurrent stage I malignant melanoma. AB - The outcome of patients with stage I malignant melanoma has been well assessed in terms of prognostic factors and their effect on survival; however, little is known of the recurrence patterns of cutaneous melanoma or the survival of these patients subsequent to recurrence. A retrospective, computer-aided chart review identified 4185 patients with melanoma who had stage I disease clinically. During a follow-up period of one to 14 years, 35.9% suffered a recurrence. Melanoma of the trunk (37.8%) and head and neck area (46.1%) had an increased incidence of recurrent metastases compared with melanoma of the extremities (29.8%). Local regional metastases accounted for 62.5%, 77.3%, and 85.6% of the recurrences in the head and neck, trunk, and extremity primary sites, respectively, with 65% of the relapses occurring within the first three years. Actuarial five-year survival rates of patients who had recurrent disease were significantly decreased compared with those of patients who had no evidence of metastases during their clinical course. A multivariate analysis was performed to estimate the survival of patients after recurrence. One may use this mathematical model to predict the outcome of individual patients after recurrence and provide a more rationally based prognosis for them and their families. PMID- 3675197 TI - Therapy of peritoneal carcinomatosis of human colon cancer xenografts with yttrium 90-labeled anti-carcinoembryonic antigen antibody ZCE025. AB - The present study was undertaken to determine whether an anti-carcinoembryonic antigen (CEA) monoclonal antibody (MAB), labeled with the potent beta emitter yttrium 90, could alter the growth of diffuse intraperitoneal carcinomatosis of colon cancer. Nude mice bearing the CEA-producing human tumor line LS174T received therapy with the anti-CEA MAB ZCE025 90Y. Animals were evaluated 12 days after therapy. Untreated animals had a mean (+/- SEM) tumor burden of 3.99 +/- 0.10 g, while animals treated with ZCE025 90Y had 0.29 +/- 0.04 g present. This decrease was significant compared with the 1.31 +/- 0.16 g of tumor present in animals treated with a 90Y-labeled nonspecific antibody 96.5c. The therapeutic effects seen with ZCE025 90Y suggest a potentially useful role for 90Y-labeled anti-CEA MABs in the treatment of gastrointestinal carcinomatosis. PMID- 3675199 TI - Influence of the extent of resection on survival after curative treatment of gastric carcinoma. A retrospective multivariate analysis. AB - The therapeutic value of extensive gastric resection and regional lymphadenectomy in the curative treatment of gastric adenocarcinoma is controversial. We undertook a retrospective study of 210 patients treated with curative intent from 1960 to 1980. A multivariate survival analysis using the Cox model revealed five significant variables predictive of death from gastric cancer--two inherent pathologic factors: (1) nonpyloric site and (2) metastases in more than three lymph nodes, and three treatment factors that could often be controlled by the surgeon: (3) microscopic positive gastric resection margin, (4) inadequate lymphadenectomy, and (5) total gastrectomy. These observations reaffirm the value of wide gastric resection and adequate lymphadenectomy but argue against a general policy of elective total gastrectomy in the curative treatment of gastric carcinoma. PMID- 3675201 TI - [AIDS in Japan (present status and future trends)]. PMID- 3675200 TI - Prognosis in occult thymomas in myasthenia gravis following transcervical thymectomy. AB - Thymomas were noted in 239 (11%) of 2097 myasthenic patients followed up at our institution. Among 996 patients who had undergone thymectomy, 191 patients (19%) had thymomas compared with 48 (4%) of 1101 patients treated without surgery. A definitive diagnosis of thymoma was not made until after thymectomy in 61 patients (35%); in patients not treated with thymectomy, 23% of associated tumors were diagnosed at autopsy. Patients with occult thymomas treated with the transcervical approach had a clinical course superior to those with tumors diagnosed prior to surgery and treated with the transsternal approach. Most of the advantage could be attributed to the association of occult thymomas with small tumor size and to the association of the latter with absence of invasiveness. Small tumor size was significantly associated with higher remission and lower mortality as shown in a proportional hazards analysis. Occult thymomas were accessible through the transcervical approach, with some operations necessitating a complementary mediastinotomy. Thymectomy, through the transcervical approach if technically feasible, is of benefit to all patients, has minimal morbidity, and should be performed early in the course of the disease as a diagnostic and therapeutic intervention since the risk of occult thymomas in patients with myasthenia gravis is high. PMID- 3675202 TI - [Murine monoclonal rheumatoid factor as a staff for detection of circulating immune complexes]. PMID- 3675203 TI - [Induction of non-specific killer cells by delayed type hypersensitivity (DTH) reaction against soluble protein antigens in the murine peritoneal cavities]. PMID- 3675204 TI - [Antigen presenting Langerhan's lineage cells in granulomatous skin diseases]. PMID- 3675205 TI - Holter monitor ST segment evaluation in hospitalized patients with unstable angina. AB - The correlation of angina attacks with ST segment changes detected during ambulatory Holter monitoring was evaluated in patients with unstable angina. Forty hospitalized patients had one to three 24-hour Holter recordings each. Twenty-three patients had a cardiac catheterization, confirming significant coronary artery disease. The Holter recordings, scanned blindly by computer, were evaluated for ST segment shifts (defined as +/- 1.5 mm from baseline, lasting 60 seconds or longer). Angina attacks were carefully logged. Over the total forty patient experience, only 15 of 74 (20.3%) angina attacks had corresponding ST segment shifts on the Holter recordings. Nine of 34 (26.5%) angina attacks in the 23 patients who had a cardiac catheterization had corresponding ST segment shifts. A total of 159 ST segment shifts were recorded on these forty patients, but only 15 (9.4%) ST shifts corresponded to a time when the patients were actually experiencing angina attacks. The performance of the test procedure was quantified by use of Youden's J statistic. The aggregate J, over all patients, was 0.203 (J = 1.0 is perfect, J = 0.0 is useless). When consideration was restricted to patients with cardiac catheterization, the aggregate experience J was 0.263. Dealing with only the patients who had angina attacks during the monitoring, and computing the J statistic for each individual patient, the resulting mean J statistic was 0.146, with SEM = 0.0731. The Holter monitoring worked reasonably well in only 2 of the 14 patients who gave clear tests of the procedure. In an attempt to improve the performance of the procedure, 21 Holter recordings in eight patients were reread for ST segment shifts of only +/- 1 mm from baseline, lasting 30 seconds or longer. In these eight patients with rescanned Holter recordings, only five of 17 (29.4%) angina attacks resulted in an ST segment shift. In conclusion, ambulatory Holter recordings proved not to be a suitable method of documenting ST segment shifts during angina attacks in this study. PMID- 3675206 TI - [Ultrastructural changes in the neurons and interneuronal synapses of the hypothalamus in the progeny of morphine-dependent rats]. AB - The electron microscopic method has revealed early maturation of the protein synthesizing apparatus of some cells, on the one hand, and underdevelopment of neuroblast volumes, appearance of artificial contacts, axonal degeneration and destruction in large trunks, on the other hand. Compensatory-restorative processes in the cell on the 14th and 21st days of the postnatal development result in a complete restoration of morphological organization of neurons and interneuronal connections in the hypothalamus of offspring of the morphine dependent rats. PMID- 3675207 TI - [Retrograde degeneration of the neurons of the cerebellar nuclei after partial removal of the associative cerebral cortex]. AB - Retrograde degeneration of the cerebellar nuclei cells has been studied after partial ablation of the associative parietal cerebral cortex in the cat. The material is stained after Nissl. Retrogradely degenerated and normal cells are counted. The "ghost-cells" in the cerebellar nuclei indicate that a direct axonal connection exists between some neurons and the cerebral cortex operated, while the cells that are at other stages of degeneration are, perhaps, connected with this part of the cortex by means of axonal collaterals. PMID- 3675208 TI - [Development of the uterine microcirculatory bed in postnatal ontogeny]. AB - Age peculiarities of common structure of the microcirculatory pathways, specific volumes and amount of microvessels, zonal parameters of pericapillary microcirculation of metabolites, glycosamine glycans and glycoproteins contents, phosphatase and ATPase activity, collagen and elastic fibers of the microcirculatory bed vessels have been studied in 190 unchanged uteri, beginning from 36-week-old fetuses up to 35 years of age. The microcirculatory bed of myometrium during the period of postnatal ontogenesis investigated possesses a polymer-homonomous structural organization; its base make myoangiomas, including the terminal arteriole with precapillaries and collecting venule, that run from it. Similar structure of the myometrium microcirculatory pathways is already observed in fetuses of late antenatal period. In endometrium formed glanduloangionomas are revealed in the prepubertal age. Increase in glycosamine glycans contents is stated in the microvessel walls and in the uterine stroma during the process of its development. Compensatory-adaptive changes in the uterine microcirculatory bed are described during the newborn period up to the puberty. Functionally mature structures of the microcirculatory pathways in the submucosal and vascular layers of myometrium, endometrium and in the cervix uteri are found to be formed earlier than in other areas of the organ. PMID- 3675209 TI - [Anatomy and topography of the common iliac lymph nodes in human beings in the 1st period of maturity]. AB - The investigation of common iliac lymph nodes has been performed in 20 corpses of the first mature age of both sex (5 male and 5 female corpses) of persons died from causes not connected with the lymphatic system diseases, the lower extremities and the pelvic organs. The common iliac lymph nodes with their afferent and efferent lymphatic vessels are revealed by means of interstitial injection into the lower extremities and the pelvic organs and with direct injection into the lymphatic vessels. The form, amount, size and topography of the common iliac lymphatic vessels have been studied. The lymphatic vessels, that go from certain body parts and organs to various subgroups of the common iliac lymph nodes, as well as the lymphatic vessels that connect the nodes both within the subgroup and also between the subgroups. The amount and size of the lymphatic nodes of the lateral subgroup predominate over the nodes of other subgroups of the common iliac lymph nodes; the amount of the common iliac lymph nodes predominates in men, and their size--in women. Amount of these nodes in the right and their size in the left predominate in both sex. Among the common iliac lymph nodes there are no teniform nodes, and efferent lymphatic vessels of the lateral and medial subgroup of the common iliac lymph nodes in 15% of cases run towards the lumbar nodes in the opposite side. PMID- 3675210 TI - [Extra-organic lymphatic vessels and regional lymph nodes of the kidneys in dogs]. AB - An anatomical investigation of extraorganic lymphatic vessels and regional renal lymph nodes has been performed in 70 dogs. The regional lymph nodes in the right kidney are stated to be quantitatively constant, as well as cranial and caudal lateroaortal lymph nodes in the left kidney in regard to the middle left lateroaortal nodes, that get lymph from the left kidney parenchyma. One middle left lateroaortal lymph node is found in 47 animals examined, two lymph nodes--in 17 animals. In 6 cases a lymphatic vessel, that gets lymph from the renal parenchyma and independently runs into the cistern of the thoracic duct is found for the first time. The variant revealed is an exception from the rule known in lymphology: lymph in its way from periphery to the central collector runs, at least, through one lymph node. PMID- 3675211 TI - [Analysis of stresses in the wall of the urinary tract based on urographic data]. AB - Mathematical analysis has been performed from the position of the strength of material theory and the elasticity theory, taking into account forms of surfaces in various parts of the urinary pathways (UP). At an increased pressure in UP cavities the deformity degree of their walls is not similar and depends on expressiveness of positive or negative curvature of saddle-like surfaces. In its turn, according to changes of the curvature radii in UP contours in roentgenograms, it is possible to consider on an increased pressure in their lumen, depending on disturbances in UP conductivity. PMID- 3675213 TI - [Development of dendritic spines in the piriform neurons of the cerebellar cortex in human prenatal ontogeny]. AB - The submicroscopic investigation on developmental peculiarities of the dendritic spines in the piriform neurons of the cerebellar cortex has been performed during the human prenatal ontogenesis. The process of morphogenesis of the spines of the tertiary dendrites in the piriform neurons is demonstrated to start rather early- on the 24th week of embryogenesis and goes through three successive stages: 1) formation of a long cytoplasmic processes deprived of any membranous specialization; 2) formation of the terminal spinal head, making synapses with parallel fibers of the cerebellar cortex; 3) definitive stage. A suggestion is made that differentiation processes of the spines depend on inductive influence of the parallel fibers of the cerebellar cortex. PMID- 3675212 TI - [Age-related dynamics of the shape and size of the subpubic angle in children and adolescents]. AB - The roentgenoanatomical investigation, performed according to archival roentgenograms of the urinary tracts in 57 boys and 294 girls at the age of 2-16 years, characterizes the value of the subpubic angle and age dynamics of its form and size. The form and size of the subpubic angle in the children of the given age varies within large range--acute, right, obtuse; sex differentiation is clearly followed in the group of 11-16 years of age, when in the boys there are three forms of the angles--right (most often occurring), then obtuse and acute (seldom occurring), while in the girls of this age group there are only two forms -obtuse and right with definite predominance frequency of the obtuse angle. The formation of the feminine type of the subpubic angle takes a longer period of time than the masculine type. PMID- 3675214 TI - [A case of cranioencephalopagus]. AB - A rare case of head accretion of monozygotic girl-twins 6 years of age has been investigated. The common cavity of the endocranium has appeared as a result of accretion of the skull cap bones. The truncal parts of the brain have not any peculiarities, parts of the diencephalon and telencephalon are deformed. In each brain the corpus callosum and fornix are not defined anatomically. A complex configuration of the III ventricle cavity, common for both brains, is formed by means of turned to each other medial surfaces of the thalami and subthalamic parts. Oppositely situating pair of the thalami of both brains is connected by means of the white substance cord. This case is described as an example of cranioencephalopagus (diencephalopagus). PMID- 3675215 TI - [Development of different types of muscle fiber in the postnatal ontogeny of guinea pigs]. AB - As demonstrates estimation of myosin ATPase and SDG activity, the guinea pig is already born with differentiated muscle fibers (MF), and the first histochemical differences between them take place in the uterine 10 days before birth. Tonic oxidative fibers of the first type, arranging hexagonally, develop especially quickly at early stages of postnatal ontogenesis. Their relative contents up to the end of the observations (185 days) do not change, and area of their transversal section increases but slightly in comparison to the phasic fibers. The main age changes of the muscle tissue are connected with formation and rearrangement of the phasic fibers. The most intensive reconstructions of the phasic fibers coincide with the period of game activity and sex maturation. In mixed muscles the part of the glycolytic fibers increase during the postnatal ontogenesis. In the process of ontogenesis the soleus muscle fully consists of oxidative fibers. The definitive level of the MF development is established after the guinea pigs have reached their sex maturation. Comparing the results of the given investigation with the previous data on development of MF in rats, it is possible to conclude that term and premature animals have various rates in development of the muscle system, however, main stages of myogenesis coincide, though they are connected with various phases of ontogenesis. PMID- 3675216 TI - [Serous papillary cancer of the endometrium]. AB - A study of 10 endometrial serous papillary cancers (ESPC) showed them not to differ morphologically from ovarian serous papillary cancer. A close association of ESPC with areas of tubal mucosal metaplasia of the uterine body was demonstrated. The proliferative changes undergone by these metaplastic areas and leading eventually to malignancy were followed step by step. The tumors were refractory to hormonal (progestagen) therapy and ran an aggressive course. In some of the cases, the ovaries, uterine body, and uterine tube were affected concomitantly. The occurrence of ESPC lends strong support to the hypothesis that ovarian epithelial tumors originate from the epithelium of Muller's canal. PMID- 3675217 TI - [Electron microscopic-radioautographic study of bacterial invasion in severely burned patients]. AB - Wound pieces taken from 3-6 sites at a time during surgical treatment of the wound in 10 patients with thermal burns involving 25-50% of the body surface area, were examined by electron-microscopic radioautography and bacteriologically. The burn wounds were found to contain not only live (RNA synthesizing) bacteria but also replicating (DNA-synthesizing) bacteria, and to be heterogeneous in terms of bacterial seeding (the largest numbers being present in the scab and the smallest, in the granulation tissue), but not of bacterial species; these were represented in all layers by mixed populations (Pseudomonas aeruginosa, pathogenic Staphylococcus, Proteus), although the deep layers contained more pathogenic and more virulent subpopulations than the more superficial ones. Septic patients had considerably more organisms in all layers of their wounds than nonseptic patients, and contained proliferating organisms in the granulation tissue. The main steps in the penetration of individual microbial species into the circulation were traced out by means of electron-microscopic radioautography. PMID- 3675218 TI - [Results of the electron microscopic diagnosis of human tumors (an analysis of 1000 cases)]. AB - A review of electron-microscopic diagnostic investigations made on biopsy specimens from 1000 patients showed the range of tumors requiring ultrastructural diagnosis to be fairly broad, encompassing virtually all major tumor sources including soft tissues (37% of the cases), epithelium (31.8%), hematopoietic organs (21.3%), pigment-forming tissues (4.9%), and bones (3.3%). The tissue and cellular origin of the tumor was identified, i.e. a differential diagnosis was correctly made and/or the histogenetic (cytogenetic) type of the tumor was established, in most (83.0%) of the cases, whereas the organ of tumor origin was identified in only 6.0%. Electron-microscopically, the histological diagnosis was confirmed in 45.3% of the cases, made more precise in 19.0%, and discarded in 5.1%; in 5.8%, electron microscopy confirmed as correct one of the diagnoses presumed on histologic grounds, while in 3.9% the diagnosis could not be verified because the tumors consisted of undifferentiated cells in their entirety. Historic material (formalin-fixed or from paraffin blocks) and stained histologic sections were used for the ultrastructural diagnoses. PMID- 3675219 TI - [Pathogenetic characteristics of cervical erosion in puerperae]. AB - A study of 72 cervical biopsy specimens from puerperants revealed several pathogenetic features of endocervicitis, glandular ectropions, and authentic erosions. In particular, pseudoerosions were the result of excessive cervical gland hyperplasia that combined, in nearly all cases, with decidual transformation and chronic stromal inflammation. Ectropions were most likely to have been due to inversion of a moderately hyperplastic mucosa during delivery. In contrast, true erosions developed where the stratified squamous epithelium was hyperkeratotic and atrophic, and were often complicated by acute cervicitis. PMID- 3675220 TI - [Morphofunctional state of the gastric parietal and gastrin-producing cells in chronic gastroduodenitis in children]. AB - Morphofunctional studies of parietal and gastrin-producing cells in 30 children with chronic gastroduodenitis with (10 patients) or without (20) recurrent erosions in the pyloroduodenal region showed functional inhibition of G cells and hyperplasia of P cells in the antral part of the stomach in children with recurring erosions. In these children, the increased surface area and density of parietal cells, the increased perimeters of secretory canaliculi's membranes, and the consequent elevated gastric juice acidity were probably due to P-cell hyperplasia in the gastric antrum and G-cell hyperplasia in the duodenal bulb. In children, gastroduodenitis with recurrent erosions should be considered a pathogenetic variant of duodenal ulcerous disease. PMID- 3675221 TI - [A European Diploma in Pathology (a proposal for discussion)]. PMID- 3675222 TI - [Erdheim's disease: morphogenetic problems]. AB - Structural studies of resistive vessels in a 21-year-old woman who died in the postpartum period from rupture of the aorta in the presence of Erdheim's disease are described. Histological, histochemical, and immunomorphological methods were used, and microcirculation was examined in film preparations of adventitia treated with silver nitrate by Kupriianov's method. In the media of the aorta and the proximal parts of its large branches, nonspecific necrobiotic processes were in evidence, believed to be due to lesions in the microcirculatory bed of the vascular wall. PMID- 3675223 TI - [Ameloblastoma of the mandible: cytohistological parallels]. AB - Ameloblastoma (also known as adamantinoma, adamantine epithelioma, adamantinoblastoma, and epithelial odontoma) is a benign tumor of ectodermal origin arising from odontogenic epithelium, most commonly in the lower molar region in individuals aged between 20 and 50 years. Several histological variants are recognized, the most common being the follicular type. The present communication demonstrates the desirability of conducting parallel cytological and histological studies in cases of jaw tumors. Results of one study are reported; the cytologic profile of the tumor enabled the authors to identify cell type and establish the odontogenic origin and benign nature of the tumor. Such studies are stated to be essential in developing criteria for cytologic diagnosis of odontogenic tumors. PMID- 3675224 TI - [Cancer of the small intestine at the site of an ileostomy]. AB - A rather rare case of tubular-villous adenoma located on the small intestine mucosa in the ileostomy area and its transformation into adenocarcinoma is described. The patient had undergone previously a two-stage colectomy for a giant creeping large intestinal tumor with malignancy in the left and right colic flexure and in the rectum 7 cm apart from the anal margin. Adenocarcinoma of the small intestine developed 5 years later in the ileostomy zone. Ileostomy was reconstructed with the excision of 15 cm of the small intestine. The tumor structure at the site of ileostomy was that of adenocarcinoma, and it infiltrated the muscular layer of the small intestinal wall. PMID- 3675225 TI - [Teratoma of the testicle with very highly differentiated structures]. AB - A teratoma is described that was composed of differentiated derivatives of the germ layers--ectoderm (central and peripheral nervous systems, epiphysis, adenohypophysis, and skin with appendages), endoderm (bronchial and intestinal epithelia), and mesenchyme (fibrous and smooth-muscle tissue, cartilage, and bone) and of mesoderm (mesonephros). PMID- 3675226 TI - [Diastolic thrill in the mitral area in the presence of aortic insufficiency. A variant of Austin Flint murmur. Report of 2 cases]. PMID- 3675227 TI - [Primary sarcoma of the heart. A case report]. PMID- 3675228 TI - [Comparative study of the acute hemodynamic effects of verapamil and nifedipine in patients with ischemic heart disease]. PMID- 3675229 TI - [Selection and combination of anti-angina drugs]. PMID- 3675230 TI - [Lipid profile in normal elderly subjects]. PMID- 3675231 TI - [Surgical treatment of infective endocarditis]. PMID- 3675232 TI - [The interaction between preload and afterload. Afterload maladjustments: clinical implications]. PMID- 3675233 TI - [Psychological behavior and ischemic cardiopathy]. PMID- 3675234 TI - Hemodynamic and metabolic evaluation of an acute left ventricular failure model induced by coronary artery embolization. PMID- 3675236 TI - [A valved tube made of the bovine pericardium. A case report]. PMID- 3675235 TI - [Atrial fibrillation in the hospital phase of myocardial infarction]. PMID- 3675237 TI - [Spontaneous occurrence of atrioventricular block of Wenckebach type of alternate beats in the His-Purkinje system. A case report]. PMID- 3675238 TI - [Apparent double atrial activation in conjoined twins. A case report]. PMID- 3675239 TI - [Biochemical bases of platelet activity in hemostasis and thrombogenesis. I]. PMID- 3675240 TI - Neurologic aspects of boxing. PMID- 3675241 TI - Parkinson's disease and smoking. PMID- 3675242 TI - Dietary therapy for motor fluctuations in Parkinson's disease. PMID- 3675243 TI - A controlled study of survival with dementia. AB - Widely conflicting data exist regarding the relationship of dementia to mortality and the relative risk of senile dementia of the Alzheimer type vs multi-infarct dementia with respect to mortality. In a historic prospective study, 202 patients with dementia were matched by age and sex with 202 nondemented controls attending the same geriatric assessment clinic and receiving comparable medical and psychiatric care. The three-year survival rate was 70% for patients with dementia and 84% for controls. Patients with multi-infarct dementia survived more poorly than patients with senile dementia of the Alzheimer type, but the difference did not reach statistical significance. The relative risk associated with dementia in the context of a multivariate analysis was 1.92 (95% confidence [1.25, 2.97]). We conclude that dementia carries a significantly increased risk of mortality but that the survival of patients with dementia may be better than previous reports would suggest. PMID- 3675244 TI - Dementia following strokes in the mesencephalon and diencephalon. AB - Six patients had ischemic infarcts in the paramedian thalamic, subthalamic, and mesencephalic areas. In addition to ocular motility problems, ataxia, dysmetria, and mild pyramidal signs, there were consistent behavioral observations and neuropsychological findings. All of the patients had initial deficits in arousal, and gradually improved to normal wakefulness. When awake, all of the patients had impaired attention, mental control, and slowed verbal and motor responsiveness. They were apathetic, poorly motivated, and affect was flat or occasionally labile. All of the patients had a memory disorder characterized by anterograde and retrograde loss. One patient had significant language impairment. These deficits persisted in all but one patient who had a predominantly mesencephalic lesion. We believe the cluster of findings in these patients constitutes a characteristic syndrome of dementia related to paramedian mesencephalic and diencephalic infarcts. This syndrome bears close resemblance to that associated with some subcortical degenerative disorders such as progressive supranuclear palsy. In cases of paramedian mesencephalic and diencephalic infarcts, however, computed tomography and magnetic resonance imaging can delineate clinicoanatomic relationships that account for specific constituents of the syndrome. PMID- 3675245 TI - Basal forebrain infarction. A clinicopathologic correlation. AB - Following the repair of a ruptured anterior communicating artery aneurysm, a patient had a severe anterograde amnesia with sparing of other intellectual functions, apathy and loss of volition, altered arousal, and partial diabetes insipidus. Postmortem examination of the brain revealed bilateral destruction of the septal gray, nucleus accumbens, and nucleus of the diagonal band of Broca. Also involved in the lesion were inferior portions of the anterior limb of the internal capsule and globus pallidus. Discrete, microinfarcts were present in the paraventricular hypothalamic gray. Long-term therapy with desaminoarginine vasopressin nasal spray had no effect on the patient's neuropsychologic deficits. PMID- 3675246 TI - Acute confusional state and acute agitated delirium. Occurrence after infarction in the right middle cerebral artery territory. AB - Acute confusional state (ACS) and acute agitated delirium (AAD) after infarction in the right middle cerebral artery territory were investigated in 41 consecutive patients. Acute confusional state was diagnosed on the basis of the results of the Mini-Mental State Examination, and AAD was distinguished from ACS by the characteristic behavioral abnormality. Of these patients, 25 presented with ACS, and six with AAD. Acute confusional state and AAD are common syndromes after infarction of the right middle cerebral artery, and infarction in this territory, therefore, has an important clinical implication as a cause of these syndromes. Acute confusional state is a disorder in which cognitive and integrative functions become defective, reflecting disturbance of global attention, and is closely correlated with other right hemispheric global and directed attentional disorders. It is linked to damage to the right frontostriatal region and is associated with lesion volume. In comparison, AAD is a disorder in which emotional and affective components are predominantly altered. None of the right hemispheric behavioral syndromes correlated with AAD. It may be related to damage to the right middle temporal gyrus. PMID- 3675247 TI - Regional cerebral blood flow in severe developmental dyslexia. AB - Regional cerebral blood flow was measured under three task conditions in 14 men with severe developmental dyslexia and their control subjects using a xenon 133 inhalation technique. No group differences in overall level or in pattern of gray matter flow were seen under relatively undemanding cognitive conditions. Despite minimal group differences in performance, the dyslexic group showed an increased hemispheric asymmetry (left greater than right) on a semantic classification task and a reduced anteroposterior difference on a line orientation task relative to controls. The exaggerated asymmetry suggests the possibility of less efficient information processing or inadequate bihemispheric integration. The reduced anteroposterior gradient may reflect a deficit in the ability of frontal systems to respond adequately to cognitive demands. PMID- 3675248 TI - Diagnosis of thoracic outlet syndrome. Value of sensory and motor conduction studies and quantitative electromyography. AB - Ten patients with wasting of hand muscles and sensory symptoms mainly in the ulnar nerve area were diagnosed as having a thoracic outlet syndrome and were operated on for it. Sensory action potentials (SAPs) from digit 5 were reduced in amplitude in eight patients and those from digit 3 in three patients, and the SAP amplitude ratio between digits 3 and 1 was decreased in five patients. Sensory and motor conduction velocity was normal in all. Quantitative electromyographic studies of ulnar and median innervated small hand muscles revealed changes compatible with chronic partial denervation in most patients. The combined findings of chronic partial denervation of the small hand muscles, decreased SAP amplitude from digit 5 and sometimes also from digit 3, and normal motor and sensory conduction velocity are compatible with a compression of the C-8 and T-1 roots or the lower trunk of the brachial plexus. PMID- 3675249 TI - Multivariate analysis of improvement and outcome following stroke rehabilitation. AB - This study documented the status of 432 patients and characteristics of functional improvements and outcomes achieved by 163 patients who participated in comprehensive stroke rehabilitation. Scores on the 100-point Activities of Daily Living Index improved from hospital admission to discharge and declined slightly at follow-up. An average Activities of Daily Living Index point gain of 0.6 per day was found that was unrelated to age, sex, side of hemiparesis, or admission functional status. Seventy-nine percent of the patients were discharged home; 85% were home at follow-up. Eleven percent of the patients were working at follow-up. Patients traveled outside their homes an average of 24.6 days during the three months immediately following discharge. A significant number of patients achieved favorable functional housing, employment, and social outcomes. This study supported referral for rehabilitation services regardless of age, side of hemiparesis, or degree of impairment. PMID- 3675251 TI - First seizure management--reconsidered. Response I. PMID- 3675250 TI - Longitudinal study of auditory brain-stem response in patients with minor head injuries. AB - In a longitudinal study of 119 patients with minor head injuries, 13 had abnormal auditory brain-stem responses (ABRs) within 48 hours after trauma. At follow-up examination one month later, ten patients had abnormal ABRs. The ABRs remained stable in most patients; in nine patients they normalized. However, in six patients initially normal ABRs became abnormal. This instability limits the medicolegal application of ABR testing after minor head injury. PMID- 3675252 TI - First seizure management--reconsidered. Response II. PMID- 3675253 TI - First seizure management--reconsidered. Response III. PMID- 3675254 TI - Telodiencephalic ischemic syndrome. PMID- 3675255 TI - Guillain-Barre syndrome following Campylobacter jejuni enteritis. PMID- 3675256 TI - A multicenter study of anticoagulation parameters when using heparin and warfarin. AB - Anticoagulation with heparin and warfarin is used in the treatment of several diseases including cerebrovascular disease. While the most effective therapeutic range of anticoagulation is unclear, some investigators have found an increased risk of bleeding complications with more intense anticoagulation. Recent studies have suggested that lower levels of anticoagulation may be as efficacious as high levels but with a reduced incidence of bleeding complications. In order to better assess the anticoagulation parameters used by neurologists and house officers, we performed a questionnaire survey at six major medical centers. Responses were obtained from 30 attending neurologists and 52 house officers. Attending physicians and house officers selected mean partial thromboplastin times of 57.7 s and 63.3 s, respectively. The mean prothrombin time (PT) was 21.0 s for attending neurologists and 19.4 s for house officers. The average PT ratio was 1.82 for attending neurologists and 1.69 for house officers. Forty percent of attending neurologists and 17.7% of house officers specified PT ratios of 2.0 or greater. These results indicate that many physicians may be using warfarin in dosages above recommended guidelines. PMID- 3675258 TI - Treatment of aphasic perseveration (TAP) program. A new approach to aphasia therapy. AB - We have devised a new approach to the therapy of aphasia. Rather than focus on rehabilitation of linguistic errors, we treat perseveration, which may be an integral component of the aphasic symptoms. In this report we provide key elements of our Treatment of Aphasic Perseveration (TAP) technique, and the successful use of this method with three aphasic patients. PMID- 3675257 TI - Evoked potentials to test a treatment of chronic multiple sclerosis. AB - Multimodal evoked potentials (EPs) were obtained serially in 57 patients with multiple sclerosis enrolled in a double-blind, controlled study of hyperbaric oxygen. We encountered drawbacks in the use of EPs in monitoring effects of a treatment for chronic multiple sclerosis. Limitations include a relatively arduous testing protocol and the significant occurrence of ambiguous and frankly unreproducible results. Test/retest variability is large in stable patients. There is poor correspondence between EP changes and changes of clinical function as well as among EP modalities. Whether EP measurements ultimately prove to be useful in testing new therapies awaits the development of a truly effective treatment, the effects of which can be shown despite these factors and limitations. PMID- 3675259 TI - Alexia without agraphia in a left-handed patient with a right occipital lesion. AB - A left-handed patient who had suffered an ischemic vascular accident in the territory of the right posterior cerebral artery displayed alexia without agraphia. Clinical examination of this alexia revealed semiological characteristics comparable with those observed in cases of left temporo-occipital lesions in right-handed patients. Analysis of these disturbances indicated that they were agnosic in nature. The associated disturbances included problems of visual representation and topographic memory together with an amnesic syndrome. PMID- 3675260 TI - Response preparation and response inhibition after lesions of the medial frontal lobe. AB - Two patients with chronic unilateral medial frontal lobe lesions, including the supplementary motor area, were given tasks of response preparation and response inhibition. Whereas the patient with a left-sided lesion, like normal controls, did benefit from preparatory information regarding a subsequent response, the patient with a right-sided lesion did not. On a task requiring the inhibition of an inappropriate response, the patient with a left-sided lesion again performed normally. Conversely, the patient with a right-sided lesion had significant problems inhibiting the extremity contralateral to the lesion. We postulate that the medial frontal lobe may participate in response preparation and response inhibition by modulating the levels of excitability of the motor systems. Our findings also suggest that the right hemisphere may have a dominant role in mediating these processes. PMID- 3675261 TI - Yes, brain biopsy should be a prerequisite for herpes simplex encephalitis treatment. PMID- 3675262 TI - No, brain biopsy need not be done in every patient suspected of having herpes simplex encephalitis. PMID- 3675263 TI - Brain biopsy in suspected herpes encephalitis. PMID- 3675264 TI - Oligodendrocyte development and the natural history of multiple sclerosis. A new hypothesis for the pathogenesis of the disease. AB - The cause of multiple sclerosis (MS) is not known. This article presents a review of recent studies concerned with the development of oligodendrocytes and suggests that the primary lesion in MS could be related to damage to oligodendroglial progenitor cells. Loss of the capacity to generate oligodendrocytes could alter the course of normal development such that insufficient cells are produced to support growth and replace cells lost through attrition, and as a result, regions of demyelination appear. The site and extent of the primary loss of oligodendroglial precursors would then predetermine the time of onset, site, and severity of the neurologic manifestations of MS. It is suggested that MS is a single, continuous process and that clinical, pathologic, and immunologic findings may be understood as the consequences of the acquired inability to generate sufficient oligodendrocytes to maintain myelin. PMID- 3675265 TI - The effect of pregnancy on diabetic retinopathy. PMID- 3675266 TI - Medical therapy for the acute postoperative intraocular pressure rise following argon laser trabeculoplasty. PMID- 3675267 TI - Age covariance and open angle glaucoma. PMID- 3675268 TI - Dry vitreous biopsy with gas-vitreous exchange. PMID- 3675269 TI - Relationship between refractive error and visual acuity in the PERK study. PMID- 3675270 TI - Magnetic resonance imaging and retinal tacks. PMID- 3675271 TI - Laws of behavior. PMID- 3675272 TI - Phosphate concentration of viscoat. PMID- 3675273 TI - Bilateral syphilitic optic neuritis in a patient with a positive test for HIV. Case report. PMID- 3675274 TI - AIDS complicated by syphilis can mimic uveitis and Crohn's disease. Case report. PMID- 3675275 TI - Visual loss in a patient with primary empty sella. Case report. PMID- 3675276 TI - Suprasellar meningioma with intrasellar extension simulating pituitary adenoma. Case report. PMID- 3675277 TI - Bilateral retinal detachment repaired with bilateral pneumatic retinopexy. Case report. PMID- 3675278 TI - Bloody tears associated with familial telangiectasis. Case report. PMID- 3675279 TI - Acute foveal outer retinopathy. Case report. PMID- 3675280 TI - Rationing of health care--is it inevitable? PMID- 3675281 TI - Photorefraction. A technique for preschool visual screening. PMID- 3675282 TI - Intelligence, education, and myopia in males. AB - We conducted a nationwide study of the relationship among refractive error, intelligence scores, and years of schooling in 157,748 males aged 17 to 19 years. We found a strong association of myopia with both intelligence and years of school attendance. The prevalence of myopia was found to be significantly higher in the more intelligent and more educated groups. By fitting models of logistic regressions, we worked out a formula expressing the relationship among the rate of myopia, years of schooling, and intelligence level. We found that years of schooling and intelligence weigh equally in the relationship with myopia. PMID- 3675283 TI - Cysts of Tenon's capsule following filtration surgery. Medical management. AB - Cysts of Tenon's capsule (encapsulated blebs) developed postoperatively in 77 (13%) of 607 eyes that underwent filtration surgery between 1980 and mid-1985. The annual incidence was not uniform, increasing markedly throughout the period. Seventy-four eyes were treated with medical therapy only. At a mean follow-up of 19 months, the success rate for these eyes, defined as an intraocular pressure (IOP) of 21 mm Hg or less, was 92%. The three eyes that underwent surgical revision subsequently failed clinically by the study criteria. Those patients in whom cysts of Tenon's capsule developed were compared with an age-matched control group to assess for possible differences in long-term outcome. There was a significantly higher IOP in the Tenon's cyst group at one and three months after surgery, and an increased proportion of IOPs above 30 and 40 mm Hg. At a six month and later follow-up, there was no significant difference in the mean IOP or in progression of visual field loss. Causative factors were sought for the development of these cysts of Tenon's capsule. Prior conjunctival surgery, or previous cyst formation in the other eye, were the significant risk factors noted. PMID- 3675285 TI - Clinical evaluation of a commercial photorefractor. AB - The Visiscreen 100 is a system designed to detect ocular anomalies photographically. Photorefractions obtained in 63 consecutive 3-month-old to 8 year-old patients were compared in a masked fashion with results obtained by conventional techniques, including cycloplegic refraction. In 87% of the 57 patients with analyzable photographs, photorefractive and examination results correlated for the detection of constant tropias. The photorefractor detected all ocular media opacities. In 77% of the cases, its refraction was within 2.5 diopters or 33% of the cycloplegic spherical equivalent. In detecting abnormal ocular status, the Visiscreen had a 91% sensitivity and a 74% specificity. The overall agreement rate in distinguishing abnormal from normal status was 84%. Most errors were related to inaccuracies in fixation and positioning, rather than the optical principles utilized. This device offers a rapid technique for the detection of factors predisposing preverbal children to amblyopia. PMID- 3675286 TI - Transient blindness associated with transurethral resection of the prostate. AB - Visual impairment or even transient blindness can result from transurethral resection of the prostate when glycine is used as the irrigating fluid. Electroretinograms were obtained from patients in the anesthetic preparation area and in the recovery room immediately after surgery. Four patients reported visual aberrations ranging from a "gray darkening" to "light perception only" coincident with elevated serum levels of glycine. Electroretinograms consistently demonstrated a loss of oscillatory potentials only in those patients with visual impairment. Thirty-hertz "flicker-following" was also attenuated. The excessive serum levels of glycine may contribute to visual impairment and may account for the dropout of oscillatory potentials generated by the retina due to glycine's role in the retina as an inhibitory transmitter. PMID- 3675284 TI - Complications of clear lens extraction in axial myopia. AB - Clear lens extraction is a refractive surgery used to compensate axial myopia. Formerly, intracapsular lens extraction was performed, but the present surgical method is extracapsular lens extraction or phacoemulsification. Clear lens extraction is becoming controversial because of the danger of complications. We retrospectively reviewed the postoperative complications in 33 eyes of 20 patients who underwent clear lens extraction at other institutions between 1966 and 1984. Twelve patients (60%) had motility disturbances. Eight (24%) of 33 eyes suffered secondary glaucoma; ten (30%), retinal detachment; 12 (36%), lens remnants in the pupillary space; and six (18%), blindness caused by clear lens extraction or by additional surgery performed by us while attempting to improve a poor prognosis. Clear lens extraction appears to be contraindicated in the young, in those with axial diameters greater than 29 mm, and in those presenting with peripheral chorioretinal degeneration. Moreover, clear lens extraction does not avoid the progression of myopia at the posterior segment. We suggest the use of safer, noninvasive, reversible alternatives. PMID- 3675287 TI - The afferent pupillary defect in asymmetric glaucoma. AB - The OCTOPUS 2000 perimeter and a central 30 degrees program were used to study consecutively 27 patients with glaucoma who had either a relative afferent pupillary defect (APD) or asymmetric optic nerve cupping without an APD. The mean difference in visual field sensitivity between fellow eyes was 48.2% (range, 13% to 93%) for the APD group and 5.5% (range, 0% to 9.0%) for the non-APD group. The mean difference in cup-disc ratio was 0.43 (range, 0.2 to 0.6) for the APD group and 0.24 (range, 0.2 to 0.3) for the non-APD group. The APD depth was quantitated with neutral density filters and correlated with visual field asymmetry but not with cup-disc ratio asymmetry. There was no overlap between the APD and non-APD groups in the amount of visual field asymmetry: Every patient with a sensitivity difference of 13% or greater had an APD. The presence of an APD indicates that a threshold of asymmetric optic nerve damage has been exceeded. With automated perimetry, this threshold can be quantitated and may improve the assessment of patients with glaucoma. PMID- 3675288 TI - Normal variability of static perimetric threshold values across the central visual field. AB - We assessed the variability of results in normal subjects of computerized static threshold perimetry of the central 30 degrees field. Variability of measured threshold values was highly dependent on eccentricity. This included variability among individuals, test-to-test variability within individuals, and intratest variability. All values were significantly larger in the midperiphery than centrally. We found that the mean sensitivity decrement with age was eccentricity dependent, so that the age-corrected normal visual field became not only depressed but also steeper with age. Distributions of individual pointwise deviations from the age-corrected normal mean thresholds were significantly nongaussian. The dependency of variability on test point location, the nongaussian distributions of deviations from age-corrected means, and the variability of age-induced sensitivity reduction should all be considered in the interpretation of computerized visual fields, and particularly in the design of statistical programs for field analysis. Programs not considering these factors are likely to result in misleading analyses. PMID- 3675289 TI - Anterior segment fluorophotometry in acute anterior uveitis. AB - Anterior segment fluorophotometry was used to assess the severity of blood aqueous barrier disruption in 25 patients with acute anterior uveitis. The results indicated that HLA-B27-positive patients had a more severe inflammation than did HLA-B27-negative patients, which was not discernible when judged by clinical signs and symptoms. Follow-up studies showed that the blood-aqueous barrier was disturbed for longer than the clinical signs indicated, and sometimes a temporary subclinical relapse was demonstrated on early withdrawal of topical therapy. The blood-aqueous barrier appeared to be restored after each attack of acute anterior uveitis in the majority of patients, with no evidence of progressive damage from repeated attacks. Our results indicated that fluorophotometry provides an objective and sensitive method of assessing anterior uveitis. PMID- 3675290 TI - Sympathetic ophthalmia complicating helium ion irradiation of a choroidal melanoma. AB - Sympathetic ophthalmia was diagnosed 49 months after helium ion irradiation of a left choroidal melanoma. The patient maintained good vision until 18 months after therapy, when she developed neovascular glaucoma. This complication required multiple therapeutic procedures, including topical anti-inflammatory and antiglaucomatous drops, 360 degrees peripheral panretinal cryoblation, and a single 180 degrees application of inferior cyclocryotherapy over a 2 1/2-year period. Four weeks after the cyclocryotherapy, inflammation was noted in both eyes, and, one month later, enucleation of the left sympathogenic eye was performed. Serial histopathologic sections showed a full-thickness, fibrovascular, scleral scar and tantalum marker ring suture without uveal incarceration. Penetrating surgical trauma, a uveal melanoma, and multiple nonpenetrating treatments resulted in the development of sympathetic ophthalmia. PMID- 3675291 TI - Fetal alcohol syndrome. Eye malformations in a mouse model. AB - Acute maternal ethanol administration on gestational day 7 (gastrulation stage) in C57Bl/6J mice results in a spectrum of ocular malformations. A deficiency in the anterior neural plate observable within 24 hours of exposure results in corresponding defects in the optic sulcus and subsequent optic vesicle. Deficiency in the size of the lens vesicle induced by a small optic vesicle is demonstrable as microphakia in older embryos. Delayed detachment of the lens vesicle from the surface ectoderm manifests in the live offspring as progressive corneal opacification and vascularization related to defects in corneal endothelium and Descemet's membrane. Anterior segment dysgenesis results in persistent iridocorneal adhesions, dyscoria, and abnormal formation of the anterior chamber. In contrast, ethanol exposure on day 8 of gestation did not result in eye malformations. Thus, it appears that many of the ocular abnormalities associated with fetal alcohol syndrome may result from an acute insult to the optic primordia during a very specific period that corresponds to the third week after fertilization in the human. PMID- 3675292 TI - Chemotactic activity of lens proteins and the pathogenesis of phacolytic glaucoma. AB - Leakage of lens proteins from a hypermature cataract can result in a characteristic glaucoma that is associated with the invasion of the anterior chamber by monocytes. We hypothesized that the lens proteins themselves might account for the monocyte response. A sonicated lens induced concentration dependent migration of monocytes in a Boyden chamber assay system. Checkerboard analysis indicated that the movement was directed rather than merely random. Relative to a control chemoattractant, N-formyl-methionyl-leucyl-phenylalanine, the lens induced monocyte migration more potently than neutrophil migration. The ability to induce migration was markedly reduced by incubating the lens with either trypsin or papain. Chemotactic activity was readily demonstrable in lenses from young donors without cataracts. Separation of lens proteins by gel filtration with high-performance liquid chromatography indicated that the chemotactic activity was most consistently associated with the gamma crystallin fraction. The chemotactic activity of lens proteins may contribute to the pathogenesis of phacolytic glaucoma or the uveitis resulting from retained cortical material after cataract extraction. PMID- 3675293 TI - Encapsulated filtering blebs. PMID- 3675294 TI - The removal of silicone oil from the anterior chamber in phakic eyes. AB - The appearance of large silicone oil globules in the anterior chamber of phakic eyes leads to serious intraoperative and postoperative problems. Using hyaluronate sodium, the silicone can be safely removed from the anterior chamber, the crystalline lens may be saved, and the posterior segment procedure can be completed. PMID- 3675295 TI - An improved needle holder for scleral buckling surgery. AB - A new needle holder was designed to provide the surgeon with a stout-angled jaw and a round locking handle. It is useful for holding large needles commonly used in scleral buckling surgery. PMID- 3675296 TI - Ophthalmology in Peru. PMID- 3675297 TI - The role of saccular afferents in vertical optokinetic nystagmus in primates. A study in relation to optokinetic nystagmus in microgravity. AB - After bilateral sacculectomies, the squirrel monkey's vertical optokinetic nystagmus showed a gain increase of slow-phase down-nystagmus and a gain decrease of the slow-phase up-nystagmus. The nystagmus beating field of the former shifted upward but that of the latter did not change clearly. These results are in general agreement with the findings in man during the recent shuttle flight and indicate the functional linkage of saccular afferents to the vertical optokinetic nystagmus. PMID- 3675298 TI - The caloric vestibular test in weightlessness. AB - Although the theoretical background for the caloric vestibular test was assumed to be known, recent studies in weightlessness have thrown doubts on the original theory of its mechanism. It is most likely that several mechanisms are involved in the generation of caloric nystagmus in addition to the convection current theory. Experiments with the caloric test in humans conducted during parabolic flight are described. These results are compared with the results of similar experiments performed in orbital missions. PMID- 3675299 TI - Electrocochleographic study of experimentally induced endolymphatic hydrops. AB - An endolymphatic hydrops was induced in the left ear of each of 32 guinea pigs by obliteration of the endolymphatic sac. Both the hydropic ear and the control ear were examined by electrocochleography 1, 2, 4 or 8 months after obliteration of the sac using electrodes on the apex and near the round window. One month after obliteration, the threshold of the compound action potential (AP) and the increase of the AP amplitude with sound pressure level (SPL) were the same as the results recorded from the control ears despite the presence of a histologically confirmed hydrops. In the 2-month group, small AP threshold differences (10-20 dB) were recorded, increasing up to 10-40 dB in the 4- and 8-month groups. In the latter animals we also found a more rapid increase of the AP amplitude with SPL, a finding suggestive of recruitment. In the 1-month group we recorded an enhanced negative SP for 2- and 4 kHz stimuli when the electrode was placed near the apex. The same was recorded for 4-kHz stimuli in the 2-month group. In the 4- and 8 month groups there was a tendency towards a decrease in the negative SP. The SP AP ratio recorded from the apical position showed the same pattern as the SP amplitude, an increase after 1 month and a tendency to decrease in the following months. Near the round window there was no significant effect of hydrops on the SP amplitude or on the SP-AP ratio. A deviation in the AP-SP wave form was recorded in 69% (22/32) of the guinea pigs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675300 TI - Histopathological study of experimentally induced endolymphatic hydrops with emphasis on Reissner's membrane. AB - We investigated the histopathological changes of the guinea pig cochlea in experimentally induced endolymphatic hydrops 1, 2, 4 and 8 months after obliteration of the endolymphatic sac. In this paper special attention is given to the morphological changes created in Reissner's membrane. Reissner's membrane showed various foldings, bony wall connections, local thickenings, duplications, mesothelial defects, ruptures and atrophy. The incidence of these changes increased with survival time. The stria vascularis and hair cells showed degeneration starting apically and proceeding towards the cochlear base. The possible implications of these findings are discussed. PMID- 3675301 TI - A functional and histological study of the combined effects of gentamicin and aminooxyacetic acid on the organ of Corti of the guinea pig. AB - Aminooxyacetic acid (AOAA) is a transaminase inhibitor that has been shown to protect the inner ear from loud noises. This study was done to determine if it can also protect against the cochleotoxic action of gentamicin. Four groups of guinea pigs were injected with gentamicin in doses approximating a clinical therapeutic dose and then in ototoxic doses. Thereafter animals were treated with parenteral AOAA. The effect on hearing was investigated using Preyer's reflex measurements. All animals were sacrificed and their cochleas were examined histologically using the surface preparation technique and mid-modiolar semithin sections. Histocochleograms were plotted to compare the effects of treatment in the animal groups. There was no difference seen among the groups tested. Cochlear damage was nearly equal in all animals, and AOAA was not found to protect the cochlea against gentamicin-induced ototoxicity of gentamicin. The mechanism of the ototoxicity produced is discussed on the basis of the findings. Additionally, hair cell degeneration was studied after therapeutic doses of gentamicin. Changes seen were found to be equal to or less than 5% of the hair cells and were scattered throughout the entire cochlea. PMID- 3675302 TI - A clinical correlation between hypozincemia and tinnitus. AB - We examined a group of 115 patients suffering from tinnitus and have attempted to find a statistically significant correlation between the tinnitus experienced and low blood zinc levels (hypozincemia). No particular correlation could be made between the nature of the tinnitus experienced and hypozincemia except for the continuation of head noises, these being more frequently associated with hypozincemia when they are intermittent. Two hypotheses of pathogenesis are proposed to explain this phenomenon and are based on the importance of zinc to the syntheses of enzymes and proteins. PMID- 3675303 TI - Fish oil inhibits development of atherosclerosis in rhesus monkeys. AB - The effect of feeding fish oil (Menhaden) on the progression of rhesus monkey atherosclerosis was determined by feeding diets containing 2% cholesterol and either 25% coconut oil (Group I), 25% fish oil/coconut oil (1:1) (Group II), or 25% fish oil/coconut oil (3:1) (Group III) for 12 months (n = 8/group). The average serum cholesterol levels were 875 mg/dl for Group I, 463 mg/dl for Group II, and 405 mg/dl for Group III. HDL cholesterol levels were 49 mg/dl for Group I, 29 mg/dl for Group II, and 20 mg/dl for Group III. An average of 79% of the aortic intima was involved with atherosclerosis in Group I, 48% in Group II, and 36% in Group III. The aortas of both fish-oil groups (II or III) contained significantly less cholesterol (total, free, and esterified), as well as less acid lipase, cholesteryl esterase, and ACAT activities when compared to the coconut-oil group (I) (p less than 0.05). Microscopically, the aortic and carotid artery lesions were smaller in cross-sectional area and in thickness, and contained less macrophages in the fish-oil groups (II and III) when compared to the coconut-oil group (I) (p less than 0.05). This protective effect was not consistently enhanced by increasing the proportion of fish oil to 3:1 (Group III) over 1:1 (Group II). The results indicate that fish oil-containing diets reduce serum cholesterol levels and inhibit atherosclerosis even in the face of lowered HDL cholesterol levels when compared to a pure coconut oil/cholesterol diet in rhesus monkeys. Therefore, fish-oil diets exert effective protective control of progression of atherosclerosis during severe atherogenic stimuli. PMID- 3675304 TI - Unsaturated fatty acids enhance low density lipoprotein uptake and degradation by peripheral blood mononuclear cells. AB - The precise mechanism by which unsaturated fatty acids lower low density lipoprotein cholesterol is not known. Because cis-unsaturated fatty acids incorporated in cell membranes increase membrane fluidity and can thereby dramatically alter membrane-dependent cellular functions, we examined the effect of linoleate and oleate incorporation in peripheral blood mononuclear cell membranes on the physical properties of the membrane and concomitantly on low density lipoprotein uptake and degradation. We found that membrane enrichment with linoleate increased the rate of low density lipoprotein degradation in both freshly isolated and derepressed mononuclear cells. Enrichment with oleate led to similar increases in degradation. "Specific" low density lipoprotein uptake by derepressed cells was also enhanced by linoleate and oleate incorporation. Enrichment with both of these fatty acids produced an increase in membrane fluidity, as indicated by a reduction in the steady-state fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene incorporated in the membrane. In contrast, stearate enrichment had little effect on uptake or degradation of low density lipoprotein, nor did it affect membrane fluidity. These data point to a novel mechanism for the reduction in low density lipoprotein produced by unsaturated fatty acids that involves their physical effects on cell membranes as it relates to metabolism of the lipoprotein. PMID- 3675305 TI - Regulation of vascular smooth muscle cell growth by endothelial-synthesized extracellular matrices. AB - Previous work has demonstrated that aortic endothelial cells (EC) produce a heparin-like inhibitor of smooth muscle cell (SMC) growth when both cell types were cultured on plastic. We have now tested the influence of the extracellular matrix on this EC-SMC interaction. Specifically, we examined: 1) the role of different substrates (plastic, fibronectin, monomeric, and fibrillar collagens I and III, and EC-derived matrices) on the growth rate and population density of SMC; 2) the heparin-sensitivity of SMC on these diverse substrates; and 3) the effect of these same substrates on EC ability to secrete heparin-like and polypeptide inhibitors of SMC growth. SMC demonstrated a sixfold difference in sensitivity to heparin when grown on different substrates, with the following rank order: EGTA matrix greater than collagens = plastic = fibronectin greater than deoxycholic acid (DOC) matrix. Maximally, we found a 10-fold difference in the potency of the inhibitory activity secreted by EC grown on different substrates, with the following order: plastic = EGTA matrix greater than fibronectin greater than collagens = DOC matrix. Treatment of the conditioned mediums with heparinase and trypsin indicated that 58% to 76% of the inhibitory activity was due to heparin-like species, and 24% to 42% was due to protein(s). When EC cultured on EGTA matrix are compared to those pleated on DOC matrix, the potency of the heparin-like and peptide inhibitory activities increased 8- and 17 fold, respectively. Hypothetically, one would predict a 60-fold change in the potency of the antiproliferative effect if the contributions of substrate to EC production of inhibitors and SMC sensitivity were additive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675307 TI - Physiological markers of smoking and their relation to coronary heart disease. The Lipid Research Clinics Coronary Primary Prevention Trial. AB - Several physiological variables which have previously been found to be associated with extent of cigarette smoking were investigated in a population selected to be free of existing coronary heart disease yet having high circulating cholesterol levels. Of these variables, white blood cell count had the strongest association with the extent of smoking. The addition of hematocrit and heart rate to white blood cell count strengthened the association. Given these three variables, however, other physiological variables had a minor effect on the association. Finally, the combination of these three physiological variables was more strongly predictive of subsequent coronary heart disease than was self-reported smoking level. PMID- 3675306 TI - Accelerated rates of collagen synthesis in atherosclerotic arteries quantified in vivo. AB - Rates of arterial collagen and noncollagen protein synthesis were quantified in vivo in rabbits maintained for 4 months on a control diet or the same diet supplemented with 2% peanut oil and 0.25% cholesterol. Thoracic aortas from animals fed the atherogenic diet exhibited raised lesions covering 75% to 100% of the surface. The dry delipidated weight and collagen content of these arterial segments both were significantly increased. The rates of protein synthesis were determined in rabbits given a bolus intravenous injection of 3H-L-proline (1.0 mCi/kg) and unlabelled proline (7 mmol/kg) to attain steady-state levels of specific radioactivity of free proline in plasma and tissues. Plasma proline specific activity decreased only 20% over a 5-hour period and was similar to free proline in arterial tissue, skin, and lung. Collagen synthesis rates (ng/mg dry delipidated weight per hour) were increased 10-fold in the intima plus inner media of atherosclerotic thoracic aortas compared with controls. Rates of collagen synthesis were also increased in the abdominal aortas, whereas protein synthesis in lung and skin was unaffected by diet. Increased rates of collagen synthesis in atherosclerotic arteries significantly exceeded the increases in noncollagen protein synthesis. In addition, collagen synthesis rates in vivo were 12 to 20 times greater than previously measured in vitro. These results demonstrate for the first time in vivo that collagen accumulation in the developing atherosclerotic plaque is in part due to accelerated rates of collagen synthesis by intimal smooth muscle cells. PMID- 3675309 TI - Abstracts. 41st annual meeting, Council on Arteriosclerosis, American Society for the Study of Arteriosclerosis. Anaheim, California, November 1987. PMID- 3675308 TI - Effect of gender, age, and lipid status on low density lipoprotein subfraction distribution. Results from the Framingham Offspring Study. AB - The presence of low molecular weight low density lipoprotein (LDL) particles in plasma has been associated with premature coronary artery disease. In this study we have examined factors affecting LDL subfraction distribution as determined by 2% to 16% polyacrylamide-agarose gradient gel electrophoresis of whole plasma in a normal, primarily middle-aged, population of adult male and female participants (n = 280, ages 25 to 75 years) in the Framingham Offspring Study. Seven major LDL bands (LDL-1 to LDL-7) were observed in different individuals, with most subjects having either one or two major bands. The presence of low molecular weight LDL (LDL-4 to LDL-7) in plasma as the predominant LDL type was significantly more common in men than in women (43.5% versus 14.8%, p less than 0.001). The presence of low molecular weight LDL was correlated (p less than 0.01) with increased age, plasma triglyceride, total cholesterol, very low density lipoprotein (VLDL) cholesterol, LDL cholesterol (in women only), and apolipoprotein (apo) B concentrations, as well as with decreased high density lipoprotein (HDL) cholesterol and apo A-I levels. Approximately 69% of the variability in LDL subfractions could be accounted for by alterations in plasma triglyceride and HDL cholesterol levels. These data are consistent with the concept that LDL subfraction distribution is influenced by gender and plasma lipoprotein levels and can be determined readily by the use of whole plasma. PMID- 3675310 TI - Rate and filter effects on the developing middle-latency response. AB - Auditory middle-latency responses (MLRs) were obtained from 71 unanesthetized gerbils ranging in age from 10 to greater than 90 days. Effects of age, stimulation rate, high- and lowpass filter settings and filter slope were examined. MLR amplitude decreased significantly with increased stimulation rate at all ages, at rates up to 40/s. The detection of MLR waves (presence or absence) varied inversely with the rate of stimulation only in immature subjects. The amplitude of waves B (15 ms) and C (25 ms) was significantly larger with a highpass filter setting of 3 Hz as compared to 10 and 30 Hz. This effect was significantly more pronounced in developing animals as compared to adults. MLR amplitude was greater with a filter slope of 6 dB/octave as compared to 48 dB/octave, (10-2,000 Hz) and this effect was also significantly greater in developing animals than in adults. There was no interaction between lowpass filter setting and age (100 vs. 2,000 Hz). A prominent positive wave occurring at approximately 50 ms was present in the 48 dB/octave condition although it was not observed with 6 dB/octave filtering. The clinical use of the MLR requires a better understanding of the effects of stimulus and recording procedures on the response, and how they vary as a function of subject age. PMID- 3675311 TI - Rate and filter dependence of the middle-latency response in infants. AB - Auditory evoked-potential activity in the 0 to 100-ms latency range was explored using wide-band filtering and a range of stimulus rates, in 8 babies ranging in age from 2 to 6 months. We observed both a stable early positive peak, in the 10 to 15-ms region, and a rate-dependent, positive peak at about 50 ms in all 8 babies. The latter response was best observed at rates of 1-2.5 stimuli/s and seldom observed at rates above 4/s. This peak may represent a developmentally early version of the Pa peak of the adult middle-latency response. PMID- 3675313 TI - Validation of the pediatric speech intelligibility test in children with central nervous system lesions. AB - The pediatric speech intelligibility (PSI) test was administered to 21 children with a variety of documented central nervous system (CNS) lesions. Ages ranged from 3 to 8 years. PSI test results demonstrated both high sensitivity and high specificity. Results were consistently (1) abnormal in children with lesions in areas of the brain important for auditory function (CNS auditory disorders) and (2) normal in children with lesions in areas anatomically remote from auditory nuclei and pathways (nonauditory CNS disorders). PMID- 3675312 TI - Brainstem electric-response audiometry in infants of a neonatal intensive care unit. AB - Brainstem electric-response audiometry was used to assess the auditory function of 600 infants from a neonatal intensive care unit. Two groups of children were tested, one group as inpatients prior to discharge with a mean age at test of 39.4 weeks and one group as outpatients with a mean age at test of 55.4 weeks. Our results indicate that testing infants when they are older will reduce the incidence of failure on the initial evaluation and will reduce the identification of transient hearing losses which resolve spontaneously. Our results also indicate that a threshold of 30 dB nHL or less is probably normal and that some infants with a threshold of 40 dB nHL at first test require otological or audiological management. PMID- 3675314 TI - Age-related morphological changes in auditory middle-latency response. AB - Age-related changes in the waveforms of the middle latency response (MLR) were investigated in 9 adults and 28 children aged between 4 and 14 years. The children were classified into three groups according to their age. For obtaining characteristic configurations in the responses for each group, composite group averaging was performed by summating the individual recordings in each group. With high-pass digital filtering at 20 Hz, composite MLR for adults showed a well defined Na-Pa-Nb-Pb complex with peak latencies at about 17, 30, 45 and 63 ms, respectively. The composite response for children aged 4-7 years was characterized by a broad positive deflection (Pa) followed by a negative peak (Nb) at about 40 and 60 ms after stimulus onset, respectively. The peak latency of Pa was close to the adult value in the composite MLR for subjects aged 8-11 years, while the complete adult pattern in the later part of the response was not reached even in the composite response for subjects aged 12-14 years. PMID- 3675315 TI - Quality assurance in health care in Victoria. Task Force on Quality Assurance. PMID- 3675316 TI - First year evaluation of a private MRI facility. AB - OBJECTIVE: To review the first years experience of the only private MRI facility in Australia. METHOD: Utilisation Review. RESULTS: 1497 scans have been comprehensively analysed, with regard to the efficacy of the procedure in examining the brain, spinal cord, the lumbar region and the knee joint. PMID- 3675317 TI - An audit of upper gastrointestinal endoscopy in Australian facilities--results of a pilot study. AB - OBJECTIVE: To test the endoscopy audit protocol for larger prospective study. METHOD: Prospective medical audit. RESULTS: Sixty two endoscopies provided both patient data and suggestions for improvement in the protocol. PMID- 3675319 TI - Quality assurance issues for the future from an Australian perspective. PMID- 3675318 TI - The use of nasogastric tubes after abdominal surgery--a criteria audit. AB - OBJECTIVE: To evaluate the use of nasogastric tubes after gastrointestinal surgery. METHOD: Prospective criteria audit. RESULTS: In this study, 32.5% of patients (65/200) undergoing laparotomy had a nasogastric tube inserted during the perioperative period. Of these patients, 20% vomited whilst the tube was in situ and there was a poor correlation between the volumes of fluid aspirated and the timing of tube removal. These results suggest that nasogastric tubes were inserted too often and then left in situ for too long. PMID- 3675320 TI - Musculoskeletal medicine. Time for scientific method. PMID- 3675321 TI - Doctors or dictators. PMID- 3675322 TI - Opiate intoxication. PMID- 3675323 TI - Sex advice for adolescents. PMID- 3675324 TI - Therapeutic snake bite. PMID- 3675325 TI - The pinch test. PMID- 3675326 TI - Whiplash. PMID- 3675327 TI - The thoracic spine and its pain syndromes. PMID- 3675328 TI - Management of the hand in rheumatoid arthritis. PMID- 3675329 TI - Muscle energy therapy. PMID- 3675330 TI - Surgical relief for the painful shoulder. PMID- 3675331 TI - The painful tendon. A pathophysiological approach. PMID- 3675332 TI - Management of common fractures of the upper limb. PMID- 3675333 TI - Alpine skiing--injuries and prevention. PMID- 3675334 TI - Rheumatoid arthritis. PMID- 3675336 TI - Surgical treatment of a chalazion or hordeolum internum. PMID- 3675335 TI - Treatment of common eyelid cysts. PMID- 3675338 TI - Hydrotherapy pools. PMID- 3675337 TI - Hazards of cross country skiing. PMID- 3675339 TI - Care of the malformed neonate. A continuing cause for concern. PMID- 3675340 TI - Developments in consulting skills. PMID- 3675341 TI - The painful foot. An overview of podalgia. PMID- 3675342 TI - Vascular causes of the painful foot. Diagnosis and management. PMID- 3675343 TI - Painful skin conditions of the foot. PMID- 3675344 TI - Stress fractures of the foot. PMID- 3675345 TI - Foot orthoses. Simple prescriptions can mean dramatic pain relief. PMID- 3675346 TI - Plantar fasciitis. PMID- 3675348 TI - Anatomy of a shoe. PMID- 3675347 TI - Morton's neuroma. PMID- 3675349 TI - Gout. PMID- 3675350 TI - Herpes zoster in general practice. PMID- 3675351 TI - Improve your medical practice. Start thinking like a marketeer. PMID- 3675353 TI - Laboratory oddities: the ESR. PMID- 3675354 TI - Prostatitis. PMID- 3675352 TI - Alcohol: hazardous, harmful and dependent use. Recognition and management. PMID- 3675355 TI - Foot deformity in the neonate. PMID- 3675356 TI - Lumbar puncture and cerebrospinal fluid examination. PMID- 3675357 TI - The problems of resuscitation. Part 1: Modern dilemmas. PMID- 3675358 TI - Teamwork. PMID- 3675359 TI - The ghost that haunts us--AIDS. PMID- 3675360 TI - A pharmacist's point of view. PMID- 3675361 TI - Respiratory infections: when to use antibiotics. PMID- 3675362 TI - The rational prescribing of antimicrobials. PMID- 3675363 TI - The use of antibiotics in general practice. PMID- 3675364 TI - Urinary tract infections: in hospitals and the community. PMID- 3675365 TI - Urinary infection: public and private. PMID- 3675366 TI - Think 'CBA' for antimicrobial therapy. Revised version. PMID- 3675367 TI - Surgical infection--prevention. PMID- 3675369 TI - The problems of resuscitation. Part 2: The efficacy of resuscitation. PMID- 3675368 TI - Musical epilepsy--a neurological oddity. PMID- 3675370 TI - The laboratory diagnosis of sexually transmitted diseases. PMID- 3675371 TI - Marketing in medical practice. Part one. PMID- 3675372 TI - Congenital ear deformities. PMID- 3675373 TI - The fragile (X) syndrome. PMID- 3675374 TI - Health education on epilepsy. PMID- 3675375 TI - The practicalities of acupuncture practice. PMID- 3675376 TI - Sharing research ideas. PMID- 3675377 TI - When is a hostel not a hostel? PMID- 3675378 TI - Adolescent parenting education: the WA experience. PMID- 3675379 TI - Operation cover-up: a nursing intervention with a difference. PMID- 3675380 TI - Nurse & the law. When the customer is always right. PMID- 3675381 TI - New anti-arrhythmia. Part II. PMID- 3675382 TI - AIDS 1987. PMID- 3675383 TI - Juvenile rheumatoid arthritis in Auckland: a long term follow-up study with particular reference to uveitis. AB - Although features of juvenile rheumatoid arthritis (JRA) have been well described in British, American, and to a lesser extent Australian communities we can find no previous study of the clinical characteristics of this disease in a New Zealand population or indeed in any population containing Polynesians. In a follow-up study of 55 Auckland residents with juvenile rheumatoid arthritis, current information was obtained for 78% of the study group with a mean interval from disease onset to follow up of 9.3 years. The outcome for the group as a whole was excellent although patients with a polyarticular course, regardless of onset subtype, had a poorer outcome with respect to both ongoing disease activity and functional disability. Polynesian patients were represented in all onset subtypes in proportion to their frequency in the general community and there was no recognisable influence of race on the course of the disease. Despite careful ophthalmological examination only one case of mild uveitis was detected, a much lower incidence than in British and American reports. PMID- 3675384 TI - Variation in death certification of ischemic heart disease in Australia and New Zealand. AB - This study was designed to test the hypothesis that the between-State variation in death rates from ischemic heart disease may be due in part to variation in the manner in which death certificates are completed or the diagnoses on them are assigned numerical codes. Random samples of 75 doctors who had recently completed a death certificate in an Australian State or in Auckland, New Zealand, as well as all doctors who had recently completed a death certificate in the Northern Territory were asked to participate. They were sent a book of 10 actual case histories and asked to complete a death certificate for each case. Seventy per cent of the doctors returned death certificates (range from 64% to 81%). Each certificate was coded by the Australian Bureau of Statistics (ABS) in the doctor's State of residence, or by the New Zealand Health Statistics Centre for Auckland respondents, and then coded again by the federal office of the ABS in Canberra. There was considerable variation in the codes assigned to each case history but systematic variation large enough to account for the variation in between-State ischemic heart disease death rates was not seen. There was little systematic variation between codes assigned in each State and by the federal ABS office, although a few isolated discrepancies were identified which need attention by the ABS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675385 TI - Acute scleroderma in stable mixed connective tissue disease: treatment by plasmapheresis. AB - This report describes a case of stable mixed connective tissue disease (MCTD) with development of acute scleroderma with hypertension, oliguric renal failure, microangiopathic hemolytic anemia, and pulmonary infiltrates. The renal histology in the acute episode was that of scleroderma with intimal sclerosis and 'onion skinning' of vessels and glomerular ischemic injury but with no evidence of damage by immune complexes either histologically or by immunofluorescence. improvement occurred after treatment with plasmapheresis, cyclophosphamide, and captopril with return of near normal renal function. PMID- 3675386 TI - Localising value of primary position upbeating nystagmus. AB - Primary position upbeating nystagmus has been associated clinically with intra axial brainstem and cerebellar lesions but evidence for more precise localisation to the ponto-mesencephalic and ponto-medullary junctions is accumulating. We report the occurrence of primary position upbeating nystagmus in three patients who had clinical signs of pontine lesions at the ponto-mesencephalic and ponto medullary junctions. Radiological confirmation was possible in two cases. PMID- 3675387 TI - Intravenous catheter-associated Staphylococcus epidermidis bacteremia in hematology/oncology patients. PMID- 3675388 TI - Continuing education and peer review in internal medicine (CEPRIME) PMID- 3675389 TI - Hodgkin's disease presenting with central nervous system involvement. PMID- 3675390 TI - Hepatic resection for colorectal metastases--selection of cases and determinants of success. AB - Twenty-six patients undergoing hepatic resection for colorectal metastases have been followed for periods varying from 1 month to 8 years. The actuarial 5 year survival rate was just over 50% for all patients. Patients surviving for more than 2 years have been considered separately, and an attempt was made to determine what clinical factors determine whether a patient is likely to benefit from surgery or not. A stage I hepatic lesion, involvement of one rather than both lobes, the presence of less than four metastases and pathological proof that resection margins were free of tumour combined to define a group of patients with a 75% 5 year survival rate. The stage of the disease and the presence of unilobar metastases were the most important determinants of benefit. Patients demonstrating one or more unfavourable factors did not appear to benefit from hepatic resection. PMID- 3675391 TI - Benign biliary strictures: a proposed combined surgical and radiological management. AB - A combined surgical and radiological approach to the management of complex biliary strictures is described. Radiological access for stricture dilatation or stone extraction is created at the time of surgery either by insertion of a transhepatic U-tube or superficial fixation of the afferent limb of the Roux-en-Y loop. Each of seven patients treated in this way had multiple complicating factors known to adversely affect the outcome of operative repair. Five of the seven have had an excellent outcome at a median follow-up of 15 months (mean 21 months, range 2-39 months). PMID- 3675392 TI - An assessment of trauma management in the Wellington region. AB - Trauma is one of the leading causes of death and disability. In an effort to reduce mortality and morbidity from trauma changes to the methods of delivery of trauma care have been proposed, with the establishment of trauma units in Europe and the United States. There is little data to support the efficacy of these changes. This study reports the results of management of 311 multiple trauma victims from the time of the accident until the final outcome was known. The results cast doubt on some of the claims made which have been used to justify the establishment of trauma units. PMID- 3675393 TI - Appendicectomy in childhood: pathology found. AB - A review of the operation and pathology reports from 500 consecutive childhood appendicectomies by one surgeon revealed true acute appendicitis in 64% of patients, other pathology in 19.8% and normal operation findings and histology in 16.2%. When a normal appendix was found at operation, search of the adjacent peritoneal cavity produced a positive yield in 14% of searches, including abnormality in the small bowel in 4%, in the omentum or mesentery in 3% and in the female pelvic organs in 7%. Of appendices deemed normal by the surgeon 8.7% were histologically inflamed and of those deemed inflamed by the surgeon 3.5% were histologically normal. These figures emphasize the need for a more critical approach to the diagnosis of appendicitis both pre- and peroperatively and of the importance of histological examination of the organ. PMID- 3675394 TI - Auricular haematoma--treatment options. AB - The acute auricular haematoma following a blow to the external ear presents a number of treatment options. If a satisfactory final cosmetic result is to be obtained a minor surgical procedure of one sort or another must be performed to prevent a 'cauliflower ear'. Simple needle aspiration is often insufficient to prevent this complication. Different procedures are reviewed and a simple, reliable technique for treating the acute auricular haematoma is described. PMID- 3675395 TI - Validation of a prognostic index in breast cancer. AB - The validation of a prognostic index for patients with primary breast cancer is described. The actual survival data in a group of 383 patients was compared with expected survival predicted by an index based on axillary lymph node status, oestrogen receptor, progesterone receptor and age. There was no significant difference between actual and predicted deaths for five ranges of index value at 2 years and for the three highest ranges of index value at 5 years. However, in the two lowest ranges, the index significantly underpredicted deaths at 5 years. The Cox proportional hazards model was used to determine if there was any significantly better combination of coefficients and covariates to predict survival in the test group. The original index--1 = N + E + P + A, where N = 0 if no nodes are involved, 13 if one to three nodes are involved, and 31 if more than three nodes are involved; E = 15 if oestrogen receptor value is less than 10 fmol/mg cytosol protein and 0 otherwise; P = 12.5 if progesterone receptor value is less than 10 fmol/mg cytosol protein and 0 otherwise; and A = number of years over age 65--was as good as any competing model in ranking survival prospects in the test group. However, it was a less sensitive predictor in this group than in the original set of patients. A second index based on tumour size, hormone receptor status and age, for use when lymph node status was unavailable, was tested by the same method and validated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675396 TI - Limy 'milky' bile: without apparent gall-bladder obstruction by a gallstone. AB - Limy bile, characterized by excessive precipitation of calcium carbonate, is an uncommon complication of gallstone disease, and is a condition that seems to follow gall-bladder obstruction. Limy bile was observed at cholecystectomy in a 57 year old woman who presented with biliary colic. At operation a mass of precipitated cohesive crystals, that had coalesced into a whitish paste of calcium carbonate, was observed obstructing the outlet of the gall-bladder. This case report is unique in that calcium carbonate precipitation appears to have preceded gall-bladder obstruction. PMID- 3675397 TI - Isolated tuberculous hepatic abscess. AB - Tuberculous hepatic abscess occurs rarely, most of these being associated with tuberculosis at other sites. Only 11 reports of isolated tuberculous hepatic abscess have been made in the English literature. A further case of isolated tuberculous hepatic abscess is reported with particular emphasis on the difficulty that may be encountered in reaching the correct diagnosis. PMID- 3675398 TI - Some of the things the United States should learn from Australasian medicine and surgery. PMID- 3675399 TI - Resecting liver metastases. PMID- 3675400 TI - Craniofacial resection of extensive benign lesions of the anterior skull base. AB - The craniofacial resection operation was developed for the treatment of advanced nasal, paranasal and orbital malignancies. It has been refined in recent years, giving increased cure rates and better palliation when cure is not possible. When used to treat extensive benign lesions involving the anterior skull base, this procedure allows more complete and safer resection with better access for repair and avoidance of major complications of brain damage, cerebrospinal fluid leak and haemorrhage. Presented here is a technique for craniofacial resection. The study demonstrates its effectiveness and low morbidity in treating 10 patients with extensive benign disease. PMID- 3675401 TI - Marginal resection of the mandible in treatment of cancer of the floor of the mouth. AB - In a series of 253 excisions of cancer of the floor of the mouth, 57 marginal resections of the mandible retaining mandibular continuity were performed. Tumour recurred at the primary site in six of the 47 patients available for review at three years; three within the mandible itself. Three patients died with uncontrolled primary disease, but the other three survived after additional surgery and/or radiation therapy. Although this recurrence rate might appear high, the outcome of the total series is comparable with other reported series. The results do not finally demonstrate that marginal resection can be used freely, but the low morbidity and good functional results make the technique attractive. Further prospective study is needed to refine the indications for both conservation and ablation of the mandible. PMID- 3675402 TI - Surgical resection of oral and oropharyngeal cancer with pedicle flap reconstruction. AB - Seventy patients with squamous cell cancer of the oral cavity or oropharynx, because of advanced disease, or excision of residual or recurrent disease after radiotherapy required pedicle flap reconstruction. All were treated before 1 January 1976. Analysis of the outcome of these patients, some of whom were elderly, and most heavy smokers, showed that 17 (24.3%) survived 10 years or more. Age, metastatic neck nodes, and prior failure of radiation therapy to control the cancer did not seem to influence the prognosis significantly. It is concluded that, if patients are fit, and a reasonable quality of life can be assured with either a pedicle or vascularized free flap reconstruction, major resection is justified when technically feasible. PMID- 3675403 TI - A randomised comparison of three drainage systems following cholecystectomy. AB - The efficacy of low pressure, high pressure and passive drainage systems have been compared after cholecystectomy. Symptoms of pain, discomfort and nausea were compared using linear analogue scales and spirometry was used to examine pre operative and postoperative respiratory function. The low pressure suction drain removed an intraperitoneal marker, gentamicin, more effectively than the high pressure suction drain, but not more effectively than the passive drain. There were no differences in postoperative respiratory function nor in the amount of pain or discomfort between the groups. The passive drain group reported less nausea than the suction drain groups. If a negative pressure drainage system is to be used, a low pressure suction drain should be used in preference to a high pressure system. PMID- 3675404 TI - Severe pancreatitis--still a frequently mortal illness. AB - The treatment of severe pancreatitis remains a challenge. Eighty-six cases were retrospectively reviewed after treatment in intensive care units at two major Brisbane Hospitals between January 1980 and May 1986. Thirty-three patients died. Sixty-one patients had 97 operations, with 40% mortality. The severity of biliary and postoperative pancreatitis is highlighted. After early detection and aggressive resuscitation of severe cases, repeated debridement of necrotic pancreas and retroperitoneal slough may offer the best treatment. Marsupialization is an effective method of controlling sepsis after necrosectomy and abscess drainage. PMID- 3675405 TI - Major trauma in an urban New Zealand setting: resource requirements. AB - Patients with severe injuries, place significant demands on an institution's facilities and staff if these patients are to be treated adequately. In the USA, requirements for institutions managing patients with major injuries have been outlined and 'trauma centres' designated. In New Zealand, the requirements for care of patients with severe injuries have not been documented. One hundred and fourteen patients who presented to the Accident and Emergency Department at Auckland Hospital over a 6 month period were prospectively evaluated. All patients had Injury Severity Scores greater than or equal to 16 and the majority were young males. The greatest number of patients presented at night and during the weekend. Radiographic studies and resuscitation room procedures were commonly required and 54% of patients required surgery within the first 24 h after presentation. Management of patients required involvement by a large variety of specialties with general surgery, intensive care, anaesthetics, neurosurgery and orthopaedics more commonly involved. Sixty per cent of patients required intensive care admission and the overall group had a 30% mortality rate. This study confirms that major trauma in New Zealand patients places similar demands on resources to that experienced in the USA. Although health resources are currently limited, appropriate allocation of these resources must be considered to best treat patients suffering severe injuries. PMID- 3675406 TI - Ruptured spleen in the adult: an account of 205 cases with particular reference to non-operative management. Papua New Guinea Splenic Injury Study Group. AB - A series of 205 ruptured adult spleens, half of them due to personal assault, has been collected from several hospitals. In some of these cases a trial of non operative management has become standard practice unless other abdominal injuries are suspected. One hundred and thirty-seven cases were managed this way initially, successfully so in 80%. Splenectomy was performed in 70 patients with eight deaths; three of them in the 27 instances where non-operative management was said to have failed. None of these eight deaths was due to operative delay. PMID- 3675407 TI - Restorative proctocolectomy with ileal reservoir and ileoanal anastomosis: a clinico-physiological study. AB - The results of nine patients undergoing restorative proctocolectomy with ileal reservoir are presented. Mean frequency of defaecation per 24 h is 5.8. The reservoir was removed in one patient. Continence was normal in six patients and two had minor soiling. Manometry was normal in all except one with minor soiling and electromyography showed no features of sphincter denervation. PMID- 3675408 TI - Intraluminal pH measurement to monitor the vascular perfusion of free jejunal autografts: an experimental study. AB - An evaluation of the effect of ischaemia upon the intraluminal pH of microvascular free jejunal autografts was undertaken with a view to developing a monitoring system to be used clinically. Employing a canine model, the intraluminal pH of isolated jejunal segments was measured during normal perfusion and under conditions of arterial and venous occlusion. Ischaemia induced a rapid, easily measured fall in intraluminal pH reversible after 1 h of normothermic ischaemia. The most rapid pH change occurred within the first 10 min. It is felt that continuous intraluminal pH measurement may form a reliable method of monitoring the postoperative vascular perfusion of clinical free jejunal transfers. PMID- 3675409 TI - Reproductive patterns of pedigree cats. AB - A survey of Brisbane catteries was carried out to investigate reproductive patterns of pedigree cats. Eighteen breeders supplied data on 751 litters with a total of 3171 kittens covering the Persian, Chinchilla, Siamese, Burmese and Abyssinian breeds. The overall sex ratio at birth was 100 males to 92 females. There was a significant seasonal effect on sex ratio with litters conceived during the wet season (September to February) producing more males than expected and litters conceived during the dry season producing more females than expected. Litter size and breed had no significant effect on the sex ratio. The average litter size varied with the breed with the most prolific being the Burmese (5.0) then the Siamese (4.5), Persian (3.9), Abyssinian (3.5) and Chinchilla (2.8). The average litter size was smaller for the first litter than for the subsequent 3 litters. The maximum average litter size was reached at 6 years with only a moderate decline thereafter. There was a seasonal fluctuation in births with the greatest numbers being born in spring and the least in late autumn. Longhair cats showed a more marked seasonal distribution of births than the shorthairs which reproduced for most of the year, particularly the Burmese breed. PMID- 3675410 TI - Canine neural angiostrongylosis: the clinical and therapeutic features of 55 natural cases. AB - The clinical features of 55 naturally occurring cases of neural angiostrongylosis caused by the parasite Angiostrongylus cantonensis are described. The principal clinical feature is an ascending paresis of varying severity, mainly effecting the limbs and bladder. In severely affected animals the cranial nerves and central nervous system are affected. A distinguishing clinical sign is a variable severe lumbar hyperalgesia. For prognostic purposes the severity of the disease is divided into 3 grades. Recovery occurs in the first 2, however in the third, the most severe grade, animals do not recover. Corticosteroids and supportive nursing facilitate recovery and lessen the residual neurological dysfunction. Anthelmintics were included in the therapeutic regimen but their use worsened the signs. Death was recorded in association with the use of anthelmintics in cases that should have otherwise recovered. PMID- 3675411 TI - Natural establishment of thiaminase activity in the alimentary tract of newborn lambs and effects on thiamine status and growth rates. AB - Thiaminase activity was detected in the faeces of lambs at 2 to 5 days of age. Levels of activity increased for 10 days and then declined over the next 3 to 4 weeks. Decreased erythrocyte transketolase activity indicated thiamine insufficiency in lambs with high thiaminase activity. Mean growth rates were 17% less in lambs with high thiaminase activity than in lambs with zero or low thiaminase activity. Bacillus thiaminolyticus was the only organism isolated which produced thiaminase. Treatment of newborn lambs with intramuscular injections of sulphadoxine did not prevent them from excreting thiaminase in their faeces. It is proposed that oral thiamine supplementation of lambs at 2 to 3 weeks of age may be the most appropriate prevention and treatment for subclinical thiamine deficiency of the cause described. PMID- 3675412 TI - Curing experimental Bryophyllum tubiflorum poisoning of cattle with activated carbon, electrolyte replacement solution and antiarrhythmic drugs. AB - A slurry of activated carbon (activated charcoal) in electrolyte replacement solution given by stomach tube and antiarrhythmic drugs given parenterally cured 9 of 11 calves dosed 7 to 24 h previously with a lethal amount (20g/kg) of Bryophyllum tubiflorum flower heads. Two of another 4 calves treated 26 to 36 h after dosing with flowers survived. B. tubiflorum toxins are bufadienolides (cardiac glycosides). Activated carbon was effective at a single dose of 5 g/kg. Calves were rehydrated with oral electrolyte replacement solution at 150 ml/kg in divided doses over 24 h. Tachycardia was treated with intravenous lignocaine (200 mg doses) or propranolol (5 mg doses) and atrioventricular block with atropine (0.5 mg/kg). PMID- 3675413 TI - The effect of the accidental feeding of lasalocid sodium to breeder birds. PMID- 3675414 TI - Congenital malformation/absence of the left fourth aortic arch in a dog. PMID- 3675415 TI - The morphology of the ovine placenta in pregnancy toxaemia. PMID- 3675416 TI - A pemphigus foliaceus-like eruption associated with the use of ampicillin in a cat. PMID- 3675417 TI - Determination of the congenital myoclonus genotype of bulls by multiple ovulation embryo transfer. PMID- 3675418 TI - Feeding grain contaminated with Fusarium graminearum and Fusarium moniliforme to pigs and chickens. PMID- 3675419 TI - Blindness in kids associated with overdosage of closantel. PMID- 3675420 TI - Caseous lymphadenitis and tuberculosis. PMID- 3675421 TI - An evaluation of Newcastle disease virus spray vaccination programs of market turkeys. AB - Commercial market turkeys that were spray-vaccinated at 2 to 3 weeks of age with viable Newcastle disease virus (NDV) vaccine usually did not develop high or persistent levels of serum antibody as detected by the hemagglutination inhibition test. Vaccinated turkeys exhibited a satisfactory level of resistance to infection and clinical disease when challenged by the oculonasal or aerosol route at 2 weeks post-vaccination, and they resisted clinical disease when challenged at 6 weeks, but the level of protection diminished by 10 weeks post vaccination. It is suggested that market turkeys produced in an NDV-enzootic area may require two or more NDV vaccinations by spray during their growing period in order to be adequately protected against natural NDV infection. PMID- 3675422 TI - Evaluation of factors associated with infection of commercial layers with Mycoplasma gallisepticum and M. synoviae. AB - Information on factors possibly associated with the risk of infection with Mycoplasma gallisepticum (MG) or M. synoviae (MS) were collected from nearly 400 layer flocks in California. Factors associated with the probability of flock infection with either MG or MS were identified, and their magnitude was quantified by statistical analysis. More frequent administration of several vaccines was associated with decreased probability of both MG and MS infection of flocks. Also identified were housing or hygiene factors and system of management (i.e., multiple-age status) that could reduce the probability of infection of flocks with mycoplasma. The change in probability of MG infection resulting from modifying certain management factors was examined. PMID- 3675423 TI - Economic impact of Mycoplasma gallisepticum and M. synoviae in commercial layer flocks. AB - An egg-production function was constructed, using data collected from 366 commercial layer flocks in California, to predict the impact of Mycoplasma gallisepticum (MG) and M. synoviae (MS) on egg production while controlling for confounding factors. In the first and second cycles, respectively, an MG-infected flock produced 12 and 5 fewer eggs per hen than an uninfected flock. Flocks that became infected with MG after F-strain vaccination produced 6 eggs/hen more than unvaccinated infected flocks in the first cycle, but no significant difference was observed between such groups in the second cycle. No association was found between MS-infection and egg production. Commercial layer producers in Southern California lost an estimated 127 million eggs because of MG in 1984. This lost egg production and associated MG-control-program costs amounted to an estimated financial loss of approximately $7 million. This represented a loss of approximately $6 million in consumer surplus. PMID- 3675424 TI - A statistical model to optimize indirect sandwich enzyme-linked immunosorbent assay parameters of antigen and antibody: a microcomputer program. AB - A new computer software program "AVCRV" was developed using a statistical model to analyze the data from the indirect sandwich enzyme-linked immunosorbent assay (ELISA). The software program calculates a sigmoid type of regression analysis and can be run on most microcomputers in the laboratory. The program permits those who are not familiar with computers to complete this type of analysis in a few seconds without a large mainframe computer or complicated software. This statistical model for a sigmoid type of regression analysis of ELISA data may improve the analysis of research data for various avian pathogens from several different experiments. PMID- 3675425 TI - Emergence of amantadine-resistant H5N2 avian influenza virus during a simulated layer flock treatment program. AB - An experiment was designed to simulate field conditions in which preventive treatment is not initiated until after some chickens in a flock are infected with avian influenza (AI). Twelve hens began to receive amantadine hydrochloride on the day they were inoculated (day 0) with highly pathogenic AI virus, A/chicken/Pa/1370/83. These hens remained clinically normal through 8 days postinoculation (PI), but five died after day 9; mean death time (MDT) was 18 days. Three of 12 hens given amantadine beginning 1 day PI died (MDT 5.4 days), seven of 12 hens given amantadine beginning 3 days PI died (MDT 3.7 days), and all 12 inoculated hens not given amantadine died (MDT 4.9 days). The delayed mortality in the day 0 treatment group was likely due not to the original inoculum but to the emergence of a drug-resistant virus population. Virus isolated from a dead hen from that group was resistant to the actions of amantadine in both in ovo and in vivo tests. The lack of late mortality due to the drug-resistant virus in the day 1 and day 3 treatment groups, which were in close contact with the day 0 treatment group, was attributed to their becoming infected before treatment with the drug and to the development of protective immunity. PMID- 3675426 TI - Comparison of culturing Mycoplasma gallisepticum from fresh eggs and 18-day-old embryos. AB - Twenty-four 70-week-old and sixteen 27-week-old white leghorn hens were challenged with R strain Mycoplasma gallisepticum (MG) by injection into the caudal thoracic air sac and infraorbital sinus. Eggs were collected daily and cultured within 7 days or incubated for 18 days. Vitelline membranes of eggs were cultured directly; in 18-day-old embryos, cultures were taken from the yolk sac, air sacs, and oral cavity. Culture of vitelline membrane of eggs within 2 days was compared with culture of eggs stored 10 days post oviposition. The first MG positive egg was laid 2 days postinfection (PI). Hens continued to lay positive eggs to the end of the experiments. There was no significant difference in MG recovery between eggs cultured within 2 days and those cultured 10 days post oviposition. MG was isolated at a significantly higher rate from eggs than from 18-day-old embryos. MG was isolated at a higher rate from the yolk sac of 18-day old embryos than from the air sacs or oral cavity of the same embryos. PMID- 3675427 TI - Lack of protection against Bordetella avium in turkey poults exposed to B. avium like bacteria. AB - Six laboratory experiments were designed to determine whether poults infected with the nonpathogenic Bordetella avium-like (BAL) bacteria would develop immunity to B. avium (BA), the causative agent of turkey coryza. The BAL bacteria were isolated from poults given that organism, but few colonies were observed by 3 weeks postexposure. No serum-agglutinating antibody to the BAL bacterium was detected in poults exposed to that organism. Poults exposed to BAL bacteria either once or twice at different ages were not protected from infection or disease following experimental challenge between 1 and 7 weeks of age with pathogenic BA. PMID- 3675428 TI - The effect of Eimeria acervulina infection on hearts of young broiler chicks. AB - Hearts from 2-to-3-week-old broiler chicks that were inoculated with 2 X 10(6) sporulated oocysts/bird weighed significantly less than hearts from control chicks at 4 and 7 days postinoculation (PI). However, heart weights of infected chicks expressed as percentage of body weights were not significantly different from those of controls throughout the experiment. Infection also had no significant effect on heart protein content. Cardiac glycogen was significantly increased at 7 days PI but not at 4 days PI. Oxidation of both alpha-ketoglutaric and octanoic acids by mitochondrial preparations from hearts of infected chicks was significantly depressed at 4 days PI compared with controls; at 7 days PI, however, oxidation of octanoic acid was significantly increased, but that of alpha-ketoglutaric acid was not. PMID- 3675429 TI - Lyophilization of Mycoplasma synoviae hemagglutination antigen. AB - Two hemagglutination (HA) antigens produced from Mycoplasma synoviae isolates WVU 1853m and FMT grown in Frey's mycoplasma broth were lyophilized for HA preservation. Some increase in the HA titer occurred following lyophilization. PMID- 3675430 TI - Kinetics of the wattle reaction to human plasma. AB - Human plasma produced cutaneous basophil hypersensitivity when injected into chicken wattles. The kinetics of the response development were affected by presensitization, whether or not complete Freund's adjuvant was used. Presensitized chickens developed their maximum response significantly sooner (12.6 hr earlier) than the controls. PMID- 3675431 TI - Interaction between chicken lymphocytes and Newcastle disease virus. AB - Different strains of Newcastle disease virus (NDV) were added to chicken lymphocytes and JMV-1 and MSB-1 Marek's-disease-derived tumor cell lines to determine the virus-cell interaction. NDV caused fusion and lysis of the cells, and cells supported the growth and multiplication of NDV. PMID- 3675433 TI - Antibiotic aerosolization: tissue and plasma oxytetracycline concentrations in parakeets. AB - Oxytetracycline hydrochloride (OTC) was delivered to adult parakeets by aerosolization using a DeVilbiss model 65 ultrasonic nebulizer. Trachea, lung, and plasma concentrations were ascertained at 1, 2, 4, 6, and 8 hours postaerosolization (PA). An average of 284 ml of a solution containing 2 mg OTC/ml was aerosolized over a 1-hour period into a 0.0596 M3 chamber containing 10 parakeets. The trachea and lung concentrations were more than 10 micrograms/g at 1 and 2 hours PA, had decreased to approximately 3 micrograms/g by 4 hours PA, and were below 2 micrograms/g by 8 hours. The plasma concentration never exceeded 2.6 micrograms/ml and was at 1.6 micrograms/ml by 8 hours. This study demonstrates that it is possible to achieve therapeutic concentrations of OTC by aerosolization in lung and trachea, but treatment may need to be repeated every 4 6 hours. Since the plasma concentration never reached high levels, aerosolization under the conditions of this study is not an effective way to treat systemic infections outside the respiratory tract. PMID- 3675432 TI - Furazolidone-associated cardiomyopathy in two Indiana flocks of ducklings. AB - Furazolidone (FZ)-induced congestive cardiomyopathy was diagnosed as the cause of high mortality and unthriftiness in two flocks of white pekin ducklings. Cumulative mortality at 7 weeks of age was 10.0-14.4%. Samples of FZ-supplemented feeds fed to flocks 1 and 2 from day 1 to day 14 had 140 and 150 mg FZ/kg, respectively. Both flocks had various degrees of water restriction. Clinically, the ducklings had dyspnea, incoordination, and abdominal distention. Necropsy findings included pulmonary edema and congestion, ascites, atrophic congested livers covered with sheets of fibrin, and cardiac enlargement with biventricular dilatation. Cardiac alterations were minimal by light microscopy. Ultrastructurally, scattered myocytes had myofibrillar lysis. These outbreaks occurred following intake of FZ at therapeutic dosages and emphasize the high susceptibility of young ducklings to FZ cardiotoxicity. PMID- 3675434 TI - A papova-like virus infection of splendid parakeets (Neophema splendida). AB - The lesions associated with a papova-like virus infection in two splendid parakeets (Neophema splendida) are described. The most obvious microscopic lesion in both birds was enlargement of renal medullary collecting-duct epithelial cells. The nuclei of these cells were also enlarged, pleomorphic, and often bizarre, and intranuclear and intracytoplasmic virus-like particles (48 nm in diameter) were demonstrated within them. One bird also had a hepatopathy characterized by hepatocyte enlargement and nuclear pleomorphism. PMID- 3675435 TI - Dactylaria gallopava encephalitis in two grey-winged trumpeters (Psophia crepitans). AB - Encephalitis caused by Dactylaria gallopava is reported in two 17-to-18-day-old grey-winged trumpeters (Psophia crepitans). One of the chicks was housed in a tropical exhibit, and the other was in an adjacent room. Fir bark litter and aerosol infection were the suspected source and route of infection. The occurrence of this disease in a species other than the domestic chicken and turkey suggests the presence of a broader avian population at risk than previously indicated. Adult trumpeters and both young and old passerines housed in the same exhibit were not affected. PMID- 3675436 TI - The management of severe preeclampsia with intravenous magnesium sulphate, hydralazine and central venous catheterization. AB - A prospective study of patients with severe preeclampsia managed by magnesium sulphate infusion for eclampsia prophylaxis, hydralazine infusion for vasodilatation and central venous catheterization for fluid monitoring is reported. In this preliminary report of 46 patients, there was no episode of eclampsia following treatment, no maternal death, and hypertension was well controlled in all patients. Of the 51 babies born, there were 7 stillbirths, and 4 neonatal deaths; 6 of the 7 stillbirths were less than 30 weeks' gestation, and 23 of the 46 patients were delivered by Caesarean section. PMID- 3675437 TI - Pregnancy outcome in women with reflux nephropathy--a review of experience at the Royal Women's Hospital Brisbane, 1977-1986. AB - The outcome of pregnancy was examined, retrospectively, in women with a diagnosis of reflux nephropathy attending The Royal Women's Hospital from January, 1977 to August, 1986. Of 15 women, 10 were known to have had the disease antepartum and 5 were diagnosed postpartum. On the basis of plasma creatine concentration prior to pregnancy, 10 patients had 22 pregnancies with normal renal function and 5 patients had 7 pregnancies with plasma creatinine concentrations ranging from 0.12 to 0.17 mmol/l. The pregnancies of the women with normal renal function were complicated by urinary tract infections, while those with impaired renal function were associated with preeclampsia. The perinatal mortality for both groups were zero. A relatively low incidence of vesicoureteric reflux was found in 12 of the offspring who were subjected to micturating cystourethrography (mild reflux in 1 of 24 ureters). PMID- 3675439 TI - Vaginal delivery after 3 previous caesarean sections. AB - A patient who had had 3 previous Caesarean sections was permitted a trial of scar in her subsequent confinement. Labour occurred spontaneously at 39 weeks, and was closely monitored. After an uneventful labour of 3 1/2 hours, a Wrigley forceps lift-out was performed. There was no maternal or neonatal morbidity and the uterine scar was intact. PMID- 3675438 TI - Trend in breech delivery in Saudi Arabia. AB - An analysis of 2,168 consecutive singleton breech deliveries showed significant improvement in neonatal mortality and morbidity rates for babies delivered by Caesarean section (CS) compared with vaginal delivery (p less than 0.001). The CS rate was 19%. The uncorrected perinatal mortality (PNM) rate was 90.4/1,000 which was 2.5 times higher than the overall hospital PNM rate. In the vaginal delivery group the neonatal death (NND) rate of 206/1,000 among low birth-weight infants (less than 2,500 g) was significantly higher than that of 18/1,000 among babies of greater than 2,500 g (p greater than 0.001). There was no significant difference in the NND rate between these 2 birth-weight groups delivered by CS (p greater than 0.3). Social conservatism, large family size and limited neonatal care facilities were deterrents to an increase in the Caesarean section rate. PMID- 3675440 TI - The vertical birthing position of the Trobrianders, Papua New Guinea. AB - During an ethnomedical field study the author succeeded in participating and photographing 4 traditional birthgivings among the Trobrianders/Papua New Guinea. Their various vertical postures are described with special reference to specific Trobriand practices and discussed by literature review. The results suggest that vertical birthing positions are advantageous to horizontal ones and should be reconsidered by modern Western obstetrics. PMID- 3675441 TI - The value of clinical symptoms in the diagnosis of urinary incontinence in the female. AB - In a study of 566 patients with urinary incontinence the presenting symptom or combination of symptoms were shown to have limited diagnostic predictive value as measured by urodynamic diagnostic criteria. PMID- 3675442 TI - Treatment of the unstable bladder with propantheline and imipramine. AB - This study shows propantheline and imipramine to be effective in the management of the unstable bladder. It emphasizes the need for urodynamic studies for the accurate diagnosis of urinary incontinence. Comparisons have been made of the efficacy of propantheline and imipramine in various groups of incontinent women and indicates that in appropriately selected groups the 'cure' rate is over 70% but if sphincter weakness is excluded, urodynamics cannot differentiate between those women with unstable bladders who will respond to this medication and those who will not. PMID- 3675443 TI - The use of prolonged bladder distension in the treatment of intractable urinary incontinence in females with detrusor instability. AB - Fifty patients suffering from detrusor instability who failed to respond to anticholinergic treatment were treated with prolonged bladder distension. Twelve months after treatment 9 were symptom free, 15 improved and 26 remained symptomatically unchanged. Extraperitoneal bladder rupture occurred in 2 patients. PMID- 3675444 TI - Behcet disease in pregnancy. PMID- 3675445 TI - Non-obstetric female genital tract trauma in Port Moresby, Papua New Guinea. AB - In a 3-year period there were 25 admissions to Port Moresby General Hospital because of non obstetric injuries to the female genital tract. The injuries were caused by voluntary coitus, rape, assault and falls. The most frequent injury was a laceration to the posterior fornix of the vagina. Although rape was frequently committed in Port Moresby, it was not the major cause of genital tract injury. PMID- 3675446 TI - Cervical entrapment of a polythene vaginal ring pessary--a clinical curiosity. AB - An extremely rare complication of cervical entrapment of a polythene ring pessary within an epithelial 'tunnel' of the cervix is reported. The pessary was removed by dividing a segment of it with bone cutting forceps. PMID- 3675447 TI - Gestational diabetes. PMID- 3675448 TI - Selective termination in the first trimester. PMID- 3675449 TI - Antepartum cardiotocography--an audit. AB - Between 1981 and 1986, 9,840 women were monitored by antepartum nonstressed cardiotocography (CTG). A satisfactory fetal reserve pattern was detected in 91%, a reduced reserve pattern in 8% and a critical reserve pattern in 1%. The incidences of fetal growth retardation, Apgar score less than 6 at 1 minute, perinatal mortality and Caesarean section all increased significantly (p less than 0.001) as the degree of cardiotocographic fetal reserve worsened. Intrauterine growth retardation and/or low urinary oestriol excretion was associated with a highly significantly increased incidence of abnormal CTG traces (14.2%, p less than 0.001). A satisfactory fetal reserve pattern on cardiotocography was a reliable predictor of fetal well-being, since after exclusion of lethal malformations, the perinatal mortality rate in those patients monitored within 7 days of delivery was 3/1,000. PMID- 3675450 TI - The relevance of antenatal cardiotocography. AB - In a prospective study of 3,083 patients having antenatal cardiotocography it was shown that ominous fetal heart rate traces were most likely to occur when the test was applied in specific 'at risk' situations rather than as a routine screening test, and when the need for monitoring was perceived relatively early in the pregnancy. The majority of ominous traces were not preceded by a normal trace. PMID- 3675451 TI - Maternal narcotic addiction: pregnancy outcome in patients managed by a specialized drug-dependency antenatal clinic. AB - A retrospective analysis has been made of the outcome of pregnancy in 174 women abusing narcotics, managed by a specialist team from a drug-dependency antenatal clinic. These women were cared for through 182 pregnancies of greater than 20 weeks' gestation, resulting in 183 live and 5 stillbirths. The majority of patients were enrolled in a methadone programme and stabilized on the drug before the third trimester. The group was characterized by a high prevalence of previous obstetric and medical problems. The most common antenatal complications were preterm labour (24%) and anaemia (12%). Preterm delivery and small-for gestational-age each occurred in a quarter of pregnancies. The mean birth-weight for the group was 2,746 g +/- 721 g; mean +/- S.D. Eight perinatal deaths occurred (5 stillbirths, 3 neonatal deaths), giving a perinatal mortality rate of 43/1,000. The data on narcotic abusers have been compared with similar data obtained from randomly selected public antenatal clinic patients who delivered during the same period. PMID- 3675452 TI - Psychiatric services for the elderly. PMID- 3675453 TI - Science and psychoanalysis. PMID- 3675454 TI - Family functioning and overprotection following a natural disaster: the longitudinal effects of post-traumatic morbidity. AB - The longitudinal impact of a natural disaster on the patterns of interaction in families with latency-aged children is examined. An 11-item questionnaire was developed and two factors were isolated: irritable distress and involvement. A group of 183 disaster-affected families were contrasted with 497 families who had not been exposed to the disaster. Eight months after the disaster, the interaction in the disaster-affected families was characterised by increased levels of conflict, irritability and withdrawal. Maternal overprotection was also a common feature of the pattern of care in these families. Post-traumatic morbidity in parents was the major determinant of the observed changes in family functioning and the overprotection. PMID- 3675455 TI - Parasuicide: interaction between inadequate parenting and recent interpersonal stress. AB - We report a controlled study in which we searched for links between early family adversity and recent interpersonal stress in parasuicidal patients. Our subjects reported fewer adverse experiences in childhood than did the younger, predominantly female, patients investigated in previous studies. Nevertheless, 47% of our parasuicidal group, as compared to 19% of control subjects, reported a sequential pattern of relationship difficulties starting in childhood. The pattern of early exposure to neglectful and overprotective parenting followed by recent conflict or separations in adulthood was found to discriminate most clearly between the parasuicidal and control groups. We suggest that factors such as low self-esteem, a sense of helplessness in the face of adversity and an abiding insecurity in intimate relationships may variously account for this heightened vulnerability. We conclude that a history of adverse relationships beginning in childhood should alert primary care-givers to the risk of suicidal behaviour in patients who are exposed to distressing separations or interpersonal conflict. PMID- 3675457 TI - Relation of attention deficit and conduct disorder to vigilance and reading lag. AB - The relationship between DSM-III Axis I diagnoses 'attention deficit disorder with hyperactivity' (ADDH), 'conduct disorder' (CD) and 'anxiety disorder' (AD) and measures of attention and reading were studied in 158 children. Children diagnosed as having severe or moderate ADDH were found to be younger at referral and to have a lower IQ than were children with CD and AD. When age, IQ, social class and sex were controlled, children with severe ADDH were found to perform significantly worse than other diagnostic groups on some tests of vigilance and reading age. The data suggest that children with severe ADDH form a distinct group, and those with mild ADDH overlap symptomatically and on tests of vigilance with children with CD. PMID- 3675456 TI - Minor psychiatric morbidity in a casualty population: identification, attempted intervention and six-month follow-up. AB - The prevalence of minor psychiatric morbidity (MPM) was investigated in 523 adults presenting to the casualty section of an Australian public hospital. Relationships between subject characteristics and the level of MPM were also examined, together with the acceptability of an offer of short-term intervention and the effectiveness of this intervention in reducing distress. Threshold morbidity on initial presentation to casualty was 41% (using the GHQ-12 with the customary 1/2 cut-off point) and the probable prevalence was estimated to be about 27%. The intervention was initially offered to a random sample of those identified as being 'under stress' (GHQ of three or above), but as there was a 90% rejection rate, it was offered to all symptomatic subjects. Overall, 26% accepted our offer of intervention. Those who accepted intervention and those who rejected it did not differ in their improvement in MPM during the subsequent six months. However, these groups improved slightly more than the group that was eligible for intervention but to whom it was not offered. Forty-seven per cent of subjects who were 'under stress' on initial presentation to casualty fell below the GHQ-12 threshold at the six-month follow-up; this compared with a shift of only 26% in the opposite direction (i.e., non-stressed to stressed). Regression to the mean offered the most parsimonious explanation for these GHQ changes. PMID- 3675458 TI - Should there be a treatment levy on alcohol sales? PMID- 3675459 TI - Post-traumatic stress disorder in Japanese prisoners of war. PMID- 3675460 TI - Elite special forces: physiological description and ergogenic influence of blood reinfusion. AB - We measured the physical exercise capabilities of U.S. Army Special Forces soldiers (male) and determined the subsequent ergogenic influence of autologous blood reinfusion. Twelve subjects (Ss) completed maximal exercise treadmill testing in a comfortable (Ta = 20 degrees C, Tdp = 9 degrees C) environment. Six Ss were later transfused with a 600 ml autologous red blood cell (50% Hct) NaCl glucose-phosphate solution and completed identical maximal exercise tests 3 and 10 d posttransfusion. Pretransfusion, the 12 Ss had a maximal oxygen uptake (VO2max) of 4.36 +/- 0.56 L . min-1 and 55 +/- 4 ml . kg-1 . min-1 with a heart rate of 188 +/- 10 b . min-1 and ventilatory equivalent for oxygen of 37 +/- 3. For the 6 reinfused Ss, hemoglobin and red cell volume (RCV) increased by 10% (p less than 0.05) and 11% (p less than 0.05), respectively, posttransfusion. Reinfusion increased (p less than 0.05) VO2max from 4.28 +/- 0.22 L . min-1 (54 +/- 5 ml . kg-1 . min-1) to 4.75 +/- 0.42 L . min-1 (60 +/- 6 ml . kg-1 . min-1) and 4.63 +/- 0.21 L . min-1 (59 +/- 6 ml . kg-1 . min-1) at 3 and 10 d posttransfusion, respectively. No significant relationship was found between the individual change in RCV and VO2max values pre- to posttransfusion. We conclude that Special Forces soldiers have high levels of aerobic fitness that can be further increased by blood reinfusion for at least 10 d. PMID- 3675461 TI - Apical hypertrophic nonobstructive cardiomyopathy in a pilot. AB - Apical hypertrophic cardiomyopathy is a form of nonobstructive hypertrophic cardiomyopathy characterized by disproportionate hypertrophy of the left ventricular apical region. With increasing reports of apical hypertrophic cardiomyopathy appearing in the literature, this condition is certain to be diagnosed amongst airmen. The question of flying status in these pilots may create a problem for the flight surgeon. We present a pilot with clinical and morphological features typical of apical hypertrophic cardiomyopathy who has remained asymptomatic over a 15-year follow-up period. There appears to be a spectrum of severity in apical hypertrophic cardiomyopathy ranging from mild to severe. Those having the mild form of the disease may be considered for restricted licensing subject to having a normal exercise test and no significant arrhythmias on 24-h ambulatory electro-cardiogram. If licensed, review by a cardiologist should be required every 6 months. PMID- 3675462 TI - Small groups in orbit: group interaction and crew performance on Space Station. AB - Orbiting space stations herald a new era of enterprise, but they raise unprecedented issues about crew interaction and performance. It is argued that group interaction, despite its effect on crew performance, is an area largely ignored in current space planning. This article identifies these issues using a model of group interaction and findings from situations similar to orbiting stations. Directions for possible solutions and research are noted. PMID- 3675463 TI - G-tolerance standards for aircrew training and selection. AB - G tolerance widely among individuals. It stands to reason that aircrew with higher G tolerance are less likely to experience symptoms of G stress in flight than are those with lower G tolerance, and that they can fly highly maneuverable aircraft with greater safety and effectiveness. To assure that aircrew with abnormally low G tolerance are not assigned to aircraft that operate in the high G environment, a G-tolerance standard and the means to implement that standard are necessary. Since 1977, for human centrifuge operations, the USAF School of Aerospace Medicine has used an informal G-tolerance standard for selecting experimental subjects, evaluating medically disqualified aircrew, and ensuring efficacy of high-G training for aircrew. That standard consists of the subject's being able to sustain a rapidly applied +7-Gz load for 15 s, without totally losing peripheral vision or losing consciousness, while wearing a functioning anti-G suit, performing an anti-G straining maneuver, and sitting in a conventionally configured fighter aircraft seal. Inability to tolerate a 7-G, 15 s, rapid-onset G profile in a centrifuge is also the basis of internationally recognized (NATO, ASCC) definitions of low G tolerance. The rationale for choosing the 7-G, 15-s standard is discussed. Experience with use of this standard, and the equivalent standard of 8 G for 15 s when the F-16-configured seat is used, reveals that fewer than 1% of actively flying aircrew are unable to meet the standard. Eventually a formal, more stringent, G-tolerance standard may become a valuable component of the means of selecting and training aircrew for high-performance fighter aircraft. PMID- 3675464 TI - Predictive value of the routine testing ECG for serious ventricular arrhythmias. PMID- 3675465 TI - Recurrent +Gz-induced loss of consciousness. AB - G-LOC--+Gz-induced loss of consciousness--results in significant acute incapacitation, including a period of unconsciousness lasting approximately 15 s followed by an additional period of approximately 15 s of confusion and disorientation. During routine experimentation for other purposes, four individuals experienced recurrent (3-5) episodes of G-LOC over 6-15 min. While G LOC was neither an intended nor a desired event, we acknowledged the difficulty of stopping very high onset +Gz (VHOG) runs rapidly enough on the basis of visual endpoints to avoid occasional G-LOCs, which occurred in this limited series of experiments at a greater rate than in our more typical protocols. The requirement to define physiologic responses of fliers to operationally-relavent VHOG profiles made the development of these data pertinent and necessary. The recurrent G-LOC episodes accentuated the psychologic reactions experienced by the subjects, and allowed detailed analysis. Three of the individuals underwent detailed psychiatric interrogation to define the resultant G-LOC reactions. In addition to the post-G-LOC difficulty in recognizing the unconsciousness episode due to amnesia, specific psychologic reactions such as suppression (denial) further complicate one's ability to recognize the episode. G-LOC episodes may also lead to a reduction in combat readiness and aggressive capability in aerial combat. Recovery from G-LOC occurs in phases characterized by specific psychologic factors. The major psychologic reactions following G-LOC include confusion, disorientation, suppression of G-LOC recognition, unreliability, altered judgment, embarrassment, dissociation, euphoria, anxiety, fear, antagonism, and a "give-up" attitude.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675466 TI - Responses of distance runners and sprinters to exercise in a hot environment. AB - The responses of highly trained distance runners and track sprinters and age matched untrained men were compared during bicycle ergometry in a 40 degree temperature-controlled environmental chamber. There were no differences among groups in rectal temperature following the 90 min exercise bout. Distance runners had a lower heart rate than either sprinters or untrained subjects. There was no difference in heart rate between sprinters and untrained subjects. Distance runners and sprinters had a much greater sweat rate than untrained subjects and dissipated a greater proportion of their total heat load by evaporation of sweat. Sprinters, however, had a lower sweat rate than distance runners in the hot environment and could only maintain as low a skin temperature as distance runners for 75 min of the 90 min session. Both aerobic training and anaerobic training confer some degree of protection from heat injury during exercise in a hot environment. However, sprinters have a higher heart rate and cannot sustain a low skin temperature as long as distance runners. Sprinters lost their advantage over untrained subjects in skin temperature after 75 min of exercise in a hot environment and did not have a lower heart rate than untrained subjects. Distance runners had a significantly lower heart rate and maintained a lower skin temperature than untrained subjects for the entire 90 min exercise bout. PMID- 3675467 TI - Ventilatory criteria for aeromedical evacuation. AB - Ventilatory requirements during simulated aeromedical transportation were investigated in normal dogs and animals with oleic acid-induced lung injury. Inspired oxygen fractions of 0.21 and 1.0 were used to ventilate the normal and injured dogs, respectively. Both groups were ventilated with a constant-volume piston ventilator. After a control period, animals were exposed to a simulated altitude of 8,000 ft (barometric pressure 564 mm Hg), followed by a second control period at ground level. Both groups of animals had no change in carbon dioxide production, arterial PCO2 or ventilation during exposure to reduced barometric pressure. Systemic blood pressure, heart rate, cardiac output, and lung volume were all lower in oleic acid-injured animals than controls; the alveolar-arterial oxygen difference was larger in the oleic acid group. With altitude exposure, arterial and mixed venous oxygen tensions were decreased in both groups. Adequate gas exchange can be maintained during exposure to altitude even in animals with abnormal function provided that ventilation is constant and the inspired oxygen fraction is increased to compensate for the reduced barometric pressure. PMID- 3675468 TI - Immersion suit insulation: the effect of dampening on survival estimates. AB - Immersion suit leakage values were obtained from realistic testing of helicopter passenger immersion suits using eight subjects. Simulated helicopter underwater escape resulted in mean leakages of 198 +/- 103, 283 +/- 127, 203 +/- 179, and 45.7 +/- 31.6 g (mean +/- S.D.) when wearing four different immersion suits. Suit leakages obtained from a 20-min swim test to simulate vital in-water survival actions produced leakages of 213 +/- 224, 1398 +/- 691, 145 +/- 96.5, and 177 +/- 139 g (mean +/- S.D.). Dampening of undergarments during simulated helicopter travel at an elevated cabin temperature of 30 degrees C was 115 +/- 47.3 (mean +/ S.D.; n = 4) when wearing an impermeable suit and 19 +/- 16.7 g (mean +/- S.D.; n = 4) when wearing a vapour-permeable suit. The commensurate loss of insulation with the impermeable suit at the upper level of temperature could reduce clothing insulation by 17%. A reduction of less than 5% may result under similar conditions when wearing the permeable suit. The combined dampening effect of sweating, helicopter underwater escape, and performance of vital survival actions could result in a total dampening of 247-1712 g, depending on the type of suit worn. The respective loss of insulation would be 15% and 50% respectively. This could reduce, for the 10th percentile thin man, his survival time in water at 5 degrees C from 3.5 h to between 2.4 h and 1.1 h, respectively. PMID- 3675469 TI - Femur-bending properties as influenced by gravity: V. Strength vs. calcium and gravity in rats exposed for 2 weeks. AB - Growing bone material strength (S) can increase with gravitational intensity (g). That would be consistent with demineralization reported during space flight and reports that strength increases with mineral content. This study, however, shows an increase in material strength independent of calcium content (C). Male, Sprague-Dawley rats were exposed to chronic simulations of altered gravity from the 28th to 42nd d of age. Zero G was stimulated for 13 animals by harness suspension and 3 G for 30 animals by centrifugation. For fresh femurs, S as determined by bending and C as determined by AA spectrometry were compared with results for 11 harnessed, control animals and 13 normal, control animals. Multiple regression shows significant dependence of S (10(6) N.m-2) upon g (multiples of Earth's gravity, G) as independent from C (% by mass) for which there is no significant coefficient of partial regression: S = (62 +/- 1) + (7 +/ 1 g) + (0 +/- C). PMID- 3675470 TI - Comparative study of serum ferritin and its correlation with different blood parameters of students at Amman and Dead Sea levels. AB - Serum ferritin levels, RBC count, Hb, PCV% and MCV were measured in high school students living at Dead Sea (390 m below sea level) and Amman (766 m above sea level). A total of 96 male and 95 female healthy volunteers of age range 17-19 years, having almost identical economic and nutritional status were studied. It was found that serum ferritin levels of males and the levels of the females at Dead Sea and Amman were identical. However, the ferritin levels of males were much higher than those of females in both places. It was also found that the MCV levels in both the sexes were almost same in Dead Sea and Amman. The RBC counts, Hb concentration, and PVC% were significantly lower (p greater than 0.05) in both sexes at Dead Sea level than at Amman, as found in our previous study. PMID- 3675471 TI - Buspirone blocks motion sickness and xylazine-induced emesis in the cat. AB - Cats were tested for motion sickness following s.c. pretreatment with four doses of buspirone. Buspirone blocked motion sickness with an ED50 of 0.46 mg . kg-1 base. Buspirone pretreatment (4.0 mg . kg-1 base) also significantly blocked vomiting in cats later injected with 0.66 mg . kg-1 (base) s.c. of the emetic drug xylazine. The results are interpreted as showing that buspirone is acting at the vomiting center, the point of convergence for the separate mechanisms subserving chemically-induced emesis and motion sickness. PMID- 3675472 TI - Decompression and occurrence of cataract in enucleated eyes of experimental animals. AB - Chamber flight at a simulated altitude of 58,000 ft (17,680 m) or more caused marked lens opacities in enucleated eyes of the experimental animals. After descent to ground level, the opacity could subsequently be regressed despite complete deprivation of blood supply to the eye. The present finding suggests that decompression might play an important role in inducing such a cataract. PMID- 3675473 TI - Disuse atrophy, plasma corticosterone, and muscle glucocorticoid receptor levels. AB - A suspension model, characterized by differential atrophy of disused hindlimb skeletal muscles, was utilized to investigate plasma levels of and tissue sensitivity to glucocorticoids. The three objectives were determination of time course and extent of plasma corticosterone changes during 1 week of whole-body suspension; comparison of glucocorticoid receptor site concentrations in muscles differing in morphology and antigravity function; and investigation of the effect of disuse on tissue glucocorticoid receptor site concentrations. Plasma corticosterone increased significantly (p less than 0.01) on the first and third days of suspension, but returned to control levels by day 7. Muscle glucocorticoid receptors exhibited a characteristic hormonal specificity. In controls, receptor site concentration in the slow-twitch soleus (48 +/- 5 fmol/mg prot.) was comparable to that in the fast-twitch gastrocnemius (47 +/- 6) and plantaris (58 +/- 4) muscles but significantly (p less than 0.02) less than the extensor digitorum longus (66 +/- 5). Seven days of suspension resulted in significant differential effects on muscle receptor levels, with a large increase in the soleus (140%), lesser increments in the gastrocnemius (55%) and plantaris (45%), and only a small, statistically insignificant alteration in the EDL (10%). Receptor levels in the soleus remained elevated following 14 d of suspension, but levels in other muscles returned to control values. These results suggest that circulating glucocorticoids, as well as increased tissue hormonal sensitivity, may be related to muscle responses in this model of disuse. PMID- 3675474 TI - Effects of microgravity on tissue perfusion and the efficacy of astronaut denitrogenation for EVA. AB - The prevention of astronaut decompression sickness (DCS) during extravehicular activity (EVA) from the Shuttle Orbiter entails basic questions about how the efficacies of pre-EVA denitrogenations are affected by physiological responses and adaptations to microgravity. Many of these questions may be answered, without requiring inflight decompression experiments, when suitable inflight measurements of N2 elimination from spacecrew breathing 100% O2 can be analyzed using an N2 elimination/DCS risk correlation which has been calibrated in ground-based studies. In order to pursue this approach in our laboratory, a potentially flight applicable, breath-by-breath method for measuring N2 elimination from human subjects breathing 100% O2 for 2-3-h periods has been developed. The present report describes this development with particular emphasis on required methodological accuracy and its achievement in view of certain properties of mass spectrometer performance. A method for the breath-by-breath analysis of errors in measured N2 elimination profiles is also described. PMID- 3675475 TI - A likelihood analysis of experiments to test altitude decompression protocols for shuttle operations. AB - The principle of maximum likelihood and the method of linear regression both are used to fit mathematical models to experimental data, but likelihood can be applied to binary data such as the outcome of a decompression, whereas linear regression cannot. Maximum likelihood was applied to 548 individual altitude exposures from 30 experimental pressure profiles tested by NASA and the Air Force. Twelve decompression models were studied including modified Haldane models and models which assume that stationary bubbles cause Type I decompression sickness. The data was best represented by a model in which a bubble in tissue is surrounded by a diffusion barrier, but this representation was statistically indistinguishable from a single tissue Haldane model with a halftime of 508 min. By providing a quantitative measure of the agreement between theory and data, the principle of maximum likelihood offers an opportunity for improving the understanding of decompression mechanisms and for developing safer and faster decompression procedures. PMID- 3675476 TI - Probability of oxygen toxicity using an 8 psi space suit. AB - Breathing oxygen at high partial pressure is toxic to all systems of the body. However, the effect a of a high PO2 on the pulmonary and erythropoietic systems pose the greatest threat to the EVA astronaut utilizing a single gas space suit system. Oxygen toxicity has been studied extensively, and a review of the literature suggests that continuous exposure to a PO2 of 8 psi can be tolerated indefinitely and should not present the astronaut with a problem for the Extravehicular Activity (EVA) scenarios projected for Space Station. However, the cause of the decrease in circulating red blood cell mass, which has been shown to accompany exposure to microgravity as well as hyperoxemia, is not as well defined when both conditions are simultaneously present. PMID- 3675477 TI - Metabolic and hormonal status of crewmembers in short-term spaceflights. AB - In order to clarify biochemical adaptation of the human body to short-term microgravity, metabolic and hormonal parameters were investigated in 20 cosmonauts who performed orbital flights of 4 to 14 d in duration. The specific feature of adaptation to this exposure is the transition to a new level of hormonal regulation with a significant increase of the content (production) of glucocorticoids, catecholamines, components of the renin-angiotensin-aldosterone system, which determines a modified activity of tissue hormones, and fluid electrolyte homeostasis, as well as simultaneous increase of insulin secretion that diminishes the metabolic effects of glucocorticoids and catecholamines. PMID- 3675478 TI - Measures of auditory evoked potentials during optokinetic stimulation. AB - In this investigation auditory brainstem responses (ABR) elicited by click stimuli were recorded before, during, and after optokinetic stimulation in subjects that were (N = 10) or were not (N = 10) prone to visually induced motion sickness. The latency of Wave I, and the I-III and I-V interwave intervals were measured. A significant increase in the I-III interwave interval occurred only during optokinetic stimulation. Neither the Wave I latency nor the interwave interval differed with respect to subject groups and this factor did not interact with any other variables. These results suggest that optokinetic stimulation may alter neural activity in the region of the superior olivary complex, a structure known to be important in sound-source localization. PMID- 3675479 TI - Effects of hypokinesia and hypodynamia upon protein turnover in hindlimb muscles of the rat. AB - Hypokinesia/hypodynamia was induced in the hindlimb muscles of the rat using a suspension technique. This caused differing degrees of atrophy in different muscles, however, this atrophy was reduced in muscles held in a lengthened position. The greatest degree of wasting was observed in the unstretched soleus, a slow postural muscle, where both Type 1 and Type 2a fibers atrophied to the same degree. However, wasting of the gastrocnemius muscle was associated with a reduction in the size of the Type 2b fibers. In both slow postural and fast phasic hindlimb muscles, atrophy was brought about by a reduction in the rate of protein synthesis in conjunction with an elevation in the rate of protein degradation. When inactive muscles were passively stretched, both protein synthesis and degradation were dramatically elevated. Even periods of stretch of as little as 0.5 h.d-1 were found to significantly decrease atrophy in inactive muscles. PMID- 3675481 TI - Vasopressin and motion sickness in cats. AB - Levels of arginine vasopressin (AVP) in blood plasma and cerebrospinal fluid (CSF) were measured in cats under several motion-sickness-inducing conditions. Plasma AVP increased significantly in both susceptible and resistant animals exposed to motion. When vomiting occurred, levels of plasma AVP were dramatically elevated (up to 27 times resting levels). There was no difference in resting levels of AVP of susceptible and resistant cats. Levels of CSF-AVP were not elevated immediately after vomiting, but the resting levels of CSF-AVP were lower in animals that vomited during motion than in those animals which did not vomit during motion. The results of these experiments show that changes in systemic AVP are directly related to vomiting induced by motion, however, CSF-AVP apparently does not change in association with vomiting. CSF-AVP does appear to be lower in animals that reach frank vomiting during motion stimulation than in animals which do not vomit. PMID- 3675480 TI - Simulation of spaceflight with whole-body head-down tilt: influence on intraocular pressure and retinocortical processing. AB - Cephalad fluid shifts occur in the microgravity environment of spaceflight. Whole body head-down tilt was used to simulate the influence of these fluid shifts upon intraocular pressure (IOP) and the bioelectrical activity of neural elements in the retinocortical pathway. Noninvasive techniques were used to monitor IOP, pattern reversal electroretinograms (prERGs), and pattern reversal visual evoked cortical potentials (prVEPs) when subjects were oriented either upright or in a head-down position (6 degrees or 90 degrees). The results indicate that there is a significant elevation in IOP when an individual is oriented in a head-down position. Significant alterations of neurophysiological processing in the retinocortical pathway also occur when individuals are oriented in a head-down position. PMID- 3675482 TI - The nature of sensorimotor adaptation to altered G-levels: evidence from mass discrimination. AB - Mass discrimination is impaired under zero G compared to 1 G. This is partly due to loss of weight information (a reduction in z-axis pressure stimulation), and probably also to incomplete adaptation to the reduced G-level. Maladaptation to an increased G-level postflight causes objects to feel too heavy and weight discrimination to be impaired. Video tapes of hand movements while shaking test objects were made before, during, and after the D-1 Spacelab mission. Movements were faster inflight than preflight, slowed down postflight and returned to baseline by about the third day. Corresponding changes in movement amplitude also occurred. Errors of weight or mass perception during the maladaptation phase may be due to both inadequate monitoring of command signals and to inappropriate scaling of afferent signals. High-acceleration shaking was found to improve mass discrimination but impair weight discrimination. PMID- 3675483 TI - Effects of prolonged weightlessness on self-motion perception and eye movements evoked by roll and pitch. AB - Seven astronauts reported translational self-motion during roll stimulation 1-3 h after landing following 5-7 d of orbital flight. Two reported strong translational self-motion perception when they performed pitch head motions during entry and while the orbiter was stationary on the runway. One of two astronauts from whom adequate data were collected exhibited a 132 degrees shift in the phase angle between roll stimulation and horizontal eye position 2 h after landing. Neither of two from whom adequate data were collected exhibited increased horizontal eye movement amplitude or disturbance of voluntary pitch or roll body motion immediately postflight. These results are generally consistent with an otolith tilt-translation reinterpretation model and are being applied to the development of apparatus and procedures intended to preadapt astronauts to the sensory rearrangement of weightlessness. PMID- 3675485 TI - Resolving perceptual conflicts: the cognitive mechanism of spatial orientation. AB - The cognitive mechanisms of spatial orientation were studied in an experiment varying different perceptual cues systematically: the retinal, the visual background, the vestibular, and the somatosensory information. Verbal descriptions of visually presented arrays were required under different head positions (straight/tilt) and under different gravity conditions (1 G/micro G). Results for two subjects clearly show that different coordinate systems are used under the two gravity conditions. Under 1 G it is the gravitational vertical which is chosen for primary reference, whereas under microgravity retinal information is primary. Conflicts between competing pieces of sensory information are solved by weighting the perceptual cues differently. The finding that consistent assignment can be made immediately after first exposure to weightlessness indicates that mental representations of space can be used independently of perceptual input parameters. PMID- 3675484 TI - Gastrointestinal motility in space motion sickness. AB - Gastrointestinal (Gl) symptoms in space motion sickness (SMS) are significantly different from those in ordinary motion sickness (MS). Vomiting is sudden, often unexpected, infrequent, never prolonged and usually without nausea. Inflight bowel sounds are absent in those with SMS but present after recovery and in those not affected. Recording and tabulation of sounds was the only technique that could be used as a measure of motility during spaceflight operations. There were 17 subjects, 6 unaffected by SMS, who made ambulatory recordings pre- and inflight. With one exception, all those affected had sharply reduced sounds while those unaffected had increases or moderate reductions. The mechanism of vomiting in SMS appears to be secondary to this ileus in contrast to vomiting in ordinary MS, where the emesis center is thought to be directly triggered by the vestibular system. This ileus appears to be the only consistent and reliable indicator for SMS to date. PMID- 3675486 TI - The vestibulo-ocular reflex and its possible roles in space motion sickness. AB - Prolonged exposure to an inappropriate vestibulo-ocular reflex (VOR) will usually lead to motion sickness, and it has been predicted on theoretical grounds that VOR gain may be decreased in weightlessness. While experiments during parabolic flight in aircraft tend to confirm this prediction, experiments during orbital spaceflight have led to apparently contradictory results. It is suggested that VOR gain is reduced initially, but that rapid compensatory mechanisms restore it to normal within minutes of reaching weightlessness. However, even though this process may lead to the rapid return of functionally normal gaze stability, it may not protect against the development of motion sickness. PMID- 3675487 TI - Vestibulo-ocular reflex during magnified vision: adaptation to reduce visual vestibular conflict. AB - This report describes the short-term effect of 2.2X telescopic spectacles on the vestibulo-ocular reflex (VOR) in seven volunteers. VOR gain was initially measured in darkness and light during passive sinusoidal rotations. Subjects were then rotated in light for 15 min while wearing telescopic spectacles. Dynamic visual acuity (DVA), vision during head rotation, was measured with telescopic spectacles. Initial VOR gain in darkness was 0.74 +/- 0.10 (mean +/- S.D.); VOR gain with unmagnified vision was 1.07 +/- 0.04. Initial VOR gain with magnified vision was 1.37 +/- 0.53. DVA was poorer than static acuity in three of four subjects. After adaptation, VOR gain in darkness increased to 0.83 +/- 0.12, with six of seven subjects exhibiting a gain increase of 7-23% (p less than 0.05 for 5). Adapted VOR gain with magnified vision was 1.54 +/- 0.25. Adapted performance was more consistent and oscillopsia was reduced. Adapted DVA improved 30-100% in four subjects. These changes indicate VOR adaptation to telescopic spectacles decreases visual-vestibular conflict. PMID- 3675488 TI - Optokinetic and vestibulo-ocular reflex responses to an unpredictable stimulus. AB - Horizontal plane optokinetic (OKR) and vestibulo-ocular reflex (VOR) eye movements were obtained from normal subjects in response to pseudorandom rotational stimulation. Results showed large intersubject variability in OKR responses. Typical OKR responses had approximately constant gain (Mean 0.65) over 0.02-1.5 Hz. Response phase was near zero below 0.1 Hz with increasing phase lags as frequency increased consistent with time delays of 180 ms (Mean value). Variations in OKR responses included declining gains with increasing frequency and phase lags consistent with time delays of 90 to 268 ms. Significant interactions of visual and vestibular motion information were detected at the highest stimulus frequency at which both were tested (1.5 Hz). Results suggested that visual motion information could be significant in the control of eye movements up to 6.1 Hz. Pseudorandom optokinetic stimulation induced motion sickness symptoms in approximately 20% of 213 subjects tested. Pseudorandom vestibular stimulation of twice the amplitude and duration did not initiate motion sickness symptoms in any subject. PMID- 3675489 TI - Gain and phase of cat vertical eye movements generated by sinusoidal pitch rotations with and without head tilt. AB - Vertical EOGs were recorded in cats during sinusoidal head pitch from 0.01 to 4.0 Hz with peak velocities of 50 degrees X s-1. The purpose of the experiments was to determine whether dynamic response properties of the vertical vestibulo-ocular reflex (VOR) elicited by pitch with the animal lying on its side (on-side pitch) differ from those resulting from normal (upright) pitch. During on-side pitch (not changing head position with respect to gravity), the vertical VOR gain was 13.5% less than during upright pitch. Thus, the vertical VOR was more compensatory than during on-side pitch. Phase did not differ between the two conditions. The results indicate the importance of interactions between otolith and vertical canal stimulation for vertical eye movement control. The results imply that in micro-gravity, where head tilt does not lead to otolith stimulation as regards gravity, vertical head and eye movements may not be controlled appropriately, leading to vestibular-visual conflicts at the same time that horizontal eye movement controls are normal. PMID- 3675490 TI - An analysis of asymmetries in cat vertical eye movements generated by sinusoidal pitch. AB - Asymmetries in the fast and slow components of nystagmus in the cat vertical vestibulo-ocular reflex (VVOR) were analyzed. Sinusoidal pitch stimuli were used in two experimental conditions, one with the animals on their sides and the other with the animals upright. The half-periods of upward and downward slow component position were generally not of equal duration in the on-side condition. Such was not the case for upright pitch where the slow component was symmetric. In addition, the number of fast components in the two directions was not equal with downward-directed predominating regardless of pitch condition. These two results led to the conclusions that gravity plays an essential role in the normal VVOR and fast component asymmetries may be inherent in the reflex. PMID- 3675491 TI - Eye movements produced by utricular and saccular stimulation. AB - This study investigated the direction of eye movements produced by localized high frequency electrical stimulation of spots on the utricular and saccular macula in lightly anesthetized guinea pigs using fine bipolar stimulating electrodes to minimize current spread and attempting to keep the other labyrinthine sensory regions functional. Threshold stimulating currents produced upward or upward torsional movements of the ipsilateral eye. There was no evidence of different directions of eye movements corresponding to different hair cell orientations, nor was there evidence of opposite directions of eye movements produced by stimulation on opposite sides of the striola. These results are not consistent with the earlier report of Fluur and Mellstrom (8-10) and reasons for this conflict are considered. PMID- 3675492 TI - Effects of a visual-vestibular stimulus on the vestibulo-ocular reflex. AB - Exposure before flight to an environment that provides altered visual-vestibular relationships similar to those seen in weightlessness might facilitate adaptation to spaceflight. Fifteen normal subjects were exposed for 0, 5, and 20 min to an abnormal visual-vestibular environment in which the vestibular sensation of lateral tilt was associated with the visual impression of lateral translation. Lateral eye movement elicited by similar tilt in darkness was measured before and at intervals after the exposure. Of the 15 subjects, 12 showed increased VOR amplitude following the exposure, but this increase appeared unrelated to the duration of exposure to the visual stimulus and may be an effect of the VOR measurement procedure. Most subjects showed little shift in the phase relationship between tilt and eye motion. Three subjects showed changes in VOR and five reported changes in perception of motion which appear clearly related to the visual-vestibular exposure. PMID- 3675493 TI - Role of otolith endorgans in the genesis of vestibular-visual conflict sickness (pitch) in the squirrel monkey (first report). AB - This experiment was designed to clarify each vestibular submodality's role in the genesis of vestibular-visual conflict sickness in pitch. We wanted to determine whether the ablation of the macula utriculi and macula sacculi, totally or separately, unilaterally and bilaterally, preserving the semicircular canals intact, could eliminate the conflict emesis in the squirrel monkey model. Observations were carried out over 5 months. In susceptible animals, the difference in conflict sickness scores between the pre- and the postutriculosacculectomy conditions was statistically significant. However, in less susceptible animals, the scores were low from the beginning and the differences were not statistically significant. Unilateral sacculectomy was performed at the smallest otolith endorgan lesion. The conflict sickness scores declined significantly and no emesis occurred. However, at 4.5 months after the operation, animals regained their preoperative scores; thus indicating that the afferents from the remaining endorgans were sufficient to provoke the sickness. This result indicated that functional neural adaptation took place within the equilibrium system. The trial repetition in normal animals and stapedectomized controls did not produce any clear score change. PMID- 3675494 TI - Head movements in low and high gravitoinertial force environments elicit motion sickness: implications for space motion sickness. AB - Astronauts report that head movements in flight tend to bring on symptoms of space motion sickness (SMS). We evaluated how head movements in pitch, yaw, and roll--made both with normal vision and eyes-occluded--affect susceptibility to motion sickness in the zero G phase of parabolic flight maneuvers. The findings are clearcut: pitch head movements are most provocative, yaw least provocative, and roll intermediate. Susceptibility is greater with normal vision than with eyes occluded. The same susceptibility pattern emerged for head movements in the 1.8-2.0 G phase of parabolic flight. These experiments suggest that SMS is not a unique nosological entity but, rather, is the consequence of exposure to nonterrestrial force levels. Head movements during departures in either direction from 1 G elicit symptoms. This implies that, rather than speaking of "space motion sickness," it would be more appropriate to think in terms of "nonterrestrial motion sickness." PMID- 3675495 TI - The influence of gravitoinertial force level on oculomotor and perceptual responses to Coriolis, cross-coupling stimulation. AB - Susceptibility to motion sickness during exposure to constant levels of Coriolis, cross-coupling stimulation is lower in zero G and higher in 1.8 G than in a 1-G force environment (10, 13). The goal of the present experiment was to determine whether gravitoinertial force magnitude also influences oculomotor and perceptual responses to Coriolis, cross-coupling stimulation. We had blind-folded subjects who were rotating at constant velocity make standardized head movements during the free-fall and high force phases of parabolic flight, and we measured both the characteristics of their horizontal nystagmus and the magnitude of their experienced self-motion. Both responses were less intense in the free-fall periods than in the high force periods. Although the slow phase velocity of nystagmus reached the same initial, peak level in both conditions, it decayed more quickly in zero G. These findings suggest that the response to semicircular canal stimulation depends on the background level of gravitoinertial force. PMID- 3675496 TI - Adaptation and habituation of motion-induced vomiting in squirrel monkeys. AB - Nonrestrained adult squirrel monkeys were found to be prolific vomiters when rotated in the horizontal plane for at least 1 h with visual cues available. When multiple daily spins were given, monkeys who vomited early during the first session tended to habituate during subsequent rotations. Subjects who vomited late during the first spin tended to vomit increasingly earlier for several days before the trend reverted to habituation. When a single rotation was continued for up to 8 h, emetic waves occurred with a high probability density for about 2 h, then ceased for many hours with an occasional animal exhibiting isolated emetic episodes. Adaptation effects were transient; when retested beyond a week, most subjects vomited in less time than did inexperienced monkeys on their first exposure to rotation. Attempts to confirm the findings using sinusoidal vertical acceleration were unsuccessful because of failure to induce vomiting using this type of motion. PMID- 3675497 TI - The influence of gravitoinertial force level on oculomotor and perceptual responses to sudden stop stimulation. AB - Our goal was to determine whether the vestibular response to vertical, z-axis body rotation in the dark is influenced by the magnitude of gravitoinertial force. We measured the nystagmus and the duration of illusory self-motion elicited in blindfolded subjects by cessation of such rotation during the free fall, high, and terrestrial force phases of parabolic flight maneuvers. Both measures were significantly lower in zero G than in 1 G, and lower to a smaller extent in 1.8 G. The decreased intensity of nystagmus was due specifically to a decrease in the time constant of slow phase velocity decay with no decrement in peak velocity. This pattern of findings is consistent with the responses we had observed earlier to constant levels of Coriolis, cross-coupled stimulation during parabolic flight maneuvers both in terms of the mode of nystagmus suppression and the effect of G-level. Attenuation of the vestibular response to rotary acceleration in free-fall causes sensory-motor mismatches during natural head movements in orbital flight that may be important factors in the evocation of space motion sickness. PMID- 3675498 TI - A new and simple calibration of the electro-ocular signals for vestibulo-ocular measurements. AB - Reliable calculation of the gain of the vestibulo-ocular reflex depends on a reliable way of calibrating the eye movements. During the new calibration manoeuvre, the subject fixes the eyes at a point about 1 m away and moves the head either in pitch or yaw approximately +/- 30 degrees. The head movements are recorded by means of an angular rate sensor. The eye movements are recorded with standard surface electrodes. By integrating the angular rate signal the precise head position angle is calculated. The fixating eyes will compensate for this angle and, thus, the signal level of the eye movements is defined. A systematic error is introduced in this procedure. Because the distance to the fixating point is finite, the eyes must deviate more than the head movement. The extra angle is dependent on the distance to the target. In yaw, the angle is independent of the direction of the head movement. In pitch, the angle is both dependent on the distance to the target and on the direction of the head movement. Correction for the error must, in most cases, be performed directly on the eye recordings before calculating the VOR gain. PMID- 3675500 TI - A new aspect in pathogenesis of experimental hydrops: role of calcium. AB - An imbalanced Ca++-homeostasis in the inner ear was demonstrated using an animal model for Meniere's disease (MD). An increase of Ca++ concentration in the endolymph, as well as in some cells of the inner ear tissue, causes a rise of osmotic pressure and decrease of electric potential. Based on these results, we assume a new aspect in the pathophysiology of MD. It is proposed that the common denominator of MD, experimental endolymphatic hydrops (EEH), and space motion sickness (SMS) is primarily a shift of the inner ear Ca++ homeostasis towards a higher concentration of free Ca++ in the fluid compartments and adjacent intracellular spaces. It is postulated that an increase of Ca++ in this system might affect the transduction process and other functions associated with Ca++, such as turnover of otoconia. PMID- 3675499 TI - Normative study of Spacelab preflight/postflight vestibular test battery. AB - A study was designed to establish baseline normative responses to the MIT/Canadian Spacelab vestibular test battery. Three tests used a linear acceleration sled to measure otolith function: 1) perception of linear motion (threshold determination); 2) compensatory eye movements (linear VOR); 3) closed loop nulling, in which the blindfolded subject nulls his velocity with a joystick under the influences of a pseudorandom sled disturbance. Rotational VOR was measured at 0.3 and 0.8 Hz in the dark and the light. Static visual-vestibular interaction was tested with a standard rod and frame apparatus, while dynamic interaction was assessed by susceptibility to roll vection induced by a rotating peripheral visual field. Two examples are presented of how results from this study can aid in the interpretation of data from preflight/postflight testing of Space Shuttle/Spacelab crews on these same experiments. PMID- 3675501 TI - Rotation test in the weightless phase of parabolic flight. AB - Human test-persons and pigs were subjected to pendular swing movements during parabolic flight. The rotary-induced nystagmus frequency in pigs increased during a G-load of more than 1.5 G. In the trajectory from zero G to 1.5 G the nystagmus SPV in pigs increased. In human subjects weightlessness suppressed the rotary induced nystagmus, and gravitational conditions over 2 G increased the nystagmus amplitude. Nystagmus responses in experienced test-persons proved to be independent of changes in G-load. The differences in the results in man and pig support the assumption that rotary-induced nystagmus is not solely a response of the cupulae and the otoliths, but is also affected by tactile and somatosensory stimulation. PMID- 3675502 TI - Mechanisms of antimotion sickness drugs. AB - Eight subjects, male and female, were rotated using the step method to progressively increase the speed of rotation (+2 rpm) after every 40 head movements to a maximum of 35 rpm. The end-point for motion sickness was the Graybiel Malaise III total of symptoms short of frank nausea. The drug treatments were placebo, scopolamine 0.6 mg and 1 mg, scopolamine 0.6 mg/d-amphetamine 10 mg, scopolamine 1 mg/d-amphetamine 10 mg and amphetamine 10 mg. RESULTS: Scopolamine increased tolerated head movements over placebo level by +81, scopolamine 1 mg + 183, d-amphetamine + 118, scopolamine 0.6/d-amphetamine + 165, and scopolamine 1 mg/d-amphetamine 10 mg + 201. DISCUSSION: The drugs effective in preventing motion sickness are divided into those with central acetylcholine blocking activity and those which enhance norepinephrine activity. A combination of both of these actions produces the most effective antimotion sickness medications. CONCLUSIONS: The balance between the acetylcholine and norepinephrine activity in the CNS appears to be responsible for motion sickness. PMID- 3675503 TI - Effects of proposed preflight adaptation training on eye movements, self-motion perception, and motion sickness: a progress report. AB - A program has been initiated to develop apparatus and procedures to preadapt astronauts to the sensory rearrangement associated with weightlessness in spaceflight. If space motion sickness is a consequence of adaptation to that sensory rearrangement, preflight training could afford astronauts significant relief from the motion sickness. The preflight adaptation trainer (PAT) was designed to produce rearranged relationships between visual and otolith signals analogous to those experienced in space. Investigations have been undertaken with three prototype trainers. The results indicated that exposure to the PAT sensory rearrangement altered self-motion perception, induced motion sickness, and changed the amplitude and phase of the horizontal eye movements evoked by roll stimulation. However, the changes were inconsistent. Appropriate measures of adaptation and protocols for producing the adaptation efficiently remain to be determined. PMID- 3675504 TI - Reliability of provocative tests of motion sickness susceptibility. AB - Accurate prediction of space motion sickness is dependent, in part, upon the reliability of terrestrial-based motion sickness susceptibility tests. In the present study, test-retest reliability values were derived from motion sickness susceptibility scores obtained from two successive exposures to each of three tests: 1) Coriolis Sickness Sensitivity Index (CSSI); 2) Staircase Velocity Movement Test (SVMT); and 3) Parabolic Flight Static Chair Test (PSCT). The reliability of the three tests ranged from 0.70 to 0.88. Normalizing values from predictors with skewed distributions improved the reliability. The apparent inconsistency between our finding of high reliability of predictive tests, and previous reports of low correlations between ground-based predictors and space motion sickness may be due to unreliability in assessment of the sickness criterion. Issues of reliability and validity of predictor and criterion measures, and their implications for future development of ground-based predictive tests are discussed in some detail. PMID- 3675505 TI - Central and coronary circulation of the normal man during orthostatic and lower body negative pressure tests. AB - The effects of the tilt test (at 60-70 degrees for 20 min) and LBNP test (at -30 and -60 mm Hg for 20 min each) on the basic parameters of central circulation (15 test subjects) and coronary circulation (11 test subjects) were investigated. The study was performed using thermistor-equipped catheters implanted into the pulmonary artery and coronary sinus and Teflon catheters implanted into the brachial artery. In the study, the basic parameters of central circulation (pressure in the right atrium and pulmonary artery, transmural pressure in these compartments, cardiac index, stroke index, etc.) and coronary circulation (blood flow in the coronary sinus, left ventricle oxygen consumption, coronary resistance, etc.) were measured. Correlation between circulation variations and metabolic requirements was assessed (with respect to changes in acid-base equilibrium of blood). The effect of the tilt test and LBNP test on the basic parameters of central and coronary circulation, blood acid-base equilibrium and oxygenation was compared. PMID- 3675506 TI - Heart volume during short-term head-down tilt (-6 degrees) in comparison with horizontal body position. AB - The immediate effect of head-down tilt (5 min., -6 degrees) on heart volume was investigated in nine healthy male volunteers. Heart volumes were determined by the X-ray method of Kahlstorf and Rohrer as modified by Musshoff and Reindell. Biplane chest orthodiagrams were taken after 5 min of rest in a prone horizontal position (control values) and 5 min after tilting the examination table into a -6 degrees head-down tilt position. After 5 min head-down tilt, cardiac volumes had increased significantly (+ 5.2%). The results indicate that head-down tilt leads to an immediate increase in heart volume, which is similar in terms of elapsed time to results of immersion experiments conducted by other researchers, but not in terms of percent of increase. PMID- 3675507 TI - Echocardiographic measurements of left ventricular mass by a non-geometric method. AB - The accuracy of a new non-geometric method for calculating left ventricular myocardial volumes from 2-D echocardiographic images was assessed in vitro using 20 formalin-fixed normal human hearts. Serial oblique short axis images were acquired from one point at 5 degree intervals, for a total of 10 to 12 cross sections. Echocardiographic myocardial volumes were calculated as the difference between the volumes defined by the epi- and endocardial surfaces. Actual myocardial volumes were determined by water displacement. Volumes ranged from 80 to 174 ml (mean 130.8 ml). Linear regression analysis demonstrated excellent agreement between echocardiographic (X) and direct measurements (Y) i.e., y = 0.98 X + 4.3 ml; r = 0.94; SEE = 8.4; p = 0.001. Comparison of 10 duplicate measurements by two independent observers yielded an r of 0.96. These in vitro results suggest that with this technique, quantitative analysis of a limited number of cross sectional echocardiographic views will provide accurate left ventricular mass estimates. PMID- 3675508 TI - Ultrasound techniques in space medicine. AB - Ultrasound examinations have been performed on 15 cosmonauts who have remained in orbit for flights ranging from 2.5 to 8 months in duration. Soviet researchers have combined hemodynamic assessments with parallel attempts to develop improved ultrasound techniques and equipment for use onboard space stations. These techniques and equipment are reviewed, as are findings relative to exercise effects on hemodynamic changes. In general, longitudinal echocardiographic studies have suggested that 1) few differences exist between resting preflight and on-orbit cardiac contractility measures; 2) declines in orthostatic stability after long-term flights are not due to deterioration of the myocardial functional state; and 3) lower stroke volumes and heart rate increases occurring during exertion may be considered compensatory hemodynamic resettings rather than indications of disturbed left ventricular contractility. PMID- 3675509 TI - Fluid control mechanisms in weightlessness. AB - Experiments performed on Space Shuttle flights have emphasized study of the earliest effects of the cephalad fluid shift resulting from microgravity. Analysis of one subject's urine collected during flight showed that a sharp increase in antidiuretic hormone occurred within 2 h of launch, followed by an increase in cortisol excretion. Although this subject had symptoms of the space adaptation syndrome (SAS), inflight data from Spacelab missions suggested that these transient changes were not caused by SAS. Unpaired t-tests and Mann-Whitney tests showed that before and after flight, plasma thyroxine and urine osmolality were significantly higher in Shuttle crewmembers who exhibited more severe symptoms of SAS than in asymptomatic crewmembers. Collection of inflight data from more crewmembers should allow distinction between the effects of SAS and effects of weightlessness, and in the future several additional fluid regulation hormones will be measured in samples from crewmembers for a more complete understanding of fluid control during weightlessness. PMID- 3675510 TI - Body volume changes during simulated weightlessness: an overview. AB - It has been hypothesized that many of the adaptive processes that occur in man during exposure to space involve the rapid headward shift of tissue fluids, blood, and other fluids during the first few hours of spaceflight. A total of 53 men and women between the ages of 22 and 55 years were tested during four bed rest studies lasting between 4 h and 7 d to define the segmental volume changes that took place during simulated weightlessness. Impedance plethysmography can be used to measure baseline resistance (Ro) changes of the calf, thigh, total leg, pelvic, torso, and arm segments before, during, and after each bed rest exposure. Records of Ro were analyzed to determine the fluid volume and volume change of each segment during each test sequence. PMID- 3675511 TI - Fluid shifts in weightlessness. AB - Studies of leg volumes in space by multiple girth measurements showed reductions of 1.9 L (12.8% of leg volume) with 1.1 L from the non-dominant leg on Skylab 4. On landing, 65% of postflight leg volume increase was complete at 1.5 h. Measurement of the dominant leg during the equivalent period on Shuttle showed a mean loss of 0.9 L which was 90% complete at 150 min. Postflight increases were 87% complete at 1.5 h postlanding. Mass measurements during and after Skylab 4 showed a loss of 2.5 kg over the first 4 d on-orbit with a gain of 2.7 kg over the first 4 d of recovery. These changes are assumed to be tissue fluids secondary to changes in hydrostatic pressures and are much greater than those seen in bed rest. Rate and magnitude of inflight and postflight changes have significant operational impact. PMID- 3675512 TI - The use of the logistic model in space motion sickness prediction. AB - The one-equation and the two-equation logistic models were used to predict tested subjects' susceptibility to motion sickness in KC-135 parabolic flights using data from other ground-based motion sickness tests. A data set containing data from 6 provocative tests, 2 vestibular function tests, and 1 motion sickness experience questionnaire from 162 subjects was used in this study. The prediction results from the logistic models were compared with those from the previously used Bayes linear discriminant analysis procedures. The results based on this data set show that the logistic models correctly predicted substantially more cases (an average of 13%) in the data subset used for model building. In the data subset used for model cross-validation, the logistic models correctly predicted 4% and 5% more cases in the prediction of vomit or nonvomit, and of degree of susceptibility, respectively. Overall, the logistic models ranged from 53 to 65% predictions of the three endpoint parameters, whereas the Bayes linear discriminant procedure ranged from 48 to 65% correct for the cross validation sample. PMID- 3675513 TI - Space shuttle inflight and postflight fluid shifts measured by leg volume changes. AB - This is a study of the inflight and postflight leg volume changes associated with spaceflight on Space Shuttle missions. The results of this study show an inflight volume loss of 2 L from lower extremities, 1 L from each leg, representing an 11.6% volume change. The vast majority of this change appears to be a shift in body fluids, both intravascular and extravascular. The fluid shift occurs rapidly on Mission Day 1 (MD-1), with it being essentially complete by 6 to 10 h. The regional origin of shift and leg volume change shows a far greater absolute volume (708 ml vs. 318 ml) and percentage (69% vs. 31%) of the total change coming from the thigh as compared to the lower leg. Postflight, the return of fluid to the lower extremities occurs rapidly with the majority of volume return complete within 1.5 h postlanding. At 1 week postflight there is a residual leg volume decrement of 283 ml or 3.2% that is probably due to tissue loss secondary to atrophic deconditioning and weight loss. PMID- 3675514 TI - The effects of exercise on bubble formation and bends susceptibility at 9,100 m (30,000 ft; 4.3 psia). AB - This study assessed the value of controlled exercise in a bends susceptibility test. Healthy male subjects were exposed to a pressure altitude of 9,100 m (30,000 ft; 4.3 psia) for a period not exceeding 8 h on two separate days at least 1 week apart. During one exposure, subjects performed five deep knee bends followed by five upward arm extensions with 5-lb weights every 15 min; during the other exposure, they remained sedentary. Exercise and no-exercise altitude exposures were randomized between subjects. A precordial Doppler monitoring technique was used to record venous bubbling at 15-min intervals. Bends was diagnosed from subjective symptoms. Results have shown that controlled exercise decreases time to maximum venous bubbling and increases the incidence of Grade 2 bends compared to no-exercise conditions. Exercise also appears to increase the validity of precordial Doppler monitoring as a method to predict bends onset. PMID- 3675515 TI - Vasopressin injections impair working memory in a delayed matching to sample task in rats. AB - Effects of vasopressin were measured in a nonspatial working memory task: food reinforced, delayed matching to sample. Subcutaneous injections of 0.2 microgram of lysine vasopressin (LVP) or saline were alternately administered to Sprague Dawley rats after the presentation of the sample and compared to the effect of the same treatments given to a yoked control group of rats. Different durations of sample presentation (5 and 30 min) and various retention intervals (10 min, 3 h, 24 h) were selected. The results showed that LVP never facilitated retention performance: there was no improvement under conditions of weak memory (short presentation of the sample and long retention interval); moreover LVP abolished the facilitation normally obtained when either the length of the sample presentation was longer or the duration of the retention interval was shorter. The performance after the injection of the peptide was differentially impaired, according to brightness of the sample which had been presented: after the presentation of the white box, LVP injections lead to more errors and after that of the black one the treatment induced an increase in latencies of response. All these data may suggest that the physiological consequences of hormonal modifications triggered by the LVP injection are processed along with the stimuli of the learning episode and interfere with the learned positive value of the sample. PMID- 3675516 TI - Differential sexual activity of isolated and grouped male mice despite testosterone administration. AB - In Experiment 1, adult male C57 mice were castrated, housed individually or in groups of four, and repeatedly injected with either of two doses of testosterone. Control mice were sham-castrated, individually or group housed, and injected with oil vehicle. In repeated tests of sexual behavior with receptive females, isolated males in all surgery-dose combinations showed significantly more mounts and intromissions than did their group-housed counterparts. Ejaculations were fully restored by testosterone in castrated grouped males but not in castrated isolated males. In Experiment 2, administration of either of two doses of testosterone failed to elevate the sexual behavior of intact group-housed males. These experiments show that housing with other males depresses all major measures of sexual behavior, and suggest that this is probably independent of testicular hormones. PMID- 3675517 TI - Food arousal in the pond snail, Lymnaea stagnalis. AB - Factors affecting food arousal were examined in a behavioral study of the freshwater, browsing pulmonate, Lymnaea stagnalis. Presentation of a food stimulus (sucrose) leads to a progressive decrease in interbite interval over the first four subsequent bites. This is thought to represent an increase in food induced arousal. The latency to first bite is correlated with total number of bites in the first 5 min following application of food. Latency to bite is significantly reduced for up to 15 min following a brief food stimulus. Previous levels of food consumption do not significantly affect latency to bite (i.e., food responsiveness). However, hunger does lead to an increase in spontaneous biting activity in the absence of food (i.e., food search activity). Latency to bite is negatively correlated with a more general measure of behavioral arousal, the Behavioral State Score. These results are discussed in relation to previous work on other gastropod species. It is concluded that mechanisms of food arousal are adapted to the animal's habitat and life-style. PMID- 3675518 TI - Stability of long temporal gradients of retrograde amnesia in mice. AB - Mice were given a single training trial and then received a series of four electroconvulsive shocks (ECS), 1 h apart, at one of several times after training (1-180 days). Retention was then tested at one of three times after ECS: 7, 14, or 28 days. Control animals that received sham treatment exhibited gradual forgetting with increasing training-retention intervals. Mice given ECS exhibited temporally graded retrograde amnesia, which affected memories acquired up to about 14 days before treatment. The retrograde amnesia was relatively stable, maintaining its temporally graded appearance for at least 28 days after ECS. Some recovery may have occurred in the case of memories acquired 7 days or longer before ECS, but memories acquired only 1 or 5 days before ECS did not recover. These findings extend the parallel between experimental amnesia in laboratory animals and human amnesia. PMID- 3675519 TI - Long-term memory formation in chicks is blocked by 2-deoxygalactose, a fucose analog. AB - When day-old chicks are trained on a passive avoidance task there is enhanced synthesis of glycoproteins. Bilateral intracerebral injections of 20 mumole of 2 deoxygalactose (2-D-gal), administered just before and just after training on the task, produce amnesia for the avoidance. Amnesia develops slowly over the first hour and persists for at least 24 h subsequently. If 2-D-gal injections are administered 4 h prior to the training or delayed for 3 h after training, no amnesia occurs. Apart from a brief initial suppression of pecking following injection there are no effects of 2-D-gal on other observed behaviors of the birds. Within the first hour this dose of 2-D-gal inhibits [3H]fucose incorporation into acid-insoluble material by 26% (or 68%, calculated relative to free pool fucose). The amnestic effect of 2-D-gal is not shown by galactose, glucose, fucose, or 2-D-glucose. Injecting 40 mumole of galactose simultaneously with the 2-D-gal abolishes the 2-D-gal-induced amnesia; 40 mumole of fucose, however, does not abolish the amnesia. The utility of 2-D-gal as an agent for analyzing the role of glycoproteins in memory formation is discussed. PMID- 3675520 TI - Operant punishment of eye elevation in the green crab, Carcinus maenas. AB - Extension of the eye after reflex withdrawal was suppressed by punishing each extension with a brief puff of air. Experimental animals showed a decrease in the rate of responding, and an increase in the latency to the next response during 30 min sessions. The effect of punishment per se was controlled for by the use of yoked animals that received punishments whenever the experimental (master) animals did. This control group did not show the increased latency, and kept the eye erect for most of the session. Experiments were performed with pairs of animals, one eye of each used as master or control, or, alternatively, with single animals in which one eye served as the yoked control for the other. This latter group gave more reliable and reproducible differences between master and yoke than the pairs of animals. Retention was tested by subjecting animals to three sessions separated by a 12-hr rest. The results indicated some savings but this was not a dramatic effect. To demonstrate that the learning was operant in nature, that is, that it depended on the contingency between the act of eye extension and punishment, experiments were performed in which a delay was introduced between the response and the onset of punishments. A delay of 20 s was found to completely eliminate the learned suppression: animals showed latencies close to that of naive animals and responded at a constant high rate throughout the session. Delays of 10, 5, and 2.5 s were found to have a decreasing effect on the learning, and a delay of 1.25 s produced behavior that was within experimental error of that of animals subjected to immediate punishment. PMID- 3675521 TI - Mechanisms underlying satiation of feeding behavior of the mollusc Aplysia. AB - Animals filled almost to satiation by nonnutritive bulk do not satiate when they ingest a small amount of seaweed. This suggests that satiation is not triggered by chemostimulation of an anteriorly located "hot spot." Inflation of a balloon placed in the gut of the animal results in satiation as reflected in a number of different parameters of feeding behavior. The suppressive effect of a relatively brief inflation is rapidly and fully reversible, although repeated inflation and deflation appeared to produce slowly reversible or irreversible effects. The parameters of the changes in feeding during gut inflation are comparable to those of normal animals that are slowly fed individual pieces of food. The inflation volume needed to satiate the animal is a function of the rate of inflation--more rapid inflations requiring larger volumes. Cutting of the esophageal nerves results in a significant increase in the volume needed to satiate the animals, but nevertheless they eventually cease feeding and generally do not show a burst gut. The evidence indicates that the satiation that eventually occurs in nerve sectioned animals, at least in part, is due to depression of feeding following very prolonged sensory stimulation. The data suggest that for a rapidly consumed meal, satiation results primarily due to distension-related gut signals conveyed by the esophageal nerves, whereas for very slowly consumed meals, the former factor interacts with a process associated with sensory stimulation, such as receptor adaptation. The current results indicate that balloon distension can serve as a reasonable stimulus in experiments in simplified preparations in which the nervous system can be studied. PMID- 3675522 TI - Analgesia induced by exposure to a novel environment in rats: effect of concurrent and post-training stressful stimulation. AB - Exposure of rats for 2 min to a new environment (a 50 X 25 X 25-cm box) induced a mild analgesia measured by the tail-flick method. Additional stressful stimuli (0.5 mA, 1.5-s footshocks, light flashes, or tones) presented during the 2-min exposure did not alter the analgesia. However, the postexposure presentation of light flashes or tones, for either 10 s or 2 min, while the animals were alone in a waiting cage, prevented the analgesic response. Similarly, placing the subjects with their conspecifics in the home cage for 2 min after the exposure prevented the analgesic response. The data suggest that the analgesia may represent a physiological correlate of novelty and that the response can be impaired by post training treatments. PMID- 3675523 TI - Offspring sex ratio in hamsters is correlated with vaginal pH at certain times of mating. AB - Golden hamsters (Mesocricetus auratus) are sexually receptive for 19-21 h around the time of ovulation. Vaginal pH was measured immediately before mating in four groups of animals each mated at a different time during the female's receptive period. Litter size and sex ratio (percentage male offspring) were recorded at parturition. Mean litter size decreased while offspring sex ratio increased in matings occurring later in estrus. Significant negative correlations were found between vaginal pH and sex ratio of subsequent litters when matings occurred during midestrus. Fluctuations in vaginal pH may differentially affect longevity, motility, or fertilizing capacity of X and Y sperm and/or may reflect other physiological changes in the female which occur over the receptive period. Such a prefertilization mechanism for sex ratio regulation could be highly adaptive since little or no parental reproductive potential is lost. PMID- 3675524 TI - Environmental influences on lactose tolerance. PMID- 3675525 TI - Testing genetic models for multiple symptoms: an application to the genetic analysis of liability to depression. PMID- 3675526 TI - Recruitment bias in twin research: the rule of two-thirds reconsidered. PMID- 3675528 TI - [Results of surgical treatment of idiopathic femur head necrosis]. PMID- 3675527 TI - Genetic and environmental factors in primary dysmenorrhea and its relationship to anxiety, depression, and neuroticism. PMID- 3675529 TI - [Value of bone scintigraphy in aseptic loosening of the endoprosthesis]. PMID- 3675530 TI - [Differentiated therapeutic procedure in epiphyseolysis capitis femoris]. PMID- 3675531 TI - [Lateral discoid meniscus]. PMID- 3675532 TI - [Lunate endoprosthesis in advanced destructive lunate necrosis]. PMID- 3675534 TI - [Sexology and penal law]. PMID- 3675533 TI - [Malignant lumbar chordoma--problems in diagnosis and therapy]. PMID- 3675535 TI - [Decriminalization politics in sexual jurisprudence]. PMID- 3675536 TI - [No penal law against exhibitionism]. PMID- 3675537 TI - [Rape in marriage]. PMID- 3675538 TI - [Legal assessment of sexual homicide]. PMID- 3675539 TI - [Therapy with sexual perpetrators]. PMID- 3675540 TI - [Sexual science and penal law]. PMID- 3675541 TI - [5 years of transsexual law--an intermediate evaluation]. PMID- 3675542 TI - [Paragraph 175 from the sexual science viewpoint]. PMID- 3675543 TI - [Legal treatment of pedosexuality]. PMID- 3675544 TI - [Herd therapy and prevention in cattle]. PMID- 3675545 TI - [Current problems of preventive vaccination in birds]. PMID- 3675546 TI - [Modern procedures in the federal prevention of animal epidemics]. PMID- 3675547 TI - Immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) as a marker of interferon therapy in patients with persistent hepatitis B virus infection. AB - Immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) was measured by radioimmunoassay in the sera of 96 HBV carriers. IgM anti-HBc was detected in 17 of 66 patients with chronic active hepatitis and in 4 of 11 with liver cirrhosis. This antibody was not present in asymptomatic carriers or in patients with chronic persistent hepatitis. Testing of sequential samples revealed that the presence of IgM anti-HBc indicated active replication of HBV and at the same time an immune response to the virus. The relationship between IgM anti-HBc and the response to interferon (IFN) therapy was also studied. Results showed that IgM anti-HBc is a useful marker of the efficacy of interferon therapy. PMID- 3675548 TI - Possible conversion of axonemal microtubules to pellicular microtubules in Trypanosoma gambiense treated with vinblastine, colchicine plus concanavalin A. AB - The effects of vinblastine alone and in combination with vinblastine, colchicine and concanavalin A on microtubules of Trypanosoma gambiense cultured in vitro were studied ultrastructurally. Trypanosomes treated with vinblastine at 20 micrograms/ml, showed fusion of the extracellular flagellum with the plasma membrane of the parasite. As a result, the axoneme with the paraxial rod in the extracellular flagellum was taken into the cytoplasm. Although the axonemal and pellicular microtubules in T. gambiense differ in function and origin, the axonemal microtubules of the extracellular flagellum that was taken into the cytoplasm could be converted to pellicular microtubules by treatment with a combination of vinblastine (20 micrograms/ml), concanavalin A (10 micrograms/ml) and colchicine (100 micrograms/ml). PMID- 3675549 TI - Corneal test as a reliable method for detection of the delayed-type hypersensitivity reaction in mice. AB - Antigen solution could be injected into the cornea of sensitized mice using a fine needle and a stereoscopic dissecting microscope. The resulting corneal reaction was shown to be a reliable method in the detection and estimation of delayed-type hypersensitivity in mice that had been immunized with a water-in-oil emulsion containing an ovalbumin and a cell wall adjuvant. Unlike the delayed skin reaction in the ear lobe, this corneal reaction was not affected by a coexisting Arthus reaction. PMID- 3675550 TI - An intracellular simian malarial parasite (Plasmodium knowlesi) induces stage dependent alterations in membrane phospholipid organization of its host erythrocyte. AB - The membrane phospholipid organization in monkey erythrocytes harbouring different developmental stages of the simian malarial parasite Plasmodium knowlesi was studied using phospholipase A2 from two different sources and Merocyanine 540 as the external-membrane probes. Experiments were done to confirm that the phospholipases did not penetrate into the infected cells or hydrolyse phospholipids during membrane isolation. The parasite-free erythrocyte membrane was isolated by differential centrifugation or by using the cationic beads Affi Gel 731. The purity of the membranes was established by optical and electron microscopy, and by assaying the parasite-specific enzyme glutamate dehydrogenase. About 10% of the phosphatidylethanolamine and none of phosphatidylserine were hydrolysed by the phospholipases in intact normal monkey erythrocytes. However, accessibility of these aminophospholipids to the enzymes was significantly enhanced in the infected cells under identical conditions. The degree of this enhancement depended on the developmental stage of the intracellular parasite, but not on the parasitaemia levels in the infected monkeys, and increased with the parasite growth inside the cells. Analogously, Merocyanine 540 was found to label the trophozoite- or schizont-infected erythrocytes, but not the ring infected or normal cells. These results demonstrate that the intracellular malarial parasite produces stage-dependent alterations in the membrane phospholipid organization of its host erythrocyte. PMID- 3675551 TI - Identification and partial characterization of two major proteins of Mr 47,000 synthesized by bovine retinal endothelial cells in culture. AB - Biosynthetic experiments with cultured bovine retinal endothelial cells have identified a glycoprotein of Mr 47,000 (Gp47) as a major component secreted into the medium. Gp47 is a non-collagenous glycoprotein with a pI of 4.6-5.5, which does not bind to either gelatin-Sepharose or heparin-Sepharose but is retained by concanavalin A-Sepharose. The Mr of this species decreases to approx. 42,000 in the presence of tunicamycin, indicating that it contains asparagine-linked oligosaccharides. A second protein of Mr 47,000 (P47) is present in the cell layer/matrix of these cultured cells. The electrophoretic mobility of P47 remains unaltered when synthesized in the presence of tunicamycin. Peptide-mapping experiments using N-chlorosuccinimide and Staphylococcus aureus V8 proteinase demonstrate that Gp47 and P47 are distinct proteins, and are not related to colligin, a membrane-bound collagen-receptor protein of similar size, or to SPARC, a major secreted product of parietal endodermal cells and sparse cultures of aortic endothelial cells. PMID- 3675552 TI - On the disulphide bonds of rhodopsins. AB - Carboxymethylation using 14C- or 3H-labelled iodoacetic acid has been used to identify the cysteine residues in bovine rhodopsin involved in the formation of the two intramolecular disulphide bridges. Iodo[2-14C]acetic acid was used to modify 5.8-5.9 residues of cysteine under non-reducing conditions. After dialysis and reduction of disulphide bridges by 2-mercaptoethanol, iodo[2-3H]acetic acid was employed to covalently modify 3.3-3.6 residues of cysteine. Peptide purification and sequencing has unambiguously shown that cysteine residues 322 and 323 are only carboxymethylated after reduction of disulphide bridges. Indirect evidence presented, now coupled with the earlier finding [Findlay & Pappin (1986) Biochem. J. 238, 625-642] suggests that the other disulphide bridge is formed between cysteine residues 110 and 187. A comparison is made of all the sequences of mammalian rhodopsins and colour pigments and attention is drawn to the fact that whereas Cys-322 and Cys-323 are conserved only in three rhodopsins (bovine, ovine and human), the residues corresponding to Cys-110 and Cys-187 are found in all the visual proteins (from rods as well as human cones). PMID- 3675554 TI - Mitogenic stimulation transiently increases the exchangeable mitochondrial calcium pool in rat thymocytes. AB - Exchangeable calcium pools were measured in rat thymocytes by 45Ca labelling and selective depletion of intracellular pools with oligomycin in the presence or absence of rotenone. The mitochondrial pool increased by 150% after 3 min of treatment with the mitogen concanavalin A, and decreased to zero 10 min after mitogen addition. No significant change in the ATP-dependent pool could be detected. PMID- 3675553 TI - A 31P-n.m.r. study of the acute effects of beta-blockade on the bioenergetics of skeletal muscle during contraction. AB - 1. The effects of beta-adrenoceptor antagonist administration on skeletal muscle contractile performance and bioenergetics in vivo have been investigated during unilateral sciatic nerve stimulation in the rat. 2. Two muscle stimulation protocols have been used: supramaximal stimulation at 4 Hz, or incremental supramaximal stimulation at 1, 2 and 4 Hz. Changes in high-energy phosphate concentrations were followed using 31P-n.m.r., and gastrocnemius muscle twitch characteristics were monitored continuously. 3. Under all conditions investigated, DL-propranolol administration (2.5 mg/kg body wt.) caused a significant decrease in cyclic AMP concentrations in resting and stimulated gastrocnemius muscle, prevented an increase in heart rate upon muscle stimulation, but did not affect plasma glucose, fatty acid or lactate concentrations in comparison with values obtained in control experiments. 4. Administration of DL-propranolol 5 min or 35 min before unilateral stimulation of 4 Hz had no effect on changes in muscle phosphocreatine, ATP or Pi concentrations, intracellular pH or contractile performance. 5. In contrast, animals receiving DL-propranolol 5 min before unilateral stimulation of 1, 2 and 4 Hz showed a significant deterioration in gastrocnemius muscle tension development during 2 and 4 Hz stimulation compared with control animals. Concurrent with this change in contractile performance was a higher muscle concentration of phosphocreatine, a lower concentration of Pi and no significant change in intramuscular pH compared with control experiments. 6. The changes in muscle performance and bioenergetics observed during the incremental stimulation protocol were not observed when D-propranolol was administered and could be completely circumvented by a short period of muscle stimulation of 4 Hz prior to initiation of the incremental stimulation protocol. 7. Mechanisms are discussed which may account for the failure of gastrocnemius muscle to generate the expected force during the incremental stimulation protocol in the presence of beta-blockade. PMID- 3675555 TI - Interaction of Zn2+ and Eu3+ with bovine liver glutamate dehydrogenase. AB - Bovine liver glutamate dehydrogenase is potently inhibited by Zn2+ ions. At pH 7.0 a kinetic dissociation constant for Zn2+ of 18 microM is obtained. The fluorescent lanthanide Eu3+ competes for the Zn2+-binding site and relieves the Zn2+-induced inhibition, but does not cause inhibition. Studies on the effects of Zn2+ or Eu3+ on the tertiary and quaternary structure of the enzyme by the use of protein fluorescence, heat-stability and re-activation after guanidinium chloride denaturation indicate that, whereas Zn2+ affects both tertiary and quaternary structure, Eu3+ does not affect either, consistent with its lack of effect on enzymic properties. Eu3+ fluorescence had a strong excitation peak at 395 nm with emission at 456 nm. In the presence of glutamate dehydrogenase the fluorescence emission is shifted to 501 nm. Eu3+, with high-affinity binding site and distinctive fluorescence properties after binding, would appear to be an ideal fluorophore for use in conformational studies or resonance-energy-transfer studies. PMID- 3675556 TI - Chemically-induced formation of an inhibitor of hepatic uroporphyrinogen decarboxylase in inbred mice with iron overload. AB - An inhibitor of hepatic uroporphyrinogen decarboxylase (EC 4.1.1.37) was demonstrated in heat-treated extracts of livers from C57BL/10ScSn mice with iron overload after a single dose (100 mg/kg; 350 mumol/kg) of hexachlorobenzene (HCB). Inhibition was not due to accumulated uroporphyrin since this could be removed by a SEP-PAK C18 cartridge without affecting inhibitor activity. The presence of the inhibitor could be first demonstrated 2 weeks after mice received HCB and before major elevation of hepatic porphyrin levels. Maximum inhibitory potential was reached at about 8 weeks and was still detected 25 weeks after the chemical, thus paralleling the depression of enzyme activity reported previously [Smith, Francis, Kay, Greig & Stewart (1986) Biochem. J. 238, 871-878]. The inhibitor was not detected following treatment of mice with either iron or HCB alone or after the decarboxylase activity was destroyed in vitro by the combination of uroporphyrin and light. The formation of the inhibitor by inbred mouse strains nominally Ah-responsive (C57BL/6J, C57BL/10ScSn, BALB/c, C3H/HeJ, CBA/J and A/J) and Ah-nonresponsive (SWR, AKR, 129, SJL, LP and DBA/2) did not correlate fully with their reported Ah-phenotype. There was a correlation amongst the Ah-responsive strains only, with hepatic ethoxyphenoxazone de-ethylase activity induced in parallel experiments by treatment with beta-naphthoflavone. De-ethylase activity induced by HCB, however, was considerably less than that with beta-naphthoflavone, which has not been reported as porphyrogenic. Other polyhalogenated chemicals, such as 2,3,7,8-tetrachlorodibenzo-p-dioxin, 2,3,4,2',3',4'-hexachlorobiphenyl and hexabromobenzene, also caused the formation of the inhibitor of uroporphyrinogen decarboxylase. PMID- 3675557 TI - The binding of the cyclic AMP receptor protein to synthetic DNA sites containing permutations in the consensus sequence TGTGA. AB - The binding of the cyclic AMP receptor protein (CRP) to symmetrical synthetic DNA binding sites was investigated with a gel-retardation assay. A set of ten different sequences was employed, comprising all base permutations at positions 2, 4, and 5 of the consensus sequence 5'(TGTGA)3'. We show that: (i) CRP has a higher affinity for the completely symmetrical site than towards the lac wild type site; (ii) base substitutions at position 2 lead to either a complete loss of specific CRP binding (G----C), a reduction in specific CRP binding (G----A) or only marginal effects on specific CRP binding (G----T); (iii) changes at position 4 abolish (G----C; G----A) or reduce (G----T) specific CRP binding; and (iv) base permutations at position 5 reduce specific CRP binding, but never completely abolish it. Thus position 4, and to a lesser extent position 2, in the DNA consensus sequence are the most crucial ones for specific binding by CRP. PMID- 3675558 TI - Effects of fasting on tissue glucose utilization in conscious resting rats. Major glucose-sparing effect in working muscles. AB - The effects of fasting on glucose metabolism in the conscious resting rat were studied. Fasting decreased whole-body glucose utilization by 40%. The fast induced a decrease in glucose utilization in muscles which are constantly working even in the resting state, i.e. heart, diaphragm and postural muscles. No modification was observed in other tissues. PMID- 3675560 TI - The 48 kDa Ca2+-binding protein of bovine brain. AB - A Ca2+-binding protein of molecular mass 48 kDa and named 'CAB-48' has been purified from bovine brain 100,000 g supernatant. About 30 mg of CAB-48 was purified from 1 kg of bovine brain. The protein has been characterized with respect to its physical, chemical and Ca2+-binding properties. It has an apparent molecular mass of 48 kDa by SDS/polyacrylamide-gel-electrophoresis and 75.2 kDa from sedimentation-velocity and Stokes-radius data. The acidic nature of the molecule is suggested by its pI of 4.7. In the presence of 3.0 mM-MgCl2 and 150 mM-KCl, CAB-48 binds 1.0 mol of Ca2+/mol of protein with an apparent Kd of 15 microM. A tyrosine protein kinase partially purified from rat spleen catalysed the incorporation of 0.73 mol of phosphate/mol of CAB-48, and phosphoamino acid analysis revealed that phosphorylation of CAB-48 was specific for tyrosine residues. PMID- 3675561 TI - Effect of cations and temperature on kinetics of desmin assembly. AB - Smooth-muscle desmin, which was isolated from avian gizzard, was purified and used to form reconstituted intermediate filaments. Filament assembly was done in the presence of physiological cations, Ca2+, Mg2+, Na+, and Na+ plus Mg2+, and with non-physiological cations Cu2+ and Ni2+. Assembly was done at 2 degrees, 22 degrees and 37 degrees C, and was monitored by absorbance and by electron microscopy. Absorbance increased most rapidly during the first 2-5 min and then increased at a slower rate with the physiological cations, but decreased after that time with the non-physiological cations. For each physiological cation, absorbance increased with increasing temperature. This was particularly evident with Ca2+, which produced the lowest absorbance at 2 degrees C and the highest at 37 degrees C. When ionic strength was comparable, filament-forming buffers that contained bivalent cations were associated with higher absorbance values. Filament diameters were significantly smaller 60 min after assembly initiation than after 5 min. Average filament diameters, when formed in the presence of Cu2+ or Ni2+, were 10% greater than in the presence of the physiological cations and did not show a consistent tendency to decrease as time increased. These results demonstrate the importance, not only of the pH and ionic composition of the filament-forming buffer, but also of the temperature and duration of dialysis for reconstitution of desmin filaments. PMID- 3675559 TI - Characterization of a monoclonal antibody that probes the functional domains of the glucocorticoid receptor. AB - Monoclonal antibodies to the rat hepatic glucocorticoid receptor (GR) were produced by using 4000-fold-purified unactivated rat hepatic GR as the immunogen in an immunization in vitro. Hybridomas were screened for anti-GR antibody production by using an enzyme-linked immunosorbent assay. The antibody, 3A6, described here, is an IgM (lambda). The interaction of 3A6 with the purified GR was explored by sedimentation analysis, where a shift of the 9 S GR to a form with a higher s20,w value was demonstrated. Binding specificity and sensitivity were demonstrated by protein immunoblotting. 3A6 cross-reacted with all rat tissue glucocorticoid receptors (GRs) examined, except those of the brain. Species cross-reactivity was observed with other mammalian GRs (from human CEM-C7 cells and from pig and mouse liver). Immunocytochemical localization of the GR was assessed by indirect immunofluorescence in intact fixed cells, which demonstrated intense cytoplasmic staining in the absence of pretreatment with glucocorticoids and nuclear localization when cells were pretreated with glucocorticoids. This monoclonal antibody significantly inhibited steroid binding to unoccupied receptor and DNA binding of activated steroid-receptor complexes. Furthermore, preincubation of the purified activated GR complex with 3A6 prevented phosphorylation of the GR in vitro. Thus 3A6 differs from previous monoclonal antibodies to the GR in its capacity to cross-react with the human GR and by its specificity for an epitope on or near a functional domain of the GR. PMID- 3675562 TI - Effect of glucocorticoids on plasma cholinesterase in the rat. AB - Changes in plasma cholinesterase (ChE) activity after administration of glucocorticoids (prednisone, methyl-prednisolone and dexamethasone) were studied in male and female rats. The decrease of ChE activity-probably due to inhibition of ChE synthesis in the liver-was more marked in female than in male rats. This difference could be explained by the more rapid metabolism of glucocorticoids in male than in female rats or by the decreased stimulatory effect of estrogens on ChE synthesis after administration of glucocorticoids. The inhibitory effect of dexamethasone on ChE synthesis was significantly greater than the effect of equivalent antiinflammatory doses of the other two glucocorticoids investigated. The inhibitory effect of glucocorticoids on ChE activity increased with the duration of their administration. Decrease of ChE activity was more marked after the p.o. than after the i.p. route of application, indicating that inhibition of ChE synthesis after p.o. administration of glucocorticoids occurs partially during the first pass of these drugs in the liver. PMID- 3675563 TI - Biliary excretion of synthetic benzamidine-type thrombin inhibitors in rabbits and rats. AB - In rabbits and rats the excretion via the bile of the highly effective and selective synthetic thrombin inhibitor N alpha-(2-naphthylsulfonylglycyl)-4 amidinophenylalanine piperidide was studied after various routes of administration and varying doses. The concentration in the bile was determined using a biological method, the reliability of which was checked by HPLC determinations. The compound was excreted in the bile in biologically active unchanged form. Cumulative biliary excretion of the synthetic thrombin inhibitor in rabbits amounted to a high percentage of the administered dose after low doses given either systemically or intraportally. In rats the excretion rates during and after intravenous infusion reached a maximum indicating saturation kinetics. Hepatic uptake and biliary excretion of the highly basic benzamidine derivative essentially contribute to its short plasma half-life. PMID- 3675564 TI - Protective effect of bis-pyridinium compounds on the rat brain acetylcholinesterase inhibition by carbamate in vitro. AB - The inhibition of the rat brain acetylcholinesterase by quaternary bis-pyridinium compounds and the protection against acetylcholinesterase inhibition by 3-diethyl aminophenyl-N-methylcarbamate methiodide was studied with three bis-pyridinium compounds. These compounds have two pyridinium rings connected by a dimethylether link and alkyl groups in position 4 of both pyridinium rings. Toxogonin was used as a reference compound. Bis-pyridinium compounds studied are weak reversible inhibitors of acetylcholinesterase (I50 from 10(-4) to 10(-3) M) and exert also the ability to protect acetylcholinesterase against inhibition by 3-diethyl aminophenyl-N-methylcarbamate methiodide in vitro at a concentration of 0.1 mM. Negligible protection was obtained with Toxogonin. PMID- 3675565 TI - Binding and uptake of asialothyroglobulin by isolated rat hepatocytes. AB - Binding and uptake of asialothyroglobulin by freshly isolated rat hepatocytes were studied in dependence on temperature as well as on the concentrations of the ligand and of calcium ions. The endocytosis of native thyroglobulin occurred as a nonspecific process. The number of galactose-specific receptors on the hepatocyte surface was estimated to be 47,400 per cell. The cells exhibited only a single class of binding sites with an association constant for asialothyroglobulin of Kass = 0.18.10(8)M-1. The internalization of surface-bound asialothyroglobulin appeared to be a first-order process. The rate constant of internalization ki, was estimated to be 0.6.10(-3) s-1. The obtained data provide an explanation of the extreme half-life of asialothyroglobulin in the circulation. PMID- 3675566 TI - Flow-dependence of vasodilatory response in renal vascular bed to hemorrhage in dogs. AB - The vasodilatory response in the renal vascular bed was studied after quick mild hemorrhage under different levels of renal blood flow. In neuraxis intact dogs, the renal vascular resistance increased or decreased within 5 s after hemorrhage and reached a stable level close to the control within 10 s. The responses under neuraxis intact conditions may involve both responses of the renal vascular resistance to changes in renal sympathetic nerve activity caused by the baroreceptor reflex and responses to decrease in renal perfusion pressure after hemorrhage. In order to exclude baroreflex neural regulation of renal blood flow, we sectioned the carotid sinus and vagus nerves. The renal vascular resistance decreased within 5 s after hemorrhage, and was maintained at around this level for about 2 min. The decrease in renal vascular resistance and control (prehemorrhage) renal blood flow revealed a significant hyperbolic relationship. Since the systemic arterial pressure was not restored after hemorrhage and reflexogenic changes in sympathetic nerve activity were excluded after barodenervation, the vasodilatory response in the renal vascular bed after hemorrhage should reflect only hemodynamic changes. We conclude that the vasodilatory response to pressure fall in the renal vascular bed increases with a decrease in the control renal blood flow. PMID- 3675567 TI - [Kidney function in spontaneously hypertensive rats under minoxidil treatment]. AB - In 25 spontaneously hypertensive rats the blood pressure was lowered from 192 +/- 11.6 to 130 +/- 11.7 mm Hg and in 26 normotensive Wistar rats from 129 +/- 9.1 to 107 +/- 6.7 mm Hg by applying 1 mg/kg body weight minoxidil twice a day orally. 19 spontaneously hypertensive and 21 normotensive rats served as untreated control groups. During the treatment the glomerular filtration rate, determined by the slope clearance of Tc-99m-DTPA, remained unchanged. Under maximal water diuresis the excretion fraction of sodium was diminished compared with the control data. The Na+ and water reabsorption was increased in the proximal tubules (not an aldosterone effect) only in the treated spontaneously hypertensive rats. The potassium clearance was increased in this group, but decreased in the treated normotensive group. The different reactions of the renal tubular function to the treatment with minoxidil in spontaneously hypertensive compared with normotensive rats were discussed in connection with changes of membrane transport in essential hypertension. PMID- 3675568 TI - Total phospholipids in lung and amniotic fluid of chick in determining lung maturity. AB - The total phospholipid (TPL) concentration in lung and amniotic fluid of chick increases with the advancement of incubation period. A positive correlation (r = 0.77) exists between the lung and amniotic fluid phospholipids. Highest value of TPL was observed at the end of incubation period. Interestingly, in few samples of both lung and amniotic fluid, low concentrations of TPL were also observed. PMID- 3675569 TI - Reduced behavioural inhibition after lesions in the dorsomedial pontine reticular formation of rats. AB - Male hooded rats of the Long-Evans strain were investigated in an open field (OF), in an Y-maze and in a pole-climbing (jump) test before and after small bilateral symmetric lesions of the dorsomedial pontine reticular formation, medial from the locus coeruleus including lateral parts of the central gray. Postoperative values of ambulatory activity were increased above 300%. This hyperactivity in the OF was characterized by weakened habituation in the OF, increased locomotor speed, increased climbing rate, whereas horizontal exploratory activity was significantly decreased. The preoperatively learnt Y maze avoidance tasks were correctly performed after lesions without any retention deficit and without errors in brightness-discrimination. The postoperative acquisition of a jump test avoidance task was impossible because the lesioned rats did not find the escape possibility in spite of a great number of variant jumps. They never showed tendencies of arrest behaviour ("learned helplessness"). The syndrome is characterized by weakened behavioural inhibition of incorrect or redundant responses. PMID- 3675570 TI - Reversible oxidation of glyceraldehyde 3-phosphate dehydrogenase thiols in human lung carcinoma cells by hydrogen peroxide. AB - Human lung carcinoma cells (A549) were oxidatively stressed with mildly-toxic or non-toxic amounts of hydrogen peroxide (H2O2, 0.1 mM to 120 mM) for 5 min. Hydrogen peroxide exposure resulted in a dose dependent inhibition of binding (pH 7) of the thiol reagent iodoacetic acid (IAA) to a 38 kDa cell protein. Incubation of cells in saline for 60 min following H2O2 removal restored the ability of IAA to bind to the protein. Treatment with 20 mM dithiothreitol or 2 M urea also restored IAA binding, but 10% Triton X102 or 1 mM Brij 58 had no effect. Increasing to pH 11 during the IAA binding also increased thiol availability. Glyceraldehyde 3-phosphate dehydrogenase (EC 1.2.1.12) has been identified as the protein undergoing thiol/disulfide redox status and enzymic activity changes. PMID- 3675571 TI - A membrane protein from IFN-beta-treated Daudi cells causes a cessation in cell growth. AB - An interferon-induced 17 kDa protein has been partially purified from the membranes of interferon-beta-treated Daudi cells. A fraction containing the 17 kDa protein purified 200 fold causes an inhibition of growth of Daudi, Namalva and Hela cells. The same fraction purified from the membranes of untreated cells causes no inhibition of cell growth. This interferon-beta-induced protein is located on the exterior of Daudi cells for it can be labeled with [125I] iodine catalyzed by lactoperoxidase. These results suggest that interferons induce a cell surface protein whose role is to cause an inhibition of cell growth. PMID- 3675572 TI - Vitamin K-dependent oxygenase/carboxylase; differential inactivation by sulfhydryl reagents. AB - Inhibition of vitamin K-dependent carboxylase and oxygenase by sulfhydryl reagents was compared. Formation of vitamin K epoxide and vitamin K-dependent carboxylation are both strongly (greater than 90%) inhibited by l mM p-hydroxy mercuribenzoate, and this inhibition is reversed by dithiothreitol. Both activities are also effectively inhibited by N-ethylmaleimide (NEM). Preincubation with vitamin K hydroquinone prevents NEM inhibition of epoxide formation but not of carboxylation. These data argue that separate active sites are required to support vitamin K-dependent epoxide formation and carboxylation and that the binding site vitamin K oxygenase contains an active thiol group. PMID- 3675573 TI - Eightfold induction of nicotine elimination in perfused rat liver by pretreatment with phenobarbital. AB - Elimination of nicotine by isolated rat livers was increased eightfold after pretreatment with phenobarbital (PB) as an inducer of cytochrome P-450 while it was only marginally influenced after pretreatment with 5,6-benzoflavone (BF) as an inducer of cytochrome P-448. Initial rates of cotinine formation were enhanced in the same order of magnitude in PB-induced livers. The 14C-nicotine-derived radioactivity excreted into bile within 2 h ranged between 6 -17% of the dose with only 2.7 fold higher values after PB pretreatment compared to controls. PMID- 3675574 TI - Formation of inositol 1,3,4,6-tetrakisphosphate during angiotensin II action in bovine adrenal glomerulosa cells. AB - Angiotensin II stimulates the formation of several inositol polyphosphates in cultured bovine adrenal glomerulosa cells prelabelled with [3H] inositol. Analysis by high performance anion exchange chromatography of the inositol phosphate compounds revealed the existence of two additional inositol tetrakisphosphate (InsP4) isomers in proximity to Ins-1,3,4,5-P4, the known phosphorylation product of Ins-1,4,5-trisphosphate and precursor of Ins-1,3,4 trisphosphate. Both of these new compounds showed a slow increase after stimulation with angiotensin II. The structure of one of these new InsP4 isomers, which is a phosphorylation product of Ins-1,3,4-P3, was deduced by its resistance to periodate oxidation to be Ins-1,3,4,6-P4. The existence of multiple cycles of phosphorylation-dephosphorylation reactions for the processing of Ins-1,4,5-P4 may represent a new aspect of the inositol-lipid related signalling mechanism in agonist-activated target cells. PMID- 3675575 TI - Vasopressor peptides and depolarization stimulated Ca2+-entry into cultured vascular smooth muscle. AB - 45Ca-uptake was measured in monolayers of cultured rat aortic smooth muscle cells. Sufficient extracellular 45Ca could be removed by a 90 second cold La3+ was to reveal stimulation of 45Ca-uptake by high K+-depolarization and the vasopressor peptides angiotensin II and vasopressin. The high K+-stimulated 45Ca influx was blocked by a dihydropyridine-type Ca2+-antagonist while that stimulated by angiotensin II or vasopressin was not. The 45Ca-influx stimulated by high K+-depolarization was additive to that stimulated by angiotensin II. Vasopressin and angiotensin II stimulated 45Ca-fluxes were not additive. It is concluded that vasopressor peptides stimulate Ca2+-entry through receptor operated Ca2+-channels which are distinct from voltage gated Ca2+-channels. PMID- 3675576 TI - Purification and characterization of human liver cytochrome P-450-ALC. AB - Cytochrome P-450-ALC, an ethanol-oxidizing form of microsomal cytochrome P-450 (P 450), has been purified from human liver. P-450-ALC (Mr = 54,000 daltons) is a low-spin ferric hemeprotein with a CO-reduced Soret maximum at 452 nm, and has an NH2-terminal amino acid sequence nearly identical to that deduced from a human P 450-ALC cDNA clone. In a reconstituted system, P-450-ALC oxidizes ethanol and aniline at turnover rates (12.2 and 7.3 nmol min-1, respectively) 10-fold greater than two other human P-450 isozymes (termed P-450-B and P-450-C) purified from the same liver. Both P-450-ALC and P-450-C effectively demethylate N nitrosodimethylamine (NDMA) at low substrate concentrations (0.5 mM), especially in the presence of cytochrome b5. Our results provide direct evidence for a liver P-450 isozyme in humans with catalytic properties similar to the related alcohol inducible rodent P-450s and also reveal a new human NDMA demethylase. PMID- 3675577 TI - Intracellular transport and processing of lysosomal cathepsin B. AB - Intracellular transport and processing of lysosomal cathepsin B was investigated in the subcellular fractions of rat liver by pulse-labeling experiments with [35S]methionine in vivo. A newly synthesized procathepsin B with a molecular weight of 39 kDa firstly appeared in the rough microsomal fraction at 10 min postinjection of label. This procathepsin B moved from the microsomal fractions to the Golgi subfractions at 30 min postinjection, and then a processed mature enzyme appeared in the lysosomal fraction at 60 min. These results suggest that the propeptide-processing of procathepsin B takes place in lysosomes in the course of intracellular transport from endoplasmic reticulum through Golgi complex to lysosomes. PMID- 3675578 TI - Vasopressin increases 45Ca2+ influx in rat aortic smooth muscle cells. AB - [Arg8]Vasopressin (AVP)-induced 45Ca2+ influx was examined in vascular smooth muscle cells derived from rat aorta. AVP stimulated the 45Ca2+ influx in a concentration-dependent manner. The effect was abolished in the presence of La3+. The dihydropyridine calcium channel antagonist darodipine did not affect the AVP induced influx of 45Ca2+. These data suggest that AVP stimulates in these cultured aortic smooth muscle cells a receptor-operated channel (ROC) that is permeable to Ca2+. PMID- 3675579 TI - Serum amyloid P component is the major calcium-dependent specific DNA binding protein of the serum. AB - Serum amyloid P component (SAP), a member of the highly conserved pentraxin family of plasma proteins, was found to be the only protein in whole normal or acute phase serum which underwent specific calcium-dependent binding to either single or double-stranded DNA immobilised on gel. Isolated purified SAP also bound to long chromatin, to H1-stripped chromatin and to native DNA in solution at physiological ionic strength. Pure SAP which had been immobilised on gel, specifically bound nucleosome core particles from solution. These observations strongly suggest that SAP may bind to extracellular chromatin and DNA in vivo and that this may be its physiological role. PMID- 3675580 TI - Nucleotide sequence of a bovine lens alpha A-crystallin cDNA. AB - We have determined the nucleotide sequence of a bovine lens alpha A2-crystallin cDNA clone, designated pBL alpha A2-1. The 793 bp cDNA insert contains coding information for the entire 173 amino acid alpha A2-crystallin polypeptide, as well as non-translated sequences located both upstream and downstream from the coding region. The coding sequences contained in pBL alpha A2-1 are at least 89% homologous with the corresponding sequences from other mammalian alpha A crystallin genes, and are 78% homologous to the frog alpha A-crystallin coding region. In contrast, the downstream nontranslated sequences of the mammalian alpha A-crystallin transcripts show much greater sequence divergence, with the bovine sequences averaging 47% homology with the corresponding sequences from other mammalian species. PMID- 3675581 TI - Intracellular transport and processing of lysosomal cathepsin H. AB - Intracellular transport and processing of lysosomal cathepsin H was investigated in the subcellular fractions of rat liver by pulse-labeling experiments with [35S]methionine in vivo. A newly synthesized procathepsin H with a molecular weight of 41 kDa first appeared in the rough microsomal fraction at 10 min postinjection of label. This procathepsin H moved from the microsomal fraction to the Golgi subfractions at 30 min. Then a processed single-chain form with 28 kDa appeared in the lysosomal fraction at 60 min and persisted as the predominant form after 180 min. These results suggest that the propeptide-processing of procathepsin H indeed takes place in lysosomes in the course of intracellular transport from endoplasmic reticulum via Golgi complex to lysosomes. PMID- 3675582 TI - Identification of a precursor form of cathepsin D in microsomal lumen: characterization of enzymatic activation and proteolytic. AB - A precursor form of cathepsin D with 45 kDa was demonstrated in the rat liver microsomal lumen by immunoblotting analysis. The microsomal fraction containing procathepsin D which passed through a pepstatin-Sepharose resin showed no appreciable activity of cathepsin D. The in vitro incubation of this fraction at pH 3.0 resulted in a gradual increase of proteolytic activity toward hemoglobin as substrate and also, the proteolytic conversion of procathepsin D to the mature form was concomitantly observed. The proteolytic processing step was sensitive to pepstatin. These results suggest that procathepsin D is inactive in the endoplasmic reticulum and may be converted to the active forms by autoproteolytic processing mechanism at acidic pH during biosynthesis. PMID- 3675583 TI - Functional drug targeting to erythrocytes in vivo using antibody bearing liposomes as drug vehicles. AB - Covalent attachment of anti-erythrocyte F(ab')2 to the liposome surface has recently been shown to considerably enhance the liposome binding to erythrocytes in vivo. These antibody bearing liposomes have now been found quite effective as vehicles for delivering the antimalarial drug, chloroquine, to erythrocytes in Plasmodium berghei-infected mice. This demonstrates the usefulness of antibody targeted liposomes as carriers for site-specific drug delivery. PMID- 3675584 TI - Carboxylate polyanions accelerate inhibition of thrombin by heparin cofactor II. AB - The heparin cofactor II (HCII)/thrombin inhibition reaction is enhanced by various carboxylate polyanions. In the presence of polyaspartic acid, the HCII/thrombin reaction is accelerated more than 1000-fold with the second-order rate constant increasing from 3.2 x 10(4) M-1 min-1 (in the absence of polyAsp) to 3.6 x 10(7) M-1 min-1 as the polyAsp concentration is increased from 1 to 250 micrograms/ml. This accelerating effect was observed for HCII/thrombin, though to varying degrees, with other carboxylate polyanions. In contrast to HCII, the rate of antithrombin III inhibition of thrombin was decreased in the presence of polyAsp. The HCII/thrombin complex is rapidly formed in the presence of 10 micrograms/ml polyAsp when 125I-labeled-thrombin is incubated with plasma. It is possible that at physiological sites rich in carboxylate polyanions, thrombin may be preferentially inhibited by HCII. PMID- 3675585 TI - Decrease of palmitoyl-CoA elongation in platelets and leukocytes in the patient of hereditary methemoglobinemia associated with mental retardation. AB - Effect of the deficiency of NADH-cytochrome b5 reductase on fatty acid elongation was studied in the platelets and leukocytes taken from a patient of hereditary methemoglobinemia associated with mental retardation. The activity of fatty acid elongation was determined by measuring the incorporation of [2-14C]malonyl-CoA into palmitoyl-CoA. The de novo biosynthesis of fatty acids was blocked by the addition of phosphotransacetylase, and the elongation system could be assayed in the homogenates separated from de novo biosynthesis. As compared to normal subjects approximately 40% decrease of fatty acid elongation was observed both in the platelets and leukocytes from the patient. PMID- 3675586 TI - Fibrinolysis by urokinase endowed with magnetic property. AB - The activated magnetic modifier was synthesized from magnetite, alpha, omega dicarboxymethylpoly(oxyethylene) and N-hydroxysuccinimide (Biochem. Biophys. Res. Commun., 145, 908-914, 1987). Urokinase was directly coupled with the activated magnetic modifier to obtain magnetic urokinase. The magnetic urokinase dispersed in saline and exerted high fibrinolytic activity (13.8 X 10(4) IU/mg protein), and was readily recovered from saline by magnetic force of 250 Oe. By applying magnetic force, the urokinase was attracted at our will and local fibrinolysis was achieved on fibrin gel in a petri dish. PMID- 3675587 TI - A 31P-NMR study on multilamellar liposomes formed from the lipids of a thermophilic bacterium. AB - The membrane lipids of a thermophilic bacterium, Thermus SPS11, isolated from thermal springs in Sao Pedro do Sul, Portugal, were fractionated by chromatography on silica gel. The total lipid extract was found to contain one major phospholipid (PL), which accounts for about 90% of the total lipid phosphorous, and one major glycolipid (GL), which accounts for about 95% of the total carbohydrate in the non-phospholipid fraction. The membranes also contain about 11% by weight of a complex mixture of carotenoids (CA). Multilamellar liposomes, in excess water, formed from PL and mixtures of PL with GL and CA in proportions found in the natural membrane were investigated by proton-decoupled 31P-nuclear magnetic resonance (NMR) spectroscopy and X-ray diffraction. All mixtures examined were found to be in a lamellar phase with disordered hydrophobic chains with no evidence for "non-bilayer structures" between 23 degrees and 85 degrees C. Compared to bilayers formed from pure PL or mixtures of PL and CA, significantly larger values for the chemical shift anisotropy of the 31P-NMR powder patterns were obtained from bilayers formed from mixtures of PL and GL, at temperatures above 75 degrees C, and mixtures of PL, GL and CA at all temperatures examined. These differences are interpreted in terms of changes in the order of the bilayer and/or changes in the orientation of the phosphate moiety of PL. The significance of these results to the thermophily of the bacterium is discussed. PMID- 3675588 TI - Carbon monoxide generation from tin- and zinc-protoporphyrin by tissue homogenates. AB - Both heme and tin-protoporphyrin (TP), but not zinc-protoporphyrin (ZP), supported significant NADPH-stimulated, concentration-dependent CO production in all tissues. These rates, for 400 microM substrate, ranged: for heme 0.52 (intestine) to 4.18 (spleen); for TP 0.08 (kidney) to 0.71 (liver); and for ZP 0.01 (liver) to 0.25 (kidney) nmoles CO/hr/mg protein. All three metalloporphyrins (400 microM) supported concentration-dependent CO production in the absence of NADPH. The rates ranged: for heme 0.31 (kidney) to 0.80 (spleen); for TP 0.41 (kidney) to 1.04 (intestine); and for ZP 0.12 (kidney) to 0.51 (spleen) nmoles/hr/mg protein. We conclude that both TP and ZP are subject to in vitro degradation by 13,000 x g supernatants of adult rat organs via CO-producing reactions. PMID- 3675589 TI - Ornithine decarboxylase induction and polyamine biosynthesis by phorone (diisopropylidene acetone), a glutathione depletor, in rats. AB - The administration of Phorone (diisopropylidene acetone, 250 mg/kg, ip.), a glutathione (GSH) depletor, markedly induced (400-fold of the control at 12 hr) ornithine decarboxylase (ODC) in the liver of rats. Parallel to ODC induction there was a marked increase in hepatic putrescine content. Phorone also produced an increase in spermidine content and a decrease in spermine content. The effects of phorone on ODC and putrescine content occurred dose-dependently with more than a 1000-fold increase in ODC activity over the controls at a dose of 500 mg/kg. Pretreatment of rats with buthionine sulfoximine, a GSH depletor by inhibition of biosynthesis, failed to inhibit phorone-mediated induction of ODC. In contrast, pretreatment with GSH, but not post-treatment, blocked the induction of ODC by phorone. PMID- 3675590 TI - High concentrations of STOP protein induce a microtubule super-stable state. AB - We have previously shown that mammalian brain crude extracts contained two classes of stable microtubules: "cold stable" and "super-stable" microtubules. We now find that both species are generated by a single protein factor (STOP protein) in a dose dependent manner. These results show that STOP protein action can be extreme, inducing resistance to -80 degrees C or to sonication and that no other factor seems to be required to account for the various subclasses of highly stable microtubules in brain. Finally, the rapid procedure described for the preparation of purified "super-stable microtubules" should be useful for the obtention of fractions with high STOP protein activity. PMID- 3675591 TI - Mitogenic activity in platelet-poor plasma from rats with persistent liver nodules or liver cancer. AB - Platelet-poor plasma (PPP) from F-344 rats with chemically-induced preneoplastic liver nodules or hepatocellular carcinoma stimulated S-phase DNA synthesis in monolayer cultures of normal rat hepatocytes. Similar mitogenic activity was detected in PPP 6 hrs to 1 week after partial hepatectomy (PH) or after necrotizing doses of CCl4 or diethylnitrosamine (DENA). Very little activity was found in PPP4 from control rats. The mitogenic activity in PPP from animals with nodules was non-dialyzable (greater than 14 kd) and bound to a heparin-sepharose affinity column. None of the mitogenic PPPs competed with [125I] epidermal growth factor (EGF) for binding sites on A431 cells or normal rat hepatocytes. These studies indicate that persistent proliferation of preneoplastic and neoplastic hepatocytes is associated with increased circulating levels of mitogenic hepatocyte growth factor. PMID- 3675592 TI - Partial characterization and amino acid composition of a high molecular weight peptide with salmon calcitonin immunoreactivity in a crustacean: Nephrops norvegicus. AB - Anti-salmon calcitonin antibodies were used to follow the purification of a high molecular weight peptide present both in the haemolymph and in the hepatopancreas of the Norway lobster Nephrops norvegicus. An apparent molecular weight of 22 kDa has been measured in electrophoresis on SDS gels and amino acid composition compared to salmon calcitonin. The amount determined by the immunoreactivity assay corresponds to about 1/40 and 1/140 of that which is based on direct protein measurement for the hepatopancreas and the haemolymph respectively. The total amount of this peptide could be estimated as 3.5 mg/g fresh weight for the hepatopancreas and 140 ug/ml for the haemolymph. The function of this peptide is still unknown. PMID- 3675593 TI - Histamine stimulates inositol phosphate accumulation via the H1-receptor in cultured human endothelial cells. AB - The effects of histamine on [3H]inositol phosphate ([3H]IP) accumulation was examined in the presence of lithium in [3H]inositol-prelabelled human umbilical vein endothelial cells. Histamine stimulated total [3H]IP formation in a dose dependent manner with a half-maximal value (EC50) of around 1-2 X 10(-6) M. Mepyramine, but not cimetidine, completely abolished the histamine response indicating that activation of phosphoinositide hydrolysis is mediated via H1 receptors. These data are the first to suggest that activation of inositol lipid hydrolysis is the underlying transmembrane signalling mechanism histamine H1 receptors employ in mediating various endothelial cell functions. PMID- 3675594 TI - Identification and characterization of a human transthyretin variant. AB - An apparent Mr variant of plasma transthyretin (TTR), previously detected using 2 D PAGE, is the first reported occurrence of this type of human TTR variant. We characterized the variant TTR to determine the nature of this difference. Comparative tryptic peptide maps of variant and normal TTR and sequencing of peptides which differed indicated the variant contained a single amino acid substitution of valine for tyrosine at position 116. Because such a change requires two nucleotide substitutions, we postulate the variant arose through mutation in codon 116 of a heretofore unrecognized polymorphic or rare variant allele of TTR. PMID- 3675595 TI - Glycosylated prolactin in the murine pituitary: detection by a novel assay and alteration of concentrations by physiological and pharmacological stimuli. AB - In both rat and mouse pituitary extracts, we detected concanavalin A-binding prolactin immunoreactivity by a lectin-binding radioimmunoassay developed recently. The activity increased in response to estradiol benzoate treatment and lactation, stimuli that augment prolactin secretion, and decreased in response to acute nursing and perphenzine administration, stimuli that cause massive release of prolactin. Western blot analysis revealed a prolactin-immunoreactive band 2,000-3,000 greater in Mr than the main prolactin band that bound to 125I-labeled concanavalin A. These results suggest the existence in the murine adenohypophysis of a glycosylated form of prolactin, which seems to be released under certain physiological states. PMID- 3675596 TI - A 'molten globule'-like unfolding intermediate of a four domain protein, the Fc fragment of the IgG molecule. AB - The Fc fragment of human IgG1 can be trapped in a stable intermediate state during thermal denaturation. In this conformation the molecule is compact with a native-like secondary structure, however, the tertiary structure is perturbed as revealed by intrinsic fluorescence measurements, the near-UV CD spectra and by mapping of antigenic sites with monoclonal antibodies. Similar phenomena were recently described for a few globular proteins of small size, and termed 'the molten globule' state. Our observation is a unique example of this phenomenon for a four domain protein. PMID- 3675597 TI - Immunological evidence for the presence of hormone-sensitive lipase in rat tissues other than adipose tissue. AB - A polyclonal rabbit antibody was used to detect hormone-sensitive lipase in rat organs other than white adipose tissue. Inhibition of tissue diacylglycerol lipase activity by the anti-hormone-sensitive lipase, and by NaF, Hg2+ and diisopropyl fluorophosphate, known inhibitors of the hormone-sensitive lipase, demonstrated its presence in the adrenals, ovaries, testes, heart and skeletal muscle, but not in the liver and kidneys. After enrichment by immunoprecipitation an immunoreactive protein, corresponding to the adipose tissue hormone-sensitive lipase 84 kDa subunit, and some additional, higher Mrapp proteins, were detected by Western blotting in the same tissues. The adipose tissue contained greater than 80% of the total hormone-sensitive lipase, with 5-10- and 50-100-fold lower specific activity in the steroid-producing and the muscle tissues, respectively. PMID- 3675598 TI - The disposition of primaquine in the isolated perfused rat liver. Stereoselective formation of the carboxylic acid metabolite. AB - The disposition of (+) and (-) primaquine (PQ) was studied in the isolated perfused rat liver (IPRL) preparation following a bolus dose (2.0 mg diphosphate salt; N = 6) of each enantiomer. Perfusate plasma concentrations of PQ and the carboxylic acid metabolite (PQm) were determined using previously reported methods. To enable the simultaneous measurement of PQ and PQm in bile a selective and reproducible HPLC assay was developed. Clearance of (-)PQ (8.8 +/- 2.9 ml min 1) was significantly greater than that of (+)PQ (5.5 +/- 1.5 ml min-1) and the apparent volumes of distribution of (-)PQ (606 +/- 182 ml) and (+)PQ (930 +/- 171 ml) were significantly different. Stereoselectivity in the hepatic elimination efficiency was manifest as a significant reduction in half-life (-)PQ 54 +/- 29 min; (+)PQ 123 +/- 33 min) and smaller area under the curve to infinity (-)PQ 254 +/- 96 micrograms ml-1.min, (+)PQ 387 +/- 108 micrograms ml-1.min) for (-)PQ when compared with (+)PQ. A significantly greater peak concentration of PQm was achieved following administration of (-)PQ (0.61 +/- 0.26 micrograms ml-1.min) than (+)PQ (0.19 +/- 0.09 micrograms ml-1). There was no difference between the sum of the areas under the curve to 4 hr for (+) and (-)PQ and the corresponding carboxylic acid metabolite (322 +/- 64 micrograms ml-1 and 317 +/- 75 micrograms ml min-1 respectively). There was no difference in the biliary clearance of (+) and (-)PQ (0.08 +/- 0.02 ml min-1 and 0.14 +/- 0.10 ml min-1 respectively) or the corresponding carboxylic acid metabolites (0.24 +/- 0.13 ml min-1 and 0.29 +/- 0.09 ml min-1). These results strongly suggest stereoselective formation of the carboxylic acid metabolite of primaquine. The significant increase in the volume of distribution of (+)PQ suggests the enantiomer has either an increased affinity for binding sites within the liver and/or erythrocytes or a decreased affinity for circulating perfusate albumin. PMID- 3675599 TI - Self-catalyzed inactivation of cytochrome P-450 during microsomal metabolism of cannabidiol. AB - When cannabidiol (CBD) was incubated with hepatic microsomes of mice in the presence of an NADPH-generating system, a significant decrease of cytochrome P 450 content was observed by measuring its carbon monoxide difference spectra. The decrease of cytochrome P-450 by CBD required NADPH and molecular oxygen. The effect was partially inhibited by SKF 525-A but not by various scavengers of active oxygen species, superoxide anion, hydroxyl radical and singlet oxygen. The incubation of CBD with hepatic microsomes did not affect total heme but decreased significantly free sulfhydryl contents in the microsomes. The derivatives of CBD modified in the resorcinol moiety, CBD-monomethyl- and dimethylethers, almost lost the effect on cytochrome P-450, whereas those modified in the terpene moiety, 8,9-dihydro- and 1,2,8,9-tetrahydro-CBDs exhibited some potency to inactivate cytochrome P-450. The inactivation of cytochrome P-450 by CBD and related compounds led to the inhibition of hepatic microsomal p-nitroanisole O demethylase and aniline hydroxylase activities. These results suggest that the resorcinol moiety of CBD plays some role in the inactivation of cytochrome P-450 by the cannabinoid. PMID- 3675600 TI - Drug-protein conjugates--XIII. The disposition of the benzylpenicilloyl hapten conjugated to albumin. AB - The disposition and metabolic fate of benzylpenicillin conjugated to a protein, human serum albumin (HSA), were compared with those of free penicillin in the rat. The conjugate was prepared by in vitro incubation of [3H]-benzylpenicillin and HSA at pH 10.8 for 24 hr at 37 degrees, conditions which favour the formation of penicilloyl-lysine residues. The synthetic conjugate was cleared more slowly from plasma than free penicillin after intravenous administration; thus at 3 hr, concentrations of 5.08 +/- 0.50% dose/ml of the conjugate (0.31 microCi; 2.92 mg protein) was obtained. In an earlier study a concentration of 0.03 +/- 0.01% dose/ml was obtained after administration of free BP (2.7 mmol kg-1). During this time, 1.41 +/- 0.50% of the conjugate dose was excreted in urine while 5.0 +/- 0.2% of the dose was excreted in bile. Tissue analysis indicated that the liver contained 15.3 +/- 0.9% of the dose, while other tissues contained less than 6% of the dose. In long term metabolism studies it was found that 39.5 +/- 1.0% and 46.5 +/- 0.9% of the dose (0.43 microCi; 6.33 mg protein) was excreted in the urine after 3 and 7 days respectively. The principal metabolite (63-68%) excreted in both bile and urine was identified on the basis of cochromatography and fast atom bombardment mass spectrometry as benzylpenicilloic acid, indicating that the conjugate undergoes specific cleavage at the bond between the benzylpenicilloyl moiety and the protein. In vitro degradation studies indicate that the metabolism occurs primarily in the liver. Therefore benzylpenicilloic acid excreted in urine, after administration of free BP, may be formed either by direct hydrolysis of the beta-lactam ring, and/or result from catabolism of protein conjugates formed in vivo. PMID- 3675601 TI - The effects of cigarette smoke compared to 3-methylcholanthrene and phenobarbitone on alkoxyresorufin metabolism by lung and liver microsomes from rats. AB - The rates of metabolism of phenoxazone and a homologous series of its ethers (alkoxyresorufins) by liver and lung microsomes of rats exposed to cigarette smoke were compared with the metabolism in rats pretreated with 3 methylcholanthrene (3MC) or phenobarbitone (PB). The rate of resorufin production was dependent on the length of the ether side chain. Liver and lung microsomes from control rats differed in their activity profiles (rate of resorufin production plotted against side-chain length), showing highest activity with ethoxy- and benzyloxyresorufin respectively. 3MC and PB selectively induced hepatic microsomal resorufin production with only certain of the substrates and the two agents differed in their selectivity, inducing most greatly with ethoxy- and benzyloxyresorufin respectively. Pulmonary microsomal resorufin production was induced by 3MC with a substrate selectivity similar to that shown for liver, but PB suppressed pulmonary metabolism with all the substrates. A single, short exposure to cigarette smoke induced ethoxyresorufin O-deethylase activity transiently in liver and lung microsomes. Three consecutive daily short exposures to cigarette smoke caused a weak 3MC-like induction of liver microsomal alkoxyresorufin metabolism, but the effect on lung microsomes was like weak 3MC and PB inductions combined. It is concluded that cigarette smoke induces selected cytochrome P-450-linked alkoxyresorufin O-dealkylase activities to a similar extent in both lung and liver and that the effects of cigarette smoke are characteristic of both 3MC-type and non-3MC-type inducers. PMID- 3675602 TI - Synergy of phenobarbital and 3-methylcholanthrene in "superinduction" of cytochrome P-450c mRNA but not enzyme activity. AB - The combination of phenobarbital and 3-methylcholanthrene in the inductive process of the rat hepatic cytochrome P-450c gene was evaluated. Daily injections of phenobarbital (80 mg/kg, i.p.) had little or no effect on the amount of poly (A)+ RNA encoding cytochrome P-450c, whereas a single injection of 3 methylcholanthrene (25 mg/kg, i.p.) produced a significant accumulation at 15 hr in cytosolic mRNA coding for cytochrome P-450c. Four daily injections of phenobarbital followed by a single dose of 3-methylcholanthrene produced 5-24 times more poly (A)+ RNA coding for P-450c than 3-methylcholanthrene treatment alone. This superinduction of RNA transcripts was also observed for a species coding for cytochrome P-450d, which was increased 3-6 times over 3 methylcholanthrene treatment alone. However, the elevated concentration of transcripts for both the P-450d and P-450c RNA species did not result in an increase in the marker enzyme activity for cytochrome P-450c, 7-ethoxyresorufin O deethylase. These data implicate a regulatory step in the induction of cytochrome P-450c enzyme activity which must occur at a level beyond transcription. PMID- 3675603 TI - Pivampicillin-promoted excretion of pivaloylcarnitine in humans. AB - Pivampicillin treatment of seven children (five boys and two girls) for 7 days significantly reduced the amounts of total acid-soluble carnitine, free carnitine, and long-chain acylcarnitines and increased the amounts of acid soluble acylcarnitine in plasma. The fasting plasma levels of 3-hydroxybutyrate at the end of treatment were 15% of the control value. The levels of free fatty acids were decreased, whereas triglyceride levels were unaffected, indicating impaired fat metabolism. Daily urinary excretion of total carnitine was four to five times higher than controls after the first day of treatment, although the amounts of free carnitine and acetylcarnitine were decreased. The urinary acylcarnitines were isolated and characterized by gas chromatography/electron impact mass spectrometry and fast-atom bombardment mass spectrometry. Pivaloylcarnitine was the predominant urinary acylcarnitine; it represented greater than 96% of the increased excretion of total carnitine and 75-80% of the total conjugated pivalic acid. The renal clearance of acylcarnitines was comparable to that of creatinine, indicating no reabsorption of pivaloylcarnitine. These data suggest a detoxification function of carnitine for pivalic acid in humans. PMID- 3675604 TI - Hepatic and cardiac carnitine palmitoyltransferase activity. Effects of adriamycin and galactosamine. AB - Carnitine palmitoyltransferase (CPT) activity is located on both the outer and inner sides of the mitochondrial inner membrane and is influenced by the surrounding lipids of the inner mitochondrial membrane. Both adriamycin and galactosamine interact with mitochondrial lipids as a part of their mechanism of toxicity, and thus these agents might be expected to affect CPT activity. Addition of adriamycin to both intact rat liver and heart mitochondria (CPT-A, outer CPT) and inverted submitochondrial vesicles (CPT-B, inner CPT) depressed CPT in the forward direction of reaction (palmitoyl-l-carnitine formation), but the CPT-B activity was more sensitive to the inhibitor. Adriamycin depressed the CPT-A reverse reaction (palmitoyl-CoA formation) to 40% of control, but it had no effect on the CPT-B reverse reaction. In vivo galactosamine administration depressed CPT-A and CPT-B 20-30% and did not affect subsequent action of in vitro adriamycin. Addition of cardiolipin (0.25 to 1.0 mg/assay) increased activity of the CPT-A forward reaction of both control and galactosamine-treated rats, but it did not affect CPT-B activity. The results suggest that CPT-A and CPT-B may be influenced differently by perturbants that affect lipids of the membrane. PMID- 3675605 TI - Inhibition of blood-brain barrier permeability to DL-propranolol by serum from acute renal failure rats. AB - The effect of uranyl nitrate-induced acute renal failure on the brain uptake of DL-propranolol was investigated in rats with a series of tissue-sampling single carotid injection techniques. When the buffer solution was used as an injection solution, the brain uptake index (BUI), the extraction ratio (ET), and the blood brain barrier (BBB) permeability-surface area product (PSapp) and PSu (corrected PSapp for the unbound fraction) in uremic rats were significantly lower than those in control rats. These parameters for DL-propranolol were decreased significantly in both control and uremic rats receiving injection of the uremic serum. The PSu values in both of the control and uremic rats injected with either control or uremic rat serum were significantly higher than those in rats injected with the buffer solution, suggesting the presence of a protein-mediated transport mechanism; that is, the conventional assumption that the fraction of the drug which is available for the uptake in vivo is equal to the unbound fraction as measured in vitro may not hold. In contrast, the brain extraction of D [14C]glucose, [3H]inulin and [3H]water, which show no binding to serum protein, was not affected by the coinjection of either control or uremic rat serum. On the other hand, using either the ultrafiltrate from serum (control and uremic) or supernatant fraction from heat-treated serum (control and uremic) as the injection solution, no significant difference in the PSu value for DL-propranolol was observed between control and uremic serum. These results suggest that (1) the decrease in the PSu value for DL-propranolol in uremic rats may be attributed mainly to the presence of an endogenous inhibitory substance(s) for the brain uptake or to the decrease in the exchangeable fraction in vivo in the uremic serum; (2) the decrease in the PSu value for DL-propranolol may also be partly attributed to the change in the BBB permeability and/or surface area; (3) the inhibitor for the brain uptake may be characterized as a temperature-sensitive and nonfiltrable substance(s) at physiological pH; and (4) the ability of protein mediated transport for DL-propranolol into brain was decreased in uremic rats. PMID- 3675606 TI - Conversion of spironolactone to 7 alpha-thiomethylspironolactone by hepatic and renal microsomes. AB - Recent observations indicate that 7 alpha-thiomethylspironolactone is an important circulating metabolite of the mineralocorticoid antagonist spironolactone (SL). Studies were carried out to determine possible sites and pathways of 7 alpha-thiomethyl-SL formation and, in particular, to evaluate SL metabolism by guinea pig hepatic and renal microsomal preparations. In the absence of S-adenosylmethionine (SAM), liver and kidney microsomes rapidly converted SL to 7 alpha-thio-SL as the only metabolite. The rate of 7 alpha-thio SL production was greater in liver than kidney. In the presence of SAM, 7 alpha thio-SL was further converted to 7 alpha-thiomethyl-SL by liver and kidney microsomes. The rates of methylation with 7 alpha-thio-SL as substrate were three to four times greater for liver than for kidney, but the Km values were similar (approximately 30 microM) in the two issues. Maximal enzyme activity was obtained with SAM concentrations of 25-200 microM. NADPH had no effect on SL or 7 alpha thio-SL metabolism by liver or kidney microsomes. To determine if a pathway involving the C-S lyase enzyme might contribute to circulating 7 alpha-thiomethyl SL levels in vivo, guinea pigs were treated with SL or its dethioacetylated derivative, canrenone, and plasma metabolites were analyzed by HPLC. Both 7 alpha thiomethyl-SL and canrenone were found to be circulating metabolites in SL treated animals, but only canrenone was identified in the plasma of canrenone treated guinea pigs. The results indicate that the liver and kidney are potential sites of 7 alpha-thiomethyl-SL production and that its formation probably does not involve the C-S lyase pathway. PMID- 3675607 TI - In vitro metabolism of chlorpheniramine in the rabbit. AB - The in vitro metabolism of 3-(p-chlorophenyl)-3-(2-pyridyl)-N, N dimethylpropylamine (chlorpheniramine, I) by rabbit liver microsomes was examined. The metabolites, tentatively identified by gas-liquid chromatography mass spectrometry, included the mono- and didemethyl metabolites, the aldehyde that results from deamination, and further metabolites of this aldehyde including its intramolecular cyclization product, an indolizine, and its reduction product, the alcohol. Inhibition of metabolism of I by N2, CO, SKF-525A, 2,4-dichloro-6 phenylphenoxyethylamine (DPEA), or deletion of NADPH implies some involvement of cytochrome P-450 in the metabolic reactions. Quantitation of metabolism in these studies accounted for only 69% of the dose, so that binding and/or other undetected metabolic pathways were operative. PMID- 3675608 TI - 4-Chloro-4'-biphenylol as an uncoupler and an inhibitor of mitochondrial oxidative phosphorylation. AB - 4-Chloro-4'-biphenylol (4'-OH-4-CB), a metabolite of 4-chlorobiphenyl (4-CB), stimulated state 4 respiration and released oligomycin-inhibited state 3 respiration of rat liver mitochondria with succinate as the respiratory substrate. When glutamate/malate and beta-hydroxybutyrate were used as the substrates, however, 4'-OH-4-CB was ineffective on these parameters. This indicates that 4'-OH-4-CB uncouples oxidative phosphorylation with succinate, but not with glutamate/malate and beta-hydroxybutyrate. 4'-OH-4-CB severely inhibited 2,4-dinitrophenol (DNP)-stimulated respiration with glutamate/malate (ID50, 25 microM) and beta-hydroxybutyrate (ID50, 32 microM) because of the blockade of electron transfer between NADH and CoQ span, masking the uncoupling action of 4' OH-4-CB. On the other hand, the inhibition of the respiration with succinate was only apparent at high 4'-OH-4-CB concentrations (ID50, 260 microM). 4'-OH-4-CB also inhibited the oxidation of NADH in submitochondrial particles (ID50, 35 microM). State 3 respiration was more intensely inhibited by 4'-OH-4-CB in the presence of either glutamate/malate (ID50, 23 microM) or beta-hydroxybutyrate (ID50, 26 microM) than that in the presence of succinate (ID50, 220 microM). Thus, 4'-OH-4-CB acts as both an uncoupler and an inhibitor of oxidative phosphorylation. The overall in vitro effect is to prevent ATP synthesis, which may be an important factor in the mechanism underlying the toxicity of 4-CB. PMID- 3675609 TI - Is misonidazole binding to mouse tissues a measure of cellular pO2? AB - Misonidazole (MISO), a hypoxic cell radiosensitizer, forms covalently-linked adducts to cellular molecules as a result of bioreductive metabolism, a process which is strongly dependent upon oxygen concentration. MISO binding to liver tissue taken from air-breathing mice was three to five times greater than binding to other normal tissues. The relative binding of [14C]MISO to various mouse tissue cubes in vitro was measured by autoradiography as a function of defined oxygen concentrations, and standard curves (binding rate vs oxygen concentration) were generated. The oxygen concentration for half-maximum binding as well as the maximum and minimum binding rates (grains per 100 micron 2) observed for liver tissue were not significantly different from those measured for brain or heart tissue. These results, along with previously published data on MISO binding to isolated hepatocytes in vitro, suggest that the elevated binding to liver in vivo may result, in part, from the organ existing at a significantly lower pO2 than other normal tissues. They also suggest that this drug adduct procedure could be developed as a sensitive method for the quantitative measurement of tissue pO2 at the cellular level. PMID- 3675610 TI - Anti-aggregatory and contractile activity of analogues of prostaglandins E1, D1 and H1. PMID- 3675611 TI - Elevated serum copper concentration in monocrotaline pyrrole treated rats with pulmonary hypertension. PMID- 3675612 TI - Unresponsiveness of female rat hepatic monooxygenases to physiological levels of testosterone. PMID- 3675613 TI - Interaction of an intercalating antitumoral agent: 9-hydroxy-2-methyl ellipticinium (NMHE) with chromatin. AB - In this work we study the effects of an intercalating antitumoral agent: 9 hydroxy-2-methyl ellipticinium (NMHE) on the structure of chromatin, using micrococcal nuclease and DNase 1 as structural probes. The binding of the drug to chromatin, either in vitro or in the nuclei, induces two structural changes of chromatin: (a) an unfolding of the overall structure which results in an activation of the rate of degradation of chromatin by micrococcal nuclease and (b) a disorganisation of the core particle structure leading to the unwrapping of the DNA from the histone core. Moreover, by studying the interaction of MMHE with nuclei labeled in the active regions of the genome through a nick-translation reaction, it appears that the drug is overconcentrated in these regions and does not induce any new structural changes. The interaction of NMHE with DNase 1 sensitive regions of chromatin indicates that these regions are already "open" or relaxed and represent a preferential target for the drug. PMID- 3675614 TI - Stereoselective hydrolysis of soman in human plasma and serum. AB - The contribution of various human serum and plasma fractions to the total hydrolysis rate constants of the four isomers of soman is studied. Spontaneous hydrolysis (as measured in buffer) occurs at a faster rate for the C(+)P(+)- and C(-)P(-)-isomers. A stereoselectively catalyzed hydrolysis of soman occurs in serum fractions IV and V (albumin). In fraction V the C(+)P(+)- and C(-)P(-) isomers are hydrolyzed at a faster rate than their respective epimers, while in fraction IV-1 a stereoselective effect towards C(+)P(+)-soman is found. All the forementioned contributions, however, are negligible in comparison with the stereoselective enzymatic hydrolysis of the P(+)-isomers. The latter reaction is characterized by a significant lowering of the activation energy as compared with the spontaneous hydrolysis of the P(+)-isomers. Such a lowering in activation energy is not found for the hydrolysis of the P(-)-isomers in whole serum or plasma; hence it can be concluded that a phosphorylphosphatase hydrolyzes the P(+)-isomers in a stereoselective way, the P(-)-isomers either not being affected by this (these) enzyme(s) or the mechanism of catalysis being fundamentally different. This conclusion is in agreement with the observations on the influence of Hg2+ on the hydrolysis of soman in serum; the hydrolysis of the P(+)-isomers is significantly inhibited by 1 mM of Hg2+ while the P(-)-hydrolysis is unaffected by this concentration of Hg2+. The action of some potential inhibitors on this phosphorylphosphatase activity was studied. Iodoacetate did not inhibit nor did Ba2+, Sr2+, Co2+ or Mn2+ show a significant effect on the hydrolysis of the P(+)-isomers. On the other hand the hydrolytic activity in serum was nearly completely inhibited by EDTA but restored upon addition of Ca2+. These findings suggest that this enzymatic activity can be classified as an arylesterase (paraoxonase). Finally, the influence of pH on the hydrolytic activity shows a different pattern for C(+)P(+)- and C(-)P(+)-soman, which may suggest that more than one enzyme is involved in the degradation of soman. PMID- 3675615 TI - Stereoselective phosphonylation of human serum proteins by soman. AB - Phosphonylation has been reported as part of the degradation of soman in human serum. The concentration of phosphonylation sites can be quantified by comparing the degradation in serum, preincubated with soman (all sites occupied), with the degradation in serum not preincubated. The mean value of 73 nM of phosphonylation sites is in agreement with the concentration of active sites of butyrylcholinesterase (EC 3.1.1.8.), which is known to be phosphonylated by soman. Hence, it is concluded that butyrylcholinesterase accounts for all the phosphonylation sites present in human serum. The stereoselectivity of the reaction was investigated by using epimeric pairs of soman, in casu C(+)P(+/-)- and C(-)P(+/-)-soman. In a first approach enzymatic hydrolysis was blocked and the ratios of phosphonylation rate constants, C(+)P(+)/C(+)P(-) and C(-)P(+)/C( )P(-), were determined to be 0.15 and 0.31, respectively. In a second approach, in untreated serum, the bimolecular phosphonylation rate constants of C(+)P(-)- and C(-)P(-)-soman were determined, neglecting their small hydrolysis rate and taking advantage of the fast enzymatically catalysed disappearance of their respective P(+)-epimeric counterparts. Values for C(+)P(-)- and C(-)P(-)-soman are 3.6 X 10(7) and 0.6 X 10(7) M-1.min-1, respectively. Using a combination of both approaches, a relative ranking of phosphonylation rates of the four isomers was found to be C(+)P(-) much greater than C(+)P(+) approximately equal to C(-)P( ) greater than C(-)P(+). PMID- 3675616 TI - Inhibition of human serum and rabbit muscle cholinesterase by local anesthetics. AB - The effects of tertiary amine local anesthetics (procaine, mepivacaine, lidocaine, tetracaine, dibucaine, and bupivacaine) and chlorpromazine were investigated for rabbit muscle acetylcholinesterase and human serum cholinesterase. The muscle enzyme was poorly inhibited by local anesthetics containing an amide linkage. The serum cholinesterase was inhibited by all those compounds, their relative potencies being proportional to their octanol/water partition coefficients. The dissociation constants of tetracaine and procaine, ester anesthetics, were 1000-fold and 100-fold, respectively, that which would be expected from their partition coefficient basis respective to the other amide anesthetics. Procaine showed competitive inhibition of serum cholinesterase, whereas for most anesthetics a mixed type of inhibition was observed. Procaine probably binds at the main anionic site, while the other positively charged anesthetics bind to either the catalytic centre or to the peripheral or modulator anionic site, modifying the kinetic behaviour of cholinesterase as has been demonstrated by the appearance of negative cooperativity for binding to the substrate. PMID- 3675617 TI - Expression of five forms of microsomal cytochrome P-450 in primary cultures of rabbit hepatocytes treated with various classes of inducers. AB - In order to investigate the expression of five different forms of microsomal cytochrome P-450 including P-450 2 (P450IIBI), 3b (P450IIC3), 3c (P450IIIA4), 4 and 6 (P450IA2 and A1), hepatocytes were isolated from untreated rabbit and maintained in primary monolayer cultures in serum free modified Waymouth medium in the absence and in the presence of various classes of inducers including phenobarbital (PB), rifampicin (RIF), dexamethasone (DEX) and B-naphthoflavone (BNF). In untreated cultures the level of the various forms of P-450, determined by immunoblot with the use of specific antibodies, generally declined with time but at markedly different rates. In cultures treated with the inducers decline of the various forms was either unaffected, reduced, or even reversed, so that 96 hr after plating some of these forms appeared to be induced several-fold with respect to the untreated cultures. The forms 2 and 3c were co-induced by PB, RIF or DEX; as in vivo, BNF induced forms 4 and 6. Induction of forms 2, 3c, 4 and 6 was accompanied by stimulation of related monooxygenase activities, benzphetamine demethylase, progesterone 6B hydroxylase and benzpyrene hydroxylase and ethoxyresorufin deethylase, respectively. In all cases, induction was accompanied by an increased rate of de novo synthesis of the protein, determined by radio immunoprecipitation assay with the use of specific antibodies on [3H]-Leu labeled cell lysate. Both induction and increased de novo synthesis were time- and inducer concentration-dependent. In cultures treated with RIF or BNF de novo synthesis of P-450 3c or of P-450 4 and 6 was correlated with the level of their specific mRNA quantitated from northern blots probed with either pLM3c-4.1 or pLM6.1, two plasmids containing inserted cDNA coding for P-450 3c or P-450 6, respectively. We conclude from these experiments that rabbit hepatocytes in primary monolayer cultures represent suitable models for studying regulation induction and pharmacological implications of the microsomal cytochromes P-450. PMID- 3675618 TI - Binding of catecholamines to alpha-1 acid glycoprotein, albumin and lipoproteins in human serum. AB - The binding of catecholamines in human serum was determined by equilibrium dialysis at 37 degrees. For serum concentrations of 10-15 nM the bound fractions were 28.8 +/- 2.2%, 25.7 +/- 1.7% and 22.2 +/- 2.2% for (+/-)-isoproterenol (IPR), (+/-)-norepinephrine (NE) and (+/-)-epinephrine (EPI), respectively. At higher serum concentrations saturation occurred. Alpha-1 acid glycoprotein (AAG) possessed one high affinity binding site and approximately 10 low affinity sites. The catecholamines were bound to AAG with the same order of potency for both classes of binding sites: IPR (Kd1: 100 microM Kd2: 2.2 mM) greater than NE (Kd1: 120 microM, Kd2: 6.5 mM) greater than EPI (Kd1: 140 microM, Kd2: 14 mM). Human serum albumin (HSA) and lipoproteins (SLP) interacted with the catecholamines in a non-saturable manner. IPR showed the strongest and EPI the weakest association to both of these serum protein fractions. (-)-Propranolol was able to inhibit the binding of IPR in serum and to isolated AAG, but not to HSA or to SLP. The present results show that AAG is an important catecholamine-binding protein in human serum. AAG, but not HSA or SLP, possesses binding sites shared by adrenergic receptor stimulators and blockers. PMID- 3675619 TI - Characterization of the cytochrome P-450 monooxygenase system of hamster liver microsomes. Effects of prior treatment with ethanol and other xenobiotics. AB - The cytochrome P-450 monooxygenase system of hamster liver microsomes and its response to prior treatment with ethanol and other xenobiotics have been examined. Male Syrian golden hamsters were administered ethanol (ETOH), phenobarbital (PB), 5,6-benzoflavone (BF) or isoniazid (INH). Each treatment resulted in a moderate increase (20-60%) in the specific content of liver microsomal cytochrome P-450 along with a unique hemeprotein ferrous carbonyl Soret maximum. Sodium dodecyl sulfate-polyacrylamide gel electrophoretic analysis of liver microsomes revealed distinctive changes in protein banding patterns in the cytochrome P-450 (45-60 kDa) region with each treatment. NADPH: cytochrome c reductase activity was increased by both PB and INH, whereas cytochrome b5 content was increased by INH only. Microsomal oxidation of ETOH and aniline p hydroxylation (expressed per nmol cytochrome P-450) were enhanced dramatically by ETOH and INH, whereas PB and BF had no effect on these enzymatic activities. Both ETOH and INH also increased zoxazolamine 6-hydroxylation but, in contrast to other rodent species, this drug-metabolizing activity was decreased in hamster liver microsomes after treatment with either PB or BF. Microsomal benzphetamine N demethylation was decreased by ETOH, INH and BF administration and was only modestly enhanced after treatment with PB. ETOH and INH had no effect on the O deethylation of 7-ethoxycoumarin, and enzymatic activity increased by BF but decreased by PB. These results demonstrate that the cytochrome P-450-dependent monooxygenase system of hamster liver microsomes responds to treatment with ETOH and other xenobiotics in a manner that is quantitatively and, in certain respects, qualitatively different from that reported for the rat, rabbit, and mouse. PMID- 3675621 TI - Amphotericin B: a biological response modifier in targeting against the salvage pathways. AB - Dipyridamole, a nucleoside transport inhibitor which blocks the rescue effect of exogenous nucleosides, is a compound of interest for use in combination with antimetabolites of de novo purine and pyrimidine biosynthesis. This study has provided evidence that the dipyridamole inhibitory effect on nucleoside incorporation varied markedly during the course of cell growth in culture. Human colon cancer HT-29 cells in lag and log phases were highly sensitive to the blocking action of dipyridamole on thymidine incorporation with IC50 values of 0.06 and 0.07 microM respectively. In contrast, stationary phase cells were comparatively insensitive to dipyridamole with an IC50 of 46 microM. Amphotericin B restored the sensitivity of stationary phase cells to dipyridamole, lowering the IC50 value for thymidine incorporation to 0.03 microM. A similar pattern was observed for cytidine incorporation. Amphotericin B also enhanced the growth inhibitory action of dipyridamole in stationary phase cells. The combination of amphotericin B and dipyridamole should be potentially useful in cancer chemotherapy. PMID- 3675620 TI - Competition of milrinone, a non-iodinated cardiac inotropic agent, with thyroid hormone for binding sites on human serum prealbumin (TBPA). AB - Milrinone [2-methyl-5-cyano-(3,4'-bipyridin)-6(1H)-one] is a positive cardiac inotropic agent recently shown to have thyromimetic activity in vitro in a rabbit myocardial membrane Ca2+-ATPase system [K. M. Mylotte et al., Proc. natn. Acad. Sci. U.S.A. 82, 7974 (1985)]. In the present studies, milrinone was examined for activity as an inhibitor of iodothyronine binding by human serum thyroid hormone transport proteins, thyroxine-binding globulin (TBG), prealbumin (TBPA) and albumin. Polyacrylamide gel electrophoresis at pH 9.0 of sera equilibrated with [125I]thyroxine showed that milrinone competed with L-thyroxine (T4) for binding sites on TBPA (10 and 100 microM milrinone caused 61 and 73% reductions, respectively, in T4 binding to TBPA, P less than 0.01); T4 displaced from TBPA was bound by TBG and albumin. Comparable reductions in T4 binding to TBPA were observed in electrophoretic studies conducted at pH 7.4. Binding of triiodo-L thyronine (T3) to TBPA was electrophoretically confirmed and shown to be decreased in the presence of milrinone. Electrophoresis of purified TBPA also demonstrated that [14C]milrinone co-migrated with this transport protein and that milrinone displaced tracer T4 from TBPA. Amrinone, the 2-H-5-NH2 analog of milrinone, had less than 5% of the activity of milrinone as an inhibitor of T4 binding in electrophoretic studies. Scatchard analysis of T4 and milrinone binding to purified TBPA, measured by equilibrium dialysis, showed two classes of binding sites, with association constants, respectively, of 6.1 X 10(7) M-1 and 1.6 X 10(6) M-1 for T4, and 1.7 X 10(6) M-1 and 8.9 X 10(2) M-1 for milrinone. Computer graphic modeling of the binding of milrinone to the T4 site in the crystal structure of TBPA showed that milrinone best occupied this site when the substituted bipyridine ring overlapped the phenolic ring of T4. In this orientation the 5-cyano group, which has an electronegativity similar to that of iodine, occupied the same volume as the 5'-iodine of T4. The 5-amino group of amrinone lacks these characteristics. In this orientation, the keto function of milrinone overlapped the T4 4'-hydroxyl and could participate in similar intermolecular interactions. Thus, milrinone, a non-iodinated bipyridine, and thyroid hormone share structural and biochemical homologies and compete for the same binding site on TBPA. PMID- 3675622 TI - Conjugation reactions in hepatocytes isolated from streptozotocin-induced diabetic rats. AB - The activities of three drug conjugation reactions, glutathione, glucuronic acid and sulphate conjugation and the synthesis of glutathione, have been measured in hepatocytes isolated from streptozotocin-induced male diabetic rats. The intracellular content of reduced glutathione (GSH) was decreased in diabetic rat hepatocytes compared with controls. Following depletion of the intracellular GSH stores with diethylmaleate, the resynthesis of GSH in the presence of 0.5 mM L methionine, occurred faster in diabetic rat hepatocytes than in those from control rats indicating that the cystathione pathway may be more efficient in the diabetic animals. In contrast, there was no significant difference in the resynthesis of GSH between control and diabetic rat hepatocytes in the presence of L-cysteine. The GSH conjugation of 1-chloro-2,4-dinitrobenzene (CDNB) and 3,4 dichloronitrobenzene (DCNB) was deficient in diabetic rat hepatocytes, although only the effect on the former reaction was statistically significant (P less than 0.05). The Vmax for CDNB conjugation was significantly lower (P less than 0.05) in cytosolic fractions prepared from diabetic rat liver than in control rat liver fractions. This was accompanied by an increase in the affinity of the enzyme for CDNB. In contrast, the Vmax and Km for the conjugation of DCNB in cytosolic fractions were unaffected by the induced-diabetes. Glucuronic acid conjugation of both 1-naphthol and phenolphthalein was markedly deficient in diabetic rat hepatocytes. The intracellular concentrations of the cofactor for glucuronidation, UDP-glucuronic acid, were decreased in diabetic rat liver and this was thought to contribute to the defect in glucuronidation. The sulphation of 1-naphthol was not significantly altered by the induced diabetes. Deficiencies in glutathione and glucuronic acid conjugation in streptozotocin-induced diabetic rats may result in an increased susceptibility to xenobiotic induced cytotoxicity. PMID- 3675623 TI - Accumulation of newly synthesized serum proteins by cadmium in cultured rat liver parenchymal cells. AB - Effects of cadmium on secretion of the two major serum proteins, albumin and transferrin were studied in primary cultured rat liver parenchymal cells. Exposure to 7 microM cadmium for 8 hr did not inhibit synthesis of both albumin and transferrin whereas secretions of the two proteins were effectively depressed. In the cells exposed to cadmium serum type albumin and proalbumin were accumulated. Cadmium may affect intracellular processing of secretory proteins and also retard the discharge of these proteins resulting in inhibition of protein secretion from the liver parenchymal cells. PMID- 3675624 TI - Lipid peroxidation, protein thiols and calcium homeostasis in bromobenzene induced liver damage. AB - The mechanisms of bromobenzene hepatotoxicity in vivo were studied in mice. The relationships among glutathione (GSH) depletion, lipid peroxidation, loss of protein thiols, disturbed calcium homeostasis and liver necrosis were investigated. Liver necrosis (as estimated by the serum glutamate-pyruvate transaminase (SGPT) level) appeared between 9 and 12 hr and increased at 18 hr. Lipid peroxidation which was already detectable at 6 hr in some animals, increased thereafter showing a good correlation with the severity of liver necrosis. Despite a quite fast depletion of hepatic GSH, a significant decrease in protein thiols could be observed at 12-18 hr only. Loss of protein thiols in both whole liver and subcellular fractions (microsomes and mitochondria) was correlated with lipid peroxidation. Also a good inverse correlation was seen between lipid peroxidation and the calcium sequestration activity of liver microsomes and mitochondria. The treatment of mice with desferrioxamine (DFO) after bromobenzene-intoxication completely prevented lipid peroxidation, loss of protein thiols and liver necrosis in the animals sacrificed 15 hr after poisoning. When, however, the animals were examined at 24 hr, although the general correlation between lipid peroxidation and liver necrosis was held, in some animals (about 30% of the survivors) elevation of SGPT was observed in the virtual absence of lipid peroxidation. It seems likely therefore that the liver damage seen during the first phase of bromobenzene-intoxication is strictly related to lipid peroxidation. It is, however, possible that in some animals in which for some reason lipid peroxidation does not develop, another mechanism of liver necrosis unrelated to lipid peroxidation occurs at later times. PMID- 3675625 TI - Alkaline labilization of DNA photosensitized by promazine derivatives. AB - Superhelical pBR322 DNA has been photosensitized in the presence of various promazine derivatives. Agarose gel electrophoresis of the photosensitized DNA reveals that true single-strand breaks are induced during irradiation. Alkaline treatment of the photosensitized DNA with a subsequent alkaline agarose gel electrophoresis demonstrates that in addition to true single-strand breaks, these drugs can induce alkali-labile lesions. Although true single-strand breaks are induced randomly into a 5'-[32P]-end labeled pBR322 DNA fragments, the alkaline labile alterations are located specifically at the level of guanine residues. A strong correlation seems to exist between the visualization of this labilization and the induction of a covalent photoadduct on guanine by the photosensitization mediated by PZ. PMID- 3675626 TI - Characterization of human erythrocyte aldehyde dehydrogenase. AB - Human erythrocyte aldehyde dehydrogenase was purified to homogeneity. The enzyme exhibited a single band of activity on starch gel electrophoresis and on isoelectric focusing. It was a tetramer with an estimated molecular weight of 230,000 daltons and an isoelectric point of 5.0. Its pH optimum of 8.5, Michaelis Menten constant for acetaldehyde of 46 microM, and high sensitivity to noncompetitive inhibition by disulfiram resembled human liver cytosolic aldehyde dehydrogenase. Low concentrations of magnesium (5-10 microM) resulted in enhancement of erythrocyte aldehyde dehydrogenase activity, whereas higher physiological concentrations of magnesium resulted in uncompetitive inhibition of enzyme activity. Magnesium inhibited the enzyme activity by increasing the binding of NADH to the enzyme as had been found to be the case for the inhibitory effect of magnesium on the human liver cytosolic enzyme. Erythrocyte aldehyde dehydrogenase may metabolize small amounts of acetaldehyde escaping the liver during ethanol metabolism and protect extrahepatic tissues from acetaldehyde toxicity. PMID- 3675627 TI - Novel dynamic flow cytoenzymological determination of intracellular esterase inhibition by BCNU and related isocyanates. AB - We present a novel dynamic flow cytoenzymological demonstration of the potent inhibition by the antitumour chloroethylnitrosourea BCNU of the intracellular hydrolysis of fluorescein diacetate by esterases of viable, intact murine and human tumour cells in vitro. The BCNU metabonate chloroethyl isocyanate and the related compound n-butyl isocyanate were also potent inhibitors. I50 values were in the range 4.2 X 10(-5)-2.0 X 10(-4) M. Generally similar quantitative results were obtained for intact cells and sonicates by conventional spectrofluorimetry, and inhibition of purified porcine liver carboxyl esterase (EC 3.1.1.1) was demonstrated. Little or no inhibitory activity was seen with the alkylating agents methyl methane-sulphonate, melphalan and nitrogen mustard. The results are consistent with carbamoylation of the esterase molecules by isocyanates, and this may provide a basis for the flow cytometric determination of intracellular carbamoylation in discrete subpopulations of heterogeneous samples. PMID- 3675628 TI - Effects of substituted 2-nitroimidazoles and related compounds on unscheduled DNA synthesis in rat hepatocytes and in non-transformed (BL8) and transformed (JB1) rat liver epithelial derived cell lines. AB - 1. Using unscheduled DNA synthesis as an index, the possible interaction of a number of substituted nitroimidazoles, e.g. misonidazole, with cellular DNA has been investigated. Transformed (JB1), non-transformed (BL8) rat liver epithelial derived cell lines and freshly prepared rat hepatocytes have been used. 2. Under anaerobic or aerobic conditions, relative to cells exposed to a nitroquinoline-N oxide standard, misonidazole and related nitroimidazoles were very poor at stimulating unscheduled DNA synthesis in JB1 or BL8 cells or in hepatocytes, even at the highest concentrations tested (10 mM). Under anaerobic conditions, metabolic activation did occur as judged from the time-dependent depletion of cellular reduced glutathione in all three cell types. 3. It was concluded that in hypoxic cells an important mode of action of such nitroimidazoles as chemotherapeutic sensitisers may be by their interaction with cellular thiols rather from their interaction with DNA. 4. Functionalisation of the nitroimidazole ring with a side chain containing an aziridine function, e.g. RSU 1069 (1-(2-nitro-1-imidazolyl)-3-(1-aziridinyl)-2-propanol), results in the induction of unscheduled DNA synthesis in cells exposed under both aerobic and anaerobic conditions. On a molar basis, however, this induction was not so great as that caused by the simple monofunctional alkylating agent 1-aziridineethanol itself. Methyl-substitution of the aziridine ring in RSU-1069 reduced the extent of unscheduled DNA synthesis. 5. With all the compounds tested, unscheduled DNA synthesis was greater in JB1 cells than in BL8s or in hepatocytes. PMID- 3675629 TI - Intramolecular deuterium isotope effect and enantiotopic differentiation in oxidative demethylation of chiral [monomethyl-d3]methoxychlor in rat liver microsomes. AB - Intramolecular deuterium kinetic isotope effects on the O-demethylation of methoxychlor [2,2-bis-(4-methoxyphenyl)-1,1,1-trichloroethane] were measured in liver microsomes taken from rats treated with phenobarbital or beta naphthoflavone and from untreated rats. The substrates were (R)-, (S)- and racemic [monomethyl-d3]methoxychlor, and the ratio of [d3]- to [d0]-mono-O demethylated metabolites was measured by GC-MS selected-ion monitoring. The magnitude of the observed ratio of [d3]- to [d0]-metabolites in each microsomal preparation was largest on the reaction of the (S)-substrate, followed by racemic substrate, and then (R). Each value is a composite of the intramolecular kinetic isotope effect and enantiotopic differentiation during the reaction. Each intramolecular isotope effect value estimated from these values was smaller than the reported intrinsic value. A relatively slow intramolecular interchange of two methoxyl groups in the methoxychlor molecule in the enzyme-substrate complex was indicated during the reaction. There also was evidence of high enantiotopic differentiation. PMID- 3675630 TI - The effect of vesicle lipid composition on the metabolism of lignocaine by a male specific isozyme of cytochrome P-450 from rat liver. PMID- 3675631 TI - Relationship between age of mice, enzymes such as acetylcholinesterase and aliesterase, and toxicity of soman (pinacolyl methylphosphonofluoridate). PMID- 3675632 TI - [Chemical modification of cysteine residues of cholesterol-hydroxylating cytochrome P-450. Identification of the cysteine residue participating in the formation of a proximal ligand]. AB - A chemical modification of cysteine residues in mitochondrial cytochrome P-450scc from adrenal cortex has been carried out. Cysteine residues in this hemoprotein were shown to form two pools: one available to the chemical modification, which does not affect spectral and functional properties of the cytochrome and another accessible for the modification only after the protein inactivation and the heme removal. The proximal ligand in the polypeptide chain of cytochrome P-450scc was localized. Cys422 was shown to be involved in the heme coordination and Cys264 was found to be exposed and accessible to sulfhydryl reagents. The data obtained are discussed in terms of the functional role of cysteine residues in monooxygenase catalysis. PMID- 3675633 TI - [Localization of tetranitromethane-modified tyrosine residues in the polypeptide chain of cholesterol-hydroxylating cytochrome P-450]. AB - As a continuation of earlier structure-function relationship studies on cholesterol-hydroxylating cytochrome P-450 from the adrenal cortex mitochondria, the present study deals with the distribution of tetranitromethane-modified tyrosine residues in the hemeprotein polypeptide chain. Amino acid residues Tyr 24, -46, -50, -93, -94, -199, -246 are shown to be modified with tetranitromethane. Tyr-93, -94 are supposedly involved in the active site formation of cytochrome P-450. PMID- 3675634 TI - [2-(4-Chlorophenyl)sulfonylethoxycarbonyl (Cps) amino-protecting group for the synthesis of peptides in a solution. Synthesis of [Leu]enkephalin and its [D ala2]analog]. AB - Solution syntheses of [Leu]enkephalin and its [D-Ala2]analogue were accomplished using a new 2-(4-chlorophenyl)sulfonylethoxycarbonyl (Cps) base-labile group for amino protection and a chromogenic acid-labile 4-(4-phenylazo)benzyloxybenzyl (Abz) group for carboxyl protection. The syntheses were performed by stepwise attachment of Cps-amino acids, which were introduced as pentachlorophenyl esters or as dicyclohexylammonium salts in the presence of tris(dimethylamino)chlorophosphonium perchlorate. To remove Cps-group, Abz-esters of Cps-peptides were treated with two molar equivalents of 1,8 diazabicyclo[5.4.0]undec-7-ene in dimethylformamide followed by neutralization of the base with an excess of 1-hydroxybenzotriazole; the deblocked amino components were then used without isolation. Fully deblocked pentapeptides were purified and characterized by HPLC, FAB mass spectra and amino acid composition. PMID- 3675635 TI - [Amino acids as catalysts of the binding reaction of formaldehyde with adenine residue in polyadenylic acid]. AB - Binding of formaldehyde and amino acids (Gly, Lys and Leu) with poly(A), poly(G), and poly(C) has been investigated in comparison with treatment with formaldehyde alone. It was found that in the case of poly(A) amino acids were found to catalyze the N-hydroxymethylation reaction on exocyclic amino groups of adenine. For example, at 20 degrees C and pH 6.0 the rate of this reaction increased about 10 fold in the presence of glycine. PMID- 3675636 TI - [Characteristics of the carbohydrate component of trophoblastic beta1 glycoprotein]. AB - By use of the methylation method, trophoblast-specific beta 1-glycoprotein (TSG, SP-1) has been shown to contain N-glycosidically linked oligosaccharide chains of the N-acetyl lactosamine type. Methylation analysis of TSG fractions which have various affinity to concanavalin A indicates that the diantennary carbohydrate chains prevail in the glycoprotein molecule. PMID- 3675637 TI - [Computer analysis of polysaccharides with linear repetitive link from 13C-NMR data]. AB - The possibility of computerised analysis of primary structures of polysaccharides on the basis of 13C NMR data and average values of alpha- and beta-effects of glycosidation was evaluated. Theoretical 13C NMR spectra for all possible structures of some linear polysaccharides were calculated by using additive scheme of glycosidation effects. In each case it was found that the structure characterised by the least sum of squared deviations of chemical shifts for the signals in the calculated and experimental spectra corresponds to the sequence and modes of linkages between monosaccharide residues in polysaccharides determined by an independent way. PMID- 3675638 TI - [Addressed modification of the promoter region of DNA in a complex with RNA polymerase by alkylating oligonucleotide derivatives]. AB - Addressed chemical modification of double-stranded DNA unwound with the specific protein has been demonstrated. 4(N-2-chloroethyl-N-methylamino)benzyl-5' phosphoamides of oligonucleotides d(CG)rC, d(ATCG)rC, d(AATCG)rC, which can serve as primers in the RNA polymerase-catalyzed transcription, alkylated A2 promoter region of pSK-A2 plasmid in its "open" complex with E. coli RNA polymerase. PMID- 3675639 TI - [High performance exclusion microcolumn chromatography of proteins and peptides]. AB - A new method of determination of molecular mass of proteins and peptides has been developed, basing on the microcolumn exclusion chromatography on non-modified silica sorbents in trifluoroacetic acid. It is shown that in this eluent the proteins and peptides adopt the random-coil conformation and are not hydrolyzed for three days at room temperature. PMID- 3675640 TI - [Primary structure of the full-length DNA copy of the influenza virus A/Kiev/59/79 (H1N1) PB2 gene]. AB - The complete nucleotide sequence of a cloned full-length DNA copy of the A/Kiev/59/79 (H1N1) influenza virus PB2 gene has been determined. This strain is shown to be the natural reassortant which inherited its NP and PB2 genes from the contemporary H3N2 influenza strains. PMID- 3675641 TI - [Synthesis and antimetabolite properties of 5-substituted 2'-deoxyuridines. Anomeric 5-(2-aminohexafluoroprop-2-yl)- and 5-(2 trifluoroacetylaminohexafluoroprop-2-yl)-2'-deoxyuridine]. AB - Alkylation of 2,4-bis-O-(trimethylsilyl)uracil with hexafluoroacetone trifluoroacetylimine gave 5-(2-trifluoroacelylaminohexafluoroprop-2-yl)uracil, which was transformed by alkaline hydrolysis to 5-(2-aminohexafluoroprop-2 yl)uracil. The latter was glycosytated with 2-deoxy-3,5-di-O-p-toluoyl-alpha-D ribofyranosyl chloride by means of various modifications of the silyl method leading to the predominant formation of beta-deoxynucleoside; after deacylation 1 (2-deoxy-beta-D-ribofuranosyl)-5-(2-aminohexafluoroprop-2-yl)ura cil was obtained. Interaction of silylated 5-(2-trifluoroacetylaminohexafluoroprop-2 yl)uracil with acylgalogenose gave anomeric O-substitutet deoxynucleosides, which were deblocked to give 5-(2-trifluoroacetylaminohexafluoroprop-2-yl)-2' deoxyuridine and corresponding alpha-anomer. Alkaline hydrolysis of N trifluoroacetyl group in both individual anomers produced 1-(2-deoxy-alpha-D ribofuranosyl)-5-(2-aminohexafluoroprop-2-yl)ur acil and the abovementioned beta anomer. Of all compounds synthesised only 1-(2-deoxy-beta-D-ribofuranosyl)-5-(2 aminohexafluoroprop-2-yl)ura cil has a moderate inhibitory effect on replication of vaccinia virus in vitro. PMID- 3675642 TI - [Synthesis of oligosaccharide fragments of the capsular polysaccharide of Streptococcus pneumoniae type 3]. AB - Di-, tri- and tetrasaccharide fragments of the linear chain of the capsular polysaccharide of Streptococcus pneumoniae type 3 consisting of glucose and glucuronic acid residues connected with beta 1----3- and beta 1----4-glycosidic linkage have been synthesised. A new method for selective deprotection of C3 hydroxyl group in the glucopyranuronic acid moiety is proposed. PMID- 3675643 TI - [Synthesis of the capsular polysaccharide of Streptococcus pneumoniae type 14. 1. Synthesis of a derivative of the tetrasaccharide repetitive link]. AB - A branched tetrasaccharide derivative of the repeating unit of the capsular polysaccharide of Streptococcus pneumoniae type 14 has been synthesised by condensation of per-O-benzoylated 1,2-O-(1-cyano)ethylidene derivative of lactose with 6-O-tritylated methyl lactosaminide. PMID- 3675644 TI - [Synthesis of the capsular polysaccharide of Streptococcus pneumoniae type 14. 2. Synthesis of methyl-6-O-acetyl-4-O-(2,3,46-tetra-O-benzoyl -beta-D galactosylpyranosyl)-2-deoxy-2-phthalimido-beta-D-gluco- pyranoside--a lactosamine precursor in the monomer synthesis for polycondensation]. AB - Glycosylation of methyl 6-O-acetyl-3-O-benzoyl-2-deoxy-phthalimido-beta-D glucopyranoside and its 4-trityl ether by benzobromogalactose, 1-O-acetyl-2,3,4,6 tetra-O-benzoyl-beta-D-galactopyranose, 1,2-[(alpha-p-tolylthio)benzylidene]- and 1,2-O-[(alpha-cyano)benzylidene]-3,4,6-tri-O-benzoyl-alpha-D- galactopyranoses proceeds non-stereospecifically. The best yield of beta-linked disaccharide was obtained upon glycosylation by benzobromogalactose in the presence of silver triflate and tetramethylurea in nitromethane. PMID- 3675645 TI - [Toxic components of the venom of the cellar spider Segestria florentina]. AB - Two neurotoxins and one insectotoxin have been isolated from venom of the cellar spider Segestria florentina, their homogeneity being proved by disk electrophoresis, isoelectric focusing, and analysis of N-terminal amino acid residues. The neurotoxins are polypeptides with molecular mass about 5000 D. For the insectotoxin, containing 35 amino acid residues with molecular mass 3988 D, the total primary structure is established. PMID- 3675646 TI - [RNA-ligase of bacteriophage T4. IV. Synthesis of pentadecaribonucleotide ApUpG(pU)6(pA)5pAp]. AB - Oligoribonucleotide ApUpG(pU)6(pA)5pAp (I) has been prepared by means of RNA ligase. ApUpG, synthesised by the phosphotriester approach, was elongated in the 3'-direction by adding (pU)6 and then (pA)6, which was 3'-blocked with the phosphate or with the periodate-oxidized AMP residue, the latter giving considerably lower level of by-products. Condensation of ApUpG(pU)6 with blocked (pA)6 was carried out under conditions optimal for poor acceptors (20 degrees C, 48 h, pH 8,7) to afford (I) with the yield of 20% (105 OE260); ApUpG(pU)6(pA)10pAp was identified as a byproduct. PMID- 3675647 TI - [Enzymatic incorporation into oligonucleotides of modified nucleosides]. AB - Behaviour of modified nucleosides, tRNA components, and their analogues has been studied in the internucleotide bond formation catalysed by ribonucleases of various substrate specificity, polynucleotide phosphorylases, and T4 RNA ligase and the results are summarised in this paper. Pseudouridine, dihydrouridine, ribothymidine, 5-methylcytidine, inosine, and 6-methyladenosine can participate in the reaction of internucleotide bond formation the presence of most ribonucleases used, viz. Pb2, Pcl2, Pb1, Pch1, C2, T1, pancreatic RNase. 3 Methylcytidine and 4-acetylcytidine form internucleotide bond (as phosphate acceptors) usually by means of guanyl-specific ribonucleases, whereas 1 methylandenosine is incorporated with ribonuclease Pel2. 7-Methylguanosine and 1 methylguynosine 2',3'-cyclophosphates can be used as phosphate donors in the presence of ribonuclease Pb2; in the similar enzymatic reaction 6 isopentenyladenosine is an uneffective acceptor. PMID- 3675648 TI - [The use of cross-linking platinum reagents in the study of tRNA and mRNA interaction with ribosomes]. AB - The use of some bifunctional Pt(II)-containing cross-linking reagents for investigation of structural organization of ribosomal tRNA- and mRNA-binding centres is demonstrated for various types of [70S ribosome.mRNA-tRNA] complexes. It is shown that treatment of the complexes [70S ribosome.Ac[14C]Phe tRNA(Phe).poly(U)], [70S ribosome.3'-32pCp-tRNA(Phe).poly(U)] and [70S ribosome.f[35S]Met-tRNA(fMet).AUGU6] with Pt(II)-derivatives results in covalent attachment of tRNA to ribosome. AcPhe-tRNA(Phe) and 3'-pCp-tRNA(Phe) bound at the P site were found to be cross-linked preferentially to 30S subunit. fMet tRNA(fMet) within the 70S initiation complex is cross-linked to both ribosome subunits approximately in the same extent, which exceeds two-fold the level of the tRNA(Phe) cross-linking. All used tRNA species were cross-linked in the comparable degree both to rRNA and proteins of both subunits in all types of the complexes studied. 32pAUGU6 cross-links exclusively to 30S subunit (to 16S RNA only) within [70S ribosome.32pAUGU6.fMet-tRNA(fMet)] complex. In the absence of fMet-tRNAfMet the level of the cross-linking is 4-fold lower. PMID- 3675649 TI - [DNA carrying aliphatic amino groups and the use of its fluorescent derivative as a probe in molecular hybridization]. AB - A two-step method of labelling DNA through aliphatic amino groups with various reporter molecules has been developed. The method is based on reaction of cytosine-residues of polynucleotide chain with 4-aminooxybutylamine; the latter's synthesis is described. DNA modified on this way with fluorescein isothiocyanate functions a probe in molecular hybridisation. The sensitivity of this method for fluorochrome-labelled DNA probes in the dot hybridisation procedure is about 200 pg per mm2. PMID- 3675650 TI - [Synthesis of capsular polysaccharide of Streptococcus pneumoniae type 14. 3. Synthesis of a monomer for polycondensation]. AB - Synthesis of a tritylated tetrasaccharide 1,2-O-(1-cyano) ethylidene derivative is described by glycosylation of 3,6-di-O-benzoyl-4-O-(2,4,6-tri-O-benzoyl-beta- D-galactopyranosyl)-1,2-O-[1-(exo-cyano)ethylidene]-alpha-D- glucopyranose with 6 O-acetyl-3-O-benzoyl-4-O-(2,3,4,6-tetra-O-benzoyl-beta- D-galactopyranosyl)-2 deozy-2-phthalimido-D-glucopyranosyl. bromide followed by selective deacetylation and tritylation. PMID- 3675651 TI - [Synthesis of capsular polysaccharide of Streptococcus pneumoniae type 14. 4. Polycondensation of the monomer and characteristics of the polysaccharide]. AB - Synthesis of a regular branched polysaccharide [6(Gal beta 1-4)GlcNAc beta 1-3Gal beta 1-4Glc beta 1]n whose structure corresponds to that of the capsular polysaccharide of Streptococcus pneumoniae type 14, is described, involving a stereospecific polycondensation of the tetrasaccharide monomer, deacylation, and N-acetylation. PMID- 3675652 TI - [Study of complex lipids. Synthesis of diphosphatidylglycerol (cardiolipin) with unsaturated fatty acid residues]. AB - Diphosphatidylglycerol (cardiolipin) with different fatty acid residues has been synthesised by condensation of 1,2-diacyl-sn-glycero-3-phosphoric acid (obtained, e.g., by the cabbage phospholipase D cleavage of 1,2-dioleyl-sn-glycero-3 phosphocholine or egg phosphatidylcholine) with 2-O-tert butyldimethylsilylglycerol in the presence of 2,4,6 triisopropylbenzenesulphonylchloride. The synthetic cardiolipins as unsonicated aqueous calcium-free dispersions were shown, by means of 31P NMR spectroscopy, to form aggregates of the bilayer structure. PMID- 3675653 TI - [Chemical reactions in double-stranded nucleic acids. The nature of the bond formed during chemical ligation using a cis-diol group]. AB - Chemical and enzymatic ligation between the 5'-terminal phosphate of one oligonucleotide and the 3'-terminal 2',3'-cis-diol group of the other oligonucleotide on a complementary template was studied. Carbodiimide, imidazolide and N-hydroxybenzotriazole ester methods were used for chemical activation of the phosphate group, and T4 DNA ligase for enzymatic ligation. All the chemical activation methods produced 3',5'- and 2',5'-phosphodiester bonds (40-45 and 55-60%, resp.), whereas enzymatic ligation gave the product only with 3',5'-phosphodiester bond. PMID- 3675654 TI - Direct immunochemical sensing: basic chemical principles and fundamental limitations. AB - Models describing the binding of antigens to surface immobilised antibodies have been developed. These models are applied to the assessment of the likely analytical utility of direct immunochemical sensors employing immobilised antibody layers. Fundamental limitations to the device response arising from the equilibrium and kinetic characteristics of the binding reaction and from mass transport constraints imply that measurement over the micromolar to nanomolar concentration range may be practical. PMID- 3675655 TI - A simple, inexpensive, disposable electrochemical sensor for clinical and immuno assay. AB - An inexpensive, rapid, disposable electrochemical system has been developed for both clinical and immunochemical assays. The three-electrode planar configuration is produced by silk screening graphite paint on to cardboard. Assays are carried out amperometrically using constant voltage and monitoring current produced by the oxidation of an electron mediator. In the case of immuno-assay the system described uses the enzyme glucose oxidase with 1,4-benzoquinone as the mediator. The assay is carried out by effecting a separation of the bound and free fractions of the immunoreactants via immobilizing the antibodies on to magnetic particles which are magnetically concentrated on the electrode surface for analysis. This concentration of the bound antigen-antibody complex with the glucose oxidase label effectively increases the concentration of the reduced mediator in the electrode vicinity, thus increasing the amperometric response to the bound fraction of the label. PMID- 3675656 TI - Increase in OKM1+ granular lymphocytes in patients with rheumatoid arthritis. AB - Patients with very active rheumatoid arthritis that was being treated only with nonsteroidal antiinflammatory drugs had increased numbers of peripheral blood OKM1+ lymphocytes. In 3 patients, 90 degrees light scatter analysis revealed a double lymphocyte peak. When sorted, the high scatter peak contained a large percentage of granular lymphocytes. Patients with mild-to-moderately active rheumatoid arthritis had normal levels of OKM1+ lymphocytes, but when the drugs were discontinued, the activity of the disease and the numbers of OKM1+ cells increased. Administration of piroxicam was associated with clinical improvement and a decrease in levels of OKM1+ cells. OKM1+ granular lymphocytes are increased in some rheumatoid arthritis patients, and their numbers may correlate with clinical disease activity and/or therapy. PMID- 3675657 TI - Analyses of HLA linkage in white families with multiple cases of seropositive rheumatoid arthritis. AB - Families with multiple cases of seropositive rheumatoid arthritis (RA), identified through 2 probands with the disease, were analyzed for genetic linkage between an autosomal susceptibility gene for RA and the HLA loci. These analyses were carried out over a wide range of penetrances (0.1-0.4), with prevalence for the disease fixed at 0.01 or 0.04. In some models, a sporadic frequency of 20% was assumed. Close linkage to the HLA loci was ruled out for all models where the gene was autosomal dominant, except for those with low penetrance and with prevalence set at 0.04. The models in which the gene was autosomal recessive produced results similar to those in models where it was autosomal dominant when prevalence was set at 0.01, and close linkage was ruled out, except at very low penetrances. With prevalence set at 0.04, the autosomal recessive gene model produced log odds scores which were all negative (-2.6 to -0.3). Therefore, the evidence in these families does not support close linkage with HLA, even though a significant DR4 RA population association exists. The data suggest that non-major histocompatibility complex (MHC) genes may contribute to the development of RA and, therefore, disease susceptibility may involve the genetic interaction of one or more MHC genes and non-MHC genes, in addition to environmental agents. PMID- 3675658 TI - Prevalence of thyroid disease and abnormal thyroid function test results in patients with systemic lupus erythematosus. AB - Although thyroid disease has been associated with other autoimmune conditions, it is not well recognized in systemic lupus erythematosus (SLE) patients. We found that in 332 SLE patients hospitalized during a 5-year period, the overall prevalence of diagnosed thyroid disease (7.5%) was similar to that in other female populations, but the prevalence of diagnosed hypothyroidism (6.6%) was unexpectedly high. There was also a high frequency of abnormal thyroid function test results in 175 SLE patients without diagnosed thyroid disease who underwent laboratory screening. More than 45% of these patients had elevated levels of thyroid-stimulating hormone, 34% had low T3 determinations, and 18% had high antimicrosomal antibody titers. When patients were categorized into "functional groups," some showed evidence of the "euthyroid sick syndrome" (15%), but many more had laboratory test results suggestive of true (5%) or incipient (39%) primary hypothyroidism. We conclude that abnormal thyroid function test results are common in patients with SLE and that hypothyroidism, especially, should be considered when evaluating symptoms and signs in SLE patients. PMID- 3675659 TI - Arthritis in hereditary hemochromatosis. AB - Seven pedigrees with 45 members were evaluated for arthropathy associated with hereditary hemochromatosis (HC). Patients with symptomatic extraarticular disease were compared with asymptomatic patients who had evidence of HC on laboratory findings, and with normal subjects. Patients who were homozygous for HC were compared with heterozygous patients and normal subjects. HC arthritis does not appear to be an early predictor of disease, and chondrocalcinosis is a late manifestation of HC arthropathy. PMID- 3675660 TI - Serum concentrations of salicylate and naproxen during concurrent therapy in patients with rheumatoid arthritis. AB - The kinetic interaction between salicylate and naproxen was investigated in 25 rheumatoid arthritis patients. Kinetic interactions were tested in serum after patients had been on each drug regimen for 1 month. Salicylate decreased serum naproxen concentration from 89.5 mg/liter to 65.9 mg/liter (P less than 0.001) and increased serum naproxen clearance by 56%. Naproxen had minimal effect on serum salicylate concentrations. PMID- 3675661 TI - Glutathione peroxidase activity in patients with rheumatoid arthritis and in normal subjects: effects of long-term selenium supplementation. AB - The effects of dietary supplementation with selenium were studied in 6 patients with severe, active rheumatoid arthritis (RA) and in 6 healthy control subjects. Initial concentrations of Se in red blood cells and in serum, and the activity of the Se-dependent enzyme glutathione peroxidase (GSH-Px) in red blood cells, serum, and granulocytes were significantly lower in RA patients compared with controls. During Se supplementation, however, the differences in Se levels and in GSH-Px activity between the 2 groups disappeared, except that, in RA patients, GSH-Px activity in granulocytes increased but remained significantly lower than in controls. PMID- 3675662 TI - In vivo capillary microscopy findings and ophthalmoscopy findings in scleroderma. AB - We used in vivo capillary microscopy to examine the nailfold capillaries of 19 patients with scleroderma (18 women and 1 man; average age 56.6), and compared these findings with those obtained using an ophthalmoscope. The ophthalmoscope revealed hemorrhages in 68% of the patients, a reduction in the number of capillaries in 79%, avascular areas in 79%, and dilated capillaries in 84%. The findings from ophthalmoscopy showed a correlation of approximately 80% with those from capillary microscopy. Since the diagnosis of scleroderma can be confirmed with this instrument, we suggest that it be used when microscopy equipment is not available. PMID- 3675663 TI - Avidity of anti-Yersinia antibodies in yersiniosis patients with and without Yersinia-triggered reactive arthritis. AB - Avidity of IgM, IgG, and IgA class anti-Yersinia antibodies was compared in sera of 22 patients with yersiniosis and subsequent reactive arthritis versus sera of 22 patients without postinfection complications. An enzyme-linked immunosorbent assay was used for antibody determination. Less than 2 months after onset of the infection, the patients with arthritis had fewer high-avidity IgM antibodies against the bacterial lipopolysaccharide (P = 0.035) and more high-avidity IgA antibodies against bacterial cell extract (P = 0.039) than did the patients without arthritis. This difference increased with time. PMID- 3675664 TI - Hemodialysis is not essential for the development of destructive spondylarthropathy in patients with chronic renal failure. AB - Since 1984, there have been several reports of a destructive spondylarthropathy occurring in patients who have received hemodialysis over a long period of time. Two cases of a similar syndrome were observed in nonhemodialyzed patients with chronic renal failure, one of whom underwent a lumbar disc excision. The results of disc examination and of radiographic and biologic investigations prompted reconsideration of factors previously considered to be pathogenetic (amyloidosis, hydroxyapatite crystal deposition, aluminum toxicity), except one: secondary hyperparathyroidism. PMID- 3675665 TI - Methotrexate therapy for severe systemic lupus erythematosus. PMID- 3675666 TI - The relationship between ocular and articular disease activity in juvenile rheumatoid arthritis complicated by chronic anterior uveitis. PMID- 3675667 TI - Reactive arthropathy following Salmonella vaccination. PMID- 3675668 TI - Eosinophilic synovitis and urticaria: an association with symptomatic dermatographism or urticarial vasculitis? PMID- 3675669 TI - Virus safety of a pasteurized antithrombin III concentrate. Preclinical and clinical data. AB - Blood derived products carry the risk of virus transmission, especially for the hepatitis B virus (HBV), non-A/non-B virus(es) (NANBV) and human immunodeficiency virus (HIV). The precautionary measures for guaranteeing the virus safety of the pasteurized antithrombin III concentrate Kybernin HS/P are described and the efficacy of these measures is demonstrated by in vitro studies and by chimpanzee trials. The inactivation rate is greater than or equal to 10(6.7) for HIV, greater than or equal to 10(6.7) for HBV, and greater than or equal to 10(5.3) for NANBV (Hutchinson Pool). Clinically, virus safety was demonstrated by long term drug surveillance as well as by both a retrospective and prospective clinical trial. The 13 participants of the prospective study were checked clinically and biochemically according to the standards of the International Committee of Thrombosis and Hemostasis (ICTH). Within an observation period of 12 months, no seroconversion has been detected for HIV or HBV. Neither have any increases in the transaminases occurred which would indicate NANB hepatitis. PMID- 3675670 TI - Synthesis and antitumor activity of triazolium-bis(triazole)-tetrachlororuthenate (III) and bistriazolium-triazolepentachlororuthenate (III). Two representatives of a new class of inorganic antitumor agents. AB - The synthesis of the two water-soluble heterocycle coordinated ruthenium complexes triazolium-bis(triazole) tetrachlororuthenate (III), TrH(RuTr2Cl4), and bistriazolium-triazolepentachlororuthenate (III), (TrH)2(RuTrCl5), is described. For these complexes, antitumor activity against the P 388 leukemia model was observed with T/C values of 137% to 150%, compared with 144% and 175% for 5 fluorouracil and cisplatin, respectively. These complexes belong to a new class of antitumor active ruthenium compounds with the general formulas HB(RuB2Cl4) and (HB) 2(RuBCl5). The here described complexes with B = triazole are less active than the same type of complexes with B = imidazole, which were described by us previously. PMID- 3675671 TI - Preventive effects of the cerebral circulation improver 6,7-dimethoxy-1-(3,4 dimethoxybenzyl)-4-([4-(2-methoxyphenyl)- 1-piperazinyl]methyl)isoquinoline on stroke symptoms in stroke-prone spontaneously hypertensive rats. AB - Stroke-prone spontaneously hypertensive rats (SHRSP) were treated with food admixed, 6,7-dimethoxy-1-(3,4-dimethoxybenzyl)-4-([4-(2-methoxyphenyl)-1- piperazinyl]methyl)isoquinoline (Ro 22-4839), a novel cerebral circulation improver, for a period of 15 weeks starting from 5 weeks of age at an average daily dose of 30.6 or 66.0 mg/kg. As compared with normotensive Wistar Kyoto rats, SHRSP in the control group rapidly developed severe hypertension (244 mmHg at the end of the experiments) accompanied with deterioration of cardiovascular parameters including left ventricular hypertrophy, reduction in pumping ability and increase in peripheral vascular tone. At 20 weeks of age (i.e. at the end of experiments), 75% of SHRSP developed stroke signs and concomitant cerebral edema evidenced by the increases in water and sodium contents in the brain. These stroke symptoms were accompanied with a profound externalized shape change of erythrocytes after in vitro treatment with Ca2+ and ionophore A23187, an increased plasma level of thiobarbituric acid reacting substance (TBARS), a measure of lipid peroxides, and a decreased sensitivity of platelets to ADP. The long-term treatment with Ro 22-4839 prevented the progress of stroke and cerebral edema, although the deteriorated cardiovascular parameters were not prevented by the treatment. This compound was also found to prevent the hypersusceptibility of erythrocyte membrane to Ca2+-ionophore and Ca2+, the hypoaggregability of platelets and the elevated plasma TBARS in SHRSP. These results indicate that the beneficial effects of Ro 22-4839 in SHRSP may be attributable to its calmodulin antagonistic and anti-lipid peroxidative actions but not to its hypotensive action. PMID- 3675672 TI - Pharmacokinetics of the new local anaesthetic N-[2-(2 Heptyloxyphenylcarbamoyloxy)ethyl]piperidinium chloride in rats and mice. AB - Pharmacokinetics of a local anaesthetic of the carbanilate type (Heptacaine; in the following briefly called HCP), was studied using a labelled product, N-[2-(2 [1-14C]-heptyloxyphenylcarbamoyloxy)ethyl]piperidinum++ + chloride. Determination of HCP in biological material was based on double extraction of HCP from alkaline media into n-heptane. The plasma concentration of HCP following i.v. administration to rats was approximated by a biexponential function. An open two compartment pharmacokinetic model was conferred to the data. The model parameter estimates are as follows: terminal elimination half-life 3.80 +/- 0.15 h, distribution volume at steady state 9.31 l/kg, total body clearance 73.4 ml/min/kg, mean residence time 2.1 h. The systemic availability of the orally given HCP in solution was 35.8%. The HCP plasma AUC vs. dose relationship was linear within doses ranging from 2.78 to 4.33 mg/kg. The brain uptake index of HCP in comparison with 3H2O was 62.2%. Autoradiography in mice injected i.v. showed a heterogeneous distribution of the label in the tissues and its excretion by the urinary and biliary pathways. HCP showed strong affinity to the lung tissue. During 96 h after i.v. administration, 21% and 62% of the 14C dose was excreted into urine and faeces, respectively, and after oral administration, the excretion was 17% and 43%, respectively. PMID- 3675673 TI - Penetration of ciprofloxacin into parotid gland tissue and parotid saliva. AB - The penetration of 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3 quinoline carboxylic acid (ciprofloxacin, Bay o 9867, Ciprobay) into parotid gland tissue and parotid saliva of the rat after intravenous administration (6 mg/kg body weight) was studied. 2 h after bolus injection ciprofloxacin mean levels in parotid gland tissue (0.60 mg/l) nearly reached 2-fold mean blood levels (0.36 mg/l). In parotid saliva the mean concentration of the gyrase inhibitor (0.20 mg/l) was lower than in blood, however, still high enough to be effective against the pathogens which most often cause inflammation of the parotid gland. PMID- 3675674 TI - Kinetics of erythromycin uptake into Ehrlich mouse ascites tumor cells. AB - The uptake was studied with freshly isolated Ehrlich ascites tumor (EMAT) cells and with 14C-labelled erythromycin. Erythromycin was accumulated by EMAT cells. The uptake rates and quotes of erythromycin increased with increasing temperature and with increasing pH value (alkaline pH). The uptake was reduced by SH-group reagents, by inhibitors of electron transport and of oxidative phosphorylation and by ouabain. The uptake was saturable (Km = 6.0 X 10(-4) mol/l). The release of the accumulated erythromycin followed first order kinetics (k = 4.5 X 10(-2) min-1). The uptake and accumulation of erythromycin cannot be explained by non ionic partition. An active uptake mechanism is suggested. PMID- 3675675 TI - Immunological safety evaluation of a haemostatic agent and wound dressing made of horse collagen fibrils. AB - A haemostatic agent and wound dressing made of horse collagen (Tachotop) was applied to guinea-pigs in such a way that the intended use of this material in humans was simulated, and cell-mediated and humoral immune responses of the animals were investigated. In addition, immune reactions were forcefully induced in guinea-pigs in order to validate the methodical approach and quantitate the observed reactions. Cell-mediated immunity was measured as delayed-type hypersensitivity skin reactions, and antibodies were detected by an enzyme-linked immunosorbent assay (ELISA). Simulation of the intended application of this haemostyptic material did not induce immune reactions in guinea-pigs even under critical conditions. The animals could only be immunized when the antigen was administered in solution or finely dispersed and together with adjuvant. Immune reactions thus induced were specific for collagen, no reaction was obtained against possible impurities such as albumin, immunoglobulin or fibronectin. It is concluded--in accordance with clinical experience--that this material is very unlikely to induce immune reactions upon clinical application to humans. PMID- 3675676 TI - Pharmacokinetics and metabolism of [14C]-proglumetacin after oral administration in the rat. AB - The pharmacokinetics and metabolism of 1H-indole-3-acetic acid, 1-(4 chlorobenzoyl)-5-methoxy-2-methyl 2-[4-[3-[[4-(benzoylamino)-5-(dipropylamino)-1, 5-dioxopentyl]oxy]propyl]-1-piperazinyl]ethyl ester (+/-) (proglumetacin, CR 604), 14C-labelled in position C-2 of the indolic moiety, was studied in male and female rats after oral administration. The radioactivity is slowly absorbed from the gastrointestinal tract and reaches the peak in plasma 6 h after administration. Afterwards the radioactivity is eliminated from plasma according to a bi-exponential equation, with an initial elimination rate having a t1/2 of 4.5 h and a terminal elimination rate having a t1/2 of 16 h. The elimination rate is probably dependent on the slow absorption rate (flip-flop system) and on an entero-hepatic recirculation of the radioactivity. The radioactivity is excreted with the feces (60.8%) and with the urines (33.5%). No radioactivity is eliminated with the expired air. About 13% of the fecal radioactivity is represented by proglumetacin. This fraction or radioactivity (ca. 8% of the administered) represents probably the non-absorbed amount of substance. The parent proglumetacin is not found in blood, urine and organs. Conversely several indolic metabolites are found, with a predomination of indometacin. Proglumetacin is therefore a pro-drug of indometacin and of other indolic metabolites, which are responsible for the antiinflammatory activity of proglumetacin. The radioactivity is distributed in all tissues. The maximum radioactivity is found in liver and kidneys, however, always in a smaller concentration than in plasma. No "deep compartment" was found. PMID- 3675677 TI - [The percutaneous kinetics of ibuprofen from a cream formulation]. AB - The percutaneous penetration of an ibuprofen cream at 5% (Dolgit Creme) was tested in guinea pigs. Already 20 min after application of the cream on the shaved skin high ibuprofen concentrations of about 10 micrograms/g were found in the subcutaneous and in the muscular tissue. The plasma concentrations reached only one tenth of the values ascertained in the tissues. 2 h after application the concentrations in the tissue increased by 50%, whereas the increase of the plasma concentrations was more significant. The results confirm in agreement with kinetic studies in man that ibuprofen penetrates from the tested formulation directly and very quickly in deeper tissues. The deviation of the active ingredient over the systemic circulation is improbable. PMID- 3675678 TI - Studies on the embryotoxic risk of exposure to caffeine and ethanol during the preimplantation period in the mouse. AB - Pregnant mice were exposed before implantation to caffeine and ethanol to determine the dose-response relation for embryolethality during the preimplantation period. For risk estimation the embryotoxicity was evaluated at term and also 24 h after implantation. For ethanol no embryotoxic risk could be detected. Caffeine unexpectedly exhibited a high risk for embryoethality when compared to the maternal LD50. However, when taking into account realistic exposure levels an embryotoxic risk in early pregnancy can be excluded in humans for both caffeine and ethanol. PMID- 3675679 TI - Clinical efficacy and bioavailability of a sustained release nifedipine formulation. AB - A new oral sustained release formulation containing 20 mg nifedipine (Coral retard) was administered twice daily to 30 patients suffering from coronary diseases and/or hypertension, in order to assess its clinical effectiveness. The controls of blood pressure and pain before, during and after 30 days of treatment revealed a significantly good therapeutic action of the new formulation, both as an antihypertensive and an antianginal remedy. Blood examinations exhibited an optimum tolerability of the test product. Moreover, in 8 additional subjects free of cardiovascular and other diseases, the formulation was compared to a commercial sustained release product in order to evaluate its bioavailability after a single 20 mg dose. The product under study showed a satisfactory bioavailability when compared to the reference product. It is concluded that the new formulation can be successfully applied to the treatment of hypertensive and/or coronary diseases with a considerable simplification of the dosing schedule and an improved patient compliance. PMID- 3675680 TI - Pharmacokinetics of isosorbide mononitrate in a new sustained release oral form in comparison with a conventional formulation. AB - 40 mg of isosorbide mononitrate (isosorbide-5-mononitrate, IS5MN) in conventional (Ismo 20) and sustained release formulations (Ismo Diffutab) were administered to 5 male healthy volunteers. The administration of the sustained release formulation was repeated for seven days in order to evaluate the possible occurrence of accumulation. Pharmacokinetic data showed that the sustained release formulation reached significantly lower and delayed mean peak plasma levels compared with the conventional formulation, respectively 452.8 +/- 67.8 ng/ml and 706.7 +/- 57.3 (mean +/- SE) (p less than 0.05). Peak times were 4.6 +/ 0.2 and 2.4 +/- 0.2 (p less than 0.005) h, respectively. A longer plasma half life together with larger AUC for the sustained release formulation was also observed. The pharmacokinetic parameters of the sustained release formulation are consistent with a therapeutic usefulness and suggest further clinical evaluation. PMID- 3675681 TI - [The effect of cephalexin on thrombocyte function in diabetics and normal persons]. AB - Studies on the Effect of Cephalexin on Platelet Functions in Diabetics and Healthy Volunteers. The effect of cephalexin (Ceporexin) on platelet functions of diabetics with proliferative retinopathy and of healthy volunteers was studied. Cephalexin, 3 X 1 g for 7 days, reduced epinephrine- and collagen-induced platelet aggregation of the diabetics in a significant, but clinically not relevant manner. Platelet factor-3 availability and retraction remained unaffected by treatment with cephalexin. Cephalexin in vitro in a concentration of 500 mg/l reduced the rate and peak amplitude of platelet aggregation in diabetics and healthy volunteers to the same extent. The in vitro inhibition of epinephrine- and collagen-induced platelet aggregation was lacking clinical relevance. Platelet factor-3 availability was not changed by addition of cephalexin in vitro; the retraction was significantly increased, however, without clinical relevance. PMID- 3675682 TI - Clinical pharmacokinetics and metabolism of pyrazinamide in healthy volunteers. AB - Eight healthy volunteers were treated with a single dose of pyrazinamide 35 mg/kg. The aim of the study was to evaluate the pharmacokinetic profile of the product and of its metabolites. Urine and blood samples were collected till the 60th h. The kinetics of pyrazinamide could be characterized as follows: CPmax = 50.1 micrograms/ml, tmax less than 1 h, t1/2 alpha = 3.2 h, t1/2 beta = 23 h, U(0 60 h) = 1.6% of the dose administered. The kinetics of the main metabolite, the pyrazinoic acid, gave the following values: CPmax = 66.6 micrograms/ml, tmax = 4 h, t1/2 beta = 12.3 h, U(0-60 h) = 37.5%, of the administered dose. PMID- 3675683 TI - [Isolation of chlorphenoxamine metabolites in human urine and their identification]. AB - After the administration of chlorphenoxamine (2-[1-(4-chlorophenyl)-1 phenylethoxy]-N,N-dimethylethanamine++ +, Systral) (I) the following compounds have been detected in human urine. They were identified as chlorphenoxamine (I), N-demethyl-chlorphenoxamine (II), chlorphenoxamine-N-oxide (III), 1-(4 chlorophenyl)-l-phenylethanol (IV), 1-(4-chlorophenyl)-1-(4'-hydroxyphenyl) ethanol (V), 1-(4-chlorophenyl)-1-(4'-hydroxyphenyl)-ethene (VI), 1-(4 chlorophenyl)-1-(4'-hydroxy-3'-methoxyphenyl)-ethanol (VII), 1-(4-chlorophenyl)-1 (4'-hydroxy-3'-methoxyphenyl)-ethene (VIII), 2-[1-(4-chlorophenyl)-1-(4' hydroxyphenyl)-ethoxy]-N-methyl-ethanamine (IX) and 2-[1-(4-chlorophenyl)-1-(4' hydroxy-3'-methoxyphenyl-ethoxy]- N-methylethanamine (X). The compounds IV, V, VI, VII, VIII, IX and X were also found to be excreted as conjugates. It cannot be excluded that the compounds VI and VIII are artefacts. PMID- 3675684 TI - Ibopamine post-marketing surveillance. First report from a parallel-cohorts survey ongoing since April 1st, 1985. PMID- 3675685 TI - Superoxide dismutase in trematodes. Isoenzymatic characterization and studies of inhibition by a series of benzimidazoles and by pyrimidines of recent syntheses. AB - A comparative study was carried out of superoxide dismutase (E.C.1.15.1.1) (SOD) and catalase activities in purified extracts of two trematodes: Fasciola hepatica and Dicrocoelium dendriticum. The superoxide dismutase activity was very similar to that measured in other eukaryotic cells. As no catalase activity was detected, the possibility that SOD in these trematodes might have the particular importance of removing superoxide radicals is discussed. The SOD isoenzymes of each species were analysed by polyacrylamide gel electrophoresis and the patterns revealed a quantitative difference in the number of isoenzyme bands: F. hepatica showed three, and D. dendriticum only two. Determinations were made of the in vitro inhibitory activities of four benzimidazoles and six synthesised pyrimidine derivatives on SOD from trematodes. The present results confirm that the percentage inhibitions of the pyrimidine derivatives are markedly superior to those produced by the benzimidazoles. PMID- 3675686 TI - Assessment of the electrophysiologic, antiarrhythmic and haemodynamic profile of a new isoquinolinedione derivative. AB - The electrophysiological, antiarrhythmic and haemodynamic profile of a new isoquinolinedione derivative, 2,2'-[iminobis(trimethylene)]-di(4,4-dimethyl-1,3 (2H,4H)-isoqu inolinedione) hydrochloride (AR-03 Cl) was evaluated using dog models relevant to conditions in humans. In 16 animals dose-related effects on intercardiac conduction, ventricular refractoriness and on haemodynamic parameters were determined. In another 7 dogs antiarrhythmic actions of AR-03 Cl on delayed reperfusion arrhythmias following release of coronary artery occlusion after 2 h of obstruction were investigated. The results show: AR-03 Cl causes a significant prolongation in conduction through all parts of the conducting system. The AH-interval, HV-interval and QRS-duration are significantly lengthened. Ventricular repolarization is only slightly changed. There are no significant changes in heart rate, systolic and diastolic aortic pressure up to doses of 2 mg/kg b.w. However, left ventricular (dp/dtmax) and cardiac output are significantly reduced, and left ventricular enddiastolic pressure is increased. In acute myocardial necrosis delayed reperfusion arrhythmias are almost completely abolished, the effective dose is lower than that required with any other antiarrhythmic drug investigated so far in this particular experimental set up. Further experimental and clinical testing of the new compound seems to be promising because of its strong dose-related antiarrhythmic potency. However, there is a need for further analysis of potential haemodynamic side effects of the new compound to establish the clinical significance of negative inotropic actions at therapeutic doses. PMID- 3675687 TI - Antiarrhythmic activity of alpha-tocopherol nicotinate and related compounds and their physico-chemical properties. AB - The effect of alpha-tocopherol nicotinate (Renascin), alpha-tocopherol and dodecanoic acid (lauric acid) on the positive inotropic action of ouabain and digoxin and on cardiac glycoside induced arrhythmias has been tested in isolated guinea-pig left atria and in anaesthetized guinea-pigs. alpha-Tocopherol nicotinate and dodecanoic acid significantly decrease the positive inotropic action of digoxin, but not that of ouabain in isolated guinea-pig atria. Ouabain and digoxin induced arrhythmias are suppressed by the three compounds in isolated guinea-pig atria and in anaesthetized guinea-pigs: alpha-tocopherol nicotinate has the highest antiarrhythmic activity followed by dodecanoic acid and alpha tocopherol. These results are further evidence for the dissociation between the positive inotropic and arrhythmogenic action of cardiac glycosides. The antiarrhythmic activity of the three compounds and the physico-chemical properties, as measured in liposomes, are compared with that of quinidine and aprindine. As nicotinic acid does not show any effect on cardiac glycoside induced arrhythmias, the ester linkage in alpha-tocopherol nicotinate seems to be of particular importance for its antiarrhythmic activity. PMID- 3675688 TI - [The effectiveness of trapidil and trapidil derivatives on drug-induced heart arrhythmias in the rat and guinea pig]. AB - Trapidil and some selected derivatives of trapidil were investigated in ouabain induced arrhythmia in guinea-pigs and in aconitine induced arrhythmia in rats. In both models trapidil exerted a marked antiarrhythmic effect. Investigations on ouabain induced arrhythmia showed that three derivatives were more effective than trapidil concerning the threshold for premature ventricular beats and flutter. One derivative only was able to decrease the sensitivity for fibrillation in the same order of magnitude as trapidil. On aconitine induced arrhythmia all derivatives of trapidil were less effective in elevating the threshold of arrhythmia than trapidil itself, but three derivatives showed antiarrhythmic properties. PMID- 3675689 TI - [Histopathologic studies modification of genetically fixed arthrosis in C 57 black mice by glycosaminoglycan polysulfate]. AB - The effect of the chondroprotective substances glycosaminoglycan polysulfate (GAGPS) and chondroitin sulfate upon the genetically fixed osteoarthritis of C 57 black mice has been investigated. The histological preparation showed that at the age of 13 months all mice suffered from more or less severe articular changes resembling an osteoarthritis of the knee. In comparison to the control group, however, the degree of severity and the frequency of the arthrotic changes were significantly lower in the GAGPS groups. Moreover, a dose-dependent effect of GAGPS was found. PMID- 3675690 TI - Therapeutic effects of sofalcone on experimental gastritis. AB - A study was made on the therapeutic effects of sofalcone (SU-88), an antiulcer agent, on erosive and atrophic gastritis induced experimentally by 6-month administration of 5 mmol/l of sodium taurocholate (TCA) in rats. A standard meal including sofalcone of 0.25% and 1.0% shortened the total length of erosions, normalized the mucosal thickness, and reduced collagenous fibers in the gastric mucosa in one month. The doses administered were 116.3 mg and 486.1 mg/kg/week for one month. Sofalcone, thus, had a good therapeutic effect on experimental erosive and atrophic gastritis in rats. PMID- 3675691 TI - Gas chromatographic evaluation of trapidil and its desethyl metabolite in biological fluids for pharmacokinetic and bioavailability investigations. AB - This paper describes a suitable and cost-saving method for quantitative analysis of trapidil (5-methyl-7-diethylamino-s-triazolo [1,5-a]pyrimidine) and its desethyl metabolite in plasma and urine for pharmacokinetic and bioavailability investigations. Trapidil and desethyl-trapidil were extracted from plasma, concentrated and injected into the gas chromatography without any derivatization process. The authors suggest a series of internal standards. A thermoionic specific detector enables high sensitivity to be achieved, i.e. 20 ng/ml, and good specificity. The method is cost-saving in that it allows about 30 analyses a day to be performed without automatic integrators, and about 50 analyses a day with these integrators. PMID- 3675692 TI - Determination of verapamil and norverapamil in human biological material. Investigation of plasma concentrations after oral administration of two different verapamil formulations. AB - A method for the simultaneous determination of the cardiovascular agent verapamil and its major metabolite norverapamil in human plasma is described. Analysis is performed after alkaline extraction with n-heptane by subsequent ion-paired high performance liquid chromatographic (HPLC) separation, and direct fluorimetric measurement of both compounds (lambda maxex. = 278 nm, lambda maxem. = 320 nm). The sensitivity of the procedure (detection limit less than 1 ng/ml) is suitable for pharmacokinetic studies after therapeutic doses. The applicability of the method was tested by performing a clinical study. Plasma concentrations of two verapamil formulations for oral administration were examined. The active metabolite norverapamil was included in the investigation. PMID- 3675693 TI - [Renal and adrenal function following acute administration of urapidil in hypertensive patients with normal and impaired renal function]. AB - The effects of i.v. injection of urapidil (Ebrantil) (25 mg) on arterial blood pressure, renal function and renin-aldosterone system were studied in a group of patients with hypertension and normal renal function, in patients with hypertension and chronic renal failure and in normotensive controls. The pharmacokinetics of urapidil were evaluated simultaneously by measuring blood levels of the compound and its main metabolite. In the controls and in patients with hypertension, systolic and diastolic blood pressure were lowered few minutes after injection. Minimal blood pressure values were reached after 15-20 min. Hypotensive action was more pronounced in hypertensive patients as compared to controls. In contrast, increment in heart rate was greater in the controls. Despite the fall in blood pressure, renal plasma flow and glomerular filtration rate remained unchanged. Following the injection of urapidil, plasma renin activity increased with no change in plasma aldosterone levels. Plasma half-life of urapidil averaged 1.96 +/- 0.17 h in controls, 3.31 +/- 0.75 h in patients with hypertension and normal renal function and 2.52 +/- 0.46 h in patients with hypertension and chronic renal failure. Urapidil effectively lowers arterial blood pressure in patients with normal and impaired renal function with no deterioration in renal function. PMID- 3675694 TI - Influence of ambroxol on lung tissue penetration of amoxicillin. AB - Lung amoxicillin levels were assessed in tissue obtained from 16 patients who underwent lung resection due to different pulmonary diseases. In this double blind placebo controlled study patients were allocated to two groups in randomized order; one group received amoxicillin 1000 mg t.i.d. (n = 8) and the other amoxicillin 1000 mg + ambroxol 60 mg t.i.d. (n = 8). A trend towards higher antibiotic lung tissue levels was observed in patients who received the antibiotic together with the mucolytic agent. The ratio pulmonary tissue/serum amoxicillin levels reached a significant difference being higher in the amoxicillin plus ambroxol group than in the other one (0.411 +/- 0.04 vs 0.672 +/ 0.07; p less than 0.01), even if the amoxicillin plasma levels were lower. A possible effect of ambroxol on lung tissue penetration of amoxicillin is suggested and discussed. PMID- 3675695 TI - Influence of ambroxol on amoxicillin levels in bronchoalveolar lavage fluid. AB - Amoxicillin levels were measured in bronchoalveolar lavage (BAL) fluid samples obtained from patients who after randomization were treated in double-blind fashion either with amoxicillin 1000 mg p.o.t.i.d. or with amoxicillin 1000 mg + ambroxol 60 mg p.o.t.i.d. Antibiotic levels were higher in the group receiving ambroxol (0.32 +/- 0.02 micrograms/ml; n = 8) than in the other one (0.19 +/- 0.02 micrograms/ml; n = 6). This difference was statistically significant (p less than 0.001). Comparisons of protein concentrations in BAL fluid samples and of amoxicillin plasma levels did not show significant differences in the two groups. These results seem to prove that ambroxol is able to increase the antibiotics concentration in the lungs, although the mechanism of action is still unclear. In addition it could be shown that the BAL technique is suitable for exploring the lung concentration of antibiotics. PMID- 3675696 TI - Ambroxol plus amoxicillin in the treatment of exacerbations of chronic bronchitis. AB - Twenty-three patients with exacerbations of chronic bronchitis were divided in two groups in a randomized fashion receiving either amoxicillin 1500 mg/d (n = 13) or amoxicillin 1500 mg/d associated with the mucolytic drug ambroxol 90 mg/d (n = 10). The improvement in cough, expectoration difficulties and sputum purulence was statistically more evident and occurred earlier in the ambroxol + amoxicillin group than in the amoxicillin only group. Although amoxicillin plasma and sputum levels were similar in both groups, the differences in daily sputum volume, which was also statistically greater in patients receiving ambroxol, suggests that this drug favours the bronchial mucus clearance of the antibiotic which could be related to the more favourable clinical evolution. No changes were observed in lung function tests and blood gases. PMID- 3675697 TI - An alprostadil analogue and human gastric secretion. A double-blind placebo controlled study of the effects of a tablet and lyovial formulation. AB - The effects of single doses of 800 micrograms and 1200 micrograms of the new alprostadil analogue (prostaglandin E1 16-methyl-16-methoxy derivative) MDL 646, presented as tablet and lyovial formulations, on basal and pentagastrin stimulated gastric acid secretion, were studied in 10 normal male volunteers using a randomised, double-blind placebo-controlled cross-over design. Compared to placebo, both doses of MDL 646 significantly decreased acid output during the basal and pentagastrin-stimulated periods. No difference between the tablet and lyovial formulations was found. Total basal output (tablet and lyovial data pooled) was reduced by 58% and 68% following 800 micrograms and 1200 micrograms MDL 646, respectively. Stimulated output was reduced to a lesser degree (15% and 27%). Inhibition of the stimulated acid secretion was observed up to 1.5 to 1.75 h after drug administration. Tolerance was good with only one subject reporting nocturnal abdominal pain following each dose of the drug and placebo. PMID- 3675698 TI - Study on the bioequivalence of two ranitidine formulations. AB - Two 150 mg ranitidine containing tablet formulations were administered to 10 healthy volunteers in order to examine the biological equivalence. The study considered the area under the curve as the most important parameter, and also the duration of suppression of the gastric acid to 50%, based on a threshold concentration of ranitidine in serum of 165 ng/ml. The evaluation of data by statistical means shows that the formulations are equivalent. PMID- 3675699 TI - Bioavailability study of a new amoxicillin tablet designed for several modes of oral administration. AB - A new tablet of amoxicillin (Flemoxin solutab) has been formulated with galenic properties which allow it to be taken as a tablet, either swallowed, chewed or sucked, or to be taken after dispersion in water. This study was undertaken to compare the bioavailability of the new tablet (swallowed as such, or after dispersion) with a commercially available amoxicillin capsule and, for purposes of internal reference, with a Flemoxin forte suspension. Each formulation was administered to 12 volunteers according to a repeated 4 X 4 latin square design. Statistical analysis revealed that the tablet and suspension formulations tested gave significantly higher maximum plasma levels, occurring significantly faster after intake, when compared to the capsule. Furthermore, the new tablet showed a statistically significantly greater area under the plasma concentration-time curve with a highly predictable absorption when compared to the capsule. The method of intake of the new tablet appeared to be of no relevance with respect to the observed bioavailability. PMID- 3675700 TI - Pharmacokinetics of pirenzepine in patients with gastric or duodenal ulcers. AB - 1. The pharmacokinetics of pirenzepine (Gastrozepin) was studied after single and multiple oral administration in gastric ulcer and duodenal ulcer patients. 2. With a dose of 50 mg of pirenzepine, plasma levels reached a maximum 2 h after the administration in both groups (gastric ulcer patients: 57.2 +/- 31.8 ng/ml, duodenal ulcer patients: 48.0 +/- 18.0 ng/ml), and decreased bi-phasically with an elimination half-life (t1/2 beta) of 13.9 +/- 4.0 and 17.9 +/- 4.5 h, respectively. The area under the plasma level curve were 844 +/- 319 ng X h/ml and 663 +/- 151 ng X h/ml in the respective group. 3. The plasma levels of pirenzepine after multiple administration (50 mg was given as a loading dose, and thereafter 25 mg was given as a maintenance dose at an interval of 12 h for 7 days) maintained certain steady state levels from just after the start of administration. 4. It can be concluded that there is no significant difference in the pharmacokinetics of pirenzepine between gastric and duodenal ulcer patients. It can be judged that twice-daily administration of pirenzepine is enough for ulcer treatment. PMID- 3675701 TI - Transformation of sulfated bile acids by human intestinal microflora. AB - The in vitro transformation, under anaerobic conditions, of 3- and 7-monosulfated and unsulfated bile acids, was studied in incubates of fecal flora from three healthy subjects. Chenodeoxycholic acid 7 alpha-sulfate and ursodeoxycholic acid 7 beta-sulfate were recovered unchanged, in all cultures, at the end of the incubation time. 3-Sulfated bile acids were metabolized in a different way by the three stool specimens. During the transformation of chenodeoxycholic acid 3 sulfate, desulfation, 7-dehydroxylation and 3-epimerization were observed. In contrast, 3-epimerization was not noticed when ursodeoxycholic acid 3-sulfate and lithocholic acid 3-sulfate were metabolized, the latter being principally transformed into delta 3-cholenic acid, probably by a bacterially mediated trans elimination of sulfate group. The results obtained seem to prove that the presence of a SO3H group in 7-position usually hinders microbial transformations, which are not affected by a sulfate group in 3-position. Moreover, the 3-sulfated bile acids proved to be less sensitive to the microbial action than the corresponding unsulfated acids, with exception of lithocholic 3-sulfate. PMID- 3675702 TI - Coronary artery spasm: involvement of small intramyocardial branches. AB - A study was conducted to determine if the small (resistance) vessels of the coronary circulation could undergo spasm comparable to that of the major conductance (epicardial) arteries which in the rat measure 275-300 micron in diameter. This information may be relevant to the growing evidence of ischemic myocardial disease without significant coronary atherosclerosis or even spasm of the larger vessels. Vascular corrosion casts of the coronary circulation were prepared in the rat 20 min after intravenous injection of arginine vasopressin, a powerful coronary constrictor substance, under continuous electrocardiographic monitoring. Electrocardiographic changes observed consisted of S-T segment elevation and conduction disturbances, implying ischemic effects on the myocardium. Corrosion casts revealed spasm of smaller arteries only (50-150 micron diameter). Controls (vehicle-injected or untreated) showed no abnormalities of the coronary vasculature. These results suggest that myocardial vessels of this size are comparable in their potential for spasm to the large conductance arteries. Similar findings in patients involving smaller vessels could explain ischemic myocardial events in the absence of significant spasm, or organic stenosing pathology of major coronary arteries. As a corollary, it is suggested that the term "coronary artery spasm" could be enlarged in its definition to include other levels of the coronary circulation rather than that of the large conductance arteries alone. PMID- 3675703 TI - High density lipoprotein alterations induced by bezafibrate in healthy male volunteers. AB - The alterations of HDL structure and metabolism induced by bezafibrate administration were studied in healthy male volunteers. As usually observed in hyperlipaemic patients, bezafibrate induced a decrease of the plasma concentrations of apo B and LDL-cholesterol and an increase of that of HDL cholesterol. Analysis of HDL by gradient polyacrylamide gel electrophoresis revealed that bezafibrate administration resulted in a change of the particle size distribution likely suggesting a drop of the HDL2/HDL3 ratio. This was accompanied by a 30% enhancement of the plasma concentration of apoprotein A-II, while that of apoprotein A-I remained unchanged. These data suggest an increase of the HDL concentration, preferentially in the HDL3 subfraction. In spite of these HDL alterations, there was no evidence of change in the three stages of the reverse pathway of cholesterol, since bezafibrate did not induce any significant alteration in the in vitro properties of plasma with respect to (a) cholesterol transport from cultured cells, (b) cholesterol esterification, and (c) transfer of cholesteryl esters from HDL to VLDL-LDL. PMID- 3675704 TI - Relationships between dietary cholesterol, cholesterol absorption, cholesterol synthesis, and plasma cholesterol in rhesus monkeys. AB - The relationships between the cholesterol content of the diet, plasma cholesterol concentration, cholesterol absorption, and cholesterol synthesis (measured indirectly by desmosterol suppression technique) are explored in groups of high- and low-responding rhesus monkeys fed diets containing 0.02, 0.15 and 0.75 mg cholesterol/kcal. The cholesterol content of the diet (expressed as mg/kcal) is positively correlated with plasma cholesterol concentration and is negatively correlated with percent cholesterol absorption in both groups. Also the cholesterol content of the diet is negatively correlated (r = -0.66) with cholesterol synthesis only in low-responders but not in high-responders. Similarly, the correlation between percent cholesterol absorption and cholesterol synthesis is significant in the low-responders (r = 0.82, P less than 0.01) but not in the high-responders (r = 0.12, P greater than 0.1). Further, a negative correlation (r = -0.61) is observed between cholesterol synthesis and plasma cholesterol concentration in the low-responders but in the high-responders, there is no relationship between the parameters. From these correlations we conclude that the higher cholesterol absorption in the high-responders than in the low responders is one important mechanism responsible for the development of severe hypercholesterolemia in the high-responding monkeys fed cholesterol. The results also suggest that there might be a lower sensitivity in the feedback inhibition mechanism of cholesterol biosynthesis in the high-responding than in the low responding rhesus monkeys. PMID- 3675705 TI - Plasma lipid and lipoprotein concentrations in Chinese males with coronary artery disease, with and without hypertension. AB - Plasma lipid and lipoprotein concentrations were determined in 125 Chinese males with a medical history and electrocardiographic abnormalities consistent with the diagnosis of coronary artery disease (CAD). All subjects underwent coronary arteriography, and patients were divided into 3 groups based upon the results of the coronary arteriograms: 1) patients with a negative angiogram (CAD-, n = 30), without hypertension; 2) patients with a positive angiogram, without hypertension (CAD+, n = 70); and 3) patients with a positive angiogram, who had hypertension (CAD + HT, n = 25). Mean fasting plasma lipid and lipoprotein concentrations of these 3 groups of patients were compared to values in age and weight-matched groups of normal individuals (n = 80) and untreated patients with hypertension and no evidence of CAD (HT, n = 20). The results indicated that total plasma triglyceride, cholesterol, and LDL-cholesterol levels were significantly higher (P less than 0.001) than normal in patients with CAD+ and CAD + HT, whereas only plasma cholesterol levels were higher than normal in patients with HT. Although patients with CAD- had values intermediate between normal and CAD, the differences were not statistically significant. In addition, the ratio of LDL to HDL-cholesterol was significantly increased (P less than 0.05-0.001) above normal in patients with CAD+, CAD + HT, and HT. As before, the values in patients with CAD- were intermediate. These data document the presence of multiple abnormalities of lipid and lipoprotein concentration in patients with angiographic evidence of CAD, whether or not they were hypertensive. Furthermore, abnormalities in lipid and lipoprotein metabolism were seen in patients with hypertension alone. PMID- 3675706 TI - Studies on aorta during development. I. Fetal rabbit aorta under ex vivo and in vitro conditions: rapid changes in smooth muscle cell phenotype, cell proliferation and cholesterol content with organ culture. AB - The structural development of the already well defined fetal rabbit aortic wall from 22 to 31 days of gestation in vivo consists of increasing aortic wall thickness, elastic lamina continuities, extracellular matrix deposition, and maturing of the fine structure of the medial smooth muscle cells. In vivo at term (31 days), the mature aortic smooth muscle cells demonstrated the characteristic thin, thick and intermediate filaments, dense plaques, endoplasmic reticulum, golgi, plasmalemma vesicles and an incomplete basal lamina. The fetal aorta rapidly responded to organ culture with various changes. Fetal smooth muscle cells modified their phenotype to the synthetic state when cultured in both serum supplemented and serum-free media. This smooth muscle cell modification occurred after 3 days of culture in fetal explants. The synthetic type smooth muscle cells (fetal) began to proliferate after 6 days of culture. This proliferation resulted in a peripheral outgrowth after 9 days of 10-20 layers in fetal cultures from serum-supplemented media and of 2-4 layers in serum-free media. The orderly arrangement of the internal elastic lamina and alternating medial layers of smooth muscle cells and elastic lamina seen in vivo was disrupted along with increased matrix after 9 days of fetal explant culture. Significant numbers of 'modified' synthetic phenotype smooth muscle cells were not observed in adult aortic explants until after 15 days in culture in serum supplemented media. The mature contractile phenotype smooth muscle cell predominated in adult explants cultured in serum-free media. Significant synthetic phenotype smooth muscle cell proliferation only occurred in adult explants after 15 days culture in serum supplemented media. When compared to aorta in vivo evidence for increases in cholesterol esterification were observed in both fetal (9 days) and adult (15 days) explants cultured in both serum-supplemented and serum-free media. The fetal aorta in organ culture appeared to be more susceptible than the adult aorta to (a) phenotypic modulation of smooth muscle cells to the synthetic state, (b) smooth muscle cell proliferation, and (c) early cholesteryl ester accumulation. PMID- 3675707 TI - Studies on aorta during development. II. Differences in ontogeny of the key enzymes involved in cholesteryl ester synthesis and hydrolysis in rabbit aorta. AB - It is well known that cholesteryl ester accumulation is dramatically increased in the atherosclerotic artery. The enzymes acyl-CoA: cholesterol acyltransferase (ACAT), acid cholesteryl esterase (ACE) and neutral cholesteryl esterase (NCE) may play key roles in the accumulation of cholesteryl esters in the arterial wall. However, very little is known regarding the developmental pattern of the key enzymes involved in cholesteryl ester synthesis and hydrolysis. The total activities of ACAT, ACE and NCE were measured by radioassay using liposomal substrates in rabbit aortic homogenates. Our results indicate that ACAT activity decreases as a quadratic function with age (P less than 0.05). ACAT activity (pmol/100 mg protein/min) decreased from a high value in the fetus at term (63.3 +/- 7.4) to gradually lower values with increasing age. On the other hand, ACE activity (pmol/mg protein/min) was low in the fetus at term, and changed as a quadratic function with age (P less than 0.05) increasing gradually to higher activities with age up to a maximum at 12 weeks then decreased at 21 weeks. NCE activity (pmol/mg protein/min) increased dramatically from a low value in the fetus at term (3.34 +/- 0.48) to a maximum value at 1.5 weeks (14.65 +/- 2.73) then decreased as a linear function with increasing age up to 21 weeks (P less than 0.05). Plasma total cholesterol (mg/dl) also increased sharply from the fetal value at term of 98.5 +/- 5.2 to a maximum value at 1.5 weeks of 666.4 +/- 33.4, then decreased as a quadratic function with increasing age up to 21 weeks (40.8 +/- 6.7) (P less than 0.05). The free cholesterol content (microgram/mg protein) of the aortic tissue was initially high in the fetus (24.8 +/- 5.9) then increased with age. Examination of the ratio of synthesis to hydrolysis of cholesteryl esters as an index of enzyme activity units demonstrated a very high index in the fetus of 6.1 that rapidly decreased with increasing age in the young adult rabbit down to a value of 0.4 by 21 weeks of age. Correlation coefficients between enzyme activities, plasma cholesterol levels and aortic cholesterol levels indicated (a) a positive correlation of NCE activity with plasma cholesterol, (b) a negative correlation of NCE and ACE with aortic-cholesteryl ester content, and (c) no significant correlation of ACAT activity with either plasma cholesterol or aortic cholesterol content, indicating other factors are involved.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3675708 TI - Re: Fish oil feeding results in enhancement of cholesterol-induced atherosclerosis in rabbits. PMID- 3675709 TI - Effect of arterial proteoglycans on the interaction of LDL with human monocyte derived macrophages. AB - The effect of human arterial proteoglycans (PG1) on the interaction of low density lipoprotein (LDL) with cultured human monocyte-derived macrophages (HMDM) was studied. LDL was insolubilized by treatment with chondroitin-6-sulfate-rich, partially purified PG1. The LDL, resolubilized in culture medium, was added to HMDM. The PG1 pretreated LDL induced lipid accumulation in the HMDM, converting them into foam cells. Mass determination of lipids by spectrophotometric and chromatographic procedures showed a 2-4-fold accumulation of triglycerides, phospholipids, unesterified cholesterol and cholesterol esters in 48 h, in the HMDM incubated with PG pretreated LDL, when compared to those incubated with native LDL. Incorporation of [14C]oleic acid into the HMDM lipid esters correlated with the accumulation. Association of 125I-labeled LDL and of fluorescent labeled LDL (3,3-octadecyl indocarbocyanine) to HMDM also indicated that the PG1-pretreatment of LDL increased its uptake. Density gradient centrifugation, isoelectric focusing and electron microscopy showed that, when added to the cells, the PG1 pretreated LDL was not aggregated or altered in its surface charge. However, controlled trypsin treatment and polypeptide pattern analysis indicate that the accessibility of apoB has been altered. The results suggest that changes in the surface of LDL, induced by the arterial PG1, lead to increased endocytosis of the lipoprotein and stimulation of lipid synthesis in the macrophages. The possibility that a similar process may cause lipid accumulation in arterial macrophages is discussed. PMID- 3675710 TI - Serum lipoproteins, sex hormones and sex hormone binding globulin in middle-aged men of different physical fitness and risk of coronary heart disease. AB - Serum concentrations of lipoproteins, apolipoprotein A-I (Apo A-I), androgens, including biologically active free testosterone (free T), and sex hormone binding globulin (SHBG) and their associations were studied in 3 groups of men of different physical fitness and risk of CHD, consisting of male CHD patients, joggers and healthy controls. Of the 3 study groups, men with angiographically assessed CHD had the lowest HDL-C (P less than 0.002) and highest LDL-C and triglyceride (TG) levels (P = 0.05 and P less than 0.001) and lower 5 alpha dihydrotestosterone (5 alpha-DHT) levels than joggers (P less than 0.02). Joggers had the highest serum high density lipoprotein cholesterol (HDL-C), Apo A-I and SHBG levels and lowest serum low density lipoprotein cholesterol (LDL-C) compared to the other groups (P less than 0.01). In correlation analysis 5 alpha-DHT was the most significant positive determinant of HDL-C and Apo A-I levels in CHD patients (r = 0.56 and r = 0.55, respectively, P less than 0.05). Moreover, SHBG was significantly positively correlated to both HDL-C and Apo A-I levels in patients, in the whole study group and in healthy men separately (r = 0.37-0.52, P less than 0.01). These significant correlations were also confirmed when age variation and differences in body mass index and smoking were controlled in multivariate analysis and in addition, in multivariate analysis both serum free and total testosterone were inversely related to serum triglyceride (TG) levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675711 TI - On the associations of body cholesterol pool size with age, HDL cholesterol and plasma total cholesterol concentration in humans. AB - Data from 17 subjects, in whom cholesterol kinetics had been measured by two-pool analysis of medium-term plasma cholesterol specific activity-time curves, were examined by multiple linear regression to explore the determinants of the size of the slowly exchanging cholesterol pool (MBmin) in humans. Pool size was independently and positively related to body weight (regression coefficient, 0.94 g per kg; P = 0.05) and age (1.77 g per year; P = 0.02). After allowance for these effects, MBmin retained a significant negative association with the plasma high density lipoprotein (HDL) cholesterol concentration (-0.56 g per mg/dl; P = 0.03), but was unrelated to plasma total cholesterol. This result is consistent with published data on the composition of those human tissues whose cholesterol is known to be largely a component of the slowly exchanging pool. It differs, however, from that of a recent study of cholesterol turnover [Blum et al, J. Lipid Res., 1985; 26: 1079-1088] in which pool size, measured by three-pool analysis of long-term decay curves, was unrelated to HDL and directly related to plasma total cholesterol. On the basis of other published data, it is considered that this discrepancy is unlikely to be a consequence of the difference between our respective studies in the duration and method of analysis of the specific activity decay curves. Differences in the variances of HDL cholesterol and plasma total cholesterol concentration that were examined, and in the biochemical genetic factors underlying these variances, provide a more likely explanation. The overall weight of evidence favours the view that the pool of slowly exchangeable cholesterol in many human tissues expands during ageing at a rate which is increased in the presence of severe hypercholesterolemia, and which under some, but not all, circumstances also varies inversely with HDL cholesterol. The critical components of HDL metabolism which affect this process remain to be identified. PMID- 3675712 TI - Effect of atherogenic diet on lipoprotein lipase activity in cynomolgus monkeys. AB - Cynomolgus monkeys (Macaca fascicularis) fed monkey chow (n = 10) had a mean +/- SD post-heparin plasma lipoprotein lipase (LPL) activity level (14.7 +/- 5.5 units/ml) similar to that found in human beings (15.7 +/- 3.9 units/ml). However, the hepatic triglyceride lipase (H-TGL) in these monkeys was extremely low (0.5 +/- 0.3 units/ml) when compared with that in human beings (10.9 +/- 4.3 units/ml). The consumption of isocaloric atherogenic diets (0.2 mg cholesterol/Cal) with either saturated (P/S = 0.34) or polyunsaturated (P/S = 2.2) fat led to increased LPL activity levels (27.6 +/- 6.5 and 28.8 +/- 16.1 units/ml, respectively) and the accumulation of plasma low density lipoprotein cholesterol (LDL-C). The results indicate that cholesterol-containing atherogenic diets with either primarily saturated or polyunsaturated fat have similar potential for the increase of LPL activity. However, it is not clear whether the high dietary cholesterol content represents an obligatory component for the increase of LPL. We speculate that the high level of LPL in cynomolgus monkeys when fed a cholesterol-rich, high fat diet could be a contributing factor to the accumulation of excessive plasma LDL-C. PMID- 3675713 TI - Three-year tracking of serum fatty acids in Finnish boys and girls. AB - The composition of fatty acids in serum lipids has been shown to reflect the quality of dietary fat. In order to examine the long-term stability (tracking) of the serum (and hence dietary) fatty acid composition serum cholesteryl ester fatty acids were analysed by gas chromatography in a randomly selected population sample of 1029 Finnish boys and girls aged 3, 6, 9, 12, 15 and 18 years, and again from the same individuals 3 years later. The tracking was evaluated by calculating linear correlation coefficients for the percentages of individual fatty acids between the 2 time points. For all fatty acids the correlations were highly significant, e.g. for linoleate and arachidonate they were 0.58 and 0.61, respectively. In 1980 the means of the percentages of some fatty acids showed certain differences between the various age and sex groups; in 1983 these differences had become smaller and had largely shifted towards three years older age groups, implying that the differences were due to dietary differences between the cohorts rather than to age and sex per se. The present results indicate that serum fatty acid composition has a fairly good biological reproducibility (tracking) and suggest that age and sex as such are only minor determinants of the serum fatty acid composition. PMID- 3675714 TI - Cellular events in the development of valvular atherosclerotic lesions induced by experimental hypercholesterolemia. AB - The onset and evolution of ultrastructural changes in the cardiac valves induced by a cholesterol-rich diet were investigated in rabbit and hamster. In both animal models, the atrioventricular and sigmoid valves were comparably affected by lesions intermediary between fatty streak and fibrous plaque. The earliest detectable modification was the progressive accumulation in the subendothelium of extracellular liposome-like structures rich in unesterified cholesterol, associated with the proliferation of a basal lamina-like material. This was followed by the diapedesis of blood monocytes in the same location, which became macrophages increasingly loaded with lipid deposits. Resident interstitial cells accumulate lipids, as well. In advanced stages, the macrophage-derived foam cells clustered, deforming the valve leaflets. The resident macrophages accumulated lipids later and more slowly, while partly preserving their ultrastructure. The advanced lesions are characterized by marked stromal proliferation, massive intra and extracellular deposition of lipids and cholesterol crystals and the appearance of a necrotic core. The salient findings of these studies were: (1) the appearance of extracellular liposomes as the earliest event in atherogenesis; (2) the capability of the valvular interstitial cells to accumulate lipids; and (3) the slow response of resident macrophages to the cholesterol-rich diet. The results revealed that hypercholesterolemia produces in the cardiac valves atherosclerotic lesions of an intermediate type, which can deform the leaflets thus altering their normal function. PMID- 3675715 TI - Smooth muscle cell migration and proliferation: atherogenic mechanisms in hypertension. AB - The proliferative and migratory behavior of explanted rat aortic smooth muscle cells (SMC) was investigated in cells obtained from either 24-week-old normotensive Wistar-Kyoto (WKY) or age-matched spontaneously hypertensive (SHR) rats. Time lapse video analysis of primary SMC growth in the presence of 10% serum revealed that interdivision times of cells from SHR were significantly shorter than those from WKY. Differences in the proliferative capacity of these cells were still present after two subcultivations, as analyzed by conventional growth curves. In contrast to the proliferative behavior, no differences in the migratory characteristics of SMC could be detected in a migration assay analyzing the SMC outgrowth of standardized aortic explants under low serum conditions (0.1% fetal bovine serum). It has been shown that another model of hypertension, the 4 week DOC/salt hypertensive rat results in a different reaction of SMC. Therefore, it can be considered that the extent of the potentially atherogenic alterations of SMC function in hypertension is dependent on the type, duration and the rate of increase of hypertension. PMID- 3675716 TI - Association of polymorphonuclear leukocytes with sites of aortic catheter-induced injury in rabbits. AB - The kinetics of the association of polymorphonuclear leukocytes (PMNs) with arterial balloon catheter-induced injury have been examined. An average of 6 X 10(7) PMNs were isolated from 20 ml of blood and labelled with 111In-oxine for reinfusion into the donor rabbit. The cells remained viable as demonstrated by both in vitro and in vivo tests of cell function. The abdominal aorta of rabbits was denuded of endothelium and immediately, 24 h, or 5 weeks later, exposed to autologous radiolabelled PMNs for 1 h. The presence of PMNs at sites of denudation was demonstrated by detection of the radioactive label and was confirmed by light and electron microscopy after 24 h, but not at 5 weeks. Immediately following denudation radioactivity was 2.44 +/- 0.33 times control (P = 0.006); 2.52 +/- 0.18 at 24 h (P = 0.005); and 1.88 +/- 0.32 times control at 5 weeks (P = 0.045). The presence of PMNs, or their products, 5 weeks after denudation suggests a more complex role of PMNs and possibly a direct involvement in the long term changes resulting from arterial balloon catheter injury. PMID- 3675717 TI - Cortisol and the hypercholesterolemia of pregnancy and labor. AB - Lipids and lipoproteins are known to increase substantially during pregnancy and to decrease rapidly after delivery. The factors responsible for the changes have not been identified, however, they could be related to changes in one or more of the endocrine hormones. Since studies relating lipid and lipoprotein changes to cortisol or estradiol concentrations have not been made, we sought to perform such a study. For this study, we measured cholesterol, HDL-C, VLDL/LDL-C, cortisol, and estradiol concentrations from early gestation through delivery in 32 normal pregnant women. During the course of pregnancy, cholesterol increased from 145 to 211 mg/dl (45%); plasma cortisol increased from 8.6 to 17.8 micrograms/dl (107%); and urinary cortisol increased from 0.10 to 0.177 microgram/mg of creatinine (72%). Further significant increases in cholesterol (256 mg/dl, P less than 0.005) and cortisol (77.6 micrograms/dl, P less than 0.001) occurred during labor, and both decreased after delivery. Pooled correlations were calculated and both cholesterol and VLDL/LDL-cholesterol concentrations were found to be related to plasma cortisol as well as to urinary cortisol (P less than 0.001). Plasma estradiol concentrations increased during pregnancy, but not during labor. The results suggest that the increases in cholesterol during pregnancy and labor could be due, in part, to the metabolic and stress-related increases in cortisol. The studies also suggest that both pregnancy and labor and delivery might be useful "natural" models for studying hormonal mechanisms involved in lipid and lipoprotein metabolism. PMID- 3675718 TI - Blood carbonmonoxyhaemoglobin levels are chronically elevated in alcoholics treated for detoxification. AB - Self-reported daily consumption of cigarettes and ethanol was recorded from a group of 59 ethanol-dependent persons admitted to a detoxification clinic at 2000 2400 h and averaged 40 cigarettes per day and 320 g ethanol per day, respectively. In consequence, concentrations of blood COHb and ethanol were high. Mean values for COHb were 8.5 and 9.9% in men and women, respectively, while the corresponding levels for ethanol were 220 and 280 mg/100 ml. Blood acetate concentrations were also elevated and correlated negatively with mixed venous oxygenhaemoglobin concentrations. The mean carbonmonoxyhaemoglobin concentration at 0700 h was found to be approximately 65% of that on admission. Biochemical and haematological analysis, past medical history and current physical examination revealed a high degree of ethanol and/or cigarette-related pathology. Studies on lipid and lipoprotein metabolism in ethanol-dependent persons should take into account their simultaneous high cigarette abuse. PMID- 3675719 TI - Pseudocholinesterase and serum lipoproteins. PMID- 3675720 TI - Nutritive and non-nutritive sucking in preterm infants. AB - Nutritive and non-nutritive sucking was studied in 9 preterm infants with postmenstrual ages ranging from 28 to 33 weeks and postnatal ages ranging from 0 to 8 weeks. During nutritive sucking, sucking bursts were longer than sucking pauses. During non-nutritive sucking the opposite was seen. The sucking rate was lower during nutritive sucking. During nutritive sucking the respiratory rate was higher during the pauses than during the bursts. During non-nutritive sucking the respiratory rate was higher during sucking. It is concluded that non-nutritive sucking cannot serve as a model for studying feeding mechanisms in the preterm infant. PMID- 3675721 TI - Some haematological and clinical-chemical parameters of sight hounds (Afghan hound, saluki and whippet). AB - Blood was collected from 111 clinically healthy dogs of sight hound breeds for haematological and clinical chemical analyses. The distributions according to age, breed and sex are tabulated. Reference values for haemoglobin were established as 172-240 g/l for adults and 136-217 g/l for growing dogs; the respective packed cell volume values were 50-69% and 41-64%. Ten serum parameters were determined: AP, ALAT, ASAT, GT, CK, urea, cholesterol, creatinine, total protein and albumin. The results are given as means +/- S.D., and a reference value for serum creatinine was established as less than or equal to 165 mumol/l for adults. PMID- 3675722 TI - Accessibility of cell surface thiols in human lymphocytes is altered by ionophores or OKT-3 antibody. AB - The accessibility of cell surface sulfhydryl groups in human peripheral lymphocytes was investigated with 5,5'-dithiobis-(2-nitrobenzoic acid) in the presence and absence of ionophore antibiotics and the monoclonal antibody, OKT-3. Only a few accessible protein thiols have been found on the cells as demonstrated by labeling with a fluorescent non-penetrating thiol-marker, monobromotrimethyl ammoniobimane and the subsequent gel electrophoretic analysis of the protein pattern. Difference spectrophotometric measurement of thiol-DTNB reaction revealed that ionophores altering the transmembrane potential induced an enhanced cell surface thiol-exposure on the minute time scale. The effect showed a dependence on the external concentration of the cations. The binding of monoclonal antibody, OKT-3, directed against T3 complexes, resulted in a similar, concentration-dependent increase of thiol-accessibility. These data are interpreted as early membrane-effects of ionophores and the specific antibody including changes in the conformational equilibrium or vertical displacements of certain membrane proteins. These events are likely to be coupled to the changes in the transmembrane potential of the lymphocytes. PMID- 3675724 TI - Yellow nail syndrome in association with sleep apnea. PMID- 3675723 TI - Age, period and cohort models: the use of individual records. AB - Problems with the interpretation of age-period-cohort models are discussed. If individual records are available for cancer incidence in Scotland, then a solution is obtainable. An example using incidence data for cancers of the lung and larynx in Scotland is presented to illustrate the models. PMID- 3675725 TI - Smoking Part III: Two minutes of your time: a guide to helping your patients to stop smoking. PMID- 3675726 TI - Acute bronchiolitis in infancy. The relationship to later recurrent obstructive airways disease. AB - Fifty-one infants admitted to hospital because of acute bronchiolitis were followed until 2 years of age. Sixty per cent had three or more attacks of bronchopulmonary obstruction, and the remainder two or less attacks. The children with three or more attacks also had more respiratory infections. They had younger parents and their close relatives more often had respiratory atopic illness. The children with three or more attacks wheezed for a longer time after the bronchiolitis. No difference was found for breast-feeding, neonatal respiratory complications, crowded homes, parental smoking and other social factors. To detect children at risk of recurrent obstructive airways disease after bronchiolitis, a discriminant analysis was performed. The discriminant function classified 28 of the 31 children with recurrent obstructive episodes as belonging to the risk group, and 18 of the 20 children with two or less episodes to the non risk group. PMID- 3675727 TI - Monitoring and treating life-threatening ventricular dysrhythmias. AB - Dealing with cardiac emergencies resulting from the development of life threatening dysrhythmias always presents some degree of stress to the practitioner, regardless of the amount of experience and exposure to cardiac arrests. Dealing effectively with these emergencies is threefold. First is prevention of the event. The astute practitioner utilizes knowledge of precipitating factors, data collection, assessment, and intervention to prevent a patient's condition from advancing to an emergency situation. Second, one must be prepared to deal with the emergency, by having a plan of action and knowing what to expect. Finally, one must deal with the emergency as effectively as possible, and then evaluate what has occurred, how the emergency was handled, and what actions would have improved the experience. PMID- 3675728 TI - [Alcoholic cardiomyopathy in the preclinical stage: non-invasive clinico instrumental research study on 112 chronic alcoholics]. AB - 112 consecutive asymptomatic patients who assumed alcohol in excess (1-2 g/kg/die) for 5 years or more were admitted to our hospital for detoxication. They were examined both clinically and with chest x-rays, ecg, phonocardiography, external pulse recording, and M-mode/2-D echocardiography to detect myocardial involvement. Heart disease not related to alcohol abuse was found in 6 cases. In the remaining 106/112 patients electrocardiographic abnormalities (aspecific ST-T changes, left bundle branch block, intraventricular conduction defects, left ventricular strain pattern and atrial fibrillation) were present in 18 per cent of cases. PEP, LVET intervals and PEP/LVET, were calculated only in 39/106 patients and did not differ significantly from the control group. The echocardiographic study showed hypokinesis and left ventricular dilatation in 9/106 patients. In other 5 cases echocardiographic findings were at upper limits of normal for left ventricular dimension and motility. Therefore in 13 per cent of cases a dilated cardiomyopathy was revealed by the echocardiographic study. In 6 of these 13/106 patients ecg was either normal or showed only aspecific ST-T changes. Echocardiography failed to confirm augmented left ventricular thickness and mass as reported in asymptomatic alcoholic patients in the literature. Probably several factors (different interval of time between the interruption of the alcoholic abuse and the time of examination, the quantity of alcohol in excess and the echocardiographic technique) may influence the results of such studies. The present report nevertheless points out to the validity of the echocardiographic study in the detection of subclinical myocardial involvement in alcoholic patients and should be performed in such cases. PMID- 3675729 TI - Re: 'Developmental progress in very low birth weight infants during the first year of life'. PMID- 3675730 TI - On the mode of action of six putative dopamine receptor agonists on suppression of exploratory behaviour in rats. AB - The effects of six putative dopamine receptor agonists on exploratory behaviour in rats were assessed: pergolide, (+)- and (-)-3-PPP, bromocriptine, mesulergine and CQ 32-084. Behaviour was automatically recorded in a holeboard apparatus and the data were analysed by the novel multivariate statistical method of partial least squares. All six substances suppressed exploratory behaviour at low doses. Pergolide and (+)-3-PPP-induced stereo-typed behaviour at higher doses. The suppression of exploration induced by pergolide was completely antagonised by sulpiride, partly antagonised by metoclopramide and weakly affected by haloperidol pretreatment. The effects of a low dose of (+)-3-PPP, bromocriptine or CQ 32-084, but not (-)-3-PPP or mesulergine, were antagonised by sulpiride. These findings support the hypotheses that pergolide, (+)-3-PPP, bromocriptine and CQ 32-084 inhibit exploration via stimulation of dopamine receptors. The present data do not substantiate the hypothesis that the suppression of exploration induced by (-)-3-PPP is mediated by stimulation of dopamine autoreceptors. A detailed analysis of the dose curves for pergolide and (+)-3-PPP indicates that the latter compound may have effects in addition to those of a dopamine receptor agonist. PMID- 3675731 TI - The value of retropharyngeal soft tissue measurements in trauma of the adult cervical spine. Cervical spine soft tissue measurements. AB - Widening of the retropharyngeal soft tissue space (RSTS) has been interpreted as a sign of cervical spine trauma. Widely differing measurements are reported in the literature. However it is clear that, using the currently acceptable limits of normal, a large number of patients without spinal injury are subjected to further tests. The RSTS on lateral cervical spine radiographs of 318 patients with a history of cervical spine trauma were measured at the C2-C4 level. The values for patients found to be normal or with fractures/dislocations were evaluated. Statistical analysis of the results demonstrates a considerable overlap in the RSTS of normal and abnormal patients. Therefore we suggest that RSTS measurements are of limited diagnostic value. Using the statistical probability of abnormality, guidelines that indicate which patients may require additional study are suggested. PMID- 3675732 TI - 1985 incomes of US veterinarians. PMID- 3675733 TI - The maturation of the central auditory conduction in preterm infants until three months post term. V. The auditory cortical response (ACR). AB - Auditory cortical evoked responses (ACRs) were recorded in 65 preterm infants, at least on 3 occasions in 48 of them. The infants were divided into 5 groups according to their gestational age (GA). The recording sessions were performed at 8 conceptional age (CA) levels, defined as the gestational age added to the chronological age. The last recordings were obtained at 50-52 weeks CA. The ACRs were analyzed for the primary complex containing middle latency components (MLR) and the secondary complex, containing the slow late components. The ACR records first appear at about 25 weeks CA, initiating the premature stage followed by a transitional stage around term date and the gradual development into the mature stage, achieved at 50-52 weeks CA. The detectability rate of the various components generally increased with increasing conceptional age, for some of the components, especially N2p and N2, this rate achieved a value of about 80%. The degree of prematurity did not influence appreciably the development of the ACR. The waveforms, and to a lesser extent the latency and amplitude values, are strongly age dependent. Remarkable topographic differences between the ACR parameter latency and more importantly amplitude values are found between the derivations from the vertex and the central temporal areas, supporting the theory of different generation sites for the ACR components. The premature and mature ACR appeared relatively insensitive to changes in the states of vigilance. The ACR in premature infants are useful in developmental studies with respect to the central audition in premature infants and might contribute in the clinical assessment on the quality of the premature central auditory system. PMID- 3675734 TI - Technetium-99m radiopharmaceutical preparation by surface adsorbed stannous ions. AB - A method of producing technetium-99m (99mTc) radiopharmaceuticals is described, where reduction of pertechnetate occurs through stannous ions adsorbed on the surface of an infusion catheter. This leads to radiopharmaceuticals containing microgram quantities of stannous ions and that, therefore, results in minimal blood-pool labeling and essentially the elimination of tin colloids. Other advantages of the method include a reduction in quantities of ligand required and the possibility to mass produce the "tinned" catheters as technetium "reduction" kits. A wide variety of 99mTc radiopharmaceuticals have been prepared in high yield. Excellent biodistribution in several of these is demonstrated. PMID- 3675735 TI - pBD7, a novel cell-free expression vector with efficient translation initiation signal. PMID- 3675736 TI - Current concepts and clinical strategies for managing low-birth-weight infants under radiant warmers. PMID- 3675737 TI - [Diagnosis of primary hyperparathyroidism]. PMID- 3675738 TI - [Percutaneous transluminal balloon valvuloplasty in older patients with acquired aortic valve stenosis]. PMID- 3675739 TI - Polymorphism of the vitamin D binding protein (DBP) among primates: an evolutionary analysis. AB - The distribution of the DBP (vitamin D binding protein) polymorphism is now well characterized among human populations but for primates only limited results are known. The aim of this paper is to describe the electrophoretic polymorphism of this protein among various species. Using three different electrophoretic methods, we are able to detect an unknown polymorphism and to classify the different alleles observed. These results may be used to set an international nomenclature for further comparisons. The different electrophoretic mobilities between Old and New World Monkeys show that: 1) the Cercopithecoidea are presenting the largest genetic heterogeneity; 2) the DBP among the Galago corresponds to the lowest isoelectric points observed among Primates; 3) during the evolution from nonhuman Primates to Man, the DBP is able to keep its affinity for vitamin D derivatives despite the occurrence of significant molecular modifications; 4) among Anthropoidea, the electrophoretic patterns of DBP are very close to the human Gc1 proteins. These results show that evolution at the DBP level can be considered as a continuous mechanism of structural modifications. A significant transition occurs during the differentiation between Cercopithecoidea and Anthropoidea. It is not too speculative to consider that some electrophoretic forms detected among Gorilla, Pongo, or Pan may be identical to rare variants observed among humans. PMID- 3675741 TI - [On the occasion of the 20th anniversary of the Pediatric Clinic of Luxemburg. 1966-1986. Pediatric surgery]. PMID- 3675740 TI - Fatal haemoperitoneum from ruptured hepatic metastases from testicular teratomas. PMID- 3675742 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 41-1987. A 27-year-old woman with remote idiopathic thrombocytopenic purpura, recurrent thrombocytopenia, and headache. PMID- 3675743 TI - Fatal heat stroke in a dog. PMID- 3675744 TI - The impact of professional liability insurance on nurse anesthesia practice. PMID- 3675746 TI - The effect of nursing care planning systems on patient outcomes. AB - Are written or standardized nursing care plans (NCP) as effective in enhancing the quality of patient care, and thus patient outcomes, as has been proposed for well over a decade? Data in this study did not validate the superiority of these two types of NCPs over another planning system. If the findings of this study are supported by further research, there will be scientific evidence upon which JCAH can base a reconsideration, and possible elimination, of their requirement for written/printed nursing diagnoses with corresponding nursing orders as part of nursing care planning systems. PMID- 3675747 TI - Proposal to establish a NSW Nurses' Association strike fund. PMID- 3675745 TI - Dietary carbohydrate assimilation in the premature infant: evidence for a nutritionally significant bacterial ecosystem in the colon. AB - Carbohydrate energy absorption and breath hydrogen concentration were measured in 12 premature infants 28-32 wk gestational age and 2-4 wk postnatal age. Each of two groups of six infants were randomly assigned to receive one of two formulas that differed only in carbohydrate source: 100% lactose (LAC) or 50% lactose: 50% glucose polymer (LAC + GP). In 11 infants the peak breath hydrogen concentration suggested extensive colonic fermentation (range 44-239 ppm/5% CO2 or 44-239 microL/L per 50 mL/L CO2). An approximate 100% increase in lactose intake in the LAC group was associated with a similar increase in breath hydrogen concentration at 30, 60, and 120 min. None of the infants exhibited diarrhea or vomiting or developed delayed gastric emptying. Carbohydrate energy absorption (mean +/- SD) was, respectively, 86 +/- 5% and 91 +/- 3% in the LAC and the LAC + GP groups (p greater than 0.05). Thus, colonic bacterial fermentation may be critical to energy balance and to the prevention of osmotic diarrhea in premature infants fed lactose. PMID- 3675748 TI - Nutrition know-how. Combating pressure sores--nutritionally. PMID- 3675749 TI - Cancer screening: an educational program for employees. PMID- 3675750 TI - Prenatal education: should it be part of your worksite health program? PMID- 3675752 TI - Contracting for care. A method to increase client compliance. PMID- 3675751 TI - Antineoplastic drugs. Handle with care. PMID- 3675753 TI - Framework for tomorrow. The future of occupational health nursing. PMID- 3675754 TI - Occupational health nursing worldwide. PMID- 3675755 TI - [Researches on the clothing of adult males classified by the season--comparison between the student group and the father group]. PMID- 3675756 TI - [Skin surface temperatures during submaximal cycling observed by color thermography]. PMID- 3675757 TI - [Breath-by-breath estimation of alveolar gas exchange]. PMID- 3675758 TI - [Effects during isometric voluntary contractions of elbow flexion muscles on EMG reaction time (EMG-RT)]. PMID- 3675759 TI - Effect of far-infrared radiation on forearm skin blood flow. PMID- 3675760 TI - Seasonal variation in sweating threshold of men. PMID- 3675761 TI - Alveolar membrane conductance (Dm), pulmonary capillary volume (Vc) at various levels of lung inflation. PMID- 3675762 TI - [Effect of exercise on muscle protein metabolism during growth in a rat]. PMID- 3675763 TI - [The effect of partial pressure on upper extremity upon psychological characteristics]. PMID- 3675764 TI - The role of shivering thermogenesis and total body insulation in core cooling rate. PMID- 3675765 TI - [The effect of partial pressure on lower extremity upon skin temperature and electromyogram]. PMID- 3675766 TI - [The effect of partial pressure on upper extremity upon skin temperature and electromyogram]. PMID- 3675767 TI - [Relationship between housing and goods]. PMID- 3675769 TI - [Living environments of weak persons]. PMID- 3675768 TI - [Living environment and comfort]. PMID- 3675770 TI - [Effects of living environments on motor ability and physical fitness]. PMID- 3675771 TI - The influence of acute and chronic hypoxia on the electroencephalogram of human body. PMID- 3675772 TI - The influence of simulated saturation diving on electroencephalogram of human at different depths. PMID- 3675773 TI - The influence of apparel on aerodynamic drag in running. PMID- 3675774 TI - Thermoregulation in athletic racing apparel. PMID- 3675775 TI - [On the manual dexterity and behavior of daily living of children]. PMID- 3675776 TI - Circadian variations of sweating in man exposed to thermal stimuli. PMID- 3675777 TI - Prevalence and causes of blindness in Greenland. PMID- 3675778 TI - A cluster of ischaemic heart disease in Northern Ostrobothnia, Finland. PMID- 3675780 TI - International co-ordination and Antarctic Medical Research and Medicine. PMID- 3675779 TI - Mortality pattern in Greenland. An analysis of potential years of life lost 1968 83. PMID- 3675781 TI - Clothing design for work in the cold. PMID- 3675782 TI - The University of Alaska-Siberian Medical Research Program: a circumpolar model agreement. PMID- 3675783 TI - Health services in Longyearbyen, Svalbard/Spitsbergen. PMID- 3675784 TI - Establishing Arctic Medical Research as an international journal of Arctic medicine. PMID- 3675785 TI - Patellar instability: treatment by arthroscopic electrosurgical lateral release. AB - We reviewed the results of arthroscopic lateral release using electrosurgery in 39 patients (45 knees) with a history of recurrent patellar subluxation or dislocation. The average follow-up time was 28 months (range, 24-36). At follow up, the patients had decreased swelling, instability, and pain. There was an improvement in flexion activities, sports participation, and overall functional ability. Only 20% of the knees had completely normal physical findings: 11.1% of the knees were rated as excellent; 64.4% were improved; and 24.5% were poor. Dislocators had more frequent poor results. The complication rate was 4.4%. There were no postoperative hemathroses. One patient was considered a surgical failure. The technique yields results comparable with those of open extensor realignment procedures and avoids the complications inherent to lateral release in general. The place for this procedure in patellar instability is well-documented. PMID- 3675786 TI - The correlation between osteoarthrosis as seen on radiographs and on arthroscopy. AB - The correlation between arthroscopic and radiographic osteoarthrosis was studied in 63 patients (51 +/- 12 years) with degenerative changes in the medial compartment of the knee involving the medial meniscus with or without chondral damage. Chondral damage on arthroscopy was classified in grades 1-3 modified after Outerbridge. The radiographic evaluation was done according to Ahlback classification. Twenty-eight patients (44%) did not show any significant chondral damage on arthroscopy (grades 0-1). The radiographic findings in this group were usually normal. Three patients, however, showed a slight narrowing of the medial joint space (Ahlback I). All three had severely degenerated menisci, and two of them showed superficial fibrillation of both the tibia and the femur. Twenty-four patients (38%) showed a partial thickness chondral damage with fragmentation of the surface (grade 2). Radiographic findings were usually normal; however, patients with involvement of both the tibia and the femur often showed a joint space narrowing on radiographs. Eleven patients (18%) showed destruction of the cartilage down to subchondral bone (grade 3). The typical radiographic finding was a joint space obliteration (Ahlback II). Involvement also of the lateral compartment as assessed on arthroscopy was significantly more common in patients with 2nd and 3rd degree chondral disease and Ahlback II and III on radiographs than in those with 2nd and 3rd degree chondral damage and normal radiographs. In all but one of the patients with involvement of both compartments, the lateral compartment was considered normal on radiographic examination. PMID- 3675787 TI - Knee function after meniscus repair and total meniscectomy--a 7-year follow-up study. AB - Meniscus repair has been performed with a high success rate where the rupture occurs within the vascular zone. However, no study has compared the functional result of meniscus repair and total meniscectomy in similar patients with similar kinds of meniscus tear, with or without intact anterior cruciate ligament (ACL). We studied 48 knees, 44 men and 4 women divided into matched pairs, some with, and some without torn anterior-cruciate ligaments. Follow-up was done 6-8 years after surgery. We concluded that meniscal repair has a high success rate in stable and unstable knees. At 7-year follow-up, meniscal repair showed no better functional result than meniscectomy. A meniscus repair technique which allows early range of motion training and muscle rehabilitation is, therefore, needed to improve functional end results. PMID- 3675788 TI - The superolateral approach: a better view of the medial patellar plica. AB - When attempting to perform medial patellar plica surgery, the arthroscopist often finds that the three standard portals, namely, central, inferolateral, and midpatella lateral, offer poor visualization, awkward instrumentation, or both. This article suggests and describes the superolateral approach as a better arthroscopic portal for medial patellar plica surgery; while affording a sweeping, unobstructed view of the entire plica, this approach enables the arthroscopist to utilize the midpatella lateral portal for effective and convenient excision, with no damage to articular surfaces. The superolateral approach also offers excellent visualization of the suprapatellar pouch, the suprapatellar plica, and the patellofemoral joint. We further recommend the use of an infusion pump to improve knee distension, as well as the use of arthroscopic electrocoagulation to minimize postoperative hemarthrosis. PMID- 3675789 TI - Arthroscopic subacromial decompression: analysis of one- to three-year results. AB - Arthroscopic subacromial decompression (ASD) is a method of performing anterior acromioplasty utilizing basic arthroscopic techniques. The procedure is indicated in cases of chronic impingement syndrome that have failed to respond to prolonged conservative management. The purpose of this study is to present an analysis of the 1- to 3-year follow-up results of the initial 50 consecutive cases of ASD that I have performed. Forty (80%) of the cases had advanced stage II impingement without rotator cuff tear. Ten (20%) had full-thickness tears of the rotator cuff. Patients were evaluated pre and postoperatively on the UCLA Shoulder Rating Scale, which includes an assessment of pain, function, range of motion (ROM), strength, and patient satisfaction. Eighty-eight percent of the cases were rated "satisfactory" (excellent or good), and 12% were rated "unsatisfactory" (fair or poor). The procedure is technically demanding, and to achieve a satisfactory result the criteria of open anterior acromioplasty must be met. Arthroscopic subacromial decompression is presented as an alternative to open anterior acromioplasty in advanced stage II and selected cases of stage III impingement syndrome. PMID- 3675790 TI - Ligament and tendon oxygenation measurements using polarographic oxygen sensors. AB - This pilot study was designed to investigate a new flexible polarographic oxygen sensor for intraarticular oxygen tissue tension monitoring, as a first step in designing a combined simultaneous oxygen and perfusion monitor. The tendoachilles in the sheep provided the initial testing model, which was followed by in vivo testing in the human knee. In the animal model, the tendoachilles was perforated by a single needle through which the new flexible multichannel polarographic oxygen sensor probe was passed. Variations in blood and oxygen delivery to the hindlimb were then produced by tourniquet and fraction of inspired oxygen (FiO2) changes. The oxygen sensors appropriately recorded current variations proportional to the hypothesized oxygen delivery. In the human model, the anterior cruciate ligament (ACL) in five human knees was exposed during routine total knee replacement surgery and stripped of the fat pad and synovial attachments. The probe was inserted into the substance of the ligament from distal to proximal. Oxygen measurements were taken with the tourniquet elevated and then inflated, in an effort to evaluate the response of the oxygen sensors and to establish the degree of oxygenation that the bone blood supply provides to the ACL. In the sheep, 100% of the time (13 of 13 events), the current changed appropriately to a change in the FiO2. Ninety-four percent of the time (17 of 18 events), the current changed appropriately to a tourniquet change. In the human ACL, the probe was 83% sensitive (5 of 6 events) to a tourniquet change. The FiO2 changes were inconclusive owing to an insufficient amount of time allowed for tissue perfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675791 TI - Arthroscopic removal of entrapped debris following dislocation of a total hip arthroplasty. AB - The entrapment of a foreign body within a dislocated hip prosthesis is an unusual occurrence. Dislodgement of the fragments by closed reduction should be attempted to try to extricate the fragment from the femoral head and acetabular cup interface. If closed techniques prove unsuccessful, arthroscopy can be used to guide instrumented removal of the interposed fragments. PMID- 3675792 TI - Motorized arthroscopic instruments: a review. PMID- 3675793 TI - Arthroscopy and evolution. PMID- 3675794 TI - Computerized tomography of the patellofemoral joint before and after release realignment. PMID- 3675795 TI - Lateral retinacular release with Ringer's lactate irrigating medium. PMID- 3675796 TI - Development of an imaging flow cytometer. AB - A cell analyzer that combines the characteristics of image cytometry and flow cytometry is being designed and constructed at the University of Sydney. This paper describes the image acquisition and processing components and some preliminary applications. Cells stained by a fluorescent dye and suspended in a liquid medium are conveyed by a hydraulic system to a flow channel assembly, where they are detected and illuminated by a laser beam. A two-dimensional charge coupled device is used to acquire the cell images. Image processing and classification is to be carried out by a special-purpose computer comprising an array of four conventional microprocessors and a highly parallel processor consisting of an array of 32 X 32 processing elements. The analyzer will be capable of using morphologic, immunologic and biochemical information to classify and sort up to 500 cells per second. Because of its unique characteristics, the instrument will be of particular use in tumor heterogeneity studies. PMID- 3675797 TI - Automation of routine clinical chromosome analysis. I. Karyotyping by machine. AB - An automated karyotyping system suitable for widespread use in clinical laboratories is described. The software is implemented on a general-purpose, commercially available image analyzer (Magiscan 2) using TV input from a conventional research microscope with minimal modification. The analysis is automatic, but operator interaction is used to resolve difficulties. Extensive experience with a routine clinical workload shows that the system is robust and easy to use and that its use results in a substantially increased laboratory throughput. PMID- 3675798 TI - Automation of routine clinical chromosome analysis. II. Metaphase finding. AB - Metaphase finding is an essential activity in chromosome analysis, and there is much to gain from its automation. This paper describes software for automatic metaphase finding developed for use as part of a routine clinical chromosome analysis system, principally for samples from blood and amniotic fluid. Since the metaphase finding and analysis programs were intended to be used widely in clinical laboratories, cost and portability were important design features. The metaphase finder has been implemented on a moderately priced, general-purpose image analyzer (Magiscan 2), which controls a standard research microscope with motorized stage and focus. Metaphases are detected using fast gray-level processing on whole fields of view, followed by binary processing to produce a figure of merit for each detected object. Clinical experience has shown that this ability to rank detected objects on the basis of their suitability for analysis is a critical feature in determining the usefulness of an automatic metaphase finder. PMID- 3675799 TI - Relation of quantitative features of visually normal intermediate cells in cervical intraepithelial neoplasia I and II smears to progression or nonprogression of the lesion. AB - The relationship between the quantitative features extracted from digitized images of visually normal intermediate cells in cervical intraepithelial neoplasia (CIN) I and II smears and the subsequent follow-up diagnosis was studied. Using the ISPAHAN interactive system of pattern recognition, the average rate of correct classification of progressive or nonprogressive lesions was 80% at the specimen level. It is concluded that additional diagnostic information regarding the probability of progression of CIN I and II lesions may be obtained by studying the microphotometric features of visually normal intermediate cells in the cervical smears. Significant differences were found between intermediate cells close to obviously dysplastic cells and those at a distance. The implication of this finding and the problems involved in the selection of the cells are briefly discussed. PMID- 3675800 TI - Nuclear DNA changes during pathogenesis of squamous carcinoma of the cervix in 3,4-benzopyrene-treated mice. AB - The pathogenesis of squamous carcinoma of the uterine cervix was studied by means of morphologic and cytochemical techniques in mice treated with 3,4-benzopyrene. The results indicate that carcinogen-induced transformation of normal cervical epithelium into squamous carcinoma occurs through a sequence of cellular alterations, demonstrated by progressively increasing cellular atypia and a progressively increasing and scattered DNA content. PMID- 3675801 TI - Simultaneous measurement of DNA content and detection of surface antigens of cervicovaginal cells by flow cytometry. AB - A method is described by which the measurement of the DNA content and the light scatter and the detection of a cervical carcinoma-associated antigen (CCA) of squamous epithelial cells can be simultaneously accomplished by flow cytometry (FCM). Cervicovaginal cellular samples obtained from 30 patients were analyzed by this method. Cell populations with an abnormal DNA content or with the presence of CCA were detected in 20 samples, 18 of which contained dysplastic cells as detected by routine cytologic screening. The remaining ten cases, which were interpreted as cytologically normal by routine screening, were also interpreted as normal by FCM analysis. PMID- 3675802 TI - The nuclear DNA content of human breast carcinoma. Associations with clinical stage, axillary lymph node status, estrogen receptor status and outcome. AB - Using Feulgen-DNA cytophotometry, the nuclear DNA content was determined in specimens from 169 female patients with unilateral primary carcinoma of the breast. The tumors were classified as either diploid (73 cases: 43%) or hyperdiploid (96 cases), according to the ploidy of the tumor cells. Statistically significant associations were found between the DNA content and other characteristics of the patients and their tumors. (1) In postmenopausal women, inoperable tumors were more likely to be hyperdiploid (P less than .005). (2) In patients with operable disease, diploid tumors were less likely to have metastasized to the axillary lymph nodes (P less than .005) and were also less likely to have four or more positive nodes (P = .0044). (3) Overall, 71% of the diploid tumors and 52% of the hyperdiploid tumors were estrogen-receptor (ER) positive. This difference in proportions was statistically significant (P less than .05), but when the patients were divided into premenopausal and post menopausal groups, the proportions of ER-positive tumors were not significantly different in either group. (4) In 113 patients considered suitable for studies on outcome (mean length of follow-up of 27 months, with a range from 0 to 71 months), the rates of relapse were 3 of 55 diploid cases and 17 of 58 hyperdiploid cases. The rate of relapse was higher in the hyperdiploid group, irrespective of lymph node status. PMID- 3675803 TI - DNA content and chromosomes in permanent cultured cell lines derived from malignant human gliomas. AB - DNA content, as determined by flow cytometry (FCM), and ploidy, as determined planimetrically from chromosomes, were measured for 17 established human glioma derived cell lines. Values obtained by these methods corresponded well for two of two near-diploid lines, two of two hyperdiploid-hypotriploid lines, four of four hypertriploid-hypotetraploid lines, two of six hypertetraploid-hypopentaploid lines, the one hyperpentaploid line and two of two multiclonal lines. For the remaining four lines, ploidy values obtained by karyotyping were more than 10% lower than those obtained by FCM. Since karyotypic ploidy was determined by planimetric measurements of the chromosomes, which corrects for deviations in chromosome size, the lower values could not be explained by large marker chromosomes. Technical problems, such as random chromosomal loss in karyotypic preparations, adherent bits of cytoplasm in nuclear preparations for FCM or differences in nuclear stainability, are possible reasons for the discrepancies. Alternatively, chromosomes in some glioma cell lines may actually contain an increased amount of DNA. FCM and karyotyping provide complementary information in the initial evaluation of cultured cell lines. For sequential studies, such as are used for monitoring cultured lines, the rapidity of FCM makes it the more practical method. PMID- 3675804 TI - Morphometry in surgical pathology. AB - The potential role of morphometry in surgical pathology is discussed. Specific areas in which morphometry could be helpful are in (1) identifying malignant cells in lesions that are largely composed of benign-appearing cells (e.g., follicular thyroid neoplasms), (2) defining reference points in apparent continua (e.g., in the progression from normal colon to adenoma to adenocarcinoma), (3) distinguishing between benign and malignant lesions with similar appearances (e.g., fibromatosis and fibrosarcoma of the soft tissue) and (4) distinguishing between similar-appearing types of malignant neoplasms (e.g., between small-cell carcinoma of the lung and small-cell lymphoma). Morphometric techniques are already being used in DNA ploidy determinations, which frequently bear prognostic information. The measurement of other nuclear and cellular parameters has been used for both diagnostic and prognostic ends; one example is the relation of nuclear roundness to metastatic potential in prostatic carcinomas. Morphometry is now being increasingly applied to histologic sections, as in the prognostic study of lesion thickness in malignant melanoma and the diagnostic study of glandular architecture in colonic adenoma. The use of morphometry can enhance the observation and interpretation of morphologic features, which, combined with the clinical data and the experience of the pathologist, can lead to greater accuracy and precision in surgical pathology diagnoses. PMID- 3675805 TI - Training children in road crossing skills using a roadside simulation. AB - Five-year-old children were trained in road-crossing skill using a new method which allows them to act safely in relation to vehicles on a normal road. The children learned to time their crossings of a "pretend road" as if the vehicles were on this, rather than on the adjacent road. A previous study, using a single lane of traffic, showed that many children performed well in this simulation with minimal instruction, but that five-year-olds were generally less proficient than older children. In the present study, the method was extended to the more realistic case of two-way traffic, and training programmes for five-year-olds were assessed. (In addition, the performances of adults in the two-way pretend task and in actually crossing the road were compared; the results confirmed the validity of the simulation. After a few sessions of guided practice, the children's efficiency in making use of gaps by setting off promptly after a vehicle had passed improved markedly; in single-lane crossing they reached almost adult standard. In both single-lane and two-way crossing they became as successful as adults in completing their crossings before a second vehicle passed and they took account of the duration of the gap by crossing more quickly when time was short. They remained very cautious, rejecting many adequate gaps. The standard of performance after a few sessions of two-way crossing was maintained over a three week break in training. Practice with one-way traffic did not help them with two-way crossing. In sum, after practice in the simulation, five year olds develop a degree of competence normally shown by older children, whose experience on the roads puts them at lower risk. This suggests that the simulation, which allows children to safely explore and develop their capabilities more fully than when actually crossing the road, would be a valuable addition to road safety programmes. PMID- 3675806 TI - Condition of vehicles in Saudi Arabia. AB - Saudi Arabia has experienced an enormous growth in its motorization rate since 1970, and there has been a resultant increase of nearly 600 percent in traffic fatalities. The fatality rate (per 100,000 vehicles) has been found to be at least three times higher than that of most developed countries. One of the factors which may be contributing to the serious accident problem in Saudi Arabia is the poor condition of some of the vehicles. The main goal of this study was to investigate the socioeconomic determinants of vehicle condition, using data gathered in Saudi Arabia. Detailed information on the condition of vehicles and the characteristics of drivers were collected by roadside surveys in the Eastern Province. The results from 508 surveys indicated that: 1. The condition of vehicles was three to four times as bad as in some other states. 2. There was a strong relationship between driver characteristics and vehicle condition. Drivers who were poor, uneducated, and drove without a license were more likely to have unsafe vehicles than their counterparts who were rich, educated and had driver's licences. 3. On the average trucks and vehicles used for public transportation and the movement of goods, and vehicles owned by companies and the government, were in worse condition than other vehicles. 4. There were significant differences among certain makes of vehicles. PMID- 3675808 TI - An analysis of the severity and incident duration of truck-involved freeway accidents. AB - Data associated with over 9000 accidents involving large trucks and combination vehicles during a two-year period on freeways in the greater Los Angeles area are analyzed relative to collision factors, accident severity, and incident duration and lane closures. Relationships between type of collision and accident characteristics are explored using log-linear models. The results point to significant differences in several immediate consequences of truck-related freeway accidents according to collision type. These differences are associated both with the severity of the accident, in terms of injuries and fatalities, as well as with the impact of the accident on system performance, in terms of incident duration and lane closures. Hit-object and broadside collisions were the most severe types in terms of fatalities and injuries, respectively, and single vehicle accidents are relatively more severe than two-vehicle accidents. The durations of accident incidents were found to be log-normally distributed for homogeneous groups of truck accidents, categorized according to type of collision and, in some instances, severity. The longest durations are typically associated with overturns. PMID- 3675807 TI - Perception of risk from automobile safety defects. AB - Descriptions of safety engineering defects of the kind that compel automobile manufacturers to initiate a recall campaign were evaluated by individuals on a set of risk characteristic scales that included overall vehicle riskiness, manufacturer's ability to anticipate the defect, importance for vehicle operation, severity of consequences and likelihood of compliance with a recall notice. A factor analysis of the risk characteristics indicated that judgments could be summarized in terms of two composite scales, one representing the uncontrollability of the damage the safety defect might cause and the other representing the foreseeability of the defect by the manufacturer. Motor vehicle defects were found to be highly diverse in terms of the perceived qualities of their risks. Location of individual defects within the factor space was closely associated with perceived riskiness, perceived likelihood of purchasing another car from the same manufacturer, perceived likelihood of compliance with a recall notice, and actual compliance rates. PMID- 3675809 TI - An in-depth study of accidents involving collisions with utility poles. AB - This paper summarizes the objectives, methodology, findings, and recommendations of a large-scale study of automobile crashes involving utility poles. In an 8 month survey of accidents, information on site characteristics and accident severity was obtained for a sample of 879 crashes. Randomly-selected samples of 795 sites and 627 vehicles provided control information. An accident-predictor model which identifies accident risk on the basis of site measurements has been derived. The model reveals a range of relative risks in the population of exposed poles of the order of 1000:1, and enables the identification of the relatively small proportion of poles which account for the majority of accidents. The model was used in conjunction with estimates of the costs of accidents to show that a number of remedial treatments are warranted. The hazardous effects of low tyre tread depths and improper tyre inflation pressures are also demonstrated. PMID- 3675810 TI - [Hemodynamics and gas exchange in high-frequency jet ventilation (HFJV) in lung surgery]. PMID- 3675811 TI - [Etomidate (Radenarcon) infusion anesthesia]. PMID- 3675812 TI - Hypotensive anaesthesia for microsurgery of the ear: a comparison of labetalol with sodium nitroprusside. PMID- 3675813 TI - Reversal of neuromuscular blockade--effects of administration of atropine and neostigmine at different rates in man. PMID- 3675814 TI - [Editorial responsibilities in the publishing of a medical journal]. PMID- 3675815 TI - [Survey of the use of antibiotics and oral dehydration in acute infectious diarrhea in Mexican rural areas]. PMID- 3675816 TI - [Age of menarche in a rural population: accuracy of records four years later]. PMID- 3675817 TI - [Giardiasis in relation to blood group A]. PMID- 3675818 TI - [Renal cystic lesions in infancy]. PMID- 3675819 TI - [Feeding soy meal and rice cereal to malnourished infants during convalescence]. PMID- 3675820 TI - [Hydroa vacciniforme. Report of a case]. PMID- 3675821 TI - [Oral hydration of children with acute diarrhea]. PMID- 3675822 TI - [Guidelines for the treatment of acute respiratory infections. Management of otitis media and sinusitis]. PMID- 3675823 TI - Open field and elevated plus-maze: a behavioural comparison between spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats and the effects of chlordiazepoxide. AB - An interstrain comparison was conducted between male spontaneously hypertensive rats and Wistar-Kyoto rats, in both the open field and the elevated plus-maze. Wistar-Kyoto rats, as compared to the hypertensive animals, showed, beside an attenuated locomotor activity in both test situations, a higher reaction to aversive environments (less entries into the central area of the open field and less visits to the open arms of the elevated plus-maze). Chlordiazepoxide, as potent anxiolytic, increased (1) general activity, (2) the frequency of entries into the open area of the open field, and (3) the number of visits to the open arms of the elevated plus-maze in both rat strains. PMID- 3675824 TI - Role of dorsomedial thalamic nucleus and piriform cortex in processing olfactory information. AB - Four experiments were conducted to characterize the role of primary and secondary olfactory projection areas (piriform cortex and dorsomedial thalamic nucleus (DMN] in olfactory information processing. Rats had to learn to discriminate between odors that were simultaneously released from different arms of an automated olfactory maze. When standard training conditions were used, damage of the DMN severely impaired both preoperatively trained and naive animals in acquiring an odor discrimination set (i.e. in most problems no learning was demonstrated). An additional group of DMN animals that received 4 times the standard amount of daily trials was unable to acquire the first two problems but successfully solved the third and all subsequent discriminations. Analysis of performance patterns suggested that destruction of the DMN initially leads to a strong procedural impairment that can be overcome by extensive training. After solving the third problem the animals with DMN damage required much less training to reach the learning criterion but generally made more errors than controls. Transfer of savings rarely occurred when a problem was repeated. Whether this secondary learning deficit observed in later discriminations is due to a specific effect of the lesion on the encoding of olfactory cues and thus on memory formation, or due to a disturbance in the regulation of emotional factors such as motivation, arousal, and attention is discussed. Lesions of the thalamus that spared the DMN had no effect on learning or retention of olfactory discriminations. Animals with ablations of the piriform cortex only acquired odor discriminations if they had been trained in the olfactory maze before the lesion. Moreover, their performance depended on the odor quality: they had great difficulty learning complex cues consisting of several odorants and learned simple odors virtually identical to control rats. The results indicate that an intact piriform cortex is needed to acquire the procedures involved to perform an olfactory discrimination task as well as to build neural representations of olfactory cues. PMID- 3675825 TI - Neurological and neurobehavioral development of the mutant 'twitcher' mouse. AB - The present study described the neurological and locomotor development of the mutant 'twitcher' mouse (B57BL/6J-twi), an enzymatically authentic model of globoid cell (Krabbe) leukodystrophy. Comparisons were made on a neurological developmental battery and a series of behavioral tests, including open field, rotorod, and hangtime performance. Homozygous affected (twi/twi), heterozygous carriers (+/twi) and homozygous normals (+/+) were compared. Neurological development was slowed in twi/twi with some subtler differences between +/twi and normals. Twi/twi reached all functional milestones except grasp. There was a rapid deterioration of motor indices after 20 days of age. However, most sensory markers were preserved. On hangtime, there were significant differences from normal for both twi/twi and +/twi at 15 days of age and across the 15-30 day developmental stage, with the +/twi males slightly more impaired. On the rotorod, all animals were equally unable to stay on the rod at 15 days of age and neither male nor female twi/twi showed significant development. Male +/twi lagged significantly behind male +/+. In the open field, all groups were equally inactive at 13-15 days and showed similar increases in activity, rearing, and grooming until weaning. All groups peaked immediately after weaning and declined thereafter, with twi/twi showing the lowest activity. The data were discussed in terms of the relationship between the human disease and the animal model. PMID- 3675826 TI - Parameters and sites of brainstem stimulation capable of eliciting the rabbit nictitating membrane response. AB - One hundred and thirty-five different combinations of pulse amplitude, pulse width, pulse train duration, and pulse frequency were delivered to either pars oralis of the spinal trigeminal nucleus, the accessory abducens nucleus, the abducens nucleus, or the reticular formation at the level of the spinal trigeminal nucleus. The percentage of occurrence, amplitude, and latency of the rabbit nictitating membrane response were shown to be lawfully related to the parameters of stimulation. Moreover, the electrode sites were ordered from reticular formation to abducens to accessory abducens to pars oralis in terms of the increasing efficacy with which stimulation elicited the nictitating membrane response. PMID- 3675827 TI - Binocular interactions measured by choice reaction times in pigeons. AB - In 7 pigeons binocular interactions were studied by recording monocular and binocular choice reaction times (RTs) to a pattern discrimination task. In all the animals binocular responses were found to be significantly faster than monocular RTs. In order to assess whether binocular advantage might be ascribed to a neural interaction between the two eyes, monocular and binocular performances were evaluated according to a probability summation model. The results indicate that in the great majority of animals, probability summation alone can account for binocular superiority. PMID- 3675828 TI - Movements of cats on a rotating cylinder: role of the substantia nigra pars reticulata and the deeper layers of the superior colliculus. AB - Recently it has been shown that the substantia nigra pars reticulata (SNR) is required for adjusting the body position. In this study the role of the SNR in the execution of movements was investigated. Therefore, the effects of bilateral SNR injections of picrotoxin (500 ng/0.5 microliter) and muscimol (200 ng/1 microliter) were investigated on movements of cats which were trained to cross a rotating cylinder. SNR injection of picrotoxin suppressed the movements that were executed by cats injected with distilled water (0.5 microliter), i.e. 'normal movements'. While crossing the rotating cylinder, picrotoxin-injected cats mainly executed movements that almost never occurred in distilled water treated cats. Picrotoxin-injected cats executed 'special movements', i.e. forward locomotion in which the hindlimbs were affected, and 'counter-movements'. While executing the latter movements no forward locomotion occurred at all; the cats solely executed lateral fore- and hindlimb movements opposite to the direction in which the cylinder rotated. SNR application of muscimol enhanced the execution of 'normal movements'. Since the SNR sends information to the deeper layers of the superior colliculus (dl-SC) via GABAergic fibers, it was also investigated whether pharmacological stimulation (muscimol) and inhibition (picrotoxin) of the GABAergic dl-SC activity affected these movements on the rotating cylinder: no changes were observed after injecting otherwise effective doses of muscimol (75 ng/1 microliter) and picrotoxin (100 ng/0.5 microliter). In order to compare the function of the SNR and dl-SC in programming a different type of movements, the effects of GABAergic agents in the dl-SC (picrotoxin 100 ng/0.5 microliter and muscimol 75 ng/1 microliter) and the SNR (picrotoxin 500 ng/0.5 microliter and muscimol 200 ng/1 microliter) were investigated on the feline ability to execute goal-directed movements in an experimental set-up that prevented the occurrence of targeting movements which were continuously guided by external, i.e. auditory, visual, tactile and olfactory stimuli. For that purpose cats were trained to step out of a startbox on a rotating cylinder, i.e. the target. Dl-SC injection of muscimol or SNR application of picrotoxin prevented the cats from stepping out of the startbox on the rotating cylinder. In contrast, cats injected with muscimol into the SNR or picrotoxin into the dl-SC stepped out of the startbox, although dl-SC application of picrotoxin elicited forelimb misplacements: frequently the cats placed their forelimbs alongside of, but not on the cylinder when trying to leave the startbox.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3675829 TI - The development of daytime rearing behavior in methylazoxymethanol-treated rats: methodological considerations. AB - The development of daytime rearing behavior was studied in the offspring of pregnant rats which received injections of methylaxymethanol acetate (MAM) or saline during the 15th day of gestation. MAM and control rats were tested at 10, 15, 20, 25, and 30 days of age. The results indicated that the onset of rearing for both groups appeared at approximately 15 days of age, with no significant differences found between sexes. No rearing deficits were seen in MAM rats through 25 days of age despite the fact that these animals sustained greater than a 50% reduction in telencephalic mass. However, at 30 days of age MAM rats reared for significantly longer periods of time during each episode than did their control counterparts, although the actual number of rears did not differ between groups. The results are discussed in terms of neuroplastic events which follow MAM-induced damage and the need for multivariate research when analyzing rearing behavior. PMID- 3675830 TI - Unilateral removal of the posterior insula or of area SII: inconsistent effects on tactile, visual and auditory performance in the monkey. AB - Unilateral removals of the posterior insula or of the second somatic sensory projection area (SII) were made in respectively 8 and 6 monkeys. These animals were divided into a 'contralateral' group of 7 with removals from the hemisphere opposite to the preferred hand; and an 'ipsilateral' group of 7 animals with removals from the hemisphere on the same side as the preferred hand. In addition, 6 unoperated monkeys were trained comparably. Both the contralateral and ipsilateral animals were impaired in comparison with unoperated animals at threshold discriminations of graded roughness and/or sizes when using the hand opposite the removals. Animals with contralateral ablations were impaired in comparison with those having ipsilateral ablations only in a few of many instances: with the hand ipsilateral to the removals at re-learning a tactile discrimination and at learning an auditory discrimination; with the hand opposite to the removals when it was initially used on visual or auditory tasks that had already been mastered with the other hand. It is suggested that in addition to SII the insula is also organized asymmetrically in relation to hand preference in the monkey, but the insula of the predominant hemisphere may be involved as much in non-tactual as tactual performances, for example in tasks involving successive discrimination and when a familiar task has to be performed initially with the other hand. PMID- 3675831 TI - Effects of gamma-hydroxybutyrate on the performance of monkeys in a Go/No-go visual discrimination task. AB - It has been suggested that monkeys, administered gamma-hydroxybutyrate (GHB), manifest a state resembling petit mal status. This implies that an animal would produce erroneous responses immediately prior to, and discontinue behaviors requiring any cognitive effort concurrently with, an episode of GHB-induced generalized 3 cps wave-spike bursts in the EEG. This prediction was not confirmed in the present study. Rhesus macaques (Macaca mulatta) were trained to perform in a visual discrimination Go/No-go test. Thereafter bipolar transcortical electrodes were implanted in the hemisphere contralateral to the preferred hand. All monkeys discontinued to lever-press for water reward when administered GHB (125 or 250 mg/kg, esophageal intubation) and exhibited signs of reduced postural control and somnolence punctuated by episodes of hypermotility about 40-50 min after GHB. However, the monkey's difficulties in completing the program were not associated with the development of generalized hypersynchronous EEG activity. While occasional wave-spike bursts did occur, they were poorly regulated, often 'focal' (i.e. developed only in isolated areas), and had a frequency of 1.5-2 cps. In this state, animals could be easily roused by sensory stimuli. All of them reacted with a characteristic aversive-aggressive display when confronted by a direct gaze. These effects are interpreted to be more consistent with characterization of GHB activity as that of a potent hypnotic rather than a convulsant agent. PMID- 3675833 TI - Persistence of habituation deficits after neurological recovery from severe thiamine deprivation. AB - Rats were fed a thiamine-deficient diet for 4 weeks and injected daily with pyrithiamine during the last two weeks of the diet. This regime induced severe neurological anomalies such as ataxia, loss of righting reflex and visual place reflex, and finally full tonic-clonic seizures. These symptoms are reminiscent of the clinical Wernicke-Korsakoff syndrome. Injection of thiamine dramatically reversed these symptoms within one or two hours as seen in Wernicke patients. Six weeks later these rats showed a marked deficit in habituation of exploratory behavior and of the auditory orienting response. To what extent this chronic deficit in habituation contributes to the cognitive dysfunctions seen in Wernicke Korsakoff patients is discussed. Histological examination of the brains of 6 of the rats revealed a heterogeneous pattern of damage to the brainstem, including mamillary bodies and several thalamic nuclei, reminiscent of that seen in Korsakoff patients. In addition there were many dark abnormal cells in limited fields of hippocampus neocortex and thalamus in almost all animals. PMID- 3675832 TI - Entorhinal transplants and spatial memory abilities in rats. AB - Transplants of embryonic entorhinal tissues, placed into the angular bundle region of adult rats, innervate appropriate areas of the host hippocampal formation and amygdala, provided that native entorhinal connections have been destroyed. In the present study, transplants were examined for their ability to restore spatial memory abilities which are lost following the bilateral destruction of native entorhinal connections. Animals were tested for their ability to perform an 8-arm radial maze task, for spontaneous alternation in a T maze, and for their ability to learn to alternate in a T-maze for a food reward. Animals with lesions, and those with lesions + implants, remained impaired on all 3 tasks examined for as long as 6 months postimplantation. During this time, no transplant-induced behavioral recovery was observed, although behavioral stabilization was observed on the spontaneous alternation task at 6 months post transplantation. The data suggest that these transplants may be limited in their ability to restore functions which are highly dependent upon the anatomical integrity of the damaged circuits and the precise organization of information flow through the damaged area. PMID- 3675834 TI - Recovery from early cortical damage in rats. II. Effects of experience on anatomy and behavior following frontal lesions at 1 or 5 days of age. AB - Perinatal cortical damage is often associated with significant overall shrinkage of the remaining cortex and severe behavioral impairments. Environmental experience was manipulated in order to determine if the anatomical and behavioral effects of neonatal frontal decortication might be attenuated by rearing in a complex environment. Rats received frontal decortication on the day of birth or 5 days later and were subsequently raised, along with littermate controls, in a complex environment or in standard laboratory cages. In adulthood, the animals were tested on a battery of behavioral tests which showed that enrichment markedly attenuated the effects of the early lesions, especially for the 5-day operates, even on tests such as tongue extension that would not be expected to benefit from specific practice in the complex environment. Analysis of the remaining cortex revealed that all groups raised in the complex environment developed thicker cortex, the increase being most dramatic in the rats given lesions at 5 days of age. PMID- 3675835 TI - Intravenous cocaine-induced place preference: attenuation by haloperidol. AB - Cocaine reward was demonstrated by establishing a conditioned place preference (CPP) to a distinctive location paired with cocaine administered either intravenously (i.v., 0.5 mg/kg) or intraperitoneally (i.p., 10 mg/kg). Significant i.p. or i.v. cocaine CPP was observed following the second conditioning trial. Haloperidol (0.2 mg/kg) pretreatment disrupted CPP induced by i.v., but not i.p., cocaine. The haloperidol effect built up over successive trials. The involvement of dopaminergic transmission in i.v. cocaine-induced CPP is discussed. PMID- 3675836 TI - Hippocampectomy and feature-positive discrimination. AB - The effects of hippocampal lesions on feature-positive discrimination were investigated using the nictitating membrane response preparation. During training, animals received a simultaneous reinforced compound as the conditioned stimulus (CS+) and a non-reinforced element as the CS-. The compound consisted of a tone and a light, with the tone being more salient than the light. The light and tone served as the CS- in Expts. 1 and 2, respectively. There were no significant differences between hippocampectomized animals and the controls (cortical and sham) when the CS- was the light; however, when the more salient tone stimulus was the CS-, hippocampectomized animals exhibited high levels of responding to both the CS+ and CS- and failed to acquire the discrimination. The results are discussed in terms of attentional and response inhibition theories of hippocampal function. PMID- 3675837 TI - An application of the image processing system for detecting and controlling pigeon's peck location. AB - A microcomputer system equipped with an image processing peripheral board was applied for detecting and controlling the pigeon's peck location. The peripheral board digitized a TV image of an experimental chamber at the instant of the occurrence of a response, and a simple machine language routine analyzed the digitized image to determine the location of pigeon's beak in real-time. Using this system, pigeons were trained to peck a target area of a long response key and their peck locations were analyzed. PMID- 3675838 TI - Cholinergic receptor blockade produces impairments in a sensorimotor subsystem for place navigation in the rat: evidence from sensory, motor, and acquisition tests in a swimming pool. AB - Studies have shown that central cholinergic receptor blockade biases the behavior of rats so that they make less use of the sensorimotor behaviors that are normally used to orient to the relational properties of distal cues and that they simultaneously become more reliant on proximal cues. In Experiment 1, control rats and rats treated with atropine sulfate or atropine methyl nitrate (50 mg/kg) were trained to escape to a visible platform from different starting points in a swimming pool. All groups learned the task by concomitantly developing position responses, by orienting according to room cues, and by orienting to the platform, but probe trials showed that the atropine-sulfate group made more use of the platform as a local cue and made less use of distal cues than did the other groups. The atropine-sulfate group also made fewer searches during acquisition, made fewer searches when the platform was removed on probe trials, and were less responsive to novel cues placed above and around the pool. Swim speed, as estimated by the distance swum on probe trials, was also greater in atropine sulfate-treated rats. The postulate that rats treated with atropine sulfate preferentially guide swimming by using position responses and local cues was tested in Experiment 2 by comparing their performance with that of control rats in a place task in which a target platform was hidden (no local cues present) and in a similar place task in which the target platform was visible, as was a second incorrect platform that sank when climbed upon (two competing local cues present). Although both tasks were acquired by the control and drugged rats, the two-platform task, as predicted, was comparatively more difficult for the atropine-treated rats. These results suggest that one effect of central cholinergic blockade is to impair the use of a sensorimotor subsystem used for place navigation. PMID- 3675839 TI - The hippocampus and conditioning to contextual cues. AB - Two experiments are reported in which behavioral control by contextual cues was assessed in groups of rats with dorsal hippocampal (HC), neocortical (NC), or operated control (OC) lesions. Following Odling-Smee's (1975) procedure, a Pavlovian conditioning paradigm was followed in which conditioned stimuli (CSs: tone, light) predicted an unconditioned stimulus (US:footshock) always, never, or half the time. Conditioning trials took place in a small black box. Subsequently, conditioning to background contextual cues was assessed by measuring the amount of time rats spent in the black box in preference to an adjacent white one with neither CS nor US presented. In OC groups and, to a lesser extent, NC groups, conditioning to background cues was inversely related to the probability that CS predicted US. In contrast to graded contextual conditioning in control groups, the HC groups consistently showed abnormally strong conditioning to context that was at or near asymptotic level. The results, which were related to current theories of the relation between contextual stimuli and CSs, suggest that the hippocampus may play an important role in stimulus selection during learning. PMID- 3675841 TI - Hippocampal lesions in rats alter learning about intramaze cues. AB - In these experiments, we used a new procedure to study cognitive mapping in normal rats and those with hippocampal lesions by observing their behavioral responses to a rearrangement of intramaze cues. Controls learned cognitive maps, and their goal-directed behavior was disrupted by a change in the cue sequence. A comparison of pre- and postoperatively trained rats with hippocampal lesions (HPLs) showed that hippocampal damage prevented the acquisition, but not retrieval, of cognitive maps. HPL subjects learned a discrimination between mazes as quickly as controls did, but learning did not facilitate the acquisition of maps. The rats with lesions were moderately impaired in a discrimination reversal, but their behavior suggested that they could sometimes interrupt and correct their errors. In summary, controls and HPLs were equally able to run the mazes, but additional testing revealed a dissociation between the learning and performance of the two groups. These data add to our understanding of how normal rats learn about their environment and how HPL damage affects this type of learning. PMID- 3675840 TI - Operant conditioning of hippocampal theta: dissociating reward from performance deficits. AB - Dopaminergic blocking agents have been known to suppress intracranial self stimulation, but whether the suppression results from a reduction in the rewarding value of stimulation or from motor deficits has remained controversial. We have resolved this controversy by developing an operant technique minimally dependent on motor activity: Rats were trained to perform a bar-holding response for 3s or to produce hippocampal theta waves for 3s when the bar was retracted. Decamethonium bromide (a muscle relaxant) reduced bar holding without affecting theta production for brain stimulation. Pimozide (a dopaminergic blocking-agent) reduced both bar holding and theta production for stimulation, though rats were still capable of making the theta response at a rate comparable to the preinjection rate. Dopaminergic blocking at low doses reduces the rewarding value of brain stimulation at the level of the lateral hypothalamus. The method described in this report has wide applicability. PMID- 3675842 TI - Cholinergic neurons, learning, and recovery of function. AB - Two experiments were designed to examine the role of the cholinergic septo hippocampal projection in spatial and nonspatial learning processes. In Experiment 1 the interaction of individual learning strategies and recovery of function was investigated following medial septal lesions, by assessing individual learning styles and number of trials to recovery on a standard radial eight-arm-maze task. Experiment 2 addressed the relevance of the cholinergic septo-hippocampal pathway in the acquisition of spatially mediated behavior, by employing medial septal lesions, prior to acquisition learning of a modified version of the radial eight-arm-maze task. The data from these two experiments demonstrated that (a) the cholinergic septo-hippocampal projection is important for the acquisition and maintenance of spatial learning strategies, (b) loss of cholinergic function leads to alteration of learning strategies, (c) different learning strategies can be employed to acquire the same behaviors, and (d) the rate of recovery following brain injury can be influenced by preoperative learning strategies. PMID- 3675843 TI - Differential susceptibility to anterograde and retrograde amnesia treatments in preweanling rats. AB - Although there have been several reports that preweanling rats and mice are relatively resistant to experimentally induced retrograde amnesia, there is virtually no information concerning susceptibility to anterograde amnesia in subjects of this age. Therefore, in the present experiment, 23-day-old rats received hypothermia either prior to, or immediately after, punishment training in an attempt to induce anterograde and retrograde amnesia, respectively. When tested 24 hr later, only those subjects given hypothermia prior to training exhibited any loss of retention. Thus these results confirmed previous evidence of resistance to retrograde amnesia in preweanling rats and further demonstrated that substantial anterograde amnesia could be obtained in these subjects. Performance of subjects tested after a 5-min retention interval revealed that the poor retention performance in subjects cooled prior to training and tested 24 hr later was not due to a learning deficit. These results are also discussed with respect to the issue of the independence of anterograde and retrograde amnesia. PMID- 3675844 TI - Temporal order sensitivity of associative neural and behavioral changes in Hermissenda. AB - Hermissenda's neural and behavioral changes produced by light-rotation pairings were assessed as a function of the temporal relations between visual and vestibular stimulation. The results of in vitro simulations of conditioning indicated that simultaneous pairings (synchronous onsets and offsets of light and caudal hair cell stimulation) resulted in significantly greater cumulative depolarization of Type B photoreceptors than did either forward (light preceded hair cell stimulation) or backward (hair cell stimulation preceded light) pairings. Further experiments revealed that the attenuation of cumulative depolarization produced by the forward and backward pairings reflected the asynchrony of stimulus offsets that characterize these conditioning sequences, rather than their onsets. Analogous behavioral experiments revealed that intact animals trained with forward or backward pairings exhibited significantly less conditioning than those trained with simultaneous pairings. Strong parallels between the magnitude of cumulative depolarization from in vitro conditioning studies and the behavioral results for intact animals were also observed in experiments in which stimulus onset synchrony was held constant but offsets were made asynchronous, and vice versa. Thus Hermissenda exhibits a sensitivity to the temporal arrangement of light and rotation, and the results of behavioral conditioning can be predicted accurately from the outcome of in vitro conditioning of the isolated nervous system. PMID- 3675845 TI - Classical conditioning of the rabbit eyelid response with a mossy-fiber stimulation CS: II. Lateral reticular nucleus stimulation. AB - Stimulation of mossy fibers arising from the pontine nuclei can be used as a conditioned stimulus (CS) during classical conditioning of the eyelid/nictitating membrane response (NM). In the present experiment we stimulated another source of mossy fibers, the lateral reticular nucleus (LRN), as a CS for NM conditioning. LRN stimulation was an effective CS, resulting in learning, and the conditioned response to LRN stimulation showed normal extinction. Unpaired presentation of CS and UCS did not result in pseudo-conditioning. Lesions of the cerebellar dentate interpositus region abolished the conditioned response but left the unconditioned reflex response intact. We suggest that mossy fibers may normally carry CS information to the cerebellum. PMID- 3675846 TI - Flavor, not postingestive, cues contribute to the salience of proteins as targets in aversion conditioning. AB - Proteins have proven to be more salient targets for aversion conditioning than carbohydrates. The present studies examined the contribution of flavor and postingestive factors to the salience of proteins as targets in aversion conditioning in the rat. Two methods for separating flavor and postingestive cues were used, sham feeding and intragastric gavage. Both methods agreed in indicating that postingestive consequences of protein consumption were neither necessary nor sufficient for the development of more severe protein than carbohydrate aversions. Differences in palatability did not appear likely to be the basis of protein salience because when acceptability or palatability of the nutrient solutions was matched, aversions to protein continued to be more severe. Differences in odor intensity of nutrient solutions may be important because when an odorant was added to a carbohydrate solution, the severity of aversions to protein and carbohydrate was no longer different. These results indicate that the presence of both taste and odor cues in target nutrients may contribute importantly to their salience. PMID- 3675847 TI - Morphine attenuation of conditioned autoanalgesia: implications for theories of situation-specific tolerance to morphine analgesia. AB - The effect of morphine administration on the development of conditioned autoanalgesia was investigated in four experiments. Animals were administered either morphine or saline and then either exposed or not exposed to nociceptive stimulation. In Experiments 1, 2, and 4 the nociceptive stimulus to which animals were exposed was electric footshock, and in Experiment 3 it was thermal stimulation produced by exposure to a hot plate. It was found that morphine administration attenuated the development of conditioned autoanalgesia produced by exposure to 1-mA shock for 45 s when tests for conditioned autoanalgesia were conducted when animals were under the influence of saline or morphine (Experiments 1 and 2). Morphine also attenuated the conditioned autoanalgesia arising from exposure to 1-mA shock for 15 s, but only when the conditions for the development and expression of conditioned autoanalgesia were made optimal (Experiment 4). Morphine failed to block conditioning when animals were exposed to 2.5-mA shock for 180 s (Experiment 1). Morphine also attenuated conditioned autoanalgesia when animals were exposed to thermal stimulation (Experiment 3), with the degree of attenuation increasing as a function of the intensity of the nociceptive stimulus. The results are discussed in terms of their implications for theories of situation-specific tolerance to the analgesic effect of morphine. PMID- 3675848 TI - Localization of noise, use of binaural cues, and a description of the superior olivary complex in the smallest carnivore, the least weasel (Mustela nivalis). AB - Cats and dogs have relatively good sound-localization acuity, and the question arises as to whether this trait is a characteristic of all carnivores or whether it is due to the fact that they have large heads and correspondingly large binaural localization cues available to them. The localization acuity of the least weasel, the smallest extant carnivore, was found to be less accurate than larger carnivores but more accurate than other small mammals. This suggests that carnivores may be under strong selective pressure to localize accurately but that interaural distance may be a limiting factor. The least weasel is capable of using both binaural phase differences and intensity differences to localize, but has a relatively broad mid-frequency range for which neither cue is optimal. Finally, the superior olivary complex of the least weasel is well developed and resembles that of larger carnivores more than that of small rodents. PMID- 3675849 TI - Olfactory mechanisms in the control of maternal aggression, appetite, and fearfulness: effects of lesions to olfactory receptors, mediodorsal thalamic nucleus, and insular prefrontal cortex. AB - During lactation the female rat is hyperphagic, aggressive toward adult conspecifics, and less fearful than usual. In the first experiment the importance of olfactory receptors was investigated by surgically removing the olfactory epithelium of the nasal cavity. Mother rats subjected to this treatment consumed significantly less food and weighed less than sham-operated females. Moreover, experimental subjects displayed a dramatic decrease in maternal aggression. Fear behavior (sound-elicited freezing), on the other hand, was not affected by the lesions. The mediodorsal thalamic nucleus and the prefrontal insular cortex form part of the central olfactory system. The second experiment assessed the involvement of this olfactory-related thalamocortical system and the behavioral profile of mother rats. It was found that whereas the thalamic and cortical lesions left food intake and fear behavior unaffected, they significantly decreased the frequency with which the mother would attack an intruder male placed into her home cage. The sense of smell appears, according to the present experiments, to play a crucial role in maternal aggression. PMID- 3675850 TI - Estradiol benzoate facilitates lordosis and ear wiggling of 4- to 6-day-old rats. AB - The effects of exogenous and endogenous steroids on components of female sexual behavior of neonatal male and female rats were investigated. In Experiment 1, 4 day-old rats were treated with 0, 0.1, 1.0, 10, or 100 micrograms/10 g body weight estradiol benzoate (EB) and were tested 44 hr later. In Experiment 2, male rats castrated within 24 to 48 hr of birth were compared with sham operated controls and castrates given steroid replacement. The results indicated that most 6-day-old pups will display lordosis and ear wiggling; therefore, the display of these responses is not dependent upon exogenous steroids. However, a fine-grained behavioral analysis revealed that EB treatment increased the frequency, duration, and intensity of lordosis and the frequency of ear wiggling in infant females, and it increased lordosis duration in males. Castration of infant males decreased the likelihood that male infants would display lordosis, whereas testosterone replacement restored behavior to control levels. These data question the concept that organizational and activational actions of estrogens occur during completely separable times in development and should provide new insights into the development of estrogen receptor function and the process of sexual differentiation of brain and behavior. PMID- 3675851 TI - Salt appetite is enhanced by one prior episode of sodium depletion in the rat. AB - A single sodium depletion enhances the salt appetite that is expressed after a second and subsequent sodium depletions. The enhanced salt intake, as measured by a decrease in latency to drink and an increase in volume of 3% NaCl ingested, is not accounted for by an increased sodium loss. The enhanced salt intake occurs even when the interval between first and second depletion is as long as 4 months. The enhanced salt appetite does not depend on the drinking of salt after the animal's first sodium depletion and is specific for NaCl but not for KCl. Moreover, it can be produced without sodium depletion by the actions of the hormones aldosterone and angiotensin on the brain. These results suggest that angiotensin and aldosterone, which are released in response to sodium depletion, (a) increase renal sodium conservation, (b) evoke a salt appetite to restore the lost sodium, and (c) produce enduring changes in the brain that prepare it for more rapid and more vigorous expression of salt appetite in response to future sodium depletions. Thus the neural mechanisms that govern salt appetite are not only activated by the hormones of sodium conservation but appear also to be organized by them for a lifelong increase in avidity for salty substances. PMID- 3675852 TI - Development of interocular equivalence of place learning in the rat requires convergence sites established prior to training. AB - Interocular equivalence for spatial-navigation learning requires that the neural pathways originating in each eye converge on common memory sites. Rats fail to display interocular equivalence if they are trained and tested on the Morris (1981) place-navigation task when they are 22 days old, but they succeed if they are trained and tested when they are 28 days old (Rudy & Stadler-Morris, 1987). This delay suggests that there is a period in development when the interhemispheric connections necessary for convergence are immature and rats behave temporarily as split-brain organisms. In the present experiment, rats completed training when they were 22 days old but were not tested for interocular equivalence until they were 28 days old. Nevertheless, these subjects failed to demonstrate equivalence. Thus, for interocular equivalence to be observed, the neural pathways from each eye must converge on common neural sites that are functional at the time the memory representation is established. PMID- 3675853 TI - Strain differences in reversal of conditional analgesia by opioid antagonists. AB - The ability of both naloxone and naltrexone to block conditional analgesia produced by shock associated contextual stimuli was determined using rats from three suppliers. Naltrexone (7 mg/kg) was equally effective in reversing analgesia on the formalin test in all rats tested. Naloxone (7 mg/kg) significantly affected analgesia in Long-Evans and Holtzman Sprague-Dawley rats but had no effect on Charles River (CD) Sprague-Dawley rats. Charles River rats also differed from the other groups in the amount of time spent freezing to apparatus cues. These results indicate that genetic factors and the choice of antagonists may complicate distinctions between opioid and nonopioid analgesia. PMID- 3675854 TI - Behavioral observations of sensory substitution in neonate macaques (Macaca arctoides). AB - The ability of neonate macaque monkeys to learn to respond to artificial spatial sensory information was studied through the use of compact, head-worn, electronic spatial sonars with audible displays, which translate spatial information into auditory dimensions specifying distance, direction, and surface characteristics. Three animals were born in the dark and raised without vision for 1 to 3 months while wearing either the Binaural Sensory Aid (Animal 1; Kay, 1974) or the Trisensor (Animals 2 and 3; Easton & Jackson, 1983) airborne sonars. Each animal demonstrated alertness to information transmitted by the devices in spontaneous reaching or reinforced discrimination tasks, and more device-related, perceptual motor activities were observed when the sensors were switched on than when they were switched off. The results show that neonate monkeys can learn effective use of information obtained from sensory substitution devices through unstructured interaction with the environment. PMID- 3675855 TI - Cyanamide given ICV or systemically to the rat alters subsequent alcohol drinking. AB - Cyanamide or disulfiram serves to suppress volitional intake of alcohol presumably because of the toxic build-up of acetaldehyde dehydrogenase (AIDH). However, the presence of acetaldehyde systemically favors the in vivo synthesis of addictive-like metabolites in the brain which in turn enhance alcohol drinking. The purpose of this investigation, therefore, was to determine whether cyanamide administered to the rat, which did not have access to alcohol during treatment, would nevertheless affect the subsequent preference for alcohol. In the first experiment, cannulae were implanted bilaterally above the cerebral ventricle of 33 adult male Sprague-Dawley rats so that an artificial CSF or a solution of cyanamide could be infused intracerebroventricularly (ICV). Following post-operative recovery, each rat was tested for its alcohol preference by offering it water and a solution of ethyl alcohol which was increased over 8 days from 3-20%. After a single test concentration of alcohol (range of 5-9%) was selected for each individual animal presented with water over a 5-day interval, cyanamide was infused in a volume of 2.5 microliters per side three times daily for 4 days in one of the following total doses: 0.03, 0.1, 0.3, 0.5 or 1.0 mg. A second five-day preference test was run, and 6 weeks following cyanamide infusions a final 3-20% alcohol preference screen was run over 8 days. The results showed that a long-term, dose-dependent increase or decrease in alcohol intake occurred in those rats reactive to the drug.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675856 TI - Tolerance to ethanol in the rat vas deferens. Effect of a calcium channel antagonist. AB - Previous research from this laboratory indicated that ethanol dose-dependently depressed vas deferens contractions. The experiments described here examine the role calcium plays in the inhibitory action of ethanol in this tissue. Rat vas deferens tissues obtained from control (dextrin maltose) or chronically ethanol treated animals were stimulated in the absence and then in the presence of 181 mM ethanol and/or a calcium channel blocker. Increasing the extracellular calcium concentration from 2.1 to 5.0 mM decreased ethanol's in vitro inhibitory effect on contractions induced by norepinephrine, KCl or electrical stimulation. Following chronic in vivo ethanol administration, increasing the calcium concentration to 5 mM blocked this inhibition. Nifedipine, a calcium channel antagonist inhibited vas deferens contractions. In the presence of nifedipine, in vitro ethanol further depressed vas deferens contractions stimulated by norepinephrine, K+ and by electrical stimulation. In vivo ethanol treatment attenuated ethanol's inhibition in vitro, and reduced the blocking effect of the calcium antagonist on mechanical responses of the vas in ethanol-free medium. These data suggest that changes in calcium mobilization are involved in both the acute action of ethanol and the development of tolerance. PMID- 3675857 TI - Ethanol intoxication fails to affect sprouting induced by entorhinal cortex lesions. AB - After unilateral entorhinal cortex lesions, acute ethanol exposure (mean daily intake = 16.3 +/- 0.3 g/kg for 15 days) of juvenile rats failed to alter lesion induced axonal sprouting in the dentate gyrus. The distribution of acetylcholinesterase in the dentate gyrus was identified histochemically as an indicator of axonal sprouting. Comparisons between operated and intact sides were based on qualitative observations and quantitative morphometry techniques using a computerized image analyser to evaluate the widths of the bands of the molecular layer. Whether ethanol-exposed or not, rats with unilateral entorhinal cortex lesions exhibited substantial qualitative and quantitative evidence of axonal sprouting. These results indicate that a 15-day post-operative ethanol exposure had no effect on axonal sprouting in juvenile rats and thus qualify previous findings about ethanol-mediated effects on axonal sprouting. PMID- 3675858 TI - Responses of midbrain dorsal raphe neurons to ethanol studied in brainstem slices. AB - The effects of ethanol on midbrain dorsal raphe (DR) neurons were studied using the brainstem slice preparations. Ethanol in low doses (100 mg% and 200 mg%) exerted more excitation than inhibition on DR cells. Higher doses of ethanol produced inhibition in the majority of DR neurons. The present data indicate that the effects of ethanol were biphasic with low concentrations tending to excite and high concentrations to inhibit DR neurons. PMID- 3675859 TI - Long-term intracoronary ethanol administration electrophysiologic and morphologic effects. AB - The long-term intracoronary infusion of ethanol was used to evaluate the potential of ethanol to produce myocardial injury and cardiac rhythm disturbances. In 22 dogs, electrophysiologic testing was performed 48 hr after cessation of alcohol administration. Multiple premature ventricular beats occurred spontaneously in 3 dogs with spontaneous sustained monomorphic ventricular tachycardia observed in 1 dog. Provocative ventricular pacing produced ventricular tachycardia lasting 20 or more beats in 13 animals with sustained tachycardia observed in 3 animals. Provocative ventricular pacing in the presence of lidocaine or epinephrine produced sustained ventricular tachycardia in an additional 4 dogs. The electrophysiologic properties of Purkinje fibers from the zone receiving ethanol were altered when compared to the control zone. The resting membrane potential was decreased (-76 +/- 2 mV vs. -85 +/- mV, p less than 0.001) with a decrease in action potential amplitude (91 +/- 4 vs. 109 +/- 2 mV, p less than 0.001) and phase 0 upstroke (231 +/- 27 vs. 456 +/- 25 V/sec, p less than 0.02). Prolonged refractoriness was observed in the ethanol zone without a prolongation of action potential duration. Intramural lesions observed within the left circumflex distribution varied from focal acute myofibrillar degeneration and necrosis to severe local scarring. The data suggest that intracoronary ethanol administration at human abuse levels of blood alcohol concentrations produces histologic and electrophysiologic injury in the canine heart. The electrophysiologic ch changes provide a substrate sufficient for the induction and maintenance of ventricular arrhythmia. PMID- 3675860 TI - Ethanol-stress interaction: immediate versus delayed effects of ethanol and handling on stress responses of ethanol-consuming rats. AB - Rats screened for voluntary ethanol intake (high, medium, and low ethanol preferring rats and non-ethanol-exposed controls) were given acute immobilization stress either immediately following the ethanol screening procedure, or after a 20 day period without access to ethanol. Among animals examined for stress responses immediately after ethanol screening, it was observed that water-only control rats developed significantly less frequent and less severe gastric stress ulcers than rats in all ethanol-exposed groups. This result suggests that ethanol, stress and routine handling may have contributed to ulcer formation in these animals. In contrast, among rats tested for stress responses after 20 days without ethanol, it was observed that the high ethanol-preferring animals showed less severe stress ulcers. These results indicate that among high ethanol consuming animals, the presence of ethanol enhances ulcer severity, while prior experience with ethanol consumption does not appear to predispose rats to exacerbated stress gastric pathology. PMID- 3675862 TI - Concomitant mutagenicity of ethanol and x-ray irradiation in the mouse male germ cells. AB - The mutagenic effect of ethanol and x-ray irradiation on the male germ cells was investigated in the mouse. The meiotic micronuclei in the testis were recorded and the abnormalities in the epididymal sperm heads were counted. The number of micronuclei in early spermatids did not differ in the ethanol-exposed groups from that of their control groups at the end of 5 week ethanol diets. However, in the mice irradiated with a dose of 0.5 Gy, there was a statistically significant (p less than 0.01) difference in micronucleus induction between the groups of different ethanol exposure levels. No statistically significant differences were found in the numbers of abnormal sperm heads immediately after the diet or 25 days, 5 weeks and 10 weeks after the cessation of the diet. However, sperm abnormality frequencies were elevated at 5 weeks after 4 and 6% (v/v) ethanol diets and at 25 days after the 6% diet. The results suggest that ethanol is co mutagenic with x-rays in the mouse male germ cells. Ethanol alone showed also a tendency to be mutagenic in the sperm abnormality test. The stage and mechanism of action of ethanol is discussed. PMID- 3675861 TI - Ethanol lowers heart carnitine in the methionine and choline deficient rat. AB - In agreement with the findings of others, heart carnitine levels of male, weanling Sprague-Dawley rats fed nutritionally adequate liquid diets with 35% of calories as ethanol for 3 weeks were not different from control or pair-fed rats (Experiment 1). When ethanol was given as 30% of energy in combination with a diet deficient in methionine and choline, and the feeding period was extended to 5 weeks, heart carnitine levels were significantly affected (Experiment 2). Carnitine levels in whole heart homogenates of the methionine and choline deficient chronic ethanol-fed group were 2.14 +/- 0.74 mumoles per g dry wt. significantly lower (p less than 0.05) than deficient controls, 3.08 +/- 0.85 mumoles per g dry wt. We conclude that a methionine and choline deficient diet exacerbates the effects of alcohol on methyl-group metabolism so as to produce decrements in heart carnitine not seen when alcohol is given with an adequate diet. PMID- 3675863 TI - RO 15-4513 induces seizures in DBA/2 mice undergoing alcohol withdrawal. AB - RO 15-4513, an imidazodiazepine that has been reported to reverse some of the behavioral effects of ethanol, was given to DBA/2 mice. Although no animals treated with a 6 mg/kg dose of this drug had seizures, 20% of animals given 20 mg/kg of this drug had tonic seizures. Ethanol withdrawal was induced in DBA/2 mice treated with 4-methyl pyrazole using an inhalation paradigm. Mice were more likely to have a seizure during ethanol withdrawal if treated with RO 15-4513 (6 mg/kg) than if they received the vehicle. These data suggest administering RO 15 4513 as an alcohol antagonist to alcoholic subjects may increase the incidence of seizures. PMID- 3675864 TI - Human brain aldehyde dehydrogenase: activity with DOPAL and isozyme distribution. AB - Aldehyde dehydrogenase (ALDH, EC 1.2.1.3), has been shown to be the most important enzyme for DOPAL metabolism in human brain (Agarwal et al.). In the present investigation cerebellum, corpus striatum and pons showed the highest ALDH activity. Most of the enzyme activity was found in the mitochondrial and microsomal fractions. Two activity bands on IEF gels and dual Km values indicate the presence of two distinct isozymes in all the fractions. Two cerebella from alcoholics yielded the same results as the control group regarding their total ALDH activity, subcellular distribution pattern and protein content. The presence of DOPAC (acid metabolite of DOPAL), pargyline, pyrazole or ethanol in the assay mixture did not alter the ALDH activity significantly. PMID- 3675865 TI - [Autumn meeting of the Society of Biological Chemistry. 27-30 September 1987, Erlangen. Abstracts of announced presentations and posters]. PMID- 3675866 TI - [65th conference of the Society of Biological Chemistry. 1st conference of the Study Group on Biochemical Pharmacology and Toxicology. Erlangen, September 28th, 1987. Abstracts]. PMID- 3675867 TI - Identification of different transport systems for bile salts in sinusoidal and canalicular membranes of hepatocytes. AB - The preservation of the functional polarity of hepatocytes in liver snips (1 x 2 x 4 mm) was demonstrated by fluorescent microscopic studies using the sodium salt of (N-[7-(4-nitrobenzo-2-oxa-1,3-diazol)]-3 beta-amino-7 alpha,12 alpha- dihydroxy-5 beta-cholan-24-oyl)-2-aminoethanesulfonic acid. This fluorescent bile salt derivative is not only taken up by hepatocytes of several cell layers at the surface of the snips but also secreted into bile canaliculi. The intact hepatobiliary transport of bile salts by hepatocytes of liver snips demonstrates that they are a useful system for the investigation of those transcellular transport processes which require the integrity of hepatic structure. Photoaffinity labelling of liver snips with the sodium salt of (7,7-azo-3 alpha,12 alpha-dihydroxy-5 beta-[3 beta-3H]cholan- 24-oyl)-2-aminoethanesulfonic acid revealed that the bile-salt-binding membrane polypeptides with apparent Mr values of 54,000 and 48,000 are exclusively located in the sinusoidal membrane, whereas a single bile-salt-binding polypeptide with an apparent Mr of 100,000 is located in the bile-canalicular membrane. Photoaffinity labelling of liver snips at 4 degrees C, when transcellular bile-salt transport is insignificant, resulted in the labelling of the two sinusoidal membrane polypeptides and practically no labelling of the polypeptide with an apparent Mr of 100,000. This latter polypeptide was also not labelled when Ca2 deprivation abolished bile secretion completely. These results indicate that the directed hepatobiliary transport of bile salts in hepatocytes is accomplished by transport systems which are different for sinusoidal uptake and canalicular secretion. PMID- 3675868 TI - Quantification of kininogen in human renal medulla. AB - Renal kininogen was detected in human medullary tissue as well as human medullary tubule suspensions. After treatment with pig pancreatic kallikrein or human renal cortical homogenate liberated kinin was measured by bradykinin radioimmunoassay. In the absence of inhibitors kinins were degraded by kininases located in the same part of the kidney. Several known inhibitors of kininase I and II did not inhibit this activity. Endogenous medullary kininase was inhibited by preincubation of homogenates at 56 degrees C for one hour or by addition of 0.25 mmol/l HgCl2. Under these conditions endogenous medullary kinin release amounted to 9-26 nmol/g protein. The action of renal cortical kininogenase on kinin formation from papillary kininogen was completely inhibited by addition of 1 mumol/l aprotinin. Kininogen examined in renal tubule suspensions revealed an increase in amount per g protein compared to homogenates, confirming the tubular localization of renal kininogen. PMID- 3675869 TI - Structure and function of L-lactate dehydrogenases from thermophilic and mesophilic bacteria, VI. Nucleotide sequences of lactate dehydrogenase genes from the thermophilic bacteria Bacillus stearothermophilus, B. caldolyticus and B. caldotenax. AB - Based on the previously determined amino-acid sequence of lactate dehydrogenase from B. stearothermophilus, an oligonucleotide probe was synthesized and used to clone the structural genes for lactate dehydrogenase from B. stearothermophilus, B. caldolyticus and B. caldotenax. The nucleotide sequences of the entire LDH genes from these three thermophilic bacilli were determined by the method of Maxam and Gilbert. The nucleotide sequence of the LDH gene from B. stearothermophilus is exactly identical to the one published recently; it agrees with the experimentally determined amino-acid sequence except at three positions. The amino-acid homologies among these thermophilic enzymes are 90% or more. The LDH genes are efficiently expressed in E. coli. PMID- 3675870 TI - N-terminal amino-acid sequence of a sphingolipid activator protein missing in a new human Gaucher disease variant. AB - A naturally occurring non-enzymic sphingolipid activator protein (A1a activator) shown previously to be immunochemically not detectable in a new variant of human Gaucher disease (glucosylceramide-lipidosis) without glucosylceramidase deficiency was characterized by partial sequence analysis. The N-terminal amino acid sequence of the A1a activator--a glycoprotein with high carbohydrate content -could be determined up to position 38. About 20% of the polypeptide chain are shorter by two amino-acid residues at the N-terminal end. Position 22 seems to be occupied by a carbohydrate-binding asparagine. The N-terminus of the A1a activator does not show any homology with the activator for the enzymic sulfatide degradation. PMID- 3675871 TI - The primary structure of the pallid bat (Antrozous pallidus, Chiroptera) hemoglobin. AB - The complete primary structure of the hemoglobin from the Pallid Bat (Antrozous pallidus, Microchiroptera) is presented. This hemoglobin consists of two components with identical amino-acid sequences, differing, however, in the N terminus which is formylated in 12.5% of the beta-chains. The alpha- and beta chains were separated by reversed phase high performance liquid chromatography. The sequences of both chains were established by automatic Edman degradation with the film technique or gas phase method using the native chains and the tryptic peptides. The formylation of a part of the N-terminal peptide of the beta-chains was determined by mass spectrometric examination. Compared to the corresponding human chains we found 14 substitutions in the alpha-chains and 21 in the beta chains. One substitution in the alpha-chains and three in the beta-chains are involved in alpha 1/beta 1-contacts. Among these the exchange beta 123(H1)Thr--- Cys is unusual because cysteine was so far not found in this position of mammalian beta-chains. Compared to the hemoglobin of Myotis velifer, another representative of the family Vespertilionidae, 5 residues are replaced in the alpha-chains and 18 in the beta-chains. PMID- 3675872 TI - Hydrolysis of human high-molecular-mass kininogen by human plasma kallikrein. Proposal of a new model concept for the course of reaction in presence and absence of C1(-)-inhibitor. AB - Hydrolysis of high-molecular-mass kininogen was studied by following the changes in the amounts of substrate, intermediates and products as a function of time using quantitative polyacrylamide-gel electrophoresis (silver staining). The experimental data was analysed on the basis of the concept that the overall reaction is composed of three hydrolysis reactions, two positional-change processes of intermediates at the active site, and two product-substrate exchange processes. It is proposed C1(-)-inhibitor to form two types of complexes with kallikrein, one with non-covalent and one with covalent bonds. With an adequately chosen set of reaction-partner concentrations and four different kinds of experimental conditions with respect to kininogen and inhibitor addition to kallikrein, the following results were obtained: 1) Non-covalently bound inhibitor has no effect on the first and the second hydrolysis reaction, but efficiently interferes with the third hydrolysis reaction; 2) Nicked kininogen (first intermediate; one of the two bradykinin bonds split) for the second bond to be hydrolysed undergoes a positional change during which it remains strongly bound to the enzyme, never exchanges with kininogen, and is not displaced by non covalently bound inhibitor; 3) Intermediate kinin-free kininogen (second intermediate; both bradykinin bonds split and bradykinin released) prior to turning over into stable kinin-free kininogen (final product; histidine-rich fragment split off and released) undergoes a positional change involving dissociation and reassociation so that non-covalently bound inhibitor finds access to the active site; 4) Intermediate kinin-free kininogen to sustain multiple turnovers exchanges with kininogen via a stable complex of such structure that during this process non-covalently bound inhibitor cannot or can only slightly interfere; 5) Stable kinin-free kininogen to sustain multiple turnovers exchanges with intermediate kinin-free kininogen via free enzyme with the effect that non-covalently bound inhibitor efficiently interferes; 6) As hydrolysis proceeds more and more inhibitor becomes covalently bound, gradually leading to complete inactivation of the enzyme. PMID- 3675873 TI - In vivo binding partners of the Lens culinaris lectin. AB - The immobilized lectin from the lentil (Lens culinaris) specifically binds two fractions out of the L. culinaris seed globulins. Both fractions are displaced from the lectin at low pH values. In addition, fraction I fails to interact at high ionic strengths, and fraction II in the presence of glucose or other lectin specific sugars. The behaviour in zonal isoelectric precipitation and electrophoretical patterns indicate that both fractions represent subpopulations of the storage proteins. The interaction as demonstrated by affinity chromatography is corroborated by nephelometry: If the dissolved proteins (lectin plus fraction I or fraction II) are mixed under proper conditions the solutions become turbid. An even more pronounced interaction is observed if the lectin is reacted with both fractions at the same time. Seed albumins able to interact with the immobilized lectin include the dissolved lectin and two glycosidases (alpha mannosidase, alpha-galactosidase) all of which are located in the protein bodies. A third glycosidase (beta-galactosidase) from outside of the protein bodies does not bind to the lectin. The results are discussed in view of the possibility that lectins may serve as packaging aids for other proteins in the protein bodies. PMID- 3675874 TI - A multivariate study on enzymatic changes in limb muscles and heart muscle of dystrophic mice. AB - The present study was undertaken to elucidate further the enzymatic changes in dystrophic muscle using multivariate analysis. The activities of 14 kinds of enzymes, including 6 exopeptidases, 4 endopeptidases, beta-N-acetyl-D glucosaminidase, phosphatase, esterase, and ribonuclease, were examined in forelimb and hindlimb muscles as well as in cardiac muscle of dystrophic mice and their controls. Two principal components identified from the enzymatic spectrum proved to be related especially to aminopeptidases and to serine proteinases, respectively. The enzymatic changes in forelimb muscle were very similar to those in hindlimb muscle when both were compared to those in cardiac muscle. The changes in aminopeptidases were unique to the limb muscles, whereas those of serine proteinases were unique to cardiac muscle of dystrophic mice. In the future, more attention should be focused on the role of exopeptidases in pathogenetic mechanisms of muscular dystrophy, because of the possibility that they play a major role in the initial stage of muscular dystrophy. PMID- 3675875 TI - Purification and properties of a phospholipase C that has high activity toward sphingomyelin from Aspergillus saitoi. AB - An enzyme hydrolyzing sphingomyelin was purified from extracts of solid cultures of Aspergillus saitoi 7041 by fractionation with isopropanol followed by successive column chromatographies on DEAE-Sepharose CL-6B, butyl-Toyopearl 650 M, and phenyl-Sepharose CL-4B. The preparation of purified enzyme was homogeneous and had an activity increased 81-fold over that of the isopropanol fraction. The yield was about 65%. The molecular weight was estimated to be 54,000 by sodium dodecyl sulfate-gel electrophoresis. The enzyme solution had a violet color and contained iron atoms. The enzyme catalyzed the hydrolysis of sphingomyelin to N acylsphingosine and phosphorylcholine. The optimum pH for hydrolytic activity was around 3.5. The Km values for sphingomyelin and 2-hexadecanoylamino-4 nitrophenylphosphorylcholine were 0.11 and 0.33 mM, respectively. The enzyme also catalyzed the hydrolysis of other phospholipids; the order of its hydrolytic activity at a substrate concentration of 2.5 mM was phosphatidylcholine greater than or equal to sphingomyelin = phosphatidylethanolamine = lysophosphatidylethanolamine greater than phosphatidyl DL-glycerol = phosphatidyl L-serine greater than phosphatidylinositol. From these results, this enzyme appears to be a new type of phospholipase C(phosphatidylcholine cholinephosphohydrolase, EC 3.1.4.3). PMID- 3675877 TI - 19th forum in immunology. Mode of action of cyclosporin A. PMID- 3675876 TI - Hepatic or splenic targeting of carrier erythrocytes: a murine model. AB - Carrier mouse erythrocytes, i.e., red cells, subjected to a dialysis technique involving transient hypotonic hemolysis and isotonic resealing were treated in vitro in three different ways: (a) energy depletion by exposure for 90 min at 42 degrees C; (b) desialylation by incubation with neuroaminidase; and (c) oxidative stress by incubation with H2O2 and NaN3. Procedure (c) afforded maximal damage, as shown by analysis of biochemical properties of the treated erythrocytes. Reinfusion in mice of the variously manipulated erythrocytes following their 51Cr labeling showed extensive fragilization as indicated by rapid clearance of radioactivity from the circulation. Moreover, both the energy-depleted and the neuraminidase-treated erythrocytes showed a preferential liver uptake, reaching 50 and 75%, respectively, within 2 h. On the other hand, exposure of erythrocytes to the oxidant stress triggered a largely splenic removal, accounting for almost 40% of the reinjected cells within 4 h. Transmission electron microscopy of liver from mice receiving energy-depleted erythrocytes demonstrated remarkable erythrocyte congestion within the sinusoids, followed by hyperactivity of Kupffer cells and by subsequent thickening of the perisinusoidal Disse space. Concomitantly, levels of serum transaminase activities were moderately increased. Each of the three procedures of manipulation of carrier erythrocytes may prove applicable under conditions where selective targeting of erythrocyte-encapsulated chemicals and drugs to either the liver or the spleen has to be achieved. PMID- 3675878 TI - Cyclosporin-induced alterations of lymphocyte physiology. PMID- 3675879 TI - Cyclosporin A. PMID- 3675880 TI - Hospice for AIDS patients. Interesting times ahead. PMID- 3675881 TI - A method for hospice economic survival. Comprehensive fund raising. PMID- 3675882 TI - Pain management practices in a home care hospice program. Physicians, staff should share responsibility. PMID- 3675883 TI - Hospice care and passive euthanasia. Can they be equated? PMID- 3675884 TI - The role of continuous intravenous and subcutaneous narcotic infusions in pain management. PMID- 3675885 TI - Hospice for AIDS patients. New teams should be developed for AIDS care. PMID- 3675886 TI - Hospice for AIDS patients. Break down barriers and accept AIDS patients. PMID- 3675887 TI - [Antiobiograms: paper disks versus tablets]. PMID- 3675888 TI - [Criteria for the validation of analytical methods]. PMID- 3675889 TI - Studies on the alteration of orange lemonade during storage under different conditions. PMID- 3675890 TI - [Aromatic plants in food: criteria for evaluation of their safety in use]. PMID- 3675891 TI - [HPLC determination of caffeine in food and dietetic products]. PMID- 3675892 TI - Magnetic resonance imaging of the eustachian tube. A correlative anatomical study. AB - Magnetic resonance (MR) imaging of the eustachian tube (auditory tube) was performed in normal subjects and in a patient with nasopharyngeal carcinoma. The MR images obtained in an anteriorly tilted transaxial plane parallel to the eustachian tubes were compared with serial slices of a cadaver specimen. The eustachian tube cartilage, mucous lining of the eustachian tube, the lateral pharyngeal recess, the tensor veli palatini muscle, and the levator veli palatini muscle were identified in MR images using anatomical relationships. A patient with nasopharyngeal carcinoma is described to demonstrate an example of topographical morbid changes appearing around the eustachian tube. PMID- 3675893 TI - Acute traumatic tympanic membrane perforations. Cover or observe? AB - The influence of a paper prosthesis on healing in acute traumatic tympanic membrane perforations was studied in 60 patients randomly selected for a treatment group or a control group. The majority (42 [70%] ) were seen within two days. All patients were treated with oral antibiotics for ten days. The overall healing rate two months after the trauma was 94% (37 of 39 patients). No significant difference between the study group and the control patients was observed. Intermittent secretion was seen in six patients but did not influence the outcome. The perforations occurred in patients with normally sized mastoid air cell systems as seen on roentgenograms. We conclude that acute traumatic tympanic membrane perforations do not need to be treated routinely with paper patching. PMID- 3675894 TI - Myringoplasty in the pediatric population. AB - The long-term results of myringoplasty in children, including closure of perforation and hearing improvement, were reviewed in relation to age, condition of the operated-on ear, and condition of the untreated ear. The overall success rate in 155 operations evaluated one year postoperatively was 79%. Children in the 5- to 8-year-old age group had a success rate comparable to that of older (9- to 12-year-old) children (77.7% vs 80.4%). Where graft failure occurred, it was usually within one year of surgery. The outcome of surgery could not be related to the presence or absence of chronic otitis media in the untreated ear, the status of the operated-on ear (whether dry or discharging), or the performance of adenoidectomy before myringoplasty. Results of postoperative hearing, analyzed by calculating the postoperative air-bone gap and by speech audiometry, were similar in the two age groups. It is concluded that myringoplasty has a good chance of success in children, regardless of age. PMID- 3675895 TI - Facial-nerve and vocal-cord monitoring during otoneurosurgical operations. AB - We describe a newly developed instrument to monitor facial muscles and vocal-cord function during neurosurgical and otoneurosurgical operations. The device (Myo Alarm) transforms into acoustic signals the pressure variations that are induced by facial muscles and vocal-cord contractions on air-inflated rubber sensors that are positioned, respectively, beneath the superior lip and between the vocal cords. It represents an effective and dependable method to monitor facial and vocal-cord functional preservation during surgery. PMID- 3675896 TI - Nasal mucosal changes in children with frequent infections. AB - Children with frequent recurrent respiratory tract infections and constant mucopurulent secretion from the nose were thoroughly examined, including bacteriologic and immunologic analyses. Biopsy specimens from the nasal mucosa were investigated by light and electron microscopy. Eight different histopathologic factors were distinguished and evaluated in relation to the continual nasal discharge. The mucus production was increased, due to an increased number of goblet cells or submucosal glands. The mucus transport was impaired owing to a decreased number of ciliated cells or different deficiencies in the structure of the cilia. The secretion of periciliary fluid was altered due to dysfunction of microvilli-equipped cells and the availability of tissue fluid due to vascular changes. Leakage of tissue fluid partly reflects deficiencies in the epithelial lining. Purulent discharge was observed from microabscesses. Reactive changes in the nasal mucosa are described and discussed in relation to treatment schedules aimed at reducing short- and long-term discomfort and complications. PMID- 3675897 TI - Metastatic neck disease. A clinical/radiographic/pathologic correlative study. AB - The concept of treating prophylactically the neck of the patient with head and neck cancer is based on the presence of neck metastases in a large number of cases, even if not always detected by physical examination. A modality that could reveal abnormal nodes accurately would change this management attitude so that a number of necks could be left untreated. A retrospective comparative study was undertaken to determine whether high-resolution computed tomographic (CT) scanning might play this role, and whether it has any advantage over physical examination. The radiographic findings of 79 patients with head and neck cancer who had undergone a total of 100 neck dissections were compared with the findings of physical and histopathologic examinations. This study shows similar sensitivity rates for both physical examination and CT scanning (61.55% and 59.6%, respectively) and slight superiority of the positive predictive values of physical examination (91.4%) over those of CT scanning (81.6%). The study suggests that CT offers no advantage over physical examination and should therefore not be used for neck management decisions. Measuring the size of involved lymph nodes showed that occult nodes fall within the same range as normal nodes and thus cannot be differentiated from normal nodes by size alone. PMID- 3675898 TI - A case of 'spontaneous otoacoustic emission'. AB - A 25-year-old man produced a continuous high-pitched pure tone (6.1 kHz, 37.2-dB sound pressure level) in his right ear. The tone was not audible to the patient. He had sensorineural deafness over 1 kHz with a dip of 45 dB at 6 kHz. The tone was considered to be emitted through the eardrum from the inner ear, ie, a "spontaneous otoacoustic emission". PMID- 3675899 TI - Autosomal recessive progressive high-frequency sensorineural deafness in childhood. AB - Autosomal recessive progressive high-frequency sensorineural deafness in childhood occurred in six patients from two families. This progressive sensorineural hearing loss starts mainly in the higher frequencies. There is an abrupt decline in the audiogram that slowly decreases with the increase of the hearing loss in the lower frequencies. PMID- 3675900 TI - A histological study of the temporal bones and the nose in Wolf-Hirschhorn syndrome. AB - We report the histopathological findings of the temporal bones and the nasal and paranasal specimen of a 7-month-old girl diagnosed as having Wolf-Hirschhorn or 4p- syndrome (deletion of the short arm of chromosome 4). This syndrome is characterized by growth retardation, mental retardation, and multiple congenital abnormalities, including craniofacial anomalies and hearing disturbance. These temporal bones displayed malformation of the ossicles, absence of the oval windows, abnormal course of the facial nerve with incomplete bony canal, and depression of the cochlear duct and the saccule. In addition, cholesteatoma, which might be of congenital origin, was present behind the eardrum. The nasal and paranasal specimen showed bilateral complete cleft palate with normal development of paranasal sinuses, nasal septum, and conchae. PMID- 3675901 TI - Pathologic quiz case 2. Neurilemmoma (schwannoma). PMID- 3675902 TI - Surgical management of epistaxis. PMID- 3675903 TI - Medical recertification. PMID- 3675904 TI - Rationalized nomenclature for head and neck carcinomas. PMID- 3675905 TI - Congenital absence of incus and head of stapes. PMID- 3675906 TI - Mechanics of obstructive sleep apnea: a dentist's perspective. PMID- 3675907 TI - The prevalence of ocular disorders in 1000 Queensland primary schoolchildren. PMID- 3675908 TI - Assessment of the Queensland School Health Service vision screening programme. AB - Despite the widespread acceptance of vision screening programmes as a means of detecting ocular disorders in children, there has been little formal assessment of their validity and reliability. One such screening programme is conducted in Queensland State Primary Schools by the Division of School Health Services of the State Department of Health. A group of 877 children was screened by the Service and subsequently subjected to a formal independent ophthalmological examination. A comparison of the results of these procedures revealed that the visual screen as performed by the Service was highly accurate in the determination of distant visual acuity. Detection of manifest strabismus was less satisfactory, with between 30 and 74% of sufferers being detected. There is no evidence to suggest that a more complex protocol will improve the detection of ocular disorders. Rather, a more effective implementation of the current screening procedure is required. PMID- 3675909 TI - Oculomotor nerve palsy in childhood. AB - Oculomotor nerve palsy was found in 28 children. Trauma was the cause in seven, infection in six, while tumour, poison and migraine were each responsible for one case. Twelve cases were cryptogenic: eight of these were present at birth (but three were probably due to birth trauma), and four cases appeared in infancy, but with no cause found even on full neuroradiological investigation. Among these 12 cases the pupil was large in only three, normal in four and small in five. Cyclic spasms were not seen in this series. Among the five congenital cases associated abnormalities including spina bifida, Goldenhar's syndrome and developmental delay were found in four. Acquired palsy does not seem to have a sinister significance. PMID- 3675910 TI - Assisted local anaesthesia for cataract surgery (ALACS). AB - This paper describes an assisted local anaesthetic technique which we have used almost exclusively for extracapsular cataract extraction and posterior chamber intraocular lens implant surgery over the last 12 months. This ALACS technique was developed from a combined neurolept-local anesthetic into an assisted local anaesthetic suitable for day-stay cataract surgery. The technique combines the advantages of purely local (retrobulbar and facial) anaesthesia with the advantages usually inherent in a good general anaesthetic. Thus the patient is in a state of general quiescence and psychic indifference throughout the procedure. ALACS provides excellent and long-lasting akinesia and analgesia, with adequate proptosis of the eye which facilitates surgical access. ALACS is suitable for almost all adult cataract and implant surgery. Our results in 104 cases of ALACS are reviewed in terms of visual results and complications both ocular and anaesthetic; the results appear good and the complications minimal. The results of blood gas estimations done intraoperatively in a small number of patients are also presented, and suggest that the technique is systemically safe. PMID- 3675911 TI - Efficacy and safety of hypromellose in ocular implant surgery. AB - In order to assess the efficacy of hypromellose as a viscoelastic substance in cataract surgery with posterior chamber intraocular lens implantation, we studied a series of 88 cases who underwent surgery with either alternate use of a viscoelastic substance (hypromellose, 39 patients, or sodium hyaluronate, 5 patients) or air (44 patients) in the anterior chamber. Endothelial cell loss was least in the group in which air was used (18 +/- 3% cell loss, mean +/- SEM), compared with hypromellose (26 +/- 3%) and sodium hyaluronate (28 +/- 6%), but the difference in percentage cell loss between the groups did not reach statistical significance. Some operative difficulties were encountered in both groups. In both the air and hypromellose groups there were two patients with an early postoperative rise in intraocular pressure, but this was easily controlled, and in both groups there were two patients with postoperative corneal oedema which soon cleared. Visco-elastic substances used in this study were not shown to be superior to air in protecting the corneal endothelium. For this reason use of hypromellose should be confined to situations where its use is likely to confer some special advantage, as in the presence of a bound-down pupil in patient's with chronic glaucoma or perhaps to facilitate "in the bag" implantation. PMID- 3675912 TI - Combined extracapsular cataract extraction and posterior chamber intraocular lens implantation and trabeculectomy. AB - In a retrospective study in a consecutive series of operations performed by the author, 13 eyes in 10 patients underwent combined extracapsular cataract extraction, posterior chamber intraocular lens (IOL) implantation and trabeculectomy. All had significant cataract and chronic open-angle glaucoma with field loss, uncontrolled or marginally controlled on maximum tolerable medical treatment. All had a postoperative reduction in intraocular pressure. Significant complications included malignant glaucoma (in two eyes) and a late choroidal detachment (in one eye). The indications for and the advantages of the combined procedure are discussed, emphasising the advantages of extracapsular cataract extraction (ECCE) and posterior chamber lens implantation, in patients with chronic open-angle glaucoma (COAG). PMID- 3675913 TI - Ciliary-block glaucoma treated by posterior capsulotomy. AB - Ciliary-block glaucoma occurred in one eye of a 65-year-old-male, following a combined trabeculectomy and extracapsular lens extraction for long-standing angle closure glaucoma. After pupillary block was excluded as a cause, a posterior capsulotomy resolved the condition. This procedure was repeated successfully when a flat anterior chamber recurred on spontaneous closure of the initial capsulotomy. The ciliary block appeared to be caused by the residual zonule and lens capsule. PMID- 3675914 TI - Serum tryptophan and cataract. AB - Total serum tryptophan concentrations were measured in 74 cataractous patients and 124 controls. No significant differences were observed in the mean values for the cataractous and normal subjects, 11.4 +/- 2.6 and 11.3 +/- 2.2 micrograms/ml respectively, or in the range of values, 7.4-17.1 and 7.3-17.4 micrograms/ml respectively. These results do not support previous reports that serum tryptophan is elevated in cataractous subjects. PMID- 3675915 TI - Quality control issues in modern cataract surgery. AB - Modern extracapsular cataract surgery is considerably more complex than the previous intracapsular procedure. Intraocular manipulations are required, and solutions and products must be introduced into the eye. Due to the shift to ambulatory surgery, modern cataract surgery is also being performed in a difficult and more dangerous environment. In these circumstances, sterility and product quality may be compromised when a lack of appropriate surveillance techniques leads to the use of defective products in surgery. The modern cataract surgeon must, therefore, become knowledgeable about infection and quality control procedures in the operating room, and also about details of manufacture and industrial standards applicable to the products used in eye surgery. PMID- 3675916 TI - Effect of erythropoietin on the glucose transport of rat erythrocytes and bone marrow cells. AB - The effect of Ep on radioactive glucose and methyl-alpha-D-glucoside transport by rat erythrocytes and bone marrow cells were studied. There is initial linearity followed by saturation kinetics of [14C]glucose transport by the erythrocytes of starved and starved plus Ep-treated rats at different concentrations of glucose. Starvation caused slight inhibition of glucose transport which increased markedly on Ep administration to starved rats. Normal animals failed to show any significant change in glucose transport after Ep treatment. Methyl-alpha-D glucoside inhibited the Ep-stimulated glucose transport significantly. Ep also stimulated the transport of radioactive methyl-alpha-D-glucoside which was competitively inhibited in presence of D-glucose. Glucose transport in erythrocytes was found to be sensitive to metabolic inhibitors like azide and DNP. A sulfhydryl reagent and ouabain also inhibited the transport process. Ep stimulated glucose and methyl-alpha-D-glucoside transport in the bone marrow cells of starved rats. The sugar analog competitively inhibited the glucose transport in bone marrow cells and vice versa. PMID- 3675917 TI - The binding of decomposition products of UDP-galactose to the microsomes and polyribosomes isolated from rat liver. AB - UDP-D-[U-14C]galactose is decomposed to [U-14C]galactose-1-phosphate and [U 14C]galactose by rat liver microsomal and crude polyribosomal fractions, under conditions commonly used to assay of glycosyltransferase activities. UDP-D-[U 14C]galactose, at neutral pH, is also chemically degraded to the [U-14C]galactose 1,2-cyclic phosphate. The 1,2-cyclic phosphate derivative of galactose also exists in the commercial UDP-D-[U-14C]galactose. It is a very important finding that products of the UDP-D-[U-14C]galactose decomposition are tightly, although nonenzymatically, bound to tested subcellular fractions and may create a false impression of protein glycosylation. The application of controls containing all radioactive substances present in suitable samples is recommended in order to avoid incorrect interpretations of the results. PMID- 3675918 TI - Stimulatory effect of ADP, ATP, NAD(P) on pyruvate production from malate by uncoupled human placental mitochondria. AB - It has been shown that ADP, ATP, NAD(P), and NAD(P)H significantly stimulate pyruvate production from malate by intact uncoupled human term placental mitochondria. No stimulation by ADP was observed when mitochondria were incubated in the presence of NAD(P) or NAD(P)H or when mitochondrial membrane had been disrupted. Atractyloside and oligomycin were without effect on ADP- and ATP stimulated pyruvate production. Other dinucleotides tested such as GDP, UDP, and CDP, stimulated pyruvate production only slightly when mitochondria were incubated in the absence of phosphate. The rate of pyruvate production by intact mitochondria is commensurate with partly purified NAD(P)-linked malic enzyme activity as measured by NAD(P) reduction as far as the effects of pH of hydroxymalonate on these both processes is concerned. It is concluded that pyruvate production by intact human placental mitochondria is catalyzed by NAD(P) linked malic enzyme and that this process is stimulated by ADP and ATP. PMID- 3675919 TI - Liposome-loaded phenylalanine or tryptophan as sickling inhibitor: a possible therapy for sickle cell disease. AB - Phenylalanine or tryptophan entrapped in small unilamellar liposomes was used to transport Phe or Trp across the red blood cell membrane. The incorporation of Phe or Trp into RBCs via liposomes markedly inhibited and reversed the in vitro sickling of deoxy Hb S. Furthermore, normal and SS RBCs loaded with Phe or Trp did not exhibit significant change in osmotic fragility, mechanical fragility, autohemolysis, and glycolysis when compared to untreated RBCs. In addition, the oxygen affinity measured as the P50 and concentrations of 2,3-DPG and ATP were not affected by the incorporation of Phe or Trp into AA or SS RBCs. These results demonstrate that this liposomal transport system which transferred Phe and Trp into intact RBCs did not have any adverse effect on RBC metabolism and function, and may have therapeutic implications in the treatment of sickle cell disease. PMID- 3675920 TI - Lipid oxidation in plasma and tissues from estrogenized chicken hens. AB - Four groups of 5-month-old chicken hens were given estradiol treatments and/or 5% dietary oil supplement for 14 days, after which blood plasma, liver, heart, and skeletal muscle were analyzed for lipid oxidation by TBA assay for malonaldehyde. Plasma from estradiol-treated birds had 8-fold higher levels of malonaldehyde compared to untreated birds. The bulk of this effect was due to a 5-fold increase in plasma lipid, but this lipid also contained a 70% higher concentration of malonaldehyde. Estradiol treatments produced significantly increased TBA numbers in liver, heart, and skeletal muscle. Corn oil supplementation significantly increased the malonaldehyde concentration in fat extracted from liver and heart, but not from plasma or skeletal muscle. It was concluded that estradiol treatment, in addition to generally increasing the deposition of fat in plasma and organs, also enhanced the concentration of malonaldehyde equivalents in plasma and organ fat. PMID- 3675921 TI - A study of the mechanisms of proteinuria in nephritis and chronic renal failure. AB - This study was carried out on 50 patients suffering from renal disorders; 30 nephritis patients and 20 chronic renal failure patients. Twenty-four healthy persons were used as a control group. In order to cast some light on the degree of the impaired glomerular permeability with respect to the blood proteins, selectivity of proteinuria was assessed by means of the clearance of albumin, ceruloplasmin, transferrin, and haptoglobin. Disturbances in the metabolism of these proteins were observed and discussed in light of the proteinuria selectivity index. The demonstration of the selective proteinuria in the presence of haptoglobin was concluded to be indicative of the degree of impaired glomerular permeability in nephritis and chronic renal failure. PMID- 3675923 TI - Reproductive defects in the male diabetic athymic nude mouse. AB - We have previously reported spontaneous hyperglycemia and impaired glucose tolerance in male athymic nude Balb/c mice. This colony also demonstrates impaired fertility. Previous studies in both athymic nude and diabetic obese (ob/ob) mice have shown reproductive abnormalities. It was the purpose of this investigation to further elucidate the endocrine abnormalities which might contribute to the reduced fertility observed in this model. Fasting plasma glucose was measured on each nude mouse to ensure that a diabetic state existed. Testes were removed and intratesticular testosterone and LH receptors were measured. Testosterone levels in diabetic, athymic nude Balb/c (DAN) mice were significantly decreased to 46.5% of control Balb/c mice. LH receptors in DAN mice were significantly elevated by 23.6% when compared to control animals. These results demonstrate that the impaired fertility observed in the DAN mouse may result from decreased testosterone production. The increased LH receptor levels seen in the DAN mouse might reflect a regulatory event in response to the decreased intratesticular testosterone levels. PMID- 3675922 TI - Effects of energy deprivation and hydrogen peroxide on contraction and myoplasmic free calcium concentrations in isolated myocardial muscle cells. AB - The effect of energy deprivation and H2O2 on the contraction, shape, and intracellular free Ca2+ concentration of myocardial muscle cells was investigated using suspensions of freshly isolated, electrically stimulated rat ventricle heart cells. The mitochondrial uncoupling agent carbonyl cyanide m chlorophenylhydrazone (CCCP) was used to decrease the rate of ATP synthesis. At 0.9 mM extracellular Ca2+, CCCP (0.25 microM) reduced the number of contracting cells by 50% after 5 min, and the number of rod-shaped cells by 40% after 10 min. The effects of CCCP were associated with a substantial decrease in measured cellular ATP concentrations. The deleterious effect of exposure of myocytes to CCCP for periods of up to 5 min was enhanced by an increase in the extracellular Ca2+ concentration, but markedly reduced in the absence of electrical stimulation. Verapamil protected myocytes from the deleterious effects of CCCP during the first 5 min but not at later times. In the presence of 46 mM extracellular K+, CCCP caused a marked increase in the myoplasmic free Ca2+ concentration (measured using quin2). This effect was inhibited by verapamil and was not observed in the absence of K+-induced depolarization. Exposure of myocytes to H2O2 (0.5 mM) caused a substantial decrease both in the number of cells which exhibited normal end-to-end synchronous contraction and in the total number of cells which contracted either partially or fully. The effects of H2O2 were more pronounced at higher concentrations of the peroxide, with longer times of exposure to the agent, and at higher concentrations of extracellular Ca2+, and were partially reversed by dimethyl sulfoxide. The results indicate that both ATP deprivation and H2O2, possibly through the generation of free radicals, cause substantial and rapid damage to cardiac myocytes and induce the movement of additional Ca2+ across the sarcolemma to the myoplasm. In the case of ATP deprivation, this initially occurs through voltage-operated channels. PMID- 3675924 TI - Effect of phenylalanine- or tryptophan-loaded liposomes on the rheological properties of AA and SS erythrocytes. AB - Phenylalanine or tryptophan was incorporated into AA and SS red blood cells by a liposomal transport system which was previously shown by Kumpati to inhibit and reverse sickling of intact SS red blood cells in vitro. In the present study, the effect of phenylalanine or tryptophan incorporation on the rheological properties was evaluated. The incorporation of phenylalanine or tryptophan into red blood cells decreased the viscosity of deoxy SS red blood cells which reached a level close to that for normal red blood cells due to the antisickling effect. These results demonstrate that this liposomal transport system which transferred phenylalanine or tryptophan into intact red cells and did not have any adverse effect on red cell metabolism or function did correct the viscosity of deoxy SS red cells by its antisickling effect. This method may have significant therapeutic implications in the treatment of sickle cell disease. PMID- 3675925 TI - Existence of fatty acyl-CoA oxidizing system in (micro)peroxisomes of rabbit aorta. AB - A cyanide-insensitive palmitoyl-CoA oxidizing activity was detected in rabbit aorta. An assay developed for the arterial acyl-CoA oxidizing system was linear with respect to protein content of the homogenate between 12.5 and 100 micrograms and incubation time for at least 15 min. The system was shown to be localized in (micro)peroxisomes by centrifugation in sucrose density gradient. With a diet containing 1% (w/w) cholesterol and 3% (w/w) olive oil for 8 weeks the activity of peroxisomal beta-oxidation increased from 1.38 to 2.54 nmole/min/g aorta. These results show that the aortic catalase-positive particles have a capacity to oxidize fatty acyl-CoA and participate in fatty acid metabolism. PMID- 3675926 TI - [A case of pycnodysostosis--observation of the skull by CT scan]. AB - A 13-year-old boy was presented to the Department of Neurosurgery, Saiseikai Fukuoka General Hospital for further examinations concerning abnormal findings in the skull radiogram taken when he struck his head. His physical features showed some characteristics the same as those of pycnodysostosis as follows- proportionate dwarfism, prominent forehead, short spoon-shaped fingers, bilateral exophthalmos. A skull radiogram revealed widely open cranial sutures with no healing of the fracture and craniotomy which was performed for an acute epidural hematoma 6 years ago. Furthermore, the mandible was hypoplastic with a virtual loss of mandibular angle. CT of the soft tissues showed somewhat dilated cortical sulci and ventricles without any structural abnormalities in the brain. CT of bone algorithm revealed specific characteristics of this disease. The paranasal sinuses were quite hypoplastic. Especially in the maxillary sinuses, frontal sinuses and mastoid air cells, none of developments of sinuses were noted, even though the middle and internal ear seemed to be normal. Moreover, the ethmoid and sphenoid sinuses were noted, although their developments were poor. The appearance of skull base was normal, including the inlets and outlets of cranial nerves or vessels and synchondroses. However, the density of the skull base, especially in the diploe, was higher than normal in Hansfield number. Furthermore, detailed measurements of skull base demonstrated that the skull base itself was also dwarfism. Pycnodysostosis is a generalized skeletal disease whose cardinal features are moderate generalized osteosclerosis and dwarfism. However, the detailed observation on the cranium by CT has not been reported. In our study, the development of sinuses in bones with intramembranous ossification are worse than that with endochondral ossification.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675927 TI - [Morphological, morphometrical and metal analysis studies of oral aluminum neurotoxicity]. AB - Environmental factor is noteworthy for pathogenesis of ALS. Yase reported low contents of Ca, Mg and high contents of Al, Mn in environmental samples (soil and water) obtained from Kii Peninsula and Guam where ALS has been occurring in high incidence. In this paper, to evaluate the role of these environmental factors for degeneration of ALS, morphological, morphometrical and metal analytical studies on experimental animals will be described with special attention to the neurotoxicity of oral administration of Al. The rabbits (2-2.3 kg) were divided into 3 groups. Group 1 was fed standard diet (Ca 1.24% Mg 0.37%), Group 2 was fed low-Ca Mg diet (Ca 0.27% Mg 0.05%) for 40 days, and Group 3 was fed low-Ca Mg diet for 40 days and was injected Al-lactate solution (10 ml) into the stomach through the tube 6 times/week for 4 weeks. Al-lactate solution contained Al in dosage of 0.06 g/ml for the first 2 weeks and 0.12 g/ml for the following 2 weeks. And also to compare with the change by oral administration of Al, rabbits were injected Al-phosphate intracerebrally 14 days before the examination. The rabbits were anesthetized and perfused through the aorta with 10% formalin or 2.5% and 5% glutaraldehyde (pH 7.4), and examined light and electron microscopically. For morphometrical examination, 100 sections of 6 microns specimen at intervals of 30 microns in each rabbit spinal cord (c-5) were prepared and examined using the ocular micrometer. Contents of Al and Ca of the spinal cord and cortex were measured by neutron activation analysis with formalin fixed samples.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675928 TI - [Neuropsychological disturbance in Parkinson's disease--analysis of a new modified Wisconsin Card Sorting Test and of the P300 component evoked by auditory stimuli]. AB - To clarify the neuropsychological disturbances in Parkinson's disease, we used the New Modified Wisconsin Card Sorting Test (WCST) which is simpler and less ambiguous than the other methods. We also examined P 300 components evoked by auditory stimuli. In the previous paper, we reported that the latencies of P 300 component evoked by the complex visual stimuli were prolonged. These two examination were administered to 25 parkinsonian patients with normal intelligence and 15 normal controls. In the New Modified WCST, parkinsonian patients had fewer categories achieved. And they made a higher proportion of total errors, preservation errors and difficulty of maintaining set than normal controls. In the latencies and the amplitudes of P 300 components, there were no significant differences between the two groups. In the group of parkinsonian patients, significant correlations were demonstrated between the P 300 latency and the scores of the New Modified WCST. These results show that the New Modified WCST is useful for the detection of neuropsychological disturbance in Parkinson's disease and that P 300 components evoked by simple task could not disclose it. PMID- 3675929 TI - [Clinical and myopathological findings in polymyositis]. AB - The present report analyzed a clinical and myopathological findings of 60 patients defined for the diagnosis of polymyositis. Patients were classified in four groups according to the system Walton and Adams. Forty five per cent were classified as Group I, 28.3 per cent as Group II, 15.0 per cent as Group III and 11.7 per cent as Group IV. Seven patients were associated with a malignant neoplasm and all of them were over fifty. The primary growth was carcinoma of the lung in 2, of the prostate, ovarium, stomach in one case each, and in one case a chronic myelogenous leukemia and in one case a malignant lymphoma. The female to male ratio was 2:1. Though cases were seen in all age groups, the largest number was in the sixth decade. The presenting symptoms and signs were essentially similar to those reported before. Proximal lower and upper limb weakness was the most frequent symptoms (91.7 and 83.3 per cent respectively). Other characteristic symptoms were skin changes, muscle pain, arthralgia and Raynaud's phenomenon. The CK was measured at the time of presentation in 58 of the 60 cases. Normal values were found in 18.3 per cent of cases. In general, muscle biopsy was performed in the first stage of the disease. A diagnostically abnormal biopsy was 55 cases (92 per cent), but 8 per cent of cases had normal biopsy. The characteristic changes in the biopsies from 60 cases were muscle fiber necrosis, inflammatory infiltration, fibrosis, basophilia and increase of internal nuclei. We could not get a significant difference between the two groups. However all of the cases of Group IV had muscle fiber necrosis, inflammatory infiltration and fibrosis. PMID- 3675930 TI - [Clinical validity of lumbar subarachnoid pressure measurement]. AB - To evaluate the clinical usefulness for measuring lumbar subarachnoid pressure (LSP) as an index of intracranial pressure, the relation between LSP and epidural pressure (EDP) was studied by the cisternal saline infusion and bolus injection in 12 cats at the range of pressure up to 50 mmHg. In the steady state infusion (0.238 ml/min, 0.476 ml/min), the data from LSP and EDP were correlated very well and the LSP value was at least above 80-90% of EDP value at any pressure level. In the bolus injection (0.4 ml), the degree of pressure rise and the time course of both LSP and EDP were quite similar at any pressure level. However, the compliance calculated from the pressure change of LSP and EDP revealed to have a different tendency according to the baseline pressure level at bolus injection. Below 10 mmHg of EDP, the compliance calculated from LSP was usually higher that of EDP. This was considered due to the distensibility of spinal theca. But above 10 mmHg of EDP, the compliance of both LSP and EDP became almost equal and then gradually decreased as the elevation of baseline pressure at bolus injection. This was considered to be the result of disappearance of the distensible effect of spinal theca. In this study, two polyethylene tubes of different size (I. D. 0.45 mm, 0.58 mm) were used for spinal drainage tube to compare the pressure dumping effect of tube. However, on both tubes, the pulse pressure of LSP was usually smaller than that of EDP, with each having almost constant difference.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3675931 TI - Significance of hepatic assist by plasma exchange. With special reference to host defense mechanisms. PMID- 3675932 TI - Polarization and adsorption effects on sieving in membrane protein filtration. PMID- 3675933 TI - Axillary artery to iliac vein vascular access using an externally supported prosthetic graft. A new procedure for the recalcitrant secondary access patient. AB - The axillary artery-iliac vein graft using externally supported PTFE is a viable option for this difficult patient group. It is capable of functioning well for up to 12 months. Most importantly, despite numerous prior access procedures, the axillary artery and iliac vein in each case were amenable to the procedure. Critical technical points include the use of externally splinted PTFE grafts, avoidance of crossing joints, and angling of the graft in the direction of the iliac vein at that anastomosis. The lack of thrombosis or infection to date, coupled with successful dialysis in every patient, suggests that this is one more option that can be used in the difficult secondary access patient. PMID- 3675934 TI - A completely new poly(ether-urethane) graft ideal for hemodialysis blood access. PMID- 3675935 TI - A femoral vein catheter with immobilized urokinase (UKFC) as an antithrombotic blood access. PMID- 3675936 TI - Recurrent venous thrombosis associated with permanent internal jugular vein hemodialysis catheters. AB - Eight Permcaths were placed into seven patients without other alternative hemodialysis access sites. They lasted from 1-109 treatments. However, recurrent thrombi formed at the tip of two catheters. Although urokinase successfully dissolved the thrombi, recurrence of clot despite anticoagulation therapy led to removal of both catheters. We conclude that the Permcath should be used with caution in patients on hemodialysis who have no alternative vascular access sites because of the risk of thromboembolism. The value of anticoagulants to prevent recurrent thrombi is unclear, because thrombi recurred in both patients despite their use. PMID- 3675937 TI - Hemodynamic and functional considerations of the Jarvik total artificial heart (TAH). PMID- 3675938 TI - A new connector system for total artificial hearts. Preliminary results. PMID- 3675939 TI - Long-term survival with a pneumatic artificial heart. PMID- 3675940 TI - Ventricular interaction during right ventricular assist. PMID- 3675941 TI - Long-term follow-up study of survivors of postcardiotomy circulatory support. PMID- 3675942 TI - Registry and tabulations of orthotopic total artificial hearts in humans. PMID- 3675943 TI - Mode comparison study for a completely implantable TAH (CITAH) system. PMID- 3675944 TI - Infectious complications associated with ventricular assist device support. PMID- 3675945 TI - Effectiveness of a counterpulsation device implanted on the ascending aorta. PMID- 3675946 TI - Mechanical assistance in severe experimental cardiogenic shock. PMID- 3675947 TI - The total artificial heart. A better model to study the hemodynamic effect of protamine. PMID- 3675948 TI - A new right ventricular assist device. The extracorporeal pulsatile assist device (EPAD). PMID- 3675949 TI - Toward a completely implantable TAH. A left-right simultaneously ejecting motor driven TAH system. PMID- 3675950 TI - Hemodynamic adaptation to exercise after total artificial heart (TAH) implantation. PMID- 3675951 TI - Clinical, morphologic, biochemical, and immunohistochemical aspects of dialysis associated amyloidosis. PMID- 3675952 TI - Microbiologic contamination of liquid bicarbonate concentrate for hemodialysis. PMID- 3675954 TI - Relationship between sympathetic dysfunction and hemodialysis instability. PMID- 3675953 TI - Rapid improvement of uremic neuropathy on short high-efficiency hemodialysis with special reference to middle molecules. PMID- 3675955 TI - Percent reduction in blood urea concentration during hemodialysis (PRU). A simple and accurate method to estimate Kt/V urea. PMID- 3675956 TI - Effects of 25(OH)-vitamin D3 in hypocalcemic patients on chronic hemodialysis. PMID- 3675958 TI - Effect of blood and ultrafiltrate flow rates on drug sieving during continuous hemofiltration. PMID- 3675957 TI - Polymethylmethacrylate in chronic hemodialysis. Is it of benefit in patients with uremic neuropathy? PMID- 3675959 TI - Aminoglycoside binding to polyacrylonitrile hemofilter membranes during continuous hemofiltration. PMID- 3675960 TI - A mathematical model of continuous arteriovenous hemofiltration predicts performance. PMID- 3675961 TI - Regional heparinization for continuous arterio-venous hemofiltration (CAVH). PMID- 3675962 TI - A potentially implantable thermoelectric sensor for measurement of glucose. PMID- 3675964 TI - Platelet reactions with artificial surfaces. PMID- 3675963 TI - Use of a capillary filtrate collector for monitoring glucose in diabetics. PMID- 3675965 TI - Oxygen transport by a pyridoxalated-hemoglobin-polyoxyethylene conjugate. PMID- 3675966 TI - Microencapsulation of parathyroid cells as a bioartificial parathyroid. In vitro studies. PMID- 3675967 TI - Prevention of thrombosis-related complications in cardiac catheterization and angiography using a heparinized catheter (Anthron). PMID- 3675968 TI - Importance of membrane physicochemical properties on LDL/HDL separation. PMID- 3675970 TI - Salvage of ischemic myocardium by retrograde venous perfusion. PMID- 3675971 TI - Long-term experience with the HELP system for treatment of severe familial hypercholesterolemia. PMID- 3675969 TI - Selective removal of high level cryoglobulins (CG) and immune complexes (IC) by a large pore membrane. AB - The investigated membranes having a pore size of 3 micron or less can retain over 95% of cryoprecipitable proteins and immune complexes with nearly complete passage of other plasma proteins at 4 degrees C. Based on this result, the G-3 module consisting of V-3000 membrane was chosen for further study. The G-3 module (0.148 m2 of surface area) processed a 10 times higher plasma volume per unit surface area with higher selectivity than the Asahi Plasmaflo AP 06M. Separation efficiency of cryoprecipitable proteins and immune complexes in cryoglobulinemic plasmas by cryofiltration at 4 degrees C is related to the composition of the cryoprecipitable protein; three of four plasmas contained cryoprecipitable proteins that were removable by cryofiltration. Cryoprecipitation was too slow in one of four plasmas. For this plasma SDS PAGE showed its light chain to be of higher molecular weight than other plasmas. Two of four plasmas had elevated amounts of IC that were removed by cryofiltration. PMID- 3675972 TI - The calf as a model for thromboembolic events with the total artificial heart. PMID- 3675973 TI - A compact neonatal extracorporeal oxygenator (ECMO) system using a single lumen catheter. PMID- 3675974 TI - Pump-induced hemolysis in a rabbit model of neonatal ECMO. AB - There is no significant difference in hemolysis between pediatric centrifugal pumps and roller pumps during ECMO of 8 hours duration in rabbits or in comparable 24 hour isolated pump circuits. There is also no significant difference in heat production by either pump. Reports of severe hemolysis using the centrifugal pump in neonatal ECMO are likely due to other factors. Proper cannula selection and positioning are important measures to reduce hemolysis by minimizing circuit pressure and maximizing venous return. Avoidance of inadvertently high rotor speed in the centrifugal pump is also recommended. PMID- 3675975 TI - Piezoelectric nerve guidance channels enhance peripheral nerve regeneration. PMID- 3675976 TI - The phrenic pacemaker. Substitution of paralyzed functions in tetraplegia. PMID- 3675977 TI - Autostatic endourethral prosthesis for long-term modeling-replacement of the male urethra. PMID- 3675979 TI - Human endothelial cell attachment receptors. PMID- 3675978 TI - Low density lipoprotein accumulation by PTFE grafts in the rabbit aorta. Autoradiographic-morphologic correlations. PMID- 3675980 TI - Erythrocyte and granulocyte interactions with endothelialized polymer surfaces. PMID- 3675981 TI - Visual evidence of concentration polarization in cross-flow membrane plasmapheresis. PMID- 3675982 TI - Accumulation of serum amyloid P and its deposition in the carpal tunnel region of long-term hemodialysis patients. PMID- 3675983 TI - Factors affecting morbidity and mortality during long-term short dialysis. PMID- 3675985 TI - Potential bacteriologic and endotoxin hazards associated with liquid bicarbonate concentrate. PMID- 3675984 TI - Long-term follow-up of patients on short-time dialysis. PMID- 3675986 TI - Technical requirements for rapid high-efficiency therapy in uremic patients. Paired filtration-dialysis (PFD) with a two-chamber technique. PMID- 3675987 TI - IgE antibodies to isocyanates in hemodialyzed patients. PMID- 3675988 TI - Conductivity measurements for analysis of transcellular fluid shifts during hemodialysis. PMID- 3675989 TI - Renal insufficiency and volume overload in neonatal ECMO managed by continuous ultrafiltration. PMID- 3675990 TI - Vented ECMO for biventricular failure. PMID- 3675991 TI - Degradation by gamma irradiation of regenerated cellulose membranes for clinical dialysis. PMID- 3675992 TI - Effect of polymeric albumin-IgG on blood-material interaction. PMID- 3675993 TI - Evaluation of nonthrombogenic polymers in a new rabbit A-A shunt model. PMID- 3675994 TI - Minimum heparin release rate for nonthrombogenicity. PMID- 3675995 TI - Plasma protein and gelatin surface interactions. Kinetics of protein adsorption. PMID- 3675996 TI - Development of a novel membrane apheresis system for plasma collection at mobile sites. PMID- 3675997 TI - Endothelial cell seeding of ULTI carbon-coated small-diameter PTFE vascular grafts. PMID- 3675998 TI - Effect of red blood cells on platelet adhesion and aggregation in low-stress shear flow. PMID- 3675999 TI - Initiation and growth of calcification in a polyurethane-coated blood pump. PMID- 3676000 TI - Nutritional assessment of continuous ambulatory peritoneal dialysis patients. AB - This study revealed the following. Malnutrition was frequent (41.6%) in patients on CAPD for less than three months and was present in 18.1% of patients on CAPD for longer than 3 months. Fifty percent of these malnourished patients returned to normal on conventional nutritional management within 2 to 6 months, but 10% remained malnourished throughout the study period. There was increased mortality among malnourished patients, but we were unable to demonstrate that the state of nutrition was an independent risk factor, because of the increased prevalence of other co-morbid risk factors known to influence survival and because of the limitation of a small sample size. The influence, if any, of nutritional state as an independent risk factor on the survival of CAPD patients should be answered, because malnutrition is potentially reversible with aggressive nutritional interventions, such as enteral, parenteral, or intraperitoneal supplementation. PMID- 3676001 TI - Treatment of iron overload in continuous ambulatory peritoneal dialysis patients. PMID- 3676003 TI - Predictors for weaning patients from ventricular assist devices (VADs). PMID- 3676002 TI - Peritoneal sclerosis. Role of plasticizers. PMID- 3676004 TI - Experimental model for LVAS evaluation under unphysiologic conditions. PMID- 3676005 TI - Intra-right-atrial balloon pumping (IRABP) during a Fontan procedure. PMID- 3676006 TI - Toward an implantable impeller total heart. PMID- 3676007 TI - Bisected diastolic driving to control combined clinical use of left ventricular assist device and intraaortic balloon pumping and its effect on renal function. PMID- 3676008 TI - Minimum power consumption of the electric ventricular assist device through the design of an optimal output controller. PMID- 3676009 TI - Direct mechanical ventricular assistance promotes salvage of ischemic myocardium. PMID- 3676010 TI - A clinical estimation model for noninvasive determination of atrial pressure in total artificial heart patients. PMID- 3676011 TI - Evaluation of thrombogenesis on smooth and rough intima in artificial ventricles. PMID- 3676012 TI - Immobilized desferrioxamine (DFO) for the extracorporeal removal of aluminum. PMID- 3676013 TI - Extracorporeal removal of iron with immobilized desferrioxamine. PMID- 3676014 TI - Ultra-short dialysis and internal physiologic resistance. PMID- 3676016 TI - Increased vancomycin elimination with continuous hemofiltration. PMID- 3676017 TI - Presidential address. Innovation and maturity. PMID- 3676015 TI - High-efficiency hemofiltration. PMID- 3676018 TI - Renal epithelial cells grown on semipermeable hollow fibers as a potential ultrafiltrate processor. PMID- 3676019 TI - Blood flow patterns in the human aorta studied by magnetic resonance. AB - Magnetic resonance velocity mapping by the field even echo rephasing sequence was used to provide two dimensional velocity profiles in the ascending and the descending aorta. Flow patterns were studied in ten healthy volunteers by a display method that gave clear details of the profiles. Velocity profiles in the ascending aorta were skewed in systole with an axis of skew roughly symmetrical about the plane of the aortic arch. During diastole flow was reversed along the posterior left wall of the ascending aorta while it continued forwards at the anterior right wall. In the descending aorta plug flow occurred but with minimal skew. Flow along the right wall was reversed during diastole. Turbulent flow did not occur in the ascending or descending aorta of any healthy subject. Magnetic resonance velocity mapping is a very powerful tool for the study of cardiovascular physiology. Its non-invasiveness, its quantitative two-dimensional data, its accuracy, and its high spatial resolution make it suitable for clinical use. PMID- 3676020 TI - Value of the resting 12 lead electrocardiogram and vectorcardiogram for locating the accessory pathway in patients with the Wolff-Parkinson-White syndrome. AB - The resting 12 lead electrocardiogram and vectocardiogram were reviewed in 47 patients with the Wolff-Parkinson-White syndrome (a) who had pre-excitation on the resting 12 lead electrocardiogram, (b) who had a single anterograde conducting accessory pathway assessed and located during preoperative electrophysiological study and during epicardial mapping at operation, and (c) in whom surgical division of the accessory pathway resulted in loss of pre excitation. The site of the accessory pathway established during operation was compared with that established by evaluating the polarity of the delta wave and QRS complex on the resting 12 lead electrocardiogram. The electrocardiogram was assessed by the Rosenbaum criteria (Wolff-Parkinson-White type A, left-sided pathway; or type B, right-sided pathway), the Gallagher criteria (atrial pacing resulting in maximal pre-excitation), and the World Health Organisation criteria (a composite of previous studies). The Gallagher and World Health Organisation criteria were derived from patients demonstrating maximal pre-excitation that often required atrial pacing. The present study was designed to determine whether these criteria could be accurately applied to the resting 12 lead electrocardiogram on which the degree of pre-excitation was variable. The Rosenbaum criteria correctly identified a left sided accessory pathway in 26 of 34 patients and a right-sided accessory pathway in nine of 13 patients. The Gallagher and World Health Organisation criteria correctly identified the location in only 15 (32%) of the 47 patients. The resting vectorcardiogram was inaccurate for locating the accessory pathway. Although published criteria are useful for identifying the site of the accessory pathway from an electrocardiogram obtained when rapid atrial pacing is being used to achieve maximal pre-excitation, they are not suitable for identifying the exact site of an accessory pathway from the resting 12 lead electrocardiogram. PMID- 3676021 TI - Left ventricular performance in alcoholic patients without chronic liver disease. AB - Left ventricular performance was studied non-invasively in 24 chronic alcoholics without liver disease. Twelve patients who had abstained from drinking for at least one month (group A) and 12 sex and age matched patients who had ceased drinking during the preceding 24 hours (group B) were studied at rest and during 50% submaximal exercise. Cardiac output and stroke volume were measured by first passage and left ventricular ejection fraction by multigated radionuclide cardiography. Twelve healthy sex and age matched controls were also studied. Haemodynamic variables were similar in group A and the controls, except that in group A left ventricular end systolic volume index did not decrease during exercise. In group B the heart rate was increased both at rest and during exercise and plasma noradrenaline concentrations were increased. The stroke volume index did not increase significantly during exercise in group B. In addition, the increase in left ventricular ejection fraction was smaller in group B than in controls. End systolic contraction was reduced in group B patients and diastolic blood pressure was increased. These results suggest that cardiac abnormalities in chronic alcoholics may be reversed after cessation of drinking if no chronic liver disease is present. Recent alcohol consumption increases sympathetic nervous activity, impairs cardiac contractility, and increases afterload during physical stress. PMID- 3676022 TI - The aetiology and course of isolated severe aortic regurgitation: a clinical, pathological, and echocardiographic study. AB - Seventy two consecutive patients with severe isolated aortic regurgitation were evaluated by preoperative echocardiographic and angiographic assessment of the aortic root. Biopsy specimens of the aortic wall were taken at operation. Two major groups of patients were found: those with cusp derangement but normal aortic roots and those with normal cusps but dilated aortic roots. Of the 42 cases of abnormal cusps, 20 were rheumatic, 15 were infective, and six were bicuspid. One patient had a tear in an otherwise normal cusp. Of the 30 cases of abnormal roots but normal cusps, six had inflammatory changes (syphilis, Reiter's disease, giant cell aortitis) and 24 had root dilatation caused by non inflammatory destruction of elastic laminae. Echocardiographic measurement of the aorta at the level of the top of the commissures predicted the findings at pathology. In 37 of 39 patients with cusp disease the measurement was less than 37 mm. In 27 of 33 patients with root disease the measurement was greater than or equal to 37 mm. This difference was statistically significant. There was no difference in the sizes of the prosthesis used in each group, suggesting that it was the diameter of the junction of the aorta with the sinuses rather than the junction of the sinuses with the ventricle that was important in aortic regurgitation. Clinical progression in patients with non-inflammatory aortic root disease is slower than in patients with infective disease but faster than in those with rheumatic cusp disease. PMID- 3676023 TI - Balloon dilatation of unoperated aortic coarctation: immediate results and one year follow up. AB - Fifteen patients aged 1-19 years (mean 10.9) with previously unoperated aortic coarctation underwent percutaneous balloon angioplasty between January 1985 and February 1986. Nine (60%) were hypertensive at presentation. Under general anaesthetic the systolic coarctation gradient was 24-50 mm Hg (mean 29) and the coarctation diameter was 4-9 mm (mean 5.5). Meditech balloon catheters 8-18 mm in diameter were inflated 1-4 times at 410-760 kPa. After dilatation the systolic coarctation gradient decreased to 0-20 mm Hg (mean 6) and the coarctation diameter increased to 7-20 mm (mean 12). One patient developed a fusiform aneurysm of the aorta at the coarctation site immediately after the procedure. At reinvestigation 6-16 months (mean 12.5) after dilatation 14 of the 15 patients were normotensive. In 13 patients the residual coarctation gradient was 0-10 mm Hg (mean 3). Two patients had recoarctation with residual gradients of 20 and 24 mm Hg and underwent successful repeat dilatation. One patient had developed a small discrete aneurysm at the coarctation site. Balloon angioplasty is thus a safe and effective method of relieving unoperated aortic coarctation. The frequency of aortic aneurysm and recoarctation is small and probably related to balloon size. This early experience is encouraging, but long term results and further experience are required before this approach is used to treat coarctation generally. PMID- 3676024 TI - Operative balloon dilatation for pulmonary atresia with intact ventricular septum. AB - In six infants with pulmonary atresia and intact ventricular septum operative balloon dilatation was used to achieve continuity between the right ventricle and the main pulmonary artery as the initial procedure. Two of the six subsequently needed an aortico pulmonary shunt. All six are alive and well. PMID- 3676025 TI - Anomalous left coronary artery from the pulmonary artery: a 15 year sample. AB - Eleven patients with anomalous left coronary artery arising from the pulmonary artery were identified from the beginning of 1970 to the end of 1985. The only male patient presented at the age of eight years for assessment of a murmur and was symptom free. The remainder presented in infancy with features of cardiac failure. The electrocardiogram was abnormal in all patients, the majority showing anterolateral ischaemia. Cross sectional echocardiography when available showed a dilated, poorly contracting left ventricle, and in two cases what appeared to be a "normal" origin of the left coronary artery. Aortography was performed in 10 patients and led to the correct diagnosis in eight. The diagnosis was made at necropsy in three infants. One patient has remained well without treatment. The anomalous left coronary artery was ligated in three of the earlier patients, including the asymptomatic boy. Two of these cases had concurrent saphenous vein graft to the anomalous left coronary artery. The four most recent cases were treated by successful direct reimplantation of the anomalous left coronary artery to the aorta when they first presented in infancy. They continue to improve symptomatically and show objective improvement of myocardial function. In this recent experience supports our policy of early surgical re-establishment of a two coronary system from the aorta. PMID- 3676026 TI - Prediction of outcome in dilated cardiomyopathy. AB - One hundred and sixty nine patients (mean age 39.1 years) with documented dilated cardiomyopathy were studied for a mean of 5.5 years One hundred and four patients died during this period. The average (SD) interval from the onset of symptoms to death was 4.1 (3.7) years. One year and five year mortality rates were 27.8% and 57.4% respectively. Most of the deaths occurred within two years of diagnosis. The only difference between survivors and those who died was in the severity of left ventricular dysfunction at the time of referral. Significant differences between survivors and non-survivors were found for left ventricular end diastolic pressure (17.3 versus 23.4 mm Hg), left ventricular end systolic volume (87.4 versus 128.9 ml/m2), left ventricular end diastolic volume (130.7 versus 173.2 ml/m2), and ejection fraction (32.8 versus 25.4%). The duration of previous symptoms, preceding virus infection, positive family history, recent pregnancy, or heavy alcohol intake did not seem to influence prognosis. Nor did treatment, which was similar in both groups with a quarter of the patients receiving vasodilators. Patients with dilated cardiomyopathy have a high mortality irrespective of treatment. The only identifiable prognostic indicator was the severity of left ventricular impairment at referral. PMID- 3676027 TI - Ebstein's anomaly of the tricuspid and mitral valves in an otherwise normal heart. AB - A case in which there was Ebstein's anomaly of both the tricuspid and mitral valve is described: the structure of the h eart was otherwise normal. PMID- 3676028 TI - "Late" manifestations of cardiovascular syphilis occurring in a young man. AB - A young man who presented with a short history of angina was found to have syphilitic coronary ostial stenosis six years after the primary infection. He was successfully treated with bilateral internal mammary grafts. PMID- 3676029 TI - Atrioventricular canal mimicking tricuspid atresia: echocardiographic and angiographic features. AB - In a rare case of common atrioventricular canal mimicking tricuspid atresia the clinical, radiographic, electrocardiographic, and M mode echocardiographic features were indistinguishable from those of classic tricuspid atresia. The cross sectional echocardiographic appearance and right atrial cineangiographic features were distinctive, however, and can be used to discriminate between this anomaly and other types of tricuspid atresia. PMID- 3676030 TI - Rapid growth of a left atrial myxoma shown by echocardiography. AB - Rapid growth of a left atrial myxoma was demonstrated in a patient who showed no echocardiographic evidence of the tumour when he was admitted for coronary artery bypass grafting. Eight months later he complained of dyspnoea and fatigue, and cross sectional echocardiography showed a 6 x 4 cm left atrial myxoma. This was removed and the diagnosis was confirmed by histological examination. PMID- 3676031 TI - Variant angina induced by biliary colic. AB - A 65 year old woman with gall stones presented with crushing chest pain after an attack of biliary colic. The electrocardiogram showed ST segment elevation in leads I, aVL, and V1-V3 while leads II, III, and aVF showed ST segment depression. Cardiac enzyme activity remained within the normal range. During the next three weeks attacks of epigastric and right hypochondrial pain preceded by crushing chest pain with identical electrocardiogram changes occurred with decreasing frequency. Coronary arteriography showed 60% obstruction of the left anterior descending coronary artery and good left ventricular function. During the next three years the patient complained both of mild abdominal pain, probably biliary colic, and mild effort related angina pectoris without a relation between the two symptoms. It is suggested that the attack of variant angina was triggered by biliary colic through sympathoadrenal discharge causing vasospasm. PMID- 3676032 TI - Reversibility of primary pulmonary hypertension during six years of treatment with oral diazoxide. PMID- 3676033 TI - Viral myocarditis and dilated cardiomyopathy in early childhood. PMID- 3676035 TI - Cardiac stroke volume during exercise measured by Doppler echocardiography: comparison with the thermodilution technique and evaluation of reproducibility. AB - Cardiac stroke volume was measured simultaneously by Doppler echocardiography and thermodilution in patients with severe coronary artery disease. One group (20 patients) was examined during supine exercise at 25 W and a second group (20 patients) during sitting exercise at 25 W and 50 W. In a third group (10 patients) the reproducibility of the non-invasive stroke volume estimate was determined during upright exercise. There was a considerable variation between results obtained with the invasive and non-invasive technique at rest and during exercise, but no systematic differences were found. Analysis of variance showed that no systematic differences between ultrasonic results were introduced by two observers or by measurements on different days. The coefficient of variation between any pairs of Doppler measurements in each patient was 6%. These findings demonstrate that the ultrasonic technique is suitable for detecting changes in stroke volume induced by low load exercise in patients with severe angina pectoris. PMID- 3676034 TI - Detection of exercise induced changes in left ventricular performance by Doppler echocardiography. AB - A study was performed to test the hypothesis that Doppler echocardiographic measurement of ascending aortic blood flow can detect exercise induced changes in left ventricular performance during exercise in patients suspected of having ischaemic heart disease. Acceleration and peak velocity of flow and stroke volume were determined by non-imaging Doppler echocardiography in the suprasternal notch in 38 patients as they underwent simultaneous exercise radionuclide ventriculography. The patients were divided into four groups: group 1 had resting ejection fractions greater than or equal to 50% and increased their ejection fractions greater than or equal to 5% during exercise; group 2 had resting ejection fractions of greater than or equal to 50% but the ejection fraction either fell or rose less than 5% during exercise; group 3 had resting ejection fractions less than 50% but the ejection fraction rose greater than or equal to 5% during exercise; and group 4 had resting ejection fractions less than 50% and the exercise ejection fraction either fell or rose less than 5% during exercise. Acceleration, velocity, and stroke volume all rose significantly during exercise in group 1. Acceleration also increased in group 2 but to a lesser extent; velocity and stroke volume did not increase. In group 3 acceleration and velocity increased but to a lesser extent than in group 1; stroke volume did not increase. In group 4 velocity increased slightly during exercise but acceleration and stroke volume were unchanged. Doppler echocardiography thus appears capable of detecting exercise induced changes in left ventricular performance and can identify normal and abnormal responses, as defined by radionuclide ventriculography. PMID- 3676036 TI - Continuous arteriovenous haemofiltration in children with postoperative cardiac failure. AB - Six children with refractory heart failure were treated by continuous arteriovenous haemofiltration. The cause of the failure was postoperative fluid overload or low cardiac output with anuria or oliguria. This produced a mean (2 SD) negative fluid balance of 1.4 (0.6) ml/kg/h and reduced mean (2 SD) body weight from 4.7 (2.2) to 4.2 (2.3) kg over a period of 57.5 (31.1) hours. Central venous pressure fell significantly from 13.7 (3.1) to 7.7 (0.7) mm Hg while the mean (2 SD) arterial pressure increased significantly from 44.6 (5.5) to 52.6 (5.1) mm Hg. In three infants urine production resumed when normal blood volume had been achieved. The other three infants needed further haemofiltration because of prolonged renal failure. All but one was weaned from artificial ventilation and catecholamine treatment. No adverse haemodynamic effects were noted. One child need operation for a femoral artery thrombosis after 12 days of continuous arteriovenous haemofiltration. PMID- 3676037 TI - A long term follow up of 15 patients with arrhythmogenic right ventricular dysplasia. AB - The clinical course in 15 patients with features consistent with arrhythmogenic right ventricular dysplasia is described. At referral seven patients had abnormal physical findings, nine had abnormal electrocardiograms with non-specific right sided abnormalities, and seven patients had increased heart size or prominent right ventricles on chest x ray. During long term follow up (mean 8.8 years, range 1.5 to 28 years) 11 patients had abnormal physical findings, 11 had electrocardiographic changes, and nine had increased heart size. Recurrent sustained right ventricular tachycardia was the most common arrhythmia (10 patients). Two patients experienced ventricular fibrillation. Seven patients suffered from over 10 episodes of ventricular tachycardia, nine required cardioversions, and 10 patients had associated serious symptoms such as syncope, severe hypotension, or cardiac arrest. Four patients required operation to correct the arrhythmia and three patients developed right heart failure. Two out of three deaths were sudden. These data suggest that in arrhythmogenic right ventricular dysplasia right ventricular abnormalities may be progressive and that the condition may affect the left ventricle. The course of the ventricular arrhythmias was highly variable and could not be predicted in individual patients. The potential for lethal ventricular arrhythmias is evident and warrants intensive diagnostic efforts to identify patients with adverse prognostic features. PMID- 3676038 TI - Induction of ventricular arrhythmias by programmed ventricular stimulation: a prospective study on the effects of stimulation current on arrhythmia induction. AB - A protocol for programmed ventricular stimulation is described in which the effect of increasing stimulation current on ventricular refractoriness and arrhythmia induction was specifically examined. The protocol was evaluated prospectively in 70 patients undergoing electrophysiological study for documented or suspected ventricular arrhythmias. Programmed electrical stimulation was performed at the right ventricular apex and outflow tract using single and double extrastimuli and burst pacing. Stimulation currents of 2, 5, 10, and 20 mA were used in ascending order. The initial (lowest) current was never less than twice diastolic threshold and was maintained during each stimulation run until refractoriness was reached. The current was then increased to the next level to facilitate premature capture until refractoriness was encountered at 20 mA or a sustained arrhythmia occurred. Ventricular arrhythmias were induced in 34 patients, 31 of whom had presented with a sustained ventricular arrhythmia. The incidence of induced arrhythmias was low in those patients who had presented with symptoms alone, a non-sustained arrhythmia, or a sustained arrhythmia in association with a predisposing clinical event. Only one patient with a negative result had further ventricular arrhythmias during the mean follow up period of 15 months. Although each increase in stimulation current caused a decrease in measured ventricular refractoriness, this resulted in only four arrhythmias. Only one arrhythmia was induced above 5 mA. These results suggest that this simple protocol using two extrastimuli and a single stimulation current of 5 mA will reliably identify most patients who have symptomatic ventricular arrhythmias. PMID- 3676039 TI - Correcting a block?: successful experience of a small British pacing centre. AB - The establishment of a local permanent pacemaker service in a district general hospital increased the pacemaker implantation rate from 22 per million population per year to 152 per million population per year over the first 6 years of the service. Forty eight per cent of patients were referred by general practitioners and 52% by hospital specialists. Single chamber demand pacing (VVI) was used exclusively. Indications for pacing and complications were comparable to those of specialist cardiac centres. Management of symptomatic bradycardia by cardiac pacing in the United Kingdom may be facilitated by further development of small pacing centres. PMID- 3676040 TI - Diltiazem treatment for the management of ischaemia in patients with poor left ventricular function: safety of long term administration. AB - The tendency of oral diltiazem (a calcium entry blocking agent and a negative inotrope) to induce or exacerbate congestive heart failure when used for the long term management of myocardial ischaemia in patients with poor left ventricular function has not been investigated before. Twenty two patients (aged 42-73 years) with pretreatment left ventricular ejection fraction ranging from 0.11 to 0.39 were given open label oral diltiazem (120-360 mg/24 h (mean 254 mg)) for two weeks to 16 months (mean 7.5 months, median 6.2 months). There was a weight change of greater than 3 lb (1.35 kg) in nine patients--five gained weight and four lost it. Diltiazem treatment did not alter the mean (SD) cardiothoracic ratio on chest x ray (0.47 (0.06) before vs 0.48 (0.05) after) or the left ventricular ejection fraction at rest (0.28 (0.09) before vs 0.26 (0.08) after). Diltiazem was discontinued in one patient because of symptoms indicative of worsening congestive heart failure. No patient required admission to hospital for treatment of symptoms resulting from further left ventricular decompensation. Diltiazem was discontinued in six other patients for other reasons. Long term administration of oral diltiazem was not regularly associated with a deterioration in clinical, radiographic, or radionuclide ventriculographic estimates of left ventricular function, even in patients with poor baseline left ventricular systolic performance. PMID- 3676041 TI - Conjoined twins, right atrial isomerism, and sequential segmental analysis. AB - Three cases of twins conjoined across the chest were examined. In one set, one twin showed right atrial isomerism and the other showed the usual atrial arrangement. The other two sets showed the usual atrial arrangement in both twins. The associated cardiac anomalies were diverse, ranging from atrioventricular septal defects to absent atrioventricular connections. Sequential segmental analysis was used successfully in each case to classify the complex cardiac anomalies. The first step was the recognition of the atrial arrangement. This was easily achieved despite the complexity of the intracardiac morphology. PMID- 3676042 TI - Severe pulmonary hypertension and multiple left coronary arterial fistulas in association with congenital hepatic fibrosis. AB - Multiple fistulous communications between the left anterior descending coronary artery and the left ventricle were found in a 55 year old woman with congenital hepatic fibrosis presenting with breathlessness. At cardiac catheterisation severe pulmonary hypertension was also found. In view of the persistent hypoprothrombinaemia, severe thrombocytopenia, and the multiple fistulas the risk of operation was thought to be unacceptable and she continues on medical treatment. PMID- 3676043 TI - Termination of focal atrial tachycardia by adenosine triphosphate. AB - An atrial aneurysm gave rise to incessant atrial tachycardia in a 21 year old Seychellian soldier. This arrhythmia was suppressed by intravenous adenosine triphosphate and ajmaline. Resection of the aneurysm abolished the arrhythmia and re-established sinus rhythm. PMID- 3676044 TI - Development of subaortic stenosis and regurgitation several years after successful operation on a common atrium. AB - A patient who had had successful operation for a common atrium subsequently developed subaortic stenosis and regurgitation several years later. The diagnosis of subaortic lesion was confirmed by echocardiography. This case shows that the left ventricular outflow tract gradient should be measured before operation for common atrium and that after operation such cases should be examined by cross sectional echocardiography at follow up visits. PMID- 3676045 TI - Mirror image arrangement of the abdominal organs with a left-sided morphologically normal heart. AB - A twenty year old man is described who has a left-sided liver, a single right sided spleen, an anomalous inferior vena cava with azygos continuation, and a morphologically normal left-sided heart. These findings emphasise the pitfalls in predicting cardiac abnormalities from other aberrations of anatomical situs. PMID- 3676046 TI - Cardiology in the district hospital. Report of a working group of the British Cardiac Society. PMID- 3676047 TI - Monitoring: bane or blessing? PMID- 3676048 TI - Antibody to halothane-induced liver antigen. PMID- 3676049 TI - Cerebral blood flow and metabolism during isoflurane-induced hypotension in patients subjected to surgery for cerebral aneurysms. AB - Cerebral blood flow and cerebral metabolic rate for oxygen were measured during isoflurane-induced hypotension in 10 patients subjected to craniotomy for clipping of a cerebral aneurysm. Flow and metabolism were measured 5-13 days after the subarachnoid haemorrhage by a modification of the classical Kety Schmidt technique using xenon-133 i.v. Anaesthesia was maintained with an inspired isoflurane concentration of 0.75% (plus 67% nitrous oxide in oxygen), during which CBF and CMRO2 were 34.3 +/- 2.1 ml/100 g min-1 and 2.32 +/- 0.16 ml/100 g min-1 at PaCO2 4.1 +/- 0.1 kPa (mean +/- SEM). Controlled hypotension to an average MAP of 50-55 mm Hg was induced by increasing the dose of isoflurane, and maintained at an inspired concentration of 2.2 +/- 0.2%. This resulted in a significant decrease in CMRO2 (to 1.73 +/- 0.16 ml/100 g min-1), while CBF was unchanged. After the clipping of the aneurysm the isoflurane concentration was reduced to 0.75%. There was a significant increase in CBF, although CMRO2 was unchanged, compared with pre-hypotensive values. These changes might offer protection to brain tissue during periods of induced hypotension. PMID- 3676050 TI - Cerebrovascular effects of isoflurane in man. Intracranial pressure and middle cerebral artery flow velocity. AB - Twelve hydrocephalic patients undergoing hydrodynamic studies and shunt procedures during general anaesthesia were subjected to short term observations of the cerebrovascular effects of isoflurane. Intraventricular pressure (IVP), arterial pressure (AP); cerebral perfusion pressure (CPP = AP-IVP), end-tidal PCO2, Cerebral Function Monitor (CFM) activity and middle cerebral artery (MCA) flow velocity were measured. Introduction of 1% isoflurane for a 10-min period did not cause significant changes in IVP or MCA flow velocity, but caused marked and significant reductions in arterial pressure and CPP, and increases in CFM activity. In five patients 2% isoflurane was administered for another 5 min before discontinuation of the isoflurane. This caused further significant reduction in arterial pressure and increased IVP in four of the five patients. The decrease in CPP was thus even greater than the reduction in arterial pressure and the CFM activity decreased in four out of five patients. The MCA flow velocity did not change significantly. PMID- 3676051 TI - Single breath induction of anaesthesia with isoflurane. AB - This study has compared a single breath induction technique and a conventional inhalation induction technique using isoflurane in nitrous oxide and oxygen. Each group consisted of 36 unpremedicated patients. Single breath induction was associated with fewer problems on induction, but required more patient co operation. Ninety-four percent of patients were willing to repeat the single breath induction technique, compared with 74% of patients receiving a conventional inhalation induction. PMID- 3676052 TI - Isoflurane in a circle system with low gas flow. AB - Isoflurane was administered from a Goldman vaporizer to a circle breathing system with low fresh gas flows. The uptake and vapour concentration of isoflurane were compared in two groups of spontaneously breathing patients receiving oxygen alone (n = 19), or nitrous oxide and oxygen (n = 30). Anaesthesia was maintained successfully in all patients. The authors believe this to be a safe and economical way of delivering isoflurane. PMID- 3676053 TI - Continuous i.v. infusion of labetalol for postoperative hypertension. Haemodynamic effects and plasma kinetics. AB - Labetalol is a combined alpha- and beta-adrenoreceptor blocking agent. A loading dose may be used to antagonize sympathetic overactivity rapidly after surgery and be followed by a continuous infusion to achieve a stable effect. The haemodynamic effects and pharmacokinetics of this method of labetalol administration were studied in six rewarmed, extubated and sedated patients 15 +/- 2 h after aortobifemoral bypass surgery. Patients were monitored with radial and thermistor tipped pulmonary artery catheters. Labetalol 1.5 mg kg-1 was injected i.v. over 5 min and a maintenance infusion of 0.2 mg kg-1 h-1 was started 30 min later and continued for 5.5 h. Within 5 min of the loading dose, i.v. labetalol induced significant (P less than 0.05) decreases in mean arterial pressure (-32 +/- 11%), in heart rate (-20 +/- 11%) and in cardiac index (-26 +/- 15%) that lasted throughout the infusion. Changes in systemic vascular resistance were not uniform, but an increase was not observed in any patient. Mean stroke volume index and ventricular filling pressures were not significantly affected by labetalol administration. The mean measured steady state plasma concentration (Css) (264 +/- 46 ng ml-1) was higher than predicted (170 ng ml-1) because the clearance (13.1 +/- 2.4 ml kg-1 min-1) was lower than that used to calculate the infusion rate. We conclude that labetalol is an effective antihypertensive agent in the postoperative period. A Css can be achieved rapidly by such i.v. administration and this offers the advantage of inducing rapid and stable haemodynamic effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676054 TI - High frequency jet ventilation: the influence of different methods of injection on respiratory parameters. AB - Fourteen critically ill patients with ventilatory failure were ventilated with HFJV using a constant driving pressure of 3 atm and a constant I:E ratio of 0.43. In six (group I) HFJV, using a frequency of 100 b.p.m., was delivered via a proximal injector cannula. Four injector cannulae (i.d. 1.8, 1.6, 1.4 and 1.2 mm, respectively) were used at random. In eight patients (group II), HFJV using three frequencies (100, 300 and 600 b.p.m.) was administered either via a 1.8-mm i.d. proximal injector cannula (proximal injection), for via a Hi-Lo jet tracheal tube (distal injection). The following indices were measured in vivo: mean airway pressure (Paw), mean pulmonary volume above apnoeic FRC (delta V), mean alveolar pressure (clamps method) and arterial blood-gas tensions. Injected volume (Vinj), entrainment (E) and tidal volume (VT) were measured in vitro using a water-sealed spirometer. Operating pressure (the pressure in the connecting tube) was measured directly using a high pressure calibrated transducer. In group I, Paw, delta V, PaO2, Vinj and VT significantly decreased whereas operating pressure and E significantly increased when the internal diameter of the injector cannula was reduced. In group II, Paw, delta V, E, VT and operating pressure significantly decreased, whereas Vinj increased and PaO2 and PaCO2 remained unchanged, when proximal injection was switched to distal injection. In both groups, a significant relationship was found between operating pressure and E. At a constant driving pressure, operating pressure increased with narrow injector cannulae and increased frequency, and decreased when proximal injection was switched for distal injection. PMID- 3676055 TI - Effects of extradural anaesthesia on human fetal blood flow in utero. Comparison of three local anaesthetic solutions. AB - Twenty-seven women, scheduled for elective Caesarean section under extradural anaesthesia were allocated randomly to one of three groups: group Ea received 1.5% etidocaine with adrenaline, group Bp 0.5% bupivacaine plain, and group Ba 0.5% bupivacaine with adrenaline. There was no difference in the quality and distribution of sensory blockade between the three groups. Motor blockade was most profound in group Ea. Maternal heart rate and arterial pressure were only slightly affected in the three groups. Before induction of extradural anaesthesia, and 15 and 30 min after, fetal umbilical and aortic blood flows were examined using a combination of real-time ultrasonography and the pulsed Doppler technique. Blood flow in the umbilical vein was not affected in any of the groups, and blood flow in the fetal aorta remained unchanged in groups Ea and Bp, but was increased by 12% after 30 min in group Ba. We conclude that, with the three local anaesthetic solutions studied during extradural anaesthesia for elective Caesarean section, fetal circulatory variables remained stable and within normal limits, when in association with normal values of maternal arterial pressure. PMID- 3676056 TI - Specific antibodies to halothane-induced liver antigens in halothane-associated hepatitis. AB - Antibodies to halothane-altered liver cell determinants (halothane antibodies) have previously been detected in serum of patients with fulminant hepatic failure after halothane anaesthesia. However, their diagnostic value has not been reported in patients with non-fulminant hepatitis. Sera from 39 patients who developed hepatitis following halothane anaesthesia between January 1983 and December 1985 were tested for antibodies to halothane-induced liver antigens using an ELISA; 22 of these patients had hepatitis without encephalopathy. Nineteen of the sera were from patients anaesthetized during 1985; four of the patients were aged 15 yr or less. All patients had undergone previous anaesthesia 17 days to 13 yr (median 3 yr) earlier. In 19 of the patients the final operation was a minor surgical procedure, lasting less than 45 min. In 13 patients a previous adverse reaction to halothane was documented in the case records. Twelve of the patients died. Halothane antibodies were detected in 12 of the 16 (75%) patients with hepatic encephalopathy and 16 of the 23 (70%) who did not develop encephalopathy, demonstrating that halothane antibodies are detectable in a wider spectrum of halothane-associated liver damage than previously appreciated. PMID- 3676057 TI - Reproductive and teratogenic effects of nitrous oxide, fentanyl and their combination in Sprague-Dawley rats. AB - The reproductive and teratogenic effects of 35% and 50% nitrous oxide, fentanyl 500 micrograms kg-1/day and their combinations were studied using a total of 419 timed-pregnant Sprague-Dawley rats. On day 7 of pregnancy, osmotic minipumps which delivered either fentanyl 500 micrograms kg-1/day or normal saline for 2 weeks were implanted subcutaneously in the back of the rats. Animals then were exposed to air, 35% nitrous oxide or 50% nitrous oxide for 24 h on day 9 of pregnancy. On day 21 of pregnancy, Caesarean sections were performed and all 2693 offspring were preserved and subsequently examined microscopically for external, visceral and skeletal abnormalities. There were no reproductive or teratogenic effects observed with 35% nitrous oxide, but adverse effects were observed with 50% nitrous oxide. The addition of fentanyl to the nitrous oxide increased the mortality rate among the rats, but did not significantly add to the adverse reproductive or teratogenic effects of nitrous oxide. PMID- 3676058 TI - Management of tracheomalacia in association with congenital tracheo-oesophageal fistula. AB - Tracheomalacia is commonly associated with oesophageal atresia and tracheo oesophageal fistula. Severe cases may present with life threatening cyanotic and apnoeic attacks following surgical repair of the oesophageal atresia. The anaesthetic, and surgical management (by tracheopexy), of such a case are described. PMID- 3676059 TI - Proceedings of the Anaesthetic Research Society. Glasgow meeting. June 26-27, 1987. Abstracts. PMID- 3676060 TI - Unconscious perception during general anaesthesia. PMID- 3676061 TI - Haemodynamic disturbances during anaesthesia in a patient receiving verapamil. PMID- 3676063 TI - The economic implications of the American Nurses Association proposal on entry into practice. PMID- 3676062 TI - Lessons from a patient. PMID- 3676064 TI - Bonding: a critical component for learning, performing, and staying. PMID- 3676065 TI - Gerontological nursing: forging new paths. PMID- 3676066 TI - Humanities for the health professional. PMID- 3676067 TI - Who's hiring the GNs? PMID- 3676069 TI - Improving blood flow following stroke. PMID- 3676068 TI - Immobility syndrome: use it or lose it! PMID- 3676070 TI - Trial of scar--is it safe in developing countries? PMID- 3676071 TI - The bacteriology of superficial sepsis. PMID- 3676072 TI - Computer generated information leaflets for surgical patients. PMID- 3676073 TI - Femoral hernia in children. PMID- 3676074 TI - Neonatal urinary ascites due to bladder perforation. PMID- 3676075 TI - Auto-immune thyroiditis and thyroid lymphoma arising in a patient with sarcoidosis. PMID- 3676076 TI - Vocalisations before and after cleft palate surgery: a pilot study. PMID- 3676077 TI - Stuttering children: investigation of a stereotype. PMID- 3676078 TI - Coexisting psychogenic and neurogenic dysphonia: a source of diagnostic confusion. PMID- 3676079 TI - Psychogenic voice disorder unresponsive to speech therapy: psychological characteristics and cognitive-behaviour therapy. PMID- 3676080 TI - IgG4 antibodies in patients with atopic dermatitis. AB - The role of IgG4 in atopic dermatitis was investigated by determining the total amounts of IgG4 and of IgG4 specific for ovalbumin (a food allergen), Dermatophagoides farinae mite antigen and house dust (inhalant allergens) and Candida. These were related to the amounts of total and antigen specific IgE in patients with atopic dermatitis and normal healthy controls. Most patients with atopic dermatitis had greater amounts of total IgG4 and of antigen-specific IgG4 than did normal control individuals. Patients who had received hyposensitization treatment injections had greater amounts of IgG4 than the atopic dermatitis patients not so treated. In patients treated by hyposensitization there was a large increase in the amount of blocking antibody detected by incubating the antigen with the serum overnight before injecting the mixture into the skin of a patient sensitive to the antigen. Blocking activity was also examined by partial inhibition by the serum of IgE-mediated mast cell degranulation and by injection of serum into the skin of sensitive patients before challenge with antigens. In all tests the blocking activity of the serum was related to the amount of antigen specific IgG4 but not related to total IgG4. In patients with atopic dermatitis who were sensitive to mite antigen, severe cases had small amounts of specific IgG4 and large amounts of specific IgE but in mild cases there was an opposite trend with relatively large amounts of specific IgG4. Large amounts of IgG4 ovalbumin specific antibody were found in children and adults with atopic dermatitis and egg allergy but small amounts of IgE. In infants most of the anti ovalbumin antibody was IgE with little or no IgG4. The work of others has confirmed that increased amounts of total and antigen-specific IgG4 occur in atopic dermatitis, and it is concluded that IgG4 is a blocking antibody for anaphylactic sensitization responses. PMID- 3676081 TI - Magnetic resonance imaging as a screening procedure for methotrexate induced liver damage. AB - Spin lattice relaxation time (TI) measured with a low field strength magnetic resonance imager in 51 patients with severe psoriasis did not correlate with the histological findings of liver biopsies taken during treatment with oral methotrexate. Liver TI measurement at low magnetic field is of no value as a screening procedure in monitoring methotrexate induced liver damage. PMID- 3676082 TI - Sensory loss following cryosurgery of skin lesions. AB - Sensory testing by means of a graded bristle technique was performed following cryosurgical treatment of 183 skin lesions in 169 patients. Mild, generally transient, sensory loss was found in 28% of the treated lesions. This sensory loss appeared not to be influenced by differences in the cryosurgical procedures nor by postoperative complications in wound healing, but was dependent on the area of the body where cryosurgery was performed. Treated lesions on the trunk and neck and on the arms and legs showed the most profound and longest lasting sensory loss. PMID- 3676083 TI - Therapy of basal cell carcinoma--treatment in 1980-81 compared with 1985-86 and advantages of shave excision for smaller tumours. AB - A survey of basal cell carcinoma treatments in two 12-month periods, 1980-81 and 1985-86, revealed that more tumours and an older age group of patients were presenting to the Lancaster dermatology department in the latter period. Whereas the most frequent surgical treatment in 1980-81 was curettage and cautery, shave excision and cautery was the treatment of choice in 1985-86. Shave excision is quick, easy to perform and gives good specimens for histological assessment. The method is suitable for smaller tumours but not for more difficult tumours or tumours in difficult sites. PMID- 3676084 TI - An outbreak of scabies in a residential home. AB - An outbreak of scabies in a residential home for the elderly is described, and the investigation and management of the problem discussed. Multiple cases of scabies in this type of community are almost invariably associated with the presence of an unrecognized case of crusted (Norwegian) scabies. Unless such an individual is recognized, attempts to eradicate the problem may prove unsuccessful. PMID- 3676085 TI - Sweat-gland necrosis after beta-adrenergic antagonist treatment in a patient with pheochromocytoma. AB - We describe the dermatological consequences of treatment with a beta-adrenergic antagonist, atenolol, in a patient with pheochromocytoma. There were acral skin lesions, histologically characterized by epidermal and sweat-gland necrosis. It is believed that the combined action of severe local ischaemia and profuse sweating produced these lesions, which resembled histologically the changes found in patients comatose as the result of carbon monoxide or drug poisoning. The importance of such lesions in diagnosis is discussed. PMID- 3676086 TI - Epidermal dysplasia and skeletal deformity in congenital poikiloderma (Rothmund Thomson syndrome). AB - Two sisters with congenital poikiloderma (Rothmund-Thomson syndrome) are described. One sister developed numerous keratotic lesions on the skin at an early age; these showed histological, ultrastructural and autoradiographic features of dysplastic change. The second sister had severe skeletal involvement in addition to the cutaneous poikiloderma, but no keratotic lesions. The clinical features of these cases demonstrate the variation in phenotypic expression of this disorder within a single family. PMID- 3676087 TI - High weekly intravenous doses of desferrioxamine in porphyria cutanea tarda. AB - Two elderly patients with sporadic porphyria cutanea tarda (PCT) and severe associated diseases were treated with high weekly intravenous doses of desferrioxamine. This therapy proved more effective than slow subcutaneous desferrioxamine infusion and no adverse effect was recorded. We consider high dose intravenous desferrioxamine a suitable treatment for those PCT patients with severe associated diseases who are unable to apply the technique of subcutaneous desferrioxamine infusion. PMID- 3676088 TI - Onychotillomania. PMID- 3676089 TI - NK cells in systemic sclerosis. PMID- 3676090 TI - Dithranol mediates pro-oxidative inhibition of polymorphonuclear leukocyte migration and lymphocyte proliferation. AB - Dithranol (0.01-1 micrograms/ml), but not the auto-oxidized form, caused a dose related enhancement of the generation of reactive oxidants by leukoattractant activated polymorphonuclear leukocytes (PMNL) in vitro. At the same concentrations dithranol inhibited both PMNL migration to leukoattractants and mitogen-stimulated mononuclear leukocyte (MNL) proliferation. Catalase (50-100 units/ml) protected both PMNL migration and MNL proliferation from dithranol whilst ascorbate and cysteine (1 mM), which maintain dithranol in the biologically active reduced state, potentiated the inhibition. To establish the molecular mechanism of the pro-oxidative activity of dithranol its effects on cytosolic protein kinase C (PKC) activity were investigated. Dithranol caused a dose-related activation of PKC by apparent substitution for 1,2-diolein. These results demonstrate that dithranol, but not its auto-oxidation products, activates PKC which in turn initiates the generation of reactive oxidants by PMNL. Since reactive oxidants are immunosuppressive the therapeutic mechanisms of dithranol may be related to pro-oxidative interactions of this agent with skin phagocytes. PMID- 3676091 TI - Type I and III collagen content and fibre distribution in normal human skin during ageing. AB - The content of type I and III collagen in normal human skin from subjects of different ages was studied by means of a new high performance liquid chromatography method and by SDS-polyacrylamide gel electrophoresis and scanning electron microscopy. The ratio of types I and III collagen in covered skin remained constant throughout childhood and young adult life and the proportion of type III was shown to be the same as previously reported. However, in the elderly, the proportion of type III collagen in the dermis increased to a variable degree. Scanning electron microscopic examination showed a decrease in the number of collagen fibre bundles with age. Average bundle width varied significantly with age. These results may reflect an impaired synthesis of type I collagen in aged skin. PMID- 3676092 TI - Scheduled and unscheduled DNA synthesis in epidermal cells of hairless mice treated with immunosuppressive drugs and UVB-UVA irradiation. AB - The effects of the immunosuppressive drugs azathioprine, prednisolone and cyclosporin A, and UV irradiation on scheduled DNA synthesis, representing mitotic activity, and unscheduled DNA synthesis, representing DNA repair activity, in the skin of hairless mice were determined autoradiographically following intradermal administration of [3H]-thymidine. Azathioprine and prednisolone, and, to a lesser extent, cyclosporin A, were found to impair normal repair of UVR-induced DNA lesions in epidermal keratinocytes. Prednisolone, but not the other two drugs, further suppressed the normal delayed mitotic response in the skin following UVR. The depressive effects of these drugs, particularly the combined azathioprine/prednisolone regime, on scheduled and unscheduled DNA synthesis are considered likely to predispose skin to mutagenic and carcinogenic processes. PMID- 3676093 TI - The risk of malignant melanoma, internal malignancy and mortality in xeroderma pigmentosum patients. AB - Mortality and malignancy were studied in a series of 32 patients with xeroderma pigmentosum presenting during the period 1950-84. Twenty-nine of the patients were followed to the end of 1984 using the National Health Service Central Register, and hospital case records and correspondence with referring physicians; three patients had incomplete follow-up. Three of the patients developed malignant melanoma during follow-up, but none developed internal malignancy. Two males and one female died [standardized mortality ratio (SMR) = 971, P less than 0.05, for males; SMR = 1931, not significant, for females]. All three deaths were from non-malignant causes: severe neurological involvement with terminal infection. This high mortality from neurological complications in xeroderma pigmentosum patients contrasts with previously reported mortality, particularly from actinic-induced cutaneous tumours. PMID- 3676094 TI - Involucrin expression in keratinization disorders of the skin--a preliminary study. AB - We have studied the expression of involucrin in a variety of keratinization disorders, mostly of genetic origin using an avidin-biotin-peroxidase technique. In normal human epidermis 25% of the living epidermis was labelled. The diseases studied fell into two groups. Diseases with greatly increased involucrin staining including collodion baby (38%), Darier's disease (49%), Flegel's disease (56%), erythrokeratoderma variabilis (60%), epidermal naevus with epidermolytic hyperkeratosis (45%) and congenital bullous (58%) and non-bullous (44%) ichythyosiform erythroderma; and diseases with normal or slightly increased staining, including ichthyosis vulgaris (27%), X-linked ichthyosis (25%), confluent and reticulate papillomatosis (27%) and simple epidermal naevus (28%). These results demonstrate that involucrin expression is altered in some keratinization disorders and suggest that in such conditions cellular functions other than keratin metabolism are also affected. PMID- 3676095 TI - Reticulate hyperpigmentation distributed in a zosteriform fashion: a new clinical type of hyperpigmentation. AB - We have recently seen two cases of hyperpigmentation in children, which was reticulate and distributed in a zosteriform fashion. As another two cases of hyperpigmentation of this kind in children have been reported previously, described as reticulate hyperpigmentation distributed in a zosteriform fashion, this gives a total of four cases of hyperpigmentation of this kind reported recently from Japan. These four cases differed from progressive cribriform and zosteriform hyperpigmentation, the condition which these cases resembled most closely, with respect to the age of onset of the hyperpigmentation, which in the four Japanese cases was not confined to a dermatome. Like a variant of incontinentia pigmenti (IP), all four cases showed eosinophilia. But they differed from IP in that there was no inflammatory stage, no pigmentary incontinence detectable on histology, and no evidence that the condition was hereditary. These four cases do not conform completely to any described entities and we suggest that they represent a new clinical entity. PMID- 3676096 TI - Genital and extragenital lichen sclerosus et atrophicus in a male patient with hepatosis and anti-mitochondrial antibodies. PMID- 3676097 TI - Harlequin baby: inheritance and prognosis. PMID- 3676098 TI - Topically active vitamin D3 analogue, 1 alpha,24-dihydroxy-cholecalciferol, has an anti-proliferative effect on the epidermis of guinea pig skin. PMID- 3676099 TI - Selective perturbation of epidermal cell membranes in human acute contact dermatitis. PMID- 3676100 TI - Erythema multiforme in a mother and daughter after M. pneumoniae infection; a coincidence? PMID- 3676101 TI - Cloning of human erythroid progenitors (BFU-E) in the absence of fetal bovine serum. AB - We describe culture conditions which enabled us to clone early human erythroid progenitors (BFU-E) in the absence of fetal bovine serum (FBS). Our medium, which is chemically fully defined, supports proliferation and differentiation of erythroid progenitors comparable to that in FBS-supplemented cultures. Furthermore, it allows cloning of BFU-E from all human haemopoietic tissues (adult marrow, embryonic liver and yolk sac) and adult or perinatal blood. This system should facilitate the investigation of human erythroid differentiation in vitro (e.g. cell-cell interaction, mechanism of action of haemopoietins and inhibitors, regulation of Hb synthesis) as well as the mechanisms underlying myeloproliferative disorders. As an example, we have found that recombinant Ep shows, in this culture system, the same dose response as Ep from conventional sources. PMID- 3676102 TI - Myelodysplastic syndromes: evolution of overt leukaemia by one or several steps of transformation. AB - The evolution of leukaemia was studied prospectively in 29 patients with myelodysplastic syndrome (MDS) followed for 2-6 years by sequential blast counts, cell kinetics derived from quantitative 14C-autoradiography and karyotype analysis. Overt leukaemia developed in seven patients. Two distinct patterns of leukaemic evolution were identified. The first was characterized by a gradual increase in blast cell count and in the frequency of labelled blasts, and a corresponding reduction in myeloid maturation index indicating increased intracompartmental myeloblast divisions and premature myeloid cell death. A second pattern of leukaemic evolution was marked by a sudden rise in the blast cell population in a previously stable MDS. This rise was attributed both to an increased rate of blast proliferation, and the accumulation of non-proliferating blasts. In an additional patient with smouldering ANLL and multiple karyotype abnormalities, transient clinical remission took place following prednisone and oxymetholone therapy, characterized by a sideroblastic morphology, normal karyotype, and persistence of a highly abnormal myeloid maturation index. The sudden emergence of overt leukaemia in previously stable MDS in some of our patients and the temporary reversal of overt leukaemia into sideroblastic anaemia in one case, lend support to the notion of leukaemic evolution by several steps of transformation. On the other hand, the gradual transition of MDS into overt leukaemia in other patients is compatible with a single step leukaemia transformation, although the possibility of clonal disease prior to the development of MDS cannot be excluded with certainty. PMID- 3676103 TI - Mechanisms and prognostic value of cell kinetics in the myelodysplastic syndromes. AB - Cell kinetics were studied by quantitative autoradiography in 29 patients with myelodysplastic syndromes (MDS) and in four with smouldering leukaemia (SML) in a prospective 6-year study. Cellular turnover in all FAB groups was characterized by reduced labelling index and prolonged DNA synthesis time indicating reduced proliferative activity. Two more parameters were derived from the measurements. (1) The relative cell production rate, which is increased in proerythroblasts and myeloblasts in most cases. This could be attributed to an increased number of divisions in early recognizable precursors in the absence of maturation, and (or) an increased influx from the progenitor compartments. (2) The maturation index of a cell lineage was determined by the ratio of relative cell production rate increase from the first to the last proliferative compartment over the corresponding normal value. It showed a high degree of abnormality in all FAB subgroups, indicating premature cell death in the bone marrow. None of the kinetic parameters proved to be of value in predicting the evolution of leukaemia. In contrast, an excellent correlation was found between the myeloid maturation index and survival (P less than 0.0001). No correlation, however, was found between survival and the erythroid maturation index, which was relatively normal in the worst prognostic group. These findings indicate that although in vitro cell kinetic studies can not predict the evolution of overt leukaemia, the myeloid maturation index is a useful predictor of survival in patients with MDS and SML. PMID- 3676104 TI - Platelets in idiopathic thrombocytopenic purpura are increased in size but are of normal density. AB - To determine whether platelet size and volume are related to one another or to platelet age, subpopulations of platelets from patients with idiopathic thrombocytopenic purpura (ITP) have been produced on the basis of density using Percoll gradients. The density distribution of platelets from patients with ITP and from patients with other forms of thrombocytopenia (thought to be nonimmune in nature) was the same as in normal controls. However, the platelets in each density subpopulation from ITP patients were increased in size. beta thromboglobulin (beta TG) content of platelets from each patient group and the normals increased with density and tended to be higher in ITP than in normal controls. beta TG concentration per unit platelet volume and its level in plasma were similar in ITP patients and in normal controls. This suggests that the apparently normal density of ITP platelets was not a result of degranulation of large, dense platelets. Thus platelet size and density are independently determined and the increased size of platelets in immune thrombocytopenia may be the result of abnormalities in their production. PMID- 3676105 TI - Splenic platelet-sequestration following routine blood transfusion is reduced by filtered/washed blood products. AB - The mean fall in the platelet count following 23 routine transfusions of 3-5 units packed cells for anaemia was 32.5%. This was significantly reduced to 12.5% in 15 similar transfusions through a 40 microns microaggregate filter (P less than 0.01) and to 4.6% following five transfusions through a polyester fibre filter (P less than 0.005). In 10 transfusions with frozen or polyester fibre filtered, washed red cells, the decrease in platelet count was 4.2% (P less than 0.001). A study of 111In-oxine labelled autologous platelets in nine patients indicated that the fall in platelet count was due to increased splenic sequestration. Since thrombocytopenia following routine transfusion is reduced by procedures which filter the packed cells, the decrease in platelets is probably caused by their adherence to infused microaggregate debris causing their premature removal from the circulation. Patients with preexisting thrombocytopenia who receive red cell transfusions for anaemia, should therefore receive blood products depleted of microaggregate debris in order to avoid exacerbation of thrombocytopenia and haemorrhagic complications. PMID- 3676107 TI - The effect of an adrenaline infusion on the splenic blood flow and intrasplenic platelet kinetics. AB - The effect of an adrenaline infusion on the venous platelet count, splenic blood flow and intrasplenic platelet kinetics was investigated in seven healthy male volunteers by using 111In-labelled platelets and dynamic gamma camera scintigraphy. The infusions were administered in two different doses, 0.2 microgram/kg/min and 0.1 microgram/kg/min, respectively. Regardless of the given dose, adrenaline was found to markedly decrease the splenic blood flow, decrease the exchangeable splenic platelet pool size and to prolong the intrasplenic platelet transit time. In response to the higher dose of adrenaline the splenic blood flow was 1.3 +/- 0.5 (SD) % of total blood volume per min and the intrasplenic platelet transit time 17.3 +/- 2.3 (SD) min. In contrast, after termination of infusion, the splenic blood flow was 7.0 +/- 2.1 (SD) % of total blood volume per min and the intrasplenic platelet transit time was 11.5 +/- 1.5 (SD) min. The present results firmly demonstrate that the splenic blood flow is the immediate variable governing the size of the exchangeable splenic platelet pool, and that the adrenaline-induced depletion of the splenic platelet pool is a consequence of the splenic blood flow reduction. Finally, the splenic perfusion appears to be a major determinant of the intrasplenic platelet transit time. PMID- 3676106 TI - Splenic blood flow and intrasplenic platelet kinetics in relation to spleen volume. AB - The relationship between the splenic blood flow and the intrasplenic platelet kinetics on the one hand, i.e. the two factors which govern the size of the exchangeable splenic platelet pool, and the spleen size on the other were assessed in 21 patients afflicted with haematologic disorders and variable splenomegaly. The splenic blood flow and intrasplenic platelet kinetics were measured using 111In-labelled platelets and compartmental analysis of their equilibration between circulating blood and splenic pool; the spleen size was determined by scintigraphy using 99mTc-labelled stannous colloid. Significant correlations were recorded between the spleen size and the splenic platelet pool size (r = 0.76; P less than 0.001) and between the spleen size and the splenic blood flow (r = 0.56; P less than 0.01). Splenic perfusion decreased significantly with increasing spleen size, but there was no relationship between the spleen size and the intrasplenic platelet transit time. However, an association was present between splenic perfusion and intrasplenic platelet transit time (r = -0.44; P less than 0.05). It is concluded that the splenic blood flow is the major determinant of the size of the exchangeable splenic platelet pool in splenomegalic states, and that the determination of spleen size using 99mTc-scintigraphy gives a rough estimation of the pool size. Splenic perfusion appears to be one of the factors which determine the intrasplenic platelet transit time. PMID- 3676108 TI - Quinine- and quinidine platelet antibodies can react with GPIIb/IIIa. AB - Quinine- and quinidine-dependent antiplatelet antibodies are generally believed to bind to the membrane glycoprotein complex, GPIb/IX. However, we and others have found that some drug-dependent antibodies bind to platelets from patients with the Bernard-Soulier syndrome which lack these glycoproteins. We therefore studied the reactions of a group of these antibodies with normal and Bernard Soulier platelets and their membrane proteins. As indicated by rosette formation of the sensitized platelets around protein A-Sepharose beads, two quinine- and two quinidine-dependent antibodies reacted with both normal and Bernard-Soulier syndrome platelets at a high (300 microM) concentration of drug. At a pharmacologic drug concentration (10 microM), all four antibodies reacted with normal platelets but only the two quinine-induced antibodies reacted with Bernard Soulier platelets. Immunoprecipitation studies with solubilized, tritium-labelled normal platelets, at both high and low drug concentrations, showed that each of the four antibodies precipitated proteins corresponding to GPIb and GPIX. Fainter bands corresponding to glycoproteins IIb and IIIa, which do not label well with tritium, were also detected. With radioiodinated normal platelets, it was found that each of the four antibodies was capable of precipitating GPIIb/IIIa, but only in the presence of drug. The four antibodies also promoted drug-dependent precipitation of GPIIb and GPIIIa from lysates of radioiodinated Bernard-Soulier platelets. The two quinine-dependent antibodies precipitated these glycoproteins at both high and low drug concentrations, while the quinidine-dependent antibodies reacted much more strongly at the higher drug concentration. Precipitation of GPIb/IX was not observed with BSS platelets. Absorption of a quinine-induced antibody with Bernard-Soulier platelets in the presence of drug eliminated its ability to precipitate GPIIb and GPIIIa. However, the absorbed antibody retained the ability to precipitate GPIb from solubilized normal platelets. Thus, at least two drug-dependent antibodies were present, one specific for GPIb/IX and the other for GPIIb/IIIa. These findings indicate that glycoproteins IIb and/or IIIa, in addition to the GPIb/IX complex, can serve as targets for drug-dependent antibodies in both intact and detergent-solubilized platelet preparations. PMID- 3676109 TI - A new unstable haemoglobin variant: Hb Shanghai [beta 131(H9)Gln----Pro] found in China. AB - A 34-year-old woman patient was found to have a chronic hereditary haemolytic anaemia. No abnormal haemoglobin band was detected by conventional electrophoresis, but a slow beta chain could be separated on urea-carboxymethyl cellulose chromatography. Investigations of the patient's haemoglobin revealed an unstable component. Analyses of chemical structure, including isolation and TPCK trypsin digestion of the abnormal globin chain. HPL chromatography, amino acid composition as well as sequence determination of the abnormal peptide, indicated that a glutamine was replaced by a proline at position beta 131 (H9). Biosynthesis studies demonstrated a normal rate of synthesis but relatively fast degradation of the mutant beta chain. The new variant is named as Hb Shanghai according to the place where it was discovered. PMID- 3676110 TI - Molecular characterization of a normal Hb A2 beta-thalassaemia determinant in a Sardinian family. AB - In this study we have carried out haplotype analysis at the beta-globin gene cluster and defined the beta-thalassaemia mutations in a large Sardinian family, ascertained through a proband with thalassaemia major, in which several members were carriers of a beta-thalassaemia allele characterized by microcytosis, hypochromia and normal Hb A2 levels (type 2 normal Hb A2 heterozygous beta thalassemia). The proband was a compound heterozygote for the beta zero 39 and the beta + IVS-2, nt 745 mutations and all the beta-thalassaemia heterozygotes with normal Hb A2 showed the beta + IVS-2, nt 745 mutation, always associated with haplotype VII. Because of the consistent association of a specific beta thalassaemia mutation and normal Hb A2 levels, we postulate that this beta thalassaemia chromosome carries a delta gene (delta-thalassaemia) which is unable to increase the delta-globin output in response to beta-thalassaemia. PMID- 3676111 TI - Interpretation of red cell survival data for in vivo compatibility testing: a normal value study. AB - Short-term survival studies are sometimes required to determine the compatibility of donor red cells. The results of these studies are generally expressed as per cent survival at 60 min. The present study was undertaken to investigate the potential for more sophisticated data analytical techniques to improve sensitivity. In one group of eight healthy male volunteers, autologous red cells were labelled with 51chromium and injected immediately, while in a second group, red cells were stored for 5 d prior to injection. In both groups, eight to 10 samples were collected in the first 6 h and another 10-12 samples over the next 4 weeks. Estimation of the 60 min per cent survival was insufficiently sensitive to detect 'physiological' haemolysis following injection of 5-d-old autologous blood. Regression analysis of 6 h survival data, however, demonstrated significantly higher red cell clearance rates in these cases than in those receiving fresh cells, with a mean 24 h loss of 3.3% of activity. The upper limit for the 6 h red cell clearance rate was 1.63%/h after fresh autologous blood and 2.43%/h after 5-d-old blood. The significance of these findings is discussed and a protocol suggested for the analysis of short-term red cell survival data. PMID- 3676112 TI - Erythropoiesis and anaemia in heterozygous beta-thalassaemia. PMID- 3676113 TI - Ring neutrophils in megaloblastic anaemia. PMID- 3676114 TI - Room temperature hyperaggregation of human blood platelets. PMID- 3676115 TI - Differentiation of leukaemic myeloblasts. PMID- 3676116 TI - Ectopic production of calcitonin and hypocalcaemia in acute leukaemia. PMID- 3676117 TI - Feasibility of route extrapolation in risk assessment. PMID- 3676118 TI - Inorganic particulates in pneumoconiotic lungs of hard metal grinders. AB - Data from the analysis of lung dust in 16 metal grinders who had been exposed to hard metals between five and 44 years is reported. The mean latent time between the first exposure and analysis in biopsy or necropsy specimens was 33.6 years. Mineralogical and elementary analysis by a variety of techniques showed small or trace amounts of hard metal in all lungs. Many specimens, however, did not contain all hard metal components, cobalt, for example, being detected in four cases only. All the lungs contained quartz and silicates and in most of the necropsy cases carborundum and corundum could also be shown. Histologically no specific pattern was found. The appearances included mixed dust nodular pneumoconiosis, diffuse interstitial lung fibrosis, and foreign body and sarcoid like granulomatous changes. In view of the mixed dust exposure of the hard metal grinders and the variable histological appearance we think that the term "mixed dust pneumoconiosis in hard metal grinders" is more appropriate than "hard metal lung" to describe this condition. PMID- 3676119 TI - Exposure to respirable coalmine dust and incidence of progressive massive fibrosis. AB - Data gathered since 1953 concerning more than 30,000 coalminers while employed at 24 collieries in England, Scotland, and Wales have been used to study the incidence of progressive massive fibrosis (PMF) in working coalminers. Results refer to 52,264 approximately five year intervals when the miners were at risk of an attack of PMF. One objective of the present study was to describe how the five year attack rate of PMF was related to miners' age, colliery, and simple pneumoconiosis category at the start of the periods at risk. The main objective was to estimate the relation between exposure to dust and incidence of PMF and to examine how this relation changes in the presence of coalworkers' simple pneumoconiosis (CWSP). Film readings, in some cases based on clinical assessments only, showed 462 attacks of PMF over the five year risk periods. The men concerned had experienced higher cumulative exposures to dust than their colleagues of similar age at the same collieries, a result found at 65 of the 68 age colliery groups where an attack had occurred. The association was highly significant statistically. Simple pneumoconiosis clearly predisposed to PMF, with five year attack rates of 13.9%, 12.5%, 4.4%, and 0.2% among men with categories 3, 2, 1, and 0 respectively at the start of the risk periods. Once simple pneumoconiosis category 1 or more had been attained, those with higher cumulative exposure to dust were not at greater risk of an attack of PMF than other men with the same CWSP category. Among most miners, those with category 0, however, the risks of an attack of PMF increased clearly with exposure. Risks of an attack were higher among older men irrespective of CWSP category. In addition, there were large colliery specific variations in incidence related to variations in the carbon content of the coal though not fully explained by them. It is concluded that cumulative exposure to respirable dust is the decisive central factor in the development of PMF. Its effect is primarily in causing simple pneumoconiosis category 1 or higher which predisposes to PMF, though the dust related incidence among men with category 0 is not negligible in view of the large numbers at risk. Continuation of the policy to minimise dust concentrations underground therefore seems the only secure strategy to limit, and eventually eliminate, PMF. PMID- 3676121 TI - Possibility of inducing glandular stomach cancer in rats exposed to asbestos. AB - The possibility of glandular stomach cancer being induced was studied in 75 random bred white rats exposed to chrysotile asbestos. A perforated polyethylene capsule containing 100 mg asbestos and filler (beef fat and natural wax mixture 1:1) was introduced in an artificial bag placed on the greater curvature of the stomach. A capsule containing filler only was introduced in a similar way in 40 control rats. In the following 25 months, 18 tumors of the stomach and abdominal cavity were found in the rats treated with asbestos (eight adenomas, two adenocarcinomas, one carcinosarcoma, one forestomach cancer, one intestinal adenocarcinoma, two peritoneal mesotheliomas, and three abdominal lymphoreticulosarcomas.) Among the control rats no such tumors were found. The results of the experiment are discussed in connection with epidemiological data on stomach cancer in asbestos workers. PMID- 3676120 TI - Development, radiological zone patterns, and importance of diffuse pleural thickening in relation to occupational exposure to asbestos. AB - The radiographic appearance of the lateral pleura was divided into an upper, a middle, and a lower zone. Bilateral changes of the pulmonary layer of the pleura (diffuse pleural thickening) within the upper pleural zones were found in 863 (71%) of 1204 workers exposed to asbestos and in 249 (40%) of 622 non-exposed controls. Downwards along the chest wall this ratio of 7:4 increased progressively up to 10:1 at the lower parts of the pleura. Bilateral diffuse pleural thickening in at least two adjacent zones on each side was found in 652 (54%) of exposed and in only 86 (14%) of unexposed subjects. The difference was even more striking when comparing bilateral involvement of all three zones (28% and 3% respectively). Unilateral change was rare (4.8% and 7.8% respectively) and often due to causes other than exposure to asbestos. Pleural findings were the earliest radiographic features detectable associated with former exposure to asbestos. Bilateral diffuse thickening in at least two adjacent zones on each side seems to be a striking feature and an early indication of former occupational asbestos damage. Modifications of the International Labour Organisation 1980 classification are proposed. PMID- 3676122 TI - Surface character and membranolytic activity of rutile and anatase: two titanium dioxide polymorphs. AB - Biological studies of two titanium dioxide polymorphs, rutile and anatase, have produced conflicting results. Generally, the in vivo and in vitro methods used to evaluate pneumoconiotic dusts have shown the polymorphs to be inert, but occasionally both minerals have been reported to produce effects consistent with biologically active minerals. Many of these reports failed to specify which polymorph was used experimentally. While this limited the value of the data, the problem was further compounded by the variation in the surface properties of each polymorph depending on whether the specimen was a naturally occurring mineral or was made synthetically. Five naturally occurring and 11 synthetically produced titanium dioxide specimens were studied. The physical characterisation of each specimen entailed the determination of the polymorph type(s) by continuous scan x ray diffraction and the size distribution by transmission electron microscopy. The ability of each specimen to lyse erythrocytes was determined and compared with quartz. Only two, both synthetic rutiles, were found to be active. The hydrogen bonding ability of the surfaces of these rutiles were compared with inert rutile and quartz. The binding properties of the active rutile have been found to be consistent with those properties associated with biologically active quartz. The surface properties of rutile are the determinants of its activity. Because natural and synthetic rutiles possess different surface properties, they display different activities. PMID- 3676123 TI - Calculating expected deaths: a comparison of two methods. AB - A comparison is presented between the traditional "person-years" and more recently described "prospective model" methods for calculating mortality expectations. Problems arising from the fact that expectations under the person years method are calculated on the basis that a null hypothesis is true, which results in artificial figures that, at least theoretically, are meaningless if the hypothesis is rejected, are discussed. Data are presented from two studies in which expectations have been calculated both ways, showing important differences between the two methods with an exaggeration of the expectation when the study group has an above normal mortality experience. It is suggested that the person years methodology should be replaced by that of the prospective model. PMID- 3676124 TI - Exposure to vinyl chloride monomer: report on a cohort study. AB - In 1980 a prospective exposed/non-exposed cohort study was initiated in France by the Institut National de la Sante et de la Recherche Medicale (INSERM U 287) to evaluate the association between mortality and cancer morbidity and occupational exposure to vinyl chloride monomer (VCM). Eleven hundred VCM exposed subjects and 1100 VCM non-exposed controls matched for age (+/- 2 years), plant, and physician were included and followed up over a five year period for vital, health, and occupational status. The percentages of deaths observed among the exposed (1.8%) and non-exposed subjects (1.6%) did not differ. Eighteen (1.6%) and 15 (1.4%) cases of cancer were reported among exposed and non-exposed subjects, respectively (NS). One case of angiosarcoma of the liver occurred among the exposed group; six cases of lung cancer occurred among exposed subjects and two among non-exposed subjects (NS). The percentage of diseases of the circulatory system was higher (p less than 0.02) in the exposed group than in the non-exposed group: this difference was explained mainly by the high incidence of Raynaud's disease (p less than 0.006). The percentages of diseases of the respiratory system did not differ between the two groups. PMID- 3676125 TI - Update on lung disease in coal miners. PMID- 3676126 TI - Incidence of cancer among vinylchloride and polyvinylchloride workers: further evidence for an association with malignant melanoma. PMID- 3676127 TI - Pulmonary fibrosis in asbestos insulation workers with lung cancer. PMID- 3676128 TI - King Lear and some anxieties of old age. AB - The experience of ageing and the resulting emotional difficulties of elderly patients have only recently begun to be understood from a psychodynamic perspective. This paper draws on two sources, literary (Shakespeare's King Lear) and clinical (consultations with elderly patients in primary care) to highlight a fundamental anxiety of old age: the dread of being abandoned to a state of utter helplessness. This state is felt to be caused by the catastrophes of old age, such as stroke and dementia. The defence against this anxiety is often a narcissistic tyranny. PMID- 3676129 TI - Rhetoric as remedy: some philosophical antecedents of psychotherapeutic ethics. AB - Earliest forms of psychotherapy were based on noble rhetoric and a model of the human encounter regulated by values of virtue and courage (responsible autonomy). In this paper the relationship between noble and base rhetoric and values is considered and applied to the psychotherapeutic setting. Buhler's and Popper's hierarchy of language and values is extended so that the language of expression, communication, description, advice, argument, and promises may be related to noble and base values which, it is argued, therapists and clients invoke to define and condition the therapeutic relationship. An ethical hierarchy of language and values, based on the principle of responsible autonomy, is suggested for psychotherapeutic practice. PMID- 3676130 TI - Expectant fathers: emotional reactions, physical symptoms and coping styles. AB - This study investigated emotional and physical reactions in two groups of expectant fathers: expecting a first child, expecting a second or subsequent child. These were compared with each other and with a control group of fathers whose wives were not pregnant. The hypotheses predicted that expectant fathers in general, and expectant fathers expecting their first child in particular, would report higher situational anxiety and would experience physical symptoms more frequently than the control group. It was also predicted that expectant fathers who reported high levels of emotional involvement with their wives' pregnancy would report high levels of anxiety and high frequency of physical symptoms while expectant fathers who reported active involvement would report a lower level of anxiety and lower frequency of symptoms. Contrary to prediction, expectant fathers, particularly those who were expecting their first child, reported lower levels of anxiety. The hypothesis about physical symptoms was confirmed. Expectant fathers reported experiencing physical symptoms more frequently than controls, and the highest frequency was reported by those expecting their first child. The correlations between types of involvement and anxiety or physical symptoms indicate that all types of involvement are negatively correlated with anxiety. Emotional involvement correlates with frequency of experiencing physical symptoms, and active involvement does not correlate with frequency of experiencing physical symptoms. PMID- 3676131 TI - Construction and constriction in agoraphobia. AB - A formulation of agoraphobia is presented in personal construct theory terms. It is hypothesized that the construing of agoraphobics and their spouses is characterized by low cognitive awareness of constructs concerning interpersonal conflict and lack of tenderness; by dilemmas in which the ability to go out implies possible infidelity; and by low self-esteem in the agoraphobic and high self-esteem in their spouse. Evidence in support of these hypotheses is provided by a repertory grid study comparing agoraphobics, non-agoraphobic neurotics, spouses of both client groups, and normal subjects. Features of construing of agoraphobic and spouse are shown to be predictive of the agoraphobic's response to behaviour therapy, and therapeutic improvement to be associated with some reconstruction in the above areas. The role of mutual validation of constructions between agoraphobic and spouse in the maintenance of agoraphobic behaviour is discussed, as are implications for the treatment of agoraphobia. PMID- 3676132 TI - Extraversion, neuroticism, obsessionality and the type A behaviour pattern. AB - A questionnaire consisting of a subset of questions from the Jenkins Activity Survey was given to 135 male military personnel aged between 18 and 25, together with the EPQ and the AI3, an obsessionality scale. A factor analysis of the answers revealed a four-factor structure - impatience, hard-driving competitiveness, speed and emotional unrepression. Neuroticism was found to correlate positively with impatience and speed, but negatively with hard-driving competitiveness, which together with emotional unrepression correlated positively with extraversion. Impatience, speed and emotional unrepression also correlated positively with obsessionality. Obsessionality was the only personality measure to correlate significantly with the total Type A score. The nature of the relationships between the Type A behaviour pattern and the Eysenckian personality measures are discussed. PMID- 3676133 TI - Cardiovascular unwinding, type A behaviour pattern and locus of control. AB - Three studies are reported, in which subjects were exposed for a period of three minutes to a threat of possible shock. On average subjects showed higher heart rates before the trial than after the trial, and higher rate during the first minute of the trial than the final minute. Results are reported here which show that Type A behaviour pattern and internal locus of control are consistently related to less decline in heart rate. PMID- 3676134 TI - Type A behaviour and time urgency: perception of time adjectives. AB - Relations between time perception and Type A behaviour were investigated. Extreme Type A (n = 26) and B (n = 28) male college undergraduates rated the appropriateness of 158 adjectives as descriptors of time. Adjectives were independently rated using seven-point Likert 'speed' and 'energy' scales. Analyses showed that Type As rate adjectives low in speed and energy as less descriptive of time than Type Bs and vice versa. PMID- 3676135 TI - Reactive-narcissistic character, obsessional personality and obsessive-compulsive behaviour: a study of the validity of Sandler and Hazari's typology. AB - Sandler & Hazari's (1960) questionnaire measuring reactive-narcissistic character and obsessional personality was filled in by 120 medical students. Principal components analysis was applied to their scores. The resulting factor structure is highly similar to Sandler & Hazari's. Both reactive-narcissistic character and obsessional personality can be measured in a reliable way. In support of the hypotheses, reactive-narcissism is correlated positively with achievement motivation, but shows no correlation with traits reflecting lack of self confidence (external locus of control and negative fear of failure), nor with aggression. Contrary to expectation, a positive correlation was found with control uncertainty. According to expectation obsessionality is correlated negatively with achievement motivation and positively with traits reflecting lack of self-confidence and with aggression. The hypothesis that obsessional subjects exhibit more obsessive-compulsiveness in a decision-making task than reactive narcissistic subjects could not be confirmed. Results are discussed in the light of previous findings. The conclusion is that the typology as measured by Sandler & Hazari's (1960) questionnaire has high construct validity. The question whether the typology is predictive of future obsessive-compulsive behaviour remains unanswered. PMID- 3676136 TI - Group psychotherapy for prolonged postnatal depression. AB - Twelve women who had been depressed for more than one year after the birth of a child were offered group psychotherapy. Seven accepted. Our therapy aimed at providing the opportunity for supportive and confiding relationships to develop between the women in the group and the therapists. The Kelly repertory grid and Beck Depression Inventory administered before and after group therapy showed that group psychotherapy helped the women considerably. PMID- 3676137 TI - Paradoxical psychotherapy in a case of transvestism. AB - Paradoxical psychotherapy succeeded in removing the compulsive element and reducing the guilt attached to transvestism in a male transvestite patient. Cross dressing at home became acceptable to him and the temptation to cross-dress in public ended. Data suggested three independent motivational systems in this patient. PMID- 3676138 TI - The relationship between stereotyped and self-injurious behaviour. AB - Despite the widespread nature of stereotyped and self-injurious behaviours within many patient groups, the precise relationship between these two behaviours has never been clearly delineated. A classification based on the frequency of emission is proposed which suggests separate forms of treatment for each behaviour class. PMID- 3676139 TI - A note on a modification of the Parental Bonding Instrument. AB - In order to eliminate the confusion caused by five negatively worded items, the Parental Bonding Instrument (PBI) was modified, with these items reconstructed to form positive statements. Subjects completed both the original and the modified PBI, with little difference resulting in scores between the two versions. Use of the modified version is recommended over either the original PBI or Parker's recent revision in which the five confusing items were completely removed. PMID- 3676140 TI - Morphological changes in the human corneal epithelium associated with surgical corneal clouding. AB - Light microscopy and electron microscopy were used to define morphological changes occurring in human corneal epithelium during surgery. No correlation was established between preoperative medication or peroperative fluids and corneal epithelial clouding. It is suggested that the changes we observed in relation to epithelial clouding were the direct result of disturbance to endothelial pump functions. PMID- 3676141 TI - Acanthamoebic keratitis diagnosed by paracentesis and biopsy and treated with propamidine. AB - A previously healthy 53-year-old man had keratitis of the right eye for six months, unresponsive to topical medical therapy. Acanthamoeba was grown from tissue obtained by corneal biopsy and from aqueous from an anterior chamber tap. The patient was treated with propamidine isethionate 0.1% drops and dibromopropamidine isethionate 0.15% ointment, and after two and a half months the ocular inflammation was continuing to resolve. This case supports a role for the diamidines in the treatment of acanthamoebic keratitis. PMID- 3676142 TI - Entoptic phenomena and reproducibility of corneal striae following contact lens wear. AB - Vertical corneal striae distributed across the posterior cornea are one of the objective signs of clinically unacceptable corneal swelling (greater than 6%) resulting from contact lens wear. This study reports that corneal striae are repeatable both in configuration and location with different levels of hypoxia. In most instances entoptic phenomena result from the presence of these lines. The results suggest that the healthy, avascular, transparent cornea has certain localised areas in its anatomical structure which may give rise to bundles of collagen fibres being made visible objectively and subjectively during conditions of corneal swelling. PMID- 3676143 TI - Serious eye injury in badminton players. AB - Serious eye injury can occur in badminton players and may become more frequent. The causes and nature of such injuries in this sport in six patients are discussed. All were playing competitive doubles matches. Penetrating eye injury due to a shattered glass spectacle lens occurred. Players should be advised not to wear spectacles with glass lenses. Ocular protection in this sport is desirable, and the forward player should hold the racket in front of the face. PMID- 3676144 TI - Oncocytoma of the eyelid: a case report. AB - Oncocytic tumours of the eyelids are rare, only one previous case having been reported. This paper describes a second such lid tumour affecting the medial upper lid. We present the clinical features, surgical management, and histology of the lesion. PMID- 3676145 TI - Retinal microangiopathy in pigmented paravenous chorioretinal atrophy. AB - This report describes an atypical case of pigmented paravenous chorioretinal atrophy, associated with focal progressive peripheral retinal microangiopathy, in a 51-year-old black female. The eyes were asymmetrically involved. Although several cases have been reported with typical features of this uncommon entity, none of them have been known to be associated with retinal microangiopathy. The occurrence of such microangiopathy supports the hypothesis that damage to the retinal photoreceptors may induce retinal microangiopathy, as suggested in other clinical and experimental studies. PMID- 3676146 TI - Rod-cone interaction in patients with fundus flavimaculatus. AB - Dark adaptation and the rise of cone flicker threshold (25 Hz) during dark adaptation were measured psychophysically in three patients with fundus flavimaculatus. The dark adaptation curve showed a delayed rod-cone break but a normal final rod threshold in all these patients. However, the rise of cone flicker threshold during dark adaptation was not delayed and also reached a normal final value. This indicates that the delay in rod dark adaptation does not influence the rise of cone flicker threshold during dark adaptation. This finding contrasts with current concepts that the rise of the cone flicker threshold reflects an increasing inhibitory influence of dark adapting rods. PMID- 3676147 TI - Epidemiology of intraocular pressure in a population screened for glaucoma. AB - This study evaluated the association between intraocular pressure and various sociodemographic characteristics, ocular findings, and cardiovascular risk factors in a population screened for glaucoma. A total of 2594 subjects older than 40 years residing in three urban areas of southern Israel participated. Of those screened 6.1% had a raised intraocular pressure (IOP greater than or equal to 21). The mean IOP increased with age, was higher among persons born in Africa or Asia than those born in Europe or America, higher among myopes than hypermetropes and among those with an enlarged cup-disc ratio (CDR). Analysis of variance tests indicated that refractive status, CDR, age, country of birth, and diabetes were each independently associated with IOP. In addition, associations between raised intraocular pressure and age, country of birth, myopia, CDR, diabetes, and glaucoma in the family were found. PMID- 3676148 TI - Intraocular pressure rise after argon laser trabeculoplasty. AB - Eighty-four eyes received 107 argon laser trabeculoplasty treatments at Beth Israel Medical Center between 1982 and 1984 for advanced primary and secondary glaucoma. The prelaser mean pressure was 20.25 mmHg. Pressures taken 1 1/2 hours postoperatively varied widely: the pressure rose after 47 treatments and fell or remained the same after 60. Significant increases in pressure occurred in 10 eyes, after 12 treatments; 42% of these had received burns of 0.8 watts or greater. Pressure changes were correlated with laser burn energy level. Both patients who had significant increases in pressure initially were retreated again -in the same eye--at another time had similar increases in postoperative pressure again, even with lower energy levels. Comparison with the results of previous reports highlights the advantages of limited treatment to the anterior trabeculum with low energy levels. PMID- 3676149 TI - Alterations of aqueous humour outflow following argon laser trabeculoplasty in monkeys. AB - We performed argon laser trabeculoplasty in one eye in each of three cynomolgus monkeys, leaving the contralateral eyes as controls. Four weeks later in both eyes of each monkey we infused cationized ferritin as a tracer of the aqueous outflow pathways for 30-40 minutes before fixation. In the control eyes cationized ferritin was found throughout the conventional aqueous outflow tract, labelling trabecular endothelial cells, both inner and outer walls of Schlemm's canal, and the collecting channels. No permeation of cationized ferritin through continuous cellular layers such as the corneal endothelium was detected. In the lasered spots of the treated eyes cationized ferritin was found to label the cellular sheet covering the trabecular scar at the lasered site, but no tracer was detected within the scar or in Schlemm's canal immediately beneath. In contrast in adjacent non-lasered regions the trabecular cells, the observed juxta canalicular herniations, and the vacuoles of the inner wall as well as Schlemm's canal itself were extensively labelled. Our findings suggest impermeability to aqueous humour flow through the actual lasered lesion, with shift of flow to adjacent, non-lasered regions. In the normal monkey these regions compensate structurally and functionally in ways that may help to deal with this diverted flow. PMID- 3676150 TI - Parameters for neodymium-YAG laser trabeculotomy: an in-vitro study. AB - A Biophysic Medical Nanolas Q-Switched pulsed neodymium-YAG laser has been used to produce lesions in human trabecular meshwork in vitro. Sectors of corneoscleral tissue containing trabecular meshwork were suspended in a waterbath which had had a Trokel gonioscopic contact lens mounted into one side by means of a watertight seal. The laser was used to produce lesions in the trabecular meshwork on either side of each specimen. The energy levels delivered ranged from 0.5 to 7.0 mJ, and convergence angles of 10 degrees and 18 degrees were employed. The energy levels required to produce discrete lesions into the canal of Schlemm without perforating the underlying sclera were 3.0-5.0 mJ at the 10 degrees convergence angle and 4.0-6.0 mJ at the 18 degrees convergence angle setting. It is recommended that such data be determined for each type of laser prior to attempting short-pulsed laser internal trabeculotomy in patients with glaucoma. PMID- 3676151 TI - Contrast sensitivity, acuity, and the perception of 'real-world' targets. AB - A major assumption underlying the use of contrast sensitivity testing is that it predicts whether a patient has difficulty seeing objects encountered in everyday life. However, there has been no large-scale attempt to examine whether this putative relationship actually exists. We have examined this assumption using a clinic based sample of adults aged 20-77 years. Contrast thresholds were measured for both: (1) gratings of 0.5-22.8 cycles/degree; and (2) real-world targets (faces, road signs, objects). Multiple regression techniques indicated that the best predictors of thresholds for real-world targets were age and middle to low spatial frequencies. Models incorporating these variables accounted for 25-40% of the variance. Although acuity significantly correlated with thresholds for real world targets, the inclusion of acuity as a predictor variable did not improve the model. These data provide direct evidence that spatial contrast sensitivity can effectively predict how well patients see targets typical of everyday life. PMID- 3676152 TI - Assessment of the Catford drum in visual acuity testing and its use as a measurement of visual performance in low-vision patients. AB - Objective measurements of visual acuity were determined with the Catford drum in 82 eyes of patients in our Low-Vision Clinic who typically suffered from visual loss due to macular disease. The results were compared with subjective measurements of visual acuity by the Snellen chart. The findings indicated a significant overestimation of Snellen visual acuities by the Catford drum in 90.2% of eyes tested by a factor of 1.05 to 20.0, average 4.73. The correlation coefficient for the study was +0.40. This differs from the original results of Catford and Oliver in 1971. In addition, the Catford drum was used on follow-up visits in the same patients to assess 'visual performance'. The initial results showed an improvement in visual acuities when the Catford drum was used in 12 of 15 patients, while the Snellen acuities remained stable when retested after one month of basic instruction and use of standard low-vision aids. This improvement in 'Catford' acuity was by a factor of 0.3 to 10.0, average 4.08. This is thought to represent the patient's ability to learn the use of eccentric viewing or parafoveal retinal areas for vision. It confirms previous intuitive findings and helps to explain why low-vision patients seem to function at a higher level than expected from their Snellen visual acuities. PMID- 3676153 TI - Digestion of the zinc in human milk, cow's milk and a commercial babyfood: some implications for human infant nutrition. AB - 1. The digestion of zinc present in human milk, cow's milk and a commercial babyfood was compared, using the piglet as a model for the human infant. 2. In piglets given human milk the pH of stomach contents was approximately 1 and 0.4 units lower than that of animals given respectively cow's milk and babyfood. The pH values of intestinal contents were approximately neutral and did not vary with the type of feed. 3. Hard casein curds were present throughout the stomachs and small intestines of animals fed on cow's milk or babyfood and between 55 and 70% Zn in these digesta samples were recovered in an insoluble form by centrifugation. In contrast, little solid material was observed in the digesta of animals fed on human milk, and 57 and 93% respectively of the Zn in digesta were recovered in a soluble form in the stomach and small intestine. 4. Soluble fractions prepared by centrifugation of digesta were analysed by filtration on Sephadex G-150. After any of the three feeds, soluble Zn in stomach contents was mainly in a low-molecular-weight form. In intestinal samples, however, Zn was present in low- and high-molecular-weight forms. Whilst there were similar amounts of Zn in the low-molecular-weight form in all samples, approximately three times as much of the total intestinal Zn was in a soluble high-molecular weight form complexed to proteins in the animals fed on human milk compared with those fed on cow's milk or babyfood. 5. Analysis of protein-bound soluble Zn in intestinal samples on SDS-polyacrylamide gels resulted in a similar pattern of proteins for all feeds. Results indicated that at least some of these proteins were derived from intestinal secretions of the piglet. 6. Some implications of these results in respect of the mode of digestion of Zn and its biological availability to the human infant are discussed. PMID- 3676154 TI - Nutritional availability to rats of selenium in four seafoods: crab (Callinectes sapidus), oyster (Crassostrea virginica), shrimp (Penaeus duorarum) and Baltic herring (Clupea harengus). AB - 1. The present study was conducted to determine the biological availability to rats of the selenium in four high-Se seafoods: crab (Callinectes sapidus), oyster (Crassostrea virginica), shrimp (Penaeus duorarum) and Baltic herring (Clupea harengus). 2. Weanling male rats were fed on a Se-deficient Torula yeast diet for 4 weeks followed by either continued depletion or repletion for 4 weeks with 0.05, 0.1 or 0.2 microgram Se as selenite/g, or 0.1 or 0.2 microgram Se as freeze dried cooked test food/g. Plasma and liver Se levels or glutathione peroxidase (EC 1.11.1.9; GSH-Px) activities were used as indicators of body Se status. 3. Except for oysters, the biological availability of Se in all these seafoods was close to that of selenite (selenite 100%) when the criterion used was either plasma Se level or plasma GSH-Px activity. 4. By the criterion of increased liver Se level of restored hepatic GSH-Px activity, only herring-Se had a biological availability comparable to that of selenite-Se under all conditions tested, whereas crab-Se and oyster-Se were distinctly inferior in this regard. 5. Increasing the amount of crab-Se, oyster-Se or shrimp-Se supplied in the diet from 0.1 to 0.2 microgram/g changed the apparent availability (%) of Se for hepatic GSH-Px restoration from 38 to 78, 22 to 53 and 57 to 90 respectively. 6. The present study demonstrates that the availability of Se in certain foods is a function of the criterion chosen, the level of Se supplied in the diet, and possibly other unknown interacting dietary factors. PMID- 3676155 TI - Selenium status in patients with liver cirrhosis and alcoholism. AB - 1. Selenium status and blood levels of other nutrients related to lipid peroxidation were studied in patients with advanced alcoholic liver cirrhosis, in male alcoholics who had been abstinent for at least 1 month and in healthy control subjects. 2. Plasma Se was decreased in alcoholic cirrhosis but not among alcoholics in abstinence. Platelet glutathione peroxidase (EC 1.11.1.9; GSH-Px) activity was decreased in cirrhotic patients, whereas GSH-Px in blood and plasma was the same as in controls for both groups of patients. 3. Plasma retinol and plasma alpha-tocopherol were decreased in alcoholic cirrhosis, whereas plasma ascorbic acid was the same in all groups. 4. The decreases in platelet GSH-Px, plasma Se and alpha-tocopherol indicate a deranged antioxidant defence in patients with advanced alcoholic cirrhosis, but the levels of these and other nutrients were generally not correlated to common clinical chemical indicators of liver disease. PMID- 3676156 TI - An in vitro method for estimating biologically available vitamin B6 in processed foods. AB - 1. An in vitro method which used enzymic digestion of the food matrix to release biologically available vitamin B6 is described. 2. Vitamin B6-fortified liquid model foods were thermally processed. After these foods had been freeze-dried, one part was subjected to enzymic hydrolysis at pH 2.0 with pepsin (EC 3.4.23.1) followed by a hydrolysis at pH 8.0 with pancreatin. The vitamins that were found in the supernatant fraction, after an acidified methanol treatment of the hydrolysate, were estimated by high-performance liquid chromatography (HPLC). The other part was given to rats who were kept on a vitamin B6-depleted diet. 3. The biologically available vitamin B6 content of the processed model foods, as determined by rat bioassay, showed good correlation with the vitamin B6 determined by HPLC. 4. It has proved possible to use this in vitro, two-stage enzymic digestion system followed by HPLC determination to determine biologically available vitamin B6 in vitamin B6-fortified processed model foods. PMID- 3676157 TI - The distribution of nutrient intake within families. AB - 1. During 1978 and 1979, the 343 members of seventy-nine families representative of households with two adults and two or three children living in Cambridge, England, completed 7-d records of food consumption using the semi-weighed technique. Nutrient intakes were calculated using food composition tables. 2. Amongst males, the average intakes of energy and most nutrients were highest in men and boys aged 11-17 years, and lowest in boys under 5 years. Amongst females, intakes were highest in girls aged 11-17 years, and lowest in those under 5 years. At each age, intakes in males were generally higher than those in females. 3. Nutrient distribution within families was described using the ratio, intake of each subject:intake of the male head of the household. The problems inherent in using this ratio are discussed. 4. The distribution of nutrient intakes within the families was not in accordance with the recommended daily amounts (RDA). Men and young boys received more than their fair share of the family diet, while women and girls aged 5-17 years received less. 5. Estimates of dietary adequacy based on the averages of family consumption and requirements (RDA) concealed up to twofold variations in the adequacy of diet of different age-sex-groups. 6. The interpretation of dietary adequacy in household food surveys should take into account the distribution of nutrient intakes within the household, as the distribution may be substantially different from that predicted by the RDA. PMID- 3676158 TI - Studies on iron availability in man, using stable isotope techniques. AB - 1. Iron absorption from 10 mg Fe (as ferrous sulphate), labelled with 1.3 mg 58Fe, was measured in fasting, non-anaemic adult subjects by the faecal-balance technique. The measurement was performed twice, each subject being given, in random order, either 50 mg Fe or a placebo 18 h before the 58Fe-labelled FeSO4. 2. The 50 mg Fe load significantly reduced Fe absorption the following day (P less than 0.01), from a mean of 35.4 (SEM 4.6)% to 29.0 (SEM 5.1)%. This points to the importance of strict dietary control during Fe-absorption studies to eliminate bias in results. 3. In a separate study, the feasibility of using 58Fe enrichment of erythrocytes, measured by neutron activation analysis (NAA), 10 d after a meal labelled with 0.69 mg 58Fe as an index of Fe absorption was examined. The levels of 58Fe in the blood were detectable by NAA. Regression analysis showed a significant relation between 58Fe-enrichment of blood and 58Fe absorption, calculated as the difference between intake and faecal excretion (R 0.59, P less than 0.05). PMID- 3676159 TI - Biochemical observations on rat aorta: interaction of dietary protein and cholesterol. AB - 1. The effect of cholesterol feeding during and after a period of protein malnutrition lasting 4 weeks was examined in the rat. Indices measured were plasma total cholesterol, triglycerides and protein levels, and aorta total cholesterol, triglycerides, hexosamine and hydroxyproline concentrations. 2. In both plasma and aorta, total cholesterol and triglycerides levels were higher in the low-protein diet group than in the standard-protein diet group, when cholesterol was supplied in both diets. 3. During the malnutrition period, cholesterol feeding led to a greater decrease in plasma protein than that promoted by the low-protein diet without cholesterol, while aorta hexosamine levels decreased to a lesser extent. 4. Cholesterol feeding with a standard protein diet promoted a slight and temporary increase in aorta hydroxyproline levels, while a decrease in aorta hexosamine concentration was observed. Cholesterol feeding with the low-protein diet, on the other hand, also promoted a decrease in aorta hexosamine levels but to a lesser extent. 5. During the recovery period, cholesterol feeding impaired the return of plasma protein, aorta hexosamine and lipid levels to that of the control values. 6. These findings demonstrate that cholesterol feeding promotes different changes in aorta and plasma, depending on whether or not protein is supplied by the diet in adequate amounts. This point could be important in relation to the development of atherosclerosis during recovery from a period of malnutrition. PMID- 3676160 TI - Some effects of selenium deficiency on glutathione peroxidase (EC 1.11.1.9) activity and tissue pathology in rainbow trout (Salmo gairdneri). AB - 1. Two duplicate groups of rainbow trout (Salmo gairdneri; mean weight 27 g) were given diets of differing selenium content (deficient 0.025 mg Se/kg; supplemented 1.022 mg Se/kg) for 30 weeks. 2. There were no significant differences between treatments in weight gain but packed cell volume, liver vitamin E and liver and plasma Se concentrations were all significantly lower in the Se-deficient trout. 3. Ataxia occurred in about 10% of the Se-deficient trout and histopathologies were evident in nerve cord (damage to axon sheath) and liver (loss of integrity in endoplasmic reticulum and mitochondria with appearance of increased vesiculation). 4. Glutathione peroxidase (EC 1.11.1.9) activity was significantly reduced in liver and plasma of Se-deficient fish but there was no indication, from differential assay, of any non-Se-dependent glutathione peroxidase activity. Glutathione transferase (EC 2.5.1.18) activity was significantly increased in Se deficient trout. PMID- 3676161 TI - Nitrogen and carbon flows between the caecum, blood and rumen in sheep given chopped lucerne (Medicago sativa) hay. AB - 1. Experiments involving 15N and 14C tracers were made in sheep consuming 800 g air-dry chopped lucerne (Medicago sativa) hay/d and providing 20.4 g N/d to study N and C flows within the caecal digesta and between the caecum, blood and rumen. 2. Continuous infusions of 15N tracers were made into the caecal ammonia, blood urea and rumen NH3 pools. The concentration and enrichment of caecal digesta NH3 N, caecal microbial N, caecal digesta non-urea, non-ammonia-N (NU-NAN), faecal NU NAN, blood urea-N, rumen digesta NH3-N and rumen bacterial N were estimated at intervals during the infusions. A three-pool open-compartment model was solved to estimate N flows between the caecal digesta NH3-N, blood urea-N and rumen digesta NH3-N pools. 3. The rate of irreversible loss from the caecal digesta NH3-N pool was 2.17 (SE 0.623) g N/d. On average 0.9 (SE 0.56) g N/d of caecal digesta NH3-N was derived from blood urea and 0.1 (SE 0.08) g caecal digesta NH3-N/d was apparently derived from the fermentation of undigested rumen microbes in the caecum. The amount of NH3-N produced by proteolysis and deamination of dietary and endogenous N was 1.1 (SE 0.13) g/d. 4. There was net incorporation of 0.56 (SE 0.306) g caecal digesta NH3-N/d into caecal microbes. The microbial N synthesized de novo in the caecum was not determined, but 2.9 (SE 0.52) g microbial N/d of both rumen and caecal origin flowed out of the caecum and constituted 0.48 of the NU-NAN flow. The majority (mean 0.83 (SE 0.044] of this microbial N was excreted in faeces. 5. On average 1.8 (SE 0.80) g caecal digesta NH3-N/d were absorbed. Of this NH3-N, 0.92 (SE 0.054) was converted to blood urea, contributing 0.10 (SE 0.031) of blood urea-N. Only 0.012 (SE 0.0041) of rumen digesta NH3-N and 0.005 (SE 0.0009) of rumen bacterial N were derived from caecal digesta NH3-N. 6. Infusions of 14C tracers were made into the caecal digesta bicarbonate, blood bicarbonate, rumen digesta bicarbonate and blood urea pools, and samples were obtained at intervals to determine the specific radioactivity of each pool. A four-pool open-compartment model was solved to estimate C flows between these pools. 7. The rate of irreversible loss of blood urea estimated with [14C]urea (17.1 (SE 1.18) g N/d) was greater (P less than 0.01) than that estimated with [15N]urea (14.0 (SE 0.87) g N/d).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676162 TI - Effects of short- and long-term feeding of zinc oxide-supplemented diets on the mature, female domestic fowl with special reference to tissue mineral content. AB - 1. In Expt 1, the effects on laying hens of diets supplemented with zinc oxide providing up to 20 g added zinc/kg were compared. In Expt 2 the diets contained up to 6 g added Zn/kg. 2. In both experiments, food intake, body-weight, egg number, and liver, oviduct and ovary weights/kg body-weight were significantly reduced by added ZnO; gizzard weight/kg body-weight was significantly increased. In Expt 2, pancreas weight was significantly reduced by added ZnO. 3. Liver, kidney and pancreatic Zn and iron concentrations were significantly elevated in both experiments. 4. In both experiments, liver, kidneys and pancreatic copper concentrations gave quadratic responses to added ZnO. PMID- 3676163 TI - The alleviation of chronic copper toxicity in sheep by ciliate protozoa. AB - 1. Rams, fauna-free from birth and initially of 48-65 kg live weight, were allocated to two groups of ten each and given a diet containing 14 micrograms copper/g dry matter; five additional rams were killed and their livers were analysed for Cu. 2. One group (faunated) was inoculated with a mixed population of ciliate protozoa, and contained between 60 x 10(5) and 195 x 10(5) protozoa/ml rumen fluid throughout the 184 d experiment. The other group remained fauna-free. Following blood sampling, three rams in each group were killed on day 63, two on day 125 and four on day 184. One sheep in each group died during the experiment. 3. Faunated rams showed higher weight gains and feed consumption than fauna-free rams. 4. Plasma Cu concentration (microgram/ml) increased from an initial 0.82 to a final 1.00 in faunated and 1.36 in fauna-free rams. Liver Cu concentration (micrograms/g dry matter) increased from an initial 745 to a final 962 and 1684 in faunated and in fauna-free sheep respectively, representing a 4.3-fold greater increase in the fauna-free than in the faunated group. The absorption and retention of Cu was 38-50% higher in the fauna-free than in the faunated rams. 5. It was suggested that rumen ciliate protozoa increased rumen production of sulphide (through increased breakdown of soluble proteins) which complexed part of the Cu, making it unavailable for absorption and utilization. Therefore, ciliate protozoa could determine susceptibility to chronic Cu toxicity in sheep. PMID- 3676164 TI - Physiological zinc-binding proteins of medium molecular weight in the rat gut. AB - 1. Gel filtration on Sephadex G 75 was used to separate the medium-molecular weight zinc-binding proteins from the soluble fractions from the duodenal and jejuno-ileal segments of the rat gut at 30 min after the intragastric administration of a tracer dose of 65Zn. These proteins were resolved by ion exchange chromatography on DEAE cellulose. 2. In both the duodenum and jejuno ileal segment an appreciable fraction of the total soluble Zn was bound in a protein fraction that resembled metallothionein (MT) in its behaviour on gel filtration. These fractions, however, were not homogeneous, but contained several medium-molecular-weight Zn-binding proteins. In the duodenum, but not in the jejuno-ileal segment, two of these proteins appeared to be the isometallothioneins, ZnMT-I and ZnMT-II. 3. These results suggest a possible role for MT in the binding of newly-absorbed Zn in the duodenal mucosal cells. They also show that gel filtration alone is insufficient for the identification of MT in the intestine. PMID- 3676165 TI - Metabolism of dehydroretinyl ester in White Leghorn chicks. AB - 1. The metabolism of dehydroretinyl ester has been studied in vitamin-A-deficient white leghorn chicks. Dehydroretinyl ester was metabolized to 3-hydroxyretinol diester, 3-hydroxyanhydroretinol and rehydrovitamin A2 which were isolated from the intestines and livers of chicks. 2. The metabolism of 3-hydroxyretinol diester and 3-hydroxyanhydroretinol, which were immediate metabolites of dehydroretinol, was studied in chicks. 3. Retinol was not detected in these experiments. PMID- 3676166 TI - Rumen degradation and fractional outflow rates of nitrogen supplements given to cattle eating sodium hydroxide-treated straw. AB - 1. Six rumen and abomasal cannulated heifers were used to study the effects of intake on the fractional outflow rates (FOR) of chromium-mordanted cotton-seed meal (Cr-CSM) and meat meal (Cr-MM), CrEDTA, ytterbium and lignin from the rumen. Values of FOR of Cr-CSM and Cr-MM were combined with values of nitrogen disappearance from the protein supplements, placed in porous synthetic (nylon) bags and incubated within the rumen (P), to calculate effective degradation (D) of CSM and MM when fed to heifers eating sodium hydroxide-treated straw. Also, N degradation in vivo (V) was measured as the difference between abomasal N flow and the sum of flows of microbial and endogenous N. 2. FOR were positively related to intake and differences between supplements were significant (P less than 0.01). FOR pertaining to high and low intakes respectively were 0.073 and 0.052 for Cr-CSM, 0.082 and 0.071 for Cr-MM, 0.030 and 0.023 for lignin, 0.082 and 0.073 for CrEDTA and 0.044 and 0.035 for Yb. 3. A rise of 28.8 and 13.4% in FOR of Cr-CSM and Cr-MM respectively, associated with an increase in intake from maintenance to 1.5 times maintenance, resulted in 10.7 and 2.2% reductions in D, 24 h after feeding, for CSM and MM respectively. 4. With the exception of CSM at the high intake, estimates of V were underestimated by D and were 8.6-25.0% greater than the D values when time of incubation (t) = infinity. The two techniques, however, ranked the degradation of the two supplements in the same order at both levels of intake. 5. Underestimation of V by D may be attributable to underestimation of P, overestimation of FOR (both resulting in underestimation of D) or overestimation of V due to biases associated with the estimation of this part of the comparison. The relative importance of these factors remains to be determined. PMID- 3676167 TI - Metabolism of lactic acid isomers in the rumen of silage-fed sheep. AB - 1. Four mature sheep were offered perennial ryegrass (Lolium perenne, cv. S23) silage (885 g dry matter/d) at hourly intervals. The silage was well fermented with a pH of 4.0, a lactic acid content of 139 g/kg dry matter and an organic matter digestibility of 0.766. 2. Continuous intraruminal infusions of 14C labelled sodium salts of [U-14C]acetic acid, [2-14C]propionic acid, [2 14C]butyric acid and D- and L-[U-14C]lactic acid and an intravenous infusion of [U-14C]glucose were made on separate occasions to estimate the fluxes of rumen acetate, propionate, butyrate and lactate as well as plasma glucose. The data were resolved by the use of appropriate four-compartment (rumen) and three compartment (rumen-plasma) models. 3. Irreversible loss rate (g C/h) of rumen acetate (5.32 g C/h) was considerably greater than values obtained for propionate (2.58), butyrate (2.80) and lactate (2.91). 4. Total flux of lactate (1.83 mol/d) exceeded the amount of lactate consumed in the diet (1.37 mol/d) indicating a net synthesis of 0.46 mol lactate/d. Approximately 0.90 of total lactate flux was metabolized in the rumen, with 1.00 mol/d converted to acetate, 0.57 to propionate and 0.08 to butyrate. The flux to acetate was significantly (P less than 0.05) greater than that to propionate. Both the D- and L-isomers appeared to have similar metabolic fates. 5. Lactate appeared to make no direct contribution to glucose flux in the animal, but 0.10 of total lactate was converted to glucose through propionate. 6. The results are discussed in relation to overall lactate metabolism, and it is suggested that almost 0.30 of ruminally digested organic matter may be fermented via lactate. PMID- 3676168 TI - Pigeon (Columba L.) meat iron solubility and availability for absorption in rats. AB - 1. The distribution of iron in 59Fe-labelled pigeon (Columba L.) leg and breast muscle and liver were determined by gel filtration. While the insoluble Fe was between 14 and 25% of the total Fe from the tissues, the haem-Fe represented 79.1% (breast) to 45% (liver) of the total Fe and ferritin was between 5.5% (breast) and 26.5% (liver) of the total Fe. 2. The tissue haem-Fe concentration was found to be lower than that determined by gel filtration using the method of Schricker et al. (1982) for non-haem-Fe and obtaining haem-Fe by difference. 3. A simulated in vitro digestion procedure showed significantly (P less than 0.01) reduced 59Fe solubility from 59Fe-labelled pigeon meat after cooking at 90 degrees for 30 min. 4. 59Fe absorption from whole pigeon meat and soluble extract was significantly reduced by cooking when given to Fe-replete rats. Cooking liver, however, slightly improved 59Fe absorption in Fe-replete rats. 5. 59Fe absorption from the separated pigeon-meat fractions (haemoproteins, ferritin and haemosiderin) was variable but considerably lower than that from whole meat. 6. The relative distribution of Fe compounds in meat, the processing conditions they are subjected to and the protein content and composition may all influence the absorption of meat-Fe to some degree. PMID- 3676169 TI - Effect of soya-bean protein on meat iron solubility and absorption in rats. AB - 1. Soya-bean proteins were used to replace 30 and 50% of the protein from 59Fe labelled pigeon (Columba L.) and chicken meat, and the solubility of the meat 59Fe in vitro and its absorption in vivo in rats in the presence and absence of soya-bean proteins were measured. 2. Replacement of part of the chicken meat by soya-bean proteins reduced 59Fe solubility from chicken meat at all stages during simulated in vitro digestion. 3. 59Fe absorption from 59Fe-labelled chicken meat when given to both Fe-replete and Fe-deficient rats was reduced in the presence of soya-bean proteins but was unaffected by the presence of casein or bovine serum albumin. 59Fe-absorption from pigeon meat in the presence of soya-bean proteins was not reduced to the same extent as that from chicken meat. 4. There was no significant effect of soya-bean proteins on 59Fe-labelled haemoglobin Fe absorption in vivo in Fe-replete rats. 5. Absorption of 59Fe from the isolated haemoproteins from chicken meat was unaffected by soya-bean proteins but 59Fe absorption from the main non-haem-Fe fractions was strongly inhibited, particularly from haemosiderin. PMID- 3676170 TI - The effect of riboflavin deficiency on methylenetetrahydrofolate reductase (NADPH) (EC 1.5.1.20) and folate metabolism in the rat. AB - 1. Riboflavin deficiency at two levels of severity was produced in weanling rats by feeding deficient diets for 6 weeks and using neck collars to prevent coprophagy. The severity of deficiency was monitored by growth, liver flavin levels and the activation coefficient of erythrocyte glutathione oxidoreductase (NAD(P)H) (EC 1.6.4.2). Control groups, receiving the same diet with ample added riboflavin, were fed either ad lib., or were pair-fed with the deficient animals. 2. The hepatic flavoenzyme, methylenetetrahydrofolate reductase (NADPH) (EC 1.5.1.20), was very markedly affected by severe riboflavin deficiency and was significantly, but less markedly, affected by the intermediate level of deficiency. This reduction in activity was due primarily to the direct effect of the diminished supply of riboflavin, and occurred to only a small extent as a result of inanition, demonstrated by a moderate reduction in activity in the more severely food-restricted of the two pair-fed groups. Since the enzyme is assayed in the presence of its flavin cofactor, FAD, it clearly cannot be reactivated in vitro, as some other depleted flavoenzymes can. The discriminatory ability in distinguishing between severe and moderate riboflavin deficiency in vivo confers some potential advantages on this oxidoreductase as a possible index of riboflavin status. 3. The hepatic activity of another key folate-metabolizing enzyme, dihydrofolate reductase (EC 1.5.1.3), was not diminished by riboflavin deficiency in the present study. 4. The ratio, labelled 5-methyltetrahydrofolic acid:other labelled compounds derived from intraperitoneally injected pteroylglutamic acid in extracts of hepatic tissue was significantly reduced in the riboflavin-deficient groups, indicating the possibility of an effect of riboflavin deficiency on folate metabolism in vivo. PMID- 3676171 TI - The degradation of guar gum by a faecal incubation system. AB - 1. Homogenized and diluted faeces (50 g/l) from one human source were incubated with the complex plant polysaccharide, guar gum, to investigate the degradation of viscous polysaccharides by intestinal bacteria. 2. Incubation of the faecal homogenate with guar gum produced a rapid decrease in viscosity and in pH, accompanied by the release of hydrogen. 3. No changes in viscosity or pH were observed and there was no production of H2 gas when guar gum was incubated with autoclaved faecal homogenate (20 min, 1.03 x 10(5) Pa). 4. A bacteria-free filtrate of faeces was prepared by centrifuging the faecal homogenate (2400 g for 100 min) followed by filtration through a Seitz filter and then a millipore filter (size 0.45 micron). Incubating this with guar gum produced a slow decrease in viscosity, but no significant change in pH and no generation of H2. 5. Our results show that guar gum can be fermented by human colonic bacteria and suggest the possibility of predigestion by extracellular free enzymes. PMID- 3676172 TI - Gastrointestinal adaptation in response to soluble non-available polysaccharides in the rat. AB - 1. Rats were fed on a control semi-synthetic diet containing insoluble cellulose (Solkafloc; 100 g/kg; control group) as the only source of dietary fibre, or on one of two test diets containing the same quantity of either guar gum or carboxymethylcellulose (CMC). Animals in the test groups showed similar growth rates and food intakes, which were significantly lower than those of the control group. The CMC group produced frequent poorly formed faeces throughout the 21 d feeding period. 2. The small intestines of animals in both test groups were significantly longer than those of the control group at the end of the study. The caeca were also enlarged and heavier, particularly in the CMC-fed group. 3. The rate of production of mucosal cells was increased in the small and large intestines of both test groups. The CMC-fed group exhibited a particularly high rate in the distal ileum, where the rate of cell divisions per crypt was over three times greater than at the same site in the control group. The increased proliferation was associated with a significant lengthening of the crypts and an approximately 25% increase in the basal width of the villi. 4. Mucosal alkaline phosphatase (EC 3.1.3.1) and lactase (EC 3.2.1.23) levels were lower than those of the control group at proximal and distal sites in the small intestines of both CMC- and guar-gum-fed groups. Altered spatial distributions of maltase (EC 3.2.1.20) and sucrase (EC 3.2.1.48) activities were also observed in these animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676173 TI - Nutrition and cellular immunity in hospital patients. AB - 1. The interrelations between nutritional and cellular immune function measurements were studied in seventy patients suffering from various degrees of malnutrition. They included patients with liver disease, inflammatory bowel disease, neoplastic disease, neurological patients, post-operative surgical patients and patients with respiratory problems. 2. Nutritional measurements included: anthropometry, serum proteins, various vitamins and trace elements, and a prognostic nutritional index (PNI) was calculated. 3. Immunological measurements included: (1) natural killer (NK) cell activity, (2) antibody dependent cellular cytotoxicity (ADCC), (3) lymphocyte proliferation in response to the mitogens concanavalin A (Con A), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) in both AB and autologous serum. 4. There was no association between anthropometric measurements and tests of immune function. 5. The lymphocyte proliferation in response to mitogenic stimulation in the malnourished patients was depressed in autologous serum compared with the response of the same lymphocytes in pooled AB serum. The lymphocyte proliferation in response to Con A correlated with transferrin in autologous serum (r 0.46, n 49, P less than 0.01) and to a lesser extent in AB serum (r 0.33, n 51, P less than 0.05). There was a difference in the Con A-stimulated tritiated-thymidine uptake between patients with low and normal serum zinc levels (P less than 0.05) for cultures performed in autologous serum, but not AB serum. 6. There was a significant correlation between NK cell activity and vitamin C (r 0.43, n 60, P less than 0.01). There was no relation between nutritional measurements and ADCC or the lymphocyte response to stimulation with PHA or PWM. 7. The results suggest that the severity of overall malnutrition does not influence several different aspects of the cellular immune response. However, the results do suggest that certain individual nutrients, particularly vitamin C and Zn, do influence the immunoreactivity of different lymphocyte subpopulations. PMID- 3676174 TI - The effect of abrupt changes in the concentration and frequency of feeding milk substitute diets on the voluntary food intake of calves. AB - 1. To examine the relations between short- and long-term regulation of food intake in calves given milk-substitute diets, abrupt changes were made in the dry matter (DM) concentration of the diet (Expt 1) and in the frequency of feeding (Expts 2 and 3). 2. When calves, fed once daily, had the DM concentration of their diet changed, they drank the same volume of milk on the 1st day they received the new diet as they had on the previous days; so the DM intakes changed in proportion to the change in milk DM concentration. Over the subsequent 6 d, milk intake progressively increased when milk DM concentration was reduced. When the DM concentration of milk was increased the volume of milk drunk was reduced to a minimum value 2-3 d after the change in diet and increased thereafter. The size of the changes was dependent on the initial and changed DM concentrations of the milk. 3. In calves receiving milk-substitute diets containing 80-260 g DM/kg, milk intakes were reduced by up to 30% on the 1st day that calves were fed once daily instead of twice daily. Over the subsequent 13 d of once-daily feeding, milk intakes increased, particularly for calves given diets of low DM concentration. 4. Feeding the calves once daily reduced the digestibility of DM in Expt 2 but not the digestibility of crude protein (nitrogen x 6.25) and fat; diets containing lower concentrations of DM were particularly affected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676175 TI - The nitrogen and energy metabolism of lactating cows given abomasal infusions of casein. AB - 1. Four cows in early lactation were given continuous infusion into the abomasum of 0, 200, 400 or 600 g lactic casein/d according to a Latin-square design. Each period was of 14 d and the Latin square was followed by 7 d in which an infusion of 800 g glucose/d was given. The basal diet was given at a level which provided sufficient nitrogen and energy for 10 kg milk yield/d. 2. Infusion of casein resulted in significant increases in milk yield, milk N yield and milk energy yield; milk N increased progressively but milk energy reached a maximum at 400 g casein/d. Milk yields and composition when glucose was infused resembled those seen on the zero casein treatment. 3. N-balance measurements indicated a severe deficit (-20 g/d) on the zero casein treatment and a progressive increase to +7 g/d as casein increased; N equilibrium was achieved at about 400 g casein/d. The regression of net productive N on N intake (P less than 0.001) indicated that the efficiency of utilization of dietary N did not differ between treatments. 4. Heat production increased with increase in casein infused (P less than 0.05) but remained a constant proportion of the metabolizable energy (ME) intake. Energy balances were negative and did not differ significantly between treatments but calculation of the protein and fat components indicated a threefold increase in body fat mobilization in response to the first increment of casein. Milk yield adjusted to zero energy balance was significantly related to ME intake (P less than 0.001) but the efficiency of energy utilization was not affected by the level of casein infusion. 5. The concentrations of glucose, beta-hydroxybutyrate and non-esterified fatty acids in plasma did not differ between treatments but the concentration of urea in plasma increased markedly (P less than 0.05) at the highest level of casein addition. Insulin concentrations increased and growth hormone decreased (both P less than 0.05) with increase in casein infusion. 6. The concentration of total amino acids (AA) in plasma increased up to 400 g casein/d and then declined. Changes in concentration and in the ratio of essential:total AA indicated a very high extraction rate of essential AA at the lower levels of casein infusion. 7. The observed lactational responses are discussed in relation to the ratio of protein:energy in the absorbed nutrients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676176 TI - Supplemental protein degradation, bacterial protein synthesis and nitrogen retention in sheep eating sodium hydroxide-treated straw. AB - 1. Alkali (sodium hydroxide)-treated wheat straw was given to six rumen- and abomasal-cannulated sheep to study the rumen degradation of cotton-seed meal (CSM) and barley (B), and the effects of these supplements on nitrogen retention and efficiency of bacterial protein synthesis were measured. 2. N degradation, using porous synthetic (nylon) bags incubated within the rumen (P), and in vivo measurement determined from the abomasal flow of N (V), distinguished quantitatively between the two supplements. Estimates of P, corrected for fractional outflow rates/h (FOR), underestimated estimates of V when FOR of undegraded protein from the rumen (k) of 0.05 and 0.08 were used. Estimates of V for CSM and B were 70.9 and 80.8% respectively. 3. Intakes of alkali-treated straw were not affected by the supplements. Intakes of digestible organic matter (DOM) for the diets comprising alkali-treated straw alone (W), straw plus CSM (WC) and straw plus barley (WB) were 477, 575 and 590 g/d respectively (P less than 0.05) and organic matter (OM) apparently digested in the rumen (OMADR) was 339, 399 and 435 g/d respectively (P less than 0.05). 4. On W, WC and WB respectively, flows at the abomasum were 11.0, 14.0 and 13.3 g/d for bacterial N (P less than 0.05) and 0, 2.8 and 0.5 g/d for dietary supplemental N; g bacterial N/kg OMADR were 32.4, 35.6 and 30.9 (P greater than 0.05) and N balances were 2.37, 4.27 and 3.29 g/d (P less than 0.05) on the respective treatments. It was suggested that supplements increased total OM intake as a result of increased OM digested in the rumen rather than OM flow from the rumen. PMID- 3676177 TI - Digestion of milk, fish and soya-bean protein in the preruminant calf: flow of digesta, apparent digestibility at the end of the ileum and amino acid composition of ileal digesta. AB - 1. Digesta were collected from eleven preruminant calves fitted with re-entrant (four calves in Expt 1 and three in Expt 2) or single cannulas (four calves in Expt 1) in the terminal ileum. Collection periods lasted 24 h (Expt 1) or 96 h (Expt 2). 2. Two milk-substitutes (fish and soya bean) and a control diet were given to the calves. In the control diet, protein was entirely provided by skim milk powder. In the other two diets, protein was provided mainly by a partially hydrolysed white-fish protein concentrate or a soya-bean protein concentrate prepared by extracting soya-bean meal with hot aqueous ethanol. 3. In Expt 1, flow rates of fresh matter, dry matter, nitrogen and ash exhibited two maxima between 6 and 8 h after the morning meal and between 4 and 6 h (control and soya bean diets) or 6 and 8 h (fish diet) after the evening meal. Minimum pH values were observed at times of maximum flow rate. Variations observed in the flow rates and pH values were larger with fish and especially soya-bean diets than with the control diet. 4. The apparent digestibility of the three diets in the terminal ileum was significantly higher in Expt 2 than in Expt 1: for N, the values were 0.92, 0.83 and 0.75 (Expt 1), and 0.94, 0.87 and 0.88 (Expt 2) with the control, fish and soya-bean diets respectively. 5. The amount of N apparently absorbed in the terminal ileum represented 90-96% of the amount that disappeared from the whole digestive tract in Expt 1 and 95-99% in Expt 2. 6. In Expt 1 the amino acid (AA) composition of digesta changed little with the flow rate when the calves were given the control diet (from 158 to 179 g glutamic acid/kg AA). With the fish and soya-bean diets the AA composition was similar to that observed with the control diet when the flow rate was minimum, but differences became apparent as the flow rate increased (281 and 161 g glutamic acid/kg AA for the soya-bean and control diets respectively with maximum flow rate). In Expt 2, the mean compositions of the digesta were very similar to the means obtained in Expt 1. 7. Different comparisons with dietary, endogenous and bacterial proteins indicated that for the three diets a common mixture containing approximately 65% endogenous and 35% bacterial proteins reached the terminal ileum.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676178 TI - Intestinal microflora, morphology and enzyme activity in zinc-deficient and Zn supplemented rats. AB - 1. Immature, male Wistar rats were given a low-zinc diet (2 mg/kg) for 22-24 d. Control groups received a similar diet supplemented with 58 mg Zn/kg either ad lib., or in amounts matched to the consumption of the Zn-deficient group. Food consumption, rate of growth and food conversion efficiency were markedly lower in the Zn-deficient group of rats compared with controls. Appetite, growth rate and food utilization improved dramatically over a subsequent 4 d period of Zn supplementation. 2. Morphological examination of samples of jejunum and ileum confirmed that Zn deficiency in the rat is accompanied by a reduction in villous dimensions and increase in villous density. After a short period of Zn supplementation, villous density and the basal width and maximum height of individual villi in the jejunum returned to normal. Similar changes occurred in the ileum but to a lesser extent. 3. Mucosal alkaline phosphatase (EC 3.1.3.1) activity was significantly lower in the small intestine of Zn-deficient rats compared with Zn-supplemented rats. Disaccharidase activities were lower in the Zn-deficient group, compared with their feed-restricted counterparts, but were similar to values for ad lib.-fed controls. Tissue alkaline phosphatase and disaccharidase activities were consistently higher after a 4 d period of Zn supplementation, compared with non-supplemented animals, but this increase was only significant for alkaline phosphatase. 4. Although there were striking similarities in the mucosal characteristics of gnotobiotic and Zn-deficient rats, there was no indication that even severe dietary Zn depletion reduced the numbers of viable bacteria present in either the small or large intestine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676179 TI - Experimental zinc deficiency in guinea-pigs: biochemical changes. AB - 1. Zinc deficiency was produced experimentally in guinea-pigs fed on a diet containing 1.25 mg Zn/kg diet over a period of 60 d. In addition, the response of the Zn-deficient (ZnD) animals to Zn supplementation was studied for 15 d. 2. In the ZnD group a significant reduction was found in serum Zn and protein concentrations and in alkaline phosphatase (EC 3.1.3.1; AP) activity from day 24 onwards. 3. Paper electrophoretic studies on serum revealed a significant decrease in relative values, as well as absolute values, of albumin and gamma globulin and an increase in beta-globulin. 4. Albumin:globulin increased on day 24 but decreased significantly from day 48 onwards. 5. The kidney and testis of the ZnD group showed a reduction in Zn and protein contents, and AP activity. 6. Zn supplementation of the previously ZnD group resulted in marked although incomplete improvement in the biochemical indices studied. PMID- 3676180 TI - Lipocyte hyperplasia and sexual maturation of Japanese quail (Coturnix coturnix japonica). AB - 1. Hyperplastic growth of adipose tissue in Japanese quail (Coturnix coturnix japonica) was examined in relation to sexual maturity to determine whether fat cell number is fixed in mature individuals of this species. 2. Total DNA concentrations in the lipid (lipocyte) and non-lipid (stroma) fractions of collagenase (EC 3.4.24.3)-digested abdominal (retroperitoneal) fat depots were determined on a chronological-age basis from 28 to 240 d of age. The in vivo incorporation of [methyl-3H]thymidine into DNA of both the lipocyte and stroma fractions of abdominal fat from both ad lib. and restricted-fed (75% of ad lib.) females was also examined at ages before and subsequent to sexual maturity. 3. In both males and females, significant increases in abdominal fat weights at ages beyond sexual maturity were associated with increased lipocyte DNA. Regardless of the feeding regimen and stage of maturity, substantial radioactivity was recovered from both the stromal and lipocyte fractions of abdominal fat when female quail were examined 24 h after the administration of tritiated thymidine. When examined 5 d post-injection, the majority of the radioactivity was contained in the lipid fraction of collagenase-digested adipose tissue. 4. Both the total DNA content of adipose tissue and the incorporation of tritiated thymidine into adipose tissue indicated that lipocyte hyperplasia contributes to postmaturational increases in fat deposition. PMID- 3676181 TI - A mechanism for the hypocholesterolaemic activity of saponins. AB - 1. Saponins are steroid or triterpene glycosides which occur in a number of important food plants, including such staples as soya beans (Glycine max) and chickpeas (Cicer arietinum). They are known to be hypocholesterolaemic. 2. Some saponins form an insoluble complex with cholesterol which prevents its absorption from the small intestine. Others cause an increase in the faecal excretion of bile acids, an indirect route for elimination of cholesterol. 3. We have investigated the effects of different saponins on absorption of the bile salt sodium cholate from perfused loops of small intestine, in vivo, in the rat. Purified saponins from soapwort (Saponaria officinalis), soya beans and quillaia (Quillaia saponaria) reduced the rate of absorption of the bile salt; soya-bean and soapwort saponins substantially so but quillaia saponin to a much lesser extent. 4. These results were explained by the formation of large mixed micelles by bile acid and saponin molecules in aqueous solution. These aggregates can have molecular weights in excess of 10(6) daltons, consequently the bile acid molecules incorporated in them are not available for absorption. 5. Control of plasma cholesterol and nutrient absorption through dietary saponins could provide substantial health and nutritional benefits in humans. PMID- 3676182 TI - Influence of dietary protein concentration on the oxidation of phenylalanine by the young pig. AB - 1. Piglets were weaned at 3 d of age and reared to 2.5 kg on a liquid diet in which the protein was supplied by dried skim milk and a mixture of free amino acids. The oxidation of L-[1-14C]phenylalanine was measured as an indication of the partition of amino acids between retention and catabolism in pigs (2.5 kg) offered meals containing varied concentrations of crude protein (nitrogen x 6.25). 2. The dietary protein concentration was varied either by increasing the inclusion of a mixture of free amino acids in a series of diets containing 100 g protein/kg from skim milk, or by increasing the level of inclusion of the skim milk in a series of diets containing the equivalent of 100 g protein/kg from the free amino acid mixture. 3. The oxidation of phenylalanine was minimized by dietary protein concentrations of 240 and 258 g/kg for the diets containing increasing concentrations of free amino acids or skim milk respectively. 4. These results show that a mixture of free amino acids is used more effectively than intact protein for promoting retention of essential amino acids. 5. The recovery of radioactivity in expired carbon dioxide was inversely related to the recovery of radioactivity in liver tissue when the concentration of dietary crude protein was increased from deficient to adequate, demonstrating that the fractional oxidation of the indicator amino acid was inversely related to protein synthesis. PMID- 3676183 TI - Proline as an essential amino acid for the young pig. AB - 1. The catabolism of L-[1-14C]phenylalanine was used to indicate the effects of single amino acid supplementation of an inadequate protein diet (200 g crude protein (nitrogen x 6.25)/kg) on the utilization of dietary amino acids in pigs of 2.5 kg body-weight reared on an adequate protein diet (240 g crude protein/kg) containing skim milk and a mixture of free amino acids. 2. The oxidation of phenylalanine was decreased by the addition of proline or arginine to the inadequate protein diet but not by the addition of threonine, methionine, lysine or a mixture of essential amino acids, indicating that proline and arginine were limiting the utilization of dietary amino acids in the inadequate protein diet. 3. Dietary proline concentrations of 13.9 and 14.2 g/kg minimized phenylalanine oxidation in diets containing 200 or 260 g protein/kg. This indicates a dietary proline requirement of 14 g/kg. 4. Increasing the dietary arginine concentration in a diet containing 240 g protein/kg showed that an arginine concentration of 5.1 g/kg minimized phenylalanine oxidation. However, increasing the arginine concentration in a diet containing 200 g protein/kg increased phenylalanine oxidation, suggesting an amino acid imbalance involving arginine at this lower level of protein. PMID- 3676184 TI - The efficiency of energy utilization in growing cattle consuming fresh perennial ryegrass (Lolium perenne cv. Melle) or white clover (Trifolium repens cv. Blanca). AB - 1. Twenty Friesian steers (225 kg live weight) were fed on mid- (M) (June-July) and late- (L) (August-September) season crops of either fresh perennial ryegrass (Lolium perenne cv. Melle) (G) or white clover (Trifolium repens cv. Blanca) (C). Each of the forage diets was offered at three restricted planes of nutrition above maintenance to compare the effect of forage species on the efficiency of energy utilization. All diets were harvested daily from swards of regrowth forage of intended equivalent digestibility. 2. Faecal and urine excretions were measured for 7 and 5 d respectively, followed by two consecutive 24 h measurements of methane, carbon dioxide and oxygen exchange in open-circuit respiration chambers. 3. The apparent digestibility of the energy in perennial ryegrass (0.759) was marginally higher (P less than 0.01) than that in white clover (0.748); the mid- and late-season forages were of similar (P greater than 0.05) digestibilities. Metabolizable energy (ME): digestible energy (DE) in diet G (0.837) was significantly (P less than 0.001) different from that in diet C (0.812). The partition of energy losses when expressed as MJ/GJ gross energy intake (GEI) indicated that energy lost as methane was not significantly different (P greater than 0.05) either between forages (G 62.8, C 63.4) or between seasons (M 63.2, L 63.1). Energy excretion in urine was higher for cattle fed on diet C (77.5) compared with diet G (60.5) (P less than 0.001). Heat production was similar (P greater than 0.05) between forages (G 480, C 478), but lower (P less than 0.01) for L (471) compared with M(486). Energy retention (by difference) was lower (P less than 0.001) for diet C (132) than G (156) and for M (138) than L (149) (P less than 0.05). 4. Parallel-line analysis of unscaled ME intake (MEI) in relation to retained energy (RE; MJ/d) indicated that the efficiency of utilization (kt) was similar (P greater than 0.05) between perennial ryegrass (0.42) and white clover (0.46). Linear extrapolation of the values to zero energy retention indicated that maintenance requirements of ME (Em; MJ/d) were 23.3 for diet G and 28.8 for diet C. The extrapolated Em when expressed in relation to a measured fasting heat production (FHP) of 22.8 (MJ/d) resulted in a derived efficiency of utilization of ME for maintenance (km) of 0.97 (G) and 0.79 (C), suggesting an underestimate of Em for diet G.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676185 TI - The early anaemia of the premature infant: is there a place for vitamin E supplementation? AB - 1. The efficacy of oral vitamin E supplementation in preventing the early anaemia of the premature infant was assessed in a 10-week double-blind trial. Forty-two babies received either a placebo or 5 or 15 mg supplementary vitamin E/d with oral feeding. No infant received less than the recommended vitamin E:polyunsaturated fatty acid (E:PUFA) value of 0.6. No iron supplement was given. 2. Weekly full blood counts were taken, and plasma vitamin E assay and in vitro haemolysis tests performed on blood sampled on day 1, and also at 6 and 10 weeks of age. All blood withdrawn and transfused and all feeds were documented. 3. Thirty-six (86%) of the babies had a plasma vitamin E level at birth below the accepted adult norm, i.e. less than 5200 micrograms/l. At 6 weeks of age thirty three (79%) and at 10 weeks thirty-five (83%) of the babies had levels within the normal adult range. No baby showed either clinical or haematological evidence of a vitamin E deficiency state during the trial. 4. It is concluded that in the absence of Fe supplementation and observing the minimum recommended E:PUFA value, contemporary feeding practices allow for the absorption of sufficient vitamin E by the premature baby to prevent the development of an early haemolytic anaemia. 5. No significant relation was found between plasma vitamin E levels and the degree of peroxide haemolysis. PMID- 3676186 TI - Balance studies in patients with intestinal resection: how long is enough? AB - 1. Results from two independent metabolic balance studies in patients with ileal resection with or without a remaining colon were examined to assess the precision of the mineral, protein and fat balances obtained. 2. Low day-to-day variation in balances was found in patients with ileostomy/jejunostomy, irrespective of formula diet composition. In contrast, patients with a remaining colon showed considerable variation, with reliable cumulative balances often not reached for many weeks. 3. In conclusion, short-term cumulative balances can be performed with good precision in patients with ileostomy or jejunostomy. PMID- 3676187 TI - Carotene dioxygenase (EC 1.13.11.21) activity in rat intestine: effects of vitamin A deficiency and of pregnancy. AB - 1. Female weanling rats were fed on a purified diet containing either no vitamin A, apart from traces present in casein (deficient groups), or the same diet containing 1.55 mg retinol as retinyl acetate/kg (control groups). In one experiment the deficient groups were given 1 microgram retinol/d after 10 weeks, to permit successful reproduction under conditions of marginal vitamin A status. A proportion were mated at 11 weeks after weaning, and fetal development was permitted for 7 d or for 20 d before killing. 2. Carotene dioxygenase (EC 1.13.11.21) activity was measured in a supernatant fraction from intestinal mucosal scrapings. For each group, activity was 20-30% greater in the vitamin-A deficient animals than in the controls, and the difference reached statistical significance for the virgin and 7 d pregnant animals in the first experiment (severe deficiency) and for the 20 d pregnant animals in the second experiment (less-severe deficiency). 3. It is suggested that low tissue vitamin A levels may feedback to increase carotene dioxygenase activity, by mechanisms at present unknown, presumably to ensure a more efficient use of precursor dietary carotenoids. PMID- 3676188 TI - Influence of environmental temperature on energy balance, diet-induced thermogenesis and brown fat activity in 'cafeteria'-fed rats. AB - 1. Young male rats were fed on a pelleted stock diet or a variety of palatable food items ('cafeteria' diet) and housed at 24 degrees or 29 degrees. 2. 'Cafeteria' feeding at the lower temperature stimulated energy intake, gain and expenditure, but reduced energetic efficiency such that over 70% of the excess intake was expended. 3. Housing at 29 degrees suppressed intake and expenditure in animals on both diets, but to a greater extent in 'cafeteria'-fed rats and energetic efficiency was greater than control values at this higher temperature. 4. The thermogenic capacity of brown fat (mitochondrial purine nucleotide binding) was increased by 'cafeteria' feeding, but was suppressed in animals kept at 29 degrees. 5. The results demonstrate that diet-induced thermogenesis is inhibited by high environmental temperatures. PMID- 3676189 TI - Microbially corrected amino acid composition of rumen-undegraded feed protein and amino acid degradability in the rumen of feeds enclosed in nylon bags. AB - 1. In the previous work (Varvikko & Lindberg, 1985), 15N-labelled rapeseed (Brassica napus), barley, ryegrass (Lolium perenne) and barley straw were incubated in the rumen in nylon bags for 5, 12 and 24 h and microbial nitrogen in the residues was quantified using the feed 15N-dilution method. In the present study, residual amino acids (AA) of these feeds were analysed, and microbially corrected AA of feed origin (feed AA) were estimated as the difference between total residual AA and respective microbial AA, assuming a constant AA composition for the microbial protein. 2. In barley and barley-straw residues, and also in ryegrass incubated in the rumen for 24 h, very large enrichment by microbial N and AA-N was found. The microbial enrichment was rather small in rapeseed residues and ryegrass incubated for 5 or 12 h. During the rumen incubation, feed N and AA-N (g/kg feed dry matter (DM] decreased very clearly in all the feeds, and feed and incubation time effects were always statistically significant (P less than 0.001). 3. The slow degradation of essential (E) feed AA compared with the respective non-essential (NE) AA degradation increased the proportion of feed EAA (g/kg determined feed AA) in barley and barley-straw residues. In rapeseed and ryegrass, residual feed EAA:NEAA remained very similar to the original. Branched-chain (Br) AA tended to increase proportionally in all the feed residues, suggesting these AA to be, on average, more resistant against microbial degradation in the rumen than other AA. Similarly, lysine was clearly increased in barley residues. A rumen degradation faster than the average rate caused decreased residual feed glutamic acid in rapeseed; methionine, alanine and glycine in barley; arginine and alanine in ryegrass; and methionine, asparagine and tyrosine in barley straw. Feed and incubation time effects were significant (P less than 0.05-0.001) for feed AA (g/kg determined feed AA) grouped as EAA, BrAA or NEAA, and for most individual AA, as well as for feed AA disappearance (%) and relative amounts (%) of feed AA in the respective residual AA. 4. According to present findings, AA composition of the rumen-degraded vegetable feed residues may markedly differ, either quantitatively or qualitatively (or both), from their original AA composition. When determining the feed AA composition of nylon-bag residues, the microbial error may be very large with starchy or fibrous feeds of low protein content. The microbial AA do not, however, considerably confuse the AA determination of protein-rich feeds. PMID- 3676190 TI - Effects of adrenalectomy before weaning in the genetically obese Zucker rat (fa/fa). AB - 1. Lean (Fa/?) and obese (fa/fa) Zucker rats were adrenalectomized or sham operated at 19 d of age (3 d before weaning). Injection of corticosterone for 3 d after weaning (1.0 mg/d) was necessary to ensure survival of adrenalectomized fa/fa but not Fa/? rats. Intact and adrenalectomized fa/fa rats had a lower rectal temperature than Fa/? animals before and 3 d after adrenalectomy. The post weaning survival of adrenalectomized fa/fa rats was enhanced by maintenance at an ambient temperature of 30 degrees rather than 22 degrees. 2. Adrenalectomized and sham-operated rats were therefore kept at 30 degrees, fed ad-lib. and killed at 34 d. Adrenalectomy had only small effects on the growth, body composition and appetite of Fa/? rats. The hyperphagia, greater lipid content, reduced protein content and hyperinsulinaemia of fa/fa rats were completely abolished by adrenalectomy. 3. Intact fa/fa rats had higher liver glycogen contents and higher activities of the hepatic enzymes tyrosine aminotransferase (EC 2.6.1.5) and acetyl CoA carboxylase (EC 6.4.1.2) than intact Fa/? animals. Adrenalectomy abolished these phenotypic differences. 4. Injection of adrenalectomized rats with 1.0 mg corticosterone-21-acetate daily from weaning to 34 d restored the abnormal body composition, hyperphagia, hyperinsulinaemia, higher hepatic glycogen and enzyme activities of fa/fa rats. 5. In a second experiment adrenalectomized rats were injected with 1.0 mg corticosterone-21-acetate daily from weaning to 34 d and kept at 22 degrees. fa/fa rats adrenalectomized and injected with corticosterone had a reduced body lipid content compared with intact fa/fa rats but still contained more lipid than intact or similarly treated Fa/? animals. 6. In both experiments adrenalectomized Fa/? and fa/fa rats injected daily with corticosterone had the same plasma concentrations of this hormone when killed 3 h after the last injection at 34 d. It is concluded that corticosterone is required for expression of the abnormal appetite, hyperinsulinaemia and body composition of the fa/fa rat. PMID- 3676191 TI - Production of tricarballylic acid by rumen microorganisms and its potential toxicity in ruminant tissue metabolism. AB - 1. Rumen microorganisms convert trans-aconitate to tricarballylate. The following experiments describe factors affecting the yield of tricarballylate, its absorption from the rumen into blood and its effect on mammalian citric acid cycle activity in vitro. 2. When mixed rumen microorganisms were incubated in vitro with Timothy hay (Phleum pratense L.) and 6.7 mM-trans-aconitate, 64% of the trans-aconitate was converted to tricarballylate. Chloroform and nitrate treatments inhibited methane production and increased the yield of tricarballylate to 82 and 75% respectively. 3. Sheep given gelatin capsules filled with 20 g trans-aconitate absorbed tricarballylate and the plasma concentration ranged from 0.3 to 0.5 mM 9 h after administration. Feeding an additional 40 g potassium chloride had little effect on plasma tricarballylate concentrations. Between 9 and 36 h there was a nearly linear decline in plasma tricarballylate. 4. Tricarballylate was a competitive inhibitor of the enzyme, aconitate hydratase (aconitase; EC 4.2.1.3), and the inhibitor constant, KI, was 0.52 mM. This KI value was similar to the Michaelis-Menten constant (Km) of the enzyme for citrate. 5. When liver slices from sheep were incubated with increasing concentrations of tricarballylate, [14C]acetate oxidation decreased. However, even at relatively high concentrations (8 mM), oxidation was still greater than 80% of the maximum. Oxidation of [14C]acetate by isolated rat liver cells was inhibited to a greater extent by tricarballylate. Concentrations as low as 0.5 mM caused a 30% inhibition of citric acid cycle activity. PMID- 3676192 TI - Somatomedin-C and zinc status in rats as affected by Zn, protein and food intake. AB - 1. The objective of the present experiment was to study the level of plasma somatomedin-C (SM-C) and the status of zinc in rats as affected by three levels of Zn given in combinations with two levels of protein. 2. Six groups of rats were fed, for 21 d, on six different diets based on combinations of two levels of dietary protein (low protein, 75 g/kg; high protein, 200 g/kg) and three levels of zinc (low Zn, 0.9 microgram/kg; moderate Zn, 55 micrograms/kg; high Zn, 110 micrograms/kg). All groups were pair-fed with the group receiving the low-Zn-low protein diet. An additional group of six rats served as an ad lib.-fed control group and was fed on a diet that contained 55 micrograms Zn/kg and 200 g protein/kg ad lib. 3. Body-weight gain and food intake were recorded daily. Rats were killed at the end of the experimental period (21 d). Zn was assayed in plasma, tibia and liver by atomic absorption technique. Plasma SM-C was assayed by radioimmunoassay. 4. In rats given the low-Zn-low-protein diet, the level of plasma SM-C increased in response to the increase in the amount of Zn or Zn and protein in the diet. However, no change was observed when the level of protein alone was increased. 5. Among all groups tested, ad lib.-fed rats showed the highest level of plasma SM-C. Thus it may be concluded that a balanced diet combined with adequate food intake is necessary to maintain an optimal level of plasma SM-C. PMID- 3676193 TI - Taurine concentrations in the diet, plasma, urine and breast milk of vegans compared with omnivores. AB - 1. The concentration of taurine in the diets, plasma, urine and breast milk were measured in vegans and age- and sex-matched omnivore controls. Plasma and urinary amino acid concentrations were also determined. 2. Taurine was absent from the vegan diet and occurred in variable amounts in the diets of the omnivores. Urinary taurine levels were less than half those of the omnivores but plasma and breast-milk levels were only slightly lower. 3. Dietary energy intakes were similar in the vegans and omnivores, but protein intakes tended to be lower in the vegans. PMID- 3676194 TI - The influence of riboflavin deficiency on absorption and liver storage of iron in the growing rat. AB - 1. Iron absorption was measured in weanling riboflavin-deficient (RD) rats or weight-matched (WM) controls fed on appropriate diets for 7 weeks. Concentrations of radio-Fe (59Fe) in plasma were monitored every 30 min for 4 h following intragastric administration. 2. Total Fe absorption in RD rats was significantly lower than that in WM controls, and the tissues of the stomach and small intestine of RD rats retained significantly (P less than 0.001) more 59Fe by comparison with WM groups. 3. In a separate experiment, ferritin-Fe concentrations were measured in the livers of four groups of rats (ad lib. (C), pair-fed (PF) and WM controls and RD) at day 0, and subsequently at days 14, 21, 28, 35 and 49. 4. Liver ferritin-Fe concentration was significantly lower (P less than 0.05) in RD rats than in all other controls after 3 weeks on the respective diets and remained lower for the remainder of the experiment. PMID- 3676195 TI - Effects of sodium intake on lactation and Na levels in body fluids of Blackface ewes. AB - 1. A low-sodium diet was given to Blackface ewes over two reproductive seasons; the diet provided 3-7 mmol Na daily, except for the period of lactation, when Na intake was increased to around 11 mmol/d. The diet of the control ewes was supplemented with sodium chloride to provide the recommended allowance of about ten times the level in the experimental low-Na diet. 2. Milk production was assessed during the first 2 months of lactation from incremental changes in the live weight of lambs during controlled sucking periods. Na and potassium were determined in milk and also in plasma, saliva and urine. 3. Neither yield nor concentration of Na and K in milk was affected by the level of Na in the diet. These results were supported by the similarity in live-weight gain of lambs in both years regardless of diet. 4. Plasma Na and K concentrations were not affected by the level of dietary Na. Na concentration in saliva and urine was significantly lower in the treated than in the control ewes, and K concentration in saliva was significantly higher. PMID- 3676196 TI - Energy and nitrogen metabolism of rabbits during pregnancy, lactation, and concurrent pregnancy and lactation. AB - 1. In an experiment twenty-four cross-bred does were used, six in each of four physiological states: non-pregnant (NP), pregnant (P), lactating (L) or concurrently pregnant and lactating (CPL). They were offered a diet of high nutrient density (crude protein (nitrogen x 6.25) 272 g/kg dry matter (DM), metabolizable energy 15.5 MJ/kg DM) at one of two intakes on a scale based on metabolic body-weight (kg body-weight 0.75). The study lasted for 24 d and was divided into three consecutive 8 d periods: 'early', 'mid-' and 'late' pregnancy or lactation, or concurrent pregnancy and lactation. 2. Around the mid-point of each period the does were placed for 24 h in a gradient-layer calorimeter, and measurements of energy exchange were made. N balance was also measured throughout each period of the study. 3. Milk output in L and CPL does was measured by weighing the does immediately before and after suckling once each day. Milk samples were taken from a parallel group of does and the estimates of milk composition applied to the experimental group. 4. Milk yields and composition were similar for L and CPL does in early and mid-lactation, but in late lactation the milk output from CPL does declined rapidly. This was the period of maximal fetal growth rates. Energy and N retention increased in P and CPL does in late pregnancy. 5. Regression analysis was carried out to summarize the relations between metabolizable energy intake (MEI) and energy retention (ER; MEI-heat loss) in each physiological state. The equations were: NP: ER = 0.67 (SE 0.057) MEI-208, P: ER = 0.67 (SE 0.095) MEI-224, L: ER = 0.90 (SE 0.022) MEI-441, CPL: ER = 0.85 (SE 0.036) MEI-387, where all variables are expressed in kJ/kg body weight 0.75 per d. PMID- 3676197 TI - Effect of forage species and season on nutrient digestion and supply in grazing cattle. AB - 1. A total of twenty Friesian steers were grazed on pure swards of either perennial ryegrass (Lolium perenne cv. Melle) or white clover (Trifolium repens cv. Blanca) from May to late August to examine the effect of forage species and season on nutrient digestion and supply. Within each forage species, two daily allowances of forage (i.e. 30 and 60 g dry matter (DM)/kg live weight) were given, and nutrient flow into the small intestine was measured on thirteen separate occasions (viz. seven grasses and six clovers). 2. Total nitrogen content of the grasses varied between 28 (early season), 19 (mid-) and 33 (late) g/kg DM, whilst the clovers showed a much narrower range and all values were higher (39-45 g/kg DM). In vitro organic matter (OM) digestibilities of plucked samples ranged from 742 to 809 g/kg OM (grass) and 712 to 790 g/kg OM (clover), the lowest values being noted in late June (grass) and mid-July (clover). 3. OM intakes calculated from estimated faecal OM output (using unlabelled ruthenium) and predicted OM digestibility of the consumed forage indicated mean values of 20.9 (grass) and 26.0 (clover) g/kg live weight (P less than 0.001), whilst the higher forage allowances increased OM intake by approximately 8% on both grass and clover (P less than 0.01) compared with the low allowance. OM intake was significantly (P less than 0.01) lower on the two primary growths of grass examined in May (mean 16.8 g/kg live weight) than the other five grass diets. 4. Rumen molar propionate levels declined with season but were at all times higher on the grass than on the clover diets, whilst acetate levels were unaffected by forage species. Apart from the late-season grass, mean rumen ammonia concentration was less than 100 mg NH3-N/l on all grass diets, whilst values on the clover diets ranged from 200-350 mg/l. 5. Daily duodenal OM flows in relation to animal live weight were approximately 20% higher on the clover than on the grass diets (grass 9.2, clover 11.2 g/kg live weight, P less than 0.001), but estimates of the proportion of digestible OM apparently digested in the rumen were not significantly influenced by forage species (grass 0.69, clover 0.71).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676198 TI - Determination of digestible and available amino acids in meat meal using conventional and caecectomized cockerels or chick growth assays. AB - 1. The present study was designed to compare true digestible amino acid values for meat meal with available amino acid values. True digestible values were determined with a 48 h excreta collection assay using conventional (CONV) and caecectomized (CEC) cockerels. Available values for lysine, methionine and cystine were estimated by chick growth assays. 2. True digestibilities of all sixteen measured amino acids (expressed as a proportion of the total) were lower for CEC than for CONV cockerels, with the average difference being approximately 0.10. 3. Chick growth assays based on total weight gain indicated that the availabilities of amino acids expressed as a proportion of the total amino acids in meat meal were: 0.70 for lysine, 0.75 for methionine and 0.48 for cystine. Partitioning weight gains to reflect only growth attributable to supplemental crystalline amino acid or meat meal intake consistently yielded higher availability values than when total weight gains were used. 4. True digestibility values determined with CEC cockerels were in better agreement with chick available values than were true digestibility values determined with CONV cockerels. 5. The amounts of amino acids present in the caeca of meat meal-fed CONV cockerels at 48 h after feeding were small when compared with those levels voided in the excreta and those levels consumed in the feed. 6. Multiple regression analyses of excreta and caecal amino acid profiles at 12 and 48 h after feeding suggested that significant amounts of non-digested dietary amino acids flowed into the caeca and were subsequently metabolized by the caecal microflora. PMID- 3676199 TI - Flow of nitrogen from the rumen and abomasum in cattle and sheep given protein free nutrients by intragastric infusion. AB - 1. Three experiments were conducted to determine the flow of nitrogen through the rumen and abomasum when cows, steers and lambs were totally nourished on volatile fatty acids infused into the rumen. 2. In two dairy cows (650-700 kg) and two large steers (370-405 kg) the daily flow of non-ammonia-N (NAN) from the rumen was 50.7 and 58 mg/kg live weight (W)0.75 respectively. 3. The flows of NAN through the rumen and abomasum in four young steers (240-315 kg) were 85.0 (SE 21.0) and 195 (SE 7.0) mg/kg W 0.75 respectively. 4. In the third experiment the effects of altering rumen pH and osmotic pressure on flow of NAN through the rumen and abomasum were investigated in lambs. While rumen pH and osmotic pressure influenced rumen volume and outflow they had no significant effect on NAN flow. The mean values for NAN outflow from the rumen and abomasum were 76 and 181 mg N/kg W 0.75 respectively. 5. Abomasal NAN flow increased with increasing abomasal pH. When osmotic pressure was greater than about 330 mosmol/l in the rumen there was a net inflow of water, while below this value there was net loss of water. 6. For all experiments the flow of N both from the rumen and abomasum was highly variable; this has to be considered if a constant value is used for endogenous N in estimating dietary N in the abomasum. 7. With N-free infusion the rumen NH3 concentration varied from 50 to 120 mg NH3-N/l. 8. The amino acid composition of rumen and abomasal N was also determined. Relative to tissue N it contained a higher proportion of cysteine. PMID- 3676200 TI - Stimulation of muscle growth by clenbuterol: lack of effect on muscle protein biosynthesis. AB - 1. Young rats were offered to appetite a semi-synthetic diet either alone or containing the beta 2-selective agonist clenbuterol (4-amino-alpha[t butylamino)methyl]-3,5-dichlorobenzyl alcohol). 2. In female rats (starting weight 116g) the presence of the drug at daily doses greater than 10 micrograms/kg body-weight per d increased the growth of skeletal and cardiac muscle but had no stimulatory effect on the growth of the liver, gastrointestinal tract and kidney. 3. Male rats (starting weight 53 g) received clenbuterol at a daily oral dose of 200 micrograms/kg body-weight per d. Animals were slaughtered after 0, 4, 8, 11, 18, 21 and 25 d of treatment. At 4, 11, 21 and 25 d muscle protein synthesis was measured by the method of Garlick et al. (1980). Although clenbuterol increased the rate of protein and RNA accretion in gastrocnemius and soleus muscles, protein synthesis was not increased. 4. The results suggested that the drug had a rapid, perhaps direct, inhibitory effect on protein degradation. It is concluded that the growth-promoting effect of clenbuterol may be specific to muscle and that the drug may act in a novel manner which circumvents the physiological mechanisms responsible for the control of muscle growth. PMID- 3676201 TI - Compensatory nitrogen retention in growing pigs following a period of N deprivation. AB - 1. Semi-synthetic diets, with dried microbial cells (Pruteen) as the nitrogen source, were used to measure N retention in 50 kg pigs given different combinations of N intake involving periods of deprivation and enhanced supply. 2. Metabolic faecal N losses were 1.92 g/d (1.26 g/kg dry matter eaten) and endogenous urinary losses were 3.96 g/d for pigs given an N intake of 6.9 g/d. 3. Compensatory N retention averaging 4.2 g extra N/d was observed in pigs given enhanced N supply by diets providing 31.0, 60.4 and 93.4 g N/d. In some instances enhanced N retention was maintained for 22 d. 4. Pigs given enhanced N supply by extravagant N intake did not maintain the compensatory response which had been evident initially. PMID- 3676203 TI - The effects of age, dietary restriction, exercise and maternity on the abundance and volume of adipocytes in twelve adipose depots of adult guinea-pigs. AB - 1. The mean adipocyte volume and cellularity of adipose tissue in twelve anatomically defined depots were measured in 190 virgin and reproductive guinea pigs aged 6 months to 2 years, maintained on five different regimens of diet and exercise. 2. The total adipocyte complement was constant up to the age of about 10 months and increased by 65-70% during the 2nd year of life. At constant percentage body-weight as fat, age-related accumulation of adipocytes was accompanied by reduction in average adipocyte volume. A period of high percentage body-weight as fat was not a necessary antecedent to age-related accumulation of adipocytes, and the effect was not observed in specimens that exercised regularly. 3. In guinea-pigs over 13 months old, changes in adipose tissue cellularity made a major contribution to total fatness. The mean volume of samples of adipocytes was a satisfactory indicator of fatness only in younger specimens in which adipose tissue cellularity was not changing. 4. The lean body mass and the total adipocyte complement were lower in guinea-pigs on the sedentary, restricted-diet regimen, whether the regimen began at the age of 19 weeks or 31 weeks, but the depots studied were not equally affected. Both moderate and strenuous exercise on an ad lib. diet caused a reduction in the percentage body-weight as fat in males but not in females. The total adipocyte complement and lean body mass were unchanged, although the males became almost as thin following exercise as those on the restricted-diet regimen. 5. Among guinea pigs under 400 d old, there were no significant differences between males and virgin females in the site-specific volume of adipocytes relative to the size of those in other depots of the same specimen; there was only one significant difference in this index between the older and the younger specimens. The diet and exercise regimens modified the site-specific adipocyte volume relative to those in other depots; adipocytes under the trapezius muscle of the neck (UMN), at the interscapular depot (HUMP) and those in the depots anterior to the forelimb became relatively smaller following exercise, while those in the popliteal fat mass were relatively larger. Adipocytes in the UMN and HUMP also became more numerous relative to those in the other depots following both moderate and strenuous exercise. Those in the groin site, the intra-abdominal depots and the intermuscular depots became relatively smaller following dietary restriction without exercise.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676202 TI - Estimation of tissue protein synthesis in sheep during sustained elevation of plasma leucine concentration by intravenous infusion. AB - 1. The fractional rate of protein synthesis (FSR) was determined in skeletal muscle, liver, rumen and cardiac muscle of wether sheep by continuous intravenous infusion of L-[4,5-3H]leucine accompanied by infusion of 0, 7.6, 15.2 or 22.8 mmol leucine/h (three sheep per treatment). FSR was calculated assuming plasma (ksp) or intracellular (ksi) leucine-specific radioactivity (SRA) was representative of the leucine precursor pool SRA for protein synthesis. 2. Plasma leucine concentration (plateau) was linearly related to leucine infusion rate, 22.8 mmol/h evoking a tenfold increase in plasma concentration. 3. Difference between plasma leucine SRA and intracellular leucine SRA in all tissues diminished as plasma leucine concentration increased. 4. There were significant differences between ksi and ksp estimates for liver and rumen in control sheep. 5. As leucine infusion rate increased, differences between ksi and ksp diminished in all tissues. With increasing leucine infusion, in liver ksi decreased and ksp was increased, in rumen ksi decreased and ksp was stable, while in cardiac and skeletal muscle ksi and ksp both increased. 6. At a leucine infusion rate of 22.8 mmol/h, mean ksp and ksi respectively were: 11 (SE 2), 13 (SE 1); liver 19 (SE 2), 21 (SE 2); cardiac muscle 3.6 (SE 0.4), 3.8 (SE 0.3); skeletal muscle 4.1 (SE 0.2), 4.5 (SE 0.5) and did not differ significantly in any tissue. PMID- 3676204 TI - Effect of glucose on fermentation heat in sheep rumen fluid in vitro. AB - 1. Heat production rate (H) of rumen fluid was measured in a direct calorimeter. Basal H of samples of 15 ml rumen fluid mixed with 45 ml buffer was 0.4 mW/ml rumen fluid. 2. Addition of glucose (0.4-6.4 mg/sample) was followed by a dose dependent increase in H. Maximal H was 1.1 mW/ml and lasted up to 5 min, returning thereafter to the basal level. 3. Expression of fermentation heat (Hf; kJ/mol substrate added) against glucose dose indicated an asymptotic dose response. 4. Maximal Hf (at infinite dilution) agreed with stoichiometric calculations whereas minimal Hf suggested a partial fermentation of the substrate at a high-glucose dose in the rumen environment. PMID- 3676205 TI - Errors in blood flow measurements. PMID- 3676206 TI - Thyroid hormone assay. PMID- 3676207 TI - Energetic efficiency and amino acid supply in ruminants. PMID- 3676208 TI - Yield and nutrient content of milk in eight women breast-feeding twins and one woman breast-feeding triplets. AB - 1. The milk yield of eight mothers each breast-feeding twins was determined by test weighing the mothers. Milk yield was determined at 2, 3, 6, 9, and 12 months post partum; however, only one mother was studied at all these times. 2. At 6 months post partum the milk yield for individual breasts of three mothers fully breast-feeding and four mothers partially breast-feeding their infants ranged from 0.84 to 2.16 kg/24 h and 0.42 to 1.39 kg/24 h respectively. The average frequency of breast-feeding for the mothers studied at 6 months post partum was 15.4 feeds/24 h. 3. The milk yield of one mother fully breast-feeding 2.5-month old triplets was 3.08 kg/24 h and the infants were fed twenty-seven times in 24 h. 4. The concentration of lactose, protein and mixed fat in the milk from individual breasts of mothers fully breast-feeding their infants ranged from 65.6 to 82.2, 7.8 to 15.7 and 16.7 to 46.2 g/l respectively. For the three mothers partially breast-feeding 12-month-old infants the values ranged from 54.8 to 71.8, 14.2 to 19.9 and 4.7 to 40.5 g/l respectively. 5. At 6 and 12 months of age, the proportion of the total energy intake of the infants which was derived from breast milk ranged from 64 to 100% and 6 to 13% respectively. 6. It is concluded that the maximum potential milk yield for women may be higher than the often quoted value of 700-800 ml/24 h. PMID- 3676209 TI - The nutrient intakes of pregnant and lactating mothers of good socio-economic status in Cambridge, UK: some implications for recommended daily allowances of minor nutrients. AB - 1. Forty-two mothers from social classes I, II and III non-manual and twenty-one from social classes III manual M), IV and V were studied longitudinally. The mean daily nutrient intakes in months 4-9 of pregnancy, months 2-4 of lactation and 3 and 6 months post-lactation are presented and are compared with the UK and the US recommended daily allowances (RDA). 2. The quality of the diets (nutrients per 4184 kJ (1000 kcal] was found to be better than that of other adult female populations studied in the UK, except for a group of dietitians. 3. The mean daily intakes of nutrients for which there are UK RDA were almost all greater than 100% of the RDA. The exceptions were iron, which in the manual group (social classes IIIM, IV and V) was 85% of the RDA in pregnancy and 75% post-lactation, and vitamin D. 4. Among the nutrients for which there are US, but not UK RDA, only phosphorus and vitamin B12 intakes were greater than 100% of the RDA in both groups at all stages of the study. Intakes of other nutrients were below the RDA: pantothenate 70-91, vitamin B6, zinc, vitamin E and copper 40-72, folate 21-44, and biotin less than 20% of the RDA. 5. The bases of the RDA for adult women were examined; for most nutrients the information is limited. It was concluded that the RDA for magnesium, vitamin E and pantothenate are probably higher than necessary and that deficiency is unlikely; that zinc, copper, vitamin B6 and folate are probably 'marginal' nutrients for 'at risk' groups; and that information on biotin is insufficient even roughly to assess the dietary requirement. PMID- 3676210 TI - The effect of a high-fat diet and sucrose drinking option on the development of obesity in spontaneously hypertensive rats. AB - 1. Energy intakes, body-weights, body fat index, total body fat and interscapular brown adipose tissue (IBAT) were examined in adult male, spontaneously hypertensive, stroke-prone (SHR-SP) rats and normotensive Wistar/Kyoto (WKY) controls given one of four diets for 33 d: (a) a starch diet, (b) a starch diet and a sucrose solution drinking option, (c) an 80% energy from fat (F80) diet, (d) the F80 diet and a sucrose drinking option. 2. The SHR-SP rats showed a complete resistance to obesity on all four diets. For the high-fat diet the WKY animals became markedly obese with approximately two-fold increases in body weight gain and body fat index when compared with the SHR-SP rats. The gain in total body fat was also significantly greater. IBAT as a percentage of total body weight did not differ between the WKY and SHR-SP groups. 3. Compared with the WKY animals, the SHR-SP rats showed a reduced food intake but had the same potential to gain weight from the high-fat diet. 4. It is concluded that the resistance to obesity by the hypertensive animals is the result of a diminished energy intake. PMID- 3676211 TI - Alcohol and high-density-lipoprotein cholesterol: a randomized controlled trial. AB - 1. A randomized controlled trial of cross-over design was set up to examine the effect of alcohol on blood lipids and certain haematological variates relevant to ischaemic heart disease. 2. One hundred subjects drank some alcohol for 4 weeks (mean intake 18.4 g/d) and abstained totally for 4 weeks, the order of these periods being randomized. 3. Alcohol appeared to produce a rise of 7% in serum high-density-lipoprotein (HDL) cholesterol, probably due to a rise in the HDL2 subfraction. 4. No significant change was detected in plasma fibrinogen or the other haematological indices. 5. These results are consistent with the hypothesis that a moderate intake of alcohol confers some protection against heart disease. PMID- 3676212 TI - n-3 Essential fatty acids decrease weight gain in genetically obese mice. AB - 1. Lean (ln/ln) and obese (ob/ob) mice were given diets containing a fat source of 100 g evening primrose (Oenothera biennis) oil (fatty acids 18:2n-6, 18:3n-6; EPO) or 100 g cod liver oil (20:5n-3, 22:6n-3; CLO)/kg diet. 2. Weight gain was lower in the ob/ob mice fed on CLO, an effect unrelated to food intake. 3. In the ob/ob mice fed on CLO, thromboxane synthesis by clotting platelets was reduced compared with that in ob/ob mice fed on EPO. 4. The ob/ob CLO-fed mice had lower arachidonic acid but higher levels of n-3 fatty acids in liver, brown adipose tissue and white adipose tissue. 5. The n-3 fatty acids in CLO therefore replaced the n-6 fatty acids in tissue lipids and reduced synthesis of '2 series' prostaglandins in addition to causing lower weight gain in the CLO-fed ob/ob mice. PMID- 3676213 TI - Percentage body fat and prevalence of obesity in a UK offshore population. AB - 1. Body-weight, body height and skinfold measurements were taken in 419 adult males working in the UK offshore oil industry. Percentage body fat was estimated from skinfold thicknesses and the Quetelet index (weight:height) determined. 2. The prevalence of overweightness, assessed from the Quetelet index, in the age groups 20-29, 30-39 and 40-49 years was 31.6, 50.0 and 66.2% respectively. The Office of Population Census and Surveys (1981) showed that for age-matched groups, the incidence of overweightness in an onshore population was 26, 40 and 50% respectively. 3. The percentage body fat for each respective age group was greater than that reported for an age-matched onshore population. 4. The Quetelet index was significantly related to body fat (r 0.765, P less than 0.0001) and poorly correlated with height, thus this weight:height relation may be utilized in the assessment of overweightness in offshore personnel. 5. In conclusion it appears that the offshore population had a higher percentage body fat than their onshore peers and that the prevalence of overweightness was also greater. PMID- 3676214 TI - Energy metabolism in healthy black Kenyan children. AB - 1. Twenty-four healthy black Kenyan children, mean age 29 (SD 19) months, were studied over a 24 h period. Energy expenditure (EE) was determined using a ventilated-hood indirect calorimeter; measuring oxygen consumption and carbon dioxide production. Metabolizable energy intake was measured in twenty children. Anthropometric measurements were used to estimate surface area and lean body weight. 2. The mean daily intake of metabolizable energy was 338.4 (SE 28.4) kJ/kg; 70% of gross dietary energy being provided by carbohydrate. The level of postprandial EE was significantly (P less than 0.05) higher than the resting level (12.6 (SE 0.47) and 11.38 (SE 0.37) kJ/kg per h respectively) while the level of the postprandial respiratory quotient (RQ) was similar to the resting level (0.94 (SE 0.02) and 0.98 (SE 0.03 respectively). In 33% of total observations of the resting RQ the value was more than 1.0. These findings suggest that short-term fat storage may be a normal feature of metabolism in children, and also that the energy cost of (postprandial) fat synthesis is increased by a high-carbohydrate diet. 3. Values for the resting metabolic rate and various estimators of body size were compared using regression analysis. It was evident that, in these young children with considerable variation in body composition, body-weight remained a satisfactory metabolic-size estimator. PMID- 3676215 TI - The effect of protein and energy deficiency on skin glycosaminoglycan levels in the rat. AB - 1. The effects of protein-deficient and energy-deficient diets on the concentrations of skin glycosaminoglycans (GAGs) and collagen were studied in young rats. 2. In Expt 1, comparisons were made between animals fed on a control (C) diet (protein:energy (P:E) 0.210), a low-protein (LP) diet (P:E 0.032) and a very-low protein (VLP) diet (P:E 0.005) ad lib. Skin GAGs and collagen concentrations were determined at intervals as the animals became malnourished and when some of those fed on the VLP diet started showing signs of oedema. Concurrently, plasma albumin concentrations were determined to assess the extent of hypoalbuminaemia. With prolonged severe protein deficiency all GAGs species were reduced below normal levels. Collagen concentration decreased with prolonged protein deficiency. Protein-deficient rats developed hypoalbuminaemia. 3. In Expt 2, comparisons were made between animals fed on the C, LP and VLP diets ad lib. and others given the C diet in restricted amounts sufficient to maintain body weights identical to those fed on LP or VLP diets ad lib. Energy-deficient rats, wasting at rates similar to protein-deficient ones, had higher skin GAGs concentrations than those in protein-deficient or control animals. With prolonged malnutrition, collagen concentrations were similar in protein- and energy deficient animals and lower than those observed in control animals. Plasma albumin concentrations in energy-deficient animals were above starting values, except in severely energy-deficient animals at the end of the experiment. Protein deficient animals developed hypoalbuminaemia. 4. In conclusion, the present study has shown that the main difference between prolonged severe protein deficiency and energy deficiency in the rat is that skin hyaluronic acid concentration is higher than normal in energy deficiency but below normal levels in prolonged severe protein deficiency. Initially skin collagen concentrations are higher than normal in both protein- and energy-deficient animals. However, with prolonged malnutrition the concentrations are reduced. PMID- 3676216 TI - The effects of a high-animal- and a high-vegetable-protein diet on mineral balance and bowel function of young men. AB - 1. Twelve young men were given for periods of 20 d, each of three mixed diets, namely a low-protein (LP) diet (9% total energy as protein, 67% of animal origin), a high-animal-protein (HA) diet (16% total energy as protein, 67% of animal origin) and a high-vegetable-protein (HV) diet (16% total energy as protein, 67% of vegetable origin). Retention of calcium, magnesium, iron, zinc and copper as well as various bowel function indices were investigated during each dietary period. 2. Neither the HA diet nor the HV diet changed the retention of the minerals considerably. Only Fe balance decreased significantly on the HV diet. 3. Substituting the HV diet for the HA diet resulted in significant increases in faecal wet weight (17 g/d), defaecation frequency (0.12 stools/d), faecal volatile fatty acids (2.6 mmol/d) and a decrease in faecal bile acids (128 mumol/d). 4. It is concluded that a HV diet, rather than a HA diet is to be recommended with respect to bowel function, whereas the HV diet does not necessarily have a significant influence on mineral retention. PMID- 3676217 TI - The effect of oral contraceptives on the apparent vitamin B6 status in some Sudanese women. AB - 1. In vitro activation of erythrocyte aspartate aminotransferase (EC 2.6.1.1) activity by pyridoxal phosphate was used to assess vitamin B6 nutritional status in forty Sudanese women taking combined, low-dose oral contraceptives (oestrogen progestogen; OC) and in thirty healthy, non-pregnant women not taking OC. 2. Fourteen (35%) out of forty OC users showed apparent vitamin B6 deficiency. 3. Side-effects associated with OC were more common among the apparently vitamin-B6 deficient OC users than among OC users and non-OC users not deficient in vitamin B6. PMID- 3676218 TI - Abnormal fermentations in continuous cultures of rumen micro-organisms given cobalt-deficient hay or barley as the food substrate. AB - 1. Four experiments, each with four concurrent continuous cultures of rumen micro organisms, were used to investigate the effects of inoculum, food substrate and cobalt supplementation on the course of fermentation and vitamin B12 synthesis. The inocula came from sheep receiving either a Co-rich, complete diet (Ruminant A: Expts 1, 2 and 4) or a Co-deficient hay (Expt 3). In Expt 2, inocula from different donors were used for each culture but for other experiments they were pooled. Co-deficient hay was used as the initial substrate and Co-supplements were given after 8-54 d Co-depletion. 2. In three of four experiments, two using a pooled inoculum, uncharacteristically low acetate (Ac) and high propionate (Pr) outputs were obtained from the hay substrate in some cultures. In all, six cultures gave Ac:Pr values in the effluent less than 2:1 and, in Expt 3, the differences remained evident for at least 6 d after a change to a Co-deficient barley substrate. 3. Abnormal cultures gave lower cobalamin (cbl) and vitamin B12 analogue outputs than normal cultures: when supplemented with Co they showed small responses in cbl and large responses in analogue output with a slow increase in Ac:Pr. 4. We suggest that the use of Co-deficient substrates led to shifts in the microbial populations of some cultures, indicating the cbl dependence of some species of rumen micro-organisms. PMID- 3676219 TI - Effects of intraruminal sodium chloride infusion on rumen and renal nitrogen and electrolyte dynamics in sheep. AB - 1. Sheep were given 800 g low-protein roughage/d at 2 h intervals and infused intraruminally with 0,500, 750, 1000, 1250, 1500 or 2000 mmol sodium chloride/d in 436 ml water. The digestibility of various food fractions and rumen ammonia, volatile fatty acids (VFA) and liquid turnover rate were measured, along with renal haemodynamics and the renal excretory patterns of nitrogen and electrolytes. Ad lib. food intake was determined during the infusion of 0 and 2000 mmol NaCl/d. 2. Infusion of NaCl up to 750 mmol/d had virtually no effect on the indices measured, except water intake and water excretion. Infusion of greater amounts caused a step-wise decrease in the digestibility of organic matter (OM) and N. Rumen liquid turnover rate was increased substantially and rumen NH3 and VFA concentrations were decreased. Ad lib. food intake was not different when either 0 or 2000 mmol NaCl/d were infused into the rumen. 3. The glomerular filtration rate and effective renal plasma flow (ERPF) were substantially increased after the infusion of 1250 mmol or more NaCl/d. Extracellular fluid volume was also increased. The renal excretion of urea and uric acid + allantoin (URAL) were decreased at the higher infusion rates but the fractional excretions of both these substances were enhanced. The excretion of sodium, chloride, calcium and magnesium were markedly increased with increasing salt infusion. 4. The results suggest that high NaCl inputs into the rumen increase the rumen turnover rate, which in turn decreases the digestibility of OM, particularly N. This causes lower rumen NH3 and VFA concentrations. Plasma urea and URAL concentrations are also decreased and this causes lower renal excretion of these substances despite a much higher fractional excretion resulting from the greatly enhanced urine flow rate. 5. When roughages low in N are given, NaCl intake should be kept below 20 mmol/kg body-weight per d to prevent a decline in the digestibility of the food and any consequent reduction in protein available to the sheep. PMID- 3676221 TI - Role of rumen protozoa in nitrogen digestion in sheep given two isonitrogenous diets. AB - 1. The effect of protozoa on digestion in the rumen was studied using either defaunated or faunated sheep. 2. Six wethers, each fitted with rumen and simple duodenal cannulas, were given two isonitrogenous diets containing either lucerne (Medicago sativa) hay (diet L) or sodium hydroxide-treated wheat straw (diet S). The diets were given in eight equal portions per day at 3-h intervals. The mean intake of dry matter, 53 g/kg body-weight0.75 per d, was similar for the two diets and each diet had a similar digestible organic matter content. Diet L promoted a large protozoal population and was rich in nitrogen sources of low rumen-degradability, while diet S supported a smaller protozoal population and was rich in rumen-degradable N. 3. Digesta flow at the duodenum was estimated by means of a dual-marker technique using chromium-mordanted lucerne hay and polyethylene glycol as markers. The microbial flow at the duodenum was estimated using diaminopimelic acid (DAPA), nucleic-acid purine bases (PB) and 35S incorporation simultaneously. The different microbial markers were compared in the defaunated sheep. Protozoal N contribution was estimated in faunated sheep. 4. Defaunated sheep had lower rumen ammonia concentrations and molar proportions of butyric acid than faunated sheep, but they had higher molar proportions of propionic acid. 5. Rumen organic matter digestion was reduced by defaunation, but this decrease was compensated for by increased intestinal digestion. 6. There was a net increase of N flow (approximately 10 g/d) between mouth and duodenum in defaunated sheep. This was explained by increases in both microbial and dietary N flows from the rumen compared with faunated sheep. 7. The influence of protozoa on solid- and liquid-phase retention times in the rumen is discussed, as well as the protozoal contribution to microbial N flow in the duodenum of faunated sheep. PMID- 3676220 TI - Methionine metabolism in isolated perfused livers from rats fed on zinc-deficient and restricted diets. AB - 1. Sulphur amino acid metabolism in livers from rats which had been fed ad lib. on a restricted diet (malnourished) or a Zn-deficient diet was investigated. Perfusion of normal livers with different amounts of L-methionine revealed that homocysteine was recycled four to five times before being eliminated via the transsulphuration pathway. 2. From the perfusion experiments, we found no evidence that any of the enzymes involved in recycling homocysteine back to methionine (methylation pathway) were adversely effected by Zn deficiency or malnutrition. 3. The intracellular concentration of cystathionine and S adenosylmethionine increased in all livers in response to increased concentrations of L-methionine (L-Met) in the perfusate. 4. The intracellular concentration of S-adenosylhomocysteine remained the same in all livers regardless of the concentration of perfusate methionine. 5. Although homocysteine did not accumulate in the cell, it was excreted into the perfusate. The amount of homocysteine in the perfusate of livers from Zn-deficient rats was higher than either ad lib. or pair-fed rats. 6. The breakdown of homocysteine, via the transsulphuration pathway, was augmented by Zn deficiency. This was apparent from the greater amount of alpha-ketobutyrate excreted by livers from Zn-deficient rats compared with pair-fed or ad lib.-fed controls. 7. The increase in metabolism of L-Met, via the transsulphuration pathway, in the livers from Zn deficient rats appears to reflect the lack of demand for this compound in protein synthesis and methylation reactions (Wallwork & Duerre, 1985). PMID- 3676222 TI - Effect of selenium deficiency on hydroperoxide-stimulated release of glutathione from isolated perfused liver of rainbow trout (Salmo gairdneri). AB - 1. Duplicate groups of rainbow trout (Salmo gairdneri) were each given partially purified diets which were either adequate or depleted in selenium for 40 weeks. 2. Although there was no significant difference in weight gain, liver Se concentration was significantly lower in fish given the deficient diet. 3. Glutathione (GSH) peroxidase (EC 1.11.1.9) activity was significantly reduced in liver of Se-deficient fish but a differential assay did not indicate the presence of a non-Se-dependent GSH peroxidase activity, although liver GSH S-transferase (EC 2.5.1.18) was significantly increased. 4. Perfusion of livers from trout given Se-adequate diets with t-butyl hydroperoxide (BuOOH) or hydrogen peroxide caused an increase in the rate of release of glutathione disulphide (GSSG) into the perfusate. 5. Perfusion of livers from Se-deficient trout with BuOOH or H2O2 did not result in any change in rate of release of GSSG into the perfusate. 6. These findings confirm the absence of any compensatory non-Se-dependent peroxidase activity in Se-depleted trout. PMID- 3676223 TI - The effect of forage species and stage of harvest on the processes of digestion occurring in the rumen of cattle. AB - 1. Pure swards of perennial ryegrass (Lolium perenne L. cv. Melle) or white clover (Trifolium repens L. cv. Blanca) were harvested daily as either primary growth (May-June) or mid- (July) and late- (August-September) season 4-week regrowths and offered to Friesian steers at two levels of feed allowance (18 and 24 g dry matter (DM)/kg live weight), to examine the effect of forage species and stage of harvest on nutrient digestion and supply. 2. The early- and mid-season grasses had low nitrogen (23 g/kg DM) and high water-soluble carbohydrate (169 g/kg) contents whilst the late-season grass had a higher N content (28 g/kg). All clover diets had high N (average 45 g/kg) and low water-soluble carbohydrate (89 g/kg) contents, and DM digestibility on all diets ranged from 0.77 to 0.83 (mean of two feeding levels). 3. Mean total rumen volatile fatty acid concentrations were significantly (P less than 0.001) higher on the clover diets, whilst on the grass diets molar proportions of propionate showed a slight but not significant decline with advancing season and tended to be higher than those on the clover diets. Mean rumen ammonia concentrations were significantly (P less than 0.001) lower on the early- and mid-season grasses (59 mg NH3-N/l) than the late-season grass (242 mg/l) and early-season clover (283 mg/l) which were all significantly (P less than 0.01) lower than the mid- and late-season clovers (372 and 590 mg/l) respectively. 4. Rates of organic matter (OM) and N digestion in the rumen were estimated using established nylon-bag techniques and found to be high on all diets, but significant effects due to forage species (clover greater than grass; P less than 0.001) were detected, whilst overall potential degradability in the rumen exceeded 0.89 for both OM and N on all diets. 5. Significantly (P less than 0.001) more OM entered the small intestine of calves fed on white clover (10.2 g/kg live weight) than those fed on ryegrass (8.33 g/kg) and similar effects due to level of feeding (g/kg; low 7.9, high 10.6; P less than 0.05) and stage of harvest (g/kg; early 8.3 v. mid 10.0, late 9.50; P less than 0.05) were also detected.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676224 TI - Dynamics of large ciliate protozoa in the rumen of cattle fed on diets of freshly cut grass. AB - 1. The dynamics of large ciliate (holotrich) protozoa (Isotricha and Dasytricha spp.) in the rumen of cattle given cut, fresh ryegrass (Lolium multiflorium Lam) were studied by means of a single intrarumen injection of 14C-labelled protozoa prepared in vitro by adding [Me14C]choline to rumen fluid containing protozoa and incubating at 39 degrees for 2 h. 2. An indication of the lysis rate of protozoa in the rumen was obtained from the radioactivity apparently lost through the methane pool. 3. The turnover time of the holotrich protozoa indicates that these protozoa were extensively retained in the rumen and that only a small proportion of those produced in the rumen flowed out in the digesta. This was supported by the estimation of the rate of lysis which was approximately 85% of the turnover rate in the rumen. 4. The apparent production rate of the larger protozoa indicates that they contribute only about 9% of the predicted net microbial protein synthesis in the rumen. PMID- 3676225 TI - The effect of digestibility and forage species on the removal of digesta from the rumen and the voluntary intake of hay by sheep. AB - 1. The characteristics of digestion, passage and rumen fill of three hays: early- and late-cut perennial ryegrass (Lolium perenne cv. Endura) and white clover hay (Trifolium repens cv. Blanca and Pronitro) were studied using six rumen cannulated sheep fed at a restricted level of intake (18 g dry matter (DM)/kg live weight (LW) per d), in a two 3 x 3 Latin square design. 2. Voluntary intake of the same diets was measured using a further six non-cannulated sheep in a similar design. 3. Rate of digestion of the three hays was measured using dacron bags and the rates of digestion of DM and neutral-detergent fibre (NDF) for clover hay were significantly (P less than 0.05 and P less than 0.001 respectively) faster than those for the two grass hays whose rates did not differ. Rates of passage, determined using chromium-mordanted hay, did not differ between treatments. 4. Rumen pool sizes of DM, organic matter and fibre were generally greatest for the late-cut grass hay and lowest for the clover hay, while voluntary intake was highest (P less than 0.001) for the clover hay (36.6 g DM/kg LW per d) and lowest for the late-cut grass hay (24.7 g/kg LW per d). 5. The net rate of removal of indigestible fibre from the rumen appeared to vary within the day, with maximal disappearance occurring during eating, followed by a lag phase between 5 and 10 h after feeding, with a second increase in rate between 10 and 24 h post-feeding. PMID- 3676226 TI - The effect of supplementation with maize starch and level of intake of perennial ryegrass (Lolium perenne cv. Endura) hay on the removal of digesta from the rumen of sheep. AB - 1. Eight wether sheep were offered a diet of perennial ryegrass (Lolium perenne cv. Endura) hay once daily at two levels of intake (11 and 16.5 g dry matter (DM)/kg live weight (LW] with or without maize starch (175 g DM/kg hay DM). The experiment consisted of four periods, each lasting 32 d. Rates of digestion of the hay were measured by incubation in dacron bags and rates of passage using chromium-mordanted hay. Rumen pool sizes of DM, organic matter and fibre were measured by emptying the rumen. 2. The inclusion of starch in the diet appeared to increase significantly (P less than 0.01) the lag phase before the start of fibre digestion, as observed both in the dacron bag studies and in the slower initial disappearance of digestible neutral-detergent fibre (NDF) from the rumen recorded by emptying of rumen contents. However, there was no significant effect of starch on apparent digestibility of fibre in the whole tract. 3. The main effect of increasing the level of feeding was to increase the rate of passage with a consequent decrease in overall digestibility. The fractional rate of passage increased from 0.0318 to 0.0400 as the level of feeding increased, while apparent digestibility of NDF decreased from 0.755 to 0.724. 4. On all treatments the weight of indigestible fibre in the rumen remained more or less constant between 5, 10 and 15 h after feeding, but was significantly lower at 24 h. These results suggest that a high proportion of the outflow of material from the rumen not associated with feeding appears to occur during the second half of the feeding cycle. PMID- 3676227 TI - Effects of supplements on intake, rumen function and nutrient supply and growth in cattle eating alkali-treated oat straw. AB - 1. Expt 1. Six 200 kg Hereford heifers fitted with rumen and abomasal cannulas were fed ad lib. on alkali-treated oat straw sprayed with urea and minerals, with no supplement (O), or 700 g rolled barley (B) or cottonseed meal (C)/d, in a 3 x 3 Latin square with two replicates. 2. Intakes of the basal diet were not significantly affected by the supplements. Intakes of digestible organic matter (OM) were 3135, 3325 and 3515 g/d on diets O, B and C respectively. Abomasal OM flow on diet C was 13 and 12% higher than on diets O and B respectively (P less than 0.05) which was associated with a decrease in the proportion of OM intake apparently digested in the rumen (P less than 0.05) and an increase in the proportion of abomasal OM digested in the lower gut (P less than 0.05). 3. Total nitrogen and bacterial N flows at the abomasum were significantly higher (P less than 0.01 and P less than 0.05 respectively) on diet C than on diets O and B. Efficiency of bacterial N synthesis on diet C was 19 and 28% higher than on diets O and B respectively (P less than 0.05). 4. Dry matter (DM) pool size in the rumen was greater on diet C than on diets O and B (P less than 0.05). 5. Expt 2. Thirty-three 210 kg Friesian heifers were allocated to the same treatments as in Expt 1. Intakes of the basal straw diet were not significantly affected by the supplements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676228 TI - Effects of semi-starvation and potassium deficiency on the concentration of [3H]ouabain-binding sites and sodium and potassium contents in rat skeletal muscle. AB - 1. Using vanadate-facilitated [3H]ouabain binding, the effect of semi-starvation on the total concentration of [3H]ouabain-binding sites was determined in samples of rat skeletal muscle. When 12-week-old rats were semi-starved for 1, 2 or 3 weeks on one-third to half the normal daily energy intake, the [3H]ouabain binding site concentration in soleus muscle was reduced by 19, 24 and 25% respectively. In extensor digitorum longus, diaphragm and gastrocnemius muscles the decrease after 2 weeks of semi-starvation was 15, 18 and 17% respectively. The decrease was fully reversible within 3 d of free access to the diet. Complete deprivation of food for 5 d caused a reduction of 25% in soleus muscle [3H]ouabain-binding-site concentration. It was excluded that the reduction in [3H]ouabain binding was due to a reduced affinity of the binding site for [3H]ouabain. 2. Semi-starvation of 12-week-old rats for 3 weeks caused a reduction of 45 and 53% in 3,5,3'-triiodothyronine (T3) and thyroxine (T4) levels respectively. As reduced thyroid hormone levels have previously been found to decrease [3H]ouabain-binding-site concentration in skeletal muscle, this points to the importance of T3 and T4 in the down-regulation of the [3H]ouabain-binding site concentration in skeletal muscle with semi-starvation. Whereas potassium depletion caused a decrease in K content as well as in [3H]ouabain-binding-site concentration in skeletal muscles, semi-starvation caused only a tendency to a decrease in K content. Thus, K depletion is not a major cause of the reduction in [3H]ouabain-binding-site concentration with semi-starvation. 3. Due to its high concentration of Na,K pumps, skeletal muscle has a considerable capacity for clearing K from the plasma as well as for the binding of digitalis glycosides. Semi-starvation causes a severe reduction in the total skeletal muscle pool of Na,K pumps and may therefore be associated with impairment of K tolerance and increased digitalis toxicity. PMID- 3676229 TI - Seasonal variations in the nutritional status of urban Gambian children. AB - 1. Children aged 6-35 months in an urban community in The Gambia, West Africa, were weighed and their lengths measured at four surveys over an 18-month period, twice towards the end of the rains, and twice during the dry season. 2. Relative to international standards, height-for-age deteriorated steadily with age, while weight-for-age fell sharply in the second-half of infancy but showed no further deterioration from 12 to 35 months of age. 3. Height-for-age showed little seasonal variation, but weight-for-age and weight-for-height were lower at the end of the rains than during the dry season. Weight and height velocities were much lower during the rains than in the dry season, with more than 20% of the children losing weight during the rains. Possible reasons for these seasonal variations are discussed. Compensatory weight gain in the dry season exceeded the velocity expected from the standards in children aged 12 months or more, but height velocity fell below the standards all year. 4. The results are compared with previous findings from Keneba, a rural Gambian village. Weight velocity during the dry season was similar in the two communities, but the village children experienced a sharper decline in weight gain during the rains. 5. These results suggest that seasonal ecological factors may seriously influence the nutritional status of children living in an urban environment with adequate availability of food. PMID- 3676230 TI - Energy balances of eight volunteers fed on diets supplemented with either lactitol or saccharose. AB - 1. Complete 24 h energy and nitrogen balances were measured for eight subjects both while consuming a basal diet supplemented with 49 g saccharose/d (diet S) and while consuming the same basal diet but supplemented with 50 g lactitol monohydrate/d (diet L). 2. The subjects ate the two diets for 8 d. Faeces and urine were collected for the final 4 d. Exchange of respiratory gases (oxygen, carbon dioxide, hydrogen and methane) was measured during the final 72 h while the subjects stayed in an open-circuit respiration chamber, 11 m3, and simulated office work. Before eating diet L, subjects ate 50 g lactitol daily for 10 d. 3. On diets L and S, faecal moisture content averaged 0.787 and 0.753 g/g respectively, the difference being significant (P less than 0.05). On diet L, energy and nitrogen digestibilities and energy metabolizability averaged 0.922, 0.836 and 0.881 respectively, and on diet S 0.935, 0.869 and 0.896 respectively; the differences were also significant (P less than 0.05). Urinary energy losses and N balances were not significantly different for the two diets. 4. In all subjects only traces of methane were produced but hydrogen production differed significantly (P less than 0.05) for diets L and S, being 2.3 and 0.4 litres (normal temperature and pressure)/d respectively. 5. Intakes of metabolizable energy (ME) were corrected, within subjects, to energy equilibrium and equal metabolic body-weight. The corrected ME intakes did not show differences between diets. However, when on diet L the subjects were probably less active than when on diet S because differences within subjects of ankle actometer counts between diets showed a high correlation with the corresponding differences in corrected ME intakes (r 0.92). Further correction of ME intake toward equal actometer activity showed a significant (P less than 0.05) difference between diets: for maintaining energy equilibrium 5.6 (SE 0.8; P less than 0.05)% more ME from diet L was needed than from diet S. The reliability of this 5.6% difference depends on whether or not one ankle actometer gives an accurate picture of the subject's physical activity. 6. The energy contribution to the body is clearly smaller from lactitol than from saccharose, certainly due to the effect of lactitol on digestion, and probably also due to the effect on the utilization of ME. PMID- 3676231 TI - Blood rheology in vegetarians. AB - 1. Blood rheology has been quantified by measuring blood and plasma viscosity, packed cell volume (PCV), erythrocyte filterability and erythrocyte aggregation in forty-eight voluntary vegetarians and compared with matched controls. 2. Results show that in vegetarians, values for PCV were lower than those in controls, leading to reduced native blood viscosity. In addition PCV-standardized blood viscosity was also decreased. This was brought about mostly by lower plasma viscosity. Erythrocyte rheology seemed to be unaltered. Stricter avoidance of animal products was associated with even lower values for these indices. 3. These observations are in agreement with the fact that other low-cardiovascular-risk groups show better than average blood fluidity. They are consistent with the hypothesis that in vitro measurements of blood rheology may provide signs of early atherosclerotic changes in vivo. PMID- 3676232 TI - Effects of a low-energy diet associated with egg supplementation on plasma cholesterol and lipoprotein levels in normal subjects: results of a cross-over study. AB - 1. The influence of a low-energy diet when associated with high-cholesterol intake was investigated in seventeen normal men during an 8-week cross-over study. The subjects were given a daily supplement of two whole eggs and two egg yolks (approximately 1 g cholesterol) either with their usual diet for 4 weeks or with a low-energy diet for 4 weeks. Each subject took part randomly in both dietary periods. 2. During the first part of the study, no changes occurred in the plasma cholesterol of the subjects with egg supplementation of the usual diet. 3. In contrast, the low-energy diet and associated weight loss markedly decreased tolerance to high-cholesterol intake resulting in increased plasma cholesterol. The mean rise was 22.7% but with wide individual variations in the response. This was almost completely normalized when the subjects returned to their usual energy intake indicating the involvement of weight reduction in the increase observed. 4. Changes in low-density-lipoprotein (LDL) cholesterol were parallel to those of total plasma cholesterol with an increase following the low energy diet and normalization after body-weight recovery. 5. The opposite effect was shown with the low-energy diet after previous adaptation to the consumption of four eggs per day. This dietary regimen resulted in a decrease in plasma cholesterol although it was not significant. Moreover, the lipoprotein profile was improved with a decrease in very-low-density-lipoprotein (VLDL) cholesterol and an increase in high-density-lipoprotein (HDL) cholesterol. 6. High cholesterol intake induced significant changes in lipoprotein composition whatever the energy ration. LDL and HDL were enriched in cholesterol esters as early as the 1st month of egg supplementation of the diet. 7. Taken together, the results emphasize the possible adverse effect of slimming diets when associated with high-cholesterol intake. The existence of 'high-responders' to these dietary conditions calls for special attention to be paid to the cholesterol content of restricted diets. PMID- 3676233 TI - The effect of dietary polyunsaturated fat on cation transport and hypertension in the rat. AB - 1. Essential hypertension is associated with increased intracellular sodium in both erythrocytes and leucocytes. Reports in the literature indicate that increasing the level of polyunsaturated fat in the diet reduces hypertension. In the present study, spontaneously hypertensive rats (Wistar-Kyoto, which develop systolic blood pressures in excess of 140 mmHg by 8 weeks of age) were fed on high-fat diets (40% energy derived from fat), the fat being maize oil (high in polyunsaturated fatty acids, PUFA) and coconut oil (low in PUFA). 2. Significantly higher blood pressures developed by 110 d of age in the rats fed on a high-PUFA diet, compared with those fed on the low-PUFA diet. 3. In thymocytes, ouabain-sensitive efflux rate constants were significantly lower in the group fed on the high-PUFA diet. Ouabain-insensitive efflux rate constants were unaffected by diet. PMID- 3676234 TI - Effect of previous nutrition on body composition and maintenance energy costs of growing lambs. AB - 1. Forty-eight intact male lambs (30 kg) were fed to gain 16 (H), 5 (M) or -6 (L) kg during a 42 d interval (period 1). Lambs from each of the H and M groups were fed to gain either 16 (HH, MH), 5 (HM, MM) or -6 (HL, ML) kg and lambs from the L group were fed to gain 27 (LS), 16 (LH) or 5 (LM) kg during the ensuing 42 d (period 2). 2. Fasting heat production (FHP) of four lambs from each treatment was determined at the end of period 2. 3. Weights and compositions of the carcass, offal and digesta-free body as well as weights of major internal organs were determined for four lambs of each treatment at the end of periods 1 and 2. 4. Within groups of lambs of similar weight at the end of period 2, body composition was, in general, similar, but FHP was greater in lambs that had been on higher planes of nutrition during period 2. 5. Within groups of lambs of similar weight, lambs that were fed at higher planes of nutrition during period 2 had greater weights or proportions of liver, small intestine, large intestine and stomach. 6. Neither weight of the liver, kidney, stomach, small intestine, large intestine nor daily fasting heat production were constant functions of body weight. Relations of these traits to body-weight changed with rate of gain. 7. Regression analysis indicated that the feeding of lambs at higher planes of nutrition during period 1 resulted in higher maintenance requirements of those lambs during period 2. PMID- 3676236 TI - Effects of preweaning nutritional deprivation on basal metabolism and thermoregulatory thermogenesis in the rat. AB - 1. Nutritional deprivation was induced preweaning in Wistar rats by increasing the litter size to sixteen, while paired litters with only five pups served as controls. The nutritionally deprived pups were rehabilitated after weaning by ad lib. access to an adequate diet. 2. The body-weights and body lengths were significantly lower in the nutritionally deprived group and significant differences persisted even after 9 weeks of rehabilitation. 3. The body temperature of the nutritionally deprived animals was significantly lower than that of their paired controls, both before and following nutritional rehabilitation, except for a short period after weaning when the nutritionally deprived animals were initially given the diet ad lib. 4. The resting oxygen consumption of the nutritionally deprived animals was comparable to that of the controls when corrected for metabolic body size, both before and after weaning. Noradrenaline-stimulated increase in O2 consumption (non-shivering thermogenesis; NST) was reduced by 50% at weaning in the nutritionally deprived animals and returned to levels comparable to those of controls within a short period of rehabilitation. 5. The decrease in NST capacity seen in the nutritionally deprived animals was associated with an inability to thermoregulate when exposed to cold (5 degrees), resulting in death. Cold-induced thermogenesis (CIT) also reappeared soon after nutritional rehabilitation. 6. Reduction in metabolic rate, NST and CIT seen in the animals nutritionally deprived preweaning was short-lived and disappeared soon after nutritional rehabilitation. Rapid reversal of these physiological changes indicates that they do not confer any long-term benefit or change in metabolic efficiency and are unlike the changes in body size and growth which do not completely recover following nutritional rehabilitation. PMID- 3676235 TI - The role of condensed tannins in the nutritional value of Lotus pedunculatus for sheep. 5. Effects on the endocrine system and on adipose tissue metabolism. AB - 1. Three experiments were conducted using Lotus pedunculatus containing high concentrations of condensed tannins (CT), and utilizing the principle that polyethylene glycol (PEG) application (molecular weight 3350) will irreversibly bind a portion of the CT and thus reduce the dietary reactive (i.e. non-PEG bound) CT concentration. Lotus diets containing 95, 45 and 14 g total reactive CT/kg dry matter (DM), induced by spraying with three PEG rates, were given to sheep at hourly intervals (600 g DM/d) for 21 d (Expt 1). In Expts 2 and 3, lambs grazed areas oversown with either lotus (89 g CT/kg DM) or clovers (Trifolium repens and Trifolium pratense; less than 1 g CT/kg DM) for 42 and 92 d respectively. In Expt 2 half the animals grazing each forage received oral PEG (75 g/d), whilst in Expt 3 half the lambs were sired by rams selected respectively for low or high levels of subcutaneous fat deposition. 2. Hormone concentrations in plasma (Expt 1 only) were determined by radioimmunoassay. Rates of [U-14C]-acetate and D-[U-14C]glucose incorporation and oxidation by subcutaneous and abdominal adipose tissue removed at slaughter, together with rate of glycerol release, were determined during in vitro incubation in all three experiments. 3. Plasma concentration of growth hormone was positively and linearly related to dietary reactive CT concentration, whilst 3,5,3' triiodothyronine (T3) concentration tended to be negatively and linearly related to dietary reactive CT concentration. Diet CT concentration had no effect on plasma concentrations of the other hormones measured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676237 TI - The passage of protozoa from the reticulo-rumen through the omasum of sheep. AB - 1. Protozoa in rumen contents and omasal effluent of growing wethers were counted. The wethers were equipped with rumen and abomasal cannulas, and omasal sleeves attached to the omasal-abomasal orifice. Rumen fluid dilution rates were elevated by continuous infusions of hypertonic mineral solutions (3-4 litres/d) for 24 d. Rumen contents and omasal effluent were sampled between 9 and 21 h during the last 10 d of each experiment. 2. Protozoal concentrations in omasal effluent were only 0.2-0.3 those found in the rumen under normal conditions. The ratio of protozoal concentrations in rumen: those in omasal effluent was for small Diplodinium spp. 4.6 (SD 0.9), for Ophryoscolex spp. 4.3 (SD 1.0), for Dasytricha ruminantium 4.0 (SD 0.5), for Isotricha spp. 3.8 (SD 0.8), for Entodinium spp. 3.6 (SD 0.9) and for Polyplastron multivesiculatum 2.6 (SD 0.5). 3. Elevation of rumen fluid dilution rate by 20 and 55% respectively, increased protozoal concentrations in omasal effluents from 22 to 33% and from 31 to 47% those in rumen contents. The apparent residence times of protozoa in the rumen were decreased 50% by the infusion of a mineral-salt solution. The increase in rumen fluid dilution rate had no significant effect on concentrations of protozoa in the rumen or on the differences of the apparent residence times between different species. The apparent residence time of holotrichs remained the same before and after infusion of the mineral-salt solution. 4. Apparent residence times of individual species of protozoa in the rumen were, under normal feeding conditions, 2.55 d, and were four to six times longer than the mean residence time of CrEDTA in the rumen. PMID- 3676238 TI - Effects of vitamin D on calcium regulation in vitamin-D-deficient pigs given a phytate-phosphorus diet. AB - 1. Vitamin-D-deficient pigs were fed on a phytate-phosphorus diet and treated with vitamin D3 (+D) to examine the time-course of adaptative changes in plasma minerals, vitamin D metabolites, parathyroid hormone (PTH) and calcium balance and intestinal Ca-binding protein (CaBP). 2. The 5-week vitamin D repletion (25 micrograms cholecalciferol/kg diet) regimen restored plasma Ca, P and alkaline phosphatase (EC 3.1.3.1) to normal, decreased PTH and markedly and rapidly increased plasma 25-hydroxycholecalciferol (25-OHD, sevenfold after 4 d) and 1,25 dihydroxycholecalciferol (1, 25(OH)2D3, 1.8-fold after 4 d). 3. CaBP concentrations were markedly elevated all along the digestive tract, especially in the distal regions. 4. Ca absorption and retention were enhanced (fourfold and sixfold respectively) by the +D diet. 5. The improved Ca absorption, coupled with increased CaBP and 1,25(OH)2D3 levels, suggest that vitamin D metabolism in phytate-P-fed pigs is sensitive to the depressed Ca availability due to phytate feeding. It also indicates that CaBP may play an important role in the adaptation of Ca absorption. 6. Persistent hypercalciuria indicates that mineral metabolism was still affected by the phytate nature of the dietary P in spite of the vitamin D treatment. PMID- 3676239 TI - Raw soya-bean flour increases cholecystokinin release in man. AB - 1. The aim of the present study was to determine whether oral ingestion of raw soya-bean flour, which contains trypsin inhibitors, alters the release of cholecystokinin (CCK) in man. 2. Eleven healthy volunteers ate two mixed meals: one with raw soya-bean flour and the other with soya-bean flour that had been heat-treated. The two flours inhibited 34 and 3 mg trypsin/g flour respectively. 3. CCK was measured in plasma using a bioassay based on the release of amylase (EC 3.2.1.1) from dispersed rat pancreatic acini. 4. The peak CCK response was 16.8 (SE 8.1) pmol/l with raw soya-bean flour but 4.9 (SE 2.8) pmol/l with heat treated flour (P less than 0.05). 5. We conclude that ingestion of raw soya-bean flour increases CCK release in man and that heat treatment which reduces the trypsin inhibitor content of the flour also diminishes its CCK-releasing effect. PMID- 3676240 TI - Liver stores of vitamin A in human fetuses in relation to gestational age, fetal size and maternal nutritional status. AB - 1. Studies were made on liver stores of retinol in aborted human fetuses and stillborn babies in relation to gestational age, fetal size and maternal retinol status. The mothers belonged to low- and high-income groups (LIG and HIG respectively) in urban Baroda. 2. Fetal weights were less than those reported by Widdowson (1968) for similar gestational ages and the deficits were greater in LIG. 3. The combined mean values (microgram/l) for maternal serum retinol for all gestational ages were 193 for LIG and 261 for HIG. They were found to decline in late pregnancy in the former but not significantly in the latter. 4. Fetal liver retinol concentrations were much lower than those reported for healthy Thai subjects by Montreewasuwat & Olson (1979) in early pregnancy but showed complete 'catch up' in late pregnancy for HIG and to a considerable extent for LIG. 5. Significant correlations were found between maternal serum retinol, fetal liver retinol and fetal growth. 6. These findings stress the importance of adequate vitamin A supplies during pregnancy to prevent vitamin A deficiency and intra uterine growth retardation in the newborn. PMID- 3676242 TI - Hydrolysis of lactitol, maltitol and Palatinit by human intestinal biopsies. AB - 1. The hydrolysis of sugar alcohols of the disaccharide type such as lactitol, maltitol and Palatinit (the latter an equimolar mixture of 6-O-alpha-D glucopyranoside-D-mannitol and 6-O-alpha-D-glucopyranoside-D-sorbitol) by homogenates of human intestinal biopsies were compared with corresponding natural disaccharides such as lactose, maltose and isomaltose. Seven of the human biopsies were normal with regard to their disaccharidase activities, while twelve biopsies showed decreased levels of disaccharidase activities. 2. All biopsies, normal as well as abnormal, showed essentially the same capacity to hydrolyse the sugar alcohols. Activities towards lactitol (0.34 IE/g protein (where IE = mumol disaccharide hydrolysed/min at 37 degrees)) and Palatinit (2.50 IE/g protein) were only 1.3% of those towards lactose and isomaltose. The activity towards maltitol was much higher (19.1 IE/g protein), approximately 10% of that towards maltose and about as high as the activity towards trehalose. This finding indicates that despite the fact that lactitol and Palatinit were poor substrates, significant amounts of ingested maltitol might be digested and utilized by man. 3. Glucose release was reduced by approximately 25% when maltitol or Palatinit were present at concentrations equal to those of maltose. Palatinit decreased the hydrolysis of sucrose by 12%. Lactitol had no inhibitory effect on the hydrolysis of disaccharides. PMID- 3676241 TI - Vitamin E status of the newborn in relation to gestational age, birth weight and maternal vitamin E status. AB - 1. Studies were made on the vitamin E status of the newborn as judged by cord serum vitamin E and erythrocyte haemolysis in vitro in relation to gestational age, birth weight and maternal vitamin E status in subjects belonging to low (LIG)- and high (HIG)-income groups in urban Baroda. 2. In the case of full-term infants, the mean values for maternal serum vitamin E (mg/l) for LIG (n 73) and HIG (n 43) were 9.9 (SE 0.4) and 11.6 (SE 0.5). The corresponding values for cord serum vitamin E were 3.6 (SE 0.2) and 4.6 (SE 0.2) mg/l. 3. Serum vitamin E levels (mg/l) were lower in premature infants (2.3 (SE 0.2); n 20) and low-birth weight full-term infants (2.9 (SE 0.2); n 25) than in full-term normal infants (4.2 (SE 0.1); n 91). This was associated with differences in maternal serum vitamin E levels (7.4 (SE 0.5), 8.2 (SE 0.5) and 11.1 (SE 0.3) respectively). The differences were more marked for LIG. 4. A negative correlation was found between serum vitamin E and erythrocyte haemolysis in vitro in the case of maternal blood but not in cord blood. 5. These results suggest that maternal vitamin E deficiency is one of the features associated with prematurity and intra-uterine growth retardation. PMID- 3676243 TI - Urinary excretion of 5-oxoproline (pyroglutamic aciduria) as an index of glycine insufficiency in normal man. AB - 1. The evidence is accumulating to suggest that glycine, the simplest amino acid, is conditionally essential in man. Benzoic acid, by conjugation with glycine to form hippuric acid, is known to deplete the free glycine pool of the body. Glycine is one substrate for the enzyme glutathione synthase (EC 6.3.2.3) and in the inborn error of metabolism in which glutathione synthase function is defective, increased quantities of 5-oxoproline are excreted in the urine. 2. An oral dose of 4-10 g sodium benzoate was given to six normal adults to deplete the metabolic pool of glycine, and the urinary excretion of 5-oxoproline was followed for 6 h. In five of the six, a significant increase in the urinary 5-oxoproline was seen within 3 h. 3. These findings show that 5-oxoprolinuria can result from limited glycine availability, and may provide a useful test for assessing glycine sufficiency in a range of physiological and pathological states. PMID- 3676244 TI - Dietary fat and N-nitrosation in the rat. AB - 1. Groups of four conventional (CV) rats ate natural or purified diets either with or without 100 g fat/kg and drank 0.235 M-sodium nitrate. The fats tested were butterfat, coconut oil, olive oil, maize oil and safflower oil. 2. Decreased urinary excretion of N-nitrosoproline (NPRO) was observed in rats fed on fat supplemented diets compared with those fed on low-fat diets, with butterfat having the greatest effect of the fats tested. 3. Reduced excretion of NPRO was not the result of inhibition of the intragastric N-nitrosation reaction or absorption of nitrosamine from the gastrointestinal tract. 4. The availability of nitrite in aqueous solution was decreased by the fat diets but the effect was similar in all the fats tested. 5. Nitrate reductase activity was present in the forestomach contents of CV rats at pH greater than 4 and was apparently inhibited by feeding a fat diet. No nitrate reductase activity was detected in stomach contents of germ-free rats. 6. Nitrate reductase activity in stomach and small intestinal tissue was not altered by feeding a fat diet. 7. It was concluded that nitrate reductase activity in stomach contents was of microbial origin and the decreased urinary excretion of NPRO on feeding the fat diets was mainly due to the inhibition of nitrate reductase activity in stomach contents. PMID- 3676245 TI - Effects of early-life undernutrition in artificially reared rats: subsequent body and organ growth. AB - 1. Four groups of rat pups were reared: mother-reared (MR) control (well-fed) and undernourished (MRC and MRU respectively) and artificially reared (AR) control and undernourished (ARC and ARU respectively). Pups for artificial rearing were fitted with a gastric cannula on postnatal day 5 and were fed, by intermittent gastric infusion, expressed rats' milk (days 5-7), mixtures of rats' milk and milk-substitute (days 8-16), and milk-substitute only (days 17-20). Solid food was available to MR pups throughout and to AR pups from day 14. Undernutrition, imposed from postnatal days 5 to 25, was effected initially by underfeeding the mother (MRU) or by infusing restricted quantities of milk (ARU). Weaning was at 21 d and undernutrition from day 21 to day 25 was by restricting the supply of solid food. All rats were fed ad lib. from 25 d. 2. The developmental milestone, eye-opening, was delayed by undernutrition but unaffected by artificial rearing. 3. Growth curves in body-weight during the refeeding phase were influenced most by previous undernutrition and to a lesser extent (also negatively) by artificial rearing. 4. Fourteen measures of body and organ growth were taken at autopsy at 39 weeks. Twelve measures were affected by nutrition and only four by rearing (weight of whole body, epididymal fat pads, renal fat pads and adrenals). 5. AR rats had lighter epididymal and renal fat pads than MR rats perhaps due to the low fat content of the expressed milk they received early in artificial rearing. PMID- 3676246 TI - A comparison of the effects of soya-bean protein and casein on bile composition, cholelithiasis and serum lipoprotein lipids in the vervet monkey (Cercopithecus aethiops). AB - 1. Two groups of vervet monkeys (Cercopithecus aethiops) were fed on high cholesterol diets which differed only with respect to the protein source. In one group casein was the only protein source, while the other group received only soya-bean protein. 2. Samples of blood, bile and liver biopsy material were collected at the commencement of the study and at 3-monthly intervals until termination 12 months later. 3. At the end of the experimental period all the animals (n 19) had high plasma cholesterol levels and had developed pigment gallstones, the compositions and weights of which were not related to the protein source or to plasma cholesterol levels. Gallstone weight was related to the presence of acidic and sulphated mucins in gallbladder mucosa. We were also unable to confirm the hypocholesterolaemic effect of soya-bean protein which has been demonstrated previously in rhesus monkeys and hamsters. Bile composition and plasma lipids did not differ significantly between the casein-fed and soya-bean fed animals. Lithogenic index was below 1 for both groups and did not differ significantly between the two groups. 4. No significant difference was found in the severity of cholelithiasis between the casein-fed and the soya-bean-fed animals. PMID- 3676247 TI - Involvement of the solid phase of rumen digesta in the interaction between copper, molybdenum and sulphur in sheep. AB - 1. Merino sheep fed on a diet of chopped wheaten hay, chopped lucerne (Medicago sativa) hay and oat grain were the source of rumen contents for the study. The diet contained (mg/kg dry weight) 3.3 copper, 0.24 molybdenum and 2.8 sulphur. The effects of adding between 5 and 25 mg Mo/kg as ammonium molybdate (AM) or tetrathiomolybdate (TTM) on the distribution and forms of Cu and Mo in rumen contents were investigated in vivo and in vitro. 2. Approximately 88% of the Cu and 94% of the Mo in rumen contents were associated with the solid phase. When AM or TTM was added to rumen contents in vivo or in vitro the proportion of these elements in the solid phase was increased at the expense of the fluid phase. 3. The addition of AM and TTM to rumen contents also decreased the proportion of Cu that was soluble in trichloroacetic acid (50 g/l; TCA) and increased the proportion of Cu that was not extractable by sequential treatment with TCA and neutral detergent. 4. Column chromatography of neutral-detergent extracts of rumen contents revealed that TTM treatment caused Cu to be strongly bound to proteins of high molecular weight. 5. Addition of sulphide to rumen contents did not result in significant changes in the distribution of Cu between the fluid and solid phases, or in the solubility of Cu in TCA. 6. It is postulated that constant removal of TTM from the fluid phase via reaction with proteins and other macromolecules in the solid phase results in greater formation of TTM in vivo than would be expected from solution chemistry. The molybdo-proteins so formed are strong chelators of Cu and may be the agents responsible for the decrease in Cu absorption in animals that consume diets containing high concentrations of Mo. PMID- 3676248 TI - Identification of a new in vitro substrate of tyrosine protein kinase. AB - Recent studies in our laboratory [Tokuda, M., Khanna, N.C., Aurora, A., & Waisman, D. M. (1986) Biochem. Biophys. Res. Commun. 139, 910-917] have identified in membranes of rat spleen two tyrosine protein kinases named TPK-I and TPK-II. In this paper the identification of the Ca2+ binding protein CAB-48 as a major in vitro substrate of TPK-II is reported. TPK-II catalyzed the incorporation of 0.73 mol of phosphate/mol of CAB-48. Phosphoamino acid analysis revealed that phosphorylation of CAB-48 was specific for tyrosine residues. Phosphorylation of CAB-48 by TPK-I (rat spleen), protein kinase C, casein kinase I, casein kinase II, cAMP-dependent protein kinase, or calcium calmodulin dependent protein kinase was not observed. PMID- 3676249 TI - The eighth component of human complement: evidence that it is an oligomeric serum protein assembled from products of three different genes. AB - The eighth component of human complement (C8) consists of three nonidentical subunits arranged asymmetrically as a disulfide-linked alpha-gamma dimer and a noncovalently associated beta chain. Genetic studies of C8 polymorphisms established that alpha-gamma and beta are encoded at different loci. Implicit in this finding was the existence of two different genes and the likelihood that alpha-gamma would be synthesized in single-chain precursor form. However, recent characterization of cDNA clones revealed separate mRNAs for human alpha and beta but no evidence of a single-chain precursor for alpha-gamma. A cDNA clone containing the entire coding region for human gamma has now been characterized, and its sequence supports the existence of a separate gamma mRNA. Included are a consensus translation initiation sequence, an apparent initiation methionine, and a signal peptide. By use of cDNA probes specific for human alpha, beta, or gamma, analysis of poly(A) RNA from normal baboon liver revealed separate mRNAs of 2.5, 2.6, and 1.0 kilobases (kb), respectively. Parallel analysis of poly(A) RNA from rat liver identified mRNAs of 3.4, 2.3, and 0.9 kb. These results argue against the possibility that C8 is assembled from products of two different genes (alpha gamma and beta) and suggest it is comprised of three different gene products (alpha, beta, and gamma) that undergo both covalent and noncovalent association to yield the mature protein. PMID- 3676250 TI - Expression of human insulin-like growth factor I in bacteria: use of optimized gene fusion vectors to facilitate protein purification. AB - Several fusions between the gene for human insulin-like growth factor I (IGF-I) and the genes for different IgG-binding fragments of staphylococcal protein A were assembled and compared regarding expression, secretion, and purification of the peptide hormone. After IgG affinity purification of the fusion proteins from the growth medium of Staphylococcus aureus or Escherichia coli, native IGF-I was released by cleavage of an Asn-Gly peptide bond with hydroxylamine. An optimized expression system based on a modified synthetic IgG-binding domain (z), resistant to hydroxylamine, gave the highest yield of fusion protein. After cleavage, the hormone could be separated from the IgG-binding moiety and from noncleaved fusion protein by a second passage through the IgG affinity column. The biological activity and the purity of the IGF-I obtained were confirmed by a radioreceptor assay, N-terminal sequence analysis, polyacrylamide gel electrophoresis, isoelectric focusing, and high-performance liquid chromatography. PMID- 3676251 TI - Nucleotide sequence of the mouse alpha 1-acid glycoprotein gene 1. AB - In a previous paper we presented evidence for the existence of at least two alpha 1-acid glycoprotein (AGP) genes in the mouse. One of the cDNA clones characterized in those studies was used to isolate several unique AGP genomic clones. In these studies we present the complete sequence of one of the mouse AGP genes. The sequence analysis includes 595 base pairs (bp) 5' to the site of initiation of transcription and 135 bp 3' to the polyadenylation signal. This mouse AGP gene, designated AGP-1, has six exons, a structure similar to those of the AGP genes in rats and humans. Analysis of the sequence has revealed a number of potential regulatory sites. These include a run of alternating purine pyrimidine bases [(GT)N] at +2890 to +2945, flanked by three potential glucocorticoid receptor binding sites within intron 5. Two of these TGTTCT at +3069 to +3074 and +3082 to +3087 flank the (GT)n track at its 3' end, and one, which is oriented in the opposite direction (AGAACA), at +2771 to +2776 flanks the track at its 5' end. A longer version of the glucocorticoid receptor site, GGGTACAATGTGTCCT, has been located in the 5' flanking region of the gene (-94 to 79); the sequence AGAACA is another potential glucocorticoid receptor site oriented in the opposite direction and located at -127 to -122. This entire region, from -146 to -42, in the mouse has a strong homology (approximately 85%) to the 5' flanking region of the rat AGP gene, which contains a 78-bp fragment ( 120 to -42) that represents the minimal sequence required for glucocorticoid regulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676252 TI - Enhanced antigen-antibody binding affinity mediated by an anti-idiotypic antibody. AB - We previously described the production of four monoclonal antibodies to the beta adrenergic receptor antagonist alprenolol. One of these antibodies, 5B7 (IgG2a, kappa), was used to raise anti-idiotypic antisera in rabbits. In contrast to the expected results, one of the anti-idiotypic antisera (R9) promotes [125I]iodocyanopindolol (ICYP) binding to antibody 5B7. In the presence of R9, the dissociation constant decreases 100-fold from 20 to 0.3 nM. This increase in binding affinity of antibody 5B7 for ICYP is not observed in the presence of preimmune, rabbit anti-mouse or anti-idiotypic antisera generated to a monoclonal antibody of a different specificity. Furthermore, R9 in the absence of 5B7 does not bind ICYP. The F(ab) fragments of 5B7 and R9 behaved in a similar manner, and the soluble complex responsible for the high-affinity interaction with ICYP can be identified by gel filtration chromatography. The elution position of the complex is consistent with a 5B7 F(ab)-R9 F(ab) dimer, indicating that polyvalency is not responsible for the enhanced ligand binding. Kinetic analysis of ICYP-5B7 binding revealed that the rate of ICYP dissociation from 5B7 in the presence of R9 is approximately 100 times slower than in the absence of R9 [k 1(+R9) = 0.025 min-1 vs. k-1(-R9) = 2.04 min-1], consistent with the 100-fold change in binding affinity of 5B7 for ICYP. The available data best fit a model in which an anti-idiotypic antibody binds at or near the binding site of the idiotype participating in the formation of a hybrid ligand binding site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676253 TI - Noncooperative vs. cooperative reactivation of D-beta-hydroxybutyrate dehydrogenase: multiple equilibria for lecithin binding are determined by the physical state (soluble vs. bilayer) and composition of the phospholipids. AB - D-beta-Hydroxybutyrate dehydrogenase (BDH) is a lecithin-requiring mitochondrial enzyme that catalyzes the interconversion of beta-hydroxybutyrate and acetoacetate. The purified soluble enzyme devoid of lipid (i.e., the apodehydrogenase) can be reactivated with soluble lecithin or by insertion into phospholipid vesicles containing lecithin. Lipid activation curves have a sigmoidal shape, and two models have been proposed to explain them. We have previously reported that the kinetics of reactivation with short-chain lecithins in the soluble state is consistent with a model in which the enzyme enzyme contains two identical, noninteracting lecithin binding sites, both of which must be occupied to activate the enzyme [noncooperative mechanism; Cortese, J.D., Vidal, J.C., Churchill, P., McIntyre, J.O., & Fleischer, S. (1982) Biochemistry 21, 3899-3908]. More recently a kinetic model involving cooperative interactions between lecithin binding sites was proposed for the reactivation of the membrane bound enzyme [Sandermann, H., Jr., McIntyre, J.O., & Fleischer, S. (1986) J. Biol. Chem. 261, 6201-6208]. This study reinvestigates the basis for the different conclusions in these two studies. The previous study with soluble lecithins was limited to about 34% of maximal activation compared with mitochondrial phospholipid, due to inactivation of the enzyme at the critical micellar concentration. We could now extend this study to 91% activation by increasing the ethanol concentration. This experimental evidence confirms that the soluble system follows a noncooperative equation. We provide a new kinetic approach to test the cooperative model. A velocity equation is derived for a Hill type cooperative ligand binding system interacting with a mixture of ligands. This equation predicts a proportionality between an overall weighted cooperative dissociation constant [Kcoop(w)] and a dissociation constant for a single lecithin (PC) species from interacting sites (KPC), regulated by the PC molar fraction (XPC): 1/Kcoop(w) = XPC/KPC. The equation was applied to the data of Sandermann et al. [Sandermann, H., Jr., McIntyre, J.O., & Fleischer, S. (1986) J. Biol. Chem. 261, 6201-6208] as well as to newly obtained data. The results obtained over a wide range of PC molar fractions and different mixtures of bilayer phospholipids fit this equation, confirming the cooperative behavior. We conclude that BDH has a different mode of reactivation depending on the nature of the lipid environment. With soluble lecithin, the activation is noncooperative, whereas in the bilayer, mixtures of phospholipids give cooperative behavior that fits a Hill equation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676254 TI - Characterization of alternate reductant binding and electron transfer in the dopamine beta-monooxygenase reaction. AB - The steady-state limiting kinetic parameters Vmax, V/KDA, and V/KO2, together with deuterium isotope effects on these parameters, have been determined for the dopamine beta-monooxygenase (D beta M) reaction in the presence of structurally distinct reductants. The results show the one-electron reductant ferrocyanide to be nearly as kinetically competent as the presumed in vivo reductant ascorbate. Further, a reductant system of ferricyanide plus substrate dopamine yields steady state kinetic parameters and isotope effects very similar to those measured solely in the presence of ferrocyanide, indicating a role for catecholamine in the rapid recycling of oxidized ferrocyanide. Use of substrate dopamine as the sole reductant is found to lead to a highly unusual kinetic independence of oxygen concentration, as well as significantly reduced values of Vmax and V/KDA, and we conclude that dopamine reduces enzymic copper in a rate-limiting step that is 40-fold slower than with ascorbate. The near-identical kinetic parameters measured in the presence of either ascorbate or ferrocyanide, together with markedly reduced rates with dopamine, are interpreted in terms of a binding site for reductant that is physically distinct from the substrate binding site. This view is supported by molecular modeling, which reveals ascorbate and ferrocyanide to possess an unexpected similarity in potential sites for interaction with enzymic residues. With regard to electron flux, identical values of V/KO2 have been measured with [2,2-2H2]dopamine as substrate both in the presence and in the absence of added ascorbate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676256 TI - Structure of canine tracheobronchial mucin glycoprotein. AB - Canine tracheal mucin glycoprotein was isolated from beagle dogs fitted with tracheal pouches. Following exclusion chromatography on Sepharose CL-4B, noncovalently associated proteins were further resolved by dissociative density gradient centrifugation in CsBr-guanidinium chloride, and the mucin was then extracted with chloroform-methanol. The delipidated high-density product obtained had a nominal molecular weight of about 10(6) and an overall composition characteristic for a mucin glycoprotein, viz., a high content of serine and threonine, about 80% carbohydrate by weight, the absence of mannose or uronic acid, measurable ester sulfate, and a Pronase-resistant domain of molecular weight (1.75-3.0) X 10(5) which contains essentially all of the saccharide residues. Noncovalently bound lipid amounted to 6-10% by weight and was primarily cholesterol and cholesteryl esters. Cleavage of disulfide bonds by performic acid oxidation resulted in the release of a protein (Mr 65,000) not otherwise resolved by sodium dodecyl sulfate gel electrophoresis or the purification scheme. PMID- 3676255 TI - Deglycosylation studies on tracheal mucin glycoproteins. AB - Following several model experiments, conditions were developed for optimal deglycosylation of tracheal mucin glycoproteins. Exposure of rigorously dried material to trifluoromethanesulfonic acid at 0 degree C for up to 8 h results in cleavage of essentially all fucose, galactose, and N-acetylglucosamine, about 80% of the N-acetylneuraminic acid (NeuNAc), and a variable amount of N acetylgalactosamine (GalNAc), the sugar involved in linkage to protein. Residual N-acetylneuraminic acid is sialidase susceptible and apparently in disaccharide units, presumably NeuNAc2----GalNAc. The remaining N-acetylgalactosamine is mostly present as monosaccharides, and a few Gal beta 1----3GalNAc alpha units are also present; both are cleaved by appropriate enzymatic treatment. The saccharide-free proteins obtained from either human or canine mucin glycoproteins have molecular weights of about 100,000 and require chaotropic agents or detergents for effective solubilization. PMID- 3676257 TI - A calorimetric study of the thermotropic behavior of pure sphingomyelin diastereomers. AB - The phase-transition properties of sphingomyelins were investigated in detail with totally synthetic, chemically and stereochemically pure (2S,3R)-(N stearoylsphingosyl)-1-phosphocholine (D-erythro-C18-SPM) (1) and the corresponding 2S,3S isomer (L-threo-C18-SPM) (2). Heating scans of an unsonicated dispersion of 1 right after hydration showed a main transition (I) at 44.7 degrees C (delta H = 6.8 kcal/mol). Upon incubation at 20-25 degrees C a second transition (II) appeared at 36.0 degrees C (delta H = 5.7 kcal/mol). The two gel phases were designated as G alpha and G beta phases, respectively. The G beta phase was also metastable and relaxed to a third gel phase (G gamma) upon incubation below 10 degrees C. Conversion of the G gamma phase to the liquid crystalline phase occurred via two new endotherms at 33.4 degrees C (2.6 kcal/mol) (III) and 43.6 degrees C (8.0 kcal/mol) (IV) as well as a main transition at 44.7 degrees C (9.5 kcal/mol). Possible interpretations have been proposed to account for the observed phase transitions. The L-threo isomer 2 showed similar thermotropic behavior to dipalmitoylphosphatidylcholine (DPPC): a "main transition" at 44.2 degrees C (6.0 kcal/mol), a "pretransition" at 43.1 degrees C (1.8 kcal/mol), and upon incubation at 7 degrees C for 2 weeks, a very broad "subtransition" at ca. 35 degrees C. The results are substantially different from previous studies of sphingomyelins using mixtures of stereoisomers. Mixing of 1 with 2, 1 with DPPC, and 2 with DPPC removed the metastability of the gel phase and resulted in a single transition. PMID- 3676258 TI - Spontaneous fusion of phosphatidylcholine small unilamellar vesicles in the fluid phase. AB - Using a high-sensitivity differential scanning microcalorimeter capable of performing cooling scans, we have examined the phase behavior of small unilamellar vesicles (SUV) as a function of time of storage above their order disorder phase transition. Vesicles composed of dipalmitoylphosphatidylcholine (DPPC) and dimyristoylphosphatidylcholine (DMPC) were examined. Cooling scans on fresh (5-7-h postsonication) samples revealed broad, relatively simple heat capacity peaks (peak temperatures: 19.9 degrees C for DMPC, 37.8 degrees C for DPPC) free of high-temperature spikes or shoulders. Subsequent heating scans displayed a sharp peak characteristic of previously described fusion products formed below the phase transition. SUV samples stored for 1 or more days above their phase transition displayed a moderately broad, high-temperature shoulder (23.8 degrees C for DMPC and 40.2 degrees C for DPPC) in the cooling profile. For DMPC, the enthalpy associated with this peak increased in a first-order fashion with time. Hydrolysis products were not detected until 12-20 days of storage. Both the rate and extent of shoulder appearance increased with temperature (k = 0.0017 h-1, fraction of total enthalpy = 0.1 at 36 degrees C; k = 0.0037 h-1, fraction = 0.2 at 42 degrees C). Freeze-fracture electron micrographs confirmed that an intermediate-sized vesicle population (diameters 400-500 A) appeared in SUV samples stored above their phase transition. Also, the trapped volume of DMPC SUV increased from 0.26 microL/mumol after 17 h of storage to 0.54 microL/mumol after storage for 16 days at 36 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676259 TI - Functional effects of cis-thymine glycol lesions on DNA synthesis in vitro. AB - Thymine glycol, a DNA lesion produced by ionizing radiation, has been introduced site specifically at high frequency into a synthetic oligonucleotide by chemical oxidation of the single thymine residue within the sequence. The lesion containing template was then annealed to a complementary synthetic primer and used to study the effects of cis-thymine glycol lesions on DNA polymerase function in vitro. Synthesis by polymerase I (Klenow fragment), T4 DNA polymerase, and polymerase alpha 2 was arrested quantitatively at the site of the lesion. AMV reverse transcriptase was less inhibited and was able to synthesize past a significant fraction of the lesions. Changing the template base immediately 5' to thymine glycol from A to C did not significantly alter the pattern of synthesis arrest for any of the polymerases. The correct nucleotide, dAMP, was inserted opposite the lesion more than 90% of the time by all four polymerases, suggesting that thymine glycol forms a reasonably stable base pair with adenine. However, the 3'-5' exonuclease activity of polymerase I removed a 3'-terminal dAMP residue more rapidly from an A . thymine glycol base pair than from an A.T base pair. These results suggest that increased nucleotide turnover at the site of the lesion contributes to the inhibitory effects of thymine glycol lesions on DNA synthesis in vitro, at least for polymerases such as polymerase I that have intrinsic or associated editing exonuclease functions. PMID- 3676260 TI - Modeling and molecular mechanical studies of the cis-thymine glycol radiation damage lesion in DNA. AB - Computer graphics and energy minimization techniques were used to construct a model of DNA containing cis-thymine glycol, an oxidation product of thymine formed in DNA by ionizing radiation. The model simulated an experimental DNA substrate used to study the effects of this lesion on DNA synthesis in vitro. The results derived from the model indicate that cis-thymine glycol lesions introduce localized perturbations of DNA structure. Specifically the model shows that interactions with the neighboring base pair on the 5' side are significantly destabilized by thymine glycol whereas interactions with the 3' base pair are stabilized by the lesion. The magnitude of these effects is modulated by the nucleotide sequence around the lesion, particularly by the nature of the base on the 3' side. The base pair formed between adenine and thymine glycol is energetically stable and shows minimal distortion, suggesting that this lesion retains the ability to direct the insertion of the correct nucleotide during DNA synthesis. PMID- 3676261 TI - The elasticity of uniform, unilamellar vesicles of acidic phospholipids during osmotic swelling is dominated by the ionic strength of the media. AB - Uniform, unilamellar vesicles have been prepared by the pH-modification technique. The initial sizes of the vesicles were from 200 to 700 nm and were measured to within 1-3% by photo correlation spectroscopy. Vesicles were made of the dioleoyl esters of phosphatidic acid, phosphatidylcholine, phosphatidylglycerol, phosphatidylethanolamine, the diphytanyl ethers of phosphatidylglycerol, Escherichia coli lipids, and lac permease reconstituted into E. coli lipids. The vesicle suspensions were prepared and then diluted with electrolyte (KCl) and/or nonelectrolyte (sucrose, trehalose, pentaerythritol) impermeants. The amplitude of the swelling is linearly proportional to the osmotic pressure difference across the bilayer. We have determined the elastic modulus, the elastic limit (percent surface expansion at bursting), and the transbilayer pressure difference at bursting for each of these vesicles at constant osmolarity but at different ionic strengths. We find that the elastic properties of the bilayer vary by a factor of 10 in electrolyte media as compared to isosmolal nonelectrolyte media and that this variation appears to be related to both the charge density at the surface and the ionic strength of the media. Anionic lipid vesicles in 150 mM KCl have a significantly higher modulus (50 X 10(7) dyn/cm2) and transbilayer pressure difference (40 mosM) at bursting with a small capacity to stretch (3-4% surface expansion) compared to the same vesicles suspended in nonelectrolyte impermeants. The latter vesicles undergo a significant surface expansion (8-10%), display a low modulus (3 X 10(7) dyn/cm2), and burst at 3-4 mosM bilayer pressure difference. Vesicles suspended in media of constant osmolarity at various ionic strengths display properties with proportional values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676262 TI - Binary mixtures of asymmetric phosphatidylcholines with one acyl chain twice as long as the other. AB - High-resolution differential scanning calorimetry and 31P NMR spectroscopy have been used to study aqueous phosphatidylcholine (PC) dispersions prepared from colyophilized mixtures of C(10):C(22)PC/C(22):C(12)PC of various molar ratios. These two lipid species are highly asymmetric but have a common structural feature; namely, one acyl chain in the fully extended conformation is about twice as long as the other. Our experimental results support two conclusions: (1) These two component lipids are miscible in all proportions in both gel and liquid crystalline states. This type of system behaves as a nearly ideal mixture. Its calorimetric parameters are those expected on the basis of the mole fraction weighted average of the corresponding parameters for the pure components. (2) The component lipids appear to self-assemble, at T less than Tm, into a mixed interdigitated bilayer in excess water. In a mixed interdigitated bilayer, the short acyl chain of one asymmetric phosphatidylcholine on one side of the bilayer leaflet is apposed with the short acyl chain of another lipid molecule on the other side of the bilayer leaflet, while the longer acyl chain from each of the two leaflets crosses the entire hydrocarbon width of the bilayer. The fundamental packing unit, as well as the dynamic unit describing the axial rotator motion about the bilayer normal for this mixed interdigitated bilayer, is thus a dimer, whereas the packing unit assigned for the noninterdigitated bilayer such as C(16):C(16)PC lamellae is a monomer. PMID- 3676263 TI - Spontaneous transfer of ganglioside GM1 between phospholipid vesicles. AB - The transfer kinetics of the negatively charged glycosphingolipid II3-N acetylneuraminosyl-gangliotetraosylceramide (GM1) were investigated by monitoring tritiated GM1 movement between donor and acceptor vesicles. After appropriate incubation times at 45 degrees C, donor and acceptor vesicles were separated by molecular sieve chromatography. Donors were small unilamellar vesicles produced by sonication, whereas acceptors were large unilamellar vesicles produced by either fusion or ethanol injection. Initial GM1 transfer to acceptors followed first-order kinetics with a half-time of about 40 h assuming that GM1 is present in equal mole fractions in the exterior and interior surfaces of the donor vesicle bilayer and that no glycolipid flip-flop occurs. GM1 net transfer was calculated relative to that of [14C]cholesteryl oleate, which served as a nontransferable marker in the donor vesicles. Factors affecting the GM1 interbilayer transfer rate included phospholipid matrix composition, initial GM1 concentration in donor vesicles, and the GM1 distribution in donor vesicles with respect to total lipid symmetry. The findings provide evidence that GM1 is molecularly dispersed at low concentrations within liquid-crystalline phospholipid bilayers. PMID- 3676264 TI - Dependence on phospholipid composition of the fraction of cholesterol undergoing spontaneous exchange between small unilamellar vesicles. AB - Spontaneous cholesterol exchange between small unilamellar vesicles comprised of different phospholipids and their binary mixtures has been studied in order to understand the factors involved in the establishment and maintenance of intracellular cholesterol distributions. Exchange was performed from neutral donor vesicles containing different cholesterol concentrations, traces of [3H]cholesterol, and [14C]cholesteryl oleate as a nonexchangeable marker. The acceptor vesicles, in 10-fold excess, had the same composition, but 15 mol % phosphatidylglycerol was included to permit chromatographic separation. Data were best fitted by a single exponential and a base value. In donor vesicles containing only one phospholipid, the kinetic rate constants agreed with data reported previously; however, the base values were larger than the expected equilibrium value of 9.09%. The size of this nonexchangeable pool and the exchange rate were found to depend on the type of phospholipid. In binary phospholipid donor systems, well above the transition temperatures of the lipid components, the exchange parameters were preferentially closer to those of one component according to the order POPC greater than DMPC greater than DPPC greater than bovine brain SPM. PMID- 3676265 TI - Structural comparison of human apolipoproteins B-48 and B-100. AB - In this study we have investigated the structural relationship between human apolipoproteins B-48 and B-100 by comparing protein structure and by comparing nucleotide sequence from intestinal and hepatic cDNA clones. Sequences from intestinal and hepatic cDNA were identical over the entire distance analyzed (7194 bases), which is more than required to code for B-48. The amino-terminal amino acid sequences from intact B-48 and B-100 proteins were also identical over the entire distance analyzed (16 residues). Additional protein homology was evaluated by the combined techniques of peptide mapping and immunoblotting. Purified B-48 and B-100 were each digested with three different endoproteases, and the resulting peptides were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Peptide bands were then detected by silver stain and by Western blotting with antisera against specific regions of B-48 and B-100. The resulting patterns suggest that B-48 is extensively homologous with the amino-terminal portion of B-100. We have identified only four peptides from B 48 (at least one in each digest) that are absent from the parallel digests of B 100. These peptides appear to arise from the ultimate carboxyl terminus of B-48 and appear to be totally homologous with a region located near the center of B 100. Our observations suggest that mature, circulating B-48 is homologous over its entire length (estimated to be between 2130 and 2144 amino acid residues) with the amino-terminal portion of B-100 and contains no sequence from the carboxyl end of B-100.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676266 TI - Isolation and characterization of four heparin-binding cyanogen bromide peptides of human plasma apolipoprotein B. AB - Apolipoprotein B-100 (apoB-100) is the major protein constituent of human plasma low-density lipoproteins (LDL). On the basis of its amino acid sequence [Chen, S. H., Yang, C.-Y., Chen, P.-F., Setzer, D., Tanimura, M., Li, W.-H., Gotto, A. M., Jr., & Chan, L. (1986) J. Biol. Chem. 261, 12918-12921], apo B-100 is one of the largest monomeric proteins known with a calculated molecular weight of 512937. Heparin binds to the LDL surface by interacting with positively charged amino acid residues of apoB-100, forming soluble complexes in the absence of divalent metals and insoluble complexes in their presence. The purpose of this study was to isolate and characterize the heparin-binding domain(s) of apoB-100. Human plasma LDL were fragmented with cyanogen bromide (CNBr). After delipidation and reduction-carboxymethylation, the CNBr peptides were fractionated by sequential chromatography on DEAE-Sephacel, Mono S, and high reactive heparin (HRH) AffiGel 10; HRH was purified by chromatography of crude bovine lung heparin on LDL AffiGel-10. Heparin-binding peptides were further purified by reverse-phase high performance liquid chromatography. Heparin-binding activity was monitored by a dot-blot assay with 125I-HRH. The amino-terminal sequences of four CNBr heparin binding peptides (CNBr-I-IV) were determined. CNBr-I-IV correspond to residues 2016-2151, 3109-3240, 3308-3394, and 3570-3719, respectively, of the amino acid sequence of apoB-100. Each CNBr peptide contains a domain(s) of basic amino acid residues which we suggest accounts for their heparin-binding activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676267 TI - Physical-chemical interaction of heparin and human plasma low-density lipoproteins. AB - This study characterizes the physical-chemical interactions of heparin with human plasma low-density lipoproteins (LDL). A high reactive heparin (HRH) specific for the surface determinants of LDL was isolated by chromatography of commercial bovine lung heparin on LDL immobilized to AffiGel-10. HRH was derivatized with fluoresceinamine and repurified by affinity chromatography, and its interaction with LDL in solution was monitored by steady-state fluorescence polarization. Binding of LDL to fluoresceinamine-labeled HRH (FL . HRH) was saturable, reversible, and specific; HRH stoichiometrically displaced FL . HRH from the soluble complex, and acetylation of lysine residues on LDL blocked heparin binding. Titration of FL.HRH with excess LDL yielded soluble complexes with two LDL molecules per heparin chain (Mr 13,000) characterized by an apparent Kd of 1 microM. Titration of LDL with excess HRH resulted in two classes of heparin binding with two and five heparin molecules bound per LDL and apparent Kd values of 1 and 10 microM, respectively. At physiological pH and ionic strength, the soluble HRH-LDL complexes were maximally precipitated with 20-50 mM Ca2+. Insoluble complexes contained 2-10 HRH molecules per LDL with the final product stoichiometry dependent on the ratio of the reactants. The affinity of HRH for LDL in the insoluble complexes was estimated between 1 and 10 microM. Insoluble LDL-heparin complexes were readily dissociated with 1.0 M NaCl, and their formation was prevented by acetylation of the lysine residues on LDL. PMID- 3676268 TI - Detection of intermediate species in the refolding of bovine trypsinogen. AB - The mixed disulfide of bovine trypsinogen and glutathione was refolded at pH 8.6 and 4 degrees C with a mixture of 3 mM cysteine and 1 mM cystine catalyzing disulfide interchange. The folding process was monitored by analysis of quenched samples with isoelectric focusing and size-exclusion chromatography. Isoelectric focusing showed a progressive change from a pI of 5.2 for the mixed disulfide derivative to a pI of 9.3 for native trypsinogen. A number of principal intermediates were detected as a function of the refolding time. These intermediates were also separated and further characterized by size-exclusion chromatography on columns of TSK G2000 SW operated in the high-performance liquid chromatographic mode. Rechromatography of a series of sequential fractions taken from the parental peak was necessary to resolve and characterize the principal intermediates. The loss of glutathione moieties produced a partly folded structure with an apparent hydrodynamic volume (Stokes radius, Rs) of 33.9 A. These structures became compact with time, and more intermediates were detected between 33.9 and 29.2 A. Finally, a change in conformation, resembling a two state transition, changed the molecules of Rs 29.2 to the compact structure of native trypsinogen (22.4 A). The rate of formation of the native structure was determined from the progress curves derived from isoelectric focusing and size exclusion chromatography.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676269 TI - Kinetics of coupled enzyme reactions. AB - A theory has been developed for the kinetics of coupled enzyme reactions. This theory does not assume that the first reaction is irreversible. The validity of this theory is confirmed by a model system consisting of enoyl-CoA hydratase (EC 4.2.1.17) and 3-hydroxyacyl-CoA dehydrogenase (EC 1.1.1.35) with 2,4-decadienoyl coenzyme A (CoA) as a substrate. This theory, in contrast to the conventional theory, proves to be indispensible for dealing with coupled enzyme systems where the equilibrium constant of the first reaction is small and/or the concentration of the coupling enzyme is higher than that of the intermediate. Equations derived on the basis of this theory can be used to calculate steady-state velocities of coupled enzyme reactions and to predict the time course of coupled enzyme reactions during the pre steady state. PMID- 3676270 TI - A reexamination of the reported B----Z DNA transition in nucleosomes reconstituted with poly(dG-m5dC).poly(dG-m5dC). AB - Polynucleosomes with poly(dG-m5dC).poly(dG-m5dC) have been reconstituted, and well-defined nucleosome core particles from these have been prepared. Upon addition of MgCl2 to the levels used to induce the B to Z transition in this highly methylated DNA, significant changes in the circular dichroism spectrum are observed in solutions of these particles. However, such core particles also exhibit a noticeable instability when compared to chicken erythrocyte core particles under the same conditions. The change in circular dichroism can be entirely accounted for on the assumption that only free nucleotide, released by core particle dissociation, undergoes the B----Z transition. Therefore, no evidence has been found for "Z nucleosomes" in these solutions. In fact, the histone-DNA interaction in the nucelosome seems to partially inhibit the B to Z transition of the DNA. The analysis of our results is consistent with a model in which all of the DNA that remains bound to the histone octamer retains the B form. PMID- 3676271 TI - Binding of the DNA polymerase alpha-DNA primase complex to the nuclear matrix in HeLa cells. AB - It is well-known that there are multiple forms of DNA polymerase alpha. In order to determine which form(s) is (are) tightly bound, the activities were dissociated from DNA-poor nuclear matrices, with octyl beta-D-glucoside. Sucrose gradient sedimentation analysis revealed three bands with s values of 7.5, 10.5, and 13. The 7.5S form was free of DNA primase and represented only 10% of the total DNA polymerase alpha bound to the nuclear matrix. The 13S and the 10.5S forms each contained DNA primase activity. The 10.5S form comprised 85% of the DNA polymerase alpha activity and 95% of the DNA primase activity, dissociated from the nuclear matrix. Neither temperature of nuclease digestion nor various salt treatments of nuclei had significant effects on the proportions of DNA polymerase alpha and DNA primase activities bound to, or subsequently dissociated from, nuclear matrices. In a comparison of primase activity bound to the nuclear matrix, dissociated from the nuclear matrix, and in the soluble fraction, it was found that the bound activity had a lower ATP dependence, had less KCl inhibition, and was less sensitive to heat, compared to the dissociated and soluble activities. No differences in Mg2+ or pH dependence were noted. The amounts of DNA polymerase alpha and DNA primase activities bound to the nuclear matrix varied over the cell cycle of synchronized cells. Over the S phase, there were two peaks of matrix-bound DNA primase and two peaks of subsequently dissociated DNA polymerase alpha-DNA primase complex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676272 TI - Proteins associated with untransformed estrogen receptor in vitro. Perturbation of hydrophobic interactions induces alterations in quaternary structure and exposure of the DNA-binding site. AB - Estrogen receptors from calf uteri have been analyzed by high-performance size exclusion chromatography, chromatofocusing, and DNA affinity chromatography using conditions designed to evaluate the relative contribution of hydrophobic interactions between the steroid-binding subunit and other receptor-associated proteins. The single large (untransformed) species of soluble estrogen-receptor consistently (n = 9) found in calf uteri displayed a rapid change in Stokes radius from 8.0 to 3.5 nm upon exposure to elevated ionic strengths (0.4 M KCl). However, equilibration of the estrogen-receptor complex into urea (up to 6 M) did not dissociate the untransformed receptor into the 3.5-nm receptor form (subunit) observed in hypertonic (0.4 M KCl) buffers. Exposure to 6 M urea did result in conversion of the untransformed receptor (8.0 nm) to a 6.0-6.5-nm receptor form not previously observed in either hypotonic or hypertonic buffers. In the presence of both 6 M urea and 0.4 M KCl, the untransformed estrogen-receptor complex was converted to a smaller receptor form intermediate in apparent size (4.5-5.0 nm) to that observed in 6 M urea or 0.4 M KCl alone. The formation of this 4.5-5.0-nm receptor form was partially estrogen dependent as determined by parallel analyses of unliganded receptor in urea/KCl buffer. The urea-induced change in apparent size (8 nm to 6.0-6.5 nm) at low ionic strength was accompanied by little or no detectable change in net surface charge as determined by chromatofocusing but a complete exposure of the DNA-binding site as evidenced by nearly quantitative interaction with DNA-agarose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676273 TI - NMR studies on an oligodeoxynucleotide containing 2-aminopurine opposite adenine. AB - A heteroduplex containing the mismatch 2-aminopurine (AP)-adenine has been synthesized and studied by proton NMR. The mismatch was incorporated into the sequence d[CGG(AP)GGC].d-(GCCACCG). One-dimensional nuclear Overhauser effect measurements in H2O and two-dimensional nuclear Overhauser effect spectra in D2O show AP.A base pairs in a wobble structure in which both bases are in the anti conformation. The adenine is stacked well in the helix, but the helix twist between the adenine and neighboring cytosine in the 3' direction is unusually small. As a result, the aminopurine on the opposite strand is somewhat pushed out of the helix. From the measurements of the imino proton line widths, the two adjacent G.C base pairs are not found to be significantly destabilized by the presence of the purine-purine wobble pair. PMID- 3676274 TI - NMR studies of the stable mismatch purine-thymine in the self-complementary d(CGPuAATTTCG) duplex in solution. AB - One- and two-dimensional nuclear Overhauser effect experiments demonstrate that a single hydrogen bond between a T imino proton and purine N3 is sufficient to hold the base pair dPu.dT in d(CGPuAATTTCG) by a Watson-Crick fashion rather than a Hoogsteen type. In addition, the dPu.dT base pair is well stacked with neighboring base pairs. The spin-lattice relaxation measurements at 30 and 35 degrees C of two decamers, d(CGPuAATTTCG) and d(CGAAATTTCG), reveal that the elimination of two single hydrogen bonds of dA.dT base pairs (due to the substitution of adenine for purine) in the sequence results in an increase in the overall imino proton exchange rate from 7 to 36 s-1 at the site of mismatch. PMID- 3676275 TI - Synthesis and 1H NMR spectroscopic characterization of trans [Pt(NH3)2[d(ApGpGpCpCpT)-N7-A(1),N7-G(3)]]. AB - The reaction of trans-[Pt(NH3)2Cl2] with the sodium salt of [d(ApGpGpCpCpT)]2 in aqueous solution at 37 degrees C was monitored by reversed-phase high-performance liquid chromatography and UV spectroscopy. Two intermediates, most likely monofunctional adducts, were observed, which subsequently formed one predominant single-stranded product, as well as several polymeric species proposed to be interstrand cross-linked products. The single-stranded adduct was structurally characterized by 1H NMR spectroscopy. From the pH dependence of the chemical shifts, two-dimensional homonuclear chemical shift correlation (COSY) spectroscopy, and one- and two-dimensional nuclear Overhauser effect (NOESY) experiments, the platinum(II) moiety was found to be coordinated to the N7 positions of adenine(1) and guanine(3), with the intervening guanine(2) base destacked from its neighboring residues. This intrastrand 1,3 adduct induces changes in the backbone torsion angles and causes the deoxyribose ring of adenine(1) to switch from a C2'-endo to a predominantly C3'-endo conformation. The other deoxyribose rings retain B DNA type conformations. The structure of trans-[Pt(NH3)2[d(ApGpGpCpCpT)-N7-A(1),N7-G(3)]] differs from those previously reported for cis-DDP 1,2- and 1,3-intrastrand oligonucleotide adducts but is consistent with the structures of trans-DDP 1,3-intrastrand adducts of two previously reported trinucleotides. PMID- 3676276 TI - Active site of human liver aldehyde dehydrogenase. AB - Bromoacetophenone (2-bromo-1-phenylethanone) functions as an affinity reagent for human aldehyde dehydrogenase (EC 1.2.1.3) and has been found specifically to label a unique tryptic peptide in the enzyme. Amino-terminal sequence analysis of the labeled peptide after purification by two different procedures revealed the following sequence: Val-Thr-Leu-Glu-Leu-Gly-Gly-Lys. Radioactivity was found to be associated with the glutamate residue, which was identified as Glu-268 by reference to the known amino acid sequence. This paper constitutes the first identification of an active site of aldehyde dehydrogenase. PMID- 3676277 TI - Purification and amino acid sequence of chicken liver cathepsin L. AB - Cathepsin L was purified from chicken liver lysosomes by a two-step procedure. Cathepsin L exhibited a single band of Mr 27,000 by sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing conditions, presented a high affinity for the substrate Z-Phe-Arg-NMec, was very unstable at neutral pH, and was inhibited by Z-Phe-Phe-CHN2. The complete amino acid sequence of cathepsin L has been determined and consists of 215 residues. The sequence was deduced from analysis of peptides generated by enzymatic digestions and by chemical cleavage at methionyl bonds. Comparison of the amino acid sequence of cathepsin L with those of rat liver cathepsins B and H and papain demonstrates a striking homology among their primary structures. PMID- 3676278 TI - Function and reactivity of sulfhydryl groups of rat liver glycine methyltransferase. AB - Rat liver glycine methyltransferase is completely inactivated by 5,5'-dithiobis(2 nitrobenzoic acid) (DTNB). Treatment of the inactivated enzyme with KCN results in a reactivated enzyme having values of Vmax and S0.5 for S-adenosyl-L methionine comparable to those of the native enzyme and about a 4-fold greater Km value for glycine. Kinetics of inactivation and reactivation show that one cysteine residue is involved in this process. Reaction of the methyltransferase with iodoacetate leads to partial inactivation of the enzyme; about 22% of the initial activity is retained in the modified enzyme. The relationship between the loss of enzyme activity and the number of iodoacetate molecules incorporated and the sequence analysis of peptides containing the modified residues indicate that carboxymethylation of Cys-282 is responsible for loss of activity. The observations that the activity of the cyanylated glycine methyltransferase shows no decrease upon incubation with iodoacetate and, conversely, the residual activity associated with the iodoacetate-modified enzyme is not abolished by DTNB suggest that Cys-282 is also involved in the inactivation by DTNB. Besides this residue, Cys-185, Cys-246, and Cys-262 are modified upon prolonged incubation with iodoacetate. 5'-[p-(Fluorosulfonyl)benzoyl]adenosine (FSBA) inactivates glycine methyltransferase by forming 1 disulfide/subunit [Fujioka, M., & Ishiguro, Y. (1986) J. Biol. Chem. 261, 6346-6351]. Despite this stoichiometry, treatment of the FSBA-inactivated enzyme with unlabeled iodoacetate and then with iodo[14C]acetate after reduction with 2-mercaptoethanol and subsequent peptide analysis show that the incorporated radioactivity is distributed equally among Cys-185, Cys-246, Cys-262, and Cys-282.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676279 TI - Phosphatidylinositol anchor of HeLa cell alkaline phosphatase. AB - Alkaline phosphatase from cancer cells, HeLa TCRC-1, was biosynthetically labeled with either 3H-fatty acids or [3H]ethanolamine as analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and fluorography of immunoprecipitated material. Phosphatidylinositol-specific phospholipase C (PI-PLC) released a substantial proportion of the 3H-fatty acid label from immunoaffinity-purified alkaline phosphatase but had no effect on the radioactivity of [3H]ethanolamine labeled material. PI-PLC also liberated catalytically active alkaline phosphatase from viable cells, and this could be selectively blocked by monoclonal antibodies to alkaline phosphatase. However, the alkaline phosphatase released from 3H-fatty acid labeled cells by PI-PLC was not radioactive. By contrast, treatment with bromelain removed both the 3H-fatty acid and the [3H]ethanolamine label from the purified alkaline phosphatase. Subtilisin was also able to remove the [3H]ethanolamine-labeled from purified alkaline phosphatase. The 3H radioactivity in alkaline phosphatase purified from [3H]ethanolamine-labeled cells comigrated with authentic [3H]ethanolamine by anion-exchange chromatography after acid hydrolysis. The data suggest that the 3H-fatty acid and [3H]ethanolamine are covalently attached to the carboxyl-terminal segment since bromelain and subtilisin both release alkaline phosphatase from the membrane by cleavage at that end of the polypeptide chain. The data are consistent with findings for other proteins recently shown to be anchored in the membrane through a glycosylphosphatidylinositol structure and indicate that a similar structure contributes to the membrane anchoring of alkaline phosphatase. PMID- 3676280 TI - Enhanced processivity of nuclear matrix bound DNA polymerase alpha from regenerating rat liver. AB - Translocation of DNA during in vitro DNA synthesis on nuclear matrix bound replicational assemblies from regenerating rat liver was determined by measuring the processivity (average number of nucleotides added following one productive binding event of the polymerase to the DNA template) of nuclear matrix bound DNA polymerase alpha with poly(dT).oligo(A)10 as template primer. The matrix-bound polymerase had an average processivity (28.4 nucleotides) that was severalfold higher than the bulk nuclear DNA polymerase alpha activity extracted during nuclear matrix preparation (8.9 nucleotides). ATP at 1 mM markedly enhanced the activity and processivity of the matrix-bound polymerase but not the corresponding salt-soluble enzyme. The majority of the ATP-dependent activity and processivity enhancement was completed by 100 microM ATP and included products ranging up to full template length (1000-1200 nucleotides). Average processivity of the net ATP-stimulated polymerase activity exceeded 80 nucleotides with virtually all the DNA products greater than 50 nucleotides. Release of nuclear matrix bound DNA polymerase alpha by sonication resulted in a loss of ATP stimulation of activity and a corresponding decrease in processivity to a level similar to that of the salt-soluble polymerase (6.8 nucleotides). All nucleoside di- and triphosphates were as effective as ATP. Stimulation of both activity and processivity by the nonhydrolyzable ATP analogues adenosine 5'-O-(3 thiotriphosphate), 5'-adenylyl imidodiphosphate, and adenosine 5'-O-(1 thiotriphosphate) further suggested that the hydrolysis of ATP is not required for enhancement to occur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676281 TI - Electrostatic effect upon association of reduced nicotinamide adenine dinucleotide and equine liver alcohol dehydrogenase. AB - The rate of association of equine liver alcohol dehydrogenase and its coenzymes exhibits a large pH dependence with slower rates at basic pH and an observed kinetic pKa value of approximately 9-9.5. This pH dependence has been explained by invoking local active site electrostatic effects which result in repulsion of the negatively charged coenzyme and the ionized hydroxyl anion form of the zinc bound water molecule. We have examined a simpler hypothesis, namely, that the pH dependence results from the electrostatic interaction of the coenzyme and the enzyme which changes from an attractive interaction of the negatively charged coenzyme and the positively charged enzyme to a repulsive interaction between the two negatively charged species at the isoelectric point for the enzyme (pH 8.7). We have tested this proposal by examining the ionic strength dependence of the association rate constant at various pH values. These data have been interpreted by using the Wherland-Gray equation, which we have shown can be applied to the kinetics of enzyme-coenzyme association. Our results indicate that the shielding of the buffer electrolyte changes from a negative to a positive value as the charge on the protein changes at the isoelectric point. This result is exactly that which is predicted for electrostatic effects that depend on the charge of the protein molecule and is not consistent with predictions based upon the local active site effects. At low ionic strength values of 10 mM or less, approximately 75% of the observed pH dependence results from the enzyme electrostatic effects; the remaining pH dependence may result from active site effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676282 TI - Substrate specificity of human class I alcohol dehydrogenase homo- and heterodimers containing the beta 2 (Oriental) subunit. AB - In order to gain a better understanding of the metabolism of ethanol in Orientals, the kinetic properties of human alcohol dehydrogenase (ADH) isozymes containing the beta 2 (Oriental) subunit, i.e., alpha beta 2, beta 2 gamma 1, beta 2 beta 2, beta 2 gamma 2, as well as gamma 1 gamma 1, were examined by using primary and secondary alcohol substrates of various chain lengths and compared with those of the corresponding beta 1 (Caucasian) subunit containing isozymes already on record [Wagner, F. W., Burger, A. R., & Vallee, B. L. (1983) Biochemistry 22, 1857-1863]. With primary alcohols, these isozymes follow typical Michaelis-Menten kinetics with a preference for long-chain alcohols, as indicated by Km and kcat/Km values. The kcat values obtained with primary alcohols, except methanol, do not vary greatly, i.e., less than 3-fold, whereas the corresponding Km values span a 3600-fold range, i.e., from 26 microM to 94 mM, indicating that the specificity of these isozymes manifests principally in substrate binding. As a consequence, ethanol--which might be thought to be the principal in vivo substrate for ADH--is oxidized rather poorly, i.e., from 50- to 90-fold less effectively than octanol. Secondary alcohol oxidation by the homodimers beta 2 beta 2 and gamma 1 gamma 1 also follows normal Michaelis-Menten kinetics. Again, values of Km and kcat/Km reveal that both isozymes prefer long carbon chains. For all secondary alcohols studied, the Km and kcat values for beta 2 beta 2 are much higher than those for gamma 1 gamma 1, i.e., 25- to 360-fold and 6- to 16-fold, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676283 TI - Beta 2 (Oriental) human liver alcohol dehydrogenases do not exhibit subunit interaction: oxidation of cyclohexanol by homo- and heterodimers. AB - The steady-state kinetics of isozymes of human liver alcohol dehydrogenase (ADH) containing the beta 2 (Oriental) subunit were investigated in order to confirm the supposition [Fong, W.P., & Keung, W. M. (1987) Biochemistry (preceding paper in this issue)] that the subunits of such heterodimeric ADHs act independently and noncooperatively. The ADH isozymes alpha beta 2, beta 2 beta 2, beta 2 gamma 1, and beta 2 gamma 2 as well as gamma 1 gamma 1 were purified by chromatography on DEAE-cellulose, 4-[3-[N-(6-aminocaproyl)amino]propyl]pyrazole--Sepharose, and CM-cellulose. Their kinetics were studied at pH 9.0 with cyclohexanol since this substrate permits maximal differentiation between activities of the heterodimeric subunits. Oxidation of cyclohexanol by the homodimers beta 2 beta 2 and gamma 1 gamma 1 follows conventional Michaelis-Menten kinetics. The values of Km and kcat determined for beta 2 beta 2 and gamma 1 gamma 1 are 0.11 M and 260 min-1 and 79 microM and 45 min-1, respectively, indicating that beta 2 beta 2, like the previously studied beta 1 beta 1, has an unusually low binding affinity for cyclohexanol compared to that of the ADH isozymes formed by the combination of alpha, gamma 1, and gamma 2 chains. Cyclohexanol oxidation by the heterodimers alpha beta 2, beta 2 gamma 1, and beta 2 gamma 2 follows biphasic kinetics which can be fully accounted for by the individual subunits, one exhibiting a high and the other a low substrate-binding affinity. Eadie-Hofstee plots resolve the biphasic kinetics into two linear components, each of which yields a set of kinetic parameters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676284 TI - Conformational aspects and rotational dynamics of synthetic adrenocorticotropin (1-24) and glucagon in reverse micelles. AB - The tryptophan (Trp) rotational dynamics and the secondary structure of the peptide hormones adrenocorticotropin-(1-24) [ACTH(1-24)]--the fully active N terminal fragment of adrenocorticotropin-(1-39)--and glucagon were studied in aqueous solutions and in reverse micelles of sodium bis(2-ethylhexyl) sulfosuccinate (AOT)/water/isooctane, a system selected to mimic the membrane water interface. In aqueous solutions, the total fluorescence intensity decays of their single Trp residue [Trp-9 and Trp-25 for ACTH(1-24) and glucagon, respectively] are multiexponential. This is also the case for ACTH(5-10), a fragment of the adrenocorticotropin "message" region. Time-resolved fluorescence anisotropy data evidence a high degree of rotational freedom of the single Trp residue. Transfer of these peptides from water to the aqueous core of reverse micelles induces severe restrictions of the Trp internal motion and of its local environment. The results indicate that the Trp-9 residue in ACTH(1-24 is maintained in the close neighborhood of the water-AOT molecular interface where the water molecules are strongly immobilized. By contrast, the Trp residues in ACTH(5-10) and glucagon are likely to be located closer to the center of the micellar aqueous core where the water molecules are in a more mobile state. Furthermore, the above location of Trp can be extended to the peptide chains themselves as evidenced by the overall correlation time values of the peptide containing micelles. Nevertheless, in all peptides, the indole ring remains susceptible to oxidation by N-bromosuccinimide. Circular dichroism measurements evidence the induction in glucagon of alpha-helices remaining unaffected by the micellar water content. Conversely, beta-sheet structures are favored in ACTH(1 24) at low water-to-surfactant molar ratios (w0) but are disrupted by subsequent additions of water. These results are discussed in terms of the possible role of the micellar interfaces in selecting the preferred peptide dynamical conformation(s) PMID- 3676285 TI - Degradation of native type IV procollagen by human neutrophil elastase. Implications for leukocyte-mediated degradation of basement membranes. AB - Leukocyte-derived proteases may contribute to the destruction of basement membranes during inflammation. We have, therefore, examined the degradation of human type IV procollagen (PC) by purified human neutrophil elastase (HLE). Native [14C]proline-labeled type IV PC was isolated from cultures of human HT 1080 cells and incubated with HLE for various times at 25 or 37 degrees C. Cleavage products were resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and identified by CNBr peptide mapping. Incubation of type IV PC with HLE (less than 1:10 HLE:type IV weight ratio) resulted in cleavage of the pro alpha 1 (IV) and pro alpha 2 chains (Mr 180,000 and 175,000) to discrete components of Mr greater than 140,000. Peptide mapping indicated that the carboxy terminal collagenase-resistant domains of both chains were rapidly and preferentially degraded. Longer incubations or incubations at higher enzyme:substrate ratios resulted in extensive and asymmetric internal cleavage with the generation of fragments similar in size distribution to the major pepsin resistant fragments of type IV collagen. Our findings indicate that soluble, native human type IV PC is a substrate for HLE and is preferentially cleaved within the globular carboxy-terminal domains of the pro alpha 1 and pro alpha 2 chains. We suggest that even limited cleavage of type IV PC by HLE may disrupt intermolecular carboxy-terminal interactions believed to be important for basement membrane assembly and for maintaining basement membrane structure in vivo. PMID- 3676286 TI - Properties of carboxymethylated cross-linked hemoglobin A. AB - The selective carboxymethylation of the N-terminal amino groups of hemoglobin A with glyoxylic acid and sodium cyanoborohydride has been studied as a function of the state of ligation of hemoglobin. The N-terminal residues have been established as the primary sites of reaction by peptide mapping of the tryptic digest of each chain and subsequent amino acid analysis of the modified peptides. With oxyhemoglobin, the desired derivatives with a carboxymethyl group at the N terminal of either or both chains amounted to 55% [Di Donato, A., Fantl, W. J., Acharya, A. S., & Manning, J. M. (1983) J. Biol. Chem. 258, 11890-11895]. In the present study it is shown that with deoxyhemoglobin the amount of the desired derivative is increased to 75%. The oxygen equilibrium curve of hemoglobin A carboxymethylated on its four N-terminal residues [0.5 mM as tetramer in 50 mM [bis(2-hydroxyethyl)amino]tris(hydroxymethyl)methane (Bis-Tris), pH 7.5, 37 degrees C] had a P50 value of 30 mmHg (Hill coefficient n = 2.8, alkaline Bohr value = 0.4) compared to a P50 of 9 mmHg for unmodified hemoglobin under the same conditions (n = 2.5, alkaline Bohr value = 0.5). In carboxymethylated oxyhemoglobin A, cross-linked with the mild agent glycolaldehyde for 3.5 h, there was 85% of Mr 64,000 species and 15% of Mr 128,000 or higher species. For the former, the extent of cross-linking between two subunits was 19%. For the latter, there was 29% of two cross-linked subunits and 13% of three cross-linked subunits. Termination of cross-linking, which may be desirable in some circumstances, can be successfully achieved with isonicotinic acid hydrazide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676287 TI - Thermodynamics of the quenching of tyrosyl fluorescence by dithiothreitol. AB - Tyrosyl fluorescence quenching by oxidized dithiothreitol (DTTo) in N-acetyl-L tyrosine N'-methylamide, and native bovine pancreatic ribonuclease A and its reduced, S-methylated form, in aqueous solution is studied at pH 3.0. From the temperature dependence of the fluorescence quenching, it is demonstrated that the mechanism of the quenching process is probably static (formation of a complex), and not dynamic (collisional), in origin. Although other quenching mechanisms cannot be ruled out, our proposition that the quenching of tyrosyl fluorescence in these molecules is due to the formation of a complex between the tyrosyl moieties and DTTo is consistent with previously reported evidence indicating a strong tendency for aromatics to complex with various disulfide-containing compounds. The strength of binding is approximately the same for these three tyrosine-containing compounds, indicating that the microenvironments of their tyrosyl residues may be similar. With 1 M as the reference standard state, the following average thermodynamic parameters are established for the complexation (at 298 K): delta G0 = -3.32 kcal/mol, delta H0 = -1.1 kcal/mol, and delta S0 = 7.4 eu. The large positive value of delta S0 suggests that hydrophobic interactions may play an important role in the stabilization of such tyrosyl disulfide complexes; the negative value of delta H0 suggests that polar interactions may also contribute to the formation of these complexes. Some possible implications with regard to protein-folding studies are discussed. PMID- 3676288 TI - High-resolution proton and laser photochemically induced dynamic nuclear polarization NMR studies of cation binding to bovine alpha-lactalbumin. AB - alpha-Lactalbumin (alpha-LA) is a calcium binding protein that also binds Mn(II), lanthanide ions, A1(III), Zn(II), Co(II). The structural implications of cation binding were studied by high-resolution proton (200 MHz) NMR and photochemically induced dynamic nuclear polarization (CIDNP) spectroscopy. Marked changes were observed in the NMR spectra of the apoprotein upon addition of a stoichiometric amount of calcium to yield Ca(II)-alpha-LA, manifested particularly in ring current shifted aliphatic peaks and in several shifts in the aromatic region, all of which were under slow exchange conditions. The CIDNP results showed that two surface-accessible tyrosine residues, assigned as Tyr-18 and -36, became inaccessible to the solvent upon addition of 1:1 Ca(II) to apo-alpha-lactalbumin, while Tyr-103 and Trp-104 remained completely accessible in both conformers. The proton NMR spectra of apo-alpha-LA and A1(III)-alpha-LA were extremely similar, which was also consistent with intrinsic fluorescence results [Murakami, K., & Berliner, L. J. (1983) Biochemistry 22, 3370-3374]. The paramagnetic cation Mn(II) bound to the strong calcium binding site on apo-alpha-LA but also to the weak secondary Ca(II) binding site(s) on Ca(II)-alpha-LA. It was also found that Co(II) bound to some secondary sites on Ca(II)-alpha-LA that overlapped the weak calcium site. All of the lanthanide shift reagents [Pr(III), Eu(III), Tb(III), Dy(III), Tm(III), Yb(III)] bound under slow exchange conditions; their relative affinities for apo-alpha-lactalbumin from competitive binding experiments were Dy(III), Tb(III), and Pr(III) greater than Ca(II) greater than Yb(III). PMID- 3676289 TI - Monoclonal antibodies that bind the renal Na+/glucose symport system. 1. Identification. AB - Phlorizin is a specific, high-affinity ligand that binds the active site of the Na+/glucose symporter by a Na+-dependent mechanism but is not itself transported across the membrane. We have isolated a panel of monoclonal antibodies that influence high-affinity, Na+-dependent phlorizin binding to pig renal brush border membranes. Antibodies were derived after immunization of mice either with highly purified renal brush border membranes or with apical membranes purified from LLC-PK1, a cell line of pig renal proximal tubule origin. Antibody 11A3D6, an IgG2b, reproducibly stimulated Na+-dependent phlorizin binding whereas antibody 18H10B12, an IgM, strongly inhibited specific binding. These effects were maximal after 30-min incubation and exhibited saturation at increased antibody concentrations. Antibodies did not affect Na+-dependent sugar uptake in vesicles but significantly prevented transport inhibition by bound phlorizin. Antibodies recognized a 75-kDa antigen identified by Western blot analysis of brush border membranes, and a 75-kDa membrane protein could be immunoprecipitated by 18H10B12. These properties, taken together with results in the following paper [Wu, J.-S.R., & Lever, J.E. (1987) Biochemistry (following paper in this issue)], provide compelling evidence that the 75-kDa antigen recognized by these antibodies is a component of the renal Na+/glucose symporter. PMID- 3676290 TI - A deuterium and phosphorus-31 nuclear magnetic resonance study of the interaction of melittin with dimyristoylphosphatidylcholine bilayers and the effects of contaminating phospholipase A2. AB - The interaction of bee venom melittin with dimyristolphosphatidylcholine (DMPC) selectively deuteriated in the choline head group has been studied by deuterium and phosphorus-31 nuclear magnetic resonance (NMR) spectroscopy. The action of residual phospholipase A2 in melittin samples resulted in mixtures of DMPC and its hydrolytic products that underwent reversible transitions at temperatures between 30 and 35 degrees C from extended bilayers to micellar particles which gave narrow single-line deuterium and phosphorus-31 NMR spectra. Similar transitions were observed in DMPC-myristoyllysophosphatidylcholine (lysoPC) myristic acid mixtures containing melittin but not in melittin-free mixtures, indicating that melittin is able to stabilize extended bilayers containing DMPC and its hydrolytic products in the liquid-crystalline phase. Melittin, free of phospholipase A2 activity, and at 3-5 mol% relative to DMPC, induced reversible transitions between extended bilayers and micellar particles on passing through the liquid-crystalline to gel phase transition temperature of the lipid, effects similar to those observed in melittin-acyl chain deuterated dipalmitoylphosphatidylcholine (DPPC) mixtures [Dufourc, E. J., Smith, I. C. P., & Dufourcq, J. (1986) Biochemistry 25, 6448-6455]. LysoPC at concentrations of 20 mol% or greater relative to DMPC induced transitions between extended bilayers and micellar particles with characteristics similar to those induced by melittin. It is proposed that these melittin- and lysoPC-induced transitions share similar mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676292 TI - Control of the action of phospholipases A by "vertical compression" of the substrate monolayer. AB - Monolayers of rac-1,2-didodecanoyl-sn-glycero-3-phosphoglycerol at an air-water interface were "vertically compressed" by substituting an alkylated glass plate for air while maintaining a constant surface pressure of 15 mN m-1. At this surface pressure the overlaying of the lipid film by the alkylated surface resulted in an average increase of 16 A2/molecule in the mean molecular area of those phospholipid molecules residing at the interface between water and the alkylated glass. Subsequently, the activities of phospholipases A1 and A2 toward the monolayers were measured both in the presence and in the absence of the support. While phospholipase A1 activity was increased 4-fold by the support, the activity of phospholipase A2 was reduced to 15% of the activity measured in the absence of the alkylated surface. These findings indicate that such a "vertical compression" of the monolayer is likely to induce a conformational change in the phospholipid molecules, which in turn would cause the above reciprocal changes in the activities of phospholipases A1 and A2. A molecular model accounting to these findings is presented. PMID- 3676291 TI - Characterization of the chromatin acceptor sites for the avian oviduct progesterone receptor using monoclonal antibodies. AB - Monoclonal antibodies (MAb) against the chromatin acceptor sites for the avian oviduct progesterone receptor were prepared with highly purified hen oviduct acceptor proteins reconstituted to hen DNA. Addition of the MAbs to a cell-free assay blocked progesterone receptor from chick oviduct (PRov) binding to native like acceptor sites on nucleoacidic protein (NAP) representing a partially deproteinized chromatin, which has been shown to be enriched in these binding sites. However, the antibodies do not block PRov binding to pure DNA, nor do they affect the receptor itself. Estrogen receptor binding to NAP was not inhibited, supporting a receptor specificity of the PRov acceptor sites as reported previously from direct competition studies. These data support earlier studies showing that (1) the reconstituted PRov acceptor sites resemble the native sites, (2) the acceptor sites are receptor specific, and (3) the PRov binding sites of NAP are different from those of pure DNA. While some animal-species specificity in the PRov binding inhibition was observed, no tissue specificity was seen. Direct binding of the antibodies to native acceptor sites was demonstrated in an enzyme-linked immunosorbent assay (ELISA) system. The antibodies showed little recognition of free acceptor protein or DNA alone, indicating specificity for the protein-DNA complex. A partial evolutionary conservation of the nuclear acceptor sites for PRov was shown by the fact that about 50% of the inhibition seen with hen NAP was obtained with NAPs from several other species, and this partial cross reactivity of the MAbs with the same NAPs from other animal species was also seen in the ELISA. PMID- 3676293 TI - Effect of free cholesterol on incorporation of triolein in phospholipid bilayers. AB - Triacylglycerols are the major substrates for lipolytic enzymes that act at the surface of emulsion-like particles such as triglyceride-rich lipoproteins, chylomicrons, and intracellular lipid droplets. This study examines the effect of cholesterol on the solubility of a triacylglycerol, triolein, in phospholipid surfaces. Solubilities of [carbonyl-13C]triolein in phospholipid bilayer vesicles containing between 0 and 50 mol % free cholesterol, prepared by cosonication, were measured by 13C NMR. The carbonyl resonances from bilayer-incorporated triglyceride were shifted downfield in the 13C NMR spectra from those corresponding to excess, nonincorporated material. This enabled solubilities to be determined directly from carbonyl peak intensities at most cholesterol concentrations. The bilayer solubility of triolein was inversely proportional to the cholesterol/phospholipid mole ratio. In pure phospholipid vesicles the triolein solubility was 2.2 mol %. The triglyceride incorporation decreased to 1.1 mol % at a cholesterol/phospholipid mole ratio of 0.5, and at a mole ratio of 1.0 for the bilayer lipids, the triolein solubility was reduced to just 0.15 mol %. The effects of free cholesterol were more pronounced and progressive than observed previously on the bilayer solubility of cholesteryl oleate (Spooner, P. J. R., Hamilton, J. A., Gantz, D. L., & Small, D. M. (1986) Biochim. Biophys. Acta 860, 345-353]. As with cholesteryl oleate, we suggest that cholesterol also displaces solubilized triglyceride to deeper regions of the bilayer. PMID- 3676294 TI - Deuterium nuclear magnetic resonance studies on the plasmalogens and the glycerol acetals of plasmalogens of Clostridium butyricum and Clostridium beijerinckii. AB - Deuterium nuclear magnetic resonance was used to investigate the structure of different lipid fractions isolated from the anaerobic bacteria Clostridium butyricum and Clostridium beijerinckii. The fractions isolated from C. butyricum were (1) phosphatidylethanolamine/plasmenylethanolamine and (2) the glycerol acetal of plasmenylethanolamine, and from C. beijerinckii similar fractions containing principally (1) phosphatidyl-N-monomethylethanolamine, along with its plasmalogen, and (2) the glycerol acetal of this plasmalogen were isolated. The third fraction from both species consisted largely of the acidic lipids phosphatidylglycerol and cardiolipin along with plasmalogen forms of these lipids. Palmitic acid with deuterium labels at C-2, C-3, or C-4 or oleic acid with deuterium labels at C-2 and C-9,10 was added to the growth medium and incorporated to various extents in the lipid fractions. Biochemical analysis showed that palmitic acid and oleic acid were preferentially bound to the sn-2 and sn-1 positions, respectively, of the glycerol backbone when both fatty acids were added to the medium. From the 2H NMR spectra, the hydrocarbon chain ordering near the lipid-water interface could be determined and appeared to be similar for all three lipid fractions. The deuterium quadrupole splitting and order parameter were low at the C-2 segment and increased by almost a factor of 2 at positions C 3 and C-4 for cells fed with deuterated palmitic acid along with unlabeled oleic acid. These results agree with previous findings on pure diacyl lipids in which the sn-2 chain was found to adopt a bent conformation at the carbon segment C-2. However, two unusual quadrupole splittings could be detected for the plasmalogens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676295 TI - Acidic fibroblast growth factor is present in nonneural tissue: isolation and chemical characterization from bovine kidney. AB - Endothelial cell growth factor activity purified from bovine kidney by heparin Sepharose affinity chromatography was previously identified as basic fibroblast growth factor [Baird, A., Esch, F., Bohlen, P., Ling, N., & Gospodarowicz, D. (1985) Regul. Pept. 12, 202-213]. We now show that a major mitogenic fraction, isolated from heparin-Sepharose-purified material by Mono-S cation-exchange chromatography and reverse-phase high-performance liquid chromatography, is related to acidic fibroblast growth factor (aFGF). Sequence analysis showed the amino-terminal sequence to be Tyr-Lys-Lys-Pro-Lys-Leu-Leu-Tyr-X-Ser-Asn-Gly-Gly Tyr-Phe-Leu-Arg-Ile-Le u-Pro- Asp-Gly-Thr-Val-Asp-. The molecular mass of the protein, as determined by polyacrylamide gel electrophoresis, was 15.5 kDa. In combination, those data strongly suggest that this mitogen is amino terminally truncated acidic fibroblast growth factor. So far, aFGF has only been found in neural tissues, i.e., in the brain and retina. Our results strongly suggest that this mitogen also occurs in extraneural tissue. PMID- 3676297 TI - Interactions of troponin subunits: free energy of binary and ternary complexes. AB - We have determined the free energy of formation of the binary complexes formed between skeletal troponin C and troponin T (TnC.TnT) and between troponin T and troponin I (TnT.TnI). This was accomplished by using TnC fluorescently modified at Cys-98 with N-(iodoacetyl)-N'-(5-sulfo-1-naphthyl)ethylenediamine for the first complex and TnI labeled at Cys-133 with the same probe for the other complex. The free energy of the ternary complex formed between troponin C and the binary complex TnT.TnI [TnC.(TnT.TnI)] was also measured by monitoring the emission of 5-(iodoacetamido)eosin attached to Cys-133 of the troponin I in TnT.TnI. The free energies were -9.0 kcal.mol-1 for TnC.TnT, -9.2 kcal.mol-1 for TnT.TnI, and -8.7 kcal.mol-1 for TnC.(TnT.TnI). In the presence of Mg2+ the free energies of TnC.TnT and TnC.(TnT.TnI) were -10.3 and -10.9 kcal.mol-1, respectively; in the presence of Ca2+ the corresponding free energies were -10.6 and -13.5 kcal.mol-1. Mg2+ and Ca2+ had negligible effect on the free energy of TnT.TnI. From these results the free energies of the formation of troponin from the three subunits were found to be -16.8 kcal.mol-1, -18.9 kcal.mol-1, and -21.6 kcal.mol-1 in the presence of EGTA, Mg2+, and Ca2+, respectively. Most of the free energy decrease caused by Ca2+ binding to the Ca2+-specific sites is derived from stabilization of the TnI-TnC linkage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676296 TI - A physical-chemical model for cellular uptake of fatty acids: prediction of intracellular pool sizes. AB - If the uptake of fatty acids by liver is a physical, not a biological, process, then the size and location of the intrahepatic pool of fatty acids can be predicted from uptake rates and thermodynamic data. The purpose of the experiments in this paper was to test the accuracy of this idea. Rat livers were perfused with palmitate bound to albumin, and the total amounts of palmitate removed from the perfusate were measured at 3-s intervals. The intrahepatic pools of palmitate calculated from these data were 13.8 and 23.0 nmol/g of liver at ratios of palmitate/albumin (mol/mol) (afferent side) of 2/1 and 4/1, respectively, in the steady state. The intrahepatic pools of palmitate calculated from the distributions of palmitate between membranes, H2O, albumin, and fatty acid binding protein and the measured first-order rate constants for acyl-CoA ligases in mitochondria and microsomes were 12.1 and 34.6 nmol/g for perfusate ratios of palmitate/albumin of 2/1 and 4/1, in the steady state. Intrahepatic pools of palmitate measured after establishment of a steady-state rate of uptake were 15.0 and 31.8 nmol/g for these ratios of palmitate/albumin of 2/1 and 4/1. PMID- 3676298 TI - Pyrene-labeled gangliosides: micelle formation in aqueous solution, lateral diffusion, and thermotropic behavior in phosphatidylcholine bilayers. AB - By use of the excimer technique, the formation in aqueous solution of pyrene labeled ganglioside micelles and their lateral diffusion and distribution in phosphatidylcholine membranes were investigated. For these studies 12-(1 pyrenyl)dodecanoic acid was covalently attached to the ceramide part of lysogangliosides GM1, GM2, GM3, GD1a, and GD1b. The 12-(1-pyrenyl)dodecanoic acid substitute of phosphatidylcholine was used for comparison. All pyrene-labeled gangliosides were present in aqueous solution in a predominantly micellar form down to 2 X 10(-8) M, which is the technical limit of this method. The tendency to aggregate is highest for PyGD1a and PyGD1b. In fluid dipalmitoylphosphatidylcholine bilayers the excimer-to-monomer fluorescence intensity ratio of pyrene-labeled gangliosides PyGM1, PyGM2, PyGM3, PyGD1a, and PyGD1b increases linearly with ganglioside concentration. The calculated diffusion coefficients for gangliosides are comparable to 1.6 X 10(-7) cm2/s, which is the diffusion coefficient of pyrene-labeled phosphatidylcholine [Galla, H.-J., & Hartmann, W. (1980) Chem. Phys. Lipids 27, 199-219]. In comparison to phosphatidylcholine, the diffusion of monosialogangliosides is slightly increased, with that diffusion of disialogangliosides being slightly decreased. Ca2+ ions up to 200 mM do not affect ganglioside diffusion significantly. The shape of the lipid phase transition curves obtained by the excimer technique yields information on the lateral distribution of the tested probe molecules. Pyrene-labeled phosphatidylcholine was taken as reference for a system with complete miscibility but nonideal mixing. 1-Acyl-2-[10-(1-pyrenyl)decanoyl]-sn glycero-3-phosphocholine (PyPC) is known to be randomly distributed in the gel and in the fluid-crystalline lipid phase of dipalmitoylphosphatidylcholine bilayer membranes. It distributes preferentially into the fluid phase in the phase-transition region. In comparison, PyPC in dimyristoylphosphatidylcholine membranes is an example of a system with nearly ideal mixing [Hresko, R. C., Sugar, J. P., Barenholz, Y., & Thompson, T. E. (1986) Biochemistry 25, 3813 3828]. Phase-transition curves of pyrene-labeled gangliosides exemplify a nearly ideal mixing system with PyGD1a or PyGD1b producing best effects. The monosialogangliosides, however, exhibit less ideality of mixing, the deviation from an ideal mixing behavior increasing with decreasing number of both neutral sugar residues and sialic acid groups. Addition of Ca2+ triggers a tightening of the phosphatidylcholine bilayer and thus induces a change in the lateral distribution of the gangliosides at the phase transition.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676299 TI - Porin pores of mitochondrial outer membranes from high and low eukaryotic cells: biochemical and biophysical characterization. AB - The mitochondrial porins from mammalian tissues and from low eukaryotic cells were purified with a high yield, and their biochemical and functional properties were investigated. When analyzed by SDS gel electrophoresis, all mammalian porins show a very similar apparent molecular mass (35-35.5 kDa). In contrast yeast and Paramecium porins have a molecular mass of 30 and 37 kDa, respectively. The peptide maps of mammalian porins are very similar although small differences are apparent between porins of different tissues of the same organism and also between those of the same tissue of different organisms. The peptide patterns of porins from yeast and Paramecium are completely different from those of mammalian porins. Antibodies raised against the rat liver porin cross-react with all the other mammalian porins but not with that of yeast. The incorporation of porins into artificial lipid bilayer membranes showed that they are able to form pores with approximately the same specific activity. The single-channel conductance is for all porins, except for that of Paramecium, about 4 nS in 1 M KCl, corresponding to an effective pore diameter of 1.7 nm. They are voltage-dependent and switch to substates at transmembrane potentials higher than 10 mV. The number of gating charges varies, however, for pores from different tissues, indicating a different sensitivity to the potential as a result of a possible different function. PMID- 3676300 TI - Purification by affinity chromatography of the dicarboxylate carrier from bovine heart mitochondria. AB - Submitochondrial particles were prepared from bovine heart mitochondria, solubilized with Triton X-114 in the presence of lipids and submitted to hydroxylapatite chromatography. The eluate obtained, containing a mixture of mitochondrial carriers, was processed further by affinity chromatography using as ligand p-aminophenylsuccinate coupled via a diazo bond to aminohexyl-Sepharose 4B. The activity of the dicarboxylate exchanger was measured after reconstitution into asolectin vesicles at each step of the purification procedure. All samples studied were found to display substrate and inhibitor specificity similar to those described for the dicarboxylate carrier in mitochondria. The specific activity of the final material eluted from the affinity column was found to be about 1000-times higher than that of the Triton X-114 extract of submitochondrial particles. SDS-polyacrylamide gel electrophoresis analysis of the affinity chromatography eluate showed the presence of only two polypeptides. PMID- 3676301 TI - The purification of cytochrome f and plastocyanin using affinity chromatography. AB - Both plastocyanin and cytochrome f were purified using a combination of affinity chromatography together with established methods. Plastocyanin was partially purified using the method of Davis and San Pietro (Anal. Biochem. 95 (1979) 254 259), after which it was further purified using a column of cytochrome c covalently attached to Sepharose 4B. The affinity column was prepared using the method of Godinot and Gautheron (Methods Enzymol. 54 (1979) 112-114). The final purity index ratio (A278/A597) was less than 1.2, which is equal to that obtained using the more expensive FPLC procedure (Anderson, G.P., Sanderson, D.G., Lee, C.H., Durell, S., Anderson, L.B. and Gross, E.L. (1987) Biochim. Biophys. Acta 894, issue 3). Cytochrome f was partially purified using a modification of the method of Matazaki et al. (Plant Cell. Physiol. 16 (1975) 237-246) and bound to an affinity column of plastocyanin covalently attached to Sepharose 4B. Cytochrome f purified using this procedure had a purity index ratio (A554.5/A277) of 1.2. Both proteins are tyrosine proteins containing no tryptophan residues. After the affinity chromatography step, the fluorescence emission spectrum of either plastocyanin or cytochrome f was typical of a tyrosine protein free from tryptophan contamination. PMID- 3676302 TI - Dehydration of the lipid-protein microinterface on binding of phospholipase A2 to lipid bilayers. AB - A novel method is described to demonstrate inaccessibility to the bulk aqueous phase of the microinterface between pig pancreatic phospholipase A2 and lipid bilayers to which this protein is bound. The method is based on the fact that the fluorescence emission quantum yields of the tryptophan residue of the protein and of a 5-dimethylaminonaphthalene-1-sulfonyl (dansyl) chromophore attached to a lipid are lower in water as compared to that in deuterated water. The fluorescence emission quantum yield of these chromophores is measured in water and in deuterated water under conditions where the protein is either bound or not bound to the surface of a lipid bilayer containing the dansyl chromophore. Under conditions where the protein is tightly bound to the surface of the bilayer, desolvation of both fluorophores abolishes the observed effect of deuterated water. The tryptophan residue in the bound phospholipase A2 also becomes inaccessible to fluorescence quenching by acrylamide or succinimide. Desolvation of the microinterface is observed only under conditions that are significant for the catalytic action of phospholipase A2 in the scooting mode and not in the hopping mode. Also, under similar conditions, binding of pro-phospholipase A2 to anionic vesicles does not cause dehydration of the microinterface. The mechanistic significance of these observations for lipid-protein interactions, in general, and for interfacial catalysis and interfacial activation, in particular, is discussed. PMID- 3676303 TI - Heat-induced dissociation of human erythrocyte spectrin dimer into monomers. AB - Human erythrocyte spectrin heated above 49 degrees C could be separated into two fractions by DEAE-Toyopearl column chromatography at room temperature. The first fraction eluting with the salt gradient was predominantly the alpha subunit, indicating a heat-induced dissociation of the spectrin alpha beta dimer into monomers. The second fraction, obtained with 0.5 M NaOH after salt elution, consisted of high-molecular-weight proteins in addition to alpha and beta subunits, which were visualized by gel electrophoresis with sodium dodecyl sulfate. The isolated beta subunit when heated above 48 degrees C could also be separated into two fractions by column chromatography. About 30% of the protein eluted with the salt solution and the rest of the proteins were in the alkali eluate in which high molecular weight protein bands also appeared, indicating a heat-induced aggregation of the beta subunits. Almost all the isolated alpha subunit, however, eluted out with the salt solution, even though the subunit was heated at 52 degrees C. Studies of the binding of subunits to inside-out vesicles indicate that the isolated beta subunit was denatured irreversibly by heating; on the other hand, the alpha subunit kept its binding ability after heating above 50 degrees C. These findings are attributed to the heat-induced dissociation of the spectrin molecules into alpha and beta subunits at 49-50 degrees C, and eventual aggregation of the denatured beta subunits. PMID- 3676304 TI - Porcine ileal polypeptide causes an increase in cytoplasmic Ca2+ in both parietal and chief cells resulting in acid and pepsinogen secretion. AB - Porcine ileal polypeptide, an enterooxyntin isolated from distal small intestinal mucosal epithelium, has been observed to stimulate gastric acid secretion in vivo as well as in vitro (Wider, M.D. et al. (1984) Endocrinology 115, 1484-1491, Wider M.D. et al. (1986) Endocrinology 118, 1546-1550). We report here that porcine ileal polypeptide stimulates both acid (aminopyrine accumulation) and pepsinogen secretion in isolated, enriched populations of guinea pig parietal and chief cells in a dose-dependent manner. Further, 10(-9) M porcine ileal polypeptide caused an increase in cytoplasmic Ca2+ concentration in both parietal and chief cells similar in magnitude to that observed with gastrin-17 (10(-8) M) (as measured by both fura-2 and aequorin) and cholecystokinin octapeptide (CCK OP) (10(-8) M), respectively. Porcine ileal polypeptide has been observed to cause no stimulation of cAMP production in gastric glands from guinea pigs (Gespach, C., personal communication) nor is there any effect of medium Ca2+ depletion on acid production observed with guinea pig gastric mucosal sections. It is concluded that porcine ileal polypeptide, at concentrations similar to circulating levels observed in plasma of normal pigs (5 x 10(-9) M), acts directly on the parietal and chief cells to cause the mobilization of intracellular Ca2+ from the stores resulting in acid and pepsinogen secretion. These experiments demonstrate that this peptide is a potent enterooxyntin and chief cell secretagogue which acts via the same signal transduction mechanisms as gastrin and cholecystokinin. PMID- 3676305 TI - Effects of dolichol on membrane permeability. AB - Small vesicles containing the tetra-anionic fluorescent probe calcein were prepared by sonication of mixtures of plant phosphatidylethanolamine, plant phosphatidylcholine, and dolichol. Following chromatography, the isolated vesicles were found to retain entrapped calcein over the temperature range of 15 to 40 degrees C. Utilizing an assay measuring the fluorescence quenching of entrapped calcein by cobalt ions, the presence of dolichol in the membranes was found to promote the permeability of the phospholipid bilayers to the divalent cation. The permeability was shown to be dependent on temperature with an increase in rate of 17-fold between 15 and 35 degrees C although the plant phospholipids used in these experiments have no known phase transition within this temperature range. The incorporated dolichol was distributed uniformly throughout the vesicle population. Similar vesicles prepared from phosphatidylethanolamine and phosphatidylcholine without added dolichol, from phosphatidylcholine alone, or with phosphatidylcholine and dolichol were far less permeable to the divalent cation under the same assay conditions. These results demonstrate that dolichols have significant effects on the permeability properties of phospholipid bilayers that contain phosphatidylethanolamine. PMID- 3676306 TI - Alcohol interactions with lipids: a carbon-13 nuclear magnetic resonance study using butanol labeled at C-1. AB - The interactions of carbon-13 enriched butanol with dipalmitoylphosphatidylcholine (DPPC) and dimyristoylphosphatidylcholine (DMPC) were studied using C-13 nuclear magnetic resonance. It was found that above the gel to liquid crystal phase transition the resonance from the butanol could be resolved into two signals with similar chemical shifts but different T1 values and line widths. In contrast, only one narrow resonance was observed for ethanol, which has considerably less solubility in the lipids than butanol. Thermodynamic analyses of the effects of butanol on the phase transition temperature predict much greater solubility or butanol when the lipid is above the phase transition temperature than when it is below. It was concluded that the two butanol resonances represent two slowly exchanging populations, the free butanol in the aqueous phase and butanol dissolved in the liquid crystalline region of the lipid. No bound butanol was detected below the gel to liquid crystal phase transition. Relaxation studies were performed on the resonance of the bound butanol in DPPC and DMPC, including measurements of T1, line width, and nuclear Overhauser enhancement. Theoretical analysis of the relaxation parameters indicates that the lipid-bound alcohol has very high mobility within the fluid lipid bilayer. The data are consistent with butanol being present at the aqueous boundary or head group region of the lipid. PMID- 3676307 TI - Phase equilibria in the phosphatidylcholine-cholesterol system. AB - A thermodynamic and a microscopic interaction model are proposed to describe the phase equilibria in the phosphatidylcholine-cholesterol system. The model calculations allow for a solid phase with conformationally ordered acyl chains and liquid phases with conformationally ordered as well as disordered chains. The resulting phase diagram is in excellent agreement with the experimental phase diagram for dipalmitoylphosphatidylcholine bilayers with cholesterol as determined by a recent NMR and calorimetry study. It is thus demonstrated that the phase behaviour of phosphatidylcholine-cholesterol mixtures can be rationalized using only a few basic assumptions: (i) Cholesterol interacts favourably with phosphatidylcholine chains in an extended conformation, (ii) the main transition of pure phosphatidylcholine bilayers takes place in terms of translational variables as well acyl-chain conformational variables, and (iii) cholesterol disturbs the translational order in the crystalline (gel) state of phosphatidylcholine. These results suggest that the occurrence of specific phosphatidylcholine-cholesterol complexes is not implied by the experimental thermodynamic data. PMID- 3676309 TI - Porphyrin-membrane interactions: binding or partition? AB - Porphyrins are photodynamic drugs employed in an experimental tumor-treatment modality in which cell membranes are one of the primary drug-action sites. To gain insight into the nature of the interaction of these drugs with those primary sites we have studied the affinity of porphyrins to the lipid moieties of biological membranes, at the molecular level. The association of porphyrins to large unilamellar liposomes, modeling the lipid regions of biological membranes was studied (at equilibrium) for deuteroporphyrin IX and protoporphyrin IX, at neutral pH and 37 degrees C, taking into account porphyrin aggregation. Two thermodynamic approaches were investigated: (i) Simple partition equilibria between the external aqueous phase and the lipid bilayer, for drug monomers and dimers. (ii) Binding equilibria of drug monomers and dimers to the lipid bilayer. Using two types of experimental design and processing the data according to the expectations of both approaches, three different models for the binding (differing in the participation assigned to the dimer) were considered. Our major findings are: (a) The data clearly do not fit with the expectations for simple partition equilibria, nor with binding models assuming direct participation of the dimers. (b) The data fit well with a binding process, in which the membrane binds the porphyrin monomers only, with the dimers participating indirectly through the aqueous dimerization equilibrium. (c) At 37 degrees C and neutral pH, for liposomes composed of phosphatidylcholine/cholesterol at molar ratios of 3:2, we found for both investigated species a binding constant of 2.3 x 10(4) M-1. (d) For each species the binding constant is independent of the initial and final states of drug aggregation in the aqueous phase. PMID- 3676308 TI - Purine and pyrimidine transport and permeation in human erythrocytes. AB - Time courses of the uptake of radiolabeled hypoxanthine, adenine and uracil were measured by rapid kinetic techniques over substrate ranges from 0.02 to 5000 microM in suspensions of human erythrocytes at 25 or 30 degrees C. At concentrations above 25 microM, the rate of intracellular phosphoribosylation of hypoxanthine and adenine was insignificant relative to their rates of entry into the cell and time courses of transmembrane equilibration of the substrates could be measured and analyzed by integrated rate analysis. Hypoxanthine and uracil are transported by simple facilitated carriers with directional symmetry, high capacity and Michaelis-Menten constants of about 0.2 and 5 mM, respectively. Adenine is probably transported by a carrier with similar properties but no saturability was detectable up to a concentration of 5 mM. Cytosine entered the cells much more slowly than the other three nucleobases, and its entry seems not to be mediated by a carrier. The hypoxanthine transporter resembles that of one group of mammalian cell lines, which does not exhibit any overlap with the nucleoside transporter and is resistant to inhibitors of nucleoside transport. Results from studies on the effects of the nucleobases on the influx and countertransport of each other were complex and did not allow unequivocal conclusions as to the number of independent carriers involved. At concentrations below 5 microM, radiolabel from adenine and hypoxanthine accumulated intracellularly to higher than equilibrium levels. Part of this accumulation reflected metabolic trapping, especially when the medium contained 50 mM phosphate. But part was due to an apparent concentrative accumulation of free adenine and hypoxanthine up to 3-fold at medium concentrations much less than 1 microM and when cells were incubated in phosphate-free medium. This concentrative accumulation could be due to the functioning of additional high-affinity, low capacity, active transport systems for adenine and hypoxanthine, but other factors could be responsible, such as saturable binding to intracellular components. PMID- 3676310 TI - Intracellular K+, Na+ and Cl- concentrations and membrane potential in human monocytes. AB - The relationship between the resting membrane potential and the intracellular ionic concentrations in human monocytes was investigated. Cell volume, cell water content, and amount of intracellular K+, Na+, and Cl- were measured to determine the intracellular concentrations of K+ (Ki), Na+ (Nai) and Cl- (Cli) of monocytes, and of lymphocytes and neutrophils. Values found for monocytes were similar to those for neutrophils, i.e., cell volumes were 346 and 345 micron3, respectively, cell water content 78%, and Ki, 128 and 125, Nai, 24 and 26, and Cli, 102 and 103 mmol/l cell water, respectively. Lymphocytes, however, had different values: 181 micron3 cell volume, 77% cell water content, and for Ki, Nai, and Cli, 165, 37, and 91 mmol/l cell water, respectively. The resting membrane potential of cultured human monocytes (range -30 to -40 mV), determined by measurement of the peak potential occurring within the first milliseconds after microelectrode entry, was most dependent on extracellular K+, followed by Cl-, and Na+. The membrane permeability ratio of Cl- to K+ was estimated by use of the constant field equation to be 0.23 (range 0.22 to 0.30). PMID- 3676311 TI - Adsorption of ionized and neutral pentachlorophenol to phosphatidylcholine membranes. AB - We have studied adsorption of pentachlorophenol (PCP) to phosphatidylcholine (PC) membranes by measuring the electrophoretic mobility of multilayered lipid vesicles in PCP solutions. PC vesicles become negatively charged due to the adsorption of ionized PCP, and we have found that their zeta potential depends upon the ionic strength and pH of the aqueous suspension. We have shown that the experimental results can be adequately accounted for in terms of a two-component Langmuir-Stern-Grahame adsorption model assuming that the 'PCP adsorption sites' are occupied either by the neutral (HA) or the ionized (A-) species. The characteristics of adsorption isotherms of the PCP - PC membrane are as follows: the association constants are KA = 55,000 dm3/mol, KHA = 279,000 dm3/mol; 4.3 PC molecules make up each PCP adsorption site at saturation; the linear partition coefficients are beta HA = (15.5 +/- 0.7) x 10(-5) m and beta A = (3.0 +/- 0.3) x 10(-5) m. The properties of PCP adsorption isotherms for PC membranes predict an increased pKa value of membrane-bound PCP, which has been observed in related studies. PMID- 3676312 TI - The mechanism of liposomal damage by taurocholate. AB - The stability of small unilamellar vesicles formed by egg-yolk phosphatidylcholine (PC) has been examined in the presence of sodium taurocholate. The permeability of the vesicular membrane changes as the total taurocholate concentration increases, until a transformation from mixed bile salt/PC vesicles to mixed micelles occurs. Based on experiments in which the bile salt-induced release of either hydrophilic (carboxyfluorescein) or hydrophobic (Bromothymol blue) probes was studied, and on fluorescence polarization of the probe 1,6-diphenyl-1,3,5-hexatriene and turbidity measurements, a two-step process for the initial stage of liposomal damage by taurocholate is postulated. PMID- 3676313 TI - Activity of bile-salt-stimulated human milk lipase in the presence of liposomes and mixed taurocholate-phosphatidylcholine micelles. AB - (1) The interaction of bile-salt-stimulated human milk lipase and liposomal membranes has been investigated in the presence or absence of sodium taurocholate. Freshly purified enzyme enhances the permeability of liposomal membranes but thermally inactivated enzyme does not. (2) The ability of the enzyme to catalyze the hydrolysis of a relatively hydrophilic substrate, 4 nitrophenyl acetate, and a more hydrophobic substrate, 4-nitrophenyl palmitate, has also been measured in media containing small unilamellar vesicles of egg phosphatidylcholine in both the absence and presence of taurocholate, and also in the presence of free taurocholate in the absence of liposomes. (3) The enzyme catalyzed hydrolysis of 4-nitrophenyl acetate is enhanced in all of these systems, but 4-nitrophenyl palmitate is protected from enzymic attack in the phosphatidylcholine-bile salt systems. If free taurocholate be present in the system before 4-nitrophenyl palmitate is added, then, and only then, is enzymic activity observed. (4) These results have been interpreted in terms of the importance of the microenvironment around the substrate and the role played by the bile salt surfactant in stimulating the enzyme. PMID- 3676314 TI - Effect of neuraminidase treatment on the lipid fluidity of the intestinal brush border membranes. AB - The effect of neuraminidase treatment on the lipid fluidity of the porcine intestinal brush-border membranes was studied using two fluorescence dyes, pyrene and 1,6-diphenyl-1,3,5-hexatriene. By treatment of the membranes with neuraminidase, the fluorescence parameters of pyrene-labeled membranes changed; i.e., a shift of thermal transition temperature, an increase in the fluorescence quenching rate for Tl+ and a decrease in the fluorescence lifetime. These results suggest that the environmental properties around the dye molecules in the membranes change sensitively upon neuraminidase treatment. Perturbation of the lipid domain in the membranes associated with neuraminidase treatment is also demonstrated by a stimulated solubilization of diphenylhexatriene molecules in the membrane lipids, an increased quenching efficiency with Tl+ and a decreased rotational correlation time of diphenylhexatriene-labeled membranes. Based on these results, we conclude that the lipid organization of the membranes is susceptible to neuraminidase treatment and that the membrane lipid fluidity increases by desialylation by the enzyme treatment. PMID- 3676315 TI - Identification of identical binding polypeptides for cephalosporins and dipeptides in intestinal brush-border membrane vesicles by photoaffinity labeling. AB - The uptake of a photolabile derivative of the orally effective cephalosporin cephalexin, N-(4-azidobenzoyl)cephalexin, was investigated in brush-border membrane vesicles. The compound was taken up into the intravesicular space and inhibited the active uptake of cephalexin in a concentration-dependent manner. Therefore, this probe interacts with the transport system shared by alpha aminocephalosporins and dipeptides. Photoaffinity labeling of brush-border membrane vesicles from rat small intestine with N-(4-azido[3,5-3H]benzoyl) derivatives of the cephalosporin cephalexin and the dipeptide glycyl-L-proline resulted in the covalent incorporation of radioactivity into membrane polypeptides with apparent molecular weights of 127,000, 100,000, 94,000 and 86,000, the polypeptide of molecular weight 127,000 being predominantly labeled. The specificity of labeling was demonstrated by a decrease in the labeling of the polypeptide of apparent molecular weight 127,000 in the presence of beta-lactam antibiotics and dipeptides, whereas glucose, taurocholate or amino acids had no effect on the labeling pattern. These data demonstrate an interaction of cephalosporins and dipeptides with a common membrane protein of molecular weight 127,000, which could be a component of the intestinal transport system(s) responsible for the uptake of orally effective cephalosporins and dipeptides. PMID- 3676316 TI - Inhibitory effects of long-chain alkyltrimethylammonium ions on aggregation of bovine platelets and the relation of their effects to Ca2+ mobilization. AB - The inhibitory effects of alkyltrimethylammonium ions on ADP- and thrombin induced aggregation of bovine platelets were investigated. The ammonium cations inhibited the two aggregation reactions to similar extents. The relationship between their inhibitory effects on ADP-induced aggregation and their alkyl chain lengths from C8 to C18 was investigated. Results showed that the inhibitory effects of ammonium cations increased with increase of their alkyl chain lengths up to C16, and that the increase was linear with chain lengths of up to C14. This linear relation and slope of the linear regression line suggested that the inhibitory effects of the ammonium cations depended on their partitioning into the membrane. However, unlike long-chain unsaturated fatty acids, they did not affect the membrane fluidity of the platelets. Fluorescence analysis of fura-2 loaded platelets revealed that, in the concentration range where the alkyltrimethylammonium ions inhibited aggregation, they inhibited agonist-induced increase in cytosolic Ca2+ both in the presence and absence of extracellular Ca2+. These results suggest that inhibition of platelet aggregation by alkyltrimethylammonium ions is mainly due to their inhibition of increase in cytoplasmic Ca2+ by inhibition of both intracellular Ca2+ mobilization and Ca2+ uptake. PMID- 3676317 TI - Effects of cholesterol on the divalent cation-mediated interactions of vesicles containing amino and choline phospholipids. AB - We have used assays of lipid probe mixing, contents mixing and contents leakage to monitor the divalent cation-mediated interactions between lipid vesicles containing phosphatidylserine (PS) as a minority component together with mixtures of phosphatidylethanolamine (PE), phosphatidylcholine (PC) or sphingomyelin, and cholesterol in varying proportions. The initial rates of calcium- and magnesium induced lipid probe quenching between vesicles, which reflect primarily the rates of vesicle aggregation, are strongly reduced as progressively higher proportions of PC or sphingomyelin are incorporated into PE/PS vesicles. The initial rates of divalent cation-induced contents mixing and contents leakage for PE/PS vesicles are also strongly reduced when choline phospholipids are incorporated into the vesicles in even low molar proportions. Sphingomyelin has a more potent inhibitory effect on these processes than does PC at an equal level in the vesicle membranes. The inclusion of cholesterol in these vesicles, at levels up to 1:2 moles sterol/mole phospholipid, has little effect on the rates of calcium- or magnesium-induced vesicle aggregation. However, cholesterol significantly enhances the initial rates of vesicle contents mixing and contents leakage in the presence of divalent cations when the vesicles contain choline as well as amino phospholipids. This effect is substantial only when the level of cholesterol exceeds the level of choline phospholipids in the vesicles. These results may have significance for the fusion of certain cellular membranes in mammalian cells, whose cytoplasmic faces have lipid compositions very similar to those of the vesicles examined in this study. PMID- 3676318 TI - Leakage from egg phosphatidylcholine vesicles induced by Ca2+ and alcohols. AB - The results shown in this paper indicate that the permeability properties of egg yolk phosphatidylcholine sonicated vesicles as detected by the leakage of carboxy fluorescein changes according to the Ca2+ content. Vesicles containing Ca2+ show a higher rate of leakage than those containing Na+ solutions in response to the increase of Ca2+ concentration in the outer solution. The results are interpreted in terms of the rigidity promoted by Ca2+ and are compared to those obtained with long and short chain alcohols. PMID- 3676319 TI - Transport, utilization and biliary secretion of lysophosphatidylcholine in the rat liver. AB - The hepatic uptake, transport and utilization of plasma lysophosphatidylcholine (lysoPC) and its contribution to biliary lipid secretion have been investigated in bile-fistula rats. The animals were given a single intravenous dose of sn-1-[1 14C]palmitoyl-lysoPC, under constant intravenous sodium taurocholate infusion (1 mumol/min), and the fate of the label was followed in blood, bile and liver for up to 3 h. The livers were excised at given time points, extracted and/or homogenized to determine the lipid distribution and subcellular location of radioactivity. LysoPC was rapidly cleared from plasma, though a consistent fraction of the label persisted in plasma over the experimental time-period in the form of either lysoPC or PC. Recovery of radioactivity in the liver varied from 15.6% after 5 min to 19.5% after 3 h. Hepatic lysoPC underwent rapid microsomal acylation to form specific PC molecular species (mainly 16:0-20:4 and, to a lesser extent, 16:0-18:2 and 16:0-16:1). Ultrafiltration, dialysis and gel chromatographic analyses of cytosolic fractions (post 105,000 X g supernatants) indicated that lysoPC is transported to the site of acylation mostly as a macromolecular aggregate with an approx. Mr of 14,400. Small amounts of radioactivity were secreted into bile over 3 h (20% in the form of lysoPC and the remainder as 16:0-18:2 and 16:0-20:4 PC species). Plasma lysoPC, taken up by the liver, is mostly transported by a cytosolic carrier with a molecular weight close to fatty-acid-binding proteins; it then enters a distinct acylation pathway, selective for some polyunsaturated-PC species and does not contribute significantly to biliary secretion, either directly, or through its products. PMID- 3676320 TI - Thermal denaturation and fluorescence study of nucleosomes containing non-histone chromosomal protein HMG2. AB - Interaction of calf thymus non-histone chromosomal protein HMG2 with H1,H5 depleted nucleosomes from chicken erythrocytes was studied by means of thermal denaturation and an N-(3-pyrene)maleimide fluorescence probe. Under low ionic conditions (2 mM Tris buffer plus EDTA) addition of 1-2 molecules of HMG2 per nucleosome markedly stabilized the segment of the linker DNA against thermal denaturation. Under approximately physiological ionic conditions (0.1 M NaCl) addition of two HMG2 molecules per nucleosome, labeled by N-(3-pyrene)maleimide at the sulfhydryl groups of Cys-110 of histones H3, resulted in a decrease of the pyrene excimer fluorescence corresponding to the slight movement of the sulfhydryl groups of the two histone H3 molecules apart. PMID- 3676321 TI - Expression of the avian c-erb B (EGF receptor) protooncogene during estrogen promoted oviduct growth. AB - Expression of cellular erb B protooncogene messenger RNAs has been analyzed in the oviducts of immature chicks during estrogen-promoted growth. Hybridization of oviduct total cellular RNA with viral-derived erb B oncogene probes demonstrated significant expression of c-erb B mRNA in oviduct cells of untreated chicks. Daily administration of estrogen (diethylstilbestrol) to chicks results in marked oviduct growth but did not appreciably affect expression levels of c-erb B messenger RNA in oviducts after 2, 4 or 6 days of treatment. Withdrawal of chicks from estrogen treatment resulted in termination of oviduct growth. However, c-erb B messenger RNAs were detectable in the nonproliferative tissue at 5 days after hormone withdrawal. Readministration of diethylstilbestrol, progesterone or diethylstilbestrol plus progesterone to hormone-withdrawn birds (secondary stimulation) also did not affect c-erb B messenger RNA levels in the oviduct. These results demonstrate significant expression of the cellular erb B (epidermal growth factor receptor) gene in the avian oviduct. However, EGF receptor messenger RNA synthesis is not modulated in the oviduct by steroid hormones. PMID- 3676322 TI - Evidence of a regulatory role of the level of poly (ADP-ribose) in chromosomal proteins in metallothionein gene expression by glucocorticoids but not by heavy metals. AB - The induction capacity of dexamethasone, a synthetic glucocorticoid, for the synthesis of metallothionein was about the same as that of 3-aminobenzamide, which is an inhibitor of ADP-ribosylation of chromosomal proteins, in cultured mouse mammary tumor cells. Both inductions of metallothionein were temporally correlated with a decrease in the amount of endogenous poly (ADP-ribose) on nonhistone high-mobility-group 14 and 17 proteins. In contrast, the extent of cadmium-induced metallothionein synthesis was 2-3-times that of dexamethasone or 3-aminobenzamide. However, cadmium had essentially no effect on de-ADP ribosylation of these proteins. PMID- 3676323 TI - Identification of vaccinia promoters by heterologous expression of hepatitis B surface antigen in mouse cells infected by recombinant vaccinia viruses. AB - DNA fragments preceding open reading frames in a conserved segment of the vaccinia virus genome (Plucienniczak A., et al. (1985) Nucleic Acids Res. 13, 985 998) were cloned into plasmids upstream of the S gene of the hepatitis B virus encoding the surface antigen (HBsAg). Recombinant vaccinia virus obtained after insertion of these constructs into the thymidine kinase gene were used to infect mouse 1D cells. HBsAg was assayed in cellular supernatants. A strong promoter was thus identified in a 295 bp fragment preceding the coding region of the 147 kDa subunit of the vaccinia RNA polymerase. PMID- 3676324 TI - Characterisation of the ribosomal binding site for eukaryotic elongation factor 2 by chemical cross-linking. AB - Ribosomal complexes containing elongation factor 2 (EF-2) were formed by incubation of 80 S ribosomes in the presence of EF-2 and the non-hydrolysable GTP analogue GuoPP[CH2]P. The factor was covalently coupled to the ribosomal proteins located at the factor binding site, by treatment with bifunctional reagents. After isolation of the covalent EF-2.ribosomal protein complexes, the proteins were labelled with 125I and the introduced covalent links cleaved. The ribosomal proteins were identified by electrophoresis in two independent two-dimensional gel systems, followed by autoradiography. After cross-linking with bis(hydroxysuccinimidyl) tartrate (4 A between the reactive groups), protein S3/S3a, S7 and S11 were found as the major ribosomal proteins covalently linked to EF-2. The longer reagent, dimethyl 3,8-diaza-4,7-dioxo-5,6 dihydroxydecanbisimidate (11 A between the reactive groups), covalently coupled proteins S7, S11, L5, L13, L21, L23, L26, L27a and L32 to EF-2. After cross linking with dimethyl suberimidate (9 A between the reactive groups) proteins S3/3a, S7, S11, L5, L8, L13, L21, L23, L26, L27a, L31 and L32 were identified as belonging to the EF-2-binding site. The results indicate that the ribosomal domain interacting with EF-2 is located on both the small and the large ribosomal subunit close to the subunit interface. PMID- 3676325 TI - (A)GGG(A), (A)CCC(A) and other potential 3' splice signals in primate nuclear pre mRNA sequences. AB - Several 3' splice signals in nuclear precursor mRNAs have already been known for some time: the AG doublet on the left-hand side of the splice and a run of pyrimidines just upstream of it. More recently it has been noted that the YNYTRAY sequence (where Y is a pyrimidine, R a purine and N any base) is a branching sequence participating in formation of a lariat structure. Keller and Noon have shown the existence of several putative consensus sequences at this site. In this work, extensive computations of the distributions of 256 quartets in all primate nuclear pre-mRNA intron sequences present in GenBank have been carried out. Several putative signals upstream and downstream of the 3' splice have been detected. These have been compared with the results obtained in analogous computations carried out on all nuclear pre-mRNA introns present in a combined eukaryotic file containing mammal, non-mammalian vertebrate, invertebrate and plant sequences. The distributions of the more interesting oligomers are shown here. Of particular interest are the putative (A)GGG(A) signal 60 nucleotides upstream of the 3' splice site and (A)CCC(A) 3-40 nucleotides downstream of it. A possible splicing model explaining these data and involving formation of alternative hairpin loop structures is proposed. PMID- 3676326 TI - A comparison of accessibility of ribosomal proteins on free and membrane-bound ribosomes: the ribosomal proteins potentially involved in ribosome-membrane binding. AB - The relative accessibility of rat liver ribosomal proteins to reductive methylation was examined using membrane-bound and free ribosomes. Comparisons indicated that 12-13 large ribosomal proteins are masked by ribosomal association with membranes. These consisted of L8, L10, L17, L26-28, L31 and L36, and probably also include L4, L5, L7 and L29. These proteins seem to surround a region centered about L3 and may partly define a ribosomal channel through which the nascent peptide emerges. Approx. 10-20% of the large ribosomal subunit surface area is shielded by the membrane. PMID- 3676327 TI - Inactivation of de novo DNA methyltransferase activity by high concentrations of double-stranded DNA. AB - The activity of eukaryotic DNA methyltransferase diminishes with time when the enzyme is incubated with high concentrations (200-300 micrograms/ml) of unmethylated double-stranded Micrococcus luteus DNA. Under similar conditions, single-stranded DNA induces only a limited decrease of enzyme activity. The inactivation process is apparently due to a slowly progressive interaction of the enzyme with double-stranded DNA that is independent of the presence of S-adenosyl L-methionine. The inhibited enzyme cannot be reactivated either by high salt dissociation of the DNA-enzyme complex or by extensive digestion of the DNA. Among synthetic polydeoxyribonucleotides both poly(dG-dC).poly(dG-dC) and poly(dA dT).poly(dA-dT), but not poly(dI-dC).poly(dI-dC), cause inactivation of DNA methyltransferase. This inactivation process may be of interest in regulating the 'de novo' activity of the enzyme. PMID- 3676328 TI - Kinetic effects of ATP, divalent metal ions and pH on chicken liver mevalonate 5 diphosphate decarboxylase. AB - The activity of chicken liver mevalonate 5-diphosphate decarboxylase was measured over a wide range of Mg2+ and ATP concentrations. It was found that free ATP activated the enzyme, whereas free Mg2+ had no effect on the enzyme activity. Computed analyses of free species concentrations and pH studies indicated that MgATP2- is the true substrate. The relative efficiencies of Mg2+, Mn2+, Cd2+, and Zn2+ as activating metal ions were evaluated in terms of V/Km for the corresponding (metal-ATP)2- complexes, and the relative ratios were: Mn2+ 100, Cd2+ 37, Mg2+ 14, Zn2+ 1.7. Inhibitory effects were demonstrated for all free divalent cations tested, except for Mg2+, and were in the order Zn2+ greater than Cd2+ greater than Mn2+. PMID- 3676329 TI - Diethyl pyrocarbonate inactivation of human placental aldehyde reductase II. AB - Diethyl pyrocarbonate inactivated aldehyde reductase II (L-gulonate:NADP+ 6 oxidoreductase, EC 1.1.1.19) from human placenta. A concentration of 0.5-1.0 mM diethyl pyrocarbonate caused 40-65% loss of activity. The inactivation of the enzyme by diethyl pyrocarbonate was reversed by hydroxylamine and was accompanied by a large change in the absorbance of the protein at 242 nm, but not at 278 nm, indicating that only the histidine residues were modified. NADPH, but not glucuronate afforded significant protection to the enzyme from inactivation by diethyl pyrocarbonate. With 0.2-1.0 mM diethyl pyrocarbonate, 4-5 histidine residues were modified with a pseudo-first-order rate process. A double log plot of the fraction of the unmodified residues indicates that only one functional histidine residue is essential for the catalytic activity of aldehyde reductase II. PMID- 3676330 TI - Kinetic evidence for thermally induced conformational change of butyrylcholinesterase. AB - The effect of temperature on the kinetics of human plasma butyrylcholinesterase catalyzed reactions was studied. The Arrhenius plot of o-nitrophenylbutyrate hydrolysis presents a break at 21 degrees C. However, nucleophilic competition data indicate that there is no change in the rate-limiting step of the overall reaction. In addition, the temperature dependence of the bimolecular rate constant of enzyme carbamylation shows a break at 18 degrees C. These results argue for the existence of thermally induced conformational active states of the enzyme tetramer. It is suggested that the effects of this transition on kinetics arise at the acylation step. PMID- 3676331 TI - Secondary structure predictions and medium range interactions. AB - Several authors have proposed that predictions of protein secondary structure derived from statistical information about the known structures can be improved when information about neighboring residues participating in short and medium range interactions is included. A substantial improvement shown here indicates that current methods of including this information are not more successful than methods that do not. Evaluations of the Chou and Fasman method (Adv. Enzymol. 47 (1978) 45-148), that does not include information about interactions (except in averaging), have shown it to be about 49% correct for three states (helix, beta sheet and undefined). In comparison, the method of Garnier et al. (J. Mol. Biol. 120 (1978) 97-120), that explicitly includes information about neighboring residues, has an accuracy of 57% residues correct for three states. However, we have obtained an 8% improvement for predictions of secondary structure based on the algorithm by Chou and Fasman. The improvements are obtained by eliminating many rules and by choosing the best decision constants for structure assignments. The simplified method described here is 57% correct for three states using preference values calculated in 1978. PMID- 3676332 TI - Enantiomeric specificity at the deacylation process of tryptic catalysis. AB - Trypsin-specific substrate analogs, 'inverse substrates', carrying chiral acyl group were synthesized. Kinetic analysis of the trypsin-catalyzed hydrolysis of these substrates revealed that the deacylation process is also appropriate for discrimination between enantiomers. The enantiomeric preference during the deacylation process was analyzed by comparing the hydrolytic rates corresponding to eight enantiomeric pairs of the substrates. The spatial requirement of the enzyme active site for catalytic efficiency is discussed, based on the steric characteristics of the optically active acyl residues. PMID- 3676333 TI - On the tertiary structure of the extracellular domains of the epidermal growth factor and insulin receptors. AB - Alignment of the sequences, the identification of conserved residue patterns and secondary structure predictions indicate that the extra-cellular regions of the human and Drosophila epidermal growth factor (EGF), c-erb-B2 and human insulin receptors each contain two large, homologous domains (L) which are probably comprised of at least four short alpha-helices followed by turns of conserved length and beta-strands. In the human and Drosophila EGF and c-erb-B2 receptors these homologous domains are each followed by a series of smaller cystine-rich domains (S) to give a gene-duplicated structure of L1S11S12S13L2S21S22S23. In the human insulin receptor, the second series of cystine domains is replaced by a different sequence. These duplicated structures are probably organised as a pseudo-symmetrical dimer. There are two 'hyper-variable' regions, one at the end of the large domains and one in the cystine-rich sequences, which are candidates for hormone or growth-factor binding. PMID- 3676334 TI - On the non-existence of a tryptic peptide with biological activity derived from mouse nerve growth factor. AB - Reverse-phase high-performance liquid chromatography was used to analyse the products of treatment of mouse nerve growth factor with cyanogen bromide followed by trypsin as described by Mercanti et al. All the biological activity was found to be due to incompletely cleaved starting material. Total digestion with trypsin led to complete loss of activity. PMID- 3676335 TI - High-cholesterol diet-induced lipoproteins stimulate lipoprotein lipase secretion in cultured rat alveolar macrophages. AB - We have previously shown that cultured rat alveolar macrophages synthesize and secrete lipoprotein lipase into the medium. The purpose of the present experiments is to examine whether cholesterol-enriched lipoproteins from cholesterol-fed animals have any effects on the lipoprotein lipase secretion and the lipid accumulation in macrophages. Macrophages incubated with the VLDL obtained from rats fed a normal diet secreted 2-fold higher amounts of lipoprotein lipase than those without lipoproteins. Intermediate-, low- and very low-density lipoproteins from rats fed a high-cholesterol diet also enhanced the lipoprotein lipase secretion. Normal high- and low-density lipoproteins, and high density lipoproteins from hypercholesterolemic animals did not cause any increase in the lipoprotein lipase secretion. The lipoproteins which stimulated the lipoprotein lipase secretion caused intracellular accumulation of both triacylglycerol and cholesterol. It is speculated that macrophages residing in the environment rich in lipoproteins, especially hypercholesterolemic lipoproteins, take them up and accumulate lipids intracellularly, and that this process links with the lipoprotein lipase secretion. The secreted lipoprotein lipase could facilitate, by degrading lipoproteins, the uptake of lipoprotein lipase-modified lipoproteins. Probably such a series of events is of importance in the foam cell formation of macrophages. PMID- 3676336 TI - Metabolism of the cholestanol precursor cholesta-4,6-dien-3-one in different tissues. AB - Cerebrotendinous xanthomatosis (CTX) is a lipid storage disease where the basic defect is a lack of the mitochondrial C27-steroid 26-hydroxylase involved in bile acid synthesis (EC 1.14.13.15). Cholestanol and cholesterol accumulate in all tissues. At least part of the accumulation of cholestanol is due to a 7 alpha dehydroxylation of early bile acid intermediates. Cholesta-4,6-dien-3-one, a proposed intermediate in this pathway, is found in increased concentrations in serum of the patients. This study shows that cholesta-4,6-dien-3-one may be metabolized to 4-cholesten-3-one and cholestanol by liver, adrenals and brain. No conversion was found in intestinal mucosa or in kidneys. The capacity to convert cholesta-4,6-dien-3-one into 4-cholesten-3-one and cholestanol varied in different tissues as well as in different species. The results are discussed in relation to the cholestanol accumulation in CTX. PMID- 3676337 TI - Dexamethasone-induced alterations in the glycosphingolipids of rat proximal small intestinal mucosa. AB - Prior studies have demonstrated that glucocorticoids can influence the structure and function of several different organs, including the small intestine. However, to date, the effects of glucocorticoids on the glycosphingolipids of the rat small intestinal mucosa have not been examined. In the present experiments, male albino rats of the Sherman strain were subcutaneously administered dexamethasone (100 micrograms/100 g body wt. per day) or diluent for 4 days, and the ceramide, acidic and neutral glycosphingolipid compositions of the proximal small intestine of these animals were examined and compared. The results of these studies demonstrate that dexamethasone administration: (1) increased the content and relative percentage of hematoside (GM3) in this tissue; (2) increased the percentage of N-glycoylneuraminic acid of hematoside; (3) decreased the percentage of the long-chain base phytosphingosine of hematoside, glucosyl- and globotriaosylceramide; and (4) did not appear to influence significantly the concentration of the neutral glycosphingolipids or ceramide in this tissue. These data, therefore, indicate that dexamethasone administration induces alterations in the glycosphingolipids, particularly hematoside, of rat small-intestinal mucosa. PMID- 3676338 TI - Biliary lipid secretion in the rat. The uncoupling of biliary cholesterol and phospholipid secretion from bile acid secretion by sulfated glycolithocholic acid. AB - Glycolithocholic acid and its sulfated derivative are major metabolites of the secondary bile acid lithocholic acid in man. Both compounds are known to induce cholestasis in experimental animals. We compared the effects of these endogenous hepatotoxins on bile production and biliary lipid composition in rats with chronic biliary drainage. The compounds were administered enterally at relatively low rates (5-50% of the rats' endogenous bile acid secretion in these experiments) to simulate enterohepatic circulation. Both compounds were substantially secreted into bile (more than 90% of dose); sulfated glycolithocholic acid unchanged and glycolithocholic acid after hepatic hydroxylation predominantly in the form of glyco-beta-muricholic acid (cf. Kuipers et al. (1986) Am. J. Physiol. 251, G189-G194). Neither glycolithocholic acid nor its sulfated derivative affected the biliary excretion of endogenous bile acids or bile flow in these experiments. In spite of this, phospholipid and cholesterol secretion were significantly reduced by sulfated glycolithocholic acid but were not altered by glycolithocholic acid. Phospholipid and cholesterol secretion rapidly decreased to 25 and 50% of their initial values, respectively, at biliary output rates of sulfated glycolithocholic acid up to 2 mumol/h, and did not further decrease when this output was increased to 6 mumol/h. Small unilamellar liposomes consisting of cholesterol, [Me-14C]choline-labeled phosphatidylcholine, phosphatidylserine and [3H]cholesteryl oleate in a 5:4:1:0.1 molar ratio were employed to label intrahepatic lipid pools. Administration of sulfated glycolithocholic acid slightly reduced bile acid synthesis from [3H]cholesteryl oleate, but significantly reduced the biliary secretion of [14C]phospholipid. Glycolithocholic acid did not affect the hepatic processing of liposomal lipids. It is concluded that sulfated glycolithocholic acid at low doses causes the uncoupling of biliary lipid secretion from that of bile acids, which might represent in initiating event in sulfated glycolithocholic acid hepatotoxicity. PMID- 3676339 TI - Changes in the secondary structure of apolipoprotein B-100 after Cu2+-catalysed oxidation of human low-density lipoproteins monitored by Fourier transform infrared spectroscopy. AB - Fourier transform infrared (FTIR) spectra have been obtained of human low-density lipoproteins (LDL) in H2O and 2H2O buffers. The absorption bands are assigned to vibrations of the lipid and apolipoprotein B-100 components. The analysis of second-derivative spectra allowed an assignment of individual protein bands to alpha-helical, random, coil or beta-structure and beta-turn conformations. Changes in the FTIR spectra after Cu2+-catalysed oxidation of the LDL particles indicate that the structure of apolipoprotein B-100 becomes less ordered, with some alterations of alpha-helical and beta-turn conformation. The main beta structure absorption at 1620 cm-1 is unaffected by oxidation. Taking into account the resistance to oxidation and the slow H-2H exchange it is suggested that the beta-structure is hidden from external factors whereas other structures are mostly present on the surface of the LDL particle. Oxidation affects mainly the surface region of apolipoprotein B-100 and leads to a structural rearrangement which consequently changes the receptor specificity of the LDL. PMID- 3676340 TI - Effect of albumin on the solubility of cholesterol in bile. AB - Despite the fact that a considerable amount of albumin is present in bile, little is known about the effect of albumin on micellar solubility of cholesterol. The effect of albumin on solubility of cholesterol in various micellar bile salt solutions was studied using Millipore filtration after equilibration. In addition, partitioning of cholesterol from micellar solution was studied using a polyethylene disc method. Decrease of the solubility of cholesterol by the presence of albumin was observed only in unconjugated bile salt solution. The lowering effect of albumin on the cholesterol solubility was found to be proportional to the hydrophobicity of bile salt. In contrast, albumin had almost no effect on cholesterol solubility, either in conjugated bile salt solution or in micellar bile salt solution containing phosphatidylcholine. Addition of albumin enhanced the partitioning of cholesterol out of the micelles in sodium chenodeoxycholate solution as a result of decreased micellar solubility and increased the aqueous solubility of cholesterol in the presence of albumin. Therefore, conjugated bile salt and phosphatidylcholine exert a buffering action on the albumin-induced adverse effect on cholesterol solubility, thus stabilising bile against inadvertent precipitation of cholesterol. PMID- 3676341 TI - The phospholipid and fatty acid composition of skeletal muscle cells during culture in the presence of vitamin D-3 metabolites. AB - The phospholipid and fatty acid composition of primary cultures (24 h) of chick embryo skeletal muscle myoblasts treated for 4-24 h with physiological concentrations of 1,25-dihydroxyvitamin D-3 and 25-hydroxyvitamin D-3 were analyzed. 25-Hydroxyvitamin D-3 did not alter the relative amounts of individual muscle cell phospholipids whereas 1,25-dihydroxyvitamin D-3 significantly increased phosphatidylcholine content, mainly at the expense of a decrease in phosphatidylethanolamine concentration. The increase in phosphatidylcholine occurred at a faster rate during the first 8 h than in the subsequent 8-24 h treatment period. A similar time course in 1,25-dihydroxyvitamin D3-dependent changes in myoblast calcium uptake has been observe. In addition, this metabolite markedly increased (100%) the arachidonate content of myoblast phosphatidylcholine near the fusion stage of the cells (24 h of treatment). The levels of docosahexaenoate, a minor polyunsaturated fatty acid, in phosphatidylcholine and phosphatidylethanolamine were also substantially elevated by 1,25-dihydroxyvitamin D-3. No significant changes in fatty acid composition in response to 25-hydroxyvitamin D-3 were observed. Modifications in phospholipids and polyunsaturated fatty acids may play a role in the effects of 1,25 dihydroxyvitamin D-3 on muscle cell calcium transport and differentiation. PMID- 3676342 TI - Metabolic fate and effect on cholesterol removal of liposomes prepared from 1,3 di-O-octadecenylglycero-2-phosphocholine studied in vivo and in vitro. AB - Available methodology was adapted to synthesize a labeled diether analog of 2 phosphatidylcholine (1,3-di-O-9'-cis-[9',10' (n)-3H]octadecenylglycero-2 phosphocholine [( 3H]DOE-2-PC). Unilamellar liposomes prepared by sonication from this phospholipid were injected into rats and, 4 h later, 65-78% of injected label was recovered in the liver. Thereafter, liver radioactivity disappeared with a half-life of 2-3 days. The radioactivity lost from the liver was recovered in the feces and in bile. Analysis of liver radioactivity showed that at all time intervals examined (4 h to 3 days after injection), 90% of the label remained as phospholipid. These findings provide evidence that this structural isomer is not readily metabolized, but is fairly rapidly eliminated from the liver. Of the 10% recovered as neutral lipid, 70% comigrated with diacylglycerol and 30% with triacylglycerol. Similar results were obtained when human hepatoma G2 cells in culture were incubated with [3H]DOE-2-PC liposomes. Following incubation of liposomes with liver homogenates, up to 10% conversion of [3H]DOE-2PC to neutral lipid occurred at pH 4.6, but not at pH 7.4. These data show that conversion of [3H]DOE-2-PC to dialkenylglycerol is catalyzed by a lysosomal enzyme. In separate experiments with cultured cells, sonicated dispersions of DOE-2-PC were mixed with high-density apolipoprotein and were shown to enhance markedly cellular cholesterol efflux. This novel diether phospholipid fulfills some of the criteria required of liposomes for their ability to remove cholesterol from the periphery as well as for drug delivery to the liver, i.e., stability in the circulation, marked hepatic uptake, slow metabolism, and elimination from the body. PMID- 3676343 TI - Bovine pregastric lipase: a model for the human enzyme with respect to properties relevant to its site of action. AB - Preduodenal lipolysis is considered to promote efficient lipid digestion in the neonatal period. The lipase(s) responsible may be of pregastric or gastric origin depending upon the species. We have previously reported on purification and molecular characterization of a pregastric lipase from calf. Antibodies to this bovine enzyme crossreact with a protein of similar size in human gastric contents and also inhibit its lipolytic activity. Since the bovine and human enzymes also have similar kinetic properties, the view is favoured that the bovine enzyme can be used as a model for physiological studies relevant to human neonates. In contrast to the lipases operating in the small intestine pregastric lipase has the unique property of initiating the hydrolysis of human milk fat globule triacylglycerol. In order to do this no cofactor is required. Pregastric lipase was stable at low pH and had an acid-pH optimum. Furthermore, it was extremely resistant to pepsin. In contrast, pancreatic proteinases, i.e. trypsin and chymotrypsin, inactivated the enzyme. The rate of inactivation was increased in the presence of bile salts which by themselves could inhibit enzyme activity. Thus, pregastric lipase is ideally suited for activity in the stomach but will not, under healthy conditions, contribute to lipid digestion in the duodenum. PMID- 3676344 TI - Biliary lipid secretion in the rat during infusion of increasing doses of unconjugated bile acids. AB - The aim of the present study was to examine the secretion of biliary components in rats during infusion of increasing doses of either deoxycholic acid, chenodeoxycholic acid or cholic acid and to test the hypothesis that biliary phospholipids may regulate the hepatic bile acid secretory capacity. Analysis of bile samples, collected every 10 min throughout the infusion period showed that there was an elevation of bile acid, phospholipid, cholesterol and alkaline phosphodiesterase secretion, with all the bile acids, peaking and then gradually declining. Their secretory rates maximum differed and were inversely related to their detergent strength. However, the secretory rates maximum and total output of phospholipids and cholesterol were similar for all bile acids infused. The per cent contribution of phosphatidylcholine to total bile acid-dependent phospholipid secretion was reduced from 84% (in the pre-infusion period) to 59, 46 and 13% at the end of the cholic acid, chenodeoxycholic acid and deoxycholic acid infusions, respectively. This decrease in the per cent contribution of phosphatidylcholine was associated with an increase in the contribution of both sphingomyelin and phosphatidylethanolamine. The biliary phospholipid fatty acid pattern corroborated these changes in the phospholipid classes. Since sphingomyelin and phosphatidylethanolamine are major phospholipids in bile canalicular and other hepatocellular membranes, the marked increase in their secretion in bile during the infusion of high doses of bile acids may indicate solubilization of membrane phospholipids, resulting in membrane structural changes responsible for the reduced excretory function of the liver. PMID- 3676345 TI - X-ray diffraction study of cholesterol-phosphatidylserine mixtures. AB - Phosphatidylserine-cholesterol mixtures at a molar ratio of 2:1 were investigated by X-ray diffraction. Phase separation of cholesterol independent of temperature was detected, indicating limited solubility of cholesterol in phosphatidylserine bilayers. The second phase present, the mixed phospholipid-cholesterol phase, continued to undergo melting as determined by changes with temperature in both the small angle scattering profile and in the acyl chain packing. PMID- 3676346 TI - Structural studies on proteoglycan catabolism in rabbit articular cartilage explant cultures. AB - Mature rabbit articular cartilage cultures have been used to study the catabolism of aggregating proteoglycan monomers in normal cartilage. During the first 4 days of culture, about 40% of monomers are degraded and lose the ability to bind to hyaluronate. The non-aggregating products (NAgg-PG) have been isolated and compared structurally and immunologically to aggregating monomers (Agg-PG) purified from fresh tissue. The results show that: (1) NAgg-PG are smaller, more heterogeneous in size and have a lower protein/glycosaminoglycan ratio than Agg PG. (2) NAgg-PG and Agg-PG have a very similar chondroitin sulfate/keratan sulfate ratio. (3) NAgg-PG have 25-50% lower disulfide content than Agg-PG. (4) NAgg-PG have only about 20% of the reactivity of Agg-PG towards a monoclonal antibody (12-20/1-C-6) specific for the hyaluronate binding region of the core protein. These results provide further evidence that proteoglycan catabolism in cartilage explants involves proteolysis of core protein resulting in separation of the hyaluronate binding region from the glycosaminoglycan-rich regions. PMID- 3676347 TI - Localization of neutrophil adherence-inhibiting factor in guinea pig platelets. AB - The effect of constituents of guinea pig platelets on neutrophil adherence was examined. The platelet sonicate supernatant contained adherence-inhibiting activity which strongly inhibited neutrophil adherence to glass. When the platelet sonicate supernatant was treated with neuraminidase or trypsin, the adherence-inhibiting activity was significantly inhibited, suggesting that the adherence-inhibiting factor (AIF) is a glycoprotein. The subcellular fractionation experiments indicated that the AIF activity was present at about 40% in both the cytosol and granule fractions. From the Sephadex G-200 gel filtration analysis, AIF of cytosol fraction and granule fraction proved to be different molecules, with molecular masses of about 230 and 12 kDa, respectively. When platelets were stimulated with thrombin, about 20% of total AIF was released extracellularly without the release of the cytoplasmic enzyme lactate dehydrogenase. These results suggest the possibility that a biologically active substance, AIF, is released from platelets in response to stimuli and regulates neutrophil functions through interference with neutrophil adherence. PMID- 3676348 TI - Single cell laser light scattering spectroscopy in a flow cell: repeated sickling of sickle red blood cells. AB - We performed dynamic laser light scattering measurements of hemoglobin aggregates in single, sickle erythrocytes. Sickle erythrocytes were attached to the poly-(L lysine)-coated surface of a flow cell. They were exposed to several oxygenation deoxygenation cycles by repeatedly changing the flowing solution. The rate of cycling was found to be a determining factor for the formation of irreversible morphologic alterations as well as irreversible hemoglobin aggregates. In slow cycling, the sickle erythrocytes took an irreversible, irregular, rounded shape, and hemoglobin aggregates were observed even in the oxygenated state after 20 cycles. In the fast cycling, however, these changes did not take place even after 60 cycles. PMID- 3676349 TI - A 31P-NMR study on the recovery of intracellular pH in LLC-PK1/Cl4 cells from intracellular alkalinization. AB - The regulation of intracellular pH (pHi) in a renal epithelial cell line, LLC PK1/Cl4, during re-acidification from an alkaline load was studied by 31P-NMR. Intracellular alkalinization was induced by 10 mM ammonium glucuronate or by preloading with and subsequent removal of 20% CO2; the rate of re-acidification was found to be 0.047 pH units/min and 0.053 pH units/min, respectively. This rate of re-acidification was inhibited by 83% if Cl- was removed from the extracellular medium. A similar inhibition was found in the presence of 1 mM 4 acetamido-4'-isothiocyanostilbene-2,2'-disulphonic acid (SITS) (76% inhibition) and 1 mM bumetanide (81% inhibition). No change in recovery was found after removing sodium from the extracellular medium, indicating that LLC-PK1/Cl4 cells recover from an intracellular alkaline load by a Cl-/HCO3- exchanger, which is SITS- and bumetanide-sensitive and has no requirement for sodium. In addition, the steady-state pHi in Cl4 cells was monitored by 31P-NMR. Removal of Cl- from the extracellular medium introduced an increase in pHi by 0.33 pH units, whereas 1 mM SITS and 1 mM bumetanide caused an increase in pHi by 0.14 or 0.13 pH units. In the presence of 1 mM amiloride, an inhibitor of the Na+/H+ exchanger, the steady-state pHi did not change significantly. These results indicate that at pHo 7.4 the steady-state intracellular pH of LLC-PK1/Cl4 cells strongly depends on the activity of the Cl-/HCO3- exchanger. Under the same conditions the activity of the Na+/H+ exchanger seems to be negligible. PMID- 3676350 TI - Effect of diet and starvation on the activity state of branched-chain 2-oxo-acid dehydrogenase complex in rat liver and heart. AB - In rats fed a high-protein diet, the branched-chain 2-oxo-acid dehydrogenase complex in liver was essentially fully active and its activity state was unaffected by subsequent starvation for 48 h. Feeding with a low-protein diet led to a decrease in the activity state which was essentially reversed by 48 h of starvation. In heart, the enzyme was primarily inactive (activity state 18%) in rats fed a high-protein diet, with both low-protein diet and starvation leading to a further decrease in the activity state. PMID- 3676351 TI - Phosphorylation of troponin I by protein kinase C: mechanism of inhibition by calmodulin and troponin C. AB - The mechanism by which calmodulin and troponin C influence phosphorylation of troponin I (TnI) by protein kinase C was investigated. The phosphorylation of TnI by protein kinase C requires the presence of acidic phospholipid, calcium and diacylglycerol. Light scattering intensity and fluorescence intensity experiments showed that TnI associated with the phospholipid membranes and caused extensive aggregation. In the presence of Ca2+, TnI-phospholipid interactions were prevented by approximately stoichiometric amounts of either troponin C or calmodulin. Troponin C was shown to completely inhibit phosphorylation of TnI by either protein kinase C or by phosphorylase b kinase. In contrast, calmodulin completely inhibited phosphorylation of TnI by protein kinase C, but had only little effect on TnI phosphorylation by phosphorylase b kinase. Inhibition by calmodulin did not appear to be due to interaction with PKC, since calmodulin mildly increased protein kinase C phosphorylation of histone III-S. The ratio of phosphoserine to phosphothreonine in protein kinase C-phosphorylated TnI remained approximately constant for reactions inhibited by up to 90% by calmodulin. TnI interactions with phospholipid and phosphorylation of TnI by PKC were also prevented by high salt concentrations. However, salt concentrations adequate to inhibit phosphorylation were sufficient to dissociate only TnI, but not protein kinase C from the membrane. These results suggest that the binding of TnI to phospholipid is required for phosphorylation by protein kinase C and that prevention of this binding by any means completely inhibited phosphorylation of TnI by protein kinase C. PMID- 3676352 TI - Murine antiestrogen-binding protein: characterization, solubilization and modulation by lipids. AB - The properties of the antiestrogen-binding protein have been examined in mouse tissues, a species in which nonsteroidal antiestrogens are virtually pure agonists. As in other species studied, this protein was distributed in all tissues - highest levels being in the liver. Subcellular fractionation of mouse liver showed that 82% of the antiestrogen-binding protein was associated with the rough endoplasmic reticulum where it was confined to the membranous component. The antiestrogen-binding protein was also present in smooth endoplasmic reticulum, nuclei and cytosol. Its concentration in intact nuclei was at least 10 times higher than levels previously reported in intact rat liver nuclei. Binding of [3H]tamoxifen to the murine antiestrogen-binding protein was of high affinity (Kd = 1 nM) and was inhibited by unsaturated fatty acids and 7-ketocholesterol. In general, cis-isomers of unsaturated fatty acids were more effective binding inhibitors than trans-isomers. The antiestrogen-binding protein solubilized from rough endoplasmic reticulum membranes by the zwitterionic detergent CHAPS, had a molecular mass of approx. 700 kDa and a sedimentation coefficient of about 19 S. [3H]Tamoxifen binding capacity of the solubilized protein was abolished by trypsin and nonspecific proteinases but not by clostripain or Staphylococcus aureus V8 proteinase, suggesting that lysine residue(s) may be involved in [3H]tamoxifen binding. PMID- 3676353 TI - Phosphorylation of high-mobility-group chromatin proteins by protein kinase C from rat brain. AB - Chromosomal high-mobility-group (HMG) proteins have been examined as substrates for calcium/phospholipid-dependent protein kinase C. Protein kinase C from rat brain phosphorylated efficiently both HMG 14 and HMG 17 derived from calf thymus and the reactions were calcium/phospholipid-dependent. About 1 mol of 32P was incorporated per mol of HMG 14 and HMG 17. Phosphopeptide mapping suggested that the same major site was phosphorylated in both proteins at serine. The apparent Km values for HMG 14 and HMG 17 were about 5 microM. HMG 14, HMG 17 and the five histone H1 subtypes prepared from rat thymus, liver and spleen were phosphorylated by the kinase. HMG 14 and HMG 17 from transformed human lymphoblasts (Wi-L2) were also phosphorylated in a calcium/phospholipid-dependent manner. HMG 1 and HMG 2 from the tissues examined were found to be poor substrates for the kinase. PMID- 3676355 TI - A hierarchical neural-network model for control and learning of voluntary movement. AB - In order to control voluntary movements, the central nervous system (CNS) must solve the following three computational problems at different levels: the determination of a desired trajectory in the visual coordinates, the transformation of its coordinates to the body coordinates and the generation of motor command. Based on physiological knowledge and previous models, we propose a hierarchical neural network model which accounts for the generation of motor command. In our model the association cortex provides the motor cortex with the desired trajectory in the body coordinates, where the motor command is then calculated by means of long-loop sensory feedback. Within the spinocerebellum- magnocellular red nucleus system, an internal neural model of the dynamics of the musculoskeletal system is acquired with practice, because of the heterosynaptic plasticity, while monitoring the motor command and the results of movement. Internal feedback control with this dynamical model updates the motor command by predicting a possible error of movement. Within the cerebrocerebellum- parvocellular red nucleus system, an internal neural model of the inverse dynamics of the musculo-skeletal system is acquired while monitoring the desired trajectory and the motor command. The inverse-dynamics model substitutes for other brain regions in the complex computation of the motor command. The dynamics and the inverse-dynamics models are realized by a parallel distributed neural network, which comprises many sub-systems computing various nonlinear transformations of input signals and a neuron with heterosynaptic plasticity (that is, changes of synaptic weights are assumed proportional to a product of two kinds of synaptic inputs). Control and learning performance of the model was investigated by computer simulation, in which a robotic manipulator was used as a controlled system, with the following results: (1) Both the dynamics and the inverse-dynamics models were acquired during control of movements. (2) As motor learning proceeded, the inverse-dynamics model gradually took the place of external feedback as the main controller. Concomitantly, overall control performance became much better. (3) Once the neural network model learned to control some movement, it could control quite different and faster movements. (4) The neural network model worked well even when only very limited information about the fundamental dynamical structure of the controlled system was available.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676354 TI - A model of direction-selective "simple" cells in the visual cortex based on inhibition asymmetry. AB - Direction selectivity is a prominent feature of single units in the central visual pathway of cat and monkey. Various mechanisms have been proposed for the generation of this property. Experimental evidence suggests that intracortical inhibition is a major factor contributing to direction selectivity. We have developed a one-dimensional computer model for direction selective simple cells in the visual cortex under two basic assumptions: 1) Inhibition is exerted upon a cortical cell by neighboring cells from either side within a retinotopic array, 2) The relative strength of inhibition from both neighbors can be varied, interneurons always having larger time constants than the simple cells. Summation in the model is linear, but is followed by an essential non-linearity. ON- and/or OFF-center cells of the sustained type (X-cells) are used as an input to the simple cells. The computer simulation demonstrates that various subtypes of direction-selective simple cells in area 17, as described by Schiller et al. (1976), can be generated by different amounts of inhibition asymmetry, different delays and by different spatial arrangements of the input. Only one type of input (ON or OFF) is required to generate direction selectivity, but a greater variety of cell subtypes is created by combining both. Length-summation, contributing to orientation selectivity, was not considered in this one-dimensional model. PMID- 3676356 TI - On the recognition of order and disorder. AB - We compare several algorithms for the recognition of ordered and disordered images. As image sources we use waves of the Belousov-Zhabotinskii reaction coupled to convective motion in a petri dish. This device allows reversibly the generation of periodic (ordered) and aperiodic (disordered) patterns. The best match between the parametric description and the observations is obtained by an "autodifference function". This function is computed by summing up intensity differences over all pairs of picture elements having a given distance on the picture plane. Then, the minimum of this function is determined upon variation of the distance. This algorithm is not only efficient for the recognition of order and disorder in "machine vision", but also plausible in biological visual perception. PMID- 3676357 TI - A cognitive and associative memory. AB - By introducing a physiological constraint in the auto-correlation matrix memory, the system is found to acquire an ability in cognition i.e. the ability to identify an input pattern by its proximity to any one of the stored memories. The physiological constraint here is that the attribute of a given synapse (i.e. excitatory or inhibitory) is uniquely determined by the neuron it belongs. Thus the synaptic coupling is generally not symmetric. Analytical and numerical analyses revealed that the present model retrieves a memory if an input pattern is close to the pattern of the stored memories; if not, it gives a clear response by going into a special mode where almost all neurons are in the same state in each time step. This uniform mode may be stationary or periodic, depending on whether or not the number of the excitatory neurons exceeds the number of inhibitory neurons. PMID- 3676358 TI - Mathematical analysis of the changes in the parameters of the action potentials, membrane and ionic currents of frog muscle fibre during the recovery cycle. AB - The method of mathematical modelling was used to study the excitability changes of the membrane of a frog skeletal muscle fibre and the parameters of the action potentials, membrane and ionic currents during the first 30 ms of the recovery cycle. The threshold current for a fibre at rest was found to be 0.32 microA and the durations of the absolute and relative refractory periods were respectively 4 ms and 5.2 ms. With increasing interpulse interval, the subnormality of the membrane excitability is followed by supernormality. Under the same condition the supernormality in the velocity recovery cycle is not obtained. In the recovery cycle, the shape (polarity, sequence and number of phases) of the action potentials, of the membrane and ionic currents and their conductances, are unchanged. Only the time and amplitude parameters of the quantities listed above are known to vary. With increasing the interpulse interval, the amplitudes of the quantities increase and their durations are shortened attaining the values of the corresponding quantities of the initial action potential. The membrane properties are recovered 30 ms after application of the initial pulse, but the supernormality of the excitability is still preserved. PMID- 3676359 TI - [Mechanisms of inhibition of vascular-platelet hemostasis by salivary gland secretion of the medicinal leech Hirudo medicinalis]. AB - The mechanism of inhibition of the vascular-platelet stage of hemostasis by medicinal leech salivary gland secretion was studied. It was shown that the secretion blocks platelet adhesion on the surface of collagens belonging to different genetic classes, inhibits the primary attachment of platelets and completely suppresses their spreading on collagen surface. Whatever its antithrombin activity, the leech secretion inhibits platelet aggregation stimulated by various inductors, e. g., ADP, prostaglandin endoperoxide analog U 46619, Ca2+ ionophore A23187, arachidonic acid. The secretion possessing the antithrombin activity causes a greater inhibition of the thrombin-stimulated aggregation than that devoid of this activity. Leech secretion stimulates adenylate cyclase of platelet membranes in a receptor-mediated fashion and increases the level of cAMP. The active substance is a low molecular weight, thermostable trypsin-resistant fraction of the secretion. Stimulation of adenylate cyclase is not mediated by adenosine receptors. It is supposed that the mechanism of this activating effect involves platelet prostaglandin receptors. PMID- 3676360 TI - [Activation of lipolysis and ketogenesis in tumor-bearing animals as a reflection of chronic stress states]. AB - In order to elucidate the peculiarities of brain metabolism in tumour-bearing organisms, the arterio-venous (A-V) content of glucose, acetoacetate (Ac-Ac), beta-hydroxybutyrate (beta-HB) and non-esterified fatty acids (NEFA) in growing Zajdela ascite hepatoma (ZAH) and solid hepatoma 27 (H-27) was compared. Analysis of metabolic patterns of healthy, starving and fed recipients (ZAH and H-27) revealed the inadequacy of the concepts on anorexia as being the cause of carbohydrate-lipid metabolic disturbances. In tumour-bearing organisms lipolysis and ketogenesis reflect the tumour-induced chronic stress. Absorption of beta-HB and release of Ac-Ac by brain were observed at all stages of malignant growth. This is probably due to a partial switch-over of brain metabolism to non carbohydrate energy sources. Besides, certain stages of tumour growth are associated with active assimilation of NEFA by brain. A correlation between the A V difference with respect to glucose and Ac-Ac as well as between the glucose and NEFA contents was established. It was assumed that the A-V difference in glucose is the main regulator of ketone body metabolism. PMID- 3676361 TI - [Determination of isoelectric points of oligomeric forms of mitochondrial creatine kinase]. AB - Using isoelectrofocusing in three pH gradients differing in the initial pH value of the ampholyte gel mixture and in gradient pH range, the isoelectric points for the dimeric and octameric forms of mitochondrial creatine kinase from bovine heart and pigeon breast muscle were determined. The isoelectric points for the dimer and octamer are equal to 9.67 +/- 0.01 and 8.93 +/- 0.05 for the heart enzyme and to 9.56 +/- 0.08 and 8.91 +/- 0.23 for the skeletal muscle enzyme. The correctness of identification of the oligomeric forms of mitochondrial creatine kinase was confirmed by ultracentrifugation in a sucrose density linear gradient. Since creatine kinase is known to bind to mitochondrial membrane cardiolipin by electrostatic forces, it can be assumed that both oligomeric forms of the enzymes can bind to the membranes. However, the properties of the creatine kinase dimer suggest its greater ability to bind to mitochondrial membranes. PMID- 3676362 TI - Composition of weight gain during the neonatal period and longitudinal growth follow-up in premature babies. AB - Changes in the rate of growth and adiposity index (Quetelet index), calculated as weight/(length)2, kg/m2, were monitored from birth to 3 years in 19 premature babies (post-conceptional age 31.2 +/- 2 weeks) who were subjected during rapid growth (16 +/- 4 g/kg.day) to initial metabolic balance studies in the first weeks of life. These studies showed that the rate of fat accretion in these infants (3.3 +/- 0.9 g/kg.day) was substantially greater than that observed in fetuses of the same gestational age (2 g/kg.day) but the adiposity index was lower (9.6 +/- 1 kg/m2) than intrauterine values (11 kg/m2). Since at 6 months of age (corrected for gestational age at birth) the adiposity index was close to normality (103% of standard), the greater rate of fat accretion in early life contributed to progressively restore total body fat in premature babies. It is concluded that despite substantial fat deposition during the first weeks of life, the future evolution of these premature babies is favourable as judged from the normalization of adiposity index within the first 2 years of life. PMID- 3676363 TI - Glucose homeostasis in the newborn: effects of an intravenous glucose infusion in normal and intra-uterine growth-retarded neonatal piglets. AB - Disturbances of glucose homeostasis are a common clinical problem in low birth weight human infants. Previous studies have demonstrated that the intra-uterine growth-retarded piglet is a suitable animal model for the study of such problems. The effects of an intravenous glucose infusion on glucose homeostasis have been studied in normal and intrauterine growth-retarded neonatal piglets using a non steady state tracer technique. Despite suppression of hepatic glucose output, hyperglycaemia (plasma glucose greater than 10.0 mmol/l) developed in the majority of animals. The hyperglycaemia resulted from a failure to increase glucose utilisation adequately in response to the glucose infusion. Growth retarded animals had an impaired ability to increase their rate of glucose utilisation, although, in common with the normally grown animals, they demonstrated a graded response to different infusion rates of glucose. PMID- 3676364 TI - Lipid peroxidation and vitamin E levels during pregnancy in rats. AB - The present study examined pregnancy-related changes in the level of lipoperoxides and antioxidative substances such as superoxide dismutase (SOD), catalase, glutathione peroxidase (GSH-Px) and vitamin E in the maternal and fetal serum, liver, lungs, and placenta using Wistar rats. Pregnant rats fed a standard diet (control animals) showed an increase of lipoperoxides in the blood to a level 3 times greater than the non-pregnant level. When the rats were fed a vitamin E-deficient diet, lipoperoxides were produced in much greater amounts. Fetal blood also contained greater concentrations of lipoperoxides by the use of a vitamin E-deficient diet. However, liver and lung tissues contained lipoperoxides in essentially constant concentrations throughout non-pregnancy and pregnancy. Fetal liver and lung tissues showed higher concentrations than the maternal concentrations. Fetal blood and tissue concentrations of vitamin E reflected the maternal concentrations, and the values in vitamin E-deficient animals were as small as 0.1-0.2 of the values in normally fed animals. As a protective factor against lipid peroxidation, SOD was slightly increased in the liver tissues of pregnant control animals, but catalase and GSH-Px were significantly decreased in the organ. A similar tendency was observed in vitamin E-deficient animals. PMID- 3676365 TI - High levels of group-specific component (vitamin-D-binding protein) in the cerebrospinal fluid of infants aged less than 2 months. AB - Because of the possible involvement of group-specific component (Gc) or vitamin-D binding protein in the immunological functions of mononuclear cells and the increased risk of central nervous system infections in early infancy, we studied Gc levels in the cerebrospinal fluid (CSF) of children. CSFs were examined for the Gc concentration using ELISA and rocket immunoelectrophoresis, with purified Gc as standard. The results showed a significant inverse correlation (p less than 0.05) between the age of the patients and CSF Gc levels. Gc levels in the CSF were significantly increased in infants less than 2 months of age (12.5 micrograms/ml), as compared to infants greater than 2 months (1.7 micrograms/ml, p less than 0.0028). In children greater than 2 months of age a significant correlation was found between Gc levels and those of other CSF proteins (albumin, IgG and total protein, p less than 0.002). However, no significant correlation between Gc levels and those of other CSF proteins was apparent in infants less than 2 months of age, indicating the possibility that the concentration of Gc in the CSF may be selectively increased in this age group. PMID- 3676366 TI - Action of acetaldehyde on glucose metabolism of newborn and adult erythrocytes. AB - This paper reports the effect of acetaldehyde on erythrocytes (RBC) of human adults and newborns. Acetaldehyde increases glucose consumption in adult RBC, but has no effect on that of newborn RBC. The compound stimulates the hexose monophosphate shunt and decreases the pyruvate production of the two RBC suspensions. In newborn RBC, acetaldehyde slightly modifies triose-P and fructose 1,6-bisphosphate but has no effect on the ATP/ADP ratio and glucose-1,6 bisphosphate content, which change markedly in adult RBC. Analysis of aldehyde dehydrogenase reveals nearly one half of enzyme activity in newborn RBC. The data indicate that in both adult and newborn RBC, acetaldehyde causes an intracellular reduced state, but the newborn cells take advantage of their greater pyruvate production for complete removal of the exceeding NADH equivalents. PMID- 3676367 TI - Acidemia potentiates the plasma catecholamine response to hypoxemia in fetal sheep. AB - Though hypoxemia has been shown to stimulate adrenal medullary catecholamine (CA) release and raise plasma CA concentrations, the extent to which concomitant acidosis influences the magnitude of this response is unclear. Eleven chronically catheterized late gestation (0.8 term) fetal lambs in utero were investigated during a baseline control period and following the onset of umbilical cord constriction-induced hypoxemia (PO2 = 5-15 Torr). Plasma CA rose in response to hypoxemia in all animals but was potentiated by the development of acidemia. Baseline norepinephrine (NE = 487 +/- 113 pg/cm3 and increased to 1,386 +/- 127 pg/cm3 (p less than 0.001) in response to hypoxemia. Hypoxemia combined with acidemia promoted an even greater rise in NE to 6,726 +/- 1,289 pg/cm3 (p less than 0.05). Plasma epinephrine (E) = 99 +/- 36 pg/cm3 during baseline observations and increased to 512 +/- 81 pg/cm3 (p less than 0.001) in response to hypoxemia. However, an additional 9-fold increase (p less than 0.05) was noted when hypoxemia was combined with acidemia (E = 4,311 +/- 1,449 pg/cm3). Thus, acidosis significantly potentiates the magnitude of the plasma CA response to hypoxemia in the late gestation fetus. PMID- 3676368 TI - Influence of food intake during late gestation on serum lipids of sows and their progeny. AB - Serum and lipoprotein lipids were quantified in pregnant and nonpregnant sows allowed restricted and ad libitum access to a low-fat cholesterol-free diet, and in the progeny of these sows. Pregnant sows exhibited a mild increase in serum triglycerides in the third trimester, reflecting an increase in very low density lipoprotein (VLDL)-triglyceride concentration. Ad libitum feeding enhanced this increase. Free fatty acids were depressed in mid-pregnancy (60 days gestation), but were normal or elevated in the final trimester. Total cholesterol was similar in all groups. Pregnancy and level of food intake interacted to increase VLDL cholesterol in pregnant sows fed ad libitum. Pregnancy decreased high density lipoprotein cholesterol. Level of food intake by sows had no influence on serum lipid concentrations of newborn pigs. Distribution of cholesterol and triglyceride between lipoprotein classes was different in newborn pigs when compared to sows. These results imply fetal self-regulation of lipid metabolism during late gestation. Sow serum lipids are not identical to those in humans. However, when fed a modified diet that resembles a human diet, sows may be useful as a model for humans in studies of lipid metabolism during pregnancy. PMID- 3676369 TI - The history of intelligence. PMID- 3676370 TI - Decreased plasma serotonin in melancholic patients: a study with clomipramine. AB - Eighteen unmedicated patients suffering from major depressive disorder with melancholia (DSM-III) were examined for abnormalities in peripheral serotonin (5 HT) and related metabolites. Serotonin in platelet-free plasma and in platelets from melancholics was significantly reduced to 30% and 60% of their respective control values. Plasma 5-hydroxyindoleacetic acid was also found to be reduced, but not significantly. Other plasma compounds related to 5-HT (indoleacetic acid, total tryptophan, and free tryptophan) were found to be unchanged in these patients. Of all variables, only platelet 5-HT was affected while patients were on clomipramine (CIM) treatment. After 2 weeks on CIM (100-150 mg/day, orally), platelet 5-HT was reduced to 8% of pretreatment values, but plasma 5-HT did not change and continued to be reduced upon clinical recovery. The existence of a distinct pool of plasma 5-HT that is clearly independent of the platelet pool is indicated by the differences observed in plasma and platelet 5-HT during CIM treatment, as well as by previous data from this laboratory. The very marked decrease in plasma 5-HT levels may be in accord with the central nervous system changes reported in depression and suggests the possibility of using plasma 5-HT as a peripheral indicator of abnormal serotonin function in melancholia. PMID- 3676371 TI - Acute effect of some psychotropic drugs on low-frequency amygdaloid kindled seizures. AB - We assessed the acute effects of some psychotropic drugs on amygdaloid-kindled seizures produced by low-frequency stimulation. We used the number of stimulating pulses required for the induction of epileptic afterdischarge (pulse-number threshold, PNT) as an indicator for the seizure-generating threshold, and the duration of the epileptic afterdischarge (AD duration, ADD) as an indicator for the duration of the induced seizures. Methamphetamine and atropine elevated the PNT and reduced the ADD. Haloperidol reduced the PNT at all tested doses and reduced the ADD at high dosage. Imipramine elevated the PNT at low doses and reduced the PNT at high dosage. Imipramine also reduced the ADD. Reserpine at high dose elevated the PNT without affecting the ADD. PMID- 3676372 TI - Muscarinic cholinergic receptors on intact human lymphocytes. Properties and subclass characterization. AB - Saturable specific binding of tritiated N-methyl-scopolamine (3H-NMS) can be demonstrated on intact circulating human lymphocytes, with an average KD of 7 nmol/liter and an average density of about 15 fmol/10(6) cells. Specific 3H-NMS binding can be inhibited by cholinergic antagonists and agonists, is highly stereospecific for the enantiomers of the cholinergic antagonist quinuclidinyl benzilate (QNB), and is modulated by the stable guanosine triphosphate (GTP) analog GppNHp in a fashion similar to the specific binding of the same radioligand to rat heart membranes. The results indicate the presence of muscarinic cholinergic receptors on intact human lymphocytes, with a predominance of the M2 subtype. As central muscarinic cholinergic receptors have been reported to play an important role in the pathogenesis of affective disorders, the lymphocyte might represent a suitable model for the study of muscarinic receptor functions in humans. PMID- 3676373 TI - Plasma catecholamine metabolites in subtypes of major depression. PMID- 3676374 TI - Cardioacceleratory responses to arecoline infusion during sleep in depressive, anxious, and normal subjects. PMID- 3676375 TI - Clinical correlates of sleep onset REM periods in depression. PMID- 3676376 TI - Taste and smell perception in depression. PMID- 3676377 TI - Decrease in core temperature as an indication of cholinergic overdrive during amitriptyline withdrawal. PMID- 3676378 TI - Antibody to discrete areas of the brain in normal individuals and patients with schizophrenia. PMID- 3676379 TI - Plasma MHPG in untreated panic disorder. PMID- 3676380 TI - Lack of effects of hospitalization and oral contraceptives on DST results in control subjects. PMID- 3676381 TI - 5-HT and the functional approach. PMID- 3676382 TI - Maybe handwriting would help. PMID- 3676383 TI - Water availability affects reproduction in deer mice. AB - Water restriction impaired sperm production in deer mice, a seasonally breeding mammal that encounters aperiodic droughts in its natural habitat throughout North America. Water-induced spermatogenic responses were sorted into three categories based upon epididymal sperm numbers: aspermic, oligospermic, and euspermic. Average gonadal mass was reduced after 10 wk of limited water consumption. Inter individual variation in gonadal response to a simulated drought was similar to phenotypic differences in reproductive function in response to other environmental cues that direct annual reproductive cycles. Our findings suggest that water availability may act as a cue to suppress gametogenesis in deer mice independently from food, temperature, and day length. PMID- 3676384 TI - Growth and reproductive development in the male tree shrew (Tupaia belangeri) from birth to sexual maturity. AB - The growth and reproductive development of the male tree shrew were studied from birth to sexual maturity. An infantile phase from birth to Day 30 was characterized by the rapid involution of the testis and adrenal gland from a fetal condition followed by a nadir in testosterone levels and slow growth and differentiation of the testis and accessory sex organs. The initiation of puberty occurred collaterally with the emergence of the young from the nest and was marked by a sharp rise in testosterone levels from Days 30 to 35 to maximum levels at Days 40-55. Peak testosterone levels were temporally correlated with the onset of maximum growth and differentiation of the testis and accessory sex organs, descent of the testis, development of the scrotum, and a pronounced peak in the weight-velocity curve. The rapid growth of males at puberty contributed to a moderate degree of sexual dimorphism in this species. Puberty was attained at about Day 90 with the completion of spermatogenesis and the functional differentiation of the accessory sex organs. The postnatal development of the tree shrew conforms with the general primate pattern. The precise endocrine correlates established during puberty make Tupaia belangeri a useful small animal model for the study of puberty in primates. PMID- 3676385 TI - Effects of unilateral ovariectomy before and after mating on growth of corpora lutea and peripheral progestagen concentrations in pregnant rats. AB - Unilateral ovariectomy was performed on 20 rats 4-5 wk before mating (ULO-B group), and 18 rats 8 days after mating (ULO-A group); 16 rats were maintained as controls. The effects on growth of individual corpora lutea (CL) in the remaining ovary and peripheral blood progestagen concentrations were examined. CL hypertrophy was observed by Day 13 in the ULO-B group and by Day 16 in the ULO-A group. Progesterone and 20 alpha-dihydroprogesterone concentrations were double control values at Day 16 in the ULO-B group, but half the control values in the ULO-A group. The CL hypertrophy and increased progestagen concentrations in the ULO-B group occurred despite crowding due to a doubling of the normal number of CL within the remaining ovary. PMID- 3676386 TI - Effect of trypsinization on lectin binding to germ cells from ICR and T/t6 mice. AB - Flow cytometry was used to quantify the binding of fluorescein isothiocyanate (FITC)-labeled lectins to testis cells from ICR and T/t6 mice before and after trypsin treatment. Soybean agglutinin, wheat germ agglutinin, and concanavalin A bound well to testis cells of both mouse strains. Limax flavus agglutinin (LFA) bound very slightly and Ulex europeas agglutinin (UEA) did not bind at all. Trypsinization increased binding of soybean agglutinin and decreased binding of wheat germ agglutinin in both mouse strains, providing evidence for masked carbohydrate-binding sites on the surface of germ cells. It did not affect binding of the other lectins. Trypsin treatment was an attempt to increase lectin binding, particularly the binding of LFA and UEA to the reported T/t-specific carbohydrates, sialic acid, and L-fucose, respectively. These studies indicate that the T/t6 locus alleles do not alter the surface carbohydrate content of testis cells sufficiently to be detected by lectin-binding differences. PMID- 3676387 TI - Neutral amino acid absorption by the rat epididymis. AB - The technique of stopped-flow/split-drop microperfusion was used to study the absorption of the neutral amino acid alpha-aminoisobutyric acid (AIB) from different epididymal regions of the rat. Absorption of AIB from the lumen of the caput, corpus, and cauda was saturable and time-dependent. The apparent Km values for each of the regions studied were similar (approximately 6 mM), whereas the Vmax values were progressively higher from caput, corpus, and cauda, respectively. Absorption of AIB from the lumina of the caput, corpus, and cauda epididymidis was linear over 60 min. The absorption of AIB from the lumen of the caput was sodium-dependent and inhibitable by 2-methyl-alpha-aminoisobutyric acid (MeAIB), a specific inhibitor of neutral amino acid transport. Similarly, absorption of AIB from the lumen of the corpus epididymidis was sodium-dependent; however, uptake was not significantly reduced in the presence of MeAIB. Absorption of AIB from the lumen of the cauda epididymidis was neither sodium dependent nor inhibitable by MeAIB. It is suggested that neutral amino acid absorption involves different transport carriers in different epididymal regions. These findings also support our previous observations that there exists a selective permeability barrier from lumen to blood along the epididymal duct. PMID- 3676388 TI - Oxytocin response to conditioned and nonconditioned stimuli in lactating ewes. AB - We have measured oxytocin release during lactation in the ewe in response to normal tactile sucking stimuli as well as exteroceptive stimuli emanating from the lamb. Four puerperal ewes that had indwelling catheter inserted in the femoral artery while still pregnant were used. Each nursed a single lamb. Each was studied 2 or 3 times between Days 1 and 15 of lactation during a 2.5-h experimental period that was preceded by a 2-h separation from the lamb in the early morning. Samples were taken before and after the lamb was brought within sight and sound of the ewe but without contact, and then 0.5, 1, 5, 10, 15, 30, and 60 min after suckling began. When another suckling episode intervened, the same sampling schedule was immediately restarted. Suckling occurred in an intermittent fashion; 3 to 4 episodes of 2.9 +/- 2.0 (SD)-min duration took place with variable intervals during the 2.5-h experimental period. Exteroceptive stimuli emanating from the lamb caused plasma oxytocin to rise significantly from basal levels of 10.0 +/- 4.5 to 21.8 +/- 5.7 pg/ml (mean +/- SE, n 10, p less than 0.05). This rise was not seen on Day 1 and in only half of the ewes on Day 2, but thereafter the rise occurred in every instance. A further rise in plasma oxytocin was observed in almost all instances (86%) at suckling. Peak levels were usually observed within 1 min. They were quite variable, ranging from 15 pg/ml to 287 pg/ml, and not related to the milk yield, but were significantly greater than spontaneous pulses observed in nonlactating puerperal sheep.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676389 TI - Glandular kallikrein levels in the rat anterior pituitary during the estrous cycle and pregnancy. AB - Glandular kallikrein (a trypsin-like serine protease) is a major estrogen-induced protein in the rat anterior pituitary, which appears to be associated with lactotropes. The present study examined glandular kallikrein levels in the anterior pituitary during the rat estrous cycle and pregnancy. After trypsin treatment of anterior pituitary homogenates (to activate latent forms of the enzyme), glandular kallikrein activity was measured by using the chromogenic substrate D-val-leu-arg-p-nitroanilide: 98-95% of the enzymatic activity was immunoprecipitable with glandular kallikrein antiserum. Glandular kallikrein levels did not change significantly during the various phases of the rat estrous cycle. However, a sharp decrease was observed starting on Day 15 of pregnancy and lasting through parturition; levels had almost returned to control values by Day 5 of lactation. PMID- 3676390 TI - Hypoxanthine causes a 2-cell block in random-bred mouse embryos. AB - Ham's F-10, a chemically defined, complex culture medium, commonly used for in vitro fertilization of human as well as animal oocytes, blocked development at the 2-cell stage of greater than 92% of embryos from random-bred Swiss mice (CD 1), but did not block development of embryos from hybrid-inbred mice (BDF1). In contrast, BWW, a simple, modified Kreb's-Ringer bicarbonate medium, supported development to blastocysts of 85% and 100% of 2-cell embryos from CD1 and BDF1 females, respectively. As little as 15% (v/v) Ham's F-10 added to the BWW blocked the development of the random-bred embryos. Supplementing the BWW with Ham's F-10 components revealed that hypoxanthine (6-30 microM) was responsible for the developmental block to the random-bred embryos. The hypoxanthine block was partially (40%) reversed by adding the chelating agent, ethylenediaminetetraacetic acid. Breeding experiments showed that the hypoxanthine sensitivity of embryos from CD-1 mothers was not affected by the paternal genome. PMID- 3676391 TI - A time-course study of chronic paternal cyclophosphamide treatment in rats: effects on pregnancy outcome and the male reproductive and hematologic systems. AB - We have found previously that daily treatment of male rats for 11 wk with low doses of the anticancer drug cyclophosphamide had no apparent effect on male reproductive organ weights, epididymal sperm counts, or serum hormones at the end of the treatment period; yet, upon breeding to untreated females, these males produced a high rate of post-implantation loss and fetal anomalies. The present study was designed to investigate the time course and dose response of the effects of chronic cyclophosphamide treatment on the male reproductive and hematologic systems. Male Sprague-Dawley rats were gavage-fed for 1, 3, 6 and 9 wk with saline (control), or 5.1 (low dose) or 6.8 (high dose) mg/kg/day of cyclophosphamide. After each of the treatment periods, males were mated to determine the effect on pregnancy outcome, then killed, and the effects on the male reproductive and hematologic systems were assessed. After 6 wk of treatment, a sharp increase in mortality was found between the 5.1 and 6.8 mg/kg/day doses of cyclophosphamide. The high dose of cyclophosphamide induced higher levels of pre- and post-implantation loss but fewer fetal anomalies than did the low dose. The low dose of cyclophosphamide did not affect reproductive organ weights; in contrast, the high dose caused decreases in epididymal, ventral prostate, and seminal vesicle weights after 3, 6, and 9 wk. Testicular and epididymal sperm counts were decreased in a dose-dependent manner after 3 wk; in addition, the high dose led to a decrease in epididymal sperm counts after 6 wk of treatment. Another rapidly proliferative tissue, the bone marrow, was dramatically affected by both doses of cyclophosphamide at all time points, with leukocyte counts decreasing to 40% of control by 1 wk. After 9 wk of treatment, effects on the male reproductive system were less marked, compared to earlier time points, whereas those on the hematologic system and pregnancy outcome persisted. Thus chronic low-dose treatment of male rats with cyclophosphamide not only had early and striking effects on the bone marrow and the pregnancy outcome but also affected the male reproductive system in a clear time- and dose-dependent manner. PMID- 3676392 TI - Effect of estradiol-filled polydimethylsiloxane subdermal implants in adult male rats on the reproductive system, fertility, and progeny outcome. AB - Combinations of testosterone and estradiol have been proposed as potential male contraceptives. For any compound to be an acceptable male contraceptive, it must be demonstrated either to prevent pregnancy completely or, if contraceptive failure occurs, to not have any adverse effect on pregnancy outcome. We have previously established that increasing doses of testosterone given via subdermal implants to adult male rats will decrease spermatogenesis and fertility but will not result in an increased incidence of pre- or postimplantation loss or in abnormal progeny. In the present study, we have monitored the effects of a dose of estradiol that has been proposed for the contraceptive regimen, as well as doses three and seven times as large, on progeny outcome. Adult male Sprague Dawley rats received s.c. implants of estradiol-filled polydimethylsiloxane capsules of varying lengths and, after three months, were each mated twice to two females in proestrus. The smallest dose of estradiol (the dose used in the contraceptive formulation) did not have any significant effects on any of the measured parameters of the male reproductive system, or on the incidence of pre- or postimplantation loss or on progeny outcome. With increasing doses of estradiol, there was a marked reduction in fertility. This reduction in fertility was not associated with a sufficient decrease in epididymal sperm reserves to account for the decrease in number of females impregnated, but was associated with a major reduction in seminal plugs; this would suggest that the large doses of estradiol were decreasing male sexual behavior.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676393 TI - Maintenance of unimplanted fertilized ova in sprayed rats. IV. Effects of duration of ovarian hormone deprivation and progesterone therapy prior to the deprivation. AB - Studies were carried out in the spayed-rat delayed-implantation model to determine whether progesterone treatment prior to an ovarian hormone deprivation during the pre-implantation period would influence the incidence of subsequent delayed ovo-implantation induced with progesterone plus estrone. Implantation was rarely induced with 4 mg progesterone plus 1 microgram estrone/day after 5 to 11 days of ovarian hormone deprivation in rats that were spayed on Day 3, if progesterone treatment were not given before ovarian hormone deprivation. In contrast to this, implantation was fairly consistently induced with 4 mg progesterone plus 1 microgram estrone/day after 3, 5, 7, or 11 days of ovarian hormone deprivation in rats that were spayed on Day 3 and received 4 mg progesterone/day before the deprivation period (i.e., on Days 2 through 3, 2 through 6, or 2 through 8). The post-implantation viability of the embryos of the dams undergoing the longer periods of ovarian hormone deprivation, however, was reduced. PMID- 3676394 TI - Tripronuclear human oocytes: altered cleavage patterns and subsequent karyotypic analysis of embryos. AB - Between 1 and 4% of human oocytes fertilized in vitro are tripronuclear. It has been reported that these tripronuclear oocytes can develop to grossly normal appearing morulae and that chromosomally, these embryos could be triploid, diploid, or severely depleted. The etiology and proportion of apparently diploid and aneuploid embryos deriving from tripronuclear human oocytes is unknown. This study provides evidence for the first time that most (18 of 29) tripronuclear human oocytes cleave directly to 3-cells at the first cleavage division. These embryos have a severely abnormal (but not triploid) chromosomal complement. Furthermore, some (4 of 29) tripronuclear human oocytes cleave to 2-cells plus an extrusion, and these embryos are diploids, whereas some (7 of 29) cleave to 2 cells, and these embryos are triploid after the first cleavage division. These findings demonstrate that most tripronuclear human oocytes have an altered cleavage pattern at the first cleavage division, that most tripronuclear human oocytes (76% in this study) do not develop into triploid embryos, and that a correlation exists between the pattern of the first cleavage division and the subsequent karyotype of these embryos. Insight into the mechanisms by which these oocytes fail to develop into triploid embryos is also provided. PMID- 3676395 TI - Unique regional distribution of delta 4-3-ketosteroid-5 alpha-oxidoreductase and associated epididymal morphology in the marsupial, Didelphis virginiana. AB - The epididymal epithelial ultrastructure has been described in the adult male North American opossum, Didelphis virginiana. Morphological results have suggested that absorptive activity is prominent in the proximal epididymal region by virtue of numerous microvilli, an endocytotic complex, dense granules, and multivesicular bodies in the apical cytoplasm. In contrast, the middle and distal epididymal regions exhibit ultrastructural features indicative of protein synthesis such as large invaginated euchromatic nuclei, large nucleoli, and increased amounts of granular endoplasmic reticulum. It is in the middle and distal epididymal regions where sperm head rotation and sperm pairing take place. Epididymal delta 4-3-ketosteroid-5 alpha-oxidoreductase (5 alpha-reductase) activity also has been measured. It has been found that the level of enzyme activity differs significantly (p less than 0.01) between the proximal, middle, and distal epididymal regions. Enzyme-specific activity has been found to be highest in the middle region (47.6 +/- 5.4 picomoles 5 alpha-reduced androgens formed/b/mg protein), lower in the distal region (18.3 +/- 0.7 picomoles 5 alpha reduced androgens formed/b/mg protein), with little activity (2.4 +/- 1.2 picomoles 5 alpha-reduced androgens formed/h/mg protein) found in the proximal epididymal region. This regional distribution of enzyme activity differs markedly from that reported for eutherian mammals. Both the suggested epididymal protein synthetic and secretory activity and the level of epididymal 5 alpha-reductase activity appear to correlate regionally with the morphological changes that occur in the opossum spermatozoa as they transit the epididymis. PMID- 3676396 TI - Relation of parity and estrous cyclicity to the biology of pregnancy in aging female rats. AB - In the female rat, the incidence of regular estrous cyclicity and fertility decreases progressively during aging, and the causes for these are unknown. To reveal the biology of pregnancy in aging rats, we performed a longitudinal study in a colony of multiparous rats bred every 2 mo. Beginning at 4 mo and continuing to 12 mo of age in these same individual females, we determined the chronological changes in estrous cyclicity, examined the relationship between the estrous cycle pattern and fertility, and recorded the numbers of live and dead pups delivered at term. In separate groups of 4- to 12-mo-old multiparous rats, we counted the number of ova present in the oviducts (ovulation rate) one day after mating and the number of grossly normal blastocysts found in the uteri on Day 5 of pregnancy. Similar studies were also performed in primiparous rats of 8, 10, and 12 mo of age. The cessation of regular cyclicity during aging occurred significantly (p less than 0.01) earlier in virgin than multiparous rats. Fertility followed a similar but more dramatic pattern of decline than did the incidence of regular cyclicity in both the multiparous and virgin females. Few irregularly cyclic and persistent-estrous females had fertile gestations after mating, and increasing proportions of regularly cyclic females also failed to reproduce successfully at middle age (8-12 mo). Thus, regular ovulatory cycles were essential but not sufficient for fertile gestations in aging rats. Beginning at 6 mo of age, the litter sizes of multiparous rats decreased progressively, and these decreases were associated with a similar decline in the number of live but not dead pups delivered. Also, the percentage of dead pups/total number of pups delivered increased steadily during aging in multiparous (from 14% to 69%) but not primiparous females. The litter sizes of 8- to 10-mo-old primiparous females were not different from those of multiparous rats. However, the litter sizes of irregularly cyclic rats were consistently smaller than those of regularly cyclic females. Thus, parity had little effect on fecundity in aging females, whereas the cessation of regular ovulatory cycles during aging greatly decreased both the incidence of fertility and the litter size.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676397 TI - Human seminal vesicle-specific antigen during semen liquefaction. AB - Binding of monoclonal antibody MHS-5 to western blots of human seminal plasma was employed to follow the fate of a seminal vesicle-specific antigen (SVSA) during semen liquefaction. Ejaculates from four vasectomized donors were collected in a manner to inhibit liquefaction or to allow liquefaction to proceed at room temperature. Aliquots of the liquefying seminal fluid were removed at specific time points and further liquefaction inhibited with sodium dodecyl sulfate (SDS). Western blot analysis using monoclonal antibody MHS-5 demonstrated that the SVSA epitope in all donors was located on multiple bands ranging in mass from 15-92 kDa in unliquefied ejaculates; immunoreactive peptides below 15 kDa were not detected. As early as 5 min post ejaculation, immunoreactive bands below 15 kDa were identified in liquefying samples. During the same time period (5 min), immunoreactive bands of 69-71 and 58 kDa could not be immunologically detected in liquefying samples. A decrease in immunoreactive staining of components higher molecular mass was accompanied by a concomitant increase in immunoreactive staining of intermediate and small molecular mass molecules during the first 2 h of liquefaction. After 8-24 h of liquefaction, two immunoreactive bands of 10.9 and 12.5 kDa predominated. Between 24 and 48 h, each donor's ejaculate demonstrated a common single immunoreactive band of 10.9 kDa. These results indicate that there is a rapid transformation in mass of the SVSA with major 69 71 and 58 kDa bands being converted to forms of lower mass within 5 min of ejaculation. PMID- 3676398 TI - Changes in the organization of the actin cytoskeleton during preimplantation development of the pig embryo. AB - The organization of the actin cytoskeleton was studied in unfertilized porcine oocytes and preimplantation stage embryos from Day 1 through Day 8 of development. Fixed and detergent-extracted oocytes and embryos were analyzed by fluorescence microscopy after staining with either rhodamine-phalloidin to localize filamentous actin or with affinity-purified anti-actin antibodies to localize the total immunodetectable actin. Whereas unfertilized oocytes contain immunoreactive cytoplasmic actin, rhodamine-phalloidin binding is not detected until fertilization when a prominent cortical staining pattern becomes apparent. In early cleavage stage embryos, filamentous actin is concentrated in the cell cortex of blastomeres especially at sites of cell-cell contact. Compacting morulae exhibit a marked accumulation of actin at the margins of blastomeres where numerous interdigitating cell processes are located. The predominantly pericellular distribution of actin becomes a distinguishing feature of trophectodermal cells in the expanding blastocyst at Day 6 of development; these cells form a prominent actin-limited zone circumscribing the inner cell mass. In Day 8 blastocysts, three cell types are present that are readily distinguishable based upon their actin displays among other cytological features. Trophectodermal cells exhibit continuous actin-rich lateral borders and stress fibers along their basal surface. Inner cell mass cells contain a discontinuous actin boundary and prominent foci of actin along their blastocoelic surface. Lining the blastocoel are patches of endodermal cells in which the actin is exclusively cortical. The data are discussed with respect to differences between species and the chronology of actin rearrangements during preimplantation development of the porcine embryo. PMID- 3676399 TI - The ovulated ovum of the horse: cytology of nonfertilized ova to pronuclear stage ova. AB - Fertilization and early development in the horse were studied by recovering oviductal ova at various times after postovulatory mating. Ova collected between 7 and 22 h post coitum (pc) were examined for evidence of fertilizing sperm, cellular changes accompanying fertilization, and pronuclear development. Five ova collected between 7 and 9 h pc contained a marginal metaphase plate, but had no indication of sperm components; three of these, however, showed reduced numbers of cortical granules. Two activated ova (10 and 14 h pc) were in telophase of the second meiotic division, following incorporation of the fertilizing sperm. The fertilizing sperm was situated in a slight elevation; the nucleus was expanding but lacked a nuclear envelope. The pronuclear stage in the horse began as early as 12 h pc, and lasted at least until 21 h pc. Sperm tail remnants were seen in 5 of 7 pronuclear-stage ova, although the crowding of the cytoplasm with clusters of lipid and vacuoles made discerning sperm tail remnants difficult. The spindles of the metaphase stage of the second meiotic division were oriented radially, that is, at right angles to the cell surface, in all but one ovum, so this orientation is not a response to fertilization. PMID- 3676400 TI - Both P1 and P2 protamine genes are expressed in mouse, hamster, and rat. AB - To date, in mammals except for the mouse and human, only one protamine variant has been isolated from sperm. These mammalian protamines share amino acid sequence homology with mouse protamine 1 (mP1), the tyrosine-containing variant. Southern blot analysis of restriction enzyme digests of hamster and rat liver DNA reveals the presence of sequences homologous to mP1, and also to mouse protamine 2 (mP2) cDNAs. Northern blots of hamster and rat total testis RNA probed with mP2 cDNA confirm that the protamine 2 gene in these species is transcribed into two size classes of mRNA of approximately 830 and 700 nucleotides. However, the relative abundance of the rat and hamster protamine 2 mRNAs (rP2 and hP2) in total testis is approximately 50-fold lower and 2- to 5-fold lower, respectively, than the mouse protamine 2 mRNA. Northern blot analysis of hamster and rat testis polysome gradients demonstrates that although the amount of rP2 mRNA and hP2 mRNA is reduced, both are present on polysomes. The decreased expression of rat and hamster protamine 2 mRNA relative to their protamine 1 counterparts contrasts protamine expression in the mouse testis, where approximately equal amounts of mP1 and mP2 protamine mRNAs are present. These results suggest differential expression of the P1 and P2 protamine genes in three closely related mammals. PMID- 3676401 TI - Hormonal regulation of maternal behavior in rats: stimulation following treatment with ectopic pituitary grafts plus progesterone. AB - Changes in hormone secretions during pregnancy help to stimulate the onset of maternal behavior at parturition. To date, studies have demonstrated that estradiol (E2) appears to be a necessary component in the hormonal induction of maternal behavior in rats and other mammals. In the present study, we have reevaluated the contribution of E2, progesterone (P), and hormone-secreting pituitary grafts in the rapid induction of maternal behavior by measuring the behavioral effects of exposure to various combinations of P and prolactin secreting ectopic pituitary grafts in the absence of estrogen. Adult hypophysectomized and nonhypophysectomized nulliparous rats were ovariectomized 2 3 days (Treatment Day 1) after their arrival in our laboratory. In Experiment #1, experimental, hypophysectomized rats were implanted s.c. with 6 P-filled Silastic capsules and given 2 anterior pituitary (AP) glands that were grafted beneath the kidney capsule on Treatment Day 1. Controls were given blank implants and were sham-grafted. P-filled and blank Silastic capsules were removed on Day 11, and behavioral testing was conducted once-a-day beginning on Day 12 for eleven days. Animals treated with P-plus-pituitary grafts displayed full maternal behavior significantly faster than did controls (median latencies of 3.0 and 7.5 days, respectively). In Experiment #2, nonhypophysectomized rats were assigned to one of three treatments. On Treatment Day 1, one group of rats received 6 P-filled Silastic implants and had 2 AP glands grafted under their renal capsules. A second group of animals received 6 P capsules and was sham-grafted, while controls were given blank implants and were sham-grafted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676402 TI - The estrogenic responses to clomiphene in the different cell types of the rat uterus: morphometrical evaluation. AB - The present study was designed to investigate the dose-response of clomiphene on several estrogenic responses in the immature rat uterus and to compare it to available data on estradiol-17 beta. A dissociation was demonstrated among the different estrogenic responses induced by clomiphene. Very high doses of clomiphene were needed to induce the 6-h uterine eosinophilia and deep endometrial edema, and maximal response levels were not reached at any dose studied. On the contrary, many genomic responses were induced with much lower doses of clomiphene, and maximal response levels were reached with at least the two highest doses of clomiphene. This dissociation is in agreement with the existence of separate groups of responses that are mediated by multiple and independent mechanisms of estrogen action involving different kind of receptors. Luminal epithelial, glandular epithelial, and myometrial hypertrophies were also found to differ with regard to the dose needed to induce this response in each cell type. The dissociation between genomic responses of the different uterine cell types supports the hypothesis of different estrogen receptors for each kind of cell. Clomiphene induces mitoses in the different cell types, but the proportion of mitoses in the cell types was different from that described for estradiol. It is suggested that these differences are also due to differences between receptors involved in cell proliferation. PMID- 3676403 TI - Increased number of mast cells in the dominant follicle of the cow: relationships among luteal, stromal, and hilar regions. AB - The number of mast cells per microscopic field at 450X (0.123 mm2) was determined in the bovine ovary on Days 4, 10, and 19 of the cycle (Day 0 = estrus). Mast cells were observed in the theca externa of follicles, the external capsule of the corpus luteum, and in the stromal and hilar regions of the ovary. The stromal and hilar regions exhibited the highest number of mast cells (per field = 7.51 10.15) compared with the follicular and luteal compartments (2.65-3.70 mast cells/field). Most interestingly, on Day 19 a significant increase in the number of mast cells was observed in the theca externa of the dominant follicle (10.4 mast cells/field) compared with nondominant healthy follicles on Days 4 and 10 (2 3/field). After ovulation, the number of mast cells surrounding the corpus luteum on Day 4 was significantly lower than 19 values in the dominant follicle; this was further diminished on Day 10 of the cycle. These results indicate that the increase in mast cells associated with the dominant follicle on Day 19 may be related to its development and the decline in mast cells related to ovulation. PMID- 3676404 TI - Sexual behavior and fertility of little mice. AB - Male mice homozygous for the little gene mutation (lit) were originally reported to have a marked incidence of infertility. We have previously reported that these diminutive mice have normal spermatogenesis and testicular steroidogenesis. In the present study, one research goal was to determine if the reported infertility was due to a defect in male sexual behavior. Quantitative analyses of male sexual behavior of little mice and their normal siblings were completed. Natural breeding trials were also performed to reexamine the fertility of little male mice. The experimental results suggested that little mice require significantly longer times for the first mount, first intromission, and ejaculation. More importantly, the investigation provided evidence that the little mice were not infertile but that they were subfertile. The diminutive size of the little mice may be the primary etiological factor for the observed subfertility. PMID- 3676405 TI - A theory of follicle selection: II. Computer simulation of estradiol administration in the primate. AB - A theory of follicle selection (Lacker, 1981) is tested in the primate by simulating the effects of estradiol administration at different times, strengths, and durations during the follicular phase of the menstrual cycle (Clark et al., 1981; Zeleznik, 1981; Dierschke et al., 1985). The theory can account for the observed atretogenic effects of circulating estradiol on follicle development including full, partial, and delayed atresia of the dominant follicle (Dierschke et al., 1985) and can explain why similar estradiol doses achieve different qualitative effects when given at different times during the cycle. The theory predicts that recovery from early atresia may be possible, and it can also account for the loss of control in the number of maturing follicles that has been observed when estradiol antibodies are given in the midfollicular phase (Zeleznik et al., 1985). These results support the hypothesis that the selection mechanism in the primate is a consequence of feedback involving an essentially equipotent follicle population interacting through circulating estradiol and pituitary gonadotropins. A quantitative test of the theory awaits experimental identification of the maturation surfaces that are predicted by it. An experimental design for this purpose is proposed. PMID- 3676406 TI - Experimental evidence supporting a mathematical theory of the physiological mechanism regulating follicle development and ovulation number. AB - In higher vertebrates, follicular development is regulated so that the number of follicles that periodically mature and ovulate is controlled within a narrow range. Lacker has proposed a simple mathematical model of follicle development that can account for the regulation of ovulation number. To support the assumption of the theory that follicle interactions are mediated by estradiol acting as a chemical messenger to communicate follicular maturity to the pituitary and other follicles, we have presented data to demonstrate that in the rabbit physiological concentrations of circulating estradiol inhibit follicle maturation. Implants containing estradiol were placed subcutaneously after surgical rupture of the existing follicles that were 1 mm in diameter or larger. Serum estradiol concentrations were maintained near physiological concentrations by the implants. Concentrations of circulating estradiol were 74 +/- 5.7 pg/ml in the untreated groups, whereas the concentrations with the implants were increased by approximately 50 pg/ml/implant over this basal concentration with a range of 100-300 pg/ml. In the control groups, the average number of follicles before surgical rupture was 27 +/- 2.9 and there was no significant difference (p greater than 0.05) in the number of follicles, 26 +/- 1.9, three days after follicle rupture. The follicles ranged in size from 1 mm to 4 mm, and only those over 3 mm were considered mature. In the first group of animals with implants, the total number of follicles before surgery was 19 +/- 3; three days after follicle rupture, the number of follicles was only 9 +/- 1.1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676407 TI - Utilization of circulating androstenedione and testosterone for estradiol production during gestation in the rat. AB - The placenta provides androgen precursors for ovarian estradiol (E2) production during the second half of gestation in the rat. However, no studies have measured E2 synthesis in vivo from circulating testosterone (T) or androstenedione (A) before or after Day 12 of gestation. In addition, it is not known whether the placenta near term continues to serve as the major source of androgens. Therefore, we measured the ovarian conversion of circulating T and A to E2 in vivo on Days 11, 16, and 21 of gestation (term = Day 23). Rats (N = 6-8/group) were anesthetized with pentobarbital and a constant infusion of [3H]T or [3H]A initiated via a jugular vein. After isotopic equilibrium was achieved at 60 min, blood samples were obtained from the contralateral jugular (J) vein and a uterine ovarian (UO) vein, and the ovaries were removed. In a second group of rats on Day 16 of gestation, either the gravid uterus or both ovaries were removed after initiation of isotope infusion, and blood samples obtained 60 min later. Radiolabeled T, A, and E2 were isolated and purified by sequential paper chromatography. The concentration of [3H]E2 following infusion of either androgen was greater in the UO vein than in the J vein on Days 16 and 21 (p less than 0.02), but not on Day 11, of gestation. In animals infused with [3H]T, [3H]E2 (cpm/ml) in UO vein increased (p less than 0.001) from 84 +/- 33 (mean +/- SE) on Day 11 to 357 +/- 30 and 312 +/- 46 on Days 16 and 21, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676408 TI - Food-restricting first generation juvenile female hamsters (Mesocricetus auratus) affects sex ratio and growth of third generation offspring. AB - Female hamsters (Generation 1) were fed ad libitum or were food-restricted to 65 75% of the amount consumed by controls during their first 50 days of life. Subjects were mated at 91 days of age. Their offspring (Generation 2) were fed ad libitum throughout the experiment, and female offspring were also mated at 91 days of age. Generation 3 litters were monitored every fifth day from birth until Day 25 post partum for litter size, sex ratio, and pup weights. Although there were no significant differences in Generation 3 litter sizes at birth, litters descended from food-restricted Generation 1 females (Group R) were significantly smaller on Days 5-25 than litters descended from control Generation 1 females (Group A). Sex ratios remained significantly greater in Group A than in Group R litters from birth to Day 25 but did not vary over time, suggesting similar post partum mortality rates for both male and female pups. Weights of Generation 3 male and female pups did not vary significantly within treatments at any time. Group A males weighed significantly more than Group R males from birth through Day 25, but weights of Group A and Group R females were always similar. Food restriction early in life may have long-term consequences on sex ratios of subsequent generations in hamsters. PMID- 3676409 TI - Time-course and steroid specificity of aromatase induction in rat hypothalamus preoptic area. AB - We studied the time-course and steroid specificity for aromatase induction in the hypothalamus-preoptic area (HPOA) of the adult male rat. Aromatase activity (AA) was measured in tissue homogenates by using a radiometric assay that quantifies the stereospecific production of 3H2O from [1 beta-3H] androstenedione. We found that by 48 h after administration of testosterone, HPOA AA was significantly (p less than 0.01) greater than control values in castrated rats. In contrast, AA was significantly (p less than 0.01) reduced 12 h after castration, and reached its lowest levels by 4 days after castration. Several other steroids, administered in 3-cm Silastic capsules for 7 days, were tested for their capacity to induce hypothalamic AA. In addition to testosterone, only 5 alpha dihydrotestosterone and 5 alpha-androstane-3 alpha, 17 beta-diol were effective. Neither the stereoisomers of these compounds nor several other steroids, including estradiol, progesterone, and corticosterone, were active. This profile of activity indicates that the induction of HPOA AA is androgen-specific and, together with the demonstrated time-course of induction, lends further support to the hypothesis that androgens regulate AA through a receptor mechanism and the synthesis of new protein. PMID- 3676410 TI - Absence of an increase in gonad-independent drive to pulsatile luteinizing hormone secretion during photoperiod-induced puberty. AB - This study was conducted to determine if photoperiod can influence the pattern of luteinizing hormone (LH) secretion in the absence of the ovaries in the developing female sheep. Lambs were raised in a photoperiod sequence (short, long, short days) known to induce puberty between 30 and 35 wk of age, or in a photoperiod (only short days) that prevents puberty during the first year. Their ovaries were removed at 10 wk of age, and the detailed pattern of LH was assessed (samples at 12-min intervals for 4 h) each 3- to 5-wk period between 9 and 45 wk of age. Rapid LH pulses (40- to 50-min interpulse interval) were evident within a few weeks after ovariectomy in both groups of females. Those exposed to the artificial photoperiod sequence that induces normal sexual maturity did not increase their pulse frequency further during the pubertal period. Moreover, their LH pulse frequencies were not greater than those in agonadal females exposed to the photoperiod that delays puberty. These findings indicate that photoperiodic induction of puberty in the sheep does not require steroid independent modulation of pulsatile LH secretion. PMID- 3676411 TI - Blood flow changes and vascular appearance in preovulatory follicles and corpora lutea in immature, pregnant mare's serum gonadotropin-treated rats. AB - In the present study, synchronized follicular growth, ovulations, and luteogenesis were prematurely induced in 26-day-old immature rats by the s.c. injection of 4 IU of pregnant mare's serum gonadotropin (PMSG) at 2100 h. Relative blood flow of follicles/corpora lutea, fallopian tube, and uterus was measured with radioactive microspheres during the periovulatory period (Day 28, 1700 h-Day 31, 1300 h). Also, follicular/corpus luteal light microscopy and plasma progesterone were studied at the same intervals after PMSG injection. It was found that the relative follicular blood flow did not increase after the endogenous gonadotropin surge (Day 29, 0300-0500 h) and toward ovulation (Day 29, 1300-1500 h). During the same time period, light microscopy showed an interstitial edema and extravasation of erythrocytes appearing in the follicular wall near the time of ovulation. The relative blood flow reached its nadir in the young corpus luteum (21 h after ovulation) and increased thereafter (i.e., 48 h after ovulation). Plasma progesterone showed a preovulatory increase and then declined just prior to the ovulatory period. Between 24 and 48 h after ovulation, parallel increases in relative blood flow, morphological vascularization, morphological luteinization, and plasma progesterone levels were observed in the growing corpus luteum. These data indicate that a functional relationship between blood flow and steroid output may exist within the ovarian follicle and corpus luteum. PMID- 3676412 TI - Functional differences between small and large luteal cells of the late-pregnant vs. nonpregnant cow. AB - This paper describes an in vitro model for the study of two types of steroidogenic luteal cells from cows in different physiological states. Two different populations of enzymatically dispersed bovine luteal cells were separated on the basis of size in a Cel-Sep Sedimentation Chamber. The separated small (12.5-23 micron in diameter) and large (greater than 23 micron in diameter) luteal cells of late-pregnant cows (Days 190-280) contained the distinct morphological characteristics previously defined for these two populations of cells. Cells were evaluated for progesterone (P4) production during a 3-h incubation with and without bovine luteinizing hormone (bLH, 10 ng/ml). Both small and large luteal cells from the late-pregnant cow were found to contain equal levels of P4 at Time 0 and increased but equal levels of P4 after a 3-h incubation. Neither cell type showed an increase in P4 production in response to the addition of bLH (p greater than 0.05). Since these results differed from earlier reports for luteal cells of the nonpregnant cow, small and large luteal cells of the mid-cycle (Day 14) were incubated, and the levels of P4 production were compared with P4 levels from the late pregnant cow. In agreement with previous reports for nonpregnant cows, progesterone content at Time 0 was 7-fold higher in large cells than in small cells (p less than 0.05), and after 3 h of incubation, 13-fold higher (p less than 0.05). Although the small cells responded to the presence of bLH in the incubation medium with a 4-fold increase in P4 production, this increase was not significant (p greater than 0.05). The large cell did not respond to bLH. However, the large cell type continued to contain and produce more P4 than did the small cells treated with bLH. This study indicates that both the small and large luteal cells of late-pregnancy are able to produce P4. However, the large luteal cell of the estrous cycle produces greater quantities of P4 than does the small luteal cell or the large luteal cell of late pregnancy. PMID- 3676413 TI - The roles of prolactin and testosterone in the development and function of granulosa lutein tissue in the rat. AB - The luteotropic roles of prolactin and testosterone (or estradiol formed in luteal tissue) were investigated in hypophysectomized rats with homografts of granulosa lutein tissue. Using this approach, we could determine the effects of prolactin independently of estrogen, since granulosa lutein tissue does not produce estrogen de novo under these conditions. Luteinizing granulosa cells were expressed from the ovaries of immature pregnant mare's serum gonadotropin-primed Fischer 344 rats 6 h after injection of human chorionic gonadotropin. The cells were transplanted beneath the kidney capsule of adult, hypophysectomized, ovariectomized Fischer 344 recipients, which were treated with hormones daily for 12 or 14 days. In rats without treatment (no hormones, n = 3) and in rats treated with only testosterone (Silastic capsule, n = 6), only small amounts of luteal tissue (less than 5 mg/rat) were found and serum progesterone remained at low concentrations (10 ng or less) throughout the experiment. In contrast, in rats treated either with ovine prolactin (300 micrograms/day, n = 10) or with the combination of prolactin and testosterone (n = 12), serum progesterone increased to 43 ng/ml by Day 8. Beyond Day 8, serum progesterone continued to rise in rats treated with the combination of prolactin and testosterone to reach a mean value of 87 ng/ml by Day 14, and mean homograft wet weight was 49 mg/rat; in rats treated with only prolactin, serum progesterone decreased to 25 ng/ml by Day 14 and homograft wet weight was lower (24 mg/rat). Prolactin and testosterone together stimulated more homograft aromatase activity in vivo than did prolactin alone, but the in vitro production of progesterone was not different.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676414 TI - The fungicide methyl 2-benzimidazole carbamate causes infertility in male Sprague Dawley rats. AB - A serial breeding technique was used to evaluate the fertility of male Sprague Dawley rats after exposure to the fungicide carbendazim (methyl 2-benzimidazole carbamate). Proven-fertile male rats (90 days old) received 10 daily doses of corn oil or carbendazim (400 mg/kg/day) peroral. Each male was bred with a new female each week; breeding began on the third day of treatment and continued for 32 wk after the last day of chemical exposure. Twelve days after each breeding period, the females were killed, their uteri were examined for resorptions, and the number of dead and viable fetuses was determined. All males were killed 35 wk post exposure, and testicular tissue was prepared for histopathological examination by vascular perfusion. Fertility (percent fertile as indicated by pregnant females) of males in the carbendazim-treated group was depressed the first post-exposure week; 10 of the 24 treated males failed to produce a pregnant female as compared with no failures in the control group. By the fifth post exposure week, 16 of the 24 carbendazim-treated males were infertile. Of these 16 males, 4 recovered fertility after a failure to produce a pregnant female for 5 11 consecutive breeding periods. However, 12 of the males did not recover fertility during the remainder of the 32-wk post-exposure period. Histological examinations of testicular sections 245 days post exposure revealed that exposure to carbendazim caused severe seminiferous tubular atrophy (greater than 85% of tubules were atrophic) in those carbendazim-treated males that failed to recover fertility.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676415 TI - Plasma relaxin levels in pregnant and lactating dogs. AB - The pattern of plasma relaxin has been studied during pregnancy and following parturition in two breeds of dogs, Labrador retrievers and beagle hounds. Blood samples were collected at weekly intervals following mating and during pregnancy, parturition, and lactation. Relaxin, progesterone, and estradiol-17 beta were determined by specific double antibody radioimmunoassays. Immunoreactive relaxin (IR) was not detectable in plasma of male dogs, bitches in anestrous, or pseudopregnant bitches that had undergone an infertile mating. IR was first detectable in plasma in the third or fourth week of gestation in retrievers and beagles. IR levels rose to a peak of 4-5 ng/ml in both breeds. The peak plasma levels were reached 2-3 wk before whelping and declined significantly prior to that event. IR then persisted during lactation at a level of 0.5-2 ng/ml for 4-9 wk, but was significantly higher (p less than 0.01) at all time periods and persisted longer in labradors than in beagles. The secretion of relaxin did not parallel that of progesterone, which was highly elevated in the first samples drawn (during the first week of pregnancy), remained high through 5 or 6 wk of gestation, then slowly declined until the time of parturition, becoming undetectable during lactation. Plasma estradiol-17 beta was low after the second week of pregnancy in both breeds of dogs and became undetectable during lactation. The source of relaxin in the dog is not known currently, and its sites of secretion and role in pregnancy are currently under investigation in our laboratories. The dog is the first species in which plasma IR is detectable during lactation using antibody R6.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676416 TI - Effect of photoperiod on the size of the Leydig cell population and the rate of recruitment of Leydig cells in adult Syrian hamsters. AB - The number of Leydig cells was determined by stereologic procedures in adult Syrian hamsters housed in long days (14L:10D) to maintain testicular activity (active), in short days (5L:19D) for 12-13 wk to induce testicular regression (photoperiod-induced regressed), or in short days for a period of 21 wk or more to allow spontaneous gonadal recrudescence (spontaneously recrudesced). Testes were removed, sliced, fixed, embedded in Epon 812, and observed by bright-field microscopy. Testicular and seminal vesicle weights, plasma testosterone concentration, total Leydig cell volume per testis, and volume of single Leydig cell were greater (p less than 0.01) in active and recrudesced animals than in regressed animals. The density of Leydig cells was greater in the regressed testes, but the total number per testis was not influenced by photoperiod. In Experiment 2, the rate of recruitment of Leydig cells was determined in 5 adult hamsters exposed to long days (active) or 5 hamsters whose testes were regressed by exposure of animals to short days for 13 wk followed by long-day exposure to initiate testicular growth (photoperiod-induced recrudescing). Hamsters were injected for 3 days/wk for 3 wk with tritiated thymidine, 0.5 or 1 microCi/g body weight. Testes were fixed and tissues prepared, as above, and processed for autoradiography. Again, the photoperiod did not influence the number of Leydig cells per testis. Labeling of Leydig cell nuclei revealed that recruitment of new Leydig cells occurred at approximately 1.3% per day in recrudescing testes but also occurred at approximately 0.6% per day in active testes. Without change in the total number of Leydig cells, new Leydig cells were added continually to the existing population in adult hamsters with either recrudescing or active testes. PMID- 3676417 TI - Quantification of human spermatogenesis: germ cell degeneration during spermatocytogenesis and meiosis in testes from younger and older adult men. AB - Germ cell degeneration during spermatocytogenesis and meiosis was investigated to explain the age-related decline in daily sperm production (DSP). Numbers of Types A-dark, A-pale, and B-spermatogonia, potential daily sperm production per g parenchyma (PDSP) based on type B-spermatogonia, early primary spermatocytes, and late primary spermatocytes, and DSP per g based on early spermatids were determined in 15 men aged 20 to 48 yr (mean +/- SEM, 33 +/- 2 yr) and 15 men aged 52 to 90 yr (65 +/- 3 yr). Testes obtained within 15 h of death (largely due to trauma or heart failure) were perfused vascularly with glutaraldehyde. The number of each cell type per g parenchyma was calculated as the product of the percentage of nuclei in the parenchyma times a correction factor for section thickness and nuclear diameter divided by the volume of a single nucleus of that cell type. Paired testicular weight was lower (p less than 0.01) in older men (33 +/- 3 g) than in the younger men (49 +/- 3 g). Younger and older men had similar numbers of A-dark, A-pale, and B-spermatogonia per g parenchyma. PDSP based on late primary spermatocytes and DSP based on early spermatids were lower (p less than 0.01) in older men than in younger men. In younger men, PDSP was similar (p greater than 0.05) between B-spermatogonia and late primary spermatocytes, whereas DSP measured at the spermatid level was abruptly lower than that estimated from younger cell types. Older men showed reduction in PDSP between early and late primary spermatocytes, with further reduction occurring in DSP at the spermatid level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676418 TI - Adhesion of cultured human endothelial cells onto methacrylate polymers with varying surface wettability and charge. AB - The adhesion of human endothelial cells (HEC) onto a series of well-characterized methacrylate polymer surfaces with varying wettabilities and surface charges was studied either in serum-containing (CMS) or in serum-free (CM) culture medium. HEC adhesion in CMS onto (co)polymers of hydroxyethyl methacrylate (HEMA) and methyl methacrylate (MMA) was found to be optimal on the moderately wettable copolymer (mol ratio 25 HEMA/75 MMA). Positively-charged copolymers of HEMA or MMA with trimethylaminoethyl methacrylate-HCl salt (TMAEMA-Cl), both with mol ratios of 85/15 and a negatively-charged copolymer of MMA with methacrylic acid (MAA), mol ratio 85/15, showed high numbers of adhering HEC. In CM, HEC adhered onto the three charged copolymers mentioned above, but neither onto the copolymer of HEMA and MAA (mol ratio 85/15) nor onto the HEMA/MMA co- and homopolymers. Complete cell spreading in CM was only observed on the positively-charged copolymers. PMID- 3676419 TI - Properties of extruded poly(tetramethylene oxide)-polyurethane block copolymers for blood-contacting applications. AB - The bulk and surface properties and blood compatibility of a series of polyurethanes based on methylene bis(p-phenyl isocyanate), 1,4-butanediol, and poly(tetramethylene oxide) of molecular weight 1000 were studied. The hard-to soft segment ratio of these multiphase polymers was varied, and the effect of substituting a poly(dimethylsiloxane)-containing polyol in place of 5% of the polyether soft segment was studied. Bulk properties such as tensile strength and modulus increased with hard segment content, as did surface wettability and ESCA nitrogen content. However, blood compatibility measured by a canine ex vivo blood contacting experiment was not found to vary with hard/soft segment ratio. The addition of the silicone-containing polyol did not significantly lower the surface wettability, although ESCA-measured silicon content increased and physical properties were unfavourably affected by the incorporation of this co soft segment. Incorporation of the siloxane-containing component resulted in increased platelet adhesion and fibrinogen deposition at most blood contact times in comparison with the other polyurethanes. PMID- 3676420 TI - General solution of the diffusion equation: application to formaldehyde sterilization and desorption of polymers. AB - A general solution of the diffusion equation for gas in polymers is developed by a numerical method. This solution allows diffusion to be calculated in all cases, by gas desorption after an incomplete adsorption, which is not the case for analytical solutions. When the analytical solutions are valid, both types of solution give identical results. The effect of equivalent sterilization treatment at different temperatures and gas concentrations on formaldehyde residuals in 9 polymers is calculated. High temperature gives lower residual content. Short sterilization times at high gas concentration produce a higher residual content at the end of the adsorption and a lower residual content during desorption than longer sterilization times with lower gas concentration. This is due to sharper gradients of diffusant in the polymer. PMID- 3676421 TI - Polymers for biodegradable medical devices. III. Polymerization and copolymerization of cyclic derivatives of tartronic acid. AB - The syntheses of anhydrosulphite and anhydrocarboxylate derivatives of tartronic acid are described. These compounds, more correctly named 5-carboxy-1,3,2 dioxathiolan-4-one-2-oxide and 5-carboxy-1,3-dioxolan-2,4-dione have been shown to undergo polymerization and copolymerization to poly-alpha-esters containing the tartonic acid residue, characterized by the presence of a pendant carboxyl group. Thermal polymerization of the anhydrosulphite appears to proceed in a substantially identical manner to other members of the series in which the monomer decomposes by a first order process to yield an alpha-lactone which polymerizes by a rapid chain growth reaction. Because the rate of thermal polymerization of tartronic acid anhydrosulphite is much more rapid than simple alkyl substituted anhydrosulphites, copolymerization favours the former residues. More successful copolymerization was achieved by the use of tertiary base initiators and the anhydrocarboxylate derivative of tartronic acid. The polymers and copolymers described are of potential value in the synthesis of drug-carrying biodegradable matrices or more hydrophilic analogues of poly(glycolic acid) which combine the known bioerodibility of the moiety with that presence of a pendant carboxyl group. PMID- 3676422 TI - Microencapsulation of CHO cells in a hydroxyethyl methacrylate-methyl methacrylate copolymer. AB - Chinese hamster ovary fibroblasts, as model cells, have been microencapsulated in a hydroxyethyl methacrylate-methyl methacrylate copolymer (HEMA-MMA) by interfacial precipitation. The polymer containing approximately equal to 75 mol% HEMA, dissolved in polyethylene glycol 200 (PEG 200) was coextruded with the cell suspension (4-6 X 10(5) cells/ml in the alpha-MEM with 10% foetal calf serum +/- Ficoll 400/PBS) through a concentric needle assembly. Polymer solution droplets, containing cells, were blown off the end of the needle assembly by a coaxial filtered air stream into a nonsolvent bath containing phosphate buffered saline (PBS) with 5 ppm Pluronic L101, overlaid with hexadecane. The nascent capsules hang at the hexadecane/PBS interface while the solvent is extracted into the aqueous nonsolvent, to precipitate the polymer around the cells. The resultant capsules were 500 microns-1 mm in diam. with a microporous sponge-like interior, and also very tough and flexible. The cells survived encapsulation based on subculture ability, retention of some fluorescein diacetate (FDA) activity over 5 d and direct light microscopic evidence of cell growth over 10 d after histological sectioning and staining. However, cell growth was not uniformly observed (especially in the FDA assay) and this was attributed to space limitations for growth within the microporous interior. Continued development of this process and adaptation to cells such as pancreatic islets is expected to lead to hybrid artificial organs which are capable of ameliorating metabolic disorders such as diabetes. PMID- 3676423 TI - The preclinical evaluation of the water vapour transmission rate through burn wound dressings. AB - The control of evaporative water loss, following burn injury, is of major importance to the overall condition of the patient, whether this control is by natural eschar or by a dressing. It is therefore important to preclinically determine the water vapour transmission rate of these dressings, firstly to make comparisons between different materials and secondly to screen prototype materials, under controlled conditions. A preclinical (in vitro) technique is described and the results are given for several commercially available dressings which encompass foam, film and hydrogel material categories. PMID- 3676424 TI - An in vitro assessment of wound dressing conformability. AB - An in vitro assessment technique has been developed to determine the conformability of wound dressings. The technique employed is based on an inflation technique which provides a measurement of the minimum radius of curvature which a specific dressing will adopt under pressure. A pressure of 40 mmHg was chosen as this had been shown to be the maximum tolerable pressure before the occurrence of tissue breakdown. This radius is then matched to the natural radii of the body surfaces and an assessment of conformability can be made. A series of commercially available dressings have been assessed with respect to their conformability, and to the enhancement of their conformability due to viscoelastic creep behaviour. PMID- 3676425 TI - The effect of grinding conditions on the toxicity of cobalt-chrome-molybdenum particles in vitro. AB - Powders of cobalt-chrome-molybdenum alloy were produced by grinding larger particles for 8 h in water, serum or joint fluid. They were administered, in low doses (0.05-0.5 mg/ml) for 1-6 d, to human dermal fibroblasts in vitro. Particles were ground in a biological fluid in order to simulate conditions in an artificial hip joint. Such particles adhered to, or were phagocytosed by, the cells far less than those ground in water. The toxicity of the alloy was linked with a failure of test cells to grow as quickly as the controls - particles ground in water were the most toxic. PMID- 3676426 TI - Evaluation of the biocompatibility of a Ni-Cr-Mo dental alloy with human gingival explant culture in vitro: morphological study, immunodetection of fibronectin, and collagen production. AB - This study was undertaken to evaluate the biocompatibility of a Ni-Cr-Mo dental casting alloy by an in vitro explant culture method. Through ultrastructural features, the immunolabelling of fibronectin, and the immunodetection of type I and III collagen production, we investigated the behaviour of gingival cells (both fibroblasts and epithelial cells) in contact with the alloy in comparison with control cultures. Our results indicate that cultured gingival cells present a well preserved ultrastructure and synthesized fibronectin (the main glycoprotein involved in adhesion to substrates). The alteration of collagen production concerned only type III collagen which decreased significantly in the cultures on the dental alloy. PMID- 3676427 TI - Diffusion characteristics of alginate membranes. AB - The diffusive properties of alginate membranes prepared by the interfacial reaction of sodium alginate solution with gypsum substrates were studied. The penetrants of primary importance for the above study were methyl methacrylate (MMA) and water, since alginate membranes are used as mould release agents, during the casting of poly(methyl methacrylate) (PMMA) in gypsum moulds in a water bath. Vapour sorption measurements were carried out at various temperatures. The effect of temperature and the combined action of water and MMA on the swelling behaviour of the membrane was also investigated. The results indicate that the water sorption of alginate membranes is non-Fickian, in spite of the linearity of the curves obtained by plotting Mt/M infinity versus t 1/2, at least for a short time period. The membrane treatment with methyl methacrylate, leads to considerably lower equilibrium sorption, possibly because of the formation of a thin film of poly(methyl methacrylate) on the membrane surface. PMID- 3676428 TI - Renal cortical mercury levels associated with experimental amalgam tattoos: effects of particle size and amount of implanted material. AB - Powdered dental amalgam that had passed through either a 106 microns or a 45 microns sieve was implanted subcutaneously in guinea pigs for periods of up to 2 yr. The renal cortical mercury levels associated with the 106 microns material were on average 16% of those produced by the 45 microns material. A reduction in the amount of 45 microns powder implanted, by a factor of 75%, resulted in a fall of only 27% in renal mercury concentrations. The marked effect of particle size on mercury release may be explained by the large increase in the proportion of implanted material that was degraded within phagocytic cells in the local lesions. PMID- 3676429 TI - Prediction of feed comonomer and solvent composition for monomer-free polymer production. AB - A method has been developed to establish the desirable polymerization conditions for the production of monomer-free polymer at 100% conversion. The limits of desirable comonomer composition and solvent content in the feed are determined for both bulk and solution homo- and copolymerizations. An example of the result of the polymerization of 2-hydroxyethyl methacrylate and methyl methacrylate is used to illustrate the application of this method. PMID- 3676430 TI - Variations in tooth surface temperature in the oral cavity during fluid intake. AB - Measurements were made of the extremes in temperature which occur at different sites in the oral cavity during fluid intake. The results indicate that temperatures noted at the tooth surface, within the mouth, during fluid intake were less than the temperatures of the fluid imbibed. Variations in temperature were noted in different areas of the mouth. This may be associated with the position of the tongue during swallowing and the effect of the tissues of the oral cavity as heat absorbers. The range of temperatures noted at the tooth surface and the duration of the temperature changes were at variance with those utilized in many thermocycling studies. It is suggested that closer alignment with the clinical situation is desirable. PMID- 3676431 TI - [Phantoms for quality assurance in quantitative studies with Scheimpflug photographs]. PMID- 3676432 TI - [Method of video capillary microscopy: determination of geometric and dynamic measuring parameters]. PMID- 3676433 TI - [Processing of bones with sawing equipment]. PMID- 3676434 TI - Oxygen-organophosphate linkage in hemoglobin A. The double hump effect. AB - At low concentrations of chloride ions, and in the presence of nonsaturating concentrations of organophosphates, the oxygen equilibrium curves (OEC) for solutions of human adult hemoglobin exhibit a biphasic shape conveniently revealed by graphical analysis of the first derivative of the Hill equation with a characteristic form that we call "the double hump effect." This shape, observed for sub-saturating concentrations of organophosphates, stands in marked contrast to the simple lateral shifts of the OEC represented largely by scaling factors when pH or chloride are varied. In the case of protons or chloride, there is a self-buffering effect due to the presence of a large reservoir of proton or chloride binding sites not necessarily linked to oxygen, whereas such sites do not exist in the case of organophosphates. In addition, in the former case, we are dealing with curves measured at constant activity of the effector, while in the latter, at constant concentration. In the presence of saturating concentrations of inositol hexaphosphate (IHP), at low chloride concentration, the entire OEC is shifted to the right, including both its upper and lower asymptotes, indicating a decrease in the intrinsic oxygen affinities of both the T and R states. Theoretical considerations leading to a successful modeling of OEC obtained under nonsaturating and saturating concentrations of IHP required an expanded two-state allosteric model in which IHP-dependent variations in oxygen association constants for both the T and R conformations are taken into account. PMID- 3676435 TI - Magnetic particle motions within living cells. Physical theory and techniques. AB - Body tissues are not ferromagnetic, but ferromagnetic particles can be present as contaminants or as probes in the lungs and in other organs. The magnetic domains of these particles can be aligned by momentary application of an external magnetic field; the magnitude and time course of the resultant remanent field depend on the quantity of magnetic material and the degree of particle motion. The interpretation of magnetometric data requires an understanding of particle magnetization, agglomeration, random motion, and both rotation and translation in response to magnetic fields. We present physical principles relevant to magnetometry and suggest models for intracellular particle motion driven by thermal, elastic, or cellular forces. The design principles of instrumentation for magnetizing intracellular particles and for detecting weak remanent magnetic fields are described. Such magnetic measurements can be used for noninvasive studies of particle clearance from the body or of particle motion within body tissues and cells. Assumptions inherent to this experimental approach and possible sources of artifact are considered and evaluated. PMID- 3676436 TI - Magnetic particle motions within living cells. Measurement of cytoplasmic viscosity and motile activity. AB - Submicrometer magnetic particles, ingested by cells and monitored via the magnetic fields they generate, provide an alternative to optical microscopy for probing movement and viscosity of living cytoplasm, and can be used for cells both in vitro and in vivo. We present methods for preparing lung macrophages tagged with magnetic particles for magnetometric study. Interpretation of the data involves fitting experimental remanent-field decay curves to nonlinear mechanistic models of intracellular particle motion. The model parameters are sensitive to mobility and apparent cytoplasmic viscosity experienced by particle containing organelles. We present results of parameter estimation for intracellular particle behavior both within control cells and after (a) variable magnetization duration, (b) incubation with cytochalasin D, and (c) particle twisting by external fields. Magnetometric analysis showed cytoplasmic elasticity, dose-dependent motion inhibition by cytochalasin D, and a shear thinning apparent viscosity. PMID- 3676437 TI - A new constitutive formulation for characterizing the mechanical behavior of soft tissues. AB - We present a new constitutive formulation that combines certain desirable features of two previously used approaches (phenomenological and microstructural). Specifically, we assume that certain soft tissues can be idealized as composed of various families of noninteracting fibers and a homogeneous matrix. Both the fibers and the matrix are assumed to follow the gross deformation. Within the usual framework of pseudoelasticity, incompressibility, homogeneity, and the continuum hypothesis, a pseudostrain energy function (W) is proposed wherein W is expressed in terms of matrix and fibrous contributions. Unlike phenomenological approaches where a W is usually chosen in an ad hoc manner, the present approach can be used to postulate reasonable forms of W based on limited structural information and multiaxial stress-strain data. Illustrative applications of the theory are discussed for visceral pleura and myocardium. Concise structurally motivated constitutive relations result, wherein load-dependent anisotropy, nonlinear material behavior, finite deformations, and incompressibility are accounted for. PMID- 3676438 TI - Activity-dependent calcium transients in central nervous system myelinated axons revealed by the calcium indicator Fura-2. AB - Optical measurements from rat optic nerve, loaded with the new Ca2+ indicator Fura-2, provide the first evidence for the presence of activity-dependent fast intracellular [Ca2+] transients in mammalian central nervous system (CNS) myelinated axons. The results suggest that voltage-dependent Ca2+ channels are present in some of the myelinated axons. Optical measurements from axons stained with anterogradely transported voltage-sensitive dye suggest the presence of Ca2+ dependent potassium conductances in these axons. This report also demonstrates that Fura-2 can readily detect changes in [Ca2+] inside cells as a result of electrical activity, and establishes its suitability for measurements of intracellular Ca2+ transients in the millisecond time domain. PMID- 3676439 TI - Kinetics of charge transfer at the lipid bilayer-water interface on the nanosecond time scale. AB - Advances in instrumentation allow electrical measurements across the planar lipid bilayer to be made with nanosecond time resolution. The electron transfer reaction between photoexcited magnesium octaethylporphyrin in the lipid to a variety of ionically charged acceptors in the water is found to be purely dynamic over a wide range of concentrations of acceptors and up to the time constant of the apparatus, 4 ns. The saturation of the amplitude of the photovoltage with increasing concentration of acceptor is caused by the finite lifetime of the excited state, not by formation of a static pigment-acceptor complex. The reactions are an excellent probe of the lipid-water interface over an extended time scale. No appreciable barrier to reaction exists at this interface beyond the 5-ns time. That is, any water or choline group structure may be evanescent on this time scale. Electrostatic interactions indicate that the acceptor molecules penetrate to the level of the phosphocholine groups with differing orientations. It will be possible to extend the time scale into the picosecond range by decreasing the response time and by deconvolutions. PMID- 3676440 TI - Raman microscope and quantum yield studies on the primary photochemistry of A2 visual pigments. AB - The 77-K resonance Raman vibrational spectrum of intact goldfish rod photoreceptors containing 3,4-dehydro (A2) retinal is dominated by scattering from the 9-cis component of the steady state at all excitation wavelengths. Intact goldfish photoreceptors were regenerated with an A1-retinal chromophore to determine whether this behavior is caused by the protein or the chromophore. The resulting Raman spectrum was typical of an A1-pigment exhibiting significant scattering from all three components of the steady state: rhodopsin, bathorhodopsin, and isorhodopsin. Furthermore, regeneration of bovine opsin with A2-retinal produces a characteristic "A2-Raman spectrum" that is dominated by scattering from the 9-cis pigment. We conclude that the differences between the Raman spectra of the A1-and A2-pigments are caused by some intrinsic difference in the photochemical properties of the retinal chromophores. To quantitate these observations, the 77-K adsorption spectra and the photochemical quantum yields (phi) of the native A2-goldfish and the regenerated A2-bovine pigments were measured. In the goldfish A2-pigment, the value of phi 4 (9-cis----trans) is 0.05; phi 3 (trans----9-cis) is 0.10; and phi 2 (trans----11-cis) is 0.35. By contrast, in the bovine A1-pigment, these quantum yields are 0.10, 0.053, and 0.50, respectively. The reduced value of phi 4 and the increased value of phi 3 in the goldfish pigment confirms that the 9-cis isomer is photochemically more stable in A2-pigments. PMID- 3676441 TI - In vivo measurements of intra- and extracellular Na+ and water in the brain and muscle by nuclear magnetic resonance spectroscopy with shift reagent. AB - The introduction of new paramagnetic shift reagents in the nuclear magnetic resonance (NMR) method has made it possible to distinguish intra- and extracellular ions in tissues or organs in vitro. We measured the intra- and extracellular 23Na and 1H in vivo in the gerbil brain and skeletal muscle by NMR spectroscopy employing the shift reagent, dysprosium triethylenetetraminehexaacetate (Dy[TTHA]3-). Without Dy(TTHA)3-, the 23Na and 1H signals were seen only as single peaks, but gradual intravenous infusion of Dy(TTHA)3- separated these signals into two peaks, respectively. The unshifted peaks reflected the intracellular 23Na and 1H signals, while the shifted peaks reflected the extracellular signals. In the brain spectra, an additional small peak, which represented intravascular signals, was detected and its intensity increased after injection of papaverine hydrochloride. The present method is advantageous over the microelectrode technique because of its nondestructiveness and its capability for obtaining intra- and extracellular volume information from measurements of the 1H spectra, the peaks of which reflect the intra- and extracellular water amounts. The intracellular Na+ increase associating with increased cellular volume after ouabain in the muscle was clearly visualized by this method. The technique is clearly of use for physiological and pathophysiological studies of organs. PMID- 3676442 TI - Conformational changes in bacteriorhodopsin studied by infrared attenuated total reflection. AB - We report on a new method based on Fourier transform infrared (FTIR)-difference spectroscopy for studying the conformational changes occurring during the photocycle of bacteriorhodopsin. Previous studies have been made by measuring the absorbance of an infrared (IR) beam transmitted through a thin hydrated purple membrane film. In contrast, the present study utilizes the technique of attenuated total reflection (ATR). Purple membrane is fixed on the surface of a germanium internal reflection crystal and immersed in a buffer whose pH and ionic composition can be varied. Measurements of the amide I and II absorbance with light polarized parallel and at 45 degrees to the crystal surface reveals that the membrane is highly oriented. An ATR-FTIR-difference spectrum of the light to dark (bR570 to bR548) transition is similar but not identical to the transmittance FTIR-difference spectrum. This disagreement between the two methods is shown to be due in the ATR case to the absorption of transition moments oriented predominantly out of the membrane plane. Raising the pH of La3+ substituted purple membrane films from 6.8 to 8.0 slows the M-decay rate sufficiently so that a bR570 to M412 difference spectrum can be obtained with steady state illumination at room temperature. A comparison of this difference spectrum with that obtained at -23 degrees C using the transmittance method reveals several changes that cannot be attributed to out-of-plane transition moments. An increase in the intensity of peaks in the amide I and II regions agrees with recent time-resolved kinetic FTIR-difference measurements and indicates that a localized protein conformational change involving the peptide backbone of bR occurs which is not evident at the lower temperature. PMID- 3676443 TI - A variable stoichiometry model for pH homeostasis in bacteria. AB - The composition of the proton-motive force of a hypothetical bacterial cell of wide pH tolerance is analyzed according to a model whereby the electron transport chain and various proton-linked sodium and potassium ion transporting modes are responsible for the development of the membrane potential and the chemical potentials of the three cations. Simultaneous use of two or more modes employing the same metal cation, but at a different stoichiometric ratio with respect to protons, produces nonintegral stoichiometry; the modes could represent either different devices or different states of a single device. Cycling of the cation, driven by proton-motive force, results. The relative conductances of the various modes are postulated to be pH-dependent. The pattern of potentials that results is qualitatively in accord with current knowledge and may reflect the mechanism of pH homeostasis in bacteria. The membrane potential is outwardly directed (positive inside) at extremely acid pH, becoming inwardly directed as the pH increases; the pH gradient across the membrane is large and inwardly directed (alkaline inside) at acid pH, becoming smaller and eventually inverting at alkaline pH values; the transmembrane potassium gradient is outwardly directed (high concentration inside) at all pH values; the transmembrane sodium gradient is inwardly directed at all pH values, following the pH gradient from acid through neutral pH, but then diverging at alkaline pH. PMID- 3676444 TI - A microcomputer interface for a digital audio processor-based data recording system. AB - An inexpensive interface is described that performs direct transfer of digitized data from the digital audio processor and video cassette recorder based data acquisition system designed by Bezanilla (1985, Biophys. J., 47:437-441) to an IBM PC/XT microcomputer. The FORTRAN callable software that drives this interface is capable of controlling the video cassette recorder and starting data collection immediately after recognition of a segment of previously collected data. This permits piecewise analysis of long intervals of data that would otherwise exceed the memory capability of the microcomputer. PMID- 3676445 TI - Partial specific volumes of lipid and water in mixtures of egg lecithin and water. AB - We describe in this paper measurements of the partial specific volumes of lipid (upsilon L) and water (upsilon W) in mechanical mixtures of egg yolk lecithin and water over a range of hydrations (5-55 wt% water) that includes the region at which excess water appears. upsilon L and upsilon W are found to be very nearly 1 cm3/g over the entire range. The water activities of the mixtures were also determined and found to be the same as for lipid deposited as oriented multilayers on solid substrates. PMID- 3676446 TI - Scanning calorimetry reveals a new phase transition in L-alpha dipalmitoylphosphatidylcholine. AB - We report a new phase transition in fully hydrated dispersions of dipalmitoylphosphatidylcholine (DPPC). This new transition, called the sub subtransition, exhibits a transition enthalpy of 0.25 kcal/mol with a Tm at 6.8 degrees C. Unlike the subtransition, no extended low temperature incubation is required to observe the sub-subtransition. This new sub-subgel (SGII) phase may be a precursor to the subgel (SGI) phase, and this discovery is discussed in relation to the current knowledge regarding the polymorphic gel phases of both ester- and ether-linked lipids with identical acyl chains. PMID- 3676447 TI - Effects of purified myosin light chain kinase on myosin light chain phosphorylation and catecholamine secretion in digitonin-permeabilized chromaffin cells. AB - Many non-muscle cells including chromaffin cells contain actin and myosin. The 20,000 dalton light chain subunits of myosin can be phosphorylated by a Ca2+/calmodulin-dependent enzyme, myosin light chain kinase. In tissues other than striated muscle, light chain phosphorylation is required for actin-induced myosin ATPase activity. The possibility that actin and myosin are involved in catecholamine secretion was investigated by determining whether increased phosphorylation in the presence of [gamma-32P]ATP of myosin light chain by myosin light chain kinase enhances secretion from digitonin-treated chromaffin cells. In the absence of exogenous myosin light chain kinase, 1 microM Ca2+ caused a 30-40% enhancement of the phosphorylation of a 20 kDa protein. This protein was identified on 2-dimensional gels as myosin light chain by its comigration with purified myosin light chain. Purified myosin light chain kinase (400 micrograms/ml) in the presence of calmodulin (10 microM) caused little or no enhancement of myosin light chain phosphorylation in the absence of Ca2+ in digitonin-treated cells. In the presence of 1 microM Ca2+, myosin light chain kinase (400 micrograms/ml) caused an approximately two-fold increase in myosin light chain phosphorylation in digitonin-treated cells in 5 min. The phosphorylation required permeabilization of the cells by digitonin and occurred within the cells rather than in the medium. Myosin light chain kinase-induced phosphorylation of myosin light chain was maximal at 1 microM Ca2+. Under identical conditions to those of the phosphorylation experiments, secretion was unaltered by myosin light chain kinase. The experiments indicate that the phosphorylation of myosin light chain by myosin light chain kinase is not a limiting factor in secretion in digitonin-treated chromaffin cells and suggest that the activation of myosin is not directly involved in secretion from the cells. The experiments also demonstrate the feasibility of investigation of effects of exogenously added proteins on secretion in digitonin-treated cells. PMID- 3676448 TI - Control of secretory granule interaction and exocytosis in pancreatic cells. AB - Application of the laser-based technique of photon correlation spectroscopy to an in vitro study of the ionic stability and interaction kinetics of zymogen granules isolated from rat exocrine pancreas is described here. In addition the separation from pancreatic acinar cell cytosol of a factor which stabilizes isolated zymogen granules and inhibits cation-induced granule aggregation is outlined. The basis of this action and the significance of the cytosolic inhibitory factor in the regulation of granule mobility and exocytosis in vivo is discussed. PMID- 3676449 TI - [Reflection of the magnitude of the arm rotation angle by the time parameters of kinesthetic evoked cortical potentials in rhesus macaques]. AB - The electrophysiological experiments were carried out on five male macaques rhesus under nembutal anesthesia. Kinesthetic evoked potentials in response to arm rotation in the elbow joint were registered in the contralateral primary somatosensory cortex. The data obtained show a significant increase in the duration of kinesthetic potential first positive component with 10 degrees-40 degrees arm rotation amplitude, as compared to 2 degrees rotation. On the contrary, the latent period and amplitude of the component in this stimulation range (2 degrees-40 degrees) were similar. It is suggested that the increase in the arm rotation angle is selectively reflected in the temporary parameters of kinesthetic potential first positive component. PMID- 3676450 TI - [Afferent determination of transfer factor formation in the rat spinal cord]. AB - The mechanisms causing the appearance of transfer factor (TF) in the cerebrospinal tissue of rats were studied. Intracerebral TF injections to intact recipients were found to change asymmetrically the reflectory muscular responses. TF could be found in the extract of the rat spinal cord in rats with cut off n. tibialis sin. or with alcohol-novocaine blockade of posterior left tibial muscles, i.e., the reaction of the cerebral cells to the break in axon integrity is not responsible for TF formation. The appearance of TF in the cerebrospinal tissue less than two hours after alcohol-novocaine muscular blockade does not suggest that the axon integrity is the cause initiating TF formation. It is assumed that the deafferentation determines TF appearance in the cerebrospinal tissue. PMID- 3676451 TI - [45Ca2+ and 3H-GABA transport in nerve endings separated from the cerebral cortex of rats with hypoparathyroidism]. AB - Ca2+ blood serum level was reduced by 34.5% in rats with hypoparathyroidism (HPT) on the 7th-12th day after the damage of parathyroid glands. Synaptosomes isolated from the brain cortex of rats during this period accumulated in a normal medium more 45Ca2+ than synaptosomes from healthy animals. In potassium depolarization, control and experimental synaptosomes accumulated more 45Ca2+, however in HPT the increment in 45Ca2+ uptake in high potassium medium was less temperature dependent. In normal medium 3H-GABA uptake and release by synaptosomes from the brain of rats with HPT slightly differed from those in the control. On the contrary, 3H-GABA release induced by synaptosome depolarization was depressed in HPT. It is suggested that nerve terminal excretory function disturbances contribute to increased excitability of the central nervous system in hypoparathyroidism. PMID- 3676452 TI - [Modelling psychosis in cats by creating a generator of pathologically enhanced excitation in one of the septal nuclei]. AB - The experiments on adult freely behaving cats have shown that the injection of penicillin into the internal part (TI) of bed nucleus of stria terminalis (BST) caused the formation of the generator of pathologically enhanced excitation (GPEE). This part of BST became hyperactive and played the role of a pathologic determinant which caused the formation of a complex pathologic system and behavioural disorders with catatonia, stereotypy, food rejection, eating of uneatable things, hypoalgesia, zoosocial behavioural changes, depression of different emotions, etc. The development of these disorders was progressing and was accompanied by corresponding electrophysiological activity in TI and other brain structures studied. Coagulation of GPEE zone at the early stages of the process prevented the development of the above disorders. PMID- 3676453 TI - [Characteristics of cardiac regulation in ischemic damage to the ventricular myocardium]. AB - The evoked potentials produced by the irritation of the heart sinus node zone in the brain cortex and bradycardia have been registered in 5 to 40-min ischemia of the left and right ventricular myocardium during the electrical stimulation of the vagus. Restricted cardiac afferentation and the heart escape from vagus influences have been revealed at the early stages of ischemia. PMID- 3676454 TI - [Increased enzymatic activity of antioxidant protection of the heart in the adaptation of rats to short-term stress exposure]. AB - It has been shown that adaptation to short-term emotional-painful stresses leads to an increase in antioxidant enzyme activities but does not change vitamin E content in the myocardium. The most labile enzyme was catalase (35% increase). During stress in nonadapted animals the enzyme activity decreased, as compared to the control, while in the group of adapted animals with subsequent stress the activity was even higher than in the control. During initiation of lipid peroxidation in the heart homogenates in vitro there was a 3-fold increase and a 1%-fold decrease in the oxidation intensity in rats exposed to stress and in adapted animals, respectively. The role of adaptation activation of cardiac antioxidant system in the prevention of stress-induced heart damage is discussed. PMID- 3676455 TI - [Effect of dibunol and isoptin on the creatine kinase and myoglobin content of the blood serum in dogs undergoing postischemic coronary reperfusion]. AB - The effect of an antioxidant dibunol and calcium antagonist verapamil on postperfusion release of myoglobin (Mb) and MB-creatine kinase (MB-CK) has been assessed in 30 dogs with experimental coronary occlusive myocardial infarction. It has been shown that reperfusion after 3-hour ischemia does not only accelerate the release of intracellular proteins, but also leads to pronounced myoglobinemia and blood enzymes. In postischemic blood flow recovery with combined dibunol and verapamil preliminary injections, an almost threefold decrease in MB-CK and Mb blood content, as compared to "reperfusion" indexes, was observed by the 10th minute of reperfusion. PMID- 3676456 TI - [Characteristics of Na+/H+ metabolism in the erythrocytes of rats with spontaneous hypertension]. AB - The dependence of the rate of valinomycin-induced Na+/H+ erythrocyte metabolism on the extracellular K+ concentration has been investigated. It has been established that Na+/H+ metabolism in the erythrocytes of spontaneously hypertensive rats (SHR) is induced at higher [K+]o concentrations than in normotensive controls (WKY). The distinctions in the maximum rate of Na+/H+ metabolism were revealed only in SHR in pre-hypertensive stage (it was 20% lower than in WKY). It is suggested that the distinctions are determined by peculiarities of membrane cytoskeleton formation. The conclusion was confirmed in experiments on erythrocyte stability to orthovanadate effect. PMID- 3676458 TI - [Inhibition of the motility of the gastrointestinal tract by low-molecular peptides from k-casein]. AB - Two low-molecular peptides, peptide III and peptide IV-1, were isolated from peptic digest of k-casein by Sephadex G-50 and BIO-Gel P-2 chromatography. Intravenous administration of these peptides to dogs at a dose of 0.006 mg/kg inhibited food motility of the stomach and duodenum, but did not change or stimulate fasting motility. The duration of the inhibition was decreased with the diminution of the molecular weight of peptide fractions. Peptide III consisted of two inhibitors. Inhibitor I acted immediately after the injection, while inhibitor 2 acted 60-75 minutes later. Being the natural products of food protein proteolysis, these inhibitors may be apparently used in the clinical practice. PMID- 3676457 TI - [Effect of 1-(chloromethyl)silatrane on the alteration of the blood elements during extracorporeal circulation]. AB - The damaging effect of cardiopulmonary bypass on blood elements and the possibility of its correction with 1-(chloromethyl) silatrane have been investigated. Cardiopulmonary bypass is a powerful damaging factor producing a wide range of effects including the activation of lipid peroxidation, reduction of erythrocyte membrane resistance to ultra-sound, destruction of blood elements and appearance of hemoglobin in the plasma (hemolysis). A possible mechanism of cardiopulmonary bypass damaging effect on blood elements is suggested. The use of 1-(chloromethyl)silatrane drastically increases the resistance of blood element membranes to injury, which seems promising for the drug application during cardiopulmonary bypass. PMID- 3676459 TI - [Free amino acids in the blood serum of rats with liver failure developing as a consequence of the functioning of small intestine fistulae]. AB - The experiments on 60 mongrel rats with hepatic failure due to small intestinal fistulas of high and medium location were carried out for the examination of amino acid spectrum in the animal plasma. 16 free amino acids were studied by ion exchange chromatography. It has been established that hepatic failure due to small intestinal fistulas is characterized by the reduction of the total amino acid content by 20-30%. These changes were brought about mainly by the reduction of glucoblastic and essential amino acids. A dramatic (400%) increase in His and a slight (20%) increase in Asp were noted in high fistulas. The changes were caused by profound losses through fistulas which markedly activated gluconeogenesis and led to full exhaustion of amino acid reserves. It was concluded that the question of diagnostic amino acid value should be considered taking into account the amount of losses and the activity of gluconeogenesis in the pathogenesis of hepatic failure. PMID- 3676460 TI - [Determination of the reversible uptake of 3H-serotonin in synaptosomes: an adequate evaluation of the contribution of nonspecific uptake]. AB - Serotonin (5-HT) uptake in synaptosomes was studied at 0 degree C (1), at 37 degrees C in the presence of 100 microM imipramine (IIa) or 100 microM zimelidine (IIb), in the absence of Na+ ions (III) in the incubation medium. A significant decrease (P less than 0.01) of the uptake rate has been found (III greater than IIa, b greater than I). Nonspecific uptake inhibition was thought to be the cause of these differences. Determination of specific uptake, using control III, has shown Na+-dependent transport of 5-HT only on the one type of carrier (Km = 174 + 24 nM). It is concluded that determination of 5-HT nonspecific uptake, using control III, has permitted a more exact evaluation of specific uptake parameters, than determination, using controls I and IIa, b. PMID- 3676461 TI - [Accumulation of acridine amino derivatives by electron-dense granules in thrombocytes]. AB - The uptake and release of dense bodies' content were studied using fluorescent amines. Real-time measurements of fluorescence spectra by a device developed on the basis of a multichannel optical analyzer and computer technique of spectrum deconvolution made it possible to investigate the kinetics of monoamine uptake and release in intact cells. PMID- 3676462 TI - [Interaction of the complex copper compound Cu-2 with liver monooxygenases]. AB - It has been shown that the antitumour drug Cu-2 (copper complex compound) inhibited the activity of liver monooxygenases in male CBA mice. The in vivo experiments have revealed a considerably increased duration of sleep in mice treated with hexenal after the administration of different Cu-2 doses. In vitro, after the incubation of intact mouse liver microsomal fractions with different concentrations of Cu-2 the level of cytochrome Y-450 was decreased and a non active form of hemoprotein--cytochrome P-420--appeared. At the same time, after the incubation of Cu-2 with liver microsomal fractions stabilized by 20% glycerol type I spectral changes (Ks 330 microM) were registered. This shows the possible metabolism of Cu-2 by cytochrome P-450. The role of the revealed interaction of Cu-2 with liver microsomes is being discussed for the chemotherapy of cancer. PMID- 3676463 TI - [Lipid peroxidation in the dynamics of experimental toxic adrenal encephalopathy]. AB - TBA-active product plasma content, unsaturated fatty acid level in erythrocyte membrane and peroxide resistance of erythrocytes 1, 7, 15, 30, 45 and 60 days after the onset of experimental toxico-adrenal encephalopathy (ETAE) have been investigated in the peripheral blood of 7 dogs. The first 30 days were characterized by an increase in the indexes indicative of lipid peroxidation (LPO) intensification and a trend towards their further normalization. It is suggested that at early stages of ETAE LPO intensification plays a predominant role in the pathological chemistry of model dystrophic process, while at later stages the leading role is played by other brain metabolism disturbances, associated with LPO activation. PMID- 3676464 TI - [Role of the microsomal ethanol-oxidizing system in regulating linoleoyl CoA desaturase activity in long-term ethanol loading]. AB - Long-term ethanol load resulted in a decrease of the rat liver linoleyl desaturase activity and the activation of MEOS accompanied by an increase in the activity of NADPH-dependent chain and the initial steps of NADH-dependent chain of microsomal electron transport, indicating electron transfer from NADH to cytochrome P-450. It is suggested that, when the main potential of NADH- and NADPH-dependent chains is transferred to microsomal ethanol oxidation, insufficient electron supply for linoleyl-CoA desaturase decreases the activity of this process. PMID- 3676465 TI - [Effect of hemodynamic disorders on the transepithelial potential of the rat liver in vivo]. AB - The presence of transepithelial electrical potential (TEP) formed on the border between the interstitium and the interior of the rat liver bile capillary has been demonstrated. The initial TEP value (II+ 3 mV) reduced rapidly to zero after the ligation of different portal fissure vessels, while ischemia arrest led to TEP restoration. True periodical oscillations of TEP value with the period and amplitude of about 30 s and 1-2 mV, respectively, were registered. These oscillations appeared in all cases of liver ischemia 5-7 min after ischemia removal and lingered till the end of the experiment. It was assumed that variations in TEP and membrane potential of hepatocytes have the common nature. PMID- 3676466 TI - [Lysosomal enzyme activity of the gastric mucosa in rats during experimental ulcer formation]. AB - Lysosomal membrane stability has been studied in the gastric mucosa in response to mechanical damage caused by lysosomal fractionation and release of lysosomal enzymes from mucous cells into the gastric cavity of alive animals during induction of acetic ulcer or erosive damage of the gastric mucosa resulting from intraperitoneal introduction of histamine and serotonin. It has been found that all types of ulcerogenesis in the gastric mucosa led to the decrease in lysosomal membrane stability to mechanical stress in the course of lysosomal fractionation. In addition there was a substantial release of lysosomal enzymes into the gastric cavity in different types of ulcerogenesis. The decrease in lysosomal membrane stability combined with a subsequent development of ulcers and erosions in the gastric mucosa seems indicative of the fact that lysosomal enzymes take part in the initial formation of ulcers in the gastric mucosa. PMID- 3676467 TI - [Changes in the learning ability of epiphysectomized rats]. AB - The experiments on rats have shown changes in the learning ability of animals. The learning of locomotor reactions of escape and avoidance conditioned reflex was accelerated in animals after pinealectomy. Training of rats in U-shaped and 16-door mazes was significantly affected after pinealectomy. The index of reflex retention (1 and 7 days later) was not changed in the operated animals. Epithalamin (0.5 mg/kg for 5 days) selectively facilitated learning of visual and space discrimination. PMID- 3676468 TI - [Effect of sidnocarb on learning and memory]. AB - It has been established that in well-trained rats sydnocarb (mesocarb) does not exert a considerable effect on the generation of conditioned reflex of passive avoidance (CRPA). On the contrary, in poorly-trained animals sydnocarb significantly improves CRPA indexes at all three stages of its generation. Sydnocarb proved most effective, when injected before training (on day I). The absence of sydnocarb-induced pain threshold decrease in response to electrical pain stimulation suggests a direct drug effect on memory processes. PMID- 3676469 TI - [Effect of bemetil on the perception of visual stimuli]. PMID- 3676470 TI - [Effect of isolation stress on ethanol pharmacokinetics in the blood of rats developing a taste for alcohol and in the stage of physical dependence on alcohol]. AB - Head space chromatography was used to study the rate of ethanol excretion as a criterion of the activity of ethanol-oxidizing enzymatic system in rats. Isolation stress was shown to be one of the factors determining inclination to voluntary ethanol intake. The level of alcohol motivation directly correlated with the degree of stress. At the stage of physical dependence on ethanol the activity of ethanol-oxidizing enzymatic system and ethanol consumption were independent of the isolation stress, but related to profound biochemical and neurochemical variations. PMID- 3676471 TI - [Correction of arterial pressure in rats with hereditary hypertension by altering catecholamine metabolism in early ontogeny]. AB - In a newly developed rat strain with inherited stress-sensitive arterial hypertension (ISSAH) an attempt was made to reduce arterial blood pressure by L DOPA injections during a short time period of the early ontogenesis. It was shown that L-DOPA injections to rats on days 7-9 or 14-16 of life had no effect. The same procedure performed on 21-23 or 21-25-day-old rats was followed by a decrease in the basal and stress-induced arterial blood pressure levels, measured in adulthood. Injections of dopamine-beta-hydroxylase inhibitor (FLA-59) with parallel L-DOPA administration completely blocked the blood pressure decreasing effect. It can be suggested that injections of L-DOPA in the 4th week of post natal life reduce the blood pressure level in ISSAH rats by enhancing the rate of brain noradrenaline biosynthesis. PMID- 3676472 TI - [Participation of cholinergic systems in the recovery period following acute hypobaric hypoxia]. AB - The influence of some cholinergic drugs has been studied during prophylactic treatment and the recovery period after acute hypobaric hypoxia (AHBH) on AHBH model. Cholinolytics and cholinomimetics were shown to produce different effects on the animal resistance to AHBH, their role in the formation of resistance to hypoxia depending on the type of animal, the extent of hypoxic damage and duration of the recovery period after primary AHBH. The experiments performed suggest an important role of cholinergic system in the formation of hypoxic resistance in animals. PMID- 3676474 TI - [Repair in the nuclear matrix of DNA damaged by benz(a)pyrene]. AB - The confluent culture of hamster embryo cells was incubated with benzo(a)pyrene for 24 hours. Then the medium was replaced by maximal lacking both the serum and benzo(a)pyrene. The process of DNA repair was observed in four nuclear fractions according to two indexes: the disappearance of metabolites of benzo(a)pyrene covalently bound to DNA and the incorporation of 3H-thymidine to DNA in the period from I min to 72 hours. Hydroxyurea at the concentration of 5 mM was added 2-19 hours before 3H-thymidine. The highest concentration of benzo(a)pyrene metabolites was found in the DNA of nuclear matrix fraction throughout all the experiment. The initial concentration of 3H-thymidine right after its addition into the cell culture medium was the highest in DNA of nuclear matrix fraction and the lowest in DNA fraction soluble in the buffer with low ionic strength. Later on, the concentration of 3H-thymidine was decreased in matrix-bound fractions and increased in other fractions up to the total DNA level. The results suggest that the repair process requires joining of benzo(a)pyrene damaged DNA region to the nuclear matrix with the following reverse transition into the fraction where the fragment was initially located. PMID- 3676473 TI - [Effect of benzamide derivatives on convulsions induced by the toxic action of oxygen in rats]. AB - The reversible MAO-A inhibitor moclobemide (5 mg/kg) was shown to prevent seizures in rats during exposure to toxic oxygen (6 ata). Benzamide derivatives increased the latent period of oxygen seizures and decreased the lethality following hyperbaric oxygenation. The range of anti-MAO activity of moclobemide and clorgyline in the rat brain and heart after toxic oxygenation was studied. It was distinct from those in control animals. Clorgyline was found to be more active in inhibiting MAO during toxic oxygenation in the heart and moclobemide-in the brain. The possibility is shown to prevent oxygen seizures not only with irreversible MAO-A inhibitors (clorgyline), but also with reversible ones (moclobemide). PMID- 3676475 TI - [Carbohydrate metabolic disorder in experimental secretory diarrhea induced by cholera toxin]. AB - Cholera toxin induced a massive mucus accumulation and a significant enhancement of arteriovenous difference in glucose concentration in the isolated loop of rabbit small intestine. Mucus hexosamine secretion increased threefold, whereas mucous lactate level remained unchanged. It is suggested that intensive mucus secretion is ensured by significant amounts of blood glucose, whose level is 65% increased, possibly due to the observed 1-6-fold liver gluconeogenesis acceleration. Though the mechanism of the latter is not yet known, the data obtained provide evidence that this stimulation is not cAMP-dependent. PMID- 3676476 TI - [Significance of the intervals of hydroxyurea administration for epithelial damage to the small intestine in mice]. AB - The states of the murine small intestinal epithelium 6, 30 and 78 h after the end of the multiple regular injections of hydroxyurea (HU) were analysed with the aid of the light and electron microscopy. The course of 6 regular injections of 5 mg/mouse HU was begun 24 h after the initiating gamma-irradiation in a dose 200 rad and the interval between injections was varied from 7 to 19 h for different experimental groups of mice. The analysis of the epithelial state revealed two minima of the tissue damage which correspond to the courses of HU injections with the intervals close 9 h and 16.5 h. PMID- 3676477 TI - [Modelling of ovarian tumors in rats]. AB - The investigation of ovary tumours induced by different methods has revealed their highest frequency (75%) and shortest latent period (4 months) when the ovaries were transplanted into the spleen. The incidence of ovary tumours induced by carcinogens, androgen, subtotal castration and irradiation accounted for 14 28%. Histological picture of the ovary tumours (granulosa cell tumours, granulosa thecoma, luteoma) was identical in all the experimental groups. PMID- 3676478 TI - [Role of angiotensin II in elaborating the escape reaction during electric stimulation of the ventromedial hypothalamus in rabbits]. AB - The action of angiotensin-II, saralazin, captopril and antiserum to angiotensin II, injected into the brain ventricles, on avoidance reaction to electrical stimulation of ventromedial hypothalamus was studied in experiments on rabbits. It has been found that angiotensin-II had a pronounced inhibitory effect, while saralazin, captopril and antiserum to angiotensin-II had a facilitating effect on the reaction. PMID- 3676479 TI - [EMG-force relation during potentiation]. AB - The influence of muscle potentiation due to short-term arbitrary contraction on electromyogram (EMG)-force relationship was studied in men (m. flexor digitorum sublimis). It has been shown that in the majority of subjects the value of smoothed rectified EMG vs force considerably decreased after the development of potentiation. When the subjects were asked to memorize the level of force and reproduce it upon the development of potentiation without the visual feedback they reproduced a higher level of force. EMG in this case did not change considerably. It was concluded that EMG-force relationship depends on the previous muscular activity. PMID- 3676480 TI - [Mechanisms of cutaneous-cardial interconnections]. AB - Using the method of double stimuli, some features of inhibitory influences of conditioning stimulation of cutaneous zones on the afferent transmission from the heart were studied in the experiments on cats. It has been shown that when the interval between testing and conditioning stimuli is from 50 to 150 ms, the cutaneous stimulations effectively block the appearance of evoked potentials in the rostral parts of the cerebral cortex, which were induced by the electrical stimulation of the sinoatrial nodal zone. Bilateral vagotomy completely eliminated this reaction. Stimulation of the peripheral part of the cut vagus also effectively blocked the transmission of the afferent impulses from the heart. It was concluded that inhibitory cutaneo-cardiac effects are determined by the mechanisms of presynaptic inhibition, which develop at the level of intracardiac nervous system. PMID- 3676481 TI - [Mechanism of self-regulation and the inotropic reaction of the rat myocardium during aging]. AB - The experiments on rat papillary muscles revealed that in ageing rats myocardium has a decreased distension ability. The curves of shortening value/length and force/velocity for the myocardium of old animals are shifted downwards. The alterations in isotonic contraction parameters had a distinct age differentiation, while the age did not affect the inotropic effects of increased frequency, paired stimulation and external calcium. It is suggested that changes in biomechanical properties of ageing myocardium are associated with alterations in calcium transport in sarcoplasmic reticulum. PMID- 3676482 TI - [Effect of thymalin on protein synthesis in the brain and conditioned-reflex activity of the progeny of neurosensitized female rats]. AB - Thymalin administration to two-week-old offspring of neurosensitized female rats prevented the development of protein synthesis disturbances in the central nervous system and the retention of conditioned reflex of passive avoidance. Thymalin injection to the offspring of intact female rats improved conditioned reflex retention and did not affect brain protein synthesis. A possible mechanism of thymalin effect in conditions of congenital neuroimmunopathology is discussed. PMID- 3676483 TI - [Morphologic and biochemical changes in brain cells of mice with influenza]. AB - The influence of influenza virus infection on the brain cells was studied in mice. Virology, electron microscopy and biochemistry methods were used for this purpose. It has been shown that intracerebral injection of pathogenic strain of influenza virus A/PR/8/34 is accompanied both by the reproduction of virus in the central nervous system tissue and the morphology changes in ependial cells of the vascular plexus of the brain lateral ventricle. It has been found that the level of the lipid peroxidation products in lipid extracts of infected mouse brain is greater than their level in extracts from control mouse brain. It has been concluded that the influenza virus has a damaging effect on the central nervous system cells. PMID- 3676484 TI - [Status of the "dead point" of blood flow in anastomoses of superficial cerebral arteries as affected by an acute increase of blood pressure]. AB - Changes in pial arteries diameter and the condition of blood flow "dead point" in arterial anastomoses were established using the brain window during an acute increase of mean arterial pressure (MAP) induced by intravenous injection of norepinephrine (NE) with microcineangiography and the analysis of films and frames on a montage table and TAS ("Leitz"). During an acute increase of MAP the movement of blood flow "dead point" in anastomoses and the expansion of plasma segments occurred much more frequently than in normotension. The stabilization of blood flow "dead point" was observed at high constant MAP. Pronounced dilation of both pial arteries and veins first occurred in anastomoses, then spread to arterial branches. It is assumed that high vulnerability of the brain vessels of the borderline zones is due to breakthrough in autoregulation of cerebral blood flow on its upper limit and depends on the repeatedly changing directions of the blood flow and its moving "dead point", as the peripheral resistance of arterial anastomoses-forming branches under these circumstances changes in an irregular manner. PMID- 3676485 TI - [Study of articular cartilage and the synovial membrane using IR spectroscopy]. AB - The infrared spectra of normal knee joint cartilage, normal and rheumatoid arthritis-affected human synovial membrane and the same normal bovine tissues were obtained over the region of 400--4000 cm-1. A comparative analysis of the spectra of these tissues and those containing hyaluronate, protein-chondroitin keratan sulfate aggregates of cartilage proteoglycans and heparin made it possible to identify greater absorption bands of these biopolymers in the tissue spectra. The interpretation of the results obtained is presented. PMID- 3676486 TI - [Structural heterogeneity of chromatin preparations at the level of DNA topology]. AB - The structural heterogeneity of calf thymus chromatin preparations was studied at the level of DNA topology by analysing the influence of ethidium bromide on the chromatin viscosity in deproteinizing medium. In 0.7 M NaCl the chromatin was separated into the fractions with linear DNA (3--36% in various preparations) and with supercoiled circular DNA (scc DNA), which differ from each other in their adhesive properties. Reduction of disulfide bonds in residual chromatin protein with 5% mercaptoethanol linearized scc DNA, present in chromatin preparations as nuclear matrix subunits containing some loops of scc DNA on the protein globule. PMID- 3676487 TI - [Comparative study, using fluorescent methods, of cell membranes and their reconstituted liposomes]. AB - Cell plasma membranes and proteoliposomes reconstituted from solubilized plasma membranes of thymocytes and Ehrlich ascites carcinoma cells have been studied by fluorescent methods. It has been shown that proteoliposomes are characterized by greater polarization and rigidity of microsurroundings in membrane proteins and greater microviscosity of membrane lipids. Proteoliposomes from thymocyte membranes contain less membrane proteins and express lower polarity of the lipid bilayer than proteoliposomes from Ehrlich ascites cells. PMID- 3676488 TI - [Effect of components of the extracellular matrix on the accumulation of lipids in human cells]. AB - The effect of extracellular matrix components on cholesterol accumulation in different human cells was studied. Insoluble LDL-Heparin-Fibronectin-Gelatin complexes were incubated with human cells: fibroblasts, monocytes, peritoneal macrophages, cells of the aortic wall--endothelial, subendothelial intimal, medial; and total cholesterol content in these cells was determined. It has been demonstrated that components of extracellular matrix being complexed with LDL enhance total cholesterol accumulation in all cell types studied: the highest amount of cholesterol was accumulated by subendothelial intimal cells and peritoneal macrophages. It is suggested that components of extracellular matrix can play an important role in the development of lipid-laden foam cells that are accumulated in the arterial wall in atherosclerotic lesions. PMID- 3676489 TI - [Spectrophotometric method of determining the osmotic resistance of lysosomes isolated from animal tissue]. AB - Rapid spectrophotometric determination of animal tissue lysosome osmoresistance is described. The duration of analysis is decreased by 5-6 h, as compared to enzymatic method. The process of lysosome degradation was linear at 0.7 M sucrose concentration. The dependence of sucrose molarity on the extent of lysosome lysis was complex. The lysosome lysis rate rapidly increased at sucrose molarity less than 0.7 M. Lysosome incubation at 0.4 degrees C for 24 h increased their osmotic sensitivity within the whole investigated osmotic pressure range. Isolated lysosome osmoresistance may be used as an index of dynamic structural and functional state of these particles and the extent of their degradation caused by various physical and chemical factors in vivo and in vitro. The measure of the initial absorption (A520) and the initial lysosome lysis rate (delta A520/min), as well as biological half-life may be the index of such an effect. PMID- 3676490 TI - [Effect of thyroxine in vitro on the transmembrane potential of rat liver mitochondria]. AB - It has been shown in in vitro experiments that a certain latent period after the addition of thyroxine (T4) and triiodothyronine (T3) was necessary for the manifestation of their effects on transmembrane potential (TMP) of the rat liver mitochondria. The duration of the lag-period decreased upon an increase in the concentrations of these hormones, and T4 at a dose of 2.10(-4) M produced a fall in TMP immediately after its addition. The rate of TMP fall was in proportion with the concentrations of thyroid hormones introduced into the cell, with T3 30 40% more effective than T4. It was established that the action of I2 resembled that of thyroid hormones, namely, a fall in TMP, mitochondrial swelling, activation of transhydrogenase Kl was ineffective. It is suggested that the appearance of the lag-period upon the action of thyroid hormones might be explained by the period of time necessary for the formation of the active iodine forms, as well as by the formation of fatty acids (donators of H+) by mitochondrial phospholipases. All these factors lead to TMP fall resulting in decreased formation of sufficient ATP quantities in mitochondria. PMID- 3676491 TI - [Effect of the ulcerogenic agent cysteamine on the content of glutathione and glutathione-dependent enzymes in the mucous membrane of the gastroduodenal region in the rat]. AB - A comparative study of reduced and oxidized glutathione forms and the activity of glutathione-dependent enzymes (glutathione peroxidase, glutathione-S-transferase, and glutathione reductase) has been performed in the rat mucous membranes of different gastroduodenal areas 24 hours after the injection of cysteamine--a specific ulcerogenic agent. It has been shown that cysteamine causes a decrease in the concentration of reduced and an increase in the concentration of oxidized glutathione forms in all gastroduodenal areas. The fall in reduced glutathione form concentration is the greatest in the duodenal mucosa. A considerable decrease in glutathione-dependent enzyme activity, especially glutathione-S transferase, was observed in duodenal mucosa. It is concluded that glutathione and glutathione-dependent enzyme system may be directly related to pathogenetic mechanisms of gastroduodenal ulcer formation. PMID- 3676492 TI - [Structural analysis of the functional status of the brain as affected by bemethyl using pattern recognition theory]. AB - Evoked visual potentials in associated, parietal and second somatosensory zones of the neocortex were analysed in trained cats using implanted electrodes. The influence of bemethyl on the structure of behavioral reactions was analysed using theoretical methods of perceptual images, particularly the method of cluster analysis. Bemethyl was shown to increase the level of interaction between the functional elements of the system, leading to a more stable resolution of problems facing the system, as compared to the initial state. PMID- 3676493 TI - [Behavioral and electrophysiologic characteristics of a peptide analog of piracetam--L-pyroglutamyl-D-alanine amide]. AB - The effect of L-pyroglutamyl-L-alanine amide, a structural analog of nootropil, was studied in the passive and active conditioned avoidance tests in rats. The compound (1 mg/kg, i. p.) was shown to be able to improve the performance in the shuttle-box. This effect is selective because it is not followed by psychomotor stimulation. In experiments on undertrained animals in passive avoidance test the compound reveals its positive amnestic effect with its administration prior to, immediately after learning and prior to testing. This provides the evidence that the dipeptide activates all the phases of memory formation. The compound raises the amplitude of transcallosal responses in temporal associative area and S-1 and increases facilitation phase in the recovery cycle, being inactive in respect to primary somatosensory evoked responses in S-1. All the data obtained suggest the nootropil-like effect of the dipeptide. The analysis of the dipeptide by MR spectrometry reveals its stability in the presence of serum or enterocyte enzymes. PMID- 3676494 TI - [Comparative study of the effect of 3-carboxy-beta-carboline methylamide and diazepam on rat behavior]. AB - The effects of benzodiazepine receptor agonist, diazepam, and inverse agonist, FG 7142, were examined. Strong antagonism between FG 7142 (10 mg/kg) and diazepam (1 mg/kg) activity was revealed in the open field test. On the other hand, both FG 7142 and diazepam inhibited isolation-induced intraspecies aggressive behaviour of rats. FG 7142 also reduced interspecies aggression of mouse-killing rats. The findings suggest that both diazepam and FG 7142 have antiaggressive properties in the isolation-induced aggression model, which are mediated by benzodiazepine receptors of the central nervous system. PMID- 3676495 TI - [Effect of the delta sleep peptide on epileptic activity in the cerebral cortex of rats and cats]. AB - In free behaviour experiments on rats it has been shown that the intraperitoneal injection of delta sleep-inducing peptide (DSIP) (100 micrograms/kg) suppressed penicillin-induced relatively moderate epileptic foci which generated spike potentials as well as severe foci with ictal epileptic discharges. In the experiments on cats it was shown that intravenous DSIP injection (100 micrograms/kg) suppressed strychnine-induced epileptic focus and complexes of epileptic foci. PMID- 3676496 TI - [Role of the GABAergic system in the mechanism of the stress-regulating action of phenibut]. AB - Disturbances in GABA-ergic inhibitory system were noted upon the exposure of thalamus and hypothalamus of experimental animals to stress of 18 hours and longer duration but not of 3 hours duration. Phenibut (I mg/kg) eliminates the symptoms of GABA-system disturbances revealed upon exposure to stress, decreases the tension of stress reaction and hyperglucocorticoidemia which causes hyperglycemia. In the bodies of intact rats phenibut causes "switching on" of adaptive GABA-system function, which is more physiological than the one appearing on short-term stress. PMID- 3676497 TI - [Effect of nonachlazine on the adenylate cyclase system of the rabbit heart]. AB - The influence of nonachlazine on the adenylate cyclase system of the rabbit heart was investigated. The faint beta-blocking activity (displacement of up to 20% of [3H]-dihydroalprenolol and inhibition of isoproterenol-stimulated activity) as well as the ability to stimulate basal activity in micromolar concentrations has been observed. Such combination of properties may be important in the realization of some positive effects of nonachlazine pharmacological activity. PMID- 3676498 TI - [Effect of morphine on the supra- and segmental mechanisms of regulating arterial pressure in pain]. AB - It has been demonstrated in experiments on nonanesthetized intact and spinalized cats that intrathecal morphine increased blood pressure and renal nerve sympathetic activity and enhanced the nociceptive reactions. It is suggested that morphine plays an essential role in the effect of propriospinal system on the generation of sympathetic spinal reflexes. PMID- 3676499 TI - [Effect of tageflar, a synthetic analog of L-enkephalin, on the morphogenesis of experimental pancreatitis]. AB - It has been substantiated that the use of a new synthetic drug tageflar analogous to L-enkephalin was accompanied by the depression in pancreatic enzyme activity in the blood of rats, acceleration of necrotic and lytic processes in irreversibly damaged exocrine pancreocytes in the course of experimental pancreatitis. The drug promoted microcirculation retention in the injury zone and acceleration of the arrangement and elimination of necrotic glandular tissue. The influence of tagaflar diminished the extent of perifocal necrobiotic zone and suppressed sclerotic processes and pancreatic lipomatosis. PMID- 3676500 TI - [Effect of zixoryn on diuresis and renal transport of xenobiotics]. AB - A new inducer of the monooxygenase system zixoryn (oral dose--100 mg/kg, for 4 days) increased the excretion and maximum tubular transport of cardiotrast (diodrast) in rats. Zixoryn had no effect on daily and water diuresis and renal excretion of sodium, potassium and creatinine. PMID- 3676501 TI - [Immunochemical determination of the heterogeneity of leukocyte thermostable alpha-glycoprotein]. AB - A comparative immunochemical and physico-chemical study of leukocyte thermostable alpha-glycoprotein (LTG) has been performed in pus extract, hemolysate, leukolysate and blood plasma. Immunochemically determined LTG is heterogeneous in respect of molecular charge, sialic acid content and temperature stability. LTG in the blood plasma has a form of alpha-globulin, while in hemolysate it is a beta-globulin, with both forms present in pus. In leukolysate LTG possessing incomplete immunochemical identity with pus and plasma LTG was detected. It is suggested that LTG forms detected differ in their biological activity as well. PMID- 3676502 TI - [Determination of the elastase activity of the leukocyte thermostable alpha glycoprotein from human blood plasma]. AB - The possibility of isolation of specific human granulocyte antigen--leukocyte thermostable alpha-glycoprotein (LTG) from plasma was shown. The isolation of preparations containing LTG was carried out on CNBr-activated sepharose with immobilized soluble fraction of pus. Using immunochemical analysis with standard antisera, the absence of plasma and leukocyte proteins and the presence of LTG in the preparations obtained were demonstrated. Pus may comprise a protein component capable of binding LTG. Elastase activity of the preparations obtained was established. The identity of LTG and granulocyte elastase is suggested. PMID- 3676503 TI - [Immuno-correcting activity of vitamin A in stress]. AB - Experiments on CBA mice have shown that oral vitamin A administration prevents stress-induced immunological disorders: depression of antibody-forming cell production, decrease in natural killer cell activity and T-lymphocyte mitogenic response. Vitamin A also prevents the development of thymus atrophy, lymphopenia and depression of phagocytic activity of peritoneal macrophages. PMID- 3676504 TI - [Glucocorticoid-mediated degradation of DNA in thymocytes of rats with transplantable Zajdela ascites hepatoma]. AB - Tumour growth was shown to be associated with DNA breakdown in thymocytes of rats bearing Zajdela ascites hepatomas. The tumour action on the thymus is mediated through adrenal glands since bilateral adrenalectomy completely prevents DNA breakdown in thymocytes. Using Southern hybridization of DNA genome with probes for histone, ribosomal and heat shock gene (hsp 70), it was shown that the degradation products of specific DNA sequences are as heterogenous as those of total DNA, although marked differences in appearance of nucleosomal ladder were seen. These data were interpreted to indicate different patterns of DNA breakdown in dying thymocytes. DNA breakdown in thymocytes in vivo and in isolated rat liver nuclei in vitro seems to proceed by similar mechanisms. PMID- 3676505 TI - [Interspecies similarity of the trajectory of reactive leukocytosis]. AB - Reactive leukocytosis was studied in 60 patients after appendectomy by daily test for 8 days. Reactive leukocytosis trajectory in these patients was compared to the analogous trajectory in 87 dogs with experimentally induced inflammation. The similarity of reactive leukocytosis trajectory in humans and animals has been established and a uniform period of leukocyte blood count changes equal to 48 h has been determined. PMID- 3676506 TI - [Histostereologic analysis of the myocardium of homoiothermic animals during cooling]. AB - A stereologic study of the myocardium exposure to cold for 4 hours, 8 and 16 days was carried out on Wistar rats. It has been shown that during the first 8 days acute hemodynamic disorders and cardiomyocyte contractures developed. These changes were followed by a decrease in the volume and surface capillary density resulting in the impairment of transcapillary exchange and reduction of the intracellular regeneration processes in cardiomyocytes. By the 16th day the compensatory-adaptive reactions developed, i.e., the volume and surface density of endothelial cells and capillaries was increased. At the same time the lysis processes caused by the general decrease in the inflow of plastic substances to the myocardium due to the increase in thermogenesis were revealed in part of cardiomyocytes. These changes in parenchymatous cells were accompanied by the intensification of desmoplastic reactions in the myocardial stroma. PMID- 3676507 TI - [Morphometric study of the ultrastructural organization of the endotheliocytes of blood capillaries in the iliac lymph nodes of pregnant rats]. AB - The ultrastructure of blood capillary endotheliocytes of iliac lymph nodes during pregnancy was investigated in rats. It was found that changes in microcirculation during pregnancy are accompanied by the appearance of the adaptive changes at all levels of lymph node structural organization. They are: increased lumen of arterial and venous part of the capillaries, increased intermediate sinus volume, increased fenestration of both parts of capillaries, a sharp increase in the number of micropinocytous vesicles and activation of transendothelial channel formation. PMID- 3676508 TI - [Decrease in the degree of lipoid infiltration of rabbit tissues during feeding with cholesterol freed from autoxidation products]. AB - Lipid accumulation in the rabbit liver and myocardium has been investigated by histochemical and biochemical methods. The rabbits received cholesterol that contained 5% of autooxidation products or purified cholesterol. Lipid accumulation took place in the liver and intramural myocardial vessels during feeding of rabbits with autooxidated cholesterol. Feeding with pure cholesterol free from autooxidation products caused but slight changes or no changes at all. PMID- 3676509 TI - [Electron-autoradiographic demonstration of intra- and extracellular bactericidal activity of polymorphonuclear leukocytes]. AB - A technique for the determination of intra- and extra-cellular bactericidal activity of neutrophils has been suggested. A mixture of neutrophils and bacteria was incubated for 30 min and subsequently 3H-uridine was added to the incubated mixture. If phagocytized and extracellularly located bacteria remain alive they incorporate 3H-uridine. Killed bacteria fail to incorporate 3H-uridine. Intra- and extracellular killing capacity of neutrophils is determined by the content of labelled and unlabelled bacteria in radioautographs. PMID- 3676510 TI - Twenty-ninth annual meeting of the American Society of Hematology. Washington, DC, December 5-8, 1987. Abstracts. PMID- 3676511 TI - Incidence of aplastic anemia: the relevance of diagnostic criteria. By the International Agranulocytosis and Aplastic Anemia Study. AB - The incidence of aplastic anemia was estimated in a 4-year study conducted in Israel and seven areas in Europe. Strict definition criteria were used, and all data and bone marrow specimens were reviewed by a panel of experienced hematologists. Complete ascertainment of cases was attempted by establishing a telephone network including all relevant hospitals in the study areas. The incidence of aplastic anemia was estimated to be less than three per million per year, a figure lower than previously reported. The most likely explanation for the differences among studies is variation in diagnostic criteria, which might lead to an overestimation of the incidence in some previous studies. PMID- 3676512 TI - Analysis of the erythroid phenotype of HEL cells: clonal variation and the effect of inducers. AB - The erythroid phenotype of HEL cells, before and after the addition of a variety of inducers, was assessed at the cellular and biochemical level. Among 14 inducers used, delta-aminolevulinic acid (delta-ALA) was identified as the most optimal inducer of heme and globin synthesis in HEL cells. The relative synthesis of globin chains produced by HEL cells, mainly gamma and alpha chains with traces of epsilon and zeta chains, was not influenced by the majority of the inducers used. However, delta-ALA and bromodeoxyuridine did increase the relative synthesis of alpha and epsilon chains respectively. Subcloning experiments revealed heterogeneity in the constitutive expression of alpha globin; however, the latter was inducible in all clones by either hemin or delta-ALA. One rare clone of HEL cells was found to produce, in contrast to parental cells, significant amounts of epsilon globin. This clone differed from K562 cells by the absence of any zeta globin expression, thus demonstrating the independent regulation of the two embryonic chains, epsilon and zeta. Changes in the expression of several surface markers specific for erythroid cells were found to accompany the globin accumulation in these cells, and some of these changes appeared to be inducer specific. Thus, the unique globin and nonglobin phenotypic properties of HEL cells and their subclones make them valuable cellular models complementary to the existing K562 cells for studying regulatory aspects of erythroid-specific proteins. PMID- 3676514 TI - Association of hemoglobin H disease with Hb J-Iran (beta 77 His----Asp): impact on subunit assembly. AB - A young Iranian female was found to be heterozygous for hemoglobin (Hb) J-Iran (beta 77 His----Asp) in combination with Hb H disease. The proportion of Hb J in the patient's hemolysate was surprisingly high: 65% Hb J, 30% Hb A. Thus, the interaction of a negatively charged beta subunit variant of Hb with alpha thalassemia leads to a marked increase in the relative amount of the variant Hb within red cells. This observation provides further support for an electrostatic model of Hb subunit assembly. PMID- 3676513 TI - Proteoglycan synthesis in two murine bone marrow stromal cell lines. AB - There is evidence indicating that stromal proteoglycans are an important functional component of the hematopoietic microenvironment. Proteoglycan synthesis was therefore investigated in the MS3-2A and D2XRII hematopoietic stromal cell lines. These lines differ in their capacity to support hematopoiesis in vitro, D2XRII supporting in vitro hematopoiesis, whereas MS3-2A does not. Cells were labeled with 35S-sulfate as precursor, and 4 mol/L guanidine HCl extracts of cells and media were analyzed by ion-exchange chromatography, cesium chloride density gradient centrifugation, and molecular sieve chromatography. Proteoglycans were further examined by enzymatic and chemical digestions. MS3-2A cells produced at least three proteoglycan species. Two chondroitin/dermatan sulfate (CS/DS) proteoglycans, Kav = 0.40 and Kav = 0.68 on Sepharose CL-2B, were present primarily in the medium. The respective glycosaminoglycan molecular weight (mol wt) values were 38 kd and 40 kd. A heparan sulfate (HS) proteoglycan of Kav = 0.58 and glycosaminoglycan mol wt 36 kd was present primarily in the cell layer extract. D2XRII cells synthesized two HS proteoglycans. The larger (Kav = 0.45; glycosaminoglycan mol wt, 30 kd) was of low density on gradient centrifugation and more prominent in the cell layer extracts, whereas the smaller (Kav = 0.68; glycosaminoglycan mol wt, 38 kd) was dense and present mainly in the culture medium. A single CS/DS proteoglycan species of Kav 0.78 and average glycosaminoglycan of mol wt 18 kd was present in roughly equal amounts in the medium and in the cell layer. MS3-2A and D2XRII thus appear phenotypically distinct with respect to proteoglycan synthesis. These differences are discussed in relation to the microenvironmental function of bone marrow stromal elements. PMID- 3676515 TI - Inhibition of K transport by divalent cations in sickle erythrocytes. AB - We report experiments on the effect of intracellular divalent cations (Mg, Ca, Mn) on K transport and cell volume in erythrocytes from patients with homozygous hemoglobin S disease (SS cells). When CO-treated SS erythrocytes are exposed to the ionophore A23187, removal of cell Mg markedly stimulates K efflux, whereas increasing cell Mg inhibits K efflux. The Ki for the inhibition by internal free Mg is 0.38 +/- 0.10 mmol/L, a value comparable to the concentration of free Mg in normal cells (0.3 to 0.4 mmol/L). When swollen SS cells with increased Mg content were incubated in plasma-like medium, they shrunk much less than swollen SS cells with normal Mg content. Thus, elevation of cell Mg produces inhibition of swelling-induced K movement from SS cells. Internal Ca and Mn also inhibit K movement from SS cells. The inhibition of volume regulation by divalent cations suggests that increases in intracellular divalent ions, especially Mg, could induce a persistent degree of cell swelling in SS RBCs and thereby inhibit intracellular polymerization. PMID- 3676516 TI - Dermatan sulphate induces plasminogen activator release in the perfused rat hindquarters. AB - Heparin or heparin-like substances have been described to induce the release of plasminogen activator (PA) activity in different animal perfusion models. In this paper we report that Dermatan Sulphate (DS) is able to induce PA activity release in the perfused rat hindquarters. Perfusion of different doses of DS (0.1 to 0.8 mg/mL) stimulates a release of PA activity that is maximum after the initial two minutes of perfusion. The amount of PA activity released rises progressively within a certain concentration range of DS (0.1 to 0.4 mg/mL) and declines thereafter (0.6 to 0.8 mg/mL). The type of PA activity increased during DS perfusion was characterized by SDS-PAGE and fibrin autography as tissue-type PA (t-PA) on the basis of its mol wt (67,000 d) and inhibition by a specific anti t PA antiserum. This effect might be considered as potentially contributing to the antithrombotic activity of DS, at least at the local level. PMID- 3676517 TI - Deoxygenation inhibits the volume-stimulated, Cl(-)-dependent K+ efflux in SS and young AA cells: a cytosolic Mg2+ modulation. AB - We recently reported that the Cl(-)-dependent K+ (K:Cl) efflux, which can be stimulated by cell swelling in the presence of inhibitors of the Na+ pump (ouabain) and of the Na-K-Cl cotransport (bumetanide), is highly active in young AA and SS RBCs. We report here that deoxygenation inhibits volume-stimulated K:Cl efflux in SS and reticulocyte-enriched density-separated SS and AA RBCs. In SS whole blood, the K:Cl efflux stimulated by hypotonic (220 mOsm) swelling was reduced from 9.2 +/- 2 (mean +/- SE) in oxygen to 2.7 +/- 1.9 (mmol/L cell/h = flux units = FU) (n = 4) under deoxygenated conditions (P less than .005). Deoxygenation also decreased the acid pH-stimulated K:Cl efflux from 5.9 +/- 1.5 to 3.7 +/- 1.1 FU (n = 3) (P less than .025) but did not inhibit NEM-stimulated K:Cl transport. The effect of deoxygenation on density-separated SS cells is similar: When fraction SS2 (reversible discocytes) is deoxygenated under hypotonic conditions, the K:Cl efflux is reduced by 50%. In reticulocyte-enriched AA cells obtained from anemic patients, deoxygenation under hypotonic conditions also reduces K+ efflux by 50%. In SS cells only, deoxygenation under isotonic conditions results in an increased Cl(-)-independent K+ efflux. Because ionized Mg2+ in the cytosol increases during deoxygenation, we investigated the effect of external and internal Mg2+ on the volume-stimulated K:Cl efflux. Removal of external Mg2+ did not influence the rate of transport in oxygenated cells. When internal Mg2+ was clamped at 0.15 mmol/L with A23187 and EDTA at ionized cytosolic Ca2+ = O, however, the inhibitory effect of deoxygenation on the K:Cl efflux was eliminated. We conclude that deoxygenation inhibits the volume stimulated, Cl(-)-dependent K+ efflux in AA and SS young red cells by concomitantly increasing ionized cytosolic Mg2+. PMID- 3676518 TI - Cytogenetic studies and in vitro colony growth in patients with mastocytosis. AB - Cytogenetic analysis of bone marrow cells and in vitro growth for bone marrow granulocytic-macrophage stem cells have been performed in 13 patients with mastocytosis, six with systemic mastocytosis, and seven with urticaria pigmentosa. Clones with chromosome abnormalities were found in five patients. The number of clusters and/or colonies after seven days in culture was increased in seven patients, compared with the growth in a control group. Three patients with chromosome abnormalities showed an abnormal growth pattern, yet exhibited normal peripheral blood values. Two patients with systemic mastocytosis had clones with chromosome abnormalities and some abnormal hematological values. The proportion of patients with chromosome abnormalities and an abnormal growth pattern was higher among these patients with mastocytosis than in healthy control subjects. These results may be of interest when discussing the origin of mast cell disorders and indicate an association with the myeloproliferative disorders. PMID- 3676519 TI - Serum transferrin receptor as a new index of erythropoiesis. AB - Serum transferrin receptors were measured by a sandwich radioimmunoassay procedure in patients with iron deficiency anemia, autoimmune hemolytic anemia and aplastic anemia. The mean circulating transferrin receptor concentration of normal subjects and patients with iron deficiency anemia, autoimmune hemolytic anemia and aplastic anemia are 253 +/- 82 ng/mL, 730 +/- 391 ng/mL, 1,426 +/- 1,079 ng/mL, and 182 +/- 39 ng/mL, respectively. The values for those with iron deficiency anemia and autoimmune hemolytic anemia were significantly higher than that of normal controls and the values for those with aplastic anemia were lower than that of normal controls. After iron supplementation in iron deficiency anemia, the serum transferrin receptor values increased twofold over those of pretreatment values. This increase parallels an increase in peripheral reticulocytes. Therefore, the number of circulating transferrin receptors in anemic patients may reflect the level of bone marrow erythropoiesis and is a potentially useful new index for red cell production. PMID- 3676520 TI - Intestinal iron absorption and mucosal transferrin in rats subjected to hypoxia. AB - Three days hypoxia (0.5 atm) increased the haemoglobin and haematocrit values in rats paralleled by enhanced intestinal iron absorption. The destination of recently-absorbed iron was primarily the erythropoietic system, viz. bone marrow, spleen and red cells. Total plasma transferrin, was increased by 30%, but no significant changes in mucosal transferrin were found. No increase in labelling of mucosal transferrin by absorbed iron was observed. These results suggest that mucosal transferrin does not play a major role in the regulation of intestinal iron absorption in hypoxia. PMID- 3676521 TI - Cytostatic drug testing in human leukemias by means of multiparametric flow cytometry. AB - Human bone marrow cells from 20 patients as well as the permanent human B-cell lines RPMI 1788, Raji, Daudi, T-cell lines Molt, CEM, Jurkat and the promyelocytic line HL 60 were assayed by means of a newly developed in vitro flow cytometric cytostatic drug assay. The cells were exposed to cytosine-arabinoside, L-asparaginase, daunorubicin, prednisone or vincristine. Surviving cells were stained after an incubation period of 2 to 7 days with esterase and pH-indicator dye ADB (1,4-diacetoxy-2,3-dicyanobenzene), dead cells with DNA-dye PI (propidium iodide). Dose-response curves were established using percent surviving cells. It was possible to evaluate bone marrow samples from 16 out of 20 patients. Seven samples were leukemic (acute myeloid leukemia (AML) n = 6, Non-Hodgkin's Lymphoma (NHL) n = 1). Nine samples were from patients either in complete remission or with benign diseases. Daunorubicin and cytosine-arabinoside were cytotoxic in both groups, whereas vincristine was effective mainly in the leukemic group (p less than 0.05). There was significant heterogeneity in the reactivity of AML marrow cells from different patients to different drugs. The cell lines exhibited different patterns of sensitivity. Vincristine arrested cells in G2/M-phase, cytosine-arabinoside caused an increase of cells in the S-phase. PMID- 3676522 TI - The forensic psychiatrist of the future. AB - The rate of change in scientific knowledge and the growing psychiatric sophistication of attorneys and courts have made it increasingly difficult for forensic psychiatrists to retain proficiency in the full spectrum of potential professional activities. As the consumers of forensic services become more sophisticated, forensic psychiatrists have an increasing need to become scientifically informed and a decreasing need to become legally informed. Traditional training in forensic psychiatry, which emphasizes clinical, legal, and institutional knowledge and experience, gives short shift to behavioral science and other technical knowledge that can enhance the validity of forensic assessments and their value to the legal system and society. Forensic psychiatrists can best respond to these changes and maximize the value of their assessments by narrowing their focus to some subset of the four branches of the discipline: criminal behavior, mental disability, forensic child psychiatry, and legal aspects of psychiatric practice. Maximal proficiency in each of these four branches requires a greater depth of knowledge and experience than was once sufficient among those who practiced in all four areas. Fellowship training programs and professional organizations should lead forensic psychiatry into the twenty-first century by organizing their efforts along these four parallel tracks. PMID- 3676523 TI - "Crudely, without any finesse": the defendant hears his psychiatric evaluation. AB - This paper examines the issue of potential harmful effects on an individual who hears a description of his psychodynamics in the highly charged, adversarial context of a courtroom. Ethical considerations and strategies for minimizing such harm are discussed, accompanied by illustrative clinical case material. PMID- 3676524 TI - Defining a clinically useful model for assessing competence to consent to treatment. AB - Burdened with the responsibility of making an initial assessment of their patients' capacity to make treatment decisions, clinicians need a sound clinical assessment model. Drawing on ethical, legal, and clinical sources, the author reviews the appropriateness of existing models and standards and describes why each fails the needs of the clinician. The patient's ability to form a therapeutic alliance is shown to be a valid assessment model for defining a treatment decision-making ability threshold because it adheres to widely accepted ethical and legal standards. Using threshold because it adheres to widely accepted ethical and legal standards. Using this model to set a threshold for the decision to bring cases to the attention of a court or administrative body, the therapist arrives at a satisfactory balance between competent treatment, patient autonomy, and judicially mandated due process imperatives while providing a forum for patient education and assessment of the clinician's technical skill. Explanations of case examples illustrate the use of the therapeutic alliance for this purpose in a variety of clinical situations. Specific recommendations are made on what may be represented to court in cases in which the patient's competence appears to fall below this treatment threshold. PMID- 3676525 TI - Testamentary capacity. AB - Wills are more prone to challenge on the issue of testamentary capacity because, as people live longer, they are more likely to have the kind of conditions that interfere with capacity and because the courts seem to be more apt to hear evidence and allow findings of lack of testamentary capacity than in the past. Therefore, it is incumbent on attorneys to protect the interests of their clients by addressing the issue of testamentary capacity in any case in which a will contest might be anticipated. Ideally, attorneys in such situations should have their clients counsel with a psychiatrist who is knowledgeable and experienced in matters of probate and will contests. Further, the attorney and the client must provide extensive data (of the kind which a jury might ultimately obtain) on which the psychiatrist can base his or her conclusions that the client is of "sound mind." PMID- 3676526 TI - Pastoral counseling and the concept of malpractice. AB - The discipline of pastoral counseling has developed to the point at which malpractice claims against pastoral counselors are a reality. The need for forensic psychiatrists to participate in such suits is likely to increase. In this article, we review the recent California case of Nally v. Grace Community Church. Kenneth Nally committed suicide while under the care of clergy. His parents claimed that the pastoral counselors negligently counseled their son and that this counseling led to his death. This case will serve as a point of departure for reviewing the developments and evolution of pastoral counseling as a discipline. Then we shall highlight the difficult problem of whether pastoral counseling ought to be classified as a religious or a secular activity, while pointing out that this dichotomous view does not accurately portray the activities and beliefs of pastoral counselors. Nevertheless, we underline the connection made between the definition of pastoral counseling and the assertion that pastors should be shielded from malpractice claims. PMID- 3676527 TI - More forensic romances: De Clerambault's syndrome in men. AB - De Clerambault's syndrome (erotomania) has invariably been regarded as a female disorder (with male victims); however, a number of recent reports describe male patients with the disorder, especially in violence-prone male offender populations. Seven cases are presented of violence-prone men suffering from the disorder, including Hinckley and Poddar. The syndrome is discussed from a nosological point of view and in terms of its impact on competency to stand trial. Psychiatrists should be aware that the syndrome is not a rarity among men, as previously thought, and that proper diagnosis and management are essential in view of the clinical course of the disorder and the potential for violence when the patient's "love" is persistently unrequited by the delusional love object. PMID- 3676528 TI - Death notification. AB - Death notification--informing the deceased's family of an unexpected death--is a singularly stressful task common to medical personnel, clergy, and police. We surveyed by questionnaire a group of 50 Los Angeles Police Department homicide detectives, 21 of whom were subsequently interviewed by telephone. The detectives stated that their initial apprehension stemmed from feeling unprepared. Identification with victims' families was common and compounded the stress. One prevalent worry concerned the possible reactions of the family upon hearing the news, especially the risk of a violent attack on the police officer. Several coping styles were recognized. Our findings suggest that the repetitive performance of this continuously stressful task may be a prominent and underappreciated contribution to occupational burnout. PMID- 3676529 TI - Patient warnings in court-ordered evaluations of children and families. AB - The rules covering disclosure of information generated by court-ordered clinical evaluations in Massachusetts require that patients be warned that the patient psychotherapist privilege does not apply to the evaluation interview. The nature of the warning required ("the Lamb warning") is not perfectly clear and is especially uncertain when those being warned are children and families. Comparing the Lamb warning to the Miranda warning offers some insight but is not conclusive. To reach conclusions regarding the type and degree of procedural protections for children required by the Lamb warning, it is necessary to analyze the stakes, interests, and capacities involved for children in juvenile court. This analysis suggests that in most situations a relatively informal procedure is sufficient to provide the required warning. However, there are some exceptional circumstances in which more formal and thorough warnings should be required. These include juvenile transfer hearings and some situations involving child abuse and neglect. PMID- 3676530 TI - Mutism, malingering, and competency to stand trial. AB - Mutism and mental illness have had a long-standing historical relationship with regard to the issue of competence to stand trial. This article reports a defendant who remained mute for 10 months and describes his use of the symptom of mutism in his malingering. Although mutism is frequently used by defendants for malingering, clinicians must have a high index of suspicion for the possibility. We recommend a comprehensive evaluation including neurologic workup, repeat interviews, observation of the defendant at unsuspected times for communicative speech with other inmates, study of handwriting sample, collateral nursing documentation, and, if necessary, Pentothal interviews to establish authenticity of mutism. The authors review the historical background and legal considerations of the relationship between mutism and malingering. PMID- 3676531 TI - Qualifications sought by employers of health sciences librarians, 1986. AB - Two hundred ninety-four job advertisements that appeared in MLA News in 1986 were analyzed to determine whether MLA certification had become a more frequent requirement than it was at the time of Schmidt and Swanton's 1980 study. Other qualifications studied were subject background, health sciences library courses, online searching experience, and OCLC experience. Library experience, educational requirements, and geographic distribution were also included. PMID- 3676532 TI - Impact of the Pacific Southwest Regional Medical Library Service on hospital library development. AB - A study was designed to evaluate the progress of hospital libraries within Region 7 since the Pacific Southwest Regional Medical Library Services (PSRMLS) began in 1969. Library progress was defined as an increase in extent and types of services and resources offered. The study assessed the impact of Regional Medical Library programs on hospital libraries and compared resources and services reported in 1969, 1971, and 1984. The 1984 data were also measured against a set of core library services and resources that should be provided by a full-service hospital library. In addition to assessing the quality of PSRMLS programs and their effect on Region 7 hospital libraries, the study documented extensive growth in staffing, collection size, and services. PSRMLS programs were highly rated by the respondents, who also indicated that participation in PSRMLS programs improved specific library resources and services. PMID- 3676533 TI - Faculty input in book selection: a comparison of alternative methods. AB - In an era of tight funding, academic medical center libraries need to determine their users' needs in order to provide cost-effective resource collections. Although faculty input is valuable, it is impractical to impose such ongoing responsibility on faculty members. This study tested an alternative method by comparing faculty preferences in discipline-specific subjects with faculty choices on corresponding discipline-specific, new-book approval slips from a vendor. Collection development librarian selections, based on formal selection criteria, were evaluated against both measures of faculty preferences. It was found that faculty members' subject ratings did not accurately predict their book choices. Implications of this and the other findings are discussed. PMID- 3676534 TI - Educational services in health sciences libraries: an analysis of the periodical literature, 1975-1986. AB - The periodical literature on group instructional services in health sciences libraries was analyzed to determine the nature of these services, their target audiences, and their institutional settings. Three kinds of reports were identified: descriptions of services (70%), reviews of the literature (10.5%), and future-oriented articles that advocate various group instructional services (19.5%). Five target audiences were identified: library users, staff, librarian peers, library science students, and patients. Instructional services were offered primarily in medical school/center libraries, hospital libraries, and the National Library of Medicine and its Regional Medical Libraries (RMLs). To a lesser extent, health sciences educational services are offered through other professional school libraries, library associations and consortia, and schools of library science. There are gaps in the literature in the areas of library experience with marketing, evaluation, administration of the offered educational services, and continuing education for health sciences librarians. PMID- 3676535 TI - Perspectives on medical school library services in Turkey. AB - This paper gives a brief overview of medical education in Turkey and shows the impact of established social, educational, and economic patterns upon current medical library services. Current statistical information is given on the twenty two medical school libraries in Turkey. Principal problems and chief accomplishments with library services are highlighted and discussed. PMID- 3676536 TI - A cost-sharing formula for online circulation and a union catalog through a regional, multitype library cooperative. AB - The experience of the Capitol Region Library Council and the University of Connecticut Health Center in developing a cost allocation formula for a circulation and online catalog shared by twenty-nine libraries is reviewed. The resulting formula identifies a basic unit cost as a minimum for each system participant. PMID- 3676537 TI - Telefacsimile from a user perspective. AB - A study conducted at Montana State University compared telefacsimile service with mail delivery. Recipients of telefax materials who answered questions about the purpose, timeliness, and quality of the materials were generally well pleased. Telefacsimile was found to be a cost-effective and efficient method of document delivery over long distances. PMID- 3676538 TI - A hospital library's joint venture: the Microcomputer Resource Center. PMID- 3676539 TI - Creativity in aging persons. PMID- 3676540 TI - Impasse, finitude, and guilt. Some religious challenges of aging. PMID- 3676541 TI - Hope. PMID- 3676542 TI - Maintaining hope in adversity. PMID- 3676543 TI - What is the most effective way to treat opiate addiction? PMID- 3676544 TI - The rising costs of contrast media. PMID- 3676545 TI - AIDS phobia. PMID- 3676546 TI - Sex reassignment surgery in the male transsexual. AB - Failure of psychotherapy alone in the treatment of male transsexuals led to the development of modern sex reassignment surgery. Here we describe our technique, its indications, complications and outcome. PMID- 3676547 TI - Bilateral acute dacryocystitis in an infant. PMID- 3676548 TI - Evidence for significant risk factors in stroke. PMID- 3676549 TI - Psychosurgery--a very effective last resort. PMID- 3676550 TI - Further developments in sex therapy. PMID- 3676551 TI - Low risk of recurrent thromboembolism in pregnancy. PMID- 3676552 TI - Speed of onset of pulmonary tuberculosis. PMID- 3676553 TI - Whispering pectorilique and pleural effusion. PMID- 3676554 TI - Achieving a Balance--no simple solution. PMID- 3676555 TI - How to die of ignorance without catching AIDS. PMID- 3676557 TI - The academic needs of nursing. PMID- 3676556 TI - Cerebral resuscitation: let the clinician be wary. PMID- 3676558 TI - Evaluation of a support group for cancer patients and their families and friends. PMID- 3676559 TI - The role of the hospice for the dying child. AB - Health authorities and individuals involved in the care of children with life threatening disease are expressing concern about the suggested proliferation of children's hospices. I believe they are right in their concern. A very small number of families need the facility of a hospice building. A very great number of families can benefit from the philosophy of hospice care. PMID- 3676561 TI - Intradiaphragmatic abscess: a complication of biliary sepsis. PMID- 3676560 TI - The basal cell naevus syndrome. AB - The basal cell naevus syndrome, classically described as a triad of multiple basal cell carcinomas, odontogenic keratocysts of the jaws and skeletal anomalies, is well known by oral and plastic surgeons and dermatologists. This paper describes the clinical features in a series of 60 patients, and highlights some problems of diagnosis and management. PMID- 3676563 TI - Inflammatory abdominal aortic aneurysms. PMID- 3676562 TI - Diagnosis of osteomalacia in the elderly. PMID- 3676564 TI - Rival technologies in breast cancer screening. PMID- 3676565 TI - Diaphragms and condoms for prostitutes. PMID- 3676566 TI - Changing attitudes to AIDS. PMID- 3676567 TI - Growing support for psychosurgery. PMID- 3676568 TI - Is the policy of informed consent in the interest of the surgeons or the patients? PMID- 3676569 TI - Venous lakes: treatment by infrared coagulation. AB - A new treatment for venous lakes (Bean and Walsh, 1956) has been devised using an infrared coagulator. The solid light guide with its sapphire cap enables the ectatic vessels to be compressed prior to coagulation, minimising the energy required to destroy the vessels. We have successfully treated 10 lesions with a pulse duration of 1.125 seconds. PMID- 3676570 TI - A new method of resurfacing the lip. AB - The whole lip can be resurfaced with sensate musculo-mucosal flaps taken from the cheeks. These flaps can be combined with major resection of the whole lip curtain. The return of sensation is of particular benefit to elderly patients who make up the greatest number of patients in the series. PMID- 3676572 TI - Extensive pharyngo-oesophageal reconstruction using multiple jejunal loops. AB - Two patients underwent subtotal pharyngo-oesophageal reconstruction using jejunum transferred by means of microvascular anastomosis. In both cases, two sets of vascular anastomoses were required, one in the lower neck and the other at the mid-sternal level. In the first patient, a continuous length of jejunum was employed but this led to great redundancy of the bowel on account of coiling as a result of its mesenteric attachment. In the second case, two isolated loops were employed with minimal redundancy. An anatomical study on three fresh cadavers indicated that the maximum defect which can be bridged by a single loop of jejunum lies between 15 and 20 cm. No particular part of the jejunum or ileum seems particularly advantageous in terms of its ability to span large defects. PMID- 3676571 TI - The action of piracetam in ischaemic flaps. AB - The effects of piracetam on skin flap viability, capillary blood flow and temperature were studied in abdominal cutaneous flaps in rats. The drug significantly increased the viability of the distal (random) portion of the flap and this response was dose-related. Compared with controls, the area of skin necrosis was 12.4% less in the piracetam-treated animals and extended necrosis was not observed. Piracetam appeared to act by increasing the capillary blood flow, mainly in the distal portion of the flap. The improved perfusion was reflected as a smaller drop in the recorded temperature compared with controls. Blood levels of this drug in animals receiving the maximum effective dose corresponded to the active drug concentration in human rheology. PMID- 3676573 TI - A review of nasolabial flaps for intra-oral defects. AB - The nasolabial flap has been used in 23 patients for reconstruction of moderate size intra-oral defects. Versatility in design of the flap is allowed by the numerous blood vessels supplying the nasolabial skin. Flap vascularity was reliable, there being no cases of total loss and three cases (12%) of partial necrosis. Recurrence of tumour occurred in 8.7% of cases and in those operated in the first instance for recurrence, there was no further local disease. There were minor problems of intra-oral hair growth, donor site distortion and obstructive sialadenopathy. However, because of its simple elevation, proximity to the defect and versatility, we believe that the nasolabial skin flap is a useful procedure for closure of selected intra-oral defects. PMID- 3676574 TI - Use of an abdominal rotation flap for inguinal lymph node dissection. AB - In order to reduce the incidence of skin edge necrosis following dissection of the inguinal lymph nodes, an abdominal rotation flap has been used to help with closure. This allows excision of the most vulnerable skin, and closure without tension. Our experience in 13 groin dissections is presented, with skin edge necrosis in one patient (7.6%). This is compared with previously reported series and the reasons for the precarious blood supply to the skin following groin dissection are discussed. PMID- 3676575 TI - Post-burn squamous cell cancers in Nigerians. AB - Eighteen patients with post-burn skin cancers seen at Enugu over an 8-year period have been reviewed. All the tumours were well differentiated squamous cell carcinomas. The mean age of the patients was 36 years and the incubation period of 17.5 years was shorter than in previously reported studies. An aggressive policy in the treatment of these tumours by surgery alone has resulted in an 87% 5-year survival rate for lower limb tumours. When secondary tumours due to pre existing dermatological diseases are excluded, post-burn skin epitheliomas constituted the largest group of squamous cell skin cancers seen in Enugu, Nigeria. PMID- 3676576 TI - Modification of the "Mustarde-Mathieu" and "Horton-Devine" urethroplasty in the management of hypospadias. AB - This paper reports on the method of repairing distal or mid-shaft hypospadias in 42 patients using a modification of the Mustarde-Mathieu and Horton-Devine techniques. A terminal meatus was achieved in all cases; there were two fistulae and one meatal stenosis. PMID- 3676577 TI - A new radio-opaque injection technique for tissue preservation. AB - This study has investigated the action of two commonly available preservatives, chlorbutol and chlorocresol, on fresh cadaver tissue. If the arterial system of the subject is perfused first with either preservative then the progression of tissue necrosis can be delayed for up to 1 month. The preservative can be combined with the lead oxide-gelatin mixture described by Rees and Taylor without compromising the results of radiographic studies. Both chlorocresol and chlorbutol have the advantage over formalin of retaining the normal colour and texture of the tissues. A regimen is suggested which has all of the advantages of the mixture originally described by Salmon, but is much simpler and cheaper to produce. It has proved successful when used in whole cadavers but the visceral contents must be removed at an early stage. PMID- 3676578 TI - Artificial syndactylisation for congenital crossed toes. AB - Congenital crossed toe is a common deformity which frequently causes disability. The fifth toe is affected and over-rides the fourth toe. Correction is carried out to relieve pain caused by pressure and to improve appearance. Methods of correction range from conservative manipulation and splintage to radical amputation. The method of syndactylisation is a plastic procedure which is simple, safe and reliable. PMID- 3676579 TI - The "Zulu" tissue expansion in construction of the helix and ear lobe. AB - A traditional custom has been employed in a design of a new technique to expand a rudimentary auricle. The technique involves a full thickness incision of the blob of tissue and positioning of a spacer which is gradually expanded by means of a conical obturator. The technique provides a large amount of local tissue that can be used in helix and ear lobe reconstruction. An illustrative case is reported. PMID- 3676580 TI - The bi-scapular flap. AB - The free transfer of two transverse scapular flaps in continuity is described. This provides a donor site capable of yielding a skin flap 50 x 10 cm. Some observations on the vascularity of adjacent axial territories are made. PMID- 3676581 TI - One stage reconstruction of a massive back defect with a large fasciocutaneous flap. AB - The use of fasciocutaneous flaps in the treatment of soft tissue defects has been widely accepted. This study presents a case in which a huge defect after surgical resection of an advanced rhabdomyosarcoma was reconstructed by an extraordinarily large vertical fasciocutaneous flap from the back. PMID- 3676582 TI - An extended latissimus dorsi "non-free" flap. AB - A case is reported in which perfusion of a latissimus dorsi musculocutaneous flap was maintained through its secondary blood supply during transfer to a sacral defect, while its thoracodorsal pedicle was being lengthened by saphenous vein grafts. The secondary blood supply was divided only when the microvascular anastomoses were seen to be functioning so this flap was never a truly "free" flap. PMID- 3676583 TI - The extended deep inferior epigastric flap: a case report. AB - The extended deep inferior epigastric flap, described by Taylor et al. (1983), 1984), offers a versatile and reliable technique for covering defects in the lower limb. A case of shark bite is described in which extensive soft tissue loss in the thigh resulted in a denuded femoral shaft which was successfully treated using such a flap. PMID- 3676584 TI - Distally based dorsalis pedis island flap for coverage of the distal portion of the foot. AB - A distally based dorsalis pedis island flap is described which has been successfully used for reconstructing the distal portion of the foot in two patients with amputation of all 5 toes. The indication for this flap is a wide skin defect of the distal half of the dorsal foot without history of local vascular disorder. The arterial inflow of the flap comes from the posterior tibial artery via the deep plantar branch of the dorsalis pedis artery, while the venous drainage is most likely to be through the venae comitantes of the dorsalis pedis artery to those of the deep branch. PMID- 3676585 TI - Venous bridge used in free flap transfer for the lower leg in the presence of venous hypertension: a case report. AB - Reconstruction with free flaps for the lower leg in the presence of venous thrombosis or venous hypertension has a high risk of failure. We describe the use of the contralateral leg for venous drainage through a pedicled skin bridge containing a tributary of the long saphenous vein. The recipient artery was a main artery of the ipsilateral leg. Two weeks later, once there was a well established venous communication between flap and recipient site, the venous bridge was divided. Because the arterial inflow to the flap was not interrupted by the division of the skin bridge, the flap has good viability and good resistance to infection or ulceration 3 years later. PMID- 3676586 TI - Multiple metastases from basal cell naevus syndrome. AB - A patient with basal cell naevus syndrome (Gorlin-Goltz Syndrome) is presented. Of note in the case was the extensive symmetrical tumour invasion of both external auditory canals requiring bilateral radical resection. The patient expired 14 months later, at which time the autopsy revealed widespread metastases to the pleura, diaphragm, pericardium, epicardium and myocardium. Although lung metastases have been reported in this syndrome, no cases have been reported of metastases to these sites. PMID- 3676587 TI - Ectopic thymus in the neck; a case report and review of the literature. AB - A soft, poorly defined mass in the right upper neck of a 7-week-old boy was shown on histology to be ectopic thymus. As aberrant thymic tissue often does change into cysts or neoplasms removal is the treatment of choice. Its persistence in the upper neck seems to be very rare. Embryology, incidence, differential diagnosis and treatment are discussed with a review of the literature. PMID- 3676588 TI - Chronic pain: illusion or pathology? A case report of a vascular leiomyoma in the leg. AB - Patients with chronic pain constitute a major problem for the surgeon as the cause of their pain is often difficult to diagnose and is only rarely a well circumscribed lesion which is amenable to surgical or other treatment. We report a case of chronic pain due to a vascular leiomyoma beneath the deep fascia of the leg. Angioleiomyomas are rare tumours that are usually found in the subcutaneous tissue. PMID- 3676590 TI - A simplified pedicle delay for axial pattern flaps. PMID- 3676589 TI - Chylo-pharyngeal fistula after radical neck dissection. PMID- 3676591 TI - The DIY mini suction drain. AB - Using readily available materials, a versatile mini suction drain system can be quickly constructed. PMID- 3676592 TI - Long-lasting complications with the use of polyurethane-covered breast implants. PMID- 3676593 TI - Studies on the induction of pharmacological responses to des-Arg9-bradykinin in vitro and in vivo. AB - 1 The mechanisms by which agents modulate the induction of kinin B1-receptors were investigated by studying the effects of kinins in vitro, by use of the rabbit isolated aorta, and in vivo by measuring the blood pressure of anaesthetized rabbits. 2 The contractile response of the rabbit isolated aorta to kinins increased in a time-dependent manner in vitro. This effect was abolished by continuous exposure to the protein synthesis inhibitor cycloheximide (71 microM). 3 Several substances were found to increase specifically the rate of sensitization to des-Arg9-bradykinin (des-Arg9-Bk), when applied continuously in vitro to tissues isolated from normal animals: bacterial lipopolysaccharide (LPS; 1 micrograms ml-1), muramyl-dipeptide (MDP; 2 micrograms ml-1), phorbol myristate acetate (PMA; 320 nM), epidermal growth factor (EGF; 100 ng ml-1) and endothelial cell growth factor (150 micrograms ml-1). 4 The protease inhibitors phenylmethylsulphonyl fluoride and aprotinin, a non-adjuvant isomer of MDP, rabbit purified leukocyte interferon, fibroblast growth factor and the chemotactic peptide N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP) did not have this effect. 5. It has been demonstrated that LPS induces B1-receptors in rabbits enabling des-Arg9-Bk to act as a hypotensive agent. In these experiments neutropenia induced by nitrogen mustard, did not prevent the in vivo effect of LPS. MDP (300 micrograms) and PMA (100 micrograms) were also found to induce a state of responsiveness to des-Arg9-Bk in vivo. FMLP (1 mg i.v.) induced a temporary decrease in blood neutrophil counts but had no effect on the induction of responses to des-Arg9-Bk. 6. The development of responses mediated by the B, receptor in the two experimental systems seems to be unrelated to the activation of neutrophil leukocytes, but may be related to the activation of tissue macrophages. Approximately 3% of cultured adherent cells derived from rabbit aorta strips following protease digestion were stained for non-specific esterase, supporting such a possibility. PMID- 3676594 TI - Lack of evidence for increased descending inhibition on the dorsal horn of the rat following periaqueductal grey morphine microinjections. AB - 1 Recordings were made from 18 neurones in the dorsal horn of the rat, anaesthetized with halothane. All cells received A- and C-fibre inputs and responded to innocuous and noxious stimuli applied to their excitatory receptive fields located on the extremity of the ipsilateral hindpaw. Transcutaneous application of suprathreshold (mean 3.2 T) 2 ms square-wave pulses to the centre of the receptive fields resulted in responses to A- and C-fibre activation being observed; a mean 32.4 +/- 6.0 C-fibre latency spikes were evoked per stimulus. 2 A high dose (20 micrograms) of morphine in 0.5 microliter sterile saline, microinjected into the periaqueductal grey matter (PAG) had no effect on the C fibre-evoked activity of thirteen cells (72%) and facilitated 5 neurones (28%). Microinjection sites covered most of the PAG particularly the caudal medioventral zone. 3 A relatively high dose (6 mg kg-1, i.v.) of systemic morphine chloride, sufficient to elicit the direct spinal action of the opiate, inhibited all 5 cells tested. 4 We conclude that there is little evidence that the supraspinal action of morphine includes increased descending controls and depression of dorsal horn neurones in the rat. PMID- 3676595 TI - Renal vascular effects of leukotriene C4 in the isolated perfused kidney of the rat. AB - 1 The vascular effects of leukotriene C4 (LTC4) were investigated in the isolated perfused kidney of the rat. 2 LTC4 (6.4 X 10(-10) to 3.2 X 10(-8) mol kg-1 min-1 given over 5 min) resulted in a prompt, dose-dependent increase in renal vascular resistance in a recirculating system, which lasted for more than 60 min. 3 LTC4 was 10 to 20 fold and 1000 to 2000 fold, respectively, less active on a molar basis than noradrenaline and angiotensin II in eliciting renal vasoconstriction. 4 The vascular response to LTC4 was blocked dose-dependently by FPL 55712, an antagonist of slow reacting substance of anaphylaxis. OKY 1581, a specific thromboxane synthetase inhibitor, and indomethacin, a cyclo-oxygenase inhibitor, did not influence the LTC4 response. 5 LTC4 given in a single-pass perfusion system resulted in a short lasting response with baseline values for renal vascular resistance reached after 4 min. 6 These results show that LTC4 is a short acting renal vasoconstrictor with less potency than noradrenaline and angiotensin II. Its pressor effects seem to be mediated by specific leukotriene receptors and independent of cyclo-oxygenase products. The long-lasting effect in the recirculating arrangement, in contrast to the single pass system, is compatible with formation of active metabolite(s). PMID- 3676596 TI - L-proline depolarizes rat spinal motoneurones by an excitatory amino acid antagonist-sensitive mechanism. AB - 1 Isolated spinal cords prepared from neonatal rats were used to examine the effects of L-proline (L-Pro). 2 L-Pro (1-8 mM) depolarized ventral and dorsal roots in a dose-dependent manner with one sixth of the potency of L-glutamate (L Glu). L-Pro was four times more potent than D-Pro. Prolonged application of L-Pro produced a plateau depolarization of motoneurones with no apparent fade. 3 Omission of calcium ions from the medium potentiated the depolarizing actions of L-Pro, L-Glu and quisqualate. 4 L-Pro was antagonized by concentrations of 2 amino-5-phosphonovalerate (25 microM), gamma-D-glutamylglycine (100 microM) and Mg2+ ions (1 mM) that depressed responses to N-methyl-D-aspartate (NMDA). The NMDA receptor-mediated component of the response to L-Pro was estimated to be 60 70%. 5 These data suggest that L-Pro should be considered as a possible excitatory neurotransmitter and that, because L-Pro is a neutral compound, excitatory amino receptors may not require an agonist to possess two anionic groups and one cationic group. PMID- 3676597 TI - The effects of agonists on the components of the cardiac muscarinic receptor. AB - 1 The binding of eleven agonists to muscarinic receptors in the rat heart has been measured in competition with [3H]-N-methylscopolamine. 2 Full analysis of binding required the resolution of three components (SH, H and L). 3 The proportion of the H component was independent of agonist structure. The proportion of the SH component ranged from 2-36% of the total and was dependent on the agonist. The proportion of the L component varied in a complementary way from 59-22% of the total. 4 The ratios of the affinities of ten of the agonists to the three components of the receptors were constant; the weakest binding agonist, choline, had lower ratios of affinity. 5 When saturated with guanylylimidodiphosphate (GppNHp) the SH receptor population was no longer detectable and the H receptor population was reduced by 63%: about 85% of the receptors was in the L population. 6 The affinity constants of agonists for the H and L forms of the receptors were not changed by GppNHp. 7 The results are interpreted in terms of the effects of accessory proteins on the proportions of binding and non-binding conformations of the receptor. PMID- 3676598 TI - Effects of amiodarone and thyroid dysfunction on myocardial calcium, serum calcium and thyroid hormones in the rat. AB - 1 Myocardial calcium content was found to be elevated and serum calcium reduced in hypothyroid rats. 2 Treatment of rats with amiodarone at either 30 mg kg-1 or 150 mg kg-1 daily did not result in any significant changes in myocardial or serum calcium. 3 The administration of amiodarone to hypothyroid rats attenuated the changes in serum but not myocardial calcium, suggesting that amiodarone may exert a thyroid hormone-like effect in the hypothyroid state. 4 The administration of amiodarone to thyroid hormone-treated rats resulted in attenuation of the effects on serum calcium and calculated intracellular calcium; this was consistent with an antagonistic interaction between amiodarone and thyroid hormones. 5 Administration of amiodarone resulted in significant changes in circulating thyroid hormone levels in the rat; triiodothyronine was reduced and basal thyrotrophin elevated compared to euthyroid controls. Serum thyroxine was not changed; this is in contrast to the effects in man. 6 Amiodarone does not exert its anti-arrhythmic action via changes in total myocardial calcium content in the euthyroid rat; nonetheless the described interactions between the drug and thyroid hormones may be involved in its mechanism of action. PMID- 3676599 TI - Membrane mechanism associated with muscarinic receptor activation in single cells freshly dispersed from the rat anococcygeus muscle. AB - 1 The mechanism of action of carbachol was studied on freshly dispersed cells of the rat anococcygeus using microelectrodes and patch pipettes. 2 Micro ionophoretic application of carbachol evoked reproducible depolarizations which were reduced or blocked by atropine (10(-7)-10(-6) M). The time courses of the responses to noradrenaline and carbachol were similar. 3 The reversal potential of the carbachol-induced response was -3.8 mV and similar to the value (-6.2 mV) found for noradrenaline. 4 During the response to carbachol the membrane conductance was increased. At depolarized membrane potentials carbachol evoked biphasic membrane responses suggesting an increase in two separate ionic conductances. 5 With patch pipettes in the whole-cell configuration under voltage clamp, carbachol produced an inward current at a holding potential of -50 mV. The inward current was associated with an increase in membrane conductance with an equilibrium potential of about 0 mV. 6 It is suggested that muscarinic receptors and adrenoceptors in the rat anococcygeus may activate similar membrane conductances. The most prominent mechanism is an increase in chloride ion conductance. PMID- 3676600 TI - Differential effects of epithelium removal on the responsiveness of guinea-pig tracheal smooth muscle to bronchoconstrictors. AB - 1 The influence of the epithelium on contractions produced by the peptidoleukotrienes, 5-hydroxytryptamine (5-HT) and the thromboxane mimetic, U 44069, was examined in trachea from control and ovalbumin-sensitized guinea-pigs. 2 In control tissues removal of the epithelium produced an approximately 2 to 4 fold leftward shift in leukotriene C4 (LTC4) and LTD4 concentration-response curves, but no effect on LTE4-induced contractions. Similar results were obtained in preparations from ovalbumin-sensitized animals. 3 Responses produced by 5-HT or U-44069 were similar in the presence and absence of the epithelium in control guinea-pigs. 4 Indomethacin produced contrasting effects on leukotriene-induced contractions in control guinea-pigs: an increase in sensitivity to LTC4 in the presence but not absence of the epithelium, no effect on LTD4-induced contractions and a decrease in sensitivity to LTE4 in both epithelium-containing and epithelium-free preparations. 5 These results indicate that there is selectivity in the effects of epithelium removal on agonist-induced contractions of the guinea-pig trachea. This provides further evidence for the modulatory influence of the epithelium on the reactivity of mammalian airway smooth muscle and supports the postulated existence of an epithelium-derived inhibitory factor. The observation that in intact trachea indomethacin mimics the effects of epithelium removal on LTC4-induced responses, suggests the involvement of a prostanoid(s) in this phenomenon. PMID- 3676601 TI - Origin of 5-hydroxytryptamine-induced hyperpolarization of the rat superior cervical ganglion and vagus nerve. AB - 1 5-Hydroxytryptamine (5-HT)-induced membrane potential changes were recorded extracellularly from rat superior cervical ganglia (SCG) and cervical vagus nerves in vitro. 2 On the SCG, low concentrations of 5-HT (1 X 10(-8)-3 X 10(-7) M) induced concentration-related hyperpolarization responses. Higher concentrations of 5-HT (1 X 10(-6) 1 X 10(-4) M) induced complex responses which typically consisted of an initial hyperpolarization, followed by a depolarization and subsequent after-hyperpolarization. The depolarization, but not the initial hyperpolarization, was blocked by metoclopramide (3 X 10(-5) M), quipazine (1 X 10(-6) M) or MDL 72222 (1 X 10(-5) M). 3 5-HT-induced hyperpolarization of the SCG was potentiated when the amount of calcium chloride added to the superfusion medium was reduced from 2.5 to 0.15 mmol l-1. Hyperpolarization responses recorded from SCG preparations superfused with this low-calcium medium were unaffected by the substitution of lithium chloride for sodium chloride and were potentiated by the omission of potassium ions. Ouabain (1 X 10(-3) M) abolished both the hyperpolarization and the depolarization induced by 5-HT. 4 On the vagus nerve, 5-HT (1 X 10(-7) - 3 X 10(-5)M) did not induce initial hyperpolarization in either normal or low-calcium Krebs-Henseleit medium. However, in the latter solution only, depolarization responses induced by 5-HT at concentrations of 1 X 10(-6)M or greater were followed by hyperpolarization. Both the depolarization and the post-5-HT hyperpolarization were blocked by metoclopramide (3 X 10(-5)M) but were unaffected by spiperone (1 X 10(-7)M). 5 On the vagus nerve, post-5-HT hyperpolarization responses were selectively and reversibly inhibited by ouabain, and by superfusion with Krebs-Henseleit medium that was either potassium-free or contained lithium chloride in place of sodium chloride. 7 These results demonstrate the generation in the rat SCG of a 5-HT-induced hyperpolarization response that is not mediated through 5-HT3 receptors and is unlikely to be a consequence of depolarization. In contrast, on the rat vagus nerve, the post-5-HT hyperpolarization observed in the present study had the characteristics expected of depolarization-dependent activation of a sodium ion pump. PMID- 3676602 TI - Pharmacological characterization of 5-hydroxytryptamine-induced hyperpolarization of the rat superior cervical ganglion. AB - 1 A study has been made of the pharmacology of 5-hydroxytryptamine (5-HT)-induced hyperpolarization responses recorded extracellularly from the rat isolated superior cervical ganglion (SCG). 2 Hyperpolarization responses induced by 5-HT (1 X 10(-8)-1 X 10(-4) M) in the presence of MDL 72222 (1 X 10(-5) M) were not antagonized by phentolamine (1 X 10(-6) M), prazosin (1 X 10(-7)-3 X 10(-7) M), haloperidol (1 X 10(-6) M) or ketanserin (1 X 10(-7)-1 X 10(-6) M). However, the latter two compounds both potentiated and increased the persistence of the hyperpolarization induced by moderate to high concentrations of 5-HT. Spiperone (1 X 10(-7) M) caused similar effects. All further experiments were performed in the presence of ketanserin (1 X 10(-6) M) as well as MDL 72222. 3 8-Hydroxy-2(di n-propylamino)-tetralin (8-OH-DPAT; 1 X 10(-7)-1 X 10(-4) M) and ipsapirone (3 X 10(-5)-3 X 10(-4) M) behaved as weak hyperpolarizing agonists on the SCG. However, at concentrations below those required to produce hyperpolarization, both compounds acted as unsurmountable antagonists of 5-HT-induced hyperpolarization. 4 5-Carboxamidotryptamine (5-CT; 1 X 10(-9)-1 X 10(-5) M) mimicked the hyperpolarizing activity of 5-HT on the SCG. The EC50 for 5-CT was approximately 9 fold lower than that for 5-HT. 5 Spiperone (1 X 10(-7) - 1 X 10( 5) M) behaved as a reversible competitive antagonist of hyperpolarization responses induced by 5-HT with a pKB value of 7.40 +/- 0.09. Spiperone (1 X 10( 7)-1 X 10(-6) M) also caused concentration-dependent rightward displacement of the 5-CT concentration-hyperpolarization response curve. In this case, the pKB was 7.80 +/- 0.05. 6 (+/-)-Cyanopindolol (3 X 10(-7)-3 X 10(-6) M) caused non parallel rightward displacements of the 5-HT concentration-response curve. Against 5-CT, (+/-)-cyanopindolol (3 X 10(-7)-3 X 10(-6) M) caused a concentration-independent rightward displacement of the concentration-response curve, accompanied by a large increase in the maximum response. 5-CT-induced hyperpolarization recorded in the presence of (+/-)-cyanopindolol (3 X 10(-7) M) was not significantly antagonized by methiothepin (1 X 10(-6) M) or methysergide (1 X 10(-6) M). 7. It is concluded that 5-HT-induced hyperpolarization of the rat SCG is mediated via a 5-HT1-like receptor which resembles the 5-HT1A binding site. However, a lack of selective drugs precludes more definitive characterization of this receptor. PMID- 3676603 TI - A study on the effect of a single dose of tamoxifen on uterine hyperaemia and growth in the rat. AB - 1 The effect of a single subcutaneous dose of tamoxifen on the rat uterotrophic response was investigated. 2 The parameters examined were uterine blood flow (measured by the microsphere technique), uterine wet and dry weights and the concentrations of cytosolic and nuclear oestrogen receptors. 3 Tamoxifen or its metabolites proved to be capable of eliciting a uterotrophic response of 35-42 days duration. The changes seen in uterine blood flow and weight are discussed in relation to oestrogen receptor distribution. PMID- 3676605 TI - Assessing the functional value of relatives' knowledge about schizophrenia: a preliminary report. AB - An instrument for assessing and evaluating what relatives know about schizophrenia was evaluated as both a pre- and a post-test for an educational programme. The Knowledge About Schizophrenia Interview (KASI) places emphasis on the functional value of the reported knowledge rather than on the recall of information; it is quick, easy to administer, can be rated reliably, and has face validity for the relative. The educational programme increased scores from pre test to a post-test one week after the programme. Relatives with high criticism ratings on the Camberwell Family Interview had lower scores at both tests. Relatives of less chronic patients showed lower scores at pre-test and acquired significantly more information from the programme, while relatives of more chronic patients were less influenced by the information sessions. PMID- 3676604 TI - An investigation of the actions of diltiazem on rat aorta exposed to acute hypoxia followed by re-oxygenation. AB - 1 The effects of diltiazem and removal of extracellular Ca2+ were examined on contractions, of the rat isolated aorta, to noradrenaline (NA) and high K+, during exposure to oxygenated conditions and hypoxia followed by re-oxygenation. 2 Exposure to hypoxia caused a similar reduction of contractile responses to NA and KCl, while re-oxygenation restored contractile activity. 3 Ca2+-free conditions abolished responses to KCl but a transient response to NA remained which was resistant to hypoxia. 4 Diltiazem produced similar reductions of responses to NA during both oxygenated conditions and hypoxia, whereas during re oxygenation the effects of diltiazem upon responses to NA were enhanced. 5 Diltiazem produced a more pronounced reduction of responses to KCl than of responses to NA. However, the reduction of responses to KCl by diltiazem was not modified by the changes in PO2 examined in the present study. 6 The present study indicates that contractions of the rat aorta mediated by intracellular Ca2+ are resistant to the hypoxic conditions studied in the present investigation, whereas those responses mediated by an influx of Ca2+ are reduced. The increase in the contractile response to NA following re-oxygenation may result from an increased influx of extracellular Ca2+ since such responses show an enhanced sensitivity to diltiazem. PMID- 3676606 TI - Response of depressive symptoms to nortriptyline, phenelzine and placebo. AB - The effects of nortriptyline, phenelzine, and placebo on 13 symptoms of depression were compared in 75 patients, aged 55 or over, who were suffering from major depression. Nortriptyline and phenelzine were more effective than placebo in treating depression mood, guilt feelings, suicidal ideation, agitation, anxiety, loss of energy, and a.m. diurnal variation of mood. Nortriptyline was better than phenelzine or placebo in improving middle/late insomnia. Most of the symptoms did not show significant improvement until the fourth week of treatment. PMID- 3676607 TI - Outcome in bipolar affective disorder after stereotactic tractotomy. AB - Nine patients have been treated by subcaudate stereotactic tractotomy for bipolar affective disorder resistant to drug treatments. In the majority, after the operation there was a reduction in frequency and severity of depressive and manic episodes. There was a trend for the operation to have more effect on the manic than on the depressive phases. Drugs which had been inert previously sometimes became therapeutically useful after surgery. PMID- 3676608 TI - Monitoring the occurrence and duration of electroconvulsive fits. AB - During 100 routine psychiatric hospital electroconvulsive treatments the medical staff administering treatment experienced little difficulty in deciding that a fit had occurred. The judgement was based on simple clinical observation of a succession of clonic bodily movements, and high inter-rater agreement was found for the measurement of fit duration. The cuff technique was also used, but it tended to underestimate fit duration and is not recommended for routine ECT practice. PMID- 3676609 TI - Recurrent pseudocyesis and hypomania. AB - The case of a young woman presenting with three distinct episodes of pseudocyesis occurring concurrently with annual hypomanic illness is described, and the association between pseudocyesis and affective disorder discussed, with regard both to possible underlying psychopathology and to previously proposed psychoneuroendocrine mechanisms. PMID- 3676610 TI - Seasonality, birth complications and schizophrenia in a high risk sample. AB - It has been suggested that viral infections, more prevalent in the winter months, might increase pregnancy and birth complications, which might in turn be responsible for the excess of winter-born patients with schizophrenia. In this study it was found that the rate of schizophrenia among high risk winter-urban births who had suffered a perinatal complication was significantly greater than that for those who had not, thus supporting the hypothesis. PMID- 3676611 TI - Continuum of psychosis and the gene. PMID- 3676612 TI - AIDS panic. PMID- 3676613 TI - Not a case of pseudo-AIDS. PMID- 3676614 TI - The burden of care: The impact of functional psychiatric illness on the patient's family. PMID- 3676615 TI - Prognosis of depression in old age. PMID- 3676616 TI - Folate, vitamin B12 and posture. PMID- 3676617 TI - Transient effect of diazepam in some sub-acute organic states. PMID- 3676618 TI - Similar incidence worldwide of schizophrenia: case not proven. PMID- 3676619 TI - 'Afternoon radiator sitting syndrome': hyperthermia and early diagnosis of self induced water intoxication. PMID- 3676620 TI - A search for sub-clinical arteriosclerotic dementia. PMID- 3676621 TI - Asymmetry of lateralised hemispheric functions in schizophrenia. Influence of clinical and epidemiological characteristics on quality extinction test performance. AB - The Quality Extinction Test was used to detect lateralised abnormalities of hemispheric functions in schizophrenic patients. Course of illness significantly affected the distribution of tactile extinctions, chronic patients showing more left-side extinctions than sub-chronic ones. Ages significantly affected the number of left extinctions, and sex the number of right extinctions. The importance of clinical and epidemiological characteristics of the patients in determining the quality and degree of hemispheric dysfunction in schizophrenia was confirmed. PMID- 3676622 TI - Correlates of suicide attempts and ideation in schizophrenia. AB - A group of 118 patients with a hospital diagnosis of schizophrenia was reviewed. The incidence of suicide attempts was significantly correlated with more frequent past psychiatric admissions, more frequent past diagnoses of schizophrenia, and poor work function. The apparent relationships could be spurious or based on a reversed causal sequence; for example, suicide attempts are likely to be followed by psychiatric admissions. PMID- 3676623 TI - Psychological correlates of unemployment among male parasuicides in Edinburgh. AB - Variations in clinical features associated with unemployment among a sample of male parasuicides were examined. Employed and unemployed persons did not differ in mean scores on the Suicidal Intent Scale, but the unemployed were rated significantly worse on measures of depression (Beck Depression Inventory) and hopelessness (Hopelessness Scale). A covariance analysis showed that hopelessness, rather than depression, is the important discriminator. Different patterns of relationships between the three clinical measures were observed in the two groups. Hopelessness may be a key social-psychological variable for inclusion in any model of the pathways which link unemployment with parasuicide. PMID- 3676624 TI - The Newcastle Adolescent Behaviour Screening Questionnaire. AB - As part of a larger study, a brief rating-scale was developed which focuses on the mid-adolescent phase of development. Completed by teachers, the questionnaire has an inter-rater reliability of 0.78, with a test-retest correlation of 0.82. When the performances of various screening instruments were compared it became clear that no single questionnaire was obviously more efficient than the others at detecting potential disturbance in an urban adolescent population. Indeed, different questionnaires seemed to highlight particular facets of functioning. The Newcastle Adolescent Questionnaire proved to be a reliable and valid screening measure. PMID- 3676625 TI - The outcome of neurotic disorders after out-patient and day hospital care. AB - New psychiatric out-patients with depressive, phobic, and anxiety neurosis were randomly allocated to out-patient care or to one of two types of day hospital treatment, one specialising in psychotherapy and the other offering all forms of day care. Of 106 patients who entered the study, 78 had assessments of psychiatric symptomatology and social adjustment both before treatment and after 4, 8 and 24 months. There was no significant difference in outcome between depressive, phobic, and anxiety neurosis, and no overall difference in response to treatment between the three types of care. Suicidal symptoms were significantly less common in out-patients. In many respects, neurotic disorder can be regarded as a single syndrome. PMID- 3676626 TI - Does violence have cognitive correlates? AB - The relationship between cognitive function and violence in 76 remanded prisoners, without formal psychiatric illness, was investigated. The violent group tended to be of slightly lower general ability than the non-violent group, but not abnormally so in relation to the general population; no relationship was found between specific patterns of cognitive functioning and violence. The violent group reported significantly higher levels of neurotic symptoms than the non-violent group, and were more socially deviant. To a small extent, general intelligence (reasoning ability), in interaction with many other factors, may be related to a propensity for violent behaviour, but no particular aspect of cortical functioning seems to be related to violence. PMID- 3676627 TI - Cerebral and brain stem changes after ECT revealed by nuclear magnetic resonance imaging. AB - Nuclear magnetic resonance images of the brain were obtained in fourteen patients with major depression during a course of ECT. The T1 relaxation time rose immediately after the fit, reaching a maximum 4-6 h later. The T1 values then returned to their original level; no long-term increase occurred over the course of treatment. These results are consistent with an extensive but temporary breakdown of the blood-brain barrier during ECT. PMID- 3676628 TI - In-patient treatment for drug abuse. AB - During 1984 there were 253 admissions to the in-patient drug dependence treatment unit at Tooting Bec Hospital. Of the 198 patients responsible for these admissions, 60% were male and 43% were over the age of 30 years. There were 151 patients admitted for opiate detoxification, and 75% completed the withdrawal schedule. However, only 15 out of 25 patients admitted for benzodiazepine withdrawals were found to be physically dependent. Other reasons for admission included stabilisation of the dose of opiate (24%) and the treatment of physical complications of addiction. PMID- 3676629 TI - Anorexia nervosa in males. A comparison with female patients. AB - The demographic features, clinical picture, antecedent events and family background in 13 male patients with anorexia nervosa are compared with those in a control group of 39 adolescent female anorectics; the general picture of the illness in males is similar to that in females. Focusing on a group of males, usually less vulnerable to anorexia nervosa, can highlight possible predisposing factors. PMID- 3676630 TI - Specific cross-gender behaviour in boyhood and later homosexual orientation. AB - Data from a group of males aged 13 to 23, who as children exhibited extensive cross-gender behaviour, was analysed. In boyhood they frequently played with dress-up dolls, role-played as females, dressed in girls' clothes, stated the wish to be girls, primarily had girls as friends, and avoided rough-and-tumble play. The majority of the group evolved a bisexual or homosexual orientation; two types of behaviour, boyhood doll play and female role-playing, were found to be associated with later homosexual orientation. The findings suggest developmental associations between specific types of boyhood cross-gender behaviour and the objects of later sexual arousal. PMID- 3676631 TI - Coronelismo, caciquismo, and oyabun-kobun bonds: divergent implications of hierarchical trust in Brazil, Mexico and Japan. PMID- 3676632 TI - Heroin use and acquisitive crime in an English community. PMID- 3676634 TI - A formal communication network analysis technique. PMID- 3676633 TI - From differentiation to individuation: a look at the encounter process. PMID- 3676635 TI - Psychological monitoring of overtraining and staleness. AB - It is widely agreed that overtraining should be employed in order to achieve peak performance but it is also recognised that overtraining can actually produce decrements in performance. The challenge appears to be one of monitoring stress indicators in the athlete in order to titrate the training stimulus and prevent the onset of staleness. The present paper summarises a ten-year research effort in which the mood states of competitive swimmers have been monitored at intervals ranging from 2-4 weeks during individual seasons for the period 1975-1986. The training cycle has always involved the indoor season which extends from September to March and the athletes who served as subjects were 200 female and 200 male competitive swimmers. The results indicate that mood state disturbances increased in a dose-response manner as the training stimulus increased and that these mood disturbances fell to baseline levels with reduction of the training load. Whilst these results have been obtained in a realistic setting devoid of experimental manipulation, it is apparent that monitoring of mood state provides a potential method of preventing staleness. PMID- 3676636 TI - Knee pain in sports people--a prospective study. AB - Knee pain caused by sport is a common cause of rheumatic symptoms. Clinical diagnosis is frequently difficult and an attempt was therefore made to determine whether particular symptoms and signs were sufficiently characteristic in 129 patients to enable easier recognition of knee disorders. Strict criteria for arthrography and arthroscopy included classical features of internal derangement or disabling pain. Arthrograms were performed in 39 and arthroscopy in 30, revealing good concordance for meniscal tears but none for cruciate tears. Classical histories and signs were often absent from patients with meniscal and cruciate tears. Patellar pain was a prominent symptom of 58 (45%). Questionnaires one year after assessment were returned by 91 (70%). Many patients had persistent symptoms or were unable to resume their sports. The unreliability of clinical diagnosis suggests that more frequent arthroscopic examinations could have increased the recognition of meniscal and cruciate tears. PMID- 3676637 TI - The influence of training on endurance and blood lactate concentration during submaximal exercise. AB - The purpose of this study was to examine the effect of short-term training on maximum oxygen uptake (VO2 max) and two different measures of endurance performance. Endurance was determined for 15 female subjects (7 training, 8 control) as (1) exercise time to exhaustion at 80% VO2 max (T80%) and (2) the highest relative exercise intensity tolerable during a 30-minute test (T30 min), before and after a 6-week training period. In addition, VO2 max and the work rate equivalent to a blood lactate concentration of 4 mmol.l-1 (OBLA) were determined. Maximum oxygen uptake increased by 24% (p less than 0.01) for the training group (TG) and 7% (p less than 0.01) for the control group (CG). Cumulative average work rate (CAWR) during T30 min increased by 25% for the TG while there was no change for the CG. No significant difference was found pre- and post-training in the %VO2 max (estimated from CAWR) at which the TG and CG performed T30 min. Exercise time to exhaustion on T80% increased by 347% (p less than 0.01) and 16% (NS) for the TG and the CG respectively. Good correlations were found between VO2 max and CAWR (W) (pre-training r = 0.84; post-training r = 0.83), OBLA (W) and CAWR (W) (pre-training r = 0.89; post-training r = 0.88) and change in endurance time and the change in submaximal blood lactate concentration (r = 0.70, p less than 0.01). The results of this study suggest that the ability to sustain a high relative exercise intensity is not enhanced following short-term training. PMID- 3676638 TI - Roller skating--is it a dangerous sport? AB - A prospective survey of 111 cases of roller skating injuries within one year are reported. Males were more commonly injured than females. There was a high incidence (86%) of serious injuries, 28% of which required surgical treatment. The wrist (23%) was the commonest region involved, followed by the shoulder (20%), the elbow (15%) and the ankle (12%). Collision with other skaters and loss of control were the main factors leading to injury. Better rink discipline, instruction classes and safety publicity should be helpful in minimising accidents. PMID- 3676639 TI - Inexpensive probes for the determination of body temperature. AB - Two-terminal integrated circuit temperature transducers (Analog Devices' AD 590) were used to fabricate skin and rectal probes for the monitoring of mean body temperature. They are inexpensive, robust, easily constructed and of low mass. The skin sensor system described is capable of being solidly attached regardless of the body contour such that it remains integral throughout profuse sweating and vigorous movement. Both types of probe are stable, accurate to within +/- 0.05 degree C over the physiological range of measurement and exhibit 100% response times of approximately 60 s to a square wave stimulus of 10 degrees C. PMID- 3676640 TI - Treadmill performance and selected physiological characteristics of wheelchair athletes. AB - The purpose of this study was to examine selected physiological characteristics and pushing performance over a distance of five kilometres (5 km) in twelve wheelchair athletes (10 paraplegics and 2 tetraplegics). The physiological tests and 5 km wheelchair time trials were performed on a motorised treadmill adapted for use by wheelchairs. The maximum oxygen uptake (VO2 max) and %VO2 max utilised at a fixed speed equivalent to a blood lactate concentration of 4 mmol.l-1, identified as being of importance in successful able-bodied endurance performance, were also found to correlate highly with 5 km performance in wheelchair athletes. Low correlations were found between performance and mean %VO2 max utilised over the whole distance and between performance and oxygen uptake at a standard speed. The results also showed that the tetraplegics had lower physiological reserves than the paraplegics, with a much reduced maximum heart rate and ventilation. The findings indicate that a combination of physiological characteristics influence pushing performance in wheelchair athletes. PMID- 3676641 TI - Weight-lifter's headache. PMID- 3676642 TI - Post 400 m race collapse and vomiting. A successful prevention therapy. PMID- 3676643 TI - Bilateral anterior dislocation of the shoulders due to the bench press. PMID- 3676644 TI - Use of a simple Leeds test object for rapid assessment of image intensifiers. PMID- 3676645 TI - A simple technique for double-contrast oesophagrams. PMID- 3676646 TI - Idiopathic spinal arachnoid cyst and syringomyelia. PMID- 3676647 TI - Radiographic appearance of frontal osteomyelitis in two patients with extradural abscess. AB - Extradural abscess can be a complication of frontal sinusitis. The chronicity of this condition can give rise to extreme frontal hyperostosis which can be an important radiological sign in a condition which may be clinically obscure. PMID- 3676648 TI - Demonstration of a matrix calculus using computed tomography. PMID- 3676649 TI - Appendix mass in AIDS? PMID- 3676650 TI - Case of the month. A lump on the thigh. PMID- 3676651 TI - Vascular injury in the mouse rectum after irradiation and cis diamminedichloroplatinum (II). PMID- 3676652 TI - Accuracy and precision in the measurement of relaxation times from nuclear magnetic resonance images. PMID- 3676653 TI - Divergence of opinion over the linear-quadratic model. PMID- 3676654 TI - Proceedings of the British Institute of Radiology. Radionuclide investigations of the lung. Joint meeting with The Institute of Physical Sciences in Medicine Radionuclide Topic Group. London, February 11, 1987. Abstracts. PMID- 3676655 TI - A comparison of angiographic and electrocardiographically gated computed tomographic measurements of left-ventricular function. AB - Fifty patients with ischaemic heart disease have been studied by electrocardiographically gated computed tomography (CT) and left-ventricular angiography to assess the accuracy of the former in the measurement of left ventricular volumes and ejection fraction. There was no significant difference in the measurements of end-diastolic volume (p = 0.9, r = 0.81). Computed tomography significantly overestimated end-systolic volume (p less than 0.001, r = 0.89) and significantly underestimated ejection fraction (p less than 0.001, r = 0.74). Although there is some variation between the two sets of measurements, the correlation between the two techniques is good, indicating that electrocardiographically gated CT could be a useful noninvasive technique for assessing left-ventricular function. PMID- 3676656 TI - Pitfalls in interpretation of computed tomography prior to second-look laparotomy in patients with ovarian cancer. AB - Fifty-seven patients with ovarian cancer were assessed with computed tomography (CT) prior to undergoing second-look laparotomy. All patients were clinically free of disease following chemotherapy. Patients were scanned from the top of the liver to the symphysis pubis using oral, rectal and intravenous contrast medium. Tumour was correctly identified on CT scan in nine of 25 patients who had visible evidence of cancer at laparotomy. However, in the remaining 16 patients peritoneal studding was present and was not detected. Tumours smaller than 1.5 cm in size were not found by CT scanning. Computed tomography showed abnormality in eight of 32 patients subsequently found to be free of disease. Fine-needle aspiration cytology, bolus contrast injection and repeat scanning with additional oral contrast medium could have assisted in these circumstances. As persistent disease is by definition, a contraindication to second-look laparotomy, aggressive pre-operative assessment will spare some patients unnecessary surgery. However, CT cannot detect the small nodules often present in ovarian cancer, and thus, normal scans cannot replace surgical restaging. PMID- 3676657 TI - The measurement of heart size in the antero-posterior chest radiograph. AB - A computed tomography model was used in eight patients to show how the heart diameter and cardiothoracic ratio might change between antero-posterior and postero-anterior positions. Results were compared with measurements made on erect antero-posterior chest radiographs taken on 103 patients without cardiac failure (controls) and 106 with cardiac failure. An upper limit of cardiothoracic ratio of 55% and of heart diameter of 165 mm in males and 150 mm in females was shown to provide useful discrimination between normal and abnormal heart size. PMID- 3676658 TI - Radiology of normal and abnormal gastric mucus. AB - Original surgical methods (selective vagotomy etc.) of lowering acid pepsin production in the stomach for the control of peptic ulceration have been mirrored by medical measures using H-antagonistic drugs. These have resulted in excessive quantities of mucus in the stomach. Such masses of mucus may give rise to pseudotumours in the stomach--mucomas either pure or of mixed type when the mucus is admixed with vegetable fibres. Distinction of these masses from others in the stomach is important for the establishment of correct treatment. The radiological and clinical features seen in six cases of gastric PMID- 3676659 TI - Congenital diaphragmatic hernia: the prognostic significance of the site of the stomach. AB - Congenital diaphragmatic hernia is associated with a significant mortality, despite intensive treatment. The degree of pulmonary vascular hypoplasia is the main factor affecting mortality. Various features have been considered to determine the prognosis in these infants. In this study a series of 50 consecutive cases of left-sided diaphragmatic hernia has been reviewed. The site of the stomach (abdominal or intrathoracic), demonstrated radiologically and confirmed at operation, has been related to the final outcome (survival or death). An abdominal site is associated with an excellent prognosis (6.2% mortality), while an intrathoracic site is associated with a 58.8% mortality. PMID- 3676661 TI - Oncocytomas of the kidney. AB - Seven cases of oncocytoma of the kidney are reported. In three patients this was the original histological diagnosis; the other four were diagnosed after a review of 165 renal tumours which had been previously diagnosed as carcinoma. The oncocytomas were also analysed by electron microscopy. In one case adenomas of the suprarenal glands were also found. PMID- 3676660 TI - Position of the superior mesenteric artery on computed tomography and its relationship to retroperitoneal disease. AB - The superior mesenteric artery (SMA) is constant in its retroperitoneal course and easily identified on computed tomography (CT). In 225 CT examinations, anterior and lateral displacement from a defined normal position of the proximal SMA were assessed and correlated with the presence of retroperitoneal disease. Displacement beyond the left margin of the adjacent vertebral body was always due to disease, whereas an SMA situated to the right of a normal aorta was virtually always normal. Lesser degrees of displacement were not reliably associated with disease. In cases where there was minor SMA displacement but CT appeared normal, clinical follow-up revealed retroperitoneal disease in only three out of 40 patients (7.5%). Minor displacement of the SMA is not a good indicator of occult retroperitoneal disease. PMID- 3676662 TI - Effects of vesicoureteric reflux on renal growth and function as measured by GFR, plasma creatinine and urinary concentrating ability. An experimental study in the minipig. AB - The influence of vesicoureteric reflux (VUR) on renal growth and function measured by glomerular filtration rate (GFR), plasma creatinine concentration and urinary concentrating ability has been examined in a simple one-kidney model in the growing minipig over a period of approximately 5 months. Animals with reflux in association with low voiding pressures and normal bladder function (n = 6), as well as those with raised voiding pressures and abnormal bladder function (n = 5), were investigated together with appropriate non-refluxing controls (n = 12). Urinary infection and renal scarring were avoided since these factors may affect kidney function and growth independently. Statistical tests of difference failed to demonstrate any effect of VUR on 51Cr EDTA GFR or renal growth even in the presence of elevated voiding pressures and abnormal detrusor function. However, a significant association between VUR and reduced urinary concentrating ability was shown. PMID- 3676663 TI - Neurophysiological measurement of the voiding reflex arcs in patients with functional disorders of the lower urinary tract. AB - Neurophysiological measurements were carried out in 180 patients presenting to a Joint Incontinence Clinic with a history of lower urinary tract dysfunction. A full urodynamic assessment was performed along with neurophysiological measurement of the voiding reflex arcs. The majority of patients were shown to have significantly abnormal responses on neurophysiological measurement when compared with normal controls. Two particular groups, patients with acute retention and females with stress incontinence, were shown to have markedly poorer results than patients with other urodynamic problems. These results suggest that many patients with lower urinary tract dysfunction may have a neurological component. PMID- 3676664 TI - The vagina as an alternative to the rectum in measuring abdominal pressure during urodynamic investigations. AB - Pressure in the vagina as well as within the bladder and rectum was measured during urodynamic investigations. Rectal pressure is normally used to represent changes in abdominal pressure which, when subtracted from the total bladder pressure, provides a method of assessing detrusor function. This study showed that vaginal pressure represented changes in abdominal pressure more accurately and consistently than did rectal pressure, and the vagina is therefore recommended as an alternative site in conducting urodynamic studies. PMID- 3676665 TI - Intraperitoneal rupture of the bladder causing the biochemical features of renal failure. AB - A group of 20 patients with intraperitoneal rupture of the bladder was compared with a group of 20 patients with haematuria due to renal injury. In patients admitted to hospital within 24 h of sustaining an intraperitoneal bladder rupture, the mean serum levels of creatinine and potassium were increased and the mean serum sodium level was decreased. However, the individual serum creatinine values were within normal limits in six of the 11 patients in this group. Patients presenting more than 24 h after intraperitoneal bladder rupture had an increased mean serum urea, creatinine and potassium level and a decreased mean serum sodium and CO2 content. The individual serum urea and creatinine values on admission to hospital were higher than normal in all nine patients in this group but the serum urea/creatinine ratio was not significantly elevated. A dramatic decrease in serum urea and creatinine levels was seen within 24 h after laparotomy and suturing of the bladder rupture. In patients with abdominal symptoms and signs, haematuria and the biochemical features of renal failure (elevated serum urea, creatinine and potassium, decreased serum sodium and CO2 content), the clinician should suspect an intraperitoneal rupture of the bladder. PMID- 3676666 TI - Treatment of massive haematuria with aluminous salts. AB - Fifteen patients with massive vesical haematuria were treated with a 1% aluminium potassium sulphate solution in sterile distilled water, using continuous intravesical lavage with a double channel catheter. The haematuria was caused by vesical tumours in 13 patients, radiation cystitis in one and transurethral resection in one. Immediate side effects were few and none were noted in the long term, as judged by randomised biopsies from vesical mucosa. A complete response was noted in 66% of the patients, partial response in 15% and failure in 20%. This treatment is recommended for intractable bleeding from radiation cystitis and bladder tumours. PMID- 3676667 TI - The choice of suprapubic continent catheterisable urinary stoma. AB - Two types of continent urinary diversion are compared. In six patients a Kock pouch was used. Two were completely successful but the other four patients required 10 revision operations between them and only two achieved complete continence. In seven patients a Mitrofanoff operation was done. The results were much better and six achieved complete continence with only three revision operations in two patients. It was concluded that the Kock pouch was more difficult and where possible the Mitrofanoff operation should be used to form a continent suprapubic catheterisable stoma. PMID- 3676668 TI - Augmentation and replacement sigmoid colocystoplasty. A review of 10 patients. AB - Ten cases of sigmoid colocystoplasty carried out over a 19-year period have been reviewed. The indications were bladder gangrene (1), interstitial cystitis (2), bladder fibrosis (1), failed vesico-vaginal fistula (1), tuberculous contracture (2), atonic bladder (1) and invasive bladder carcinoma (2). All patients void with control every 2 to 4 h throughout the day and twice at night. There has been no long-term deterioration of the upper tract and no delayed complications. PMID- 3676669 TI - Carcinoma associated with augmentation cystoplasty. AB - Three patients with augmentation ileocystoplasties developed carcinoma at the ileovesical junction 7, 22 and 24 years after surgery. All were originally reconstructed for genitourinary tuberculosis and all had developed huge capacity ileal segments with large residual urines, associated with recurrent urinary tract infection. With the current trend for using small bowel for both augmentation and substitution cystoplasty, balanced voiding must be achieved and maintained, and long-term follow-up is mandatory. PMID- 3676670 TI - Bladder cancer flow cytometry profiles in relation to histological grade and stage. AB - Flow cytometry was used as an additional measurement to monitor 59 untreated patients with bladder cancer. The findings indicate that tumours belonging to the same stage and grade can demonstrate different flow cytometric profiles. Using this technique, together with routine histological assessment, we were able to subclassify bladder tumours in respect of their progress. Flow cytometric profiles are recommended for additional information about the aggressiveness of the tumour and the potential response to treatment. PMID- 3676671 TI - Invasive bladder cancer. Should patients who respond to radiotherapy be treated by cystectomy? AB - A retrospective study was carried out on the long-term survival (5-12 years) of 160 patients with invasive transitional cell cancer of the bladder treated with irradiation between 1972 and 1980. Following 40 Gy irradiation of the lower abdomen, treatment consisted of cystectomy or continued irradiation of the bladder region only. A full urological examination of the bladder established whether a patient was a responder or non-responder. The patients were divided into four groups: 27 responders treated with cystectomy and diversion; 48 responders treated with continued radiotherapy up to 65 Gy; 24 non-responders treated with cystectomy and diversion; 42 non-responders treated with continued radiotherapy up to 65 Gy. Survival and complications of treatment were compared with regard to category and grade of the tumours and sex and age of the patients. It was concluded that the responders who underwent cystectomy after 40 Gy irradiation survived longer than those who received a full course of radiotherapy. The responders had a better survival rate than non-responders, regardless of further treatment. Salvage cystectomy was rarely carried out and proved to be an unsatisfactory alternative, with a high operative risk and short survival. PMID- 3676672 TI - Bacteraemia following perineal prostatic biopsy. AB - Forty patients undergoing needle biopsy of the prostate via the perineal route were studied bacteriologically. Four had positive blood cultures 5 min after the biopsy but none developed septicaemia, although no prophylactic antibiotics were used. Three of the four patients developing bacteraemia were found to have an unsuspected urinary tract infection and the same organisms were cultured from blood and urine, suggesting that this was the source of the bacteraemia. PMID- 3676673 TI - Intrascrotal adenomatoid tumours. AB - The adenomatoid tumour occurs in the genital tract of both sexes and is probably of mesothelial origin. We describe its occurrence in five men, two of whom had an intratesticular tumour, and discuss the clinical features of this lesion and the lessons to be learned regarding the management of testicular and paratesticular swellings. PMID- 3676674 TI - Congenital penile deviation and its treatment with the Nesbit-Kelami technique. AB - Ten years' experience in the treatment of 100 cases of congenital penile deviation using the Nesbit-Kelami technique showed excellent results in 96 patients, all of whom had a straight penis with full ability to penetrate. Only four patients wished to have a "straighter" penis, although penetration was possible. PMID- 3676675 TI - Congenital penile angulation. AB - Congenital penile angulation without epispadias and hypospadias (Krummerik) is more frequent than previously believed, and the prevalence seems to be higher than 0.4/1000. The malformation, which may threaten the sex life of young patients, can be corrected by a simple out-patient operation. PMID- 3676676 TI - Preliminary report of a new concept in the pharmacological treatment of erectile impotence using an implantable drug delivery system. AB - A new approach in the treatment of erectile impotence by means of pharmacologically induced erections using a totally implantable drug delivery system is described. This method allows administration of the appropriate drug at a site remote from the penis, thereby overcoming the pain and discomfort associated with direct intrapenile injection. PMID- 3676677 TI - Renal angiomyolipoma as a cause of fever of unknown origin. PMID- 3676678 TI - The cobra raises its head--transitional cell tumour progressing as acquired ureterocele. PMID- 3676679 TI - Inverted papilloma of the ureter lying within an ileal carcinoid. PMID- 3676680 TI - Xanthogranulomatous pyelonephritis with reno-colonic and cutaneous fistulae. PMID- 3676681 TI - Cyclophosphamide and ureteric carcinoma. PMID- 3676682 TI - Blind-ending duplex ureter. PMID- 3676683 TI - Mullerian inhibiting factor deficiency syndrome with crossed testicular ectopia. PMID- 3676684 TI - Reflux following endoscopic treatment of ureteroceles. A new approach using endoscopic subureteric Teflon injection. PMID- 3676685 TI - Removal of ureteric stents with the flexible cystoscope. PMID- 3676686 TI - A simple test to diagnose iritis. PMID- 3676687 TI - Pregnancy testing today. PMID- 3676688 TI - The continuing threat of exotic disease. PMID- 3676689 TI - Detection of subclinical mastitis in ewes. PMID- 3676690 TI - The effect of Trypanosoma congolense infection on the oestrous cycle of the goat. PMID- 3676691 TI - The tortoise trade--mortality in transport: an analysis of 21 years of importations into the United Kingdom. PMID- 3676692 TI - Neutralization of Pasteurella haemolytica leucotoxin by bovine immunoglobulins. PMID- 3676693 TI - Inter-relationships between plasma luteinizing hormone, testosterone and cortisol, as revealed by frequent blood samples of mature bulls. PMID- 3676694 TI - The pattern of neuropsychological impairment associated with left posterior cerebral artery infarcts. AB - We investigated the neuropsychological correlates of left posterior cerebral artery (LPCA) infarcts with a quantitative systematic approach and found a pattern of impairment extending well beyond the classical syndrome of alexia without agraphia. Sixteen consecutive patients with CT scan evidence of an infarct confined to the territory of LPCA were given a battery of tests assessing the following abilities. (1) Reading and writing; (2) naming and pointing to colours; (3) naming the same 30 objects on visual (objects and coloured photographs), tactile and verbal presentation; and (4) verbal memory. These tests were administered to large control samples and the performance of LPCA patients was considered pathological if it fell below the score of the last or second to last control patient. Seventy five per cent of PCA patients had alexia without agraphia. Although a lesion of the CT scan slice where the pineal is represented appeared to be crucially associated with alexia, the severity of the disorder increased when contiguous upper or lower slices were also involved. Not only colour anomia, but also object and especially photograph anomia could almost always be shown in alexics and were highly correlated with the degree of the reading impairment. The naming deficit was also present when items were presented in the tactile and verbal modality, in spite of the integrity of the oral language areas. Every right-handed patient, alexic as well as nonalexic, was impaired on at least two of the three verbal memory tests and most on all of them. The findings are discussed in terms of the anatomofunctional mechanisms subserving verbal memory and the transmission of visual information to the speech areas. PMID- 3676695 TI - Knowledge of motor commands and the recruitment of human motoneurons. AB - This study examined the extent to which subjects can direct internal motor commands to specific pools of motoneurons. These commands were subthreshold for muscle activity and were presumably not associated with any change in background afferent activity. Percutaneous stimuli were delivered to the motor cortex using the technique of Merton and Morton (1980) while the discharge of the first recruited motor units from two intrinsic hand muscles was recorded with selective needle electrodes. In the absence of movement or detectable electromyographic activity subjects learned to focus their internal command upon one of the pair of hand muscles such that a liminal cortical stimulus activated motoneurons in the 'focused' but not the 'unfocused' muscle. This ability was not acquired for pairs of muscles in the forearm. When the cortical stimuli activated only one motor unit in a muscle, the same unit was the first recruited during a voluntary contraction. These results suggest that motor commands can be precisely monitored and fractionated for individual intrinsic muscles of the human hand without recourse to afferent feedback. This ability may be useful for organizing and learning fine manipulative tasks. PMID- 3676696 TI - Posterior callosal infarction. Clinicopathological correlations. AB - Clinicoanatomical observations on a patient with partial interhemispheric disconnection associated with complete ischaemic destruction of the splenium and of the posterior part of the body of the corpus callosum are presented. Neuropathological examination of the areas containing degenerated white matter indicated that the lesions affected the transcallosal fibres that link the cortex of the occipital lobes and the superior parietal lobules (SPL). The white matter situated in the temporal lobes was intact. This suggests that in man, and contrary to what has been described in the monkey, the callosal pathway followed by the temporal fibres is rostral to the one followed by the parietal or at least by the SPL fibres. The most prominent disconnection syndrome elements were left tactile anomia (in spite of a rather good tactile-motor integration between the hemispheres), left visual anomia, agraphia of the left hand and 'diagnostic' apraxia. The fact that the anterior part of the corpus callosum was intact accounts for the preservation of interhemispheric transfer of somatic sensory information and for the absence of left extinction during the dichotic listening test. An attempt is made to give a more detailed explanation of the results obtained during the different tests. PMID- 3676697 TI - Motor cortex stimulation in intact man. 1. General characteristics of EMG responses in different muscles. AB - This paper is the first of two papers describing our five-year experience with the technique of electrical stimulation of the human motor cortex. In this first paper we illustrate the basic distribution and behaviour of electromyographic responses in limb muscles to anodal stimulation of the motor cortex in intact, awake human subjects. These responses may be recorded at short latency, with estimates of conduction velocities from the brain to the spinal cord suggesting transmission in rapidly conducting pathways, such as the corticomotoneuronal component of the corticospinal tract. The site at which the stimulus activates these motor pathways to produce responses at such short latency is likely to be at, or adjacent to the origin of these major descending motor pathways in the cerebral cortex. The best stimulating sites for activation of arm or leg muscles corresponds to the known somatotopic arrangement of the cerebral cortex. The electromyographic response characteristics are different in the contracting, as compared with the relaxed muscle; the EMG response latency shortens, its size becomes larger and its threshold is lowered when the muscle is voluntarily made to contract. The mechanisms that are responsible for these characteristics are examined in the following paper. PMID- 3676698 TI - Motor cortex stimulation in intact man. 2. Multiple descending volleys. AB - Using an isometric strain gauge, we measured the twitch force produced in the first dorsal interosseous (FDI) muscle by a single anodal shock to the contralateral scalp. At high intensities of stimulation this twitch can greatly exceed the force produced by supramaximal stimulation of peripheral nerve. This indicates that a single cortical shock can cause repetitive firing of some or all FDI motoneurons. Such repetitive firing was demonstrated using a collision technique in which a supramaximal ulnar nerve stimulus was given at the wrist shortly after a cortical shock. The antidromic volley from the peripheral nerve stimulation failed to obliterate completely the response to cortical stimulation. Additional EMG activity was visible in the normally silent period between ulnar M and F waves. This activity must have been due to the presence of repetitive volleys of activity set up in spinal motoneurons by the cortical shock. Such activity summates with the twitch produced by the ulnar M wave to produce a very large force twitch of the muscle. Multiple firing of some motoneurons can be observed in some individuals at cortical stimulation intensities below that necessary to evoke activity in all the motoneurons in the FDI pool. Multiple firing probably was caused by repetitive excitatory inputs impinging on spinal motoneurons. These could be demonstrated using poststimulus time histogram techniques on single motor units. Low intensities of cortical stimulation produced a single short duration (mean 1.8 ms) peak of increased motor unit firing 20 to 30 ms after the shock. At high intensities, this was followed by extra peaks some 4 to 5 ms later. H reflex testing showed that the threshold of the initial descending volley, produced by the cortical stimulus was uninfluenced by a voluntary contraction. These results are discussed with reference to the D and I waves recorded from pyramidal tract after anodal stimulation of the exposed cortex in animals. PMID- 3676699 TI - Hereditary amyloid polyneuropathy in north west Ireland. AB - Seven cases of chronic sensorimotor polyneuropathy due to amyloidosis, from 7 different families, are described, in addition to the pathology in a sibling of 1 case. The age of onset ranged from 55 to 72 years. Cardiac involvement, intermittent diarrhoea and syncopal attacks were a frequent occurrence. Motor conduction velocity showed a moderate degree of slowing in 5 of 6 cases studied and marked slowing in 1. Amyloid deposits were seen in nerve biopsy material of all 8 subjects and in rectal mucosa from 1. Immunohistochemical identification revealed AF (transthyretin-derived)--amyloid in all 8 instances, confirming the presence of type 1 familial amyloid neuropathy. The genealogical data supported this analysis. Six of the 8 cases originated in a small area of the north-west coast of County Donegal in Ireland. The remaining cases also originated in the same county. PMID- 3676700 TI - Programming and execution of movement in Parkinson's disease. AB - Programming and execution of arm movements in Parkinson's disease were investigated in choice and simple reaction time (RT) situations in which subjects made aimed movements at a target. A no-aiming condition was also studied. Reaction time was fractionated using surface EMG recording into premotor (central) and motor (peripheral) components. Premotor RT was found to be greater for parkinsonian patients than normal age-matched controls in the simple RT condition, but not in the choice condition. This effect did not depend on the parameters of the impending movement. Thus, paradoxically, parkinsonian patients were not inherently slower at initiating aiming movements from the starting position, but seemed unable to use advance information concerning motor task demands to speed up movement initiation. For both groups, low velocity movements took longer to initiate than high velocity ones. In the no-aiming condition parkinsonian RTs were markedly shorter than when aiming, but were still significantly longer than control RTs. Motor RT was constant across all conditions and was not different for patient and control subjects. In all conditions, parkinsonian movements were around 37% slower than control movements, and their movement times were more variable, the differences showing up early on in the movement, that is, during the initial ballistic phase. The within-subject variability of movement endpoints was also greater in patients. The motor dysfunction displayed in Parkinson's disease involves a number of components: (1) a basic central problem with simply initiating movements, even when minimal programming is required (no-aiming condition); (2) difficulty in maintaining computed forces for motor programs over time (simple RT condition); (3) a basic slowness of movement (bradykinesia) in all conditions; and (4) increased variability of movement in both time and space, presumably caused by inherent variability in force production. PMID- 3676701 TI - Categories of knowledge. Further fractionations and an attempted integration. AB - In this study we investigated the category specificity of the comprehension impairments of Y.O.T., a patient with a severe global dysphasia. Using matching to sample techniques it was possible to demonstrate selective impairments and selective preservations not only of broad categories of semantic knowledge but also of particular subsets of such categories. Specifically, Y.O.T.'s comprehension of 'objects' was, in general, significantly more impaired than for foods or living things. Within the broad class of objects she was significantly more impaired in the comprehension of small manipulable objects than large man made objects. Within her proper noun vocabulary there was a significant dissociation between her good comprehension of proper nouns having a unique and well-known referent (e.g., Churchill) and common proper nouns without such a referent (e.g., Jones). Her error responses were not consistent, semantic similarity and significant rate effects were observed, and it was therefore considered that her category specific comprehension deficits were primarily ones of access to a full semantic representation. We attempt to give a principled account of the increasing number of seemingly arbitrary instances of fine-grain categorical impairments of semantic knowledge. We have suggested that different weighting values from multiple sensory channels will be important in the acquisition of different categories of knowledge and that such differential weightings could be the basis of the categorical organization of systems in the brain subserving semantic knowledge. PMID- 3676702 TI - Cholinesterase activities in cerebrospinal fluid of patients with senile dementia of Alzheimer type. AB - Acetylcholinesterase (AChE) and nonspecific cholinesterase (nsChE) activities of lumbar ceresbrospinal fluid (CSF) from patients with a clinical or histological diagnosis of Alzheimer's disease have been compared with those of normal age matched control patients and patients with dementia of non-Alzheimer aetiology. No significant differences in the AChE activity of lumbar CSF from histologically and clinically diagnosed Alzheimer's disease patients and normal age-matched controls were found, although they could be distinguished from controls and other dements by their lower lumbar CSF levels of nsChE activity and by their elevated ratio of AChE/nsChE. A lower level of AChE activity was observed in the lumbar CSF of patients with dementia of non-Alzheimer aetiology. The AChE and nsChE activities of ventricular CSF obtained at postmortem have also been examined. The AChE activity of the ventricular CSF of patients with histologically confirmed Alzheimer's disease was 66% lower than that of age-matched controls; these patients could also be distinguished from normals by their lower levels of nsChE and by the elevated ratio of AChE/nsChE activities. A molecular defect in the AChE in the ventricular CSF of Alzheimer patients is indicated by the finding that the enzyme failed to show inhibition by high concentrations of substrate. The lower level of AChE in ventricular CSF may reflect the changes in this enzyme in forebrain regions of Alzheimer patients. Although it is at present not possible to correlate the lower levels of nsChE found in CSF with any known brain pathology, the significantly altered ratio of AChE/nsChE activities in lumbar CSF may possibly form the basis for a diagnostic test of Alzheimer type dementia. PMID- 3676703 TI - Supraspinal control of motoneurons innervating the striated muscles of the pelvic floor including urethral and anal sphincters in the cat. AB - The nucleus of Onuf (ON) in mammals contains motoneurons innervating the pelvic floor muscles including the external urethral and anal sphincters. Recently, direct pathways from the dorsolateral pons to the ON, probably involved in supraspinal micturition control, have been reported (Holstege et al., 1986). Since the pelvic floor muscles are involved not only in micturition but also in various other functions (e.g., coughing, vomiting, defaecation, parturition), an attempt has been made to establish whether, in the cat, there exist other direct brainstem pathways to the ON motoneurons. Our results indicate that specific projections to the ON are derived from 3 different areas: (1) the ipsilateral paraventricular hypothalamic nucleus; (2) the ipsilateral caudal pontine lateral reticular formation; and (3) the contralateral caudal nucleus retroambiguus. More diffuse projections (to all motoneuronal cell groups in the spinal cord including the ON) are derived from (1) neurons in the area of the nucleus subcoeruleus in the dorsolateral pontine reticular formation, (2) the nucleus raphe pallidus, and (3) the ventral part of the medullary medial reticular formation. Possible functional implications of these pathways are discussed. PMID- 3676704 TI - Changes of regional cerebral blood flow measured simultaneously in the right and left hemisphere during automatic speech and humming. AB - Regional cerebral blood flow (rCBF) was measured simultaneously in both hemispheres during automatic speech and during humming. During automatic speech rCBF increased slightly but significantly more in the right hemisphere. No side difference was found during humming. At rest and in both test situations the rCBF was highest bifrontally. Regional analysis revealed multiple regions of significantly increased rCBF in both hemispheres during both speech and humming. Some of these regions coincided with known speech centres in the left hemisphere. Others, especially on the right, did not. It is concluded that vocal activation during both speech and humming requires a collaboration of the two hemispheres in various functional patterns. PMID- 3676705 TI - Generator mechanisms of giant somatosensory evoked potentials in cortical reflex myoclonus. AB - In order to clarify the generator mechanisms for giant cortical evoked potentials, scalp topographies of somatosensory evoked potentials (SEPs) following various types of stimulation, including electrical nerve trunk and finger stimulation and mechanical stimulation, were investigated in 5 patients with cortical reflex myoclonus. For SEPs evoked by median nerve stimulation, not only the P25 and N34 components in central and parietal regions but also N25 in the frontal region were markedly enlarged in each patient. Their scalp distributions were not significantly different from those of normal subjects. P25 and N25, but not N34, were considerably attenuated by interfering tactile stimulation applied to the hand. The components corresponding to P25, N25 and N34 following electrical stimulation of the digital nerves as well as mechanical stimulation of the finger were also remarkably large and showed scalp distributions similar to those for median nerve SEPs. It is therefore concluded that the giant cortical SEPs of cortical reflex myoclonus are generated in those areas of the primary sensory cortex which generate normal SEPs, in response to an input, at least in part, from cutaneous afferents on the basis of an extremely enhanced cortical excitability. PMID- 3676706 TI - A new look at the human split brain. AB - The 'split-brain' syndrome results from the severance of neocortical commissures, and it is characterized by an incapacity of the cerebral hemispheres to exchange information and by the coexistence of two independent cognitive systems in the same cranium. Research on commissurotomized patients, for the most part, has focused on the disconnection and has treated the hemispheres as two independent entities. A different perspective was adopted in the present study, which considered the 'split brain' as a single organism, and the two disconnected hemispheres as integral components of this organism connected to one another through subcortical structures. Eight independent tasks were conducted on 2 commissurotomized patients who were presented tachistoscopically with simultaneous bilateral information such that neither hemisphere received sufficient information to make a final decision. Only by combining the initially segregated information could a correct response be produced. Both patients performed significantly above chance in 7 of the tasks (spatial orientation, calculation, lexical decision), suggesting that the information divided between the hemispheres could be united, related, and acted upon in a unified manner. This performance was achieved in spite of each hemisphere being unaware of the information received by the other, as typically observed in 'split-brain' patients. The results indicate the coexistence of perceptual disunity and behavioural unity, and they suggest that, even when the two disconnected hemispheres receive different information, the commissurotomized brain works as a single and unified organism. PMID- 3676707 TI - Electropalatographic analysis of apraxia of speech in a left hander and in a right hander. AB - Two cases with 'pure' apraxia of speech are reported. The articulatory disturbances were quite similar. One of the two cases was a left-handed male with a subcortical haemorrhage and the other a right-handed male with a cerebral infarct. The MRI and CT scans showed that the first case had a lesion that mainly involved the right precentral gyrus and its deep white matter, and that the second had a lesion mainly affecting the lower parts of the left precentral and postcentral gyri and their deep white matter. These findings and a literature review suggest that a corticosubcortical lesion of the lower part of the left precentral gyrus in most right handers and a lesion of the symmetric region in the right hemisphere in some left handers cause apraxia of speech. The omission errors for sounds articulated by the tongue and the hard palate were analysed using electropalatography, which records visually the dynamics of the palatolingual contact. The results demonstrated that there were three kinds of omission errors: true omissions (no palatolingual contact); omissions with incorrect contact (palatolingual contact for a different sound or undifferentiated sound); and omissions with correct contact (correct palatolingual contact for a target sound). The latter two types of omission error were observed for initial consonants and they were probably caused by a delay in air flow. The patients also showed a tendency to substitute one of the two consonants/t, t/for other sounds, which suggested that they had difficulty in the inhibition of tongue activity. PMID- 3676708 TI - Expression and characterization of hydroxyindole O-methyltransferase from a cloned cDNA in Chinese hamster ovary cells. AB - We have used two kinds of expression systems to test whether the cloned cDNA encoding hydroxyindole O-methyltransferase (HIOMT) of the bovine pineal gland was functional or not. First, when mRNA was synthesized in vitro by the SP6 system and injected into Xenopus oocytes, the enzymatic activity was expressed in the oocytes. Second, the cloned cDNA was recombined to a vector under the control of the simian virus 40 early promoter and transfected to Chinese hamster ovary (CHO) cells. The enzymatic activity of the crude supernatant of transfected cells (CHO HT2) reached to 400 pmol melatonin formed per min per mg of protein, which value was approximately 9% of that of bovine pineal supernatant. The amounts of enzyme protein estimated by immunoblotting were proportional to the enzymatic activity in both CHO and pineal gland. The content of HIOMT protein was 8- to 30-fold larger in pineal gland compared to CHO cells. On the other hand, the content of mRNA encoding the enzyme measured by dot hybridization with [32P]cDNA, was in the same range in both CHO cells and pineal glands. These data suggest that the 11 fold higher enzymatic activity in pineal gland is due to an accumulation of the enzyme protein, not to a high level of the mRNA and also indicate that the cloned cDNA can express an intact hydroxyindole O-methyltransferase enzyme in CHO cells. PMID- 3676709 TI - Expression of mouse-Torpedo acetylcholine receptor subunit chimeras and hybrids in Xenopus oocytes. AB - In this study, in vitro synthesized mRNA encoding mouse and Torpedo nicotinic acetylcholine receptor subunits was injected into Xenopus oocytes, followed by assays for assembly onto the oocyte surface (using [125I]alpha-bungarotoxin binding) and for acetylcholine-induced conductances (using voltage clamp). We constructed hybrid acetylcholine receptors in Xenopus oocytes by injecting all 8 possible combinations of 4 subunit-specific mRNAs in which a single subunit is derived from the other species. For each hybrid combination, there is detectable assembly and conductance. We also constructed cDNA clones that encode chimeric acetylcholine receptor subunits in which part of the gamma subunit from Torpedo was replaced by the homologous region of the delta subunit from mouse. None of the chimeric subunits was able to replace the Torpedo gamma, mouse delta, or Torpedo delta subunit with regard to assembly or function. We therefore conclude that widely spaced (and unknown) parts of the protein chain are required for the intersubunit interactions that eventually lead to functional assembly of the receptor. PMID- 3676711 TI - Synthesis and expression of functional angiotensin II receptors in Xenopus oocytes injected with rat brain mRNA. AB - Xenopus laevis oocytes were injected with poly(A)+ mRNA isolated from rat brain and superfused in a medium containing either serotonin, angiotensin II or bradykinin. Applications of serotonin or angiotensin II to injected oocytes elicited, in a dose-dependent manner, changes in membrane potential. The angiotensin II receptor was desensitized fairly rapidly in the continued presence of the agonist. No response was obtained with bradykinin. The selectivity of the angiotensin II-induced response was demonstrated by the finding that the angiotensin II antagonist [( Sar1,Ala8]angiotensin II, saralasin) blocked the angiotensin II-induced response. It is concluded that an appropriate fraction of brain mRNA is capable of directing the synthesis and correct insertion of functional angiotensin II receptors in the Xenopus oocyte membrane. PMID- 3676710 TI - Increases in ribosomal RNA within the denervated neuropil of the dentate gyrus during reinnervation: evaluation by in situ hybridization using DNA probes complementary to ribosomal RNA. AB - Previous studies have revealed that there are increases in the incorporation of [3H]amino acids into protein in the denervated neuropil of the dentate gyrus during periods of reactive synaptogenesis. The present study evaluates whether the increase in incorporation reflects an increase in protein synthetic machinery (ribosomes) in the denervated zone. We evaluated the distribution of ribosomal RNA (rRNA) in the denervated dentate gyrus 2-14 days after unilateral destruction of the entorhinal cortex using DNA probes complementary to rRNA for in situ hybridization. Animals with comparable lesions were injected with [3H]leucine 30 min prior to sacrifice and prepared for autoradiography in order to define the extent of protein synthesis within the denervated neuropil. Quantitative analyses revealed that the increases in [3H]leucine incorporation were accompanied by increases in labeling with the rRNA probe. In both cases, the increases were first apparent at 2 days postlesion, reached a peak on day 6, and then declined between 8 and 14 days postlesion. Plots of grain density across the neuropil revealed that the increases in rRNA, like the increases in amino acid incorporation, occurred selectively within the denervated portion of the neuropil. We propose that increased incorporation of protein precursor is the result of an increase in protein synthetic machinery within the denervated neuropil. These increases may reflect in part the increases that we have previously noted in polyribosomes under dendritic spines. PMID- 3676712 TI - The relationship between metal ion levels and biogenic amine levels in epileptic mice. AB - The metabolism of various metal ions and biogenic amines in El mice, an inbred mutant strain susceptible to epilepsy, was investigated as a possible model for seizure mechanism. Serum Na, P, Ca, Mg, Fe and Zn levels in El mice were lower than those in ddY mice, the mother strain of El mice. Conversely, bone Ca, P, Na, Mg and Zn levels in El mice were higher than those in ddY mice. The results obtained by chemical analysis are consistent with radiographic observations. Possible mechanisms for the lower serum metal ion levels seen in El mice include a decrease in availability of these ions from bone. The dopamine (DA) level in El mouse brain was 15% lower than in ddY mice but could be raised by intraventricular administration of CaCl2. This result was supported a decreased ethanol-induced sleeping time in El as compared to ddY mice, with 'normalization' occurring after intraventricular administration of Da or CaCl2. The biogenic amine levels disorder in El mice is discussed on the basis of our pharmacological observation that biogenic amine synthesis is regulated by divalent cations via a calmodulin-dependent system. Our results suggest that the disorders of metal ion metabolism could be a mechanism for epileptic convulsions in El mice. PMID- 3676713 TI - Is the motivational effect of opiate withdrawal reflected by common somatic indices of precipitated withdrawal? A place conditioning study in the rat. AB - Rats implanted for 5 days with a morphine pellet were dosed once with naltrexone (subcutaneous, s.c.) or methylnaltrexone (intraventricular, i.c.v.). Then the rats were observed for several somatic signs of precipitated withdrawal and tested for aversion to the place of the withdrawal. The two antagonist treatments produced different withdrawal syndromes, but both were associated with a place aversion which followed a simple monophasic function of the dose of antagonist. More importantly, there was an absence of any overall relation between individual withdrawal signs (jumping, writhing, shaking, diarrhea, and weight loss) and the aversive effect seen. It was concluded, therefore, that the motivational impact of opiate abstinence is not always addressed in conventional models of withdrawal. PMID- 3676714 TI - Evidence for synaptic potentiation in a cortical network during learning. AB - The connections between the lateral olfactory tract (LOT) and layer I of the piriform cortex were used to test the idea that certain forms of learning involve potentiation of cortical synapses. Rats were trained on a series of two-odor discriminations over a period of several days after which patterned electrical stimulation (short, high frequency bursts with 5-6 bursts per second) of the LOT was used as a discriminative cue. The animals reacted to the stimulation as though it were an odor and quickly learned to respond appropriately and to distinguish between 'positive' and 'negative' electrodes. Comparisons of the monosynaptic responses in the piriform cortex evoked by single pulse stimulation of the LOT before and after learning revealed that the population synaptic responses were substantially potentiated by the training. This effect was present in an unchanged form 24 h later. Responses elicited by control stimulating electrodes were slightly or not at all affected by training to stimulation with another electrode. Synaptic potentiation was not found in a small group of rats that did not learn to respond to patterned stimulation and was also absent when the stimulation was applied to naive rats. These results provide evidence that rapid learning of a specific cue potentiates cortical synapses in a defined terminal field. PMID- 3676715 TI - Odor-elicited activity monitored simultaneously from 124 regions of the salamander olfactory bulb using a voltage-sensitive dye. AB - In response to controlled, odor pulse stimulation of the olfactory receptor mucosa, large fluorescence signals were recorded simultaneously from 124 contiguous anatomical regions of the salamander olfactory bulb using the potentiometric probe RH 414. The amplitudes and waveforms of the signals varied systematically across the bulbar surface in apparent correspondence with the laminae of the bulbar neurons. Qualitatively similar results were obtained using both intact and decorporate preparations, although fluorescence signals obtained from intact animals were distorted by optical noise generated by mechanical disturbances related to the functioning cardiovascular system. These results indicate that multiple site optical recording can be used to obtain information about spatio-temporal patterning of bulbar electrical activity evoked by physiological odor stimulation of the receptor mucosa. This is the first demonstration that activity elicited by a single, one second odor stimulus at physiological concentration and duration can be measured across many elements in the olfactory bulb. Information provided by this approach, in combination with complementary data derived from 2-deoxyglucose and single unit studies, may yield a better understanding of how the vertebrate central nervous system extracts quality and concentration information from olfactory afferent input. PMID- 3676716 TI - Morphine-induced analgesia and exposure to low-intensity 60-Hz magnetic fields: inhibition of nocturnal analgesia in mice is a function of magnetic field intensity. AB - In 2 experiments male CF-1 mice were exposed for 60 min, during the mid-dark period of the day-night cycle, to low-intensity (0.5-1.5 gauss, rms) 60-Hz magnetic fields and then tested for levels of analgesia induced by morphine (10 mg/kg) injections. The magnetic field exposures inhibited the degree of morphine induced analgesia in a field intensity-dependent manner in both experiments (P less than 0.01) with the largest inhibitory effect after exposure to the 1.5 gauss field. Analysis of the combined data from the two experiments revealed a significant (P less than 0.001) linear relationship between level of analgesia and magnetic field intensity. Thus, these data demonstrated a functional relationship between the behavioral effects of morphine in mice and the strength of the 60-Hz magnetic field. Possible mechanisms underlying these effects are discussed. PMID- 3676717 TI - The effects of chronic two-fold dietary vitamin E supplementation on subarachnoid hemorrhage-induced brain hypoperfusion. AB - The effects of chronic dietary supplementation with D-alpha-tocopherol (vitamin E, 70 I.U./lb dry food for 16 weeks) were examined on the acute pathophysiology of experimental subarachnoid hemorrhage (SAH). The SAH was induced in alpha chloralose-anesthetized cats by intracisternal injection of 0.5 ml/kg of unheparinized arterial blood after prior withdrawal of an equivalent cerebrospinal fluid (CSF) volume. Caudate nuclear blood flow (CBF) was measured via H2 clearance together with intracranial pressure (ICP), mean arterial blood pressure (MABP), cerebral perfusion pressure (CPP), and caudate vascular resistance (CVR). In 6 non-supplemented cats (30 I.U. vitamin E/lb dry food), the SAH resulted in an initial 21.3 +/- 2.4% decrease in CBF by 5 min, followed by a slower secondary decline of 30.1% over the subsequent 3 h after SAH. Together with the fall in CBF, the ICP rose progressively by 18.5 mm Hg (P less than 0.004) and CPP decreased by 36.6 mm Hg (P less than 0.01) at 3 h post-SAH. Furthermore, the CVR increased by 42.9% over the course of the experiment. In comparison, in 6 vitamin E-pretreated cats, there was a complete inhibition of the acute decline in CBF and increase in CVR. In addition, the magnitude of the SAH-induced increase in ICP was significantly less than in the non-supplemented animals. However, the decrease in CPP was unaffected. The ability of intensive anti-oxidant treatment to antagonize post-hemorrhagic hypoperfusion suggests that cerebral microvascular lipid peroxidation may play a key role in its development. PMID- 3676718 TI - Spontaneous eye motility following a unilateral vestibular lesion. AB - The strong imbalance of the output of vestibular nuclei, resulting from a hemilabyrinthectomy, causes among other postural and ocular symptoms, a failure to hold a steady ocular position in the dark. In this study the time course of the spontaneous eye motility following a right hemilabyrinthectomy was analyzed. In all animals, at the first recordings, drifts of 0.8-1.0 degrees/s were present. These drifts were directed to the lesion side, then they shifted their trajectory more than once. At the final recordings, most animals exhibited very slow drifts (0.05-0.1 degrees/s) directed to the intact side suggesting an overcompensation of the initial extreme rightward deviation. PMID- 3676719 TI - Altered modulatory actions of serotonin on dentate granule cells of aged rats. AB - The effects of serotonin (5-HT) on dentate granule (DG) neurons in hippocampal slices taken from young mature (6-8 months) and old (25-29 months) rats were compared. Intracellular measurements of membrane potential, cell input resistance and slow postspike afterhyperpolarization did not differ significantly between young and old neurons. Neurons recorded in slices taken from old animals responded with less hyperpolarization to increasing doses of the drug, and their responses were significantly reduced after repeated applications of 5-HT. Serotonin-mediated reduction of the slow afterhyperpolarization in young DG neurons was less prominent or totally absent in the old cells. It is concluded that serotonergic postsynaptic actions are impaired in old age. PMID- 3676720 TI - In vivo synthesis of phosphatidylcholine in rat brain via the phospholipid methylation pathway. AB - We examined the in vivo synthesis of brain phosphatidylcholine (PC) by the methylation of phosphatidylethanolamine (PE). [3H-methyl]methionine was infused i.c.v., by indwelling cannula, and brain samples were taken 0.5-18 h thereafter and assayed for [3H]PC, as well as for its biosynthetic intermediates [3H]phosphatidylmonomethylethanolamine ([3H]PMME) and [3H]phosphatidyldimethylethanolamine ([3H]PDME), and for [3H]lysophosphatidylcholine ([3H]LPC) and S-[3H]adenosylmethionine ([3H]SAM). Most of the [3H]PC (79-94%) was present ipsilateral to the infusion site, indicating that the radioactivity in the [3H]PC was primarily of intracerebral origin, and not taken up from the blood. Moreover, only very low levels of [3H]PC were attained in brains of animals receiving [3H]methionine i.p. and these levels were symmetrically distributed. [3H]PMME and [3H]PDME turned over with apparent half-lives of 2.2 h and 2.4 h. In contrast, the accumulation of brain [3H]PC was biphasic, suggesting the existence of two pools, the more labile of which turned over rapidly (t1/2 = 5 h) and was formed for as long as [3H]PMME and [3H]PDME are present in the brain, and another, which was distinguishable only at 18 h after the [3H]methionine infusion. (The latter pool may have been synthesized from [3H]choline that was released via the hydrolysis of some of the brain [3H]PC previously formed by the methylation of PE.) Subcellular fractionation of brain tissue obtained after in vivo labelling with [3H]methionine revealed that mitochondrial PC had the highest specific radioactivity (dpm per mumol total lipid phosphorus), and myelin the least. These observations affirm that rat brain does synthesize PC in vivo by methylating PE, and the technique provides an experimental system which may be useful for examining the physiological regulation of this process. PMID- 3676721 TI - Anomeric specificity of D-glucose metabolism in rat brain cells. AB - Rat brain cells were incubated at 9 degrees C (and occasionally at 37 degrees C) in the presence of the anomers of D-[5-3H]glucose, D-[U-14C]glucose, D-[6 14C]glucose and D-[1-14C]glucose (1.0 mM). The utilization of beta-D-[5 3H]glucose was slightly higher than that of alpha-D-[5-3H]glucose, a situation possibly attributable to the anomeric behaviour of hexokinase. However, the production of 14CO2 from the alpha-anomer always largely exceeded that from the beta-anomer. The anomeric difference in D-[U-14C]glucose oxidation, relative to D [5-3H]glucose utilization, was suppressed in the presence of NH4Cl. Even at anomeric equilibrium, the relative contribution of alpha-D-glucose to 14CO2 output exceeded its relative abundance. The beta/alpha ratio for D-[1-14C]glucose oxidation (or D-[U-14C]glucose oxidation) was higher than that for D-[6 14C]glucose oxidation. Comparable observations were made in brain cells from albino rats and either lean or obese Zucker rats. It is concluded that D-glucose metabolism displays anomeric specificity in rat brain cells, even when the latter are exposed to equilibrated D-glucose. It is also speculated that anomeric differences in the phosphorylation of D-glucose by bound hexokinase may directly influence mitochondrial oxidative events. PMID- 3676722 TI - Morphological response of injured adult rabbit optic nerve to implants containing media conditioned by growing optic nerves. AB - Adult rabbit retina can express regeneration-associated characteristics after optic nerve injury, provided it is supplied with appropriate diffusible substances originating from media conditioned by regenerating fish optic nerves or by optic nerves of a newborn rabbit [Hadani et al., Proc. Natl. Acad. Sci. U.S.A., 81 (1984) 7965; Schwartz et al., Science, 228 (1985) 600]. This was shown by applying the active substances to the injured axons in the form of 'wrap around' implants, consisting of collagen-coated silicone tubes which had been soaked in the conditioned media (CM). The regeneration-associated response was manifested biochemically and by sprouting of nerve fibers in culture. The present work provides morphological evidence that the implantation prolongs survival of ganglion cells and optic nerve fibers and induces new growth. Light microscopic analysis (using horseradish peroxidase (HRP) for labeling the fibers) revealed, 1 week following optic nerve injury, labeled fibers and ganglion cells in both the implanted and control (injured only or injured and implanted with collagen-coated silicone tubes free of CM) nerves. However, from the second week after the injury, distinct differences in the appearance of viable ganglion cells and labeled fibers, were seen between experimental and control preparations. In sections taken through the optic nerve, at the region distal to the site of injury, HRP-labeled fibers were seen in the experimental nerves 1 week, 2 weeks and to a significantly lesser extent 1 month after injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676723 TI - Hippocampal electrical activity following local tetanization. I. Afterdischarges. AB - Following a short (1-10 s) train of repetitive stimulation delivered to the hippocampal CA1 region, the following sequelae of afterdischarges (ADs) was seen: (1) a silent period of 2-4 s, (2) a large primary (1 degree) AD usually alvear surface negative and deep positive, (3) a period of suppressed hippocampal EEG, (4) a secondary (2 degrees) hippocampal AD, and after 3-6 min, (5) 15-25 min of enhanced (up to 10 times normal) fast (30-70 Hz) waves. The 2 degrees hippocampal AD was preceded by or simultaneous with large AD at the amygdaloid electrodes. Electrolytic lesions (n = 7) or large heat lesions of the amygdala (n = 5) or electrolytic lesions of the medial septum (n = 10) were not successful in suppressing the 2 degrees hippocampal AD. However, 4 rats with radiofrequency lesion and 3 rats with bilateral aspiration lesion of the entorhinal cortex had diminished or no 2 degrees hippocampal AD. The fast waves after tetanization were reversed 180 degrees across surface and deep CA1 electrodes. The fast wave increase was blocked by atropine sulfate (25-50 mg/kg i.p.), scopolamine hydrochloride (5 mg/kg i.p.) and medial septal lesions. It was concluded that the 2 degrees hippocampal AD may depend on a reverberation of neural circuitry involving the entorhinal cortex. The 2 degrees AD recorded from amygdala electrodes may partly reflect spreading of activities from the entorhinal cortex. On the other hand, the increase in fast waves after tetanization requires an intact septohippocampal, muscarinic cholinergic input, and may depend on an enhanced cholinergic input or an increased response. PMID- 3676724 TI - Characteristics of memory impairment following lesioning of the basal forebrain and medial septal nucleus in rats. AB - Memory impairment in rats with lesions of the basal forebrain (BF) and medial septal nucleus (MS) including cell bodies of the cortical and septohippocampal cholinergic systems, respectively, were compared in order to evaluate the functional contribution of the two cholinergic systems to memory. Biochemical assay revealed that lesioning of the BF and MS resulted in marked and selective decreases in both choline acetyltransferase and acetylcholinesterase activities in the cerebral cortex and hippocampus, respectively. Rats with BF lesions exhibited a severe deficit in a passive avoidance task; acquisition of passive avoidance by repeated training was sluggish, and the acquired response was rapidly eliminated in a subsequent extinction test. However, only slight impairment of passive avoidance was observed in rats with MS lesions. Memory impairment in rats with BF or MS lesions was also investigated using two spatial localization tasks, the Morris water task and the 8-arm radial maze task. Both BF and MS lesions elicited a significant impairment in the Morris water task that required reference memory, as demonstrated by an apparent increase in the latency to escape onto a hidden platform in a large water tank. The impairment was much more obvious in the BF-lesioned rats. In contrast, in the radial maze task primarily requiring working memory, rats with lesions of the MS showed severe disruption, exhibiting a marked increase in total errors, a decrease in the number of initial correct responses, and an apparent change in the strategy pattern. However, corresponding changes in the rats with BF lesions were slight. These results suggest that BF lesions may lead to substantial long-term memory impairment while MS lesions may primarily produce short-term or working memory impairment, indicating a qualitatively different contribution of the two cholinergic systems to memory. It is also suggested that these two experimental animal models may be useful for evaluation of therapeutic drugs for senile dementia of the Alzheimer type. PMID- 3676725 TI - A Met-enkephalin releaser (kyotorphin)-induced release of plasma membrane-bound Ca2+ from rat brain synaptosomes. AB - The neuropeptide kyotorphin (Tyr-Arg) released 45Ca2+ from synaptosomal membrane preparations of the rat lower brainstem. This dipeptide also decreased plasma membrane-bound Ca2+ ([Ca2+]m), determined using chlorotetracycline, in the slice and synaptosome of the rat lower brainstem. Taken together with other data indicating that kyotorphin induces an increase in synaptosomal intracellular Ca2+ ([Ca2+]i) in a Ca2+ channel-independent manner, it is suggested that kyotorphin may mobilize the [Ca2+]m and thus increase the [Ca2+]i in the nerve terminals of the rat lower brainstem. PMID- 3676726 TI - The effects of in vivo inactivation of GABA-transaminase and glutamic acid decarboxylase on levels of GABA in the rat retina. AB - Gabaculine and gamma-vinyl GABA (GVG) are specific enzyme-activated irreversible inhibitors of GABA-transaminase (GABA-T). gamma-Acetylenic GABA (GAG) irreversibly inhibits both GABA-T and glutamic acid decarboxylase (GAD). Subcutaneous injection of any of those compounds rapidly elevated levels of GABA in the retinae of rats. After injection of 10 mg/kg gabaculine, levels of retinal GABA climbed 5-fold in 4 h, and peaked 16 h after injection at levels approximately 7 times those from water-injected control rats. They remained significantly elevated compared to control levels for at least 6 days after injection. The postgabaculine increase in levels of retinal GABA was linear with time between 0.5 and 4 h after injection. In contrast, retinal GABA levels peaked at less than 3 times control levels within 8 h of injection of 50 mg/kg GAG and returned to baseline levels within 4 days. GAG, upon coadministration with gabaculine, significantly attenuated the postgabaculine rise in levels of GABA in retinae. Neither the rate of rise, nor the maximum levels, of retinal GABA was so great after injection of GAG plus gabaculine, compared to those after injection of gabaculine alone. The degree to which postgabaculine GABA accumulation was inhibited in the retina by 50 mg/kg GAG closely corresponded with the extent to which that dose of GAG inactivated retinal GAD activity. The results of this study extend previous reports from this laboratory that systemically administered gabaculine, GVG and GAG all inactivate target enzymes more potently in retina than in other brain regions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676727 TI - Effects of muramyl dipeptide on sleep, body temperature and plasma copper after intracerebral ventricular administration. AB - Muramyl peptides are the monomeric components of bacterial cell wall peptidoglycans. Many muramyl peptides, such as muramyl dipeptide (MDP), (N acetylmuramyl-L-alanyl-D-isoglutamine), are immune response modifiers, pyrogenic and somnogenic. The purposes of this study were to measure the somnogenic effects of MDP in conjunction with a biochemical measure of the host defense response, plasma Cu, and to determine if plasma Cu levels, like sleep, are regulated by a central nervous system process. MDP administered into a lateral cerebral ventricle induced a dose-dependent rise in plasma copper at 28 h postinfusion. This was usually associated with dose-dependent fevers, increases in SWS and reductions in rapid eye movement (REM) sleep during the first 6 h after infusion. Intravenous (i.v.) administration of the same amount of MDP did not affect any of these variables. We conclude that the syndrome induced by centrally administered MDP includes activation of the host defense response with respect to a rise in plasma copper in addition to fever and enhanced sleep. PMID- 3676728 TI - Down-regulation of tryptamine receptors following chronic administration of clorgyline. AB - Chronic treatment with clorgyline, a type A monoamine oxidase (MAO) inhibitor (1 mg/kg/day for 11 days), reduced the number (Bmax) but not the affinity (Kd) of [3H]tryptamine binding sites in rat frontal/parietal cortical membranes. Binding was reduced for at least 36 days following the last injection. The reduction in [3H]tryptamine binding was dose-related and appeared to be maximal following a daily dose of 3 mg/kg. Chronic treatment with deprenyl, a type B MAO inhibitor (1 mg/kg/day for 11 days), did not affect [3H]tryptamine binding. Acute clorgyline administration (11 mg/kg) also had no effect. These data suggest that [3H]tryptamine binds to neurotransmitter receptors for tryptamine since mere chemical recognition sites would not be expected to be modulated by chronic drug treatment. Also, since [3H]tryptamine binding was down-regulated by a type A, but not a type B, MAO inhibitor, tryptamine may be selectively metabolized by type A MAO in vivo. PMID- 3676729 TI - Temporal relationship between single unit activity in superior olivary complex and scalp-derived auditory brainstem response in guinea pig. AB - Single unit activities in the region of the superior olivary complex were recorded from 8 guinea pigs concurrently with the recording of auditory brainstem potentials from the scalp. At any one anatomical site, be it a fiber tract (e.g. trapezoid body) or a nucleus (e.g. medial nucleus of the trapezoid body), the modal latency of the onset discharge of the units encountered corresponded in time with the latencies of several different waves (waves P2-P5) of the auditory brainstem response (ABR). Moreover, at the time of occurrence of just one of the ABR waves, single units in several diverse anatomical sites in and around the superior olive were found with modal latencies of onset discharge at that same time period. The slopes of the latency/intensity functions for both the peaks of the ABR and the modal latency of the onset discharge for most of the single units studied in the superior olive and its adjacent fiber tracts were remarkably similar. These data support the hypothesis of multiple rather than single generator site(s) for components of the ABR, at least, for waves P2-P5 in the guinea pig. These data do not distinguish whether the ABR are generated in part by travelling nerve action potentials or graded synaptic events. PMID- 3676730 TI - Caffeine-diazepam interaction and local cerebral glucose utilization in the conscious rat. AB - The quantitative 2-[14C]deoxyglucose autoradiographic method was used to study the effects of the acute administration of a sedative anticonvulsant dose of diazepam (2 mg/kg) on rat brain energy metabolism. This benzodiazepine was injected to rats chronically treated for two weeks either by caffeine (10 mg/kg/day) or by saline. After the administration of diazepam to saline-treated rats, average glucose utilization of the brain as a whole was reduced by 21% and rates of glucose utilization were deeply decreased in frontal and auditory cortex, mammillary body, lateral thalamus, medial and lateral geniculate. In caffeine-treated rats, the administration of diazepam induced the same effects of brain energy metabolism as in saline-treated rats. The results of the present study indicate that diazepam mainly decreases glucose utilization in structures widely believed to mediate anxiety. PMID- 3676731 TI - Activity of suprachiasmatic and hypothalamic neurons during sleep and wakefulness in the rat. AB - Single unit activity was recorded from the suprachiasmatic nucleus (SCN) and preoptic/anterior hypothalamus (POAH) of unrestrained Wistar rats during sleep and wakefulness. Regularly firing cells, which are abundant in in vitro SCN preparations and have been considered the basis of a central neuronal oscillator, were conspicuously absent in this preparation and in other in vivo studies. Most of the 55 cells recorded in the SCN and POAH were characterized by spontaneous firing rates below 12 Hz and with heterogeneous patterns of changes in frequency with arousal states. In vivo neurophysiological studies of the SCN in which the anesthetic agent urethane is used should consider the effect of different levels of arousal, as indicated by the cortical EEG, in evaluating the relationship between sensory stimulation and single unit activity. PMID- 3676732 TI - Autonomic control of von Ebner's lingual salivary glands and implications for taste sensation. AB - To learn the nature of the autonomic control of the serous lingual salivary glands of von Ebner, parasympathetic and sympathetic agonists were injected into rats, and the extent of depletion of the secretory granules in gland acini was measured. Injection of the beta-adrenergic agonist isoproterenol caused a concentration-dependent reduction of the secretory granule content of the acinar cells. Injection of the beta-adrenergic antagonist propranolol, combined with isoproterenol, blocked the reduction in secretory granule content seen with isoproterenol alone. Injection of the parasympathetic agonist carbachol also produced a concentration-dependent reduction in granule content of the acini. This reduction was partially blocked by injection of atropine, and completely blocked by injection of atropine and propranolol. beta-Adrenergic and parasympathetic agonists alone did not cause total degranulation of the acini. However, this was achieved by injection of both agonists. It is concluded that protein secretion in von Ebner's glands is under both sympathetic and parasympathetic nervous control. It is hypothesized that the glands contain two sets of granules with different compositions, each under the control of either the parasympathetic or sympathetic nervous system. Because von Ebner's glands are closely associated with taste buds and because the glands supply the microenvironment of these taste buds the secretion of these glands may be very important in the mechanism of taste transduction. PMID- 3676733 TI - DL-2-[3,4-3H]amino-4-phosphonobutyrate binding sites in the rat hippocampus: distribution and possible physiological role. AB - Binding sites for the novel, glutamate-like radioligand DL-2-[3,4-3H]amino-4 phosphonobutyrate (DL-[3H]APB) on rat hippocampal synaptic membranes were identified and characterised. The existence of a single, saturable population of binding sites was demonstrated. These appeared to be indistinguishable, in terms of their pharmacological profile and ionic dependence, from those described previously in the striatum and whole brain. The distribution of these sites was also examined using a number of discrete neuronal lesions. A majority of sites (approx. 55%) were located on dentate gyrus granule cells. Smaller populations appeared to be situated on perforant path terminals and on pyramidal cells. However, L-APB was found to be ineffective as an inhibitor of basal and potassium evoked D-[3H]aspartate release from hippocampal slices. A presynaptic location can therefore presumably be ruled out. The likely postsynaptic location of DL [3H]APB-binding sites in the hippocampus suggests that this site may be involved in synaptic neurotransmission. This possibility is discussed with regard to electrophysiological data concerning the synaptic pharmacology of neuronal connections within the hippocampus. PMID- 3676734 TI - The metabolism of dopamine in the median eminence reflects the activity of tuberoinfundibular neurons. AB - The purpose of the present study was to characterize the metabolism of dopamine (DA) in tuberoinfundibular (TI) neurons terminating in the median eminence and to examine the effects of procedures that alter the synthesis and turnover of DA in these neurons on the concentrations of dihydroxyphenylacetic acid (DOPAC) in the median eminence. The DA uptake inhibitor nomifensine (25 mg/kg, i.p.; 30 min) failed to alter median eminence DOPAC concentrations indicating that very little released DA is recaptured and metabolized by TIDA neurons. Within 5 min following the administration of the monoamine oxidase inhibitor pargyline (50 mg/kg, i.v.) median eminence DOPAC concentrations declined to 15% of control demonstrating that this metabolite has a high turnover rate and is rapidly removed from the median eminence. Median eminence DOPAC concentrations in diestrous female rats, whose TIDA neuronal activity is higher than in the male, were two-fold greater than in male rats. Prolactin (10 micrograms/rat, i.c.v.; 12 h), which increases TIDA neuronal activity, produced a corresponding increase in median eminence DOPAC concentrations in male rats. Restraint stress (30 min), which decreases TIDA neuronal activity, produced a corresponding decrease in median eminence DOPAC concentrations in diestrous female rats. The results from the present study suggest that DOPAC concentrations in the median eminence can be used as an index of TIDA neuronal activity. PMID- 3676735 TI - Intracellular recording from hippocampal CA1 interneurons before and after development of long-term potentiation. AB - Synaptic efficacy is modified following a brief train of high frequency stimulation (HFS) to a cell's afferent fibers (long-term potentiation, LTP). Modulation of synaptic efficacy could be achieved through changes in excitability of interneurons. To test this hypothesis, we used the in vitro hippocampal slice to record intracellularly from CA1 basket cell interneurons before and following a period of HFS to fibers in stratum radiatum. Stimulation of stratum radiatum consistently produced action potential discharge in the basket cell interneuron prior to the discharge of a population spike in stratum pyramidale. This result is consistent with findings that basket cells may receive direct excitatory afferent input from neurons extrinsic to the CA1 region, and mediate a powerful feed-forward inhibition. Interneuron responses were recorded under 3 experimental conditions, in which stimulus intensity was varied. The level of basket cell excitability, as assessed by responses to orthodromic input, was not decreased following a train of HFS. Rather, the evoked EPSP in basket cells was often enhanced following high frequency stimulation to the cell's afferent fibers. These findings support the notion that decrement in basket cell activity is not responsible for LTP in CA1 hippocampus. PMID- 3676736 TI - The pretectal nucleus of the optic tract modulates the direction selectivity of accessory optic neurons in rats. AB - Direction-selective single units within the medial terminal nucleus of the rat were shown to prefer motion in upward-temporal or downward-nasal directions. Lesions of the optic tract nucleus practically abolished responses to the nasal direction of motion and increased the directional bias toward the temporal direction. Such results suggest a significant role of that pretectal nucleus in the determination of direction selectivity of accessory optic neurons. PMID- 3676737 TI - Reduction of 125I-angiotensin II binding sites in rat brain following monosodium glutamate treatment. AB - Adult Sprague-Dawley rats were pretreated with 6 g/kg of monosodium glutamate (MSG). After one month, specific binding of 125I-angiotensin II was measured in membrane preparations from the brain. A 40-45% decrease in the number of 125I angiotensin II binding sites was observed in brain tissues containing circumventricular organs. No decrease in binding sites was observed in the thalamus/hypothalamus brain region, which resides totally within the blood-brain barrier. The results suggest that MSG can destroy angiotensin-sensitive neurons in circumventricular structures, which are located primarily outside the blood brain barrier. PMID- 3676738 TI - An analysis of the responses of rat striatal neurones to scrotal skin temperature. AB - The responses of neurones in the caudate-putamen complex of anaesthetised rats to different scrotal skin temperatures were examined, together with the electroencephalogram (EEG). Caudate neuronal firing patterns did not change independently of rate, unlike the thermo-responsive cells of the hypothalamus previously reported. The scrotal skin temperature threshold for the caudate neuronal response corresponds precisely with the temperature which provokes desynchronisation of the EEG. PMID- 3676739 TI - Time course of degeneration of the visual system induced by spontaneous glaucoma in the albino quail (Coturnix coturnix japonica). AB - The retinal projection of an imperfect albino quail mutant with a sex-linked recessive gene was examined 2 weeks-16 months post-hatch using various histological methods. During the first weeks the visual system was normal. Initial signs of buphthalmos, a form of spontaneous glaucoma, appeared between the 3d and 5th months. Its development induced a degeneration of the retinal projections according to a relatively precise sequence progressing from the mesencephalic tegmentum to the optic tectum, then from the pretectum to the thalamus. The data suggest that the degeneration of the optic axons results from their mechanical compression due to the increased intraocular pressure. PMID- 3676740 TI - Vanadate ions: central nervous system action on glucoregulation. AB - Vanadate (VO-3), an essential trace element with insulin-mimetic actions, produces systemic hyperglycemia following central administration in mice. The hyperglycemic effect is due to specific action of vanadate or its reduced form, vanadyl (VO2+); other ions of similar atomic weight (Cr, Mn) or structure (phosphate) have no effect. The effect of central vanadate to raise circulating glucose is blocked by coadministration of 3-O-methylglucose or polymyxin B, which prevent insulin- and vanadate-stimulated glucose transport. Finally, the central hyperglycemic effect is prevented by treatments which block sympathetic outflow from the CNS or diminish the levels of circulating epinephrine. These results show that vanadate is able to influence peripheral glucoregulation by increasing sympathetic outflow from the CNS. Moreover, they suggest that this effect is linked to action of VO-3 or its reduced form, VO2+, to stimulate glucose transport into neuronal cells. PMID- 3676741 TI - Peripheral nerve implant effects on survival of retinal ganglion layer cells after axotomy initiated by a penetrating lesion. AB - A lesion paradigm involving a small penetrating incision made through the sclera, choroid and retina of the adult rat eye creates a unique environment for the study of the damaged retina. More specifically, the dependable formation of a small focal retinal lesion makes this an ideal model for the determination of conditions that may stimulate retinal regeneration, wound repair and/or cell survival. Our previous studies have indicated that the placement of a desheathed peripheral nerve implant (PNI) into the lesioned adult rat eye: (1) initiated the rescue of retinal tissue that would normally die due to trauma; and (2) maintained the thickness and organization of most retinal layers adjacent to the lesion site, particularly the retinal ganglion cell layer (RGL). We report in the present work that a more detailed analysis of the RGL revealed a significant increase in the survival of axotomized neurons within this layer in the presence of a PNI over an 8-week post-implantation period. More specifically, there was a 60% loss of control RGL cells axotomized by the lesion 3 weeks previously in contrast to only a 30% loss in those tissues exposed to a PNI. Additional RGL cell size distribution studies point to the fact that the PNI appeared to affect the increased survival of cells greater than or equal to 70 micron2. Also the PNI effect demonstrated a specificity of response when tested against the influence of a tendon or suture implant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676742 TI - Auditory space representation in the inferior colliculus of the FM bat, Eptesicus fuscus. AB - The auditory spatial response areas of 333 inferior collicular (IC) neurons of Eptesicus fuscus were studied under free-field acoustic stimulus conditions. A stimulus was delivered from a loudspeaker placed 14 cm in front of a bat and the best frequency of an encountered neuron was determined. Then a best frequency (BF) stimulus was delivered as the loudspeaker was moved across the frontal auditory space to determine the response center of the neuron. At the response center, the neuron had the lowest minimum threshold. The stimulus was then raised 3-15 dB above the lowest minimum threshold of the neuron and the spatial response area for each stimulus intensity was measured. The response center and spatial response area of a neuron measured with a one-octave downward-sweep FM stimulus were similar to those measured with the pure tone pulse. The spatial response area of a neuron expanded asymmetrically with the stimulus intensity. High BF neurons generally had smaller spatial response areas than low BF neurons had. All 333 response centers were located in the contralateral auditory space. Response centers of low BF neurons tended to be located laterally while those of high BF neurons were located medially. Although each neuron had a point of lowest minimum threshold in the contralateral auditory space, the point-to-point representation of the auditory space was not systematically organized. This representation was not correlated with the recording sites of the neurons in the mediolateral, posteroanterior and dorsoventral axes of the IC. PMID- 3676743 TI - Effects of enhanced cerebrospinal fluid levels of vasopressin, vasopressin antagonist or vasoactive intestinal polypeptide on circadian sleep-wake rhythm in the rat. AB - Several endogenous peptides have been implicated in the regulation of sleep and wakefulness. The present study was carried out in order to determine whether the light-dark rhythm of vasopressin (VP) in the cerebrospinal fluid (CSF) had functional significance in relaying information from the circadian pacemaker, i.e. the suprachiasmatic nuclei (which synthesize VP as well as vasoactive intestinal polypeptide (VIP], to the centra regulating sleep. After constant delivery of VP in the CSF via an Accurel/collodion implant in the lateral ventricle, the VP CSF level was raised from 20-35 pg/ml to ca. 265 pg/ml whereby a VP rhythm in the CSF could no longer be detected. Under these conditions VP was found to increase the arousal state of the rat in the dark period, which resulted in a higher amplitude of the circadian sleep-wake rhythm. Application of the VP antagonist d(CH2)5[Tyr(Me)2]VP partly had opposite effects. A similar approach with central application of VIP resulted in an increase in rapid eye movement and quiet sleep but did not affect the amplitude of the circadian rhythm. It was concluded that although peptide levels in the CSF may show clear temporal variations with the light-dark cycle, this rhythmicity is not causally related to the circadian aspect of sleep-wakefulness. However, both VP and VIP contribute to the regulation of the amount of time spent in sleep and wakefulness and the level of VP in the CSF is correlated with the amplitude of the rhythm. PMID- 3676744 TI - Dorsal and ventral respiratory groups of neurons in the medulla of the rat. AB - The aim of the present work was to identify and localize in rat the medullary neurons involved in respiration. Neural activity was recorded in ketamine anesthetized, paralyzed and artificially ventilated rats. Active sites were marked by electrocoagulation. Neurons firing in relation to phrenic nerve activity were located between 0.5 and 2 mm lateral to the midline, extending from 0.5 mm caudal to 2 mm rostral to the posterior end of the area postrema. Two groups of respiratory neurons were found: a dorsal group located ventrolateral to the tractus solitarius and a ventral group located in the ventrolateral reticular formation close to the nucleus ambiguus. Neurons were classified as bulbospinal or laryngeal if stimulation of the spinal cord or the vagus nerve, respectively, elicited antidromic action potentials, or as propriobulbar if they were not activated. Neurons firing synchronously with lung inflation were termed pump (P) cells. The dorsal respiratory group includes inspiratory (I) bulbospinal and propriobulbar neurons, P cells, but few expiratory (E) propriobulbar neurons. The ventral respiratory group includes bulbospinal, laryngeal and propriobulbar I and E neurons. Laryngeal motoneurons project ipsilaterally whereas bulbospinal neurons project contralaterally. Cross-correlations between inspiratory bulbospinal neuronal activity and phrenic discharge suggest that bulbospinal I neurons of dorsal and ventral groups project monosynaptically to contralateral phrenic motoneurons. These results indicate a similarity of the medullary respiratory centers of rats and cats, suggesting that rats may profitably be used in studies of respiratory rhythmogenesis. PMID- 3676745 TI - Facilitation of kindling by prior induction of long-term potentiation in the perforant path. AB - Previous studies have revealed that a form of synaptic potentiation resembling long-term potentiation (LTP) occurs at various sites as a result of stimulation that leads to kindling. The present study evaluates what role this synaptic potentiation plays in the development of kindling following periodic stimulation of the entorhinal cortex of the rat. LTP was repetitively induced in the pathway from the entorhinal cortex (EC) to the dentate gyrus (DG) by daily stimulation with high frequency trains that led to LTP, but did not evoke afterdischarge (AD). Subsequently, animals received stimulation designed to induce kindling (that led to AD), and this stimulation was delivered once per day until kindled seizures were induced. While repetitive induction of LTP was not sufficient to produce kindling, prior induction of LTP significantly increased the rate of subsequent kindling as evidenced by a decrease in the number of kindling stimulations required to induce the kindled state. As a group, animals that had received stimulation designed to induce LTP developed kindled seizures after an average of 10 AD's, whereas a control group that had received non-potentiating stimulation required 25 AD's. These results indicate that LTP at EC-DG synapses cannot represent the mechanism of kindling following EC stimulation. However, synaptic potentiation at this site can facilitate the development of epileptogenesis in response to subsequent activation of the perforant path. PMID- 3676746 TI - Neurotransmitters of the cerebellar glomeruli: uptake and release of labeled gamma-aminobutyric acid, glycine, serotonin and choline in a purified glomerulus fraction and in granular layer slices. AB - We have studied some properties of the uptake and release of labeled gamma aminobutyric acid (GABA), glycine, serotonin and choline in a purified fraction of glomeruli and in slices of the granular layer of the rat cerebellum. The uptake of both GABA and glycine into the glomerulus particles was dependent on the presence of Na+ in the medium. In contrast, the uptake of both serotonin and choline was Na+-independent. In slices of the granular layer also a slight Na+ dependence was observed for both serotonin and choline uptake; imipramine and hemicholinium partially inhibited the uptake of serotonin and choline, respectively. Choline uptake into the glomerulus particles showed two components, with apparent Km values of 16.8 and 102 microM. GABA release was stimulated by K+ depolarization about 100% (peak stimulation) and this value was reduced to 50% when Ca2+ was omitted. The release of glycine was stimulated more rapidly and notably than GABA (200%) and this stimulation was completely abolished in the absence of Ca2+. Serotonin release from the glomerulus particles was only slightly stimulated by depolarization, but this stimulation was strictly Ca2+ dependent. In slices of the granular layer, this stimulation was considerably larger (about 40%) and it was also almost totally dependent on Ca2+. In contrast, after loading with labeled choline the release of radioactivity from both the glomerulus particles and the cerebellar slices was not stimulated at all by K+ depolarization, either in the presence or in the absence of Ca2+. Most of the radioactivity released spontaneously corresponded to choline, and only a small proportion (8-14%) to acetylcholine. From the results of the release experiments and taking into account the pertinent data from the literature, it is concluded that GABA and glycine are probably the transmitters of different populations of Golgi axon terminals, whereas serotonin might be the transmitter of at least a certain population of the mossy fiber giant terminals, in the rat cerebellar glomeruli. In contrast, acetylcholine does not seem to have any transmitter role in the synaptic structures of the glomeruli. PMID- 3676747 TI - Selective enhancement of shock avoidance responding elicited by GABA blockade in the posterior hypothalamus of rats. AB - Recent studies have shown that blockade of gamma-aminobutyric acid (GABA) in the posterior hypothalamus in anesthetized rats elicits cardio-respiratory stimulation similar to that seen in emotional defense reactions and, in conscious rats, locomotor arousal suggesting a flight response. The present study was conducted in order to test the hypothesis that the behavioral effects elicited by GABA blockade in the posterior hypothalamus were the results of disinhibiting a mechanism whose activation selectively enhances reactivity to aversive stimuli. Male rats were trained on a Sidman shock avoidance schedule (RS20:SS10) as well as a food-reinforced approach schedule (VI 1). Under anesthesia, guide cannulae were stereotaxically implanted bilaterally in the posterior hypothalamus at sites where microinjection of the GABA antagonist, bicuculline methiodide (BMI) 25 ng, increased heart rate. After recovery, rats were tested in both the avoidance and VI 1 schedules after hypothalamic microinjection of saline, BMI 25 ng, and the GABA agonist, muscimol 25 ng. Microinjection of BMI significantly increased the avoidance responses but had no effect on the approach responses. Muscimol decreased both the avoidance and approach responses. When microinjected into the lateral hypothalamic area, BMI had no effect on the response rates in either schedule while muscimol decreased the approach responding only. Therefore, GABA blockade at the discrete area of the posterior hypothalamic nucleus appears to elicit a selective enhancement of avoidance responses. These results suggest that an endogenous GABAergic system in the posterior hypothalamus may tonically inhibit a constellation of autonomic, locomotor and motivational responses that are necessary for some types of defense reaction. PMID- 3676748 TI - Brain vasoactive intestinal peptide: a potent stimulant of gastric acid secretion. AB - Vasoactive intestinal peptide (VIP) belongs to a rapidly expanding family of cerebrogastrointestinal oligopeptides. This report describes a potent dose-, time and vagus-dependent stimulation of gastric acid secretion by brain VIP. Physiologic evidence favoring a role of VIP on acid secretion was provided by the finding that immunoneutralization of endogenous brain VIP produced a significant decrease of acid secretion. These and other data contained herein suggest that the mechanism by which central VIP stimulates acid secretion appears to involve peripheral cholinergic pathways. PMID- 3676749 TI - Noradrenaline induces rhythmic bursting in sympathetic preganglionic neurons. AB - In the in vitro slice preparation of upper thoracic cord of the cat, noradrenaline, at concentrations of 10-50 microM, induced rhythmic bursting in 30% of sympathetic preganglionic neurons of the intermediolateral nucleus. The bursting frequencies were between 0.2 and 1.0 Hz at membrane potentials between 45 and -65 mV. The bursting rhythm could be reset by short intracellular current pulses. In the presence of tetrodotoxin noradrenaline produced a rhythmic oscillation in membrane potential in the same frequency range as the bursting. The frequency of oscillation was voltage dependent. Neuronal input resistance decreased at the oscillation peak and the oscillation was abolished by cobalt or low calcium. PMID- 3676750 TI - Visual-auditory interactions in cat superior colliculus: their role in the control of gaze. AB - Superior colliculus cells that respond to a given sensory input (visual or auditory) were influenced by the presence of a stimulus in the other modality. This is a form of sensory-sensory integration which has previously been thought to be involved in initiating the orientation of receptor organs in response to such cues. The present results demonstrate directly that some neurons in cat superior colliculus exhibit premotor discharges which are facilitated when evoked by combinations of visual and auditory stimuli. Other neurons showed sensory interactions which were more difficult to relate directly to orienting behavior; these cells might have a role in mediating attentional functions. PMID- 3676751 TI - Muscarinic cholinergic receptor binding and electrophysiological response to acetylcholine in cultured rat caudate putamen nucleus neurons. AB - Binding sites with specificity for N-[3H]methylscopolamine ([3H]NMS) are present in homogenates of primary culture neurons from the rat caudate putamen nucleus (CPN). Specific binding is saturable with respect to [3H]NMS. The Scatchard analysis indicates a dissociation constant of 0.6 nM and a density of 7.0 X 10(3) per cell, or 78 fmol/mg protein. In electrophysiological measurements, excitatory postsynaptic currents (EPSCs) in larger cells were increased by pressure application of acetylcholine under voltage clamp condition. The EPSCs may come from neighboring smaller cells with muscarinic acetylcholine receptors. PMID- 3676752 TI - Dose-dependent antinociceptive action of neurotensin microinjected into the rostroventromedial medulla of the rat. AB - Microinjection of neurotensin into the rat rostroventromedial medulla produces dose-dependent inhibition of the tailflick reflex (ED50 of 2.06 nmol/animal (1.33 3.19)). The peak effect occurs 15-20 min following injection and, at the highest dose used, lasts up to 70 min. PMID- 3676753 TI - The regional hypothalamic distribution of type II 5'-monodeiodinase in euthyroid and hypothyroid rats. AB - The brain topographical distribution of type II 5'-monodeiodinase (5'D-II), which converts thyroxine (T4) to triiodothyronine (T3), was studied in euthyroid and hypothyroid rats. Low levels of 5'D-II activity were detected in the median eminence, but not in any other brain regions of euthyroid rats. The arcuate nucleus and median eminence were also the sites of highest 5'D-II activity in brains of hypothyroid rats. Under these conditions, the paraventricular nucleus contained almost no detectable 5'D-II, while intermediate enzyme activity was present in other medial basal hypothalamic sites. PMID- 3676754 TI - Transplantation of oligodendrocytes in the newborn mouse brain: extension of myelination by transplanted cells. Anatomical study. AB - The shiverer model allows for the immunocytochemical staining of the patches of myelin formed by transplanted oligodendrocytes from a normal newborn mouse. Fragments of the olfactory bulb were transplanted into various parts of the brain to place the myelinating cells in different anatomical conditions. Whole brains were horizontally sectioned in order to study the full pattern of migration and myelination of the grafted oligodendrocytes. Transplanted oligodendrocytes were capable of short and long distance migration before their differentiation. Long distance migration occurred in the caudal as well as in the rostral direction and into the contralateral part of the brain through the commissures. The patches of immunoreactive myelin were mainly found in the large myelinated bundles: corpus callosum, internal capsule, fimbria-fornix, medial lemniscus, cerebellar peduncles and spinal cord funiculi. Some sites of migration indicate that oligodendrocytes followed at least two different axonal pathways successively. The thalamic area which contained numerous patches could be a place where oligodendrocytes switch from one fasciculus to another. PMID- 3676755 TI - Role of microtubules in the cytoplasmic compartmentation of neurons. AB - We have examined the role of microtubules (MTs) in the development and maintenance of the cytoplasmic compartmentation of ribosomes in cultured embryonic chick sensory neurons. Control neurons show a sharp cytoplasmic demarcation between the ribosome-rich/MT-deficient 'translational' cytoplasm of the perikaryon and the ribosome-deficient/MT-rich 'expressional' cytoplasm of the axon-like neurites. Neurites treated with 1.0 microgram/ml nocodazole for 15-20 min show in addition to the depolymerization of MTs a clear loss of the cytoplasmic demarcation between the soma and neurite. We found a decreasing density of ribosomes with increasing distance from the soma in the nocodazole treated neurites. Ribosomes, as confirmed by their diameter and sensitivity to ribonuclease treatment, populated the first 100 microns of neurites at roughly the same density as found in the soma (150-300 ribosomes per microns2 in 50 mm longitudinal thin sections). The second 100 microns contained a lower density of ribosomes than the first, 20-60 per microns2, but still higher than controls. Distances past 200 microns were devoid of unambiguous ribosomes. Neurites amputated between 50 and 150 microns from the soma then treated with nocodazole contained a dense population of ribosomes in the proximal segment still attached to the soma, but few or none in the distal segment. We interpret these findings as evidence that ribosomes are able to move from the soma down the neurite after MT disassembly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676756 TI - Mapping of a putative genetic locus determining ethanol intake in the mouse. AB - In the mouse, there is evidence that a single genetic locus is a major determinant of differences in ethanol intake between some preferring and non preferring inbred strains. In this report, we present evidence from two independent experiments indicating that this locus maps to chromosome 1 and that its expressed product is the abundant protein LTW-4 (a 28 kDa, pI 5.6 protein expressed in brain, liver and kidney). The genetic association was found using a panel of 14 polypeptides of mouse brain which were visualized by two-dimensional electrophoresis and which exhibit genetic variation in isoelectric point. Fifteen BXD recombinant inbred strains and the two parental strains were typed for these loci and also tested for ethanol acceptance. Strains exhibiting the basic allele showed significantly higher ethanol acceptance. When 19 distantly related inbred mouse strains were tested for ethanol acceptance and typed for LTW-4, it was again found that strains exhibiting the basic allele showed significantly higher ethanol acceptance. PMID- 3676757 TI - Prolactin secretion in posterior pituitary lobectomized rats: differential effects of 5-hydroxytryptophan and ether. AB - The objective of this study was to determine whether the posterior pituitary mediates the prolactin (PRL) releasing activities of serotonin and ether. Ovariectomized (OVEX) rats were subjected to posterior pituitary lobectomy (LOBEX) or sham surgery (SHAM). Either 1 or 12 days after surgery, rats were injected i.v. with 20 mg/kg b. wt. of 5-hydroxytryptophan (5-HTP), which is a precursor of serotonin. A second group of rats was exposed to ether vapors for 10 min. Blood was collected from a jugular cannula before and after the treatments and analyzed for PRL. On either 1 or 12 days after surgery, injection of 5-HTP increased plasma PRL levels 5-10 fold in both LOBEX and SHAM rats. This was followed by a decline to preinjection levels within 60-90 min. LOBEX and SHAM male rats which were injected i.p. with 50 mg/kg b. wt. of 5-HTP, also showed marked and similar elevations of plasma PRL levels 12 days after surgery. Exposure of OVEX rats to ether elicited a 2-3 fold rise in plasma PRL levels only on day 1, but not on day 12, after LOBEX. The ether-induced rise in PRL was similar in SHAM rats tested on both days. These results indicate that the 5-HTP induced rise in plasma PRL levels is independent of the posterior pituitary, regardless of the sex, the route of drug administration or the length of time after surgery. In contrast, the PRL response to ether stress is diminished within 12 days after LOBEX. The evidence that the PRL responses to 5-HTP and to ether might be mediated via different neuronal mechanisms is discussed. PMID- 3676758 TI - Antibodies to the neuronal cytoskeleton are elicited by Alzheimer paired helical filament fractions. AB - Antibodies were raised to paired helical filament (PHF) enriched fractions obtained from brains of individuals with Alzheimer disease by extraction with ionic detergent followed by sucrose gradient centrifugation. Electron microscopic examination showed that the fractions were enriched in Alzheimer PHF but contained also lipofuscin, amyloid, granular material and membranous elements. Analysis of these fractions with SDS-PAGE stained with Coomassie blue showed only a faint band at approximately 60 kDa while most of the material was excluded from the stacking gel. BALB/c mice were injected weekly with 100 or 200 micrograms of these fractions or corresponding fractions from age-matched control brains. The 3 mice injected with Alzheimer brain, but not the 5 mice injected with control brain fractions, produced antibodies that reacted with central and peripheral nervous system axons, Alzheimer neurofibrillary tangles in intact tissue as well as with isolated, SDS-treated paired helical filaments. In gel strips antibodies from all 3 mice injected with Alzheimer brain fractions reacted with the 200-kDa and 168-kDa but not the 68-kDa neurofilament subunits. The 3 antisera reacted also with some forms of the microtubule-associated protein tau. Adsorptions with the insoluble fraction from Alzheimer but not from control brains blocked staining of axons and NFT by all 3 antisera. Adsorption with highly purified neurofilament proteins or with a preparation containing the 200-kDa and 168-kDa neurofilament subunits blocked axon and NFT immunostaining only in one antiserum. Adsorptions with microtubule protein, heat-stable microtubule-associated protein, or a preparation of tau did not completely block immunostaining by any of the 3 antisera. These results demonstrate that fractions enriched with Alzheimer paired helical filaments contain insoluble neurofilament, tau and other yet unidentified antigens. PMID- 3676759 TI - Synaptic reorganization in the medial amygdaloid nucleus after lesion of the accessory olfactory bulb of adult rat. I. Quantitative and electron microscopic study of the recovery of synaptic density. AB - The time course of the appearance of degenerating synapses and the loss and reappearance of intact synapses was investigated in the medial amygdaloid nucleus (MAN) following lesions of the accessory olfactory bulb (AOB). Degenerating synapses were concentrated in the molecular layer of MAN. A quantitative electron microscopic analysis of the molecular layer was performed at 2, 4, 8, 16, 32 and 64 days after the placement of kainic acid injections within AOB. At each survival time, counts of synapses were made from photomicrographic montages. The degenerating synapses were observed at 2 days after lesion. Their density reached a peak at 2 or 4 days after the lesion and decreased thereafter. No degenerating synapses were found at 64 days following the lesion. Shrinkage of the thickness of molecular layer was observed following the AOB lesion. This was most pronounced at 4 or 8 days after the lesion at which time the thickness was 70-75% of the contralateral molecular layer. The shrinkage receded moderately (85% of contralateral layer at 64 days after lesion). The compensated synaptic density of intact synapses was reduced to less than half of the control density at 4 or 8 days after the lesion. Thereafter synaptic density increased gradually and reached more than 80% of control density at 64 days after lesion. The recovery in number of intact synapses following the lesion suggests the possibility of synaptic reorganization by remaining afferent fibers. PMID- 3676760 TI - Comparative neurology of the optic tectum in ray-finned fishes: patterns of lamination formed by retinotectal projections. AB - Retinotectal projections were studied in 33 different species of Actinopterygii, the ray-finned fishes, with horseradish peroxidase and cobalt tracing techniques. The distribution of retinorecipient layers in the contralateral optic tectum was analyzed. In addition, the degree of differentiation of the stratum periventriculare, and the presence of ipsilateral retinotectal projections was examined. Retinofugal fibers are labeled in the stratum opticum (SO), stratum fibrosum et griseum superficiale (SFGS), stratum griseum centrale (SGC), stratum album centrale (SAC) and stratum periventriculare (SPV). Some species lack the projection to the SO, others lack the projection to the SGC, and a third group of fishes lack both projections. Five different patterns of retinorecipient tectal strata are distinguished. These patterns correlate with the species' taxonomic position. Evolutionary trends of tectal lamination and retinotectal innervation are described. The retinotectal projection patterns provide a useful indicator of phylogenetic relationships. Some of our data suggest different relationships between actinopterygian species than hitherto believed. PMID- 3676761 TI - Heightened blood pressure and drinking responsiveness to intracerebroventricularly applied angiotensins in the spontaneously hypertensive rat. AB - The effects of bolus intracerebroventricular (i.c.v.) injections of angiotensin II (AII) and angiotensin III (AIII) on blood pressure and water consumption were investigated in Okamoto-Aoki spontaneously hypertensive rats (SHR), and Wistar Kyoto (WKY) and Sprague-Dawley (SD) normotensive controls. Heightened sensitivity to i.c.v. administered AII and AIII was observed in the SHR as compared with WKY and SD strains for both pressor and drinking responses. The results are consistent with the notion that the SHR has a genetic defect that directly perturbs central angiotensinergic transmission. Two types of defects appear plausible, an alteration in the central angiotensin receptor and its associated transduction system and/or a decrease in the efficiency of signal termination. The present results are interpreted to primarily support the second possibility that a dysfunction in central aminopeptidase activity results in an extended life expectancy of angiotensin, and perhaps other peptides, that contribute to the hypersensitivity seen in the SHR. PMID- 3676762 TI - Effect of transection in the brainstem on short-term maintenance of deoxycorticosterone-salt hypertension. AB - Sections were made to determine supraspinal areas that participate in the maintenance of deoxycorticosterone (DOC)-salt hypertension. Blood pressure (BP) falls after cuts which severed: (a) the lateral connections between pons and midbrain, (b) the pathways between caudal hypothalamus and midbrain, and (c) parasagittal connections between medial and lateral hypothalamus. No changes in BP were found either after coronal cuts that severed a central area located at: (a) the pons-midbrain edge, (b) above the caudal hypothalamus, and (c) the level of the anterior hypothalamic area, or after parasagittal cuts at the level of the capsula interna or after a hypophysial stalk lesion. These results implicate the hypothalamus in the maintenance of DOC-salt hypertension. The hypothalamus-neural lobe system appears not to be involved in the lowering of BP found. PMID- 3676763 TI - Ontogeny of muscarinic receptors in the rat brain with emphasis on the differentiation of M1- and M2-subtypes--semi-quantitative in vitro autoradiography. AB - The ontogeny of muscarinic acetylcholine receptors (mAChR) in the rat brain was studied with emphasis on the differentiation of M1- and M2-receptor subtypes through semi-quantitative in vitro autoradiography. [3H]Quinuclidinyl benzilate (QNB) and [3H]pirenzepine (PZ) were used for labeling total mAChR and M1 receptors, respectively. In the cerebral cortex of adult rats, [3H]QNB binding sites were more richly present in the superficial and deeper layers than in the middle layer, while M1-receptors were diffusely observed in all the layers. This means that M2-receptors are highly concentrated in the superficial and deeper layers. The ontogenetical differentiation of the laminar distribution between M1- and M2-receptors first appeared at 14 days of postnatal age. In the hippocampus and striatum whose mAChR were predominantly of the M1-type in the adult rat brain, ontogenic patterns of M1-receptors were almost identical to those of total mAChR. On the other hand, mAChR in the cerebellar cortex and lower brainstem of the adult rat were mainly of the M2-subtype. In these areas, the ontogeny of total mAChR was apparently observed. However, M1-receptors were not observed at any stage of the ontogeny. The above-mentioned results indicate that M1- and M2 receptors show distinct developmental behaviors in the rat brain. PMID- 3676764 TI - Morphological and biochemical differences expressed in separate dissociated cell cultures of dorsal and ventral halves of the mouse spinal cord. AB - The neuronal properties of separate dissociated cell cultures of dorsal and ventral halves of the embryonic mouse spinal cord (E 13.5) were investigated. Ventral-half cultures grew on a variety of substrates and in a variety of media; dorsal-half cultures required a non-neuronal feeder layer and supplemented medium for survival. The two types of cultures differed in their morphological and biochemical properties. Ventral-half neurons remained well separated on the culture plate, whereas dorsal-half neurons tended to aggregate. Lucifer yellow fills showed that ventral-half neurons were substantially larger and had more processes than dorsal-half neurons. Because of the large size and good separation of the neurons, ventral-half cultures provide an especially attractive system for electrophysiologic and morphologic studies. Ventral-half cultures were highly enriched for choline acetyltransferase (ChAT) activity and had more neurons that stained for intracellular acetylcholinesterase (AChE); dorsal-half cultures were enriched for glutamic acid decarboxylase (GAD) activity, and high-affinity gamma aminobutyric acid (GABA) uptake. The clear differences between the two cultures indicate that many morphological and biochemical properties are already specified on embryonic day 13.5. PMID- 3676765 TI - Characterization of hindlimb motoneuron membrane properties in acute and chronic spinal cats. AB - The purpose of this study was to determine if changes in hindlimb motoneuron membrane electrical properties occur 4-6 months after spinal transection in the adult animal. Eight acute and nine chronic animals were spinalized at T12. Intracellular recordings from motoneurons innervating the triceps surae were performed. Membrane electrical properties, including resting potential, action potential peak amplitude, afterhyperpolarization duration, rheobasic current, input resistance and axonal conduction velocity were measured. There were no statistical differences found between group means or frequency distributions in the membrane properties of motoneurons assessed from acute and chronic spinal animals. Thus, alteration of motoneuron membrane properties does not appear to be a major contributing factor to the hyperexcitable hindlimb reflex activity demonstrated by chronic spinal animals. PMID- 3676766 TI - Characterization of postsynaptic potentials evoked by sural nerve stimulation in hindlimb motoneurons from acute and chronic spinal cats. AB - The purpose of this study was to characterize the changes in postsynaptic potentials recorded in ankle extensor motoneurons resulting from activation of the sural nerve after spinal cord transection in the adult cat. Eight acute and nine chronic animals were spinalized at T12. Intracellular recordings from motoneurons innervating the triceps surae were performed. Sural nerve stimulation evoked complex synaptic potentials consisting of early and late components in all motoneurons. Early excitatory and inhibitory postsynaptic potentials (PSPs), as well as long latency excitatory postsynaptic potentials were recorded and averaged for assessment of PSP amplitude and duration. Early PSPs, both excitatory and inhibitory, were significantly larger in the motoneurons of cats spinalized 4-6 months earlier. Central latency of excitatory potentials were similar in the two samples of motoneurons, but the central latency associated with the initial inhibitory PSP was significantly shorter in the recordings from motoneurons of chronic spinal cats. In most recordings, an additional inhibitory PSP followed the initial excitatory PSP in motoneurons, and this secondary inhibitory PSP was similar in peak amplitude and duration in both samples of motoneurons. Also, a long latency excitatory PSP was recorded in a large percentage of motoneurons from both samples. This potential was typically of greater amplitude and longer duration in the motoneurons from chronic animals, when compared to recordings from acute animals. Although changes in amplitude and duration of PSP activity could be documented, there was no marked alteration in the frequency of occurrence of each PSP pattern recorded from the two preparations. This suggests that the synaptic pathways mediating the sural nerve reflexes have not qualitatively changed in the chronic spinal animal. The changes in amplitudes and durations of the PSPs in the chronic spinal cat indicate, however, that quantitative changes have occurred. The quantitative changes have probably occurred in the interneuronal networks activated by cutaneous nerve (sural) stimulation, since it was shown that only minor changes in motoneuron membrane properties could be recorded in these same chronic spinal animals. PMID- 3676767 TI - Competitive inhibition of phosphoinositide hydrolysis by the muscarinic receptor antagonist AF-DX 116 is of low affinity in mouse cerebral cortex. AB - Carbamylcholine stimulated [3H]inositol phosphate accumulation in mouse cerebral cortical slices with an ED50 value of approximately 70 microM. Increasing concentrations of the M2 selective muscarinic cholinergic receptor antagonist, AF DX 116 (0.3-3.0 microM). produced parallel shifts to the right for concentration response curves to carbamylcholine. A pA2 value for AF-DX 116 of 6.5 (low affinity) was obtained from Schild plot analysis. It is concluded that the M2 muscarinic receptor subtype, as defined by high affinity [3H]AF-DX 116 radioligand binding, is not appreciably coupled to polyphosphoinositide hydrolysis in the mouse cerebral cortex. PMID- 3676768 TI - Increased affinity of choline acetyltransferase for choline in Alzheimer's disease: a steady-state kinetic study. AB - The steady-state kinetics of choline acetyltransferase (CAT) from autopsy samples of human caudate nucleus of aged controls and of patients with Alzheimer's disease was studied. In 10 samples from Alzheimer's disease-afflicted brains the affinity for the limiting substrate choline (Ch) was significantly higher: Michaelis constant KmCh was for these samples 1.93 +/- 0.72 mM while in the samples from 9 age-matched controls KmCh was 2.53 +/- 0.78 mM. The difference is statistically significant (P less than 0.05). Endogenous choline concentrations in the samples were 124 +/- 39 (n = 10) nmol/g wet wt. in the Alzheimer's disease afflicted samples and 180 +/- 57 (n = 9) nmol/g wet weight (n = 9) in the control samples (P less than 0.05). The initial velocity at 70 microM acetyl co-enzyme (AcCoA) in Alzheimer's samples was 171.5 +/- 131.0 pmol [14C]acetyl choline [14C]ACh/mg protein/min as compared to the controls 422.1 +/- 231.0 pmol [14C]ACh/mg protein/min replicating many previous findings about decline of CAT activity in Alzheimer's disease. However, in the same samples the affinity for the other substrate acetyl-CoA (AcCoA) was significantly lower for the Alzheimer patients, KmAcCoA = 61 +/- 40 microM, than for the age-matched control patients, KmAcCoA = 28 +/- 8 microns (P less than 0.01). The data suggest some compensation of the loss of enzyme molecules via changed affinity for the limiting substrate, Ch. PMID- 3676769 TI - Angiotensin receptor binding in human hypothalamus: autoradiographic localization. AB - Binding of 125I-[Sar1,Ile8]angiotensin II in the human hypothalamus was mapped by in vitro autoradiography carried out on frozen sections of hypothalamus from two human brains. Regions showing the greatest specific binding of this radioligand were the organum vasculosum of the lamina terminalis, median preoptic nucleus, subfornical organ, median eminence, arcuate nucleus and paraventricular nucleus. These regions may be sites of angiotensin II receptors involved in the regulation of blood pressure, fluid balance and pituitary hormone secretion. PMID- 3676771 TI - Neuronal versus endothelial origin of vasoactive acetylcholine in pial vessels. AB - Functional pial vessels denuded in situ of the endothelial cell layer exhibit a markedly decreased choline uptake capacity (-53%) but integrally preserved choline acetyltransferase (ChAT) activity and acetylcholine (ACh) release mechanisms. These studies demonstrate that endothelial cells possess a specific choline uptake system. However, the unimpaired ChAT activity in denuded pial vessels implies that the endothelial pool of choline is not significantly metabolized into ACh. In spite of possible differences in the mechanisms that govern release processes in endothelial and neuronal elements, taken together the findings of the present study suggest that the ACh released following depolarization of pial blood vessels originates predominantly from cholinergic perivascular nerve terminals. PMID- 3676770 TI - Inhibition of vasodepressor neurons in the caudal ventrolateral medulla of the rabbit increases both arterial pressure and the release of neuropeptide Y-like immunoreactivity from the spinal cord. AB - The role of bulbospinal neuropeptide Y (NPY)-containing neurons of the rostral ventrolateral medulla in the rabbit in mediating the increase in blood pressure that occurs during inhibition of cells in the caudal ventrolateral medulla was investigated in urethane-anaesthetized rabbits. In the present experiments bilateral injections of the GABA agonist, muscimol, into the caudal ventrolateral medulla elicited a slowly-developing rise in arterial pressure that was maximal 15 min after the injection. Accompanying this increase in arterial pressure was an increase in the release of NPY-like immunoreactivity (NPY-LI) into the spinal subarachnoid space. This pattern of response is similar to that seen after direct chemical stimulation of the NPY-containing cells of the rostral ventrolateral medulla. Taken together, these findings suggest that tonically active neurons in the caudal ventrolateral medulla exert their effects by inhibiting sympathoexcitatory NPY-containing neurons whose cell bodies are situated in the rostral ventrolateral medulla. PMID- 3676772 TI - Suppression of pineal melatonin in Peromyscus leucopus by different monochromatic wavelengths of visible and near-ultraviolet light (UV-A). AB - The purpose of this study was to examine the effects of monochromatic visible and near-ultraviolet radiation (UV-A) on pineal melatonin suppression in the white footed mouse, Peromyscus leucopus. To this end, mice were entrained to a daily cycle of 8 h of light and 16 h of darkness. During the night when pineal melatonin contents were high, mice were individually exposed for 5 min to specific wavelengths of monochromatic light (10 nm half-peak bandwidths). Control animals received the same handling conditions but no experimental exposure. Pineal glands were collected from animals 18 min after the 5 min experimental exposure and were later assayed for melatonin content. In groups of animals exposed to equal photon densities (2.64 X 10(15) photons/cm2) of either 320, 340, 360, 500, or 560 nm, mean pineal melatonin content was significantly suppressed as compared to the unexposed control animals. The 640 nm wavelength (red) at the same photon density did not suppress pineal melatonin. These experiments are the first to demonstrate light-induced suppression of pineal melatonin in Peromyscus leucopus. In addition, these data reveal a novel finding: the suppression of pineal melatonin content by ultraviolet wavelengths as low as 320 and 340 nm. PMID- 3676773 TI - Altered sensitivity to arginine vasopressin (AVP) in area CA1 of the hippocampal slice following pretreatment of rats with AVP. AB - Extracellular recordings from cells in the CA1b region of the in vitro hippocampal slice preparation demonstrate that bath-applied AVP (10(-6)-10(-12) M) frequently results in a decrease in the orthodromically evoked population spike amplitude. This suggests that AVP inhibits CA1 pyramidal cell firing in response to an orthodromic volley. This effect appears to be receptor-mediated, since a potent antagonist of the AVP V1 (vasopressor) receptor and a mixed oxytocin/vasopressin antagonist prevented the decrease in population spike amplitude observed in response to bath application of AVP. Hippocampal slices prepared from rats injected two days earlier with 1.0 micrograms AVP (intracerebroventricular) display increased sensitivity to the depressant effects of AVP at lower doses compared to controls. These results suggest that pretreatment of rats with AVP may alter the sensitivity of hippocampal cells to the depressant effects of this neuropeptide. PMID- 3676774 TI - Bombesin microinfusion into the paraventricular nucleus suppresses gastric acid secretion in the rat. AB - Bombesin is a particularly potent inhibitor of gastric acid secretion when injected intracisternally in the rat. Because bombesin-like immunoreactivity is found in several forebrain regions implicated in gut regulation, the ability of bombesin to affect gastric secretion was tested in these areas by direct microinfusion. Bombesin significantly and dose-relatedly suppressed gastric acid secretion when it was infused into the hypothalamic paraventricular nucleus. Bombesin microinfusion into the ventromedial or lateral hypothalamic areas, or the caudate-putamen, had no significant effect. A further experiment using glass micropipets showed that back-diffusion of bombesin along the cannula track to a distant site of action was unlikely to account for the results obtained, and provided further evidence that the active site is limited to the paraventricular nucleus and possibly the ventralmost nucleus reuniens. The results suggest that the bombesin receptors and immunoreactive terminals previously identified in this region may be involved in the central regulation of gastric secretion. PMID- 3676775 TI - Behavioral actions of baclofen in the rat ventromedial thalamic nucleus: antagonism by delta-aminovalerate. AB - Baclofen, an agonist at GABAB receptors injected locally into the rat ventromedial thalamic nucleus (VM) induced catalepsy in a dose-dependent, stereospecific and site-specific way. Baclofen-induced catalepsy was accompanied by tonic activity in the electromyogram (EMG) recorded from the gastrocnemius muscle, which is considered to be a measure of limb rigidity. delta-Aminovalerate (delta-AVA) coadministered with baclofen into the VM prevented the development of both catalepsy and limb rigidity. delta-AVA injected alone into the VM was devoid of depressant or stimulating behavioral effects. In contrast to delta-AVA, bicuculline, a GABAA antagonist, failed to antagonize baclofen-induced catalepsy. On the other hand, catalepsy due to local injection of a GABAA agonist, muscimol into the VM was antagonized by bicuculline, but not by delta-AVA. The present results suggest that delta-AVA may be useful as an antagonist of central pharmacological actions of baclofen. PMID- 3676776 TI - Neuroanatomical distribution of testosterone-metabolizing enzymes in the Japanese quail. AB - We describe a very sensitive and precise assay which allows one to study the metabolism of testosterone (T) in small brain nuclei dissected out according to the method of Palkovits and Brownstein. With this method, the neuroanatomical distributions of aromatase, and 5 alpha- and 5 beta-reductase activities were studied in adult male quail (Coturnix coturnix japonica). The different enzymes show different neuroanatomical distributions. Production of estradiol-17 beta (E2) was highest in the sexually dimorphic nucleus preopticus medialis (POM). We showed previously that the preoptic aromatase activity is higher in male than in female quail. As the POM is a central and very large structure within the preoptic area, the present results suggest a relationship between the neuroanatomical and the biochemical sex differences. By contrast, the production of 5 alpha-DHT was highest in the lateral hypothalamic area (LHY), the bed nucleus of the pallial commissure (BPC) and the lateral septum (SL). The 5 beta reductase activity was highest in the lateral septum and in the ventral part of the archistriatum (AV). Moreover, there was a rostral to caudal decrease in 5 beta-reductase activity in the hypothalamus. PMID- 3676777 TI - The comparative immunocytochemical distribution of 28 kDa cholecalcin (CaBP) in the hippocampus of rat, guinea pig and hedgehog. AB - The distribution of 28 kDa cholecalcin (calcium-binding protein, CaBP) in the hippocampal formation of the rat, guinea pig and European hedgehog was examined by immunocytochemistry. The extension of the mossy fibers (the axons of the granule cells of the dentate gyrus) was also studied using the Timm's sulfide silver method. Cholecalcin was present in all mossy fibers. In the rat, only those pyramidal cells not reached by the labeled mossy fibers displayed cholecalcin immunoreactivity. Immunocytochemical staining of the hedgehog hippocampus showed that contacts between cholecalcin-containing mossy fibers and cholecalcin-containing pyramidal cells are possible. Consequently, the protein is probably not involved in the control of mossy fiber extension. Strikingly, no guinea pig pyramidal cells showed cholecalcin immunoreactivity. The possible involvement of cholecalcin in the differential excitability of pyramidal cells in the CA3 and CA1 areas of the hippocampus could therefore be tested in a comparative study of rat, guinea pig and hedgehog. PMID- 3676778 TI - Effects of calcium antagonists on muscarinic receptor subtypes in the rat brain. AB - The effects of several calcium antagonists, including nicardipine, nifedipine, verapamil, and diltiazem, on muscarinic acetylcholine antagonist binding were studied in the P2 fraction of the rat cerebral cortex using either [3H]quinuclidinyl benzilate ([3H]QNB) or [3H]pirenzipine as the radioactive ligand. (1) The potency of [3H]QNB binding inhibition was in the order nicardipine greater than verapamil greater than diltiazem greater than nifedipine. The IC50 values of nicardipine, verapamil, and diltiazem were 2.56 X 10(-6) M, 1.28 X 10(-5) M, and 6.00 X 10(-5) M, respectively. (2) The inhibition of [3H]QNB binding by nicardipine was significantly decreased in the presence of Ca ions. (3) In saturation experiments of [3H]QNB binding in the presence of nicardipine, the Kd value appeared to be significantly affected, but the Bmax value was unchanged. This indicated that nicardipine probably inhibited [3H]QNB binding allosterically. On the other hand, (4) nicardipine inhibited [3H]pirenzipine binding completely with an IC50 value of 7.87 X 10(-7) M. It was concluded that nicardipine had an inhibitory effect on M1-receptor binding. PMID- 3676779 TI - Effects of physiological manipulations on locus coeruleus neuronal activity in freely moving cats. I. Thermoregulatory challenge. AB - This and the following two papers examine the activity of locus coeruleus noradrenergic (LC-NE) neurons in response to a variety of physiological manipulations in unanesthetized, unrestrained cats. Unit responses were studied during a constant behavioral state in order to avoid the potentially confounding effects of state changes upon LC-NE unit discharge. In the present study, LC-NE unit activity was recorded during two thermoregulatory challenges: ambient heating and pyrogen-induced fever. These two conditions are particularly interesting since the direction of body temperature change that they produce is the same, but the thermoregulatory responses elicited are opposite, i.e. heat loss and heat gain. LC-NE neurons were activated by both manipulations. In response to ambient heating, neuronal activity increased only with the occurrence of panting, and not during earlier portions of the heating session. Following pyrogen administration, LC-NE neurons responded only during the peak increase in body temperature. Both of these effects on unit activity occurred independent of changes in behavioral state. Since both manipulations similarly increased LC-NE unit activity, despite eliciting opposite thermoregulatory responses, it appears that these neurons do not play a specific role in thermoregulation, but may participate in the response to physiological challenges in general. PMID- 3676780 TI - Electrophysiological study of synaptic connections between a transplanted lateral geniculate nucleus and the visual cortex of the host rat. AB - The lateral geniculate nucleus (LGN) of a fetal rat was transplanted to the visual cortex (VC) of a neonatal rat. A current source-density analysis of field potentials and an intracellular study of neuronal responses were conducted in slice preparations by electrical stimulation of transplanted LGN and host VC. The results indicated that synaptic connections were established reciprocally between the transplanted LGN and the host VC. PMID- 3676781 TI - Selective persistent reduction in choline acetyltransferase activity in basal forebrain of the rat after thyroid deficiency during early life. AB - The effect of thyroid deficiency on the activity of choline acetyltransferase (ChAT; the marker for cholinergic neurons) was studied in different parts of the rat brain at ages 5, 10, 15 and 25 days, and at day 130 following 102 days of rehabilitation. During normal development, the activity of ChAT increased in the cerebral cortex, hippocampus and basal forebrain, and decreased in the cerebellum. Neonatal thyroid deficiency resulted in a marked retardation of the developmental patterns of the enzyme activity. In the hippocampus the effect diminished with age even during the period of thyroid hormone deprivation, while in the cerebral cortex and cerebellum the enzyme activity was restored to normal only after rehabilitation. In contrast, ChAT activity in the basal forebrain remained persistently reduced in comparison with controls. The results indicate that neonatal thyroid deficiency causes selective irreversible biological damage to subcortical cholinergic neurons. PMID- 3676782 TI - Divalent cations reduce depolarization of primary afferent terminations by GABA. AB - Divalent metal cations, including zinc, cadmium, cobalt, nickel, strontium, manganese, magnesium and calcium, reduced the depolarization by microelectrophoretic gamma-aminobutyric acid (GABA) and piperidine-4-sulphonic acid of the central terminations of muscle group Ia primary afferent fibres in the cat spinal cord without affecting the inhibition by GABA of the firing of spinal interneurones. There thus appears to be a difference in either the interaction of GABA with recognition sites, or in the mechanism by which such interaction activates chloride ionophores, at GABA-mediated bicuculline-sensitive synapses on the central terminals of peripheral primary afferent neurones and those on neurones located within the central nervous system. PMID- 3676783 TI - Effects of physiological manipulations on locus coeruleus neuronal activity in freely moving cats. II. Cardiovascular challenge. AB - Several cardiovascular manipulations were examined for their effects on single unit activity of locus coeruleus noradrenergic (LC-NE) neurons in unanesthetized, unrestrained cats: hydralazine (1 mg/kg, i.v.) was administered to present a tonic hypotensive stimulus, and to activate preferentially the neural component of the sympathoadrenal system; hemorrhage was used to decrease blood volume and to activate both the neural and hormonal components of the sympathoadrenal system; intravenous infusion of isotonic saline was used to increase blood volume. LC-NE neurons were activated by hydralazine, in parallel with the sympathetic response (indicated by elevated heart rate and plasma NE). LC-NE unit activity was decreased following a volume load. However, contrary to previous findings in anesthetized animals, hemorrhage had no effect on LC-NE unit activity, but did activate both components of the sympathetic response. It is concluded that: (1) cardiovascular stimuli can influence the activity of LC-NE neurons, though they show less sensitivity to such stimuli than do primary regulatory mechanisms; (2) the response of LC-NE neurons to physiological stimuli can occur independent of changes in behavioral state; (3) these neurons do not appear to play a specific role in cardiovascular regulation, but may respond to physiological challenges in general; (4) finally, in agreement with previous studies, our data show that LC-NE neurons are generally co-activated with the sympathetic nervous system, but also that the two can be dissociated (e.g. hemorrhage). PMID- 3676784 TI - Distinct influences of nerve growth factor and a central cholinergic trophic factor on medial septal explants. AB - A central cholinergic trophic factor (C-CTF), previously reported in hippocampal extracts, enhances acetylcholine synthesis (ACh) and to a lesser extent choline acetyltransferase (ChAT) activity in cultured explants of the rat medial septal nucleus. Nerve growth factor (NGF) has been reported to enhance ChAT in several systems in vitro and in vivo, and clearly stimulates septal explants. At optimal concentrations of NGF and C-CTF, there is an additive effect on ChAT activity. The effects of NGF on ACh synthesis are minimal. Antibodies to NGF block effects of added NGF but have no effects on C-CTF activity. The ability of C-CTF to enhance ACh synthesis appears related to its ability to enhance the acetylation of the choline that has been taken up by a sodium dependent, high affinity transport system. Thus, actions of NGF and C-CTF appear qualitatively and quantitatively distinct, yet both can influence the cholinergic activity of the developing medial septal nucleus. PMID- 3676785 TI - Red nucleus lesions delay the evolution of amygdala kindling in cats. AB - There are some papers which claim that the red nucleus (RN) is related to epileptic manifestations. Though the lesion or electrographic recording of the RN include many paths which assemble into it, the possibility that its cells are implicated in epilepsy is deduced. This paper compares the evolution of amygdaloid kindling in cats with bilateral RN lesions, with the epileptic disturbances provoked by lesion or stimulation of approach cells. Due to the intrinsic error of the stereotaxic method, only 7 of 13 cats show lesions in the RN with a diameter extending down to 150 micron. Only these show a shortening of the afterdischarge duration, a delay in the appearance of the consecutive clinical stages, and a lengthening in the appearance of generalized tonic-clonic seizures. In comparison, the 6 other cats show lesions mainly in the adjacent central tegmental field, and their kindling evolution was similar to that of a control group with intact mesencephalon. We conclude that the RN lesions interfere with the kindling generation, presumably by lesioning the cerebello cerebral paths which produce a depression of cortical activity, during the consolidation of clinical and electrographic manifestations. PMID- 3676786 TI - Response characteristics of tooth pulp-driven postsynaptic neurons in the spinal trigeminal subnucleus interpolaris of the cat: comparison with primary afferent fiber, subnucleus caudalis, reflex, and sensory responses. AB - Tooth pulp-evoked single neuron responses were recorded in the spinal trigeminal subnucleus interpolaris of the cat. The thresholds to monopolar electric pulses of varying duration (0.2-20 ms) were determined using a constant current stimulator. The thresholds were comparable with those of primary afferent A fibers, although the most sensitive primary afferent fibers have lower thresholds. The thresholds and latencies showed that none of the interpolaris neurons received their input solely from intradental C-fibers. The most sensitive subnucleus interpolaris neurons had lower thresholds than the respective subnucleus caudalis neurons studied in our previous work. The thresholds and strength-duration curves of the most sensitive interpolaris neurons and of the tooth pulp-elicited jaw-opening reflex are nearly similar, although the jaw reflex can be elicited at an intensity which is slightly lower than that needed to activate the most sensitive interpolaris neurons of the present sample. The most sensitive interpolaris neurons were activated at current intensities that were below the intensity needed to produce liminal dental pain in man, and the strength-duration curves of these neurons were flatter than the curve depicting liminal dental pain sensation in man. The relationship between stimulus intensity and response magnitude could be well described by power functions, the median exponent of which was 1.251. A conditioning stimulation of the tooth pulp at low intensity produced a short (less than 25 ms) enhancement of the response to the following test stimulus, whereas a high intensity conditioning stimulus produced a longer (greater than 40 ms) suppression of the response to the following stimulus. The threshold of 33% of the neurons was elevated during a noxious tail pinch, and this elevation was not reversed by naloxone, an opioid antagonist. The results indicate that in the trigeminal subnucleus interpolaris there are tooth pulp-driven neurons with an input from intradental A-fibers and that a considerable temporal summation of impulses from primary afferent fibers is needed to activate most of them. Human dental pain thresholds cannot be explained by the liminal response properties of the most sensitive interpolaris neurons, but they may be important in the mediation of near-threshold reflex events. It is possible, however, that the high-threshold interpolaris neurons may have a role in the mediation of sensory responses. PMID- 3676787 TI - Antagonism of endogenous opioids modulates memory processing. AB - The studies reported here demonstrate that opioid antagonism enhances memory in two classes of animals viz. Aves and Mammalia. In mice, immediate posttraining administration of naloxone produces a time-dependent improvement in retention tested one week later. This effect is stereospecific. As naloxone was approximately 1000-fold more potent when administered intracerebroventricularly compared to subcutaneously, it appears that it produces its effect within the central nervous system. Pretest administration of naloxone, at a dose that failed to alter acquisition, also improved test performance, suggesting that naloxone also improved recall. Similar improvement in retention was demonstrated with the more potent opioid antagonist, nalmefene, at a 500-fold lower dose. The dose response to naloxone in both the mouse and the chick and to nalmefene in the mouse had the characteristics of an inverted U, with high doses either being ineffective or suppressing memory retention. In mice, naloxone demonstrated anti amnestic properties against both anisomycin, a protein synthesis inhibitor, and scopolamine, an acetylcholine receptor blocker. Administration of beta funaltrexamine (B-FNA) 72 h prior to training did not alter acquisition but did enhance retention. In studies where the mu-opioid receptor was blocked with B FNA, naloxone was unable to enhance retention. B-FNA failed to impair the memory enhancing properties of arecoline, fluoxetine or clonidine. This demonstrates specificity of the B-FNA ability to prevent naloxone from enhancing memory and suggests that the opioid antagonist effects on memory are mediated by the mu receptor. PMID- 3676789 TI - State-dependent spike train dynamics of hippocampal formation neurons: evidence for theta-on and theta-off cells. AB - In these experiments the firing patterns of neurons located throughout the CA1 dentate region were recorded during the occurrence of either larger amplitude irregular activity (LIA) or slow wave theta activity, in the hippocampal formation of urethane-anesthetized rats. The main conclusion was that there were two distinct populations of neurons whose spike train dynamics varied systematically in relation to the ongoing EEG state and therefore probably played a role in the genesis of these slow wave rhythms. Within each of the two populations, called theta-on and theta-off cells, there were several subtypes labelled tonic and phasic. Tonic subtypes provided information about the change from one EEG state to another and phasic subtypes, in addition to showing this, provided specific information about frequency changes within the theta state. The importance of extending these observations to freely moving animals was discussed. PMID- 3676788 TI - Spatial patterns of visual cortical fast EEG during conditioned reflex in a rhesus monkey. AB - A preliminary assay was made of the existence of time-space coherence patterns of fast EEG activity in the visual cortex of a Rhesus monkey. The primary intent of the present study was to evaluate the similarities and differences in relation to the olfactory bulb, where such coherences have been described and have been demonstrated to be associated with behaviour. Segments 1.5 s in duration were recorded simultaneously without averaging from 16 to 35 subdural electrodes fixed over the left occipital lobe in an array 3.6 cm X 2.8 cm. Each segment was taken during the delivery of a visual conditioned stimulus (CS) and the performance of a conditioned response (CR) by a well-trained Rhesus monkey. The EEGs appeared chaotic with irregular bursts lasting 75-200 ms, resembling those in the olfactory EEG but with lower peak frequencies. Fourier spectra showed broad distributions of power resembling '1/f noise' with multiple peaks in the range of 20-40 Hz. Time intervals were selected where coherent activity seemed to be present at a number of electrodes. A dominant component waveform that was common to all channels was extracted by principal components analysis (PCA) of each segment. The distribution of the power of this component across the electrodes (the factor loadings) was used to describe the spatial pattern of the coherent cortical activity. Statistical analyses suggested that different patterns could be associated to the CS and the CR, as has been found in the olfactory system. These patterns remained stable over a 6 week recording interval. The patterns can be better discriminated, when the factor loadings of each channel are normalized to zero mean and unit variance, to discard a basic pattern of power distribution, which may reflect anatomical and electrode positioning factors that are related to behavioral information processing by the cortex. The wide spatial distribution of the common patterns found suggests that EEG patterns that manifest differing states of the visual cortex may also be accessible with scalp electrodes. PMID- 3676790 TI - Evidence for a functional relationship between noradrenaline and neurohypophyseal peptides in the brainstem of rats. AB - The possibility of a functional relationship between noradrenaline and neurohypophyseal peptides in the control of cardiovascular function in the nucleus tractus solitarius of rats has been investigated. The hypotensive response to microinjections of noradrenaline (20 nmol) was abolished by simultaneous (but not prior) microinjections of [Arg8]vasopressin (AVP) and oxytocin at doses (0.9 pmol) which alone had no effects on cardiovascular parameters. AVP plus noradrenaline actually resulted in a transient pressor effect. Simultaneous administration of [deamino-D-Arg8]vasopressin, a selective agonist of AVP V2 receptors, did not modify the effect of noradrenaline, whereas the specific V1 antagonist D-(CH2)5-Tyr(Me)-AVP partially decreased its intensity. When subthreshold doses of both AVP (0.9 pmol) and noradrenaline (10 pmol) were administered simultaneously, a pressor response was observed. In vasopressin-deficient Brattleboro rats, microinjections of 0.9 pmol AVP had no effects, but a marked pressor response was observed after the administration of a higher dose (9 pmol). In parent strain Long-Evans rats, noradrenaline (20 nmol) also produced a hypotensive response, but in Brattleboro rats microinjections of this amine elicited a marked pressor effect. In these rats, simultaneous administration of a subthreshold dose of AVP (0.9 pmol) reversed this response in such a way that a fall in blood pressure, similar to that observed in Long-Evans rats after injection of noradrenaline alone, was registered. These results provide evidence for a functional interaction between noradrenaline and neurohypophyseal peptides in the control of cardiovascular function in the brainstem. PMID- 3676791 TI - Astrocytes protect cultured neurons from degeneration induced by anoxia. AB - Neurons grown in cultures of dissociated brain cells degenerate when exposed to anoxia and deprived of glucose. We have developed culture systems in which neurons can be grown in the presence or absence of astrocytes and have used them to study the influence of astrocytes on the neuronal degeneration induced by anoxia and glucopenia. Cultures were prepared from fetal rat forebrains. Mixed cultures contained neurons (identified by immunocytochemical staining of neuron specific enolase, NSE) and about an equal number of non-neuronal cells (identified by glial fibrillary acid protein). Pure neuronal cultures were prepared by adding a cytostatic compound (cytosine arabinoside) to the medium. Treated cultures were exposed for 4 h to glucose-free medium and an atmosphere of 95% N2 and 5% CO2, whereas control cultures were left in the usual medium containing glucose and in an atmosphere composed of 95% air and 5% CO2. After an interval of 24 h, cultures were fixed, taken for NSE staining, and the number of surviving neurons was counted. Exposure to anoxia and glucopenia reduced the number of surviving neurons in pure neuronal cultures to 5-10% of control levels. In contrast, in mixed cultures 40-60% of the neurons survived these conditions. Anoxia without glucose deprivation reduced the number of surviving neurons in both types of cultures to the same extent as anoxia combined with glucopenia. Glucose deprivation alone was ineffective. The findings suggest a protective influence of astrocytes on neurons under anoxic conditions. gamma-D Glutamylglycine protected neurons in both types of cultures from anoxia-induced degeneration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676792 TI - Ventrolateral medullary pressor area: site of hypotensive action of clonidine. AB - Intravenous injections of clonidine produce an initial transient increase in blood pressure followed by a long-lasting hypotension and bradycardia. The initial pressor response is due to activation of vascular alpha 1-adrenergic receptors while the hypotension and bradycardia are caused by the central actions of clonidine. Although, hypothalamus, nucleus tractus solitarius (NTS), ventrolateral medulla and the intermediolateral cell column of the thoracolumbar spinal cord (IML) have been implicated, the exact site of these actions of clonidine in the central nervous system is not established. The results of this investigation suggest that the pressor area in the ventrolateral medulla (VLPA) is the site of hypotensive and bradycardic actions of intravenously administered clonidine. This conclusion is based on the observation that microinjections of idazoxan, a specific alpha 2-adrenergic receptor blocker, into the VLPA prevented and reversed the hypotension and bradycardia despite the fact that other proposed sites of these actions (NTS, hypothalamus and IML) were intact and accessible to intravenously administered clonidine. PMID- 3676793 TI - Specific angiotensin II binding sites in the rat stellate and superior cervical ganglia. AB - Angiotensin II binding sites were localized and quantified in rat stellate and superior cervical ganglia by quantitative autoradiography using 125I-Sar1 angiotensin II as a ligand. Both ganglia possess a single class of angiotensin II binding sites. High concentrations of binding sites were localized in the areas rich in principal ganglion cells. These binding sites might mediate the facilitatory action of angiotensin II on the ganglionic transmission. PMID- 3676794 TI - Synapses on dendritic shafts exhibit a perforated postsynaptic density. AB - Synapses on dendritic shafts were examined in electron micrographs of serial sections obtained from the molecular layer of the rat dentate gyrus. Some of these synapses have been found to exhibit profiles of a discontinuous postsynaptic density (PSD). PSD reconstructions from serial sections were performed in a plane perpendicular to that of the sections. The results obtained indicate that profiles of discontinuous PSDs observed in random sections of dendritic shaft synapses are generated by sectioning of PSD plates that contain 1 3 holes or perforations. Earlier serial section studies of osmicated material have demonstrated that a proportion of axospinous synapses also exhibit a perforated PSD. It appears, therefore, that the presence of PSD perforations is a general phenomenon shared by subpopulations of different types of synapses, both those involving dendritic shafts and those involving dendritic spines. PMID- 3676795 TI - Left-right symmetry of neuronal cell counts in the nucleus basalis of Meynert of control and of Alzheimer-diseased brains. AB - The nerve cell counts indicated that the neuronal population of the nucleus basalis of Meynert (nbM) was bilaterally symmetrical in both control and Alzheimer-diseased brains. In addition, the discussion deals with the possibility that a loss of neurons from rostral vs caudal parts of the nbM may occur during different stages of the disease. PMID- 3676796 TI - Topographic representation of periodicities in the forebrain of the mynah bird: one map for pitch and rhythm? AB - Coding of amplitude modulated acoustic stimuli was studied within isofrequency planes of the tonotopically organized field L, the avian analogue of the mammalian auditory cortex. The synchronization of unit responses to envelopes of sinusoidally amplitude modulated tones (AM) and repetitive noise bursts (RN) were determined as a function of envelope frequency (EF). From 249 synchronizing units, 66% were tuned to a best envelope frequency (BEF) using a synchronization criterion. BEFs varied from 0.3 to 380 Hz and showed an orderly representation within isofrequency planes orthogonal to the lamination of field L. The majority (68%) of these units had BEFs below 20 Hz down to 0.3 Hz. Thus, they were tuned to rhythms typical for animal communication sounds, speech, and music. Thirty-two % had BEFs between 20 Hz and 380 Hz and covered at least 4 of 5 octaves of the range of periodicity pitch sensation. PMID- 3676797 TI - Catch-relaxing peptide isolated from Mytilus pedal ganglia. AB - A peptide that relaxes catch tension of the anterior byssus retractor muscle of Mytilus edulis was purified from pedal ganglion extracts of the mussel. Its primary structure was determined to be H-Ala-Met-Pro-Met-Leu-Arg-Leu-NH2. This peptide was found to have not only catch-relaxing action on the byssus retractor muscle but also modulatory actions on contractions in various molluscan muscles. PMID- 3676798 TI - Presaccadic spike potential: a computer model based upon motor unit recruitment patterns in the extraocular muscles. AB - Details are presented of a computer model of the presaccadic 'spike' potential based upon the discharge properties of motor units in the extraocular muscles. The model provides support for the hypothesis that the spike potential represents the summated electrical activity from the near-synchronous recruitment of motor units in the extraocular muscles by the presaccadic burst of motoneurone activity. PMID- 3676799 TI - Binocular afferents to the salamander pretectum mediate rotation sensitivity of cells selective for visual background motions. AB - The majority (85%) of background motion-sensitive pretectal cells in salamanders was found to be binocularly driven. In 70% of the units the binocularity establishes a rotation selectivity with respect to background pattern-movements. This results in a considerable augmentation of the discharge rate when pattern movement is perceived simultaneously in the temporonasal direction by the contralateral eye and nasotemporally by the ipsilateral eye. The response is depressed when the pattern movement is seen in the same direction by both eyes. It is concluded that the rotation-sensitive cells are mainly excited by contralateral retinal afferents selective for temporonasal movements and inhibited by direct or indirect ipsilateral afferents with the same type of direction selectivity. PMID- 3676801 TI - Hippocampal rhythmical slow activity following ibotenic acid lesions of the septal region. II. Changes in hippocampal activity during sleep. AB - Ibotenic acid injections in the septal nuclei of the forebrain produced severe cell loss in the dorsal lateral septal nucleus and the septohippocampal nucleus. Chronic recording of hippocampal and neocortical slow-wave activity and muscle activity showed that the ibotenic acid treatment had selectively abolished the atropine-sensitive (presumably cholinergic) form of hippocampal rhythmical slow activity (RSA) normally seen during the tonic component of active sleep. Large amplitude irregular activity (LIA), that is normally associated with waking immobility and quiet sleep, and the atropine-resistant (probably serotonergic) RSA that normally accompanies phasic muscular activity during active sleep, were also somewhat depressed. However, clear RSA was seen during phasic muscular activity in active sleep and LIA was clearly seen during quiet sleep in all rats. Neocortical activity was not affected by the ibotenic acid treatment. The results are consistent with the hypothesis that, both in the sleeping and the waking state, RSA can be produced by either of two distinctive inputs to the hippocampus. No support was found for the hypothesis that RSA during active sleep has a different basis than RSA in the waking state. PMID- 3676800 TI - Circadian vasopressin release from perifused rat suprachiasmatic explants in vitro: effects of acute stimulation. AB - Using a perifusion culture technique, the pattern of vasopressin release from the suprachiasmatic nucleus was studied in vitro under basal and stimulated conditions. Individual rat suprachiasmatic explants released vasopressin in a rhythmic fashion and these rhythms persisted with a circadian period for up to 4 cycles. One-hour exposures to KCl on days 2 and 4 in culture induced acute increases in vasopressin output and altered the circadian pattern of release from perifused suprachiasmatic explants. These results provide evidence that the release of vasopressin in an acute as well as a circadian fashion from isolated suprachiasmatic neurons is indicative of active release processes. Furthermore, it is anticipated that this method of studying circadian rhythms generated by suprachiasmatic explants may provide a basis for elucidating the neural organization of mammalian circadian pacemakers. PMID- 3676802 TI - Recovery profile of single motoneurons after electrical stimuli in man. AB - The H-reflex of 120 soleus motoneurons was recorded using fibre EMG. The recovery profile of these motoneurons was studied during monitoring surface H-reflex records in 28 adult subjects. The spectrum of motoneurons tested was homogeneous with two extremes of neurons having different characteristics. A motoneuron population (forming about 69% of our sample) had a high threshold level for electrical stimuli, short recovery time, and short recovery fringe time (called type A). A second population of motoneurons (forming about 20-30% of our sample) had a low threshold level for electrical stimuli, long recovery fringe time (called type B). During an isometric muscle contraction every motoneuron showed an early shift in recovery time (i.e. each had a shorter recovery time) with shortened recovery fringe time. These changes were larger for motoneurons type B than motoneurons type A. With paired identical electrical stimuli of varying interstimulus intervals a motoneuron may fire in response to the conditioning and test stimuli giving an H2, but not in response to both stimuli. This occurred for interstimulus intervals of 4-11 ms. A strong inhibition period was recorded with interstimulus intervals of 12-80 ms in which all motoneurons did not show any recovery. Most motoneurons recovered in orderly fashion between 80 and 300 ms of interstimulus interval, and this recovery coincided with the fast recovery recorded in surface H-reflex. All motoneurons were recovered by 3000 ms of interstimulus intervals. These findings emphasize the importance of eliciting the H-reflex every 3-5 s in H-reflex methodology in order to be assured that all excited motoneurons have been recovered. PMID- 3676803 TI - Nodes of Ranvier in acrylamide neuropathy: voltage clamp and electron microscopic analysis of rat sciatic nerve fibres at proximal levels. AB - Adult male rats were injected with acrylamide monomer (50 mg/kg i.p., 3 times/week). The animals developed hind limb paresis and distal motor nerve conduction velocity decreased. Three of 14 examined isolated myelinated sciatic nerve fibres showed a reduced excitability. In the remaining fibres the action potentials were normal. Potential clamp analysis of nodes of Ranvier in the single fibres revealed large delayed nodal K currents in 6 cases. Four of these 6 fibres exhibited a markedly increased membrane capacitance and in 2 fibres an increased Na permeability was found. Electron microscopic examination of sciatic nerves revealed comparatively subtle internodal and nodal-paranodal alterations in large myelinated fibres. Internodally, focal aggregates of tubulovesicular profiles could be found and some Schwann cells were hypertrophic. Paranodally, axonal evaginations penetrated in between the terminating myelin lamellae. Some paranodes had a very thin myelin covering and/or exhibited varying degrees of myelin sheath retraction. In the nodal axon domains lacking an axolemmal undercoating and partly non-undercoated axolemmal protrusions could be found. Similar physiological and morphological alterations occur in the rat sciatic nerve above a neuroma. Therefore, the presently observed proximal changes may, to some extent, represent non-specific alterations, secondary to a target deprivation caused by the distal axon degeneration typical for acrylamide neuropathy. PMID- 3676804 TI - Effects of single and repeated electroconvulsive shock on local cerebral glucose utilization in the conscious rat. AB - Local rates of cerebral glucose utilization (LCGU) were determined in adult rats submitted to electroconvulsive shock (ECS) treatment. One group of rats (n = 5) received a single ECS, a second group (n = 5) was treated once daily for 7 days. A third group (n = 5) of unshocked rats served as control. LCGU measurements were performed one day after either the single or the last ECS. Following a single ECS, most of the 45 brain regions examined exhibited lower rates of LCGU than controls, in contrast after repeated ECS treatment the metabolic activity results increased in segments of the hippocampus. The results indicate that repeated ECS treatment selectively increases metabolic rates within the hippocampus, a structure of the limbic system thought to be related to affective disorders and memory. PMID- 3676805 TI - Axospinous synapses with segmented postsynaptic densities: a morphologically distinct synaptic subtype contributing to the number of profiles of 'perforated' synapses visualized in random sections. AB - Axospinous synapses were examined in the molecular layer of the rat dentate gyrus. Serial section analysis of synapses, which exhibited a discontinuity of the postsynaptic density (PSD) in at least one consecutive section, was performed. Reconstruction of each discontinuous PSD was made in a plane perpendicular to that of serial sections. The results obtained confirm earlier observations that profiles of 'perforated' synapses visualized in random sections of osmicated material are produced by sectioning of synapses with perforated and horseshoe-shaped PSDs. Additionally, it has been found that two other synaptic subtypes, namely synapses with notched and segmented PSD, contribute to the number of profiles of 'perforated' synapses. Synaptic contacts with notched PSD are characterized by an indentation of an otherwise continuous PSD, relatively small dimensions and simple shape. They appear to be unrelated to the category of synapses with discontinuous PSD. Synaptic contacts with segmented PSD are distinguished by the presence of 2-5 discrete PSD segments at the interface between a presynaptic axon terminal and a postsynaptic dendritic spine. Some PSD segments exhibit 1-3 perforations, while others are horseshoe-shaped. It is postulated that the segmented PSD may evolve through the stages of perforated and horseshoe-shaped PSD to form a specialized synaptic contact of an unusually high efficacy. Every PSD segment is a component of a separate synaptic complex, each one comparable to that of a small, simple-shaped synapse. A concerted activation of several synaptic complexes belonging to a single synaptic junction may provide a mechanism for an amplification of synaptic transmission. PMID- 3676806 TI - GFA-protein gene expression on the astroglia in cow and rat brains. AB - The distribution of messenger RNA for glial fibrillary acidic protein (GFA protein) of cow and rat brains was studied by an in situ hybridization technique using a tritium-labeled cDNA probe and autoradiography. The results were compared to the findings of GFA-protein immunohistochemistry. The signals of GFA-protein mRNA were detected on the perikaryal cytoplasm of astroglia observed in the following areas: the subpial area and the white matter of the cerebrum and cerebellum of the cow and the rat; gray matter of cow spinal cord; the thalamus, pontine reticular formation and white matter of the rat brainstem. All of these areas contain astroglia which are strongly positive for GFA-protein immunohistochemistry. On the other hand, we could detect no GFA-protein mRNA positive glial cells in the areas where astroglia are negative for this immunostaining. These results indicate that the regional differences in the amount of GFA-protein in astroglia depend primarily on the degree of expression of their GFA-protein gene. PMID- 3676807 TI - Variations in nuchal muscle tonus following paradoxical sleep deprivation in the rabbit. AB - Although tonic inhibition of nuchal or facial musculature is considered an intrinsic component of paradoxical sleep (PS) in mammals, this inhibition is either absent or greatly attenuated in the rabbit. To further explore the characteristics of this phenomenon in this species, variations in quantified nuchal muscle activity were examined before, during and following 24 h of PS deprivation. It was postulated that if the substrate for PS-associated tonic electromyogram (EMG) inhibition is present, this procedure--which is known to affect both tonic and phasic components of PS--might enhance such inhibition. For these investigations chronically implanted rabbits (electroencephalographic, eye movement and nuchal muscle placements) were recorded continuously for 5 consecutive days (two day baseline, one day deprivation, two day recovery). Muscle activity was quantified by resetting integration techniques and comparisons made of activity levels before, during and after PS episodes across conditions. The deprivation procedure significantly reduced the amount of PS relative to baseline values, and a significant PS increase (rebound) occurred during postdeprivation recordings. Across-condition EMG-related effects included the corroboration of previous reports of an absence of nuchal atonia during PS, a significant diurnal variation in EMG activity--with greater activity occurring during the dark portion of the light-dark cycle, and enhanced activity immediately following PS episodes relative to either pre-PS or PS levels. Deprivation-related changes in quantified EMG activity included a pre-PS decrease during both the last 12 h of deprivation and the initial 12 h of recovery sleep, and an enhancement of EMG activity during PS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676808 TI - Excitatory action of N-acetylaspartylglutamate on Purkinje cells in guinea pig cerebellar slices: an intrasomatic study. AB - The action of N-acetylaspartylglutamate (NAAG) on Purkinje cell somata in guinea pig cerebellar slices was intracellularly investigated in comparison with L aspartate (Asp) and L-glutamate (Glu). A synthetic NAAG sample used was confirmed not to be contaminated with free Glu and Asp. NAAG, applied by either iontophoresis or superfusion, dose-dependently depolarized Purkinje cell somata, and iontophoretically applied NAAG decreased the membrane resistance in voltage- and Mg2+-dependent manners, like Asp or Glu. Relative depolarizing potencies seemed to be Glu greater than NAAG not equal to Asp in the presence of external Mg2+ and Asp greater than NAAG greater than or equal to Glu in the absence of Mg2+. In addition to this selective blocking effect of Mg2+, 2-amino-5 phosphonovalerate (APV) antagonized the actions of NAAG and Asp more strongly than that of Glu, while 2-amino-4-phosphonobutyrate showed rather non-selective antagonisms. The reversal potential of the NAAG action was at about 10 mV and similar to that of the action of Asp or Glu. These results suggest that NAAG itself is excitatory to guinea pig cerebellar Purkinje cells and is likely to be acting on Asp- and APV-sensitive, Mg2+-dependent receptors on cerebellar Purkinje cells. PMID- 3676809 TI - Observations on the morphology of axons and somata of slowly conducting dorsal root ganglion cells in the cat. AB - In anaesthetized cats, the somata of cervical dorsal root ganglion (DRG) cells were impaled with glass micropipettes containing horseradish peroxidase. Slowly conducting afferent units were first classified by the conduction velocity of the peripheral axon (group IV: less than 2.5 m/s, group III: 2.5-30 m/s) and then injected iontophoretically with horseradish peroxidase in order to visualize the perikaryon and the axons close to the ganglion. All units classified as group IV had non-myelinated peripheral and central axons. DRG cells classified as group III were morphologically heterogeneous. Units conducting in the lower group III range had non-myelinated axons on both sides of the bifurcation; in those having an intermediate conduction velocity only the peripheral axon was myelinated, and in the fastest conducting group III units both the peripheral and central axons were myelinated. One out of the 36 stained cells gave rise to 3 processes, namely 1 central axon and 2 peripheral branches. The latter ones left the ganglion at its distal pole. Within the ganglion a significant tapering of the peripheral axon of group IV afferent units was observed. In the frequency distribution histogram of cell sizes, the cross-sectional areas of group IV somata were not restricted to the lower extreme of the distribution, but showed a great overlap with the somata of group III and even group II and I units. PMID- 3676810 TI - Intracerebroventricular arginine vasopressin causes intracranial pressure to rise in conscious goats. AB - The effects of intracerebroventricular (i.c.v.) infusion of arginine vasopressin (AVP) on intracranial pressure (ICP), blood pressure (BP) and plasma AVP were investigated in conscious goats. The animals were implanted with ventricular (V) and cisternal (C) cannulae under halothane anaesthesia and allowed to recover prior to experimentation. After 30 min infusion of 20 microliter/min artificial cerebrospinal fluid (CSF) alone, to allow the animals to settle, ICP (estimated at both C and V cannulae), BP and plasma AVP were measured. Then the animals were infused with either artificial CSF alone or 1 or 10 pmol/min AVP for a further 150 min. One pmol/min AVP i.c.v. resulted in significant ICP increases of +2.2 cm CSF (C) and +3.1 cm CSF (V) when compared with artificial CSF alone. Ten pmol/min AVP also led to significant ICP rises of +3.2 cm CSF (C) and +4.2 cm CSF (V). There were no significant changes of BP or plasma AVP during the infusions. We conclude that central infusion of AVP leads to elevated ICP in conscious goats by a mechanism that does not involve BP alteration or changes in plasma AVP. PMID- 3676811 TI - Comparative studies of circadian pacemaker coupling in opisthobranch molluscs. AB - The eyes of several marine molluscs contain circadian pacemakers. The ocular pacemakers of one mollusc, Bulla gouldiana, are mutually coupled, and this coupling can be demonstrated in vitro. Induced phase separations between the two ocular pacemakers are reduced if the pacemakers are allowed to interact. The interaction between the pacemakers is mediated by the exchange of optic nerve impulses from eye to eye. In contrast, in vivo studies with another mollusc, Aplysia californica, have revealed that this snail's pacemakers are not strongly coupled. We have now determined in Bursatella leachi plei, an Opisthobranch closely related to A. californica, that the ocular pacemakers are mutually coupled. By virtue of the interaction between the pacemakers of B. leachi plei, the period of the ocular rhythm is increased by 1.5 h. In addition, eyes that remain attached to the nervous system show an increase in the sustainability of the free-running rhythm compared with isolated eyes. The increase in sustainability however, is due to the effects of attachment to the cerebral ganglion, and not the contralateral eye, since most single eyes attached to the brain show sustained, short-period rhythms. Thus, two properties of a circadian system, the pacemaker period and pacemaker sustainability, may be influenced by separate physiological mechanisms. We also confirm, using our in vitro techniques, the lack of strong coupling between the ocular pacemakers of A. californica. PMID- 3676812 TI - Effect of inhibitory amino acid antagonists on IPSPs induced in lumbar motoneurons upon stimulation of the nucleus reticularis gigantocellularis during active sleep. AB - The present study was performed to generate data implicating glycine or gamma aminobutyric acid as neurotransmitter candidates mediating the IPSPs which are recorded in lumbar motoneurons following electrical stimulation of the nucleus reticularis gigantocellularis (NRGc) during the atonia of active sleep. Accordingly, intracellular records were obtained from lumbar motoneurons in unanesthetized, normally respiring cats during naturally occurring states of active sleep, while inhibitory amino acid antagonists were microiontophoretically released next to the recorded cell. Electrical stimuli, applied to the NRGc during active sleep under drug-free conditions, evoked inhibitory postsynaptic potentials (IPSPs) in all of the lumbar motoneurons which were examined. These NRGc-induced IPSPs exhibited an average latency-to-onset of 26.6 +/- 1.3 ms, a latency-to-peak of 42.5 +/- 1.3 ms, an average amplitude of 3.9 +/- 0.4 mV and a duration of 34.4 +/- 2.1 ms. Strychnine, when applied microiontophoretically, abolished or markedly suppressed these NRGc-induced IPSPs. In contrast, the microiontophoretic application of picrotoxin or bicuculline methiodide failed to block these IPSPs. To the extent that strychnine may be considered to be a specific antagonist of glycine, the present results suggest that glycine (or a structurally related amino acid) participates in the generation of NRGc-induced IPSPs during the atonia of active sleep. PMID- 3676813 TI - Impaired control of information transfer at an isolated synapse treated by aluminum: is it related to dementia? AB - Information transfer across an isolated cholinergic synapse exposed to aluminum was investigated using conventional electrophysiological techniques and computer assisted analysis. Spontaneous and stimulation-induced release of neurotransmitter from frog motor nerve endings was augmented in the presence of aluminum (6-200 micrograms/ml). The release-enhancing effect of aluminum was dose dependent and it was independent of the concentration of calcium ions in the extracellular solution. These results indicate that aluminum at concentrations similar to those found in the diseased brain of demented patients modulates synaptic transmission. PMID- 3676814 TI - Increased norepinephrine turnover in the median preoptic nucleus following reduced extracellular fluid volume. AB - The role of noradrenergic input to fluid balance regulatory systems in the anterior hypothalamus was studied by examination of norepinephrine (NE) turnover during reduction of systemic extracellular fluid volume. Extracellular fluid volume was decreased iso-osmotically by subcutaneous polyethylene glycol (PEG), known to increase thirst and vasopressin secretion. NE turnover was assessed by measuring the decline of NE concentration in brain micropunches after administration of alpha-methyl tyrosine in PEG- or sham-treated groups. Several hypothalamic areas were investigated, including the median preoptic area (MnPO), preoptic area (POA), paraventricular nucleus, supraoptic nucleus (SON), subfornical organ, ventromedial hypothalamus, and posterior hypothalamus. Volume depleted animals showed significantly increased NE turnover in the MnPO, an important area for integration of fluid balance information. The POA and the SON also showed trends toward increased NE turnover. All other areas showed no difference in NE turnover between volume-depleted and normal animals. These results are consistent with previous findings that NE innervation to the MnPO is important in the control of fluid balance and also support the hypothesis that basal forebrain NE projections facilitate thirst and vasopressin secretion. PMID- 3676815 TI - A blood pressure lowering effect of lesions of the caudal periaqueductal gray: relationship to basal pressure. AB - Basal mean arterial pressure (MAP) measured one week following placement of pontine lesions was markedly lower (-27.85 mm Hg) in cats with bilateral lesions of the caudal periaqueductal gray than in cats with bilateral lesions of the area anteroventral to the locus coeruleus. Regression models of the relationship between basal arterial pressure (MAPbasal) and the change in arterial pressure (MAPchange) after the lesions indicate that lesions of the caudal periaqueductal gray led to a marked decrease in MAP in animals with an elevated basal MAP (MAPchange = MAPbasal x (-1.182) + 139.433; r = -0.902; P less than 0.002). In contrast, lesions of the area anteroventral to the locus coeruleus had no such effect (MAPchange = MAPbasal x (-0.363) + 56.49; r = -0.375; P greater than 0.1). The region of the caudal periaqueductal gray affecting MAP appears anterior to the locus coeruleus and through intrinsic neurons or fibers of passage may play a critical role in control of arterial pressure. PMID- 3676816 TI - Release of norepinephrine from rat hypothalamic slices: effects of desipramine and tyrosine. AB - We studied the release of endogenous norepinephrine (NE) from rat hypothalamic slices. The slices were superfused with Krebs-bicarbonate buffer and field stimulated with 960 or 1800 pulses applied 40 min apart. The spontaneous and stimulation-evoked overflow of NE into the medium were both enhanced by addition of a NE reuptake inhibitor, desipramine (10 microM). Repeated stimulations in the presence of desipramine decreased the evoked release of NE during the second and third stimulation periods (S2 and S3). The attenuation of NE release during S2 was not reversed by the addition of tyrosine (50 microM) to the medium. PMID- 3676817 TI - Diazepam dissociates the analgesic and aversive effects of periaqueductal gray stimulation in the rat. AB - Electrical stimulation of the periaqueductal gray matter (PAG) of the rat can produce both analgesia and aversive reactions. To determine if these two effects can be dissociated, diazepam, a benzodiazepine, was administered to rats chronically implanted with electrodes in the PAG. The threshold for stimulation produced analgesia or aversion, whichever was lowest, was determined before and after drug administration. Diazepam (1 mg/kg) attenuated stimulation-produced aversive reactions at 12 of 20 stimulation sites, allowing analgesia to be measured at the same threshold. Diazepam did not alter baseline pain sensitivity or thresholds for stimulation-produced analgesia. These results indicate that aversive reactions and analgesia from PAG stimulation can be pharmacologically dissociated. PMID- 3676818 TI - Differential glucose utilization in the parafascicular region during slow-wave sleep, the still-alert state and locomotion. AB - Regional cerebral glucose utilization (CGU), detectable by the uptake of 2-deoxy [14C]glucose [( 14C]2DG), was examined during 3 behavioral states--slow-wave sleep (SWS), the still-alert state (SAL) and locomotion (LOC). Examination of the autoradiograms, generated by exposing the [14C]2DG incorporated brain sections to Kodak Royal X Pan film revealed a high level of uptake bilaterally and discretely in the parafascicular (PF) region during these behaviors. This pattern of [14C]2DG uptake does not correspond to any of the anatomical structures previously identified by histo- and cytochemical methods, including the [14C]2DG method. Further, optical density measurements of this region indicated that the [14C]2DG uptake was significantly lower during SWS than during SAL or LOC. The present finding is compatible with the interpretations of previous physiological and behavioral studies that there is an inhibition by cells at the PF relay to the dentate gyrus that is lowered during the SWS compared to the SAL state, thus allowing preferential brain-stem activation of the dentate gyrus. PMID- 3676819 TI - Accumulation of circulating endogenous and exogenous immunoglobulins by hypothalamic magnocellular neurons. AB - Rat monoclonal antibodies, used in immunocytochemistry of normal rat brain, result in a granular reaction product within neurons innervating areas lacking a blood-brain barrier. Immunocytochemical characterization shows that the staining is independent of the primary antibody and exclusively dependent on the presence of anti-rat immunoglobulin. This granular staining could be selectively eliminated by pre-adsorption of the anti-rat immunoglobulin with purified rat immunoglobulin or disruption of microtubule retrograde transport systems by intraventricular injection of colchicine. A dependence on retrograde transport and complete independence from local synthesis was further substantiated by the rapid uptake and accumulation of intravenously administered rabbit or rat [125I]immunoglobulins by the supraoptic-neurohypophysial system. Immunoelectron microscopy was used to identify the endogenous rat immunoglobulin within lysosome like organelles in the cytoplasm of magnocellular neuroendocrine cells. The uptake and incorporation of plasma macromolecules into the lysosomal system of magnocellular and other neurons projecting to regions with a weak blood-brain barrier may represent a novel mode of blood-central nervous system interactions. PMID- 3676820 TI - Recovery of regenerating goldfish retinal ganglion cells is slowed in the absence of the topographically correct synaptic target. AB - When the axons of goldfish retinal ganglion cells are severed the cell bodies undergo a series of changes as the axons regenerate. These changes begin to reverse when the axons start to innervate the tectum and by 3 months after the lesion the cell bodies have nearly returned to normal. When the axons projecting to the caudal tectum were severed by a mediolateral transection of the tectum, only retinal ganglion cells in the nasal portion of the contralateral retina underwent the changes normally associated with regeneration, followed by a speedy return to normal. Because the injured fibers probably did not fully retract from the tectum, these results indicated that: (1) the complete removal of the axons from the tectal milieu was not essential for initiating the cell body changes, and (2) close proximity to the target sites would speed the recovery of the cells. When the caudal portion of the tectum was ablated the retinal ganglion cells of the nasal retina remained enlarged significantly longer than after tectal transection. During the time the cells remained enlarged the electrophysiological projection onto the remaining rostral part of the tectum revealed no significant 'compression' of the visual field. Compression of the visual field onto the rostral portion of the tectum can be accelerated if the caudal tectal ablation is accompanied by an optic nerve crush. However, under this condition the recovery of ganglion cells in the nasal retina was significantly slower than the recovery of cells in the temporal retina. This may reflect an element of topographical specificity in the regulation of the recovery of the cell body from axonal injury. PMID- 3676821 TI - Age-related changes in cerebellar noradrenergic pre- and postsynaptic mechanisms: intrinsic vs extrinsic determinants evaluated with brain grafts in oculo. AB - Intrinsic versus extrinsic determinants of changes in cerebellar noradrenergic transmission during senescence in the rat were measured using homologous cerebellar grafts in oculo. Postsynaptic sensitivity of Purkinje neurons to catecholamines was determined by perfusing the anterior eye chamber with known concentrations of norepinephrine (NE) dissolved in a balanced salt solution. NE elicited a dose-dependent slowing of spontaneous Purkinje neuron discharge in both young (3-6 months) and aged (20-22 months) cerebellar grafts. Hill plots demonstrated that the dose-response relationships in both age-groups were linear and parallel to one another. Aged transplant Purkinje neurons manifested a marked and highly significant subsensitivity to NE with an EC50 of 583 microM, as compared with an EC50 of only 15.9 microM in the young grafts. Young grafts in 15 21-month-old hosts manifested an EC50 of 20 microM for the depressant actions of NE. Collaterals of host iris sympathetic fibers innervate the grafts. Activity of these fibers can be reflexly altered by changing illumination of the retina. The dynamics of presynaptic NE release from these fibers was evaluated using in vivo electrochemistry with Nafion-coated graphite epoxy capillary electrodes, which are highly selective for the monoamine neurotransmitters. As illumination of the ipsilateral retina is increased, the release of catecholamine in the cerebellar graft decreases. A mean change in the extracellular electroactive species of 4.2 +/- 0.6 microM was found in young cerebellar grafts. Equivalent stimuli induced a mean change of 2.3 +/- 0.8 microM in aged grafts. However, this diminished release was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676822 TI - Detection of dopamine overflow and diffusion with voltammetry in slices of rat brain. AB - Voltammetric electrodes have been used to monitor extracellular dopamine in rat brain slices. The electrode tips are small enough to be immersed inside the slice. Specificity for dopamine is increased through the use of voltammetry and a cation exchange membrane at the electrode tip. Dopamine overflow is observed in the caudate nucleus following electrical stimulation (60 Hz, 1 s, 3 V) with an adjacent bipolar electrode. The amount of overflow observed is increased when the tissue is perfused with 10 microM cocaine or nomifensine, both recognized inhibitors of dopamine uptake. The ability of dopamine in the perfusion buffer to permeate the slice was monitored with two voltammetric electrodes, one in the cerebral cortex and the other in the caudate nucleus. At a high concentration (100 microM), dopamine rapidly appeared (2.7 +/- 0.4 min) in the interior of the cortex, but dopamine was not observed in the caudate until a significantly later time (8.9 +/- 1.0 min). To examine whether this difference is a reflection of the presence of different uptake systems in the two regions, pressure ejection was employed. In this experiment a double-barrelled pipette was used to eject dopamine or DOPAC at a fixed distance (approximately 70 micron) from the voltammetric electrode. Ejection of small amounts of both substances could be detected in the cortex. When the ejector-detector assembly was moved to the caudate, dopamine could only be observed following pressure ejection after perfusion of the slice with 10 microM nomifensine. Detection of DOPAC was unaffected. All of these experiments indicate that uptake systems in the caudate keep dopamine concentrations very low in the extracellular fluid of the slice. PMID- 3676823 TI - Hippocampal rhythmical slow activity following ibotenic acid lesions of the septal region. I. Relations to behavior and effects of atropine and urethane. AB - The effects of intraseptal injections of various concentrations of ibotenic acid on hippocampal electrical activity were studied in freely moving and urethane anesthetized rats. Ibotenic acid selectively abolished the atropine-sensitive form of hippocampal rhythmical slow activity (RSA) normally seen during urethane anesthesia. Large amplitude irregular activity (LIA) and RSA in the waking state were somewhat depressed as well. Despite this, clear RSA persisted in the waking state in association with locomotion or struggling (Type 1 behavior). As in normal rats, such RSA was resistant to systemic administration of atropine. Analysis of brain sections stained with gallocyanin or for acetylcholinesterase showed that ibotenic acid produced cell loss in the dorsal lateral septal nucleus and the septohippocampal nucleus. Cells in the medial septal and diagonal band nuclei were resistant to ibotenic acid. The results suggest that intrinsic septal circuitry is critically involved in the generation of the atropine-sensitive (presumably cholinergic) form of RSA. The mechanisms by which LIA and the two forms of RSA are generated in the hippocampus is discussed. PMID- 3676824 TI - Selective labeling of vagal sensory nerve fibers in the lower esophageal sphincter with anterogradely transported WGA-HRP. AB - Wheat germ agglutinin-horseradish peroxidase conjugate (WGA-HRP) injected into the nodose ganglion was anterogradely transported into the vagal sensory terminal fibers that were further visualized in the lower esophageal sphincter (LES) of the cat. The distribution pattern of the labeled fibers in the LES wall was investigated. All the labeled fibers came from the serosa and penetrated between the bundles of longitudinal muscle fibers. Then the labeled fibers took two different pathways: they either ran, and probably ended, between the longitudinal and circular muscle layers, or they ran directly from the longitudinal to the circular muscle layer. Between the longitudinal and circular muscle layers, they followed a sinuous pathway. In contrast, when they crossed the circular muscle layer toward the mucosa, they ran perpendicular to the orientation of the muscle fibers. After having entered the mucosa, they became twisted and penetrated deeply into the epithelium. These two populations of vagal sensory labeled fibers might correspond respectively to the muscular and mucosal receptors classically described in previous electrophysiological studies. PMID- 3676825 TI - A combined method for measurement of cerebral blood flow and immunohistochemistry for investigation of cerebral ischemia. AB - A combined method was established where measurement of cerebral blood flow (CBF) by quantitative autoradiography and detection of morphologic ischemic damage by immunohistochemistry could be accomplished simultaneously with the same brain. The method was applied to the gerbil brain 15 min after occlusion of the right common carotid artery which demonstrated that the reduction of focal CBF can be heterogenous at an early ischemic period, that the residual focal CBF was below 8.0 ml/100 g/min in some areas with ischemic lesions but other areas were tolerant of severe hypoperfusion. The results also suggested that the pathophysiological mechanism of selective tissue vulnerability might be different from one site to another in cerebral ischemia. This method will be useful for autoradiographic measurement of other physiological and biochemical parameters in combination with the immunohistochemical method for demonstration of not only the structural damage, but also the alteration of cell-specific functions. PMID- 3676826 TI - Fetal hypothalamic brain grafts reduce the obesity produced by ventromedial hypothalamic lesions. AB - Bilateral destruction of the rat ventromedial hypothalamus (VMH) produces a syndrome characterized by hyperphagia and obesity. In the present study we examined whether grafts of fetal hypothalamus could reverse the effects of this lesion. Three groups of adult rats received bilateral electrolytic lesions of the VMH. The first group of animals was then implanted with embryonic day 14-16 hypothalamic tissue by stereotaxic injection into the lesion sites. The second series of animals received comparable-sized grafts from a variety of non hypothalamic regions of the fetal CNS. The third group experienced similar VMH lesions but did not receive any tissue grafts. After surgery, body weight and food consumption were recorded daily for up to 8 weeks. These measures were compared with similar ones obtained from non-operated rats. Hyperphagia and obesity were consistently observed in all of the lesioned animals not bearing transplants. An initial period of weight gain was also observed in animals receiving hypothalamic grafts, but the duration of the 'dynamic' phase of this syndrome was reduced. Consequently, these graft recipients exhibited significantly less weight gain. This depressed weight gain, however, did not coincide with a statistically significant decrease in hyperphagia. Transplantation of non-hypothalamic tissue also caused an attenuation of the VMH lesion effect but this was more modest than that induced by homotopic grafts. The results of this experiment show that homotopic transplants can alter the dynamics of weight gain induced by bilateral VMH lesions. However, lesion-induced hyperphagia was not completely reversed in these grafted animals. The fact that other regions can exert a similar effect, though of lesser magnitude, suggests that a more general property of fetal CNS tissue may be involved. PMID- 3676827 TI - In vivo metabolic activity of the suprachiasmatic nuclei: non-uniform intranuclear distribution of 14C-labeled deoxyglucose uptake. AB - Anatomical techniques have shown that the suprachiasmatic nuclei (SCN) are organized into distinct dorsomedial and ventrolateral subdivisions. As a functional correlate to this morphological organization, the intranuclear distribution of SCN glucose utilization was mapped using the autoradiographic 14C labeled deoxyglucose method. In nocturnal rats and diurnal squirrel monkeys injected with the tracer during the light portion of the light-dark cycle, the middle of the SCN was metabolically more active than its rostral or caudal ends. No obvious dorsomedial/ventrolateral parcellation of SCN functional activity was disclosed. The rostrocaudal metabolic contour persisted unchanged in the absence of external light and resembled the 3-dimensional shape of the SCN (the highest metabolic activity was generally found at the largest cross-sectional area). This result is discussed with respect to its implications for the generation of circadian rhythmicity by the endogenous pacemaker in the SCN. PMID- 3676828 TI - The effects of the aminopeptidase inhibitors amastatin and bestatin on angiotensin-evoked neuronal activity in rat brain. AB - During a recent comparison of iontophoretically applied angiotensin II (AII) and angiotensin III (AIII) in the paraventricular nucleus of the rat, we observed that the response latency for AIII was much shorter than that for AII. This suggested that AII may have to be converted to AIII before it becomes active. To test this hypothesis we performed 3 experiments. (1) We examined the effects of bestatin, an aminopeptidase B inhibitor, on the activity of applied AII and AIII. (2) Next, we monitored the effects of amastatin, a specific aminopeptidase A inhibitor, on the action of co-applied AII or AIII. (3) And, finally, we examined the response to the aminopeptidase-resistant analog Sar1-AII, both applied alone and in combination with AII or AIII. Bestatin, while having no activity of its own, dramatically enhanced the actions of both AII and AIII. Amastatin, on the other hand, had little effect on AII's action and diminished or totally blocked AII-dependent activity. Like bestatin, amastatin had no effect alone. Sar1-AII reduced spontaneous activity of angiotensin-sensitive neurons and inhibited the actions of AII and AIII in a reversible manner. The same cells were also blocked by the recognized angiotensin antagonist Sar1, Ile8-AII. In total these results strongly support the notion that AII must be converted to AIII in the brain before it is activated. PMID- 3676829 TI - Characteristics of the spinal nucleus of the bulbocavernosus are influenced by genotype in the house mouse. AB - Sex differences and differences related to genotype have been observed in the nervous system. These observations provide the opportunity to relate differences in neural structure to functional differences. The spinal nucleus of the bulbocavernosus (SNB) was examined in castrated and gonadally intact male house mice from the following 3 genotypes: C57B1/6J, DBA/2J, and the B6D2F1 (F1) hybrid (resulting from a cross between a C57B1/6J female and a DBA/2J male). The number and size of SNB neurons were determined from thionin-stained thick sections from spinal cords of these mice. The gonadally intact DBA males had significantly fewer SNB motoneurons than either the C57 or F1 males, but no strain differences were observed for the size of SNB cells. Castration of adults significantly reduced SNB neuronal number, but not somatic area, in the C57s (the maternal strain) and reduced somatic area, but not neuronal number, in the DBAs (the paternal strain). Both characteristics of the SNB were reduced by castration in the F1 hybrid. Thus, the size and number of SNB neurons appear to be inherited independently and the influence of gonadal hormones on these traits varies with genotype. PMID- 3676830 TI - Tolerance to morphine microinjections in the periaqueductal gray (PAG) induces tolerance to systemic, but not intrathecal morphine. AB - The acquisition and retention of tolerance to the antinociceptive effect of supraspinal morphine on the tail withdrawal reflex was assessed in rats implanted with unilateral cannulae in the periaqueductal gray (PAG). Development of tolerance to daily microinjections of morphine was indicated by the return of the tail flick response within 4 days, followed by the recovery of analgesic sensitivity one week later. After tolerance had developed, the effect of an acute systemic (1.5-4.5 mg/kg) or intrathecal (5-15 micrograms) morphine injection was determined. 'Cross-tolerance' was observed between systemic and supraspinal morphine but not between intrathecal and supraspinal morphine. The data indicate that tolerance to chronic intracerebral morphine produces the same behavioral consequences as tolerance to systemic morphine. PMID- 3676831 TI - Differential rearing effects on rat visual cortex synapses. III. Neuronal and glial nuclei, boutons, dendrites, and capillaries. AB - Morphological measures of neurons, astrocytes, oligodendrocytes, presynaptic boutons, dendrites and capillaries were examined in the upper 4 layers of occipital cortex in rats reared for 30 days postweaning in complex (EC), social (SC) or individual cage (IC) environments. EC rats had a lower numerical density of neuronal nuclei with a comparable volume fraction to SC and IC rats. The volume fraction of astrocyte and oligodendrocyte nuclei was significantly greater for EC rats than IC littermates, and IC rats also had more synapses and neurons/micron3 of glial nuclei. Environmental groups did not differ in the numerical density of presynaptic boutons but the number of boutons per neuron was greater in EC than in IC or SC rats. This result parallels the findings that EC rats have more synapses per neuron than IC rats. Electron microscopic estimates of dendritic volume fraction confirmed estimates from Golgi-impregnated neurons that there is more dendrite per neuron in the occipital cortex of EC rats than IC or SC rats. EC rats also had a larger capillary volume than SC or IC and these capillaries were closer together and had fewer synapses/micron3 of capillary in ECs. Another indicator of metabolic activity, mitochondria volume per neuron, gave similar results with ECs having a greater volume than ICs and SCs intermediate. These results indicate that not only are there more synapses per neuron in the visual cortex of rats from more complex environments but also that the brain appears to adjust to the metabolic requirements of its synapses or neurons, in terms of vascular, mitochondrial and glial support. PMID- 3676832 TI - Plasticity of the synaptic contact zone following loss of synapses in the cerebral cortex of aging humans. AB - Quantitative ultrastructural analyses of ethanolic phosphotungstic acid-stained human layer 1 precentral motor cortex (Brodmann's area 4) and layer 1 postcentral somatosensory cortex (Brodmann's area 3) were undertaken to determine the nature of synaptic changes occurring over a series of ages (45-84 years) of a normal aging human population. In the precentral cortex, a significant decrease in the number of synapses was accompanied by an increase in mean length of the postsynaptic contact zone and a decrease in the mean width of the presynaptic paramembranous density. The frequency of mature type A and immature type E synaptic profiles decreased with age. There were no changes in the width of the postsynaptic paramembranous density, cleft width or the number of presynaptic dense projections per synapse. In the postcentral cortex there were no significant changes in synaptic number or in any of the synaptic parameters measured. The present study demonstrates that age-related synapse loss in the human cerebral cortex may be confined to specific cortical regions. The data suggest that in the precentral cortex the plasticity of the synaptic contact zone may be a compensatory response by the remaining synapses to age-related synapse loss. PMID- 3676833 TI - The afferent innervation of the thymus gland in the rat. AB - The afferent nervous supply to the thymus gland has been investigated by means of the retrograde transport of horseradish peroxidase. It has been shown that the thymus receives an afferent supply from the nodose ganglia of the vagus and from the dorsal root ganglia C1-C7. The afferent innervation of the right and left thymic lobes is bilaterally organized; the fibers of a small celled population of nodose ganglion neurons cross outside the thymus and those of a larger celled population cross within the thymus gland. The functional implications of these findings are discussed in the context of central nervous system-immune system interactions. PMID- 3676834 TI - Intracellular injection of phorbol ester increases the excitability of neurons of the motor cortex of awake cats. AB - The electrophysiological effects of two intracellularly injected phorbol esters (PhEs) which activate protein kinase C, phorbol 12,13-dibutyrate and phorbol 12 myristate 13-acetate, were investigated in neurons of the motor cortex of awake cats. The major finding was that intracellularly injected PhEs increased the excitability of the neurons. This was indicated by (1) an increase in spontaneous firing and depolarizing current-induced spike activity, accompanied by a decrease in the latency and threshold of current-induced spike discharges, (2) a reduction in slow afterhyperpolarizations following action potentials and depolarizing pulses, and (3) the development of bursting activity. Neither increases in input resistance nor depolarization of the resting potential sufficient to account for these excitability changes were found. Increases in the amplitudes of action potentials and their fast afterhyperpolarizations were also observed. All changes occurred within 2-8 min after injection and lasted for 50 min or longer. Control injections of 4 alpha-phorbol 12,13-didecanoate, which does not activate protein kinase C, failed to induce changes in neuronal excitability or in any of the above parameters. We conclude that the excitability of neurons of the motor cortex of the awake cats can be increased by phorbol esters that translocate and activate protein kinase C. PMID- 3676835 TI - Changes in the numbers of retinal ganglion cells and optic nerve axons in the developing albino rabbit. AB - In albino rabbits aged from the 16th postconceptional day (16PCD) to adulthood, the number of axons in the optic nerves were estimated from sample areas totalling 1-12% of the cross-sectional area of the nerve. On the 16PCD there are about 20,000 axons in the optic stalk. The number of axons in the retrobulbar part of the optic nerve reaches a peak value of 766,000 on the 23PCD, and then decreases to about 350,000 by the 32PCD (the day of birth). The number of axons does not change between the 32PCD and 50PCD, but thereafter it slowly decreases, reaching the adult number (294,000) by the 84PCD. A similar trend is apparent in pigmented animals. Thus, on the 25PCD there are 736,000 axons in the retrobulbar part of the optic nerve and the number decreases to 428,000 by the 31PCD. In the adult pigmented rabbit there are 280,000 axons in the optic nerve. In animals younger than the 32PCD, growth cones are present, and the number of axons in the prechiasmal part of the optic nerve was 8-22% lower than in the retrobulbar part of the same nerve. These observations suggest that there is a continued outgrowth of axons from the eye towards the target nuclei. By the 32PCD, the numbers of axons in the retrobulbar and prechiasmal parts of the nerve were very similar, suggesting that by this age all axons had reached the chiasm. The numbers of retinal ganglion cells (RGCs) labelled by massive injections of horseradish peroxidase into the retino-recipient nuclei were estimated in albino rabbits aged from the 24PCD to adulthood. RGCs were counted in evenly spaced sample areas totalling 4-11% of the retinal area. On the 24PCD, the number of labelled RGCs (500,000) was lower than the number of axons in the optic nerve (probably because not all RGC axons had reached their target nuclei by this age). However, by the 27PCD the number of labelled RGCs (550,000) was very similar to the number of prechiasmal axons (568,000). At all ages thereafter, the numbers of both RGCs and axons were very similar, with adult RGC numbers (about 291,000) being reached by the 85PCD. We conclude that axon loss in the rabbit optic nerve after the 27PCD is almost certainly due to the elimination (presumably death) of the parent RGCs, and we suggest that RGC death is also the most likely cause of axon loss prior to the 27PCD.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3676836 TI - High-affinity uptake of choline, a marker for cholinergic nerve terminals, is not specific in developing rat brain. AB - Developmental changes in the synthesis of acetylcholine (ACh) were investigated in rat hippocampus and frontal cortex. Particular reference was made to the conversion, into ACh, of the choline accumulated by high-affinity uptake as defined using 1 microM hemicholinium-3 (HC-3). Using solutions containing 11.1 mM glucose, conversions were respectively 31 and 55%, in fine slices from 4-8-day olds. Free choline accounted very largely for the remainder of the choline accumulated. In samples from adults, ACh accounted for 80% of the uptake. The inefficient conversions (into ACh) in immature brain were not the result of a requirement for ketone bodies as the source of acetyl-coenzyme A (acetyl-CoA). Greater rates of release of newly synthesised ACh, than in mature samples, were not responsible, neither were greater cholinesterase activities. The stimulation of high-affinity choline uptake, caused by prior depolarisation of the tissues using K+, also increased during development from 78 to 238% with hippocampus and from 49 to 170% with frontal cortex. Furthermore, prior depolarisation increased the efficiency with which choline, accumulated by high-affinity uptake, was converted into ACh. At all stages of development 80% of the additional choline accumulated, after depolarisation, was converted into ACh. It is concluded that the specificity of HC-3-sensitive uptake is incomplete in immature brain, i.e. high-affinity choline uptake is not exclusively into cholinergic neurones. The cholinergic neuronal compartment becomes more prominent during development so that the specificity is complete in mature brain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676837 TI - Direct and indirect effects on the lateral geniculate nucleus neurons of prenatal exposure to methylazoxymethanol acetate. AB - In this study the morphology of the lateral geniculate nucleus and occipital cortex in rats with methylazoxymethanol acetate (MAM Ac)-induced micrencephaly was examined. The aim was to examine the relative contributions of (a) the direct cytotoxic action of the drug on precursors of dorsal lateral geniculate nucleus (dLGN) neurons in the fetal brain and, (b) the postnatal degeneration of the dLGN following prenatal destruction of target neurons in the occipital cortex, to the final extent of damage to the dLGN. Exposure to MAM Ac on E13 produced severe necrosis in the fetal thalamus and caused a 77% deficit in neuronal numbers in the mature dLGN. Exposure to MAM Ac on E15 did not cause necrosis in the fetal thalamus but when animals exposed at this time were examined at 5 weeks postnatal age there was an 87% deficit in neuronal numbers in the dLGN. The hypothesis that this deficit was the result of postnatal death of the dLGN neurons following the destruction by MAM Ac of their normal target population in laminae iii and iv of the occipital cortex was supported by the observation of severe postnatal degeneration in the dLGN of animals exposed to MAM Ac on E15. The significance of these direct and indirect effects of the cytotoxic teratogen, MAM Ac, for understanding the mechanisms by which brain abnormalities in human micrencephaly are produced is discussed. PMID- 3676838 TI - The development of soma size changes in the C-laminae of the cat lateral geniculate nucleus following monocular deprivation. AB - This study examined the pattern of soma size changes in the cat dorsal lateral geniculate nucleus (dLGN) from 4 weeks of age to adulthood following monocular lid suture at two weeks of age. Different patterns of soma size changes were found between the A-laminae and C-laminae. In layers A, A1, and C significant soma size differences were found between the deprived and non-deprived laminae by 4 weeks of age. However, the magnocellular portion of layer C was affected more by deprivation than the parvocellular portion. Layer C1 did not reveal significant soma size changes until 20 weeks of age. Layer C2 did not exhibit any soma size changes at any age. These differential responses to monocular deprivation suggest different time courses of development among the dLGN laminae. PMID- 3676839 TI - Synaptic structural changes during development and aging. AB - Although a great deal is known about the development of synaptic number, comparatively little is known about the effects of development, and particularly aging, on the structure of the synapse. The present study examined synaptic structure in the molecular layer of the motor-sensory neocortex during early development (postnatal days (P) 1, 3, 5, 7, 10, 15, 20, 30), adulthood (P60, 90), and old age (28 months). Tissue was stained with osmium tetroxide (osmium) or ethanol phosphotungstic acid and the following synaptic characteristics were quantified: (1) presynaptic element length, area, thickness, maximal projection height and smoothness, and number and size of vesicles adjacent to the presynaptic element; (2) postsynaptic element length, area, and thickness; and (3) cleft width. There is an early developmental increase in synaptic element length, followed by an increase in thickness into adulthood. During development the height and width of the presynaptic dense projections increase, after which they remain stable. While the number of adjacent synaptic vesicles increases throughout the lifespan, there is a parallel decrease in their size. During the period of rapid synaptogenesis in this brain region there are no decreases in any of the synaptic structural parameters examined, indicating that newly generated synapses are either formed the same size as the existing mature synapses, or are extremely plastic and grow very rapidly. Unlike age-associated changes in synaptic number, no changes were found in synaptic structure during aging. PMID- 3676840 TI - Postnatal development of rat peripheral nerves: an immunohistochemical study of membrane lipids common to non-myelin forming Schwann cells, myelin forming Schwann cells and oligodendrocytes. AB - Interest in the role of membrane lipids in Schwann cell function prompted this study of lipid antigens on myelin- and non-myelin forming Schwann cells. Using the monoclonal antibodies 07, which recognises galactocerebroside, 08, 09 and 011, the distribution and time course of expression of the 4 membrane lipids have been determined in Schwann cells of the rat sciatic nerve and sympathetic trunk, derived from 1-60-day-old rats. The proportion of Schwann cells binding each monoclonal antibody was found by dissociating the nerves and allowing 3 h for the cells to attach to coverslips, prior to double label immunofluorescence, using the monoclonal antibody in conjunction with antibodies to S100 as a general Schwann cell marker, or P0 to distinguish cells which had formed myelin. All 4 lipid antigens were expressed by myelin forming Schwann cells, appearing just before, or at the time that the cells started to form myelin. Only 011 was restricted to myelin forming Schwann cells. Non-myelin forming Schwann cells expressed 07, 08 and 09. In the cervical sympathetic trunk, the developmental expression of these 3 lipids was essentially complete by postnatal day 20, whereas in the sciatic nerve, expression was not complete until days 40-60. The results show that the biochemical maturation in non-myelin forming Schwann cells differs greatly between different nerves, and may not be completed until several weeks postnatally. The results also demonstrate that in addition to galactocerebroside, other similarities exist in the lipid composition of myelin and the plasma membrane of non-myelin forming Schwann cells since the lipids defined by 08 and 09 antibodies are found among both Schwann cell variants. PMID- 3676841 TI - Spectral analysis of the electroencephalogram in the developing rat. AB - Power spectral measures of the EEG obtained from the frontal cortex and hippocampal formation during different vigilance states in the developing rat have been computed and compared. The most significant ontogenetic changes were observed in the hippocampal power spectra obtained during the vigilance state of REM sleep. These spectral analyses have revealed in the hippocampus: (1) a significant increase in the frequency at which the peak power occurs in the theta frequency (4-11 Hz) band from 14 to 45 days of age; (2) a decrease in the quality factor of the peak from 14 to 45 days of age; (3) a decrease in the relative power co-ordinate for the center of spectral mass associated with the 0-4-Hz frequency band coupled with an increase in the frequency coordinate of the 4-11 Hz frequency band from 14 to 45 days of age, and; (4) a significant decrease in the average percent relative power associated with the 0-4-Hz frequency band from 14 to 22 days of age. For the EEG obtained from the frontal cortex, the major findings of note were: (1) a dominant contribution of relative power in the 0-4 Hz frequency band which was observed at every age and during every vigilance state tested, and; (2) a significant increase in the average percent relative power associated with this band at 18, 22, and 45 days of age. The results of this study provide a quantitative description of the electroencephalographic (EEG) ontogeny of the hippocampal formation and the frontal cortex in the rat. These ontogenetic changes in EEG activity relate closely to development of the internal circuitry and synaptic maturation in the hippocampal formation and frontal cortex. PMID- 3676842 TI - The development of laterality in the forebrain projections of midline thalamic cell groups in the rat. AB - Bilateral forebrain (caudoputamen, nucleus accumbens and frontal cortical areas) injections of two different fluorescent retrograde tracers demonstrated that labeled cells situated in the midline nuclei of the thalamus and midbrain each project only unilaterally to the forebrain, regardless of the laterality of their perikarya. Thus, these intermingling midline perikarya send their axons primarily ipsilaterally and to a lesser degree contralaterally, but never bilaterally to the forebrain. At embryonic day 19, these midline nuclei exist as two bilaterally situated, independent structures, each projecting only ipsilaterally to the forebrain. By postnatal day 2, these perikarya fuse into a single mass on the midline. Upon fusion, many of the perikarya of the two developing subnuclei cross the midline, intermingle with each other, and thus some neurons come to have contralateral forebrain projections. These observations suggest that neurons are able to maintain their axonal projections while migrating short distances. PMID- 3676843 TI - Growth of corticospinal axons on prosthetic substrates introduced into the spinal cord of neonatal rats. AB - Nitrocellulose implants treated with biological materials known to support neurite growth in vitro were introduced at thoracolumbar levels of the neonatal rat spinal cord before the arrival of growing corticospinal tract (CST) axons. Implant placement was designed to interrupt the normal CST growth path and provide a potential, alternative growth path. Subsequent growth of CST axons within the spinal cord in the vicinity of the implants was evaluated by labeling the axons with the anterograde transport of horseradish peroxidase. Untreated implants either blocked further CST axon growth or deflected CST axons to abnormal positions. Implants bearing living cells from spinal cord primary cultures were able to support the adhesion and growth of CST axons. Similarly, acellular implants coated with laminin, but not with poly-L-lysine supported the adhesion and growth of CST axons, suggesting that laminin or some other adhesive factor produced by immature neuroglial cells may be normally involved in CST axon growth and guidance. PMID- 3676844 TI - A defect in the cell cycle of neuroglia in the myelin deficient jimpy mouse. AB - One h after receiving a single pulse of [3H]thymidine, spinal cords from jimpy and control animals were examined for labeled cells and for cells in mitosis. Although the number of labeled cells was significantly higher in jimpy spinal cords at 14 and 20 days postnatal, the number of mitotic cells was not. In normal animals, the ratio of the number of labeled cells to the number of mitotic cells (L:M) was close to 4:1 regardless of the age of the animal or the labeling index. In jimpy animals, the L:M ratio was always close to 8:1. Previous ultrastructural studies have shown that the great majority of [3H]thymidine-labeled cells in jimpy central nervous system (CNS) at these ages are oligodendrocytes. Therefore, the unusually high L:M ratio indicates that there is an abnormality in some aspect of the jimpy oligodendroglial cell cycle. PMID- 3676845 TI - One-trial olfactory learning enhances olfactory bulb responses to an appetitive conditioned odor in 7-day-old rats. AB - The expression of a conditioned odor preference and focal uptake of [14C]2 deoxyglucose (2-DG) within the olfactory bulb was assessed in neonatal rat pups that had undergone a single olfactory classical conditioning trial. At 6 days of age, rat pups were simultaneously exposed for 10 min to an odor (peppermint) and to a reinforcing tactile stimulation similar to that received from the dam. Three control groups received only the odor, only the stimulation, or neither of these stimuli. The next day, pups were either assessed for differential olfactory bulb activity using the 2-DG technique or tested for their olfactory preference behavior. Only pups that received simultaneous odor and tactile stimulation exhibited an attraction to the conditioned odor in the two-odor choice test. Furthermore, such pups had greater focal 2-DG uptake in the olfactory bulb glomeruli that were responsive to the odor than pups in all other groups. Thus, the olfactory bulb responds differentially to an odor which has acquired attractive value. PMID- 3676846 TI - Enhanced Purkinje cell survival in granuloprival cerebellar cultures. AB - The number of large cortical neurons that survived in cerebellar cultures in which granule cells had been destroyed by exposure to cytosine arabinoside was 3 4 times the number in normal cultures. Transplantation of granuloprival cerebellar cultures with granule cells and glia resulted in a reduction of the large cortical neuron population (predominantly Purkinje cells) to normal, while the number of such neurons remained elevated after transplantation with glia alone. These results indicated that granule cells were critical for the reduction of large cortical neurons. The rescue of large cortical neurons in granuloprival cultures was attributed to an expanded target field for Purkinje cell axon collateral projections. PMID- 3676847 TI - An interaction between thyroid hormone and nerve growth factor in the regulation of choline acetyltransferase activity in neuronal cultures, derived from the septal-diagonal band region of the embryonic rat brain. AB - Culture conditions have been established for growing neurons from the medial frontal part of the forebrain, containing the septum and the diagonal band of Broca, of 17-day-old rat embryos in a chemically defined medium. At 10 days in vitro, the cultures contained more than 96% nerve cells of which about 18% were cholinergic neurons, while the proportion of astrocytes was less than 1%. The majority of the cells that stained for acetylcholinesterase were bipolar but with different sizes and shapes. During development both the specific activity of choline acetyltransferase (ChAT) and the amount of protein increased markedly in the cholinergic cultures, ChAT activity rising much more than the protein content. Exposure of the cultures to nerve growth factor (NGF) or 3,3',5-triiodo L-thyronine (T3) enhanced the expression of ChAT activity in a dose-dependent manner. The elevation of ChAT activity was due to an increase in the amount of enzyme per cholinergic cell, since, during the experimental period studied, neither treatment with NGF nor with T3 had significant effects on the total protein content of the cultures or on the number of cells, including the cholinergic neurons. When cultures were supplemented with both agents at maximal effective concentrations, the stimulation in ChAT activity was much greater than the sum of the individual effects. The observations indicate that subcortical cholinergic neurons, which are affected in Alzheimer's disease and in Down's syndrome, are subject to regulation by an interaction between thyroid hormone and local humoral factors such as NGF. PMID- 3676848 TI - An anterograde tracer study of the developing corticospinal tract in the rat: three components. AB - Light microscopic analysis of anterogradely transported wheat germ agglutinin conjugated horseradish peroxidase (WGA-HRP) has been used to study the developing corticospinal tract (CST) in the rat. This study was carried out to examine the relationship between the site of injection within the cortex and the pattern of labelling of the developing CST in the spinal cord from postnatal day 1 (P1) through postnatal day 10 (P10). For this purpose the cortex was subdivided into 3 equal areas along the rostrocaudal axis: anterior, intermediate and posterior. After the operation the animals were allowed to survive for 24 h. The caudal extension of labelled CST axons originating in the anterior cortical area was restricted (L1 at P7 or P10) as compared with that of the CST fibres originating in the intermediate cortical area (S3 at P10). The axons of the posterior corticospinal (CS) neurones reach their most caudal extension in the spinal cord (T5) at P7 but then gradually disappear up till P14. Quantitative analysis of the amount of label along the length of the outgrowing CST fibres revealed the formation of a large stable peak at the level of the cervical enlargement after labelling of either the anterior or the intermediate cortical area. The formation of a second 'running' peak which moves caudally from mid-thoracic levels at P5 to mid-lumbar levels at P10 was only accomplished by labelling the intermediate cortical area and is probably caused by the accumulation of label in the growth cones at the distal ends of the outgrowing CST fibres. After labelling the posterior cortical area, no peaks could be detected, neither at the cervical nor at the lumbar intumescence. The major spinal grey termination field of the anterior CS neurones appeared to be the cervical intumescence, whereas the major spinal grey termination field of the intermediate CS neurones is the lumbar enlargement. By contrast, axons of posterior CS neurones never showed any outgrowth into the spinal grey matter at any level. Concluding, the developing CST in the rat consists of 3 components: the first having its originating neurones in the anterior part of the cortex and its termination field in the cervical intumescence; the second with its originating neurones in the intermediate part of the cortex and its termination field predominantly in the lumbar enlargement, and a third transient one, originating in the posterior cortex and gradually disappearing from spinal cord levels. Research using anterograde tracing techniques in combination with electron microscopy is necessary to further analyse these 3 different components. PMID- 3676849 TI - Immunocytochemical demonstration of radial glia in the developing rat olfactory bulb with antibodies to glial fibrillary acidic protein. AB - Olfactory bulbs of 8-, 12-, 16- and 30-day-old rats were studied by means of immunocytochemistry using antibodies to glial fibrillary acidic protein (GFAP) and with the Toluidine blue-staining of semithin sections. Until day 12 the GFAP reaction revealed a radial glia system, the fibres of which extended from the axial ventricular cleft to the surface. From day 16 onwards radial fibres were gradually replaced by typical astrocytes. The lack of proliferative activity within the bulb during the early postnatal period suggests that its cells are generated at and migrating from an external site. An intensely proliferating area was detected in the frontal lobe subventricular layer from where a bundle of migratory cells extends into the bulb. Radial glia may thus be of importance in guiding the migration of cells from this axial bundle to more peripheral regions of the olfactory bulb. PMID- 3676850 TI - Electron microscopic localization of acetylcholinesterase in the dentate gyrus of young and adult rats. AB - Acetylcholinesterase (AChE) histochemical staining occurred in neurons of the dentate gyrus at the day of birth and steadily increased in intensity and distribution during the first 3 postnatal weeks until the adult pattern was reached. Granule cells failed to display AChE staining; however, the somata of most non-principal cells in these regions showed AChE activity. It is interesting that most hilar neurons in the dentate gyrus were AChE-positive, but molecular layer local circuit neurons and pyramidal basket cells associated with the granule cell layer did not display AChE staining. AChE reaction product was localized to the nuclear envelope and cisternae of the granular endoplasmic reticulum in the labeled neuronal somata. In addition, the neuropil in the dentate gyrus displayed AChE staining associated with membranes. The possible cholinoceptive role of the AChE somata in the hilus is discussed. PMID- 3676851 TI - Brain lectin-mediated agglutinability of dissociated cells from embryonic and postnatal mouse brain. AB - Brain extracts contain a soluble lectin which enables the agglutination of dissociated mouse brain cells via saccharidic receptors. The ability of the brain cells to be agglutinated depends on their stage of development in vivo. Furthermore, after birth, the mechanism of the lectin-promoted agglutination is complicated by the appearance of a self-aggregation of the dissociated cells. Lactose and galactosides are inhibitors of lectin-mediated agglutination as well as of the dissociated cells' self-aggregation. PMID- 3676852 TI - Analysis of sex and regional differences in androgen receptors in fetal rhesus monkey brain. AB - Cytosolic androgen receptor levels were measured in different brain regions of fetal male and female rhesus monkeys (day 135 post-conception). The hypothalamus preoptic area, amygdala and cerebellum exhibited higher receptor concentration in comparison to the cerebral cortex (parietal, temporal frontal, and occipital lobes), hippocampus and cingulate gyrus (P less than 0.001). No sexual difference in receptor concentrations was found except in the amygdala where fetal males exhibited slightly higher levels than females. The similarity in androgen receptor levels suggests that the developing brain of both sexes could be influenced by circulating androgens under normal or pathological conditions. PMID- 3676853 TI - Astrocyte-mediated induction of tight junctions in brain capillary endothelium: an efficient in vitro model. AB - Fourth passage rat brain capillary endothelial cell cultures, which no longer possess the tight junctions characteristic of this highly specialized component of the blood-brain barrier, were used to study induction of zonulae occludentes in vitro. These cells, when grown in 50% rat brain astrocyte-conditioned medium and 50% alpha-MEM on an endothelial cell matrix-coated substrate (Cedarlane Labs, Hornby, Ont.), possessed numerous, elaborately complex, tight junctions which were identical to those displayed in vivo by intact brain capillary endothelium. Endothelial cells grown in 50% astrocyte-conditioned medium and 50% alpha-MEM on bare plastic or fibronectin-coated substrate, possessed no tight junctions. Results of this study clearly demonstrate the local control of tight junction biogenesis in brain capillary endothelial cells depends on: (1) an astrocyte produced factor(s), and (2) a 'competent' (cell-produced) extracellular matrix. PMID- 3676854 TI - Glial and glycoconjugate boundaries during postnatal development of the central nervous system. AB - The localization of glycosylated molecules and glia has been studied during early postnatal development in the mouse central nervous system (CNS) using autoradiographic detection of radiolabeled fucose incorporation, and in sections processed either for histochemistry or immunocytochemistry following binding of labeled lectins or an antibody to glial fibrillary acidic protein. Radiolabeled sugar incorporation, lectin binding of glycoconjugates, and glial labeling all reveal borders between nuclei within the diencephalon, midbrain, and brainstem through the first postnatal week. Glycoconjugate and glial boundaries exist throughout the CNS during pattern formation events, and they also are seen in relation to fine aspects of developing functional organization within individual structures (e.g. segmentation associated with the representation of mystacial vibrissae within the brainstem trigeminal complex). The observation that each of the probes employed in this study fails to label boundary organization during later postnatal times suggests that the distribution and chemistry of the glial/glycoconjugate network are dynamic, and they change in accordance with distinct maturational states of the nervous system. PMID- 3676855 TI - Early postnatal development of monkey subthalamic nucleus: a light and electron microscopic study. AB - The subthalamic nuclei of 9 rhesus monkeys, ranging in age from newborn to 17 weeks, were examined at the light and/or electron microscopic levels, using computer assisted quantitative methods. The volume of the structure does not change significantly over the period of study. The mean cross-sectional area of neuronal somata, however, decreases by 33%, and most markedly during the first month. This is paralleled by a similar change in the mean area of cell nuclei but the perikaryon/nucleus ratio increases steadily after the first week. There is an overall decline in total cell numbers from newborn to 17 weeks. Ultrastructural features include dendritic growth cones in the neonatal monkey, and signs of axonal degeneration during the entire period. In addition to conventional axosomatic and axodendritic synapses, there are also synaptic junctions between vesicle-containing profiles which are seen only after the first month. The distributions of plaque diameters were reconstructed by the Coupland stereologic method from linear measurements of synaptic profiles and used to calculate synaptic densities and estimate the total number of synapses. This number is stable during the first postnatal month, declines markedly in the second month, and to a lesser degree thereafter, reaching a value of 55% of that at birth by 16 weeks. Findings indicate the occurrence of substantial changes within the subthalamic nucleus during the first 4 postnatal months, the most prominent of which is a marked synapse elimination. PMID- 3676856 TI - Morphology and axon terminal pattern of glutamate decarboxylase-immunoreactive cell types in the white matter of the cat occipital cortex during early postnatal development. AB - During early postnatal development glutamate decarboxylase (GAD)-immunoreactive (ir) neurons are present in the white matter of the kitten occipital cortex. Most neurons are located below layer VI in the 'upper subplate' zone, others are located deeper in the white matter. In animals at postnatal (P) days 10 and 20 we classified two cell types on the basis of their axonal pattern. One type, the axonal loop cells, displays loops of 180 degrees formed either by the main axonal stem or by a major recurrent collateral. The neurons do not form terminals in the white matter. The other type, the local axon cells, have frequently branching axons giving rise to terminal varicosities contacting other white matter neurons in a basket-like manner. The local cells form terminal plexuses which occupy the white matter of younger kittens and are concentrated in a 100-150 micron wide zone subjacent to layer VI. In P48 kittens, density and width of the plexus is reduced and axonal loop cells and the local axon cells have disappeared. Some GAD ir white matter neurons observed at this age have large fusiform somata and straight projecting axons. The origin and fate of the early postnatal white matter neurons will be discussed. PMID- 3676857 TI - Innervation and behaviour of ectopic limbs in Xenopus. AB - The hindlimb bud of Xenopus tadpoles was replaced with a forelimb bud, or vice versa, prior to axon invasion of the limb. Ectopic hindlimbs supported 94% as many brachial motoneurons as the remaining forelimb, and ectopic forelimbs supported 46% as many lumbar motoneurons as the remaining hindlimbs, on average, after the period of motoneuron death. The patterns of movement of ectopic limbs were characteristic of the innervating spinal cord segments, and not the limbs. The anatomical patterns of nerve trunks were characteristic of the ectopic limbs, and not the sources of innervation. HRP transport studies showed a resemblance between the locations of lumbar motoneurons supplying ectopic forelimb muscles and those supplying the homologous muscles of the hindlimb. It was concluded that motoneurons could survive the period of cell death following connection to muscles for which their patterns of activity were inappropriate, and the projections to ectopic limb muscles were specific although the nerve paths within the limbs were different. PMID- 3676859 TI - Enhancement of performance by methyl beta-carboline-3-carboxylate, in learning and memory tasks. AB - Benzodiazepines are known to induce a profound anterograde amnesia in man. In this report, it is shown that methyl beta-carboline-3-carboxylate (beta-CCM), an inverse agonist of the benzodiazepine receptor, has the opposite effect; it enhances performance in learning and memory tasks. Three different learning models were used: habituation to a new environment and passive avoidance in mice and imprinting in chicks. The opposite effects of both beta-CCM and the benzodiazepine diazepam were blocked by administration of the benzodiazepine receptor antagonist Ro 15-1788, providing evidence that the benzodiazepine receptor is involved in these effects. PMID- 3676858 TI - Bidirectional effects of beta-carbolines and benzodiazepines on cognitive processes. AB - Experiments with benzodiazepine receptor ligands in two paradigms involving cognitive processing were performed in order to test whether the concept of bidirectional effects of benzodiazepine receptor ligands could also be applied to cognitive functions. Benzodiazepine receptor agonists like chlordiazepoxide, lorazepam, ZK 93423 and ZK 91296 induced amnesia in a passive avoidance paradigm. Mice treated with the benzodiazepine receptor antagonist, ZK 93426, reached a learning criterion after fewer foot-shocks than saline treated mice both in naive animals and in scopolamine pre-treated animals. Furthermore, ZK 93246, attenuated the amnesic effect of corneal electroshock. The inverse agonists FG 7142 and DMCM decreased the detrimental effect of scopolamine on retrieval. In a signal detection paradigm, chlordiazepoxide impaired signal detection. In aged rats ZK 93426, ZK 90886 and FG 7142 had no effect on signal detection but ZK 93426 and FG 7142 attenuated the impairment of signal detection induced by scopolamine. These effects of benzodiazepine receptor ligands may reflect changes in arousal/vigilance, suggesting that BZ inverse agonists may have useful properties in enhancing vigilance. PMID- 3676860 TI - Characterization of benzodiazepine withdrawal in high- and low-dose dependent psychiatric inpatients. AB - Fourteen patients with high- (n = 7) and low-dose (n = 7) benzodiazepine (BDZ) dependency presented predominantly with anxious and depressive neurotic symptoms which caused long-term BDZ medication. Their BDZ dependency was characterized by giving preference to the abuse of benzodiazepines with long elimination half life. Significant enlargement of CSF spaces was only found in high-dose dependent patients. Withdrawal after long-term BDZ medication revealed no differences between high- and low-dose BDZ dependency with respect to onset of withdrawal reaction and the correlation between onset of withdrawal and peak fall of BDZ serum level. The peak of withdrawal was reached 3-4 days later in high-dose BDZ dependent patients compared with those with a low-dose dependency. The peak withdrawal in high-dose dependent patients appeared when the serum BDZ metabolite nordiazepam dropped significantly. No such concomitant appearance of peak withdrawal and drop of serum nordiazepam level could be found in low-dose dependent patients. Specificity and intensity of BDZ withdrawal symptoms were the same for those dependent upon high doses of BDZs and those dependent upon low doses, but a protracted withdrawal was only observed in low-dose BDZ-dependent patients. During the withdrawal period psychopathometric measurements consistently revealed parallel changes in the scores for physical withdrawal symptoms, anxiety and depression. It is not clear whether anxiety and depression are "typical" BDZ withdrawal reactions or represent a "reactivated" state of the psychopathological disturbance which lead to the BDZ dependency. Possible implications for the therapeutical management of BDZ-dependent patients are discussed. PMID- 3676861 TI - [The role of drugs and their forms in effective and safe pharmacotherapy]. PMID- 3676862 TI - [The micronucleus test of the local anesthetic pentacaine on human fibroblastoid cells in vitro]. PMID- 3676863 TI - [Cytotoxicity mediated by NK cells]. PMID- 3676864 TI - [Problems with thrombocyte transfusion]. PMID- 3676865 TI - [Immunologic indicators in adnexitis]. PMID- 3676866 TI - [Levels of progesterone in the blood during normal and complicated pregnancy]. PMID- 3676867 TI - [Changes in the ultrastructural picture of the placental trophoblast in the hypotrophic fetus]. PMID- 3676868 TI - [Glucose-6-phosphate dehydrogenase and lactate dehydrogenase in erythrocytes in mothers of hypotrophic neonates]. PMID- 3676869 TI - [The present state of surgical treatment of tubo-peritoneal factors in female sterility]. PMID- 3676870 TI - [The role of gynecologic inflammations in acute abdominal emergencies in gynecologic surgical practice]. PMID- 3676871 TI - [Cooperation in education and medicine between Algeria and Czechoslovakia]. PMID- 3676872 TI - Effects of constant environmental temperatures on the performance of laying pullets. AB - 1. Two experiments are described in which laying pullets maintained at constant temperatures were fed a range of diets with a view to defining optimum combinations of temperature and nutrient intake. 2. In the first experiment, all combinations of 6 temperatures (15 degrees, 18 degrees, 21 degrees, 24 degrees, 27 degrees and 30 degrees C) 9 diets (three protein concentrations and three energy contents) and two stocks were tested for 34 weeks using 4320 pullets. In experiment 2, all combinations of three rearing temperatures, three laying temperatures (18 degrees, 22.5 degrees and 27 degrees C) three diets (protein concentration) and two stocks were tested for 61 weeks using 2160 pullets. 3. As anticipated, higher dietary protein concentrations were needed to maintain egg output at higher temperatures. If diets suplying adequate amino acid intakes were provided, egg output was unaffected by temperatures in the range 15 degrees to 27 degrees C although, at the highest temperature, egg weight was slightly reduced and rate of lay (particularly in the later part of the laying year) was increased. At 30 degrees C, egg output was depressed whichever diet was fed. 4. Dietary energy content had small but significant effects on egg weight and egg output but did not interact with temperature. It was not possible to maintain egg weight or egg output at 30 degrees C by feeding a high energy, high protein diet. 5. Estimated heat output of the birds increased during the course of the experiment at the lower temperatures but decreased with time at 30 degrees C. Feather loss occurred earlier at the lower temperatures and this is interpreted as an effect of temperature on the timing of the annual moult, which also accounts for the better persistency of lay observed at 27 degrees C. PMID- 3676873 TI - Effect on shell strength of feeding supplemental sources of calcium to adult laying hens given insoluble grit during the rearing period. AB - 1. An experiment was conducted to determine the separate and combined effects of giving insoluble grit during the rearing period and small or large particle size (0.3 mm and 3 to 8 mm in diameter) limestone or oyster shell, as extra sources of calcium, during the laying period. 2. For the entire laying period the extra sources of calcium resulted in improved shell strength but, overall, grit supplements during the rearing period did not affect either egg shell strength or other performance traits. 3. An analysis for interactions however revealed that limestone of larger particle size coupled with rearing period-grit resulted in improved egg-shell strength during the last quarter of the laying period. PMID- 3676874 TI - Restricted feeding time and the behaviour of caged laying hens. AB - 1. Layers housed as pairs in cages were denied access to food from 07.30 to 15.30 h each day. Analyses of video records of daily activity patterns showed several behaviour changes compared with the patterns shown by similar birds allowed ad libitum (AL) access to food. 2. Birds given restricted access (RA) to food spent more time sitting and cage pecking while unable to feed than those feeding ad libitum during the same period. They also engaged in less agonistic pecking and the lengths of bouts of drinking were reduced during the period of food denial compared with the AL treatment. 3. After the food troughs were uncovered birds on the RA treatment showed fewer bouts of feather pecking but more bouts of drinking than the AL treatment. 4. Improvements previously reported in the efficiency of food utilisation of birds on the RA treatment may have been the result of additional sitting, although other activities requiring energy expenditure were performed. 5. It is concluded that restricting access to food on a time basis has both positive and negative effects on the welfare of caged layers. PMID- 3676875 TI - Feeding responses to infusions of glucose solutions into the duodenum of cockerels and the influences of pre-fasting or vagotomy. AB - 1. The duodenum of cockerels was chronically catheterised, to study the effects of 3 h infusions of glucose solutions on voluntary food intake. 2. Compared to water, solutions containing 30, 60 and 90 g glucose/l infused at 1 ml/min induced significant, dose-related depressions in intake after the first 30 min of infusion. 3. Fasting the birds for 3 h before the start of infusion resulted in higher intakes during the period of infusion than in unfasted birds. 4. Vagotomy at the level of the proventriculus prevented the inhibitory effects of glucose infusion into the duodenum, except at the highest concentration (120 g/l). PMID- 3676876 TI - Reproductive performance of dwarf broiler breeders given different allowances of food during the rearing and breeding periods and two lighting patterns. AB - 1. Dwarf broiler breeders were either fed ad libitum or restricted to allow growth to mean body weights of 1.4 or 1.8 kg at 20 weeks of age. During the breeding period these birds were fed ad libitum, or food was restricted to different degrees and the birds subjected to two different incremental lighting patterns. 2. Egg production of birds fed ad libitum during the breeding period increased with the degree of food restriction during rearing. 3. Food restriction during the breeding period increased the egg production of birds weighing 1.8 kg at 20 weeks but decreased that of birds weighing only 1.4 kg. 4. Fertility was relatively low and inversely related to body fatness of females. 5. The differences in lighting pattern did not influence performance. 6. For optimum reproductive performance during the rearing period dwarfs should not be restricted so severely as conventional breeders. Best chick production was obtained from birds with a bodyweight of 1.8 kg at 20 weeks of age, which were subjected to a 10% restriction of food during the breeding period. PMID- 3676877 TI - Withdrawal of zinc oxide-containing diets from mature, female domestic fowl: effects on laying performance and the weights of selected tissues. AB - 1. Two hundred and sixteen laying hens of two strains were given diets containing ZnO to provide 0, 0.5, 0.75, 1.00, 1.25, 1.50, 2.00, 3.00 or 4.00 g added Zn/kg. These diets were given ad libitum for 5 consecutive 28-d periods. All hens subsequently received the control diet with no added ZnO for 5 weeks. 2. Four hens from each treatment were killed 0, 1 and 5 weeks after substitution of the ZnO-supplemented diets by the control diet. 3. The adverse effects of the ZnO containing diets on body weight, food intake, egg production, pancreas, gizzard, oviduct and ovary weights/kg body weight were reversed by removal of the ZnO from the diets. 4. Five weeks after withdrawal egg production of the group which had received the diet with the highest concentration of added ZnO was only 50% of that of the control birds. 5. The beneficial effect of the added ZnO on internal egg quality was not maintained after withdrawal of the ZnO-containing diets. PMID- 3676878 TI - Withdrawal of zinc oxide-containing diets from mature, female domestic fowl: effects on selected tissue mineral contents. AB - 1. Two hundred and sixteen laying hens of two strains were given diets containing ZnO to provide 0, 0.5, 0.75, 1.00, 1.25, 1.50, 2.00, 3.00 or 4.00 g added Zn/kg. These diets were offered ad libitum for 5 consecutive 28-d periods. All hens were subsequently offered the control diet with no added ZnO for 5 weeks. 2. Four hens from each treatment were killed 0, 1 and 5 weeks after substitution of the ZnO supplemented diets by the control diet. 3. Dietary addition of ZnO significantly increased liver, kidneys, pancreas and gizzard Zn contents but this effect was rapidly reversed on removal of the ZnO-containing diets. 4. Hepatic and renal Fe contents were significantly depressed by dietary ZnO but after substitution of these diets by the control diet the values were comparable to that of the controls. 5. Liver Cu content declined significantly as dietary ZnO concentration increased but there was a return towards normal after ZnO withdrawal. Renal, pancreatic and gizzard Cu contents showed quadratic responses to added ZnO. 6. After ZnO withdrawal for 5 weeks, pancreas Cu contents declined linearly, whereas renal and gizzard Cu values were similar for all treatments. 7. Overall the long term feeding of ZnO-supplemented diets followed by a period of withdrawal of the ZnO supplement had no detrimental effects on tissue mineral contents. PMID- 3676879 TI - A new approach to recording plumage deterioration. AB - 1. Recording methods for the scoring of plumage wear are reviewed. 2. A new technique, distinguishing between feather tracts, the surface to which damage occurs and the degree of degradation to the feathers themselves is elaborated: a 5 step scale for degradation is applied to all appropriate fractions of 6 feather regions. After correcting for the normal feather weight in the respective areas, all 6 area values are summed to constitute an overall index of body plumage wear (IBPW). PMID- 3676880 TI - Influence of dietary protein intake on whole-body protein turnover in chicks. AB - 1. Experiments were conducted to investigate whether or not varying dietary protein intake affects whole-body protein turnover rates in young chicks. 2. Seven-d-old single comb White Leghorn male chicks were fed on diets with protein concentrations of 0, 100, 200 or 400 g/kg diet under conditions of ad libitum or equalised feeding. At the end of the experiments, the rate of protein synthesis and protein degradation in the whole body were measured in vivo. 3. The results showed that both fractional and absolute rates of protein synthesis increased with increasing dietary protein up to 200 g/kg; above this concentration they remained almost constant when feeding was ad libitum. 4. Similar responses were found with equalized feeding except that a significant reduction in protein synthesis was found when dietary protein was increased from 200 to 400 g/kg diet. 5. Less sensitive and almost parallel changes in protein degradation rates were found. 6. It was concluded that adaptation to varied dietary protein intake occurred primarily through changes in protein synthesis, accompanied by parallel alterations in protein degradation in the whole body. PMID- 3676881 TI - Effects of ovalbumin on the motility and fertilising ability of fowl spermatozoa stored for 24 H at 4 degrees C. AB - 1. The effects of 0.1, 0.5, 1 and 3 g ovalbumin/100 ml diluent on spermatozoa stored for 24 h at 4 degrees C in TES diluent or BPSE diluent with or without seminal plasma were studied. 2. There was no effect of ovalbumin on the motility of spermatozoa stored in whole semen, except at an incorporation rate of 3 g/100 ml, when motility was reduced for spermatozoa stored in TES diluent. When sperm were stored in the absence of seminal plasma, ovalbumin stimulated motility but this effect was transitory. 3. The effects of ovalbumin on fertilisation rates were diluent- and concentration-dependent. Ovalbumin concentrations of 0.1 and 0.5 g/100 ml increased the fertilising ability of whole semen stored in TES diluent but 1 g/100 ml ovalbumin decreased it. However, 0.5 g ovalbumin/100 ml had no effect on the fertilising ability of spermatozoa stored in BPSE diluent, irrespective of the presence or absence of seminal plasma. PMID- 3676882 TI - Ovarian follicular structure of White Leghorns fed ad libitum and dwarf and normal broiler breeders fed ad libitum or restricted until point of lay. AB - 1. Yellow follicle numbers when the first egg was laid were 6.3, 9.0 and 12.4 for ad libitum reared Leghorns, sex-linked Dwarf (AL Dwarf) and Normal broiler breeders respectively. Multiple ovulation resulted in low egg production and a high proportion of defective egg shells in AL Dwarf and Normal broiler breeders during early lay. 2. Restricting the growth of broiler breeders during rearing by restricting food intake (R Dwarfs) reduced the number of yellow follicles to 6.8 and increased the rate of lay. 3. Atretic yellow follicles were common among broiler breeders but not in Leghorns or R Dwarfs when the first egg was laid. 4. Poor egg production in older broiler breeders was caused by birds with few or no developing yellow follicles, atresia in yellow follicles and the continued occurrence of multiple ovulations. 5. There was no relationship between the number of yellow follicles and the number of white follicles less than 5 mm diameter but atresia in white follicles 2 to less than 5 mm was negatively related to the number of yellow follicles. 7. No relationship was observed between abdominal fat weight and yellow follicle number, though birds which ate more had more yellow follicles. 8. The sex-linked dwarfing gene dw was associated with increased atresia among the white follicles and low numbers of yellow follicles compared with the Normal DW broiler breeder genotype. PMID- 3676883 TI - Effect of early nutrition on fattening and growth of broiler chicks at 7 weeks of age. AB - 1. Six experiments were carried out with male and female broiler chicks in a factorial arrangement to evaluate the combined effects of fat concentration or energy-to-protein (E:P) ratio in diets fed from 1 to 7 or 14 d of age, and of the E:P ratio in diets fed from 1 or 2 to 7 weeks of age on fattening and performance of the birds. 2. Diets with a wide E:P ratio fed from 1 or 2 to 7 weeks consistently and significantly increased abdominal fat pad size at 7 weeks of age. On the other hand, in 5 of the experiments, the nutritional treatments from 1 to 7 or 14 d did not significantly affect this variable in chicks fed on diets with either the narrow or the wide E:P ratio. 3. Body weights and food utilisation at 7 or 14 d were consistently and significantly improved by increasing dietary fat concentration and using diets with a narrow E:P ratio. However, at 7 weeks of age, in only two of the experiments were body weights still significantly affected by early nutrition. 4. Diets with a wide E:P ratio consistently and significantly reduced the performance of chicks up to 4 weeks of age. Nevertheless, at 7 weeks of age the performance of these chicks tended to be better (at times significantly so) in most of the experiments, despite their excess fattening. PMID- 3676884 TI - Correlation between low gastric pH and the formation of gizzard erosions in chicks. AB - 1. The inner lining of the gizzard was degraded by in vitro pepsin treatment at pH values lower than 2. 2. A significant linear regression was observed between the pH values on the surface of the inner lining and those on the gizzard mucous layer just under the lining. 3. The control chicks had a specific distribution pattern of pH values on the lining of the gizzard. By feeding a gizzard erosion inducer, pH values were lowered and the distribution pattern disappeared. In the latter case, however, a gastric erosion was observed consistently at the area which showed the lowest pH value in the control chicks. 4. From the results, possible mechanisms of the formation of gizzard erosions are discussed. PMID- 3676885 TI - Noise output of hens subjected to interrupted lighting regimens. AB - 1. Noise output from domestic hens subjected to an interrupted lighting regimen began before dawn of the apparent day. 2. Noise output did not cease during the scotoperiod(s) which interrupted the apparent day. 3. Differential noise outputs during the 30 min. 4 h and 10 h scotoperiods of a 1L:7(30D:30L):4D:2L:10D regimen indicated that the hen's interpretation of darkness, even within the apparent day, was complex and probably dependent on several factors. 4. Noise output data suggested that the intense feeding behaviour at the end of the apparent day, effected by the interrupted lighting regimen, appeared to prevent the pre-dusk reduction in activity observed in conventionally lighted birds. 5. Noise output was negligible during the scotoperiod which the hen interpreted as night. PMID- 3676887 TI - C. Henry Kempe memorial lecture. PMID- 3676886 TI - Influence of the dwarfing gene dw on egg production and viability under summer heat stress. AB - 1. Dwarf egg layer (Narmada XL) dwarf broiler (DB) and normal bodied sib (NB) hens were studied under cyclic summer hot and dry heat stress of 21.1 to 45.5 degrees C for a period of 50 d. The genotype effect for egg production was significant (P less than 0.01). 2. N-XL and DB genotypes laid 12.1% more eggs than NB. Egg production declined by 3.17, 1.27 and 3.25% for a rise in temperature (maximum) of 1 degree C for N-XL, DB and NB genotypes respectively. 3. Egg production in Narmada XL declined by 42% compared to 25% in the dwarf broilers. The regression coefficients differed significantly. 4. For polygenically identical DB and NB broiler breeder hens the heat stressor significantly reduced egg production 1.98% more in the NB genotype compared with DB with a 1 degree C rise in temperature. 5. Mortality was less in the N-XL as compared to DB, but NB hens showed 11.7% more mortality than dwarfs. PMID- 3676888 TI - Developmental origins of moral masochism: a failure-to-thrive toddler's interactions with mother. AB - The case of a toddler diagnosed as failure to thrive with an unusual history of "accidents" illustrates the circumstances which may account for the infant's intense attachment to a sadistic love object and lead to moral masochism in adulthood. The observed behaviors of the toddler in interaction with mother show the pathological consequences of the infant's openness to influences of the social environment. He becomes attuned to his mother's wishes and performs behaviors which successfully evoke her attention and reciprocity even if these behaviors are contradictory to his survival. The mother's own experiences with unempathic and hostile parents are reflected in her attitudes and behaviors to the child. Suffering and victimization evoke her interest although she lacks the capacity for an empathic response to pain. Berliner's work on the origin of moral masochism, as well as the work of Steele on generational repetition, suggest the processes through which the infant's attachment to a sadistic mother gives rise to masochistic tendencies which may be reenacted throughout life in an effort to reproduce the affective feelings associated with mother's love and affection. PMID- 3676889 TI - Cruelty begins at home. AB - The abuse of children is presumed by most mental health professionals to occur at the hands of parents who were themselves harshly traumatized by abuse or neglect. A 14-month-old child is presented who was well treated by his family and developed well until 6.5 months of age, after which, due to traumatization of his mother, the child became neglected and physically abused. In a therapeutic observational environment, as the child recovered from his massive depression, much explosive destructive behavior not seen in him before was observed. From his past studies and those of other psychoanalysts, the author presents the collectively advanced hypothesis that excessive unpleasure mobilizes hostility in humans and suggests that this hypothesis may be fruitfully applied to explain why the abused become abusers. The hypothesis may also serve to guide the treatment of abused children so as to prevent their becoming tomorrow's abusers. Furthermore, the hypothesis suggests that strategies can be proposed toward preventing child abuse. PMID- 3676890 TI - Awareness of inner experience: a systems perspective on self-regulatory process in early development. AB - This brief synopsis of an organizational perspective on early development represents an integration of three major areas of the author's research: that of a detailed observational study of early mother-infant interaction over the first three years of life; that of a continuous neonatal state and caregiving interactional monitoring method over the first two months of life; and that of a 25- to 30-year follow-up on the same infants observed initially. From these data a ground plan is proposed for our thinking about the individual's life span trajectory as a unique construction within a unique context for that individual's interactional and adaptive self-regulatory strategies. Beginning with a review of biological principles, the paradoxical integration of complexity and unity in living systems is traced from the conceptualization of infant state and observations on its regulation through the role of state in the origins of awareness of inner experience, to the consolidation and validation of the self as agent in self-regulation. Central to integration is the recognition process, stemming from one's awareness that another is aware of what one is aware of within oneself. The constructionist perspective on the critical role of specificity in this organizing process is illustrated by reference to the negotiation between caregiver and infant of seven issues of adaptive coordination over the first three years of life. Finally, five propositions are formulated describing such specificity in this organizing process, as one that underlies integration of levels of the living system relating the biological, the developmental, the shaping of the life span trajectory, and the reconstructive therapeutic process. PMID- 3676891 TI - Infant abuse and neglect: lessons from the primate laboratory. AB - We review the several areas in which research on nonhuman primates contributes to our understanding of child abuse and neglect in human children. One special advantage of primate studies is that the experimental method can be utilized to examine the short- and long-term effects of relatively well-defined and circumscribed alterations in early experience and the manner in which they can affect later behavioral and physiological development. Four studies in M. nemestrina (pigtail) monkeys are described in which relatively short social separation experiences in infancy were associated with evidence of persistent changes in certain aspects of social behavioral functioning and immunological functioning, up to six years later, when the previously separated animals were in late adolescence or early adulthood. Such findings suggest that nonhuman primates may be used as animal model systems with considerable relevance to issues surrounding human child abuse and neglect. PMID- 3676892 TI - Resilience in child maltreatment victims: a conceptual exploration. AB - While many child maltreatment victims suffer serious negative emotional sequelae, others do surprisingly well. Resilience in children is a relative concept which can change over time and is affected by environment and genetics. Resilience is fostered by protective factors which ameliorate or alter a child's response to the hazards of maltreatment that usually predispose to maladaptive outcome. Personal characteristics or skills that may foster resilience include (1) rapid responsivity to danger; (2) precocious maturity; (3) dissociation of affect; (4) information seeking; (5) formation and utilization of relationships for survival; (6) positive projective anticipation; (7) decisive risk taking; (8) the conviction of being loved; (9) idealization of an aggressor's competence; (10) cognitive restructuring of painful experiences; (11) altruism; and (12) optimism and hope. There are also generic life circumstances, such as having access to good health, educational, and social welfare services, that foster resilience in children regardless of the specific nature of the stressor. Additionally, there may be abuse-specific protective factors in the environment. Examples might include the quick and full acknowledgment of an offender regarding abuse, or timeliness and permanence of legal actions affecting a child's custody. The life stories of three well-known survivors of various forms of child maltreatment illustrate how protective factors contribute to resilience. A caution is noted regarding how personal characteristics developed for survival may become maladaptive if overused and/or not given up when the stressor no longer exists. Characterological problems are most likely to develop when a child's life circumstances fail to change and the environment never becomes secure. PMID- 3676893 TI - A contribution to the concept "the exception" as a developmental phenomenon. AB - The sense of "entitlement" or of being an exception has been noted in people who have suffered from severe childhood deformities or from other forms of severe deprivation. In such cases it constitutes a restitution for earlier suffering. In this vignette from the treatment of a patient who, because of sexual abuse by her mother, did not feel that she owned her own genitals, the sense of entitlement represented a developmental step toward ownership of her own body. PMID- 3676894 TI - Personality development following sexual abuse. AB - Thirty-seven girls and twelve boys who had been sexually abused at an average of 2.6 years previously were traced and reviewed. The nonoffending parents participated in a structured interview and the children were assessed using the Piers-Harris Self-Concept Scale and the Achenbach Child Behavior Checklist. Each child was matched with a child not known to have been sexually abused and these control children underwent a similar psychological assessment. Interviews with the nonoffending parents found that 76% of the children were thought to be less confident than before, 30% had fewer friends, and 20% were more aggressive. Increased sexual awareness was noted in 24%. School teachers reported that 28% still had behavior problems, 17% had repeated a year at school, and a further 17% had deteriorated in their school work. The sexually abused girls had significantly lower self-esteem than the control girls. There was no difference in self-esteem between the control and the sexually abused boys. There was a higher incidence of stranger assault in the boys compared with the girls. The Child Behavior Checklist completed by the parents, the Teacher Report Form, and the Youth Self-Report of the Child Behavior Checklist showed that a highly significant proportion of sexually abused children fell into the clinical range. Sexual abuse appears to have long-term adverse consequences for many of the victims. This may have implications for their ability to relate to others, for the adult friendships they will make, and eventually for the way they will relate to their own children. PMID- 3676895 TI - Juvenile sex offenders: development and correction. AB - This paper addresses the developmental nature of sexually abusive behaviors as they apply to juvenile male sexual offenders. Socialization and sexual victimization are discussed. Three case histories elucidate and support the discussion of the development of victim offending. Significant treatment issues of juvenile male sexual offenders center around the sexual assault cycle which provides a framework for sexual offenders to conceptualize and understand the cognitive, behavioral, psychological, and situational factors which have resulted in their offense(s). Although sexual offenders and sexual offenses are each unique, the sexual assault cycle offers a means of addressing essential commonalities in the treatment of juvenile sexual offenders. Sexual offender specific treatment is viewed as essential for decreasing the risk of further sexual offenses, and thus decreasing the incidence of sexual victimization. PMID- 3676896 TI - Incarcerated mothers' perceptions and interpretations of their fatally maltreated children. AB - Fatally maltreated children are an elusive component in the complex interaction that has led to their premature deaths. Retrospective research with women imprisoned for fatal child maltreatment indicated recurring themes of maternal interpretations of their children as rejecting and developmentally abnormal, either advanced or delayed. Separations and difficulties during reunions were critical. The fatality was not a one-time event, but the exit point of a recurrent cycle of abusive interaction. PMID- 3676897 TI - Is treatment too late: what ten years of evaluative research tell us. AB - Since 1974, the U.S. federal government has funded four major multiyear evaluation studies to determine the relative effectiveness of different approaches to the treatment of child abuse and neglect. A total of 89 different demonstration treatment programs were studied, and data on 3,253 families experiencing difficulties with abuse and neglect were gathered. Collectively, the studies document treatment approaches which improve clients' functioning (notably lay counseling and various group services including Parents Anonymous, group therapy, and parent evaluation) and suggest greater success with clients experiencing difficulty with sexual abuse than other forms of maltreatment. However, overall the studies show that one-third or more of the parents served by these intensive demonstration efforts maltreated their children while in treatment, and over one-half of the families served continued to be judged likely to mistreat their children following termination. PMID- 3676898 TI - Child placement conflicts: new approaches. PMID- 3676899 TI - Sexual abuse in vulnerable and high risk children. PMID- 3676900 TI - [Halothane and the liver. Clinical experience]. PMID- 3676901 TI - [Immunological aspects of halothane hepatoxicity]. PMID- 3676902 TI - [Halogenic anesthetics. Their current use]. PMID- 3676903 TI - [Volatile anesthetics other than halothane]. PMID- 3676904 TI - [Halothane. Medico-legal considerations]. PMID- 3676905 TI - [Etiological factors in halothane hepatoxicity]. PMID- 3676907 TI - CNA backs state AIDS legislation. PMID- 3676906 TI - Mammography bill becomes law. PMID- 3676908 TI - An evaluation of outcome from intensive care in major medical centers. PMID- 3676909 TI - Critical care, AIDS and the law. PMID- 3676910 TI - Evaluation of a learning package for staff education. PMID- 3676911 TI - Tricuspid atresia: a nursing outlook. PMID- 3676912 TI - Vaginoplasty. PMID- 3676913 TI - The legal woes of appraising professional performance. PMID- 3676914 TI - Post-mastectomy breast reconstruction ... A new life. PMID- 3676916 TI - Disorders of muscle tone. Proceedings of a symposium. Lake Louise, Alberta, February 6-8, 1987. PMID- 3676915 TI - Cochlear implants. PMID- 3676917 TI - Geography, drinking water chemistry, pesticides and herbicides and the etiology of Parkinson's disease. AB - In 1984 we made the first observation of a correlation between early age exposure to rural environment (and drinking well water) and development of idiopathic Parkinson's disease (IPD). These findings were subsequently confirmed elsewhere (Barbeau, 1985;25 Tanner, 1985). Analysis of all early age onset IPD (EPD) cases born and raised in Saskatchewan revealed that 20 of 22 had exclusively rural exposure during the first 15 years of life. This distribution was significantly different from the general population (p = 0.0141). Further study of the EPD group included sampling and metal analysis of childhood sources of drinking water in 18 cases and 36 age and sex-matched controls. Water collected from the two groups was analyzed for 23 metals (including 7 elements implicated in the etiology of IPD). There was no difference in the metal composition of the water between the two groups. Finally, a review of herbicide and pesticide use in Saskatchewan agriculture was undertaken to determine if there was an increased incidence of EPD following utilization of any particular chemical. No increase was found in the incidence of EPD with the introduction of any pesticide or herbicide, including Paraquat, for agricultural use. We conclude that there is a strong correlation between early age rural environmental exposure and development of IPD. We believe well water is a likely vehicle for the causal agent, but neither water metal concentration nor any of the herbicides and pesticides used in Saskatchewan agriculture are related to the cause. PMID- 3676918 TI - Aging of the nigrostriatal pathway in humans. AB - Progressive degeneration of functionally related groups of neurons occurs in certain infective, toxic, nutritional and genetically determined neurological diseases. It also takes place in normal aging, and several of the regions that undergo selective decay with the passage of time seem to be the same target regions that are afflicted in degenerative disorders such as Parkinson's disease. Alzheimer's disease and amyotrophic lateral sclerosis (ALS). Infective etiology is relatively easy to exclude by a combination of immunological tests and transfer experiments. Genetic causation can be rendered unlikely when large kindreds are available for study. Nutritional deprivation and acute or subacute toxicity are accessible to explanation by examining the environment. The most difficult mechanism of pathogenesis to refute is chronic toxic damage, where the lesion may derive from long-term exposure to a relatively widespread noxious agent or agents. Variations in involvement of individuals within a population may stem from differing capacities to activate or inactivate a toxin. Inherent in this concept of etiology is recognition that compensatory potential within the central nervous system may contribute to prolonged existence of subclinical lesions so that a latent period may exist for several decades, between causal event and the onset of symptoms. Furthermore, progressive clinical deterioration may take place even though the cause may have been transient, many years before.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3676919 TI - Current status of levodopa therapy in idiopathic Parkinson's disease. AB - Levodopa is currently used at all stages of Parkinson's disease, particularly from Stage 3 onward. Most patients start levodopa within four years of the onset of disease, earlier in the akineto-rigid patients (average delay of 2.1 years) than in those where resting tremor predominates (average delay of 3.4 years). Advanced age (greater than 80) is no deterrent to the use of levodopa if required. Wearing off is most noticeable in Stage 3 or after 10 years of therapy with levodopa. An inverse correlation was found between age and wearing off, suggesting a marked sensitivity of younger patients to levodopa. Future studies on the use of dopamine agonists should thus be stratified according to age. PMID- 3676920 TI - Bromocriptine and the clinical spectrum of Parkinson's disease. AB - As the direct agonist with the widest clinical use, bromocriptine provides a unique window into the clinical spectrum of Parkinson's disease. The efficacy of bromocriptine for therapy of de novo Parkinson's disease has recently been confirmed using a double-blind design with L-Dopa (Sinemet). Over a period of 5.5 months, bromocriptine was found to be as effective as L-Dopa in reducing the functional and neurological disability of Parkinson's disease. This study complements others and demonstrates a role for bromocriptine as de novo therapy. A longitudinal study comparing bromocriptine with L-Dopa is underway, but previous observations with bromocriptine suggest modest, transient beneficial effects with significantly less fluctuation of disability and less dyskinesia when used alone or in combination with L-Dopa. The transient benefits of bromocriptine on progressive disability suggest that both pre- and post-synaptic defects are eventually involved in Parkinson's disease. While agonists with improved efficacy and minimal side effects are required for symptomatic treatment of Parkinson's disease, strategies to protect pre- and post-synaptic neuron populations against progressive dysfunction must be developed. PMID- 3676921 TI - Optimum symptomatic control of Parkinson's disease with dopaminergic therapy. AB - This paper presents a review of the literature on the therapeutic action and the side effects of the two main dopaminergic agents: L-DOPA/decarboxylase inhibitor (L-DOPA/DI) and bromocriptine (Parlodel used either as monotherapy or in combination in patients with Parkinson's disease. The combination of L-DOPA/DI and bromocriptine gives the best therapeutic efficacy (49% improvement) in the total score (bradykinesia, rigidity and tremor). However, treatment by monotherapy or combination gives the same pattern of activity: greatest improvement in tremor, followed by rigidity and bradykinesia. Improvement observed in the short term is not sustained over longer periods of time for monotherapy with either drug. The short-term side effects are similar for each treatment, whereas long-term complications (dyskinesia, end-of-dose deterioration and on-off phenomenon) appear only when levodopa is used, alone (high incidence) or in combination with bromocriptine (low incidence). The overall optimum treatment is obtained with a combination of L-DOPA/DI and bromocriptine. PMID- 3676922 TI - Continuous dopaminergic stimulation in Parkinson's disease. AB - Complex motor fluctuations and dyskinesias ("on-off" phenomenon) in Parkinson's disease can be corrected by parenteral administration of levodopa, levodopa methyl-ester, lisuride and apomorphine. Levodopa and levodopa-methyl-ester may only be administered intravenously because of their low solubility. Lisuride and apomorphine are readily absorbed after subcutaneous administration. Repeated or continuous intravenous infusions of levodopa have been given for a few days, using a wearable "jacket-like" pump, with good results. So far, lisuride is the only dopamine agonist used for chronic treatment by continuous infusion. The "on off" effect is adequately controlled in most patients by subcutaneous lisuride administration (plus oral levodopa). However, adverse effects, particularly psychiatric complications, constitute a major limiting factor for routine applications of this form of treatment. Subcutaneous apomorphine infusion is unlikely to become a standard therapeutic procedure in Parkinson's disease, but it is a very valuable research method to gain further insight into the pathophysiology of motor fluctuations in Parkinson's disease. PMID- 3676923 TI - Treatment of spasticity with tizanidine in multiple sclerosis. AB - Spasticity is a frequent and often disabling symptom in MS patients. Current drugs used as antispastic agents include Dantrolene Sodium, Baclofen and Diazepam. Tizanidine (5-chloro-4-(2imidazolin-2 yl amino)-2,1,3 benzothialdiazole) is a new antispasticity agent that has purported central action. A double blind placebo controlled trial was performed to study the efficacy of this drug in MS patients. Sixty-six patients entered an eight week therapeutic trial and fifty-nine completed the trial. Patients were assessed at 0, 2, 3 and 8 weeks of therapy for clinical effects. Electrophysiologic tests were performed at 0 and 8 weeks. A statistically significant benefit was noted in spastic muscle groups in the legs with concomitant significant reduction in hyperactive stretch reflexes and ankle clonus. Side effects most frequently cited included dry mouth and drowsiness. Two patients developed elevated liver function test that decreased with cessation of therapy. Other clinical details, side effects and electrophysiologic data will be presented. Tizanidine appears to reduce clinical spasticity and hyperreflexia in MS patients although no change in functional status was detected. Tizanidine may well serve as an alternate antispastic agent, alone or in combination with other agents. PMID- 3676924 TI - Local treatment of spasmodic torticollis with botulinum toxin. AB - Fifty-six patients with spasmodic torticollis were treated with local injections of botulinum toxin. The drop out rate was 21%. The remaining 44 patients were followed for a period of 3 to 21 months. Thirty-two patients (76%) had pain relief out of 42 presenting with pain; 37 (66%) improved in the amount of sustained movements of torticollis. The efficacy was reproducible after repeated injections. PMID- 3676925 TI - Tobacco bill in jeopardy without MD support. PMID- 3676926 TI - Lavage fluid in sexual-assault examination. PMID- 3676927 TI - Asbestos: promotion or prohibition? PMID- 3676928 TI - Midwifery and home birth: an alternative view. PMID- 3676929 TI - Experience of the Manitoba Perinatal Screening Program, 1965-85. AB - The Manitoba Perinatal Screening Program is guided by a committee of medical specialists with skills in the diagnosis and management of disorders of metabolism in the newborn. The program is voluntary and is centralized at Cadham Provincial Laboratory, in Winnipeg. A filter card blood specimen is collected from newborns on discharge from hospital, and a filter card urine sample is collected and mailed to the laboratory by the mother when the infant is about 2 weeks of age. The overall compliance rates for the blood and urine specimens are approximately 100% and 84% respectively. The blood specimen is screened for phenylalanine and other amino acids, thyroxine, galactose, galactose-1-phosphate and biotinidase. The urine specimen is screened for amino acids, including cystine, as well as methylmalonic acid and homocystine. Between 1965 and 1985, 83 cases of metabolic disorders were detected, including 23 cases of primary hypothyroidism, 14 of classic phenylketonuria, 5 of galactosemia variants, 3 of galactosemia, 2 of maple syrup urine disease and 1 of hereditary tyrosinemia. The direct cost per infant screened is $5.50, and the cost:benefit ratio is approximately 7.5:1. Maternal serum alpha-fetoprotein screening is being made available as the necessary supporting clinical facilities become available. On the basis of this experience, the author outlines the components that are important for an effective screening program. PMID- 3676930 TI - Ethical decision making by Canadian family physicians. AB - Canadian family physicians were sent questionnaires that asked how they would handle the ethical problems posed by six sample cases and what reasons were relevant to their decisions. The ethical problems concerned how much information to divulge to patients, how extensively a physician should become involved in the lifestyles of patients and how to deal with a possible family problem. The study identified characteristics of family physicians that affect their ethical decision making and tested a theoretical model that regards ethical problems as conflicts between respecting patient autonomy and promoting patient welfare. The varied responses suggested that ethical issues are resolved on a case-by-case, rather than a theoretical, basis. Certification in family medicine was the only characteristic associated with a consistent pattern of responses; certificants were more likely than other physicians to involve patients in decisions. PMID- 3676931 TI - Active abdominal tuberculosis in Canada in 1970-81. AB - We reviewed all 341 cases of abdominal tuberculosis reported in Canada between 1970 and 1981. Over the study period abdominal tuberculosis accounted for a stable proportion (0.8%) of all reported cases of tuberculosis in Canada. Its incidence declined steadily. It was more common in women, in native Indians and in people born in Asia. Detailed records of the 55 cases reported to Statistics Canada from British Columbia and of an additional 31 cases not reported to Statistics Canada (usually because they involved concomitant disease elsewhere, notably the lungs) were studied. Five of the 55 cases reported to Statistics Canada had been reported incorrectly. Of the 81 cases in British Columbia 51% involved peritonitis, 21% ileocecal disease, 20% anorectal disease, 10% mesenteric lymphadenitis, 1% disease of the sigmoid colon and 1% disease of the liver. The rate of bacteriologic confirmation was low (51%). PMID- 3676932 TI - Re-evaluating the cost of outpatient cancer chemotherapy. AB - Chemotherapy for common malignant tumours has historically been considered relatively expensive. An examination of costs at the Toronto-Bayview Regional Cancer Centre and Sunnybrook Medical Centre, Toronto, suggests that this perception is not accurate. The cost of chemotherapeutic agents administered on an outpatient basis over 4 to 6 months in established drug protocols ranged from $260 to $5374 (mean $2224). The total cost of outpatient administration was estimated to be $152.53 per dose, compared with $185.39 for inpatient administration of the same protocol, a difference of 22%. The difference was predominantly due to a higher allocated per-diem charge at the medical centre. The results indicate that outpatient administration reduces the overall cost of chemotherapy. PMID- 3676933 TI - The cost of radiation treatment at an Ontario regional cancer centre. AB - The cost of radiation treatment in 1985 at an Ontario regional cancer centre accruing 2500 new patients annually was examined. The radiation treatment department was equipped with three high-energy treatment machines, a treatment simulator and a treatment planning computer and was appropriately staffed. The total average annual cost of operating one high-energy treatment machine was $668,963. Salaries and employee benefits accounted for 78% of the costs. An average of 5439 radiation treatments were given annually with each treatment machine, at a cost $123 per treatment. The cost of a curative course of radiation treatment (average of 21 treatments) was $2583, and the cost of a palliative course (average of 7 treatments) was $861. PMID- 3676934 TI - Possible roles of normeperidine and hyponatremia in a postoperative death. PMID- 3676935 TI - Laboratory reports of chlamydial infections in Canada in 1986. PMID- 3676936 TI - Only a dream. PMID- 3676937 TI - Cashing in on AIDS: turning a disaster into a business proposition. PMID- 3676938 TI - Free trade: there'll be no free ride for this deal. PMID- 3676939 TI - Newfoundland: it shouldn't be hard to attract specialists, or to keep them. PMID- 3676940 TI - Margaret Somerville: putting medicine, ethics and the law under one roof. Interview by Bill Trent. PMID- 3676942 TI - Medical school: your chance of getting in is better in the US. PMID- 3676941 TI - On a wing and a prayer: health care in the Peruvian jungle. PMID- 3676943 TI - The right to give life and not to be deprived of it. PMID- 3676944 TI - Improving our ability to diagnose infections associated with central venous catheters: value of Gram's staining and culture of entry site swabs. AB - We prospectively studied 45 central venous catheters to determine whether Gram's staining and culture of skin swabs from the entry site could be used to predict catheter-related infection. Data were collected from insertion site swabs, intracutaneous and intravascular catheter segments, and blood cultures. Surveillance site cultures at the time of dressing changes showed that bacterial growth, once established, persisted until removal of the catheter but that the time of onset of infection was not predictable. Gram's staining alone and Gram's staining combined with culture were tested for their ability to predict catheter colonization and catheter-related infection. Bacteria seen with Gram's staining invariably denoted catheter colonization. When bacteria were not seen with Gram's staining, positive results of culture did not change the pretest probabilities of colonization or infection; however, negative results of culture reduced the probability of colonization to low levels (likelihood ratio less than 0.06). We conclude that Gram's staining and culture of skin swabs from the entry site provide, without line removal, a simple, inexpensive and practical test for the diagnosis of catheter-related infection. PMID- 3676945 TI - Northern obstetrics: a 5-year review of delivery among Inuit women. AB - There are over 18,000 Inuit in the Northwest Territories. As a group they have the highest birth rate, the lowest cesarean section rate and one of the highest perinatal death rates in Canada. We reviewed the obstetric experience of 512 Inuit women who either gave birth at Stanton Yellowknife Hospital or were referred from Yellowknife and gave birth at a southern facility between January 1981 and December 1985. Our experience is consistent with that documented in earlier reviews, which concluded that Inuit women tend to have efficient uterine action, to endure labour well and to rarely have dystocia. During the periods covered by these reviews delivery was frequently in the settlements; now hospital delivery is the norm. Substantial improvements in perinatal outcome are evident, but there remains a considerable gap between the northern and southern experience. Those attempting further progress must recognize that the need for obstetric care away from the home community is not fully appreciated by Inuit women, their families or their communities. PMID- 3676946 TI - Delirium related to tiaprofenic acid. PMID- 3676947 TI - The seat-belt syndrome. PMID- 3676948 TI - Western's research day: can you judge a patient by his looks? PMID- 3676949 TI - AIDS in the OR: a surgeon's view. PMID- 3676950 TI - Birth control at McGill. PMID- 3676951 TI - Outport medicine: here, a GP is more than a doctor. PMID- 3676953 TI - Emergency department space. PMID- 3676954 TI - Can "ethical" clinical trials be unethical? PMID- 3676952 TI - The "Eve" decision: "it may turn out to be a meek authority indeed". PMID- 3676955 TI - Removal of esophageal foreign bodies with a Foley catheter under fluoroscopic control. PMID- 3676956 TI - Binding of bismuth to cell components: clue to mode of action and side effects. PMID- 3676957 TI - Systemic absorption of intraurethral lidocaine. PMID- 3676958 TI - Duplicate publishing--again. PMID- 3676959 TI - Transmission of HIV. PMID- 3676960 TI - Protection from AIDS needed for surgeons. PMID- 3676961 TI - Pharmaceutical research in Canada. PMID- 3676962 TI - The quest for a sexless language. PMID- 3676963 TI - Septicemia due to coagulase-negative Staphylococcus in a community hospital. PMID- 3676964 TI - Blow-drying for otitis externa. PMID- 3676965 TI - Multiple authorship: a mathematical sanctuary. PMID- 3676966 TI - Sexual misconduct. PMID- 3676967 TI - Asthma in young Canadians and marihuana use. PMID- 3676968 TI - Poliomyelitis in North America: the disease is not dead yet. PMID- 3676970 TI - Screening for psychosocial problems among primary care patients: a pilot study. AB - The symptoms that a patient presents to the doctor are often not the underlying concern that prompted the consultation. The success of consultations involving a hidden diagnosis depends on how well the patient can express his or her concerns to the doctor and on how skilfully the doctor can encourage this. This study tested the feasibility and acceptability of having patients complete a brief health index questionnaire designed to help them describe their underlying concerns to the doctor. In two family medicine centres 996 patients were asked to complete a questionnaire while waiting to see the doctor; 724 (73%) did so. An evaluation of their responses showed the method to be acceptable to most. The doctors judged that it added valuable information in 41% of all consultations and in 73% of consultations in which the patient presented with psychologic complaints. There was, nevertheless, considerable variation among the physicians in their acceptance of the approach. This variability is discussed in the light of alternative models of how, in practical terms, to treat the psychosocial dimensions of a patient's complaint. PMID- 3676969 TI - Long-term outcome after respiratory rehabilitation. AB - To determine the long-term effect of respiratory rehabilitation, we followed up for 6 months after discharge 31 consecutive patients enrolled in a multidisciplinary inpatient rehabilitation program lasting 4 to 6 weeks. Of the 31, 24 showed improvement in quality of life (as measured with a previously validated questionnaire) and in functional exercise capacity (as measured with the 6-minute walk test) 2 weeks after discharge. The improvement was sustained for 6 months in 11 of the 24. Other investigators have found higher response rates than those that we report. The differences are likely due to our enrolment of consecutive patients, the length and completeness of follow-up, and the objective measurement of quality of life by an interviewer not associated with the rehabilitation program. Controlled trials of respiratory rehabilitation measuring both costs and benefits are warranted. In the meantime, strategies to maintain the initial improvement seen after rehabilitation should be developed and studied. PMID- 3676971 TI - Expo '86, Vancouver: impact on British Columbia's Children's Hospital. AB - Over 22 million visitors attended the 1986 world exposition in Vancouver, and this had a significant impact on the local pediatric facility. A total of 559 children visited the emergency department of British Columbia's Children's Hospital with injuries or illnesses resulting from the fair. Of these, 193 (34%) had come directly from the site. The children's ages ranged from 1 1/2 months to 18 years, 4 months (mean 6.99 years). Of the 559 children 31% were not covered by medical insurance. Twenty-four of the children were admitted to the hospital, and one died at the Expo site. Most of the illnesses were upper respiratory tract infections and gastroenteritis. The proportion of visits for trauma was 50%, compared with the yearly average of 25%. There was a 6% increase in the workload in the emergency department during the fair; the percentage was even higher during July and August, particularly after 1800 hours. Recommendations are made to aid with the planning of medical care for similar events. PMID- 3676972 TI - Near death caused by accidental misconnection to an endotracheal tube. PMID- 3676973 TI - Otolaryngologists hit hardest as CMPA fees increase. PMID- 3676974 TI - Cosmetic surgery is coming out of the closet. PMID- 3676975 TI - Womb for rent: ethical aspects of surrogate motherhood. PMID- 3676976 TI - Ethics and medicine come together at US transplant meeting. PMID- 3676977 TI - Cancer II: Specific neoplasms. PMID- 3676979 TI - Child psychiatry: one nation. AB - This essay discusses the position of child psychiatry as a subspecialty in Canada today. Proceeding from a review of a paper written by Dr. Quentin Rae-Grant in 1970 "Adult and Child Psychiatry--One or Two Nations?" the author, using the concept of a nation as a metaphor, explores the evolution of child psychiatry as a subspecialty in Canada. The history of child psychiatry in Canada is reviewed briefly; from its early beginnings to an increased understanding of its uniqueness as a subspecialty, finally through to the formation of the Canadian Academy of Child Psychiatry in 1980. The essay stresses the mutuality of our dependence on the Canadian Psychiatric Association. The author emphasizes our mutual dependence on the greater organizational body of psychiatrists, and encourages a greater participation of child psychiatrists within the Canadian Psychiatric Association. The author also emphasizes the need to have a closer relationship with the Canadian Paediatric Society. In addition, the author discusses in some detail the more complex and controversial relationship between child psychiatry and the Royal College of Physicians and Surgeons of Canada. Finally the author emphasizes the importance of a close working relationship with the American Academy of Child and Adolescent Psychiatry. All of these relationships are emphasized in terms of mutual dependence. PMID- 3676978 TI - The discipline of child psychiatry. PMID- 3676980 TI - The relevance of infant psychiatry to the understanding of adult psychopathology. AB - This paper examines the relevance recent findings in Infant Psychiatry may have for the understanding of adult psychopathology. For example, evidence of both continuity and discontinuity within development is cited as one way in which the continuity of specific psychiatric conditions from childhood to adulthood can be understood. Another example are the aims of Developmental Psychopathologists who examine the mechanisms which underlie developmental transformations and who try to differentiate variations seen in normal individuals from disorders. The paper ends by citing the advantages Infancy as a developmental period has in providing reference points for the understanding of cohesion within development. These are: 1. The rapid rate of change seen in children during this age period. This allows the observation of many developmental transformation and reorganizations. 2. The degree to which infants document how much we can shape our own environment. 3. The pervasive importance interpersonal relationships have for any human activity. 4. The need to understand development and hence change within the context of the environment. 5. The persuasive evidence which suggests that psychological disorders are generally based on real rather than imagined adverse events. PMID- 3676981 TI - Psychiatric disorder and poor school performance among welfare children in Ontario. AB - Parental welfare status was found to be a marker for identifying a group of children with an increased prevalence of psychiatric disorder and poor school performance. The marker was particularly strong for psychiatric disorder in young boys and for poor school performance in young girls. For instance, the prevalence rates of psychiatric disorder, in the 6 to 11 age group, for welfare and non welfare boys, were 40.0% and 13.9%, respectively; and for poor school performance in welfare and non-welfare girls, 27.8% and 6.1%, respectively. The relationship between different measures of psychosocial disadvantage and these child deficits was examined. Multivariate analyses revealed, for example, that parental welfare status made an independent contribution to the prediction of psychiatric disorder and was a more powerful predictor of poor school performance in girls compared to boys. The implications of these and other results are discussed. PMID- 3676982 TI - The relationship between family functioning and demographic characteristics in an epidemiological study. AB - This paper reports on the characteristics of two dimensions (behavior control and communication) of the McMaster Model of Family Functioning (MMFF) as assessed through the MMFF semi-structured interview in families of the normal nonclinical population of Quebec City (N = 118). Interrater reliability as well as scores distribution are reported. Particular attention is given to the absence of association found between family functioning and socioeconomic status. Exploratory data about the relationship between parental conflict and family functioning are also discussed in terms of future inquiries in child psychiatric epidemiology. PMID- 3676983 TI - Neuropsychiatry and child psychiatry: the case of the brainstem evoked potential as an illustration. AB - In child psychiatry one may frequently and reasonably suspect the existence of a neurophysiological abnormality of some kind even though this abnormality is not detectable with readily available technology: in children presenting developmental or acquired aphasia, in some specific learning disabilities, in severe developmental disorders or perhaps in a subgroup of those labeled Attention Deficit Disorder. 1. The importance for us as child psychiatrists to keep in mind the possible role of neurophysiological factors is put into perspective. 2. What Evoked Potentials are is briefly described as well as the basic principles of the technique used in recording them. 3. A review of the literature reveals how the Brainstem Auditory Evoked Responses (BAER) have helped in understanding unknown facets of known diseases (Diabetes, Hyperthyroidism, Bell Palsy, etc. . . . ) from this, it is argued that this is reasonable to expect the same usefulness for diagnosis in child psychiatry. 4. An opinion is offered as to how and when a child psychiatrist should make use of this investigation. PMID- 3676984 TI - The assessment of custody and access disputes in cases of sexual abuse allegations. AB - Sexual abuse allegations directed at one parent can arise in the context of custody and access disputes. The role of the clinician, when such allegations occur, is to provide an assessment of the total situation, taking the allegations into account. To assess the probability that sexual abuse has occurred involves a thorough assessment of the accuser, the accused, the accusation, the child, and different family subsystems. Particular attention should be paid to interviewing the young child with detailed focus on the interviewing process, how the interviews are reported and what conclusions may be drawn from them. Following a thorough assessment, the clinician may reach one of three conclusions: that the sexual abuse has probably occurred, has probably not occurred, or is unsure. A strong caution is given against becoming entangled in an endless process of trying to find out whether the allegations are true or false. Whatever conclusions are reached are but one factor in the recommendation regarding custody and/or access. Ultimately the recommendation will be made according to the best interests of the child, taking into account the child's relationships and attachments, as well as the sexual abuse allegations. PMID- 3676985 TI - The prospect of surrogate mothering: clinical concerns. AB - There have been, in the last decade, approximately 500 surrogate births in the United States and the demand is increasing. The average cost is $25,000 and as there is no regulatory legislation in place, each arrangement is covered by a private legal contract. There is little reliable data regarding any member of the "incubating family", or on the adopting couple. This paper is an attempt to point out the potential hazards, based on a theoretical and clinical appreciation of child and adult biopsychosocial processes. The authors advocate careful longitudinal study of all children and adults involved in this complex reproductive alternative. PMID- 3676986 TI - What do children know about preventing sexual assault? How can their awareness be increased? AB - Recent awareness of the pervasiveness of sexual abuse of children has resulted in a move to implement prevention programs. In conducting these programs the question of effectiveness is frequently asked. In an attempt to answer some of this concern, a questionnaire was developed and tested to determine children's base level of knowledge. The video format prevention program, "Feeling Yes, Feeling No", available from the National Film Board (Canada) was tested as a method of increasing awareness. A school with a cross section of town and rural children, with differing socioeconomic backgrounds, participated in the study. The study consisted of a pretest of knowledge, a structured video interactive classroom prevention program, and a post-test measure of change. One hundred and thirty-seven students in grades 4, 5, and 6 participated. The program took 4 weeks to complete. When asked about their feelings with regard to the program, 97% of the children stated that they enjoyed it. The results indicated that while most children have a basic level of self-protective knowledge and assertiveness, they can, in a classroom setting, learn significant and additional facts about avoiding sexual assault. Eight of twenty-nine knowledge questions elicited a large change in response, suggesting increased awareness of self-protection. The most significant changes occurred with girls, the same group apparently most at risk. PMID- 3676987 TI - Strategic family therapy interventions with deaf member families. AB - A deviance based model of deafness is compared with one based on ethnicity. The function of inadequate communication in deaf member families is explored. Techniques of intervention are examined with a focus on three strategic interventions namely: 1) circular interviewing; 2) positive connotation; and, 3) use of rituals. Case histories are provided. PMID- 3676988 TI - Children of parents with manic-depressive illness: a follow-up study. AB - Thirty-seven offspring from 21 families with a manic-depressive parent were studied 3 to 7 years following initial evaluation. The study examined both pedigree information and psychosocial variables including parental, marital and overall adjustment, measures of chronicity and severity of parental illness and family assessment measures in relationship to offspring functioning. Nine of the 37 offspring (24%) received a positive DSM-III diagnosis, which is a similar percentage of positive diagnosis of children as we found previously. The diagnoses clustered in the affective illness spectrum. When the presence of affective traits was considered, there was evidence for continuity of psychopathology in most cases. Associations between offspring psychopathology and both non-specific and specific parental risk factors are discussed. PMID- 3676989 TI - A rural child psychiatry day treatment centre: systemic perspective. AB - The author presents the complexities of directing a DTC (Day Treatment Center) in a rural setting. These complexities are explored from the perspective of system's theory. The various systems contained within the DTC are in dynamic equilibrium with each other as well as with various community groups. Changes in any one system have significant impact on the groups the system impinges on. As an example, the DTC had not functioned well for a period of time prior to the author's arrival. During that period the staff communicated poorly among themselves, resulting in conflicts between the teaching and non-teaching staff. When these conflicts were resolved the well-established incompatibilities and stresses within the system of the non-teaching staff surfaced. In the process of this conflict resolution the DTC was reorganized. New groups were established to access children at primary and secondary levels of medical prevention. Rapport with other systems in the community improved. Consequently, with better communication between groups of staff and with the community, the treatment of the children could be more effective. PMID- 3676990 TI - Residential treatment of disturbed delinquents: description of a centre and identification of therapeutic factors. AB - Residential treatment for disturbed, particularly delinquent, adolescents has been described several decades ago by the founders and leaders of institutions. Theoretical considerations in treatment were prominent. The importance of structured milieu and the control of aggression came to acquire recognition. This study describes a structured centre, known to be effective in treating disturbed delinquents, using data gathered over twelve years of clinical work, observation and research. Factors considered essential in defining this institution are isolated and made compatible with the factors indicated by Rutter in his review of the residential treatment of delinquents. These factors are being used in a further study which compares the effectiveness of different types of facilities for a range of diagnostic categories. PMID- 3676991 TI - A case of mistaken identity: a fourth ventricular tumor presenting as school phobia in a 12 year old boy. AB - A 12 year old boy was diagnosed as having overanxious disorder of childhood and school phobia. He was later found to be suffering from the effects of a cerebral tumor. Surgical removal of the tumor led to alleviation of the anxiety. The authors utilize this case to illustrate some aspects of differential diagnosis in child psychiatry. In particular, they point out the necessity of comprehensive physical examination in child psychiatry impatient units. The danger of attributing physical symptoms to functional illness purely in the absence of positive physical findings is noted. The importance of utilizing a biopsychosocial diagnostic model in child psychiatry is stressed. PMID- 3676992 TI - The psychological development of a twin: a case study of the importance of a symptom. AB - In this paper we focus on the evaluation, assessment, diagnostic conclusions, and individual psychotherapy of a four year old twin who presented with the symptom of encopresis. Of great relevance to this boy is the literature concerning his vulnerability as a twin to develop symptomatology as he starts dealing with separation and individuation issues. Especially relevant are the multiple impacts of attitudes, perceptions and family rearing issues on the psychological development of this twin, and also on the development of this specific symptom choice--encopresis. Incorporating literature with case material, the meaning of the symptom of encopresis to this twin is discussed. The hypothesis defended is that the symptom enabled the twin to attract attention from his somewhat favoured brother, and to promote the process of separation and individuation from his parents and from his twin. It promoted his sense of himself as a separate and unique person in his own right. The child developed a sense of himself despite parental interference. With individual psychotherapy and family therapy, the need for the symptom was neglected. PMID- 3676993 TI - Integrating systems theory and attachment theory: the use of radio communication to modify attachments in a patient with psychogenic vomiting. AB - A case is presented that shows the usefulness of integrating systems theory and attachment theory in the formulation and treatment of a clinical problem. The 5 year old son of East Indian immigrants presented with persistent psychogenic vomiting associated with pathological family attachments. It was evident that the precarious family equilibrium was stabilized by the child's psychogenic vomiting. The therapeutic team suggested to the family that their problems might be more satisfactorily resolved if the mother and child maintained their link by two-way radio. Three weeks later the vomiting had ceased, the child no longer felt that he needed the radio and both parents had established new patterns of relating to their child, whose attendance and peer socialization at school showed marked improvement. To some extent the rapid resolution of the problems was facilitated by the cultural strengths of the family. PMID- 3676994 TI - Gender dysphoria in a child with true hermaphroditism. AB - This case report describes the psychosexual development of a child with true hermaphroditism who was assigned to the male sex at birth, but reassigned to the female sex at age two months. Given this child's excessive exposure to male sex hormone in utero, relative to physically normal females, one would predict a biological predisposition to behave in a masculine manner. This has occurred since two years of age. In addition, this child has had periodic episodes of gender disturbance, dysphoria, and ambivalence. In contrast, a physically normal fraternal twin sister has been conventionally feminine. A number of psychosocial factors appeared to have exacerbated the biologic predisposition to behave in a masculine manner, and thus may have been responsible for "pushing" this child into varying degrees of gender identity conflict. These included a closer father daughter than mother-daughter relationship, parental tolerance of cross-gender behavior, and a mother who has been psychologically disturbed since the birth of her children. The heuristic value of this case will be discussed in relation to contemporary models of psychosexual development which emphasize the interaction of biological and psychosocial factors. PMID- 3676995 TI - The effects of teaching medical students psychotherapy skills in the outpatient department. PMID- 3676996 TI - Sexual disinhibition on clonazepam. PMID- 3676997 TI - Lithium and memory. PMID- 3676998 TI - Treatment of intrathyroidal papillary carcinoma of the thyroid. AB - Among 237 patients with grossly noninvasive (intrathyroidal) papillary carcinoma of the thyroid treated by surgery at the Massachusetts General Hospital and followed for a median of 14 years, no patient had tumor recurrence either in the thyroid bed or opposite lobe. There were 12 metastatic recurrences with risks of recurrence 4.0% and 6.9% at 10 years and 20 years respectively. Eight of these recurrences were restricted to cervical lymph nodes and did not herald the development of more serious recurrent disease. The remaining recurrences were lung metastases in four patients, two of whom died, accounting for the only deaths from thyroid carcinoma in this series. Factors that influenced the risk of recurrence included lymph node metastases at initial surgery, large tumor size, and to a lesser extent, male sex. The majority of patients (176) had subtotal thyroidectomies, mostly lobectomy (131 patients). There was no evidence that the 61 patients who underwent total thyroidectomy fared better than those with similar patient and tumor characteristics on whom subtotal procedures were performed. The overall findings of this study strongly support the concept that intrathyroidal thyroid carcinoma can be successfully treated by conservative surgery. PMID- 3676999 TI - Cisplatin and 5-fluorouracil chemotherapy in advanced or recurrent squamous cell carcinoma of the head and neck. AB - Fifty-three patients with advanced or recurrent squamous cell carcinoma of the head and neck (SCCHN) were treated with bolus cisplatin (CDDP) and 96-hour infusion of 5-fluorouracil (5-FU). Twenty-six patients with advanced disease (21 T4 and/or N3) and no prior therapy (NPT) received 2 to 3 cycles of chemotherapy prior to surgery and/or radiation. There were four complete responses (CR) and 12 partial responses (PR) to chemotherapy for an overall response rate of 61%. In 20 patients with locally recurrent or disseminated disease there was one CR and six PR for an overall response rate of 35%. All but one responding patient in both groups showed clear evidence of tumor response after the initial cycle of chemotherapy. Two of the five complete responders required at least three courses to achieve CR. Disease-free survival was poor: only five of 26 patients in the NPT group remain alive and free of disease 8 to 28 months from initial therapy. CDDP and 5-FU is an active combination for SCCHN, but survival benefit remains to be proven. PMID- 3677000 TI - Early and delayed thallium 201 imaging. Diagnosis of patients with cold thyroid nodules. AB - To investigate the utility of thallium 201 (Tl-201) thyroid scintigraphy for the detection of thyroid malignancies, early and delayed Tl-201 scintigraphy was done in 70 consecutive patients with a clinically solitary cold (Iodine 123 [I-123]) nodule. Early Tl-201 scintigraphy had a sensitivity of 100% and a specificity of 7% in predicting malignancy. With a combination of early and delayed Tl-201 scintigraphy, sensitivity ranged from 17 to 25% and specificity from 95 to 100%. Early and and delayed Tl-201 scintigraphy are only of limited value for the detection of thyroid cancer. PMID- 3677001 TI - Splenic irradiation in chronic lymphocytic leukemia. A 10-year experience at a single institution. AB - A group of 38 patients with a median age of 70 years and chronic lymphocytic leukemia (CLL) were treated using a cobalt 60 U or a 6-MeV linear accelerator. A direct field or two opposite fields covered the palpable spleen area in most patients. 100 cGy were administered weekly for a total dose of 10 Gy, given over 10 weeks. The stage arrangement (according to Rai) for the 32 evaluable patients was as follows: Stage I: 11 patients, Stage II: nine patients, Stage III: three patients, and Stage IV: nine patients. Patients in Stages I and II were treated when symptomatic. Twenty-five patients (78%) achieved hematologic response (HR), defined as normalization of the differential leukocyte count, of the total blood cell count, and of bone marrow infiltration. However, no complete response according to the standard criteria of response has been obtained. The median response time of HR was 7 months (range, 1.5 months to greater than 120 months). The overall median survival time from the start of splenic irradiation (SI) was 40 months. More than 50% splenomegaly reduction was obtained in 63% of patients, whereas no benefit was verified in the lymphadenopathy. The incidence of second tumor was 29%. Fourteen patients benefited from a further 21 SI cycles. SI does not result in a complete remission and therefore cannot modify the course of CLL. This treatment is most advisable for elderly patients with predominant bone marrow lymphocytosis, for patients with previous extensive chemotherapy or radiotherapy, and for patients with poor marrow reserve. Moreover, because of the absence of toxicity subsequent treatment is not compromised. PMID- 3677002 TI - Reversal of autoimmune hemolytic anemia associated with chronic lymphocytic leukemia following high-dose immunoglobulin. AB - An 85-year-old man with chronic lymphocytic leukemia developed severe warm antibody-type autoimmune hemolytic anemia. Initial therapy with high-dose corticosteroids had no discernible effect on the hemolytic process. Following treatment with high-dose intravenous immunoglobulin (0.4 g/kg/d for 5 consecutive days) there was an immediate and sustained increase in hematocrit accompanied by a progressive decline in reticulocyte count. A review of the literature reveals that some patients with steroid-resistant immune hemolysis may benefit from high dose immunoglobulin. This approach should be considered in elderly patients with severe anemia whose medical status precludes splenectomy. PMID- 3677004 TI - Ectopic prolactin secretion from a gonadoblastoma. AB - A 6.5-year-old girl developed isosexual, pseudoprecocious puberty secondary to a gonadoblastoma. The tumor was found to produce and secrete both immunoassayable and bioassayable prolactin based on immunohistochemical techniques and the presence of a prolactin gradient between the tumor vein and peripheral vein. The source of the prolactin was a Sertoli-like cell. Neither growth hormone nor growth hormone-releasing hormone was detected within the tumor. This case confirms the ectopic production of prolactin by neoplastic tissue. PMID- 3677003 TI - Abnormalities of protooncogenes in non-small cell lung cancer. Correlations with tumor type and clinical characteristics. AB - Twenty-seven primary non-small cell (NSC) lung cancers were analyzed for alterations of protooncogenes by DNA hybridization techniques. Abnormalities were found in 56% of tumors including ten of 16 adenocarcinomas, three of nine squamous cell cancers and two of two larger cell cancers. Five protooncogenes were found to be commonly altered in tumors at frequencies between 12% and 60%. These were c-myc, c-myb, c-ras-Ha, c-erbB-1 and c-erb-B-2. Alterations in c-erbB 1 and c-erbB-2 correlated with histologic type of tumor and were more common in advanced cancers. Allelic deletions of c-ras-Ha or c-myb were frequently observed in primary tumors which recurred or progressed after surgery (five of six). Analysis of protooncogenes may provide insights into the pathogenesis of lung cancer and may aid in predicting clinical behavior. PMID- 3677005 TI - Malignant lymphomas of follicular center cell origin in man. VI. Large cleaved cell lymphoma. AB - Between 1970 and 1986 61 patients with large cleaved cell lymphoma (LCCL) were observed and treated. Median age was 56, and there were slightly more women than men (ratio, 1.4:1). Forty-four cases (72%) had both a nodular and diffuse pattern; eight cases were nodular; nine cases were diffuse. Forty-three patients (70%) had Stage III or IV disease; four patients were Stage I (7%); 14 were Stage II (23%). Bone marrow was involved in 15 of 56 evaluable patients (27%). The median survival was 57 months. It was significantly shorter in symptomatic patients (median, 20 months) than in asymptomatic patients (median, 66 months; P = 0.002). Survival time was also shorter in Stage III and IV patients (median, 46 months) compared with Stage I and II patients (median, 100+ months; P = 0.032). Survival was independent of the disease pattern, marrow involvement, age, gender, and surface immunoglobulin heavy or light chain. Among Stage III and IV patients, survival was the same in patients who received therapy initially and in those who were treated expectantly. Among 10 advanced-stage patients who did not initially receive therapy, the median time to beginning therapy was 17 months; five patients received no therapy for 40 to 96 months. Among 14 advanced-stage patients receiving therapy regarded as curative in aggressive lymphoma, 50% experienced a complete remission (CR). However, unlike other aggressive large cell lymphomas, long-term, relapse-free survival was observed in only 9% of patients as the majority of CRs were associated with relapse rather than cure. Despite the fact that it is a large cell lymphoma, LCCL is best regarded as an indolent lymphoma. PMID- 3677006 TI - Prognostic value of the lymphocyte doubling time in chronic lymphocytic leukemia. AB - The prognostic value of lymphocyte doubling time (LDT), expressed in months and obtained by means of a linear regression, has been studied in 99 previously untreated chronic lymphocytic leukemia (CLL) patients. LDT is defined as the period of time needed for lymphocytes to double in number the amount found at diagnosis. When the analysis was extended to the whole population, it showed clear differences in the life expectancy of patients with LDT of less than or equal to 12 months (median survival, 36 months; relative death rate [O/E]1.57) compared with those with LDT of more than 12 months (median survival not yet reached; O/E, 0.37) (P less than 0.001). The significance of LDT remained even after adjustments were made for age, sex, lymphocyte count, anemia, and thrombocytopenia. The lack of statistical significance after adjustment for Binet's clinical stage corresponds to the fact that clinical stages are not distributed homogeneously, high LDT being more frequently associated with earlier stages and low LDT with more advanced forms of the disease (P less than 0.001). In this study LDT was a useful parameter in predicting disease progression. Patients in Stages A and B and with rapidly increasing lymphocytes counts became worse more frequently (33.3% and 29.1%, respectively, at 12 months after diagnosis) than those with a slow increase (no change in clinical stage at 12 months). It is concluded that since LDT appears to predict the progression of the disease, it is useful in the clinical management of CLL. PMID- 3677007 TI - High-grade mantle zone lymphoma. AB - A 66-year-old man with a 6-month history of sweating at night, generalized lymphadenopathy, hepatosplenomegaly, and paraproteinemia was diagnosed to have a Stage IV mantle zone lymphoma (MZL), which behaved aggressively. The neoplasm rapidly disseminated to extranodal sites--the skin, lungs, pleural cavity, and the central nervous system. The neoplasm did not respond to initial double-agent chemotherapy, but it did partially respond to multi-agent chemotherapy. In addition, the neoplasm had histopathologic features not reported previously in MZL--vascular invasion, massive extranodal infiltration, high mitotic count, and convoluted nuclei. PMID- 3677008 TI - Thymoma. A clinicopathologic review. AB - The clinical and pathologic features of 283 patients with thymoma treated at the Mayo Clinic (147 female and 136 male; ages 16 years to 90 years; mean, 52 years) were examined. Forty-six percent of the patients had myasthenia gravis and 10% had other paraneoplastic phenomena. The tumors were locally invasive at operation in 32%, including 6% with metastasis to lung or pleura. Intrathoracic recurrence was noted postoperatively in 15% of those who had total excision and distant metastasis developed in 3% of patients. Thirteen percent died of their thymomas and 16% died of myasthenia. Overall 5-year survival was 67% and 10-year survival was 53%. Poor prognostic factors included presence of tumor-related symptoms, large tumor size, local invasion or metastasis in initial operation, and predominantly epithelial histologic features. Although true thymomas are composed of cytologically benign elements, they show a propensity for local invasion and intrathoracic recurrence. They rarely metastasize outside the thorax. PMID- 3677009 TI - Prevalence of benign, atypical, and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study. AB - A forensic autopsy series of 519 women more than 14 years old was studied for prevalence of benign, atypical, and occult malignant breast lesions. The women included Anglos (non-Hispanic whites), Hispanics, and American Indians from New Mexico and Eastern Arizona. These three ethnic/racial groups are at markedly different risk for the development of breast cancer (Anglo 89 of 100,000 women per year, Hispanic 45.5, and American Indian 24.9. There were striking ethnic/racial and age-related differences in both the prevalence and magnitude of all forms of nonproliferative and proliferative fibrocystic disease. The various subsets of fibrocystic disease were highly associated with each other. Such lesions as apocrine metaplasia, sclerosing adenosis, and lobular microcalcification showed as much difference according to ethnic/racial background and age as the more common cystic change and duct epithelial hyperplasia. Atypical lobular and ductal hyperplasia, carcinoma in situ, and occult invasive carcinoma were uncommon and also occurred in ethnic/racial groups in a pattern that parallels the cancer risk in those groups. PMID- 3677010 TI - Transitional cell neoplasms of the urinary bladder. Can biologic potential be predicted from histologic grading? AB - The concept that most transitional cell neoplasms of the urinary bladder exist as either nonaggressive lesions of low cytologic grade or aggressive anaplastic cancers is gradually gaining acceptance. The extent to which the biological potential of these neoplasms is revealed in their pathologic features is the subject of this article. Using guidelines developed in experimental models, a series of 400 transitional cell neoplasms selected for long-term follow-up were classified into the WHO system. The results indicate that (1) almost all transitional cell tumors can be grouped into low and high grades at initial presentation; (2) the low grade lesions (usually designated transitional cell carcinoma, Grade I) are benign and should be called papillomas rather than carcinomas; (3) the risk of progression is not a function of the number of recurrences for these noninvasive, low-grade, papillary tumors; (4) the high grade neoplasms are aggressive whether papillary or nodular and account for greater than 93% of tumor-related deaths; (5) patients with high-grade lesions have a reduced life expectancy even if progression does not occur; (6) depth of invasion and growth pattern are limited as predictive factors compared with histologic grade; (7) histologic grading of the initial tumor tissue can be highly predictive of outcome. PMID- 3677011 TI - Dedifferentiated liposarcoma of the liver. AB - Among the rare occurrences of primary malignant mesenchymal tumors of the liver, the development of liposarcoma has been only theoretically listed--there is no proven example in the literature. This article documents a case of primary liposarcoma of the liver in a 30-year-old woman who presented with a huge intrahepatic tumor in the left lobe measuring 14 X 10 X 6 cm. It was composed of two distinct macroscopic and histologic features--the well-differentiated liposarcoma and the cellular, nonlipogenic pleomorphic sarcoma. The former was a mature, lipomatous tumor with various stages of lipoblasts. The latter was much more cellular, made up of pleomorphic cells admixed with a few areas of spindle cells with many mitotic figures, resembling a pleomorphic variant of malignant fibrous histiocytoma. Oil red O stain revealed multifocal, but a scanty amount, of fat-storing tumor cells in both compartments aside from large fat globules in the differentiated area. This is the first reported case of primary liposarcoma of the liver. PMID- 3677012 TI - Clinical features and management of malignant histiocytosis of the intestine. AB - This article documents the clinical course of nine patients diagnosed as having malignant histiocytosis of the intestine (MHI). Five patients had a history of gluten-sensitive enteropathy. This tumor commonly affects the small bowel in a widespread, patchy fashion causing ulceration, stricture formation, and perforation. Metastases to mesenteric nodes, liver, and the bone marrow were common. Although the diagnosis of MHI was often made at laparotomy, surgical resection, even when extensive, was not curative in any case. All nine patients were treated with a variety of chemotherapeutic regimes. This tumor proved chemosensitive, although response was usually brief and difficult to accurately evaluate. Chemotherapy was poorly tolerated because these patients were malnourished. In two cases small bowel perforation occurred, and in one gastrointestinal bleeding occurred after chemotherapy. Eight patients have died of disease from 0 to 16 months after the diagnosis was made, and a single patient is apparently cured 5+ years after completing chemotherapy. Malignant histiocytosis of the intestine has a characteristic clinical course. It is hoped that increased clinical awareness and early diagnosis will improve the outcome. PMID- 3677013 TI - Cell kinetics as a prognostic tool in patients with metastatic malignant melanoma of the skin. AB - The 3H-thymidine labeling index (LI) was determined on 178 lesions, four of which were primary, from 129 patients with malignant melanoma. The overall analysis showed a wide variability of LI values, from 0.01% to 31.7%, with an exponential distribution and a median value of 8.0%. Similar median LI values were observed for the various metastatic sites, and no difference was found between patients who only had surgery and those who also received systemic therapy. Cell kinetics and patient age and sex were not related in terms of extent and type of nodal involvement. Conversely, a trend toward higher proliferative activity was observed in amelanotic (8.3%) than in melanotic (5.9%) lesions (P = 0.08). The follow-up study on a series of 48 Stage II patients has shown a higher probability of 2-year survival for patients with slowly proliferating tumors than for those with rapidly proliferating tumors (86.9% versus 40.4%, P = 0.054). Along with this finding, the absence of a relationship between cell kinetics and both the main host and tumor characteristics indicated that cell kinetics was a prognostic variable and could be an important tool in the evaluation of patients with metastatic melanoma. PMID- 3677014 TI - Primary cardiac lymphoma in a patient with acquired immune deficiency syndrome. AB - A 34-year-old male prisoner with a history of intravenous drug abuse presented with fever, lymphadenopathy, weight loss, and recent onset of congestive heart failure. Serologic testing was positive for antibodies to human immune deficiency virus. There was intense myocardial uptake of gallium. Autopsy showed a primary immunoblastic lymphoma involving only the myocardium. While primary cardiac lymphoma is an extremely rare condition, the incidence may be higher in patients with acquired immune deficiency syndrome (AIDS) and should be suspected in cases with atypical cardiomyopathy. PMID- 3677015 TI - The protective potential of the combination of verapamil and cimetidine on cisplatin-induced nephrotoxicity in man. AB - Nine patients (Group A) with histologically proven, nonseminomatous testicular cancer were treated with cisplatin (CDDP) according to the Einhorn regimen. Renal function studies including the measurement of the effective renal plasma flow (ERPF) and the glomerular filtration rate (GFR) were performed prior to the chemotherapy and then after treatment on days 10 and 21 of the first course. In order to prevent CDDP-induced nephrotoxicity, verapamil (a calcium entry blocker) and cimetidine were given along with CDDP. The results were compared with others from another group of nine patients (Group B) treated with CDDP, but without verapamil and cimetidine. In Group A there was much less of a decrease in ERPF as compared to Group B on day 21. In addition, the decrease in GFR on days 10 and 21 was totally prevented in the verapamil- and cimetidine-treated group. PMID- 3677016 TI - Primary Ewing's sarcoma involving the bones of the head and neck. AB - Ewing's sarcoma is a rare tumor of the bone. In the Intergroup Ewing's Sarcoma Study (IESS) approximately 4% of the primary bone tumors arose in the bones of the head and neck. The mean age of patients was 10.9 years; boys slightly dominated the group. Signs and symptoms were local in distribution, with a mass or swelling most frequent. As in other sites, we categorized the dominant histologic pattern as diffuse or filigree, the latter carrying a more unfavorable prognosis. The radiographic appearance may be atypical as compared to Ewing's sarcoma at other sites. Prognosis of head and neck Ewing's is significantly better than Ewing's sarcoma overall. The gnathic bones were commonly affected, yet there was no associated mortality. No patient with primary disease in the bones of the head and neck who survived for 5 years on any of the IESS protocols has subsequently died. PMID- 3677017 TI - Regional variation in Hodgkin's disease incidence by histologic subtype in the US. AB - Geographic distribution in Hodgkin's disease (HD) incidence was examined for whites by age, sex and Rye histologic subtype in several regions of the US for 1969 to 1971 and 1973 to 1980, using data from national cancer surveys. Average annual age-adjusted rates (1973-1980) ranged between 2.0 and 3.6 per 100,000 persons. Significant regional variation in HD was confined to elevated rates in Connecticut and San Francisco-Oakland, and low rates in Hawaii, Atlanta, and New Orleans. In young adults (ages 20-34 years) HD was positively associated across regions with rates for children (ages 5-14 years), and with community-wide socioeconomic status (SES), but did not vary with older adult rates. Patterns of geographic variation differed among the histologic subtypes, with no significant variation for the lymphocyte predominance form. Incidence of nodular sclerosis increased with regional SES, and was inversely correlated with rates of lymphocyte predominance. Among women, HD incidence became less heterogeneous across regions with time. PMID- 3677018 TI - Incidence and familial occurrence of colorectal cancer and polyps in a health care district of northern Italy. AB - The first year of registration of colorectal tumors in a predominantly urban population (263,546 inhabitants) of northern Italy gave us the opportunity to investigate: (a) the incidence (crude, age-specific, age-standardized) of both colorectal cancer and polyps and their localization; (b) the familial occurrence of these neoplasms; and (c) if the data could fit into the "Adenoma-Carcinoma Sequence." Crude incidence of cancer was 52.8 new cases/100,000 in 1984, with 53.4 cases in men and 52.2 cases in women. The corresponding figures for polyps were 59.6 new cases, with 83.4 in men and 37.3 cases in women. The incidence increased with age for both cancer and polyps, although the latter were more frequent until patients were in their sixties and the peak of incidence of polyps anticipated that of cancer by a 5 year period. Both cancer and polyps had a similar distribution in the large bowel, more than 60% being located in the left distal portion. There were 72 cases of colorectal cancer among the first-degree relatives of the registered patients compared with 16 in the controls (RR = 4.26, chi 2 = 27.2 p less than 0.001). An increased frequency of cases of colorectal cancer in the families was found in both the cancer group and the polyp group. In conclusion, the observed incidence of large bowel tumors was similar to that of other well-developed countries. The earlier rise and peak of age-specific incidence of polyps as compared to cancer, the similar distribution of benign and malignant neoplasms in the various intestinal tracts, and the similar familial aggregation observed both in the cancer and in the polyp groups further support the "polyp-cancer sequence" and provide us with a promising strategy for the prevention of colorectal malignancies. PMID- 3677019 TI - Irradiation of primary thalamic and brainstem tumors in a pediatric population. A 33-year experience. AB - A retrospective analysis of 70 pediatric patients (less than 16 years of age) with histologically proven or presumed primary neoplasms of the thalamus, hypothalamus, and brainstem, treated with combined surgery and postoperative radiotherapy or radiotherapy alone at the Washington University Medical Center from January 1950 through December 1983, is reported. Overall survival for all patients at 5 and 10 years was 34.9% and 32.7%, respectively. Follow-up of the 22 surviving patients ranged from 3.0 to 20.0 years (median, 10.6 years). Statistical analysis of multiple prognostic factors was performed. Prognostic factors found by single variate analysis to significantly influence survival were primary site of disease, extent of surgery, race, cranial nerve paresis at diagnosis, and dose of radiation. Factors evaluated but found to be insignificant were age at diagnosis, duration of symptoms before diagnosis, sex, and volume irradiated. Multivariate analysis revealed that only total radiation dose and race were of prognostic significance. PMID- 3677020 TI - The effect of tumor necrosis factor on normal human hematopoietic progenitors. AB - Tumor necrosis factor-alpha (TNF-alpha), a product of activated macrophages that is cytotoxic to tumor cells, could be used to purge tumor cells from bone marrow before autologous bone marrow transplantation for hematologic malignancies and/or solid tumors. To determine whether exposure to TNF-alpha would have an inhibitory effect on hematopoietic progenitors, we incubated normal human bone marrow with a wide range of concentrations of recombinant human TNF. In order to mimic the conditions that would be used in bone marrow purging, bone marrow cell suspensions were incubated with TNF in doses ranging from 500 to 100,000 U/ml for 24 hours, and were assayed for colony formation in agar. We noted a dose dependent inhibition of total colony-forming units (CFU) at days 7 and 14, with 50% inhibition occurring at 60,000 U/ml of TNF. TNF exerted a differential effect on CFU so that colony formation by erythroid (CFU-E), multipotential (CFU-GEMM), and macrophage (CFU-M) progenitors was suppressed to a greater extent than that by granulocyte progenitors (CFU-G). However, even after preincubation with TNF at high doses such as 100,000 U/ml, the inhibitory effects of TNF could be abolished by washing cells before culturing. This study demonstrates that hematopoietic precursors survive treatment with TNF at doses that have been shown to be cytotoxic to tumor cells. Although TNF has a significant inhibitory effect on the growth of erythroid, multipotential, and macrophage progenitors in vitro, this effect depends on continuous exposure to TNF for more than 24 hours. Thus, TNF may be useful as a bone marrow purging agent against tumor cells, with relative sparing of normal marrow elements. PMID- 3677021 TI - The lymphoproliferative disease of granular lymphocytes. A heterogeneous disorder ranging from indolent to aggressive conditions. AB - A multiparameter analysis, which included the evaluation of clinical features, cell morphology, karyotype, phenotypic and functional immunologic findings, and T cell receptor beta-chain configuration was performed on 34 patients with lymphoproliferative disease of granular lymphocytes (LDGL). The two-fold aim of the study was to identify the most useful tools that would more accurately characterize these patients and to deal with the problem of classifying these lymphoproliferative disorders. The data presented in this article suggest that a single parameter may not be sufficient to define the nature of the proliferating cells or to predict the clinical course of the disease and prognosis for the patient. The use of a multiparameter approach, however, may reach this goal, thus providing important prognostic and therapeutic information. Our study supports the concept that lymphoproliferative disease of granular lymphocytes is a heterogeneous disorder that ranges from indolent and possibly reactive conditions to the manifestation of aggressive malignancies. PMID- 3677022 TI - Intranuclear rod-shaped actin filament bundles in poorly differentiated axillary adenosquamous cell carcinoma. AB - An axillary cystic poorly differentiated adenosquamous cell carcinoma was studied by electron microscopy and immunohistochemistry for keratin, vimentin, desmin, and actin. Many tumor cells had rod-shaped intranuclear fibrillary inclusions which consisted of 60 A microfilaments. These intranuclear inclusions reacted with antiactin antibody and were considered to be F-actin bundles. The cells having intranuclear inclusions were frequently found in areas close to the cystic space, and inclusions of tumor cells close to the cyst were thicker. However, mitotic figures were predominantly found in the periphery of the tumor. Intranuclear actin is known to be mainly soluble G-actin, and one of its important functions is reported to be the chromosome condensation in mitosis. It is speculated that the cells having intranuclear fibrillary inclusions of actin have impairment of mitosis. PMID- 3677023 TI - Expression of blood group antigens A, B, H, Lewis-a, and Lewis-b in fetal, normal, and malignant tissues of the uterine endometrium. AB - Fetal, normal adult, and malignant tissues of the uterine endometrium were examined by immunoperoxidase staining for the blood group antigens (BGA) A, B, H, Lewis-a, and Lewis-b. Antigens A, B, and H compatible with the ABO status of fetuses were detected in 20 of the 22 fetal tissues that were examined. Lewis-b immunoreactivity was also found in 21 fetuses, and Lewis-a was present in a third of the cases. In adult endometrium the expression of BGA H and Lewis-b was considerably lower than in fetal tissues. Malignant endometrial glands extensively reexpressed H and Lewis-b regardless of ABO status. BGA A and B were neither absent nor accumulated in cancer tissues. Thus, H and Lewis-b can be considered as oncofetal antigens since they were frequently expressed in fetal and cancer tissues, but not in normal adult tissues. The increased expression of Lewis-a antigen might be associated with malignant transformation as it was observed only in malignant tissues. However, the functional significance of alterations in BGA expression that may be associated with oncogenesis remains to be investigated. PMID- 3677024 TI - Carcinoembryonic antigen estimation in nipple discharge as an adjunctive tool in the diagnosis of early breast cancer. AB - To assess the usefulness of carcinoembryonic antigen (CEA) estimation in nipple discharge for the detection of nonpalpable breast cancer, CEA activity in nipple discharge was measured by enzyme immunoassay using monoclonal antibody. The specificity of the antibody for breast cancer was assessed by an immunohistochemical method. Mean CEA levels in the nipple discharge from 18 patients with benign breast diseases (ten intraductal papilloma; eight fibrocystic disease) was 43 ng/ml (SD, 34 ng/ml), suggesting an upper reference limit of 100 ng/ml. Six of seven nonpalpable breast cancer patients had higher CEA levels than this tentative cutoff value, as did three of five patients with borderline lesions. The incidence of elevated CEA levels in nipple discharge correlated significantly with the incidence of intratumoral antigen expression. These results lead us to conclude that CEA measurement in nipple discharge may be a useful adjunct in the diagnosis of nonpalpable breast cancer. PMID- 3677025 TI - Myelodysplastic syndromes. A multiparametric study of prognostic factors in 336 patients. AB - Two groups of patients with a myelodysplastic syndrome (MDS) were analyzed by univariate (log-rank test) and multivariate (logistic regression) analyses to detect the most important prognostic factors. By stepwise analysis, the variables found to have prognostic significance for death were as follows: age, percentage of marrow blasts, presence of circulating blasts, and number of platelets. The variables found significant for predicting progression to acute leukemia (AL) were as follows: hemoglobin level, percentage of marrow blasts, and presence of circulating blasts. The first group of 193 patients was used to build a prognostic index which reflected the probability of a given patient dying or progressing to AL within 6, 9, or 12 months. The application of this prognostic index to a test group of 143 patients was used to determine the expected error rate and the validity of the prediction rule. PMID- 3677026 TI - Nuclear DNA content and its prognostic value in lymphoma of the stomach. AB - Nuclear DNA content of 27 primary lymphomas of the stomach was determined by flow cytometry from paraffin-embedded tissue. Thirteen (50%) of the 26 non-Hodgkin's lymphomas were aneuploid. The only case with Hodgkin's disease was diploid. The mean age of patients with aneuploid lymphoma was less than that of patients with diploid lymphoma (53 years versus 63 years, P = 0.02). DNA aneuploidy was more common in tumors with extragastric spread into the adjacent organs or the upper abdominal lymph nodes than in intragastric lymphomas (73% versus 17%; P = 0.003). Patients with aneuploid lymphoma had both inferior crude recurrence-free survival rate (P = 0.05) and survival rate corrected for known intercurrent diseases (P = 0.02) than patients with diploid lymphoma. Extragastric spread of lymphoma into the adjacent organs or the upper abdominal lymph nodes was, however, the most important prognostic factor by a multivariate analysis. PMID- 3677027 TI - Ovarian Sertoli-Leydig cell tumor (androblastoma) with retiform pattern. A clinicopathologic study. AB - The clinicopathologic findings in nine patients with ovarian Sertoli-Leydig cell tumor with retiform pattern are described. The patients ranged in age from 11 months to 23 years; and seven patients were 12 years of age or younger. The most frequent presenting sign was the finding of an abdominal mass. This was associated with pain in five patients. In three patients the pain was severe due to torsion, causing an acute abdominal emergency. Slight virilization was observed in one patient only. Two patients had elevated serum alphafetoprotein (AFP), which correlated well with disease activity. The remaining patients had normal serum AFP. All the tumors were unilateral. At laparotomy the tumor was intact in six patients and ruptured in three. The tumors ranged from 8 to 22 cm, were round or oval, and cystic or solid and cystic. Eight tumors were in FIGO Stage I, and one was associated with abdominal metastases and was Stage III. Histologically, the retiform component varied from moderate to predominant in eight of the nine cases. In two tumors a heterologous component composed of striated muscle was also present. Three patients developed metastases. Two of the patients died 11 months and 2 years after diagnosis and the third patient was lost to follow-up with evidence of disease 2 years after diagnosis. The remaining six patients were well and disease-free for periods of 8 months to 6 years. The majority of these tumors were misinterpreted as serous papillary cystadenocarcinoma or endodermal sinus tumor, which are more malignant neoplasms requiring different therapy. This further underlines the importance of recognizing this histopathologic entity. PMID- 3677028 TI - Serum lipids and lipoprotein disorders in cancer patients. AB - Total serum cholesterol, free and esterified cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, serum triglycerides and serum lipoproteins were measured in 103 consecutive cancer patients (60 men and 43 women; mean age, 56 years) and 100 age-matched noncancer inpatients. Cancer patients as a group demonstrated significantly lower total cholesterol, esterified cholesterol and LDL cholesterol, compared with noncancer patients. Breast cancer proved to be an exception associated with increased serum total cholesterol, free cholesterol, LDL cholesterol, and triglycerides. a lipoproteins were constantly increased in cancer patients whereas no differences were found in the other lipoprotein fractions. Finally, the observed overall incidence of hyperlipidemia in cancer patients (23/103) was not significantly different from the controls (29/100). PMID- 3677029 TI - Female patients with meningioma of the sphenoid ridge and additional primary neoplasms of the breast and genital tract. AB - Of 283 meningioma patients seen at the University of Kansas from 1948 to 1984, eight women acquired two primary extraneural cancers in addition to their meningiomas. Of these eight patients, six (75%) had sphenoid ridge meningiomas compared with 15% of meningioma patients overall (P less than 0.001). Seven (87.5%) had at least one breast or genital cancer (P less than 0.001). Of the six with sphenoid ridge meningiomas, five (83.3%) had both of their additional tumors in these two organ systems, and the sixth had one such tumor. It is proposed that this grouping of sphenoid ridge meningioma, breast cancer, and genital cancer represents a unique constellation of neoplasms in women. PMID- 3677030 TI - Multiple primary cancer risk in patients with squamous cell carcinoma of the oral cavity. AB - During 6375 patient-years of observation, 136 new cancers developed in 117 of 1429 patients with squamous cell carcinoma of the oral cavity. The risk of multiple cancers was excessive in the upper digestive or respiratory tract in patients with squamous cell carcinoma of the oral cavity, accounting for 87 (64%) of the 136 later cancers. In addition, multiplicity of cancers was site-specific, being common in the oral cavity-esophagus-lung axis and uncommon in sites such as the maxillary sinus and epipharynx. In addition, the observed-to-expected ratio was different in each site of the oral cavity-esophagus-lung axis, i.e., 57.5 for the oral cavity and pharynx, 12.0 for the esophagus, 7.3 for the larynx, and 2.0 for lung cancers. PMID- 3677031 TI - Risk factors for laryngeal cancer. AB - One hundred seven patients afflicted with incident laryngeal cancer and 290 controls with diseases considered not related to tobacco and alcohol exposure were interviewed in the University Hospital of Montevideo, Uruguay. The study followed a case-referent design, and epidemiologic analysis was carried out at the Louisiana State University, New Orleans. Dark tobacco smoking was the strongest risk factor, with an RR 2.5 times higher than that showed by light (flue-cured) tobacco smokers and 35 times that of non-smokers. Alcohol exposure displayed lesser effects but its interaction with tobacco smoking resulted in very high risks (more than 100 times higher). Among particular types of alcoholic beverages, red wine showed RR's similar to those displayed by hard liquor consumption. The habit of drinking a local tea called "mate" was associated with a threefold increase in risk, after controlling for the effects of age and tobacco and alcohol consumption. Infrequent consumption of vegetables and fruits showed RR on the order of 2.7, suggesting a role of diet in the causation of laryngeal cancer. PMID- 3677032 TI - Laryngeal carcinoma in patients 40 years of age and younger. AB - Between 1950 and 1985, 570 patients with squamous cell carcinoma of the larynx were diagnosed and treated in the Otolaryngology Department of the Beilinson Medical Center. Of these, 20 patients (2.8%) were aged 40 years or younger. Twelve patients (60%) had glottic carcinoma in Stage I (T1N0M0) when initially diagnosed, one patient had supraglottic carcinoma in Stage I (T1N0M0) and seven patients (35%) had laryngeal carcinoma in Stage II (T2N0M0) and III (T3N0M0). Patients with T1N0M0 received only radiotherapy. Three patients with T2N0M0 underwent total laryngectomy and also received postoperative radiotherapy. Four patients with the tumor in T3N0M0 received pre-operative and postoperative radiotherapy in addition to total laryngectomy. The 5-year survival rate for T1N0M0 and T2N0M0 was 100% and for T3N0M0 66%. Although a high percentage of the young patients presented for treatment with advanced disease, the survival rate compared the same or favorably with rates in older patients. This supports the concept of aggressive treatment when there is a recurrence or second primary, particularly because it is well tolerated in the young age group who do not exhibit many of the conventional risk factors and therefore, have a better prognosis. PMID- 3677033 TI - The frequency of cold thyroid nodules and thyroid malignancies in patients from an iodine-deficient area. AB - An analysis of thyroid cancer morbidity was carried out in two adjacent areas of Sicily differing in iodine intake. A consecutive series of 911 patients with "cold" nodules from an iodine-deficient area (IDA) and 2537 from a control area (CA) were examined by fine needle aspiration and selected for surgery and pathologic examination. Malignancies were found in 27 of the patients (2.96%) from the IDA and in 139 patients (5.48%) from the CA. Based on a population survey indicating that "cold" thyroid nodules were 2.5 times more frequent in the IDA with respect to the CA, we calculated a prevalence of 127 thyroid cancers per 10(5) inhabitants in the IDA versus 93 in the CA (P less than 0.001). Moreover, follicular and anaplastic carcinomas were three times more frequent in the IDA than in the CA (75 versus 24 cases per 10(5) inhabitants, respectively). These studies indicate that iodine deficiency may be one factor in the development of certain thyroid malignancies in man. PMID- 3677035 TI - New hope for a permanent, biologically compatible joint prosthesis. PMID- 3677034 TI - Photodynamic therapy in the management of resistant lower urinary tract carcinoma. AB - Twenty-three patients with resistant transitional cell carcinoma (TCC) of the bladder and posterior urethra had photodynamic therapy (PDT). Seventy-two hours after an intravenous injection with 2 mg/kg of the photosensitizer dihematoporphyrin ether (DHE) (Photofrin II, Photomedica, Raritan, NJ), each patient received cystoscopic light treatment. The light dose to the whole bladder using the bulb diffuser ranged from 5 to 60 J/cm2; power density ranged from 9 to 22 mW/cm2. The focal light dose ranged from 100 to 200 J/cm2 at a power density from 100 to 200 mW/cm2. To treat the urethra, a diffuser fiber was used to deliver 200 to 400 J/linear cm at a power of 110 to 300 mW/cm. In the 19 of 23 patients who were treated for resistant superficial TCC, 83.3% of the tumors had responded at the initial follow-up evaluation. Seven patients had a complete response and 10 had a partial response. Three of 19 patients who received inadequate light treatment failed to respond. Control of intractable gross hematuria was the only benefit for patients with locally invasive disease (greater than or equal to T2). Irritating lower urinary tract symptoms that varied in severity and duration occurred in all patients. Four patients experienced bladder shrinkage, which did not resolve. Although the light and drug doses remain to be determined, a whole bladder light dose of 15 to 20 J/cm2 with a drug dose of 2 mg/kg seems to be effective enough without producing permanent adverse effects in the bladder. PMID- 3677036 TI - Coping with diabetes: a unique response. PMID- 3677038 TI - Taking the challenge. PMID- 3677037 TI - Health waves. PMID- 3677039 TI - Unionism and professionalism in nursing. PMID- 3677040 TI - Evolution of a nursing research program. PMID- 3677041 TI - Putting theory into practice. PMID- 3677042 TI - [Physical restraint]. PMID- 3677043 TI - [Intramuscular injection into the deltoid muscle]. PMID- 3677044 TI - Chromosomal composition of a series of 22 human low-grade gliomas. AB - G-banded chromosomal analysis was performed on direct and/or in vitro cultures of 22 low-grade gliomas, including nine grade I-II astrocytomas, nine oligodendrogliomas, one mixed tumor oligodendroglioma-astrocytoma, and three ependymomas. Normal diploid stem lines were present in most astrocytomas and oligodendrogliomas, whereas, all three ependymomas displayed polyploid modal numbers. However, secondary cell lines showed the presence of clonal recurrent numerical abnormalities, mainly polysomy 7, monosomy 10 and 22, and loss of the Y chromosome. Clonal structural rearrangements were present with a low incidence; they mainly involved chromosomes #1 and #7. These patterns of chromosome involvement seem to correlate with the scarce previous cytogenetic banding data available from low-grade gliomas. They are also similar to the chromosome alterations found in high-grade gliomas. PMID- 3677045 TI - Mechanisms in cyclophosphamide induction of cytogenetic damage in human lymphocyte cultures. AB - Low-dose cyclophosphamide treatment of human lymphocyte cultures in concentrations ranging from 0.001 to 0.00001 microgram/ml produced a statistically significant dose response in chromosome breakage and cell death. However, a dose as high as 0.2 micrograms/ml did not produce significant damage in comparably treated whole blood cultures. These results suggest that lymphocytes in culture have the ability to metabolize the nonmutagenic cyclophosphamide parent compound to its more mutagenic metabolite, but that such conversion may be prevented by binding of cyclophosphamide to red blood cells. PMID- 3677046 TI - Trisomy 12 in Burkitt-like lymphoma associated with acquired immunodeficiency syndrome. AB - Cytogenetic abnormalities have been reported in lymphoproliferative disorders, the most common of which is the t(8;14) translocation in Burkitt and Burkitt-like lymphomas. We report a 30-year-old homosexual male with Burkitt-like lymphoma and trisomy 12. This patient presented with persistent generalized lymphadenopathy and subsequently developed advanced lymphoma. Cell surface markers revealed a monoclonal pattern containing mu heavy chain and kappa light chain immunoglobulins. Cytogenetic analysis of bone marrow involved with lymphoma revealed an additional chromosome #12. Mitogen-stimulated cultures of peripheral blood showed a normal 46,XY karyotype. Trisomy 12 has been found in chronic lymphocytic leukemia and in other low-grade B-cell lymphoproliferative disorders, but not in Burkitt-like lymphoma. PMID- 3677047 TI - Cytogenetics of trophoblasts from complete hydatidiform moles. AB - The risk of developing choriocarcinoma following a complete hydatidiform mole (CHM) is 2000-4000 times greater than the risk following a normal pregnancy. To understand more fully the increased susceptibility of the molar trophoblast to malignant transformation, we separated the trophoblastic cells from the stromal cells in 14 complete moles and cultured them for cytogenetic analysis. The numerical and structural abnormalities found were compared with those found in the trophoblasts from normal pregnancy and malignant choriocarcinoma cell lines. The percentage of polyploid cells was 2.8 times greater in molar trophoblasts than in normal trophoblasts. Although we found no consistent chromosomal abnormality in the molar trophoblasts, these cells were significantly more vulnerable to chromosomal breakage than the molar fibroblasts, normal trophoblasts, normal fibroblasts, and maternal decidual cells. Out of a total of 103 breakpoints observed in 338 cells, 42 coincided with known fragile sites, 18 with the location of protooncogenes, 27 with breakpoints reported in other neoplasia, and 18 with breakpoints found in four choriocarcinoma cell lines. The chromosomes in choriocarcinoma cell lines have hypotetraploid mode and many structural rearrangements. Our results suggest that the genetic instability found in the molar trophoblasts may be responsible for progressive karyotypic changes and greater susceptibility to malignant transformation. PMID- 3677048 TI - Trisomy 14 in refractory anemia with excess of blasts in transformation. AB - Trisomy 14 was demonstrated on four occasions over a 2-year period in the bone marrow cells of a 63-year-old patient with refractory anemia with excess of blasts in transformation (RAEB-t). Trisomy 14 as the sole karyotype abnormality has been documented in only six malignancies, namely, in two cases of acute leukemias, one Philadelphia-negative chronic myeloid leukemia, one pancytopenia, and in two colonic polyps. In hematologic neoplasms, this rare primary change preferentially occurs in elderly adults and seems exclusively associated with the myeloid cell lineage. PMID- 3677049 TI - Species correlation in long-term carcinogenicity studies. AB - Species correlation in neoplastic response was examined for 266 long-term toxicology and carcinogenicity studies. The overall concordance between rats and mice exposed to the same chemical was 74% (198/266). Within a species, the results for males and females were also highly correlated (87% concordance for rats and 89% for mice). Had only male rats and female mice been utilized in these experiments, the same conclusions regarding carcinogenicity would have been reached in 96% of the studies (255/266). The high interspecies correlation shown in these studies supports the view that extrapolation of carcinogenicity outcomes to other species, including humans, is appropriate. PMID- 3677050 TI - Observation and quantification of aberrant crypts in the murine colon treated with a colon carcinogen: preliminary findings. AB - In the present study a methodological approach is taken which quantitates aberrant dysplastic crypts in the unsectioned murine colon. C57BL/6J or CF1 female mice (7-8 weeks old) were injected (i.p.) with azoxymethane (5 mg/kg body wt./week) for 4 weeks. Their colons were excised, cut open on the median axis and fixed flat in buffered formalin. Unsectioned colons were stained with methylene blue. The mucosal side was examined under a light microscope. The aberrant crypts, which are larger and have a thicker epithelial lining, were easily visualized using X 4 or X 10 objectives. CF1 mice, which are more sensitive to developing colon tumors, had a higher number of aberrant crypts/colon than their less sensitive counterparts, C57BL/6J mice (5.0 +/- 0.7 vs. 2.4 +/- 0.7). The usefulness of this observation as a possible measure of neoplastic events is discussed in the animal and human situation. PMID- 3677051 TI - Tritiated-thymidine labeling of rectal epithelial cells in 'non-prep' biopsies of individuals at increased risk for colonic neoplasia. AB - Recent measurements have shown increased proliferation of colonic epithelial cells in individuals at heightened risk for cancer of the large intestine. This biomarker has facilitated measurements of the effects of nutritional intervention in studies that are attempting to inhibit tumor development in high-risk individuals. In this study, further measurements were made of the proliferation of rectal epithelial cells, when biopsies were removed from mucosa that had not previously been disturbed by any tapwater or other enema preparations. Progressive increases were found in the numbers of [3H]dThd-labeled epithelial cells in rectal crypts, and in labeling index profiles, in patients having previous sporadic adenomas or colon cancer, compared to individuals who had not developed colonic neoplasms. The most quiescent proliferative equilibrium was found in individuals without previous colonic disease. Findings indicated that 'non-prep' rectal biopsies obtained from the most accessible region of the large intestine, show modifications in the biomarker of cell proliferation paralleling colon cancer risk. PMID- 3677053 TI - The effect of hyperthermia on intracellular K+ in Chinese hamster ovary cells. AB - The effect of hyperthermia on intracellular K+ concentrations was studied in Chinese hamster ovary (CHO) cells in vitro, using a flame photometer. Intracellular K+ concentrations decreased with increasing exposure time at temperatures from 40 degrees C to 45 degrees C. The decrease in K+ concentrations preceded any loss of reproductive capability at 43 degrees C and also occurred at the non-lethal temperature of 40 degrees C. Prolonged exposure to 45 degrees C resulted in an irreversible decrease in K+ concentrations. The decrease in K+ concentrations at elevated temperatures was not accounted for by changes in cell volume, loss of cells or failure of the Na+/K+ pump. PMID- 3677052 TI - Compared promoting potential of D-galactosamine, carbon tetrachloride and partial hepatectomy in rapid induction of preneoplastic liver lesions in the rat. AB - Effectiveness of two different chemically induced stimuli for hepatocellular proliferation was compared with regard to that of commonly used partial hepatectomy (PH), for the purpose of developing short-term protocol for the assay of promoting agents of hepatocarcinogenesis. Enhancing effect of D-galactosamine (DGA) and carbon tetrachloride (CCl4) given during the promotion procedure by 2 acetylaminofluorene (2-AAF) was compared along with PH in rats initiated by diethylnitrosamine (DEN), using preneoplastic glutathione S-transferase positive (GST-P+) hepatocyte foci as an end-point marker lesion. The number of GST-P+ foci per cm2 was largest in the group given CCl4 followed by DGA, no treatment (2-AAF alone) and PH. In contrast, the area (mm2) per cm2 and mean diameter of the focus were largest in the PH group then DGA followed by CCl4 and no treatment. The results indicate that the number of GST-P+ foci were not clearly affected by 3 different treatments whereas area and size of foci which represented the result of promoting effect were clearly influenced by those treatments, indicating they caused differential proliferation of initiated cells. In this respect, even though PH is the most potent procedure, DGA is also efficient and preferred to CCl4 for the non-surgical enhancing method. PMID- 3677054 TI - The effect of fecapentaenes on nuclear aberrations in murine colonic epithelial cells. AB - Fecapentaenes, human fecal mutagens of bacterial origin, were intrarectally administered to mice in suppository form. Despite the strong, positive mutagenic response of fecanpentaenes using Ames tester strains TA 98 and TA 100, no increase in nuclear aberrations, taken as a measure of genotoxicity in colonic epithelial cells, was observed over control levels. In fecapentaene treated animals, however, the incidence of mitotic figures was increased above control levels to values comparable to those observed in mice treated with the known colon carcinogen, N-ethyl-N-nitrosourea. Thus, it would appear that fecapentaenes are not cytotoxic to murine colonic epithelia as judged by the nuclear aberration assay. PMID- 3677055 TI - Irreversible inhibition of the cytosolic metabolism of N-hydroxy-2 acetylaminofluorene by its glycolyl analog. AB - The glycolyl hydroxamic acid derivative of 2-aminofluorene was found to be a potent inhibitor of its own metabolism and the metabolism of N-hydroxy-2 acetylaminofluorene by rat liver cytosol. The inhibition was irreversible, as well as time and concentration dependent, which indicates a suicide-inhibition type of metabolism. There was a direct correlation between the inhibition of N hydroxy-2-acetylaminofluorene disappearance and 2-acetylaminofluorene formation. In contrast, both the glycolyl and acetyl hydroxamic acid derivatives were metabolized to a similar extent by enzymes in the microsomal fraction. PMID- 3677056 TI - The effect of exposure to elevated temperatures on membrane permeability to adriamycin in Chinese hamster ovary cells in vitro. AB - The effect of environmental temperature on plasma membrane permeability to Adriamycin was studied in Chinese hamster ovary (CHO) cells in vitro using flow cytometry. Initial rates of uptake increased steadily between 23 degrees C and 47 degrees C and there was a greater than 2-fold increase in permeability between 37 degrees C and 47 degrees C. The increase in permeability with increasing temperature was greater than expected based on the model of passive drug influx. Adriamycin uptake was also measured at 37 degrees C following previous exposure of the cells to elevated temperatures. Twenty-minute preexposures to temperatures above 41 degrees C caused a significant decrease in membrane permeability, which fell to approximately 60% of control levels after exposure to 45 degrees C. Longer periods of pre-exposure to temperatures as low as 40 degrees C were also shown to decrease membrane permeability to Adriamycin subsequently measured at 37 degrees C. The state of decreased permeability to Adriamycin induced by hyperthermia persisted for at least 2 h. The thermally induced decrease in membrane permeability to Adriamycin is of potential importance to the design of optimal schedules for thermochemotherapy. PMID- 3677057 TI - Immunocytochemical localisation of VP16-213 in normal and malignant tissues. AB - Immunocytochemistry has been used to visualise the distribution of the anti cancer drug VP16-213 in tissues from normal and leukaemic mice, and in EMT6 mammary tumours. Uptake of the drug into EMT6 tumour tissue was poor compared to uptake into normal tissues (liver, kidney, heart, small intestine). Uptake of the drug into tissues from L1210 mice was greater than that into normal tissues. Immunocytochemistry promises to be a very useful additional technique for studying the distribution of drugs given singly or in combination, specific organ toxicities, and mechanisms of resistance. PMID- 3677058 TI - 32P-postlabeling analysis of DNA adducts from non-alternant PAH using thin-layer and high performance liquid chromatography. AB - DNA adduct formation in vivo in mouse skin following a single topical application of benzo[a]fluoranthene (BbF), benzo[j]fluoranthene (BjF), benzo[k]fluoranthene (BkF), or indeno[1,2,3-cd]pyrene (IP) was investigated in female CD-1 mice using 32P-postlabeling analysis. Distinct adduct profiles were detected for each of the non-alternant hydrocarbons examined. Two adducts, one major and one minor, were detected using polyethyleneiminecellulose (PEI-cellulose) thin-layer chromatography (TLC) for BbF and BjF while a single major adduct was detected for BkF and IP. The relative extent of binding to mouse skin DNA was in the order BbF greater than BjF greater than BkF greater than IP. 32P-Postlabeled DNA adducts separated by PEI-cellulose TLC were further analyzed by high performance liquid chromatography (HPLC). A single radioactive peak was detected for 32P-labeled DNA adducts of BjF and BkF. Three general areas of radioactivity were detected when 32P-labeled DNA adducts of BbF were separated on HPLC. PMID- 3677059 TI - Tumorigenic activity of the tobacco-specific nitrosamines 4-(methylnitrosamino)-1 (3-pyridyl)-1-butanone (NNK), 4-(methylnitrosamino)-4-(3-pyridyl)-1-butanol (iso NNAL) and N'-nitrosonornicotine (NNN) on topical application to Sencar mice. AB - The tumor-initiating activities of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), 4-(methylnitrosamino)-4-(3-pyridyl)-1-butanol (iso-NNAL) and N' nitrosonornicotine (NNN) were evaluated on the skin of female SENCAR mice. A total initiator dose of 28 mumol/mouse of each nitrosamine was applied in 10 subdoses administered every second day. Promotion commenced 10 days after the last initiator dose and consisted of twice weekly application of 2.0 micrograms of tetradecanoylphorbol acetate for 20 weeks. NNK induced a 79% incidence of skin tumors with an average of 1.6 tumors/mouse and a 59% incidence of lung adenomas. In contrast, iso-NNAL and NNN were not active as tumor initiators in either the skin or lung of mice. The tumorigenic activity of NNK on SENCAR mouse skin was evaluated at several doses. At a total initiator dose of 28 and 5.6 mumol/mouse, NNK exhibited significant activity (P less than 0.005) inducing a 59% and 24% incidence of skin tumors, respectively. In this dose response bioassay, NNK at a total initiator dose of 28 mumol induced a 63% incidence (P less than 0.005) of lung adenomas. The numbers of lung adenomas induced at the lower doses employed were not significant. NNK, at a total initiation dose of 1.4 mumol, did not exhibit significant tumorigenic activity (P greater than 0.05). Analysis of DNA from the skin of mice treated with NNK using HPLC with fluorescence detection failed to detect O6- and N-methylguanine (O6-MG and N7-MG) adducts. These data indicate that NNK can exert a contact carcinogenic effect and suggest that mechanisms other than DNA methylation may be involved in its activation to a tumorigenic agent in mouse skin. PMID- 3677060 TI - Activation of lymphocytes of normal and tumor bearing mice by mangiferin, a naturally occurring glucosylxanthone. AB - Mangiferin, a naturally occurring glucosylxanthone, was assessed for its immunomodulatory potential. The phytochemical induced extensive in vitro proliferation of murine splenocytes and thymocytes at the doses of 5-40 micrograms ml-1. Suppression of the proliferative response of the cells was observed with higher doses of mangiferin. Mangiferin also activated the splenocytes of tumor hosts at early and late stages of tumor growth. The Phytohemagglutinin (PHA) and Con A unresponsive splenocytes of advanced tumor bearer proliferated extensively in response to mangiferin. Mangiferin when used with Con A produced additive stimulatory effect and induced heightened DNA synthesis of normal and advanced tumor bearers' splenocytes. PMID- 3677061 TI - Initiation, promotion and complete carcinogenesis by N-methyl-N'-nitro-N nitrosoguanidine or ethylnitrosourea in the Sencar mouse skin tumorigenesis model. AB - Five doses of either N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) or ethylnitrosourea (ENU) were tested as complete carcinogens, tumor initiators and tumor promoters in the SENCAR skin tumorigenesis model. As tumor initiators, MNNG induced papillomas at all doses tested, while ENU was active from 10-40 mumol. As complete carcinogens, MNNG from doses of 0.5-5.0 mumol and ENU from doses of 10 mumol-40 mumol were potent inducers of both papillomas and carcinomas indicating that these agents are active as both tumor initiators and tumor promoters. PMID- 3677062 TI - Distribution of carbon tetrachloride-metabolite(s) to DNase I-sensitive and resistant chromatin. AB - The distribution of carbon tetrachloride (CCl4) metabolite(s) to DNase I sensitive and -resistant regions of mouse hepatic chromatin was determined following incubation of whole chromatin with [14C]CCl4 in the presence of hepatic microsomes and an NADPH-regenerating system. At 2 h of incubation, [14C]CCl4 metabolite(s) bound essentially to the same extent to DNase I-sensitive and resistant chromatin regions. Binding of [14C]CCl4 metabolite(s) to DNase I resistant regions, however, increased significantly over the DNase I-sensitive regions when incubation was prolonged to 4 h. This result suggests that CCl4 does not bind preferentially to DNase I-sensitive regions of chromatin. PMID- 3677063 TI - Effect of phytic acid on colonic epithelial cell proliferation. AB - Cell proliferation was studied in descending, transverse and ascending colonic crypts of rats fed either 0%, 0.6%, 1.2% or 2.0% phytic acid (PA). Significant effects of phytic acid were seen only in the descending colon. No changes in crypt height were observed. Both the 1.2 and 2.0% phytic acid groups exhibited significantly lower uppermost labelled cells than the control group. Animals given 1.2% and 2.0% phytic acid also showed significantly reduced DNA synthetic cells, as indicated by lower labelling indices. PMID- 3677064 TI - Influence of mitoxantrone on nucleolar function in MDA-MB-231 human breast tumor cell line. AB - The effect of mitoxantrone (DHAQ) on [3H]thymidine and [3H]uridine incorporation by exponentially growing MDA-MB-231, a human breast tumor cell line has been studied. The results have indicated that DHAQ was more effective in inhibiting [3H]thymidine than [3H]uridine incorporation in a concentration dependent manner. Following drug treatment at 20 ng/ml concentration, 50% inhibition of growth and [3H]thymidine incorporation were noted, whereas [3H]uridine incorporation was only inhibited by about 12%. At 2000 ng/ml of DHAQ the inhibition of cell growth, [3H]thymidine and [3H]uridine incorporations were 78%, 95% and 62%, respectively. Nuclear-associated radioactivity detected at light and electron microscope autoradiographic levels after [3H]thymidine and [3H]uridine incorporations, into DHAQ treated cells indicated that DHAQ prevented the accumulation of radioactivity into the nuclei in a concentration dependent manner. These results gave further indication that mitoxantrone induced a definitive alteration of nuclear template activities, correlated with nuclear functional-structural relation and suggested that the nucleoli were the primary site of DHAQ action. PMID- 3677065 TI - Comparative carcinogenic potencies of 7H-dibenzo[c,g]carbazole, dibenz[a,j]acridine and benzo[a]pyrene in mouse skin. AB - The relative carcinogenic potencies of three combustion products of fossil fuels, 7H-dibenzo[c,g]carbazole (7H-DB[c,g]C), dibenz[a,j]acridine (DB[a,j]A) and benzo[a] pyrene (B[a]P) were compared using complete carcinogenicity C3H mouse skin bioassays. Both 7H-DB[c,g]C and B[a]P produced tumors in 48 of 50 mice with latency periods of 36.6 and 32.4 weeks, respectively. DB[a,j]A produced tumors in 25 of 50 mice with a latency period of 80 weeks. 7H-DB[c,g]C was found to be as potent a carcinogen as B[a]P when applied to mouse skin. These results have important implications in the determination of relative carcinogenic potencies of complex mixtures. PMID- 3677066 TI - Estrous cycle modification of rat uterine DNA alkylation by N-methyl-N nitrosourea. AB - The present study was designed to determine whether the stage of the estrous cycle at the time of N-nitroso-N-methylurea (NMU) presentation altered DNA adduct formation and repair in the rat uterus. In uterus the rate of O6-methylguanine (O6-meGua) and 7-methylguanine (7-meGua) formation and the total yield of adducts was estrous cycle dependent. Uterine DNA from rats injected with NMU on diestrus formed O6-meGua and 7-meGua more rapidly and had significantly higher adduct levels than those rats injected on proestrus or estrus. Repair of O6-meGua and 7 meGua was also significantly faster between 1 and 24 h post-NMU in uterine DNA isolated from rats injected on diestrus compared to those injected on proestrus or estrus. PMID- 3677067 TI - Identification of tumorigenic metabolites of benzo[j]fluoranthene formed in vivo in mouse skin. AB - The metabolism of benzo[j]fluoranthene (BjF) in vivo in mouse skin was investigated. trans-4,5-Dihydro-4,5-dihydroxybenzo[j]fluoranthene (BjF-4,5-diol) and trans-9,10-dihydro-9,10-dihydroxybenzo[j]fluoranthene (BjF-9,10-diol) have been identified as major metabolites. In addition, 4- and 10 hydroxybenzo[j]fluoranthene and benzo[j]fluoranthen-4,5-dione have been tentatively identified among the metabolites formed in vivo in mouse skin. The enantiomeric purity of the metabolic dihydrodiols of BjF as formed in vivo in mouse skin was determined. The major enantiomer of BjF-4,5-diol was present in 57 62% enantiomeric excess while that of BjF-9,10-diol was present in 66-71% enantiomeric excess. In each case the later-eluting enantiomer on chiral stationary-phase high performance liquid chromatography predominated. The tumor initiating activity of trans-2,3-dihydro-2,3-dihydroxybenzo[j]fluoranthene (BjF 2,3-diol), BjF-4,5-diol, BjF-9,10-diol, and BjF was evaluated on the skin of female CD-1 mice. As a total initiation dose of 3 mumol/mouse BjF-4,5-diol resulted in a 100% incidence of tumor-bearing mice with 5.0 tumors/mouse. In comparison, BjF-9,10-diol elicited a 60% incidence of tumor-bearing mice with 1.7 tumors/mouse, while BjF-2,3-diol was inactive. At the same dose, BjF gave rise to a 90% incidence of tumor-bearing mice with 7.8 tumors/mouse. At a 1-mumol dose, BjF-4,5-diol induced a 78% incidence of tumor-bearing mice with 4.3 tumors/mouse while BjF gave rise to a 70% tumor incidence with 3.4 tumors/mouse while BjF gave rise to a 70% tumor incidence with 3.4 tumors/mouse. These studies indicate that while BjF-9,10-diol could contribute to the overall tumorigenic activity of BjF in mouse skin, BjF-4,5-diol is a more potent tumor initiator in the target tissue. PMID- 3677068 TI - Enhancement of metastasis from a transplantable mouse mammary tumor by dietary linoleic acid. AB - The influence of quantitative differences in dietary linoleic acid (18:2) on the metastasis as well as the development of line 4526 mouse mammary tumors was investigated. High fat diets (20%, w/w) that contained either 1, 2, 4, 8, or 12% 18:2 by weight, were prepared by using mixtures of coconut and safflower oil and fed to female BALB/c mice that were subsequently inoculated with 10(4) 4526 tumor cells s.c., either at the lateral abdominal wall (LAW) or in the mammary fat pad (MFP). Latency of LAW tumors was influenced by the level of dietary 18:2, whereas the latency of MFP tumors was not. When metastasis was assessed, mice with MFP tumors fed 1, 2, 4, or 8% 18:2 diets had 62-73% fewer lung surface tumor nodules than similar mice fed 12% 18:2. Mice in all dietary groups with LAW tumors had fewer metastatic lung nodules than mice with MFP tumors; mice with LAW tumors fed diets containing 1, 2, or 4% 18:2 had 52-69% fewer nodules than similar mice fed diets containing 8 or 12% 18:2. There were no significant differences in the rate of increase of body weight or the daily mean tumor volumes when compared with dietary 18:2 level. Fatty acid composition of the tumor, particularly the level of 18:2, was significantly altered by diet. This study demonstrates that while the level of dietary 18:2 does not enhance the growth rate of primary 4526 tumors and does or does not affect the latency depending on the primary site, it does significantly alter the metastasis. These results stress the importance of metastasis assessment in future studies involving dietary fat effects on tumorigenesis. PMID- 3677069 TI - Characterization of a novel reaction by human O6-alkylguanine-DNA alkyltransferase with 1,3-bis(2-chloroethyl)-1-nitrosourea-treated DNA. AB - The reaction of partially purified human O6-alkylguanine-DNA alkyltransferase with 1,3-bis(2-chloroethyl)-1-nitrosourea-treated DNA produces a covalent DNA protein complex. Evidence that the complex-forming and the alkyltransferase activities are one and the same includes their copurification, identical heat inactivation kinetics, and similar responses to inhibitors. This novel reaction thus provides a sensitive alternative assay for detecting the alkyltransferase. It also provides support for a model in which N1,O6-ethanoguanine is an intermediate in formation of chloroethylnitrosourea-induced DNA interstrand cross links. PMID- 3677070 TI - Progesterone-binding cyst protein in human breast tumor cytosol. AB - Breast tumor cytosol has been analyzed for the presence of a progesterone-binding protein (PBCP), commonly present in benign breast cysts in huge concentrations. In 377 primary carcinoma investigated PBCP was present in measurable quantities in 60.7% using "rocket" immunoelectrophoresis. Concentrations of PBCP ranged from 0 to 12.4% of total cytosol protein with an average of 4.0 micrograms/mg cytosol protein. The distribution of PBCP values seems to suggest two tumor populations, one of which is lacking in PBCP and the other showing a lognormal distribution. In malignant tumors PBCP levels were negatively correlated (P = 0.024) to estrogen receptor but not to (P = 0.38) progestin receptor levels. There was a highly significant (P less than 0.001) positive correlation to cytosol albumin concentration which suggests an extracellular localization of PBCP possibly caused by restricted lymphatic drainage of tumor tissue. In benign breast tumors, mainly fibroadenomas, both PBCP incidence (81%) and average concentration (13.5 micrograms/mg protein) was higher than in malignant tumors. A positive correlation to sex-hormone receptor levels were observed indicating that PBCP production could be under hormonal control in this type of tumor development. In 71 metastatic tumors examined PBCP incidence was far less than in primary tumors (P less than 0.001) and the levels seen were also considerably lower. PBCP holds promise as a marker of tumors in an early stage of development and/or with a low metastatic potential. PMID- 3677071 TI - Effect of a single injection of two new bisphosphonates on the hypercalcemia and hypercalciuria induced by Walker carcinosarcoma 256/B in thyroparathyroidectomized rats. AB - The effect of one single injection of two new bisphosphonates, 4-amino-1 hydroxybutylidene-1,1-bisphosphonate and 2-(2-pyridyl)ethylidene-1,1 bisphosphonate, and of dichloromethylenebisphosphonate on the hypercalcemia and hypercalciuria induced by the Walker carcinosarcoma 256/B in the thyroparathyroidectomized rat was evaluated. When given either before or after the development of hypercalcemia and hypercalciuria, 16.1 mumol/kg 4-amino-1 hydroxybutylidene-1,1-bisphosphonate or 2-(2-pyridyl)ethylidene-1,1 bisphosphonate totally inhibited hypercalciuria, whereas hypercalcemia was only partially reduced over the 14 days of the experiment. At 10 and 100 times lower doses, the effect was strongest the first days, but still partially present 14 days later. The difference of activity on calcemia and calciuria appears to be due to the fact that the tumor increased both bone resorption and renal reabsorption of calcium. Only the former was altered by the bisphosphonates. The two new compounds appeared to be of similar potency and more active than dichloromethylenebisphosphonate. These compounds could be promising for the treatment of malignant hypercalcemia and other conditions with increased bone resorption in humans, even when given only over short periods of time. PMID- 3677072 TI - Inhibition by retinoids of anthralin-induced mouse epidermal ornithine decarboxylase activity and anthralin-promoted skin tumor formation. AB - The retinoids all-trans-retinoic acid, 13-cis-retinoic acid, 4-[2-(5,6,7,8 tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)-1E- propen-1-yl]benzoic acid, 6-[1 (4-carboxyphenyl)-1E-propen-2-yl]-3,4-dihydro-4,4-dimethyl-2H -1-benzothiopyran, and 6-(5,6,7,8,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)- 2 naphthalenecarboxylic acid inhibited the induction of ornithine decarboxylase in CD-1 mouse epidermis treated with the weak tumor promoter anthralin (444 nmol). Enzyme activity reached maximal levels 48 h after the application of the promoter. This activity was most effectively inhibited when retinoids were applied to the epidermis 24 h after the promoter. These retinoids also inhibited the appearance of papillomas in mouse epidermis in the two-stage tumorigenesis model using 7,12-dimethylbenz(a)anthracene (200 nmol) as the initiator and anthralin (444 nmol) as the promoter during the 32-week period of promotion. Comparison of the doses of retinoids required to inhibit anthralin-induced ornithine decarboxylase by 50% and those required to inhibit anthralin-induced tumor promotion by 50% demonstrated that these values correlated. PMID- 3677073 TI - Enhancement by cyclosporin A of daunorubicin efficacy in Ehrlich ascites carcinoma and murine hepatoma 129. AB - Cyclosporin A abrogates pleiotropic drug resistance in certain experimental tumors. Its impact on drug-sensitive tumors has not been investigated. Our studies show that in drug-sensitive Ehrlich ascites carcinoma and hepatoma 129 cyclosporin A enhances daunorubicin inhibition of DNA synthesis in vitro and prolongs survival of host mice in vivo. Of particular interest is that cyclosporin A converts ineffective daunorubicin regimens into those which result in prolongation of host mice survival. Other agents known to reverse pleiotropic drug resistance are reported to exert their effects by increasing intracellular drug accumulation. In contrast, our studies of drug transport in drug-sensitive Ehrlich ascites carcinoma and hepatoma 129 show that cyclosporin A causes minimal enhancement of [3H]daunorubicin uptake without inhibition of [3H]daunorubicin efflux in both the presence and absence of interrupted active daunorubicin efflux. This suggests that the mechanism of action of daunorubicin enhancement by cyclosporin A in drug-sensitive tumors is not simply the result of increased intracellular daunorubicin accumulation. In vivo dosages of cyclosporin A in the current study are comparable to those which can be used with reasonable safety in humans. We conclude that cyclosporin A may be useful in the potentiation of anthracycline antibiotic therapy directed against drug-sensitive as well as drug resistant tumors. PMID- 3677074 TI - Physicochemical and pharmacological properties of the antitumor ellipticine derivative 2-(diethylamino-2-ethyl)9-hydroxy ellipticinium-chloride, HCl. AB - 2-(Diethylamino-2-ethyl)9-hydroxyellipticinium-chloride, HCl (DHE), a new congener of the antitumor agent elliptinium acetate (Celiptium) (NMHE), has recently been selected for phase I clinical trials. NMHE has a methyl group at nitrogen 2 on the ellipticine ring while DHE possesses a basic diethylaminoethyl chain at this position. Compared to NMHE, the presence of the diethylaminoethyl side chain results in the following: a significant increase in the lipophilicity of the drug; no significant modification in either the binding constant values to DNA or the ability to intercalate between DNA base pairs; a marked decrease in the unwinding angle value of supercoiled DNA; and no significant change in the alteration of the catalytic activity of topoisomerase II in vitro. DHE appears to act as a simple reversible intercalating agent as shown by the selective mutagenic effect on Salmonella TA 1977 tester strain and by its inability to induce the SOS functions in a sfiA lac fusion containing Escherichia coli strain. From a pharmacological point of view, the presence of the diethylaminoethyl chain results in a 2-fold increase in the cytotoxicity to L1210 cultured cells, a strong increase in the antitumor efficiency on experimental murine tumors such as L1210 and P388 leukemia, B16 melanoma, M 5076 reticulosarcoma, and colon 38 adenocarcinoma, and finally an objective decrease in the acute and subacute toxicity in mice, rat, and macaque. The absence of significant differences in the interaction of NMHE and DHE with their potential targets in vitro leads to the hypothesis that the superiority of DHE in terms of cytotoxicity and antitumor efficiency may be due to an increase in the diffusion across cellular membrane and a more favorable biodistribution in vivo. PMID- 3677075 TI - Circadian gating of S phase in human ovarian cancer. AB - Cell proliferation in 30 patients with ovarian cancer was analyzed using flow cytometry to determine changes in the percentage of cells in S phase. By this measure, proliferation in tumor cells appears to follow a cyclical pattern of peaks and troughs that is out of phase with the circadian rhythm in proliferation of normal tissues. In round-the-clock monitoring of replication stages in tumor cells recovered from i.p. lavage fluid in postsurgery patients, peaks of tumor and nontumor cell DNA synthesis commonly occurred at different times of day. When patients were grouped so that only tumor cell proliferation was being measured, a highly significant 24-h rhythm nearly 12 h out of phase with nontumor cell proliferation was found. This peak in the percentage of S-phase cells occurs most commonly in mid- to late morning and appears to offer an opportunity for timing chemotherapy to coincide with high tumor cell vulnerability and low toxicity to normal tissue. PMID- 3677076 TI - Carcinogen-DNA adduct formation in the lungs and livers of preweanling CD-1 male mice following administration of [3H]-6-nitrochrysene, [3H]-6-aminochrysene, and [3H]-1,6-dinitropyrene. AB - 6-Nitrochrysene (NC) and 6-aminochrysene (AC) have been shown to be potent lung and liver carcinogens when administered in multiple i.p. doses to preweanling mice. 1,6-Dinitropyrene has been shown to be a strong hepatocarcinogen but a weak lung carcinogen in this same bioassay. We have examined carcinogen-DNA adduct profiles in the target tissues of preweanling male CD-1 mice following administration of single or multiple doses of these compounds. Depending on the tissue and the dosing schedule, the total level of DNA modification in animals dosed with [3H]NC was 2- to 9-fold higher than in animals dosed with [3H]AC. Regardless of the dosing schedule, DNA isolated from the lungs and livers of both [3H]NC- and [3H]AC-treated preweanling male mice contained a single major and chromatographically identical adduct. This major adduct, which accounted for as much as 90% of the total carcinogen-DNA adducts in enzymatic hydrolysates from treated animals, was chromatographically distinct from the major C8-purine substituted adducts formed from the reaction of N-hydroxy-AC with calf thymus DNA. In contrast to the results obtained with NC and AC, the major carcinogen-DNA adduct formed in the livers of mice treated with [3H]-1,6-dinitropyrene was found to cochromatograph with 1-N-(deoxyguanosin-8-yl)amino-6-nitropyrene, a product derived from N-hydroxy-1-amino-6-nitropyrene. Since NC and its nitro-reduced derivative, AC, yielded an identical carcinogen-DNA adduct in vivo and this adduct was not derived from N-hydroxy-AC, we conclude that the metabolic activation of NC in the neonatal mouse must involve some previously undescribed combination of ring-oxidation and nitro-reduction pathways. This activation pathway could be an important factor in determining the potency of NC and AC as carcinogens in this bioassay system. PMID- 3677077 TI - Increased fragile sites and sister chromatid exchanges in bone marrow and peripheral blood of young cigarette smokers. AB - Cigarette smoking is considered to be the single most important acquired cause of cancer mortality. Studies of chromosome aberrations, sister chromatid exchanges, and fragile sites in peripheral blood or bone marrow are useful methods to detect the effects of the environmental mutagens or carcinogens found in cigarette smoke. The effects of smoking on the immature cells in the bone marrow have not been studied. Here, we examine the peripheral blood and bone marrow in 18 smokers (15 females and 3 males) with a median age of 25 years (range, 21-40) and an average cigarette use corresponding to 6 pack years. In both bone marrow cells and peripheral blood lymphocytes, we were able to show a significantly increased frequency of sister chromatid exchanges in smokers with a 5 or more cigarette pack year history, but not in those who smoked less than 5 pack years. We also found a higher frequency of sister chromatid exchanges in peripheral blood lymphocytes than in bone marrow cells. In addition, the peripheral lymphocytes of smokers demonstrated (a) a significantly higher frequency of fragile sites, (b) an increased number of metaphases with extensive breakage; and (c) elevated expression of fragile sites at the cancer breakpoints 3p14.2, 11q13.3, 22q12.2, and 11p13-p14.2 and at the oncogene sites bcl 1, erb B, erb A, and sis. Our results suggest that chromosomal DNA of peripheral blood lymphocytes is sensitive to cigarette smoking. Studies of the chromosomal changes in these cells provide an index of the mutagenic damage caused by these exogenous agents in individual patients and the ability of individuals to repair that damage, and might predict susceptibility to malignant events. PMID- 3677078 TI - Inheritance of susceptibility to phototumorigenesis and persistent hyperplasia in F1 hybrids between SENCAR mice and BALB/c or C57BL/6 mice. AB - SENCAR mice are selectively bred for hypersusceptibility to two-stage chemical skin carcinogenesis. They are also hypersusceptible to UV radiation tumorigenesis with single high-dose, but not chronic low-dose, exposures. In addition, SENCAR mice exhibit an exaggerated and persistent epidermal hyperplasia (due to sustained proliferation of the basal cells) in response to UV-induced tissue damage. In the present study, we have examined the inheritance of susceptibility to both phototumorigenesis and persistent hyperplasia in the F1 offspring of SENCAR mice crossed with either of two inbred strains (BALB/c or C57BL/6) which are relatively resistant to phototumorigenesis. A total of 428 mice from the parental strains and reciprocal F1 crosses were given a single high dose (8.64 x 10(4) J/m2) of UV radiation (FS40 sunlamps) which causes persistent hyperplasia and tumorigenesis in many SENCAR, but no BALB/c or C57BL/6, mice. F1 hybrids between SENCAR and C57BL/6 mice did not develop persistent hyperplasia or skin tumors, which indicates that susceptibility to both traits is completely recessive to the C57BL/6 genotype. In contrast, F1 hybrids between SENCAR and BALB/c mice developed both persistent hyperplasia and skin tumors, although at a much lower incidence than the SENCAR mice, indicating that susceptibility to both traits is only partially (incompletely) recessive to the BALB/c genotype. Thus, in either F1 cross, susceptibility to phototumorigenesis decreased in parallel with persistent hyperplasia. These results are consistent with the hypothesis that the two characteristics are mechanistically related. PMID- 3677079 TI - Experimental metastasis of mouse embryonal carcinoma cell lines to specific locations. AB - Embryonal carcinoma cell lines produced tumors in highly specific and unusual sites when injected into mice. The pattern that developed when cells were injected into the left ventricle of the heart involved target organs related either to specific nerve patterns or neuronal outgrowth factors, or to pathways of primordial germ cell migration. Major sites included the ovary, testis, adrenal, iris, whiskers, and male submaxillary gland. Neither local growth responses, determined by direct injection of tumor cells into different organ parenchyma, nor initial attachments, observed upon injection of radiolabeled cells, appeared to sufficiently account for the specificity of tumor metastases occurring after arterial injection. However, tissue from uninjected target sites, but not other tissues, stimulated the in vitro migration of embryonal carcinoma cells. Conditioned medium from only target tissues had a similar effect. These results suggest that the specificity of this tumor pattern may depend on migration responses that are significant in the localization of embryonic germ and neural cells. The specific metastatic pattern observed following i.p. injection of embryonal carcinoma cells, involving only the ovary, appeared to require an additional component of high adhesivity to the target organ. PMID- 3677080 TI - Nerve growth factor stimulation of mouse embryonal carcinoma cell migration. AB - Embryonal carcinoma cells localize to a specific array of target tissues including the male submaxillary gland following intracardiac injection. These target tissues or conditioned medium derived from them have been shown to stimulate the in vitro migration of embryonal carcinoma cells. Here we show that in vitro migration of mouse embryonal carcinoma cells is induced by the simultaneous presence of two different components. One of these is a specific requirement for a fibronectin substrate. The other component is present in male submaxillary conditioned medium and may be nerve growth factor (NGF). Migration of embryonal carcinoma cells on a fibronectin substrate could be induced by purified NGF, but not epidermal growth factor, and submaxillary conditioned medium contained very high levels of nerve outgrowth activity which could be blocked by anti-NGF antibody. Only the high molecular weight 7S NGF complex was active in inducing migration, while the low molecular weight 2.5S NGF inhibited migration. Neither type of NGF or submaxillary conditioned medium stimulated the in vitro growth of embryonal carcinoma cells. 7S NGF thus differentially affects murine embryonal carcinoma cells by inducing cell motility but not cell division. That embryonal carcinoma cells require 7S NGF for their migration in vitro raises the interesting possibility that these cells may respond similarly in vivo, and be stimulated by tissue-specific high molecular weight NGF molecules to migrate or extravasate into the parenchyma of target organs. PMID- 3677081 TI - Survival of highly proliferative colony forming cells after treatment of bone marrow cells with 4-hydroperoxycyclophosphamide. AB - We investigated the in vitro effects of 4-hydroperoxycyclophosphamide (4-HC) on human hemopoietic stem cells. Marrow cells were exposed to 4-HC and then assayed for mixed (CFU-GEMM), erythroid (BFU-E), megakaryocyte (CFU-M), and granulocyte macrophage (CFU-GM) colony forming cells. We found that highly proliferative colony forming cells, especially CFU-GEMM and BFU-E, were relatively spared by 4 HC treatment. One third of the surviving progenitors formed large colonies, some of which contained more than 50,000 cells. By sequential examination of the formation of these large colonies, we found immature colonies consisting of blasts at the early stage of culture. The morphology of these "blast cell colonies" in situ was arbitrarily classified into four types. Among them were the blast cell colonies consisting of the individual cells that were dispersed and had a few granules within the cytoplasm (type A); these cells finally formed very large colonies on day 22 of culture. Approximately 70% of the single cells derived from type A blast cell colonies produced secondary colonies consisting of erythroblasts, macrophages, eosinophils, and/or basophils. These results show that the blast cells in type A colonies have a highly proliferative capacity. The availability of a highly enriched population of primitive hemopoietic progenitors will provide us with a unique opportunity to study the interaction between a single stem cell and purified hemopoietic factors. PMID- 3677082 TI - Selective targeting of boronophenylalanine to melanoma in BALB/c mice for neutron capture therapy. AB - Melanoma cells actively accumulate aromatic amino acids for use as precursors in the synthesis of the pigment melanin. Using the Harding-Passey melanoma carried s.c. in BALB/c mice, we have demonstrated that p-boronophenylalanine (BPA) is taken up by melanoma tissue to a much greater extent than by normal tissues. Following a single i.p. injection, or a series of injections given over 1 h, the accumulation of boron in melanoma was found to be transient, reaching a maximum approximately 6 h postinjection. The concentrations of boron achieved in tumor ranged from 9-33 micrograms/g, and are within the range estimated to be necessary for successful application of the nuclear reaction 10B(n,alpha)7Li for neutron capture therapy. Boron concentrations in tumor and tissues were determined using either a prompt-gamma spectroscopic technique or by quantitative neutron capture radiography using whole-body sections. Distribution studies with the resolved stereoisomers of BPA indicated that the L isomer is preferentially accumulated in the melanoma compared to the D isomer. The L isomer of BPA was shown to be targeted to actively dividing tumor cells by simultaneously comparing the boron and [3H]thymidine distribution in tumor. Under conditions which selectively deliver high concentrations of boron to Harding-Passey melanomas in BALB/c mice, BPA did not deliver useful concentrations of boron to a mammary adenocarcinoma in Hale-Stoner mice. These results, along with the selectivity of the Harding-Passey melanoma for the L isomer of BPA, are consistent with our working hypothesis that BPA is actively transported into the melanomas as an analogue of natural melanin precursors. PMID- 3677083 TI - Inherent tumorigenic and metastatic properties of rat-1 and rat-2 cells. AB - Rat-1 and Rat-2 cells have been used in many studies of in vitro transformation and are widely assumed to be nontumorigenic because of their low incidence of focus formation, their poor growth in soft agar, and their reported failure to form tumors in animals. We examined more carefully the relationship between the in vitro and in vivo behavior of these cells and found that in spite of their in vitro characteristics, injection of these cells into Fischer rats invariably produced invasive tumors which frequently metastasized. When cells from primary tumors or metastases were cultured in vitro, the resultant cell lines were usually morphologically indistinguishable from parental cells and neither formed foci nor grew in soft agar. Thus, in vitro growth patterns do not correlate well with in vivo behavior in these cells and their inherent tumorigenicity warrants caution in the interpretation of results of in vitro transformation studies. PMID- 3677084 TI - Murine epidermal xanthine oxidase activity: correlation with degree of hyperplasia induced by tumor promoters. AB - Topical application of the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) to SENCAR mouse skin results within 48 h in a 3-fold elevation of xanthine oxidase (XO) activity, an enzyme capable of generating the reactive oxygen species superoxide and hydrogen peroxide. The antiinflammatory steroid fluocinolone acetonide, an inhibitor of TPA-induced hyperplasia, as well as the multiple stages of tumor promotion as defined in SENCAR mice (Stages I and II), inhibited the TPA-dependent elevation of epidermal XO activity. Neither tosylphenylalanyl chloromethyl ketone nor retinoic acid, inhibitors of promotion Stages I and II, respectively, had significant effects on TPA-induced hyperplasia or elevated XO activity. The nonpromoting but hyperplasiogenic agents ethyl phenylpropiolate and acetic acid significantly elevated XO activity within 48 h of topical application. The non-phorbol ester tumor promoter benzoyl peroxide also elevated XO activity consistent with the degree of induced hyperplasia. Multiple treatments with TPA or ethyl phenylpropiolate resulted in a sustained elevation of XO activity which peaked at five treatments and then declined. Sustained inhibition of XO activity by p.o. administration of allopurinol did not inhibit the TPA-induced hyperplasia as determined histologically. These results suggest that the TPA-dependent elevation of epidermal XO activity is associated with the hyperplasia induced by the agent, and is a consequence of the hyperplasia rather than the cause of it. PMID- 3677085 TI - Clinical studies on a new screening assay for anticancer agents using nude mice and isotopic evaluation. AB - A new screening assay for anticancer agents was established using an in vivo nude mouse model. Assessment of the chemosensitivity of individual human tumors was determined by [3H]thymidine incorporation by the treated tumors. Three hundred and thirty tumors derived from cancer patients were transplanted into nude mice s.c. and treated with anticancer agents. Mitomycin C, 5-fluorouracil, cyclophosphamide, and doxorubicin were used in the present studies. In 270 of 330 cancers, chemosensitivity was evaluated by this method (evaluable rate, 81.8%). The rate of positive sensitivity against all tumors was 21.9% in mitomycin C, 12.2% in 5-fluorouracil, 27.4% in cyclophosphamide, and 23.6% in doxorubicin, respectively. The tumor sensitivity to anticancer agents varied according to the type of cancer. Retrospective and prospective clinical studies were performed to determine the usefulness of the nude mouse-isotope assay for the prediction of tumor sensitivity. The 24-month survival rates of 24 gastric cancer patients treated with tumor-sensitive agents was significantly higher than that of 28 patients treated with tumor-resistant agents. The end results after chemotherapy in far-advanced and inoperable terminal cases of gastrointestinal cancers was also investigated, prospectively. Out of 19 cases, the 50% survival time of 11 patients treated with tumor-sensitive agents was longer than that of eight patients treated with tumor-resistant agents. From prospective correlative studies carried out on 25 patients, this assay correlated with clinical responses (overall agreement, 76.0%; P less than 0.05) with specific agreements of sensitivity and resistance of 37.5 and 94.1%, respectively. From these results, it seems reasonable to conclude that nude mouse-isotope assay is a screening assay to identify appropriate agents for the treatment of patients with cancer. However, there is still a need to develop a better protocol in this assay, especially for antimetabolites, and to continue research in order to find more sufficient assays to predict clinical sensitivity to anticancer agents. PMID- 3677086 TI - Enhancement of antineoplastic effects of cisplatin by calmodulin antagonists in nude mice bearing human ovarian carcinoma. AB - The present study was designed to potentiate the antineoplastic effects of cisplatin by combination with calmodulin antagonists [N-(6-amino-hexyl)-5-chloro 1-naphthalenesulfonamide (W-7) and N-(6-aminohexyl)-1-naphthalenesulfonamide (W 5)] in nude mice bearing human ovarian carcinoma. Tumor growth of nude mice treated with W-7 or W-5 combined with cisplatin was significantly inhibited, compared to that of nude mice treated with W-7 alone, W-5 alone, or cisplatin alone. Although treatment with cisplatin alone markedly inhibited lytic activity of spleen cells from tumor-bearing nude mice against the tumor cells, the inhibitory effect was eliminated by combination with W-7 or W-5. There was no significant difference in survival time among untreated, cisplatin-treated, W-7 treated, and W-5-treated groups. Only when cisplatin was followed by W-7 or W-5 was a significant enhancement by W-7 or W-5 of the antitumor effect of cisplatin observed with respect to inhibition of tumor growth as well as prolongation of survival time. PMID- 3677087 TI - Murine mammary tumor response to hyperthermia and radiotherapy evaluated by in vivo 31P-nuclear magnetic resonance spectroscopy. AB - The response of the s.c.-implanted murine mammary carcinoma NU-82 to hyperthermia was followed as a function of time by 31P-nuclear magnetic resonance spectroscopy. Treatment consisted of elevation of the temperature of the tumors to 41-45 degrees C during 15 min. At 18 h after temperatures of up to 42, 43, 44, and 45 degrees C the ratio of ATP/Pi was unchanged, decreased, largely decreased, and approaching zero, respectively. After the higher doses the relative concentrations (in percentage of total phosphate as visible in the nuclear magnetic resonance spectrum) of phosphomonoesters (mainly phosphoethanolamine) and phosphocreatine also decreased in favor of Pi. The changes in phosphodiesters (mainly glycerophosphocholine) correlated linearly with the changes in ATP (r = 0.84, P less than 0.025). Whereas the limited spectral changes after a dose of 43 degrees C were nullified within 24 h, the more drastic changes after a dose of 45 degrees C lasted at least 8 days. The heavier dose not only induced temporary decreases in tumor perfusion like the lower dose (phase 1) but subsequently, unlike the lower dose, resulted in formation of necrosis (phase 2). In the same tumor we found increases in Pi and decreases in ATP and phosphodiesters after radiotherapy with a dose of 20 Gy. Radiotherapy (20 Gy) combined with hyperthermia (44 degrees C) appeared to strengthen these effects and resulted in an improved tumor response (regression). PMID- 3677088 TI - Nuclear magnetic resonance analysis of tumor necrosis factor-induced alterations of phospholipid metabolites and pH in Friend leukemia cell tumors and fibrosarcomas in mice. AB - The alterations induced on the pool sizes of five phospholipid metabolites, glycerol 3-phosphorycholine, glycerol 3-phosphorylethanolamine, phosphorylcholine, sn-glycerol 3-phosphate, and choline were studied by nuclear magnetic resonance (NMR) spectroscopy in murine tumors injected with recombinant murine tumor necrosis factor (TNF). Solid tumors were obtained by s.c. injection of either Friend leukemia cells (clones 3C1-8 and 745) in DBA/2 mice or murine fibrosarcoma cells (HeN4) in C3H/HeN mice. After tumor nodules had developed, TNF or bovine serum albumin was injected intratumorally. Treatment of both tumors with TNF resulted in a marked inhibition of tumor growth. 31P-NMR analyses of Friend leukemia cell tumors (and tissue extracts), 6 h after injection of TNF, showed: (a) a 1.5- to 3.5-fold decrease in the pool sizes of glycerol 3 phosphorylcholine and glycerol 3-phosphorylethanolamine; (b) a 7- to 8-fold increase of sn-glycerol 3-phosphate; (c) a 2- to 3.5-fold decrease of phosphorylcholine; (d) an alkaline shift (0.2 units) in intratumoral pH. Similar metabolic alterations occurred in TNF-treated HeN4 fibrosarcoma. 1H-NMR analyses of Friend leukemia cell tumor extracts also indicated, 6 h after tumor injection with TNF: (a) elevated choline levels (9X); (b) a 19-fold increase in the ratio [choline]/[phosporylcholine]; (c) elevated (1.4X) levels of lactic acid; and (d) a 1.6-fold decrease in the [taurine]/[glycine] ratio. The results are interpreted in the light of possible alterations in the activity of enzymes controlling the de novo biosynthesis and catabolism of phospholipids. We concluded that NMR spectroscopy can be a useful means to monitor the level of some phospholipid precursors and/or derivatives as early markers of therapeutic efficacy in intact neoplastic tissues. PMID- 3677089 TI - Prevention by fructose-1,6-bisphosphate of cardiac oxidative damage induced in mice by subchronic doxorubicin treatment. AB - An experimental model of mild, subchronic doxorubicin cardiotoxicity in mice was investigated by monitoring changes of biochemical parameters related to cell response against oxidative stress in both liver and heart. A specific increase of the lactate dehydrogenase isoenzyme typical of the heart was observed for doxorubicin-treated mice. Lipid peroxidation, as evaluated by malondialdehyde determination, and catalase activity were greatly increased in heart and unaffected in liver. On the other hand, these changes can be considered as indicative of early heart damage induced by doxorubicin. Glutathione, glutathione peroxidase, and 6-phosphogluconate dehydrogenase values were not significantly altered by the treatment and glucose-6-phosphate dehydrogenase increased in both liver and heart. Administration of fructose-1,6-bisphosphate strongly reduced the increase of plasma lactate dehydrogenase, heart lipid peroxidation, and heart catalase while no effect on the diagnostically irrelevant increase of glucose-6 phosphate dehydrogenase was observed. The inhibitory effect on the onset of biochemical modification typical of early subchronic doxorubicin cardiotoxicity may be related to stimulation of ATP synthesis by fructose-1,6-bisphosphate and is therapeutically promising in view of the lack of toxicity of fructose-1,6 bisphosphate as a drug. PMID- 3677090 TI - Stimulation of c-myc oncogene expression associated with estrogen-induced proliferation of human breast cancer cells. AB - Regulation of c-myc expression is known to be sensitive to a variety of mitogenic stimuli in various cell types. Since estrogen is a well documented mitogen of estrogen-responsive human breast cancer (HBC) cells, we studied the influence of estradiol and its antagonist tamoxifen on the expression of c-myc in HBC cell lines. Using Northern hybridization analysis, we monitored the accumulation of c myc mRNA in a number of HBC cell lines. The cell lines studied included the estrogen-responsive, estrogen receptor positive (ER+) MCF-7, T-47D, the nonresponsive, estrogen receptor negative (ER-) MDA-MB-231, BT-20, and a nontumorous breast cell line, HBL-100. The effects of endogenous estrogen were minimized by culturing the cells in medium containing 10% (v/v) charcoal-treated fetal bovine serum and tamoxifen (10(-6) M) for 48 h prior to estradiol (10(-7) M) treatment. In the ER+ cell lines the addition of estradiol resulted in a noticeable increase in c-myc expression after 15 min with a maximal (greater than 10-fold) induction in 1-2 h. In the ER- cell lines the level of c-myc mRNA was high and was unaffected by estrogen or tamoxifen; in the ER- cancer cell lines, neither amplification nor rearrangement of the c-myc gene was observed. In contrast, the expression of another oncogene, c-H-ras, remained constant in both ER+ and ER- cell lines and was insensitive to estrogen and antiestrogen. These results suggest that regulation of c-myc expression may be an important step in estrogen-induced proliferation of HBC cells. PMID- 3677091 TI - Antibody-guided localization of intraperitoneal tumors following intraperitoneal or intravenous antibody administration. AB - Intraperitoneal tumors from a human cancer cell line (LoVo) were established in nude mice by i.p. inoculation of a single cell suspension. Two preparations of the same monoclonal antibody, radiolabeled with 125I and 131I were injected i.p. and i.v. into the same animals. Localization was assessed by dissection and counting the activity in tumors and normal tissues. Tumor/tissue ratios 1 h after i.p. injection of antibody were approximately 50 times higher than after i.v. administration. This i.p./i.v. advantage fell to around 4 by 8 h and was just greater than 1 by 24 h. This effect was observed with both specific and nonspecific antibody, indicating that it is due to the route of administration. However, the absolute amounts of antibody bound to tumors depended on the specificity of the antibody. Twenty % of the injected dose of specific antibody was bound per gram to tumor 1 to 2 h after i.p. injection, falling to 10%/g by 24 h and remaining at this level up to 5 days after antibody administration. In contrast, less than 10%/g of nonspecific antibody was detected in tumors after 1 h; this fell rapidly to normal organ levels of less than 5%/g by 8 h. This study demonstrates a major advantage when administering radiolabeled monoclonal antibodies i.p. for targeting intraperitoneal tumors. PMID- 3677092 TI - 32P-postlabeling analysis of aromatic DNA adducts in fish from polluted areas. AB - Brown bullheads (Ictalurus nebulosus) were sampled from sites in the Buffalo and Detroit Rivers where fish are exposed to high levels of sediment bound polycyclic aromatic hydrocarbons, and suffer from an elevated frequency of liver cancer. DNA was isolated from the livers of these wild fish and from control specimens which were raised in clean aquariums. DNA was enzymatically digested to normal and adducted nucleotides, and hydrophobic/bulky adducts were enriched in the digests either by preparative reverse-phase high-pressure liquid chromatography, or selective nuclease P1 dephosphorylation of normal nucleotides. Aromatic DNA carcinogen adducts were then quantitated using 32P-postlabeling analysis. Using both adduct enrichment procedures, chromatograms derived from DNA of fish from polluted areas showed a diffuse diagonal radioactive zone not present in DNA from aquarium raised fish. The diagonal zone appeared to consist at least in part of multiple overlapping discrete adduct spots which could be partially separated by gradient high-pressure liquid chromatography prior to 32P-postlabeling analysis, and most of which were more strongly retained on a reverse-phase column than the major benzo(a)pyrene-DNA adduct. The behavior of the adducts in the diagonal radioactive zone and of their unlabeled precursors is consistent with their identification as nucleotide adducts of a variety of bulky hydrophobic aromatic environmental compounds. Total pollution-related adduct levels as analyzed by HPLC adduct enrichment and 32P-postlabeling were 70.1 +/- 29 (SD) nmol/mol normal nucleotide in fish from the Buffalo River, and 52 and 56 nmol/mol for two specimens from the Detroit River. PMID- 3677093 TI - Differential uptake of cis-diamminedichloroplatinum (II) by sensitive and resistant murine L1210 leukemia cells. AB - The uptake of cis-[14C]dichloro(ethylenediamine)platinum(II) (cis-DEP) is reduced in cis-diamminedichloroplatinum(II) (cis-DDP)-resistant L1210 cells [L1210/DDP (SRI)] in comparison to cis-DDP-sensitive L1210 cells (L1210/0). A difference in uptake is observed as early as 6 min after addition of cis-[14C]DEP and increases to approximately 3-fold after 30 min. This reduction in uptake is reflected in a decrease in the binding of platinum to DNA isolated from cis-DDP-treated cells as measured by atomic absorption spectroscopy and in the quantity of intracellular cis-DEP metabolites as measured by high-performance liquid chromatography. Similar differences in uptake are observed between ascitic L1210/0 and L1210/DDP (SRI) cells in vitro and in vivo, showing that the differences in uptake are not due to an artifact of the culturing process. The differences in cis-DEP uptake between the two cell lines were relatively unchanged during 7 mo in culture; however, both cell lines exhibited altered sensitivities to cis-DEP during extended culturing. No difference was observed in the efflux of cis-DEP by the two cell lines. Similarly, no difference in nonprotein and total sulfhydryl contents was observed between L1210/0 and L1210/DDP (SRI) cells. The difference in uptake (3-fold) of cis-DEP between L1210/0 and L1210/DDP (SRI) cells may not account fully for the observed differences in sensitivity of the two cell lines to cis-DDP (18-fold) and cis-DEP (19-fold). A portion of the resistance may be due to differences in the capacity of the two cell lines to survive in the presence of platinum damage. PMID- 3677095 TI - Modulation of human hemopoietic progenitor cell growth in vitro by recombinant human beta-interferon. AB - Interferons are known to have modulatory effects on hemopoiesis. Human bone marrow mononuclear cells were employed to test the effects of human recombinant beta-interferon on myeloid and erythroid hemopoietic stem cell growth. Results demonstrated that 1,000 U/ml of beta-interferon significantly inhibited myeloid growth [colony-forming unit (CFU)-granulocyte macrophage] by 40-50%, whereas a higher concentration (10,000 U/ml) abolished CFU-granulocyte macrophage growth by 80-100%. The inhibitory effects of beta-interferon were partially reversible by increasing the concentrations of colony stimulating activity in the culture and could not be abrogated by addition of toxic oxygen radical scavengers such as superoxide dismutase and catalase. The inhibitory effect of interferon was found to be partially dependent on the presence of accessory cells, since less inhibition was seen using T-cell and monocyte depleted bone marrow cells. Lower concentrations of beta-interferon (10-100 units/ml) were without effect. In contrast to myeloid cells, the human erythroid progenitors (CFU-erythroid, burst forming unit-erythroid) appear to be more sensitive to the inhibitory effects of beta-interferon. In this regard it was found that 100 U/ml of beta-interferon suppressed erythroid growth by 40-50%. These results suggest that human recombinant beta-interferon is capable of suppressing hemopoietic colony growth. PMID- 3677094 TI - Inhibitory and stimulatory effects of glucocorticoid on androgen-induced growth of murine Shionogi carcinoma 115 in vivo and in cell culture. AB - It has been generally accepted for 20 years that the growth of Shionogi carcinoma 115 (SC115) is stimulated only by androgen in vivo and in cell culture. However, we recently found that the growth of SC115 is also stimulated by pharmacological, but not physiological, doses of glucocorticoid both in vivo and in cell culture and by pharmacological doses of estrogen only in vivo. In the present study, therefore, we investigated the effect of dexamethasone on androgen-induced growth of SC115 cells in vivo and in cell culture. In a serum-free medium [Ham's F 12:Eagle's minimum essential medium (1:1, v/v) containing 0.1% bovine serum albumin], the proliferation of SC-3 cells (a cloned cell line from SC115 cells) estimated by cell number and DNA synthesis reached a plateau at 10(-8) M testosterone (up to 93-fold) or 10(-6) M dexamethasone (up to 7.2-fold); high stimulation induced by higher than 10(-8) M testosterone was inhibited by the addition of 10(-5)-10(-8) M dexamethasone in a concentration-dependent manner, whereas low stimulation induced by lower than 10(-10) M testosterone was significantly enhanced by the addition of dexamethasone. The presence of typical glucocorticoid and androgen receptors in SC-3 cells was also demonstrated; dexamethasone did not bind to androgen receptor and testosterone did not bind to glucocorticoid receptor. In castrated mice, the concomitant administration of dexamethasone again significantly inhibited the high growth of SC115 tumors induced by high doses of androgen but significantly enhanced the low growth induced by low doses of androgen. The present results demonstrate both inhibitory and stimulatory effects of glucocorticoid on androgen-induced proliferation of SC115 cells in cell culture and probably in vivo. PMID- 3677096 TI - Marked synergism of dimethylnitrosamine carcinogenesis in rats exposed to cadmium. AB - The combined carcinogenic effect of cadmium and dimethylnitrosamine (DMN) was examined in male Wistar rats, to test whether the previously observed synergism in mutagenicity between cadmium and 2 N-nitroso compounds would be paralleled by a synergism in carcinogenicity. In experiment 1, 50 five-month old rats received 18 mg DMN/kg i.p. followed by cadmium i.m. in two injections totaling either 1.5 or 3.0 mg Cd2+/kg. In experiment 2, 30 weanling rats received five i.m. doses totaling 6 mg Cd2+/kg followed by 18 mg DMN/kg. After 52 weeks, the incidence of renal tubular neoplasms was significantly increased above additivity in both experiments (P = 0.0005 to 0.017). Experiment 1 also showed a synergistic increase in the incidence of neoplastic (P = 0.024) and preneoplastic (P less than 0.01) microscopic liver lesions, of tumors of organs other than liver and kidney (P less than 0.01), of malignant versus benign tumors (P = 0.038), and of multiple versus single tumors (P = 0.0019). In experiment 2, the incidence of DMN induced hepatocellular adenomas was significantly lower than additivity, suggesting an antagonistic, protective effect of cadmium pretreatment. The overall incidence of tumors of any type was 17.5 versus 67.7% in control (one agent or none) versus test animals. Malignant tumors included carcinomas, sarcomas, and lymphomas, involving nine different sites. Cadmium appears to enhance the initiation of carcinogenesis induced by DMN. Both cadmium and nitrosamines are known environmental contaminants present in air, food, water supplies, and tobacco smoke. PMID- 3677097 TI - Inhibition of 12-O-tetradecanoylphorbol-13-acetate induction of ornithine decarboxylase activity, DNA synthesis, and tumor promotion in mouse skin by ascorbic acid and ascorbyl palmitate. AB - The effects of topically applied 12-O-tetradecanoylphorbol-13-acetate (TPA) on the level of ascorbic acid in the epidermis and the effects of topically applied ascorbic acid, ascorbyl palmitate (a synthetic lipophilic derivative of ascorbic acid), palmitic acid and sorbitan monopalmitate on TPA-induced epidermal ornithine decarboxylase activity, epidermal DNA synthesis, and the promotion of skin tumors were evaluated in female CD-1 mice. Topical application of 5 or 16 nmol of TPA resulted in a 45-50% decrease in the amount of ascorbic acid per mg protein in mouse epidermis at 5 h after TPA application. Large topical doses of ascorbic acid inhibited TPA-induced tumor promotion in mouse epidermis, but smaller doses were inactive. The topical application of relatively small doses of ascorbyl palmitate had a marked inhibitory effect on TPA-induced ornithine decarboxylase activity, DNA synthesis, and tumor promotion in mouse epidermis. Ascorbic acid, palmitic acid, and sorbitan monopalmitate were less effective than ascorbyl palmitate as inhibitors of tumor promotion. The topical application of 4 mumol of ascorbyl palmitate inhibited by 60-76% the induction of epidermal ornithine decarboxylase activity and DNA synthesis that occurred after a single topical application of 2 nmol of TPA whereas similar doses of ascorbic acid had no inhibitory effect. The topical application of 4 mumol of ascorbyl palmitate together with 5 nmol of TPA twice weekly for 20 weeks to previously initiated mice inhibited by 91% the number of tumors per mouse. PMID- 3677098 TI - Cytogenetic alterations associated with the acquisition of doxorubicin resistance: possible significance of chromosome 7 alterations. AB - Cytogenetic abnormalities associated with the acquisition of doxorubicin (DOX) resistance (DOXR) were examined in two cell lines (HT1080 fibrosarcoma and LoVo colon adenocarcinoma) which were selected in the presence of increasing concentrations of DOX over a 2-year period. Karyotypes of both tumor lines were initially near-diploid although they differed significantly in their intrinsic sensitivities to DOX (DOX 50% inhibiting concentrations: LoVo, 0.10 micrograms/ml; HT1080, 0.006 microgram/ml). Chromosome banding analysis of DOXR sublines of the LoVo and HT1080 cell lines demonstrated a strikingly different response to DOX selection with regard to both numeric and structural chromosome alterations. DOXR LoVo cells maintained the parental modal chromosomal number of 49 despite a 285-fold increase in the level of resistance, with minimal structural chromosome changes observed. In contrast, the development of DOXR in HT1080 cells was accompanied by marked aneuploidy, including a significant increase in the complexity of the tumor karyotype with increasing levels of DOXR. Cytogenetic evidence suggestive of gene amplification (double minutes and homogeneously staining regions) was also observed in the DOXR HT1080 cell line. Examination of chromosome alterations common to both resistant lines revealed alterations of chromosomes 1, 5, 7, and 11, with chromosome 7q the most frequent site of chromosome change. Reversion of DOXR in both the HT1080 and LoVo cell lines (by continuous in vitro passage once off drug) resulted in an accompanying loss in structurally altered No. 7 chromosomes. Our data suggest that alterations of chromosome 7 are a common and perhaps significant feature of DOXR tumor cells. PMID- 3677099 TI - Characterization of estrogen receptor messenger RNA in human breast cancer. AB - The importance of estrogen receptor (ER) determination in breast cancer is well established. Approximately 70% of ER-positive tumors are hormone responsive compared to 5-10% of ER-negative tumors. However, one-third of ER-positive tumors fail to respond, and the reasons for this are unclear. To further investigate these relationships we have determined levels of ER protein and mRNA in a number of human breast cancer biopsies. ER protein was estimated by the dextran-coated charcoal steroid binding method and by an ER immunocytochemical assay using a specific monoclonal antibody. A complimentary DNA clone (lambda OR3) encoding part of the human ER was used to determine mRNA levels. Dot blot analysis of twenty-seven tumors revealed a close agreement between ER mRNA and the dextran coated charcoal assay (rs = 0.9; P less than 0.001). ER immunocytochemical assay staining also correlated with ER mRNA in twenty-five cases (rs = 0.75; P less than 0.001). Tumors from postmenopausal patients contained much higher levels of ER mRNA and ER protein than their premenopausal counterparts. ER-negative tumors produced no measurable ER mRNA. Northern blot analysis revealed a 6.4- and 3.7 kilobase species in ER-positive tumors and also in the human breast cancer cell line MCF-7. No differences in transcript sizes were found in tumors from hormone responsive patients compared to nonresponding patients. We have also demonstrated, in tissue sections of normal and malignant breast, localization of ER mRNA by in situ hybridization to the same population of cells which exhibit immunoreactive ER. PMID- 3677100 TI - A new in vivo model to study invasion and metastasis of human bladder carcinoma. AB - An animal model to investigate the invasive and metastatic properties of human bladder transitional cell carcinoma (HTCC) was established. Two long-term HTCC cell lines (RT4 and EJ) and one HTCC cell line derived in our laboratory (LD-71) were tumorigenic when injected s.c. into nude mice but had little potential to invade locally or metastasize before the animals succumbed to tumor burden. Experimental lung metastases were, however, observed in approximately 60% of animals given injections of RT4 or EJ cell lines in the tail vein. The cells were also implanted transurethrally into the urinary bladders of athymic mice. RT4 cells, which were originally isolated from a superficial papillary tumor, produced histologically noninvasive tumors after transurethral inoculation with no evidence of metastasis. In contrast EJ cells, which were originally isolated from a more aggressive tumor, produced invasive tumors in nude mouse bladders and metastasized to the lungs spontaneously. The invasive cell line LD-71 was weakly tumorigenic and was successfully implanted into the bladder on only one of five attempts. The human origin of the implanted tumors was documented by Southern blot analysis using human repetitive DNA as a probe. The results indicate that the site of injection strongly influences the behavior of the resulting tumors and that intravesical implantation of these HTCC cell lines produces pathological expression of invasiveness and metastatic potential. PMID- 3677101 TI - Ionizing radiation as an initiator: effects of proliferation and promotion time on tumor incidence in mice. AB - Previously we have shown that a single subcarcinogenic dose of ionizing radiation followed by 60 wk of 12-O-tetradecanoylphorbol-13-acetate (TPA) leads to the formation of squamous cell carcinoma in Sencar mice. Our previous results also indicate that TPA pretreatment prior to irradiation results in an overall increase in total tumor incidence, including both epidermal and nonepidermal tumors (D. R. Jaffe and G. T. Bowden, Radiat. Res., 106: 156-165, 1986). These studies have been expanded in CD-1 mice to further investigate the effect of the proliferative state of the skin prior to irradiation and the promotion duration after irradiation on tumor incidence. To examine the influence of the proliferative state of the skin, 17 nmol of TPA were applied to one-half of the mice 24 h prior to irradiation. The skin was irradiated using 4 MeV X-rays at a dose rate of 0.31 Gy/min. Animals received a single dose of X-rays at 0.5 or 11.25 Gy followed by twice weekly applications of TPA (8 nmol). The animals were then promoted for either 10 or 60 wk. All animals that were promoted with TPA for the same duration had a similar incidence of papillomas regardless of radiation or TPA pretreatment. Increasing the promotion duration did not significantly alter the incidence of squamous cell carcinomas at either initiation dose. At the lower initiation dose only animals that were promoted for 60 wk developed squamous cell carcinomas. TPA pretreatment at the higher dose resulted in a slight decrease in tumor incidence; however, this was not statistically significant. The incidence of basal cell carcinomas was dose dependent and appeared to be independent of TPA promotion. These data support our earlier findings that radiation can act as a weak initiator of squamous cell carcinomas and induce basal cell carcinomas in mouse skin. PMID- 3677102 TI - Strong promoting activity of reversible uracil-induced urolithiasis on urinary bladder carcinogenesis in rats initiated with N-butyl-N-(4 hydroxybutyl)nitrosamine. AB - The tumor-promoting effect of uracil-induced calculi on rat urinary bladder carcinogenesis was investigated in male F344 rats pretreated with N-butyl-N-(4 hydroxybutyl)nitrosamine (BBN). Since uracil-induced calculi and papillomatosis of the bladder are reversible, uracil was given for a limited period after the treatment with BBN. Animals were given 0.05% BBN in their drinking water for 4 wk and then treated with uracil as 3% of the diet for 8 or 16 wk. After the uracil treatment, rats were given basal diet without uracil until Wk 28 of the experiment. Animals were killed from each group at the end of either Wk 12, 20, or 28. The incidence of carcinoma of the bladder was 40% after only 8 wk of uracil treatment following BBN initiation and increased to 100% when uracil treatment was extended to 16 wk. After discontinuation of uracil treatment, the papillomatosis disappeared, but the incidence of carcinoma steadily increased with increasing time. In the control group given BBN alone, only 1 of 16 rats had carcinoma at Wk 28. The present findings clearly demonstrate that uracil-induced urolithiasis had a strong promoting activity on BBN bladder carcinogenesis. PMID- 3677103 TI - Probable free radical effects on rat liver nuclei during early hepatocarcinogenesis with a choline-devoid low methionine diet. AB - Fischer-344 rats fed a choline-devoid diet show lipid peroxidation in the liver nuclei, beginning at 1 day, reaching a peak at 3 days, and subsequently declining by 35 days. Lipid peroxidation in the mitochondria was seen first at 3 days, increased to a maximum at 28 days, and decreased after 35 days to undetectable values at 49 days. Lipid peroxidation was found in both nuclear and mitochondrial fractions both before and after stripping of their outer membranes. No microsomal lipid peroxidation could be detected at any time up to 63 days. The animals fed the same diet supplemented with choline showed no lipid peroxidation in any liver fraction. Animals given CCl4 showed the expected lipid peroxidation in the microsomes but not in the nuclear fraction. The administration of the free radical trapping agent, N-tert-butyl-alpha-phenylnitrone, prevented completely or almost so, microsomal lipid peroxidation induced by CCl4 and nuclear lipid peroxidation in the animals fed the choline-devoid, low methionine diet. The genesis of free radicals in the livers of rats fed a choline-devoid diet is considered as a likely hypothesis for the observed lipid peroxidation. The lipid peroxidation in turn is considered to be closely related to the induction of liver cell death and to the production of alterations in DNA. The DNA alterations coupled with regenerative liver cell proliferation suggest an attractive hypothesis for the initiation of hepatocarcinogenesis in rats fed a choline devoid diet. PMID- 3677104 TI - Mouse monoclonal antibodies to human epithelial differentiation antigens expressed on the surface of ovarian carcinoma ascites cells. AB - Four different human epithelial differentiation antigens (MT179, MW162, MW207, and MX35) have been defined by mouse monoclonal antibodies obtained from mice immunized with either an ovarian carcinoma cell line or fresh ovarian carcinoma cells. In an attempt to identify tissue-specific antigens restricted to ovarian epithelial cells, sections of a benign ovarian cyst were used as the initial target for screening hybridoma supernatants. The distribution of the antigens detected by these monoclonal antibodies was determined on frozen sections of 24 normal tissues and on 103 cultured cell lines of various histological types. In spite of the method used to select these monoclonal antibodies, they all reacted to some degree with normal epithelial cells in tissues other than ovary. All antibodies were unreactive with nonepithelial cells in frozen sections. These antibodies also reacted with frozen sections of most or all fresh ovarian carcinomas and benign ovarian cysts. All antibodies were unreactive with ABH, Lewis blood group-related antigens and appeared to be different in specificity from previously described well-characterized antigens of ovarian carcinoma cells. MW162 was characterized as a high-molecular-weight mucin-like molecule, and the determinant recognized is probably carbohydrate in nature. MW207 was identified as a Mr 37,000 protein. These monoclonal antibodies and 24 other previously derived antibodies that react with epithelial differentiation antigens were tested for reactivity with the surface of fresh ovarian carcinoma ascites cells and for nonreactivity with normal mesothelial cells. This assay was designed to select monoclonal antibodies that might be effective agents for i.p. therapy or radioimmunodetection of human ovarian carcinoma. Five antibodies with the desired specificity were selected; these were the four new antibodies described herein and MH99, which was characterized previously and recognizes a glycoprotein having Mr 38,000 and 29,000 subunits. The degree of heterogeneity of antigen expression on ascites carcinoma cell was dependent on the particular antigen being examined and was related to the biochemical nature of the antigen. In particular, most ABH and Lewis blood group-related antigens showed a striking degree of heterogeneity. PMID- 3677105 TI - Occupational risks for bladder cancer among men in Sweden. AB - With the use of the Swedish Cancer-Environment Registry, census data on employment in 1960 were linked with registry data on bladder cancer during 1961 79. This hypothesis-generating study revealed for the first time associations between bladder cancer and employment in pulp and fiberboard manufacturing, in rope and twine making, and work as a dental technician. Statistically significant increases in risk were also found for several occupations previously associated with bladder cancer, including barbers and beauticians, artistic painters, toolmakers and machinists, and physicians, and employment in butcher shops, industrial chemical making, apparel manufacturing, and plumbing. Etiologic inferences cannot be made from this investigation, but the findings from this large national resource provide further clues to the occupational determinants of bladder cancer. PMID- 3677106 TI - Phase I and pharmacokinetic study of flavone acetic acid. AB - Flavone acetic acid is the second in a series of compounds based on the flavonoid aglycone ring structure to be clinically evaluated in malignant disease. Preclinical studies have indicated that a minimum plasma level of 150 micrograms/ml is required before therapeutic efficacy (in a wide range of experimental tumors) is seen in mice; both in vitro and in vivo studies also suggest that the duration of drug exposure is crucial in determining activity. Thus a Phase I trial has been performed in a total of 54 patients using 3 schedules, i.e., a 1-, 3-, and 6-h infusion. In each case, treatment was given once weekly for a minimum of 3 weeks. The maximum tolerated doses were 6.4, 6.4, and 10.0 g/m2, respectively. Dose limiting toxicity was denoted by an intense feeling of warmth and flushing with a 1-h infusion, hypotension with a 3-h infusion, and hypotension and diarrhea with a 6-h infusion. No objective responses were seen in this Phase I trial. The recommended doses for Phase II trials of flavone acetic acid in Europe are 4.8 g/m2 over 1 h or 8.6 g/m2 over 6 h. At these doses the peak plasma concentrations obtained are 650 and 388 micrograms/ml, respectively. Total drug exposure (assessed by an area under the curve greater than 100 micrograms/ml) was approximately 50% greater for the 6-h schedule. This Phase I trial indicates that peak plasma concentrations associated with experimental activity are achievable in humans, although optimal drug exposure times have not yet been defined. PMID- 3677107 TI - Phase I clinical study of the new amino acid-linked nitrosourea, S 10036, administered on a weekly schedule. AB - Diethyl-1-[3-(2-chloroethyl)-3-nitrosoureido]ethylphosphonate (S 10036) is a new nitrosourea that has been evaluated in a clinical trial because of its activity in the National Cancer Institute panel screen and its rational chemical approach. A Phase I study was conducted in 22 evaluable patients with advanced cancers. The drug was given as a slow i.v. infusion over a period of 60 min on days 1, 8, 15, and 22 followed by a 4-week rest period. The dose levels ranged from 25 to 200 mg/m2/week for 4 consecutive weeks using a modified Fibonacci scheme. Thrombocytopenia was the only acute dose-limiting toxicity and started at a dose of 100 mg/m2/week and above. Hematological toxicity was delayed, cumulative, and dose related. Nausea and vomiting were moderate to severe and dose related. Three responses (one complete and two partials) have been noted. Phase II studies of S 10036 are planned at a dose of 100 mg/m2/week for 4 consecutive weeks ("induction therapy") for patients without prior therapy and 100 mg/m2/week for 3 consecutive weeks for those with prior chemotherapy or radiotherapy. Because of the cumulative toxicity, the recommended dose for the second cycle of S 10036 chemotherapy ("maintenance therapy") is 100 mg/m2/week every 3 weeks. PMID- 3677108 TI - Inherent sensitivity of cultured human embryonal carcinoma cells to adducts of cis-diamminedichloroplatinum(II) on DNA. AB - Clinical and experimental data indicate that human embryonal carcinoma cells are unusually sensitive to the antitumor drug cis-diamminedichloroplatinum(II) (cisplatin), but the basis of this sensitivity is unknown. Using colony formation assays we measured survival of cultured human embryonal carcinoma cells following cisplatin treatment and related survival to the amount of platinum bound to DNA, determined by isolation of cellular DNA and flameless atomic absorption spectrometry, over a range of drug doses. Similar measurements were carried out on F9 mouse embryonal carcinoma cells and on a fibroblast cell strain from a patient with the genetic disease Fanconi's anemia, a syndrome associated with hypersensitivity to cytotoxic and clastogenic effects of difunctional DNA-binding agents. These results were compared with similar analyses on a variety of cultured cells from previous studies. The embryonal carcinoma cells and the Fanconi's anemia fibroblast strain were among the most sensitive cells on a dose response basis. Since the amount of platinum bound to DNA after treatment of these cells was similar to values reported for many other cell types, it follows that mouse and human embryonal carcinoma cells are inherently sensitive to DNA bound platinum adducts, to a degree approaching the sensitivity of fibroblasts from patients with xeroderma pigmentosum and Fanconi's anemia. PMID- 3677109 TI - Continuous 5-day infusion of vinblastine for percutaneous hepatic arterial chemotherapy for metastatic breast cancer. AB - We assessed the therapeutic efficacy and toxicity of continuous hepatic infusion of vinblastine in the treatment of breast cancer predominantly metastatic to the liver. Twenty-six patients previously treated with one or more chemotherapeutic regimens received vinblastine at a dose of 2.0 mg/m2 daily for 5 days, via percutaneously inserted intra-arterial catheters, at 3-4-week intervals. Nine of 25 evaluable patients (36%) achieved partial response and four (16%) had minor response. For responding patients, the median time to disease progression was 21 weeks (range, 12-99), with a median survival of 11 months (range, 4-29) from the beginning of hepatic arterial infusion. The toxicity of the treatment was acceptable, and drug-related effects were comparable to those seen in patients with breast cancer treated by iv continuous infusion of vinblastine at slightly lower doses. We observed two episodes of transient inappropriate antidiuretic hormone secretion. Percutaneous hepatic arterial infusion of vinblastine had significant activity in the treatment of breast cancer metastatic to the liver. PMID- 3677110 TI - High-dose pulse chlorambucil in advanced, low-grade non-Hodgkin's lymphoma. AB - High-dose pulse chlorambucil was given orally at a dose of 16 mg/m2 daily for 5 consecutive days each month, as reported by Cadman et al. It was used to treat 33 patients with advanced, low-grade non-Hodgkin's lymphoma. With median follow-up of 4.2+ years, 70% of the patients achieved objective response. Eleven of 24 patients with follicular small cleaved cell lymphoma (FSCL) had pathological complete response; nine of 24 with FSCL and three of seven with small lymphocytic lymphoma had partial response. Median disease-free survival was 28 months. Actuarial survival for all patients was 60% at 5 years from initiation of therapy. Treatment toxicity was minimal. Pulse chlorambucil is an effective and minimally toxic palliative therapy for advanced FSCL. PMID- 3677111 TI - Inadequacy of predicted creatinine clearance as guide to chemotherapy. AB - Many chemotherapeutic agents are nephrotoxic and/or excreted via the kidney. Thus, careful evaluation of renal function is important since drug dosages are often lowered in patients with impaired renal function. When the creatinine clearance as calculated by the method of Cockcroft and Gault from the patient's age, weight, and serum creatinine was compared to the measured creatinine clearance in the same patients, the correlation coefficient was low (r = 0.40) and the average difference between the predicted and measured creatinine clearance values was 25.3%. Thus, in our patient population, creatinine clearance calculated by the method of Cockcroft and Gault did not correlate well with measured creatinine clearance and thus was not useful as a clinical tool. PMID- 3677112 TI - Management of learned food aversions in cancer patients receiving chemotherapy. AB - Aversions that form towards foods after their ingestion has been associated with illness are termed learned food aversions (LFA). This adverse treatment side effect has been implicated in the anorexia of cancer and can compromise the quality of patients' lives. In an attempt to block the formation or ameliorate the manifestations of this treatment sequela, a nutritionally inconsequential "scapegoat" food was presented to patients just prior to their first course of therapy. The hypothesis was that treatment-related aversions would be targeted towards the scapegoat, thereby sparing acceptable and nutrient-dense items in the patient's typical diet. LFA were observed in 55.3% of 76 patients receiving chemotherapy for different cancers. Following formation of a scapegoat aversion, the incidence of LFA was only 11.1% (two of 18) during the 6-month follow-up period. In contrast, 48.4% (15 of 31) of the patients not exposed to the scapegoat formed LFA. More than twice as many patients with treatment-related LFA had a pretreatment histology of the problem, suggesting the presence of a subgroup of high-risk patients. Strategies for improving upon the present results are discussed. PMID- 3677113 TI - Chemotherapy of adult soft tissue sarcoma with combination of doxorubicin and methotrexate. AB - Thirty-six adult patients with measurable advanced soft tissue sarcoma were treated with a combination of doxorubicin (70 mg/m2) and methotrexate (50 mg/m2) iv every 21 days. Partial remission was seen in ten of 33 evaluable patients (30%). Median duration of remission was 23 weeks, and median survival was 42 weeks. Bone marrow toxicity was the main toxic effect; 23% of the patients had a nadir leukocyte count less than 2.0 X 10(9)/L during therapy. These results do not suggest any therapeutic advantage in adding methotrexate to doxorubicin in this context. PMID- 3677114 TI - Inhibitory action of flurbiprofen and mopidamole on tumor lung metastasis formation in mice. AB - Flurbiprofen, 0.25 mg/kg, administered to mice orally once daily during 3 days prior to an iv transplantation of Lewis lung carcinoma cells, protected 50%-57% of experimental animals from the formation of lung tumor colonies. With the daily dose of 1.0 mg/kg, this effect was less pronounced. Mopidamole, twice daily 90 mg/kg orally during 3 days, did not have this effect. PMID- 3677115 TI - Oral gestrinone: a novel antiprogestin with no antitumor activity in endocrine sensitive breast cancer. AB - We have treated 15 patients with locally advanced or metastatic breast cancer using the synthetic 19-norsteroid gestrinone (2.5 mg orally every 3 days). All patients had assessable disease and endocrine-sensitive tumors, as defined by a previous positive response to endocrine therapy. There were no objective responses. Six patients had disease stabilization and nine had progressive disease on treatment. Seven patients were given endocrine therapy after gestrinone and three have responded. Gestrinone has no significant antitumor activity in hormone-sensitive breast cancer. This, however, does not preclude its use in benign breast disease, particularly since other agents used for benign breast disease can mask occult primary carcinoma. PMID- 3677116 TI - Facilitation of emergence of multidrug-resistant state by alteration of tumor environment: implications from competitive ecology models. AB - The presence of multidrug-resistant (MDR) cells in a solid tumor constitutes a major problem in cancer therapy. Current thinking suggests that the resistant phenotype arises de novo during the tumor's evolution via somatic mutation mechanisms. The proportion of MDR cells, once established, may be enriched during therapy as a consequence of differential cell kill. Michelson et al have developed mathematical models of these phenomena to gain an insight into the dynamics of clonal subpopulation emergence in general and MDR emergence in particular, and I now show that one unexpected consequence of therapy may be the facilitation of MDR emergence due to damage inflicted on the host. The therapeutic damage to the host is modeled as a decreased ability to carry a specific tumor burden. PMID- 3677117 TI - Oral urea in treatment of liver metastases from colorectal adenocarcinoma. PMID- 3677118 TI - Generation of dose intensity-response data suggested for drug studies. PMID- 3677119 TI - Dacarbazine, vindesine, and cisplatin combination chemotherapy in advanced malignant melanoma: a phase II study. PMID- 3677120 TI - A semiempirical theory of the optical activity of saccharides. AB - A semiempirical theory of optical activity of saccharides is developed that (a) goes beyond previous empirical treatments, (b) yields calculated NaD rotations which correlate well with experimental data, and (c) accounts for a characteristic c.d. band observed for polysaccharides in the vacuum u.v. spectrum. PMID- 3677121 TI - Synthesis of alpha-(2----9)-disialic acid. PMID- 3677122 TI - Effect of glucocorticoid deficiency after adrenalectomy on antitumor immunity. AB - We studied the effect of corticosterone after adrenalectomy on antitumor immunity in immunogenic tumors in mice. Antitumor immunity in the glucocorticoid deficient adrenalectomized mice (ADX mice) examined via comitant immunity and cytotoxic activity of spleen cells was compromised. Antitumor immunity was detected in ADX mice receiving sufficient supplementary doses of corticosterone. Loaded stress compromised the cytotoxic activity of the spleen cells in the ADX mice receiving adequate corticosterone, and the failure also contributed to the glucocorticoid deficiency because the activity was not affected by stress in the sham ADX mice. A matured effector cell activity was transferred to the glucocorticoid deficient ADX mice. We conclude that glucocorticoid deficiency compromises the antitumor immune response and that glucocorticoid might play an important role in the maturation of immunocompetent cells. PMID- 3677123 TI - Immune response of chimpanzee to purified melanoma 250 kilodalton tumor associated antigen. AB - Melanoma high molecular weight tumor-associated antigen (TAA), having a molecular weight of 250 kilodaltons (Kd), was purified from a crude cell membrane extract through a combination of lectin affinity, immunoadsorption, and high performance liquid molecular filtration chromatography. Compared to the starting extract, purified TAA was 600-fold higher in TAA activity per microgram of protein. Purified TAA was used to immunize a chimpanzee and the resulting antiTAA immune response was evaluated. Postimmune chimpanzee serum reacted in solid phase radioimmunoassay against purified TAA with a titer in excess of 100,000. In contrast, preimmune serum had a titer of less than 100 in the same assay. By immunoprecipitation analysis, we were able to demonstrate reactivity of the chimpanzee immune serum with a 250 Kd TAA in spent culture medium from melanoma cells metabolically labeled with 35S-methionine and with iodinated purified 250 Kd TAA. Reactivity of the chimpanzee antiserum for the 250 Kd TAA was confirmed in blocking and reciprocal immunodepletion studies using murine monoclonal antibody 9.2.27. These studies suggest that the 250 Kd TAA defined by murine monoclonal antibodies may prove to be immunogenic in man and that manipulation of the immune response to this TAA might be used to the clinical benefit of the patient. PMID- 3677124 TI - Some characteristics of the in vivo antitumor immunity exhibited by mice cured of a large MOPC-315 tumor by a low dose of melphalan. AB - BALB/c mice cured of a large MOPC-315 or MOPC-104E plasmacytoma following treatment with a low dose (2.5 mg/kg) of melphalan (L-PAM) were resistant to challenge with the other plasmacytoma but to a much lesser extent than to challenge with the autochthonous plasmacytoma. The resistance of the L-PAM-cured MOPC-315-tumor bearers to challenge with MOPC-104E tumor cells was increased when the MOPC-104E tumor cells were admixed with MOPC-315 tumor cells prior to their inoculation. This enhanced resistance to MOPC-104E cells was due to elimination of the MOPC-104E tumor cells through an innocent bystander killing effect since it did not render the mice more resistant to a subsequent challenge with MOPC 104E tumor cells alone. Administration of carrageenan to L-PAM-cured MOPC-315 tumor bearers 1 day after the challenge with the mixture of MOPC-104E and MOPC 315 tumor cells drastically reduced the ability of the mice to resist the tumor challenge. All of the tumors that developed in such mice were of MOPC-104E origin only (as judged by the binding specificity of the myeloma proteins secreted by the tumor cells as well as that present on their surface) even though (a) the tumor inoculum used consisted of up to 10-fold more MOPC-315 than MOPC-104E tumor cells and (b) the MOPC-315 tumor cells divide more rapidly. The same protocol of carrageenan treatment did not reduce the ability of normal BALB/c mice to develop in vivo a primary cell-mediated cytotoxic response nor a primary antibody response indicating that it has no effect on the initiation of an immune response. Therefore, it is conceivable that carrageenan treatment reduced the ability of L-PAM-cured MOPC-315-tumor bearers to reject a challenge with MOPC-315 and MOPC-104E tumor cells by interfering at the effector stage. The ability of the L-PAM-cured MOPC-315-tumor bearers to reject the MOPC-315 cells present in the challenge mixture was reduced when the mice were treated with anti-Thy 1.2 antibody but not with carrageenan, indicating that T-cells independent from carrageenan-sensitive effector cells are required for the rejection of the MOPC 315 tumor cells. Thus, at least two different effector mechanisms participate in the rejection of a challenge composed of MOPC-315 and MOPC-104E tumor cells by L PAM-cured MOPC-315-tumor bearers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3677125 TI - Abrogation of the tumor promoting effect of allogeneic blood transfusion by polyadenylic-polyuridylic acid (poly A-poly U). AB - Studies from several centers have shown an immunosuppressive effect of surgical procedures, whilst others have shown blood transfusion in association with cancer surgery to have an adverse effect on ultimate prognosis. We have previously demonstrated enhanced growth of tumor metastases, in rats following allogeneic blood transfusion and surgery. Polyadenylic-polyuridylic acid (poly A-poly U) has been reported to stimulate immune responses. In this report, we have investigated the effectiveness of poly A-poly U as an adjuvant to blood transfusion and surgical procedures in BN rats bearing artificial lung metastases. Significantly reduced tumor growth was observed, following poly A-poly U adjuvant treatment. These results lead to serious contemplation of the use of this drug as adjuvant therapy in blood transfused and surgically treated patients. PMID- 3677126 TI - Evidence that treatment with vaccinia melanoma cell lysates (VMCL) may improve survival of patients with stage II melanoma. Treatment of stage II melanoma with viral lysates. AB - A total of 80 patients with melanoma metastases in regional lymph nodes were treated by i.d. injections with a vaccine prepared from a vaccinia virus-infected allogeneic melanoma cell line; 39 patients have been followed for a 2-year period. Interim results from comparison of the treated group with 151 historical controls treated without the vaccine from September 1978 to December 1981 at the same institution and 56 non-randomized concurrent controls suggest that survival was significantly prolonged in the vaccinated group. At the 2-year period overall survival was 75% in the treated compared to 57% in the historical control group. Subset analysis showed a greater apparent benefit of vaccine therapy among patients who had metastases detected at the time of treatment of the primary melanoma (synchronous metastases), while therapy appeared less effective in patients with metastases detected at some time after treatment of the primary (delayed metastases). In the latter only those with one lymph node appeared to benefit from the treatment whereas in patients with synchronous metastases patients with three or more nodes as well as one node appeared to have improved survival. The survival rates at 2 years for treated patients with synchronous metastases in one, two, three or more lymph nodes was 100%, 83% and 79% respectively compared with that of 82%, 86% and 47% respectively in the equivalent control groups. Survival rates in treated patients with delayed metastases in one, two, three or more lymph nodes was 70%, 70% and 65% compared with 47%, 42% and 35% in the equivalent control groups. Treatment and control groups appeared well matched for a number of known prognostic features, including number and size of involved nodes, sex and thickness of primary tumor. Multivariate analysis indicated the effect of treatment was independent of these factors. Despite the empiricism of this approach the present results suggest that this form of therapy warrants further evaluation in a randomized controlled trial. PMID- 3677127 TI - Interferon-alfa corrects thrombocytosis in patients with myeloproliferative disorders. AB - During previous therapeutic trials with interferon, decreased levels of peripheral platelet counts have been observed. Taking advantage of this effect, we investigated the efficacy of recombinant interferon (rec-IFN) in the treatment of thrombocytosis in myeloproliferative diseases. A total of 15 patients with polycythemia vera, essential thrombocytosis, or chronic myeloid leukemia received rec-IFN-alfa at initial doses of 25-70 x 10(6) units/week; maintenance therapy following week 8 of treatment consisted of 20-35 x 10(6) units/week rec-IFN. Observation periods ranged from 24 to 48 weeks. Significant reductions in the number of platelets were noted in all cases; 12/15 patients achieved platelet counts below 440 x 10(9)/l and maintained those normal values for at least 4 weeks. The number of bone marrow megakaryocytes, which had been increased prior to treatment, diminished during rec-IFN therapy, while the previously shortened platelet half-life further decreased with rec-IFN treatment. During rec-IFN induced remission, the plasma levels of platelet factors, the activity of natural killer cells, and platelet aggregation showed changes between slight improvement and normal values. Severe side effects were only observed with the highest rec IFN doses; dosage adjustments were effective in improving or eliminating all treatment-related symptoms. Rec-IFN may prove to be a valuable therapeutic alternative to cytostatic treatment of thrombocytosis in myeloproliferative disorders. PMID- 3677128 TI - [Thyroid hormones and the heart]. PMID- 3677129 TI - [Diagnosis and functional characterization of the initial myocardial damage in patients with cardiac arrhythmias]. PMID- 3677130 TI - [Relations between pre- and post-infarction angina]. PMID- 3677132 TI - [Reproducibility of recordings of a new apparatus for the ambulatory monitoring of arterial pressure]. PMID- 3677131 TI - [Release of norepinephrine by cardiac sympathetic fibers in vitro. Pharmacologic modulation]. PMID- 3677133 TI - [Hemofiltration as an acute remedy in intractable cardiac decompensation. Guidelines for correct application]. PMID- 3677135 TI - [Central and regional hemodynamics during stimulation of cardiopulmonary receptors]. PMID- 3677134 TI - [Electrocardiographic aspects of phases of relapse in patients with multiple sclerosis]. PMID- 3677136 TI - [Familial idiopathic dilated cardiomyopathy. Description of 2 cases]. PMID- 3677137 TI - Conceptualization in cardiovascular nursing research. PMID- 3677138 TI - Protection by superoxide dismutase and catalase in the isolated rat heart reperfused after prolonged cardioplegia: a combined study of metabolic, functional, and morphometric ultrastructural variables. AB - To determine the protective effect during ischaemia and reperfusion of removing oxygen radicals two groups of isolated Langendorff perfused rat hearts were arrested with cardioplegic solution at 4 degrees C and kept ischaemic at 15 degrees C for 210 min before being reperfused for 60 min at 37 degrees C. To remove oxygen radicals superoxide dismutase and catalase were added to the cardioplegic solution and to the buffer during the first 30 min of reperfusion in one group, the other group serving as control. At the end of reperfusion the first derivative of left ventricular developed pressure (dP/dt), coronary flow, high energy phosphate concentrations, and ultrastructure were determined. The ultrastructure was examined using a stereological method based on point counting and the results presented as volume fractions (Vv). DP/dt after 60 min of reperfusion was 61.6(5.6)% (mean (SEM)) of the initial values in the control group and 77.6(3.4)% in the superoxide dismutase and catalase supplemented group (p less than 0.05). In the supplemented group coronary flow was significantly higher than in the control group but only in the first part of reperfusion. The concentrations of adenosine triphosphate and creatine phosphate in the control group were 9.9(1.0) and 19.6(1.8) mumol.g-1 dry weight respectively; corresponding values in the supplemented group were 14.4(2.1) and 29.4(3.6) mumol.g-1 dry weight. The morphometric examination of the ultrastructure showed no significant difference in interstitial fluid accumulation evaluated by Vv(myocyte/myocardium) measurements and there was no difference in mitochondrial alteration between the two groups. There was, however, a significant reduction in the volume of cellular oedema (Vv(cell oedema/myocyte)) in the supplemented group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677140 TI - Differences in ischaemic dysfunction after gradual and abrupt coronary occlusion: effects on isovolumic relaxation. AB - The effects of both gradual and abrupt coronary occlusion on regional wall function (sonomicrometry) and left ventricular relaxation were studied in the intact dog heart. The ischaemic dysfunction observed in the two interventions as assessed by pressure-length loops showed considerably different patterns. The regional ischaemia after abrupt occlusion of the left anterior descending coronary artery was characterised by a bulge during isovolumic relaxation in contrast to the pattern observed during gradual occlusion, which was characterised chiefly by early systolic lengthening and post-systolic shortening. The effect of regional dysfunction on left ventricular relaxation was evaluated using peak negative dP/dt and tau, the time constant of isovolumic pressure decline. Abrupt occlusion had a more profound effect on relaxation than did gradual occlusion, though there were no significant changes in either pressure or flow derived indices of systolic ventricular function with abrupt occlusion of the left anterior descending artery. Two distinct patterns of regional dysfunction were produced at zero coronary flow depending on the time course of the occlusion. The regional dysfunction observed during abrupt occlusion may in part be explained by the mechanical effect of abrupt cessation of coronary flow, which in turn influences relaxation. With gradual occlusion tau was less affected even though substantial regional dysfunction was observed. This may reflect the development of collateral flow. Thus the patterns of regional dysfunction and ventricular relaxation depend on the time course of ischaemia. PMID- 3677139 TI - Protection from reperfusion injury in the isolated rat heart by postischaemic deferoxamine and oxypurinol administration. AB - A Langendorff isolated rat heart preparation was used to determine the effect of oxypurinol, a xanthine oxidase inhibitor, and deferoxamine, an iron binding agent, on the extent of myocardial reperfusion injury after 60 minutes of ischaemia. Thirty rats were divided into three groups of 10, and an isolated heart preparation made from each rat. The isolated hearts were perfused for 15 minutes with a modified Krebs-Henseleit perfusate solution to permit stabilisation of the preparation. Each heart was then subjected to 60 minutes of total ischaemia at 37 degrees C followed by 60 minutes of reperfusion with either saline treated perfusate, oxypurinol treated perfusate (1.3 mmol.litre-1), or deferoxamine treated perfusate (0.61 mmol.litre-1). Reperfusion injury was assessed by the total amount of creatine phosphokinase released into the perfusate, by changes in myocardial vascular resistance, and by morphological examination. The saline treated group released significantly more creatine phosphokinase into the perfusate than either the oxypurinol treated group (p less than 0.05) or the deferoxamine treated group (p less than 0.05). The mean vascular resistance increased for all groups during the 60 minutes of reperfusion compared with that just before ischaemia but was significantly greater in the saline treated group than in the drug treated groups (p less than 0.01). Ultrastructural examination of a randomly selected heart from each group after 60 minutes of reperfusion showed pronounced attenuation of mitochondrial and endoplasmic reticulum swelling, increased maintenance of membrane integrity, and diminished separation of myofilaments in the oxypurinol treated and deferoxamine treated hearts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677141 TI - Effects of carotid artery occlusion on the pressor response induced by sustained isometric contraction in the cat. AB - The effects of clonidine, a central alpha 2 agonist, on changes in blood pressure caused by muscle afferent nerve (ergoreceptor) activation and baroreceptor manipulation were studied in cats. Prolonged isometric contractions (ergoreceptor activation) of the gastrocnemius and plantaris muscles increased mean arterial pressure by 53 mmHg. This pressor response was not altered by naloxone (0.5 mumol.litre-1) but was eliminated by clonidine (0.5-2.0 micrograms) when injected into the cerebral aqueduct. Brief occlusion of the carotid artery (15-30 s) caused mean arterial pressure to increase by 32-42 mmHg at rest. Neither naloxone nor clonidine altered the magnitude of the reflex pressor response to carotid occlusion. Similar increases in pressure were measured when occlusion was applied during fatiguing isometric contractions; thus baroreceptor induced increases in pressure were superimposed on the ergoreceptor induced blood pressure changes. Naloxone did not affect the changes in pressure caused by either reflex response. Clonidine continued to eliminate the pressor response to muscular contraction but did not affect the pressure increase when the carotid occlusion was applied during contractions. Electrical stimulation of the carotid sinus nerve caused blood pressure to decrease by 36 mmHg during rest and by 41 mmHg during fatiguing isometric contractions. Clonidine did not alter the depressor response to carotid sinus nerve stimulation. These data may indicate that separate pathways centrally mediate the changes in blood pressure caused by ergoreceptor and baroreceptor afferent activation. The integration of the ergoreceptor pathway may involve a catecholaminergic-opioidergic system but the present results do not suggest a similar interaction for the baroreceptor integration. PMID- 3677142 TI - Regional myocardial blood flow during cardiac tamponade in hearts with chronic coronary artery occlusion. AB - The effects of increased pericardial pressure on blood flow to collateral dependent and normal myocardium were investigated and the mechanisms responsible for these effects evaluated in 10 anaesthetised dogs after collateral inducement by gradual occlusion of a coronary artery. Regional myocardial blood flows were measured with radioactive microspheres during control conditions, mild tamponade, severe tamponade, and severe tamponade with aortic blood pressure held at the control value by blood volume expansion. Mild tamponade increased heart rate by 10% and decreased aortic blood pressure by 15%. Left atrial and central venous blood pressures were moderately increased, and indices of cardiac function were reduced. Blood flow to collateral dependent and normally perfused myocardium was not significantly altered, but the endocardial to epicardial flow ratio was significantly decreased in collateral dependent myocardium. Severe tamponade decreased aortic blood pressure by 45% and cardiac index by 62%. Left atrial and central venous blood pressures were appreciably increased and cardiac function indices considerably depressed. Blood flow to collateral dependent and normally perfused myocardium was decreased similarly (by 54-57%), but the endocardial to epicardial flow ratio was decreased by a greater degree in collateral dependent myocardium. During severe tamponade at control aortic blood pressure, left atrial and central venous blood pressures were further increased, but blood flow to collateral dependent and normally perfused myocardium returned to within 84% of control and endocardial to epicardial flow ratios were normal. Total peripheral vascular resistance increased during severe tamponade, but coronary vascular resistance remained constant. Thus blood flow to collateral dependent and normally perfused myocardium varied according to net coronary perfusion pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677143 TI - Myocardial reperfusion in the pig heart model: infarct size and duration of coronary occlusion. AB - The effect of coronary artery reperfusion on infarct size was studied in a pig heart model. Forty four open chest pigs underwent occlusion of the mid-left anterior descending artery. Fifteen minutes after occlusion the animals were randomised to one of five groups: reperfusion at 30, 45, 60, or 90 min after occlusion (groups 1-4) or permanent occlusion (group 5). Twenty four hours after coronary occlusion the pigs were killed. The heart was sectioned in slices, which were incubated in triphenyl-tetrazolium. Mean(SEM) infarct sizes calculated by planimetry were 0.46(0.42), 2.85(1.14), 9.74(1.65), 8.93(1.37), and 13.17(1.17)% of left ventricular mass in the five groups. The transmural extension of the infarct was 14.6(11.4), 42.1(12.9), 87.4(6.6), 96.2(3.2), and 100(0)% and a transmurality index used as an estimate of the mean extension of the infarct relative to wall thickness was calculated to be 0.08(0.06), 0.32(0.10), 0.72(0.06), 0.79(0.04), and 0.92(0.02) respectively. Infarct size was similar in groups 3-5, but significantly smaller in groups 1 and 2 (p less than 0.05). Infarct size and the transmurality index correlated exponentially with the duration of the occlusion (r = 0.80, p less than 0.01; and r = 0.95, p less than 0.001 respectively). These results indicate that in the pig heart model submitted to an acute coronary occlusion cell viability may be less than that suggested by previous canine studies. This observation is probably related to a less well developed collateral blood flow in the pig heart and may provide an experimental model that better resembles certain clinical conditions. PMID- 3677144 TI - Enhanced vagal activity and normal arginine vasopressin response in carotid sinus syndrome: implications for a central abnormality in carotid sinus hypersensitivity. AB - The relation between arginine vasopressin and vagal activity in carotid sinus syndrome was studied in 10 patients and 17 age matched controls using head up tilt as a stimulus. Of the controls, seven had unexplained syncope and 10 were healthy elderly subjects with no previous history of syncope. Subjects were studied supine for 45 min and thereafter during 120 min head up tilt to 40 degrees. Phasic arterial pressure and heart rate were monitored throughout. Serum was sampled at frequent intervals to measure arginine vasopressin, noradrenaline, and adrenaline concentrations. Seventy per cent of carotid sinus patients had vasovagal syncope at (mean(SD)) 25(4) min after tilt compared with 43% of subjects with unexplained syncope and one healthy elderly control. The maximum (mean(SD)) fall in systolic blood pressure and heart rate was 70(20) mmHg and 20(7) beats.min-1 (p less than 0.001 and p less than 0.01 respectively). Arginine vasopressin, noradrenaline, and adrenaline concentrations rose significantly in syncopal subjects (p less than 0.001, p less than 0.01, and p less than 0.05 respectively). Changes in systolic blood pressure, heart rate, and hormone concentrations were similar for patients with carotid sinus syndrome and control subjects. For those who completed the tilt period without the development of symptoms, systolic blood pressure and arginine vasopressin and adrenaline concentrations were unchanged, whereas noradrenaline concentrations and heart rate rose significantly. Vasovagal activity is thus appreciably increased in carotid sinus syndrome. Furthermore, the afferent limb of the carotid sinus reflex appears to be intact in patients with carotid sinus syndrome since the pattern of arginine vasopressin release was not different from controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677145 TI - [Physiatrics (physical medicine) and its relation to medical therapy and rehabilitation]. PMID- 3677146 TI - [Comparison of left ventricular function in chronic postinfarction aneurysms in the anterior, lateral, apical and diaphragmatic location]. PMID- 3677147 TI - [Lecithin-cholesterol-acyltransferase in obese children and adolescents]. PMID- 3677148 TI - [Botulism in Czechoslovakia from the viewpoint of the National Reference Laboratory for Clostridia]. PMID- 3677150 TI - [Problems in realizing the results of medical research in practice]. PMID- 3677149 TI - [Heart involvement in systemic lupus erythematosus: comparison of the results of noninvasive tests and autopsy findings]. PMID- 3677151 TI - [Laboratory reference values in coagulation. Facts and theory]. PMID- 3677152 TI - [Laboratory reference values in coagulation. Statistical evaluation]. PMID- 3677153 TI - [Serum ferritin levels in the aged]. PMID- 3677154 TI - [Screening for biochemical and hematologic values in the oldest old from a selected region in Czechoslovakia]. PMID- 3677156 TI - [Further simplification of 17-OH-corticosteroid determination in urine (without hydrolysis)]. PMID- 3677155 TI - [Is the eliminating capacity of the HLA system in paternity disputes most frequently 90-96%?]. PMID- 3677157 TI - [New legal regulations for the artificial termination of pregnancy]. PMID- 3677158 TI - [Validation of data on smoking and alcohol consumption in the population]. PMID- 3677159 TI - [Chain reactions in functional disorders of the locomotor system]. PMID- 3677160 TI - [Detection of HLA-DR, DQ and DP loci on monocytes using monoclonal antibodies]. PMID- 3677161 TI - [Effectiveness of magnesium supplementation by the oral administration of magnesium oxide]. PMID- 3677162 TI - [Psychiatrist-psychologist: misunderstanding or dialog?]. PMID- 3677163 TI - Attacks and relapses of sputum-smear-positive tuberculosis over seven years at three Transkei hospitals. PMID- 3677164 TI - Hypertension in Harare Hospital out-patients: drugs prescribed, drugs taken and control achieved. PMID- 3677165 TI - Visual prognosis in blunt eye trauma. PMID- 3677166 TI - Symposium on chemoprophylaxis of malaria. PMID- 3677167 TI - Nonhomologous views of a terminology muddle. PMID- 3677168 TI - glp-1 is required in the germ line for regulation of the decision between mitosis and meiosis in C. elegans. AB - In the wild-type C. elegans germ line there are both mitotic and meiotic germ cells. Mutations in glp-1 cause germ cells that would normally divide mitotically to enter meiosis. This mutant phenotype mimics the effect of killing the distal tip cell, a somatic cell that interacts with the germ line to regulate the mitotic/meiotic decision. In addition, wild-type glp-1 product is required maternally for embryogenesis. Temperature-shift experiments indicate that the temporal requirement for glp-1 activity in the germ line is the same as that for distal tip cell regulation. Mosaic analyses suggest that glp-1 is produced in the germ line. We propose that glp-1 acts as part of the receiving mechanism in the interaction between the distal tip cell and germ line. PMID- 3677169 TI - The glp-1 locus and cellular interactions in early C. elegans embryos. AB - Interactions between the early blastomeres in a C. elegans embryo are required for the specification of certain cell fates. Blastomeres that produce neurons and skin cells when cultured in isolation are induced to also produce pharyngeal cells in intact embryos. We have identified maternal effect lethal mutations that, on the basis of phenotype and temperature-sensitive period, appear to disrupt this inductive interaction. These mutations are all alleles of glp-1, a gene also involved in the control of germ cell proliferation during postembryonic development of C. elegans. PMID- 3677170 TI - Binding of transcription factor TFIID to the major late promoter during in vitro nucleosome assembly potentiates subsequent initiation by RNA polymerase II. AB - A plasmid containing the major late promoter was assembled into nucleosomes in a Xenopus oocyte extract, isolated by gel filtration, and found to be refractory to transcription initiation in vitro. However, exposure of the promoter to HeLa nuclear extract or to a mixture of isolated transcription factors prior to nucleosome assembly prevented nucleosome-mediated repression of the promoter. Inactivation or elimination of the TATA box-binding factor (TFIID) abolished the ability of these treatments to preserve promoter function. Preincubation with TFIID alone prevented repression and resulted in TFIID being sequestered into the nucleosome-assembled templates. Preincubation with all the transcription factors resulted in the assembly of nucleosome templates containing a near complete preinitiation complex, which required only the addition of TFIIE for transcription initiation. PMID- 3677171 TI - Differential 5S RNA gene expression in vitro. AB - In extracts derived from activated eggs of Xenopus, oocyte 5S RNA gene transcription complexes are destabilized under conditions where somatic 5S RNA gene transcription complexes are stable. Trans-acting factors in destabilized complexes are in equilibrium with free factors in the extract, and thus transcription becomes dependent upon the concentration of the limiting factor in the extract. By reducing TFIIIA, a limiting factor in the egg extract, a cloned somatic 5S RNA gene is transcribed as much as 400-fold more efficiently than a cloned oocyte 5S RNA gene. PMID- 3677172 TI - Purification and characterization of OTF-1, a transcription factor regulating cell cycle expression of a human histone H2b gene. AB - An octamer-binding transcription factor, OTF-1, which stimulates transcription of a human histone H2b gene, has been purified from HeLa nuclear extracts. This purification was achieved through the use of DNA affinity chromatography, and the factor was unambiguously identified by renaturation of activity following SDS polyacrylamide gel electrophoresis. The purified factor retained the ability to efficiently stimulate H2b transcription in a reconstituted in vitro system. This effect was dependent upon an intact octamer element and was observed in the absence of the other H2b promoter elements (except the TATA motif). Furthermore, this activity was not detected in nuclear extracts prepared from cells synchronized in G2, in agreement with the in vivo data showing S-phase-specific utilization of the octamer element. From these data, we conclude that we have purified the bona fide H2b transcriptional regulatory factor. PMID- 3677173 TI - Demonstration that a chemically synthesized BPV1 oncoprotein and its C-terminal domain function to induce cellular DNA synthesis. AB - Bovine papillomavirus type 1 contains the smallest known oncogene (ORF E5), encoding a hydrophobic 44 amino acid protein. To study the biochemical functions of the E5 oncoprotein, we have chemically synthesized it and several deletion mutant peptides. We demonstrate induction of cellular DNA synthesis in growth arrested cells by microinjection of E5 oncoprotein. This activity can be broken down into two functionally distinguishable domains. Remarkably, the first domain, which alone is sufficient to induce cellular DNA synthesis, contains only the C terminal 13 amino acids. This is the smallest known protein fragment that can autonomously activate cellular DNA synthesis. The second domain is the hydrophobic middle region, which by itself fails to induce cellular DNA synthesis but confers a 1000-fold increase in specific activity. The N-terminal one-third of the molecule is dispensable for induction of DNA synthesis. PMID- 3677174 TI - Neurofascin: a novel chick cell-surface glycoprotein involved in neurite-neurite interactions. AB - We have identified neurofascin, a novel chick cell-surface glycoprotein involved in neurite-neurite interactions. Neurofascin is defined by its reactivity with monoclonal antibody (MAb) F6, which detects two polypeptides (160 and 185 kd) in immunotransfers of brain plasma membrane proteins. Immunoaffinity chromatography using immobilized MAb F6 yields major molecular mass bands at 185, 160, 135-110, and 92 kd. Fingerprint analyses show that these polypeptides are related. Neurofascin is expressed primarily in fiber-rich areas of embryonic cerebellum, spinal cord, and retina. Fab fragments of polyclonal antibodies to neurofascin interfere with the outgrowth of retinal and sympathetic axons in two different in vitro bioassays. Neurofascin is immunologically distinct from other known neurite associated surface glycoproteins. PMID- 3677175 TI - Gap junctional communication and compaction during preimplantation stages of mouse development. AB - The ability of gap junction antibodies to block dye transfer and electrical coupling was examined in the compacted 8-cell mouse zygote. In control zygotes, Lucifer yellow injected into 1 cell transferred to the rest of the embryo. When antibodies raised against the major protein extracted from gap junctions were co injected with Lucifer yellow, dye transfer failed in 86% of the zygotes tested and electrical coupling was almost completely inhibited. Subsequently, the antibody-containing cells were extruded. When the antibodies were injected into 1 cell at the 2-cell stage, 82% of the zygotes divided normally to the 8-cell stage. Cells containing gap junction antibodies were uncompacted, but continued to divide. We conclude that these antibodies inhibit gap junctional communication in the early mouse zygote and that communication through gap junctions may be involved in the maintenance of compaction. PMID- 3677176 TI - Effect of heparin on membrane associated clathrin basketwork of cultured cells derived from the stromal-vascular fraction of mouse brown adipose tissue. AB - The effect of heparin treatment on clathrin basketwork of cell membranes was examined in cultured cells derived from the stromal-vascular fraction of neonatal mouse brown adipose tissue. The cytoplasmic surface of the plasma membrane of ruptured cells was examined with surface replicas. Heparin treatment significantly decreased the extent of clathrin basketwork associated with the membrane from 3.4 to 0.2%. The loss of clathrin basketwork suggests that heparin treatment of these cells affected intracellular sorting processes associated with endocytosis. PMID- 3677177 TI - Fatty acid acylation of proteins in Physarum polycephalum. AB - We have investigated the occurrence of protein-fatty acid acylation by metabolic incorporation of [3H]myristic and [3H]palmitic acids in Physarum polycephalum. We show that this organism contains fatty acylated proteins with mainly myristic acid covalently attached in alkali-stable linkages, probably amides. We find no evidence for ester-linked fatty acids, in contrast to the situation in vertebrate cells. PMID- 3677178 TI - Stimulation of Paramecium phagocytosis by phorbol ester and forskolin. AB - Phorbol ester (PMA) exerted a dose- and time- dependent stimulating effect on phagocytosis in axenic Paramecium aurelia. When cells were exposed to 200-800 nM PMA in the presence of latex beads, the phagocytic coefficient was enhanced 2.25 to 3.14 times, during 10 min of continuous treatment and then rapidly declined. A similar effect was observed when the cells were exposed to a forskolin treatment, which resulted in nearly a twofold increase in phagocytic activity after a 10 min pulse. Both PMA and forskolin strongly stimulated phagocytosis (i.e. fivefold and threefold, respectively) in cells in which such activity had been completely inhibited by pre-exposure to the beta-receptor antagonist 1-propranolol. PMID- 3677179 TI - Ultrastructural changes in acinar cells of hamster pancreas in chemically induced carcinogenesis. AB - Ultrastructural changes arising in the pancreas of the Syrian golden hamster after treatment with N-nitrosobis (2-oxopropyl) amine (BOP) were studied at short intervals. Alterations were found in acinar cells i.e. loss of zymogen granules, dilatation of granular endoplasmic reticulum, depolarization, irregular nucleus and separation of lateral surfaces (intermembranary spaces). As a result, the compact morphology of normal acini switched towards a new structure resembling a pseudo-ductule. Such alterations occurred from the 3rd month and preceded tumor formation. It is noteworthy that ducts and islets of Langerhans appeared unaltered in all instances. These results are consistent with the hypothesis that BOP induced pancreatic adenocarcinoma in hamsters originates in the acinar cell. PMID- 3677180 TI - Freeze-fracture electron microscopic observations on the effects of sulphydryl group reagents on human erythrocyte membranes. AB - Freeze-fracture electron microscopy of human red blood cells at pH 7.4 and 5.5 reveals the presence of membrane elevations (50-100 nm diameter). These are also observed after incubation of the erythrocytes with N-ethylmaleimide but not after incubation with p-chloromercuribenzene sulphonate. Neither of the sulphydryl group reagents affects the distribution or size of intramembrane particles. The findings are discussed in the light of the effects of mercurials on erythrocyte membrane proteins. PMID- 3677181 TI - Characterization of acidic actin in mouse sarcoma 180 cells. AB - Mouse sarcoma 180 cells have a polypeptide that has the same molecular weight as actin but it is more acidic than alpha-actin. Its tryptic peptide pattern on reversed-phase HPLC was very similar to that of beta + gamma-actin, an actin sample prepared by affinity chromatography on DNase I-Sepharose contained the acidic polypeptide, and monoclonal anti-actin antibody reacted with it; therefore, the polypeptide is considered an actin isoform. The mRNA for this variant actin was identified by analyzing the polypeptides translated in vitro, which indicated that the variant actin is not a post-translationally modified form of any known actin. The variant actin was not stained by polyclonal anti gizzard actin antibody which reacts with gamma-cytoplasmic, alpha-smooth and gamma-smooth muscle actins, nor by polyclonal anti-skeletal muscle actin antibody which reacts with skeletal, cardiac and alpha-smooth muscle actins. These results suggest that this variant actin is related to beta-cytoplasmic actin or, is a novel species whose N-terminal amino acid sequence is not Glu-Glu-Glu. PMID- 3677183 TI - [Initial experience with the social medicine specialty and the organization of health care]. PMID- 3677182 TI - Immunoelectron microscopic localization of dopamine beta-hydroxylase and chromogranin A in adrenomedullary chromaffin cells. AB - Dopamine beta-hydroxylase (DBH) was purified from bovine adrenal medullae. Rabbit IgG raised against DBH inhibited its activity by 80%. In an immunoblot analysis, the IgG specifically recognized two subunits of DBH the 72 and 75 KD components. Chromogranin A (CGA) also was purified from bovine adrenal medullae, and rabbit IgG against CGA recognized this chromogranin A in the immunoblot analysis. The intracellular distribution of DBH and CGA in bovine chromaffin cells was determined quantitatively by immunoelectron microscopy using post-embedding protein A-gold technique. DBH and CGA were localized exclusively on chromaffin granules. The binding of gold particles to these granules was saturable. The maximum number of gold particles bound to the granules roughly corresponded to the number of DBH or CGA molecules in the granules estimated biochemically. DBH was observed evenly in the periphery and in the dense matrix of the chromaffin granules. PMID- 3677184 TI - [Dispensary care]. PMID- 3677185 TI - [Illness and the family]. PMID- 3677186 TI - [How shall we proceed with the hospitalization of children?]. PMID- 3677187 TI - [Analysis of the relation between drug utilization and selected indicators. II]. PMID- 3677188 TI - [Health education in health care institutions]. PMID- 3677189 TI - [The nature of intra-articular and extra-articular localization of microcrystals in chondrocalcinosis]. PMID- 3677190 TI - Integrating quality assurance and risk management. PMID- 3677191 TI - New directions in home care quality assurance. PMID- 3677192 TI - Gene-dependent effect of lithium on circadian rhythms in mice (Mus musculus). AB - Lithium has been shown to lengthen free-running circadian periods in a variety of species. Here we show that lithium carbonate differentially lengthens the free running period of a circadian wheel running rhythm in BALB/CByJ and C57BL/10Sn inbred mouse strains. This result supports previous evidence that lithium lengthens mammalian circadian rhythms, and also demonstrates that gene differences can mediate individual differences in response to lithium treatment. PMID- 3677193 TI - Interindividual differences in the circadian hematologic time structure of cancer patients. AB - The complete hematologic blood cell count of 11 patients with advanced cancer were determined on 14 occasions, every 4 hr over 36-48 hr. Oral temperature was also measured at the same times as blood sampling. Five patients had breast cancer, five had ovarian cancer and one a leiomyosarcoma. Circadian rhythms were detected by the cosinor method for seven hematologic variables (red blood cells, hemoglobin, hematocrit, white blood cells, neutrophils, lymphocytes, platelets) and for oral temperature in the whole group of patients. All acrophases were located between 1300 and 1700 hr, except for lymphocytes (2100 hr). A rhythm with a period of 8 hr was validated for lymphocytes and monocytes. Validated or estimated amplitudes and acrophases were closely similar in both breast and ovarian cancer subgroups. Individual cosinor analyses documented large differences from patient to patient, which were accounted for by differences in performance status. Thus, subjects with poor performance status and rapidly progressive disease had very few validated rhythms as compared to those patients with good performance status. As a result a statistically significant correlation was found between the number of validated hematologic circadian rhythms and the performance status (r = -0.88; P less than 0.01). PMID- 3677194 TI - Cisplatin chronotherapy and disulfiram rescue reduce toxicity without interfering with anticancer activity: animal findings and preliminary clinical experiences. AB - Cisplatin-induced mortality and nephrotoxicity are each predictably worse when the drug is given at certain points within the circadian schedule. Oral disulfiram protects rats from toxic effects at some circadian stages but not others. This manuever does not diminish the anticancer activity of cisplatin in these rats. Human beings given 2 g of oral disulfiram and high doses of cisplatin at the circadian stage associated with least cisplatin nephrotoxicity (prospectively determined potassium excretion acrophase) suffer little or no kidney damage. Disulfiram administration apparently does not interfere with the antineoplastic activity of cisplatin in humans. This is the first demonstration of the feasibility of assignment of treatment time according to a measure of the patient's 'internal clock' as assessed by pretreatment marker rhythmometry. It also establishes the feasibility of giving disulfiram to human beings. PMID- 3677195 TI - Effect of imipramine on the circadian rhythm of plasma melatonin in unipolar depression. AB - The authors took a series of 20 serum samples over a 24-hr period for measurement of melatonin in four men and six women with Major Depressive Disorder (DSM-III), at baseline (depressed) and after 4 weeks on imipramine (150-200 mg/day) after achieving clinical remission. After successful treatment with imipramine, 24-hr secretion and peak levels of melatonin were significantly higher than at baseline, with no difference in time of peak level. Testing after 2 weeks of treatment (four subjects), with only a partial or no clinical response, revealed no differences compared with baseline. The therapeutic efficacy of imipramine may be associated with an enhancement of noradrenergic activity. PMID- 3677196 TI - Many circadian oscillators regulate developmental and behavioural events in the flesh-fly, Sarcophaga argyrostoma. AB - In the flesh-fly, Sarcophaga argyrostoma, the initiation of larval wandering, pupal eclosion, and the induction of pupal diapause by seasonal changes in night length, are all regulated by circadian oscillators. They differ, however, in several respects. The rhythm of larval wandering shows a free-running period (tau) of about 20 hr and a steady-state phase-relationship to the light cycle (psi) in which maximum activity occurs at dusk or in the night; that for pupal eclosion shows tau close to 24 hr and psi close to dawn; and that for diapause induction tau longer than 24 hr and a photoinducible phase (phi i) late in the subjective night. The three oscillators are, therefore, considered to be functionally separate. In addition, adult locomotor activity, the deposition of cuticular growth layers on thoracic apodemes, and the duration of larval wandering, are possibly regulated by further, distinct, oscillators. The circadian system in S. argyrostoma, therefore, contains at least three, and probably as many as six, known circadian pacemakers. PMID- 3677197 TI - Constant pharmacologic effect and chronopharmacology: theoretical aspects. AB - The theoretical drug infusion rates requisite to obtain a constant pharmacologic effect are determined taking into account chronopharmacologic phenomena. The introduction of chronopharmacology into pharmacokinetic theory leads to a clocktime-dependent infusion rate. The infusion modulation depends both on type of chronophenomenon, chronopharmacokinetics or chronestesy, and plasma clearance rate of the drug. In the presence of chronestesy of a biosystem the pharmacologic effect can be maintained constant only when plasma drug clearance is fast enough to allow an adequate modulation of the plasma drug concentration. Although the established equations proceed from theoretical concept they could be useful for programming drug delivery systems. PMID- 3677198 TI - Circadian modification of 5-fluorouracil-induced teratogenesis in mice. AB - Pregnant mice were treated intraperitoneally with 5-fluorouracil in a single dose of 30 mg/kg once on gestation day 11 at one of four selected times along the 24 hr time scale. All animals were kept under a lighting regimen of 12 hr (0600 1800) alternating with 12 hr of darkness. They were injected at the same circadian phase as they were mated. The developmental age of all fetuses was 264 +/- 1 hr at the time of injection. Fetuses collected on day 18 showed a circadian variation in teratogenic susceptibility to 5-fluorouracil. The lethal and teratogenic risk posed by the drug were highest among animals treated at the mid light period until the onset of darkness. PMID- 3677199 TI - The photoperiodic entrainment and induction of reproductive rhythms in male blackheaded buntings (Emberiza melanocephala). AB - Groups of photosensitive, unstimulated or stimulated, male blackheaded buntings were subjected to photoregimes of 15 hr of green light of three intensities and 9 hr of dark per day. In some groups green light was interrupted with 90 min of bright fluorescent light at different times in the subjective day. While gonads did not develop or regressed in some groups, birds in others behaved as if exposed to long daylengths. The results besides suggesting the involvement of endogenous circadian rhythm during initiation and maintenance of gonadal growth indicate that the reproductive rhythms are entrained and induced by environmental photoperiod. PMID- 3677200 TI - Interactions between inter-individual and inter-task differences in the diurnal variation of human performance. AB - Thirty-six undergraduate subjects were divided into 'larks' and 'owls' by median split using the morningness test devised by Horne and Ostberg. Each was given a battery of two performance tests at six times of day, in a design that counter balanced for practice effects. Oral temperatures were also recorded. Slight (1 hr) phase differences (in the predicted direction) were observed between 'larks' and 'owls' in temperature rhythm, and in the performance test that paralleled temperature (a serial search task). Much more striking differences, though, were observed in the cognitive (logical reasoning) performance test which (as predicted) peaked earlier in the day, on average, than the serial search task. Not only did 'larks' peak much earlier in the day than 'owls', but there were also quite dramatic differences between the two groups in amplitude and shape. Possible mechanisms regarding oscillatory control and performance strategy are discussed. PMID- 3677201 TI - Erythrocyte sedimentation rate of healthy subjects--chronological aspects. AB - Thanks to an elaborated mathematical approach, based on statistics and signal processing, the chronological changes of the Erythrocyte Sedimentation Rate (ESR) of young healthy subjects, considered from a collective point of view, have been discriminated into genuine and well-defined rhythms. These rhythms are tied up either to natural (year, season) or 'social' (month, week, holidays) cycles, or to some other causes, still unknown and possibly intrinsic (such is probably the case of a 26.5-day strongly marked period). The solar induced time variation strictly obeys a frequency modulation law, the relative amplitude of which is 10 per cent. Two axes of symmetry are found, centered on 8 August and 8 February. The rhythm is roughly in accordance with seasons. The modulation frequency is maximum at summer time. Oscillations of the ESR are observed during the week and the month. Fridays and the last fortnight of each month appear to be low ESR time. PMID- 3677202 TI - Circadian characteristics of urinary epinephrine and norepinephrine from healthy young women in Japan and U.S.A. AB - Clinically healthy diurnally active young adult women were studied during the same season (March) at the Universities of Kyushu (Fukuoka City, Japan) and of Minnesota (Minneapolis, U.S.A.), under comparable conditions, except that the habitual diets were not changed. The subjects (20 Japanese and 16 Americans of mixed Caucasian background) were studied over a single 24-hr span. Urine was collected at 4-hr intervals. A circadian rhythm in total urinary norepinephrine excretion showed similar characteristics in Japanese and Americans. In epinephrine excretion, the Japanese women showed a statistically significantly higher amplitude with higher peak values, but no statistically significant difference in the rhythm-adjusted mean. This intergroup difference is strictly time dependent; it does not come to the fore in urine samples covering the nocturnal rest span of the subjects. PMID- 3677203 TI - The circadian rhythm of plasma thyrotropin in depression and recovery. AB - The 24-hr patterns of plasma thyrotropin have been observed in 12 endogenous depressed patients in both depressed and recovered states and in 13 normal subjects. A clear circadian rhythm was detected in controls with high values at night. In depression, the circadian rhythm was altered with amplitude reduction and blunted nocturnal secretion, abnormalities particularly relevant in bipolar patients. This flattened profile could be linked to the blunted response of TSH to TRH administration reported in depressed patients. Normal nyctohemeral patterns have been restored after recovery. These chronobiological abnormalities as well as their normalization under antidepressant drugs seem to be similar to those reported for various parameters (e.g. temperature, cortisol, etc) in depression which could support the chronobiological hypothesis for affective disorders. PMID- 3677205 TI - Circadian rhythm in mammary cytoplasmic estrogen receptor content of Balb/C female mice with and without pituitary isografts. AB - Cytoplasmic estrogen receptors were determined by the dextran-coated charcoal method in inguinal breast tissue of three groups of Balb/C female mice 6-8 weeks following subcutaneous implantation into the intact animals of three pituitary glands and three pieces of skeletal muscle (group I), three pituitary glands and three segments of hypothalamic tissue (group II), or three pieces of skeletal muscle (group III) obtained from animals of the same inbred strain as control. A circadian rhythm in estrogen receptor content was statistically quantified by cosinor analysis in the muscle implanted control and the pituitary and hypothalamic implant groups. In the pituitary and muscle implant group the circadian rhythm is of borderline significance with a P-value between 0.05 and 0.10. The timing (acrophase) and extent of change (amplitude) are similar in all three treatment groups. The average receptor content (MESOR) in the two pituitary implanted groups, which in previous studies were shown to have an increased breast cancer incidence is about twice that of the control group. The reduction in the pituitary induced breast cancer rate by hypothalamic tissue addition to a cancer incidence between the animals with pituitary and muscle isograft and the mice carrying no pituitary at all has also been shown previously in this strain of mice and is not reflected in receptor content. PMID- 3677204 TI - Circadian rhythm of hepatic cytosolic and nuclear estrogen receptors. AB - The distribution of estrogen receptor between the cytosolic and nuclear compartments were evaluated in liver of male rats to determine whether a circadian rhythm exists. Cytosolic receptor reached a maximum level at 400 hours and a minimum at 2000 and 2400 hr. Nuclear receptor reached a maximum level at 800 hr and was lowest at 1600 and 2000 hr. Serum estradiol levels were also highest at 800 hr and lowest at 1600 hr. The variations in cytosolic and nuclear receptors are not reciprocal; in fact, the overall content of receptor in the liver is not constant and also displays a circadian rhythm. PMID- 3677206 TI - The effects of various lighting schedules upon the circadian rhythms of 23 liver or brain enzymes of C57BL/6J mice. AB - The activities of 23 brain or liver enzymes were studied in 5-6 week old C57BL/6JNctr male and female mice that had been fed ad libitum and standardized for 2 weeks to either (1) 12 hr of light (0600-1800) alternating with 12 hr of darkness (1800-0600) (LD 12:12), (2) staggered sequences of 12 hr of light and 12 hr of dark (SLD 12:12) or (3) continuous illumination (LL 12:12) for 2 weeks. Mice in the LD 12:12 and LL 12:12 experiments were killed at 4 hr intervals along a 24-hr span in order to sample at six different circadian stages. Lighting schedules for mice in the SLD 12:12 experiment were organized such that six different circadian stages were sampled when all mice were killed at one time of day. All 23 enzymes demonstrated a prominent circadian rhythm in at least one of the experiments. Moreover, about two-thirds of the enzymes in LD and SLD 12:12 had a statistically significant fit to a 24-hr cosine curve, while only one-third of the enzymes in LL 12:12 had significant fits to cosine curves. Peak activities of enzymes from mice in LD 12:12 were clustered at the time of transition from light to dark. This was also the trend for the activities of enzymes from mice in SLD 12:12, but resynchronization did not appear completed within the 2-week span. This, along with the observation that mesors (mean 24-hr activity) were reduced and amplitudes altered, indicated that the 2-week standardization period was not sufficient for some enzymes. Times of peak activities, mesors and amplitudes were affected for most enzymes from mice in the LL 12:12 environment. This suggests that individual mice became desynchronized from one another with respect to the original light-dark schedule and that rhythms were altered or lost because individual mice were free running with frequencies different from 24 hr. PMID- 3677207 TI - Synchronization of the circadian activity rhythm in hamsters following intermittent schedule shifts. AB - The time course of resynchronization of the circadian activity rhythm of hamsters was observed following a 10-hr advance or delay in the light-dark cycle (LD 12:12). Twenty-six shift patterns of the lighting schedule were studied; they consisted of continuous (daily), three-step, two-step and one-step shifting. So long as the daily shift of the lighting schedule was 1 hr or less, the locomotor rhythm followed the continuous shift perfectly. As the amount of daily shift increased, the time course of activity onset deviated more from the time of lights off; the tendency was more marked in advancing than in delaying shifts. Responses of the activity rhythm to stepwise shifting were essentially the same as those to a continuous shift. They were, however, characterized by larger individual variations, and it took additional days before entrainment was achieved. By fitting the time course of entrainment to an exponential model with a constant term, estimates of time constant and shift error were derived. The time constant became shorter with increasing amounts of daily shifts up to 2 hr per day, increasing the number of shift steps, and/or reducing the amount of the initial shift of the seies. The shift error estimated was 0.51 +/- 0.12 hr, indicating precise resynchronization. Accordingly, a quicker resynchronization may be expected when a multiple step shift with a moderate initial shift are employed. In the case of a 10-hr shift, for example, a shift of 3 hr followed by another 7 hr may be recommended. PMID- 3677208 TI - Diurnal variation in subjective and objective measures of sleepiness: the effects of sleep reduction and circadian type. AB - In young, good sleepers the diurnal evolution of alertness was studied as a function of degree of morningness: (1) during habitual sleep routine and (2) in a 2-hr sleep reduction protocol. During habitual sleep routine, alertness was assessed using both the subjective evaluation based on Thayer's Activation Deactivation Adjective Checklist (43 subjects) and the objective measurement of sleep latency (Multiple Sleep Latency Test, MSLT). Self-alertness scored highest around midday. Later it showed a dip, then stayed on a plateau until about 2200 hr. On average, 77% of the subjects fell asleep at the 1400 hr MSLT session while only 35.5% did at 1000 hr and 25.8% at 2000 hr. Morning-types (MT) and evening types (ET) differed only during the morning: ET fell asleep more frequently at 1000 hr and 1200 hr and rated lower self-alertness on arising than did MT. Twelve subjects were given the protocol of a 2-hr sleep reduction (both in delayed bedtime and advanced rising time conditions). At 0700 hr, MT rated their alertness lower when they had only just gotten up (delayed bedtime condition) than when they had been awake for 2 hr (advanced rising time condition). In contrast, ET had the same low level of alertness at 0800 hr, independent of the time elapsed since arising. On average the advanced rising time condition affected the general pattern of alertness more than did delayed bedtime. PMID- 3677209 TI - Peak amplitude and frequency of urinary free cortisol excretion in patients with a history of major depressive disorder. AB - Seven male recovered depressive patients who were dexamethasone suppression test (DST) nonsuppressors while ill and eight male controls submitted an average of thirty-six 24-hr urine specimens for analysis during a 12-mo collection period. Recovered depressive patients had a significantly greater mean peak amplitude (mean distance from fitted regression line to the highest point on the peak) when compared to controls. Peak frequency (number of peaks per year) for recovered depressive patients for peaks greater than 30 micrograms/g-cr was three times that found in the control population. The number of collections by each patient did not account for these differences. Only one of seven recovered depressives had a circasemiannual rhythm of cortisol excretion while none demonstrated a seasonal rhythm. These findings suggest that patients with a history of depression and DST nonsuppression have greater variability in cortisol excretion than a control population while in the compensated state. PMID- 3677210 TI - Chronobiology and ulcerogenesis. PMID- 3677211 TI - Chronobiology and ulcerogenesis. PMID- 3677212 TI - Circadian rhythm of gastric acid secretion in active duodenal ulcer: chronobiological statistical characteristics and comparison of acid secretory and plasma gastrin patterns with healthy subjects and postvagotomy and pyloroplasty patients. AB - Twenty-one male patients with active duodenal ulcer underwent hourly 24-hr gastric acid collections under controlled, calorically deprived conditions. The 24-hr hourly acid secretory output for the group displayed a statistically significant (p less than 0.001) rhythm, with peak rates occurring during the evening hours and low rates during the early morning hours, by population-mean cosinor statistical analysis. Population-mean cosinor analysis also verified the occurrence of a significant (p = 0.034) circadian rhythm in unstimulated acid secretion in a group (N = 14) of healthy male subjects similarly studied and reported previously. In contrast, population-mean cosinor analysis confirmed the absence of any detectable circadian rhythm in unstimulated acid secretion in a group (N = 17) of postvagotomy and pyloroplasty patients studied 2-11 years after surgery. Population-mean cosinor analysis of 4-hr plasma gastrin determinations, obtained in all groups during the 24-hr gastric acid collection, revealed an absence of any detectable circadian rhythm in plasma gastrin. This latter finding is compatible with the interpretation that the circadian rhythm of unstimulated gastric acid secretion, observed in the clinically healthy and active ulcer groups, is unrelated to changes in plasma gastrin levels. The employment of quantitative chronobiological inferential statistical techniques is important to the analysis of any time-dependent measurement in gastrointestinal function, of which gastric acidity is one example. PMID- 3677213 TI - Day and night aspirin-induced gastric mucosal damage and protection by ranitidine in man. AB - The severity of gastric mucosal injury produced by aspirin (ASA) was endoscopically assessed during morning and evening studies in 10 healthy, male volunteers. In a randomized, double-blind design, subjects received either ASA (1300 mg) alone or ASA (1300 mg) plus Ranitidine (150 mg) or placebo tablets during morning and evening studies. Each subject had 3 morning and 3 evening studies. The severity of damage produced by ASA was assessed by counting the number of punctate mucosal hemorrhages observed in the gastric antrum and low body. This study demonstrated (1) wide intersubject variability in the severity of damage produced by ASA (range of 47-1030 lesions/subject in morning studies), (2) significant protection against ASA-induced damage by Ranitidine and (3) significantly greater damage produced by ASA in the morning compared to the evening studies. Because evening acid secretory rates are higher and because ASA induced damage is believed to be acid-dependent, this last observation was unexpected. It suggests mucosal resistance is higher in the evening and raises the possibility that there may be circadian variation in gastric mucosal resistance. PMID- 3677214 TI - Circadian rhythmicity of acid secretion and electrical function in intact and injured rat gastric mucosa--the relation of timing to ulcerogenesis. AB - Alteration of electrical function in mammalian gastric mucosa is considered as an indicator of gastric barrier rupture. Measurements of transmucosal potential difference (PD) and electrical resistance (R) have documented such alterations to a variety of mucosal damaging agents. This study was designed to test whether the rat gastric mucosa exhibits circadian rhythms in acid secretion and electrical function and whether the damage produced by a mucosal acting agent (butyric acid) is also circadian-stage dependent. Mucosa was isolated from the gastric body of male rats standardized from birth to a light-dark regimen. Circadian rhythms of acid secretion and PD and R with acrophases during the dark hours were documented. Administration of butyric acid produced circadian-stage dependent damage with an acrophase also during the dark-phase span. Thus, in this experimental model, measurements of electrical function represented a poor index of gastric mucosal susceptibility to damaging agents. The authors discuss the possibility that rhythms other than those related to electrical function may better define mucosal vulnerability to ulcerogenesis. PMID- 3677215 TI - Small bowel and plasma gastrin rhythms in cats. AB - The purpose of this experiment was to study the possible role of the gastric antrum and small bowel in the rhythm(s) of plasma gastrin. The cat was used as the laboratory animal. Three groups of cats were provided with a gastric fistula for the study of gastric acid and plasma gastrin rhythms. The first group (N = 7) served as controls. A second group (N = 3) was antrectomized and later subjected to a 80% small bowel resection. Gastric acid secretions were collected every 30 min from 0800 to 2400. Blood samples for determination of gastrin were drawn every 2 hr from 0800 to 2400. In control animals a circadian (i.e. approximately 24 hr) and 3 ultradian (i.e. less than 24 hr) rhythms were detected for acid output. In the antrectomized cats, circadian and ultradian rhythms were documented. After small bowel resection circadian and ultradian rhythms in gastric acid secretion were observed. For plasma gastrin, circadian and ultradian rhythms were found in the control cats. In the antrectomized cats no rhythms were observed. After small bowel resection an ultradian rhythm reappeared in these antrectomized cats. Removal of the antrum in the cat induces disappearance of circadian and ultradian rhythms of plasma gastrin but fails to modify the acid rhythms. Small bowel resection results in the reappearance of an ultradian rhythm for plasma gastrin and a shift in acrophase for the circadian rhythm in acid secretion. PMID- 3677216 TI - Circadian rhythm-adapted theophylline schedules for asthma. PMID- 3677217 TI - Steady state pharmacokinetics, metabolism and pharmacodynamics of theophylline in children after unequal twice-daily dosing of a new sustained-release formulation. AB - This was an open-label study in 19 children aged 9-13 years, weighing 27-44 kg, with bronchial asthma. Twenty-four-hour steady-state concentrations of theophylline and its metabolites 1,3-dimethyl uric acid, 3-methyl xanthine and 1 methyl uric acid were assessed after daily dosing of 600 mg (ca 18 mg/kg/day) of the sustained-release theophylline micro-pellet sprinkle system BY158K, for 4 days. The dosing regimen used was an unequal twice-daily dose of 200 mg in the morning after breakfast and 400 mg in the evening after dinner. Twenty-four-hour peak expiratory flow (PEF) profiles were compared before treatment and at steady state, along with lung function parameters after bronchial provocation. Mean values +/- SD (n = 16) of the steady-state characteristics were Cmin 6.8 +/- 2.1 mg/l, Cmax 14.5 +/- 4.8 mg/l and Cav 10.5 +/- 2.9 mg/l, the plateau time was 11.7 +/- 4.8 hr and peak-trough fluctuation and swing were 72 +/- 21 and 118 +/- 52%, respectively. There was an excellent reproducibility of theophylline pre-dose levels at corresponding time points of the 24-hr sampling period [r = 0.864 (p less than 0.001)]. Mean values +/- SD of the 24 hr average serum metabolite levels were 0.9 +/- 0.2 mg/1 for 1,3-dimethyl uric acid, 0.6 +/- 0.1 mg/1 for 3 methyl xanthine and 0.4 +/- 0.1 mg/1 for l-methyl uric acid. Lung function (n = 17) following bronchial provocation, improved in 10 children after theophylline treatment of 4 days, remained stable in 2 patients and deteriorated in 5 patients. Serum theophylline profiles and PEF profiles ran largely in parallel over the 24-hr period. Six children exhibited typical theophylline induced side effects, headache (n = 3), nausea (n = 4), dizziness (n = 1), vomiting (n = 4), sleep disturbances (n = 1), pallor (n = 1) and tremor (n = 1), necessitating in 3 children one dose omission/reduction (n = 2) or subsequent dose reduction (n = 1). It has been shown that a twice daily dosing regimen with unequal doses of anhydrous theophylline (BY158K) is well suited to this population of fast metabolisers. The patients were well protected throughout the day, including the critical early morning hours. PMID- 3677218 TI - NMR spin-lattice relaxation times of intracellular Na-23 on rat livers and related lipid peroxidation following CCl4 intoxication. AB - Liver tissues were isolated from rats acutely intoxicated with carbon tetrachloride, and Na-23 NMR signals were analyzed to investigate the T1 relaxation times of intracellular sodium ions under pathological conditions in presence of the paramagnetic shift reagent (dysprosium tripolyphosphate). We studied the significant increase of T1 found in CCl4 treated rats with respect to controls, which was elsewhere demonstrated as being independent of cell necrosis. Evidence is given that neither fat accumulation nor proliferative processes affect the observed T1 lengthening. When T1 relaxation times were measured in the liver of vitamin E treated rats subsequently intoxicated with carbon tetrachloride, a significative shortening of T1 with respect to CCl4-intoxicated rats was observed. These results were discussed in terms of the antioxidant action exerted by vitamin E, taking into account that peroxidation of microsomal lipids is the key factor in the process of carbon tetrachloride induced liver injury. Furthermore, the observed T1 changes were discussed in terms of the interactions of Na+ with cell membranes and/or the occurrence of viscosity changes. PMID- 3677219 TI - Identification of metabolites of benzo[j]fluoranthene formed in vitro in rat liver homogenate. AB - The metabolites of benzo[j]fluoranthene (BjF) as formed in vitro using the 9000 X g supernatant from Aroclor-pretreated rats have been identified. Two dihydrodiols, trans-4,5-dihydro-4,5-dihydroxyBjF and trans-9,10-dihydro-9,10 dihydroxyBjF have been identified as major metabolites by comparison of their spectral and chromatographic properties with those of pure synthetic standards. There was no evidence that any of the isomeric 2,3-dihydrodiol was formed as a metabolite of BjF under these incubation conditions. Neither of the metabolic dihydrodiols of BjF were formed with a high degree of stereoselectivity. The enantiomeric purity of the 4,5-dihydrodiol was 20% while that of the 9,10 dihydrodiol was 46%. At least four phenols were detected among the metabolites of BjF. These were identified as 3-, 4-, 6- and 10-hydroxyBjF based upon comparison of their UV spectra and HPLC retention times with those of synthetic reference standards. BjF-4,5-dione was also identified as a metabolite under these incubation conditions. PMID- 3677220 TI - The relationship between the effects of drugs on bilayer stability and on protein kinase C activity. AB - A variety of substances of diverse structure have been shown to affect the activity of protein kinase C. Many of the agents which affect protein kinase C activity also markedly shift the bilayer to hexagonal phase transition temperature of phosphatidylethanolamines. Although one of the more potent activators of protein kinase C, diacylglycerols, are effective destabilizers of the bilayer phase of membranes, this is not a general property of all protein kinase C activators nor are inhibitors of this enzyme bilayer stabilizing agents. However, if we consider only compounds which are uncharged or are zwitterionic, then those which promote the conversion of phospholipid bilayers to the hexagonal phase are all activators of protein kinase C, while those which stabilize the bilayer phase are protein kinase C inhibitors. Among charged substances, all of those which are negatively charged are activators of protein kinase C, while all of the positively charged compounds are protein kinase C inhibitors. PMID- 3677221 TI - HRP-catalyzed bioactivation of carcinogenic hydroxamic acids. The greater reactivity of glycolyl- versus acetyl-derived hydroxamic acids. AB - An analysis of the hydroxamic acid oxidation reaction by H2O2 and horseradish peroxidase (HRP) was made with three pairs of hydroxamic acids. Each pair consisted of the aceto- and glycolhydroxamic acid derivatives from one of three different arylhydroxylamines. The parent arylhydroxylamines were the known carcinogens, N-hydroxy-2-aminofluorene and N-hydroxy-4-aminobiphenyl and the noncarcinogen 4-chlorophenyl-hydroxylamine. All the hydroxamic acids appeared to be converted to products that were expected on the basis of the previously proposed mechanism of this peroxidative reaction. Each acetohydroxamic acid gave the corresponding nitroso compound and O-acetyl ester of the starting material in approximately equal amounts. The glycolhydroxamic acids gave the corresponding nitroso compound and a relatively unstable product that was proposed, by analogy, to be the O-glycolyl ester of the starting material. A comparison of the initial rates of reaction of each hydroxamic acid pair showed that the glycolhydroxamic acid was much more susceptible to the peroxidation reaction than was the corresponding acetohydroxamic acid. The initial rate of the reaction was also highly dependent upon the nature of the aromatic ring in the order fluorene greater than biphenyl greater than 4-chlorophenyl. The relative degree of HRP catalyzed covalent binding to DNA of the aceto- and glycolhydroxamic acids in the fluorene series was studied and found to parallel the relative rates of reaction of these substrates in the H2O2/HRP system. It was proposed that glycolhydroxamic acids are likely to be more genotoxic than are acetohydroxamic acids when subjected to peroxidative bioactivation conditions. PMID- 3677222 TI - Electron microscopic visualization of DNA single strand breaks. AB - DNA single strand breaks (ssb) have been induced in FLC/C cells in culture. They have been visualized in the electron microscope after decoration with biotin avidin-ferritin complexes and spreading as monomolecular mixed films. This allowed one to determine the average number of decorated ssbs per unit of DNA length applying straight-forward and simple evaluation methods. This method has been used to investigate the DNA alterations by benzo[a]pyrene (B[a]P) on FLC/C culture cells. Thus a B[a]P-DNA damage curve can be constructed as a regression with a correlation coefficient of r = 0.97, while its isomer benzo[e]pyrene (B[e]P) known to have only low mutagenicity under the same experimental conditions is virtually without effect. The method has further informational potential regarding damage distribution and repair of DNA. PMID- 3677223 TI - Nitration of 3-acylindoles in the presence of metal MeCN solvates and synthesis of the antibiotic alkaloid chuangxinmycin. PMID- 3677224 TI - Inhibitors of the arachidonate cascade from Allium chinense and their effect on in vitro platelet aggregation. PMID- 3677225 TI - Inhibitors of prostaglandin biosynthesis from Mucuna birdwoodiana. PMID- 3677227 TI - Chemical synthesis of deoxyribonucleotide with a 5'-phosphoryl group on a polystyrene polymer support by the phosphotriester method. PMID- 3677226 TI - New methods and reagents in organic synthesis. 69. A new synthesis of alpha-amino acid and peptide amides of aromatic amines using a modified Curtius reaction with diphenyl phosphorazidate. PMID- 3677228 TI - Benzylpiperazine derivatives. I. Syntheses and biological activities of 1-(2,3,4 trimethoxybenzyl)piperazine derivatives. PMID- 3677229 TI - Benzylpiperazine derivatives. II. Syntheses and cerebral vasodilating activities of 1-[(3-alkyl-3-hydroxy-3-phenyl)propyl]-4-benzylpiperazine derivatives. PMID- 3677230 TI - Benzylpiperazine derivatives. III. Quantitative structure-cerebral vasodilating activity relationships of 1-benzyl-4-(3-hydroxy-3-phenylpentyl)piperazine derivatives. PMID- 3677231 TI - Studies on alpha 2-plasmin inhibitor fragment T-11. I. Synthesis of the protected hexadecapeptide ester corresponding to positions 11 through 26 of alpha 2-plasmin inhibitor fragment T-11. PMID- 3677232 TI - Studies on alpha 2-plasmin inhibitor fragment T-11. II. Synthesis of the entire amino acid sequence of alpha 2-plasmin inhibitor fragment T-11. PMID- 3677233 TI - Studies on alpha 2-plasmin inhibitor fragment T-11. III. Structure-activity relationships among the fragments of T-11, the plasminogen binding site(s) of human alpha 2-plasmin inhibitor. PMID- 3677234 TI - Synthesis and pharmacological activities of 3-phenyl-2-(1-piperazinyl)quinolines and related compounds. PMID- 3677235 TI - Synthesis of 2-phenylthiazolidine derivatives as cardiotonic agents. IV. Modification of the phenylpiperazino moiety of 2 (phenylpiperazinoalkoxyphenyl)thiazolidine-3-carboth ioamides and the corresponding carboxamides. PMID- 3677236 TI - Synthesis of 1,2,3,4-tetrahydro-beta-carboline derivatives as hepatoprotective agents. I. Dithiocarbamates of several alpha-amino acids. PMID- 3677237 TI - Mutagenic principles in Sinomeni Caulis et Rhizoma. I. The structure of a mutagenic alkaloid, N-demethyl-N-formyldehydronuciferine, in the neutral fraction of the methanol extract. PMID- 3677238 TI - Studies on crude drugs effective on visceral larva migrans. I. Identification of larvicidal principles in betel nuts. PMID- 3677239 TI - Selective measurement of hepatic triglyceride lipase and lipoprotein lipase in rat postheparin plasma with pentachlorophenol and dichlorodiphenyltrichloroethane. PMID- 3677240 TI - Studies on synthesis of 3-O-alkyl-D-glucose and 3-O-alkyl-D-allose derivatives and their biological activities. PMID- 3677241 TI - Improvement in percutaneous absorption of prednisolone by beta- and gamma cyclodextrin complexations. PMID- 3677242 TI - Infusion rate-dependent positive inotropic action of ouabain in rabbits. PMID- 3677243 TI - Percutaneous absorption of indomethacin from mixtures of fatty alcohol and propylene glycol (FAPG bases) through rat skin: effects of fatty acid to FAPG base. PMID- 3677244 TI - Application of synthetic liposomes based on acyl amino acids or acyl peptides as drug carriers. I. Their preparation and transport of glutathione into the liver. PMID- 3677245 TI - Glassy state of pharmaceuticals. II. Bioinequivalence of glassy and crystalline indomethacin. PMID- 3677246 TI - Coating of pharmaceutical powders by fluidized bed process. I. Aqueous enteric coating with methacrylic acid-ethylacrylate copolymer and the dissolution behavior of products. PMID- 3677247 TI - Possible eye-irritant test using polysaccharide-coated liposomes as a corneal epithelium model. PMID- 3677248 TI - Metabolism of thiabendazole and teratogenic potential of its metabolites in pregnant mice. PMID- 3677249 TI - Antitumor principles from Ginkgo biloba L. PMID- 3677250 TI - Diterpene glycosides from leaves of Chinese Rubus chingii and fruits of R. suavissimus, and identification of the source plant of the Chinese folk medicine "fu-pen-zi". PMID- 3677251 TI - Preparation and evaluation of fatty acid esters of fluorescent p-substituted phenols as substrates for measurement of lipase activity. PMID- 3677252 TI - Determination of dibucaine and its metabolites in human urine by high-performance liquid chromatography with fluorescence detector. PMID- 3677253 TI - Nasal absorption of nifedipine from gel preparations in rats. PMID- 3677254 TI - Preparation of controlled-release granules of sodium diclofenac. PMID- 3677255 TI - Effect of solvents on the permeation of nicardipine hydrochloride through the hairless rat skin. PMID- 3677256 TI - Photochemical synthesis of antitumor platinum pyrimidine greens; possible contribution of singlet oxygen. PMID- 3677257 TI - Acute insecticidal activity of quassin and its congeners against the American cockroach. PMID- 3677258 TI - [Experience in carrying out primary nursing with special emphasis on the critical care unit]. PMID- 3677259 TI - [Nursing care of swelling of the neck after thyroidectomy]. PMID- 3677261 TI - [Experience in the nursing of 2 infants of very low birth weight]. PMID- 3677260 TI - [Prevention of common peroneal nerve injury caused by lithotomy position]. PMID- 3677262 TI - [Use of the hand splint]. PMID- 3677263 TI - [Traditional Chinese medical nursing for aged patients]. PMID- 3677264 TI - [Safe administration of drugs in elderly patients]. PMID- 3677265 TI - [Ethical dilemmas for nurses]. PMID- 3677266 TI - [Notes in editing video tapes for nursing education]. PMID- 3677267 TI - [Clinical effect of primary nursing and functional nursing]. PMID- 3677268 TI - [Pre-and post-operative care of patients with Budd-Chiari syndrome]. PMID- 3677269 TI - [Tracheal intubation for emergency patients]. PMID- 3677270 TI - [Care of patients suffering from acute gasoline poisoning and chemical burns]. PMID- 3677271 TI - [Observation on the patient's consciousness, pupils and breath in cases of cranial injuries]. PMID- 3677272 TI - [Manifestation of unhealthy psychological states in the aged with laryngeal cancer and nursing measures]. PMID- 3677273 TI - [Opinions on writing a nursing history of the patient treated by Chinese traditional medicine]. PMID- 3677275 TI - [Exploration of the thinking mode of nursing]. PMID- 3677274 TI - [Care of the airway in older patients with respiratory failure: report 60 cases]. PMID- 3677276 TI - The dilemma of the epidural test dose. PMID- 3677277 TI - Electrocardiographic changes during and after isoflurane-induced hypotension for neurovascular surgery. AB - We evaluated the effects of isoflurane anaesthesia and induced hypotension in 33 neurosurgical patients by electrocardiographic monitoring and serial cardiac enzyme measurements. An electrocardiogram (ECG) and serum enzymes were obtained preoperatively, intraoperatively and postoperatively in the recovery room and for three consecutive days. ECG leads II, V1 and V5 were monitored continuously during anaesthesia. Patients who had had a subarachnoid haemorrhage and a high incidence of abnormal preoperative ECG (42 per cent). Ten patients developed ECG changes intraoperatively, but these changes were unrelated to isoflurane-induced hypotension. Fifty-three per cent of patients developed an abnormal postoperative ECG. These abnormalities consisted mostly of nonspecific ST segment or T wave changes. At no time was there an elevation in cardiac enzyme activity. We found that nonspecific ECG changes are relatively common in patients undergoing vascular neurosurgical procedures. There was no enzymatic evidence of myocardial infarction and we can only speculate that these ECG changes are related to intracranial surgical manipulation. PMID- 3677278 TI - Accelerated onset and delayed recovery of d-tubocurarine blockade with pancuronium in infants and children. AB - The effect of age on the onset and duration of action of a d-tubocurarine (DTC) neuromuscular blockade with and without pancuronium priming in children was examined. Sixty ASA physical status I or II patients in three age ranges (0-1 yr, 1-3 yr and 3-10 yr) were anaesthetized with thiopentone, halothane and nitrous oxide. Each patient received either a single paralyzing dose of DTC 0.4 mg.kg-1, or DTC 0.36 mg.kg-1 preceded three minutes earlier by pancuronium 0.007 mg.kg-1. Evoked force of contraction of the adductor pollicis was measured using train-of four stimulation applied every 12 sec. Time to 90 per cent first twitch depression after a single dose of DTC increased with increasing age (r = 0.65, p less than 0.01), and was 1.6 min (SEM +/- 0.3) in the 0-1 yr group, 1.9 +/- 0.3 min (1-3 yr), and 5.2 +/- 1.2 min (3-10 yr). Time to ten per cent spontaneous recovery after single dose DTC was shorter in older individuals (r = 0.40, p less than 0.05), being 36.4 +/- 5.1 min in infants 0-1 yr, 30.6 +/- 4.6 min (1-3 yr), and 24.0 +/- 2.7 min (3-10 yr). Priming with pancuronium accelerated the onset significantly in all age groups with 90 per cent T1 depression occurring at 0.7 +/- 0.1 min (0-1 yr), 0.9 +/- 0.1 min (1-3 yr), and 2.1 +/- 0.6 min (3-10 yr). However, priming delayed recovery, especially in infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677279 TI - Sodium citrate in paediatric outpatients. AB - To determine whether the gastric content pH of paediatric patients could be raised in an effort to decrease post-aspiration morbidity and mortality, the antacid sodium citrate (0.4 ml.kg-1) was given preoperatively to 25 patients aged 1 to 14 (6.0 +/- 3.5, mean +/- SD) years. Their gastric content pH was measured following induction of anaesthesia. These values were compared to those obtained from a control group (n = 20) ranging in age from seven months to nine (3.3 +/- 2.7) years. A gastric content pH value of greater than 2.5 was measured in 23 of the 25 patients who received sodium citrate. There were only two patients in the control group with a gastric content pH greater than 2.5, p less than 0.001, Fisher exact test. Only one child refused to take the medication. The administration of sodium citrate appears to be an effective method of raising the gastric content pH in paediatric patients. PMID- 3677280 TI - Effect of chlorpromazine on drug absorption and gastric emptying in man. AB - In a double-blind study the effect of a single IV dose (25 mg) of chlorpromazine on gastric emptying, as determined by the rate of paracetamol absorption, was measured in seven healthy volunteers. Each volunteer acted as his/her own control. There was no significant difference between the maximum paracetamol concentration, the time to reach the plasma maximum concentration, and the area under the plasma concentration time curve from 0-120 minutes on the two occasions, indicating unchanged gastric emptying after administration of chlorpromazine. PMID- 3677281 TI - Comparison of lidocaine hydrocarbonate, lidocaine hydrochloride and mepivacaine in the axillary block. AB - Axillary block was performed on 60 patients undergoing various types of surgical procedures on the upper limb. The patients were divided randomly into three equal groups of 20 and received lidocaine hydrocarbonate 1% or lidocaine hydrochloride 1% or mepivacaine 1%, each solution containing epinephrine 1/400,000. A double blind design was used. Lidocaine hydrocarbonate and lidocaine hydrochloride were both found to have a shorter latency of analgesia than mepivacaine. Duration of analgesia, quality of the sensory and motor block were not found to be statistically different between the three groups. PMID- 3677282 TI - The effect of procainamide on plasma cholinesterase activity. AB - The in vitro effect of procainamide on plasma cholinesterase (PCHE) activity in the plasma of ten normal ASA physical status I patients was studied using a kinetic method. The mean plasma cholinesterase activity without procainamide (control) was 0.90 +/- 0.09 units.ml-1. The dibucaine numbers of all the samples were in the normal range of 78 to 86, indicating normal genotypes. The mean plasma cholinesterase activity, in the presence of procainamide in concentrations of 5.0, 10.0, 20.0 and 40.0 micrograms.ml-1, was reduced to 0.73 +/- 0.04, 0.61 +/- 0.03, 0.45 +/- 0.02, and 0.36 +/- 0.01 units.ml-1, respectively. At therapeutic concentrations of 4 to 12 micrograms.ml-1, procainamide inhibited cholinesterase activity 15 to 30 per cent. The authors also showed that the concentration of procainamide required to inhibit 50 per cent of plasma cholinesterase activity was 20 micrograms.ml-1 (I50). The authors conclude that procainamide when tested in vitro had a statistically significant depressant effect on plasma cholinesterase activity at all the concentrations studied. PMID- 3677283 TI - Neostigmine, pyridostigmine and edrophonium as antagonists of deep pancuronium blockade. AB - To compare the ability of equipotent doses of neostigmine, pyridostigmine and edrophonium to antagonize intense pancuronium neuromuscular blockade, one hundred and twenty ASA physical status I or II patients scheduled for elective surgery received 0.06 mg.kg-1 pancuronium during a thiopentone nitrous oxide-enflurane anaesthetic. Train-of-four stimulation was applied every 12 s and the force of contraction of the adductor pollicis muscle was recorded. In the first 60 patients, spontaneous recovery was allowed until ten per cent of initial first twitch height. Then neostigmine (0.005, 0.01, 0.02 or 0.05 mg.kg-1), pyridostigmine (0.02, 0.04, 0.1 or 0.2 mg.kg-1), or edrophonium (0.1, 0.2, 0.4 or 1 mg.kg-1) was injected by random allocation. Dose-response relationships were established from the measurement of first twitch height (T1) ten minutes later. From these, neostigmine, 0.04 and 0.08 mg.kg-1 was found to be equipotent to pyridostigmine, 0.2 and 0.38 mg.kg-1, and edrophonium, 0.54 and 1.15 mg.kg-1, respectively. These doses were given by random allocation to the next 60 patients, but at one per cent spontaneous recovery. Neostigmine, 0.04 mg.kg-1, produced a T1 of 73 +/- 4 per cent (mean +/- SEM), and a train-of-four ratio (TOF) of 39 +/- 3 per cent. This was significantly greater than with pyridostigmine, 0.2 mg.kg-1 (T1 = 50 +/- 6 per cent; TOF = 25 +/- 3 per cent), and edrophonium, 0.54 mg.kg-1 (T1 = 54 +/- 3 per cent; TOF = 17 +/- 2 per cent).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677284 TI - The relationship between central venous pressure and pulmonary capillary wedge pressure during aortic surgery. AB - Twenty-three ASA physical status II-III patients scheduled for elective abdominal aortic surgery were studied preoperatively with multiple unit gated acquisition angiography (MUGA) scan to determine the resting left ventricular and right ventricular ejection fractions (LVEF and RVEF respectively). Intraoperatively pulmonary capillary wedge pressure (PCWP) and central venous pressure (CVP) were measured in each patient at five different time periods in the horizontal, 24 degrees head up, and 24 degrees head down table tilt positions. The correlation between absolute values and changes in PCWP and CVP, and the degree to which preoperative knowledge of LVEF and RVEF predicted these correlations were examined. Resting LVEF ranged from 0.1 to 0.84. Thirteen of the 23 patients failed to show significant correlation (p less than 0.05) between the absolute values of PCWP and CVP either before and/or after aortic crossclamp. When the correlation coefficients from this analysis were ranked against LVEF, there was a weak but significant correlation before aortic crossclamp (r = 0.41), but not after. The correlation between a change in PCWP and a change in CVP was significant for the 23 patients at all time intervals, before and after aortic crossclamp. However, the prediction of a change of PCWP value from a known change of CVP value ranged in accuracy from +/- 3 mmHg to +/- 12.5 mmHg. The study suggests that if the filling pressures of both ventricles need to be assessed during aortic surgery, then the PCWP and CVP must be independently measured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677285 TI - The ultra-thin bronchoscope in management of the difficult paediatric airway. AB - The use of an ultra-thin flexible fiberoptic bronchoscope with a single lumen diameter of 2.7 mm at the distal tip to assist intubation of paediatric patients with a difficult airway is reported. Two patients (ages 30 months and 18 months) with mandibular hypoplasia and one patient (three months) with the Pierre-Robin syndrome are reported. In each case two fiberoptic bronchoscopes were used. The first allowed introduction of topical local anaesthetic while the second and smaller one was used for tube placement. PMID- 3677287 TI - Anaesthetic management of patients with placenta accreta. AB - The management of a 28-year-old primigravida with placenta accreta diagnosed during Caesarean section is described. A hysterectomy was required to control massive haemorrhage, and the patient made a full recovery. The increased incidence of placenta accreta over the last three decades is thought to be associated with the concomitant increased frequency of Caesarean section, resulting in an increased incidence of placenta praevia (1.9 per cent to 3.9 per cent). Patients with placenta praevia who have had a previous Caesarean section have a remarkably increased risk of placenta accreta. Management of placenta accreta is primarily by control of haemorrhage on delivery of the placenta. Control can be assisted by infrarenal cross-clamping of the aorta and/or intra myometrial injection of prostaglandin F2 alpha which produces myometrial and vascular contraction. Identification of patients at increased risk, preparation for treatment and effective treatment of placenta accreta will minimize maternal morbidity and mortality. PMID- 3677286 TI - Bupivacaine-fentanyl epidural analgesia for a parturient in status asthmaticus. AB - Regional anaesthesia is a suitable technique for the management of the asthmatic parturient. We report the case of an asthmatic gravida in labour in whom prompt institution of bupivacaine-fentanyl epidural analgesia was associated with enhancement of the effectiveness of concurrent medical therapy for bronchospasm. Prior to the initiation of epidural blockade, inhaled atropine was employed in an effort to reduce parasympathetic tone in the bronchial smooth muscle. Sustained clinical improvement did not occur until after delivery of the fetus and placenta. PMID- 3677289 TI - Profound hypercapnia due to disconnection within an anaesthetic machine. AB - A 25-year-old patient received general anaesthesia for an emergency Caesarean section. Arterial blood gases obtained because of prolonged postoperative coma demonstrated profound hypercapnia (PaCO2 246 mmHg). Examination of the anaesthetic machine revealed a complete disconnection of the metal components of the main gas line downstream from the vaporizer, in a location that was obscured from the anaesthetist's view. Causes of profound hypercapnia are reviewed and preventive measures are discussed. PMID- 3677288 TI - Precipitous bradycardia induced by laryngoscopy in cardiac surgical patients. AB - We present three patients with severe ischaemic heart disease who developed profound bradycardia (heart rates of 15 beats.min-1, 10 beats.min-1 and asystole) at the time of laryngoscopy and spraying of the trachea with topical lidocaine. All patients had received fentanyl 20-30 micrograms.kg-1 and pancuronium 0.1-0.13 mg.kg-1 and in each case laryngoscopy was performed three minutes after the administration of these agents. We believe that in these cases the dosage of fentanyl was inadequate and since increasing the dosage of fentanyl to at least 50 micrograms.kg-1 and eliminating the manoeuvre of laryngeal spraying with topical anaesthesia, we have not encountered this problem. PMID- 3677290 TI - Evaluation of the premature infant at risk for postoperative complications. AB - We reviewed anaesthetic records of 35 infants with a history of prematurity, who presented for elective herniorrhaphy. We applied a scoring system to help evaluate risk of postoperative complications. Six patients experienced postoperative complications. All six patients had a score of five or more and gave history of either apnoea or a history of moderate bronchopulmonary dysplasia. A preoperative history of apnoea and/or moderate bronchopulmonary dysplasia appear to be valuable markers for postoperative complications. A conceptual age of 40 weeks is an acceptable lower limit of age providing there is no history of apnoea or pulmonary disease. PMID- 3677291 TI - Severe hypercarbia with a Bain breathing circuit during malignant hyperthermia reaction. PMID- 3677292 TI - Monitoring and anaesthetic management of parturients with mitral stenosis. PMID- 3677293 TI - Respiratory complications in patients with upper respiratory tract infections. PMID- 3677294 TI - Continuous epidural infusion of ketamine during labour. PMID- 3677295 TI - Modulation of adriamycin transport by hyperthermia as measured by fluorescence activated cell sorting. AB - Heat-induced (45.5 degrees C) modification of adriamycin uptake and efflux were measured by flow cytometry in CHO cells in vitro. Administration of adriamycin with simultaneous 15-min or 30-min heat treatment increased drug uptake in a dose dependent manner. Fluorescence-activated cell sorting showed that cytotoxicity to adriamycin was correlated with relative cellular concentration (fluorescence) for both unheated cells and those heated and simultaneously treated with adriamycin. However, if adriamycin administration followed the heat treatment, accumulation was significantly reduced, primarily as a result of decreased passive drug diffusion (rather than increased efflux) in the heated cells. Cells made heat tolerant by prior heating also exhibited reduced adriamycin uptake 12 h later, and further heating did not increase uptake. Cell sorting experiments indicated that cytotoxicity of adriamycin was not necessarily correlated with intracellular drug levels when drug administration followed the heat treatment. Also, heat sterilized cells exhibited a two-fold increase in adriamycin uptake over surviving cells, as assessed by simultaneous measurement of dansyl lysine and adriamycin content. These results indicate that sensitization to adriamycin by simultaneous heat treatment is probably due to increased drug uptake. The decreased sensitization observed when drug administration is followed by heating is probably the result of both decreased uptake and decreased drug DNA accessibility. PMID- 3677296 TI - Distribution of nitroimidazoles and L-phenylalanine mustard in mammary adenocarcinoma 16/C tumors. AB - Using the triphenylmethane dye, lissamine green, as an indicator of blood perfusion, we have demonstrated that L-phenylalanine mustard (L-PAM) is differentially distributed in mice bearing mammary adenocarcinoma 16/C tumors. Following i.p. administration, concentrations of L-PAM in various regions of the tumors vary by as much as 10-fold or more between regions of low and high perfusion. Since the nitroimidazoles, metronidazole and misonidazole, increase the cytotoxicity of certain antitumor agents, these compounds were investigated for their ability to increase the distribution of L-PAM into tumor regions of low perfusion. Administration of metronidazole (400 mg/kg) or misonidazole (800 mg/kg) 1 h prior to L-PAM and lissamine green resulted in elevated plasma levels of L-PAM and increased concentrations of L-PAM in tumor regions of high perfusion. A slight increase in the normally low levels of L-PAM in tumor regions of low perfusion was observed but the increase was not statistically significant. In contrast to the uneven distribution of L-PAM, metronidazole and misonidazole were evenly distributed throughout plasma and tumor regions of both high and low perfusion. Bioassay of tumors following in vivo exposure to metronidazole and L PAM indicated decreased viability in fragments from tumor regions of high perfusion, but not from tumor regions of low perfusion. These studies demonstrate that the nitroimidazoles increased L-PAM levels in plasma and in tumor regions of both high and low perfusion but did not induce a uniform distribution of L-PAM throughout the tumors. The nitroimidazoles may enhance the effectiveness of L-PAM as an antitumor agent by increasing the concentration of drug that reaches a tumor. PMID- 3677297 TI - Concurrent allopurinol and 5-fluorouracil: 5-fluoro-2'-deoxyuridylate formation and thymidylate synthase inhibition in rat colon carcinoma and in regenerating rat liver. AB - The formation of FdUMP and the inhibition of TS were studied in a subcutaneously growing transplantable rat colon carcinoma and in regenerating rat liver following bolus administration of 5-FU, with or without HPP pretreatment. In tumor, peak levels of FdUMP at 30 min following bolus 5-FU, 100 mg/kg, averaged 4931 +/- 587 pmol/g. Pretreatment with HPP, 50 mg/kg, 24 h and 1 h before 5-FU, reduced the peak FdUMP level to 2085 +/- 387 pmol/g. The inhibition of TS by 5-FU treatment was greater than 95% by 30 min, and after 48 h residual enzyme inhibition averaged 40%. No effect on TS inhibition by 5-FU treatment could be observed as a result of HPP pretreatment. The levels of TStot increased linearly after 5-FU treatment and doubled within 48 h. In regenerating rat liver, neither FdUMP levels nor TS inhibition, studied at 1 h after bolus 5-FU, were affected by HPP pretreatment. PMID- 3677298 TI - Acetylation and oxidation phenotypes in malignant lymphoma. AB - 101 white British adults with Hodgkin's disease or non-Hodgkin's lymphoma were phenotyped for acetylation status using dapsone and for oxidation status with debrisoquine prior to treatment. The frequencies of acetylation and oxidation phenotypes in these patients were compared with reference populations of normal subjects. No significant difference in phenotype frequency was found in the lymphoma patients. This suggests that neither of these metabolic polymorphisms for exogenous compounds is strongly associated with these malignancies. Owing to the small size of the study, however, an effect of these phenotypes could not be excluded. PMID- 3677299 TI - Oral 4-hydroxyandrostenedione, a new endocrine treatment for disseminated breast cancer. AB - Thirty-one post-menopausal female patients, with locally advanced or disseminated breast cancer were treated with the aromatase inhibitor 4-hydroxyandrostenedione given orally at a dose of 500 mg daily. Twenty-nine patients had assessable disease. Eight patients (28%) had objective evidence of partial response and six remain in remission 7-10 months later. A further four patients (14%) had stabilisation of disease and 11 patients (37%) had progressive disease in spite of treatment. Plasma oestradiol levels were measured throughout therapy in 16 patients and were lowered to 53% +/- 8% of baseline levels within 7 days of commencing 4-hydroxyandrostenedione. With regard to toxicity, one patient developed a transient skin rash and another patient some facial swelling. A further patient developed a transient leucopaenia and treatment was therefore discontinued. Twenty-seven of the 30 evaluable patients (90%) experienced no side effects. These results indicate that oral administration of 4 hydroxyandrostenedione is an acceptable new treatment for post-menopausal women with disseminated breast cancer. PMID- 3677300 TI - Occurrence of circulating 7-deoxyaglycone metabolites of 4'-deoxydoxorubicin in man. AB - In five cancer patients we have determined the pharmacokinetics of 4' deoxydoxorubicin (4'-DOX), its alcoholic metabolite 4'-deoxydoxorubicinol and the occurrence of circulating 7-deoxyaglycone metabolites. The 7-deoxyaglycone of the alcohol metabolite, the major aglycone of Adriamycin (ADR) present in man, was not detected in any serum sample. The 7-deoxyaglycone of the parent drug, which appears in concentrations in excess of 30 ng/ml after ADR administration, was detected in only 2/5 patients in trace amounts. These preliminary data indicate a difference in biotransformation between ADR and 4'-DOX despite their close structural similarities. PMID- 3677301 TI - High-dose VP-16 with intermediate-dose cytosine arabinoside in the treatment of relapsed acute nonlymphocytic leukemia. AB - In a study of 11 adult patients with acute nonlymphocytic leukemia (ANLL), infusion therapy with high-dose VP-16 and intermediate-dose cytosine arabinoside was administered. Response was assessed with reference to bone marrow aspirations performed on days 1; 12, 13, or 14; and 21 of treatment. All 7 of the patients with ANLL in relapse achieved marrow hypoplasia, and 3 of them achieved complete response. LFTs were elevated in most patients but no evidence of hepatocellular necrosis was observed. It is concluded that the value of VP-16 in ANLL may have been underestimated in the past because of inadequate dosing. PMID- 3677302 TI - Doxorubicin concentration time course in the myocardium after single administration to the dog. Possible role in the cardiac effects. AB - Three hours after i.v. administration of doxorubicin, concentrations of the drug in the myocardium are much higher (about 50 times) and decrease much more slowly (drug still detected 21 days later) than those in the plasma, so that storage results from too early readministration, with possible toxic signs. PMID- 3677303 TI - Acetylator genotype-dependent metabolic activation of carcinogenic N hydroxyarylamines by S-acetyl coenzyme A-dependent enzymes of inbred hamster tissue cytosols: relationship to arylamine N-acetyltransferase. AB - A genetic polymorphism in S-acetyl coenzyme A (AcCoA)-dependent N acetyltransferase has been associated with a differential risk for certain cancers in humans. In this study, several tissues from the inbred Syrian hamster with a genetically defined AcCoA-dependent N-acetyltransferase polymorphism (homozygous rapid acetylator, Bio. 87.20; homozygous slow acetylator, Bio. 82.73/H; and heterozygous acetylator, Bio. 87.20 X Bio. 82.73/H F1), were investigated for the relationship of arylamine N-acetyltransferase to the AcCoA dependent metabolic activation of carcinogenic N-hydroxy (N-OH)-arylamines to bind to DNA (O-acetyltransferase). The levels of both 2-aminofluorene (AF) N acetyltransferase and N-OH-AF O-acetyltransferase activity reflected the N acetylator genotype in liver, intestine, kidney and lung cytosols. A significant acetylator gene--dose response for AF N-acetyltransferase and N-OH-AF O acetyltransferase activities was observed in liver and lung cytosols. In contrast, acetylator genotype was not consistently expressed for the AcCoA dependent N-acetylation of 4-aminobiphenyl (ABP), nor for the AcCoA-dependent metabolic activation of N-OH-ABP and N-OH-3,2'-dimethyl-4-aminobiphenyl in these same tissue cytosols. Two peaks of acetyltransferase activity were partially purified by ion exchange FPLC chromatography from the hepatic cytosol of both the homozygous rapid and homozygous slow acetylator hamster. In contrast to unfractionated cytosol, the isozyme(s) eluting first clearly demonstrated levels of AcCoA-dependent arylamine N-acetyltransferase and N-OH-arylamine O acetyltransferase activities that were consistent with N-acetylator genotype (polymorphic) for all substrates tested. In contrast, the slower eluting isozyme(s) in each acetylator cytosol showed levels of AcCoA-dependent N- and O acetyltransferase activities that did not vary with N-acetylator genotype (monomorphic). The AcCoA-dependent O-acetyltransferase activity of both the monomorphic and polymorphic peaks was paraoxon resistant. These studies demonstrate acetylator genotype-dependent control of AcCoA-dependent metabolic activation of N-OH-arylamines(O-acetylation) by polymorphic isozyme(s) similar to that for AcCoA-dependent N-acetylation of arylamines in the hamster. The polymorphic genetic control of N-OH-arylamine O-acetyltransferase may be an important risk factor for arylamine-induced cancer, in those species and tissues expressing appreciable levels of O-acetyltransferase activity. PMID- 3677304 TI - In vivo and in vitro formation of glutathione conjugates from the K-region epoxides of 1-nitropyrene. AB - 4,5-Epoxy-4,5-dihydro-1-nitropyrene (1-nitropyrene 4,5-oxide) and 9,10-epoxy-9,10 dihydro-1-nitropyrene (1-nitropyrene 9,10-oxide), which are electrophilic metabolites formed during the metabolism of the environmental pollutant, 1 nitropyrene, reacted slowly with glutathione. The rate of conjugation was greatly enhanced by the addition of purified rat liver glutathione (GSH) transferases, with transferases 3-3 and 4-4 exhibiting higher catalytic activities than transferases 1-1, 2-2 and 7-7. Two GSH conjugates were formed from each of the oxides: 1-nitropyrene 4,5-oxide gave a 1:1 mixture of 4-(glutathion-S-yl)-5 hydroxy-4,5-dihydro-1-nitropyrene and 5-(glutathion-S-yl)-4-hydroxy-4,5-dihydro-1 nitropyrene while 1-nitropyrene 9,10-oxide gave a 2:1 mixture of 9-(glutathion-S yl)-10-hydroxy-9,10-dihydro-1-nitropyrene and 10-(glutathion-S-yl)-9-hydroxy-9,10 dihydro-1-nitropyrene. Both K-region oxides were converted to trans-dihydrodiols by hepatic microsomal epoxide hydrase, and faster rates were observed with 1 nitropyrene 4,5-oxide. In subsequent experiments [4,5,9,10-3H]1-nitropyrene was administered to Sprague-Dawley rats by intravenous and intraperitoneal injections. HPLC analysis of biliary metabolites indicated the presence of four GSH conjugates that were identical to those obtained from reactions of the K region oxides with GSH. In addition, glucuronide conjugates were detected from trans-4,5-dihydroxy-4,5-dihydro-1-nitropyrene (1-nitropyrene trans-4,5 dihydrodiol) but not trans-9,10-dihydroxy-9,10-dihydro-1-nitropyrene (1 nitropyrene trans-9,10-dihydrodiol). These data combined with earlier studies indicate that 1-nitropyrene is oxidized preferentially to 1-nitropyrene 4,5-oxide and that, while the main detoxification pathway of 1-nitropyrene 9,10-oxide is GSH conjugation, 1-nitropyrene 4,5-oxide is excreted via both GSH conjugation and dihydrodiol formation followed by O-glucuronidation. PMID- 3677305 TI - Mechanism of mouse skin tumor promotion by n-dodecane. AB - Application of the alkane n-dodecane to the dorsal skin of 6-8 week old female SENCAR mice initiated with 10 nmol dimethylbenz[a]anthracene led to papilloma formation in the majority of treated animals. Compared to the potent phorbol diester 12-O-tetradecanoylphorbol-13-acetate (TPA), n-dodecane was several orders of magnitude less potent on a dose basis, and maximal papilloma response required more extended application (22 weeks for 50 mg dodecane compared to 12 weeks for 2 micrograms TPA). In two-stage promotion experiments n-dodecane appeared to act as a stage II promoting agent at appropriate doses, being comparable in activity to mezerein--an agent with well-characterized activity of this type. Dodecane, unlike mezerein, did not induce the formation of a significant number of pyknotic cells, however, suggesting that the weak promoting activity of dodecane in stage 1 was not a result of toxicity. In comparison with TPA, both mezerein and n dodecane at promoting doses induced less sustained hyperplasia in SENCAR mouse skin, a finding also consistent with the proposal that n-dodecane is principally active in stage II of two-stage promotion models. Both agents induced ornithine decarboxylase activity in SENCAR mouse skin, the maximal induction being observed at apparently the same time after a single application. PMID- 3677306 TI - Evidence for cytosolic glutathione transferase-mediated denitrosation of nitrosocimetidine and 1-methyl-2-nitro-1-nitrosoguanidine. AB - Nitrosocimetidine (NC) and 1-methyl-2-nitro-1-nitrosoguanidine (MNNG) are closely related N-nitrosamidines. NC is the nitrosated derivative of cimetidine (Tagamet), an orally administered compound used extensively in the treatment of gastric ulcers. MNNG is a potent carcinogen capable of initiating tumors close to the site of administration and used experimentally to produce stomach cancer. It has become evident that the primary metabolic fate of both of these agents is denitrosation. We have discovered an activity in the cytosol fraction of hamster liver which is capable of denitrosating these nitrosamidines with an efficiency approaching 100%. The activity is heat sensitive and requires reduced glutathione as a cofactor. Inhibition of the denitrosating activity with compounds which inhibit in parallel the conjugation of glutathione with 1-chloro-2,4 dinitrobenzene (CDNB) provides evidence that the activity is glutathione transferase. One molecule of reduced glutathione is consumed in each denitrosation event. Nitrite is formed as denitrosation proceeds with a yield equivalent to 25-50% of the denitrosated product produced. Glutathione disulfide is a minor reaction product, representing 3% of the denitrosation product yield in the MNNG case and 12% in the NC case. Thus far in our survey of N nitrosamines, N-nitrosamides and N-nitrosamidines, only the nitrosamidines appear to be vulnerable to the cytosolic denitrosating activity. In an attempt to evaluate the importance of the glutathione-dependent reaction in the intact hamster, we have depleted glutathione by pretreatment with the commonly used agents diethyl maleate (DEM) and L-buthionine-S,R-sulfoximine (L-BSO). Nitroso compound was administered i.v. and the circulating blood levels of intact and denitrosated compound 5 min after dosing quantified. NC- and MNNG-derived methylation of organ DNA was also monitored. Pretreatment had no effect on the cytosolic denitrosating or CDNB-conjugating activities. L-BSO pretreatment had no apparent effect on the denitrosative metabolism of NC or MNNG. With DEM pretreatment we obtained clear indications of a decreased rate of denitrosation and observed a 10-fold increase in MNNG-derived liver DNA methylation. The differential effects of these pretreatments are taken as an indication that DEM sensitive processes other than those requiring glutathione dominate N nitrosamidine denitrosation in the hamster. PMID- 3677307 TI - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) does not inhibit intercellular communication in Chinese hamster V79 cells. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a ubiquitous environmental pollutant which has been shown to be both a potent teratogen and carcinogen and also to have tumor-promoting activity. We have compared TCDD with the proto-type phorbol ester tumor promoter, 12-O-tetradecanoylphorbol-13-acetate (TPA) using the metabolic cooperation assay as a measure of tumor promotional competence. Unlike TPA, TCDD was found to be ineffective in inhibiting metabolic cooperation at concentrations which elicit many of TCDD's biological responses. These results suggest that TPA and TCDD elicit tumor promotion by different pathways. We discuss these results in the context of cell-type-specific and TCDD receptor mediated biological responses to tumor promoters. PMID- 3677308 TI - Tumorigenicity study in Syrian hamsters fed areca nut together with nitrite. AB - In order to evaluate the effect of concurrent administration of areca nut and sodium nitrite, a long-term feeding study was conducted with 120 Syrian hamsters. The animals were divided into four treatment groups, each consisting of 15 males and 15 females, and received 2 g/kg diet of sodium nitrite (group I), 20 g/kg diet of powdered areca nut (group II), 2 g/kg diet of sodium nitrite plus 20 g/kg diet of areca nut (group III) or powdered diet only (group IV) throughout their lifetime. Urine samples from all groups were analysed for N-nitrosonipecotic acid (NNIP), a major urinary metabolite of areca-nut-derived nitrosamines. NNIP was only detected in the urine of hamsters fed nitrite plus areca nut (concentration: 1.9 +/- 0.9 ng/ml urine), indicating that areca nut alkaloids underwent in vivo nitrosation to form areca-nut-specific nitrosamines. The total tumour response was not significantly elevated in groups II and III. Hamsters of group III had a markedly, but also insignificantly higher frequency of malignant tumours than those of the other groups, with a statistically significant increase in malignant lymphomas in the males. Although limited by the low number of animals per group, these results indicate that exposure to nitrite together with areca nut constituents appears to enhance the risk of developing malignancies. PMID- 3677309 TI - Metabolism of the carcinogenic air pollutant 2-nitrofluorene in the isolated perfused rat lung and liver. AB - The metabolism of 2-nitrofluorene (NF), a model substance for nitrated polycyclic aromatic hydrocarbons, was studied in the isolated perfused rat lung and liver. NF has been identified in urban air and diesel exhaust and occurs in the gas, as well as in the particulate phase. Therefore, it is conceivable that the lung represents one point of entry of this compound into the body. The lung metabolizes NF to hydroxylated NFs, mainly 9-hydroxy-NF, independently of the route of administration (intravascular or intratracheal). After intratracheal administration, NF is rapidly excreted into the perfusate, indicating that other organs might be exposed to unmetabolized NF. The liver excretes NF metabolites as biliary glucuronides. Untreated bile is not mutagenic. However, after beta glucuronidase treatment of bile, direct-acting mutagens were detected. The mutagenic metabolites in beta-glucuronidase-treated bile were the same as identified in the perfusate of the isolated lung. Since beta-glucuronidase is an enzyme found in the human intestinal microflora, inhalation of NF could result in the liberation of genotoxic metabolites in the colon. PMID- 3677310 TI - Metabolism of benzo[f]quinoline by rat liver microsomes. AB - The metabolism of [1,3-14C]benzo[f]quinoline (BfQ) by liver microsomes from control, 3-methylcholanthrene (3-MC)-pretreated and phenobarbital (PB)-pretreated rats has been investigated in order to gain insights into the effect of mixed function oxidase inducers on the types and levels of specific metabolites as formed in vitro. The rates of metabolism of BfQ by liver microsomes from control, 3-MC- and PB-pretreated rats were 0.5, 3.6 and 2.4 nmol/min/mg of respectively. The most predominant metabolite of BfQ detected with liver microsomes from 3-MC pretreated rats was BfQ-7,8-dihydrodiol, a precursor of the bay-region diol epoxide, constituting 41% of the total ethyl acetate-extractable metabolites. Other metabolites obtained along with their relative proportions were as follows: BfQ-N-oxide, 23% 7-hydroxyBfQ, 15%; 9-hydroxyBfQ, 9%; and BfQ-9,10-dihydrodiol, 6%. BfQ-5,6-dihydrodiol, a K-region dihydrodiol, was a trace metabolite representing approximately 1.0% of the total metabolism. Liver microsomes from PB pretreated rats oxidized BfQ primarily to BfQ-N-oxide and 9-hydroxyBfQ, which constituted 41% and 20% of the total ethyl acetate-extractable metabolites of BfQ. The relative proportions of BfQ-9,10-dihydrodiol, BfQ-7,8-dihydrodiol and 7 hydroxy-BfQ formed were 12%, 3% and 13% respectively, while the figure for BfQ 5,6-dihydrodiol was 0.5%. The profile of metabolites formed by liver microsomes from control rats was similar to that generated by microsomes from PB-pretreated rats. While benzo-ring metabolites represented a major part of the metabolism of BfQ by liver microsomes from either 3-MC- or PB-pretreated rats, these two types of microsomes exhibited a positional selectivity in the oxidation of BfQ, the former primarily attacking the 7,8-position of BfQ while the latter preferentially oxidizing the 9,10-position. The preponderance of the potentially mutagenic BfQ-7,8-dihydrodiol amongst the metabolites generated by liver microsomes from 3-MC-pretreated rats suggests a possible role for cytochrome P 450c, the major form of rat hepatic cytochrome P-450 induced by 3-MC, in the metabolic activation of BfQ. PMID- 3677311 TI - Dietary fat regulation of the association of protein kinase C activity with epidermal cell membranes. AB - An apparent redistribution of protein kinase C activity was noted in the particulate and soluble fractions of basal epidermal cells isolated from mice receiving semi-purified diets varying in fat content. An increase in the amount of protein kinase C activity in the particulate fraction and a decrease in the soluble fraction were observed with the mice fed high-fat (24.6% corn oil) diet as compared with those given the low-fat (5% corn oil) diet. Increased levels of phospholipids and an increase in 18:2 and 18:3 side chains of the phospholipids were observed with the high-fat diet. PMID- 3677312 TI - Benzoyl peroxide activation of protein kinase C activity in epidermal cell membranes. AB - We have investigated the effects of various tumor promoting agents on protein kinase C activity in adult female SENCAR mice. Topical application of benzoyl peroxide increased the calcium-independent activity of protein kinase C in the particulate fraction of basal epidermal cells while decreasing protein kinase C activity in the soluble fraction of basal epidermal cells isolated from the mice. Benzoyl peroxide apparently altered protein kinase C indirectly, as it had no direct effect on the activity of protein kinase C partially purified from bovine brain. Topical application of 12-O-tetradecanoyl phorbol-13-acetate to mouse skin resulted in increased protein kinase C activity associated with the particulate fraction of the epidermal cells with no change in the calcium-dependence of the enzyme. Since the proliferative agent ethylphenylpropiolate had no effect on protein kinase C in epidermis from SENCAR mice, the ability of benzoyl peroxide to influence protein kinase C activity in mouse skin may reflect its tumor promoting capabilities rather than its ability to induce hyperplasia. PMID- 3677313 TI - The correlation between DNA adducts and chromosomal aberrations in the target organ of benzidine exposed, partially-hepatectomized mice. AB - An experimental system was developed to test the association between benzidine- DNA adduct levels and chromosome aberrations in the target organ, the liver, of mice. A 2/3 partial hepatectomy was performed (0 h), then the animals were treated with benzidine (0, 7.8, 19.5, 38.2 or 97.8 mg/kg, i.p.) and an agar coated 50 mg 5-bromodeoxyuridine tablet was implanted subcutaneously (58 h). Colcemid was given at 4 mg/kg i.p. (70 h), and the animals were sacrificed 2 h later. The liver from each animal was divided, with portions allocated for cytogenetics and DNA adduct analysis. DNA adducts were analyzed with the 32P postlabeling technique. DNA adduct and chromosomal aberration data were available on a total of 43 animals. Benzidine was shown to be a potent clastogen in liver, the target organ, as opposed to its reported weak activity in the bone marrow. A linear dose response was demonstrated for benzidine--DNA adducts found in the liver. The correlation between adduct levels and aberrations in individual animals was 0.43 (P less than 0.05). However, most of the residual variance was due to four outlying cases. When these cases were removed from the data set and the analysis repeated, the linear correlation coefficient increased to 0.74. When the data were analyzed by dose groups, the correlation was 0.91. These data support the hypothesis that carcinogen-DNA adducts are responsible for the induction of chromosomal aberrations, and perhaps other genotoxic events, including neoplasia. PMID- 3677314 TI - Species, sex and organ differences in induction of a cytochrome P-450 isozyme responsible for carcinogen activation: effects of dietary hepatocarcinogenic tryptophan pyrolysate components in mice and rats. AB - Both sexes of BALB/c X DBA/2 F1 mice and F344 rats were treated for 1 week with a diet containing 0.02% of hepatocarcinogenic tryptophan pyrolysate component (Trp P-1 or Trp P-2), and changes in the carcinogen activation enzyme activity in various organs were examined comparatively using a mutation test with Salmonella typhimurium TA98 as a tester bacterium. Hepatic enzymes from untreated mice and rats showed a definite catalytic activity for mutagenic activations of Trp P-1 and Trp P-2, whereas the activities of other organs--such as lung, kidney, small intestine and colon--were undetectable or very low. In both mice and rats either the Trp P-1 or Trp P-2 feeding resulted in induction of cytochrome P-450 isozyme(s), which could mediate in the liver but not in other organs the mutagenic activation of the carcinogen itself. As to the sex difference, the induction of the activation enzyme(s) was greater in the female animals than in the males. Species difference in the activity of hepatic enzymes catalyzing the Trp P-1 and Trp P-2 mutageneses was also observed in animals treated with the basal diet; the activity was higher in mice than in the sex-matched rats (Trp P 1, approximately 1.5-fold; Trp P-2, approximately 7-fold). When diet containing Trp P-1 or Trp P-2 was fed for 1 week, the activity of the rat liver for Trp P-1 mutagenesis was of a level similar to that of the sex-matched mice, but for Trp P 2 mutagenesis it was less than half that in the mice. The induced hepatic enzymes in mice and rats were suggested to be 3-methylcholanthrene-inducible cytochrome P 448 isozymes as determined by mutation tests with Trp P-1, Trp P-2 and two other substrates and by immunochemical analyses of rat hepatic cytochrome P-450 using monoclonal antibodies against rat cytochrome P-448 isozymes. These results indicate that a form of cytochrome P-450 responsible for activation of Trp P-1 and Trp P-2 is inducible by dietary treatment of mice or rats with these carcinogens and that the amount of the cytochrome P-450, including resident and induced forms, is related to the species, sex and organ differences in their carcinogenic susceptibility to these chemicals. PMID- 3677315 TI - Psoralen adducts in a shuttle vector plasmid propagated in primate cells: high mutagenicity of DNA cross-links. AB - A Simian virus 40-driven shuttle vector plasmid (pZ189) was treated with 8 methoxypsoralen plus a split dose of long-wavelength UV (UVA) radiation in order for a large number of psoralen cross-links, as compared with monoadducts, to be formed in the plasmid DNA. The shuttle vector was then transfected into monkey Vero or human Raji cells. Plasmids replicated in the primate host cell were extracted 2 days later and analysed for mutations in the vector suppressor tRNA (supF) gene. A spontaneous mutation frequency of 0.7 X 10(-3) was 15-fold elevated in vectors exposed to psoralen plus two UVA irradiations. Most of these mutations were considered to be dependent on DNA cross-link adducts, since psoralen plus only a single UVA dose (producing mainly monoadducts) did not appreciably affect the mutation rate. DNA sequence analysis revealed a hot spot at an AT repeat constituting a potential site for psoralen cross-link formation, whereas the second hot spot noted did not contain any sequence where psoralen adduct formation is likely to occur. Since the AT repeat hot spot was not represented in previous studies with pZ189 exposed to other genotoxic agents, the results indicate that a specific mutational pattern may be resulting from induction of DNA cross-links. PMID- 3677316 TI - Correction of alkylation hypersensitivity of CHO-W27-1 cells by transfection with human DNA. AB - Chinese hamster cells of the mutant strain W27-1 which is hypersensitive to UV and monofunctional alkylating agents were transfected with human DNA ligated to the bacterial xanthine-guanine phosphoribosyltransferase (gpt) gene. Selection was performed for resistance to mycophenolic acid and finally for survival after treatment with high doses of methyl methanesulfonate. A gpt+ transfectant was generated (T38-2-7) which acquired resistance to methyl methanesulfonate and cross-resistance to N-methyl-N'-nitro-N-nitrosoguanidine at levels comparable with the parental (wild-type) strain CHO-9. T38-2-7 cells were not more resistant, however, to UV, mitomycin C and N-hydroxyethyl-N chloroethylnitrosourea than the mutant W27-1. The transfectant contains integrated human DNA and was shown to be deficient for the O6-methylguanine-DNA methyltransferase. The results indicate that the transfected DNA specifically complemented the defect underlying alkylation hypersensitivity of W27-1 cells or that a gene was transfected which is generally inactive in CHO cells and which causes alkylation resistance. PMID- 3677317 TI - Genetic variability in deacetylation of 2-acetylaminofluorene and N-hydroxy-2 acetylaminofluorene in inbred strains of mice. AB - Genetic variability in 2-acetylaminofluorene (AAF) and N-hydroxy-2 acetylaminofluorene (N-OH-AAF) deacetylase activities was examined in 19 inbred strains of mice. AAF deacetylase activities ranged from 0.60 to 1.33 nmol/min/mg protein, and there was an approximately 2.5-fold difference in AAF deacetylase activity between the fastest (C57BL/6J) and slowest (RIIIS/J) mouse strains. N-OH AAF deacetylase activities ranged from 3.28 to 13.24 nmol/min/mg protein, and the difference between the fastest (AU/SsJ) and slowest (RIIIS/J) strains was 4-fold. N-OH-AAF deacetylase activity was higher (5-13 times) than AAF deacetylase activity in all strains examined. Thus, there are genetic differences in AAF and N-OH-AAF deacetylase activities; these differences may play an important role in individual susceptibility to the mutagenic and carcinogenic effects of the aromatic amides. PMID- 3677318 TI - Direct evidence for phorbol ester-stimulated accumulation of diacylglycerol derived from phosphatidylcholine. AB - A fluorescent analog of phosphatidylcholine, 1-acyl-2-[N-(4-nitrobenzo-2-oxa-1,3 diazole)aminocaproyl]phosphatidyl choline (NBD-PC), was inserted into the plasma membrane of HeLa cells. Treatment of NBD-PC-labelled cells with the tumour promoting phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA), resulted in the production of fluorescent diacylglycerol, 1-acyl-2-[N-(4-nitrobenzo-2-oxa-1,3 diazole)-aminocaproyl]diacylglycerol (NBD-DG), suggesting that phorbol ester activates a PC-specific phospholipase C in these cells. Furthermore pretreatment of cells with phorbol-12,13-dibutyrate for 24 h, a process which depletes cellular protein kinase C activity, inhibited the ability of TPA to induce this effect. These results suggest that TPA stimulation of a phospholipase C specific for PC in HeLa cells is mediated via protein kinase C. PMID- 3677319 TI - Assay of 1-nitropropane, 2-nitropropane, 1-azoxypropane and 2-azoxypropane for carcinogenicity by gavage in Sprague-Dawley rats. AB - 1-Nitropropane (1-NP), 2-nitropropane (2-NP), 1-azoxypropane (1-AP) and 2 azoxypropane (2-AP), were assayed for carcinogenicity by gavage in male Sprague Dawley rats. 2-NP was given at 1 mmol/kg three times per week for 16 weeks. 1-NP (1 mmol/kg), 1-AP (0.1 mmol/kg), 2-AP (0.1 mmol/kg) or Emulphor EL-620 vehicle was given three times per week for 16 weeks, and then once per week for 10 weeks. In the 2-NP treated group both benign and malignant liver tumors occurred in 100% of the animals. No treatment related tumors occurred in rats receiving 1-NP. In rats treated with 1-AP, a high incidence of skin tumors (100%), mostly keratoacanthomas, and of tumors of the nasal cavity (59%) was observed. Rats which were given 2-AP also showed an increased incidence of skin keratoacanthomas (21%), but not of other tumors. These findings (i) confirm, using the oral route of administration, the results of inhalation studies by others indicating the potent hepatocarcinogenicity of 2-NP, (ii) establish a practical model in which the mechanism of 2-NP carcinogenicity can now be more readily studied, and (iii) demonstrate that 1-AP, and probably 2-AP, like other aliphatic azoxy compounds thus far examined, are carcinogenic in rats. PMID- 3677320 TI - The induction of growth-altered cell populations (tumor-initiation sites) in rat tracheal implants exposed to benzo[a]pyrene and formaldehyde. AB - The effects of exposure to benzo[a]pyrene (BAP) and formaldehyde (HCHO), alone and combined, on the induction of carcinogenesis in rat tracheal implants was determined as the number of growth-altered cell populations (tumor-initiation sites, TIS) per trachea. While exposure twice-weekly for 4.5 months to 0.2% HCHO solution gave only a weak response (0.25 TIS/trachea), 2.37 TIS per trachea were detected after exposure to 20 micrograms BAP in the same regimen. The combination of BAP followed by HCHO had a greater response than either agent alone (7.83 TIS/trachea), while the reverse exposure gave 1.49 TIS per trachea, which was less than BAP alone. Thus, the induction of TIS by combined exposure to BAP and HCHO was dependent on the order of exposure, and could not be predicted from their individual exposures. PMID- 3677321 TI - Oral administration of the renal carcinogen, potassium bromate, specifically produces 8-hydroxydeoxyguanosine in rat target organ DNA. AB - Following oral administration of a renal carcinogen, potassium bromate (KBrO3), to the rat, a significant increase of 8-hydroxydeoxyguanosine (8-OH-dG) in kidney DNA was observed. In the liver, a non-target tissue, the increase in 8-OH-dG was not significant. The non carcinogenic oxidants, NaCIO and NaCIO2, had no effect on 8-OH-dG formation in kidney DNA. These results suggest that formation of 8-OH dG in tissue DNA is closely related to KBrO3 carcinogenesis. PMID- 3677322 TI - The S-acetyl coenzyme A-dependent metabolic activation of the carcinogen N hydroxy-2-aminofluorene by human liver cytosol and its relationship to the aromatic amine N-acetyltransferase phenotype. AB - A genetic polymorphism in the enzymatic N-acetylation of sulfamethazine and other drugs in humans is well known and has been related to differential susceptibility to drug toxicities. Carcinogenic aromatic amines such as 2-aminofluorene also undergo N-acetylation, and phenotypic slow acetylator individuals have been suggested to be at increased risk to arylamine-induced urinary bladder cancer. However, acetyltransferases have also been shown to catalyze a final metabolic activation step in the conversion of both hydroxamic acid (e.g. N-hydroxy-N acetyl-2-aminofluorene N,O-acyltransferase) and N-hydroxy-arylamine (e.g. N hydroxy-2-aminofluorene O-acetyltransferase) metabolites to DNA-bound adducts. In this regard, rapid acetylators have recently been reported to be at higher risk for colorectal cancer. In this study, we examined the enzymatic activity of 35 human liver cytosol samples (obtained surgically from organ donors) for sulfamethazine and 2-aminofluorene N-acetyltransferase activities, N-hydroxy-N acetyl-2-aminofluorene N,O-acyltransferase activity, and the acetyl coenzyme A (CoA)-dependent O-acetylation of N-hydroxy-2-aminofluorene to form DNA-bound products. The results with sulfamethazine indicated that about two-thirds of the human liver samples were of the slow acetylator phenotype; the same individuals also exhibited levels of 2-aminofluorene N-acetylation that were consistent with their respective sulfamethazine-N-acetylation activity. N-Hydroxy-N-acetyl-2 aminofluorene N,O-acyltransferase activity was not detected. However, the acetyl CoA-dependent activation of N-hydroxy-2-aminofluorene was observed for nearly all of the samples and was consistently higher in the fast acetylator group. These data support the hypothesis that phenotypic rapid acetylator individuals are likely to be at higher risk to aromatic amine-induced cancers in those tissues containing appreciable levels of N-hydroxy arylamine O-acetyltransferase. PMID- 3677323 TI - Inhibitory effects of benzyl isothiocyanate administered shortly before diethylnitrosamine or benzo[a]pyrene on pulmonary and forestomach neoplasia in A/J mice. AB - The inhibitory effects of benzyl isothiocyanate, a naturally-occurring constituent of cruciferous vegetables, on carcinogenesis of the forestomach and lungs of female A/J mice given dimethylnitrosamine (DEN) or benzo[a]pyrene (BP) was investigated. When administered by gavage 15 min prior to p.o. carcinogen challenge, benzyl isothiocyanate almost completely inhibited forestomach tumor formation resulting from DEN but had no effect on pulmonary tumor formation. With BP as the carcinogen, benzyl isothiocyanate had inhibitory effects on carcinogenesis of both the forestomach and lungs, the latter being greater. The implications for epidemiology studies and for chemopreventive strategies of compounds that inhibit when administered shortly before carcinogen challenge are discussed. PMID- 3677324 TI - A multiparameter analysis of the perfused rat heart: responses to ischemia, uncouplers and drugs. AB - In perfused rat hearts alterations of aortic flow and mitochondrial membrane potential resulting from uncoupling of oxidative phosphorylation, hypoxia and treatment with a cardioprotective drug (2-mercaptopropionylglycine (MPG) have been studied. Mitochondrial membrane potential was followed by surface fluorimetry on DASPMI stained hearts. This fluorochrome specifically stains mitochondria in living cells; fluorescence intensity is related to the electrochemical gradient. Aortic flow turned out to be a much more sensitive indicator of heart function than ventricular pressure or mitochondrial membrane potential. No direct relationship exists between mitochondrial membrane potential and ATP production under the different metabolic conditions. Two phases of hypoxic mitochondrial damage have been deduced: the first results in derangement of ATP synthases while membrane potential is maintained, the second in irreversible damage of mitochondrial membranes with loss of membrane potential. PMID- 3677325 TI - A critical evaluation of the use of filipin-permeabilized rat hepatocytes to study functions of the endoplasmic reticulum in situ. AB - We have used transmission (TEM) and scanning electron microscopy (SEM) and leakage of lactate dehydrogenase (LDH; EC 1.1.1.27) to evaluate two published procedures which use filipin to render isolated rat hepatocytes permeable to ionic substrates. Cells treated by the procedure of Jorgenson and Nordlie retained less than 10 per cent of their LDH. TEM revealed severe damage to the internal structure of these cells, which included swelling, disintegration and extensive vesicularization of the endoplasmic reticulum (ER). Hepatocytes treated with filipin by the procedure of Gankema et al. retained 65-75 per cent of their LDH and displayed incomplete but highly variable permeability to Trypan blue. SEM revealed the loss of microvilli, other signs of swelling, and the presence of large lesions in the plasma membrane. TEM revealed signs of cell swelling, but the nuclei and the mitochondria were only moderately altered. The rough ER was not swollen, but significant fragmentation was evident and characteristic stacks of lamellar ER were never seen. We conclude that useful information about the functions of the ER in situ cannot be obtained from studies of filipin-treated cells. Our results indicate that retention of LDH is not a sufficient criterion of preservation of cell morphology and that staining with Trypan blue may significantly underestimate the permeability of cells to small ionic metabolites. PMID- 3677326 TI - Age-dependent changes in rat liver lipid peroxidation and glutathione content induced by acute ethanol ingestion. AB - The study of the influence of the age of animals (13 to 53 weeks) on total liver thiobarbituric acid reactive substances (TBAR) content showed an increase which is maximal in rats of 39 weeks of age compared to young animals (13 weeks), followed by a dimunition in the 53 weeks old group. In this situation, the content of hepatic GSH and total GSH equivalents as well as the GSH/GSSG ratio were decreased with ageing, while GSSG levels were enhanced in the oldest group studied. Acute ethanol intoxication resulted in a marked increase in liver TBAR content in young animals, together with a decline in GSH, total GSH equivalents and GSH/GSSG ratio, and an enhancement in GSSG. These changes elicited by ethanol intake were reduced with ageing. It is concluded that ethanol-induced oxidative stress in the liver is diminished during ageing, despite the progressive decrease in the glutathione content of the tissue observed in control animals. PMID- 3677327 TI - Pyruvate kinase activity and response to allosteric effectors in rat erythrocytes and reticulocytes fractionated by multiple partitioning in aqueous two-phase systems. AB - Specific activity of pyruvate kinase decreases as the age of rat erythrocytes increases in fractions obtained by counter-current distribution in dextran polyethylene glycol biphasic systems; the enzyme is inhibited by ATP and activated by fructose-1,6-bisphosphate at low phosphoenol pyruvate concentrations. Specific activity does not change in fractions from greater than 95 per cent-rich reticulocytes (anaemic rats); the enzyme is inhibited by ATP but not activated by fructose-1,6-bisphosphate. These results can be explained on the basis of different pyruvate kinase isozymes and suggest that decrease in activity is not affecting regulatory properties during erythrocytes aging. PMID- 3677328 TI - Toddler's diarrhoea: individual variation with environmental change. AB - Growing evidence suggests that environmental influences are relevant to the aetiology, maintenance and treatment of the common complaint of toddler's diarrhoea. Two presented cases demonstrate systematic fluctuations in frequency of diarrhoea by individual subjects, concurrent with changes of environment. PMID- 3677329 TI - A preschool severely disabled boy and his powered wheelchair: a case study. AB - A detailed account of the progress of a preschool child learning to steer a powered wheelchair via a mouth-operated joystick is described. Some problems were encountered during learning, but the positive effect on emotional, intellectual and behavioural development was noted. PMID- 3677330 TI - Assessment of abnormalities of gait in children from measurements of the instantaneous foot velocities during the swing phase. AB - A new gait analysis system is described which is microcomputer-based, of low cost and both suitable for and acceptable to children with neurological motor disorders. A variety of different gait abnormalities and neurological conditions have been analysed and quantitative gait information is illustrated from this equipment which provides, after a short walk, an immediate profile of the objective measurements of the main spatial and temporal parameters of the gait cycle, i.e. step length, stride time, double support time, cadence, average walking speed and maximum velocity of the foot during the swing phase. PMID- 3677331 TI - Monitoring the developmental examination schedule in an inner city health district. AB - Returns of scheduled school entry examinations, from 838 primary school children in West Lambeth Health Authority, were analysed to assess the possible association of a child's home language background, age, sex, behaviour, and examiner with the results of the developmental examination. To allow for variation in social characteristics between participating schools, a ward index of deprivation based on the 1981 census was assigned to all the children in the schools of each ward. Variables representing development were most consistently associated with the child's behaviour during the examination and with the examiner. A child's home language background was associated only with the auditory memory test. The child's ability to concentrate during the test situation was closely related to his performance. With respect to the examiners, it is suggested that community health services need to consider schemes of ongoing in-service training and careful calibration of the tests. PMID- 3677332 TI - A move from hospital to community: evaluation of community contacts. AB - A small-scale evaluation was made of the activities and social contacts of a group of young mentally handicapped people in one project, leaving hospital to a house in the community. The results are consistent with other recent work in suggesting that residential provision in small homes for people with severe or profound intellectual or multiple handicaps is likely to lead to increased family contact, increased participation in activities outside of the residence, and an increased frequency and duration of contact with non-handicapped people. The study suggests that many of these benefits of life in the community are dependent in various ways upon the staff employed. The nature of the young people's social contacts is examined and conclusions are drawn about specific issues, including staff selection and training, and attention to the maintenance as well as the provision of social contact. PMID- 3677333 TI - Effect of hemodilution on endothelium-dependent vasodilation in the in vivo canine femoral artery. AB - The vasodilation responses to increased blood flow and acetylcholine require endothelial cells. We noticed that dogs with low hematocrit had reduced endothelial cell dependent responses; infusion of whole blood often restored the responses. Therefore, experiments were designed to test the hypothesis that hemodilution attenuates endothelial cell-dependent dilation. An extracorporeal shunt was created from the femoral artery to the jugular vein in pentobarbital anesthetized dogs. Femoral artery diameter was measured by sonomicrometry. Blood flow was controlled by a screw clamp placed distally on the shunt tubing, and flow was increased from control (10% maximum) to maximum by opening the clamp for 3 mins. Hemodilution was achieved by withdrawal of whole blood and infusion of either 1) saline, 2) physiologic salt solution (PSS, containing 2.7 mM CaCl2), 3) saline with CaCl2 (2.7 mM), or 4) PSS without CaCl2. Endothelial cell-dependent dilations were evaluated after a 50% decrease in hematocrit. Hemodilution with either PSS or saline with CaCl2 did not decrease dilation responses to increased flow or acetylcholine. However, hemodilution with saline or PSS without CaCl2 markedly attenuated endothelium-dependent dilations. Ionized plasma calcium concentration decreased with saline and PSS without CaCl2 hemodilution, but it was maintained with PSS and saline with CaCl2 hemodilution. These data suggest that a 50% decrease in hematocrit does not influence endothelium-dependent dilation if plasma calcium is maintained. Our data support in vitro results that suggest that extracellular calcium is necessary for the release of endothelium derived relaxing factor. Furthermore, relatively small changes in ionized calcium, within the physiologic range, have large effects on endothelial cell mediated dilator responses to flow and acetylcholine. However, relatively large changes in hematocrit have no effect on the endothelium-dependent responses. PMID- 3677334 TI - Role of adrenal steroids in the recovery from platelet activating factor challenge. AB - Previous studies have shown that platelet activating factor (PAF) is a potentially important mediator of the acute hypotensive response to endotoxin. Direct administration of PAF to rodents induces profound hypotension and hemoconcentration; normal blood pressure recovery requires an intact sympatho adrenal medullary system. Because adrenal steroids are also important in the physiological response to shock, the present studies were conducted to determine whether treatment of rodents with cortisone or surgical adrenalectomy would alter cardiovascular parameters during recovery from PAF challenge. When rats were pretreated daily for four days with cortisone (25 mg/kg, sc), the hypotensive response to PAF injection (2 micrograms/kg, iv) was significantly blunted (P less than 0.05). In adrenalectomized rats, recovery of blood pressure was significantly delayed (P less than 0.01). Heart rate was not significantly changed in the anesthetized rat preparation used. Pretreatment of mice with cortisone (25 mg/kg/day, sc, 4 days) completely blocked the increased vascular permeability, as measured by a rise in hematocrit induced by PAF (2 micrograms/kg, iv) (P less than 0.001). Adrenalectomized mice had a rise in hematocrit similar to that in sham-operated animals. Lung wet:dry weight ratio after PAF challenge was unaffected by cortisone or adrenalectomy. These results suggest that adrenal cortical glucocorticoids, in addition to adrenal medullary catecholamines, participate in the recovery from the cardiovascular alterations following PAF administration. Further, the efficacy of steroid pretreatment in shock models might involve, in part, the inhibition or reversal of PAF-induced cardiovascular alterations. PMID- 3677335 TI - Inotropic response to hypothermia and the temperature-dependence of ryanodine action in isolated rabbit and rat ventricular muscle: implications for excitation contraction coupling. AB - We have used the sarcoplasmic reticulum (SR) inhibitor ryanodine to assess the contribution of the SR to the increase in twitch tension seen on cooling the mammalian myocardium. To select a suitable concentration of ryanodine, i.e., one that will exert a maximal effect at all temperatures studied, concentration response curves for ryanodine action were constructed at 37 degrees, 29 degrees, and 23 degrees C in ventricular muscle from rabbit and rat. Using a concentration of ryanodine (1 microM) that exerted a maximal effect at all temperatures studied, the ability of ryanodine to inhibit SR function at 37 degrees, 29 degrees, and 23 degrees C was then confirmed by using rapid cooling contractures (RCCs) to provide an indirect assessment of the SR calcium content. To estimate the rest decay of the SR calcium content in the absence and presence of ryanodine (1 microM), RCCs were initiated after a range of rest intervals (0.3-300 seconds) in rabbit muscles maintained at 37 degrees, 29 degrees, or 23 degrees C. In the absence of ryanodine, low temperatures elevated RCCs at all rest intervals studied. In the presence of ryanodine, RCCs were only seen at rest intervals shorter than 2.0 seconds, even at 23 degrees C, the lowest temperature studied. Thus, even at 23 degrees C, ryanodine appears to be effective at inhibiting SR calcium release in muscles stimulated at 0.5 Hz (i.e., after 2 seconds rest). Therefore, using this concentration of ryanodine (1 microM) and a stimulation rate of 0.5 Hz, we have investigated the contribution of the SR to the positive inotropic response to hypothermia. Under these conditions, the positive inotropic response to cooling in rabbit ventricle was almost unaffected by the inhibition of the SR with ryanodine. In rat ventricle, a tissue in which SR calcium release may dominate excitation-contraction (EC) coupling, the inotropic response to hypothermia was still observed, although developed tension was strongly depressed at all temperatures. These results suggest that a change in SR function is not the principal mediator of the large (400-500%) increase in force associated with cooling mammalian ventricular muscle from 37 degrees to 25 degrees C. The ryanodine-sensitive fraction of tension development was greatest at 37 degrees C, suggesting that the relative contribution of the SR to tension development in rabbit ventricle is reduced at temperatures below 37 degrees C.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3677336 TI - Cardiovascular and respiratory effects of adenosine in conscious man. Evidence for chemoreceptor activation. AB - The cardiovascular and respiratory effects of intravenous adenosine were studied in conscious normal volunteers. Bolus injections of adenosine increased systolic and diastolic pressures initially (+15 and +13 mm Hg after 100 micrograms/kg) followed by a subsequent reduction in systolic and diastolic pressures (-12 and 16 mm Hg). Heart rate increased during trough blood pressure (R-R interval shortening of 298 msec after 100 micrograms/kg). Adenosine steady-state infusions increased heart rate (+30 beats/min during 140 micrograms/kg/min), systolic pressure (+16 mm Hg), and pulse pressure (+21 mm Hg) but decreased diastolic pressure slightly (-5 mm Hg), resulting in no significant change in mean arterial pressure. Adenosine stimulated respiration, resulting in decreased PaCO2 (41 to 31 mm Hg), increased PaCO2 (101 to 113 mm Hg), and increased pH (7.42 to 7.50). The increased ventilation was not explained by bronchoconstriction, hypotension, or hypoxia. The observed pressor and tachycardic effects are mediated through reflex autonomic mechanisms since they are completely abolished in patients with severe autonomic failure. These autonomic mechanisms probably involve chemoreceptor activation since adenosine is pressor when infused in the aortic arch proximal to the origin of the carotid arteries but depressor when infused in the descending aorta. It is concluded that the hemodynamic and respiratory effects of adenosine observed in normal volunteers are in part due to chemoreceptor stimulation. These findings raise the possibility that adenosine is an endogenous modulator of respiration in man. PMID- 3677337 TI - Effects of a drag-reducing polyelectrolyte of microscopic linear dimension (Separan AP-273) on rat hemodynamics. AB - Separan AP-273, a polydisperse, high molecular weight (10(5)-10(7) dalton range), anionic polyacrylamide, demonstrates polymer drag reduction (Toms effect) in the flows of several substances including blood. That is, under appropriate conditions, pipe flow can be increased markedly for a given pressure gradient, sometimes threefold or more, by nanomolar concentrations of linear macropolymers. The effect of intact and degraded Separan was tested in the open-chest, anesthetized rat, and left ventricular and carotid pressures, aortic blood flow (electromagnetic flow probe on ascending aorta), and the electrocardiogram were recorded. The results indicate that aortic flow, which in control animals was about half the flow reported for conscious rats, increases markedly after injection of Separan. The effect on blood pressure after an initial fall was variable, but the slope of arterial diastolic pressure was consistently steepened. Electrocardiographic changes were unremarkable except for a slow decline in heart rate. Although secondary reflexes undoubtedly influenced the results, the primary mechanism of the polymer appears to involve a reduced resistance to flow. The results are compatible with the proposal that the Toms effect, or some variant of it, is operative in vivo under favorable conditions. If this view is correct, then Separan and two other chemically different macropolymers with similar hemodynamic effects and physical attributes, i.e., linearity and molecular lengths approaching 100 micron, might be prototypes of a novel category of cardiovascular drugs. PMID- 3677338 TI - A model study of the effects of the discrete cellular structure on electrical propagation in cardiac tissue. AB - The effects of the discrete cellular structure on propagation of electrical excitation in cardiac muscle were studied in a one-dimensional fiber model containing a periodic intercalated disk structure. Globally, the macroscopic velocity of propagation follows the behavior associated with propagation in a continuous tissue (except for high values of disk resistance). In addition, the computed spatial extracellular potential along the fiber is a smooth biphasic waveform and does not reflect the underlying discrete cellular structure of the tissue. Other results of the simulations demonstrate the discontinuous nature of propagation and the importance of the structure in arrhythmogenesis. Vmax displays a biphasic behavior as a function of increasing intercalated disk resistance. An initial "paradoxical" increase in Vmax (with a simultaneous decrease in conduction velocity) is followed by a decrease that leads to decremental propagation and conduction block. The time constant of the foot of the action potential (tau foot) increases monotonically with increasing intercalated disk resistance. An increase in the leakage current to extracellular space brings about a significant decrease in the action potential duration and a loss of the plateau. This major effect is accompanied by a relatively smaller decrease in conduction velocity. Collision of two activation wavefronts results in a significant (100%) increase in Vmax and a very small (0.6%) decrease in tau foot. PMID- 3677339 TI - Accumulation of 5-hydroxytryptamine leads to dysfunction of adrenergic nerves in canine coronary artery following intimal damage in vivo. AB - Previous in vitro studies have demonstrated that coronary artery adrenergic nerves are a principal site of accumulation of 5-hydroxytryptamine released from aggregating platelets. The purpose of this study was to determine whether 5 hydroxytryptamine is accumulated by adrenergic nerves at sites of endothelial damage and platelet aggregation in vivo. Coronary artery 5-hydroxytryptamine content and response to in vitro adrenergic nerve stimulation were studied in dogs 24 hours following balloon catheter-induced intimal injury. 5 Hydroxytryptamine content was significantly increased in the catheter-damaged arteries, and there was a coincident decrease in the content of norepinephrine. The relaxation caused by acetylcholine was abolished in the catheter-injured arteries, indicating loss of this endothelial cell-mediated function. The normal beta-adrenergic relaxation caused by nerve stimulation was inhibited, and in some cases, contractions resulted; these effects were prevented by serotonergic receptor antagonists. The sensitivity to exogenously added norepinephrine was unchanged, indicating that the changes in the response to nerve stimulation were not due to an altered smooth muscle response to the native neurotransmitter. These observations indicate that following intimal damage, which produces platelet aggregation on the luminal surface of the blood vessel, 5 hydroxytryptamine can assume a transmitter role in coronary artery adrenergic nerves and thereby cause their dysfunction. PMID- 3677340 TI - Reversibly injured, postischemic canine myocardium retains normal contractile reserve. AB - Transient coronary occlusion (15 minutes) does not result in irreversible myocardial injury but is associated with a depression of contractile function sustained for several hours to days ("stunned myocardium"). The defect in the contractile process responsible for this phenomenon has been suggested to be causally related to a reduced energetic state, altered excitation or excitation contraction coupling, or damaged contractile filaments. The purpose of this study was to attempt to exclude one or more of these hypotheses by evaluating the contractile reserve of reperfused myocardium. Regional subendocardial segment function was measured (sonomicrometry) in a control region and in an area (treatment region) perfused by a carotid artery to anterior descending coronary artery bypass in 13 chloralose-anesthetized dogs. Dose-response curves were constructed from changes in segment shortening (%SS) in response to intracoronary calcium infusion before ischemia and following 5 or 15 minutes of occlusion and reperfusion (30 minutes). Calcium infusion before ischemia resulted in dose dependent increases in %SS in the treatment area to a maximum value of 36.6% from a preinfusion value of 25.5% (p less than 0.01), in the absence of changes in control region shortening (23.7%). After 15 minutes of occlusion and reperfusion, treatment area %SS had fallen to a depressed but stable level (46% of preischemic values; p less than 0.01). Subsequent calcium infusion at the same doses as in the preischemic trial produced increases in treatment segment function with return of shortening to control levels at an intermediate dose. At the highest dose, %SS was 35.4%, which was not different from the maximal value found in the preischemic trial. Alterations in heart rate and left ventricular systolic and diastolic pressures during calcium infusion were minor and similar before and after ischemia. Calcium-induced increases in regional segment shortening above control levels (113% of control) in reperfused myocardium were sustained with continuous infusion (30 minutes) without deleterious effects on subsequent function. These results demonstrate that stunned myocardium in this model retains a normal contractile reserve in response to calcium, suggesting that the mechanism responsible for postischemic contractile dysfunction involves calcium. PMID- 3677341 TI - Negative inotropic effects of amrinone in the neonatal piglet heart. AB - Cardiac mechanical function and coronary flow (CF) were measured in isovolumically beating hearts from neonatal piglets 0.5 to 12 days of age. The hearts were perfused retrogradely at 70 cm H2O with a recirculating modified Krebs-Henseleit solution containing washed adult pig red cells (hematocrit, 25%). They were electrically paced (180 beats/min), and left ventricular developed pressure (delta P), maximum rate of rise of pressure (dP/dt), CF, and myocardial oxygen consumption were measured. These parameters were found to remain stable for at least 60 minutes. In one group, a single dose of amrinone was added to the perfusate to yield a concentration of 50 micrograms/ml. Within 5 minutes delta P decreased from 104.0 +/- 7.1 to 65.3 +/- 8.6 mm Hg (p less than 0.001), and dP/dt fell from 1,160 +/- 96 to 658 +/- 78 mm Hg/sec (p less than 0.001). In a second group, successive doses of amrinone were added to yield concentrations ranging from 5 to 50 micrograms/ml. There was a progressive decrease in delta P and dP/dt to 66.5 +/- 4.2% and 57.6 +/- 4.8% of initial values, respectively. CF increased progressively from 3.2 +/- 0.2 to 6.8 +/- 0.5 ml/min/g. In 3 experiments, amrinone was washed out after achieving the maximum concentration. Depressed mechanical function reversed and delta P and dP/dt returned to control values in each heart. Additionally, CF decreased from 7.6 +/- 0.3 to 5.0 +/- 0.2 ml/min/g. It is concluded that amrinone has concentration-dependent negative inotropic actions in the neonatal piglet heart. Hence, the drug may not be useful in treating heart failure in the human neonate. PMID- 3677342 TI - Enhancement of mitochondrial oxidative phosphorylation capability by hypoperfusion in isolated perfused rat heart. AB - To define alterations in myocardial mitochondrial function due to hypoperfusion, oxidative phosphorylation was simultaneously studied in 17 control (stable perfusion pressure) rat hearts and 17 hypoperfused isolated rat hearts. Hypoperfusion for 30 minutes was achieved by a reduction in coronary perfusion pressure from 77.8 +/- 1.2 mm Hg (mean +/- SEM) to 20.2 +/- 1.8 mm Hg in the experimental group (control perfusion pressure after 30 minutes 75.6 +/- 1.2). Hypoperfusion caused a reduction in left ventricular developed pressure to 20.5 +/- 1.5 mm Hg (versus control 74.8 +/- 3.3, p less than 0.0001), a reduction of coronary flow rate to 4.9 +/- 0.3 ml/min (versus control 19.4 +/- 1.2, p less than 0.0001), and a drop in myocardial oxygen consumption to 0.06 +/- 0.005 ml O2/min (versus control 0.17 +/- 0.01, p less than 0.0001). Myocardial lactate production was increased by hypoperfusion (3.0 +/- 0.6 mumol/min) compared with controls (0.7 +/- 0.5, p less than 0.02), but myocardial creatine kinase release was similar in the hypoperfused and control groups. Hypoperfusion was associated with an augmentation of state 3 mitochondrial respiration with glutamate and malate as respiratory substrates (448.8 +/- 14.0 ng atoms O/min/mg mitochondrial protein versus controls 290.7 +/- 13.4, p less than 0.001). When rates were normalized for mitochondrial malate dehydrogenase (MDHm), state 3 respiration was still increased in hypoperfused hearts (24.1 +/- 2.1 ng atoms O/min/IU MDHm) compared with controls (15.5 +/- 1.6, p less than 0.02). The rates of dinitrophenol-uncoupled electron transport were similar to the rates of state 3 respiration in both the hypoperfused and control groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677343 TI - Acute hypertension selectively potentiates constrictor responses of large coronary arteries to serotonin by altering endothelial function in vivo. AB - We tested the hypothesis that acute coronary artery hypertension may damage vascular endothelium and alter vasomotor responses to humoral agents. We examined effects of intracoronary infusion of the endothelium-dependent agent serotonin and two endothelium-independent agents, angiotensin II and methoxamine, on large coronary artery diameter in the blood perfused dog heart. Responses were examined before and 30 minutes after brief periods of coronary hypertension (200 mm Hg for 10 seconds to 15 minutes). In open-chest anesthetized dogs, the left anterior descending coronary artery was perfused at constant pressure. Coronary diameter (D) was measured with piezoelectric crystals. At a control perfusion pressure of 80 mm Hg, serotonin produced dose-dependent constriction of the large coronary artery (mean +/- SEM; delta D = -22 +/- 10 microns at 5 micrograms/min; -108 +/- 50 microns at 50 micrograms/min). Increasing perfusion pressure to 200 mm Hg increased flow 515 +/- 79% and coronary diameter 509 +/- 9 microns. After 15 minutes of hypertension, when coronary diameter had returned to baseline values, the constriction of the large artery to serotonin was potentiated (delta D = -89 +/- 33 microns at 5 micrograms/min; -207 +/- 45 microns at 50 micrograms/min; p less than 0.05). Hypertension for 1-5 minutes potentiated constrictor responses of large coronary arteries for at least 2 1/2 hours. Removal of endothelium prevented effects of hypertension on constrictor responses of large arteries to serotonin. Hypertension did not alter constrictor responses to angiotension II (1 and 2.5 micrograms/min) or methoxamine (50 and 100 micrograms/min) or the dilator response to acetylcholine (40 micrograms/min). Acute hypertension altered endothelial morphology. There were small endothelial craters following 10 seconds of hypertension, and disruption of endothelial junctions with leukocyte adherence following 1-15 minutes of hypertension. We conclude that acute hypertension alters constrictor responses of large coronary arteries to serotonin by impairing endothelial function and not by directly affecting vascular smooth muscle. These effects of acute hypertension on vascular reactivity are selective in that they do not involve non-endothelium-dependent agents or the endothelium-dependent agent, acetylcholine. The effect of hypertension also persists long after pressure is restored to normotensive levels. PMID- 3677344 TI - Acute decrease in left ventricular diastolic chamber distensibility during simulated angina in isolated hearts. AB - It is not clear what factors contribute to the prompt and reversible decrease in left ventricular diastolic chamber distensibility during angina pectoris that is induced by an increase in myocardial energy demand due to exercise or pacing tachycardia. To simulate the demand ischemia that occurs clinically during pacing induced angina, we used isolated, blood-perfused rabbit hearts with restricted coronary flow and increased myocardial energy demand. A constant left ventricular balloon volume model was used to measure left ventricular diastolic chamber distensibility during 6 minutes of low-flow global ischemia, induced by a reduction in coronary perfusion pressure from 100 to 20 mm Hg. To investigate the influence of different levels of myocardial energy demand, the effects of two different heart rates were studied during low-flow global ischemia; pacing tachycardia (6.4 +/- 0.2 Hz, n = 7) was compared with the rabbit's baseline heart rate of 4 Hz (n = 7). Low-flow ischemia caused a marked decrease in contractile function relative to the baseline preischemic state. In the pacing-tachycardia group, myocardial energy demand, as estimated by the rate X systolic pressure product, was significantly greater than in the constant heart-rate group. When tachycardia was imposed during low-flow global ischemia, there was a transient and reversible increase in isovolumic left ventricular end-diastolic pressure from 14 +/- 1 to 25 +/- 4 mm Hg (measured during long diastoles obtained with transient cessation of pacing) in the pacing-tachycardia group, but there was no increase in left ventricular end-diastolic pressure during low flow ischemia in the constant heart-rate group with lower energy demand (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677345 TI - Cytosolic calcium staircase in cultured myocardial cells. AB - To elucidate the mechanism of the tension staircase, chick embryonic myocardial cell aggregates were loaded with the fluorescent cytosolic calcium indicator, indo 1. Fluctuations in indo 1 fluorescence were compared with recordings of cell edge movement during spontaneous beating and during stimulation by intracellular current pulses. Indo 1-loaded aggregates exhibit fluorescence transients during each transmembrane action potential. The rising phase of the transients is rapid, but the decaying phase is slow (several hundred msec) and is similar in time course to the pandiastolic relaxation seen in the optical recordings of cell edge movement. Acceleration of beat frequency by brief depolarizing current pulses produces an ascending staircase in both edge movement and systolic [Ca2+]i. There is a similar staircase in the diastolic [Ca2+]i, which is also reflected by diastolic cell edge movement. The existence of a diastolic [Ca2+]i staircase may provide new insight into the mechanism of the force-frequency relation in the heart. PMID- 3677346 TI - Comments on "Analysis of systolic bulging: mechanical characteristics of acutely ischemic myocardium in the conscious dog". PMID- 3677347 TI - Prediction of complex atrioventricular conduction rhythms in humans with use of the atrioventricular nodal recovery curve. AB - Theoretical considerations indicate that complex patterns of atrioventricular conduction produced by rapid atrial stimulation can be predicted from changes in atrioventricular conduction produced by premature stimulation of the atrium. The purpose of this study was to evaluate the validity of this theoretical approach in seven patients undergoing electrophysiologic investigation. The atrioventricular nodal recovery curve was determined at two different basic cycle lengths. Subsequently, periodic atrial stimulation was delivered for 30 sec periods over a range of frequencies giving 11, Wenckebach, reverse Wenckebach, and 21 rhythms. The recovery curve data was then used to compute the response to periodic stimulation by an iterative technique. The conduction patterns actually seen during periodic atrial stimulation showed close agreement with the computed patterns. This work thus provides a unified explanation for the appearance of Wenckebach, reverse Wenckebach, alternating Wenckebach, and high grade block rhythms. PMID- 3677348 TI - Effects of pacing-induced ischemia on early left ventricular filling and regional myocardial dynamics and their modification by nifedipine. AB - The effect of pacing-induced ischemia on early left ventricular filling and regional myocardial lengthening was studied in 11 patients with coronary artery disease (CAD) and six control patients with normal coronary arteriograms. All of the 11 patients with CAD developed typical anginal pain during pacing tachycardia, and in the postpacing beat, the left ventricular end-diastolic pressure (LVEDP) rose from 13 +/- 4 to 26 +/- 4 mm Hg (mean +/- SD, p less than .01), the relaxation time constant increased from 43 +/- 9 to 59 +/- 7 msec (p less than .01), and the ejection fraction diminished from 62.1 +/- 6.7 to 51.6 +/ 10.6% (p less than .01). However, the peak rate of early left ventricular filling (LVPF) obtained from frame-by-frame analysis of left ventriculograms and the LVPF normalized for the stroke volume and for the end-diastolic volume did not change significantly. In the ischemic segment, the peak rate of lengthening (PL) decreased by 45% with ischemia, and the PL normalized for the end-diastolic segment length decreased by 42%. However, the PL normalized for the extent of systolic shortening did not change. In the control segment there was a tendency for these three variables to increase, but the changes were not statistically significant. The time difference from the PL to the LVPF increased significantly in the ischemic segment (31 +/- 28 vs 75 +/- 48 msec, p less than .05). Although the LVEDP rose slightly but significantly from 9 +/- 3 to 12 +/- 5 mm Hg (p less than .05) in the control patients in the postpacing beat, the other global hemodynamic variables and the variables of regional myocardial dynamics did not change. The administration of nifedipine in six patients with CAD resulted in the disappearance or diminution of anginal pain even with the same duration and rate of pacing and was associated with restoration of global systolic function and regional myocardial shortening and lengthening in the ischemic segment. In the control segment, the three variables of segmental lengthening increased with administration of nifedipine. Thus, the segmental myocardial lengthening rate decreased with ischemia due to a decrease in segmental shortening and impairment of myocardial distensibility. The LVPF did not decrease with ischemia despite impairment in isovolumetric relaxation, accentuation of asynchrony in left ventricular filling, and a decrease in the PL in the ischemic segment because of an increase in the PL in the nonischemic segment secondary to an increase in left ventricular filling pressure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3677349 TI - Secular decline in death rates due to ischemic heart disease in Mexican Americans and non-Hispanic whites in Texas, 1970-1980. AB - Although the decline in ischemic heart disease mortality is now entering its third decade, there has been no definitive information on the experience of Mexican Americans, the nation's second largest minority group. Earlier studies carried out in the 1970s were hampered by the unavailability of satisfactory population data beyond 1970. In the present study we have used 1970 and 1980 census data to compute death rates in Mexican Americans and non-Hispanic whites from Texas for the periods 1969-1971 and 1979-1981. All four sex-ethnic groups showed statistically significant declines in death rates due to all causes, due to total ischemic heart disease, and due to acute myocardial infarction between 1969-1971 and 1979-1981. Declines in the latter two causes of death were least marked in Mexican American men. This sex-ethnic group was also the only one that failed to show a decline in death rates due to chronic ischemic heart diseases. The fact that Mexican Americans have been shown to be less well informed about and less likely to adopt lifestyle changes aimed at reducing heart disease risk than non-Hispanic whites may account for the less striking mortality decline observed in Mexican American men, but is harder to reconcile with the apparent equal decline in Mexican American women compared with non-Hispanic whites. PMID- 3677350 TI - Quantitative relationship between left ventricular function and serum cardiac myosin light chain I levels after coronary reperfusion in patients with acute myocardial infarction. AB - To estimate the extent of myocardial infarction after coronary artery reperfusion, serum levels of cardiac myosin light chain (LC) I and creatine kinase (CK) were determined serially in 49 patients with acute myocardial infarction. Intracoronary thrombolysis was successful in 25 patients (reperfusion group), and 24 patients were treated in a conventional manner (control group). The peak level of CK appeared significantly earlier in the reperfusion group (11.3 +/- 3.1 hr, mean +/- SD) than in the control group (21.6 +/- 7.2 hr). Cumulative release of CK was significantly related to angiographically determined left ventricular ejection fraction 1 month after the attack in both groups (r = .50; -.45, respectively). However, the amount of cumulative release of CK in the reperfusion group was greater compared with that in those with the same left ventricular ejection fraction in the control group. Peak appearance time of LCI was almost equal in the two groups (3.8 +/- 1.4 vs 3.9 +/- 1.2 days). Peak levels of LCI were related to the left ventricular ejection fraction in the reperfusion group (r = -.63) and in the control group (r = -.74), and the slopes of their regression lines were similar. The cardiac index obtained on the day of onset in the two groups was related to peak levels of LCI but not to total release of CK. These results suggest that serum levels of LCI reflect the changes in left ventricular function after acute myocardial infarction, regardless of the presence of coronary reperfusion. Thus, serial determinations of LCI in serum facilitate noninvasive assessment of the effects of intracoronary thrombolysis on infarct size. PMID- 3677351 TI - Measurement of myocardial blood flow by ultrafast computed tomography. AB - Myocardial blood flow was analyzed by radioisotope-labeled microspheres and ultrafast computed tomography (CT) in 16 closed-chest, anesthetized dogs. The first set of 10 dogs had CT and microsphere measurements before and after chromonar-induced increases in myocardial blood flow. A second set of six dogs had flows measured at control and during temporary reductions in regional flow produced by balloon cuff occlusion of the left anterior descending coronary artery. All dogs had four-slice, 20-instance CT scans after injection of a medium bolus (0.35 ml/kg) of contrast medium into a femoral vein simultaneous with injection of microspheres into the left atrium. CT myocardial flow was calculated as the change in myocardial CT numbers divided by the area from a blood pool time density curve. A wide range of myocardial blood flows was produced as determined by microspheres (0 to 6.7 ml/min/g). Global flow of the first set of dogs was shown to have excellent correlation (r = .95, n = 17) for a limited range (.4 less than X less than 1.4 ml/min/g) of flows. Regional flows of these measurements demonstrated less correlation (r = .63, n = 110) but extended the range of flow to 1.7 ml/min/g. At higher flows (greater than 2.5 ml/min/g) the correlation for global and regional flows was not significantly different than zero. Regional ischemic flow correlation extended the linear range of flow to 0 ml/min/g (r = .62, n = 17). These results show that CT can measure myocardial blood flow over a limited but clinically relevant range of flows defined as slightly above normal to ischemic. These results indicate that another preparation of CT flow measurement must be sought for quantification of myocardial perfusion values significantly above normal. PMID- 3677353 TI - A validation of derived epicardial potential distributions by prediction of the coronary artery involved in acute myocardial infarction in humans. AB - We have developed computer algorithms that enable epicardial potential distributions to be calculated from electrocardiographic body surface data. To validate this inverse transformation we obtained body surface maps during the ST segment in 55 patients with acute infarction who subsequently underwent coronary arteriography and we constructed epicardial ST segment potential distributions for each patient. From the unlabeled epicardial maps one of us predicted the coronary artery that would be found to be involved in the infarction. These predictions were compared with the results of coronary arteriography and this showed that the analysis of the epicardial map correctly predicted the coronary artery involved in 40 of 55 patients (72.7%). In another eight patients the anatomy was partially predicted. In the 15 patients in whom the prediction was incorrect or partially correct (27.3%), 11 had critical disease or occlusions of the predicted coronary artery but the infarct-related artery was incorrectly identified. This verifies that sensible epicardial potential maps can be calculated from body surface electrocardiographic data, and that these data are sufficiently accurate to predict the vessel involved in acute infarction. PMID- 3677352 TI - Load independence of the rate of isovolumic relaxation in man. AB - This investigation was designed to determine whether the rate of isovolumic left ventricular pressure decline is affected by load in man. Fourteen patients were instrumented with micromanometer left ventricular and right atrial pacing catheters to maintain a constant heart rate during control conditions and infusion of methoxamine or nitroprusside. The isovolumic relaxation period was defined as the time from peak (-)dP/dt to 5 mm Hg above left ventricular end diastolic pressure of the following beat. The rate of isovolumic relaxation was calculated as time constants (Tau) from the linear regression of natural log pressure vs time (Tln) and instantaneous (-)dP/dt vs pressure (TD), which includes a variable asymptote (PB). The mean heart rates and average (+)dP/dt values normalized at 40 mm Hg development pressure (DP40) did not differ significantly, despite 33% and 43% increases in left ventricular peak and end diastolic pressures during the infusion of methoxamine (p less than .001 and p less than .01, respectively) and 24% and 29% decreases during the infusion of nitroprusside (p less than .001 and p less than .01, respectively). The average Tln and TD values were not significantly affected by these alterations in load. In two patients, an inverse linear relationship was demonstrated between decreases in Tau and increases in contractile state produced by an infusion of dobutamine, as shown by correlation of Tln and TD with (+)dP/dt/DP40 (r = -.88 and -.83, respectively). We conclude that the time constants of left ventricular isovolumic relaxation are unaffected by modest alterations in loading conditions in man when heart rate is maintained constant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677354 TI - Detection and localization of coronary artery disease with body surface mapping in patients with normal electrocardiograms. AB - Patients with clinically significant coronary artery disease often have normal resting electrocardiograms. Clinical and experimental studies have shown that body surface potential maps provide improved recognition of some disease states and more regionally selective information than standard electrocardiograms. Body surface maps were recorded at rest from 41 symptomatic patients with angiographically documented coronary artery disease and normal electrocardiograms. Patient maps were statistically compared with maps recorded from 644 normal subjects with the use of previously reported data representation technique. By this technique, maps from patients with symptomatic coronary artery disease and normal electrocardiograms were separated from maps of normal subjects with a sensitivity and specificity greater than 94%. The majority of discriminating information was present in the QRS interval. Fifteen of the 41 symptomatic patients had documented single-vessel coronary disease and their maps were separately compared with normal maps. Average maps from each of three patient groups with single-vessel disease contained abnormal patterns during the QRS interval that were unique to the vessel affected. In comparison with a average map from normal subjects, the average map from the group with left anterior descending coronary disease showed lower potentials over the anterior and inferolateral thorax during the early to mid QRS interval, the average map from the circumflex disease group showed decreased potentials around the entire inferior thorax in the mid to late QRS interval, and the average map from the right coronary disease group showed decreased potentials over the right anterior thorax during the mid to late QRS interval.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677355 TI - Neodymium:YAG laser photocoagulation: a successful new map-guided technique for the intraoperative ablation of ventricular tachycardia. AB - Neodymium:YAG laser photocoagulation was used in the intraoperative treatment of drug-resistant ventricular tachycardia (VT) in 17 consecutive patients. The cause of VT was previous myocardial infarction in 15, sarcoid in one, and idiopathic in one patient. Electrophysiologic studies were performed preoperatively, before hospital discharge, and 8 to 12 weeks and 1 year after surgery. At surgery, laser photocoagulation was performed on the normothermic heart during VT. Surgical mortality was 11.7%. There was one late nonarrhythmic death 35 days postoperatively. There were 55 VT morphologies. Laser successfully abated 52 of 55. Associated use of cryoablation was required in two of 55. One VT in the patient with sarcoidosis was not successfully ablated but was controlled by procainamide. In the long-term survivors with VT due to myocardial infarction the surgical cure rate was 100%, i.e., no spontaneous or inducible VT. Follow-up ranges from 6 to 18 months (mean 11.8 +/- 4.3). Nd:YAG laser photocoagulation is an effective addition to the operative treatment strategies for VT. PMID- 3677356 TI - Cryosurgical treatment of atrioventricular node reentrant tachycardia. AB - Paroxysmal supraventricular tachycardia most commonly arises from reentry within the atrioventricular (AV) node. Although ablation of the His bundle has gained popularity for treating patients with AV node reentrant tachycardia refractory to medical therapy, undesirable sequelae include complete heart block and the necessity for a permanent pacemaker. To obviate this limitation, we have developed a discrete cryosurgical procedure that interrupts the reentrant circuit responsible for AV node reentrant tachycardia without blocking AV conduction. After first characterizing the salutary effects of this approach in experimental animals, we performed this procedure in eight patients with AV node reentrant tachycardia. Preoperative, intraoperative, and postoperative electrophysiologic studies were performed in each patient. Under conditions of normothermic cardiopulmonary bypass and during atrial pacing at a constant rate with continuous monitoring of AV conduction, nine separate 3 mm cryolesions (-60 degrees C for 2 min) were placed at predetermined sites around the triangle of Koch in the lower right atrial septum. Postoperatively, each patient had a single AV node conduction curve. No patient had AV node reentrant tachycardia induced or has experienced AV node reentrant tachycardia clinically during a follow-up of up to 5 years. The cryosurgical procedure had no detrimental effects on the AH or HV interval or on the paced cycle length at which AV node Wenckebach occurred. Based on these results, this curative operation offers promise for patients with AV node reentrant tachycardia that is refractory to medical treatment. PMID- 3677357 TI - Blood flow distribution within skeletal muscle during exercise in the presence of chronic heart failure: effect of milrinone. AB - Recent studies suggest that, in the presence of heart failure, the capability of skeletal muscle to utilize delivered flow may be impaired due to maldistribution of blood flow within working muscle. Similarly, this mechanism could explain the failure of drugs to improve maximal oxygen consumption (VO2max) immediately. Accordingly, we assessed muscular blood flow distribution (ml/min/g, radioactive microspheres, 15 +/- 5 micron) among and within working muscle, VO2max, and arterial lactate in a rat preparation of myocardial infarction and heart failure (infarct size 36.0 +/- 3.3% of the left ventricle, n = 9), and in sham-operated animals (n = 11). Data were obtained at maximal treadmill exercise during alternate infusions of milrinone and saline. Total skeletal muscle blood flow during exercise was significantly lower in the infarction group (p less than .05 vs sham); reduced blood flow was primarily attributed to decreased flow to oxidative working muscle such as soleus and the red portion of gastrocnemius, whereas blood flow to glycolytic muscle portions (e.g., gastrocnemius white, vastus lateralis white) was similar in the infarction and sham-operated groups. Milrinone increased flow to the glycolytic working muscle portions in sham operated animals (e.g., vastus lateralis white, 0.23 vs 0.29, p less than .05); by contrast, blood flow to the oxidative muscle fibers was increased in the infarction group (e.g., gastrocnemius red, 1.45 vs 1.87, p less than .05). Arterial lactate levels at similar workloads during exercise were higher in the infarction group (p less than .05). Neither lactate nor VO2max were significantly altered with milrinone in either group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677358 TI - Laser probe ablation of normal and atherosclerotic human aorta in vitro: a first thermographic and histologic analysis. AB - The metal-tipped optical fiber or "laser probe" has been extensively studied in animal preparations in vivo and in human clinical trials of revascularization. The aim of this study was to evaluate the thermal characteristics of laser probe tissue ablation and to contrast the vascular tissue response to exposure to the laser probe and bare optical fiber. A 2 mm laser probe was heated with up to 4 W of argon-ion laser irradiation and applied to six postmortem strips of human nonatherosclerotic aorta as well as to five atherosclerotic aortic specimens. Surface temperature maps of the laser probe and of the vascular tissue in air were obtained via 8 to 12 micron thermographic imaging. Laser probe temperature was additionally monitored via thermocouples. Two strips each of normal and diseased aorta were irradiated directly with the bare optical fiber. Thus a total of 43 laser probe application sites and 19 bare fiberoptic laser irradiation sites on a total of 15 aortic strips were analyzed both thermographically and histologically. Based on measured temperature rises and histologic findings, the following observations were made: (1) The laser probe heats initially at its tip and attains a uniform surface temperature distribution within 5 sec. The steady state temperature attained by the probe is inversely related to the thermal conductivity of the surrounding media. In all media studied, probe temperature increases linearly with applied laser energy. (2) Tissue ablation starts at temperatures greater than 100 degrees C, and ablation temperatures typically exceed 180 degrees C. Adventitial temperatures during laser probe application may reach 70 degrees C. Tissue ablation is enhanced both by greater laser energy deposition in the probe and by higher force at which the probe is applied to tissue. (3) Ablation of fibrofatty atheromata is more extensive than of nonatherosclerotic aortic tissue. This may be due to the lower thermal conductivity of atheromatous tissue. (4) In contrast to direct argon-ion laser ablation of aortic tissue, laser probe-mediated ablation occurs in a controlled fashion, is not associated with extensive subintimal dissections, and allows uniform conduction of heat to tissue as reflected by essentially "isothermal" injury lines. PMID- 3677359 TI - Inhibition of coronary atherosclerosis by propranolol in behaviorally predisposed monkeys fed an atherogenic diet. AB - We studied the effect of propranolol on the diet-induced coronary artery atherosclerosis (CAA) in 30 adult male cynomolgus monkeys living in social groupings of five animals each. Animals in the "treated" segment (n = 15) consumed propranolol, which was mixed into an atherogenic diet. Animals in the "untreated" group (n = 15) consumed only the atherogenic diet. Finally, the social groupings were subjected to disruption through monthly redistribution of monkeys among the groups within each treatment segment. The experiment lasted 26 months, following which all animals underwent autopsy during which the coronary arteries were evaluated for atherosclerosis. Regarding atherosclerosis, we observed a significant interaction between social status and experimental condition (p less than .03). Socially dominant animals had (as in previous studies) significantly exacerbated CAA, but only in the untreated segment; the effect of social dominance on CAA was abolished by long-term administration of propranolol. The antiatherogenic effect of propranolol on dominant animals was independent of the influences of serum lipid concentrations, blood pressure, and resting heart rate. We conclude that treatment with beta-adrenergic-blocking agents may confer a degree of protection against CAA among individuals behaviorally predisposed to coronary heart disease. PMID- 3677360 TI - Enhancement of procainamide-induced rate-dependent conduction slowing by elevated myocardial extracellular potassium concentration in vivo. AB - Procainamide, a type 1A antiarrhythmic drug, blocks sodium channels and reduces the maximum rate of rise of the cardiac action potential (Vmax) in a rate dependent fashion. In vitro, the magnitude of this rate-dependent reduction in Vmax is greater in tissue that is partially depolarized at rest than in tissue with a normal resting potential. Reductions in Vmax produced by drugs that block sodium channels are also directly related to the reductions in longitudinal conduction velocity of action potential propagation in papillary muscle preparations. We therefore sought to determine whether the rate-dependent conduction slowing induced by procainamide in the intact canine heart is enhanced in myocardial tissue abnormally depolarized by an elevated myocardial extracellular potassium concentration, [K+]o. QRS duration and epicardial activation times were measured as indexes of myocardial conduction. QRS duration and epicardial activation times were measured at control (4.0 mM) and at intermediate (6.5 mM) and high (9.2 mM) myocardial [K+]o in the presence or absence of a clinically relevant procainamide concentration (12.2 +/- 2.6 g/ml) at the longest obtainable interstimulus interval of 440 msec and at 330, 280, and 250 msec. Intermediate and high myocardial [K+]o alone induced rate-dependent conduction slowing as the frequency of stimulation increased (cycle length 440 msec to 330, 280, and 250 msec). In the presence of procainamide, rate-dependent conduction slowing was observed at all levels of myocardial [K+]o, and the amount of rate-dependent change in conduction time increased as the myocardial [K+]o was increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677361 TI - Overdrive suppression of conduction at the canine Purkinje-muscle junction. AB - We have shown previously that overdrive suppression of conduction in depolarized His-Purkinje tissue requires conduction asymmetry. In this study we examined whether overdrive suppression of conduction can occur at the Purkinje-muscle junction, where natural asymmetry of conduction exists. Canine Purkinje-muscle preparations were superfused with hyperkalemic Tyrode's solution (KCl 8 to 12 mM), and action potentials were recorded from Purkinje, junctional, and muscle cells. Initially, the Purkinje fiber was paced at the shortest cycle length at which 1:1 anterograde Purkinje-muscle conduction occurred. The papillary muscle then was paced for 10 to 50 beats at shorter cycle lengths during which, because of conduction asymmetry at the Purkinje-muscle junction, 1:1 retrograde muscle Purkinje conduction also occurred. After overdrive papillary muscle pacing, Purkinje fiber pacing at the same cycle length that previously resulted in 1:1 conduction now produced transient Purkinje-muscle conduction block (overdrive suppression of conduction). The degree and duration of overdrive suppression of conduction were proportional to the rate and duration of overdrive pacing. After overdrive pacing, Purkinje cell action potential amplitude and Vmax recovered within 300 msec, yet conduction block persisted for up to 7 sec. In contrast, excitability in papillary muscle cells near the Purkinje-muscle junction increased continuously after overdrive pacing. These data suggest that rapid activation of Purkinje cells during overdrive pacing was not required for overdrive suppression of conduction and that restoration of conduction after overdrive pacing was determined primarily by recovery of excitability in papillary muscle cells. Transient Purkinje-muscle conduction block after periods of rapid ventricular rates might account for overdrive-induced conduction disturbances normally attributed to bundle branch block. PMID- 3677362 TI - Effects of nifedipine on diastolic function during brief periods of flow-limiting ischemia in the conscious dog. AB - To determine the contribution of transsarcolemmal calcium flux to abnormal diastolic function produced by brief periods of flow-limiting ischemia and reperfusion, we evaluated early and late diastolic function during transient coronary occlusion and reperfusion before and during administration of intravenous nifedipine (NIF) (10 +/- 1 microgram/kg/min) in nine preinstrumented conscious dogs. We also assessed the effects of nitroprusside (NTP) (2 +/- 0.2 micrograms/kg/min) during an identical period of ischemia and reperfusion to independently assess the consequences of altered loading alone on diastolic function. To minimize the effects of temporal dysynchrony and altered ventricular loading conditions on isovolumetric relaxation, we developed a conscious dog preparation of reversible transient (30 to 60 sec) bilateral coronary occlusion (BCO). BCO was characterized by significant systolic depression: maximum (+)dP/dt decreased (from 2617 +/- 600 to 1981 +/- 565 mm Hg/sec, p less than .05), left ventricular transverse dimension shortening diminished (from 20 +/- 5 to 9 +/- 5%, p less than .05), and the left ventricle dilated (42.4 +/- 6.4 to 43.8 +/- 6.3 mm, p less than .05). Concomitantly the time constants of isovolumetric relaxation prolonged (from 22 +/- 3 to 28 +/- 4 msec, p less than .05) and minimal diastolic left ventricular pressure increased (from -3 +/- 6 to 6 +/-6 mm Hg, p less than .05). The passive diastolic pressure-dimension relationship shifted upward and to the right and was associated with increased chamber stiffness (from 0.50 +/- 0.26 to 1.03 +/- 0.53 mm Hg/mm, p less than .05) and increased left ventricular end-diastolic pressure (from 7 +/- 7 to 19 +/- 7 mm Hg, p less than .05). Reperfusion immediately after BCO was characterized by prompt restoration of systolic contractile performance [maximum (+)dP/dt 3220 +/- 530 mm Hg/sec] but persistently abnormal early and late diastolic function (time constant of isovolumetric relaxation 30 +/- 6 msec, left ventricular end diastolic pressure 20 +/- 7 mm Hg). The effects of drug administration on ventricular function during BCO were then evaluated under matched loading conditions. NTP improved time constant of isovolumetric relaxation (20 +/- 8 vs 28 +/- 4 msec, p less than .05) and minimal diastolic left ventricular pressure (2 +/- 5 vs 6 +/- mm Hg, p less than .05) during BCO, but NIF did not (time constant of isovolumetric relaxation 27 +/- 6 msec, minimal diastolic left ventricular pressure 7 +/- 5 mm Hg).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3677363 TI - Quantitative exercise testing for the cardiac patient: the value of monitoring gas exchange. Atlanta, Georgia, March 7-8, 1986. Proceedings. PMID- 3677364 TI - Metabolic responses to exercise in patients with heart failure. AB - Metabolic and hemodynamic responses to exercise were evaluated in 10 patients with chronic congestive heart failure. We utilized an exercise protocol in which the work rate was increased continuously and oxygen uptake (VO2) kinetics were characterized by linear, first-order dynamics. VO2 at peak exercise (VO2max) was depressed at 12.8 +/- 2.3 ml/min/kg and the anaerobic threshold occurred at 63 +/ 10% of the VO2max. A significant correlation was observed between the VO2 at the anaerobic threshold and the resting cardiac index (r = .74, p less than .05). Ventilation-perfusion relationships improved during exercise, despite the presence of a widened alveolar-arterial gradient in oxygen tension and elevation of the physiologic dead space/tidal volume ratio. At peak exercise, a large breathing reserve (maximal voluntary ventilation-minute ventilation), a decline in arterial carbon dioxide tension, and a slight increase in arterial oxygen tension were observed. Plasma epinephrine levels at peak exercise correlated directly with VO2max (r = .74, p less than .05). Thus, although disturbances in ventilation-perfusion relationships occur in association with heart failure, exercise is not limited by an impairment in pulmonary function. The glycogenolytic action of epinephrine may play an important role in determining peak exercise capacity since glycogen stores are increasingly utilized at work rates above the anaerobic threshold. PMID- 3677365 TI - Safety of graded symptom-limited exercise testing in patients with congestive heart failure. AB - The safety and end points of graded symptom-limited bicycle exercise were assessed in 607 patients before they were randomized to vasodilator or placebo in the Veterans Administration Cooperative Study-Vasodilator Heart Failure Trial. Their mean age was 58 years and left ventricular ejection fraction averaged 30%. The peak exercise responses were as follows: oxygen consumption, 14.5 +/- 3.9 ml/kg/min; heart rate, 132 +/- 24 beats/min; systolic blood pressure, 154 +/- 29 mm Hg. No major complications occurred with the baseline tests. The initial baseline test was stopped in only 10 patients (1.6%) for arrhythmias and in one patient for hypotension. Ventricular tachycardia assessed by ambulatory electrocardiographic monitoring during the second exercise test (before exercise, during exercise, and 4 hr after the test) revealed a prevalence of 5.7% during exercise and 28.8% during the rest of the monitoring period. This study has demonstrated that stable male patients with congestive heart failure can safely exercise on a bicycle ergometer to their peak effort in a well-supervised setting. In addition, we have demonstrated that ambulatory electrocardiographic monitoring is a better method than exercise testing to evaluate presence and extent of ventricular arrhythmias in patients with congestive heart failure. PMID- 3677366 TI - Decreased adreno-cortical suppression utilizing the Nebuhaler for inhalation of steroid aerosols. AB - The influence on the adrenocortical function of high-dose topical glucocorticoids inhaled via conventional devices and via a Nebuhaler, was studied in ten children with asthma. In patients treated with dosages of beclomethasone dipropionate or budesonide, in excess of 2100 micrograms/1.73 m2 body surface, the 24-h urinary excretion of free cortisol increased when the inhaler device was changed from a conventional one to a Nebuhaler. This suggests a decreased systemic influence of the inhaled glucocorticoids when these were administered via a Nebuhaler. PMID- 3677367 TI - Allergenicity of alum-precipitated grass pollen extracts with different RAST activity. AB - The biological potency of therapeutic allergen extracts is fundamentally important in terms of maximal security of immunotherapy, especially when changing batches. As regards pyridine-extracted alum-precipitated allergen preparations, the potency is commercially controlled by the RAST technique. In the present study, titrated intradermal tests were performed in thirty-three adult grass pollen rhinitis patients with three ten-fold dilutions of two batches of Allpyral 5-grass mix with different RAST activity. The difference in potency was estimated as the horizontal distance at the midpoint of the two dose-response curves after performing linear regression on the log-dose/log-weal area response, and as the concentration of each batch eliciting a weal equal to the histamine HC1 0.1 mg/ml reference. The difference in potency as estimated by RAST was a factor 5.0 vs a factor 8.3 and 7.2 (median) estimated by the horizontal distance and histamine equivalent reaction, respectively. Considering the biological variation, the RAST estimated difference in potency is in the same order as that found by skin test. It is, therefore, concluded that the routine control of new production batches by RAST is acceptable with the use of standardized reference sera as regards alum precipitated grass pollen allergen extracts. PMID- 3677368 TI - Relationship between skin reactions to common allergens and non-specific bronchial reactivity in young healthy subjects. AB - In patients with respiratory symptoms, several studies have provided data supporting the hypothesis that there is a casual relationship between allergen exposure and variations in bronchial reactivity. In order to determine if this relationship holds when atopy is defined only on the basis of positive skin tests to common allergens, we compared bronchial reactivity in a group of twelve healthy subjects with positive skin tests and twenty-eight healthy subjects with negative tests. The two groups were comparable in terms of gender, age, smoking habits and family history of atopic diseases. The slopes of the dose-response curves, using airway conductance as an index of response, were similar in the two groups. Thus, in this healthy group of subjects, there was no relationship between skin and bronchial reactivity. It can be hypothesized that, if genetic factors determine bronchial reactivity, such reactivity might not be revealed until skin-test positive subjects have received repeated bronchial stimulation through inhalant allergens. PMID- 3677369 TI - Diagnostic value of the skin-prick test and RAST assay in insect sting allergy. AB - The results of skin-prick tests to four concentrations of venom (0.1, 1, 10 and 1000 micrograms/ml) carried out on two occasions were analysed in relation to the history of adverse reactions to stings and to the level of venom-specific IgE antibody in serum, in forty-two subjects allergic to insect stings (sixteen to bee and twenty-six to wasp). Fifty control subjects (some of whom had never been stung by bee or wasp) with no history of adverse reaction to stings were also studied. No subject gave a positive skin-test reaction to 0.1 microgram/ml, and small numbers reacted to either 1 or 10 micrograms/ml. The lowest concentration of venom to which most subjects had a positive skin test was 100 micrograms/ml. Our data suggest that in wasp-allergic patients a positive skin test to 100 micrograms/ml is normally significant (reflecting the presence of specific IgE), whereas in bee-allergic patients a skin test reaction to 100 micrograms/ml is usually non-specific for the following reasons. (i) In the allergic patients when skin tests were repeated, a reaction to 100 micrograms/ml bee venom often became negative (in six of eight), whereas for wasp venom the reaction became more positive (at 10 or 1 micrograms/ml) in seven of eight patients. Whilst this might reflect lack of reproducibility, the consistent direction of change for either bee or wasp venom suggests responses to this concentration of these venoms may have different interpretations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677370 TI - Bronchial allergen challenge: comparison between two different methods of provocation. AB - Bronchial allergen challenge was performed twice in ten well-defined stable asthmatic patients. On each provocation day the allergen was administered either by a standard method at tidal volume breathing or by a dosimeter method. Ten-fold increasing concentrations of allergen were administered with an interval of 10 min. Total amount of allergen of 9, 90, 900, 9000 and 90,000 SQ units using the standard method, whereas the corresponding amount by the dosimeter method was 0.5, 5, 50, 500, and 5000 SQ units. The bronchial response was determined by forced expiratory volume in the first second (FEV1) and by total resistance to breathing (Rt) measured by an opening interrupter method. The provocation was stopped when a decrease of at least 20% of the post-saline FEV1 and a 40% increase in post-saline Rt was observed. A PC20-FEV1 and a PC40-Rt was calculated by interpolation on the log dose-response curve. The late reaction was recorded and defined as a 20% reduction in peak expiratory flow (PEF) occurring during the 24-hr period after challenge. The comparability of PC20-FEV1 and PC40-Rt obtained with the standard method and with the dosimeter was high, r = 0.89 and r = 0.88. Furthermore, no significant difference was found by comparing delta FEV1 and delta Rt during provocation by either method as well as the occurrence and magnitude of the late reaction. We conclude that there exists a high comparability of the bronchial response to an allergen challenge performed either by a standard method at tidal volume breathing by continuous inhalation of the allergen aerosol or by a dosimeter method of inhalation despite the difference in the total allergen doses inhaled. PMID- 3677371 TI - Effect of homogenization and pasteurization on the allergenicity of bovine milk analysed by a murine anaphylactic shock model. AB - In a factorial design study a murine anaphylactic shock model was used to analyse the effect of homogenization, pasteurization, and fat content on the ability of bovine milk to induce anaphylactic reactions. Mice were sensitized by either oral or subcutaneous immunizations with various types of bovine milk. In spite of a significantly higher antibody titre in the mice sensitized subcutaneously, there was no difference in the sensitivity between orally and subcutaneously immunized mice with respect to anaphylactic reactions. Pasteurization did not seem to change the ability of milk to induce anaphylactic reactions. However, increasing fat contents in combinations with homogenization resulted in an increase of the ability of the milk to induce anaphylactic reactions. PMID- 3677372 TI - High IgG4 antibody level is associated with failure of immunotherapy with inhalant allergens. AB - We have analysed all available data on the relationship between IgG4 Ab level and clinical effect of immunotherapy (IT) with inhalant allergens. The data from three of the seven independent studies could, without reservations, be analysed by a joint statistical analysis. We found that late high IgG4 Ab level, measured at the end of IT, was strongly associated with treatment failure (P = 6.54 x 10(5); n = 67). The ratio of risks for treatment success in the group with late low IgG4 Ab level was 1.82, whereas the ratio of risks for treatment failure in the group with late high IgG4 Ab level was 11.4. The data from a fourth, presumably comparable, study further supported the existence of an association between high IgG4 Ab level and treatment failure. In contrast, two other studies found that high mean IgG4 Ab level was associated with good clinical response. Possible reasons for this apparent discrepancy are discussed. We also found that early high IgG4 Ab level, measured within 3 months after initiation of IT, was strongly associated with treatment failure after 1-2 years of IT (P = 1.05 x 10( 4); n = 30). The sensitivity and specificity of early high IgG4 Ab level as indicator for treatment failure was 100% and 83%, respectively. At the prevalences found in the present study, the predictive value of early high IgG4 Ab level for treatment failure was 0.6, whereas the predictive value of early low IgG4 Ab level for treatment success was 1.00. PMID- 3677373 TI - Optimized atomic absorption spectrophotometry of calcium in erythrocytes. AB - We sought to establish optimum conditions for measuring calcium in erythrocytes by atomic absorption spectrophotometry. The conditions we selected are as follows. Wash one volume of fresh heparin-treated packed cells once with 30 volumes of isotonic buffered saline (pH 7.4) at a temperature somewhat exceeding 25 degrees C. Dilute the washed packed cells 10-fold with 12 mmol/L hydrochloric acid, and analyze the supernate for calcium. Measure the hematocrit of the washed packed cells, then analyze an aliquot of them for calcium, using a computer readout type of flame or a non-flame atomic absorption spectrophotometer equipped with a pyrocoated graphite tube. The temperature program is 1000 degrees C for ashing [corrected] and 1800 degrees C for the atomizing cycle. Intraday and day to-day reproducibility of the assay was 6.55% and 8.19%, respectively, at the mean concentration of calcium in the erythrocytes of healthy adults, which is 4.30 mumol/L. PMID- 3677374 TI - Radioimmunoassay of tumor necrosis factor in serum. AB - We present a double-antibody radioimmunoassay for determination of the concentration of tumor necrosis factor (TNF) in serum. TNF in serum competes with a fixed amount of 125I-labeled TNF for the binding sites of specific rabbit antibodies. The bound TNF is precipitated with Sepharose-bound anti-rabbit IgG, then centrifuged, and the radioactivity of the pellets is counted. The detection limit of the assay is 7 ng/L (B0-3 SD). Bound radioactivity in the range of 10% to 90% of the B0 counts corresponds to TNF concentrations of 26 to 10,000 ng/L. Of 40 sera from healthy subjects, 21 (53%) contained TNF concentrations greater than 7 ng/L (range 8-40 ng/L). Some patients with parasitic or neoplastic disease and patients with septic shock had highly increased TNF values. Three of the 14 sera (21%) from patients with rheumatoid arthritis had TNF concentrations greater than 40 ng/L. PMID- 3677375 TI - Selecting the optimum specimen for assessing slight albuminuria, and a strategy for clinical investigation: novel uses of data on biological variation. AB - To investigate the optimum specimen for quantifying low, but abnormal, concentrations of albumin in urine, we assessed the analytical and biological components of variation in first morning, random untimed, and 24-h urine specimens from 11 apparently healthy individuals. The results were expressed in terms of albumin concentration, albumin/creatinine ratio, and albumin excretion rate. Analytical methods generally can meet the analytical goal of CV less than or equal to 18%. For reasons detailed herein, we prefer measurement of the albumin concentration in the first morning specimen. Expressing results as an albumin/creatinine ratio has little advantage. Albumin concentrations in first morning urines from 16 diabetic subjects showed larger intra-individual variation than for nondiabetic subjects but clearly fell into two groups: those with consistently normal albumin concentrations in urine and those with abnormal concentrations in some specimens. The intrinsic biological variation of the latter group means that the ideal 100% nosological specificity cannot be achieved with any cutoff point without inclusion of a large proportion of the former. Qualitative testing with a latex-agglutination technique also demonstrates this problem. Use of data on biological variation allows development of an appropriate clinical strategy to investigate diabetic patients. PMID- 3677376 TI - Isoforms of creatine kinase isoenzymes in serum in acute myocardial infarction after intracoronary thrombolysis. AB - Kinetics of the catalytic activities of creatine kinase (CK;EC 2.7.3.2) for three CK-3 and two CK-2 isoforms in serum were studied in 20 patients with myocardial infarction randomly assigned to receive either intracoronary urokinase (group A) or conventional therapy (group B). The temporal characteristics of isoform changes described were (a) time at which the isoform activities are significantly greater than initial values, (b) maximal rate (Ka) at which isoforms are released into blood, (c) time lag from onset of pain until maximum activity value, (d) peak value of each serum isoform, and (e) rate (Kd) at which each isoform is cleared from serum. Thrombolytic treatment induced earlier peak times in group A: for CK-3(3), 7.4 vs 20.0 h; for CK-3(2), 11.6 vs 24.8; for CK-3(1), 18.6 vs 34.3; for CK-2(2), 9.1 vs 17.8; and for CK-2(1), 11.8 vs 26.8 (numbers given are medians; for all isoforms, P less than 0.05). Ka values were at least twofold greater and the first increase was significantly earlier in the urokinase group. Consequently, the ratio for CK-3(3) to CK-3(1) activities peaked significantly earlier in group A. Isoform peak activities and Kd were not significantly different between the two groups. PMID- 3677377 TI - Simple liquid-chromatographic measurement of vanillylmandelic acid and homovanillic acid in urine on filter paper for mass screening of neuroblastoma in infants. AB - We describe a simple and rapid method for measuring catecholamine metabolites in urine collected on filter paper. By this method, "high-performance" liquid chromatography, urinary vanillylmandelic acid and homovanillic acid can be measured within 15 min after being eluted from filter paper treated with tartrate buffer. One hundred urine samples can be pretreated within 2 h and 100-120 samples analyzed at 18-min intervals overnight in two chromatographic systems. Moreover, urinary creatinine also can be measured rapidly because of the use of microtiter plates. We applied this method in a mass screening program for early detection of neuroblastoma in infants. Between April 1986 and March 1987, two patients with neuroblastoma were detected. In all, neuroblastoma has been detected in 17 of 88,887 infants so examined since April 1981. PMID- 3677378 TI - Free cortisol and creatinine in urine of healthy children. AB - Cortisol and creatinine were measured in two consecutive overnight urine collections from 103 healthy school children, ages seven to 18.5 years. Mean cortisol and creatinine concentrations were respectively 194 nmol/L and 12.7 mmol/L. The data were statistically analyzed to simultaneously assess any effects of sex, age, weight, day of collection, and urine volume. Mean urine volume for boys exceeded that for girls, increased with body weight, and was greater on the second day of collection than on the first. Cortisol concentration was independent of sex, age, and weight, but decreased with urine volume. Boys excreted more cortisol than did girls, and the amount increased with urine volume. Creatinine concentration increased with weight, decreased with urine volume. Total creatinine increased with weight, was greater for boys than girls, and increased with urine volume. The cortisol/creatinine ratio was valueless as an index of adrenocortical status. PMID- 3677379 TI - Liquid chromatography with multichannel ultraviolet detection used for studying disorders of purine metabolism. AB - We used a reversed-phase "high-performance" liquid-chromatographic system equipped with a multichannel ultraviolet spectrometric detector and a micro computer for analyzing urine samples from patients with disorders of purine metabolism. This system recorded a series of absorption-spectrum data from a single chromatographic run and stored them for subsequent analysis. Because the retention times and ultraviolet absorption spectra of the eluates were recorded simultaneously, identification of peaks was easy and quite accurate for simultaneous quantification of orotidine, adenine, hypoxanthine, uric acid, xanthine, allopurinol (4-hydroxypyrazolo[3,4-d]pyrimidine), oxypurinol (4,6 dihydroxypyrazolo[3,4-d]pyrimidine), inosine, and 2,8-dihydroxyadenine--compounds extremely difficult or even impossible to quantify simultaneously with a conventional single-wavelength spectrometer. We used this method to investigate purine metabolites in urines from a patient with hereditary xanthinuria, three patients with 2,8-dihydroxyadenine urolithiasis, and a gouty subject taking allopurinol. PMID- 3677380 TI - Trace-element concentrations in human autopsy tissue. AB - In this report on trace-element concentrations (As, Ca, Cd, Cl, Co, Cr, Cu, Fe, Hg, K, Mg, Mn, Mo, Na, Ni, Pb, Rb, Sb, Se, Zn) in human heart, liver, kidney, aorta, and rib obtained from 200 autopsied patients, we give special attention to sampling procedure, analysis technique, and various sources of error (autolysis, contamination with blood, and lack of sample homogeneity). We present the concentration data (averages, standard deviations, and ranges) obtained by neutron activation analysis, and we analyze the distribution of the data. The three types of distribution we distinguished are relevant to considerations of the importance of processes of storage of certain elements in specific organs. PMID- 3677381 TI - Computer-aided infrared analysis of urinary calculi. AB - We have created a library of 497 digitized infrared spectra of 58 components of urinary calculi and of their usual binary and ternary mixtures. We tested the operation of the "Birsy" search program (Bruker Analytische Messtechnik) with this library for the interpretation of infrared spectra of 50 urinary calculi, selected from both classical and difficult cases. This program correctly identifies the two first components 98% of the time and the third (minor) component 70% of the time. Using this program, those without training or experience in infrared analysis can routinely use the infrared method of analysis of urinary calculi. PMID- 3677382 TI - Determination of unconjugated 3-methoxy-4-hydroxyphenylglycol by liquid chromatography for monitoring inhibition of monoamine oxidase activity in plasma. AB - We describe a simple method for extracting 3-methoxy-4-hydroxyphenylglycol (MHPG) from plasma. The sample is applied to a 1-mL "Extrelut" column (EM Industries) and eluted 15 min later with ethyl acetate. After mixing the eluate with pentane and back-extraction into water, we inject 25 or 50 microL of the aqueous phase onto a Beckman 15 cm x 4.6 mm (i.d.) column packed with 5-micron ODS particles (Beckman). Peaks are detected with a coulometric detector. The resulting chromatogram is clean, with few extraneous peaks. The extraction recovery of MHPG is 55-60%, which allows for detection of as little as 0.2 microgram of the analyte per liter. The decrease in the concentration of MHPG in plasma of patients treated with phenelzine agrees with the decrease in monoamine oxidase activity in platelets of these patients. PMID- 3677384 TI - Evaluation of the Hitachi 704 automatic analyzer. AB - We evaluated the analytical performance of the Hitachi 704 automatic analyzer. The spectrophotometer showed a linearity of response at 340 nm up to 2.8 A. Photometric imprecision measured bichromatically at 340 and 376 nm was 0.49% at 0.16 A, 0.14% at 0.46 A, and 0.17% at 0.76 A. Imprecision of the sample probe was 0.4% for 5, 10, and 20 microL, and the volume delivered deviated -2.4%, -4.4%, and -4.2% from these preset volumes, respectively. Imprecision of the reagent probe over the range 50 to 500 microL ranged from 0.14% to 0.29%; volume delivered deviated from +1.7% to +4.4%). At equilibrium, the temperature in the cuvets was 29.8 (SD 0.05) degree C as measured by cresol red spectrophotometry. No sample carryover was detected. Reagent carryover was detected when a bilirubin assay was preceded by a total protein assay and when lactate dehydrogenase was measured after alanine aminotransferase. Imprecision for nine tests at three concentrations ranged from 1.1% to 4.4%. Comparison of methods with the SMAC II as reference method showed good results. Precision was better than reported for the Hitachi 705 automatic analyzer. PMID- 3677383 TI - Antimony accumulation in hair during treatment of leishmaniasis. AB - We used instrumental neutron activation analysis (INAA) to determine antimony in small quantities of hair from individuals living in an area of endemic leishmaniasis. The groups studied were 12 patients undergoing treatment with N methylglucamine antimoniate, 34 patients who had received such treatment a year ago, and 17 control subjects (untreated) who were living in the same area. Patients receiving treatment showed mean and median (12.13, 2.9 micrograms/g) values for antimony in hair that significantly exceeded those in either controls (1.01, 0.4 microgram/g) or patients one year after treatment (1.54, 1.0 microgram/g). We conclude that INAA can be useful in monitoring and differentiating such exposure to antimony in patients under treatment. PMID- 3677385 TI - Routine urinalysis (dipstick) findings in mass screening of healthy adults. AB - We present results of simple urinalysis examinations (dipstick) in a large (approximately 21,000 people) working population. In about 10% of the screened individuals at least one abnormality was found. In men the most common finding was proteinuria (4.9%). Hematuria was found in 2.6% and glycosuria in 0.6%. The most prevalent finding in women was hematuria (8.1%), followed by proteinuria (3.9%) and glycosuria (0.6%). Only about 1% of the examinees had two or more abnormalities in their urine examinations. These findings attest to the utility and practicability of incorporating urine testing into various screening and clinical examinations. PMID- 3677386 TI - Increased serum lactate dehydrogenase isoenzyme 1 and "flipped" LD-1/LD-2 ratio in myopathy associated with partial carnitine palmitoyltransferase deficiency. AB - We describe a case of a limb-girdle myopathy presenting with myoglobinuria. A partial deficiency of muscle carnitine palmitoyltransferase (EC 2.3.1.21) may also have been present. All "muscle-type" serum enzymes were markedly increased (to between 30- and 400-fold their respective upper reference limits) and creatine kinase (EC 2.7.3.2) isoenzyme 2 (CK-MB) was increased 130-fold but was still less than 2% of the total creatine kinase activity. The isoenzyme pattern of lactate dehydrogenase (EC 1.1.1.27) in serum was "anodic," with isoenzyme 1 greater than isoenzyme 2--an unusual pattern for myopathies. The possible physiological basis for such a finding is discussed. PMID- 3677387 TI - Revised nomenclature for tests of thyroid hormones and thyroid-related proteins in serum. Report of the American Thyroid Association Nomenclature Committee. PMID- 3677388 TI - Precision of assays for sex-hormone-binding globulin: an I-IRMA kit and two Eu IFMA kits compared. PMID- 3677389 TI - Automated method for phosphohexose isomerase with a centrifugal analyzer. PMID- 3677391 TI - Performance of two time-dependent analyses compared with an end-point analysis, in DataChem's clinical analyzer. PMID- 3677390 TI - Massive overestimation of albumin in analbuminemic rat serum by bromcresol green. PMID- 3677392 TI - Inexpensive alternative to kit methods for extraction of urinary catecholamines. PMID- 3677393 TI - Ciba Corning Diagnostics' Monoclonal TSH: is it truly a highly sensitive TSH assay? PMID- 3677394 TI - Individual variations of carcinoembryonic antigen (CEA) in serum of healthy subjects. PMID- 3677395 TI - An emergency test for fetal lung maturity: OD 650 or amniostat-FLM? PMID- 3677396 TI - Improved Jaffe creatinine reagent for the "Parallel" Analyzer. PMID- 3677397 TI - Detection of morphine in hair with the Abbott TDX. PMID- 3677398 TI - Interference of fluorescein, used in retinal angiography, with certain clinical laboratory tests. PMID- 3677400 TI - Cyclosporine: interlaboratory Q.C. program. PMID- 3677399 TI - Errors in estimating urinary protein by use of benzethonium chloride. PMID- 3677401 TI - More on sigma's oxalate kit. PMID- 3677402 TI - Reliability of breath-alcohol measurements during the absorption phase. PMID- 3677403 TI - Corrections to a report. PMID- 3677404 TI - Cardiac enzymes and hypothyroidism. PMID- 3677405 TI - Increased diagnostic potential of a monoclonal assay of carcinoembryonic antigen. PMID- 3677406 TI - Drug abuse in the workplace: prevention and control. Proceedings of the tenth annual Arnold O. Beckman Conference in Clinical Chemistry. January 19-21, 1987, Newport Beach, CA. PMID- 3677407 TI - Employee assistance programs. AB - The substance abuser brings his problems to the workplace. Ninety-five percent or more of all individuals experiencing alcohol-or drug-related problems are either employed or the spouse or dependent of someone who is working. It is clear we are facing a problem which transcends the boundaries of the workplace. The result in the workplace, of course, is increased costs, lower productivity, more accidents on the job, but most importantly additional suffering for the individuals involved. It is important to remember that neither GM, the UAW, nor the IUE can be expected to accept responsibility for those individuals who have the ability to control their own "wellness" and productivity. Any joint union-management substance abuse program can only be a catalyst to help individuals confront their problems. Along with the other groups and institutions concerned with these problems, GM, in cooperation with the UAW, IUE, and the other unions that represent our employees, is trying to help individuals with addictive diseases confront and obtain treatment for their problems. We believe our programs are moving in the right direction and will continue to make progress. PMID- 3677408 TI - Quality assurance in drug-use testing. PMID- 3677409 TI - Statistical considerations of the random selection process in a drug-test program. AB - In a prospective drug-testing program, individuals whose job classifications have been defined as sensitive are placed in a selection pool. Periodically, individuals are chosen from this pool for drug testing. Random selection is a fair and impartial approach for this because each individual has an equal chance of being selected. Random selection also serves to reinforce the deterrent potential of a drug-testing program because individuals in the pool never know when or if they will be selected. This uncertainty discourages drug usage because of the risk involved in being selected and tested. A random selection process generates a Poisson distribution of probabilities that can be used to predict how many times an individual will be selected during a specific time interval. This information can be used to model the selection part of a drug-testing program to determine whether specific conditions of testing are met. For example, the probability of being selected a given number of times during the testing period can be minimized or maximized by varying the frequency of the sampling process. Consequently, the Poisson distribution and the mathematics governing it can be used to structure a drug-testing program to meet the needs of any given situation. PMID- 3677410 TI - Drug abuse in the workplace: an industry's point of view. PMID- 3677411 TI - Hemoglobin J-Baltimore (beta 16(A13)Gly----Asp): interference with the assay of HbA1c. AB - Three independent cases of Hemoglobin J-Baltimore(beta 16(A13)Gly----Asp) were detected through the assay of HbA1c in diabetic patients. Using chromatography on Bio-Rex 70 resin, one large peak replaced the usually well resolved peaks of HbA1a + b and HbA1c. The species that overlapped the latter fractions was identified as HbJ1c. HbJ-Baltimore itself was identified using HPLC of the beta chain tryptic peptides. This observation emphasizes the errors that hemoglobin variants may introduce in the assay of HbA1c. PMID- 3677412 TI - Detection of glucose-6-phosphate dehydrogenase deficiency in erythrocytes: a spectrophotometric assay and a fluorescent spot test compared with a cytochemical method. AB - The results of a quantitative spectrophotometric enzyme assay, a fluorescent spot test and a cytochemical assay for glucose-6-phosphate dehydrogenase deficiency were compared systematically. The high sensitivity of the spectrophotometric assay and the fluorescent spot test in the detection of severely deficient individuals was confirmed. For the detection of heterozygote females, however both tests were unreliable; the sensitivities of the fluorescent spot test and the spectrophotometric assay being 32% and 11% respectively. Specificities for both tests were high (99%). Introduction of the ratio of glucose-6-phosphate dehydrogenase and pyruvate kinase (G-6-PD/PK ratio) activities increased the sensitivity of the spectrophotometric assay to nearly 100%. It is concluded that the fluorescent spot test should be used for the diagnosis of G-6-PD deficiency in developing countries; whereas if spectrophotometric enzyme assays are available, the G-6-PD/PK ratio should always be performed. In cases where the ratio is less than 0.70, cytochemical analysis is indicated. PMID- 3677413 TI - The molecular nature of cholecystokinin in human plasma. AB - Using a radioimmunoassay specific for the bioactive, tyrosine-sulfated sequence of cholecystokinin (CCK) we have studied the molecular nature of CCK in plasma from normal human subjects. CCK was extracted from postprandial plasma by Sep-Pak cartridges prior to Sephadex G-50 gel chromatography. Four CCK components eluting like CCK-58, CCK-33, CCK-22, and CCK-8, were identified in all samples. Of these, CCK-33- and CCK-8-like peptides predominated. The heterogeneity of circulating CCK emphasizes the importance of plasma assays that measure all bioactive forms of CCK. PMID- 3677414 TI - Relation of hyperlipidemia in serum and loss of high density lipoproteins in urine in the nephrotic syndrome. AB - The mechanism leading to hyperlipidemia in the nephrotic syndrome is not fully understood but may be related in part to loss of high density lipoproteins in the urine of patients with nephrosis. To prove this hypothesis, we compared serum lipoprotein profiles with the excretion of high density lipoproteins in urine in 19 nephrotic patients. Serum cholesterol ranged from 19-152 (median value 45) mg/dl in very low density lipoproteins (VLDL), from 130-443 (median 186) mg/dl in low density lipoproteins (LDL) and from 19-64 (median 33) mg/dl in high density lipoproteins (HDL). Hyperlipoproteinemia was found in 17 patients, which was classified as phenotype IIa (Fredrickson) in 2, as phenotype IIb in 9 and as phenotype IV in 6 subjects. Two patients showed normal lipoprotein patterns. VLDL and LDL-cholesterol were not found in detectable amounts in urine, whereas HDL cholesterol was measured in low concentrations from 0.1-8.3 mg/24 h in all samples. There was no correlation between serum HDL-cholesterol and urinary HDL cholesterol, but a positive correlation between serum LDL-cholesterol and urinary HDL-cholesterol (r = +0.54, p less than 0.05). However, the total amount of the daily urinary loss of HDL (less than 1% of total plasma HDL) seems not to be sufficient to explain hyperlipoproteinemia in the nephrotic syndrome. PMID- 3677415 TI - Direct determination of lead in blood by differential pulse stripping voltammetry. AB - A simple and rapid method for determination of lead in blood by differential pulse stripping voltammetry (DPS) without preliminary mineralization of the sample, is described. Lead determination was performed in native samples of blood in the electrolyte of Britton-Robinson buffer (pH 5-5.5). The proposed method is shown to be reproducible and in good agreement with the reference technique AAS used on mineralized blood samples. Our results indicate that differential pulse stripping voltammetry is a reliable, rapid and highly sensitive method for blood lead analysis. PMID- 3677417 TI - Studies on the mechanism of acetaldehyde-mediated inhibition of rat liver transaminases. AB - Incubation of mitochondria-depleted rat liver homogenates with 5 mmol/l acetaldehyde at 37 degrees C for 1 h inhibited both aspartate and alanine aminotransferases by 30%. Inhibition was prevented by decreasing temperature to 4 degrees C or by preincubating homogenates with cyanate but was unaffected by cyanamide and methylpyrazole which block acetaldehyde oxidation and reduction respectively. Cyanate-sensitive acetaldehyde-mediated inhibition of purified porcine heart transaminases was also demonstrated in the presence of rat liver homogenate but not in Tris/sucrose medium. Moreover, porcine transaminases were inhibited by trichloroacetic acid extracts of rat liver homogenates previously incubated with acetaldehyde but not by extracts of homogenates incubated with both acetaldehyde and cyanate. These findings suggest that acetaldehyde-mediated transaminase inhibition requires further non-oxidative metabolism of acetaldehyde. Since transaminase activities were not restored by addition of pyridoxal 5'-phosphate to the assay systems, acetaldehyde-induced transaminase inhibition does not appear to be mediated by displacement or depletion of this B6 coenzyme. PMID- 3677416 TI - Bile acid metabolism in cirrhotic liver tissue--altered synthesis and impaired hepatic secretion. AB - Bile acid analysis of mild and severe cirrhotic liver showed that with the advancement of cirrhosis the concentration of chenodeoxycholic acid in liver tissue becomes higher, resulting in the lower ratio of cholic to chenodeoxycholic acid probably due to the progressive alteration of cholic and chenodeoxycholic acid synthesis with the advancement of liver cirrhosis. Bile acid analysis of paired liver and bile of severe cirrhosis showed that the ratio of cholic to chenodeoxycholic acid in liver was lower than that in bile or even with that in bile. This can be explained by postulating the impaired hepatic secretion of bile acids, especially chenodeoxycholic acid. The impaired secretion together with the relatively well preserved chenodeoxycholic acid synthesis results in the accumulation of chenodeoxycholic acid in liver tissue with cirrhosis. PMID- 3677418 TI - Determination of acid phosphatase in biological fluids using a new substrate, 2,6 dichloro-4-nitrophenyl phosphate. AB - A new substrate, 2,6-dichloro-4-nitrophenyl phosphate (DCNP-P), is used for the determination of acid phosphatase (EC 3.1.3.2) in serum and urine. It was hydrolyzed by acid phosphatase to 2,6-dichloro-4-nitrophenol (DCNP) and phosphoric acid. At a pH of 4.5-6.0, the absorption of DCNP liberated by acid phosphatase was much higher than that of p-nitrophenol, which is commonly used as an aglycone in the acid phosphatase assay. By using DCNP-P as a substrate for acid phosphatase activity, determinations can be made without the colour reaction which requires the addition of an alkaline solution, and can be determined by the rate assay that does not require measurement of sample blanks in serum or urine. This method using DCNP-P is highly sensitive and is the most suitable for the rate assay of acid phosphatase activity in biological fluids. PMID- 3677419 TI - Development of an automated kinetic Jaffe method designed to minimise bilirubin interference in plasma creatinine assays. PMID- 3677420 TI - Fructosamine measurements in serum and plasma. PMID- 3677421 TI - A simple and sensitive assay for blood ketone bodies using highly purified 3 hydroxybutyrate dehydrogenase. PMID- 3677422 TI - Determination of erythrocyte porphobilinogen deaminase activity using porphobilinogen as substrate. PMID- 3677423 TI - Improved procedure for determining serum D-arabinitol by resazurin-coupled method. PMID- 3677425 TI - A second albumin variant in an Irish population. AB - Three patients with bisalbuminemia of the slow type (relative mobility 0.94) were detected and the properties of the variant albumin investigated. Three additional patients possessing a fast type variant (relative mobility 1.05) have been detected since a previous report of 4 such cases and studies on these patients are also reported. PMID- 3677424 TI - Stability of radioiodinated ferritin. AB - Ferritin which had been radioiodinated using chloramine T exhibited marked instability on storage at 4 degrees C. Both [125I]human liver and heart ferritins showed a similar rate of decline in immunoreactivity (t 1/2 = 20-23 days) indicating that deterioration with storage was not a function of isoferritin composition. The decrease in radioactivity associated with ferritin was due not only to loss of 125I from the molecule but also to protein degradation as shown by enzyme-linked immunoassay and gel filtration. The degradation products had an Mr of at least 69,000 although low Mr material could be identified by gel filtration when a marked reduction in immunoreactivity had occurred. Ferritin instability was much more pronounced than when other proteins such as immunoglobulin and albumin were radioiodinated with chloramine T. These observations indicate that when performing in vivo and in vitro studies with labeled ferritin, degradation of the protein during storage should be carefully monitored and the protein repurified before use. PMID- 3677426 TI - Plasma fibronectin in normolipidaemic and hyperlipidaemic uraemic patients treated with haemodialysis. AB - Plasma fibronectin (PF) concentrations, were investigated in normolipidaemic and hyperlipidaemic (type IV) patients with chronic renal failure treated with hemodialysis (n = 29) and in controls (n = 34). Mean PF was significantly reduced in both subsets of dialysed patients. Among the hemodialysed patients the presence of hyperlipidaemia did not modify PF levels, which resulted, on the contrary, significantly higher in hyperlipidaemic controls as compared with the normolipidaemic group. In controls, according to a multivariate analysis model, PF was directly related with age and inversely with HDL-cholesterol. In the hemodialysed patients total cholesterol was the unique significant PF related variate, being this group, therefore, characterized by the lack of any inverse relation between PF and HDL-cholesterol. Finally, no PF modifications were observed in hemodialyzed patients affected by arterial hypertension or clinically evident atherosclerotic lesions. PMID- 3677427 TI - Microheterogeneity of serum alkaline phosphatase isoenzymes as revealed by isoelectric focusing. AB - The microheterogeneity of human serum alkaline phosphatase (ALP) was investigated by means of isoelectric focusing. Liver and bone isoenzymes focused in a similar pattern, with about 10 bands located between pH 3.7 and 4.9, but differed in the relative intensity of the various bands. Intestinal ALP exhibited 7 to 8 bands at pH 4.9-5.1, and the placental enzyme showed 2 to 3 bands at pH 4.9. Mild digestion with neuraminidase revealed that the banding of liver and bone isoenzymes was at least partly due to differences in the sialic acid content of the various fractions. Extensively desialylated liver and bone isoenzymes showed apparently identical patterns with 6 to 7 bands focused at pH 6.2-6.7. Isoelectric focusing is a useful method for characterizing the microheterogeneity of alkaline phosphatase isoenzymes. The clinical value of this method seems to be limited, however, since it did not distinguish between liver and bone isoenzymes and failed to detect 'specific' isoelectric fractions correlated to various diseases. PMID- 3677428 TI - Determination of erythrocyte protoporphyrin by magnetic circular dichroism. AB - A method for the determination of erythrocyte protoporphyrin by magnetic circular dichroism is reported. The method was sufficiently sensitive to distinguish normal from elevated levels of erythrocyte protoporphyrin and may be useful for diagnostic screening purposes. Erythrocyte protoporphyrin levels determined by magnetic circular dichroism correlated well with levels determined by the fluorimetric method of Piomelli, viz. a plot of MCD versus fluorimetry yielded a straight line relationship with a slope of 0.98 +/- 0.01, y-intercept of 0.05 +/- 0.35 and correlation coefficient of 0.99. PMID- 3677429 TI - Laboratory and clinical features of self-poisoning with salbutamol and terbutaline. AB - A method has been developed for the simultaneous determination of the sympathomimetic drugs salbutamol and terbutaline in the plasma of poisoned patients, using ion-pair high-performance liquid chromatography with amperometric detection. Plasma concentrations of the drugs, measured in 8 poisoned patients, were well above the therapeutic range. The clinical and metabolic effects of overdose with these drugs were considerably less severe than those seen in patients with plasma theophylline concentrations elevated to the same degree. PMID- 3677430 TI - Determination of selenium in human spermatozoa and prostasomes using base digestion and electrothermal atomic absorption spectrophotometry. AB - A method for the determination of selenium in human spermatozoa and prostasomes is described. The samples were digested with 25% (w/v) tetramethylammonium hydroxide (TMAH) in methanol and analyzed by atomic absorption spectrometry with electrothermal atomization and Zeeman background correction (ET-AAS). Nickel was used as a matrix modifier. Calibration was performed using the matrix-based calibration curve. The TMAH-digestion method agreed well with a conventional digestion procedure using concentrated nitric acid. The TMAH-digestion does not require heating or strong acids and it was suitable for small biological samples. The average recovery of added selenium in spermatozoan digests was 95.1 +/- 5.2% (n = 5). The coefficient of variation was 9.1% (n = 21). The accuracy of the method tested with the NBS standard 1577 (bovine liver, certified at 1.1 +/- 0.1 micrograms Se/g) resulted in a value of 0.98 +/- 0.10 micrograms Se/g (n = 16). The method was further tested in an interlaboratory comparison study. PMID- 3677431 TI - Assay of sodium-lithium countertransport rate by direct measurement of erythrocyte lithium concentrations. AB - A method is described for the in-vitro measurement of erythrocytic sodium-lithium countertransport rate (SLC) by direct assay of intra-erythrocytic lithium (Li) concentrations in Li loaded cells during controlled Li efflux. Bicarbonate stimulated erythrocytic Li loading to an approximate intracellular concentration of 3 mmol/l can be achieved within 4 min. Maximum SLC rates are achieved at intra erythrocytic concentrations greater than 2.5 mmol/l. Lithium efflux is linear over 0-60 min, and independent of pH change. The within-batch coefficient of variation for positive displacement pipetting of Li loaded erythrocytes is 2.8%. Storage of erythrocytes in isosmotic MgCl2 for 24 h had no effect on the SLC. Intra-individual coefficient of variation for SLC was less than 6%. The reference range for Caucasian subjects (n = 43) was 0.14-0.49 mmol Li +/l erythrocytes/h. PMID- 3677432 TI - A modified statistical approach for the detection of outlying values in external quality control: comparison with other techniques. AB - Laboratory results submitted to External Quality Assessment Schemes (EQAS) are evaluated against the arithmetic mean (m) and standard deviation (SD) of the result from other participants assuming a normal distribution of individual results. The sample statistics m and SD can only be reliable estimates of the theoretical mean (mu) and standard deviation (sigma), if they are not distorted by outlying values. Outliers are commonly detected by defining a confidence interval m +/- k SD, typically with k-values fixed at 3.0 or 3.2. The objective of our study was to prove the deficiency of the use of these fixed limits in large-scale EQAS, because it results in an unacceptable increase of outlier rate and hence in a serious distortion of the estimate of sigma. We have proposed a modified approach using a variable k-value which is dependent upon sample size and keeping the significance level constant at 5%. The influence of different decision limits on the number of outliers and on the sample statistics m and SD was compared using data from the Belgian National EQAS obtained in 6 consecutive surveys. PMID- 3677433 TI - Removal of interference by antihypertensive drugs in the spectrophotometric assay of metanephrines. PMID- 3677434 TI - A simple diagnostic method of adrenoleukodystrophy: total fatty acid analysis of erythrocyte membranes. PMID- 3677435 TI - Urinary bile alcohols in liver dysfunction. PMID- 3677436 TI - Problems and promises arising from measuring salivary testosterone. PMID- 3677437 TI - New conjugated urinary metabolites in intermediate type maple syrup urine disease. AB - N-Lactylvaline, N-lactylleucine, N-lactylisoleucine and the N-2-hydroxyisovaleryl conjugates of glycine, valine, leucine and isoleucine have been identified in urine from a patient with the intermediate type of maple syrup urine disease. PMID- 3677438 TI - Plasma glutathione S-transferase measurements in patients with alcoholic cirrhosis. AB - Hepatocellular damage has been assessed in 54 patients with biopsy proven alcoholic cirrhosis by measuring the activity of aspartate aminotransferase (AST) and the concentrations of glutathione S-transferase B1B1 (GST B1B1) and B2B2 (GST B2B2) in serum. The levels of AST, GST B1B1, or GST B2B2 were abnormal in 28, 28 and 17 patients respectively but abnormalities in AST and GST measurements appeared to identify different populations of patients. PMID- 3677439 TI - Lactate dehydrogenase, isoenzyme patterns and cation levels in human breast gross cyst fluid. AB - In order to investigate the diagnostic and/or prognostic value of total activity and isoenzymatic patterns of lactate dehydrogenase, 24 human breast gross cystic fluids were studied. A comparison of total lactate dehydrogenase activity to the serum level revealed an increased activity in about 63% of the cases examined; moreover, a significant increase in the slow-moving lactate dehydrogenase 4 and 5 isoenzymes was observed in some cyst fluids. The levels of Na+ and K+ concentrations were also analyzed and two classes of cysts were identified: one presenting Na+ and K+ levels similar to those found in extracellular compartment; the other with high K+ and low Na+ levels, characteristic of an intracellular fluid. This latter pattern could indicate an active metabolism of the epithelial cells lining the cysts. This breast cyst fluid also showed increased levels of lactate dehydrogenase 4 and 5 isoenzymes. The correlation between an increased activity of lactate dehydrogenase 4 and 5 isoenzymes and high K+ and low Na+ levels could be the expression of a high biosynthetic activity and of an anaerobic metabolism in some cysts, suggesting the evolution of the breast gross cyst lesion to malignancy. The importance of these observations is discussed. PMID- 3677440 TI - Improved method for the quantification of aminoglutethimide in urine samples. AB - Due to an unknown mechanism aminoglutethimide (AG) in urine samples is partly present in a form in which it is not detected. Though most evident if samples had been stored at -20 degrees C (about 60% trapped), it also occurred in fresh urine samples (about 20% trapped). Heating the urine sample for 15 min at 100 degrees C liberated all AG. This phenomenon has led to the underestimation of the excretion of unchanged AG in previous publications. This study shows that AG was excreted unchanged for 47.5 +/- 7.3% (mean +/- SD) in patients received 2 X 125 mg or 2 X 250 mg AG. Direct measurement of hydroxylaminoglutethimide (HxAG) was found difficult, due to its instability with respect to oxidation. We found azoxyG to be a stable oxidation product derived from HxAG. The concentration of azoxyG formed was proportional to the amount of HxAG converted. HxAG seemed subjected to the same phenomenon as AG. A conversion of HxAG into an unknown compound which seemed to occur very easily and which was even accelerated by heating, made it impossible to accurately measure the concentration of HxAG. PMID- 3677441 TI - Two factors associated with increased uptake of calcium in platelets from essential hypertensive patients. AB - The relative rate of calcium transport into platelets from essential hypertensive patients and healthy normotensive donors was measured using the metallochromic indicator arsenazo III and recording net decrease in optical density per 5 minutes (O.D.U./5 min). When platelets from essential hypertensive patients were suspended in the patient's own serum, calcium was transported more rapidly than when suspended in normal sera (0.0166 vs 0.0113 O.D.U./5 min, P less than 0.01) indicating that the difference is due to a circulating factor. When platelets from healthy normotensive volunteers were suspended in the donor's own serum or in a pool of normal sera, the relative rate of transport was lower than in the case of platelets from hypertensives suspended in the pool of normal sera (0.005 vs 0.0113 O.D.U./5 min, P less than 0.01) which suggests a membrane alteration rendering the platelets from hypertensives more permeable to calcium. It was observed that the increase of calcium entry was inhibited by verapamil. The nature of these circulating and membrane-associated factors is at present unknown, but the circulating factor was capable of increasing the membrane permeability to calcium in normal human platelets (from 0.0057 to 0.011 O.D.U./5 min, P less than 0.01) and even in rat liver mitochondria, an effect that was inhibited by ruthenium red. PMID- 3677442 TI - Effect of meta-chlorophenylpiperazine (mCPP), a central serotonin agonist and vascular serotonin receptor antagonist, on blood pressure in SHR. AB - mCPP (meta-chlorophenylpiperazine) has agonist activity at some central serotonin receptors and antagonist activity at peripheral vascular 5HT2 receptors, both effects that have been postulated to lower blood pressure. mCPP (10 and 30 mg/kg, i.p. 1 hr after administration) increased serotonin and decreased 5-hydroxy indolacetic acid (5-HIAA) brain concentrations and elevated serum corticosterone and prolactin, indications of central serotonergic agonist activities. The same doses of mCPP also antagonized vascular 5HT2 receptors as measured by blockade of pressor responses to serotonin in pithed rats. Although mCPP could be demonstrated to activate central serotonergic receptors and block peripheral vascular 5HT2 receptors, mCPP (10 and 30 mg/kg, i.p.) produced little effect on blood pressure in either the anesthetized or conscious spontaneously hypertensive rat (SHR) up to 1 hr after intraperitoneal administration. The findings are consistent with initial studies in normotensive humans that have not demonstrated a reduction in blood pressure clinically after mCPP in doses that produce elevations in serum cortisol and prolactin levels. PMID- 3677443 TI - The influence of antihypertensive treatment on the renal arterial structure in spontaneously hypertensive rats. A morphometric study. AB - Spontaneously hypertensive rats (SHR) and stroke-prone spontaneously hypertensive rats (SHRSP) were treated with a combination of a beta 1-blocker (metoprolol) and a Ca++-antagonist (felodipine) from 1 to 4 months or 4 to 6 months of age. The renal arterial trunks as well as more distal parts of the renal arterial bed were fixed by immersion and embedded in plastic. The media cross-sectional area and the length of the internal elastic membrane were measured on cross-sectioned arteries. The media thickness, luminal radius and the ratio between media thickness and luminal radius (m/r ratio) were then calculated for a standardized condition, assuming a smooth and circular internal elastic membrane, in which the arteries were compared. The m/r ratio was markedly reduced in the most proximal as well as in more distal arterial segments of the treated animals when compared with untreated rats of corresponding age and category. The quotient was somewhat reduced also when compared with normotensive controls (WKY) although the systolic blood pressure in younger treated rats was not fully normalized. The results may suggest that the present treatment influences the arterial walls not only by reducing the pressure load but also through pressure-independent mechanisms. PMID- 3677444 TI - Involvement of dopamine in development of hypertension in spontaneously hypertensive rat: effect of carbidopa, inhibitor of peripheral dopa decarboxylase. AB - The demonstration of acceleration of hypertension was investigated in spontaneously hypertensive rats (SHR) treated with carbidopa, inhibitor of peripheral dopa decarboxylase. Oral administration of carbidopa to young SHR for 4 weeks accelerated significantly (P less than 0.05) development of hypertension as compared to SHR treated with vehicle. Urinary excretion of dopamine (DA) (P less than 0.01) and renal content of DA (P less than 0.02) were significantly decreased by carbidopa treatment. Urinary excretion of sodium (P less than 0.05) was significantly decreased and renal content of norepinephrine (NE) (P less than 0.01) was significantly increased by carbidopa. Urinary excretion of NE and epinephrine (E) did not change during the experimental period. Negative correlation between systolic blood pressure and urinary excretion of sodium (P less than 0.05) or dopamine (P less than 0.01) and positive correlation between systolic blood pressure and renal content of NE (P less than 0.05) were significantly observed in both groups of SHR treated with carbidopa and with vehicle for 4 weeks. These results suggest that decreased DA biosynthesis in peripheral tissues accelerates development of hypertension mediated by decrease of natriuresis and enhanced release of NE in the kidneys of SHR. DA plays an important role in regulation of blood pressure, and reduced dopaminergic mechanisms enhance blood pressure in SHR. PMID- 3677445 TI - The actions of dopamine on the blood pressure and heart rate of conscious hypertensive rats: evidence for reduced dopaminergic activity in rats of the Japanese strains. AB - The effects of intracerebroventricularly (icv) and intravenously (iv) administered dopamine (DA) on mean arterial pressure (MAP) and heart rate were investigated in conscious spontaneously hypertensive rat (SHR), stroke-prone SHR (spSHR) and normotensive Wistar-Kyoto (WKY) rat of Japanese strains, genetically hypertensive (GHR) and normotensive (NT-NZ) rat of New Zealand strains, Sprague Dawley (SD) rat, and left renal artery stenosed hypertensive WKY (WKYLRAS) and SD (SDLRAS) rats. Icv DA (0.0125-0.4 mg/kg) caused a linear dose-related decrease in MAP, accompanied by bradycardia in all animals. By contrast, the same doses of DA given iv caused a linear dose-related increase in MAP, accompanied by reflex bradycardia in most groups (except the spSHR, SHR and WKYLRAS where tachycardia occurred to most of the doses employed), indicating that the decrease in MAP following icv DA is centrally-mediated. A "greater" relative hypotensive effect to icv DA was seen in the Japanese hypertensive strains SHR and spSHR compared to the WKY, but not between the New Zealand strains or the renal hypertensive animals. Our data also show that this marked hypotensive responsiveness is not related to the basal MAP, but appears to be strain-specific. It is thus possible that the alleged reduced central dopaminergic activity in the Japanese strains of hypertensive rats may be responsible for exaggerated hypotensive responses observed in these strains. PMID- 3677446 TI - Respiratory variations in arterial blood pressure and heart rate in normotensive and renal hypertensive dogs. AB - Respiratory sinus arrhythmia (RSA), systolic and diastolic respiratory blood pressure waves (RBPWsyst, RBPWdiast), mean heart rate (HR), mean respiratory frequency (RF) and the heart beat to respiratory cycle ratio (HB/RC) were measured in 23 spontaneously breathing, normotensive or renal hypertensive dogs under light anaesthesia. No significant differences were found between conditions of normal and chronically elevated blood pressure. All these parameters were analyzed statistically by means of linear regression analysis and rank correlation coefficient (rs). A correlation was found to exist between RSA and mean systolic blood pressure (negative), RF (negative), RBPWsyst (positive), RBPWdiast (positive). RF correlated with both HB/RC (negative) and RBPWsyst (negative). A correlation was also seen between PA and both BPsyst (positive) and BPdiast (positive), BPsyst and BPdiast (positive) and between HR and RBPWdiast (negative); however, all the remaining, theoretically possible correlations were not significant. The results may be referred to resonance mechanisms in a common nervous oscillator system. PMID- 3677447 TI - Electrophysiological characteristics of sensory mechanisms in the kidney. AB - R2 chemoreceptors are excited by backflow of urine or isotonic KCl into the renal pelvis, they do not respond to backflow of isotonic saline at the same intrapelvic pressure but are excited during periods of renal ischemia. R1 chemoreceptors are excited during complete renal ischemia but otherwise exhibit no activity. The responses of multiunit afferent renal nerve activity (ARNA) to these stimuli in Sprague Dawley rats follow the same patterns exhibited by R2 chemoreceptors, and the data do not support the presence of mechanoreceptive nerves which are excited by increases in intrapelvic pressure in these animals. The responses of multiunit ARNA in SHR and WKY rats were not different from Sprague Dawley rats. In contrast, while the response of WKY rats during renal ischemia was not different from Sprague Dawley rats the excitation of SHR during ischemia was more than 10 fold greater than that of the normotensive animals. PMID- 3677448 TI - Proceedings of the Maastricht Symposium on Renal Nerves and Hypertension. Satellite symposium to the 11th scientific meeting of the International Society of Hypertension. Maastricht, The Netherlands, September 6-7, 1986. PMID- 3677449 TI - Renorenal reflex responses to renal sensory receptor stimulation in normotension and hypertension. AB - The renorenal reflex responses to renal mechano-(MR) and chemoreceptor (CR) stimulation have been examined in anesthetized dogs, cats, and rats. Renal MR were stimulated by increased ureteral pressure and renal CR by retrograde ureteropelvic perfusion with 0.9 M NaCl at unchanged ureteral pressure. In the dog, renal MR stimulation results in an increase in ipsilateral afferent renal nerve activity (ARNA) and contralateral efferent RNA (ERNA) and a contralateral renal vasoconstriction. Mean arterial pressure (MAP) is unchanged. Renal CR stimulation is without effect. In the cat, renal MR and CR stimulation increases MAP and either increases or decreases contralateral urine flow rate and urinary sodium excretion at unchanged renal perfusion pressure. In the rat, renal MR and CR stimulation increases ipsilateral ARNA, decreases contralateral ERNA and increases contralateral urine flow rate and urinary sodium excretion. The magnitude of the renorenal reflex responses is related to the magnitude of the stimulation. Furthermore the renorenal reflex responses are attenuated in spontaneously hypertensive rats (SHR). We conclude that there is a species difference in the nature of the renorenal reflex responses to renal MR and CR stimulation. The attenuated renorenal reflexes in SHR might contribute to their hypertension by promoting increased ERNA and sodium retention. PMID- 3677451 TI - The extrinsic innervation of the rat kidney. AB - The anatomy of the extrinsic renal nerves is described making use of an in toto staining procedure for acetylcholinesterase activity. Nervous connections between the kidney and the celiac plexus, major and minor splanchnic nerves, the lumbar splanchnic nerves and the intermesenteric nerve plexus have been established. Bundles of nerve fibers enter or leave the kidney in the (peri-) hilar region. The occurrence of inter- and intraindividual variability is emphasized. Implications of these findings for the use of the rat as an experimental animal in denervation experiments are discussed. PMID- 3677450 TI - Extraneuronal production of dopamine by kidney slices in normo and hypertensive rats. AB - Synthesis of dopamine (DA) was studied in cortical slices of Sprague-Dawley (SD) rat kidneys incubated with L-DOPA (10(-6) M). In morphological studies, formaldehyde-induced histofluorescent deposits were detected at the apical pole of the convoluted parts of the proximal tubules. Elsewhere along the nephron, no positive reaction appeared. DOPA decarboxylase inhibitors suppressed the advent of the deposits, but prior denervation did not. Biochemical studies showed: (a) slices produced 2.2 nmol mg-1 protein, glomeruli 0.2 and cytosol 43 nmol. In absence of L-DOPA or in presence of DOPA decarboxylase inhibitors, DA production was suppressed. Prior denervation did not influence DA production; (b) DA synthesis increased with sodium concentration of the milieu (range 95 to 152 mmol). Adult spontaneously hypertensive rats (SHR) produced less DA than SD or normotensive Wistar-Kyoto, at any sodium concentration from 95 to 142 mmol. This discrepancy could be related to the pathogenesis of hypertension. PMID- 3677452 TI - Characterization of hypertension induced by long-term intrarenal norepinephrine infusion in conscious rats. AB - This paper reviews some of the data that we have collected over the last years in an animal model in which, to study the role of renal nerves in hypertension, increased efferent sympathetic activity was simulated by a 5-day intrarenal infusion of norepinephrine (NE; 4-36 ug/kg.hr) in rats. This resulted in an exaggerated hypertensive reaction as compared to intravenous infusions of the same amounts. Hypertension was characterized by increased total peripheral resistance and decreased cardiac output. From plasma volume and renal function studies, no evidence for volume-dependent hypertension could be obtained. The most striking difference between intrarenally and intravenously infused rats was a greater increase in plasma NE levels in the former group. This pointed towards a possible activation of afferent renal nerves by intrarenally applied NE. However, neither total nor selective afferent renal denervation prevented hypertension by intrarenal NE. This suggests either that afferent renal nerves do not play a role or, alternatively, blood pressure is controlled differently in intact and denervated rats. PMID- 3677453 TI - Afferent renal nerves and hypertension. AB - Adenosine-sensitive nerve endings have been found in the renal pelvis which when stimulated increase sympathetic activity producing hypertension. When urinary adenosine concentration is lowered by intrarenal infusion of adenosine deaminase in one-kidney one-clip rats, peripheral sympathetic nervous system activity and arterial pressure decrease if the renal nerves are intact. These data suggest that a stimulus for afferent renal nerve activity in one-kidney, one-clip hypertension is intrarenal adenosine. This intrarenal adenosine hypertensive reflex was examined further observing the responses to renal pelvic xylocaine infusion, selective renal deafferentation, adrenal demedullation and spinal cord transection (T6). The intrarenal adenosine hypertensive reflex was interrupted by renal pelvic xylocaine infusion, renal deafferentation and adrenal demedullation in normotensive and one-kidney, one-clip hypertensive animals. The intrarenal adenosine hypertensive reflex persisted after spinal cord transection (T6). These data support the concept that adenosine-sensitive intact afferent renal nerves located in the renal pelvis enhance sympathoadrenal activity resulting in the maintenance of one-kidney, one-clip hypertension and that this intrarenal adenosine-hypertensive response may occur as a spinal-level reflex in the rat. PMID- 3677454 TI - Role of sensory renal nerves in the development of spontaneous hypertension in rats. AB - In order to study the role of afferent renal nerves in the development of spontaneous hypertension, 3-4 weeks old uninephrectomized spontaneously hypertensive rats were deafferented selectively by a unilateral dorsal rhizotomy. Control rats were sham-operated. Until 10 weeks of age, systolic tail cuff blood pressures were identical in both groups. Although from 12 weeks on systolic blood pressure was slightly (10%) but significantly lower in deafferented rats, mean arterial pressures from an indwelling catheter were identical in deafferented and control rats. We therefore conclude that a selective destruction of afferent renal nerves does not delay or prevent the development of spontaneous hypertension in rats. PMID- 3677455 TI - Inhibitory effect of the contralateral kidney on the renal pressor reflex evoked by ipsilateral renal artery stenosis. AB - We previously identified a sympathoexcitatory pressor reflex that is evoked by acute (90 min) unilateral renal artery stenosis (RST). The reflex is strongly expressed in conscious rats when the renin-angiotensin system and baroreflexes are diminished by captopril and sinoaortic denervation, and is eliminated by denervation of the stenosed kidney. In the present study, dorsal rhizotomy inhibited the reflex, establishing the role of afferent renal nerves (ARN). During sustained (10 h) RST, the reflex reversed within 4 hours after onset of RST, but persisted after removal of the contralateral kidney. Hematocrit measurements did not support pressure diuresis as a mechanism for inhibition by the contralateral kidney. Other studies suggest that ARN signals and/or release of antihypertensive renomedullary lipid from the contralateral kidney are not involved in inhibition of the reflex. These data suggest that the contralateral kidney can oppose, at least acutely by an as yet undefined mechanism, an ARN dependent pressor reflex evoked by ipsilateral renal artery stenosis. PMID- 3677456 TI - Efferent renal nerve traffic in the spontaneously hypertensive rat. AB - Renal nerve activity has been recorded in anaesthetised and conscious spontaneously hypertensive rats (SHR) and normotensive control rats (WKY). SHR showed an elevated renal nerve discharge in the control situation both when mean rectified activity was measured in conscious rats and when single fibre activity was recorded in anaesthetised rats. The renal nerve response to stress was also markedly augmented in SHR, and parallel with the nerve response we observed a greater decrease in renal sodium excretion in SHR than in WKY. Baroreflex inhibition of heart rate was markedly attenuated in SHR. In contrast, baroreflex inhibition of renal nerve activity was, if anything, augmented. Left atrial receptors were reset in SHR. Interestingly enough, SHR had an augmented response to volume loading, due to a decreased distensibily of peripheral veins, which counteracted the resetting of the left atrial receptors. PMID- 3677457 TI - Adrenergic receptors and sodium reabsorption in normotensive subjects as related to salt sensitivity. AB - We have studied proximal tubular sodium reabsorption as measured by lithium clearance, alpha-2 and beta-2 adrenergic receptors on circulating platelets and lymphocytes, respectively, and urinary aldosterone after variations of sodium intake in 24 normotensive volunteers. Fractional lithium clearance was 14.8% +/- 2.64 under a high salt diet of 200 mmol per day. After a low salt diet of 50 mmol/d for two weeks fractional lithium clearance did not change significantly (13.3% +/- 3.35). There were no correlations between alpha-2 adrenergic receptors, beta-2 adrenergic receptors or the alpha-2/beta-2 ratio and fractional lithium clearance, irrespective of the high or low salt diet. In contrast, a significant correlation was found between urinary aldosterone excretion and alpha 2 receptor densities under low salt diet (r = -0.55, n = 17, p less than 0.02). There were no correlations between beta-2 adrenoceptor density, alpha-2/beta-2 ratio and urinary aldosterone during high or low salt diet. Whereas our results are inconclusive about the value of lithium clearance determinations as a measure of proximal tubular sodium reabsorption during variations of sodium intake, we conclude, that alpha-adrenoceptor density, as measured on circulating blood cells, may possibly be representative for alpha-adrenergic equipment of the kidney. The inverse correlation between urinary aldosterone excretion in subjects equilibrated on a low salt diet of 50 mmol/d and alpha-2 adrenoceptor densities could be interpreted as an indirect evidence, that those subjects with a high alpha-2 adrenoceptor equipment show a high proximal tubular sodium reabsorption and thus can afford a low rate of aldosterone mediated distal tubular sodium reabsorption to maintain sodium balance. Our results are thus in accord with our previous hypothesis, that different receptor equipment of individual subjects may cause marked differences in sodium handling by the kidney. These differences may be responsible, at least in part, for the degree of salt sensitivity in individual subjects. PMID- 3677458 TI - Absence of reflex sympathetic activation by the selective renal vasodilator CGP 22979A in the conscious rat. AB - The effects of the selective renal vasodilator prodrug CGP 22979A on mean arterial blood pressure (MAP), heart rate (HR) and sympathetic efferent splanchnic nerve activity (SpNA) were investigated in conscious normotensive rats, and compared with those of the active drug CGP 18137A, a hydrallazine-like systemic vasodilator. CGP 18137A (0.03 to 1mg/kg i.v.) produced a dose-dependent decrease in MAP, whereas HR and SpNA increased. CGP 22979A affected neither BP nor HR and SpNA at doses of 1 and 3mg/kg i.v. which induce a selective increase in renal blood flow. In contrast, a dose of 30mg/kg i.v., which produced systemic effects comparable to those of CGP 18137A, stimulated SpNA to the same extent as 18137A did. These results demonstrate that the rise in renal blood flow induced by low doses of CGP 22979A is not associated with an increase in efferent sympathetic nerve activity. They suggest also that selective renal vasodilatation can be accomplished without an activation of the sympathetic nervous system. PMID- 3677459 TI - Attenuation of hypothalamo-sympathetic hyperactivity by renal denervation in experimental hypertensive rats. AB - To clarify the effect of renal nerves on hypothalamic cardiovascular regulation in hypertension, posterior hypothalamus was electrically stimulated in renal denervated SHR (RD-SHR) and DOCA hypertensive (RD-DOCA) rats during recording blood pressure and sympathetic nerve activity. In urethane anesthetized SHR, mean blood pressure was not different between RD- and sham-operated SHR 48 hours after denervation, but two weeks later, blood pressure was lower in RD-SHR. Pressor and sympathetic nerve responses to hypothalamic stimulation were partly attenuated 48 hours after denervation, but two weeks later, attenuation was strong. The development of hypertension was abolished during two weeks observation in RD-SHR. In DOCA hypertensive rats, the development of hypertension was significantly inhibited by renal denervation. Pressor and sympathetic nerve responses to hypothalamic stimulation were significantly diminished in RD-DOCA rats. Water intake and urine volume was identical in both groups. These results suggest that renal denervation inhibited the development of hypertension accompanied with the inhibition of hypothalamo-sympathetic nerve system, furthermore, it is indicated that hypothalamic cardiovascular regulation controlled by afferent renal nerve could contribute to the development of hypertension in SHR and DOCA hypertensive rats. PMID- 3677460 TI - Pitted enamel hypoplasia in tuberous sclerosis patients and first-degree relatives. AB - Thirty-six families with tuberous sclerosis (TS) including 49 affected persons and 68 apparently unaffected first-degree relatives were examined for dental abnormality. Fifty unrelated controls were similarly examined. Clinically observed multiple enamel pits (pitted enamel hypoplasia) were noted in 71% of persons with typical TS and in one out of 10 "atypical" cases. Enamel pits were rarely seen, and in small numbers only, in the control series, and they were rare in the otherwise apparently normal TS first-degree relatives. However, one parent and one half-sib of persons with typical TS, but themselves without other signs of TS, were found to have multiple enamel pits. Examination for pitted enamel hypoplasia should be made in all persons suspected of having TS and in all close relatives; enamel pits are a valuable clinical sign and may identify otherwise unsuspected carriers of the gene within the family. PMID- 3677461 TI - Family resemblance for fasting blood glucose: the Jerusalem Lipid Research Clinic. AB - Familial aggregation of fasting plasma glucose was studied in a sample of families examined at the Jerusalem Lipid Research Clinic. We first examined homogeneity of familial correlations across major origin groups in the Israeli sample. Correlations were generally homogeneous across origin groups, except for mother-son pairs. The pooled familial correlations were relatively low for unadjusted blood glucose values, and somewhat higher upon adjustment for sex, age, ethnicity, education, seasonality, body mass, cigarette smoking, alcohol consumption and dietary intake. Genetic and cultural determinants of blood glucose were estimated utilizing a path model with 10 parameters to be estimated from a total of 16 correlations. Under a reduced model genetic heritability (h2) was estimated to be 0.18 +/- 0.08 and cultural heritability (c2) was 0.10 +/- 0.02. However, within this population the additive variation could be explained by a cultural model of inheritance without introducing genetic parameters, and most of the variance is due to "random" unmeasured environmental factors. Commingling analysis was also performed, and our findings imply that there is no evidence for admixture in the distribution of fasting blood glucose in this Israeli population sample. PMID- 3677462 TI - Difficulties encountered in a randomization trial of CVS versus amniocentesis for prenatal diagnosis. AB - In April 1985, having completed a study of the short-term complications of chorionic villus sampling (CVS), we began a randomized comparison of CVS versus amniocentesis. Our study continued over a 15-month period, and during that time we had difficulty recruiting patients, with only 10.6% of 1254 women referred for prenatal diagnosis fully participating in this study. However, 30.2% of those eligible by dates and indication chose to enter the study. CVS was available in our province only through this study, and the two most common reasons for such a low rate of recruitment were reporting too late in pregnancy and the concern about the potential risks of CVS. Patients continued to seek counselling too late for CVS despite direct and continuous contact with regional physicians. Our patients' concern about risk might well vary with the attitude of their physicians towards CVS, and with the information provided at the time of pre-test counselling. The small number of patients actually enrolled did not permit any meaningful comparison of amniocentesis to CVS. However, our experience with pregnancies lost post-CVS suggests that a pregnancy with an apparent low implantation at the time of sampling may be at a higher risk of loss. PMID- 3677463 TI - Relative effect of parental birth weight on infant birth weight at term. AB - The relations between some hereditary and environmental factors and the variation in infant birth weight were estimated by multiple linear regression analyses on a sample of 276 Scandinavian single term pregnancies. Gestational age explained 10.9%, fetal factors (maternal and paternal birth weights and fetal sex) 7.9%, maternal factors (parity, pre-pregnancy weight and height) 5.5% and external factors (adjusted weight gain and smoking) 5.8% of the variation in infant birth weight. It is concluded that maternal and paternal birth weights are rather poor predictors of infant birth weight. Together they explain only 5.6% of the variation in infant birth weight at term. PMID- 3677464 TI - Isochromosome (18q) in siblings. AB - A report is presented on a familial occurrence of isochromosome (18q) in a newborn infant and in a fetus in the 24th week of gestation after amniocentesis. PMID- 3677465 TI - Transcultural study of Turner's syndrome. AB - A transcultural questionnaire study was made of 111 girls with Turner's syndrome aged 17 to 30 from Belgium, Canada, Denmark, France, the FRG and Hungary. The study reveals that there is still too much secrecy and ignorance concerning Turner's syndrome, and the diagnosis should be made and presented together with full information much earlier than at present, preferably at birth. More and better information concerning Turner's syndrome is needed in all participating countries, but more in some countries than in others. The study further shows that there is a great need for the establishment of Turner's syndrome societies or Turner contact groups so that such groups are available in all countries. The study also shows that in spite of personality profiles with characteristics such as happy, active, extroverted, realistic, talkative, and good contact abilities, far too many girls with Turner's syndrome suffer from anxiety, loneliness and inferiority feelings, especially in certain countries. This is definitely due to environmental factors that ought to be changed and can be changed by an increase in the level of information and research, together with establishment of Turner contact groups in all countries. PMID- 3677467 TI - PEDIGREE-PLOT: a computer program for plotting pedigrees. AB - PEDIGREE-PLOT is a FORTRAN program which can be used for the drawing of pedigrees in either a horizontal or a circular shape. Eight different symbols are available for characterizing a person. Special symbols for stillbirth, abortion, unspecified sex, twins and half sibships exist. PMID- 3677466 TI - Effect of screening for cystic fibrosis on the influence of genetic counseling. AB - We studied the influence of genetic counseling for cystic fibrosis on family planning, using neonatal screening, family size at time of diagnosis, and maternal age as possible determinants for reproductive behaviour. The expected number of children born to mothers of equal age and parity in the same period was approximated on the basis of population statistics. These numbers were compared to the numbers of children born in the study group after a CF diagnosis and information on the 25% recurrence risk were given. A 50.8% reduction in childbirth was found in the study group, although 77% of families had decided against further high-risk pregnancies. No statistically significant influence of neonatal screening could be demonstrated, but this may be due to the small number of families involved. PMID- 3677468 TI - Neonatal phototherapy for jaundice--a dermatological assessment. PMID- 3677469 TI - Cryotherapy for dermatofibromas. PMID- 3677470 TI - Stevens-Johnson syndrome due to tetracyclines--a case report (doxycycline) and review of the literature. PMID- 3677471 TI - Clinical features and therapy of lichen sclerosus et atrophicus affecting males. PMID- 3677472 TI - Calcifying arthropathy of the hips and diffuse hyperostosis associated with etretinate. PMID- 3677473 TI - Extensive congenital bilateral epidermal naevus syndrome--a case report from Nigeria with ultrastructural observations. PMID- 3677474 TI - Atopy from a respiratory physician's standpoint. PMID- 3677475 TI - The effect of fixation on monoclonal antibody labelling of cell surface antigens in cutaneous tissue. PMID- 3677476 TI - Characterization of the glucocorticoid receptor in human epidermis and dermis. PMID- 3677477 TI - A comparison of the glucocorticoid receptors in the dermis and epidermis of the rat. PMID- 3677478 TI - Trace element status in eczema and psoriasis. PMID- 3677479 TI - Efficacy of etretinate for the PUVA-dependent psoriatic. PMID- 3677480 TI - Noradrenergic reinnervation of the rat vas deferens after vasovasostomy following vasectomy. AB - 1. Anastomosis (vasovasostomy) of epididymal and prostatic halves of vasa deferentia was carried out in rats in which unilateral or bilateral medial transection (vasectomy) had been performed 4 weeks previously. 2. Noradrenaline levels in epididymal halves of vasa deferentia, 8 weeks after anastomosis with prostatic halves, were approximately 40% of those in epididymal halves of contralateral, unoperated vasa deferentia. Catecholamine fluorescence was partially restored after anastomosis. 3. Responses of epididymal halves of transected vasa deferentia to electrical field stimulation (1 ms, 60 V, 10 pulses at 0.01-50 Hz) were partially restored 8 and 15 weeks after anastomosis. 4. Noradrenaline was equipotent in causing contraction of epididymal halves of unoperated and anastomosed vasa deferentia at 8 and 15 weeks after vasovasostomy. The ability of nisoxetine (0.1 mumol/l) to potentiate the effects of noradrenaline was partially restored by vas deferens repair. 5. Noradrenaline levels and neurotransmission in prostatic halves of vasa deferentia were relatively unaffected by vasectomy and subsequent vasovasostomy. 6. Fertility was restored 4-8 weeks after bilateral anastomosis performed in a group of eight rats 4 weeks after bilateral vasectomy. 7. These observations show that in the rat the noradrenergic denervation of the epididymal segment of the vas deferens after medial transection is partially reversible by anastomosis 4 weeks later, and that full noradrenergic reinnervation of the organ is not essential for the return of fertility after vasectomy and vasovasostomy in this species. PMID- 3677481 TI - Neurological consequences of magnesium deficiency: correlations with epilepsy. AB - 1. The plasma calcium and magnesium concentrations of sheep have been manipulated by feeding liquid diets with various calcium and magnesium concentrations. 2. When the magnesium status of the diet was low, both plasma calcium and magnesium concentrations declined, but the decline in calcium was much more rapid and extensive when the content of calcium in the diet was also low. This loss of calcium control in magnesium deficiency was attributed to end-organ resistance to parathyroid hormone. 3. Correlation between plasma and CSF calcium and magnesium concentrations indicated that convulsions occurred when CSF magnesium and plasma calcium concentrations declined. 4. The neurological mechanisms likely to be responsible for the induction of these convulsions are discussed and the factors precipitating convulsions in magnesium deficiency and epilepsy are compared. PMID- 3677482 TI - Inhibitory effect of frusemide on sympathetic vasoconstrictor responses: dependence on a renal hormone and the vascular endothelium. AB - 1. Mesenteric perfusion pressure was measured in the in situ mesentery perfused at a constant rate with blood drawn from the carotid artery of the same anaesthetized rat. Increases in perfusion pressure were produced by mesenteric periarterial electrical stimulation. These responses were measured before and 30 min after the administration of frusemide (5 mg/kg i.v.) to the rat. Loss of volume due to the frusemide-induced diuresis was prevented by a urinary bladder venous extracorporeal circuit. 2. Responses to stimulation were reduced after frusemide and were not increased by the subsequent administration of indomethacin (2 mg/kg i.v.). This indomethacin treatment rapidly and completely prevented the fall in blood pressure produced by i.v. arachidonic acid. 3. In rats where the renal papilla had been ablated by treatment with bromoethylamine (200 mg/kg i.p.) 5 weeks previously, frusemide administration did not reduce sympathetic responses in the in situ blood-perfused mesentery. 4. A segment of rat tail artery, cannulated at both ends was mounted in an organ bath and perfused with blood withdrawn from, and returned to, an anaesthetized rat. Increases in perfusion pressure produced by periarterial electrical stimulation of this ex vivo blood perfused tail artery segment were reduced by frusemide administration to the anaesthetized rat. 5. When the endothelium was removed from the tail artery segment, frusemide administration did not lead to any reduction of vasoconstrictor responses. 6. Frusemide may lead to the release of a non prostanoid hormone from the renal medulla which results in inhibition of peripheral sympathetic vasoconstrictor responses. The release of the hormone may involve intra-renal prostaglandins. The final antivasoconstrictor effect requires an intact vascular endothelium. PMID- 3677483 TI - The interaction of nicotinic receptor antagonists at muscarinic receptors. AB - 1. The interaction of some neuromuscular blocking drugs such as gallamine, pancuronium and stercuronium with muscarinic receptors has several features which distinguish these compounds from competitive antagonists in functional and binding studies. 2. They also differentiate between muscarinic receptors and may produce effects on ion channels. PMID- 3677484 TI - Modification by diltiazem, a calcium antagonist, of the pulmonary vagal and cardiac sympathetic chemoreflexes in the dog. AB - 1. Experiments were performed on anaesthetized, open-chest dogs to determine the effects of diltiazem on: the pulmonary vagal chemoreflex evoked by intravenous (i.v.) injection of capsaicin; cardiac sympathetic chemoreflexes activated by epicardial application of bradykinin or capsaicin; and baroreflex-mediated changes in heart rate resulting from both pressor and depressor effects produced by i.v. injections of noradrenaline and bradykinin, respectively. 2. Diltiazem infused i.v. at a rate of 10-30 micrograms/kg per min (mean cumulative dose 0.53 +/- 0.05 mg/kg, n = 9), did not affect basal heart rate, despite significant (P less than 0.001) reduction of resting blood pressure. 3. Diltiazem treatment did not affect the pressor responses to i.v. noradrenaline (0.3 micrograms/kg) or the hypotensive effects of i.v. bradykinin (0.3 micrograms/kg), but reduced significantly both the baroreflex-mediated bradycardia (P less than 0.01) and tachycardia (P less than 0.05) occurring with noradrenaline and bradykinin, respectively. 4. In contrast, diltiazem greatly enhanced reflex bradycardia (P less than 0.001) and systemic hypotension (P less than 0.01) resulting from activation of the afferent vagal pulmonary receptors by i.v. capsaicin (3-5 micrograms/kg). 5. Reflex pressor responses evoked by activation of the afferent cardiac sympathetic neurons by epicardial application of bradykinin (1 microgram) or capsaicin (10-20 micrograms) were not affected by diltiazem, but the corresponding reflex increases in heart rate evoked by both substances were significantly (P less than 0.01) reduced. 6. The results indicate that diltiazem, while reducing the influence of sinoaortic baroreceptors on heart rate, facilitates the reflex vagal control of the cardiac pacemaker by the afferent cardiopulmonary vagal receptors. These nervous reflex mechanisms, which include attenuation of positive chronotrophic effects that may result from ischaemia induced activation of the afferent cardiac sympathetic neurons, may play an important role in the protective action of diltiazem in ischaemic heart disease. PMID- 3677485 TI - Sensitivity changes of the perfused hindquarters' vasculature in rats with alloxan-induced diabetes mellitus. AB - 1. Arachidonic acid (AA, 0.125-1.0 mg/kg) injected via the aorta into the autoperfused hindquarters caused dose-dependent increases in perfusion pressure. This effect was reduced after intravenous administration of the thromboxane receptor antagonist AH23848 (5 mg/kg) or indomethacin (5 mg/kg). 2. Responses to AA (0.125-1.0 mg/kg) were reduced markedly in the Krebs-perfused hindquarters when compared with those occurring in the blood-perfused preparation. 3. Doses of guanethidine (1 mg/kg) and pentacynium (1 mg/kg) blocking pressor responses to intravenous administration of the ganglion stimulants McN-A-343 and DMPP, respectively, did not affect responses to AA. 4. Constrictor responses to AA (0.5 1.0 mg/kg) in blood-perfused hindquarters were increased in 14 day alloxan diabetic rats but those to the thromboxane A2-mimetic U46619 (0.5-8.0 micrograms/kg, i.a.) were reduced when compared with non-diabetic controls. 5. In 14 day alloxan-diabetic rats vasoconstrictor responses to noradrenaline and methoxamine were potentiated but those to 5-hydroxytryptamine were reduced compared with non-diabetic animals. 6. It is concluded that AA causes constriction in the blood-perfused hindquarters by release of a product of cyclo oxygenase acting on thromboxane A2-receptors. A constituent of blood, perhaps the platelet, appears necessary for this effect. Conversion of AA to the constrictor metabolite is augmented during experimentally induced diabetes. PMID- 3677486 TI - Role of pulmonary innervation in canine in situ lung-perfusion preparation: a new model of neurogenic pulmonary oedema. AB - 1. In situ canine lungs were perfused in the presence or absence of the nerves which coursed to the heart and lungs (the cardiopulmonary nerves, CPN). 2. A right heart-bypassed preparation was made first, so that the respiratory and circulatory conditions could be controlled beforehand. It was then switched to a lung-perfusion preparation, in which the lungs receive all influences of sudden cessation of the brain and systemic circulations solely via the CPN. Hydrostatic mechanisms causing pulmonary oedema were excluded by adjusting the pulmonary arterial pressure under 300 mmH2O (less than 24 mmHg). 3. Accumulation of extravascular lung water and the rate of reservoir blood loss were significantly lower in the CPN-severed group than in the CPN-intact group. 4. After perfusion of 90 min, total loss of reservoir blood was correlated significantly with extravascular water content in lungs. The former was larger than the latter. 5. Elevation of left atrial pressure caused an increase in the rate of reservoir blood loss. When the CPN was severed, the relation between these two parameters was shifted to the right. 6. These findings indicate a CPN-mediated genesis of permeability pulmonary oedema. PMID- 3677487 TI - Effects of Panax ginseng on blood alcohol clearance in man. AB - 1. Fourteen healthy male volunteers were studied to assess the effects of Panax ginseng on blood alcohol clearance, utilizing each subject as his own control. 2. At 40 min after the last drink, the blood alcohol level in the test group receiving ginseng extract (3 g/65 kg body weight) along with alcohol (72 g/65 kg body weight) was about 35% lower than their control values. 3. When the blood alcohol level was compared on individual bases, alcohol concentrations in 10 out of 14 test subjects ranged from 32 to 51% lower than their control values. 4. These results demonstrate that P. ginseng extract enhances blood alcohol clearance in man. PMID- 3677488 TI - AIDS and HIV infection: estimates of the magnitude of the problem worldwide in 1985/1986. AB - This review summarizes observations about the distribution of AIDS and HIV infection throughout the world. The United States has reported the greatest number of cases to the World Health Organization (WHO), but data from many areas are lacking or incomplete, making comparisons between different areas unreliable. Even within the United States, data are difficult to interpret and require careful consideration of the size of the various HIV-risk groups in the population and the degree to which results of studies of selected cohorts within a risk group can be extrapolated to the whole of that population. Outside of the United States, Europe, and Australia, less information is available. Almost every country in South America has reported cases of AIDS, although in most reports the number is small. In Asia, many countries have not yet reported cases or have had only a small number of cases. By the end of 1986, many countries in Africa had not yet reported any AIDS cases to the WHO, even from areas where AIDS is known to occur (i.e., Zaire). However, there is ample evidence from regional studies in Africa that AIDS and HIV infection are a major public health problem. Using admittedly questionable information for estimating the size of the problem worldwide, I project that between two and three million persons worldwide were infected with HIV by 1985/1986. Despite the lack of an effective therapy or vaccine, much can be and is being done to limit the global spread of HIV infection and AIDS. PMID- 3677489 TI - Protooncogene expression in peripheral blood mononuclear cells from patients with systemic lupus erythematosus as an indicator of the disease activity. AB - In the present study, we examined the various protooncogene expressions in PBMC (peripheral blood mononuclear cell) of systemic lupus erythematosus (SLE) patients to determine if they could be an indicator for the disease activity. We divided SLE patients into "very active," "active," and "remitting" states according to the clinical symptoms in addition to the laboratory data peculiar to SLE. In addition, we determined the amount of circulating immune complex (IC) as one of the representative laboratory indicators for the disease activity. We found a positive correlation with either c-myc or c-myb expression and the amounts of IC and clinical disease activity. The degree of c-myc and c-myb expression was significantly reduced along with or prior to the amelioration of clinical symptoms and improvement as determined by laboratory data under treatment with prednisolone and/or azathioprine administration. The degree of c myc and c-myb gene expression had no direct relation to the presence of particular clinical sign(s) or autoantibody. The expression of the c-raf gene was found in SLE and other systemic autoallergic patients although it showed no correlation with the disease activity. No significant expression of c-src, c-ras, c-fos, c-fgr, c-fps, c-fes, c-fms, c-yes, c-rel, c-abl, c-mos, c-sis, and c-erb B genes was found in the patients. c-myc and c-myb expression as having pathogenic and clinical significance is discussed. PMID- 3677490 TI - Peripheral and intestinal lymphocyte activation after in vitro exposure to cow's milk antigens in normal subjects and in patients with Crohn's disease. AB - We studied in Crohn's disease and controls the in vitro activation of either peripheral (PBMNC) or intestinal (LPMNC) mononuclear cells in response to the cow's milk antigen beta-lactoglobulin (Blg). The activation of mononuclear cells was investigated by analyzing the kinetics of the transferrin receptor (T9 antigen) and interleukin 2 receptor (Tac antigen) expression. In both controls and Crohn's disease patients Blg (1 microgram/ml) induced a significant (P less than 0.01) increase of T9 and Tac expression by both PBMNC and LPMNC cultured for 3 days. After Blg exposure the counts of T9- and Tac-bearing cells were significantly (P less than 0.05) higher in PBMNC cultures from healthy controls than in those from patients with Crohn's disease. In both groups peripheral T enriched cell suspensions did not express T9 and Tac when stimulated with Blg but were restored to express either antigen by the addition of 10% autologous adherent cells. In LPMNC cultures from patients with Crohn's disease the Tac expression after 3 days of Blg stimulation was significantly (P less than 0.05) higher than in the autologous PBMNC. Data from this study indicate that in both controls and patients with Crohn's disease lymphocytes sensitized to Blg occur in the circulation as well as in the gut lamina propria. Our data also suggest that in Crohn's disease an increased proportion of lymphocytes sensitized to Blg are recruited from the circulation into the site of the intestinal lesion. PMID- 3677491 TI - Splenocytes from MRL/Mp-lpr/lpr mice spontaneously produce antibodies against a cell-surface protein cross-reacting with DNA. AB - Anti-double-stranded (ds) DNA autoantibodies are considered as pathogenic in systemic lupus erythematosus (SLE). Anti-DNA antibodies have been shown to be released by B cells from lupus mice or patients in vitro. A monoclonal anti-DNA antibody (PME 77) specific for dsDNA has previously been shown to react with a cell-surface protein called LAMP (lupus-associated membrane protein), which is present on the cell surface of various cell types involved in SLE pathogenesis. Using an immunoreplica analysis technique, we show here that spleen cells from MRL/Mp-lpr/lpr lupus mice, cultured in vitro, spontaneously produce anti-LAMP IgG antibodies. Conversely, anti-LAMP antibodies were not detected in spleen-cell culture supernatants from nonautoimmune CBA/Ca mice. Taken together with our previous reports, this result adds a new argument for a pathogenic role of anti LAMP autoantibodies in SLE. PMID- 3677492 TI - AIDS education: a mandate for schools of nursing. PMID- 3677493 TI - Disorders of mucous membranes. PMID- 3677494 TI - Analysis of ambulatory electrocardiograms in 14 patients who experienced sudden cardiac death during monitoring. AB - The Holter monitors of 14 patients (out of 58,000 Holter recordings performed between 1978 and 1984) who experienced cardiac arrest and expired during the recording period were analyzed. Tachyarrhythmic arrest patients frequently had coronary heart disease, congestive heart failure, and prolonged QTc intervals. The highest incidence of intermediately frequent premature ventricular complexes (PVCs) occurred between 15 and 6 hours prior to death. The frequency of ventricular couplets increased toward the time of arrest. The hours with greatest frequency of ventricular tachycardia (VT) were found to be the last 5 hours of life. An increasing incidence of ST-segment changes greater than 2 mm was noted throughout all of the risk periods until the third hour prior to arrest when the incidence diminished. Conversely, the incidence of lower amplitude ST-segment changes (usually elevation) increased over the final 6 hours. The mean time of death was 0228 hours +/- 5:20. In conclusion, we observed two patterns of Holter monitored changes which usually occurred prior to death and may represent predictors of sudden death: (1) an increasing incidence of intermediately frequent isolated PVCs followed by increased ventricular couplets and runs of VT; (2) return of high amplitude ST-segment changes toward baseline. To our knowledge, the temporal relationship of the degree of ST-segment deviation to sudden death and the time of sudden death have not been reported in large studies of Holter-monitored sudden death patients. PMID- 3677495 TI - Inverted U wave in ergonovine-induced vasospastic angina. AB - The relationship between inverted U wave in leads V5 and II and the location of myocardial ischemia was studied in 52 positive patients and in 50 negative patients with ergonovine provocation test. Development of a biphasic or negative U wave, or increased negativity of U wave (inverted U wave) was observed in 15 of 17 patients with spasm in only the right coronary artery (RCA), in 6 of 8 with spasm in only the left anterior descending artery (LAD), in 2 of 8 with spasm in only the left circumflex artery (LCx), and in 23 of 24 with spasm in two or more vessels. Of 52 positive patients in the ergonovine provocation test, 46 (88.5%) had inverted U wave. Of these, 17 (32.7%) had inverted U wave without discernible ST deviation. Of 50 negative patients, 2 had inverted U wave. Inverted U wave in lead V5 was frequently seen in patients with spasm of LAD, but this finding was not uncommon in spasm of RCA or LCx. On the other hand, inverted U wave in lead II was frequently seen in spasm of RCA and LCx, but not in spasm of LAD. These findings suggest that inverted U wave in lead V5 is not specific for myocardial ischemia due to spasm of LAD and that inverted U wave in lead II is specific for spasm of RCA and LCx. PMID- 3677496 TI - Role of infarct expansion in rupture of the ventricular septum after acute myocardial infarction: a two-dimensional echocardiographic study. AB - To verify the role of infarct expansion (IE) in ventricular septal rupture (VSR) after transmural acute myocardial infarction (TAMI), topographic parameters were measured using tomographic imaging with two-dimensional echocardiography (2-D echo) and computer-aided analysis in four groups of patients: 8 patients with VSR (Group 1); 24 patients with TAMI but no mechanical complications (Group 2); 11 normal athletes (Group 3); 5 adults with congenital ventricular septal defect (Group 4). Measurements made on end-diastolic outlines of mid-left ventricular (LV) short-axis images included: LV asynergy (akinesis and/or dyskinesis), expansion index (asynergy/nonasynergy-containing endocardial segment length), thinning ratio (asynergic/nonasynergic wall thickness), and new indexes of regional shape distortion (RSD) by quantifying the deviation of the actual asynergic segment from the ideal asynergic arc constructed using the nearly circular nonasynergic contour. In Group 1, clinical IE (hypotension, congestive heart failure, no signs of new infarction) preceded detection of the VSR and portable 2-D echo showed the VSR associated with LV asynergy, marked IE, and RSD. Although Groups 1 and 2 had similar LV asynergy (28.7 vs. 26.9% LV) and ejection fraction (38.9 vs. 41.8%), Group 1 had higher expansion index (1.50 vs. 1.17, p less than 0.05), lower thinning ratio (0.54 vs. 0.67, p less than 0.005), and higher RSD parameters (e.g., peak distortion, Pk or maximum radial distance from the ideal arc, 19.3 vs. 3.9 mm, p less than 0.01; area of distortion, Ad, 7.4 vs. 1.1 cm2, p less than 0.05) than Group 2. Groups 3 and 4 had normal regional and global function and no evidence of expansion, thinning, or RSD. Thus, IE with marked diastolic RSD on an early 2-D echo after TAMI might identify patients at risk for VSR. PMID- 3677497 TI - Comparison of arm and treadmill exercise at 85% predicted maximum heart rate. AB - Both treadmill exercise and arm exercise are used for evaluating coronary artery disease, but arm exercise has lower diagnostic sensitivity. We compared the two exercise modalities with respect to the rate-pressure product at 85% predicted maximal heart rate, a parameter frequently used to denote performance of sufficient exercise to derive clinical conclusions. At this heart rate, treadmill exercise resulted in a significantly greater systemic oxygen consumption (2.7 +/- .8 vs. 2.1 +/- .6 l/min) and rate-pressure product (30.6 +/- 4.4 X 10(3) vs. 28 +/- 3.3 X 10(3)) than arm ergometry. An inability to generate sufficient imbalance of myocardial oxygen supply and demand may account for the relatively higher incidence of false negative exercise tests seen with arm ergometry, especially if the exercise test is stopped when the patient attains 85% predicted maximal heart rate. PMID- 3677498 TI - Pressor effects from daily events and laboratory complex stimuli relating personality factors. AB - Our preliminary research has attempted to establish a series of methods to study the complex interactions occurring between pressor reactivity and personality profile. Ten untreated mild hypertensives (age 42.9 +/- 8) without damaged target organs were recruited from an outpatient hypertension center along with an equal number of normotensive volunteers (age 38.2 +/- 8.1). We performed a sequence of stressor types under laboratory conditions (sensory perceptual activities, psychomotor responses, and cognitive behavior) following an order ranging from inferior levels to superior levels of systemic integration. The subjects also underwent a 24-h automatic noninvasive blood pressure recording which took into account the situational reactivity. They filled in MMPI and STAI questionnaires before and after the stressor batteries. Only the sensory-perceptual test (Stroop color test modified), the arithmetic test, and the psychomotor test provoked a significant increase in blood pressure and, in the latter test, also a significant increase of the heart rate. The test batteries' mean differences were not significant between the two groups. Similarly, the answers to the trait anxiety questionnaires did not allow us to make a substantial division between normotensive and hypertensive subjects. On the contrary, the situational anxiety questionnaires showed a significant difference in the score reading preceding and following a task performed by the hypertensive subjects. We observed significant differences for both systolic and diastolic 24-h blood pressure data in transition from a working situation to the sleeping period. However, there was not a significant difference in hypertensive blood pressure readings recorded during work and at home.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677499 TI - The role of active myocarditis in the development of heart failure in chronic Chagas' disease: a study based on endomyocardial biopsies. AB - The authors analyze the presence of active myocarditis in endomyocardial biopsies from 38 patients with chronic Chagas' disease diagnosed serologically. The patients were divided into three clinical groups of increasing severity. Group I: 13 patients with normal electrocardiograms, normal chest x-rays, and no symptoms; Group II: 13 patients with abnormal electrocardiograms and no cardiomegaly; and Group III: 12 patients with abnormal electrocardiograms, cardiomegaly and heart failure. In order to diagnose myocarditis activity, two sets of criteria were used: one mainly observing histopathologic aspects of inflammatory cells aggressing cardiac fibers; and the other counting the mean number of lymphocytes per high power microscopic field. The results of both methods showed a higher incidence of active myocarditis in the clinical group with heart failure. The present report clearly shows the important role played by activity of myocarditis in the development of heart failure in chronic Chagas' disease. Therefore, the possibility of using drugs to control early stages of the activity of the inflammatory process is suggested. On the other hand, endomyocardial biopsy (EMB) seems to be an adequate method to evaluate the intensity of the cardiac inflammatory process in Chagas' heart disease. PMID- 3677500 TI - Dopamine-induced increase in atrioventricular conduction in atrial fibrillation flutter. AB - We report a patient with controlled atrial fibrillation-flutter (AFF) and mitral stenosis who developed a marked increase in atrioventricular conduction during an infusion of low dose dopamine with development of hemodynamic compromise. This side effect has not been previously described in humans. Dopamine infusion should be used with caution in patients with AFF. PMID- 3677501 TI - Distribution of amiodarone and desethylamiodarone in a patient with acute myocardial infarction after intravenous administration. AB - The autopsy tissues concentration of amiodarone and desethylamiodarone of a man with acute myocardial infarction treated acutely with intravenous amiodarone is reported. Our data indicate that amiodarone is quickly distributed into all highly perfused tissues after intravenous administration with a high amiodarone/desethylamiodarone ratio. We also report here the autopsy case of a woman who died after 30 days of oral therapy with amiodarone. The increase in heart/plasma ratio of amiodarone and desethylamiodarone concentrations and the decrease in amiodarone/desethylamiodarone ratio after one month of therapy could explain the latency in the antiarrhythmic action of the drug. PMID- 3677502 TI - Coronary arteritis in nonspecific aortoarteritis. AB - Nonostial distal coronary artery involvement in nonspecific aortoarteritis is rare. We report a 35-year-old patient with features of nonspecific aortoarteritis who had an inferolateral myocardial infarction and on coronary angiography was shown to have severe disease of the left circumflex artery in its middle third. PMID- 3677503 TI - Right ventricular thrombus and pulmonary emboli in a patient with emphysema: an echocardiographic and Doppler documentation. AB - Pulmonary hypertension is a known complication of chronic obstructive pulmonary disease (COPD). A worsening dyspnea in a patient with COPD is usually a sequela of the pulmonary disease. However, it may be due to pulmonary embolism, a complication which is difficult to diagnose in such patients. We present a patient with COPD in whom two-dimensional and Doppler echocardiography confirmed the diagnosis of pulmonary emboli by documenting right ventricular thrombus and pulmonary hypertension. This case report emphasizes the usefulness of these noninvasive cardiac imaging techniques in the detection and evaluation of pulmonary embolism in patients with COPD. PMID- 3677504 TI - Pharmacokinetic disposition of isoxicam in hepatic cirrhosis. AB - To determine the effect of liver dysfunction on the absorption and disposition of isoxicam, we administered a single oral dose of 200 mg to 8 patients with alcoholic cirrhosis, and followed the plasma concentration-time curve for 96 h. The calculated isoxicam disappearance t 1/2 of 30 +/- 19.1 h in these patients was not different from the mean value of 31 +/- 5.7 h obtained in 10 normal subjects studied earlier by our group; however, interindividual variation was larger. No differences in lag time (0.42 +/- 0.3 vs 0.49 +/- .2 h) or time to peak concentration (9.0 +/- 2.5 vs 10.0 +/- 2.9 h) were observed. However, the peak plasma isoxicam concentrations and the areas under the plasma concentration time curves (AUC) were reduced 32% (p less than 0.01) and 41% (p less than 0.01), respectively. Plasma protein binding of isoxicam studied by equilibrium dialysis was 80 +/- 16% in the cirrhotic patients compared with 96 +/- 1.4% in the normal volunteers (p less than 0.02), again with larger interindividual variation noted in patients with cirrhosis. The binding did not correlate significantly with any laboratory tests of liver function or with the AUC for plasma isoxicam. As compared to the normal subjects, these cirrhotic patients had decreased plasma isoxicam binding, peak plasma isoxicam concentrations and AUC, without a significant change in the apparent disappearance half-life of total plasma isoxicam after a single oral dose. PMID- 3677505 TI - Interaction of high density lipoprotein with adipocytes in a new patient with Tangier disease. AB - A 56-year-old man, the offspring of a consanguineous first cousin marriage, presented with clinical, morphological, and biochemical features of familial deficiency of high-density lipoproteins (Tangier disease). Of 8 first- and second degree relatives examined, 4 had either plasma apo A-I or HDL cholesterol concentrations 2 standard deviations below normal population mean on at least 1 occasion. The patient and a majority of his relatives also had high plasma apo B concentrations relative to their levels of cholesterol. Adipose tissue biopsy was undertaken to study HDL interaction with the patients' cells. Specific uptake of HDL3 was demonstrated in adipocytes of this patient, but was decreased relative to a control of similar fat cell size. However, no marked difference in fat cell cholesterol content was observed between the Tangier patient and the control. Thus it appears unlikely that adipocytes play a role in the etiology of Tangier disease. PMID- 3677506 TI - The hepatitis B carrier state--a follow-up study of 100 consecutive cases. AB - The clinical, demographic, serologic, and histopathologic features of 100 consecutive patients with chronic hepatitis B were studied. The subjects were from diverse racial backgrounds; 59 had emigrated to Canada from geographical areas with high hepatitis B carrier rates. A reduced 5-year survival rate was seen only in those with cirrhosis; death was most commonly related to sepsis. The male to female ratio was 4.0 in the total study group but was higher in those with elevated transaminases (6.0 vs 2.0, p less than 0.05). Those patients with mild-to-heavy alcohol consumption were more likely to have elevated transaminase values than those who drank no alcohol (p less than 0.05). The mean annual sero conversion rate from HBeAg to Anti-HBe was 8.0%. The HBeAg status did not correlate with the presence of histologic activity or fibrosis. PMID- 3677507 TI - Pharmacokinetics and haemodynamic effects of felodipine as monotherapy in hypertensive patients. AB - The acute and steady-state pharmacokinetics and dynamics of felodipine as monotherapy have been studied in 12 hypertensive patients. Felodipine was acutely administered by a constant infusion, 1.5 mg over a 30-min period, or as a 10-mg tablet. Chronic administration was performed on a fixed dose of 10 mg b.i.d. for 28 days. The systemic availability of felodipine after the acute dose was 15%, and at steady state 12% (N.S.), with a 3-fold variation between patients. The mean plasma clearance was 0.6 L/h. The half-life measured in the 4- to 10-h interval after dose was about the same: 3.4, 3.2, and 3.3 h after the i.v. dose, the acute oral dose, and at steady state, respectively. The mean terminal half life was 24.5 h after the oral dose at steady state. Both the intravenous and the oral doses of felodipine decreased the diastolic blood pressure for about 8 hours after dosing. The reduction in diastolic blood pressure was about 20 mmHg 1 to 2 hours after dose. Supine diastolic blood pressure was significantly reduced up to 48 h after dose at steady state. Maximum reduction of diastolic blood pressure ( 22 mmHg) already occurred on the first day of treatment, while systolic blood pressure was further decreased during chronic treatment. There was a correlation between the individual maximum decrease in diastolic blood pressure after the acute oral dose with that after repeated administration (r2 = 0.70, p less than 0.01). Changes in heart rate were non-significant at steady state. PMID- 3677508 TI - Biomechanical evaluation of anatomic reduction versus medial displacement osteotomy in unstable intertrochanteric fractures. AB - The biomechanical characteristics of anatomic reduction versus medial displacement osteotomy were compared for four-part intertrochanteric fractures experimentally produced in cadaver femurs. Eighteen pairs of femurs were assigned randomly to either the anatomic (A) or the medial displacement (MD) group and instrumented with multiple strain gauges. The femurs in the MD group were tested while intact and following four-part fracture with fixation. The femurs in the A group were first tested intact, followed by a stable two-part fracture with fixation, and then by a four-part fracture with fixation and perfect reduction of the posteromedial fragment (PMF) with a lag screw, partial reduction of the PMF, and with the PMF omitted. All fractures were fixed with a 135 degrees, four-hole, sliding hip screw. The strain distribution in the MD group changed significantly after fracture. The plate tensile strain increased by 360% while the compressive calcar strain decreased 85%. The plate tensile strain in the A group also increased significantly after four-part fracture when the PMF was perfectly reduced (160%), partially reduced (290%), or discarded (275%); the calcar compressive strains for these subgroups decreased approximately 50%. This laboratory study indicates that anatomic reduction of four-part intertrochanteric fractures with the sliding hip screw, regardless of the presence or position of the PMF, provides significantly higher compression across the calcar region and significantly lower tensile strain on the plate than fractures reduced by medial displacement osteotomy. The more physiologic strain distribution and the increased medial load transmission support the use of anatomic reduction for the treatment of unstable intertrochanteric fractures. PMID- 3677509 TI - A histologic comparison of aseptic loosening of cemented, press-fit, and biologic ingrowth prostheses. AB - The histology of interface membranes from aseptic loosened prostheses of various types including cemented, press-fit, and biologic ingrowth varieties was compared. Pseudosynovial implant-facing surfaces were present in specimens from all types. The remaining portions of these membranes showed distinct characteristics as well. Cemented implant membranes contained many macrophages and giant cells and evidenced frequent granuloma formation. Press-fit membranes consisted of poorly vascularized, dense fibrous tissue within the loosened press fit membrane. Macrophages and giant cells were rare, except in one specimen containing ceramic debris particles. Biologic ingrowth membranes were the most vascular and contained loosely organized connective tissue and islands of woven bone. Macrophages were common. One out of six specimens from patients with rheumatoid arthritis contained massive numbers of lymphocytes and plasma cells but not mast cells. The greatest numbers of mast cells were present in membranes from patients with osteoarthritis and in all cases were associated with the presence of stainless steel and/or chrome cobalt particles. PMID- 3677510 TI - Long-term results of cemented total hip arthroplasty. AB - Long-term results of total hip replacement by low-friction arthroplasty show a consistent and reproducible outcome for relief of pain, increased mobility, and function in most patients followed for five to 15 years after surgery. In a review of 1009 consecutive operations, the rate of reoperation and potential failures for mechanical and infectious causes was 4.5%, which compares favorably with similar results in the literature. Seven series of operations employing the Charnley low-friction arthroplasty technique were compared. The failure rate was less than 10% in these series, provided that the operations had been performed either at a center dedicated to hip arthroplasty or by a surgeon devoting his career to hip replacement surgery. PMID- 3677511 TI - Disc space infection and vertebral osteomyelitis as a complication of percutaneous lateral discectomy. AB - Percutaneous lateral discectomy (PLD) in a 32-year-old man was followed by postoperative disc space infection and adjacent vertebral osteomyelitis caused by Staphylococcus aureus. The simplicity and decreased morbidity associated with PLD may be offset by severe infections. The small incision made in the annulus during PLD may not allow adequate drainage in the case of infection and may subsequently direct the infective process to the adjacent vertebral endplates. Meticulous aseptic technique, and possibly the use of prophylactic antibiotic therapy, is important in PLD. PMID- 3677512 TI - Erythrocyte sedimentation rate and C-reactive protein values in patients with total hip arthroplasty. AB - Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured serially in 50 osteoarthritic patients treated with uncomplicated primary total hip arthroplasties (THAs) and also in 28 patients with painful hip for different periods after THA. The follow-up period was one year. In uncomplicated primary THA, the ESR was slightly elevated before surgery and was variable after surgery; some patients continued to have abnormally high ESRs one year after surgery. However, CRP was normal before surgery and after surgery showed a distinctive pattern that rapidly normalized within three weeks. In patients with a painful hip after THA, ESR was elevated in those with septic loosening and variable in those with mechanical loosening; however, the difference was not significant. ESR after successful revision THA was also variable. CRP was high in patients with septic loosening and normal in those with mechanical loosening. Normalization of CRP was rapid after control of infection or within three weeks of successful revision THA. Uneventful recovery after THA is indicated by normalization of CRP within three weeks, regardless of ESR. Measurement of both ESR and CRP is helpful in differentiating septic and mechanical loosening, detecting complications, and monitoring the effects of treatment, but CRP is more informative and sensitive than ESR for these purposes. PMID- 3677513 TI - Effects of nandrolone therapy on forearm bone mineral content in osteoporosis. AB - Forearm bone mineral content (BMC) was measured sequentially on and off anabolic steroid therapy in 52 postmenopausal women with osteoporosis. The steroid used was nandrolone decanoate in a dose of 50 mg every two weeks by intramuscular injection. In 16 of the patients nandrolone was given first (for 6.2 +/- 0.6 months) followed by a control period (6.1 +/- 1.0 months) and in 36 there was an initial control period (9.5 +/- 1.1 months) followed by nandrolone (for 5.8 +/- 0.4 months). Any other therapy was continued unchanged during both treatment and control periods. There was a significant rise in BMC on nandrolone (p less than 0.001) and a nonsignificant fall in BMC off nandrolone. The difference between the rates of change on and off nandrolone was highly significant (+53 vs. -7 mg/cm/year; p less than 0.001). PMID- 3677514 TI - Pathogenesis of membranous lipodystrophy. Case report and review of the literature. AB - Membranous lipodystrophy occurred in a 35-year-old woman and membrane-like material was found in her epiphyses and short bones. Electron microscopy allowed a study of the relationship between the pathologic tissue and normal fat, suggesting that the membrane-like material is derived from degenerated cells. Nucleation of hydroxyapatite crystals was also observed in the membranous material. Because basal ganglia calcifications were demonstrated with the use of computed tomography, brain and bone lesions may be assumed to share the same pathogenesis. Lipid and mucopolysaccharide metabolism was found to be normal. PMID- 3677515 TI - Treatment of congenital dislocation of the hip. Management before walking age. AB - Neonatal infants with Ortolani-positive dislocated hips are easily managed by reduction and maintenance of the reduction using a divarication splint, cast, or Pavlik harness. Sixty-six patients with 85 complete, congenitally dislocated hips (Ortolani negative) unassociated with other neuromuscular disorders were examined to assess a method of prereduction traction in the treatment of congenital dislocation of the hip. Forty of the 66 patients were six months of age or younger at the beginning of traction treatment. The remaining 26 were younger than 12 months of age prior to the treatment protocol. Overhead traction with the hip flexed to 90 degrees was employed. Gradual hip abduction to 70 degrees (140 degrees combined abduction) was accomplished over the next ten to 14 days. If the dislocated hip was still in a station above Hilgenreiner's line, then cross traction was applied to add another vector of force to pull the femoral head distally. At an average of 18 days into the treatment protocol, an examination under anesthesia with closed reduction was performed and the patient immobilized in a double hip spica in the "human" position for six to eight weeks. This was followed by use of an Ilfeld divarication splint for nine months. This traction/reduction program was effective in 91% of these cases (60 of 66). Six patients (ten hips) required an open procedure because of persistent instability in spite of reducibility. To date, there is no incidence of avascular necrosis using the criteria of Salter for whole head avascular necrosis and the criteria of Kalamchi and MacEwen for partial head avascular necrosis. PMID- 3677516 TI - Treatment of congenital dislocation of the hip in older children. AB - The aims of treatment of a child with congenital dislocation of the hip (CDH) untreated until walking age should be to reestablish the mechanics of the hip joint and avoid complications, especially avascular necrosis, thus delaying the development of osteoarthritis. The pathology in the older child shows that both soft tissues and bony parts are distorted to some degree. The acetabular index and center-edge (CE) angle evaluations are helpful in the initial evaluation and in the follow-up examinations. A computed tomography (CT) scan may be helpful in determining a reduction and distinguishing between dysplasia and subluxation. A controversy still exists as to the relative value of closed and open reduction in the treatment of a child who has reached walking age. For most surgeons, in a child up to three years of age, a careful closed reduction following a period of traction is the most useful form of treatment. The home traction program has been successful in this age group. For gentle closed reduction all maneuvers must be done as gently as possible and carried out as "positioning" the leg rather than forcing a reduction. The indications for open reduction are (1) if the femoral head persistently lies above the triradiate cartilage on roentgenographic examination, (2) if the arc of reduction and redislocation is less than 25 degrees after an adductor tenotomy, (3) if the femoral head will not enter the acetabulum, (4) if the femoral head is still laterally placed in the acetabulum after four weeks of partial reduction, and (5) if a previous reduction has failed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677517 TI - Hip pain in adolescence. AB - No single pelvic or femoral osteotomy can be expected to correct the range of deformity encountered in the adolescent with a subluxed hip or the sequelae of treatment at a younger age. A range of pelvic and femoral osteotomies on both sides of the joint are required when there is marked deformity. The principles of management of the anatomic derangement of the painful adolescent hip are different from those in the younger child. Anatomic and biomechanical restoration at skeletal maturity must be perfect for the hip to function well in the long term. The plasticity and capacity for remodeling is much less than in the child. Postoperative immobilization must be avoided if joint stiffness is to be avoided. While the results of arthroplasty are the standard to which osteotomy must be compared, the high failure rate in young adults and pessimistic prospects of revision make biologic alternatives more attractive. The success of osteotomy depends on correct indications, careful preoperative planning, precise technique, rigid fixation, and early postoperative movement. When the indications for osteotomy cannot be met, arthrodesis is still the best solution for unilateral hip disease in patients younger than 30 years of age of either sex. PMID- 3677518 TI - Technetium-99m serum albumin measurement of gastrointestinal protein loss in a subtotal gastrectomy patient with giant hypertrophic gastritis. AB - Gastrointestinal protein loss was measured using Tc-99m labeled human serum albumin in a patient with giant hypertrophic gastritis. Gastric secretion was aspirated via a nasogastric tube and measured for radioactivity after intravenous injection of Tc-99m albumin. Assessment of radioactivity of the collected gastric secretion yielded a total radiocount of 98.7 kilocounts per minute within 6 hours, which is equivalent to 1.1% of the total dose. Therefore, at least 1.1% of the circulating albumin was excreted into the gastric cavity within 6 hours, and, since simultaneous abdominal imaging did not demonstrate obvious accumulation of tracer in the gastrointestinal tract, protein loss was thought to be due to giant gastric rugae of the resected stomach. It was concluded that Tc-99m albumin is a valuable means for detection of the site of protein loss in patients with protein losing gastroenteropathy. This method has several advantages in the clinical setting; it is less time consuming, easy to perform, and provides quantitative and qualitative assessment of protein loss. PMID- 3677519 TI - Cholescintigraphic detection of intraperitoneal bile leakage from a perforated duodenal ulcer. AB - A 66-year-old woman with known gallstones and peptic ulcer disease presented with acute epigastric pain. Cholescintigraphy revealed nonvisualization of the gallbladder with subhepatic and perihepatic accumulation of tracer. An upper gastrointestinal examination with water-soluble contrast revealed a perforated duodenal ulcer, with leakage confirmed at laparotomy. The gallbladder was intact. PMID- 3677520 TI - Skeletal photopenic appearance of Paget's disease with indium-111 white blood cell imaging. AB - A case of focal decreased skeletal uptake with In-111 labeled white blood cells representing Paget's disease is reported. Although uncommon, other causes for skeletal photon deficient areas using In-111 white blood cells have been described. To the authors' knowledge, this finding representing Paget's disease has not been previously described. PMID- 3677521 TI - The noninvasive diagnosis of intrathoracic splenosis using technetium-99m heat damaged red blood cells. AB - Intrathoracic splenosis results from the implantation of splenic tissue in the thoracic cavity following simultaneous rupture of the spleen and diaphragm. These implants may form mass lesions that lead to an extensive, costly, and invasive series of investigations, usually resulting in unnecessary surgery. The key to diagnosis is a high index of suspicion provoked by the history of a traumatic event, possibly in the distant past. This report emphasizes that because of its ability to demonstrate the functional nature of tissue, a definitive diagnosis can be made using heat-damaged Tc-99m RBCs without the need for surgical intervention. PMID- 3677522 TI - Cavernous hemangioma. Why is peripheral filling at scintigraphy so rare? AB - Peripheral filling at dynamic CT occurs frequently with cavernous hemangiomas, yet this phenomenon is a rare finding on Tc-99m RBC imaging. A case of peripheral filling of a cavernous hemangioma with scintigraphy is reported and the rationale for its infrequent occurrence is discussed. PMID- 3677523 TI - Colloid shift in technetium-99m sulfur colloid liver-spleen scans of trauma patients. AB - To assess the radiosulfur colloid distribution in the liver-spleen scans of trauma patients, 73 trauma patients (age: 4-74 years, mean: 32 years) who had Tc 99m sulfur colloid liver-spleen scans for trauma workup were studied and compared with the liver-spleen scans of 87 control patients (age: 2-64 years, mean: 36 years). Radiocolloid distribution was visually assessed by two physicians independently, and the areas of the greatest density in the liver and spleen on the posterior view that included both organs were compared. The scans were grouped into three grades: Grade I, liver density greater than spleen density; Grade II, both organs showing equal density; and Grade III, splenic density greater than liver density (colloid shift). Forty-three of the trauma patients (59%) were in Grade III, 22 (30%) in Grade I, and 2 (11%) in Grade II. The control group had 12 (14%) patients in Grade III, 54 (62%) in Grade I, and 21 (24%) in Grade II. When the young adults and children of the trauma patients (age: 4-20 years, mean: 14 years) were looked at separately, 17 of 20 (85%) showed colloid shift (Grade III). It is concluded that there is a significantly higher incidence of colloid shift in trauma patients compared to control patients (P less than .01). PMID- 3677524 TI - Three-phase radionuclide bone scanning in evaluation of local radiation injury. A case report. AB - The management of local radiation injuries is influenced by the degree of vascular compromise within the skin and underlying tissues. Other authors have used thermography and angiography in assessing the blood flow to radiation damaged tissues. This report describes the use of radionuclide imaging in the evaluation of a patient who developed necrosis of his distal digits following a radiation accident. In addition to determining the vascular status of the hands, imaging helped indicate an appropriate level for amputation. PMID- 3677525 TI - Paget's disease. A cause of artificially elevated bone mineral density. AB - A 48-year-old man with a ten-year history of corticosteroid-dependent asthma and a previous fracture of the right humerus after minimal trauma was referred for a dual photon absorptiometry (DPA) study to assess the degree of osteoporosis. The DPA study revealed a large discrepancy in bone mineral density (BMD) between the right and left hips. A Tc-99m MDP bone scan and an anteroposterior frog-leg radiograph demonstrated changes typical of Paget's disease in the sacrum, pelvis, and femurs. This case is an example of how underlying bone disease may artificially elevate bone mineral density, and demonstrates the value of performing BMD tests on both hips and the necessity for correlative bone scans and radiographs in selected cases. PMID- 3677526 TI - The symmetry of hip bone mineral density. A dual photon absorptiometry approach. AB - Dual photon absorptiometry studies were performed on the hips of 23 patients to determine whether bone mineral density values obtained from one hip were indicative of the values in the contralateral hip of the ambulatory patient. The femoral neck, trochanteric, and Ward's triangle areas of both hips were analyzed. There were no significant differences between the right and left hip bone mineral density measurements in any of these three areas. Since the right and left hip readings were highly correlated, either hip may be used to evaluate osseous status. PMID- 3677527 TI - Tuberculous pseudotumor of the liver. AB - Tuberculosis of the liver in association with generalized miliary tuberculosis is not an uncommon clinical entity. A solitary tuberculous liver abscess, however, is rare. Two such cases, in which there was no clinical evidence of extrahepatic tuberculosis, are reported. The similarities between this condition and other causes of hepatic lesions are discussed, with particular emphasis placed on the imaging patterns of various diagnostic imaging procedures. PMID- 3677528 TI - Bone imaging showing shin splints and stress fractures. PMID- 3677529 TI - Huge abdominal aortic aneurysm demonstrated by technetium-99m labeled RBC blood pool imaging. PMID- 3677530 TI - Detection of an apico-aortic conduit by radionuclide ventriculography. PMID- 3677531 TI - Renal imaging on liver-spleen scans. PMID- 3677532 TI - Evaluation of erythrocyte disorders with mean corpuscular volume (MCV) and red cell distribution width (RDW). AB - The red cell distribution width (RDW), which provides a quantitative measure of heterogeneity of red cells in the peripheral blood, and the mean corpuscular volume (MCV) are part of the routine red cell indices reported by automated blood analyses. This study evaluated 193 pediatric patients with a wide range of erythrocyte disorders and determined the diagnostic utility of the RDW in relation to the MCV. Six different groups of erythrocyte disorders by MCV and RDW values are described: low MCV/normal RDW, low MCV/high RDW, normal MCV/normal RDW, normal MCV/high RDW, high MCV/normal RDW, high MCV/high RDW. This combination established a useful differential diagnosis of erythrocyte disorders. The data provided a baseline against which future studies of infants and children can be compared, though each laboratory has to verify its own normals. It should be cautioned that different electronic counters yield different RDW values, so there have to be qualifications when reporting reference values. The RDW may find its best use as a guide in the differential diagnosis of anemia, rather than as a definitive test per se. PMID- 3677533 TI - Transient neutropenia of childhood. AB - Patient characteristics and clinical course are described in 21 children with newly discovered neutropenia (absolute neutrophil count less than 1500/microliter). Only children over age 3 months are included; 19 of 21 were less than age 2 years. The majority had respiratory tract infections and 11 had been on various medications at the time neutropenia was discovered. Bacteria were isolated from the blood of three patients (S. pneumoniae in two, H. influenzae in one) and from urine in one (E. coli). Respiratory syncytial virus was cultured from the nasopharynx of two patients. Opportunistic, gram-negative and staphylococcal infections did not occur. Neutrophil counts in all but one child returned to normal within 6 weeks of onset; half recovered within 7 days. Bone marrow examination was performed in 13 patients: maturation arrest at various stages in the myeloid series was noted in six, and seven had normal myeloid maturation. Bone marrow findings did not correlate with degree or duration of neutropenia. These observations indicate that previously well infants with isolated neutropenia generally have a benign clinical course, although three patients were ultimately proven to have significant chronic illness. Recommendations are made as to management. PMID- 3677534 TI - Combined iron deficiency and lead poisoning in children. Effect on FEP levels. AB - Concern for the concomitant occurrence of iron deficiency and elevated blood lead in children is raised by animal studies documenting increased gastrointestinal lead absorption in the presence of iron deficiency. An elevation in free erythrocyte protoporphyrin (FEP) above 35 mg/dl is seen with both iron deficiency and lead toxicity. To determine whether the degree of elevation in FEP is useful in predicting which children with elevated blood lead levels have concomitant iron deficiency, 109 children suspected of having an elevated lead burden were studied. A complete blood count, reticulocyte count, FEP, lead, and ferritin were measured on each child. The effect of the independent variables, lead and iron status, both alone and in combination, on the dependent variable, FEP, was analyzed through a linear regression model. Lead status alone accounted for 42 percent of the explained variance in FEP, and the lead-iron interaction increased the explained variance by only an additional 1 percent. Screening for iron deficiency in children with elevated blood lead should continue to be based on dietary and socioeconomic risk factors and not on degree of elevation in FEP. PMID- 3677535 TI - Chronic pigmented purpura: a case report of Schamberg's disease. AB - The syndrome of chronic pigmented purpura (CPP) consists of pigmented macular lesions, predominantly involving the lower extremities. An 11-year-old girl was diagnosed initially as suffering from vasculitic purpura, but the clinical course and the skin histology proved to be consistent with CPP. This syndrome should be included in the differential diagnosis of childhood purpura. PMID- 3677536 TI - Vitamin B12 deficiency due to a strictly vegetarian diet in adolescence. AB - A 14-year-old white girl suffered from severe neurologic disturbances caused by vitamin B12 deficiency, due to failure to provide vitamin B12 supplementation to a strictly vegetarian diet. The disturbances resolved completely following treatment with vitamin B12. Physicians should be alert to the necessity for vitamin B12 supplementation for strict vegetarians, who eat no meat, fish, eggs, or dairy products. PMID- 3677537 TI - Should the mobile intensive care unit respond to pediatric emergencies? PMID- 3677538 TI - On phenotyping with isoniazid: the use of urinary acetylation ratio and the uniqueness of antimodes. Study of two Amerindian populations. AB - Various conventions have been used to express the activity of polymorphic hepatic N-acetyltransferase of isoniazid. Among them, two of the most common are the "percentage of acetylisoniazid" and the "inactivation index." A third alternative convention is proposed, the "molar acetylation ratio," which showed the most clear-cut bimodal distribution when applied to the results obtained for Cuna and Teribe Amerindians living in Panama. Through this method a unique antimode was assigned to each Amerindian group and the same frequency of slow acetylators (24% to 29%) was found, unlike the results obtained by conventional approaches and antimodes derived from white populations. PMID- 3677539 TI - Biliary excretion of intravenous [14C] omeprazole in humans. AB - We have studied the biliary excretion of [14C] omeprazole in humans. The study was performed in eight healthy subjects and the technique used was based on multiple marker dilution principles with double-lumen tubes placed in both the stomach and intestine. The results obtained show a 16% biliary excretion of [14C] omeprazole. These data suggest a minimal "spillover" of omeprazole from the gastric mucosa into the gastric lumen in humans. The results also agree with previous data of the fecal recovery of radiolabeled omeprazole that suggest that the fecal excretion of intravenous omeprazole in humans is entirely accounted for by biliary excretion. PMID- 3677540 TI - An alternative test for acetylator phenotyping with caffeine. AB - Previously published methods allow the determination of the genetically controlled acetylator status using caffeine as a test drug, based on the urinary excretion of a ring-opened metabolite of caffeine, an acetylated uracil (5 acetylamino-6-formylamino-3-methyluracil). 5-Acetylamino-6-formylamino-3 methyluracil is labile but can be converted into a stable, deformylated product referred to as 5-acetylamino-6-amino-3-methyluracil, which has recently been shown to be quantifiable by exclusion chromatography. The first part of the present article represents a longitudinal study of three subjects to assess the intraindividual variability of those caffeine metabolite ratios that are of potential interest for the determination of acetylator phenotypes. Effects of single and multiple doses, as well as of different periods of urine collection, were tested. A ratio relating the excretion of 5-acetylamino-6-amino-3 methyluracil to that of all products of the 7-demethylation pathway of paraxanthine proved to be highly reproducible, particularly after collection of overnight urine after coffee consumption during the day. This ratio showed complete concordance with the plasma index for sulfamethazine acetylation. The second part of this article showed the use of this ratio in a population study. It allowed a good separation of slow and fast acetylators and probably also a separation of homozygous and heterozygous fast acetylators. PMID- 3677542 TI - Lamotrigine, a new anticonvulsant: pharmacokinetics in normal humans. AB - The pharmacokinetics of lamotrigine, a new anticonvulsant, were studied in three studies in normal volunteers. In the first study, five subjects received oral doses of lamotrigine up to 240 mg. A linear relationship was observed between dose administration and both peak drug concentration and AUC. In a second study 10 subjects received 120 mg lamotrigine and the mean (+/- SD) of the elimination half-life (t1/2) was 24.1 +/- 5.7 hours and of volume of distribution/bioavailability 1.2 +/- 0.12 L/kg. Saliva concentrations were 46% of the plasma concentration. Total urinary recovery of drug over 144 hours was 70.5% of the oral dose. A glucuronide conjugate accounted for 89.4% of the urinary recovery. In a third study the kinetics of repeated administration were studied. Fifteen subjects were randomized to lamotrigine (n = 10) or placebo (n = 5) and received multiple doses over 7 days. The overall plasma elimination t1/2 calculated from data during the 7 days was 25.5 +/- 10.2 hours. Observed pharmacokinetics on multiple administration obeyed closely those predicted from the single-dose experiment, suggesting the absence of autoinduction of metabolism. No clinically important side effects or changes in central nervous system or cardiovascular system variables, hematology, biochemistry, or urinalysis occurred during the 7 days. PMID- 3677541 TI - Disposition kinetics and dynamics of nicainoprol, a new antiarrhythmic agent, in humans. AB - Kinetics and resting and exercise-induced hemodynamic and ECG effects of nicainoprol, a new antiarrhythmic structurally resembling propafenone or propranolol, were investigated in eight healthy male subjects receiving a 1-hour infusion (100 mg) and oral dose (200 mg) in a randomized-crossover fashion. Nicainoprol in plasma and urine was determined by a specific HPLC assay. Plasma concentration-time data were fitted to a triexponential equation. Mean postinfusion kinetic data were: alpha-phase half-life = 3.1 minutes, beta-phase half-life = 106.6 minutes, and gamma-phase half-life = 12.4 hours; volume of central compartment = 0.114 L/kg; steady-state volume of distribution = 0.67 L/kg; total clearance = 3.6 ml/min/kg; and renal clearance = 0.56 ml/min/kg. Absolute bioavailability was approximately 70% and peak plasma drug concentration occurred 2.3 hours after oral administration. Interindividual variability in AUC was 1.6- and 2.4-fold after intravenous and oral administration, respectively. Cumulative fraction excreted unchanged in urine was approximately 15% and 9% of the dose after intravenous and oral administration, respectively. Resting heart rates were increased, whereas exercise-induced heart rates were unchanged after both doses. QRS durations were widened after both doses. PR and QTc intervals were prolonged during intravenous study. The results suggest that nicainoprol is an enzyme-limited or poorly extracted drug suitable for both intravenous and oral administration and devoid of beta-blocking action in humans, at least with doses tested in this study. Its ECG properties appear to be similar to those of class I antiarrhythmics. PMID- 3677543 TI - Sulindac inhibits bumetanide-induced sodium and water excretion. AB - In an open-label pilot study, we investigated the effect of sulindac on bumetanide-induced diuresis. Nine healthy volunteers were placed on diets with a standard sodium and potassium content. Each volunteer received 1 mg bumetanide orally, and blood and urine samples were collected during an 8-hour period. Urinary losses were replaced isovolumetrically with intravenous normal saline solution. Creatinine clearance and sodium and potassium excretion were compared with and without sulindac pretreatment (200 mg administered orally b.i.d. for 5 days). Sulindac pretreatment resulted in a 22% decrease in the mean cumulative sodium excretion after 3 hours (p less than 0.05) and a 21% decrease in the mean urine flow rate after 2 hours (p less than 0.05). The results suggest that sulindac has an effect on the kidney similar to that of other nonsteroidal agents. PMID- 3677544 TI - Total and free ketoprofen in serum and synovial fluid after intramuscular injection. AB - Free and total ketoprofen levels in serum and synovial fluid were determined in 37 patients after a single intramuscular injection of ketoprofen, 100 mg. Free drug was separated by equilibrium dialysis. Ketoprofen was assayed by HPLC. Ketoprofen penetrated into the joints rapidly and significant concentrations were found at 15 minutes. The equilibrium time was about 3 1/2 hours. The AUC for total ketoprofen was greater in serum than in synovial fluid. On the other hand, the free fraction AUC in the serum and synovial fluid were quite similar. The mean residence time in the joint was about three times that in the systemic circulation. Ketoprofen was strongly bound to proteins and the percentage of free ketoprofen was not significantly different between serum and synovial fluid. These results provide a possible explanation for duration of the therapeutic effect of ketoprofen despite the short elimination half-life from the serum. PMID- 3677545 TI - A genetic polymorphism of the N-oxidation of trimethylamine in humans. AB - Trimethylamine (TMA) and its N-oxide (TMAO) are normal components of human urine. They are present in the diet and also derived from the enterobacterial metabolism of precursors such as choline. Dietary TMA is almost entirely metabolized to and excreted as TMAO. However, the extent to which TMA undergoes N-oxidation appears to be polymorphic in a British white population study (n = 169). Two propositi were identified with relative TMA N-oxidation deficiency that was further confirmed by oral challenge with TMA (600 mg). The study of the families of the two propositi, as well as those of two identified subjects with trimethylaminuria, under both normal dietary conditions and after oral TMA challenge strongly indicates that the conditions of impaired N-oxidation is inherited as a recessive trait. It is proposed that the N-oxidation of TMA in humans is polymorphic and under single gene diallelic control in which individuals who are homozygous for the variant allele exhibit marked N-oxidation deficiency and trimethylaminuria. PMID- 3677546 TI - [Value of nuclear magnetic resonance tomography in the staging of tumors of the urinary bladder]. AB - The accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) in the staging of bladder tumors was evaluated in 46 patients. In the T-staging MRI was superior to CT. With MRI 38 out of the 46 tumors were correctly staged into the four groups T0, T1-T3a, T3b and T4. With CT this classification was only possible in 28 cases. The main advantages of MRI were the capability for multiplanar imaging, which improved evaluation of the bladder base and the bladder dome, as well as a better differentiation between tumor recurrency and fibrosis. In the evaluation of adenopathy MRI and CT proved to be equal and demonstrated a sensitivity of 50%. PMID- 3677547 TI - [Nuclear magnetic resonance tomography studies of orbital space occupying lesions]. AB - A comparative study of MRI, CT and ultrasound of orbital tumors revealed that only for malignant melanomas and orbital pseudotumors MRI had the most diagnostic relevance. Malignant melanomas could be differentiated from a haematoma due to their characteristic T1 and T2 signal intensity. MRI is impaired by its long examination time and the danger of quality reduction caused by motion artifacts. PMID- 3677548 TI - [Radiation absorption and proton relaxation times of the liver in vitro following carbon tetrachloride poisoning]. AB - In 57 rats the radiation absorption or proton relaxation times were determined in vitro after single carbon tetrachloride poisoning. The inflammatory changes induced by CCl4 result in marked water absorption and moderate of fat. Histologically, there are cell necroses, toxic swellings of cells, regenerating cells rich in water content, and fatty vacuoles. These phenomena result in a reduction of radiation absorption due to the increased water and fat accumulation. Prolongation of both relaxation times is mainly due to water absorption. PMID- 3677549 TI - [Relaxation times and proton density of the healthy kidney and its lesions and graphic view of T2 decay]. AB - Kidney diseases, healthy kidney tissue and adjacent organs like liver, musculature and fatty tissue were evaluated in respect to their T1-, T2 relaxation times and proton density values. In addition the results of an evaluation of T2-short, T2-long, Rho-short, Rho-long, which were calculated from the T2-relaxation times, are reported. The T2-times are very sensitive in demonstrating differences between the tissues, as significantly different values for healthy kidney tissue and hypernephromas could be found. Different values could be seen dependent on the calculation mode, whereby the calculations had been made from double echo and multiple echo sequences. The T1-relaxation times were less sensitive, differences could be also found between the calculations from the IR and SE mode. The values of T2-long and T2-short and the proton density values differed very much for the same organ in the examined groups of patients, therefore these additionally calculated values unlikely will help in the differential diagnosis of unknown kidney diseases. PMID- 3677550 TI - [Goldenhar syndrome and other ear abnormalities in HR-PCT]. AB - The use of CT in hospitals in which also ENT departments are located will be useful in cases of osseous congenital disorders of the ear. In combination with the clinical and audiometric investigations CT of the temporal bone will be helpful for the indication of the operations to ameliorate the hearing. PMID- 3677551 TI - [Therapeutic effectiveness of CT-controlled drainage puncture in amebic abscesses of the liver]. AB - Amebic liver abscesses are the most frequent clinical manifestations of the extra intestinal amebiasis and have to be considered as a serious complication in the course of disease. The abscesses have by their risk of rupturing and bacterial superinfection quoad vitam an unfavourable prognosis. CT-guided relief punctures can, as it is demonstrated by two cases of critical amebic abscesses, effectively improve the therapy with systemic amebicides, prevent imminent rupture and contribute to the healing of the abscesses. Thus a surgical treatment of the abscess was not necessary. PMID- 3677552 TI - [Evaluation of computerized tomograms using a black and white and a color monitor: an ROC (receiver operation characteristic) comparison]. AB - Different views about the value of a colour monitor for the evaluation of computer tomograms have prompted us to carry out this ROC (Receiver Operation Characteristic) examination. The latter was based on patient computer tomograms in which lesions of the liver were simulated by image manipulation. 5 radiologists analysed the image material (a) on a black-and-white monitor, (b) on a colour monitor, and (c) simultaneously on a black-and-white and a colour monitor. The study shows that the use of a colour monitor gives no essentially different result than evaluation with a black-and-white monitor. The slightly better result of 2% more true positive findings with simultaneous representation of black-and-white and colour image relative to the sole use of black-and-white display is within error limits. The colour representation gives no advantage for the evaluation of usual computer tomograms because the window technique enables a contrast representation in black-and-white too. PMID- 3677553 TI - The ethical and scientific considerations of human immunodeficiency virus antibody screening in volunteers for clinical pharmacologic research. PMID- 3677554 TI - Is the pursuit of scientific truth always the greatest good? Ethical issues in health care research. PMID- 3677555 TI - Whole body leucine turnover and nutritional status in continuous ambulatory peritoneal dialysis. AB - 1. Nutritional status and leucine turnover has been measured in ten patients with chronic renal failure before the onset of continuous ambulatory peritoneal dialysis (CAPD) and after 3 months treatment, and in five normal subjects. 2. Somatic muscle protein reserves, as judged by anthropometry and measurement of total body potassium, showed no significant changes after 3 months treatment and were not significantly different from normal. 3. Visceral protein reserves, as judged by serum albumin and plasma amino acids, showed a significant fall after 3 months CAPD and were also lower than in normal subjects. 4. Protein turnover was lower in uraemic than in normal subjects, but the balance between synthesis and breakdown was significantly higher and was maintained after 3 months on CAPD. PMID- 3677556 TI - Studies to assess the biological relevance of anti-Tamm-Horsfall protein antibodies detected by direct-binding enzyme-linked immunosorbent assay. AB - 1. A role has been suggested for anti-Tamm-Horsfall protein (THP) antibodies in renal disease based on the results of immunoassays of pathological sera. The putative autoantibodies have not been isolated from such sera nor have definitive inhibition studies of their binding been carried out. We have carried out such studies using rabbit anti-THP antibodies as control reagents. 2. Urinary THP prepared by salt precipitation was used to prepare four immunoabsorbent columns by covalent coupling to CNBr-activated Sepharose 4B. After washing with a variety of dissociating agents to remove any non-covalently bound subunit THP, each column was incubated with normal and immune rabbit serum. Fractions washed and eluted from columns were tested for anti-THP antibodies by enzyme-linked immunosorbent assay (ELISA) and THP antigen by radioimmunoassay, and showed NH4SCN (3 mol/l) and guanidine hydrochloride (GuHCl) (6 mol/l) equivalent and sodium dodecyl sulphate (20 g/l) to be inferior in their capacity to produce immunoabsorbent THP capable of isolating specific antibodies from immune rabbit serum. 3. The column treated with GuHCl (6 mol/l) was used further in attempts to isolate putative anti-THP antibodies from five patients, who had a history of urinary tract infections and whose sera showed strong binding by ELISA. 4. Results from direct and inhibition ELISA experiments on fractions collected after washing and elution with all sera suggested that the putative human anti-THP antibodies were of very low affinity and/or directed against non-subunit THP. 5. The pathological relevance of human anti-THP antibodies measured by ELISA remains to be established. PMID- 3677557 TI - Influence of exercise on ascorbic acid status in man. AB - 1. The response of circulating leucocytes with regard to changes in number, proportion of granulocytes and lymphocytes, as well as changes in the ascorbic acid (AA) concentration of plasma and isolated lymphocytes, were studied in nine men who ran a 21 km race. A marked leucocytosis was noted 5 min after the race, the predominant increase being in granulocytes (P less than 0.001) with smaller relative increases in circulating lymphocytes (P less than 0.01) and platelets (P less than 0.001). Numbers of leucocytes and platelets returned to pre-exercise levels within 24 h after the race. 2. The concentration of AA in plasma increased from 52.7 +/- 4.1 mumol/l before the race to 67.0 +/- 5.3 mumol/l within 5 min after the race (P less than 0.001). This increase in plasma AA concentration was positively correlated with the rise in plasma cortisol concentration during the race (r = 0.89; P less than 0.01). However, within 24 h after the race the plasma concentration of AA fell 20 +/- 4% below pre-exercise values (P less than 0.01) and remained low for at least the next 2 days (P less than 0.05). 3. Lymphocyte AA concentration increased from 15.6 +/- 0.6 to 19.7 +/- 0.9 mumol/g of lymphocyte protein during the race (P less than 0.01) but returned to normal levels within 2 days after the race. 4. It is suggested that the adrenal gland may be the major source of AA efflux into the circulation during exercise. PMID- 3677558 TI - Voluntary isocapnic hyperventilation and breathlessness during exercise in normal subjects. AB - 1. Nine normal subjects performed 6 min, constant-workload, exercise tests on a bicycle ergometer at either a 'high workload' or at a 'low workload'. During the first 'high workload' test their spontaneous breathing pattern was recorded on to magnetic tape. During one subsequent 'high workload' test and one 'low workload' test they voluntarily copied their recorded breathing pattern. During a second 'low workload' test they breathed spontaneously. Isocapnia was maintained by the operator throughout both the copying tests. During the exercise tests ventilation was recorded and subjects indicated the level of their sensation of breathlessness every 30 s. 2. Subjects felt markedly less breathless when a proportion of their ventilation was produced by voluntary effort than when the same total level of ventilation was produced entirely by the stimulus of exercise. Furthermore, voluntary isocapnic hyperventilation during exercise did not increase breathlessness above that normally associated with that level of exercise. 3. These results suggest that it is reflexly driven ventilation, and not simply the level of ventilation itself, which relates to the level of breathlessness during exercise. PMID- 3677559 TI - Evidence for gamma-aminobutyric acid as the inhibitor of gamma-aminobutyric acid binding in the plasma of humans with liver disease and hepatic encephalopathy. AB - 1. Gas-liquid chromatography and a radioreceptor assay were used to measure plasma gamma-aminobutyric acid (GABA) in patients with liver disease and hepatic encephalopathy. 2. There was a significant correlation between the results obtained by the two methods, and compared with controls plasma GABA was elevated. 3. These findings suggest that the increased GABA binding inhibitory activity of plasma of these patients is probably due to GABA itself. PMID- 3677560 TI - Muscle strength in healthy white and Asian subjects: the relationship of quadriceps maximum voluntary contraction to age, sex, body build and vitamin D. AB - 1. The maximum voluntary isometric contraction (MVC) of the dominant quadriceps muscle was measured in 136 healthy White and 172 healthy Hindu Asian subjects resident in London, using a specially designed chair equipped with a force measuring load cell. 2. Males were stronger than females, and for both sexes MVC declined with age. From age 20 to 60 the annual decline in MVC ranged from 0.56% in White males to 1.5% in female Asians. 3. White subjects were stronger than Asian subjects even after correcting for the effect of age, height, weight and sex in a multi-factorial analysis. 4. Only in males did MVC correlate with height and weight. Asian women were more obese than any other group, and showed an increase in body mass index with age. 5. Twenty-two per cent of Asian subjects had marked vitamin D deficiency (plasma 25-hydroxycholecalciferol less than 10 nmol/1). There was no correlation between MVC, and plasma 25 hydroxycholecalciferol. PMID- 3677561 TI - Time course of end-expired carbon monoxide concentration is important in studies of cigarette smoking. AB - 1. Fifteen asymptomatic habitual smokers each smoked one of their usual cigarettes, not having smoked for 2 h. End-expired carbon monoxide concentration (EECO) was measured with an Ecolyzer 2000 series analyser before smoking (pre-S value), 1 min after finishing smoking (post-S value) and then at intervals up to 1 h. 2. The mean EECO boost (increase) over all subjects declined biphasically after smoking, with an initial fast phase from 1 to 5 min, and then a slow phase from 5 to 60 min. EECO fell by as much in the first 5 min as in the next hour. 3. Post-S EECO was related to pre-S EECO (r = 0.89, P less than 0.001), but EECO boost was not related to pre-S (r = 0.00). EECO boost was unaffected by the sampling manoeuvre. 4. EECO measurements in epidemiological and smoking studies should not be made for at least 5 min after a cigarette is finished. PMID- 3677562 TI - Familial pseudohyperkalaemia: inhibition of erythrocyte K+ efflux at 4 degrees C by quinine. AB - 1. Mechanisms responsible for increased erythrocyte K+ efflux in vitro have been investigated in a patient with familial pseudohyperkalaemia. Mean net K+ efflux (4 degrees C) was 108 nmol h-1 10(-9) erythrocytes, seven times greater than the mean for controls (15.2 nmol h-1 10(-9) erythrocytes). Net K+ efflux was not increased at 22 degrees C or 37 degrees C and losses at 4 degrees C were reversed by subsequent incubation at 37 degrees C. 2. Erythrocyte glucose consumption (4 degrees C) was 14 nmol h-1 10(-9) erythrocytes, similar to the mean for controls of 16.8 nmol h-1 10(-9) erythrocytes. This suggests that the increased net K+ efflux (4 degrees C) was not associated with abnormal energy consumption and was therefore unlikely to be due to an abnormality of the Na+, K+-pump. 3. Incubation of erythrocyte suspensions with ouabain (0.1 mmol/1) or frusemide (1 mmol/1) at 4 degrees C or 37 degrees C resulted in no differences in K+ efflux between patient and controls. Incubation with quinine (2 mmol/1), an inhibitor of the erythrocyte Ca2+-dependent K+ channel, reduced net K+ efflux at 4 degrees C, but the effect persisted in Ca2+-depleted erythrocytes, implying that quinine was acting in a non-specific fashion. 4. Chemical pathologists and clinicians must be aware of this condition if inappropriate treatment of pseudohyperkalaemia is to be avoided. PMID- 3677563 TI - Colorado physician health program. Residency stress. PMID- 3677564 TI - Treatment of magnesium deficiency. PMID- 3677565 TI - Disposition of phenytoin in critically ill trauma patients. AB - Estimates of phenytoin pharmacokinetic variables and protein binding were determined in 10 adult critically ill trauma patients. Each study subject received phenytoin sodium as an intravenous loading dose of 15 mg/kg, followed by an initial intravenous maintenance dose of 6 mg/kg/day. Serial blood samples were obtained throughout the seven-day study period and analyzed for total and unbound serum phenytoin concentrations. The concentration data for each patients were fitted to a one-compartment model with elimination defined by the Michaelis Menten constant Km and the maximum rate of metabolism (Vmax) and to a one compartment model with first-order elimination. The Michaelis-Menten model used Bayesian parameter estimation while the linear model used weighted non-linear least-squares regression analysis. Unbound phenytoin fraction ranged from 0.073 to 0.25. Free fraction increased 7% to 108% in 9 of 10 patients (median increase 29%) from day 1 to day 7 of therapy. Variable estimates using the Michaelis Menten model were as follows: volume of distribution, 0.76 +/- 0.15 L/kg (0.58 1.01 L/kg); Vmax, 568 +/- 197 mg/day (350-937 mg/day); and Km, 4.5 +/- 1.8 mg/L (1.8-6.2 mg/L). These estimates fell within the wide range of values obtained in studies using stable patients or healthy volunteers. The Michaelis-Menten model was significantly less biased and more precise than the linear model. Three of four patients who continued to receive their study maintenance dose had substantially lower measured total serum concentrations of phenytoin than predicted using the study variable estimates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677566 TI - Accuracy of three methods for predicting concentrations of free phenytoin. AB - Predictions of free (unbound) serum phenytoin concentration by three methods were compared with results obtained by the Abbott TDx Free Phenytoin ultrafiltration and fluorescence-polarization immunoassay technique. Data were obtained for hospitalized adults who had been receiving phenytoin for at least five days and were free of renal or hepatic disease. Total phenytoin concentration was determined, and free phenytoin concentration was measured in ultrafiltrate at 25 degrees C. For each patient, measured concentrations of total phenytoin and albumin were used to predict free phenytoin concentrations by the Gugler method, the Sheiner-Tozer nomogram, and the Sheiner-Tozer equation. Mean measured percentages of free phenytoin were 17.79%, 12.13%, and 8.73%, respectively, for patients with albumin concentrations of less than 2 g/dL (n = 5), 2-3 g/dL (n = 18), and greater than 3 g/dL (n = 26). There was a strong correlation between actual and predicted free phenytoin concentrations for each of the methods, but all methods were found to lack precision. All methods also exhibited bias, as demonstrated by overprediction of the free concentration; however, none of the methods exhibited bias when the difference between the in vitro temperature of 25 degrees C and the in vivo temperature of 37 degrees C was considered. Because of their poor precision, the three methods evaluated in this study are not recommended for predicting free phenytoin concentration. PMID- 3677567 TI - Single-dose pharmacokinetics of cefuroxime and cefamandole in healthy subjects. PMID- 3677568 TI - Safety of estrogen therapy for women with fibrocystic breast disease. PMID- 3677569 TI - Effect of metoclopramide on the absorption of an oral sustained-release quinidine product. PMID- 3677570 TI - Effect of needle size on pain and hematoma formation with subcutaneous injection of heparin sodium. PMID- 3677571 TI - Phenytoin-induced hypersensitivity reactions. AB - A case of phenytoin-induced hepatitis with mononucleosis is reported, and syndromes associated with phenytoin hypersensitivity reactions are discussed. A 23-year-old black woman with a two-month history of seizure disorder was admitted to a hospital with nausea, vomiting, fever, lymphadenopathy, diffuse maculopapular rash, left-upper-quadrant tenderness, and hepatomegaly. She was receiving phenytoin sodium 300 mg/day; carbamazepine 200 mg four times daily had been discontinued four days before admission because of leukopenia. Phenytoin was discontinued after admission; however, phenytoin 1 g i.v. was given for a tonic clonic seizure two days after admission, after which swelling of the face and legs and pruritus developed. Over the next few days, signs and symptoms of hepatotoxicity progressed, and she became comatose. Seizures were treated with diazepam. She began to recover after 10 days of supportive therapy and was discharged several weeks later on primidone therapy. Serious phenytoin hypersensitivity reactions may appear as dermatologic, lymphoid, or hepatic syndromes. Fever, rash, and lymphadenopathy often accompany hepatic injury. Encephalopathy and death may occur. Proposed mechanisms for phenytoin hypersensitivity include antigen-antibody reactions, alteration of lymphocyte function, and an enzyme abnormality causing the production of toxic metabolites. Treatment is supportive; phenobarbital and carbamazepine may be used with caution as alternate anticonvulsant therapy. The possibility of phenytoin hypersensitivity reactions should be considered when patients receiving phenytoin have unusual symptoms, particularly fever, rash, and lymphadenopathy. PMID- 3677572 TI - Productivity and constraints in the acquisition of the passive. PMID- 3677573 TI - Clauses are perceptual units for young infants. PMID- 3677575 TI - The clinical laboratory evaluation of cryptococcal infections in the acquired immunodeficiency syndrome. AB - The medical and laboratory records were reviewed in 37 acquired immunodeficiency syndrome (AIDS) patients with cryptococcal infections. In 24 patients with the presentation of cryptococcal meningitis, the initial cerebrospinal fluid (CSF) culture was positive. The initial India ink mount demonstrated organisms in 79% of culture positive CSF specimens. After therapy the subsequent India ink mounts demonstrated 84% sensitivity and 53% specificity with respect to culture outcome. Cultures of blood, bronchoalveolar lavage fluid, and brain were more likely to be positive than cultures from other sites. The initial blood cultures were positive in eight of eight patients at presentation of cryptococcal meningitis. When the initial CSF titer was greater than 1:2, the corresponding CSF culture was always positive. A negative culture during therapy did not necessarily indicate eradication of infection. The initial cerebrospinal fluid and serum cryptococcal antigen titers varied significantly and could not be correlated with survival. In three instances when the CSF cryptococcal antigen titers and cultures were negative, a positive serum cryptococcal antigen greater than 1:8 suggested disseminated infection. PMID- 3677574 TI - Serratia bacteremia. AB - During a 6-yr period, 146 patients at our institution had Serratia bacteremia (3.8% of the total number of episodes of bacteremia), with an incidence of 1.24/1000 admitted patients. We chose a random group of 50 cases for clinical analysis in the present study. The disease was community-acquired in 8% of the cases and nosocomially-acquired in the remaining 92%. The bacteremia was unimicrobial in 84% and part of a polymicrobial bacteremia in 16% of the episodes. The most frequently isolated species of the Serratia genus was S. marcescens. Portals of entry, in decreasing order of frequency, were: urinary, unknown, respiratory, and surgical wound infections. Clinically, the most frequent finding was fever (100%). Shock occurred in 28% of the patients, and none of our cases showed evidence of disseminated intravascular coagulation. We found 62% of Serratia isolates resistant to gentamicin. Overall mortality was 38% and factors associated with a poor prognosis were: severity of the underlying disease, critical clinical situation at onset of bacteremia, presence in the intensive care unit (I.C.U.), occurrence of shock or polymicrobial bacteremia, portal of entry in the respiratory tract, and inadequate treatment. PMID- 3677576 TI - Hymenolepis diminuta: one of three enteric pathogens isolated from a child. AB - This article describes a case of enteritis in a 3.5-yr-old child with persistent diarrhea and the isolation of three gastrointestinal pathogens, including a rare human pathogen Hymenolepis diminuta (rat tapeworm). This is the first reported case in the northeastern United States in 20 yr and demonstrates that persons living in homes infested with rodents and arthropods are at risk of acquiring this infection. PMID- 3677577 TI - Pulmonary infection by Mycobacterium gordonae in an immunocompromised patient. AB - Mycobacterium gordonae, a scotochromogenic organism, is considered a saprophyte and isolation of this organism in sputum cultures is not generally considered clinically significant. We report the case of 70-yr-old man with Hodgkin's disease and pulmonary infection caused by Mycobacterium gordonae. The clinical and radiographic findings in this case and the course are outlined. Mycobacterium gordonae isolated from patients with debilitating diseases should not automatically be rejected as a contaminant. PMID- 3677578 TI - A simple broth-disk elution test for screening methicillin-resistant (heteroresistant) staphylococci. AB - Forty-six strains of Staphylococcus aureus and 47 strains of unspeciated coagulase-negative staphylococci were inoculated in tubes containing a cation supplemented Mueller-Hinton broth with 4% (wt/vol) NaCl. A critical concentration of methicillin (10 micrograms/ml) or oxacillin (6 micrograms/ml) was achieved in each tube by adding the appropriate number of antibiotic disks. Growth was interpreted as resistance. Results obtained with fully resistant or fully sensitive strains showed complete agreement with the reference method. Four strains with intermediate sensitivity (two S. aureus and two coagulase-negative staphylococci) were classified as resistant by the broth-disk elution test. PMID- 3677579 TI - In vitro activity in deptomycin (LY-146032) compared with other antimicrobial agents against gram-positive cocci. AB - A comparison was made of the activity of deptomycin (LY-146032) with that of ampicillin, cephalexin, cefamandole, cephalothin, erythromycin, teicoplanin, tetracycline, and vancomycin. The minimal inhibitory concentration (MICs) for greater than or equal to 90% of 356 Gram-positive cocci, against deptomycin, were less than or equal to 2 micrograms/ml. The MICs for the other antimicrobials varied greatly depending on the compound. A slight and unexplained inoculum effect was observed for LY-146032. PMID- 3677580 TI - Fish oil and ischemic heart disease. PMID- 3677581 TI - Pathogenesis, diagnosis, and treatment of stenosis of the internal carotid artery. PMID- 3677582 TI - Snoring and cardiovascular disease. PMID- 3677583 TI - Chlamydia, the silent sexually transmitted disease. PMID- 3677584 TI - Identification and ratings of caricatures: implications for mental representations of faces. PMID- 3677585 TI - Structural packaging in the input to language learning: contributions of prosodic and morphological marking of phrases to the acquisition of language. PMID- 3677586 TI - Tolerance of deviance and the community adjustment of the mentally ill. AB - The influence of social variables on the level of community adjustment of 60 former state hospital patients was examined. Community adjustment was operationalized to include measures of instrumental performance, social participation and satisfaction with community circumstances. Hierarchical regression analysis was utilized to assess the contribution of social-level predictors. The results of the study suggest that the character of a psychiatric patient's social milieu can influence the success she/he experiences in attempting to adjust to life in the community. Specifically, each of the measures of adjustment was closely related to significant other attitudes, i.e., expectations and tolerance of deviance. Overall, the results suggest the importance of a social-environmental strategy as a means to achieve positive changes in patients' adjustment to community living. PMID- 3677587 TI - Commitment of the mentally ill to outpatient treatment. AB - Outpatient commitment is examined in order to determine what types of civil commitment respondents are ordered to outpatient treatment. The sample consisted of 1226 adult civil commitment respondents having initial hearings in North Carolina. Respondents placed on outpatient commitment are compared with respondents who were released and respondents who were committed to the hospital. Respondents ordered to outpatient commitment are significantly more likely to be of the chronic, revolving door population of mental patients. Potential problems in evaluating the success of outpatient commitment are discussed. PMID- 3677588 TI - Community factors influencing psychiatric hospital utilization in rural and urban Ireland. AB - The role of community factors in psychiatric hospital utilization in rural and urban Ireland was evaluated using Hollingshead & Redlich's conceptual model. Rural and urban differences in identification of psychiatric disorders, attitude to psychiatric facilities and social isolation were assessed using a community survey (N = 200). No difference was found in the recognition of schizophrenic behavior. Rural residents tended to normalize neurotic behavior and significantly fewer recognized it as deviant. The two communities did not differ in the identification of alcoholism or neuroses as mental illness. Rural individuals had a more negative attitude to psychiatric facilities, and sought help more frequently from relatives who were less accessible than their urban counterparts. PMID- 3677589 TI - Retention of Hispanics in public sector mental health services. AB - Hispanic underutilization of mental health facilities extends to lowered retention rates among the chronically mentally ill. A theoretical model of retention was developed with four domains of variables: personal traits, accessibility of social support, treatment characteristics, and facility characteristics. Using data collected from CMHC clinical charts in 1983 and 1984, the model was tested using multiple regression and commonality analysis. The model was tenable (R = .59). However, the commonality analysis suggested that most of the unique variance was contributed by the treatment domain. The social support domain made negligible unique contribution. Implications of the model are discussed. PMID- 3677590 TI - Preventive strategies for dealing with violence among blacks. AB - In regular medicine if a patient goes to a doctor to be treated for a rat bite, the physician cleans the bite, dresses it, gives antibiotics, and gives a tetanus shot. The physician practicing social medicine would give our imaginary patient the same treatment but would go a step further; he would arrange for someone to go into the patient's community and set rat traps. A similar distinction is made between general psychiatry and community psychiatry, and this distinction highlights one of the main principles of the community psychiatrist's mission, community development. Community development being the art of helping a community achieve a social and interpersonal milieu that promotes an optimum level of mental health (Freed, 1972; Freed, 1972). This aspect of community psychiatry takes on an even greater significance when the community being served is a lower socioeconomic, minority community because of the conditions found in such communities that can impair the overall mental health of the community's individuals, families, and groups. This article will illustrate the principle of community development, the role of one psychiatrist in community development, and its importance to deprived minority communities by describing a community psychiatry approach to the problem of black-on-black homicide. PMID- 3677591 TI - Psychiatric home health nursing: a new role in community mental health. PMID- 3677592 TI - Chemical structures of a galactose-rich glycoprotein of Leishmania tarentolae. AB - 1. Aqueous phenol treatment of water extracted disrupted cells of Leishmania tarentolae (LV-414) provided a glycoprotein mixture which was purified by gel filtration chromatography, and Concanavalin A-Sepharose column. 2. The bound fraction on Concanavalin A-Sepharose column (protein 74%, and carbohydrate, 26%) had [alpha]D + 9 degrees and contained mannose (18%), galactose (60%), and glucose (22%), and some of the galactose residues were resistant to periodate oxidation. 3. Treatment of the phenol extract with hot aqueous NaBH4 containing NaOH gave a preparation having mannose (12%), galactose (82%), and glucose (6%). 4. Methylation analysis showed the presence of a mainly linear structure with non reducing end-units of mannopyranose (6%), 3-O-substituted galactopyranosyl (64%), 2-O- (11%), and 6-O- (5%) substituted mannopyranosyl, and 4-O- (9%), and 4,6-di-O (3%) substituted glycopyranosyl units. 5. The specific rotation of the preparation, +20 degrees, indicated beta-linked galactopyranosyl units. PMID- 3677593 TI - Activities of enzymes associated with phosphoenolpyruvate metabolism in the mudskippers, Boleophthalmus boddaerti and Periophthalmodon schlosseri. AB - 1. PK and LDH activities in the muscle of Periophthalmodon schlosseri and Boleophthalmus boddaerti were at least 100-fold higher than their respective activities in the liver. 2. The ratio of PK:PEPCK in liver of B. boddaerti was smaller than that of P. schlosseri. 3. PK:PEPCK ratios in both fishes were intermediate between those of aerobic and anaerobic organisms. 4. MDH activity was higher than other enzymes assayed in the liver of both fishes. 5. The ratios of LDH:MDH in the liver of both mudskippers were comparable to those of anaerobic organisms. 6. AST was at least eight times more active than ALT in the liver of both fishes. 7. In the muscle of these mudskippers, the aspartate content was significantly less than that of alanine. 8. Exposure of these fishes to various experimental conditions led to changes in specific activities of PEPCK, LDH, AST and ALT. PMID- 3677594 TI - Optimal isolation conditions for rainbow trout (Salmo gairdneri) hepatic ribosomes. AB - 1. Isolation conditions for rainbow trout (Salmo gairdneri) liver ribosomes were optimized. 2. Optimal initial buffer (Buffer I) concentrations were 250 mM sucrose, 50 mM Tris (pH 7.6, 25 degrees C), 75 mM KCl, and 5 mM MgSO4.7H2O. 3. Optimal concentrations for post-105 supernatant buffer (Buffer III) were 25 mM Tris (pH 7.6, 25 degrees C), 75 mM KCl, and 8 mM MgSO4.7H2O. PMID- 3677595 TI - The effects of ammonium sulfate and acid on horse and human serum butyrylcholinesterase (EC 3.1.1.8). AB - 1. Results of laboratory experiments which compared horse and human serum butyrylcholinesterase (EC 3.1.1.8) with respect to their acid inactivation and ammonium sulfate protection show: 2. Horse serum butyrylcholinesterase is more resistant to inactivation at pH 3.0 than human serum butyrylcholinesterase. 3. The loss of activity at pH 3.0 for both horse and human butyrylcholinesterase does not follow first order kinetics. 4. Both human and horse serum butyrylcholinesterase are protected from pH 3.0 inactivation by ammonium sulfate concentrations up to 33% saturation (1.37 M). PMID- 3677596 TI - Glutathione and lipid peroxidation in the aging rat. AB - 1. Tissue extracts were prepared from liver, kidney, heart, brain, lung and spleen of male Sprague-Dawley rats of different ages (1-36 months); each of the extracts was analyzed for reduced glutathione (GSH) and lipid peroxides. 2. At all ages the GSH content in the liver was 3-10 times higher than that in other tissues. 3. In the old (36 months) rat the GSH content of all the tissues studied were lower (35-60%) than that in 2.5 month old rat. 4. The lipid peroxides levels increased by age in all tissues studied. 5. These findings indicate that general characteristics of aging tissue may include a decrease in GSH content and increase in lipid peroxides showing a decrease in reducing potential in senescence. PMID- 3677597 TI - Effects of dietary saturated and polyunsaturated fat on lipoprotein lipase and hepatic triglyceride lipase activity. AB - The effects of saturated and polyunsaturated dietary fat on the lipolytic activity of post-heparin plasma, lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL) were studied in the rat. The lipolytic activity was studied from 0 to 60 min using labelled chylomicrons as the substrate. Triacylglycerol hydrolysis rate was higher for the plasma of rats fed high fat diets (14% fat by weight). Chylomicrons of rats fed saturated or unsaturated fats were hydrolyzed at the same rate within the first 15 min but afterwards hydrolysis of chylomicrons of rats fed saturated fat was slower. The activities of LPL and HTGL were increased by high fat diets. Unsaturated fat increased more LPL activity than saturated fat conversely, HTGL activity was enhanced more by saturated fat than by unsaturated fat. PMID- 3677598 TI - Mitochondrial Acyl-CoA dehydrogenase activity of fish red muscle and pig liver. AB - 1. A method is described for the estimation of in vivo activity of mitochondrial Acyl-CoA dehydrogenase, without the addition of extra ETF (electron transferring flavoprotein). 2. Using Fumarase as a marker enzyme, the activity of Acyl-CoA dehydrogenase was calculated per gram wet weight. 3. The enzyme displays negative cooperativity in fish muscle, but positive cooperativity in pig liver. S0.5 values for the substrate octanoyl-CoA are between 3 and 5 microM. PMID- 3677599 TI - Adaptative features of enzymes from family sciaenidae (Perciformes)--I. Studies on soluble malate dehydrogenase (s-MDH) and creatinine kinase (CK) of fishes from the south coast of Uruguay. AB - 1. Electrophoretic analysis of the soluble malate dehydrogenase (s-MDH) and creatine kinase (CK) isozyme patterns of three species of temperate fishes (Scianidae, Perciformes) indicates at least two loci for s-MDH, Mdh-A and Mdh-B, and four CK, Ck-A, Ck-B, Ck-C and Ck-D. 2. The subunits encoded by these loci occurred at different levels in different tissues and organs analyzed. 3. Through electrophoretic analysis the products of these loci showed different behaviour to changes in temperature. 4. Relative activities of s-MDH and CK isozymes were compared by Klebe's (1975) method to determine pattern of divergence of duplicated gene expression in the three studied species. PMID- 3677600 TI - Adaptative features of enzymes from family sciaenidae--II. Studies on phosphoglucose isomerase (PGI) of fishes from the south coast of Uruguay. AB - 1. The electrokinetic and thermostability properties of phosphoglucose isomerase (PGI) in three species of temperate fishes (Perciformes, Acanthopterygii)- Cynoscion striatus, Macrodon ancylodon and Micropogonias furnieri--have been analyzed in order to study the adaptative 2. Unlike most diploid fishes the PGI of these species seemed to be encoded by three PGI loci. 3. The subunits encoded by these loci occurred at different levels in the different tissues and organs analyzed. 4. Genetic variants at two loci (Pgi-A and Pgi-B2) were detected in Cynoscion striatus, and at one (Pgi-A) in Micropogonias furnieri. 5. The product of these loci could be separated in three PGI regions based on their electrophoretic distribution and thermostability properties. 6. The more anodal region (including isozymes and allozymes) was more thermolabile than the less anodal one, which is predominant in a single tissue skeletal muscle. 7. Relative activities of PGI isozymes were compared by Klebe's method to determine pattern of divergence of duplicated gene expression in the three species studied. PMID- 3677601 TI - Developmental changes in membrane proteins from baboon erythrocytes. AB - 1. Total membrane proteins from freshly isolated erythrocytes of fetal, newborn, and adult baboons were analyzed by electrophoresis. 2. The electrophoretic patterns of proteins from newborns and adults were similar but those from adults and fetuses were different. 3. Four proteins, P165, P155, P75, and P49, with approximate mol. wts of 165,000, 155,000, 75,000, and 49,000, respectively, were present in adult but not in fetal samples. 4. P155 and P49, were glycoproteins; P49 was a cell-surface protein. 5. The membrane protein characteristics of the adult erythrocyte differ from those of the fetal erythrocytes and at least four polypeptides are associated with development of the adult phenotype. PMID- 3677602 TI - Subcellular localization and kinetic properties of arginase from the liver of Genypterus maculatus. AB - 1. From the liver of the teleost fish Genypterus maculatus, a partially purified preparation of arginase was obtained and characterized. 2. The Km value for arginine was found to be 9.1 mM at pH 7.5 and 11.5 mM at the optimum pH of 9.5. At both pH values, competitive inhibition was caused by ornithine and lysine, whereas proline, leucine, valine and isoleucine caused a non-competitive inhibitory effect. Branched chain amino acids were more inhibitory than proline. 3. The enzyme was found localized in the mitochondrial matrix of the liver of Genypterus maculatus. It is suggested that this localization would be of importance in the use of arginine as an energy source. PMID- 3677603 TI - Cholesterol transfer from rat, human and sheep erythrocytes. AB - 1. The spontaneous transfer of cholesterol out of sheep, rat and human erythrocyte membranes was measured. 2. The rates of cholesterol transfer did not correlate with the very different levels of sphingomyelin in the membranes. 3. Cholesterol transferred at similar rates out of vesicles made of lipids extracted from the three types of erythrocyte. 4. The results are discussed in relation to the proposal that cholesterol and sphingomyelin are closely associated in cell surface membranes. PMID- 3677604 TI - Acid-stable protease inhibiting polypeptides formed from denatured horse plasma by proteolysis. AB - 1. Trypsin digestion of perchloric acid precipitated horse plasma yielded polypeptides with inhibitory properties for trypsin, chymotrypsin and, to a small extent, kallikrein. 2. The Mr of the inhibitory polypeptides were 73,000 and 24,000. 3. The number, enzyme specificity and Mr of the inhibitory polypeptides differed from the values known for the human being. 4. The inhibitory polypeptides were purified by affinity chromatography on Sepharose-trypsin and by gel filtration through Sephadex G-75. 5. Protease inhibitory polypeptides were generated in the same manner by chymotrypsin, elastase, proteinase K, pronase, collagenase, papain and subtilisin. 6. The number and electrophoretic migration of the inhibitory polypeptides obtained with the different enzymes were variable. 7. The enzyme specificity was constant since all polypeptides inhibited only trypsin, chymotrypsin and kallikrein to a small extent. 8. None of the inhibitory polypeptides were immunologically related to native plasma proteins or plasma protease inhibitors. PMID- 3677605 TI - Changes in plasma lipoproteins and tissue lipoprotein lipase and salt-resistant lipase activities during spawning in the rainbow trout (Salmo gairdnerii R.). AB - 1. Lipoprotein lipase and salt-resistant lipase activities increased in the ovaries but decreased in the adipose tissue of female trout in the months leading up to spawning. 2. The activity of the plasma cholesterol esterifying enzyme increased significantly immediately prior to spawning. 3. Plasma lipoprotein concentrations decreased during the approach to spawning. 4. These studies suggest that the developing ovaries in the trout receive their nutrients by lipolysis of plasma lipoproteins as well as by vitellogenin uptake; differentiation of the roles of the lipid stores in different tissues is proposed. PMID- 3677606 TI - Fish skin type I collagen: wide distribution of an alpha 3 subunit in teleosts. AB - 1. Skin Type I collagen was isolated from 15 species of teleosts. 2. Chromatographic and electrophoretic analyses revealed that most of the teleost skin collagens possessed a unique subunit, alpha 3, which had not been detected in other vertebrate Type I collagens. 3. The skin collagen seems to exist as an alpha 1 alpha 2 alpha 3 heterotrimer in many teleosts and as an (alpha 1)2 alpha 2 heterotrimer in some teleosts. PMID- 3677607 TI - Comparison of in vivo energy metabolism in the brain of rainbow trout, Salmo gairdneri and bullhead catfish, Ictalurus nebulosus during anoxia. AB - 1. Rainbow trout and bullhead catfish (Ictalurus nebulosus) were exposed to anoxic water inside a plastic tube until death (12 min for trout; 62 min for catfish). Immediately upon death, the brain was removed and analyzed for metabolites, high energy phosphate compounds, and metabolic fuel while the blood was analyzed for metabolites. 2. Control bullhead brains had higher concentrations of glycogen, ATP, creatine phosphate (CrP), and glucose than control trout. 3. After anoxia bullheads showed a significant decrease in ATP, CrP, and glycogen while lactate more than doubled in concentration. 4. After anoxia trout showed a doubling in brain lactate and a decline in glycogen, but no decline in ATP or CrP. There were no changes in brain glucose, ketone bodies, or alternative anaerobic end-products in either species although an elevation in blood isobutyrate was noted. 5. Brain death in the catfish may be due to depletion of fuel for anaerobiosis and a subsequent loss of ATP. In the trout there may be other causes such as a greater permeability of its neuronal membranes and alterations in intracellular free calcium stores. PMID- 3677608 TI - Erythrocyte biochemistry of the grey-headed fruit bat (Pteropus poliocephalus). AB - 1. Several haematological and biochemical parameters were measured in the erythrocytes of the grey-headed fruit bat. 2. The level of 2,3-diphosphoglycerate was almost twice that found in human erythrocytes. Similarly pyruvate kinase activity was more than twice that of man. 3. The activities of other enzymes of the glycolytic pathway were similar to those found in man. 4. The level of reduced glutathione (GSH) and the GSH regeneration rate in the erythrocytes of the bat were comparable to those found in man. PMID- 3677609 TI - Determination of polyamines in digestive and reproductive tissues of adult Asterias vulgaris (Echinodermata: Asteroidea). AB - 1. The polyamines spermine, spermidine and putrescine were extracted from tissues of Asterias vulgaris and quantitated using thin layer chromatography. 2. In the pyloric caeca, mean (+/- SE) levels of spermine, spermidine and putrescine were 138(15), 86(24) and 415(77) nmol/g wet wt tissue, respectively. In the testes, levels were 95(12), 13(6) and less than 6 nmol/g wet wt. In the ovaries, levels were 105(9), 11(0.8) and 15(8) nmol/g wet wt. 3. High levels of polyamines in the pyloric caeca may be related to secretion or excretion in this tissue. 4. We hypothesize that polyamines will be important in the regulation of cellular activity in these tissues during the annual reproductive cycle. PMID- 3677610 TI - Comparative studies on lipid metabolism in various salt transporting organs of the European eel (Anguilla anguilla). Mono-unsaturated phosphatidylethanolamine as a key substance. AB - 1. Incorporation in vivo into tissue lipids of (1-14C)acetate added to the water in the incubation tank showed the same relative distribution pattern of 14C activity among various phospholipids in the gills, the esophagus and the intestine, when the eel was incubated in sea-water; in fresh water this pattern was found only in the intestine, while both the gills and the esophagus showed a relative excess of 14C-label in phosphatidylethanolamine (PE). 2. Similar studies with (32P)phosphate also showed a relative excess of (32P)PE in both the gills and esophagus in fresh water compared to sea-water, and no such difference in the intestine. 3. As long as the labelled precursors were added to the water in the incubation tank both (14C)PE and (32P)PE were not identical to unlabelled PE on thin-layer chromatograms, and the 14C-labelled lipids contained predominantly C16:1 and C18:1 fatty acids. 4. However, when the two precursors were injected directly into the eel there was no longer any marked difference between the distribution patterns of radioactivity among gill phospholipids in fresh water and sea-water; there was no longer any difference between labelled and unlabelled PE on thin-layer chromatograms, and the 14C-labelled gill lipids contained predominantly C16:0 and C18:0 fatty acids. 5. The corresponding liver lipids were affected neither by a change in environmental salinity nor in precursor application. PMID- 3677611 TI - Bovine serum hemopexin: properties of the protein from a single animal. AB - 1. Hemopexin was isolated from bovine serum of a single animal in a yield of 0.5 mg/ml. 2. Bovine hemopexin was found to exist in two isoforms of mol. wt 68,000 and 65,000. 3. Treatment of hemopexin with glycopeptidase F yields a single band corresponding to a mol. wt of 51,000. 4. The protein binds heme on an equimolar ratio and shows a single component in reverse-phase high performance liquid chromatography. 5. The amino acid composition of bovine hemopexin compares with that of hemopexin isolated form other animals. PMID- 3677612 TI - Comparison of ornithine aminotransferase activities in the pigment epithelium and retina of vertebrates. AB - 1. The specific activities of ornithine aminotransferase (OAT) in the pigment epithelia, retinas, and livers from several classes of vertebrates were assayed. 2. The specific activities of OAT were much higher in the pigment epithelia from mammals and birds than in their respective retinas or livers. 3. Pigment epithelium from porcine eyes had the highest specific activity measured. The specific activity of OAT in the pigment epithelium from the pig was five times higher than the OAT activity in its retina and 13 times higher than the OAT activity in its liver. PMID- 3677613 TI - Identification of multiple glutathione S-transferases from Daphnia magna. AB - 1. Six anionic glutathione S-transferases (GST) were purified from the crustacean, Daphnia magna, by means of affinity chromatography, that are responsible for ca. 40% of cytosolic GST activity. 2. Electrophoresis in the presence of sodium dodecyl sulfate (SDS) revealed the presence of three proteins, with molecular weights of 27,500, 28,000, and 30,200. 3. Separation under nondenaturing conditions revealed six proteins, all of which exhibited GST activity, with molecular weights ranging from 55,000 to 61,700. 4. Ethacrynic acid is a competitive inhibitor of activity towards CDNB of all six GSTs, binding each with similar affinities. 5. Chlorinated phenols are also competitive inhibitors of the enzyme, with the degree of inhibition being directly correlated with the lipophilicity of the compounds. 6. Analysis of inhibition of separated isoforms reveals that form 4 is most strongly inhibited by these chlorinated phenols, with forms 5 and 6 being inhibited to a lesser degree. PMID- 3677614 TI - Volatile fatty acid concentrations in the digestive tract of the West Indian manatee, Trichechus manatus. AB - 1. Digesta samples were collected from five West Indian manatees, Trichechus manatus, for volatile fatty acid (VFA) analysis. 2. Mean total VFA concentrations were low in the stomach and duodenum (18.6 and 12.3 mM/l, respectively). Mean VFA concentrations were considerably higher in the cecum and colon (220.6 and 307.3 mM/l, respectively). 3. The relative proportions of the individual VFA's shifted from predominantly acetic acid in the foregut to a mixture of acetic, butyric and propionic acids in the hindgut. 4. The VFA concentrations in the manatee are similar to those in the dugong, Dugong dugon, and the green sea turtle, Chelonia mydas. 5. The mean total VFA concentrations indicate that the cecum and colon of the manatee are sites of microbial cellulose fermentation. The contribution of VFAs to the manatees' total energy requirements could not be calculated, but it is probably considerable. PMID- 3677615 TI - Effects of glucose transport on the incorporation of 32P-inorganic phosphate into phospholipids in Hymenolepis diminuta (Cestoda). AB - 1. The absorption of glucose and alpha-methyl-D-glucoside by Hymenolepis diminuta was concentration dependent. 2. alpha-Methyl-D-glucoside competitively inhibited glucose absorption and was not metabolised by the parasite. 3. alpha-Methyl-D glucoside significantly lowered (P less than 0.05) the incorporation of 32Pi into all phospholipid classes. 4. Glucose inhibited (P less than 0.01) 32Pi incorporation into phosphatidylcholine only. 5. Phlorizin did not affect 32Pi labelling of phospholipids. 6. Serotonin and histamine stimulated (P less than 0.01) 32Pi labelling of all phospholipid classes. 7. Radioactivities in water soluble fractions were increased (P less than 0.01) in the presence of glucose, serotonin and histamine. PMID- 3677616 TI - A comparative study of some properties of vitellogenin (Vg) and yolk proteins in a number of freshwater and marine teleost fishes. AB - 1. Injection of oestradiol results in induction of vitellogenic proteins in the plasma of stickleback, sea bass, sea horse, pipe-fish, rainbow trout and roach. 2. Immunoblotting after SDS-PAA gradient gel electrophoresis of plasma proteins of stickleback, sea bass and rainbow trout reveals that vitellogenins from these species share common antigenic determinants. 3. Yolk proteins are recognized by antivitellogenin antisera which shows that proteolytical cleavage does not destroy all antigenic determinants. 4. Vitellogenic proteins are present only in the yolk granules and near the theca cell layer as is shown by immunocytochemical methods. PMID- 3677617 TI - Steroid analogs inhibit hormone binding by an extract from Nippostrongylus brasiliensis (Nematoda). AB - 1. An extract from the rodent nematode Nippostrongylus brasiliensis contained putative receptors that bound radiolabeled sex hormones, based on isoelectric focusing. 2. Binding of radiolabeled testosterone by receptors at pH 4.4 was highly inhibited by the androgen analogs, testosterone-3-oxime and 4-aza-5 androsten-3-on-17 beta-ol. 3. Binding of radiolabeled progesterone by receptors at pH 6.4 was highly inhibited by the progesterone analogs 3,5-seco-4-norpregnan 5-on-3-oic acid and 19-norethisterone or 21-deoxycorticosterone. 4. Binding of radiolabeled 17 beta-estradiol by receptors at pH 4.9 was highly inhibited by epiandrosterone. 5. In vivo development of N. brasiliensis to the adult was partially inhibited by selected steroid analogs. PMID- 3677618 TI - Kinetic characteristics and binding process of substrate analogs to the adenosine deaminase in the marine mussel, Mytilus edulis. AB - 1. The purified mussel enzyme deaminated several adenosine analogs with different Km and relative Vmax values. Affinity for adenine was similar to that for adenosine but the deamination rate was extremely slow. 2. Purine riboside was competitive, coformycin was a tight, slow binding inhibitor, and inhibition by both these compounds was pH-dependent. 3. Inosine, hypoxanthine, guanosine and 6 mercapto-purine riboside were slightly inhibitory. 4. The results suggested that initial binding of the substrate was guided by the adenine moiety followed by a stereospecific steering due to a ribose-dependent distortion in the complex to facilitate nucleophilic attack at C-6. PMID- 3677619 TI - Computer simulation of human mitral valve mechanics and motion. AB - The human mitral valve is the left atrio-ventricular valve which is composed of several components including leaflets, chordae tendineae, papillary muscles, and the valve annulus. Any or all of these components may fail and contribute to various valvular diseases including mitral regurgitation and mitral valve prolapse. A computer simulation of mitral valve mechanics and motion was written in BASIC for micro-computers. This program allows valvular geometry and biomechanical parameters to be varied and records time varying motion of the valve and all components during systole including a graphic display of the valve leaflets. PMID- 3677620 TI - Computerized body temperature telemetry in small animals: use of simple equipment and advanced noise suppression. AB - Telemetric measurement of body temperatures in small animals implanted with commercially available transmitters (Mini-Mitter) has been automated using the Commodore C-64 microcomputer. Transmitter output frequencies are received by common AM-radios, converted to TTL level by a simple interface and measured by a machine language subroutine. Multiplexed input is under software control and allows for the recording of at least 16 animals selectively, with data points for each sample every 3 min. The effects of environmental electrical noise are significantly reduced by an error detection system based on the separate reception of interference. PMID- 3677621 TI - A BASIC program for calculation of often needed parameters in intensive care medicine. AB - For rational therapeutic decision making in intensive care patients with artificial ventilation and the use of vasoactive drugs, parameters such as pulmonary shunt, cardiac index and other determinants of gas exchange and circulation are often necessary. For this purpose, a BASIC program suitable for microcomputers was established which facilitates control of therapy. The formulae needed for the calculations are described, and the program is discussed. PMID- 3677622 TI - Correcting for baseline differences in the comparison of rates. AB - Statistical adjustment of baseline differences (bias attributable to confounding covariates) in the comparison of rates is often carried out by the stratification approach (e.g. the "direct standardization method"). However, this approach is usually not feasible for simultaneous adjustment of more than one confounding covariates given modest sample size. Also, the stratification approach requires grouping a continuous adjustment variable into broad categories, and consequently, residual confounding of the adjusted rates can still occur. These drawbacks can be overcome by multiple regression. This communication considers a statistical procedure for the comparison of occurrence rate of some event across two or more exposure or treatment groups adjusting for one or more confounding covariates. The procedure is based on the multiple logistic regression model. A detailed numeric example to illustrate the application of the method is presented. A computer program to carry out the statistical procedures is available from the authors. PMID- 3677623 TI - A FORTRAN technique for correlating a circular environmental variable with a linear physiological variable in the sugar maple. AB - This paper deals with a computer program adapted to a statistical method for analyzing an unlimited quantity of binary recorded data of an independent circular variable (e.g. wind direction), and a linear variable (e.g. maple sap flow volume). Circular variables cannot be statistically analyzed with linear methods, unless they have been transformed. The program calculates a critical quantity, the acrophase angle (PHI, phi o). The technique is adapted from original mathematics [1] and is written in Fortran 77 for easier conversion between computer networks. Correlation analysis can be performed following the program or regression which, because of the circular nature of the independent variable, becomes periodic regression. The technique was tested on a file of approximately 4050 data pairs. PMID- 3677624 TI - ECG waveform analysis by significant point extraction. I. Data reduction. AB - We present a new technique for automatic data reduction and pattern recognition of time-domain signals such as electrocardiogram (ECG) waveforms. Data reduction is important because only a few significant features of each heart beat are of interest in pattern analysis, while the patient data collection system acquires an enormous number of data samples. We present a significant point extraction algorithm, based on the analysis of curvature, that identifies data samples that represent clinically significant information in the ECG waveform. Data reduction rates of up to 1:10 are possible without significantly distorting the appearance of the waveform. This method is unique in that common procedures help in both data reduction as well as pattern recognition. Part II of this work deals specifically with pattern analysis of normal and abnormal heart beats. PMID- 3677625 TI - ECG waveform analysis by significant point extraction. II. Pattern matching. AB - From a set of significant points which characterizes the ECG waveform, the pattern matching algorithm detects and classifies QRS complexes. R waves are detected from the analysis of global curvature. Next, the morphology of the QRS complex is determined. QRS complexes with different morphologies are classified by a correlation algorithm. This method is sensitive to changes in shape, such as that of abnormal QRS complexes. The algorithm should be useful in automated analysis of waveforms, such as ECG signals recorded in clinical environments. PMID- 3677626 TI - The algorithm of the cockshafer walk: a movement automaton applied to the construction of the integrated optical density profile of prometaphase chromosomes. AB - We present an algorithm designed to obtain the optical density profile of prometaphase chromosomes. Our movement automation (the cockshafer) is able to move along the median axis of the chromosome. The criterion used to maintain the correct movement direction lies on the distances from the automaton position to the side boundaries (lengths of the cockshafer antennae). The automaton movements are regulated by rules defined in a decision repertory. This new method does not use a transformation of the image and does not require any prior knowledge of the shape of the chromosome to be sampled. PMID- 3677627 TI - Simulating failure times when the event of interest is unobservable with emphasis on animal carcinogenicity studies. AB - This paper discusses and summarizes the methods which can be used to simulate failure times when an intermediate event of interest is unobservable. Data from animal carcinogenicity experiments are typically of this form. The simulation of time-to-event data where cause of failure is known and the case where cause of failure is unknown are discussed. The methods proposed for simulating failure times use identifiable hazard functions and allow for random sampling of functioning experimental units at fixed times. Some useful design and programming tools are also given. PMID- 3677628 TI - Comparison of the ID3 algorithm versus discriminant analysis for performing feature selection. AB - Having obtained disappointing results in a small medical data set despite the fact that our data seemed to be well suited for induction via ID3, we decided to compare the performance of ID3 to discriminant analysis. Performance was gauged by the percentage of correct classification in a second, independent data set. Examples were obtained from a cardiology project on the accuracy of auscultation. There were 107 examples in the first data set and 67 cases in the second. We found that ID3 and discriminant analysis performed equally poorly, with ID3 classifying only 60% of the second set correctly and discriminant analysis classifying 66% of the second set correctly. Also, the ID3 probability statistic for estimating the accuracy of ID3 for classifying further cases was markedly optimistic compared to our actual second data set results. Moreover, with an increase in sample size, ID3 seemed to break down, producing a large, complex decision tree of dubious generality, whereas discriminant analysis, with a larger sample size, used more independent variables but maintained its first set accuracy. These data suggest that there is a need for more sophisticated algorithms than ID3, even at the risk of giving up some computational efficiency. PMID- 3677629 TI - The effect of blood flow and diffusion impairment on pulmonary gas exchange: a computer model. AB - An assumption of the classical three-compartment lung model is that the physiologic shunt fraction (Qs/Qt) remains constant with changes in cardiac output (Qt). As a result, when Qt decreases, both the arterial O2 tension (PaO2) and the mixed venous O2 tension (PvO2) must also decrease. Yet observations in intact dogs with pulmonary edema and humans with the adult respiratory distress syndrome (ARDS) indicate that as Qt decreases, Qs/Qt occasionally declines while the PaO2 increases. The present study was conducted to examine these discordant observations using a computer model of pulmonary gas exchange with a diffusion impairment. A computer model of gas exchange was developed to specifically analyze the effect of changing Qt upon PaO2 and Qs/Qt in the presence of diffusion impairment. Using the classical three-compartment model of gas exchange, a diffusion impairment was inserted by a MIMIC subroutine. The results of this computer simulation indicated that in the presence of a diffusion impairment, lowering Qt caused PaO2 to increase while Qs/Qt and PvO2 decreased. These changes indicated that a diffusion impairment might account for the experimental observations of the effects of Qt on PaO2 in ARDS. PMID- 3677630 TI - Modelling, simulation and control in a data-rich environment. AB - This paper describes the use and potential use of mathematical modelling, computer simulation, real-time parameter identification and adaptive feedback control techniques in data-rich clinical environments. We consider a system to be operating in a data-rich environment when measurements of system inputs and outputs are frequently available. Two particular application examples which illustrate the power of these techniques will be examined. The first example that will be described involves the development and testing of a real-time adaptive controller for simultaneous regulation of mean arterial pressure and cardiac output using two drugs. The second application of these techniques involves the real-time control of electrical stimulation for the functional use of paralyzed muscles in neuroprosthetic devices. PMID- 3677631 TI - A workstation for multi-dimensional display and analysis of biomedical images. AB - The capability to extract objective and quantitatively accurate information from 3-D radiographic biomedical images has not kept pace with the capabilities to produce the images themselves. This is rather an ironic paradox, since on the one hand the new 3-D and 4-D imaging capabilities promise significant potential for providing greater specificity and sensitivity (i.e. precise objective discrimination and accurate quantitative measurement of body tissue characteristics and function) in clinical diagnostic and basic investigative imaging procedures than ever possible before, but on the other hand, the momentous advances in computer and associated electronic imaging technology which have made these 3-D imaging capabilities possible have not been concomitantly developed for full exploitation of these capabilities. Therefore, we have developed a powerful new microcomputer-based system which permits detailed investigations and evaluation of 3-D and 4-D (dynamic 3-D) biomedical images. The system comprises a special workstation to which all the information in a large 3 D image data base is accessible for rapid display, manipulation, and measurement. The system provides important capabilities for simultaneously representing and analyzing both structural and functional data and their relationships in various organs of the body. This paper provides a detailed description of this system, as well as some of the rationale, background, theoretical concepts, and practical considerations related to system implementation. PMID- 3677632 TI - Design of a medical image management system: a practical cost-effective approach. AB - The impact of technology and economics is driving radiology departments into a digital era. There have been significant developments in the design of Medical Image Management System components. However, many important design criteria have been neglected, leading to an ineffective end product. This paper will discuss the more important design criteria. The design will be considered from the user's point of view. The implementation of a prototype Medical Image Management System (MIMS) serving a Medical Intensive Care Unit in our Institution will be presented. The structure and very preliminary results of a clinical evaluation will be discussed. Plans to expand the MIMS beyond the Department and the Hospital will also be briefly discussed. The role of the personal computer in the design of a MIMS will be reviewed. PMID- 3677633 TI - Transaction processing using remote procedure calls (RPC) for a heterogeneous distributed clinical information system. AB - The Johns Hopkins Hospital is developing a distributed clinical information system that integrates functionally several UNIX, IBM MVS/CICS and MUMPS computer systems. Distributed application development is accomplished by interprocess communications across Ethernet using remote procedure calls. The remote procedure call (RPC) protocol provides a standard approach to the development of distributed applications using the metaphor of a subroutine call. The Sun Microsystems RPC and XDR (external data representation) protocols have been implemented in these environments. The systems, the distributed model, RPC implementations and applications examples are discussed. PMID- 3677634 TI - The regulation of medical computer software as a 'device' under the Food, Drug, and Cosmetic Act. AB - Recent developments in computer software have raised the possibility that federal regulators may claim to control medical computer software as a 'device' under the Food, Drug and Cosmetic Act (FDCA). The purpose of this paper is to analyze the FDCA to determine whether computer software is included in the statutory scheme, examine constitutional arguments relating to computer software, and discuss regulatory principles that should be taken into account when deciding appropriate regulation. This paper is limited to computer program output used by humans in deciding appropriate medical therapy for a patient. PMID- 3677635 TI - Medical computers from the manufacturer's viewpoint. AB - The recent surge in the scope of computer applications in medical care has brought with it great strides in patient care, but it has also created a variety of concerns to manufacturers of medical software. The spate of product liability suits, with its potentially crippling effects in terms of product development, makes it increasingly vital that manufacturers engage in prospective planning, to anticipate problems and take steps before legal action ensues, so that all parties--the manufacturer, the hospital, and ultimately, the patient--benefit from the availability of new technology. The Food and Drug Administration (FDA) and Congress are similarly grappling with the implications of this new technology, to assure that patient care is not compromised by products that have not yet been fully tested. The tension between the desire to make technology available to the public and the realities of the present regulatory and litigious climate is the key dilemma facing manufacturers of medical software. PMID- 3677636 TI - [Survey on nursing actions related to excretion--patients' psychology and nursing actions]. PMID- 3677637 TI - [For better nursing education. Part II. A trial in education to teach a basic attitude necessary for nursing personnel--teaching of humanistic nursing]. PMID- 3677638 TI - [For better nursing education. Part III. The role of teachers in clinical training--observation of two teaching processing]. PMID- 3677640 TI - [Evaluation of hematological and urinalysis data from a nursing viewpoint--as part of nursing assessment]. PMID- 3677639 TI - [Psychocybernetics and nursing]. PMID- 3677641 TI - [For better nursing education. Part I. Start from nursing experiences which constitute the basis of nursing philosophy]. PMID- 3677642 TI - [Learning from the profession--my method for self-enlightenment]. PMID- 3677644 TI - Leg ulcers. Healing information. PMID- 3677643 TI - [Definition of psychiatry--establishment of scientific psychiatry (8)]. PMID- 3677645 TI - Incontinence: too ashamed to tell. PMID- 3677646 TI - And so to beds. PMID- 3677647 TI - Supporting the family: village volunteers. PMID- 3677648 TI - Immunisation: vital jabs. PMID- 3677649 TI - Vietnamese refugees: slow boat to Southwark. PMID- 3677650 TI - Maternity benefits: a woman's lot. PMID- 3677652 TI - Leg ulcers. An underlying problem. PMID- 3677651 TI - Mental handicap: as the tide turns. PMID- 3677653 TI - Incontinence: doing it yourself. PMID- 3677655 TI - Contact dermatitis in Nigeria. (III). Dermatitis of the neck. AB - Out of 545 consecutive contact dermatitis clinic patients, 73 (13%) had dermatitis of the neck of whom 18 (25%) were nickel positive. 7 had clothing dermatitis and 3 of them reacted to chromate in military uniforms. 5 patients were sensitised to perfume and 4 to medicaments used to treat existing dermatitis. 3 patients were sensitised to hair dyes. Nickel dermatitis, was clinically overdiagnosed, mainly due (for various reasons) to inability to make a firm diagnosis of atopy. PMID- 3677654 TI - Is sesamol present in sesame oil? AB - Sesame oil has been reported to contain sesamolin, sesamin and sesamol as contact allergens. A female patient had cheilitis due to sesame oil in a lipstick. She reacted to sesamolin and sesamin, but not to sesamol. We carried out analysis of the sesame oil by high performance liquid chromatography. We detected sesamolin and sesamin but not sesamol in sesame oil. PMID- 3677656 TI - Contact dermatitis in Nigeria. (IV). Dermatitis of the feet. AB - Contact dermatitis of the feet is common in Nigeria. 136 patients with dermatitis of the feet were investigated; 83 had positive patch tests. 59 to chemicals in shoes; 22 reacted to rubber chemicals and 16 to chromate, 53 had negative patch tests. The causal mechanisms and treatment methods are described. PMID- 3677657 TI - Desensitization to DNFB in hairless mice. AB - Naive hairless mice may be rendered partly tolerant to dinitrofluorobenzene (DNFB) by painting DNFB on skin irradiated with 30 mJ.cm-2 ultraviolet B light (UVB) over 4 days. However, DNFB-sensitized hairless mice show no decrease in sensitivity when repainted with DNFB on skin irradiated with the same dose of UVB. Hence, established hypersensitivity appears not to be reduced by this method of inducing tolerance in naive mice. PMID- 3677658 TI - Sensitivity to sunscreens. AB - The patients sensitised to sunscreen agents who attended our Contact Dermatitis Clinic between February 1985 to March 1987 have been reviewed. 15 (5%) of 280 patients tested with sunscreens had positive reactions; 3 of them were allergic to more than one agent. The most frequent contact allergens were hydroxy methoxy methyl benzophenone (Mexenone) [6], followed by isopropyl dibenzoylmethane (Eusolex 8020/8021) [5], octyl dimethyl para-aminobenzoate (Escalol 507) [2], and one reaction each to butyl methoxy dibenzoylmethane (Parsol 1789), amyl dimethyl para-aminobenzoate (Escalol 506), and ethoxy ethyl-p-methoxy cinnamate (Givtan F). Positive photopatch tests were seen with isopropyl dibenzoylmethane, butyl methoxy dibenzoylmethane, para-aminobenzoate (PABA) and ethoxy ethyl-p-methoxy cinnamate, one reaction each. PMID- 3677659 TI - Propolis allergy. (II). The sensitizing properties of 1,1-dimethylallyl caffeic acid ester. AB - As shown in the preceding paper, propolis or bee-glue is the cause of an increasing number of allergic reactions in persons using it in external preparations and cosmetics. Propolis and its main contact allergen, 1,1 dimethylallyl caffeic acid ester, designated LB-1, show strong sensitizing properties in patients as well as in guinea pig experiments. 9 patients have been patch tested with this compound, 8 of whom reacted strongly. Chemical separation of different propolis samples and poplar bud extracts reveal that LB-1 is always present. Poplar bud secretion is the bee's major source for propolis and hence the origin of LB-1. A warning is indicated, in agreement with several other authors, that propolis should not be used in topical products because of its strong sensitizing properties. PMID- 3677660 TI - Skin absorption from patch test systems. AB - The development of topical drug products requires testing for skin toxicology reactions. A variety of patch test systems are available with which chemicals are applied to skin. The purpose of this study was to determine the skin absorption of paraphenylenediamine (PPDA) from a variety of such systems. [14C]-PPDA (1% pet., USP) was placed in a variety of patch test systems at a concentration normalized to equal surface area (2 mg/mm2). Skin absorption was determined in the guinea pig by urinary excretion of 14C. There was a six-fold difference in the range of skin absorption (p less than 0.02). In decreasing order, % skin absorption from the systems were Hill Top Chamber (53.4 +/- 20.6) greater than Teflon Control patch (48.6 +/- 9.3) greater than Small Finn Chamber with paper disc insert (34.1 +/- 19.8) greater than Small Finn Chamber (29.8 +/- 9.0) greater than Large Finn Chamber (23.1 +/- 7.3) greater than AL-Test Chamber (8.0 +/- 0.8). Thus, the choice of patch system could produce a false negative error if the system inhibits skin absorption, with a subsequent skin toxicology reaction. PMID- 3677661 TI - Immunologic contact urticaria to fish. PMID- 3677662 TI - Contact urticaria from nickel. PMID- 3677663 TI - Kathon CG. PMID- 3677664 TI - Nickel allergy. PMID- 3677665 TI - Utility of emergent computed tomograms of head in diagnosis and patient management. PMID- 3677666 TI - Immediate and long-term results of vertical banded gastroplasty for morbid obesity. PMID- 3677667 TI - Surgery for thyroid cancer: recommendations versus reality. PMID- 3677668 TI - Investigation of a cluster of appendicitis cases--Texas. Centers for Disease Control. PMID- 3677669 TI - Update on influenza activity worldwide and World Health Organization and United States recommendations for influenza vaccine composition for the 1987-1988 season. PMID- 3677670 TI - Report of the Special Task Force on Professional Liability and Insurance and the Advisory Panel on Professional Liability. AMA Board of Trustees. PMID- 3677671 TI - Imaging studies: on request or by direction? PMID- 3677672 TI - AIDS is first a medical and public health problem. PMID- 3677673 TI - Reflections on medicine. Last things: planning ahead. PMID- 3677674 TI - Confidentiality and AIDS. PMID- 3677675 TI - Postcoital contraception with dl-norgestrel/ethinyl estradiol combination: six years experience in a student medical clinic. AB - Postcoital contraception with ethinyl estradiol/dl-norgestrel in combination has been available to women students attending the University of British Columbia since 1974. This paper reports on the side effects, cycle control and efficacy, for a six-year period (1979-1985). In this sample of women 50% reported side effects of nausea alone or nausea with vomiting. Length of the menstrual cycle was shortened in women who took the medication prior to the expected day of ovulation. The number of pregnancies reported was significantly (p less than 0.002) less than the number expected had the medication not been taken. Some women took the medication even though there was a possibility of conception earlier in the cycle and this might account for four of the failures. The mode of action of the postcoital medication remains unsolved making it difficult to understand possible reasons for the other 14 failures. PMID- 3677676 TI - The effect of acetylsalicylic acid on menstrual blood loss in women with IUDs. AB - Fifty-three volunteer women using Copper T 220C IUDs, complaining of increased menstrual bleeding, received per os 1 g, three times a day, of acetylsalicylic acid, for 5 days, during their menstrual periods. Menstrual bleeding for each patient was measured at least once before treatment. Bleeding estimates were also performed from the second to the fifth treatment cycle. From the 53 women admitted to the study, only 13 subjects (24.7%) had pre-treatment menstrual bleeding of more than 80 ml; 40 subjects had less than 80 ml. The group with hypermenorrhea had slightly decreased (not significant) the amount of menstrual blood loss with acetylsalicylic acid intake. On the other hand, 67.1% of women with bleeding less than 80 ml observed a significant increase in menstrual blood loss. PMID- 3677677 TI - The influence of different copper wires on human sperm penetration into bovine cervical mucus, in vitro. AB - The influence of four different copper-containing intrauterine devices (IUD) (Nova-T, Multiload, Fincoid 250 and copper-T 250) on the penetration of human sperm into bovine cervical mucus were assessed. Pooled samples of predetermined sperm concentration were suspended in Earl's medium in which a copper IUD was previously incubated for periods between one hour to fourteen days. The mean copper concentration was determined for each of the medium containing IUD and was found to be between 284 +/- 93 micrograms/100 ml to 392 +/- 138 micrograms/100ml. While there was no adverse effect on sperm motility by the copper-containing medium, there was a significant reduction in the number of sperm penetrated into the bovine cervical mucus as compared to the penetration of sperm suspended in pure Earl's medium. It therefore seems that the influence of copper on sperm penetration might be by an effect on the environment or spermatozoal migration rather than by direct effect of copper on sperm motility. PMID- 3677678 TI - Influence of vitamin E administration on platelet functions in hormonal contraceptive users. AB - Platelet functions (aggregation, clotting activity), platelet lipid biosynthesis, sterol composition and phospholipid fatty acids were studied in relation to plasma lipids and fatty acids as well as dietary habits at day 5 and 21 of the menstrual cycle in 30 women having used hormonal contraceptive for several years. The women were studied again on day 21 of the second cycle after they had taken for two months 200 mg vitamin E per day in addition to the contraceptive. At day 21 (after 3 weeks of hormonal contraceptive) as compared to day 5, there was a significant increase in the clotting activity of platelets and the response to ADP-induced aggregation concomitant with a decrease in plasma vitamin E. After vitamin E administration, platelet activity at day 21 was markedly decreased, being similar to the activity at day 5, with a significant increase in the level of vitamin E in plasma and platelets. The high response of platelets to aggregation in women using contraceptives does not seem to be associated with the intake of saturated fat but rather with that of 18:2. The aggregation to thrombin was mostly related to lanosterol biosynthesis and the aggregation to ADP to platelet cholesterol, but not to plasma lipids or apoproteins. The present pilot study suggests that the platelet hyperactivity of long-term hormonal contraceptive users might be dependent upon a low level of platelet alpha tocopherol which can be rapidly overcome by giving a supplement of vitamin E. PMID- 3677679 TI - Effect of oxytocin on plasma testosterone levels in the male macaques (Macaca fascicularis). AB - The effect of oxytocin on testicular function was examined in the adult male long tailed macaques (Macaca fascicularis). The monkeys were either infused with increasing concentrations of synthetic oxytocin (16-128 m.i.u./min for 3 h) or injected daily for a week with the same hormone (20 i.u., i.v.) and the plasma testosterone levels measured. The results of the present study show that acute infusion or chronic injection of oxytocin does not significantly affect the plasma testosterone levels, suggesting that systemic control of testicular endocrine function by oxytocin may be unimportant. PMID- 3677680 TI - Pregnancy following minilaparotomy tubal sterilization--an update of an international data set. PMID- 3677681 TI - Peritonitis in CAPD. PMID- 3677682 TI - Bacterial peritonitis in CAPD: pathogenesis, symptoms, therapy and progress. PMID- 3677683 TI - Morbidity of fungal peritonitis. PMID- 3677684 TI - Fungal peritonitis in CAPD--which treatment is best? PMID- 3677685 TI - Results of electron microscopic studies of peritoneal dialysis catheters: conclusions for peritonitis therapy. PMID- 3677686 TI - Straight Tenckhoff catheter implantation technique. PMID- 3677687 TI - Design criteria for artificial percutaneous leads, with emphasis on the comparison between the Tenckhoff catheter and the Berlin catheter. PMID- 3677688 TI - Efficacy of 'disinfectants' frequently used in dialysis. PMID- 3677689 TI - Prevention of peritonitis: filter or UV system? PMID- 3677690 TI - Experience with the Travenol ultraviolet germicidal exchange system. PMID- 3677691 TI - Y-system with disinfectant in the prevention of peritonitis in CAPD. PMID- 3677692 TI - Quantitative in vitro contamination and recovery studies: the flush principle in CAPD. PMID- 3677693 TI - Does CCPD lower the peritonitis rate? PMID- 3677695 TI - Sclerosing encapsulating peritonitis in rats: an experimental study with intraperitoneal antiseptics. PMID- 3677694 TI - Role of acetate in loss of ultrafiltration during CAPD. PMID- 3677696 TI - Peritoneal membrane failure as a determinant of the CAPD future. An epidemiological, functional and pathological study. PMID- 3677697 TI - Bacterial peritonitis in IPD: pathogenesis, symptoms, therapy and progress. PMID- 3677698 TI - Sclerosing encapsulating peritonitis in children. PMID- 3677699 TI - Bacterial peritonitis in surgery: pathogenesis, symptoms, surgical therapy, peritoneal lavage and progress. PMID- 3677700 TI - Structure of the peritoneum and changes brought about by infection. PMID- 3677701 TI - Bacteriological spectrum of CAPD peritonitis. PMID- 3677702 TI - Changes of eicosanoid metabolism in CAPD-associated peritonitis. PMID- 3677703 TI - Risk factors for peritonitis and technique failure in CAPD: increased age and dialysate IgG protect against peritonitis. PMID- 3677704 TI - Slime production by coagulase negative staphylococci--a major virulence factor? PMID- 3677705 TI - Phagocytic defence against CAPD peritonitis. The bacterium, the phagocyte, and the doctor. PMID- 3677706 TI - Treatment of peritoneal infection by the natural defences of the peritoneal cavity. PMID- 3677707 TI - Rumen collapse in cattle. AB - Simultaneous auscultation and percussion of the bovine abdomen is a standard physical diagnostic tool employed to detect gas and fluid distention within an organ such as a displaced abomasum or dilated cecum. Such distension results in an area of tympanic resonance or ping. A previously unreported condition--rumen collapse--may also cause a left-side abdominal ping that can easily be misdiagnosed as left displacement of the abomasum. Associated medical problems causing complete anorexia may lead to the rumen collapse syndrome in cattle. Differentiation of rumen collapse from displacement of the abomasum is important since cattle with rumen collapse require only medical therapy, and surgical intervention is not necessary. PMID- 3677708 TI - Thiamine deficiency encephalopathy with concurrent myocardial degeneration and polyradiculoneuropathy in a cat. AB - Hyaline degeneration, myofiber fragmentation, and mineralization were present in the left ventricle of an aged, female Siamese cat with both clinical and histopathological evidence suggestive of a thiamine deficiency encephalopathy. Both a thiamine related biochemical lesion and neurogenic myocardial degeneration ("Brain-Heart" Syndrome) may have contributed to the development of the heart lesions. A concurrent lumbar polyradiculoneuropathy, characterized by ballooning myelin sheaths with axonal degeneration, was considered an incidental, age related finding. PMID- 3677709 TI - Infiltrative lipoma in the heart of a horse. AB - An expansile, yellow, soft mass was observed in the free wall of the right ventricle of a 3-year-old, male, Morgan, horse at necropsy. The mass was composed of well differentiated adipocytes in solid sheets or infiltrating between muscle fibers with associated myofiber degeneration. The mass was interpreted to be an infiltrative lipoma of the heart. PMID- 3677710 TI - Immune-mediated hemolytic anemia induced by penicillin in horses. AB - Three horses developed severe, immune-mediated hemolytic anemia after treatment with penicillin. The horses had positive direct antiglobulin (Coombs) tests and high titers of IgG antibody that agglutinated penicillin-coated equine red cells. Two of the horses were tested for antibodies to autologous red cell antigens; autoantibodies were not present. Titers of antipenicillin antibody decreased after penicillin was discontinued but IgG antibody was detectable months after recovery. One of the horses was challenged with penicillin; antibody titer increased slightly, but anemia did not develop. Antipenicillin antibody of the IgM class was present in low titer in 23 (77%) of 30 non-anemic horses tested. Apparently, the horse is similar to man in that penicillin-induced anemia is rare but the percentage of individuals with antipenicillin antibody is high. PMID- 3677711 TI - Background lead levels in dairy cattle: updated values for 1986. AB - Lead poisoning continues to be a problem in cattle. The toxicologic significance of blood lead levels requires the differentiation of background blood lead from toxic levels. A ten-fold variation of background blood lead levels reported in previous studies has prompted us to conduct our own survey. Our results indicate significantly lower background blood lead levels in New York State cattle analyzed in 1986 than in those levels previously reported elsewhere. PMID- 3677712 TI - Bovine superfetation by natural conception secondary to an embryo transfer pregnancy. AB - There was only one embryo transferred to the recipient female. There was no chance for natural service to occur from 21 days prior to the transfer of the embryo to 31 days after the transfer of the 7 day old blastocyst. The surrogate female was palpated as being 38 days pregnant 31 days after the transfer of a 7 day old embryo by an experienced professional before being exposed to the natural service sire. The second fetus was of a different sex than the first and was approximately 60 days less mature. All other pregnancies within this well managed herd were accounted for and no other cows calved within the area close to that time. The remaining recipients carried pregnancies to the approximate expected calving date. Conclusion. This case report should support earlier evidence that superfetation in the bovine can and does occur. PMID- 3677713 TI - Ivermectin kills ascarids but not rumors. PMID- 3677714 TI - The dynamics of healing processes in the heart muscle in acute myocardial infarction. AB - Healing processes in the myocardium in acute myocardial infarction (AMI) were assessed by dynamic monitoring of changes in the levels of collagen metabolites- free (FO) and peptide-bound (PBO) oxyproline--in 50 patients and in 30 healthy controls. Basic parameters of protein metabolism using radionuclide markers were determined simultaneously with FO and PBO values in 33 patients with AMI. The following changes in the blood levels of collagen metabolites were found: FO level increased in the acute stage of MI and correlated with the parameters of protein degradation; PBO level increased in the subacute stage of disease in a close correlation with protein synthesis parameters. Dynamic monitoring of PBO level can thus be used to assess the rate of healing processes in the myocardium. PMID- 3677715 TI - 5- and 10-year mortality in a rural middle-aged population at Haapavesi, Northern Finland, with special reference to ischaemic heart disease. AB - As a part of a larger prospective population study of ischaemic heart disease (IHD) the causes of 5- and 10-year mortality were analysed in 1554 rural inhabitants aged 40 to 59 years (90.0% of the population of this age group) in Northern Finland. The total mortality in 5 years was 2.3% among women and 6.3% among men. The respective 10-year mortality figures were 6.2% and 13.4%. The proportion of IHD as a cause of these deaths among women was 35% and 34% in 5 and 10 years, respectively; among men 46% and 46% of the deaths were due to IHD in 5 and 10 years, respectively. Among women the proportion of strokes was 22% and 19% in 5 and 10 years, respectively; the other causes of death among women amounted to 43% and 47% in 5 and 10 years, respectively. Among men, strokes resulted in the death of 14% and 7% in 5 and 10 years, respectively, the other causes of death amounted to 40% and 47% in 5 and 10 years, respectively. The incidence of IHD as a cause of death among women was higher than previously reported. PMID- 3677716 TI - Value of electrocardiography and echocardiography for diagnosing ventricular enlargement in dilated cardiomyopathy. AB - A comparison is made of the informative value of ECG voltage criteria, echocardiographic signs (90 cases) and autopsy findings (38 cases) for diagnosing heart enlargement in dilated cardiomyopathy. Besides enlargement of both ventricles there can also occur predominant enlargement of the left or right ventricle. Echocardiographic signs of the ventricular dimensions correlate closely with the ventricular mass established by separate weighing at autopsy. 65.5% of the patients presented one or several ECG voltage signs of myocardial hypertrophy. Comparison of the results of instrumental examination with autopsy findings showed that EchoCG and ECG have a sufficiently high informative value in assessing the degree of left ventricular enlargement; however, their sensitivity is smaller in enlargement of the right ventricle. PMID- 3677717 TI - [The physiologic 3d heart sound in childhood. Determination in phonocardiography and assessment by auscultation]. AB - The phonocardiographic characteristics of the IIIrd heart sound in children, accepted in the literature, are examined. In 231 out of 687 children with a normal heart, aged from hour 0 to 17 years, the IIIrd heart sound (HS) was phonocardiographically registered in the t and m1 frequency band. The findings on the frequency, sound frequency, sound duration, intervals II-III and T-III, and IIIrd HS amplitude related to the Ist and IInd HS amplitudes are compared with data in the literature. The audibility of the IIIrd HS increases with its low frequency equal or higher than 25 Hz, and its amplitude reaching or exceeding one quarter of the preceding Ist HS and one-third of the preceding IInd HS. PMID- 3677718 TI - Right atrial mobile thrombi: two-dimensional echocardiographic diagnosis and clinical outcome. AB - Four patients with pulmonary embolism and right atrial mobile thrombi (RAMT) are described. One patient died during intravenous heparin treatment because of a "saddle" pulmonary artery embolus, another died from surgical complications after successful embolectomy. One of the two survivors was treated with intravenous streptokinase and the other with intravenous heparin. Echocardiographically detected RAMT seems a reliable sign of impending massive pulmonary embolism. Pulmonary angiography is unnecessary and may be dangerous. Surgical removal of RAMT, fibrinolytic treatment or intravenous heparin introduced promptly may be lifesaving. PMID- 3677719 TI - Light microscopy of sinoatrial node ischaemia. AB - Ischaemia of the sinoatrial node (SAN) region was produced in 57 dogs by obstructing the sinoatrial nodal artery by injecting it with various media. In the light microscope ischaemia of the nodal cells resulted in myocytolysis. The cells were oedematous, with a distinctly cleared cytoplasm and cytoplasmic vacuolization. Macrophages penetrated into the nodal cells. Myocytolysis resulted either in disintegration of the cell membrane and the nucleus or in atrophy of nodal cells. The damaged cells were gradually replaced with collagenous connective tissue. Ischaemic changes in the light microscope appeared between hours 3 to 24 after the onset of ischaemia and continued to develop for a period of 4 to 5 weeks showing a variable intensity in different areas of the SAN region. The process became virtually stabilized between months 1 to 7. The degree of ischaemia was most probably responsible for the fact that changes of various degree--myocytolysis, atrophy and fibrosis--were present simultaneously. The preservation of ganglion cells in ischaemic tissue is discussed. PMID- 3677720 TI - The impact of butyric acid on the cardiovascular system. AB - The influence of sodium salt of butyric acid (C4H7NaO2) on the functional state of the cardiovascular system was studied on 12 guinea-pigs and 15 rabbits by the thermodilution method. The following parameters were determined: cardiac output (CO), arterial blood pressure (AP), total peripheral vascular resistance (TPVR), and in rabbits the heart rate (HR). It was found that butyric acid induces significant changes in TPVR, which correlate with changes in CO and AP. These changes could to a considerable extent be prevented by the administration of indomethacin. Haemodynamic changes induced by butyric acid are primarily connected with changes in vascular tonus, induced by the action of F2 alpha prostaglandins whose synthesis is intensified by the influence of butyric acid. PMID- 3677721 TI - The biology of wound healing in the corneal stroma. Castroviejo lecture. AB - The healing and remodeling of a stromal incision in described at the gross, fibrillar, and cellular levels. The possibility that the healing of the wound and the clearing of the scar can be accelerated by biological interventions is discussed. Castroviejo Lecture was given on November 9, 1986. PMID- 3677722 TI - Mycobacterium avium-intracellulare corneal ulcer. AB - A healthy 28-year-old man developed a slowly progressive corneal ulcer 21 months after an episode of corneal trauma. Acid-fast bacilli were identified in corneal scrapings, and the causative organism was identified as Mycobacterium avium intracellulare. Medical treatment with topical amikacin and oral rifampin was ineffective, and a therapeutic penetrating keratoplasty was necessary to cure the infection. To the best of our knowledge, this is only the second reported case of a corneal infection caused by a slow-growing nontuberculous mycobacterium (Runyon groups I, II, and III) and the first caused by M. avium-intracellulare. Slowly growing nontuberculous mycobacteria should be considered among those organisms that cause corneal infection, especially in cases characterized by a protracted course and lack of response to conventional antimicrobial therapy. PMID- 3677723 TI - Actin filament localization in developing and pathologic human corneas. AB - Actin is associated with motility, cell morphology, and cell-substrate adhesion. The molecular probe NBD phallacidin, which reacts with filamentous actin, was used to study the distribution of actin filaments in the corneal and conjunctival epithelium, stroma, and endothelium. Frozen sections of human fetal eyes from 8 weeks to 40 weeks of gestation were reacted with NBD phallacidin. Pathologic tissues included keratoplasty specimens from patients with hereditary posterior polymorphous corneal dystrophy (PPMD) and surgically excised tissues removed for treatment of epithelial down-growth. Normal human cornea was used as a control. Immunofluorescent staining disclosed actin filament distribution in corneal epithelium as early as 9-10 weeks of gestation. Staining increased with maturation until term. Adult human corneal epithelium showed more pronounced staining of the surface layers. Stromal staining was more extensive in earlier stages of gestation and decreased in later stages of gestation, after 20-21 weeks. In pathologic corneas with posterior polymorphous dystrophy, there was localization of actin, as well as keratin, in the abnormal epithelial-like layers lining the posterior cornea. In epithelial downgrowth, actin and keratin were demonstrated in multilayered squamous epithelium on the anterior iris surface. Actin appears to be involved in migration of corneal epithelial and endothelial cells. PMID- 3677724 TI - Myopic hydrogel keratophakia. Improvements in lens design. AB - In order for a refractive surgical procedure to be generally accepted, it must give a predictable result as well as generate a suitable optical surface. Previously, in a non-human primate model, we showed that hydrogel intracorneal lenses could flatten the cornea and thereby be used as a potential treatment for myopia. Over 20 D of central corneal flattening was observed in some cases. It was evident that the major corneal flattening occurred only in a very small area covered by the first corneascopic ring and that this area was irregular in that an elliptical reflection was generally obtained. We herein present the results of myopic hydrogel lens design modification. By enlarging the size of the lens and optical zone, the central corneal flattening became more regular as judged by corneascopic analysis. With the most recent lens designs, animals with high-minus implants showed circular corneascopic images with an average of 10.0 D of central flattening. This observation of corneal flattening was confirmed with autorefractor readings (average, -8.5 D) and keratometric readings (average, -9.0 D). These results are compared with earlier lens implants 5.5 mm in diameter where flattening was documented by reading the central corneascopic ring and could not be confirmed with either keratometric or autorefractor data. We feel these preliminary attempts at lens design modification have significantly enhanced the potential for future clinical application of this technique. PMID- 3677725 TI - Keratophakia--postoperative astigmatism. AB - Forty-nine cases of primary keratophakia and 13 cases of secondary keratophakia were analyzed for postoperative astigmatism. For primary cases, the surgically induced astigmatism was 1.55 D, whereas for secondary cases it was 0.19 D (insignificant). There was a tendency for both procedures to induce against-the rule astigmatism, and both procedures were found capable of producing irregular astigmatism. PMID- 3677726 TI - Comparative tonometric measurements of eye bank eyes. AB - A comparison was made of the accuracy of the Tono-Pen, Pneumatonometer, and Perkins hand-held tonometers by measuring the hydrostatically controlled intracular pressure from 10 to 50 mm Hg in human eye bank eyes. The open stopcock method was used in which the cannulated eye, the hydrostatic pressure controlling column, and a manometer were continuously open to each other. The Pneumatonometer gave accurate results at 50 mm Hg but overestimated the lower intraocular pressures; whereas, the Perkins gave satifactory results at 10 and 20 mm Hg but underestimated higher intraocular pressures. The Tono-Pen displayed the least deviation from the controlled pressure over the entire range studied. Another aspect of this study involved determining that a therapeutic soft contact lens did not have any noticeably adverse effect on the accuracy of the Pneumatonometer and Tono-Pen tonometers. PMID- 3677727 TI - Auditory syntactic comprehension in nine aphasia groups (with CT scans) and children: differences in degree but not order of difficulty observed. AB - Auditory syntactic comprehension was examined in nine groups of aphasics (60 stroke cases) and 3 and 6 year old children. Ten syntactic contrast pairs were studied. Differences in degree but not order of difficulty were observed. The 5 easier pairs were Gender; On/Under; Negative/Affirmative; Object-number; Subject number; the 5 more difficult pairs were Past/Present; Subject/Object Reversible; Is/Are; Relative Clause; and Future/Present. The "marked" half-pair was significantly more difficult--i.e., Negative vs. Affirmative; Plural vs. Singular Subject; Future or Past vs. Present. Performance on the test was significantly correlated with the BDAE Auditory Comprehension z-score and Token Test. The 3 year old children most closely resembled the Severe Wernicke's (but were better than the Globals), and the 6 year old children were similar to aphasia cases with mild comprehension deficits and frontal or parietal perisylvian lesions which spared most of Wernicke's area. Wernicke's area (posterior two-thirds superior temporal gyrus area) appears to be the area most sensitive to auditory syntactic comprehension. However, the surrounding perisylvian areas including frontal and parietal lobes are also areas sensitive to syntactic comprehension. PMID- 3677728 TI - Differential accuracy of aimed movements to visual and somatic targets in young children. AB - Children, aged 2.5-8 years, were required to touch accurately a target located either on their bodies or on the chair in which they sat. Movements were made when visual information was: 1. complete (target lit for 3 s, room illuminated); 2. partial (target lit for 3 s, room dark); 3. reduced (target lit for 0.7 s, room dark); and finally, when the target was somatically specified. Movements to visible targets did not differ in any important way as a function of target location with respect to on/off body. Accuracy improved with age to visually but noto somatically specified targets, decreased with decreasing availability of visual information, and was poorest to somatically specified targets. We conclude that during development, the sense-modality through which the target is specified and the visibility of the arm/hand during the movement, but not the personal/extra personal visible space in which the target is located, are important determinants of reaching performance. PMID- 3677729 TI - Dichaptic-visual form matching in adults. AB - Although previous visuo-dichaptic matching studies report hemispheric asymmetries in spatial-form perception, more recent studies have failed to support these findings. Three cross-modal matching experiments examined hemispheric asymmetries in adult spatial-form matching. In the first experiment, subjects simultaneously felt two eight-point or 12-point tactile shapes patterned after Vanderplas and Garvin (1959) for four seconds and were then required to identify both shapes from a visual response array. Results showed subjects were significantly better identifying eight point shapes. A marginally significant feeling hand by pointing hand interaction indicated that recognition accuracy was higher when shape ipsilateral to the pointing hand was identified. In the second experiment, only one of the two tactile shapes had to be identified from the visual array. Results showed a significant interaction between complexity and feeling hand, where the left and right feeling hands were respectively better at identifying 12-point and eight-point shapes. The third experiment was an attempt to more directly examine the Witelson (1976) experiment using her spatial-form stimuli. Results showed no significant laterality nor stimulus-response compatibility effects. These findings are discussed in terms of cerebral asymmetry and stimulus-response compatibility models. PMID- 3677730 TI - Race categorization and face recognition stages in the processing of laterally displayed unknown faces. AB - Bruyer and Dussart (1985) have recently shown that the "race effect", i.e. the difficulty in recognizing faces issuing from an ethnic group different from that of the subject, is limited to the right visual field. They suspected familiarization to be responsible for this asymmetry. In Exp. I, we tested this hypothesis by repeating the experiment of Bruyer and Dussart with a greater number of trials. A sample of 16 subjects were given the task of recognizing black and white faces laterally displayed for 180 msec. No laterality effect appeared, and the race effect was observed to an equal degree in each hemifield at all stages of the experimental session. It could thus be that various kinds of familiarization must be distinguished. In Exp. II, with 16 new subjects, the black and white faces were mixed so that the subjects had first to perform racial categorization, then a recognition. This time, an advantage of the left field appeared, the race effect was larger in the right than in the left field, and the race effect decreased with familiarization in the left field only. Two complementary experiments with 24 and 16 subjects showed that this phenomenon was not explainable by laterality effects in the early racial decision operation, but well by a lateralized effect of tasks requirements. PMID- 3677731 TI - Age related differences in left and right hand skill and in visuo-spatial performance: their possible relationships to the hypothesis that the right hemisphere ages more rapidly than the left. AB - Young and old right handed people were disproportionately worse with their left hand when speed was stressed but showed no especial difficulty when accuracy of performance was emphasised. Both groups of people were also tested on the AH4 test of cognitive abilities. As frequently reported by Rabbitt, the old were disproportionately worse on the visuo-spatial part than on the verbal part compared with the young, even though both parts required "fluid" abilities and even though both were given under time constraints. There was no correlation amongst the elderly people between speed stressed deficits in their left hand performance and their deficits on the visuo-spatial part of the AH4. Both fine control of the left hand and fingers and visuo-spatial performance are likely to be mediated by the right cerebral hemisphere and the implications of these results for a variety of possible views about selective aging of the right hemisphere are discussed. PMID- 3677732 TI - A left hemisphere contribution to visuospatial processing. AB - Men with chronic, focal, unilateral missile injures of the brain--twenty-five with left hemisphere lesions (LH group) and twenty with right hemisphere lesions (RH groups)--and twenty-two control subjects were given two visuoperceptual and two visuospatial tests. The LH group was significantly impaired in relation to the control group on both the spatial tasks. A different pattern of dissociable perceptual and spatial deficits was found in the experimental groups: better preserved perceptual than spatial performance was observed more frequently in the LH group whereas the converse--relatively better spatial than perceptual performance--was more evident in the RH group. Double dissociations in performance on the two spatial tasks were found predominantly in the LH group. These findings suggest an important left hemisphere contribution to visuospatial processing and the possibility of a more focal representation of spatial abilities in the left hemisphere than in the right. PMID- 3677733 TI - Memory for spatial and temporal order in aphasics and right hemisphere damaged patients. AB - Sets of five photographs per item were presented successively in five vertically arranged frames to 53 aphasics, 27 right hemisphere damaged (RHD) patients and 18 normal subjects. Following the presentation of the five slides subjects were given a spatial and a temporal recognition task. In the spatial task subjects had to indicate which of two pictures of a probe had been nearer to the top of the vertically arranged set of frames. In the temporal task they had to indicate which of the two pictures of the probe had been presented earlier. Aphasics made significantly more errors than RHD and normals in both the spatial and the temporal task, while RHD were significantly impaired in comparison to the normal controls only in the spatial task. PMID- 3677734 TI - Age and evolution of language area functions. A study on adult stroke patients. AB - This study attempted to verify some of the hypotheses advanced to explain the repeatedly reported finding that non-fluent aphasics are younger than fluent aphasics. One hundred and ninety eight vascular patients with cerebral infarcts documented by CT-scan were investigated. Also in this sample fluent patients were older than non-fluent patients. Age was found not to differ according to lesion site (anterior versus posterior). Patients with extensive lesions were, on average, younger than those with more restricted damage. The most interesting finding was that more than half patients with anterior lesion had fluent aphasia and that were remarkably older than anterior patients presenting with the classical non-fluent picture. It is inferred that anterior language areas undergo some kind of progressive functional evolution with age, though not in the sense postulated by Brown and Jaffe. PMID- 3677735 TI - Lateralization of kinesthetically guided spatial perception. AB - The present study measured unimanual kinesthetic discrimination for the right and left thumb angular position of male and female right handers without left handed relatives. Each subject's discrimination threshold and constant error were obtained by the Method of Constant Stimuli. Subjects either made an active movement in assessing the standard thumb angle or were passive while the angle was set by the experimenter. Subjects either reported their decision orally or made a non-verbal movement. A difference was found between the thumbs in the direction of more sensitive kinesthetic discrimination by the left thumb (right hemisphere). The left thumb was found to have smaller discrimination threshold of angular position by about 20% over the right thumb. Sex, passive movement mode, and verbal response were not related to the lateralization effect. PMID- 3677736 TI - Lateral preferences and performance on non-verbal laterality tests in a normal population. AB - The goal of the present study was to determine if, in a normal population, handedness, footedness, eyedness, earedness and overall congruency across lateral preferences were predictive of perceptual asymmetry on non-verbal tasks. In Experiment 1, subjects had to decide whether a laterally presented facial expression matched a previously presented target. In Experiment 2, subjects had to determine whether the tone of voice heard on dichotic and binaural presentations was the same or different. Eye preference was the most successful variable in predicting both visual field and ear advantages. Knowledge of a person's eye preference however, did not allow for a very accurate prediction of perceptual asymmetry. Nonetheless, the findings suggest that eye preference should be taken into account in future non-verbal laterality studies. PMID- 3677737 TI - The disconnection in anomic aphasia between semantic and phonological lexicons. AB - PB, a right handed woman aged 26, has developed anomic language disturbances following right frontal and left temporal brain damage due to a road traffic accident. Her anomia shows exceptional features: it occurs in naming tasks in test conditions but not in continuous speech; it involves comprehension deficits but very few semantic errors in expression; it improves with phonemic, but not with semantic cues. These features, it is argued, indicate the disconnection between two intact lexicons: the semantic and the phonological. PMID- 3677738 TI - Naming errors in healthy aging and dementia of the Alzheimer type. AB - Naming errors were analyzed for healthy younger and older adults and patients with a diagnosis of senile dementia of the Alzheimer type (SDAT). Three types of errors were identified, varying in relatedness to the target word: near synonyms; semantically related naming errors; and unrelated naming errors. Older adults made relatively more related errors than did younger adults. SDAT patients were distinguished by the number of unrelated responses given. In addition, SDAT patients who scored within the normal range were identified by the high number of response attempts relative to the number of initial errors. We suggest that error patterns on naming tasks may potentially serve as clinical markers to distinguish healthy older persons with mild naming disorders from patients with SDAT. PMID- 3677739 TI - Transitive movements in a deafferented man. AB - It has not been determined if the performance of transitive movement requires sensory feedback from the limb to the brain. We tested a deafferented patient's ability to pantomime, imitate, and use actual objects in both eyes open and eyes closed conditions. Although his performance deteriorated when his eyes were closed, the major error made by this patient was the inability to correctly orient the instrument (or pretended instrument) toward the object of the instrument's action. PMID- 3677740 TI - Hemodynamic effects of digoxin during acute cardiac failure: a comparison in patients with and without acute myocardial infarction. AB - The hemodynamic effects of digitalis were examined in ten patients with acute cardiac failure. Administration of 10 micrograms/kg of digoxin iv resulted in significant increases in cardiac index, stroke volume index, and left ventricular stroke work index within one hour in five patients with acute myocardial infarction (AMI) and five patients with atherosclerotic heart disease without AMI. These increases were maintained 2 h after digoxin therapy. Indirect assessment of global myocardial oxygen supply (coronary perfusion pressure) and demand (heart rate X systolic arterial pressure X wedge pressure product) did not reveal adverse changes. Digoxin therapy results in rapid improvement in cardiac function during acute cardiac failure in patients with and without AMI. PMID- 3677741 TI - Erythrocyte electrolyte abnormalities. AB - In contrast to lymphocytes and skeletal muscle cells, erythrocyte electrolytes may be easily determined. In this study Na, K, and Mg concentrations in plasma and erythrocytes of 100 consecutive ICU patients were compared to evaluate their potential clinical usefulness. The predictive indices of electrolyte changes in plasma vs. those in erythrocytes were low for all of the electrolytes studied. The erythrocyte Mg assessment was particularly useful for the high frequency of abnormalities observed, because it was less affected than plasma Mg by such transitory clinical states as hemodilution or lipolysis. The erythrocyte K was less frequently altered; no patient with a high K deficit was studied, excluding one patient with Crohn's disease. Finally, abnormally high erythrocyte Na levels correlated closely with some pathologic status, in particular respiratory failure. PMID- 3677742 TI - Prevention of bradycardic responses to endotracheal suctioning by prior administration of nebulized atropine. AB - Endotracheal suctioning can elicit bradycardia and hypotension. We compared the effectiveness of nebulized atropine with that of parenterally administered atropine in preventing these responses. Six mechanically ventilated patients who reproducibly experienced a 20% or greater fall in resting heart rate exclusively with endotracheal suctioning were given three trials: a) inhaled atropine sulfate (0.05 mg/kg); b) inhaled saline aerosol (0.05 ml/kg); and c) atropine sulfate (1 mg, given im or iv). Mean heart rate fell from 114 +/- 10 to 45 +/- 5 beat/min with suctioning after the saline aerosol (p less than .001). Both nebulized and parenteral atropine sulfate prevented the bradycardic response in all six subjects (p less than .001). After nebulized saline, three patients also experienced a greater than or equal to 10 mm Hg fall in systolic BP. Both nebulized and parenteral atropine prevented the hypotensive response. Tachycardia occurred after parenteral atropine in all six patients, while only one episode of tachycardia was seen after nebulized atropine. Both parenteral and nebulized atropine can prevent bradycardia and hypotension elicited by endotracheal suctioning, but nebulized atropine may have a wider margin of safety at the doses used in this study. PMID- 3677743 TI - Active tuberculosis in the medical intensive care unit: a 15-year retrospective analysis. AB - Of approximately 6000 admissions to the Henry Ford Hospital medical ICU between October 1969 and September 1984, 61 (1%) had active tuberculosis (TB). Forty three (70%) of these 61 had acute respiratory failure (ARF). TB was considered to be the sole cause of ARF in 12 and contributory in 31. Eighteen patients with TB but without ARF were admitted for treatment of other critical illnesses. Alcoholism was present in 31 (51%) of the TB patients. Only one of 12 whose ARF was caused primarily by TB had a history of known TB at the time of admission. Important factors contributing to ARF in TB patients included Gram-negative pneumonia and/or sepsis, chronic obstructive pulmonary disease, prior TB with anti-TB medication noncompliance, and malignancy. Six patients were not suspected of having TB when admitted to the medical ICU; three patients who had not been treated for TB were found to have TB on autopsy. The inhospital mortality rate for all patients with TB requiring intensive care was 67%, but was 81% in those with ARF. PMID- 3677744 TI - Elevated pulmonary artery systolic storage volume associated with redistribution of pulmonary perfusion. AB - The possibility that an increased pulmonary arterial systolic storage volume (PASSV) correlates with a significant redistribution of pulmonary perfusion was examined in 30 surgical patients. Right ventricular stroke work index (RVSWI) was used as an index of distribution of pulmonary perfusion. The systolic storage volume was calculated from the pulmonary arterial compliance and mean pulmonary arterial distending pressure. Pulmonary arteriolar pressures were computed by Fourier analysis. Pulmonary arterial compliance was derived from the pulmonary arterial time constant and pulmonary arterial resistance. There was a linear relationship between PASSV and RVSWI (r = .81, p less than .001). Also, a direct correlation was found between RVSWI and pulmonary arterial time constant (r = .45, p less than .01). When the patients were divided into three groups according to the severity of pre-existing disease, linear relationships between PASSV and RVSWI were present in all groups, and the slopes were not different among the three groups. The patients were also divided into two groups based on a storage volume fraction of stroke volume index, to evaluate the effect of other hemodynamic data on the PASSV. Comparison of the two groups revealed that pulmonary arterial pressure and pulmonary arterial compliance were significantly higher in the group with a high storage volume fraction (p = .05 and p = .01, respectively). RVSWI and time constant were also significantly different between the groups (p less than .01 and p less than .01, respectively). We conclude that the pressure work generated by the right ventricle improved the distribution of pulmonary perfusion by increasing PASSV. PMID- 3677745 TI - Directly measured tissue oxygen tension and arterial oxygen tension assess tissue perfusion. AB - Mean subcutaneous tissue PO2 (PsqO2) measurements were obtained in dogs with an unheated electrode placed in an implanted Silastic tonometer, while PaO2 was increased in increments from 40 to 600 torr during normal, increased, and reduced blood volume. These changes reflect that the mean PsqO2 is approximately 10 torr below the PO2 of venous blood draining that tissue. Since PaO2 was already known, the oxygen content of arterial and venous blood entering and leaving this tissue could be determined by reference to blood-oxygen dissociation curves. Therefore, relative changes in blood flow could be calculated using the Fick principle. After a 20% blood loss, the PsqO2 measured during breathing of room air fell to 20% of baseline, corresponding to an 80% fall in sc blood flow; it remained low until the shed blood was returned despite compensatory changes in cardiac output. Rapid infusion of electrolyte solutions in normovolemic animals produced a temporary increase in local blood flow. Subcutaneous oximetry seems capable of quantifying peripheral perfusion and may be clinically useful. PMID- 3677746 TI - Endobronchial instillation of epinephrine during cardiopulmonary resuscitation. AB - We used a standard animal CPR model to study the effectiveness and hemodynamic response of 100 micrograms/kg epinephrine administered endobronchially and to compare the findings after conventional iv administration. Results showed that the endobronchial and iv epinephrine medication improved the survival rate by 100% compared to that of a control group receiving no medication. Although the hemodynamic conditions during cardiac compression were not significantly different after both routes of drug administration, endobronchial instillation produced a prolonged drug action during the first hour of restored spontaneous circulation. A more extensive use of this type of drug administration, especially in out-of-hospital resuscitation, is suggested. PMID- 3677748 TI - A technique for the administration of ribavirin to mechanically ventilated infants with severe respiratory syncytial virus infection. AB - Fifteen infants with respiratory syncytial virus pulmonary infection admitted to our pediatric ICU from December 1, 1985 through April 30, 1986, required mechanical ventilation. These patients were placed on an open trial of ribavirin therapy. We describe a technique for the safe delivery of aerosolized ribavirin to these infants while on the ventilator. The agent was delivered for 16 h/day for 7 days. Modifications of the ventilator circuit were needed to prevent the condensation of the drug in the ventilator tubing and to allow for the safe and effective operation of the ventilator. A common ventilator strategy was used for all patients. The highest positive inspiratory pressure generated was 42 +/- 9.5 (SD) cm H2O, the highest PEEP was 5.9 +/- 3.2 cm H2O, the duration of ventilation was 10.7 +/- 8.5 days, and exposure to fraction of inspired oxygen was greater than or equal to 0.6 for 55.3 h. Ribavirin levels were measurable in two patients, thereby demonstrating that the drug was in fact delivered and absorbed. Our preliminary results demonstrate that ribavirin can be delivered to the patients with respiratory syncytial viral infections who require mechanical ventilation; however, further studies are indicated to evaluate the efficacy and dose responsiveness, alterations in pulmonary dynamics, and safety of ribavirin in delivery to infants requiring ventilation. PMID- 3677747 TI - Cardiorespiratory and metabolic effects of dopamine and dobutamine infusions in dogs. AB - The effects of iv dobutamine and dopamine infusions were studied at six incremental doses (range 5 to 160 micrograms/kg.min) in two groups of five dogs. Dobutamine decreased the systemic vascular resistance (SVR), without significant changes in mean arterial pressure (MAP), or pulmonary vascular resistance (PVR). Dopamine increased MAP, SVR, and PVR, except for a decrease at 10 micrograms/kg.min. Both drugs produced dose-related increases in cardiac output and venous admixture; however, with dopamine the dose-response curve reached a plateau at doses greater than 40 micrograms/kg.min. While the oxygen consumption (VO2) increased progressively in both groups, the oxygen availability ratio (DO2/VO2) and arteriovenous oxygen content difference (CaO2 - CvO2) were maintained mainly by increased cardiac output in the dobutamine group and hemoglobin concentration in the dopamine group. Thirty minutes after termination of drug infusions, the DO2/VO2 dropped, and CaO2 - CvO2 increased significantly in both groups. These changes were mainly due to sustained high VO2; however, in the dopamine group, a larger imbalance resulted from further decreases in cardiac output to levels below the control value. PMID- 3677749 TI - Oxygen tensions and oxyhemoglobin saturations in the assessment of pulmonary gas exchange. AB - We studied the theoretical basis for continuous monitoring of pulmonary gas exchange using arterial and mixed venous oximetry by examining the mathematical relationships between the calculated venous admixture (Qsp/Qt) and the ventilation-perfusion index, which is derived from oxyhemoglobin saturations. We compared this relationship with that between Qsp/Qt and its commonly used estimates: inspired oxygen concentration to arterial blood oxygen tension ratio, arterial to alveolar oxygen tension ratio, and alveolar-arterial oxygen tension difference. The relationship between Qsp/Qt and the oxygen tension-based indices is nonlinear and substantially influenced by changes in inspired oxygen concentration and arteriovenous oxygen content difference. Therefore, it is inaccurate within the clinically acceptable range of arterial blood oxygenation. In contrast, calculation of ventilation-perfusion index from arterial and mixed venous blood oxyhemoglobin saturations provides a linear estimate of Qsp/Qt that is minimally affected by alterations in inspired oxygen concentration or oxygen uptake and, therefore, will allow accurate continuous assessment of pulmonary gas exchange. PMID- 3677750 TI - Noninvasive pulse oximetry in children with cyanotic congenital heart disease. AB - Arterial oxygen saturation, determined noninvasively by pulse oximetry in 32 pediatric patients with cyanotic congenital heart disease (CHD), was compared with oxygen saturation measured by a cooximeter in simultaneously obtained arterial blood samples. The patients were studied in the cardiac catheterization laboratory, operating room, and ICU. Excellent correlation by linear regression (n = 108, r = .95) was observed between the two methods at oxygen saturations ranging from 35% to 95%. These observations show that in infants and children with cyanotic CHD, arterial oxygen saturations can be determined accurately and reliably by pulse oximetry at rest and during changing circulatory states. PMID- 3677751 TI - Training and practice patterns of Society of Critical Care Medicine internists. PMID- 3677752 TI - Hypokalemic paralysis associated with renal tubular acidosis. AB - Patients with renal tubular acidosis may show hypokalemic paralysis. We report a case in which the symptoms of hypokalemia and the onset of paralysis were initially mistaken for the Guillain-Barre syndrome. PMID- 3677753 TI - Chloramphenicol toxicity in critically ill children with cardiac disease. PMID- 3677754 TI - Use of doxapram to increase respirations without a concomitant increase in intracranial pressure. AB - We treated a brain-damaged 8-month-old male with iv doxapram in order to discontinue mechanical ventilation. We were able to monitor intracranial pressure (ICP) throughout the course of doxapram via an ICP monitor. Despite normal and then excessive PaCO2, the patient's spontaneous respiratory rate remained nil before doxapram treatment. However, after an iv bolus dose followed by a maintenance drip, the patient's spontaneous respiratory rate increased while his ICP remained at baseline or slightly less than baseline, thereby allowing mechanical ventilation to be discontinued. PMID- 3677755 TI - An acute life-threatening complication caused by a Guedel airway. PMID- 3677757 TI - Transient peritoneovenous shunt dysfunction during mechanical ventilation. PMID- 3677756 TI - Pulmonary edema secondary to warfarin-induced sublingual and laryngeal hematoma. PMID- 3677758 TI - A cluster of unexplained cardiac arrests in a surgical intensive care unit. PMID- 3677759 TI - Hypermetabolic response after hypothermic cardiopulmonary bypass. AB - Sixteen patients undergoing hypothermic cardiopulmonary bypass for open heart surgery were studied prospectively. Oxygen consumption and CO2 production showed a marked increase during the first 6 h postoperatively. Consequently, the measured resting energy expenditure was markedly elevated compared to the predicted energy expenditure. This hypermetabolic response occurred simultaneously with maximum spontaneous rewarming after the end of surgical procedures. Ventricular function was low throughout the postoperative period, and no cardiac response to increased energy requirements was recorded. On the contrary, marked increases in arteriovenous oxygen and CO2 difference were observed during the period of highest resting energy expenditure. We conclude that the first hours after hypothermic cardiopulmonary bypass represent the period of highest risk for decompensation. The continuous monitoring of CO2 production is suggested as a useful clinical method to detect postoperative changes in metabolic rate. PMID- 3677760 TI - Do periodic hyperinflations improve gas exchange in patients with hypoxemic respiratory failure? AB - Prolonged artificial ventilation may result in worsening gas exchange and pulmonary compliance in patients with otherwise normal lungs. Prolonged hyperinflations to 40 cm H2O can completely reverse deterioration of gas exchange and compliance in such patients. Similar efforts have effectively recruited atelectatic lung regions in critically ill patients. Less aggressive hyperinflations have not improved lung function in patients with abnormal lungs with hypoxemia. However, sustained exaggerated hyperinflations may successfully open collapsed lung units in these patients when standard recruitment techniques fail. We compared periodic hyperinflations of 40 cm H2O lasting 15 to 30 sec associated with body positioning (directed recruitment [DR]) to standard bag-sigh suctioning (BSS) for their effects on gas exchange and pulmonary compliance in 16 stable surgical ICU patients with hypoxemic respiratory failure of 24-h duration or longer. Patients were sequentially alternated between DR and BSS (group 1, BSS followed by DR; group 2, DR followed by BSS). Neither technique, alone or in sequence, resulted in a sustained (greater than or equal to 5 min) improvement or deterioration in either gas exchange or pulmonary compliance. We conclude that neither BSS nor DR reliably affects gas exchange or compliance in patients with established hypoxemic respiratory failure. PMID- 3677761 TI - Plasma fibronectin levels in sepsis: influencing factors. AB - Low plasma levels of the opsonic glycoprotein fibronectin (Fn) have been suggested to imply an impaired host defense against sepsis. However, the mechanism(s) behind Fn depletion in sepsis are obscure. We measured the Fn plasma concentration in 32 patients 12 to 24 h after the diagnosis of septic shock. Although the average plasma level was low (214 +/- 80 [SD] mg/L) compared to that of a reference material (p less than .001), the range was great (60 to 403 mg/L). A multivariate analysis of some possible influencing factors showed significant (p less than .01) positive correlations to the prothrombin level (r = .62) and the amount of insulin infused per 24 h (r = .63). The relationships to disseminated intravascular coagulation-related variables, hemodilution, and outcome were weak. Cryoprecipitate was infused into 16 patients; Fn levels increased by 52 +/- 18% of the expected increase. The most severely ill patients displayed the lowest rates of increase. The postinfusion decrease in Fn plasma concentration indicated that the plasma half-life of cryoprecipitate Fn was about 25 h. The results support the concept that decreased Fn synthesis, probably in the liver, is the major reason for Fn depletion in sepsis, rather than an increased rate of consumption. PMID- 3677762 TI - Metabolic acidosis not due to lactic acidosis in patients with severe acute asthma. AB - Asthmatics seeking emergency care for severe acute asthma may show metabolic acidosis. We sought to determine the frequency of metabolic acidosis in such patients and to assess the relative contributions of renal bicarbonate loss and lactic acid accumulation to this acidosis. Twenty-two asthmatics (21-71 yr; four males, and 18 females) who came consecutively to the emergency department with severe acute asthma were studied. Most patients reported that their asthmatic symptoms had begun to worsen greater than or equal to 2 days before the emergency department visit. Within several hours, simultaneous measurements of arterial blood gases, whole blood lactate, and serum electrolytes were made. Ten of 22 patients were found to have metabolic acidosis (base deficit greater than 2 mEq/L). All ten patients had nonanion gap acidosis, while nine of ten had whole blood lactate values in the normal range (0.33 to 2.55 mmol/L). In the one patient with an elevated whole blood lactate level, the concentration of lactate in excess of normal (0.45 mmol/L) could not account for the magnitude of the base deficit (-4.9 mEq/L). We conclude that a) nonanion gap metabolic acidosis is very common in asthmatics with acute severe asthma (prevalence 45% in our series), and b) the mechanism of the base deficit in these patients is excessive renal bicarbonate excretion. We believe that the latter occurs as a renal compensatory response to a preceding period of hypocapnia due to hyperventilation related to worsening asthma. PMID- 3677763 TI - Radial arterial catheters in children and neonates: a prospective study. AB - Over a 3-yr period (1982 to 1984), 533 arterial catheters were inserted in 476 patients admitted to the pediatric ICU or the operating room. Radial arterial catheterization with small-bore, 0.8-mm, 22-ga Teflon cannulas was the most common method (376 of 533 cannulations), and 296 of these catheters were inserted in patients less than 1 yr of age. All catheters were flushed intermittently with heparin (12.5 U/ml) in isotonic saline. The mean catheter duration was 2.6 days, and only minor complications were noted. The main reason for catheter removal was malfunction of the arterial line. There was no difference in duration or complication rate between catheters inserted percutaneously or by cutdown. Over a 6-month period (1985 to 1986), 42 0.8-mm, 22-ga radial arterial catheters were inserted in 39 patients less than 1 yr of age; all catheters were maintained by a continuous flushing system using heparin (5 U/ml) in isotonic saline. The mean duration was 6.3 days. No complications were noted, and the proportion of catheter malfunction decreased. This study confirms the safety of radial arterial catheterization in children and neonates. The continuous flushing system considerably improved catheter patency compared to a method using intermittent flushing. PMID- 3677764 TI - Effects of colloid or crystalloid solutions on edemagenesis in normal and thrombomicroembolized lungs. AB - We studied the effects of crystalloid (75 ml/kg of Ringer's lactate) or colloid (6% dextran-70, 6% hydroxyethyl starch, or 25 ml/kg of 5% human serum albumin) fluid infusions or no treatment (control) on the calculated lung capillary (Pc) plasma oncotic pressure (pi c) gradient and pulmonary edema. Two sets of mongrel dogs were studied: uninjured (n = 25; 14 to 22 kg) and pulmonary fibrin microembolized (n = 25; 15 to 23 kg). In both sets of experiments, left atrial pressure was controlled (15 mm Hg) throughout the 4-h plus experimental period. In the uninjured set, the Pc-pi c gradient averaged +1.0 and -0.2 mm Hg in the hydroxyethyl starch and dextran groups, +0.7 and +2.3 mm Hg in the human serum albumin and control groups, and +6.2 mm Hg in the Ringer's lactate group. In the fibrin-microembolized group, this gradient averaged 2.6, 2.4, 3.0, 5.3, and 9.5, respectively. The extravascular lung water to bloodless dry lung wet weight ratios in the no-fluid treatment group of the uninjured and microembolism groups with increased pressure (3.8 +/- 0.3 to 4.1 +/- 0.4 [SEM]; NS) are consistent with interstitial or perivascular edema. There were, however, no significant differences noted between the respective control groups or any fluid treatment group in either set of experiments. These data support the view that infusion of either colloid or crystalloid solutions in normal or pulmonary fibrin microembolized lungs does not produce sufficient change in the Pc-pi c gradient to elevate edemagenesis when pulmonary capillary pressure is limited to 22 mm Hg in dogs. PMID- 3677765 TI - Transbronchial biopsy during mechanical ventilation. AB - The diagnostic yield and risks of transbronchial biopsy (TBB) during mechanical ventilation were assessed in 13 patients with progressive pulmonary infiltrates. TBB was of considerable diagnostic value in ten patients and useful in excluding potentially treatable infections in the remaining three patients. Complications included two pneumothoraces, pulmonary hemorrhage in one case, and supraventricular tachycardia in another. No fatalities were attributable to TBB. TBB proved to be a relatively safe procedure, with a high diagnostic yield in these critically ill patients. PMID- 3677766 TI - A simple technique to accurately determine intra-abdominal pressure. AB - The determination of intra-abdominal pressure (IAP) may be useful in a variety of clinical situations. Despite this, invasive IAP monitoring is seldom performed due to the risks involved. Using a standard canine model of increased IAP, we evaluated the accuracy of transurethral bladder catheter pressure in reflecting IAP. Throughout the range of IAP studied (10 +/- 5 to 70 +/- 10 mm Hg), bladder pressure did not differ significantly from the direct measurement of IAP. We conclude that the measurement of bladder pressure using a standard transurethral bladder catheter provides an accurate determination of IAP. PMID- 3677767 TI - Inadequacy of standard aminoglycoside loading doses in acutely ill patients. PMID- 3677768 TI - Early diagnosis of shock due to pericardial tamponade using transcutaneous oxygen monitoring. AB - The early diagnosis of traumatic pericardial tamponade may be difficult. The transcutaneous oxygen (PtcO2) monitor has been shown to be a useful indicator of low-flow shock. In the case presented, PtcO2 monitoring was the earliest indicator of shock due to pericardial tamponade and led to successful early therapy before other signs of physiologic decompensation were evident. In the management of acutely traumatized patients, PtcO2 monitoring is useful both in identifying patients who are in shock and in helping to guide therapy. PMID- 3677769 TI - Right ventricular influence on left ventricular performance in septic patients. PMID- 3677770 TI - One-lung high-frequency ventilation in the management of traumatic tear of bronchus in a child. AB - An 8-yr-old child suffered traumatic bilateral pneumothoraces and a ruptured right main bronchus. Surgical repair of the bronchus was postponed for 18 h after a definite diagnosis was established due to severe hypoxemia and hypercarbia. Only left endobronchial high-frequency ventilation with muscle relaxation corrected this pulmonary dysfunction sufficiently to enable surgical intervention. PMID- 3677771 TI - Written policy and patient transport from the intensive care unit. PMID- 3677772 TI - Critically ill polyneuropathy. PMID- 3677773 TI - Use of the knee-chest position during resuscitation: report of two cases. PMID- 3677774 TI - The "cross your heart" pulmonary artery catheter: a simplified transport method. PMID- 3677775 TI - Ranitidine-induced mental confusion. PMID- 3677776 TI - A study of change and depression among Havik Brahmin women in a south Indian village. AB - The author has gathered data from Havik Brahmin women on depression. Cultural factors predisposing to depression are especially salient to this analysis. Beck's triad of negative self image, negative interpretation of life events, and negative view of the future is regarded as the cultural ideal for older women. With cultural changes including an increased marriage age, increased educational level, and increased decision-making for women Beck's triad is no longer culturally sanctioned. Although these cultural changes are recent and the sample is too small for a statistical analysis, the article concludes that there is a possible association between depression and cultural factors such as early marriage. Additional possible associations with depression reviewed in this paper are separation from important people, support systems, loss of parent at an early age, poor marital relationship, and the perception of helplessness. PMID- 3677778 TI - Effect of light on the transfer of sugars from sugar nucleotides to rod outer segment membranes of control and dystrophic rats. AB - The transfer of N-acetyl-D-glucosamine (GlcNAc), D-mannose (Man), D-galactose (Gal) and L-fucose (Fuc) from their nucleotide complexes to isolated rod outer segment (ROS) membranes obtained from dark-adapted 21 +/- 2 days old dystrophic (RCS) and control (RCS-rdy+) rat retinas, was studied under light or dark conditions of incubation. It was found that all of these sugars were transferred to ROS membranes in the dark. Under these conditions there was significantly less (p less than 0.001) Gal transferred to dystrophic than to control membranes. Exposure to light affected the transfer of Gal and Fuc only. Thus, the transfer of Gal and Fuc to control ROS membranes was increased by about 50% compared to the level observed under dark conditions of incubation. On the other hand, exposure to light had no effect on the transfer of Gal to dystrophic ROS membranes but it enhanced the transfer of Fuc to these membranes by about 250% above the level observed in the dark. Under light there were highly significant (p less than 0.001) differences between control and dystrophic membranes in the transfer of Gal and Fuc. The transfer of Fuc to dystrophic ROS membranes was proportional to the concentration of GDP-Fuc but the acceptors on control membranes were saturated at low concentrations of substrate. However, the transfer of Gal from UDP-Gal to both types of membranes was proportional to the concentrations of substrate and ROS membrane protein and to the period of incubation. The transfer of Gal and Fuc to both types of membranes was significantly reduced after denaturation of ROS membrane proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677777 TI - Premenstrual syndrome as a western culture-specific disorder. AB - Premenstrual syndrome (PMS) has a phenomenology resembling many culture-bound (culture-specific) syndromes described in the anthropological literature. Viewed as a culture-specific syndrome, PMS is an appropriate symbolic representation of conflicting societal expectations that women be both productive and reproductive. By simultaneously denying either alternative, PMS translates role conflict into a standardized cultural idiom. Thus, despite obvious biopsychological determinants, PMS is best understood as a sociocultural phenomenon illustrating both the special status of women in Western culture and the ethnocentrism of Western anthropology which heretofore has only recently begun to identify culture specific syndromes in its own back yard. PMID- 3677779 TI - Vascular reactivities of simian ophthalmic and ciliary arteries. AB - Vascular reactivities to vasoactive substances were compared with ophthalmic and ciliary arteries (OAs and CAs) of Japanese monkeys. These two kind of arteries were perfused with Tyrode solution under a constant flow rate at 37 degrees C, respectively. Each drug solution was given by a microinjector into the endothelial side of the artery through a cannulated tubing, and responses were obtained as changes in perfusion pressure. Results were as follows: 1) Norepinephrine induced vasoconstriction in a dose-related manner in both arteries. The threshold dose was approximately 0.01 microgram in OAs and 0.1 microgram in CAs. The maximum value was approximately 45 mmHg in OAs and 20 mmHg in CAs. 2) Phenylephrine induced vasoconstriction in almost the same grade in both arteries. 3) Xylazine caused no significant change in perfusion pressure in both arteries. 4) Tyramine showed only small vasoconstrictor responses in both arteries. 5) 5-HT induced vasoconstriction in a dose-related manner in both arteries. The threshold dose was 0.001 microgram in CAs and 0.003 microgram in OAs, which indicated the smallest threshold dose in examined substances. However, the maximum increase in perfusion pressure was about 30 mmHg in OAs and 20 mmHg in CAs even at large doses. 6) PGF2 alpha induced a moderate increase in perfusion pressure, and the response in CAs was significantly greater than that in OAs. 7) KCl induced dose-dependent vasoconstriction. In CAs, the constriction induced by KCl was slightly greater than that in OAs but not significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3677780 TI - Effects of aFGF and bFGF on wound healing in rabbit corneas. AB - After the debridement of the entire corneal epithelium of the rabbit eye, epithelial cells of conjunctival origin cover the denuded corneal surface. Under such experimental conditions, the rate of wound healing is considerably delayed and total regeneration is completed within 15 to 20 days, allowing evaluation of various drugs, such as the Fibroblast Growth Factor. Both acidic and basic FGF were administered topically on totally de-epithelialized rabbit eye, at three different concentrations of 1.5 and 10 Stimulation Units/50 microliters, 3 times per day. A dose-response effect was observed and in each case, acidic FGF was found to be much more potent than bFGF in increasing the rate of wound healing of the cornea. These results are correlated with a new purification procedure, avoiding acid treatment of the tissue extract. The systemic diffusion of FGF allows the contralateral eye cells to be also stimulated for mitosis and migration and to heal faster than the control eyes. PMID- 3677781 TI - Bruch's membrane age-related changes vary by region. AB - Aging changes known to occur in Bruch's membrane may be associated with drusen formation and retinal pigment epithelial mottling, which often have a peripheral as well as a macular distribution. Few details of peripheral Bruch's membrane aging changes have been reported. We conducted a histochemical investigation of Bruch's membrane in 31 postmortem donor eyes and an ultrastructural morphometric investigation of these regional changes in a subgroup of 22 eyes. The age of our donors ranged from 12 days to 80 years. When we reacted 5 micron paraffin embedded sections of chorio-retinal complex fixed in 2% glutaraldehyde-1% paraformaldehyde, we observed increased PAS positivity, and staining with Weigert's elastin and alcian blue at pH 2.5 in Bruch's membranes from donors over 46 years. In this older group, the macula showed increased histochemical reactivity for glycoconjugates, glycosaminoglycans, collagen and elastin as compared with the equator and periphery. Thickening of Bruch's membrane was first detected in the periphery in tissue from donors aged 10 to 45. Thickening of macular Bruch's membrane was first detected in tissue from donors older than 45. The major proportion of thickening, which appears to be due to the deposition of fibrillar and amorphous material, occurred earlier in the inner than the outer collagenous zone. The equatorial region was relatively spared. Our findings confirm and extend the observations of the timing, regional predeliction, and extent of Bruch's membrane aging changes. PMID- 3677782 TI - Anomeric preference in uptake of D-glucose and of D-galactose by rat lenses. AB - To determine the anomeric preference of uptake of D-glucose and of D-galactose by rat lenses, we crystallized alpha-, beta-D-[U-14C]glucose (720 microCi/mmol) and alpha-, beta-D-[U-14C]galactose (180 microCi/mmol) by our method and incubated them separately with rat lenses for 1 min, because of the short half-life of mutarotation of alpha-D-glucose (9.6 min) and of alpha-D-galactose (4.6 min) in HEPES medium at 30 degrees C. During aerobic incubation of rat lenses in HEPES medium containing radioactive alpha or beta anomer of D-glucose, there was no significant difference in the rate of uptake between alpha and beta anomers of D glucose by rat lenses. However, 1.59 times greater incorporation of alpha-D galactose was observed over that of beta-D-galactose under the same conditions. PMID- 3677783 TI - Aporphine derivatives affect ocular function in diverse ways. AB - The sympathetic nervous system has been implicated in the ocular effects of several classes of dopamine receptor agonists. Two agonists of the aporphine class, (-) N-propylnorapomorphine [-)NPA) and norapomorphine (NA), were evaluated for effects on intraocular pressure (IOP) and pupil diameter (PD) in cats and normal (NL) and sympathectomized (SX) rabbits and on contractions of the cat nictitating membrane (CNM). Topically administered (-)NPA produced a monophasic IOP drop in the ipsilateral eye and a biphasic (increase, decrease) IOP response in the contralateral eye of normal rabbits. Pupil diameter increased bilaterally. In NL cats, the ipsilateral IOP and PD response to (-)NPA was biphasic (increase, decrease) and the contralateral IOP response was monophasic (increase). (-)NPA produced an increase in spontaneous motor activity (SMA) in rabbits and cats. NA lowered IOP unilaterally in NL rabbits. In SX rabbit eyes, (-)NPA lowered IOP as much as in NL eyes but with less mydriasis. NA did not lower IOP in SX rabbit eyes. Both (-)NPA and NA inhibited contractions of the CNM elicited by electrical stimulation of the pre- and post-superior cervical ganglionic nerves. (-)NPA, but not NA, inhibited contractions elicited by exogenous norepinephrine. These results suggest that aporphine derivatives produced two diametrically opposed effects on ocular function; 1) a centrally mediated effect that enhanced noradrenergic activity to elicit mydriasis, SMA and ocular hypertension, and 2) a peripherally mediated effect to produce miosis and ocular hypotension. PMID- 3677784 TI - Lacrimal gland, cornea, and tear film in the NZB/NZW F1 hybrid mouse. AB - The NZB/NZW F1 hybrid mouse has been reported to contract a disease similar to Sjogren's syndrome in man. We studied lacrimal gland morphology, corneal morphology, and tear osmolarity in this mouse as a function of age. Lacrimal glands of hybrid mice contained abnormal periductal infiltrates of lymphocytes and plasma cells. Maximum infiltration of the lacrimal gland occurred in the 29 week-old female hybrid mouse and was estimated to involve 12% of the gland, but was insufficient to alter tear osmolarity relative to DBA and Balb/c control mice. Nevertheless, both NZB/NZW F1 hybrid mice and DBA and Balb/c control mice had tear osmolarity and corneal surface morphology similar to that reported for keratoconjunctivitis sicca in man. Although the NZB/NZW F1 hybrid mouse may provide a valuable model for the study of lacrimal gland infiltration, since its tear osmolarity and ocular surface remain normal for a mouse, its usefulness as a model for ocular surface disease in human keratoconjunctivitis sicca may be more limited than previously thought. PMID- 3677785 TI - Glutathione reductase in human lens epithelium: FAD-induced in vitro activation. AB - Glutathione reductase (GR) activity was measured with and without the addition of flavin adenine dinucleotide (FAD) in freshly excised human lens epithelium following cataract surgery, and in control eye bank lens epithelium. Large individual variations in activity were found in both groups. Out of 32 epithelia obtained from cataractous lenses, 14 showed no measurable GR activity. Activity in eight of these 14 epithelia was restored after FAD was added, implying that the apo-enzyme in these 8 epithelia was functional but FAD was not available. Another group of 8 active epithelia showed a significant increase in GR activity upon the addition of FAD, suggesting a mixed population of active enzyme and available fraction of apo-enzyme which was reactivated by the addition of FAD. Unusually high GR activities were observed in epithelia of several patients. This correlated principally with daily intake of thyroxine which is known to have a direct effect on the metabolism of riboflavin. The fact that in a significant number of cataract patients epithelial GR was not active, and the observation that activity could be restored by adding in vitro FAD, demands that more attention should be given to riboflavin nutritional status and FAD synthesis in the eye. PMID- 3677786 TI - Effects of benfluorex on patients with endogenous hypertriglyceridaemia. AB - Twenty-two patients showing persistent endogenous hypertriglyceridaemia after an individually designed diet for 1 month were randomly divided into two groups. Each was treated during two crossover consecutive 40-day periods, either starting with benfluorex (450 mg/day) or with placebo. They were followed as out-patients and were investigated at the start of the study, and at the end of each treatment period. A number of laboratory measurements were undertaken at each visit, including triglycerides, cholesterol, uric acid, fatty acids, and glucose and insulin after an oral glucose tolerance test. The results showed a significant (p less than 0.01) reduction in triglyceride blood levels of 32.7% after benfluorex treatment compared to 11.7% with placebo, irrespective of the treatment order. Other laboratory measurements were in the normal range, and there were no significant changes, except for uric acid which showed a small decrease but of little clinical significance. Benfluorex would appear to have an important therapeutic effect on endogenous hypertriglyceridaemia. PMID- 3677787 TI - A comparison of the antifibrillatory effect of midazolam and flunitrazepam in acute myocardial ischaemia in the dog. AB - A study was carried out using a model of myocardial ischaemia in the dog after ligation of the left coronary artery to determine the effects of the benzodiazepines, flunitrazepam and midazolam, on the ventricular fibrillation threshold. The fibrillation threshold was measured twice within 15 min and 8 min after ligation. Fifteen minutes after the onset of ischaemic heart attack, 1.2 mg midazolam/kg or 0.25 mg of ischaemia. Their effects on haemodynamics were negligible. It is suggested that both benzodiazepines can be used for increasing electrical stability of the heart in patients with acute myocardial infarction and to inhibit the psychic stress response. Because of its short biological half life and water solubility, allowing painless intravenous administration, midazolam offers a more flexible approach to pharmacotherapy immediately after acute heart attack according to the patient's current clinical status. PMID- 3677788 TI - Nalbuphine: a supplement to isoflurane and enflurane anaesthesia. AB - A retrospective study was carried out to review the intra-operative use of nalbuphine at the average dose of 1.5 mg/kg as a supplement to isoflurane and enflurane in balanced anaesthesia in 108 surgical patients. Intra-operative cardiovascular stability and the quality of emergence were examined. The amount of halogenated anaesthetic used was compared to the theoretical amount that would have been needed in the absence of nalbuphine. In 90% to 95% of patients, blood pressures remained within 20% of baseline for the duration of anaesthesia. At emergence, 80% of patients had no pain. Nalbuphine appeared to reduce halogenated anaesthetic requirements by approximately 50%. These promising results for the intraoperative use of nalbuphine need to be confirmed by controlled prospective studies. PMID- 3677790 TI - Efficacy and tolerability of cefuroxime axetil in patients with upper respiratory tract infections. AB - A study was carried out in general practice to assess the clinical effectiveness and tolerability of the oral cephalosporin, cefuroxime axetil, in the treatment of 369 patients presenting with acute infections of the upper respiratory tract. The main diagnoses were tonsillitis, pharyngitis, sinusitis and otitis media. Patients were treated for 7 days with 1 tablet of 250 mg cefuroxime axetil twice daily. Details of fever and signs and symptoms of infection such as pain, sinus tenderness and reddening of the eardrum were recorded before and after treatment. Response was assessed by the physician on the basis of the clinical findings (the microbiological findings will be reported separately), and by patients on their satisfaction with their therapy. The results indicated an overall clinical improvement rate of 89%: all clinical parameters showed significant improvement and most patients were symptom-free when seen after treatment. Only 2 patients were classified as treatment failures and withdrawn from the study. Complete resolution of the infection was seen more often in patients with tonsillitis and pharyngitis than in those with sinusitis or otitis media. Over 80% of patients expressed their satisfaction with therapy. Adverse events reported were few, even though patients were prompted with a non-leading question, and were mainly mild in nature. The most frequently reported were diarrhoea (5%) and loose motions (3%). PMID- 3677789 TI - Is the combination inhaler of salbutamol and beclomethasone dipropionate as effective as the same agents from separate inhalers in the management of childhood asthma? AB - A double-blind crossover study lasting 16 weeks was carried out in children with chronic extrinsic asthma to compare the clinical effects of regular inhalations of salbutamol and beclomethasone dipropionate from a combination inhaler and regular inhalations of the same two drugs used sequentially from separate inhalers. Eighteen patients entered the study and 16 completed both 8-week treatment periods. However, there was a large amount of missing data, with only 9 complete sets of paired data; efficacy analyses were performed on data from 10 patients on separate inhaler therapy and from 14 patients on combination inhaler therapy. There were no significant differences between daily peak flow rate measurements, symptom scores, additional symptomatic bronchodilator therapy, acute exacerbations of asthma or incidence of adverse events, demonstrating that both treatments were similarly effective in controlling the patient's asthmatic symptoms. There was, however, a trend for higher peak flow values and lower symptom scores on separate inhaler therapy in this small group of asthmatic children. Although the results suggest that regular therapy using a combination inhaler is as effective as sequential administration of salbutamol and beclomethasone dipropionate from separate inhalers, it is concluded that the study should be extended to a larger group of patients to determine whether there might be any statistically significant differences between the two regimens. PMID- 3677791 TI - The antihypertensive efficacy of nifedipine alone and in combination in general practice. AB - A multi-centre study in general practice involving 3242 hypertensive patients, aged up to 70 years, was carried out to evaluate the efficacy and tolerability of nifedipine used alone or in combination with other antihypertensive agents in step-care treatment. Patients were treated for up to 8 weeks with one of four regimens: nifedipine monotherapy; diuretic and nifedipine; beta-blocker plus nifedipine; and nifedipine added to a combination of diuretic and beta-blocker. All patients received 20 mg nifedipine, in slow-release tablet form, twice daily; at Week 4, dosage was increased to 40 mg twice daily in 8.5% patients because their supine diastolic blood pressure still exceeded 95 mmHg. Changes in mean blood pressure of the total study group for systolic and diastolic, supine and standing, were highly significant both from baseline (Week 0) to Week 4 (p less than 0.0001) and from baseline to Week 8 (p less than 0.0001). Mean blood pressure reduction was 29/18 mmHg supine and 27/18 mmHg standing. Statistical differences in blood pressure response between age, sex and treatment groups were not of clinical significance. Statistically significant reductions in heart rate (mean 1.9 beats/min, p less than 0.001) and body weight (mean 0.48 kg, p less than 0.001) were noted, but were not of clinical relevance. Nifedipine produced a net increase of 12% in side-effects at Week 4 compared to the profile at entry. PMID- 3677792 TI - Facial involvement as a marker of severe psoriasis. PMID- 3677794 TI - Diagnostic techniques for hair disorders. Part II: Microscopic examination of hair bulbs, tips, and casts. 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 bulb, tip, and cast examination is presented as a technique for establishing a definitive diagnosis. PMID- 3677793 TI - Naproxen-induced pseudoporphyria presenting a diagnostic dilemma. AB - A case of clinical porphyria cutanea tarda posed a diagnostic dilemma when screening tests for porphyrinuria gave negative results and two skin biopsy specimens failed to show the histologic picture of porphyria cutanea tarda, pseudoporphyria, or epidermolysis bullosa acquisita. The dilemma was resolved when the eruption cleared following elimination of naproxen from the patient's treatment. Subsequent naproxen challenge resulted in new bullae on the dorsum of the hands. PMID- 3677795 TI - Disseminated angiolupoid sarcoidosis. AB - A case of a patient with a rare variant of cutaneous sarcoidosis, angiolupoid sarcoidosis, with pulmonary involvement and an unusual number of widely disseminated elements is presented. Disseminated angiolupoid sarcoidosis is not mentioned in major textbooks of dermatology. PMID- 3677796 TI - Ultrasound-induced hyperthermia in the treatment of cutaneous leishmaniasis. AB - Local hyperthermia induced by ultrasound was delivered two or three times weekly to twenty-eight lesions of acute cutaneous leishmaniasis in eighteen patients. Twenty-two lesions (78.5 percent) in thirteen patients resolved completely five to ten weeks after the start of treatment. Our results are explained by the thermosensitivity of the parasite and its inability to survive at supranormal temperatures. Ultrasound hyperthermia was tolerated by most of the patients. The results of this study indicate that topical heat is safe and effective for the treatment of patients with acute cutaneous leishmaniasis. PMID- 3677797 TI - Lentigo maligna presenting as an eczematous lesion. AB - A case of lentigo maligna manifesting as an eczematous lesion is presented. Unlike previous reports of dermatitic lesions of lentigo maligna, hyperpigmentation of the specimen was noted on microscopic examination. PMID- 3677798 TI - Oral cavity abscess due to Neisseria gonorrhoeae. AB - A patient with an abscess in the oral cavity caused by Neisseria gonorrhoeae is presented. The suspected gonococcal cause was confirmed by the presence of gonococci in smears of material evacuated from the abscess and the growth of bacteria in a modified Thayer-Martin culture medium. This represents, to our knowledge, the first reported case of oral cavity abscess due to N. gonorrhoeae. PMID- 3677799 TI - Atopic dermatitis-like eruption with elevated IgE levels possibly due to chenodeoxycholic acid. PMID- 3677800 TI - Stereological analysis of the ultrastructure of the early chick embryo cell types involved in sorting out. AB - Analysis of the aggregates obtained from the prenodal region of the chick embryo (stage 5) show the existence of three cell types which sorted out. The application of morphometrical and stereological methods show that each of these cell types has a characteristic subcellular organization which is discussed with respect to the cytometrical characteristics of embryonic cells of stage 5. This early ultrastructure of each cell type is presumably related to its state of differentiation and consequently to some of the potential morphogenetic roles. PMID- 3677801 TI - 'Metamorphosis': computer-assisted rotational analysis and interspatial distribution of nuclear structures from serial ultrathin sections. AB - 'Metamorphosis' is a group of computer programs designed to permit rapid three dimensional analysis and generation of models of nuclei cells from digitized data. Infinite exterior views are possible using the rotation program and the user has the added ability to enter the object and peer out. This permits analysis of structural associations from any perspective. Since many chromosome associations cannot be abstracted without a computer, using rotation and cluster analysis reveals obscure relationships. This concept becomes important when proposing theories involving interactions between two or more objects. The program is written in BASICA and designed for use on IBM-compatible personal computers equipped with a digitizer. Three-dimensional transformations are accomplished via matrix manipulation which permits rapid generation of new images. PMID- 3677802 TI - A miniaturised parallel-plate shearing apparatus for the measurement of cell adhesion. AB - The design and construction of a miniaturised shearing apparatus is described. Cultures (24 h) of an established epithelial cell line (BEB) were exposed to flow conditions in the shearing chamber at 37 degrees C, and subsequently glass coverslip cultures were prepared for photography. The critical shear radius (CSR) was determined by densitometry from a negative film and the minimum distraction force (MDF) at the CSR calculated using predetermined viscosity values of the flow medium. The mean calculated MDF of BEB cells ranged from 1.04-1.36 Nm-2, and was independent of the culture inoculation density (9 to 37 X 10(4) cells cm-2) and the time (5-20 min) of exposure to shearing conditions. The MDF was increased to 3.3 Nm-2 by a 30 min exposure of cultures to concanavalin A (50 micrograms ml 1), and this effect was abolished by treating with mannose (0.05 M). The results demonstrated that the radial flow chamber principle is applicable to the measurement of cell to substratum adhesion of cultured mammalian cells. PMID- 3677803 TI - Planar stress thallium-201 scintigraphy. First experiences with a new circumferential programme. AB - A new computer programme was used in 22 patients referred for suspected ischaemic heart disease (IHD) or for assessment of the size of a suspected ischaemic or infarcted area. An interpolative method was used to construct the net myocardial images. Initial imaging in three projections was started at five minutes after thallium-201 injection and delayed imaging three hours after the injection. The data were presented as analog images, circumferential profile curves, and washout curves. The calculated delayed/initial count ratio is an important measure of redistribution. In the 12 patients referred to detect clinically or electrocardiographically suspected IHD, the diagnosis IHD was made by the cardiologists on the basis of current routine criteria and the thallium test. The technique was found useful in localising and assessing the size of a suspected ischaemic or infarcted area in nine of 10 patients. Our experience with the new programme confirms the experience of others that a combination of analog images and computer processed data gives much more precise information than the visual inspection of the analog pictures alone. PMID- 3677804 TI - Citric acid aerosol as a potential smoking cessation aid. AB - We tested the ability of a citric acid aerosol to simulate the tracheal sensations produced by cigarette smoke and to satisfy smokers' desire for cigarettes. Fifteen smokers rated puffs from their own brand of cigarette, citric acid aerosol, a low tar and nicotine cigarette, and air. To focus on tracheal perceptions and pharmacologic effects of nicotine, we equated visual, olfactory and taste cues across conditions. Subjects rated the citric acid aerosol more similar to their own brand, more desirable, and more satisfying (after a block of puffs) than control puffs of air. It was also rated equal to or better than the low tar and nicotine cigarette. Subjects' own brands were rated best, although puffs of citric acid aerosol were of comparable strength and harshness. The results suggest that a nebulizer delivering citric acid in a fine mist might reduce craving for cigarettes in smokers attempting to quit and may thereby increase cessation rates. PMID- 3677805 TI - Smoking and the increased risk of contracting spontaneous pneumothorax. AB - The relation between smoking habits and the occurrence of spontaneous pneumothorax (SP) was studied in a Swedish population, predominantly urban. The study group consisted of a consecutive series of 138 patients admitted to Huddinge University Hospital over ten years for treatment of their first spontaneous pneumothorax. Their smoking habits were routinely analyzed. The sample consisted of 15,204 persons domiciled in the same circumscribed area (County of Stockholm). The annual incidence of first SP in the admission area is 6/100,000 for women and 18/100,000 for men. The study showed that smoking increased the relative risk of contracting a first spontaneous pneumothorax approximately ninefold among women and 22-fold among men and that there is a striking, statistically significant (p less than 0.001) dose-response relationship between smoking and the occurrence of SP. The life span risk of contracting SP among lifelong heavily smoking men is roughly estimated to be 12 percent but only 1/1,000 among never smokers. PMID- 3677806 TI - Catheter drainage of the pericardium. Practical method to maintain long-term patency. AB - Pericardiocentesis with catheter insertion and drainage is widely used in management of large pericardial effusions and cardiac tamponade. Two potential problems with an indwelling pericardial catheter system are catheter blockage and infection. We have utilized slow infusion of heparinized saline solution (3 ml/hr) via a continuous flush device to maintain catheter patency for up to seven days (mean 3.6) in 16 patients. Pericardial effusions were secondary to malignancy, uremia, and cardiac surgery. This article describes practical aspects of the technique. Most pericardial effusions can be successfully treated with pericardiocentesis and catheter drainage, provided the drainage is continued reliably and safely for several days. Surgical treatment such as subxiphoid pericardiostomy or partial pericardiectomy should be reserved for loculated effusions, clotted blood, subacute effusive-constrictive pericarditis, or significant recurrences after initial drainage. PMID- 3677807 TI - Natural killer cell activity in lung cancer patients. AB - A total of 50 lung cancer (CA) patients and 20 normal persons as controls were included in our study. We obtained lymphocytes from heparinized blood by Ficoll Hypaque gradient method, and after the macrophages were removed, they were incubated with 51Cr-labelled K562 cells at concentrations of 100:1, 50:1, 12.5:1 for four hours. We calculated the cytotoxicity activity and lytic unit (LU) of natural killer (NK) cells. Significant impairment was noted in the comparison of NK cytotoxicity and LU between stage III-M1 lung CA patients (n = 28) and the control group. However, significant impairment was also noted in stage III-M1 and III-M0 patients. Four cases in stage I underwent surgery, and the NK cytotoxicity before the operation was noted to be low. After the operation, the NK cytotoxicity increased. These results indicate that NK cytotoxicity assay was impaired in stage III-M1 lung CA and also suggest that it may act as a therapeutic guide in determining the results of the operation. PMID- 3677808 TI - Oronasal distribution of ventilation during exercise in normal subjects and patients with asthma and rhinitis. AB - This study was undertaken to determine whether the resistance to nasal airflow and differences in oronasal distribution of ventilation at rest and during exercise alter the pattern of breathing. We observed six normal subjects, six patients with symptomatic allergic rhinitis, and six patients with asymptomatic bronchial asthma (three men and three women in each group), all of whom had normal pulmonary function. At rest, five of the six normal subjects breathed nasally but 11 of the 12 patients breathed with an oronasal distribution. Five normal subjects who breathed nasally at rest breathed with an oronasal distribution of ventilation during exercise, and one normal subject who breathed oronasally at rest had slightly less oral ventilation during exercise. In the patients, the change in oral distribution of ventilation during exercise was variable. Among the three groups, there were no significant differences from the resting oronasal distribution for ventilation during exercise, and all subjects breathed oronasally during exercise. The oronasal distribution of ventilation did not correlate with the level of nasal airflow resistance. Analysis of the timing, volume, and flow components of breathing showed no statistically significant differences among the three groups at rest and exercise. Thus, neither the level of resistance to nasal airflow, even up to moderately high values, nor the nasal distribution of ventilation at rest and with moderate exercise appears to have a major role in the pattern of breathing. PMID- 3677809 TI - Intra-subject variability of noninvasive oxygen measurements. AB - We studied ten healthy, nonsmoking adults to determine the intra-subject variability for repeated measurements of transcutaneous oxygen pressure (tcPO2) and oxygen saturation by pulse oximetry (SaO2). Intra-subject variability was less for SaO2 than for tcPO2 and increased at lower arterial oxygen tensions. Inter-machine variability was an important contributor to intra-subject variability for tcPO2. The percentage change from baseline required to detect a significant physiologic change while breathing room air was 1.2 percent for SaO2 and 13.8 percent for tcPO2. When subjects breathed a 15 percent oxygen mixture, the percentage change for significance increased to a maximum of 4.7 percent for SaO2 and 35.8 percent for tcPO2. These results are applicable to non-neonatal pediatric and adult patients and demonstrate the importance of intra-subject variability when performing noninvasive measurements of patient oxygenation over time. PMID- 3677810 TI - Pleural biopsy with Cope and Abrams needles. AB - The object of this study was to compare the diagnostic yield of Abrams and Cope needles. Pleural biopsies were performed in 24 patients with both needles. In two patients, the procedure was repeated within a few days. All patients had pleural effusion. The biopsies were performed at the same time; the biopsy sites were no more than 5 cm distant from each other. Diagnoses were exclusively pathologic. There was no difference between the needles in relation to diagnosis; greater size of the fragment, mesothelial cells, and fibrin were most frequently obtained by Abrams needle, while muscle was better obtained with the Cope needle. The biopsies with both needles were very similar regarding chronic inflammation, granuloma, caseous necrosis, neoplastic tissue, granulation, neutrophils, hemorrhage, vessels, nerves, adipose tissue and epidermis. The advantages of more pleural tissue obtained with the Abrams needle was not translated into better diagnostic yield in the present series. PMID- 3677811 TI - Effect of nasal obstruction on upper airway muscle activation in normal subjects. AB - It is not known whether nasal occlusion produces obstructive sleep apnea (OSA) by decreasing upper airway muscle activation via nasal reflexes or by increasing upper airway resistance and hence lowering the pressure in the pharnyx. The purpose of this study was to determine the effect of nasal occlusion on upper airway muscle activation. We studied seven men and measured alae nasi (AN) and genioglossal (GG) electromyograms (EMGs) during two nights of sleep, one with their nose open and the other with their nose occluded. Nasal occlusion produced OSA in all subjects and also increased the percentage of time during sleep in which phasic AN and GG EMG activity was present. Apneas tended to occur at the nadirs of EMG activity. This suggests that nasal occlusion generally increases respiratory drive to upper airway muscles during sleep and that it does not cause OSA by merely decreasing respiratory drive to these muscles. PMID- 3677812 TI - Bronchopleural fistulas after pneumonectomy. A problem with surgical stapling. AB - After multiple reports demonstrating excellent results and improved healing of the bronchial stump in cases of pneumonectomy performed with standard reusable parallel firing stapling devices, there has been an isolated report from Europe of increased incidence of bronchopleural fistulas with the use of the modified reusable hinged stapling device. Our report confirms and extends that observation. Review of 42 successive pneumonectomies revealed one case of bronchopleural fistula with the use of the standard reusable parallel firing stapling device; there were six cases of bronchopleural fistulas in 36 successive pneumonectomies performed with the modified hinged stapling device (four with reusable and two with disposable instruments). Improperly formed staples were identified by x-ray examination or reoperation. We recommend that only the standard reusable parallel firing stapling devices be used for bronchial closure in pneumonectomy. PMID- 3677813 TI - Diffuse interstitial pulmonary disease from the perspective of the clinician. AB - Diffuse interstitial pulmonary disease encompasses a large number of diverse entities having in common the diffuse infiltration of alveolar walls by inflammatory or malignant cells, connective tissue, or fluid that impairs transfer of oxygen to blood. Pertinent clues to the diagnosis may be obtained by careful analysis of history, physical examination, chest roentgenogram, pulmonary function, and other laboratory data. This analytic process is referred to as the "algorithmic synthesis." This synthesis can guide the clinician in the selection of tissue sampling techniques most likely to confirm the diagnosis. PMID- 3677814 TI - The rise and fall of the diaphragm. PMID- 3677815 TI - Severe precocious emphysema in intravenous methylphenidate (Ritalin) abusers. AB - Intravenous (IV) drug abuse is known to cause pulmonary tale granulomatosis. Reports have documented a syndrome of pulmonary vascular sclerosis in long-term IV methylphenidate users. Although this would be expected to produce restrictive lung disease, we hereby report six patients who have severe obstructive lung disease. All had used IV methylphenidate for at least four years. One of these patients died of progressive respiratory insufficiency and the others are clinically disabled. Their symptoms and airflow obstruction are more severe than those of most patients with chronic obstructive pulmonary disease. In these individuals, we cannot say that precocious obstructive lung disease is not due to a combination of smoking and other factors, nor can we be certain that methylphenidate is the offending agent. However, this cluster of cases among methylphenidate abusers suggests that long-term IV exposure to this drug might lead to early severe obstructive lung disease. PMID- 3677817 TI - The pain-ischemia dilemma. PMID- 3677816 TI - Effects of ibuprofen on the hypoxemia of established ethchlorvynol-induced unilateral acute lung injury in anesthetized dogs. AB - Nonsteroidal anti-inflammatory agents, given prior to induction of unilateral acute lung injury with ethchlorvynol (ECV) in anesthetized dogs, prevent the decreases in systemic oxygen tension (PaO2) which are observed when ECV is given alone. We investigated whether ibuprofen, administered after acute lung injury, would result in improvement in arterial oxygenation. In animals not receiving ibuprofen after unilateral acute lung injury with ECV, PaO2 decreased and venous admixture increased significantly from control values at all experimental time periods. In those animals receiving ibuprofen, significant decreases in venous admixture were noted. The decrease in PaO2 after ECV administration was significantly less than that observed in animals that did not receive ibuprofen after acute lung injury (p less than 0.05). Ibuprofen had no effect on extravascular lung water. These results demonstrate that in an ECV model of acute lung injury the administration of ibuprofen, after the acute lung injury, results in significant decreases in venous admixture. PMID- 3677818 TI - Management of resistant hypertension. PMID- 3677819 TI - Bochdalek hernia of diaphragm in the adult. Diagnosis by computed tomography. AB - Two cases of asymptomatic Bochdalek hernia in adults with identical roentgenographic findings are reported. Computed tomography (CT) in each case revealed a round mass with a low attenuation coefficient identical to that of adipose tissue, abutting the thoracic surface of the diaphragm and connecting with the subdiaphragmatic density through a diaphragmatic defect. A case of diaphragmatic lipoma was also presented for demonstration of the CT differentiation between lipoma and hernia of the diaphragm. The CT findings for a Bochdalek hernia are characteristic enough for making a definite diagnosis and render other diagnostic modalities unnecessary. PMID- 3677820 TI - Prolonged myocardial ischemia after intravenous dipyridamole thallium imaging. AB - Intravenous dipyridamole thallium imaging is reported to be a safe test with minimal side effects. It has been proposed by some that the test simply dilates the coronary vessels without actually producing myocardial ischemia. In this report, we describe a patient who, following intravenous dipyridamole thallium imaging, developed severe myocardial ischemia which persisted for 90 minutes, requiring emergency coronary angioplasty to alleviate the ischemic insult. Sequential electrocardiograms and cardiac isoenzyme levels following coronary angioplasty were within normal limits. Thus, severe myocardial ischemia following intravenous dipyridamole testing can occur and emphasizes the importance of careful monitoring of these patients, particularly when the pretest risk of coronary disease is high. PMID- 3677821 TI - Altered therapy of suspected pulmonary embolism using leg venography. AB - The traditional approach to the diagnosis of pulmonary embolism involves attempts to document the embolus in the lungs. An alternative diagnostic approach is to document the source of the embolus in the iliofemoral venous system. The present case shows how a search for leg thrombosis in suspected pulmonary embolism can also have an impact in choosing the optimal therapy to prevent recurrent embolization. PMID- 3677822 TI - Plastic endobronchial tubes in the management of life-threatening hemoptysis. AB - Plastic double-lumen endobronchial tube was used to maintain the airway in a patient with massive hemoptysis and nonresectable lung cancer. This tube is superior to the previously used Carlens tube, as it can be inserted in emergency situations and does not require surgical setting. In addition, the larger internal diameter of these tubes allows better airway clearance and passage of a flexible bronchoscope. The double-lumen tube may be considered as an alternative to selective main-stem intubation. PMID- 3677823 TI - Benefit of the steroid electrode. AB - A permanent pacemaker was implanted in an 80-year-old patient with complete heart block. The electrode had to be changed six times (endocardial, five and epicardial, one) due to a progressive rise in threshold with recurrent exit block. A porous, steroid eluting, endocardial electrode was implanted and has given 27 months of excellent service. This lead may be ideal for patients who have a progressive increase in threshold after repeated electrode implantation. PMID- 3677824 TI - Malignant course of a benign anomaly: myocardial bridging. AB - A 35-year-old man, with recent onset angina, developed recurrent episodes of syncope due to ventricular tachycardia. His coronary angiogram showed normal coronary arteries and myocardial bridging of the left anterior descending causing severe systolic milking effect. Extensive invasive and noninvasive investigations did not reveal cardiac pathology other than the myocardial bridging. Electrophysiologic studies, not previously reported in myocardial bridging, demonstrated inducible sustained ventricular tachycardia at a rate of 280 beats/min. The possible relationship between the arrhythmia and the myocardial bridge is suggested. Combined medical treatment with amiodarone and diltiazem proved to be an effective alternative to surgical myotomy of the bridge. PMID- 3677825 TI - Adult respiratory distress secondary to strongyloidiasis. AB - A patient with a renal transplant who was receiving immunosuppressive therapy developed the adult respiratory distress syndrome (ARDS). Numerous filariform larvae of Strongyloides stercoralis were seen in the bronchial lavage. The patient died despite intensive treatment, and the postmortem examination revealed abundant larvae of the parasite in the lungs. There were no other factors that could explain the ARDS. PMID- 3677826 TI - Progressive heart failure secondary to a high output state. AB - A high cardiac output state has been an infrequent but previously reversible cause of heart failure in patients with hemodialysis fistulas. A patient with two proximal upper extremity fistulas was found to have progressive depression in his left ventricular function and a high output state. His symptoms did not respond to the removal of the most prominent fistula, suggesting that chronic volume overload from the high output state may irreversibly depress left ventricular function. PMID- 3677827 TI - Ring-calcification of coronary artery aneurysms in an adolescent. AB - A 17-year-old asymptomatic boy with a history of Kawasaki disease in infancy was found to have an abnormal ring-calcification as seen in the chest roentgenogram and the electrocardiographic evidence of anteroseptal myocardial infarction. Coronary angiogram revealed aneurysms associated with ring-calcifications in the right coronary artery and subtotal obstruction of the left anterior descending coronary artery. A plain chest roentgenogram may, at times, be useful for identifying coronary aneurysms in patients with a possible history of Kawasaki disease. PMID- 3677828 TI - Intraatrial conduit repair in Scimitar syndrome. AB - A 26-year-old woman with partial anomalous pulmonary venous drainage into the right atrium (Scimitar syndrome) was successfully operated upon by incorporating an intra-atrial conduit. The single right pulmonary vein present was connected to the right atrial inferior vena cava junction. The atrial septum was extremely deviated to the left, and the left atrium was located entirely on the left of the spine. A small patent foramen ovale was found. The distance between the orifice of the right pulmonary vein and the enlarged atrial septal defect was too great to use an intracardiac patch, so a 14 mm woven Dacron graft, 6 cm long, was interposed between them. The patient is doing well 21 months following the operation. PMID- 3677830 TI - To publish or not to publish? PMID- 3677829 TI - Bronchial adenocarcinoma presenting as a lingual tonsillar metastasis. AB - We describe a case of a lingual tonsillar metastasis as the first manifestation of a bronchial adenocarcinoma. Tonsillar metastases infrequently become manifest before the diagnosis of the primary neoplasm. A review of the literature disclosed 89 cases of carcinoma metastasizing to the palatine tonsil, but no one has reported the involvement of the lingual tonsil. Our patient is the first described case of bronchogenic carcinoma with this unusual form of presentation and furthermore is also the first carcinoma metastasizing to the lingual tonsil. PMID- 3677831 TI - Peer review in medical journals. A bad example. PMID- 3677832 TI - The need to test home monitoring for SIDS. PMID- 3677833 TI - A case history: Pulmonary eosinophilia and coccidiodal infections. PMID- 3677834 TI - NK cells in sarcoidosis. PMID- 3677835 TI - Cost reduction efforts in a tuberculosis laboratory. PMID- 3677836 TI - Fibronectin concentration in pleural effusions. PMID- 3677837 TI - Gag reflex in disease. PMID- 3677838 TI - Reducing the urge to smoke. PMID- 3677839 TI - Variant angina pectoris. Is the parasympathetic nervous system at fault? PMID- 3677840 TI - The bureaucratic imperative in continuing medical education. PMID- 3677841 TI - Lack of association of pleural effusion with chronic pulmonary arterial and right atrial hypertension. AB - Right atrial hypertension has been considered to have a major physiologic influence on the formation of transudative pleural effusions. Since pleural fluid is thought to be cleared primarily by the parietal pleural lymphatic vessels that empty into the systemic veins, systemic venous hypertension secondary to right atrial hypertension should decrease the lymphatic drainage of the pleural space. We retrospectively studied nine patients and prospectively studied 18 patients with long-term right atrial or pulmonary arterial hypertension (or both). All patients had stable respiratory symptoms, and none had a significantly elevated pulmonary arterial wedge pressure. Our purpose was to determine the relationship of right atrial and pulmonary arterial hypertension to the development of transudative pleural effusions. Posteroanterior and bilateral decubitus chest roentgenograms and ultrasound were used to detect pleural effusions. Pleural effusions were not identified in any of the 27 patients, even in four patients with right atrial pressures greater than 20 mm Hg. We conclude that chronic elevation of right atrial pressure or pulmonary arterial pressure (or both) alone is not a cause of pleural effusion. In contrast, elevation of left atrial and pulmonary arterial wedge pressures is associated with the formation of transudative pleural effusions in man. Thus, if pleural effusions are detected in patients who have cor pulmonale, a search should be made for coexisting left heart failure or a primary cause of pleural inflammation, such as pulmonary emboli or infection. PMID- 3677842 TI - Failure to predict six-month survival of patients with COPD requiring mechanical ventilation by analysis of simple indices. A prospective study. AB - We analyzed the outcome of 39 consecutive acute exacerbations of chronic obstructive pulmonary disease (COPD) in 35 patients requiring mechanical ventilation, in order to identify the features related to survival. Patients were divided into those surviving less (group A; n = 14) and more (group B; n = 24) than six months. Pulmonary function tests, arterial blood gas levels either on admission or while in a steady state, and nutritional parameters were similar in both groups. Only the duration of mechanical ventilation was longer in group A when compared to group B. In patients dying while being ventilated or surviving less than ten days after extubation, only the forced vital capacity (FVC) was different when compared to the rest of group A. The duration of mechanical ventilation was not related to age or the forced expiratory volume in one second (FEV1). Only a multivariate analysis accounting simultaneously for eight parameters could separate with 78 percent accuracy the different groups of patients; however, following this analysis, 23 percent of the patients in group B could have been falsely classified as nonsurvivors and perhaps rejected for mechanical ventilation. We conclude that the six-month survival of patients with COPD who required mechanical ventilation for an acute exacerbation of their disease cannot be predicted from simple data generally available to the physician in charge at the time of intubation. PMID- 3677843 TI - Pre- and postoperative inspiratory mechanics in ischemic and valvular heart disease. AB - In 12 mechanically-ventilated, anesthetized, paralyzed patients undergoing cardiac surgery for either coronary bypass (six subjects) or to correct valvular disfunctions, volume, airflow, tracheal, esophageal, and transpulmonary pressures were measured. Respiratory system elastance and resistance were partitioned into lung and chest wall components. Resistances were further split into homogeneous and uneven elements. Measurements were performed prior to thoracotomy and just after rib cage closure. Before surgery, valvular patients had significantly higher elastances and uneven resistances of the respiratory system and lung than those with ischemic heart disease. Postoperatively, the patients presented with an increase in respiratory system and lung elastances, a decrease in pulmonary resistance, and a rise in chest wall resistance. Surgically induced mechanical changes were similar in ischemic and valvular patients. PMID- 3677844 TI - In vitro comparison of DeVilbiss jet and ultrasonic nebulizers. AB - Output, droplet size (by laser instrument), and nebulization time have been compared in vitro for eight individual ultrasonic nebulizers (DeVilbiss Pulmosonic) and eight individual jet nebulizers (DeVilbiss 646), the latter operated by compressed air at flows of 6 and 12 L/min. A solution of hypertonic (7 percent) saline was nebulized. The ultrasonic nebulizer retained a higher "dead" volume of solution on completion of nebulization (p less than 0.05), but the increase in saline concentration was less marked than for the jet (p less than 0.01). The mass of NaCl released as aerosol was similar for the ultrasonic and for the jet at 6 L/min but was increased for the jet at 12 L/min (p less than 0.05). There was a fivefold interindividual variation in output for the ultrasonic. Droplet mass median diameters for the ultrasonic (mean 5.4 micron) were slightly lower than those for the jet at 6 L/min (mean 6.0 micron, p less than 0.05) but were higher than those for the jet at 12 L/min (mean 3.7 micron, p less than 0.01). The ultrasonic emitted virtually no droplets less than 2 micron diameter and may be unsuitable for applications requiring high yields of fine particles for delivery to the peripheral lung regions. PMID- 3677845 TI - A comparison of patients with endoscopic esophageal perforations and patients with Boerhaave's syndrome. AB - A review was conducted to ascertain whether patients who suffered spontaneous postemetic esophageal rupture (Boerhaave's syndrome) experienced higher morbidity and mortality than patients who had endoscopic iatrogenic esophageal perforations. Review of the records of three medical centers from 1960 to 1985 identified 11 patients with Boerhaave's syndrome (group B) and 19 with iatrogenic perforations (group E). In group B, four patients were diagnosed greater than 24 h after perforation. Nine were treated surgically; of these one died. Two group B patients who were treated conservatively survived. In group E, only four patients were diagnosed greater than 24 h after perforation. Of 19 patients, 15 were treated surgically and four, medically. In group E, three patients died (one surgically and two conservatively treated). This study suggests that there is little difference in mortality between the two groups of patients as long as the diagnosis is made early and therapy is instituted promptly. PMID- 3677846 TI - Self-esteem and compliance in encopretic children. PMID- 3677847 TI - Classroom behaviors related to academic gains in a group of low achieving children. PMID- 3677848 TI - The psychiatrist in neonatology: a new frontier. PMID- 3677849 TI - A long-term follow-up study of a children's psychiatric day treatment center. PMID- 3677850 TI - Meeting the mental health needs of severely emotionally disturbed minority children and adolescents: a national perspective. PMID- 3677852 TI - Helping our children. PMID- 3677851 TI - Alaska native youth. A new approach to serving emotionally disturbed children and youth. PMID- 3677853 TI - Head start combats baby bottle tooth decay. PMID- 3677854 TI - A last chance for youth "aging out" of foster care. PMID- 3677855 TI - Clinician and state children's services worker collaboration in treating sexual abuse. AB - The authors report on the pitfalls, contradictions, and potential of a three-year interagency collaborative effort between clinicians and state children's services workers treating child victims of sexual abuse. PMID- 3677856 TI - Rhode Island's child protective service system. AB - Rhode Island has found that an adaptation of the Illinois child protective services system has successfully enabled it to improve its protective service, giving primacy to children's rights while minimizing intrusion on family privacy. PMID- 3677857 TI - Adolescents in families adopting older children: implications for service. AB - Editor's Note: The study reported here is of necessarily limited scope and design because of the realistically small number of adoptions with families containing adolescents that are available for examination. The findings and conclusions of the authors are nonetheless useful for agencies involved in special-needs adoption. PMID- 3677858 TI - [Current opinions on the diagnosis of soft tissue tumors of the locomotor system]. PMID- 3677859 TI - [Laminal anatomy of the human knee joint for the purpose of computerized tomography]. PMID- 3677860 TI - [Treatment of fractures of the distal end of the patella]. PMID- 3677861 TI - [Chondrolysis of the hip joint in juvenile epiphysiolysis of the femur head]. PMID- 3677862 TI - [Prevention and ambulatory treatment of congenital hip dislocation in the Democratic Republic of Germany]. PMID- 3677863 TI - [The Buck-Jakab operation in the treatment of various forms of spondylolisthesis]. PMID- 3677864 TI - [Morphology of the distal insertion of the superficial muscle tendon of the fingers]. PMID- 3677865 TI - [Use of an insular forearm flap in the treatment of heat-press injury of the dorsum of the hand]. PMID- 3677866 TI - [Restoration of hand function using a free muscle transplant with microsurgical anastomosis of blood vessels and nerves]. PMID- 3677867 TI - [Our experience with continuous elastic traction in congenital luxation of the hip]. PMID- 3677868 TI - [Renal osteodystrophy]. PMID- 3677869 TI - [CT in the study of the external hyper-pressure syndrome]. PMID- 3677870 TI - [Remote evaluation of orthopedico-rehabilitation treatment in distortions of the cervical spine]. PMID- 3677871 TI - [Neuromuscular diseases at the local Central-South Medical Unit of Bolzano: orthopedic aspects]. PMID- 3677872 TI - [Latero-cervical osteochondroma: remote observations in a case]. PMID- 3677873 TI - [Bilateral Perthes disease occurring in early childhood: description of an unusual case]. PMID- 3677874 TI - [Angioma of the long bones: presentation of a case with femoral localization]. PMID- 3677875 TI - [Atypical localizations of eosinophilic granuloma. Clinical and therapeutic observations]. PMID- 3677876 TI - [Reinsertion of the meniscus: our experience in the treatment of chronic laxity]. PMID- 3677877 TI - [Remote results in the treatment of bimalleolar fractures]. PMID- 3677878 TI - [Multiple injuries--rescue systems, transport and first aid]. PMID- 3677879 TI - [Degree of severity and priorities in multiple injuries]. PMID- 3677880 TI - [Thoracic and abdominal injuries in polytrauma]. PMID- 3677881 TI - [Spinal and pelvic fractures within the scope of multiple injury]. PMID- 3677882 TI - [Prognostic factors in cardia cancer]. AB - Among 164 patients operated upon for adenocarcinoma of the cardia 102 (61%) were resected, 87 of them with curative intent. The mortality within 30 days was 20%, and the 5-year survival 15%. A total gastrectomy was performed in 36 patients, whereas a proximal partial gastrectomy was carried out in 66 cases. The median survival was 19 months after total gastrectomy, and 11 months after proximal resection (Breslow: 0.22). Only in stages N0 and N1 total gastrectomy resulted in a significantly longer (32 months) median survival than proximal resection (11 months; p = 0.03). The impact of total gastrectomy was more pronounced in the diffuse type according to Lauren, whereas lymphadenectomy was more effective in stages N0 and N1 and in Lauren's intestinal type. It is concluded that total gastrectomy should be carried out in all cases of carcinoma of the cardia. PMID- 3677883 TI - [Is intrahepatic cholangiojejunostomy in liver hilus-localized malignant occlusive jaundice a better alternative to endoscopic transhepatic drainage?]. AB - The malignant obstruction of the hepatic confluence has a poor prognosis and no chance of cure. Therefore the therapy of choice today is usually a transpapillary drainage and surgical interventions are avoided. Before the indication for a transhepatic drainage is established the malignant etiology of this disease should be verified in every case and inoperability should be cleared in case of doubt by laparotomy. In a few cases a curative resection is possible. From January 1st, 1979 to September 1st, 1986 we succeeded in a curative resection in one out of fourteen cases; in thirteen cases an intrahepatic cholangio enterostomy, eleven times with the left intrahepatic duct and two times with the right intrahepatic duct, was performed. Though the rate of postoperative complication was 54%, in hospital mortality was only 7%. The curatively operated woman is now living for six years postoperatively and the man with a benign intrahepatic stricture after right hepatectomy because of hepatocellular cancer is now living 44 months after the first operation. The mean survival time of the palliative operated patients is 12.3 months. Thus the intrahepatic cholangio enterostomy seems to be superior to the endoscopic transpapillary drainage in comparable cases of tumor obstruction of the hepatic confluence concerning life quality and life expectancy. PMID- 3677884 TI - [Significance of primary radical surgery for survival following treatment of breast cancer. Problems of interpretation of treatment results of prospective, nonrandomized studies exemplified by the Southwest Germany Breast Cancer Study]. AB - In a prospective non-randomised trial 1642 patients were included. After a mean time of 10 years a follow-up analysis was performed. The importance of the radicality of the primary operative therapy of breast cancer should be evaluated. The mean 5 years survival rate was 67.3%, the 10 year survival rate 51.6%. Tumor stage and age had a highly significant influence on the survival rate. Patients with simple mastectomy had a lower survival rate as patients with radical mastectomy. This apparent difference was caused by a different age distribution in the therapy groups. Accordingly the mean life deficiency was the lowest in the simple mastectomy group. In a multiple hazard statistical analysis tumor stage and age showed a highly significant influence on the survival rate. The intraoperative radicality classification showed a significant correlation to the prognoses of the patients. The operative therapy itself had no significant influence on the survival rate of the patients. PMID- 3677885 TI - [Transcatheter embolization of the internal mammary artery in traumatic hemorrhage]. PMID- 3677886 TI - [Fascioliasis--a rare differential diagnosis of liver tumor]. PMID- 3677887 TI - [Perforations of the small and large intestine]. PMID- 3677888 TI - [Acute mesenteric vascular occlusions]. PMID- 3677889 TI - [Pseudo-obstruction of the intestine]. PMID- 3677890 TI - [Current role of immunoscintigraphy for surgical therapy of the recurrence of colorectal cancers]. AB - In patients with local recurrence or liver metastases from colorectal cancer the preoperative results of conventional diagnostic methods (sonography, computed tomography, x-ray, endoscopy) and immunoscintigraphy performed with 131I labeled CEA/Ca 19-9 antibodies were compared to intraoperative findings. Specificity of immunoscintigraphy in detecting liver metastases was higher compared to conventional diagnostic methods but its predictive reliability was disappointing, especially in regard to diagnosis of the number of liver metastases and detection of local recurrence or peritoneal seedings. Compared to all intraoperative findings a positive predictive value of 74% and a negative predictive value of 42% for immunoscintigraphy could be found as compared to 88% and 63%, respectively, for conventional diagnostic methods. So immunoscintigraphy in our experience cannot give more information beyond conventional diagnostic tools for indication or planning of operative strategy in the treatment of recurrent colorectal cancer. PMID- 3677891 TI - [Neurogenic appendicopathy--long-term results following appendectomy]. AB - The neurogenic appendicopathy is a disease which is caused by proliferation of nerve fibres and hyperplasia of endocrine cells in the submucosa of the appendix. It is to be diagnosed surely only histologically. 28 patients in which appendectomy specimens solely changes of neurogenic appendicopathy type were present have been traced. Following statements can be made: 1. The disease is curable in 96% by simple appendectomy. 2. Concerning this diagnosis about 60% of so-called "negative" appendectomies will find a reasonable explication. 3. At the same time a facultative precurser disease of appendiceal carcinoid tumor is removed. PMID- 3677892 TI - [Lengthening of the extremities and treatment of segmental defects by callus distraction]. AB - Under certain conditions after osteotomy, continuous distraction of the bone ends can induce regeneration of bone tissue with bridging of the defect. This method has been used by Ilizarov for over 30 years and has proved very useful in lengthening procedures of the extremities and curing segmental defects. Particularly large defects (over 5 cm) may be bridged much faster than by conventional methods with repeated bone grafting. In many cases a single surgical procedure will suffice. PMID- 3677893 TI - [Surgical treatment of large thoracic wall recurrences in breast cancer]. PMID- 3677894 TI - [Resection of the sacrum]. PMID- 3677895 TI - [Hemobilia of arterial origin. Apropos of a case]. PMID- 3677896 TI - [Excision of hepatic metastases of colorectal cancers]. PMID- 3677897 TI - [Reoperation after Heller's operation for megaesophagus]. PMID- 3677898 TI - [Course and surveillance of severe injuries of the pancreas. Apropos of 3 cases followed for more than 15 years. Value of fluorescein dilaurate and glycosylated hemoglobin]. PMID- 3677899 TI - [Portal hypertension due to prehepatic obstruction. Results of surgical treatment]. PMID- 3677900 TI - [The Ilizarov procedure: revolution or evolution in treatment by external fixation. Apropos of 18 cases]. PMID- 3677901 TI - [Pre- and postoperative chemotherapy of inflammatory breast cancers. Analysis of a series of 41 cases]. PMID- 3677902 TI - [The Dautry-Gosset operation in ruptures of the rotator cuff and scapulo-humeral periarthritis]. PMID- 3677903 TI - [Surgical aspects of hemorrhage of duodenal ulcers]. PMID- 3677904 TI - [Acute postoperative cholecystitis. Apropos of 27 cases]. PMID- 3677905 TI - [Treatment of gastroesophageal reflux by Nissen's complete fundoplication. Results in 112 cases]. PMID- 3677906 TI - [Superoxide dismutase in general surgery. Preliminary results]. PMID- 3677907 TI - [Conservative surgery of meniscal lesions]. PMID- 3677908 TI - [Value of ketoconazole in combination with the surgical treatment of fungal mycetoma]. PMID- 3677909 TI - [Operation to open the carpal tunnel. Advantages and disadvantages]. PMID- 3677910 TI - [Surgical treatment of hepatic metastases of colorectal cancers]. PMID- 3677911 TI - [Superoxide dismutase in general surgery]. PMID- 3677912 TI - [Superficial cancers of the stomach. 40 operated cases]. PMID- 3677913 TI - [Long-term results of aponeurectomy for Dupuytren's disease]. PMID- 3677914 TI - [Sclerosing adenomatosis of the mammary gland with Aschoff's sclero-hyaline nodules. Apropos of 20 cases]. PMID- 3677915 TI - [Endarterectomy 40 years later. Reappraisal of its feasibility based on anatomic and microscopic data]. PMID- 3677916 TI - [Pancreatitis and primary hyperparathyroidism. 14 cases of pancreatitis--500 cervicotomies]. PMID- 3677917 TI - [Resection by abdominal approach with manual anastomosis in cancer of the rectum. Study of 282 cases. Technic. Results]. PMID- 3677918 TI - [Place of gastroduodenal anastomosis in the ulcer zone in the treatment of penetrating hemorrhagic duodenal ulcers]. PMID- 3677919 TI - [Treatment of inflammatory breast cancers at the Institut Gustave Roussy. Apropos of 230 cases]. PMID- 3677920 TI - [Surgical debridement of the carpal tunnel]. PMID- 3677922 TI - Transcription of the histone loci on lampbrush chromosomes of the newt Notophthalmus viridescens. AB - We have investigated transcription of the histone gene cluster on lampbrush chromosomes of the newt Notophthalmus viridescens. Clusters of the five histone genes are separated by long tracts of a DNA repeat called satellite 1. Previous in situ hybridization results demonstrated the presence of histone gene coding regions, intergene spacers, and flanking satellite repeats in giant transcription units on lampbrush chromosomes. These results suggested a model in which transcription initiates at histone gene promoters and continues through the rest of the gene cluster into satellite repeats. The readthrough transcription model predicts that spacer regions upstream of the first promoter in the gene cluster should be absent from nascent transcripts on chromosome loops. We have used such upstream spacer probes for in situ hybridization to lampbrush chromosomes. Contrary to our expectation, the results show that upstream spacer regions are transcribed, and indicate that transcription often initiates upstream of the first histone gene promoter. The relationship of giant transcription units in oocyte nuclei to cytoplasmic histone mRNA is discussed. PMID- 3677923 TI - Novel cytogenetic expression of gene amplification in actinomycin D-resistant somatic cell hybrids: transfer of resistance by centric chromatin bodies. AB - SEWATC13 mouse cells, resistant to 0.1 microgram/ml of actinomycin D (AMD), were fused to AMD-sensitive cells of the Chinese hamster ovary cell line (CHO). Twenty two hybrid clones were isolated and put into serial culture in the selective medium. Unexpectedly, identifiable mouse chromosomes were found only in one of the hybrids. All the others had only hamster chromosomes and, in addition, numerous chromatin bodies (CBs), mostly small and irregularly shaped, but also larger, more chromosome-like ones. The CBs were distinctly C-band positive and a mouse satellite probe hybridized strongly to them. The AMD resistance of the murine parental cells had previously been attributed to gene amplification in two large homogeneously staining regions (HSR-AMD1 and 2). They were not observed in the hybrid cells but had supposedly reappeared in the guise of the CBs. It was established by Southern DNA blot analysis that amplified DNA sequences, localized to the HSR-AMD1 and 2 of the SEWA parent were present in multiple copies in the hybrids. It was also established by in situ hybridization that they were located in the CBs. Unlike double minutes (DMs) the CBs were all centric. PMID- 3677924 TI - Chronotoxicity of methotrexate in mice after intraperitoneal administration. AB - Methotrexate (MTX), an effective agent in treatment of cancer, is one of the most versatile antineoplastic agents in spite of severe toxicity problems. The purpose of this study was to determine the circadian variation of this toxicity in order to decrease the side effects. The experiments were done in mice given a single i.p. dose. The toxicity of MTX, estimated from the relative weight loss, varied according to the time of administration, with a maximum after administration at 0900 (02 HALO). The dose-effect relationship can be described by a linear function: delta P/P versus log (dose). The slope of this line varies with the time of administration. These variations are correlated with the variations in biochemical [dihydrofolate reductase (DHFR) activity] and pharmacokinetic parameters (AUC) studied in previous works. PMID- 3677921 TI - Human chromosome-specific repetitive DNA sequences: novel markers for genetic analysis. AB - Two recombinant DNA clones that are localized to single human chromosomes were isolated from a human repetitive DNA library. Clone pHuR 98, a variant satellite 3 sequence, specifically hybridizes to chromosome position 9qh. Clone pHuR 195, a variant satellite 2 sequence, specifically hybridizes to chromosome position 16qh. These locations were determined by fluorescent in situ hybridization to metaphase chromosomes, and confirmed by DNA hybridizations to human chromosomes sorted by flow cytometry. Pulsed field gel electrophoresis analysis indicated that both sequences exist in the genome as large DNA blocks. In situ hybridization to intact interphase nuclei showed a well-defined, localized organization for both DNA sequences. The ability to tag specific human autosomal chromosomes, both at metaphase and in interphase nuclei, allows novel molecular cytogenetic analyses in numerous basic research and clinical studies. PMID- 3677925 TI - Distribution of sleep and wakefulness in 24-h light-dark cycles in the juvenile and adult magpie, Pica pica. AB - The daily organization of sleep and wakefulness was examined electrographically under natural conditions in captive juvenile and adult magpies, Pica pica. Electrographic indices of sleep in the magpie were found to be similar to those of other avian species. The daily amount of TS in juveniles was 17% greater than in adults. The amount of paradoxical sleep (PS) in adults was one-fifth that of juveniles. In adults sleep was confined to darkness, while in juveniles it also occurred during the light period. SWS in adults was almost constant, while PS slightly increased across the night. No systematic trends were observed in juveniles. In both groups of birds, the longest sleep episodes appeared around midnight. PMID- 3677927 TI - Autoimmunity and autoimmune disease. PMID- 3677926 TI - Further steps toward a neonatal chronocardiology. AB - The study of 53 series of blood pressures at half-hour intervals from clinically healthy full-term newborns during the first days of life reveals various classifiers correlating with a history of high blood pressure: the circadian amplitude of diastolic blood pressure, the 50% range of systolic blood pressure and the standard deviation of heart rate. PMID- 3677928 TI - [Free flap with arterialized venous trunk: report of 4 cases]. PMID- 3677929 TI - [Anterior interosseous nerve syndrome: report of 8 cases]. PMID- 3677930 TI - [A new method of compression fixation of the interphalangeal joint]. PMID- 3677931 TI - [Diagnosis and treatment of fractures and dislocations of the pisiform triquetrum and hamate bone]. PMID- 3677932 TI - [Technical improvements in reconstruction of the thumb and finger by transfer of the second toe]. PMID- 3677933 TI - [Torsion of the testicle or testicular appendages: report of 13 cases]. PMID- 3677934 TI - [Surgical treatment of thoracoabdominal aortic aneurysms]. PMID- 3677935 TI - [Some aspects of smooth muscle tumors of the digestive tract]. PMID- 3677936 TI - [Resection and reconstruction of the carina]. PMID- 3677937 TI - [Clinical analysis of 53 cases of pneumonectomy in lung cancer]. PMID- 3677938 TI - [Urokinase in the treatment of hypertensive intracerebral hematoma]. PMID- 3677939 TI - [Morphology of the sinuvertebral nerve]. PMID- 3677940 TI - [Moire topography in school screening for scoliosis]. PMID- 3677941 TI - [Posterior instrumentation and spondylodesis for scoliosis under halo-pelvic distraction with local anesthesia]. PMID- 3677942 TI - [Luque's operation in spinal surgery]. PMID- 3677943 TI - [Use of interbody fixation nails for anterior fusion of the thoraco-lumbar spine. A preliminary report of 49 cases]. PMID- 3677944 TI - [Posterior osteotomy and Harrington compression rods to correct spinal kyphosis following ankylosing spondylitis]. PMID- 3677945 TI - [Microfracture of the trabecula of the lumbar vertebral bodies caused by fatigue load and its relations to disk herniation]. PMID- 3677946 TI - [Value of serum C-reactive protein and temperature in detecting postoperative infection]. PMID- 3677947 TI - [Clinical use of the E 8410 extracorporeal shock wave lithotriptor in the treatment of renal and upper ureteral stones: report of 200 cases]. PMID- 3677948 TI - [Use of a transhepatic U-tube in biliary stricture]. PMID- 3677949 TI - [Primary dilatation of intrahepatic ducts: report of 14 cases]. PMID- 3677950 TI - [Treatment of retrohepatic vena cava obstruction by prehepatic cavoatrial shunt]. PMID- 3677951 TI - [An attempt at preserving facial nerve function in total removal of the large type acoustic neuroma by microsurgery]. PMID- 3677952 TI - [Venous regurgitation of the testis after high ligation of the spermatic vein]. PMID- 3677953 TI - [Management of burns in newborn infants]. PMID- 3677954 TI - [A life-saving measure in the treatment of hepatic and posthepatic inferior vena cava trauma with an abdominal IVC balloon catheter: animal experiment]. PMID- 3677955 TI - [Experimental study on the use of autogenous peritoneum in the reconstruction of blood vessels]. PMID- 3677956 TI - Definitive management of rectal cancer by contact (endocavitary) irradiation. AB - In a retrospective review, 62 patients treated for rectal cancer by contact (endocavitary) irradiation at The Cleveland Clinic Foundation were analyzed. This treatment modality delivers high dose, low penetration irradiation to a rectal cancer by direct contact of a 50 KV x-ray source through a special proctoscope. Cancers selected for this treatment include small (3 cm or less), mobile tumors without presacral lymphadenopathy that are within reach of digital examination and are well- or moderately well-differentiated adenocarcinomas. Between 1973 and 1984, 62 patients (37 males, 25 females) were treated--46 by contact irradiation alone and 16 by contact irradiation after excisional biopsy. The median tumor dose was 12,000 rads administered in four fractions at monthly intervals. Mean follow-up was 31 months. Fifty-six patients (90 percent) were disease-free at the time of review or death (ten died from unrelated causes). Eleven patients (18 percent) developed local recurrence but eight of these without distant metastases were rendered disease-free by other treatment--six by surgical resection and two by further radiotherapy. Mean time since secondary treatment is 20 months. Three patients are alive with incurable disease and three have died from cancer--in three of these six patients there was no evidence of local disease. Ulcerated tumors developed local recurrence in five of 17 cases (29 percent) while polypoid tumors recurred locally in six cases (14 percent). Morbidity from the treatment was minor in nature. It is suggested that contact (endocavitary) irradiation is effective treatment for carefully selected cases of rectal cancer. PMID- 3677957 TI - Screening for colorectal neoplasms. A comparison of the fecal occult blood test and endoscopic examination. AB - Testing for occult blood in stool is used frequently as a screening technique for colorectal carcinomas, but no study has ever shown an improved survival rate for colorectal carcinoma in patients screened by this method. Consequently, the authors have prospectively compared the sensitivity of endoscopy and occult blood testing in finding colorectal neoplasms. During the first year of the Surgical Endoscopy Service, 585 patients underwent sigmoidoscopy or colonoscopy. Seventy nine patients (13.5 percent) were excluded from the study because their occult blood status was not recorded. Patients averaged 63 + 10 years of age and 98 percent were men. Of the 348 patients with occult blood negative stools 55.5 percent underwent colonoscopy and 44.5 percent underwent sigmoidoscopy. Polyps were found in 25.6 percent of these patients, colorectal carcinomas in 2.6 percent, and diverticulosis 36.2 percent. Of the 158 patients with occult blood positive stool, 76.5 percent underwent colonoscopy and 23.4 percent underwent sigmoidoscopy. Polyps were discovered in 39.0 percent of these patients, colorectal carcinomas in 10.1 percent, and diverticulosis in 43.0 percent. Thus, the occult blood test was negative in 59 percent of patients with polyps and 36 percent with colorectal cancers. These data indicate that lower gastrointestinal endoscopy is superior to occult blood testing in detecting colorectal neoplasms. These results further suggest that using the occult blood test as a screening test for colorectal neoplasms will result in a significant number of these lesions being missed at an early curable stage. PMID- 3677958 TI - Biofeedback training for constipation in adults and children. AB - Forty-two patients complaining of constipation with abnormal anorectal motility were studied: 20 children and 6 adult females had a decreased rectoanal inhibitory reflex (RAIR) amplitude and 16 adult females had anal hypertonia and ultra slow waves (USW). Biofeedback training was used to condition the patients to relax the anal sphincter during the desire to defecate. After two to eight (mean, 4) training sessions, the authors observed simultaneously a normal RAIR amplitude and recovery from constipation for at least six months in 15 children and five females with decreased RAIR amplitude. Nine of the adult females with hypertonia and USW were able to suppress USW but did not recover from constipation. The data suggest that biofeedback training could be useful in some groups of constipated patients. PMID- 3677959 TI - Anal pressure measurements in the study of hemorrhoid etiology and their relation to treatment. AB - The etiology of hemorrhoids has been explained in the past based on anatomic principles, but this study examines the relationship of resting anal pressures to hemorrhoid etiology in 38 patients with hemorrhoids and 29 controls with no perianal symptoms. Three months after treatment by elastic band ligation, anal pressures were again measured in the hemorrhoid group. Anal pressures were significantly higher in the hemorrhoid group before treatment (102 +/- 26.33 mmHg) as compared with the controls (76.75 +/- 19.56 mmHg) (P less than .001). Three months following elastic band ligation there was a small drop in anal pressure (100 +/- 26.84 mmHg) but it remained significantly higher than the control group. There was also a significant correlation between symptoms and level of anal pressures. The results indicate that persons with hemorrhoids have higher anal pressures than controls. Elastic band ligation relieves the symptoms but should not affect the anal sphincter pressure. The fact that the anal pressures remained high after treatment could imply that higher pressures are an etiologic component in the formation of hemorrhoids. PMID- 3677960 TI - Continent ileostomy simplified by musculo-serosal window. An experimental study. AB - Experience with pouch procedures in the quest for continence after total panproctocolectomy has been associated with significant reoperation rates, making these procedures suitable only for highly selected and motivated patients. The purpose of this study was to determine, in an acute dog model, the optimum configuration of a new continence mechanism consisting of a musculo-serosal window formed between the afferent and efferent loops of small bowel. The following geometric measures were varied: single or double window (efferent and afferent loops, respectively); percent circumference of bowel wall used for the window; and distance between pouch apex and window. Intraluminal pressure against volume infused in standard time was recorded. Four hundred seventy experiments in 47 pouches were conducted. The authors suggest that the optimal configuration for this "valve" is bowel circumference used for the window--50 to 60 percent on both the afferent and efferent loops, with a pouch-valve distance of 5 to 6 cm. It is concluded that a biologic valve obviating the need for a nipple may be possible. The geometric configuration has been defined and should be studied in a chronic animal model to determine long-term results. PMID- 3677961 TI - Technique of mesenteric lengthening in ileal reservoir-anal anastomosis. AB - Construction of a satisfactory ileal reservoir-anal anastomosis is dependent on the ability of the reservoir to reach the anus without tension. A technique has been developed for the generation of satisfactory mesenteric length in 159 consecutive J-reservoir procedures. By careful attention to technical details with particular reliance on the division of branches between the primary and secondary arcade vessels within the mesentery, sufficient length can be achieved in each case with an acceptable complication rate. When combined with the ease of construction of the J-reservoir, this technique of mesenteric lengthening has made the double-loop reservoir the procedure of choice. PMID- 3677962 TI - Tissue oxygen tension as a predictor of colonic anastomotic healing. AB - Inadequate blood flow causing tissue hypoxia can result in failure of anastomotic healing. Tissue oxygen tension (ptO2) measurement has been used to predict anastomotic leakage in animals, but its use in humans has not been described previously. A Clark-type oxygen electrode was used to measure ptO2 on the colon of 50 patients undergoing colonic resection and anastomosis. Baseline ptO2 levels were lowest on the descending colon (31.8 +/- 7.4 mmHg, mean +/- SD) and tended to increase at all sites with increasing arterial paO2 (r greater than .76, P less than .001). Perianastomotic ptO2 levels were predictive of subsequent anastomotic leakage when they were less than either 20 mmHg; 50 percent of the preresection ptO2; 15 percent of the arterial paO2; or 40 percent of the ptO2 at a control site (ileum). It is concluded that perioperative ptO2 measurements are of value in the prediction of anastomotic leakage. PMID- 3677963 TI - Carcinoma of the splenic flexure. AB - Carcinoma of the splenic flexure is uncommon and the diagnosis should be kept in mind, particularly in patients with recurring upper gastrointestinal symptoms. Resection is usually possible and operative complications are few. The site of the tumor does not affect long-term survival. Subtotal colectomy with ileosigmoid anastomosis would seem to be a safe method of treating patients with an obstructed carcinoma at that site. PMID- 3677964 TI - Clinical course of Crohn's disease in Italy. AB - The clinical course of Crohn's disease in 131 patients was studied for a mean period of 4.2 +/- 3.2 years. The clinical activity of the disease, expressed as percentage of patients per year in an active phase, is high in the first year (70.2 percent) and progressively decreases during subsequent years (25 percent after seven years). The percentage of patients who needed steroid treatment is high during the first year (68 percent) and falls to 19 percent after seven years. An operative risk rate of 54 percent was registered, with a probability of reoperation equal to 34 percent. Clinical relapse after the first surgery occurred in 70 percent of cases. The registered mortality was 6.9 percent, with a ratio of 6 to 1 between observed and expected mortality. In conclusion, the disease, while showing a tendency to reduce its activity over the years, is burdened by a risk of surgery and mortality which progressively increases with time. PMID- 3677965 TI - A model for the study of metastases from colonic tumors by autotransplantation. AB - Thirty male Sprague-Dawley rats received weekly injections of dimethylhydrazine for three months. They were subsequently laparotomized and tumors were palpated in 21 rats. The colonic tumor was removed and a fraction was autotransplanted into the wall of the transverse colon and a second fraction into the subcapsular space of the left kidney. The results demonstrated successful autotransplantation of colonic tumors in 13 of 21 rats (i.e., 62 percent). In 11 of the 21 rats (52 percent) the tumor grew in the left kidney. Of the various experimental methods proposed for the study of tumor metastases, the one described herein appears to be the first in which primary and secondary tumors were studied in the same individual, since dimethylhydrazine-treated rats usually develop more than one colonic tumor per individual. The model may be useful to monitor the effect of various drugs known to affect tumor growth, not only at the primary site, but also at the site of metastasis. PMID- 3677966 TI - Colonic lipomas. Report of two unusual cases and review of the Mayo Clinic experience, 1976-1985. AB - Two cases of symptomatic submucosal lipomas of the large intestine are described. One occurred in a patient with familial multiple lipomatosis causing an intussusception and intermittent obstruction. The other caused subacute obstruction and rectal bleeding and was thought to represent a carcinoma. These two cases closely resemble those few patients with symptomatic lipomas of the colon that make up a small subgroup (6 percent) of a series of 91 patients with this diagnosis managed surgically at the Mayo Clinic between the years 1976 to 1985. The majority of patients in this series had lipomas that were entirely incidental findings usually associated with more significant pathology that dictated the operative procedures undertaken. Lipomas themselves may be managed by local excision only although segmental resection may be necessary in isolated cases. PMID- 3677967 TI - Use of the fascial stapler in proctopexy for rectal prolapse. AB - Proctopexy using synthetic mesh is a popular method of treating rectal prolapse. Suturing the graft to the presacral fascia is time-consuming and can lead to complications. With the fascial stapler, two parallel rows of three staples are used to quickly and securely anchor the Marlex sling to the sacrum, thus avoiding hemorrhage from the presacral veins. Fourteen patients have been treated with no complications. PMID- 3677968 TI - Endoscopic retrieval of foreign bodies from the rectum. AB - A technique is described and illustrated by case reports wherein removal of foreign bodies of the rectum is simplified by using the flexible sigmoidscope. Evidence from the literature indicates that delayed perforation is rare in this situation, and that outpatient management would suffice for most patients. PMID- 3677969 TI - Failure of prophylactic indomethacin to improve the outcome of the very low birth weight infant. AB - Prophylactic closure of the patent ductus arteriosus (PDA) has been recommended as a means of decreasing early respiratory distress, and thereby chronic respiratory sequelae in the very low birth weight (VLBW) neonate. This study was undertaken to evaluate some possible mechanisms for the observed failure of early indomethacin therapy to achieve such improvement. 24 VLBW infants with echocardiographic evidence of PDA were randomized to receive either indomethacin or placebo at 48 h of life; and then they were studied for clinical, metabolic and laboratory signs of ductal constriction and/or reopening. Early indomethacin conferred no improvement in respiratory sequelae. However, this was not secondary to a short-term therapeutic failure. Prophylactic indomethacin, even in the VLBW infant, was successful in decreasing dilator prostaglandin production, and probably in closing the PDA and in decreasing the number of recurrences. The implications are that even with effective ductal constriction, overall morbidity is not affected. PMID- 3677970 TI - Serum protein binding of furosemide in newborn infants and children. AB - The protein binding of furosemide was studied in the serum from 8 umbilical cords, in 51 children (aged between 2 weeks and 13.5 years) and in the plasma of 10 volunteers (aged between 28 and 42 years). The drug was added to the buffer to give a final concentration of 2 micrograms/ml. The unbound fraction of furosemide was 2.5 +/- 0.1% (cord serum) and 1.7 +/- 0.7% (adult plasma). These figures are different at a level of 0.001. The unbound fraction of furosemide reached the adult values during the 1st year of life. A correlation (level of significance greater than 0.01) was found between the unbound fraction and the age during the first 6 months of life. The furosemide binding kinetics were studied in 3 cord serum and in 3 adult plasma samples. The concentration of the drug in the buffer ranged between 1 and 16 micrograms/ml. The kinetic constants (mean +/- SEM) were: association constant (K = 10(5) M-1) 2.4 +/- 0.3 (cord serum), 2.0 +/- 0.2 (adult plasma); the number of binding sites per gram protein (n = 10(-6] was 3.2 +/- 0.5 (cord serum) and 3.9 +/- 0.7 (adult plasma). When the concentration of furosemide was increased up to 200 micrograms/ml buffer, the free fraction of the drug increased up to 4.8 +/- 0.2% (cord serum) and 2.9 +/- 0.4% (adult plasma). PMID- 3677971 TI - Dissociation and association rate constants changes following bilirubin binding affinity decreases. AB - The effect of sulfisoxazole, sodium salicylate, sodium cholate, urea and dimethyl sulfoxide on the kinetics of the bilirubin to human serum albumin at 24 degrees C and pH 7.40 was investigated. A marked decrease of the association constant was obtained. It was due mainly to that of the association rate constant, and might be an additional risk factor to the icteric newborn: when blood bilirubin increases, unbound bilirubin which cannot rapidly associate to albumin may reach a dangerous level, even when its equilibrium concentration is low. PMID- 3677972 TI - Verapamil and nifedipine effect on K+-induced contractions of guinea pig ileum during postnatal development. AB - The effects of verapamil and nifedipine on K+-induced contractions were studied in the isolated ileum of newborn, 30-day-old and adult guinea pigs. Both verapamil and nifedipine inhibited the K+-induced contractions, with nifedipine demonstrating the highest activity. The tonic component of the K+ response was more affected by the calcium antagonists than the phasic component. No changes in sensitivity to verapamil and nifedipine were recorded during the first month of postnatal development, thus suggesting that the function of calcium channels involved in the response to K+ does not change during this period. PMID- 3677973 TI - The pharmacokinetics of naloxone in the premature newborn. AB - We examined the pharmacokinetic properties of naloxone in a group of premature infants infused with an intravenous bolus of the drug. Ten infants with a mean birth weight of 1,328 +/- 402 g and a gestational age of 29.4 +/- 2.8 weeks were studied at an age of 4.5 +/- 3.2 days of life. Following administration of 0.4 mg/kg of naloxone, we obtained blood samples at specific time intervals, and stored the serum for later analysis by a radioimmunoassay method. Calculations from the serum concentration versus time relationship resulted in an elimination rate constant of 0.75 +/- 0.39/h, a half-life of 70.5 +/- 35.2 min, a systemic clearance of 39.13 +/- 14.53 ml/min/kg, and an apparent volume of distribution of 3.52 +/- 1.20 liters/kg. PMID- 3677974 TI - Type II diabetic subjects lose less weight than their overweight nondiabetic spouses. AB - To determine whether diabetic individuals have more difficulty losing weight than nondiabetic individuals, 12 overweight diabetic subjects (6 men, 6 women) and their overweight nondiabetic spouses were treated together in a behavioral weight control program. Diabetic and nondiabetic subjects did not differ in age, weight, or percent overweight. Weight losses of nondiabetic spouses were significantly greater than those of diabetic patients (13.4 +/- 1.7 vs. 7.5 +/- 1.4 kg; P less than .01). Differences emerged by wk 5 and became greater over the 20-wk program. Nondiabetic subjects reduced their intake significantly more than diabetics, suggesting that differences in dietary adherence were responsible for the differences in weight loss. PMID- 3677975 TI - Community-based exercise intervention: Zuni Diabetes Project. AB - Non-insulin-dependent diabetes mellitus (NIDDM) is a serious health problem among the Zuni Indians of New Mexico. In July 1983, Indian Health Service personnel initiated a community-based exercise program designed to help control NIDDM in the community. To retrospectively evaluate the effects of the exercise program, the medical records of 30 participants with NIDDM were compared with the medical records of 56 nonparticipants with NIDDM matched by age, sex, health-care provider, and duration of NIDDM. From 1 July 1983 through 1 October 1985, participants had a mean weight loss of 4 kg, whereas nonparticipants had a mean weight loss of 0.9 kg (P less than .05). Participants' fasting blood glucose values dropped by a mean of 43 mg/dl, compared to a mean drop of 2 mg/dl among the nonparticipants (P less than .05). Participants were significantly more likely than nonparticipants to have stopped their hypoglycemic medication (relative risk 4.2) and to have decreased their medication dosage (relative risk 2.2). These results suggest that participation in a community-based exercise program can produce significant weight loss and improvement in glycemic control among a group of Native Americans with NIDDM. PMID- 3677976 TI - Postexercise late-onset hypoglycemia in insulin-dependent diabetic patients. AB - A new clinical entity that is prevalent in young type I (insulin-dependent) diabetic patients, postexercise late-onset (PEL) hypoglycemia, is described. A prospective case-finding study suggested that PEL hypoglycemia occurred in 48 of approximately 300 diabetic type I patients who were diagnosed as diabetic before age 20 yr and who were monitored for up to 2 yr. Typically, hypoglycemia was nocturnal and occurred 6-15 h after the completion of unusually strenuous exercise or play. In more than half the cases the hypoglycemia resulted in loss of consciousness or seizures and necessitated treatment with subcutaneous glucagon or intravenous glucose and/or attendance by a health professional. The hypoglycemia was not limited to patients in good or excellent metabolic control and often occurred after a single bout of exercise in patients unaccustomed to exercise or in athletic patients who were making the transition from an untrained to a trained state. Surprisingly, 12 of the patients who experienced nocturnal PEL hypoglycemia were not using significant amounts of insulin that peaked at night. Type I diabetic patients should be made aware of the possibility of PEL hypoglycemia to enable them to make adjustments in their management plans in anticipation of unusually strenuous exercise, so that they may attempt to minimize or avoid late-onset hypoglycemia. PMID- 3677977 TI - Macrosomia in pregnancy complicated by insulin-dependent diabetes mellitus. AB - We assessed the factors influencing the birth weight of infants born to 83 women with insulin-dependent diabetes mellitus (IDDM) over a 5-yr period. Maternal glycosylated hemoglobin (HbA1) concentrations at delivery correlated with the percentile birth-weight ratios (r = .43, P less than .001) and indicated that approximately 18% of variance in the birth weight could be ascribed to glycemic control in the third trimester. Fetal macrosomia occurred in 22 (27%) pregnancies. When 20 of these pregnancies were compared closely with 20 nonmacrosomic pregnancies in diabetic women, the mothers of macrosomic infants were found to be more obese, have a history of previous macrosomic birth, and have higher concentrations of serum human placental lactogen and urinary estriols in the third trimester. Macrosomic pregnancy was further distinguished by accelerated fetal growth (judged by serial ultrasonography) from the 32nd wk of gestation and by biochemical (but asymptomatic) hypoglycemia in the neonate. In our study, no serious neonatal morbidity could be attributed to macrosomic pregnancy. Good glycemic control was attained in both groups, and no significant differences between the groups in overall glycemic control throughout pregnancy were noted. Thus, despite good glycemic control, macrosomia remains comparatively common in modern pregnancy complicated by IDDM, and factors other than maternal hyperglycemia must contribute to its etiology. PMID- 3677978 TI - Is aspirin usage associated with diabetic retinopathy? AB - The relationship between the history of aspirin usage and diabetic retinopathy is examined in this report. The study population consists of a sample of people (n = 1370) who developed diabetes mellitus after 30 yr of age, who lived in south central Wisconsin, and who participated in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. These participants were questioned about recent and past use of aspirin. There was no association between the number of aspirin used in the month before the exam and the severity of diabetic retinopathy. Three hundred thirty-eight of these individuals reported taking aspirin daily for at least 3 mo since they were diagnosed as having diabetes. There was no association between the severity of retinopathy and having used aspirin in this way. These analyses suggest that aspirin usage, as herein described, is unrelated to the severity of diabetic retinopathy in older-onset diabetic patients. PMID- 3677979 TI - Urinary N-acetyl-beta-D-glucosaminidase activity does not predict development of diabetic nephropathy. AB - Urinary activity of N-acetyl-beta-D-glucosaminidase (NAG) has been suggested as a marker for diabetic nephropathy. In this study, urinary activity of NAG was measured with an interval of 5 yr in 36 insulin-dependent diabetic subjects to evaluate its predictive value for development of diabetic nephropathy. During the observation period, 9 patients developed detectable signs of diabetic nephropathy. In these patients, urinary albumin concentration had increased to 503 +/- 185 mg/L, compared to 16 +/- 1 mg/L in patients without nephropathy (P less than .01; means +/- SE), and the fractional albumin excretion rate was 0.21 +/- 0.07 X 10(-3), compared to 0.01 +/- 0.00 X 10(-3) (P less than .01). However, the activity of urinary NAG was not different in these patients compared with the patients without nephropathy (0.69 +/- 0.15 and 0.61 +/- 0.09 U/mmol creatinine, respectively). Furthermore, no increase in the activity of urinary NAG was seen during the observation period in either group. We concluded that the urinary activity of NAG is not related to the development of microalbuminuria and therefore cannot be used as a predictor for the development of diabetic nephropathy. PMID- 3677980 TI - Oral candidiasis in patients with diabetes mellitus: a thorough analysis. AB - It has generally been assumed that oral candidiasis occurs with increased frequency in patients with diabetes mellitus. To evaluate this, we compared the frequency and severity of oral Candida colonization in 60 patients with insulin dependent diabetes mellitus (IDDM) admitted to a low-intensity-care diabetes unit with those in 57 age- and sex-matched controls. Swabs taken from the tongue and buccal mucosa were examined by cytology rather than culture because of the discrimination provided by the former. Cytological smears were classified according to the presence and morphology of the Candida organisms. Overall, a significant difference in Candida species colonization was found between patients with diabetes (75.0%) and controls (35.1%) (P less than .005). In the diabetic group, no relationship was found to recent use of antibiotics, total or differential white blood cell count, serum glucose, presence of diabetic retinopathy, or glycosylated hemoglobin values. We conclude that in IDDM there is a predisposition to oral candidiasis and that this predisposition is independent of glucose control. PMID- 3677981 TI - Influence of height on quantitative sensory, nerve-conduction, and clinical indices of diabetic peripheral neuropathy. AB - We have examined associations between height and quantitative sensory, nerve conduction, and clinical indices of diabetic peripheral neuropathy in adult diabetic patients. Vibratory sensitivity was strongly related to height when measurements were made with either the vibration sensitivity tester (P = .02) or the biothesiometer (P less than .01); however, there was no relation between thermal sensitivity (as measured with the thermal sensitivity tester) and height. The peroneal and posterior tibial motor nerve-conduction velocities were inversely related to height (P less than .05 for both). When age and diabetes duration were included as variables in multiple regression analyses, the associations with height became stronger. Clinical indices of peripheral neuropathy were also related to height in these analyses. Glycosylated hemoglobin was significantly related to thermal sensitivity and the peroneal and posterior tibial motor nerve-conduction velocities but not to vibratory sensitivity. These data indicate that height has a marked influence on quantitative sensory, nerve conduction, and clinical indices of diabetic peripheral neuropathy. PMID- 3677982 TI - Fear of hypoglycemia: quantification, validation, and utilization. AB - Hypoglycemia can lead to various aversive symptomatic, affective, cognitive, physiological, and social consequences, which in turn can lead to the development of possible phobic avoidance behaviors associated with hypoglycemia. On the other hand, some patients may inappropriately deny or disregard warning signs of hypoglycemia. This study presents preliminary reliability and validity data on a psychometric instrument designed to quantify this fear: the hypoglycemic fear survey. The instrument was found to have internal consistency and test-retest stability, to covary with elevated glycosylated hemoglobin, and to be sensitive to a behavioral treatment program designed to increase awareness of hypoglycemia. PMID- 3677983 TI - Evaluating clinical accuracy of systems for self-monitoring of blood glucose. AB - Although the scientific literature contains numerous reports of the statistical accuracy of systems for self-monitoring of blood glucose (SMBG), most of these studies determine accuracy in ways that may not be clinically useful. We have developed an error grid analysis (EGA), which describes the clinical accuracy of SMBG systems over the entire range of blood glucose values, taking into account 1) the absolute value of the system-generated glucose value, 2) the absolute value of the reference blood glucose value, 3) the relative difference between these two values, and 4) the clinical significance of this difference. The EGA of accuracy of five different reflectance meters (Eyetone, Dextrometer, Glucometer I, Glucometer II, Memory Glucometer II), a visually interpretable glucose reagent strip (Glucostix), and filter-paper spot glucose determinations is presented. In addition, reanalyses of a laboratory comparison of three reflectance meters (Accucheck II, Glucometer II, Glucoscan 9000) and of two previously published studies comparing the accuracy of five different reflectance meters with EGA is described. EGA provides the practitioner and the researcher with a clinically meaningful method for evaluating the accuracy of blood glucose values generated with various monitoring systems and for analyzing the clinical implications of previously published data. PMID- 3677984 TI - Fingerstick glycosylated hemoglobin, plasma protein, and albumin. AB - We have developed techniques that permit the affinity-chromatographic determination of glycosylated hemoglobin, plasma protein, and albumin on fingerstick samples of whole blood. The fingerstick glycohemoglobin technique takes advantage of the high sensitivity of measurement of hemoglobin by absorbance at 414 nm. The glycosylated plasma protein is assayed by a highly sensitive method based on binding of Coomassie blue. An enzyme-linked immunosorbent assay is used to measure albumin in the bound and nonbound fractions of an aminophenylboronic acid chromatographic separation. The fingerstick method for assay of glycosylated plasma albumin gives results that are approximately 40% higher than comparable values obtained on the same patient with a 1-ml plasma sample determined with the bromcresol green technique. There is good correlation of fingerstick glycoalbumins with fingerstick glycohemoglobins and glycosylated plasma protein values. These procedures should be useful for children and for large-scale ambulatory screening for diabetes mellitus. PMID- 3677985 TI - New management concepts for timely diagnosis of diabetic retinopathy treatable by photocoagulation. AB - Diabetic retinopathy is a leading cause of blindness in the United States. Photocoagulation has been shown to reduce visual loss from macular edema and proliferative retinopathy. Because serious diabetic retinopathy may be asymptomatic and its detection difficult, several recommendations have been made by the National Diabetes Advisory Board for routine ophthalmologic examinations to ensure timely treatment. In geographic areas devoid of ophthalmologists, alternate approaches are necessary. These include intensive training of primary care physicians in ophthalmoscopy, use of objective recording of retinopathy by fundus photography with interpretation of fundus photographs by retinal specialists, and better communication between primary-care physicians and retinal specialists. PMID- 3677986 TI - Nuts and bolts. PMID- 3677987 TI - Eating patterns in young women with IDDM: another look. PMID- 3677989 TI - Primary hypogonadism in two siblings with Wolfram syndrome. PMID- 3677988 TI - Hypercortisolism in diabetes mellitus. PMID- 3677990 TI - Residential treatment program for children with diabetes mellitus. PMID- 3677991 TI - Effectiveness of exchange diet vs. basic diet teaching in achieving treatment goals. PMID- 3677992 TI - Sucrose in the diabetic diet. PMID- 3677993 TI - Symposium on immunology and diabetes. PMID- 3677994 TI - Alternative splicing increases the diversity of the human protein kinase C family. AB - Isolation of two protein kinase C (PKC) cDNA clones containing divergent carboxy terminal sequences suggested a common genetic origin for these cDNAs. Partial characterization of the hPKC beta chromosomal gene provided direct evidence for the existence of two adjacent carboxy-terminal exons (beta 1 and beta 2) that are alternatively spliced to generate two types of hPKC beta sequences. PKC beta 1 and beta 2 mRNAs are expressed in a selective manner in both human hematopoietic cells and bovine brain tissues. PMID- 3677995 TI - DNA sequence responsible for the amplification of adjacent genes. AB - A 10.3-kb DNA fragment in the 5'-flanking region of the rat prolactin (rPRL) gene was isolated from F1BGH(1)2C1, a strain of rat pituitary tumor cells (GH cells) that produces prolactin in response to 5-bromodeoxyuridine (BrdU). Following transfection and integration into genomic DNA of recipient mouse L cells, this DNA induced amplification of the adjacent thymidine kinase gene from Herpes simplex virus type 1 (HSV1TK). We confirmed the ability of this "Amplicon" sequence to induce amplification of other linked or unlinked genes in DNA mediated gene transfer studies. When transferred into the mouse L cells with the 10.3-5'rPRL gene sequence of BrdU-responsive cells, both the human growth hormone and the HSV1TK genes are amplified in response to 5-bromodeoxyuridine. This observation is substantiated by BrdU-induced amplification of the cotransferred bacterial Neo gene. Cotransfection studies reveal that the BrdU-induced amplification capability is associated with a 4-kb DNA sequence in the 5' flanking region of the rPRL gene of BrdU-responsive cells. These results demonstrate that genes of heterologous origin, linked or unlinked, and selected or unselected, can be coamplified when located within the amplification boundary of the Amplicon sequence. PMID- 3677996 TI - Database bias and the identification of protein coding sequences. AB - A simple quantitative test for the probability that an open reading frame actually codes for a protein has been described by Tramontano and Macchiato (1986). However, their test is only valid for the special case in which both coding and noncoding sequences are represented equally. We present a generalized adaptation of their method that uses estimates for the relative proportions of coding and noncoding sequences to provide a more accurate prediction. PMID- 3677997 TI - Enzymatic synthesis of oligoribonucleotides of defined sequence. AB - A plasmid DNA vector is described that is suitable for cloning synthetic DNA sequences. These cloned synthetic DNA sequences can be transcribed in vitro to produce oligoribonucleotides of defined sequence. Transcription is directed by a promoter based on the consensus sequence for Escherichia coli promoters and uses E. coli RNA polymerase. The vector is useful for cloning oligodeoxyribonucleotides of mixed sequences, the individual sequences being resolved by transformation and colony selection. Oligoribonucleotide synthesis from the vector is highly specific. Application of these sequences in hybridization experiments is demonstrated. PMID- 3677998 TI - Tailored removal of flanking homopolymer sequences from cDNA clones. AB - Terminal homopolymer sequences introduced during the synthesis and cloning of cDNA molecules often interfere with subsequent expression of the cloned cDNA. We describe a general method for the removal of homopolymer flanking sequences from cDNA inserts and subsequent tailoring of the resulting termini. The cDNA insert containing homopolymer tails is first subcloned into the multiple cloning site of an appropriate transcription vector. cDNA copies are then generated from in vitro synthesized transcripts using oligonucleotide primers complementary to the nucleotide sequences adjacent to the homopolymer tails. The resulting double stranded cDNA contains the homopolymer flanking sequences as 3'-terminal extensions that are conveniently removed by the 3'----5' exonuclease activity of T4 DNA polymerase. If the oligonucleotide primers also contain 5'-terminal noncomplementary sequences that specify potential restriction endonuclease sites, those sites are subsequently generated by the 5'----3' polymerase activity of the T4 DNA polymerase. Thus, in the same reaction, flanking homopolymer sequences are removed and the resulting termini are tailored to specify desired sequences. PMID- 3677999 TI - Facially distributed pattern-evoked potentials in multiple sclerosis. AB - Among 56 established cases of multiple sclerosis in our clinic from April 1978 to March 1985, optic neuritis was found in 38; 21 cases were bilateral. We studied pattern-evoked potentials detected with 16 electrodes placed on both the scalp and the facial area. Pattern-evoked potentials (PERGs) were obtainable at the facial area in multiple sclerosis patients with optic neuritis, except in long standing cases. However, a significant reduction of amplitude was found even in cases without optic neuritis. No correlation was found between visual acuity and amplitude or peak latency of PERGs in MS patients. PMID- 3678000 TI - The electrical response of the human eye to patterned stimuli: clinical observations. AB - Following the first recording of electroretinographic responses in man to a barred pattern by Riggs and associates (1964) in normal and by Lawwill (1973, 1974) in clinical cases, the first striking observation of a complete loss of pattern electroretinogram (PERG) after injurious section of the optic nerve by Groneberg & Teping (1980) has led to the conclusion that the PERG originates from proximal retinal structures different from those responsible for the luminance electroretinogram (LERG). Typical changes of the PERG are seen during branch occlusion of the central retinal artery and vein. In ocular hypertension without visual field loss and glaucoma-related papillary changes the PERG is decreased at intraocular pressures above 26 mm Hg. In cases of primary glaucoma with regulated intraocular tension and without using miotics the amplitude of the PERG reflects the damage to the inner retinal layers. This favorably compares with the P100 latencies of the visual evoked cortical potential (VECP) which in primary glaucoma were partly within, partly outside the normal range. Other retinal diseases showing amplitude changes in the PERG are primary macular dystrophy, diabetic retinopathy, and the acute stage of optic neuritis. In all these cases the Ganzfeld LERG may be normal or nearly normal, whereas the PERG undergoes typical changes. On the contrary a highly preserved PERG can be recorded in cases of retinitis pigmentosa where the electrooculogram light rise and the LERG are already missing. In light of these findings the recording of PERG constitutes a new promising method of clinical electroretinography reflecting the activity of the hitherto omitted innermost retinal layers. It thereby contributes essentially to the location of disturbances within the visual system. PMID- 3678001 TI - The effect of fluphenazine on rod-mediated retinal responses. AB - The effect of various concentrations of the dopamine antagonist fluphenazine on ocular field potentials, recorded under scotopic conditions from isolated, arterially perfused cat eyes, was studied. Responses from outer (isolated PIII component of the electroretinogram, ERG), middle (b-wave), and inner (optic nerve response, ONR) retinal layers were separated. Neither the fast or slow PIII amplitude nor the temporal characteristics of the response were influenced by any of the drug concentrations tested. In contrast, fluphenazine reversibly increased the rod b-wave amplitude over a large range of concentrations. Only very high drug concentrations led to an irreversible loss of the b-wave. In the ONR the initial transient on-response increased during drug injection, whereas the sustained on-response and off-response decreased. In summary, the dopamine antagonist fluphenazine affects mainly the signal processing of the rod pathway in the inner retinal layers, while responses from outer retinal layers are not influenced. On- and off-responses of the ONR are affected differently. PMID- 3678002 TI - Pattern electroretinogram: effects of reference electrode position. AB - The pattern electroretinogram has assumed greater clinical and experimental significance because of its inner retinal origins. However, clinical tests may be confounded by an artifact. We tested subjects varying reference electrode position and eye stimulated while employing the Dawson-Trick-Litzkow (DTL) fiber electrode as the active electrode. The presence of a statistically significant artifactual response could not be confirmed. However, the variability of responses elicited with the outer canthus was less and the signal-to-noise ratio greater than with other reference positions. PMID- 3678004 TI - Gamma-aminobutyric acid- and picrotoxin-induced changes in c-wave and light peak of retinal potentials in the chick. AB - Retinal potentials were recorded from the eyes of anesthetized and immobilized chicks by a standard direct current method. The amplitude of the electroretinogram (ERG) c-wave was measured 2 and 5 sec after the onset of the light stimulus, as indexes of the fast-rise c-wave (cF-wave) and the slow-rise c wave (cS-wave), respectively. An intravitreal injection of gamma-aminobutyric acid (GABA) at an estimated intravitreal concentration of 10(-9)-10(-7) M resulted in an increase of the amplitude of the cS-wave, a less remarkable change in the a- and cF-waves, and a slight decrease in the b-wave. The light peak of the retinal standing potential increased in amplitude following GABA administration (10(-7)-10(-4) M). Following an intravitreal injection of picrotoxin (10(-5)-10(-3) M), the polarity of the cS-wave changed from positive to negative and a significant decrease and deformation in the light peak was observed. The amplitude of the a-wave, however, increased in the range of the higher dose, while that of the b- and cF-waves decreased markedly but no polarity reversal of the cF-wave was found. The results may suggest that the GABA-ergic synapse plays a significant role in production of the cS-wave and the light peak, along with that of the pigment epithelium. PMID- 3678003 TI - Oscillatory potentials of visually inattentive children. AB - The oscillatory potentials (OPs) are probably generated in the proximal retina. The OPs of 20 visually inattentive infants and children were recorded. All 20 had evidence of abnormalities of the visual parts of the brain. The a- and b-waves, indices of distal retinal function, were normal in 10 patients, abnormal in the other 10. Among the patients with abnormal, attenuated a- and b-waves, OP amplitudes were more attenuated than among those with normal a- and b-waves. However, the timing of the OP wavelets was not correlated with distal retinal activity. These results suggest that in humans OP amplitude may be determined by inputs from the distal retina, but OP latency and periodicity are governed by processes within the proximal retina. PMID- 3678005 TI - Simultaneous macular and paramacular ERGs recorded by standard techniques. AB - A technique for the simultaneous recording of two small-field electroretinograms (ERGs), macular and paramacular, employing standard apparatuses for stimulation and analysis is described. The stimuli consisted of two adjacent checks (6 deg/side) obtained by masking the display of a commercially available TV pattern stimulator. The checks were square-wave-modulated in counterphase at 3.12 Hz. The subjects fixated the center of one of two checks. In one stimulus cycle, two ERGs could be distinguished: one from the macular area and the other from the adjacent area. The macular ERG is about twice as large as the paramacular. ERGs recorded by this technique can be considered focal since (i) they show a sharp fall-off in amplitude when the stimulus is displaced from the fovea, and (ii) they are no longer recordable when the stimulus is centered on the optic disk or on a large macular scar. PMID- 3678006 TI - Pattern electroretinogram as a function of spatial frequency in ocular hypertension and early glaucoma. AB - Pattern electroretinograms (PERGs) in response to 8.3 Hz alternating gratings (16.6 rev/sec) of different spatial frequencies were recorded in normal subjects as well as in patients affected by early glaucoma and ocular hypertension. In normal subjects the PERG response is spatially tuned, with a maximum at about 1.5 cycles/deg and attenuation at higher and lower spatial frequencies. In all cases of early glaucoma and in the great majority of cases of ocular hypertension the PERG was reduced, as compared with that of normal subjects, mainly in the medium range of spatial frequencies (at which the PERG has its maximal amplitude). PMID- 3678007 TI - Fluctuations of visual evoked potential amplitudes and of contrast sensitivity in Uhthoff's symptom. AB - Visual evoked potentials (VEPs) to pattern reversal and psychophysical contrast sensitivity (CS) were tested in five patients with Uhthoff's symptom before and after exercise. Four of the cases were related to a demyelinating disease and one patient had a severe brain injury. Uhthoff's symptom occurred also in neuropathies without previous clinical neuritis and in eyes with normal latency time of the VEPs. A depression of CS was observed by all five patients after exercise; a transient "overshoot" of CS following the depression was present in three of the patients. VEP amplitudes were reduced by exercise in three cases. Responses by stimulation with small checks were more affected. Paradoxical increased VEP amplitudes after exercise in the presence of a loss of psychophysical CS were found in one case. PMID- 3678008 TI - Check size and defocusing effects on equipotential maps of pattern-evoked electroretinograms. AB - The spatial distribution of the pattern-evoked potentials on the face was studied with a simultaneous 16-channel recording system. The potentials had the first positive component at a peak latency of approximately 55 msec, which was much earlier than the latency of the response picked up from the scalp. The maximal potential value in the maps was found at the region around the stimulated eye. This configuration of the equipotential map was not influenced by defocusing and check size of the pattern, but was altered by changing the contrast. Our results of equipotential maps constructed at around 55 msec after pattern reversal proved that the responses recorded in the facial region originated in the retina and were not a reflection of the scalp potentials. PMID- 3678009 TI - Pharmacological dissociation of the b-wave and pattern electroretinogram. AB - Electroretinographic responses to modulation of either luminance (focal ERG) or spatial contrast (pattern ERG) were recorded from the pigeon eye before and after intravitreal injection of glutamate analogues DL alpha amino adipic acid (DL alpha AA) and 2-amino-4 phosphonobutyric acid (APB). Both toxins reversibly abolished the b-wave. The pattern ERG was still present, however, when the b-wave had been abolished by the toxins. This result demonstrates that the b-wave and the pattern ERG can be pharmacologically dissociated and suggests the possibility that in pigeons the b-wave and pattern ERG reflect the activity of different generators. PMID- 3678010 TI - C-wave versus electrooculogram in diseases of the retinal pigment epithelium. AB - The c-wave and the electrooculogram (EOG) are retinal potentials predominantly generated by the pigment epithelium. In most diseases both parameters show a parallel decrease in amplitude. However, in patients with dominant drusen, and cone dystrophies, and in clinically nonaffected members of families suffering from vitelliform macula degeneration, the EOG is close to normal whereas the c wave shows a reduced amplitude. These findings suggest a higher sensitivity of the generators of the c-wave compared with those responsible for the EOG. Thus the direct current electroretinogram provides additional diagnostic information. PMID- 3678011 TI - Familial retinoschisis in female patients. AB - We report two female patients, a mother and daughter, with bilateral foveal changes that resembled those of X-linked recessive juvenile retinoschisis. The 23 year-old daughter had flat retinoschisis at the temporal periphery with multiple small inner-layer breaks in both eyes. There was foveal retinoschisis with fine radial folds. The optic disc was dragged to the nasal side. The 49-year-old mother also had foveal retinoschisis in each eye but there was no peripheral retinoschisis. In the left eye several retinal breaks with minimal retinal detachment were found. Electrophysiological findings in both cases were similar. Single-flash electroretinogram (ERG) showed normal a-wave and decreased b-wave, presenting a negative shape. Averaged scotopic and photopic ERGs showed slightly reduced b-waves, but they were within normal ranges. Visually evoked potentials were subnormal. Ophthalmoscopic and electrophysiologic findings were compatible with X-linked recessive juvenile retinoschisis, but an autosomal dominant inheritance was most likely. Our cases do not follow previously reported characteristics and may represent a new clinical entity. PMID- 3678012 TI - [Modification of esophageal epithelium DNA in the human fetus by N nitrosomethylbenzylamine (NMBzA)]. AB - Human fetal esophageal epithelium, after being exposed to NMBzA, was found to contain O6-methyldeoxyguanine (O6-MedG), a NMBzA-modified DNA adduct, in tissue DNA by radioimmunoassay and monoclonal antibody, which is highly specific to O6 MedG. The highest level of O6-MedG was 58.83 pMol/mg DNA after adding 5.0 mM NMBzA in vitro. The level of O6-MedG and the concentration of NMBzA followed the dose-effect relationship. O6-MedG could be eliminated from DNA by normal human fetal esophageal epithelium. About 50% of O6-MedG was cleared away in the first 1 2 hours during the post-treatment incubation, which was followed by a slower phase of elimination with 18% left in 24 hours. The results indicate that the human fetal esophageal epithelium can metabolically activate NMBzA in vitro and form O6-MedG, which, as well known, can cause mutagenesis and carcinogenesis and, hence, may most likely be related to the development of human esophageal cancer. PMID- 3678013 TI - [Ultrastructural study on the model of human lung adenocarcinoma heterotransplanted to nude mice]. AB - A human lung adenocarcinoma from surgical biopsy specimen was successfully heterotransplanted into nude mice and has been maintained for 40 generations. The experiments were made on 6-8 week old male or female nude mice with Swiss genetic background cultivated in specific pathogen-free condition. The electron microscopic observation on transplanted tumor of passages 2, 6, 12, 18 and 23 revealed that the ultrastructural features of this tumor were strictly maintained and no obvious change of differentiation was found. But there was a potential prone to regional squamous epithelial metaplasia in the transplanted tumor. The nude mice model of human lung adenocarcinoma so established can be used as a good experimental system of the homologous and reproducible human cancer for the study of basic medical sciences and chemotherapy of human lung carcinoma. PMID- 3678014 TI - [Mechanism of the anticancer action of selenium--influence on glycolysis and its key enzyme]. AB - The aerobic glycolysis rate and mitochondria-bound hexokinase activity of ascitic liver cancer cells are 8 and 50 times as high as those of the normal liver cells, and they can be inhibited by Na2SeO3 in concentration below 10 micrograms/ml. The inhibitory effect increases with selenium concentration. In contrast, Na2SeO3 at the same concentration does not significantly affect the glycolysis rate and mitochondria-bound hexokinase activity of the normal liver cells. The selective action of selenium on energy metabolism of the liver cancer cells may account for its inhibitory effect on cancer cells. PMID- 3678015 TI - [PSD-007 luminescence in the diagnosis of exfoliative cells from malignant tumors]. AB - This paper presents the first report in China on the use of luminescence method with hematoporphyrin derivative PSD-007 in the analysis of the exfoliative malignant cells. By this method, pleurorrhea and ascites from 226 suspicious patients were detected. The results showed that its positive rate was 42.23% higher than that of Wright's stain and its positive conformation rate to HE stain could reach as high as 90.2%. Especially, cancer cells could be distinguished from various kinds of non-cancer cells by an objective quantitative analysis of the cellular fluorescent intensity using microfluorophotometer. This new method, being simple, economical and highly specific, is used not only in the qualitative study of the exfoliative tumor cells, but also in the quantitative analysis. PMID- 3678016 TI - [Establishment of a mouse forestomach carcinoma cell line (MFC) with spontaneous hematogenous metastasis and preliminary study of its biological characteristics]. AB - A mouse forestomach carcinoma cell line (MFC) prone to blood-born metastasis to lung was established in vitro. This cell line has been subcultured for more than 132 passages. MFC cells lacked in contact inhibition and, morphologically, appeared as round, polygonal and spindle cells. Ultrastructurally, there were abundant microvilli on the cellular surface and extensive filopodia in the cytoplasm; nuclei showed irregular shape with an increased nucleus-cytoplasm ratio; desmosomes, hemidesmosomes as well as a small number of tonofibrils were observed. The doubling time of MFC cell population was 24.7 hours. The average mitotic index was 32.9% and the maximum was 62% with 70-76 mode. The homotransplant efficiency was 100% (11/11). In morphology, the solid tumors induced were similar to FC tumor, from which the MFC cell line was derived and 81.8% (9/11) developed spontaneous lung metastasis. It is indicated that this cell line still retains the primary tumor's feature of spontaneous hematogenous metastasis. MFC cell line might be very useful in experimental treatment, study of tumor metastatic mechanism and isolating subpopulation. PMID- 3678017 TI - [Establishment of human glioma cell line--nude mice solid tumor model NHG-1 and its characteristics]. AB - Establishment and its characteristics of a nude mice solid tumor model NHG-1 from human glioma cell line are reported. 5-8 week old NC nude mice of both sexes and SHG-44 cell line used in this experiment were from our laboratory. The initial successful transplantation rate was 7/11 (64%) and that of 30 passages in the subsequent 4 years was 100%. After subcutaneous inoculation, growth curve showed a latent period in week 1-2, slow growing period in week 3-4, rapid growing period in week 5-6 and a final plateau period in week 7. The doubling time was 7 days and cell cycle time was 2.5 days. The cells in G1, S and G2M phases comprised 56%, 27% and 17%, respectively. The survival time of the host was 54 +/ 15 days. The tumor tissues showed a tendency towards invading the surrounding soft tissues. By morphological observation with light and electron microscopes, LDH isozyme assay, PAP immuno-histochemistry labelling GFAP and chromosome analysis, it is confirmed that the transplantable tumor possesses the characteristics of human malignant glioma. The estrogen receptor in the transplantable tumors demonstrated by cytochemical assay indicates that the glioma carcinogenesis is related to endocrine factor of the host. The therapeutic effects of anticancer drugs, such as ACNU, BCNU and 10-hydroxy-2-decenoic acid from the royal jelly on NHG-1 model are evaluated. PMID- 3678018 TI - [Comparison of gastric mucosal lesions in high and low incidence areas of gastric cancer--analysis of 3146 operated gastric specimens and 112 autopsied samples. National Gastric Cancer Pathology Cooperative Group]. AB - Gastric mucosal lesions, including 3146 gastric specimens resected for various benign diseases and 112 autopsied samples, in both high and low incidence areas of gastric cancer in China were analysed and compared. The results showed that, in high and low incidence areas of gastric cancer, the detection rate was 59.96% and 52.02% for chronic atrophic gastritis, 60.60% and 52.76% for intestinal metaplasia, 37.60% and 22.97% for atypical hyperplasia, 0.44% and 0.13% for microcarcinoma and small carcinoma of the stomach, 2.52% and 0.79% for gastric polyp. The data suggest that a positive correlation be present between the gastric mucosal lesions and gastric cancer. Prevalence of the gastric mucosal lesions in an area may be regarded as an indication of incidence of the gastric cancer. Microcarcinoma and small carcinoma of the stomach were 0.44% of the gastric specimens resected for benign diseases in high incidence area of gastric cancer, which indicates that more tissue sections will have to be taken for examination in order to avoid missing the early carcinoma. PMID- 3678019 TI - [Indication of radical surgery (R2, R3) based upon the pattern of lymph node metastasis from gastric cancer]. AB - From Jan. 1980 to June. 1984, radical operation was performed in 156 patients with gastric cancer according to the "protocol" introduced by the Gastric Cancer Research Society of Japan. There were 24 early and 132 advanced gastric cancers. Seventy patients were treated by type R2, 86 by R+2 and R3. Radical distal subtotal gastrectomy was done in 116, proximal subtotal gastrectomy in 7, simple total gastrectomy in 13 and subtotal or total gastrectomy combined with neighbouring organ resection in 20. According to TNM staging, 24 (15.4%) lesions were stage I, 9 (5.8%) stage II, 100 (64.1%) stage III and 23 (14.7%) stage IV. Twenty four lesions were within the mucosa or submucosal layer, 11 in proprius muscle layer, 18 to subserosa, 15 to serosa, 46 beyond serosa, 42 involving the surrounding organs. Lymph node metastatic rate was 66% (103 cases), metastatic degree was 21.5% (558/2593). The metastatic degree of lymph node line I, II and III was 24.7%, 20% and 8.3%, respectively. Basing on lymph node metastatic rate and degree as well as the line degree, it is proposed that, in the early stage of gastric cancer, type R1 be performed for cancer limited to the mucosa, especially the minute type, R2 for cancer invading the submucosa, in which, R+2 be indicated for some isolated patients. In the advanced gastric cancer, type R+2 be performed in the majority of patients and R3 in a few. R3 or total gastrectomy combined with neighbouring organ resection be carried out only in a part of cases with the limited type infiltrating beyond the serosa or invading the neighbouring organs. PMID- 3678020 TI - [Prognostic factors of primary non-Hodgkin's lymphoma of the stomach- clinicopathologic study of 21 cases]. AB - Clinical, X-ray and pathological materials of 21 cases of primary non-Hodgkin's lymphoma (NHL) of the stomach were reviewed. According to NHL classification- working formulation for clinical usage sponsored by NCI, USA, there were 13 (61.9%) intermediate grade, 6 (28.6%) high grade and 2 (9.5%) low grade malignant lymphomas. By X-ray manifestations, they were classified into 5 types: multinodular type (4 cases), infiltrative (4), ulcerative (3), giant rugal (1) and mixed (9). Clinically, 10 lesions were stage I, 4 stage II, 1 stage III and 4 stage IV, 2 unclassified. The median survivals were 101 months for stage I, 15 months for stage II and less than 6 months for stages III and IV. The 5 and 10 year survival rates were 70% and 40% in stage I patients. The prognosis is related to clinical stage, depth of the tumor infiltration and histology type but not related to the tumor size or X-ray manifestations. PMID- 3678021 TI - [Ultrastructural and clinical study on neuroblastoma]. AB - Ultrastructures of 11 cases of neuroblastoma and ganglioneuroblastoma were observed. Ultrastructurally, the neuroblastoma could be classified into four types: immature, poorly differentiated, differentiated and ganglioneural cell. Neurosecretory granules (NSG) of round or oval shapes with various diameters in the tumor cells and neural processes were observed. The presence of NSG in the tumor tissue is one of the pathognomic features for neuroblastoma. Comparing and study of the relation between the ultrastructural findings and the excretory patterns of the urinary catecholamine as well as the prognosis, it was shown that the tumor of the differentiated type and the presence of abundant NSG lead to a good prognosis. Some slight differences in ultrastructure were found in neuroblastoma specimens from children of various ages. Infants under 18 months had a longer survival time, which is related to the differentiation and other features of the tumor cells. PMID- 3678022 TI - [Primary gastric malignant lymphoma--analysis of 40 patients]. AB - This paper reports 40 patients with primary gastric malignant lymphoma as proved by pathology and treated in our hospital from October 1958 to December 1984. There were 20 males and 20 females, including 3 Hodgkin's disease and 37 non Hodgkin's lymphoma. The patients were treated by surgery, radiotherapy and chemotherapy separately or combined. In this series, the 5 and 10 year survival rates were 48.6% and 47.6%. The combination of surgery with postoperative radiotherapy and/or chemotherapy gave better results. In postoperative radiation to the whole abdomen, the tissue dose should not be less than 30-35 Gy. The incidence, diagnosis, clinical staging and the indication of primary gastric malignant lymphoma are discussed with a review of literature. PMID- 3678023 TI - [Treatment of male breast cancer]. AB - From Mar. 1958 through 1985, 50 male patients with breast cancer were treated in our hospital. The ratio of male and female with primary breast cancer was 1:90 during the same period. All were proven by pathology except one case. Forty seven have been followed for more than 5 years. There were 12 stage I lesions, 19 stage II and 16 stage III. Radical mastectomy was performed in 22 patients, total mastectomy in 11 and lobectomy in 12, supplemented by radiotherapy, chemotherapy, hormonal therapy or their combination. Two were not indicated for surgery and were only given a combination combination therapy without operation. The irradiation after radical mastectomy was to deliver to the regional lymph nodes and for the rest, a dose of 5,000-6,000 cGy/5-6 weeks should be added to the chest wall. The chemotherapy, including Thio-TEPA, 5-fluorouracil, cyclophosphamide and methotrexate etc, in the form of single or multi-drug for 1 3 courses, was given. The overall 5 and 10 year survival rates were 51% and 22.5%. The 5 year survival rates of stage I, II and III patients were 83%, 53% and 25%. The 5 year survivals of radical mastectomy, total mastectomy and lobectomy combined with radiotherapy, chemotherapy and hormonal therapy were 59%, 27% and 67%. In those who failed, 50% developed local recurrence or regional metastasis or both and 60% had extensive dissemination. The results indicate that the combination therapy comprising radical mastectomy and lobectomy has a good prognosis. The authors believe that the male breast cancer is more hormone dependent than the female breast cancer, orchiectomy plays an important role in the treatment of advanced lesions. PMID- 3678025 TI - [Regulation of the spatial structure of DNA liquid crystals using anthracycline and anthraquinone compounds]. PMID- 3678024 TI - [Dysgerminoma of the ovary--a clinical report of 27 patients]. AB - Twenty seven patients with dysgerminoma of the ovary were treated in our hospital from 1959 to 1982. 18 of them had no prior treatment and the other 9 had undergone operation and were admitted for recurrence. Among these 18 untreated patients, all were successfully operated. Apart from 4, the others were supplemented by radiotherapy and/or chemotherapy. 17 (94%) were free of disease from 3 to 24 years, only one died of tumor recurrence within 5 years after the initial treatment. The 5 year survival rate was 94%. However, among the 9 recurrent patients, 6 were treated by operation, supplemented by postoperative radiotherapy and/or chemotherapy but only 3 survived for 7, 14 and 15 years respectively without any evidence of disease. The 5 year survival rate was 33%. As those patients who received conservative operation initially gave a high recurrence rate, the authors propose that the patients be treated individually according to the condition of disease. The choice of treatment for the individual patient is discussed. PMID- 3678026 TI - [Non-coenzyme mechanism of pyruvate dehydrogenase inhibition by a phosphorylated thiamine analog]. PMID- 3678027 TI - [Cytology of secretion in sheep skin tubular glands--a nonapocrine type of secretion in the apocrine gland]. PMID- 3678028 TI - [Iron, zinc, chromium and selenium in chromatin and various fractions of nonhistone proteins in normal conditions and in malignant growth]. PMID- 3678029 TI - [High selectivity in the effect of organophosphorus insecto-acaricides containing the acetylene bond on Arthropoda]. PMID- 3678030 TI - [Nuclear-cytoplasmic transport of mRNA in the rat liver during ontogenesis]. PMID- 3678031 TI - [Structural-functional characteristics of the small intestine in adult and growing rats after various surgical procedures]. PMID- 3678032 TI - [Physiological characteristics of adaptation processes which precede the restructuring of functional systems]. PMID- 3678033 TI - [Dynamic mapping of induced magnetic fields in the human brain]. PMID- 3678034 TI - [Mechanisms of increased reactivity and tonus of blood vessels caused by blood movement]. PMID- 3678035 TI - [The origin of domestic sheep from the data of DNA molecular hybridization]. PMID- 3678036 TI - Effects of methylprednisolone and dexamethasone on polymorphonuclear leukocyte adherence in vivo. AB - It has been proposed that corticosteroids may be effective in the treatment of shock and the adult respiratory distress syndrome (ARDS) by inhibiting complement induced granulocyte aggregation and by disaggregating granulocyte aggregates in vitro. In the present investigation we have examined the effects of sera from patients who had received comparable doses of methylprednisolone (MP) and dexamethasone (DEX) on the adherence of polymorphonuclear leukocytes (PMNs). Sera obtained from patients that had received MP markedly reduced PMN adherence with maximum effect noted by 8 h. In contrast, sera from patients receiving DEX had no effect on PMN adherence. The results of this study indicate that MP may be more effective in the treatment of septic shock and other conditions associated with microvascular leukostasis. PMID- 3678037 TI - Mechanism of the scavenger-like activity of bendazac. AB - By using EPR spectroscopy of spin-labelled bovine serum albumin (BSA), bendazac was shown to prevent the BSA denaturation induced by urea, heat and free radicals produced in the xanthine/xanthine oxidase system. Bendazac did not inhibit the reduction of ferricytochrome c due to the superoxide flux in the above system nor did it possess a significant antioxidant activity on Fe(II) or Fe(III)-induced peroxidation of lecithin liposomes. It is concluded that the scavenger-like activity of bendazac is due to its interaction with protein molecules, rather than free radicals. PMID- 3678038 TI - Effects of buprenorphine in heroin addicts. AB - Twelve heroin addicts on the 8th day after withdrawal, and 8 healthy volunteers were given a single i.m. injection of buprenorphine 0.6 mg and their subjective response rated on 10 psychological variables. Pre-injection rating differed significantly between addicts and controls on 7 variables out of 10. Following buprenorphine more subjective changes were noted in the control group which became more calm, depressed, more aware of the environment, sleepy, tired, intoxicated, dizzy and nauseated. The drug addicts reported changes only in 2 variables (less tense and dysphoric) but otherwise showed no significant changes. These findings support the notion that buprenorphine induces low or normalizing effects in heroin addicts. This drug might thus be suitable for maintenance therapy in opiate addiction. PMID- 3678039 TI - Results of prevention programs with adolescents. AB - Programs for preventing smoking and alcohol and drug abuse have radically changed in the past decade. Instead of being regarded as a health or discipline problem that involves only a few deviant adolescents, drug use has begun to be viewed as social behavior that is functional for adolescents, not capricious, and is normative for that population. The most successful prevention programs have sought to delay the onset of tobacco use. Based on theoretical and etiological research, these programs target factors that have repeatedly been predictive of adolescent smoking, alcohol and drug use. The programs teach adolescents (1) why people their age smoke tobacco or use alcohol and drugs; (2) how these meanings get established by peers, older role models and advertising; (3) how to resist these influences to smoke or to use alcohol and drugs; and (4) life skills and competencies to counterbalance the functions that drug use serves. Because of the association with the onset of smoking and the onset of using other drugs, these strategies are being studied for alcohol use and other drugs. In addition, elected peer leaders are trained to conduct these activities with their classmates and act as new role models for non-use. Evaluations of these approaches are optimistic. Studies in northern California and Minnesota reveal 50 70% reductions in the onset of smoking. Botvin's 'Life Skills Training' program demonstrates success in delaying heavy alcohol and marijuana use. PMID- 3678040 TI - Influencing adolescent life style: the role of mass media. AB - Since 1981, the Alberta Alcohol and Drug Abuse Commission has been conducting a primary prevention program intended to alter the development of intoxicant use patterns in adolescents. The program uses an integrated set of approaches involving mass communications, face-to-face program elements, community action and small-scale education activities. Mass media have a unique and powerful role as one element of such a program. Able to introduce broad concepts and convey basic, general information, they can also aid in establishing an atmosphere of acceptance of critical issues. Mass media alone probably cannot alter behavior. However, they can reinforce essential arguments and legitimize the community based, face-to-face program elements that may be able to achieve lasting behavior change. PMID- 3678041 TI - The diabetic alcoholic: characteristics and treatment outcome. AB - We had previously found a correlation between a recovering alcoholic's propensity to choose free sugar in his diet and his ability to remain sober. To determine if chronic hyperglycemia in itself is a predictor of sobriety, we examined the outcome of alcoholism treatment in 138 diabetics we could identify among 9000 alcoholism treatment outpatients. In general, the diabetics did no better or worse in alcoholism treatment than the whole clinic population, but a subset of the diabetics, those whose diabetes resulted from pancreatitis or pancreatectomy, did very badly. The implications of these findings for future research are discussed. PMID- 3678042 TI - Effect of chronic acetaldehyde intoxication on ethanol tolerance and membrane fatty acids. AB - Recent studies have suggested that acetaldehyde participates directly in the pathogenesis of alcoholism. Its action has been attributed mainly to its physico chemical properties. Results of direct intoxication of laboratory animals with acetaldehyde have been reported, but only for short periods of exposure and at high doses. These are probably not representative of the conditions found during alcohol intoxication. The pulmonary route of administration described here enables long term intoxication with acetaldehyde, at levels corresponding to values measured during chronic ethanol intoxication. Chronic administration of acetaldehyde during 3 weeks induced a metabolic tolerance to ethanol as tested by the sleeping time after a challenge dose of ethanol; behavioural tolerance (measured by blood alcohol levels on waking) was not observed. At the end of the intoxication, phospholipid fatty acids of erythrocyte and synaptosome membranes were also analysed. Small changes in levels of the shorter fatty acids were observed in the phosphatidyl-choline fraction. By comparison with the effects of ethanol on the same membrane preparations, only a small part of this effect can be attributed to acetaldehyde. The first metabolite of ethanol has, however, a sure effect on the pattern of fatty acid phospholipids. PMID- 3678043 TI - Drug findings in 'Driving Under the Influence of Drugs' cases: a problem of illicit drug use. AB - Drug findings in 137 drug positive cases of Driving Under the Influence of Drugs (DUID) occurring in St. Louis, Missouri, U.S.A. from June 1983 through May 1986 are presented. Thirty-two different drugs were detected. A single agent was detected in only 34% (47/137) of cases. The most frequently encountered drugs, expressed as percent of positive cases, were: phencyclidine, 47%; marijuana, 47%; benzodiazepines, 22%; barbiturates, 15%; opiates, 11%; and cocaine, 9%. Most multiple drug cases involved popular illicit drug mixtures, such as cocaine and morphine (speedballs) or phencyclidine on marijuana (whack). All the drivers in this survey had displayed inappropriate or impaired operation of a motor vehicle to the extent that a law enforcement officer had stopped and charged them for DUID. In at least 81% of the drug positive cases, persons impaired in the operation of a motor vehicle from a drug or drugs other than alcohol, were impaired not as the result of side effects of therapeutic drug use, but as the result of deliberate self intoxication with illicit or controlled substances. PMID- 3678044 TI - Alcoholics' beliefs about abuse: causes, effects and treatment. AB - The beliefs that problem drinkers hold about the causes of abuse, effects of alcohol, and methods of treatment were investigated. The drinkers' beliefs about their own abuse as well as their beliefs about other abusers were both studied. It was found that own abuse was mostly explained by internal factors (drinking to reduce distress or to achieve an elated mood) while external factors (e.g. unemployment) were more often referred to as explanations of the abuse by other persons. Alcohol abuse as an illness was a frequently endorsed concept, while explanations in terms of social or macro level factors were rarely accepted. Females tended to accept more explanations of abuse than males. Many of the problem drinkers tended to see very few explanations for their own abuse and to be quite skeptical about treatment. Factor analysis resulted in three factors: acceptance of reasons for abuse, perceived dependence and experienced control of drinking. Cluster analysis indicated that about 25% of the problem drinkers had a high level of acceptance, perceived dependence and control. These problem drinkers may be a prime target group for treatment. PMID- 3678045 TI - Normal testosterone plasma levels in non-abstinent alcoholics. AB - Testosterone (T), prolactin (PRL), and luteinizing hormone (LH) levels were estimated in plasma of 32 male chronic alcoholics during a period of their usual alcohol consumption and compared to the values of 32 age-matched controls. T levels were not different from normals, while both PRL and LH were significantly elevated. The subgroup of patients with severe liver injury (n = 11) showed elevated PRL (2P less than 0.001), but normal LH and T, while patients with normal hepatic function (n = 21) showed normal PRL levels, elevated LH, and a tendency to elevated T levels. PMID- 3678046 TI - Effects of smoked marijuana on social interaction in small groups. AB - Twelve adult male research volunteers, in four groups of three subjects each, resided continuously in a residential laboratory for up to 18 days. Subject's behaviors, including social interaction, were continuously recorded. During the first part of the day (1000-1600), subjects remained in their private rooms doing work activities, and during the remainder of the day (1600-2345), they had the option to socialize with the other subjects. Four cigarettes containing active marijuana (1.84%, delta 9-tetrahydrocannabinol (delta 9 (THC)), w/w) or placebo were smoked daily: one each prior to the work and social access period, and two during the social access period. When the results were averaged across all groups and individuals, active marijuana significantly increased total daily social interaction time. However, drug effects were a function of the baseline amount of social interaction. The results of these experiments also showed that the pattern of increases in social interaction following smoked active marijuana varied within different groups of individuals. PMID- 3678047 TI - Prevention of alcohol-related problems. Introduction to a symposium. AB - Despite major biomedical advances, the most important health gains of this century have been due to preventive measures. Primary prevention includes: (a) health protection--the use of public direct regulatory activities (e.g. regulations regarding the sale and availability of alcohol, requirements for warning labels); (b) disease prevention--services directed to reducing the occurrence of specific identifiable disorders (e.g. Fetal Alcohol Syndrome) using strategies derived from risk factor research; and (c) health promotion- activities which foster positive behaviors and general good health practices. Although there is a measure of agreement that 'something must be done' to prevent alcohol problems, it is not quite so easy to find agreement on what is the best preventive approach, or even what the focus of prevention should be--problem drinkers, drinking habits or alcohol itself. To change attitudes and practices requires more than token nods towards alcohol education. More attention is now being given to psychologically and socially based prevention programs. The next three papers discuss behavioural approaches to prevention of alcohol-related problems. PMID- 3678048 TI - Ethanol exposure as inducer of stable voluntary ethanol drinking in the male rat. AB - The effects of restricted 'Saturday night drinking' on voluntary ethanol intake was tested in male rats. During a treatment period of 57 weeks the animals (group B) could choose between ethanol and water for 24 h each week. After this period of choice they received ethanol (2.0 g/kg) i.v. Total weekly exposure was around 6-7 g/kg. Of two control groups, one was given i.p. injections of saline once a week (group A) and the other, in addition to saline injections, a continuous choice between ethanol (10%) and water as drinking fluid (group C). Weekly ethanol exposure was approximately 14 g/kg in group C. During a testing period of 46 weeks group A and C had continuous access to a choice between ethanol and water. After week 5 of the testing period concentrations of ethanol varied in 3 week intervals. For each tested concentration (5, 15, 20 and 25%) intake was calculated as g/kg per day based on the total period. For the reference concentration (10%) corresponding intake was calculated on 2 weeks prior to and 2 weeks after the tested concentration. In group B there was always a very strong correlation (r = 0.86-0.99) between intake of the different tested concentration and the corresponding reference concentration. This indicates that a strong individual preference for a defined daily dose of ethanol had developed in these rats. The corresponding relation was less developed in group C especially when higher concentrations of ethanol were tested. At the end of the testing period voluntary ethanol intake was slightly higher in group B and C when compared to group A. Analyses of blood ethanol levels at defined times during the testing period indicated an interrupted ethanol intake with occasionally substantial blood levels. Thus intermittent ethanol exposure can induce a voluntary ethanol drinking pattern in male rats which might be used as an animal model of alcoholism. PMID- 3678049 TI - Alcohol consumption and casualties; drinking in the event. AB - The data reported are from a 20% probability sample (n = 2516) of all adult patients seeking care in the emergency room at San Francisco General Hospital during a 60-day period. Thirty-five percent (35%) of the injured and 18% of the non-injured reported drinking prior to the event. This paper compares the following variables related to drinking-in-the-event for injured and non-injured: drinking places, drinking companions, amount consumed, time lapsed between drinking and the event, effects of drinking and causality attributed by the patient to drinking and the event. When these variables were entered into a logistic regression to evaluate their predictive value on injury status, only time lapsed since the last drink and drug use prior to the event were predictive of injury with both being negatively associated with admission to the emergency room for an injury. Injuries were more likely than non-injuries to occur in close proximity to drinking (44% of injuries occurred in less than 1 h of the last drink), and close to a third of the injured attributed a causal association of drinking with the event, with 60% of these feeling they were drunk at the time of injury. PMID- 3678050 TI - The changes in sulfhydryl compounds in plasma, liver and brain after acute and chronic ethanol administration in rats. AB - The content of sulfhydryl compounds in proteins and non-proteins of plasma, liver and brain after acute and chronic ethanol administration was investigated in rats. After ethanol ingestion for 4 weeks (6 g/kg, day 30% w/v) significant changes were observed in plasma proteins and in liver proteins and non-proteins. In brain proteins and non-proteins we did not find any changes in sulfhydryl compounds content after acute and chronic ethanol administration. PMID- 3678051 TI - Sensitivity of human lymphocytes to acetaldehyde: comparison between alcoholic and control subjects. AB - The action of acetaldehyde (ACH), the first metabolite of ethanol, was studied on human lymphocytes stimulated in vitro by phytohemagglutinin (PHA) or Concanavalin A (Con A). ACH caused a dose-dependent decrease of [3H]thymidine uptake in lymphocytes from both alcoholic and control subjects. The area under the curve of [3H]thymidine incorporation as a function of ACH concentration was determined for each subject and referred to as the lymphocyte sensitivity index. Indexes for alcoholic subjects were found to be higher than those for controls, indicating a lower sensitivity to ACH of lymphocytes from alcoholics. We also found a wide range of sensitivity indexes within the same group. These results are consistent with the current hypothesis that not everybody is at equal risk to develop alcohol related disorders. PMID- 3678052 TI - Calcitonin and prolactin serum levels in heroin addicts: study on a methadone treated group. AB - Serum calcitonin (CT) and prolactin (PRL) levels were determined in 21 heroin addicts in hospital treatment with methadone. After withdrawal of heroin the values of CT 112.4 +/- 62.9 pg/ml, and PRL 19.1 +/- 10.1 ng/ml were both significantly higher (P less than 0.001) than in normal controls (62.2 +/- 43.8 pg/ml and 9.1 +/- 3.5 ng/ml, respectively). After withdrawal of methadone, i.e. 12 +/- 3.7 days after heroin withdrawal, CT values were 76.6 +/- 32.7 ng/ml (a significant level of P less than 0.02 towards initial values). No correlation was noted between CT and PRL values. PMID- 3678053 TI - Decreased serum selenium and magnesium levels in drunkenness arrestees. AB - Serum levels of selenium magnesium, copper, zinc and iron were studied in chronic drunkenness arrestees and a healthy control group. The mean serum concentrations of selenium and magnesium were both significantly lower (P less than 0.01) in drunkenness arrestees than in the control subjects. The mean alcohol intake was 190 g of absolute alcohol daily in drunkenness arrestees and 14 g in controls. The erythrocyte glutathione peroxidase concentrations of the study groups did not support poor selenium intake as a principal cause of low selenium concentration in the serum. PMID- 3678054 TI - Individualizing nutrition in patients with acute respiratory failure requiring mechanical ventilation. AB - Provision of adequate nutrition is recognized as a therapeutic necessity to maintain inspiratory muscle strength and prevent weaning failures in patients with acute respiratory failure requiring mechanical ventilation. Total caloric needs are empirically estimated by calculation of basal energy expenditure and modified by correction factors for concurrent levels of stress. Energy requirements can vary considerably from empiric estimations and may be better defined by indirect calorimetry that measures oxygen consumption and carbon dioxide production. Protein constituents are initiated empirically until patient specific urea nitrogen excretion is available. The addition of fat emulsion as 20 50 percent of total daily calories limits lipogenesis, prevents excessive carbon dioxide production, and provides a volume-concentrated caloric source to fluid restricted patients. Manipulation of nutrient composition can improve or impair ventilatory weaning and nutritional rehabilitation. The significance of substrate utilization is reviewed and recommendations for establishing nutritional regimens for mechanically ventilated adults with acute respiratory failure are provided. PMID- 3678055 TI - Antibiotics and Hib in pregnancy. PMID- 3678056 TI - Irrigating solutions in bladder stone dissolution. PMID- 3678057 TI - Naltrexone in the management of seizures associated with Rett syndrome. PMID- 3678058 TI - Phenytoin hypersensitivity with pulmonary involvement in a hemophiliac patient with human immunodeficiency virus infection. AB - Acquired immunodeficiency syndrome (AIDS), with its attendant sequelae of opportunistic infections and aggressive lymphatic malignancies, continues to dominate the world's medical literature. Pneumocystis carinii pneumonia (PCP) remains as the most commonly encountered infection in AIDS and an early cause of morbidity and mortality. Current therapy for PCP revolves around the administration of either pentamidine isoethionate or trimethoprim sulfamethoxazole; however, the major AIDS centers report a high incidence of adverse drug reactions to these drugs. We describe an association with human immunodeficiency virus (HIV) infection in a hemophiliac with multiple drug related hypersensitivity reactions, which include constitutional, dermatologic, and pulmonary manifestations. This observance is intriguing and suggests that the presence of HIV infection may predispose a patient treated with a multitude of drugs and medications to a higher incidence of adverse reactions. PMID- 3678059 TI - Clomipramine-induced urinary dysfunction in an obsessive-compulsive adolescent. AB - Two episodes of urinary retention occurred in a 15-year-old male following administration of clomipramine given for obsessive-compulsive disorder. Improvement of behavioral symptoms along with side effects was clearly correlated with clomipramine dosage. Severity of side effects, and their resistance to bethanechol and to phenoxybenzamine, necessitated a complete withdrawal of clomipramine. This case demonstrates that clomipramine-induced urinary retention is not limited to older individuals. Possible involvement of noncholinergic and nonadrenergic mechanisms in this adverse drug reaction is suggested. PMID- 3678060 TI - Increased theophylline concentrations secondary to ciprofloxacin. AB - An 82-year-old man with a history of myasthenia gravis and heart failure was admitted to the hospital with respiratory failure. Aminophylline and eventually theophylline therapy were initiated to improve respiratory status. During the hospital stay, the patient developed a resistant pseudomonal pneumonia. After failure with conventional antibiotics, ciprofloxacin was initiated because of favorable sensitivity and the planned avoidance of aminoglycoside therapy. Seventy-two hours after initiation of ciprofloxacin, the patient's theophylline level rose from a steady-state baseline of 9.8 micrograms/ml to 34.7 micrograms/ml. After the theophylline dose was reduced by approximately 67 percent, the patient's theophylline serum concentration returned to baseline (10 micrograms/ml). Until more data concerning the interaction of theophylline and ciprofloxacin are available, we recommend close monitoring of theophylline serum concentrations in patients receiving concomitant ciprofloxacin. PMID- 3678061 TI - Severe thrombocytopenia associated with once-daily rifampin therapy. AB - Rifampin-induced thrombocytopenia has been recognized as an immunological reaction associated with intermittent high-dose therapy, and rarely seen with daily low-dose regimens. Our patient was a 33-year-old male with Marfan's syndrome who was given rifampin 600 mg/d po along with intravenous vancomycin for the treatment of Staphylococcus epidermidis endocarditis. His platelet count dropped from a baseline of 519,000/mm3 to 4000/mm3 after four doses of rifampin. Petechiae were present on the lower extremities without the presence of other bleeding sites. Rifampin, low-dose aspirin, and dipyridamole were discontinued. His platelet count returned to normal nine days after discontinuation of therapy. With the increasing use of rifampin for the treatment of nontuberculosis infections, clinicians should recognize the possibility of this drug causing such serious immunological reactions as thrombocytopenia, hemolytic anemia, acute renal failure, and shock with daily or intermittent therapy. PMID- 3678062 TI - Costs associated with the inappropriate route of administration of parenteral histamine2-receptor antagonists. AB - The objectives were to assess the parenteral route for cimetidine and ranitidine and to determine excess medication costs associated with inappropriate use. Criteria were based on clinical situations that do not permit oral therapy, result in questionable dry absorption, or require a more rapid onset of action. The parenteral route was assessed as appropriate, inappropriate, or questionable. During two months, parenteral therapy was prescribed for 199 adult inpatients. Initially, 63 percent received the parenteral form appropriately; only 16 percent continued to receive the parenteral form appropriately throughout therapy. Less than half of the parenteral doses were determined to be appropriate. A major reason appears to be that orders are not changed as patients' conditions improve. Excess medication costs attributed to inappropriate parenteral therapy for the study period amounted to $6796 or $8002, depending on whether questionable doses were considered appropriate or inappropriate, respectively. An annual projected savings of $40,776 or $48,012 could be achieved if oral doses had been administered in place of inappropriate parenteral therapy. PMID- 3678063 TI - Impact of computerized drug profiles and a consulting pharmacist on outpatient prescribing patterns: a clinical trial. AB - The effects of computerized drug profiles and clinical pharmacist consultation in the internal medicine clinics at a Veterans Administration hospital were studied. Population included patients (n = 512) and physicians (n = 35) of three internal medicine clinics during an eight-week period. The first four weeks were the preintervention period. The second four weeks were the intervention period in which a clinical pharmacist attended one clinic (A) and provided drug profiles on all patients. Two other clinics (B and C) served as controls. During the intervention, patients in clinic A experienced a significant reduction in prescribing problems as identified by the pharmacist: 49 percent of patients before the intervention versus 9.4 percent after the intervention (p less than 0.001). Patients in clinic B had no significant change in prevalence in the number of problems identified (39 versus 40 percent; NS), and patients in clinic C had a significant but less dramatic decrease (35 versus 22 percent; p less than 0.05). The proportion of patients in clinic A with net decrease in the number of prescribed medications rose from 7.1 to 34.9 percent (p less than 0.001), with a mean decrease of 0.3 medications per patient. No significant differences in number of prescribed medications were noted in clinics B or C. Accuracy of physician medication charting improved for patients in clinic A from 54 percent of charts with accurate drug lists before the intervention to 78.3 percent after the intervention (p less than 0.001). No significant improvements were noted for clinics B and C. These results suggest that computerized drug profiles together with clinical pharmacist consultation can improve prescribing practices in a hospital outpatient department. PMID- 3678064 TI - Serum phenobarbital concentration predictions by a personal computer software system. AB - The ability of a personal computer software system to predict actual serum phenobarbital concentrations (SPC) in outpatients taking phenobarbital chronically was assessed by comparing actual with predicted SPC for accuracy, bias, and precision. Data for a four-year period were collected on patients at an outpatient clinic's pharmacokinetic consultation service. The study group included 50 adults and children with at least one SPC taken at a known time after dose administration. Input variables were weight, sex, height, age, concomitant drugs and diseases, phenobarbital dosage regimen, and the time and reported value of all SPC. Initially, SIMKIN (SIMulated KINetics) simulated dosing regimens on the basis of literature estimates of pharmacokinetic parameters; SPC were then estimated for these regimens and compared with actual values. One or two additional SPC were added to the input data and analyzed, and the predicted SPC compared with actual values. Although SIMKIN's accuracy and bias as measured by regression analysis and mean prediction error, respectively, were within clinically acceptable limits, the precision was not. However, these results are limited by the population studied. Patient compliance, concomitant phenytoin therapy, changes in phenobarbital pharmacokinetic parameters with chronic dosing, and disease interactions may significantly affect predictive ability. The clinical effects of these factors need to be evaluated to further improve predictions. PMID- 3678065 TI - A clinical pharmacy-oriented drug surveillance network: I. Program description. AB - The limitations of the new drug development process, particularly in regard to the evaluation of drug safety, have resulted in a need for monitoring drug experience in the postmarketing period. Although a number of systems have evolved to perform postmarketing surveillance, each has important limitations, suggesting the need for an alternative, innovative approach that would permit rapid identification of potential problems and support studies of multiple drugs and/or disease states in patient populations large enough to permit identification of uncommon, but significant adverse drug reactions. This has led to the organization of a nationwide network of clinical pharmacists with an active role in patient-care monitoring to collect information regarding the safety and effectiveness of drugs. At the present time there are 383 clinical pharmacists from all 50 states participating in the network. These individuals collectively monitor more than 150,000 inpatient hospital beds, more than 40,000 nursing home beds, and more than 800,000 ambulatory care visits per year. Participating clinical pharmacists, using standardized data collection forms, perform concurrent monitoring of drug-therapy outcome in targeted patient populations. Careful analysis and interpretation of this information will yield clinically relevant information regarding the outcome of drug therapy under actual clinical conditions. PMID- 3678066 TI - A clinical pharmacy-oriented drug surveillance network: II. Results of a pilot project. AB - A nationwide network of clinical pharmacists has been organized for the purpose of collecting drug experience data generated during the routine clinical care of patients. In order to assess the utility of this network a pilot project was performed to obtain a cross-sectional view of antibiotic utilization in the U.S. and to identify potential problems with a more widespread implementation of this program. One hundred eleven pharmacists enrolled in the drug surveillance network participated in this survey and collected information on more than 2000 patients treated with antimicrobial agents over approximately a three-month period (February-April 1987). The most common sites of infection were the lung, genitourinary tract, skin and soft tissue, and the abdomen, and accounted for approximately 75 percent of infections. Overall, the aminoglycosides, the first generation cephalosporins, and the aminopenicillins remain the most commonly used antibiotics and represent approximately 50 percent of antimicrobials used in the surveyed population. The results of this pilot project suggest that the use of a nationwide network of clinical pharmacists is a promising source of clinically relevant drug experience data. The ability to concurrently evaluate patients and link information regarding patient demographics, drug therapy regimens, diagnosis, and clinical outcomes fills an important gap in our knowledge of clinical drug utilization. PMID- 3678067 TI - Adverse drug events: identification and attribution. AB - The definition of an adverse drug event should be tailored to one's purpose in examining the incident. Although the more specific of these definitions is required for scientific evaluation of the link between drug and event, other less stringent definitions are usually adequate for clinical purposes. Knowledge about the safety profile of a drug in humans is limited at the time of marketing. The mechanisms for supplementing safety data during postmarketing include (1) the Spontaneous Reporting System maintained by the Food and Drug Administration, (2) formal projects to assemble safety data on larger or more complex populations, and (3) formal projects designed to answer specific research questions. Judgments about attribution can be no better than the data that support them. The criteria applied by the clinician to the individual adverse drug experience to determine association differ from those required to establish causation based on epidemiologic evidence. In most situations, regulatory action on drug recall should be based on epidemiologic evidence. This article will discuss the choice of a definition for an adverse drug event, examine the extent and nature of the safety data assembled on a drug at the time it is marketed, propose the best methods for collecting additional information after marketing, and designate factors to be considered in judging a drug to be causally related to an adverse event. PMID- 3678068 TI - Amiodarone--phenytoin interaction. PMID- 3678070 TI - Hetastarch-induced hyperkalemia. PMID- 3678069 TI - Phenazopyridine-induced hemolytic anemia in G-6-PD deficiency. PMID- 3678071 TI - Aminoglycoside therapy and toxicity in the elderly. PMID- 3678072 TI - Comment: ambulatory kinetic monitoring. PMID- 3678073 TI - [Are we prescribing too many sulfonylurea drugs?]. PMID- 3678074 TI - [Lyme borreliosis in South Germany. Epidemiologic data on the incidence of cases and on the epidemiology of ticks (Ixodes ricinus) carrying Borrelia burgdorferi]. AB - Among 2403 ticks (Ixodes ricinus) tested in 1985 for Borrelia 328 (13.6%) were carriers (adults about 20%, nymphs about 10%, larvae about 1%). The highest prevalence of infected ticks was among adult ticks in the Isar region north of Munich (33.8%). Among 9383 persons whose serum had been examined by fluorescence serology in 1985 and 1986, 1035 (11%) had raised Borrelia-specific IgG and/or IgM antibodies greater than or equal to 1:64. In 18.7% only IgM antibodies were demonstrated. Among 375 proven cases there were 78 with erythema migrans, 211 with neurological signs, 48 with Lyme arthritis and 36 with acrodermatitis. Seasonal incidence peaks were in June-August for erythema migrans, July-September for neurological signs, with no clear-cut seasonal peaks with Lyme arthritis and acrodermatitis. The incubation time for 80% of cases of each abnormality was 5-29 days for erythema migrans, 20-59 for neurological signs and 2-8 months for Lyme arthritis. Erythema migrans was most frequent among those aged 30-60 years, neurological signs among children and juveniles up to 20 years and those aged 40 to 70 years, Lyme arthritis among those aged 30-60 years, and acrodermatitis among those aged 40-80 years. Significantly more women than men developed acrodermatitis. PMID- 3678075 TI - [Recurrent cerebral emboli in nonbacterial thrombotic endocarditis]. AB - A 28-year-old woman developed thrombophlebitis migrans and right hemiparesis with motor aphasia. Chest X-ray revealed a plum-sized central infiltrate in the right lower lobe of the lung. Transbronchial lung biopsy showed bronchoalveolar carcinoma. Subsequently recurrent cerebral infarcts developed from which the patient died. Autopsy revealed nonbacterial thrombotic endocarditis as the cause of the cerebral infarcts. This form of endocarditis is characterized by the parallel occurrence of arterial emboli and thromboses of the superficial and deep veins. It develops in association with various diseases, especially malignant tumors, and is an expression of a generalized thrombosis disposition. PMID- 3678076 TI - [Local excision of tumors of the rectal cavity]. PMID- 3678077 TI - [Establishment of clinical research groups by the Federal Ministry of Research and Technology]. PMID- 3678078 TI - [Diagnosis and therapy of stroke]. PMID- 3678079 TI - [The airways in sarcoidosis]. AB - In a retrospective study of 152 patients with histologically proven sarcoidosis (stage I: 76 patients; stage II: 70; stage III: 6) clinical pointers towards respiratory involvement were found in 45%, morphological evidence in the form of epithelioid cell granulomatosis of the mucosa in 20%, and histological findings in the form of nonspecific inflammatory and degenerative mucosal changes in 90%. In 30% of patients there were indications of respiratory tract obstruction in the lung function tests. Circumscribed central granulomatous lesions with stenoses of a segment or lobar bronchus and resulting atelectasis were rare, seen in only three. Generalized central respiratory tract obstruction, diagnosed by an increase in airway resistance, was present in 8-17% and was stage-dependent. It correlated in a statistically significant manner with the occurrence of epithelioid-cell granulomas. Peripheral airway obstruction with involvement of the small airways, of which there was functional evidence, can be caused by peribronchial formation of granulomas, as typically seen in transbronchial lung biopsies. But these findings were not of any clinical significance nor required changes in the therapeutic regimen. Functionally precipitated airway obstruction caused by bronchospasm was not demonstrated in the inhalation carbachol provocation test. On the other hand, a subgroup of sarcoidosis patients with raised serum IgE levels had a significantly lower stimulation threshold of the respiratory tract to carbachol. PMID- 3678080 TI - [Severe bleeding from a cavernous hemangioma of the liver during treatment with streptokinase]. AB - Severe bleeding from a subcapsular flat haemangioma of the liver occurred in a 32 year-old woman receiving streptokinase infusion for suspected femoral vein thrombosis. The bleeding was diagnosed by ultrasound undertaken because of atypical upper abdominal symptoms: the cause of the bleeding remained unexplained. Only after the streptokinase infusion had been discontinued were there clinical signs of bleeding, which during preparation for laparotomy led to shock. After segmental resection of the left lobe of the liver and an complicated post-operative course the patient left hospital in good condition. PMID- 3678081 TI - [Labor legislative aspects of the regulation of ambulance fees in contracts with the chief hospital medical officer]. PMID- 3678082 TI - [Macrocytosis caused by alcohol and/or drugs]. PMID- 3678083 TI - [Fine-needle biopsy: erroneous presumption of powerful aspiration suction]. PMID- 3678084 TI - [HIV transmission from a smear infection?]. PMID- 3678085 TI - [Arterial fibromuscular dysplasia as an unexpected cause of death in adults]. AB - In a 38-year-old woman, arterial hypertension was diagnosed a few weeks before her death. She died unexpectedly before a diagnostic clarification of the cause was possible. Autopsy revealed an arterial fibromuscular dysplasia with manifestation in both common iliac arteries, both renal arteries, the celiac trunk and the splenic artery. Both renal arteries displayed stenotic dissecant aneurysms which were the cause of the arterial hypertension. As a rare and lethal complication of fibromuscular dysplasia, a ruptured saccular aneurysm was found in the splenic artery. Histologically, the vascular alterations were a combination of medical fibromuscular dysplasia (type II) and periarterial or adventitial fibroplasia (type III). On the basis of the immunohistochemical detection of abundant lysozyme-positive cells, the periarterial fibroplasia appears to be a secondary chronic granulating and cicatricial reaction and not a separate form of fibromuscular dysplasia. PMID- 3678086 TI - [Tumor lysis syndrome in a young patient with Burkitt-type lymphoblastic lymphoma]. AB - A tumor lysis syndrome with hyperkalaemia, hyperphosphataemia, hyperuricaemia and hypocalcaemia developed 48 hours after start of combined cytostatic treatment in a 16-year-old boy with Burkitt's lymphoma. Despite prophylactic administration of allopurinol and urinary alkalization, postrenal precipitation of urates and calcium phosphate caused acute renal failure. Ureteric splinting and percutaneous fistulization of the contralateral renal pelvis became necessary. Elevated renal retention values became normal after these measures and infusions with balanced alkalized electrolyte solutions, and the hypocalcaemia was counteracted. PMID- 3678087 TI - [Cholelithiasis in childhood]. PMID- 3678088 TI - [Psychological symptoms in hypoglycemia]. PMID- 3678089 TI - [Radioisotope-storing metastases of a medullary thyroid carcinoma]. PMID- 3678090 TI - [Is chronic gastritis an infection and does it pave the way for peptic ulcer disease?]. PMID- 3678091 TI - [Benzodiazepines and barbiturates in chronic alcoholics and opiate addicts. An epidemiological study of hospitalized addicts]. AB - In a prospective study of 282 chronic alcoholics and 67 opiate addicts, frequency and pattern of drug intake were determined by questioning and urinalysis on admission to a special unit of a psychiatric hospital. 20.2% of alcoholics and 44.8% of opiate addicts stated that they had taken psychotropic drugs before admission, women in both groups naming such drugs significantly more frequently than men. But taking into account results of urinalysis, 25.5% of alcoholics and 31.3% of opiate addicts were found to have taken benzodiazepines before hospital admission. 41.8% of opiate addicts either stated or were found to have taken barbiturates. High dosages of benzodiazepines were found in those alcoholics who had mentioned taking them. Thus in practice the treatment of addicts differs markedly from recommendations made by well-known experts. There is also a need to improve the clinical diagnosis and treatment of addicts. PMID- 3678092 TI - [Acute trichinosis. 193 cases in an epidemic]. AB - In 1982, an epidemic of acute trichinosis occurred in Bitburg with 402 cases. The acute stage was observed and documented in 193 patients. The first signs of the disease appeared on average 17 days after eating trichina-containing meat. Muscle pain was reported by 85% of patients, lid and/or facial edema by 83%, gastrointestinal complaints by 62%, fever by 60%, flu-like symptoms by 56%, headache by 26%, eye complaints by 19%. Eosinophils were present in the blood of 92%. Trichinella antibodies were demonstrated in 98% of patients examined for them. Interstitial myositis was found in 90% of muscle biopsies (from 162 patients). Serious complications--thrombosis, myocarditis, pneumonia, hepatitis or meningism--occurred in 26 (13.5%) of the 193 patients. Even six months after onset of the disease 43% of patients were still not free of symptoms. PMID- 3678093 TI - [Follow-up care in colorectal adenoma]. AB - From 1980 to 1985, 319 adenomatous colorectal polyps were removed in 297 patients. All patients were entered into a computerized follow-up programme with yearly follow-up. The recommended follow-up was rejected by 58 patients (22.1%). 93 new adenomatous polyps were found in the course of the follow-up in 53 patients (35.8%), five of them histologically invasive carcinomas. The proportion of carcinomas was lowered from 10.6% at first examination to 5.4% in the follow up period. Size of polyp correlated significantly with carcinomatous change. Size of the adenomas removed at follow-up was markedly smaller than that removed at first examination (69.4% smaller than 1 cm compared with 44.2% at follow-up). In six patients with early invasive carcinoma, further resections were undertaken, while in six others only the polyps were removed. But local recurrences occurred in both groups. Regular follow-up after polypectomy of colorectal adenoma is thus essential. PMID- 3678094 TI - [Lung manifestations in chronic polyarthritis]. PMID- 3678095 TI - [Iontophoresis treatment of hyperhidrosis of the hands and feet]. PMID- 3678096 TI - [Disseminated intravascular coagulation caused by contrast media?]. PMID- 3678097 TI - [Emergency measures following an apoplectic seizure]. PMID- 3678098 TI - [Ergometry in the diagnosis of hypertension]. PMID- 3678099 TI - [The combination of atrial myxoma and multiple skin myxomas: a characteristic symptom complex?]. AB - In 1980, a then 7-year-old boy from Yugoslavia had an atrial myxoma removed. Since then there have been no abnormal cardiac signs or symptoms. Between 1982 and 1986 five cutaneous myxomas in the trunk region were removed. None of the tumours had histological signs of malignancy. These observations can be fitted into the symptom complex (described in 1985 by Carney et al.) of cardiac myxoma, cutaneous myxoma, changes in skin pigmentation, and abnormal endocrine functions- although not all signs need be present together. A disposition towards the development of myxomatous tumours is to be assumed in these patients. One should, therefore, always suspect an occult cardiac myxoma in the presence of multiple cutaneous myxomas. Appropriate diagnostic measures need to be taken before the typical and sometimes lethal consequences of a cardiac myxoma have occurred. PMID- 3678100 TI - [Extracorporeal shock-wave lithotripsy of gallstones and the role of gallbladder surgery]. PMID- 3678101 TI - [Bone scintigraphy in questionable fractures]. PMID- 3678102 TI - [Coronary angiography following myocardial infarct]. PMID- 3678103 TI - [Fibrinolytic therapy in ischemic brain infarct]. PMID- 3678104 TI - Asbestos toxicity. Papers from the Asbestos Toxicity Symposium. April 24, 1985, Miami, Florida. PMID- 3678105 TI - Asbestos in peripheral lung culture a species comparison of pulmonary tissue response. AB - We have recently developed culture techniques to allow the long-term maintenance of adult peripheral lung tissue in vitro from a variety of mammalian species including hamster, rat, bovine, and human. The technique involves perfusion of the major airways with agarose gel and culture media followed by thin sectioning and culture on porous surgical foam. Cross sections of lung lobes 1-2 mm thick have been cultured for periods beyond four weeks with maintenance of structural and biochemical integrity of the lung. In vitro exposure of lung explants to crocidolite asbestos through the airways produced fibrotic and hyperplastic lesions similar to those reported after in vivo exposure. The incidence and severity of interstitial fibrous was concentration-dependent, including the human specimens, and the morphologic appearance of the lesions was similar in explants derived from each species. The lung explant model is well suited for further mechanistic evaluations of asbestos-induced lung lesions. It is notable that the pulmonary lesions were produced without the possibility for recruitment of hematogenous inflammatory cell populations. PMID- 3678106 TI - Characterization of fetal human brain cultures. Development of a potential model for selectively purifying human glial cells in culture. AB - Seven fetal human brain and three fetal human leptomeningeal cultures were characterized according to cell morphology, ultrastructural features, antigen expression, and collagen biosynthesis capabilities. Primary cultures derived from mechanically and enzymatically dissociated samples of fetal human brain consisted of a heterogeneous cell population in which astrocytes, oligodendrocytes, neurons, mesenchymal (leptomeningeal) cells, and macrophages were identified by light and electron microscopy. With progressive subcultivation, a homogeneous, leptomeningeal cell-derived population predominated. Fetal human brain and leptomeningeal specimens embedded in paraffin were analyzed immunohistochemically for the distribution of glial fibrillary acidic protein (GFAP), vimentin, factor VIII-related antigen, fibronectin, laminin, type IV collagen, and procollagen III. Only GFAP and vimentin identified astrocytes and radial glia in the developing human brain; fibronectin, laminin, and the collagen types were immunolocalized largely to the leptomeninges and to the cerebral vasculature. The percentage of cells positively identified by antiserum to GFAP was greatest in primary cultures of fetal human brain; by the fourth passage, none of the fetal brain cultures were GFAP positive. The progressive decrease in the percentage of GFAP-positive cells was accompanied by an increase in the percentage of cells identified by collagen immunomarkers. Furthermore, in double immunolabeling experiments, antibodies to GFAP recognized a population of cells that was not identified by antibodies to laminin, fibronectin, type IV collagen, or procollagen III. SDS-PAGE and DEAE-cellulose chromatography of [3H]-proline labeled early-passage fetal human brain cultures revealed collagen profiles identical to those obtained from direct cultures of the leptomeninges. The characteristics of later-passage fetal human brain cultures were identical in all respects to those of the fetal human leptomeningeal cultures. The proliferation of leptomeningeal cells could be inhibited by exposing the cells to cis hydroxyproline (200 micrograms/ml). Primary fetal human brain cultures similarly treated with the proline analogue were found to be highly enriched for glial cells; these cultures were more than 90% GFAP positive. We conclude that primary fetal human brain cultures consist of a heterogeneous population of cells, most of which under the present culture conditions can be identified as glial cells. Subcultivation of human fetal brain cultures results in the overgrowth of mesenchymal cells, which are presumably derived from the leptomeninges.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3678107 TI - Effect of chlorpromazine on Purkinje cell growth patterns. AB - The phenothiazine, chlorpromazine, when administered perinatally to rats is implicated in the production of both motor and behavioural deficits. In this study the effects of chlorpromazine on dendritic growth of cerebellar Purkinje cells were examined after administering the drug to litters of Long-Evans hooded rats from 18 days postcoitus to 21 days postnatum. Various parameters of Purkinje cell growth were analysed at specific times after treatment utilizing Golgi prepared specimens. Granule cell density was used as an estimate of parallel fibre numbers. When compared with control Purkinje cells the treated cells at 7 weeks postnatum had established longer segments and increased mean vertex path length. The total number of segments was also increased and the distribution of segments of different orders was abnormal. In addition, the spines on terminal dendritic branches were both longer and of increased density in the chlorpromazine-treated group. These observations confirm that chlorpromazine produces distinct morphological alterations in mature Purkinje cells. PMID- 3678108 TI - Professional liability, peer review, and antitrust law. PMID- 3678109 TI - Long-term hearing effects in cleft palate patients. PMID- 3678110 TI - Endaural approach to the middle ear. PMID- 3678111 TI - Primary squamous-cell carcinoma. PMID- 3678112 TI - Objective measures of voice function. PMID- 3678113 TI - Speech-language pathology and the professional voice. PMID- 3678114 TI - Common medications with laryngeal effects. PMID- 3678115 TI - Neurolaryngology. PMID- 3678116 TI - Surgery in professional singers. PMID- 3678117 TI - The value of correction for age in the assessment of prematurely born children. AB - The value of correction-for-age in assessing psychomotor development during the first year of life was studied in prematurely born children. As part of a prospective follow-up study two pre-term age cohorts, born between 1976 and 1977, were evaluated prospectively to the age of 4.5 years. Data on first year psychomotor development were able to be collected concerning 66 prematurely born children and 36 full-term controls, whose neurodevelopmental and psychological status were found to be normal at the age of 4 years. On using uncorrected ages (chronological ages), achievement of developmental stages was significantly later among the premature children than among the fullterm children. If the corrected age was used, the developmental profile of the premature children became similar to that of the full-term controls. Over-correction in relation to the achievement of early developmental stages was found among very premature children (those born at or before 33 weeks of gestation). Over-correction diminished during the first year of life. On the basis of the present study, both corrected and uncorrected ages should be used when assessing first-year development, especially in very premature children. PMID- 3678118 TI - The effect of dexamethasone on neutrophil adherence in umbilical cord blood. AB - Neutrophil adherence immediately after delivery and after incubation with saline and with two different concentrations of dexamethasone was studied in umbilical cord blood of 27 full-term neonates. Dexamethasone was not found to have any significant effect on neutrophil adherence in vitro. PMID- 3678119 TI - Relationship of serum bilirubin levels and hearing impairment in newborn infants. AB - A comparison has been made between 39 infants with a birthweight of 1500 g or less and a bilirubinlevel of 240 mumol/l or above, born between January 1980 and December 1983 and 19 infants with the same criteria, born between January 1984 and December 1985. Eight of the 22 high risk and two of the 17 low risk infants were diagnosed to have sensorineural deafness (SND) during the first period and this was strongly associated with the duration of the hyperbilirubinaemia. During the second period, more active intervention for hyperbilirubinaemia led to an increased number of exchange transfusions and a marked drop in the mean duration of hyperbilirubinaemia (less than 240 mumol/l). None of the very low birth weight (VLBW) infants born in the second period have developed SND. To investigate the independent effect of hyperbilirubinaemia on hearing, six low risk infants with bilirubin levels less than 320 mumol/l were studied by serial auditory brainstem responses (ABR). Impairment of the ABRs was found in four infants, with further deterioration with the persistence of high bilirubin levels in two. Although recovery of hearing thresholds was noted in all infants with impaired ABRs, an absence of wave I was noted in three infants at 6 months of age, which could indicate damage to the auditory nerve-cochlear complex. These findings suggest that hyperbilirubinaemia in itself can have an adverse effect on hearing and that careful management of hyperbilirubinaemia may reduce the incidence of sensorineural deafness. PMID- 3678120 TI - Assessment of proportional growth of very low birth weight infants fed banked human milk. AB - Twenty appropriate (mean +/- S.D., gestational age (AGA): 29.9 +/- 1.5 weeks) and 15 small (GA: 34.6 +/- 2.4 weeks) for gestational age (SGA) very low birth weight infants fed banked mature human milk were studied until term for anthropometric parameters: midarm (MAC), chest (CC), head (HC) circumferences, triceps (TSKF) and subscapular (SSKF) skinfold thickness recorded at 15 and 60 s, dynamic skinfold (delta % SKF), muscle (AMA) and fat (AFA) areas, weight and length. In AGA infants, all the parameters at term were significantly lower in extrauterine (EUL) that in intrauterine life (IUL). At term the relative proportion of AFA to total arm area was increased in EUL compared to IUL both in AGA (25.87 +/- 3.8 vs. 23.26 +/- 1.27% respectively, P less than 0.01) and in SGA infants (21.89 +/- 4.63 vs. 18.81 +/- 3.9 respectively, P less than 0.05). SGA infants showed a similar growth in EUL compared to IUL, and a significantly lower AMA and AFA than in AGA infants in EUL. Although HC was in both infants below the 10th centile at term, the ratio weight/HC2 suggests a relative preservation of head growth in EUL compared to IUL (AGA: 20.72 less than 0.87 vs. 22.65 +/- 1.46 respectively, P less than 0.001; SGA; 20.82 +/- 1.16 vs. 21.62 +/- 1.86 respectively, NS). Delta %SKF were negatively correlated with post-conceptional age suggesting a loss of extracellular water in AGA (delta %TSKF: r = -0.287, P less than 0.02) and in SGA infants (delta %TSKF: r = -0.301, P less than 0.02; delta %SSKF: r = -0.316, P less than 0.02). An intrauterine model of discrimination between AGA and SGA infants does not apply to EUL. An equation was established in SGA infants with the best discriminant parameters giving a predictive post-conceptional age: post conceptual age (PCA) (weeks) = 0.276 HC (cm) + 0.723 CC (cm) - 0.122 MAC (cm) + 0.5 TSKF (mm) + 10.173, (r = 0.867, P less than 0.001) allowing a clear discrimination between AGA and SGA infants. These results suggest that infants show quite different growth patterns between IUL and EUL both for AGA and SGA infants. PMID- 3678121 TI - The automatic sampling shield: a device for sampling suckled breast milk. AB - The automatic sampling shield uses the negative pressure exerted by the breast feeding baby during sucking to withdraw a series of small samples from the milk stream. Shield performance was studied at four feeds for each of 13 babies. Acceptance of the shield was good (96% of feeds) and samples were obtained in 88% of feeds. Sample weight was large enough for micro-biochemical analysis of composition (median weight 1.3 g), without depriving the baby of important amounts of milk (median percentage of weight of milk intake was 4.3% and sample weight was less than 5 g in all cases). The shield should sample a constant proportion throughout the feed, in order to obtain a sample that is representative of the infant's nutrient intake. Fractional test-weighing of feeds showed a tendency for a larger proportion of the feed to be collected at slower flow rates. Modelling on the basis of the observed flow profiles in conjunction with a theoretical fat concentration profile showed that the observed 'disproportionality' would have over-estimated fat intake by a mean of 2.6% per feed (S.D.9.1 range -18.9% to + 16.9%). Using the shield in random sequence at two out of the first four feeds after 0800 h, showed that an infant's mean milk intake with the shield was on average 32% less than on control feeds. Allowing for possible compensation by the infant when control feeds followed low shield intakes, mean milk intakes with the shield were 17% smaller than without the shield. PMID- 3678122 TI - [Regulation of the proliferation of granulocyte-macrophage progenitors in human bone marrow]. AB - The colony stimulating activity (CSA) of bone marrow cells in 50 children with normal bone marrow was studied. A method for quantitative estimation of CSA of bone marrow cells has been suggested. Essential distinctions between CSA of bone marrow cells and that of peripheral blood leukocytes were established considerable decrease mainly at the expense of reduction of the proliferation of colony-forming progenitors was found. CSA of bone marrow cells appears to be a result of complicated interaction between bone marrow adherent and non-adherent fractions. Each of these two fractions produces approximately the similar level of CSA which is lower than that of unfractionated bone marrow. It is supposed that there are two types of granulocyte macrophage progenitors in the human bone marrow which are specifically-sensitive to CSA of leukocytes and bone marrow cells and possess different proliferative potential. PMID- 3678123 TI - [Interrelation between the ribosome content of lymphocytes and hypogammaglobulinemia in chronic B-cell lymphatic leukemia]. AB - The serum immunoglobulin levels, ribosome contents and protein synthesis rate in peripheral blood lymphocytes have been studied in 35 patients with chronic lymphatic leukemia. It is shown that in patients whose lymphocyte ribosome content corresponds to that of the donors IgG, IgA, IgM levels were on the average normal whereas in the patients with the decreased ribosome content IgG and IgA were 2-2.7 times lower, while the IgM concentration was normal. Hypogammaglobulinemia of IgG, IgA and IgM types in 47% of patients with the normal ribosome contents was 23%, 29% and 23%, respectively, and in 100% of patients with the low ribosome content it was 72%, 83% and 68%, respectively. There was no distinct correlation between the immunoglobulin levels and the protein synthesis rate. The ribosome pattern in the lymphocyte maturation in chronic lymphatic leukemia is discussed. PMID- 3678124 TI - [Characteristics of anthracycline-resistant strains of P388 leukemia]. AB - Two strains of P388 murine leukemia with acquired resistance to rubomycin (P388/rm) and its nitroxyl derivative ruboxyl (P388/rx). The rubomycin resistance has been developed by the 14th generation and ruboxyl one-by the 8th generation. The growth kinetic patterns and the cell cycle time of the parent and resistant strains were similar. An increased tumourogenicity of both resistant strains cells was found. The resistance development was accompanied by the appearance of the additional chromosome materials, namely of homogeneously staining region (P388/rx) and of double chromatin bodies (P388/rm). The partial recovery of sensitivity to rubomycin occurred during 36 generations (1 year). Simultaneously the genetic markers have been lost. The recovery of sensitivity to ruboxyl in this period was not observed. The obtained resistant strains possessed the multidrug resistance: the cross resistance of P388/rm and P388/rx to actinomycin D, Vinca alkaloids and colchicine was shown. PMID- 3678125 TI - [Sensitivity of clonogenic cells of human ascitic ovarian cancer to antitumor agents]. AB - A soft agar colony assay using diffusion chamber technique in vivo for studying the sensitivity to chemotherapeutic agents of clonogenic tumor cells of primary ovarian carcinoma was used. The highest cytotoxic sensitivity on human clonogenic tumour cells was observed to cyclophosphamide and 5-fluorouracil. The sensitivity of human ovarian carcinoma to chemotherapeutic agents was dependent essentially on the presence of macrophage in cell culture. PMID- 3678126 TI - [Effect of 1,2-dimethylhydrazine on the level of specific binding and ligand affinity to the estradiol receptor in the cytosol of uterine tissue in CBA mice]. AB - 1,2-dimethylhydrazine (DMH) inducing uterine sarcomas in CBA mice was studied for its prolonged effect on the level of specific binding and affinity to the estradiol receptors in cytosol fraction of CBA mice uterine tissue. It is shown that the dissociation constant 3H-estradiol-17 beta with a receptor protein in the cytosol of uterine tissue of DMH treated mice was slightly higher than in control mice. The theoretical number of the ligand binding sites with receptor protein and the level of free binding sites of estrogen receptors were higher in DMH-treated animals than in control mice during the whole period of observation. PMID- 3678127 TI - [Study of neuroblastomas in children using a complex of monoclonal antibodies]. AB - The possibility to reveal the following types of neuroblastoma is described: with c-ALL-antigen; with Thy-1-antigen (ICO-10); with granulocytic antigen (ICO-G2); with B-cell antigen (IPO-10). Immunocompetent cells in the tumour may be studied with the use of monoclonal antibodies ICO-1, ICO-11, ICO-GM-1, OKT3, IPO-3. PMID- 3678128 TI - [Characteristics of disorders of water-electrolyte homeostasis in rats with transplantable hepatomas]. AB - The growth of ascitic Zajdela and solid 27 hepatomas in vivo is accompanied by significant changes in parathyroid hormones, calcitonin and aldosterone blood levels. In periods close to terminal ones, their level decreases presumably as a result of energy deficiency in the endocrine glands. The arising hormonal shifts are a result of a "metabolic stress" caused by the growing tumour. PMID- 3678129 TI - [A low molecular-weight angiogenesis factor isolated from Lewis lung carcinoma]. AB - A fraction with the angiogenetic activity was obtained by the methods of the gel chromatography on G-100 and the ion-exchange chromatography on DEAE-cellulose. Treatment of this fraction with the 10% water isopropanol solution has led to dissociation of the obtained material with a release of a low-molecular-weight angiogenic factor with a high angiogenic activity when tested on the chorioallantoic membrane. The molecular weight of this factor (300-600 daltons) was estimated by the chromatography on the biogel P2. PMID- 3678130 TI - [Dynamics of levels of 3-OAK antigens and ascorbic acid in the liver of rats and mice during hepatocarcinogenesis]. AB - Dynamics of the content of 3-OAK-A in the liver, blood and urine as well as of free and bound AK in the liver of rats and mice was traced by the quantitative precipitation reaction and oxidimetric method of ascorbic acid (AA) determination. It was shown that an increase in the content of 3-OAK-A in the liver during carcinogenesis initiation and progression is accompanied by a decrease in the AA content in this organ. One of the possible mechanisms inhibiting the formation of 3-OAK-A is "interception" of the proteins involved in the formation of 3-OAK-A. PMID- 3678131 TI - Growth stimulation of rat calvaria osteoblastic cells by acidic fibroblast growth factor. AB - Purified acidic fibroblast growth factor (aFGF) from bovine brain stimulates the proliferation of calvaria-derived osteoblastic cells. Maximum stimulation, relative to corresponding controls, was seen at 0.2% serum (2- to 3-fold), and no stimulation was seen in the absence of serum or under serum replete conditions. The effect was dose-dependent with an ED50 of around 750 pg/ml (47 pM). aFGF (5 ng/ml) sustained the growth of calvaria cells in culture during multiple passages (72 days) at 0.2% serum. In DNA synthesis assays aFGF produced 2- to 4-fold stimulation; insulin-like growth factor I had a slight effect on DNA synthesis on its own, but enhanced the effect of aFGF 2-fold. In cells fully stimulated by epidermal growth factor (5-fold), aFGF had no further effect. Stimulation of DNA synthesis peaked at 5 ng/ml, while higher concentrations were inhibitory. Recombinant aFGF (bovine sequence) also stimulated cell proliferation (1.5-fold), and its potency was augmented by heparin (50 micrograms/ml), about 2-fold. Using simultaneous histochemical staining for alkaline phosphatase activity and [3H]thymidine nuclear uptake we found that aFGF stimulates DNA synthesis to the same extent in alkaline phosphatase-rich (osteoblastic) and alkaline phosphatase poor (nonosteoblastic) cells. However, after cell division there is a significant decrease in PTH-responsive adenylate cyclase (2- to 3-fold) and in alkaline phosphatase levels (4- to 8-fold). These findings indicate that aFGF is mitogenic to rat calvaria osteoblastic cells, its action requires additional factors, and its growth stimulation is associated with a reduction in phenotypic expression. PMID- 3678133 TI - Enhancement of the hypertensinogenic action of 19-hydroxyandrostenedione by aromatase inhibitor, delta 1-testololactone. AB - To evaluate the enhancing effects of 1,2-dehydrotestololactone (delta 1 testololactone) on the hypertensinogenic action of 19-hydroxyandrostenedione (19 OH-A-dione), 1 mg 19-OH-A-dione, 10 mg delta 1-testololactone, or a combination of 1 mg 19-OH-A-dione and 10 mg delta 1-testololactone was injected into intact rats drinking water once a week for 4 weeks. The blood pressure of control rats and rats given 19-OH-A-dione, delta 1-testololactone, and a combination of 19-OH A-dione and delta 1-testololactone in the fourth week was 130 +/- 2 (SE), 140 +/- 2, 128 +/- 6, and 152 +/- 5 mmHg, respectively. The blood pressure of rats given 19-OH-A-dione and a combination of 19-OH-A-dione and delta 1-testololactone was significantly higher than that of control rats. In addition, the blood pressure of rats given a combination of 19-OH-A-dione and delta 1-testololactone was significantly higher than that of rats given 19-OH-A-dione alone. As delta 1 testololactone itself did not show any hypertensinogenic action, it is considered to enhance the hypertensinogenic action of 19-OH-A-dione. Although plasma 19-OH-A dione concentrations of control rats and rats given delta 1-testololactone were lower than the sensitivity of RIA, those of rats given 19-OH-A-dione and a combination of 19-OH-A-dione and delta 1-testololactone were 116 +/- 3 and 222 +/ 37 pg/ml, respectively. Plasma 19-OH-A-dione concentrations of rats given a combination of 19-OH-A-dione and delta 1-testololactone were significantly higher than those of rats given 19-OH-A-dione alone. Therefore, delta 1-testololactone is considered to enhance the action of 19-OH-A-dione by increasing plasma concentrations of 19-OH-A-dione. As delta 1-testololactone is an aromatase inhibitor, the inhibition of the conversion of circulating 19-OH-A-dione to estrogens in peripheral tissues might be the cause of the elevation of plasma 19 OH-A-dione concentrations. These results indicate that aromatose inhibitors enhance the hypertensinogenic action of 19-OH-A-dione by decreasing the degradation of 19-OH-A-dione. PMID- 3678132 TI - Growth allometry of the organs in giant transgenic mice. AB - We have analyzed the absolute and relative (allometric) growth of a series of internal organs in giant transgenic (MTrGH) and littermate control mice to determine the general and organ-specific effects of the altered hormonal environment on growth in these rodents. Comparison of cross-sectional growth allometries of organ weights and external body dimensions between the two samples was based on analyses of covariance. We report significantly increased growth in all of the organs and measurements examined except for the brain. Coefficients of growth allometry differ significantly from isometric values in a number of cases, and thus, the adult transgenic mice exhibit body proportions different from those of the adult controls. Most of these shape differences reflect general allometric size increase, but the liver and spleen of the transgenics undergo special enlargement or growth. These results indicate that the primary effect of elevated GH and IGF-I levels is increased overall growth, but in the relative proportions set by the intrinsic controls of individual organs and body regions. PMID- 3678134 TI - Thioredoxin stimulates enzymatic outer ring monodeiodination of reverse triiodothronine. AB - Thioredoxin (Thd) and NADPH-Thd reductase, purified to near homogeneity from rat liver cytosol, stimulated, in the presence of NADPH, the 5'-monodeiodination of rT3 by renal and hepatic microsomes at nanomolar, but not micromolar, substrate concentrations. T4 was not deiodinated at either concentration. Reduced Thd was effective at physiological concentrations in stimulating microsomal rT3 deiodination (EC50, approximately 15 microM); Thd-supported microsomal deiodination showed a maximum velocity approximately one third that in the presence of dithiothreitol (DTT), and Thd-supported deiodination, compared to that with DTT, was 10- and 2000-fold more sensitive to inhibition by propylthiouracil and iopanoate, respectively, than was the DTT-supported reaction. The Michaelis constants for rT3 (2.5 nM) were identical for the Thd- and DTT-activated reactions, suggesting that these thiols stimulated deiodination by the same enzyme. Arrhenius plots also revealed comparable activation energies for Thd- and DTT-mediated low Km rT3 monodeiodination; these activation energies were, moreover, distinct from those observed with the low Km T4 deiodination in the presence of DTT. The data suggest that renal and hepatic microsomes contain separate low Km rT3-specific and T4-specific 5'-monodeiodinases and that the rT3 specific monodeiodinase can use the reducing potential of NADPH, via the Thd system. Such an enzyme could mediate the disposal of rT3, the noncalorigenic metabolite of T4, independently of the conversion of T4 to T3. PMID- 3678135 TI - Physiological concentrations of glucocorticoids stimulate formation of bone nodules from isolated rat calvaria cells in vitro. AB - Isolated rat calvaria cells plated at low density in medium supplemented with ascorbic acid and organic phosphate form discrete three-dimensional mineralized nodules having the characteristics of bone. We have studied the effects of glucocorticoids on the formation of bone nodules by these cell populations. Cells isolated from 21-day-old fetal rat calvaria were maintained in vitro for up to 27 days. Dexamethasone (Dex) induced a dose-related increase in the number of nodules formed, with a peak at 10 nM and a half-maximal response at about 1 nM. Dex (10 nM) also significantly increased the size of bone nodules formed (P less than 0.002). High concentrations of Dex (1 microM) did not increase nodule number. In cells in primary culture maintained in medium containing 10 nM Dex, the increase in nodule number was 50-100% over the control value. The effect of Dex was much greater in first subculture cells, where the number of nodules was 600-800% higher than the control value. Dishes collected and quantitated from 12 27 days showed that nodule formation ceased between 15 and 18 days in cultures without Dex, whereas in the presence of Dex the number of nodules increased up to 27 days. Addition of 10 nM Dex only during specific periods resulted in significantly more nodules than in control cultures, but significantly fewer nodules than in cultures constantly exposed to Dex. Cell population doubling times during log phase growth were unaltered, but a significant increase in saturation density (P less than 0.001) was observed with 10 nM Dex. Hydrocortisone also caused an increase in the number of nodules formed, with a maximal effect of 50 nM and a half-maximal response at 8 nM. The results indicate that physiological levels of glucocorticoids stimulate bone nodule formation in long term cell culture by increasing the number of cells forming bone nodules and that maximization of the stimulatory effect of glucocorticoids on bone formation may require constant exposure to low levels of the hormone. PMID- 3678136 TI - Correlation of rat pituitary prolactin messenger ribonucleic acid and hormone content with serum levels during the estrogen-induced surge. AB - The model of the serum PRL surge generated in the ovariectomized rat after estradiol benzoate (EB) treatment was used to study the relationship between serum and pituitary PRL levels and pituitary PRL mRNA levels. Adult ovariectomized rats were injected sc with 7 micrograms EB or vehicle at noon on day 0. Three days later (day 3), the rats were decapitated every 4 h over a 24-h period (0800 h on day 3 to 0400 h on day 4) for determination of serum and pituitary PRL and GH levels by RIA. In addition, PRL and GH mRNA content was determined using dot blot hybridization with cDNAs. Administration of EB resulted in a significant rise in serum PRL levels at 1200, 1600, and 2000 h on day 3 compared to control values. At other times, serum PRL levels in the EB group were the same as control values. EB treatment also elicited a marked increase in pituitary PRL content at all time periods examined except during (1600 and 2000 h) and after the PRL surge (2400 h on day 3) when there was a significant reduction in stored pituitary PRL. The pituitary PRL mRNA content in the EB treated group was significantly elevated (4- to 6-fold) over control levels throughout the study. Furthermore, PRL mRNA levels in EB-treated rats were significantly higher at 2000 and 2400 h on day 3 than at other time periods. In contrast to its effects on PRL, EB treatment had a slight inhibitory effect on pituitary GH content at 2000 and 2400 h on day 3 compared to control values; otherwise, this steroid had no effect on serum GH levels and pituitary GH mRNA content. Interestingly, serum GH levels and pituitary GH mRNA content in both treatment and control groups fluctuated in a pattern consistent with circadian rhythms, with peak values occurring during the lights-on hours. These data show that estrogen has a stimulatory effect on pituitary content of PRL and its corresponding mRNA in the rat 3 days after injection. These elevated PRL mRNa levels may be necessary for the occurrence of PRL surges. Furthermore, the facts that serum PRL levels were elevated only at certain times (1200-2000 h on day 3) while PRL mRNA content was increased at all times in the EB-treated rats suggest a differential regulation between PRL release and biosynthesis. PMID- 3678137 TI - Insulin-like growth factor I action on rat anterior pituitary cells: effects of intracellular messengers on growth hormone secretion and messenger ribonucleic acid levels. AB - We have previously shown that insulin-like growth factor (IGF-I) suppresses basal and GHRH-induced GH gene transcription. cAMP is a putative intracellular mediator of GHRH action. We, therefore, studied the mechanism of IGF-I action on the somatotroph with or without cAMP activators. Primary rat pituitary cells growing in serum-free medium were treated with IGF-I. GH secretion was measured by RIA, and mRNA levels were measured by hybridization to [32P]GH cDNA. 8-Bromo-cAMP (8 Br-cAMP; 0.625 mM) stimulated GH mRNA levels after 72 h by 238%. IGF-I (6.5 nM) caused a 64% inhibition of 8-Br-cAMP-stimulated GH mRNA levels and a similar inhibition of GH secretion. This inhibition was time and dose dependent, with maximal (71%) suppression of cAMP-induced GH achieved with 13 nM IGF-I after 72 h. Forskolin (1 microM), a stimulator of adenylate cyclase, stimulated GH secretion (198%) which was inhibited by IGF-I by 42%. 12-O-Tetradecanoylphorbol 13-acetate, (a phorbol ester; 50 nM), a potent activator of protein kinase C, strongly stimulated GH secretion (347%), which was similarly suppressed by IGF-I by 51%. The suppressive action of IGF-I on somatotroph gene expression is unimpaired by direct activation of both cAMP and protein kinase C, suggesting that IGF-I acts upon the GH gene by a mechanism that is not altered by these second messengers. The negative feedback inhibition of physiological concentrations of IGF-I on GH, therefore, appears to override the potent stimulation of GH by these intracellular messengers. PMID- 3678138 TI - The effect of 3,5,3'-triiodothyronine on leucine uptake and incorporation into protein in cultured neurons and subcellular fractions of rat central nervous system. AB - Previous studies have shown that nuclear thyroid hormone receptors in rat brain are preferentially localized within neurons. These cells also synthesize protein at a high rate, and the aim of the present study was to investigate any relationship between these two characteristics. In this paper we have shown that T3 stimulates leucine uptake and incorporation into protein in primary cell cultures of neurons. Stimulation was apparent with concentrations of hormone as low as 1.25 nM and increased in a dose-dependent manner up to 10 nM T3. However, the rapidity of the effect (evident at 25 min, and significant at 40 min) suggests that protein synthesis is stimulated at the level of translation, rather than transcription. More detailed study with 5 nM T3, revealed that incorporation into both soluble (cytoplasmic) and insoluble (membrane-associated) protein fractions was stimulated to similar degrees, and therefore the effect on protein synthesis was general. Furthermore, T3-mediated stimulation of leucine uptake into neurons was completely abolished in the presence of the protein synthesis inhibitors, actinomycin D and cycloheximide, and therefore the effect on leucine uptake was attributed to an increased requirement for the amino acid in protein synthesis (pleiotrophic effect). Parallel studies conducted with synaptosomes and mitochondria isolated from the central nervous system of adult euthyroid animals revealed that 5 nM T3 was without effect on leucine uptake and incorporation into protein. Possible reasons for this lack of effect are discussed. PMID- 3678139 TI - Tissue differences in estrogen receptor dynamics: nuclear retention, rate of replenishment, and transient receptor loss vary in hypothalamus, pituitary, and uterus of C57BL/6J mice. AB - Little is known about tissue differences in estrogen receptor (ER) dynamics, despite evidence that they could play a role in the tissue specificity of estrogen action. This study was designed to test the hypothesis that ER dynamics differ in uterus (UT), pituitary (PIT), and hypothalamus (HYPO), as measured by 1) duration of peak nuclear ER (ERn), 2) rate of replenishment of cytosolic ER (ERc), and 3) loss of total ER (ERt) after a bolus of estradiol (E2). Young adult mice were studied at two hormonally distinct stages of the cycle [days 2 or 3 (D2 3) and D5 (D1 = proestrus)]. Animals were injected with a dose of E2 (0.05 microgram/10 g BW) sufficient to achieve maximal ERn or with vehicle only, and ER was determined in nuclear and cytosolic fractions 1, 2, 4, 8, 12, and 24 h later. ERn peaked concomitantly with plasma E2 at 1 h in all tissues, but the duration of peak ERn varied among tissues: 4 h in HYPO compared to 1-2 h in UT and PIT. ERc replenishment was complete by 12 h in HYPO, but not until 24 h or more in PIT; replenishment in UT was intermediate (12-24 h). The transient loss of ERt after E2 injection was pronounced in UT and PIT, but was undetectable in HYPO. These tissue differences were maintained across cycle state, despite effects of cycle state on ER dynamics. The effects of cycle state on ER dynamics were also tissue specific; they were greatest in UT and absent in HYPO. On D2-3 in UT, ERn and ERt were lower, and replenishment of ERc was slower than on D5. Parallel effects of cycle state were seen in PIT, with the exception of ERn, which was unaffected. Because altered ER dynamics similar to those observed on D2-3 can be produced by progesterone pretreatment, the altered ER dynamics on D2-3 may be a consequence of recent exposure on D1 to the ovulatory surge of progesterone. Taken together, these results indicate that the mechanisms governing intracellular ER dynamics vary markedly among tissues and provide an impetus for further examination of their role in the tissue specificity of estrogen action. PMID- 3678140 TI - Purification and characterization of mouse uterine estrogen receptor under conditions of varying hormonal status. AB - Mouse uterine estrogen receptor (ER) was purified about 11,000-fold from normal mouse uteri by affinity chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified ER demonstrated a major component of 65,000 mol wt with minor fragments of the 54,000- and 37,000-dalton species, as judged by affinity labeling with [3H]tamoxifen aziridine and immunodetection with an ER monoclonal antibody (H-222). The minor fragments were not detected with additional monoclonals (H-226 or D-547), which recognize different domains on the ER molecule. Two-dimensional gel electrophoresis revealed that the major component with a mol wt of 65,000 had a pI of about 6.5. The 54,000- and 37,000 dalton components had similar pI values. Saturation binding and Scatchard plot analysis of purified ER yielded one class of binding sites with an apparent dissociation constant of about 1.4 nM. Changes in the hormonal status resulted in changes in the size of the ER even in the presence of molybdate and leupeptin. PMID- 3678141 TI - Characterization of the subunit structure of the thyrotropin receptor in the FRTL 5 rat thyroid cell line. AB - Radioiodinated TSH was covalently cross-linked to monolayers of FRTL-5 rat thyroid cells using the homobifunctional cross-linking agent disuccinimidyl suberate. Analysis of the cross-linked samples by sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing conditions demonstrated the presence of three specifically labeled complexes with apparent mol wt of 68,000, 85,000, and 145,000, in addition to the TSH alpha-beta dimer and its alpha- and beta-subunits. When bound [125I]iodo-TSH was cross-linked with increasing concentrations of disuccinimidyl suberate, the formation of the 68,000 and 85,000 mol wt complexes was sequential, with the 68,000 complex appearing first. These two complexes were also observed after labeling with radioiodinated TSH hybrid molecules (alpha-beta or alpha-beta), in which the label is in only one subunit, or immuno-precipitation with antibodies against either the alpha- or beta-subunit of TSH. Similar complexes (65,000, 82,000, and 145,000 mol wt) were also formed after cross-linking with the alkaline-cleavable cross-linker (bis-[2 (succinimidooxycarbonyloxy)ethyl]sulfone. Again, the appearance of these three complexes was sequential and dependent on the cross-linker concentration. At low concentrations and under reducing conditions, the 65,000 mol wt complex was the major band. However, at high concentrations, especially under nonreducing conditions, most of the radioactivity was present in the 145,000 mol wt complex. Alkaline cleavage of these three complexes followed by electrophoresis in a second dimension resulted in the release of three components with approximate mol wt of 31,000, 17,000, and 63,000 in addition to the TSH alpha-beta dimer and its alpha- and beta-subunits. Reduction by dithiothreitol followed by electrophoresis in a second dimension resulted in the release of only the 17,000 and 63,000 components. Taken together, these results suggest that 1) both the 65,000 and 82,000 complexes are formed after incremental cross-linking of TSH alpha-beta dimer to receptor subunits; and 2) the TSH receptor may be an oligomer composed of three different subunits, 31,000, 17,000, and 63,000, of which only the 31,000 subunit binds TSH. PMID- 3678142 TI - Insulin-like growth factor gene expression during rat embryonic development. AB - The function of insulin-like growth factors I and II (IGF-I and IGF-II) in embryogenesis is unknown. To investigate the ontogeny of IGF gene expression during mammalian development we used a highly sensitive and specific solution hybridization assay to determine the steady state levels of IGF mRNAs during midgestation in the rat. IGF-I mRNA can be detected as early as day 11 of embryonic development and rises 8.6-fold over the ensuing 48 h. By contrast IGF II mRNA is relatively constant over days 11-14 of gestation. These observations suggest that both IGFs may play important roles in early fetal development. PMID- 3678143 TI - Intracellular transport of 3,5,3'-triiodo-L-thyronine in rat skeletal myoblasts. AB - Since in skeletal muscle circulating L-T3 is the only source for the hormone bound to nuclei, we investigated the intracellular and intranuclear transport of L-T3 in L6E9 rat skeletal muscle cells. The characteristics of this process were assessed by analyzing the nuclear bound L-T3 as a marker of the internalized hormone and by determining the initial rate of L-T3 uptake. [125I]L-T3 cellular uptake at 37 C reached a plateau at 2 h when the nuclear uptake, after an initial lag phase, was still increasing and represented 4.7% of the cellular uptake. Incubation at 4 C caused [125I]L-T3 cellular uptake to decrease by 77% and nuclear uptake to be abolished. A similar effect on [125I]L-T3 nuclear uptake was obtained after myoblasts were incubated at 37 C with a 1000-fold excess of unlabeled L-T3. The addition of various inhibitors of ATP production, cytoskeleton integrity, endocytosis, and Na+, K+-ATPase that did not interfere with [125I]L-T3 binding to the cell surface or to isolated nuclei caused a dose dependent reduction of both extranuclear and nuclear uptake, ranging from 34-85%. Scatchard analysis revealed the presence on the myoblast surface of L-T3 high affinity (Ka = 1.6 X 10(9) M-1) and low affinity (Ka = 5.4 X 10(6) M-1) binding sites; other iodothyronines exhibited lower affinity for both sites. Kinetic analysis of L-T3 transport after 60-sec incubation at 23 C defined a process with a Km of 17 +/- 5.6 nM and a maximum velocity of 83 +/- 35 pmol/mg DNA. These results indicate the existence in rat myoblasts of a temperature-dependent, energy-requiring, saturable, and stereospecific L-T3 uptake mechanism, probably mediated through an endocytotic pathway, located on the myoblast plasma membrane, that may regulate L-T3 action in skeletal muscle. PMID- 3678144 TI - Androgen dependence of growth and epithelial morphogenesis in neonatal mouse bulbourethral glands. AB - The early development of the mouse bulbourethral gland (BUG) and the role of testosterone (T) in the normal growth and epithelial morphogenesis of this male accessory sex gland were examined. The mouse BUG differentiates from the urogenital sinus on day 17 of gestation (vaginal plug = day 0; birth = day 19), and initially consists of a solid epithelial rudiment encased in a large condensed capsular mesenchyme. The epithelium begins to branch and canalize on day 1 postnatally, and the branches enlarge and become more numerous on days 2 and 3. On day 4, secondary branches appear, and by day 6, the epithelium has become extensively arborized and almost fills the mesenchymal capsule. The BUG increases 3.9-fold in DNA content from day 0 (day of birth) to day 6 postnatally; the epithelium grows proportionately more than the mesenchyme during this period (12-fold vs. 2.3-fold). Growth of BUGs in mice castrated at birth or castrated and then treated with cyproterone acetate, an antiandrogen, over the first 6 days of life was reduced by 80%, but not abolished. Thus, the growth of the BUG is partially independent of androgens during early neonatal life. However, morphogenesis of the BUG epithelium is totally abolished in neonatally castrated mice. T replacement given to neonatally castrated mice during days 0-6 restored development to normal. T injections also reinitiated growth and morphogenesis in developmentally retarded BUGs from 6-day-old neonatally castrated mice. The partial dependence of the neonatal BUG on androgens for growth is similar to that seen in the prostate, which is also derived from the urogenital sinus. In contrast to the prostate, where neonatal castration reduces but does not abolish epithelial morphogenesis, androgen deprivation completely abolished epithelial morphogenesis in the neonatal BUG. (Endocrinology 121: 2153-2160, 1987). PMID- 3678145 TI - Circadian periodicity in circulating cortisol is absent after orchidectomy in rhesus macaques. AB - Circadian/ultradian patterns of plasma cortisol were assessed in four intact and four gonadectomized male rhesus macaques. Concomitant measures of testosterone (T) were analyzed in the intact animals. Blood samples were drawn every 15 min for 28 h via an indwelling catheter. Plasma concentrations of cortisol and T were determined by RIA. Inverse diurnal patterns of cortisol and T secretion were documented in the control group. The circadian pattern of plasma cortisol was characterized by a progressive rise during the early morning hours (0200-0800 h), followed by a gradual decline until lowest levels were reached at 1600-1900 h. T levels were lowest from 0800-1200 h (2-4 ng/ml) and reached a zenith from 2200 0200 h (8-10 ng/ml). Surprisingly, circadian fluctuations in cortisol were absent after orchidectomy. Cortisol levels in castrates were less (P less than 0.05) than those during peak levels of cortisol secretion in the intact animals (6.25 vs. 10.1 micrograms/100 ml) and elevated (P less than 0.01) compared to concentrations in the intact animals at their nadir (6.4 vs. 2.5 micrograms/100 ml). The loss of circadian fluctuation was not associated with a significant change in frequency of pulsatile cortisol release or a change in the daily mean level. These results are the first in nonhuman primates to demonstrate that the testes modulate circadian activity in the hypothalamic-pituitary-adrenocortical axis. The data differ from previous findings in rodents suggesting that castration increases the synthesis and release of ACTH/corticosterone. PMID- 3678146 TI - Influence of the gonads on cortisol secretion in female rhesus macaques. AB - Circadian and ultradian patterns of plasma cortisol were assessed in four intact female rhesus macaques during both the late follicular (days 9-10) and midluteal (days 21-22) phases of the menstrual cycle and compared to patterns in four ovariectomized macaques. Blood samples were drawn from a remote site at 15-min intervals for 24 h via an indwelling catheter. Measures of estrogen and progesterone were obtained for each subject. For purposes of data analyses, group cortisol measurements were collapsed across hourly intervals and submitted to analysis of variance. Pulsatile characteristics of cortisol release were determined for each subject using the PULSAR computer program. Circadian cortisol patterns, present in all three groups, were characterized by a progressive rise during early morning hours (0300-0600 h), followed by a decline of short duration. All groups then displayed an unexpected midday peak (0900-1400 h), at which time cortisol levels reached their daily zenith. In each of the three groups, cortisol levels reached a nadir during late afternoon hours shortly after the light phase ended. The amplitude of circadian changes and daily mean levels of cortisol were significantly reduced by ovariectomy, without alterations in pulsatile characteristics of cortisol secretion. Daily mean cortisol levels decreased from approximately 8 micrograms/100 ml in intact subjects to 4.5 micrograms/100 ml after ovariectomy. No significant differences in the circadian/ultradian periodicity of cortisol secretion were detected between the follicular and luteal groups. When data in the intact female groups were combined and compared to those previously obtained from gonadally intact adult male macaques, similar 24-h patterns of cortisol secretion were detected. Surprisingly, amplitude changes in cortisol concentrations after ovariectomy were temporally and quantitatively similar to those in orchidectomized males. In both male and female animals, circadian patterns of cortisol secretion were reduced by gonadectomy. These results are discussed in terms of the activational influence of gonadal steroids on hypothalamic-pituitary-adrenocortical function. PMID- 3678147 TI - Genetic evidence for androgen-dependent and independent control of aromatase activity in the rat brain. AB - To investigate the role of androgen receptors in the regulation of brain aromatase activity (AA) in adult rats, the levels of AA in discrete brain areas of androgen-insensitive testicular feminized (Tfm) rats were compared with those in their normal male littermates (NL). AA was measured in homogenates of brain tissue by using a radiometric assay that quantifies the production of 3H2O from [1 beta-3H]androstenedione as an index of estrogen formation. Initially, we assessed the capability of block-dissected tissues to aromatize androgens. We found that the AA in the amygdala and hypothalamus-preoptic area of Tfm rats was significantly lower (P less than 0.001) than the AA in NL despite the fact that circulating androgen concentrations in the Tfm were significantly higher. Kinetics studies demonstrated that the apparent Michaelis constant was equivalent for both groups (0.02-0.03 microM). Administration of testosterone propionate to castrated males produced 3 to 4-fold elevations of AA in NL, but did not affect brain AA in Tfm rats. To pinpoint specific sites where AA is affected in Tfm rats, we measured AA in 10 hypothalamic and limbic nuclei that were dissected from 300-micron frozen brain sections. Compared to NL, Tfm rats exhibited significantly lower levels of AA in all micro-dissected brain regions studied, except for the medial and cortical amygdala. These data provide genetic evidence for both androgen-dependent and independent regulation of AA in the rat brain. PMID- 3678149 TI - Evidence for the presence of active and inactive forms of cytosolic triiodothyronine binding protein in rat kidney: cooperative action of Ca2+ in NADPH activation. AB - The effect of NADPH and Ca2+ on 3, 5, 3'-L-triiodothyronine (T3) binding to cytosolic T3 binding protein (CTBP) in rat kidney was investigated in vitro. Extraction of rat kidney cytosol with 10% charcoal at 4 degrees C for 30 min. inactivated specific T3 binding. The decreased T3 binding activity in extracted cytosol could be restored by adding NADPH or Ca2+ to the incubation medium. Each substance increased the capacity for T3 without changes in the affinity for T3. The T3 binding was maximally increased by 25 microM NADPH or by 1.0 mM Ca2+ in the presence of 0.1 mM EDTA. The increase in T3 binding, induced by 25 microM NADPH, was enhanced by adding 0.2-1.0 mM Ca2+ in a concentration dependent manner. The increase in T3 binding, induced by 1.0 mM Ca2+, was also enhanced by adding 3.125-25.0 microM NADPH. The NADPH-induced increase in T3 binding capacity was amplified by Ca2+ in a multiplicative manner. The results suggested that Ca2+ cooperatively augmented an NADPH function in cytosolic T3 binding. PMID- 3678148 TI - Examination of exchange assay for glucocorticoid receptor. AB - We examined a method for the measurement of total, activated and non-activated glucocorticoid receptors using sodium-p-hydroxymercuribenzoate (PHMB) and dithiothereitol (DTT) developed by Banerji and Kalimi (1981). Since the concentration of PHMB required for dissociation of the ligand from the receptors varied with the concentration of protein in the reaction mixture and the rate of reassociation of the ligand to the ligand-liberated receptors was sensitive to the concentration of PHMB used, it was necessary to find the minimum concentration of PHMB which was required for complete dissociation of the ligand. When the optimum concentration of PHMB was selected based on the concentration of protein in the cytosol, almost 100% exchange was attained in the non-heated dexamethasone (Dex)-receptor complexes by this method. However when Dex-receptor complexes were heated at 25 degrees C for 30 min, the amount of 3H-Dex reassociated with the glucocorticoid receptors dropped to 60% of that of the non heated ones. DEAE-cellulose chromatography of the heated sample revealed that approx. 40% of the bound receptors were activated (eluted with 0.05 M KCl) during the heating period. After DEAE cellulose column chromatography of the exchanged 3H-Dex receptor, complexes reassociated with 3H-Dex were observed only in the fraction of unactivated receptor complexes (eluted with 0.2 M KCl). Furthermore, the fraction eluted with 0.05 M KCl in the DEAE cellulose chromatography of liver cytosol bound to unlabelled Dex did not exchange significantly with 3H-Dex with the method used in the present study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678150 TI - Hyperinsulinemic yellow KK mice and norepinephrine turnover. AB - To clarify whether hyperinsulinemia accelerates sympathetic nervous system (SNS) activity, norepinephrine (NE) turnover, a reliable indicator of SNS activity, was measured in the interscapular brown adipose tissue (IBAT) and heart of hyperinsulinemic yellow KK and normoinsulinemic C57BL control mice at 12 weeks of age. The yellow KK mice were more obese and had higher levels of plasma glucose (about 2.3 times) and of plasma insulin (about 24 times) than did the control mice. In IBAT, the rate of NE turnover following blockade of NE synthesis with alpha-methyl-p-tyrosine (alpha-MPT) was significantly slower in yellow KK mice than in C57BL mice, although in heart, no significant difference between both groups was observed in NE turnover. These results suggest that hyperinsulinemia dose not always increase NE turnover, and furthermore that the reduced NE turnover in IBAT of yellow KK mice may be one of the important factors in the development of obesity of this animal, as it is recognized that brown adipose tissue is a main effector of diet-induced thermogenesis and its defect or absence would predispose to obesity. PMID- 3678151 TI - A case of systemic lupus erythematosus (SLE) and Sjogren's syndrome associated with anti-T3 autoantibodies. AB - A case of systemic lupus erythematosus (SLE) associated with Sjogren's syndrome had extremely low serum triiodothyronine (T3) with normal levels of serum thyroxine (T4) measured by single antibody radioimmunoassays (RIAs) and thyroid stimulating hormone (TSH) during steroid treatment. Measurement of serum T3 and T4 with double antibody RIAs showed unusually high T3 and normal T4 concentrations. Examination of her serum revealed the presence of IgG class anti T3 autoantibodies whose Scatchard plot was analyzed in two components; one with a higher associate constant (8.6 X 10(8)M-1) and a lower binding capacity (5.6 X 10(-7) mol/ml serum); the other a lower associate constant (3.5 X 10(7)M-1) and a higher binding capacity (2.1 X 10(-6) mol/ml serum). Antithyroglobulin (Tg) autoantibody has been positive throughout the seven year observation period. A significant positive correlation between titers of anti-Tg autoantibodies indicated that the antigen of anti-T3 antibodies in the patient could be T3 containing antigenic site(s) on the Tg molecule. PMID- 3678152 TI - Involvement of calmodulin and calmodulin binding site in the TSH receptor of thyroid. AB - Calmodulin (CaM) antagonists, W-7 and W-5, chlorpromazine and haloperidol, especially W-7 inhibited 125I-bovine TSH binding to human and porcine thyroid receptors dose-dependently in the presence of calcium ion. This inhibitory effect of W-7 was diminished by the addition of ethylenglycol tetraacetic acid (EGTA) or ethylendiamine tetraacetic acid (EDTA). CaM also dose-dependently inhibited the binding of 125I-TSH to thyroid receptor in the presence of calcium ion. TSH binding to thyroid receptor was completely inhibited by more than 30 micrograms of CaM, and this inhibition was abolished by adding EGTA. On the other hand, the antibody to CaM inhibited partially 125I-TSH binding to its receptor. These results suggest involvement of CaM and CaM-binding sites in the TSH receptor of thyroid. PMID- 3678153 TI - Characteristics of antibodies to calmodulin in patients with Graves' disease. AB - We detected an antibody to calmodulin (CaM) in sera from patients with Graves' disease. Four sera out of 300 from patients with Graves' disease demonstrated increased CaM binding activity as compared with 300 sera from normal subjects, while no binding activity was detected in sera from autoimmune thyroiditis. The binding could be demonstrated as due to the antibody to CaM by the double antibody method, polyethyleneglycol method, gel filtration and radioimmunoelectrophoresis, respectively. These antibodies were thought to be polyclonal immunoglobulins (IgG and/or IgA). CaM has proven to be a poor antigen because of the structural identity of CaM from different species. The incidence of the antibody to CaM in Graves' disease is low and the pathophysiological significance of this antibody to CaM had remains obscure. PMID- 3678154 TI - The effect of iopanoic acid on thyrotropin secretion in patients with cirrhosis of the liver. AB - Ten patients with liver cirrhosis and six normal subjects were studied to evaluate the effect of iopanoic acid (IA) on thyrotropin secretion. A thyrotropin releasing-hormone (TRH) test was performed before and 5 days after IA administration (single oral dose of 3 g). After IA administration, a significant increase in TSH response to TRH was observed in normal subjects. In cirrhotics, however, it did not significantly increase after IA administration. The serum T3 and T3/TBG ratio were significantly decreased and the serum T4 and T4/TBG ratio were increased after IA administration in normal subjects and cirrhotics. There was no significant difference in the % decrease in serum T3, % increase in serum T4 or other thyroid hormone parameters including TSH in IA induced TSH responders (R) and non-responders (NR). However, r-T3 before and after IA in R was higher than those in NR. The values for hepatic function tests such as serum albumin, prothrombin time, 45 minutes retention rate of bromsulphalein (BSP 45 min) and the cholinesterase (ChE) level in R were not different from those of NR. These results suggested that in cirrhotics, abnormal regulation of the hypothalamo pituitary system might exist. PMID- 3678155 TI - Highly sensitive immunoradiometric assay for TSH and thyroid radioiodine uptake as predictors of thyroid suppression test. AB - Suppression of TSH and thyroid radioiodine uptake by doses of either T4 or T3 were compared in 33 patients in whom Graves' thyrotoxicosis had been treated with thioamide drugs and the medication was discontinued for at least 4 months. Thyroidal radiodine uptake was suppressed in 19 patients and was not suppressed in the remaining 14 patients. Basal TSH levels before suppression were 2.07 microU/ml in the former, significantly exceeding those of the latter (0.91 microU/ml). A TSH level of at least 1.2 microU/ml before suppression is a good predictor of positive thyroid radioiodine suppression with a predictive value of 76%. A level lower than 0.7 microU/ml before suppression is a good predictor of negative thyroid radioiodine uptake suppression with a predictive value of 89%. The determination of TSH levels before the thyroid suppression test was helpful in predicting the result, but there were limitations. In the thyroid suppression test positive group, circulating T4 was depressed by doses of T3. In them, the magnitude of T4 depression correlated with the levels of thyroid radioiodine uptake before suppression. The levels of TSH correlated neither to changes in T4 nor to those in thyroid radioiodine uptake. This indicates that the thyroid glands which show high radioiodine uptake are sensitive to TSH and are also sensitive to suppression. The elevated sensitivity to TSH probably warrants the disappearance of abnormal thyroid stimulation more precisely. PMID- 3678156 TI - A case report of growth attenuation during methionyl human growth hormone treatment. AB - A 10-year-old child with idiopathic growth hormone deficiency was treated with recombinant methionyl human growth hormone (m-hGH, Somatonorm) at a dose of 14 IU/week. Height increased from 122.3 to 126.5 cm during the first 9 months of treatment (5.6 cm/y), but only from 126.5 to 126.6 cm during the next 3 month of treatment (0.4 cm/y). Anti-hGH antibody was detected at 2 months of treatment, reached its maximum at the end of 9 months with a titer of 10(6) and a binding capacity of 2.0 mg/L. After switching from m-hGH to pituitary extracted hGH (p hGH) treatment, his height increased again from 126.6 to 132.2 cm during the next 12 months of p-hGH treatment (5.6 cm/y). The cause of growth attenuation during m hGH treatment was concluded to be the high titer of anti-hGH antibody. This is the first case in Japan and one of only three cases in which growth attenuation occurred during m-hGH treatment. PMID- 3678157 TI - [12th meeting of the Polish Endocrinology Society. Szczecin, 2-5 June 1987. Abstracts and author index]. PMID- 3678158 TI - The endoscopic spectrum of primary non-Hodgkin's lymphoma of the stomach. AB - Thirty-one consecutive patients with primary non-Hodgkin's lymphoma of the stomach were studied to outline the spectrum of endoscopic abnormalities. The 17 men and 14 women had a median age of 65 years. There were 22 patients in stage I and 9 in stage II. Three endoscopic patterns were recognized: diffuse infiltration (9), ulceration (9) and polypoid lesions (13). There was no apparent correlation between the endoscopic appearance and the grading or subtype of the malignancy. Local recurrence did not occur once complete remission was obtained. The disease-free 5-year survival rate was 45%. Recognition of these endoscopic patterns may lead to earlier detection and, hopefully, improved survival. PMID- 3678159 TI - Histological features and recurrence of completely and incompletely healed gastric ulcers classified by the methylene blue dye method. AB - Histological features and recurrence of gastric ulcers classified as completely or incompletely healed by the methylene blue dye method were investigated. On chromo-endoscopic examination, complete healing was defined as a scarred area completely covered with granular patterns, while incomplete healing was defined as a scarred area surrounded only marginally by granular patterns. The methylene blue dye method was significantly more accurate than routine endoscopy for determining the histological completeness of healing. Recurrences were significantly more frequent in incompletely healed ulcers classified by the dye method than in completely healed ulcers. Heavy smoking, male sex, and location of ulcers were closely related to recurrence. Therapy should be continued until the healed ulcers are wholly covered by granular patterns, and physicians should encourage their patients to stop smoking. PMID- 3678160 TI - Fractional cleansing of the large bowel with "Golytely" for colonoscopic preparation: a controlled trial. AB - "Golytely", a lavage solution for colonoscopic preparation, has been in clinical use since 1980. Patients usually drink all the fluid (4-61 "Golytely") the morning before colonoscopy. However, clinical observation shows that many, especially elderly, patients have difficulty tolerating these large volumes. We therefore compared two methods of drinking "Golytely" in 36 patients: One group of 18 patients underwent a two-stage lavage preparation (in the evening and the following morning before the examination), the other group drank all the fluid in the early morning before colonoscopy. Patients tolerated the two-stage method significantly better-in terms of nausea (p less than 0.05) and their willingness to repeat the procedure (p less than 0.001). In both groups the bowel was equally clean and the amount of fluid required for preparation did not differ. We conclude that this new method of drinking "Golytely" is far more convenient for the patient and does not reduce the effectiveness of bowel preparation. PMID- 3678161 TI - A randomised, prospective study comparing two contrast media in ERCP. AB - A randomised, prospective, stratified, double blind study comparing two contrast media in endoscopic retrograde cholangio-pancreatography (ERCP) was undertaken. Forty-six patients received Meglumine/Sodium Ioxaglate (Hexabrix 320) and forty eight received Meglumine/Sodium Diatrizoate (Urografin 310). The two groups were evenly matched for age, sex and diagnosis. Radiographs were examined independently by two radiologists. There were no differences in radiograph quality with either type of contrast medium. More patients developed pancreatitis following Urografin, suggesting that Hexabrix is a safer contrast medium for ERCP. PMID- 3678162 TI - Disintegration of a pancreatic duct stone with extracorporeal shock waves in a patient with chronic pancreatitis. AB - We report the case of a 33-year-old woman with chronic calcifying pancreatitis in whom an intraductal pancreatic stone with a diameter of 8 mm was successfully disintegrated with extracorporeal shock waves, permitting subsequent endoscopic extraction of the fragments. The patient had a mild attack of pancreatitis after the treatment. We conclude that shockwave lithotripsy of a pancreatic duct stone in patients with chronic pancreatitis is possible. It should, however, be viewed with reservation until further experience has been gained. PMID- 3678163 TI - Rectoscopic decompression of acute recto-sigmoid obstruction. AB - Effective non-operative decompression of a low obstruction of the colon can sometimes be accomplished by inserting a tube into the rectum and threading the tip up to a point proximal to the obstruction (1). Failure of this non-surgical decompression would require emergency surgery--either a diverting colostomy or a two-stage resection. A new non-surgical treatment performed on a patient with an obstructive tumor of the recto-sigmoid is described. Decompression of the obstructed bowel was achieved with a rectal tube introduced over a flexible guide wire proximal to the obstruction with the aid of a rectoscope, following which a one-stage procedure--an anterior resection was performed in one patient, while the other was referred for oncological treatment. PMID- 3678164 TI - A new technique for endoscopic implantation and explantation of large-bore biliary endoprostheses in patients with non-surgical common bile duct obstruction. AB - A new system for endoscopic implantation and explantation of large-bore biliary endoprostheses is presented. This technique permits corrective placement of prostheses dislodged during implantation, as well as explantation and replacement through the biopsy channel of the endoscope in a single sitting. The method has been successfully employed in 10 patients. PMID- 3678165 TI - Endoscopic mechanical lithotripsy for the treatment of common bile duct stone. Experience with the improved double sheath basket catheter. AB - Using a newly designed basket catheter, endoscopic mechanical lithotripsy was attempted in 14 patients with common bile duct stones following endoscopic sphincterotomy, and was successful in all cases. Endoscopic mechanical lithotripsy is a supplementary means of removing common bile duct stones after endoscopic sphincterotomy, and its usefulness is highly rated. In some cases, however, there is difficulty in inserting the basket catheter into the common bile duct and grasping the gallstone. The newly designed forceps was accordingly developed, to smash these bile duct stone more reliably and effectively. PMID- 3678166 TI - Promoting self-directed hemodialysis: measurement and cognitive-behavioral intervention. AB - Approximately 98% of hemodialysis patients who are treated in hemodialysis units currently use staff-directed treatment. This may well be the most expensive and most dependent mode of hemodialysis treatment. If an effective strategy were developed to enhance degree of self-directed care, millions of public health dollars might be saved while patients reap potentially substantial psychological benefits. The present research took two steps in the direction of promoting increased self-directed treatment of hemodialysis. First, a reliable and easily used behavioral observation system was developed to define and measure degree of self-directed treatment of hemodialysis. Second, a five-step cognitive-behavioral strategy to improve degree of self-directed treatment was developed and tested preliminarily. The strategy includes an initial rationale, decisional counseling, behavioral contracting, self-monitoring, and staff support/problem solving. Four nurses used this approach with 4 elderly patients (mean age = 70.5 years). A multiple-baseline-across-subjects design revealed substantial and relatively rapid improvements in degree of self-directedness associated with the intervention for the 3 patients who remained healthy throughout the study. The discussion focuses on the implications of the results for future research. PMID- 3678167 TI - Differential effects of social support and social network on physiological and social outcomes in men and women with type II diabetes mellitus. AB - Patients with non-insulin-dependent diabetes mellitus (NIDDM) were advised to comply with a complex behavioral regimen of diet and exercise. The relationship between social support satisfaction and social support network size was evaluated using the Social Support Questionnaire for 32 men and 44 women with a confirmed diagnosis of NIDDM. Control of diabetes, as measured by the glycosylated hemoglobin assay, was significantly correlated with social support satisfaction for women but negatively correlated with social support satisfaction for men. Social support network size differentially predicted success in a program for men and women. For women, network size was significantly correlated with failure to attend sessions and with failure to complete a diary. For these women, network size was not significantly correlated with weight loss, which was the goal of the program. For men, network size was correlated with increases in weight, cholesterol, and triglycerides over an 18-month period. We conclude that social support network size and satisfaction have different functions for men and women faced with a serious chronic illness. Network size adversely affects success in a program, whereas social support satisfaction has some benefits for women. The direction of the influence of social network may be determined by the similarity or dissimilarity of network norms to the desired behavior. PMID- 3678168 TI - Syndrome-specific descriptor profiling: a psychophysiological and psychophysical approach. AB - Migraineurs and nonmigraineurs were compared in their selection of, psychophysical evaluation of, and psychophysiological response to verbal pain descriptors. Participants observed a series of 20 pain descriptors, each presented twice, 12 sec each time. Skin conductance responses (SCRs) were recorded during each presentation. Using the McGill Pain Questionnaire (MPQ), participants also selected pain descriptors that described migraine headaches. Results indicated that migraineurs demonstrated greater skin conductance responsivity to the visual presentation of pain descriptors as compared to nonmigraineurs. Pain descriptors more frequently selected by migraineurs on the MPQ were associated with greater skin conductance orienting responses. No differences were observed between migraineurs and nonmigraineurs in the number of intensity of pain descriptors chosen for any of the sensory, affective, evaluative, or miscellaneous dimensions of the MPQ. Results suggest that migraineurs may be conditioned or sensitized to particular sets of verbal pain descriptors and that these processes may serve to differentiate among pain sufferers and pain-free populations. PMID- 3678169 TI - Parental history of hypertension and screening attendance: effects of wellness appeal versus threat appeal. AB - This study examined whether the orientation of a health appeal differentially influences health beliefs and early-detection practices among young individuals who are potentially at risk. Undergraduates with and without a hypertensive parent were given printed material about hypertension and the importance of early detection framed in either a wellness or illness-threat format. The major dependent measure was attendance at a blood pressure screening during the week following the experimental session. Results showed that parental history (PH) participants were more than twice as likely to attend the screening when given a wellness message in comparison to threat. In the threat condition, PH participants also reported that hypertension was less preventable in comparison to participants without a hypertensive parent. Reported likelihood of developing hypertension was inversely related to subsequent screening attendance among PH participants only. Factors accounting for the efficacy of wellness-oriented appeals among individuals who report a family history are discussed. PMID- 3678170 TI - Relationship of type A behavior pattern in smokers to carbon monoxide exposure and smoking topography. AB - Stress-related physiological factors have been proposed to mediate the Type A behavior pattern (TABP) and coronary heart disease (CHD). However, collateral behavioral factors, such as the exaggerated consummatory response patterns of Type As, may also be involved. Study 1 examined this hypothesis by comparing exposure to cigarette smoke in 42 graduate and undergraduate student smokers assessed for the TABP. After controlling for smoking rate and Federal Trade Commission cigarette carbon monoxide yield, Type As' alveolar carbon monoxide (COa) levels were higher than Type Bs', and Jenkins Activity Survey scores were correlated with COa. To determine the source of this difference, we measured smoking topography in 10 Type As and 10 Type Bs in Study 2. Type As and Type Bs did not differ in number of puffs taken or puff volume, but Type As' inhalation duration was 70% longer than Type Bs'. These results suggest that consummatory behaviors of Type As may help account for the Type A-CHD relationship for smokers. Due to increased smoke exposure, Type A smokers may also be at greater risk for cancer and lung disease than Type B smokers. PMID- 3678171 TI - Relative contributions of protection motivation theory components in predicting exercise intentions and behavior. AB - A factorial design was employed to test the relative effectiveness of the four cognitive appraisal processes (severity, vulnerability, response efficacy, and self-efficacy) contained in the revised protection motivation theory (PMT). One hundred sixty undergraduate women read persuasive appeals for increasing exercise, which varied on these four dimensions. As predicted, both the vulnerability and self-efficacy variables enhanced intentions to exercise along with similar effects on self-reported exercising. Intentions were predictive of self-reported changes in behavior. The obtained interaction between vulnerability, self-efficacy, and response efficacy suggests that individuals employed a "precaution strategy": They intended to adopt the recommended behavior even though they held weak beliefs about its effectiveness and were not convinced of their at-risk status. These findings are compared to others obtained using the PMT, and the issue of main and interactive effects produced by the model is also addressed. PMID- 3678172 TI - Recidivism and self-cure of obesity: a test of Schacter's hypothesis in diabetic patients. AB - Schacter (1982) suggested that, given a lifetime perspective, a significant number of people "cure" themselves of their obesity. He supported this contention with retrospective self-report data from community residents that reveal that the majority of once-obese study participants are no longer overweight. The current study investigated the weight histories of obese diabetic outpatients. Retrospective self-reports (N = 152) indicated that about one third could be classified as "cured" of their obesity, and an additional 26%, although still obese, weighed 10% less than they had at their maximum. Medical records (N = 219), however, revealed that less than 10% could be considered "cured" and only another 12% "partially cured." Although some support was found for the hypothesized relationship between weight-loss success and time in treatment, it is possible that this reflects a tendency for those initially successful to remain in treatment longer. Finally, maximum weights of at least 30% over ideal were associated with more success, but primarily in achieving a 10% weight loss, not in being "cured" of obesity. PMID- 3678173 TI - Psychosocial factors in sunbathing and sunscreen use. AB - Excessive exposure to the sun has been related to the development of various types of skin cancer, but use of sunscreen decreases the risk. The present project was designed to empirically examine psychosocial factors in sunbathing and sunscreen use. One hundred twenty sunbathing and nonsunbathing beachgoers were interviewed about their health practices, knowledge about skin cancer, moods, and social rewards obtained through sunbathing. They also completed several relevant personality questionnaires. Data were considered using a theoretical perspective combining aspects of health belief, social influence, social learning, and risk-taking models. Results indicate that sunbathing is clearly related to having a positive attitude toward risk taking, having little knowledge about skin cancer, reporting a relaxed mood, having friends who sunbathe, and engaging in activities related to maintaining a positive physical appearance. Sunscreen use is related to sex, having knowledge about skin cancer, knowing people who have had cancer, and reporting high levels of anxiety. The implications of these findings for the design of intervention strategies and for the future study of health-compromising behaviors are discussed. PMID- 3678174 TI - Exercise induced pulmonary haemorrhage (EIPH): could Leonardo have got it right? PMID- 3678175 TI - Equine respiratory medicine and surgery. PMID- 3678176 TI - Effect of shutting the top half of the stable door before the horse has bolted. PMID- 3678177 TI - Roaring, whistling; cornage, siffleurs; Kehlkopfpfeifen, Pfeiferdampf. PMID- 3678178 TI - Dum spiro spero, dum spero vivo--'whilst I breathe I hope, whilst I hope I live'. PMID- 3678179 TI - Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. I. Clinical profile of horses. AB - Detailed physical and clinical examinations were performed on 26 Thoroughbred racehorses which were used subsequently in a series of studies to investigate the contribution of the pulmonary and bronchial arterial circulations to the pathophysiology of exercise-induced pulmonary haemorrhage (EIPH). Twenty-five of the horses had been retired from race training in Hong Kong during the 1984-85 season, all but four raced that season; one horse had been retired the previous season. The average number of races for the group that season was 4.1 +/- 2 with an average distance of 1502 +/- 216 metres, mean racing speed 15.5 +/- 0.5 metres/sec. Time from last race to necropsy was 177 +/- 155 days, range 12 to 572 days. All but one horse had a known history of either EIPH or epistaxis. Time from last recorded incident of expistaxis (17 horses) to necropsy was 156 +/- 141 days, range 12 to 513 days, with a longer interval since last recorded endoscopic observation of EIPH. Focal abnormal lung sounds were detected in the dorsocaudal lungfields on auscultation during rebreathing in three horses and six had tracheobronchial cytology consistent with previous episodes of pulmonary haemorrhage (haemosiderophages). No other characteristics which might have allowed separation of this group of horses from other Thoroughbred horses recently in race training were identified. PMID- 3678180 TI - Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. II. Gross lung pathology. AB - Gross post mortem examinations were performed on the lungs of 26 Thoroughbred horses of known exercise-induced pulmonary haemorrhage (EIPH) status. The most consistent finding was a variable degree of bilaterally symmetrical, dark discolouration of the dorsocaudal regions of the caudal lung lobes. In more severely affected lungs, the stained areas extended cranially along the dorsal surfaces of the lungs, and in some cases affected approximately one third of the lung surface. Discoloured areas of lung were denser than normal, collapsed less readily, often contained trapped air and were slow to inflate. The subpleural bronchial arteries were more prominent in the discoloured regions. Pleural adhesions were noted in two horses but were not related to the discoloured lung regions. It was concluded that the discoloured lesions have a complex pathogenesis and were related directly to previous bouts of EIPH. Associated with them were signs indicating probable partial small airway obstruction, decreased tissue compliance and direct involvement of the bronchial arterial circulation. PMID- 3678181 TI - Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. III. Subgross findings in lungs subjected to latex perfusions of the bronchial and pulmonary arteries. AB - Latex was injected under pressure into bronchial and pulmonary arteries of the inflated lungs of Thoroughbreds and transverse sections taken to calculate the area of lesions resulting from exercise-induced pulmonary haemorrhage. Extensive areas of dense brown haemosiderin varying from 0 to 45 per cent of total lung volume were identified, predominantly in the dorsocaudal lungfields. Bronchial arterial proliferation appeared to have replaced the pulmonary supply in affected areas of the lung. Closely associated with the staining and bronchial arterialisation, there was widespread small airway disease. The most severely affected bronchioles contained thick gelatinous or mucous exudate or mucoid plugs and had grossly thickened walls. These lesions suggest that the source of haemorrhage in exercise-induced pulmonary haemorrhage is from alveolar capillaries anomalously supplied by the bronchial arterial circulation through the development of pathological shunts. Small airway disease is suggested as being of major importance in the pathogenesis of the disease and may have led to the initial proliferation of the bronchial circulation. PMID- 3678182 TI - Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. IV. Changes in the bronchial circulation demonstrated by C.T. scanning and microradiography. AB - The purpose of this study was to use radiographic contrast techniques and special imaging methods to identify and high-light bronchial arterial involvement in lung lesions associated with exercise-induced pulmonary haemorrhage (EIPH) in horses. The lungs from four horses with histories of EIPH were prepared for computerised tomographic scanning and microradiography by perfusing the broncho-oesophageal artery with a mixture of red latex and either barium or iodine contrast materials while the pulmonary supply received only blue latex. Computerised tomographic scan slices of the prepared inflated lungs were obtained from the caudal tip of the lung to the hilus. Microradiography of selected lung slices was also performed on a Faxitron. Diffuse areas of increased density, with preferential bronchial arterial supply noted on the computerised tomographic scans were confirmed by microradiography. Dense focal and diffuse plexuses of markedly hypertrophied and highly branched bronchial arterial networks were identified, centred around certain small airways. The vascular supply to these plexuses was recruited predominantly from neighbouring bronchial vessels, and in some cases, from the enlarged vasa vasorum of pulmonary arteries sending anastomoses to the affected areas. The authors conclude that bronchial vascular lesions in EIPH cases are the likely origin of haemorrhage; that small airway disease is the probable initiating stimulus for bronchial vascular proliferation in these lesions; and that the morphology and nature of the neovascular tissue in these lesions provides the conditions leading to haemorrhage in the lungs of horses with EIPH. PMID- 3678183 TI - Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. V. Microscopic observations. AB - Lungs from 19 Thoroughbred racehorses with a history of exercise-induced pulmonary haemorrhage (EIPH) were studied using several forms of microscopy. Light microscopy of paraffin sections revealed three lesions in the caudodorsal region of the lungs from each horse. These correspond with the location of blue to brown stains seen at necropsy. These lesions include sequelae of bronchiolitis, hemosiderophages and increased connective tissue. Much of each of the lungs appeared normal, especially the more cranial or ventral portions. Foci of eosinophil infiltration were found in seven of the 19 lungs examined. With two exceptions, these eosinophilic foci had a different distribution to the three lesions. In areas of severe bronchiolar changes and fibrosis, vascular lesions typical of hypertension were found occasionally. Transmission electron microscopy was used to confirm cell types seen by light microscopy and to examine arterioles for changes characteristic of neovascularisation. Areas of enlarged airspaces from the vascular injected right lungs were examined by scanning electron microscopy. The balance of fibrosis and destruction varied in these areas, but none were as extensive as those seen in chronic obstructive pulmonary disease. The authors hypothesise that bronchiolitis and related neovascularisation are essential components of the aetiology of EIPH. PMID- 3678184 TI - Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. VI. Radiological/pathological correlations. AB - This study was initiated to determine if the extent and intensity of lung lesions associated with exercise-induced pulmonary haemorrhage (EIPH) in horses could be predicted from thoracic radiographs. Sets of thoracic radiographs from 24 horses with varied histories of EIPH were subjectively coded for radiographic quality, and perceived extent and intensity of diffuse interstitial opacity by three radiologists who had no knowledge of the corresponding autopsy results. Codes assigned from radiographs for the chosen parameters were compared with coded estimates of lung surface staining assigned at post mortem and volume measurements of haemosiderin deposits and bronchial arterial neovascularisation recorded from lung slices in separate studies. The non-parametric Spearman rank correlation test was used to test for statistical significance. All radiographically coded estimates of lesion severity were positively correlated with post mortem measurements of actual lesion involvement, but only the correlation between coded estimates of lesion opacity versus haemosiderin deposits and bronchial artery neovascularisation were statistically significant (P less than 0.05). Correlations between radiographic codes for lesion extent versus haemosiderin deposits and neovascularisation were just beyond the level of significance (P greater than 0.05 less than 0.1). These findings indicate that there are graded, radiographically discernible increases in interstitial opacity related to actual lesion severity. However, under the conditions of the study, accurate prediction of lung pathology in individual cases based on radiographic criteria was precluded by the wide variance of the coded values. The authors believe that with good radiographic technique and careful criteria selection, satisfactory prediction of lesion severity in EIPH cases could be achieved. PMID- 3678185 TI - Exercise-induced pulmonary haemorrhage in the horses: results of a detailed clinical, post mortem and imaging study. VII. Ventilation/perfusion scintigraphy in horses with EIPH. AB - Detailed post mortem examination of the lungs of horses with exercise-induced pulmonary haemorrhage (EIPH) has demonstrated significant small airway disease and intense bronchial arterial proliferation in the dorsocaudal lungfields. The purpose of this study was to investigate ventilation and perfusion distribution in the lungs of a similar group of horses to compare changes in the live animal with the previously reported post mortem findings. Thoracic radiography and ventilation/perfusion (V/Q) scintigraphy were performed on five racing Thoroughbreds with recent histories of EIPH. Parametric images of V/Q ratios for left and right lungfields were also generated from the scan images. In all horses, ventilation and perfusion deficits were demonstrated in the dorsocaudal areas of the lung corresponding closely to the observed radiographic lesions. In particular, the perfusion images and V/Q ratio displays indicated that, in affected areas of lung, pulmonary arterial perfusion was the more seriously impaired. This finding appears to confirm the post mortem evidence of reduced pulmonary arterial perfusion and bronchial arterial dominance in these areas. Ventilation deficits in the same areas also confirmed the likelihood of partial airway obstruction consistent with the small airway disease noted in previous post mortem observations. These results suggest that the vascular and airway lesions demonstrated in detailed post mortems of horses with EIPH are also functionally important in affected horses, even at rest. As a consequence of the apparent persistent, insidious and progressive nature of the lesions associated with EIPH there are serious long term implications for management of the condition. PMID- 3678186 TI - Exercise-induced pulmonary haemorrhage in the horse: results of a detailed clinical, post mortem and imaging study. VIII. Conclusions and implications. AB - This paper reviews a series of clinical, post mortem and imaging studies on exercise-induced pulmonary haemorrhage (EIPH) performed on 26 Thoroughbred racehorses. Post mortem techniques included routine gross, subgross and histological examination; coloured latex perfusions of pulmonary and bronchial circulations; and microradiography and computerised tomography scans of lungs with contrast injected vasculature. The major lesions were multiple, separate and coalescing foci of moderately proliferative small airway disease accompanied by intense neovascularisation of the bronchial circulation. As a result of bronchial artery angiogenesis, the systemic circulation dominated the vascular supply of the air exchange structures in affected areas, producing an apparent left to right shunt. Extensive areas of sequestered haemosiderophages indicated previous haemorrhage from vessels apparently supplied by the bronchial arteries. Diffuse and focal parenchymal destruction and connective tissue reactions in affected areas were considered to be secondary to localised haemorrhage and macrophage induced damage. The aetiology of EIPH was not determined, but the multifocal, small airway-centred lesions indicated that low grade bronchiolitis, possibly of viral origin, was a factor. Gravitational effects also appear to contribute to dorsal distribution of the lesions. The mild focal and subclinical lesions confined to secondary lobules are thought to evolve into the serious lung pathology observed in EIPH cases through the effects of localised hypoxia induced by maximal exercise and partial airway obstruction. Once initiated, a vicious cycle of increasing inflammatory damage and further local bleeding is set in motion. PMID- 3678187 TI - Technique for assessing respiratory health hazards from hay and other source materials. AB - This paper describes and compares three techniques of categorisation of hay, straw and other feeds and beddings collected from stables. A hand-held sampler was used to categorise samples according to the presence of plant material, fungal spores and dust mites. An Andersen sampler was used to categorise samples according to the thermotolerances of fungi and actinomycetes. An aerodynamic particle sizer was used to categorise samples according to respirable particle release rates. The highest burden of respirable particles was associated with the presence of thermophilic and thermotolerant actinomycetes and fungi. The portable slit sampler proved to be an accurate, quick and simple semiquantitative method of assessing the mould contamination of source materials. This latter technique requires only a microscope and the sampler, and is thus ideal for veterinary practices and small diagnostic laboratories. PMID- 3678188 TI - Air hygiene in stables. 1: Effects of stable design, ventilation and management on the concentration of respirable dust. AB - The concentration of fungal spores, the main constituents of respirable dust in stables, is determined by rates of release from fodder and bedding and rate of clearance, principally by ventilation. This paper outlines the principles that govern the application of natural ventilation to the control of air hygiene in barns and individual boxes for horses. When release rates are low, ventilation rates over four air changes per hour are satisfactory. Ventilation was satisfactory in individual boxes but usually unsatisfactory in barns and specific recommendations are made for improvement. Preliminary observations in stables with clean, well-managed bedding revealed only small differences between straw, wood shavings and paper. In these circumstances hay tended to be the major source of respirable spores. PMID- 3678189 TI - Survey of the designs of racehorse stables in the south west of England. AB - The design of 96 racehorse stables in the south west of England were surveyed. The 'typical' racehorse is kept in a loose box, bedded on straw and remains indoors while the stable is cleaned. It is given a floor area of 12 m2 and shares its airspace of 39 m3 with seven other horses. Overall, the predicted minimum rate of air change by natural convection in calm winds is 6.6 air changes/h but this is reduced to 2.2 if the top door of the stable is closed. On balance, racehorse stables in use today are based on designs which are worse overall than the best available in the 19th century. PMID- 3678190 TI - Cellular content of secretions obtained by lavage from different levels of the equine respiratory tract. AB - Lavage procedures were used to obtain samples of respiratory secretions from the nasal cavity, trachea, bronchi and bronchoalveolar level of apparently normal conscious horses, and the cellular composition of the lavage fluids was assessed. There was a progressive increase in total cell count of the secretions obtained from the upper to the lower respiratory tracts. Nasal lavage fluid was composed chiefly of epithelial cells, whereas tracheal, bronchial and bronchoalveolar fluids contained higher proportions of macrophages, lymphocytes and neutrophils. Eosinophils and mast cells were identified in small numbers. The results of the differential cell counts were compared with previous published reports, which revealed some major differences between studies. It is suggested that these differences may relate to variations in the collection technique, the cytological interpretation of cell types, the presence of subclinical airway disease, and the degree of exposure to airborne environmental contaminants. PMID- 3678191 TI - Value of tracheal aspirates in the diagnosis of chronic pulmonary diseases in the horse. PMID- 3678192 TI - Radiographic examination of the facial, nasal and paranasal sinus regions of the horse: I. Indications and procedures in 235 cases. AB - The radiographic procedures used for examination of the facial area and paranasal sinuses of 235 horses are reported. Clinical indications for these examinations and the diagnoses made are reviewed. Unilateral nasal discharge was the commonest reason for radiography, accounting for about one third of cases, most of which had radiological signs of paranasal sinus disease recognisable on erect lateral films. Oblique projections were required to obtain further information about the maxillary dental arcades and ventro-dorsal views demonstrated sinus expansion and extension of disease into the nasal cavity. In 24 horses with bilateral nasal discharge, the origin was usually shown to be in the lower respiratory tract and radiographic abnormalities were found in only 20 per cent of cases. Facial swelling was a feature of 25 per cent of cases; the commonest causes were premolar periapical disease, best shown on oblique views with the patient recumbent, and suture periostitis, easily demonstrated on erect lateral films. Other causes of facial swelling, which required multiple radiographic projections for evaluation, were sinus cysts and tumours and peripheral soft tissue masses. Epistaxis for which no cause could be found in the lower respiratory tract was the indication for radiography in a further 10 per cent of cases. In almost half of these a radiopaque shadow representing an ethmoid haematoma could be seen on an erect lateral film. A sinus cyst and a tumour were also recorded but most other causes of epistaxis failed to produce radiographic signs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678193 TI - Radiographic examination of the facial, nasal and paranasal sinus regions of the horse. II. Radiological findings. AB - The radiographic findings in 167 horses subjected to radiography of the facial area, nasal cavity and paranasal sinuses are recorded. Cases were grouped according to clinical diagnosis and the common and disparate radiographic features between and within groups are discussed. Dental disease occurred most frequently and accounted for about 30 per cent of cases, most of which had periapical infection. This disorder presented as two distinct clinical entities in almost equal numbers affected teeth with roots rostral to the maxillary sinus usually produced facial swelling, whereas those with roots within the sinus were generally associated with nasal discharge as a result of secondary sinusitis. In the former group periapical changes could readily be identified on radiographs, but in the latter group affected teeth could be recognised with confidence in only about half the cases. Primary sinusitis was the commonest specific condition recorded and accounted for 32 cases, three of which were mycotic. Using lateral erect projections, comparison of the radiographic features of primary sinusitis and sinusitis secondary to dental disease showed some useful differentiating signs. In four ponies, rhinitis associated with sinusitis led to disruption of the intra-nasal structures but mycotic rhinitis, nasal ulceration and an intra nasal foreign body produced no radiographic abnormalities. Sixteen cases of suture periostitis were recorded, with varying degrees of new bone formation, and of 13 animals presented for evaluation of trauma, pre-diagnosed fractures were demonstrated in 10 and complications due to sinusitis in three.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678194 TI - Lumbo-sacral loads and selected muscle activity while turning patients in bed. PMID- 3678195 TI - Influence of back angle on the quality of sleep in seats. PMID- 3678196 TI - Determination of clothing microenvironment volume. PMID- 3678197 TI - Electromyographic analysis of a postal sorting task. PMID- 3678198 TI - Anthropometric study of Egyptian women. PMID- 3678199 TI - Exposure to ergonomic stressors in the garment industry: application and critique of job-site work analysis methods. PMID- 3678200 TI - Sequence-specific interactions of a pea nuclear factor with light-responsive elements upstream of the rbcS-3A gene. AB - Pea nuclear extracts were used in gel retardation assays and DNase I footprinting experiments to identify a protein factor that specifically interacts with regulatory DNA sequences upstream of the pea rbcS-3A-gene. This factor, designated GT-1, binds to two short sequences (boxes II and III) in the -150 region that are known to function as light-responsive elements (LREs) in transgenic tobacco. Binding of GT-1 to homologous sequences further upstream (boxes II and III in the -220 region) indicates that these boxes comprise the redundant LRE that functions in vivo when boxes II and III are deleted. In both box II and box II, methylation interference experiments demonstrate that two adjacent G residues are critical for GT-binding. Single Gs present in boxes III and III are also important. Since GT-1 is present in nuclear extracts from leaves of light-grown and dark-adapted pea plants, its regulatory role does not depend on de novo synthesis. Thus if GT-1 binds differentially in vivo it must be postranslationally modified or sterically blocked from binding by another factor in response to light. PMID- 3678201 TI - Characterization of a slowly proliferative cell along the oligodendrocyte differentiation pathway. AB - A single bipotential glial progenitor cell of newborn rat optic nerve (the O-2A progenitor) characterized by its reactivity with antibodies to surface gangliosides (A2B5) and the presence of vimentin, can grow in microcultures in conditions which favor this progenitor's differentiation into oligodendrocytes. We selected at 8 days larger clones derived from such bipolar progenitors which had steadily proliferated on a layer of Type-1 astrocytes during the first week. Clonal growth and ratio of progenitor cells to oligodendrocytes was measured over the next two weeks by phase microscopy and double immunofluorescence labeling for the specific markers A2B5, GC (galactocerebroside, a surface marker for differentiated oligodendrocytes), O4 (a glycolipid marker of oligodendrocytes and some progenitors), GFAP (an astrocyte specific intermediate filament protein) and vimentin. Two types of clones were identified: type A clones (the majority), which were still slowly expanding at three weeks, and type B clones (the minority), which had stopped proliferating during the second week. In type A clones, some cells became GC positive multipolar oligodendrocytes, while other multipolar cells remained GC negative for days and expressed A2B5 and O4, but not GFAP or vimentin. Type B clones contained only GC positive, vimentin negative oligodendrocytes, which were generated during the second week and then decreased in number because of their restricted lifespan. Type B clones only developed in the presence of insulin or neurons. The number of GC negative cells in type A clones increased when insulin or neurons were deleted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678202 TI - Functional reconstitution of influenza virus envelopes. AB - We have examined several procedures for the reconstitution of influenza virus envelopes, based on detergent removal from solubilized viral membranes. With octylglucoside, no functionally active virosomes are formed, irrespective of the rate of detergent removal: in the final preparation the viral spike proteins appear predominantly as rosettes. Protein incorporation in reconstituted vesicles is improved when a method based on reverse-phase evaporation of octylglucoside solubilized viral membranes in an ether/water system is employed. However, the resulting vesicles do not fuse with biological membranes, but exhibit only a non physiological fusion reaction with negatively charged liposomes. Functional reconstitution of viral envelopes is achieved after solubilization with octaethyleneglycol mono(n-dodecyl)ether (C12E8), and subsequent detergent removal with Bio-Beads SM-2. The spike protein molecules are quantitatively incorporated in a single population of virosomes of uniform buoyant density and appear on both sides of the membrane. The virosomes display hemagglutination activity and a strictly pH-dependent hemolytic activity. The virosomes fuse with erythrocyte ghosts, as revealed by a fluorescence resonance energy transfer assay. The rate and the pH dependence of fusion are essentially the same as those of the intact virus. The virosomes also fuse with cultured cells, either at the level of the endosomal membrane or directly with the cellular plasma membrane upon a brief exposure to low pH. PMID- 3678204 TI - GCN4, a eukaryotic transcriptional activator protein, binds as a dimer to target DNA. AB - The eukaryotic transcriptional activator protein, GCN4, synthesized in vitro from the cloned gene, binds specifically to the promoters of yeast amino acid biosynthetic genes. Previous analysis of truncated GCN4 derivatives localized the DNA binding domain to the C-terminal 60 amino acids and revealed that the size of the GCN4 derivative and the electrophoretic mobility of the protein-DNA complex were inversely related. This observation was utilized here to develop a novel method for determining the subunit structure of DNA binding proteins. A mixture of wild-type GCN4 protein and a smaller GCN4 derivative generated three complexes with DNA, two corresponding to those observed when the proteins are present individually and one new complex of intermediate mobility. This extra complex results from the heterodimer of the two GCN4 proteins of different sizes, demonstrating that GCN4 binds DNA as a dimer. The contacts sufficient for dimerization were localized to the 60 C-terminal amino acid, DNA binding domain, suggesting that dimerization of GCN4 is a critical aspect of specific DNA binding. Furthermore, stable GCN4 dimers were formed in the absence of target DNA. These observations suggest a structural model of GCN4 protein in which a dimer binds to overlapping and non-identical half-sites, explaining why GCN4 recognition sites act bidirectionally in stimulating transcription. PMID- 3678203 TI - Deletion analysis of the internal signal-anchor domain of the human asialoglycoprotein receptor H1. AB - The human asialoglycoprotein receptor H1 is a single-spanning membrane protein with the amino terminus facing the cytoplasm and the carboxy terminus exposed on the exoplasmic side of the plasma membrane. It has been shown earlier that the transmembrane segment, residues 38-65, functions as an internal signal directing protein synthesis to the endoplasmic reticulum and initiating membrane insertion. This process is co-translational and mediated by signal recognition particle (SRP). To identify subsegments within this region containing the signal information, we prepared deletion mutants at the level of the cDNA and analysed them in a wheat germ in vitro translation system with microsomes as the target membrane. Insertion and membrane anchoring were judged by the glycosylation of the protein, its resistance to exogenous protease and the extent to which it can be extracted from the microsomes by alkaline treatment. It was found that very small deletions already reduce the stability of membrane anchoring. However, nearly half of the transmembrane domain can be deleted, both from the amino terminal and from the carboxy-terminal side, without completely abolishing membrane insertion. Several mutants, although not inserted, still interact with SRP. The results support the notion that the main feature of a signal sequence is a hydrophobic stretch of sufficient length (10-12 residues in our sequence), and indicate that recognition by SRP is not sufficient for membrane insertion. PMID- 3678206 TI - Induction and transmission of chemically induced chromosome aberrations in female germ cells. AB - Female mice were dosed with a number of chemical clastogens. The dosed females were then mated 28.5, 6.5, and 0.5 days after dosing, corresponding to various developmental stages of oogenesis (ie, early pre-antral to late antral stages). One-cell embryos derived from these mating were then isolated and analysed for structural and/or numerical chromosome aberrations. Chromosome damage, either structural or numerical, was induced only in oocytes at the late antral stages of oogenesis (i.e. when females were dosed 0.5 days prior to mating). There were few chromosome aberrations in embryos obtained from females dosed 6.5 or 28.5 days prior to mating. The results show that the analysis of one-cell embryos derived from the germ cells of dosed females is a potentially useful test system for the identification of chemically induced structural and numerical chromosome aberrations. However, the technically demanding methods involved in the preparation of these one-cell embryos prevent their use for routine screening purposes. PMID- 3678205 TI - A cell-free plant extract for accurate pre-tRNA processing, splicing and modification. AB - An intron-containing tobacco tRNA(Tyr) precursor synthesized in a HeLa cell nuclear extract has been used to develop a cell-free processing and splicing system from wheat germ. Removal of 5' and 3' flanking sequences, accurate excision of the intervening sequence, ligation of the resulting tRNA halves, addition of the 3'-terminal CCA sequence and modification of seven nucleosides were achieved in appropriate wheat germ S23 and S100 extracts. The maturation of pre-tRNA(Tyr) in these extracts resembles the pathway observed in vivo for tRNA biosynthesis in Xenopus oocytes and yeast in that processing of the flanks precedes intron excision. Most of the modified nucleosides (m2(2) G, psi 35, psi 55, m7G and m1A) are introduced into the intron-containing pre-tRNA with mature ends, whereas two others (m1G and psi 39) are only found in the mature tRNA(Tyr). Processing and splicing proceed very efficiently in the wheat germ extracts, leading to complete maturation of 5' and 3' ends followed by about 65% conversion to mature tRNA(Tyr) under our standard conditions. The activity of the wheat germ endonuclease is stimulated 3-fold by the non-ionic detergent Triton X-100. All previous attempts to demonstrate the presence of a splicing endonuclease in wheat germ had failed (Gegenheimer et al., 1983). Hence, this is the first cell-free plant extract which supports pre-tRNA processing and splicing in vitro. PMID- 3678208 TI - Genetic effects of methylmercury in human chromosomes: I. A cytogenetic study of people exposed through eating contaminated fish. AB - An analysis of chromosomal aberrations (structural and numerical) and sister chromatid exchange (SCE) was carried out on 16 people exposed to methylmercury through eating fish caught in Cartagena Bay (Columbia), an area of known methylmercury contamination. Fourteen people whose diet consisted mainly of fish caught in another, noncontaminated area of the Atlantic acted as controls. The results showed a significant difference between the experimental and control groups in methylmercury (MM) concentrations measured in hair and peripheral blood. Subsequently, significant differences between levels of organic mercury in blood and hair were found when all the individuals studied were classified in two groups according to their blood mercury levels. When achromatic lesions were included, the frequency of structural chromosome aberrations differed significantly between the exposed and control groups. Furthermore, a significant correlation (p less than 0.05) was found between structural chromosome aberrations and groups (exposed and control). When achromatic lesions were excluded from the analyses, these differences were not found. There was a significant correlation between SCE and age. This is the first report of a study on the frequency of SCE in a population exposed to methylmercury. PMID- 3678207 TI - Low oxygen tension, as found in tissues in vivo, alters the mutagenic activity of aristolochic acid I and II in primary fibroblast-like rat cells in vitro. AB - The mutagenic activities of aristolochic acid I (AAI) and II (AAII), the two main components of aristolochic acid (AA), were tested for mutagenicity in vivo in a subcutaneous granulation tissue in rats and in vitro in the corresponding freshly isolated and cultured target cells. In vivo at equimolar dose, AAI induced 16 times more 6-thioguanine resistant cells than AAII. Oxygen tension in vitro was adjusted to that found in vivo: in the subcutaneous connective tissue, the pO2 was determined to be 40 +/- 9 mm Hg, which corresponds in vitro to an O2 concentration of 5% in the incubator atmosphere. In vitro, AAI was 19 times more mutagenic than AAII at this low oxygen tension but exhibited only 4 times greater activity than AAII under standard culture conditions. These results indicate that the genotoxic activity of AA in mammals is mainly caused by AAI and that the exposure of cells to AAI and AAII in vitro at low pO2 corresponds more closely to the metabolic situation in vivo. Therefore, the mutagenic potency of the two chemicals can only be estimated correctly at tissue oxygen tension. The influence of pO2 on the mutation frequencies seems to arise from a modulation of the activation/detoxification pathways. PMID- 3678209 TI - Increased chromosome damage in pediatric heart catheterization patients after diagnostic fluoroscopy and cineangiography. AB - Chromosome damage (CD) and sister chromatid exchange (SCE) levels were studied in lymphocytes from 30 pediatric heart catheterization patients receiving radiation during diagnostic fluoroscopy and cineangiography procedures. Forty-eight-hour CD and 72-hr SCE cultures were prepared from sequential samples taken from each patient: samples 1-3 via the catheter the same day (1) before exposure, (2) after fluoroscopy, and (3) after cineangiography; and sample 4 by venipuncture the next morning. Significant increases in CD (dicentrics, rings, and fragments), but not SCE, were observed. From a mean base level of 0.4% cells with CD, the CD levels increased 2-3-fold in samples 3 and 4 (p = .001). Rings only occurred in samples 3 and 4. While increased CD levels also correlated with increasing age, body surface area, and weight, partial correlations controlling for these factors clearly indicate that the CD effects are principally attributable to the radiological procedures (p = .001). Increased CD levels correlated with both the roentgen dose of cineangiography exposure (p = .002) and the volume of contrast medium (p = .000); however, partial correlations, controlling for either factor, indicate that the contrast medium was the principal factor (p = .006). PMID- 3678210 TI - In vivo induction of sister chromatid exchange by clinical doses of haloperidol in Swiss albino mice. PMID- 3678211 TI - Choice of route of exposure in mammalian genotoxicity experiments. PMID- 3678212 TI - The pattern of breathing during hypoxic exercise. AB - Breathing pattern was studied in six subjects in normoxia (FIO2 = 0.21) and hypoxia (FIO2 = 0.12) at rest and during incremental work-rate exercise. Ventilation (V) as well as mean inspiratory flow (VT/TI) increased with exercise intensity and were augmented in the hypoxic environment, whereas the ratio between inspiratory (TI) and total (Ttot) breath durations increased with exercise intensity but was unaffected by hypoxia. The relationship of tidal volume (VT) and inspiratory time duration (TI) showed linear, coinciding ranges for the normoxic and hypoxic conditions up to VT/TI values of about 2.5 1.s-1. At higher VT/TI values TI continued to decrease, whereas VT tended to level off, an effect which was more evident in the hypoxic condition. The results suggest that the hypoxic augmentation of exercise hyperpnea is primarily brought about by an enhancement of central inspiratory drive, the timing component being largely unaffected by the hypoxic environment, and that at low to moderate levels of exercise hyperpnea inspiratory off-switch mechanisms are essentially unaffected by moderate hypoxia. PMID- 3678213 TI - Study of human muscle contraction using electrically evoked twitch responses during passive shortening and lengthening movements. AB - Electrically evoked twitch properties of the human plantarflexor muscles were measured with the muscles at a constant length (static) and during passive shortening and lengthening. A Kin-Com dynamometer system was used to passively move the ankle joint at 0.52 rad s-1 (30 degrees s-1), as well as to record the twitch responses which were elicited by supramaximal electric shocks applied over the tibial nerve in the popliteal fossa. In the lengthening and shortening conditions, twitches were evoked by triggering the shocks so that the twitch response occurred at a similar angular position for all three conditions. The lengthening twitch peak torque was about twice as large as that recorded for the shortening condition. There was, however, no statistical difference in the twitch time course in these three testing conditions. This twofold increase in the peak twitch torque during lengthening, compared to shortening, is much greater than the torque increase reported during eccentric, as compared to concentric maximal voluntary contractions. These findings suggest that a deactivation process of the contractile system occurs during muscle shortening, while in contrast, during passive lengthening a potentiation mechanism is acting, and that both these mechanisms are independent of volitional muscle activation. The present study is the first to demonstrate the possibility of electrically evoked contractions of human muscles during passive lengthening and shortening. We believe that the use of such evoked contractions may be promising for the study of contractile behaviour of human skeletal muscles during eccentric and concentric conditions. PMID- 3678214 TI - Regulation of growth hormone during exercise by oxygen demand and availability. AB - Five normal men performed seven sets of seven squats at a load equal to 80% of their seven repetition maximum. Plasma growth hormone (GH) and lactate levels increased during and after the completion of the exercise. A significant (r = 0.93, P less than 0.001) linear correlation was found between GH changes and the corresponding oxygen Demand/Availability (D/A) ratio expressed by (equation; see text) (where f = [lactate at time x]/[lactate at time 0]). A retrospective examination of previously published data from our laboratory and others also demonstrated the existence of a significant correlation between changes in plasma GH levels and the D/A ratios over a wide variety of exercise; aerobic and anaerobic, continuous and intermittent, weight lifting and cycling, in both fit and unfit subjects under normoxic and hypoxic conditions. It is suggested that the balance between oxygen demand and availability may be an important regulator of GH secretion during exercise. PMID- 3678215 TI - Physiological responses to fire fighting activities. AB - Eight professional fire fighters participated in six fire fighting scenarios at a training facility. Data on heart rate (HR), rectal temperature (Tre), and skin temperatures at the chest and thigh were collected using a portable data acquisition system. Average HR ranged from 122 to 151 beats.min-1 during the six scenarios. Detailed analyses indicated that HR and Tre increases are related to both the physical and environmental stresses of the various activities carried out. The most demanding activity, that of building search and victim rescue, resulted in an average HR of 153 beats.min-1 and Tre rise of 1.3 degree C, while the least demanding activity, that of the crew captain who directs the fire fighting, resulted in an average HR of only 122 beats.min-1 and a Tre rise of only 0.3 degree C. This study shows that fire fighting is strenuous work for those directly entering a building and performing related duties, but that the physical demands of other activities are considerably less. The results further suggest that heat strain injuries in fire fighters could perhaps be reduced by rotating duties frequently with other crew members performing less stressful work. PMID- 3678216 TI - Formation of acetylcarnitine in muscle of horse during high intensity exercise. AB - To study the changes in carnitine in muscle with spring exercise, two Thoroughbred horses performed two treadmill exercise tests. Biopsies of the middle gluteal were taken before, after exercise and after 12 min recovery. Resting mean muscle total carnitine content was 29.5 mmol.kg-1 dry muscle (d.m.). Approximately 88% was free carnitine, 7% acetylcarnitine and acylcarnitine was estimated at 5%. Exercise did not affect total carnitine, but resulted in a marked fall in free carnitine and almost equivalent rise in acetylcarnitine. The results are consistent with a role for carnitine in the regulation of the acetyl CoA/CoA ratio during sprint exercise in the Thoroughbred horse by buffering excess production of acetyl units. PMID- 3678217 TI - Force-velocity relationship and maximal power on a cycle ergometer. Correlation with the height of a vertical jump. AB - The force-velocity relationship on a Monark ergometer and the vertical jump height have been studied in 152 subjects practicing different athletic activities (sprint and endurance running, cycling on track and/or road, soccer, rugby, tennis and hockey) at an average or an elite level. There was an approximately linear relationship between braking force and peak velocity for velocities between 100 and 200 rev.min-1. The highest indices of force P0, velocity V0 and maximal anaerobic power (Wmax) were observed in the power athletes. There was a significant relationship between vertical jump height and Wmax related to body mass. PMID- 3678218 TI - Serum creatine kinase activity following repeated bouts of isometric exercise with different muscle groups. AB - The purpose of this study was to examine the relationship between the muscle mass involved in exercise and post-exercise serum creatine kinase (CK) elevation. Twelve untrained college-aged men completed three isometric exercises: one arm flexion (OAF), two arm flexion (TAF) and one leg knee extension (OLE). These exercises were balanced over subjects and days and separated by two week intervals. Each exercise consisted of 40 maximal isometric concentrations lasting for 10 s with a 20 s rest between contractions. Relative increases in serum CK for OAF, TAF, and OLE were 181 +/- 70% (SD), 222 +/- 69% and 297 +/- 67%, respectively. An ANOVA using a latin square design for analysis of carry over effects showed that these CK increases were not significantly different (p greater than 0.05). However, the increase in serum CK following the first exercise (379 +/- 90%), regardless of what it was (OAF, TAF, or OLE), was significantly greater (p less than 0.05) than those following bouts 2 and 3 (155 +/- 29%; 167 +/- 54%). Regression analysis indicated that post-exercise serum CK elevation was not related to the amount of muscle mass involved in the exercise (r = 0.30, p greater than 0.05) nor to muscle tension developed (r = 0.28, p greater than 0.05). We conclude that post-exercise serum CK elevation is not necessarily related to the muscle mass involved in the exercise. Because each exercise involved the use of different muscle groups, factors outside the exercising muscle may contribute to post-exercise serum enzyme activity. PMID- 3678219 TI - Recovery of dynamic muscular endurance. AB - Recovery of the rate of dynamic muscular endurance was measured in two groups of college-aged males. Subjects were required to perform elbow flexion (between the angles of 70 and 170 degrees) for as long as possible at the rate of 38 contractions/min while loaded with 1/6 of their maximum isometric strength (MVC). The task was terminated when the subject fell four contractions behind the required cadence or failed to complete two successive contractions. Subsequent to the task the subject was given a predetermined rest period after which a second fatigue bout to failure was performed. The rest intervals for Gp I (n = 22) were 5, 15, 45, 135, 405, and 1215 seconds, while the rest intervals for Gp II (n = 17) were 10, 30, 90, 270, 810, and 2550 s. Each subject completed six recovery intervals with the order of administration assigned at random. The percentage of recovery was calculated by dividing the exercise time of the first bout into the time of the second bout. These normalized data for the two groups were combined for analysis providing a 12 point recovery curve. The percentage of recovery ranged from 15.4% after 5 s to 91.8% after 2550 s. Analysis of the data revealed that the recovery pattern of dynamic muscular endurance progressed very rapidly initially, reached 50% at approximately 2 min and 15 s and was slightly less than 90% complete at 20 min. Exponential analysis of these data yielded a three component curve. PMID- 3678220 TI - Effects of downhill or uphill training prior to a downhill run. AB - Nine men volunteered to undergo 10% downhill (DT) or 10% uphill (UT) treadmill training at 60% VO2max for 12 minutes on two consecutive days. Four days later the downhill run (DR) was repeated. All subjects reported considerable muscular soreness following DT but not UT. When DR followed UT muscular soreness was again reported but not when DR followed DT. Peak knee flexion and extension moment of force data at five angular velocities, ranging from 0.52-4.71 rad s-1, were reduced following DR regardless of whether soreness was present. During each run VO2 was stable during UT but drifted upwards during DT and DR. This increase in VO2 was not due to changes in the stride frequency since the stride frequency remained nearly constant on all days except for the second day of the DT when an increase of 20 strides per minute occurred; this was the only day the subjects ran while sore. It was concluded that two 12 minute bouts of downhill running were sufficient to protect against the occurrence of muscular soreness in subsequent downhill run. However, this training was insufficient to prevent a 2-3 day loss of muscular strength. These results support the hypothesis that the sensation of delayed onset muscle soreness and the temporary strength loss associated with eccentric contraction have different physiological causes. PMID- 3678221 TI - Early fluid and protein shifts in men during water immersion. AB - High precision blood and plasma densitometry was used to measure transvascular fluid shifts during water immersion to the neck. Six men (28-49 years) undertook 30 min of standing immersion in water at 35.0 +/- 0.2 degrees C; immersion was preceded by 30 min control standing in air at 28 +/- 1 degrees C. Blood was sampled from an antecubital catheter for determination of blood density (BD), plasma density (PD), haematocrit (Ht), total plasma protein concentration (PPC), and plasma albumin concentration (PAC). Compared to control, significant decreases (p less than 0.01) in all these measures were observed after 20 min immersion. At 30 min, plasma volume had increased by 11.0 +/- 2.8%; the average density of the fluid shifted from extravascular fluid into the vascular compartment was 1006.3 g.l-1; albumin moved with the fluid and its albumin concentration was about one-third of the plasma protein concentration during early immersion. These calculations are based on the assumption that the F-cell ratio remained unchanged. No changes in erythrocyte water content during immersion were found. Thus, immersion-induced haemodilution is probably accompanied by protein (mainly albumin) augmentation which accompanies the intravascular fluid shift. PMID- 3678222 TI - Perceived exertion related to heart rate and blood lactate during arm and leg exercise. AB - To compare some psychophysiological responses to arm exercise with those to leg exercise, an experiment was carried out on electronically braked bicycle ergometers, one being adapted for arm exercise. Eight healthy males took part in the experiment with stepwise increases in exercise intensity every 4 min: 40-70 100-150-200 W in cycling and 20-35-50-70-100 W in arm cranking. Towards the end of each 4 min period, ratings of perceived exertion were obtained on the RPE scale and on a new category ratio (CR) scale:heart rate (HR) and blood lactate accumulation (BL) were also measured. The responses obtained were about twice as high or more for arm cranking than for cycling. The biggest difference was found for BL and the smallest for HR and RPE. The incremental functions were similar in both activities, with approximately linear increases in HR and RPE and positively accelerating functions for CR (exponents about 1.9) and BL (exponents 2.5 and 3.3 respectively). When perceived exertion (according to the CR scale) was set as the dependent variable and a simple combination of HR and BL was used as the independent variable, a linear relationship was obtained for both kinds of exercise, as has previously been found in cycling, running, and walking. The results thus give support for the following generalization: For exercise of a steady state type with increasing loads the incremental curve for perceived exertion can be predicted from a simple combination of HR and BL. PMID- 3678224 TI - Effect of muscle temperature on leg extension force and short-term power output in humans. AB - The effect of changing muscle temperature on performance of short term dynamic exercise in man was studied. Four subjects performed 20 s maximal sprint efforts at a constant pedalling rate of 95 crank rev.min-1 on an isokinetic cycle ergometer under four temperature conditions: from rest at room temperature; and following 45 min of leg immersion in water baths at 44; 18; and 12 degrees C. Muscle temperature (Tm) at 3 cm depth was respectively 36.6, 39.3, 31.9 and 29.0 degrees C. After warming the legs in a 44 degrees C water bath there was an increase of approximately 11% in maximal peak force and power (PPmax) compared with normal rest while cooling the legs in 18 and 12 degrees C water baths resulted in reductions of approximately 12% and 21% respectively. Associated with an increased maximal peak power at higher Tm was an increased rate of fatigue. Two subjects performed isokinetic cycling at three different pedalling rates (54, 95 and 140 rev.min-1) demonstrating that the magnitude of the temperature effect was velocity dependent: At the slowest pedalling rate the effect of warming the muscle was to increase PPmax by approximately 2% per degree C but at the highest speed this increased to approximately 10% per degree C. PMID- 3678223 TI - Prediction of mean skin temperature in warm environments. AB - The data collected by the authors in four experimental series have been analysed together with data from the literature, to study the relationship between mean skin temperature and climatic parameters, subject metabolic rate and clothing insulation. The subjects involved in the various studies were young male subjects, unacclimatized to heat. The range of conditions examined involved mean skin temperatures between 33 degrees C and 38 degrees C, air temperatures (Ta) between 23 degrees C and 50 degrees C, ambient water vapour pressures (Pa) between 1 and 4.8 kPa, air velocities (Va) between 0.2 and 0.9 m.s-1, metabolic rates (M) between 50 and 270 W.m-2, and Clo values between 0.1 and 0.6. In 95% of the data, mean radiant temperature was within +/- 3 degrees C of air temperature. Based on 190 data averaged over individual values, the following equation was derived by a multiple linear regression technique: Tsk = 30.0 + 0.138 Ta + 0.254 Pa-0.57 Va + 1.28.10(-3) M-0.553 Clo. This equation was used to predict mean skin temperature from 629 individual data. The difference between observed and predicted values was within +/- 0.6 degrees C in 70% of the cases and within +/- 1 degrees C in 90% of the cases. It is concluded that the proposed formula may be used to predict mean skin temperature with satisfactory accuracy in nude to lightly clad subjects exposed to warm ambient conditions with no significant radiant heat load. PMID- 3678225 TI - Effects of standing cycling and the use of toe stirrups on maximal oxygen uptake. AB - Twenty-eight subjects (6 normal men, 14 distance runners, and 8 rowers) were tested for maximal oxygen uptake (VO2max) and associated physiological measures during bicycle ergometer exercise with toe stirrups while standing (BEts) and during treadmill exercise (TM). Correlation between BEts VO2max and TM VO2max was high (r = 0.901, p less than 0.05). No significant difference existed between the two VO2max values (60.3 +/- 8.9 vs. 60.5 +/- 9.7 ml.kg-1.min-1; n = 28). No differences were found even when three different subgroups were separately compared. It is concluded that the higher VO2max elicited during BEts as compared with normal sitting cycling may be attributed to the increased muscle blood flow and/or involvement of a larger muscle mass, the latter being partly evidenced by the observation of greater electromyographic activity during BEts. PMID- 3678226 TI - Human muscle function following prolonged eccentric exercise. AB - 4 subjects performed repeated eccentric contractions with leg extensors during prolonged downhill walking (-25% gradient) at 6.44 km.h-1 until collapse due to muscle weakness (range of exercise duration 29 to 40 min). During the exercise oxygen uptake rose progressively from approximately 45% of the previously determined VO2max at 10 min to approximately 65% at the end of the exercise. Following the exercise there was an immediate, significant, and sustained reduction in maximal voluntary isometric contraction, and short term (anaerobic) power output measured concentrically on an isokinetic ergometer. These reductions in muscle function persisted for 96 hours post exercise, and were reflected by significant reductions in the tension generated at low frequency (20 Hz) relative to higher frequency (50 Hz) percutaneous stimulation of the quadriceps. All four subjects showed an increase in plasma levels of creatine kinase post eccentric exercise. Performing concentric contractions by walking uphill for one hour at a significantly greater metabolic cost failed to induce comparable reductions in muscle function. These results provide evidence for the consequences of prolonged eccentric work upon dynamic function which complements earlier reports of structural, enzymatic, and static function changes. PMID- 3678227 TI - The influence of training on physical and functional growth before, during and after puberty. AB - In boys, the ages at which growth rates for body weight, height, VO2max, maximum O2 pulse and VImax reached their peaks were approximately the same (means and SD: 14.64 +/- 0.98, 14.67 +/- 0.99, 14.71 +/- 1.59, 14.38 +/- 1.36 and 14.64 +/- 1.42 years respectively). There was a positive relationship between the peak velocities of functional capacity indicators (VO2max 0.79 +/- 0.19 1.min-1.year 1, O2 pulse max 4.1 +/- 1.20 ml.year-1, VImax 27.3 +/- 7.15 l.min-1.year-1) and the peak growth velocity of weight and/or height (weight 9.1 +/- 1.92 kg.year-1, height 9.8 +/- 1.92 cm.year-1). A positive relationship between the age at peak velocity of VO2max and O2 pulse max with the age at peak velocity for body weight was also found (r = 0.524 and 0.400 respectively). No relationship was revealed between the age at peak velocity on the one hand and the peak velocities of body weight, height, VO2max, O2 pulse or VImax on the other. Moderate training did not influence acceleration in growth--the age at peak velocity and the peaks of the growth rate did not differ in groups with a different regime of exercise (higher n = 8, medium - n = 9, lower - n = 12; the peak velocity of VO2max--means and SD -being 0.85 +/- 0.15, 0.76 +/- 0.22 and 0.78 +/- 0.17.min-1.year-1 respectively). PMID- 3678228 TI - Relationships between body dimensions and resting and working oxygen consumption in boys aged 11 to 18 years. AB - The relationships between VO2 at rest, VO2max and VO2 during submaximal work on a treadmill with body weight, height and lean body mass assessed by densitometry were analyzed annually in 39 boys aged 11 to 18 years. Interindividual differences in VO2 at rest and VO2max during growth depended in the first place on interindividual differences in lean body mass, to a lesser extent on differences in body weight and least on differences in height. Intersubject differences in VO2 during submaximal work were primarily conditioned by differences in body weight, due to the fact that, at a given running speed, energy output depends on body weight. The differences in submaximal VO2 depended to a lesser extent on differences in lean body mass and least on differences in height. The relationships between VO2 increments and increases in body dimensions were somewhat different in 90 boys between the ages of 11 and 15 years: VO2max increments were determined primarily by changes in body weight and height, changes in lean body mass being of secondary importance. Increases in submaximal VO2 were influenced decisively by increments in body weight, followed by increments in lean body mass and least by increments in height. In the equation y = a.xb expressing the relationship of VO2max to body weight and height, the values of b at the ages of 14 and 15 years were 0.87 and 0.88 in relation to body weight, 2.63 and 2.72 in relation to height. These values are significantly higher than the theoretical values of 0.67 for body weight and 2.00 for height. Similar significant differences from these theoretical values were found for all values between the ages of 11 and 15 years. PMID- 3678229 TI - Nuclear basic protein transition during sperm differentiation. Amino acid sequence of a spermatid-specific protein from the dog-fish Scylliorhinus caniculus. AB - During dog-fish spermatogenesis, chromatin undergoes a continuous processing which involves two basic protein transitions: the first from somatic-type histones to spermatid-specific proteins and the second leading to protamines. Two spermatid-specific proteins S1 and S2 were isolated from nuclei of spermatid enriched testis zone and the amino acid sequence of S1 has been determined. S1 contains 87 amino acids and has a molecular mass of 11179 Da. It is mainly characterized by a high content of basic residues (45%) and the presence of one residue of cysteine. Its primary structure shows that the N-terminal half is highly basic while the hydrophobic residues are preferentially localized in the C terminal region. Three forms of S1 are present in testis which correspond to di-, mono- and nonphosphorylated molecules. This spermatid-specific protein shares no common structural feature with either histones and dog-fish protamines or rat spermatid-specific protein which has been previously described. PMID- 3678230 TI - Human gastric lipase. A kinetic study with dicaprin monolayers. AB - The effects of several proteins on the hydrolysis at pH 3.0 of didecanoylglycerol monolayers by human gastric lipase were investigated. Among the six proteins tested (bovine serum albumin, myoglobin, a protein inhibiting lipase isolated from soya bean, melittin, beta-lactoglobulin and ovalbumin), only the first three proteins were found to inhibit lipase activity. The inhibition capacity of the proteins was not related to the decrease in interfacial tension or to their isoelectric points. However, inhibition of human gastric lipase by proteins may be correlated with the penetration power of the protein into the lipid interface. It is hypothesized that this lipase has a higher penetration power than that of pancreatic lipase, even though the former enzyme is more susceptible to interfacial denaturation. PMID- 3678231 TI - Purification and properties of beta-ureidopropionase from the rat liver. AB - beta-Ureidopropionase was purified 1000-fold over the initial rat liver extract, using heat treatment, ammonium sulfate fractionation, CM-Sepharose CL-6B, DEAE Sepharose CL-6B, hydroxyapatite and Sephacryl S-300 chromatographies. The purified enzyme was shown to be homogeneous by gel electrophoresis both in the presence and absence of sodium dodecyl sulfate. Its molecular mass, determined by gel filtration and sucrose density gradient centrifugation, was 327,000 +/- 9000 and 323,000 +/- 13,000 respectively, and the subunit molecular mass was 54,000 +/ 600. The pH optimum for enzyme activity was 7.0 and pI was 6.4. The enzyme catalyzed the amidohydrolysis of N-carbamoyl-beta-alanine and N-carbamoyl-DL-beta aminoisobutyrate but did not catalyze that of other ureido compounds including N carbamoyl-DL-aspartate. With N-carbamoyl-beta-alanine and N-carbamoyl-DL-beta aminoisobutyrate as substrate, the enzyme exhibited positive cooperativity with a Hill coefficient h = 2. The enzyme activity was proportional to the enzyme concentration between 0.2 nM and 0.5 microM. Arrhenius plots of the influence of temperature on the catalytic activity of the enzyme showed a sharp break at 19 degrees C. PMID- 3678232 TI - Plectin from bovine lenses. Chemical properties, structural analysis and initial identification of interaction partners. AB - Plectin was purified to near homogeneity from epithelial and cortical cell layers of bovine lenses using a simple and fast purification scheme that included as last step, gel permeation chromatography in the presence of 0.25% sodium N lauroyl sarcosinate. Lens cell plectin showed extensive structural homology to plectin from cultured cells as revealed by immunoblotting experiments and amino acid analysis. Further characterization included solubility in various buffer solutions, codistribution with vimentin in repeated rounds of intermediate filament disassembly and assembly, and hydrodynamic behaviour in high-performance gel permeation chromatography. Electron microscopy of negatively stained and rotary shadowed plectin molecules revealed a dumb-bell-like structure with an estimated relative molecular mass of 1.16 X 10(6). Specific head-to-head self interaction of plectin molecules at low salt concentrations and formation of large aggregates under high-salt and physiological conditions was also demonstrated. Isolation, as well as reconstitution of soluble protein complexes containing plectin, vimentin and other cytoskeletal and membrane skeleton proteins, provided first hints to plectin's role as an interlinking component of the cytoskeleton and the membrane skeleton of lens tissue. PMID- 3678233 TI - Conserved exon-intron organization in two different caerulein precursor genes of Xenopus laevis. Additional detection of an exon potentially coding for a new peptide. AB - From a genomic library of Xenopus laevis, two genes coding for different preprocaeruleins have been isolated and sequenced. These correspond to the type I and type III precursors analyzed previously at the cDNA level [Richter, K., Egger, R. and Kreil, G. (1986) J. Biol. Chem. 261, 3676-3680]. The type III gene comprises eight exons; the type I apparently contains eight exons as well, of which six have been sequenced. The genetic information for the dekapeptide caerulein is present on small exons of 45 base pairs. The two genes are highly homologous in their 5'-flanking region, the exon/intron boundaries, and long stretches of intron sequences. A possible scheme for the evolution of this small family of genes through exon and gene duplications is presented. In the type I gene, in place of one of the caerulein exons, a potential exon with conserved splice sites was discovered. If expressed in some frog cells, this exon would code for a new peptide 60% homologous to caerulein. PMID- 3678234 TI - Electroblotting of individual polypeptides from SDS/polyacrylamide gels for direct sequence analysis. AB - A scheme for electroblotting of individual unstained protein bands from SDS/polyacrylamide gels and subsequent amino acid sequence analysis is described. Principal features are: detection of the polypeptide bands by visualization with KCl; electroblotting of excised gel pieces that correspond to the protein bands only; blotting onto polybrene-pretreated glass-fiber filter discs (12 mm diameter) placed in an electrophoretic concentrator. A high yield over all steps from gel application through electrophoresis, blotting, gas-phase sequencer degradation, and phenylthiohydantoin analysis is obtained with several different types of polypeptide (combined average yield over all steps 20%, spread 10-50%). Background is low and samples can be stored under vacuum for long periods after blotting. PMID- 3678235 TI - Coronary risk factors in men occupationally exposed to vibration and noise. AB - In a group of 481 men (group A) exposed occupationally to vibration (exceeding by four times the permissible levels in the frequency band 32-64-125 Hz) and noise (105-116 dB), and in a group of 303 men without contact with vibration and noise at work (reference group R) the prevalence of coronary risk factors was assessed. Socioeconomic status, level of occupational physical activity and family history of heart disease were comparable in the two groups. Mean blood pressure values and the percentage with hypertension were significantly higher in the exposed than in the reference group (P less than or equal to 0.01). Overweight and hypertrigliceridemia occurred less frequently in group A than in group R (P less than or equal to 0.01 and P less than or equal to 0.05 respectively). The prevalence of hypercholesterolaemia and smoking habits was similar in both groups. The results suggest that vibration and noise may be factors which increase the risk of coronary heart disease. PMID- 3678236 TI - Left bundle branch block: prevalence, incidence, follow-up and outcome. AB - In a randomly selected population screening study of 8450 men and 9039 women 33 to 71 years of age conducted in Iceland in 1967-1977, 27 men and 17 women were found to have left bundle branch bock (LBBB). The prevalence of LBBB at that time was 0.43% for men and 0.28% for women. The incidence of LBBB was 3.2 per 10,000 per year for men and 3.7 per 10,000 per year for women. All except one of 37 alive patients with LBBB were examined in 1984 including chest X-ray, echocardiography and exercise testing (Bruce protocol). Eight men had had myocardial infarction (P less than 0.05), 12 had angina pectoris, 15 had hypertension, 7 had cardiomyopathy, 13 had primary conduction disease, and 3 had pacemakers. Five men and two women had died in comparison with 18 men and 1 woman in an age-matched control group of 176 people (P : ns). Three of 5 decreased LBBB men had cardiomyopathy at autopsy. Three men died suddenly. The two women died of noncardiac causes. Only one patient in the control group had cardiomyopathy (P less than 0.01). There was no significant difference in other cardiac diagnoses between the groups. Eleven LBBB women out of thirteen had a normal exercise duration (greater than or equal to 6 min) and 11/17 men exercised normally (less than or equal to 7 min). In comparison with the control group, the LBBB patients had an increased LV diameter 2.85 +/- 0.38 vs 2.58 +/- 0.38 cm m-2 body surface area (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678237 TI - Electrophysiological effects and mechanism of action of oral quinidine in patients with sinus bradycardia and first degree A-V nodal block. AB - The effects of quinidine on sinus nodal and A-V nodal function were assessed in 20 patients (age: 60 +/- 7 years) with sinus bradycardia and a prolonged A-H interval. Electrophysiological studies were performed twice in each patient. In the first study, the measurements of sinus and A-V node function were evaluated both in the basal state and after autonomic blockade (propranolol 0.2 mg kg-1 and atropine 0.04 mg kg-1). Oral quinidine was administered for 3-4 days (1200 mg day 1) and the study was then repeated using the same methods. Comparison of data obtained in the two studies in the basal state allowed us to evaluate the overall effect of quinidine. Comparing the results obtained following autonomic blockade, the direct action of the drug could be assessed. In the basal state quinidine did not significantly change the function of either node. In contrast, after autonomic blockade, significant changes were noted after quinidine. In 3 patients with sinus rate less than 50 beats min-1 and an abnormal intrinsic heart rate, quinidine induced marked depression of sinus automaticity. These data suggest that: (1) in patients with sinus bradycardia and prolongation of the A-H interval, oral quinidine has a direct depressant effect on sinus and A-V nodal function, but this effect is counteracted by autonomically mediated actions; (2) in patients with moderate or severe bradycardia and an abnormal intrinsic heart rate, the drug can induce marked depression of sinus automaticity. PMID- 3678238 TI - Long-term follow-up in 54 patients after combined mitral and aortic valve replacement with the Lillehei-Kaster prosthesis. Overall results and prosthesis related complications. AB - A follow-up study was carried out in 54 patients after combined mitral and aortic valve replacement with the Lillehei-Kaster prosthesis. Twenty-two males and thirty-two females with a mean age of 54 years provided a total of 272 years of observation. The operative mortality was 16.7%. The long-term survival rates were 67% after 5 years and 55% after 8 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 incidents were the most frequent valve-related complications. The percentage of patients free from valve-related morbidity and mortality was 75% after 8 years. Valve related death accounted for 4% of all 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- 3678239 TI - Non-invasive assessment of end-systolic pressure-length and stress-shortening relationships in normal individuals: significance of different loading conditions induced by methoxamine and angiotensin II. AB - To evaluate whether the end-systolic pressure-dimension and stress-shortening relations are influenced by the drugs used for their assessment, we analysed the effects of angiotensin II (N = 30) and methoxamine (N = 10) in normal individuals. Serial measurements of left ventricular dimensions and wall thickness were performed by M-mode echocardiography; the end-systolic pressure was assessed by indirect, calibrated carotid pulse tracings. The end-diastolic dimension, which reflects preload, remained unchanged during the afterload challenge using angiotensin II, but increased significantly using methoxamine (P less than 0.001). Significant differences due to the agent used were observed for the end-systolic pressure-dimension relationship (P less than 0.002), the relation between end-systolic wall stress and fractional shortening (P less than 0.0002), and the relation between end-systolic wall stress and mean fibre shortening velocity (P less than 0.02). The extrapolated end-systolic dimension D0 at zero end-systolic pressure was significantly shifted to the left when using angiotensin II (P less than 0.02); this is considered to be due to its negligible effect on preload. Our data suggest that the assessment of the end-systolic pressure-dimension and stress-shortening relationships depends significantly on drug specific effects and the variation of preload during the afterload challenge. Based on these results, the use of angiotensin II is emphasized for the assessment of the end-systolic pressure-dimension and stress-shortening relationships. PMID- 3678240 TI - Evaluation of three methods for quantifying valvular regurgitation using gated equilibrium radionuclide ventriculography. AB - The non-invasive quantification of mitral and aortic regurgitation using the left to-right stroke count ratio (SCR) calculated with gated equilibrium radionuclide ventriculography (RNV), is affected by the overlap of atria and ventricles and the consequent difficult definition of the ventricular regions of interest (ROI). Various solutions of the problem have been proposed. In this study we evaluated the results obtained with a technique based on visual inspection of the RNV images (variable ROI method--VRI) and those of two approaches which utilize functional images (stroke volume image method--SVI--and Fourier amplitude ratio- FAR), by comparing them with the invasive quantification of valvular regurgitation according to Sandler et al. (stroke volume ratio--SVR). Forty patients (15 controls and 25 valvular patients) were studied. In the control group the range of the SVR was 0.81 +/- 1.11 (mean +/- 1 SD = 1.01 +/- 0.08). The SCR was 0.83-L28 (1.03 +/- 0.15) with VRI, 1.10-1.15 (1.30 +/- 0.14) with SVI and 1.11-1.58 (1.35 +/- 0.17) with FAR. The correlations between SVR and SCR were r = 0.47 (P less than 0.05), r = 0.62 (P less than 0.001) and r = 0.55 (P less than 0.01) respectively with VRI, SVI and FAR. The SCR of valvular patients fell in the range of controls in 11/25 using VRI, 6/25 using SVI and in 4/25 using FAR. This overlap was present in 2/25 with the invasive quantification. Irrespective of the method used, a reliable assessment of the valvular regurgitation was not possible in two patients with severely depressed left ventricular function. We conclude that the use of techniques based on functional images clearly improves the effectiveness of the non-invasive quantification of valvular regurgitation with the SCR even if this cannot be regarded as a substitute for invasive quantification and has a limited reliability in particular groups of patients. PMID- 3678241 TI - Impressive lung uptake during exercise thallium imaging with decrease of systolic blood pressure. AB - A case of very high thallium lung activity during exercise myocardial imaging in a patient with an old myocardial infarction but free from typical angina or heart failure symptoms is reported. The impressively abnormal lung uptake occurred in connection with a stress-induced fall in the systolic blood pressure, pointing out a causal role of a transient left ventricular dysfunction and interstitial pulmonary oedema in the genesis of the scintigraphic picture. Three weeks after the test, the patient suddenly died at home. PMID- 3678242 TI - Echocardiographically revealed collapse of the right ventricle and prolonged inversion of both atria without clinical cardiac tamponade. AB - In a patient with a large pericardial effusion without any clinical signs of cardiac tamponade, echocardiography revealed collapse of the right ventricle and prolonged (greater than 34%) inversion of the free wall of both atria, maximal in early systole. The presence of such findings in the absence of clinical signs of haemodynamic compromise is discussed. PMID- 3678243 TI - The usefulness of Doppler echocardiography in the management of rhabdomyoma diagnosed prenatally. AB - Cardiac rhabdomyoma diagnosed prenatally by cross-sectional echocardiography was confirmed after birth by Doppler echocardiography and cardiac catheterization in a baby with tuberous sclerosis. Doppler echocardiographic follow-up after 2 years revealed regression of tumour masses and concomitant disappearance of pulmonary regurgitation which was caused by the large tumour mass in the right ventricular outflow tract. In spite of a sizeable mass protruding into the left ventricular outflow tract, repeated Doppler examination failed to demonstrate any significant obstruction, thus avoiding repeated catheterizations and unnecessary surgery. Doppler examination of ventricular inflow revealed normal filling characteristics. Doppler and cross-sectional echocardiography was of great value in the management of this patient. PMID- 3678244 TI - Meeting of the European Society of Cardiology Working Group on Valvular Prostheses: Quantification of valvular regurgitations-- appraisal of new techniques. 11-12 October 1985, Namur, Belgium. Proceedings. PMID- 3678245 TI - Value of qualitative angiographic grading in aortic regurgitation. AB - The aim of this study was to assess the accuracy of angiographic grading of regurgitation in patients with aortic regurgitation (AR). In 204 adult patients (149 men, 55 women, aged 51 +/- 13 years) with AR, the forward cardiac index was measured by the indicator dilution technique, and the left ventricular angiographic index by the area length method, from which the regurgitant stroke index and the percentage of regurgitation were calculated. In 80 other patients without regurgitation, there was a good correlation between forward and angiographic cardiac indices (r = 0.83, P less than 0.001). Aortic regurgitation graded on a 1-4 scale was, in the 204 patients with AR, correlated with the percentage and the volume of regurgitation (respectively r = 0.87, P less than 0.001 and r = 0.92, P less than 0.001). The regurgitant stroke index and the percentage of regurgitation were significantly different from one group to another (P less than 0.001). However, there was a range in amount of regurgitation within each grade and an overlap from one grade to another. There were no differences in regurgitant stroke index or in the percentage of regurgitation when patients were categorized according to LV end-diastolic or endsystolic volume, LV ejection fraction, forward cardiac index or intracardiac pressure. PMID- 3678246 TI - Digital videodensitometric measurement of aortic regurgitation. AB - A videodensitometric method for quantification of aortic regurgitation which requires neither measurement of cardiac output nor determination of enddiastolic and endsystolic left ventricular volumes has been developed. The injection of 20 ml of contrast medium into the left ventricle is digitally recorded at 25 images s-1 during 20 s using an equipment for digital subtraction angiography (Digitron 2, Siemens). The Digitron computes 2 'time dilution curves' (TDC) from the unsubtracted image sequence, for 2 regions of interest drawn around the angiographic enddiastolic and endsystolic left ventricular silhouettes. Enddiastolic and endsystolic points of the TDC are then entered into a VAX-750 computer, which calculates the ejection fraction (EF), the forward ejection fraction (FEF) and the regurgitant fraction (RGF). This is performed by a complex fitting algorithm based on a physical model of the washout process of contrast medium, which reconstructs the two best enddiastolic and endsystolic baselines in the washout parts of the two TDC. The EF, FEF and RGF obtained in 9 regurgitant and 11 nonregurgitant patients have been compared with the corresponding values EFv, FEFv and RGFv obtained by a conventional technique (Cardiogreen and biplane LV area-length volumetry). Regression analysis yielded: EF = 0.88 X EFv (regression line forced through the origin), r = 0.77, FEF = 0.76 X FEFv + 3, r = 0.96, RGF = 0.94 X RGFv + 5, r = 0.98 (v stands for volumetry). PMID- 3678247 TI - Diagnosis and quantification of aortic regurgitation by pulsed Doppler echocardiography in patients with mitral valve disease. AB - To test the ability of pulsed Doppler echocardiography (PDE) to detect and quantify aortic regurgitation (AR), 55 consecutive patients (14-74 years) with aortic and mitral valve disease were examined clinically and by echocardiography before cardiac catheterisation. The severity of AR was determined angiographically (I-IV) and compared to the extent of the regurgitant jet in the left ventricle measured by PDE. In 13 of 55 patients (3 with mitral stenosis, 3 with mitral incompetence, 3 with combined mitral lesions, 3 with aortic stenosis, one with aortic and mitral stenosis) neither angiography nor PDE showed AR (specificity 100%). Apart from 3 patients with poor echo quality PDE correctly detected AR in 39 of 42 patients (sensitivity 93%). Clinical examination (62%), mode M.mode (62%) and both methods combined (81%) were significantly less sensitive than PDE, especially in mild AR (P less than 0.008). The PDE degree of AR closely correlated with angiography (corrected contingency coefficient 0.91). Differentiation between AR III and IV was not possible. Mitral valve disease did not affect quantification of AR (n = 20 patients). CONCLUSIONS: Pulsed Doppler echocardiography is better than auscultation and M-mode echocardiography in the diagnosis of aortic regurgitation, especially in grades I and II. PDE can reliably discriminate between three degrees of aortic regurgitation (I-III). Mitral valve disease does not affect quantification of aortic regurgitation by PDE. PMID- 3678248 TI - Quantification of mitral regurgitation by Doppler echocardiography. AB - The present study was undertaken to evaluate a new non-invasive approach to the quantification of mitral regurgitation. Doppler echocardiography and left ventriculography were performed in 20 patients without valvular heart disease (group A), and in 30 patients with pure mitral regurgitation (group B). Volumetric flows through the aortic and mitral valve orifices were determined by Doppler technique. The aortic flow (AF) was calculated as the product of the aortic orifice area by the systolic velocity integral. The mitral flow (MF) was computed as the product of the corrected mitral orifice area by the diastolic velocity integral. The mitral regurgitant fraction (RF) was calculated as: RF = 1 - AF/MF. In group A, there was a close agreement between aortic and mitral flows (r = 0.94, P less than 0.001), and there was no significant difference between the two measurements. In group B, the mitral flow was significantly higher than the aortic flow. The regurgitant fraction assessed by Doppler echocardiography correlated well with the grades of severity of regurgitation obtained at left ventriculography. We conclude that combined measurement of both aortic and mitral flows by Doppler echocardiography provides a new and promising approach to the noninvasive quantification of mitral regurgitation. PMID- 3678249 TI - Quantification of valvular regurgitation by cardiac blood pool scintigraphy: correlation with catheterization. AB - The diagnosis of valvular regurgitation (R) is usually based on clinical signs. Quantification conventionally requires catheterization (C). We have quantified R with cardiac blood pool scintigraphy (CBPS) and compared the results with those obtained by C. Regurgitant fraction (RF) determined by C was calculated with the technique of Dodge. Forward output was measured by thermodilution or cardiogreen dilution. The RF at CBPS was obtained by the stroke index ratio (SIR) minus 1.2 divided by SIR, where SIR is the ratio of the stroke counts of left ventricle over those of the right ventricle. Stroke counts are calculated directly from the time-activity curves. Each time-activity curve was obtained by drawing one region of interest around each diastolic image. The correction factor (1.2) was calculated from a large normal population. 22 patients had aortic R, 7 mitral R, 12 both, 8 patients had no evidence of regurgitation. RF of the patients with R varied from 27 to 71% (x = 42%) at C and from 26 to 74% (y = 41%) at CBPS. Linear regression shows a good correlation coefficient (r = 0.82). The regression equation is y = 0.93x + 1.8. No correlation was found between RF (CBPS or C) and the severity of R assessed visually from angiography. IN CONCLUSION: CBPS, a non invasive method, allows easy and repeatable determination of RF and correlates well with data obtained at catheterization. PMID- 3678250 TI - European Society of Cardiology Working Groups on Exercise, Physiology, Physiopathology and Electrocardiography and on Arrhythmias and Intracardiac Electrophysiology in the Evaluation of Antiarrhythmic Drugs. Symposium on exercise in the diagnosis and evaluation of treatment of arrhythmias. 17-19 April 1986, Athens. PMID- 3678251 TI - Use of diprafenone, a new potent propafenone-analogue, in acute experimental myocardial ischaemia and infarction. AB - Diprafenone (D) is a new class I c antiarrhythmic agent, structurally similar to propafenone. We assessed its antiarrhythmic and anti-fibrillatory effects during acute coronary occlusion and reperfusion and the underlying mechanisms of action by epicardial mapping of the conduction delay; also the effects of D on stimulus induced ventricular tachycardia 18-24 h after permanent coronary occlusion were assessed. Experiments were performed on 32 mongrel dogs with temporary coronary occlusion lasting 20 min and subsequent reperfusion. Control ligations in 16 animals were compared to ligations after pretreatment with D (2 mg kg-1) in 6 dogs. In another 10 dogs a permanent coronary occlusion was performed and the inducibility of ventricular tachycardia was assessed by programmed stimulation before and after D (2.4 mg kg-1). Following D the incidence of ventricular arrhythmias including rapid ventricular tachycardias was not reduced during acute coronary occlusion, but even enhanced in some animals, whereas the frequency of ventricular fibrillation was diminished. No significant difference was observed following reperfusion. Conduction delay in the ischaemic area increased significantly during both phase Ia and Ib following pretreatment with D. During reperfusion conduction delay was significantly prolonged in the D group. At 18-24 h after permanent coronary occlusion the new compound proved to be highly effective in suppressing stimulus-induced ventricular tachycardia. During acute coronary occlusion D diminished the incidence of ventricular fibrillation. D is similar to other class Ic compounds; however, there are some important differences with respect to its additional beta-sympatholytic activity. PMID- 3678252 TI - Comparative investigations on the antiarrhythmic and electrophysiological effects of various calcium antagonists (diltiazem, verapamil, gallopamil, nifedipine) following acute transient coronary artery occlusion and reperfusion. AB - The effects of various calcium antagonists on ventricular arrhythmias, particularly fibrillation (VF), in relation to epicardial conduction delay during acute myocardial ischaemia and reperfusion were investigated in 40 open-chest anaesthetized dogs. Acute transient coronary artery occlusion lasting 20 min was performed in all animals. Sixteen dogs served as controls; diltiazem (D) (0.5 mg kg-1 iv), verapamil (V) (0.25 mg kg-1 iv), gallopamil (G) (0.13 mg kg-1 iv) and nifedipine (N) (0.04 mg kg-1 iv) were given in six animals each 5 min prior to coronary occlusion. Epicardial conduction delay was assessed by means of an epicardial mapping electrode array consisting of 42 bipolar electrodes. In the control group, conduction delay showed a bimodal time course in the ischaemic area with a maximum of 38 +/- 10 ms 6 min after coronary occlusion followed by partial improvement. After pretreatment with D, V or G the peak in conduction delay as well as the maximum dispersion of conduction times in the ischaemic area were significantly diminished, whereas N failed to improve conduction in the ischaemic area. Correspondingly, ventricular arrhythmias and VF were almost completely suppressed by D, V or G, but not affected by N. Following release of coronary artery occlusion none of the compounds proved to influence the rapid and heterogeneous improvement of conduction immediately after the onset of reperfusion. Correspondingly, none of the drugs diminished the incidence of VF immediately after release. Delayed ventricular reperfusion arrhythmias, arising parallel to complete restoration of conduction, were significantly reduced by D, V and G but not affected by N. Delayed and inhomogeneous activation of the ischaemic myocardium plays an important role in the genesis of ventricular arrhythmias in the early stage of acute myocardial ischaemia; thus a reduction in conduction delay and dispersion of conduction times seems to be a precondition for antiarrhythmic action. The different effects of calcium antagonists type V and type N on ischaemia-induced conduction delay and ventricular arrhythmias can be assumed to result from differences in the electropharmacological properties of the compounds. PMID- 3678253 TI - Treatment of resistant ventricular tachycardia by endocavitary fulguration associated with anti-arrhythmic therapy. AB - Endocavitary fulgurations were practised in 26 cases of high risk ventricular tachycardia (VT) for which antiarrhythmics including amiodarone and class I antiarrhythmic agents given alone or in combination proved ineffectiveness. Permanent VT was present in nine patients at the time of the fulguration session: three were moribund, and two were unconscious. Included in the series were 10 cases of arrhythmogenic right ventricular dysplasia, nine patients had chronic VT several months after myocardial infarction, four had a non obstructive cardiomyopathy, two were idiopathic and one came after repair of the right ventricular outflow tract. Fulguration succeeded in preventing VT in the 22 patients who survived the initial period of treatment in association with therapeutic antiarrhythmics, in eight cases. Three of the four early deaths were probably related to imperfections in the technique. Two late deaths were due to spontaneous evolution of the disease. The follow-up period ranges from a minimum of 15 to a maximum of 34 months, with an average follow-up of nearly two years. The success rate of fulguration alone or for patients receiving prophylactic antiarrhythmic drugs is 90%. Ten patients required two sessions or more before VT was brought under control. PMID- 3678254 TI - Clinical use of automatic implantable defibrillators. AB - We implanted the automatic implantable defibrillator model B (AID-B) in 11 patients (pts). Seven pts had coronary disease with sustained VT, and/or VF. Two had syncopal VT due to primary cardiomyopathy, and two pts had syncopal torsades de pointes (Tdp) without cardiac disease (1 long QT syndrome). These arrhythmias occurred despite antiarrhythmic drugs or beta blockers. Four pts had implanted: an epicardial patch by thoracotomy, an intra-atrial string electrode by the jugular vein, then AID-B by abdominal route. In 7 pts, subcostal approach was used, for implanting simultaneously 2 epicardial patches and the AID-B itself. During the operation, VT, Tdp and/or VF were induced in all pts by 50 Hz alternating current. The defibrillation threshold (DT) between atrial catheter and epicardial patch was less than 15 J in 4 pts, and greater than 25 J in two, requiring a larger patch in 1, and replacement of atrial electrode by another patch in the 2nd pt to obtain a DT less than 20 J. In the 6 pts implanted with 2 patches, DT was always less than 25 J. In 3 pts, DT was markedly higher for VF (25 J) than for VT (less than 15 J). One pt died from pulmonary embolism, another died after 3 years, before replacement of a failing battery, and a third died from progressive congestive heart failure, 6 months later. Eight pts are alive with a follow-up greater than 6 months. Local aseptic reactions obliged a removal of the implant in 2 pts operated by bifocal approach, and none when the subcostal route was used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678255 TI - Pacemaker inhibition by myopotentials associated with motion and exercise. AB - The standard exercise tests are usually inadequate for revealing the nature of oversensing problems associated with skeletal muscle myopotentials. We used special exercises, designed to test the rectus abdominis (RA) and pectoralis major (PM) muscle groups specifically, in a study of a large number of paced patients. We examined a total of 252 paced patients, with or without symptoms and in steady pacing rhythm, for the occurrence of pacemaker inhibition (215 VVI, 15 VVI Activitrax and 22 DDD, from 9 different manufacturers). Inhibition was observed in 75 (34.9%) of the conventional VVI, in 4 (26.6%) of the VVI Activitrax and in 17 (77.3%) of the DDD paced patients. It was found that both the PM and RA were capable of causing inhibition alone in some cases, while in others a synergy of the two groups was required. It is clear that the RA must always be considered as a possible serious source of inhibiting myopotentials, irrespective of the location of the pacemaker. The most effective exercise for eliciting PM exertion was pulling the flexed arm towards the chest against resistance, while in the supine position. For RA exertion, the best exercise was raising the head and trunk from the supine position and holding the trunk at an angle of about 30 degrees to the horizontal. Both these exercises gave good, consistently reproducible results. PMID- 3678256 TI - Comparative study in exercise tolerance between VVI and activity-sensing rate responsive pacing. PMID- 3678257 TI - Arrhythmias in children: the influence of exercise and the role of exercise testing. PMID- 3678258 TI - Arrhythmias in athletes: comparison of stress test, 24 h Holter and Holter monitoring during the game in squash players. PMID- 3678259 TI - Relative value of exercise electrocardiography, long-term electrocardiographic monitoring and programmed electrical stimulation of the heart in the treatment of cardiac arrhythmias. AB - A long time ago, Senac (1683-1770) treated palpitations with quinine. Three centuries later Wenckebach rediscovered the value of quinine in atrial fibrillation and now gets the credit for it, at least in the American literature. Life has plenty of paradoxes; the history of the treatment of arrhythmias too. Pope Clement XI (1649-1721) has become known in history for his opposition to adapting Catholic rituals to Chinese habits. He will never be credited as the man, however, who supported the first 'epidemiological' study on sudden death. It was 1705 when he ordered Lancisi to study by autopsy the cause of any unexpected death among Roman nobles. The results were rather disappointing. We have come a long way since then. While good clinical judgement and common sense remain the most important tools in the treatment of cardiac arrhythmias, technicological progress has provided us with refined techniques for studying that problem. Among them, long-term electrocardiographic monitoring, exercise testing and programmed electrical stimulation of the heart. However, and as Zipes pointed out, we are far from perfection in the treatment of cardiac arrhythmias. Whether it was Senac or Wenckebach who first observed that quinine could change an irregular heart rhythm (atrial fibrillation) into a regular one (sinus rhythm), we are not far from their empiricism. However refined they may look, our present methods of diagnosis and treatment of arrhythmias are regrettably imperfect. These techniques have to be used carefully and rationally. Their present value and limitations will be outlined here. PMID- 3678260 TI - Ergometric evaluation of physical fitness of athletes affected by mitral valve prolapse: study of 80 cases. AB - Physical fitness of athletes affected by mitral valve prolapse (MVP) was examined, in order to evaluate the influence of sport activity on the natural history of the disease. Maximal workload, total workload, percentage efficiency (according to Hollmann's formula), double product of maximal cycloergometric stress test performed by 80 athletes (53 male, 27 female, mean age 23.8 yrs) with MVP were considered and compared with the same parameters obtained by 160 (120 male, 40 female) normal athletes (N) matched for age and weight. Moreover, the same ergometric data of two maximal exercise tests, performed by 30 subjects of the MVP group, a mean follow-up period of 2.5 years (range 1-6 years) were compared. No significant difference was found between MVP and N group ergometric data, except for double product, that was significantly lower in MVP group with respect to N group (P less than 0.001). Moreover, no difference was found between MVP with or without mitral regurgitation, and N. No difference was found between the first and the last ergometric test in the follow-up group. In conclusion, our results suggest that athletes with MVP have no reduction of physical fitness. Ergometric follow-up, almost in our cases, does not indicate a negative influence of physical activity on the natural history of the disease. PMID- 3678261 TI - Arrhythmias in sport. AB - The presence of arrhythmias in athletes is not infrequent. Bradyarrhythmias are more frequent in sportsmen than in the general population. This fact is often due to a 'relative vagal hypertony', owing to a training effect. Tachyarrhythmias are also present in sportsmen in almost the same percentage as in sedentary people. Any of several types of tachyarrhythmia can be seen. Abnormal heart conditions can be demonstrated in many athletes with symptomatic tachyarrhythmias. These arrhythmias frequently occur during exercise and in the early phase of recovery. An organic disorder was present in 26 of 32 athletes who were investigated with an exercise test, Holter monitoring and an electrophysiological test because of the presence of tachyarrhythmias. In six cases we were not able to find any cardiac disease. In 75% of these cases the arrhythmias had a strong relation with exercise. During follow-up (1-5 years; mean 2.88 years) some arrhythmias recurred in spite of medical treatment, in 12 of the 32 subjects, while the other 20 were free of symptoms and arrhythmias. In our opinion it is not possible to ascribe to sport, per se, the direct responsibility for these arrhythmias. PMID- 3678262 TI - Incidence and prognostic implications of repetitive ventricular complexes during pre-discharge bicycle ergometry after myocardial infarction. AB - The clinical significance of repetitive ventricular complexes (RVCs) during pre discharge bicycle ergometry after acute myocardial infarction has been assessed in 408 consecutive patients. RVCs occurred in 32 patients (8%). When compared to patients without RVCs, those with RVCs had a larger infarction, a higher prevalence of heart failure and late sustained ventricular tachycardia or fibrillation, a lower radionuclide ejection fraction and more frequent RVCs during pre-discharge 24-hour electrocardiographic monitoring. During a follow-up 30 patients died, 17 suddenly. Mortality was 15% (N = 5) in patients with RVCs during exercise test and 7% (N = 25) in those without RVCs. Sudden death occurred in only one patient with RVCs. When multivariate analysis was applied to clinical and exercise test data, RVCs during exercise did not predict cardiac mortality independent of variables related to left ventricular function, such as a history of previous myocardial infarction, persistence of heart failure in the late hospital phase and the extent of blood pressure rise during exercise test. PMID- 3678263 TI - Ventricular arrhythmias during exercise in patients with heart failure: the effect of amiodarone. AB - In a group of 62 patients with chronic heart failure 29% developed ventricular tachycardia during exercise testing. The two-year survival of this group was only 22%, compared to 55% in those not demonstrating ventricular tachycardia (P less than 0.01). In a double-blind cross-over study against placebo, with three-month treatment periods, amiodarone, in a dose of 200 mg day-1, was found effectively to suppress ventricular arrhythmias during exercise and in the immediate post exercise period. Exercise performance was not impaired. Amiodarone may be useful in preventing life-threatening arrhythmias in patients with heart failure. PMID- 3678264 TI - Rehabilitation: effect on exercise arrhythmias. PMID- 3678265 TI - New antiarrhythmic drugs: still looking for the ideal one. PMID- 3678266 TI - The efficacy of propafenone on exercise-induced ventricular arrhythmias. AB - We studied the efficacy of propafenone in 16 patients (pts) with exercise-induced ventricular arrhythmias (VA). Propafenone was given in doses of 450 mg (13 pts) to 900 mg (3 pts) per day and was compared with placebo. An arrhythmic index was calculated by dividing the frequency and severity of VA by the duration of exercise test (in min). Propafenone reduced that VA index from 17.05 +/- 16.32 to 3.75 +/- 7.47 (P less than 0.005). In 8 pts the VA were completely abolished, and in 8/10 grade greater than or equal to 3 VA, while no significant change was seen with placebo. In 8 pts in whom exercise had been prematurely terminated because of significant VA, a longer duration was achieved with propafenone (from 4.19 +/- 2.74 to 9.39 +/- 1.63, P less than 0.02). In those with the same pre-planned duration, a smaller peak heart rate was seen with propafenone. Resting P-R was significantly prolonged. PMID- 3678267 TI - Lipoproteins and atherosclerosis: current views, future trends. 17-18 October, 1986, Helsinki, Finland. PMID- 3678268 TI - Long term administration of lovastatin in the treatment of hypercholesterolaemia. AB - Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis, has been shown to be an effective hypocholesterolaemic agent when given in relatively short term studies to normal human subjects and patients with primary hypercholesterolaemia. The present report reviews the author's experience with lovastatin in the treatment of patients with hypercholesterolaemia (predominantly attributable to heterozygous familial hypercholesterolaemia) over a four year period. Lovastatin has been well tolerated and patients maintained on this drug as a single agent have shown sustained reductions in the plasma concentrations of total and low density lipoprotein cholesterol. The hypocholesterolaemic effects of lovastatin can be potentiated by combination therapy with other currently approved lipid lowering medications including bile acid sequestrants and nicotinic acid. Side effects have been uncommon and no consistent pattern of adverse effects of lovastatin has developed with more prolonged use. Lovastatin and related drugs represent a major advance in the therapy of hypercholesterolaemia. PMID- 3678269 TI - Paediatric guidelines for lipid reduction. AB - Due to the fact that atherogenesis starts even in early childhood there is no doubt that the primary prevention of atherosclerotic diseases is a paediatric problem and therefore must start as early as possible in childhood. Thus, there is now indeed strong support for increasing efforts toward identifying those subjects with elevated total cholesterol or low density lipoprotein (LDL) cholesterol levels and for providing appropriate treatment in order to achieve a substantial and pertinent reduction of those levels. Based on the data from the Lipid Research Clinics Program, the diagnosis of hypercholesterolaemia during infancy and childhood can easily be made, using the 95th percentiles for total cholesterol and for LDL-cholesterol. Today there is no doubt that elevated plasma cholesterol levels should be lowered first by dietary modification even in early childhood, beginning at the age of two years. Most authors report an average cholesterol reduction of about 10-15% by a low cholesterol-low fat diet. Our group had the opportunity to study 11 hypercholesterolaemic children consuming a type II diet containing 15-20 g soybean-protein, which resulted in a reduction of 32% in total cholesterol and 37% in LDL-cholesterol. In an individual patient who does not respond adequately to diet, drug treatment should be started. Bile acid binding resins in a dose of 4-8 g are the drugs of choice at this time. A further 15-20% reduction of total plasma cholesterol can be achieved in most children. It is concluded that detection and adequate treatment of disorders of lipoproteins should be carried out early in childhood, in particular in families with a cardiovascular history.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678270 TI - High frequency ventilation in the neonatal period. AB - There are three forms of high frequency ventilation, high frequency jet ventilation (HFJV, up to 400/min), high frequency oscillation (HFO, up to 40 Hz), and high frequency positive pressure ventilation (HFPPV, rates between 60 and 150/min). The first two forms of ventilation are still experimental and have been used only in critically ill children where respiratory failure has been unresponsive to more conventional therapy. Unfortunately, however, HFJV has already been associated with a high incidence of tracheal lesions. High-frequency positive pressure ventilation, on the other hand, using conventional ventilators, has been used and studied widely. Certain neonatal ventilators function suboptimally at increased rates, resulting in a reduction in tidal exchange with a consequent clinical deterioration. Using appropriate ventilators, arterial oxygen tensions improve and carbon dioxide tensions are reduced at fast rates in non-paralysed infants. Air-trapping, however, may be a problem in infants paralysed and ventilated at fast rates. HFPPV have been associated with a reduced incidence of pneumothoraces, but there is no knowledge of the effect of this form of ventilation on subsequent lung growth. PMID- 3678271 TI - Neurodevelopmental screening of in utero growth-retarded prematurely born children before school age. AB - As part of a prospective follow-up study of two premature cohorts (gestational age less than or equal to 36 weeks) born between 1976 and 1977, designed to evaluate the effects of IUGR on morbidity, mortality and neurological development in prematurely born children, 71 prematurely born children (48 AGA, 23 IUGR) without major neurological handicaps were subjected to detailed assessment of their neurological and psychological status at the age of 4 years. Thirty-six healthy full-term children formed a control group. The socioeconomic status of the families of the premature groups was similar to that of the families of the control group. The assessment consisted of a neurodevelopmental screening test and four psychological tests. Validation of the NDS test in relation to proven cognitive problems (sensitivity 96%, specificity 64%, relative risk 16.74) and determination of normal ranges were based on findings in the control group. There were significantly more children with moderate to high risk scores (greater than or equal to 10) among the IUGR group than among the AGA group. The neurodevelopmental profile of the preterm IUGR group was characterized by complex deviations of motor, visual and perceptual functions from normal. Preterm AGA children had only slightly higher risk scores in relation to fine motor, upper motor and perceptive functions than control children. Of the various perinatal factors studied, IUGR (especially in relation to boys who needed respirator therapy) was the most likely to be associated with abnormal NDS scores before school age. PMID- 3678272 TI - Diagnostic categories in infants referred for an acute event suggesting near-miss SIDS. AB - Among 857 infants admitted between 1977 and 1984 for a life-threatening apnoeic event a definite pathologic condition was found in 576 (66%). In 32 (6.5%) of the latter the polysomnogram was abnormal. The major clinical diagnostic categories were, with decreasing frequency: digestive (n = 263), vasovagal (n = 95), neurological (n = 78), respiratory obstructions (n = 33), and respiratory infections (n = 27); miscellaneous causes were found in 80 infants. No obvious cause could be traced in the remaining 281 infants. According to those caring for them the episode was severe in 77 (27%) of these infants, 57 (74%) of which had an abnormal polysomnogram, and minor in 204 (73%), 36 (18%) of which had an abnormal sleep study. Home monitoring was performed for 145 patients: all those with an abnormal polysomnogram and the 20 infants with an unexplained severe episode associated with a normal sleep study. We conclude from our experience that when an infant is referred for an acute event suggesting near-miss sudden infant death syndrome (SIDS), a large array of diagnoses can be found and that an electric monitoring device will ultimately be advocated for only 17% of all infants presented, but for all those with an unexplained severe episode, irrespective of the results of the sleep study. PMID- 3678273 TI - Quality of perinatal death registration. A study in Hainaut, Belgium. AB - The quality of national perinatal mortality statistics was evaluated from a survey in nine maternity hospitals in Hainaut, Belgium (total births: 7862). The overall completeness of perinatal death registration was 86%. Under-registration was especially frequent in low birth weight babies. In 69% of cases, the birth weight value reported on death certificates was in exact agreement with the value in hospital records. Using detailed categories of causes, there was, in 37% of cases, agreement between the underlying cause on death certificates and the main cause identified in hospital records. Using gross categories of causes, the level of agreement was 56%. Disagreement was mostly due to the lack of specificity of the underlying cause on death certificates. The authors suggest ways to improve the quality of registration. PMID- 3678275 TI - Adult height in thalassaemia major without hormonal treatment. AB - Height and sitting height were measured in all the 28 patients (19 females and 9 males) of our Thalassaemic Centre who exhibited evidence of cessation of growth. Their average final stature, which had been spontaneously achieved at an age ranging from 15.0-21.5 years (mean 17.9), was slightly lower with respect to the mean standards for women (159.1 +/- 8.4 vs 160.0 +/- 6.0 cm) and men (167.8 +/- 6.4 vs 172.5 +/- 6.0 cm). Height deficiency exceeded 2 SD scores in only 3/28 patients. If compared to the familial target height, patients' stature fell within the familial range in 19/24 cases and in only one case was it below the lower limit. In the whole sample the patients' height was positively related to their familial target height (r = 0.72, P less than 0.0002) and also to mid parental stature (r = 0.45, P less than 0.05). Heights of both females and males were superimposable on those of their own mothers and fathers respectively. Average values of either SH (76.4 +/- 3.8 vs 79.9 +/- 3.4 cm, 2 P less than 0.02) or SH/H ratio (48.9 +/- 2.5 vs 51.5 +/- 1.0, 2 P less than 0.005) were significantly lower in the female thalassaemics than in the sex-matched controls. Three females and one male showed subnormal values of both SH and SH/H ratio. Two out of these patients with eunochoid body proportions and another one with a decreased SH/H ratio have hypogonadotropic hypogonadism and are undergoing a chronic substitutive treatment with sexual hormones, which was instituted after the achievement of final stature. PMID- 3678274 TI - The value of determination of homovanillic and vanillylmandelic acids in plasma for the diagnosis and follow-up of neuroblastoma in children. AB - The plasma levels of homovanillic and vanillylmandelic acids were determined in 84 children with neuroblastoma prior to treatment to evaluate the usefulness of these parameters for the diagnosis of this disease. Elevated levels of one or both of these metabolites were observed in 50% of children with Stage I or II disease, in 88% of those with Stage III, in 93% of those with Stage IV and in 100% of children with Stage IV-S for a total of 88% of all patients. The clinical course of the disease can be followed readily by determination of these metabolites, successful therapy or surgery being accompanied by a corresponding decrease in the plasma levels and relapse by a corresponding increase. Determination of homovanillic and vanillylmandelic acids in plasma can obviate many of the problems associated with the collection of urine, especially in young children or ambulant patients, and thus facilitates a more frequent control with consequent advantages for the management of this disease. PMID- 3678276 TI - Psychosexual outcome of assigned females and males with 46,XX virilizing congenital adrenal hyperplasia. AB - Seven genotypic female (46,XX) patients with congenital adrenal hyperplasia, four reared as girls and three reared as boys were evaluated at 16-26 years of age with psychological interviews and testing. A small penis in the three young men produced a practical and psychological barrier that severely injured their personality. In spite of some degree of pre-adolescent tomboyism and a somewhat injured body image, the girls adjusted to their feminine gender identity. It is concluded that in cases of both early and late diagnosis, the genotypic female sex should be preferred. PMID- 3678277 TI - Gastro-oesophageal reflux in infants. Evaluation of treatment by pH monitoring. AB - Forty bottle-fed babies, 4-12 weeks old, with clinical gastro-oesophageal reflux were studied. Continuous 24 h oesophageal pH monitoring in a prone position demonstrated a gastro-oesophageal reflux with all of the following parameters: reflux index, duration of the longest reflux episode, number of reflux episodes in 24 h, number of reflux episodes greater than 5 min in 24 h. Positional therapy (prone-antitrendelenburg position), applied to all infants, resulted in a normalization of these parameters in ten of them. The remaining 30 infants were treated with milk-thickening agents, as recommended by Carre. Nearly all (N = 25) showed an important clinical improvement. A third pH monitoring was performed after 10-14 days of treatment. In six infants the results were completely within normal ranges. In 24 infants a decrease in the number of reflux episodes was demonstrated, with a comparable reflux index and number of long lasting reflux episodes. The duration of the longest reflux episode however increased significantly (P less than 0.001). Drugs (domperidone, Gaviscon) added to the milk-thickening agents in these 24 children, led to normalization of pH tracings. Clinical symptoms were less severe or disappeared in all infants but one. We conclude that if positional therapy (prone-antitrendelenburg) does not correct gastro-oesophageal reflux in infants, pharmacological treatment should be applied. Milk-thickening agents alone can be effective in individual cases but should be prescribed with care as they can lead to more occult gastro-oesophageal reflux with episodes of longer duration, increasing the risk of oesophagitis or respiratory distress. PMID- 3678278 TI - Application of a new test for vitamin E deficiency to cystic fibrosis. AB - Cystic fibrosis patients with pancreatic insufficiency are at risk for the development of vitamin E deficiency. We report here the outcome of screening 13 cystic fibrosis patients with conventional descriptive measures of vitamin E status and a new functional test. The results were compared with those from age appropriate controls. Nine patients were found to be vitamin E sufficient based upon normal plasma vitamin E levels, the ratio of plasma vitamin E to total plasma lipids, and normal levels of in vitro erythrocyte malondialdehyde formation, the new functional measure of vitamin E status. Four patients considered vitamin E deficient, based upon low plasma vitamin E levels and plasma vitamin E to total plasma lipid ratios, demonstrated increased erythrocyte malondialdehyde formation in vitro when compared to age-matched controls. Since limited reference data in children are available to define normal plasma vitamin E levels and plasma vitamin E to total plasma lipid ratios, we suggest that for cystic fibrosis patients the functional in vitro malondialdehyde formation test may be a better measure of vitamin E status than static plasma levels. PMID- 3678279 TI - Activity of blood coagulation factor XIII as a prognostic indicator in patients with Henoch-Schonlein purpura. Efficacy of factor XIII substitution. AB - Determination of coagulation Factor XIII (F XIII)-related parameters in 21 patients with Henoch-Schonlein purpura documented a significant decrease of F XIII activity as well as of the F XIII-related antigenic determinants. Subgroup analysis with regard to the clinical symptoms showed an even further decrease of these parameters in patients with gastrointestinal complications. Stimulated by these findings a substitution therapy with a F XIII concentrate was initiated in those patients whose F XIII activity in plasma remained low and who developed severe abdominal pain accompanied by persisting gastrointestinal bleeding. This therapeutic approach not only corrected the laboratory data, but more important led to a cessation of pain and bleeding. A rapid decrease of F XIII levels after transfusion below 40 U/ml was indicative of relapse of abdominal symptoms, while increasing values were associated with the recovery of the patients. IN CONCLUSION: F XIII activity determinations appear to have a predictive value in patients with Henoch-Schonlein purpura, and the administration of F XIII concentrates may contribute to the improvement of gastrointestinal complications. PMID- 3678280 TI - Intravenous gamma globulin therapy for thrombocytopenic purpura associated with active varicella infection. AB - Thrombocypenic purpura was noted in a 3-year-old Japanese girl with an active varicella infection. The administration of intravenous gamma globulin (IVG) drastically improved bleeding manifestations as well as the active varicella infection. We believe that IVG should be the first choice of therapy for thrombocytopenic purpura associated with active infections. PMID- 3678281 TI - Congenital microcephaly, infantile spasms, psychomotor retardation, and nephrotic syndrome in two sibs. AB - Two boys are described with congenital microcephaly, infantile spasms, psychomotor retardation and an early-onset nephrotic syndrome. The autopsy findings of one patient are described in detail. Polymicrogyria was the most prominent feature and the kidneys showed focal segmental glomerulosclerosis. These findings have been described as a clinical entity, the leading symptoms being congenital microcephaly, early-onset nephrotic syndrome and mental retardation, accompanied by various other clinical symptoms. A review of the literature suggests an autosomal recessive mode of inheritance. PMID- 3678282 TI - Lacrimo-auriculo-dento-digital (LADD) syndrome. PMID- 3678283 TI - Childhood plumbism due to lead paint in Belgium. PMID- 3678284 TI - Combined therapy with acyclovir and adenosine arabinoside in herpes simplex encephalitis. AB - We report a case of herpes simplex encephalitis (HSE) with initial coma and severe left-sided hemiparesis in which combined treatment with adenine arabinoside and acyclovir was followed by complete recovery. This favorable result is discussed in view of the literature of HSE treatment including experimental studies on antiviral activity of both drugs. Combined treatment may be useful in severe cases of HSE. PMID- 3678285 TI - Hereditary multi-infarct dementia. AB - This paper summarizes the clinical and genetic features of a disease occurring in 16 patients from the same extended family, which resembles the multi-infarct dementia described by Sourander and Walinder [Acta neuropath. 39: 247-254, 1977]. This family has relapsing strokes with neuropsychiatric symptoms, and they affect relatively young adult individuals of both sexes. The entity of the disease is characterized by autosomal dominant transmission with late onset and by association with occlusive cerebrovascular infarcts in the white matter, which was also generally reduced. Both of these features can be seen in the CT scan. In 13 members of this family the diagnosis can be regarded as certain and in a further 3 cases as more or less probable. PMID- 3678286 TI - Falling spells in normal pressure hydrocephalus: a favourable prognostic sign? AB - Two patients with idiopathic normal pressure hydrocephalus are described suffering from so called 'falling spells'. Both patients showed marked improvement after ventriculoatrial shunting, and the falling spells ceased. The literature concerning falling spells is reviewed. The possible pathogenesis and the relationship to shunting are discussed. PMID- 3678287 TI - Unilateral pseudobulbar syndrome with limited capsulothalamic infarction. AB - A unilateral pseudobulbar syndrome consequent to unilateral capsulothalamic infarction is described. Motor deficit of the face was associated with marked velar and pharyngeal unilateral palsy; paresis of limbs was mild. ACT scan revealed a circumscribed infarction of the genu of the internal capsule. This raised the problem of unilateral supranuclear pharyngeal palsies and of the precise anatomy of the genicular tract in the genu of the internal capsule. PMID- 3678288 TI - Electrocutaneous reflexes in upper limbs--reliability and normal values in adults. AB - The present study provides information as to both the range of normality and reliability of the electrocutaneous reflex (ECR) in upper limbs as a routine diagnostic procedure. Measurements were performed on 70 adult volunteers under optimized and standardized conditions. The mean latency was 40.3 +/- 3.2, 50.9 +/ 3.5 and 65.8 +/- 5.8 ms for E1, I1 and E2, respectively, and 21.9 +/- 1.6 ms for N22 of the cortical somatosensory-evoked potentials as recorded under identical stimulus conditions. Arm length represented the most important factor of interindividual variability while age was of minor and sex of no importance after normalization of the latencies for arm length. PMID- 3678289 TI - Are complex partial seizures an uncommon withdrawal sign in the elderly? AB - An elderly female alcohol and benzodiazepine addict presented with an atypical amnestic episode. Five days later she showed several complex partial seizures as main signs of a withdrawal state. The value of the EEG in the differential diagnosis of amnestic syndromes is emphasized. Temporolimbic involvement in withdrawal states is discussed and our ignorance regarding drug dependence and withdrawal in the elderly is stressed. It is suggested that late-onset partial seizures with unknown etiology in the elderly might be more often related to drug dependence than generally accepted. PMID- 3678291 TI - Pattern reversal visual evoked potentials (white-black- and colour-black-PVEPs) in the study of eye dominance. AB - We investigated the influence of eye dominance scaled by 6 tests on the parameters (N80, P100 latency and N80-P100 amplitude) of the white-black-, green black-, red-black- and blue-black-pattern visual evoked potentials (PVEPs) of 40 healthy subjects (20 males and 20 females) with normal visual acuity. The P100 latency of the white-black PVEPs was, for both sexes, shorter (P less than or equal to 0.001) in the PVEPs of the dominant eyes. This P100 latency shortening could also be verified for both right dominant and left dominant eyes with no significant difference between them. A consistent relationship, however, between the different degrees of eye dominance and the P100 latency shortening could not be established. In contrast to the P100 latency findings the N80 latencies of the white-black-PVEPs and the N80-P100 amplitudes did not show any significant differences with respect to eye dominance. Furthermore, the colour-black PVEPs did not present any differences of latency and amplitude depending on eye dominance. Thus our results give further electrophysiological evidence for eye dominance as a lateralized CNS phenomenon that is not influenced by colour. PMID- 3678290 TI - Quantitative analysis of the effects of slow wave sleep deprivation during the first 3 h of sleep on subsequent EEG power density. AB - The relation between EEG power density during slow wave sleep (SWS) deprivation and power density during subsequent sleep was investigated. Nine young male adults slept in the laboratory for 3 consecutive nights. Spectral analysis of the EEG on the 2nd (baseline) night revealed an exponential decline in mean EEG power density (0.25-15.0 Hz) over successive nonrapid eye movement--rapid eye movement sleep cycles. During the first 3 h of the 3rd night the subjects were deprived of SWS by means of acoustic stimuli, which did not induce wakefulness. During SWS deprivation an attenuation of EEG power densities was observed in the delta frequencies, as well as in the theta band. In the hours of sleep following SWS deprivation both the power densities in the frequency range from 1 to 7 Hz and the amount of SWS were enhanced, relative to the same period of the baseline night. Both the amount of EEG energy accumulating subsequent to SWS deprivation and its time course could be predicted accurately from the EEG energy deficit caused by SWS deprivation. The data show that the level of integral EEG power density during a certain period after sleep onset depends on the amount of EEG energy accumulated during the preceding sleep rather than on the time elapsed since sleep onset. In terms of the two-process model of sleep regulation (Borbely 1982; Daan et al. 1984) this finding indicates that EEG power density reflects the rate of decay of the regulating variable, S, rather than S itself, as was originally postulated. PMID- 3678292 TI - Abnormal seasonality of schizophrenic births. A specific finding? AB - The unusual finding of an abnormal seasonal distribution of schizophrenic births, showing an excess of 10% in the winter or spring months and an equal deficit in the summer or autumn months, cannot be explained by artefacts. It has not yet been established whether the finding is specific to schizophrenia. We observed an excess of schizophrenic births of some 10% in March to May, significant at the 5% level, and a deficit of approximately the same size in June to August on the birth data of first-admission patients with the clinical diagnosis of schizophrenia. The data, obtained from the Mannheim Psychiatric Case Register, were compared with those of the Mannheim population and a control group matched by birth year and sex. The total population of mentally retarded children aged 7 to 16 years from the Mannheim population showed an excess of some 20% in April to June and an equal deficit in the last two quarters of the year, compared with the Mannheim population of the same birth years. The finding was not significant, but allowance must be made for the low case number of 415. We also compared 3409 first-admission patients with depressive syndromes (ICD 296 and 300.4) and 5615 first-admission patients with the diagnosis of "neurosis and personality disorders" (ICD 300-302, except 300.4, and 305-309) from the Mannheim Case Register with a control population and a parallel control group. Depressed males showed an excess of births in March to May, which was significant at the 1% level; the birth peak for females was smaller and not significant. The same findings were obtained for the category of neurosis and personality disorders, i.e. an excess of about 10% in March to May for males, significant at the 1% level, and a non-significant excess for females. Our findings are awaiting replication. Causal explanations will be discussed with great reservation. The procreational hypothesis, assuming those factors that lead to an equidirectional seasonal pattern of births with a slight deviation from the average of a year in the general population, to be reinforced in the disease categories mentioned, is regarded as the most simple and plausible explanation. It is based on the assumption that some of the parents of individuals suffering from schizophrenia, mental retardation or probably also some other mental disorders running from generation to generation, have a higher threshold in partner-seeking behaviour, which is overcome more easily in the summer months with the consequence of increased pregnancies. PMID- 3678293 TI - Neurotic depression: a diagnosis based on preexisting characteristics. AB - A neurotic depression is a depression in an emotionally unstable person. Secondary depressions to major personality disorders, neuroses, and drug use disorders fit the above definition. Likewise, primary depressions with a family history of alcohol (depression spectrum disease) are characterized by a long history of stormy life problems and, therefore, would fit the definition. Using these two preexisting characteristics, we examined a group of 401 neurotic depressives and compared them to 536 nonneurotic (endogenous) depressives. The neurotic depressives were younger and the neurotic patients had made more previous suicide attempts. They were less likely to show memory deficits or delusions and less likely to show symptom criteria of melancholia. They were more likely to have suicide thoughts at index. Treatment was more effective in the nonneurotic patients and such patients made fewer suicide attempts in follow-up. These differences confirm the validity of the distinction between neurotic and nonneurotic depression. PMID- 3678294 TI - Prediction of therapeutic response in acute treatment with antidepressants. Results of an empirical study involving 159 endogenous depressive inpatients. AB - A study was carried out involving 159 endogenous depressive inpatients treated with antidepressants. Using standardized rating instruments, a large set of potential predictor variables was tested. After cross-validation according to the split-half technique, only very few of these proved to be suitable as predictors for the main outcome criteria. These predictors included premorbid maladjustment, neurotic traits of premorbid personality, intensity of depressive-apathetic symptoms at admission, and the self-evaluated mood assessment score 3 weeks after commencement of treatment. This last criterion demonstrated the highest predictive value. Several predictors known from the literature could not be reproduced in this study. PMID- 3678296 TI - Supervision of mental health care in The Netherlands. AB - In the Netherlands the Inspectorate of Mental Health has to supervise the quality of mental health care that is given to its citizens. A shortage of inspectors hampers effective accomplishment of this task, and government budget cuts have increased this problem. Another obstacle is the absence of standardized methods of supervision and clear norms for medical practice. This paper describes the efforts of the Inspectorate to develop a new technique of supervision to solve this problem, the so-called frames of reference. PMID- 3678295 TI - Somatosensory evoked potentials following median and tibial nerve stimulation in patients with Friedreich's ataxia. AB - The changes in evoked potentials following median and tibial nerve stimulation in nine patients with clinically defined Friedreich's ataxia are reported and discussed. The response originating in the brachial plexus (Erb's point potential) was absent or reduced in amplitude with no prolongation of peak latency, and the response generated in the cauda equina (N18) was absent in all cases. Conduction time from the brachial plexus to cervical spine and medulla oblongata was normal, whereas the central conduction time (N13a/N20, N13b/N20) was delayed. There was moderate to marked attenuation of the primary cortical response to median nerve stimulation. In one patient N20 disappeared during the course of the disease as opposed to the persisting subsequent negative wave, the latter thus simulating a very marked delay in the primary cortical response. Accordingly the cortical response to tibial nerve stimulation, which was only present in two patients and was markedly delayed, might represent a later potential with the primary response absent. The findings are consistent with neuropathological descriptions of a dying back neuropathy with primary axonal degeneration concerning the 1st order sensory neuron. In addition there is evidence either of delayed conduction in 2nd and 3rd order sensory neurones or of abnormal synaptic transmission. PMID- 3678297 TI - Intellectual function in muscular dystrophies. AB - Intellectual function was studied in 28 boys with Duchenne dystrophy, 12 patients with facioscapulohumeral-type and 10 patients with limb-girdle-type muscular dystrophy. A definite relationship between intelligence level and the type of muscle disease was found. The more severe the genetic damage manifested by the rapidity of progression of muscular dystrophy the more definite the affection of the CNS manifesting as mental deficit. The factors influencing the level and structure of intelligence seem to exert their effect before the manifestation of muscle lesions. PMID- 3678298 TI - Elective treatment of ureteral stones with extracorporeal shock wave lithotripsy. AB - Extracorporeal shock wave lithotripsy was used as an elective treatment in 128 ureteral stones. Of the 108 with adequate follow-up, 88% were successfully disintegrated. Ureteral catheters proved to be particularly useful for more precise stone localization and as a mechanical means to push the calculi inside the renal cavities or to create a fluid interface around them, in order to increase the efficiency of the shock waves. When ureteral catheters were used a success rate of 95.5% was observed, as opposed to 82.8% when stents were not used (p less than 0.05). PMID- 3678299 TI - Diagnosis of urothelial tumor by ureterorenoscopy. AB - In the past, radiologically detected filling defects in the upper urinary tract were correctly interpretable only by means of cytological techniques. The introduction of ureterorenoscopy has provided a reliable method for the detection of tumors in the ureter and renal pelvis. In contrast to transurethral ureterolithotripsy, diagnostic ureterorenoscopy entails few complications. It thus fills a diagnostic gap and facilitates therapeutic planning. A report is presented on 15 patients with obscure hematuria, or unclear filling defects in the upper urinary tract. In 10 patients, the unequivocal diagnosis of urothelial carcinoma was endoscopically and bioptically established by ureterorenoscopy. Small nonradiopaque concrements were found in 3 cases. The origin of hemorrhage could not be determined in 2 patients. PMID- 3678300 TI - Treatment of invasive grade 3 transitional cell bladder cancer. A retrospective study of 10 years' experience with external irradiation, and preoperative irradiation and cystectomy. AB - Three hundred and seventy-four patients with invasive grade 3 bladder cancer treated with either external irradiation or preoperative irradiation and cystectomy were re-evaluated. Cancer-free survival was markedly better for patients who underwent preoperative irradiation and operation than irradiation only, even if a complete clinical response had occurred initially. PMID- 3678301 TI - Prognosis of bladder cancer. II. The fate of patients with T1b transitional cell bladder cancer. AB - We have reviewed the tumor progress in 46 patients who presented T1b lesions in a previous study on the prognosis of superficial bladder cancer. A group of 12 patients with single or very few localizations was treated by transurethral resection. Five patients progressed and were submitted to cystectomy. Two of these 5 patients died within 3 years of the surgical treatment. Twenty-seven patients with multiple lesions underwent cystectomy soon after the initial diagnosis. Nearly 30% experienced progression; 4 patients died within 4 years after cystectomy. A delayed cystectomy was performed in 7 patients with multifocal disease; in all but one the tumor progressed; 5 patients died between 7 and 28 months after the surgery. PMID- 3678302 TI - The role of chemotherapy in the treatment of penile metastases from carcinoma of the bladder. AB - Four cases of metastasis to the penis from transitional cell carcinoma (TCC) of the bladder are reported, with special regard to the improved prognosis using combination chemotherapy. The possible routes of tumour spread are discussed. PMID- 3678304 TI - Histological classification of spermatic cord cysts in relation to their histogenesis. AB - Light microscopy study of spermatic cord cysts in 26 men revealed three different histological patterns. First, cysts of probable mesothelial origin (14 cases) with an unilocular aspect: their epithelial cells showed poor cohesion and often appeared sloughed; subepithelial hyalinization or fibrin deposits were frequent. Second, cysts of probable embryonal (mesonephric) origin (8 cases): they were usually multilocular cysts and their epithelial cells showed great cohesion: zones of ciliated columnar epithelium associated with embryonal remnants displaying a similar epithelium were often found; the embryonal remnants and the cyst lumen contained spermatozoa in 2 cases. Third, cysts of doubtful origin (4 cases) showing abundant inflammatory infiltrates, which had destroyed the epithelium; the unilocular pattern observed in 3 cases suggests a mesothelial origin for these cysts, while the multilocular pattern and presence of embryonal remnants in the other case suggest an embryonal origin. PMID- 3678303 TI - Idiopathic retroperitoneal fibrosis: a long-term follow-up study. AB - Eleven patients (8 male) with idiopathic retroperitoneal fibrosis (IRPF) were reviewed. The mean age of the patients was 44 years. Five patients (group 1) who had moderate obstruction were treated only by steroids. Six patients (group 2) who presented with severe obstructive uropathy (and/or serious metabolic disturbances) were treated with a combination of surgery and steroid administration. Unilateral or bilateral ureterolysis was performed in 5 patients. It was associated with nephrostomy in 2 cases and intraperitoneal disposition of the ureters in 1 case. Left nephrostomy without ureterolysis was performed in 1 patient. The mean follow-up period was 5.5 years (5 months to 20 years). All patients of group 1 now have normal renal function. In 5 patients of group 2, renal function improved significantly after operation; one of them was started on regular dialysis 16 years later. In another patient, IRPF recurred in the ureter of a living related renal graft 6 months after transplantation. In conclusion, steroid treatment alone offers a long-term survival in patients with IRPF of moderate severity. Combined treatment must be recommended for patients who present with severe obstruction and advanced uremia. PMID- 3678305 TI - Effect of testicular torsion on the contralateral testis and prevention of this effect by prednisolone. AB - This study was instituted to evaluate the effect of unilateral testicular torsion on contralateral testicular histology and the prevention of this effect by prednisolone. Fifty Swiss albino rats were equally divided into 5 groups. In group 1, it was observed that, due to torsion, the mean seminiferous tubular diameter and percentage of spermatogenetic activity of the contralateral testes were reduced and an inflammatory reaction was also noted. In group 2, detorsion increased the above-mentioned damage, and in group 3, orchiectomy failed to prevent it. In group 4, it was seen that prednisolone slightly increased the mean percentage of spermatogenetic activity and produced proliferation of the Leydig cells in the intact testicle. In group 5, when prednisolone was injected just after torsion, no damage to the contralateral testes appeared. It has been thought that damage to the contralateral testes may arise from an autoimmune mechanism and prednisolone appeared to be very helpful in preventing damage by immunologic suppression. PMID- 3678306 TI - Transurethral resection of the ureteral meatus invaded by carcinoma of the prostate: a new approach. AB - We present herewith our surgical procedure for the management of bilateral hydronephrosis and renal failure due to distal ureter infiltration by cancer of the prostate: transurethral resection of the ureteral meatus and intramural ureter or even extravesical ureter invaded by the carcinoma and placement of a double J catheter. We have performed this technique in 3 patients with good results. PMID- 3678307 TI - Rokitansky's syndrome in association with reno-ureteral abnormalities. Teratogenic period. AB - A case of Rokitansky's syndrome in association with complete duplication of the right upper urinary tract is presented. From a chronological point of view, the morphogenetic processes of the urinary and genital tract are analyzed. It is supposed that the congenital abnormality is produced between the 30th and 37th day of gestation, because reno-ureteral duplication appears at 30-32 days and involution of the Mullerian structures appears at 37 days. PMID- 3678308 TI - Endourologic approach of ureteral gunshot lesion. AB - We report a case which demonstrates that to approach an ureteral gunshot lesion endourologically may be an alternative to surgical intervention. We believe that drainage of a damaged ureter should, in selected cases, constitute the first option. This procedure often is successful, but may not be feasible in all cases. We do not believe that simple catheter drainage should replace standard surgical procedures. However, it presents a less invasive treatment alternative which still adheres to conventional surgical principles if a proper patient selection is made. PMID- 3678309 TI - Still less extensive surgery for breast cancer. PMID- 3678310 TI - Blood transfusions for surgical cancer patients: more harm than good? PMID- 3678311 TI - A pathologist's view on how diagnostic material should be obtained. PMID- 3678312 TI - Epidemiologic patterns in lung cancer by histologic type. AB - Three thousand and ninety-seven lung cancer patients interviewed in different U.S. hospitals in 1977-1984 were classified into Kreyberg I and Kreyberg II categories. In both sexes, Kreyberg II patients were found to be younger and more frequently Jewish; among the male patients only, Kreyberg II cases were higher in educational and occupational level. These differences remained when the effect of cigarette smoking was controlled. Study data showed an increase in the frequency of Kreyberg II cases over time, and significantly, a decrease with younger age of the Kreyberg I:Kreyberg II ratio in both sexes. It is concluded that the observed secular increase in Kreyberg II is real and not merely due to changes in diagnostic methodology. On the basis of demographic differences noted, possible etiologic factors that may have contributed to the recent changes in lung cancer distribution by cell type are suggested. PMID- 3678313 TI - The prognostic significance of proliferative activity in poor histology non Hodgkin's lymphoma: a flow cytometry study using archival material. AB - The DNA content and proliferative activity of paraffin-embedded lymph node tissue from 111 patients with poor histology non-Hodgkin's lymphoma were measured by flow cytometry. These patients had been entered into a prospective randomized trial which, to date, has shown no survival difference by treatment arm. Forty four (40%) samples showed evidence of aneuploidy with three samples having more than one aneuploid population. The aneuploid populations had a bimodal distribution with one group having a DNA index between 1.1-1.3 and the other 1.8 2.2. The incidence of aneuploidy did not correlate with age, stage or survival. In 56 diploid samples the S phase values below 10% had a significantly better survival than those with S phase values above 10% (P less than 0.011). For patients with diffuse large cell histology the corresponding discriminatory S phase value was 19% (P less than 0.009). PMID- 3678314 TI - Estramustine binding site in human breast cancer biopsy samples. Its relation to estrogen and progesterone receptor levels, age and menopausal status. AB - Estramustine is a cytotoxic metabolite of estramustine phosphate (Estracyt), which is used in the treatment of prostatic carcinoma. An estramustine binding site (EMBS) at pH 4.8-4.9 was demonstrated in 74 of 306 (24%) breast cancer biopsy samples using isoelectric focusing in polyacrylamide gels. The presence of EMBS was significantly (P less than 0.001) correlated with negative or low estrogen and progesterone receptor values. EMBS positivity was found in 31% of the samples from pre- and perimenopausal patients and in 22% of the samples from postmenopausals. If patients were instead divided into different age groups, EMBS positivity was most frequent in samples from patients between 50 and 59 years of age (42%). With increasing age the percentage of EMBS positivity fell successively. For patients under 50 years, no difference with respect to EMBS positivity between age groups could be demonstrated. The possible value of EMBS determinations in breast cancer tissue specimens for the selection of those patients that will respond to Estracyt therapy should be evaluated. PMID- 3678315 TI - 1-Hexylcarbamoyl-5-fluorouracil is more cytostatic than 5-fluorouracil against human tumors in vitro. AB - The sensitivity of HeLa cells and 15 human tumors, including eight gastric cancers, five colorectal cancers and two lung cancers to 1-hexylcarbamoyl-5 fluorouracil (HCFU) was compared with that to 5-fluorouracil (5-FU) in vitro. HeLa cells were doubly sensitive to HCFU, as compared to 5-FU. After the HeLa cells had been treated with 5-FU or HCFU at 77 microM for 1-5 h, the intracellular levels of 5-FU and HCFU were determined, using gas chromatographic mass spectrometric methods. The level of HCFU plus 5-FU in the HCFU-treated cells was twice as high as the level of 5-FU in the 5-FU-treated cells. The sensitivity to HCFU in 15 tumor tissues varied with the tissue; however, all tissues tested were more sensitive to HCFU than to 5-FU, assessed using the succinate dehydrogenase inhibition test. These results suggest that the hexylcarbamoyl structure facilitates the rapid uptake of HCFU through the cell membrane. HCFU may prove to be more effective for treating each individual patient with a malignant lesion. PMID- 3678316 TI - Antiproliferative properties of flavone acetic acid (NSC 347512) (LM 975), a new anticancer agent. AB - The antiproliferative activity of flavone acetic acid (LM 975) was investigated on human adenocarcinoma cell lines (HCC-P2998, HCC-M1544, HCC-M1410, HT 29, LoVo), on a murine colon adenocarcinoma cell line (Colon 26), on murine pancreatic adenocarcinoma cells growing in primary culture (Pan 03) and on human normal fibroblasts (N1). No cytotoxic effects were found against human normal fibroblasts. LM 975 was active against murine adenocarcinoma Pan 03 and Colon 26, known to be sensitive in vivo too and, to variable extents, on human adenocarcinoma cell lines. LM 975 in vitro cytotoxic potency was relatively low. The high concentrations (1.0-1.4 mM) required to obtain a cytotoxic effect are, however, pharmacologically reasonable since they are comparable with drug plasma levels in mice or in patients treated with tolerable doses. After a relatively short LM 975 treatment (2 h) DNA, RNA and protein synthesis were inhibited in different proportions. In more sensitive cells LM 975 appeared to inhibit RNA synthesis more than DNA and protein synthesis. Inhibition of macromolecule synthesis after 2 h exposure was completely reversed in 24 h recovery. After 2 h treatment no detectable DNA breakage was found by the alkaline elution method, thus corroborating the idea that this compound does not act by causing DNA damage. PMID- 3678317 TI - Enhanced growth of artificial tumor metastases following blood transfusion: the effect of erythrocytes, leukocytes and plasma transfusion. AB - Clinical and experimental investigations have shown that allogeneic blood transfusions may modulate the growth of tumors. Dependent on the tumor model used in animal studies, the effects observed ranged from inhibition to stimulation of tumor growth. We have demonstrated previously that allogeneic blood transfusions gave rise to enhanced growth of a transplantable sarcoma (LS 175) in BN rats. In the experiments reported here the effect of transfusion of different allogeneic blood constituents on the growth of artificial LS 175 lung metastases was investigated. Erythrocytes and leukocytes were found to promote tumor growth to a similar degree as whole blood transfusions, plasma transfusions had no effect. PMID- 3678318 TI - The relationship between blood prolactin levels and risk of breast cancer in premenopausal women. AB - Single specimens of blood have been taken from over 5000 normal volunteer women in each of two sequential (1967-1976, 1977-1984) population-based studied on the Island of Guernsey. Multivariate analysis was used to determine the relationship between prolactin levels and risk factors in breast cancer in 2591 and 1959 premenopausal women in whom blood prolactin had been measured. In both populations the prolactin concentrations appeared to be log-normally distributed and therefore all analyses have been done on log-transformed data. Initially the variables in the statistical model were age at menarche, ages at first and last baby, parity, ponderosity (Quetelet Index), mammographic pattern (as graded by Wolfe), family history of breast cancer, age, menstrual cycle status, time of day of blood sampling, oral contraceptive use, history of breast feeding and methodological changes in the laboratory measurement of prolactin. Of these variables age at menarche, ages at first and last child and family history of breast cancer were found not to be significant and were excluded from the final model. The main finding to emerge was that after standardizing for all the other variables, prolactin levels in the follicular phase were significantly lower than those found at midcycle or during the luteal phase of the menstrual cycle. A peak level of prolactin was found at day 12 of the cycle. Increasing parity was related to a steady decrease in prolactin concentration. Increasing ponderosity was associated with an increased prolactin level as was a DY compared to an N1 mammographic pattern. Women with a history of oral contraceptive use had lowered prolactin concentration. All these effects occurred evenly over the menstrual cycle and were generally found for both data sets. Thus body weight, parity and, indirectly, age at first baby might influence breast cancer risk by being associated with changes in blood prolactin concentration. PMID- 3678319 TI - Effects of glycyrrhizin and glycyrrhetinic acid on growth and melanogenesis in cultured B16 melanoma cells. AB - The effects of glycyrrhizin (GL) and its aglycone, glycyrrhetinic acid (GA), on the growth and differentiation of mouse melanoma (B16) cells in culture were studied. GA inhibits the growth of B16 melanoma cells, causes morphological alterations and stimulates melanogenesis. GL also resulted in the same changes but only when the concentration was about 20 times more than that needed for GA. When GA was removed after 84 h of treatment, the growth rate recovered slightly, but the doubling time was about twice that of the control. Cytofluorometric analysis showed that the growth inhibition of GA is the result of inhibition of the transfer from G1 to S phase. PMID- 3678320 TI - Priming: theory or fact? PMID- 3678321 TI - The pyrimido-pyrimidine derivatives RA 233 and RX-RA 85 affect growth and cytoskeletal organization of rat mammary adenocarcinoma cells. AB - The pyrimido-pyrimidine derivatives RA 233 and RX-RA 85, which are potent inhibitors of platelet and tumor phosphodiesterase, were developed as antitumor agents. When tested by us, these drugs were cytostatic at low concentrations and produced dramatic changes in cell shape and organization of cytoskeletal structures in cultured MTF7 cells derived from the rat 13762NF mammary adenocarcinoma. At high concentrations (up to 600 micrograms/ml) RA 233 was cytostatic but not cytotoxic to MTF7 cells during a 24 hr incubation in vitro, whereas RX-RA 85 was cytotoxic at concentrations above 4 micrograms/ml. These drugs caused MTF7 cells to elongate and form numerous vacuoles, which surrounded the cell nucleus. Treatment of MTF7 cells with RA 233 or RX-RA 85 enhanced microtubular organization concomitant with a decrease in microfilament organization. In contrast, treatment of MTF7 cells with 1 mM dibutyryl cAMP resulted in an enhanced organization of microtubules but had no effect on microfilament organization. Previous studies suggested that RA 233 and RX-RA 85 increase cAMP levels in 2 other cell clones of rat 13762NF mammary adenocarcinoma by inhibiting phosphodiesterases. However, additional sites of drug action should also be considered based on the effects of these drugs on microfilament systems and cell vacuoles. PMID- 3678322 TI - Clinical pharmacology of sodium butyrate in patients with acute leukemia. AB - Since cancer may be regarded as a disease of differentiation and sodium butyrate induces differentiation of malignant cells in vitro, a study of the clinical pharmacology of sodium butyrate was undertaken. Nine patients with acute myeloid (n = 1), acute monocytic (n = 1), acute myelomonocytic (n = 6) and acute undifferentiated (n = 1) leukemia were treated. Their median age was 52 (range, 27-78) years. Six of the nine patients were pretreated with cytostatic agents. Sodium butyrate was administered i.v. at a dosage of 500 mg/kg/day as continuous infusion over 10 days. A sensitive and reproducible high-performance liquid chromatographic separation was developed after derivatization of sodium butyrate with 2,4'-dibromoacetophenone employing crown ether catalysis. Plasma concentrations and urinary excretion of sodium butyrate were monitored during the 10 days of continuous infusion and for 2 days thereafter. During infusion, plasma concentrations increased 6-fold over the endogenous butyrate level and reached 39 59 microM. The area under the curve of the exogenous butyrate was 384 +/- 50 microM X day (mean +/- S.D.). After the end of infusion, concentrations declined rapidly with a half-life of 6.1 +/- 1.4 min, and reached pretreatment values within 1 hr. The total clearance rate was 83 +/- 12 ml/kg/min and the volume of distribution 738 +/- 245 ml/kg. The excreted amounts of butyrate in the urine were minimal as compared to the infused dose. Although excretion by other organs was not ruled out, it is suggested that the infused sodium butyrate was rapidly metabolized. A significant increase in peripheral blast cells was observed, whereas bone marrow cytologies before and after treatment did not reveal a significant change in blasts. Differential counts of peripheral white blood cells did not show significant changes. No toxicity was encountered. The apparent lack of clinical efficacy may be explained by the low plasma levels of sodium butyrate due to its short half-life in vivo. In comparison, concentrations reported for in vitro studies were at least 10 times higher. PMID- 3678323 TI - Cytotoxic effects and physicochemical properties of marycin: a new hematoporphyrin derivative. AB - This paper reports some physico-chemical properties and cytotoxic activity of marycin, a new hematoporphyrin derivative. The data show that marycin is a new compound, different from the other porphyrins tested. This product appears to be pure by adsorption or reversed phase thin-layer chromatography and high performance liquid chromatography and has chromatographic behavior different from those of other porphyrins tested. It does not appear to link to some tested metals and has a UV-visible absorbance spectrum different from that of a hematoporphyrin methylester. Furthermore, marycin has cytotoxic activity against K-562, ZR-75, MCF-7, HT-29, LOVO, human tumor cell lines and the MRC-9 human lung embryonic cell line. The new radiometric assay was used for all cell lines. Marycin decreases the growth index, measured by the radiometric assay as 14CO2 production. The cytotoxic activity is dose-dependent. Marycin is active at low doses but the activity varies with the cell line studied. The compound has low toxicity on the normal cell line MRC-9. Marycin is very liposoluble and would be expected to have high affinity and toxicity for tumors. The compound is active without light activation. How marcyin acts is still a matter for speculation. PMID- 3678324 TI - Modification of cellular efflux and cytotoxicity of adriamycin by biscoclaulin alkaloid in vitro. AB - The intracellular uptake, retention and cytotoxicity of adriamycin (ADR) combined with a biscoclaulin alkaloid, cepharanthine, were investigated by flow cytometry in NIH 3T3 cells. Cepharanthine suppressed the efflux of ADR in a similar fashion to verapamil. The intracellular uptake and retention of ADR were increased gradually by 0.1 to 1 microgram/ml of cepharanthine and reached a plateau at greater than 1 microgram/ml. Cepharanthine, which had no toxic action on survival, increased intracellular ADR uptake by about 20% for 1 h incubation at 37 degrees C, and increased cellular ADR retention after incubation in an ADR free medium for 4 h from 15% to 75%. The cytotoxicity of ADR was enhanced 5-fold in the cells pre- and co-incubated with cepharanthine. When cepharanthine was present in the medium before, during and for colony formation (10 days) after incubation with ADR, the cytotoxicity increased to about 300-fold. Furthermore, an increase in intracellular uptake of ADR was induced by an elevated temperature of 43 degrees C, and the efflux of ADR was inhibited by cepharanthine. A high level of intracellular ADR was maintained during the treatment. These results suggest a possible novel use of cepharanthine to improve the drug sensitivity of tumors resistant to ADR. PMID- 3678325 TI - The effect of the non-ionic surfactant Brij 30 on the cytotoxicity of adriamycin in monolayer, spheroid and clonogenic culture systems. AB - The effects of a non-ionic polyoxyethylated lauryl ether surfactant (Brij 30) on monolayer uptake and spheroid penetration of adriamycin have been studied. Co incubation of adriamycin with Brij 30 increases intracellular adriamycin levels by 2-3-fold. Although, in the concentrations used, Brij 30 alone is not cytotoxic, adriamycin and Brij 30 mixtures are significantly more cytotoxic (monolayer ID90 = 0.6 microgram/ml; disaggregated spheroid ID50 = 1.9 micrograms/ml) and induce significantly longer spheroid growth delay than adriamycin alone (monolayer ID90 = 2.1 micrograms/ml; disaggregated spheroid ID50 = 3.3 micrograms/ml). Adriamycin is equally cytotoxic to mouse normal granulocytes and chronic myeloid leukaemic (M1 cell line) cells in agar clonogenic cultures. The addition of Brij 30 appears to enhance preferentially the activity of adriamycin against these tumour cells relative to the normal granulocytes. PMID- 3678326 TI - Increased uptake of 5-FU in experimental liver tumours by simultaneous infusion of norepinephrine. AB - The effect of the simultaneous administration of norepinephrine and 5 fluorouracil (5-FU) on the uptake of radiolabelled 5-FU by liver tumours was studied in rats. Three different concentrations of 5-FU were used (15, 1.5 and 0.15 microgram/g body weight). The drugs were infused over a 30 min period via the hepatic artery, following cannulation of the gastroduodenal artery. The radioactivity in liver tumour, normal liver, lungs and intestines was estimated by liquid scintillation counting. At all concentrations tested, an increased uptake of radioactive 5-FU was found in the tumour when norepinephrine was infused. Tumour/liver ratios also increased significantly in all these cases. No significant differences were noted between norepinephrine infused and control animals in the radioactivity in normal liver, lungs and intestines. The effects noted were possibly due to changes in blood flow within the liver, but the possibility of a direct effect of norepinephrine on DNA metabolism is discussed. PMID- 3678327 TI - Prognostic significance of pretreatment variables in patients with invasive cervical cancer. AB - In 119 consecutive patients with invasive cervical cancer 92 variables of potential significance in predicting recurrence were determined before treatment. In 49 patients recurrent disease was diagnosed during follow-up after therapy. The investigated variables include: clinical data, routinely performed hematological and biochemical tests, histopathological data, oncofetal antigens, placental and pregnancy associated substances, serum levels of acute phase reactants, complement components, immunoglobulins and circulating immune complexes, and assays measuring the general immune competence of the patient. Thirty-three of the variables appeared to give statistically significant differences between values of future recurrence and non-recurrence patients. Further selection was carried out by stepwise forward discriminant analysis. This selection resulted in a prognosis rule using a subset of 7 variables. Carcino embryonic antigen and the complement component C3PA appeared to be the most powerful variables. Although the stage of disease was the third most important single variable, it did not add prognostic information, once CEA and C3PA were used. By applying the prognosis rule a probabilistic prediction is obtained for each patient. In about 60% of the future recurrences and 40% of the future non recurrence patients, these predictions reached a high level of accuracy. It was argued that the prediction of non-recurrence does not warrant to change the treatment protocol at present. Whether the prediction of recurrence is clinically useful remains to be clarified. PMID- 3678328 TI - Phase II study of 1,2,4-triglycidyl urasol (TGU) in advanced soft tissue sarcoma. A trial of the EORTC Soft Tissue and Bone Sarcoma Cooperative Group. PMID- 3678329 TI - A mathematical model of the development of drug resistance to cancer chemotherapy. AB - A mathematical model incorporating descriptions of tumour growth kinetics and the effects of cytotoxic chemotherapy on established tumours, is presented. It is shown how models of this kind may be used to investigate the potential of hypothetical chemotherapy strategies, and to identify general principles for successful treatment. The model is intended to be an aid to clinicians designing new chemotherapy programmes for diseases in which progress has been disappointing. PMID- 3678330 TI - Parent participation by ethnicity: a comparison of Hispanic, black, and Anglo families. PMID- 3678331 TI - Community-referenced instruction in technological work settings. PMID- 3678332 TI - Preschool programming: legal and educational issues. PMID- 3678333 TI - Reducing the number of students identified as learning disabled: a question of practice, philosophy, or policy? PMID- 3678334 TI - Special class placements as labels: effects on children's attitudes toward learning handicapped peers. PMID- 3678335 TI - Word processor versus handwriting: a comparative study of writing samples produced by mildly mentally handicapped students. PMID- 3678336 TI - Holland personality types among learning disabled and nonlearning disabled high school students. PMID- 3678337 TI - The end of responsible relative liability. PMID- 3678338 TI - Effects of social metacognitive training for enhancing overt behavior in learning disabled and low achieving delinquents. PMID- 3678339 TI - Status of educational services to handicapped students with limited English proficiency: report of a statewide study in California. PMID- 3678340 TI - Teachers' judgments of problem behaviors. PMID- 3678341 TI - Childhood predictive characteristics of aggressive adolescents. PMID- 3678342 TI - Norm-referenced tests: are they valid for use with handicapped students? PMID- 3678343 TI - Financial implications of half- and full-time employment for persons with disabilities. PMID- 3678344 TI - On the differentiation of memory beliefs from memory knowledge: the factor structure of the Metamemory in Adulthood Scale. AB - This study was designed to test the hypothesis that there are multiple factors of metamemory present in the Metamemory in Adulthood (MIA) questionnaire. Data on seven MIA scales from six separate studies on memory/metamemory relationships (total N = 750) were combined to yield two half-samples for cross-validation purposes. The samples were partitioned into young, middle-aged, and old groups. A multiple group confirmatory factor analysis was then conducted on the data, using the first half sample to develop a model and the second half sample to validate it. Although the models did not fully cross-validate, both analyses indicated that there are at least two higher-order factors in the MIA. The first involves beliefs about self-efficacy in using memory. The second factor combines knowledge about memory and affect concerning memory (e.g., achievement motivation). The analyses also indicated that the factor loadings for the second factor, tentatively labelled Knowledge, were invariant across the three age groups, but that there were age differences in the Self-Efficacy Beliefs factor loadings. The differences were localized to age-related increases in the loadings for the MIA Change and Locus scales. The two factor solution has potential for resolving conflicting results in the literature regarding age differences in both metamemory and metamemory/memory performance relationships. PMID- 3678345 TI - Personnel aptitude test scores as a function of age, education and job type. AB - A battery of personnel aptitude tests were administered and correlated with age for individuals working in skilled and unskilled jobs at a surface coal mining operation. Relationships between age and several measures of cognitive ability were significantly different when computed for skilled versus unskilled employees. Specifically, decreases in cognitive test performance with increasing age were more pronounced for unskilled workers. The partialling out of education had relatively little impact on relationships found between age and cognitive test performance for both skilled and unskilled workers. PMID- 3678346 TI - Picture associations among old and young adults. AB - Fifty college students (M age = 19.6 years) and 42 older adults (M age = 68.6 years) generated associations to drawings of common objects. Participants were given 90 s to generate as many associations as they could to each of 24 of the 48 drawings in the stimulus set. There was considerable agreement between the two age groups as to specific associations generated in response to individual drawings. However, older persons generated fewer associations per drawing than did younger persons, and there was some evidence that older persons were less consistent in their associations. PMID- 3678347 TI - From retina to response: contrast sensitivity and memory retrieval during visual word recognition. AB - Twenty-four young adults (M = 19.5 years) and 24 older adults (M = 68.4 years) performed a word/nonword classification task (i.e., lexical decision) in which a single letter-string was presented on each trial. Estimates were obtained of the time required to retrieve information regarding the orthography (pronounceability) and meaning of the letter-string. A measure of subjects' spatial resolution ability (contrast sensitivity) was also obtained. In the lexical decision task, the older adults' word recognition speed was slower than that of the young adults overall, but there was no age-related slowing associated specifically with the retrieval of either orthographic or semantic information. The similarity of the two age groups' retrieval estimates was independent of whether a manual or vocal response was required. An age-related change in the shape of the contrast sensitivity function was present. The age differences in the speed of word recognition, however, were not attributable to contrast sensitivity. PMID- 3678348 TI - Behavioral slowing and neuropsychological signs in a sample of active older men. AB - The neuropsychological test profiles of older men (62+) enrolled in a continuing education program differed from those of a comparison group of younger men, but fell well within the normal range. These findings ran counter to the assumption that characteristic and easily observed signs of brain dysfunction are a necessary accompaniment of old age. The further finding that the older men also were slower on digit symbol coding, a standard task used to measure behavioral slowing, was contrary to the hypothesis that slowing in the elderly reflects a developmental sequence of central nervous impairment, at least insofar as such impairment can be measured by neuropsychological tests. The good health and active lifestyles of the older sample may have played a role in forestalling neuropsychological signs otherwise seen among individuals their ages. PMID- 3678349 TI - Adult development: plasticity of stable behavior. AB - Gerbils in a longitudinal study demonstrated very stable behavior over more than a third of their median lifespan. There was highly significant individual stability of such behaviors as locomotor activity, rearing on the hind legs, latency to jump down from a platform, and marking with the ventral gland for thirteen months of adult life, from six to eighteen months of age. In some of these behaviors, general changes were observed over time, such as increased latency to jump down from a platform. Additionally, brief, outdoor enrichment (one hour a month) resulted in more scent marking than was found in control gerbils. In gerbils tested monthly there was less locomotor activity and rearing on the hind legs than in gerbils tested only once. It was observed that gerbils with a strong tendency to have seizures had more locomotor activity, more rearing, fewer markings, and shorter latency to jump down from a platform than those who rarely seized. Further, when gerbils had a seizure prior to testing, their activity scores and number of rearings were greater than on days when they did not have a seizure. Sex differences are discussed. These normative data provide important knowledge of adult development for comparison with studies of aging changes in gerbils. PMID- 3678350 TI - Movement specification time with age. AB - An experiment is reported which localizes and compares movement specification times between three age groups, young (18-25 yrs.), middle (40-50 yrs.), and elderly (65-75 yrs.), in order to assess whether movement planning processes are partially responsible for the commonly observed slowing of response initiation time in the elderly. A movement precuing paradigm was used in which 24 subjects (8/age group) received either no, partial, or complete movement task information prior to the imperative response signal. The results established that the elderly had slower reaction times, movement times, information transmission rates and more errors. While the results indicated that the elderly could use precue information to prepare an upcoming movement, their specification times for arm, direction, and extent were markedly slower. The data are interpreted as providing evidence that part of the slowing in reaction time observed in the elderly is due to the increased time required to specify a dimension of movement. PMID- 3678351 TI - Syntactic complexity and elderly adults' prose recall. AB - Elderly adults in their 70s and 80s and middle-aged adults in their 40s and 50s recalled a series of paragraphs made up of single-clause sentences and sentences with right-branching or left-branching embedded or subordinate clauses. Overall, the middle-aged adults recalled 65% of the propositions regardless of syntactic form. While the elderly adults recalled 43% of the propositions from the single clause sentences, they recalled 60% of the propositions from the right-branching clauses but only 22% of the propositions from the left-branching clauses. These results, in conjunction with prior research on elderly adults' production and imitation of complex syntactic constructions, demonstrate age-related changes in syntactic processing. PMID- 3678352 TI - The life-span trend in the magnitude of the Mueller-Lyer illusion as a function of hue and age. AB - Mueller-Lyer illustrations produced by hue contrast were used to investigate age differences with participants ranging in age from 20 to 79 years. As expected, there was no age difference in the magnitude of the illusion when the Mueller Lyer figure was produced by hue contrast. A significant main effect of hue was found, with no interaction between hue and age. These findings support Pollack's nondevelopmental explanation for age effects on Type I illusions. PMID- 3678353 TI - Field dependence in the institutionalized elderly. AB - The institutional-inducement hypothesis of field dependence regression in the elderly was assessed by administering the Children's Embedded Figures Test (CEFT) to a group of elderly upon admission to a nursing home and to a group of community-living elderly. Both groups were retested four months later. The institutionalized group exhibited significantly lower CEFT scores on initial testing than the community-living group. In addition, the CEFT scores for the institutionalized group declined significantly from pretest to posttest. The results suggested that greater field dependence in the institutionalized elderly may be due to pre-institutional dependence regression that continues after institutionalization. Additional measures of mental status and activity levels were also lower in the institutionalized group upon admission supporting a pre institutional generalized regression effect. PMID- 3678354 TI - Brain reactive antibodies and the blood-brain barrier: observations in aging rodents and the effects of peripheral kainic acid. AB - This study was initiated to confirm the existence of brain-reactive autoantibodies and to determine if such antibodies have higher affinity for brain regions especially affected in Alzheimer's disease. Serum collected from 90, 300, and 600 day old mice was incubated against brain tissues from these same mice, followed by incubation with fluorescently tagged rabbit antimouse IgG. No antibodies were present in the youngest serum, but considerable antibodies were present at 300 and, especially, at 600 days. Such antibodies were present in the blood vessels, but not in the brains of older animals. These antibodies, applied exogenously, labeled cells equally in all three ages of brains including most cortical and many other neurons, indicating that they are not neurotransmitter specific. In a further study, kainic acid or saline was administered peripherally to 15-month old rats. Kainic acid damaged the blood brain barrier and allowed the CNS entry of brain-reactive antibodies, especially into the subregions of hippocampus most damaged in Alzheimer's. PMID- 3678355 TI - Cardiovascular aging in Syrian hamsters: similarities between normal aging and disease. AB - The functional status of the cardiovascular system in health and cardiomyopathic (CM) hamsters was assessed throughout their lives by measuring heart weight and fluid in the pleural and peritoneal cavities. An index of cardiovascular age was developed from a multiple regression model of changes in these variables with chronological age. This index showed parallel changes in healthy and CM hamsters with increasing age, but CM hamsters with shorter lifespans underwent the changes at earlier ages. It was also a better predictor of viability than chronological age. The cardiovascular age index correctly predicted the early death of those hamsters which died before the average death age, whereas they should have been alive according to their chronological age. Conversely, hamsters which lived beyond the average death age had cardiovascular ages younger than the average death age, whereas their chronological ages erroneously indicated they should have been dead. This index may have been able to assess viability because it was correlated with histopathological signs of congestive heart failure in both strains of hamsters, as well as with the total amount of pathology found in them. Hamsters which die naturally at a particular age should have older cardiovascular indices than those sacrificed at the same age, and CM hamsters which died at 11 13 months of age did have older cardiovascular ages than hamsters that were sacrificed at these ages. Three experiment examined the effects of various treatments on the index of cardiovascular age. Life in constant light decreased the cardiovascular age of CM hamsters by 30% and extended life by 25%. Chronic digitalis treatment will improve cardiovascular performance, and it prevented increases in cardiovascular age during the end stages of heart failure. Finally, life-threatening chronic stress increased cardiovascular age in CM hamsters, which suggested that severe stress brought CM hamsters nearer to death. However, it was not possible to determine whether the effects of these treatments were on aging or health. Thus, the data suggested that aging, at least in hamsters, may be closely related to the natural development of heart failure which represents a common end stage of life in both cardiomyopathic hamsters and very old, supposedly healthy hamsters. PMID- 3678356 TI - Lack of evidence for an impairment of tuberoinfundibolar dopaminergic neurons in aged male rats of the Sprague-Dawley strain. AB - Circulating prolactin (PRL) levels, dopamine (DA) content, in vitro basal and stimulus-evoked endogenous DA release from arcuate-periventricular nuclei median eminence fragments were studied in young (4 months) and old (24-25 months) male rats of Sprague-Dawley strain. Serum PRL levels did not differ in young and aged animals. In addition DA tissue content, basal and K+- or d-amphetamine evoked endogenous DA release did not show age-related differences. These results suggest that in male rats of the Sprague-Dawley strain the activity of tuberoinfundibular dopaminergic (TIDA) neurons does not change during senescence, unlike what happens in other strains of rats. PMID- 3678357 TI - Pre-experimental knowledge facilitates episodic recall in young, young-old, and old-old adults. AB - Younger adults (mean age = 19.6), 73-year-olds and 82-year-olds were examined on free recall of verbal materials varying in datedness (i.e., names of people who attained their fame during the 1930s or the 1980s). The main result was an interaction between age and type of materials. Whereas younger adults performed better for "new" than for "old" items, both elderly groups recalled more old than new items. A highlight of these data is that activation of pre-experimental knowledge structures appears to improve episodic recall in both young-old and old old adults. PMID- 3678358 TI - Age and diabetes related changes in verbal fluency. AB - Non-insulin-dependent diabetes mellitus is present in 7-10% of the aged. This disease appears to be associated with an acceleration of the aging process and results in compromised performance on learning and memory tasks. The present study used a verbal fluency test to examine semantic memory performance in two age groups (55-64 and 65-74 years) of diabetic subjects and controls. In addition, immediate and secondary memory were also examined using the digit symbol and digit span tests and a serial learning task. Results showed that digit symbol performance was poorer for older subjects and diabetics while serial learning was poorer only for diabetic subjects. However, the number of words generated on the verbal fluency test was similar for all groups. Qualitative analyses of the verbal output revealed that older subjects and diabetics produced the greatest number of previously recited words (repetitions). Repetitions may signal a failure to adequately monitor behavior which in turn could contribute to cognitive decline. PMID- 3678359 TI - Adult age differences in the attentional capacity demands of letter matching. AB - The attentional demands of letter matching were assessed using a secondary task technique with three adult subject groups. The mean ages were: Group 1 = 19.9 years, Group 2 = 58.7 years, Group 3 = 68.9 years. The primary task was letter matching on the basis of physical identity (PI) or name identity (NI); the secondary task was speeded response to a tone. Relative to baseline (single-task) tone RTs, subjects at all ages responded more slowly in the dual-task condition to tones on name-match trials than on physical-match trials. Also, the proportional difference in tone RT between baseline and dual-task trials was significantly larger for Group 3 than Group 1, but this analysis did not reveal a larger age difference for NI than PI matching. However, a second analysis revealed that absolute differences in tone RT between baseline and dual-task trials increased with age, and the magnitude of this effect was larger for NI than PI matching. The implications of the findings for theories of age differences in attentional capacity, and for issues in the measurement of attentional demands, are discussed. PMID- 3678360 TI - Immuno-electron microscopic characterization of large granular lymphocytes (natural killer cells) from rat liver. AB - The immunocytochemical characteristics of large granular lymphocytes (LGL), isolated from the liver sinusoids of euthymic and athymic (nude) rats, were investigated in electron microscopy by the immunoperoxidase technique. The LGL were found positive for MRC OX-8 (natural killer cells and cytotoxic/suppressor T cells) and negative for MRC OX-19 (pan-T marker) in both rat strains. The LGL were heterogeneous in the expression of the natural killer cell marker asialo-GM1 which was found on 56% of the LGL from euthymic and on 71% of the LGL from athymic rats. LGL were easily distinguished from the other cells in the preparations, "conventional" lymphocytes and monocytes, thanks to their highly characteristic ultrastructural features, in particular by the presence of specific electron-dense cytoplasmic granules and rod-cored vesicles. These features have been described formerly for the so-called "pit cells" and are more reliable than the classical LGL characteristics at the light microscopic level, i.e. the presence of azurophilic granules. Our results give further support for the existence of an important population of natural killer cells in the liver sinusoids. PMID- 3678361 TI - Dendritic cells of the mouse recognized by two monoclonal antibodies. AB - A new monoclonal antibody, MIDC-8, is described which shows a comparable tissue distribution as the recently described NLDC-145 antibody. It recognizes interdigitating cells, veiled cells and Langerhans cells in lymphoid organs and the skin of the mouse. In contrast to NLDC-145 it recognizes a cytoplasmic component of these cell types. Its distribution is more restricted to the T cell dependent areas than NLDC-145. Isolation of dendritic cells from lymph nodes, spleen and thymus revealed that both antibodies react with the in vitro isolated dendritic cells. The results show that these antibodies can be used to study dendritic cells in vitro and emphasize the relationship between the in vivo interdigitating cells of the T cell areas and the in vitro isolated dendritic cells. PMID- 3678362 TI - A genetically determined lack of oral tolerance to ovalbumin is due to failure of the immune system to respond to intestinally derived tolerogen. AB - In this study we have examined whether differences between mouse strains in the induction of tolerance after feeding ovalbumin (OVA) are due to differences in intestinal processing of OVA or are determined by the systemic immune system. Compared with major histocompatibility complex (MHC)-congenic BALB/c mice, BALB/B mice develop much less tolerance of systemic delayed-type hypersensitivity (DTH) and humoral immunity after feeding OVA and this defect is also expressed partially in (BALB/B x BALB/c)F1 animals. Serum taken from either BALB/c or BALB/B mice fed OVA 1 h before produced significant suppression of systemic DTH responses in BALB/c, but not in BALB/B mice. Although OVA-fed BALB/B serum was slightly less tolerogenic than BALB/c serum, we conclude that the defective induction of oral tolerance in BALB/B mice is due primarily to a MHC-influenced defect with the immune system. These findings support the idea that clinical food sensitive enteropathy reflects an immune response gene-controlled defect in tolerance to dietary proteins. PMID- 3678363 TI - Effects of anoxia and ischemia on uptake2 of catecholamines in perfused rat heart. AB - The effects of 30 min periods of either anoxia or ischemia (stop-flow) on the uptake2 of isoprenaline and on the production of O-methyl-isoprenaline, a major metabolite of isoprenaline formed by catechol-O-methyltransferase (COMT), were examined in the perfused rat heart. After either glucose deprivation or anoxia, the uptake2 of isoprenaline in hearts subsequently perfused with isoprenaline and 3',4'-dihydroxy-2-methyl-propiophenone, a COMT inhibitor, was similar to control values. However, uptake2 was decreased following either anoxia in association with glucose deprivation or ischemia. In the absence of the COMT inhibitor, neither glucose deprivation nor anoxia alone had any effect on the production of [3H]3-O-methyl-isoprenaline from [3H]isoprenaline, but both anoxia together with glucose deprivation and stop-flow ischemia decreased it. These findings indicate that both anoxia coupled with glucose deprivation and ischemia inhibit both uptake2 and COMT activity and suggest that such inhibition may be responsible for the high concentration of catecholamines released locally following myocardial infarction. PMID- 3678364 TI - The effect of inhaled leukotriene D4, histamine, or antigen on central and peripheral airways of guinea pigs: analysis of bronchograms with an interactive image analysis system. AB - The effect on guinea pig airways of the inhalation of leukotrienes, histamine or antigen was investigated by measuring changes in lung volume and analyzing the airway area on bronchograms with the Zeiss interactive image analysis system (IBAS). LTC4, LTD4, LTE4 and histamine inhaled through an ultrasonic nebulizer caused inflation of the lung: LTD4 was the most potent of the leukotrienes and was 100 times more potent than histamine on a molar basis. The results of analyses of areas of large and small bronchi and bronchioles on the bronchograms indicated that LTD4 selectively decreased the area of the peripheral airways. Inhalation of an antigen in actively sensitized animals resulted in inflation of the lung and in a selective decrease in the area of the peripheral airways. Anaphylactic bronchoconstriction provoked by antigen inhalation was clearly inhibited by AA-861, a 5-lipoxygenase inhibitor but not significantly by mepyramine, an antihistamine. These observations indicate that LTD4 is a potent constrictor of the peripheral airways in guinea pigs and that the anaphylactic bronchoconstriction provoked by antigen inhalation could be mediated by LTD4 in actively sensitized guinea pigs. PMID- 3678365 TI - Helodermin stimulates prolactin secretion in the rat. AB - The effect of helodermin, a member of the secretin/vasoactive intestinal polypeptide (VIP)/peptide histidine isoleucine (PHI) family of peptides, on pituitary prolactin (PRL) secretion was examined in the rat. Either i.c.v. or i.v. injection of helodermin resulted in a dose-related increase in plasma PRL levels in urethane-anesthetized male rats. At the doses tested the potency of helodermin to raise plasma PRL levels was greater than that of rat PHI and porcine PHI, and as great as that of VIP. PMID- 3678366 TI - [Selective media for Pasteurella pneumotropica]. AB - Bacteria from the subcutaneous abscesses which appeared in a laboratory colony of DS mouse since October of 1977 were identified as Pasteurella pneumotropica by various biological examinations. The abscess formation was limited to multiparous female mice over 100 day-age, but virgin females were free from the disease. The MIC of various antibacterial substances showed that potassium tellurite, kanamycin and bacitracin were effective to isolate the organism selectively from various infection sites harboring many other species of bacteria. A novel NKBT medium was prepared by adding these antibacterial substances to the heart infusion agar (HIA) supplemented by 10% Fildes digested blood. A fluid culture medium, TGN broth was prepared for multiplication of the organism by adding 10% Fildes digested blood and potassium tellurite to GN broth. To isolate the organism from the pharyngo-larynx a direct application of mucus wiped off the infection site onto the culture medium was sufficient, but pre-multiplication in the TGN broth was required for isolation of the organism from gut contents before inoculation onto the NKBT medium. The pre-cultivation in the TGN broth vastly improved the recovery of the organism especially from feces. Thereby we could easily detect the latent infection of this bacterium without sacrificing animals. PMID- 3678367 TI - Inactivation of Bacillus piliformis spores by heat and certain chemical disinfectants. AB - The inactivation of Tyzzer's organism (Bacillus piliformis) spore isolated from rats by heat and various chemical disinfectants was studied. The spores were from B. piliformis-infected rat liver tissues. The spore suspension (10(4) 50% of rat liver lesion producing dose with prednisolone treatment/ml) was treated with heart or disinfectants. Inactivation of the spores was examined in experimentally infected rats. Rats were inoculated perorally with a treated spore suspension and injected subcutaneously with prednisolone. On the sixth day after inoculation, rats were examined grossly for liver lesions. Spores were inactivated at 80 degrees C for 15 min but not at 60 degrees C for 30 min. Spores were inactivated by 0.4% peracetic acid, 0.015% sodium hypochrolite, 1% iodophol, 5% phenol. Alcide and 0.37% formaldehyde solution, but not by 0.037% formaldehyde solution, 70% ethanol, 0.3% benzethonium chloride solution, 3% cresol and soap solution, or 4% chlorhexidine digluconate. These findings suggest that B. piliformis spores are relatively sensitive to heat and certain chemical disinfectants. PMID- 3678368 TI - [Discriminant analysis of hematological and serum biochemical values in cynomolgus monkey (Macaca fascicularis) bred and reared under the indoor individually-caged conditions]. AB - The data on hematological and serum biochemical properties of laboratory-bred cynomolgus monkeys (Macaca fascicularis) at different ages were analyzed by discriminant analysis. All the animals had been bred and reared under uniform environmental conditions at Tsukuba Primate Center for Medical Science, N.I.H., Japan. The items used were as follows: red blood cell count (RBC), hematocrit value (Ht), hemoglobin concentration (Hb), mean corpuscular volume (MCV), white blood cell count (WBC), glutamic oxaloacetic transaminase activity (GOT), glutamic pyruvic transaminase activity (GPT), total protein concentration (TP), albumin concentration (ALB), albumin-globulin ratio (A/G), blood urea nitrogen (BUN), glucose concentration (GLU), total cholesterol concentration (TCHO), free cholesterol concentration (FCHO), triglyceride concentration (TG) and alkaline phosphatase activity (ALP). In total, 1086 animals in 10 age groups were examined. Data analyses were done with respect to the difference of sex. Discrimination was possible by Mahalanobis' generalized distance between centroids of groups. In canonical discriminant analysis (discriminant analysis with reduction of dimensionality), age was highly correlated to the value of the first canonical variate. From the approximate relative value of the eigenvector of the first canonical variate, the most discriminant variables are WBC, TP, ALB, A/G, TCHO, FCHO, TG, and ALP. It can be concluded that periodic measurement of these 8 parameters is necessary and sufficient to monitor the physiological conditions of growing monkeys. PMID- 3678369 TI - Morphological and reproductive characteristics of musk shrews (Suncus murinus) collected in Bangladesh, and development of the laboratory line (BAN line) derived from them. AB - To establish a unique laboratory line of the musk shrew with different genetic properties from previously developed laboratory lines, 49 male and 49 female shrews were captured in the campus of Bangladesh Agricultural University from October through November in 1983 and from December in 1985 to January in 1986. The shrews collected were of various ages. They had light gray coats, with slight variations in color. Except for the 12 shrews introduced into our laboratory, the total length and body weight of the shrews ranged from 17.2 to 31.9 cm and 32.5 to 147.0 g in males, and 21.1 to 26.6 cm and 40.8 to 110.0 g in females, respectively. Pregnant females were found throughout the trapping period, and the average fetal litter size was 3.54 (11 cases). Five males and 7 females of the shrews captured in 1983 were transported to our laboratory. After more than 100 days of laboratory rearing, their total length and body weight averaged 27.6 cm and 147.3 g in males, and 24.6 cm and 81.7 g in females. Their body weight was more than double that of Japanese shrews. The shrews introduced (except for one male) produced a total of 59 offspring, which were regarded as the first generation of the laboratory line (BAN Line). Gestation period and average litter size were between 28 and 30 days (10 cases) and 3.47 (17 cases), respectively. The BAN line has consisted of about 60 individuals at each generation and has been maintained as a closed breeding colony. PMID- 3678370 TI - Malformations in rat fetuses induced by trypan blue. AB - Malformations of fetuses obtained from Wistar rat dams treated with trypan blue during gestation were studied. Fetuses were examined on day 20 of gestation. One hundred and twenty-seven fetuses showed abnormalities of the external features, skeleton and internal organs, separately or in combination. External malformations were found in 108 fetuses. The most frequent external malformation was anomaly of tail. Spina bifida, club foot, exencephaly and anal atresia were also observed frequently. Skeletal malformations were detected in 48 fetuses. Deformity of vertebrae in the lumbar, sacral and/or caudal regions was found in 46 fetuses. Internal malformations were observed in 27 fetuses. Anomaly of heart and/or great vessels, hydrocephaly and micro- or anophthalmia were observed frequently. About 90% of the fetuses with skeletal malformations also showed some external malformations. In contrast, about 48% of the fetuses with internal malformations also had some external malformations. These results suggest that, for teratological study, internal examination is more important in detecting malformations of fetuses than skeletal examination. PMID- 3678371 TI - A new polymorphic pepsinogen locus (Pg-2) in the rat (Rattus norvegicus). AB - Only two types of pepsinogens, which are products of the Pg-1 locus, are present in rat urine. In gastric mucosa, however, additional pepsinogen isozymes are expressed. We have found a polymorphism for rat gastric mucosa pepsinogen using agarose gel electrophoresis. Some inbred rat strains expressed a pepsinogen band, while others did not. The trait was found to be controlled by a single autosomal locus. We tentatively designated the locus as Pg-2 with two alleles, Pg-2a for the one controlling presence of the band and Pg-2o for the one controlling absence. Linkage analysis using BN and TM strains revealed that Pg-2 was closely linked to Pg-1 (3.7 +/- 1.8 cM), and that it did not belong to LG I (Hbb and p), LG II (Acon-1 and Mup-1), LG IV (Hao-1 and Svp-1), LG V (Es-1 and Es-3), LG VI (Gc and h), LG IX (RT1), LG X (Fh and Pep-3), nor a LG containing Ahd-2 (as yet undetermined). PMID- 3678372 TI - [Lifelong coprophagy in male mice]. AB - Changes in coprophagy with age were investigated in male ICR mice during their life span. Sucklings showed coprophagy at 17 to 18 days old, i.e., a few days after they began to excrete feces autonomously. The number of fecal pellets ingested peaked at 5 to 6 weeks old (13 pellets/day) and gradually decreased, thereafter (2.1 pellets at 78 weeks old, 1.5 pellets at 104 weeks old). The diurnal pattern of coprophagy also changed with age. Growing mice showed vigorous coprophagous activity in both light and dark phases, whereas animals over 30 weeks old exhibited less activity in both phases, especially in the dark phase. Feces proved to be abundant in vitamin B12 and folic acid throughout the life span. These results suggest that the frequency of coprophagy changes in association with the nutritional requirements of mice during the process of growth or aging. PMID- 3678373 TI - [Occurrence of granulomatous appendicitis in rabbits]. AB - Granulomatous appendicitis was observed in all of the 45 Japanese white rabbits examined. Histologically, multiple microgranulomas were accompanied with foreign body giant cells and focal calcifications in lymph nodules of appendix. Foreign body giant cells contained hair coat and larvae of Passalurus ambiguus. In addition, the sacculus rotundus and mesenteric lymph nodes were affected with the same lesions. PAS- and Gram- positive bacilli were phagocytized in the microgranulomas and macrophages. They were also stained positively with the immunoperoxidase method for the auto-sera of rabbits. Isolation of these bacilli in pure culture has not yet been accomplished. The occurrence of granulomatous lesions due to tuberculosis, pseudotuberculosis, tularemia and actinomycosis seems unlikely in the present cases because none of these organisms nor characteristic lesions were detected. It was suggested that the Gram-positive bacilli appeared to play a role in granulomatous appendicitis. PMID- 3678374 TI - [Management of cynomolgus monkey infants after separation from their mothers]. AB - To establish an efficient rearing system for weaned cynomolgus infants, 51 groups composed of 4 weanlings each were formed. Of them each of thirty-eight groups had an adult female "nurse" monkey, who had no kinship with any of the 4 weanlings. The nurse was present during the first 4 weeks after weaning. The daily incidence of watery diarrhea was analyzed to assess the usefulness of the nurse monkey for stabilizing physiological conditions of the weanlings. Diarrheal incidence was significantly lower in the 38 groups with a nurse than in the 13 control groups without a nurse throughout the 4-week period of observation. This trend continued for more than 5 weeks after removal of the nurse. Thus, the time and manpower necessary for treating infant diarrhea were greatly reduced in this rearing system. PMID- 3678375 TI - Cloning and expression of cDNA for two endogenous UV-2237 fibrosarcoma lectin genes. AB - cDNA libraries from the murine UV-2237-IP3 fibrosarcoma cell line were prepared in the expression vector lambda gt11. Using specific antibodies, cDNA clones coding for the 14.5-kDa and the 34.0-kDa endogenous galactoside-specific lectins were isolated. In vitro translation and immunoprecipitation of mRNAs hybrid selected by the cloned sequences from whole cell RNA provided confirmation for the clones. RNA and DNA blot analyses revealed that the two lectin proteins represent products of two different genes. We found differential levels of the specific mRNAs when low- and high-metastatic counterparts of the UV-2237 tumor system were compared, and these genes were not expressed in detectable amounts in normal mouse liver. PMID- 3678376 TI - Establishment and characterization of Xenopus oviduct cells in primary culture. AB - Based on a previously established procedure for Xenopus hepatocytes, we describe tubular oviduct cells in primary culture which continue to secrete substantial quantities of egg jelly for several days, as can be visualized microscopically. Freshly isolated cells exhibited a culture shock response [A. P. Wolffe, J. F. Glover, and J. R. Tata (1984) Exp. Cell Res. 154, 581], from which they recovered by the third day in culture. This recovery was characterized by (a) the diminished synthesis of heat shock proteins hsp 70 and hsp 85, (b) the cessation of the drop in number of estrogen receptor, and (c) the enhanced rate of synthesis of cellular and secreted proteins. The oviduct estrogen receptor had the same characteristics as those in other estrogen target tissues and was present in the same amount as in adult female Xenopus hepatocytes [A. J. Perlman, A. P. Wolffe, J. Champion, and J. R. Tata (1984) Mol. Cell. Endocrinol. 38, 51]. Unlike the latter in primary culture [M. P. R. Tenniswood, P. F. Searle, A. P. Wolffe, and J. R. Tata (1983) Mol. Cell. Endocrinol. 30, 329], oviduct cell cultures did not actively metabolize either estradiol or progesterone (t1/2 approximately equal to 55 and 7 h, respectively). The successful establishment and characterization of primary cultures of both liver and oviduct cells now fulfil the conditions required for investigating the basis for tissue specificity of regulation by estrogen of Xenopus egg protein gene expression in primary cell culture. PMID- 3678377 TI - Inhibitory effects of tetradecanoylphorbol acetate and diacylglycerol on erythropoietin production in human renal carcinoma cell cultures. AB - A human renal carcinoma from a patient with an erythrocytosis, serially transplanted into athymic nude mice, was grown in primary monolayer cell cultures. After reaching confluency the cultured cells formed multicellular hemicysts (domes) which became more abundant as the cultures approached saturation density. Erythropoietin (Ep) production by this renal carcinoma in culture was only slightly increased at the time of semiconfluency but showed a marked increase in Ep levels in the culture medium after the cultures reached confluency, in parallel with an increase in dome formation. The phorbol ester tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) showed a significant dose-related inhibitory effect on Ep production and dome formation in the renal carcinoma cell cultures, suggesting an important role of protein kinase C, the only known receptor for TPA, in inhibiting the expression of differentiated phenotypes in the renal carcinoma cells. TPA also suppressed Ep secretion over a period of 96 h, indicating a time course of suppression of this differentiated function of the renal carcinoma cells in culture. This hypothesis was further supported by the observation that diacylglycerol, the endogenous activator of protein kinase C, likewise inhibited Ep production and dome formation in the renal carcinoma cell cultures. These studies suggest a role of the inositol-lipid second messenger path and protein kinase C in the regulation of Ep production. PMID- 3678378 TI - Regulation of cardiac myosin synthesis: studies of RNA content in cultured heart cells. AB - Contraction regulates the myosin content and the rate of myosin synthesis in cultured neonatal rat heart cells. To further explore the mechanism for this regulation we examined various parameters of RNA content and RNA synthesis in contacting versus noncontracting myocytes. While contraction stimulated myosin heavy chain (MHC) synthesis by 72% compared to that of KCl-arrested cells, simultaneous analyses of polysome profiles were no different under the two culture conditions. Incorporation of [3H]uridine monophosphate into cellular RNA revealed no change in the rate of total RNA or ribosomal subunits synthesis. In vitro translation of cellular RNA yielded similar incorporation of [35S]methionine into trichloroacetic acid precipitable protein. Specific transcription of the MHC gene was examined by dot-blot analysis and was unaltered by contraction. Northern blot analysis of the MHC sequences detected by a cDNA probe revealed an mRNA sequence corresponding to a molecular weight of approximately 30 S. These data suggest that RNA synthesis and RNA content are unaltered by contraction in cultured heart cells and therefore the changes in myosin synthesis may be mediated at a post-transcriptional control level. PMID- 3678379 TI - The anti-invasive flavonoid (+)-catechin binds to laminin and abrogates the effect of laminin on cell morphology and adhesion. AB - To study the effect of the flavonoid (+)-catechin on cell-matrix interactions two cell types with a different morphology on and adhesion to laminin were used. MO4 virally transformed fetal mouse cells adhere and spread when cultured on top of laminin-coated coverslips or on human amnion basement membrane. M5076 mouse reticulum cell sarcoma cells poorly adhere to these substrates and remain round. Both cell types are invasive in confronting cultures with embryonic chick heart fragments. (+)-Catechin binds to laminin in a pH-dependent way. Pretreatment of laminin-coated coverslips or amnion basement membrane with 0.5 mM (+)-catechin abrogates the effect of laminin on cell morphology and adhesion. MO4 cells do not adhere to the pretreated substrates and remain round, while M5076 cells now adhere and spread. (+)-Catechin inhibits the invasion of MO4 cells but not of M5076 cells into embryonic chick heart in vitro. We speculate that the anti invasive activity of the flavonoid to MO4 cells is the result of its interference with MO4 cell adhesion to laminin. Invasion of M5076 cells does not imply adhesion to and spreading on laminin. PMID- 3678380 TI - Transfer of purine metabolites between cells through the medium and via cell contacts in cocultures of HGPRT+ and HGPRT- cells. AB - Cells with and without hypoxanthine-guanine phosphoribosyltransferase (HGPRT) activity were used to examine the transfer of purine metabolites through the medium and via cell contacts. HGPRT- Chinese hamster and human fibroblasts were able to incorporate 3H-labeled purine metabolite(s) from medium in which mouse HGPRT+ B82 cells had been grown for 24 h with [3H]hypoxanthine, but mouse A9 fibroblasts that were deficient in HGPRT, adenine phosphoribosyltransferase (APRT), and methylthioadenosine phosphorylase (MTAP) were unable to incorporate these metabolites. This suggests that in recipient cells incorporation is due to [3H]MTA, which has been shown previously to be the major 3H-labeled purine metabolite to accumulate in B82 medium, being cleaved by MTAP to [3H]adenine, which is phosphoribosylated by APRT to [3H]AMP. Incorporation by recipient cells of metabolites from the medium is referred to as contact-independent metabolite transfer (CIMT). In autoradiograms of B82/A9 cocultures that were labeled with [3H]hypoxanthine, grains were found over A9 that were not in contact with B82, although A9 did not act as recipients of CIMT. This is termed proximity-dependent metabolite transfer (PDMT). Both CIMT and PDMT interfered with the assessment of nucleotide exchange between HGPRT+ and HGPRT- cells through cell contacts, which is referred to as contact-dependent metabolite transfer (CDMT). These problems were unique to HGPRT+ mouse L cells. However, HGPRT- mouse L cells, A9, could be used as potential recipients. A9 were positive recipients of CDMT with only one of five cell lines tested, which suggested that these cells were selective communicators. CDMT could not be studied with [3H]guanine because the nuclei of HGPRT- cells became labeled. PMID- 3678381 TI - In situ localization of mRNAs coding for mouse testicular structural genes. AB - In situ hybridization histochemistry has been used to localize mRNA transcripts of five nuclear and cytoplasmic structural genes in the mouse testis. The mRNAs for three nuclear structural proteins involved in chromatin transformation during spermatogenesis (the two protamine variants of the mouse and one of the testis specific proteins) are restricted solely to postmeiotic germ cells. In contrast, mRNAs for two other structural proteins, actin and alpha tubulin, are detected throughout spermatogenesis. Although present in premeiotic, meiotic, and postmeiotic cell types, the mRNA levels of actin and alpha tubulin differ considerably during spermiogenesis, the haploid phase of spermatogenesis. Actin mRNA levels decrease markedly as the male gamete differentiates during spermiogenesis whereas alpha-tubulin mRNAs are equally abundant in the haploid round and elongating spermatids. PMID- 3678382 TI - Phagocytosis of in vitro-aged erythrocytes--a sharp distinction between activated and normal macrophages. AB - Phagocytosis experiments performed in vitro in the absence of serum with mouse peritoneal macrophages have shown that normal macrophages can bind to in vitro aged sheep red blood cells without antibody or complement, but only activated macrophages are able to ingest these erythrocytes. This sharp qualitative functional difference may be an index for the characterization of the activated state of macrophages. PMID- 3678383 TI - Intrinsic difference in beat frequency between the two flagella of Chlamydomonas reinhardtii. AB - The flagellar beat frequency of the biflagellated green alga Chlamydomonas reinhardtii was measured by fast Fourier transform analysis of the light intensity fluctuation in microscope images of swimming cells. Live cells had a mean beat frequency of 48-53 Hz at 20 degrees C. However, detergent-extracted "cell models," when reactivated in the presence of 1 mM ATP, appeared to have two different beat frequencies of about 30 and 45 Hz. Measurements in cell models in which only one of the two flagella was beating indicated that the lower and higher frequencies most likely represented the beat frequency of the flagellum nearer to the eyespot (the cis-flagellum) and that of the flagellum farther from it (the trans-flagellum), respectively. In live cells also, the trans-flagellum beat at a frequency about 30% higher than that of the cis-flagellum when the cells were rendered uniflagellated by mechanical treatment, whereas both flagella beat at the frequency of the cis-flagellum under normal conditions. These observations suggest that the two flagella of Chlamydomonas have different intrinsic beat frequencies but that they are somehow synchronized when beating together on a live swimming cell. PMID- 3678384 TI - Exogenous GM1 ganglioside caused G1-arrest of human diploid fibroblasts. Flow cytometric studies. AB - Exogenous GM1 ganglioside (II3 NeuAc-Gg0se4-Cer) inhibited growth and DNA synthesis of human diploid fibroblasts, TIG-1 cells. We examined the effect of exogenous GM1 on their cell cycle traverse by flow cytometry. When the cells were partially synchronized by serum deprivation, addition of GM1 at the time of refeeding caused about 70% reduction of their reentry into S phase from the level observed in the control culture untreated with the ganglioside. However, the addition of GM1 6 h later caused only about 30% reduction of the reentry from the control level. These results suggest that the exogenous ganglioside blocks the cell cycle traverse in an early G1 period. This is consistent with the fact that GM1-treated cells showed a high level of histone H1(0) similar to that observed in G1-arrested cells in confluent culture. PMID- 3678385 TI - Precommitment states induced during HL-60 myeloid differentiation: possible similarities of retinoic acid- and DMSO-induced early events. AB - The possible relationship of the pathways by which two inducers, retinoic acid and DMSO, cause myeloid differentiation of HL-60 promyelocytic leukemia cells was studied. HL-60 cells were first exposed to retinoic acid and then washed free of it. As reported previously, this brief exposure results in no subsequent G0 growth arrest or phenotypic differentiation. When these cells were subsequently exposed to DMSO, onset of G1/0 growth arrest but not phenotypic differentiation occurred within 24 h. Since in these cells retinoic acid or DMSO normally requires 48 h of continuous exposure for onset of significant G0 growth arrest and phenotypic differentiation, it appears that retinoic acid and DMSO induce similar early cellular events needed for subsequent G0 growth arrest but not for phenotypic differentiation. While onset of growth arrest and differentiation occur together when the cells are exposed for 48 h to retinoic acid, the present results indicate that their occurrence can be uncoupled by this split dosage to inducers. The results are discussed in terms of a previously hypothesized model of cellular response to the inducers. PMID- 3678386 TI - Improved methods for the isolation of individual and clustered mitotic chromosomes. AB - We have optimized procedures for the isolation of mitotic chromosomes from tissue culture cells. The first procedure is a rapid method for obtaining individual, structurally intact chromosomes suitable for analysis by electron microscopy. Further purification of these on Percoll gradients results in chromosomes free of cytoplasmic contamination, allowing biochemical characterization of the structural proteins and enzymatic activities intrinsic to mitotic chromosomes. A third procedure permits efficient, large-scale purification of chromosomes clustered together, referred to as a chromosomal cluster. The use of EDTA containing polyamine buffers minimizes modifications of proteins and DNA during isolation and maintains the integrity of the chromosomal structure. The conditions which lead to the isolation of chromosomal clusters, as opposed to individual chromosomes, have been analyzed. Comparison of the gei patterns of proteins derived from individual chromosomes, as compared to clusters, identifies additional proteins in the latter pattern. These proteins could be involved in maintaining interchromosomal organization or positioning in the metaphase cell. PMID- 3678387 TI - Legionella pneumophila: monoclonal antibody typing of clinical and environmental isolates. AB - Forty-one clinical isolates of Legionella pneumophila from sporadic cases of legionella pneumonia were collected from laboratories throughout the United Kingdom and were compared with 300 routine environmental isolates using two panels of monoclonal antibodies, covering serogroups 1-10. Eighty-five per cent of the clinical isolates belonged to the subgroup Pontiac of serogroup 1, whilst only 13% of the environmental isolates did. Approximately half of the clinical isolates tested came from patients with a recent history of foreign travel, mainly to southern Europe. PMID- 3678388 TI - Legionella pneumophila: comparison of isolation from water specimens by centrifugation and filtration. AB - A comparison was made between membrane filtration and centrifugation for the isolation of Legionella pneumophila from seeded water samples. Using samples of varying concentration, the optimum speed and time of centrifugation were determined and the relationship between the number of organisms present in the water and the proportion recovered was examined. Following this, sequential routine environmental waters were filtered and centrifuged in parallel. Centrifugation and filtration using nitrocellulose filters were found to be comparable. The optimum speed and time of centrifugation was approximately 6000 g for 10 min. There was a constant proportion of viable organisms recovered irrespective of the concentration in the unspun samples. PMID- 3678389 TI - Food-borne outbreak of group G streptococcal sore throat in an Israeli military base. AB - A food-borne outbreak of sore throat caused by Lancefield group G beta-haemolytic streptococci and involving 50 persons occurred in May 1983 in an Israeli military camp. All of the patients available for clinical examination had sore throat and difficulty in swallowing. Exudative tonsillitis occurred in 46% of the patients and the body temperature was above 37.5 degrees C in 81%. The pattern of attack was uniform over the base and 37 became ill during the night and morning of the 5 May. Thirty-two (84%) of the throat cultures taken from 37 patients grew group G beta-haemolytic streptococci. Eight of 29 contacts were positive for group G beta haemolytic streptococci and 6 of the 28 foodhandlers examined had positive cultures of the same group. The organism was also isolated from one food sample. The epidemiological and laboratory investigations indicated that a food handler, a convalescent carrier of group G streptococci, might have been the source of infection. Assumptions on the potential of non-group A streptococci to cause epidemics are discussed. PMID- 3678390 TI - Group L beta-haemolytic streptococcal infection in meat handlers: another streptococcal zoonosis? AB - Group L, beta-haemolytic streptococci can cause infection in dogs, pigs, cattle and sheep but there have been very few reports in man. In studies of skin infection in meat handlers we cultured group L streptococci from clinically infected wounds, impetigo and paronychia of 15 patients involved in the slaughter and processing of chickens and pigs. Staphylococcus aureus was also present in eight (53%) of the lesions. At least five other infections with group L streptococci in meat and animal handlers are known to have occurred in other parts of England in recent years, and brief details are given. PMID- 3678391 TI - Survival of thermophilic campylobacters on fingertips and their elimination by washing and disinfection. AB - A simple impression-plate technique has been used to investigate the survival of four thermophilic campylobacter strains applied to fingertips. Campylobacters suspended in 0.1% peptone water and dried on the fingertips survived for different periods of time ranging from less than 1 to greater than or equal to 4 min. However, campylobacters suspended in chicken liquor or blood survived for much longer periods. The most resilient organism was Campylobacter jejuni NCTC 11392 which, when suspended in 50% horse blood, survived for an hour. Suspensions containing 10(6)-10(7) organisms prepared in 50% blood and dried on to fingertips were removed by thorough hand washing with either soap and water or water alone followed by drying on paper towels, but persisted on wet hands. The organisms were also eliminated by wiping the hands with a tissue saturated with 70% isopropyl alcohol for 15 sec. PMID- 3678392 TI - Serogroups of thermophilic campylobacters from humans and from non-human sources, Israel 1982-1985. AB - The distribution of serogroups of thermophilic campylobacters isolated in Israel from human patients (2421 isolates), chicken (942), turkeys (158), cattle (398), wild birds (234) and other sources, was studied. Among the human isolates, 74 ROG serogroups were identified. The six most commonly isolated of these (1, 18; 11; 12; 8,23; 4 and 5,39) were found frequently in chickens. Only four common serogroups in man were also common in cattle, three in turkeys and two in wild birds. Two common serogroups in man (1,18 and 5,39) were prevalent all over the country, while others were regionally distributed. When the prevalence of different serogroups in Israel was compared to that in Canada, some groups were common to both countries and others were common in only one or the other. Campylobacter jejuni accounted for 86.7% to 92.1% of the isolates from man, chickens, turkeys, cattle and most of the wild birds. C. coli was found in 34.4% of isolates from cattle egrets and in 76.5% of those from pigs. PMID- 3678393 TI - Molecular relationship among Salmonella dublin isolates identified at the Center for Enterobacteriaceae of Palermo during the years 1971-85. AB - A molecular epidemiological study was carried out on 60 Salmonella dublin isolates identified at the Southern Italy Enterobacteriaceae Center between 1971 and 1985. These included 23 isolates from children with diarrhoea in Palermo obtained during 1984. All isolates from the outbreak of gastroenteritis in children were resistant to chloramphenicol and streptomycin and harboured two plasmids of 50 MDa and 3 MDa molecular weight, whereas the majority of the isolates identified before 1984 were susceptible to these antibiotics and carried only a 50 MDa molecular weight plasmid. Four S. dublin strains successively identified from cattle (Palermo, Foggia, Portici) and from a child (Palermo) were shown to possess similar antibiotic resistance patterns and plasmid profiles to S. dublin isolates from the outbreak of gastroenteritis in children. The 50 MDa plasmid was shown to be associated with virulence in mice, while it was not possible to assign any genetic function to the 3 MDa plasmid. PMID- 3678395 TI - An estimate for the source of coagulase-negative staphylococci in blood cultures. AB - An estimate for the source of coagulase-negative staphylococci in blood cultures is presented and its use illustrated in two populations. The method estimates the probability that a positive blood culture is positive due to contamination and the probability of it being positive due to bacteraemia. The effect of changes in efficiency of the blood culture technique on these estimates is demonstrated. One of the illustrative populations consists of 537 sample pairs from 273 patients, taken after open-heart surgery in 1978-80. The other consists of 500 consecutive sample pairs taken in one of two hospitals in 1983-4. PMID- 3678394 TI - Salmonella serotypes and incidence of multiply-resistant Salmonellae isolated from diarrhoeal patients in Hong Kong from 1973-82. AB - Salmonella was the most frequent bacterial pathogen isolated from patients with acute diarrhoea in Hong Kong. In Queen Mary Hospital, the major hospital on Hong Kong Island, 94.7% of salmonellae isolated from faecal specimens from patients during the period 1973-82 belonged to the gastroenteric group, while 5.3% belonged to the enteric fever group. Amongst the gastroenteric group, 68 salmonella serotypes were identified, with Salmonella derby, S. typhimurium and S. anatum being the predominant ones. Three outbreaks caused by S. johannesburg, S. worthington and S. wandsworth were detected. Of S. typhimurium, 61.6% were resistant to multiple antibiotics and belonged to four major phage types: 193, 22, 138 and U288. The majority (96.8%) of S. johannesburg strains which caused a widespread epidemic were multiply-resistant. Multiple antibiotic resistance was rarely observed in most other gastroenteric salmonellae. S. typhi was the commonest of the enteric fever group isolated from the blood of patients. Nineteen phage types were identified; E1 being the commonest (18.5%) while 21% were nontypable. Many of these isolated were resistant to streptomycin or sulphadiazine, but none were resistant to ampicillin, chloramphenicol or trimethoprim. PMID- 3678396 TI - Staphylococcal food poisoning on a cruise ship. AB - Two waves of vomiting and/or diarrhoea affected approximately 215 of the 715 passengers on a Caribbean cruise ship. The outbreak was independently associated with eating cream-filled pastries at two separate meals. Staphylococcus aureus phage type 85/+ was isolated from cases and pastry cooks, but not from controls. This is the first well-documented outbreak of staphylococcal food poisoning on a cruise ship. PMID- 3678398 TI - A new serovar mogdeni of serogroup Tarassovi of Leptospira interrogans isolated from a sewage plant in England. AB - Among 30 strains of leptospires isolated from samples of sewage taken before and during treatment at two sewage plants in England, only one appeared to belong to Leptospira interrogans, the species that comprises the leptospires that are pathogenic to man and animals. That strain, Compton 746, was isolated from settled sewage, before treatment at a treatment plant that deals mainly with human sewage. It was shown serologically to belong to serogroup Tarassovi and appears to represent a new serovar that has been named mogdeni after the name of the sewage plant, Mogden, from which it was isolated. PMID- 3678397 TI - The isolation of fusobacteria from tropical ulcers. AB - Tropical ulcer is a disease found most commonly in the tropics, although the disease is not confined to those areas. Young children are affected most frequently and the disease is thought to be a polymicrobial infection with fusobacteria, aerobic microorganisms and spirochaetes each playing a role. The fusobacteria have been reported on smears but have not been cultured thus far. We report the isolation and culture of these organisms from 46 ulcers and have also demonstrated the same organisms in skin biopsies from these lesions. PMID- 3678400 TI - Serodiagnosis of leptospirosis in China by the one-point MCA method. AB - The one-point MCA method is very simple to perform and useful as a screening test in diagnosing leptospirosis in routine clinical laboratories. The kit, sensitized with six serovars occurring in Japan, was also useful in detecting serum antibodies of patients with leptospirosis in China. PMID- 3678399 TI - Serological prevalence of leptospiral infection in domestic animals in West Malaysia. AB - A cross-sectional serological survey of domestic animals in West Malaysia revealed that 25.5% of the animals examined had agglutinating antibodies to one or more antigens belonging to Leptospira interrogans. Significant prevalence of infection was observed in cattle (40.5%), buffaloes (31%) and pigs (16%). The Sejroe serogroup was shown to be the principal one involved in cattle and buffaloes, and to a lesser extent the Tarassovi and Pomona serogroups. Evidence of infection in domestic animals by strains bearing the other seven antigens appeared insignificant and was indicative of sporadic infection. A majority of the large (semi-intensive) cattle and buffalo farms demonstrated a high prevalence of leptospiral infection. In both species of domestic animals mentioned above, the prevalence of infection was significantly higher (P = 0.01) in the semi-intensive farms than in the smallholdings. Amongst cattle, the droughtmasters had the highest prevalence whilst the Kedah-Kelantan (an indigenous breed) had the lowest prevalence of leptospiral infection. In general, the temperate breeds of cattle had a significantly (P = 0.01) higher prevalence of infection than local breeds. Leptospiral infection in goats and sheep was shown to be sporadic, and the Pomona serogroup was the principal leptospiral serogroup involved in these small ruminants. The prevalence of infection in pigs was observed to decline during the study period, and it is suspected that pigs in West Malaysia are the maintenance host for serovar pomona whilst cattle are the maintenance host for serovar hardjo. Overall, it appears that domestic animals in Malaysia will play a bigger role in the epidemiology of leptospiral infection with the advent of sophisticated farming. PMID- 3678401 TI - One-point method for serological diagnosis of leptospirosis: a microcapsule agglutination test. AB - This paper describes a simple and rapid microcapsule agglutination (MCA) test. The results obtained by this new test have been compared with those obtained by the microtitre MCA and the microscopic agglutination (MA) test. The procedures required for the new test are easier and can be performed more rapidly than those necessary for the microtitre MCA test. Furthermore, the new test is more sensitive than the MA test in the early stages of leptospirosis. This new test appears satisfactory as a screening test for the early diagnosis of leptospirosis. PMID- 3678402 TI - Invasive nosocomial pulmonary aspergillosis: risk factors and hospital building works. AB - A retrospective epidemiological study of 22 observations of invasive pulmonary aspergillosis, of which 18 were fatal, occurring over a period of 30 months, implicated certain building sites within the hospital. The building works were responsible for the diffusion into the atmosphere of fungal spores from normally closed reservoirs, notably false ceilings, fibrous thermal and/or acoustic insulation materials and roller-blind casings. The results of our study permit us to suggest that protective measures should be set up or that immunodepressed patients are evacuated when such works are to be carried out in an in-patient establishment. PMID- 3678403 TI - The bacteriological quality of traditional water sources in north-eastern Imo State, Nigeria. AB - Monthly bacteriological water testing of traditional water sources (ponds, rivers, unprotected springs and traditional wells) used by five villages in northeastern Imo State, Nigeria, was conducted during the period January 1983 to August 1985. The membrane-filtration technique was used to detect faecal coliforms (FC) and faecal streptococci (FS). Evidence of faecal pollution was seen throughout the year for all water sources. During the study period, the monthly geometric mean counts per 100 ml of water (all sources combined) ranged from 760 to 17877 for FC and from 678 to 17394 for FS. The peak period of faecal pollution occurred during the transition between the dry and wet seasons and in the early wet season. During this peak pollution season (February-May), the geometric mean counts were 2.5-7.2 times higher than in the remaining part of the year for all source types except rivers, with ponds being the most heavily polluted. Preliminary findings on the sensitivity and specificity, in this tropical environment, of the standard membrane-filtration technique for enumerating FC are presented. The implications of the findings of this study for the environmental control of waterborne and hygiene-related diseases are discussed. PMID- 3678404 TI - The bacteriological quality of bottled natural mineral waters. AB - Fifty-eight bottles of natural mineral water, taken from the point of sale, were bacteriologically examined. No coliforms or Aeromonas sp. were isolated from any sample. High total bacterial counts were found particularly in the still waters. Most of the organisms isolated in the total counts were Gram-negative rods, but Gram-positive organisms were also isolated. Gram-positive cocci were further identified, some of which were known human commensals suggesting contamination of the waters prior to bottling. PMID- 3678405 TI - An assessment of methods for routine local monitoring of vaccine efficacy, with particular reference to measles and pertussis. AB - The efficacy of measles and pertussis vaccines was investigated using several different procedures based upon data routinely available at Local Health Authority level in England and Wales. It is demonstrated that such estimates can be derived by methods which can be carried out simply and routinely by local health department staff. Several theoretical and practical difficulties in the procedures are discussed. It is recommended that Health Authorities consider monitoring by a routine procedure based on crude case-control analysis of recorded vaccination status of notified cases compared with that of the population in the Child Health computer file, or of matched controls drawn from Child Health Registers. A simple protocol for such studies is provided. PMID- 3678406 TI - Rift Valley fever: a sero-epidemiological survey among pregnant women in Mozambique. AB - Rift Valley fever (RVF) causes abortion in sheep and cattle. However, the teratogenic and abortogenic potential of RVF in humans is not known. Sera from a total of 1163 pregnant women in Mozambique were tested for RVF virus antibodies by ELISA and 28 (2%) were found to be positive. Mothers experiencing fetal death or miscarriage (155) had the same RVF virus antibody prevalence as those with normal deliveries. Analysis of maternity histories showed some indication of increased fetal wastage among women positive for RVF virus antibody. The ELISA used in this study was compared with a plaque reduction neutralization test and found to be equally sensitive and specific for the detection of RVF virus IgG antibodies. PMID- 3678407 TI - The levels of measles antibodies in Nigerian children aged 0-12 months and its relationship with maternal parity. AB - Six hundred and fifty-seven children aged between 0 and 12 months were randomly chosen and studied for measles antibody titres by the haemagglutination inhibition (HAI) test. The results showed significant variations in HAI antibody titres. Children between 0-3 months showed high measles HAI antibody titres which declined to a trough between 4 and 6 months. A rise in HAI antibody titre was observed from 10 to 12 months age. Multiparity and higher age in the mothers were noted as probable factors influencing the titres of measles HAI antibody in children. The results indicated that with increased maternal parity, measles HAI antibody titres in the children declined. PMID- 3678408 TI - Antigenic relationship of West Nile strains by titre ratios calculated from cross neutralization test results. AB - The antigenic relationship of ten South African West Nile isolates, the South African prototype virus H442, the Egyptian strain EG101 and the Indian strain G2266 were compared using titre ratios. The titre ratios or 'R' values were calculated from heterologous and homologous neutralization titres and expressed as a percentage. Substantial antigenic differences were demonstrated between the South African prototype strain and the majority of the recently obtained South African isolates, seven of which were fairly closely related and possibly form a distinct antigenic sub-set. The recent isolates also differed from the Egyptian and Indian West Nile isolates. The heterologous results between the South African West Nile strains and the Indian strain G2266 suggest that prior infection with an Indian West Nile virus would give poor protection against the South African viruses, whereas the reverse would not be so. PMID- 3678409 TI - Quantitative methods in the review of epidemiologic literature. PMID- 3678410 TI - Inhibition of human bone marrow-derived stem cell colony formation (CFU-E, BFU-E, and CFU-GM) following in vitro exposure to organophosphates. AB - Cholinergic toxicity of organophosphate insecticides is regarded as the principal health hazard associated with both human and animal exposures. Recent studies indicate that these pesticides may have important effects on both the immune and hematopoietic systems. In the present study, human bone marrow cells were exposed in vitro to paraoxon and malaoxon (the primary metabolites of parathion and malathion). These compounds produced dose-dependent depression of colony formation by erythrocyte (burst-forming units-erythroid [BFU-E] and colony forming units-erythroid [CFU-E]) and granulocyte-macrophage progenitors (colony forming units-granulocyte-macrophage [CFU-GM]). CFU-E colony formation was reduced 15%-57%, by both paraoxon and malaoxon, in the range of 10(-8)-10(-5) M. No effects were seen at 10(-9) and 10(-10) M. Colony formation by BFU-E was reduced 15%-75%, at 10(-9)-10(-5) M organophosphate (OP), then returned to normal at 10(-10) M OP. In comparison to CFU-E, BFU-E appeared to be more sensitive to the suppressive action of OPs. Numbers of CFU-GM colonies were reduced 16%-59% in the range of 10(-9)-10(-5) M OP, then returned to normal at 10(-10) M OP. Choline chloride added to marrow cultures (final concentration, 10 mM) enhanced CFU-GM colony formation at all concentrations of paraoxon and malaoxon. Our results provide a rationale for assessing hematologic parameters in occupationally exposed individuals, and indicate the need to determine both the mechanism and the environmental health consequences of the observed hematopoietic effects. PMID- 3678411 TI - Fractionation of normal and beta-thalassemic human hemopoietic progenitor cells by immunomagnetic beads. AB - Depletion of adherent cells, followed by simultaneous immunomagnetic bead depletion of Leu 4+, Leu 7+, Leu 11+, Leu M1+, Leu M3+, B1+, WEM-G11+, and Glycophorin A+ cells from normal bone marrow mononuclear cells, consistently led to recoveries of erythroid and nonerythroid colony-forming cells of greater than 100% and enrichment of 13- to 99-fold. Similarly, the recovery of mixed erythroid colony-forming cells was greater than 100%, with enrichments of 7.5- to 262-fold. This simple procedure, when used on normal bone marrow and beta-thalassemic peripheral blood mononuclear cells, as well as providing significant enrichment, suggests that colony assays on unfractionated human mononuclear cells specifically underestimate the number of BFU-E, Mix-CFC, and nonerythroid-CFC present. PMID- 3678412 TI - Effect of oxygen on the clonal growth of adherent cells (CFU-F) from different compartments of mouse bone marrow. AB - We have used collagenase to isolate cell populations from different compartments of mouse bone marrow. Cells were obtained from the shaft of the femur, the endosteum, and compact bone. We have studied the growth-enhancing effects of physiologically low oxygen levels on fibroblast colony-forming unit (CFU-F) growth in vitro. Low oxygen levels (0.1%-10% O2) increased CFU-F formation 1.8- to 2.8-fold. However, cells from the compact bone consistently grew with much higher efficiencies (12- to 31-fold) than did cells from femoral cavity and endosteal areas. These data indicate the usefulness of enzymatic methods of isolating cells from compartments of bone and the use of low oxygen atmosphere to enhance stromal cell growth in vitro. PMID- 3678413 TI - Degeneration and atrophy of the thymus of lethally irradiated dogs, rescued by transfusion of cryopreserved autologous blood leukocytes. AB - Dogs exposed to a fatal radiation dose of 12 Gy were rescued by transfusion of autologous blood leukocytes. A severe acute and long-lasting damage to the thymus was observed. The acute damage, as observed on the tenth day, consisted of a marked reduction in the number of lymphocytes, degeneration of Hassall's bodies, and hemorrhage. Long-term effects, observed several months after irradiation, were partial to total atrophy of the thymus. Regeneration, when it occurred, was limited to a few small isolated areas in which lymphopoiesis was supported by epithelial reticular cells. In contrast, the lymph nodes of all dogs had abundant cortical lymphopoiesis. The abundant hemopoiesis present in the marrow from the tenth day after irradiation until the end of the observation period should have provided sufficient circulating precursor cells to seed the thymus and regenerate the organ to the same extent as that observed in the other blood-forming organs. The impairment of lymphopoietic regeneration in the thymus seems to be due, therefore, to damage caused by irradiation on the specific stroma of the organ, which is not able to support such activity. PMID- 3678414 TI - Aerosol deposition in automatic dosimeter nebulization. AB - A new dosimeter nebulization method was studied in 10 asthmatics and 8 normal volunteers by delivering fixed doses of 99mTc-traced radioaerosol in 0.2 s periods of tidal breathing. Two separate inspiratory phases were studied with the onset of nebulization, when in the earlier phase 15% and in the later phase 60% of tidal volume was inhaled. Further, bronchodilator administration was analogically assessed in the asthmatics. In healthy subjects, the total lung deposition was 17% greater in the earlier phase (p less than 0.005) than in the later one. In asthmatics, the difference was not significant. The losses of aerosol outside the lower respiratory tract were minimized, in the mouthwashing 0.3% and in the exhaled air 1.4%. The onset of nebulization (early or late) had no significant effect on bronchodilation with salbutamol in asthmatics. We conclude that the present dosimeter method is useful for efficient delivery of radioaerosols and drugs, and for standardization of bronchoprovocation. PMID- 3678415 TI - Bronchodilator effect of Aerochamber and Inspirease in comparison with metered dose inhaler. AB - This trial was performed in a randomized double-blind manner on four different days in 13 asthmatic patients in order to compare the bronchodilator efficacy of two different inhalation devices, Inspirease (IP) and Aerochamber (AC), to the conventional metered dose inhaler (MDI). The results showed that clenbuterol determined a significant FEV1 increase inhaled either via MDI or via IP and AC. IP caused a greater bronchodilatation than AC, 30 min after clenbuterol administration. IP caused a greater mean increase (P less than 0.05) in FEV1 than the MDI at all time intervals; AC provided an improvement in bronchodilator response over directly administered MDI. Such responses are only marginally clinically relevant when patients use MDI correctly. These devices are mainly indicated in patients with poor hand-lung coordination. PMID- 3678416 TI - Severe alveolar haemorrhage in Churg-Strauss syndrome. AB - We report two patients with Churg-Strauss syndrome (CSS), who presented with life threatening alveolar haemorrhage as the major manifestation of their disease. One improved on high doses of steroids and cyclophosphamide; the other deteriorated on prednisolone alone, but responded rapidly to the addition of cyclophosphamide and plasma exchange. On follow-up, neither showed further evidence of lung disease except for well-controlled asthma. Pulmonary haemorrhage is a well recognised phenomenon in patients with other forms of systemic vasculitis, and CSS must now be considered in the differential diagnosis of such cases. PMID- 3678417 TI - Increased serum placental-like alkaline phosphatase activity in smokers originates from the lungs. AB - To study the origin of increased serum placental-like alkaline phosphatase (PLAP like) activity in smokers, heat stable alkaline phosphatase activity was assayed from serum and bronchoalveolar lavage (BAL) fluid in 83 smoking and non-smoking patients. PLAP-like activity was increased in about 80% of the smokers, independently of the underlying lung disease. Isoenzyme activities in BAL fluid correlated (r = 0.631, p less than 0.001) with serum values. When adjusted for the albumin concentration, mean PLAP-like activity in BAL fluid was almost 1000 fold higher than that in serum, suggesting local synthesis of PLAP-like isoenzymes in the lungs. Although a direct dose-response effect was not observed, the values in serum and in BAL fluid tended to be higher in patients smoking over 10 cigarettes daily as compared to patients smoking less. In ex-smokers the results indicated that PLAP-like activity decreased to the level observed in non smokers within 5 years after cessation of smoking. PLAP activity was L-leucine sensitive compatible with the Nagao-variant type of PLAP in almost all cases. In three patients the activity was due to the L-leucine resistant (true placental) isoenzyme. PMID- 3678418 TI - Gastro-oesophageal reflux and triggering of bronchial asthma: a negative report. AB - The aim of this study was to investigate whether a direct causal relationship exists between gastro-oesophageal (GO) reflux episodes and bronchial asthma. Forty-two patients with moderate or severe asthma and pathological GO-reflux were examined using a 24-h pH test at a proximal and a distal level of the oesophagus. Respiratory symptoms and the use of extra beta-2 agonist metered dose inhaler were recorded in a standardized protocol, and peak expiratory flow (PEF) was recorded once an hour until the patient went to bed. No association was found between reflux at either the proximal or the distal level of the oesophagus and bronchial symptoms or PEF reductions. We conclude that GO-reflux does not play an important role as an immediate trigger factor in bronchial asthma. PMID- 3678419 TI - Onset of symptoms in spontaneous pneumothorax: correlations to physical activity. AB - The degree of physical activity at the onset of spontaneous pneumothorax was evaluated retrospectively in 219 patients, predominantly smokers who had had this disease for the first time. More than 87% had been inactive at the onset of the symptoms. Moderate exertion was recorded in only 2%, and no patients were exerting themselves heavily when the symptoms began. The occurrence of spontaneous pneumothorax was unevenly (p less than 0.001) distributed over the day. In 9% the symptoms had their onset during quick movement--such as fastening a seat belt--without any effort. The inactivity or low activity at the onset of symptoms of spontaneous pneumothorax suggests that this condition is unrelated to muscle effort. PMID- 3678420 TI - Ultrastructure of the bronchial epithelium in adult patients with cystic fibrosis. AB - The respiratory epithelium of large airways was studied in biopsy specimens obtained by bronchoscopy in seven patients with cystic fibrosis (CF). All but one of these patients were chronically colonised with Pseudomonas aeruginosa. Biopsy specimens were also obtained from the large airways of 10 control patients with or without signs of chronic bronchitis. All samples were studied by transmission electron microscopy. Morphometry was applied to assess the volume density of various cell types and intercellular spaces and for quantification of microvilli of ciliated cells. In CF patients, the average number of microvilli per ciliated cell was decreased by 17% compared to patients with chronic bronchitis and by 34% compared to patients with apparently normal bronchi (p less than 0.02, respectively), but otherwise no abnormalities were found. In particular, the volume density of goblet cells was not increased. Thus the ultrastructure of the airway epithelium may be nearly normal in CF, even in adult patients with chronic respiratory infection. PMID- 3678421 TI - Effects of nifedipine and oxygen on pulmonary haemodynamics in severe scoliosis. AB - In the present study the response of the pulmonary circulation to a vasodilator agent (nifedipine) and to low-flow oxygen (FiO2 35%) has been studied both at rest and during exercise (steady state, 25 W) in nine patients with severe scoliosis (spinal curve + 100 degrees, FVC 38%). All patients were dyspneic on exertion and had had at least one episode of right heart failure. The mean pulmonary artery pressure (Pap) ranged from 13 to 37 mmHg at rest and ranged from 30 to 75 mmHg during exercise. Standard exercise, performed 60 min after 20 mg sublingual nifedipine, was associated with a reduction in mean Pap (49 mmHg) as compared with exercise performed during the control period (58 mmHg, p less than 0.001). Pulmonary vascular resistance (PVR) on exercise decreased more on nifedipine (28.9%) than on oxygen (13.9%) (p less than 0.05). Our results suggest that nifedipine improves pulmonary haemodynamics in patients with severe scoliosis complicated by cor pulmonale. PMID- 3678422 TI - Acute fulminating alveolar hemorrhage as presenting symptom in Wegener's granulomatosis. Anticytoplasmatic antibodies as a diagnostic tool. PMID- 3678423 TI - Localized amyloidosis of central airways. PMID- 3678424 TI - Localised amyloid--presenting as bronchial asthma. PMID- 3678425 TI - S-adenosyl-L-methionine facilitates recovery from deficits in delayed response and hand movement tasks following brain lesions in monkeys. AB - Effects of S-adenosyl-L-methionine (SAMe) on deficits in a trained delayed response task or trained hand movement tasks after lesions in bilateral dorsolateral prefrontal cortices or the hand-arm area of the unilateral motor cortex in monkeys were studied. Lesions disturbed the delayed response task or hand movement tasks moderately or severely for 1 week to several months depending on the extent of the lesion and nature of the task. Although treatment with small doses of SAMe (10 mg/kg/day, i.m.) had no effect on these disturbances, treatment with moderate doses of SAMe (20 or 30 mg/kg/day, i.m.) reduced impairments and promoted recovery from both disturbances. Pretreatment with SAMe (30 mg/kg/day, i.m.) facilitated recovery from delayed response task deficits due to administration of reserpine (0.3 mg/kg, i.m.) in monkey with bilateral prefrontal cortical lesions, but not in intact monkey. The data suggest that SAMe improves recovery from behavioral disturbances due to brain damage, and this is partly due to increased monoamine turnover rate. PMID- 3678426 TI - Recovery of muscle from tetrodotoxin-induced disuse and the influence of daily exercise. 1. Contractile properties. AB - The extent of recovery in rat gastrocnemius muscles which have undergone atrophic changes due to 4 weeks of inactivity caused by sciatic nerve superfusion of tetrodotoxin, was investigated. Control and tetrodotoxin-treated female Sprague Dawley rats were subjected to either a daily program of grid-climbing or swim training for 4 weeks, or benefited from cage activity only. In situ contractile properties of the gastrocnemius were then measured. Twenty-eight days of recovery was insufficient to allow a complete reversal of the changes produced by 28 days of inactivity. The gastrocnemius remained atrophied (25%) and tetanically weaker than normal in the recovered animals. The maximal rate of rise of the twitch was partially recovered whereas that developed during a maximal contraction was normal. Maximal rate of rise expressed relative to the tension output was elevated, however, for both twitch (%Pt/ms) and maximal contraction (%Po/ms). Swimming did not influence the recovery of muscle size or strength. Grid climbing, on the other hand, produced heavier and stronger muscles and a faster recovery of %Pt/ms. This study clearly illustrates the importance of muscle load in regulating muscle size and strength. PMID- 3678427 TI - A morphological study of the collateral reinnervation of the cat's canine tooth. AB - We examined the morphologic characteristics of the collateral reinnervation of the cat's canine tooth pulp. Collateral reinnervation was stimulated in six adult cats by transecting the ipsilateral inferior alveolar nerve and preventing it from regenerating by sealing the ligated nerve inside a nylon tube. The apices of the canine teeth were examined after 15 weeks using electron microscopy and each axon was counted and measured. Compared with contralateral control teeth, the collateral reinnervation consisted of fewer myelinated fibers and in five animals the number of nonmyelinated fibers was also smaller. In one animal the nonmyelinated count on the operated side exceeded that on the control side. The total number of axons was 33.5% of the number in control teeth, considerably fewer than seen after reinnervation by regenerating fibers in previous experiments. The structural characteristics of the collateral fibers were similar to those of regenerating nerve fibers. Compared with controls the myelinated collateral fibers were smaller and had thinner myelin sheaths. There were more nonmyelinated fibers containing only one axon. More nonmyelinated fibers had exposure of part of their axolemma to the extracellular space and there was also an increase in axoaxonal apposition. PMID- 3678428 TI - Increase in ibotenate-stimulated phosphatidylinositol hydrolysis in slices of the amygdala/pyriform cortex and hippocampus of rat by amygdala kindling. AB - Hydrolysis of membrane phospholipid phosphoinositides following ibotenate stimulation of an excitatory amino acid receptor subtype has recently been demonstrated to be a receptor-mediated biochemical response. The present study examined ibotenate-stimulated phosphoinositides hydrolysis, determined as accumulation of [3H]inositol 1-phosphate, in amygdala/pyriform cortical and hippocampal slices of amygdala-kindled rats which exhibited fully developed kindled seizures on 20 consecutive days. Animals which underwent a sham operation were used as controls. Ibotenate (10(-3) M)-stimulated accumulation of [3H]inositol 1-phosphate increased significantly by 191% in the amygdala/pyriform cortex (P less than 0.01) and by 59% in the hippocampus (P less than 0.05) of the amygdala-kindled rats killed 24 h after the last seizure. One week after the last seizure, a similar magnitude of significant increase (by 171%, P less than 0.05) was maintained in the amygdala/pyriform cortex of the amygdala-kindled rats. In contrast, the increase in the hippocampus had attenuated by this time, although accumulation of [3H]inositol 1-phosphate increased significantly (P less than 0.05) when stimulated by 10(-4) M ibotenate. These results suggest that enhancement of ibotenate-stimulated phosphoinositides hydrolysis in the amygdala/pyriform cortex may be associated with the long-lasting seizure susceptibility of amygdala-kindled rats. PMID- 3678429 TI - Dissociation of the end-plate potential run-down and the tetanic fade from the postsynaptic inhibition of acetylcholine receptor by alpha-neurotoxins. AB - The effects of so-called postsynaptic snake alpha-neurotoxins (alpha bungarotoxin, cobratoxin, erabutoxin b) on the wanings of tetanic contraction (tetanic fade) and the run-down of end-plate potentials during stimulation at 100 Hz were studied, respectively, in intact and cut mouse phrenic nerve-diaphragm preparations. No tetanic fade was evident with high concentrations of toxins until the complete failure of contractile response whereas the tetanic fade was evident after prolonged incubation with lower concentrations of toxins. The proportion of junctions exhibiting end-plate potential run-down increased progressively during toxin incubation. However, depression of end-plate potential amplitude by the toxins was not necessarily accompanied by run-down. The tetanic fade and the run-down became more pronounced for a time shortly after washout of toxins despite the restoration of single twitches and end-plate potential amplitudes, indicating the presynaptic origin of these effects induced by alpha neurotoxins. We demonstrated that the functions of the pre- and postsynaptic acetylcholine receptors can be dissociated by using the different kinetics of toxin-receptor interactions. The results also implicate that a positive feedback enhancement of transmitter release operates via the presynaptic acetylcholine receptor in the neuromuscular junction in normal physiological conditions during repetitive pulses. PMID- 3678430 TI - Reciprocal pre- and postsynaptic actions of cocaine at a central noradrenergic synapse. AB - Single-unit microelectrode studies were conducted to test the effects of systemic cocaine HCl on spontaneously firing single noradrenergic locus ceruleus (presynaptic) and cerebellar Purkinje (postsynaptic) neurons in rats in vivo. The spontaneous neuronal activity of all locus ceruleus neurons was inhibited by cocaine in a dose-dependent manner (0.5 to 2 mg/kg). These doses of cocaine elicited a predominant activation of postsynaptic Purkinje neurons. No effect of cocaine on neuronal action potential amplitude or slope was observed. Similar doses of the local anesthetic agent, procaine, did not affect action potential amplitudes or slopes of either locus ceruleus or Purkinje neurons. In addition, although cocaine elicited a significantly greater absolute change in the discharge rate of locus ceruleus neurons than of Purkinje neurons, the effects of procaine on those neurons were not significantly different from each other. The inhibition of locus ceruleus neurons by cocaine was significantly attenuated by pretreatment either with the alpha 2-adrenoceptor antagonist, yohimbine, or with reserpine. The activation of Purkinje neurons by cocaine was also significantly attenuated by reserpine pretreatment. Systemic cocaine administration (1 mg/kg, i.v.) did not potentiate the inhibitory effects of either locus ceruleus stimulation or local iontophoretic application of norepinephrine on Purkinje neuron discharge rate. We conclude that cocaine potently inhibits locus ceruleus neurons and this effect probably elicits Purkinje cell activation through disinhibition. PMID- 3678431 TI - Premovement silence in agonist muscles preceding maximum efforts. AB - Electromyographic silent periods (premovement silence) preceding the initial agonist burst were studied in 11 healthy subjects who performed rapid forearm flexions and extensions. Premovement silence occurred with higher frequency during self-paced movements when subjects produced maximum power efforts than during a reaction time paradigm. The occurrence and duration were significantly correlated with the peak acceleration of the movement. Premovement silence occurred specifically in those muscles involved in the intended movement, often in several synergists with different latencies and durations. The shortest latency of premovement silence was considerably briefer than that of the earliest voluntary increase in EMG. The findings suggest that premovement silence may increase peak muscular force by bringing motoneurons into a nonrefractory state prior to their activation. The fact that it occurred on some, but not all, trials within single subjects and had a variable duration from trial to trial suggests that it may be a learned, rather than automatic, motor response. PMID- 3678432 TI - Changes of activity of cortical neurons induced by acetylcholine in adult and young rats. AB - Acetylcholine was applied microiontophoretically by means of multibarrel electrodes to neurons in the sensorimotor cortex of adult, 18-, 15-, 12-, and 9 day-old rats anesthetized with urethane. A total of 229 neurons was recorded; only 22 of them were in 18- and 15-day-old rats because of similarity of results with those from adult as well as 12-day-old animals. In adult rats 43 of 58 neurons recorded in infragranular layers responded to acetylcholine with a marked increase in their firing. In 12-day-old rats the incidence of excitatory responses to acetylcholine was also high: 59 of 86 cells again were localized predominantly in deep cortical layers (V and VI). A marked difference was observed in 9-day-old rats: only 15 of 63 neurons were excited by acetylcholine. A majority of cells did not respond at all--including units localized in infragranular layers. Two cells in layer V responded to acetylcholine by an inhibition. Our results indicate that there is a marked increase in cholinoceptivity of cortical neurons between postnatal days 9 and 12. This finding is in agreement with the finding that local application of acetylcholine can elicit an epileptogenic focus in 12-day but not in 9-day-old rat pups. PMID- 3678433 TI - Response properties of the perioral reflex in Parkinson's disease. AB - Analyses of the response magnitudes of the short-latency perioral reflex were made in a group of Parkinson disease patients and control subjects. As a group, the parkinsonian subjects manifested reflex magnitudes which were increased relative to normal. For low-acceleration, mechanical displacements of perioral tissue (less than 500 cm/s2), the perioral reflex was not elicited in normal controls. However, such low-acceleration stimuli did elicit the perioral reflex in more than half of the parkinsonian subjects studied. These findings are consistent with earlier findings of increased sensitivity of facial and perioral reflexes associated with disturbances of the basal ganglia. These results contribute to the understanding of specific stimulus-response characteristics of the facial reflex and the role of the basal ganglia in orofacial motor control. The finding of increased sensitivity to mechanical stimuli in Parkinson's disease supports the hypothesis of basal ganglia gating or regulation of afferent information. PMID- 3678434 TI - Neurobehavioral effects of chronic halothane exposure during developmental and juvenile periods in the rat. AB - Chronic exposure of rats to the surgical anesthetic agent halothane during development has been found to cause both neural and behavioral impairment. Among the halothane-induced deficits are retarded synaptogenesis and impaired spontaneous alternation. It is unclear how long after birth the susceptibility to the neurotoxic effects of halothane persists. The present study compared in rats the effects of halothane exposure on synaptic density and spontaneous alternation during early and late periods of maturation. All three experimental groups were exposed to 100 parts per million of halothane for 8 h/day, 5 days/week. One group (early exposure) was exposed from day 2 of conception until 30 days after birth. The second group (late exposure) was exposed to the same amounts from day 31 until day 90 after birth. The third group (continued exposure) received both periods. The control group was treated in the same way, but was not exposed to halothane. As found in the previous study, there were greater effects of halothane on synaptogenesis than on spontaneous alternation; impairment of spontaneous alternation behavior was found only with the early exposure. Deficits in synaptic density were found with both early and late exposure, although the early exposure had more severe effects. Halting the exposure to halothane on day 30 reinstated control-like rates of synaptogenesis, but the deficit in synaptic density from the early exposure persisted into adulthood. The potent neurotoxic effect of halothane in suppressing synaptogenesis highlights not only its potential as a hazard but also its potential as an experimental tool for manipulating the rate of synaptogenesis and examining the relationship between synaptic development and behavioral maturation. PMID- 3678435 TI - In vitro culture and labeling of neural cell aggregates followed by transplantation. AB - Septal, cortical, or whole brain fetal (E15-17) cells were dissociated and cultured in serum-supplemented Dulbecco minimum essential medium under rotating culture conditions. Preincubation and exposure to cytosine arabinoside was utilized to produce "neuron-rich" cultures. Fluorescent latex microbeads were added to cultures at seeding time or early after aggregate formation. All cell types were found to incorporate the fluorescent beads, although apparently not to the same extent. Two- to five-day-old aggregates tended to attach and grow neurites after their transfer to poly-l-lysine- or Matrigel-coated dishes under stationary conditions. Early aggregates transplanted to the hippocampus of adult rats developed into identifiable grafts, with fluorescent-labeled cells. We conclude that "young" neural cell aggregates maintain their ability to undergo two basic phenomena for cellular interaction, i.e., attachment and neuritic growth. Floating aggregates may provide a convenient cellular condition whenever culturing of neural cells is to be used before grafting them into a host animal. PMID- 3678436 TI - Fetal spinal cord homografts ameliorate the severity of lesion-induced hind limb behavioral deficits. AB - Fetal spinal cord grafts survive for long periods in host spinal cord. We explored the ability of such grafts into a lesion in C3 fasciculus gracilis to influence the expected deterioration of hind limb performance following this lesion. Ten adult Sprague-Dawley rats were placed on a schedule of 23 h off and 1 h on water. These subjects were then trained to traverse a narrow platform for a water reward. Criterion was established as 10 trials/day completed in 15 s a trial for 2 consecutive days. Animals were ranked for hind limb and forelimb performance utilizing slips, recovery, and manner of traversing the platform. In a triple-blind experimental design, the animals' identification was coded and laminectomy performed at C3. The fasciculus gracilis was bilaterally transected at the rostral and caudal borders of the segment and aspirated. Five subjects were chosen at random immediately after the lesion was made for the implantation of two 1-mm segments of E14 spinal cord from fetuses of timed pregnant Sprague Dawley dams at the time of the lesion. Coded lesion and lesion-transplant animals were then tested after 21, 30, 45, 60, and 90 days until criterion or for 4 days. Hind limb performance of the lesion-only (ANOVA chi 2 = 13.04, df 5; P less than 0.05) and lesion-transplant groups (ANOVA chi 2 = 11.82, df 5; P less than 0.05) showed that the C3 fetal transplants significantly decreased (P less than 0.05) the severity of hind limb deficit at 21 days postlesion and significantly (P less than 0.05) decreased the expected foot slips and limb recovery to the platform that was expected and did develop in lesion-only animals at 90 days. There were no significant differences in forelimb performance (ANOVAs P greater than 0.05). There were few small-caliber nerve fibers in the fasciculus gracilis at the level of C1 indicating that reinnervation was not a major factor in the reduction of the deficit. PMID- 3678437 TI - High dorsal column cordotomy plus subdiaphragmatic vagotomy prevents acute ionizing radiation sickness in cats. AB - Our purpose was to determine the effects on acute radiation sickness of interrupting afferent neural pathways that converge upon the medullary vomiting center but which bypass the emetic chemoreceptor trigger zone in the area postrema. A comparison was made of the vomiting response and other signs of sickness in three groups of chronic cats surgically prepared as follows: high spinal cord section of the dorsal columns, subdiaphragmatic vagotomy, and the combination of procedures. Every cat was exposed over the whole body to 45 Gy 60Co gamma-radiation which was effective in evoking emesis in 11 of 12 normal cats. Neither cordotomy alone (8 cats) nor vagotomy alone (2 cats) reliably blocked the vomiting response but they separately delayed its onset. On the other hand, the cordotomy prevented the loss of appetite and behavioral malaise that was invariably caused by the irradiation in normal cats. Finally, the combination of cordotomy and vagotomy protected all of 3 cats against the entire radiation syndrome. These cats then vomited appropriately in response to the injection of deslanoside which induces emesis through an action on the area postrema. Histological examination of the lower medulla revealed no damage of the area postrema resulting from the cordotomies. We conclude that acute radiation sickness in the cat is signaled through afferent neural pathways originating in the abdomen and that the area postrema does not participate in the causation of this syndrome. PMID- 3678438 TI - Monocular visual discrimination in the goldfish after unilateral ablation of the optic tectum. AB - Goldfish with unilateral ablation of the optic tectum and trained to the ablated side failed to learn or to transfer interocularly a differential classically conditioned color discrimination. The direct ipsilateral retinal projection to the intact/naive side is therefore shown to contribute little to engram formation. Evidence is also presented demonstrating that the absence of one tectum does not affect the learning of a differential bar discrimination task when trained via the intact brain side. PMID- 3678439 TI - Interocular transfer of shape discrimination in the goldfish--a reassessment of the role of the posterior commissure. AB - Previous work has implicated the hypothalamic horizontal commissure in the interocular transfer of learned shape information in the goldfish. In the experiments reported here, goldfish were classically conditioned to show a differential cardiac response. Fish with transection of this commissure acquired and transferred a circle/square discrimination, whereas animals with transection of the mesencephalic posterior commissure showed acquisition but not transfer of the same task. Other fish were trained on an orientation discrimination. Although all fish acquired the task, those with transection of the horizontal commissure showed transfer failure, whereas those with transection of the posterior commissure demonstrated transfer. We therefore suggest that information relating to shape is transferred via the posterior commissure, but that information relating to rotation transfers through the horizontal commissure. PMID- 3678440 TI - Adrenergic innervation of the vasa nervorum in the cranial nerves and spinal roots in the subarachnoid space. AB - Fluorescence microscopy revealed that the innervation of the vasa nervorum of both cranial and spinal nerve roots in the subarachnoid space in the monkey is adrenergic in nature. The endoneurium of the cranial nerve roots contained free adrenergic nerve fibers which were not related to the vessel wall. PMID- 3678441 TI - Babesia microti: prolonged survival of salavarian piroplasms in nymphal Ixodes dammini. AB - We determined how long Babesia microti survive in the salivary glands of nymphal Ixodes dammini. Of those ticks held at 21 C, the proportion with demonstrable piroplasms decreased from 95%, prior to 20 weeks post-larval-feeding (p-l-f), to less than 80% at 42 weeks p-l-f. Similarly, the number of infected acini decreased significantly. Nymphal I. dammini were kept alive for as long as 1 year, by transferring them to 4 C, at 20 weeks p-l-f. The proportion of infected ticks at 52 weeks p-l-f was less than half of the proportion of infected nymphs examined prior to 20 weeks p-l-f, and only 1/6 as many acini were infected. Ultrastructural observations of salivary glands from ticks at 44 weeks p-l-f revealed that B. microti parasites in older ticks remain in the sporoblast meshwork phase; such parasites rarely differentiated into sporozoites. Degenerating parasites containing autophagic vacuoles were also observed in older ticks. PMID- 3678442 TI - Strongyloides ratti: formation of protection in rats by excretory/secretory products of adult worms. AB - Formation of a marked protective immunity against the challenge infection was found in the rats immunized with excretory/secretory (ES) products of Strongyloides ratti adult worms. Immunization by intraduodenal injection of ES products reduced both the fecal egg counts and the adult worm burden by subcutaneous inoculation of infective larvae and by an intraduodenal implantation. The duration of parasitism in the immunized rats, however, was not shortened compared with that of control rats. The normal migration of subcutaneously challenged larvae was not affected by ES product immunization. Intestinal mastocytosis occurred according to the appearance of adult worms in the small intestine of the immunized rats earlier than it did in controls. This result suggests that mastocytosis is involved in the induction of protection by ES products of S. ratti adult worms. PMID- 3678443 TI - Leishmania chagasi: in vitro differentiation of promastigotes monitored by flow cytometry. AB - A sequential development from a less infective to an infective stage of Leishmania promastigotes growing in culture has been previously reported. The aim of this work was to investigate whether freeze-fracture electron microscopy and flow cytometry would be able to provide some reliable morphological markers of in vitro differentiation of Leishmania chagasi promastigotes. The flow cytometry technique discriminates between the L. chagasi promastigotes from the different stages of their in vitro differentiation. The "forward scatter" intensity of the parasite, very high 15 hr after seeding when the parasites were very condensed and with a high DNA content per particle, strongly decreased during the culture course. Parallel experiments have shown a striking correlation between forward scatter intensity, growth curves, and infectivity of promastigote populations. By contrast, freeze-fracture techniques showed that in either less infective or infective promastigote plasma membranes, the intramembrane particles density in protoplasmic fracture faces (about 2800/micron 2) and in exoplasmic fracture faces (about 1000/micron 2) was independent of the time of cultivation. The amount of filipin lesions, which reflects the cholesterol content within the plasma membrane, was also constant throughout the culture course. Both data suggest that the architecture of the plasma membrane is an intrinsic characteristic of the promastigote stage. This study shows that whereas freeze fracture electron microscopy does not provide markers for the differentiation of Leishmania promastigotes, flow cytometry may on the other hand be of value as a screening test for promastigote populations allowing the characterization of their developmental stages in in vitro cultures. PMID- 3678444 TI - Trichinella spiralis: differences between "early" and "late" rapid expulsion evident from inhibition studies using cortisone and irradiation. AB - Cortisone administered once at 100 mg/kg during the first 3 weeks of infection inhibited rapid expulsion. In rats immunized with an abbreviated infection (T/M regime) inhibition averaged approximately 50%, whereas in rats given a complete infection (C.I.) 14% inhibition occurred. Sensitivity to 400 rad whole-body irradiation was greatest 7 days before a challenge infection in all immune rats. Three days after beginning the T/M infection rats were highly susceptible to cortisone but only weakly so to irradiation. Rats immunized by C.I. were equally, but only weakly, susceptible to either cortisone or irradiation 3 days after infection. Acute administration of cortisone 1 or 4 hr prior to challenge did not inhibit rapid expulsion but 60% inhibition occurred when cortisone was given 24 hr prior to challenge. Inhibition of rapid expulsion by irradiation 7 days prior to challenge was not reversed by immune serum and irradiation did not affect antibody titer in treated rats. It was suggested that irradiation 7 days before challenge compromised the intestinal, and not the immunological, component of rapid expulsion. Differences in sensitivity of "early" and "late" rapid expulsion to irradiation and cortisone therapy provide further evidence of functional differences between these rejection processes. PMID- 3678445 TI - Plasmodium ovale: in vitro development of hepatic stages. AB - Primary cultures of human hepatocytes, a culture-derived clone from the human hepatoma Hep G2 line, and cultured rat hepatocytes were inoculated in vitro with Plasmodium ovale sporozoites extracted from Anopheles stephensi, An. gambiae, and An. dirus mosquitoes. Penetration and differentiation of P. ovale sporozoites into trophozoite stage parasites occurred in all three cell types, but with a lower transformation rate in the Hep G2 cell line than in the primary cultured hepatocytes. Further maturation was obtained only in the human hepatocytes, in which the parasites were uninucleate until the third day after infection, before development to 60 micron in length by the eighth day. Additionally, this culture system was used to assess the ability of an anti-P. ovale sporozoite monoclonal antibody to inhibit penetration of sporozoites into hepatocytes and to detect sporozoite determinants in the maturing liver stage parasites. PMID- 3678446 TI - Trypanosoma brucei: polyamine oxidase mediated trypanolytic activity in the serum of naturally resistant cattle. AB - Trypanosoma brucei brucei are lysed when incubated in vitro in a mixture of bovine serum and polyamine. Normal bovine serum alone or polyamine alone does not show any trypanocidal activity. The bovine serum in the mixture can be replaced by purified polyamine oxidase, and addition of polyamine oxidase inhibitors blocks trypanolysis. Using this in vitro lysis test, it is shown that West African cattle which are resistant naturally to trypanosomiasis have a higher trypanolytic activity in their serum than do trypanosensitive cattle (P less than 10(-5]. Seric trypanolytic activity of individual animals remains stable when tested over a period of 18 months; moreover, it is not modified by trypanosome infection. Higher levels of seric polyamine oxidase in resistant cattle were demonstrated also by enzymatic analysis. The factors responsible for trypanolysis have been analyzed. Oxidation of spermidine by polyamine oxidase leads to the production of unstable aldehydes, acrolein, ammonia, O2-, HO, and H2O2. Acrolein and H2O2 show strong trypanolytic activity while the other products do not appear to be toxic for trypanosomes. The physiological importance of polyamine oxidase mediated trypanolysis is unclear; even at peak parasitemia in cattle (10(7) organisms/ml) it can be calculated that trypanosomes would not release enough spermidine for the generation of sufficient quantities of toxic degradation products. Additional polyamines could be released in serum from tissues damaged as a result of the infection. PMID- 3678447 TI - Trypanosoma congolense: lack of correlation between the resistance of cattle subjected to experimental cyclic infection or to field challenge. AB - Twelve male cattle of the Baoule breed were exposed to natural trypanosome challenge in an area of high Glossina density, to characterize them as trypanoresistant or trypanosensitive. Weekly blood samples were taken for the determination of parasitemia and packed cell volume, as a measure of anemia. Seven Zebu cattle were also exposed to challenge at the same time. The Zebu proved to be trypanosensitive with high parasitemia, pronounced anemia and died or were drug treated in extremis. Five Baoule were as sensitive as the Zebu while 7 others were trypanoresistant since they showed little or no patent parasitemia, only mild transient anemia and survived in good condition. The 12 Baoule were allowed to recover from challenge in the field and along with 7 Zebu were subjected to experimental fly challenge in fly-proof accommodation. Glossina morsitans submorsitans infected with a clone of Trypanosoma congolense derived from the stock Serengeti/71/STIB/212 were allowed to engorge on the shaven flanks of tranquilized animals. All animals showed persistent parasitemia for at least 7 weeks, including all the Baoule resistant to natural challenge. Two Baoule, one resistant and one sensitive to natural challenge, and 4/7 Zebu appeared unable to control parasitemia, had severe anemia, and were drug treated in extremis. The remaining Baoule, 6 resistant and 4 sensitive, appeared to be undergoing spontaneous cure by Week 9-10, as did 3/7 Zebu. In Zebu, anemia was as pronounced as under natural challenge. Three resistant Baoule maintained packed cell volume above 30 as under field challenge but the others showed marked anemia. On the contrary, 4 sensitive Baoule showed only slight anemia after artificial fly challenge.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678448 TI - Hyalomma anatolicum anatolicum: the role of humoral factors in the acquisition of host resistance. AB - A significant degree of resistance to Hyalomma anatolicum anatolicum can be adoptively transferred to naive recipients with immune serum from rabbits repeatedly infected with adult H. a. anatolicum. Ticks fed on recipients of immune serum took longer to become engorged and showed a significant decrease (P less than 0.01) in engorgement weight and oviposition compared with ticks that fed on recipients of normal serum. A direct correlation between resistance and anti-saliva IgG antibodies was indicated by a progressive increase in the degree of resistance and IgG antibody titres following successive tick infestations. Challenge feeding sites on actively sensitised hosts and recipients of immune serum revealed significantly greater infiltration of basophils and eosinophils compared with feeding sites on recipients of normal serum. However, both the degree of resistance and the accompanying cutaneous basophil and eosinophil responses in recipients of immune serum were considerably weaker than those induced by active tick feeding, thus suggesting that nonhumoral (cell-mediated) mechanisms might also be involved in acquired host resistance to H. a. anatolicum. PMID- 3678449 TI - Leishmania major: the suitability of East African nonhuman primates as animal models for cutaneous leishmaniasis. AB - The susceptibility of four species of East African nonhuman primates to experimental infection with Leishmania major was investigated. Four Syke's monkeys (Cercopithecus mitis), two vervet monkeys (Cercopithecus aethiops), two baboons (Papio cynocephalus), and two brown bushbabies (Galago garnettii) were each inoculated intradermally on the left eyelid, left ear, and nose with 0.1 ml of medium containing 1 x 10(7) promastigotes of a characterized L. major strain. All the nonhuman primates except the bushbabies developed erythema and conspicuous nodules on the eyelids and ears by 3 weeks PI. The nodules increased rapidly in size and ulceration was evident on the eyelids and ears by 49 days PI in the vervets, Syke's, and baboons. The aspirates were positive in culture or smears at 35, 49, 63, and 77 days PI. No parasites were observed in cultures or smears at 92, 105, 128, 147, and 161 days PI. The lesions in these animals began resolving by 84 days PI and were completely healed by 112 days PI. The exception was one baboon in which lesion healing did not start until around 147 days and was completely healed by 182 days PI. Cultures from the liver failed to demonstrate visceralization of the parasite in any of the animals throughout the 68 weeks of the experiment. Challenge with the same strain of L. major 6 months PI, corresponding to about 3 months after self cure, failed to produce infection in any of these experimental hosts. All the nonhuman primates except the bushbaby when challenged with the same strain of L. major at 12 months PI developed lesions and were positive for parasites at 14 and 28 days PI. Positive cultures were obtained from the eyelid and ear of one vervet up to 42 days PI. However, the lesion sizes in all these animals were smaller than in the initial infection and did not ulcerate. The nodules disappeared within 6 to 8 weeks as compared to 16 weeks in the initial infection. The histopathological appearance of the lesions varied from diffuse infiltration of plasma cells and lymphocytes which increased progressively to granulomata with epitheloid cells. This study shows that the vervets, Syke's, and the baboons are equally susceptible to L. major infection, while bushbabies are refractory. The vervets, Syke's, and baboons demonstrate a self-healing phenomenon within about 3 months which is comparable to that observed in humans infected with L. major. These three species of nonhuman primates are therefore considered as suitable models for drug or vaccine trials against human zoonotic cutaneous leishmaniasis. PMID- 3678450 TI - Comparative glucose utilization rates in separated and mated schistosomes. AB - The rate of phosphorylation of 2-deoxyglucose (2DG) was determined by sequential pulsing of schistosomes (Schistosoma mansoni, S. japonicum, and S. haematobium) with 3H- and 14C-labeled 2-deoxy-D-glucose. Subsequent column chromatographic separation of the neutral [3H]2DG and [14C]2DG from the 3H- and 14C-labeled 2 deoxy-D-glucose 6-phosphate permitted estimation of the quantity of [3H]2DG phosphorylated in 2 min, and the proportion of [14C]2DG phosphorylated in 1 min; thus a phosphorylation rate was determined from a single tissue sample. The relative phosphorylation rate of 2-[3H]2DG to D-1-[14C]glucose (i.e., the phosphorylation coefficient) was also measured in male and female schistosomes. It was demonstrated that even though 2DG is taken up more rapidly than glucose, it is phosphorylated at a much slower rate in both S. mansoni and S. japonicum. In both of these species, mated males phosphorylate 2DG and glucose at a greater rate than do unmated males. Similarly, mated females phosphorylate and consume more glucose than do separated females. In contrast, the phosphorylation coefficient is greater in separated than in mated schistosomes. Intraspecific comparisons suggest that, at reduced substrate concentrations, glucose utilization rates are higher in S. japonicum, intermediate in S. mansoni, and lower in S. haematobium. PMID- 3678451 TI - Age-related susceptibility of the gerbil, Meriones unguiculatus, to the bovine parasite, Babesia divergens. AB - Immature gerbils (4 weeks of age or less) proved to be more resistant to Babesia divergens infections than did mature animals (greater than 8 weeks old). Nutritional studies showed that a milk diet contributes little to this innate resistance. Similarly, the apparent predilection of B. divergens for mature erythrocytes, and also in vitro serum incubation studies, suggested that blood factors do not contribute to any major degree. Splenectomy of immature gerbils abolished their nonspecific resistance and studies with splenocyte incubations with the piroplasm imply that splenic integrity is necessary for the maintenance of this, apparently antibody-independent, resistance to infection with B. divergens. PMID- 3678452 TI - Trichostrongylus colubriformis: larvicidal activity of toxic extracts from Bacillus sphaericus (strain 1593) spores. PMID- 3678453 TI - Onchocerca volvulus: partial glucose catabolism via fumarate and succinate. PMID- 3678454 TI - Relation between renal and hepatic excretion of drugs. VI. Influence of pretreatment with phenol red on renal excretion and accumulation capacity of kidney or liver slices of immature and adult rats. AB - Pretreatment with phenol red causes a significant increase in renal excretion of p-amino-hippurate (PAH) in adult rats. In vitro experiments have shown that phenol red pretreatment significantly enhances the accumulation of PAH in renal tubular cells of adult rats. Thus the stimulation of active renal tubular PAH transport is at least in part responsible for its accelerated excretion via urine. A similar phenol red administration does not enhance the renal excretion of this dye, neither in adult nor in immature rats. In accordance with these in vivo findings the renal accumulation of phenol red is not increased after pretreatment with this dye. Remarkably the repeated administration of phenol red causes a distinct reduction of phenol red accumulation capacity in liver tissue. The rate of accumulation of both PAH and phenol red in renal cortical slices increases significantly during maturation; in liver tissue slices such an intensification does not occur. Under anaerobic conditions an active energy requiring uptake of phenol red does not take place and an accumulation by active transport of the dye can also be excluded. Therefore a passive uptake of phenol red and a binding of the dye in renal tubular cells could explain the distinct accumulation of phenol red in tissue slices from the kidney under nitrogen atmosphere. In 55-day-old rats the anaerobic phenol red accumulation in the liver is diminished after pretreatment with this dye. PMID- 3678456 TI - The effects of different MNNG (N-methyl-N'-nitro-N-nitrosoguanidine)-doses on the stomach and the upper small intestine of the rat. II. The frequency of intestinal metaplasia. AB - N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) was given to 3 groups of male Wistar rats in different doses of 25 micrograms/ml, 50 micrograms/ml and 100 micrograms/ml with their drinking water for 32 weeks. After 50 weeks the antrum region of the stomach was investigated by serial sections. All animals showed tubules with metaplastic intestinal epithelium. The different values of metaplastic glands in the antrum region of the stomach were 187 (25 micrograms MNNG), 76 (50 micrograms MNNG) and 51 (100 micrograms MNNG). They indicate an inverse relationship of the frequency of intestinal metaplasia and the MNNG dose. As opposed to this dose-response pattern, cytotoxic alterations, regenerative hyperplastic lesions and tumours of the stomach are more frequent after medium of high MNNG doses. It is therefore suggested that the induction of intestinal metaplasia is a specific effect of the carcinogen mainly in the low dose range. PMID- 3678455 TI - Changes in lung activity of superoxide dismutase and copper concentration during lung tumorigenesis by hydralazine in Swiss mice. AB - Hydralazine (1-hydrazinophthalazine) was administered in drinking water as a 0.0312% solution to randomly bred Swiss mice for life beginning at 5 weeks of age. The treatments gave rise to statistically significant incidences of lung tumors: 55% in females and 43% in males. A decreased copper concentration and superoxide dismutase activity in the lung of mice were observed. The role of copper and superoxide dismutase in the malignant process is briefly discussed. PMID- 3678457 TI - Ultrastructural alteration in the rat liver produced by benzyl viologen. AB - This report presents qualitative data of the effects of a free radical generator (benzyl viologen) on rat liver. Rats were administered benzyl viologen (0.825 mg per kg of body weight) or saline solution (controls) intraperitoneally, in single daily dosage for 15 days. For microscopic examination animals were killed after 3 or 15 days of treatment. In the control animals, liver ultrastructure remained normal throughout the experiment. But in rats with benzyl viologen it was possible to observe important morphological alterations essentially in mitochondria, frequently forming ring-like bodies. Endoplasmic reticulum was observed as concentric patterns which cover the mitochondria and, on occasion, the lipid droplets within the cell. Increased number of dense granular lysosomes were observed in the apical cytoplasm mainly close to the bile canaliculus. A large quantity of lipid inclusions and cellular degeneration of the liver of treated rats showed a marked dose-response relationship. PMID- 3678458 TI - 31P-NMR spectroscopy and ultrastructural studies on nephrotoxicity of cyclosporine A. AB - NMR-spectroscopy and electron microscopy were applied in order to find out whether nephrotoxic effects of cyclosporine A in combination with ischaemia on rat kidney are of significance for the energy metabolism of the organ. CSA was administered in daily doses of 15 mg/kg rat over 20 days. Use was made of the particular advantage of 31P-NMR-spectroscopy to follow up the dynamics of high energy phosphate concentrations in the same tissue. Ultrastructural changes were observed in the region of the proximal tubule. Some mitochondria showed degenerative changes, others increased density of cristae. The total number of mitochondria was increased. This observation together with the coexistence of vacuolarly degenerated mitochondria and mitochondria with increased activity after CSA treatment is interpreted as expression of a compensatory mechanism that keeps constant the totality of high-energy phosphates despite damage to some mitochondria. PMID- 3678459 TI - Inhibition of biliary phospholipid secretion by bilirubin in partially hepatectomized rats. AB - The effect of i.v. administration of bilirubin on biliary phospholipid secretion was studied in sham operated and two-thirds hepatectomized Wistar rats. Following bilirubin infusion at 260 nmol/100 g body wt/min, a maximal biliary bilirubin excretion was reached in the sham operated rats. No modifications of bile flow or bile acid secretion appeared, but biliary phospholipid secretion was significantly inhibited. At 12 and 24 h after hepatectomy, the maximal bilirubin excretion was markedly lowered but biliary phospholipid secretion still remained significantly inhibited. The infusion of taurocholate at 200 nmol/100 g body wt/min counteracted the impairment of phospholipid secretion, both in sham operated and hepatectomized animals. Bile acid secretions more than two-fold that of the controls were needed to reach half maximal biliary phospholipid secretion in bilirubin-infused animals, with or without the addition of taurocholate. PMID- 3678460 TI - Effect of bilirubin and bile acids on biliary phospholipid secretion during bromobenzene-induced hepatic injury in the rabbit. AB - The interrelationship between the biliary secretion of phospholipids, bilirubin and bile acids was studied in New Zealand rabbits after acinar zone 3 hepatocyte damage induced by bromobenzene (4 mmol/kg body wt; i.p.). Treatment with the toxin did not significantly modify biliary phospholipid secretion, suggesting that the transport of phospholipids is mainly a zone 1 function. Bilirubin infusion at 1 mumol/min kg body wt induced a significant inhibition in biliary phospholipid secretion both in control and treated animals. This effect was overcome by the additional infusion of sodium glycodeoxycholate at 1.6 mumol/min kg body wt, although higher increases in phospholipid output were found in the control than in the treated rabbits. This would be related to the lowered recruitment of zone 3 cells for secretion in bromobenzene-damaged livers. PMID- 3678461 TI - Autoimmune fibrous thyroiditis in A/J mice. PMID- 3678462 TI - Relation between renal and hepatic excretion of drugs. V. Factors influencing accumulation of phenol red in kidney and liver tissues from rats of different ages. AB - Following bile duct ligation (DL) or bilateral nephrectomy (NX), phenol red accumulation in kidney or liver tissue, respectively, is reduced in rats of different ages. This is in contrast to in vivo experiments showing a compensatory increase of renal or hepatic excretion of phenol red in adult rats after DL or NX, respectively. The present study was performed to clarify this discrepancy. Three possible reasons were taken into consideration: 1. competition between accumulation of phenol red and bilirubin or bile acids; 2. influence of humoral factors occurring in serum of DL-rats on accumulation capacity; 3. changes of phenol red binding in homogenate of the kidney cortex or liver tissue after DL or NX. Ad 1. There exist inhibitory effects of bilirubin and cholic acid on phenol red accumulation. This inhibition is a competitive as well as a toxic one, apparently caused by a reduction of intracellular phenol red binding. Similar results have been obtained in in vivo experiments. During continuous infusion of bilirubin both renal and hepatic excretion of phenol red is significantly diminished. Ad 2. Incubation of tissue slices of control animals in serum of DL rats does not indicate the existence of humoral factors reducing accumulation of phenol red after DL. Only in adult rats the plasma protein binding of phenol red is reduced after DL; in 10-day-old rats the binding capacity of the proteins for the dye is unchanged after DL. Ad 3. In young animals the phenol red binding on tissue homogenate is significantly reduced after DL or NX in kidney or liver; binding capacity of adult rats' tissue homogenate is unchanged after both operations. It can be concluded that renal and hepatic excretion capacity cannot be increased within a few hours after these blocking operations and obviously a functional reserve of the transport mechanisms does not exist. PMID- 3678463 TI - Changes in cytoplasmic and mitochondrial enzymes in rat liver after ischemia followed by reperfusion. AB - The behavior of cytoplasmic and mitochondrial enzymes has been studied in rat liver at 1, 5, and 24 hr after 60 min of ischemia using histochemical methods. This period of ischemia resulted 24 h after ischemia in liver cell necrosis in about 15% of the volume of the ischemic liver lobes. As early as after 1 hr reperfusion lactate dehydrogenase (LDH, cytoplasm) activity decreased in a certain proportion of the liver parenchymal cells, whereas glutamate dehydrogenase (GDH, mitochondrial matrix) activity started to decrease after 5 hr reperfusion; the activities of mitochondrial membrane enzymes, monoamine oxidase and succinate dehydrogenase, did not decrease before 24 hr of reperfusion. It has been concluded that the early decrease in LDH activity is caused by leakage into the blood and reflects reversible damage; when this decrease is accompanied by a decrease in GDH activity irreversible liver cell damage is assumed. Diminished activity of mitochondrial membrane enzymes, due to leakage and denaturation, is observed when real necrosis can be assessed. PMID- 3678464 TI - Effects on in vivo and in vitro administration of vinblastine on the perfused rat liver--identification of crinosomes. AB - Livers of nonstarved rats were perfused for up to 4 hr in a recirculating system. Bile production, transaminases, and the lactate/pyruvate ratio remained at normal values. The ultrastructure of the hepatocytes was also well preserved even after the 4-hr perfusion. When vinblastine was given either in vivo or in vitro by addition to the perfusion fluid, it caused a conspicuous expansion of the autophagic-lysosomal compartment. Initially, nascent autophagic vacuoles developed, followed by the appearance of more mature ones and finally an increase in dense bodies was observed. In addition, administration of vinblastine in vivo gave rise to an increased occurrence of a subpopulation of lysosomes laden with VLDL-like particles. The term crinosomes seems appropriate for these lysosomal vesicles, since they apparently evolve by means of fusion between retained secretory granules and preexisting lysosomes (dense bodies). Addition of vinblastine of the perfusion fluid decreased the rate of proteolysis whether four times the serum concentration of amino acids were added or not. However, when vinblastine was given in vivo, proteolysis as measured in the perfusate decreased during the initial 3 hr of VBL treatment, whereas by longer times of pretreatment protein degradation exceeded the control value, constituting an example of catch up proteolysis. Autophagic vacuoles isolated after short exposure to vinblastine in vivo exhibited high rates of protein degradation when incubated at acid pH. Insufficient proton pumping rather than lack of hydrolytic enzymes seems to be the most plausible explanation for this prompt pH effect. PMID- 3678465 TI - A morphological study of the effects of ozone on rat lung. I. Short-term exposure. AB - In order to determine the effects of ozone on lungs and the course of cell renewal after damage, young male rats were exposed to 3 ppm of ozone for 4 hr. They were killed at 1, 6, 12, and 18 hr and 1, 2, 3, 4, 7, and 14 days after exposure. One hour before the killing, dividing cells were labeled with tritiated thymidine. Type 1 cells of centriacinar location and bronchiolar cells were severely damaged after exposure. Labeling indices of type 2 cells and bronchiolar nonciliated cells increased 1 day after exposure. Hyperplasia of type 2 cells and bronchiolar nonciliated cells was observed 2 and 3 days after exposure. Ciligenesis of bronchiolar ciliated cells occurred 4 days after exposure. Our study shows that injured type 1 cells are repaired by proliferation of type 2 cells and that injured bronchiolar ciliated and Clara cells are repaired by proliferation of bronchiolar nonciliated cells. These undifferentiated cells are probably progenitors of ciliated cells and Clara cells, and some nonciliated cells are in a transitional form between nonciliated and type 2 cells. PMID- 3678466 TI - Comparison of different autophagic vacuoles with regard to ultrastructure, enzymatic composition, and degradation capacity--formation of crinosomes. AB - The number of rat liver autophagic vacuoles (AVs) was increased by separate injection of three different inhibitors--vinblastine, leupeptin, and chloroquine- of lysosomal protein degradation. The different mechanisms of action of the agents correlated to the ultrastructure of the AVs. Accumulation of the base chloroquine with ensuing influx of water into AVs caused a significant swelling. The leupeptin-induced AVs were processed into residual-body-like structures within a few hours of exposure in line with the presence of a leupeptinase in liver tissue. Vinblastine was the most efficient agent in increasing the occurrence of AVs. The effect of vinblastine lasted for the entire study period (36 hr) with continuous formation of nascent AVs. In addition, vinblastine caused the appearance of a subpopulation of AVs laden with VLDL particles. The term crinosomes was suggested for these hybrid organelles, since they seemed to evolve by fusion between secretory granules and lysosomes. In addition to sequestered cell organelles, the AVs harbored cytosolic enzyme activities (LDH and aldolase). Leupeptin was the only agent that caused a decrease in cathepsin B and L activities. Similarly, leupeptin impeded protein breakdown in isolated AVs, whereas vinblastine and chloroquine evoked an increase. In vivo, chloroquine and vinblastine block protein degradation. The reason for this discrepancy is probably that during in vivo exposure the substrate (cytoplasmic proteins) is built up in the AVs because degradation is retarded. Upon isolation of the AVs the inhibitor block is released, and proteolysis proceeds at enhanced rates over control due to excess of substrates. Leupeptin, on the other hand, caused a substantial inhibition of thiol proteinases; this block remained in the isolated AVs. Accordingly, leupeptin-induced AVs displayed decreased protein degradation following shorter exposure times. Later, when leupeptin was metabolized, catch-up proteolysis was noted. The differing mechanisms of action of the inhibitors were also apparent as regards lipid contents and lipolysis. Whereas chloroquine and vinblastine increased the amounts of cholesterol and triglycerides parallel to proteins, leupeptin had no such effect. Lipolysis proceeded at normal rate following leupeptin administration, which was not the case after vinblastine and chloroquine exposure. Leupeptin has no effect on acid lipases; therefore lipids do not accumulate in AVs of hepatocytes that are exposed to leupeptin. PMID- 3678467 TI - Composition of proteoglycans from human atherosclerotic lesions. AB - Proteoglycans from human atherosclerotic lesions and from uninvolved aortic intima were isolated and their composition was studied. The tissues were sequentially extracted by guanidine hydrochloride followed by hydrolysis of the tissue by elastase. Chondroitin sulfate/dermatan sulfate proteoglycans were predominant in guanidine hydrochloride extracts of the tissue. Most of the heparan sulfate proteoglycans were released from the tissue by hydrolysis with elastase. The content of proteoglycan material, measured as uronate per unit weight of wet tissue, was lower in fatty streaks and fibrous plaques than in uninvolved tissue (0.58 and 0.48 mg vs. 0.7 mg/g wet tissue). The distribution of different glycosaminoglycans in guanidine hydrochloride-extracted proteoglycans was similar among the lesions and uninvolved tissue, but varied in the elastase hydrolyzed extracts. Gel filtration studies suggested that the major proteoglycan material, chondroitin sulfate proteoglycans, from lesions had greater molecular weight than proteoglycans from uninvolved tissue. The studies indicate that alteration in intrinsic composition and molecular size of proteoglycans occurs in atherosclerotic lesions. PMID- 3678468 TI - Chromatin solubilization in rapidly growing hepatomas. AB - The presence of substantial amounts of DNA in the cytosol fractions prepared from rapidly growing transplanted rat hepatomas was confirmed. Agarose gel electrophoresis of this DNA from the Morris hepatomas 7288CTC, 7777, and 7800 suggested that it corresponds primarily to nucleosome monomers with smaller amounts of nucleosome dimers and trimers. Despite the evidence for solubilization of chromatin in rapidly growing hepatomas the potential DNA endonuclease activity was less in nuclei from these tumors than in nuclei from more slowly growing hepatomas or host livers. It was suggested that focal necrosis in rapidly growing solid tumors may be associated with the influx of divalent cations and the activation of DNA endonuclease activity. PMID- 3678469 TI - The treatment of adult idiopathic thrombocytopenic purpura. Infusion of vinblastine in ITP. AB - 16 adult idiopathic thrombocytopenic purpura (ITP) patients, with mean age 51 years, were treated by 5 weekly slow intravenous infusions of vinblastine (0.1 mg/kg). When a complete or partial response (CR or PR) was obtained, slow infusions were repeated at 2-weekly then monthly intervals, as maintenance therapy. In 4 cases with ITP of recent onset, but presenting contraindication or failure to prednisone and high dose intravenous immunoglobulins, CR was obtained in all patients after 4 to 15 days (mean 9.5). Only one of these patients relapsed. In 12 cases of refractory chronic ITP (of whom 10 had been splenectomized), there were 2 CR, 6 PR and 4 failures. The 8 responding patients had a mean interval to response of 20 days. The 6 PR were short and did not exceed 15 days. Our results do not support a superiority of this treatment compared to other modes of administration of vinca alkaloids in ITP (intravenous bolus, vinca loaded platelets). PMID- 3678470 TI - Inhibitory effect of peak 2-4 of uremic middle molecules on platelet aggregation. AB - It is well-known that uremic patients present prolonged bleeding times as a common complication. Factors responsible for this disorder have been extensively investigated. In order to elucidate the possible role of uremic middle molecules as responsible for the bleeding tendency observed in uremia, we have studied the effect on platelet aggregation of middle molecules obtained from uremic plasma by Sephadex and ion-exchange chromatography. Our results show that some purified middle molecular fractions have a specific inhibitory activity on platelet aggregation and suggest an important role for these compounds in the pathogenesis of uremic bleeding. PMID- 3678471 TI - Potential value of vintristine-adriamycin-dexamethasone combination chemotherapy (VAD) in refractory and rapidly progressive myeloma. AB - 10 patients with myeloma refractory to alkylating agents were treated with either 4-d pulses of high-dose dexamethasone therapy, or 4-d pulsed high-dose dexamethasone in combination with 4-d continuous infusions of vincristine and adriamycin (VAD). 8 patients were evaluated after a median duration of treatment of 2.3 courses (range 1 to 4). 6 of the 8 evaluable patients achieved reduction in serum and/or urine paraprotein levels with a mean reduction in serum paraprotein of 74.1%. There was a concomitant improvement in wellbeing in these responding patients. 2 evaluable patients failed to show biochemical or clinical response (1 treated with VAD, 1 high-dose dexamethasone). 2 patients currently survive 390 d and 180 d, respectively, on continuing therapy. 8 patients died with a mean duration of survival of 99 d (range 10 to 246 d). We conclude that the use of VAD chemotherapy in patients with refractory myeloma confers both a worthwhile remission of disease symptoms and biochemical evidence of disease regression, and that trials of VAD as primary treatment for myeloma are indicated. PMID- 3678472 TI - Enrichment of blood units with young red cells (neocytes) with the IBM 2991 cell washer. AB - The transfusion of young red blood cells (neocytes) is a complementary approach to the present treatment of thalassaemia major patients. Fresh neocytes were harvested from 34 volunteers with the IBM 2991 cell washer (CW). The upper part of 24 units was separated into 6 aliquots (T1-T6) of 15 ml each and the residue homogenized. Four biological criteria were used to evaluate young red cell quality, the erythrocyte pyruvate kinase activity, the mean corpuscular volume, the reticulocyte count and ektacytometry; each sample (T1-T6) showed an enrichment with neocytes as compared with the standard unit. A real efficiency of this technique with the IBM 2991 CW was obtained with the first third of the unit, corresponding to the T1-T4 fractions. The estimation of the theoretical mean life span of T1-T2 was 270 days. The last 10 units were separated into two halves: the enrichment of the first half was worse than in the first third of the previous technique. We concluded that the transfusional program of thalassaemia patients could profit by the use of the most enriched part of a standard blood unit with the IBM 2991 CW. PMID- 3678473 TI - Effect of 32P treatment for polycythaemia vera on blood lymphocyte subpopulations and their functions. AB - The influence of 32P treatment on the blood lymphocyte population was examined in 16 patients with polycythaemia vera who had not previously been treated with cytotoxic drugs or irradiation. Before treatment the lymphocyte counts were within the normal range but the expression of certain membrane structures, as detected by monoclonal antibodies directed against total T cells (CD 3 and 5), helper/inducer (CD 4) and suppressor/cytotoxic T cells (CD 8), were slightly reduced. In addition, mitogenic responses of the lymphocytes to PHA and PWM induced Ig secretion were severely impaired. Following a single oral dose of 32P (150-305 MBq), which was shown to normalize the production of erythrocytes and/or platelets, the blood lymphocyte counts were reduced by approximately 40% 12 wk after treatment. Subset analysis showed that the proportion of B cells, as identified by monoclonal antibodies (CD 20), was reduced to the highest relative extent. On the other hand, lymphocytes expressing the above T cell markers were somewhat increased. 32P treatment sharply increased PHA reactivity but it further reduced PWM-induced Ig secretion. The latter observation was in line with the finding that serum concentrations of Ig were reduced following treatment. PMID- 3678474 TI - Alpha interferon in the treatment of symptomatic myelofibrosis with myeloid metaplasia. AB - 2 patients with myelofibrosis and myeloid metaplasia had symptomatic splenomegaly and were treated with interferon alpha-2c (IFN alpha-2c). The splenic pain and pressure symptoms disappeared, accompanied by a decrease in the size of the spleen. However, the peripheral blood count worsened and no improvement in the bone marrow fibrosis could be observed. PMID- 3678475 TI - Correlation between bone marrow karyotype and the occurrence of erythroblast micronuclei and nuclear budding in patients with myelodysplastic syndromes. AB - 147 patients with myelodysplastic syndromes were investigated for the presence of micronuclei and nuclear budding in bone marrow erythroblasts. The patients were divided into subgroups on the basis of bone marrow karyotype, 31 healthy bone marrow donors constituted a control group. Patients with monosomy 7 or 7q- and patients with major karyotypic abnormalities (MAKA) had significantly more erythroblasts with micronuclei and nuclear budding than the control group. Patients with a 5q- chromosome as the sole karyotypic aberration had more micronuclei than the controls. For other patients with MDS the differences were statistically nonsignificant. PMID- 3678476 TI - Staging and treatment of non-Hodgkin's lymphoma of intermediate-grade malignancy: a retrospective study of 102 cases. AB - Since the introduction of the Working Formulation for Clinical Usage, 3 different prognostic groups are recognized among the various histological classifications of non-Hodgkin's lymphomas. We looked at the lymphomas of intermediate-grade malignancy and studied retrospectively the staging and treatment of 102 patients. Almost half of the patients with clinical stage I disease, who therefore received radiotherapy only, later appeared to have had more extended disease. For patients with stage II, III and IV disease the complete remission rate was significantly higher with CHOP than with CVP (76% versus 36%). However, once complete remission was achieved there was no difference in disease-free survival between the 2 groups (at 4 yr, 50% of the patients were in complete remission). As far as the amount of cytostatic drugs given during the initial courses of chemotherapy is concerned, no difference was found between patients who achieved complete remission and those who did not. Most patients did not receive the full dosage. For those patients who did not respond well to initial therapy, or who suffered a relapse, second line therapy was disappointing. PMID- 3678477 TI - A synthetic hemoregulatory peptide (HP5B) inhibits human myelopoietic colony formation (CFU-GM) but not leukocyte phagocytosis in vitro. AB - A synthetic analog of a hemoregulatory peptide associated with mature human granulocyte (HP5B) has been investigated for inhibitory effects on human myelopoietic stem cells in vitro. In addition, it has been tested for effects on phagocytosis by human granulocytes and monocytes by use of an automatic flow cytometric method. A dose-dependent inhibition of colony formation was found after preincubation of bone marrow cells for 1 h at 37 degrees C in the range 10(7) -10(-11) mol/l. Above or below these concentrations, no inhibitory effects were seen. The degree of inhibition varied from experiment to experiment, indicating variable responsiveness of the donor cells. Maximal effect was of magnitude 90% inhibition, and the optimal dose was 10(7) mol/l. The peptide had no effect on the kinetics of phagocytosis by measurements of the uptake of fluorescent Zymosan particles or Staphylococcus aureus. This may indicate a selective effect on the precursor cells, with no effect on the functional state of their progeny, the granulocytes and monocytes. PMID- 3678478 TI - Effects of hypoxia on megakaryocytopoiesis and granulopoiesis. AB - Previous studies have reported that exposure of mice to hypoxic conditions results in a decrease in blood platelets. To further explore the effect of hypoxia on megakaryocytopoiesis, megakaryocytes and their progenitor cells (CFU M) were studied in hypoxic mice. Mice were exposed to hypoxia by enclosure in cages covered with dimethyl-silicone rubber membranes for up to 10 d. At various times during the hypoxic and ex-hypoxic periods the total megakaryocytes and CFU M were determined in the humerus and spleen. CFU-M were assayed in the soft gel colony forming assay using pokeweed mitogen-stimulated spleen cell conditioned medium (PWCM) as a source of colony stimulating activity. After 10 d of hypoxia, packed red cell volume (PRCV) increased to 148% of control levels and blood platelets decreased to 40% of controls. Total megakaryocytes and CFU-M per humerus decreased to 18% and 50% of controls respectively. 4 d into the ex hypoxic phase, PRCV was still increased at 128% of controls while marrow megakaryocytes and CFU-M increased to normal levels. Platelet recovery was somewhat slower, returning to normal by d 6. In contrast to the findings in the marrow, total spleen megakaryocytes and CFU-M increased to about 3- and 5-fold of control levels respectively by 6 d of hypoxia. During the exhypoxic phase, CFU-M decreased to normal on d 4, followed by a rebound of 3-fold control values on d 8. Spleen megakaryocytes decreased more slowly, returning to normal by d 10. A marked granulocytosis was observed during the hypoxic phase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678479 TI - Impaired heme synthesis in a family with Pelger-Huet anomaly, recurrent abdominal pain attacks and impaired neutrophil motility in vitro. AB - Heme synthesis was studied by measuring the activity of delta-aminolevulinic acid synthase (AmLev synthase) in granulocytes, the activity of delta-aminolevulinic acid dehydratase (AmLev dehydratase) and of uroporphyrinogen I synthase in erythrocytes as well as the concentrations of coproporphyrin and protoporphyrin in erythrocytes of 6 patients with Pelger-Huet anomaly. 3 of these patients from the same kindred had a syndrome of recurrent attacks of fever and abdominal pains, a tendency to skin infections, delayed wound healing and impaired neutrophil motility. The other 3 patients were asymptomatic. The activity of AmLev synthase was depressed in all 3 symptomatic patients and normal in the asymptomatic patients. 1 symptomatic patient had a decreased erythrocyte protoporphyrin concentration. These findings indicate a derangement of heme synthesis in the symptomatic patients. Their abdominal pain attacks could be due to heme depletion. The findings suggest that the abdominal pains of patients with porphyria could be due to decreased heme synthesis rather than due to accumulation of porphyrin precursors in tissues. The cause of the impaired neutrophil motility may be a defect in energy metabolism due to decreased supply of heme for oxidative metabolism. PMID- 3678480 TI - Adolescent mothers and their children in later life. AB - The popular belief that early childbearing almost certainly leads to school dropout, subsequent unwanted births and economic dependence is greatly oversimplified, if not seriously distorted: A longitudinal study of over 300 primarily urban black women who gave birth as adolescents in the middle to late 1960s shows that a substantial majority completed high school, found regular employment and, even if they had at some point been on welfare, eventually managed to escape dependence on public assistance. Relatively few ended up with large families; most had fewer births than they had wanted or expected at the time they first became pregnant. The study also found that the pathways to success were surprisingly diverse. Although young women who gave birth at an early age were disadvantaged when compared with their peers who bore children later, huge variability existed. Teenage childbearing lowered the women's likelihood of economic success and increased their likelihood of having a large family. However, the women who had more economically secure and better-educated parents were more likely to succeed--perhaps as a result of receiving a greater amount of direct aid and having other family resources available. In addition, differences in educational motivation and performance were especially important factors. Young mothers who had been doing well in school and who had had high educational aspirations at the time of their first birth were much more likely than others to be successful later. Additional births at young ages also constrained the mothers' ability to attend school and accrue job experience. Women who had more children in the five years after their first birth did less well in school, had lower aspirations and came from more disadvantaged families than did women who curtailed their fertility. However, even when such factors were controlled for, subsequent fertility lowered the chances of economic success in later life. Changes in the mothers' life courses affected some aspect of their children's behavior at all ages, but there was no simple or recurring pattern of influence. For example, a mother's welfare receipt was associated with behavior problems in her child during the preschool years, but not later on. In contrast, the mother's marital status was not related to behavior problems during the preschool period but was clearly related to such problems during the child's adolescence. PMID- 3678481 TI - The impact of family planning program activity on fertility. PMID- 3678482 TI - Abortion training in U.S. obstetrics and gynecology residency programs. AB - The majority (72 percent) of U.S. residency programs in obstetrics and gynecology include first-trimester abortion techniques in their training. Programs affiliated with public hospitals or with private non-Catholic institutions are the most likely to provide such training, while Catholic-affiliated training programs and those at military hospitals are the least likely to do so. Approximately 23 percent of institutions include abortion training as a routine part of residency, and 50 percent offer it as optional training. The 28 percent of residency programs that offer no abortion training represents an almost fourfold increase since 1976. Although more of the large programs affiliated with public hospitals now include such training as a routine part of their residency programs, fewer of the private non-Catholic programs--where the largest proportion of residents are trained--do so. Consequently, the number of residents exposed to abortion training may have declined slightly over the past decade. Little difference exists between the proportion of programs that offer training in first-trimester techniques and the proportion that train in second-trimester techniques. Nine percent of programs report that all residents participate in first-trimester abortion training, and another 56 percent report that at least half of their residents do so. The participation rate is linked to the expectations of the program: Approximately 88 percent of programs that routinely incorporate abortion techniques in their training report that from one-half to all their residents participate, compared with about 55 percent of programs that offer the training as an option. Approximately 82 percent of programs teach abortion techniques up to at least 20 weeks' gestation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678483 TI - Single-parent families: are their economic problems transitory or persistent? PMID- 3678485 TI - The stimulation of phosphorylation of intracellular proteins in GH3 rat pituitary tumour cells by phorbol esters of distinct biological activity. AB - Using a pituitary tumour cell line (GH3), we have studied the phosphorylation of intracellular proteins induced by phorbol esters of diverse biological activity. All the active phorbol esters, including the weakly tumour-promoting but non platelet aggregatory compound DOPPA, stimulated the phosphorylation of a cytosolic 80 kDa protein. A protein of this molecular mass has been suggested to be a marker of PKC activity. In contrast, only TPA and the non-tumour promoting but highly active phorbol ester SAP A stimulated the phosphorylation of a 130 kDa membrane protein. The results suggest that these phorbol esters activate PKC, but induce the differential phosphorylation of a variety of intracellular proteins. PMID- 3678484 TI - The need and unmet need for infertility services in the United States. PMID- 3678486 TI - Primary structure of ovine pituitary basic fibroblast growth factor. AB - The complete amino acid sequence of basic FGF (146 residues) from ovine pituitary glands has been established. This has been achieved by the sequence analysis of subnanomole amounts of the intact molecule and of peptides derived by enzymatic digestions with clostripain, chymotrypsin, pepsin and Staphylococcus aureus V8 protease. Microbore HPLC, employing 1-2 mm i.d. columns, was used to purify, concentrate and buffer-exchange the FGF peptides. A novel application of ion pairing chromatography was employed to isolate peptides which were not retained on conventional reversed-phase systems. There is only one positional difference between the ovine and bovine basic FGFs, but there are 3 positional differences between ovine and human basic FGFS. PMID- 3678487 TI - Secretion of antileucoprotease from a human lung tumor cell line. AB - Two human tumor cell lines were analyzed for the production of human antileucoprotease (ALP). One of them, a human squamous lung carcinoma cell line (HS-24) synthesized, as confirmed by Western blot analysis, high amounts of ALP in serum-free medium. The supernatant inhibited elastase, chymotrypsin and trypsin. Northern blot analysis with an 18-mer radiolabelled oligonucleotide, derived from an ALP specific cDNA clone, revealed a specific mRNA of about 700 800 nucleotides in HS-24 tumor cells. In contrast, a secondary human lung tumor cell line (SB-3), derived from the adrenal cortex, did not synthesize ALP when assayed under identical conditions. The supernatant inhibited only trypsin and chymotrypsin. PMID- 3678488 TI - Chromogranin B (secretogranin I), a putative precursor of two novel pituitary peptides through processing at paired basic residues. AB - During the course of reversed-phase high-pressure liquid chromatography (RP-HPLC) purification of the 7B2 peptide originally isolated in our laboratory from human pituitary gland extracts, two novel peptides were identified and purified to homogeneity. The complete amino acid sequence of the first one was established in 1985 and recently found to be entirely homologous to positions 420-493 of the just published chromogranin B sequence. This peptide, denoted GAWK, could originate from chromogranin B following specific cleavage at the basic amino acids flanking both termini of GAWK. Moreover, another peptide isolated in our laboratory from the same source and denoted CCB has been discovered and its sequence is also part of the same chromogranin B molecule. Here again, this peptide, occupying positions 597-653 and located at the COOH-terminal region of chromogranin B, could derive from specific processing at basic amino acids, Arg Lys-Lys, present at positions 594-596. In a manner reminiscent of the relationship between pancreastatin and chromogranin A, it is proposed that both GAWK and CCB are produced from chromogranin B after specific processing at basic amino acids. These data are thus in favor of a putative role of chromogranins as precursors to potentially bioactive peptides. PMID- 3678489 TI - Hydrophobic cluster analysis: an efficient new way to compare and analyse amino acid sequences. AB - A new method for comparing and aligning protein sequences is described. This method, hydrophobic cluster analysis (HCA), relies upon a two-dimensional (2D) representation of the sequences. Hydrophobic clusters are determined in this 2D pattern and then used for the sequence comparisons. The method does not require powerful computer resources and can deal with distantly related proteins, even if no 3D data are available. This is illustrated in the present report by a comparison of human haemoglobin with leghaemoglobin, a comparison of the two domains of liver rhodanese (thiosulphate sulphurtransferase) and a comparison of plastocyanin and azurin. PMID- 3678490 TI - The geometries of interacting arginine-carboxyls in proteins. AB - The geometries are reported for interacting arginine-carboxyl pairs obtained from 37 high resolution protein structures solved to a resolution of 2.0 A or better. The closest interatomic distance between the guanidinium and carboxyl is less than 4.2 A for 74 arginine and carboxyl groups, with the majority of these lying within hydrogen-bonding distance (2.6-3.0 A). Interacting pairs have been transformed into a common orientation, and arginine-carboxyl, and carboxyl arginine geometries have been calculated. This has been defined in terms of the spherical polar angles T theta, T phi, and the angle P, between the guanidinium and carboxyl planes. Results show a clear preference for the guanidinium and carboxyl groups to be approximately coplanar, and for the carboxyl oxygens to hydrogen bond with the guanidinium nitrogens. Single nitrogen-single oxygen is the most common type of interaction, however twin nitrogen-twin oxygen interactions also occur frequently. The majority of these occur between the carboxyl oxygens and the NH1 and NE atoms of the arginine, and are only rarely observed for NH1 and NH2. The information presented may be of use in the modelling of arginine-carboxyl interactions within proteins. PMID- 3678491 TI - Differences in the half-lives of some mitochondrial rat liver enzymes may derive partially from hepatocyte heterogeneity. AB - The different turnover rates of rat liver mitochondrial enzymes make autophagy unlikely to be the main mechanism for degradation of mitochondria. Although alternatives have been presented, hepatocyte heterogeneity has not been considered. Lighter hepatocytes isolated in a discontinuous Percoll gradient contain more glutamate dehydrogenase (GDH) (half-life 1 day) and a more active autophagic system than heavier hepatocytes. The latter contain more carbamoyl phosphate synthase (CPS) and ornithine carbamoyl transferase (OTC) (half-lives 8 days) but less lysosomal activity. As expected, isolated autophagic vacuoles contain, relative to the mitochondrial content, 3-times less OTC and CPS than GDH, probably reflecting a faster lysosomal engulfment of mitochondria in the light hepatocytes (which contain more GDH). These data may explain some of the half-life differences of the enzymes studied. PMID- 3678492 TI - Linear relationships between mitochondrial forces and cytoplasmic flows argue for the organized energy-coupled nature of cellular metabolism. AB - We have studied rates of formation of glucose, urea and lactate by isolated hepatocytes incubated with a variety of inhibitors of energy transduction. Linear relationships have been found between these metabolic rates and mitochondrial forces (membrane, redox and phosphorylation potentials). The findings are suggestive of extensive enzyme organization within these metabolic pathways. PMID- 3678493 TI - The mechanism of neuronal resistance and adaptation to hypoxia. AB - In this work we provide a theoretical explanation for the observations that: (i) young animals are more resistant to hypoxia than adult ones and (ii) repeated exposure to a hypoxic insult increases the tolerance of young animals and isolated brain tissue to that insult. Considered here is the role of taurine, a putative Ca2+ transport modulator, in attenuating Ca2+ influx and overload in brain tissue upon hypoxia. It is proposed that the higher resistance of young animals to hypoxia stems from their higher brain content of taurine as compared with adults. The increased resistance to lack of oxygen upon re-exposure to hypoxia may occur as a result of protein and coenzyme A (CoA) breakdown which leads to the accumulation of products like cystine, cysteine, cysteamine and other sulfur-containing compounds. Upon reoxygenation, these compounds are oxidized to form taurine, which in turn attenuates neuronal Ca2+ accumulation. The sulfur-containing compounds are considered to be natural scavengers of oxygen derived free radicals which are formed upon reoxygenation and have been implicated as a major component in the process leading to ischemic/hypoxic brain damage. Repeated hypoxic insults bring about the formation of higher levels of taurine and hence the observed adaptation to oxygen lack. The hypothesis presented here is supported by experimental observations in our laboratory and those of others. PMID- 3678494 TI - Nebulin and titin expression in Duchenne muscular dystrophy appears normal. AB - Monoclonal antibodies which recognize different epitopes on either titin or nebulin show normal staining patterns on frozen sections of three muscle biopsies of Duchenne muscular dystrophy (DMD). Gel electrophoresis and immunoblotting performed on two of these muscle biopsies show the normal pattern of titin and nebulin polypeptides. Since the donor of one of these biopsies has a large deletion of the 5'-region of the DMD gene, our results argue against the recent proposal that nebulin is the gene mutated in DMD. PMID- 3678495 TI - Eukaryotic elongation factor Tu is present in mRNA-protein complexes. AB - By two-dimensional gel electrophoresis, partial peptide mapping, and antibody binding we have shown that eukaryotic elongation factor Tu is in close contact with mRNA in rabbit reticulocytes. It can be crosslinked to mRNA by irradiating both polysomes and 40-80 S mRNA-protein complexes with short-wave UV light. To our knowledge this is the first case in which a known translation factor has been shown to be associated with mRNA in native ribonucleoproteins. PMID- 3678496 TI - Structure and order of the protein and carbohydrate domains of prothrombin fragment 1. AB - The three-dimensional structure of prothrombin fragment 1 has been determined by X-ray crystallography at 3.8 A resolution. The fragment is composed of a number of structural units, some of which are ordered while others are disordered. The ordered part of the structure includes a compact kringle unit, a helical domain and a carbohydrate chain. The kringle structure is organized around a close pair of buried disulfide bridges. One of its carbohydrate chains, that attached to Asn 101, is fully ordered, but the carbohydrate chain attached to Asn 77 appears to be disordered. The calcium binding unit is composed of a disordered part containing all ten gamma-carboxyglutamic acid residues and an ordered part forming the helical domain. The highly conserved residues Phe 41, Trp 42 and Tyr 45, which form a hydrophobic cluster on the first helix, interact around a crystallographic two-fold axis with the equivalent residues in another molecule to form a dimer in the crystal. PMID- 3678497 TI - Planning and management for health. Report on a European conference. PMID- 3678498 TI - Association of scrotal hyperthermia with impaired spermatogenesis in infertile men. AB - Scrotal temperatures, testicular volumes, and sperm characteristics were studied in 150 infertile, nonazoospermic men and in 37 fertile men, used as a control group. The mean scrotal temperature values of the infertile men were significantly greater than those observed in the fertile men (+0.4 degrees C for the right; +0.5 degrees C for the left). In the infertile men, it was found that the higher the scrotal temperature, the more alterated the sperm characteristics. The only clinical element that seemed to be linked to the existence of scrotal hyperthermia in the infertile men was testicular hypotrophy. Although the scrotal temperatures of the infertile men with varicocele were significantly higher than those of the fertile men, they did not significantly differ from those of the infertile men without varicocele. No other specific pathologic factor, infectious or surgical urogenital history was found to be responsible for the scrotal hyperthermia observed in the infertile men. PMID- 3678499 TI - Confirmation of an abnormal (non-Poisson) distribution of sperm from some infertile men in the hamster-ovum test. AB - The present study was carried out to investigate an earlier report that stated that some men of infertile couples (patients), but not normal donors, have an abnormal (non-Poison) distribution of penetrating sperm among ova in the hamster ovum test. Semen samples from 60 men, 24 proven fathers and 36 patients, were analyzed for agreement with the theoretical Poisson distribution (PD). Most of the fathers (23 of 24) fit PD well, but 10 of the patients did not. The overall (group) fit of fathers is good, but that of the patients is poor. Patients, but not fathers, are heterogeneous in their agreement with PD; about 25% fit poorly whereas more than 50% fit well. The 25% fitting poorly may often be those patients who are truly infertile (even when their wives are actually fertile). PMID- 3678500 TI - A comparison of thermal injury, healing patterns, and postoperative adhesion formation following CO2 laser and electromicrosurgery. AB - To further define the role of CO2 laser in infertility surgery, the authors compared the immediate tissue damage and the subsequent healing patterns that followed the randomized use of CO2 laser and electrocautery on opposite sides of the reproductive tracts of 20 mature, female rabbits. Blind histopathologic evaluations were performed on the ovarian and uterine tissues immediately to compare the extent of the acute thermal damage, and 4 weeks postoperatively to compare the healing patterns. There were no differences in the depth of thermal damage, extent of collagen deposition, or in postoperative adhesion formation between CO2 laser and electrocautery. However, the mean depth of the acute thermal damage was significantly less on the ovary than on the uterus, and the area of fibrosis was significantly less when the incised uterine surfaces were approximated. PMID- 3678501 TI - Estradiol reverses the limiting effects of clomiphene citrate on early embryonic development in the in vitro perfused rabbit ovary. AB - This study examined whether the addition of estradiol (E2) to the perfused rabbit ovary would reverse the deleterious effects of clomiphene citrate (CC) on early embryonic development. Ovaries were perfused with CC (10(-5) M) or CC + E2 (1 to 1000 ng/ml). Human chorionic gonadotropin (hCG, 50 IU) was added to the perfusate of each ovary. In vitro ovulated ova in cumulus were retrieved and inseminated in vitro. E2 significantly increased the percentage of ovulated ova achieving (1) the 2-cell stage at 36 hours, (2) the morula stage by 84 hours, and (3) the blastocyst stage at 132 hours. The percentage of inseminated ova showing evidence of degeneration was reduced in ovaries treated with E2. These data suggest that CC may exert an antiestrogenic effect on the intrafollicular oocyte, which interferes with postfertilization development. PMID- 3678502 TI - Influence of estrogens on vascular transudation and mucus production in the rabbit endocervix. AB - The manner in which estrogens mediate cyclical changes in the viscoelastic properties and volume of cervical mucus is unclear. To identify the response to estrogens of each of the major mucus components (mucin[s], soluble proteins, and small electrolytes and water), the authors quantitated their accumulation rates before and during estrogen stimulation in the rabbit. Circulating radiolabeled markers (35S-sulfate and 131I-albumin) were used to monitor the incorporation of small and large molecular weight intravascular substances into the cervical mucus. The accumulation rate of mucins was unaffected by exogenous estrogen administration, despite significant increases in mucus volume. This increase in mucus volume was attributed to a significantly increased transudation of water and small electrolytes increasing mucus hydration as early as the first 2 hours of estrogen administration. Water, small electrolytes, and soluble proteins significantly increased during the third and fourth hours of estrogen administration, not only when compared with the unstimulated basal levels, but also when compared with the levels found during the first 2 hours of estrogen administration. No significant change occurred in mucin production, while significant changes occurred in the accumulation of proteins and small electrolytes, whether estrogen was given initially or terminally in the experiment protocol. PMID- 3678503 TI - Arrested tubal pregnancy. AB - This communication presents a small series of patients operated on for tubal occlusion resulting from undiagnosed tubal pregnancy. In three of the five patients, tubotubal anastomosis after the resection of the affected tubal segment was performed on a single tube. Two of these three patients achieved viable pregnancies. This fact supports the value of reconstructive tubal microsurgery in arrested tubal pregnancy. The histopathologic findings suggest that chorionic villi are capable of surviving in a recognizable form for at least 15 months after the demise of the tubal pregnancy. PMID- 3678504 TI - Timely diagnosis of early ectopic pregnancy using a single blood progesterone measurement. AB - We obtained a single serum P measurement in 70 subjects at risk for an EP. Retrospectively, a P less than 15 ng/ml was 100% predictive of either an EP or otherwise nonviable IUP, while P greater than 15 ng/ml would have ruled out an EP in all cases. Because of this high degree of diagnostic accuracy, we speculated on the clinical utility of an outpatient D and C for those patients in our series having a P less than 15 ng/ml. Laparoscopy would be reserved for those cases without identifiable chorionic villi on frozen section of curettings. Following this course of management could have potentially diagnosed all EPs at the first ER visit without disruption of a single normal IUP in our series. This sequence could have expedited the diagnosis of EP by up to 14 days compared with a standard hCG/US protocol. This report describes a promising new test for the early detection of EP. The findings, however, require confirmation in a prospective trial before widespread clinical implementation. PMID- 3678505 TI - Cumulative pregnancy rates for donor insemination according to ovulatory function and tubal status. AB - From our study of 234 cases of AID with fresh semen, we conclude the following: (1) women who do not have other infertility problems, such as ovulatory dysfunction or evidence of tubal disease, have approximately a 90% chance of pregnancy if they stay in the program for up to 12 cycles; (2) with even greater persistence (i.e., greater than 12 cycles), it is predicted that virtually 100% of these women would conceive, but this conclusion is based on extrapolated data and therefore must be interpreted with caution; (3) women with ovulatory dysfunction who are treated with CC during their AID cycles ultimately achieve the same likelihood of pregnancy as women with normal ovulatory function, but at a slower rate; and (4) women with one patent tube (possibly a marker for generalized tubal damage) have a poorer outcome from AID than those with bilaterally patent tubes, from the standpoint of both the ultimate likelihood of pregnancy and the pregnancy rate per cycle. PMID- 3678506 TI - Age-related evolution in color appearance of endometriosis. AB - Endometriosis presents a large variety of color manifestations, most nonblack, and many easily missed unless meticulous inspection is used to identify small or nonhemorrhagic lesions. An evolution in appearance with age may occur, with resultant spurious effects on conclusions regarding the natural history of the disease. This study confirms and expands the concept of nonhemorrhagic appearances presented by Jansen and Russell. PMID- 3678507 TI - The vellus index: a new method of assessing hair growth. PMID- 3678509 TI - Relative risks of oral contraceptive usage. PMID- 3678508 TI - Electroejaculation of paraplegic males followed by pregnancies. AB - Semen obtained by electroejaculation was used to achieve pregnancies in the spouses of T5-6 and T4-5 paraplegics. Viable semen was recovered in both an antegrade and retrograde fashion. In both cases, the SPA test was positive. Semen recovered for AIH IUI was washed and swum up prior to insemination. PMID- 3678510 TI - The effects of Lubrin on sperm motility in vitro. PMID- 3678511 TI - Treatment of refractory infertility by transcervical intrauterine insemination of washed spermatozoa. AB - One hundred thirteen couples with either male factor, cervical factor, endometriosis, or idiopathic infertility of at least 3 years' duration were treated by intrauterine insemination (IUI) of washed motile sperm. Of the 68 women who became pregnant or completed at least three cycles of insemination, the overall pregnancy rate was 38.2%, with a mean of 1.7 treatment cycles per pregnancy. The average pregnancy rate per treatment cycle was 11.4%. Women who did not become pregnant underwent an average of 4.7 treatment cycles. Importantly, only two pregnancies occurred independent of treatment in 113 couples. In the male factor group, the pregnancy rate was 42.9% (n = 21). In women with a cervical factor, 34.5% became pregnant (n = 29); in idiopathic infertile couples or women suffering from endometriosis, there was a pregnancy rate of 38.9% (n = 18). The presence of sperm antibodies in either the male or female partner significantly lowered the pregnancy rate (6.7%) when compared with couples without sperm antibodies (50.0%). The authors conclude from these observations that IUI with washed sperm is a successful mode of therapy, especially in the case of males with asthenozoospermia. PMID- 3678512 TI - A comparison between two methods of chronological dating of human endometrial biopsies during the luteal phase, and their correlation with histologic dating. AB - This prospective study was performed on 61 infertile women to examine the correlation between histologic dating using the same criteria by two independent observers and chronological dating by two different methods: (1) determination of luteinizing hormone (LH) peak by daily LH assay, (2) calculation based on the onset of the next menstrual period (NMP). The correlation between histologic dating and chronological dating was found to be significantly better if the LH peak was used to determine the chronological date than if the NMP was used (r = 0.70 and 0.37, respectively). PMID- 3678513 TI - The integrated luteal progesterone: an assessment of luteal function. AB - An integrated luteal progesterone (ILPL) was calculated on the basis of a luteal progesterone (P) level with the assumption that the daily plasma P level in the luteal phase closely approximates a sine curve. The midluteal P-amplitude (K) was also obtained mathematically. Daily luteal P levels from five normal ovulatory cycles were assessed for the biologic variation of ILPL and K, then compiled to construct a normogram of the ILP during the luteal phase. The coefficient of variation of K and total ILPL in each cycle ranged from 9.7% to 24.3% and 3.5% to 13.2%, respectively. Fifty-two infertility patients were evaluated for their luteal function by the luteal P and estradiol (E2) level, K, ILPL, endometrial biopsy (EBX)-lag-day, as well as the lengths of follicular phase, luteal phase (L#), and cycle. Thirty-nine patients had EBX-lag day less than or equal to 2 days and were designated as infertile-normal (INF-NL) luteal phase, while the remaining 13 patients who had EBX-lag day greater than 2 days were considered as luteal phase defect (LPD). Significant (P less than 0.05) differences were observed between INF-NL and LPD in: luteal length (13.2 +/- 0.31 versus 11.0 +/- 0.58 days, respectively), and total ILPL (170 +/- 8.3 versus 113 +/- 8.5 ng/ml day, respectively). No differences were seen in luteal P, E2 and K levels, nor in follicular and cycle length. Significant (P less than 0.05) correlations were observed between total ILPL and luteal P, E2, L#, and K; while a negative correlation was noted between follicular and luteal length.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678514 TI - Identification and management of clomiphene citrate responses. AB - Clomiphene citrate (CC) is widely used for induction of ovulation; however, adequate time is rarely used to monitor patients on this form of therapy. Two hundred thirty-one infertility patients qualified for this study in 1155 cycles, during which basal body temperature charts were kept and the quality of cervical mucus was evaluated. Nine types of responses were classified: three ovulatory (O1, O2, O3), three anovulatory (A1, A2, A3), and three miscellaneous (M1, M2, M3). The overall, uncorrected pregnancy rate was 54.9%, and 79.2% showed ovulatory responses. The most common response was O1 (normal responses, 38.5%) with the highest pregnancy rates (92.1%). Poor estrogenic response with poor cervical mucus (CM) (O2) was fairly common (13.4%) and had poor pregnancy rates, even with the addition of estrogens (12.9%). It is suggested that this new classification of CC responses will help to identify and more efficiently manage patients undergoing this form of therapy. PMID- 3678515 TI - The role of chlamydial antibodies in an in vitro fertilization program. AB - The reported incidence of antibodies to Chlamydia trachomatis in patients attending infertility clinics is at least 30%. It has been reported that chlamydial antibodies are associated with decreased pregnancy rates following in vitro fertilization (IVF). A study was performed to investigate the significance of chlamydial antibodies in an established IVF program. The results did not show a decreased pregnancy rate in the presence of chlamydial antibodies. Of the women achieving pregnancy, 41% were seropositive compared with 38% seropositivity in women who did not become pregnant. There was no apparent benefit of the use of prophylactic antibiotics. The results also suggested that past infection with C. trachomatis in men did not adversely affect semen analysis or fertilization. PMID- 3678516 TI - Follicular fluid estradiol and progesterone are markers of preovulatory oocyte quality. AB - Follicular fluid estradiol (FF E2) and progesterone (P) have previously been shown to vary with the maturation of the follicle. A profile of follicular fluid E2 and P was obtained from follicles of 19 preovulatory oocytes, which resulted in normal term pregnancies from single embryo transfers. A narrow band was defined around the linear regression line E2/P = 1.2 X 10(-2) + 1.57 X 10(-4) E2, r = 0.806, P less than 0.01, when E2/P was plotted versus E2 that included 84.2% of these oocytes. Eleven of the 19 pregnancies were clustered between an E2 of 240 to 460 ng/ml and an E2/P ratio of 0.044 to 0.084. Sixty-eight patients undergoing in vitro fertilization and embryo transfer were studied. A significantly greater number of preovulatory follicles from the fertilized, cleaved, and pregnant group (10 of 40) was found in the cluster than from the fertilized, cleaved, but not pregnant group (4 of 46; P = 0.04) and fertilized but not cleaved group (0 of 13; P = 0.04). Significantly more pregnant patients (14 of 20) had a preovulatory follicle within the band than nonpregnant patients (11 of 36) (P less than .02), as well as in the cluster (10 of 20), compared with 4 of 36, respectively (P less than 0.01). It may be concluded that a range of FF E2 and E2/P values define a stage of maturation that is compatible with successful pregnancies. PMID- 3678517 TI - Unreported chest pain in a coronary care unit. PMID- 3678518 TI - Is caffeinated coffee consumption a risk factor for coronary heart disease? PMID- 3678519 TI - Individualized orientation in critical care. PMID- 3678520 TI - Adult respiratory distress syndrome. PMID- 3678521 TI - Endoscopic retrograde cholangiopancreatography: its role in diagnosis and treatment. PMID- 3678522 TI - Postmyocardial infarction syndrome: a case study. PMID- 3678523 TI - Dispute in the intensive care unit: should blood cultures be drawn from arterial lines? PMID- 3678524 TI - [Sexual differentiation of social play and copulatory behavior in prenatally stressed male and female offspring of the rat: the influence of simultaneous treatment by tyrosine during exposure to prenatal stress]. AB - The environmental stress in the late gestational life has been reported to induce impairments of androgen-dependent sex differentiation of the rat brain. This study was performed to investigate the effects of prenatal stress on the features of gender role behavior and copulatory behavior which are masculinized by perinatal androgens. Further, a possible counteraction of tyrosine to the long term effects of prenatal stress was examined, because the supplementation of amino-acid precursor of catecholamines during the stress is known to maintain the content of catecholamines in the brain, which is considered to contribute to the differentiation of the brain. Time-mated pregnant females were subjected to the forced immobilization stress daily from day 15 of pregnancy to the day of delivery, and they received simultaneous i.p. injections of either tyrosine methylester HCl (200 mg/kg) or saline, less than 60 minutes before stress. Social play in the peripubescent period was observed in the male and female offspring. After maturation, they were castrated and male copulatory behavior under androgen substitution was tested in the male offspring, and female copulatory behavior under estrogen-substitution was tested in the female offspring. In the male offspring, prenatal stress caused a significant depletion of social play as well as male copulatory behavior, showing the demasculinization of gender role centers and mating centers. In the female offspring exposed to the prenatal stress, a significant increase of social play was observed. And their lordosis quotient did not alter, but a reduced attractivity against male partner was found. These results in the female offspring suggest some extent of masculinization occurred in both centers, probably due to the increase of androgens derived from the adrenal glands when stressed. Tyrosine seemed to reduce the engagement of social play in both sexes, independently of the prenatal stress. On the other hand, tyrosine prevented, at least partially, the long-term effects of prenatal stress in copulatory behavior which were observed in this study. Tyrosine itself had no effect on copulatory behavior. The apparent counteraction of tyrosine in copulatory behavior suggests a positive involvement of catecholamines, especially norepinephrine, in the process of masculinization of the mating centers. The different action of tyrosine to these behaviors may reflect the fact that the different regions of the brain and separate mechanisms are responsible for the sexual differentiation of social play and copulatory behavior. PMID- 3678525 TI - [The regulation system of brain aromatase activity; distribution and changes with age of the aromatase activity of the rat brain]. AB - Sexual differentiation of brain structure and function is dependent on the hormonal environment during perinatal life. Recently, some studies have found the greatest aromatase activity in brain areas associated with sexual differentiation and sexual behavior, namely the hypothalamic and limbic structures. We have characterized the developmental and anatomical patterns of aromatase of aromatase activity in brains of fetal, neonatal, infantile and adult rats of both sexes. Aromatase activities in slices of brain were assayed by measuring the amount of 3H2O formed during the conversion of [1 beta-3H] androstenedione to estrogen. We have demonstrated major changes of the aromatase activity in the brain with age. Aromatase activities of both sexes reached peak values in the hypothalamus preoptic area (HPOA) at least 3 days before birth. Thereafter, the activities declined to 3 weeks after birth. We have found the greatest amount of aromatase activity in HPOA and amygdala of both sexes. Aromatase activities in HPOA and amygdala of neonatal male rat were higher than adult male rat. The hippocampus, thalamus, pituitary, cerebral cortex and cerebellum all contained negligible aromatase activity. And, we studied HPOA in detail, aromatase activities in preoptic area and anterior part of hypothalamus were twice higher than that in posterior part of hypothalamus. Aromatase activity reached peak values at the critical period of the sexual differentiation of the brain in HPOA and amygdala, associated with sexual behavior and sexual differentiation. We have reported that aromatase activity was regulated by androgen. We suggested that aromatization didn't occur effectively in female rat, owing to scarcity of androgen, which was activator and substrate of aromatase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678526 TI - Migration from plasticized films into foods. 1. Migration of di-(2 ethylhexyl)adipate from PVC films during home-use and microwave cooking. AB - Migration of di-(2-ethylhexyl)adipate (DEHA) into a diverse range of foods arising from the domestic use of plasticized PVC films has been determined using a stable isotope dilution GC/MS procedure. Aspects of home use reported in this study include the wrapping and covering of foods such as cheese, cooked meats, sandwiches, cakes, fresh fruit and vegetables; the use of films during food preparation such as marinading; covering during microwave reheating of previously prepared foods, and covering during microwave cooking. Contact between film and foods was for differing temperatures and times, representative of the range of conditions likely to be experienced in practice in the home. Migration increased with both the length of contact time and temperature of exposure, with the highest levels observed where there was a direct contact between the film and food, and where the latter had a high fat content on the contact surface. Highest levels of migration were observed for cheese, cooked meats, cakes and for microwave-cooked foods, whilst lower levels were observed for wrapping of unfilled sandwiches, fruit and vegetables (except avocado), and for food preparation including microwave reheating where there was covering of the food in a container but little or no direct contact. PMID- 3678528 TI - HPLC determination of the total content of aflatoxins in naturally contaminated eggs in free and conjugate forms. AB - A study was undertaken to evaluate the total aflatoxin content in naturally contaminated eggs. Two pools of eggs from laying hens were collected after 2 and 7 days of treatment with aflatoxin B1 (AFB1). An HPLC method has been developed for the determination of AFB1, aflatoxin M1 (AFM1), aflatoxin B2a (AFB2a) and aflatoxicol (Ro) both in free form and after release from water-soluble conjugates. The bound form was cleaned up after acid hydrolysis of the aqueous phase. Eggs collected after 2 days of treatment revealed residues of AFB1, AFB2a and Ro in the organic phase, but none in the aqueous portion. After 7 days of treatment both AFB1 and its hydroxy derivative were found in the organic phase but the aqueous portion showed only hydroxylated metabolites accounting for 35% of the total aflatoxin content. PMID- 3678527 TI - Migration from plasticized films into foods. 2. Migration of di-(2 ethylhexyl)adipate from PVC films used for retail food packaging. AB - A UK survey of di-(2-ethylhexyl)adipate (DEHA) levels in retail foods (83 samples) wrapped in plasticized PVC film has been carried out, examining a wide range of different food types obtained from retail and take-away outlets. Foodstuffs analysed included fresh meat and poultry, ready-cooked poultry, cheese, fruit, vegetables and baked goods such as cakes, bread rolls and sandwiches. Analysis by stable isotope dilution GC/MS showed DEHA levels ranging from 1.0 to 72.8 mg/kg in uncooked meat and poultry, 9.4 to 48.6 mg/kg in cooked chicken portions, 27.8 to 135.0 mg/kg in cheese, less than 2.0 mg/kg in fruit and vegetables and 11 to 212 mg/kg in baked goods and sandwiches. The level of DEHA migration correlated with the extent of contact between the film and exposed fatty portions of the food, whether that was the mayonnaise filling of a sandwich or the surface fat from a joint of uncooked meat. The level of DEHA in meat exposed to plasticized film was not reduced significantly by volatilization or chemical transformation on subsequent cooking by grilling or frying. PMID- 3678529 TI - A multi-residue TLC screening procedure for anabolic oestrogens and detection of oestradiol, DES or zeranol in chicken muscle tissue extracts. AB - A multi-residue HETLC (High Efficiency Thin Layer Chromatography) screening procedure for 17 beta-oestradiol, diethylstilboesterol (DES), zearalanol (zeranol), zearalenone and their metabolites oestrone, zearalanone, and zearalenol is described. The anabolic oestrogens were analyzed on HETLC plates coated with silica gel and were developed in methylene chloride:methanol: 2 propanol (97:1:2 v/v). The spots were visualized by exposure to iodine vapours and subsequently sprayed with 1% starch solution. Analysis of standards by HETLC at 4 degrees C as a seven-component mixture showed six discrete bands with mean Rfs of 0.37 (oestrone), 0.35 (zearalanone and zearalenone), 0.26 (t-DES), 0.23 (oestradiol), 0.17 (zearalenol and zearalanol), and 0.15 (c-DES). Chicken muscle tissues (1, 2.5, or 5 g) were extracted with 95% acetone. Extracts were then fortified with 50-250 ng each of the anabolic oestrogens, purified in alumina and ion-exchange columns and analyzed by HETLC. Oestradiol, zeranol or DES in fortified tissue extracts were clearly detected when an equivalent of 4 ng were analyzed by HETLC after purification in alumina and ion-exchange columns. The intensity of their bands suggested near quantitative recovery when compared to intensity of bands of known amounts of standards. The described extraction, purification, and TLC procedures can be used to screen these oestrogens at low ppb amounts in chicken muscle tissues and should be applicable to screen tissues of cattle and sheep. PMID- 3678530 TI - Evaluation of lead, cadmium, chromium, copper and zinc by atomic absorption spectroscopy in durum wheat milling products in relation to the percentage of extraction. AB - 36 samples representative of the 1981 Italian durum wheat crop were separated by an industrial Italian milling process and the products obtained analyzed by AAS for their Pb, Cd, Cr, Cu, Zn content. The results obtained were: Pb ranging from 0.04 to 0.80 ppm, Cd from 0.02 to 1.39 ppm, Cr from 0.05 to 1.60 ppm, Cu from 1.8 to 39.7 ppm and Zn from 8.8 to 117.6 ppm. Although Cr content was relatively homogeneous, Pb, Cd, Cu and Zn distribution in the various mill products proved to be rather inhomogeneous. Maximum contamination for Pb, Cd and Cr, was appreciably lower than in previous studies. PMID- 3678531 TI - Sulphite stabilization and high-performance liquid chromatographic determination: a reference method for free and reversibly bound sulphite in food. AB - A high-performance liquid chromatographic (HPLC) post-column reactor combination has been developed for the determination of sulphite (free and reversibly bound) in 15 different foods. The foods were treated with a pH 5.1 buffered aqueous 2% formaldehyde solution to convert the labile sulphite to the relatively stable hydroxymethylsulphonate. Reverse-phase ion-pairing HPLC with a post-column detector consisting of an initial reaction with KOH followed by colorimetric reaction with Ellman's reagent buffered at pH 6.3 were used for separation and quantitation. The photometric detector at 412 nm quantitated the strongly absorbing 3-carboxy-4-nitrothiophenolate anion, the product of the sulphite reaction with Ellman's reagent. The recovery at levels of 5-100 ppm as sulphur dioxide was greater than 90% by reverse isotope dilution assay. Repetitive analysis of a single grape juice extract containing 20 ppm SO2 showed a relative standard deviation of 2.2%. PMID- 3678532 TI - Delaware physicians' views of clinical ethical problems. PMID- 3678533 TI - Thoracic actinomycosis presenting as empyema necessitans. PMID- 3678534 TI - Autologous blood donation during pregnancy. PMID- 3678535 TI - The clinical use of amitriptyline in a family practice unit. PMID- 3678536 TI - Social factors and infant mortality: identifying high-risk groups and proximate causes. PMID- 3678537 TI - The influence of the family on premarital sexual attitudes and behavior. AB - This research has expanded our understanding of the determinants of adolescent sexuality in several directions. We have used a study of mothers and children to construct and estimate a model of the intergenerational transmission of sexual attitudes and behavior. With data collected from both mothers and children, we were able to proceed further than most past research and to consider both the attitudes and behaviors of mothers as reported by the mothers themselves. These data permitted an investigation of the determinants of maternal attitudes concerning adolescent sexuality as well as an examination of the influences of the attitudes and experiences of mothers on the attitudes, perceptions, and behavior of children. Obviously, limiting the study to white families prevents generalization of our findings to other subgroups of the population. The findings demonstrate the importance and relevance of parental and adolescent attitudes in understanding adolescent sexuality. Premarital sexuality is a salient issue to both young people and their parents. There are, however, very important and substantial differences in the attitudes of parents and children. On average, the attitudes of young people today are much less restrictive than those of their parents, reflecting either life cycle differences or the impact of social change. The intergenerational difference is recognized by young people themselves and probably affects the ability of parents to assist their maturing children in adjusting to and dealing with their sexuality--a difficulty likely to be reflected in the relative lack of success sexually active young people have in preventing pregnancy. Our findings also add to the research literature in demonstrating that although children, on average, have more permissive attitudes than their parents, the attitudes of individual parents tend to be reflected in the attitudes of individual children. Children whose mothers have less restrictive attitudes have, on average, less restrictive attitudes themselves. Further, the attitudes of mothers are also reflected in the behavior of their children, so on average, mothers with more permissive attitudes have children who are more sexually active. The influence of maternal attitudes, however, is stronger for children's attitudes than for their behavior. Of course, variability in children's attitudes and behavior--and even their perceptions of maternal attitudes--can only be partially explained by the attitudes of their mothers; but presumably, if the attitudes of other important family members, including fathers and siblings, were known, the prediction of adolescent attitudes would improve.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3678538 TI - Is child schooling a poor proxy for child quality? PMID- 3678539 TI - Determinants of contraceptive use in rural Bangladesh: the demand for children, supply of children, and costs of fertility regulation. PMID- 3678540 TI - A count of the uncountable: estimates of undocumented aliens counted in the 1980 United States census. PMID- 3678541 TI - Pregnancy wantedness and maternal behavior during pregnancy. PMID- 3678542 TI - Distributions of postpartum amenorrhea: some new evidence. PMID- 3678543 TI - On stable population theory with immigration. PMID- 3678544 TI - On "A new look at entropy and the life table". PMID- 3678545 TI - [Immunostimulants--experimental findings and therapeutic aspects]. PMID- 3678546 TI - [On our understanding of amelanotic lentigo maligna]. PMID- 3678547 TI - Treatment of secondary recurrent and early latent syphilis with penicillin and ethamide: clinical and experimental evaluation. PMID- 3678548 TI - Aggressive topical corticosteroid therapy: a novel approach to mast-cell dependent cutaneous disorders. AB - Topical corticosteroids are utilized in the treatment of a wide variety of skin diseases, primarily those involving an inflammatory component. Recent investigations have revealed that one of the effects of long-term usage of steroids is the depletion of skin mast cells. This led to the treatment of patients with urticaria pigmentosa with topical high potency corticosteroids for 6 weeks. At the end of treatment there was a marked reduction in tissue histamine and an absence of mast cells as well as a disappearance of pruritus and Darier's sign. Treated areas remained clinically improved for at least 9-12 months. Observations that corticosteroids profoundly affect mast cells in vivo provides a rationale to devise new treatment regimens for mast-cell-related diseases. PMID- 3678549 TI - An in vivo and in vitro investigation of the phototoxic potential of tenoxicam, a new non-steroidal anti-inflammatory agent. AB - The phototoxic potential of tenoxicam, a new non-steroidal anti-inflammatory drug (NSAID), was investigated following oral and intradermal administration of the drug. No hypersensitivity responses to ultraviolet radiation (UVR) were observed for either orally or intradermally administered tenoxicam. In a parallel in vitro study, human polymorphonuclear leucocytes (PMNL) and mononuclear leucocytes (MNL) were exposed to UVR in the presence and absence of the NSAIDs tenoxicam, piroxicam and benoxaprofen (10-40 micrograms/ml). The generation of reactive oxidants by control and UVR-treated human PMNL and MNL in the presence and absence of the NSAIDs was measured according to the extent of luminol-enhanced chemiluminescence. Only benoxaprofen activated reactive oxidant generation by PMNL and MNL. The results of these in vitro and in vivo studies show that phototoxicity is unlikely to complicate chemotherapy with tenoxicam. PMID- 3678550 TI - Treatment of subcorneal pustulosis by etretinate. AB - A 69-year-old man with sulfone-resistant subcorneal pustular dermatosis was successfully treated by etretinate, 1 mg/kg body weight for 5 days, followed by 0.75 mg/kg body weight for 2 months. This confirms the possible usefulness of systemic retinoids in nonpsoriatic pustulosis. PMID- 3678551 TI - Autoimmune thyroiditis and generalized granuloma annulare: remission of the skin lesions after thyroxine therapy. AB - A patient suffering from generalized granuloma annulare associated with mild hypothyroidism due to an atrophic autoimmune thyroiditis is presented. Treatment with thyroxine resulted in the restauration of a euthyroid state. Subsequently disappearance of the antithyroid antibodies along with a progressive decrease in the number of the skin lesions was noticed. The association between generalized granuloma annulare and autoimmune thyroiditis has been reported once previously in the literature, but it might be of more frequent occurrence. PMID- 3678552 TI - Junctional epidermolysis bullosa with urethral stricture. AB - We present a case of junctional epidermolysis bullosa (EB) associated with urethral tract involvement. He was a 27-year-old man who had symblepharon of the right eye, hoarseness and urethral stricture in addition to generalized blister formation. Ultrastructural examination of a biopsy skin specimen demonstrated the characteristic morphology of junctional epidermolysis, a form of EB that has not been previously associated with urethral stricture. PMID- 3678553 TI - Dermatitis herpetiformis and hemodialysis. AB - A case of dermatitis herpetiformis in a 60-year-old woman with polycystic kidney disease on hemodialysis is reported. Bullous dermatoses associated with hemodialysis are analyzed. PMID- 3678554 TI - Association of acrodermatitis chronica atrophicans and morphea. AB - A patient developed successively acrodermatitis chronica atrophicans (ACA) and localized scleroderma. ACA was demonstrated to be a tick-borne disease, whereas morphea is only suspected to be one. As morphea appeared after successful treatment of ACA, it suggests that localized scleroderma is not directly an infectious disease but might be rather the consequence of spirochetal infection. PMID- 3678555 TI - Increase in incidence of necrotising fasciitis is not correlated to that of streptococcal bacteraemia or erysipelas. PMID- 3678556 TI - Lymphokine-release from rainbow trout leucocytes stimulated with concanavalin A. Effects upon macrophage spreading and adherence. AB - Rainbow trout blood and head kidney leucocytes were stimulated with the mitogen ConA to release a factor(s) that increased macrophage spreading and adherence. ConA present in control cultures was also shown to have this effect and so removal of ConA was essential to investigate the action of potential lymphokines. Either a 3h pulse with ConA or absorption of supernatants with Sephadex G10 was found to successfully remove activity from control supernatants whilst having no effect upon the lymphokine-containing supernatants. PMID- 3678557 TI - The specificity of Atlantic salmon antibodies made against the fish pathogen Vibrio salmonicida, establishing the surface protein VS-P1 as the dominating antigen. AB - The specificity of salmon (Salmo salar) antibodies made against the fish pathogen Vibrio salmonicida was studied. Salmon immunized with V. salmonicida emulisified in Freund's complete adjuvant produced antibodies which preferentially bound to a 40 KD outer surface molecule (VS-P1). Moreover, the bulk of the antibodies were specific for one particular epitope on VS-P1, defined by a mouse monoclonal antibody - as detected with a blocking ELISA. The data imply that salmon B cells mainly (90%) recognize one particular determinant on V. salmonicida and thus express a limited repertoire of antibody specificities against this pathogen. PMID- 3678558 TI - Bacterial sialic acid modulates activation of the alternative complement pathway of channel catfish (Ictalurus punctatus). AB - The alternative complement pathway (ACP) provides the non-immune channel catfish (Ictalurus punctatus) with protection against many Gram-negative bacteria. Very little serum bactericidal activity (0-13%) was found against 8 fish pathogens, but a strong bactericidal response (100%) was found against 7 non-pathogens. MgEGTA chelation of catfish serum did not essentially change the bactericidal results. Catfish serum heated at 56 degrees C and serum adsorbed with zymosan had no bactericidal activity. This demonstrated that the ACP was responsible for the bactericidal response. The molecular nature of the microbial surface determines whether or not the ACP will be activated. A relative lack of surface sialic acid has been found to be important for binding complement Factor B of the ACP by susceptible microbial surfaces. This study therefore examined the 15 Gram negative bacterial fish pathogens and non-pathogens by determining their sialic acid content and their ability to elicit a bactericidal response by the catfish ACP. It was found that there was very little bactericidal activity against the fish pathogens that contained sialic acid but a very strong bactericidal response (100%) against the non-pathogens that lacked sialic acid (p = .0043). A relative lack of sialic acid or no sialic acid therefore correlated with a strong bactericidal response by the catfish ACP. Neuraminidase treatment of the bacterial fish pathogens to remove sialic acid greatly increased the bactericidal response against them by the catfish ACP when compared with untreated bacteria (p = .0431). PMID- 3678559 TI - Cortisol mediated suppression of salmonid lymphocyte responses in vitro. AB - The suppressive activity of cortisol on the in vitro induction of coho salmon (Oncorhynchus kisutch) B cell activation was examined. Suppression was observed with splenic and pronephric (anterior kidney) derived lymphocytes. The kinetics of cortisol-induced suppression revealed distinct differences in the sensitivity of splenic and pronephric lymphocytes. Pronephric lymphocytes were only sensitive to cortisol early in the induction of the antibody response, whereas the splenic cells were sensitive to cortisol throughout the culture period. Addition of supernatants from antigen stimulated pronephric cultures completely restored the ability of pronephric lymphocytes to produce an antibody response, suggesting that this glucocorticoid-suppression may be mediated by inhibition of lymphokine production. PMID- 3678560 TI - The compatibility of Xenopus antibody and homoiothermic complement. AB - Adult Xenopus laevis serum containing an anti-chicken erythrocyte antibody exhibits complement (C) activity by both the classical and the alternative pathways. Lytic activity is removed by heating serum to 50 degrees C for at least 20 min; it is also removed by polysaccharides and by 7.5 mM EDTA. The optimum temperature for Xenopus C activation is 25 degrees C. The ability of Xenopus antibody against chicken erythrocytes to co-operate with homoiothermic C in in vitro by lysis of chicken erythrocytes was tested. Removal of Xenopus C by heating resulted in apparent damage to the antibody, so C was removed by absorption with antibody/antigen complex. Xenopus antibody will apparently combine with guinea-pig and rat C to effect lysis of chicken erythrocytes; low levels of haemolysis were seen with human, rabbit and chicken sera, while horse and mouse sera were non-lytic. Xenopus C was able to restore the lytic activity of decomplemented rabbit anti-chicken erythrocyte serum. PMID- 3678561 TI - Cellular expression of MHC glycoproteins on erythrocytes from normal and aneuploid chickens. AB - The major histocompatibility complex (MHC) in the chicken (B-complex) encodes glycoproteins homologous in function and distribution to the mammalian MHC. These are the B-F (class I) and B-L (class II) glycoproteins. In addition, a third glycoprotein (B-G) is also encoded by the chicken MHC. We are interested in examining gene regulation and cellular expression of these MHC gene products in the chicken. The trisomic line of chickens is being developed as an animal model for this purpose. Birds from this line contain either 2, 3, or 4 MHC-encoding chromosomes. In this study, we investigated the hypothesis that the quantities of B-complex glycoproteins on the membranes of fully differentiated erythrocytes are proportional to the number of MHC-encoding chromosomes present in particular birds. Hemagglutination final titer and quantitative adsorption assays were carried out using erythrocytes from disomic and aneuploid chickens homozygous for the B15 haplotype. The average hemagglutination final titers were higher for tetrasomic cells as compared to disomic cells. Furthermore, in adsorption assays, employing a B15 cross-reacting alloantiserum, trisomic and tetrasomic erythrocytes displayed increased adsorption capabilities (1.6 and 3.1 fold, respectively) compared to disomic control cells. These results indicate a step wise increase in the amounts of erythrocyte surface glycoproteins per cell in the trisomics and tetrasomics, respectively. Such findings are consistent with a MHC dosage-dependent model of gene expression in homeothermic vertebrates. PMID- 3678562 TI - Natural antibodies to human lymphocytes and erythrocytes in the serum of Orcinus orca killer whale. AB - The existence of naturally occurring heterophile antibodies to antigenic determinants on human blood cell membranes has long been known. It has been shown that the serum of Orcinus orca (Killer whale) does contain similar antibody. Absorption techniques in concert with either microagglutination or complement dependent microcytotoxicity assays revealed at least three antibody specificities erythrocyte (RBC), B-lymphocyte and T-lymphocyte. Human erythrocyte specificity has been separated from other mammalian RBC specificity, and higher microagglutination titers and/or scores were observed with human group A RBC's than with group B,O, or AB. Tests run at 4 degrees, 20 degrees and 37 degrees C). Higher microcytotoxicity and microagglutination activity was demonstrated with B versus T lymphocytes. It is hoped that the characterization of the antigenic specificity of these heterophile agglutinins will prove to be useful as a biological reagent-tool which may be applied to the identification of a new receptor on human lymphocytes and/or erythrocytes. Also, if isolated, these agglutinins could be useful in the study of the occurrence and presence of specific receptors on cell membranes and give insight as to how these receptors change in health, disease and malignancy. PMID- 3678563 TI - [Nuclear magnetic resonance spectroscopy and hepatic metabolism. Real time study of cell energy and intermediate metabolism in the isolated and perfused rat liver]. AB - Nuclear magnetic resonance spectroscopy is increasingly used to study cellular metabolism in a manner respecting cell integrity. The contribution of phosphorus 31 and carbon-13 NMR is discussed and illustrated by specific examples taken from work on hepatic metabolism carried out in this laboratory. Particular emphasis is laid on metabolite identification, quantitation and fluxes as studied by phosphorus-31 NMR which provides a direct insight of energy metabolism. The analysis of perfused rat liver by naturally abundant carbon-13 NMR illustrates the potential of the method to study non invasively lipid and carbohydrate metabolism in living systems. The use of carbon-13 enriched substrates to pinpoint a specific pathway of the intermediary metabolism is described in the case of excised rat liver perfused with (2-13C)-acetate. PMID- 3678564 TI - Contraceptive practice in 209 diabetic women regularly attending a specialized diabetes clinic. AB - In order to determine their contraceptive practice, 209 diabetic women, aged 16 50 years, regularly attending the diabetic clinic of a University Hospital in Paris, France, were interviewed. 134 (64%) were current-users of contraception. Contraceptive use was significantly lower among patients with NIDDM compared to patients with IDDM (46% vs 70%, p less than 0.01). Methods used were: intra uterine devices (IUD) (32% of users), hormonal compounds (27%, almost exclusively low-dose progestogen only pill), occlusive and natural methods (27%), and tubal ligation (14%). The major gynaecological side-effects were associated with the use of low-dose progestogens (39% with amenorrhoea vs 14% for other methods, p less than 0.01). A subsample (n = 165, age-range 20-44 years) of this diabetic population was compared with a representative sample of 8,899 French women of the same age. The proportion of current-users of contraception in this diabetic population was lower than in the French population (63.5% vs 72.2%, p less than 0.02). The diabetic patients tended to use more efficient methods of contraception (pill, IUD and tubal ligation), but 11% of them used no contraception without a stated reason, compared to 4% of the French population. It is suggested that contraceptive guidance should be reinforced in diabetic women, particularly with NIDDM, in order to promote family planning, since tight glycaemic control before and during pregnancy is now recommended. PMID- 3678565 TI - Glycosylated hemoglobin (HbA1) assay as a test for detection and surveillance of gestational diabetes. A reappraisal. AB - Total glycosylated hemoglobin (HbA1) levels were measured in 96 gestational diabetics and 139 normal pregnant women in order to assess their usefulness in detection and monitoring of gestational diabetes. Different, although not significant, behaviour of HbA1 values was found in gestational diabetics and controls throughout pregnancy. Significantly higher (p less than 0.005) HbA1 values were found in gestational diabetics between the 24th and the 32nd week of gestation. In spite of this finding a low sensitivity in detecting gestational diabetes was confirmed. HbA1 values and OGTT parameters did not correlate. Delivery of a large-for-date (LGA) baby was not associated with higher HbA1 levels. Overlapping HbA1 levels were found in gestational diabetics and normal pregnant women. This study confirm the low predictive value of HbA1 assay in gestational diabetes. PMID- 3678566 TI - Salivary flow rate and salivary glucose concentration in patients with diabetes mellitus influence of severity of diabetes. AB - Eleven diabetics (eight with type I diabetes) aged 20 to 45 years underwent salivary investigations on two occasions, one to five months apart, during different metabolic control. Stimulated salivary flow rate showed a great inter individual variation, and was not changed by improved metabolic control. Salivary glucose concentration was lower during the period of better metabolic control. In stimulated parotid saliva a positive correlation between glucose levels in saliva and blood was seen. A blood glucose threshold for glucose excretion at about 10 15 mmol/L might be present. There were no significant differences in pH, buffering capacity, total amount of protein, amylase, lysozyme, peroxidase or electrolytes (Na+, K+, Ca2+, PO42- and Mg2+) in the saliva between the two occasions of different metabolic control. In conclusion, the degree of diabetic metabolic control does not seem to be of major importance for salivary flow rate or composition in diabetics except for the salivary glucose concentration. PMID- 3678568 TI - Mathematical models of musculo-skeletal systems. PMID- 3678567 TI - Plasma neurotensin response to lipid ingestion in normal and gestational diabetic pregnancy. PMID- 3678569 TI - A mathematical model of the locomotor apparatus. PMID- 3678570 TI - A leg positioning and holding mechanism for use during knee surgery. PMID- 3678571 TI - The causes of femoral head roughening in explanted Charnley hip prostheses. PMID- 3678572 TI - The thermal properties of human cortical bone: an in vitro study. PMID- 3678573 TI - Force plate studies of Duchenne muscular dystrophy. PMID- 3678574 TI - Morphometric analysis of collagen fibrils in idiopathic carpal tunnel syndrome: Part 2. AB - Morphometric parameters were evaluated in order to analyze the relation between number and covered area of collagen fibrils in normal and carpal tunnel syndrome tissue. This analysis revealed that in normal tissue twice as many collagen fibrils as in pathological tissue occupy an equal area. Taking these facts into account, some hypotheses are advanced. PMID- 3678575 TI - Proliferation of human carcinoma cells in calcium-deficient culture medium may depend on autocrine growth factor(s). AB - The ability to proliferate in media with low calcium concentrations (less than 0.1 mM) at clonal seeding densities is a characteristic of malignant cells. Cells of the carcinoma line C-4I are an exception, and are unable to proliferate in medium with 0.02 mM calcium (LCM) when seeded at low densities. Conditioned medium, derived from a subline of C-4I cells that were adapted to grow in LCM, contained an acid-stable factor of greater than 8 kilodaltons molecular weight that mediated proliferation and colony formation of unadapted C-4I cells in LCM in a concentration-dependent manner. The effect was not related to enhanced cell attachment or spreading, and was maximal when the unadapted C-4I cells were seeded in aggregates of 2-20 cells rather than singly. Thus, calcium independence, a component of the neoplastic phenotype, may be mediated by autocrine tumor-cell-derived factor(s) and may involve long- and short-range cell interactions. PMID- 3678577 TI - Pretranslational hormonal control of male-specific cytochrome P-450 16 alpha in rat liver. PMID- 3678576 TI - Isolation and morphologic characterization of human ovarian carcinoma cell clusters present in effusions. AB - Serous, mucinous, endometrioid and clear cell human ovarian carcinoma cells were isolated as multicellular aggregates from patient effusions by filtration on nylon mesh of defined porosity and examined by light microscopy. The cell clusters ranged from compact to loosely adherent groups of cells to spheroids with a central lumen surrounded by a cell monolayer. There was considerable variation in cluster morphology between effusions from different patients as well as within effusion from the same patient. Apparent budding of clusters was observed as well as different stages of cluster growth and development. This was observed for all histologic types studied. Electron microscopy of serous, mucinous and clear cell types showed that cells forming clusters were attached to each other by desmosomes, demonstrating that cluster formation did not result from a nonspecific stickiness of cells. Irregular microvilli were present on the external periphery of the various carcinoma cells and a prominent glycocalyx was present on the surface of mucinous carcinoma cells. Extensive interdigitation of cytoplasmic extensions and extended villi was present in mucinous and serous clusters which appeared to strengthen cluster cohesiveness. Nuclei were irregular with prominent nucleoli frequently present. The cell clusters usually remained intact and viable in culture but generally did not attach to glass or plastic substrata, whereas mesothelial cells and nonactivated histiocytes rapidly attached. When carcinoma cell clusters did attach, they were resistant to detachment by trypsin-EDTA treatment, in contrast to the nonmalignant cells. PMID- 3678578 TI - Cytochrome P-450 enzymes involved in genetic polymorphism of drug oxidation in humans. PMID- 3678579 TI - Molecular biology of glutathione transferases. PMID- 3678580 TI - Metallothionein gene regulation. PMID- 3678581 TI - Human P-450 genes: evolution, regulation and possible role in carcinogenesis. PMID- 3678582 TI - A new series of blood group A and H antigens expressed in human erythrocytes and the incompatible A antigens expressed in tumours of blood group O and B individuals. PMID- 3678583 TI - ABH and related tissue antigens. PMID- 3678584 TI - Biochemistry and genetics of the blood group Gerbich antigens. PMID- 3678585 TI - Biochemical genetics of blood group antigens: retrospect and prospect. PMID- 3678586 TI - Membrane-bound glutathione transferase. PMID- 3678587 TI - Expression of genes encoding glutathione S-transferases in normal and preneoplastic liver. PMID- 3678588 TI - The role of glutathione in determining the response of normal and tumor cells to anticancer drugs. PMID- 3678589 TI - Nucleotide sequence of the human liver glutathione S-transferase subunit 1 cDNA. PMID- 3678590 TI - From lysozyme to alpha-lactalbumin: protein engineering and evolution. PMID- 3678591 TI - Structural and functional studies on ferritins. PMID- 3678592 TI - Recent progress on the structure and function of glutamate dehydrogenase. PMID- 3678593 TI - Investigation of the function of plastocyanin by electrochemistry and nuclear magnetic-resonance spectroscopy. PMID- 3678594 TI - From allostery to mutagenesis: 20 years with aspartate transcarbamoylase. PMID- 3678595 TI - Absolute and relative bioavailability of a slow release theophylline preparation in asthmatic children. AB - This study was carried out on 14 asthmatic children aged 7-13 years. They all received three preparations (aminophylline by intravenous infusion, lysine theophyllinate orally in solution and slow release theophylline orally as capsules) in a single dose of 100 mg active ingredient in a crossover design. Plasma theophylline concentrations, determined by a fluorescent polarization immunoassay, were evaluated both by compartmental and non-compartmental analysis. After administration of slow release theophylline, its maximum plasma concentration and the time needed to reach this were (+/- SD) 3.19 +/- 0.63 microgram/ml and 8.71 +/- 2.30 h, respectively, compared to 4.51 +/- 0.94 microgram/ml and 1.96 +/- 0.85 h, respectively, for the oral normal release solution. Mean absolute and relative percentage bioavailabilities for slow release theophylline in asthmatic children were (+/- SD) 92.7 +/- 23.2% and 83.14 +/- 14.69%, respectively. These are similar to the values found with other slow release formulations in paediatric patients. PMID- 3678596 TI - Chemical and physicomechanical aspects of biocompatible orthopaedic polymer (BOP) in bone surgery. AB - The properties of biocompatible orthopaedic polymer developed as an alternative to the metallic materials used in reconstructive bone surgery are discussed. Experiments were conducted to enhance the mechanical characteristics of the polymer by incorporation of various fibres. The result was a super biocompatible orthopaedic polymer which could be a valuable alternative to intra-medullary long bone metallic rods, whilst normal biocompatible orthopaedic polymer is currently used for bone filling and reconstructive surgery. PMID- 3678597 TI - Protein kinase C in pig thyroid cells: activation, translocation and endogenous substrate phosphorylating activity in response to phorbol esters. AB - The phorbol ester, TPA, induced the intracellular redistribution of protein kinase C in intact thyroid cells; it caused within 5 min of incubation a 90% decrease of the cytosolic protein kinase C and an increase of the membrane associated enzyme activity which appeared to be fully activated by TPA. TSH at concentrations which gave the maximal stimulation on various parameters of iodine metabolism induced the translocation of only 10-15% of protein kinase C from the cytosol to the membrane fraction. TPA induced a 2-fold increase in the incorporation of [32P]phosphate into cellular proteins and selectively activated the phosphorylation of two molecular species: a 180,000 Da protein and to a lesser extent a 170,000 Da protein in dispersed pig thyroid cells prelabeled with [32P]orthophosphate. The effect of TPA was maximum after 5 min of incubation and was concentration-dependent between 1 nM and 1 microM. The two phosphorylated substrates were only found in the cytosolic fraction. The TPA-induced phosphorylation of the 180,000 Da protein was observed in thyroid cells in suspension, in thyroid cell monolayers and follicle-like reassociated cells. In these three experimental situations, the 180,000 Da protein was not phosphorylated in response to TSH. Incubation of thyroid cell cytosolic fraction in the presence of [32P]ATP with calcium and phospholipid led to the phosphorylation of few proteins among which a 180,000 Da component. These proteins were not phosphorylated in the cytosol of TPA-treated cells, a finding in agreement with the translocation of protein kinase C. These results indicate that (1) the activation-translocation of thyroid protein kinase C induced by TPA is associated with the phosphorylation of selective substrates, and (2) TSH, even at high concentration, failed to exert the same action as TPA on protein kinase C in pig thyroid cells. PMID- 3678598 TI - Bioelectric responses of sea urchin eggs inseminated with oyster spermatozoa: a sperm evoked potential without egg activation. AB - Multiple oyster spermatozoa can enter sea urchin eggs with or often without fertilization membrane formation (Osanai and Kyozuka, 1982). In the present work, electrical responses of sea urchin (Temnopleurus hardwicki) eggs inseminated with oyster (Crassostrea gigas) sperm were examined and correlated to the failure of monospermy and egg activation. With diluted sperm, a transient depolarization of the membrane with a constant pattern appeared repeatedly and discretely, and the depolarizations (sperm evoked potentials, SEPs) were not associated with fertilization membrane elevation. With dense sperm, the SEPs occurred consecutively, and sometimes an assembled consecutive depolarization was followed by an activation potential associated with cortical granule discharge. When the membrane potential was artificially held at positive levels, the frequency of SEPs was strongly suppressed but not completely blocked. The present results indicate that an individual heterologous spermatozoon neither produces a depolarization sufficient to block additional sperm entry, nor stimulates egg activation, and that simultaneous entries of multiple heterologous spermatozoa, as possibly reflected by the assembled consecutive depolarizations, induce cortical granule discharge and egg activation. PMID- 3678599 TI - Healing modes correlate with visuotectal pattern formation in regenerating embryonic Xenopus retina. AB - After removal of the nasal or the temporal two-thirds of the embryonic (stage 32) eye, the remaining one-third sized fragment undergoes wound healing and then, in most cases, regenerates to form a new eye. Using gross anatomy and histology techniques, we categorized eye fragments into three healing mode categories over the first 24 hr after surgery (stage 37-38). Representative animals were reared through metamorphosis and their visuotectal projections were assayed using standard electrophysiology techniques. In the "rounded-up" healing mode, the cut edges of the fragment pinch to close the wound; retinal cell type layers (pigmented retinal epithelium (pre), photoreceptors, interneurons, ganglion cells) and a lens are present by 24 hr postsurgery. No extraneous or disorganized cells are present either internal or external to the fragments. These fragments regenerated to form normal projections 83% of the time and pattern duplicated projections only 17% of the time. In the "intermediate" healing mode, wound closure is not complete by 24 hr post surgery and groups of disorganized cells are present in the fragment and amassed between the healing cut edges. These fragments formed pattern duplicated projections 72% of the time. In the tongue healing mode, an ectopic mass of cells, contiguous with the main body of the fragment, forms a supernumerary retina in the region of the ablation. At 24 hr post surgery, the cells of the main body fragment form retinal layers; the cells of the tongue, excluding the presence of differentiated pre cells, remain undifferentiated, resembling ciliary margin. The cut edges of the main body fragment eventually fuse with the tongue to form a single eyeball. Tongue fragments formed pattern duplicated projections 100% of the time. In addition, pattern duplicated points derived from nasal fragments appeared most often in the posterior region of the tectum, the normal site of innervation of the nasal retina. This differed significantly from temporal fragment derived duplicated points which appeared more often in the front of the tectum, the normal site of innervation by temporal retina. Thus, the specificity of pattern duplicated innervation is related to the positional values remaining in the fragment after partial retinal ablation. The data indicate that cell movements during healing, whether overt as in the tongue healing mode, or remaining internal to the fragment as in the intermediate healing mode, are intimately correlated with pattern forming mechanisms which underlie pathological visuotectal duplication. PMID- 3678600 TI - The effect of back-transplants of the embryonic gut wall on growth of the neural tube. AB - Experiments in which the developing gut of avian embryos was back-transplanted to permit the bowel to interact with the developing neural tube were undertaken. Segments of intestine from 4-day quail embryos were implanted between the somites and neural tubes of chick embryos of 7 to 24 somites. The spinal cord responded to the presence of the bowel by enlarging unilaterally on the side of the graft. This effect encompassed both gray and white matter and was accompanied by the extension of neuritic projections from the spinal cord into the enteric grafts. The growth-promoting effect of enteric transplants was manifest at all levels of the neural tube where the grafts were made and led to enlargement of the brain as well as the spinal cord; however, truncal neural crest derivatives in the region of the grafts, such as developing sympathetic and spinal ganglia, were unaffected. Neither sham operations nor grafts of ciliary ganglion, lung, pancreas, mesonephros, or rudiment of the eye mimicked the action of the gut. The effect of the bowel was manifest as early as 24 hr following back-transplantation and was found to be due to an increase in the number of cells in the neuroepithelium. The cell responsible for the ability of the gut wall to enhance neuroepithelial proliferation was not identified, but the effect lacked species specificity and could be elicited in the absence of endoderm or neural crest derivatives in the explant. We propose that the musculoconnective tissue of the gut produces a short-range diffusible factor that induces mitogenic activity in the neuroepithelial cells of the neural tube, but not in the crest cells that form sympathetic or sensory ganglia. Since the gut is not normally in apposition to the neural tube, we suggest that the physiological targets of this factor are the specialized crest cells that colonize the bowel and give rise to the enteric nervous system. PMID- 3678601 TI - Chronic application of curare does not increase the level of motoneuron survival promoting activity in limb muscle extracts during the naturally occurring motoneuron cell death period. AB - Naturally occurring motoneuron cell death during development is a well-described phenomenon and the existence of a survival factor provided by target muscles has been postulated. Blockade of activity by chronic application of a neuromuscular junction blocker rescues almost all motoneurons from cell death. The present study was conducted in order to examine the possibility that the motoneuron survival-promoting activity in muscles increases following activity blockade. Cell culture was used to assess the degree of motoneuron survival-promoting activity present in muscle extracts. Embryonic chick motoneurons were labeled by injecting the water-insoluble fluorescent dye, DiI (Molecular Probes, Inc.) into the spinal nerves both before and during the cell death period. The labeled cells extending long neurites were counted after 2 days of culture as viable motoneurons in low-density heterogeneous cell cultures. The culture medium, Ham F12/DMEM (1:1 mixture) supplemented with 10% horse serum, 5% chick serum, and 5% fetal calf serum, was employed as a basic culture medium for assessing motoneuron survival factor, since it supported the survival of a significantly higher number of motoneurons derived from embryos before cell death than those during the cell death period, thus representing the motoneuron's requirement for survival factor in vivo. The number of surviving motoneurons clearly increased in proportion to the amount of muscle extract added to the culture medium. In comparison with control chick embryos, the dose-response relation between the number of surviving motoneurons and the amount of muscle extract added did not change when embryos were used after chronic application of curare. These results therefore indicate that survival factor derived from target muscle is crucial to the in vitro motoneurons during the cell death period, but do not support the idea that inactive muscle contains a higher amount of the survival factor. PMID- 3678602 TI - Protein phosphorylation in response to the tumor promoter TPA is dependent on the state of differentiation of muscle cells. AB - We have shown previously (A. Sobel and A. H. Tashjian, Jr. (1983). J. Biol. Chem. 258, 10,312-10,324;A. Sobel and M.C. Boutterin (1985). Neurochem. Int. 7, 995 1006) that, in the pituitary-derived GH4C1 cells, thyrotropin-releasing hormone or the tumor promoter TPA (12-O-tetradecanoylphorbol-13-acetate) stimulates the phosphorylation of two sets of cytoplasmic proteins related to the regulation of prolactin synthesis and release, respectively. Interestingly, phosphoproteins with identical electrophoretic migration properties on two-dimensional gels were detected in cultured neonate or adult mouse muscle cells and in the L6 and C2 myogenic cell lines. In addition TPA, which is known to have many actions on muscle cell functions, proliferation, and differentiation, stimulated the phosphorylation of these same proteins in myoblasts in culture. After fusion of the proliferating myoblasts into differentiated myotubes, this TPA-induced stimulation was strongly reduced in normal muscle cell cultures where some mononucleate muscle and non-muscle cells remained present. It was totally abolished in the homogeneous L6 and C2 cell lines. These observations suggest that the same phosphoproteins may be related to the intracellular mechanisms involved in the transduction of extracellular regulatory signals in such distinct differentiated environments as those of pituitary and muscle cells. In muscle cells themselves, the regulation of the phosphorylation of these proteins is function of the cell's state of differentiation. PMID- 3678603 TI - Cerebellar mutations affecting the postnatal survival of Purkinje cells in the mouse disclose a longitudinal pattern of differentially sensitive cells. AB - The pattern of surviving Purkinje cells (PCs) was investigated in three cerebellar mutant mice with severe postnatal PC death. Two of these mutations, nervous (nr) and Purkinje cell degeneration (pcd) mutations are already well characterized. The third mutation is a new one, which appeared spontaneously in DW/J-Pas mice and was called tambaleante (tbl). PCs were identified by immunocytochemistry using an antibody against vitamin D-dependent calcium-binding protein which labels all the PCs in adult control mice. In each of the three mutations, surviving PCs are arranged according to a different and reproducible pattern which is symmetric relative to the midline. In NR and young PCD mutants, PCs are closely packed in broad sagittal bands. In TBL, they are more loosely arranged in a rather patchy pattern. In PCD and in TBL mutants the death of resistant PCs is only shortly delayed but in NR there is little change in the number of surviving PCs after 3 months. The differential sensitivity of subsets of PCs to the effect of nr, pcd, and tbl mutations is topographically determined. These results provide a new evidence of the PC heterogeneity which has been previously demonstrated by histochemical and immunohistochemical techniques. Moreover, in the anterior vermis of control mice, three thin sagittal bands of PCs are labeled by the Q113 monoclonal antibody. Similarly, in the anterior lobe of the NR cerebellum, the thin longitudinal strips of missing PCs coincide with the absence of Q113 immunoreactivity: in this region the nr mutation affects specifically the survival of Q113 positive cells. However, other clusters of Q113 immunoreactive PCs do survive in NR mice suggesting that susceptibility to the nr mutation and Q113 positivity are two independent markers of the underlying PC compartmentalization. PMID- 3678604 TI - A sodium-dependent, fast block to polyspermy occurs in eggs of fucoid algae. AB - More than 70% of Pelvetia fastigiata eggs and about 15% of Fucus distichus eggs become polyspermic when fertilized at natural sperm concentrations in a low sodium (2.5 mM Na+, 450 mM N-methyl glucamine) artificial seawater. Natural levels of polyspermy are 1-3% for both species. Polyspermic eggs germinate and respond to photopolarization, but do not develop beyond an abnormal, "stumpy," four-cell stage. They die within 1-1.5 weeks. The sodium-dependent block is a fast block, and it is replaced by a second block (probably cell wall formation) no later than 9 min (Pelvetia) after eggs are shed. The sodium-dependent block in Pelvetia is very efficient; when external sodium is raised to only 47.5 mM, the level of polyspermy drops to about 25%. These results are compared with data on marine invertebrates in the context of factors such as the sperm/egg concentration at fertilization and natural, osmotic (salinity) stress. PMID- 3678605 TI - The ectodermal control of mesodermal patterns of differentiation in the developing chick wing. AB - The influence of limb ectoderm on the dorso-ventral muscle and skeletal patterns in the chick wing was studied by recombining stage 14-21 limb mesoderm with the same stage ectoderm in dorso-ventrally reversed orientation. Recombinants grafted to the flank of host embryos were allowed to develop for 10 days. Fully developed wings obtained from stage 15-21 donor embryos have at their distal half d-v polarity conforming to the reversed ectoderm and proximally polarity conforming with the mesoderm. The ectodermal effect is generally observed as a bidorsal feather pattern at the autopod and an almost complete d-v reversal of muscle and skeletal patterns. In experimental wings from donor embryos younger than stage 15, the dorso-ventral pattern conforms with the polarity of the limb mesoderm. The results suggest that control of dorso-ventral polarity resides in the mesoderm until the onset of limb development at stage 15. At this stage, the ectoderm acquires dorso-ventral information which it can impose on the mesoderm. PMID- 3678606 TI - Chemotaxis or adhesion gradient? Pronephric duct elongation does not depend on distant sources of guidance information. AB - Previously published experimental studies have led to conflicting interpretations concerning the mechanism guiding pronephric duct elongation in the urodele embryo. Although most studies have led to the conclusion that duct migration is directed by an adhesion gradient (haptotaxis), one set of experiments has been interpreted as supporting chemotactic guidance. We have resolved this conflict by conducting grafting experiments in Ambystoma embryos which distinguish between these two possible mechanisms of cell guidance. Our results provide an alternative explanation for the observations originally interpreted as supporting chemotaxis and add further evidence for adhesive guidance. PMID- 3678607 TI - Influence of the mesonephros on the development of fetal mouse ovaries following transplantation into adult male and female mice. AB - We previously reported that fetal mouse ovaries frequently develop testicular structure following transplantation into adult male mice. The mechanism involved in gonadal sex reversal of ovarian grafts is not known. In the present study, we examined the influence of the adjacent mesonephros on development of the ovarian grafts. The results show that (1) when fetal ovaries were transplanted with the attached mesonephros, the frequency of ovotestis development was higher in male hosts than in female hosts, (2) the fetal ovaries that had been separated from mesonephros developed testicular structures more frequently than those with the mesonephros, and the incidence of ovotestis development was comparable in male and female hosts, (3) removal of the cranial or caudal half of the mesonephros resulted in a similar frequency of ovotestis development, and (4) when fetal ovaries were separated and reattached to the mesonephros, they developed testicular structures at a frequency similar to that of ovaries left attached to the mesonephros, and the sex of mesonephroi reattached to ovarian grafts did not influence the incidence of ovotestis development. These findings suggest that fetal ovaries can develop testicular structures after transplantation regardless of the sex of host, and that the adjacent mesonephros protects ovarian grafts from masculinizing stimuli more efficiently in female host than male hosts. PMID- 3678608 TI - Developmental switches of sericin mRNA splicing in individual cells of Bombyx mori silkgland. AB - Four mRNA of 10.5, 9.0, 4.0, and 2.8 kb are made from the sericin Ser1 gene by alternative maturation of a unique mRNA precursor. By means of RNA blots and in situ hybridization, we investigated variations in the distribution of these mRNA during the last larval instar in different territories of the middle silkgland. Taken together, the results from these two techniques show that 150 out of the 266 cells of this region of the organ express the Ser1 gene, but accumulate distinct mature mRNA species. Of these 150 cells 42 are specialized in a processing pathway resulting in the production of the 2.8-kb Ser1 mRNA throughout the larval instar. The 108 others perform successively three distinct splicing pathways leading to a development-dependent accumulation of, respectively, the 4.0-, the 10.5-, and the 9.0-kb mRNA. This suggests the occurrence of two switches in the splicing capacities of these cells during the fifth instar. The middle silkgland cells also express another sericin gene (Ser2) which encodes two mRNA of 5.4 and 3.1 kb, also arising by differential splicing. At the beginning of development, all the middle silkgland cells express this gene but, as development proceeds, expression becomes restricted to only the anterior cells. The biological consequence of this topological and temporal regulation of the mode of expression of these two genes is the sequential secretion and layering of the different sericins around the silk thread. PMID- 3678609 TI - H1 histone subtypes and subtype synthesis switches of normal and delobed embryos of Ilyanassa obsoleta. AB - Histone H1 subtype complexity and H1 histone subtype synthesis switches were characterized during the development of normal embryos of the mud snail Ilyanassa obsoleta. The effect of the removal of the third polar lobe on the normal H1 pattern of synthesis was then investigated in the delobed embryo to determine if classical polar lobe effects are accompanied by a perturbation of these patterns. SDS-gel electrophoresis and fluorography of radiolabeled 5% perchloric acid soluble nuclear extracts resolved six H1 proteins designated bands 1-6. Bands 1-5 migrate as a cluster of individual bands with similar mobilities. Band 6 has a substantially slower mobility. The synthesis of band 6 is predominant during the first 6 hr post-trefoil. During cleavage and gastrulation bands 1 and 2 are predominant while band 3, 4, and 5 become predominant during organogenesis. In addition, it has been found that removal of the polar lobe delays the off-switch of the early bands 6, 1, and 2 and the on-switch of the late bands 3, 4, and 5. This must result in a different H1 composition in the chromatin of the two embryo types. Cell number data of normal and delobed embryos reveal that the delay in subtype synthesis switching is not caused by an overall delay of cell division in the delobed embryo. However, the data indicate that a subpopulation of cells may not divide, or may divide late, in the delayed embryo. The data also suggest that the D cell lineage may be involved in the control of histone synthesis switching in the A, B, and C cell lineages. PMID- 3678610 TI - Scheduled and unscheduled DNA synthesis during development in conjugating Tetrahymena. AB - Autoradiography has been used to confirm and to extend previous microspectrophotometric studies (Doerder and DeBault, 1975) on the timing of DNA synthesis during conjugation in Tetrahymena thermophila. The majority of DNA synthesis occurs at the expected periods preceding gamete formation and the two postzygotic divisions and during macronuclear development. DNA in new macronuclei is endoreplicated in an extremely discontinuous fashion. Under starvation conditions, the first endoreplication (2C to 4C) occurs immediately after the second postzygotic division when both new macronuclei and new micronuclei replicate. The second endoreplication (4C to 8C) does not occur until after separation of conjugants. If mating cells are kept under prolonged starvation conditions (20-24 hr), refeeding induces a partially synchronous division, after which an unexpectedly high percentage of cells incorporate tritiated thymidine into both macro- and micronuclei. Two previously undescribed periods of DNA synthesis were observed in the micronuclei of conjugating Tetrahymena. The first occurs during the early stages of meiotic prophase, before full crescent elongation. The second takes place in an extended period corresponding to macronuclear anlagen development, before conjugants have separated. CsCl gradient analyses indicate that, in micronuclear fractions, only main band DNA is being synthesized in both of these periods. However, in macronuclear fractions from both stages, a significant fraction (approximately 20%) of the DNA being synthesized has the buoyant density of ribosomal DNA. The finding that macro- and micronuclear DNA can be synthesized simultaneously in a single cell, both during conjugation and after refeeding starved exconjugants, raises interesting questions of how macro- or micronuclear-specific histones are targeted to the appropriate nuclei. PMID- 3678611 TI - The role of synapse elimination in the establishment of neuromuscular compartments. AB - To investigate the specificity of development of initial neuromuscular connections, we examined the compartmental distribution of synapses in neonatal rat lateral gastrocnemius (LG) muscle. Initial neuromuscular connections might be restricted to the compartmental territories present in adults; alternatively, synapse elimination could establish the compartments from a less precise pattern of innervation. We examined 46 pups of ages 0 to 14 postnatal days using a variety of techniques. The principle method was evoked electromyographic (EMG) activity in response to nerve stimulation. The nerve branch to one neuromuscular compartment was cut and the remainder of the nerve was stimulated. The presence of EMG activity was used to identify the areas of muscle contracting in response to nerve stimulation. After cutting a particular branch, EMG activity generally could not be recorded from the denervated compartment. These results indicate that the pattern of innervation at birth is essentially compartment-specific, and that neuromuscular compartments are not shaped from some less precise pattern by postnatal synapse elimination. The factors which operate prenatally to determine this high degree of specificity in neuromuscular connectivity seen at the time of birth, however, remain unknown. PMID- 3678612 TI - Histone modifications accompanying the onset of developmental commitment. AB - In the sea urchin, Strongylocentrotus purpuratus, three cell types comprise the 16-cell stage embryo: micromeres, macromeres, and mesomeres. We have analyzed these three cell types for nuclear proteins that were synthesized during the earliest stages of embryonic development. The most striking differences in composition of newly synthesized proteins were found between the micromeres, which are the most committed cell type, and the macromeres and mesomeres. First, the micromeres lacked triply modified forms of histone H3; the levels of doubly modified forms of H3 were also greatly reduced. In contrast, micromeres were enriched in a band which migrated at the position of unmodified, unacetylated, histone H3 protein. Second, the overall distribution of H2A histone variants differed among the three cell types. Compared with macromeres and mesomeres, micromeres had a higher ratio of alpha-stage to cleavage-stage (CS) histone H2A; the micromere nuclei were depleted by 50 and 35%, respectively, in embryonically synthesized histone CS-H2A. Third, micromeres displayed different profiles of H1 histones. (a) They contained a cleavage-stage H1 histone which migrated faster than that of macromeres and mesomeres. This protein displays the electrophoretic behavior expected for a protein with reduced levels of posttranslational covalent modification. (b) Micromeres also had reduced levels of an H1 histone (designated H1 alpha a) band found in the alpha-H1 region of macromeres and mesomeres. These changes in chromatin modification correlate with the degree of commitment of cells in the developing embryo; they may reflect differing activities of the chromatin modifying enzymes in the various cell types at the 16-cell stage. Thus, the newly synthesized chromatin proteins of the individual blastomere types already differ in the developing sea urchin by the 16-cell stage. We suggest that variations in histone subtypes and in the levels of activity of chromatin modifying enzymes, e.g., acetylases and phosphorylases, could be involved in commitment and differentiation of different cell types. PMID- 3678613 TI - Deficient activation of heat shock gene transcription in embryonal carcinoma cells. AB - Heat shock protein (HSP) synthesis cannot be induced by stress in the cleavage stage embryos of many different species. For instance, no HSP synthesis can be induced in the mouse embryo before the formation of the blastocyst. Similarly, HSP synthesis is not stress inducible in some embryonal carcinoma (EC) cell lines such as PCC4 and PCC7 S-1009 (1009). We show that RNAs coding for the major stress inducible murine heat shock protein, HSP68, do not accumulate in PCC4 or 1009 EC cells in response to a stress. Using an in vitro nuclear transcription assay, we demonstrate that the transcription of the corresponding genes is not activated after a stress. A specific gene switch-off due to DNA methylation or chromatin conformation is unlikely to account for this result. Indeed, stress does not promote the activation of the heterologous Drosophila HSP70 heat shock promoter in transfection assays of these cells. In contrast, the same promoter, like endogenous HSP synthesis, becomes stress inducible in 1009 cells after in vitro differentiation. This suggests that, in contrast to differentiated cells, these EC cells, and maybe the very early mouse embryonic cells, could lack a transacting activating transcription factor or contain a repressor. PMID- 3678615 TI - Intersensory coordination and the effects of early sensory deprivation. AB - The effect of early visual deprivation on the ability of dark- (DR) and light reared (LR) rats to learn temporal discriminations involving sounds and lights and to abstract the intersensory correspondence involving duration from initial modality-specific training was examined in this study. While visually inexperienced DR rats were somewhat less successful in acquiring an initial discrimination involving visual events and responding to a rule reversal per se, they were as effective as their visually experienced LR counterparts in demonstrating cross-modal transfer (CMT) to signals in a new modality. The results revealed by the investigation are discussed in terms of the consequences and lack of consequences of the manipulation of early visual experience on the ontogeny of intersensory perceptual development in mammals. PMID- 3678614 TI - Sensory control of the initiation of hatching in chicks: effects of a local anesthetic injected into the neck. AB - Previous work shows that folding a posthatching chick into the hatching position results in the re-initiation of hatching. Furthermore, bending the neck to the right or left serves as a selective signal for turning on hatching behavior. The present study addresses the issue of whether sensory receptors located in the neck provide this signal. Three groups of chicks were folded into the hatching position and placed in glass eggs. In the experimental group, sensory input from the neck was eliminated with a local anesthetic, lidocaine. In these chicks, hatching was initiated only after a long latency, correlated with the time at which the anesthetic wore off. In the two control groups, in which saline was injected into the neck or lidocaine was injected into the thigh, the latency was much shorter. Therefore sensory receptors located in the neck appear to provide input that serves as a selective signal for initiating hatching. PMID- 3678616 TI - Response of sparrows to songs of deaf and isolation-reared males: further evidence for innate auditory templates. AB - Adult song sparrows (Melospiza melodia) were tested for response to songs of conspecific males that had been reared in acoustic isolation or deafened early in life. Territorial males responded more aggressively to playback of songs of isolated males than to songs of deafened males but did not discriminate between songs of deafened males and heterospecific songs. Captive females showed an identical pattern when their response was measured in terms of the number and intensity of courtship displays evoked by song. The results support the auditory template theory of song development in demonstrating that species-identifying features are present in songs of isolates and in showing that males unable to hear their own song production do not incorporate these species-identifying features into their songs. PMID- 3678617 TI - Early-life malnutrition selectively retards the development of distal- but not proximal-cue navigation. AB - The effects of early-life malnutrition on the distal-cue and proximal-cue versions of the Morris (1981) water maze were studied with different-aged rats. Consistent with the existing literature, malnutrition only mildly influenced the distal-cue navigation of relatively old pups (30 day olds). Pups 20-27 days old, however, displayed no evidence of distal-cue navigation if they had been malnourished previously. Malnutrition had no effect on proximal-cue based navigation by pups at any age. The effect of malnutrition on distal-cue performance could not be attributed to any general debilitating effects, sensory, motor, or motivational deficits. Instead, it appears to selectively influence the development of the neural system (perhaps the hippocampus and related structures) more directly involved in learning to utilize distal cues. PMID- 3678618 TI - Ontogeny of an endogenous, nonopioid and hormonally mediated analgesic system. AB - Rats of different ages (10-day, 28-day, and 3-month-old) were exposed to cold water stress in order to activate an endogenous analgesic system. The effects of naltrexone (7 mg/kg) and dexamethasone (.4 mg/kg) were also studied to examine the role of the opioid and hormonal systems in cold-water-induced analgesia. Following cold-water exposure, nociception was measured with the tail-flick procedure for 2 hr. Results revealed that cold water produced a significant level of analgesia in the 10-day, 28-day, and 3-month-old age groups with no differences between age groups. In addition, in each age group naltrexone did not block the analgesia while dexamethasone attenuated the analgesia produced by cold water. The effects of naltrexone and dexamethasone confirm that cold-water immersion activates a nonopioid, hormonally mediated analgesic system in each age group. Thus, this experiment found that the endogenous, nonopioid, and hormonally mediated analgesic system activated by cold water is functional early in the development of the rat. The early development of this hormonally mediated analgesic system is in contrast to the slower development of endogenous analgesia systems that are mediated by the central nervous system. PMID- 3678619 TI - Settling nature and nurture into an ontogenetic niche. AB - All organisms inherit parents' genes, but many also inherit parents, peers, and the places they inhabit as well. We suggest the term ontogenetic niche to signify the ecological and social legacies that accompany genes. A formal name is needed to give the idea of the inherited environment equal status with its conceptual cognates; nature and nurture. We argue here that increased recognition of the inherited environment facilitates unification efforts within the developmental sciences by emphasizing the affinity, rather than opposability, of ontogenetic processes. PMID- 3678620 TI - Development of rat embryos cultured in glucose-deficient media. AB - Embryo-culture techniques were used to study the effects of exposure to glucose deficient culture media on rat embryos during organogenesis. Embryos and their extraembryonic membranes (explants) were cultured either in control media or in media with low or very low glucose concentrations. At the start of the culture the glucose concentrations were 8.4 +/- 0.57, 4.5 +/- 0.10, and 3.5 +/- 0.07 mM. During the cultures, the explants progressively depleted the glucose in the medium until, after 48 h, the glucose concentrations were reduced to 1.1 +/- 0.18, 0.4 +/- 0.13, and 0.3 +/- 0.02 mM, respectively. At glucose concentrations less than 2.5 mM, the rate of glucose uptake by the explants progressively decreased, and embryonic growth and differentiation became increasingly retarded. After 48 h in glucose-deficient culture media, embryos had smaller crown-rump lengths, lower protein contents, and fewer somites than embryos from the control media (P less than .001). Most of the embryos exposed to the lower glucose concentrations also had severe dysmorphic lesions, especially of the head and branchial arches. The deleterious effects of exposure to low concentrations of glucose on embryonic development appeared not to be reversible. Embryos cultured for 24 h in media with a low concentration of glucose followed by 24 h in control medium grew and developed just as poorly as those cultured for the entire 48 h in the glucose-deficient media. PMID- 3678621 TI - Defective vasodilation response to exercise in cutaneous precapillary vessels in diabetic humans. AB - Although anatomic abnormalities in capillary structure are well described in diabetes mellitus, physiologic responses of diabetic microcirculation are less clear. This study addresses whether cutaneous vasodilation occurs normally in diabetic subjects in response to a standard exercise of underlying muscle. The methods involve a washout analysis from forearm skin of the fast-moving isotope 133Xe and the diffusion-limited marker 111In-diethylenetriamine pentaacetic acid. Twenty-four normotensive type II diabetic patients of age (mean +/- SE) 59 +/- 1.4 yr were age and weight matched with 24 controls. Control subjects increased flow 50.6 +/- 6.4%, which was not different from the increase in diabetic subjects of 52.7 +/- 7.6%. Permeability-surface-area product (PS) increased in control subjects from 1.77 +/- 0.20 ml.min-1.100 g-1 to 3.79 +/- 0.50 (2P = .0001), whereas diabetic subjects did not show a change in PS (3.29 +/- 0.35 to 2.69 +/- 0.31). Resting PS was higher in diabetic than control subjects (P = .0003), perhaps indicating an already recruited capillary bed. During repetitive exercise, control subjects increased capillary density 125 +/- 27% (2P = .0001) above basal with a nonsignificant 14 +/- 8.4% decrease in mean capillary blood flow. Diabetic subjects responded with a nonsignificant decrease in capillary density and a significant 139 +/- 38% increase in capillary blood flow (2P = .001). It is concluded that, although overall vasodilation occurs normally in diabetic cutaneous circulation, the mechanism is different from the normal response in that flow increases by augmentation of capillary flow rather than by recruitment. This is consistent with the thesis promulgated by others that diabetic precapillary vessels have depressed vasodilatory responses or are already maximally vasodilated. The ability of diabetic subjects to vasodilate by augmentation was not correlated with years of diabetes or use of insulin and only slightly negatively correlated with random blood glucose levels (r = -.423, P less than .05). PMID- 3678622 TI - Does galactose feeding provide a valid model of consequences of exaggerated polyol-pathway flux in peripheral nerve in experimental diabetes? AB - This study was designed to examine the effect of exaggerated polyol-pathway flux on sciatic nerve content of polyols, myo-inositol, and water. Rats with streptozocin-induced diabetes of 3- and 12-wk duration and nondiabetic rats fed for 5 days on a diet containing 20% galactose were employed initially. All three conditions showed marked elevation of nerve polyol content, combined with fructose accumulation in the diabetic rats. Galactose-fed rats showed a significant (P less than .01) increase in nerve water content of approximately 30% (when expressed as water/unit dry wt tissue). Diabetic rats showed no change in nerve water. Both diabetic and galactose-fed rats showed a depletion of nerve free myo-inositol, although the extent of depletion was greater in the latter. All these changes were prevented or attenuated by the aldose reductase inhibitor Statil (ICI 128436). When diabetic rats were fed a 20% galactose diet for 5 days, nerves of 3- but not 12-wk diabetic rats showed marked increases in water content. A more mild degree of galactosemia, induced by 5 or 21 days of feeding a diet containing 10% galactose to nondiabetic rats, provoked an increase in nerve water content associated with polyol levels of a similar order to those seen in diabetes. We do not know why polyol-pathway metabolites cause nerve hyperhydration in galactosemia but not in streptozocin-induced diabetes. Such differences urge caution in the use of galactose feeding to model the consequences of exaggerated polyol-pathway flux in nerve to face questions related to neuronal dysfunction in diabetes. PMID- 3678623 TI - Regulation of vascular permeability in cell culture. AB - Although one of the earliest findings of diabetic retinopathy is altered capillary permeability, metabolic factors in diabetes that may increase the permeability of capillaries to fluorescein are unknown. We have studied the effect of a variety of vascular and retinal cells and hyperglycemia on the diffusion rate of fluorescein. These studies were performed with a cell culture system that mimics the cross-section of a capillary by having two chambers separated with a porous membrane that can support the growth of cells on either side of the membrane. The addition of a confluent layer of endothelial cells or retinal pigmented epithelial (RPE) cells inhibited fluorescein diffusion between the two chambers 20- and 300-fold, respectively, after cells were cultured for greater than 5 days. Exposure of endothelial cells to 400 mg/dl glucose for either 3 or 100 days did not affect the barrier function of these cells. The barrier function of capillary endothelial cells isolated from BB rats with chronic diabetes and from nondiabetic animals did not differ. In contrast to endothelial cells and RPE cells, arterial smooth muscle and pericytes, which are not known to form tight junctions, did not inhibit the diffusion of fluorescein more than 2-fold. Surprisingly, the dual culture of endothelial cells with either retinal pericytes or smooth muscle cells resulted in a 50-fold increase in the rate of fluorescein diffusion, showing a disruption of the endothelial barrier. In summary, the intercellular connections between endothelial and epithelial cells that are responsible for the barrier to fluorescein diffusion are not functionally affected by chronic exposure to hyperglycemia or diabetic conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678624 TI - Autism and Rett syndrome: behavioural investigations and differential diagnosis. AB - The most common wrong diagnosis of children with Rett syndrome has been the infantile autistic syndrome, and it is probable that this false diagnosis continues to be made in many places. This paper is a follow-up to the authors' previous study concerning differential diagnosis between the two syndromes and is based on the observation of 63 patients over the age of 22 months in 10 stimulus situations. In Rett syndrome there were very small individual differences in the sensorimotor performances, which correspond only to the third and fourth stages of Piaget's 'sensorimotor intelligence' scale. There were pronounced individual differences in the levels of basic motor development and, independently from these, in autistic behavioural traits. When the children's behaviour was examined in detail, it became evident that girls with Rett syndrome differ in many subtle ways from those with the autistic syndrome. Behaviour observed in some cases of Rett syndrome but in none of the autistic syndrome included: social (non autistic) behaviour; no chewing, at most sucking of items of food placed in the mouth; monotonous 'hand-washing' movements with arms flexed in front of chest or chin. In all cases of Rett syndrome but in only some of the autistic syndrome there were: no 'social defence reactions' nor 'primary self-injuring activities'; some form of ataxia and a very restricted repertoire of postures and movements, monotonous in form and speed; and the time spent looking at objects and people was at least as long as the time taken to manipulate objects. Some causes of the characteristic stereotypic hand movements observed in Rett syndrome are also suggested. PMID- 3678625 TI - Phenylketonuria and complex spatial visualization: an analysis of information processing. AB - Recent neuropsychological studies have suggested that patients with early-treated phenylketonuria (PKU) and normal intelligence have a specific deficiency in solving complex spatial problems. In the present study a task involving the assembly of various shapes was used to compare the performance of 16 PKU patients and 11 sibling controls. Error rates generally were higher and response times slower among the PKU patients, but greater complexity did not produce differential changes in accuracy or speed in the PKU group compared to the controls. Correlations between task performance and IQ measures were significant for the PKU patients, but when IQ was controlled for the group differences vanished. The results suggest that choice of problem-solving strategy, attention span and accuracy of mental representation may be affected in PKU patients, despite efforts to maintain well-controlled phenylalanine concentrations in the blood. PMID- 3678626 TI - Visual-ocular control of normal and learning-disabled children. AB - Much of the data typically presented to support the vestibular dysfunction hypothesis among learning-disabled children is based on a measure of vestibular function that is confounded by visual input. Thus these data may provide evidence of deficits in visual-ocular function in this population. To explore this possibility the authors investigated the differences in visual-ocular function, in particular optokinetic nystagmus (OKN), between normal and learning-disabled children. Children were tested for refixation saccades, smooth ocular pursuit, spontaneous nystagmus, gaze nystagmus and OKN. The testers were blind to the group to which the children belonged. No significant differences were found between the groups on any of the variables. It is concluded that there is no difference in nystagmic behaviour between normal and learning-disabled children, and that the differences in eye movements reported among learning-disabled children should not be attributed to the visual-ocular control functions investigated here. PMID- 3678627 TI - Bone density in myelomeningocele: the effects of ambulatory status and other factors. AB - Measurements were made of distal radius, mid-radius, tibia and metatarsal bone density of 80 patients with myelomeningocele (17 thoracic, six L1/L2, 13 L3, 30 L4, 14 L5/sacral). For the upper extremity the bone density primarily was low in the thoracic patients, but in the tibia and metatarsal it showed a more linear correlation with neurological levels. The effect of age was highly significant at all sites; after controlling for this, the neurological level was a significant determinant of bone density at all sites, and this effect was greater in older children. Patients with impaired ambulation had decreased bone-density in the distal radius, tibia and metatarsal, but not in the mid-radius. Race had no significant effect on density after accounting for differences in neurological level. Weight for height and multiple fractures did not correlate with bone density. Although ambulatory status (weight-bearing stresses) and neurological status (muscle stresses) are both important factors in bone density, this study suggests that the latter is a more important determinant. PMID- 3678628 TI - Infantile febrile status epilepticus: risk factors and outcome. AB - The medical records of 68 children who had had infantile febrile status epilepticus (FSE) were examined. Follow-up periods ranged from three to 28 years (mean 8 years 10 months). Details were abstracted of relevant medical events prior to FSE, diagnosis of the febrile illness, age at onset and main characteristics of FSE, and outcome (subsequent febrile convulsions and/or epilepsy, neurological and psychiatric disorders). Neither medical events prior to FSE nor aetiology of fever were associated with subsequent febrile convulsions, epilepsy, or neurological or psychiatric abnormalities. There was a significant association between age at onset of FSE and both subsequent epilepsy and CNS disorders. 12 of the 13 children who had had transient or persistent post ictal hemiparesis subsequently developed epilepsy. Of the 46 children who later developed epilepsy, 34 had partial seizures and 12 had generalized seizures. The latter were more common among children who had had FSE before the age of one year. Likewise, all those who developed severe myoclonic epilepsy in infancy had their first FSE before age one. These findings suggest that age at onset of FSE is the most important feature determining long-term outcome. PMID- 3678629 TI - Developmental apraxia among Nigerian children in Enugu, Nigeria. AB - Developmental apraxia was studied among 421 eight- to 12-year-old children attending a normal school in Enugu, Nigeria. 25 children were found to be clumsy, a rate of 5.9 per cent. Neurological examination revealed a higher incidence of abnormality, principally dysdiadochokinesia, among the clumsy children than among a control group. There were no significant differences in perinatal factors between the two groups. The social, educational and psychological implications of developmental apraxia are discussed. PMID- 3678630 TI - Early neuromotor predictors of cerebral palsy in low-birthweight infants. AB - The purpose of this study was to analyze retrospectively which neuromotor behaviors in a sample of four-month-old low-birthweight infants were most predictive of later cerebral palsy. The infants were evaluated at four months corrected age on the Movement Assessment of Infants (MAI) and were followed to between three and eight years of age. For the CP group as a whole, 17 neuromotor items from the MAI were highly significant (p less than 0.001) predictors of cerebral palsy. A further 15 items also were significant, but less highly so (p less than 0.01 to p less than 0.05). Seven items were predictive of later spastic diplegia, seven of spastic hemiplegia, and 35 items differentiated quadriplegic infants. A shorter version of the MAI should be developed to increase its over all reliability and validity in the early detection of cerebral palsy. Only then would it be possible to implement early therapeutic intervention and to evaluate its efficacy. PMID- 3678631 TI - Early infantile epileptic encephalopathy with suppression burst: Ohtahara syndrome. AB - Eleven infants with neonatal onset of intractable epilepsy are described, who showed the clinical and electroencephalographic features of Ohtahara syndrome. With time, transition to West and Lennox-Gastaut syndromes occurred. No cause could be found in eight cases. All nine survivors are severely mentally and physically handicapped and continue to have seizures. Early infantile epileptic encephalopathy represents the earliest of the age-dependent epileptic encephalopathies. PMID- 3678632 TI - Encephalomyelitis in two sisters who died suddenly at home. AB - Two sudden infant deaths of female siblings occurring at the ages of six and 5 1/2 months are reported. The temporal separation of their deaths was 14 months. Both showed virtually identical pathological findings within the central nervous system, consistent with encephalomyelitis. No causative agent, metabolic defect or common predisposing factor was identified and no evidence of a relationship to immunisation could be established. PMID- 3678633 TI - Effective behavioral treatment of self-biting by a child with Lesch-Nyhan syndrome. AB - Behavior modification consisting of differential reinforcement of incompatible behavior and "punishment' was used for short periods at an early intervention center and was effective in eliminating self-biting of the arms, forearms and backs of the hands by a two-year-old with Lesch-Nyhan syndrome. No side-effects of the "punishment' component were observed. The effectiveness of the treatment was generalized to 3 1/2-hour sessions with his teacher at the early intervention center, and to the child's home. At six-month follow-up the teacher and parents indicated the continued absence of biting of the arms, forearms and back of the hands. The same treatment was applied to biting the fingers and the palms of the hands, without success. PMID- 3678634 TI - The changing face of cerebral palsy? PMID- 3678635 TI - Autism and infantile spasms in children with tuberous sclerosis. PMID- 3678636 TI - Antral hypergastrinemia--a report of three cases. AB - Three patients with juxtapyloric ulcers and hypergastrinemia are presented. Fasting and food-stimulated serum gastrin concentration (SGC) were measured in 1970, 1972 and 1973 before the primary ulcer operation (selective gastric vagotomy and Jaboulay gastroduodenostomy; SGV + GD). Fasting SGC were 105, 149 and 158 pg/ml and the postprandial concentrations were 400, greater than 800 and greater than 800 pg/ml, respectively. The pentagastrin-stimulated acid secretion was within the normal range. After SGV + GD, only a slight decrease in acid secretion was observed. The hypergastrinemia persisted unchanged or decreased slightly in 1 patient. A recurrent ulcer developed and a precise antrectomy was carried out. Postoperatively, the fasting SGC was markedly reduced and the postprandial gastrin response abolished. The resected specimens were subjected to immunocytochemical gastrin cell quantitation. The number of gastrin cells was elevated in all 3 patients and the gastrin cell topography was distorted, with cells being present both in the lower and upper thirds of the antropyloric glands. PMID- 3678637 TI - Effect of inhibitors on sodium and chloride transport in brush border vesicles from human jejunum and ileum. AB - Brush border vesicles were isolated from surgically resected pieces of human jejunum and ileum using a Mg2+/EGTA precipitation method. When compared to the homogenate, the final membrane preparation contained alkaline phosphatase at a 14 times higher concentration and almost no (Na++K+)-stimulated adenosine triphosphatase. An Na+/H+ antiport could be demonstrated in the jejunum by imposing a pH gradient between the interior and the outside of the vesicles (pHinside 5.2, pHoutside 7.2). In the presence of amiloride or harmaline, Na+/H+ antiport was inhibited by 60 +/- 5% (p less than 0.05) or 65 +/- 5% (p less than 0.05), respectively. In vesicles of human ileum we found an Na+/H+ antiport and in contrast to the jejunum a Cl-/OH- antiport could be demonstrated by imposing a pH gradient (pHinside 5.2, pHoutside 7.2). Besides this double-exchange mechanism for sodium and chloride, a Na+/Cl- cotransport and a Cl- conductive pathway could be detected in ileal brush border vesicles. In the presence of the anion transport inhibitors, furosemide, SITS and DIDS activities of Cl-/OH- antiport and Na+/Cl- cotransport were suppressed by 30 +/- 5% (p less than 0.05), 35 +/- 5% (p less than 0.05) and 40 +/- 5% (p less than 0.05), respectively. We conclude that absorption of sodium and chloride in the absence of organic solutes is mediated through different transport mechanisms at the luminal plasma membrane, which are in part subject to regulation by sodium and chloride transport inhibitors. PMID- 3678638 TI - Effect of bisacodyl on intestinal electrolyte and water net transport and transit. Perfusion studies in men. AB - The effect of bisacodyl on intestinal electrolyte, glucose, and water transport, and transit was studied in 6 healthy volunteers by intestinal perfusion. A 5 lumen tube with an occluding balloon allowed constant perfusion (10 ml/min) of 30 cm of the upper jejunum and a rapid collection of the perfusate free of contaminants. A phenol red bolus was injected into the tube and its passage through the test segment was calculated by dye dilution formula. A 1-hour control period was followed by a test period with 6 mg/h bisacodyl and followed by 2 other 1-hour control periods. Net absorption of Na+ (0.35 +/- 0.08 mmol/min) and water (1.7 +/- 0.6 ml/min) changed to net secretion (Na+ -0.93 +/- 0.3 ml/min; water -6.6 +/- 1.9 ml/min), glucose absorption decreased from 25.4% +/- 1.1 to 6.3 +/- 0.5 mg/min and K secretion was enhanced. 62 +/- 2.1% of bisacodyl was absorbed in the 30-cm jejunal segment. Mean transit time decreased from 8.5 +/- 1 to 4.4 +/- 0.7 min and mean flow rate increased from 8.4 +/- 0.6 16.6 +/- 1.9 ml/min. There was an inverse linear relationship between mean transit time and mean flow rate. All the effects of bisacodyl were fully or at least partially reversible. Volume and calculated radius of the test segment remained constant and did not change under bisacodyl. It is concluded, that the secretory effect of bisacodyl is mainly responsible for the decreased mean transit time rather than a direct effect on motility. PMID- 3678639 TI - Assessing assessment: the Goldman-Fristoe-Woodcock Auditory Skills Battery. AB - The purpose for this study was to determine the internal consistency (reliability) and the test-retest consistency (stability), and analyze the factor structures for the first ten tests of The Goldman-Fristoe-Woodcock Auditory Skills Battery (GFW Battery) in a population of normally hearing and regularly educated elementary children. The test battery was administered exactly as described in the test manuals to 100 children randomly selected from three public school districts. The results were that while the tests in the GFW Battery were typically reliable they were not stable. Additionally, the results indicated that factor structures suggested four distinct behaviors which conformed to auditory processing but which were significantly different than the factor structures reported for the GFW Battery. The first implication for clinicians is to retest children, after initial test administration, to ensure the stability of the initial test score. The second implication from this study is to question the validity of identifying each of the tests of the GFW Battery as unique and the validity for isolating the first 10 tests for planning and implementing auditory training. PMID- 3678640 TI - Consonant recognition and confusion patterns among elderly hearing-impaired subjects. AB - This study investigated whether unique consonant recognition and confusion patterns are associated with hearing loss among elderly listeners. Subjects were all greater than 65 years, and had normal hearing, or gradually or sharply sloping sensorineural hearing losses. Recognition of 19 consonants, paired with each of three vowels in a CV format, was assessed at two speech levels in a background of babble (+6 dB signal-to-babble ratio). Analyses of percent correct scores for overall nonsense syllable performance and for consonants according to place, manner, and voicing categories generally revealed better performance by the normal-hearing subjects than by the hearing-impaired subjects. However, individual differences scaling analysis of consonant confusions failed to retrieve speech perception patterns that were unique to listener group. These results tentatively suggest that the presence and configuration of hearing loss among elderly listeners may affect the level of performance but not the specific pattern of performance. PMID- 3678641 TI - Age-related differences in speech recognition performance as a function of test format and paradigm. AB - This study assessed speech recognition performance by young and elderly listeners with normal hearing and mild sensorineural hearing loss on a variety of speech recognition tasks. The tasks varied in terms of presence of noise, stimulus presentation level, test format, and test paradigm. The purpose was to identify a set of test conditions which is sensitive for revealing the effects of age, independent of hearing loss. The results showed that young and elderly listeners usually did not exhibit significant performance differences in quiet or fixed noise conditions. However, an age effect was observed consistently for all conditions involving an adaptive noise paradigm. These findings imply that the important variables to consider for revealing effects of age are the use of noise coupled with an adaptive paradigm. PMID- 3678642 TI - Training influences on visual consonant and sentence recognition. AB - Visual consonant and sentence reception were compared in three groups of 10 normal-hearing young adult subjects including a Training group that received 14 hours of videotaped analytic visual consonant recognition training with 100% feedback concerning the correctness of their responses, a Pseudotraining group that received the same treatment as the Training group with the exception that they were not given any information about whether their responses were correct or not, and a Control group. While all three groups scored significantly higher on the post-treatment visual consonant recognition test, there was no significant difference between the Training group and the Pseudotraining group in terms of improvement scores. Furthermore, none of the groups improved in their ability to recognize visually presented sentence length material. These results are discussed in terms of the development of task-specific performance skills. PMID- 3678643 TI - The influence of subjective factors on temporary threshold shifts after exposure to music and noise of equal energy. AB - The present study examined the influence of subjective factors on temporary threshold shifts (TTS) after exposure to noise and music. Two groups of subjects, those who indicated liking and those who indicated disliking pop/rock music, were exposed to both noise and music on separate occasions. Subjects who liked the music exhibited less TTS following music than noise. They also exhibited less TTS in music than the subjects who disliked the music. Those who disliked the music evidenced greater magnitude of TTS in music than noise. PMID- 3678644 TI - Comparison of Beyer DT48 and etymotic insert earphones: auditory brain stem response measurements. AB - Click-evoked auditory brain stem responses (ABRs) were measured using a Beyer DT48 circumaural earphone and an Etymotic ER-3A insert earphone in a group of normal-hearing subjects. Comparisons were made between time waveforms and amplitude spectra for the two transducers. ABR waveforms, latencies, and thresholds were compared for the two transducers. Click-evoked ABR and behavioral thresholds were comparable for the two earphones. In addition, absolute response component latencies differed by an amount that was equivalent to the travel time introduced by the insert earphone's sound-delivery tube. Inter-peak latency differences were virtually identical. These findings suggest that the insert earphone is a viable transducer for clinical ABR evaluations. Further, a temporal correction may be all that is necessary to account for the difference between the insert earphone and the circumaural earphone if other characteristics of the transducers are similar. PMID- 3678645 TI - Interaural attenuation for tubephone insert earphones. AB - Interaural attenuation of pure tone and speech signals was evaluated for a new audiometric insert earphone, the ER-3A tubephone, and a conventional TDH-49P supra-aural earphone in seven unilaterally deaf adult subjects. These results validate and extend the interaural attenuation data reported by the manufacturer of the ER-3A and his associates. At frequencies of 0.5 to 1 kHz, mean interaural attenuation for the deeply inserted ER-3A decreased from 94+ dB to 81 dB, with the lowest value for any subject, 75 dB. Interaural attenuation for speech approximated that of the 1 to 2 kHz frequency range. The ER-3A tubephone provides significantly greater acoustic isolation between the two ears in the low-mid frequency audiometric range than the conventional supra-aural earphone. PMID- 3678646 TI - Assessment of FM systems with an ear canal probe tube microphone system. AB - A technique is described to measure the real-ear performance of an FM system using an ear canal probe tube microphone device. The method involves placement of the FM microphone next to the monitoring (compression) microphone of the probe tube assembly to produce a constant sound pressure level input to the FM system. With the probe tube in the ear canal, a hearing aid alone is measured with a 60 dB SPL input and the FM system attached to the hearing aid (personal FM system) is assessed with an 80 dB SPL input to account for the higher input levels that occur due to the 6 inch distance between the speaker's mouth and the FM microphone. This technique permits a rapid comparison of the real-ear response of the hearing aid and the FM system. PMID- 3678647 TI - Clinical evaluation of a new ECoG recording electrode. AB - Noninvasive, extratympanic electrocochleography (ECoG) was performed on 13 normal hearing subjects with three different types of ECoG electrodes. Two of these electrodes, the Life-Tech and Axonics-3M designs are commercially available, and widely used clinically. The third electrode, the TM electrode, is a newly designed system intended to be placed directly onto the tympanic membrane. The purpose of this study was to assess the clinical performance of these different electrodes with particular attention to response amplitudes, response variability, and practical ease of use. The results indicate that the TM electrode provides improved ECoG response amplitudes while minimizing clinical preparation time. PMID- 3678648 TI - Representations of the long-term spectra of speech. AB - Numerous and somewhat different representations of the long-term spectra of speech are available in the literature. Various estimates of speech spectra have been converted to a consistent audiogram format for presentation here. Even so, plots of speech spectral levels across the frequency region of 125 to 8000 Hz vary considerably. Bases for some of these variations and clinical utilization of a speech spectrum are discussed. PMID- 3678649 TI - Factors which affect measures of speech audibility with hearing aids. AB - Speech audibility may be defined as that proportion of a speech spectrum which is above a person's threshold. To optimize speech audibility with a hearing aid, several measures are needed. These include quantification of a speech spectrum, measures of hearing sensitivity, and measures of the "real ear" gain of the hearing aid. Some procedural factors must be considered to obtain adequate measures in a typical clinical setting. Those considered here are: (1) a modified Articulation Index to quantify a speech spectrum, (2) specification of hearing sensitivity with a narrowband sound field reference where the out-of-band rejection rate of the sound field stimulus is greater than twice the slope of the hearing loss, and (3) use of functional gain (measured directly or estimated using earphone and sound field results provided that the sound field stimulus has the required characteristics for measuring hearing sensitivity in the sound field) as a measure of the real ear gain of the hearing aid. Guidelines are given for the practical measurement of speech audibility in a typical clinical setting. The guidelines are appropriate for all measures of real ear gain including those obtained with all probe tube systems. PMID- 3678650 TI - Development of the Connected Speech Test (CST). AB - This paper describes the first phase in the development of the Connected Speech Test (CST). This test of intelligibility of everyday speech has been developed primarily for use as a criterion measure in investigations of hearing aid benefit. The test consists of 48 passages of conversationally produced connected speech. Each passage contains 25 key words for scoring. All passages are of equal intelligibility for the average normal hearer. Key words vary in intelligibility within a passage but span the same intelligibility range in all passages. Several passages are administered, and the results averaged, to yield a single intelligibility score. For pairs of scores, each based on mean performance across 4 randomly-chosen passages, the 95% critical difference is estimated to be about 14 rationalized arcsine units (rau). The performance-intensity function for the CST has a slope of 12 rau/dB signal-to-babble ratio. Investigations of the test are continuing with hearing-impaired listeners. PMID- 3678651 TI - Update on real ear measures of hearing aid performance. PMID- 3678652 TI - Basic acoustic considerations of ear canal probe measurements. AB - This publication contains a review of several acoustic investigations in which the effects of probe location on real-ear gain were examined through theoretical models based on acoustic properties of the average human ear and ear simulator studies. The results of these investigations are used to demonstrate the effect of standing waves and eardrum impedance on probe measurements made in the ear canal. Investigations were also conducted in the sound field with a KEMAR manikin. A commercial probe microphone system was used to measure the SPL and real-ear gain at various locations with the KEMAR ear canal. The results emphasize the critical effect of probe location on absolute or relative ear canal measurements and indicate the necessity to establish clinical procedures for probe measurements based on relevant acoustic principles. PMID- 3678653 TI - Insertion gain repeatability versus loudspeaker location: you want me to put my loudspeaker where? AB - The traditional 0 degree (straight-ahead) location of the loudspeaker during insertion gain measurements is a poor choice, based on theoretical considerations, from the standpoint of measurement repeatability. In a series of experiments, we were able to demonstrate that a location 45 degrees to the side, or 45 degrees up and 45 degrees to the side, provided a much more repeatable measurement of basically the same insertion gain response. PMID- 3678654 TI - Clinical ear canal probe tube measurements. AB - This paper describes a variety of areas in which ear canal probe tube microphone measurements can be useful to the audiologist. Areas such as measurement of hearing aid insertion gain to match some predetermined target levels, output sound pressure level in the ear canal (real ear SSPL90), and assessment of FM systems and FM system-hearing aid combinations are discussed. In addition, some variables affecting the accuracy of these measurements and the reliability will be discussed. PMID- 3678655 TI - Some issues in utilizing probe tube microphone systems. AB - Probe tube microphone systems are a useful validation tool for optimizing the hearing aid selection and fitting processes. To date, the terminology involved in using these systems has not been standardized, resulting in confusion in the measurements themselves and in associated parameters. Real time and stored procedures for sound field equalization have been adopted for real ear measurements from ANSI and IEC standards which were written for 2 cc coupler and manikin measurements. Suggestions are made for equivalent definitions pertaining to probe tube microphone measurements. Several of the equalization methods for probe tube microphone measurements are compared in the context of those ANSI and IEC standards from which they are derived. Tradeoffs in the selection of input stimulus type are examined. Of the probe tube microphone systems currently available, performance features and flexibility varies widely. Certain optional features associated with general purpose microcomputers, if incorporated in a probe tube microphone system would enhance the day-to-day operation of a hearing aid dispensary. PMID- 3678656 TI - A correction for converting 2 cm3 coupler responses to insertion responses for custom in-the-ear nondirectional hearing aids. AB - A correction for custom in-the-ear nondirectional hearing aids is obtained for converting a frequency response measured using a 2 cm3 coupler to an insertion response, approximating that measured using a manikin and ear simulator. The results are compared to those of a previous published study. The methods used for obtaining the responses make use of a signal analyzer with discrete Fourier transform capabilities. PMID- 3678657 TI - Functional gain. AB - The concept of functional gain was popularized by Pascoe in 1975, and for some time was one of the most popular hearing aid evaluation techniques. More recently probe tube systems for measuring insertion gain have become popular, and some questions regarding the continued utility of functional gain have been raised. In this paper some of the major advantages and disadvantages of functional gain are reviewed. While functional gain is subject to contamination from noise external or internal to the hearing aid, it does provide subjective information not available from insertion gain. PMID- 3678658 TI - The complement system in type 1 (insulin-dependent) diabetes. AB - The complement proteins C1q, r, s, C2, C4, C3, factor B, C5, C6, and the inhibitors, C1 inhibitors, factors I and H were measured in 35 patients with recently diagnosed Type 1 (insulin-dependent) diabetes, 76 patients with longer duration disease (30 with complications) and 43 first-degree healthy relatives. We found that C1q, C4 and C3 were reduced significantly in all groups of patients (p less than 0.001 for each protein in recent onset and uncomplicated patients; p less than 0.01, p less than 0.01 and p less than 0.05 respectively, for patients with complications) compared to 60 control subjects and that C4 was also reduced in healthy relatives (p less than 0.001). C4 allotypes were examined in 63 subjects (selected from the patient groups) in order to clarify the role of null alleles in the production of the C4 abnormality. These showed serum C4 to be reduced significantly in 50 patients without null alleles (patient mean 0.24 g/l; control subject mean 0.34 g/l) (p less than 0.0001), although levels were lowest in the 13 patients with one or more null alleles (mean 0.19 g/l). Finally, to examine the metabolic basis for the low concentrations of C4 and C3, the turnover of highly-purified, radiolabelled C4 and C3 was measured in seven recently diagnosed patients; four of these had low levels of C4. The data showed that three out of four of these patients had reduced synthesis of C3 and C4 and normal values for fractional catabolic rate. Two patients showed features of C4 hypercatabolism. We conclude that several early complement proteins are reduced in Type 1 diabetes, irrespective of duration or complications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678659 TI - Diabetes mellitus in Swedish middle-aged men. The study of men born in 1913 and 1923. AB - As part of a study of the epidemiology of diabetes mellitus in middle-aged Swedish men, the present paper reports the prevalence and incidence of diabetes and the prevalence of impaired glucose tolerance. Two cohorts of 50-year-old men, representative of the corresponding male population of Gothenburg, Sweden, were examined in 1963 and 1973, respectively, and then followed until 1980. In the cohort of men born in 1913 (n = 855) the diabetes prevalence (WHO criteria), based on a questionnaire and fasting blood glucose, increased from 1.5% at age 50 to 7.6% at age 67. In the cohort of men born in 1923 (n = 226) the prevalence was 3.7% at age 50 and 4.0% at age 57. The overall prevalence of diabetes and impaired glucose tolerance was 25% among men born in 1913 (age 67) and 18% among men born in 1923 (age 57). The cumulative risk of developing diabetes from age 50 to 67 was 7.8%. Variables associated with impaired glucose tolerance and newly found diabetes, when degree of obesity was considered, were systolic blood pressure and triglycerides, well known risk factors for both coronary heart disease and diabetes. Uric acid, fasting insulin and glutamic puruvic transaminase, recently discussed as possible risk factors, were also associated with impaired glucose tolerance and newly found diabetes. Thus, both impaired glucose tolerance and newly found diabetes were associated with a clustering of risk factors, not only for diabetes but also for coronary heart disease. PMID- 3678660 TI - Humoral immune response and delayed type hypersensitivity to influenza vaccine in patients with diabetes mellitus. AB - The antibody response and delayed type hypersensitivity reaction to commercially available trivalent influenza vaccine in 159 patients with diabetes mellitus was compared with response and reaction in 28 healthy volunteers. A correction for prevaccination titres was made. No differences were found between diabetic patients and control subjects with respect to antibody response to the three vaccine strains as measured by the difference between geometric mean titres of post- and prevaccination sera. In Type 1 (insulin-dependent) diabetic patients the incidence of non-responders to two vaccine components was significantly increased (p less than 0.05). The delayed type hypersensitivity reaction to influenza antigen was significantly decreased in patients with high concentrations of glycosylated haemoglobin (p less than 0.01). These findings suggest a role for impaired immune response in the increased influenza morbidity and mortality in patients with diabetes mellitus. Implications for therapy and vaccination strategy are discussed. PMID- 3678662 TI - Oral glucose tolerance and ambient temperature in non-diabetic subjects. AB - When either a 960-kcal, 140-g carbohydrate meal, or a 75-g glucose load was ingested by non-diabetic Caucasians, the 2-h venous plasma glucose concentration was higher by 0.82 and 1.25 mmol/l, respectively, if the ambient temperature was 33 degrees C rather than 23 degrees C. It is likely that this is a result of relative 'arterialisation' of the venous blood. Even at 23 degrees C room temperature, use of the 'hot hand' technique to obtain 'arterialized' venous blood increases post-load glucose levels in contralateral antecubital veins. If these observations apply to those acclimatised to the heat, they could affect the diagnosis of both diabetes and impaired glucose tolerance in the tropics. PMID- 3678661 TI - Cation permeability of the blood-brain barrier in streptozotocin-diabetic rats. AB - Decreased sodium permeability across the blood-brain barrier occurs in streptozotocin-treated rats after 2 weeks of diabetes. To establish whether this is a phenomenon specific for cations, the blood-brain barrier permeability for sodium, potassium and calcium was studied with an arterial integral uptake technique. Experiments were performed in control rats and, after two weeks after diabetes induction, in untreated streptozotocin-diabetic rats and in insulin treated streptozotocin rats. In untreated diabetes, the neocortical blood-brain barrier permeability for sodium decreased by 35% (5.2 +/- 1.7 vs 3.4 +/- 1.1 10( 5).cm3.s-1.g-1) and potassium permeability by 39% (19.8 +/- 5.7 vs 12.1 +/- 3.9 10(-5).cm3.s-1.g-1), whereas no differences in calcium permeability occurred. Insulin treatment was associated with an increase in the blood-brain barrier permeability to sodium (4.8 +/- 1.0 10(-5).cm3.s-1.g-1) as compared to untreated diabetes (3.4 +/- 1.1 10(-5).cm3.s-1.g-1). It is concluded that the observed changes in sodium and potassium permeability cannot be caused by electrostatic membrane changes. More specific abnormalities of the transport of sodium and potassium across the blood-brain barrier are likely to occur; disturbances in the sodium-potassium-pump activity could account for such alterations. PMID- 3678663 TI - Rheological properties of white blood cells are changed in diabetic patients with microvascular complications. AB - Erythrocyte and white blood cell suspensions were prepared from 22 Type 1 (insulin-dependent) and 37 Type 2 (non-insulin-dependent) diabetic patients and from 57 control subjects. Cell filterability was studied with the new "St. George's Filtrometer", which can discriminate between cell deformability and filter occlusion. A pronounced increase of filter clogging was found in diabetic patients compared with control subjects. There was no significant difference between Type 1 and Type 2 diabetic patients, but a significantly increased clogging was found in patients with retinopathy compared with retinopathy-free patients. Considering that filter occlusion is mainly due to leucocytes, our results show a reduced filterability of white blood cells in diabetic patients. Altered white blood cell function may act as an additional factor in the impairment of microvascular circulation in diabetic patients. PMID- 3678664 TI - Glucose metabolism in acromegaly. PMID- 3678665 TI - [Presence of bacterial endotoxins in drinking and bottled water, with monitoring of eventual contaminations]. AB - 83 samples of drinking water of different source were examined with LAL-test, valuing some characteristics of the water (bacterial count, Coliform, pH, dissolved CO2) which might influence the test. Quantity higher than 0.5 ng/ml of endotoxin were detected in 40 of 44 mineral water samples and 37 of 39 tap water samples. The results are discussed. PMID- 3678666 TI - [From a randomized assay, Francisella turned out to be epidemiologically present in the studied areas]. AB - In the past Tularemia has largely affected animals, nowadays' in our country it could become actual one more because of wild animals repopulation actuated in many areas. Unlike the other countries, in Italy it's not well known if there are any consequences on population. The authors has conducted a research on this subject studying seroimmunologically samples taken randomly in some areas of south-central Italy. Their results confirm endemism and therefore announce the problem and the consequent pathology. PMID- 3678667 TI - [Epidemiology of rotavirus infections in a randomized study in various central southern areas of our country]. AB - The etiology of diarrhea and intestinal deficiency relative to the absorbency of glucose and some enzymes can be found in Rotavirus infection. The epidemiology of this infection has been derived by the authors even if the research was limited to some areas of central-south Italy, analyzing seroimmunologically serums randomly selected. The research outcomes fully explain the first mentioned disease because antibody markers have been founded in most of the examined people. PMID- 3678669 TI - "Practice model" used in teaching residents. PMID- 3678668 TI - [Randomized epidemiologic assay of Campylobacter infections in various areas of central-south Italy]. AB - The authors on the basic of the diffusion of pediatric and gastroenterological pathologies in Italy, have conducted a research on the epidemiology diffusion of Campylobacter infection analyzing seroimmunologically sample randomly chosen and coming from some areas of central-south Italy. Their results confirm that in such areas the infection is endemic therefore they hypothesize that enteric vascular, bacterial pathologies and spontaneous abortions are related with it. PMID- 3678670 TI - Toward rational use of modern computers. PMID- 3678671 TI - The patient-doctor relationship. PMID- 3678672 TI - Screening practices of family physicians: a comparison of STFM and AAFP members. AB - The screening practices of 146 members of the Society of Teachers of Family Medicine (STFM) and 129 members of the American Academy of Family Physicians (AAFP) are compared. The screening practices of physicians from the two organizations were generally similar for psychosocial and behavioral problems, many forms of cancer, and numerous other conditions considered for inclusion in the routine periodic screening of asymptomatic individuals. However, for numerous diseases and tests, the screening practices of physicians from the two groups were significantly different. AAFP physicians were more likely to screen for lung and skin cancer, thyroid dysfunction, diabetes, and anemia, AAFP physicians were more likely to utilize chest x-ray, ECG, urinalysis, and SMA 6/12. STFM physicians were more likely to perform gonoccocal culture and tetanus-diphtheria immunization as well as to inquire about seat belt use. Three variables were found to predict physician screening practices as well as to account for the differences found between physicians drawn from the two organizations: completion of a residency in family medicine, year of graduation from medical school, and number of patients seen per week. Physicians reported practices were compared with recommendations in the major critical reviews: Frame and Carlson, Breslow and Sommers, the Canadian Task Force, and the American Cancer Society. For a number of tests and diseases physicians' reported practices were divergent with recent recommendations. PMID- 3678673 TI - Psychosocial problems: what do patients want? What do physicians want to provide? AB - This study addressed the question of whether caregivers and patients in the same medical centers agree in their expectations of the family doctor regarding psychosocial problems, and whether demographic, socioeconomic, and family characteristics affect patient desires. A total of 375 family practice patients were asked to indicate what kind of involvement they would like from their family doctor for each of 30 problems, mostly psychosocial. Sixty-three physicians in the same settings completed a similar questionnaire indicating how involved they were in the same 30 problems. In general, physicians saw themselves as much more involved than patients wanted them to be. Patients expected referral much more frequently than physicians considered it, and for problems ranging from headaches to anxiety and life-cycle issues. Over 50% of the physicians expected to give help for relationship problems whereas 46% of the patients did not want the physician to even know that the problem existed. Demographic comparisons did not yield particularly noteworthy findings. The implications of these results are discussed. PMID- 3678674 TI - Psychiatric disorders in primary care: physician judgements of prevalence and management. AB - Primary care physicians underdiagnose depression, anxiety, and other psychiatric disorders. Decision analysis suggests that subjective estimates of the probability of a condition and the utility (severity and treatability) of identifying that condition play a role in diagnosis. We asked 108 internists (IM) and family practitioners (FP) to rank 25 conditions on ten-point scales for probability, severity, and treatability. FPs ranked depression significantly higher than IMs did on all three scales, anxiety reactions higher in probability and severity, and both alcoholism and drug dependency higher on the severity scale. Ranks for schizophrenia and personality disorder did not differ between specialties. Thirty-eight physicians completed the scales a second time after six to eight weeks. Test-retest agreement ranged from 47% to 100% for different conditions on different scales. Some common psychiatric disorders tended to have low test-retest agreement in probability and severity. With further refinement, this instrument may contribute to the investigation of psychiatric decision making in primary care. PMID- 3678675 TI - An evaluation of computerized documentation of resident experiences in training. AB - This paper describes an evaluation of the University of Washington family practice project to document resident experiences in training. The production of aggregate reports using clustering techniques and peer group comparisons were well received by residents and faculty. A questionnaire survey and personal interview with a sample of faculty and residents analyzed attitudes toward the usefulness of such a documentation system as well as the actual uses of the reports produced. Documentation of inpatient and outpatient procedures was the most highly regarded application, but an overview of the scope and content of a resident ambulatory practice experience was also considered useful. Physician behavior was altered in subtle ways as a result of the feedback. PMID- 3678676 TI - A topographical model of clinical decision making and interviewing. AB - A model linking clinical decision making, interviewing skills, and countertransference is presented. It derives from the psychoanalytical topographic model which is hierarchically organized into unconscious, preconscious, and conscious aspects of thought, feeling, and action. This model provides a format for understanding and teaching about physicians' unconscious, unrecognized responses to patients (countertransference), an important determinant of physician learning about clinical decision making and the clinical interview. PMID- 3678677 TI - A home-visit program for first-year medical students as perceived by participating families. AB - A program to train first-year medical students to identify the impact of chronic disease on family functioning consists of a lecture/demonstration, reading materials, and a family home visit for small groups of eight students and an instructor. The authors used a self-report questionnaire to evaluate 30 families (88% response rate) participating in the home visits. Although 28% of families reported they were uncomfortable sharing a family problem, 90% of families reported no tensions or problems as a consequence of the visit. Two-thirds of the families learned new information about their family and two families decided to visit a health professional as a result of the visit. Almost all families were willing to participate again, demonstrating that family home visits are feasible and have few adverse consequences in a well-supervised training program. PMID- 3678678 TI - Working with the resident in difficulty. AB - The resident in difficulty is an omnipresent and seemingly intractable problem. Some definitions of this concept are explored, as are means and methods of problem identification. Principles of successful intervention are discussed, as well as some obstacles to successful intervention. Utilization of interpersonal process recall, behavioral techniques, and a more insight-oriented approach in the remediation process are emphasized. The role of the faculty in responding to the resident in difficulty is explored, with special consideration to pitfalls and possibilities. The article concludes with a series of questions and directions for future exploration. PMID- 3678679 TI - Physician attitudes toward office based non-pharmacological treatment of anxiety. AB - Despite evidence indicating the effectiveness of behavioral techniques in treating anxiety symptoms and disorders, treatment of anxiety in the medical setting has tended to be largely pharmacological. This research project investigates the attitudes of a sample of practicing physicians toward utilization within their practices of non-pharmacological approaches in the treatment of anxiety. PMID- 3678680 TI - Obstetrical practice style and clinical policy in residency training. PMID- 3678681 TI - The effect of an office tympanogram on referrals from a primary care setting. AB - The effect of an office tympanometer on the rate of referral of children with otitis media in a family practice residency was assessed by chart review. After implementation of the tympanometer, the rate of referral to otolaryngologists was 13.9% compared to a rate of 5.1% prior to its availability. This increase in referrals appears to have resulted from improved diagnosis of persistent middle ear effusions. PMID- 3678683 TI - Physician reticence sometimes necessary. PMID- 3678684 TI - Under the banyan tree: reflections on health care in Pakistan. PMID- 3678682 TI - A model for teaching medical students ambulatory care geriatrics. AB - Several recent articles have called attention to the negative attitudes which are fostered by teaching geriatrics primarily in a long-term care facility. A transportable model has been developed using a multidisciplinary team for teaching ambulatory care geriatrics in a clinic within a congregate housing facility. This model has contributed to more positive attitudes towards geriatrics health care on the part of the students. PMID- 3678685 TI - Concerning articles on obstetrics... PMID- 3678686 TI - Type A behavior and the marital unit. PMID- 3678687 TI - If we're not part of the solution, we're part of the problem. PMID- 3678688 TI - A medical project in an African village. AB - The authors led a group of 15 students on a medical project to a remote traditional village in Sierra Leone, West Africa. The team lived in the village for one month. They staffed an outpatient clinic, performed a community health survey, and organized an immunization project and a health education program. This project offered a unique opportunity to teach many aspects of primary care, including clinical skills, use of health education, practice of preventive medicine, methods of community epidemiology, and the relationship of health to sociocultural factors. By living in the community, seeing the overwhelming health problems in the clinic, and working in the community to improve health, the students had a provocative and educational primary health care experience. Family medicine teachers are well suited for leading international medical projects. PMID- 3678689 TI - Another exciting use for the cantaloupe. AB - This paper describes an organic model used successfully to demonstrate flexible sigmoidoscopy to family medicine residents. Its advantages include low cost, portability, disposability, and ease with which it induces laughter while its drawbacks are unique and well worth tolerating. PMID- 3678690 TI - Type A behavior in married couples in a family practice population. AB - Type A behavior is characterized by status insecurity, hyperaggressiveness, free floating hostility, time urgency, and self-destructive tendencies. In this cross sectional study, a sample of 72 married couples from a family practice residency patient population completed self-administered questionnaires assessing the relationship between behavior type and perceived stress, social support, health perceptions, psychosomatic symptoms, health habits, marital discord, and family function. Type A men slept less, had more headaches, and reported more job stress than type B men. Type A women tended to report more frequent abdominal pains and backaches and perceived more job stress than type B women. The behavior types of marital partners did not affect various measures of family function. Assessments of family function by individual spouses were remarkably similar. PMID- 3678691 TI - Evaluation of freestanding emergency centers as alternate training sites. AB - To assess the potential of freestanding emergency centers (FECs) as alternative sites for residency training in ambulatory care, questionnaire data about experiences in these centers were collected from 52 residents moonlighting in FECs, and the characteristics of the patient population were gathered by reviewing the records of 5,839 visits at three centers. The FEC patients differed from those of family/general physicians and internists nationwide by age, sex, and medical problem. Moonlighting residents reported that the chief educational benefit of the FEC experience is the opportunity to treat problems they would not have seen in their academic medical center clinics. PMID- 3678692 TI - The medical record and the medical interview: an evaluation of student case histories. AB - This study assessed the results of a second-year family medicine course designed to improve student abilities in writing complete assessments and plans from interviews with standardized patients. Sixty-six students attended lectures on the patient's perception of the symptoms of the major causes of death, learned techniques of medical interviewing, saw a model interview by their tutor, received model faculty histories based on American Board of Family Practice Office Record Review Criteria, and received critiques of their own histories. Students in the highest decile recorded twice as much information as those in the lowest decile and recorded as many history items as the faculty member who recorded the most history items. The faculty, however, recorded a more complete list of diagnoses, differential diagnoses, and investigations. Students in the lowest decile recorded the least information and the least number of assessments and plans and did not respond to written critiques. Students in the lowest decile could improve if they were identified early in the course and worked intensively with role models. PMID- 3678693 TI - Using a family practice preceptorship to teach clinical epidemiology. AB - Because physicians in training can benefit from an epidemiological approach to primary care practice, research, and education, educators are turning their attention to better methods and settings to teach preventive and epidemiological principles while cultivating an attitude for clinical research. This report describes the development of a clinical epidemiological problem studied in the context of a one-week family practice preceptorship. The project was designed to study the possible association between obesity and hypertension and to familiarize students with a common study design. Data from 393 case control pairs produced results of the same magnitude as that documented by formal, carefully controlled research studies. Students participated with dedication and excitement in the clinical application of relevant and practical epidemiologic and biostatistical tools in a clinical setting. Often difficult to comprehend concepts of interaction and confounding were clearly demonstrated using data derived from actual patients encountered during the preceptorship experience. PMID- 3678694 TI - The integration of the student into ambulatory primary care: a decade of experience. AB - This paper presents a functioning model for interfacing health care delivery and medical education. The Community Health Center (CHC) of the University of Illinois College of Medicine-Rockford (UICOM-R) program is an instructive solution to many of the present and anticipated needs identified in undergraduate medical education. In this discussion the CHC program is summarized relative to its personnel, economic standing, and curricular objectives and policies. The views and experiences of students, faculty, and patients relative to the program are presented. At a time when the future of medical education is so closely tied to the cost of health care delivery, and there is a call for "retooling" academic programs, the Rockford program may provide a model for the education of physicians for the twenty-first century. PMID- 3678695 TI - Research in a busy family practice training program. AB - A newly designed framework for starting research projects in an Army family practice residency incorporates a timeline and a Family Practice Research Advisory Committee to stimulate research among residents and staff. Seventy-five percent of second- and third-year residents participated in approved projects compared to none two years ago. Sixty-six percent of the faculty have initiated research projects since implementation of the new guidelines. The combination of the committee and the timeline centralizes research within the family practice department and provides an academic environment for the department. PMID- 3678696 TI - Emotional response to malpractice suits: should residents be prepared? AB - Previous studies have indicated that physicians often react to malpractice litigation with potentially severe emotional distress. The authors surveyed the family practice residencies in Illinois to determine what these programs are doing to prepare residents for possible malpractice suits. Results indicate that in Illinois the majority of programs do not address the issue. In addition to the survey, a proposal is made regarding what residencies can do to institute a program lessening the impact of future litigation upon the emotional well-being of their residents. PMID- 3678697 TI - Perceptions and treatment of sexual problems. AB - In this research, perceptions and beliefs which affect the family physician's treatment of sexual problems were studied. A 66-item questionnaire, the Survey of Sexual Problem Care (SSPC), was completed by 68 individuals. Respondents reported that they would be more likely to consult a family physician for the treatment of sexual problems than any other individual; however, few (11%) of those surveyed had actually sought treatment for sexual problems. Confidentiality was reported to be the most important characteristic in persons consulted for sexual problems, and treatment was more likely to be sought from family physicians when problems were believed to have a physical (vs. psychological) etiology. The implications of these results are discussed. PMID- 3678698 TI - Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. AB - A study was done to examine the effects of aluminum, magnesium, and boron on major mineral metabolism in postmenopausal women. This communication describes some of the effects of dietary boron on 12 women between the ages of 48 and 82 housed in a metabolic unit. A boron supplement of 3 mg/day markedly affected several indices of mineral metabolism of seven women consuming a low-magnesium diet and five women consuming a diet adequate in magnesium; the women had consumed a conventional diet supplying about 0.25 mg boron/day for 119 days. Boron supplementation markedly reduced the urinary excretion of calcium and magnesium; the depression seemed more marked when dietary magnesium was low. Boron supplementation depressed the urinary excretion of phosphorus by the low magnesium, but not by the adequate-magnesium, women. Boron supplementation markedly elevated the serum concentrations of 17 beta-estradiol and testosterone; the elevation seemed more marked when dietary magnesium was low. Neither high dietary aluminum (1000 mg/day) nor an interaction between boron and aluminum affected the variables presented. The findings suggest that supplementation of a low-boron diet with an amount of boron commonly found in diets high in fruits and vegetables induces changes in postmenopausal women consistent with the prevention of calcium loss and bone demineralization. PMID- 3678699 TI - Electric stimulation of protein and DNA synthesis in human fibroblasts. AB - Human fibroblast cell cultures were employed as a model system to rapidly examine several potentially important variables involved in the use of high-voltage, pulsed galvanic stimulation (HVPGS) to increase the healing rate of soft tissue injuries. Fibroblasts were grown on Millipore filters and exposed to HVPGS of various voltages and pulse rates for 20 min in a rectangular, plastic chamber filled with growth medium. Filters with attached cells were placed either in the center of the chamber or close to the positive or negative electrode. Protein synthesis and DNA synthesis were monitored after stimulation using the radioactively labeled precursors, [3H]proline and [3H]thymidine, respectively. The major results obtained in this study are as follows: 1) the rates of both protein and DNA synthesis can be significantly increased by specific combinations of HVPGS voltage and pulse rate; 2) maximum stimulation of protein and DNA synthesis was obtained at 50 and 75 V, respectively, with a pulse rate of 100 pulses/s and the cells located near the negative electrode; and 3) exposure to HVPGS intensities greater than 250 V (at all pulse rates and locations within the chamber) is inhibitory for both protein and DNA synthesis. In view of the results obtained in preliminary clinical studies on the use of HVPGS for the treatment of dermal ulcers, it appears that similar voltages, pulse rates, and relative electrode location may be required for maximum acceleration of human skin wound healing. PMID- 3678701 TI - Short reports: a new format for disseminating information from scientific meetings. PMID- 3678700 TI - Platelet-activating factor: an endogenous mediator for bowel necrosis in endotoxemia. AB - We have developed a model of isochemic bowel necrosis in the rat by injecting platelet-activating factor (PAF) or PAF in combination with bacterial endotoxin. PAF causes profound hypotension, and it has been suggested that it is released during endotoxin shock. Because ischemic bowel necrosis is often associated with shock or infection, it is possible that PAF is the endogenous mediator that causes shock and bowel necrosis during sepsis. In this study, we have demonstrated that: 1) normal intestine contained a small amount of PAF; 2) necrotic lesions of the intestine could be induced by endotoxin injection; 3) PAF production in the bowel is markedly increased in animals treated with endotoxin; 4) pretreatment of the animal with PAF antagonists prevent endotoxin-induced necrosis; 5) isolated, buffer-perfused small intestine produced a small quantity of PAF in response to endotoxin injection. Therefore, we conclude that PAF is a likely endogenous mediator in endotoxemia, which causes bowel necrosis and shock. PMID- 3678702 TI - Ethanol: an enhancer of major histocompatibility complex antigen expression. AB - Ethanol enhances expression of cell surface class I major histocompatibility complex (MHC) antigens in a variety of cell lines; up to an eightfold increase is observed in an embryonic cell line. In ethanol-treated L cells, increased cell surface expression of MHC antigens occurs with a concomitant increase in steady state RNA levels. This effect is promoter dependent and restricted, because not all gene products are elevated. The effective ethanol concentration (1%) is physiologically attainable, leading to speculations about the role of elevated MHC antigens in alcohol-related diseases. PMID- 3678703 TI - Histamine-induced changes in coronary circulation and myocardial oxygen consumption: influences of histamine receptor antagonists. AB - The effects of histamine and selected H1 and H2 histamine receptor antagonists on cardiac inotropic and chronotropic activity, coronary perfusate flow (CPF), and myocardial oxygen consumption (MVO2) were studied in isolated guinea pig hearts perfused at constant pressure. Data were collected at the end of a 3-min infusion period at steady state. Cardiac performance increased significantly whereas CPF decreased during histamine infusion. MVO2 remained constant owing to a significant increase in myocardial oxygen extraction. Diphenhydramine attenuated the coronary vasoconstriction but potentiated the positive inotropic response. Cimetidine attenuated the inotropic and chronotropic responses but had no effect on coronary vasoconstriction. In combination, the histamine antagonists attenuated the changes in heart rate, contractility, and CPF. The histamine induced increase in myocardial oxygen extraction was accompanied by a significant increase in MVO2 in the presence of diphenhydramine. The ratio of the change in oxygen extraction to the change in oxygen consumption caused by histamine was significantly increased by diphenhydramine. This compensated for a histamine induced decrement in the ratio of the change of CPF to the change in oxygen consumption. Cimetidine had no effect on the changes in coronary flow, oxygen consumption, or the above ratios. Thus, histamine causes direct coronary vasoconstriction via an H1 receptor mechanism, cardiac positive inotropy by an H2 receptor mechanism, and cardiac positive chronotropy by combined H1 and H2 mechanisms. In the presence of a histamine-induced decrease in myocardial oxygen supply, increments in oxygen demand are met by increased oxygen extraction. PMID- 3678704 TI - [Early cardiologic first aid]. PMID- 3678705 TI - [Diagnostic reliability of clinical and instrumental data in identifying the presence of coronary disease in women with chest pain]. AB - The present study was performed to assess the reliability of clinical symptom, rest and exercise electrocardiogram, exercise Thallium myocardial scintigraphy, as well as rest and exercise radionuclide angiocardiography, in order to detect significant coronary artery disease in 85 female patients with chest pain, who underwent coronary angiography. Of these, 54 underwent Thallium myocardial scintigraphy, 53 rest and exercise radionuclide angiocardiography. We have evaluated sensibility, specificity and positive and negative predictive value for each single variable or every possible combination. Within the population examined, Thallium myocardial scintigraphy reaches the highest sensibility (92%), specificity (92.5%), positive predictive (81%) and negative predictive value (97%). In comparison with all other clinical or instrumental parameters, taken either single or in combination. By subdividing the sample in two groups, of 20 and 65 patients respectively on the basis of the clinical symptom angina or thoracoalgy, with different predominance of coronaropathy (60 and 15%), Thallium myocardial scintigraphy is confirmed to be the most reliable diagnostic test (within the angina group sensibility 86%, specificity 100%, positive predictive value 100%, negative predictive value 83%, within the thoracoalgy group sensibility 100%, specificity 91%, positive predictive value 70%, negative predictive value 100%). However, within the thoracoalgy group, a negative maximal exercise test and a normal rest radionuclide angiocardiography detect patients with low probability of coronaropathy (negative predictive value respectively 100% and 93%). Within the angina group only Thallium myocardial scintigraphy significantly increases the predictive value of the angina symptom itself with respect to the presence of coronaropathy (positive predictive value of angina symptom alone 60%, of angina symptom plus Thallium myocardial scintigraphy 100%). PMID- 3678706 TI - [Chronobiologic study of the dynamic electrocardiogram in healthy athletes with frequent ventricular ectopic beats]. AB - The chronobiologic analysis has been applied to Dynamic ECG data in order to verify whether or not a circadian rhythm for heart rate (HR) and ventricular ectopic beats (VEB's) can be detected in athletes with frequent ventricular arrhythmia (range 169-2120 VEB's/hour). The study was carried out on 10 athletes (7 males and 3 females, aged 11-23 years), taking part in various sports, asymptomatic but characterized by a frequent VEB's. Data have been analysed by means of cosinor method. A circadian rhythm for HR was documented. A circadian rhythm for VEB's was validated in all but one of the athletes. The circadian acrophases for HR occur early in the afternoon. The circadian acrophases for VEB's are prominently diurnal (7 out of 10 cases). The VEB's circadian crest is not associated with the physical activity supporting a relative independency of the rhythmic generator of VEB's. PMID- 3678707 TI - [Electrophysiologic study in supine and upright positions in patients with Wolff Parkinson-White syndrome]. AB - It is well known that in patients with Wolff-Parkinson-White (W.P.W.) adrenergic activity stimulation induced by exercise or isoproterenol I.V. infusion shortens the anterograde effective refractory period (E.R.P.) of the accessory pathway. Our purpose was to evaluate whether the upright position produces similar changes on the electrophysiologic properties of the accessory pathway and influences reciprocating tachycardias induction. In 18 patients, with W.P.W. syndrome, who underwent electrophysiologic study, we determined the anterograde E.R.P. of the accessory pathway and attempted to induce a reciprocating tachycardia in the supine and in the upright position. In 13 patients (72%) the anterograde E.R.P. of the accessory pathway shortened in the upright position (303 +/- 104 msec vs 331 +/- 123 msec; p less than 0.001); in 4 patients (22%) it was unchanged; in 1 patient was not defined, being inferior to the atrium E.R.P. We were able to induce a reciprocating tachycardia in 3 patients in the supine position, in 6 patients in the upright position. Electrophysiologic testing in the upright position improves the evaluation of the accessory pathway electrophysiologic properties. PMID- 3678708 TI - [Double outlet right ventricle. Angiographic study]. AB - Cineangiographic study in 41 patients with double outlet right ventricle was performed. Segmental approach was utilized to describe the anatomical features. Atrial situs was inversus in 5 cases, ambiguous in 3 and solitus in the other cases. Atrio-ventricular (a-v) connections were biventricular in 34 and univentricular in 7. A common a-v valve was found in 2 cases. Mitral valve was imperforated in 1 and straddling in 1. The most frequent relationship between aorta and pulmonary artery was side by side (41.1%). Ventricular septal defect was subaortic in 14, subpulmonary in 9, double committed in 5 and non committed in 6. In 27 cases a double infundibulum was present; in 7 patients we described a subpulmonary conus only. Some nosological aspects of this congenital heart disease are discussed particularly in conformity with the surgical needs. PMID- 3678710 TI - [Correlation between the ST/heart rate slope and the severity of coronary disease in inferior infarcts. A new criterion of positivity of the ergometric test]. AB - We reviewed a group of 80 patients who had bicycle exercise stress testing and cardiac catheterization: 60 patients with known coronary artery disease (CAD) had a remote myocardial infarction, anterior, inferior, Q and no Q wave (post MI), 20 patients evaluated for suspected CAD resulted to have normal coronary arteries or lesions less than 50%. Patients were divided into three groups according to the extent of CAD. Group I with anatomically or functionally high risk CAD: left main (LM) stenosis greater than or equal to 50%, 3 vessels CAD greater than or equal to 70%, proximal left anterior descending stenosis (PLAD) greater than or equal to 90% with another vessel CAD; group II with one or two vessels CAD greater than or equal to 70%; group III with no or insignificant CAD. Linear regression analysis of the heart rate (HR)--related change in ST segment depression (ST/HR slope) was compared with six conventional electrocardiographic exercise test criteria to evaluate whether ST/HR slope can identify with improved accuracy group I. When all 80 patients are assessed together, ST/HR slope greater than or equal to 60 mm/beat/min 10(3) compared with standard electrocardiographic criteria failed to discriminate significantly between high-risk CAD (group I) and less extensive (group II) or insignificant CAD (group III). When only Q wave inferior post MI are considered, ST/HR slope greater than or equal to 60 mm/beat/min. 10(3) compared with ST segment depression greater than or equal to 1 mm identifies group I with 90% +/- 4 versus 75% +/- 6 overall predictive accuracy (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678709 TI - [Cardiologic evaluation in a family with Emery-Dreifuss muscular dystrophy]. AB - Emery-Dreifuss muscular dystrophy is an X-linked recessive condition characterized by mild muscular weakness predominantly in a humero-peroneal distribution with variable facial involvement. Onset is in childhood with slow progression of weakness. The disease is often associated with cardiac involvement, mainly with bradyarrhythmias which might be responsible for sudden death. The most striking finding derived from the literature is the high incidence of sudden death; in the 7 large families described, out of the 79 reported patients 32 died suddenly at a young age (between 25 and 56 years). We performed a cardiologic evaluation of 11 subjects of a large italian family with affected males in four generations: 5 affected males (3 adults and 2 boys), 3 carriers and 3 healthy relatives (2 females and 1 male). Supraventricular arrhythmias were documented either in the dystrophic males or in the carriers. There was no correlation between the severity of cardiac rhythm abnormality and the severity of muscular weakness in the affected males, 3 of whom required pacemaker insertion. All the carriers were free of muscular involvement, but showed arrhythmias of variable degree, in one case requiring pacemaker insertion. In conclusion our data indicate an extremely high incidence of bradyarrhythmias, sometimes serious, in patients with Emery-Dreifuss muscular dystrophy. Holter monitoring is therefore mandatory and electrophysiological study is sometime necessary. Because of the high risk of sudden death in adult patients, we recommend permanent pacemaker implantation even in asymptomatic subjects, as soon as bradyarrhythmias are detected. PMID- 3678711 TI - [Fibrinolysis and hemorrhage after streptokinase in acute myocardial infarct]. AB - The purpose of this study is to analyze the relationship between occurrence of hemorrhagic complications, kinetic of fibrinogen degradation-regeneration and the changes of prothrombin time (PT), partial thromboplastin time (PTT), after intravenous administration of Streptokinase (SK), 1.500.000 U., in acute myocardial infarction. 45 selected patients with acute myocardial infarction had pretreatment analysis and serial post-SK measurement of fibrinogen levels, PT, PTT (for 48 hours). Basal fibrinogen levels were 3.2 g/l and displayed significant depression for 18 hours (0.30-0.46 g/l) and normalization after 30 hours from SK infusion. Similar behaviour showed PT and PTT. Minor bleeding was identified in 25 patients. In bleeders mean fibrinogen levels, PT, PTT before and maximum changes after SK were not significantly different compared with non bleeders. We conclude that SK infusion produces important and prolonged changes of fibrinogen levels, PT, PTT; hemorrhagic risk is not related, however, to the extent of lytic state, but probably to pre-existent vascular derangement, predisposing to bleeding complications during fibrinolytic therapy. Therefore we believe to be prudent to delay the infusion of heparin for 12-18 hours after SK administration, when fibrinogen levels are beginning to increase. PMID- 3678712 TI - [Effects of propafenone on arrhythmias induced by exertion in patients with ischemic cardiopathy]. AB - The efficacy of Propafenone to prevent exercise-induced ventricular arrhythmias (EIVA) has been studied in eleven patients affected by ischemic heart disease. None of the patients manifested any arrhythmia at rest, but ventricular arrhythmias occurred in every case during a treadmill test. EIVA disappeared after Propafenone in nine patients, while a reduction by 90% was achieved in the remaining two patients. A further treadmill test carried out five days after withdrawal of the drug induced again the same ventricular arrhythmias in all the patients. Thus, Propafenone appears effective to prevent EIVA in patients with ischemic heart disease. PMID- 3678713 TI - [Atresia of the tricuspid valve and total anomalous supracardiac pulmonary venous return. Description of a case associated with severe extracardiac malformations]. AB - The Authors report a case of tricuspid atresia and total anomalous pulmonary venous return of the supracardiac type, with mild pulmonary valve stenosis and extracardiac malformations as anal atresia, microphthalmia and irideo and chorioretinic coloboma. The Authors stress the importance of the electrocardiogram and standard chest X-Ray to "suspect" this rare association. PMID- 3678714 TI - [Efficacy and tolerance of diltiazem in primary pulmonary hypertension. Apropos of a case]. AB - The Authors report a case of a serious and symptomatic primary pulmonary hypertension, where the intravenous administration of Diltiazem, at a dosage of 0.3 mg/kg, resulted in an important improvement of haemodynamic parameters. This improvement was confirmed 4 months later on chronic oral therapy with Diltiazem, at a dosage of 180 mg per day. Six months after the beginning of therapy, the patient is totally asymptomatic. Even though further controls are needed, Diltiazem may represent an active drug in the treatment of primary pulmonary hypertension. PMID- 3678715 TI - [Pharmacokinetics and metabolism of rifampicin in humans]. PMID- 3678716 TI - [Pharmacokinetics of cofosfolactamines in subjects with impaired kidney function]. PMID- 3678717 TI - [Miocamycin in the treatment of infections of the respiratory tract in children of pediatric age. Multicenter research]. PMID- 3678718 TI - [Therapy of urinary infections with ureidopenicillins: controlled clinical research on mezlocillin and piperacillin]. PMID- 3678719 TI - [Aztreonam in the treatment of nosocomial urinary infections]. PMID- 3678720 TI - [Activity of ciprofloxacin in vitro]. PMID- 3678721 TI - [The educational system of the medical specialties]. PMID- 3678722 TI - [Respiratory function in ischemic cardiopathy. Volumetric, mechanical and ventilatory aspects]. PMID- 3678723 TI - [Recent memory and epilepsy]. PMID- 3678724 TI - [The nature of disease]. PMID- 3678725 TI - [AIDS and HTLV-III]. PMID- 3678726 TI - [Acting and deciding in medicine]. PMID- 3678727 TI - [Alcoholic hepatitis]. PMID- 3678728 TI - [Host-parasite relations in human and porcine cysticercosis]. PMID- 3678729 TI - [Chronic hypoxemia and its systemic impact]. PMID- 3678730 TI - [Splenectomy in hematologic disorders]. PMID- 3678731 TI - Quantitative evaluation of experimental ischemic colitis correlated with the degree of artificial bowel obstruction in rats. AB - Experimental ischemic colitis proximal to artificial bowel obstruction was produced under poor regional circulatory conditions in rats. Only the vessels of the left hemi-colon were ligated to obtain poor circulation (ischemia). Two types of aluminum rings were used to obstruct the bowel at the most distal portion of the ischemic colon. One, with a 4 mm internal diameter, was used for the model of partial colon obstruction with ischemia (partial obstruction, n = 25) and the other, with a 2 mm internal diameter, was used for complete colon obstruction with ischemia (complete obstruction, n = 25). The circumference of the dilated bowel was larger in complete obstruction than in partial obstruction. Ischemic colitis developed in 9 of 25 rats (34.0%) with partial obstruction and 16 of 25 (64.0%) with complete obstruction. In terms of morphometry, over half of the ischemic lesions in complete obstruction were more than 1.0 cm2, but such a large size in partial obstruction was not observed. It was demonstrated that the depth of ischemic lesions gradually increased in extensive lesions. In conclusion, complete colon obstruction with ischemia frequently caused severer ischemic colitis, together with marked distention of the proximal bowel, than partial colon obstruction with ischemia. PMID- 3678732 TI - Serum bile acids and oral ursodeoxycholic acid tolerance test in the diagnosis of esophageal varices. AB - The purpose of this study was to compare the endoscopic findings based on the general rules for recording endoscopic findings on esophageal varices by the Japanese Research Society for Portal Hypertension with liver function tests including serum bile acids and bile acid clearance tests in 64 patients with liver cirrhosis. Cases of esophageal varices showed significantly higher serum bile acid levels and greater ICG retention than those without esophageal varices. The oral ursodeoxycholic acid tolerance test was significantly impaired in the group with esophageal varices (p less than 0.05). In cases with esophageal varices, there was no significant difference in serum bile acid levels between white and blue varix patients, while serum bile acid levels in the red-color sign positive group were significantly higher than those in the negative group (p less than 0.01). Serum bile acid levels increased in parallel with the form of varices as reflected by the shape and size of varices and with the location of varices which reflects the longitudinal-extent of varices. These results indicate that the impaired clearance of serum bile acids in liver cirrhosis is closely related with the red-color sign on the variceal surface and with the form and location of esophageal varices, which may reflect the grade of portal-systemic shunting. PMID- 3678733 TI - Serum bilirubin fractionation using multilayer film method in hepatobiliary diseases in comparison with high performance liquid chromatography. AB - The Ektachem multilayer film method (Ektachem) and high performance liquid chromatography (HPLC) were employed to fractionate and evaluate serum bilirubin species in 45 serum samples. The false-positive or false-high levels of bilirubin close-bonded with albumin (i.e. the delta bilirubin fraction (B delta] was obtained by Ektachem in sera of cases with normal bilirubin concentration and cases with unconjugated hyperbilirubinemia when compared with the results of HPLC. In the sera of cases with conjugated hyperbilirubinemia, Ektachem gave comparable levels of total bilirubin (TB), and unconjugated bilirubin (Bu) to those of HPLC, but underestimated conjugated bilirubin (Bc) and slightly overestimated B delta. To investigate the clinical significance of B delta in 113 cases of various hepatobiliary diseases with conjugated hyperbilirubinemia, the ratios of B delta to TB (B delta/TB) and to directly-reacting bilirubin fractions (B delta/(Bc + B delta] and that of Bc to B delta (Bc/B delta) were calculated based on the results of Ektachem and compared with each other during the course of jaundice. The mean B delta/TB was below 40% in various hepatobiliary diseases but became as high as approximately 60% in the convalescence stage. The mean B delta/(Bc + B delta) was below 50% in acute hepatitis (the serum bilirubin elevating stage) and obstructive jaundice, and it increased to above 80% in the recovery stage. In decompensated liver cirrhosis and intrahepatic cholestasis the mean B delta/(Bc + B delta) was about 60%, indicating continuous backflow of Bc from liver cells. The changes in B delta/(Bc + B delta) were much greater than in B delta/TB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678734 TI - Androgen-responsive functions of male rat liver. Effect of chronic alcohol ingestion. AB - Many liver processes are sexually dimorphic, and in rats, testosterone is the major steroid hormone determinant of the differing patterns of hepatic function. The microsomal content of specific enzymes and the syntheses of specific proteins are dependent on serum testosterone to maintain this dimorphism. Because the liver of male rats is strikingly androgen responsive, and because chronic alcohol ingestion decreases serum testosterone, we sought to determine whether chronic alcohol feeding would alter the masculine pattern of hepatic liver function in male rats. We quantitated both the cytosolic and nuclear forms of the hepatic androgen receptor. Alcohol feeding of male rats results in a significant loss of both types of androgen receptor sites; the specific binding capacity of both cytosolic and nuclear receptor in alcohol-fed rats is reduced to about 30% of that in either isocalorically fed rats or rats fed ad libitum. This reduction in hepatic androgen receptor activity is concomitant with a 50% reduction in serum testosterone content in the alcohol-fed animals. In addition, the activities of two hepatic androgen-responsive proteins, namely a cytosolic estrogen binder and a microsomal enzyme, estrogen 2-hydroxylase, demonstrate a decrease in activity that parallels the decreases in both forms of the androgen receptor. Administration of testosterone to the alcohol-fed animals normalized both the hepatic androgen receptor and the androgen-responsive protein activities. From these results, we conclude that chronic alcohol feeding results in a decreased androgen responsiveness of the liver, a condition that most likely results from the decreased serum testosterone levels in the alcohol-fed animals. PMID- 3678735 TI - Chronobiological evaluation of sympathoadrenergic function in cirrhosis. Relationship with arterial pressure and heart rate. AB - Intraday activity of the adrenergic system was investigated in 7 healthy controls and in cirrhotic patients without ascites (group 1, 7 cases) and with ascites (group 2, 9 cases) by determining the urinary norepinephrine and vanillylmandelic acid excretions at 4-h intervals for 24 h. Mean arterial pressure and heart rate were also recorded. In controls, the statistical evaluation by the cosinor method showed a circadian rhythm of such variables, with zenith in the morning and nadir at night. Intraday changes of urinary excretion of norepinephrine were closely related to arterial pressure and heart rate in most subjects. The most important change in cirrhotic patients was the achronia [no detection of a statistically significant (p greater than 0.05) rhythm] in urinary excretion of norepinephrine and arterial pressure. This occurred not only in group 2 patients, who had lower arterial pressure and higher NE mesors than controls (p less than 0.05), but also in group 1 patients, whose mesors were comparable to controls. The statistical significance of heart rate rhythmicity was preserved in patients, but its zenith was progressively displaced toward evening (group 1) and night hours (group 2, whose mesor was increased). Changes in urinary excretion of vanillylmandelic acid roughly paralleled those of norepinephrine both in controls and patients, but they did not significantly increase even in the group with ascites. In both groups of cirrhotic patients, the correlation between urinary excretion of norepinephrine, arterial pressure, and heart rate within the same subject was lost in most cases. This chronobiological study showed that the sympathoadrenergic activity can be deranged also in the early stages of cirrhosis, and suggested that an altered control of cardiovascular homeostasis is present even under steady state conditions. This alteration might blunt adrenergic responses to stress conditions. PMID- 3678736 TI - Benign recurrent intrahepatic cholestasis. Evidence for an intrinsic abnormality in hepatocyte secretion. AB - The cholestasis of benign recurrent intrahepatic cholestasis (BRIC) may be secondary to factors present in the circulation or to an intrinsic abnormality in hepatocyte bile salt secretion. In the present study, we documented the effect of BRIC sera on hepatic bile flow in rats and in vitro [14C]taurocholate bile salt uptake and efflux from isolated rat hepatocytes. Sera from patients with cholestatic disease (2 patients with primary biliary cirrhosis) and healthy volunteers served as controls. Rat hepatic bile flow increased significantly (p less than 0.05) during intravenous infusions of BRIC sera but remained unaltered during infusions with disease and healthy control sera. [14C]Taurocholate uptake by isolated rat hepatocytes was decreased to a similar extent by BRIC and disease control sera. [14C]Taurocholate efflux from hepatocytes was unaltered by BRIC, disease, or healthy control sera. Quantitative technetium diisopropyliminodiacetic acid cholescintigraphy in the BRIC patient revealed prompt uptake of the radiolabeled organic anion but no biliary excretion after 21 h. Disease control patients also demonstrated prompt hepatic uptake of radiotracer, but some biliary excretion was evident. These results suggest that BRIC cholestasis is not mediated by a circulating cholestatic agent but rather is secondary to an intrinsic abnormality in hepatocyte bile salt secretion. PMID- 3678737 TI - Intracellular transport and processing of secretory component in cultured rat hepatocytes. AB - Membrane secretory component (mSC) mediates the transcellular transport of polymeric immunoglobulin A from the sinusoidal surface of rat hepatocytes to the bile, where it is released as a proteolytic fragment, fSC. We have examined the biosynthesis, posttranslational processing, transport, and cleavage of secretory component in cultured rat hepatocytes. Membrane secretory component is detected at the cell surface beginning 1.0-1.5 h after synthesis, whereas fSC is not found in the medium until 2.5-3 h after synthesis. Approximately 16% of metabolically labeled mSC is accessible at the cell surface at 4 degrees C. Surface accessible mSC labeled with 125I at 4 degrees C is internalized with a half-time of less than 5 min after warming to 37 degrees C and begins to be released as fSC after 20 min at 37 degrees C. Posttranslational processing and cleavage of mSC by cultured hepatocytes yields products that appear to be identical to those produced in vivo. Although the kinetics of some of these events are significantly slower than those observed in vivo, the major fraction of mSC accessible at the surface of cultured hepatocytes is internalized before cleavage to fSC, as occurs with mSC present on the sinusoidal domain of hepatocytes in vivo. Cultured hepatocytes provide a suitable model system for the examination of mSC transport and cleavage to fSC. PMID- 3678738 TI - Hepatitis in fatal infectious mononucleosis. AB - A detailed clinicopathologic analysis of 30 patients with sporadic fatal infectious mononucleosis and 31 males with fatal infectious mononucleosis and the X-linked lymphoproliferative syndrome was performed to determine the extent of hepatic dysfunction in these cases. At death, the median age of patients with sporadic infectious mononucleosis was 10.7 yr vs. 2.4 yr for X-linked lymphoproliferative syndrome. The median survival time was 8 wk for sporadic infectious mononucleosis and only 4 wk for X-linked lymphoproliferative syndrome. The male to female ratio was 3:2 in sporadic infectious mononucleosis; all patients with X-linked lymphoproliferative syndrome were males. Fever, sore throat, lymphadenopathy, hepatomegaly, and splenomegaly were prominent findings. Hepatic dysfunction was uniformly present and caused death in 13 of 30 sporadic infectious mononucleosis cases and 18 of 31 X-linked lymphoproliferative syndrome cases. Diagnosis of infectious mononucleosis was confirmed by heterophile antibody titers or Monospot, Epstein-Barr virus antibody studies, viral culture, molecular hybridization studies, clinical and histologic findings, and pedigree analysis. PMID- 3678739 TI - Hepatitis B virus deoxyribonucleic acid in serum during hepatitis B e antigen clearance in corticosteroid-treated severe chronic active hepatitis B. AB - The relationship between hepatitis B virus deoxyribonucleic acid in serum and histologic activity was determined in 11 patients with corticosteroid-treated severe chronic active hepatitis B who underwent clearance of hepatitis B e antigen. All patients cleared hepatitis B virus deoxyribonucleic acid from the serum, and clearance preceded the loss of hepatitis B e antigen by 9-49 mo (mean 24 +/- 4 mo). Seropositivity for hepatitis B virus deoxyribonucleic acid was always associated with histologic features of chronic active hepatitis. Resolution of histologic activity followed the loss of hepatitis B virus deoxyribonucleic acid from the serum and it preceded clearance of hepatitis B e antigen in all patients. A transient elevation of serum aspartate aminotransferase activity occurred in 5 patients at the time that absence of hepatitis B virus deoxyribonucleic acid in serum was first demonstrated, and it was followed by resolution of histologic activity. The serum level of hepatitis B virus deoxyribonucleic acid slowly decreased or remained unchanged in all but 1 patient during long-term corticosteroid therapy. We conclude that hepatitis B virus deoxyribonucleic acid in serum is associated with histologic activity in corticosteroid-treated patients with severe chronic active hepatitis B. Disappearance of hepatitis B virus deoxyribonucleic acid from the serum precedes the loss of histologic activity and clearance of hepatitis B e antigen. Serum hepatitis B virus deoxyribonucleic acid levels usually do not increase during long-term corticosteroid therapy. PMID- 3678740 TI - Granulocytopenia complicating colchicine therapy for primary biliary cirrhosis. AB - A case is presented of a 76-yr-old woman with primary biliary cirrhosis and adult polycystic liver disease who developed bone marrow toxicity associated with chronic low-dose colchicine therapy. Two months after starting colchicine therapy (0.6 mg b.i.d. p.o.), the patient developed hematologic toxicity as evidenced by transient but profound granulocytopenia which promptly reversed 4 days after the drug was stopped. Bone marrow examination revealed moderate hypocellularity of all cell lines and striking dysplastic changes in the late myeloid and erythroid series. There was no apparent toxicity involving other organ systems. The patient fully recovered. This case is compared with previous descriptions of colchicine toxicity. PMID- 3678741 TI - Hepatitis B virus deoxyribonucleic acid in liver of chronic carriers. Correlation with serum markers and changes associated with loss of hepatitis B e antigen after antiviral therapy. AB - Patients with chronic hepatitis B receiving antiviral or immunomodulatory therapy were prospectively studied to determine the relationship between the state of hepatitis B virus deoxyribonucleic acid in liver and the levels of serum markers of hepatitis B virus infection. Hepatitis B virus deoxyribonucleic acid was quantitated and the molecular forms determined using molecular hybridization in two separate liver specimens taken at least 1 yr apart. All 30 patients initially had hepatitis B surface antigen and e antigen in serum and all had hepatitis B virus deoxyribonucleic acid, including replicative intermediate forms, present in liver. The amount of viral deoxyribonucleic acid in liver correlated significantly with the e antigen titer in serum. At the time of the second liver biopsy, e antigen was no longer detectable in the serum of 12 patients although all except 1 patient still had detectable hepatitis B surface antigen. In this group, the amount of hepatitis B virus deoxyribonucleic acid in liver had decreased significantly and replicative viral intermediates had disappeared. In contrast, among patients who remained e antigen-positive, the amount of viral deoxyribonucleic acid did not change appreciably and replicative intermediate forms were still detectable. These findings imply that in chronic hepatitis B, loss of e antigen is usually associated with resolution of hepatitis B virus replication. PMID- 3678742 TI - Effect of cholecystokinin and of its antagonist, of atropine, and of food on the release of immunoglobulin A and immunoglobulin G specific antibodies in the rat intestine. AB - Cholecystokinin has previously been shown to produce a rise in immunoglobulin A (IgA) antibodies in the intestinal fluid of human volunteers. Whether the source of these antibodies was pancreatic, biliary, or mucosal had not been defined. The object of the present investigation was to study factors involved in regulating the release of IgA and IgG antibodies from the intestinal mucosa. Hooded-Lister rats were sensitized to ovalbumin. After the sensitization protocol, which lasted 21 days, the rats were anesthetized and a segment of intestine 10 cm long was isolated and perfused in vivo. This segment was flushed with normal saline for 30 min to remove all pancreatic, biliary, and other secretions. It was found in this model that after the intravenous injection of cholecystokinin-octapeptide there was a rise of IgA and IgG antibodies within 2.5 min. Significantly increased secretion of IgA lasted for 10 min, and increased secretion of IgG lasted for 20 min. The cholecystokinin antagonist proglumide reduced the secretions of both immunoglobulins. Atropine reduced baseline IgA secretion by one-half. Intragastric protein hydrolysate, which left the body through the severed end of the duodenum, also raised IgA and IgG levels significantly in the perfused intestine. Control animals receiving intragastric normal saline did not have an elevation of IgA or IgG levels. The phenomena described here demonstrate that the rate of IgA release from the mucosa is influenced by endocrine and nervous stimuli. The rate of IgG release is, as far as could be ascertained, only under endocrine control and not significantly influenced by the cholinergic antagonist atropine. PMID- 3678743 TI - Action of ethanol and some alcoholic beverages on gastric acid secretion and release of gastrin in humans. AB - The action of intragastric ethanol in various concentrations (1.4%-40% vol/vol) and of beer, white wine, cognac, and whisky on gastric acid secretion and release of gastrin was studied in healthy humans. Ethanol concentrations of 1.4% and 4% (vol/vol), but not higher, significantly (p less than 0.05) increased gastric acid secretion to 23% and 22%, respectively, of incremental maximal acid output [i.e., observed response to pentagastrin (6 micrograms/kg s.c.) minus basal acid output]. The 1-h incremental gastric acid responses to beer and wine were 96% and 61%, respectively, of incremental maximal acid output. Neither cognac nor whisky had any stimulatory effect. The 1-h incremental gastric acid response to an 8% peptone meal was 40% of incremental maximal acid output, and to peptone plus white wine 77%. Plasma gastrin levels were not altered by ethanol, cognac, and whisky. The 1-h integrated plasma gastrin responses to beer and white wine were 119% and 77%, respectively, of the response to the peptone meal. We conclude that (a) the action of pure ethanol on gastric acid secretion is related to its concentration: concentrations of 1.4% and 4% are moderate stimulants; concentrations of 5%-40% have no effect, or rather an inhibitory effect; (b) beer and white wine, but not whisky and cognac, are potent stimulants of gastric acid secretion; (c) the stimulatory mechanism of low ethanol concentrations is unknown; and (d) nonalcoholic constituents of beer and wine are most likely responsible for the stimulatory actions of both beverages on gastric acid secretion and release of gastrin. PMID- 3678744 TI - Duodenal bulb acidity in patients with duodenal ulcer. AB - Intraluminal pH was measured simultaneously in the human stomach and proximal duodenum with six small glass electrodes tied together at 1.5-cm intervals. Twenty-four healthy control subjects and 44 patients with duodenal ulcer disease were studied under fasting conditions and for 3 h after a standard liquid meal. Mean and median hydrogen ion activity, percentage of time with pH below 2 and 3, and the frequency of pH fluctuations were calculated from digital pH data sampled at a frequency of once per second from each electrode. None of these measurements of acidity differed significantly between the two groups or between subgroups of normosecretor controls and hypersecretor ulcer patients. At the time of pH study 15 of the patients had endoscopically verified active ulcer disease and 13 patients were without disease activity. Gastric as well as duodenal bulb acidity was the same in these two subgroups. We conclude that even though duodenal ulcer patients deliver more acid into the duodenum, this does not cause increased luminal acid aggression. PMID- 3678745 TI - Anorectal sensitivity and responses to rectal distention in patients with ulcerative colitis. AB - Anorectal function in ulcerative colitis was assessed by measuring pressures at multiple sites in the anus and rectum under basal conditions and during balloon distention of the rectum in 29 patients with ulcerative colitis (12 active, 11 quiescent, and 6 during both phases) and in 12 normal controls. Resting and squeeze sphincter pressures were similar in the three groups. The lowest rectal volume that could be perceived, the volume required to induce a desire to defecate, and the maximum tolerable rectal volume were all lower in patients with active colitis than in patients with quiescent colitis (p less than 0.001) and controls (p less than 0.001). The rectal volume required to cause a sustained anal relaxation was lower in patients with active colitis (p less than 0.05) than in controls. Both peak and steady state rectal pressures in response to rectal distention were significantly higher in patients with active colitis than in patients with quiescent colitis (p less than 0.05) and controls (p less than 0.02). Paired studies showed that during remission of disease there was a decrease in rectal sensitivity (p less than 0.05) and an increase in rectal compliance (p less than 0.05). These results suggest that the frequent and urgent defecation, i.e., the predominant feature of active colitis, is related to a hypersensitive and poorly compliant rectum, which, upon distention, is more reactive and is more likely to induce prolonged sphincter relaxation. PMID- 3678746 TI - 16,16-Dimethyl prostaglandin E2 aggravates gastric mucosal injury induced by histamine in rats. Possible role of the increased mucosal vascular permeability. AB - Histamine dihydrochloride (40 or 80 mg/kg, dissolved in 10% gelatin) subcutaneously administered to fasted rats induced few lesions in the gastric mucosa within 4 h. Pretreatment with subcutaneously administered 16,16-dimethyl prostaglandin E2 (dmPGE2; greater than or equal to 10 micrograms/kg) dose dependently worsened mucosal injury induced by histamine, mostly with severe hemorrhage in the corpus mucosa along the greater curvature, although dmPGE2 alone did not induce any macroscopic damage. The mucosal vascular permeability as measured using Evans blue was slightly but significantly augmented by either dmPGE2 (30 micrograms/kg) or histamine (80 mg/kg) alone, but was markedly increased by histamine in the presence of dmPGE2. The increased vascular permeability occurred within 2 h, and preceded the appearance of hemorrhagic mucosal injury. Both the mucosal injury and the increased vascular permeability caused by histamine (80 mg/kg) in the presence of dmPGE2 (30 micrograms/kg) were significantly reduced by pretreatment with tripelennamine (30 mg/kg) and prednisolone (3 mg/kg), but not affected by atropine sulfate, cimetidine, methysergide, or indomethacin. The stimulation of acid secretion caused by histamine was significantly inhibited by dmPGE2 (30 micrograms/kg). Repeated administration of histamine (40 or 80 mg/kg) in the same area of the stomach in the presence of dmPGE2 (30 micrograms/kg), once or twice daily for 4 days to fed rats, induced more pronounced damage than single-dose treatment. These results suggest that dmPGE2 may aggravate gastric mucosal injury induced by histamine in rats probably due to potentiation of the increased vascular permeability caused by histamine through stimulation of H1-receptors. PMID- 3678747 TI - Localization of specific binding sites for bombesin in the canine gastrointestinal tract. AB - The goal of these studies was to determine the tissue and cell types possessing specific binding sites for bombesin/gastrin-releasing peptide in the canine gastrointestinal tract. Monoiodinated, biologically active (Tyr-4)-bombesin 14 (100 pM) was applied to sections of canine gut and localized using quantitative autoradiography. The highest density of bombesin/gastrin-releasing peptide specific binding sites occurred over endocrine cells in the antral mucosa. Specific binding sites were also found on the circular muscle layer of the gastric fundus, gastric antrum, and ileum, on longitudinal muscle of the gastric fundus and antrum, and on neuronal elements in the myenteric plexus in the gastric fundus, antrum, and small intestine. No evidence for specific binding of 125I-(Tyr-4)-bombesin 14 was found in sections of canine esophagus, gastric cardia, gallbladder, pancreas, or colon. These results suggest sites of direct action of bombesin and endogenous gastrin-releasing peptide for gastrin release and gastrointestinal motility. PMID- 3678748 TI - Vasoactive drugs, microvascular permeability, and hemorrhagic pancreatitis in cats. AB - We investigated the mechanisms by which 16,16-dimethyl prostaglandin E2 and histamine induced pancreatic hemorrhage in an experimental model of acute pancreatitis in cats. In normal animals, when large molecular weight dextran molecules were infused into the systematic circulation, they were recovered in secretin-stimulated pancreatic juice in low concentrations. Both 16,16-dimethyl prostaglandin E2 (in a dose that increased splenic artery blood flow and microvascular permeability) and histamine (in a dose that increased permeability only) increased the amount of dextran recovered in pancreatic juice. Isoproterenol, in a dose that produced the same increase in blood flow as 16,16 dimethyl prostaglandin E2 but which did not increase microvascular permeability, did not alter the amount of dextran recovered. This suggested that the increase in dextran output after 16,16-dimethyl prostaglandin E2 was primarily due to the increase in microvascular permeability caused by the drug. In other experiments, a combination of H1- and H2-receptor antagonists (mepyramine and cimetidine) protected against the development of pancreatic hemorrhage in both the prostaglandin- and histamine-treated animals. Indomethacin (a cyclooxygenase inhibitor) protected against the development of hemorrhage in the histamine treated animals. Our results support the hypothesis that changes in microvascular permeability may be important in the pathogenesis of parenchymal hemorrhage in this model. PMID- 3678749 TI - Nuclear and cytosolic estrogen receptors in human colon carcinoma and in surrounding noncancerous colonic tissue. AB - The measurement of estrogen as well as progesterone receptors has been applied clinically to predict the effectiveness of endocrine therapy in patients with breast or endometrial carcinoma. The presence of cytosolic estrogen receptors in human colorectal carcinomas has been reported by several different groups during the past 10 yr. The aim of our current study was to evaluate the estrogen binding activity in the nuclear and cytosolic fractions of these carcinomas, as well as in surrounding noncancerous colonic tissue. Twenty-six patients, operated on for colorectal carcinoma, were studied: 16 were men and 10 were postmenopausal women, mean age 61 yr (range 43-78 yr). In neoplastic tissue, cytosolic estradiol receptors were detected in 42.3% of the patients (women 40%, men 43.7%). The values for cytosolic estrogen receptor ranged from 118 to 1214 fmol/g wet colon. Nuclear estrogen receptors were detectable in 46.1% of the patients (women 40%, men 50%) and their values displayed a range from 3.4 to 2554 fmol/g wet colon. In 30.7% of the patients, both nuclear and cytosolic receptors were demonstrated. In 38.4% of the patients, receptors were found in neither cytosol nor nuclei. Receptor positivity in men was most frequently associated with tumors removed from the rectum, and those with Dukes' classification of C1. In the surrounding noncancerous tissue cytosolic estrogen receptors were also detected (range 133 1105 fmol/g wet colon) and were present in 34.6% of the patients (women 30%, men 37.5%). Nuclear estrogen receptors (range 225-1105 fmol/g wet colon) were detected in 57.6% of the patients (women 40%, men 68.7%). In 23% of the patients, both nuclear and cytosolic receptors were demonstrated. In 30.7% of the patients, no receptors were found in either cytosol or nucleus. Therefore, the presence of cytosolic or nuclear estrogen receptors, or both, in 61.6% of human colorectal cancer specimens emphasizes the need to evaluate both forms of these receptors for studies of potential hormone dependence in these tumors. PMID- 3678750 TI - Early diagnosis of pancreatic infection by computed tomography-guided aspiration. AB - We performed 92 computed tomography-guided percutaneous needle aspirations of pancreatic inflammatory masses in 60 patients suspected of harboring pancreatic infection. Thirty-six patients (60%) were found by Gram stain and culture to have a total of 41 separate episodes of pancreatic infection. Among 42 aspirates judged to be infected by computed tomography-guided aspiration, all but one were confirmed by surgery or indwelling catheter drainage. Among 50 aspirates judged to be sterile, no subsequent evidence of infection was found. All patients tolerated the procedure well and no complications were noted. As a result of this technique, we observed that pancreatic infection occurs earlier than has been previously appreciated (within 14 days of the onset of pancreatitis in 20 of the 36 patients) and that infection may recur during prolonged bouts of pancreatitis. We conclude that guided aspiration is a safe, accurate method for identifying infection of the pancreas at an early stage. PMID- 3678751 TI - Gas-chromatographic and mass-spectrometric analysis of the odor of human feces. AB - Gas-chromatographic and mass-spectrometric analysis of human fecal samples was performed to identify the volatile compounds responsible for fecal odor. The compounds identified with fecal odor were the methyl sulfides methanethiol, dimethyl disulfide, and dimethyl trisulfide. Skatole and indole, the benzopyrrole volatiles believed to be responsible for fecal odor, in fact elaborated a napthalenelike "mothball" odor in the crystalline state as well as after purging from feces. A small amount of hydrogen sulfide gas was also identified in fecal samples. The components responsible for fecal odor are complex and may be influenced by dietary and endogenous contributions. However, the major components are methyl sulfide compounds rather than skatole and indole as is currently believed. PMID- 3678752 TI - Differential expression carcinoembryonic antigen and secretory component during colonic epithelial cell differentiation and in colonic carcinomas. AB - The cellular and ultrastructural distribution of carcinoembryonic antigen and secretory component during differentiation of normal colonic epithelium and in colonic carcinomas was evaluated by peroxidase-labeled antibody immunocytochemistry. Carcinoembryonic antigen and secretory component were found to be markers of distinctly different stages of normal colonocyte differentiation. Whereas secretory component was expressed principally by proliferating absorptive cells in the midcrypt, carcinoembryonic antigen expression was diminished in this crypt zone and was associated principally with mature columnar cells at the luminal surface and with undifferentiated cells at the crypt base. Carcinoembryonic antigen was preferentially expressed on the microvillar plasma membrane and secretory component on the basolateral plasma membrane in the normal colon. In 13 colon cancers studied, carcinoembryonic antigen was expressed on the entire surface of all the colon cancers except one anaplastic tumor, whereas secretory component was only expressed on five well or moderately differentiated cancers. These observations suggest that differentiation of colon cancers as assessed by morphology and phenotypic markers is not totally analogous to that found in the normal colon. PMID- 3678753 TI - Cholesteryl octanoate breath test. Preliminary studies on a new noninvasive test of human pancreatic exocrine function. AB - A new breath test for noninvasive assessment of pancreatic exocrine function in humans was developed. The test is based on the hydrolysis of cholesteryl-[1 14C]octanoate by pancreatic carboxyl ester lipase (cholesterol esterase) with subsequent absorption and hepatic metabolism of the liberated octanoate to 14CO2. The rate at which 14CO2 appears in breath appeared to be proportional to the rate of hydrolysis. The substrate is administered as a gum acacia stabilized emulsion of vegetable oil (18 g) containing cholesteryl octanoate (2 g; 4.4 microCi) dispersed in a 500-ml isotonic meal. Tests were performed in 6 healthy volunteers and 11 patients with pancreatic disease with varying degrees of steatorrhea. In healthy subjects, 14CO2 output was rapid with peak output occurring at 60-90 min in all subjects; cumulative output in 4 h averaged 30%. Duplicate studies indicated that the time-course of 14CO2 recovery was reproducible. The pattern of 14CO2 output in patients with pancreatic disease varied widely. Patients without steatorrhea (fecal fat less than or equal to 7 g/day) or with mild steatorrhea (fecal fat 7-11 g/day) had normal or near normal patterns of 14CO2 output, whereas patients with moderate or severe steatorrhea (fecal fat greater than 11 g/day) expired 14CO2 at a rate one-third to one-tenth that of the healthy volunteers. Addition of pancreatic enzyme supplementation to the test meal increased 14CO2 output in 6 of 6 patients with moderate or severe steatorrhea, suggesting that the activity of pancreatic carboxyl ester lipase was rate limiting in these patients. In an additional study in a healthy volunteer, 14CO2 and 13CO2 were measured simultaneously in breath after ingestion of a test meal containing cholesteryl-[1-13C]octanoate and 14C-octanoate. 14CO2 was expired more rapidly than 13CO2, suggesting that hydrolysis of the substrate may also be rate limiting in healthy volunteers. These studies indicate that severe pancreatic exocrine dysfunction can be detected with a simple breath test in 60-90 min. PMID- 3678754 TI - Salivary response to esophageal acid in normal subjects and patients with reflux esophagitis. AB - We studied the effect of esophageal acid perfusion on salivation in patients with reflux esophagitis and in normal subjects. Serial 10-min saliva collections were obtained by expectoration during perfusion of the esophagus with water, and then 0.1 N HCl (pH 1.2) for 50 min or 0.01 N HCl (pH 2.1) for 120 min. Within 1-5 min of beginning 0.1 N HCl perfusion, all 8 patients with esophagitis developed heartburn accompanied by an increase in saliva flow. By the time the severity of heartburn required discontinuation of HCl perfusion (10-40 min), saliva flow had increased nearly fourfold. With 0.1 N HCl perfusion, 8 of 10 volunteers developed mild heartburn after 22 +/- 3 min (mean +/- SE), whereas 0.01 N HCl induced heartburn in 6 of 10 volunteers after 57 +/- 12 min of perfusion. Saliva flow increased concurrently with the onset of heartburn and doubled in those volunteers who developed heartburn. Saliva flow did not change in those volunteers who were without heartburn. We conclude that esophageal acid perfusion unaccompanied by heartburn does not affect salivation. However, saliva flow increases concurrently with the onset of heartburn, a phenomenon called "water brash" when clinically evident. The increased saliva flow that accompanies heartburn may act as an endogenous antacid that serves as a protective response to symptomatic gastroesophageal reflux. PMID- 3678755 TI - Diversion colitis. Pathologic findings in a resected sigmoid colon and rectum. AB - We present here the detailed pathologic findings in the resected colon and rectum from a paraplegic patient with severely symptomatic diversion colitis and lack of anorectal function. Previous reports of the pathology of this condition have been confined to biopsy findings. A diffuse nodularity caused by lymphoid hyperplasia and an inflammatory process confined to the colorectal mucosa with erosions, crypt abscesses, mucin granulomas, and aphthoid ulcers were the main features. There was minimal distortion of crypt architecture. The pathologic features of this entity are compared to those of other inflammatory disorders of the colon and rectum. PMID- 3678756 TI - Endoscopic sclerotherapy versus percutaneous transhepatic obliteration of varices: a conceptual approach. PMID- 3678757 TI - Lowering the level of uncertainty in late pancreatitis. PMID- 3678758 TI - Only the nose knows. PMID- 3678759 TI - Progastrin in antral mucosa. PMID- 3678760 TI - Hepatic fibrin-ring granulomas caused by Staphylococcus epidermidis generalized infection. PMID- 3678761 TI - Pseudomonas aeruginosa infection during endoscopy. PMID- 3678762 TI - Increased iron absorption in uroporphyrin III dihydrochloride-treated rats. PMID- 3678763 TI - Duodenitis in children: clinical, endoscopic, and pathological aspects. AB - In a retrospective study of 320 gastroduodenoscopies performed on children in the last 2 years, 32 cases of duodenal damage, either isolated or associated with esophagitis, gastritis, or both, were selected. Twenty matched children with dyspeptic symptoms but an endoscopically normal duodenum were chosen as controls. Histological sections of fiberoptic biopsy specimens were submitted to double blind examination by two observers: only four fulfilled accepted criteria for histological duodenitis. The concordance between endoscopic and histological results in our patients was 13.8%. No changes of duodenal endoscopic appearance predictive of duodenitis were identified. In 8 more cases (6 patients and 2 controls) the histological examination showed an isolated lymphocyte and plasma cell infiltration of the lamina propria without any additional damage. We called this picture "minimal change duodenitis" and considered it as a variation of normal. In 17 patients and 11 controls, basal and maximal acid outputs were calculated and no significant differences were found. We concluded that duodenitis in children may be present, although rare, and its diagnosis requires histological examination of duodenal mucosa. PMID- 3678764 TI - A comparison of direct brush cytology and biopsy in the diagnosis of colorectal cancer. AB - Direct brush cytology has been underutilized as compared with direct biopsy in the endoscopic diagnosis of colorectal lesions. We report on a large series of patients in whom biopsy and brush cytology were compared with each other and with the pathology of the specimen. Our results show that cytology should be used with biopsy to get maximal yield (97% accuracy), especially in areas of strictures or obstruction. PMID- 3678765 TI - Percutaneous endoscopic jejunostomy in cancer patients with previous gastric resection. PMID- 3678766 TI - Cannulation of difficult malignant esophageal strictures with angiographic catheters. PMID- 3678767 TI - Endoscopic conversion of an external biliary drain to an internal common bile duct stent. PMID- 3678768 TI - Ileoscopic diagnosis of malignant lymphoma of the small bowel in acquired immunodeficiency syndrome. PMID- 3678769 TI - Toward a better terminology and classification of gastroduodenal erosions. PMID- 3678770 TI - Endoscopic therapy of esophageal cancer--lasers and other "hot" new devices. PMID- 3678771 TI - The gastric bubble. PMID- 3678772 TI - Diagnosis gastric pseudolymphoma by gastroscopic biopsy. PMID- 3678773 TI - Tetracycline and doxycycline esophageal ulcerations. PMID- 3678774 TI - Gastrojejunocolic fistula diagnosed by simultaneous gastroscopy and colonoscopy. PMID- 3678775 TI - Balloon dilation of recurrent terminal ileal Crohn's stricture. PMID- 3678776 TI - Polidocanol may directly activate the contact phase of blood coagulation during sclerotherapy. PMID- 3678777 TI - Blow-gun syndrome. PMID- 3678778 TI - [Relation between body height and weight in adult humans]. AB - Series of values for body height of adults ranging from 150 to 190 cm and the corresponding body weights for 9 age groups from 15 to 65 a are interrelated by 5 test functions. Results of nonlinear regressions as gained by minimization of the sums of the squares and absolute values of the deviations are summarized in tables for comparison. The last position in the goodness-of-fit is held by the allometric relation W = alpha L beta preceded by the exponential type W = abL. No considerable gain can be realised by taking the expression W = a exp (b Lp). A big step is reached, however, with the change to the form W = W150 + alpha (L 150) beta reducing the linear deviations to about 1/3 or more. Finally the 3 parameter structure W = W A + alpha (L-150) beta yields even closer approximations. Tables with the results for the last 2 relations are given together with a graph for the best approximation. PMID- 3678779 TI - [Simple bimolecular reaction model with physical feedback mechanism in the handling of rhythmic processes and their modification of receptor populations]. AB - A bimolecular reaction model considering a physical feedback by the concentration dependence of a kinetic coefficient is proposed for the description of the receptor action. The regulatory properties will be treated in the framework of nonequilibrium thermodynamics as dynamic critical phenomena. The receptor and the bioactive agent are regarded as a system working in the vicinity of an instability point. The kinetics contains the possibility for a bifurcation to a limit cycle behavior, a stable time-periodic solution. For the transition regime, the relevant order parameter and its evolution equation can be determined with the help of a reductive pertubation approach. On this way, the magnitude of the receptor output signal may be obtained via its dependence on some essential parameters. The influence of environmentally produced fluctuations is incorporated by a Gaussian white-noise. For the stochastic model, the static probability distributions are calculated yielding some potential laws for the behavior of interesting state variables. The model results will be useful for the understanding of certain receptor related phenomena as for instance sigmoidal relationships between the response and the dose, tachyphylaxis and specific desensitization, temporal oscillations of some concentrations, and modulation effects caused by co-factors. Within the model, pertubations can be included such as a stochastic parameter variation or a competitive mechanism. PMID- 3678780 TI - [Morphology and development of the cranium of Felis silvestris f. catus Linne 1758--a contribution to the comparative anatomy of the Carnivora. II. Orbitotemporal region]. AB - In Felis 1, the orbitotemporal region is very compressed in rostrocaudal direction. As a result, most structures are tightly pressed together. Continuing development towards the stage of Felis 2, the cranium becomes remarkably elongated in this region. In early embryonic stage, Felis builds up a primary side wall, being remarkable complete. The following development towards Felis 1 and 2 gives an interesting example for the elements changing their configuration and position during ontogenesis and thereby illustrates the problems of interpreting these conditions phylogenetically and systematically: There is an evident reduction of the structures of the primary side wall and positional changes of the whole side wall at the same time. PMID- 3678781 TI - Differential growth and tissue shifts in the developing neck of the chick embryo. An experimental study. AB - The differential growth of the neck was studied by means of linear marks in the chick embryo. The marks were inserted into 3 different zones: Zone I, between the level of 1st and 2nd branchial cleft, zone II, between the level of the 2nd and 3rd branchial cleft, and zone III, between the level of the 3rd branchial cleft and the Cuvier duct. The deformation and dispersion of marks after further incubation of labelled embryos indicate: 1. A caudocranially oriented growth of axial and paraaxial structures causing the displacement of branchial to axial and paraxial structures, 2. an extent growth in the region of the 3rd branchial arch in contrast to other branchial arches with 2 exceptions: the extent craniocaudal growth of the operculum (2nd branchial arch) and the extent caudocranially oriented growth of the hypobranchial region. On the base of our findings the differences in the topography of some neck organs of birds and mammals could be explained. PMID- 3678782 TI - Relative growth of the condylar cartilage of the rat mandibular head during postnatal life. AB - In a study using morphometric techniques, the changes in area undergone by the various constituting layers of the condylar cartilage of the mandibular head of normal rats were examined, the cell/cartilage matrix ratios were determined, and the relative growth of the various cartilage layers was analyzed during postnatal life. The approximate 15% decrease of the cell contingent, the approximate 48% increase in cartilage matrix, the abrupt changes in the descriptive curve around the 15th to 20th d of postnatal life and the analysis of the relative growth pattern of the fibrous, embryogenic, cartilage, and hypertrophic cartilage layers were related to the functional adaptations which regulate the growth of the mandible condyle by a direct or indirect action on the temporal-mandibular articulation system. PMID- 3678783 TI - Effect of sex hormones on lipid peroxidation in the necrotic liver of rat. AB - Influence of sex-hormones on hepato-toxicosis induced by 2 halogenalkanes viz. carbon tetrachloride and trichloroethylene has been studied in rats. Rate of peroxidative decomposition thus measured by determining malonaldehyde has shown the protective effects of testosterone on CCl4 toxicity but an additive effect on injury caused by trichloroethylene, whereas progesterone failed to offer protection against their toxicity. Modification in histopathological lesions thus caused by these hormones have also been studied and discussed. PMID- 3678784 TI - Quantitative study on the inferior vena cava between the renal vein and diaphragm. AB - 50 dissections of the human inferior V. cava have been performed in order to measure its right renal vein - diaphragm, retrohepatic, and suprahepatic segments. We conclude that some individual parameters as skin type, age, height, weight did not influence the magnitude of the studied segments. The average measurements of the different parameters proposed for the inferior V. cava are: 1. The distances between the right renal vein and the diaphragm and between the right renal vein and the right atrium are 113.94 mm and 135.16 mm, respectively; 2. the length of the retrohepatic portion of the inferior V. cava and the suprahepatic one were 78.34 mm and 19.34 mm respectively; 3. the valve of the inferior V. cava is present in 46% of the observations; its length and width averages are 31 mm and 10.22 mm, respectively. PMID- 3678785 TI - [Results of testing tumor resistance (in vitro--in vivo) in breast cancer]. AB - In-vitro sensitivity to cytostatics was tested in 281 carcinomas of the breast using the test method introduced by Volm. The Adriamycin 3H-uridine test system was chosen for the analysis. Altogether, 84.7% of the tumors were testable. A correlation with the subsequent in-vivo result was found in 219 of the breast cancer patients. Only 8% of the breast cancers were unequivocally sensitive to the test (uridine incorporation rate less than 55% for verification). The mean uridine incorporation rate was 577 CPM. Neither tumor size, lymph node status, nor the estrogen and progesterone receptor content of the tumor cells influenced the test result. With regard to the breast carcinoma, no relationship was found between the predictive information and the subsequent in-vivo response to chemotherapy. This applied to both short-term observation periods of three to six months as well as longer-term follow-ups. Furthermore, no connection was found between sensitivity in vitro and probability of recurrence (p = 0.69) under cytostasis. Probability of survival was higher among patients with tumors that were not sensitive to the test than among those with tumors which were (p less than or equal to 0.001). In the authors' experience the Volm chemosensitivity test only appears to furnish prognostic information about the breast carcinoma; in the light of their data the test appears rather unsuitable as an aid to deciding whether or not to institute cytostatic therapy. PMID- 3678786 TI - [Ovarian function and recurrence in adjuvant chemotherapy of breast cancer]. AB - The present paper reports the results of a prospective study of the influence of adjuvant chemotherapy (1) on ovarian function and (2) on recurrence and the patient's endocrine function status. Observation criteria were the endocrine status before, during and after chemotherapy. The follow-up period ranged from 12 to 78 months. The patient population comprised 80 women, of whom 39 were treated with AC and 41 with CMF. Of the 80 women, 56 (70.0%) had hypergonadotropic function at the end of treatment; 31 of these had been treated with AC and 25 with CMF. Significantly more women (p less than 0.1) who had undergone AC therapy were hypergonadotropic than among those treated with CMF; 28 of the patients had recurrences during the follow-up period. Among women with undisturbed ovarian function under chemotherapy (eugonadotropinemia), recurrences occurred more frequently (50.0%) than among chemically castrated patients (28.6%). This effect was especially apparent among patients in the AC group with positive receptor status and chemotherapeutically induced ovarian suppression. CMF therapy produced no difference between eugonadotropic and hypergonadotropic patients with regard to frequency of recurrences, not even when there was a correlation with their receptor status. PMID- 3678787 TI - [Significance of the examination position in urodynamic assessment of female urinary incontinence]. AB - The present paper describes a test center which permits urodynamics tests with the patient in various positions, such as lithotomy position (A), supine position with outstretched legs (B) and, by continuously raising the patient, upright position (C). The results of a comparative investigation show the influence of these different examination positions on urodynamic parameters, in particular the functional length of the urethra and maximum urethra closing pressure at rest. Urodynamic tests on 40 patients with urinary incontinence showed that there is a significant increase in the functional length of the urethra when the patient is in lithotomy position (A) as compared to lying with outstretched legs (B), and that it is once again significantly reduced when the patient is raised to upright position. Maximum urethra closing pressure at rest drops significantly when the patient is repositioned from lithotomy (A) to supine (B) position, and once again rises significantly when she is raised to the upright (C) as compared to the supine (B) position. In the light of the changes described, which cause major changes in the form of the urethra pressure profile, it makes sense to perform urodynamic measurements in at least two different positions. The authors recommend the supine position with outstretched legs (B), as it appears more physiological than the lithotomy position (A), and measurement in the upright position (C). The importance of positioning with regard to the diagnostic information value in determining the cause of urinary incontinence is discussed. PMID- 3678788 TI - [Interpretation of the stress pressure profile in the diagnosis of female stress incontinence]. AB - In 94 stress pressure profiles the electronically measured occlusion pressure under stress with a bladder filling of 100 ml in dorsosacral position and 300 ml in sitting position was compared with the computed value in the proximal and medial thirds of the urethra. Electronic measurement furnishes low, statistically confirmed occlusion pressure values. With a bladder filling of 300 ml in sitting position, urodynamic assessment of incontinence on the basis of the electronic occlusion pressure furnishes corresponding findings in over 70% of patients, while the extent of agreement with the computed values seems unsatisfactory. In stress pressure profiles, in accordance with clinical considerations and radiological studies, the proximal urethra should also be assessed as the first portion of the continence-preserving zones. The occlusion pressure, electronically measured under routine conditions, is the parameter which furnishes the most information for the urodynamic diagnosis of stress incontinence. PMID- 3678789 TI - [Chorionic villi (placental) biopsy in the 2d and 3d trimester: new perspectives in prenatal diagnosis]. AB - A report of our first experience in second and third trimester chorionic villus (placental) biopsy is given. In all 16 cases a cytogenetic result could be received within 2 to 5 days. There were 6 normal female and 9 normal male karyotypes. A third trimester CVS showed a mosaicism of a structural aberration of chromosome 9 (46, XX/46, XX, 9p+). Blood cultures of the fetus revealed a normal female karyotype. The following indications of a second and third trimester CVS are discussed: direct or indirect signs of fetal malformations in ultrasound scanning (Oligo- or Anhydramnios with severe intrauterine growth retardation), placental anomalies (exclusion of triploidies), non immunologic hydrops fetalis, low serum alpha FP and failed amniotic fluid culture. We believe that transabdominal CVS in the second and third trimester is a simple and rapid tool to exclude distinctively any chromosomal anomaly and therefore influences further management of pregnancy and parturition. PMID- 3678790 TI - [Interval CTG monitoring in labor; a contribution to family-oriented labor in the clinic or a danger to the child?]. AB - Instead of continuous CTG monitoring lasting from the onset of labor to delivery, various obstetricians recommend interval monitoring in cases designated "likely to be free of complications". This enables the mother to move freely from time to time without being permanently confronted by technological apparatus. In the study reported here the authors therefore investigated whether-and if so what risks interval monitoring involves. In order to answer this question 436 cardiotokograms recorded during labor with externally and internally attached leads were analyzed, evaluated 30 CTG minutes after the Hammacher Score in each case, and the number of points thus obtained was assigned to the corresponding cervical widths. As labor progressed from 3 to 10 cm cervix dilatation, there was a fourfold increase (p less than 0.0001) in particular in tentatively pathologic and prepathologic CTG patterns. No statistically significant difference was found between no-risk and risk patients. A check was also made as to whether the results of interval monitoring are as good as those of continuous monitoring. On the basis of two patient populations with different interval monitoring frequencies (17% versus 6.4%) it was established that with high interval monitoring frequencies the perinatal results were poorer: early morbidity of the newborns was twice as high when interval monitoring was used more often (21.4% versus 10.8%) (p less than 0.0001). From this the authors conclude that for the sake of the child, continuous monitoring during labor ought not to be dispensed with. PMID- 3678791 TI - [Development of cancer (vulvar cancer) in the Netherton syndrome (ichthyosis, hair anomalies, atopic diathesis)]. AB - So far there has been only one incidence of a malignant tumour associated with Netherton's syndrome, a rare skin disease consisting of congenital ichthyosiform erythroderma, atopic dermatitis and trichorrhexis nodosa (bamboo hair). The aetiology and clinical consequences are discussed on the occasion of a carcinoma of the vulva occurring in a case of a patient with Netherton's syndrome, both phenomena being interlinked. PMID- 3678792 TI - [Presacral malignant schwannoma]. AB - In a woman patient who was 69 years of age and who was free from complaints and symptoms we identified a cystic solid and partly calcified tumour of 11 X 9 X 7 cm size in the lower abdomen, as well as two circular pulmonary foci that were suspected of being malignant. Clinical, sonographical and radiological findings led to the suspected diagnosis of a pulmonary metastasizing ovarian carcinoma. However, laparotomy revealed that the tumour site was presacral and retroperitoneal. The tumour was extirpated, and the histological diagnosis was that of a malignant schwannoma. No radiotherapy or chemotherapy was initiated because of the slender changes of success and the considerable side effects. Clinical pattern, problems of diagnosis and the prognosis of these rare malignomas are discussed. PMID- 3678793 TI - [Elastase of polymorphonuclear granulocytes. Determination in plasma in pregnancy and following premature rupture of the membranes]. AB - Between May and October 1984 in the Department of Obstetrics of the Frauenklinik Berlin-Neukolln, 147 blood samples were taken from 106 women who were pregnant or already in labor. The purpose was to determine the concentration of the elastase of the polymorphonuclear leukocytes. Towards the end of pregnancy (from the beginning of the 28th gestational week till birth of the child), the range of 66 ng/ml-122 ng/ml with a median of 92 ng/ml was considered normal. It was shown that the concentration of elastase in the plasma of pregnant women is affected neither by the increasing gestational age nor by such pregnancy-associated diseases as the following: fetal hypotrophy, cervix insufficiency, premature onset of labor, or gestational diabetes. In addition, the elastase concentration in pregnant women who had had a premature rupture of the membranes was determined. The values were compared with other clinical and laboratory infection parameters, such as temperature, the total number of leukocytes as well as the number of rod-shaped leukocytes, and the duration of the opening of the membranes. The results indicated that under 135 ng/ml, there is most likely no infection present. Elastase concentrations between 135 ng/ml and 180 ng/ml lie in the pre-pathological range, concentrations above 180 ng/ml nearly always indicate the presence of an infection. PMID- 3678794 TI - [Histologic endometrial findings in patients on the day of planned embryo transfer]. AB - Patients under study in a programme of in-vitro-fertilisation and regarded as "normocyclic" were divided into 3 groups, depending on prior therapy: Patients in group I received clomiphene for follicle stimulation, and for ovulation HCG. Those in group II received in addition HMG for follicle maturation. Those in group III received HMG and HCG. When sonographs revealed a mature follicle about to rupture and the serum oestradiol increased, the follicle was aspirated to collect the ova. In 34 patients either no ova could be obtained, or the ova collected could not be fertilised, or because the oestradiol levels fell, no follicle was aspirated. In these 34 patients a biopsy of the endometrium was obtained some time between the 11th to 21st day of the cycle and studied histologically. Only ten of the 34 patients had a normally functioning endometrium suitable for implantation. The remaining patients revealed functional disturbances ranging from insufficient secretion to deficient proliferation to atrophy. Six biopsies could not be evaluated (advanced atrophy?). The women in group III showed the best results. The poor results obtained in group I and II were related in part to the anti-oestrogenic effect of clomiphene. Aspiration of the follicle seemed to have no deleterious effect on the endometrium. Five of the male partners of the 10 patients with a normal endometrial histology had a pathologic spermiogram. As compared to the endocrinological parameters, the histological studies revealed a high rate of pathologic endometria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678795 TI - [Fertilization of human ova in capillary tubes with a very small number of spermatozoa. A new treatment possibility in severe oligospermia?]. AB - In contrast to the in vivo situation the current in vitro fertilization techniques require large numbers of spermatozoa per oocyte to achieve successful fertilization. In this study a culture system was developed in which successful fertilization was performed in haematocrit capillary tubes (75 mm length, 0.8-0.9 mm inner diameter) even if only low numbers of spermatozoa were used. Oocytes were fertilized in 5-10 microliters of different sperm suspension containing a total number of 500, 1000, 2000 and 4000 spermatozoa per oocyte (0.1-0.4 X 10(6) sperms/ml). In 10 patients participating in an in vitro fertilization programme 32 oocytes were fertilized in capillary tubes and 32 oocytes were cultured using standard methods (1 ml culture medium in tissue culture tubes, 0.1-0.2 X 10(6) spermatozoa/ml). The overall fertilization rate of oocytes cultured in tissue culture tubes was 78% (25/32) and the fertilization rates in capillary tubes using 4000, 2000, 1000 or 500 spermatozoa per oocyte were: 71% (5/7), 86% (6/7), 60% (6/10) and 50% (4/8), respectively. The fertilization rate of mature oocytes was higher compared to immature oocytes when fertilization was performed in culture tubes (83% and 63%) or in capillary tubes (74% and 44%). Fertilization in capillary tubes using a volume of the sperm oocyte suspension of 10 microliters compared to 5 microliters seems to provide better culture conditions resulting in higher fertilization and cleavage rates (75 and 91% versus 62.5 and 60%). These preliminary results indicate that fertilization of human oocytes under in vitro conditions can be achieved even with very low numbers of spermatozoa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3678796 TI - [Catamnestic study of 96 couples with heterologous insemination]. AB - 96 couples who had made an artificial insemination with donor sperm within 1968 and were interviewed in 1984, regardless whether the treatment was successful or not. The aim of the inquiry was to see how the partnership and the children developed as well as the actual feeling of the decision made. Three groups resulted which can be compared with each other: a) couples with successful treatment and children conceived by artificial insemination, b) couples with unsuccessful treatment by artificial insemination and consequent adoption of a child, c) couples with unsuccessful treatment by artificial insemination and without adoption of a child. 63 (65.6%) had at least one conception. 68 children were born to 55 couples. In the case of 9 men a normal conception took place after completion of the treatment. About 10% became divorced in the groups a and b and about 35% in group c. No couple regretted the treatment. The fathers of the divorced couples experienced themselves as fathers. The development of the children conceived in artificial insemination with donor sperm has not been showing any signs of unusual disturbances. PMID- 3678797 TI - [Surgical gynecologic interventions in 1 to 15-year-old girls]. AB - 1200 girls, aged between newborn to fifteen years, came to our outpatient department of children and adolescent gynecology, during the last seven years. 86 children (7%) had to be hospitalized. In the 86 young patients 111 operations were necessary; 36 operations had to be performed at the vulva, 33 at or through vagina and 42 intraabdominal. As expected the girls with operative interventions were older than the mean age of all our patients. Also juridical and psychological problems are discussed. PMID- 3678798 TI - [The sigmoid vagina: experiences in the treatment of congenital absence or later loss of the vagina]. AB - Construction of a neovagina by means of a pedicled sigmoid transplant is considered a successful and for the patient satisfactory method in congenital vaginal aplasia or loss of the vagina after radical cancer surgery in the pelvis. The operative procedure and the anatomical and functional results obtained in 23 patients treated by the author are reported and discussed. PMID- 3678799 TI - [Rupture of a cerebral angioma in pregnancy]. AB - A case of a ruptured intracranial angioma in the 27th week of pregnancy is presented. The diagnosis was ensured clinico-neurologically by lumbar puncture, cranial computerized tomography and carotid angiography. After neurosurgical intervention and appropriate therapy vaginal delivery occurred despite coma of the patient, in the 36th week of pregnancy. Two days post partum the patient awakened from her coma and was eventually released from hospital after an uneventful puerperium with only slight neurological symptom pattern. Following anticonvulsive therapy because of a grand mal attack, and complete regression of the neurological pattern of signs and symptoms, therapy was discontinued. PMID- 3678800 TI - [Clinico-hematological effect of spirobromin in chronic lympholeukemia amd malignant non-Hodgkin's lymphoma]. PMID- 3678801 TI - [Characteristics of the stock of intermediates of carbohydrate-lipid metabolism in the blood in alcoholic intoxication]. PMID- 3678802 TI - [Stability of stromal precursor cells of human bone marrow preserved under various conditions]. PMID- 3678803 TI - On the politics of madness: a preliminary analysis of the relationship between social roles and psychotherapy. AB - This study presents a brief account of a theory that argues that diagnostic categories of madness and their prototypes are equivalent to the fulfillment of the roles and role stereotypes of the status groups that tend to receive the diagnoses most often. Two studies provided tentative support for the theory. The results of the first study revealed that clinicians attributed to the stereotypes of various status groups precisely those diagnoses that the groups tend to receive. The second study revealed that undergraduates who were given diagnostic prototypes from the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (1980) (DSM-III) and were asked to predict the status characteristics of the persons described therein correctly reproduced well known epidemiological data. These results imply an intimate relationship between social and psychiatric taxonomies, and thus raise questions about the meaning of madness in our society. PMID- 3678804 TI - Residency education in for-profit general hospitals. AB - In May, 1983, when the new University of Louisville teaching hospital was opened under the auspices of Humana Corporation, it became the first university hospital operated by a for-profit corporation. We describe the agreement that launched this venture and summarize the experiences of the Department of Psychiatry and Behavioral Sciences with Humana, Inc., during the past 3 years. We review our impressions of both the positive and negative effects that the for-profit managing style has had thus far on the teaching programs of the Department. Based on our experiences, there are financial and other benefits, but we think that there are also potential dangers for the future of psychiatric education inherent in the administration of a teaching hospital by a for-profit corporation. The "atmosphere of business" that pervades the climate of opinion in the United States in the 1980s and is merely epitomized by the increasing role of enterpreneurial groups in medicine can be antithetical to principles of psychiatry and has implications for psychiatric education in the future. Awareness of these developments is a task for psychiatric education and, when it is possible, comparative studies of residents and their programs in nonprofit and for-profit hospitals should be conducted. PMID- 3678805 TI - Marketing consultation-liaison psychiatry. AB - Consultation-liaison (C-L) psychiatry has demonstrated its potential to serve as a significant interface between psychiatry and the rest of medicine in health care service delivery, academic teaching, and collaborative research. The extent to which that potential is not broadly acknowledged reflects the specialty's failure to communicate effectively the contributions C-L psychiatry has to offer to the general medical community. Marketing principles, which emphasize the importance of defining a product in terms attractive to carefully targeted consumers, evaluating and refining the product to ensure its continued acceptance and use by the market, and communicating the availability of the product, offer a means of fostering the visibility and utilization of C-L psychiatry toward the end of improved quality of care. PMID- 3678806 TI - Products of consultation-liaison psychiatry. AB - The products of consultation and liaison activities differ considerably and require distinct marketing strategies. Whereas consultation results directly in improved patient care, the products of psychiatric liaison typically consist of less easily measured changes in nonpsychiatric physicians' attitudes and skills. The difficulty of demonstrating the benefits of liaison psychiatry as presently conceived suggest that its future course lies in the active collaboration of liaison psychiatrists in specialized treatment programs. PMID- 3678807 TI - Segmenting and accessing the market in consultation-liaison psychiatry. AB - Although the importance of consultation-liaison (C-L) psychiatry is increasingly recognized, obstacles to acceptance of the specialty persist in many service delivery settings. These can be countered by identifying specific consumers of C L services and demonstrating that products of the specialty will meet consumers' needs. Once access to the market is gained, it is important to monitor potential sources of competition in the interest of ensuring continued high quality patient care. PMID- 3678808 TI - Communicating an effective message. AB - The increasing pervasiveness of "business" concerns in a cost-controlled medical care environment underscores the need to target communications regarding the operations of consultation-liaison (C-L) programs to the fiscal concerns of hospital and health care program administrators. Descriptions of what C-L programs have to offer should anticipate the specific interests of those who manage inpatient and ambulatory care programs and be phrased in terminology understandable by those managers. PMID- 3678809 TI - Appraisal of marketing approaches for consultation-liaison psychiatry. AB - The high prevalence of undetected and undertreated mental disorders in the general health care sector suggests that the active "marketing" strategies proposed in these articles are overdue. However, a more extensive data base that documents the need for psychiatric involvement in the medical setting and assesses the capacities of other mental health professionals to substitute for consultation-liaison (C-L) psychiatrists in clinical care, teaching, and research is urgently needed and will prove to be the most potent marketing tool available to the specialty. PMID- 3678810 TI - A study of inpatient referral patterns to a general hospital psychiatry unit in India. AB - The pattern of inpatient referral to a general hospital psychiatry department was examined in the present study. The referral rate of 3.6% was higher than those reported by other investigators from India. The majority of the patients had concurrent physical illness. Neurotic depression and alcohol dependence were the most frequent diagnoses. A diagnosis of schizophrenia was relatively infrequent. Among the patients referred for consultation, there was a high percentage of cases of self-inflicted injury and poisoning. Psychiatric disturbances were of transient nature in about one third of the cases. In about 20% of the cases, no physical illness was detected and their somatic complaints were considered to be psychologically determined. PMID- 3678811 TI - Postoperative hospital course of patients with history of severe psychiatric illness. AB - The postoperative hospital course of 54 patients with a past history of psychiatric illness was studied through chart review. Both chronic schizophrenics and chronic depressives tolerated surgical procedures well, without any unusual difficulties or exacerbation of psychiatric illness. They represented no management problems. Patients with acute, severe upset in the preoperative period (regardless of diagnosis) presented most of the management problems postoperatively. PMID- 3678812 TI - A comparison of depressed and anxious chronic pain patients. AB - This study compared 102 depressed pain patients and 41 anxious pain patients. Depressed pain patients were significantly more often older in age. Pain patients with anxiety disorder were more often younger and unemployed. There was no significant difference in the family psychiatric morbidity. Such a subdivision of chronic pain patients based on psychopathology could be useful for management purposes and for future research. PMID- 3678813 TI - Clothing: a comfort or a catastrophe? PMID- 3678815 TI - Care of the elderly dying patient. PMID- 3678814 TI - Screening the elderly: a neglected aspect of health visiting. PMID- 3678816 TI - Movement is life. PMID- 3678817 TI - Use it, or lose it--a physiotherapist's view. PMID- 3678818 TI - Getting to grips with pain. PMID- 3678819 TI - 'Being there'. PMID- 3678820 TI - Transabdominal, a dominant mutant of the Bithorax Complex, produces a sexually dimorphic segmental transformation in Drosophila. AB - Transabdominal (Tab), a dominant mutation in the Bithorax Complex (BX-C) of Drosophila, creates a sexually dimorphic pattern of segmental transformation that has complete penetrance and expressivity. Specific regions within the notum of the second thoracic segment (T2) are transformed into abdominal-like cuticle; thus, the Tab/ + notum has sets of short stripes that are black in males and only bordered with black in females. Also, Tab/ + abdominal tergites, A1-A6, inclusive, have small patches of A7-like tergite cuticle. Tab is inseparable from an 89E/90D inversion, whose DNA breakpoint in 89E is at +188 kb in the infra abdominal-8 (iab-8) region of the BX-C. When probed with a pupal cDNA from the iab-7 region, labeling above background was not detected in wild-type wing discs but was detected in, and confined to, the notal region of Tab/ + wing discs. The Tab/ + phenotype is assumed to result from cis-overexpression of iab-7 in localized regions of segments T2-A6, inclusive. PMID- 3678821 TI - Developmental and tissue-specific regulation of beta-tubulin gene expression in the embryo of the sea urchin Strongylocentrotus purpuratus. AB - Four beta-tubulin mRNAs in the embryo of the sea urchin Strongylocentrotus purpuratus are transcribed from at least 3 of the 9-12 beta-tubulin genes. A beta 1 tubulin mRNA of 1.8 kb, transcribed from a unique beta 1 gene, is expressed with high specificity in the pluteus ectoderm. Another 1.8-kb mRNA, beta 2, and a 2.5-kb beta 3 mRNA are moderately ectoderm specific. In contrast, a 3.0-kb beta 4 mRNA is highly specific for the endomesoderm tissue fraction. Certain similarities in developmental and tissue-specific expression suggest that these beta-tubulin genes may be related in their mode of regulation to counterparts among the genes for actin, another cytoskeletal protein. Measurements of absolute amounts revealed a distinct developmental profile for each beta-tubulin mRNA. An increase in the total amount of beta-tubulin mRNA in the early blastula was correlated with an increase in transcription rate per nucleus; whereas, later in the mesenchyme blastula stage, the beta-tubulin mRNA level decreased sharply as the rate of beta-tubulin gene transcription on a per embryo basis remained constant. Thus, during development through the blastula stages, there was a switch to a predominantly posttranscriptional regulation of beta-tubulin mRNA expression, probably through a decrease in mRNA stability. PMID- 3678822 TI - Investigation of chromosome-mediated gene transfer using the HPRT region of the human X chromosome as a model. AB - A panel of over 50 hybrid cells containing varying portions of the long arm of the human X chromosome have been obtained by chromosome-mediated gene transfer (CMGT) of human chromosomes to mouse cells deficient in HPRT. This panel is used to investigate the size and integrity of transfected human chromosome fragments and also to examine the effect of including a selectable DNA plasmid in the transfection mix. Chromosomal rearrangements are found to be generated in the chromosome transfer process, and the human X centromeric region is detected in the transfected cells at an unusually high frequency. Extensive lengths of X chromosome DNA are transferred intact, suggesting potential uses of CMGT in cloning large genes and loci for which only the chromosomal map position is known. PMID- 3678823 TI - Factors that interact with the rat albumin promoter are present both in hepatocytes and other cell types. AB - The rat albumin promoter inserted in adenovirus directs transcription in human and rodent hepatoma cells and in rodent hepatocytes (Friedman et al. 1986) and Babiss et al. (1986) but not in HeLa cells or myeloma cells. The nucleotides between -43 and -156 of the RNA start site of the rat albumin gene are required for this cell-specific expression. Protein binding studies (footprints, exonuclease III stops, and gel shifts) all indicate specific interaction in the 80 to -130 region of the gene with factors present in nuclear extracts of hepatocytes and hepatomas, but also from extracts of other cells that do not express the albumin gene. To observe albumin promoter binding, a smaller amount of extract of liver cell nuclei was required compared to extracts of HeLa cell or kidney cell nuclei. In addition, the various tests of DNA-protein interaction did not give qualitatively identical results with extracts from different cells. However, it seems clear that factors are present in several cell types where albumin genes are inactive that will bind to those DNA sequences demonstrated to be necessary for cell-specific expression of this gene. These factors could either be similar but nonidentical factors or the same factors that are modified differently in different cell types. PMID- 3678824 TI - An albumin enhancer located 10 kb upstream functions along with its promoter to direct efficient, liver-specific expression in transgenic mice. AB - Transgenic mice were used to locate the cis-acting DNA elements that are important for efficient, tissue-specific expression of the mouse albumin gene in the adult. Chimeric genes with up to 12 kb of mouse albumin 5'-flanking region fused to a human growth hormone (hGH) reporter gene were tested. Remarkably, a region located 8.5-10.4 kb upstream of the albumin promoter was essential for high-level expression in adult liver and the region in between -8.5 and -0.3 kb was dispensable. The far-upstream region behaved like an enhancer in that its position and orientation relative to the albumin promoter were not critical; however, it did not function well with a heterologous promoter. Two of four DNase hypersensitive sites found in the 5'-flanking region of the albumin gene map to the far-upstream and promoter regions; the others may reflect regions involved in developmental or environmental control of this gene. PMID- 3678825 TI - Nucleic acid splicing events occur frequently during macronuclear development in the protozoan Oxytricha nova and involve the elimination of unique DNA. AB - During its life cycle, the hypotrichous ciliated protozoan Oxytricha nova transforms a copy of its chromosomal micronucleus into a transcriptionally active macronucleus which contains exclusively linear, gene-sized DNA molecules with an average size of about 2.2 kilobase pairs (kbp). The micronuclear precursors of two macronuclear DNA molecules have been examined. Each was found to contain at least five blocks of DNA sequences that are absent in the mature macronuclear DNA molecule. These blocks of sequences, referred to as internal eliminated sequences (IESs), must be removed by a nucleic acid breakage and joining process during development. The data obtained to date indicate that IESs are common and suggest that greater than 60,000 IES removal events occur during macronuclear development. Additional analyses indicate that IESs represent a portion of the unique micronuclear DNA sequences known to be eliminated during development. Comparisons of the sequences of IESs revealed common organizational features and some limited primary sequence homologies that suggest models for their developmental excision. PMID- 3678826 TI - Post-transcriptional restriction of gene expression in sea urchin interspecies hybrid embryos. AB - The synthesis of many paternal species-specific proteins is reduced in all stages of sea urchin interspecies hybrid embryos, due to the reduced amounts of some paternal mRNA species in hybrid embryos compared with the embryos of the paternal species (Tufaro and Brandhorst 1982). Possible explanations for this restriction were tested. Cloned cDNAs were selected that were specific for paternal RNA sequences having reduced amounts (to 2-20% of normal) in hybrid embryos derived from a cross of Stronglyocentrotus purpuratus eggs with Lytechinus pictus sperm. Several of these RNA species are barely detectable in the eggs, but they accumulate extensively (5- to 40-fold) during L. pictus embryogenesis. Thus, the restricted expression of these paternal genes in hybrid embryos is not the result of the persistence of stable maternal mRNA species stored in eggs and not replaced by zygotic transcription. The accumulation of some of these L. pictus transcripts is also reduced in the reciprocal cross (L. pictus eggs X S. purpuratus sperm); therefore, the full expression of these L. pictus genes in hybrid embryos is not dependent on species-specific maternal factors stored in the egg. The transcriptional activity of one such gene was estimated using a run on assay in isolated nuclei; it is as actively transcribed in hybrid as it is in homospecific embryos, but in hybrid embryos the cytoplasmic transcript accumulates to only 2-15% of the normal level. Sequence analysis indicates that this gene encodes a metallothionein. Mechanisms are discussed that might account for the post-transcriptional restriction of expression of some genes in hybrid embryos. PMID- 3678827 TI - Activation and repression of mammalian gene expression by the c-myc protein. AB - One mechanism by which nuclear-localized oncogenes might transform cells is through an ability to regulate gene expression. We show that the c-myc protein stimulates the level of appropriately initiated expression from the human heat shock protein 70 (hsp70) promoter. Sequences required for full activation lie upstream of the transcription initiation site and are distinct from sequences necessary for basal expression. These sequences also appear distinct from promoter sequences necessary for heat induction, serum induction, and induction by the papovavirus T antigens. The c-myc protein inhibits appropriately initiated expression from the mouse metallothionein I (MT-I) promoter. A mutation that removes 138 amino acids of exon 2 produces a c-myc gene product that is capable of activating the hsp70 promoter but is no longer capable of inhibiting MT-I expression, suggesting that these two properties reside in different domains of the c-myc protein. Expression from the adenovirus EII promoter is slightly inhibited, while expression from the SV40 early promoter is minimally affected by the c-myc protein. Both the spectrum of promoters regulated by the c-myc protein and the sequence requirements for that regulation differ from those of previously characterized viral trans-activating proteins. The data suggest that the c-myc protein can both stimulate and inhibit transcription from mammalian promoters in a novel manner. PMID- 3678829 TI - The lin-14 locus of Caenorhabditis elegans controls the time of expression of specific postembryonic developmental events. AB - The lin-14 locus of Caenorhabditis elegans plays an important role in specifying the normal timing and sequence of developmental events in the lateral hypodermal cell lineages. The results of gene dosage, complementation, and temperature-shift experiments indicate that the fates expressed by cells at successive stages of these cell lineages are specified by the level of lin-14 activity and that lin-14 acts at multiple times during development to control stage-specific choices of cell fate. Our observations suggest that during normal development a reduction in the level of lin-14 gene function causes the sequential expression of stage specific cell fates. PMID- 3678828 TI - Deletion and duplication of DNA sequences is associated with the embryonic lethal phenotype of the t9 complementation group of the mouse t complex. AB - We have analyzed the genomic structure of three mouse t haplotypes of the t9 complementation group. Each of these t haplotypes, tw18, t4, and tks1, is known to have resulted from a rare recombination event between a complete t haplotype and a wild-type chromosome. Using molecular probes that identify sequences in the distal portion of the t complex, we have shown that each of these t haplotypes contains a similar (perhaps identical) deletion of one group of t complex sequences, and duplication of another group. These data suggest that the recombination events that produced these three t haplotypes involved similar unequal crossovers within the distal inversion. The deletion and duplication of genetic material associated with all members of the t9 complementation group tested provides a molecular explanation for the recessive lethal mutation associated with these t haplotypes. PMID- 3678830 TI - Transcript levels and translational control of hsp70 synthesis in Xenopus oocytes. AB - Until recently it was believed that Xenopus oocytes respond to heat shock by synthesizing the 70-kD heat shock protein hsp70 and that, uniquely amongst animal cell types, this response is mediated entirely at the translational level. This view has now been challenged and we present data that reevaluate the involvement of translational control in the heat shock response of Xenopus oocytes. RNase mapping shows that up to 13 pg of hsp70A and hsp70B mRNA are accumulated by fully grown oocytes in the absence of heat shock. These transcripts are retained stably during maturation, fertilization, early cleavage, and following heat shock. However, no hsp70 protein synthesis can be detected by two-dimensional polyacrylamide gel analysis of [35S]methionine-labeled proteins from completely defolliculated oocytes, either before or during heat shock. Oocytes injected with hsp70A DNA rapidly accumulate high levels of hsp70 mRNA in their cytoplasm at normal temperature. During heat shock these oocytes accumulate more transcripts, but they remain in the nucleus and cytoplasmic levels remain constant. Translation of hsp70 from these transcripts is readily detectable at non-heat shock and heat shock temperatures. We conclude that (1) "exogenous" hsp70 transcripts are efficiently translated and not masked at normal temperatures in oocytes, and (2) oocytes are able to selectively translate hsp70 mRNA during heat shock. PMID- 3678831 TI - Isolation and characterization of the active cDNA of the human cell cycle gene (RCC1) involved in the regulation of onset of chromosome condensation. AB - The human RCC1 gene was cloned after DNA-mediated gene transfer into the tsBN2 cell line, which shows premature chromosome condensation at nonpermissive temperatures (39.5-40 degrees C). This gene codes for a 2.5-kb poly(A)+ RNA that is well conserved in hamsters and humans. We isolated 15 cDNA clones from the Okayama-Berg human cDNA library, and found two that can complement the tsBN2 mutation with an efficiency comparable to that of the genomic DNA clone. The base sequences of these two active cDNA clones differ at the 5' proximal end, yet both have a common open reading frame, encoding a protein of 421 amino acids with a calculated molecular weight of 44,847 and with seven homologous repeated domains of about 60 amino acids. This human RCC1 gene was located to human chromosome 1 using sorted chromosomal fractions. PMID- 3678832 TI - Complete structure of the human transferrin gene. Comparison with analogous chicken gene and human pseudogene. AB - The complete structure of the human transferrin gene is presented. This gene has a total size of about 33.5 kb and is organized in 17 exons separated by 16 introns. The chicken ovotransferrin gene has a size of 10.5 kb and is also organized in 17 exons and 16 introns. The analysis of the structure of the two genes confirm, at the gene level, that transferrins originated by a gene duplication phenomenon. Finally, the existence of a new member of the transferrin family, a human transferrin non-processed pseudogene is demonstrated. PMID- 3678833 TI - Genomic organization and primary structure of five homologous pairs of intron less genes encoding secretory globins from the insect Chironomus thummi thummi. AB - From a Chironomus thummi thummi genomic library we have isolated two distinct recombinant phages, CttG-1 and CttG-3, each carrying a cluster of five homologous globin genes. In addition to the previously reported nucleotide sequence of globin gene D (Antoine and Niessing, 1984) we present the chromosomal arrangement, primary structure and predicted amino acid sequence of nine globin genes. The divergently transcribed globin genes all lack introns, they encode secretory preglobins each containing a highly conserved signal peptide. The amino acid sequences deduced from the globin genes correspond to globin III and variants thereof, to globin IV, and to a novel globin, whose direct amino acid sequence has not yet been reported. PMID- 3678834 TI - Construction and characterization of cDNA clones encoding the 5' end of the chicken pro alpha 1(I) collagen mRNA. AB - As a first step in isolating the 5' end of the chicken pro alpha 1(I) collagen gene, we constructed cDNA clones complementary to the 5' end of the pro alpha 1(I) mRNA using synthetic oligodeoxynucleotides complementary to a conserved region within the N-terminal telopeptide as primers. cDNA clones corresponding to the 5'-untranslated region, signal peptide, N-propeptide and telopeptide were identified based on homology with the human pro alpha 1(I) collagen protein sequence, and on hybridization to pro alpha 1(I) mRNA on Northern blots. A comparison of the nucleotide sequence of these clones with the sequence of the 5' end of the pro alpha 2(I) collagen mRNA confirms that there is 84% homology in a 49-bp region surrounding the translation start point, and shows that there is 70% homology in the nucleotide sequences encoding the N-propeptide triple helical region of the two type-I collagen chains. PMID- 3678835 TI - Complete nucleotide sequence of the chicken alpha A-crystallin gene and its 5' flanking region. AB - The chicken alpha A-crystallin gene and 2.6 kb of its 5' flanking sequence have been isolated and characterized by electron microscopy and sequencing. The structural gene is 4.5 kb long and contains two introns, each approx. 1 kb in length. The first intron divides codons 63 and 64, and the second intron divides codons 104 and 105, as in rodents. There is little indication that the insert exon of rodents (an alternatively spliced sequence) is present in complete form in the chicken alpha A-crystallin gene; small stretches of similarity to this sequence were found throughout the gene. The 5' flanking sequence of the chicken alpha A-crystallin gene shows considerable sequence similarity with other mammalian alpha B-crystallin genes. In addition, one consensus sequence (GCAGCATGCCCTCCTAG) present in the 5' flanking region of the chicken alpha A crystallin gene was found in the 5' flanking region of most reported crystallin genes. PMID- 3678836 TI - Unusual genetic codes and a novel gene structure for tRNA(AGYSer) in starfish mitochondrial DNA. AB - The nucleotide sequence of a 3849-bp fragment of starfish mitochondrial genome was determined. The genes for NADH dehydrogenase subunits 3, 4, 5, and COIII, and three kinds of (tRNA(UCNSer), tRNA(His), and tRNA(AGYSer) were identified by comparing with the genes of other animal mitochondria so far elucidated. The gene arrangement of starfish mitochondrial genome was different from those of vertebrate and insect mitochondrial genomes. Comparison of the protein-encoding nucleotide sequences of starfish mitochondria with those of other animal mitochondria suggested a unique genetic code in starfish mitochondrial genome; both AGA and AGG (arginine in the universal code) code for serine, AUA (isoleucine in the universal code but methionine in most mitochondrial systems) for isoleucine, and AAA (lysine) for asparagine. It was also inferred that these AGA and AGG codons are decoded by serine tRNA(AGYSer) originally corresponding to AGC and AGU codons. This situation is similar to the case of Drosophila mitochondrial genome. Variations in the use of AGA and AGG codons were discussed on the basis of the evolution of animals and decoding capacity of various tRNA(AGYSer) species possessing different sizes of the dihydrouridine (D) arm. PMID- 3678837 TI - Analysis of a human gene cluster coding for tRNA(GAAPhe) and tRNA(UUULys). AB - A 13.8-kb fragment of human DNA isolated from a human lambda Charon-4A DNA library was found to contain four human tRNA genes. Nucleotide sequence analysis of approx. 3.7 kb of this segment of human DNA identified two lysine tRNA(UUU) genes identical in coding sequence to a previously reported human lysine tRNA gene [Roy et al., Nucl. Acids Res. 10 (1982) 7313-7322]. The other two tRNA genes were phenylalanine tRNA(GAA) genes, the first to be isolated from a mammalian source. These phenylalanine tRNA(GAA) genes were identical in sequence with the exception of a G/A polymorphism at coordinate 57. None of these tRNA genes contains introns. The tRNA(UUULys) and tRNA(GAAPhe) genes are organized in alternating order and are irregularly spaced, by intergenic regions of approx. 1.0, 2.6 and 5.0 kb, and randomly oriented. There was no evidence to indicate that any of these genes arose by gene duplication, since flanking sequence homology was limited to the putative RNA polymerase III termination signals in the 3'-flanking regions. A mature tRNA-sized product was identified following the transcription of each tRNA gene in a homologous in vitro transcription system. Interestingly, different levels of transcriptional activity of the three identical lysine tRNA genes were observed, suggesting modulation of tDNA expression by extragenic sequences. In addition, a minimum of eight regions of homology to Alu-type repetitive elements were detected in this human DNA fragment, one of which was located 53 bp upstream from a tRNA(GAAPhe) gene. PMID- 3678838 TI - Splicing of plant pre-mRNAs in animal systems and vice versa. AB - To investigate similarities and differences of pre-mRNA splicing between higher plants and animals, we tested whether pre-mRNAs of higher plants can be accurately spliced in animal systems, and whether an animal pre-mRNA can be spliced in plant cells. Pre-mRNAs of the maize bronze locus and oat phytochrome type 3 are accurately spliced with moderate efficiency in a human (HeLa cell) nuclear extract. The first intervening sequence (IVS1) of bean phaseolin pre-mRNA is not excised in the human nuclear extract, but is removed (although at low efficiency) in intact monkey cells. However, the IVS1 of human alpha-globin pre mRNA is not removed in tobacco cells. Our data suggest that the mechanisms of pre mRNA splicing are similar, but not identical, in plants and animals. PMID- 3678839 TI - A simple and efficient liposome method for transfection of DNA into mammalian cells grown in suspension. AB - For a highly efficient plasmid transfection into mammalian cells grown in suspension, DNA was entrapped in liposomes prepared by the phosphatidylserine calcium-induced fusion method. Employing this technique, a transfection efficiency of about 2% was achieved, with 22 tk+-transformants obtained from 10(3) of mouse mammary carcinoma FM3Atk- cells transfected with a plasmid carrying the thymidine kinase (tk+) gene of the Herpes simplex virus. As compared with a previous report [Ayusawa et al., J. Biol. Chem. 258 (1983) 48-53], this transfection method was more than four orders of magnitude higher than the calcium phosphate method used for FM3Atk- cells. It was shown that the tk+ gene was integrated into the chromosomal DNA and was expressed in all the tk+ transformant clones tested. The described method could be applied to various types of DNA and cells, including those grown as monolayers. PMID- 3678840 TI - Mental dysfunction as a sign of organic illness in the elderly. AB - Organic illness in the elderly can often present with psychiatric signs and symptoms such as anxiety, agitation, depression, mania, paranoia, delusions, hallucinations, and changes in cognitive function. The prototypes of three such diseases--B12 deficiency, hypothyroidism, and normal pressure hydrocephalus are discussed. Specifically addressed are the neuropsychiatric manifestations of these diseases and the need for a thorough and continuing evaluation of patients presenting with mental dysfunction, in order to ensure an accurate and timely diagnosis. It is only through the recognition that these symptoms may represent non-psychiatric organic disease that early treatment can be implemented and symptoms potentially reversed. PMID- 3678841 TI - Diabetic retinopathy: recommendations for primary care management. AB - Diabetic retinopathy is a major cause of vision loss in the elderly, yet it is questionable whether sufficient cases are being diagnosed promptly enough for optimal therapy. The authors summarize the salient features in the development and progression of diabetic retinopathy, review the effectiveness of therapy, and discuss physician performance in conveying this therapy to diabetic patients. The authors emphasize the role of primary care in the referral of these patients. PMID- 3678842 TI - Sleep disorders in the elderly: rationale for clinical awareness. AB - Complaints about sleep are extremely common in the elderly, leading to an impression that aging-related sleep problems are virtually normal and benign. However, studies have shown that such complaints as habitual snoring, frequent awakening, nocturnal sweating, and awakening with anxiety, may be signs of genuine sleep disorders. The most prevalent and most serious aging-related sleep disorder is sleep apnea. There is recent evidence of an association between sleep apnea and circulatory disorders, including hypertension, stroke, and angina pectoris, and with reduced life expectancy. The older sleep apnea victim may not complain of daytime sleepiness, the usual symptom in younger patients. Sleep apnea, and several other sleep disorders of the elderly are treatable, once an accurate diagnosis is made. Physicians are urged to make questions about sleep as routine as the taking of blood pressure. PMID- 3678843 TI - Glucose flux through the hexose monophosphate shunt and NADP(H) levels during in vitro ageing of human skin fibroblasts. AB - In cultured human skin fibroblasts the glucose flux through the hexose monophosphate shunt (HMS) amounts to 4% of the glucose flux through the glycolytic pathway. Upon in vitro ageing the rate of glucose utilization through the HMS is decreased more than 50%. This decrease in HMS was not caused by a limiting enzymatic capacity since glucose utilization through the HMS could be raised at least 30-fold in both 'young' and 'aged' fibroblasts upon stimulation with phenazine methosulphate. This effect of in vitro ageing upon glucose metabolism was also not due to differences in proliferation rate between 'young' and 'aged' human fibroblasts, since there was no difference in glucose utilization between proliferating and growth-inhibited (confluently cultured) fibroblasts. The NADPH/NADP ratio was found to be decreased by 12% in 'aged' cells. PMID- 3678844 TI - Age- and function-related change in the quantity of high mobility group protein in chick oviduct. AB - We describe the investigation of the content of chromosomal high-mobility group 1 (HMG1) protein in three cellular fractions (cytosol, microsomal, and nuclear) of the magnum and shell gland of young and aged hen oviducts. In the magnum of the aged hen oviduct, the amount of the HMG1 protein (microgram protein/mg DNA) in the three fractions was 9.3 +/- 1.1, 0.18 +/- 0.03, and 2.4 +/- 0.4, respectively. Whereas the values were 11 +/- 1.2, 0.27 +/- 0.08, and 4.2 +/- 0.4, respectively, for the young hen. 12, 50, and 43% less were found in the aged hen magnum. In the shell gland of the functionally active hen oviduct, the protein in the three cellular fractions was 8.6 +/- 1.05, 0.42 +/- 0.06, and 3.9 +/- 0.55, respectively. In the shell gland of the functionally inactive aged hen, the values were 8 +/- 1.05, 0.28 +/- 0.09, and 0.85 +/- 0.12, and in the inactive shell gland of the young hen, they were 7.6 +/- 1.0, 0.27 +/- 0.09, and 1.75 +/- 0.22, respectively. The most significant difference was in the nuclear fraction, where the HMG1 protein in the functional hen shell gland was 123-359% higher than that of the inactive ones. PMID- 3678845 TI - Supraacetabular and femoral head stress fracture during fluoride treatment. AB - A woman treated with fluoride for corticosteroid-induced osteoporosis presented 1 year later with an unusual localized supraacetabular followed by a same-sided femoral head fracture. Fluoride was increased in serum and urine. Transiliac bone biopsy revealed typical bone fluorosis with elevated trabecular bone fluoride. PMID- 3678846 TI - Phenol block in the treatment of spasticity. AB - Injection of dilute phenol to peripheral nerves or motor block areas when there is spasticity, can, by damage to the nerves or motor areas, relieve the spastic condition, allow better nursing care, free the patient from the embarrassment of a contorted limb and may allow voluntary movement to take place. PMID- 3678847 TI - Thrombolytic therapy in acute myocardial infarction in the elderly. AB - Fifty-seven elderly patients (35 males, 22 females; age range 65-80 years, mean 70 years) with acute myocardial infarction received thrombolytic therapy within 8 h using either streptokinase or anisoylated plasminogen streptokinase activator complex. Coronary artery reperfusion was confirmed by early coronary arteriography. The overall reperfusion rate was 77%. Accurate non-invasive markers of reperfusion included: a rapid fall in the S-T segment elevation, an early peak of the creatinine phosphokinase enzyme curve and reperfusion arrhythmias. Clinical events suggesting early reocclusion occurred in 30%. Coronary arteriography was accompanied by local bleeding associated with the arterial puncture site in 2 patients and a cerebrovascular accident in 1 patient. Minor bleeding occurred in 6 other patients. In those where reperfusion occurred, the mortality at 1 month was 6.6% and in those who did not reperfuse or had early reocclusion 38%. At 1 year the figures were 10 and 46%, respectively. PMID- 3678848 TI - Function of the diabetic retina after panretinal argon laser coagulation. AB - Panretinal photocoagulation has been demonstrated to have a beneficial effect on the natural history of diabetic retinopathy. However, it is associated with detectable loss of retinal function. To determine the best coagulation technique we conducted a prospective study in 32 eyes of 16 patients. We investigated retinal function in relation to spot size and scatter density after panretinal laser coagulation. One eye was treated with approximately 400 comparatively large laser spots (0.6-0.8 mm diameter), whereas the fellow eye was coagulated with approximately 1500 small spots (0.2-0.4 mm diameter), so that the total coagulated area was almost the same in both eyes. Subjective parameters (visual acuity, perimetry, dark adaptation, photostress), as well as objective functions (electroretinogram, ERG; electro-oculogram, EOG), were studied preoperatively and then postoperatively over a time span of 6 months. Pronounced impairment of retinal function was detected, which recovered after 3 months on the average. When the pairs of eyes were compared, persistent visual field scotomas as detected by computerized static perimetry, occurred less frequently in eyes subjected to small coagulation spots, although this tendency was not statistically significant. PMID- 3678850 TI - 5-Fluorouracil for trabeculectomy in glaucoma. AB - The effect of 5-fluorouracil (5-FU) subconjunctival injection on the bleb formation and intraocular pressure (IOP) following trabeculectomy was studied in 18 glaucoma patients (20 eyes) with poor surgical prognosis. The results were analyzed by means of life tables and compared with those of 24 glaucoma eyes that had undergone trabeculectomy without postoperative administration of 5-FU after a previous repeat trabeculectomy that had failed. The surgical techniques and postoperative care were virtually identical between the eyes treated with 5-FU and eyes that had undergone repeat trabeculectomy, except that the latter group did not receive 5-FU postoperatively. At the end of 18-month follow-up, the success probability was 68.2% in the 5-FU treated eyes, and it was already as low as 10% in the nontreated eyes at the end of the 14-month follow-up. The difference was statistically highly significant (P less than 0.001). Postoperative, subconjunctival injection of 5-FU appears to improve the prognosis following trabeculectomy in patients with a poor surgical prognosis. PMID- 3678849 TI - Neuronal ceroid lipofuscinosis. Ocular histopathologic and electron microscopic studies in the late infantile, juvenile, and adult forms. AB - Diagnosis of the neuronal ceroid lipofuscinoses (NCLF), a group of recessively inherited neurolipidoses, must rely on clinical as well as light and electron microscopic histopathologic findings, as a precise biochemical defect has not yet been identified. We have studied the eyes from two patients with the late infantile and juvenile forms of the disease. On electron microscopy, we observed, almost exclusively, inclusions with curvilinear profiles in the late infantile type, while multimembranous and curvilinear bodies were seen in juvenile NCLF. In both forms of the disease, retinal destruction seems to start at the photoreceptor and outer retinal levels and progresses from the macular area to the periphery. Conjunctival biopsy is helpful in the diagnosis of these disorders, as demonstrated in the adult case presented here. PMID- 3678851 TI - Dexamethasone and indomethacin attenuate cryopexy. Induced breakdown of the blood retinal barrier. AB - Pigmented rabbits were pretreated for 3 days with dexamethasone (0.4 mg/kg) or indomethacin (6 mg/kg tid) and then, along with control rabbits, treated with cryopexy administered to the peripheral retina. Drug treatment was continued for the duration of the study. Vitreous fluorophotometry (VFP) was performed prior to cryopexy and on postcryopexy days 3 and 7. Breakdown of the blood-retinal barrier occurred in all three groups but was significantly greater in the control group. Differences were most marked on postcryopexy day 7 when intravitreous fluorescein leakage was decreased to 36% of control in dexamethasone-treated rabbits and 42% of the control group in indomethacin-treated rabbits. Some rabbits, after dexamethasone or indomethacin treatment for 3 days, were given a single posterior cryoapplication just inferior to the optic nerve. On postcryopexy days 1, 3, 7, and 10, VFP was performed by scanning over the treated area. In control rabbits, fluorescein leakage increased over 3 days, while in dexamethasone- and indomethacin-treated rabbits, this increase was significantly blunted. These data demonstrate the beneficial effects of dexamethasone and indomethacin on cryopexy induced breakdown of the blood-retinal barrier and also suggest a possible mechanism for how such a breakdown occurs. PMID- 3678852 TI - Origin of simple glial epiretinal membranes in an animal model. AB - Severe vitreous hemorrhage was simulated by the injection of 0.2 ml fresh uncoagulated autologous blood into the vitreous cavity of eight rabbits. Four weeks later, hemoglobin released from lysis of the original intravitreal clot had formed a thick layer on the retina. At this stage, many macrophages were conspicuous on the retinal surface and, in addition, in seven of the eight eyes, small cellular membranes were found by scanning electron microscopy. Light and transmission electron microscopy showed these membranes to be derived from accessory glial cells and their progeny. The membranes resembled the simple epiretinal membranes that occur in human eyes. PMID- 3678853 TI - Release and elimination of methylmethacrylate monomer after intraocular lens implantation. AB - The potential for certain constituents in intraocular lenses, such as monomer methylmethacrylate (MMM), to induce toxic effects after intraocular implantation not only depends on their toxic potency, but also on the characteristics of their release, accumulation, and elimination from the aqueous humor. A mathematical estimation taking these factors into account shows that for a lens mass of approximately 15 mg, the concentration of MMM in the aqueous humor amounts to about 10(-4) of the respective concentration in the lens, but that value is maintained for several weeks. Therefore, experiments to test the chemical toxicity of MMM or similar lens compounds in eyes must not only take into account the actual concentration limit but also the time of exposure to the substance. PMID- 3678854 TI - Electrophysiological assessment of the human depth-perception threshold. AB - The cortical response to stereoscopic stimuli was measured as a function of disparity using visual evoked potentials (VEP). The stereoscopic stimulus consisted of a dynamic random-dot pattern that portrayed a three-dimensional horizontal grating. Disparity of the grating was variable between 0 and 18 arc min, step size being 4.22 arc s. Evoked responses were recorded using a "random sequence sweep technique." The VEP amplitude increased approximately linearly with the logarithm of disparity and allowed an estimation of the stereo threshold by linear extrapolation. The evoked potential estimates of the stereo threshold of 16 subjects were compared to psychophysically obtained thresholds. Several threshold-estimation techniques are discussed. Evoked potential and psychophysical threshold estimates had the lowest discrepancy when the VEP amplitude was linearly extrapolated to the logarithmic disparity axis. The difference between the evoked potential estimate and the psychophysical threshold was less than 20% in 56% of all cases; 16 of 18 cases (89%) agreed within a factor of 2. PMID- 3678855 TI - Number, shape, and topography of leakage points in acute type I central serous retinopathy. AB - The evaluation of 430 consecutive eyes (87.5% from male, 12.5% from female patients) showed a leakage point with uniform dye spread in 93%. In 7%, a smoke stack phenomenon was observed. The number of leakage points reached from 1 (71.6%) to 7 (0.2%). Most leakage points were found in a 1-mm-wide ring-shaped zone starting 0.5 mm from the center of the fovea. Beyond this zone the incidence dropped rapidly with the exception of the upper nasal quadrant. Of the leakage points, 33.2% were located in the upper nasal, 21.2% in the lower nasal, 19.0% in the upper temporal, and 14.8% in the lower temporal quadrant. Leakage points occurred more than 3 mm away from the center of the fovea in 11.8%. The papillomacular bundle contained 25.4% of the leakage points. Leakage points in recurrences were located within 1 mm of the primary leakage point in 80% of the cases. PMID- 3678856 TI - Vitreous fluorophotometry in patients with cataract surgery. AB - Cystoid macular edema frequently complicates recovery from cataract surgery. Our understanding of this disease would be enhanced by more sensitive and quantitative methods to evaluate it. We performed vitreous fluorophotometry in 66 nondiabetic patients who had recently undergone cataract surgery. Eyes with definite macular edema on fluorescein angiography were ranked according to the severity of the leakage. The rank of the leakage correlated significantly with the vitreous fluorophotometry values (P less than 0.01). The mean fluorophotometry result in the eyes with cystoid macular edema was greater than that in the phakic, control group (P less than 0.01). However, eyes with minimal or no leakage visible on fluorescein angiography had fluorophotometry values indistinguishable from normal. The quantitative vitreous fluorophotometry results provided an indicator of cystoid macular edema that may prove useful in following this problem and evaluating therapy for it. PMID- 3678857 TI - The physical and surgical aspects of silicone oil in the vitreous cavity. AB - Silicone oil inside the vitreous cavity exerts forces on to the retina as a result of buoyancy, volume displacement, and surface tension. Surface tension rather than viscosity is the key to understanding why the oil seals retinal breaks effectively. The physics of the tamponade was studied quantitatively. Retinal traction can be counteracted by the oil up to a calculated threshold value, depending on the size and shape of the tear, the strength of the surface tension and, most importantly, the distance between the retina and choroid. For a nearly flat retinal hole, the tamponade is very effective. These theoretical results imply straightforward rules for surgery, rules that have been tested in 150 operations. An attempt must be made to fill 100% of the vitreous cavity. Since the air-water boundary has 3 times the surface tension of the water-oil boundary, the most effective procedure is to flatten the retina by means of a fluid-gas exchange and then clamp it in a flat position, implanting the silicone oil. Silicone in the subretinal space or the anterior chamber tends to retract spontaneously, for surface tension causes the smaller bubble to blow up the larger one. Surgical methods are described to make use of it. PMID- 3678858 TI - A comparative study between the PAM and the laser interferometer in cataracts. AB - We conducted a prospective study on 35 consecutive eyes undergoing cataract extraction to compare the Guyton-Minkowski Potential Acuity Meter (PAM) and the Laser Interferometer (LI) in determining potential visual acuity. The eyes were divided into: group A, which had good visualization of optic disc details, and group B, whose media allowed only disc outline or less to be seen. We found that in group A eyes, both instruments were reliable (with accuracies of 94% for the PAM and 88% for the LI). However, in group B eyes (advanced cataracts), both instruments were unreliable (accuracies of 33% for the PAM and 53% for the LI). Interestingly, in a subgroup of high myopes (axial length greater than 29 mm) with moderate cataracts and poor visual acuties, both instruments were very reliable and helpful in determining how much of the vision loss was due to the cataracts. We therefore strongly recommend potential acuity testing in high myopes with moderate cataracts and poor visual acuity. PMID- 3678859 TI - [Experimental study of the body's metabolic reactions under different levels and durations of nitrosodimethylamine exposure]. PMID- 3678860 TI - [Measures for protecting workers from exposure to electromagnetic fields during low-frequency induction heating of metal]. PMID- 3678861 TI - [Combined action of furadan, high temperature and excessive ultraviolet irradiation in a chronic experiment]. PMID- 3678862 TI - [Hygienic evaluation of supplementary protein sources]. PMID- 3678863 TI - [Comparative sanitary chemistry evaluation of the heat resistance of organosilicon polymeric materials intended for use in the food industry]. PMID- 3678864 TI - [Statistical characteristics of radiation control data]. PMID- 3678865 TI - [Data for correcting academic material acquired by students of a therapeutics faculty in a department of general hygiene]. PMID- 3678866 TI - [Methodological aspects of the hygienic standard for metal compounds in the atmosphere over populated locales]. PMID- 3678867 TI - [Rapid assessment of the action of water-soluble chemical compounds on the cardiovascular system in an experiment]. PMID- 3678868 TI - [Integral evaluation of working conditions]. PMID- 3678869 TI - [Comparative evaluation of different methods for studying the cumulative properties of hazardous substances]. PMID- 3678870 TI - [Means for developing the principle of probability in the concept of maximum permissible and actual loads]. PMID- 3678871 TI - [Outlook for using emission spectral analysis and the method of quasiline spectra in the hygienic evaluation of polluting components of ship discharges and of substances in the water environment]. PMID- 3678872 TI - [Dynamic assessment of the degree of atmospheric pollution]. PMID- 3678873 TI - [Quantitative evaluation of the functioning of the muscle system of schoolchildren in hygiene research]. PMID- 3678874 TI - [Methodology of the hygienic evaluation of mixtures of hazardous substances]. PMID- 3678875 TI - [Means of improving and increasing the efficiency of state health inspection for protecting the health of the rural population]. PMID- 3678876 TI - [Experience with the hygienic assessment of the design of irrigation systems and other reclamation projects in the central Don Basin]. PMID- 3678877 TI - [Photochemical transformation of discharges into the atmosphere from the manufacture of butyl alcohols and 2-ethylhexanol]. PMID- 3678878 TI - [Dynamics of the health and nutritional status of pupils in boarding schools]. PMID- 3678879 TI - [Hygienic evaluation of the state of the air over population centers in the central part of the Baikal-Amur mainline]. PMID- 3678880 TI - [Methodological characteristics of an analysis of the relation of the visits of a population to a medical first aid station with the weather conditions and atmospheric pollution]. PMID- 3678881 TI - [Effect of different motor regimens on the function of the locomotor apparatus and cardiovascular system of preschool children]. PMID- 3678882 TI - [Cytogenetic examination of workers in the chemical and pharmaceutical industries]. PMID- 3678883 TI - [Use of rapid dispersion analysis in the initial stage of hygienic research]. PMID- 3678884 TI - [Carcinogenic compounds in combustion products, grass meal and granules in relation to the conditions of drying plant raw materials]. PMID- 3678885 TI - [Gonadotoxic activity of glycols]. PMID- 3678886 TI - [Effect of a low-frequency electrical field on the generative function of animals]. PMID- 3678887 TI - [Hygienic evaluation of rubbers intended for the manufacture of wet suits]. PMID- 3678888 TI - [Potential late sequelae of the action of synthetic detergents]. PMID- 3678889 TI - Interprofessional relationships in geriatrics: ethical and legal considerations. PMID- 3678890 TI - Multidisciplinary team care of the elderly: the role of the psychiatrist. PMID- 3678891 TI - Aging differently. PMID- 3678892 TI - Employment services for older job seekers: a comparison of two client-centered approaches. PMID- 3678893 TI - Reminiscence groups for community elderly. PMID- 3678894 TI - Team assessment of geriatric mental patients: the care of functional dementia produced by hysterical behavior. PMID- 3678895 TI - Effective comprehensive discharge planning for hospitalized elderly. PMID- 3678896 TI - An off-site day treatment program for mentally impaired nursing home residents. PMID- 3678897 TI - Group therapies for nursing home adults: an evaluation of two treatment approaches. PMID- 3678898 TI - An examination of the early impact of bereavement on psychological distress in survivors of suicide. PMID- 3678899 TI - The role of social support in the first two years of bereavement in an elderly sample. PMID- 3678900 TI - Depressive symptoms among younger and older couples. PMID- 3678901 TI - Future time perspective, past experiences, and negotiation of food use patterns among the aged. PMID- 3678902 TI - Role strain in mother-daughter relationships in later life. PMID- 3678903 TI - Ethical concerns of family caregivers to dementia patients. PMID- 3678904 TI - Older rural natural helpers: gender and site differences in the helping process. PMID- 3678905 TI - Current legislation concerning life care and continuing care contracts. PMID- 3678906 TI - Religion, aging, and life satisfaction: an eight-year, three-wave longitudinal study. PMID- 3678907 TI - Trends in arrests among the elderly. PMID- 3678909 TI - [Current problems of the theory of safe levels of chemicals]. PMID- 3678908 TI - The factor structure of the Facts on Aging Quiz. PMID- 3678911 TI - [Hygienic evaluation of the effect of fungi on the health of workers renovating buildings]. PMID- 3678910 TI - [Effect of chemical factors related to the use of polyvinyl chloride linoleum in finishing work on health status indicators of builders and finishers]. PMID- 3678912 TI - [Histamine-dependent reactions in occupational allergic bronchial asthma of chemical etiology]. PMID- 3678913 TI - [Antioxidants in preventing the toxic effect of acrylonitrile]. PMID- 3678914 TI - [Functional and morphologic characteristics of the gastric mucosa in patients with chronic lead poisoning]. PMID- 3678915 TI - [Characteristics of the effect of inorganic cadmium compounds on the embryogenesis of animals after their repeated administration]. PMID- 3678916 TI - [Comparative toxicologic and hygienic characteristics of polyoxypropylene epoxides and substantiation of the group maximum permissible exposure levels of their volatile components in the air of the work area]. PMID- 3678917 TI - [Antidotal effect of amino acids--glutathione precursors--in acute experimental 1,2-dichloroethane poisoning]. PMID- 3678918 TI - [Comparative evaluation of the toxicity and effect on the body of various oxazolone (phosalone) derivatives]. PMID- 3678919 TI - [Results of the medico-sociologic examination of miners from the Donetsk deep mines]. PMID- 3678920 TI - [Absorption of higher aliphatic amines by the body through the skin]. PMID- 3678921 TI - [Use of comparative quantitative evaluation of the sensitizing effect of phenylenediamine isomers in substantiating their maximum permissible exposure levels in the air of the work area]. PMID- 3678922 TI - [Substantiation of hygienic standards for the levels of synthetic pyrethroids in the air of the work area]. PMID- 3678923 TI - [Standardization of mafenide acetate aerosols]. PMID- 3678924 TI - [Polarographic analysis of copper and zinc phosphides in the air]. PMID- 3678925 TI - [Effect of intradermal administration of antigens on the dynamics of sensitizing persons in contact with years]. PMID- 3678926 TI - [Gas chromatographic analysis of isophen (acrex) in the air of the work area]. PMID- 3678927 TI - [Morphocytochemical studies of peripheral blood leukocytes in machine operators working with pesticides]. PMID- 3678928 TI - Age-related changes in plasma immunoreactive growth hormone secretory patterns in broiler pullets. AB - Apparent circulating plasma immunoreactive growth hormone (I-GH) concentrations were determined in Hubbard X Hubbard broiler pullets at weekly intervals from 1 through 12 weeks of age, in conjunction with measurement of relative weight gain (growth rate). Blood was obtained by cardiac puncture (wk 1) or venipuncture (weeks 2-12) from 12 birds (one sample per bird) at each age. Subsequently, in a second study, the growth hormone secretory pattern was quantitated for broiler pullets at 4, 8 and 12 weeks of age. At each of these ages, five birds were surgically prepared with indwelling venous catheters and blood samples withdrawn remotely at 15 or 30 min intervals for 6 h beginning at 0900 h. Plasma was assayed for I-GH and data subjected to a computer-based statistical algorithm for quantitation of secretory pattern characteristics. Plasma I-GH increased with age to peak at 4 weeks and declined thereafter, whereas relative weight gain declined overall. When adjusted for increasing body weight, however, plasma I-GH concentration per unit metabolic body size (an expression of relative tissue exposure to the hormone) was highly correlated with growth rate (P less than .007). At 4 weeks of age, chicks displayed relatively high amplitude peaks in plasma I-GH (35.0 +/- 3.20 ng/ml) (means +/- SEM) which occurred asynchronously between birds. These peaks were substantially reduced in amplitude (P less than .05) by 8 weeks (5.9 +/- 2.82 ng/ml) and remained low through 12 weeks of age (2.6 +/- 1.18 ng/ml). The baseline plasma concentration of I-GH also declined (P less than .05) from 4 to 8 weeks of age, and remained low thereafter. In contrast, the frequency and duration of peaks did not differ significantly with age, such that peaks occurred approximately every 1.75 h and were 1 h in duration, over all ages. These age-related changes in secretory pattern characteristics, and the strong association between plasma I-GH per unit of metabolic body size and growth rate, suggest that both pattern and level of tissue exposure may be important in the regulation of growth in these birds. PMID- 3678929 TI - Postnatal growth of the liver in the young fieldfare (Turdus pilaris). AB - In this paper data are presented on the postnatal growth of the body and some organs in the young fieldfare. To the best of our knowledge the fieldfare has the highest specific growth rate ever reported for an avian species. The mitotic activity in the liver has been investigated by means of flow cytometry and autoradiography. It appears that a high rate of liver growth is more nearly related to the relative number of proliferating cells than to the length of the mitotic cycle. Furthermore, it is concluded that the liver has to be large, at least in relation to its functional activities, in order to be able to grow at a very high rate. PMID- 3678930 TI - Effects of the sex-linked prenatal lethal gene tortoise (Moto) on reproduction and growth in the mouse. AB - The sex-linked prenatally lethal gene tortoise (Moto), an animal model for the human disorder known as Menkes' Kinky Hair Syndrome (MKHS), was studied in the mouse (Mus musculus). The genetic effects upon reproductive performance, birth weight, preweaning growth, and mortality were evaluated to characterize the debilitating effects of the disorder. Reproductive performance of mice were evaluated in two mating types (dam X sire), mutant female (To/+) X normal male (+/Y) and normal female (+/+) X normal male (+/Y). Litter size was reduced in the To/+ X +/Y mating type as expected due to the death of To/Y offspring in utero. Adjusted birth weight of To/+ and +/Y offspring were identical, and both were greater (P less than 0.05) than +/+ offspring. Within one day, however, the To/+ littermates were smaller (P less than 0.05) than +/+ and +/Y and remained consistently inferior in growth through day 30. Normal females and normal males were similar (P greater than 0.05) in growth from day 1 through day 21. Thereafter, +/Y mice were consistently heavier (P less than 0.05) than +/+ mice through day 30. The To/+ genotype had the greatest (13.8%) preweaning mortality rate; +/+ and +/Y genotypes were comparable as were overall comparisons between parity 1 and 2. It is apparent from this study that the copper deficiency and lethality occurring in the progeny of mottled mice were primarily the result of the gene actions in the heterozygote animals. Progression of the disorder may be prevented by experimental determination of both the timing and targeting of in utero therapy in mottled mice and MKHS fetuses. PMID- 3678931 TI - Haematologic and growth response to prepartum administration of vitamin A in calves. AB - Injectable vitamin A was given to six pregnant beef cows in their last third of pregnancy to study the effect of this vitamin in their calves. Average birth weight and growth rate of calves from the treated cows were higher than that of calves from the nontreated cows. Prepartum vitamin A injections also resulted in a significant increase (P less than 0.05) in the mean corpuscular volume (MCV), total serum protein and globulin fraction of serum protein in calves of treated cows. PMID- 3678932 TI - Androgen modulation of ornithine decarboxylase and compensatory renal growth. AB - This report presents a comparative study of the activity of ornithine decarboxylase (ODC) (L-ornithine carboxylase EC 4.1.1.17) in male and female mice and rats and the correlations between ODC, androgens and compensatory renal growth (CRG). We have found that existing levels of renal ODC activity at the onset of renal regeneration following a uninephrectomy play a determining role in the extent of CRG. Basal ODC activity varies according to species and sex, being three times higher in male than in female mice but equal in all rats; an analogous sexual dimorphism also exists in the degree of CRG. The injection of 5 alpha-dihydrotestosterone, which can stimulate ODC activity in mice and rats, is also able to induce a higher degree of CRG. Our results seem to indicate that androgens can influence CRG by modulating renal ODC and that this response to androgen may also vary with species. PMID- 3678934 TI - Incidence of breast cancer in women: a reanalysis. AB - The assumption was made that the incidence of carcinoma of the breast in women was a power function of the age of the population. This produced equations that provided excellent descriptions of the 2 lines obtained (correlation coefficients of 0.98 and 0.99). The "common point" of the 2 equations of incidence versus age was 42 years of age, suggesting that events just prior to menopause may be related to the lower rate of increase of carcinoma of the breast. The dual line description also appears, based on reported mortality data, to be relevant to cancer of the ovary, cervix and corpus uteri in women. PMID- 3678933 TI - The effects of lead nitrate on the central nervous system of the chick embryo. II. Electron microscopy and histochemistry: peroxisomes. AB - The deleterious effects of lead on the developing central nervous system were observed in chick embryos that were exposed to lead nitrate at 10 days of incubation. At 16 days, cervical, thoracic, and lumbar regions of the spinal cord were fixed in gluteraldehyde and processed for electron microscopy, either directly or following incubation in media containing 3,3-diaminobenzidine and hydrogen peroxide for the histochemical detection of catalase-reactive peroxisomes. The results indicate that peroxisomes are not destroyed as are other components of the neuropil after lead exposure. Catalase-reactive peroxisomes appear to increase in number in the spinal cords of lead-treated embryos suggesting that these organelles may play a part in the response of glial cells to metabolic alterations induced by lead. Further experimentation using the chick embryo as an animal model for studies of lead-induced neuropathy is encouraged. PMID- 3678935 TI - Comparison of three nonlinear regression models for describing broiler growth curves. AB - Three general growth models (Logistics, Gompertz and Saturation Kinetics) were compared for describing growth of broilers. Accuracy of fit, case of use and interpretation of data were used to compare the models. Data from a broiler feed restriction study was used to illustrate the parameter differences between the models. All three models accurately described the growth of the birds from the different experimental treatments based on coefficients of determination greater than or equal to .966. The Saturation Kinetics model proved to be the least accurate based on examination of residual values but still had a high association to the actual data. Linear regression applied to short intervals of the growth curve also proved to be an accurate means of interpreting growth rates. PMID- 3678936 TI - The magnitudes of litter size and sex effects on brain growth of BALB/c mice. AB - In a sample of 67 litters of genetically uniform BALB/c mice, litter size before weaning, which ranged from 2 to 11 animals, had a strong negative and approximately linear effect on body and brain sizes at 100 days after birth. For both males and females, the difference between litters of 11 and 2 was about 3.7 g body weight and 42 mg brain weight. The difference in brain weights was similar to effects produced by severe protein-calorie undernutrition in the postnatal suckling period. The relationship between body weight and brain weight was approximately linear and the fit was not improved significantly by including a nonlinear term or using the allometric equation. The allometric exponent was approximately .35, which is close to values commonly observed for populations of mice having large genetic variability. Although the slopes of the equations relating brain size to body size were similar for males and females, females had substantially larger brains than their male littermates. When males and females were equated statistically for body weight, the brains of females averaged about 32 mg heavier. Statistical considerations in making these estimates are discussed. PMID- 3678937 TI - A frequency of growth hormone secretion associated with catch-up growth in the rat detected by time domain (Box-Jenkins) analysis. AB - A time domain technique has been applied to the analysis of temporal patterns of GH concentrations determined at 15 min intervals for 24 h in rats undergoing catch-up growth after a fast and in controls. Three tests were performed on the data. The first compared the autocorrelation functions (ACF's) and partial autocorrelation functions (PACF's) of the series of the GH measurements for the two groups. The second determined whether the model which best fit the control group removed all the regular behavior from the fasted group. The third test, which was similar to the second, was carried out with the assumption that the behavior of both groups is best conceptualized as a binary pattern of periods in which GH is either secreted or not. In the first test the ACF's and PACF's indicated that both groups have a memory of 15 min and a cycle(s) with a periodic interval in the range of 75 to 105 min. There was an indication of a cycle with a periodic interval of 180 to 210 min in the fasted group. The second test confirmed that the cycle was present in only the fasted rats. The third test confirmed the result of the second test. The findings demonstrate the usefulness of time domain analysis in determining periodic behavior of GH secretion in the rat. We conclude that a frequency of GH secretion with a periodic interval of approximately 195 min is superimposed on normal basal rhythms of GH secretion during catch-up growth following a fast in rats. PMID- 3678938 TI - A comparison of statistical techniques for analysis of growth curves. AB - Frequently, experiments are conducted in order to investigate the effects of various treatments on an animal's growth rate. The data from these investigations usually consist of each animal's body weight or accumulative weight gain at specific times during the experiment. The most common statistical techniques for analysis of growth rates (increments in body weight over time) consider only terminal body weights or final accumulative weight gain. In this study, we compare growth rates over the duration of the experiment and use standard simultaneous testing procedures in order to accommodate more than two treatment groups. Results obtained by comparison of regression lines randomization analysis of variance, and repeated measures analysis are presented. PMID- 3678939 TI - Effects of stellate ganglionectomy on the cat cardiovascular function. AB - The effects of stellate ganglionectomy on cardiovascular function were assessed in pentobarbital-anesthetized cats. A right stellectomy produced much more profound bradycardiac effects than a left stellectomy. This finding demonstrated that the stellate ganglion exerted a lateralized influence on heart beat in the cat. The cardiovascular response of intact cats to phase 4 (overshoot) of the Valsalva-like maneuver (VM) was reflex bradycardia. In response to VM, however, reflex bradycardia was completely abolished by a right or bilateral stellectomy, or by pretreatment with propranolol, but not by a left stellectomy alone or with phentolamine. The data indicated that the right stellate ganglion in cats makes a major contribution to cardiovascular control, especially over reflex bradycardia mechanisms. PMID- 3678940 TI - Biogenic amines in cerebrospinal fluid and plasma of patients with dementia of Alzheimer type. AB - The involvement of monoaminergic neurons in Dementia of Alzheimer Type (D.A.T.) is still a matter for debate. In a selected group of patients with D.A.T. we evaluated monoamine levels in cerebrospinal fluid (CSF) and plasma and found a significant decrease in serotonin and dopamine metebolite levels. Dopamine levels were reduced in both CSF and plasma. Moreover, a significant correlation was found between the duration of the illness and the decrease in monoamine levels. These findings suggest that there is systemic damage to monoaminergic neurons in D.A.T. PMID- 3678941 TI - Random dominance and childhood migraine: a new marker? A controlled study of laterality in children with migraine. AB - We assessed various aspects of laterality by direct observation in children with migraine and peer controls, with special reference to the frequency of random dominance. This frequency varied with the test battery used, being lower on the Edinburgh and Oldfield inventories which measure hand-use preference, and higher on the Handedness index and Spontaneous gestural index, which explore "genetic laterality". Random dominance would seem to be a new marker of migraine in childhood, for use alongside the hyperreactivity marker found in a previous study. PMID- 3678942 TI - Analysis of higher nervous functions in migraine and cluster headache. AB - Three groups of patients, long-time sufferers from classic migraine, common migraine, and cluster headache respectively, and three control groups, age- education- and sex-matched, underwent a set of neuropsychological tests and tachistoscope tasks in order to evaluate cognitive functions and interhemispheric balance. Migraineurs and cluster headache patients were selected on the basis of the constant (90%) unilaterality of both pain and focal neurological deficits. No significant differences emerged between patients and controls in any of the neuropsychological and tachistoscopic tasks administered, thus indicating that between attacks of migraine as well as of cluster headache no evidence of cortical dysfunction is detectable. PMID- 3678943 TI - Topographic variations in EEG asymmetry during sleep. AB - EEG signals were recorded in 11 normal subjects from F4-C4, F3-C3, P4-O2 and P3 O1 during both stage 2 and the REM stage of each NREM/REM cycle. The logarithm of the right/left ratio for the power in the range of the various frequency bands showed a prevalent right-side asymmetry only with the fronto-central derivations. This trend, observed for all frequency bands, remained stable over the various NREM/REM cycles with the exception of the last one. These data indirectly support the hypothesis that the right hemisphere is more heavily involved in dreaming than the left, and suggest a prevalent involvement of the anterior regions. PMID- 3678944 TI - Psychiatry of diencephalon damages. A case report. AB - The diencephalon syndrome due to head injury in a 60-year-old woman is reported. The dicenphalon syndrome of the patient offered a variety of productive psychic and somatopsychic symptoms without reduction of intelligence; these included optic and acoustic hallucinations, delusions, cenesthesic hallucinations, disturbances of body schema and distinct functional disorders of the vegetative system. Autopsy findings of the brain were obtained in the 1.5 years up to her death. The problems of diencephalon syndrome related with suspected organic bases of schizophrenia and rhythmicity of diencephalogenic impulse reduction are discussed. PMID- 3678945 TI - Neurophysiological and magnetic resonance studies in a patient with hemiballismus. AB - A case of hemiballismus is reported. Magnetic resonance imaging revealed a cavernous hemangioma in the mesencephalon. The hemiballismus in the biceps and triceps muscles was associated with prolonged bursts of EMG activity. PMID- 3678946 TI - Circadian variation of potency of placebo as analgesic. AB - The pain threshold in healthy teeth changes significantly depending on the label of the placebo. Systematic observations during the whole day indicate that the effect of the placebo shows significant circadian variations. When a placebo is labelled an analgesic, there is a greater and quicker increase of the pain threshold in teeth during the day-time than during the night hours when the pain threshold ascends less or may even descend. A placebo can produce up to 40% of the pain threshold elevation produced by a normal analgesic. PMID- 3678947 TI - The Jubilee meeting of the British Society of Gastroenterology. London, 15-18 September 1987. Abstracts. PMID- 3678948 TI - Temporary blood flow stasis with degradable starch microspheres (DSM) for liver metastases in a rat model. AB - A reliable liver metastasis model using intraportal injections of sarcoma cells was established in syngeneic hooded Lister rats to study the blood supply of the tumours and to evaluate the role of degradable starch microspheres (DSM) in conjunction with selective hepatic arterial and portal venous chemotherapy. The tumour/normal liver (T/L) ratio after intra-arterial and intraportal injection of 113Sn microspheres was 1.04 (range: 0.38-1.15) and 0.03 (range: 0.006-0.22), respectively. After intravenous 14C-iodoantipyrine quantitative autoradiography of tumour and normal regions demonstrated a mean T/L ratio of 0.74 +/- 0.05. After hepatic artery ligation (HAL) and portal vein ligation (PVL) the values were 0.32 +/- 0.05 and 0.42 +/- 0.05, respectively. These results confirm that the vascularity of the tumours in this model is similar to human colorectal cancer metastases. Radiolabelled 14C 5-Fluorouracil (5-FU) was given intravenously, via the hepatic artery and via the portal vein (the latter two routes with and without DSM). Quantitative autoradiography of tumour regions showed that selective hepatic arterial administration with DSM resulted in a significantly increased concentration of 14C-5-FU within the tumours. These results suggest that DSM may enhance the therapeutic benefit of hepatic arterial 5-FU by increasing its uptake into tumours. PMID- 3678949 TI - In vitro stimulation of pancreatic enzyme discharge by calcium. AB - The mechanism for acute hypercalcaemia increasing pancreatic enzyme secretion is unknown. To determine if raised extracellular calcium concentrations can directly stimulate pancreatic enzyme output, we measured discharges of pulse labelled protein and chymotrypsin from isolated cat pancreatic lobules in the presence of normal and raised calcium concentrations. Incubation in 5.0 mmol/l calcium increased discharges of pulse labelled protein (four fold), chymotrypsin (2.5 fold) and amylase (2.2 fold), compared with control experiments with 2.5 mmol/l calcium (p less than 0.001). This effect was similar to the maximal effect of carbachol or caerulein. Compared with 5.0 mmol/l calcium, incubation at the higher calcium concentration of 10.0 mmol/l induced similar discharges of chymotrypsin and amylase, whereas the increase in discharge of pulse labelled protein was smaller (p less than 0.01). The effects of raised calcium were not altered by atropine. Incubation in a high calcium medium did not impair pancreatic acinar response to subsequent stimulation with carbachol, but incubation in hypothermia abolished the effects of high calcium concentrations, suggesting that increased enzyme discharge is caused by stimulation of secretion not to cell damage. These data are consistent with a direct stimulatory effect of raised extracellular calcium concentrations on pancreatic acinar cell function. PMID- 3678950 TI - Short chain fatty acids in human large intestine, portal, hepatic and venous blood. AB - Evidence for the occurrence of microbial breakdown of carbohydrate in the human colon has been sought by measuring short chain fatty acid (SCFA) concentrations in the contents of all regions of the large intestine and in portal, hepatic and peripheral venous blood obtained at autopsy of sudden death victims within four hours of death. Total SCFA concentration (mmol/kg) was low in the terminal ileum at 13 +/- 6 but high in all regions of the colon ranging from 131 +/- 9 in the caecum to 80 +/- 11 in the descending colon. The presence of branched chain fatty acids was also noted. A significant trend from high to low concentrations was found on passing distally from caecum to descending colon. pH also changed with region from 5.6 +/- 0.2 in the caecum to 6.6 +/- 0.1 in the descending colon. pH and SCFA concentrations were inversely related. Total SCFA (mumol/l) in blood was, portal 375 +/- 70, hepatic 148 +/- 42 and peripheral 79 +/- 22. In all samples acetate was the principal anion but molar ratios of the three principal SCFA changed on going from colonic contents to portal blood to hepatic vein indicating greater uptake of butyrate by the colonic epithelium and propionate by the liver. These data indicate that substantial carbohydrate, and possibly protein, fermentation is occurring in the human large intestine, principally in the caecum and ascending colon and that the large bowel may have a greater role to play in digestion than has previously been ascribed to it. PMID- 3678951 TI - Pressure and prolapse--the cause of solitary rectal ulceration. AB - The cause of solitary rectal ulceration has been investigated using a method that radiologically visualises rectal voiding whilst simultaneously measuring intrarectal pressure and external anal sphincter electromyographic activity. Control subjects and patients with the solitary rectal ulcer syndrome, both with and without mucosal ulceration, have been studied. A high incidence of rectal prolapse (94%) was present in the patients who voided. Overactivity of the anal sphincter during evacuation contributed to the fact that patients with mucosal ulceration required higher intrarectal pressures to void than the controls and the patients without mucosal ulceration. The results indicate that a combination of rectal prolapse and a high voiding pressure may act to cause the mucosal ulceration in this syndrome by exposing the rectal wall to a high transmural pressure gradient. PMID- 3678952 TI - Anal canal pressure profile: a reappraisal as determined by rapid pullthrough technique. AB - Previous station pull through techniques of anal canal pressure measurement have not truly represented the differences among individuals and between sexes in the length and pressure profile of the anal canal. Furthermore, the techniques commonly used in anal canal pressure determination have not been adequately compared or standardised. Therefore, a mechanised rapid pull through technique using an 8-lumen, 4-quadrant, continuously perfused catheter was evaluated and used to define the anal canal pressure profile. For measurement of the resting anal canal pressures, this technique was compared with the more usual station pull through technique in 12 subjects. There were no differences in resting pressure recorded by either technique with infusion rates ranging from 0.5 to 1.2 cc/min/orifice and over a range of catheter withdrawal rates of 0.19 to 0.48 cm/sec. Twenty two subjects (12 men/10 women) had their anal canal pressure profiles assessed using the rapid pull through technique. Anal canal length representing the mean of four axes differed between the sexes (p less than 0.005) and the difference was largely accounted for by a decrease in length of the anterior axis in women. A standardisation technique was used to account for between subject variation and for a more accurate between sex comparison of the pressure profiles. Significant differences in radial symmetry were found between the sexes. In the anterior axis the pressure was higher distally in women, while in the anterior and lateral axes the pressure was higher proximally in men. Anteriorly in women the highest pressures were exerted over a much shorter canal length than in men. We conclude that the usual station pull through technique can give reliable resting pressure measurements in the anal canal. The rapid pull through technique described herein, however, used a flexible catheter system which follows the normal anal canal and rectal contours, allows a more appropriate assessment of the anal sphincter profile, and provides findings that are consistent with the known local anatomy. PMID- 3678953 TI - Preservation of faecal continence during rises in intra-abdominal pressure: is there a role for the flap valve? AB - Studies were carried out in 15 normal subjects and 14 patients with idiopathic faecal incontinence to test whether a rectoanal flap valve could be responsible for maintaining faecal continence in man. Intraluminal pressures were recorded from the rectum and from three sites in the anal canal during serial increases in intra-abdominal pressure, produced by forced expiration into a sphygmomanometer keeping the height of the column of mercury at prescribed levels. The anal pressures in the normal volunteers always remained higher than the intrarectal pressures even when these were as high as 230 cm H2O. This pressure gradient was the reverse of that which would be found if an anterior rectal flap valve maintained continence and suggests instead that continence is normally maintained by a reflex contraction of the external anal sphincter. The anal pressures in patients with idiopathic faecal incontinence, however, fell below the rectal pressure as the intra-abdominal pressure increased, creating the conditions for a flap valve. The valve was incompetent, however, because fluid infused into the rectum leaked from the anus whenever the rectal pressure exceeded the anal pressure. PMID- 3678954 TI - Effect of stool size and consistency on defecation. AB - The ability of subjects to expel from the rectum objects simulating stools of different characteristics was assessed in paired studies carried out in a total of 58 normal subjects and 25 young women with severe constipation. Our results showed that a lower percentage of normal subjects and a lower percentage of constipated patients were able to pass a 1.8 cm incompressible sphere compared with a 50 ml deformable balloon, although constipated patients found it more difficult than normal subjects to expel both types of simulated stool. It was also more difficult for normal subjects to pass a soft compressible silicon rubber simulated stool than a stool made up of a similar volume of incompressible 1 cm wooden spheres contained in a cylindrical latex envelope, but both objects were much easier to pass than the same number of 1 cm spheres placed loose within the rectum. When normal subjects were instructed to expel single incompressible spheres of different sizes placed in the rectal ampulla, the intrarectal pressure and the time needed to pass these objects varied inversely with their diameter. These results suggest that more effort is required to expel stools from the rectum if they are small and hard than if they are large and soft. PMID- 3678955 TI - Psychosocial sequelae of stoma surgery for inflammatory bowel disease in childhood. AB - Three matched groups of children with inflammatory bowel disease: (a) stroma group, (b) ileorectal anastomosis group and (c) no-surgery group were compared for psychosocial adjustment. No differences were found between the groups for psychological adjustment, selfesteem, or quality of life. It is concluded that providing children are well prepared and followed up carefully and sensitively, then stroma surgery should not be deferred for fear of adverse psychological consequences. PMID- 3678956 TI - Prognosis of chronic ulcerative colitis in a community. AB - Utilising the population based data resources of the Rochester Epidemiology Project, we estimated survival and risk of subsequent colon cancer in the 182 residents of Rochester, Minnesota, initially diagnosed with chronic ulcerative colitis (CUC) between 1985 and 1979. Twenty five (13.7%) had a proctocolectomy during the course of follow up. Three patients developed colorectal adenocarcinoma after the initial diagnosis of CUC (relative risk = 1.9, 95% CI 0.4-5.4). Excluding proctitis cases, the relative risk of cancer was 2.4 (95% CI 0.3-8.7). At last follow up, 37 (20.3%) were dead; only 10 patients had chronic ulcerative colitis mentioned on the death certificate. Overall survival was similar to that expected for the general population of like age and sex. Our results suggest that chronic ulcerative colitis in the community is typically a milder disease than would appear from hospital or referral centre series. PMID- 3678958 TI - Carcinoid tumour of the ampulla of Vater presenting as acute pancreatitis. AB - The first report of a carcinoid tumour of the ampulla of Vater causing acute pancreatitis is presented. The pancreatitis resulted from ampullary obstruction and diversion of the bile through the pancreas. Endoscopic retrograde cholangiopancreatography established the correct diagnosis, making this the first occasion in which a carcinoid tumour of the ampulla of Vater has been correctly diagnosed before surgery. PMID- 3678957 TI - Delayed mouth-caecum transit of a lactulose labelled liquid test meal in patients with steatorrhoea caused by partially treated coeliac disease. AB - Mouth-caecum transit time (M-CTT) of a lactulose labelled liquid test meal has been measured in 27 coeliac patients and 10 healthy controls using the breath hydrogen technique. Although all patients were urged to maintain a gluten free diet, not all did, and there was, therefore, a wide range in the severity of fat malabsorption within the patient group. Gastric emptying of a 113Indium DTPA labelled liquid test meal was also assessed in separate studies on six healthy controls and 11 of the coeliac patients. Fasting breath hydrogen concentrations and the response to lactulose, as assessed both by the rate of rise, and the peak breath hydrogen concentration reached, showed no difference between coeliacs and controls, regardless of the presence or absence of steatorrhoea. Mouth-caecum transit time in the 16 coeliac patients with steatorrhea (faecal fat greater than 7 g/24 h) was, however, significantly prolonged being 158 +/- 18 minutes (mean +/ SEM), compared with 70 +/- 9 minutes for the controls (p less than 0.02), and 83 +/- 15 minutes for the 11 coeliacs without steatorrhoea (p less than 0.002). Mouth-caecum transit time in the coeliac patients was linearly related to the 24 hour faecal fat excretion, r = 0.55, n = 27, p less than 0.01. Slow mouth-caecum transit in the coeliacs with steatorrhoea was not caused by delayed gastric emptying as the t1/2 for coeliacs with steatorrhoea was within the normal range. Coeliacs with delayed mouth-caecum transit had impaired insulin release but the postprandial profiles of the other peptides measured (cholecystokinin, GIP, secretin, motilin, neurotensin, enteroglucagon, and peptide YY) were all within the normal range in this group of partially treated coeliac patients. PMID- 3678959 TI - AIDS related Kaposi's sarcoma presenting as ulcerative colitis and complicated by toxic megacolon. AB - Gastrointestinal Kaposi's sarcoma is a well described and usually asymptomatic manifestation of the acquired immune deficiency syndrome. We report a patient who had extensive colonic Kaposi's sarcoma and presented with an ulcerative colitis like illness. Total colectomy was subsequently required as an emergency procedure for toxic megacolon. The patient remains well on maintenance interferon therapy 21 months after surgery. PMID- 3678960 TI - Gastric ECL cell hyperplasia. PMID- 3678961 TI - Assessment of biliary tract pathology in familial adenomatous coli. PMID- 3678962 TI - Erosive gastritis--does acid matter? PMID- 3678963 TI - Portal hypertensive gastric mucosa. PMID- 3678965 TI - Improvement of abnormal lactulose/rhamnose permeability in active Crohn's disease of the small bowel by an elemental diet. AB - Intestinal permeability to sugar has been used as an objective measure of small bowel integrity to assess the efficacy of an elemental diet as the sole treatment or Crohn's disease of the small bowel. Fourteen children aged 11-17 years with active small bowel Crohn's disease were given an elemental diet for six weeks. Investigations with iso-osmolar oral test solutions before and after this treatment showed that all 14 children had abnormally raised lactulose/L-rhamnose permeability ratios, which fell significantly after the elemental diet. This change coincided with marked clinical improvement, as assessed by a disease activity index score. PMID- 3678964 TI - Passage of dietary antigens into the blood of children with coeliac disease. Quantification and size distribution of absorbed antigens. AB - The uptake of ovalbumin (OA) from egg and beta-lactoglobulin (BLG) from cow's milk into the blood was investigated for seven hours after a test meal in five children with coeliac disease on a gluten free diet and after gluten challenge, and in five children with normal jejunal mucosa. Ovalbumin was detectable by ELISA in three of five coeliac children (maximal concentrations 8-178 ng/ml serum) and in five of five controls (maximal 4-91 ng/ml serum). Beta lactoglobulin was detected in three of five coeliac children (maximal 0.6-6 ng/ml serum) and in two of five controls (maximal 0.5 and 50 ng/ml serum). No clear relationship was seen between maximal antigen concentrations and titres of serum IgG or IgA antibodies determined by ELISA, or as percentage antigen binding in a Farr type radioimmunoassay. Ovalbumin and beta-lactoglobulin was seen in serum of all coeliac patients and controls by HPLC fractionation in combination with ELISA, either in high MW fractions, or at the Mr of native OA and BLG, respectively. In one control degradation products (about 17 kD) of BLG were detectable in serum. The serum concentrations of OA and BLG were increased on gluten challenge in four or five coeliac children, indicating increased macromolecular passage through the gut mucosa in untreated coeliac disease. PMID- 3678966 TI - Propionate absorption and metabolism in the rabbit hindgut. AB - Propionate disappearance from the loops of the hindgut in the rabbit was evaluated by measuring variations in the concentration of propionate in caecocolonic loops and differences in the arterial and venous plasma. In vivo metabolism in gut and liver tissues was studied after introduction of (1-14C) propionate into the caecocolonic loops. The rate of disappearance from the loops was always quantitatively significant but was greater in the proximal colon. Hindgut tissue metabolised propionate and the intensity of the metabolism varied with the segment studied; the proximal colon showed by far the highest propionate consumption. Radioactivity was found in a certain number of free amino acids, organic acids, sugars, lipid soluble substances and proteins. Propionate is an efficient respiratory fuel for the colonocyte and a good precursor for gluconeogenesis. PMID- 3678967 TI - Effect of polymer coating on faecal recovery of ingested 5-amino salicylic acid in patients with ulcerative colitis. AB - It has been suggested that polymer coating might retard jejunal absorption of 5 amino salicylic acid (5-ASA) and thus promote delivery to its colonic site of action. Twenty three patients with active (nine), or quiescent (14) ulcerative colitis were given either uncoated or coated 5-ASA (Asacol) 400 mg qds for one to three weeks, after which they ingested five 1.5 ml dialysis membrane sachets which were recovered from the stool in the next 72 hours. After one week of treatment the concentration of 5-ASA in the faecal dialysate, urine, and fasting plasma in those receiving the coated and uncoated preparations were respectively: 25.4 +/- 5.1 compared with 1.2 +/- 0.4 mmol/l (p less than 0.001); 0.34 +/- 0.21 compared with 0.70 +/- 0.29 mmol/24h (NS) and 11.1 +/- 4.2 compared with 0.07 +/- 0.03 mumol/l (p less than 0.02). Faecal excretion of the drug appeared to be greater in patients with active colitis than in those with quiescent disease. Thus coating with pH dependent methacrylic acid copolymer B is a very effective method of promoting delivery of 5-ASA to the colon, stool dialysate concentrations being 20 fold more than those in controls. Increased trough plasma concentrations in the polymer coating group probably reflect delayed intestinal absorption but no evidence of plasma accumulation after 21 days of therapy was found. PMID- 3678968 TI - Is the diarrhoea in ulcerative colitis related to impaired colonic salvage of carbohydrate? AB - In order to determine whether failure of the colon to salvage carbohydrate could contribute to the diarrhoea of ulcerative colitis we investigated the effect of ingesting a drink containing 20 g lactulose on stool output and breath hydrogen production in 39 colitic patients subdivided according to their disease extent and activity and in 14 normal volunteers. Each subject took a standard diet for four days and stool output was monitored throughout this period. Administration of lactulose on day three significantly increased stool weight and frequency in patients with both active and quiescent total colitis (p less than 0.01), but not in patients with distal colitis or in the volunteers. The basal and peak breath hydrogen responses to ingested lactulose were similar to normal controls in all patient groups but the hydrogen concentration tended to be higher in colitics. The mouth to caecum transit of the lactulose meal was slower in all groups of colitics (p less than 0.02) when compared with controls. These results suggest that impaired colonic salvage of carbohydrate could contribute to the diarrhoea in patients with total colitis who are ingesting a diet rich in unabsorbed carbohydrate, or who are hypolactasic. PMID- 3678969 TI - Flow cytometric DNA analysis in longstanding ulcerative colitis: a method of prediction of dysplasia and carcinoma development? AB - During a prospective study lasting 3.5 years flow cytometric DNA analysis was evaluated as a possible predictor of dysplastic and malignant lesions in longstanding ulcerative colitis. Fifty three patients with total ulcerative colitis (mean disease duration of 22 years) were regularly colonoscoped. Biopsies of colonic mucosa were analysed by flow cytometric technique and were also assessed histologically. Findings of abnormal DNA pattern (aneuploidy) were compared with findings of dysplasia. Five patients (9%) had aneuploidy, four of those at repeated colonoscopies. Four of those patients also had various degrees of dysplasia. In one patient aneuploidy preceded the finding of dysplasia and in another aneuploidy preceded a well differentiated adenocarcinoma, grade Dukes' A subsequently found at surgery. Four additional patients had dysplasia, all in connection with macroscopic lesions, but were diploid. It is suggested that flow cytometric DNA analysis in long standing ulcerative colitis may be helpful in addition to histopathology in the detection of potential malignancy in ulcerative colitis. PMID- 3678970 TI - Neurotensin-like immunoreactivity after intestinal resection in the rat. AB - Neurotensin is a tridecapeptide located mainly in the distal small intestine. The present study was carried out in order to investigate the neurotensin response after proximal small intestinal resection in the rat. After resection, the median plasma concentration of neurotensin like immunoreactivity (NTLI) was unchanged compared with sham operated rats. Intragastric instillation of fat increased the plasma concentration of NTLI from 45 pmol/l (34-63) in sham operated rats to 92 pmol/l (46-121) in resected rats. No significant increase in the plasma concentration of NTLI was found after intragastric instillation of amino acids or glucose. The tissue concentration of NTLI increased significantly in the jejunum and ileum after proximal small intestinal resection, while the number of immunoreactive neurotensin cells was unchanged. This study shows that the adaptive responses in the distal small intestine after proximal small intestinal resection also involve the neurotensin producing cells. PMID- 3678971 TI - Effects of oral laxatives on colonic motor complexes in dogs. AB - The effect of oral laxatives on the organisation of colonic motor complexes was investigated in four conscious dogs. Six strain gauge transducers were implanted on the colon of each dog. After a control period of two to three hours, dogs were orally dosed with 1, 2, or 4 ml/kg of castor oil, or 0.5 g/kg magnesium citrate. Oral olive oil, 4 ml/kg, was used as control. The recording was continued for another 10 hours or until defecation occurred. Each dog showed spontaneous cyclic bursts of contractions (contractile states) at all recording sites during the control period. Contractile states migrating orad or caudad over at least half the length of the colon were called colonic migrating motor complexes (CMMC). Castor oil and magnesium citrate significantly increased the period of colonic motor complexes, but olive oil had no significant effect. None of the above substances changed the percentage of orad migrating motor complexes, as compared with the control values. Periods in which colonic motor activity was completely absent for at least 60 min over at least three consecutive recording sites occurred more frequently after all of the substances. The occurrence of these periods of inhibition, however, was not a consistent feature and there seemed to be no relationship between the occurrence of inhibitory periods and defecation during the recording period. The dogs defecated within 10 hours after administration of magnesium citrate, 1, 2, and 4 ml/kg of castor oil in 12.5, 25, 37.5, and 88.8% of experiments respectively, but never with olive oil. Defecation was generally accompanied by giant migrating contractions in the colon. We conclude that oral laxatives, magnesium citrate and castor oil have a profound effect on colonic motor complexes and colonic motor activity. The period of CMMC is significantly prolonged after their oral administration because of an increased number of non-migrating motor complexes or periods of inhibition of motor activity. PMID- 3678972 TI - Origin of gastrin liberated by gastrin releasing peptide in man. AB - Gastrin release induced by gastrin releasing peptide (GRP) in man has been studied in patients before and after complete resection of the antrum and duodenal bulb, as well as after pancreaticoduodenectomy according to Whipple. Studies in healthy subjects showed that 400 pmol/kg an hour of GRP induced a maximal release of gastrin. Infusion of this dose of GRP after a complete resection of the antrum and duodenal bulb induced a small, but significant increase in gastrin concentrations. After pancreaticoduodenectomy, however, GRP infusion had no effect on serum gastrin concentrations. In patients previously subjected to an incomplete antrectomy, GRP infusion was followed by a gastrin response considerably higher than after a complete antrectomy. Our results would suggest that GRP is capable of releasing gastrin predominantly from the antrum and the duodenal bulb, but also a small amount of gastrin from the remaining part of the duodenum. Gastrin releasing peptide infusion and determination of gastrin release may be of clinical significance in showing remaining significant gastrin pools in patients with recurrent ulceration after previous gastric resections. PMID- 3678973 TI - Pressure measurement in oesophageal varices: preliminary report on a new non invasive method. AB - Pressure in oesophageal varices has been measured either by using an invasive puncture technique, or a non-invasive pneumatic pressure sensor. Experience with these techniques and their limitations prompted a new way of measuring pressure in oesophageal varices. This was done by observing through a transparent plastic balloon fixed to the tip of a gastroscope the pressure equilibrium between the varix and the balloon. One hundred measurements on an experimental model showed the reliability of the system. Measurements on eight patients with the balloon followed immediately by the puncture technique, showed good correlation. PMID- 3678974 TI - Achlorhydria: hypergastrinaemia: carcinoids--a flawed hypothesis. PMID- 3678975 TI - Automated quantitative fluorescent image analysis of cervical cytology. AB - Cervical cytology from 122 patients with histories of one or more abnormal Pap smears were studied using slide-based automated quantitative fluorescence image analysis (QFIA) in order to determine the usefulness of the QFIA technique in detecting neoplasias. The purpose of the study was to evaluate the accuracy and validity of QFIA as a cytological method for the early detection of cervical cancer, based on comparisons with the conventional Pap smear and histopathology. The results of the analysis demonstrated that the sensitivity of the automated QFIA cytology was 100% for high-grade neoplasms (CIN III and invasive carcinoma), compared with 82% for the Pap smear. Evaluation of lower grade neoplasms was also performed. Initial analyses of the data indicate that QFIA, which uses objective biochemical criteria to identify cells with increased nuclear nucleic acid content, is a more sensitive detector of cervical neoplasia of all grades than is conventional Pap cytology. PMID- 3678976 TI - Incidence of ovarian metastasis in patients with cancer of the uterine cervix. AB - During the period from 1970 to 1985, 706 patients with cervical cancer of stage 0 and Ia were treated by a simple hysterectomy without oophorectomy. In 326 patients with invasive carcinoma in stage Ib to stage III, who were treated by a radical hysterectomy from 1977 to 1985, histological examinations were performed to detect ovarian metastasis. A total of 674 autopsy specimens were obtained from the Annual of the Pathological Autopsy Cases in Japan. (Japanese Pathological Society, 1965 to 1978). Follow-up observations on stage 0 and stage Ia revealed no recurrence in the ovaries. In invasive cases of epidermoid carcinoma (stage Ib to stage III), no ovarian metastases were detected, despite discovery of metastases to the pelvic lymph node in 21.6% of the cases. Conversely, in the cases of cervical adenocarcinoma (pure adenocarcinoma and mixed carcinoma), 6 of 48 cases (12.5%) showed ovarian metastases. Ovarian metastases were found in 22 of 77 (28.6%) autopsy cases of adenocarcinoma, but in only 104 of 597 (17.4%) cases of epidermoid carcinoma. This finding is statistically significant (P less than 0.02). Both corpus invasion and metastasis to the ovaries were found in 20 of 54 cases (37.0%). This rate was significantly higher than the rate of ovarian metastasis in cases without corpus invasion (P less than 0.001). PMID- 3678977 TI - The treatment of stage III carcinoma of the uterine cervix with telecobalt irradiation. AB - This is a retrospective analysis of 148 patients with histologically proven carcinoma of the cervix, stage III, treated with irradiation. All patients received external irradiation with cobalt 60 followed by intracavitary radium application. The median age was 55 years. Squamous cell carcinoma was found in 96.5% of the cases. The 8-year actuarial survival rate was 41%. Bilateral parametrial invasion proved to be a strong prognostic factor. Patients with unilateral disease had a survival rate of 43% whereas in those with bilateral involvement it was only 15% (P less than 0.005). The total pelvic failure rate was 29.5%. The overall incidence of distant metastasis was 11%. The complication rate (minor and major complications) was high, with vaginal stenosis (22.5%), proctitis (21.5%), cystitis (13.5%), and fistulae (4%) occurring in 33, 32, 20, and 6 patients, respectively. New treatment modalities are urgently needed for advanced carcinoma of the cervix. Bilateral parametrial involvement is an unfavorable prognostic factor and this should be kept in mind when designing new protocols. PMID- 3678978 TI - Radioimaging of human ovarian carcinoma xenograft in nude mice. AB - Human ovarian carcinomas in nude mice were radioimaged using a well-characterized antibody against a tumor-associated antigen (CA 125) and three transplantable human ovarian carcinoma tumor lines: NIH:OVCAR 3, NIH:OVCAR 5, and NIH:OVCAR 9. Radioiodinated monoclonal antibody OC125 was used in these studies. In order to establish the optimal conditions for imaging, tumor/blood ratios were determined. Gamma scintigraphy of nude mice bearing subcutaneous transplants of human ovarian carcinomas 3-4 days after 131I-OC125 administration demonstrated selective localization of the radiolabeled monoclonal antibody by these tumors without need for any background subtraction techniques. PMID- 3678979 TI - Low prevalence of cervical intraepithelial neoplasia among Egyptian females. AB - Analysis of 4458 patients evaluated by cytology at the Department of Obstetrics and Gynecology, Kasr El-Einy Hospital, Cairo University, during the years 1981 to 1985 revealed that only 1.07% of these women had abnormal cytology. The prevalence rate for cervical intraepithelial neoplasia (CIN) was remarkably low, corresponding to 3.59/1000 for CIN grade I, 2.28/1000 for CIN II, and 1.16/1000 for CIN III. The mean age for CIN was 44.23 years while that for cervical cancer was 54.32. This low prevalence rate of CIN among Egyptian females, together with the late onset of the disease in comparison with other populations, calls for further study of the epidemiologic characteristics of this low-risk community. PMID- 3678980 TI - Evaluation of the scalene lymph nodes in primary and recurrent cervical carcinoma. AB - Open biopsy of the left scalene lymph nodes has been utilized to identify distant spread of cervical carcinoma in selected groups of patients who do not have other clinical evidence of disseminated disease. Twenty-one patients with primary cervical carcinoma and histologically proven para-aortic lymph node metastases and 10 patients with centrally recurrent tumors underwent scalene lymph node biopsy at Walter Reed Army Medical Center or the Naval Hospital, Bethesda, Maryland, between July 1, 1979 and June 30, 1985. All patients undergoing scalene node biopsy had clinically negative physical examinations. There were no surgical complications. All 31 biopsies were negative for metastatic tumor. Combined with previously reported data from this institution, 3 of 28 patients (11%) with primary cervical carcinoma and involved para-aortic nodes, and 6 of 35 patients (17%) with centrally recurrent disease had subclinical scalene node metastases. Patients with clinically suspicious scalene lymphadenopathy had fine needle aspiration cytology performed to document metastatic disease. The success of this technique has eliminated the need for open biopsy in these patients. Scalene node biopsy provides valuable prognostic information in patients with cervical cancer who have positive para-aortic lymph nodes. It also obviates surgical exploration in some patients felt to have resectable recurrent disease who actually have subclinical distant spread. PMID- 3678981 TI - Cytogenetic findings in two cases of carcinoma in situ of the cervix uterus. AB - Karyotypic analysis of two cases of carcinoma in situ of the cervix uterus, studied on direct preparations by G-banding, revealed numerical and structural abnormalities characteristic of invasive cancers. Abnormalities of chromosome No. 1 were present in both cases. The chromosome No. 1 changes involved isochromosome formation of the long arm (i(1q)) in one case and monosomy in the other. The other chromosomes showing structural aberrations were Nos. 8, 11, and 21. One case revealed the presence of double minute chromatin bodies. The prognosis in both cases was good following excision of the tumor. PMID- 3678982 TI - Lipoplastic lymphadenopathy presenting as an ovarian mass: a case report. AB - Lipoplastic lymphadenopathy is a pathological condition wherein accumulations of intranodal fat result in lymph node enlargement and may mimic abdominal, pelvic, and retroperitoneal neoplasms, particularly lymphomas. The pathology appears to be different from lipomatosis in that benign, mature adipocytes and lipids are located within lymph nodes, rather than deposited in body cavities. The case of a 49-year-old woman presenting as an ovarian neoplasm is presented as an example of the pathology and its ability to masquerade as other neoplasms. The etiology of lipoplastic lymphadenopathy is unclear although associated causes are suggested. The difficulties of radiological examination of this case and others makes open lymph node biopsy important for the final diagnosis. PMID- 3678983 TI - [Radiation exposure and pregnancy]. PMID- 3678984 TI - [Healthy living during pregnancy. II]. PMID- 3678985 TI - [Sleep disorders in pregnancy. Their diagnosis and therapy from the psychiatric viewpoint]. PMID- 3678986 TI - [Varicose veins--which therapy?]. PMID- 3678987 TI - [Can the development of striae be prevented?]. PMID- 3678988 TI - [Dental care and pregnancy]. PMID- 3678989 TI - [Sauna visits and pregnancy]. PMID- 3678990 TI - [Nuclear magnetic resonance in acute and chronic renal failure in the rat]. PMID- 3678991 TI - [Surgical treatment of acoustic neurinomas with preservation of facial nerve function]. PMID- 3678992 TI - [A drug-reduction trial in elderly patients]. PMID- 3678993 TI - [Traumatic tear of major airways]. PMID- 3678994 TI - [Intestinal parasites in immigrants from Ethiopia]. PMID- 3678995 TI - [Brief treatment of vaginal mycosis with isoconazole nitrate]. PMID- 3678996 TI - [Salmonella in turtles in Israel (1953-1982)]. PMID- 3678997 TI - [The syndrome of prolapses mitral valve and autoimmune thyroid disease]. PMID- 3678998 TI - [Tropical diabetes]. PMID- 3678999 TI - [Follow-up of 1000 cases of school children with idiopathic scolioses]. PMID- 3679000 TI - [Anginal syndrome with normal coronary arteriogram]. PMID- 3679001 TI - [Postpartum silent thyroiditis]. PMID- 3679002 TI - [Urethral strictures following open-heart surgery]. PMID- 3679003 TI - [Continuous pericardial drainage by catheter in a child]. PMID- 3679005 TI - [The quadriplegic patient and his environment]. PMID- 3679004 TI - [Second malignancy: is it really a complication of chemotherapy?]. PMID- 3679006 TI - [The painful thyroid]. PMID- 3679007 TI - [The aging aorta]. PMID- 3679008 TI - [Chronic idiopathic constipation in childhood]. PMID- 3679009 TI - [Calcium antagonists in bronchial asthma]. PMID- 3679010 TI - Health/mental health: one field of practice or two? PMID- 3679011 TI - Social policy and chronic illness. PMID- 3679012 TI - Work-related post-traumatic stress reactions: the hidden dimension. AB - A variety of occupational health hazards can cause employees to experience feelings of victimization and to develop work-related post-traumatic stress responses. The author presents assessment guidelines developed in work with people suffering from toxic exposures to help identify factors that can place employees at high risk for such stress responses. These guidelines can be adapted to evaluate employee reactions to any type of occupational injury. Clinicians also need to move beyond individual treatment approaches to address workplace and policy interventions. PMID- 3679013 TI - The APA model law and three legal issues in mental health. AB - The needs of nondangerous mentally ill persons, the right of patients to refuse treatment, and professionals' duty to warn about the potential for dangerous behavior are important and controversial legal issues. The author considers the difficulties social workers have in implementing the principles and discusses the likely effects of the American Psychiatric Association's proposed model law on mental health services, particularly in the context of inadequate community care resources. PMID- 3679014 TI - Decision making in psychiatric emergencies. AB - Social workers increasingly are being required to assist clients in emergency situations. Such conditions typically require rapid decision making and quick action. In this article, the processes practitioners use in their interventions in psychiatric emergencies are examined. This examination is based on concepts derived from cognitive psychology and decision-making theory. Implications for practice and training also are discussed. PMID- 3679015 TI - Comparison of self-help groups for mental health. AB - This study examines and compares three international mental health self-help organizations: Recovery, Inc., Emotions Anonymous, and GROW International. The authors investigated membership characteristics, ideologies, meeting procedures, and the organizational characteristics of degree of centralization and formalization, roles of professionals, and sources of funding. The findings suggest differences in what types of clients benefit from participation in each of the three organizations, and counter criticisms of self-help groups. PMID- 3679016 TI - Family satisfaction with psychiatric evaluations. AB - In the current study, psychiatric patient, family, and evaluator satisfaction with initial treatment recommendations was examined in relation to patient compliance with treatment methods and clinical improvement. Only family satisfaction was positively correlated with both compliance and improvement. This finding challenges the predominant view that families play negative roles in psychiatric illness by exacerbating symptomatology and, instead, stresses the positive facilitating role of the family. Implications for involving families in treatment evaluations and social work practice are discussed. PMID- 3679017 TI - Children of psychiatric patients: rarely seen or heard. AB - A survey of inpatient psychiatric social workers and a review of inpatient charts indicate that while social workers believe the inclusion of the patients' children in their practice is important, their documentation rarely reflects such activity. The authors review relevant literature on the effect of parental psychiatric illness on children, discuss the apparent schism between theory and practice, and consider the clinical and policy implications of these findings. PMID- 3679018 TI - Communication between health care professionals and deaf patients. AB - A review of the literature about communication between health care professionals and deaf people demonstrates that a continuum of accuracy in perceptions of deaf people and their communication problems exists in health care settings. The author provides information on deaf culture, history, population size, sign language, and communication needs that is used to evaluate professional journal articles. Examples of research on this topic are presented and the need for further studies and the role of social workers are discussed. PMID- 3679019 TI - [Studies on cardiac ingredients of plants (IV). Effect of reduced proscillaridins on guinea-pig hearts]. AB - Five hydrogenated proscillaridins (bufa-4,20-dienolide (PH21), bufa-4,20 (22) dienolide (PH22), 20R-bufa-4-enolide (PH4-R), 20S-bufa-4-enolide (PH4-S), chola-4 enoate (PH4-E) ) were prepared semi-synthetically, and their pharmacological effect was studied using guinea pigs. The positive inotropic effect (PIE) was examined in papillary muscles isolated from guinea-pig hearts. These compounds produced PIE, dose-dependently; the Dose-PIE curve was characterized by a faster PIE development than that by the parent compound proscillaridin (PS). The concentrations at which half maximum PIE just developed (pD2) were as follows: PS, 7.4; PH22, 6.2; PH21, 5.8; PH4-R, 5.3; PH4-E, 5.0; and PH4-S, 4.9. The time required to the half maximum effect (T50) at a given concentration of pD2 was measured in min: PS, 33; PH4-E, 22; PH22, 15; PH21, 7; PH4-S, 7; and PH4-R, 2. The speeds of inotropy of these compounds depended on the position of lactone ring reduction, though they have the same lipophilicity (Rm). Concentration-PIE curves of reduced PS-compounds were characterized by a decrease in potency and an increase in efficacy. PH21 and PH4-R produced PIE over wider range of concentrations than those of the other compounds. When PH21 at the dose of 11.9 mg/kg, an equivalent dose of 4.4 times the pD2 values, was administrated intravenously by bolus injection into guinea pigs, no arrhythmias were observed on the ECG.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679020 TI - [Effect of S-adenosyl-L-methionine sulfate tosylate (FO-1561) on functional recovery after transient cerebral ischemia in rats]. AB - The present investigation was undertaken to examine the recovery of functions, spontaneous EEG activity and cerebral ATP content during blood recirculation following cerebral ischemia in rats. The ischemia was induced by bilateral carotid artery 30 min-occlusion 24 hr after the permanent electrocauterization of bilateral vertebral arteries. EEG spectral analysis was performed by the Berg transform. The recovery of EEG activity was assessed by the time elapsing from the onset of blood recirculation until the delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz) or beta (13-32 32 Hz) band reappeared and the relative proportion of the four bands at 45 and 60 min after recirculation. Following the 20 min recirculation, the brains were frozen in situ with liquid nitrogen and then stored at -80 degrees C for later extraction for analysis. Concentrations of ATP in the cerebral cortex were determined with enzymatic methods. In animals administered FO-1561 (10 approximately 100 mg/kg, i.v.) simultaneously with blood recirculation, the reduction of time elapsing until reappearance of the theta, alpha and beta bands, the decrease in proportion of the delta band and the increase in that of the theta, alpha and beta bands which indicated the facilitation of transition to the normal state were observed. In animals administered FO-1561 (100 mg/kg), the improvement of ATP content was detected. These results demonstrate that FO-1561 may have a beneficial effect on the recovery from dysfunctions due to cerebrovascular disorder. PMID- 3679021 TI - Effects of creatine and creatinine content on the mutagenic activity of meat extracts, bouillons and gravies from different sources. AB - Thirteen commercial meat-flavour samples were analysed for creatine and creatinine content and tested for mutagenicity in the Ames Salmonella/microsome test. In most samples, more than 50% of the creatine had been converted to creatinine. Mutagenicity was related to the creatinine content: 150 mumol creatinine/g dry matter (gdm) gave upwards of 2500 revertants/gdm, concentrations of 15-40 mumol/gdm gave about 100 revertants/gdm and concentrations of 1-10 mumol/gdm gave only low or no significant mutagenicity. No relationship was apparent between coloration and mutagenicity. Beef steaks (initial weight c. 500 g) baked at oven temperatures between 115 and 245 degrees C only showed significant mutagenicity--135 revertants/100 gE (initial raw weight)--in the crust when baked at the highest temperature (245 degrees C). The gravies (meat juice drip) collected during baking showed a linear increase in mutagenicity with baking temperatures up to 180 degrees C (48-828 revertants/100 gE) and a very sharp increase in mutagenicity for the gravy collected from beef steak baked at 245 degrees C (28,300 revertants/gdm or 19,800 revertants/100 gE). At this high temperature, the brown coloration and the proportion of creatinine to total creatine and creatinine were also dramatically increased, because this gravy dried up completely during the baking procedure. PMID- 3679022 TI - Mutagenicity of pan-fried bovine tissues in relation to their content of creatine, creatinine, monosaccharides and free amino acids. AB - The mutagenicity of pan-fried patties of five bovine tissues (meat, heart, tongue, liver and kidney) containing various concentrations of creatine, monosaccharides and free amino acids were studied. Two experiments were performed, one on single tissues fried at 150, 175 or 200 degrees C for 3 min and the other on mixtures of meat and one of the other four tissues in various proportions, fried at 200 degrees C for 3 min. For both experiments, a double sided Teflon-coated plate was used. Frying at 150 degrees C induced mutagenicity to Salmonella typhimurium strain TA98 only in the heart sample-6000 revertants/100 gE (grams initial raw weight). Meat, heart and tongue fried at 175 or 200 degrees C showed mutagenicity values between 6000 and 19,600 revertants/100 gE. A linear relationship between mutagenicity and temperature was obtained for each of the three muscles and creatine was converted to creatinine with increasing temperature. Liver or kidney samples fried alone showed insignificant mutagenicity at all three temperatures. The creatine plus creatinine levels of raw meat, heart and tongue samples were between 19 and 33 mumol/g wet tissue. Liver and kidney both showed very low amounts of creatine plus creatinine (about 2 mumol/g wet tissue) in the raw tissue, while free amino acids were high. Glucose levels were high in liver but low in kidney samples. In meat/heart and meat/tongue mixtures the mutagenicity varied between 10,800 and 17,300 revertants/100 gE. The meat/liver and meat/kidney mixtures showed linear relationships between mutagenicity and the proportions of the mixture. The values for the slopes and intercepts of the two lines were almost equal. Among the three groups of precursors (creatine plus creatinine, monosaccharides and free amino acids) the creatine plus creatine in raw tissue seems to be the most important for producing mutagenicity. However, in crusts, the creatinine concentration was the variable with which most of the mutagenicity was associated. PMID- 3679023 TI - Short-term effects of two fusarium toxins, diacetoxyscirpenol and neosolaniol monoacetate, in male Wistar rats. AB - This study compared the pathological and haematological effects of neosolaniol monoacetate in male Wistar rats with those of diacetoxyscirpenol, a highly toxic trichothecene mycotoxin. Both toxins caused statistically significant decreases in erythrocyte counts and increased the proportion of larger platelets compared to controls when dosed at 1 mg/kg body weight three times/wk for up to 5 wk. Lesions caused by treatment with either toxin at this dosage level were mild and were seen--mainly after 2-4 wk--in the actively dividing cells of the thymus, spleen, lymph nodes and bone marrow. Reduced severity or disappearance of the lesions was noted towards the end of the treatment period. The type and severity of the toxic effects of neosolaniol monoacetate appeared to be similar to those of diacetoxyscirpenol. PMID- 3679024 TI - Subchronic oral toxicity of 4-chloro-alpha, alpha, alpha-trifluorotoluene in Sprague-Dawley rats. AB - The subchronic oral toxicity of 4-chloro-alpha, alpha, alpha-trifluorotoluene (CTT) was assessed in Sprague-Dawley rats. Four groups of six male and six female rats were treated daily for 28 days, by gavage, with doses of 0, 10, 100 and 1000 mg CTT/kg body weight using olive oil as a vehicle. No clinical signs were observed, other than salivation in the high-dose group in the last week. The males of this group showed a significant decrease in body-weight gain without a concurrent decrease in food consumption. In males, there were significant dose dependent increases in blood cholesterol and triglycerides, suggestive of alterations in lipid metabolism. The females showed only a small dose-related increase in serum lactate dehydrogenase. Specific histological alterations were found in the males given 1000 mg/kg/day, namely hyaline droplet nephrosis, along with a significant increase in relative kidney weight, and an increase in lipid vacuoles in the adrenal cortex. Slight nephrosis was also observed in males given 100 mg/kg. Both male and female rats showed a significant increase in relative liver weight at a dose of 1000 mg CTT/kg. CTT appears to have a low subchronic oral toxicity. Neither pathological nor biochemical alterations were found at 10 mg/kg body weight/day and this can be defined as the no-observable-effect level (NOEL). PMID- 3679025 TI - Genotoxicity and carcinogenicity assessments of caffeine and theobromine. PMID- 3679026 TI - Osteochondral disruption of the second metatarsal: a variant of Freiberg's infraction? AB - A case of Freiberg's Infraction of the second metatarsal is presented. The metatarsal head was resected and its pathology proved very informative. Necrotic bone was not found, but a shearing type of separation was identified at the level of "tidewater mark" in the articular cartilage and was the major observation. This suggested the possibility that in adults Freiberg's Infraction rather than true avascular necrosis may be in fact the result of a shearing-compression type of injury occurring at the interface between mineralized and nonmineralized articular cartilage (tidewater mark). An anatomical examination of metatarsophalangeal joints in cadavers showed that during walking at the "toe off" position, the toes dorsiflex to force the metatarsal head into plantar flexion. The proximal phalanges ride dorsally over the metatarsal heads producing a shearing force that would support our interpretation of the observations made in the case presented. PMID- 3679027 TI - Occurrence of the plantaris tendon in patients sustaining subcutaneous rupture of the Achilles tendon. AB - Many surgeons treat closed subcutaneous rupture of the Achilles tendon with primary surgical repair. Reinforcement of the primary repair can be accomplished easily using the plantaris tendon. Unfortunately, in the population of patients who sustain this injury, the plantaris is absent in 60% of patients. This is a statistically significant difference when compared to the absence of the plantaris tendon of less than 10% in reported cadaveric studies. PMID- 3679028 TI - Extraosseous and intraosseous arterial supply to the first metatarsal and metatarsophalangeal joint. AB - The extraosseus and intraosseous circulation to the first ray was evaluated by means of vascular injection techniques. The first metatarsal and metatarsophalangeal joint receive their blood supply from the first dorsal metatarsal artery, the first plantar metatarsal artery, and the superficial branch of the medial plantar artery. These three source arteries provide variable numbers of branches to the base, shaft, and head of the first metatarsal. Ramifications of branches to the head form an extensive capsular network that is more consistent and abundant on the dorsal and lateral aspects of the joint. The source of intraosseous vascularity consists of a diffuse network of fine periosteal arteries enveloping the diaphysis of the metatarsal, a single nutrient artery that perforates the first metatarsal at the lateral aspect of the shaft distally, and a system of metaphyseal and capital arteries that appear to constitute a major source of blood supply to the metatarsal head. PMID- 3679029 TI - Freiberg's disease: a suggested pattern of management. PMID- 3679030 TI - Long-time average spectrum of speech and voice analysis. PMID- 3679031 TI - Influence of utterance length upon temporal measures of syllable production by selected hearing-impaired children. PMID- 3679032 TI - [Evaluation of European language]. PMID- 3679033 TI - Otitis media and academic achievement in Eskimo high school students. PMID- 3679034 TI - [Intensive treatment for adolescent and adult stutterers by the Boberg and Kully method]. PMID- 3679035 TI - The laboratory testing of evidential breath-testing (EBT) machines. AB - Six types of evidential breath testing (EBT) machines were tested in a laboratory. The testing experiments are classified into three paragraphs: analytical performance, sampling and operating conditions. In order to characterize the analytical performance a set of parameters (repeatability, reproducibility, linearity, accuracy, specificity) was established. The results were, in general, good, although an underestimation of the actual vapour concentration was observed. Different types of EBT machines showed significant differences measuring the same vapour. PMID- 3679036 TI - A diflunisal related fatality: a case report. AB - A case is reported where the death of an individual resulted from the ingestion of diflunisal. Diflunisal was identified by a combination of liquid chromatography, UV spectrophotometry and colorimetry. Diflunisal was quantified in blood (260 mg/l), bile (71 mg/l), kidney (350 mg/kg), liver (400 mg/kg), stomach contents (34 mg) and urine (78 mg/l). No previous literature references discussing diflunisal related fatalities were available. PMID- 3679037 TI - Study of cathepsin A, B and D activities in the skin wound edges. Its application to the differential diagnosis between vital and postmortem wounds. AB - The aims of the authors in this paper has been to check the diagnostic ability of the Cathepsin A, B and D concentrations in the skin wound edges to the differential diagnosis between vital and postmortem wounds. We have studied 56 domestic pigs grouped in seven experimental series consisting of 8 animals in each, according to the time (0, 5, 15, 30 min and 1, 3 and 6 h) after the injury. The enzymatic activities were investigated following the methods by Bowen and Davison Biochem. J., 131 (1973) 417-419, Suhar and Marks J. Biochem., 101 (1979) 23-30 and by Anson (modified by Yamamoto, Eur. J. Biochem., 95 (1979) 459-467) for Cathepsin A, B and D, respectively. For the differential diagnosis between vital and postmortem wounds, our results showed that the most useful markers studied are the Cathepsin A and D activities, Cathepsin D that of the first one. PMID- 3679038 TI - Postmortem specimen collection. AB - Collection of proper postmortem specimens is an essential step in the process of toxicology case work. Improper collection of these specimens can greatly alter or negate chemical and toxicological analysis. Presented herein is a description of a postmortem specimen collection 'kit' that has proven suitable for use not only by the forensic pathologist, but also by the assistant coroner/small town funeral director obtaining specimens. PMID- 3679039 TI - Detection of bis(2-chlorethyl)-sulfide (Yperite) in urine by high resolution gas chromatography-mass spectrometry. AB - Bis(2-chlorethyl)-sulfide (Yperite) could be detected by GC/MS in urine samples, concentration ranging from 1 to 30 ppb. These results were supported by high resolution mass spectral data. PMID- 3679040 TI - A rapid and simplified extraction of haloperidol from plasma or serum with bond elut C18 cartridge for analysis by high performance liquid chromatography. AB - This method for the determination of haloperidol (HAL) in plasma is based on high performance liquid chromatography (HPLC) with a reversed-phase column, ODS-C18. HAL is rapidly extracted from human plasma by using Bond Elut C18 cartridge and its recovery is over 90%. The mobile phase is a mixture of 1% acetate/acetonitrile/tetrahydrofuran/triethylamine (69.5: 28.2:1.9:0.4, by vol.). The method is rapid, simple and free from intereferences and gives good precision. PMID- 3679041 TI - [Primary varicose vein disease and its predisposing factors. 10-year follow-up of the pathophysiology of primary varicose veins]. PMID- 3679042 TI - [Single-fiber electromyography. Recording technic, study parameters and clinical relevance]. PMID- 3679043 TI - [Assessing the depth of anesthesia using the electroencephalogram?]. PMID- 3679044 TI - [Therapy of pathologic vertebral fractures]. PMID- 3679045 TI - [Establishment of indications for the treatment of vertebral fractures]. PMID- 3679046 TI - [Classification of fractures of the thoracic and lumbar vertebrae]. PMID- 3679047 TI - [Surgical treatment of spinal injuries]. PMID- 3679048 TI - [Many old devices in clinics. Roentgen equipment is frequently outdated- differences in West German regions]. PMID- 3679049 TI - [Personal experiences with naturopathy. Diet forms in allergy. Helping the immune system in a natural way]. PMID- 3679050 TI - [AIDS in general practice]. PMID- 3679051 TI - [Information about the warning signs of cancer. Health education using a warning signs questionnaire for patients]. PMID- 3679052 TI - [Endoscopic prosthetics in inoperable tumors. External bile drainage and tube implantation--long-term results]. PMID- 3679053 TI - [Transdermal therapeutic systems]. PMID- 3679054 TI - [Tropical rain forest of the Amazon--a sensitive giant. Basic research is difficult--the ecosystem is very much endangered]. PMID- 3679055 TI - [Physical therapy in rheumatic diseases. Principles of stage-related exercise treatment]. PMID- 3679056 TI - [Leukocyte rheology in diabetes mellitus]. PMID- 3679058 TI - Seventeen years as a district nurse: many memories to cherish. PMID- 3679057 TI - [Kidney tolerance of apalcillin. Studies with apalcillin as a monosubstance and in combination with gentamycin]. PMID- 3679059 TI - The FNS courier/volunteer program: tradition--service--adventure. Part two. The present day. PMID- 3679061 TI - [A clinical study in serum levels of neuron-specific enolase (NSE) in diabetes mellitus. Special reference to types of diabetes and neuropathy]. PMID- 3679060 TI - [Studies on hyperglucagonemia in renal failure]. PMID- 3679062 TI - Effects of propranolol and swim-training on blood pressure, plasma electrolytes, and vasopressin in spontaneously hypertensive and normotensive rats. AB - The aim of this work was to study the influence of beta-adrenoreceptor blockade on the adaptation to exercise of one of the hormonal systems (arginine vasopressin) involved in the regulation of blood volume and pressure in spontaneously hypertensive rats (SHR). Systolic blood pressure (SBP) was measured in SHR and WKY rats during 11 wk of swim training. At the end of the training program we determined post-exercise values of plasma arginine-vasopressin (pAVP), osmolality (pOsm), K+ (pK+), Na+ (pNa+), hemoglobin (Hgb), and hematocrit (Hct) in SHR and WKY rats. The following groups were studied: control (C), propranolol treated (PC), swim trained (S), and propranolol-treated and swim-treated (PS). SBP was significantly reduced by swim training or propranolol, bu these beneficial effects on SBP were attenuated when propranolol and swim training were combined. pNa+ and pOsm were significantly reduced by training alone in SHR. This reduction of pNa+ and, consequently, of pOsmol without any modification of other parameters could suggest an Na+ loss. In contrast, the SHR group treated with propranolol alone showed a significant reduction in Hct, suggesting an increased plasma volume without Na+ loss. PS SHR showed a significant reduction of Hgb, Hct, proteins, pNa+, and pOsmol, probably as a consequence of the additive effects of swimming- and propranolol-induced hypervolemia with Na+ loss. The slight and nonsignificant reduction in pAVP observed with either training or propranolol treatment alone became much more pronounced and statistically significant when the 2 treatments were combined. WKY rats showed a much smaller response to exercise and beta-adrenoreceptor blockade than SHR. We conclude that the hypervolemia suggested in PS SHR could be a possible cause of attenuation of the beneficial effects of either swimming or propranolol on SBP. PMID- 3679063 TI - Changes in platelet free Ca2+ concentration after chronic digoxin treatment. AB - Cell Na+ and Ca2+ concentrations control each other by various mechanisms. In excitable cells from various origins, Ca2+ extrusion from the cell and its entry are dependent for a large part on the activity of the Na+, Ca2+-countertransport system. Cytosolic free Ca2+ concentration is also controlled by the Na+-H+ exchange activity. To analyze the changes in cytosolic Ca2+ concentration accompanying the reduction of the membrane Na+ gradient, cytosolic free Ca2+ concentration ([Ca2+]i) was measured by fluorescent dyes in platelets and erythrocytes from healthy subjects, before and during digoxin treatment (0.25 mg/day for 6 days). [Ca2+]i was increased in platelets from 169 +/- 30 to 321 +/- 61 nmol/l (n = 7, P less than 0.02) and unchanged in erythrocytes (121 +/- 6 and 104 +/- 7 nmol/l). This increase in platelet [Ca2+]i was not accompanied by a change in serotonin content (5.43 +/- 0.67 vs 5.49 +/- 0.61 10(-7) mol per 10(11) cells) and could not be reproduced by in vitro addition of 10(-4) mol/l ouabain (198 +/- 33 vs 186 +/- 73 nmol/l). The enhanced [Ca2+]i in platelets is thus not a short-term consequence of a reduced membrane Na+ gradient, but reflects either the overload of intracellular Ca2+ stores or an enhanced in vivo stimulation by hormones or neurotransmitters. PMID- 3679064 TI - Comparative effects of zopiclone, triazolam and placebo on memory and psychomotor performance in healthy volunteers. AB - This study evaluated the effects of acute doses of zopiclone (7.5 mg), triazolam (0.25 mg) and placebo on memory and psychomotor performance of 12 normal volunteers. The subjects received both drugs in a repeated measure, double-blind Latin square design. The tests (CFF, CRT, DSST, memory assessments) were performed before and 2 and 6 hr after treatment. Zopiclone and triazolam induced an anterograde amnesia affecting short-term and long-term memory which lasted less than 6 hr. No retrograde amnesia was observed. Two hr after drug intake of both hypnotics psychomotor performances were significantly altered compared with placebo. The subjects also felt more drowsy, dizzy, clumsy and tired, and less alert and energetic 2 hr after zopiclone and triazolam compared to placebo. There was no difference between the effects of the two hypnotics at the doses studied. PMID- 3679065 TI - Characterization of silent ischemia in patients with unstable angina: prognostic and therapeutic implications. AB - The occurrence of silent ischemia in various ischemic myocardial syndromes has attracted increasing attention. In unstable angina hemodynamic monitoring has suggested that the symptomatic and silent episodes of ischemia do not differ significantly. In two discrete studies we determined the characteristics and prognostic significance of silent ischemic episodes in unstable angina. In one study with 41 patients, there were 781 episodes of ischemia in Holter recordings: 392 (50%) with ST-segment depression, 242 (31%) with ST-elevation, 45 (6%) with ST-elevation and depression in different leads, 70 (9%) with pseudonormalization of T waves and 32 (4%) with T wave augmentation. Ventricular arrhythmias were associated with 18% of the episodes. The mean duration of ischemia was 14 minutes (range 30 seconds to almost twelve hours), the majority being less than five minutes. Only 154 (20%) of the 781 episodes of ischemia were associated with pain. Conversely, 77 episodes of chest pain were not associated with electrocardiographic changes. Analysis of the temporal sequence of heart rate during the development of ischemia (analysed in 415 episodes) showed that in only 43 (10%) the heart rate at the beginning of ischemia was significantly (exceeding 6 beats/minute) greater than that at five minutes (baseline) preceding the onset of ischemia. At the peak of ischemia, the mean heart rate increase was 10% and returned to baseline at the end of the ischemic episode. The data indicate that 80% of ischemic episodes in unstable angina are silent and over 90% are not triggered by increases in heart rate indicating that increased oxygen demand is an uncommon cause of ischemia in unstable angina.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679066 TI - The prognostic importance of asymptomatic ischemic episodes in patients with unstable angina pectoris. AB - Unstable angina pectoris is a high-risk ischemic disease which is characterized by recent onset of angina, a change in preexisting stable angina pattern or the occurrence of angina at rest. In a study of 70 patients with unstable angina on treatment with a triple drug regimen of nitrates, propranolol and nifedipine, 37 patients (53%) had 205 ischemic episodes, 90% of which were asymptomatic. 33 patients (47%) had no changes in the ST-segments. Between the two groups, there were no significant differences with respect to risk factors, medical treatment or coronary angiographic findings. Only the resting ejection fraction in the former group was slightly but significantly lower than in the latter group. At one month of follow-up seven patients had developed myocardial infarction, six of whom were in the group with silent ischemia. In 13 patients, due to inadequate success of medical treatment, bypass surgery or PTCA was performed; ten of these were from the group with silent ischemia. Of patients with silent ischemia, those with episodes totaling more than 60 minutes per 24 hours had the worst outcome. Multivariate analysis showed that, with respect to prognosis, the most important parameter was silent ischemia followed by angina pectoris. PMID- 3679067 TI - Haemodynamic changes during silent myocardial ischaemia. AB - The haemodynamic significance of asymptomatic ST segment depression has been assessed in patients with coronary artery disease by direct measurement of left ventricular end-diastolic pressure (LVEDP) or pulmonary artery end-diastolic pressure (PADP). Both techniques have demonstrated a rise in pressure during such episodes of ST segment depression recorded in the Coronary Care Unit, cardiac catheter and exercise laboratories or during ambulant activity. Thus silent or asymptomatic ST segment depression is associated with similar haemodynamic changes to that seen during angina pectoris and has considerable therapeutic implications. PMID- 3679068 TI - [Fine structure of surviving heart muscle cells in ventricular aneurysms]. AB - Surgically-obtained tissue specimens from 41 patients with ventricular aneurysm were studied electron microscopically. The tissue from the resected aneurysms showed substantially varied morphological differences. In some, there were extensive regions of scar containing increased fibrotic material and few cells, in others there were also larger contiguous regions of myocardium with an essentially normal appearance. In the preserved myocardial regions, the cardiac cells showed moderate hypertrophy. There was an increase in contractile substance in parallel with an increase in mitochondria and enlargement of the nucleus with frequent waves and invaginations in the cell membrane. The cells at the marginal regions between fibrous tissue and preserved myocardium were frequently isolated from adjacent cells. In particular, when the isolated cells were completely surrounded by fibrous tissue, clear degeneration was apparent. These cells showed mainly a fibrillolysis with dissolution of the cross-bands and loss of the entire contractile apparatus. In compensation, occasionally there was proliferation of other cell structures, especially the free sarcoplasmatic reticulum. The hypertrophy of the still intact myocardial cells is considered compensatory for the infarct-incurred loss of tissue. The degenerative appearance is mainly attributable to fibrous tissue invasion. The diminished oxygen supply, compromised or abolished impulse conduction, loss of function and passive stretch during systole may be regarded as causes of the degeneration. PMID- 3679069 TI - Foundation funding for AIDS programs. PMID- 3679070 TI - A review of PPS research coverage. PMID- 3679071 TI - Capital pools: 'messy, cumbersome, and inelegant'. PMID- 3679072 TI - Family practice hits its stride. PMID- 3679073 TI - Projecting the impact of AIDS on hospitals. PMID- 3679074 TI - The regulation of preferred provider arrangements. PMID- 3679075 TI - Employers as managers of risk, cost, and quality. PMID- 3679076 TI - Surgical operations and supply: assessing future quality. PMID- 3679077 TI - A physician's view of managed care. PMID- 3679078 TI - Survey of delta infection in the Naples basin: a possible epidemiologic model for endemic areas. AB - The prevalences of delta co-infections and superinfections in 100 randomly selected subjects for each year from 1977 to 1982 and in all the subjects of subsequent years until April 1986, admitted to our Department with acute viral hepatitis B (AVHB), were evaluated and compared with the annual incidence of cases of AVHB reported in Naples during the same period. Moreover, anti-delta antibodies were determined in the sera of 25 consecutive cases of HBsAg-positive chronic active hepatitis and 25 consecutive cases of HBsAg-positive chronic active hepatitis and 25 consecutive cases of HBsAg-positive cirrhosis, respectively, for 1977, 1980, 1983 and 1986. Our data show a high, constant circulation of HDV and a decrease in its incidence in acute forms over the last 3 years, which coincides with the parallel lower incidence of AVHB, but which is not reflected in the delta prevalence in the chronic forms. They also indicate the possible existence of alternate cycles of increase and decrease in the infection, partly dissociated from HBV circulation, which present peculiar epidemiologic characteristics. PMID- 3679079 TI - The value of the hydrogen (H2) breath test for the diagnosis of bacterial overgrowth in gastric achlorhydria. AB - Sixteen healthy volunteers, 23 patients with peptic disease, and 38 patients with achlorhydria were investigated with bacterial cultures from gastric juice and a hydrogen (H2) breath test after a standard meal. In acid-secreting subjects upper respiratory tract bacteria were found in 6/39. In every single achlorhydric patient gastric bacterial concentrations were above log 10 5.7/ml. Fecal flora was found in 22/38. The patient with fecal organisms were significantly older than those without (p less than 0.05). The H2 breath test revealed low postprandial carbohydrate fermentation in acid secretors and in achlorhydrics with no fecal flora. The lowest H2 production was found 90 and 120 min after the meal. In achlorhydrics with fecal organisms the mean H2 concentration at these times of measurement was elevated (p less than 0.05). Assuming that a mean H2 concentration at 90 and 120 min above 19 ppm (mean in healthy volunteers at 90 and 120 min + 2 SD) is pathological, the association of fecal bacteria in gastric juice and a "positive" H2 breath test is highly significant (P less than 0.001). Fecal bacteria in the gastric juice would indicate small-intestinal fermentation with a probability of 81%. A gastric culture negative for fecal organisms would predict a "negative" H2 breath test with a probability of 91%. PMID- 3679080 TI - Effects of cigarette smoking on the location, healing and recurrence of gastric ulcers. AB - The effects of cigarette smoking on the location, healing and recurrence of gastric ulcers were investigated by endoscopy. The endoscopic Congo red test developed in this clinic revealed a close relationship between the location of gastric ulcers and the extent of the acid-secreting area, and the smoking index. In general, in patients with a high smoking index, gastric ulcers were located proximally and the acid-secreting area was small. These findings indicate that smoking is associated with the development of fundal gastritis and also with the development of high-lying ulcers. Healing of gastric ulcers was significantly faster, and their recurrence was significantly less frequent in patients who stopped smoking or reduced smoking by a half or more after treatment, than in those who did not. PMID- 3679082 TI - [Chromosome instability observed in cells from monospermic, homozygous moles]. AB - The present study was undertaken to disclose the mechanism which concerned to the propensity to malignancy of complete moles. For this purpose, the incidence of chromosomal aberrations and sister chromatid exchanges(SCE) after the administration of 0-30 ng/ml mitomycin C(MMC) were compared among cells cultured from molar and normal villi, and peripheral blood. Abnormally high induction of chromosomal aberrations and SCE was observed in molar cells without MMC treatment when compared with those of the remaining two cells. Then, higher susceptible responses to the low concentration of MMC were also noticeable in molar cells rather than two kinds of cells. As a result, it was assumed that chromosome instability possibly played an important role for choriocarcinogenesis of molar cells. Homozygosity of paternally derived genes may be responsible for this chromosome fragility. Six chromosomal bands (1q 21, 2p 24, 2p 13, 7q 31, 8q 22, 13q 33) were preferentially involved in the formation of chromosomal aberrations occurred spontaneously in molar cells. Four of these six bands were identical with the break points necessary for the production of the marker chromosomes in various tumors described previously, though one band was consistent with the N myc oncogene locus. Thus, the possible association between chromosome rearrangements occurred in those six bands and the choriocarcinogenesis was assumed, though further accumulation of cytogenetic and molecular data was absolutely necessary. PMID- 3679081 TI - Comparison of biopsy urease test and histologic examination for detection of campylobacter pylori in duodenal, antral and fundic biopsies. AB - The presence of Campylobacter pylori was investigated in duodenal, antral and fundic biopsies of 149 consecutive patients undergoing upper gastrointestinal tract endoscopy by biopsy urease tests (CLOtest; "CLO test") and histologic examination ("HIST") after modified Giemsa staining. Positive results were obtained rarely in the duodenum (4.7% and 12.8% by CLO test and HIST, respectively), but equally frequently in antral (48.3% and 62.4%) and fundic biopsies (55.0% and 54.4%). Using combined evaluations ("COMB") of both CLO test and HIST results, and disregarding isolated positive histologic grades "1" as C. pylori negative, the detection rates were 6.0, 53.0 and 56.4% in the above order and 63.1% overall at any of the biopsy sites. There was no close correlation between the rapidity of the color conversion of the biochemical test and the microscopic grading of C. pylori density. A positive CLO test in single antral biopsy specimens was an accurate predictor of the presence of C. pylori as compared with HIST (predictive value positive PVpos 0.97), while negative antral BUT results did not rule out C. pylori colonization of the upper GI tract (PVneg 0.52 compared with HIST). An additional negative CLO test from fundic biopsies increases the PVneg to 0.58. PMID- 3679083 TI - [Pathological study of ovarian metastasis in cervical cancer]. AB - During the period from 1977 to 1986, 860 patients with cervical cancer were examined ovarian metastasis in our department. Four hundred and seventy seven patients of stage 0 and Ia were treated by a simple hysterectomy without oophorectomy. Follow-up examinations on these stages revealed no recurrence in the ovaries and 5 year survival rate is 100%(239/239). In 383 patients with invasive carcinoma in stage Ib to stage III, who were treated by radical hysterectomy, histological examinations were performed to detect ovarian metastasis. In invasive cases of epidermoid carcinoma(stage Ib to stage III), no ovarian metastases were detected, despite discovery of metastases to the pelvic lymph node in 22.3% of the cases. Conversely, in the cases of cervical adenocarcinoma(pure adenocarcinoma and mixed carcinoma), 9 of 74 cases(12.2%) showed ovarian metastases even in early histologic stages. It is noteworthy that seven of nine cases had no lymph node metastasis. Only endocervical type had ovarian metastasis in pure adenocarcinoma. In mixed carcinoma, metastatic lesion of ovary is adenocarcinoma. PMID- 3679084 TI - [Studies on HLA specificities in molar conceptions]. AB - Complete mole is a form of natural allograft since it carries paternal genetic traits alone which differ antigenetically from those of the mother. Successful growth of mole is likely to be immunologically protected. Because the immune system is genetically controlled, the effect of HLA system on the development of androgenetic ova into moles is a subject of interest. In this study, HLA-A and -B specificities in the mole and its parent were compared with the ones of general population in Japan. Fifty-six molar tissues were used for absorption of HLA specificities determined by HLA typing of each patient and her husband. Results obtained were as follows. 1) HLA antigens were expressed on all molar tissues examined, and those antigen were derived selectively from paternal specificities, but not maternal one. 2) Fifty molar tissues had received the paternal haplotype and remaining six molar tissues had showed heterozygosity which were consistent with the paternal diplotype. Those suggested the fertilization of an empty egg by two spermatozoa. 3) A significant association was found with decreased frequency of HLA-Aw19 and HLA-Bw22 in the molar tissues (3.6% and 2.7%) compared with general population (16.4% and 11.5%). 4) The compatibility of HLA-A and -B types among moles with sequelae and the parents was higher(81%) than the estimated value(68%) in the control families. As a result, HLA analysis was useful for distinction of zygosity of molar tissues. Decreased frequencies of HLA-Aw19 and Bw22 in the mole were assumed to be resulted from the wastage of androgenetic ova.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679085 TI - [Effects of environmental changes around tumor cells on immunogenicity, and its mechanisms]. AB - I studied alterations in the tumorigenicity and immunogenicity of cultured rat fibrosarcoma clone in different growth environments. When the fetal calf serum concentration in a medium was lowered from 10% to 1%, the tumorigenicity was diminished while the immunogenicity was enhanced, accompanied by a prolongation of the in vitro doubling time in a reversible manner. These phenomena were not associated with the quantities of the tumor-associated antigen and/or the rat major histocompatibility complex, but were associated with the appearance of a unique antigen (s), which consist of glycoprotein and exist as a crypt-antigen (s). Our observations indicate that the in vitro growth environment modifies the surface of tumor cells and causes a reduction in their tumorigenicity and an enhancement of their immunogenicity. PMID- 3679086 TI - The protective effects of prostaglandin E1 in an experimental massive hepatic cell necrosis model. AB - When a small amount of Gram-negative lipopolysaccharide was intravenously injected into mice which had been injected with heat-killed Propionibacterium acnes 7 days before, massive hepatic cell necrosis was induced and most of the mice died 24 hr later. However, when prostaglandin E1 was administered with lipopolysaccharide, remarkable improvements in the survival rate and in the histological changes of the liver were observed. In order to find out how prostaglandin E1 suppressed the induction of massive hepatic cell necrosis in this experimental model, we studied the effects of prostaglandin E1 on the activation of liver adherent cells, from which the cytotoxic factor is released, and on the protection of hepatocytes from the cytotoxic factor. As a result, prostaglandin E1 not only inhibited the activation of liver adherent cells and suppressed the release of the cytotoxic factor, but it also directly affected the hepatocytes and protected them from the cytotoxic factor. PMID- 3679087 TI - Hepatic heme synthesis in a new model of experimental hemochromatosis: studies in rats fed finely divided elemental iron. AB - Rats fed chow containing finely divided elemental iron (from carbonyl-iron) develop hepatic iron overload resembling human hereditary hemochromatosis in that deposition of iron is primarily in periportal hepatocytes and with hepatic iron concentrations sufficiently high to be associated in the human disease with hepatic fibrosis or cirrhosis. In recent studies using this model, we reported changes in hepatic hemoproteins and heme oxygenase, the rate-controlling enzyme of heme breakdown. We now report effects of iron-loading on three enzymes of heme synthesis: 5-aminolevulinate synthase; the first and rate-controlling enzyme of the pathway, 5-aminolevulinate dehydrase (or porphobilinogen synthase), and uroporphyrinogen decarboxylase, the activity of which is decreased in porphyria cutanea tarda, a liver disease in which iron is known to play an important but still poorly understood role. Of the three enzymes, only activity of the dehydrase was altered by iron-loading: it was decreased significantly as early as 1 week after starting iron feeding, and with marked iron overload was 30 to 32% of control values. The degree of decrease was inversely related (r = -0.77 to 0.88) to the degree of iron overload and was partially reversed within 1 to 3 days when feeding of the iron-supplemented diet was stopped. The decrease in dehydrase activity was not attributable to lack of reduced glutathione or other disulfide-reducing agents or to zinc deficiency; nor was evidence found for inhibition by iron compounds or other possible inhibitors present in iron-loaded livers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679088 TI - Increase in the number of fenestrae in mouse endothelial liver cells by altering the cytoskeleton with cytochalasin B. AB - Endothelial cells of the hepatic sinusoid isolated from mice livers and maintained in culture display typical fenestrae grouped in sieve plates. Treatment with cytochalasin B led to no significant change in the mean diameter of the fenestrae but to an increase in their number and in the porosity of the cells (percentage of the cellular surface opened by the fenestrae) which attained up to 300% of that of the controls. Scanning electron microscopic observations of Triton-extracted cells revealed that these modifications were related to an alteration of the cytoskeleton. The effect of cytochalasin B could be reversed; 3 hr after removal of the drug, the cells recovered their original aspect with sieve plates scattered over their surface. These observations demonstrate that endothelial fenestrae are inducible structures and that the cytoskeleton seems to be involved in their formation. PMID- 3679089 TI - Serum type III procollagen and basement membrane proteins as noninvasive markers of hepatic pathology in Indian childhood cirrhosis. AB - While serum concentrations of antigens of the aminopropeptide of type III procollagen have been considered as indicators of hepatic pathology in adults, the high concentrations normally found in children during growth may preclude their use in pediatric liver disease. To clarify this and to determine the role of other circulating connective tissue-related substances in children, we have measured serum concentrations of antigens related to aminopropeptide of type III procollagen, the 7S domain of type IV collagen and the P1 fragment of laminin in healthy subjects aged 1 month to 4 years and in children with Indian childhood cirrhosis, a particularly aggressive form of liver disease. In healthy subjects, there was a considerable age variation in serum aminopropeptide of type III procollagen but not in 7S collagen or laminin P1. In Indian childhood cirrhosis, all three serum antigens were increased (p less than 0.001) above the upper limit of normal for age. Both the serum 7S collagen and laminin P1 concentrations showed a significant correlation with the degree of intralobular fibrosis and also with the severity of necrosis and cellular infiltration, suggesting that these serum antigens may be a noninvasive means of assessing and monitoring events associated with hepatic fibrosis in Indian childhood cirrhosis. The raised serum aminopropeptide of type III procollagen in Indian childhood cirrhosis did not correlate with any histological parameter assessed. Gel filtration of serum showed that, in healthy subjects, the predominant antigenic form of aminopropeptide of type III procollagen was a degradation peptide smaller than authentic aminopropeptide of type III procollagen; while in Indian childhood cirrhosis the authentic peptide and a larger degradation peptide predominated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679090 TI - Bile canalicular morphometry in arteriohepatic dysplasia. AB - The diagnosis of arteriohepatic dysplasia may be difficult, particularly in very young patients with no family history, and the pathogenesis of the disorder remains obscure. It has been reported that the typical ultrastructural changes of cholestasis are scant in this condition and proposed that there is a failure of the hepatocytes to secrete bile into the canaliculi. In an attempt to expand on these observations and to test the value of ultrastructure as a differential diagnostic test for this condition, we chose two parameters felt to be associated with cholestasis that could be reliably and relatively simply determined by ultrastructural morphometry: canalicular dilatation and loss of canalicular microvilli. The values for these parameters were compared in arteriohepatic dysplasia with those in other infantile cholestatic conditions and with those in noncholestatic controls. The results of these morphometric studies corroborated the previous observation that canalicular dilatation in arteriohepatic dysplasia is minimal. There was, however, only a marginal difference in canalicular area between patients with arteriohepatic dysplasia and those with extrahepatic biliary atresia. There was significant overlap of values for canalicular area among all groups. Surprisingly, the studies showed no real loss of canalicular microvilli in any of the cholestatic conditions. The findings suggest that, at least for these two parameters, caution should be exercised in using qualitative electron microscopic evaluation as a diagnostic test for arteriohepatic dysplasia. PMID- 3679091 TI - Mucus hypersecretion in the gallbladder epithelium of ground squirrels fed a lithogenic diet for the induction of cholesterol gallstones. AB - This study identified mucus granules, determined mode of release and quantified their volume in the gallbladder epithelium of Richardson's ground squirrels (Spermophilus richardsonii) fed a lithogenic diet of 2% cholesterol to experimentally induce gallstone formation. Tissue was examined using light microscopy histochemistry, scanning and transmission electron microscopy, as well as autoradiography and morphometry at the electron microscopic level. Autoradiography demonstrated incorporation of a glycoprotein precursor, [3H]galactose, within the membrane-bound granules localized in the supranuclear region of the epithelial cells. Exocytosis of granule contents was by merocrine secretion. Morphometry indicated a significant increase in the amount of intracellular mucin granules as early as 18 hr on the lithogenic diet, a feature that continued throughout the experimental period of 20 weeks. Mucus synthesis/secretion rates returned to control values within 3 weeks after removal from the diet. Scanning electron microscopy observations revealed a thick sludge like layer overlying the epithelium at a time in the chronology of the cholelithiasic model that correlated well with the initial phases of stone formation. Histochemistry showed this layer to be a mixture of acidic mucins. Neutral mucins were not observed. The hypersecretion of mucus and formation of this sludge-like layer appear to be critical nucleating factors in the formation of cholesterol gallstones. PMID- 3679092 TI - Electron microscopic evaluation of brain edema in rabbits with galactosamine induced fulminant hepatic failure: ultrastructure and integrity of the blood brain barrier. AB - Brain edema is a major complication of fulminant hepatic failure and is responsible for death in a large percentage of patients. We previously demonstrated the progressive accumulation of water in grey matter areas of the brain in the rabbit with galactosamine-induced fulminant hepatic failure. We now report the electron microscopic morphology of the brain in the same model of acute hepatic failure following the intravenous injection of horseradish peroxidase, an intravascular tracer which forms an electron-dense reaction product. Rabbits with both mild and severe encephalopathy had normal blood pressures and blood gases at the time of study. Fixation of brain tissue was obtained by whole-body perfusion. Marked swelling of the cytoplasm, perineuronal and perivascular processes of astrocytes were noted in cortical gray, but not white, matter areas; the other cellular components of the brain had normal morphology. Capillary endothelial cells were normal, and there was no evidence of horseradish peroxidase in endothelial cell vesicles, basement membranes or the brain parenchyma, suggesting that the blood-brain barrier was impermeable to large molecules. Histologic evidence of brain edema is seen in this model, with swelling of astrocytes as the primary manifestation of the accumulation of water. Damage to astrocytes or inhibition of their function may contribute to the pathogenesis of hepatic encephalopathy in this model. PMID- 3679093 TI - Chronic active hepatitis associated with antiliver/kidney microsome antibody type 1: a second type of "autoimmune" hepatitis. AB - Sixty-five patients with histologically proven chronic active hepatitis of unknown cause but associated with the antiliver/kidney microsome antibody type 1, confirmed by immunofluorescence and immunoprecipitation, were selected as forming a special entity. This disease was found to be rare with a prevalence of 5/1,000,000. The female to male ratio was 8:1. The condition occurred at all ages but was most common between the ages of 2 and 14 years. In 22 of the 65 cases, the hepatitis was associated with an autoimmune disease, most commonly insulin dependent diabetes, autoimmune thyroid disease and vitiligo. The same autoimmune diseases were present in first-degree relatives from seven families. In 36 cases, the onset of disease resembled acute viral hepatitis. Serum biochemical tests showed marked elevation in aminotransaminases and hypergammaglobulinemia. Paradoxically, serum and salivary IgA levels were often normal or low. Histologic findings were multifocal hepatic necrosis with bridging in the acute stage, and aggressive hepatitis with mononuclear cell infiltration or macronodular cirrhosis in the late stages. Serologically, apart from the presence of antiliver/kidney microsome antibody type 1, the disease was characterized by the absence of antiactin, antimitochondria and antinucleus antibodies; however, organ-specific autoantibodies were often present. The clinical course was usually severe: six patients in the acute stage presented with fulminant hepatitis, and all, except two, other patients progressed to cirrhosis. Prolonged treatment with corticosteroids and immunosuppressants was usually effective in rendering the cirrhosis inactive. The cumulative survival rate was 51% at 14 years. We propose to call this entity "anti-LKM1 chronic active hepatitis" or "autoimmune hepatitis type II" to differentiate it from classical "lupoid hepatitis" or autoimmune hepatitis type I. PMID- 3679094 TI - Multivariate survival analysis using Cox's regression model. PMID- 3679095 TI - Foreign language hepatologic publications. PMID- 3679096 TI - Inherited hyperammonemia: an algorithm for diagnosis. PMID- 3679097 TI - Oriental hornet venom-induced hepatic injury: the first animal-produced hepatotoxin? PMID- 3679098 TI - Portal-systemic shunts for Budd-Chiari syndrome. PMID- 3679099 TI - Chronic pain masks depression, multiple personality disorder. PMID- 3679100 TI - Beyond deinstitutionalization: a new ideology for the postinstitutional era. AB - The emergence of the young adult chronic patient, and the attendant perception that deinstitutionalization has failed, may be viewed as the inevitable result of the success of deinstitutionalization. Deinstitutionalization gave freedom to the mentally ill, but in doing so it left patients free to struggle on their own. The deinstitutionalization ideology failed to predict the difficult clinical reality that most patients do not readily choose the identity of chronic mental patient and are reluctant to make use of available treatment programs. The author presents the key principles of a new postinstitutional ideology that focuses on helping patients attain the best possible adaptation to their illness regardless of the setting in which they are treated. He hopes the ideology will infuse new hope and clinical expertise into work with people with chronic mental illness. PMID- 3679101 TI - A community survey of self-injurious behavior among developmentally disabled children and adolescents. AB - The extent, nature, and treatment of self-injurious behavior was surveyed among 2,663 developmentally disabled children and adolescents in a large metropolitan school district during the 1984-85 school year. Sixty-nine, or 2.6 percent, of the students exhibited at least one type of self-injurious behavior during the preceding 12 months; 59 percent of these students were males and 41 percent were females. Most of the self-injurious students were either severely or profoundly retarded, and their mean age was 10.2 years. Although almost three-quarters of the students exhibited self-injurious behavior at least daily, only a third were engaged in formal treatment programs for the problem. More than half (53.6 percent) had been restrained during the preceding 12 months for such behavior, and 8.7 percent had received psychotropic medications. The authors believe that the development of effective treatment strategies for self-injurious individuals living in the community may help them avoid institutionalization. PMID- 3679102 TI - A comparison of inpatients in an urban state hospital in 1975 and 1982. AB - To investigate whether there had been a rise in admissions of young, chronic, antisocial patients at a state psychiatric hospital in New York City, the authors compared 50 patients admitted in 1975 and 49 admitted in 1982 on demographic characteristics, inpatient history, and history of antisocial behavior in the community and during the hospitalization. The cohorts had comparable demographic characteristics, lengths of stay, and overall histories of antisocial behavior. However, the percentages of patients who committed assault and had encounters with the criminal justice system while living in the community were significantly higher in the 1982 cohort, as was the proportion of men who engaged in antisocial behavior in the community. The incidence of episodes of violence and of seclusion and restraint during hospitalization was significantly higher among the 1982 cohort but was not related to antisocial behavior in the community or age. The authors conclude that urban state psychiatric hospitals may have experienced a rise in admissions of antisocial patients but that current data do not explain why. PMID- 3679103 TI - A psychoeducational workshop for depressed patients, family, and friends: description and evaluation. AB - Since 1982 depressed patients enrolled in a treatment study at the Western Psychiatric Institute and Clinic and their family and friends have participated in a day-long psychoeducational workshop conducted by the clinic's staff. The workshop is designed to help family and friends become useful, long-term resources for patients with recurrent depression and to enlist their assistance in the treatment study. During the morning session, the group discusses the symptomatology, theory, etiology, and treatment of depression, and staff describe the treatment study. In the afternoon, patients and their families and friends meet separately, the patients to discuss methods of coping with depression and interacting with significant others, and the families to discuss the impact of the patient's depression on their lives and to share common problems. More than 83 percent of family and friends who evaluated the workshop considered it moderately or extremely helpful. The results of the evaluation are summarized. PMID- 3679104 TI - Short-term psychiatric hospitalization of children. AB - Recent changes in psychiatric practice, fueled in part by national economic trends, have contributed to the increasing use of short-term psychiatric hospitalization for children. The authors discuss specific approaches to treatment planning, milieu therapy, family work, and individual therapy that help maximize a patient's stay on the short-term psychiatric unit for latency-age children at Tulane University Hospital. Data on diagnosis and length of stay of children admitted during the first two years of the unit's operation are presented, and specific attributes of latency development that affect the short term process are discussed. PMID- 3679105 TI - A ten-year study of civil commitments in Washington State. AB - A ten-year longitudinal study of all civil commitments was conducted in a mid sized county in Washington State, beginning with the 1974 effective date of a more stringent commitment law and encompassing the introduction of more lenient criteria five years later. A major finding was the increase in the number of 72 hour detentions and 14-day commitments that preceded by one year the passage of the broader criteria. The number of detentions continued to rise throughout the study period, while 14-day and 90-day commitments rose but less sharply. Data on repeated detentions showed that 21 percent of the patients were detained more than once. This group of recidivists accounted for 45 percent of the total number of detentions. PMID- 3679106 TI - Group art therapy as an adjunct to treatment for chronic outpatients. AB - Art therapy has lagged behind other therapeutic modalities in being subjected to rigorous evaluation of its effectiveness. This study examines psychosocial outcome for a group of chronic psychiatric outpatients. Half the patients were randomly assigned to a ten-week supportive art therapy group as an adjunct to treatment; the other patients served as a control group. Patients who remained in the art therapy group for the full ten weeks reported a significant improvement in their attitudes toward themselves as measured by the Progress Evaluation Scales, and their therapists rated them as significantly better able to get along with others. The authors believe the study demonstrates the potential of supportive art therapy to enhance functioning of chronic psychiatric patients in the short run. Empirical attention to long-term gains and to the efficacy of specific forms of art therapy is needed in the future. PMID- 3679107 TI - The patient on the ledge: evaluation and intervention. PMID- 3679108 TI - Determining social and therapeutic rules for psychiatric inpatients. PMID- 3679109 TI - Homophobia reassessed. PMID- 3679110 TI - A borderline patient's view. PMID- 3679111 TI - Hospitals unique in mission, not operation. PMID- 3679112 TI - Salomon's exit surprises rivals and issuers. PMID- 3679113 TI - Bond volume's down again for tax-exempt debt. PMID- 3679114 TI - Sale/lease-back with doctors being explored by hospitals. PMID- 3679115 TI - Reduce malpractice risks through better communication. PMID- 3679116 TI - Marketing budgets increase a modest 4%. PMID- 3679117 TI - Babies deliver more patients to hospitals. PMID- 3679118 TI - Maternity service aimed at dad. PMID- 3679120 TI - Hospitals say labor proposal will cost money. PMID- 3679119 TI - Will the nursing shortage lead to liability suits? PMID- 3679121 TI - HMOs bid for Florida state employee contracts. PMID- 3679122 TI - Coalition creates "multicarrier-friendly" PPO. PMID- 3679123 TI - Hospitals can expect MD compensation to rise. PMID- 3679124 TI - Ibbotson chides not-for-profits on investments. Interview by Maria R. Traska. PMID- 3679125 TI - Projecting MRI use: key to scanner purchases. PMID- 3679126 TI - Not-for-profit multis must face divestitures. PMID- 3679128 TI - Genetic map gives new meaning to wellness. PMID- 3679127 TI - VHA prepares for release of mortality data. Voluntary Hospitals of America. PMID- 3679129 TI - Executives wary of info systems consultants. PMID- 3679130 TI - CSOPs: a useful tool for effecting mergers. PMID- 3679131 TI - Hospitals with the best data sets win. PMID- 3679132 TI - Traditional public relations makes a comeback. PMID- 3679133 TI - Caution: refine before adapting new techniques. PMID- 3679134 TI - Sales incentives for marketers. PMID- 3679135 TI - States preoccupied with HMO solvency issues. PMID- 3679136 TI - Rural providers ask: what's a hospital? PMID- 3679137 TI - Recruitment schemes face legal questions. PMID- 3679138 TI - Subsidizing insurance for small employers. PMID- 3679139 TI - Koop: AIDS poses ethical dilemmas for physicians. PMID- 3679140 TI - Weight-loss program has hefty bottom line. PMID- 3679141 TI - HHS's Office of Rural Health is off and running. Interview by Clay Mickel. PMID- 3679142 TI - Hospital-physician link generates $4 million. PMID- 3679143 TI - CD management: a new investment tack? PMID- 3679144 TI - CEOs forecast slight gain in executive demand. PMID- 3679145 TI - Health care not on the election agenda. PMID- 3679146 TI - Add cooperation to regulation and competition. PMID- 3679147 TI - More hospitals at financial risk in 1987. PMID- 3679148 TI - 1987: the year tax reform came home to roost. PMID- 3679149 TI - State execs see profit margins disappear in '87. PMID- 3679150 TI - Medical malpractice premiums stabilized. PMID- 3679151 TI - 1987: physician marketing continues to grow. PMID- 3679152 TI - Consolidation overshadows HMO growth in 1987. PMID- 3679153 TI - Will '88 be the year of price competition? PMID- 3679155 TI - Business health coalitions evolve in 1987. PMID- 3679156 TI - Malpractice lawsuits hit states in 1987. PMID- 3679154 TI - Tough fraud law tops '87 legislative action. PMID- 3679157 TI - Payment and quality top concerns in 1987. PMID- 3679158 TI - New trend: performing arts clinics. PMID- 3679159 TI - Hospitals, suppliers swap partners in 1987. PMID- 3679160 TI - Competition shapes multis' actions in 1987. PMID- 3679161 TI - Job security topped employee concerns in '87. PMID- 3679163 TI - Data processing budgets jump during 1987. PMID- 3679162 TI - Deregulation spurs market information demand. PMID- 3679164 TI - Quality of care good for patient and provider. PMID- 3679165 TI - [Recognition and detection of antigenic molecular weight by McAb against Pagumogonimus skrjabini]. PMID- 3679167 TI - [Ultrastructural changes of renal glomeruli in guinea pigs with leptospirosis]. PMID- 3679166 TI - [Biologic activity evaluation of 125I-labeled human chorionic gonadotropin]. PMID- 3679168 TI - [Ultrastructural observation of hepatic tissue with chronic hepatitis B]. PMID- 3679169 TI - [Experimental study on SrCO3 preparation by double decomposition at room temperature]. PMID- 3679170 TI - [Optimal conditions and affecting factors on adhesion of Campylobacter jejuni to HeLa cells]. PMID- 3679171 TI - [Effect of injection of microencapsulated compound megestrol acetate on the ultrastructure of the adenohypophysis]. PMID- 3679172 TI - [Studies on diffusion of sugars and lactic acid in human dental plaque]. PMID- 3679173 TI - [Chronic type B hepatitis with delta factor infection]. PMID- 3679174 TI - [Studies on the antitumor activity of mitoxantrone in animals]. PMID- 3679175 TI - [Carcinogenic effects on Syrian hamster embryo cells exposed to He-Ne laser in vitro]. PMID- 3679177 TI - [In vitro study of cardiotonic and vasodilator actions of Chinese-made amrinone]. PMID- 3679176 TI - [Effect of subtotal hepatectomy in rats on the induction of cirrhosis of liver and hepatocellular carcinoma by diethylnitrosamine]. PMID- 3679178 TI - [Ultraviolet spectrophotometric method for the determination of theophylline in plasma]. PMID- 3679179 TI - [Serum prolactin level of lactating mothers and its relation to milk volume]. PMID- 3679180 TI - [Comparison of 2 methods for the determination of bilirubin levels from serum and by TcBM]. PMID- 3679181 TI - [A study on GM-CFU in 23 patients with myelodysplastic syndrome]. PMID- 3679182 TI - [Total cholinesterase assay in amniotic fluid and its clinical significance]. PMID- 3679183 TI - [Evaluation of the effectiveness of a disinfectant solution]. PMID- 3679184 TI - Fibrosis and cell metabolism. PMID- 3679185 TI - A survey of first-year pathology residents: factors in career choice. AB - Pathology has become less attractive to US medical graduates by every measure available to us. In 1981, 2.3 per cent of US medical school seniors planned a pathology career; by 1986, a steady decline had reached 1.6 per cent. In absolute numbers, adjusted for the response rate to the AAMC questionnaire, this means that the 290 seniors entering pathology in 1981 had fallen to 205 by 1986. FMGs enter pathology through the matching program in greater numbers than any other specialty. Our data show that slightly less than a third of current first-year pathology residents are FMGs, mainly from Caribbean and Mexican medical schools. The decline in US graduates entering pathology has resulted almost entirely from a drop in the number of men choosing the field. In 1984, 286 male US graduates matched in pathology, but this number dropped to 150 in 1985 and 149 in 1986. The group entering in 1985 was the first who will need 5 years to be eligible for certification in the anatomic pathology/clinical pathology programs. During the same years, the 116 women who matched in 1984 were followed by 111 in 1985 and 100 in 1986. The effect of the American Board of Pathology's change in requirements is not easily analyzed. The figures for residents entering, given above, would suggest that the requirements discouraged men, especially, from entering the field. This hypothesis is supported by our questionnaire data and by anecdote concerning the pressure felt by graduating seniors to finish their postgraduate training as fast as they can and start paying off their average debt of $33,650. Pathology still seems to attract people who like to teach, study interesting case material, and do research. The percentage of PhD/MDs entering pathology is almost 10 times as high as their percentage among graduating seniors. Discouragement against entering pathology came from a perceived shortage of job openings, negative statements from other physicians (including pathologists), the addition of a fifth-year requirement, and lack of patient contact. The last is hard to account for because pathology would obviously not offer the opportunities to see patients that exist in the clinical specialties, but it was prominent in the concerns of residents answering our questionnaire. The picture that emerges from our data is one of a specialty passing through a difficult period in attracting new talent into its ranks. The first step in dealing with the problem would seem to be recognizing its existence.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3679186 TI - Omenn's syndrome--pathologic arguments in favor of a graft versus host pathogenesis: a report of nine cases. AB - Histologic, histochemical, and histoenzymatic investigations of nine cases of Omenn's disease showed generalized lymphoid depletion, including B cells and all T-cell subpopulations; an apparent proliferation of alpha-naphthyl acetate esterase-, acid phosphatase-, OKM1-positive macrophages and T6 interdigitating cells; a thymic hypoplasia with arrest of hassallian epithelial maturation; starlike fibrinous deposits in the bone marrow; and extensive cutaneous lesions characterized by hyperkeratosis, apoptotic cell death associated with the intraepidermal presence of T4+ and T8+ cells, localized necrosis of the basement membrane, expression of Ia antigens by malpighian cells, and progressive loss of the T6+ Langerhans' cells. These lesions, mainly the skin and bone marrow changes, are reminiscent of those observed in acute graft versus host reaction. Although a blood chimerism has never been demonstrated, these pathologic observations support the hypothesis of graft versus host disease in a primary cellular immunodeficiency and the persistence of the proliferating maternal cells in the peripheral target organs. PMID- 3679187 TI - Secretory immunoglobulin deposits in renal glomeruli of children with extrahepatic biliary atresia: studies in a human counterpart of experimental ligation of the bile ducts. AB - Experimental ligation of the biliary tract often results in glomerular deposits of polymeric IgA commonly associated with secretory component. These studies offer evidence that, in animals, hepatobiliary transport of polymeric IgA, which is of mucosal origin, is crucial for its clearance from the serum. We studied a human counterpart of bile duct ligation--extrahepatic biliary atresia--for the presence of secretory or polymeric immunoglobulins in renal glomeruli. Kidney was available at autopsy as paraffin or frozen blocks from 24 patients with biliary atresia and age-matched controls (5 weeks to 5 years old). Several of the patients had undergone portoenterostomy (Kasai procedure) or liver transplantation. Immunohistologic studies showed glomerular (often mesangial) deposits of IgA in 10 of 24 and IgM in 16 of 24 specimens. The differences with controls were highly significant for IgA but not for IgM. In frozen sections, secretory component was positive in glomeruli in seven of 12 specimens. In vitro glomerular binding of purified secretory component to glomeruli was shown in four of 12 samples, including three with IgM only. This last observation suggests that IgM in some of these patients was polymeric and thus derived from a mucosal source. Our study shows that in humans with biliary atresia, secretory IgA, polymeric IgA, and possibly polymeric IgM are deposited in glomeruli. The study confirms the occurrence of renal immunopathologic findings in liver disease and supports the existence of an active hepatobiliary immunosecretory transport mechanism even at the early age of these patients. PMID- 3679188 TI - Teratogenic effects of clomiphene, tamoxifen, and diethylstilbestrol on the developing human female genital tract. AB - The potential estrogenicity and teratogenicity of triphenylethylene antiestrogens were examined in 54 genital tracts isolated from 4- to 19-week-old human female fetuses and grown for 1 to 2 months in untreated athymic nude mice or host mice treated by subcutaneous pellet with the antiestrogens clomiphene and tamoxifen or the synthetic estrogen diethylstilbestrol (DES). In specimens grown to a gestational age equivalent of 15 weeks or less, the vagina and urogenital sinus were lined by an immature squamous epithelium, which were similar in both drug treated and untreated specimens. Proliferation and maturation of the squamous vaginal epithelium were observed in specimens treated with clomiphene, tamoxifen, or DES only when grown to a gestational age equivalent of 16 weeks or more. Formation of endometrial and cervical glands proceeded in 87 per cent (13 of 15) of control specimens grown to a gestational age equivalent of 13 weeks or more in untreated hosts. By contrast, age-matched drug-treated specimens contained glands in only 44 per cent (12 of 27) of specimens. In the developing uterine corpus of untreated controls, the uterine mesenchyme segregated into inner (endometrial stroma) and outer (myometrial) layers; whereas in drug-treated specimens, condensation and segregation of the mesenchyme were greatly impaired. The fallopian tube was also affected by clomiphene and tamoxifen (and to a lesser extent by DES) in that its epithelium was hyperplastic and disorganized. The complex mucosal plications characteristic of the fallopian tube were also distorted in drug-treated specimens. These results emphasize the heretofore unrecognized estrogenicity and potential teratogenicity of triphenylethylene antiestrogens on the developing human genital tract and emphasize the need for caution to prevent inadvertent exposure of the developing fetus to these compounds. PMID- 3679189 TI - Proliferative rates of non-Hodgkin's lymphomas as assessed by Ki-67 antibody. AB - The Ki-67 antibody, a monoclonal antibody that reacts with nuclei in actively proliferating cells, was used in an immunohistochemical study to assess the growth fractions of non-Hodgkin's lymphomas and related disorders. The lowest proliferative indices were found in small lymphocytic lymphoma/chronic lymphocytic leukemia and intermediate lymphocytic/mantle zone lymphoma. An intermediate proliferative index was seen in the follicular lymphomas and diffuse small cleaved cell and diffuse mixed cell lymphomas. A high index was seen in the diffuse large cell lymphoma and lymphoblastic lymphoma. The highest and most consistent proliferative index was seen in small noncleaved cell lymphoma. Cases of reactive follicular hyperplasia had a significantly higher proliferative index than those of follicular lymphoma. We conclude that the Ki-67 antibody has great utility in providing an estimate of the proliferative rate of non-Hodgkin's lymphomas. Prospective studies may show this information to have prognostic value independent of histologic classification. PMID- 3679190 TI - An ultrastructural and light microscopic study of the synovium in ochronotic arthropathy. AB - The synovium in two well-documented cases of alkaptonuric ochronosis was studied by transmission electron and light microscopy. A feature of alkaptonuria previously unreported in the English-language literature was the presence of phagocytosis of large collagen fibrils by synovial macrophages in both cases. The origin of these fibrils appeared to have been shards of ochronotic cartilage and areas of metaplastic cartilage. This finding suggests that active remodeling of the synovial tissues occurs in advanced ochronotic arthropathy. Numerous shards of ochronotic cartilage were embedded in the synovium. In addition, small aggregates of large collagen fibrils encrusted with apparent ochronotic pigment were occasionally noted in the interstitium. These aggregates of ochronotic collagen are best described as microshards, and they have not generally been recognized in the literature. What appeared by light microscopy to represent ochronotic pigment deposition in interstitial collagen actually represented embedded microshards of ochronotic cartilage in the interstitium. Slender and elongated microshards were most likely to be confused by light microscopy as ochronotic interstitial collagen. PMID- 3679191 TI - The pathogenesis of vascular changes in erythema nodosum-like lesions of Behcet's syndrome: an electron microscopic study. AB - The probable sequence of microvascular changes affecting endothelial cells in erythema nodosum-like lesions was examined by electron microscopy in 18 patients with typical Behcet's syndrome. Dark endothelial cells in the superficial and deep dermis exhibited degeneration with contraction changes. Consequently, degenerated endothelial cells showed nuclear and cytoplasmic condensation, vacuolization in the cytoplasm, and rich ribosomes. Moreover, blood vessels which were enveloped by cuffs of lymphocytes simultaneously exhibited both endothelial cell hypertrophy and endothelial cell necrosis. The implied associations between perivascular lymphocytic cuffs and blood vessels exhibiting endothelial cell alterations indicate that microvascular changes in erythema nodosum-like lesions may be closely associated with the delayed-type hypersensitivity reaction. PMID- 3679192 TI - CD-1 monoclonal antibodies identify Langerhans' cells but not lymphoreticular interdigitating cells. PMID- 3679193 TI - Cysticercosis presenting as a solitary dominant breast mass. PMID- 3679194 TI - Intracardiac ectopic thyroid. PMID- 3679196 TI - Technology assessment of urinary flow cytometry. PMID- 3679195 TI - Sudden cardiac death. PMID- 3679197 TI - The pathobiologic significance of intracellular drug storage: clear cytoplasmic vacuoles. PMID- 3679198 TI - Neuroendocrine carcinoma of the parotid gland: a report of two cases with ultrastructural and immunohistochemical studies. AB - Two cases of primary small cell carcinoma of the parotid gland are reported. This rare neoplasm usually presents as a painful or painless mass in the gland. The finding of neurosecretory granules by electron microscopic study, combined with strong immunoreactivity for neuron-specific enolase and chromogranin, confirms the true neuroendocrine origin of the carcinoma. This tumor appears to have a better prognosis than small cell carcinoma of the lung, which it resembles histologically. PMID- 3679199 TI - Catheter-induced pulmonary artery perforation: pathologic and pathogenic features. AB - Perforation of the pulmonary artery due to insertion of a balloon-tipped, flow directed (Swan-Ganz) catheter is described in four cases. These cases were found in a consecutive series of 270 autopsies done over a 1.5-year period and suggest that the incidence of this complication may be greater than the number of clinically reported cases implies. In three instances, a focal parenchymal hematoma or thrombotic nodule identified the site of rupture. Other pathologic features and the pathogenesis of the perforation are discussed. Difficulties in postmortem diagnosis include distinguishing perforation from hemorrhage due to trauma, thromboembolism, and coagulation abnormalities. PMID- 3679200 TI - The significance of nuclear diameter in the biologic behavior of thyroid carcinomas: a retrospective study of 127 cases. AB - The relationship between nuclear diameter and biologic behavior was studied in 127 cases of thyroid carcinoma. Using a sonic digitizer coupled to a minicomputer, nuclear diameters of 200 randomly selected cancer cells from each case (hematoxylineosin-stained paraffin sections) projected at X 400 magnification were traced and averaged. A total of 25,400 measurements were made. The nuclear diameters varied from 4.7 to 13.1 micron. By analysis of variance, the nuclear diameters were significantly different (p = 0.0007) among the four types of thyroid cancers, being largest in the undifferentiated cancers (8.7 +/- 0.8 micron) and smallest in the medullary cancers (6.6 +/- 0.1 micron). Nuclear diameter was also significantly correlated with degree of tumor differentiation (p = 0.002), maximal tumor diameter (p = 0.03), mitotic rate (p = 0.002), and 5 year survival (p less than 0.05) for all types of tumors. The correlation between nuclear diameter and disease stage was significant only for undifferentiated cancers (p = 0.04). No significant correlations were seen between nuclear diameter and duration of disease, sex, or age of the patient. PMID- 3679201 TI - A biologically active parathyroid hormone-like substance secreted by an adenosquamous carcinoma of the transverse colon. AB - Recently, controversy has emerged as to whether paraneoplastic hypercalcemia in nonparathyroid tumors is due to ectopic production of a parathyroid hormone (PTH) like substance. A sensitive DNA hybridization technique was unable to reveal PTH mRNA in a collection of such tumors. However, there is growing evidence that squamous differentiation of tumors favors the expression of PTH-like substances. We report the case of a 41-year-old woman with an adenosquamous carcinoma of colonic origin associated with severe hypercalcemia. The squamous component of liver metastases showed immunoreactivity with two different PTH antisera, suggesting the production of a PTH-like substance. PMID- 3679202 TI - Membranoproliferative glomerulonephritis and plexogenic pulmonary arteriopathy in a homosexual man with acquired immunodeficiency syndrome. AB - A 40-year-old homosexual man with the acquired immunodeficiency syndrome (AIDS) presented with dyspnea and renal insufficiency. A chest radiograph showed cardiomegaly and prominent pulmonary arteries, without alveolar infiltrates. Swan Ganz catheterization revealed pulmonary hypertension and no evidence of left-to right shunt. Liver function tests were normal. He was treated empirically for Pneumocystis carinii pneumonia, but he died 3 days after admission. At autopsy, membranoproliferative glomerulonephritis type III, P. carinii pneumonia, and plexogenic pulmonary arteriopathy were found. The kidney and lung were studied by electron microscopy and immunohistochemistry. Electron-dense immunoglobulin deposits were identified in glomerular capillaries and were confirmed by immunohistochemistry, but the pulmonary plexogenic lesions were negative. The combination of membranoproliferative glomerulonephritis and plexogenic pulmonary arteriopathy has not been described in AIDS to date. PMID- 3679204 TI - Enteritis cystica profunda--revisited. PMID- 3679203 TI - Ovarian yolk sac tumor arising from an endometrioid carcinoma. AB - A yolk sac tumor that arose within an ovarian endometrioid adenocarcinoma in a 50 year-old woman is described. The tumor had typical microscopic features, stained immunohistochemically for alpha-fetoprotein, and was associated with an elevated serum alpha-fetoprotein level when metastases appeared. This is the fourth case in which a yolk sac tumor has been reported to develop from a somatic carcinoma and the second in which this tumor has been associated with epithelium of endometrioid type. Tumor heterogeneity or neometaplasia may account for the origin of a tumor of germ cell type from a carcinoma of somatic origin. PMID- 3679205 TI - In situ hybridization in the analysis of abl and sis oncogenes in myeloproliferative disorders. PMID- 3679206 TI - Borreliosis and Alzheimer's disease. PMID- 3679207 TI - Do individual allocyclic chromosomes in metaphase reflect their interphase domains? AB - Individual S phase allocyclic chromosomes have been analyzed in Bloom syndrome lymphocytes, in cells with an r(9), and in hypotetraploid Ehrlich mouse ascites cells treated with 1-methyl-2-benzyl hydrazine. On the basis of the following observations, we conclude that such chromosomes more or less reflect their domains in interphase: (1) The S phase allocyclic chromosomes have the same structure as S phase prematurely condensed chromatin (PCC) in fused cells; in other words they form limited areas of chromatin dots; (2) the allocyclic chromosome is the only chromosome in a metaphase plate which synthesizes DNA simultaneously with interphase nuclei; (3) the size of the allocyclic chromosomes is related to the size of the corresponding metaphase chromosome; and (4) the S phase allocyclic chromosomes resemble closely the chromosome domains in interphase made visible with biotinylated human DNA. A variety of evidence shows that most allocyclic chromosomes are simply left behind in their cycle, which presumably is caused by a deletion or inactivation of a hypothetical coiling center situated on each chromosome arm. PMID- 3679208 TI - Development of the first meiotic prophase stages in human fetal oocytes observed by light and electron microscopy. AB - The development of the first meiotic prophase stages was studied in two series of human female embryos and fetuses aborted for social reasons. The first series (64 embryos or fetuses aborted at 6-24 weeks of gestation) was used mainly to perfect the methods applied to obtain chromosome preparations and synaptonemal complex spreads. The second series (37 embryos or fetuses aborted at 9-24 weeks of gestation) was used to establish the timing and to characterize the different stages of prophase I. Leptotene-zygotene figures were observed in some embryos at 10 weeks of gestation. Typical zygotene figures were seen at 11-22 weeks. Pachytenes were first observed at 12-13 weeks, and the proportion of these figures was usually lower than 40%. Diplotenes were seen in fetuses with a gestational age of 14 weeks or more. The duration of the process in the human female is thus about 3-4 weeks, a similar period to that described for the male. PMID- 3679209 TI - Pachytene analysis in a 17;21 reciprocal translocation carrier: role of the acrocentric chromosomes in male sterility. AB - Pachytene analysis was undertaken in an infertile male, heterozygous for a 17;21 reciprocal translocation. The quadrivalent was identified by its configuration and chromomere pattern. A non-random association was found between the quadrivalent and the sex vesicle in 77% of the pachytene nuclei analysed. In 13.1% of the cells the contact with the sex vesicle was established by the terminal chromomere of the two chromosomes 21; in 63.9% of the cells, the entire region of the breakpoints was completely hidden by the sex vesicle. In some nuclei asynapsis was found in the region of the breakpoints. The nature of the contact between the quadrivalent and the sex vesicle is discussed in this paper. It is proposed that the acrocentric chromosome favours the contact between the quadrivalent and the sex vesicle, and increases the risk of sterility in male carriers of Robertsonian translocations and of reciprocal translocations involving one acrocentric chromosome. PMID- 3679210 TI - Orosomucoid (ORM) typing by isoelectric focusing: evidence for gene duplication of ORM1 and genetic polymorphism of ORM2. AB - It has been demonstrated that the genetic polymorphism of human serum orosomucoid (ORM) is controlled by polymorphic ORM1 and monomorphic ORM2 loci. In this study a Japanese family was encountered in which several members had puzzling electrophoretic patterns consisting of four bands. The ORM patterns were due to the products of a duplicated ORM1 locus haplotype (ORM1 2.1) or the products of new variant alleles at the ORM2 locus. The ORM1 2.1 haplotype is very common in the Japanese population, occurring at an allele frequency of 0.16. The increased occurrence of ORM12-1 and the heterogeneity in band intensity among ORM12-1 phenotypes could be explained in terms of a duplicated gene ORM1 2.1. The ORM2 locus proved to be polymorphic, with six alleles in the Japanese population. PMID- 3679211 TI - Linkage relationship between the genes for adenosine deaminase and S-adenosyl homocysteine hydrolase on human chromosome 20. AB - The genes for adenosine deaminase (ADA) and S-adenosyl homocysteine hydrolase (AHCY or SAHH) are known to be syntenic and within measurable distance from each other, on chromosome 20 in man. In the present study an informative family is described in which the recombination fraction (theta) between the respective genes is estimated to be about 0.18. Together with the published finding of theta = 0.15 (Eiberg and Mohr 1985) in informative Danish families, the recombination fraction for the pooled data is calculated to be theta = 0.14 (in men), theta = 0.08 (in women) and theta = 0.13 (both sexes taken together). PMID- 3679212 TI - Localization of the human progesterone receptor gene to chromosome 11q22-q23. AB - The human progesterone receptor gene was mapped by in situ hybridization using two cDNA probes corresponding to the 5' and 3' part of the coding sequence. This gene was localized to 11q22-q23. PMID- 3679213 TI - Three new orosomucoid (ORM) variants revealed by isoelectric focusing and print immunofixation. AB - Phenotypes of orosomucoid (ORM) in human sera have been analysed by isoelectric focusing and print immunofixation. After neuraminidase treatment the band patterns indicated that the polymorphism of the structural locus ORM1 is controlled by three autosomal codominant alleles. According to the previous nomenclature they were called ORM1F1, ORM1F2, and ORM1S. In a study of 272 unrelated individuals from southern Germany, five of the six expected common ORM1 subtypes were observed. Furthermore, we found three ORM variant phenotypes which have not been reported previously. These variants were characterized by additional bands in a cathodal position. One variant had additional double bands and presumably represents a rare ORM1 variant named ORM1S1. Two variants had additional single bands. They were assigned tentatively to the ORM2 gene locus. While the common gene product of ORM2 may be called ORM2A, the two variants are named ORM2B1 and ORM2B2, respectively. ORM2B1 has, thus far, been found only in a single individual; the variants ORM1S1 and ORM2B2 were found in a father-child pair and a mother-child pair, respectively. The frequency for variants tentatively assigned to the ORM2 locus is very low and was calculated to be 0.0037. PMID- 3679214 TI - Interstitial deletion of chromosome 13 involving the region 13q14. AB - A patient with an interstitial deletion 13q14 is described who has decreased erythrocyte esterase D activity and who has not developed a retinoblastoma. PMID- 3679215 TI - An azoospermic male with reciprocal translocation t(1;15) (q11;p11). AB - The authors report on a case of 1;15 translocation and request contact with any colleagues who have observed similar cases. PMID- 3679216 TI - A new BF F variant by polyacrylamide gel isoelectric focusing. AB - Polyacrylamide gel isoelectric focusing followed by electroblotting with enzyme immunoassay was done for the investigation of allotypes of properdin factor B (BF) in serum from 326 Japanese subjects. A new BF F variant tentatively designated BF*Fb1 (b = basic) was detected, the isoelectric point of each band of homozygous BF Fb1 being higher than of BF FF. Family data were in accordance with transmission by mendelian inheritance. The allele frequencies calculated from 326 Japanese subjects were 0.7945, 0.1825, 0.0215, and 0.0015 for BF*S, BF*F, BF*Fb1, and BF*F075, respectively, with that of variant BF*Fb1 being a polymorphic frequency. The distribution of phenotypes fitted the Hardy-Weinberg equilibrium. PMID- 3679217 TI - Aetiology of genital ulceration in the Gambia. AB - The aetiology of genital ulceration was studied in 104 unselected patients (94 men, 10 women) attending a sexually transmitted disease (STD) clinic in the Gambia. Chancroid was diagnosed in 54 (52%), syphilis in 23 (22%), lymphogranuloma venereum (LGV) in seven (7%), and herpes in six (6%). In 28 (27%) patients no diagnosis was reached. Ten (10%) patients were found to have both chancroid and syphilis, three (3%) had both LGV and syphilis, and one (1%) had both herpes and syphilis. Trimethoprim 160 mg and sulphamethoxazole 800 mg twice daily for one week was found to be effective in the treatment of chancroid. This regimen with a single intramuscular injection of benzathine penicillin 2.4 MIU is recommended for the treatment of genital ulcers in Gambian health centres without laboratory facilities. PMID- 3679219 TI - Acute syphilitic transverse myelitis: unusual presentation of meningovascular syphilis. AB - A case of meningovascular syphilis presenting with the rare spinal cord manifestations is reported. The angiographic, computed tomographic, and magnetic resonance images of the subsequent cerebrovascular lesions are shown. The presentation, evolution, and treatment of this unusual form of vascular syphilis are discussed. PMID- 3679218 TI - Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa. AB - Africa in the 1980s appears to be facing problems associated with syphilis and gonorrhoea during pregnancy similar in severity and magnitude to those faced by the western world in the early 1900s. From a review of published reports, the prevalence of syphilis seroreactivity in pregnant women in many parts of Africa is at least 10%. Assuming this level of seroreactivity, we estimate that 5% to 8% of all pregnancies surviving past 12 weeks will have an adverse outcome caused by syphilis, such as spontaneous abortion, perinatal or infant death, or a living infant with syphilis. Our findings on gonorrhoea during pregnancy are almost as startling. The prevalence of gonorrhoea in pregnant women in many parts of Africa is at least 10% and it approaches 20% in some areas. The incidence of gonococcal ophthalmia neonatorum in neonates appears to be between 2% and 4%. We recommend commitment of health resources to initiatives to prevent and control sexually transmitted disease in Africa and additional research into the cost effectiveness of different prevention and control approaches. PMID- 3679220 TI - Condyloma latum mimicking keratoacanthoma in patient with secondary syphilis. AB - A 31 year old man with a condyloma latum simulating a keratoacanthoma at the umbilicus is reported. The umbilicus should be included in the list of known sites of predilection for condylomata lata. PMID- 3679221 TI - Cutaneous cryptococcal infection presenting as vulvar lesion. AB - A woman aged 60, who had been immunosuppressed since receiving a renal transplant 17 years before, developed a painless ulcerated lesion on her right labia majora. Cryptococcus neoformans was demonstrated by culture and biopsy of the lesion. This is the first reported case of a genital skin lesion caused by C neoformans. PMID- 3679222 TI - Use of slide latex agglutination test for rapid diagnosis of vaginal candidosis. PMID- 3679223 TI - Aetiology of urinary symptoms in sexually active women. PMID- 3679224 TI - School health education programmes in India. AB - In India where universalization of primary education is being greatly emphasized and is the top priority of the government, there is a tremendous scope for using the primary school infrastructure to revolutionalize and channel the available resource of school children for promotion of child survival and development. PMID- 3679225 TI - In Nigeria. A study to identify the knowledge and misconceptions of primary school pupils about tropical diseases. AB - "Since health knowledge is a prerequisite of any health action, health education is seen as an essential component of any disease control programme. However for health education to be effective and relevant the prior knowledge held by the learners must be assessed and information so obtained used in the planning and implementation of the health education programme." PMID- 3679226 TI - The strategic significance of helping a billion children learn about health. AB - "The children should and can play a decisive role in the Health for All movement. And reaching them now should be given its rightful place and significance in the overall HFA strategy in every country, in every region, and in the global plan of action". PMID- 3679227 TI - Teaching youngsters to care about health care. AB - For a variety of reasons, medical patients throughout history have generally proven unable to communicate effectively with their health care providers. HealthPACT, developed by the Schools of Nursing and Medicine at the University of Colorado, attempts to reverse this disturbing trend. Using age-appropriate materials, it teaches school-age youngsters how to become knowledgeable health consumers. It is hoped that this programme will eventually create a generation of adults which is better able to articulate individual health concerns and then follow the advice of various health care providers. PMID- 3679228 TI - "Living theatre, theatre of life". AB - Young people love to play theatre--in one way or another. They like to play with behaviours, costumes, words, communication patterns, etc.; they like to disguise themselves, to create certain spheres and scenes of drama and tragedy, excitement and extacy, satire and irony, morals and decadence. Due to the particular uncertainties of the adolescent passage, youth oscillates between taking life both, too seriously and easy. Searching for identity and integration, they tend to experiment with styles of behaviour and culturally defined patterns of lifestyles conductive to well-being. Sometimes, life is perceived as pure entertainment, and sometimes as pure drama. It's living theatre and theatre of life. On the one hand it is "acting out", on the other hand it is playing precisely defined roles. And, in-between, it is always the question: Who am I? They tend to slip into roles in order to check out whether they are willing to accept their implications with regard to the priorities they have set so far. PMID- 3679229 TI - Health education for the school-aged child. PMID- 3679230 TI - International Union for Health Education (IUHE). Policy statement on health education for the school aged child. PMID- 3679231 TI - International policies for school health programmes. PMID- 3679232 TI - Distribution of ABO genes in southeast Sweden. AB - ABO blood group data from about 78,000 conscripts born 1900-1935 in Southeast Sweden have been analyzed for regional differentiation using a hierarchical subdivision of the area. Heterogeneity was present at all levels of division. Gene diversity among subpopulations has been compared to a corresponding estimate performed on data from the country of Vasterbotten in northern Sweden. PMID- 3679233 TI - Apolipoprotein E phenotype and gene distribution in The Netherlands. AB - 2,000 male individuals randomly selected from three different areas in The Netherlands were phenotyped for apolipoprotein E. The apolipoprotein E gene frequencies and phenotype distribution did not differ significantly from that of previously studied populations, with one exception: the epsilon 4 frequency was significantly lower than that in the Finnish population. PMID- 3679234 TI - Haptoglobin patterns in essential hypertension and associated conditions- increased risk for Hp 2-2. AB - Blood samples from 257 hypertensive patients and 180 normotensive controls were analysed for their association with haptoglobin levels and phenotypes. Compared to controls, patients with Hp 2-2 phenotype showed a significantly increased risk for essential hypertension (p less than 0.001) and hypertension associated with ischaemic heart disease (p less than 0.05). There was a significant decrease in the mean levels of serum haptoglobins in hypertension as compared to controls, suggesting the possibility for intravascular haemolysis due to vascular damage leading to further complications. PMID- 3679235 TI - Sweat pore count, hair density and tooth size: heritability and genetic correlation. AB - In 109 subjects from 50 families without major inherited disorders, sweat pore count showed the anticipated reduction with age but also unexpected systematic differences between sides and between fingers. After adjustment for age and sex, significant genetic variation was found for sweat pore count, hair density and tooth size. The three traits were not phenotypically correlated but there was a significant negative genetic correlation between hair density and sweat pore count. The findings suggest that the same genes influence these two traits in opposite directions and that genetic and environmental influences may act on them through different physiological mechanisms. PMID- 3679236 TI - Family distances and human lymphocyte antigens. AB - We compared family distances of homozygotes and heterozygotes for HLA-A and -B. When matched on number of inhabitants per birthplace, no significant differences were found. However, when homozygotes were compared with heterozygotes from larger birthplaces, homozygotes showed significantly smaller family distances in the grandparental generation. We suggest that matching for population size of birthplace and the choice of the geographic study area are important factors in studies of family distances. PMID- 3679237 TI - Comparison of acid phosphatase ACP1 variants by isoelectric focusing and conventional electrophoresis: identification of three new alleles, ACP1*N, ACP1*P and ACP1*S. AB - Three new alleles of human red cell acid phosphatase (ACP1) have been identified by comparison with previously reported variants using three different electrophoretic techniques. Family data are available on all the variants and show genetic transmission of the rare alleles ACP1*N, ACP1*P and ACP1*S. Further evidence of a rare allele demonstrating reversed 'A' activity is also described. The report documents the need to use several electrophoretic techniques to characterize new or rare variants. PMID- 3679239 TI - AcP and EsD polymorphisms in Central Sardinia. AB - A sample of the population from Central Sardinia was studied with respect to acid phosphatase (AcP) and esterase D (EsD) enzymes. The gene frequencies were: AcPA = 0.322, AcPB = 0.617, AcPC = 0.061 and EsD1 = 0.892. The results were compared with those of other Italian populations. PMID- 3679238 TI - Study on a Brazilian isolate. II. Opportunity for selection. AB - The opportunity for selection, measured by prereproductive mortality and fertility, was calculated for a small and relatively isolated Brazilian population. The total index of selection opportunity (0.53) was low in comparison to those obtained for other isolated populations. The contribution of prereproductive mortality (Im = 0.28) was 40% higher than that of fertility (If = 0.20). PMID- 3679240 TI - A plasminogen silent allele detected in a Swiss family. AB - An apparent incompatibility between mother and child in the plasminogen system has been clarified by the demonstration of a silent allele in the family. PMID- 3679241 TI - Adverse reactions to foods and food additives. PMID- 3679243 TI - International opinion concerning indications, safety and availability of poison centre antidotes and treatment. PMID- 3679242 TI - Poisoning with over-the-counter doxylamine preparations: an evaluation of 109 cases. AB - One hundred and nine cases of monointoxication with doxylamine were evaluated with respect to age distribution, amount ingested, plasma level, and clinical symptomatology. The age of 60% of the patients ranged between 16 and 30 years. In about 60% of the cases 10 to 40 times a single therapeutic dose (25 mg) was ingested. Doxylamine plasma concentrations exceeded the maximum plasma level after a therapeutic dose by a factor of 10 to 40 in two-thirds of cases. The most frequent symptoms included impaired consciousness, seizures, tachycardia, mydriasis and a 'psychosis' similar to that in catatonic stupor. A serious complication may be rhabdomyolysis with subsequent impairment of renal function and acute renal failure. No symptoms were observed in 39% of the patients. No correlation was found between the amount ingested or doxylamine plasma level and the clinical symptomatology. Primary detoxication included gastric lavage, administration of activated charcoal and sodium sulfate. Regarding the high frequency of doxylamine overdose and its possible complications the question arises as to whether doxylamine-containing preparations should be subjected to prescription. PMID- 3679244 TI - Studies on the metabolic behaviour of industrial actinide-bearing aerosols after deposition in the rat lung: an experimental basis for interpreting chest monitoring data and assessing limits on intake for workers. AB - The metabolism of 239Pu and 241Am in 3 site-specific industrial dusts has been studied after their deposition in the rat lung. A comparative experiment has also been carried out with a mixture of these actinides inhaled as their nitrates. The aim of this study was to provide an experimental basis for assessing limits on intake and to establish whether the 239Pu content in the lungs could be interpolated from measurements of 241Am. THE RESULTS: 1 demonstrate the wide differences in the lung retention kinetics of the actinides and in the absolute and relative amounts translocated to the blood that can occur for industrially produced materials; 2 show that the annual limits on intake (ALIs) for the different materials vary between those postulated for class W and Y compounds by the International Commission on Radiological Protection; 3 indicate that acute intakes of 239Pu equivalent to the ALI can, depending on the nature of the dust, be estimated from 241Am chest monitoring data at times from a few days up to about 3 years after exposure. PMID- 3679245 TI - Keratoconjunctivitis sicca in the dog following 5-aminosalicylic acid administration. AB - 1 Keratoconjunctivitis sicca (KCS) is an inflammatory eye condition, affecting the cornea and conjunctiva, caused by a deficiency in the aqueous fraction of tears. The condition is relatively common in the dog with a varied aetiology. A number of drugs have been implicated in the production of KCS in the dog including salicylazosulphapyridine (sulphasalazine). 2 This paper details clinically evident KCS in a 12-month oral toxicity study with 5-aminosalicylic acid (5-ASA), the therapeutically active metabolite of sulphasalazine. 3 The condition was first diagnosed at study week 22 and subsequently progressed both in incidence and severity. There was a distinct sex-difference in the response, with treated females being more affected than males. 4 There was a close correlation between the production of KCS and reduced lacrimation as assessed by the Schirmer tear test. 5 Although sulphasalazine causes KCS in dogs there have been no reports of ocular lesions of this type in man with this drug. It is highly probable that the dog is not a predictive model for man with regard to KCS induction by sulphasalazine or its metabolite 5-ASA. PMID- 3679246 TI - Metabolism of uranium in the rat after inhalation of two industrial forms of ore concentrate: the implications for occupational exposure. AB - Aerosols produced from two commercially available ore concentrates in which the uranium was present essentially in the one as ammonium diuranate (ADU) and in the other as uranium octoxide (U3O8) were administered to rats. The results show that: 1 uranium in the ADU bearing material was cleared rapidly from the lungs, mainly to the blood, such that the retention kinetics were similar to those for a class D (highly transportable) compound as defined by ICRP; 2 uranium in the U3O8 bearing material was removed from the lungs principally by mechanical processes, the retention kinetics in this case being similar to those defined for a class Y (poorly transportable) compound; 3 for both materials the distribution of uranium amongst body tissues and the fraction of the systemic content excreted in urine were similar to those obtained after the injection of soluble hexavalent compounds; 4 for workers potentially exposed to both these materials, urine monitoring and lung radioactivity counting measurements should be used in addition to air sampling procedures for assessing the intake of uranium. 5 intakes of the ADU bearing material should be restricted to those permitted for short-term exposures on the basis of chemical toxicity, whereas those for the U3O8 bearing material should be governed by radiation dose. PMID- 3679248 TI - Pentachlorophenol and hexachlorobenzene in serum and urine of the population of Barcelona. AB - 1 Urinary chlorophenols of the general population of Barcelona, Spain were determined. Pentachlorophenol (PCP: 25.0 +/- 3.9 ng/ml; mean +/- s.e.m., n = 50) and tetrachlorophenol (TCP: 6.2 +/- 1.6 ng/ml; mean +/- s.e.m., n = 25) were found in all samples. 2 Pentachlorophenol and hexachlorobenzene were also determined in serum. Both were present in all samples (PCP: 21.9 +/- 1.9 ng/ml; HCB: 11.1 +/- 1.1 ng/ml; mean +/- s.e.m., n = 100). Their concentrations do not show any correlation, suggesting no metabolic relation between them. PMID- 3679247 TI - The spermicidal potency of Coca-Cola and Pepsi-Cola. AB - The inhibitory effect of Old Coke, caffeine-free New Coke, New Coke, Diet Coke and Pepsi-Cola on human sperm motility was studied with a trans-membrane migration method. None of them could decrease sperm motility to less than 70% of control within one hour. A previous study which claimed a marked variation of spermicidal potencies among different formulations of Coca-Cola could not be confirmed. Even if cola has a spermicidal effect, its potency is relatively weak as compared with other well-known spermicidal agents. PMID- 3679249 TI - Mianserin and complete heart block. AB - Cardiac complications are common in tricyclic antidepressant poisoning, but are rare with overdose of mianserin, which is a tetracyclic antidepressant. We report a case in which repeated episodes of complete heart block occurred following overdose with mianserin. PMID- 3679250 TI - A case of acute poisoning with fenitrothion (Sumithion). AB - A 56-year-old male attempted suicide by ingestion of about 60 ml of 50% fenitrothion (Sumithion) emulsion. Five hours later, combined hemoperfusion and hemodialysis (HP-HD) treatment was performed for 60 min and consequently the toxic symptoms improved gradually. However, cholinergic symptoms recurred 4 days after ingestion. Although HP-HD was immediately performed for 180 min, it had no effect on the clinical symptoms. He died of respiratory insufficiency 6 days after the ingestion of fenitrothion. Fenitrothion concentration in the organs and tissues showed the highest values in the fat tissue, followed in decreasing order by the pancreas, muscle, lung and brain. The results indicate that fenitrothion has high lipid solubility and deposits in the fat tissue. Furthermore, we believe that when HP-HD therapy is used in the treatment of acute insecticide poisoning it is important that it be performed continuously and in as early a stage as possible. PMID- 3679251 TI - Paracetamol conjugation: an interethnic and dietary study. AB - To test whether dietary or hereditary factors affect paracetamol metabolism, two groups of Venda and a group of Caucasian medical students were investigated. The Venda groups were selected as traditionally living villagers and those who followed a Western life-style. Salivary concentrations of paracetamol and urinary amounts of the glucuronide and sulphate metabolites eliminated over 22 h were determined by HPLC. The metabolite formation rate constants and the percentage of the dose eliminated as each metabolite were calculated. No significant differences were found between the data for total Venda, rural Venda, westernized Venda and Caucasian students for the calculated metabolite parameters. Thus environmental effects showed no apparent influence on the sulphide and glucuronide conjugation of paracetamol, and no hereditary effect was evident between the Venda and Caucasians. PMID- 3679252 TI - A method for the blocking of endogenous immunoglobulin on frozen tissue sections in the screening of human hybridoma antibody in culture supernatants. AB - Endogenous immunoglobulin in tissue sections pose a problem in immuno histochemical techniques employing homologous antibody as primary reagents and enzyme-labelled anti-immunoglobulin for the development. A method for the blocking of endogenous immunoglobulin in human tissue sections by incubation with monomeric pepsin fragments (Fab') of rabbit anti-human immunoglobulin before applying monoclonal antibody was evaluated for the screening of human monoclonal antibody. It was initially demonstrated that Fab' rabbit anti-human IgM and anti IgG could block endogenous immunoglobulin in human IgM and IgG producing tumors thereby abolishing the binding of subsequently applied peroxidase-labelled anti IgM or anti-IgG. Frozen sections of human colo-rectal adenocarcinomas show a variable background staining caused by the endogenous immunoglobulin. The background completely disappeared in the IgM system by preincubation with Fab' anti-IgM while the background was clearly reduced but not abolished in the IgG system. A human hybridoma supernatant containing IgM reactive with colo-rectal adenocarcinoma could easily be screened on frozen sections using this method. This approach should be generally useful for the screening of human antibody on human tissue sections. PMID- 3679253 TI - The isolation of cross-reactive monoclonal antibodies: hybridomas to streptococcal antigens cross-reactive with mammalian basement membrane. AB - Based upon the assumption that post-streptococcal sequelae are the result of cross-reactive antibodies, hybridomas were prepared from the spleens of mice immunized with Group A type 12 streptococcal cell membranes (SCM) specifically to screen for such cross-reactive antibodies. One fusion produced a cell population displaying antibodies reactive to both SCM and glomerular basement membrane (GBM) antigens as demonstrated by ELISA technique. Ascites produced by this cell population also showed reactivity to lung basement membrane (LBM). Limiting dilution procedures have produced 15 monoclonal hybrids with both anti-SCM and anti-GBM activity. Confirmation of the cross-reactive and monoclonal nature of the antibody was accomplished by both direct and indirect competitive ELISA. These observations have established that unique cross-reactive antibody-secreting hybrid cells with reactivity to both SCM and basement membrane (BM) antigens can be isolated by standard cloning procedures. PMID- 3679254 TI - Production of an ovine monoclonal antibody to testosterone by an interspecies fusion. AB - Hybridomas were made between NS1/1-Ag4-1 mouse myeloma cells and peripheral blood lymphocytes from a sheep immunized with a testosterone-protein conjugate. ELISAs were developed to detect ovine IgG and specific ovine anti-testosterone and these were used to screen the colonies. Although the cells fused acceptably only 3% of colonies secreted detectable quantities of antibody. The antibody was secreted at low levels (2.5 ng/ml) but was of high affinity (KD = 7.63 x 10(-12) M/1). One line, O/M 4.22, continued to secrete in culture for four months until the termination of the experiment. PMID- 3679255 TI - Production and characterization of highly specific anti-methotrexate monoclonal antibodies. AB - Spleen cells of a Biozzi HR mouse immunized with a bovine serum albumin methotrexate conjugate were fused with P3-X63-Ag8.653 mouse myeloma cells. Twenty three monoclonal antibodies (MAbs), selected by indirect ELISA, were produced and partially characterized. Using methotrexate (MTX) and eight structurally related compounds, binding specificities of the MAbs were assessed by inhibition enzyme immunoassay. All the MAbs had very low affinity for folic acid and its analogs and for the major MTX metabolite 7-hydroxymethotrexate. Using a computer cluster analysis program based on the binding specificities, the MAbs were divided into three groups. The thirteen MAbs in group I recognized primarily the pteridine portion of the MTX molecule; the eight group II MAbs recognized the benzene ring as well as the pteridine structure. The two MAbs in group III poorly distinguished between the different parts of the MTX molecule. The apparent equilibrium association constants of the anti-MTX MAbs in groups I, II, and III ranged from 7 x 10(9) to 3 x 10(8) M-1 (except for 1 MAb), from 5 x 10(7) to 6 x 10(6) M-1 (except for 2 MAbs), and from 1 x 10(6) to 3.5 x 10(5) M-1, respectively. PMID- 3679256 TI - Production and partial characterization of monoclonal antibodies against 3,3',5 triiodo-L-thyronine. AB - Spleen cells of Biozzi HL mouse (selection V) immunized with bovine albumin triiodothyronine conjugate were fused with P3-X63-Ag8.653 mouse myeloma cells. Thirteen monoclonal antibodies, selected by an enzyme-linked immunosorbent assay and a radioimmunoassay, were produced in mouse ascites fluid, purified and analyzed. All of them were IgG1 (kappa). The cross-reactivity of all these monoclonal antibodies with thyroxine (T4) was less than 0.2%. The association constant determined by Scatchard analysis ranged from 1.5 x 10(9) M-1 to 2.7 x 10(10) M-1. PMID- 3679257 TI - Affinity purification of a high molecular weight human breast cancer-associated antigen identified by the BCD-B4 monoclonal antibody. AB - This study reports the purification and characterization of a high molecular weight human breast cancer-associated antigen identified by a previously described (1,2) murine monoclonal antibody, BCD-B4. Immunohistochemical analysis indicated that BCD-B4 recognizes an antigen expressed in an altered form on the human breast carcinoma cell line, BT-20, compared to the non-malignant human mammary epithelial cell line, HBL-100. Chemical treatments and enzymatic digestions suggested that the recognized moiety was a protein. The antigenic determinant was resistant to neuraminidase and periodate treatments but was sensitive to trypsin and proteinase K. The antigen was purified by affinity chromatography and its molecular weight, determined by SDS-PAGE analysis under non-reducing conditions, was proven to be 250 Kd. Under reducing conditions, the molecule dissociated into two polypeptides of 125 and 45 Kd, respectively. Both subunits could be isolated from normal HBL-100 and neoplastic BT-20 cellular protein extracts by affinity chromatography. The higher molecular weight subunit showed; however, qualitative and quantitative differences between the two cell lines: it was expressed in greater quantity on BT-20 cells and its molecular weight was 15 Kd higher. Both subunits could also be identified by immunoblots of BT-20 cells. PMID- 3679259 TI - Autoregressive modeling of surface EMG and its spectrum with application to fatigue. PMID- 3679258 TI - A new protocol to digest human IgM with papain that results in homogeneous Fab preparations that can be routinely crystallized. AB - A method has been developed for the routine production of Fab fragments from human IgM in high yield. After the IgM is purified at physiological pH, it is digested with papain in the presence of cysteine at room temperature for 16 hours. The Fab fragments are purified initially by gel filtration and then by ion exchange chromatography. The yield of Fab has been 60-80%. Some heterogeneity in the size of the Fabs from the different monoclonal IgMs has been observed. Fab fragments from four different IgM rheumatoid factors (RF) have been crystallized after such digestion and purification, in a variety of conditions including phosphate buffer alone or with the precipitating agents ammonium sulfate, polyethylene glycol or methylpentanediol. This modified papain digestion method has also been used for another non-RF monoclonal human IgM with equally good yield. Biological activity can be detected in the purified Fab fragment indicating that this procedure does not destroy the native conformation of the molecule. PMID- 3679260 TI - Evoked response signal and system nonlinearity. PMID- 3679261 TI - Ultrasound Doppler probing of flows transverse with respect to beam axis. PMID- 3679262 TI - Linear quadratic control of a loaded agonist-antagonist muscle pair. PMID- 3679263 TI - Algorithms for the analysis of the nystagmic eye movements induced by sinusoidal head rotations. PMID- 3679264 TI - Characterization of the coronary vascular capacitance, resistance, and flow in endocardium and epicardium based on a nonlinear dynamic analog model. PMID- 3679265 TI - Diffuse reflectance of whole blood: model for a diverging light beam. PMID- 3679266 TI - The malpractice insurance crisis. PMID- 3679268 TI - Nursing shortage; nursing crisis--national problem. PMID- 3679267 TI - Flight nursing--trend for the future. PMID- 3679269 TI - Predicting the future for tomorrow's registered nurse. PMID- 3679270 TI - The impact of the nursing shortage on clinical practice: challenges and opportunities. PMID- 3679271 TI - Gender roles and the nursing shortage: where have all the nurses gone? PMID- 3679272 TI - The nursing shortage from the recruiter's viewpoint. PMID- 3679273 TI - The importance of self image in the nursing profession. PMID- 3679274 TI - Spiritual care as a part of holistic nursing. PMID- 3679275 TI - Nursing in the 80's: a time of growth. PMID- 3679276 TI - Hours of the future: 12 hour shifts. PMID- 3679277 TI - Motivation: where does it begin and is it important in the nursing profession. PMID- 3679278 TI - Transport of immune complexes from the subcapsular sinus into the lymph node follicles of the rat. AB - To study the mode of transport of immune complexes from the subcapsular sinus into the follicles of draining popliteal lymph nodes, horse radish peroxidase (HRP)-anti HRP was injected in rat footpads. Within six minutes, complexes were already present in the subcapsular sinus freely or attached to the plasma membrane of different types of cell including cells forming the stroma. A few minutes later, complexes were also seen in the deeper part of the outer cortex, and after two hours they had reached the periphery of the follicles. They were always seen scattered between lymphoid and non-lymphoid cells. After one day, complexes were present on well-developed follicular dendritic cells. After injection of HRP, no localization of this antigen was observed in the deeper part of the outer cortex including the follicles. These results strongly suggest that HRP-anti HRP complexes are passively transported through the outer cortex into the follicles where they are trapped and retained by follicular dendritic cells. PMID- 3679279 TI - Elevated plasma glutamate levels in colorectal carcinoma patients and in patients with acquired immunodeficiency syndrome (AIDS). AB - Amino acid concentrations were analyzed in the sera of HIV (LAV/HTLV-III) positive persons and in the plasma of colorectal carcinoma patients. Both groups of persons showed significantly elevated glutamate concentrations when compared with healthy control persons. Glutamate concentrations were found to be strongly elevated in all groups of HIV-positive persons including patients with acquired immunodeficiency syndrome (AIDS) or lymphadenopathy as well as HIV-positive persons without overt symptoms, indicating that increased plasma glutamate levels may be among the earliest consequences of the HIV infection. Moreover, the increased plasma glutamate concentrations in the colorectal carcinoma patients were correlated with a decreased immunological reactivity (mitogenic responses against concanavalin A). This suggests the possibility that the increased plasma glutamate concentrations may be causally responsible for the decreased immunological reactivity in colorectal carcinoma patients as well as in patients with AIDS. PMID- 3679281 TI - In vitro natural killer activity against progressive and regressive variants of a rat colon adenocarcinoma. Effect of treatments with anti-asialo GM1 plus complement. AB - In a previous work, a cell line (DHD/K12) was established from a colon adenocarcinoma induced in a BDIX rat by 1,2-dimethylhydrazine. From this line, two cloned sublines, PROb and REGb, were then isolated. When subcutaneously inoculated into syngeneic rats, PROb cells yield progressive tumors, whereas REGb cells yield tumors which regress. In this study, in a 16-h 51Cr release assay, natural cytotoxicity mediated by BDIX splenic nonadherent lymphoid cells (NK cells) was shown to be much higher against REGb cells than against PROb cells. Whatever the target cells, NK cytotoxicity was always higher when the effector cells were obtained from males rather than from females. Treatment of BDIX splenic lymphocytes by anti-asGM1 serum plus complement revealed that both anti asGM1 sensitive and non-sensitive NK cells exist. The activity of anti-asGM1 non sensitive NK cells appeared to be minor and to be detected only when the level of cytotoxicity before treatment was sufficiently high. The difference between PROb and REGb tumor growth appears to be linked, at least in part, to a higher sensitivity of REGb cells to NK cells and especially to anti-asGM1-sensitive NK cells. PMID- 3679280 TI - The immunosuppressive activities of different cyclosporins are correlated to inhibition of the early membrane phospholipid metabolism in activated lymphocytes. AB - Recently, it could be shown that Cyclosporin A (CsA) inhibited the activation of T and B lymphocytes by interfering with an early step of the activation, namely the stimulation of the plasma membrane-bound lysophosphatide acyltransferase. In this report, we compared three CsA-derivatives, Dihydro-Cyclosporin C (Dihydro CsC), "C9-O-Acetyl"-CsA (CsAAC), Cyclosporin H (CsH), regarding the inhibition of proliferation and the interference with the activation of the phospholipid metabolism. At concentrations below 1 microgram/ml, CsAAC and CsH had no effect on any parameter measured. Dihydro-CsC, however, closely resembled CsA: it inhibited the induction of DNA- and RNA-synthesis in T and B lymphocytes from mesenteric lymph nodes of rabbits. Similar to CsA, Dihydro-CsC also interfered with the enhanced incorporation of arachidonic acid into plasma membrane phospholipids by inhibiting the activation of the lysophosphatide acyltransferase. The close correlation between inhibition of proliferation and interferences with the phospholipid metabolism of the plasma membrane suggested that Dihydro-CsC as well as CsA interfered with an early step of lymphocyte activation at the level of the plasma membrane. PMID- 3679282 TI - Carrier-specific recognition for induction of secretory IgA anamnestic antibody responses. AB - This study examined antigen-carrier specificity for the induction of secretory IgA antibodies in the saliva of rats. Conjugate antigens used as probes to examined the formation of SIgA antibodies included: DNP-BGG, DNP-OVA and DNP Streptococcus mutans, as well as the unconjugated carriers BGG and OVA. The results showed that local immunization of rats with homologous hapten-carrier conjugates (i.e. DNP-BGG + DNP-BGG) resulted in secondary responses of salivary IgA and serum IgG and IgA antibodies to the hapten DNP. In contrast, heterologous conjugate (i.e. DNP-BGG + DNP-OVA) administration was unable to provide priming for anamnestic secretory or systemic responses. Priming of rats with unconjugated carrier was found to enhance the response to a local immunization with hapten carrier antigen only in an homologous system. Also, significant carrier priming was most pronounced with serum IgG and IgA. While salivary IgA was increased somewhat following priming with unconjugated carrier, this was less than following two immunizations with the homologous hapten-carrier conjugate. These findings demonstrate carrier-specific reactions in the elicitation of secretory IgA antibodies and further support evidence of the importance of T-cell co operation in the induction of secretory immune responses. PMID- 3679283 TI - Studies on the origin and composition of IgA in rat tears. AB - Experiments were carried out to quantify the proportion of IgA in rat tears that arrives from the circulating IgA pool in the blood, as opposed to that supplied by local synthesis in the lacrymal gland. Rats were injected subcutaneously with an IgA-secreting rat hybridoma cell line (91c), which was allowed to grow in vivo, in order to raise the levels of plasma IgA of known antibody specificity. In rats where serum 91c IgA concentrations had built up to 0.3 mg/ml or more, unstimulated tears contained 91c antibody activity of a molecular weight range that corresponded to that of the polymeric sizes of IgA, and was associated with secretory component. The concentrations of IgA in tear samples were about 0.3% of those in matched serum samples. Thus, a plasma contribution is made to the IgA in tears, but greater than 99% of the tear IgA is synthesized locally in the lachrymal gland. PMID- 3679284 TI - Synthesis of African swine fever (ASF) virus-specific antibodies in vitro in a porcine leucocyte system. AB - We have developed a system of porcine peripheral blood mononuclear cells for the synthesis of antibodies in vitro, induced by partially purified African swine fever virus particles inactivated with formaldehyde. The antibodies synthesized were detected by a radioimmunoassay with a sensitivity of 3 ng of immunoglobulin. Primary responses were dependent on supernatants from peripheral blood mononuclear cells incubated with concanavalin A, macrophages and T lymphocytes. Secondary responses did not require concanavalin A-conditioned medium. The kinetics of antibody synthesis was similar in both primary and secondary responses, but the extent of synthesis was four to five times larger in the secondary than in the primary response. The antibodies synthesized in vitro were specific for African swine fever virus antigens (and did not react with viral antigen other than that from African swine fever virus particles), in contrast to pokeweed mitogen-induced antibodies, which reacted with all the antigens tested. African swine fever virus-induced antibodies did not neutralize the virus. These results and the inability of the virus to stimulate a primary response in the absence of concanavalin A supernatants indicate that inactivated African swine fever virus is not a polyclonal stimulator. PMID- 3679285 TI - Deficiency of the sixth component of complement and susceptibility to Neisseria meningitidis infections: studies in 10 families and five isolated cases. AB - Complement component C6 deficiency (C6D) was diagnosed in 15 patients who presented, independently, with recurrent meningococcal infection. This condition is thus not particularly rare in the Cape. Ten of the patients belonged to multiplex families, and family studies led to the diagnosis of another 12 C6D cases among the siblings. Segregation analysis showed that C6D occurred more frequently among the siblings of affected individuals than would be expected for co-dominant inheritance. The possible reasons for this are discussed. We also observed that the 12 non-proband C6D siblings included only four with a history suggestive of meningococcal infection, and thus C6D individuals apparently differ in susceptibility to Neisseria meningitidis infection. We confirmed previous observations that primary infection occurs later in C6D individuals than amongst susceptible complement-sufficient individuals. Among 123 patients presenting with primary meningitis, one case of C6D was diagnosed. The data show that C6D is an important factor associated with susceptibility to meningococcal infection in the Cape. PMID- 3679286 TI - A human cell-surface glycoprotein that carries Cromer-related blood group antigens on erythrocytes and is also expressed on leucocytes and platelets. AB - A new human erythrocyte glycoprotein has been identified by immunoblotting with murine monoclonal antibodies under non-reducing conditions. The glycoprotein has a MW of 70,000 and carries Cromer-related blood group antigens. The monoclonal antibodies also react with normal peripheral blood leucocytes and platelets and several haemopoietic cell lines. The glycoprotein has a reduced MW after sialidase treatment. The MW is markedly reduced in Tn erythrocyte membranes and slightly increased in Cad erythrocyte membranes. These results suggest that the glycoprotein has a substantial content of O-glycans. The glycoprotein appears to be absent from, or grossly altered in, the erythrocytes of two individuals with the rare Inab phenotype. PMID- 3679288 TI - The cellular uptake and cytotoxicity of chlorambucil-monoclonal antibody conjugates. AB - To investigate the mode of entry and action of the alkylating agent chlorambucil (CBL), conjugated to monoclonal antibodies (MoAbs), CBL was coupled with three different MoAbs--to the transferrin receptor, to L3T4 and to Ly-2 molecules--and the activity of these conjugates was compared with free CBL. It was clear that CBL and CBL-MoAb conjugates enter cells and are transported differently within the cell prior to their cytotoxic action. Evidence favouring a separate entry point of CBL and CBL-MoAb conjugates is the differential effect of temperature and metabolic inhibitors (2-deoxyglucose and sodium azide) on the processing of both moieties. In addition, the likely sites of cleavage of CBL-MoAb complexes, the lysosomes, were effected by NH4Cl and chloroquine, which inhibited the activity of CBL-MoAb but not free CBL. Thus, it is likely that CBL-MoAb conjugates enter via the antibody binding sites and the CBL is internalised and transported as a passenger. PMID- 3679287 TI - Hypothalamic control of certain aspects of natural immunity in the mouse. AB - Electrothermocoagulation (ETC) of the individual nuclei of the median region of the hypothalamus (MH) in the C57BL/6 mouse leads to a significant reduction in the cytotoxic activity of natural killer cells (NK) and the number of large granular lymphocytes (LGL) compared with intact or sham-operated controls. This effect, however, is less than that observed after simultaneous destruction of all MH nuclei. By contrast, no significant change in NK activity was noted after ETC of the anterior (AH) or posterior (PH) regions. Diminution of NK activity due to nuclear MH destruction is not an outcome of the change in adenohypophysis secretion provoked by hypothalamic lesion. Natural cytotoxic activity was markedly increased after ETG located either in AH, or MH, or PH. These results indicate that NK- and NC-mediated immunity is governed by a control mechanism situated in the hypothalamus. PMID- 3679289 TI - In vivo H-2K and H-2D antigen expression in two allogeneic mouse tumours of low immunogenicity. AB - The B16 melanoma of C57BL/6 mice immunizes very poorly, even against its own major histocompatibility complex (MHC) antigens. B16 cells expressed both H-2K and H-2D antigens in vitro as judged by binding of monoclonal antibodies to these antigens in indirect immunofluorescence staining. The in vivo MHC antigen expression of B16 was examined and compared with that of a second C57BL/6 tumour, the Lewis lung carcinoma (3LL), whose defective immunogenicity has been attributed to a selective deficiency in H-2K antigen expression. We found that 125I-labelled cells of both tumours expressed sufficient allo-antigen in vivo to be lysed in BALB/c mice which had been pre-immunized with C57BL/6 lymphoid cells. 125I-B16 cells were also lysed in MHC-recombinant mice which had been immunized against either H-2Kb or H-2Db, indicating that B16 cells express both of these MHC antigens in vivo. This contrasted with our findings with 125I-3LL cells which were destroyed in mice immunized against H-2Db but not in those immunized against H-2Kb. Thus, B16 illustrates a different deficiency in tumour cell immunogenicity which appears not to be attributable to an absence of either of the class I MHC antigens. PMID- 3679290 TI - [Evaluation of the efficacy of isoconazole nitrate after once or twice daily application for a 4-week period]. PMID- 3679291 TI - [Retinol-binding protein and cutaneous disorders in children in terminal renal insufficiency undergoing extracorporeal dialysis]. PMID- 3679292 TI - [Case-control study of various phenotypic characteristics of patients with cutaneous melanoma]. PMID- 3679293 TI - [Epidemiological findings in childhood dermatology. Study of a school population]. PMID- 3679294 TI - [Pili annulati: study of a family with ultrastructural research]. PMID- 3679295 TI - [Cutis verticis gyrata. Apropos of 2 cases]. PMID- 3679296 TI - [Trigeminal neurotrophic ulceration. Apropos of a case arising after treatment]. PMID- 3679297 TI - [Kyrle disease and transepithelial elimination]. PMID- 3679298 TI - [Congenital leukonychia in a psoriasis subject. Clinical case]. PMID- 3679299 TI - [Penile metastasis of bladder heteroplasia]. PMID- 3679301 TI - [Cutaneous and mucosal candidiasis. Incidence and identification of isolated species in selected case material]. PMID- 3679300 TI - [Sclerosing epithelial hamartoma: a typical picture, a name that causes debate]. PMID- 3679302 TI - [Health education in sexually transmitted diseases in Italy]. PMID- 3679303 TI - [Postoperative therapy of keloids. Preliminary results in our cases]. PMID- 3679304 TI - [Use of etretinate in the treatment of lingua villosa nigra]. PMID- 3679305 TI - Plasma lipoproteins and LCAT in chronic liver disease. PMID- 3679306 TI - Usefulness of serum lipid and LCAT levels in diagnosing chronic hepatic dysfunction in liver cirrhosis. PMID- 3679307 TI - Bacteremia following upper gastrointestinal endoscopy. PMID- 3679308 TI - Evaluation of 3% phenol as a venous sclerosant: an experimental study. PMID- 3679309 TI - Gastric candida counts following gastric surgery: a prospective study. PMID- 3679310 TI - Wilson's disease (a study of 12 cases). PMID- 3679311 TI - Beta-glucuronidase activity in gastric aspirate in gastric carcinoma. PMID- 3679312 TI - 99m-technetium-phytate scanning in the diagnosis of hepatic hydrothorax. PMID- 3679313 TI - Chylous ascites following a Warren shunt. PMID- 3679314 TI - Diffuse abdominal echinococcosis with rupture into rectum. PMID- 3679316 TI - Campylobacter isolation. PMID- 3679315 TI - Tuberculosis of appendix with perforation. PMID- 3679317 TI - Field trial with different formulations of Bacillus sphaericus for mosquito control. PMID- 3679318 TI - Toxicologic studies of an insect repellent N, N-diethylphenylacetamide. PMID- 3679319 TI - Serum cholesterol in nephrotic syndrome associated with tuberculosis. PMID- 3679320 TI - Lipids & lipoproteins in obese females. PMID- 3679322 TI - Distance run as a predictor of aerobic endurance (VO2 max) of sportsmen. PMID- 3679321 TI - Bacteremia & pyrexia following sclerotherapy with alcohol. PMID- 3679323 TI - Fine needle aspiration cytology in diagnosis of metastatic lymphadenopathies. PMID- 3679324 TI - Etiology & distribution of mycetoma in Rajasthan, India. PMID- 3679326 TI - Efficacy of wet ice as a refrigerant for transport of oral polio vaccine. PMID- 3679325 TI - Deep bore drinking water as a practical approach for eradication of endemic fluorosis in India. PMID- 3679327 TI - K.A.P. survey of contraception in Bhopal and surrounding villages. PMID- 3679328 TI - A new carotenoid pigment found in retina. PMID- 3679329 TI - Effect of detergent on skin. PMID- 3679330 TI - ELISA today. PMID- 3679331 TI - A histopathological study of synovium in chronic joint diseases. PMID- 3679332 TI - Microvascular changes in diabetes mellitus--relation to control of diabetes and oral hypoglycaemic agents. PMID- 3679333 TI - Idiopathic granulomatous orchitis (a case report). PMID- 3679334 TI - Laryngeal amyloidosis (a report of two cases). PMID- 3679335 TI - Non-parasitic gut-associated cysts in south India. PMID- 3679336 TI - Bacterial pollution in hospital potable drinking water supplies. PMID- 3679337 TI - Bacteriuria: urinary screening on liquid medium, a preliminary report. PMID- 3679338 TI - Primary choriocarcinoma of the cervix (a case report). PMID- 3679339 TI - Serum sialic acid conjugates as biomarkers of tumor growth and therapeutic response in base tongue malignancy. PMID- 3679340 TI - Carcinoembryonic antigen as a prognostic and monitoring test in colorectal carcinoma. PMID- 3679341 TI - Biological characters and antimicrobial sensitivity of Staphylococcus epidermidis. PMID- 3679342 TI - Relevance of N-nitroso compounds to human cancer: exposures and mechanisms. Proceedings of the IXth International Symposium on N-Nitroso Compounds. Baden, Austria, 1-5 September 1986. PMID- 3679343 TI - Enzymatic mechanisms in the metabolic activation of N-nitrosodialkylamines. AB - The metabolism of several N-nitrosodialkylamines was studied using rat liver microsomes and purified cytochrome P450 isozymes in a reconstituted monooxygenase system. With purified acetone/ethanol-inducible cytochrome P450 (P450ac), high N nitrosodimethylamine (NDMA) demethylase activity was observed. Cytochrome b5 was also involved in NDMA metabolism by decreasing the Km of NDMA demethylase. A close relationship between the demethylation and denitrosation of this substrate was observed. P450ac was also active in the metabolism of N nitrosoethylmethylamine (NEMA), but was less active than phenobarbital-inducible cytochrome P450 (P450b) in the metabolism of N-nitrosobutylmethylamine (NBMA), especially in catalysing the debutylation reaction. Similar substrate specificity was demonstrated with liver microsomes from rats treated with other inducers. With different P450 isozymes and microsomes, a close relationship between metabolism and activation of nitrosamines to mutagens to V79 cells was demonstrated. DNA alkylation by NDMA in vitro was correlated with the rate of metabolism of these compounds, whereas DNA alkylation in vivo was more complex and was dose-dependent. The work demonstrates the importance of knowledge of the substrate specificity of cytochrome P450 isozymes in understanding the mechanisms of the metabolic activation of nitrosamines. PMID- 3679345 TI - Thoughts on nitrosamines and the cause and prevention of human cancer. PMID- 3679344 TI - Mechanism and control of denitrosation of N-nitrosodimethylamine. AB - The NADPH-dependent microsomal denitrosation of N-nitrosodimethylamine (NDMA) has been investigated using a new procedure which was devised for the determination of nitric oxide under aerobic conditions. On the basis of the results obtained with rat-liver microsomes it is concluded that nitric oxide is formed as a precursor of nitrite in a superoxide dismutase (SOD)-insensitive reaction. The enzyme involved in the denitrosation was found to correspond to the cytochrome P450 isoenzyme responsible for the dealkylation of NDMA. The chemical mechanism of the liberation of nitric oxide is proposed to be of an oxidative nature. PMID- 3679346 TI - Potential for metabolic deactivation of carcinogenic N-nitrosodimethylamine in vivo. AB - Enzymatic cleavage of N-nitrosodimethylamine (NDMA) to nitrite (normally representing about 10% of the total metabolism in vitro) also produces methylamine in yields roughly equimolar to those of nitrite, suggesting that the 'denitrosation' pathway may be responsible for the previously unexplained detection of methylamine as a urinary metabolite of NDMA and, at least in part, for the recovery of less than stoichiometric amounts of dinitrogen in 15N labelling experiments. We have now followed excretion of labelled methylamine by rats receiving 14C-NDMA as a possible index of the extent of in-vivo denitrosation. Correcting for the proportion of labelled methylamine recovered in the urine following its administration under the conditions used for NDMA, 2.5 10% of the NDMA metabolism in Fischer rats appeared to proceed by a methylamine forming route. The results are consistent with the conclusion that the metabolism of NDMA is best viewed as a competition between two pathways, with denitrosation diverting a significant proportion of the clearance to a presumably deactivating metabolic route at the expense of the activating alkylation pathway responsible for carcinogenesis. PMID- 3679347 TI - Some aspects of cytochrome P450-dependent denitrosation of N-nitrosamines. AB - The present paper deals with three aspects of cytochrome P450-dependent denitrosation of N-nitrosamines. (1) Nitrate was found in addition to nitrite as a metabolic product of the denitrosation reaction when N-nitrosamines were incubated with a microsomal system. This could also be shown when nitric oxide was added to the microsomes. (2) In order to determine the amount of denitrosation in vivo, the nitroso group of N-nitroso-N-methylaniline was labelled with the 15N isotope and administered to rats; then, the concentrations of 15N-nitrate and 15-N-nitrite in the urine were quantified by measuring the reaction of nitrate and benzene to nitrobenzene. It is estimated from these data that about 33% of the applied dose of 15N-nitroso-N-methylaniline is denitrosated in vivo. (3) Although N-nitrosodiphenylamine (NDPhA) has been classified as a noncarcinogen, recent long-term and short-term studies have cast some doubt. In order to evaluate the mechanism by which NDPhA exerts its possible genetoxic effects, its metabolism was studied in vitro, and NDPhA and its metabolites were tested for induction of DNA single-strand breaks in rat hepatocytes and in Chinese hamster V79 cells. One metabolite was identified as diphenylamine; others were suspected to be the 4-hydroxylated derivative and its corresponding quinoneimine. NDPhA caused DNA damage in rat hepatocytes but not in V79 cells. Diphenylamine also gave negative results in V79 cells, but its putative metabolite, diphenylhydroxylamine, induced a significant increase in DNA single strand breaks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679348 TI - Kinetic isotope effect on the demethylation and denitrosation of N nitrosodimethylamine in vitro. AB - Deuteration of N-nitrosodimethylamine (NDMA) has been shown to decrease the carcinogenicity of this compound. This result is believed to be due to a kinetic isotope effect on the metabolic activation of this carcinogen, but conflicting views exist concerning whether the isotope substitution affects the Km or Vmax of the reaction. In order to elucidate the molecular basis of these observations, as well as the mechanisms of the demethylation and denitrosation reactions, the metabolism of NDMA and deuterated NDMA (NDMA-d6) was studied using acetone induced rat-liver microsomes. The demethylation of NDMA displayed a Km of 0.06 mM and a Vmax of 7.9 nmol/min per mg protein. Deuteration of NDMA increased the Km value by five fold but did not appreciably affect the Vmax. The denitrosation of NDMA also displayed a Km of 0.06 mM, but the Vmax was 0.83 nmol/min per mg; deuteration again increased the Kmax several fold but had no effect on the Vmax. The results indicate that deuteration inhibits the metabolism of NDMA by increasing the Km but not the Vmax and suggest that there is a close relationship between the demethylation and denitrosation reactions. PMID- 3679349 TI - Structure-activity relationships in metabolism and mutagenicities of N nitrosamines. AB - The metabolism of a series of nitrosamines in vitro was monitored by measuring nitrogen production and was compared with mutagenesis by the same compounds, allowing separation of mutagenic potencies into metabolic and postmetabolic terms. The rate of nitrogen production from symmetrical di-n-alkyl and methylalkyl nitrosamines increased with increasing molecular weight. The cyclic nitrosamines N-nitrosopiperidine and N-nitrosopyrrolidine were metabolized slightly less rapidly than the most hydrophobic compounds, and N nitrosomorpholine was metabolized at about half this rate. N-Nitrosomethylaniline was metabolized to nitrogen relatively slowly. Branching at the alpha-carbons reduced alpha-oxidative metabolism several fold. Substitution at the beta-carbon of N-nitrosodiethylamine or N-nitrosodi-n-propylamine with hydroxyl, cyano, oxo and methoxyl groups reduced metabolism to an even greater extent. Carboxyl substitution at the 4-position of N-nitrosopiperidine greatly reduced nitrogen formation, but 4-tert-butyl substitution had little effect. Effects of structure on mutagenic activities in Salmonella followed a different pattern. Higher homologue di-n-alkyl nitrosamines were more potent than lower homologues at lower doses, when potencies were taken from slopes of dose-response curves. However, when mutagenic potencies were expressed as 'mutagenic efficiencies' (revertants/mumol nitrogen), regardless of dose, the order of potency was N nitrosodimethylamine greater than N-nitrosodiethylamine greater than N-nitrosodi n-propylamine greater than N-nitrosodibutylamine. For the series of methylalkyl nitrosamines, mutagenic potencies were greatest for the higher molecular weight compounds, but they were all similar to that of N-nitrosodimethylamine when expressed as mutagenic efficiencies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679350 TI - The pig as an animal model for the study of nitrosamine metabolism. AB - Surgical procedures have been developed that permit the sampling of portal blood, bile and hepatic blood in intact pigs. Animals so prepared have been used to study liver metabolism and biliary excretion of N-nitrosodimethylamine (NDMA) following oral and intravenous dosing. PMID- 3679351 TI - The ferret as a model for endogenous synthesis and metabolism of N-nitrosamines. AB - We have begun to evaluate the ferret as a model for studying gastric nitrosation and nitrosamine metabolism. Jugular cannulation allows convenient dosing and sampling of blood, and this technique has been used to study clearance of N nitrosodimethylamine (NDMA) after intravenous, intraperitoneal and intragastric administration. NDMA metabolism can be inhibited by 4-methylpyrazole for up to 24 h; the accumulation of endogenously-synthesized NDMA can therefore be observed in animals following pretreatment with this compound. We have studied endogenous NDMA synthesis in animals dosed with dimethylamine and nitrite and in animals to which no NDMA precursors were administered. PMID- 3679352 TI - A comparative study of the mutagenic activation of carcinogenic N nitrosopropylamines by various animal species and man. AB - N-Nitrosomethyl(2-hydroxypropyl)amine (NMHPA), N-nitrosomethyl(2-oxopropyl)-amine (NMOPA), N-nitrosomethyl(2,3-dihydroxypropyl)amine (NMD23HPA), N-nitrosobis(2 hydroxypropyl)amine (NDHPA), N-nitroso(2,3-dihydroxypropyl)(2-hydroxypropyl) amine(ND23HPHPA), N-nitrosobis(2-acetoxypropyl)amine (NDAcPA) and N-nitroso-2,6 dimethylmorpholine (NDMMOR) were mutagenic in Salmonella typhimurium strain TA100 in the presence of liver 9000 X g supernatant (S9) from mice, rats, hamsters, rabbits and monkeys. N-Nitroso(2-hydroxypropyl)(2-oxopropyl)amine (NHPOPA) and N nitrosobis(2-oxopropyl)amine (NDOPA) were mutagenic in strain TA100 without metabolic activation, and both compounds were further activated by animal liver S9. NMOPA and NMHPA were also mutagenic in the presence of lung S9 from these animals and in the presence of human lung or liver S9. Pancreatic S9 from any of the animals did not activate any of the nine N-nitrosamines to mutagens. PMID- 3679353 TI - Metabolism of the oesophageal carcinogen N-nitrosomethylamylamine: changes with age, clearance from blood and DNA alkylation. AB - Freshly excised rat oesophagus and other tissues metabolize N-nitrosomethyl-n amylamine (NMAA) to 2-, 3-, 4- and 5-hydroxy-NMAA (HO-NMAA), and 3- and 4-oxo NMAA. We examined the development of this metabolism in MRC-Wistar rats and Syrian hamsters. In rats, oesophagus showed maximum metabolism at nine days of age, and forestomach showed considerable metabolism at three days, but none in adults. In newborn hamsters, oesophagus showed 10.4%; and in three-day hamsters, forestomach showed 4.9% metabolism, despite low or no metabolism by the adult tissues. Clearance of NMAA (25 mg/kg) from rat blood had a half-life of 21 min. The blood also contained considerable amounts of 4-oxo- and 4-HO-NMAA. Incubation of adult oesophagus and liver slices with 3H-labelled NMAA produced DNA labelling, including labelled N7-and O6-methylguanine, with 14 times higher specific radioactivity in DNA from oesophagus than from liver. O6-Methylguanine was also measured by radioimmunoassay. PMID- 3679354 TI - Exhalation of N-nitrosoethylvinylamine after application of N-nitrosodiethylamine to Sprague-Dawley rats. AB - Our method of endotracheal intubation makes it possible to collect exhaled air directly from the respiratory tract, thus eliminating the possibility of artefact formation and decomposition of metabolites. N-Nitrosodiethylamine (NDEA) has been postulated as a precursor of N-nitrosoethylvinylamine (NEVA), however, NEVA has not been detected as a metabolite of NDEA. Following endotracheal intubation and intravenous application of 550 micrograms NDEA to Sprague-Dawley rats, appreciable amounts of NEVA and unaltered NDEA were found in exhaled air. Further confirmation that NEVA is a metabolite of NDEA was obtained when, after eliminating oxidative decomposition of the nitrosamine with disulfiram in an enzyme inhibition assay, pretreated rats exhaled only traces of NEVA. Such findings could be informative with respect to the organotropism of nitrosamine carcinogenesis. PMID- 3679355 TI - Investigation into the pharmacodynamics of the carcinogen N-nitrodimethylamine. AB - N-Nitrodimethylamine (NTDMA) was found to be a carcinogen of the nasal mucosa leading to aesthesioneuroepitheliomas in BDVI rats. N-Nitromethylamine (NTMA), a product of the oxidative metabolism of NTDMA, was also carcinogenic, leading to neurogenic tumours of the lumbar region of the spine. The 100,000 X g supernatant of both liver and nasal mucosa contains an enzyme capable of reducing NTDMA to N nitrosodimethylamine (NDMA). In the microsomal fraction of both organs, NTDMA is oxidized to formaldehyde. The fractions from nasal mucosa have a higher capacity than the corresponding liver fractions to both oxidize and reduce NTDMA. NDMA was detected in blood and urine from rats treated with NTDMA. The elimination of NTDMA from blood occurs biphasically, with an initial half-life of 3.5 min. PMID- 3679356 TI - Urinary metabolites of N-nitrosodibutylamine in the rat: identification of N acetyl-S-butyl-L-cysteine derivatives. AB - N-Acetyl-S-(butyl, 3-oxobutyl and 3-hydroxybutyl)-L-cysteines have been isolated and identified (as their methyl esters) from the urine of rats given N nitrosodibutylamine (NDBA), N-nitrodibutylamine (NTDBA) and their corresponding alpha-acetoxy derivatives, N-nitroso-N-butyl(1-acetoxybutyl)amine and N-nitro-N butyl(1-acetoxybutyl)amine, respectively. Greater amounts of these L-cysteine derivatives were detected in urine after administration of NDBA than of NTDBA. This suggests that the markedly different biological activities of NDBA and NTDBA might be due, in part, to a difference in their alkylating abilities in vivo. PMID- 3679357 TI - Extrahepatic microsomal metabolism of N-nitrosodi-n-butylamine in rats. AB - The omega- and omega-1-hydroxylation of N-nitrosodi-n-butylamine (NDBA) has been studied in microsomes from rat liver, lung, intestine and kidney. Both reactions followed at least two enzyme kinetics with low (2-10 microM) and high (1 mM) Km values. Whereas omega-1-hydroxylation was the predominant pathway in liver, omega hydroxylation was more important in extrahepatic tissues. First-pass metabolism of NDBA in lungs and intestinal mucosa may be of importance in the development of urinary bladder tumours in rats. PMID- 3679358 TI - Experimental model for investigating bladder carcinogen metabolism using the isolated rat urinary bladder. AB - The capacity of the isolated rat urinary bladder to metabolize chemical carcinogens was studied. Under our experimental conditions, the bladder carcinogen N-nitrosobutyl-(4-hydroxybutyl)amine (NBHBA) was oxidized to N nitrosobutyl(3-carboxypropyl)amine (NBCPA). A time-dependent increase in the amount of NBCPA formed and a simultaneous disappearance of NBHBA indicated that the bladder can metabolize NBHBA to the metabolite considered to be responsible for tumour induction in the urinary bladder of laboratory animals. After 15, 30, 60 and 120 min, the percentages of NBCPA formed were 10%, 21%, 35% and 61%, respectively, and 59%, 49%, 36% and 25% of NBHBA remained unchanged. When N nitrosodi-n-butylamine (NDBA) was introduced into the isolated urinary bladder and incubated for 120 min, its oxidized metabolites NBHBA and NBCPA were formed, in amounts of 0.13% and 0.06% of the substrate added. PMID- 3679359 TI - Could N-nitrosamino phosphates be transport forms of activated N-nitrosamines? AB - The stability of N-nitroso-N-methylamine-N-ethyl phosphate (NMEP) and N-nitroso-N ethylamine-N-ethyl phosphate (NEEP) was studied in rat serum and in rat liver homogenate and found to be sufficiently high for the phosphates to be transported in vivo. In liver homogenates, the cleavage was more efficient, and a higher phosphatase activity was found in liver microsomal and cytosolic fractions than in serum. The substances exert a distinct activity in the Salmonella typhimurium mutagenicity test. PMID- 3679360 TI - Chemical and mutagenic properties of alpha-phosphonooxynitrosamines. AB - The chemical and mutagenic properties of the products of solvolysis of alpha acetoxynitrosamines in phosphate buffer were investigated. alpha Acetoxynitrosamines decomposed in two ways: O-acyl fission yielded alpha hydroxynitrosamines, which decomposed into aldehydes and alcohols, while O-alkyl fission gave a resonance hybrid of alpha-N-nitrosocarbonium and -iminium ions, which was trapped with phosphate and afforded alpha-phosphonooxynitrosamine. Formation of alpha-phosphonooxynitrosamines was dependent on the structure of alpha-acetoxynitrosamines; those with a secondary alpha-phosphonooxy group, including cyclic nitrosamines, were easily formed, while among those with a primary phosphonooxymethyl group, only those with an alkyl group containing a branched alpha-carbon as isopropyl, sec-butyl and tert-butyl were isolated. They were good substrates of alkaline phosphatase and showed a nuclear magnetic resonance spectrum due to the presence of a phosphorus atom. They were decomposed by acid catalysis, and the rate was dependent on the structure. They were directly mutagenic in bacterial tester strains, except for a compound with a tert butyl group. The activity was similar or stronger in Salmonella typhimurium TA1535 and much weaker in Escherichia coli WP2 and WP2 hcr- than those of alpha acetoxynitrosamines. Stability in neutral aqueous solution and the strong mutagenicity of alpha-phosphonooxynitrosamines suggested their possible involvement in metabolic activation as a precursor of alpha-hydroxynitrosamines, and also in the organotropic carcinogenicity of N-nitrosodialkylamines as a transport form. PMID- 3679361 TI - Biochemical events in nitrosamine-induced hepatocarcinogenesis: relevance of animal data to human carcinogenesis. AB - Administration of carcinogens to experimental animals results in the early formation of phenotypically altered cell foci. Evidence suggesting their intermediary role in hepatocarcinogenesis, and some of their biological properties are reviewed. Two concepts relating to the mechanism of tumour promotion are described briefly, i.e., the 'resistant cell' hypothesis and that of 'overexpression of adaptive growth'. It is concluded that studies on liver foci may be helpful in elucidating the nature of the events involved in the initiation of carcinogenesis. Some aspects relating to human hepatocarcinogenesis are also considered briefly. PMID- 3679362 TI - Alpha-glucuronides of N-nitrosomethylbenzylamine. AB - After administration of N-nitroso[14C-methyl]benzylamine to rats, a glucuronide was demonstrated in the urine, the structure of which could be assigned on the basis of synthetic marker compounds. These findings offer an explanation for the failure to detect benzylation of DNA after administration of N nitrosomethylbenzylamine (NMBzA). The glucuronides were synthesized by a combination of enzymatic and chemical reactions. PMID- 3679363 TI - Effect of ascorbic acid on the metabolism of N-nitrosopiperidine. AB - Guinea-pigs were fed diets containing 48, 200 or 2000 mg/kg ascorbic acid (AsA) for 20-30 days and given a single oral dose of 50 mg N-nitrosopiperidine (NPIP)/kg body weight. The levels of glutaric acid, 3-hydroxy-NPIP and 4-hydroxy NPIP, but not of 1,5-pentanediol, in urine increased with the dose of AsA in the diet. PMID- 3679364 TI - Effect of dietary selenium on biotransformation and excretion of mutagenic metabolites of N-nitrosodimethylamine and 1,1-dimethylhydrazine in the liver perfusion/cell culture system. AB - The mutagenicity of N-nitrosodimethylamine (NDMA) and 1,1-dimethylhydrazine (UDMH) has been studied in an isolated liver perfusion/cell culture system. The liver donors, male Wistar rats, were either selenium (Se)-deficient or had a physiologically adequate Se status (Se-supplemented). Mutagenicity was measured in perfusate and bile with Chinese hamster V79 cells as the genetic target. Se deficiency increased the mutagenic effect of NDMA in the perfusate, whereas no mutagenicity was detected in the bile of either Se-deficient or Se-supplemented livers. No significant increase in the mutagenicity of UDMH was seen in the perfusate with Se deficiency, but the bile became mutagenic. Se deficiency thus increased the mutagenicity of both NDMA and UDMH: with NDMA, the effect was observed in the perfusate, and with UDMH, in the bile. PMID- 3679365 TI - Different effects of chemicals on metabolism of N-nitrosamines in rat liver. AB - The effects of phenobarbital (PB), 3-methylcholanthrene (MC), pyrazole (PY) and ethanol (EtOH) pretreatment on N-nitrosodimethylamine (NDMA), N nitrosobutylmethylamine (NBMA) and N-nitrosomethylbenzylamine (NMBzA) metabolism were examined in rats. In isolated hepatocytes, PB increased the metabolic decomposition of NBMA and NMBzA, and MC increased that of NBMA; PY and EtOH increased only that of NDMA. In studies of hepatic microsomal dealkylation, PB increased NBMA debutylation and NMBzA debenzylation, and MC increased NBMA debutylation; PY and EtOH increased NDMA demethylation selectively. Several cytochrome P450 (P450) species were active in dealkylating nitrosamines, indicating that the organ-specific carcinogenicity of nitrosamines might be changed by various P450 inducers. PMID- 3679366 TI - Effect of butylated hydroxyanisole on the metabolism of N-nitrosodi-n-butylamine and N-nitrosobutyl(4-hydroxybutyl)amine by rat hepatic S9 preparations in vitro. AB - N-Nitrosodi-n-butylamine (NDBA), the NADPH generating system and various concentrations of butylated hydroxyanisole (BHA) added to rat hepatic S9 fractions resulted in a significant drop (30-50%) in N-nitrosobutyl(4 hydroxybutyl)amine (NBHBA) formation and a consequent rise in the amount of substrate recovered unchanged. When NBHBA and NAD+ were incubated with BHA and S9 fractions, the amount of N-nitrosobutyl(3-carboxypropyl)amine (NBCPA) was decreased by 20-40%, and the amount of unmetabolized NBHBA increased. PMID- 3679367 TI - Formation and fate of nucleic acid and protein adducts derived from N-nitroso bile acid conjugates. AB - 14C-N-Nitrosoglycocholic acid (14C-NOGC) reacted with calf thymus DNA in vitro to give a number of carboxymethylated adducts (7-carboxymethylguanine [7-CMG], 3 carboxy-methyladenine [3-CMA] and O6-carboxymethylguanine [O6-CMG]). 7-CMG is excreted unchanged in urine, and its use as a marker for NOGC exposure was studied. Administration of 14C-NOGC results in a dose-dependent urinary excretion of 14C-7-CMG and in labelling of blood proteins, albumin and globin. The activity in albumin disappears in vivo, with a half-life very similar to that of albumin itself. The monitoring of carboxymethylated nucleic acid bases and proteins appears to be a useful way of monitoring endogenous formation of NOGC and related compounds. PMID- 3679368 TI - Comparison of induction of DNA single-strand breaks and initiation of rat hepatocarcinogenesis by different nitrosamines. AB - The capacities of nitrosamines to induce DNA single-strand breaks (SSB) and to initiate carcinogenesis in rat liver were compared. N-Nitrosodiethanolamine (NDELA), N-nitrosoethylhydroxyethylamine (NEHEA) and N-nitrosodiethylamine (NDEA) were equipotent in inducing DNA SSB when administered by gavage at doses of 0.35 mmol/kg, 0.015 mmol/kg and 0.37 mmol/kg, respectively. Male Wistar rats were injected with these nitrosamines and were then submitted to a selection procedure. Ten rats per group were sacrificed one week after the end of the selection to see the effects of the nitrosamines on the development of preneoplastic lesions. The numbers of gamma-glutamyl transferase (GGT)-positive lesions per cm2 were 0.8, 2.1, 5.2 and 40.1 in rats treated with saline, NDELA, NEHEA and NDEA, respectively. N-Nitrosobis(2,2,2-trifluorethyl)amine (6F-NDEA), a nongenotoxic and noncarcinogenic nitrosamine, induced 0.7 GGT-positive lesions per cm2. Ten rats per group also received 0.05% phenobarbital in their drinking water and were killed six months after initiation in order to see the effect of the different nitrosamines on the incidence and yield of tumours. Two extrahepatic cancers were found after administration of NEHEA, whereas two hepatocellular carcinomas were detected after injection of NDEA. No cancer developed in the other groups. Although other factors may influence the process, these results indicate that no simple correlation can be established between induction of SSB in DNA and initiation of tumours by nitrosamines in rat liver. PMID- 3679369 TI - Reactions of N-nitrosoureas with cell membranes. AB - The strongly carcinogenic N-nitrosoureas react with phosphatidylethanolamine (PE) in chicken erythrocyte ghosts or rat kidney cells, while weaker carcinogens do not. The reactions proceed through carbamoylation of the amino group of PE by isocyanates generated from the agents. Many commercial isocyanates, including methyl isocyanate, react with PE similarly to the strong carcinogens, suggesting that this reaction may be involved in promotion in human cancer. PMID- 3679370 TI - An improved method for analysis of total N-nitroso compounds in gastric juice. AB - An improved procedure for the analysis of total N-nitroso compounds (NOC) in human gastric juice was developed by modifying previous methods. The gastric juice sample, treated with sulfamic acid to remove nitrite, is injected directly into refluxing ethyl acetate containing either acetic acid for determining thermo/acetic acid-labile-thermal energy analyser (TEA)-responsive compounds (TAC), or into hydrogen bromide for the analysis of TAC and NOC. The nitric oxide (NO) levels released are measured by chemiluminescence by TEA, and the difference between the two determinations represents the concentrations of NOC in gastric juice. This method also allows the determination of nitrite and is not affected by nitrate concentrations up to 1,000 mumol/l. The method was found to be reproducible and sensitive (detection limit, 0.02 mumol NOC/l), requiring only small volumes of gastric juice and no prior extraction. Because the difficulties arising from the 'system response' to the denitrosating agent and variability of NO release by acetic acid from nitrite were eliminated, this improved method can more accurately distinguish NOC from most other TEA-responsive species. Suitable techniques for stabilizing gastric juice samples from duodenal ulcer/atrophic gastritis patients and the influence of the time and storage conditions on NOC concentrations have been studied. PMID- 3679371 TI - Thermal energy analysis of N-nitroso compounds, including ureas, urethanes and guanidines. AB - Simple, selective, sensitive analytical methods have been developed for a number of N-nitroso compounds (NOC) which are applicable to environmental and biological matrices and have been used to quantify nitrosourea anticancer drugs in human plasma. These new chromatographic detection windows can be used to screen suspect matrices for NOC. PMID- 3679372 TI - An investigation of apparent total N-nitroso compounds in beer. AB - The concentration of apparent total N-nitroso compounds (ATNC) in beer has been investigated using a group-selective procedure based on chemical denitrosation with hydrogen bromide and chemiluminescence detection of the released nitric oxide. In a survey of samples of 40 brands of beer and lager, detectable levels of ATNC were present in 17 samples at concentrations of 20-100 micrograms N-NO/kg in 11 and 100-500 micrograms N-NO/kg in six. To determine the origin of ATNC in beer the production of a commercial batch was examined in detail. ATNC levels were below the detection limit in the sweet wort (aqueous extract of malt), bitter wort (malt extract boiled with hops) and also at the start of fermentation, but during the course of fermentation the concentration of ATNC increased appreciably and that of inorganic nitrate decreased; detectable, though transitory, levels of inorganic nitrite were observed. None of the brewing ingredients contained sufficiently high enough levels of ATNC to account for the concentration of these compounds present in the beer after fermentation. These findings suggest that the presence of detectable levels of ATNC in some beers is a result of N-nitrosation reactions occurring in the fermenting wort with the nitrosating species derived from reduction of nitrate, due probably to the presence of microbial species with nitrate reductase activity. PMID- 3679373 TI - Magnetic semipermeable aqueous polyethyleneimine microcapsules for monitoring N nitrosating species in the gastrointestinal tract. AB - Magnetic polyethyleneimine (PEI) microcapsules have been developed for trapping electrophilic intermediates in the gastrointestinal (GI) tract. The N-nitrosation of these microcapsules at acid pH was found to be linearly dependent on nitrite concentration, without a pH maximum and with efficient conversion to N-nitrosated products which were detected by a total N-nitroso assay procedure. The limit of detection is in the range 1-10 nmol N-nitroso compound, depending on microcapsule preparation conditions. Nuclear magnetic resonance (NMR) indicates that such N nitrosation is favoured by incomplete protonation of the polyamine. Microcapsules administered orally to rats were recovered magnetically from faeces and showed extensive N-nitrosation when nitrite was administered in the drinking-water. PMID- 3679374 TI - Laser photofragment spectroscopy: a new technique for the detection of N nitrosamines and other nitroso compounds. AB - The potential of laser photofragment spectroscopy (LPS) for the detection and discrimination of nitrosamines, alkyl nitrites, thionitrites and C-nitroso compounds has been evaluated. The technique combines high sensitivity with the dramatic specificity of high-resolution spectroscopy and utilizes pulsed laser photodissociation with synchronized detection of the NO photofragment by laser induced fluorescence (LIF). Using supersonic molecular beam sampling and wavelength tunable photodissociation, LPS can generate well-resolved finger-print spectra characteristic of the parent nitroso compound. PMID- 3679375 TI - In-vitro assays to detect alkylating and mutagenic activities of dietary components nitrosated in situ. AB - Nitrosation of dietary components has been combined with the 4-(para nitrobenzyl)pyridine (NBP) colorimetric test for screening alkylating agents and with the Ames test for the detection of mutagenic activity. This allowed the investigation of short-lived nitrosation products of dietary components which generate electrophilic degradation products requiring no metabolic activation (natural amino acids and some derivatives, ureas, guanidines, primary alkyl and aryl amines). In a first system, precursor, nitrous acid and NBP were present simultaneously. All amino acids tested, except glutamic acid and glutamine, gave positive results. The reactivities spanned more than three orders of magnitude, with the aromatic amino acids and methionine the most active; two primary amines, tryptamine and histamine, were also strongly reactive. All guanidines tested, except the amino acid arginine, gave negative results. A second system consisted of two phases: NBP was added only after destruction of residual nitrite and adjustment of the pH to neutrality. This system was useful for the study of ureas, which are stable in acid but not in neutral media. The range of responses covered more than two orders of magnitude. Most amino acids and primary amines also gave positive results, but could be assessed only after analysing the kinetics of the competing reactions and choosing appropriate reaction times. In a third system, Salmonella typhimurium strain TA100 replaced NBP. Representatives of the class of amino acids, ureas, the primary amine tryptamine, and aniline became highly mutagenic upon nitrosation. Methylguanidine was only weakly mutagenic under the present assay conditions. The results indicate that further studies with unstable nitrosation products of dietary components are required to understand more thoroughly the role of endogenous nitrosation in gastric cancer. PMID- 3679376 TI - Syncarcinogenesis at low exposure levels of three nitrosamines with a common target of carcinogenic action: preliminary results. AB - The carcinogenic activities of N-nitrosodiethylamine (NDEA), N-nitrosopyrrolidine (NPYR) and N-nitrosodiethanolamine (NDELA) and of the combination of the three nitrosamines was determined in Sprague-Dawley rats at three logarithmically spaced exposure levels. The highest doses of the individual nitrosamines and of their combination, chosen so as to induce low specific incidences of liver tumours following life-long administration, resulted in median survival times for all treated groups of more than 30 months. The macroscopically determined incidences of liver tumours were 1% in control rats, 45%, 4% and 4% following administration of NDEA, 14%, 3% and 1% following administration of NPYR, 6%, 5% and 1% following administration of NDELA and 12%, 4% and 3% following the combined administration of all three nitrosamines. These results indicate linear, additive carcinogenicity with respect to their common target organ in the dose range investigated. PMID- 3679377 TI - Lung carcinogenesis by N-nitrosobis(2-hydroxypropyl)amine-related compounds and their formation in rats. AB - Lung carcinogenesis by a single intraperitoneal injection of N-nitrosobis(2 hydroxypropyl)amine (NDHPA) and related compounds was studied in male Wistar rats. NDHPA, N-nitrosomethyl(2-hydroxypropyl)amine (NMHPA), N-nitrosobis(2 oxopropyl)amine (NDOPA), N-nitroso(2-hydroxypropyl)(2-oxopropyl)amine (NHPOPA) and N-nitroso-2,6-dimethylmorpholine (NDMMOR) induced high incidences of lung neoplasms in rats. The formation of NDHPA, NDMMOR and NMHPA in the stomach of rats treated with precursor amines and sodium nitrite was detected by high performance liquid chromatography (HPLC). PMID- 3679378 TI - A possible mechanism for the dose-response relationship observed for renal mesenchymal tumours induced in the rat by a single dose of N nitrosodimethylamine. AB - The incidence of renal mesenchymal tumours induced in rats by N nitrosodimethylamine (NDMA) is related to the dose in a sigmoidal dose-response curve. Each kidney bears only one or two tumours at 20-24 months. In contrast, one week after dosing, a large number of preneoplastic proliferative foci is present, the incidence of which is linearly related to dose and directly proportional to methylation of DNA by NDMA. It is suggested that most of these foci are removed by host defense mechanisms before they can progress to tumour, thus accounting for the sigmoid shape of the dose-response curve for the tumours. PMID- 3679379 TI - Vascular changes and liver tumours induced in mink by high levels of nitrite in feed. AB - Two groups of female mink were fed a diet supplemented with 30-50 mg/kg bw sodium nitrite for up to six years. The first group also received dimethylamine hydrochloride. Seven male offspring from litters born in the first year were fed the same diet for nine months but showed no pathomorphological change. After three years on trial, female mink developed occlusive changes in some branches of the efferent hepatic veins, and 21% of the mink in group 1 and 31% in group 2 developed liver haemangioendotheliomas or precancerous liver changes. The pathomorphological changes were identical to those seen in animals exposed to N nitrosodimethylamine (NDMA). This result indicates in-vivo formation of NDMA as a result of the high nitrite in the diet. However, NDMA was not measured in the blood of the nitrite-exposed mink. PMID- 3679380 TI - Activation of the human c-Ha-ras-1 proto-oncogene by in-vitro reaction with N nitrosomethyl(acetoxymethyl)amine. AB - Reaction of N-nitrosomethyl(acetoxymethyl)amine in vitro in the presence of esterase with a plasmid containing the human c-Ha-ras-1 gene has been shown to generate a transforming oncogene when the methylated DNA is transfected into NIH 3T3 cells. Our results show that an activated nitrosamine can mutate a normal cellular proto-oncogene, a reaction that may be the necessary first step in the multistage process of tumour induction. PMID- 3679381 TI - Zinc-deficiency and the development of malignant lymphoma in rats given a single intragastric dose of N-methyl-N-nitrosourea. AB - Zinc-deficient rats that had received a single dose of N-methyl-N-nitrosourea (MNU) intragastrically developed malignant lymphomas involving the liver, spleen, lung and kidney, as well as the usual epithelial tumours at the site of administration. Interestingly, the incidence of squamous-cell carcinoma of the pharynx was significantly higher in zinc-deficient rats than in control animals. Since MNU does not require metabolic activation, the development of the malignant lymphomas might be related to the generally depressed immunological state of zinc deficient rats. PMID- 3679382 TI - Influence of ethyl alcohol on carcinogenesis induced by volatile N-nitrosamines detected in alcoholic beverages. PMID- 3679383 TI - Effect of the trichothecene mycotoxin diacetoxyscirpenol on nitrosamine-induced oesophageal cancer and on relevant enzymes in oesophagus and liver. AB - To test the concept that human oesophageal cancer is initiated by nitrosamines and potentiated by consumption of food contaminated by mycotoxins produced by Fusaria, the effect of the trichothecene mycotoxin diacetoxyscirpenol (DS), alone and in combination with N-nitroso-N-methylbenzylamine (NMBzA), on rat oesophagus was studied. Chronic treatment with DS induced oesophageal hyperplasia, but simultaneous treatment with NMBzA tended to inhibit rather than to enhance carcinogenesis. The mycotoxin did not inhibit O6-alkylguanine-DNA alkyltransferase in oesophagus and produced a marked induction of repair protein in liver. Depletion of the repair protein in oesophagus brought about by injection of NMBzA was not inhibited by the mycotoxin, and its reappearance was not delayed. Intubation of DS reduced DNA synthesis in the oesophagus, while dietary treatment resulted in an increase after nine weeks. The results suggest that, while simultaneous treatment with DS reduces cancer induced by NMBzA, if there is first exposure to mycotoxin and induction of hyperplasia, and then exposure to nitrosamine, so that the carcinogen acts on a vulnerable oesophagus in which there is an increased rate of cell proliferation, the mycotoxin could well enhance carcinogenesis. PMID- 3679384 TI - Analysis of N-nitrosamines for genotoxicity in primary hepatocytes derived from various species. AB - DNA single-strand breaks (SSB) were induced in metabolically competent primary hepatocytes from rats, hamsters and pigs by a series of N-nitrosamines with organ specific activities. Both hepatotrophic and nonhepatotropic carcinogens were genotoxic in the liver cells of all three species. Nonhepatotropic compounds were active at relatively lower doses than liver carcinogens in all species tested, substantiating many previous findings that organ-specific activation is not the primary determining factor of organ susceptibility to cancer. In 11 experiments of almost identical quality, the degree of SSB induced by 6.25 mumol N nitrosodimethylamine varied by 75%. This high interindividual variability, even among hepatocytes derived from a single rat strain, indicates that the slight differences seen between rat, hamster and pig hepatocytes are not necessarily due to differences in species susceptibility. PMID- 3679385 TI - Induction of DNA repair in HeLa S3 carcinoma cells by the N-nitroso derivatives of 1-(N-L-tryptophan)-1-deoxy-D-fructose and 1-(5-hydroxytryptamino)-1-deoxy-D fructose. AB - HeLa S3 cells, when incubated at 37 degrees C with the N-nitroso derivative of the Amadori compounds 1-(N-L-tryptophan)-1-deoxy-D-fructose (FRU-TRP) or 1-(5 hydroxytryptamino)-1-deoxy-D-fructose (FRU-SEROT) in the presence of a six-fold molar excess of sodium nitrite, exhibit increased intracellular DNA synthesis. Sodium nitrite alone, at identical levels, elicits a similar response, albeit to a much lesser degree. No response whatsoever is produced when the cells are incubated with the parent Amadori compounds. The observed stimulation of DNA replication is DNA repair. Two major routes are suggested by which nitrosated FRU TRP (NO-FRU-TRP) and nitrosated FRU-SEROT (NO-FRU-SEROT) could damage intracellular DNA. PMID- 3679386 TI - Synthesis, analysis and mutagenic activity of N-nitroso derivatives of glycosylamines and Amadori compounds: nitrosated model substances for the early Maillard reaction products. AB - A series of nine glycosylamines and an Amadori compound and their N-nitroso derivatives were synthesized. The structures were ascertained by spectroscopy and elemental analysis. The N-nitroso compounds were further characterized by denitrosation with hydrogen bromide-acetic acid, followed by detection of the liberated NO by a chemiluminescence detector. N-Nitroso derivatives of N-p nitrophenyl/p-methylphenyl/p-carboxyphenyl pentosylamines, N-p-methylphenyl-1 deoxy-D-fructosylamine (Amadori compound) and N-3-ethylindole-D-xylosylamine were shown to be directly-acting mutagens in Salmonella typhimurium TA100. The activity of some of the compounds was similar to that of N-ethyl-N-nitrosourea. Their mutagenic activity was shown to be dependent on the structure of the amine and the sugar moieties and requires the presence of free hydroxyl groups in the sugar. The mutagenicity of N-nitrosoglycosylamines was attributed to their hydrolysis to arene diazonium cations. Their formation was detected via azo coupling with N-ethyl-1-naphthylamine, using spectrophotometric and mass spectrometric analyses. Our data implicate arene (alkyl) diazonium cations as the ultimate mutagens of N-nitrosoglycosylamines and N-nitroso Amadori compounds, a little explored class of N-nitroso compounds which may be formed in vivo. PMID- 3679387 TI - Recently identified nitrite-reactive compounds in food: occurrence and biological properties of the nitrosated products. AB - Various Japanese foodstuffs are directly-acting mutagens in Salmonella typhimurium TA100 after nitrite treatment. Such mutagen precursors include tyramine and beta-carboline derivatives, isolated from soya sauce, and indole-3 acetonitrile, 4-methoxyindole-3-acetonitrile and 4-methoxyindole-3-aldehyde, isolated from fresh Chinese cabbage. A mutagen produced from tyramine with nitrite was found to be 4-(2-aminoethyl)-6-diazo-2,4-cyclohexadienone (3 diazotyramine), and one produced from indole-3-acetonitrile with nitrite to be 1 nitrosoindole-3-acetonitrile. These two mutagens were directly-acting mutagens not only in S. typhimurium TA100 and TA98 but also in Chinese hamster lung cells, using diphtheria toxin resistance as a selective marker. The carcinogenicity of 3 diazotyramine was demonstrated in male Fischer 344 rats. Tyramine, beta-carboline and indole compounds are present ubiquitously in our environment, especially in foods. Therefore, the role of these newly identified mutagen precursors in the development of human cancer should be taken into consideration. PMID- 3679388 TI - Endogenous formation of N-nitroso compounds: a current perspective. AB - Exposure of people to nitrosating agents occurs through multiple pathways, ranging from nitrogen dioxide reactions in the lung to acid-catalysed nitrosation in the stomach to nitrosation mediated by macrophages or bacteria. The use of N nitrosoproline (NPRO) as an index of endogenous nitrosation has proved to be especially valuable for some of these pathways but may not be universally indicative. Since the development of the NPRO test by Ohshima and Bartsch in 1981, several forms of the test have been used for different purposes. This paper examines some of the issues related to endogenous nitrosation and NPRO and attempts to view the immediate future. PMID- 3679389 TI - Absence of urinary N-nitrosodimethylamine in fasting humans following alcohol consumption. AB - Fasted volunteers consumed 350 mg nitrate in beet juice; 1 h later, they consumed a volume of 10% alcohol in carbonated water sufficient to raise blood alcohol concentrations to at least 80 mg/100 ml. This alcohol concentration was then maintained over a 6-h period. During this period, and during the subsequent 12 h, no N-nitrosodimethylamine (NDMA) or any other volatile nitrosamine was excreted in the urine of the volunteers (detection limit, 0.01 mumol). Therefore, less than 0.5 mumol NDMA is likely to be present in the stomach of a fasting human at any time. PMID- 3679390 TI - Relationship between ascorbic acid dose and N-nitrosoproline excretion in humans on controlled diets. AB - A logarithmic dose-response relationship between ascorbic acid dose and N nitrosoproline (NPRO) excretion in humans on a controlled diet was established. Seven healthy males were placed on a low-nitrate, low-ascorbic acid diet for 12 consecutive days and given nitrate on days 3-12 and L-proline on days 4-12, after the nitrate dose. Ascorbic acid was given in increasing amounts with the proline on days 5-10. Urine was analysed quantitatively for nitrate, NPRO and ascorbic acid. Ascorbic acid doses as low as 0.05 mmol reduced NPRO excretion by an average of 6 nmol/day; however, as much as 5.68 mmol ascorbic acid did not return NPRO excretion to levels observed before nitrate and proline were administered. Complete inhibition of endogenous NPRO formation from exogenous precursors requires more than the 2:1 molar ratio of ascorbic acid to nitrite that has been demonstrated in vitro. These data may be useful in interpreting epidemiological studies of nitrate exposure and in making dietary recommendations. PMID- 3679391 TI - Specificity of O6-alkylguanine-DNA alkyltransferase. AB - Extensive investigations of the specificity of O6-alkylguanine-DNA alkyltransferase (AAT) have been carried out. These studies have shown that: (i) the mammalian protein differs from that of Escherichia coli in lacking the ability to remove methyl groups from O4-methylthymine; (ii) the protein can remove longer alkyl groups from the O6 position but the rate of repair declines as the chain length increases; (iii) O6-methylguanine in RNA is much less active as a substrate for the protein than O6-methylguanine in double-stranded DNA; (iv) the free-base O6-alkylguanine is a very weak substrate for the protein so that reaction with it leads to the loss of alkyltransferase activity. (This property can be used to deplete AAT in cultured cells and in tissues and tumours after administration of O6-methylguanine); and (v) oligodeoxynucleotides containing O6 methylguanine are substrates for AAT. Such oligodeoxynucleotides can be labelled with 32P at very high specific activity and can be used in an ultrasensitive assay for AAT activity. PMID- 3679392 TI - Formation of N-nitrosoiminodialkanoic acids and their unsuitability as biological monitors for endogenous nitrosation of dipeptides. AB - Nitrosation of dipeptides that do not contain imino amino acids leads to rearrangement and formation of N-nitrosoiminodialkanoic acids. The optimal pH is 2.0 (0.8-3.2% yield). Under normal gastric conditions, a maximum yield of 0.1 mumol total N-nitrosoiminodialkanoic acid would be obtained for a typical dietary intake of 0.1 mol dipeptide. This corresponds to a total concentration of about 20 micrograms N-nitrosoiminodialkanoic acid/l gastric juice over a 24-h period. N Nitrosoiminodialkanoic acids are excreted quantitatively in urine when fed by gavage to rats; however, they were not detected in normal human urine. It was concluded that determination of these compounds in human urine is not a suitable method for monitoring endogenous nitrosation of dipeptides. PMID- 3679393 TI - Formation of diazopeptides by nitrogen oxides. AB - A versatile synthesis of diazopeptides is reported and several new compounds described. It is shown that diazopeptides form readily from gaseous nitrogen dioxide in both neutral buffers and human blood. In these media, diazopeptides are sufficiently stable (half-time 0.5-30 h) to qualify as potential circulating carcinogens. PMID- 3679394 TI - Nitrate as a precursor of the in-vivo formation of N-nitrosomorpholine in the stomach of guinea-pigs. AB - Reduction of nitrates to nitrites and formation of the carcinogen N nitrosomorpholine (NMOR) was investigated in the stomach of guinea-pigs. A semisynthetic diet with nitrate plus morpholine was administered intragastrically after a 24-h fast; after treatment, the animals were killed and stomach nitrite contents were determined 6, 12, 18, 24 and 30 min after the treatment using a colorimetric method. NMOR content was determined 18 min after treatment with nitrate plus morpholine using gas chromatography-thermal energy analysis. Reduction of nitrates to nitrites in the stomach was observed that was sufficient to synthesize NMOR in guinea-pigs under the conditions of this experiment. PMID- 3679395 TI - Roles of cysteine as both precursor of thiazolidine 4-carboxylic acids found in human urine and possible inhibitor of endogenous N-nitrosation. AB - In order to compare the utility and significance of 2-R-N-nitrosothiazolidine 4 carboxylic acids excreted in human urine as an index for exposure to N-nitroso compounds, the differences in formation of N-nitrosothiazolidine 4-carboxylic acid (NTCA; R = H) and N-nitroso-2-methylthiazolidine 4-carboxylic acid (NMTCA; R = CH3) were studied in vitro. It was determined that NMTCA has a 3:1 trans:cis stereoisomer ratio, while NTCA has a 1:1 trans:cis ratio; nitrosation acts on a pH-dependent equilibrium mixture of cysteine and aldehyde in equilibrium with thiazolidine 4-carboxylic acid, with cysteine blocking N-nitrosation. Previous reports on 2-R-N-nitrosothiazolidine 4-carboxylic acids in human urine show widespread involvement of cysteine, which has a dual role with nitrosating species. In view of this and the rapid blocking of N-nitrosation and slow trans nitrosation by cysteine at acid pH, it is suggested that there may be a hitherto unrecognized protective role of thiol functions in dietary constituents. PMID- 3679396 TI - Model risk analysis of nitrosatable compounds in the diet as precursors of potential endogenous carcinogens. AB - The potential health risk posed by the endogenous formation of N-nitroso compounds (NOC) from nitrosation of dietary ureas, guanidines, amides, amino acids and amines (primary, secondary and aromatic) was estimated according to the model: Risk = [daily intake of precursor] X [gastric concentration of nitrite]n X [nitrosatability rate constant] X [carcinogenicity of derivative]. The daily intakes of these compound classes span five orders of magnitude (100 g/day amides, top; 1-10 mg/day secondary amines, ureas, bottom); the nitrosation rate constants span seven orders of magnitude (aryl amines, ureas, top; amides, secondary amines, bottom); and the carcinogenicity estimates span a 10,000-fold range from 'very strong' to 'virtually noncarcinogenic'. The resulting risk estimates likewise span an enormous range (nine orders of magnitude): dietary ureas and aromatic amines combined with high nitrite concentration could pose as great a risk as the intake of preformed N-nitrosodimethylamine in the diet. In contrast, the risk posed by the in-vivo nitrosation of primary and secondary amines is probably negligible. The risk contributed by amides (including protein), guanidines and primary amino acids is intermediate between these two extremes. PMID- 3679397 TI - N-nitrosamine formation by macrophages. AB - Nitrate biosynthesis is a known mammalian process, and macrophages from mice treated with Escherichia coli lipopolysaccharide (LPS) have been shown to be capable of nitrate synthesis. Cell culture studies showed that macrophages produce nitrite as well as nitrate. We report here N-nitrosamine formation by stimulated macrophages. Experiments were carried out with the macrophage cell lines, J774.1, WEHI-3 and RAW 264. Macrophages were cultured in Dulbecco's modified Eagle's medium (pH 7.5) supplemented with calf serum (10%). The concentration of nitrate in the supernatant was measured. N-nitrosamines were extracted with dichloromethane and the extracts were analysed by gas chromatography-thermal energy analysis. When J774.1 (1.5 X 10(6) cells/ml) were incubated with LPS (10 micrograms/ml) and morpholine (15 mM) for 72 h at 37 degrees C, N-nitrosomorpholine (NMOR) was produced (0.8 microM). The amount of nitrite produced was 50 microM. RAW 264 and WEHI-3 also produced NMOR; LPS was required for nitrite and NMOR formation. gamma-Interferon (IFN) promoted both NMOR (2.5 microM) and nitrite (70 microM) formation. Nitrite (150 microM) incubated with morpholine and the medium did not form NMOR. Kinetics of LPS induced nitrite and NMOR formation in J774.1 showed that the rate of NMOR formation was highest in the middle incubation period (24-36 h), although the nitrite concentration was highest in the latter incubation period (48-60 h). Our results showed that macrophages may be capable of nitrosamine formation under physiological conditions that do not normally permit this reaction. PMID- 3679398 TI - Peptide nitrosation in dilute acid. AB - Rates and products are reported for the nitrosation of simple dipeptides (glycylglycine, its ethyl ester and N-acetylglycylglycine) in dilute acid at 37 degrees C. The results suggest that conversion to a diazo derivative (which rapidly decomposes) is the most likely outcome of the gastric nitrosation of small proteins and peptides. PMID- 3679399 TI - Diet- and age-dependent modulation of O6-methylguanine-DNA methyltransferase levels in mouse tissues. AB - Methylation of guanine in the O6 position by N-nitrosodimethylamine is higher in liver DNA of mice fed a diet restricted in essential amino acids than in controls. A diminished content of the repair enzyme O6-methylguanine-DNA methyltransferase (AAT) may be responsible for the elevated level of O6 methylguanine observed after amino acid deficiency. A delayed repair of O6 methylguanine can be ascribed to diminished AAT activity in amino-acid-restricted mice. In adults, but not in subadults, the diminished AAT activity in liver correlated well with a 40% decrease in overall protein synthesis. PMID- 3679400 TI - Nitrosation of drugs under in-vivo conditions. AB - Application of the WHO Nitrosation Assay Procedure (NAP test) to a range of potentially nitrosatable drugs has given rise to considerable variations in the formation of volatile N-nitrosamines and N-nitroso compounds as a group. No nitrosation whatsoever was observed with 40 mM nitrite in some instances. In simulating more closely the conditions likely to be encountered in the human stomach, however, the order of susceptibility of the drugs to N-nitrosation has proved to be very different. At a constant nitrite concentration of 25 microM, which is considered to represent the upper limit of those likely to be encountered in the acidic human stomach, the drugs giving rise to the greatest yields of products reacting as N-nitroso compounds from a maximum adult dose were the penicillins, G, V, cloxacillin and ampicillin. PMID- 3679401 TI - In-vitro and in-vivo formation of N-nitrosomethylcyclohexylamine from bromhexin and sodium nitrite, and DNA methylation in rats. AB - After oral administration of a commercial bromhexin (N-methyl-N-cyclohexyl(2 amino-3,5-dibrombenzyl)ammonium chloride) solution (1-90 mg/kg) together with sodium nitrite (1-90 mg/kg) to female Wistar rats, ring-hydroxylated metabolites of N-nitrosomethyl-cyclohexylamine (NMCA) were excreted in urine as glucuronide/sulfate conjugates. When [14C-methyl]-bromhexin (30 mg/kg) was given intragastrically together with sodium nitrite (30 mg/kg), alkylated DNA adducts were detected in liver and oesophagus. Gastric juice of 75 healthy human volunteers (fasted, then ingesting up to 200 mg nitrate) was incubated in vitro with bromhexin (16 mg/100 ml). In only one sample, 50 ng NMCA/100 ml were formed. PMID- 3679402 TI - The role of various food products in the formation of N-nitroso compounds under acidic conditions. AB - The effect of lettuce cultivars on the nitrosation rate of proline was investigated. The lettuce was analysed for the presence of phenolic compounds. Lettuce and/or fish was incubated with nitrite under acidic conditions, and the incubation mixtures were investigated for the presence of N-nitroso compounds and mutagenic activity. Both volatile N-nitrosamines and mutagenic nonvolatile N nitrosamines were detected. The formation of mutagenic N-nitroso compounds was also studied in selected cheese products after treatment with nitrite under acidic conditions. No direct relationship was observed between the total N nitroso content of the samples and the corresponding mutagenicity. The ability of cheese to inhibit the direct mutagenicity occurring in fava beans after treatment with nitrite under acidic conditions was investigated. The antimutagenic factor, possibly casein, in cheese was not extractable with different solvents. PMID- 3679403 TI - Observations of the use of 137caesium radiation to control N-nitrosopyrrolidine formation in bacon. AB - Several alternatives to the use of nitrite, including irradiation, have been developed to reduce the nitrosamine content in bacon and still retain its microbiological safety and desirable sensory characteristics. This paper presents results obtained from experiments in which 137Cs was used at +5 degrees C. Bacon prepared with 120 or 40 mg/kg sodium nitrite (NaNO2) yielded lower residual nitrite before frying and lower levels of N-nitrosopyrrolidine (NPYR) after frying when irradiated at 3.0 Mrad, compared to doses of 0, 0.75 and 1.50 Mrad. Also, a slight increase in the level of NPYR in fried bacon over the 0 control was noted with 0.75 Mrad. In bacon irradiated with 0-1.5 Mrad in 0.25-Mrad increments, a marked increase was observed at 0.5 Mrad. Bacon from pork bellies irradiated prior to processing had more NPYR after frying than bacon irradiated after processing, suggesting the formation of an additional precursor or some catalytic agent. PMID- 3679404 TI - Prevention of exposure to N-nitrosamines in the rubber industry: new vulcanization accelerators based on 'safe' amines. AB - Introduction of 'safe' amino components into traditional accelerator molecules could be an effective measure to prevent formation of carcinogenic N-nitroso compounds during rubber production. About 20 new derivatives of the dithiocarbamate and sulfenamide class, based on 'safe' amines, were synthesized and shown to be suitable for industrial application. Some of the corresponding N nitrosamines were prepared and investigated for mutagenicity in Salmonella typhimurium TA1535. No or weak mutagenic potential was observed in most cases. The nitrosatability of five sulfenamides derived from 'safe' amines was determined and found to be substantially lower than that of a commercial sulfenamide accelerator tested under identical conditions. PMID- 3679405 TI - N-nitrosamines and nitrosatable compounds in rubber nipples, pacifiers and other rubber and plastic commodities. AB - In 1983 and 1985, rubber teats and pacifiers from the Dutch market were analysed for N-nitrosamines (NA) and nitrosatable compounds (NC) by extraction with an artificial saliva test solution (24 h, 40 degrees C). NC were determined as NA (gas chromatography-thermal energy analysis) after nitrosation. In 1983, the total content of NA and NC varied from 4-40 micrograms/kg and 50-3700 micrograms/kg, respectively (18 samples). In 1985, NA and NC varied from 3-94 micrograms/kg and 26-5100 micrograms/kg, respectively (20 samples). According to Dutch legislation, teats may contain no more than 1 microgram/kg and 20 microgram/kg NA and NC. Of other rubber and plastic commodities analysed, balloons contained levels of up to 120 micrograms/kg and 2800 micrograms/kg NA and NC. PMID- 3679406 TI - Possible underestimation of nitrosatable amine levels in artificial saliva extracts of children's rubber pacifiers and baby-bottle teats. AB - Children's pacifiers and baby-bottle nipples from various countries were analysed for their content of N-nitrosamines and nitrosatable amines. Using a method involving extraction with artificial saliva, several nitrosamines including N nitrosodi-n-butylamine (NDBA), N-nitrosodiethylamine (NDEA), N nitrosodimethylamine (NDMA) and N-nitrosomorpholine (NMOR) were detected in addition to the three nitrosatable amines dibutylamine (DBA), diethylamine (DEA) and dimethylamine (DMA). Upon nitrosation in artificial saliva, these amines produced not only the related N-nitrosamines but also relatively high levels of the corresponding nitramines--N-nitrodibutylamine (NTDBA), N-nitrodiethylamine (NTDEA) and N-nitrodimethylamine (NTDMA). Thus, both N-nitramines and N nitrosamines should be measured after nitrosation; otherwise, the method probably underestimates the quantities of nitrosatable amines present in artificial saliva extracts. Whether N-nitramines, some of which have been shown to be both mutagenic and carcinogenic, are formed in the saliva of babies exposed to these products remains to be confirmed. PMID- 3679407 TI - N-nitrosamine formation in urinary-tract infections. AB - Urine samples from 31 patients with urinary-tract infections and from 31 controls were analysed for volatile nitrosamines, N-nitrosamino acids, total N-nitroso compounds as a group, and nitrite/nitrate. The concentration of N nitrosodimethylamine was significantly elevated in urines infected with Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae. The levels of nitrite, N-nitrosoproline and total N-nitroso compounds, when expressed as the amount per mol creatinine, were also significantly increased in patients with bacteriuria. Several bacterial strains were capable of catalysing nitrosation of morpholine at neutral pH. These results suggest that N-nitroso compounds can be formed in vivo in the infected bladder, which could explain the association between urinary-tract infections and increased risk for bladder cancer. PMID- 3679408 TI - Bacterially mediated N-nitrosation reactions and endogenous formation of N nitroso compounds. AB - Results are presented demonstrating some factors that affect the kinetics of bacterially mediated N-nitrosation reactions. Two groups of bacteria, differing in their nitrate/nitrite metabolism, are contrasted. These findings are discussed in relation to a role for bacteria in endogenous N-nitrosation reactions. PMID- 3679409 TI - In-vitro production of nitrosamines by bacteria isolated from the operated stomach. AB - Evidence is presented of in-vitro catalysis of nitrosation by organisms isolated from the hypoacidic operated stomach. Subjects taking part in a prospective study of potential premalignancy after benign ulcer surgery underwent endoscopy, and samples of gastric juice were obtained aseptically. The organisms present were identified using the API system and tested for their ability to catalyse the nitrosation of the secondary amine, morpholine, at neutral pH and 37 degrees C. Four of the five species tested were found to be capable of the catalysis. Cellular disruption and denaturation of protein abolished the catalytic ability, suggesting that the catalysis is mediated by an enzymic system. Osmotic shock experiments indicate that the enzyme site may be on the inner membrane. PMID- 3679410 TI - Excretion of methylated nucleic acid bases as an indicator of exposure to nitrosatable drugs. AB - Urinary excretion of 3-methyladenine (3-meA) may be a valuable monitor of exposure to methylating carcinogens. In rats, the compound is known to be liberated from DNA following its formation, is not metabolized and is excreted intact in the urine. Studies with rats administered d3-methylating agents [e.g., a mixture of d6-aminopyrine (d6-AP) and nitrite which liberates d3-N nitrosodimethylamine (NDMA) intragastrically] have confirmed that d3-3-meA is excreted in a dose-related manner. Although low levels of 'background' 3-meA have been found in rat and human urine, these are about 1000-fold lower than those of 7-methylguanine (7-meG). Thus, despite the fact that 3-meA is known to be formed at 10% of the level of 7-MeG in DNA following exposure of rats to methylating agents, the low 'background' that we have observed indicates that urinary 3-meA should be a more sensitive indicator of methylation than 7-meG. PMID- 3679411 TI - Nitrosamine measurements in ambient air of an industrial area in Austria. AB - The area of Linz (Oberosterreich) is the most heavily polluted region in Austria, due to its chemical and steel industry. In 1981, a survey of volatile nitrosamines in ambient air performed by a local laboratory revealed levels of up to 5.45 micrograms/m3. This instigated the setting up of a systematic nitrosamine monitoring programme from February 1983 to May 1984, during which the validity of the analytical procedures was determined. A total of 363 air samples was collected over 200 days at 16 different locations in and around Linz. About 6% of the samples showed low nitrosamine contamination, with levels between 0.01 and 0.04 microgram/m3 of N-nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), and N-nitrosomorpholine (NMOR). The lower limit of detection was 0.005 microgram/m3. It was not possible to confirm these low concentrations by high resolution mass spectrometry. In some samples, thermal energy analyser-responsive material was observed, which may be due to the occurrence of C-nitro compounds. PMID- 3679412 TI - Occurrence of volatile nitrosamines in food samples collected in three high-risk areas for nasopharyngeal carcinoma. AB - Fifty-four samples of foods consumed frequently in Tunisia, southern China and Greenland, all high-risk areas for nasopharyngeal carcinoma (NPC), were analysed for the presence of volatile nitrosamines by gas chromatography (GC) combined with a thermal energy analyser (TEA). Relatively high levels of N nitrosodimethylamine (NDMA), N-nitrosopiperidine (NPIP) and N-nitrosopyrrolidine (NPYR) were found in Tunisian stewing base (touklia) and dried mutton preserved in olive oil (qaddid). In one Chinese salted and dried fish sample, a high level of NDMA (133 micrograms/kg) was detected, but for the 14 others the levels ranged from undetectable to 14 micrograms/kg, with a mean of 3 micrograms/kg. Similarly high levels of NDMA, were found in Eskimo dried, unsalted fish samples. NDMA, NPIP and NPYR at various levels were present in Chinese vegetables fermented in brine. The possible role of nitrosamines in the etiology of NPC is discussed. PMID- 3679413 TI - Investigations on the molecular dosimetry of tobacco-specific N-nitrosamines. AB - Approaches for assessing molecular dosimetry of 4-(N-nitrosomethylamino)-1-(3 pyridyl)-1-butanone (NNK) and N'-nitrosonornicotine (NNN) in humans by measurement of haemoglobin or DNA adducts are discussed. NNK and NNN form haemoglobin adducts in Fischer 344 rats. Acid or base hydrolysis of the globin gives 4-hydroxy-1-(3-pyridyl)-1-butanone, which can be detected in rat blood up to six weeks after injection of NNK; it may be a useful marker for assessing uptake and metabolic activation of NNK and NNN in tobacco consumers. NNK and its major metabolite, 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanol (NNAI), methylated DNA of rat liver, lung and nasal mucosa to similar extents. NNAI is formed in human tissues from NNK, but immunoassays for O6-methyldeoxyguanosine (O6-medGuo) in exfoliated oral cells from snuff-dippers have been negative. NNK is also expected to form pyridyloxobutyl adducts in DNA; 32P-postlabelling assays for these adducts are being developed and appear to hold promise for detecting NNK- or NNN-DNA adducts in vivo. PMID- 3679414 TI - Molecular dosimetry of O6-methylguanine formation and cell toxicity in lung and nasal mucosa by 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone. AB - The molecular dosimetry of O6-methylguanine (O6-meG) in DNA from lung and nasal mucosa was determined during administration of 4-(N-nitrosomethylamino)-1-(3 pyridyl)-1-butanone (NNK) to Fischer 344 rats. O6-MeG accumulated in lung during 12 days of treatment with doses of NNK ranging from 0.1 to 100 mg/kg per day. The dose-response to NNK was nonlinear; the ratio of O6-meG to dose, an index of alkylation efficiency, increased dramatically as the dose of carcinogen decreased. These data suggest that high and low Km pathways may exist for activation of NNK to a methylating agent. Clara cells, when compared to Type-II cells, macrophages and alveolar small cells, were found to possess the greatest concentration of O6-meG. Moreover, as the dose of NNK was decreased, a marked increase in the alkylation efficiency of Clara cells was observed. Thus, the presence of a high-affinity, low-Km pathway in Clara cells for activation of NNK may be a significant factor in the carcinogenicity of this tobacco-specific carcinogen. The dose-response for O6-meG differed considerably between respiratory and olfactory mucosa. The dose-response to NNK was nonlinear in respiratory mucosa and linear in the olfactory mucosa, and the concentration of O6-meG was five times greater in respiratory than in olfactory mucosa after treatment with 1 mg/kg NNK. As the dose of NNK was increased, alkylation in the two regions of the nose became similar. Histological examination of the nasal passages following treatment with NNK indicated that the olfactory region was more sensitive than the respiratory region to toxicity induced by NNK.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679415 TI - Localization of bound metabolites in the respiratory tissues and oesophagus by high-resolution microautoradiography in Fischer 344 rats treated with N' nitrosonornicotine. AB - High-resolution microautoradiography for detection of bound radioactivity in Fischer 344 rats given a single subcutaneous dose of 3H-N'-nitrosonornicotine (3H NNN) showed a labelling of the olfactory region of the nose, which was restricted to the secretory cells of the glands of the lamina propria mucosae (Bowman's glands). In the oesophagus, bound radioactivity was present in the squamous epithelium, most marked in the middle and superficial cell layers. The olfactory nasal mucosa and the oesophagus are targets for the carcinogenicity of NNN in Fischer 344 rats. Our results indicate that the labelled cells in these tissues are the principal sites in which NNN is activated to alkylating species, and these cells may also be the ones that undergo malignant transformation. Bound radioactivity was also found in the lung (mainly in the Clara cells of the bronchi and bronchioles) and in the trachea (preferentially in the mucous cells), although NNN does not induce tumours in the lung or trachea of the rats. Why covalent binding of metabolites to cellular macromolecules is not correlated to carcinogenesis at these sites is not known. PMID- 3679416 TI - Cellular changes induced by the tobacco-specific carcinogen 4-(N nitrosomethylamino)-1-(3-pyridyl)-1-butanone in the respiratory tract of Syrian golden hamsters. AB - The N-nitrosamine 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK) is abundant in cigarette smoke and is a potent pulmonary carcinogen in Syrian golden hamsters. After intratracheal instillation of NNK to Syrian golden hamsters, we observed focal cell death in the trachea and bronchi followed by cellular regeneration. Regenerating cells were not ciliated and led to mucous-cell hyperplasia followed by squamous-cell metaplasia. Lung alterations consisted of bronchiolar hyperplasia with severe dysplastic changes in association with interstitial pneumonitis. NNK induces preneoplastic cellular changes similar to those observed in the pulmonary epithelium of smokers. PMID- 3679417 TI - Synthesis and structural studies by nuclear magnetic resonance of dodecadeoxynucleotides containing O6-methylguanine, O6-ethylguanine and O4 methylthymine. AB - Self-complementary dodecadeoxynucleotides containing either one O6-methylguanine (O6-meGua), one O6-ethylguanine (O6-etGua) or one O4-methylthymine (O4-meT) have been synthesized. They form double-stranded DNA in solution. The structures of these DNA helices containing O6-meGua:cytosine (C), O6-meGua:thymine (T), O6 etGua:C and Gua:O4-meT base pairs have been investigated by nuclear magnetic resonance (NMR). All these modified bases stack into the helix with the normal anti-glycosidic torsion angle; only in the helix containing an O6-etGua:C base pair was there evidence of significant distortion of the DNA structure. NMR did not show a strong hydrogen bond between N1 of Gua and N3 of O4-meT in the Gua:O4 meT base pair, or between N1 of O6-meGua and N3 of T in the O6meGua:T base pair. This casts doubt on the previously accepted structures for O4-meT:Gua and O6 meGua:T mispairs. PMID- 3679418 TI - Pathobiological effects of aldehydes in cultured human bronchial cells. AB - Effects of the tobacco smoke-related aldehydes, i.e., acetaldehyde, formaldehyde and acrolein, have been investigated in cultured human bronchial epithelial cells and fibroblasts. As determined from loss of colony-forming efficiency of epithelial cells, acrolein is 200- and 5000-fold more toxic than formaldehyde and acetaldehyde, respectively. The aldehydes differ markedly in their potencies to induce terminal differentiation, as indicated by cessation of growth and enhanced formation of cross-linked envelopes. The cellular content of glutathione is markedly decreased by acrolein, whereas formaldehyde and acetaldehyde only slightly decrease glutathione levels. All three aldehydes produce DNA damage, as indicated by the formation of DNA single-strand breaks and DNA protein cross links. Both formaldehyde and acrolein are weakly mutagenic in fibroblasts. In vitro assays of O6-methylguanine-DNA methyltransferase (MMT) activity indicate that it is markedly inhibited by acrolein, and to a lesser extent by formaldehyde. However, formaldehyde significantly inhibits removal of O6 methylguanine (O6-meG) in N-methyl-N-nitrosourea (MNU)-exposed cells. Thus, the many biological effects induced by aldehydes include: inhibition of proliferation, enhanced cellular differentiation, thiol depletion, DNA damage, mutation and inhibition of DNA repair in human cells. Furthermore, we speculate that exogenous or metabolically generated aldehydes may increase the genotoxicity of N-nitroso compounds by the dual action of causing DNA damage and inhibiting the repair of promutagenic O6-meG DNA lesions in human cells. PMID- 3679419 TI - Effect of cigarette smoking and dietary factors on the amount of N nitrosothiazolidine 4-carboxylic acid and N-nitroso-2-methyl-thiazolidine 4 carboxylic acid in human urine. AB - The effects of cigarette smoking and dietary factors on urinary excretion of N nitrosothiazolidine 4-carboxylic acid (NTCA; N-nitrosothioproline) and N-nitroso 2-methylthiazolidine 4-carboxylic acid (NMTCA; N-nitroso-2-methylthioproline) were studied in a male volunteer and in healthy Japanese subjects from the general population and Seventh-Day Adventists (SDA). Twenty-four-hour urine samples from the male volunteer were collected on 20 smoking days and 20 nonsmoking days during ingestion of a fixed diet, and the amounts of urinary N nitrosamino acids were analysed by gas chromatography-thermal energy analysis. Cigarette smoking caused about two-fold (significant) increases in the amounts of NTCA and NMTCA in the volunteer. In the male subjects from the general population, not controlled for diet, the amounts of NTCA and NMTCA in 24-h urines of smokers were also significantly higher than those of the nonsmokers. The urinary excretions of NTCA and NMTCA in SDA were lower than those of nonsmokers in the general population. It was concluded that cigarette smoking is one of the important factors in determining the amounts of NTCA and NMTCA in human urine. Dietary factors also apparently influence the urinary levels of these N nitrosamino acids. In addition, an apparent sex difference in the urinary excretion of NTCA and NMTCA (about two-fold higher in females) was observed in the general population but not in SDA. The N-nitrosoproline (NPRO) level was significantly higher in SDA than in nonsmokers in the general population. PMID- 3679420 TI - Effects of air-curing environment on alkaloid-derived nitrosamines in burley tobacco. AB - Levels of nitrite and pyridine alkaloid-derived total tobacco-specific nitrosamines (TSNA) were significantly higher in tobacco leaf (normal or late harvest) air-cured at 32 degrees C/83% relative humidity (RH) than in more moderate environments, i.e., 15 degrees C/50% RH and 24 degrees C/70% RH. These constituents increased appreciably from day 10 to day 21 of the cure. The near concurrent appearances of maximal total contents of TSNA [sum of N' nitrosonornicotine (NNN), N'-nitrosoanatabine (NAT), N'-nitrosoanabasine (NAB) and 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone) (NNK)] and nitrite supports the concept that nitrite is a limiting and proximal precursor of total TSNA during the curing of tobacco. During a long curing period (50 days) at 32 degrees C/83% RH, nicotine and anatabine contents decreased, but TSNA contents increased in leaves of all harvest dates and stalk positions. These results support the view that nicotine and anatabine are precursors of TSNA. Measurement of nitrite and individual alkaloids during post-harvest processing of tobacco leaf may provide an index of the potential accumulation of alkaloid-derived nitrosamines. PMID- 3679421 TI - A study of snuff carcinogenesis. AB - Dry snuff contains high levels of tobacco-specific N-nitrosamines (TSNA); their concentrations exceed by more than 100 times the quantities of nitrosamines found in any other consumer product. The concentrations of TSNA are similar in dry snuff and in the more popular moist snuff. In addition to the four TSNA identified earlier [N'-nitrosonornicotine (NNN), 4-(N-nitrosomethylamino)-1-(3 pyridyl)-1-butanone (NNK), N'-nitrosoanatabine (NAT) and N'-nitrosoanabasine (NAB)], two new nitrosamines were detected in snuff, namely 4-(N nitrosomethylamino)-1-(3-pyridyl)-1-butanol (NNAl; 0.07-0.15 ppm) and 4-(N nitrosomethylamino)-4-(3-pyridyl)-1-butanol (iso-NNAl; 0.06-1.1 ppm). After oral swabbing with a mixture of NNN and NNK, rats developed tumours of the oral cavity and lung, showing that these TSNA are not only organ-specific carcinogens but can also induce local tumours. After swabbing an extract of snuff containing the same concentrations of NNN and NNK, significantly fewer tumours were induced in the oral cavity and lung, indicating inhibition of the tumorigenic activity of the TSNA by other snuff constituents. PMID- 3679423 TI - Correlation between chewing and smoking habits and precancerous lesions in hill tribes of northern Thailand. AB - In a field study, 1866 people from different hill tribes (Lahu, Karen, Lisu and Meo) of northern Thailand and a group of rural Thai were examined for chewing, smoking and drinking habits and precancerous lesions of the oral mucosa. Traditional chewing and smoking habits were more prevalent among older people; cigarette smoking, in contrast, was more prevalent in younger and middle-aged individuals. Preleukoplakia was observed in 1.8%, leukoplakia in 1.1% and chewer's mucosa in 13.1% of the study population. Men and older patients were affected more frequently; chewer's mucosa was seen more often in women (Karen, Thai). A correlation between precancerous lesions and some oral habits could be demonstrated statistically. PMID- 3679422 TI - Mutagenicity and carcinogenicity of masheri, a pyrolysed tobacco product, and its content of tobacco-specific nitrosamines. AB - Masheri, an indigenous pyrolysed tobacco product in India, was studied for its chemical, mutagenic and carcinogenic profile. Masheri extract was found to be rich in N-nitrosamines and polycyclic aromatic hydrocarbons. It was highly mutagenic in the presence of an exogenous metabolic system in the Ames test and in the micronucleus test, in a dose-dependent manner. It also induced 8 azaguanine-resistant mutants in Chinese hamster V79 cells. On skin painting, it showed a weak carcinogenic effect in Swiss nude mice. The saliva of masheri users showed high levels of N'-nitrosonornicotine (NNN; 14-43 ppb) and N nitrosopyrrolidine (NPYR; 2.2-8.3 ppb). Thus, this widespread habit, predominant among women, could be an additive risk factor in the high incidence of oropharyngeal cancer prevalent in India. PMID- 3679424 TI - Endogenous nitrosation in the oral cavity of chewers while chewing betel quid with or without tobacco. AB - In order to evaluate endogenous nitrosation in the oral cavity of chewers of betel quid with tobacco (BQT) or without tobacco (BQ), saliva samples were collected from healthy male volunteers after chewing sequentially (i) unmodified BQT or BQ, (ii) BQT or BQ to which proline has been added, and (iii) BQT or BQ to which proline and ascorbic acid had been added. Samples were collected over 20 min and analysed for N-nitrosoproline (NPRO), tobacco-specific nitrosamines (TSNA) and areca nut-specific nitrosamines using gas chromatography-thermal energy analysis, arecoline and nicotine using gas chromatography-nitrogen phosphorus-specific detector, and for nitrite and thiocyanate. When results were expressed as a ratio of NPRO (ng/ml) to nicotine (micrograms/ml), all BQT chewers had increased NPRO contents after chewing BQT with proline. For BQ chewers, when the results were expressed as a ratio of NPRO (ng/ml) to arecoline (micrograms/ml), a similar increase in NPRO content was observed. However, the presence of ascorbic acid inhibited the increased nitrosation in only four out of ten BQT chewers and in five out of ten BQ chewers; in the rest of the samples, its presence enhanced the levels of NPRO. N'-Nitrosoanatabine (NAT) and N nitrosoguvacoline (NGCO) levels decreased significantly in saliva of chewers of BQT in the presence of ascorbic acid, suggesting inhibition of their formation. In-vitro nitrosation of BQT/BQ with proline and proline plus ascorbic acid showed a similar pattern of nitrosation at salivary pH. The study confirmed previous results that certain nitrosamines are formed during the chewing of BQT/BQ. PMID- 3679426 TI - N-nitroso compounds as a cause of human cancer. AB - Simultaneous consideration of epidemiological and experimental findings leads to the conclusion that the tobacco-specific nitrosamines (TSNA) 4-(N nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK) and N'-nitrosonornicotine (NNN) probably cause oral and respiratory cancers in humans. The role of other N nitroso compounds (NOC) in the etiology of human cancer may best be defined by the study of known human carcinogens, such as certain foods eaten exclusively by populations with exceptionally high incidences and mortality rates for certain cancers. The evidence that NOC may be responsible for these elevated rates is reviewed in relation to two such high-risk populations: (i) residents of Lin-xian county in northern China, who have a striking excess of cancer of the oesophagus, and (ii) Cantonese people who have high rates of nasopharyngeal carcinoma (NPC). More studies are needed to define clearly the relationship between various types of cancers and prenatal or lifetime exposures to passive smoking. If passive smoking is found to increase the risk of developing various childhood and adult cancers, the NOC in tobacco are likely to be among the relevant carcinogens. Carcinogenesis models for studying the effects of prenatal exposure to NNK and NNN and other NOC seem particularly promising for the study of low-dose effects and modifying factors. PMID- 3679425 TI - The role of N-(nitrosomethylamino)propionitrile in betel-quid carcinogenesis. AB - N-(Nitrosomethylamino)propionitrile (NMAP) was isolated and identified in the saliva of betel-quid chewers in amounts ranging from 0.5 to 11.4 micrograms/l. Groups of 21 male and 21 female rats were given 60 subcutaneous injections of NMAP over a 20-week period (total doses, 0.055 and 0.23 mmol/rat). After 106 weeks, the higher dose had induced 18 (86%) malignant tumours of the nasal cavity in male and 15 (71%) in female rats. Nine (43%) liver tumours were observed among animals treated with the lower dose. Fischer 344 rats were treated with a single dose of NMAP (intravenously or subcutaneously, 0.4 mmol/kg; or by swabbing the oral cavity, 2.21 mmol/kg), and the levels of N7-methylguanine (7-meG) and O6 methylguanine (O6-meG) were measured in DNA isolated from oesophagus and nasal mucosa, which are target organs, and from liver which is not. Higher levels of O6 meG and 7-meG were detected in the nasal mucosa and lesser DNA methylation in the liver and oesophagus, independent of the mode of administration. This correlates with the results of the study of the tumorigenic properties of NMAP in rats. PMID- 3679427 TI - Modulation of gastric carcinogenesis: updated model based on intragastric nitrosation. AB - The etiological model of gastric carcinogenesis is discussed. Its complexity and flexibility may be more applicable to human situations than experimental models utilizing high doses of carcinogens in homogeneous animal populations. The limitations of the epidemiological method and the use of a collaborative approach by epidemiologists and experimentalists are described. The need for markers of exposure to N-nitroso compounds is stressed. PMID- 3679428 TI - Organ specificity, metabolism and reaction with DNA of aliphatic nitrosomethylalkylamines. AB - Aliphatic nitrosomethylalkylamines are carcinogens with a remarkable organ specificity in rats, the principal targets being liver, oesophagus and bladder. We have determined the extent of DNA methylation in these tissues following a single oral dose (0.1 mmol/kg; 6-h survival) of each of 12 homologues, ranging from N-nitrosodimethylamine (NDMA, C1) to N-nitrosomethyldodecylamine (C12). Methylpurines (7- and O6-methylguanine; 7-meGua and O6-meGua) were determined by cation-exchange high-performance liquid chromatography with fluorescence detection. Highest levels of hepatic DNA methylation were found with NDMA (C1) and N-nitrosoethylmethylamine (NEMA, C2), the most potent hepatocarcinogens in this series. Concentrations of methylpurines in liver DNA decreased with increasing chain length from C1 to C5. Administration of the higher homologues (C6-C12) caused levels of DNA methylation which by themselves were considered too low to account for their hepatocarcinogenicity. In rat oesophagus, DNA methylation closely paralleled carcinogenicity, the most effective agents being the butyl and pentyl derivatives (C4 and C5). Levels of DNA methylation in bladder epithelium were close to the limit of detection (C6,C9,C10,C12) and there was no apparent correlation with carcinogenicity. It is concluded that initiation of malignant transformation by DNA methylation alone (through hydroxylation of the nitrosamine at the methylene alpha-carbon) could be operative for C1-C5. For the higher homologues, this type of DNA modification is insufficient to explain the complex pattern of tissue specificity. PMID- 3679429 TI - Consumption of precursors of N-nitroso compounds and human gastric cancer. AB - It has been hypothesized that dietary nitrate and nitrite are converted in the stomach to nitrous acid, which reacts with secondary amines and amides to form nitrosamines and nitrosamides, compounds frequently demonstrated to be carcinogenic in animals, and that vitamins C and E inhibit N-nitroso product formation by chemically reducing nitrous acid. This hypothesis and others were tested in a case-control study (controls were individually matched by age, sex and area of residence), utilizing a standardized, quantitative, dietary history questionnaire interview. Daily nutrient consumption values were calculated from interview responses, and continuous conditional logistic regression was used for the data analysis. Significant findings are as follows: (1) Average daily consumption of nitrite, chocolate and carbohydrate was associated with increasing trends in risk. (2) While citrus fruit intake appeared to be somewhat protective, any protective effect of vitamin C intake was less apparent, and of vitamin E, not at all apparent. (3) Consumption of dietary fibre was negatively associated with gastric cancer risk. These findings appear to implicate a number of dietary components, including nitrite consumption, in the genesis of gastric cancer in humans. PMID- 3679430 TI - Urinary excretion of N-nitrosamino acids and nitrate by inhabitants in high- and low-risk areas for stomach cancer in northern Japan. AB - Three samples of 24-h urine were collected from each of 104 inhabitants of high risk (Akita) and low-risk (Iwate) areas for stomach cancer in northern Japan, according to the following protocols: (i) when they were undosed, (ii) after ingestion of proline three times a day and (iii) after ingestion of proline together with vitamin C three times a day. These samples were analysed for N nitrosamino acids, nitrate and chloride ion as indices of the exposure. The median values of N-nitrosoproline (NPRO) and N-nitroso-2-methylthiazolidine 4 carboxylic acid (NMTCA) excreted in the urine of undosed subjects were not different between the two areas; however, that of N-nitrosothiazolidine 4 carboxylic acid (NTCA) was significantly higher in subjects of the high-risk area. Salt intake, estimated from the level of chloride ion in the urine, did not differ in two areas. After intake of proline, the NPRO level increased significantly only in subjects of the high-risk area, but not in those of the low risk area; intake of vitamin C inhibited this increase of NPRO and lowered the levels of other nitrosamino acids only in the high-risk subjects. In contrast, the urinary level of nitrate was higher in subjects of the low-risk area than in those of the high-risk area; nitrate levels were found to correlate well with the amounts of vegetables consumed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679431 TI - A correlation study on urinary excretion of N-nitroso compounds and cancer mortality in China: interim results. AB - Samples of 12-h overnight urine were collected from approximately 40 male adults in each of the 26 counties of China. Two urine specimens were collected from each subject--one after a loading dose of proline and ascorbic acid and another after a loading dose of proline only. Levels of N-nitrosamino acids, nitrite and nitrate were measured in urine samples and correlated with cancer mortality per 100,000 male subjects in the truncated age range 35-64 years. Preliminary results show no clear correlation between presence of stomach cancer or liver cancer and nitrosation potential [as measured by the urinary level of N-nitrosoproline (NPRO) after the proline load test or of nitrate]. There was a moderate, although not clearly significant, tendency for oesophageal cancer mortality rates to be associated positively with nitrosation potential and negatively with background ascorbate levels in plasma. This result was due chiefly to the inclusion of one county (Song Xian) in which there is a fairly high oesophageal mortality rate, an average nitrosation potential three times greater than that of any other county, and the lowest ascorbate index of any county. Further study of this county is planned. PMID- 3679432 TI - Investigations of the DNA-damaging activity of human gastric juice. AB - Human gastric juice previously treated with nitrite was examined for its ability to cause O6-alkylguanine-type modifications to 2'-deoxyguanosine or DNA in vitro. Analysis by radioimmunoassay indicated that, in five out of ten cases, incubation with 5 mM 2'-deoxyguanosine resulted in the formation of 375-1350 fmol/ml O6 ethyl-2'-deoxyguanosine (O6-etdGuo) or, in one case, 110 pmol/ml O6-methyl-2' deoxyguanosine O6-medGuo). When gastric juice-treated calf-thymus DNA was examined for its ability to consume (through suicide repair of O6-alkylguanine type damage) O6-alkylguanine-DNA alkyltransferase (AAT) from rat liver, eight out of eight samples could not. However, in four out of eight cases, a reduction in the rate of removal of O6-[3H]methylguanine from a 3H-methylated DNA substrate was observed. This finding is compatible with the presence, in gastric juice treated DNA, of damage capable of binding to, but not undergoing repair by, the AAT. PMID- 3679433 TI - Intragastric nitrosation and precancerous lesions of the gastrointestinal tract: testing of an etiological hypothesis. AB - The N-nitrosoproline (NPRO) test was used to study whether subjects with precancerous conditions of the stomach have an elevated potential for endogenous nitrosation. The highest yield of NPRO after ingestion of beetroot juice (as a source of nitrate) and proline was seen in subjects whose pH of fasting gastric juice was about 1.5-2. No increased level of NPRO was detected in subjects with more advanced lesions, compared to those with a normal stomach. Counts of total and nitrate-reducing bacteria were positively correlated with the pH of gastric juice but did not correlate with the urinary level of NPRO in the same individuals. Bacteria and intragastric nitrosation are discussed as possible etiological factors in human stomach cancer. PMID- 3679434 TI - The availability of dietary nitrate for the endogenous nitrosation of L-proline. AB - Urinary excretion of N-nitrosoproline (NPRO) following ingestion of a high nitrate salad meal, without then with an oral dose of 500 mg L-proline, was investigated in 16 healthy volunteers. The mean excretion rate following consumption of the high-nitrate meal alone was significantly lower than that measured after ingestion of the salad plus proline. Supplementation of the same meal (plus proline) with vitamin C from dietary sources resulted in a significant decrease in mean urinary NPRO levels in healthy subjects. The nitrosation inhibiting effect of vitamin C was not affected by an increase in the fat content of the meal. Supplementation of the high-nitrate salad with alcohol or coffee did not affect subsequent urinary NPRO levels. No significant difference was observed in the urinary NPRO concentrations of smokers and nonsmokers after ingestion of high-nitrate salad (with or without vitamin C) plus proline. PMID- 3679436 TI - Evaluation of the nitrosamine hypothesis of gastric carcinogenesis in man. AB - Patients who had undergone a Billroth II gastrectomy (PG) or had pernicious anaemia (PA) and healthy matched control subjects (MC) participated in 24-h studies in which bacteria, nitrite and N-nitroso compounds (NOC) were measured in gastric juice and N-nitrosoproline (NPRO) in urine. Consistent with the nitrosamine hypothesis, intragastric levels of bacteria and nitrite were positively related to intragastric pH, but, contrary to the hypothesis, NOC in gastric juice and NPRO in urine were negatively related to intragastric pH. PMID- 3679435 TI - Gastric hypoacidity as a risk factor for gastric and other cancers. AB - Evidence is presented and discussed to test the hypothesis that the excess risk of gastric cancer observed in patients with decreased gastric acidity is caused by metabolites of nitrite, possibly N-nitroso compounds. PMID- 3679437 TI - An investigation of possible risk factors associated with gastric cancer after benign ulcer operations. AB - The risk of developing gastric cancer has been investigated in a case-control study and in a prospective investigation. In the case-control study, 1495 cases of gastric cancer were identified in five city hospitals and matched with autopsy controls from the same hospitals. The frequency of operations for benign ulcer [partial gastrectomy (PG) and gastroenterostomy] was similar in the two groups. Thus, there was no increased risk for late gastric cancer after an ulcer operation. A total of 140 operated ulcer subjects [80 truncal vagotomy and drainage (TVD), 60 PG and 78 nonoperated cases attending with dyspepsia (C)] were examined by endoscopy, multiple gastric biopsy and analysis of gastric juice for nitrite. Biopsies were graded for gastritis and a gastritis index was derived (normal, 1; superficial gastritis, 2; chronic atrophic gastritis: mild, 3; moderate, 4; severe, 5). More atrophic gastritis was found in operated subjects than in controls: TVD, 2.3 +/- 0.08 (mean +/- SE); PG, 2.6 +/- 0.1 versus C, 1.8 +/- 0.08, p less than 0.01. The severity of atrophic gastritis increased after an operation interval of 20 years in PG subjects (p less than 0.05). Intestinal metaplasia was a common change, but unequivocal epithelial dysplasia was not observed. Two cases of operated stomach cancer were found. High levels of nitrite were positively correlated with pH and a high gastritis index. This evidence does not suggest that ulcer surgery leads to either an increased risk of cancer or a precancerous condition. PMID- 3679438 TI - Radioimmunoassay used to detect DNA alkylation adducts in tissues from populations at high risk for oesophageal and stomach cancer. AB - N-Nitrosamines are alkylating agents capable of forming various covalent adducts with DNA in vivo. Since formation of promutagenic DNA adducts, particularly O6 methyldeoxyguanosine (O6-medGuo), has been implicated as an initiating event in nitrosamine-induced carcinogenesis, we have used radioimmunoassay (RIA) to probe for such damage in surgical tissue samples from cancer patients in populations likely to be exposed environmentally to nitrosamines. PMID- 3679439 TI - Determination of N-nitrosamines in gastric juice and urine and a comparison of endogenous formation of N-nitrosoproline and its inhibition in subjects from high and low-risk areas for oesophageal cancer. AB - Samples of gastric juice were collected from a high-risk area for oesophageal cancer in China and analysed for N-nitroso compounds. N-Nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), N-nitrosomethylbenzylamine (NMBzA), N nitrosopyrrolidine (NPYR) and N-nitrosopiperidine (NPIP) were identified in descending order of concentration. Several unknown compounds were also detected in the fasting gastric juice. A positive correlation was found between the amount of nitrosamines in gastric juice and the degree of severity of lesions of the oesophageal epithelium: the amounts of nitrosamines in gastric juice from subjects with a normal oesophageal epithelium were lower than those in subjects with marked dysplasia or carcinoma of the oesophagus. In addition, 1500 samples of 24-h urine were collected from various communes in six high-risk areas and two low-risk areas for this cancer in China and analysed for N-nitrosamino acids. Subjects in high-risk areas excreted higher levels than those in low-risk areas. Intake of L-proline resulted in marked increases in levels of urinary N nitrosoproline (NPRO) in inhabitants from both high- and low-risk areas. Intake of moderate doses of vitamin C, alpha-tocopherol and zinc by high-risk subjects reduced the urinary levels of N-nitrosamino acids to those found in undosed subjects in low-risk areas, suggesting a rational basis for prevention in high risk areas. PMID- 3679440 TI - High urinary excretion of nitrate and N-nitrosoproline in opisthorchiasis subjects. AB - About 50% of the population in some provinces of north-east Thailand are infested with liver fluke (Opisthorchis viverrini), and many develop cholangiocarcinoma subsequently. This study was designed to demonstrate possible endogenous formation of N-nitrosoproline (NPRO) in this population. Diet samples, saliva and urine were taken from subjects with and without liver fluke and analysed for nitrate and nitrite; urine was also analysed for NPRO. Nitrate and nitrite levels in saliva were higher in subjects with liver fluke than in those without; total nitrate and NPRO excretion was also higher in this group. Subjects with liver fluke may therefore be more heavily exposed to N-nitroso compounds than others, and may be at higher risk for cholangiocarcinoma. PMID- 3679441 TI - Intake of Cantonese-style salted fish as a cause of nasopharyngeal carcinoma. AB - Ho (1971) of Hong Kong first proposed consumption of Cantonese-style salted fish, a traditional food among southern Chinese, as a possible risk factor for nasopharyngeal carcinoma (NPC) in this high-risk population. Four case-control studies have examined Ho's hypothesis; all results are supportive. The most convincing evidence of a causal association between intake of salted fish and NPC derives from a recent case-control study of young Hong Kong Chinese. It is estimated that over 90% of NPC cases under age 35 in Hong Kong are due to intake of this food during childhood. Preliminary experimental data on Cantonese-style salted fish indicate that N-nitroso compounds may be involved in the carcinogenicity of this human food. PMID- 3679442 TI - N-nitrosodiethanolamine excretion in metal grinders. AB - Grinding fluids usually contain ethanolamines and nitrite as anticorrosive agents; these are known precursors of N-nitrosodiethanolamine (NDELA). In a preliminary study, it was demonstrated that workers' exposure to NDELA can be monitored by urine analysis. In order to estimate total daily exposure, 12 workers in a grinding shop were investigated by a three-step biological monitoring programme, giving the following results: (1) after exposure-free weekends, no NDELA was found in urine; (ii) urine collected during working shifts contained NDELA in up to microgram/kg concentrations; (iii) total daily NDELA excretion in 24-h urines was up to 40 micrograms; (iv) the amount of excreted NDELA correlated with the amount of NDELA contamination in the grinding fluid; (v) NDELA seems to be accumulated in the body during the week; (vi) other workers in machine shops, like maintenance and transport workers, are also heavily exposed to NDELA. PMID- 3679443 TI - N-mononitrosopiperazine in urine after occupational exposure to piperazine. AB - We have shown previously that intake of the drug piperazine can result in the endogenous formation of N-mononitrosopiperazine (NPZ; Bellander et al., 1985). The present investigation deals with the possibility of endogenous formation of NPZ due to occupational exposure to piperazine in a chemical plant. PMID- 3679444 TI - Long-term persistence of nitrosamine-induced structural damage to heterochromatic DNA. AB - Different levels of damage and repair to eu- and heterochromatic DNA from the livers of rats receiving a dose of 10 mg/kg N-nitrosodimethylamine (NDMA) were apparent. Preincorporated 3H-thymidine was lost rapidly from euchromatic DNA but persisted in the heterochromatic fraction. Persistent damage, determined as single-stranded regions binding to benzoylated DEAE-cellulose (BD-cellulose), was evident in heterochromatic DNA for up to three months. By subjecting rats treated with NDMA to partial hepatectomy, generation of single-stranded regions in the newly synthesized heterochromatic DNA could be demonstrated. Such structural defects were evident when hepatectomy was performed two months after administration of the carcinogen. These findings indicate that structural damage to nontranscribed DNA is one of the most persistent molecular lesions following exposure to nitrosamines. PMID- 3679445 TI - N-nitroso-N-methylaniline: possible mode of DNA modification. PMID- 3679446 TI - Beta-oxidized N-nitrosoalkylcarbamates as models for DNA alkylation by N nitrosobis(2-oxopropyl)amine in Syrian hamsters. AB - A single dose of N-nitrosobis(2-oxopropyl)amine (NDOPA) can selectively induce pancreatic-duct adenocarcinomas in Syrian hamsters. Multiple doses or a higher single dose can induce tumours of the liver and other organs. Our earlier studies employing NDOPA systematically labelled with 14C in the three-carbon chain showed that hamster pancreatic DNA is almost exclusively methylated and that the sole source of the methyl group is the alpha carbon of NDOPA. Hamster liver DNA was equally methylated and alkylated by a three-carbon chain. Current studies using generally labelled tritiated NDOPA with a very high specific activity have shown that the three-carbon alkylation is 2-hydroxypropylation. We have identified two adducts isolated from hamster liver DNA, N7-(2-hydroxypropyl)-guanine and O6-(2 hydroxypropyl)guanine, which contain this group, and we have also isolated and identified N7-methylguanine and O6-methylguanine in DNA from hamster liver and pancreas. beta-Oxidized N-nitrosocarbamates, ethyl N-nitroso-2-oxopropylcarbamate (NOPC) and ethyl N-nitroso-2-hydroxypropylcarbamate (NHPC), are useful models for predicting the DNA adducts observed in vivo following NDOPA treatment. Base catalysed decomposition of NOPC in the presence of exogenous DNA yields five methylated purines (N3-, N7- and O6-methylguanines and N1- and N3 methyladenines). NHPC, a model for N-nitrosamines containing the 2-hydroxypropyl group, reacts with guanosine to yield N7- and O6-(2 hydroxypropyl)guanines.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679447 TI - Beta-oxidation of N-nitrosodiethanolamine in different animal species in vitro and in vivo. AB - The metabolism of N-nitrosodiethanolamine (NDELA) was studied to assess whether the formation of the beta-oxidized metabolites, N-nitroso(2-hydroxyethyl) (formylmethyl)amine (NHEFMA) and N-nitroso(2-hydroxyethyl)(carboxymethyl)amine (NHECMA), is involved in tumour induction in various animal species with different susceptibilities to NDELA carcinogenicity. In-vitro and in-vivo studies showed that all the animal species considered metabolize NDELA through the beta oxidation pathway, suggesting that there is no correlation between carcinogenesis by NDELA and its beta-oxidation. PMID- 3679448 TI - The possible role of digitalislike factors in pregnancy-induced hypertension. AB - A group of small, digitalislike compounds has been implicated in some forms of essential hypertension. Because of similarities between these forms of essential hypertension and pregnancy-induced hypertension, the presence of digitalislike factors in pregnancy-related fluids has been investigated. The factors are found in maternal sera with significantly higher levels of digitalislike activity, as monitored by digoxin radioimmunoassay, in the sera of third-trimester women with pregnancy-induced hypertension as compared to normotensive third-trimester controls (315 vs 195 pg digoxin equivalents/ml; p less than 0.001). Similarly, they are found in amniotic fluid, and significantly higher levels, as measured by radioimmunoassay (760 vs 540 pg digoxin equivalents/ml; p less than 0.0008) and by inhibition of ouabain-sensitive Na+,K+-adenosine triphosphatase (ATPase) (12.8 vs 2.7% inhibition; p less than 0.002), are found in those women whose pregnancies are complicated with hypertension. With purification, several digoxinlike immunoactive compounds are detected. Of these, some have a marked ability to inhibit ouabain-sensitive Na+,K+-ATPase. While as yet unidentified, these compounds have properties suggesting that they are not peptides, steroids, or fatty acids and lipids. PMID- 3679449 TI - Public health and non-communicable diseases. PMID- 3679450 TI - The role of health journal in the delivery of health care. PMID- 3679451 TI - A comparative study of cataract surgery--hospital versus camps. PMID- 3679452 TI - An evaluation of contraceptive knowledge and practice in an urban community in Benin City in Nigeria. PMID- 3679453 TI - The age at menopause in the women of Himachal Pradesh, and the factors affecting the menopause. PMID- 3679454 TI - An epidemiological study of diabetes mellitus in an rural population of Uttar Pradesh. PMID- 3679455 TI - Serodiagnosis of typhoid fever. PMID- 3679456 TI - Counter-immunoelectrophoresis as a diagnostic test for typhoid fever. PMID- 3679457 TI - Outbreak of chloramphenicol resistant typhoid fever. PMID- 3679458 TI - Salmonella senftenberg epidemic in a neonatal nursery. PMID- 3679459 TI - Problems in the rehabilitation of paralytic poliomyelitis. PMID- 3679460 TI - Side effects of measles vaccine--as perceived by mothers. PMID- 3679461 TI - Salmonella typhi meningitis. PMID- 3679462 TI - Diagnostic significance of neutrophils in CSF in meningitis without overt pleocytosis. PMID- 3679463 TI - Midbrain tuberculoma. PMID- 3679464 TI - Hypertrophic osteoarthropathy in pulmonary tuberculosis. PMID- 3679465 TI - Meningococcal resistance to conventional antibiotics. PMID- 3679466 TI - Milk or curd--what to feed during diarrhea? PMID- 3679467 TI - Primary peritoneal hydatidosis. PMID- 3679468 TI - Health care and health education: a compulsory subject. PMID- 3679469 TI - Superstitious practices. PMID- 3679470 TI - ICDS: realities and course of desired changes. PMID- 3679471 TI - Diagnostic approach to a bleeding patient. PMID- 3679472 TI - Bactericidal capacity of polymorphs in iron deficiency. PMID- 3679473 TI - Hemoglobin A2 in iron deficiency and megaloblastic anemia: relation with severity and etiology of anemia. PMID- 3679474 TI - Vitamin K deficiency related bleeding manifestations in older neonates and infants. PMID- 3679475 TI - Predictability of severity of ABO hemolytic disease. PMID- 3679476 TI - Thyroid disorders in children. PMID- 3679477 TI - Medical audit for rational treatment. PMID- 3679478 TI - Bioavailability of acetaminophen after rectal administration. PMID- 3679479 TI - Hereditary factor XIII deficiency. PMID- 3679480 TI - Skin scrapping in the diagnosis of Letterer-Siwe disease. PMID- 3679481 TI - Chronic ITP treated with intravenous pulse methylprednisolone. PMID- 3679482 TI - Infantile Gaucher's disease. PMID- 3679483 TI - Kocher Debre Semelaigne syndrome. PMID- 3679484 TI - Poliomyelitis immunization. PMID- 3679485 TI - Synovial fluid admixture during femoral blood collection. PMID- 3679486 TI - Bilaterally absent radial pulse with hypoplastic thenar eminences. PMID- 3679488 TI - Pediatrics in India: past, present and future. PMID- 3679487 TI - Detection of malnutrition. PMID- 3679489 TI - Hepatic presentation of Wilson's disease. PMID- 3679490 TI - Serum transferrin levels in Indian childhood cirrhosis. PMID- 3679491 TI - EEG, CT scan correlation in neurological disorders. PMID- 3679492 TI - Ocular manifestations in mentally retarded children. PMID- 3679493 TI - Extrahepatic portal venous obstruction in siblings. PMID- 3679494 TI - Gastric volvulus. PMID- 3679495 TI - Schmidt syndrome. PMID- 3679496 TI - Gender reassignment--a follow-up after 3 years. PMID- 3679497 TI - Meningococcal meningitis and meningococcal septicemia. PMID- 3679498 TI - Perforated stress ulcers in infancy. PMID- 3679499 TI - Mc Cune Albright syndrome with polydactyly. PMID- 3679500 TI - Tonsilloliths. PMID- 3679501 TI - Need for sex education. PMID- 3679502 TI - Intellectual assessment of school children from severely iodine deficient villages. PMID- 3679503 TI - Habit disorders--prevalence and etiology. PMID- 3679504 TI - Adolescents' anxieties related to pubertal growth and development. PMID- 3679505 TI - Perinatal hypoxic-ischemic brain damage: clinico-pathologic features. PMID- 3679506 TI - Complications of intravenous infusion through closed method. PMID- 3679507 TI - Hematological profile of enteric fever. PMID- 3679508 TI - Intracranial hemorrhage in term neonates. PMID- 3679509 TI - Psychosis associated with anticonvulsant toxicity. PMID- 3679510 TI - Metachromatic leucodystrophy. PMID- 3679511 TI - Hallermann Streiff syndrome. PMID- 3679512 TI - Aarskog syndrome. PMID- 3679513 TI - Cleidocranial dysostosis. PMID- 3679514 TI - Juvenile delinquency. PMID- 3679515 TI - Lactose free formulations. PMID- 3679516 TI - Yoghurt feeding during acute diarrhea. PMID- 3679517 TI - [Organ-specific changes in amino acid metabolism]. PMID- 3679518 TI - [Intracellular amino acid concentrations in various disease states]. AB - The determination of free amino acids (AA) in human tissue is far more complicated than the analysis of plasma AA. The concentrations of free AA are different in plasma, liver and muscle, respectively. Pathological conditions like sepsis, liver failure and glucagonoma syndrome lead to characteristic alterations in the concentrations of free AA. However, the relationship between cytosolic AA concentrations and protein synthesis are not yet clear. Possibly drastically reduced levels of single AA (e.g. glutamine) lead to a 'down'-regulation of protein synthesis. PMID- 3679519 TI - [Detection of substrate metabolism in skeletal muscles in the human]. AB - The technical procedure of puncture and catheterization of arteria brachialis and a deep forearm vein in man and practical mode of blood sampling are described. For measurement of local blood flow depending on specific study design, venous occlusion plethysmography, i.m. or i.a. injection of 133Xenon can be used. The theoretical and practical problems of these methods are discussed in detail. PMID- 3679520 TI - [Measuring blood flow and catheterization technic in the acute and chronic dog model]. AB - Metabolic studies under in vivo conditions may require a simultaneous catheterization of various organs. Because of phylogenetic relationships, pigs or dogs are best suitable for metabolic investigations. Organ-specific flow rates and substrate balances can be determined by means of dye dilution techniques (indocyanine green - ICG, para-aminohippuric acid - PAH, bromsulphthalein - BSP). An easy method for catheter insertion under anesthesiological and operative conditions is described. PMID- 3679521 TI - Isolated perfused rat liver: an experimental model for studies on ammonium and amino acid metabolism. AB - Isolated perfused rat liver is a well-established experimental model for studies on hepatic amino acid and ammonia metabolism. Some aspects and modifications of the liver-perfusion technique are discussed. Perfusion studies with the intact liver have the fundamental advantage that the structural and functional organization of the liver is preserved; however, the experimental system is more complex in view of subcellular and intercellular compartmentation and the recently demonstrated metabolic interactions of different cell populations at the acinar level. These problems of complexity by compartmentation can be largely solved by introducing further techniques such as organ spectrophotometry, the retrograde/antegrade perfusion technique, use of micro-oxygen-electrodes, use of selective inhibitors, radiolabeled compounds, different fractionation techniques of the liver tissue. By means of these approaches, intracellular events can be followed up not only indirectly by analyzing the composition of the perfusate before and after a liver passage, but also directly in the different subcellular and subacinar compartments of a structurally and metabolically intact liver. PMID- 3679522 TI - [The isolated perfused hindlimb of the rat. Method and use]. AB - Diaphragm and isolated perfused hindquarter of rat are among the most thoroughly studied skeletal muscle preparations. Preparation and perfusion techniques are described. The preparation is characterized with respect to tissue and muscle fiber type composition as well as functional metabolic parameters. Some applications are demonstrated. PMID- 3679523 TI - [Isolated perfusion of the small intestine of the rat with perfluorotributylamine as an artificial oxygen carrier]. AB - A new model of isolated intestinal perfusion could be established with fluorocarbon (FC-43) as artificial oxygen carrier. Morphology, cell metabolism of xenobiotics (phase I and II), as well as the transport of a monosaccharide, were stable for at least 2 h. Without interference with the changing metabolism of erythrocytes in the perfusion medium, the proposed model allows one to investigate exclusively the metabolic function of the perfused organ. PMID- 3679524 TI - [The method of the isolated perfused rat heart using the Langendorff model in nutrition research]. AB - The preparation technique and principle of the Langendorff model for the perfusion of isolated rat heart, as well as the assessment of circulatory and metabolic parameters in this model are described, and the role of the model in metabolic and nutrition research is discussed. PMID- 3679525 TI - [Changes in organic acids in plasma and cerebrospinal fluid in cerebral infarct]. AB - Seventeen patients with recent cerebral infarction were included in the study. The general condition of the patients was evaluated within 3 days after the incidence (rating 1) and 7-9 days after the incidence (rating 2) using a clinical rating scale for internal, psychiatric and neurological findings. The statistical evaluation showed a clinical improvement of the score of 32%. The extent of the brain lesions was determined by cranial computed tomography. Routine analysis of the cerebrospinal fluid included determination of protein, cell count, cell type, glucose, lactic acid, and hemoglobin. In addition, spinal fluid and serum concentration of pyruvic acid, citric acid, fumaric acid, alpha-ketoglutaric acid and alpha-keto-beta-methylvaleric acid (3-MKV) were determined at the two rating times. CSF and serum values of fumaric acid, 3-MKV and pyruvic acid correlated at rating 1, while at rating 2 a correlation existed only for fumaric acid. A trend analysis infarction - postinfarction period showed the concentration of all metabolites to decrease significantly. This is interpreted as a reconstitution of the initially disturbed blood brain barrier function. PMID- 3679526 TI - [Comparison of prognostic nutrition indices in preoperative detection of risk patients. A prospective trial]. AB - Malnutrition must be considered as a factor of risk in surgery and therefore it has to be taken into account in surgical planning. Many authors aggregated several measurements into an index or another mathematical model by stepwise regression or discriminant analysis. Hitherto none of these approaches has been subjected to a critical analysis designed to determine whether the information gained differentiates patients with increased operative risk from those without, to a degree that is clinically relevant. In a prospective study the predictive values of nutritional assessment techniques of various authors were examined in 246 surgical patients undergoing a major surgical procedure. The specificity, sensitivity, and validity of each assessment technique were determined. The statistical analysis showed that none of the assessment techniques separated patients who were at high risk from those who were at low risk in a statistically significant predictive power. Serum albumin level was a quite accurate prognostic indicator of postoperative morbidity and mortality. The mean complication rate in this study was 26.8%. Concerning the specificity, sensitivity, and validity the single measurement of the serum albumin had a predictive value as high as all other determined assessment techniques in this study. We contend that combining measurements into a statistically derived index is time-consuming and expensive and does not produce an assessment technique with sufficient predictive power to identity high risk patients in a clinically relevant fashion. PMID- 3679527 TI - [The safety of apparative cytapheresis]. AB - In a retrospective analysis 1568 platelet apheresis procedures and 652 leukocytophereses performed from April 1976 to June 1986 were examined. 886 procedures were performed using the Fenwal CS 3000, 777 with the IBM 2997, and 293 with the Haemonetics V50, whereas in 264 procedures the Model 30 was used. The study aims to answer 3 donor-related questions: To what extent are the blood cells changed by the donation? How does the donor respond to the technical requirements of the donation, such as length of the procedure, blood volume processed, amount of concentrate removed during the donation? How often did side effects or undesired reactions occur? We found that thrombocytapheresis led to a decrease in platelets in the peripheral blood of between 20% (CS3000) and 33.7% (IBM), and an increase in leukocytes of between 4.24% (IBM) and 17.8% (Model 30), whereas erythrocytes, hemoglobin and hematocrit showed a similar decrease within a range of between 1.1% and 2.67% in all systems. Following leukocytapheresis the leukocyte counts of the peripheral blood were decreased by up to 12%, erythrocyte counts by up to 5% and platelets between 15% (IBM) and 29% (Model 30). The list of irregularities included technical problems and donor reactions (e.g., citrate reactions, reactions of blood circulation, and blood flow in the donor). There were no serious side-effects. Early terminations of 42 (= 1.9%) donations were for prophylactic reasons exclusively. Few moderate undesired reactions occurred (4 = 0.2%), but none of the donors contributing to the more than 2,000 donations were ever hospitalized, demonstrating the safety of cytapheresis with all separators. PMID- 3679528 TI - Side-effects of cytapheresis with cell separators. AB - The rate of procedure-related side-effects was evaluated in 11,895 cytaphereses performed with a Haemonetics 30 (H-30) cell processor (2,486 procedures) or with a Haemonetics V-50 (H-50) cell processor (6,813 procedures) or with the Fenwal CS 3000 cell processor (2,596 procedures). The overall rate of side-effects was 7.41% (absolute number 881). There was a significant difference between female and male donors concerning the frequency of hypotension episodes and citrate toxicity related reactions. There were also distinct differences between the single cell separator types concerning the frequency and type of side effects. Hypotension episodes and citrate-related reactions were observed most frequently during cytapheresis with the H-30 (7.65 and 2.96% respectively). Venous access and technical problems appeared more often when the H-50 or the CS-3000 were used. Thus both the H-50 as well as the CS-3000 cell separators allow safe cytapheresis with a low number of side-effects. PMID- 3679529 TI - The safety of and the strain on the donor during thrombocytapheresis on the cell separator. A psychological study. AB - The study deals with the question as to what extent and under which existing personal characteristics does thrombocytapheresis on the cell separator (Fenwal CS-3000) lead to psychological stress for the blood donor? A comparison is made with the stress experienced during the established 450 ml full-blood donation. Because of the different procedural conditions, it was postulated that the donation on the cell separator creates greater psychological stress than the established type of donation. To examine this hypothesis, a sample group of 76 cell-separator and full-blood donors were asked to complete a questionnaire concerning the stress they experienced and their attitude before, during, and after the donation. Their personalities were also examined. A control group of 45 full-blood donors was examined in the same way. No significant statistical difference was found regarding the extent of stress under both conditions of donation. These findings are verified by the general satisfaction expressed by the cell-separator donors. Although it is confirmed that the personal cost to the donor is greater, it involves, on the other hand, a greater commitment, a positive evaluation of the more intimate involvement of the donor, and an increase in self-esteem. Since it could not be proven that there is an increase in the amount of stress during cell-separator donation, it also seems plausible that no clear decrease in stress would be observed after repeated donations. On the whole, it seems that the cell separator is well accepted by the donors. The extent of experienced stress is related to the donor's habitual anxiety and negative expectations. Since negative expectations can be influenced, it is to be expected that an informative conversation in a quiet atmosphere would further decrease the stress experienced. PMID- 3679530 TI - Safety of apheresis donation. AB - Platelet and granulocyte collections have been done for the past 15 years, and studies on the safety of these procedures have been carried out in many institutions in the USA and abroad. In general, no long-term harmful effects have been observed in donors who had undergone frequent cytapheresis. Significant decreases in donor platelet count were noted following repeated platelet apheresis. However, only a few donors became thrombocytopenic (platelet count less than 150,000/microliter). Interestingly enough, if the donor was allowed time to recover a normal platelet count, subsequent repeated platelet collection did not induce thrombocytopenia. Rebound of platelets has also been a common finding. Intensive granulocyte collections have not reduced the number of circulating granulocytes, nor has there been any report of leukopenia in donors who had undergone frequent leukocytapheresis. The limiting factor has been the need for hydroxyethyl starch as a sedimenting agent and corticosteroids to stimulate the granulocyte release from the marrow, which have known adverse effects of their own. No significant changes in plasma proteins and other biochemical and hematological parameters have been reported in cytapheresis donors. There is widely-held concern that because the collections of platelets and granulocytes are not selective to the exclusion of lymphocytes, the repeated cytapheresis may deplete the circulating lymphocytes with theoretical risk associated with long-term alterations of the immune response. In addition, if a significant number of red blood cells are removed, the frequent apheresis donations may render the donor anemic. Because of these theoretical risks, recommendations have been formulated in the USA in an attempt to ensure the safety of apheresis donors. PMID- 3679531 TI - [Implementation of apparative hemapheresis for collecting blood component stores. Recommendations of the Hemapheresis Commission of the German Society of Transfusion Medicine and Immunohematology]. PMID- 3679532 TI - [The Quebec Parents Anonymous]. PMID- 3679533 TI - [Legal responsibility of nurses and practical nurses]. PMID- 3679534 TI - Preceptorship works! PMID- 3679535 TI - [The Broken Cross of Quebec]. PMID- 3679536 TI - Phenotypic variation of Staphylococcus epidermidis slime production in vitro and in vivo. AB - Clinical studies performed by us and others have found an association between slime production and strains of coagulase-negative staphylococci that infect indwelling medical devices. By serial low-speed centrifugation of broth cultures we have isolated a stable, weakly adherent strain (RP62A-NA) from a strongly adherent, slime-producing, pathogenic strain of Staphylococcus epidermidis sensu stricto (RP62A, ATCC 35984). We obtained a second strain from RP62A-NA (RP62A NAR) by serial subculture of glass-adherent cells of RP62A-NA. All three strains had the same pattern of biochemical reactions, antimicrobial susceptibilities, and plasmid analysis. Transmission electron micrograph sections stained with the mucopolysaccharide-specific stain alcian blue demonstrated that the adherent strains RP62A and RP62A-NAR were covered with an extracellular coat of polysaccharide-rich material. In contrast, the nonadherent RP62A-NA strain lacked this external coat. All three strains were used in a mouse model of foreign body infection and a rat model of catheter-induced infective endocarditis. The adherence characteristics of isolates of RP62A and RP62A-NA recovered from experimental animals were relatively stable, although we noted a slight but a significant increase in the adherence of RP62A-NA isolates recovered from the foreign body model. The adherence characteristics of RP62A-NAR isolates recovered from infected animals were variable; in general these isolates were less adherent than the laboratory strain of RP62A-NAR. In both models the 50% infective dose (calculated by the Reed and Muench method) was three times greater for the RP62A NA strain than for the RP62A strain. The phenotypic expression of slime production is subject to both in vitro and in vivo variation and could play a role in the pathogenesis of foreign body infection. PMID- 3679537 TI - Localization of circumsporozoite protein of Plasmodium ovale in midgut oocysts. AB - Circumsporozoite (CS) proteins are the major proteins found on the surface of salivary gland sporozoites and are the protective antigens of several species of malaria parasites. Little is known about the distribution of CS proteins in developing oocysts, however. Immunoelectron microscopy with protein A-gold and a monoclonal antibody specific for the CS protein of Plasmodium ovale was performed to investigate the distribution of CS protein within developing P. ovale oocysts. There was an almost complete absence of label in immature oocysts prior to the development of sporoblasts. In contrast, sporoblasts and budding and free sporozoites in mature oocysts were labeled uniformly on the outer surfaces of their plasma membranes, indicating a uniform distribution of CS protein on these membranes. Gold particles were frequently associated with the cytoplasm of sporoblasts and sporozoites, as well as with the inner surface of the oocyst capsule. This is the first evidence that CS protein is present in oocyst sporozoites and sporoblasts of P. ovale. PMID- 3679538 TI - Quantitation of monomeric and oligomeric forms of membrane-bound staphylococcal alpha-toxin by enzyme-linked immunosorbent assay with a neutralizing monoclonal antibody. AB - A murine monoclonal antibody generated against staphylococcal alpha-toxin was shown to react only with the monomeric (native), 3S form of the toxin. A sensitive sandwich enzyme-linked immunosorbent assay (ELISA) constructed with this antibody permitted detection of 0.25 to 0.5 ng of native toxin per ml. Toxin oligomers formed either by heat aggregation in solution, on target erythrocyte membranes, or on phosphatidylcholine-cholesterol liposomes were unreactive in the ELISA when membranes were solubilized with the nondenaturing detergent Triton X 100. After dissociation of the oligomers by boiling in sodium dodecyl sulfate, however, the ELISA reactivity of the liberated 3S toxin was fully restored. Parallel determinations of membrane-bound toxin with sodium dodecyl sulfate and Triton X-100 solubilization thus permitted direct quantitation of total and monomeric toxin, respectively; the difference between these two values was represented by toxin oligomers. The detection limits for membrane-bound oligomeric and monomeric toxin on erythrocyte membranes are in the order of 100 molecules and 1 molecule per cell, respectively. Using this ELISA, we show that over 90% of alpha-toxin molecules bound to target membranes at 37 degrees C are in oligomeric form. Evidence is given that the monoclonal antibody neutralizes alpha-toxin by inhibiting its binding to both rabbit and human erythrocytes. This ELISA is the first assay that quantitatively discriminates between mono- and oligomeric forms of a pore-forming protein on target cell membranes. PMID- 3679539 TI - Bacterial-lipopolysaccharide-induced release of lactoferrin from human polymorphonuclear leukocytes: role of monocyte-derived tumor necrosis factor alpha. AB - We have examined the role played by human peripheral blood monocytes in mediating responses of human polymorphonuclear leukocytes (PMN) to bacterial lipopolysaccharide (LPS) in vitro. When incubated with Salmonella typhimurium LPS at 37 degrees C, human PMN suspended in serum-free buffer released the specific granule constituent lactoferrin into the surrounding medium. Release of lactoferrin from PMN varied with the concentration of LPS (1 to 1,000 ng/ml) as well as with the duration of incubation (2 to 60 min) and was not accompanied by significant release of the cytoplasmic enzyme lactate dehydrogenase. LPS-induced release of lactoferrin from PMN was augmented significantly when cell suspensions were supplemented with additional monocytes and lymphocytes. Only monocytes, however, secreted significant amounts of lactoferrin-releasing activity (in a time- and concentration-dependent manner) when incubated separately with LPS. Lactoferrin-releasing activity was heat (80 degrees C for 15 min) labile, eluted after chromatography on Sephadex G-100 with an apparent molecular weight of approximately 60,000, and was inhibited by antibodies to tumor necrosis factor alpha. Thus, LPS-induced noncytotoxic release of lactoferrin from human PMN suspended in serum-free buffer is mediated, at least in part, by tumor necrosis factor alpha derived from contaminating monocytes. PMID- 3679540 TI - A potassium thiocyanate extract vaccine prepared from Pasteurella multocida 3:A protects rabbits against homologous challenge. AB - Potassium thiocyanate extracts of a virulent Pasteurella multocida 3:A rabbit isolate were prepared and used as a vaccine in rabbits. The extract contained protein, carbohydrate, hyaluronic acid, lipopolysaccharide, DNA, and RNA. The protein and lipopolysaccharide profiles of the extract were similar to those of the P. multocida cell membrane. Rabbits were vaccinated intranasally (i.n.) or intramuscularly (i.m.) four times at 1- or 3-week intervals and challenged i.n. with the homologous P. multocida 2 weeks after the last vaccination. Rabbits vaccinated with the extract by the i.n. route developed persisting serum immunoglobulin G (IgG) and nasal IgA antibodies, whereas rabbits immunized by the i.m. route produced persisting serum IgG and transient nasal IgA antibodies. The extract prevents the death of rabbits which were vaccinated by either route and challenged. Vaccination by the i.n. route in rabbits reduced the numbers of virulent P. multocida in nasal cavities and lungs and the prevalence and severity of rhinitis and pneumonia. These i.n.-vaccinated rabbits were also resistant to virulent P. multocida colonization in liver, spleen, uterus, and tympanic bullae. Similarly, i.m. vaccination in rabbits resulted in a reduction in the severity of rhinitis; the numbers of virulent P. multocida in lungs; and the prevalence of colonization in liver, spleen, uterus, and tympanic bullae. Vaccination by the i.n. route was superior to that by the i.m. route in that there was a significant reduction in the severity of pneumonia and numbers of virulent P. multocida in nasal cavities and lungs. Rabbits vaccinated with the extract without challenge showed no lesions. PMID- 3679541 TI - Immunization of adult hamsters against Clostridium difficile-associated ileocecitis and transfer of protection to infant hamsters. AB - In this investigation, the role of antibodies against Clostridium difficile toxins A and B in protecting hamsters against C. difficile-associated ileocecitis was examined. We also studied the transfer of protection against C. difficile associated intestinal disease from immunized female hamsters to their infants. Adult female hamsters immunized parenterally with toxoid A or a mixture containing both toxoids A and B were protected against clindamycin-induced C. difficile-associated fatal ileocecitis. On the other hand, hamsters immunized with toxoid B or a broth filtrate from a nontoxigenic strain of C. difficile were not protected against C. difficile-induced ileocecitis. Antibody against the immunizing toxoid could be demonstrated in both the serum and the cecal contents of hamsters. Some infant hamsters from mothers immunized with toxoid A or AB were protected against C. difficile-associated ileocecitis, while infant hamsters from mothers immunized with toxoid B or a nontoxigenic broth filtrate were not protected against disease. Neutralizing antibodies to toxins A and B could be demonstrated in both maternal milk and serum, as well as in infant serum and intestinal contents. Foster-mothering experiments demonstrated that maternal protection of infants against C. difficile-associated ileocecitis was transferred to infant hamsters through breast milk. These results suggest that toxin A may play a more important role in the pathogenesis of C. difficile-associated ileocecitis in hamsters than toxin B. Furthermore, variations in the severity of C. difficile-associated illness in infants and adults may reflect the lack or presence of passively or actively acquired immunity against C. difficile toxins. PMID- 3679542 TI - Purification and characterization of levanase from Actinomyces viscosus ATCC 19246. AB - The extracellular levanase of Actinomyces viscosus ATCC 19246 was purified about 3,701-fold in 11% yield from the bacterial culture supernatant by means of ammonium sulfate precipitation, followed by DE52 column chromatography, Sephadex G-100 gel filtration, hydroxylapatite column chromatography, and Bio-Gel A 1.5m gel filtration. The molecular weight of the enzyme was estimated to be 89,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme was optimally reactive at pH 6.0 and at 45 degrees C. The activity was inhibited by MnCl2, BaCl2, FeCl3, ZnCl2, HgCl2, and EDTA at a final concentration of 1 mM. The inhibition by EDTA was recovered by adding CaCl2 or MgCl2. The enzyme specifically hydrolyzed levan, but not sucrose, raffinose, melezitose, inulin, and dextran. These results indicate that the purified enzyme is specific for fructan (i.e., levan), which mainly consists of beta-(2,6) linkages. PMID- 3679543 TI - Influence of Staphylococcus aureus antibody on experimental endocarditis in rabbits. AB - To evaluate the potential protective benefit of antibody to whole cells of Staphylococcal aureus for the prevention of endocarditis, the rabbit endocarditis model was used. Methicillin-sensitive (17A) and methicillin-resistant (173) S. aureus strains were evaluated in rabbits with or without indwelling intracardiac catheters. All immunized rabbits developed significant homologous agglutinating antibody titers (the mean reciprocal titers were 15,300 to strain 17A and 1,150 to strain 173). After challenge, virtually no significant differences were observed between immunized and unimmunized animals with respect to (i) incidence of endocarditis, (ii) concentration of bacteria in infected vegetations, (iii) incidence of metastatic renal abscesses, or (iv) concentrations of bacteria in infected kidneys. The clearance of homologous S. aureus strains from blood cultures was similar for immunized and unimmunized animals at 10 to 90 min after intravenous challenge. In vivo adherence of homologous S. aureus strains to aortic valves and vegetations was similar in immunized and unimmunized animals when evaluated at 30 and 90 min postchallenge. Even without catheterization, the incidence of bacteremia and renal abscesses was the same in immunized and unimmunized rabbits. Whole-cell-induced S. aureus antibody did not prevent or modify any stage in the development of endocarditis in rabbits. PMID- 3679544 TI - Virulence markers of mesophilic aeromonads: association of the autoagglutination phenomenon with mouse pathogenicity and the presence of a peripheral cell associated layer. AB - Autoagglutination (AA phenotype) of mesophilic aeromonads in broth was found to be a virulence-associated marker. There were two kinds of AA+ strains: those that spontaneously pelleted (SP+), and those that pelleted only after boiling (PAB+). Of 79 strains tested, 24 (30%) were AA+, and 18 of these were recovered from clinical specimens. Most of the AA+ strains (n = 21) were identified as either Aeromonas sobria or Aeromonas hydrophila. Of the well-documented clinical isolates of A. sobria and A. hydrophila available, 5 (46%) of 11 from invasive disease and 4 (14%) of 29 from noninvasive disease were SP- PAB+. The SP- PAB+ phenotype was significantly associated with invasive infections (e.g., bacteremia and peritonitis [chi 2, P less than 0.05]). All seven of the SP- PAB+ A. sobria and A. hydrophila strains tested killed mice within 48 h after intraperitoneal infection with 1 x 10(7) to 3 x 10(7) CFU, whereas only two of four SP+ PAB+ strains tested were lethal. All of the SP- PAB+ A. sobria and A. hydrophila isolates examined shared common O somatic antigens and possessed an external layer peripheral to the cell wall as determined by thin-section electron micrography. The LL1 strain of A. hydrophila used by Dooley et al. (J. S. G. Dooley, R. Lallier, and T. J. Trust, Vet. Immunol. Immunopathol. 12:339-344, 1986) to demonstrate an S membrane protein component in aeromonads virulent for fish also was SP- PAB+ and possessed the peripheral membrane, suggesting an association between these two components. Seven AA- and three SP+ strains tested lacked this layer; furthermore, 22 (71%) of 31 such isolates did not kill mice. The AA phenotype was a stable characteristic upon long-term passage of isolates in vitro. Study of SP+ and PAB+ aeromonads by surface charge and hydrophobicity analyses indicated that neither property correlated with either virulence or the presence of an external layer. PMID- 3679545 TI - Virulence of protein A-deficient and alpha-toxin-deficient mutants of Staphylococcus aureus isolated by allele replacement. AB - The gene coding for protein A (spa) of Staphylococcus aureus 8325-4 has been inactivated by substituting part of the spa coding sequence for a DNA fragment specifying resistance to ethidium bromide. The in vitro-constructed spa::EtBrr substitution mutation was introduced into the S. aureus chromosome by recombinational allele replacement. Southern blot hybridization showed that the in vitro-constructed mutation was present in the chromosomal spa locus. We have previously reported the inactivation of the alpha-toxin gene (hly) by allele replacement with an in vitro-constructed hly::Emr (erythromycin resistance) mutation (M. O'Reilly, J.C.S. de Azavedo, S. Kennedy, and T.J. Foster, Microb. Pathogen. 1:125-138, 1986). A double Spa- Hly- mutant was constructed by transduction. The virulence of Spa- and Hly- mutants was tested by experimental infection of mice. When subcutaneous injections were given, Hly- mutants formed a flat, darkened lesion, whereas Hly+ strains caused a raised, cream lesion. Alpha toxin was shown to be a major factor in forming subcutaneous lesions and in causing the death of mice injected intraperitoneally. Spa- mutants were slightly less virulent than their Spa+ counterparts, which suggests that protein A is also a virulence factor of S. aureus. PMID- 3679546 TI - Differential binding kinetics of cholera toxin to intestinal microvillus membrane during development. AB - A complete randomized block design was used to compare the binding kinetics of cholera toxin to developing rat enterocyte microvillus membranes prepared from newborn, 2-week-old, 4-week-old, and adult animals. Saturation-binding isotherms were generated on 16 independent samples (four blocks) under steady-state and reversible conditions. Scatchard analyses suggested positive cooperative binding to a single class of receptors, and the isotherms were analyzed by both the Hill Waud and Michaelis-Menten functions. Receptor density varied significantly with age (P = 0.013). An abrupt rise in receptor density occurred after the neonatal period and normalized in the adult animal. The half-dissociation constant also varied significantly with age (P = 0.019). Microvillus membranes from suckling animals had a slightly higher apparent affinity than those from weaned animals. Neither receptor concentration nor membrane purity confounded these observations. Whereas age-related changes in apparent affinity correlated with cellular responses, changes in receptor density did not. This study suggests that developmental changes in membrane structure which influence binding affinity but not receptor density may, in part, contribute to the increased sensitivity of suckling rats to cholera toxin exposure. PMID- 3679547 TI - Ingestion of Giardia lamblia trophozoites by human mononuclear phagocytes. AB - Mononuclear phagocytes may be important effector cells against Giardia lamblia. Human monocyte-derived macrophages were incubated with G. lamblia trophozoites in 13% heat-inactivated autologous serum. At a G. lamblia/macrophage ratio of 1:1, the number of trophozoites ingested per 100 macrophages ranged from 1 to 12 at 0.5 h and increased for all donors (n = 6) to 10 to 92 at 8 h. Ingestion was confirmed by electron microscopy. Increasing the parasite/phagocyte ratio to 5:1 increased the percentage of macrophages with adherent but not ingested trophozoites. Incubating Giardia cells and macrophages with 20% immune serum increased ingestion of parasites eightfold, indicating that anti-G. lamblia antibody can enhance ingestion. Both phase-contrast microscopy and electron microscopy documented trophozoite destruction within macrophages. Ingestion of parasites elicited an oxidative burst as measured by luminol-enhanced chemiluminescence. In vitro, Giardia trophozoites were killed by greater than or equal to 5 X 10(-5) M H2O2. Fusion of lysosomes with parasite-containing phagosomes was suggested by acridine orange-stained preparations. Human macrophages have the capacity to ingest Giardia trophozoites and to kill intracellular parasites, possibly by oxidative microbicidal mechanisms. PMID- 3679548 TI - Hemagglutinating activity of lipopolysaccharides from subgingival plaque bacteria. AB - Lipopolysaccharide (LPS) preparations from the Bacteroides species B. endodontalis, B. intermedius, B. denticola, and B. melaninogenicus and from Fusobacterium nucleatum, Haemophilus actinomycetemcomitans, Capnocytophaga gingivalis, and Eikenella corrodens directly agglutinated erythrocytes of some kinds of animals. LPSs from the Bacteroides species B. gingivalis, B. asaccharolyticus, B. corporis, and B. loescheii and from Capnocytophaga ochracea did not possess any hemagglutinating activity. Pretreatment of LPSs with lipase and phospholipase C completely eliminated the hemagglutinating activity. The hemagglutinating activity was also affected by human serum, saliva, colistin, and polymyxin B but was not affected by sugars, amino acids, EDTA, or proteolytic enzymes. The role of this hemagglutinating activity in colonization by these microorganisms of the periodontal region is discussed. PMID- 3679549 TI - Ploidy and DNA content of Candida stellatoidea cells. AB - Three isolates of Candida stellatoidea contained approximately the same amount of DNA per blastospore (38.3 to 41.9 fg) as did a known diploid isolate of Candida albicans and about twice as much as did a haploid isolate of Saccharomyces cerevisiae. The diploidy of C. stellatoidea was supported by demonstration of mitotic segregation of an ade marker. PMID- 3679550 TI - Differentiation of F38 mycoplasmas causing contagious caprine pleuropneumonia with a growth-inhibiting monoclonal antibody. AB - Monoclonal antibody WM-25 inhibited the in vitro growth of 13 F38 isolates from goats with contagious caprine pleuropneumonia but not 7 heterologous mycoplasma isolates representing four different species. In contrast to results with polyclonal antisera, growth inhibition by monoclonal antibody WM-25 was specific for F38 mycoplasma isolates and constituted a reliable means of distinguishing F38 from other mycoplasmas. PMID- 3679551 TI - Small airways function in workers exposed to piperazine. AB - An N2 wash-out technique was used to estimate the small airways function in 22 male workers, exposed to the asthma-inducing amine piperazine, and in 22 referent subjects, with similar smoking habits and age. The volume of trapped gas (VTG) was determined before and after a bronchial provocation with an aerosol of 0.25 ml 0.01% metacholine solution. No difference in VTG was observed between the piperazine-exposed workers and the referent subjects, either before or after the metacholine provocation. This indicates that a time-weighted average (TWA) exposure of about 0.1 mg piperazine/m3 does not cause small airways disease in non-asthmatic workers. Further, age and smoking habits were significantly associated with VTG. PMID- 3679552 TI - Excretion kinetics of the rubber anti-oxidant N-isopropyl-N'-phenyl-p phenylendiamine (IPPD). AB - Sixteen rubber vulcanizers using IPPD as anti-oxidant were monitored for the presence of the parent compound in the urine during two consecutive working weeks using HPLC for analysis. At least two components in the excretion kinetics could be demonstrated: a fast one, as end-shift urinary concentrations significantly exceeded before-shift ones, and a less rapid one, as before-shift values at the end of the week significantly differed from those determined at the beginning. A skin absorption experiment was also performed. It demonstrated three components in the excretion kinetics, with apparent half-times of approximately 3, 7 and 24 h. Excretion ceased 7 d after skin exposure. PMID- 3679553 TI - Estimation of personal exposure to ambient nicotine in daily environment. AB - To evaluate the actual exposure level of nonsmokers to environmental tobacco smoke (ETS) in their daily life, the exposure level of ambient nicotine was measured with a nicotine personal monitor carried by a nonsmoker. Average exposure levels of nicotine, even in such smoky places as cars, coffee shops and pubs, were less than 45 micrograms/m3. As a result of all-day monitoring, the highest amount of nicotine inhaled in a day was estimated, in this study, to be up to 310 micrograms, equivalent to actively smoking 0.31 ordinary cigarettes. PMID- 3679554 TI - Women in dental surgeries: reproductive hazards in occupational exposure to metallic mercury. AB - Eighty-one women (45 dentists and 36 dental assistants) occupationally exposed to metallic mercury underwent a toxicoclinical examination. Total mercury lebels (TMLs) were determined in scalp and pubic hair by cold vapour AAS. Furthermore a detailed questionnaire study was made concerning adverse reproductive events. TMLs in the hair of the exposed women examined exceeded significantly those determined in the hair of 34 controls not exposed to mercury. All exposed women had continued working during pregnancy. There was a significant, positive association between TMLs in the hair of exposed women and the occurrence of reproductive failures in their history. The relation between TMLs in the scalp hair and the prevalence of menstrual cycle disorders was statistically significant. These findings indicate that dental work could be another occupational hazard with respect to reproductive processes. PMID- 3679555 TI - Occupational exposure to cadmium and kidney dysfunction. AB - Investigations were carried out in an alkaline battery factory. The study group consisted of 102 persons and the control group of 85 persons. Cadmium in blood (Cd-B) and cadmium in urine (Cd-U), as well as beta 2-microglobulin (B2-M), retinol binding protein (RBP), amino acids in urine were determined. Exposure to cadmium was high; Cd-B and Cd-U concentrations were higher than recommended, 10 micrograms/l and 10 micrograms/g creat. In 65% and 56% of workers, respectively. Excretion of B2-M and RBP in urine was higher than the accepted upper limits of 380 and 130 micrograms/g creat. in about 20% of the workers. A significant correlation was observed between: log Cd-U.log Cd-B (r = 0.85), log B2-M.log RBP (r = 0.66), log Cd-U.log B2-M (r = 0.52), and log Cd-U.log RBP (r = 0.55). To evaluate the admissible period of occupational exposure to cadmium, an integrated exposure index (Cd-B x years of exposure) is proposed. According to the dose response relationship, an increase of low molecular protein excretion in urine can be expected in 10% of the cases at Cd-U amounting to 10 to 15 micrograms/g creat. and Cd-B x years of about 300 to 400. PMID- 3679556 TI - Some acute and long-term effects of exposure in welding and thermal-cutting operations in Nigeria. AB - The analysis of welding fumes has shown that toxic gases are present that are irritating to the respiratory system; these gases include nitrogen dioxide and ozone, as well as the oxides of cobalt and chromium. The acute and long-term effects of exposure are assessed in the context of a welding and metal plant in Nigeria. Evidence of long-term respiratory impairment and potential lung cancer was found. PMID- 3679558 TI - Antibodies to food and environmental antigens in serum, respiratory tract and intestine of pigs. AB - Serum antibodies to food, bedding and dust were detected in pigs by precipitation and ELISA. There was an age-related decrease in the number of animals with precipitating antibodies and in the specific activity of IgG and IgM antibodies. Antibodies to food, bedding and dust were detected in respiratory and intestinal secretions, but there were differences in the distribution and isotype of antibodies to these three antigens. PMID- 3679557 TI - Zinc protoporphyrin as an indicator of lead exposure: precision of zinc protoporphyrin measurements. AB - In lead-exposed workers many factors affect the relationship between the levels of lead and of zinc protoporphyrin (ZPP) in blood. When the zinc protoporphyrin level is used to assess the lead in the blood level, the analytical accuracy of the ZPP and the PbB determinations should be known. Also the variability of lead exposure over time is an important parameter of this assessment. The absolute and relative precision of ZPP measurements with two brands of ZPP meters (AVIV and ESA) were compared. The absolute precision of the ZPP measurements is not constant for the AVIV meter, but is constant for the ESA meter. The relative precision for both brands of meters decreases with increasing ZPP levels. Between the AVIV and the ESA meters, a significant difference in response, irrespective of the kind of anticoagulant used, was observed. The regression equations between PbB and ZPP levels were studied. Different factors can affect the relationship between PbB and ZPP, e.g. variability in lead exposure, the time-lag between the increase of PbB and ZPP, and the precision and accuracy of PbB and ZPP measurements. PMID- 3679559 TI - Lack of IgA antibody response in secretions of rat dams during long-term ovalbumin feeding. Induction of systemic tolerance in pups but not in adult rats. AB - Antigen uptake, serum and secretory immune response was studied in rat dams fed pellets substituted with ovalbumin during three consecutive pregnancies and lactation periods. The concentration of ovalbumin was somewhat higher in milk than in serum, and both serum and milk concentrations showed a parallel decrease with feeding time. IgA antibodies did not develop in the milk during the 7-month feeding period and no antibody response could be detected in saliva or bile. By the time of the first lactation about half of the dams had developed low titres of IgG antibodies in serum and milk and the number of IgG responders, as well as the mean antibody titre, increased with each lactation. Also when injected directly into the Peyer's patches ovalbumin induced solely IgG antibodies in the milk, while immunization with ferritin in addition resulted in both IgA and IgM antibodies in the milk against ferritin. The presence or absence of immunological tolerance to ovalbumin was examined in three groups of rats: (1) dams which had been fed ovalbumin-substituted pellets for one pregnancy and the first 14 days of the lactation period, i.e. for approximately 5 weeks altogether; (2) pups that were born by and kept together with these mothers, and (3) pups that were born by and kept together with mothers that were fed ovalbumin-substituted pellets during the pregnancy and until weaning at day 21 (altogether for 6 weeks). The rat dams in group 1 were not tolerant to a subcutaneous injection of ovalbumin 4 weeks after the termination of feeding with ovalbumin-substituted food.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679560 TI - Characterization of the main IgE-binding components of cat dander. AB - Cat dander extract (CDE) was fractionated by preparative isoelectric focusing (pIEF). All the fractions showed allergenic activity, but the most acidic ones (pH range 3.3-4.3) had the highest specific activity. These fractions also had the highest cat allergen 1 content and a partial antigenic identity as determined by fused rocket immunoelectrophoresis. Immunoblotting of the pIEF fractions and the crude CDE after analytical IEF showed the presence of native proteins with IgE-binding ability all along the pH range 3.3-6.2. However, when the IgE immunoprecipitated components of the most acidic pIEF fractions were focused in the presence of urea, a neat band was found at pH 3.9. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting of CDE proved the presence of, at least, 9 polypeptides with affinity to IgE, those with molecular weights of 18,000 and 22,000 daltons being the most active ones. These polypeptides presumably belong to cat allergen 1 since they were found in the most acidic pIEF fractions as well as in the crossed immunoelectrophoresis arc corresponding to this allergen. Furthermore, we found a group of active proteins with molecular weights of 10,000, 22,000, 25,000, 50,000 and 65,000 daltons (cat albumin) and with isoelectric points between 3.3 and 6.2. PMID- 3679561 TI - Hydrocortisone both decreases the up-regulation of complement receptors CR1 and CR3 and the ingestion process of human granulocytes. AB - We have studied the effect of hydrocortisone on the complement receptor expression (CR1 and CR3) of human granulocytes during the up-regulation phase and the following stable period when exposed to N-formyl-methionyl-leucyl phenylalanine (fMLP) or the medium alone at 37 degrees C. The receptor expression was also correlated to the C3bi-mediated phagocytosis with special reference to attachment and ingestion. The results showed that after incubation with fMLP the increased expression of CR1 and CR3 is accompanied by an increased ingestion, but not attachment, of complement-opsonized yeast particles. This increase was significantly lower with regard both to attachment and ingestion, as well as receptor expression if hydrocortisone was present during the up-regulation phase. However, the addition of hydrocortisone after the up-regulation of fMLP-treated granulocytes decreased the ingestion of particles but not the CR1 and CR3 expression. The results indicate a membrane effect of hydrocortisone that affects both the receptor mobilization and ingestion mechanism of the phagocytes. PMID- 3679562 TI - Functional heterogeneity among cytotoxic clones derived from natural killer cells. AB - Clones were obtained from highly purified populations of human peripheral blood natural killer (NK) cells propagated in the presence of interleukin-2 and phytohaemagglutinin. Almost all clones were cytotoxic against standard NK targets and many were also able to kill the B lymphoblastoid cell line BSM. This latter property was not necessarily a result of the incorporation of this cell line into the feeder mixture used to derive the clones. In most cloning experiments there was a high degree of concordance between the killing of the NK targets K562 and Molt 4 by panels of clones. In some cases this extended to the killing of BSM targets but in other instances there was no relationship or even an inverse correlation between killing of BSM and other targets. In a single cloning experiment there was no relationship between killing of BSM and Raji targets. In some cases a panel of clones could be divided into two or more distinct groups based on their differential activity towards BSM and K562. Such differences were not solely due to inter-donor variation. These findings were extended by cold target inhibition experiments in which at least three types of clone were identified. In one group of clones, which was nonreactive towards BSM, cold BSM significantly enhanced the killing of K562 in a dose-dependent fashion. These experiments provide evidence for a limited degree of functional heterogeneity among clones derived from human peripheral blood NK cells. PMID- 3679563 TI - Age-dependent bone marrow mast cell maturation in specific pathogen-free rats. AB - In the present study we have investigated an age-dependent mast cell increase. The mast cell numbers in bone marrow from (BN x Wi/Fu)F1 rats were determined using Alcian blue staining of cells in solution. From the 6th to the 19th week of age the number of mast cells in the bone marrow increased 6-fold with a marked peak around the 12th week of age. This increase in mast cell numbers was accompanied with increased histamine levels. Immunization increased the numbers further, also when the age-dependent mast cell increase was corrected for. The results should be considered in relation to previous studies revealing increased mast cell numbers in the bone marrow after immunization and also increasing numbers in the lungs of rats immunized with protein antigens or exposed to environmental antigens. PMID- 3679564 TI - Application of the first international standard of Dermatophagoides pteronyssinus (house dust mite) in the evaluation of allergen extracts produced from two different source materials. AB - The first international standard (IS) of the house dust mite Dermatophagoides pteronyssinus was used to compare side-by-side two allergen extracts prepared from two different house dust mite sources, namely whole mite cultures (WMC) and purified mite bodies (PMB), by employing several biochemical and immunochemical methods. In most methods employed, IS and WMC resembled more to each other than to PMB. These similarities comprehend protein contents, protein patterns, antigen and allergen patterns as well as total in vitro activity obtained in RAST inhibition (RI). The differences between WMC and PMB could be reproduced in different batches. Standardization in relation to IS of D. pteronyssinus yields activity ratios ranging from 2.4 to 70.1 between WMC and PMB depending on the variation of RI employed, indicating quantitative differences between the two preparations. When coupled to BrCN activated paper disks and employed in direct RAST, both preparations yielded almost identical binding values of specific IgE. Also in skin prick test, WMC and PMB produced very similar results in 12 mite allergic patients. It was not possible to differentiate between the two preparations when used in concentrations which are usually employed for diagnostic purposes. These findings demonstrate the diversity of allergens in mite extracts derived from different sources and reveal the problems which are involved with the use of the WHO D. pteronyssinus IS. PMID- 3679565 TI - Induction of photoallergy in guinea-pigs by injection of photoallergen-protein conjugates. AB - Photoconjugates were prepared by ultraviolet irradiation of guinea-pig albumin (GPA) with the photoallergens tetrachlorosalicylanilide (T4CS) and fentichlor. Injections of T4CS-GPA induced photoallergy to T4CS in 11 of 12 guinea-pigs whereas injections of fentichlor-GPA induced photoallergy in 5 of 12 guinea-pigs. Thus the fentichlor-GPA photoconjugate, which contained a molar ratio of hapten to protein 3 times higher than the corresponding T4CS conjugate, produced a significantly lower response. The results demonstrate the importance of protein conjugate formation in the induction of photoallergy, i.e. the role of carrier protein in contact sensitivity. The high potency of the T4CS-GPA photoconjugate in inducing photoallergy suggests that albumin may have a special role as a carrier protein in T4CS photoallergy. PMID- 3679566 TI - Mediators of C5a-induced bronchoconstriction in the guinea pig. AB - The effect of intravenous injection of C5a on pulmonary resistance and dynamic lung compliance was determined in anesthetized, artificially respirated guinea pigs. A mixture of C5a plus C5ades arg was purified from yeast-activated guinea pig serum and is referred to as C5a. Intravenous injection of C5a caused a dose related bronchoconstriction as evidenced by a decrease in compliance and increase in resistance. Conversion of the C5a in the mixture to C5ades arg by carboxypeptidase B digestion did not significantly alter the magnitude of the bronchoconstriction. Pharmacological antagonists were employed to determine if histamine, acetylcholine or products of the arachidonate metabolism were mediators of C5a-induced bronchoconstriction. The histamine H1 antagonist pyrilamine inhibited the C5a-induced bronchoconstriction, suggesting the involvement of histamine. The cholinergic receptor antagonist atropine in combination with pyrilamine caused an inhibition of the C5a-induced increase in resistance but not compliance, suggesting acetylcholine does not play a major role in C5a-induced bronchoconstriction beyond its known role in participating in histamine-induced bronchoconstriction. Involvement of arachidonate metabolites was suggested by the ability of the cyclooxygenase inhibitor, indomethacin, to prevent the C5a-induced bronchoconstriction. Because indomethacin also caused a delay in the leukotriene C4 (LTC4)-induced bronchoconstriction, the participation of peptidoleukotrienes in the C5a-induced bronchoconstriction could not be ruled out. The leukotriene antagonists FPL 55712 and L-649,923 were evaluated for their specificity in inhibiting LTC4-induced bronchoconstriction. FPL 55712 was nonselective since it inhibited prostaglandin D2 and histamine-induced bronchoconstriction as well as LTC4-induced bronchoconstriction. L-649,923 inhibited only the LTC4-induced bronchoconstriction and was without effect on the C5a-induced bronchoconstriction, suggesting that peptidoleukotrienes are not important mediators of C5a-induced bronchoconstriction. Using radioimmunoassay, the change in peptidoleukotriene levels detected in plasma during C5a-induced bronchoconstriction was not significantly different from 0. Thus, these studies have quantitated the C5a-induced decrease in dynamic lung compliance and increase in pulmonary resistance and suggest that histamine and cyclooxygenase products, but not peptidoleukotrienes, play a major role in C5a-induced bronchoconstriction. PMID- 3679567 TI - Circulating basophil counts in atopic individuals. AB - Absolute numbers of circulating basophils were measured in 55 atopic and 35 non atopic individuals, using a flow cytometer for automated cell counting. They were significantly elevated in the atopic group (p less than 0.001), but the total leucocyte count was not significantly different between the two groups. Eosinophil counts, which correlated with the number of basophils for both populations, were also significantly raised in the atopic group (p less than 0.001). Individual variation in absolute basophil counts was not detected in sequential samples taken at daily intervals over 5 days, in 5 atopics and 4 non atopics. In addition, no significant variation was detected in 6 atopics and 5 non-atopics over a period of up to 20 months. PMID- 3679568 TI - Treatment of metabolic alkalosis in renal failure. PMID- 3679569 TI - Profile of the uremic neutrophil. PMID- 3679570 TI - Plasma volume changes induced by sequential ultrafiltration-hemodialysis and sequential hemodialysis-ultrafiltration. AB - Isolated ultrafiltration (UF) has been shown to preserve plasma volume (PV) by means of a high plasma refilling rate, mediated by a rapid rise in oncotic pressure. This mechanism contributes to the good tolerance of sequential ultrafiltration-hemodialysis (SUH). This study compared PV changes induced by SUH and sequential hemodialysis-ultrafiltration (SHU). Seven dialysis patients underwent two sets of SUH and SHU, in which 2 h of UF (approximately equal to 3L) respectively preceded or followed 2 h of no-weight-change hemodialysis (ISO HD). VEM (volume of extravascular mobilization), VEM/VUF (percent of plasma refilling rate) and delta PV were calculated by mathematical formulas. Results showed: 1) a high VEM/VUF during the UF period, either before or after ISO HD: 80 and 77% respectively; 2) a significant increase in PV during ISO HD after UF, compared to ISO HD before UF: + 229 ml and + 43 ml, P less than 0.05; 3) VEM/VUF significantly higher during SUH than during SHU: 87 and 80%, P less than 0.01. In conclusion, the decrease in PV was lower in SUH than in SHU (11 vs. 19%, P less than 0.001) because the plasma refilling persisted through the ISO HD period. PMID- 3679571 TI - Unusual presentation of candida albicans peritonitis in continuous ambulatory peritoneal dialysis. PMID- 3679572 TI - Preserved respiratory and phagocytic functions of phagocytes exposed to flat sheet plasmapheresis equipment. AB - Monocytes and polymorphonuclear leukocytes (PMN) were tested for functional integrity after exposure to flat sheet plasmapheresis equipment. Purified PMN were tested for chemiluminescence activity in response to a variety of triggers of the respiratory burst. Monocytes were assessed for their capacity to ingest erythrocytes sensitized with varying amounts of IgG antibodies. Both assays were demonstrated to be sensitive hallmarks of functional modulation. However, no functional differences were noted between phagocytes from blood collected prior to pheresis and those exposed to flat sheet plasmapheresis cylinders. These data suggest that plasmapheresis with the Autopheresis C system does not influence the respiratory and phagocytic function of phagocytes returned back to the donor and implies that contact of phagocytes with artificial surfaces and/or their exposure to surface-activated plasma factors generated in the collection cylinder are minimal when using this plasmapheresis method. PMID- 3679573 TI - Single donor plasma in therapeutic plasma exchange for myasthenia gravis. AB - Thirty-seven myasthenic patients were treated with therapeutic plasma exchange (TPE) on different performance schedules using either random or single donor plasma. The two schedules had the same effects in terms of efficacy but single donor replacement gave significantly less side effects in the short and long term. A two exchange procedure on alternate days associated with immunosuppression seems to be an optimal schedule for the treatment of myasthenic patients. A single donor two-exchange on alternate days procedure appears to be safe, useful and can be repeated in patients who need frequent TPE. PMID- 3679574 TI - Plasma-exchange in idiopathic radiculopolyneuropathies: a study in 62 patients. AB - The effectiveness of plasma exchange (PE) in the treatment of acute and chronic idiopathic radioculopolyneuropathies (IR) is discussed on the basis of the literature and personal data. Results of controlled trials by Swedish, French and North American groups are favourable to the use of PE in acute forms, whereas one English group found no significant differences between treated patients and controls. Dick et al. (1986) reported significant improvement also in patients with chronic forms after PE. Personal data from a non-controlled series of 62 acute and chronic IR and from a trial group of 12 acute patients and 12 controls indicated that PE--though helpful in Guillain-Barre syndrome--was not so useful in chronic forms. PMID- 3679576 TI - An elastic force-length relation for tympanic membrane implants--a preliminary report. AB - An elastic force-length relation has been recorded for tympanic membrane implants. A model based on the fibre structure of these materials was used to obtain a value for their elastic modulus for tympanic membrane. PMID- 3679575 TI - Hemodynamic tolerance and plasma volume variations during plasma exchange. Replacement fluid: albumin alone or albumin plus gelatin? AB - Little is known about mechanisms of systemic hypotension frequently reported during plasma exchange (PE). Type of substitution fluids may interfere with hemodynamic tolerance. In a prospective study, right heart catheterization was performed during 18 PE by filtration with isovolumic substitution. Blood volume was measured with 51Cr tagged erythrocytes and plasma volume (PV) calculated from hematocrit. Substitution fluids were either albumin (A; n = 9) or A + gelatin (A + G; n = 9). In both groups, PE induces significant (p less than 0.01) decreases of mean arterial pressure: group A: - 21 +/- 14%; group A + G: - 23 +/- 15%; of pulmonary wedge pressure: group A: - 41 +/- 33%; group A + G: - 36 +/- 22%; of cardiac index: group A: - 38 +/- 18%; group A + G: - 25 +/- 15%. Plasma volume also decreases after PE: group A: - 13.5 +/- 4%; group A + G: - 18.5 +/- 4%. None of the variations are significantly different between the two groups. So we think that substitution with albumin alone has no advantage for hemodynamic tolerance. PMID- 3679577 TI - A stochastic compartmental model of bone cells. AB - Cellular dynamics play an important role in bone remodelling. The mesenchymal cells, osteoclasts, osteoblasts and osteocytes are the four types of bone cells, which mediate bone remodelling involving bone formation and resorption throughout the human life-span. A stochastic compartmental model of bone cells is formulated in the present analysis assuming these four types of cells to be in four distinct compartments. The cumulant generating function is first derived using the transition parameters for intercompartmental diffusion. Equations for the mean, variance and covariance for the number density of these cells are then derived from the partial differential equation for the cumulant generating function. The simulation results are consistent with previous experimental observations. PMID- 3679578 TI - Computerized home telemetry of maternal blood pressure in hypertensive pregnancy. AB - We have developed a telemetric technique whereby maternal blood pressure, which is self-measured by pregnant women in their own homes using a Dinamap 1846 automated blood pressure recorder, can then be transmitted over the commercial telephone network into the Rosie Maternity Hospital in Cambridge, where it is computer-processed. The maternal blood pressure is then reviewed by the obstetrician as part of the clinical management protocol. We have used this telemetric technique on 90 occasions, from the homes of 10 pregnant hypertensive women. On almost every occasion, the blood pressure measured at home was lower than that previously measured in the hospital antenatal clinic. This technique offers great promise, both in terms of health economics and also in terms of reducing pregnant women's unhappiness about their being admitted to hospital whenever they exhibit moderate to severe hypertension in the antenatal clinic. Indeed, in the antenatal period, home telemetry should allow the vast majority of hypertensive pregnancies to be managed just as safely at home as in hospital. In the management of high risk pregnancy, home telemetry of maternal blood pressure complements three other home telemetric techniques which have already been described: fetal heart rate, maternal blood glucose and uterine contractions. PMID- 3679579 TI - Echocardiogram calculations for the dog using Lotus 123. AB - A microcomputer (IBM-PC or compatible) program using the spreadsheet program, Lotus 123 was developed to calculate the 95% confidence intervals for the normal canine echocardiographic dimensions. Other cardiac function parameters are also calculated, but confidence intervals have not been determined. PMID- 3679580 TI - Indocyanine green pharmacokinetics calculations using Lotus 123 spreadsheet. AB - Indocyanine green (ICG; Cardio Green, Hynson, Westcott & Dunning, Baltimore, MD) is a cholephilic dye that is commonly used as a liver function test. In order to obtain the pharmacokinetic values of ICG needed for liver function determinations, a linear and a log-linear regression must be done in addition to other calculations. Results can be obtained graphically, but are not as accurate as mathematical calculations. To obtain accurate results and expedite calculation time, a program was developed using the Lotus 123 spreadsheet program (Lotus 123, Lotus Development Corporation, Cambridge, MA) and an IBM compatible computer to do these calculations. PMID- 3679581 TI - Computational decompression models. AB - Early computational models for decompression are based on supersaturation assumptions for dissolved gases. Such models, and our understanding of decompression biophysics, have been extended in the past 20 years by analyses of phase separation of gases. Generally termed thermodynamic decompression (or phase equilibration), these studies postulate a continuous exchange of inert gas between tissues and nucleation sites (gas micropockets), consistent with many commonplace phenomena. Postulates lead to decompression schedules and transfer mechanisms that differ from their earlier predecessors. The precise physical and computational bases supporting both viewpoints are described and contrasted. PMID- 3679582 TI - Identification of precursor-product relationships in kinetic studies involving radiolabeled tracer molecules. AB - In radiotracer studies, the estimation of turnover time usually depends on the assumption of steady-state compartmental precursor-product (SCP) behaviour in the pools being studied. Deviation from SCP behaviour is currently measured from the extent of hysteresis, R, in an 'area plot': a plot of the time-integrated difference between precursor and product specific activities (spec. act.) against product spec. act. We propose two approaches to evaluating the statistical significance of apparent deviations from SCP behaviour in experimental data. The first constructs the sampling distribution of R. The second compares the variance in replicate data with the value of the objective function minimized in the least squares estimation of product turnover time. We show that this test closely approximates a variance ratio (F) test. Applied to [methyl-3H]choline and [14C]acetate tracer data from lung phospholipid pools in eupneic and hyperpneic rats, the analysis rejects SCP relationships between lamellar bodies and two subfractions of alveolar lavage material. PMID- 3679583 TI - The Menu Workbench: an automatic menu generator for bio-medical programs. AB - A program development tool, The Menu Workbench, is described and applied to the computer screen architecture, menu design, and program management of bio-medical programs. Prerequisites for the approach to these problems are presented. An intuitive screen menu system, developed for the program, Immuno-Ligand Analysis System (ILAS), is described in the text. Standardized screen layout and keyboard interaction is explained. The programming of this system of menus was automated with the program, Menu Workbench, in the Turbo PASCAL language in PCDOS, MSDOS and CP/M operating systems. Use of the Menu Workbench program in other bio medical applications is discussed. PMID- 3679584 TI - A standardised comment scheme for routine pulmonary function test results. AB - Observed values of ventilatory capacity, gas transfer and lung volumes in 840 patients were used to formulate a standardised scheme of descriptive comments. Response to bronchodilators was also defined. Absolute differences between measured and predicted values are used to identify normal and abnormal patterns of results, together with an overall pattern. The algorithms are suitable for computer use. The scheme has been in routine manual use for four years and can be used by any laboratory in which the necessary quality control standards are applied. PMID- 3679585 TI - A research tool for general practitioners. AB - In this paper a research tool for general practitioners is described, that will be used in a network of community-based primary care practices in order to collect the necessary data for research purpose. The research tool is coupled to a commercial information system for general practitioners. The research tool supports coding strongly. The way in which the research tool is designed is described and examples of the use of windowing techniques are given. PMID- 3679586 TI - Automation of the patient history--evaluation of ergonomic aspects. AB - In this study it was investigated in quantitative terms how patient reactions were on automated history-taking. The study is part of a comprehensive project, in which also physicians participated in the validation of such computerized medical records. In total 99 patients, visiting the outpatient clinic of Internal Medicine for the first time, took part in this in-depth study, in which they could express themselves via an interactive and modified terminal and keyboard. The questionnaire that was used in the system contains 28 different screens. Patient complaints are entered together with data on frequency, severity, onset, and duration. The patient may indicate his physical complaints on a stylized picture of the human body. Of the 99 patients, 67 answered the full questionnaire, and another 16 the main part. On the average, 66 min were needed. Younger patients do complete the history in a significantly shorter time than older patients, resulting in relatively more completed histories for the younger group. Quick patients answered on the average 3.5 questions per minute, the slow patients only 2.5. This was strongly correlated with patient familiarization, that has also been investigated: patients who had a quick familiarization were able to finish within 50 min. Patients who needed no help at all in using the system had even answering rates of 3.9/min. PMID- 3679587 TI - Influence of pregnancy and lactation on serum and breast fluid estrogen levels: implications for breast cancer risk. AB - We investigated estrogen (estrone and estradiol) levels in serum and in nipple aspirates of breast fluid in relation to reproductive and menopausal characteristics in 104 normal women. In general, breast fluid and serum estrogen levels were not correlated and breast fluid estrogen levels were approximately 5 to 45 times higher than serum levels. Serum estrogen levels were lower in post menopausal than in pre-menopausal women. In contrast, breast fluid estrogen levels were approximately the same in pre- and post-menopausal women. Breast fluid estrogen mean levels were lower in pre-menopausal parous women than in nulligravidous or nulliparous women whereas serum estrogen levels did not differ in these 3 groups. Breast fluid estrogen levels were positively correlated with months since last birth or since last breast-feeding. Estrogen levels were low in nipple aspirates of breast milk but gradually increased in breast fluid of non lactating women over a period of several years after cessation of lactation. Serum estrogen levels did not increase with months since last breast-feeding. We were unable to evaluate the post-partum effect of pregnancy without lactation due to the small numbers of these subjects. The high concentrations of estrogen in breast fluid and the absence of a relationship to serum estrogen levels may explain why prior serum studies have failed to link variations in serum estrogens with breast cancer risk. The prolonged low levels of breast fluid estrogens following full-term birth and lactation may, in part, provide a mechanism by which parity reduces breast cancer risk. PMID- 3679588 TI - Interferon treatment of human genital papillomavirus infection: importance of viral type. AB - Eighteen women and 6 of their male sexual partners with lower genital tract infections caused by various human papillomavirus (HPV) types were treated with systemic or topical interferon (IFN) application. All patients with vulvar or penile lesions had a history of podophyllin or surgical treatment. In the female group, 9 patients showed complete response, 8 patients partial response and 1 patient no response. In the male patients complete response was seen in all patients. The response rate appears to depend on the HPV type present. Women with an HPV 16/18 infection showed a lower response rate to IFN treatment (complete response in 5 out of 14 patients), whereas lesions caused by HPV 6(11) showed complete response in all 4 cases. During follow-up examinations (mean 7.5 months) no recurrence of disease was observed. Systemic treatment showed tolerable and temporary side-effects. Topical treatment yielded identical efficacy and no side effects. PMID- 3679589 TI - A classification scheme for childhood cancer. AB - The International Agency for Research on Cancer (IARC) is sponsoring a worldwide study of childhood cancer incidence. Cancers in children are highly specific and differ in many ways from cancers found in adults. Data for the international study will be presented according to the classification scheme described below which has been devised specifically for use with paediatric cancers. The features of this scheme are: (1) it is based on the International Classification of Diseases for Oncology (ICD-O); (2) diagnostic groups are defined mainly in terms of morphology; (3) the common types of childhood cancer are individually specified; (4) certain other rare conditions of interest are distinguished; (5) it provides for flexibility of data presentation with respect to amount of detail; (6) all possible combinations of ICD-O morphology and topography codes are included; and (7) the maximum number of codes has been allocated to specific categories. There is a great need for standardization in the classification of childhood cancers and we propose that the scheme be used for presentation of incidence data for results of aetiological and other related studies of cancer in children. PMID- 3679590 TI - An estimate of the proportion of colo-rectal and stomach cancers which might be prevented by certain changes in dietary habits. AB - The colo-rectum and stomach are the 2 sites for which the role of diet in the etiology of cancer is most heavily implicated. Quantitative estimates as to the proportion of cancer deaths attributable to diet vary considerably. This may be partially due to the application of the concept of population attributable risk which has proved a useful yardstick in estimating the public health impact of completely removing an exposure factor under study. This simple concept may well serve in occupational epidemiology, but with more and more risk factors found on a metric scale, or at least characterized on an ordinal scale, extensions should be considered. In this report, a preventable proportion is defined as the excess risk which would be removed if the population exposure distribution were to change ina favorable direction. A simple way of modelling such changes is proposed. This new measure is illustrated with data from 6 case-control studies on colo-rectal or stomach cancer. The results indicate that the proportion of these cancers which may be prevented assuming arbitrary shifts of a single risk factor towards the next lower risk category if populations were to change their dietary habits is in the order of magnitude of 15% to 20%. This figure is much lower, but not necessarily in contradiction to the figures considered for the proportion of cancers attributable to diet. PMID- 3679591 TI - Alternative methods of selecting rat hepatocellular nodules resistant to 2 acetylaminofluorene. AB - Dietary 2-acetylaminofluorene (2-AAF) coupled with a stimulus for cell proliferation such as a 2/3 partial hepatectomy (PH) or a necrotizing dose of carbon tetrachloride is frequently employed to generate nodules of resistant ("initiated") rat hepatocytes. This regimen is a useful model for experimental analysis of alterations in hepatocytes during carcinogenesis, and also as an assay for initiation by various carcinogens. Because of the decreasing availability of carcinogen-containing diets from commercial sources, we have developed alternative methods of 2-AAF administration to generate nodules in rats initiated with N-nitrosodiethylamine. This study compared the nodule-selecting and cancer-promoting efficacy of 2-AAF administered by the Solt-Farber procedure (0.02% in diet for 2 weeks) with 2-AAF administered by gavage, as a suspension in 1% aqueous carboxymethyl-cellulose (CMC). Three or 4 daily administrations of 2 AAF by gavage (20 mg/kg/day) followed by PH on day 4 were equivalent to the dietary regimen in generating early resistant nodules, late persistent nodules and hepatocellular carcinomas. These regimens were similar to the dietary regimen of 2-AAF in inhibiting virtually all normal hepatocyte proliferation. These regimens permit control over the duration and level of 2-AAF exposure and the resulting size of selected nodules. PMID- 3679592 TI - Effects of ouabain on NIH/3T3 cells transformed with retroviral oncogenes and on human tumor cell lines. AB - Both murine and human cell lines transformed by the v-Ki-ras gene have been shown to be much more sensitive to the toxic effects of the cardiac glycoside ouabain than their respective controls. This differential toxicity has previously been used in the isolation of flat revertant clones from populations of Kirsten murine sarcoma virus transformed NIH/3T3 cells. Here, we have undertaken a further characterization of this phenomenon in murine and human tumor cells. Two different techniques, a 51Cr-release assay and a quantitative Crystal violet elution assay, have been employed to compare the sensitivities to ouabain of normal and v-Ki-ras-transformed NIH/3T3 cells. In each assay, ras-transformed NIH/3T3 cell lines displayed an increased sensitivity to ouabain as compared to the parental NIH/3T3 cell line, both in dose-response and in time-course experiments. In a separate study, ouabain was also able to inhibit the growth in semi-solid medium of 2 v-Ki-ras-transformed NIH/3T3 cell lines (DT and K-NIH) in a dose-dependent fashion. The same concentrations of ouabain were effective in both the 51Cr-release and Crystal violet assays. To address the question of whether increased sensitivity to ouabain is a specific result of transformation with the ras oncogene or is a common event which accompanies transformation by other oncogenes, we have screened a variety of transformed NIH/3T3 derivatives. All of these lines displayed an increased sensitivity to ouabain when compared to the parental NIH/3T3 cell line. PMID- 3679593 TI - Invasiveness, proliferative activity and ultrastructural phenotypes of hepatocytes from diethylnitrosamine-induced neoplastic nodules and hepacarcinomas in vitro. AB - The invasive behavior of hepatocytes from diethylnitrosamine (DENA) induced neoplastic nodules and hepatocarcinomas was studied in a confronting culture system in vitro. These observations confirm our previous report, demonstrating that hepatocytes from hepatocarcinomas and from neoplastic nodules invaded into embryonic chick precultured heart fragments (PHF), a property associated with malignancy (Mareel, 1979). We now further demonstrate that: (1) Invasiveness was expressed by the hepatocytes in 10 out of 12 samples from hepatocarcinomas, and in 13 out of 36 confronted nodular samples. The hepatocytes from the other two thirds of nodule samples died off in the confrontation as did all normal hepatocytes. (2) Invasive hepatocytes from tumors and from nodules showed the same arrangement of invasive liver cells in relation to the heart tissue, and the same ultrastructural phenotypes. The latter did not differ from those in the non invading subpopulations, with the exception perhaps of a higher proportion of cells with an indented nucleus. (3) None of the scored ultrastructural alterations was present in all the invasive cells, thus excluding any specific requisite in this respect. (4) When 3H-TdR was made continuously available to the cultures, starting at the time of confrontation between heart and liver tissues, unlabelled as well as labelled invasive hepatocytes were found inside the PHF in about equal proportions. It is concluded that nodular hepatocytes deviate from normality by at least 2 different properties that may or may not be related to each other and are revealed under in vitro conditions, namely the ability to survive and to proceed through S-phase and mitosis under such conditions and to actively invade precultured chick heart fragments. The latter property indicates that at least some of the nodules contain hepatocytes that have performed one step in malignant progression. PMID- 3679594 TI - Differential expression of collateral sensitivity or resistance to cisplatin in human bladder carcinoma cell lines pre-exposed in vitro to either X-irradiation or cisplatin. AB - Two sublines were derived from a human bladder carcinoma continuous cell line (RT112-P), one by exposure to fractionated X-irradiation (RT112-DXR8) and the other by continuous exposure to cisplatin (RT112-CP). RT112-DXR8 cells were 1.6- to 2-fold more sensitive to cisplatin and 2 analogues, carboplatin and iproplatin, compared with the parental line, whereas RT112-CP cells were 1.6- to 2.8-fold more resistant to these agents. Uptake of 195mcisplatin was elevated 1.4 fold in RT112-DXR8 cells compared with RT112-P cells whereas uptake into RT112-CP cells was similar to that of the parental line. Binding of 195mcisplatin to DNA was similar in all 3 lines. Levels of reduced glutathione were significantly elevated in RT112-CP cells and significantly reduced in RT112-DXR8 cells compared with the parental cells. In addition, activities of glutathione reductase and glutathione peroxidase were higher in RT112-CP cells than in the parental cells whereas the activity of glutathione-S-transferase was similar in all 3 cell lines. A 2.5-fold greater induction of DNA-DNA interstrand crosslinks occurred in RT112-DXR8 cells compared with the parental line, whereas crosslinking in RT112 CP cells, whilst initially similar to that seen in RT112-P cells, was significantly elevated at later times. These findings suggest that mechanisms associated with the expression of resistance and collateral sensitivity to cisplatin may differ. PMID- 3679595 TI - DNA cytometry and cytology by quantitative fluorescence image analysis in symptomatic bladder cancer patients. AB - A semi-automated quantitative fluorescence image analysis (QFIA) technique was developed with the Leitz TAS-Plus to detect bladder cancer using hyperploidy in urinary cells. Absolute nuclear fluorescence intensity (ANFI) (emission at 540 nm with excitation at 436 nm) of individual acridine-orange-stained cells was quantitated using (1) QFIA and (2) simple filter microspectrofluorophotometry (SFM). Both methods employed an internal phosphor particle standard which, when once calibrated against the DNA content of normal cells, obviates the necessity of routinely calibrating against normal cells in each sample. Results of SFM and QFIA were compared with routine Papanicolaou (Pap) cytopathology, using histopathology as the diagnostic standard in 272 samples from 67 symptomatic patients. The sensitivities for detecting low-grade transitional-cell carcinoma were 86% for SFM, 76% for QFIA, and 33% for Pap cytology. QFIA and SFM were significantly more sensitive at detecting bladder cancer than was Pap (0.01 greater than p greater than 0.001). Comparison of sensitivity obtained with bladder washings and urine samples showed that noninvasively obtained urines can be used. ANFI also detected recurrent and precancerous bladder lesions and kidney, ureter, and prostate lesions. This approach may prove generally useful in quantifying biochemical and immunological probes and should be broadly applicable as a research tool for studying the relationship of biochemical markers in the pathogenesis of disease and as a test for cancer control. PMID- 3679596 TI - Analysis of the chromosomal abnormalities of a woodchuck hepatocellular carcinoma derived cell line (WH257GE10). AB - The normal woodchuck karyotype was determined by the G-banding technique, and the chromosomal abnormalities of a woodchuck hepatocellular carcinoma-derived cell line (WH257GE10) were analyzed and compared with it. The normal woodchuck karyotype was 38,XY in a male, and 38,XX in a female. Autosomes were classified into 2 groups (A and B). Group A consisted of 13 pairs (1-13) of metacentric or sub-metacentric chromosomes, and group B consisted of 5 pairs (14-18) of telocentric or sub-telocentric ones. The X chromosome was sub-metacentric, and the Y chromosome was telocentric. In WH257GE10, the modal number was 36. Deletion of one of the chromosome 5 pair, of the chromosome 13 pair, and of the Y chromosome was observed. Two marker chromosomes (M1 and M2) were found. These markers showed the same G-banded patterns except for a small chromosome fragment at the distal part of the long arm of M1. The chromosome aberrations were very stable through successive passages in vitro. These findings suggest that the chromosomal abnormalities found in WH257GE10 might be associated with the pathogenesis of woodchuck hepatocellular carcinoma. PMID- 3679597 TI - The value of electrocardiography in patients with right ventricular endocardial pacemakers in the diagnosis of left ventricular hypertrophy: a correlative study of pace electrocardiography and left ventricular mass derived from M-mode echocardiography. AB - This study evaluated 51 patients with permanent apical right ventricular endocardial pacemakers. The assessment of the diagnostic value of pace electrocardiograms for the determination of left ventricular hypertrophy revealed specificity of 94% and sensitivity of 66%, applying a new parameter: RL1 + SV3 greater than or equal to 30 mm. The application of this criterion in the interpretation of pace electrocardiograms correlated well with values for the left ventricular mass derived from M-mode echocardiograms (r = 0.644, P less than 0.0001). PMID- 3679598 TI - The effect of the type A behaviour pattern on myocardial ischaemia during daily life. AB - Twenty-eight subjects completed 2 Type A questionnaires. Just under half the patients were considered Type A. Painful episodes of myocardial ischaemia occurred more frequently in Type A patients during a stressful period of ambulatory Holter monitoring compared to a later date. This difference could not be explained in terms of severity of disease or length of myocardial ischaemia. Rather it seemed to reflect increased reporting of somatic symptoms on the background of a greater sensitivity to environmental stress. Type A patients may thus present themselves earlier than their Type B peers. PMID- 3679599 TI - Differences in left ventricular function between anterior and inferior myocardial infarction of equivalent enzymatic size. AB - The reasons for the poorer prognosis of anterior versus inferior myocardial infarction of equivalent enzymatic size remain uncertain. We investigated whether there are differences in left ventricular function between patients with anterior and inferior infarctions of equivalent enzymatic size to account for their differing outcomes. Clinical, serum enzyme, and electrocardiographic data were prospectively recorded in a consecutive series of patients less than 70 years of age with their first myocardial infarction. At 29 +/- 6 days following infarction, ejection fraction and left ventricular wall motion were assessed by gated heart scintigraphy and functional capacity by treadmill exercise testing in 19 patients with anterior and in 23 patients with inferior myocardial infarction. Peak creatine kinase and QRS scores were used to estimate total infarct size and left ventricular infarct size respectively. The anterior infarcts were of similar size to the inferior infarcts as determined by peak creatine kinase (1444 [mean] +/- 1161 [SD] U/L versus 1484 [mean] +/- 1182 [SD] U/L, respectively, P = 0.91) and peak aspartate transaminases (174 +/- 112 U/L versus 164 +/- 102 U/L, P = 0.78). The anterior myocardial infarct group had a greater percentage of the left ventricle infarcted on QRS scoring than the inferior infarct group (25.9 +/- 14.4% versus 11.1 +/- 6.0% respectively, P = 0.0004), lower global left ventricular ejection fraction (45.8 +/- 16% versus 54.6 +/- 9.2%, P = 0.04) and greater left ventricular regional wall abnormality. A significant negative correlation existed between left ventricular ejection fraction and peak creatine kinase for both groups, but was more marked with anterior infarction (r = -0.78, P less than 0.01) compared with inferior infarction (r = -0.49, P less than 0.05). Exercise-induced ST segment elevation was more frequent in the anterior than the inferior infarct group (59% versus 18%, P less than 0.02). However, both infarct locations had similar exercise tolerance, exercise-induced angina and ST segment depression. Despite equivalence of infarct size of the two infarct locations on enzyme testing, anterior infarction was associated with greater abnormality of left ventricular function with lower resting global left ventricular ejection fraction; greater resting left ventricular regional wall abnormality and greater exercise-induced ST segment elevation. These differences probably contribute to the poorer prognosis of patients with anterior infarction compared to those with inferior infarction of equivalent enzymatic size, given the previously well-documented prognostic importance of left ventricular function. PMID- 3679600 TI - Outpatient pacemaker procedures. AB - Over a 46-month period 181 pacemaker procedures were performed from an outpatient practice. Patients were admitted, operated on and discharged all within a 24-hour period. There were no pacemaker emergencies, major complications or emergency readmissions. The outpatient approach to permanent pacemaker procedures was not limited by the type of pacemaker procedure, pacemaker dependence, patient age or sex. The feasibility and safety of outpatient procedures is demonstrated. PMID- 3679601 TI - Prevalence of systolic anterior motion of the mural (posterior) leaflet of the mitral valve in hypertrophic cardiomyopathy: an echocardiographic study. AB - Cross-sectional echocardiography was used to identify systolic anterior motion of the mural (posterior) leaflet of the mitral valve from a group of 53 patients with hypertrophic cardiomyopathy. This type of systolic anterior motion was identified in parasternal long axis, apical four-chamber and/or long-axis cross sections and was characterized by an elongation of the mural leaflet and an abnormal coaptation with the aortic (anterior) leaflet. At end-diastole, the aortic leaflet coapted at the basal or mid portion of the mural leaflet, leaving its distal "residual" segment in the left ventricle. Subsequently, during systole this "residual" segment approached or touched the ventricular septum. Systolic anterior motion of the mural leaflet was present in 6 (12%) of our patients with hypertrophic cardiomyopathy. Lengthening of the leaflet and an abnormal coaptation were associated with increased thickening of the posterior wall of the left ventricle and narrowing of the left ventricular outflow tract. All these elements contribute to the occurrence of systolic anterior motion and left ventricular tract obstruction. PMID- 3679602 TI - Heart failure and airway obstruction. AB - We investigated 60 patients with severe left-sided heart failure before and after cardiac recompensation. We observed that the cardiac insufficiency had a marked effect on dynamic ventilatory parameters. The "effort independent part" of the flow-volume curve was changed significantly by means of cardiac therapy. PMID- 3679603 TI - Myocardial function in alcoholic cardiac beriberi. AB - A case of alcoholic beriberi is described. Left ventricular systolic function as measured by the radionuclide ejection fraction showed an abnormal fall with exercise. Subsequent return to normal with the administration of thiamine suggests myocardial involvement in the condition. PMID- 3679604 TI - Congestive cardiomyopathy due to chronic tachycardia: resolution of cardiomyopathy with antiarrhythmic drugs. AB - A three-year-old child with arrhythmia-induced cardiomyopathy is presented. Drug treatment produced immediate symptomatic relief and subsequent reversion to normal cardiac size and function. This demonstrates that reduction of ventricular rate by drug treatment produces resolution of arrhythmia-induced cardiomyopathy and that surgical excision of atrial automatic focus is not always necessary. PMID- 3679605 TI - Cardiac tamponade following varicella. AB - An 18-month-old girl presented with cardiac tamponade five weeks after varicella. An emergency pericardiocentesis was performed and, subsequently, an anterior pericardiectomy. She eventually made a complete recovery following corticosteroid treatment. PMID- 3679606 TI - Unrecognized side effects of sublingual nitrate therapy. PMID- 3679607 TI - Oral mexiletine-theophylline interaction. PMID- 3679608 TI - Lipoprotein analysis in bodybuilders. AB - The use of anabolic steroids to augment athletic performance is widespread. It is known that these drugs can adversely affect lipoproteins in normal volunteers, leading to increased cholesterol and low density lipoprotein and depressed high density lipoprotein. It has been shown that endurance type exercise can lead to beneficial effects on lipoproteins but the effects of power exercise are less clear-cut and made more difficult to interpret by prior anabolic steroid use. This paper details the lipoprotein results in 24 subjects, eight sedentary controls, eight non-steroid and eight steroid using bodybuilders. The results revealed no significant difference between sedentary controls and non-steroid bodybuilders suggesting that this form of training does not cause beneficial effects on lipoproteins. However, the steroid-using groups had higher cholesterol and low density lipoprotein, with lower high density lipoprotein, high density lipoprotein2, high density lipoprotein3 and high density lipoprotein2/high density lipoprotein3 ratios compared to the other two groups. The long-term effects of such results may be an increased risk of atherosclerosis and requires long-term follow-up. PMID- 3679609 TI - Specific heart muscle disease in diabetes mellitus--a functional structural correlation. AB - We report the morphology of diabetic myocardium obtained by endomyocardial biopsy in 16 diabetics. The material was divided into three groups. The first comprised six patients with unexplained cardiomegaly and obscure congestive cardiac failure. The second group, also of six patients, had no cardiac signs and symptoms but exhibited abnormal systolic time intervals. The third group, of 4 patients, was without any cardiac symptoms or signs and had normal systolic time intervals. The vascular and extravascular changes observed were more pronounced in the symptomatic group, intermediate in the asymptomatic patients with abnormal intervals and least in those without symptoms and normal intervals. This provides supporting evidence for the existence of a specific primary myocardial disease in diabetes with good functional structural correlation. PMID- 3679610 TI - Percutaneous transluminal balloon pulmonary valvoplasty--long-term results. AB - Thirty-two patients with isolated valvar pulmonary stenosis (21 male; 11 female, age range 4 to 53 years, mean 14 years) underwent cardiac catheterization and balloon valvoplasty. Right ventricular systolic pressure before valvoplasty ranged from 65 to 210 mm Hg (mean 120.2 +/- 44.8 mm Hg). It fell to 24-200 mm Hg (mean 73.1 +/- 42.4 mm Hg) immediately after dilation. Peak systolic gradient across the pulmonary valve before valvoplasty ranged from 42 to 193 mm Hg (mean 98 +/- 45.3 mm Hg) and decreased significantly to 5 to 182 mm Hg (mean 52.7 +/- 43.1 mm Hg) immediately after dilation. At repeat cardiac catheterization in 21 patients 3 to 6 months after valvoplasty, a further significant fall of gradient was noted in 15 patients with no change in the remaining six patients. The right ventricular systolic pressure ranged from 30 to 100 mm Hg (mean 55.1 +/- 21.8 mm Hg) while the transpulmonary gradient varied from 12 to 84 mm Hg (mean 34 +/- 23.8 mm Hg). In the four patients evaluated 1 to 1 1/2 years after valvoplasty, the gradient further reduced in 2 patients and was unchanged in the remaining two patients. Patients with isolated valvar pulmonary stenosis can be adequately and safely treated with balloon valvoplasty, without recourse to surgery with excellent immediate and long-term results. PMID- 3679612 TI - Common arterial trunk associated with absence of one atrioventricular connexion. AB - An unusual case of common arterial trunk is described. The right pulmonary artery is supplied by the ascending trunk and the left pulmonary artery arises via an arterial duct from the left brachiocephalic trunk. Although common arterial trunk can exist with any atrioventricular connexion, the absence of one atrioventricular connexion (tricuspid atresia) is the other rarity of this case. PMID- 3679611 TI - Dynamic exercise echocardiography in children with congenital heart disease affecting the left heart. AB - Thirty-five children (male 22, female 13) with congenital heart disease resulting in volume and pressure overload of the left ventricle were investigated echocardiographically during supine bicycle exercise. The children had to follow a test-protocol with increasing workload. Left ventricular function parameters were measured from M-mode-echocardiography, electrocardiography and phonocardiograms before, during and after exercise and were expressed as fractional shortening (FS), velocity of circumferential fiber shortening (VcF) and the frequency corrected parameters: FScorr. = FS X 100/HR and VcFcorr. = VcF X 100/HR (HR = heart rate). The data of this group of children under study were compared to those obtained from 140 healthy children examined under similar conditions. In children with pressure overload, values for fractional shortening, velocity of circumferential fiber shortening and the frequency corrected parameters were significantly higher than in normals throughout exercise testing. In some children with moderate to severe aortic stenosis or coarctation the frequency corrected parameters showed a decrease at higher exercise levels instead of an increase as seen in the majority of cases. In these cases cardiac output was increased by an abnormal rise in heart rate. This was considered as a diminished left ventricular reserve. After aortic valve replacement in two cases with aortic stenosis, parameters of left ventricular function were still elevated at rest and during exercise testing. In two children with hypertrophic cardiomyopathy the almost maximally elevated rest values did not change during exercise. In children with mild volume overload (small ventricular septal defect or aortic incompetence) the left ventricular function parameters were within the normal range or slightly below. PMID- 3679613 TI - Prosthetic mitral valve mucormycosis caused by Mucor species. AB - We report, to the best of our knowledge the first case of prosthetic mitral valve mucormycosis caused by Mucor species in an 18-year-old female after mitral valve replacement. She was successfully treated with surgery and antifungal treatment. Mucormycosis was documented by direct demonstration, isolation and histopathological findings of the fungus from embolus and prosthetic mitral valve thrombus. PMID- 3679615 TI - Acute bacterial endocarditis in early infancy. PMID- 3679614 TI - Cerebellar infarction secondary to subclavian aortoplasty repair for coarctation of the aorta. AB - A five-year-old boy developed a left cerebellar infarction following repair of coarctation of the aorta by subclavian aortoplasty. At operation a large left vertebral artery had been ligated. If a large vertebral artery is encountered at repair of coarctation of the aorta then consideration should be given to a method of repair which does not sacrifice this vessel. PMID- 3679616 TI - Two centuries of hypnosis specialty journals. PMID- 3679617 TI - Factors affecting serum protein binding of phenytoin, diazepam and propranolol in acute renal diseases. AB - The effect of acute renal disease on the serum free fraction of phenytoin, diazepam and propranolol was examined in vitro among 37 patients with acute renal insufficiency of varying etiology and 10 healthy control subjects, men and women equally. The free fractions were separated at 37 degrees C using a pressure ultrafiltration method. The free fraction of phenytoin varied from about 14% to 45% and that of diazepam from 2% to 10%. The free fraction did not correlate significantly with either the serum urea or creatinine concentrations or the creatinine clearance within the acutely uremic group. The free fractions of propranolol varied considerably in the uremic patients but did not correlate significantly with the above parameters either. The mean free fractions of propranolol in the acutely uremics (11.9 +/- 1.0%, mean +/- SE) and controls (8.9 +/- 0.5%) did not differ significantly. The free fractions of both phenytoin and diazepam had a significant inverse correlation with the serum albumin level and that of propranolol with the alpha 1-acid glycoprotein (alpha, AGP) level. The correlations were similar irrespective of the etiology of renal failure. In practice, the variable best predicting the phenytoin and diazepam free fractions in acute renal insufficiency is the serum albumin concentration, and for propranolol the serum alpha 1-AGP concentration. PMID- 3679618 TI - Plasma protein binding of drugs and adjustment of their dosing regimen in patients with chronic renal failure. AB - The changes in plasma protein binding of drugs caused by chronic renal failure have been evaluated with respect to the calculation of their total plasma clearance. Theoretical analysis suggests that if the plasma protein binding of the drug is high and if it is excreted predominantly by the kidneys (e.g., cefoxitin, cloxacillin), negligible changes in the plasma protein binding caused by chronic uremia can be the source of a significant error in adjustment of its dosing regimen. A formula for the calculation of changes in total plasma clearance with respect to changes of their plasma protein binding has been recommended. PMID- 3679619 TI - Plasma lipid profile in verapamil-treated hypertensive patients. AB - Plasma lipid profiles were monitored for one year in hypertensive patients treated with verapamil. Elevations of triglyceride and very low density lipoprotein fractions were demonstrated in those patients already hyperlipidemic before commencement of verapamil. Caution may be necessary when giving verapamil to these hyperlipidemic patients. Further larger studies seem warranted. PMID- 3679620 TI - Pharmacokinetics of dextromethorphan and dextrorphan: a single dose comparison of three preparations in human volunteers. AB - We have carried out a single-dose comparison of three different dextromethorphan cough mixtures in 10 healthy human volunteers. Dextromethorphan was administered in a single dose of 60 mg in random order. The concentrations of dextromethorphan and its main metabolite, dextrorphan, were determined from the plasma samples using high performance liquid chromatography. The concentrations of dextrorphan were 170 times higher than the concentrations of dextromethorphan. No therapeutically significant differences were detected between the three preparations tested, and there were no great differences between the pharmacokinetic profiles of dextromethorphan and dextrorphan. The three test preparations were Resilar and Redol comp. (Remeda Pharmaceutical Co., Finland), and Extuson (Ferrosan Ab, Sweden). PMID- 3679621 TI - Comparative effects of verapamil, tiapamil, diltiazem and nifedipine on systemic and splanchnic hemodynamics in man. AB - The vasodilating effects of verapamil, tiapamil, diltiazem and nifedipine on splanchnic and systemic circulation have been investigated in 18 male normotensive subjects by means of the hepatic venous catheter technique, the thermodilution method and systolic time intervals. After a baseline period, calcium antagonists were administered by a primed-constant infusion. Hemodynamic changes were assessed after an adequate equilibration period. Verapamil did not change splanchnic or systemic hemodynamics. Tiapamil decreased diastolic blood pressure and systemic vascular resistance as well as splanchnic vascular resistance, and increased cardiac output. Diltiazem lowered only systolic blood pressure without effecting splanchnic circulation. The most pronounced vasodilating effect was seen with nifedipine. It significantly reduced systolic and diastolic blood pressure, systemic vascular resistance and also splanchnic vascular resistance. Our present data seem to indicate that nifedipine and tiapamil are more effective vasodilators, especially in the splanchnic vascular bed, as compared to verapamil and diltiazem. We conclude that these two calcium antagonists might be useful in the treatment of intestinal (splanchnic) vasoconstriction. PMID- 3679622 TI - Amiodarone treatment in cardiac preexcitation syndrome: use of signal averaged electrocardiogram. AB - Amiodarone effectiveness to prevent reentrant arrhythmia in Wolff-Parkinson-White (WPW) syndrome is well known. Authors tried to evaluate the results of long-term therapy in a group of 11 patients (mean age 39 +/- years) suffering from WPW syndrome. Before amiodarone treatment, a conventional ECG and a high resolution ECG (a new noninvasive technique) were performed in order to define Hisian activity. After 50 days of therapy (600 mg daily for the first week, 400 mg daily for the second week, 200 mg daily for 5 days in the following period), a second recording revealed the evidence a a lengthening of PR segment (p less than 0.05) and a disappearance of delta wave (1 patient) and arrhythmia. Before treatment, His deflection was defined only in 2 patients. After amiodarone therapy the H-V time was clearly evaluated in 9 patients. Probably the drug has induced a lengthening of AV node refractoriness and primarily an increase of accessory pathway refractoriness. PMID- 3679623 TI - Hemorrheological, micro- and macrocirculatory effects of naftidrofuryl in an acute study: a randomized, placebo-controlled, double-blind individual comparison. AB - In an intraindividual comparison, the effects of a single dose of 600 mg naftidrofuryl on the fluidity of blood, the conjunctival and transcutaneous partial pressure of oxygen and blood flow through the micro- and macrocirculation were compared with placebo, given in random order to a group of 10 women, apparently healthy apart from showing hemorrheological abnormalities. There were significant increases in erythrocyte deformability, conjunctival partial pressure of oxygen, mean blood flow in the common carotid and femoral arteries. All increases were significant compared to both the initial values and the data in the placebo group. The maximal effect was observed after 1.5 h (capillary erythrocyte velocity, blood flow in the common carotid artery) or 3 h (conjunctival partial pressure of oxygen, blood flow in the femoral artery). After 4.5 h all effects had disappeared. PMID- 3679624 TI - Comparative bioavailability study of two preparations of alpha-methyldopa after single, oral doses. AB - Bioavailability of alpha-methyldopa from a film coated tablet Dopegyt (EGIS Pharmaceutical Works, Budapest, Hungary) and from Aldometil (MSD, Sharp and Dohme GmbH, Munich, FRG) containing 250 mg of effective substance, was investigated in a crossover study in six patients with mild hypertension having normal renal and liver functions. Alpha-methyldopa was determined in plasma by fluorometry. There was no difference in the pharmacokinetic parameters calculated (Cl, Vd, AUC, t1/2) indicating that the two preparations are bioequivalent. PMID- 3679625 TI - Similarity of behavior within addict couples. Part I. Methodology and narcotics patterns. AB - The development and initial assessment of a methodology for measuring the similarity of behavioral patterns within addicted couples over the duration of a relationship is presented. Two subsamples of addicts from methadone maintenance programs in southern California were established: one of couples who had a real relationship during their addiction and treatment careers, and a group of pseudocouples (matched as closely as possible) created from unrelated clients in the same programs. Narcotics use, abstinence, and support patterns are analyzed for couples before, during, and after their relationship. When it occurs during the relationship, treatment effects are also analyzed. PMID- 3679626 TI - Abusers of alcohol and narcotics: who are they? AB - Problem drinking among addicts was studied by interviewing 781 narcotic addicts on entrance to treatment. Hierarchical multiple regression analysis (MRA) assessed the ability of 56 demographic, childhood, psychological, social, and drug history measures to predict abstinence, alcohol consumption among nonabstainers, and alcohol-related problems among heavy drinkers. MRA explained 33% of lifetime problem-drinking variance. Best predictors were traumatic events and hyperactivity in childhood, residential instability, psychopathology, and seriousness of drug problems. It was concluded that problem-drinking addicts may differ from other addicts in kind as well as in degree. The findings suggest that problem drinking in narcotic addicts may serve as a marker for some serious psychological problems, that drug treatment professionals therefore should be trained in alcohol abuse identification and treatment, and that psychiatric consultation for these addicts should be available. PMID- 3679627 TI - Perception of maternal behavior by elementary school children of alcoholic mothers. AB - Elementary-school-aged children of alcoholic mothers more often perceive their mothers to be using guilt as a means of psychological control and using lax disciplinary methods than similar children with nonalcoholic mothers. This outcome is discussed as a unique profile resulting from denial in the alcoholic family and the possible projection of guilt felt by the alcoholic mother. Implications for prevention programming and further areas for empirical investigation are suggested. PMID- 3679628 TI - Prevalence of smokeless tobacco use in Pitt County, North Carolina. AB - The purpose of this study was to estimate the prevalence of smokeless tobacco use in the largest tobacco-producing county in the United States. A 1-in-100 systematic random telephone sample was taken from the county telephone directory. A total of 280 complete questionnaires were obtained. Results indicate that .40 +/- .042 [p +/- SE(p)] males and .09 +/- .024 of females use smokeless tobacco. The point prevalence for the total population was estimated to be .15. PMID- 3679629 TI - Patterns of marijuana and alcohol use attitudes for Pennsylvania 11th graders. AB - For a 6-year period 30,000 11th graders in Pennsylvania public schools answered questions regarding their situational use of marijuana and the most popularly consumed beverage alcohol, beer. Comparing the item means for the survey responses between 1978 and 1983 supports other national data indicating a significant decline in the use of marijuana by high school students. A new finding is that 11th graders' willingness to drink beer with their friends has declined significantly, beginning in 1982, as has their willingness to drink and drive, beginning in about 1981. These changes may be related historically to the intensive public information and education efforts begun during the same time period. PMID- 3679630 TI - Weight gain associated with decreases in smoking rate and nicotine intake. AB - The mechanisms involved in the weight gain associated with smoking cessation are not well known. This study employed a single-subject design to investigate changes in weight following systematic reductions in smoking rate and cigarette nicotine content. Although there were no changes in the subject's caloric intake or physical activity, a weight gain of 3.6 kg was observed after 4 months of reduced rate and nicotine intake. These results suggest that weight change during smoking reduction and cessation may be primarily due to changes in factors other than caloric intake or activity. PMID- 3679631 TI - Smoking topography in a nonlaboratory environment. AB - The relationships between the number of cigarettes smoked/day and the number of puffs/cigarette, puff duration, and total puff time/cigarette were studied. Data were collected on 12 regular smokers for all cigarettes smoked over a 3-day period in a nonlaboratory environment. Between-subject variability was substantial on each of the topographical measures. Neither the number of cigarettes smoked per day nor the classification of Heavy (greater than 25 cigarettes/day) vs Moderate (less than 25 cigarettes/day) smoking levels was related to the intensity with which cigarettes were smoked. Within-subject consistency on the topography measures indicates that smokers may have relatively unique smoking patterns. PMID- 3679632 TI - The validity of methadone clients' self-reported drug use. AB - Drug use self-reports were compared with urinalysis for 248 clients in four methadone treatment programs. The validity of self-reporting based on urinalysis as a criterion depended on the type of drug examined. Opiate reporting was least valid, while benzodiazepine and cocaine reporting were moderately and highly valid, respectively. EMIT urinalysis was far more useful as a criterion of validity than TLC urinalysis. Self-reports helped identify drug users who were missed by urinalysis because of the latter's limited detection period, but urinalysis in turn detected an equal number of drug users missed by the interviews. The age of clients and the type of interviewer directly affected the rate of underreporting. Some respondents systematically denied disvalued behaviors (i.e., drug use and criminality), leading to a spurious correlation between these behaviors. This has important implications for future research. PMID- 3679633 TI - Collegiate alcohol/drug treatment programs in the United States. AB - A random sample of 400 U.S. colleges and universities provided data on the existence, type, structure, and philosophy of campus alcohol/drug treatment programs. Although many institutions reported service provision, a variety of approaches were described in the questionnaires. The results uncover important issues on administrative structure, licensure, treatment models, assessment procedures, and confidentiality. PMID- 3679634 TI - Toward a clear definition of inhalant abuse. AB - The study of the nature and extent of the use of volatile, psychoactive substances has been hampered by a confusing terminology. Widely disparate substances such as glue, gasoline, anesthetic gases, and nitrites have all been discussed under the single rubric of "inhalant abuse." A classification scheme is proposed which differentiates users of substances such as volatile hydrocarbons (gasoline, glue, etc.) from users of the anesthetic gases and of the amyl and butyl nitrites. Since users of these three types of volatile chemicals differ on predisposing factors, level of dysfunction, and consequences of use, the former group should be classed generically as "inhalant" users, while the latter should be diagnosed as users of a specific drug. PMID- 3679635 TI - An 8-year comparison of hospitalized veterans' attitudes toward smoking and smoking cessation. AB - A 48-item questionnaire designed to measure attitudes toward smoking and interest in smoking cessation treatment was administered to 73 male hospitalized veterans and compared with previous administrations of the same instrument 4 and 8 years earlier. A surprising degree of stability of responses over time was evident. The alarmingly high rate of smoking among hospitalized veterans was again confirmed by this survey. The present survey showed that 60% of the sample smoked, compared with 68% and 69% found in the previous surveys. Forty-five percent of the smokers surveyed reported that they would be willing to participate in a program designed to help them stop smoking. It was pointed out that the Veterans Administration has failed to adequately address the problem behavior of smoking. PMID- 3679636 TI - The efficacy of community-based smoking cessation strategies: a long-term follow up study. PMID- 3679637 TI - Cigarettes, respiratory rate, and the relaxation paradox. AB - Recent research indicates that individuals differ in their physiological reactions to nicotine, some showing strong increases in heart rate within 1 min of beginning to smoke and others showing little or no heart rate change with smoking. In the present research, monitoring of the respiratory rates of these two types of smokers before, during, and after smoking revealed that the former show an increase in respiratory rate while smoking, whereas the latter show a decrease. It is suggested that these changes in respiratory rate, a relatively easily monitored bodily function, may provide the cues used by smokers for inferring the effect that smoking has on them, that is, stimulating versus relaxing. PMID- 3679638 TI - Risk factors of drug impairment in random samples of physicians and medical students. AB - The prevalence of hypothesized risk factors of drug impairment is estimated and correlated with drug use in random samples of physicians and medical students. Substantial percentages of both physicians and medical students reported access to drugs, family histories of substance abuse, stress at work and home, emotional problems, and sensation seeking. Each of these factors correlated with drug use in physicians or medical students, and analysis suggested that in most cases the hypothesized risk factors were more likely to be causes rather than consequences of drug use. PMID- 3679639 TI - Skills enhancement to prevent substance abuse among American Indian adolescents. AB - Skills enhancement programs to prevent drug abuse have shown promise in tests with majority-culture adolescents. To date few applications of this preventive strategy have been evaluated with American Indian youth. A culturally tailored 10 session skills enhancement program was delivered in reservation and nonreservation settings in the Pacific North west. At 6-month follow-up, compared with test-only control condition subjects, intervention condition subjects had better knowledge of drug effects, better interpersonal skills for managing pressures to use drugs, and lower rates of alcohol, marijuana, and inhalant use. Intervention condition subjects were also less likely to label or consider themselves users of these substances. The findings suggest that behavioral skills training approaches hold promise for reducing substance use and abuse among American Indians. PMID- 3679640 TI - Changes in treatment-related concepts of illicit drug abusers related to time in treatment in two residential treatment programs. AB - This research investigated the effects of two residential drug treatment programs on changing the attitudes the residents had toward three treatment-related concepts over a 10-month time period. The semantic differential evaluative and potency scales of the concepts Therapeutic Community, Counselor, and Group Therapy were administered to the residents of these programs after they were residents for set periods of time. The results of this research showed that the residents rated the evaluative and potency scales of Group Therapy and Counselor higher the longer they remained in the program. PMID- 3679641 TI - Approval need in self-reports of addicts and family members. AB - Ample evidence documents the tendency of research subjects to attribute to themselves socially desirable traits and to deny having socially undesirable qualities. This tendency is particularly marked among subjects who are defensive, lacking in self-esteem, or sensitive to status differences. Drug addicts often have all of these characteristics. This paper examines the extent to which need for social approval is reflected in methadone patients' and family members' self reports of personal and family functioning. Results demonstrate the importance of taking the approval motive into account when conducting research with this population. Addicts tend to deny negative things about themselves and their families, while family members tend to exaggerate their own and their families' positive qualities. Implications for drug treatment programs and researchers are discussed. PMID- 3679642 TI - Model for the group treatment of eating disorders. PMID- 3679643 TI - Behaviour of testosterone, sex hormone binding globulin (SHBG), and cortisol before and after a triathlon competition. AB - To provide information on the duration of the regeneration phase after several hours of physical strain, venous blood samples of eight participants in a 1/4 triathlon competition were taken each day at the same time (arrival) for determinations of testosterone (T), SHBG, and cortisol (C). In addition, urea, creatinine, creatinine kinase, and the changes in plasma volume were determined. Directly after arrival, T had not changed substantially, but decreased nonsignificantly on each of the following days and obtained the lowest concentration on the 2nd day after the triathlon. T/SHBG as an expression of free testosterone was significantly reduced on the 2nd, 3rd, and 4th days after the competition. C increased up until the end of the competition by 4.5 times the original value, and during the subsequent days it decreased again to the normal range. Until the end of the observation period on the 4th day after the competition, urea was still significantly elevated. The data suggest an anabolic deficit lasting for several days as a result of prolonged physical strain. PMID- 3679644 TI - Effect of physical exercise on some parameters of immunity in conditioned sportsmen. AB - The studies were performed on 20 conditioned cyclists and 19 untrained men. At rest absolute and percent number of neutrophils, eosinophils, and monocytes, neutrophil bactericidal activity, and blood plasma beta-glucuronidase, acid phosphatase, and lactic dehydrogenase (LDH) activities were similar in sportsmen and untrained men, while neutrophil adherence was lowered in sportsmen. Maximal physical exercise induced significant rises in absolute numbers of neutrophils and monocytes in both groups. In sportsmen, adherence of neutrophils and monocytes and neutrophil bactericidal activity significantly decreased under the influence of exercise, while neutrophil phagocytic activity did not change. On the other hand, in untrained men, maximal physical exercise did not induce significant changes in neutrophil and monocyte adherence and bactericidal activity of neutrophils, but their phagocytic activity increased. Blood plasma beta-glucuronidase, acid phosphatase, and LDH activities increased during exercise in both groups. The changes observed tended to normalize during 2-h recovery. The results obtained suggest that intensive physical exercise tends to depress nonspecific immunity, which may render sportsmen more susceptible to infections. PMID- 3679645 TI - Metabolic changes during volleyball matches. AB - Urinary and/or serum concentrations of electrolytes (sodium, potassium, calcium, magnesium), hormones (aldosterone, cortisol, catecholamines), and metabolic parameters (lactate, glucose, free fatty acids) were determined during different volleyball matches. While [Na+]s was slightly increased-not exceeding the hemo concentration effect-[K+]s, and [Ca2+]s were diminished after the matches. Due to a lowered glomerular filtration rate (GFR), urinary excretion of water, sodium, and potassium was decreased. In addition, the tubular resorption and secretion of fluid and electrolytes was influenced by different hormones leading to a lowered [Na+]u and an increase of [K+]u after exercise. Low concentrations of lactate (2.54 +/- 1.21 mmol/l) during and after the matches and an increase of [FFA]s indicate that energy during the short exercise periods (9 s) is mainly supplied by a breakdown of creatine phosphate, while aerobic pathways restore the energy sources during the resting periods (12 s). Serum concentrations of aldosterone and cortisol as well as the excretion of adrenaline are enhanced on the same scale as after endurance sports. The excretion of noradrenaline corresponds to values during exercise of high intensity. PMID- 3679646 TI - Effects of electrical stimulation of different frequencies on the myonuclei and fiber size in human muscle. AB - Male physical education students were subjected to electrical stimulation for a period of 21 days. The stimulation was performed with alternating currents of rectangular wave form. Group I was stimulated with a frequency of 50 Hz, group II with a frequency of 2000 Hz. Before and after the experimental period, biopsies were taken from the m. gastrocnemius. The muscle fiber size and the number and size of nuclei was estimated at the light microscopic level using stereological methods. The fiber size was significantly increased only in group I. The nuclear number and the nuclear size increased significantly in both groups leading to a higher nuclear volume per unit tissue volume. It was assumed that the proliferation of nuclei is correlated to satellite cell proliferation resulting probably in hypertrophy or hyperplasia of electrostimulated skeletal muscle. PMID- 3679647 TI - Stereological analysis of capillaries in electrostimulated human muscles. AB - The effects of two methods of electrical stimulation on the capillary density in skeletal muscle was studied. Twenty-two male physical education students randomly divided into two groups participated in the experiment. Groups I and II were subjected to the procedure of electrical stimulation of m. triceps surae daily for a period of 21 days. Group I was stimulated by an alternating current of relatively low frequency (50 Hz), and group II was stimulated by an alternating current of relatively high frequency (2000 Hz). Biopsy specimens were obtained from the lateral portion of m. gastrocnemius 1 week before the stimulation and 1 day after the completion of the stimulation period. The capillary network was analyzed using morphometric and stereological techniques. Significant changes were found for capillary number in cross section, capillary density, intercapillary distance, tissue cylinder corresponding to one capillary (Krogh's cylinder) in both groups, and for capillary number-to-fiber area ratio in group I. Differences between the results of groups I and II were not significant in any cases. The changes observed speak in favor of an improved capillary supply to skeletal muscle after electrical stimulation. PMID- 3679648 TI - Bone mineral content and physical activity. AB - The purpose of this study was to estimate the effects of intense and regular physical activity on locomotor system modifications. Tennis, with its unilateral solicitations, allows a more precise examination of specific localized development. Ten professional tennis players were compared with sedentary age matched students. Muscular modifications were observed, mainly in the forearm circumference. The dominant side forearm circumference was 13% larger than the opposite side. Asymmetry was less in the upper arm and insignificant in the thorax and vertebra. Deep modifications in bone mineral content (BMC) were investigated by isotopic techniques, based on differential photon attenuation in bone and soft tissue of the forearm. Bone density was markedly increased in professional tennis players. Even in the nondominant side, radius BMC was 1.18 g HA/cm, 15% higher than in sedentary control students. The difference was yet larger in the dominant mid-radius, reaching 1.47 g HA/cm. The same differences were observed for the ulna and involved both cortical and trabecular bone. In the control group of sedentary students, no significant difference was noted between the two upper limbs. This study clearly demonstrates the positive correlation between exercise and bone mineralization. The precise mechanical constraints optimizing the favorable effect in the most efficient way should be studied. PMID- 3679649 TI - Acute effects of moderate exercise on plasma lipoprotein parameters. AB - The acute, transient effects of moderate exercise on plasma lipoprotein parameters were assessed in 12 healthy, normolipidemic male volunteers subjected to a 5.5-km run at a comfortable pace. The course was completed in 31.5 min (range 23-43 min) and elicited a significant increase in pulse rate and plasma lactate levels and a fall in diastolic blood pressure. Of the plasma lipid parameters, total phospholipid, apo B-associated phospholipid, plasma triglyceride, and free fatty acid levels increased substantially immediately after the run and, except for triglyceride, were still raised 2 h later. Lesser but also significant increases were also noted in high-density lipoprotein cholesterol (HDL-C), HDL3-C, and HDL-phospholipid concentrations after the run. The increase in HDL-phospholipid persisted for 2 h but the others returned to basal levels. Apolipoprotein Al, lecithin: cholesterol acyltransferase activity, total cholesterol, low-density lipoprotein-cholesterol, and the free cholesterol:cholesterol ester ratio remained essentially unaltered by exercise. The results were compatible with an increased secretion of triglyceride and phospholipid-rich VLDL, followed by the rapid clearance of the triglyceride moiety from the plasma and some redistribution of surface components to the HDL fraction. PMID- 3679650 TI - Long-term prognosis of conservatively treated acute knee ligament injuries in competitive and spare time sportsmen. AB - During the period 1975-1981, 221 persons were treated conservatively at Tampere University Central Hospital for an acute knee ligament injury. A total of 194 patients (88%) were reexamined 8 +/- 3 years after the injury. In the clinical and radiological results, there were no significant differences between competitive, spare time and non-sportsmen. However, the subjective and functional results were significantly better in competitive sportsmen than in the others. It was concluded that the amount of static knee instability and posttraumatic osteoarthritis depend much more on the seriousness of the primary ligament injury than on the muscle performance of the injured extremity, but by adequate thigh muscle rehabilitation the subjective and functional status of the injured knee can be significantly improved. Sports at the level of competitive activity seems to be an excellent means to achieve the best possible subjective and functional result after knee ligament injury. PMID- 3679651 TI - Metabolic and hormonal responses to long-distance swimming in cold water. AB - The acute effects of long-distance swimming in cold water on selected hormonal and metabolic variables were evaluated on 22 long-distance swimmers (16 males and 6 females) during a 32-km swimming competition (La Traversee Internationale du Lac St-Jean). The water temperature was 18.5 degrees C and the mean performance times were 8 h and 32 min for men (M) and 9 h and 1 min for women (F). The blood samples were withdrawn in the fasting state during the week preceding the event and within 30 min after completion of the race. A positive correlation was obtained, for both groups, between percent body fat and rectal temperature measured at the end of the competition. After the competition, an increase in plasma epinephrine, norepinephrine, cortisol, thyroxine, free fatty acids, lactate, a decrease in glucose and insulin and no change in growth hormone, triiodothyronine, triglycerides, and cholesterol concentrations were observed in both groups. The increase in plasma thyroxine was more pronounced in the slower swimmers while the change in blood cortisol concentrations was higher in the subjects having the most acute decrease in body temperature. Male and female swimmers have a similar metabolic and hormonal response to a long-distance swimming competition in cold water. PMID- 3679652 TI - The structure of habilitation. AB - Biographic, program and background variables traditionally employed in the habilitation program and accountability literature were assembled for 75 mentally handicapped adults who had completed a three year comprehensive program of training and up to three years of subsequent community placement. Factor analysis treatment yielded 12 input and 4 output factors, the nature of which suggests a greater role for cognitive and clinical variables in the overall structure of habilitation than has been supported by the habilitation services accountability literature to date. PMID- 3679653 TI - Styles of coping with handicap in mentally retarded adults. AB - Based on a conceptual analysis how mentally retarded adults experience their intellectual impairment four different styles of coping with the handicap were postulated. They could be demonstrated empirically from data of a standardized interview. The groups with different styles of coping also show difference in personality traits, in their social history, the level of independence in daily living and in psychosomatic complaints. The variables "norm orientation", "stigmatization" and "attention getting behavior" were used in a prediction analysis to characterize the coping styles in the following way: (1) the positive passive style is characterized by high norm orientation with little tendency to get attention, (2) the negative-passive style only by a high tendency to get attention, (3) the assertive style by low norm orientation together with high stigmatization and a low tendency to get attention, (4) the defensive style by low stigmatization and a low tendency to get attention. In addition to behavior oriented intervention in rehabilitation those cognitive processes should be considered, which contribute to the development of a mentally retarded person's coping style. PMID- 3679654 TI - Diagnostic validity of the McCarron-Dial System in neuropsychological rehabilitation assessment. AB - The purpose of this study was to investigate the diagnostic validity of a neuropsychologically-based vocational evaluation battery, the McCarron-Dial System (MDS), in differentiating between brain-damaged and non-brain-damaged rehabilitation clients. Multiple discriminant analysis results indicate that 89% of the subjects were correctly classified. The results tentatively support the validity of the MDS for neurobehavioral diagnosis. However, additional emotional and behavioral information may be needed to increase classification accuracy and to determine more specific diagnosis. Because of its long tradition in vocational rehabilitation and established strengths in predicting vocational and community adjustment outcomes, the MDS may be potentially useful for both vocational and clinical neuropsychological assessment. PMID- 3679655 TI - Rehabilitation of hemiplegic amputees. AB - The authors report on results of rehabilitation of their 49 hemiplegic amputee cases. Most of the patients had vascular disease. A majority of them had also other conditions with negative effects on rehabilitation. 29 patients achieved walking, 14 used a wheelchair, three remained bedridden and another three died during the hospitalization. The influence of different factors on mobility has been studied. Below-knee amputation had significant effect on mobility, and the time interval between amputation and hemiplegia was also of importance. Other correlations need further studies and more experience. PMID- 3679656 TI - Home-based learning programmes for mentally handicapped people in rural areas of Zimbabwe. AB - This paper describes the operation of a community-based rehabilitation programme specifically for mentally handicapped children and young adults living with their families in rural areas of Zimbabwe. Details are given of the clients enrolled in the programme and the teaching goals used with them. Evaluation data on the programme's effectiveness is also presented. Three features are identified as being central to the programme's success, 1) partnership with existing agencies in the area, 2) the training and monitoring that is provided by specialist staff in mental handicap, and 3) the provision of resource materials -- forms, cards, videos -- which are tailored to the cultural, linguistic and literacy needs of the recipients. The efficient use of specialist staff is highlighted as are future areas for research and development. PMID- 3679657 TI - Trends and issues in juvenile confinement for psychiatric and chemical dependency treatment. PMID- 3679658 TI - Juvenile and family mental health law. PMID- 3679659 TI - Law and random events: the state of child mental health policy. PMID- 3679660 TI - Severe reactional state in lepromatous leprosy simulating Sweet's syndrome. AB - A male patient with underlying lepromatous leprosy mimicked Sweet's syndrome clinically. He was believed to be in an atypical reactional state recognized as a variant form of erythema nodosum leprosum. In addition to the antileprosy treatment, steroid hormone was required to control the systemic symptoms. PMID- 3679661 TI - Shoe contact dermatitis. AB - In the context of contact dermatitis of a none professional character, the shoe allergic contact dermatitis has been mentioned in the literature for many years, in spite of not being frequent. During the last 15 years, our Department of Dermatology has accumulated a certain experience (225 cases) of this. The results have shown that the incriminated allergens have changed during this time. PMID- 3679662 TI - Periumbilical perforating pseudoxanthoma elasticum. PMID- 3679663 TI - White piedra. PMID- 3679665 TI - The management of pyodermas. AB - With the rising cost of medical services, it was decided to reassess the relevance of routine bacteriology investigations to the management of the individual patient with pyoderma. In both prospective and retrospective studies, it was found that laboratory reports were simply confirmatory and did not contribute to the management of the individual patient. A call is made for physicians to continuously look for cheaper ways of managing patients without necessarily causing any disservice to the patient. PMID- 3679664 TI - Improvement of chronic neurotic excoriations with oral doxepin therapy. AB - Two patients with 6- to 7-year histories of neurotic excoriations refractory to the usual dermatologic management were referred for evaluation. Both had symptoms and signs of depression associated with the onset and persistence of the skin condition. Doxepin, a tricyclic antidepressant therapy with potent antihistamine properties, was used in oral doses of 30-75 mg daily for our patients. This therapy resulted in symptomatic and clinical improvement in both patients within several weeks. This limited report of apparent benefit of doxepin in two patients with neurotic excoriations and depression offers a potential therapy in the management of this challenging clinical problem. PMID- 3679666 TI - Etretinate follow-up study. PMID- 3679667 TI - Hydroquinone. PMID- 3679668 TI - Effect of calcium chloride on the conformation of proteins. Thermodynamic studies of some model compounds. AB - Partial molar heat capacities (CP2 degrees) and volumes (V2 degrees) for some amino acids and peptides were measured in 1 M aqueous calcium chloride solutions at 298.15 degrees K using a Picker flow microcalorimeter and an oscillating-tube digital density meter. Using the data for these amino acids and peptides in water, the corresponding partial molar heat capacities of transfer (CP2,tr degree) and volumes (V2,tr degree) from water to 1 M aqueous calcium chloride were deduced. These thermodynamic parameters are significantly positive, indicating that strong interactions occur between the ions of calcium chloride and the charged centres of these amino acids and peptides. A comparison has been made with a similar transfer of these compounds to sodium chloride solutions. The thermodynamic parameters of the transfer of peptide group (-CONH) are much more positive in calcium chloride than in sodium chloride solutions. The implication of this result for the ability of calcium chloride to act as a stronger destabilizer of protein conformation is discussed. PMID- 3679669 TI - Mild, orthogonal solid-phase peptide synthesis: use of N alpha-dithiasuccinoyl (Dts) amino acids and N-(iso-propyldithio)carbonylproline, together with p alkoxybenzyl ester anchoring linkages. AB - Several N alpha-dithiasuccinoyl (Dts) amino acids (1) have been esterified without racemization by use of either N,N'-dicyclohexylcarbodiimide or 1-(3 dimethylamino-propyl)-3-ethylcarbodiimide hydrochloride, each in the presence of 4-dimethylaminopyridine (0.1 equiv.), to 2, 4, 5-trichlorophenyl 4' hydroxymethylphenoxyacetate (10) or the corresponding propionate (11). The resultant handle derivatives (8,9) were purified and then quantitatively attached onto aminomethyl supports by couplings using as solvent N,N-dimethylformamide containing 1-hydroxybenzotriazole (0.1 M). This methodology facilitates anchoring of Dts-amino acids as p-alkoxybenzyl esters, which can be cleaved in good yields by trifluoroacetic acid-dichloromethane (1:1) at 25 degrees. Model experiments established that quantitative thiolytic removal (greater than 99.8%) of the Dts group occurs with (i) beta-mercaptoethanol (0.5 M)-N,N-diisopropylethylamine (0.5 M) in dichloromethane, 2 X 2 min; (ii) N-methylmercaptoacetamide (0.5 M)-N methylmorpholine (0.5 M) in dichloromethane, 2 X 2 min; and (iii) N methylmercaptoacetamide (0.5 M)-1-hydroxybenzotriazole (0.1 M) in N,N dimethylformamide, 2 X 2 min. The susceptibility of the Dts functionality to nucleophiles was also defined, including demonstration of tertiary amine catalyzed hydantoin formation from Dts-dipeptidyl units, but side reactions from these processes are entirely avoided under appropriate conditions relevant to peptide synthesis. These observations were exploited to devise efficient, racemization-free solid-phase syntheses of a number of model peptides in high yields and purities, including L-leucyl-L-alanylglycyl-L-valine, H-Gly6-Val-OH, H Met-Ala-Gly-OH, methionine-enkephalin, and bradykinin. PMID- 3679670 TI - An acid-labile anchoring linkage for solid-phase synthesis of C-terminal peptide amides under mild conditions. AB - A series of polymer-supported benzylamides substituted with one to three alkoxy groups in the ring positions were prepared and shown to give carboxamides upon treatment with acid. Based on the initial screening, the bis(o-methoxy)-p alkoxybenzylamide anchoring linkage was selected for a detailed evaluation of its suitability for solid-phase synthesis of C-terminal peptide amides. The handle derivative 5-[(2' or 4')-Fmoc-aminomethyl-3',5'-dimethoxyphenoxy]valeric acid (1) was prepared in seven facile steps [purification of intermediates unnecessary; overall yield 15% for crystalline product, which is a mixture of positional isomers], and was quantitatively coupled onto amino group-containing supports by use of N,N'-dicyclohexylcarbodiimide plus 1-hydroxybenzotriazole in N,N dimethylformamide. Stepwise elaboration of peptide chains proceeded smoothly with both N alpha-9-fluorenyl-methyloxycarbonyl (Fmoc) and N alpha-dithiasuccinoyl (Dts) amino acids, and final cleavage of tert.-butyl side-chain protecting groups and of the anchoring linkage occurred readily in trifluoroacetic acid dichloromethane (7:3) at 25 degrees. The methodology was demonstrated by the syntheses of H-Trp-Asp-Met-Phe-NH2 (tetragastrin) and H-Tyr-Gly-Gly-Phe-Met-NH2 (methionine-enkephalinamide), both with high yields and purities. PMID- 3679671 TI - Structural identity of the subunits of pigeon liver malic enzyme. AB - Pigeon liver malic enzyme was found to have arginine, alanine, and tyrosine as the only N-terminal, N-1, and N-2 amino acids, respectively. Hydrolysis of the reduced and carboxymethylated malic enzyme by carboxypeptidase A yielded quantitative evidence for the following C-terminal sequence: -Leu-(Phe-Ala)-Ile Leu-COOH. Fifty-five trypsin-digested peptides were separated by HPLC, in accordance with the arginine and lysine contents of each subunit. This more direct structural evidence strongly supports the conclusion that pigeon liver malic enzyme is composed of four chemically identical subunits. PMID- 3679672 TI - Structure, solubility and reactivity of peptides. A conformational study of two protected key intermediates from a large-scale synthesis of thymosin alpha 1. AB - A conformational study of two protected peptide segments, (1-10 and 11-28), spanning the entire sequence of thymosin alpha 1, in solvents of different polarity and capability of forming hydrogen bonds, is reported. By using infrared absorption and circular dichroism techniques the occurrence of the random coil conformation, the self-associated beta-structure, and the alpha-helix (the latter adopted only by the longer peptide) was established. The self-associated species of the two peptide segments were disrupted either by adding increasing amounts of hexamethylphosphoramide or by dilution. This structural transition was monitored by the disappearance of the amide-I C = O stretching band of strongly intermolecularly hydrogen-bonded molecules (near 1630 cm-1) in the infrared absorption spectra. The tendency of these peptides to aggregate is paralleled by a decrease in their solubility. The conformational findings are discussed in terms of the solvent-dependent product yields obtained in the reaction of segment (1-10) with the N alpha-deprotected (11-28) segment to give the fully protected thymosin alpha 1. PMID- 3679673 TI - Synthesis, conformation, and biological activity of the carbohydrate-free vespulakinin 1. AB - Synthesis of the carbohydrate-free heptadecapeptide corresponding to the amino acid sequence of vespulakinin 1 was achieved by the continuous flow solid phase procedure on 4-hydroxymethyl-phenoxyacetyl-norleucyl derivatized Kieselguhr supported polydimethylacrylamide resin, as well as by a combination of solid phase and solution syntheses. Preformed Fmoc-amino acid symmetrical anhydrides (Boc derivative for the N-terminal residue) were used for amine acylation in the continuous flow method. Serine and threonine were side chain protected as tert. butyl ethers and the 4-methoxy-2, 3, 6,-trimethyl-benzenesulfonyl group was used for masking the guanidino function of arginine residues. After cleavage from the resin the final peptide was purified by ion exchange chromatography and characterized by amino acid analysis, high voltage electrophoresis, and RP-HPLC analysis. Alternatively, the protected N-terminal octapeptide, Fmoc-Thr(But)-Ala Thr(But)-Thr(But)-Arg(Mtr)-Arg-(Mtr)-Arg(Mtr)-Gly-OH was prepared on 4 hydroxymethyl-3-methoxyphenoxyacetyl-norleucyl derivatized Kieselguhr-supported polydimethylacrylamide resin and the C-terminal nonapeptide H-Arg(NO2)-Pro-Pro Gly-Phe-Ser-Pro-Phe-Arg-(NO2)-OBzl was synthesized in solution through the fragment condensation method. The two fragments were coupled by the DCC-HOBt procedure and the resulting heptadecapeptide was deblocked and purified. The conformational features of the synthesized peptides are reported. Preliminary pharmacological experiments indicated that carbohydrate-free vespulakinin 1 is more potent than bradykinin in lowering rat blood pressure. PMID- 3679674 TI - Chemical synthesis of phosphoseryl-phosphoserine, a partial analogue of human salivary statherin, a protein inhibitor of calcium phosphate precipitation in human saliva. AB - Human salivary secretions are supersaturated with respect to basic calcium phosphates but spontaneous precipitation of these salts from saliva, or surface induced precipitation of calcium phosphates onto dental enamel, does not normally occur. This unexpected stability has been attributed to the inhibitory activities of two kinds of salivary phosphoproteins: statherin and the acidic, proline-rich phosphoproteins (PRP). Investigation of the structure-function relationships of statherin, the most potent inhibitor of primary (spontaneous) and secondary (seeded) precipitation of calcium phosphate salts in human saliva has been limited to studies of peptide segments obtained from the native peptide by specific proteolysis. Solid phase peptide synthesis (SPPS) is a useful and potentially more flexible alternative. Phosphoserine residues (positions 2 & 3) play critically important roles in the precipitation-inhibition activities of statherin, but SPP synthesis of these phosphorylated peptides is precluded because of the instability of phosphoserine residues in the presence of HF. Thus, this peptide was synthesized by solution-phase methods. The dipeptide possessed substantial inhibitory activity in assays for inhibition of both primary and secondary precipitation of calcium phosphate salts, but was not as active as either N-terminal tryptic hexapeptide of statherin or intact statherin. Syntheses of other model phosphorylated peptides are underway to expand the structure function relationships. PMID- 3679675 TI - A psychiatric consultation/liaison clinic: follow-up of fifty-four patients referred from neurology. AB - To assess the impact of psychiatric consultation, the authors reviewed the charts of patients referred from a neurology clinic to an outpatient consultation/liaison psychiatry clinic. The patients were found to have both significant neurologic and psychiatric disorders. Only 46 percent returned to see their neurologists within six months of the referral. This finding highlights a major problem in outpatient consultation. PMID- 3679676 TI - Interpretation of negative transference in nonanalytic settings. AB - This article presents a technique and attitude for dealing with problem or difficult patients, utilizing concepts generated from psychoanalysis for use in settings or contexts that are nonpsychoanalytic. The concepts of transference, counter-transference, resistance, and interpretation of transference are defined for use in nonanalytic contexts. The process of formulation of interpretations, and modes of patient response in nonanalytic contexts are discussed and illustrated with clinical examples. The possible benefits and limitations of this way of relating to problem patients are also discussed from clinical and theoretical perspectives. PMID- 3679677 TI - Status of behavioral medicine in American and Canadian medical training. AB - This article reports a survey of attitudes and current practices regarding behavioral medicine in American and Canadian medical school departments of psychiatry. Participants were eighty-two chairpersons of departments of psychiatry. Five major areas were addressed concerning the existence, location, and composition of behavioral medicine faculty and their contribution to training and research programs. Results indicate that behavioral medicine is represented in the majority of medical schools and teaching hospitals. Faculty tended to be located in psychiatry. A majority of the respondents did not think that behavioral medicine should be considered a separate clinical specialty area, but in actual practice behavioral medicine was distinct from consultation/liaison psychiatry as often as integrated with it. The analysis of subjects and methods taught in residency training programs suggested a meaningful trend in the data. The implications of these results for models underpinning traditional medical education and psychosomatic medicine are discussed. PMID- 3679678 TI - A psychosomatic outpatient clinic. AB - Current emphasis in clinical psychosomatic medicine is on psychiatric interventions in acute medical and surgical situations (consultation-liaison psychiatry and medical-psychiatric units). Little interest has been taken in psychosomatic interventions in chronic situations and outpatient settings. The functioning of a psychosomatic outpatient clinic (POC) is described. One-hundred consecutive referrals were analyzed. The most frequent diagnostic finding- according to DSM III criteria--was subsumed under the rubric of "psychological factors affecting physical condition," followed by affective illness, anxiety disturbances, and somatoform disorders. The results indicate that a POC may serve a specific and definable segment of patients, whose characteristics depart from the clinical populations in consultation-liaison psychiatry and medical psychiatric units. PMID- 3679679 TI - An assessment of preoperative coagulation screening for tonsillectomy and adenoidectomy. AB - Preoperative coagulation studies are commonly employed in order to try to identify the 2-4% of all patients undergoing tonsillectomy/adenoidectomy surgery who experience hemorrhagic complications. In an atmosphere of increasing cost consciousness, evaluation of the efficacy of screening tests is warranted. The records of 994 out of 1050 patients consecutively scheduled for tonsillectomy, adenoidectomy or T&A over a 2.5-year period were retrospectively reviewed in order to determine the usefulness of partial thromboplastin (PTT) and prothrombin time (PT) screening in predicting surgical and postsurgical bleeding. For patients with no history or clinical signs indicating possible bleeding disorder, preoperative PT and PTT failed to predict bleeding as an outcome. Also no patients were identified in this series to have previously undiagnosed coagulopathies on the basis of screening PT/PTT. The purpose of any screening test is to identify disease early enough for therapeutic intervention to be effective. Although preoperative PT/PTT will occasionally identify an unsuspected von Willebrand's or other coagulopathy, the prevalence of bleeding disorders in patients with negative history and examination is low enough that PT/PTT has essentially a zero predictive value for surgical bleeding. Screening PT/PTT should therefore be reserved for patients with known or suspected coagulopathies. PMID- 3679680 TI - The sternocleidomastoid tumor of infancy. AB - The sternocleidomastoid tumor of infancy is an uncommon clinical entity which has received little attention in the otolaryngological literature. The diagnosis must be considered in any infant presenting with a lateral neck mass. Although its natural history favors spontaneous regression, the mass may initially grow in size. The purpose of treatment is the prevention of torticollis and craniofacial asymmetry. The initial treatment is non-surgical, passive and active exercises. Only when this treatment fails should surgery be performed. The disappearance of the lesion is not always a predictable sign. A small number of children will develop delayed torticollis or craniofacial asymmetry. It is important that parents be informed of this possibility and of the necessity for long term follow up. PMID- 3679681 TI - Idiopathic facial nerve palsy in children and the effect of treatment with steroids. AB - During a 10-year period 228 children were seen with Bell's Palsy. In half of them the palsy was incomplete. Overall the recovery rate was 96%. There was a strong female preponderance but no difference in incidence between right of left sides. Twenty-eight reported a previous episode of facial palsy. When separated into categories based on clinical assessment and evidence of nerve fibre degeneration it was evident that all children without degeneration recovered. Those with incomplete palsies recovered in about half the time taken by those with complete palsies. Only two thirds of those children in whom degeneration was evident recovered. One hundred children were treated with a course of high dose steroid. This did not influence recovery either by improving recovery rate or by decreasing the time period to recovery. PMID- 3679682 TI - Choanal atresia and associated anomalies. AB - The authors have studied 130 cases of choanal malformation. They found 53 bilateral atresias, 51 unilateral atresias and 26 cases of choanal stenosis. Fifty-seven of these cases were associated with other anomalies and 38 had at least two features of the CHARGE association (C, colobomas; H, heart defects; A, atresia choanae; R, retarded growth; G, genito-urinary defects; E, ear defects). The pathogenesis of choanal atresia in regard to the abnormal migration of neuroectodermal cells is discussed. PMID- 3679683 TI - Periorbital cellulitis. AB - Periorbital cellulitis is a common complication of sinusitis in children. At some hospitals lumbar puncture is routinely done as part of the complete evaluation of children admitted with periorbital cellulitis. Presumably, the lumbar puncture is done to rule out meningitis which could be the result of extension of infection from the orbit to the central nervous system (CNS). However, the degree to which periorbital cellulitis is associated with CNS complication is not known and the necessity for routine lumbar puncture is questioned. Therefore, records of 102 children admitted to the Children's Hospital National Medical Center from 1975 to 1982 with the diagnosis of periorbital cellulitis were reviewed. There were two cases of meningitis and one case of bilateral subdural effusions. Review of the literature and the findings in this study suggests that routine lumbar puncture in seemingly uncomplicated cases of periorbital cellulitis probably is not indicated in children 6 months of age or older. PMID- 3679684 TI - Malignant tumors of the head and neck in children: a twenty-year review. AB - This 20-year (1965-1985) retrospective review identified 241 children under the age of 19 years who presented with a malignancy of the head and neck. Hodgkin's disease and other malignant lymphomas predominated, accounting for 59% of the total number of cases. Soft tissue sarcomas, specifically rhabdomyosarcoma, were the next most common lesions (17.5%). Thyroid carcinomas (10%), neuroblastomas (5%), nasopharyngeal carcinomas (5%), salivary gland malignancies (2.5%), and malignant teratomas (1%) accounted for the remaining cases. The neck was the primary site of presentation, followed by the naso-oropharynx, orbit, face and scalp, salivary glands, and aural region, in descending order of frequency. Advances in the diagnosis, staging and treatment of children with malignant tumors of the head and neck have occurred since the last comprehensive survey of such lesions was published in 1973. Otolaryngologists must be aware of these advances in order to remain active members of a multi-discipline team responsible for the care of these children. PMID- 3679685 TI - Tympanometry and the stapedial reflex in the first five days of life. AB - Tympanometry was carried out on 45 full term neonates. It proved to be a straightforward procedure. The acoustic reflex was elicited using contralateral white noise stimulation at 70-85 dB and with a probe tone of 600 Hz. It was not detectable in the first hours of life, but was present in 100% of cases over 12 h of age. The initial absence of the reflex may be due to a transient conductive loss which resolves rapidly or, more likely, immaturity of the reflex itself at birth. PMID- 3679686 TI - Nasal obstruction in the neonate secondary to nasolacrimal duct cysts. AB - The neonate is an obligate nasal breather and any form of nasal obstruction causes respiratory distress during feeding and sleeping. We report two patients with unusual causes of respiratory distress secondary to nasolacrimal duct cysts. The failure of the lacrimal duct to perforate at the distal end results in dacryocystitis and cyst formation. Removal of the nasal wall of the cyst resolves the obstruction and the dacryocystitis. The nasolacrimal duct cyst is an unusual, but readily treated, cause of neonatal respiratory distress. PMID- 3679687 TI - Micromethods for the study of GABA biochemistry and function at single GABA acceptive membranes. AB - Three different micromethods for studying GABA biochemistry and function at single microdissected GABA-acceptive neuronal membranes are discussed. The basis for such studies is the possibility of obtaining by microdissection single Deiters' neurons from the lateral vestibular nucleus of the rat and the rabbit. From these isolated cells the plasma membrane may be prepared and studied. The first micromethod allows the study of the Na+ independent diffusion of GABA through such a plasma membrane which is postsynaptic to GABA-ergic boutons. A modification of such method allows also the study of the effects of GABA-ergic drugs on Cl- permeability. The second method allows the study by microelectrophoresis in capillaries of GABA catabolism by GABA-T associated with microdissected single Deiters' membranes. The third one was developed in order to study the characteristics of Na+ dependent GABA carrier activity present on such membranes. PMID- 3679688 TI - Measuring the effects of failure with learning disabled children. AB - The effects of failure on performance for children diagnosed as learning disabled (reading) and normal children were compared with a simple clinical measure. As hypothesized, learning disabled children stressed with failure scored significantly (p less than .05) poorer than stressed normals on a reading posttest. Learning disabled children were seen to have developed a learned helplessness response mode and experienced greater difficulty in recovering from failure than normal cohorts. The results were interpreted as lending support to the use of a clinical measure in assessing the role played by failure in children's learning disorders. PMID- 3679689 TI - A younger aged reference group for the WISC-R. AB - The present study obtained WISC-R scores for a younger aged sample. Standard scores for this sample are presented along with an adequate three factor solution reflecting verbal, general performance, and auditory-attention-perceptual performance dimensions. Furthermore, coefficients of concordance are reported for the present sample with a three factor solution for the normative WISC-R 6 1/2 year old group. Problems with the skewness of some of the subsets are discussed in light of a possible psychometrically guided approach to constructing early infant intellectual assessment measures. Implications of finding a different, from traditional, third factor are considered with respect to early school functioning. PMID- 3679690 TI - Neuropsychological impairment associated with hepatolenticular degeneration (Wilson's disease) in the absence of overt encephalopathy. AB - Neuropsychologic tests of cerebral integrity recorded impairments in visuopractic and learning capacity in patients with Wilson's disease. These psychometric findings point to the presence of a subclinical encephalopathy that is not otherwise revealed upon clinical examination. PMID- 3679691 TI - Effects of temporal lobectomy for treatment of epilepsy on hemispheric functions ipsilateral to surgery: preliminary findings. AB - Several studies have reported a pattern of ipsilateral deficit and contralateral improvement following temporal lobectomy. Presumably the contralateral improvement is due to cessation of commissural spread, and the ipsilateral deficit to surgical damage to that side. If, as hypothesized, the underlying mechanism is cessation of commissural spread of seizure activity, some ipsilateral improvements might also occur. This question was addressed in a small sample of left (N = 4) and right (N = 5) temporal lobectomy patients. It was found that the left-operated patients demonstrated improvements on tests reported to measure left frontal lobe function. In addition, both left- and right-operated patients improved on a dexterity test with the hand ipsilateral to the side of surgery. The ipsilateral improvement would be due to removal of an active electrically discharging focus impairing ipsilateral function and contralateral function by commissural spread. These data were interpreted to suggest that cessation of commissural spread of seizure activity can result in improvement in regions of the hemisphere ipsilateral to surgery, and that the contralateral hemispheric improvements may include psychomotor functions in addition to memory and IQ changes. Seizure control achieved by surgery may have influenced the pattern of results. PMID- 3679692 TI - Biosynthesis of taurine peptides in brain cytoplasmic fraction in vitro. AB - Brain homogenates and their cell-free soluble fraction incorporated labelled [14C]taurine, [14C]glutamic acid, [14C]aspartic acid and [14C]serine into a number of low-molecular weight peptides, among which glutamyl-, aspartyl- and seryl-taurines and their N-acetylated derivatives were identified. A partially purified cytoplasmic fraction catalyzed the formation of glutamyl-taurine. Excesses of aspartic acid and serine inhibited this reaction. Biosynthetic products were analyzed on thin-layer chromatography plates by an autoradiographic X-film technique and identified with the aid of synthetic peptides or endogenous synaptosomal peptides, whose structure was determined with mass spectrometry. gamma-Glutamyl-taurine was also formed through a group translocation mechanism from glutathione and taurine by the enzymes of the gamma-glutamyl cycle. The catalytic activity of the membraneous enzyme was identical with that of the commercial gamma-glutamyltransferase. PMID- 3679693 TI - The effects of DSIP on pain threshold during light and dark periods in rats are not naloxone-sensitive. AB - The effects of Delta-Sleep-Induced Peptide (DSIP) were examined in rats kept at 12:12 light:dark schedule. The peak of the circadian pain threshold of saline treated rats occurred at 10:00. Rats treated with 0.1 mg/kg, i.p. DSIP exhibited a significantly higher pain threshold level (as measured by hot plate) both in the light and dark periods. Prior to the treatment the peak was at 10:00. With treatment the peak shifted to 18:00. A dose of 1.0 mg/kg DSIP increased the pain threshold level only during the dark period. The analgesia induced by DSIP is insensitive to naloxone pretreatment. PMID- 3679694 TI - Vitamin A status in the grey seal (Halichoerus grypus) on Sable Island. AB - Vitamin A and beta-carotene concentrations in serum, liver and blubber fat were investigated in 65 grey seals of different age and sex in the pupping colony on Sable Island, Canada to determine the vitamin A status. In none of the investigated samples could beta-carotene be detected. There were no differences in the concentration of vitamin A in serum, liver and blubber between male (213 micrograms/l, 376 micrograms/g, 22 micrograms/g respectively) and female (205 micrograms/l, 319 micrograms/g, 19 micrograms/g respectively) juveniles. In adult males concentrations of vitamin A in serum, liver and blubber were higher (260 micrograms/l, 503 micrograms/g, 34 micrograms/g respectively) than in juveniles indicating an age dependent increase of vitamin A in liver and blubber. Contrary to this in lactating females concentrations of vitamin A in serum, liver and blubber were significantly different than in the other animals. While the level of vitamin A in serum and blubber was two times higher with 413 micrograms/1 and 62 micrograms/g respectively, the concentration of vitamin A in liver was much lower (265 micrograms/g) compared to juveniles and adult males. It is possible that the intensified lipid metabolism during lactation, necessary to match the energy requirements of the rapidly growing pup, causes these extreme differences in vitamin A concentrations in serum, liver and blubber of lactating females compared to juveniles and adult males. Due to high concentration of vitamin A in blubber and the high proportion in blubber to total body weight, the blubber represents approximately 40% of total body reserves of vitamin A. PMID- 3679695 TI - Modification of vitamin A metabolism in rats fed a copper-deficient diet. AB - The liver is the main storage site of vitamin A and copper. Inverse relationships between copper and vitamin A liver concentrations have been suggested. We have investigated the consequences of a copper-deficient diet on liver and blood vitamin A storage in Wistar rats. Animals were fed either a copper-deficient diet for 45 days from weaning, or an identical diet containing adequate amounts of copper. Concentrations of vitamin A were determined by isocratic high performance liquid chromatography using UV detection. We have observed in the liver of the rats fed a copper-deficient diet a significantly higher mean level of retinyl esters (148 +/- 37 micrograms/g of liver) and retinol (3.3 +/- 1.4 micrograms/g of liver) compared to the mean concentration of the retinyl esters (53 +/- 8.5 micrograms/g of liver) (p less than 0.01) and retinol (1.4 +/- 0.5 micrograms/g of liver) (p less than 0.01) in controls. Opposite results were observed in the serum of the group fed a copper-deficient diet as these rats had a significantly lower level of retinol (22 +/- 4 micrograms/100 ml) compared to the mean concentration in the controls (64 +/- 20 micrograms/100 ml) (p less than 0.01). These findings suggest that a copper-deficient diet may cause defective transport of vitamin A from liver to blood. This experimental model may be useful to further investigate unusual liver vitamin A and copper concentrations observed in children during various hepatobiliary diseases. PMID- 3679696 TI - The clinical effect of correction of vitamin E depletion in cystic fibrosis. AB - Thirty patients with cystic fibrosis, 24 of whom had longstanding low serum vitamin E, were treated with 50 mg alpha-tocopherol acetate per day for periods of 18-24 months. None of the patients received haematinics during the study period. Throughout the period of study the overall clinical state of the patients did not alter significantly. The serum vitamin E level increased in all patients, but to a variable degree which was not related to the severity of steatorrhoea. A range of nutritional parameters, including anthropometry, vitamin levels, essential elements, haemoglobin and albumin, as well as dietary intake and faecal fat excretion, were assessed at the beginning and end of the study. Haemoglobin was the only parameter to change significantly from 13.14 to 13.47 g/100 ml. Twenty one of the 30 patients showed some increase in haemoglobin values and this increase could not be related to clinical state, fat absorption or dietary intake but was related to the improved vitamin E status. PMID- 3679697 TI - Plasma and tissue levels of vitamin E in sheep following intramuscular administration in an oil carrier. AB - The bioavailability of two vitamin E preparations (d-alpha-tocopherol and dl alpha-tocopherol) suspended in sesame oil solution and administered intramuscularly was evaluated in sheep. In sheep administered d-alpha-tocopherol and killed after 360 hr (Group 2), there was a higher (P less than 0.01) bioavailability than for sheep injected with d-alpha-tocopherol (Group 3) or dl alpha-tocopherol (Group 1) and killed 240 hr after dosing. In the 3 groups (5 sheep each) the highest blood plasma alpha-tocopherol increment occurred in the d alpha-tocopherol injected sheep. For sheep injected with d-alpha-tocopherol and slaughtered at 360 hr (Group 2) the pancreatic, hepatic, lung, spleen and muscle tocopherol concentrations were higher (P less than 0.05) than in the control group. Also in group 2 there was a tendency for higher tissue tocopherol concentrations than in the other vitamin E treated sheep (Group 1 and 3). PMID- 3679698 TI - Plasma testosterone in rats exposed to ethanol during vitamin E deficiency. AB - The effects of short and long-term ethanol administration on plasma testosterone level were studied in rats with vitamin E deficiency. The animals underwent a vitamin E depletion period of 5 weeks followed by an acute dose of ethanol (1 g/kg body wt i.p.). Two hours after the ethanol dose, the plasma testosterone level had decreased both in a control group (-32%, nonsignificant) and in the vitamin E deficient group (-45%, P less than 0.05) as compared with saline treated rats. The rats which had received an ethanol dose were then exposed to ethanol in the drinking water (10% w/v) for two weeks, after which the acute ethanol dose was repeated. One hour after this second acute dose of ethanol, the plasma testosterone showed a decrease of 24% (nonsignificant) in the control group and 50% (P less than 0.05) in the vitamin E deficient group compared with saline-treated rats. Two hours after the second acute dose of ethanol, the plasma testosterone level was significantly (P less than 0.05) down both in the control group and in the vitamin E deficient group (-41 and -54%, respectively). Thus, vitamin E deficiency strengthened the effect of acute ethanol treatment on plasma testosterone in rats. Long-term exposure to ethanol appeared to sensitize rats to acute doses of ethanol, as judged by the fall in plasma testosterone levels. The present results are in agreement with previous findings in vitro thus supporting the notion that free radicals arising during ethanol oxidation have an inhibitory effect on testosterone synthesis. PMID- 3679699 TI - A new HPLC-method for the simultaneous determination of B1-, B2- and B6-vitamers in serum and whole blood. AB - Considering that the B1-, B2- and B6-vitamers in whole blood and serum are partly protein bound and partly in phosphorylated form as co-enzyme, we developed a sample treatment which is able to transduce all three vitamers in their free forms. After cleaning the sample on solid-phase-extraction columns (SPE-column) we are able to separate all three vitamers in one run with HPLC and to quantify them with simultaneous detection (UV and Fluorescence). The following reference values were obtained: (ng/ml) Serum: Thiamin 6.55 +/- 2.38, Riboflavin 4.92 +/- 1.01, vitamin B6 11.21 +/- 3.17. Whole blood: Thiamin 62.3 +/- 20.8, riboflavin 69.8 +/- 20.9, vitamin B6 59.5 +/- 22.4. PMID- 3679700 TI - Liver folylpolyglutamate synthetase activity in folic acid-deficient rats. AB - To investigate the influence of folate deficiency on the addition process of glutamyl unit to folylpolyglutamates, liver folylpolyglutamate synthetase was studied. The enzyme activity appears slightly decreased in deficient liver as compared with control. This decline might be more evident in the hepatic cell owing to the lesser availability of reduced forms, preferred substrates of the enzyme. PMID- 3679701 TI - Brain ascorbate depletion as a response to stress. AB - Ascorbate-depleted rainbow trout were fed a single dose of L-1-14C-ascorbic acid, then held in metabolism chambers for four consecutive five-day periods. Tissue samples were analyzed for 14C, ascorbate, and ascorbate-2-sulfate. Brain ascorbate showed a long turnover time following a very slow uptake. The loss of brain ascorbate after five days in metabolism chambers was highly significant (p less than 0.001) when compared with similar dosed fish not chambered. A brain ascorbate pool which does not exchange with the body pool is proposed. Possible mechanisms are discussed and a kinetic model is suggested. PMID- 3679702 TI - Reduced regulatory thermogenesis in pregnant and ovariectomized women. AB - Diet-induced thermogenesis has been evaluated in five ovariectomized young women, five late pregnant (at the 8th month of pregnancy) and five age matched lean control women. Post-prandial thermogenesis was tested after a 900 Kcal mixed meal. Although pregnant (p less than 0.05) and ovariectomized showed a basal metabolic rate higher than control females, both groups had a significantly lower post-prandial thermogenesis when compared to the lean one (p less than 0.05). It is concluded that post-prandial thermogenesis is depressed in pregnant and ovariectomized females and that this condition may facilitate, at least in predisposed adult women, the development of obesity. PMID- 3679703 TI - Plasma and leucocyte zinc concentrations and their response to zinc supplementation in an elderly population. AB - Plasma, mononuclear cell and granulocyte zinc were assessed in a group of 15 institutionalised elderly female patients, and the effect of different levels of zinc supplements (50, 100, 150 mg elemental zinc/day) on these parameters was measured. Plasma but not cellular zinc was lower in the elderly compared with a young control group, but a diminished serum albumin may explain the plasma results. Plasma zinc increased with supplementation, but only when the daily intake was 100 or 150 mg/day; the greatest response was with the higher dose. Mononuclear cell zinc did not respond to zinc supplements. There was a decrease in granulocyte zinc at all levels of zinc supplements, the greatest decrease being found with the highest dose (150 mg/day). The decrease in granulocyte zinc at high intakes may have implications in phagocytosis and chemotaxis. PMID- 3679704 TI - Dietary cholesterol-fat type combinations and carbohydrate and lipid metabolism in rats and mice. AB - In rats fed semipurified cholesterol-free diets, dietary corn oil induced higher levels of liver cholesterol, but lower concentrations of plasma cholesterol, plasma triglycerides and blood D-3-hydroxybutyric acid, than did coconut fat. Addition of cholesterol to the diets (1%, w/w) greatly increased liver cholesterol levels but did not affect the corn oil effect upon liver and plasma cholesterol. In contrast, dietary cholesterol prevented the corn oil effects upon plasma triglycerides and blood D-3-hydroxybutyric acid. Liver glycogen levels in rats increased significantly after cholesterol feeding, the effect being independent of dietary fat type. In mice, dietary corn oil, compared to coconut fat, elevated liver cholesterol only when the diet contained cholesterol. Corn oil caused an increase of liver glycogen in mice in the presence, but not in the absence of dietary cholesterol. This study shows that dietary cholesterol-fat type combinations influence various aspects of lipid and carbohydrate metabolism in rats and mice. PMID- 3679705 TI - Iron status in Ecuadorian pregnant women living at 2,800 m altitude: relationship with infant iron status. AB - An evaluation of iron status was performed in 84 pregnant women at delivery (and in cord blood from their newborn) and in a control group of 32 menstruating women living in Quito (2800 m altitude). Anemia as defined according to the WHO references adjusted to altitude was observed in 46% of pregnant women. Iron deficiency was defined as the combination of a low serum ferritin level (12 micrograms/l or less) and a low transferrin saturation percentage (less than 16%). A moderate elevation in the serum ferritin concentration (between 13 and 50 micrograms/l) associated with low transferrin saturation indicated iron deficiency in an inflammatory context. Iron deficiency was present in 46% of pregnant women. Anemia was associated with iron deficiency in 59% of cases. A correlation between maternal and cord blood hemoglobin was found and some iron parameters in cord blood were related to maternal iron status, and especially to maternal iron stores assessed by serum ferritin concentration. PMID- 3679706 TI - Vitamin estimations of three edible species of Attacidae caterpillars from Zaire. PMID- 3679707 TI - Ethanol enhances the esterification of riboflavin in rat organ tissue. PMID- 3679708 TI - Nutrition and metabolism during growth: aspects for the animal. PMID- 3679709 TI - Nutrition and metabolism during early postnatal growth: human approach. PMID- 3679710 TI - Energy-nitrogen balances and protein turnover in small and appropriate for gestational age low birthweight infants. PMID- 3679711 TI - Composition of weight gain during the neonatal period and longitudinal growth follow-up in premature babies. PMID- 3679712 TI - The effect of voluntary activity on growth and energy expenditure of female rats. PMID- 3679713 TI - Dietary substitution of methionine by its precursors: influence on body growth of rats. PMID- 3679714 TI - Effects of feeding black currant seed oil on fatty acid composition of lipid classes in the guinea pig liver. PMID- 3679715 TI - Effects of N-3 polyunsaturated fatty acids during development in the rat. 1. Functional effects. PMID- 3679716 TI - Effects of N-3 polyunsaturated fatty acids during development in the rat. 2. Biochemical effects. PMID- 3679717 TI - Effects of supplemental enzymes on the nutritive value of various cereals for growing chicks. PMID- 3679718 TI - The nursing instructor and clinical teaching. AB - Clinical teaching has long enjoyed a well deserved reputation as a difficult teaching challenge. Recent pressures, particularly those for accountability in health care, have accentuated the difficulties for clinical teaching. These pressures arise from public sensitivity to rising costs and the increasing complexity and sophistication of hospital systems (raising patient fears of technologies too complex to be understood). More than ever, patients insist on high quality care from all health profession workers. Thus, the increased frequency over the past 2 decades of articles on aspects of nursing quality is not surprising. How have these pressures affected the nursing instructor? PMID- 3679719 TI - Education in primary prevention in psychiatric-mental health nursing for the baccalaureate student. AB - The concept of primary prevention is discussed, as it has traditionally and recently been used in reference to mental health and mental illness, as an introduction to the description of a course concerned with primary prevention in psychiatric-mental health nursing. The course, developed for senior baccalaureate nursing students, included both a didactic and a clinical component, is reviewed and the evaluation outcomes are discussed. The paper concludes with a call for nursing to enhance its concern for prevention of mental illness and promotion of mental health. PMID- 3679720 TI - System of nursing care in Poland. AB - Nurse activity in Poland has reached a high level of organization and methodological development. It should be stressed that the system of nursing training is carried out not only of a medium level but also on a higher level leading to a Master's degree in nursing. High standards are set for nurses with respect both to their professional training and professional ethics. A constant tendency to improve professional and general knowledge among nurses had led recently to juridical regulations requiring that nurses holding managerial posts possess a higher education. A post-diploma system of nursing training resulted in the opening, in 1981, of facilities for professional specialization with the right to use the title of specialist nurse. A satisfactory situation concerning the employment of nurses and midwives as well as a auxiliary personnel in hospital wards has not yet been reached in Poland. It is therefore necessary to train auxiliary personnel for work in hospital wards. Discussions held in the nursing profession concerning the role of a Master's degree in nursing in the Polish system of health care must result in widening the nurse's responsibilities according to their level of education and intellectual potential. It is problematic whether specialized training of nurses should be carried out only in the post-diploma system. Properly prepared nursing staff for such specialized branches as pediatrics or psychiatry do not come out of this system. This problem should be discussed by nurses in the near future and appropriate measures adopted. The environment of professional nurses is characterized by great professional and social activity. They take part in state administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679721 TI - Sex differences in the utilization of mental health services: a nation-wide register study. AB - A nation-wide investigation of a cohort of first admissions during the period April 1, 1970 to March 31, 1971 to psychiatric institutions was followed in the Danish Psychiatric Register for a 10 year period. The cohort comprised 5,881 males and 6,856 females with an annual incidence rate of 3.14 males and 3.55 females per 1,000. Males were significantly younger than females and more frequently involuntarily admitted. Males predominated among schizophrenics and addictive disorders, females among neurotics and manic-depressive psychotics. Young males required longer hospital stays and more admissions than young females. The opposite was the case among patients over 65 years. Three outcome groups were delineated and the incidence rate calculated to: the "short term" group comprising 1.64 males and 1.90 females per 1,000, the "long-stay" group comprising 0.22 males and 0.27 females per 1,000 and the "revolving door" group comprising 0.42 males and 0.32 females. Multiple contingency analyses showed that only the outcome "revolving door" was independently associated with the sex of the patients with males being a high risk group. PMID- 3679722 TI - Schizophrenia in rural Ireland: a case of service overutilisation. AB - Rural Ireland has been characterised by various studies as having high rural rates of schizophrenia. This paper tested the hypothesis that these anomalously high rates resulted from overutilisation of psychiatric hospitals, reflecting community differences in risk for readmission. A comparison of first and total admission (1978-1981), in two broadly matched rural counties showed no significant difference in treated incidence but significant differences in treated prevalence. A demographic comparison of admittants indicated higher risk for readmission for individuals who were older and had previous hospitalisations. The implications for these findings for rural psychiatric care delivery are discussed. PMID- 3679723 TI - Standardisation of the Kannada version of the Crown-Crisp Experiential Index (CCEI). AB - The Crown-Crisp Experiential Index (CCEI), formerly called the Middlesex Hospital Questionnaire (MHQ) was standardised in Kannada. The Kannada version showed adequate reliability and yielded normative data comparable to the original version. The CCEI scores distinguished the normal group from another group of neurotic patients. PMID- 3679724 TI - Patients' views of industrial therapy. AB - Patients are rarely consulted about the major planning decisions which affect them more than anyone else. The present study, completed in 1984, sought the views of patients in the Industrial Therapy Department of a large psychiatric hospital due for closure in the next decade. Areas covered included what patients felt about the department, attitudes to staff, pay rates and working conditions, and preferences in future care. Results showed a positive attitude to Industrial Therapy tempered by some suggestions for improvement. A preference by a majority of patients for living in the community was backed by a realistic interpretation of the problems involved. PMID- 3679725 TI - The socially-oriented psychiatric hospital. AB - The programs of psychiatric hospitals illustrate the differences we have about the origins and treatment of mental illness. They reflect the conflicts which divide us into camps. Most hospitals today are biologically oriented and their programs are short-term in nature. They mainly understand mental illness to be physical in origin and emphasize the physical and physiologic in their treatment approach. Fewer hospitals are socially-oriented. This paper deals with the socially-oriented hospital. It briefly discusses their theoretical frameworks and touches upon significant contributions to the literature. Main attention is given to one particular type of such institution. Its structure is described as it is used to satisfy its patients' needs and to generate healthy behavior in them. The way it treats its patients and the use to which it puts its own value-system in the treatment process are outlined. PMID- 3679726 TI - High risk suicide factors across cultures. AB - High risk suicide factors both in India and in the United States are examined. In India these are: humiliation, reputational and economic loss, poverty, examination failure, relationship disappointments, disputes with spouse and inlaws, property disputes, loss of loved one, and chronic medical illnesses. In the United States major depressions, schizophrenia, alcoholism, recent loss(es), retirement, limited social support system, age over 45 and high risk low rescue situations are significant. Most of high risk suicide factors in India apparently are related to interpersonal and socioeconomic causes, whereas in the United States these relate to individual and psychiatric causes. These interesting differences are discussed. PMID- 3679727 TI - Staff attitude changes after environmental changes on a ward for psychogeriatric patients. AB - On a ward for chronic elderly patients, mostly senile demented patients, several environmental changes were performed to improve the patients' behaviors. Before and after these changes, the staff (N = 12) were asked about their attitudes in relation to different issues, according to a semantic differential scheme. The semantic differential scheme consisted (apart from six distractor pairs) of the following semantic pairs: (a) negative-positive, (b) valueless-valuable, (c) bad good, (d) onesided-manysided, (e) unimportant-important, and (f) stupid-smart. The object sentences tested with this semantic differential scheme were (1) cleaning the ward, (2) the patients' meals, (3) dressing the patients, and (4) social interaction with patients. The results showed significant positive changes in staff attitudes towards the patients in the three last object sentences. These also corresponded to the interventions made in the environmental program, whereas "cleaning the ward" was not really changed during the program. It is concluded that improvements in patient behaviors on the ward has important positive effects also on the staff attitudes. PMID- 3679728 TI - Influence of sialomucins at the resection margin on survival of patients with colorectal cancer. AB - In a multicentre prospective trial, 281 patients undergoing "curative" resection for colorectal cancer were followed for a mean of 13.6 months (SD 7.2 months). The presence or absence of sialomucin at the resection margin was studied histochemically using the high iron diamine-alcian blue (HID-AB) stain. There were 49 deaths relating to tumour recurrence: 21 in the sialomucin positive group (n = 77) and 28 in the sialomucin negative group (n = 204) (p less than 0.02). Life table survival was correlated against the presence or absence of sialomucin in the resection margin. At the mean follow-up (13.6 months) 85.6% of patients were alive in the sialomucin negative group, and 76.4% of patients were alive in the sialomucin positive group. Regression analysis predicts 32.8% and 18.9% five year survivals for sialomucin negative and positive groups respectively. There was no significant statistical correlation between the presence of sialomucin in the resection margin and the Dukes staging, site or tumour differentiation. The appearance of sialomucin in either resection margin appears to be an early marker of poor prognosis for patients with colorectal cancer. PMID- 3679729 TI - Percutaneous transhepatic biliary drainage for acute cholangitis. AB - Percutaneous Transhepatic Biliary Drainage (PTHBD) was performed in 56 consecutive patients with severe acute cholangitis, during a period of one year. An immediate decompression effect with a "good" response was achieved in 46 (82.2%), who usually became afebrile within 18 to 24 hours, and "poor" response in 10 (17.8%). Five died (8.93%) in a subsequent operation. No mortality was associated with the use of PTHBD. Complications related to the procedure occurred in 12 of the 56 patients (21.4%). Hemobilia was the major complication. The other complications were intraabdominal hemorrhage, bleeding from the puncture site, transient hypotension, catheter occlusion and/or dislodgement, bile leak, pneumothorax and hemothorax. Two with hemobilia, one with intraabdominal hemorrhage and the other with bile leak required an emergency operation. PTHBD procedures can be lifesaving in biliary sepsis. Once infection and hyperbilirubinemia are controlled, rational subsequent therapy can be formulated for the underlying disease. PMID- 3679730 TI - Portal pressure measurements before and after Hassab's decongestion operation. A preliminary report. AB - This preliminary study included five patients with a history of haematemesis resulting from rupture of oesophageal varices complicating schistosomal hepatic fibrosis. Simultaneous measurements were taken of the endoscopic variceal pressure (EVP) and the free portal pressure (FPP) obtained by the cannulation of a mesenteric vein radical. These measurements were taken after laparotomy, after removing the spleen and after devascularization of the lower oesophagus and upper two thirds of the stomach. At the beginning the EVP was found to be identical with the FPP. Following splenectomy, the EVP dropped from a mean of 41.9 cm H2O to a mean of 25.8 cm H2O, whereas the FPP dropped from 40.7 cm H2O to 27.8 cm H2O. After decongestion, the EVP had a mean of 21.3 cm H2O and the FPP had a mean of 32 cm H2O. Two weeks after the operation the EVP remained unchanged at the end of the operation in two cases and increased by 5 cm H2O in one case. Accordingly it was concluded that Hassab's operation results in an immediate diminution of the EVP and FPP. However, the long-term results of this operation required further studies. PMID- 3679731 TI - The distal splenorenal shunt: an update on experience of 106 cases. AB - This paper analyzes experience with 106 patients treated primarily with DSRS during a ten year period. Operative mortality was 5% of cases. Shunt patency was evaluated by postoperative angiography in 70 patients. A shunt thrombosis and a recanalization of the splenic vein were noted in a patient who had a Britton's operation resulting in a side-to-side shunt. In the other 31 cases, shunt patency was indirectly confirmed by the absence of varices at postoperative or long-term endoscopic examination. At postoperative check, esophageal varices had disappeared in only 19% of patients. However, this rose to 60% at long-term check up. Ten patients bled from varices in the postoperative period (9%). During the follow-up period, no patient bled from varices, while five patients bled from gastroduodenal lesions (5%). During the postoperative period, 52% of cases had ascites. In the long-term, ascites developed in only 15% of cases and was well controlled by standard medical treatment. Analysis of the actuarial curve showed a 5-year survival rate of 63%. During the follow-up period, 17% of patients experienced at least one episode of acute encephalopathy. Chronic encephalopathy appeared in 14% of cases: ten patients suffered a mild form (10%) and four (4%) a moderate form. No patient had severe chronic encephalopathy. DSRS is effective as treatment of portal hypertension with a low long-term morbidity despite a more troublesome early postoperative period. PMID- 3679732 TI - Assessment of post-splenectomy residual splenic function. Splenic autotransplants. AB - Splenectomy increases the risk of fulminant sepsis. The present study assesses residual splenic function in patients splenectomized due to traumatic rupture of the spleen; and six cases with splenic autotransplants. Splenic tissue was observed in only 48% of the splenectomized patients and 100% of the autotransplant cases. The two most reliable analytical parameters to assess the presence of functional splenic tissue, were the absence of Howell-Jolly bodies and normal IgM blood levels. In cases where total splenectomy is indicated, it has proved useful to perform autotransplantation of splenic tissue at omentum major level. PMID- 3679733 TI - Marlex mesh prosthesis for massive vaginal vault prolapse. AB - A case of repeatedly recurrent massive vaginal vault prolapse is presented. Representative articles on various ingenious modalities for the repair of this condition are reviewed. An additional safe and simple procedure is described. Criteria for the ideal prosthetic material are listed. Marlex mesh prosthesis, which appears to fulfil all the criteria required for use in vaginal surgery, is recommended not only as an onlay graft to support the soft tissues approximated, but also to cover wide gaps, as was presented in this case. PMID- 3679734 TI - Surgical treatment of cervical anastomotic leaks following esophageal reconstruction. AB - Cervical anastomotic leaks occurring in the early postoperative period after esophageal reconstruction are life-threatening complications, with a mortality rate similar to that of intrathoracic leaks if the posterior wall of the anastomosis is affected. Prompt diagnosis and aggressive surgical treatment is vital. The surgical procedures commonly used are often inadequate or unsatisfactory because of the difficulties encountered in the subsequent reconstruction. Twelve patient with an early cervical anastomotic leak following elective esophageal surgery were treated using an original surgical technique which allows diversion and simple delayed reconstruction of the anastomosis without risk of late stricture. Uncontrolled mediastinal sepsis accounted for the three deaths of the series and occurred in patients with a leak of the posterior anastomotic wall in whom definitive surgical treatment was delayed. PMID- 3679735 TI - Influence of the timing of physiotherapy upon the lymphatic complications of axillary dissection for breast cancer. AB - A prospective randomized study was carried out to discover the influence of the timing of shoulder physiotherapy after-axillary dissection for breast cancer upon the incidence and duration of lymphatic fluid production and seroma after these operations. Sixty-eight patients underwent a modified radical mastectomy, 31 were submitted to early physiotherapy and 37 to delayed physiotherapy after removal of the suction drainage. In 32 patients this surgery was conservative of the breast; in 16 the physiotherapy was early and in 16 delayed. The shoulder was left free when the physiotherapy was delayed. The mean volume of lymphatic fluid produced after these 100 axillary dissections was 437 cc (range: 50 to 800 cc) with a mean duration of 6.3 days (range: 2 to 11 days). There was a linear relation between the volume and the duration of the lymphatic fluid production. This volume was significantly higher in radical mastectomy than in conservative procedures (486 cc vs 333 cc - p less than 0.02). There was no significant difference in the production of lymphatic fluid with early or delayed physiotherapy, whatever the group of patients: radical or conservative surgery - age - number of excised lymph nodes - lymph node involvement. Five seromas occurred in patients with delayed physiotherapy. Delaying physiotherapy after axillary dissection for breast cancer does not seem to reduce the incidence of lymphatic complication, but the use of a conservative procedure rather than a modified radical mastectomy seems to be able to do so. PMID- 3679736 TI - Synchronous bilateral surgery for calculous disease of the upper urinary tract. AB - Bilateral calculous disease of the upper urinary tract frequently poses great difficulty in therapeutic decisions. Staged or sequential surgery is often recommended, with the side that is more obstructed, infected, or symptomatic operated on first. Despite all the rationalization for sequential surgery, we believe that a simultaneous surgical approach to bilateral calculous disease is feasible and advisable in some situations. On the basis of our experience with nine patients, we have categorized the indications for such surgery. In patients, with bilateral calculous disease for whom surgical intervention on both sides will at some point be necessary, simultaneous single-stage surgery is recommended. This is especially true: (a) with bilateral obstructive calculi; (b) in bilateral calculous disease with acute pyelonephritis when which side is affected is equivocal; (c) when anatomic proximity makes bilateral surgery easier, e.g. in bilateral lower ureteral calculi or bilateral calculi in horseshoe kidneys. PMID- 3679737 TI - CO2 laser in laryngeal microsurgery. AB - The CO2 Laser is used in the treatment of several laryngeal diseases and offers considerable advantages over traditional techniques. New applications of this surgical tool are currently under study for other laryngeal and ENT pathologies. It should be pointed out that there are some limitations to the use of the CO2 Laser; an accurate examination of its indications is needed, as well as a precise knowledge of its techniques and possibilities. PMID- 3679738 TI - Potential impact of the advanced trauma life support (ATLS). Program in a Third World country. AB - Data from Trinidad and Tobago suggest there is a positive role for the ATLS program in Third World countries. Between 1970-1979 traffic accidents increased from 16,433 to 28,003 while deaths increased from 179 to 252 per year. Sixty-nine per cent of deaths were adult males mainly between 20-30 years old and most fatal accidents occurred between 6:00 and 10:00 p.m. particularly on weekends. Because expert consultants are not always immediately available within the hospital, initial trauma resuscitation is provided by emergency room physicians. Accordingly, 75% of trauma deaths occur in hospital with 65% of those dying within six hours of reaching the hospital alive. Compared to a similar sized North American population the death to injury ratio is at least doubled. The beneficial impact of the ATLS program in Third World countries is assured if ATLS quality control is maintained and can be assessed, as outlined, by comparing pre ATLS with post ATLS data. PMID- 3679739 TI - Prognostic criteria in intra-abdominal sepsis. AB - Forty-two patients with proven intra-abdominal sepsis were studied in a prospective clinical trial. The following parameters were evaluated: (1) Nine parameters on admission: age, sex, obesity, malnutrition, history of cardiac, respiratory or renal disease, diabetes mellitus and malignant neoplasia. Four of these parameters had a prognostic value (p less than 0.05): age 65 years, diabetes mellitus and cardiac disease. (2) Thirty parameters representing the functional status of six organic systems during sepsis: respiratory, cardiovascular, nervous, kidneys, blood coagulation, liver. Six of these parameters had a prognostic values: PEEP 0-10 cm H2O to keep PaO2 greater than 60 mmHg (p less than 0.001), serum creatinine greater than 3.6 mg/dl (p less than 0.01), prothrombin time greater than 15'' or platelet count less than 100,000/mm3 (p less than 0.001), need of vasoconstrictive drug to keep arterial pressure greater than 100 mmHg (p less than 0.001), bilirubin greater than 3 mg/dl (p less than 0.01) and mental confusion. The combination of these ten statistically significant prognostic criteria for each patient showed that the mortality was 0 with 0-2 criteria, 36% with 3-5 criteria, 94% with 6-8 criteria and 100% with 8 10 criteria. Patients with more than five of these criteria had a significant higher mortality risk (p less than 0.001). PMID- 3679740 TI - Metastatic distribution in malignant melanoma. A 30-year autopsy study. AB - The metastatic pattern is described in 75 cases of malignant melanoma coming to autopsy over a 30-year period. Skin primaries were identified in 62 of them. Males outnumbered females in this, as in other autopsy studies. Metastases to lungs, liver and bone were interrelated and associated with further dissemination. Cerebral metastases occurred more often in initially localized lesions and were associated with few other metastases. It is stressed that detailed examination of the brain at autopsy is needed to identify cerebral involvement, and that brain scans may be indicated particularly in patients with seemingly localized primaries to identify latent cerebral involvement. PMID- 3679741 TI - Effects of anticancer agents on the shedding of cells from human multicellular tumor spheroids. AB - We studied the effects of anticancer agents on the inhibition of cell shedding from the surface of multicellular tumor spheroids (MTS). MTS were produced from 2 human tumor cell lines; one melanoma and the other squamous cell lung cancer, by using liquid overlay culture technique. The cell shedding from the melanoma MTS was approximately 10-fold higher than the squamous cell carcinoma MTS. In the melanoma MTS, all 3 drugs studied - vincristine (VCR), doxorubicin (ADR) and cisplatin (DDP)-inhibited cell shedding and the degree of inhibition of cell shedding was drug concentration related. In the squamous cell carcinoma MTS, VCR was as active in inhibiting cell shedding as in the melanoma MTS, but ADR and DDP were less efficacious. When effects on cell shedding were compared with those on cell lethality, VCR produced inhibition of cell shedding at much lower concentrations than those producing cell kill effects. ADR and DDP produced cell lethality as effective as, or more effective than, inhibition of cell shedding. These data seem to parallel known effects of these agents on cell kill and inhibition of metastases. MTS may serve as an in vitro model for the study of cell shedding and metastasis. PMID- 3679742 TI - Lung colonization and metastasis of murine mammary tumors: relationship to various characteristics of the primary tumors. AB - The ability to metastasize via the bloodstream of mammary tumors occurring in Balb/cfC3H and Balb/cfRIII mice (two substrains of identical Balb/c genotype carrying milk-transmitted C3H or RIII murine mammary tumor virus (MuMTV) infection, respectively) has been compared in MuMTV-free Balb/c virgin female recipients given intravenous tumor cell suspensions or subcutaneous solid tumor transplants from mammary tumor-bearing Balb/cfC3H and Balb/cfRIII breeding female donors. Tumor cell suspensions different for MuMTV inducing variant, growth rate, tumor size, and clinical duration, injected intravenously to Balb/c virgin female recipients, have been compared with respect to the foci of lung colonization induced in recipient hosts. The results obtained indicate that MuMTV variant, growth rate and clinical duration of the primary mammary tumor, but not the size of the primary tumor, significantly influence the lung colonization. Similar results were obtained with solid subcutaneous transplants of the same mammary tumors. The significance of these results for the understanding of the general mechanisms of tumor metastases is discussed. PMID- 3679743 TI - Lectin-binding characteristics of related high- and low-metastatic rat mammary adenocarcinoma cell lines. AB - Lectin-binding characteristics of a previously described highly metastatic variant (clone 4), derived in vivo from a poorly metastatic rat mammary adenocarcinoma (DMBA-8), have been investigated. of the lectins studied clone 4 cells, unlike the parent cells, bound Ulex europaeus agglutinin (UEA-1; specificity alpha-L-fucose) and peanut agglutinin (PNA; specificity D-galactose). These differences may be related to the greatly enhanced ability of clone 4 cells to form lung foci after intravenous injection. After neuraminidase treatment the differential binding of PNA, as shown by flow cytofluorography, was abrogated whereas that of UEA was unchanged. After separation by SDS-PAGE, four proteins in total cell extracts of clone 4 cells bound 125I-UEA applied to the gels. These had subunit molecular weights greater than 100,000 daltons and were also found in cellular extracts of another highly metastatic rat mammary adenocarcinoma (MAT 13762-B), but were missing from DMBA-8 cell extracts. In clone 4 and MAT 13762-B cells exogenous 3H-fucose was mainly incorporated into four fucoproteins of similar molecular weights to those which bound 125I-UEA. DMBA-8 cells, which incorporated slightly less exogenous fucose, showed a different pattern of fucoprotein labelling, which would seem to explain why DMBA-8 cells failed to bind UEA. Differences in cell surface protein iodination patterns were also noted between DMBA-8 and clone 4 cells. PMID- 3679744 TI - Tumour-cell-induced platelet aggregation: studies with cloned metastatic and non metastatic variants. AB - Blood platelets have been suggested to play an important role in modulating the development of experimental metastases. Tumour cells can induce platelet aggregation in vitro and a number of mechanisms have been proposed to explain the in vivo and in vitro observations. In the present study, we used tumour cells cloned from B16 melanoma and mouse mammary tumour virus (MMTV) carcinoma polyclonal populations to check whether tumour cells with low- and high metastatic behaviour in vivo had different quantitative and qualitative platelet aggregating activity in vitro. We found no significant quantitative difference between platelet aggregation induced by the low- and the high-metastatic clones. Indeed both the high and the low metastatic B16 melanoma clones poorly aggregated platelets, while both the high and low metastatic MMTV carcinoma clones efficiently aggregated platelets. Both the B16 melanoma and the MMTV carcinoma parental cell lines, which can be classed as intermediate metastatic, aggregated platelets well. However, based on the results with heparin and creatine phosphate/creatine phosphokinase, it appeared that qualitative differences might exist in the mechanism of platelet aggregation by tumour cells. For the parental lines and highly metastatic clone C1 a thrombin-linked component was more important than an ADP-like component, which was nevertheless present, to promote platelet aggregation. For the low-metastatic clone C2, the ADP-like component appeared to be the most important. PMID- 3679745 TI - Density and distribution of canine conjunctival goblet cells. AB - Conjunctival goblet cells (GCs) were quantitated to establish baseline values for density and distribution of these cells in healthy canine eyes. From each of 18 sites, tissue was collected, sectioned at 2 micron, and stained with periodic acid Schiff stain. Within each sampling site, 500 epithelial cells (GCs, squamous, polygonal, and basal epithelial cells) were counted and the ratio of GCs to total epithelial cells was computed as an index of goblet cell density or goblet cell index (GCI). A heterogenous distribution of canine conjunctival goblets cells was demonstrated. Lower nasal fornix (LNf) and adjacent sites, lower middle fornix (LMf) and lower nasal tarsal (LNt), had the highest mean densities of goblet cells. In contrast, GCs were essentially absent from the upper and lower bulbar areas. Remaining sites had intermediate GCIs. Sex differences in GCIs were noted for LNf and LNt sites. Mean tear film breakup times (BUTs) were determined, and, for normal beagle dogs, were 19.38 (+/- 4.80 secs) OS and 19.96 (+/- 5.01 secs) OD. The similarities between canine and human conjunctival goblet cell distributions support the use of the dog for studying the conjunctival mucous system. PMID- 3679746 TI - Proliferation of vascular endothelial cells stimulated in vitro by corneal epithelium. AB - Angiogenic activity in the corneal epithelium has been reported in an in vivo system. This study was undertaken to determine if this property would also be manifest in a direct fashion in vitro. Experiments were performed using rabbit vascular endothelial cells in culture. Rabbit corneal epithelial homogenate, medium exposed to corneal epithelial cultures (epithelial conditioned medium) and corneal keratocyte homogenate were tested for their mitogenic potential. Both corneal epithelial homogenate and epithelial conditioned medium were found to significantly increase the proliferation of vascular endothelial cells. This effect was dose dependent, manifest in media containing different sera and heat stable. Keratocyte homogenate, when prepared in the same manner, was not mitogenic. PMID- 3679747 TI - Sequential development of a conjunctival basophil hypersensitivity lesion in guinea pig. AB - We investigated the cellular profile of inflammatory infiltrate during development of a guinea pig conjunctival basophil hypersensitivity lesion at 1, 6, 24, 48, and 72 hr following injection of keyhole limpet hemocyanin (KLH). Neutrophils reached maximal accumulation at 6 hr. Eosinophils and basophils reached maximal accumulation at 24 hr. Basophil numbers remained high at 48 hr and were lower at 72 hr. The number of stromal monocytes did not vary significantly from PBS-injected tissues at any time. Mast cell number decreased at 24 hr following antigen challenge. Morphologic evidence for intense secretory activity was seen in cells at the stromal reaction site. Secretion channels and evidence of intense degranulation was seen from electron microscopy of neutrophils, eosinophils, and basophils. Inflammatory cells migrate through the basement membrane into the conjunctival epithelium. After maximal accumulation there was a decrease in the number of inflammatory cell types in the epithelium. PMID- 3679748 TI - The structural basis of the inner blood-retina barrier in the eye of Macaca mulatta. AB - This is a morphological analysis of the inner blood-retina barrier in various segments of the retinal vasculature in the eye of Macaque monkeys. The primary aims of this study are to identify the components of the walls of the arteries, central capillaries, peripheral capillaries and veins of the retina using light and electron microscopy, and to compare and contrast junctional morphology as revealed by thin section electron microscopy and freeze-fracture. The walls of these vascular segments are composed of continuous endothelium, muscle cells or pericytes, and connective tissue. Endothelial cells are joined by tight and gap junctions. In freeze-fracture replicas, tight junctions consist of a continuous, complex network of branching and anastomosing strands which do not possess free endings. The intramembrane strands of tight junction remain preferentially associated with the outer membrane leaflet or E-face of the endothelial plasma membrane and sit at the bottom of linear strands or grooves. However, particles and fragments of the intramembrane strands may be avulsed from the E-face during the fracture process and are associated with ridges on the inner membrane leaflet or P-face. The total number of plasmalemmal vesicles per unit area of endothelial cell for each vascular segment in thin sections is less than non-barrier endothelium, but greater than barrier endothelium. The paucity of plasmalemmal vesicles and the complexity of the tight junctional network contribute to the barrier function of the retinal vascular endothelium. PMID- 3679749 TI - Mechanisms of effects of small hyperosmotic gradients on the chick RPE. AB - This paper presents electrophysiological findings of the effects of small trans tissue osmotic gradients on the chick retinal pigment epithelium (RPE). These gradients are similar to those produced in the human "hyperosmolarity response," a clinical test of RPE integrity. Effects of 25 mOsm osmotic gradients (mannitol) were observed on the electrical parameters of the tissue and on light-evoked responses in a preparation of chick neural retina-RPE-choroid. Making the retinal perfusate hyperosmolar to the choroidal side, (retinal hyperosmolarity), depolarized the RPE basal membrane and increased the amplitude of the light evoked c-wave of the ERG. Retinal hyperosmolarity also decreased RPE basal membrane resistance as estimated from measurements of resistance parameters (trans-tissue resistance and a, the RPE membrane resistance ratio), and of RPE membrane polarizations during the c-wave. Choroidal hyperosmolarity led to a hyperpolarization of the basal membrane and a decrease in the amplitude of the light-evoked c-wave. Measurements of resistance parameters indicated an increase in basal membrane resistance. In addition, hyperosmolar loads of either direction decreased the amplitude of the light peak of the DC-ERG. The effects on the light evoked c-wave and light-peak responses did not occur with bilateral hyperosmolarity, indicating that a trans-epithelial osmotic gradient is necessary for the effects on the RPE. We conclude that the basal membrane of the RPE is the principal site of the effects of small hyperosmotic loads of either direction, and that the ERG c-wave is a sensitive measure of the effects on RPE basal membrane resistance. PMID- 3679750 TI - Exocytic clearing of degraded membrane material from pigment epithelial cells in frog retina. AB - Posterior eye cups of the frog Rana ridibunda were prefixed in the presence of tannic acid, osmicated and stained en bloc with uranyl acetate. Electron microscopy revealed the following features of membrane traffic in cells of the retinal pigment epithelium (RPE): (1) intracellular membranes with increased electron density undergo degradation within phagolysosomes and also outside lysosomes and are committed to be exocytized; (2) exocytized degraded membranes, organized as lamellar arrays, are evacuated through the basolateral extracellular space, through Bruch's membrane and into the choriocapillaris. Comparison of exocytic activity in animals kept either with a light cycle or in constant darkness suggests that exocytized lamellar arrays derive from membranes degraded through both lysosomal and non-lysosomal pathways. Autophagocytosis may contribute a substantial amount of material to exocytosis. On the other hand, exocytosis of heterophagosomes, if it takes place at all, involves only residual bodies at a final stage of degradation following slow proteolysis which is achieved within the RPE cells. Rapid transcytosis of heterophagosomes does not occur. Taken together, our observations suggest that, in the frog, exocytosis and subsequent evacuation of residual bodies is an efficient mechanism for clearing from worn-out organelles the metabolically highly active, non-dividing RPE cells. PMID- 3679751 TI - Retinal S-antigen in human subretinal fluid. AB - Studies in experimental models of retinal detachment have proposed that the degree of visual recovery following retinal reattachment depends upon the extent of photoreceptor degeneration. A means of assessing this degeneration would help in establishing postoperative prognosis. S-antigen (S-Ag) is a unique retinal protein found in outer segment disc membranes and photoreceptor cells. In 36 cases of human rhegmatogenous retinal detachment, subretinal fluid (SRF) concentrations of S-Ag, measured by radioimmunoassay, ranged from 43 to 170 ng/ml (serum: 1-28 ng/ml). Analysis of variance showed a positive correlation with the duration of detachment (P less than 0.001). There was a two-fold increase in S-Ag concentrations during the first 2 weeks of detachment (P less than 0.005), with constant levels thereafter. These findings reflect progressive photoreceptor degeneration and/or ongoing synthesis of outer segment proteins in the detached retina that stop after the second week of detachment. SRF S-Ag levels may provide a prognostic indicator of visual recovery after reattachment as well as a sensitive measure of retinal metabolic activity during detachment. PMID- 3679752 TI - Diurnal rhythm in the human rod ERG: retinitis pigmentosa. AB - Rod ERGs were measured at three times of day over an extensive range of retinal illuminances in six light-entrained patients with autosomal recessive or isolate forms of retinitis pigmentosa and at five times of day in six light-entrained normal volunteers. B-wave amplitude versus retinal illuminance functions from each time of day were described by determining the parameters of the best-fit Naka-Rushton function. Results from normal subjects showed that rod ERG threshold (defined as the log retinal illuminance necessary to elicit a 2.0 microV response) was elevated 1 1/2 hr after daily light-onset due to both an increase in log k (semi-saturation constant) and a decrease in log Vmax (maximum rod amplitude). The magnitude of the threshold elevation 1 1/2 hr after light-onset was comparable in patients with retinitis pigmentosa and normal subjects. Whereas thresholds returned to pre-light exposure levels rapidly during the light-phase of the daily cycle in normal subjects, thresholds continued to rise in patients with retinitis pigmentosa due primarily to a further increase in log k. These findings are consistent with abnormal rod photoreceptor disc renewal mechanisms in retinitis pigmentosa. PMID- 3679753 TI - Phorbol ester: effect on intraocular pressure, adenylate cyclase, and protein kinase in the rabbit eye. AB - Protein kinase C was identified as a major protein kinase enzyme activity in rabbit ciliary processes. Phorbol myristate acetate (4 beta-PMA) in the presence of Ca2+ activated protein kinase C but did not directly affect the cyclic AMP dependent protein kinase enzyme isolated from ciliary processes. To elucidate possible roles of protein kinase C, PMA was injected intravitreally into rabbit eyes. Fifty pmoles of PMA produced approximately a 40% decrease of the intraocular pressure relative to the control eye lasting for more than 72 hr. A reduction of intraocular pressure was still elicited by this dose of PMA in animals pretreated with systemic indomethacin given to suppress a possible inflammatory response. The biologically inactive analogue, 4 alpha-phorbol didecanoate (100 pmoles/eye) had no significant effect on intraocular pressure. In vivo and in vitro treatment with PMA had no significant effect on adenylate cyclase in ciliary process membranes assayed in vitro. However, protein kinase C isolated from rat brain, when added together with cofactors to membranes in vitro, augmented adenylate cyclase activation by isoproterenol, vasoactive intestinal peptide and aluminum fluoride. A slight increase in the basal activity and in the forskolin response was not statistically significant. The effect of protein kinase C to increase responsiveness of ciliary process adenylate cyclase was totally dependent on the presence of Ca2+ and was augmented by addition of PMA. These findings indicate modulation of adenylate cyclase activity by protein kinase C acting at the level of the G-proteins and suggest a possible role for this enzyme in water and electrolyte transport in the ciliary processes. PMID- 3679754 TI - Influence of ethacrynic acid on outflow facility in the monkey and calf eye. AB - Living monkeys were perfused via the anterior chamber by the two step constant pressure technique with the sulfhydryl (SH)-reactive diuretic, ethacrynic acid (ECA) at dosages from 0.1 to 1.0 mM. Above 0.37 mM a reproducible increase in outflow facility (C) was observed. At 0.5 mM C increased 115% with ECA compared to a 22% increase in control eyes (n = 9; P less than 0.01). In three monkeys simultaneous perfusion of ECA with cysteine in 10% excess prevented this effect. In enucleated calf eyes at dosages ranging from 0.1 to 0.5 mM ECA a similar increase in outflow facility was demonstrated. Simultaneous perfusion of 0.1 mM ECA with 0.5 mM cysteine blocked this increase in facility. At high dosages (6 mM) of ECA a decrease in C of 35% was observed (P less than 0.01, n = 8). Electron microscopic studies of the perfused monkey eyes did not readily explain the observed facility effects of ECA, except for the occurrence of a small number of breaks in the inner wall endothelium of Schlemm's canal. The juxtacanalicular meshwork appeared normal. Moderate to profound trabecular endothelial cell swelling was observed with ECA alone and with simultaneous cysteine. Morphologic studies performed 4 and 11 weeks after repetitive acute exposure to ECA indicated that the tissues of the outflow pathway appeared normal. The importance of this work is that it points to a new class of drugs that may be used someday to treat glaucoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679755 TI - Fluorophotometric study of intravenous carbonic anhydrase inhibitors in rabbits. AB - The ability of fluorophotometry to measure the time course of changes in aqueous humor flow in rabbits was evaluated by measuring the effect of intravenous carbonic anhydrase inhibitors on aqueous humor flow determinations. The abrupt changes in aqueous humor flow which were found by fluorophotometry agreed well with the expected changes in aqueous humor flow calculated from the time course of the intraocular pressure. Therefore, it was concluded that fluorophotometry could measure the time course of changes in aqueous humor flow in rabbits. Furthermore, it was suggested that the initial abrupt changes in aqueous humor flow after the administration of a carbonic anhydrase inhibitor were induced by the base content of the drug, followed by a more gradual decrease in aqueous humor flow caused by the direct effect of the drug on aqueous humor formation. PMID- 3679756 TI - Long-term neural regeneration in the rabbit following 180 degrees limbal incision. AB - Penetrating 180 degrees superior limbal incisions were made on the right eye of four adult New Zealand albino rabbits. The contralateral eye served as control. Corneal touch thresholds (CTT) for the central, superior and inferior cornea (2-3 mm from limbus) were determined 3, 9, 15, 24 and 30 months after surgery. In all animals, the CTT was significantly elevated in the superior region of the cornea throughout the measurement period. CTT was elevated in the central and inferior cornea 3 months following surgery and was not affected in the inferior cornea on all other occasions. The animals were then sacrificed and the corneas subjected to histochemical demonstration of acetylcholinesterase corneal nerves. All rabbits showed a reduction in the number of histochemically detectable stromal nerve trunks in the operated region. These stromal nerve trunks showed regenerative changes including abnormally curved course and a subnormal number of axons within a nerve trunk. Epithelial nerve fiber defects included absence or distorted architecture of the basal epithelial plexus and intra-epithelial terminals. These results indicate that although extensive stromal reinnervation had occurred, the extent and quality of stromal nerves was inadequate to restore a normal epithelial plexus and corneal sensitivity. PMID- 3679757 TI - A DNA deletion associated with multiple impaired transcripts in the visual mutant TRP. AB - The transient receptor potential (trp) mutant in Drosophila is known to manifest retinal degeneration and involves defects in the intermediate steps of visual transduction. The chromosome walking technique has been conducted at the cytogenetic location of trp. Overlapping phage clones that cover a DNA stretch of 73 kb were obtained. Southern blotting studies detected a 2.3 kb DNA deletion within this region in the mutant. The deleted DNA fragment contains exons of three transcripts with lengths of 3.5, 1.5 and 0.8 kb. The transcription of the 3.5 and 1.5 kb RNAs is completely abolished in the mutant, whereas that of 0.8 kb RNA appears to be modified. The impairment in production of three RNAs, due to the DNA deletion, offers a possible molecular basis of the multiple defects displayed by the trp- phenotype. PMID- 3679758 TI - Abnormal development of the axial length of aphakic monkey eyes. AB - Neonatal cataract surgery is becoming more common because irreversible amblyopia occurs if an eye receives inadequate inputs during an early sensitive period of visual development. To model conditions for treating congenital monocular cataracts in humans, we have reared rhesus monkeys which underwent unilateral lensectomy as neonates. Post-surgical A-scan ultrasonography at 8-26 months revealed that the axial length of the aphakic eye in these monkeys was shorter when compared to that of the unoperated eye. This finding has important implications for the long-term clinical management of lensectomized infants in order to achieve good vision in the aphakic eye. PMID- 3679760 TI - Proceedings of the 35th annual meeting of the Association of University Radiologists. Charleston, South Carolina, March 22-27, 1987. PMID- 3679759 TI - Effects of intraocular pressure and other factors on subretinal fluid resorption. AB - We observed the effects of intraocular pressure (IOP), vitreous pressure and gravity on the resorption of small retinal detachments (blebs) made with Hanks' solution or autologous serum. Raising the IOP decreased the absorption time moderately and lowering the IOP increased it. These effects were greater when the RPE had been damaged by sodium iodate or laser burns, but we conclude that IOP makes only a small, limited contribution to normal subretinal fluid absorption. Neither liquefaction of the vitreous nor retinal weight had a significant influence on fluid absorption. PMID- 3679761 TI - Xenon/computed tomography cerebral blood flow measurements. Methods and accuracy. AB - We performed a series of five baboon experiments to compare cerebral blood flow measured with an improved stable xenon/CT method and the radiolabelled microsphere technique at a PaCO2 of 40 mm Hg. The xenon/CT method was implemented by fitting the arterial xenon uptake with a double exponential function, by measuring the oxygen and carbon dioxide concentrations continuously during each breath and by taking into account the lung-to-brain transit time of xenon. The time of xenon inhalation was extended to 30 minutes to obtain more reliable estimates of CBF in white matter regions. The results indicate an overall correlation coefficient of 0.92 between the two methods and good numeric agreement. PMID- 3679763 TI - Evaluation of indium-111 chloride as a radiopharmaceutical for joint imaging in a rabbit model of arthritis. AB - The potential use of 111In-chloride as a radiopharmaceutical for quantitating the extent of synovitis was investigated in a rabbit model of antigen-induced arthritis. Rabbits with monoarticular disease were injected with 111In-chloride and imaged at 30 minutes and 24, 48, 72, and 96 hours. In control knee joints, the ratio of activity in the knee to a soft-tissue region in the thigh remained constant (1.5-1.85:1); in arthritic knees, the 111In uptake ratio increased from 2:1 to 3.2, 3.5, 3.9, and 4.6:1 at the later time points. The difference between the knee-to-soft-tissue ratios observed in the control and involved joints was significant (P less than .01, 48-96 hr). Tissue distribution measurements demonstrated that the synovium and intra-articular structures covered by synovium in arthritic joints had the highest concentration of 111In. In control joints, these tissues were found to take up tenfold less activity. Good correlation was observed between the 111In knee-to-soft-tissue ratios calculated from the images and histologic assessment of the severity of synovitis. PMID- 3679762 TI - Magnetic resonance imaging of myocardial infarction using albumin-(Gd-DTPA), a macromolecular blood-volume contrast agent in a rat model. AB - Magnetic resonance (MR) contrast enhancement of acute myocardial infarction was studied in rats using albumin-(Gd-DTPA), a paramagnetic macromolecule with prolonged intravascular retention after intravenous injection. Histologic examination and distribution measurements of radiolabeled microspheres confirmed induction of regional myocardial infarction after ligation of the left coronary artery. ECG-gated spin-echo images at 2.0 Tesla, employing short, T1-weighted pulse sequence settings, demonstrated time-persistent and significant (P less than .05) enhancement of normal myocardium (66%) and an even greater enhancement of the infarcted area (100%), for as long as 60 minutes after injection of 160 mg/kg albumin-(Gd-DTPA). The contrast difference between normal and infarcted myocardium was increased significantly (P less than .05) after administration of albumin-(Gd-DTPA). The prolonged enhancing effects of albumin-(Gd-DTPA) on MR images are useful for evaluating regional differences in blood volume and capillary integrity between normal and infarcted myocardium. PMID- 3679764 TI - Lipid/water ratio of bone marrow measured by phase-encoded proton nuclear magnetic resonance spectroscopy. AB - Proton NMR spectroscopy (spatially resolved) at 0.7 Tesla with a whole body superconducting magnet was performed on bone marrow from human lumbar spine to measure the lipid/water ratio. Phase-encoded proton spectroscopy was performed by using (1) a spin-echo sequence with selective 90 degrees and 180 degrees rf pulses on the Z and X axes; (2) 64 different phase encodes along the Y axis; and (3) echo acquisition with no gradient. The lipid/water ratios also were measured by the Folch chemical extraction technique. The set of phase-encoded spectra obtained from the spine demonstrates the chemical difference between the vertebral disk (large water peak and no lipid peak) and the marrow (smaller water peak and detectable lipids). Lipid/water ratios were lower than the chemically measured ratios. The phase-encoded proton spectroscopic technique presented in this study allowed rapid acquisition of localized spectra from the bone marrow in each of three vertebral bodies of the intact human spine. This technique provided a measure of the mobile lipid/water ratio weighted by relaxation times. PMID- 3679765 TI - The radiologist and angiographic procedures. Absorbed radiation dose. AB - The radiation dose absorbed by the angiographer during angiographic procedures is of vital importance to the radiologist. Nevertheless, most articles on the subject are incomplete, and few measure gonadal dose. In this study, three TLDs were used for each of the following sites: radiologist's eyes, thyroid, gonads with and without shielding apron, and hands. The average dose during carotid angiograms was 2.6, 4.1, 0.4, 4.7, and 7.1 mrads to the eyes, thyroid, gonads with and without .5 mm of lead shielding, and hands, respectively. Average dose during abdominal and peripheral vascular angiographic procedures was 5.2, 7.5, 1.2, 8.5, and 39.9 mrads to the eyes, thyroid, gonads with and without shielding, and hands, respectively. A literature review demonstrates a significant reduction in radiation dose to the angiographer after the advent of automated injectors. Our measured doses for carotid angiography are compatible with contemporary reported values. There was poor correlation with fluoroscopy time and measured dose to the angiographer. PMID- 3679766 TI - A 30-year-old woman with generalized skeletal pain. PMID- 3679767 TI - Training programs for researchers using animals. PMID- 3679768 TI - Kwashiorkor in Iowa: catastrophic "benign" gastrocolic fistula. PMID- 3679769 TI - Endoscopic sphincterotomy. PMID- 3679770 TI - Use of approved drugs in a nonapproved way. PMID- 3679772 TI - Transitional cell carcinoma of the bladder. PMID- 3679771 TI - Statewide plan for nurses. PMID- 3679773 TI - Bladder cancer in 156 patients aged eighty years or more. PMID- 3679774 TI - Adult-onset minimal-change nephrotic syndrome: a benign disease. PMID- 3679776 TI - Pneumomediastinum as a complication of athletic activity. Two case reports. PMID- 3679775 TI - No haematuria--no IVU. PMID- 3679777 TI - Longevity in single ventricle with transposition of great vessels. PMID- 3679778 TI - Degradation and rites of degradations in a closed psychiatric ward. PMID- 3679780 TI - Mutual help groups for widows: a study of the process. PMID- 3679779 TI - The day hospital: a comparative study of an alternative to full psychiatric hospitalization. PMID- 3679781 TI - The Community Rehabilitation Unit for discharged psychiatric patients in Kfar Saba, Israel. PMID- 3679782 TI - Relation between schizophrenic-like psychosis and Sjogren syndrome (SS). PMID- 3679783 TI - International symposium: Parkinsonism and aging. Milan, 25-28 November 1987. Abstracts. PMID- 3679784 TI - Needle biopsy for muscle diagnosis and research: an Italian experience. AB - We report our experience of needle biopsy over the past two and a half, viz. 395 cases. We find that the technique meets the needs of diagnosis and research very satisfactorily. We describe its advantages over open biopsy and recommend it in preference to the latter, provided that the necessary technical skill for processing the sample is available. PMID- 3679785 TI - Low dose lisuride in advanced Parkinson disease. AB - Lisuride was investigated for therapeutic effects in 19 patients with advanced Parkinson disease, no longer satisfactorily responding to routine L-Dopa therapy. The patients were treated with oral Lisuride (0.6-2.5 mg/die) and L-Dopa. The follow-up was at least 6 months. We noted a significant improvement on the Webster Rating Scale at 1st, 3rd and 6th months. Disability and on-off phenomen were reduced. Side effects were few. Lisuride is a valuable tool in this type of patient. PMID- 3679787 TI - Periodic activity in electroencephalography. AB - We report ana analysis of 12 cases in which periodic activity was observed in more than one EEG recording in patients with subacute sclerosing panencephalitis (4 cases), encephalitis of unknown etiology (1 case) and vascular disease (7 cases). In the patients with infective disease periodic high voltage potentials were elicited from all over the brain and the background rhythm was markedly impaired. In the patients with vascular disease the bursts were localized, reversible and sometimes recurrent. The impression gained is that a periodic EEG pattern denotes a pathological modification of behavior of the cerebral cortex rather than any particular disease. PMID- 3679786 TI - Electrophysiological analysis of motor control in patients with vascular hemichorea. AB - An EMG analysis of motor control was performed in 4 patients with unilateral choreic movements of sudden onset, 3 of whom presented CT scan evidence of lacunar infarcts involving the contralateral striatum. The choreic dyskinesias were correlated with EMG bursts of variable duration occurring with a random order of activation. Ballistic elbow flexion movements were performed with a normal triphasic EMG pattern, but both size and duration of the first agonist burst were increased on the affected side. Abnormalities of cerebral somatosensory evoked responses were observed in 3 patients on stimulation of the side with choreic movements. PMID- 3679788 TI - Lower cranial nerve palsy produced by internal carotid artery dilatation. Report of two cases. AB - We report two cases of lower cranial nerve palsies (XII in case 1, IX-X-XII in case 2) associated with abnormalities of the internal carotid artery at the base of the skull. In case 1 a limited dissection of the carotid wall produced both paresis of the hypoglossal nerve and Horners syndrome by compression of the nerve trunk against the base of the skull and stretching of the periarterial sympathetic fibres respectively. In case 2 we speculate that a narrow angled kinking of the internal carotid artery may have damaged cranial nerves IX, X and XII by interfering with the blood supply to the nerve trunks. In both cases the outcome was favorable with almost complete regression of the initial symptoms. We conclude that the association between lower cranial nerve disturbances and internal carotid artery abnormalities is probably more common than was thought. We suggest that the pathogenesis of the damage to the cranial nerves may differ from one case to the next. PMID- 3679789 TI - Altered bladder function as the only and late presenting symptom of ependymoma of the filum terminale. AB - Tumors of the spinal cord present as a rule with posterior pain with or without radiation to the limbs, with loss of strength and/or sensory disturbances. We report a case in which acute retention of urine was the only presenting symptom. PMID- 3679790 TI - Temporary transvenous pacing: analysis of indications, complications and malfunctions in acute myocardial infarction versus noninfarction settings. AB - The clinical records of 339 consecutive patients who had received temporary transvenous pacemakers were analyzed for indications, complications and malfunctions. Of the 156 patients who had had an acute myocardial infarction (AMI), 50% had had anterior wall and 43.6% inferior wall involvement. The route of electrode insertion was the antecubital vein in 71%, subclavian vein in 24%, internal jugular vein in 4%, and a femoral vein in the remainder. The indication for pacing in the AMI group was atrioventricular (A-V) block in 55%, fascicular block in 32% and other arrhythmias in 13% of the cases. In the non-AMI group, the indication for pacing was A-V block in 46.4%, sick sinus syndrome in 25%, preparation for noncardiac surgery in 12%, and diagnostic purposes in the remainder. Ventricular fibrillation (VF) occurred only in the AMI group and appeared in 9 (5.66%) of these cases. The site of infarction did not significantly affect the incidence of VF. Ventricular premature beats (VPBs) and ventricular tachycardia (VT) appeared in 28.8 and 12.8% of the AMI group and 4.4 and 3.3% of the non-AMI group, respectively. No difference in the incidence of myocardial perforation, sepsis, and phlebitis was encountered between the AMI and non-AMI groups. Total malfunction rate was significantly higher in the AMI group (15%) vs. the non-AMI group (4%). A higher rate of pacing malfunction was found when a semifloating electrode was used through the subclavian vein (14.3%) vs. a 6 or 7 French electrode through the antecubital vein (7%). Thus, temporary pacing is safe and associated with lower incidence of complications and malfunctions in non-AMI than in AMI subjects. Moreover, a lower incidence of malfunction was encountered when a 6 or 7 French electrode was inserted through the antecubital vein. PMID- 3679792 TI - Transient hyperphosphatasemia of infancy. AB - Very high serum levels of alkaline phosphatase were found in four children aged 13 to 24 months. No other abnormalities nor explanation for the raised enzyme levels were found. The origins of the elevated enzyme levels were shown by isoenzyme studies to be the liver in one case, the bone in two cases, and undetermined in one case. Serum alkaline phosphatase levels returned to normal after periods of 5 to 20 weeks. Awareness of these benign forms of hyperphosphatasemia will aid the physician in the differential diagnosis of elevated alkaline phosphatase levels. PMID- 3679791 TI - Maple syrup urine disease in a Bedouin tribe: pre- and postnatal diagnosis. AB - Maple syrup urine disease (MSUD) was diagnosed in four Bedouin infants as a result of the lack of branched-chain keto amino acids (BCKA) decarboxylase activity in leukocytes and skin fibroblasts. Second trimester amniocenteses were performed in five at risk pregnancies for measurement of BCKA decarboxylase. The activity measured in amniocytes was undetectable in two of them. Pregnancy was terminated only in one case and the second continued to term. The diagnosis of MSUD was confirmed in tissues of one aborted fetus, and in leukocytes of the liveborn infant. The other three pregnancies, in which normal enzymatic activity was found in the amniotic cells, were carried to term, and BCKA decarboxylase activity was evident in the leukocytes. PMID- 3679793 TI - Selective right ventricular dysfunction following doxorubicin therapy. AB - Cardiotoxicity is one of the major side effects of doxorubicin therapy. The side effect presents in an acute and chronic form. It has been observed mainly when the cumulative dosage exceeds 450 mg/m2 of body surface. The cardiotoxicity presents with a low left ventricular ejection fraction. We report three patients who developed selective right ventricular dysfunction, expressed by low right ventricular ejection fraction as measured by radionuclide angiography. This complication was observed with rather low cumulative dosages of the drug (105 to 318 mg/m2). Two of the patients received concurrent mitomycin-C chemotherapy and the third patient underwent prior mediastinal irradiation. The possible mechanism for this selective cardiotoxicity is discussed. Monitoring of right ventricular performance by radionuclide angiography during doxorubicin therapy is recommended so that therapy can be discontinued before the left ventricle is damaged. PMID- 3679794 TI - Right ventricular thrombus and pulmonary arteritis in Behcet's disease. AB - Prolonged fever, splenomegaly and right ventricular thrombus are rare manifestations of Behcet's disease. We report a 15-year-old boy with Behcet's disease who presents with these unusual manifestations. PMID- 3679795 TI - Muscle enzyme elevation in carbamazepine intoxication. PMID- 3679796 TI - Diarrhea and lethal bone marrow depression induced by nomifensine maleate. PMID- 3679797 TI - Marked glomerular filtration rate reduction in a child due to myxedema. PMID- 3679798 TI - Proximal femoral focal deficiency associated with severe brain atrophy. PMID- 3679799 TI - Primary torsion of the omentum in children. PMID- 3679800 TI - Annual meeting of the Israel Endocrine Society. 14 to 15 December 1986, Jerusalem, Israel. Abstracts of papers. PMID- 3679802 TI - Leptospirosis in Hawaii. PMID- 3679801 TI - Stimulation of in vivo antibody production and concanavalin-A-induced mouse spleen cell mitogenesis by prolactin. AB - Regulation of the immune system by neuroendocrine hormones is receiving increased attention. Prolactin, a hormone normally associated with lactation, has been shown recently to reconstitute immunosuppressed hypophysectomized rats. The present studies demonstrate that prolactin administration to normal mice results in a biphasic stimulation of antibody production to sheep red blood cells. While 100 and 200 micrograms bovine prolactin/animal stimulated antibody production, 400 micrograms had no effect. Potentiation of lectin-induced T-cell mitogenesis by prolactin was also biphasic. As the concentration of prolactin increased the incorporation of [3H]thymidine into the cells first increased and then decreased. Decreasing serum prolactin levels with the dopaminergic agonist bromocriptine resulted in a reduction of antibody titers to sheep erythrocytes and a modulation of thymic weight. These data show that prolactin can stimulate the immune system in a biphasic manner and that a reduction in the basal levels of this hormone results in an attenuated immune response. PMID- 3679803 TI - Hereditary anemias in Hawaii. PMID- 3679804 TI - Clinical tests of male fertility status. PMID- 3679805 TI - The rationalisation of gastro-intestinal fibre-optic endoscopy services in Lothian Health Board. PMID- 3679806 TI - Yellow book, red alert: managing change in the NHS. PMID- 3679807 TI - The use of an accident and emergency department by the single homeless. PMID- 3679808 TI - Football injuries presenting to an accident and emergency department. PMID- 3679809 TI - Oral candidiasis in terminal illness. PMID- 3679810 TI - The complaints process and the independent contractor services. PMID- 3679811 TI - [Urticaria pigmentosa--an obligate systemic disease? Results of nuclear medicine studies and etiopathogenetic significance]. AB - The objective of the present investigation was to establish the frequency of systemic spreading of urticaria pigmentosa by means of bone and bone marrow scintigraphy as a noninvasive imaging technique with a low radiation exposure. Bone scintigraphy: Seven of nine patients investigated showed diffuse and focal nuclide accumulation. After exclusion of other causes by reference to the case history and the clinical and chemical laboratory findings, these nuclide accumulations were regarded as mastocytosis-specific in accordance with the atypical localization. Bone-marrow scintigraphy: All the patient investigated showed a peripheral expansion of the bone marrow. This must be interpreted as an expansion of the macrophages of the bone marrow on the basis of the method used. Since the mast cell is regarded as a more highly differentiated form of the same cell-type as macrophages/monocytes, on the basis of the scintigraphic results presented, urticaria pigmentosa can be regarded pathogenetically as a hyperplasia of the macrophages of the bone marrow organ, with increased differentiation in mast cells. The extent of this differentiation and its pathological quality then determine the clinical signs and symptoms (cutaneous, systemic, or malignant mastocytosis). Urticaria pigmentosa thus has the character of a systemic disease. PMID- 3679812 TI - [Seasonal changes in the course of atopic eczema]. AB - To investigate seasonal changes of the course of atopic dermatitis, questionnaires were sent to patients treated for this condition in 1984. The replies obtained from 506 patients indicated that in most of them the skin condition deteriorated in winter and improved in summer. However, among patients older than 5 years the proportion of those with deterioration in summer was higher. It is suggested that seasonal factors greatly influence the skin condition of patients with atopic dermatitis and that these seasonal variations often depend on age and environment. PMID- 3679813 TI - [Desmoplastic trichoepithelioma. Clinical aspects, histology and differential diagnosis]. AB - Twelve desmoplastic trichoepitheliomas (DT) including one recurrent tumor from 9 patients are described by their clinical and histopathological features with special reference to the differential diagnostic aspects. DT typically appear as dimple lesions with raised edges in the faces of young females and histologically is composed of epithelial sheets and keratinized or calcified cysts in a desmoplastic stroma. A case showing cellular pleomorphism and followed by a relapse may represent an aggressive variant of DT. DT must be distinguished from syringoma, trichoepithelioma and especially basal cell carcinoma (BCC). PMID- 3679814 TI - [Syringoma of the vulva]. AB - A case of a 20-year-old white female patient is presented, who developed syringomas on the labia majora. The 12 cases that have previously been described in the literature are summarized. Syringomas should be considered in the differential diagnosis of papular lesions of the vulva and are probably more common than is reflected in the number of cases published. PMID- 3679815 TI - [Removal of tattoos with the Nd:YAG laser]. AB - Irradiation of 20 tattoos using the Q-switched Nd:YAG laser (energy density 3-5 J/cm2, asymmetrical pulse shape with 50% energy output in 18 ns, spot size 3 mm in diameter) gave the impression that black ink tattoos can be completely removed without scarring. Some patients needed several treatments. The results continued to improve even some months after the irradiation. In preliminary experiments on excised tattooed and untattooed skin the non-Q-switched Nd:YAG laser had distinct burning effects. It was therefore not tested in patients. The results of chemical, physical, and histological examinations are discussed with special reference to toxic side-effects that might be induced by laser irradiation. PMID- 3679816 TI - [Dowling-Degos disease: unsuccessful therapeutic trial with retinoids]. AB - A patient with the typical features of Dowling-Degos disease (reticulate pigmented anomaly of the flexures) is described; the clinical picture and differential diagnosis are discussed. Systemic retinoids were used for treatment, but no essential improvement could be observed. PMID- 3679817 TI - [Epidermolysis bullosa hereditaria dystrophica (Hallopeau-Siemens). Case report and therapy trial with (+)-cyanidanol-3 in 3 patients]. AB - The diagnosis of hereditary epidermolysis bullosa dystrophica (Hallopeau-Siemens) in three patients was confirmed by clinical and histological means as well as by electron microscopy. The clinical course was followed for many years. Since (+) cyanidanol-3 has been shown to reduce the susceptibility of collagen to mammalian collagenase under in vitro conditions, (+)-cyanidanol-3 was used to treat the three patients for a period of 27 weeks. A decrease in the amount of blistering was observed in all three patients. PMID- 3679818 TI - [Facial involvement in scabies in infancy]. AB - The infestation of a 3-month-old child with Sarcoptes scabiei by way of infested nipples during the breast-feeding period led initially to facial papules and later to generalized dermatitis. Scabies mites were not detected on the face; studies on ten infested babies in India supported this findings. Thus, direct antiscabies treatment to the face is not necessary in babies. PMID- 3679819 TI - [Lymphomatoid granulomatosis]. AB - We present two patients with lymphomatoid granulomatosis (LG) which was diagnosed from the histopathology of cutaneous lesions. Combined cytostatic and corticosteroid treatment induced transient, partial remission in one case, but a lethal outcome could not be prevented in either case. Monoclonal-antibody typing of lesional infiltrates indicated that LG is a malignant T-cell lymphoma. PMID- 3679821 TI - Writing book reviews. PMID- 3679820 TI - [Release of topical drugs containing hydrocortisone for the OTC market]. PMID- 3679822 TI - Dosimetry associated with exposure to non-ionizing radiation: very low frequency to microwaves. AB - The interpretation of the effects in biological systems exposed to electromagnetic (EM) fields requires knowledge of the internal fields and absorbed energy. The quantification of the specific absorption rate (SAR) is called dosimetry. The SAR given in units of watts per kilogram is a complex function of the source configuration, shape and size of the exposed subjects, orientation of the subject with respect to the source, and the frequency. The average and maximum SAR in the exposed subject may vary over many orders of magnitude for a given exposure level. In order to relate observed biological effects in exposed laboratory animals to safe exposure levels for man, both the fields within the environment and SAR within the exposed tissues must be determined. The environmental fields and the SAR can often be determined from EM theory, but in most cases one must rely on instrumentation such as field survey meters for quantifying the exposure fields and electric field probes, thermocouples, thermistors, fiber optic probes, thermography, and calorimetry for quantifying the SAR in the tissues or equivalent models. A combination of techniques, each valid for a particular model over a particular frequency range, have been used to determine average and peak SARs in humans and animals exposed to plane wave radiation. Though it has been considerably more difficult to quantify these quantities for near field and partial-body exposure conditions, progress is continually being made in this area. PMID- 3679823 TI - Interaction of extremely low frequency electric and magnetic fields with humans. AB - The dosimetry and physical interaction mechanisms of electromagnetic fields with frequencies in the extremely low frequency (ELF) range (below 300 Hz) are described. The mechanisms through which ELF electric and magnetic fields induce electric currents in living organisms are summarized, with particular emphasis on humans. Topics that are discussed include: (1) sources and measurements of ELF electric and magnetic fields; (2) direct and indirect coupling of these fields to humans; (3) transient discharges and contact currents, and the thresholds for human response to these phenomena; (4) protective measures for the mitigation of potential ELF field effects on humans; and (5) mechanisms of interaction of ELF fields with cellular and tissue systems, with emphasis on field transduction mechanisms involving the cell membrane. PMID- 3679824 TI - Radiofrequency radiation activities and issues: a 1986 perspective. AB - Current activities and issues related to radiofrequency (RF) radiation are discussed. They include a summary of environmental exposure levels as well as federal and other activities related to the control of exposure to RF radiation. An overview is given of the biological effects (thermal, athermal and non thermal) and the limitations in our knowledge of these effects. Resources for continued research on health effects of RF radiation are discussed. PMID- 3679825 TI - Forecasting radiation rates and exposure from multi-aged fallout. AB - A graphical method for forecasting radiation exposure rates from multi-aged fallout is extended to include a nomogram method. A simple method for forecasting accumulated radiation exposure is also presented. It is shown mathematically that these methods can provide estimates of radiation exposure rates or cumulative exposures for intervals of a few days to a few weeks in the future to within +/- 30% from assumed actual radiation exposure rates or accumulated exposures for fallout that decays according to t-n, where n is any number from 0.8 to 1.6. Because of the self-adjusting feature of the method which results in an estimated effective age for the fallout, it is not necessary to attempt to subtract contributions from separate fallouts with different ages. The method can be applied to composite fallout without knowledge of the previous history of the various-aged contributions. PMID- 3679826 TI - Patient and personnel exposure during extracorporeal lithotripsy. AB - Extracorporeal shock wave lithotripsy (ESWL) has provided a nonsurgical approach to treatment of renal stones. The Dornier lithotripter uses dual image intensified x-ray systems to center the stone before treatment. Three imaging modes are offered: a fluoroscopic mode and two video spot filming modes. The average entrance exposure to the stone side of the typical patient at our facility is 2.6 X 10(-3) C kg-1 (10 R) [range: 0.5-7.7 X 10(-3) C kg-1 (2-30 R)] which is comparable and often much less than that reported for percutaneous lithotripsy. Recommendations are made for minimizing patient exposure. Scattered radiation levels in the lithotripter room are presented. We have determined that Pb protective apparel is not required during this procedure provided x-ray operation is temporarily halted should personnel be required to lean directly over the tub to attend to the patient. If the walls of the ESWL room are greater than 1.83 m (6 feet) from the tub, shielding in addition to conventional construction is not required. PMID- 3679827 TI - The use of Teflon-embedded calcium sulphate: dysprosium thermoluminescent dosimeters for chest radiography. AB - As part of a U.S. multi-regional pilot study conducted by the six Centers for Radiological Physics, 12-mm-diameter by 0.4-mm-thick CaSO4:Dy Teflon-embedded discs were evaluated and used to measure patient entrance exposure on 60 "average" patients at 12 clinical centers. The discs were found to have adequate sensitivity, reproducibility and linearity up to 69.7 microC kg-1 (270 mR). The minimum measurable exposure was estimated as 0.4 microC kg-1 (1.5 mR). All responses were corrected for energy dependence, which varied +/- 20% from 1.7 to 6.5 mm Al half-value layer. Patient entrance exposure values ranged from 1.3 to 28 microC kg-1 (5 to 110 mR), with a median value of 5.2 microC kg-1 (20 mR). This value agreed with exposure measurements made on the chest radiography equipment using an ionization chamber and a phantom which simulated an "average" patient, and with published Nationwide Evaluation of X-Ray Trends (NEXT) data for the same period. PMID- 3679828 TI - Measured statistics of laser beam scintillation in strong refractive turbulence relevant to eye safety. AB - The time series of irradiance from a diverged He-Ne laser were measured using receiver aperture sizes that simulate the day-adapted and night-adapted human pupil. The data are within the saturation-of-scintillation regime wherein the irradiance variance decreases with further increases of propagation distance and refractive turbulence strength. Irradiance probability distributions, as well as the joint statistics of irradiance and duration of large irradiance values, are presented. The ocular hazard contributed by scintillation is found to decrease with increases of range and/or refractive turbulence strength; this effect is independent of the decrease of mean irradiance associated with such increases of range and refractive turbulence strength. PMID- 3679829 TI - Proposed revision of the Canadian recommendations on radiofrequency-exposure protection. AB - In 1979, the Canadian Federal Government published a safety code which recommended limits of exposure to radiofrequency radiation at frequencies from 10 MHz to 300 GHz. This paper outlines and discusses proposed revisions to these recommendations. The main changes include an extension of the frequency range down to 10 kHz, a change in the exposure limits for the general public, and added recommendations on limiting body current upon contact with ungrounded objects. The rationale for the proposed limits refers to recent data on dosimetry and biological effects, and includes comparison with other national and international standards for radiofrequency exposure protection. PMID- 3679830 TI - Does tributyl phosphate influence the radiation risk of a highly proliferating system--the early mouse embryo in vitro? AB - Two-cell mouse embryos were exposed in vitro to tributyl phosphate, x rays, or a combination of both. In-vitro development of the embryos was followed microscopically (cleavage to four- and eight-cell embryos, formation of morulae and blastocysts, and hatching of blastocysts). Effects on proliferation were estimated by counting the number of cells per embryo early (48 h p.c. = 48 hours post conceptionem) and late (144 h p.c.) in the preimplantation period. Cytogenetic damage was studied using micronucleus formation as the end point. Tributyl phosphate did not reveal toxic effects up to a concentration of about 5 microM after an exposure time of 18 h. At a concentration of about 15 microM, 50% of late preimplantation embryos showed effects on morphological development and on cell proliferation, and at about 40 microM, 90% of the embryos were affected. Tributyl phosphate did not induce micronuclei. Small effects by x irradiation were observed between 0.25 Gy and 0.5 Gy, depending on the end point measured in the late preimplantation stage. Fifty percent of the embryos were affected by a dose slightly higher than 1 Gy, and 90% after about 4 Gy. No enhancement in risk was found after combined treatment of the embryos with tributyl phosphate and x rays. PMID- 3679831 TI - Assessing dose equivalent from intensive short-term U product inhalation. AB - Intensive exposure of a product packaging operator to U product dust resulted in the uncontrolled inhalation of natural U. In-vivo counting yielded an estimate of about 40 mg of natural U initially deposited in the lung. An effective committed dose equivalent in the range of 67 mSv and 137 mSv was calculated to correspond to this lung contamination, using a single exponential lung clearance and the modified ICRP models, respectively. The effective committed dose equivalent of a person 47 y old involved in this incident can hardly be used to quantify the risk, and therefore committed and annual dose equivalent systems were discussed in light of risk assessment. PMID- 3679832 TI - Influence of ore type and milling process on 222Rn emanation coefficients of U mill tailings. PMID- 3679833 TI - Measurement of the transfer coefficient for radiocesium transport from a sheep's diet to its milk. AB - The rate of increase and decay of radio contamination secreted in sheep's milk, resulting from a constant level of radiocesium in the animals' diet, was investigated. Ten lactating ewes were used in the experiment. For a period of 12 d the animals fed on contaminated grass, resulting in a daily radiocesium intake of 832 Bq per animal. They were subsequently returned to a contamination-free diet and were monitored for another 9 d. Throughout the period of the experiment, 134Cs and 137Cs concentrations in the animals' milk were measured daily with an 18% efficiency, high-resolution Ge detector. The data were in satisfactory agreement with the predictions of a simple two-compartment theory. The transfer coefficient, describing the steady-state equilibrium in this model, was measured as fm = 0.058 +/- 0.007 dL-1. PMID- 3679834 TI - Questions about Chernobyl. PMID- 3679835 TI - An evaluation of the Robert Wood Johnson Foundation's Hospital-Sponsored Ambulatory Dental Services Program. AB - This article summarizes the results of an evaluation of the Hospital-Sponsored Ambulatory Dental Services Program funded by the Robert Wood Johnson Foundation. Goals of the program were to increase service to the underserved both in the volume of persons treated and in continuity of care, while supporting expanded dental general-practice residency training and aiding financial viability of the dental departments. The principal findings were that, while the volume of new patients increased, the number of disadvantaged persons did not. Continuity of care may have worsened. Policy implications are that hospital dental departments should improve their efficiency and narrow their goals to the special populations best treated in their environment. Innovative financial mechanisms should be explored, including combining with medical care hospital-based HMOs. However, the goals cannot be reached without expanded and continuing governmental subsidy. PMID- 3679836 TI - Pew Memorial Trust policy synthesis: 3. Adolescent pregnancy: the responsibilities of policymakers. AB - In recent years, adolescent pregnancy and childbearing have emerged as major health and social policy issues, sparking debates in local and national forums. The concern is a response to rates of adolescent sexual activity, pregnancy, and out-of-wedlock childbirth that have risen sharply in the past 20 years. The deleterious effects of early parenthood, especially in poor communities, have been amply documented; education, future employment, and health status are among the areas affected. Efforts at intervention have ranged from preventing pregnancy by encouraging celibacy to trying to enhance the options available to those who are already parents. Many of these efforts have fallen short, proving unequal to the complexity of the issues being tackled. Relatively successful approaches have also been developed, however, and the synthesis describes several. Strategies addressing the needs of adolescents comprehensively and involving a multiplicity of concerned players appear to be most effective in the long term. There is a pressing need for more program documentation to substantiate this and other promising strategies. PMID- 3679837 TI - The health of health risk appraisal. PMID- 3679838 TI - A research agenda for personal health risk assessment methods in health hazard/health risk appraisal. Summary of a conference. September 7-9, 1986, Wayzata, Minnesota. PMID- 3679839 TI - Health risk appraisal: its role in health services research. PMID- 3679840 TI - Potential and limitations of data and methods in health risk appraisal: risk factor selection and measurement. PMID- 3679841 TI - Composite scoring--methods and predictive validity: insights from the Framingham Study. AB - After three decades of epidemiologic research at Framingham and elsewhere, the risk factor concept is now firmly established. Atherosclerotic cardiovascular disease can now be predicted and highly vulnerable candidates identified from profiles derived from ordinary office procedures and simple laboratory tests [1]. Risk can be estimated over a 20--30-fold range, and close to half of the cardiovascular events are found to occur in a tenth of the population at highest multivariate risk. Categorical risk assessments focusing on the number of "risk factors" present also identify high-risk subjects but tend to overlook high-risk individuals with multiple marginal abnormalities. Multivariate cardiovascular risk profiles made up of the major cardiovascular risk factors can predict all of the major cardiovascular events, even in advanced age, with reasonable efficiency. Such multivariate risk assessments can be made convenient by reproduction of handbooks and use of small programmed calculators, software for personal computers, and slide rules to facilitate office and public health assessments. The sensitivity and specificity of these risk profiles can probably be improved by more detailed lipid information, including HDL-cholesterol [12], vital capacity determination, and other ECG abnormalities. General cardiovascular risk profiles can be devised to predict efficiently all of the major cardiovascular events. PMID- 3679842 TI - Behavioral science perspectives on health hazard/health risk appraisal. AB - Health-promotion efforts often employ HRA as a device for providing an individual with quantitative information about the consequences of personal health-related behaviors and as an attempt to motivate the client to adopt recommendations directed at establishing a healthier lifestyle. From a behavioral science perspective, the HRA approach and process contain elements that (at least in retrospective analysis) appear to be founded in relevant bodies of theory. First, HRA seems to be a reasonably efficient mechanism for transmitting information relative to associations between personal health behaviors and mortality risks. Moreover, while general knowledge and advice about the untoward consequences of risk factors (such as smoking, obesity, high blood pressure, etc.) are currently widespread, HRA provides new and specific information: the client's own relative risks. Some individuals who voluntarily participate in HRA bring to the experience an already high level of readiness to take action; for them, the technique may constitute the final necessary stimulus or "cue to action" [12]. Referring to a "borrowing from the future" phenomenon, Green points out that "some educational efforts are really only triggers to behavior that would have changed eventually anyway" [44, p. 159]. Thus, where motivation is sufficiently high, receipt of HRA feedback information may by itself be capable of inducing behavior change. Second, the focus on awareness and personalization of mortality risk fits well with most theoretical formulations concerning attitudes and beliefs involved in health-related decision making. Although the emphasis on mortality and often distant negative outcomes is problematic, increasing the client's perception of personal vulnerability is a psychologically defensible approach, and fear arousal can generate attitude change (although questions of appropriate level, duration of effects obtained, acceptability, etc. still need to be resolved). Third, HRA might be expected to enhance the client's perception of the benefits associated with lifestyle modifications and may even increase personal belief in his or her ability to undertake such changes in behavior. However, in light of the fact that the behaviors to be altered are complex, usually well-established and repetitive, and require different skills to extinguish, the provision of typical HRA feedback should not (on a theoretical basis) ordinarily be expected to accomplish much beyond information transmission, belief or attitude change, and the induction of some level of motivation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3679844 TI - Victims of violence. PMID- 3679843 TI - Health risk appraisal: review of evidence for effectiveness. AB - Since its introduction some two decades ago, health risk appraisal (HRA) has become a standard offering in the health promotion repertoire. The technique's distinctive feature is its use of epidemiologic data to generate quantitative risk messages for the client. Yet despite the dedication and considerable investments that have gone into HRA's development, dissemination, and use, there is only limited empirical evidence that these quantitative risk messages have any effect on clients. There do not appear to be any formal studies of HRA's effect on participation in health promotion programs, although increasing recruitment is regarded as a major benefit of using HRA. There are few indications of HRA effects on health beliefs. Most positive reports of effects on behavior change come from uncontrolled studies; several randomized controlled trials have yielded ambiguous findings. Virtually no data exist concerning the impact of the quantitative risk messages that distinguish HRA from other assessment techniques and that have motivated the substantial efforts toward developing and refining HRA. HRA has evident appeal and is probably a useful health education device for middle-class, middle-aged, nonminority clients. It may well have desirable effects on health-related beliefs, attitudes, and behaviors when accompanied by counseling or education, but available evidence has not established its effectiveness. Given the difficulty of obtaining definitive evidence of the effectiveness of HRA and specifically of its use of quantitative risk projections, the need for such evidence is debatable. An adequately funded and reviewed research program to examine whether projections of absolute risk affect knowledge, beliefs, attitudes, and intention to change is recommended as the most fruitful next step. Epidemiologically based HRA procedures that provide feedback in terms of qualitative statements or relative risk may be a promising approach to prospective health assessment. PMID- 3679845 TI - Violence: the community nurse's dilemma. PMID- 3679846 TI - Good health for women. PMID- 3679847 TI - Men only: a personal MOT at 50. PMID- 3679848 TI - Carry on health visiting. PMID- 3679849 TI - An ABC of alternative medicine. Reflexology. PMID- 3679850 TI - Hypertension in school-children: the case for screening. PMID- 3679852 TI - School-children as consumers--what are their health needs? PMID- 3679851 TI - The healthy living game. PMID- 3679853 TI - Symposium: Nursing diagnosis in critical care. March 1987 National Conference on Nursing Diagnosis in Critical Care. Milwaukee. PMID- 3679854 TI - Nursing diagnosis in critical care: impact on practice and outcomes. PMID- 3679855 TI - Administrative applications of nursing diagnosis. AB - Nursing diagnosis is not a panacea. It does not offer answers to all that ails nursing in the current health care environment. Implementation is hampered by poorly defined and confusing terms. Bedside practitioners are unable to see the value of what is perceived as merely adding more paperwork and moving them away from the patient's bedside. Nonetheless, nursing diagnosis offers a framework for the development of definitive data to address the benefit and effectiveness dimensions of cost-benefit questions. Such data are vitally needed if patient outcomes are to be, and to remain, central in the midst of the dramatic and fundamental changes impacting health care. PMID- 3679856 TI - Methods to validate nursing diagnoses. PMID- 3679857 TI - Nursing diagnoses in nursing education: effect on the profession. PMID- 3679858 TI - Care of the patient with the automatic implantable cardioverter defibrillator: a guide for nurses. PMID- 3679859 TI - Myocardial infarction during pregnancy: a team challenge. AB - Myocardial infarction during pregnancy is rare but may be increasing in frequency because of the trend toward later childbearing and an overall increase in risk factors for women (smoking, high-stress careers). The physiologic changes and stresses of pregnancy and labor provide a unique and often devastating setting for coronary diseases. The mortality rate is extremely high, approaching 40% if delivery ensues within 2 weeks of infarction. A planned, induced labor with regional anesthesia and continuous invasive monitoring in a well-equipped medical center provides the safest setting for delivery. Assisted vaginal delivery may offer a lower risk of death than cesarean section. The nurse, as well as the other members of the multidisciplinary team, should be well versed in the normal physiologic stresses of pregnancy. The fetal and cardiac effects of all medications and interventions must be explored. The almost simultaneous appearance of a new child in one's life with a heightened and immediate awareness of one's own mortality can lead to overwhelming feelings of despair and anxiety. Transition to home life may be difficult. All aspects of the patient's needs from heart to hope, should be addressed. PMID- 3679860 TI - Nursing diagnosis: ineffective coping. I. A theoretical framework. PMID- 3679861 TI - Nursing diagnosis: ineffective coping. II. Planning care. AB - It has been the intent of this discussion to provide nurses with a model for understanding the coping process and a framework for planning interventions that can affect the stress-coping cycle in a variety of ways. The model also provides a framework for research that identifies effective nursing activities. PMID- 3679862 TI - Accurate coagulation studies from heparinized radial artery catheters. AB - We studied the feasibility of obtaining accurate coagulation studies from indwelling, heparinized radial artery catheters in 28 patients after cardiac surgery. PTT assay was chosen because of its frequent clinical use. Thrombin time assay was chosen because it is a component of the coagulation screening panel and because it is useful in assessing heparin contamination of specimens. We conclude that PTT results are reliable when the dwell volume (0.6 ml for the catheter and extension tubing in our study) and an additional 4.5 ml have been discarded (5.1 ml total discard volume). We recommend the collection of samples for thrombin time assay from a separate venous site because results on samples from heparinized arterial catheters are unpredictable. PMID- 3679863 TI - Comparison of the patency of arterial lines maintained with heparinized and nonheparinized infusions. The Cardiovascular Intensive Care Unit Nursing Research Committee of St. Luke's Hospital. PMID- 3679864 TI - Minimum discard volume from arterial catheters to obtain coagulation studies free of heparin effect. AB - With the use of the canine experimental model, the accuracy and reliability of coagulation test results were compared between arterial samples and samples obtained by venipuncture. The age of the catheter, the concentration of the heparinized flush solution, and the minimum discard volume were evaluated to obtain coagulation study results free of heparin effect. Thirty-seven paired samples of PT, aPTT, and TT were obtained. Analyses revealed no significant difference in test results between new lines and 7-day-old lines, nor between heparin concentrations of 1 unit/ml, 2 units/ml, or 4 units/ml. A minimum discard volume of five times the dead space (measured from catheter tip to sampling proximal stopcock) resulted in accurate and reliable PT, aPTT, and TT test results from the arterial catheters. PMID- 3679865 TI - The problem of culpability. PMID- 3679866 TI - Effective technique of controlling volume in refractory congestive heart failure. AB - Continuous arteriovenous hemofiltration can be very effective in severe hypervolemic states associated with refractory CHF and limited renal response to diuretics and vasodilators. A reduced vascular volume is accompanied by a lower preload and afterload and thus a decrease in heart size. As a result cardiac efficiency and contractility improve, and oxygen demands are reduced. The temporal progression of CHF from a mild to a severe state need not be a sign of progressive pathology of heart muscle, but rather a result of feedback circuits where failure begets failure and leads to progressive cardiac enlargement, progressive hypervolemia, and peripheral edema. An appreciation of this concept permits a more optimistic approach to the management of CHF. Thus, the effective use of CAVH in reducing vascular volume and peripheral edema may in some patients reverse "refractory" CHF and prolong life. PMID- 3679867 TI - Symposium proceedings. Nursing interventions in limiting infarct size in the acute myocardial infarction patient: nursing implications. Pre-National Teaching Institute (NTI) Conference. May 3, 1987, New Orleans, Louisiana. PMID- 3679868 TI - Thrombolytic therapy for acute myocardial infarction: a brief review. AB - Thrombolytic therapy given within the first 4 to 6 hours to patients with evolving acute MI appears to reduce in-hospital and 1-year mortality rates. In addition, patients who receive treatment in the first few hours may also benefit through improved residual left ventricular function, resulting from the preservation of ischemic myocardium. Newer agents that are more effective in lysing intracoronary thrombi are currently under development. The most promising is tissue-type plasminogen activator (t-PA), which is being evaluated in a number of large multicenter trials, including the National Heart, Lung, and Blood Institute's Thrombolysis in Myocardial Infarction (TIMI) trial. In this study researchers are also comparing the additional value of early versus delayed coronary artery angioplasty and are evaluating a subset of patients randomly assigned to early beta-blocker therapy to assess the value of adjunctive pharmacologic therapy. In the future, it is likely that studies will be carried out to determine the usefulness of thrombolytic therapy given to patients by paramedics before hospitalization. Such a study is being planned in several communities. It is hoped that by means of prehospital therapy, it may be possible to treat a substantial group of patients with symptoms and electrocardiographic findings of acute MI before extensive left ventricular myocardial necrosis has occurred. If this goal can be realized, it may be possible to achieve a very substantial reduction in mortality resulting from acute MI. Initial experience with prehospital intravenous streptokinase therapy has already been reported from Jerusalem, Israel.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679869 TI - Home care prophecies and predictions, Part I. PMID- 3679870 TI - A new nursing diagnosis system. PMID- 3679871 TI - Costing home health care. PMID- 3679872 TI - Home health utilization review. PMID- 3679873 TI - Oncology alert for the home care nurse: superior vena cava syndrome. PMID- 3679874 TI - Social network discharge planning tool. PMID- 3679875 TI - Educating clients with COPD. PMID- 3679876 TI - Role of the home health aide in the rehabilitation process. PMID- 3679877 TI - Credible professionals doing incredible jobs: a tribute. PMID- 3679878 TI - Utilizing your rights under administrative law. PMID- 3679879 TI - Genetic differentiation of quantitative characters between populations or species. II: Optimal selection in infinite populations. AB - Using a new and more general genetic model called the discrete-allelic state model and assuming discrete-time process, the evolutionary changes of genetic variation of quantitative characters, controlled by a few loci, within and between populations during the process of genetic differentiation of populations or species, are studied under the effects of mutation and centripetal selection in infinitely large populations. While in a finite population and ignoring selection, the rate of change of additive genetic variance depends on mutation and effective population size, traits under optimal selection in infinitely large populations go through the dynamics of a rather complicated form depending on the relative intensities of selection and mutation. When a population, which has reached steady-state by mutation-selection balance, splits into two, in one of which the same optimum genotype holds but in the other the optimum shifts a few standard deviations away from the original optimum, the corresponding daughter population starts differentiating from its sister population by favouring certain class of mutant alleles and discarding others which were originally favoured. During this process of turn over of genes, both the intra- and inter-populational variances undergo a complicated change, and the ratio of the former to the latter is a non-linear function of time of divergence. This pattern is qualitatively very different from the case when selection is absent. The intra-population distribution of genotypic values, during this transition, is shown to deviate considerably from normality. The presence of linkage seems to retard the accumulation of intra-populational genetic variance. The implications of these results are discussed in comparison with the earlier findings of evolutionary models of quantitative traits. PMID- 3679880 TI - Inter and intraspecific variation in nuclear DNA content in Aedes mosquitoes. AB - Haploid nuclear DNA of 23 species of Aedes, as determined by Feulgen cytophotometry, was found to vary 3-fold. This was accompanied by a 2-fold variation in total chromosomal length. There was a significant correlation (r = 0.765, P less than 0.001) between these two parameters. Genome size varied from 0.87 pg to 1.3 pg among 10 strains of Aedes albopictus, from wide geographic regions. Large scale differences in chromosomal DNA amounts have accompanied speciation and evolution in aedine mosquitoes. PMID- 3679881 TI - Renal involvement in the acquired immunodeficiency syndrome: presentation, clinical course, and therapy. PMID- 3679882 TI - The AIDS challenge: a psychosocial perspective. PMID- 3679883 TI - AIDS update. PMID- 3679884 TI - Health care policy issues related to AIDS: lessons learned from the Henry Ford Hospital experience. PMID- 3679885 TI - Bilateral anterior cerebral artery occlusion in an alcohol abuser with sickle cell trait. PMID- 3679886 TI - Extensive morphea-form basal cell carcinoma invasion of the iris and the orbital contents. PMID- 3679887 TI - A new microdetermination method used in an analysis of the excretion of trichloro compounds in the urine of workers exposed to trichloroethylene vapour. PMID- 3679888 TI - Symptoms and signs of workers exposed to benzene, toluene or the combination. PMID- 3679889 TI - Beryllium induced haematological alterations and their response to Liv-52. PMID- 3679890 TI - Glutathione metabolism in liver, kidney and testis of rats exposed to cadmium. PMID- 3679891 TI - Measurement of ultraviolet radiation from welding arcs. PMID- 3679892 TI - IgA glomerulonephritis in a plumber working with solvent-based pipe cement. PMID- 3679893 TI - Cadmium induced ultrastructural changes in the cerebellum of weaned and adult rats. PMID- 3679894 TI - No biologically significant changes in liver function after occupational exposure to toluene at over-OEL levels. PMID- 3679895 TI - [Anatomy of the central auditory pathway. Demonstration with horseradish peroxidase in the guinea pig]. AB - The neurones of the afferent and efferent auditory pathways were labelled by axonally transported horseradish peroxidase. The first neurone of the ascending system is the acoustic nerve with the spiral ganglion. These fibres terminate mainly in the ventral cochlear nucleus (VCN). The neurones of the latter chiefly run to the contralateral superior olivary complex (SOC), whereas the neurones of the dorsal cochlear nucleus (DCN) terminate mainly in the central nucleus of the contralateral inferior colliculus (IC). The nerve cells of the superior olivary complex and nuclei of the lateral lemniscus (DLL, VLL) project to the IC. The IC neurones run mainly uncrossed to the medial geniculate body (MGB), i.e. the neurones of the central nucleus of the inferior colliculus terminate in the ventral nucleus of the medial geniculate body. This latter nucleus projects to the primary region A I of the auditory cortex, whereas the neurones in the pericentral medial geniculate body terminate in the associated auditory regions A II, EP and SF. The auditory areas of both hemispheres is well interconnected by commissural fibres. In addition to this ascending pathway there is a descending system. The parent cells correspond to pyramidal neurones in layer V in the auditory cortex. These neurones terminate in the medial geniculate body and in the pericentral nuclei of the inferior colliculus. From this, efferent neurones project to the DCN and SOC. The neurones of the olivocochlear bundles originate in the SOC; these bundles terminate predominantly on the surface of the outer hair cells in the organ of Corti. PMID- 3679896 TI - [Progression of accident-induced hearing damage]. AB - There are generally accepted opinions on the origin of auditory lesions due to accidents. The views on their possible progression, however, are divergent. One of the reasons is lack of sufficient information. Therefore serial audiological observations of such lesions are required, as are available for workers exposed to noise. In order to exclude the influence of noise on the organ of hearing, only auditory lesions which were strictly unilateral and which lay within a frequency range not susceptible to noise were followed up. The present study investigates the progressive decrease in hearing associated with the type of injury, the pure-tone audiometric pattern and the progress within a given period of time. It is remarkable that our material shows progressive hearing loss only after trauma due to explosion or head injury, and not after blast trauma. Thus it is not acoustic damage to the internal ear, but only mechanical damage which leads to progression. This theory was advanced by Lehnhardt many years ago. PMID- 3679897 TI - [Cricopharyngeal myotomy in dysfunction of the pharyngo-esophageal sphincter]. AB - Dysphagia due to upper esophageal sphincter dysfunction is usually diagnosed by cineradiography. If the treatment of an underlying disorder fails to improve swallowing or if the dysfunction is thought to be idiopathic, cricopharyngeal myotomy is considered the treatment of choice. In properly selected cases (i.e. significant dysphagia and radiological proof of pharyngo-esophageal dysfunction) cricopharyngeal myotomy offers complete or at least substantial relief of symptoms for three out of four patients. The use of an operating microscope is strongly advised. PMID- 3679898 TI - [Significance of sudden infant death (SIDS) for otorhinolaryngology]. AB - The high frequency of proven extensive infection in the upper respiratory tract, particularly the nose and pharynx, of infants with SIDS, suggests that the latter may be due to upper airway obstruction. In view of the particular vulnerability of the early infant, the widespread term "common cold" does not seem justified. The constant incidence of SIDS should stimulate study of the extension and effects of infection of the upper respiratory tract, including careful investigation, follow up and adequate therapy by otolaryngologists. Such a concept may prevent unexpected fatal complications. PMID- 3679899 TI - [Anesthesiologic viewpoints of endonasal paranasal sinus surgery]. AB - There must be close cooperation between the surgeon and the anaesthetist during surgery of the paranasal sinuses. The surgeon needs a bloodless field which the anaesthetist can achieve by lowering the patient's arterial blood pressure using controlled hypotension. Controlled hypotension carries considerable risks, and only selected cases should be treated with this method. There are two hypotensive drugs of choice: sodium nitroprusside and nitroglycerin. If the circulation and ventilation are monitored sufficiently, the surgeon can expect good results with diminished blood loss. PMID- 3679900 TI - [Failed intubation with case reports]. AB - Failed intubation in three patients is reported. All three patients suffered sudden, extreme impaired of mask-ventilation. Twice a coniotomy with subsequent tracheostomy proved to be life saving and without permanent injury. In the other patient tracheostomy had been attempted without success, and subsequent, successful, coniotomy could not prevent cerebral ischemia. Coniotomy is the only correct emergency operation for failed intubation with impaired mask ventilation. It must be followed by a standard tracheostomy with closure of the coniotomy wound to prevent permanent laryngeal damage. PMID- 3679901 TI - Relevance of soluble cytotoxic factors generated by mycoplasma-contaminated targets to natural killer cell-mediated killing. AB - The possible involvement of soluble cytotoxic factors (SCF) in the lytic mechanism of natural killer (NK) cell-mediated cytotoxicity (CMC) was investigated. Tumor target cells (TC) were examined for their ability to stimulate the release of SCF from human peripheral blood lymphocytes (PBL). SCF were detected when effector cells (EC) were stimulated with mycoplasma contaminated (MC)-TC and with concanavalin A (Con A), but mycoplasma-free (MF)-TC were unable to induce SCF. Pretreatment of EC with beta-interferon augmented the production of SCF with MC-K562 and Con A, but not with MF-K562. However, MF-K562 once infected with the culture supernatant from MC-K562, as well as mycoplasmas concentrated from culture supernatant, were able to induce SCF. Only Con A was capable of generating cytotoxic supernatants from EC that had been inactivated with MF-K562 and from EC depleted of Leu 11b positive cells. Moreover, when EC were evaluated for NK activity after coculture with MF-K562, their ability to kill fresh MF-K562 in the standard NK-CMC assay was greatly reduced. This loss of lytic potential was not accompanied by SCF release. Collectively, these data suggest that mycoplasma organisms play a crucial role in the induction of human SCF, and the implication that SCF, including NK cytotoxic factors (NKCF), are the lytic mediators in NK-CMC needs to be re-evaluated. PMID- 3679902 TI - Serologic and biochemical analysis of HLA B15 and B5 complexes. AB - Charge heterogeneity of HLA-B15 and HLA-B5 complexes was analyzed by one dimensional isoelectric focusing (1D-IEF). Frozen peripheral blood lymphocytes were metabolically labeled with 35S methionine. The class I antigens were immunoprecipitated with monoclonal antibody 4E, which detects a determinant shared by HLA-B locus and Aw19-complex antigens. The desialated 1D-IEF banding patterns were correlated to microcytotoxicity data of a panel of donors from a variety of racial groups. Serologic analysis indicated the presence of specific variants: Te76, Te78, and Te79. 1D-IEF analysis clearly showed polymorphism in the B15 and B5 complexes. The Bw62 associated variant Te79 exhibited bands distinct from Bw62. One Bw62 typed donor produced a band that was different from other Bw62 typed cells. A migration pattern difference was discovered between blacks and Caucasians that were typed Bw57. Investigated antigens included HLA B35, w46, 51, w52, w53, w57, w58, w62, w63, w70, Te76, Te78, and Te79. PMID- 3679903 TI - Molecular characterization by high-resolution isoelectric focusing of the products encoded by the class II region loci of the major histocompatibility complex in humans. I. DR and DQ gene variants. AB - We describe a new approach to the analysis of the structural polymorphism of the DR beta, DQ alpha, and DQ beta polypeptide chains of human histocompatibility class II antigens. In comparison to conventional two-dimensional gel studies, this method provides sharper definition of the protein bands and side-by-side comparisons within the same gel, thereby permitting the detection of minor differences in the isoelectric points of the protein chains. Using this methodology we have analyzed the IEF polymorphism and the variability in the number of the DR beta chains encoded by different DR haplotypes. Twenty DR beta chain variants, which include the products of no less than two separate DR beta loci, have been thus far identified. Alleles at one of these loci are assumed to code for DR beta chains carrying the DR alloespecificities DR1, DR2, DR3, DR4, DR5, DRw6, DR7, and DR8. Alleles at a second DR beta locus encode DR beta chains that may be shared by serologically DR-different haplotypes and carry supertypic serologic specificities (i.e., DRw52 and DRw53). We also demonstrate here that the structural polymorphisms of the DQ alpha and DQ beta chains are more extensive than previously thought, report the characterization of 14 DQ beta variants, and define their relationship to the previously described DQw serologic specificities. In addition, we describe the class II haplotype associations observed for the different DR and DQ variants characterized. PMID- 3679905 TI - The effects of maternal eating on fetal nonstress test reactivity. PMID- 3679904 TI - Two forms of HLA class I molecules in human plasma. AB - Soluble HLA-A,-B antigens have previously been detected in human plasma. More recently, these molecules have been demonstrated to be secreted in water soluble form by cell lines and peripheral blood lymphocytes in vitro due to RNA splicing events which delete exon five from a fraction of class I antigen transcripts. In order to determine whether plasma HLA-A,-B molecules arise by this mechanism, their biochemical properties are analyzed. Based upon molecular weight, detergent binding, and lipid binding properties, it was demonstrated that two forms of HLA A,-B molecules are present in the plasma. A 43 kd form that binds both lipids and detergents is presumed to be a shed version of the membrane form. However, a 39 kd form that fails to bind lipids and detergents has properties identical to those molecules secreted in vitro. It is suggested that these molecules arise by alternative splicing events in vivo that are identical to those characterized in vitro. Although all tested individuals display shed and/or secreted plasma class I molecules, it is striking that HLA-A24 occurs in both a shed and a secreted form at levels higher than all other alleles examined. PMID- 3679906 TI - The Papanicolaou smear versus colposcopy for evaluation of the uterine cervix in women with perineal condyloma: a preliminary study. PMID- 3679907 TI - The association of carcinoma, tuberculosis, asbestosis, and fibrosing alveolitis of the lung: report of a case and review of the literature. PMID- 3679908 TI - Abdominal aortic aneurysm repair and the horseshoe kidney. PMID- 3679909 TI - Pancreas divisum and recurrent pancreatitis. PMID- 3679910 TI - Capillary hemangioma of the orbit: the role of computed tomography. PMID- 3679912 TI - Proceedings of the thirty-first annual AOA research conference, 1987: part II. Abstracts. PMID- 3679911 TI - Andrew Taylor Still memorial lecture: the Third World of medicine. PMID- 3679913 TI - Kidney stones: crushing traditional therapy. PMID- 3679914 TI - A comparison of clinical and laboratory data on neutron therapy for locally advanced tumors. AB - Experimental results suggest advantages for neutrons where cells are hypoxic, in tumors which are slowly growing and also in a relative sparing of bone damage. The neutrons available at Hammersmith were of 7.5 MeV energy and produced a poorly penetrating beam, unsuitable for treating tumors in the pelvis and abdomen. Patients with locally advanced tumors in superficial sites were therefore selected to assess the effects of neutrons on normal and malignant tissues. One hundred and eight-nine patients had between them 191 locally advanced (T4 N0-3) tumors in the oral cavity, paranasal sinuses, salivary glands, and breast. Neutron therapy resulted in complete regression in 84% of which 13% subsequently recurred. Median survival for the whole group was 32 months. Twenty eight other patients had advanced tumors of the head and neck which were recurrent after X ray therapy and other treatments; 82% of these completely regressed for more than 1 year. Complications appeared in 27% of patients not previously treated and in 46% who had already undergone X ray therapy. Seventy four per cent of complications started in the skin. With neutrons of this energy there is minimal sparing of the skin and uneven distribution of dose resulting in "hot" spots. These affected skin, subcutis, and muscle. The high rates of control in these large tumors, the low incidence of bone necrosis, and the repair of some bones eroded by tumor correlate well with the experimental data. There was rapid regression of the tumor and close correlation between early and late effects on skin and subcutis. These two observations may relate to the fractionation, total dose, and overall time of treatment of 1560 cGy neutron dose given in 12 fractions over 28 days. PMID- 3679915 TI - An evaluation of fast neutron irradiation in the treatment of squamous cell carcinoma in cervical lymph nodes. AB - Analyses have been made of the response of metastatic cervical lymph nodes following neutron therapy, either as part of a randomized trial or in patients treated electively. In the trial patients, the overall regression and local control rates were similar after photons and neutrons. Mobile nodes, less than 3.0 cm, appeared to respond better to neutron therapy, and node masses greater than 3.0 cm had better control after photon therapy. The differences observed however were not statistically significant. There was a highly significant association between the control of the primary tumor and control of nodal disease. No survival advantage for neutrons was observed in association with apparently better control rates in cervical nodes. PMID- 3679916 TI - Treatment of pelvic sarcomas in adolescents and young adults with intensive combined modality therapy. AB - Adolescent and young adult patients with pelvic sarcomas continue to have a poor prognosis with standard combination chemotherapy and local irradiation. In addition to a significant risk of local failure, these patients are at high risk for systemic relapse. Twenty-three consecutive patients with Ewing's sarcoma, alveolar rhabdomyosarcoma, undifferentiated sarcoma, or malignant peripheral neuroepithelioma originating in the pelvis were treated with short, intensive combined modality therapy. This approach integrates 5 cycles of VADRIAC chemotherapy (Vincristine, Adriamycin, Cyclophosphamide) with high dose irradiation to the primary lesion (55-60 Gy) and sites of gross metastatic disease (45-50 Gy). Following achievement of a complete response, intensification therapy consisting of total body irradiation (TBI) (8.0 Gy), high dose VADRIAC chemotherapy, and autologous bone marow transplantation is given. All therapy is completed within 6-7 months. No maintenance chemotherapy is given; no surgery is intended. Of the twenty-three patients with pelvic sarcomas treated on this combined modality protocol, 22 achieved a complete remission. Local control was achieved and maintained in all twenty-three patients. With a median follow-up of 21 months since initiation of treatment, there have been nine relapses (all systemic). Seven relapses occurred among the thirteen patients who presented with overt metastatic disease and the other two relapses were among the ten patients with localized disease at presentation. All seven metastatic patients who relapsed have died, whereas both of the relapsed localized patients remain alive. Acute and late toxicities have been acceptable using this aggressive combined modality approach. Induction chemotherapy had a significant impact on reduction of the typically large (greater than 10 cm diameter) soft tissue mass associated with these pelvic tumors, thus facilitating achievement of local control by high dose irradiation. Of 18 patients with measureable soft tissue tumor, all experienced a partial response (greater than 50% reduction in size) following the initial two cycles of chemotherapy given prior to local irradiation. In conclusion, this short, intensive chemoradiotherapeutic regimen is highly effective in controlling the primary lesion (100% local control) and inducing a complete response in a high proportion (96%) of these high risk pediatric and young adult patients with pelvic sarcomas. The role of TBI as "systemic" adjuvant therapy to control micrometastatic disease is discussed as still under investigation. PMID- 3679918 TI - Radiation therapy for Graves' ophthalmopathy: a retrospective analysis. AB - A retrospective analysis of 29 patients with Graves' ophthalmopathy treated from 1973-1986 was undertaken to evaluate the use of radiation therapy (RT). Most patients presented with advanced disease; 20 had been treated with steroids and 8 had undergone prior surgery with orbital decompression. Post-RT evaluation was performed by the patients' Radiation Oncologist, Ophthalmologist, and Endocrinologist with a median follow-up period of 45 months. The overall assessment of the patients' disease was judged as improved with respect to the majority of signs and symptoms in 48%. Soft tissue changes were relieved in 78% and proptosis reduced in 52%. Ophthalmoplegia responded poorly and was improved in only 24%. After RT, 26/29 (90%) of patients have had no further steroid requirements. Thirteen patients underwent surgery for residual signs/symptoms post radiation therapy, indicating that combined modality may be necessary in many patients with advanced disease. PMID- 3679917 TI - Treatment of advanced head and neck cancer with concomitant radiation and chemotherapy. AB - Forty-four patients with predominantly inoperable or recurrent head and neck cancers were treated with combined chemotherapy (CT) and radiation therapy (RT) in a Phase I/II study. CT and RT were combined in a concomitant fashion to take advantage of radiosensitizing properties of the chemotherapeutic agents. Each treatment cycle consisted of cisplatin 60 mg/M2 on day 1, 5-FU infusion at a dose of 800 mg/M2 per day continuously for 5 days and RT at 200 cGy per day, days 1 through 5. The treatment cycle was repeated every 2 weeks for 7 cycles in patients treated curatively and for 2 to 6 cycles in patients treated palliatively due to prior radiation therapy or the presence of metastatic disease. Regional control was achieved in 98% of the patients. Regional control has persisted in 87% of the patients treated curatively with a minimum follow-up of 24 months. Distant failure occurred in 23% of this group. Actuarial survival of 2 years for the curative group is 66%. Concomitant combination of radiation with radiation potentiating chemotherapeutic agents shows promise of increase in local control. PMID- 3679919 TI - Radiotherapy of gastric cancer with a three field combination: feasibility, tolerance, and survival. AB - From 1980 to 1984, forty-five patients suffering gastric cancer were irradiated with curative intent. Twenty-three were considered at high risk of recurrence after complete surgical resection (invasion of the serosa, lymph nodes and/or surgical margins); eleven were treated after partial resection, and for eleven others, the local extension precluded surgery. Radiotherapy combined two lateral fields (usually with wedge filters) and an anterior field. The planned dose was 40 to 50 Gy, according to the amount of residual disease and doses delivered to the major part of the liver and the right and left kidneys did not exceed 30, 5, and 18 Gy, respectively. For patients aged less than 71 and whose general condition was acceptable, one cycle of chemotherapy (FAM for 20 patients and 5-FU for 10) preceded irradiation, followed if possible by 6 other cycles. Adverse effects, essentially anorexia, vomiting, and weight loss, led to definitively stopping irradiation in 8 cases, and were present in 21 other patients. Mean weight loss was 2.5 kg. Apart from one patient who developed a subphrenic abcess and died after reoperation, there was neither chronic complication, nor radiation hepatitis or nephritis. For 34 patients, the observation time was superior to 3 years: 23 died of their cancer, 1 of a subphrenic abcess, and 2 of an intercurrent disease. Eight were disease-free at 3 years (three of these were irradiated for macroscopic disease). For the overall series, the 4-year survival rate is 23%. There is a significant survival advantage for females versus males (p less than 0.01), a non-significant tendency in favor of microscopic residual disease versus macroscopic, and no advantage for the combination with FAM compared with no chemotherapy (non-randomized). This technique appears feasible with an acceptable tolerance and can control local tumor in a few cases. The planned dose of 40 Gy was probably too small and we are now testing 45 Gy delivered over the large initial volume, and boosts of 10-15 Gy to residual disease. PMID- 3679920 TI - Definitive radiation treatment for early stage carcinoma of the soft palate and uvula: the indications for iridium 192 implantation. AB - From 1971 to 1984 59 T1 and T2 carcinomas of the soft palate and uvula were treated definitively by irradiation at the Henri Mondor hospital. Included are ten patients previously irradiated to the oropharyngeal area for either a carcinoma of the soft palate or another malignancy. Sixteen patients were treated by external irradiation alone, 14 by Iridium 192 implantation, and 29 by a combination of the two. Two techniques of implantation were used: the guide gutter technique (33 patients) and the plastic tube technique (10 patients). Clinically negative neck nodes (51/59) either received prophylactic telecobalt therapy (39/51) or were surveilled (12/51). Clinically involved nodes (8/59) were managed either by external irradiation alone (4/8) or combined with neck dissection (4/8). Local failure was 25% (4/16) after exclusive telecobalt therapy, 18% (5/19) after combined telecobalt therapy and implantation, and 0% (0/14) after Iridium 192 implantation alone. No local failures were seen with the plastic tube technique (0/10) as compared to 15% (5/33) for guide gutters. Only two nodal failures were observed (2/59: 3%). Crude 5-year disease-free survival was 33%. Severe complications were limited to one osteonecrosis, one soft tissue necrosis, and one partial palatal incompetence. Salivary impairment was reduced when implantation was used for part or all of the treatment. We recommend 45 Gy external radiation followed by 30 Gy from Iridium 192 implantation using the plastic tube method unless there has been prior oropharyngeal irradiation, in which case we give 60 Gy from implantation alone. For clinically negative neck nodes, we recommend 45 Gy prophylactic external neck irradiation. For clinically positive lymph nodes, this should be followed by either a 25 to 30 Gy boost to the involved nodes or a neck dissection. PMID- 3679921 TI - Radiation enhancement of radiolabelled antibody deposition in tumors. AB - Recent clinical observations led to the use of external radiation to increase tumor targeting by radiolabelled 131-I antiferritin. Examination of increased uptake of 131-I labelled antiferritin following external radiation was carried out in syngeneic implanted hepatomas (H4IIE, 3924A, 7800, and 7777). Exposure to 10 Gy increased the tumor: liver uptake ratio from 1.55 to 1.86 for H4IIE; from 1.56 to 2.0 for 7800; from 1.34 to 1.97 for 7777; and from 1.05 to 1.19 for 3924A. The pattern of uptake varied among the different tumor types, reflecting their inherent differences in vascularity, tumor permeability, antigen density and growth rate, all of which influence antibody targeting of the tumors. When tumor and liver were irradiated, the tumor showed increased differential uptake of labelled antibody compared to normal liver. 51-Cr labelled erythrocytes were used to study the relative vascularity and blood pooling in H4IIE hepatoma and normal tissue. External radiation to the tumor did not increase the uptake of 51 Cr labelled erythrocytes in any site. These studies provide an insight into the role of external radiation as a modality that increases radiolabelled antibody targeting in hepatoma. PMID- 3679922 TI - Radiation therapy alone in the treatment of carcinoma of the uterine cervix: review of experience at Tokyo Women's Medical College (1969-1983). AB - Three hundred thirteen patients presented with squamous cell carcinoma of the uterine cervix at Tokyo Women's Medical College from 1969 to 1983. The results are presented here. All of the patients were treated by radiotherapy with curative intent with a combination of intracavitary cesium by low-dose rate, using T.A.O. afterloading applicators, which was made of flexible tubes to adapt to the physique of Japanese women by Tazaki, E., Arai, T. and Oryu, S. and external irradiation. One hundred and sixty patients (51.1%) presented with FIGO Stage III disease, 23 patients (7.3%) presented with Stage I disease, and 75 (24.0%) with Stage II. The 5-year cumulative survival rate was 81.7% for Stage I, 76.8% for Stage II, 53.3% for Stage III, 29.2% for Stage IVa, and 10.5% for Stage IVb, respectively. The overall 5-year survival rate was 55.8%. The local regional recurrence rate according to stage was 13.6% in Stage I, 22.4% in Stage II, 41.3% in Stage IIII, and 46.7% in Stage IVa. The incidence of locoregional recurrence rate was 35.6% and distant metastasis 37.8%. The incidence of complications involving bleeding and pain which required hospitalization, was 12.2% in all patients. Only four required surgery to manage serious complications. PMID- 3679923 TI - Size dependent changes in tumor phosphate metabolism after radiation therapy as detected by 31P NMR spectroscopy. AB - In Vivo 31P NMR spectroscopy was used to study changes in phosphate metabolism that occur after irradiation of the C3H fibrosarcoma, FSaII. Previously, we have shown that small FSaII tumors (less than 250 mm3) have a greater phosphocreatinine/inorganic phosphate (PCr/Pi) ratio and a lower hypoxic cell fraction (HCF) than large FSaII tumors (greater than 250 mm3). Six small tumors (113 +/- 26 mm3) were treated with radiation doses chosen to induce local control in greater than 50% of animals, (70-100 Gy, single fraction). Minimal changes in the tumor 31P NMR spectrum were seen over eight days of monitoring. During this interval, tumor regression began a minimum of 36 hours after radiation. This contrasted with large tumors (650-1000 mm3) wherein a significant increase in the Pcr/Pi ratio was seen 44 hr after irradiation. In tumors of this size range, a tumor growth delay of 4 to 7 days is obtained after a single 70 Gy fraction of radiation. Since small FSaII tumors have a minimal HCF (approximately equal to 4%), radiation induced reoxygenation would not be expected to have a large effect on their average cellular metabolism. Large tumors of this histology have a high HCF (greater than or equal to 40%), and may therefore be expected to have a significant average change in tumor cell metabolism with reoxygenation. The 31P NMR observations of small and large tumors after irradiation are compatible with radiation induced reoxygenation in the larger tumors. PMID- 3679924 TI - Radiation repair in human endothelial cells. AB - Damage to blood vessels caused by ionizing radiation is considered to be an important dose limiting factor for late effects in many organs. However, the radiation response of the endothelial cells which line the vasculature has not been well-documented, particularly for human endothelial cells. In the present study, human endothelial cells were obtained from fresh umbilical cords and cultured in monolayer. Immunofluorescent staining of factor VIII antigen was used to verify the endothelial nature of the cultured cells. The cells were irradiated with Cs-137 rays (1.35 Gy/min) in plateau phase to determine radiation sensitivity and ability to repair potentially lethal damage (PLD) and sub-lethal damage (SLD). The endothelial cells demonstrated moderate radiosensitivity that varied slightly between different cords. As demonstrated by delayed plating experiments, PLD repair ability was substantial, with repair factors of 0.70 0.80. SLD repair capability, as demonstrated by split dose experiments, was relatively modest. A survival enhancement of 2.0-2.2, for example, was observed when 8 Gy single dose survival was compared to two 4 Gy doses. In terms of PLD and SLD repair as well as initial slope (alpha) the endothelial cells were similar to normal human lung and skin fibroblasts previously studied. Compared to malignant cell lines, PLD repair was generally larger whereas the initial slope (alpha) was intermediate-steeper than the radioresistant tumor types but shallower than the more sensitive tumor derived cells. PMID- 3679925 TI - Response of canine oral carcinomas to heat and radiation. AB - Thermal enhancement of radiation response improved the probability for local tumor control without increasing the risk for late complications in this study of relatively advanced stage tumors. Thirty-eight dogs with naturally occurring oral carcinomas were randomized to two radiation dose response groups to receive radiation alone or combined with local hyperthermia. Radiation was delivered in 10 fractions over 22 days. Heating was done 3 hours after seven of the radiation doses. The objective was to maintain a minimum tumor temperature of 42 degrees C and a maximum normal tissue temperature of 40 degrees C for 30 minutes. Normal tissue temperatures were usually 40 degrees C or less but there was great heterogeneity in tumor temperatures. Temperatures at tumor margins never exceeded 41.5 degrees C. The TCD50 for radiation was 38 Gy (32-46 Gy, 95% C.I.) and for radiation and heat it was 33 Gy (30-36 Gy, 95% C.I.). The slope of the dose response was much steeper for radiation and heat than for radiation alone indicating that the heterogeneity of tumor response was decreased with heat. All tumors were controlled at 40 and 45 Gy with heat whereas only 57% and 75% were controlled with 40 and 45 Gy radiation only. There were no late necroses for radiation and heat. The tumor control enhancement might be improved with different sequences, number of heatings or other time temperature relationships. It is not possible to predict the optimum treatment scheme because of the lack of knowledge of the influence of hyperthermia on subsequent heat or radiation treatments. That influence could be affected greatly by changes in tumor microcirculation, pH, and oxygenation as well as development and decay of thermotolerance in tumor and normal tissue. PMID- 3679926 TI - Stability of heating temperature on cytotoxicity. AB - Chinese hamster V79 cells were used to test the cytotoxic effect of heat which alternates between high and low temperatures during the treatment period. This type of temperature fluctuation is often encountered in clinical hyperthermia. Two sets of heating protocols were used in the experiments: Temperature alternates (a) between 42 and 43 degrees and (b) between 42 and 44 degrees in cycle with equal total "thermal dose," that is heating temperature X heating time. The effectiveness of these heating protocols expressed in average percentage of cell survival depend on the initial temperature attained and the length of the time of this temperature alternation. If the period of temperature change is short such as every 5 or 10 minutes, the cytotoxicity shows very little difference whether the initial treatment temperature is low or high. However, when the period is longer than 20 minutes, the difference in cell survival between the initial temperature at 42 degrees and at higher temperatures is substantial. Cells obtained from logarithmic or plateau phases of growth yield the same result. The difference is likely resulted from a combination of thermotolerance and step-down heating mechanisms. In addition, the effects of heating temperature fluctuation on cytotoxicity is not altered by a 500 cGy of gamma-ray radiation applied either immediately before or after the heat treatment. PMID- 3679927 TI - Development of an 241Am applicator for continuous low-dose-rate irradiation of the rat sarcoma BA1112. AB - An 241Am applicator for continuous low-dose-rate irradiation of the rat sarcoma BA1112 has been developed. The irradiator consists of two disc sources, each containing 800 mCi of 241Am, an isotope which emits primarily 60 keV photons. The disc sources are held in a specially-designed light-weight helmet which surrounds the tumor on the head of the rat. Dose distributions produced by these sources have been measured using an ionization chamber, thermoluminescent dosimeters and Fricke dosimeter. A computerized treatment planning system has been modified to compute dose distributions from 241Am sources, to optimize the design of this applicator. Computed and measured dose distributions for several values of separation between the 241Am discs are presented. A survival curve for cells from tumors irradiated in vivo with this applicator has been determined by an in vitro colony formation technique. The mean lethal dose DO was found to be 720 cGy for an average tumor dose rate of 95 +/- 7 cGy/hr. The major advantages of the 241Am applicator in comparison with the 192Ir applicator used previously for continuous low-dose-rate studies are: a considerably smaller half value layer thickness and the longer half life of the radionuclide. These features make it more suitable for long-term tumor cure studies because of the lower whole body dose to the animal, the availability of relatively constant dose-rate irradiators for many years, the decreased shielding requirements for the animal care facility and the diminished exposure to laboratory personnel involved with the implants on the animals. PMID- 3679928 TI - 1986 Association of Residents in Radiation Oncology Survey. AB - Two simultaneous surveys were conducted by the Association of Residents in Radiation Oncology (ARRO). A survey of all residents in Radiation Oncology was conducted to obtain information on trends in residency training. A simultaneous survey of Chief Residents was obtained to determine more specific information on current training programs. Over one-half of residents responded. Eighty-eight percent of respondents were graduates of a North American medical school. Most did at least an internship prior to entering Radiation Oncology and 3/4 of those who did not do a separate internship rotated through other areas at a later time to broaden their knowledge. One-half are Board certified or Board eligible in another specialty or hold a Masters or Ph.D. degree. Three-quarters of all residents had authorship of at least one paper during training and one-half were primary authors. Eighty percent felt adequately prepared for practice after residency. One-half plan at least an initial post-residency affiliation with an academic center. Many were concerned that Radiation Oncologists are not afforded respect equivalent to that of other specialties. Ninety-eight percent favored departmental status for Radiation Oncology. Resident recommendations for improving the image of Radiation Oncology are presented. PMID- 3679929 TI - Integration of magnetic resonance imaging into radiation therapy treatment planning: I. Technical considerations. AB - This paper presents the results of a feasibility study specifically addressing the technical and operational difficulties in making quantitative use of Magnetic Resonance Imaging (MRI) in radiation therapy treatment planning (RTTP). Selected radiotherapy patients have been studied with both CT and MRI as part of the treatment planning process. Both sets of images, along with mechanically-obtained external contour and simulator film data, are entered into the treatment planning system. All of the capabilities of the fully three dimensional planning system U MPlan are available to both the CT and MRI images, in which any image can be used as the backdrop for interactive beam positioning, beam portal simulation, and dose distribution displays for external beam and brachytherapy applications in both 2- and 3-dimensionally-oriented displays. The study has shown that to use MRI data for RTTP, one must (a) use careful patient positioning and marking, (b) transfer information from CT to MRI and vice versa, (c) determine the geometrical consistency between the CT and MR data sets, (d) investigate the unwarping of distorted MR images, and (e) have the ability to use non-axial images for determination of beam treatment technique, dose calculations, and plan evaluation. PMID- 3679930 TI - Radiotherapy of spontaneous carotid-cavernous sinus fistulas. AB - Between 1984 and 1986, 7 patients with spontaneous carotid-cavernous fistulas (CCF) were treated by radiotherapy delivering 3,000 cGy (200 cGy, 5 times per week) to the sellar region. Improvements of clinical signs and symptoms were seen in all patients within 6 months of treatment. During a follow-up period of 7 to 35 months, 6 patients remained in good clinical condition and only one patient developed a recurrence. As an adverse effect, one patient developed early menopause, but no other side-effects or complications were seen. Radiotherapy should be considered in patients with spontaneous CCF, when CCF are seen in middle-high aged patients and progressive without relief of symptoms. PMID- 3679931 TI - Determination of depth for electron breast boosts. AB - A technique has been developed to determine the depth for the electron boost treatments for patients undergoing definitive irradiation for early stage breast cancer. A series of parallel link chains are placed on the breast over the clinically determined site of the boost. Using fluoroscopy, the physician confirms that the chains overlie the tumor bed which is outlined by radiopaque surgical clips placed at the time of the breast biopsy. A pair of orthogonal films and/or rotational stereo shift films are obtained with a standard simulator unit. Using the image of the chains to define the surface contour, the depth of each surgical clip is measured directly from the orthogonal films or calculated from the rotational stereo shift films. With this information, the physician can determine the appropriate electron energy to cover the target volume. This method was tested by comparison with depths measured from CT scan, and close agreement was demonstrated. PMID- 3679932 TI - A problem in rotation therapy with X-rays: dose distributions with an axis of symmetry. AB - We give the equations which need to be solved to extend the work of Brahme, Roos, and Lax to dose distributions which are not circularly symmetrical. These equations do not contain the linear absorption coefficient, mu, explicitly so they are valid in principle for any mu. The general solution of these equations has not been found, but the solution given by Brahme, Roos, and Lax is used to extend their work to simple dose distributions with an axis of symmetry. Some examples are given and discussed. PMID- 3679933 TI - A computer-aided treatment planning technique for universal wedges. AB - Some modern accelerators provide only one wedge built into the head of the treatment machine. A continuous range of wedge angles can be generated using wedged and unwedged beams in different proportions. However, this may pose difficulty in treatment planning since the planners will have to work with twice as many beams to achieve a desirable dose distribution. We have developed a simple algorithm to solve the treatment planning problem involving wedged and open beam combinations. The algorithm is based on the assumption that the user has some knowledge of the dose distribution to be optimized. Some properties of the distributions are then used to set up the system of equations for optimization. Unlike other optimization techniques, it does not require specification of dose value to every interest point selected, and it allows each specified dose value to vary within a clinically acceptable range. Examples are given to illustrate the application of the algorithm for some standard treatment plans. PMID- 3679934 TI - An endocavitary rectal irradiation technique. AB - An alternative to standard short target-skin distance (TSD) rectal irradiation techniques is presented. The proctoscopic rectal cone is linked outside of the patient to a superficial X ray tube operated at 50 kVp and 25 mA. The cone is rigidly held in place by a hydraulic clamp and linked to the X ray tube with an electromagnetic lock. The X ray beam is filtered by 0.3 mm of aluminum, giving a half-value-layer of 0.27 mm of aluminum and an exposure rate of 720 R/min. (0.186 C/kg-min.) at the treatment TSD of 22 cm. The physical aspects of the technique are described in detail. PMID- 3679935 TI - Backscatter radiation at bone-titanium interface from high-energy X and gamma rays. AB - Occasionally head and neck cancer patients treated with high-energy X rays and gamma rays have titanium metal dental implants in their maxillae or mandibles. The resulting effect of the bone-metal interface on the radiation dose is of interest. Ionization measurements for 60Co gamma rays and 6 MV and 25 MV X rays were made. A thin-window parallel-plate chamber was used to determine the magnitude of the dose enhancement that was due to the backscattered electrons from titanium. The results showed that for 60Co there is a 15% increase in dose to solid bone at the entrance side of the titanium. For higher energy X rays, the increase in dose was about the same or slightly lower than for 60Co. Monte Carlo calculations substantiated the measurements. This increase in dose fell off rapidly and became negligible at 1-2 mm from the interface. This backscattered dose should be taken into account when planning radiation therapy treatment for patients with dental implants. PMID- 3679936 TI - Development and use of a computer system in a radiotherapy department: SISGRAD. AB - SISGRAD, the interactive computer system of the Antoine-Lacassagne Cancer Center Radiotherapy Department, has been operational since January 1982. It completes the computerized dosimetry system installed several years earlier and is fully integrated with the institution's central network. SISGRAD is in charge of surveillance of the radiotherapy treatments given by the Center's three radiotherapy units (1400 patients per year); it is also used for administrative purposes in the Department and physically connects all of the Department's operating stations. SISGRAD consists of a series of microcomputers connected to a common mass memory; each microcomputer is used as an intelligent console. SISGRAD was developed to guarantee that the treatments comply with prescriptions, to supply extemporaneous dosimetric data, to improve administrative work, and to supply banks with data for statistical analysis and research. SISGRAD actively intervenes to guarantee treatment quality and helps to improve therapy-related security factors. The present text describes the results of clinical use over a 4 year period. The consequences of integration of the system within the Department are analyzed, with special emphasis being placed on SISGRAD's role in the prevention and detection of errors in treatment prescription and delivery. PMID- 3679937 TI - A comparison of two radiological path length algorithms. AB - Most radiation therapy dose calculation methods require the determination of the effective path length of the primary radiation from the radiation source to the point at which the dose is calculated. This usually involves representing the patient anatomy as a set of polygons (contours) as approximations to plane curves. Several algorithms are known for determining the length of a segment or segments on a ray through a planar contour, that are interior to the contour. We have implemented two of these algorithms in a test program to benchmark their relative efficiency. One algorithm uses a linear search over all the contour segments, and the other method represents the contour as a binary tree of "strips," of successively increasing resolution. In general, the tree search should give times proportional to log(n) where n is the number of contour segments, and the linear search time should be proportional to n. Thus, one might expect the tree search to run faster once the number of segments reaches some sufficiently large value. We found that this value is a number of contour points far in excess of that typical for contours representing radiation therapy patient anatomy. Therefore, for this application the linear search method is more efficient. PMID- 3679938 TI - Accelerated, interrupted, twice-a-day (AIBID) radiation therapy decreases acute mucosal toxicity. PMID- 3679939 TI - Advances in hypoxyradiotherapy. PMID- 3679940 TI - Sex differences and the asymmetry of specific and non-specific electrodermal responses. AB - Phasic electrodermal conductance responses were bilaterally recorded from 30 subjects (15 males and 15 females). After a 5-min adaptation period subjects were presented with two series of ten 80-dB tones each, with a 4-min rest period between the two series. Data from sinistrals, ambidextrous, and from subjects with familial sinistrality were excluded from statistical analysis. Males displayed more asymmetry between hands both in their non-specific and specific responses, with larger skin conductance responses on the left hand. Females showed a less marked asymmetry, with larger skin conductance responses on the right hand. Similar results were found in skin conductance levels. It was concluded that sex differences are an important variable in the study of electrodermal asymmetry. PMID- 3679941 TI - Tracking errors related to cardiac cycle: a new approach. AB - One-dimensional manual tracking was investigated in relation to cardiac activity. The task of the subjects was, by means of a joy-stick, to maintain a spotlight between two vertical lines moving horizontally across an oscilloscope screen. Error incidence was time-locked with respect to the cardiac cycle. Error rate was higher for faster (2-s trial periods) than for slower (3-s trial periods) target movement. Using linear-ramp and sinusoidal movements, it was demonstrated that error incidence is associated with positive and negative cardiac acceleration. PMID- 3679942 TI - Hemispheric activity of 40 Hz EEG during recall of emotional events: differences between low and high hypnotizables. AB - This study evaluates individual differences in hypnotizability as reflected in waking-state hemispheric engagement during recollection of 3 positively and 3 negatively valenced personal life events. The State-Trait Anxiety Inventory, Maudsley Personality Inventory, Tellegen Absorption Scale and Harvard Group Scale of Hypnotic Susceptibility (Form A) were administered. Electromyogram (EMG) and bilateral electroencephalogram (EEG) activities within the 40-Hz band were recorded during rest and task conditions in 22 high and 21 low hypnotizable women. Self-report rating scores for vividness of visual imagery and emotional feeling of the material recalled were evaluated. The 40-Hz EMG amplitude and both hemisphere 40-Hz EEG densities were obtained. A 40-Hz EEG ratio, as a measure of hemispheric asymmetry, and a hemispheric specificity index were also computed. High hypnotizables showed significantly lower 40-Hz EEG density than low hypnotizables in all experimental conditions. The relationship between lateralization of 40-Hz EEG and emotional processing was moderated by hypnotizability. High hypnotizables, with respect to rest condition, showed an increase of density over both left and right hemispheres during two of the three positive emotional tasks, while they showed a depressed activity over the left and an increased activity over the right during negative emotional tasks. Low hypnotizables, on the other hand, did not exhibit differential hemispheric patterns that could be attributed to different emotional valences. The high group showed greater hemispheric specificity in the predicted direction than the low group. High subjects exhibited greater ratings of absorptive ability and emotional feeling than low subjects. Anxiety and EMG levels did not differ between groups. EMG was dependent on the type of emotion which showed greater activity in the negative emotion condition compared with the positive one. PMID- 3679943 TI - Temporal summation of receptive fields for line orientation in humans. AB - The contrast threshold for line orientation was studied using two lines with the same orientation under three different experimental conditions (series): (1) the two lines were presented in the same part of the receptive field; (2) they were along the same straight line and separated by 14' visual angle; (3) they were parallel and displaced at 4' of visual angle. The lines were presented for the same duration with an interstimulus interval (ISI) varying between 0 and 300 ms. The threshold for line orientation when only the first or the second line was presented alone was also studied. In all series when the ISI was longer than 100 ms, the line orientation thresholds for two lines (T1,2) and for one line when presented alone (T1 or T2) were the same. At ISI varying from 50 to 100 ms the values for (T1,2) were similar to those expected with probability summation. In the third series at ISI from 0 to 10 ms, the same reciprocal inhibitory interactions prevailed as when the two lines were presented simultaneously. In the first series at the same ISI (0-10 ms), a complete temporal summation was also observed. PMID- 3679944 TI - Following complex rhythmical acoustical patterns by tapping. AB - Rhythmic acoustical sequences consisting of patterns of various complexity (number of intervals in pattern) were generated and subjects were asked to synchronize with them by finger tapping. Deviations between onset of stimuli and onset of response were measured. It has been confirmed that tapping precedes the onset of stimuli by about 20-30 ms. The duration of this anticipatory period increased with an increase in stimulus complexity to the limit of three intervals in pattern. This finding points to a systematic error in timing of rhythmic motor reactions during acoustical following. Its degree depends to a certain limit on the nature of the stimuli. Subjects are subjectively aware of this error. PMID- 3679945 TI - Judgments of emotion in words and faces: ERP correlates. AB - Visual event-related potentials (ERPs) to two types of stimuli (faces and words) were analyzed to determine the effects of the perceived emotional connotations of the stimuli (positive, neutral, or negative) in 10 right-handed normal functioning adult males. Principal component analysis (PCA) of the ERPs reveals 5 factors accounting for over 90% of the ERP waveform variance for both faces and words. In the facial data, two ERP components varied in amplitude according to the perceived emotional connotation of the stimulus. For the P3 component, neutrally rated stimuli produced significantly larger amplitudes than stimuli rated as positive or negative. This effect was lateralized to the left hemisphere. A later positive component, the slow wave (448-616 ms), manifested complementary effects, i.e. faces perceived as positive and negative produced larger amplitudes than those perceived as neutral over the right hemisphere. The verbal stimuli did not result in significant main effects for perceived emotional connotation, but produced subtle connotation-related differences in slow wave topography. Hemispheric asymmetries, unrelated to affective connotation, were evident in the verbal data, manifesting different patterns of lateralization depending on the ERP component. The results suggest that differential processing of emotional connotation affects ERP waveforms and that the effects can be understood in terms of ERP components known to be associated with more general aspects of cognitive processing. PMID- 3679946 TI - Progressive relaxation as a function of procedural variations and anxiety level. AB - Progressive relaxation is subject to many procedural variations. Although most investigators follow the 5-7 s tension interval advocated by Bernstein and Borkovec (1973), longer tension intervals may contribute to greater relaxation effects. This study compared tension intervals of 5, 15, and 45 s. Since the development of control over muscle tension requires attention to feedback signals, a focus on internal proprioceptive sensations was contrasted with an external condition in which the subjects silently subtracted numbers immediately following the tension-release cycle. Longer periods of tension resulted in lower EMG levels, with the 45-s tension interval producing the greatest relaxation. Those individuals who focused on physiological sensations during training were able to achieve greater levels of relaxation after the training phase was completed. There was a significant interaction between tension interval duration and focusing; subjects in the 45-s interval who focused on physiological functioning showed the greatest arousal reduction. Anxiety level did not differentially influence the effects of procedural variations in training. Clearly, additional parametric studies in relaxation training are needed. PMID- 3679947 TI - Event-related potentials and item recognition in depressed, schizophrenic and alcoholic patients. AB - Auditory event-related potentials (ERPs) to pure tones and performance on a measure of item recognition were compared in 20 controls, 14 alcoholics, 20 depressed and 21 schizophrenic patients. Compared with normal controls, P2 and N2 were delayed and of diminished amplitude in the psychopathological groups. Increased amplitude of P1 in alcoholics, diminished N1 in depressed patients, increased latencies of N1 in schizophrenics and N2 in alcoholics were pathology specific. Unusual patterns of response in the item recognition test (elevated intercept and flattened slope) and its relationship with ERPs distinguished the diagnostic groups from the controls. Support for the preferential involvement of the left hemisphere in schizophrenia and of the right hemisphere in depression was found. Disinhibition of CNS activity in the response of alcoholics (increased P1 and delayed P3) was indicated. The findings suggested that discriminant analysis of auditory ERPs to simple, pure tones, in conjunction with psychometric data significantly differentiated pathologic groups from each other and from controls. PMID- 3679948 TI - Effects of instructions on habituation of the orienting response: another perspective on the study by Gruzelier and Eves. AB - A recent study by Gruzelier and Eves (1987, Int. J. Psychophysiol., 4: 289-291) purported to test the hypothesis of Iacono and Lykken (1979, Schizophrenia Bull., 5: 11-14), that instructions to subjects that clarify task demands facilitate habituation. However, the Gruzelier and Eves study did not provide an adequate test of this hypothesis. Moreover, contrary to the assertions of Gruzelier and Eves, the data presented in their paper are consistent with the predictions of Iacono and Lykken. PMID- 3679949 TI - Localizing scalp-conducted electrical potentials. PMID- 3679950 TI - Confusion over jasmine and jessamine. PMID- 3679951 TI - Animal care and control center: a multifaceted veterinary challenge. PMID- 3679952 TI - Ecologic and symbiotic approaches to animal welfare, animal rights, and human responsibility. AB - Veterinarians confronted with situations involving animal welfare, animal rights, and human responsibility assume practical importance in the relationships of veterinarians with clients and other constituencies. To help resolve these situations, the authors briefly compare economics and ethics and discuss the types of rights. An attempt is made to bring animal welfare and animal rights into the same conceptual framework, using an ecologic approach. This reaches the thesis that the less human beings allow animals the right of self-determination, the more we should exercise responsibility in their care and welfare. Actively exercised human responsibility in all uses of animals is offered as a practical and valid alternative to the extreme of abolitionism. This alternative also is applied in a cautionary way to the role of veterinary medicine in specieism. The veterinary profession is urged to be active in the middle ground of the field of animal rights and to firmly establish its relationships to animal welfare and human responsibility. PMID- 3679953 TI - Temporary indwelling rectal liner for use in horses with rectal tears. AB - A temporary indwelling liner was surgically installed in 17 horses with grade III or grade IV rectal tears. The rectal tears of 9 of the horses healed. The remaining 8 horses developed peritonitis as a result of peritoneal contamination before surgery, a change in grade of the tear, or material failure. PMID- 3679954 TI - Isolation of L-form variants after antibiotic treatment in Staphylococcus aureus bovine mastitis. AB - An unstable L-form of Staphylococcus aureus was identified in milk samples from 3 quarters of 2 cows after treatment with cloxacillin. Milk samples incubated on standard 5% blood agar plates were culture-negative for 7 to 30 days after treatment, but S aureus was reisolated in 80% of 66 samples by additional culturing on enriched L-form media when incubated in 10% CO2 at 37 C. The organism was identified at various phases of reversion of L-form agar and was confirmed on transfer to blood agar plates. PMID- 3679955 TI - Urethral recess in male goats, sheep, cattle, and swine. AB - A recess of the urethra formed by a fold of tissue containing the ducts of the bulbourethral glands in male goats, cattle, sheep, and swine was investigated by anatomic dissection. The shape, size, and location of the fold and recess are described, along with their relationship to the ducts of the bulbourethral glands. The fold and recess in male ruminants are compared with those in male swine. Clinicians should be aware of the recess, because it may block the passage of a urethral catheter into the lumen of the bladder. They also should be aware of the possibility of a urethral recess in any animal species that has a fibroelastic-type penis. The fold that creates the recess may function as a check valve to aid in evacuation of the small diameter urethra found associated with that type of penis. PMID- 3679956 TI - Disseminated meningeal tumor in a dog. AB - A 6-year-old Golden Retriever was referred for evaluation of hind limb paresis and generalized weakness. Neurologic examination revealed multifocal cervical and lumbosacral spinal disease. Radiography and myelography failed to identify a lesion. Cerebrospinal fluid was markedly cellular and had a high protein concentration, consistent with myelitis or a neoplastic process. The dog did not improve with medical management. Gross and histologic examination of the brain and spinal cord revealed a thick meningeal surface characterized by polymorphic histiocytic-like cells to multinucleate giant cells. The neoplastic process was considered to be a disseminated meningeal polymorphic cell sarcoma. PMID- 3679957 TI - Acute pancreatitis in two dogs given azathioprine and prednisone. AB - Acute pancreatitis was diagnosed in 2 dogs given azathioprine and prednisone. Prednisone and azathioprine had been given as immunosuppressive therapy for pemphigus foliaceus in dog 1 and for polymyositis in dog 2. Azathioprine was discontinued in both dogs. In dog 1, prednisone was reinstituted on day 6 of hospitalization. Prednisone was continued throughout the period of hospitalization in dog 2. Both dogs recovered without complication. Glucocorticoid therapy has been associated with the development of pancreatitis. In human beings, a common side effect of azathioprine is the development of drug induced pancreatitis. Definitive identification of azathioprine as the cause of pancreatitis in these dogs was not possible; the owners refused to permit retreatment with the drug. Therefore, the synergistic action between these 2 drugs could not be ruled out as the cause of pancreatitis. PMID- 3679958 TI - Cryptococcosis in a pup. AB - Disseminated cryptococcosis was diagnosed as the cause of death of a 2-week-old pup. Cryptococcus neoformans was isolated from the dam's vaginal discharge, but not from the dam's milk, blood, feces, or environment. During succeeding months, C neoformans was isolated repeatedly from the dam's vagina, even though vaginitis was not evident. One year after the death of the 2-week-old pup, cryptococci could not be isolated from the dam's vagina, and evidence of cryptococcosis was not detected in pups of the dam's next litter. This case was unusual because cryptococcosis has been reported previously only in dogs 11 months or older and because the source of the pup's infection may have been the dam rather than the environment. PMID- 3679959 TI - Suspected chronic gastric volvulus in a dog with normal gastric emptying of liquids. AB - A 10-year-old German Shepherd Dog with intermittent eructation, borborygmi, flatulence, abdominal bloating, and vomiting was found to have gastric volvulus. Gastric emptying of liquids (determined with a modified emptying-time technique) was normal. Circumcostal gastropexy vastly reduced clinical signs and resulted in weight gain. PMID- 3679960 TI - Ivermectin treatment of urinary capillariasis in a dog. AB - Eggs of Capillaria plica were found by microscopic examination of urine sediment from a 5-year-old female Border Terrier with signs of cystitis. Two courses of oral fenbendazole treatment failed to eliminate the infection or to alleviate clinical signs of cystitis; however, a single dose of ivermectin apparently resulted in complete parasitologic and clinical cure. PMID- 3679961 TI - Septicemia and septic arthritis caused by Streptococcus pneumoniae in a cat: possible transmission from a child. AB - Streptococcus pneumoniae serotype 23F was isolated from the blood and synovial fluid of an acutely ill, 15-year-old castrated male cat and from the nasopharynx of that regularly played with it, an infant child. Information presented supports the hypothesis that the infection was transmitted from child to cat. PMID- 3679962 TI - Chromomycosis in a horse. AB - A 6-year-old Quarter Horse gelding was examined because it had a sharply circumscribed, firm, brown-black, roughly spherical dermal nodule at the right tuber ischii. After it was excised, the lesion did not recur. Microscopically, the dermis of the excised specimen had multiple pyogranulomas, many of which contained thick-walled, dark brown fungal elements, some with internal septation compatible with chromomycotic fungi. Chromomycosis is a rare skin disease in the horse. It may be included in the differential diagnoses of nodular and/or pigmented skin lesions that include melanoma, pyogranuloma, mycetoma, squamous cell carcinoma, habronemiasis, and onchocerciasis. PMID- 3679963 TI - Arthrodesis of the scapulohumeral joint in a miniature horse. AB - Scapulohumeral arthrodesis was performed successfully as treatment for severe degenerative arthritis in a 62-kg miniature horse. Using an approach similar to that used for a dog, this horse's scapulohumeral joint was opened, the cartilage was removed, and the site was stabilized, using an 11-hole narrow dynamic compression plate. Fusion was uncomplicated. The stallion became a successful pasture-breeding animal. PMID- 3679964 TI - Spinal meningiomas in dogs: 13 cases (1972-1987). AB - Medical records of 13 dogs with spinal meningiomas were reviewed. Breed predilections were not found. Males outnumbered females 9 to 4, and most of the dogs were middle-aged. All dogs had motor deficits of various degrees, and approximately half of the dogs had clinical signs of mild to moderate spinal pain. The remainder had histories of clinical signs suggestive of chronic discomfort. There was a prolonged (greater than 3 months) delay between the onset of signs and diagnosis, except in 3 dogs. The neurologic courses usually were progressive. Results of noncontrast spinal radiography were normal in 10 dogs; in 3 dogs, the lamina appeared scalloped. Results of myelography contributed to the correct diagnosis in 10 of 12 dogs; however, in 2 dogs, intradural/extramedullary tumors were thought to be intramedullary lesions. A preponderance of cervical meningiomas was found, accounting for 10 of 13 tumors. Lumbar meningiomas were found in the remaining 3 dogs. Surgery was performed in 9 of the dogs, six of which improved after surgery. Poor results were correlated with tumors that involved spinal cord segments of an intumescence, ventrally located tumors, iatrogenic trauma, and tumor invasion into adjacent neural parenchyma. Four of 13 spinal meningiomas were found to be invasive into the spinal cord itself. PMID- 3679966 TI - Optimistic about future of veterinary medicine. PMID- 3679965 TI - Colorectal adenocarcinoma in dogs: 78 cases (1973-1984). AB - Colorectal adenocarcinoma was diagnosed in 78 dogs. Clinical signs in all 78 dogs included tenesmus, hematochezia, and dyschezia; most of the dogs had clinical signs less than or equal to 12 weeks before examination. Ultimately, most dogs were euthanatized because of the severity of clinical signs. Proctoscopy and colonoscopy were essential for complete assessment of extent of disease. Tumors were classified by gross appearance and included single, pedunculated masses, 2 or more nodular masses, and annular or intraluminal masses. In dogs in which survival time was compared with location and gross appearance of the tumor, dogs with annular masses had the shortest mean survival time (1.6 months), and dogs with single, pedunculated, polypoid tumors had the longest mean survival time (32 months). The rectum was a more common site than the colon, with 48.2% of the tumors developing in the middle portion of the rectum. Six different modes of surgical treatment were used, depending on the location and type of mass. Dogs that did not have surgical treatment had a mean survival time of 15 months. Mean survival time in the surgically treated dogs varied slightly according to mode of treatment; they survived 7 to 9 months longer than the untreated dogs. Dogs that underwent cryosurgery and local excision had the longest survival times (24 and 22 months, respectively). Statistical analysis disclosed a significantly longer survival time for dogs treated by excision or cryosurgery, as opposed to dogs undergoing biopsy only (P = 0.001). Statistical difference in survival times was not found between dogs that had mass excision and those that had cryosurgery. PMID- 3679967 TI - Statutory bars to noncompetition agreements. PMID- 3679968 TI - Caring for cats. PMID- 3679969 TI - Veterinarians for society in the 21st century: an afterthought. PMID- 3679970 TI - Investigation of cryptosporidial infection in calves in San Bernardino County, California. AB - Cryptosporidium is a protozoan parasite that inhabits the intestinal epithelium of calves, lambs, foals, pigs, and poultry. Of the 500 calves studied, 95 calves had diarrhea and 20 (21.05%) of those were infected with Cryptosporidium; only 8 (1.9%) of the remaining 405 nondiarrheic calves had Cryptosporidium oocysts in their feces. PMID- 3679971 TI - Severe pleuritis associated with certain strains of Pasteurella multocida in swine. AB - Pasteurella multocida was isolated from 2 farms on which grower or finisher pigs had problems of severe emaciation and high death loss (greater than 5%). At necropsy, the pigs had extensive suppurative pleuritis and pericarditis, with adhesions over the lung surface. On one farm, the pigs also had multiple lung abscesses. Histologic findings included polymorphonuclear cell infiltration in bronchial and alveolar spaces, thickening of alveolar walls, pleuritis, and in some cases, abscesses. From all pigs, P multocida was isolated. The strains (A52, A59) were serotype A and were nontoxigenic. Experimental reproduction of the disease was achieved by sequentially infecting conventionally weaned pigs intranasally with pseudorabies virus; 7 days later, infection with selected P multocida laboratory strains (A50 and D82, A52 and A59) was achieved. At necropsy, pigs inoculated with strains A59 and A52 (serotype A, pleurotropic) had more severe lesions (P less than 0.05) than those inoculated with strain A50 (serotype A, pneumotropic). Also, pigs infected with strains A59 and A52 had extensive pleuritis and abscessation, which were not observed in the other groups. Strain D82 (serotype D) was not capable of producing pneumonia or pleuritis. Pleuritis and abscessation may be associated with certain P multocida strains that are serotype A, but not with others. These pleurotropic strains seem to be more virulent than pneumotropic strains, and infection with the former may result in extensive pleuritis and abscess formation. PMID- 3679972 TI - Copper toxicosis in cattle fed chicken litter. AB - Cattle from 2 herds developed copper toxicosis after the ingestion of chicken litter. The affected animals were adult Holstein cows and crossbred steers that ate 9 to 16 kg of litter/day. These cattle developed a sudden onset of weakness, depression, anorexia, icteric mucous membranes, and dark reddish brown urine. Liver copper concentrations in 2 cattle (1 from each herd) were 436 and 730 ppm. Results of copper analyses of chicken litter ranged from 620 to 920 ppm. Sodium molybdate and sodium thiosulfate were added to the ration of the dairy herd. Two cows with clinical signs of copper toxicosis recovered after being given additional sodium molybdate and thiosulfate supplements, orally. PMID- 3679973 TI - Diagnosis of Giardia infection in 14 calves. AB - Fourteen calves, 12 days to 12 weeks old, were treated for diarrhea. Fecal examination for parasitologic, bacteriologic, or viral infection revealed Giardia in all calves; rotavirus and coronavirus were found in some calves. Thirteen affected calves were treated orally with dimetridazole (50 mg/kg of body weight, daily, for 5 days), with complete resolution of the diarrhea and elimination of the Giardia. Giardiasis should be considered as an etiologic agent of diarrhea in calves. PMID- 3679974 TI - Diagnosis of primary generalized epilepsy in a cow. AB - On the basis of history, electrodiagnostic and neuropharmacologic studies, and results of laboratory testing and necropsy, a seizure disorder of 1.5 years' duration in an 8-year-old Hereford cow was diagnosed as primary generalized epilepsy. Evidence of metabolic, toxicologic, head trauma, or genetic cause of the seizures was not found. A morphologic cause for the convulsions also was not detected. One naturally occurring seizure was recorded electroencephalographically, but interictal EEG abnormalities were not seen. Attempts to evoke a seizure with photostimulation or therapeutic doses of acepromazine, ketamine, tripelennamine, and estradiol cypionate were unsuccessful. The seizure threshold for the CNS stimulant pentylenetetrazol was found to be less than 6 mg/kg, IV; the seizure threshold in a control cow was found to be greater than 12 mg/kg, IV. The pharmacologic protocol used for this cow may be useful for diagnosis of epilepsy in other animals. PMID- 3679975 TI - Aortic valve insufficiency in a one-year-old colt. AB - Aortic insufficiency was suspected in a thin 1-year-old colt with a grade IV/V decrescendo holodiastolic murmur and a bounding arterial pulse. Echocardiographic findings (diastolic fluttering of the septal leaflet of the mitral valve, left ventricular volume overload, and incomplete aortic valve closure) were diagnostic for aortic valve insufficiency. Moderately thick fibrotic aortic valve leaflets were found at necropsy. Fenestrations were found in the aortic and pulmonic valve cusps. Congenital valvular disease may have led to aortic valvular insufficiency in this horse. PMID- 3679976 TI - Small intestinal adenocarcinoma in a horse. AB - A 21-year-old mare was evaluated for intermittent episodes of apparent abdominal pain of 6 month's duration. Abdominal palpation per rectum revealed distended small intestine in the caudal portion of the abdomen. Ventral midline celiotomy revealed a mass in the midjejunal region. The mass was resected, and a side-to side anastomosis performed. The histologic diagnosis was tubular adenocarcinoma of the small intestine. The mare was still alive 13 months after surgery. PMID- 3679977 TI - Conservative treatment of a minimally displaced fracture of the radius of a horse. AB - The successful conservative treatment of an open, displaced fracture of the radius of a horse suggests that conservative treatment should not be ignored when surgery is not an option. The importance of proper soft-tissue management and the use of broad-spectrum antimicrobial treatment in the management of orthopedic injuries is emphasized. PMID- 3679978 TI - Comparison of duodenitis/proximal jejunitis and small intestinal obstruction in horses: 68 cases (1977-1985). AB - Sixty-eight horses with colic caused by small intestinal disease were allotted into 2 groups of 34 on the basis of recorded findings during exploratory celiotomy, necropsy, or response to medical treatment alone. Signalment, history, physical examination findings, and laboratory findings were compared between the group of horses with small intestinal obstruction and the group with duodenitis/proximal jejunitis. A significantly greater proportion of horses with duodenitis/proximal jejunitis were older than 2 years old (P less than 0.05). Differences in sex or breed distribution, or in seasonality of the 2 disease syndromes were not observed. Horses with duodenitis/proximal jejunitis had significantly greater signs of depression than those with small intestinal obstruction (P less than 0.01), and horses with small intestinal obstruction had significantly greater signs of abdominal pain (P less than 0.05). The mean heart and respiratory rates were significantly lower (P less than 0.01) and the volume of nasogastric reflux was significantly greater (P less than 0.05) in the group of horses with duodenitis/proximal jejunitis. Sections of small intestine that were palpable per rectum were less distended and there were more auscultable borborygmi in horses with duodenitis/proximal jejunitis, compared with those with small intestinal obstruction (P less than 0.05 and P less than 0.01). The group of horses with duodenitis/proximal jejunitis had lower mean plasma potassium and higher mean plasma bicarbonate concentrations (P less than 0.05) than the group with small intestinal obstruction. The mean nucleated cell count and total protein concentration of peritoneal fluid specimens were significantly less in the group with duodenitis/proximal jejunitis (P less than 0.01); however, these values were greater than normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3679979 TI - Lameness attributable to osteochondral fragmentation of the plantar aspect of the proximal phalanx in horses: 19 cases (1981-1985). AB - Osteochondral fragmentation of the plantar aspect of the proximal phalanx was diagnosed as a cause of hind limb lameness in 19 horses. The lameness was evident at the upper levels of the horses' performance capabilities, and was isolated to the metatarsophalangeal joints by use of intra-articular or regional anesthesia. Fragments were surgically removed from 10 horses that later returned to full use. Seven horses were treated intra-articularly with polysulfated glycosaminoglycans or corticosteroids; only one horse was able to return to full use. One horse was retired from work at the time of diagnosis. Surgery appeared to be the most effective treatment for osteochondral fragmentation of the plantar aspect of the proximal phalanx, although medical treatment combined with a decrease in the horses' expected performance also was believed to be useful. PMID- 3679980 TI - Use of splenectomy in the management of lymphoma in dogs: 16 cases (1976-1985). AB - Sixteen dogs with lymphoma underwent splenectomy to relieve signs of massive splenomegaly including splenic rupture. The most common preoperative hematologic abnormalities, anemia and thrombocytopenia, were reversed in all dogs surviving the initial postoperative period. Within 6 weeks after surgery, 5 dogs died because of disseminated intravascular coagulation and sepsis. The remaining 11 dogs underwent chemotherapy. These 11 dogs had a complete response rate of 66% at one month after surgery; the mean and median survival times were 9.3 and 5 months, respectively. In 7 dogs evaluated until death, the mean and median survival times were 13.4 months and 14 months, respectively. PMID- 3679981 TI - Renal medullary solute depletion resulting from psychogenic polydipsia in a rhesus monkey. AB - A rhesus monkey developed psychogenic polydipsia after a change in feeding regimen was instituted. Hyposthenuria, hyponatremia, hypochloremia, and an abnormal calculated plasma osmolality were found. Water deprivation testing and administration of antidiuretic hormone indicated that renal medullary solute depletion had resulted from the prolonged polyuria. Restricted water consumption resulted in resolution of the electrolyte abnormalities and restored ability to excrete concentrated urine. PMID- 3679982 TI - Glaucoma associated with a high number of mast cells in the uveal tract of an African lion cub. AB - An 8-week-old male lion cub (Panthera leo) was referred for evaluation of an enlarged and reddened left eye. Ocular examination revealed a buphthalmic left globe, with corneal edema, superficial neovascularization, moderate episcleral injection, a fixed dilated pupil, and an intraocular pressure of greater than 41.5 mm of Hg as measured by the Schiotz tonometer and a human conversion chart. A diagnosis of glaucoma was made. A silicone prosthesis was implanted after evisceration of the intraocular contents. Histologic examination of the eviscerated uveal tissue revealed numerous congested and dilated vessels of various sizes. Neutrophils were marginated along the vascular endothelium, and the uveal stroma was infiltrated by a few lymphocytes and numbers (3 to 30/hpf) of widely disseminated, well-differentiated mast cells with abundant, well granulated cytoplasm. PMID- 3679983 TI - Vertical membership. PMID- 3679984 TI - Thoughts on merchandising. PMID- 3679985 TI - Primary hyperparathyroidism in dogs. PMID- 3679986 TI - The human side of veterinary medicine. Identity crisis. PMID- 3679987 TI - Animal control, animal welfare, and the veterinarian. PMID- 3679988 TI - Career pathways in veterinary medicine. The world of association management. PMID- 3679989 TI - Vertebral canal and spinal cord mensuration: a comparative study of its effect on lumbosacral myelography in the dachshund and German shepherd dog. AB - One hundred noncontrast spinal radiographic studies followed by myelography were evaluated to compare vertebral canal size and spinal cord location and size in a chondrodystrophic breed (50 Dachshunds) with those variables in a nonchondrodystrophic breed (50 German Shepherd Dogs). Measurements were made of the sagittal diameter (height) of the vertebral canal, sagittal diameter (height) of the spinal cord, and transverse diameter (width) of the spinal cord in the lumbar and sacral regions. Differences were detected in the craniocaudal location of maximal vertebral canal height and maximal spinal cord height. The spinal cords in the Dachshunds terminated further caudally than those in the German Shepherd Dogs. Location of maximal spinal cord width was different between the breeds, consistent with the apparent, more caudal termination of the cord in the Dachshunds. The ratio of spinal cord to vetebral canal heights was notably greater in the Dachshunds than in the German Shepherd Dogs. These differences in vertebral canal and spinal cord mensuration may influence the choice of radiographic technique and its interpretation. Injection sites may be selected further cranially in German Shepherd Dogs (L4-5) than in Dachshunds (L5-6). PMID- 3679990 TI - Oak toxicosis in cattle in northern California: clinical and pathologic findings. AB - Sixteen calves (3 to 8 months old) affected with oak toxicosis were studied. Clinical, laboratory, and pathologic findings during the peracute through chronic stages were documented. Of the calves studied, 1 died, and 9 others were euthanatized because death was imminent. To evaluate chronic effects, the 6 remaining cattle were euthanatized after 2 months. One calf with acute toxicosis was treated successfully with diuretics and fluid volume replacements containing sodium chloride and calcium. Clinical and laboratory data were compared between survivors and nonsurvivors. A statistically significant (P less than 0.02) difference was found only in serum creatinine concentration at the time of initial reexamination. A decrease in BUN and creatinine values during the next 7 days and the lack of anorexia after the acute phase were the best prognostic indicators for survival. PMID- 3679991 TI - Hematuria caused by abdominal abscessation in a foal. AB - A 4.5-month-old Standard-bred filly was referred for evaluation of pigmenturia. Initially, the pigmenturia had resolved with the administration of antibiotics, only to recur after their withdrawal. A dark red urine sample contained numerous RBC, WBC, and gram-negative rods (Escherichia coli). Ultrasonography revealed the right kidney to be large, with multiple cystic structures and a dilated renal pelvis and calices. Cystoscopy revealed a large blood clot within the bladder and urine coming from the left ureteral opening. Urine was not observed coming from the right ureter. It was suspected that the primary infection within the urinary tract was coming from the right kidney, with secondary ureteral obstruction and cystitis. Trimethoprim-sulfamethoxazole treatment was initiated. However, acute depression and abdominal pain developed several days later, and the foal died before assistance could be provided. Necropsy revealed a large abscess that had eroded into the right ureter and aorta and had ruptured, resulting in acute blood loss and death. The location and extensive nature of the lesion would have precluded surgical intervention. PMID- 3679992 TI - Treatment of two mares with obstructive (vaginal) urinary outflow incontinence. AB - Two mares were examined because of urinary incontinence. Abnormalities of the genitourinary tract were identified and were corrected surgically. Urinary incontinence in mares generally is associated with a poor prognosis. The importance of a thorough physical examination of the genitourinary tract in the mare is emphasized, and the simple and successful surgical correction of structural abnormalities of the tract in 2 mares is described. PMID- 3679993 TI - Cerebral astrocytoma in four cats: clinical and pathologic findings. AB - Cerebral astrocytoma was diagnosed in 4 cats. A long-standing history of seizures followed by an increase in frequency of uncontrolled seizures were prominent features in these cats. Anticonvulsants provided effective seizure control in 3 cats for a period of 1 to 3 years. On initial and subsequent neurologic examinations, all cats were postictal and had focal neurologic deficits. In 2 cats, there were focal EEG patterns consistent with the neuroanatomic diagnosis of the tumor. White blood cell pleomorphism of the CSF was determined in the cats that underwent CSF analysis. Pathologic findings in all cats included tumor necrosis and edema, compression of the opposite hemisphere, and invasion of the third and lateral ventricles. PMID- 3679994 TI - False ankylosis of the temporomandibular joint in a cat. AB - Progressive inability to open the mouth developed in a cat after trauma to the head. Evaluation revealed a healed depression fracture of the left zygomatic arch and normal temporomandibular joints. Surgical exploration of the fracture confirmed a false ankylosis that developed between the depression fracture and the ramus of the mandible. Treatment included excision of the central portion of the zygomatic arch and a portion of the ramus. The cat regained normal function of its mouth. PMID- 3679995 TI - Late-onset regurgitation associated with persistent right aortic arch in two dogs. AB - Congenital persistent right aortic arch was diagnosed as the cause of weight loss and regurgitation in 2 dogs, aged 2.5 and 8 years, respectively. The first dog had 2 brief episodes of regurgitation that resolved spontaneously before the most recent onset of signs and diagnosis. The second dog had no clinical signs attributed to persistent right aortic arch until 2 months before the diagnosis was made. Dogs born with persistent right aortic arch typically have clinical signs of esophageal stenosis around the time of weaning. Evidence from the 2 dogs in this report indicate that clinical signs associated with vascular ring anomalies may not become evident until later in life. Veterinarians should consider the diagnosis of persistent right aortic arch in any age dog that is admitted because of regurgitation, weight loss, and dilatation of the cranial portion of the esophagus. PMID- 3679996 TI - Anatrichosoma sp infection in a dog. AB - Embryonated, double-operculated eggs were observed during routine examination of a fecal specimen from a 5-month-old dog. Similar eggs were found on a skin scraping of a raised, flaking, erythematous nodule on the dorsal midline in the lumbar region. Eggs were identified as being similar to those of Anatrichosoma spp. After surgical excision, histologic examination of the nodule revealed nematodes with morphologic features consistent with those of Anatrichosoma spp. PMID- 3679997 TI - Brucella canis osteomyelitis in two dogs with total hip replacements. AB - Brucella canis was isolated from the cement or bone surrounding a hip prosthesis after total hip replacement was performed for treatment of hip dysplasia in 2 dogs. Lameness or signs of infection were not evident for 9 and 16 months after surgery. Osteomyelitis surrounding the prostheses was detected radiographically only after the lameness developed. The origin of the B canis infection in the 2 dogs was believed to be hematogenous because of the biologic behavior of this organism and because of the duration of excellent limb function after hip replacement. A slide agglutination test for B canis should be performed as a screening test on any canine total hip candidate when the anamnesis and physical examination indicate that the dog may have been exposed to or infected with B canis. PMID- 3679998 TI - Chronic polyneuritis in a Rottweiler. AB - A 2-year-old male Rottweiler was examined because of progressive weakness and muscular atrophy in the 4 limbs. Neurologically, the disease was characterized by hypoactive segmental reflexes without ataxia. Function of the cranial nerves was maintained. Electromyographic findings, nerve conduction velocity measurements, recordings of somatosensory-evoked potentials, and results of histologic examination of nerve and muscle biopsy specimens indicated a peripheral neuropathy. Rapid progression of the disease over a 4.5-month period was observed before the dog was euthanatized. Necropsy was performed, and the histopathologic findings confirmed peripheral neuropathy, which appeared to involve the peripheral myelin. An immune-mediated process was suspected. PMID- 3679999 TI - Percutaneous balloon valvuloplasty for treatment of pulmonic stenosis in a dog. AB - A 2.5-year-old dog with congenital pulmonary valve dysplasia was treated by percutaneous balloon dilation of the stenotic orifice. Clinical and hemodynamic improvement was apparent immediately and for 9 months after the valvuloplasty procedure. PMID- 3680000 TI - Cerebral phaeohyphomycosis in a dog. AB - Cerebral phaeohyphomycosis was diagnosed in a 9-year-old spayed dog that had a series of epileptic convulsions a day before death. About 6 weeks before her death, she had been treated for severe demodectic mange. During this period, persistent leukopenia, lymphocytopenia, and thrombocytopenia were found by blood analyses. At necropsy, multiple large pyogranulomatous lesions were found in the cerebrum and meninges. Dematiaceous fungi with brown, branching, septate hyphae and budding yeasts were found within tissue cells and in the necrotic areas. PMID- 3680001 TI - Swalpamycin, a new macrolide antibiotic. I. Taxonomy of the producing organism, fermentation, isolation and biological activity. AB - A new macrolide antibiotic, swalpamycin, has been isolated from the culture broth of Streptomyces sp. Y-84,30967. Taxonomically the producing organism most closely resembles Streptomyces anandii and has therefore been named S. anandii subsp. swalpus. Swalpamycin is a neutral 16-membered macrolide active against Gram positive bacteria including erythromycin-resistant strains. PMID- 3680002 TI - Swalpamycin, a new macrolide antibiotic. II. Structure elucidation. AB - A new antibiotic swalpamycin (1) has been isolated from the culture broth of Streptomyces sp. Y-84,30967. The antibiotic has the molecular formula of C37H56O14 and belongs to the class of 16-membered neutral macrolide antibiotics. Its structure has been elucidated by an analysis of its spectral properties. It contains a novel aglycone herein called swalpanolide. PMID- 3680003 TI - Coloradocin, an antibiotic from a new Actinoplanes. I. Taxonomy, fermentation and biological properties. AB - Coloradocin was discovered in a screen for anti-anaerobe activity. The producing organism was determined to be a new species of Actinoplanes, designated Actinoplanes coloradoensis sp. nov. Coloradocin inhibits Bacteroides, Clostridium and other anaerobes. It does not inhibit most aerobic bacteria but is effective against Neisseria gonorrhoeae and Haemophilus influenzae. Coloradocin has low acute toxicity. PMID- 3680004 TI - Coloradocin, an antibiotic from a new Actinoplanes. II. Identity with luminamicin and elucidation of structure. AB - Coloradocin was isolated from a fermentation broth by adsorption onto Amberlite XAD-2. The activity was eluted in MeOH and purified by gel filtration on Shephadex LH-20, followed by liquid-liquid chromatography on diol-bonded silica gel. The last two steps in the purification of this antibiotic included reverse phase chromatography on C18-bonded silica gel and countercurrent chromatography on an Ito Coil Planet Centrifuge to give material of 90% purity. Analytically pure material was obtained by preparative HPLC. As a result of extensive homo and heteronuclear two-dimensional NMR studies, a structure was proposed for coloradocin. The structure consists of a decalin ring system fused to a 10 membered macrolactone which in turn is fused to a 14-membered macrolactone possessing an enol ether in conjugation with an unsaturated cyclic anhydride functionality. Coloradocin is related to a small class of antibiotics which include nodusmicin and nargenicin and was shown to be identical to luminamicin for which no structure has been reported. PMID- 3680005 TI - A novel tetracycline from Actinomadura brunnea. Fermentation, isolation and structure elucidation. AB - A novel tetracycline antibiotic, Sch 33256, was isolated from a culture broth of a new species of Actinomadura. The antibiotic was isolated by solvent extraction, Sephadex G-25 column chromatography and crystallization. The structure was determined by comparison of the spectra with that of chlortetracycline. Spectroscopic analysis of the compound yielded 2'-N-methyl-8 methoxychlortetracycline as the proposed structure. PMID- 3680006 TI - A new tetracycline antibiotic from a Dactylosporangium species. Fermentation, isolation and structure elucidation. AB - An actinomycete identified as a Dactylosporangium sp. produces a new tetracycline, 4a-hydroxy-8-methoxychlortetracycline (Sch 34164). The addition of magnesium ions to complex fermentation media increased the antibiotic titers. Sch 34164 was isolated by solvent extraction and Sephadex G-25 column chromatography. The novel structure was proposed based on spectroscopic analysis. The shift of C 4a (35 to 77 ppm) and C-8 (140 to 163 ppm) in the 13C NMR as compared to chlortetracycline was indicative of the novel hydroxyl and methoxy substituents, respectively. PMID- 3680007 TI - Direct selection of a specifically blocked mutant of Actinomadura brunnea. Isolation of a third 8-methoxy substituted chlortetracycline. AB - Actinomadura brunnea produces 2'-N-methyl-8-methoxychlortetracycline. A derivative of this strain has been isolated that is specifically blocked in methylation of the 2'-amino position. This isolate was detected by screening approximately 30,000 colonies of a mutagenized population of Actinomadura brunnea using a direct soft agar overlay with an Escherichia coli indicator. The antibiotic produced by the blocked mutant has been identified as 8 methoxychlortetracycline (Sch 36969) based upon its biological activity, relative mobility on TLC and HPLC, and spectroscopic data. PMID- 3680008 TI - In vitro and in vivo characterization of novel 8-methoxy derivatives of chlortetracycline. AB - The in vitro activities of three new 8-methoxychlortetracyclines, Sch 36969, 33256 and 34164 were compared to tetracycline, minocycline and doxycycline. Against aerobic Gram-negative rods Sch 36969 had a geometric mean MIC (GMM) of 4.2 micrograms/ml, about 8-fold more potent than Sch 33256, and similar to all the other compounds. Sch 36969 also had good activity against methicillin resistant (GMM, 0.21 micrograms/ml) and -susceptible Staphylococci (GMM, 0.14 micrograms/ml), Streptococci (GMM, 0.06 micrograms/ml), and most anaerobic bacteria (GMM, less than 0.5 micrograms/ml). In general, Sch 36969 was similar to, or more potent than, all the other compounds tested. Serum levels of Sch 36969 in squirrel monkeys were 4-fold lower (AUC, 4.5 micrograms.hours/ml) than those of chlortetracycline (AUC, 16.1 micrograms.hours/ml). In mouse protection tests (PD50s) against various strains of bacteria, Sch 36969 was similar in activity to tetracycline, but up to 6-fold less active than chlortetracycline. The structure activity relationships for these new chlortetracyclines are described. PMID- 3680009 TI - Metabolic products of microorganisms. 239. Bacimethrin isolated from Streptomyces albus identification, derivatives, synthesis and biological properties. AB - Bacimethrin (1), known as a thiamine antagonist produced by Bacillus megatherium, was isolated from Streptomyces albus and has been further characterized by NMR spectra and acetylation. A new easy three step synthesis for 1 is described. The biological activity of 1, and its mode of action were discussed. There are indications that bacimethrin inhibits the phosphorylation of 4-amino-5 hydroxymethyl-2-methylpyrimidine (Pyr-OH) during thiamine biosynthesis. PMID- 3680010 TI - Effect of spergualin in autoimmune disease mice. AB - We investigated the effect of spergualin (SGL) upon the development of spontaneous systemic lupus erythematosus-like lesions in male MRL/MpJ-lpr/lpr mice. SGL was administered ip at doses of 2.5, 5 and 10 mg/kg to two groups of mice. One group received SGL prophylactically from 7 to 21 weeks of age. The other group received SGL curatively from 13 to 27 weeks of age. The occurrence of lupus lesions was characterized by enlarged lymphoid organs, high anti-DNA titer and blood urea nitrogen, and severe glomerular nephritis. In both groups these characteristics were significantly suppressed by SGL in a dose-dependent manner. This inhibitory activity was greatest at a dose of 10 mg/kg. These findings suggest that SGL has prophylactic and curative effects against lupus lesions in autoimmune disease in mice. PMID- 3680011 TI - Hydroxychlorothricin, a new antitumor antibiotic. PMID- 3680012 TI - Identity of borrelidin with treponemycin. PMID- 3680013 TI - Biosynthetic preparation of labeled cerulenin with high specific radioactivity. PMID- 3680014 TI - Synthesis of azepinomycin and its beta-D-ribofuranoside. PMID- 3680015 TI - Total synthesis of neomycin B. PMID- 3680016 TI - Synthesis and biological properties of 7 beta-[(Z)-2-(2-amino-4-thiazolyl)-4 carboxy-2-butenoylamino]-3-cephem- 4-carboxylic acid (7432-S), a new oral cephem antibiotic. PMID- 3680017 TI - Kinetic studies of tyrosine kinase inhibition by erbstatin. PMID- 3680018 TI - Lipstatin, an inhibitor of pancreatic lipase, produced by Streptomyces toxytricini. I. Producing organism, fermentation, isolation and biological activity. AB - Lipstatin, a new and very potent inhibitor of pancreatic lipase (the key enzyme of intestinal fat digestion) was isolated from Streptomyces toxytricini. Lipstatin contains a beta-lactone structure that probably accounts for the irreversible lipase inhibition. The IC50 of lipstatin for pancreatic lipase is 0.14 microM. In mice triolein absorption was dose-dependently inhibited by lipstatin, whereas oleic acid was absorbed normally. Other pancreatic enzymes, such as phospholipase A2 and trypsin, were not inhibited even at an inhibitor concentration of 200 microM. PMID- 3680019 TI - Lipstatin, an inhibitor of pancreatic lipase, produced by Streptomyces toxytricini. II. Chemistry and structure elucidation. AB - The structure of a new pancreatic lipase inhibitor, lipstatin, produced by Streptomyces toxytricini was determined as (2S,3S,5S,7Z,10Z)-5-[(S)-2-formamido-4 methylpentanoyloxy ]-2-hexyl-3- hydroxy-7,10-hexadecadienoic lactone by spectroscopic and chemical methods. Structurally lipstatin is closely related to the known esterase inhibitor esterastin. It contains a N-formyl-L-leucine side chain instead of the N-acetyl-L-asparagine in esterastin. PMID- 3680020 TI - K-259-2, a new inhibitor of Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase from Micromonospora olivasterospora. AB - K-259-2, a new inhibitor of Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase, was isolated from the cultured broth of Micromonospora olivasterospora K-259. K-259-2 has an anthraquinone moiety in its structure. IC50 values for the effect of K-259-2 against Ca2+ and calmodulin-stimulated activity of the enzyme preparations from bovine brain and heart were 6.6 and 2.9 microM, respectively. On the other hand, basal activity (the activity in the presence of ethylene bis(oxyethylenenitrilo)tetraacetic acid (EGTA) instead of Ca2+/calmodulin) of the bovine brain enzyme, calmodulin-independent cyclic nucleotide phosphodiesterase from bovine heart, and protein kinase C from rat brain were inhibited by K-259-2 to a lesser extent with IC50 values of 27.4, 40.7 and 45.8 microM, respectively. PMID- 3680021 TI - Structure of a novel Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase inhibitor K-259-2. AB - The structure of K-259-2, a potent inhibitor of Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase, was determined to be 3-(2Z-2-ethyl-2 butenyl)-1,6,8-trihydroxy-anthraquinone-2-carboxyl ic acid by chemical conversion and spectral studies. PMID- 3680022 TI - KS-619-1, a new inhibitor of Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase from Streptomyces californicus. AB - KS-619-1, a new inhibitor of Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase, was isolated from the cultured broth of Streptomyces californicus. KS-619-1 has an anthraquinone moiety. IC50 values for the effect of KS-619-1 on Ca2+ and calmodulin-stimulated activity of bovine brain and heart enzymes were 2.0 and 1.5 microM, respectively. On the other hand, basal activity (the activity in the presence of ethylene bis(oxyethylenenitrilo)tetraacetic acid (EGTA) instead of Ca2+/calmodulin) of the bovine brain enzyme, calmodulin independent cyclic nucleotide phosphodiesterase from bovine heart, and protein kinase C from rat brain were inhibited by KS-619-1 to a lesser extent with IC50 values; 12.3, 25.9 and 151 microM, respectively. PMID- 3680023 TI - Structure of a novel Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase inhibitor KS-619-1. AB - The structure of KS-619-1, a potent inhibitor of Ca2+ and calmodulin-dependent cyclic nucleotide phosphodiesterase, was determined to be 8,13-dioxo-3-(2 oxopropyl)-5,6,8,13-tetrahydro-1,7,9,11- tetrahydroxybenz[a]naphtacene-2 carboxylic acid by spectral studies of KS-619-1 and its methyl derivative. PMID- 3680024 TI - New tylosin analogs produced by mutants of Streptomyces fradiae. AB - 2'''-Demethoxytylosin (component IIIc), 2'''-demethoxy-4'''-epi-tylosin (component IIId) and 2'''-O-demethyltylosin (component Vb) were produced by blocked mutant strains of Streptomyces fradiae. Fermentation, isolation, structure determination and biosynthetic considerations of these tylosin analogs are described. PMID- 3680025 TI - Characterization of new viridomycins and requirements for production in cultures of Streptomyces griseus. AB - Cultures of Streptomyces griseus grown under phosphate-limiting conditions produced a complex of green products. Three of these were separated from the mixture and characterized. One was identified as viridomycin A, the ferrous chelate of 4-hydroxy-3-nitrosobenzaldehyde; the second (actinoviridin A) was the corresponding carboxylic acid chelate and the third (viridomycin E) was a hybrid chelate containing both the aldehyde and acid ligands. Only two out of nine strains of S. griseus examined produced viridomycins and the ligands were biosynthesized only in media from which phosphate had been exhausted. Optimization of the production medium showed that fructose and alanine were the most favorable carbon and nitrogen sources and that relatively high concentrations of ferrous ions were necessary. The results suggest that viridomycins are not produced by S. griseus as iron scavengers in response to iron deficiency but as secondary metabolites that are stabilized adventitiously in the broth by metal ion chelation. PMID- 3680026 TI - Papulacandins--synthesis and biological activity of papulacandin B derivatives. AB - A series of papulacandin B derivatives was synthesized and their in vitro and in vivo activity against Candida albicans and other fungi was established. The biological data have shown that some 10-alkyl ether and 11-acylamino derivatives exhibit an improved in vivo activity compared to papulacandin B whereas derivatization in other positions of the molecule led to less potent compounds. PMID- 3680027 TI - Synthesis of p-hydroxyubenimex. AB - p-Hydroxyubenimex, (2S,3R)-3-amino-2-hydroxy-4-p-hydroxyphenylbutyryl-L-leucine, was synthesized starting from D-tyrosine. The structure and stereochemistry of the synthesized product were confirmed by comparison with p-hydroxyubenimex that was chemically transformed from ubenimex, an aminopeptidase inhibitor of microbial origin. Compared to ubenimex, p-hydroxyubenimex is more active against aminopeptidase B but less active against leucine aminopeptidase. By using the synthetic p-hydroxyubenimex as a reference sample, one of the metabolites of ubenimex was identified as p-hydroxyubenimex. The (2R,3R)-stereoisomer of p hydroxyubenimex was also prepared. However, its activity against aminopeptidases was much weaker. PMID- 3680028 TI - Macrolide biosynthesis: stereochemistry of the hydroxylation of brefeldin C. AB - Brefeldin C (2) is the penultimate intermediate in the biosynthetic pathway to brefeldin A (1). Using stereospecifically 2H-labeled forms of 2, the hydroxylation of 2 to 1 is shown to involve stereospecific removal of the 7 pro-S hydrogen from 2. PMID- 3680029 TI - HRE 664, a new parenteral penem. II. Evaluation of the pharmacokinetic behavior and the chemotherapeutic activity in animals. AB - The pharmacokinetic and chemotherapeutic properties of the new penem antibiotic HRE 664 (Fig. 1) were evaluated in experimental animals. High and sustained blood and serum levels were achieved following parenteral injection in mice, rats, dogs and monkeys. Half-lives ranged from 27 to 40 minutes in the various species tested. The antibiotic was well distributed in the rodents and penetrated well into tissues and body fluids. At 30 minutes after subcutaneous administration to mice (50 mg/kg), concentrations of between 12.4 and 35.9 micrograms/g were measured in the lungs, liver, heart and kidneys, that is 33 approximately 95% of the corresponding level in murine blood (37.7 micrograms/ml). In experimentally induced infections in mice, HRE 664 displayed good chemotherapeutic activity particularly against septicemias caused by methicillin-sensitive and methicillin resistant Staphylococcus aureus strains and on abscess formation induced by Bacteroides fragilis. Most of the cephalosporins and other beta-lactam antibiotics exhibited low efficacy against these strains of bacteria. PMID- 3680030 TI - Suppression of experimental allergic encephalomyelitis in guinea pigs by spergualin and 15-deoxyspergualin. PMID- 3680031 TI - A new antibiotic indisocin and N-methylindisocin. PMID- 3680032 TI - One-pot preparation of 1-chlorovinylisocyanides from carbonyl compounds. PMID- 3680033 TI - Total synthesis of indisocin and N-methylindisocin. PMID- 3680034 TI - A new semisynthetic analogue of nocardicin. PMID- 3680036 TI - Inhibition of tyrosine protein kinase by synthetic erbstatin analogs. PMID- 3680035 TI - Effective synthesis of erbstatin and its analogs. PMID- 3680037 TI - Synergy of patulin with other antibiotics. PMID- 3680038 TI - New antibiotic napyradiomycins A2 and B4 and stereochemistry of napyradiomycins. AB - Napyradiomycins A2 and B4, new members of the napyradiomycins, have been isolated from the culture broth of Chainia rubra MG802-AF1. The structure of napyradiomycin A2 was elucidated as 16-hydroxy-17-methylenenapyradiomycin A1 by NMR studies. The absolute structure of napyradiomycin B4 was determined as 13 hydroxy-13-methylnapyradiomycin B1 by X-ray crystallography and therefore the configuration of C(4a) in other napyradiomycins is assumed as the R configuration. The geometrical isomerism of napyradiomycin C1 was estimated as 12E and 16E by nuclear Overhauser effect experiments. PMID- 3680039 TI - A new pyrrole-amidine antibiotic TAN-868 A. AB - A new pyrrole-amidine antibiotic TAN-868 A was isolated from the culture broth of Streptomyces idiomorphus sp. nov. Its chemical structure was determined by spectroscopic analyses and degradation studies to be 4-[(2S,4R)-4-hydroxy-5 iminoprolyl]amino- N-(2-amidinoethenyl)-2-pyrrolecarboxamide. The antibiotic is active against bacteria, fungi and a protozoan, and has cytotoxic activity against murine tumor cells. DNA thermal denaturation studies suggest that TAN-868 A preferentially interacts with AT rich regions of double-stranded DNA. PMID- 3680040 TI - Synthesis and antitumor activity of spergualin analogues. II. Chemical modification of the spermidine moiety. AB - Chemical modifications of the spermidine moiety of an antitumor antibiotic, spergualin (Ia), and the structure-activity relationship are described. Replacement of spermidine with other polyamines decreased the antitumor activity against mouse leukemia L1210. Analogues containing an oxidized spermidine moiety that probably formed during oxidation with amine oxidase were inactive. Spermidine is indispensable for the antitumor activity. A facile method for the synthesis of glyoxyloyl polyamine, a key intermediate of spergualin-related compounds, is also reported. PMID- 3680041 TI - Synthesis and antitumor activity of spergualin analogues. III. Novel method for synthesis of optically active 15-deoxyspergualin and 15-deoxy-11-O methylspergualin. AB - Optically active 15-deoxyspergualin (II) and 15-deoxy-11-O-methylspergualin (IIa) were synthesized, and their antitumor activities were examined. The (-) enantiomers of both II and IIa were active against mouse leukemia L1210, while the (+)-enantiomers were almost inactive. The optical resolution of the key intermediate, (+/-)-N-(7-guanidinoheptanoyl)-alpha-alkoxyglycine (VI) was achieved by use of an exopeptidase, serine (acid) carboxypeptidase [EC 3.4.16.1] and (+/-)-N-(7-guanidinoheptanoyl)-alpha-alkoxyglycyl-L-amino acid (VIII) as the substrate. Considering the enzymatic susceptibility of the substrate (VIII), we deduced that the absolute configuration of the carbon at 11 (C-11) of the bioactive (-)-enantiomer, and so that of natural spergualin (I), is S. This is, to our knowledge, the first report of the use of carboxypeptidase for the resolution of N-acyl amino acid. PMID- 3680042 TI - Synthetic cephalosporins. II. The synthesis and oral activity of 7-[R-2-amino-2 (3-chloro-4-hydroxyphenyl)acetamido]-3-methylthio-3- cephem-4-carboxylic acid and related compounds. AB - A series of 3-methylthio-3-cephem-4-carboxylic acids were prepared to test their antibacterial activities, and 7-[R-2-amino-2-(3-chloro-4-hydroxyphenyl)acetamido] 3-methylthio-3-ce phe m-4- carboxylic acid was found to be a new orally active antibiotic. PMID- 3680043 TI - Isolation of (-)-gamma-cadinene and aristolochene from Aspergillus terreus. PMID- 3680044 TI - On the biosynthesis of flavipucine. PMID- 3680045 TI - Effect of some benzyl thiocyanate analogs on tetracycline production. PMID- 3680046 TI - New antitumor antibiotics, anguinomycins A and B. PMID- 3680047 TI - 4''-O-(4-methoxyphenyl)-acetyltylosin, a new macrolide derivative of therapeutic importance. PMID- 3680048 TI - Forward masking and unmasking of the offset cochlear compound action potential of the gerbil: comparison with suppression areas of the onset cochlear compound action potential. AB - Simultaneous and forward maskers were used to generate 'onset' and 'offset' compound action potential tuning curves (TCs) in the gerbil. The simultaneously masked offset TC, generated in response to a 16 kHz, 65 dB SPL probe stimulus, is W-shaped, with a low frequency tip at 11 kHz, a high frequency tip at 20 kHz, and a peak which occurs at 16 kHz. The 16 kHz forward masked onset TC has a single tip which occurs at 11 kHz. Although it lacks the finely tuned peak and high frequency tip of the stimultaneously masked offset TC, its single tip is more finely tuned than the low frequency tip of the simultaneously masked offset TC. Normalizing these two TCs [(1977) J. Acoust. Soc. Am. 62, 1048-1051] produces a figure which resembles 11 kHz onset TCs with their nonoverlapping regions which are analogs of two-tone suppression (2TS). A similar pattern occurs when probe stimuli at frequencies from 13 to 24 kHz are used to generate offset TCs; i.e., the forward masked offset TC resembles an onset TC and normalizing it to a simultaneously masked offset TC produces areas which resemble analogs of 2TS. Unmasking of the forward masked onset TCs [(1979) Hear, Res. 1, 133-154] produces regions of 2TS which are very similar to those produced by unmasking the forward masked offset TC which is generated by a higher frequency tone. These regions of 2TS for the Offset TC, as determined by unmasking, are very similar to the analogs of 2TS described above. PMID- 3680049 TI - Three molecular steps of aminoglycoside ototoxicity demonstrated in outer hair cells. AB - Previously postulated molecular mechanisms of aminoglycoside ototoxicity were investigated in outer hair cells in vitro. Cells were isolated by microdissection from the organ of Corti of the guinea pig and maintained in Hank's balanced salt solution. (1) Approx. 100 cells (the standard number per assay) bound 432 +/- 198 pmol calcium as determined with 45Ca2+ (1.2 mM). 1 mM neomycin or gentamicin lowered this value by 28% and 45%, respectively. (2) Binding of radiolabeled gentamicin (28 fmol per 100 cells at 0.1 microM gentamicin) was reduced by 55% by 1 mM neomycin or spermine. Washing with an excess of unlabeled gentamicin displaced only 60% of the drug, the remainder being tightly bound to a less accessible compartment. Incubation at low temperature essentially abolished gentamicin uptake. (3) Phospholipids were labeled with [32P]orthophosphate which was mostly incorporated into phosphatidylinositol 4,5-bisphosphate (PIP2), phosphatidylinositol 4-phosphate, phosphatidylinositol, and phosphatidic acid. When the lipids were chromatographed over immobilized gentamicin PIP2, in contrast to other lipids, was strongly retained. These results are compatible with the following actions of aminoglycosides in outer hair cells: (1) competition with calcium; (2) energy-dependent uptake competitive with polyamines; and (3) binding to the phospholipid PIP2. PMID- 3680050 TI - GABA-like immunoreactivity in the chick basilar papilla and the lagenar macula. AB - Gamma-aminobutyric acid (GABA)-like immunoreactivity in the chick basilar papilla and lagenar macula was studied by using anti-serum against GABA coupled with glutaraldehyde to bovine serum albumin. GABA-like immunoreactivity was localized selectively in the cytoplasm of both tall and short hair cells in the basilar papilla, and in the hair cell cytoplasm of the lagenar macula. This immunocytochemical finding suggests that GABA may be an afferent neurotransmitter from the hair cell to the primary afferent neuron in the auditory organs of avians and is consistent with previous findings which suggest that GABA may act as an afferent neurotransmitter in the avian vestibular organs as well. However, the distribution pattern of GABA-like immunoreactivity in the afferent system is quite different from the distribution pattern previously described in the mammalian inner ear where GABA-like immunoreactivity is found exclusively within the efferent system. PMID- 3680051 TI - Evoked response 'forward masking' functions in chinchillas. AB - Evoked potentials were obtained from the inferior colliculus of awake chinchillas using a 'forward masking' stimulus paradigm. The response was elicited using a brief probe tone presented 10 dB above threshold. Forward masking functions were then measured by determining the intensity of the masker needed to produce a 50% reduction in evoked response amplitude over a range of time intervals between masker offset and probe onset. The time course of forward masking was evaluated by fitting an exponential function to the results. The average time constant values of forward masking functions ranged from 50 to 90 ms. Although the constants at 0.5 and 8.0 kHz were somewhat longer than those at the midfrequencies, the differences were not statistically significant. The evoked response forward masking functions were quite similar to those obtained psychophysically; this suggests that it may be an efficient method of estimating the time course of forward masking in difficult to test subjects. PMID- 3680052 TI - Collagen type II in the otic extracellular matrix. Effect on inner ear development. AB - Immunocytochemistry was used to demonstrate type II collagen distribution during normal development of the mouse inner ear and in two malformed inner ears. Patterns of inner ear abnormalities and type II collagen distribution were compared between the malformed labyrinth of a mouse mutation (disproportionate micromelia, Dmm) and otic explants exposed to the teratogenic action of an L proline analog, L-azetidine-2-carboxylic acid (LACA). The results suggest that type II collagen is an important constituent of the developing inner ear's extracellular matrix. Disruptions of the spatial and temporal pattern of collagen type II can adversely affect morphogenesis of the inner ear. A common mechanism of action is postulated for the causation of both the genetic and teratogen induced inner ear malformations (i.e. disruption of the secretion of collagens to the otic extracellular matrix). PMID- 3680053 TI - Compound action potential offset and onset tuning curves generated by simultaneous masking in the mongolian gerbil. Effects of varying the intensity of the probe stimulus from 55 to 85 dB SPL. AB - Action potential tuning curves (TCs) were produced by simultaneous masking of both the onset and offset of tone bursts. Offset TCs are much more sharply tuned than onset TCs when both responses are generated by stimuli at SPLs of 55 to 75 dB. The onset TC tip and the offset TC high frequency tip thresholds accurately reflect increases of the probe SPL, but the low frequency tip and the peak of the offset TC compress this change. With increasing probe SPL, the onset TC and low frequency TC tip (but not the high frequency tip and peak) of the offset TC become progressively detuned. PMID- 3680054 TI - Sidedness of action of loop diuretics and ouabain on nonsensory cells of utricle: a micro-Ussing chamber for inner ear tissues. AB - It is known that nonsensory tissues of the utricle produce a lumen-positive transepithelial electrical potential difference (VT). This potential has been shown previously to be inhibited by ouabain and bumetanide applied to the bathing medium in vitro. In order to more fully characterize the origin of this potential we mounted the utricle as a flat sheet in a newly designed Ussing chamber and measured the VT and transepithelial resistance (RT) while perfusing the endolymphatic and perilymphatic surfaces independently with identical solutions. The aperture of the chamber was 1.5 X 10(-4) cm2. VT averaged 5.6 +/- 0.46 mV and RT was 24.0 +/- 2.43 omega X cm2 (n = 45). Ouabain and loop diuretics of the furosemide family were found to inhibit the VT only from the serosal side. The KI for ouabain was 7.63 X 10(-5) M. The loop diuretics tested inhibited the VT in the same order as in other tissues known to contain a Na/2 Cl/K cotransporter (KI: 2-benzylamino-4-cyclohexylsulfonyl-5-sulfamoylbenzolsulfonate++ + (BCSB), 1.72 X 10(-7) M; bumetanide, 1.10 X 10(-6) M; piretanide, 5.67 X 10(-6) M; furosemide, 4.14 X 10(-5) M). It is concluded that this tissue produces a lumen positive VT (i) in the absence of a transepithelial chemical gradient; the generation of which is dependent upon the activity of (ii) Na,K-ATPase and (iii) a Na/2 Cl/K cotransporter; (iv) in the basolateral membranes of the nonsensory cells; (v) which is not depressed by luminal application of inhibitors of these transporters. PMID- 3680055 TI - Pure tone overstimulation changes the micromechanical properties of the inner hair cell stereocilia. AB - The effect of permanent noise-induced hearing loss on the auditory brainstem response (ABR) and the micromechanical properties of cochlear hair cell stereocilia in guinea pigs was investigated. The threshold of movement of the stereocilia was measured by applying force from a fluid filled pipette. After exposure to a 1.0 kHz pure tone signal at 105 dB(A) for 72 h the threshold of the ABR was broadly elevated by approximately 50 dB. Inner hair cell stereocilia showed a decrease in threshold while the outer hair cell stereocilia bundles remained unaltered. This effect was localized to the 13-15 mm distance from the stapes corresponding to the region of maximal stimulation. The effect was recorded within 1 h of exposure and remained constant with exposures up to 7 days. Following a one month recovery period from sound exposure, normal threshold values of stereocilia movement were observed, indicating recovery. At this time, swelling of the afferent dendrites beneath the inner hair cells was observed throughout the cochlea together with approximately 30% scattered loss of outer hair cells in the 13 to 15 mm region. The ABR showed some recovery (approximately 20 dB), yet a threshold shift remained. PMID- 3680056 TI - A model of the generation of the cochlear microphonic with nonlinear hair cell transduction and nonlinear basilar membrane mechanics. AB - A phenomenological model of the generation of the cochlear microphonic of the guinea pig is presented which incorporates sharp tuning and nonlinear growth of the vibration of the cochlear partition, and nonlinear transduction of this response by a single linear array of hair cells (assumed to be the outer hair cells). The contribution to the microphonic potential from each hair cell generator is also assumed to decay exponentially with distance from the hair cell. Using experimentally obtained estimates for the parameters a good agreement between the theoretical microphonic tuning curves and growth functions was obtained without recourse to complex micromechanical motion of the cochlear partition, electrical tuning of the hair cells or a contribution from the inner hair cells of the cochlea. PMID- 3680057 TI - The low-frequency response of inner hair cells in the guinea pig cochlea: implications for fluid coupling and resonance of the stereocilia. AB - AC receptor potentials within the inner hair cells of the basal turn of the guinea pig cochlea have been recorded for stimuli in the frequency range 20 Hz to 3200 Hz. Comparison of these potentials with potentials recorded in scala media suggests that the stereocilia of many inner hair cells are stimulated by the transverse velocity of the cochlear partition for very low frequency, but above a transition frequency in the range 400 Hz to 1000 Hz they become entrained with partition displacement. It is suggested that such a transition is probably a simple consequence of the fluid coupling that drives these cells, and that mechanical resonance of the free-standing stereocilia of the inner hair cells does not occur in the basal turn of the guinea pig. These results do not, however, preclude the possibility of mechanical resonance involving the stereocilia of the outer hair cells. The results also indicate that the bodies of these cells low-pass filter the intracellular receptor potential, with a cutoff frequency of approximately 1000 Hz. PMID- 3680058 TI - Maturation of synapses and electrical properties of cells in the cochlear nuclei. AB - Auditory nerve fibers carry impulses from the cochlea to the cochlear nuclei. There the temporal firing patterns of auditory nerve fibers are preserved by some cells and altered by others. The two factors which govern how firing patterns are shaped are (1) the intrinsic electrical properties of cells that determine the size and time course of voltage changes caused by synaptic currents and (2) the synaptic circuitry between cells. The electrical properties of cells were measured by recording the responses to current injected intracellularly into brain slice preparations. The synaptic responses to electrical shocks of the auditory nerve were used to determine the functional properties of synaptic connections. The three distinct types of electrical properties of cells that can be distinguished electrophysiologically in similar preparations of mature tissue, bushy and stellate cells in the ventral cochlear nucleus [(1984) J. Neurosci. 4, 1577-1588] and cells in the dorsal cochlear nucleus [Hirsch and Oertel (1987) (submitted); Oertel et al. (1987) In: Functions of the Auditory System, Editor: S. Hassler. J. Wiley and Sons (in press)] can be differentiated at least as early as 7 days after birth. Young cells, however, have higher input resistances and lower input capacitances than mature cells, and they cannot sustain high firing rates. Bushy and stellate cells in the ventral cochlear nucleus respond to electrical stimulation of the auditory nerve with both excitatory and inhibitory postsynaptic potentials as early as 4 days after birth. The synaptic potentials occur with longer and more variable latencies than in mature cells and synapses fatigue more easily, however. Cells of the dorsal cochlear nucleus also receive both excitatory and inhibitory synaptic inputs 4 days after birth, upon stimulation of the auditory nerve. No systematic changes were detected in these synaptic responses as a function of age but this may have been because the variability in the shape and timing of synaptic responses was large even in mature tissue. PMID- 3680059 TI - Age-related hair cell loss in spontaneously hypertensive and normotensive rats. AB - In the spontaneously hypertensive (SH) rat, a hereditary form of hypertension and widespread vascular abnormalities develop. In the present study the inner ear degeneration pattern in SH and normotensive (N) rats not exposed to noise was investigated and correlated with frequency-specific auditory brainstem response (ABR) thresholds. Rats of both strains were found to have a spontaneous loss of apical hair cells, but this was slightly more pronounced in SH. In SH rats, but not in those of the N strain, there was an age-related progressive loss of outer hair cells in the region 3-5 mm from the stapes, and a slight additional loss at the most basal end. According to available frequency maps, the hair cell loss should correspond to hearing loss between 6 and 24 kHz. In the SH rats hearing loss was not observed in the whole of this range, only at 16 and 20 kHz. It cannot be determined to what extent the localized spontaneous loss of hair cells is caused by vascular factors and what other mechanisms are involved, but vascular factors probably only play a minor role. PMID- 3680060 TI - Loss of hair cells and threshold sensitivity during prolonged noise exposure in normotensive albino rats. AB - The relation between hearing loss and loss of hair cells after prolonged exposure to a simulated industrial noise environment was determined in normotensive albino rats. Hearing loss was assessed behaviorally by a conditioned suppression technique and electrophysiologically by auditory brainstem response to pulses of 1/3 octave filtered full cycle sine waves. The ears were analyzed in surface preparations and the hair cells counted. Sixty-two ears from 46 animals were analyzed after 1, 3, 7, and 15 months of exposure. A hearing loss of up to approximately 30 dB was consistently found with minimal loss of hair cells. Between 30 and 60 dB hearing loss there was a fair correspondence between loss of function and loss of hair cells. After 15 months exposure a relatively larger loss of hair cells was observed than expected from decrease of threshold sensitivity. The results indicate the existence of a systematic although not directly proportional relation between hair cell loss and loss of sensitivity during prolonged noise exposure. It is suggested that the correlation between hearing loss and hair cell loss is influenced, e.g., by duration and level of exposure, degree of hearing loss, and location along the basilar membrane. PMID- 3680061 TI - Acoustic overstimulation alters the morphology of the tectorial membrane. AB - After a permanent threshold shift was induced by exposing guinea pigs to a 1 kHz pure tone at 105 dB(A) for 72 h, light microscopic observations of freshly dissected and stained tectorial membranes showed an increased waviness and clumping of the fibers of the middle zone. Hensen's stripe was not seen as a continuous dense structure running through the middle zone but was at times discontinuous and curved. As measured from cross-sections of the cochlea, the thickness of the tectorial membrane was decreased after acoustic overstimulation. The stereocilia of the inner and outer hair cells lie directly under the middle zone. Visual detection levels of threshold of tectorial membrane movement was determined by stimulating the marginal zone of the tectorial membrane of isolated cochlear coils by an oscillating water jet. After acoustic overstimulation the tectorial membrane became more complaint. The tectorial membrane abnormalities were restricted to the regions of the cochlea that demonstrated a 40-50 dB hearing loss. PMID- 3680062 TI - Connections between stereocilia in auditory hair cells of the alligator lizard. AB - The interconnections between stereocilia within individual tufts of auditory hair cells in the basilar papilla of the alligator lizard were examined with a transmission electron microscope. An elaborate array of fibers near the base of each stereocilium (where it tapers to anchor into the cuticular plate) connected it to each of its neighboring stereocilia. The tips of individual stereocilia, which were slightly larger in diameter than their shaft, contacted adjacent stereocilia. Fibers also connected the tip of the kinocilium to neighboring stereocilia in the first row. The remaining regions of the stereocilia were relatively free of connecting fibers. The integrity of these connecting fibers are likely to be important in maintaining the normal micromechanical tuning and mechanoelectric transduction in these auditory hair cells. The addition of 0.1% ruthenium red to the primary fixative enhanced the preservation of the connecting structures, implying the presence of glycosaminoglycans. PMID- 3680063 TI - Qualitative and quantitative changes in the guinea pig organ of Corti after pure tone acoustic overstimulation. AB - A direct relationship between delivered sound energy and morphological overstimulation has been formulated in the so-called equal energy principle. The validity of this principle was systematically tested by studying the effects of acoustic overstimulation on the guinea pig cochlea by means of scanning electron microscopy (SEM) and light microscopy (LM) techniques. The animals in the present study were exposed to 3.85 kHz pure tones of various durations and intensities and allowed a recovery period of 4 weeks before the morphological changes in the cochlea were assessed. A 4-grade scale was devised in order to achieve a qualitative as well as a quantitative SEM evaluation of the cochlear damage. The results of the examinations by LM and SEM were compared and analysed statistically. No significant difference was observed between groups of animals exposed to a sound energy of 9.4 and 37.5 Pa2.h, irrespective of sound intensity (114 or 120 dB SPL). Groups of animals exposed to a higher energy level (150 Pa2.h) differed significantly from those exposed to higher and also lower sound energy levels. Groups exposed to different intensities (108, 114 and 120 dB SPL) did not differ significantly within this energy level. PMID- 3680064 TI - Regeneration of hair cell stereociliary bundles in the chick cochlea following severe acoustic trauma. AB - Examination of pure-tone acoustic damage in the chick cochlea revealed a significant amount of hair cell recovery over a 10 day period following the exposure. The recovery included both a regeneration of stereociliary bundles to replace those that were lost and a reshuffling of the mosaic pattern of the hair cell surfaces that survived. Ten-day-old chicks were exposed to a 1500 Hz pure tone at 120 dB SPL for 48 h and their cochleae were processed for scanning, transmission and light microscopy at 0 h, 24 h, 48 h, 4 d, 6 d and 10 d after exposure. Immediately after exposure the damaged region exhibited two types of hair cell trauma. The first was a defined area of complete hair cell loss and the second was an area where the hair cells survived but exhibited varying amounts of stereocilia injury. After 48 h of recovery, new hair cells were identifiable in the region of hair cell loss and with time they underwent a progressive maturation of their stereociliary bundles. The surviving hair cells showed a dramatic rearrangement and expansion of their surfaces but exhibited no repair of the damaged stereociliary bundles. These results suggest that the chick cochlea is capable of a significant amount of recovery and regeneration following acoustic trauma. PMID- 3680065 TI - Regeneration of the tectorial membrane in the chick cochlea following severe acoustic trauma. AB - Damage to the tectorial membrane caused by acoustic trauma was examined with scanning and transmission electron microscopy immediately after exposure and at selected time points over a 10 day recovery period. At 0 h of recovery the structure of the tectorial membrane overlying the region of hair cell damage was severely disrupted and connections between the membrane and the basilar papilla were lost. By 24 h of recovery, regeneration of the tectorial membrane was evident in the secretion of new matrix materials by the supporting cells of the basilar papilla. By 10 days of recovery a new honeycomb-like matrix had replaced the segment of damaged tectorial membrane, re-established connections with hair cell stereocilia and become fused with adjacent regions of undamaged tectorial membrane. However, the regenerated segment included only the honeycomb-like structure of the lower layer of the normal tectorial membrane. The laterally oriented fibers which form the upper layer of the membrane were not regenerated over the damaged region. These findings indicate that the tectorial membrane is regenerated in parallel with the hair cells during recovery from acoustic trauma but the full extent of this recovery and its effect on cochlear function are not yet clear. PMID- 3680066 TI - Aging and the auditory brainstem response in mice with severe or minimal presbycusis. AB - Threshold, latency, and amplitude of the auditory brainstem response (ABR) were obtained with filtered noise pips in young and aging C57BL/6J mice (to 16 months), which undergo severe progressive age-related sensorineural hearing loss (presbycusis) and CBA/J mice (to 19-months), which show only mild loss late in life. Aging per se (CBA mice) is not associated with significant changes in ABR parameters. Presbycusis, in aging C57 mice, is associated with increased thresholds; there is a trend toward increased latencies, but only when threshold elevations are substantial. Amplitudes of early waves, but not late waves, decrease greatly in aging C57 mice. In young C57 mice, amplitudes of early ABR waves vary monotonically with intensity, while amplitudes of later waves (IV and V) have a relatively flat, or even nonmonotonic, relationship to intensity; in older C57 mice, all waves have monotonic intensity functions. ABR parameters are not affected by gender in either strain. The mouse models can help to clarify some inconsistencies in the human literature on aging and the ABR. PMID- 3680067 TI - The auditory spatial acuity of the domestic cat in the interaural horizontal and median vertical planes. AB - The auditory spatial acuity of the domestic cat in the interaural horizontal plane was examined using broadband noise and nine pure-tone stimuli ranging in frequency from 0.5 to 32 kHz. Acuity in the median vertical plane was also examined using broadband noise and three pure tones of frequencies 2, 8 and 16 kHz. Minimum audible angles (MAAs) for a reference source directly in front of an animal were measured in the horizontal plane for five cats and in the vertical plane for four. The smallest MAAs measured were those for the noise stimulus, for which MAAs in the horizontal and vertical planes were similar in magnitude. Horizontal plane MAAs for low-frequency tones were smaller than those for high, and the pattern of MAA change with frequency was consistent with the use of interaural phase and sound pressure level difference cues to localize low- and high-frequency tones, respectively. Three of the four cats trained on the vertical plane MAA task did not achieve criterion performance for any of the three pure tones, and the MAAs obtained from the fourth cat at each frequency were relatively large. Vertical plane performance was consistent with the use of spectral transformation cues to discern the elevation of a complex stimulus. PMID- 3680068 TI - Differences in the distribution of F-actin in outer hair cells along the organ of Corti. AB - There is evidence of differences in the structure, innervation and physiological responses between outer hair cells (OHCs) of the basal and apical turns of the mammalian cochlea. In this study we have used rhodamine-labelled phalloidin to investigate the differential distribution of F-actin in OHCs along the organ of Corti of the guinea pig. Isolated OHCs and surface preparations and cryosections of the organ of Corti were studied. F-actin was observed in stereocilia and the cuticular plate of all OHCs. In addition, some OHCs had a network of F-actin extending from the cuticular plate towards the nucleus. This infracuticular network was observed in most OHCs of the apical cochlear turns but was not seen in any OHCs of the basal turn. These microstructural differences between OHCs of the base and apex could be related to differences in OHC function between the apical and basal portions of the cochlea. PMID- 3680069 TI - Variations of cochlear microphonic potential after sectioning efferent fibers to the cochlea. AB - Cochlear microphonic (CM) potentials were recorded, in guinea pig, with differential electrodes before and after sectioning the medial efferent innervation at the level of the brainstem. Sectioning the crossed part of the medial efferent innervation did not change the CM whatever the frequency or level of stimulation used. Sectioning the medial--crossed and uncrossed--efferent fibers diminished CM amplitude at frequencies above 2 kHz. Thus, the ipsilateral medial efferent tract seems to be involved, through a tonic action, in controlling outer hair cell micromechanics. PMID- 3680070 TI - Combined chemotherapy of multibacillary leprosy patients. PMID- 3680071 TI - [Twenty years observation of lepromin reaction (Mitsuda antigen) in leprosy patients]. PMID- 3680072 TI - [Pathological studies on the peripheral nerve involvements of leprosy in the extremities. Report I. Classification of peripheral nerve changes and observation of BL lesions in the nerve]. PMID- 3680073 TI - Ciprofloxacin therapy in cystic fibrosis. PMID- 3680074 TI - Rapid detection of a specific trimethoprim resistance gene using a biotinylated DNA probe. AB - A DNA probe specific for the dihydrofolate reductase (DHFR) type I gene was labelled with biotin by the process of nick-translation and used to screen 83 independently-derived trimethoprim R plasmids from Enterobacteriaceae. Hybridization was detected using streptavidine and a biotin-conjugated alkaline phosphatase to generate an insoluble coloured precipitate following the addition of an appropriate dye. Sixty-eight plasmids (81.9%) hybridized with the probe for DHFR type I. The method could be adapted for use with any antibiotic resistance gene for which a suitable DNA probe is available and has none of the drawbacks associated with the use of radioactively-labelled DNA in hybridization techniques. PMID- 3680075 TI - The in-vitro activity of doxycycline and minocycline against anaerobic bacteria. AB - The likelihood of bacterial resistance now prevents the use of oxytetracycline in the empirical therapy of anaerobic infections. This study investigates the in vitro activity of two semi-synthetic derivatives, doxycycline and minocycline, against a range of anaerobic bacteria. MICs for each antibiotic were determined by an agar incorporation technique. Doxycycline and minocycline were four to eight times more active against the majority of strains than oxytetracycline. With the exception of Bacteroides bivius, almost 90% of strains were inhibited by 4 mg/l of doxycycline or minocycline, but resistance to the same concentration of oxytetracycline was present in 60% of the B. fragilis group, 30% of Peptostreptococcus spp. and 24% of Clostridium perfringens. Doxycycline and minocycline represent an alternative therapy for anaerobic infections where bacterial sensitivities are known. PMID- 3680076 TI - Aminoglycoside resistance patterns in clinical isolates of Enterobacteriaceae from Czechoslovakia. AB - Multi-resistant Enterobacteriaceae isolated mainly from urine specimens from patients at the Department of Urology, Kramare Hospital, Bratislava, were characterized for resistance phenotype. Seventeen gentamicin-resistant isolates were further studied for the presence of aminoglycoside-modifying enzymes. Five enzymes were detected: AAC(2'), AAC(3)-II, AAC non-characterized, ANT(2") and APH(3')-I. The substrate range of these enzymes was found to correlate with the resistance phenotype in most isolates. In our collection the AAC(3)-II enzyme that inactivates gentamicin, sisomicin, tobramycin and netilmicin was predominant. Predominance of this type of modifying enzyme has been observed also in resistant Gram-negative strains in Belgium, The Netherlands and Chile, in contrast to the United States, Federal Republic of Germany, Switzerland, Greece and Turkey, where ANT(2") has been the most common enzyme. PMID- 3680077 TI - Influence of various antibiotics on phagocytosis of Staphylococcus aureus by human polymorphonuclear leucocytes. AB - The influence of several new antibiotics on phagocytosis of two strains of Staphylococcus aureus by human polymorphonuclear leucocytes was studied with a radioisotopic method. The following antibiotics were tested in concentrations obtained in the serum after standard administration: gentamicin, netilmicin, amikacin, oxacillin, clindamycin, vancomycin, teicoplanin, rifampicin, ansamycin, coumermycin, enoxacin, ciprofloxacin, two new fluoro-quinolones CI 934 and RO 236240, and LY 146032 a new lipopeptidic antibiotic. Among them, only coumermycin significantly decreased phagocytosis, this was dependent on concentration, strain and source of the polymorphonuclear leucocytes. PMID- 3680078 TI - Biliary penetration of cefbuperazone in the presence and absence of obstructive jaundice. AB - In thirteen patients with normal liver function, the mean concentrations of cefbuperazone in hepatic bile, gall bladder bile and gallbladder tissue 30 min after injection were 1134.8 +/- 36.8 (mean +/- S.E.M.) mg/l, 6.6 +/- 3.0 mg/l and 26.1 +/- 7.6 mg/l, respectively. In patients with obstructive jaundice, cefbuperazone concentrations in bile were 99 +/- 29.2 mg/l (mean +/- S.E.M.) 1 h post-dose and decreased to 13.9 +/- 5.1 mg/l 6 h post-dose. In both groups of patients biliary concentrations of cefbuperazone were higher than the MICs of most organisms causing biliary infection. PMID- 3680080 TI - Recent changes in antibiotic prophylactic measures taken by dentists against infective endocarditis. AB - In 1985 dentists in the Lothian Region of Scotland were questioned about their use of prophylactic antibiotics for patients at risk of developing infective endocarditis. Replies were compared with those obtained from a similar survey in 1981. The results showed a marked change in practice with widespread adoption of the single-dose oral amoxycillin regimen; this was the regimen of choice for 63% of general dental practitioners. For patients allergic to penicillin 76% of practitioners used erythromycin and there was a decline in the use of tetracycline and clindamycin. The adoption of amoxycillin reflects the ease of compliance with a simple single-dose regimen. This change has produced a striking improvement in the timing of prophylactic antibiotic therapy. PMID- 3680079 TI - Comparison of two antibiotic regimens for neonatal necrotizing enterocolitis. AB - Treatment of neonatal necrotizing enterocolitis (NEC) regularly includes broad spectrum antibiotics but there has been no comparative study of alternative regimens. We have studied 90 infants with definite NEC; 46 cases in 1982-3 were treated with ampicillin and gentamicin, while 44 cases in 1984-5 received cefotaxime and vancomycin. Groups were well matched and managed uniformly. Infants greater than or equal to 2200 g birthweight did well with either regimen. Smaller infants given cefotaxime and vancomycin had a lower risk of culture positive peritonitis (P = 0.01), and as a result, were less likely to die (P = 0.048) or develop thrombocytopenia (P = 0.004). The better outcome might be explained by the greater suppression by cefotaxime and vancomycin of the gut flora of treated patients (P less than 0.001). Both regimens were well-tolerated. Our data suggest that carefully chosen antibiotic regimens can improve the outcome of NEC. PMID- 3680081 TI - Treatment of streptococcal and staphylococcal endocarditis. PMID- 3680082 TI - Interpretation of antibiotic interactions. PMID- 3680083 TI - Acquisition of antibiotic resistance plasmids in vivo by extraintestinal Salmonella spp. PMID- 3680084 TI - Dosage of intravenous ciprofloxacin. PMID- 3680085 TI - The influence of clinical budgeting on antibiotic policies. PMID- 3680086 TI - Treatment of coagulase-negative staphylococcal infections: dilemmas for laboratory and clinician. PMID- 3680087 TI - Selective decontamination. PMID- 3680088 TI - The antibiotic sensitivity of the Bacteroides fragilis group in the United Kingdom. AB - Eight hundred and sixty-two cultures of penicillin-resistant anaerobic Gram negative bacilli collected from 14 centres in the United Kingdom were identified. Six hundred and fifty-one were members of the Bacteroides fragilis group, and their sensitivity to 14 antibiotics was determined by a microtitre method. Among the beta-lactams, moderate resistance to ampicillin (MIC greater than or equal to 8 mg/l) was common, (B. ovatus 100%, B. thetaiotaomicron 95%, B. fragilis 76%, B. distasonis 50%, B. vulgatus 25%) but high-level resistance (MIC greater than 128 mg/l) was uncommon (B. fragilis 4%, B. ovatus 4%, B. vulgatus 3%). In B. fragilis, moderate resistance to other beta-lactams was less common (cefoxitin 16%, mezlocillin 13% and cefotetan 7%), though in most non-B. fragilis species, higher numbers were moderately resistant. High level resistance to these three beta-lactams was rare. Resistance to penems (MIC greater than 4 mg/l) was not detected. All isolates of B. fragilis tested were sensitive to 16 mg/l of ciprofloxacin and ofloxacin, and 68% and 81% of isolates were sensitive to less than 4 mg/l, but one isolate of B. uniformis and one of B. thetaiotaomicron proved highly resistant. Clindamycin resistance was uncommon (1% of B. fragilis and 10% other B. fragilis group isolates were resistant to 2 mg/l clindamycin) with isolates resistant to clindamycin often also resistant to erythromycin. Tetracycline resistance was common in all species and occurred in 40% of isolates. Resistance to chloramphenicol, metronidazole or rifampicin was not detected. Significant differences were observed between the sensitivity of B. fragilis and other members of the B. fragilis group to mezlocillin, cefotetan, cefoxitin and the quinolones. There was no clear trend towards higher resistance in any one area of the country. PMID- 3680089 TI - Therapeutic efficacy of cefpiramide-ciprofloxacin combination in experimental Pseudomonas infections in neutropenic mice. AB - The therapeutic efficacy of cefpiramide and ciprofloxacin alone and in combination was investigated and compared with that of ticarcillin plus tobramycin against pseudomonal infections in mice made neutropenic by administration of cyclosphosphamide. Therapy with cefpiramide plus ciprofloxacin was significantly more effective than that by either antibiotic alone. These results were consistent with in-vitro synergistic effects. At a higher dose of ciprofloxacin (4 mg/kg) plus cefpiramide (50 mg/kg), the combination therapy protected all neutropenic mice from fatal bacteraemia, and was more protective than ticarcillin (200 mg/kg) plus tobramycin (1 mg/kg). The peak serum concentration of cefpiramide in infected neutropenic mice was 51 mg/l when they were given 50 mg/kg subcutaneously. Ciprofloxacin attained a peak serum concentration of 1.2 mg/l and a serum half-life of 34 min. PMID- 3680090 TI - One and two doses of cephradine in the prophylaxis of experimental streptococcal endocarditis. AB - The efficacy of cephradine in the prophylaxis of rabbit Streptococcus sanguis endocarditis was investigated. Three days after cardiac catheterization and prior to challenge with S. sanguis, rabbits received either 1000 mg/kg (ten animals) or 500 mg/kg cephradine intramuscularly. Infective endocarditis was prevented in only 30% of the animals. The addition of a second dose of cephradine (100 mg/kg) 8 h after an initial dose of 400 mg/kg did not prevent streptococcal endocarditis in 80% of animals tested. In one or two dose regimens cephradine was found to be inferior to a single 400 mg/kg prophylactic dose of amoxycillin. Cephradine is not recommended for prophylaxis against streptococcal endocarditis. PMID- 3680091 TI - Ciprofloxacin treatment of Staphylococcus aureus infections. AB - Ciprofloxacin appears to be safe and effective for a wide variety of clinical infections. In-vitro and animal studies point to high cure rates for both methicillin-sensitive and methicillin-resistant Staphylococcus aureus infections. Seventeen patients with staphylococcal infections severe enough to require hospital admission and initial parenteral therapy were treated with ciprofloxacin; the results were poor, with clinical failure in five and bacteriological failure in 12. All pathogens isolated were susceptible to ciprofloxacin both before and after therapy and tolerance was not detected. Further study is required before ciprofloxacin can be recommended for life threatening staphylococcal infections. PMID- 3680092 TI - Determination of methicillin-resistance in Staphylococcus aureus by agar dilution and disc diffusion methods. AB - Four-hundred and seventy-six isolates of Staphylococcus aureus from patients in Hong Kong were tested for methicillin-resistance by agar dilution and disc diffusion methods, using heavy inocula. With Mueller-Hinton agar incubated at 30 degrees C for 24 h, 216 (MRSA) isolates were resistant to 8 mg/l of methicillin and grew up to the edge of a 10 micrograms methicillin disc, and 260 strains were susceptible to greater than or equal to 4 mg/l methicillin and produced inhibition zones of at least 20 mm diameter. Incubation for 48 h, the addition of sodium chloride, or the use of a 5 micrograms disc had little effect on these results, but a significant number of MRSA strains produced inhibition zones when disc diffusion tests were incubated at 35 degrees C, and many sensitive strains showed scanty growth on salt-containing agar at high methicillin concentrations in agar dilution tests. Iso-Sensitest agar did not appear to support the growth of the minority resistant populations of MRSA unless supplemented with menadione and thiamine, and even with supplemented Iso-Sensitest medium a few presumptively resistant strains appeared methicillin-sensitive in both disc diffusion and agar dilution tests. PMID- 3680094 TI - Infective endocarditis. Based on a scientific meeting of the British Society for Antimicrobial Chemotherapy. London, 29-30 April 1986. PMID- 3680093 TI - Aztreonam concentrations in human prostatic tissue. PMID- 3680095 TI - The clinical and echocardiographic diagnosis of infective endocarditis. AB - We report the results of a series of 75 patients admitted to the East Birmingham Hospital between 1976 and 1984. Rheumatic heart disease is now an uncommon predisposing factor. The viridans streptococci are a decreasing cause of infection while staphylococcal infections are increasing and often occur on previously normal heart valves. The presenting symptoms of the disease are usually non-specific and the classical physical signs of endocarditis are uncommon. Blood culture and echocardiography are the most useful investigations in establishing the diagnosis. The diagnosis of endocarditis should be considered in all febrile patients, especially if they are ill, who have a cardiac murmur or persistent bacteraemia. PMID- 3680096 TI - The role of the laboratory in assisting treatment--a review of current UK practices. AB - A questionnaire concerning the laboratory management of endocarditis was sent to 120 UK microbiologists. The 86 replies received indicated that most microbiologists undertake in-vitro sensitivity tests on both streptococci and staphylococci and nearly all perform serum bactericidal titres. Neither the methods used for these investigations nor the interpretation of the results obtained are uniform. Considerable importance is attached to the serum bactericidal titres and many microbiologists alter the antibiotic regimen on the basis of unsatisfactory results. The serum bactericidal titre obtained in 114 patients with endocarditis seen at St. Thomas' Hospital between 1970 and 1985 were analysed according to the outcome of the infection; this was classified as (i) cure, (ii) bacteriological cure/clinical failure or (iii) failure. There were only six failures, four of which had peak titres less than 1:8. Trough titres were of no predictive value. Peak titres of greater than 1:8 were reasonably predictive of bacteriological cure but not of clinical outcome. Failure of medical treatment in endocarditis is seldom the result of inappropriate antibiotics, it usually results from late diagnosis or late referral to cardiologists and cardiac surgeons. Critical evaluation of serum bactericidal titres is long overdue. PMID- 3680097 TI - Impatience versus achievement strivings in the type A pattern: differential effects on students' health and academic achievement. PMID- 3680098 TI - Understanding, prediction, and control as moderators of the relationships between perceived stress, satisfaction, and psychological well-being. PMID- 3680099 TI - Factors to consider in performing survival studies with insect cells. AB - Insect cell lines are not well-suited to colony formation in liquid medium following low-density cell plating. The present studies demonstrate that the time of addition of fetal bovine serum to the culture medium and the number of gamma irradiated feeder cells added to each plate are important factors in developing a useful colony formation assay. TN-368 lepidopteran and WR69-DM-1 dipteran cell lines were used for these experiments. Both cell types display increased plating efficiencies if serum is added to the medium one or more days prior to plating as compared to adding serum immediately before plating. Growth curves obtained by seeding cells at higher densities also indicate that cell growth is slightly better if serum is added one or more days before seeding. These findings are especially important for survival and toxicity studies because the results demonstrate that even seemingly minor factors involved in cell survival assays may benefit treated cells to a greater degree than untreated control cells, thus providing an erroneous assessment of cell survival. PMID- 3680100 TI - Establishment and characterization of a continuous murine uterine cervix cancer cell line metastatic to lymph nodes and lungs. AB - The murine uterine cervix cancer (MUCC) cell line was derived from a chemically induced Kunming mouse uterine cervix cancer (U27) and maintained in culture on solid substrates for over 100 passages. Cultures were morphotypically heterogeneous and heteroploid, with a modal number of chromosomes = 80. Each cell showed at least two abnormal chromosomes. Immunogold-silver staining was positive for keratin, vimentin, and laminin but not for desmin. The population doubling time was 27.8 h with a saturation density of 3.2 X 10(5) cells/cm2 and a peak mitotic index of about 6%. MUCC cells produced colonies on tissue culture plastic (68%) and in soft agar (8%). MUCC cells were fully malignant inasmuch as they produced in syngeneic mice invasive tumors that reproducibly were metastatic to lymph nodes and lungs. The MUCC cell line is the first mouse cervix cancer cell line useful for the study of invasion and metastasis. PMID- 3680101 TI - Growth of human-human hybridomas in serum-free media enhances antibody secretion. AB - Human-human hybridomas derived from fusing lymph node lymphocytes with UC 729-6 were adapted to grow in commercially available serum-free medium and were compared with serum-supplemented [10% fetal bovine serum (FBS)] cultures. Over a 6-d period, no significant changes occurred in the growth of the cells in 10% FBS or serum-free medium. In cultures supplemented with 10% FBS more total proteins were secreted than in serum-free cultures. However, there was an enhanced secretion of three- to four-fold of both immunoreactive human IgG and IgM under serum-free conditions compared to serum-supplemented conditions. Serum-free conditions may provide the appropriate milieu for the increased level of Ig secretion from human hybridomas derived from UC 729-6 in that there are no inhibitors that may be present in serum. PMID- 3680102 TI - Monolayer culture of cells originating from a preimplantation bovine embryo. AB - The objective of this study was to establish a method by which trophectodermal cells originating from individual preimplantation bovine embryos could be perpetuated in monolayer culture. A single, Day-11 bovine embryo collected nonsurgically from a mixed-breed beef cow was cultured in Ham's F10 medium supplemented with fetal bovine serum, sodium pyruvate, insulin, and epidermal growth factor. After 13 d in culture the embryo had adhered to the surface of the plastic culture vessel and a monolayer covering 0.3 cm2 had developed in the manner of a tissue explant. The monolayer was successfully dispersed using trypsin-EDTA and the cells were passaged. Expansion to a 25-cm2 flask was achieved by the 4th passage. By passaging cultures at a dilution ratio of 1:2, cells were maintained for 38 passages before growth slowed. Transfers beyond the 44th passage were unsuccessful. The cell line, designated BE-13, was successfully frozen and thawed at the 9th, 12th, 15th, and 20th passages. The cell line contains both mono- and binucleate cells with a prominent rough endoplasmic reticulum characteristic of ruminant trophoblast cells. Susceptibility to eight bovine viruses was demonstrated. Such cell lines may provide inexpensive systems for the study of trophoblast metabolism and for investigation of the role of the trophoblast in the pathogenesis of selected bovine abortifacient diseases. Because of their range of viral susceptibility, these cells might also be useful for diagnostic purposes. PMID- 3680103 TI - Establishment and characterization of a new murine mammary tumor cell line, BALB/c-MC. AB - A new murine mammary tumor cell line (BALB/c-MC) was established from a spontaneous mammary tumor in a 17-mo.-old female mouse of the low mammary cancer strain BALB/cHe. The cell line was derived from a papillary adenocarcinoma. In monolayer culture the line exhibits a pavementlike arrangement of cells and forms "domes" or "hemicysts" as the cells become confluent. The cell line rapidly forms tumors when transplanted into young syngeneic BALB/cHe mice. The subcutaneous injection of 10(6) cells resulted in the development of mammary tumors (typical papillary adenocarcinomas) in 33 of 37 (87%) recipients within 2 to 3 mo. after injection. These mammary tumors also metastasize to lung [14 of 33 (42%) of recipients] during this time. The number of chromosomes in this cell line is hyperdiploid (average of 43, range 39 to 44). PMID- 3680104 TI - Differential effects of soluble and immobilized fibronectins on aortic endothelial cell proliferation and attachment. AB - We studied the effects of soluble and immobilized forms of plasma fibronectin on bovine aortic endothelial cell (AEC) proliferation and attachment. Soluble fibronectin stimulated AEC growth at 10 micrograms/ml, but at higher concentrations of soluble fibronectin AEC growth was progressively inhibited. The growth rates of arterial smooth muscle cells (ASMC) and dermal fibroblasts (DF) were not altered by soluble fibronectin concentrations of 10 to 100 micrograms/ml. Plasma fibronectin, immobilized by attachment to culture dish surfaces, had no significant effects on the proliferation of any of the cell types examined. The attachment rates of AEC were decreased in the presence of 50 micrograms/ml soluble fibronectin. Immobilized fibronectin increased the rate of AEC attachment, but had no significant effects on ASMC or DF attachment; however, 12 h after plating there was nearly 100% attachment in all groups, whether or not fibronectin was present in the system. That soluble and immobilized fibronectins elicit disparate cellular responses is consistent with published reports of different cell surface receptors for different forms of the protein; in this manner, cells enmeshed in an interstitial matrix containing immobilized fibronectin could still respond to soluble fibronectin in the extracellular milieu. PMID- 3680106 TI - Return to work after severe head injury. AB - This paper reports attempts of a series of head-injured people to regain employment. Return to work after a severe head injury is generally considered to be a function of age, severity of injury, and nature of disability. The results showed that it was the opportunity to go back to the previous job, the provision of a work trial or easier work, and a lengthy period of support that were the more important factors. This demonstrates the importance of working to provide an environment that will help the individual learn to make adaptations and accommodate his or her disabilities. PMID- 3680107 TI - The natural history of visual neglect after stroke. Indications from two methods of assessment. AB - A simple copying task and a measure of position preference on a multiple-choice test were used to assess the incidence of visual neglect after stroke. The patients studied were drawn from a register of strokes occurring in a typical health district. These tests detected visual neglect in 8-11% of patients 3 weeks after stroke and it was more frequent after right-sided rather than left-sided brain damage. Significant neglect was rarely observed by 6 months after stroke but further recovery did occur between 6 months and 1 year. Neglect appeared to exert a slowing influence on rehabilitation and we propose that training procedures to combat neglect should be evaluated for routine use in rehabilitation centres. PMID- 3680105 TI - Reduction by lead of hydrocortisone-induced glycerol phosphate dehydrogenase activity in cultured rat oligodendroglia. AB - Time- and dose-dependent toxic effects of lead (Pb) acetate on astroglia, oligodendroglia, and meningeal fibroblasts cultured from immature rat brain were measured. Cultures were exposed for 3 d to Pb (1, 10, and 100 microM) and then examined immediately (Day 0) or 3 or 10 d after Pb treatment was discontinued. The percentages of astroglia and fibroblasts excluding dye were unaffected by Pb, whereas the percentage of oligodendroglia excluding dye decreased significantly (P less than 0.01) at all time points after exposure to 100 microM Pb. Lead (100 microM) also reduced the total cell numbers of astroglia, oligodendroglia, and meningeal fibroblasts. Amino acid incorporation into protein by oligodendroglia was stimulated after exposure to 100 microM Pb at all time points and also by 1 and 10 microM on Day 3. Incorporation was stimulated in astroglia only on Day 0 by 10 and 100 microM. Hydrocortisone-stimulated glycerolphosphate dehydrogenase (GPDH) activity was assayed in oligodendroglia cultures. A significant decrease in specific activity was seen after a 4-d exposure to lead. Because oligodendroglia are responsible for myelin synthesis in the central nervous system, and GPDH may synthesize a precursor for myelin lipid synthesis, it was proposed that the hypomyelination observed in lead-intoxicated neonatal rats may result partially from a primary toxic effect on oligodendroglia. GPDH activity was not inhibited by Pb in mixed glial cultures containing both astroglia and oligodendroglia. This result suggests that astroglia in culture have the ability to delay the lead-induced inhibition of oligodendroglial GPDH activity and supports the hypothesis that astroglia in culture serve a protective function. PMID- 3680108 TI - Psychosocial rehabilitation in disasters: experience of the Spanish toxic oil syndrome. AB - In May 1981 a new disease caused by widespread food poisoning with adulterated rape-seed oil appeared in Spain. A total of 20,640 people were affected and 380 patients have died. The clinical syndrome consisted of pulmonary, neuromuscular, and systemic symptoms, which evolved to produce mild or severe physical disabilities. Although the disease is not primarily a psychiatric condition, almost 8000 TOS patients have been referred to a psychiatrist: these patients show a well-defined post-traumatic stress disorder, vulnerability being associated with female sex, low income, and class and a personal history of "nervous' disorders. Since January of 1983 the main goal of the health authorities has been social reintegration in the community of TOS patients, and teams of psychiatrists and psychologists have played an important role in this task, moving integrative rehabilitation activities from the hospital into the community. PMID- 3680109 TI - Muscle relaxants in multiple sclerosis. AB - Spasticity is an important cause of physical impediment in multiple sclerosis. Only drug therapy offers useful (but not universal) relief. Dantrolene sodium and/or baclofen are the drugs of choice, being both effective and clinically suitable in over half of cases when carefully titrated and monitored. PMID- 3680110 TI - Determination of N-nitrosodiethanolamine in dinoseb formulations by mass spectrometry and thermal energy analyzer detection. AB - A new method is described to determine trace quantities of N nitrosodiethanolamine (NDElA) in aqueous diethanolamine (DElA) formulations and in oil solutions of dinoseb. A formate anion-exchange column is used in series with a cation-exchange column if there is DElA in the formulation. The eluate is then passed through a Clin Elut column. Depending on the concentration of NDElA in the sample, a packed silica-gel column is used to purify the extract further. This extract is analyzed on a liquid chromatograph coupled with a thermal energy analyzer (LC/TEA), using a mixture of methanol-hexane-methylene chloride containing 0.1% acetic acid (8 + 56 + 35) as the mobile phase. This solvent system gives good separation of NDElA from trace quantities of dinoseb remaining in the extract. The NDElA is also converted to the trimethylsilyl derivative and analyzed by gas chromatograph coupled with a mass spectrometer (GC/MS). Analyses of 11 commercial samples of dinoseb diethanolamine salt showed NDElA levels of 116-2409 ppm expressed relative to the weight of dinoseb. In contrast, analyses of 2 samples of organic solutions of technical dinoseb showed NDElA levels to be nondetectable and 0.3 ppm, respectively. Limit of detection by LC/TEA is 6.5 ng (0.5 ppm), and by GC/MS it is 0.02 ng (0.15 ppm). Recoveries from samples spiked at 0.514-1664 ppm range from 92.2 to 105.2%. PMID- 3680111 TI - Determination of ethylene oxide in ethoxylated surfactants and demulsifiers by headspace gas chromatography. AB - A headspace gas chromatographic method for the determination of traces of ethylene oxide in ethoxylated surfactants and demulsifiers was developed. Samples are analyzed directly by the technique to a 1.0 ppm (w/w) quantitation limit. The procedure also performs well for propylene oxide, acetaldehyde, and 1,4-dioxane. It is simple, sensitive, and linear. The percent relative standard deviations for 0.5 and 30 ppm ethylene oxide in the surfactant were 2.8 and 8.3%, respectively. PMID- 3680112 TI - Liquid chromatographic determination of taurine in vitamin premix formulations. AB - A liquid chromatographic (LC) method is described for the determination of taurine in vitamin and vitamin-mineral premix formulations. The method involves extraction of taurine with 0.1 M bicarbonate buffer, followed by precolumn derivatization with dansyl chloride and LC using fluorescence detection. 6 Aminocaproic acid is used as an internal standard. A reverse phase analytical column and a mobile phase of 0.1 M acetate buffer solution (pH 7.2)-acetonitrile (75 + 25) are used. Vitamins, minerals, and other excipients in the premix formulations do not interfere in the determination. The method is simple, precise, and accurate. PMID- 3680113 TI - Sample preparation and liquid chromatographic determination of vitamin D in food products. AB - Vitamin D in different fortified foods is determined by using liquid chromatography (LC). Sample preparation is described for fortified skim milk, infant formulas, chocolate drink powder, and diet food. The procedure involves 2 main steps: saponification of the sample followed by extraction, and quantitation by LC analysis. Depending on the sample matrix, additional steps are necessary, i.e., enzymatic digestion for hydrolyzing the starch in the sample and cartridge purification before LC injection. An isocratic system consisting of 0.5% water in methanol (v/v) on two 5 microns ODS Hypersil, 12 X 0.4 cm id columns is used. Recovery of vitamin D added to unfortified skim milk is 98%. The results of vitamin D determination in homogenized skim milk, fortified milk powder, fortified milk powder with soybean, chocolate drink powder, and sports diet food are given. PMID- 3680114 TI - Stabilization of ascorbic acid and its measurement by liquid chromatography in nonfat dry milk. AB - The determination of ascorbic acid by liquid chromatography (LC) was improved by performing the analysis in the presence of solvents that had been purged with argon to reduce the concentration of oxygen. This methodological modification eliminated the oxidation of ascorbic acid during the chromatographic procedure and reduced the minimum detection level to 1 microgram. Solutions of ascorbic acid have been successfully stabilized for 67 days by addition of dithiothreitol to a deaerated solution of water-acetonitrile (25 + 75 v/v), sealed under argon in amber vials and stored at -20 degrees C. In a second independent study, a procedure for the extraction of ascorbic acid from nonfat dry milk in a single step was developed. The ascorbic acid content of Nonfat Dry Milk (SRM 1549) was determined by LC, using the method of standard additions. The mean ascorbic acid content was 54 +/- 5 micrograms/g of sample. Analysis of variance of the analytical results indicates that there is a significant continual increase in the content of the ascorbic acid in each bottle from first to last sample. PMID- 3680115 TI - Liquid chromatographic determination of depletion of bithionol sulfoxide and its two major metabolites in bovine milk. AB - A liquid chromatographic method is described for determining bithionol sulfoxide and its metabolites, bithionol and bithionol sulfone, in milk. Samples are treated with HCl to precipitate proteins and to permit extraction of bithionol sulfoxide in nonionized form. Tetrahydrofuran is added to the organic phase to facilitate extraction in diethyl ether; the dried residue is dissolved in chloroform, hexane, and sodium hydroxide and subjected to LC analysis. Residues of bithionol sulfoxide and its 2 metabolites were determined in milk of lactating cows. Holstein-Friesian dairy cows were administered a single oral dose of bithionol sulfoxide (50 mg/kg). Milk samples were analyzed with a reliable detection level of 0.025 microgram/mL for each compound. Residues of bithionol sulfoxide and bithionol were detected during 30 and 16 milkings, respectively; bithionol sulfone was never present at detectable levels. PMID- 3680116 TI - Spectrofluorometric determination of BAY Vp 2674 residues in poultry tissues. AB - A spectrofluorometric (SPF) method is described for determination of residues of BAY Vp 2674 in chicken and turkey tissues. The drug is extracted from tissues with dichloromethane-methanol. The organic extract is concentrated to near dryness and cleaned up by a series of partitionings with n-hexane, then dichloromethane against pH 2 buffer and dichloromethane against pH 12 buffer. The drug is partitioned into dichloromethane from pH 7 buffer and concentrated to dryness. The residue is dissolved in pH 3.5 buffer for SPF analysis at 282 nm (excitation) and 445 nm (emission). Recoveries of BAY Vp 2674 added to chicken and turkey tissues at levels of 0.05, 0.1, and 0.2 ppm range from 86 to 92% with a coefficient of variation of 3.4-10.1%. Detection limit is 0.02 ppm. A liquid chromatographic confirmatory procedure is also described, with ultraviolet and fluorescence detection. PMID- 3680117 TI - Liquid chromatographic method for determining the macrolide antibiotic sedecamycin and its major metabolites in swine plasma and tissues. AB - A liquid chromatographic (LC) method was developed to determine sedecamycin, a 17 membered macrolide antibiotic used for treating swine dysentery, and its major metabolites (lankacidin C, lankacidinol A, and lankacidinol) in swine plasma and tissues. Plasma is directly extracted with ethyl acetate and analyzed by liquid chromatography without purification. Tissues are homogenized in a phosphate buffer containing sodium chloride, and then extracted with ethyl acetate. The extracts are subjected to silica gel-Florisil, double-layered column chromatography to remove endogenous interfering substances. The LC determination uses silica gel and ODS-silica as a stationary phase. The detection limits for sedecamycin and its metabolites were less than or equal to 0.05 ppm, and average recoveries and coefficients of variation (0.2-1 ppm range) were greater than 75% and less than 10%, respectively. PMID- 3680118 TI - Gas chromatographic, liquid chromatographic, and titrimetric procedures for determination of glycerin in allergenic extracts and diagnostic antigens: comparative study. AB - Three methods for the determination of glycerin are examined as applied to several allergenic extracts and diagnostic antigens. The liquid chromatographic procedure uses a sulfonic acid functional PSDVB resin (Aminex HPX-87H), a mobile phase of 0.013N H2SO4; and refractive index detection. The titrimetric procedure involves oxidation of glycerin with sodium metaperiodate followed by potentiometric titration of the resulting formic acid with sodium hydroxide. Samples are quantitated by comparing the equivalence point obtained from the sample to those obtained from a series of standards. The gas chromatographic procedure includes a column of 5% Carbowax 20 M on 80-100 mesh Chromosorb WHP; p cresol was used as an internal standard. The 3 procedures are shown to be valid for the majority of product types examined. A positive interference was encountered in the titrimetric analysis of a tuberculin purified protein derivative that contained simple sugars. Recoveries of added glycerin ranged from 95.0 to 100.2% by the liquid chromatographic method, from 98.7 to 101.4% by the gas chromatographic method, and from 99.8 to 101.6% by the metaperiodate oxidation method when interference from simple sugars was not present. Coefficients of variation determined from 8 replicates of samples that contained glycerin were 2.2% or less for the liquid chromatographic method, 2.3% or less for the GC method, and 3.6% or less for the metaperiodate oxidation method. PMID- 3680119 TI - Reverse phase liquid chromatographic determination of dexamethasone acetate and cortisone acetate in bulk drug substances and dosage forms: method development. AB - The determination of the steroid acetates was evaluated for ruggedness of the method by using an octyldecylsilane column, 254 nm detection, and acetonitrile water as mobile phase. Mobile phase pH, oven temperature, and columns from various manufacturers had no dramatic effect on the chromatography. The method was then optimized for dexamethasone acetate and cortisone acetate bulk drug and dosage forms. For dexamethasone acetate, the bulk drug substance should be dried at 105 degrees C before use, and the sample should be dissolved in 50% acetonitrile-buffer pH 6 for stability. Cortisone acetate, on the other hand, was found to be nonhygroscopic and hence could be used as received. For stability, the sample should be stored in 50% acetonitrile-buffer pH 4. PMID- 3680120 TI - Liquid chromatographic methods for assay of carbamazepine, 10,11 dihydrocarbamazepine, and related compounds in carbamazepine drug substance and tablets. AB - Liquid chromatographic (LC) methods have been developed for the determination of carbamazepine, the impurity 10,11-dihydrocarbamazepine, and related compounds in carbamazepine drug substance and tablets. The LC methods specify a 5 micron diol column and a mobile phase of acetonitrile-methanol-0.05% aqueous acetic acid (5 + 5 + 90). Iminodibenzyl and iminostilbene, starting materials for some routes of synthesis, elute late in the LC system; therefore, a thin-layer chromatographic method for their detection at the 0.05% level has been developed. Eight tablet and 13 raw material samples from several sources were examined. The impurities most frequently found were 10, 11-dihydrocarbamazepine and a compound identified as 10-bromocarbamazepine at levels up to 1.3 and 0.5%, respectively; minimum detectable amounts were about 0.01 and 0.03%, respectively. PMID- 3680121 TI - Analysis of piperazine drug formulations for N-nitrosamines. AB - A quantitative method is described for the measurement of N-mononitrosopiperazine (NPIP) and N,N'-dinitrosopiperazine (DNPIP) in drug formulations containing piperazine, using a gas chromatograph interfaced to a thermal energy analyzer (GC/TEA). The method has detection limits of 20 ppb for NPIP and 12 ppb for DNPIP. In a survey of 6 products available on the Canadian market, all contained NPIP at levels of 0.38-15.3 micrograms NPIP/g piperazine and none contained any detectable amount of DNPIP. PMID- 3680122 TI - Thin-layer chromatographic determination of sterigmatocystin in cheese: interlaboratory study. AB - A collaborative study of a method for the determination of sterigmatocystin in cheese was conducted by 10 laboratories. The study included control samples and samples spiked at levels of 5, 10, and 25 ppb, in coded blind pairs. Recoveries were 60.0, 90.7, and 59.3%, outliers excluded, for the respective levels. The mean reproducibilities, outliers excluded, were 81.97, 17.13, and 52.77%, respectively. Mean repeatabilities, outliers excluded, were 77.66, 17.13, and 46.40%, respectively. Results of this collaborative study indicate that the method, modified as described in this report, is applicable to the determination of sterigmatocystin in cheese at low levels (5-50 ppb) for the purpose of surveys. With regard to the difficulty with thin-layer chromatography in this study, it is recommended that a more satisfactory determinative step be developed. Recommendation for official first action status is deferred. PMID- 3680123 TI - Determination of cytotoxic trichothecenes in corn by cell culture toxicity assay. AB - The great sensitivity of some cell species to toxins has been adapted to a direct biological determination of trichothecene contamination of food and feeds. The murine spleen lymphocyte stimulated by PHA (Phaseolus vulgaris phytohaemagglutinin) appeared to be the most convenient cells because of their particular sensitivity to cytotoxic trichothecenes and the opportunity to translate this cytotoxicity to immunosuppressive hazard, one of the most important concerns for trichothecenes. In this paper, the use of cell cultures was adapted for a survey of corn. The toxins were extracted by aqueous methanol, and the extract was defatted with hexane and purified on a silica gel/Florisil column. This extract was then used for a gas chromatographic (GC) determination and the biological test. The growth of cells was measured by the incorporation of tritiated thymidine (3H Tdr), and the inhibition was expressed by the IC50: concentration of corn extract inhibiting by half the 3H Tdr incorporation. We have tested pure toxins, control corn, corn spiked with T-2 toxin, corn experimentally inoculated with toxigenic Fusarium strains, and naturally contaminated corn. A good correlation exists between IC50 and the T-2 toxin concentration as determined by GC analysis. The response is not affected by the presence of zearalenone or by small amounts of deoxynivalenol. A quantitative evaluation of cytotoxic trichothecenes in corn is valuable in the range of 100 ppb to 10 ppm, expressed as T-2 toxin equivalents. The result is obtained in 48 h. PMID- 3680124 TI - Liquid chromatographic determination and stability of the Fusarium mycotoxin moniliformin in cereal grains. AB - Moniliformin is a mycotoxin produced by Fusarium subglutinans and other Fusarium species. A rapid, liquid chromatographic method for its determination in corn and wheat is described. Samples are extracted in acetonitrile-water (95 + 5); following defatting with n-hexane, an aliquot of the extract is evaporated and cleaned up on small C18 and neutral alumina columns successively. Reverse-phase liquid chromatography (LC) is conducted on a C18 column with 10 or 15% methanol or acetonitrile in aqueous ion-pair reagent as mobile phase, with detection by ultraviolet absorption at 229 and 254 nm. Average recoveries of moniliformin (potassium salt) added to ground corn and wheat at levels of 0.05-1.0 micrograms/g were 80% (n = 20) and 85% (n = 12), respectively, and the limit of detection was ca 0.01-0.18 micrograms/g, depending on LC conditions. Analysis of 24 samples of wheat, 4 samples of rye, and 12 samples of corn showed moniliformin in only 2 corn samples (0.06 and 0.2 micrograms/g). Moniliformin was also detected in a sample of artificially damaged (slashed) corn (0.2 micrograms/g) and selected kernels of corn that were field-inoculated with F. subglutinans and F. moniliforme (50 micrograms/g and 0.5 micrograms/g, respectively). In stability studies, moniliformin (potassium salt, 1 microgram/g) in ground corn and ground wheat heated at 50, 100, and 150 degrees C for 0.5-2 h decomposed moderately, e.g., 55% remained in corn after 0.5 h at 100 degrees C. PMID- 3680125 TI - Pesticide confirmation by triple stage quadrupole mass spectrometry: etrimfos and dimethoate. AB - The production of a protonated molecular ion, MH+, for a pesticide under investigation is often preferred for primary identification purposes. However, the lack of fragment ions under such chemical ionization conditions can place the burden of proof on a single ion species for confirmation. Although a single ion representing the molecule at the correct retention time on a packed column or high-resolution capillary column might seem to have furnished sufficient evidence for unambiguous confirmation, in a number of cases additional specificity can improve the analytical result. With the introduction into commerce of triple stage quadrupole (TSQ) instruments, the possibility of improving the degree of specificity by chemical ionization has emerged for practical pesticide residue confirmation analysis. Use of collision-activated dissociation (CAD) experiments to form daughter ions from the protonated molecular ion of 2 representative organophosphorus pesticides has provided a second dimensional plane of characterization for confirmatory purposes at incurred residue levels. PMID- 3680126 TI - Assisted distillation cleanup of pesticide residues in animal fats: new beadless distillation tube. AB - A new assisted distillation tube has been developed which contains no glass beads or glass wool. The sample is injected into the top of the tube, and a septum is not required. Large ground-glass joints (10/19) are used at the gas inlet and at the Florisil trap connection for maximum strength. Existing assisted distillation apparatus was easily modified to accept the new tubes. Recoveries of 9 organochlorine pesticides from butter and cattle fat ranged from 87 to 104% at a tube temperature of 230 degrees C and a nitrogen flow rate of 250 mL/min. No significant change occurred in recoveries of 8 of the 9 pesticides after 85 uses of the beadless tube. Only the recovery of HCB from butter decreased, from 95 to 80%, after 51 runs. The new tube was compared with the Unitrex glass bead-packed concentric tube at flow rates of 230, 400, and 600 mL nitrogen/min. Recoveries from the Unitrex tube were similar to those of the beadless tube for all pesticides except DDT which was significantly lower, indicating incomplete distillation at 250 mL/min and possible partial breakdown at 400 and 600 mL/min. A procedure is introduced for pressurized solvent washing of distillation tubes. This procedure is more efficient than vacuum washing. PMID- 3680127 TI - Total arsenic in foods after sequential wet digestion, dry ashing, coprecipitation with ammonium pyrrolidine dithiocarbamate, and graphite-furnace atomic absorption spectrometry. AB - A graphite-furnace atomic absorption (GFAAS) method is described for determining total arsenic (organic and inorganic compounds) in foods. Samples ranging from 1 to 40 g (depending on moisture content) were digested with HNO3 and dry-ashed at 500 degrees C overnight after addition of MgO. After dissolution in HCl, the arsenic was reduced with iodide and ascorbic acid and precipitated with ammonium pyrrolidine dithiocarbamate (APDC) in the presence of nickel carrier. Precipitates were collected on 0.3 micron cellulose acetate filters and dissolved in 10% HNO3 containing modifier. Ba(NO3)2 was added to remove a sulfate interference resulting from decomposition of APDC. Arsenic was determined using GFAAS. Accuracy of the method was good for 7 U.S. National Bureau of Standards (NBS) Standard Reference Materials and 3 National Research Council of Canada (NRCC) round-robin samples. Recovery of arsenic(V) from foods averaged 99.2% for peak heights and 97.1% for peak areas, with relative standard deviations (RSD) of 2.2% for peak heights and 3.3% for peak areas for all NBS and NRCC materials. Detection limit of the method was ca 10 ng arsenic. PMID- 3680128 TI - Two enzyme immunoassays to screen for 2,4-dichlorophenoxyacetic acid in water. AB - Two solid-phase enzyme immunoassays were developed to measure 2,4 dichlorophenoxyacetic acid (2,4-D), using 2 sets of structurally distinct immunogens and enzyme ligands. The 2,4-D analog, 2-methyl-4-chlorophenoxyacetic acid (MCPA), gave a similar response with both methods, whereas other phenoxy herbicides cross-reacted differently. In method A, the aromatic moiety of 2,4-D was distal from the carrier protein and labeled enzyme, whereas in method B, the acetic acid portion of the herbicide was distal. The use of both methods to screen for this herbicide in ground water and municipal and river water reduced the number of false-positive responses. Water sources having a low background response could be monitored with either method alone. When a concentration step, with disposable C18 extraction columns, was used, the limit of sensitivity was 5 micrograms/L. Method A was the more sensitive of the 2 methods with a limit of detection of 10 micrograms/L without the concentration step. PMID- 3680129 TI - Gas chromatographic relative retention data for pesticides on nine packed columns: II. Organophosphorus and organochlorine pesticides, using electron capture detection. AB - The retention time relative to parathion, absolute retention time, concentration range, peak asymmetry factor, and peak shape class are given for each of 42 organophosphorus pesticides and 28 organochlorine pesticides analyzed by gas chromatography (GC) on 9 different packed columns. The packing materials used were 3% SP-2100, 1% Dexsil-300, 3% OV-17, 1.5% OV-17 + 1.95% QF-1, 4% SE-30 + 6% QF-1, 3% OV-17 + 3% OV-210, 5% DC-200 + 7.5% QF-1,3% Carbowax-20M, and 4% Reoplex 400. Retention data were determined at 200 degrees C with a carrier gas flow at uopt, using a 63Ni electron-capture detector. Results should be useful for preliminary identification of environmental samples and also for single or multiple pesticide residue analysis. PMID- 3680130 TI - Reverse-phase liquid chromatographic determination of benzoic and sorbic acids in foods. AB - An isocratic liquid chromatographic (LC) technique is described for the determination of benzoic acid and sorbic acid in foods such as beverages, fruits, seafood, vegetables, sauces, and dairy, bakery, and confectionery products. A C18 column is used with methanol-phosphate buffer (5 + 95) as mobile phase and 4 hydroxyacetanilide or 3,5-dinitrobenzoic acid as internal standard. Sample preparation is simple, rapid, and produces a sample extract that has a minimum effect on the column performance and life. Specificity of the method was checked against common food additives such as L-ascorbic acid, caffeine, artificial sweeteners (saccharin, cyclamate, aspartame), antioxidants (BHT, BHA) and artificial colors. Also described are 2 procedures for confirmation of the preservatives, using either redox reaction of sorbic acid with potassium permanganate or gas chromatography/mass spectrometry. Mean recoveries of 90-105% were obtained with a precision of 1-6% and a detection limit of 20 mg/kg for the 2 preservatives. PMID- 3680131 TI - Comparison of HgO and CuSO4/TiO2 as catalysts in manual Kjeldahl digestion for determination of crude protein in animal feed: collaborative study. AB - Because of environmental concerns about HgO, and because of lengthy digestion requirements for HgO and CuSO4, interest in alternative catalysts for the Kjeldahl determination of animal feeds remains high. A digestion system using a mixed CuSO4/TiO2 catalyst has been found to reduce digestion times to 40 min. A collaborative study was carried out to compare this system to the official AOAC HgO method, 7.015. Thirty-eight samples, consisting of blind duplicates of closely matched pairs and 2 standard materials, were analyzed once by each method. Results were received from 13 laboratories. Means and standard deviations of individual samples were comparable, with an overall difference of grand means of 0.005% protein. With only one exception, analyses of variance showed no significant method difference at the 95% confidence level. The CuSO4/TiO2 method has been approved interim official first action as an alternative method for determination of crude protein in animal feed. PMID- 3680132 TI - Determination of phytosterols in butter samples by using capillary column gas chromatography. AB - A positive bias in the gas chromatographic (GC) analysis of butter for beta sitosterol was discovered when attempting to confirm values by gas chromatography/mass spectrometry (GC/MS). The source of the problem was traced to an interfering material that was not effectively separated by packed column GC. Because capillary columns are known to provide superior separation, they were substituted for packed columns in the assay, and instrument parameters were modified accordingly. A compound with a similar retention time, identified by GC/MS as lanosterol, was separated from beta-sitosterol by the capillary column. The capillary column technique was applied to over 300 butter samples. The results indicate that the method can accurately quantitate beta-sitosterol in butter with no known interferences. The limit of detection for this method is 1 mg/100 g. Recoveries at a level of 3 mg/100 g averaged 98% with a coefficient of variation of 3.45%. PMID- 3680133 TI - Liquid chromatographic determination of amprolium in poultry feed and premixes using postcolumn chemistry with fluorometric detection. AB - Two extraction and liquid chromatographic procedures are presented which separate amprolium from compounds in poultry feed or premixes that could interfere with its fluorometric determination. The procedures are based on earlier work on the determination of thiamine in food samples. Amprolium is extracted from feed with a hexane-aqueous sulfosalicylic acid mix, separated on a C18 column, and detected fluorometrically after postcolumn derivatization. For premixes, water extraction is used. Values for the amprolium content of poultry feed obtained with these procedures are in good agreement with those obtained with AOAC official methods. It is suggested that these methods with suitable modifications may be of use for routine analysis of amprolium in feeds. The overall methods are rapid and appear to give reasonable results. PMID- 3680134 TI - Simple method for distinguishing maneb, zineb, mancozeb, and selected mixtures. AB - Maneb, zineb, mancozeb, and arbitrarily selected mixtures of those can be differentiated by a simple method. Compounds are differentiated on the basis of colors produced after treatment of saturated solutions of the fungicides in n propanol-acetone mixture (1 + 1 v/v), first with dithizone and then with monosodium dihydrogen phosphate solution in the same solvent. The color depends on the type and concentration of metal present in the sample. PMID- 3680135 TI - Chloride determination in foods with ion-selective electrode after isolation as hydrogen chloride. AB - This report describes a sample preparation method in which chloride is isolated as hydrogen chloride from food samples prior to analysis with the chloride ion selective electrode. Chloride analyses of selected foods with this method agreed with chloride values reported in food composition tables. Chloride analysis with the present procedure also agreed with the certified value for the chloride content of the National Bureau of Standards (NBS) Standard Reference Material, Nonfat Milk Powder. Reliability of the chloride isolation procedure was evident by the complete recovery of chloride added to food samples and a narrow range of 95% confidence limits calculated for each set of analyses. The usefulness of the chloride ion-selective electrode to determine chloride in foods is greatly enhanced by this procedure because matrix interference by other sample components is removed prior to analysis. PMID- 3680137 TI - Video display of computer-analyzed breath sounds in asthma. PMID- 3680136 TI - Solvent effects on response factors for polynuclear aromatic hydrocarbons determined by capillary gas chromatography using splitless injections. AB - When standard solutions of polynuclear aromatic hydrocarbons (PAHs) were analyzed by capillary column gas chromatography using splitless injections, response factors were observed to be dependent on the solvent used to prepare the standard. This report presents the response factors for 16 individual PAHs in 5 commonly used solvents: acetonitrile, methanol, toluene, isooctane, and cyclohexane. To minimize quantitation errors due to differences in transfer efficiency, samples and standards of PAHs should be prepared in the same solvent. PMID- 3680138 TI - Holding rabbits. PMID- 3680140 TI - Photomicrography: a translation into the vernacular. Part I--The illuminating system. PMID- 3680139 TI - Photographing dermatologic patients. PMID- 3680141 TI - Contrast Process Color. PMID- 3680142 TI - Photography of small laboratory animals. Part Two: Techniques and procedures. PMID- 3680143 TI - Characteristics of the acoustic reflex in response to narrow bands of noise. AB - Normal-hearing young adults (5 M, 6 F) were exposed monaurally for 3 min to narrow-band noises centered at .5, 1, and 4 kc/s, at 20 db above respective acoustic reflex (AR) thresholds. Strip-chart recordings (1 mm/sec) of middle-ear muscle contractions were graphed and evaluated for peak amplitude, latency, adaptation, and recovery from contraction. The relative AR amplitude was greatest to the .5-kc/s band and decreased with increasing stimulus frequency. Women exhibited greater AR than men in response to the lowest frequency of stimulation. The AR latency was significantly faster for the .5-kc/s band, with no sex difference. AR adaptation increased with increasing stimulus frequency and markedly so for women in response to the mid- and high-frequency bands; but for men at all frequencies there was AR enhancement even after 3 min of stimulation. Finally, there were no significant overall differences in AR relaxation time either for men or women, though there was a significant sex by frequency interaction such that at 4 kc/s men's recovery was faster. Implications of these results were discussed relative to the research data on sex differences in TTS at different frequencies. PMID- 3680144 TI - Simple motor and phonemic processing reaction times of elderly subjects. AB - Simple motor reaction time (RT) was measured for arm movement in response to a known monosyllable presented by earphone. The required direction of movement (L or R) was known to S. Choice RT was also measured: only one word of a pair of taped monosyllabic words, differing only in the prevocalic consonant (e.g., tea key) was presented by earphone. Simultaneously, a picture of each word appeared on response plates, one to the L and one to the R of the center rest position. S had to touch the response plate with the picture of the word heard. Subtracting simple from choice RT, in msec, yielded an estimate of auditory-phonemic processing (decoding) time. Data were collected from generally normal, healthy, elderly Ss [Grp I (10 M, 10 F) of 72 yrs mean age, and Grp II (7 M, 9 F) of 84 yrs mean age] and a control group (9 M, 9 F) of 21 yrs mean age. An ANOVA with repeated measures showed that significant differences existed among the 3 groups. A similar ANOVA procedure on phonemic processing time revealed that significant differences existed between the younger and the older Ss, but not between Grps I vs II. Collectively, these findings were taken to suggest that advanced age does not affect all behavioral operations in a generalized fashion. It was suggested that auditory-phonemic processing is more resistant to the aging process than manual responses. PMID- 3680145 TI - Statistical models for predicting Edgerton-Danhauer NST scores from pure-tone thresholds. AB - Pure-tone thresholds (PTTs) and phonemic-scored responses to the Edgerton and Danhauer (1979) Nonsense Syllable Test (NST) at 25, 35, 45, and 55 db SL re each S's SRT, were taken from 97 Ss of 4 earlier studies of Danhauer and colleagues. All studies had used the same stimuli and procedures. Among the 97 Ss were heterogeneous subpopulations of normally-hearing and sensorineural hearing impaired Ss, aged 6-81 yrs. PTTs at octaves from .25-8 kc/s, singly and in various weighted combinations, were explored by step-wise multiple linear regression analyses for the best equation to predict an individual's NST score at each SL. Included were the two weighted PTT averages (over .5, 1, and 2 kc/s) proposed by Butts, Schoney and Ruth (Asha, 1984, 26, 64). PTT2 kc/s was the single most predictive datum. The most predictive equation at one NST SL was not necessarily the best at another SL. At each NST SL, the most predictive equation was always one or other of the equations of Butts et al, and at the higher levels the best equations incorporated in addition certain weighted PTTs at .5 and 1 kc/s. The results indicated that it is possible to predict a S's NST scores from PTTs with reasonable accuracy: from 86-91% of Ss' NST scores were predicted within +/- 10%. Further validation and refinement of these models on larger and different subject samples may result in equations predicting NST scores from PTTs with those difficult-to-test patients in whom speech recognition capacity cannot well be tested directly. PMID- 3680147 TI - Variable speech control vs Varispeech: does newer mean better? AB - Normal-hearing volunteers (N:30, aged 19-28 yrs) yielded intelligibility scores for W-22 word lists and CID sentences at 40 db re each S's SRT, and judgments on a 7-pt scale ("very pleasant"----"very unpleasant") for Sentence 3 of Fairbanks' "Rainbow Passage". Normal and time-altered speeds (60%: compression; 140%: expansion) were compared between the widely-used but obsolescent Lexicon Varispeech (VSp) unit vs the commercially available Variable Speech Control Model A-7 which incorporates a time-sampling technique similar to the VSp. With both VSp and VSC, intelligibility was nearly perfect at all three speeds, and thus both appear equally suitable for intelligibility studies, but at the 60% and 140% speeds the signal clarity was significantly preferable for the VSp system (p less than .01 in both cases), by .6 of a scale interval at 60% and 1.8 interval at 140%. Furthermore, the VSC does not operate beyond the 60-140% range, as occasionally may be desirable in research on the effects of time alteration on speech reception. PMID- 3680146 TI - Test of auditory comprehension: a comparison of hearing-impaired and normal hearing listeners. AB - Normal-hearing (NH) children (N:35) aged 9-11 yrs in regular classrooms were given all 10 subtests of the Test of Auditory Comprehension (TAC) (Trammel, 1976). Group means of raw scores, measures of dispersion, and of internal consistency, alpha, and of test-retest reliability, r, were computed and are presented here for the first time for NH Ss. These data were compared with TAC norms published for a group of 750 hearing-impaired (HI) children with moderate to severe sensorineural hearing loss. Group means for the NH Ss were substantially higher (p less than or equal to .05) on 9 of the 10 subtests than for the HI Ss, but the dispersion was always substantially greater. Furthermore, estimates of alpha and of r were greater on 8 of the 10 subtests for alpha and on 8 for r, the 8 tests not altogether overlapping. The implication is that different auditory processing information may be used by the two different populations, generally supporting the use in the clinic of only those tests specifically designed and demonstrated to be applicable for specific populations. PMID- 3680148 TI - Reduction of acoustic annoyance in school dining halls. AB - The sound levels in dbA and the reverberation times in sec were measured in 18 school dining areas in and around Rennes. Of these, 12 had had acoustic treatment, 6 had not. The range of levels in all schools exceeded those recommended in the literature for the avoidance of noise-induced fatigue, while the reverberation times were acceptable (less than 0.8 sec) only in those spaces acoustically treated. There was a clear relation between sound level and reverberation times, but it was not directly proportional, as other parameters influenced sound level. Suggestions for acoustic treatment of surfaces were made, together with suggestions for treatment and placement of furniture and for compartmenting the interior space. An example was given of a large dining area (2,280 m3) in which the beneficial effects of acoustic treatment of ceiling and of walls separately was demonstrated, the sound level being reduced by 4-8 dbA. It was recommended that persons at all levels, from administrators to the children themselves become aware of the necessity to lower noise levels to facilitate relaxation and communication at meal time and to control noise to innocuous levels. PMID- 3680149 TI - Effects of the menstrual cycle on the human acoustic reflex threshold. AB - Contralateral acoustic reflex thresholds (ARTs) were determined daily in 10 normal women and 10 men, aged 18-24, in response to a broad-band noise, over a 32 day period. Mean ARTs for men vs women over the period differed by only 1.55 db, but for women a stimulus level of about 6 db more was required to elicit ART over Days 1-6 of the menstrual cycle than over Days 7-26 (p less than .01). There was furthermore an increase in sensitivity in the luteal phase (Days 15-19) of the cycle. It appears that the changes in ART throughout the cycle mirror, and may reflect, concomitant changes in the hormonal (estrogen and progesterone) levels. Changes in ART over the cycle may thus be explained by hypothesizing that the ART is an aspect of sensorineural behavior affected by hormonal concentrations to which a number of other auditory phenomena are known or thought to be related. PMID- 3680150 TI - Mothers of children with autism or communication disorders: successful adaptation and the double ABCX model. AB - This study demonstrates the effectiveness of a modified Double ABCX or FAAR model in predicting successful adaptation--good marital adjustment, few maternal depressive symptoms, and an in-home rating of family functioning--in 45 families of autistic and communication-impaired children. The model consisted of severity of the handicap and other family stresses, family resources of cohesion and social support, family definition of the handicap, and adequacy of coping patterns. Canonical correlation and subsequent multiple regression procedures demonstrated that family adaptation was positively predicted by adequacy of social support and active coping patterns. Poorer adaptation was predicted by other family stresses, unwarranted maternal self-blame for the handicap, and maternal definition of the handicap as a family catastrophe. Findings for cohesion were mixed. Resources and beliefs were more predictive of adaptation than severity of the child's handicap. PMID- 3680151 TI - Perspective-taking ability and its relationship to the social behavior of autistic children. AB - A study was undertaken to assess the relationship between perspective-taking ability and the quality of social behavior in autistic children. Sixteen autistic children ranging from 6 to 14 years of age were administered three types of perspective-taking tasks (perceptual, conceptual, and affective), as well as the Peabody Picture Vocabulary Test and the Leiter International Performance Scale. Two measures of social behavior were taken: the Vineland Social Maturity Scale and the Social Behavior Rating Scale, designed for the present study. It was found that perspective-taking ability was significantly correlated with both measures of social skills, whereas receptive vocabulary and nonverbal intelligence were not. These results suggest that the social impairments of autistic children may be related to specific deficits in social cognition. PMID- 3680152 TI - Factors associated with the development of psychiatric illness in children with early speech/language problems. AB - This paper reports on the correlates of psychiatric illness in children with speech and language disorders. Of 600 children selected from a community speech clinic, 50% were found to have diagnosable psychiatric disorders according to DSM III criteria. These "psychiatrically ill" children were compared to the "psychiatrically well" children in the sample on a variety of developmental, socioeconomic, medical, and psychosocial factors. Although some differences were found between the well and ill children in other factors, the majority of the differences, and the most highly significant differences, were found in areas of linguistic functioning. It is hypothesized that this finding may be relevant not only to understanding the association between linguistic and psychiatric functioning but also to predicting the outcome and planning treatment for childhood speech and language disorders. PMID- 3680153 TI - The relationship between nurse characteristics and perceptions of psychotropic medications in residential facilities for the retarded. AB - A total of 227 nurses were surveyed regarding their attitudes, perceptions, and knowledge about the use of psychotropic drugs. In general, greater age, male sex, status, and higher qualifications tended to covary and were associated with perception of greater involvement by senior nurses in drug-related decisions, more satisfaction with the level of in-service training, awareness of certain side effects, perception of interdisciplinary decision making as a clinical reality, and the view that psychologists were not influential in medication related decisions. Those without these characteristics (e.g., females, younger nurses) more often advocated greater use of medical and laboratory tests, ongoing training, and alternatives to drugs. Nurses working in nonambulatory units more often saw senior nursing staff as influential in decisions to stop drug treatment and more often recommended that alternatives to pharmacology be employed. Some tentative conclusions about the dynamics surrounding medication use in these facilities were offered to account for these patterns. PMID- 3680154 TI - Auditory evoked responses and their modifications during conditioning paradigm in autistic children. AB - Auditory evoked responses (AERs) were recorded from 16 autistic children (ages 2 10 years) and age-matched normal and retarded controls. In order to test the ability to form auditory-visual cross-modal associations, often impaired in autism, the effects on AERs of coupling sound and light were studied with a paradigm that did not require the cooperation of the subject. Several differences between groups were found concerning the frequency and the amplitudes of present AERs. The pattern characterizing the effects on AERs of coupling sound and light (conditioning phenomenon) was observed for both autistic and normal controls, and not for retarded children. Results suggest that autistic children may have a real but slow learning ability. PMID- 3680155 TI - Parental perception of behavioral symptoms in Japanese autistic children. AB - A diagnostic questionnaire was used to study the abnormalities that parents first noticed, the ages at which parents first noticed these early symptoms, and the main problems the parents complained about in the first consultation. In this study, parents of 141 autistic children below the age of 12 were employed. Approximately 71% of the parents noticed abnormalities in their autistic children by the age of 2 1/2 years. Parents of older autistic children tended more often to report symptoms of mental retardation, ritualistic behavior, and self-injury. This study showed that the Japanese peak of abnormal social behavior, including autistic symptoms as reported by parents, was from the ages of 3 years to approximately 9 years, compared with the U.S. and European peak of 3 to 6 years. PMID- 3680156 TI - Parent and professional evaluations of family stress associated with characteristics of autism. AB - This study assessed the impact of various individual symptoms of autism on mothers and fathers, and professionals' accuracy in estimating parents' perceived stress levels. Mothers and fathers of 20 autistic children, and 20 therapists working with those children, independently rated the severity of common symptoms of autism in their child, and how stressful they found each symptom; therapists estimated parental stress. The autistic child's language and cognitive impairment were judged by all raters as most severe and stressful. In contrast with other studies, individual parents agreed on both symptom severity and degree of stress. Parents of older children judged symptom severity to be lower, but fathers reported a continued high level of stress. Professionals judged families as more stressed by the child symptoms than did families themselves. Implications for intervention and casework are discussed. PMID- 3680157 TI - Psychometric assessment of preschool atypical children. PMID- 3680158 TI - Ear infections in autistic and normal children. AB - The frequency of ear infections, ear tube drainage, and deafness was examined through parental reports in autistic and yoke-matched, normal children. For the autistic group these difficulties were additionally examined as a function of the children's cognitive and communication abilities, verbal versus nonverbal status, sex, and degree of autistic symptomatology. Autistic children had a greater incidence of ear infections than matched normal peers. Lower-functioning children had an earlier onset of ear infections than their higher-functioning autistic peers. Ear infections coexisted with low-set ears, and with a higher autistic symptomatology score. The findings are discussed in terms of greater CNS vulnerability in the autistic children, which is likely present since embryogenesis. The possible adverse consequences of intermittent hearing loss on language, cognitive, and socioaffective development are considered. PMID- 3680159 TI - Dispute over Rutter and Schopler (1987) article. PMID- 3680160 TI - [Chondrosarcomatous degeneration of an osteosarcoma]. PMID- 3680161 TI - [Ultrasound guided puncture of breast masses]. PMID- 3680162 TI - Combined percutaneous and endoscopic procedures in the biliary system. PMID- 3680163 TI - [Cutaneous metastasis as the first manifestation of adenocarcinoma in Barrett esophagus]. PMID- 3680164 TI - Werner mesomelic dysplasia. Report of two variant cases. PMID- 3680165 TI - Pediatric radiology: quo vadis? PMID- 3680166 TI - Facile autoplast generation and transformation in Bacillus thuringiensis subsp. kurstaki. AB - We describe a method for maximizing the rate of conversion of Bacillus thuringiensis subsp. kurstaki vegetative cells to osmotically fragile forms in the absence of exogenously added enzymes. Optimal generation of autoplasts occurred in 50 mM sodium acetate buffer (pH 7.0) at 37 degrees C with 10% (wt/vol) polyethylene glycol as an osmotic stabilizer. The maximum autolytic rate resulted in a conversion of greater than 90% of bacilli to spherical autoplasts in 6 min. Autoplasts regained bacillary morphology upon plating on DM3-G regeneration medium, with reversion frequencies ranging from 1.2 x 10(-1) to 5.3 x 10(-3). The autoplasts could efficiently take up exogenously added plasmid DNA. The presence of plasmids was verified by Southern hybridization analysis. PMID- 3680167 TI - Cloning and characterization of the repressor gene of the Staphylococcus aureus lactose operon. AB - The genes responsible for utilization of lactose in Staphylococcus aureus are organized as an inducible operon, with galactose 6-phosphate being the intracellular inducer. To clone the repressor gene of this operon, we constructed an integration vehicle carrying 1.9 kilobases (kb) of DNA sequences from a region upstream of the structural genes of the operon. Through integration and subsequent rescue of this plasmid, we were able to clone approximately 7 kb of staphylococcal chromosomal DNA. We have shown that the plasmid insert complemented lac constitutive mutants. This repressor activity was localized to a 1.8-kb DNA fragment and, through maxicell analysis, was shown to correlate with the presence of a polypeptide with an apparent molecular weight of 32,000. Furthermore, a region between the repressor gene and the other genes of the operon was identified which, when carried on multicopy plasmids, resulted in expression of the operon in the absence of any exogenous induction. This region may represent an operator-type element capable of titrating repressor molecules away from chromosomal operator, allowing transcription of the operon in the absence of induction. PMID- 3680168 TI - Location of acyl groups of trehalose-containing lipooligosaccharides of mycobacteria. AB - A variant of a Mycobacterium sp. originating in a patient with Crohn's disease, but not necessarily implicated in the disease, provided a simple version of a newer class of species-specific surface glycolipids, the trehalose-containing lipooligosaccharides. A combination of high-resolution 1H nuclear magnetic resonance, methylation, ethylation, and absolute configurational analysis established the structure of the oligosaccharide unit as beta-D-Glcp(1----3) alpha-L-Rhap(1----3)-alpha-D-Glcp(1----1)-alph a-D-Glcp (where Glc is glucose, Rha is rhamnose, and p is pyranosyl), and gas chromatography-electron impact mass spectrometry allowed identification of the fatty acyl esters as primarily 2,4 dimethyltetradecanoate. The relative simplicity of the glycolipid combined with the application of a mild methylation procedure and californium-252 plasma desorption mass spectrometry allowed recognition of three such acyl residues on the 3-, 4-, and 6-hydroxyl positions of the terminal glucosyl residue of the trehalose unit. Thus, the glycolipid is decidedly amphipathic yet is clearly not membranous. This observation leads to speculation about the role of these novel lipooligosaccharides in contributing to the outer segment of the hydrophobic barrier of the cell wall of certain mycobacteria. PMID- 3680169 TI - Yeast plasmids resembling 2 micron DNA: regional similarities and diversities at the molecular level. AB - The nucleotide sequence of two Zygosaccharomyces plasmids, pSB2 (5,415 base pairs), isolated from Zygosaccharomyces bailii, and pSM1 (5,416 base pairs), isolated from Zygosaccharomyces fermentati Naganishi, was determined. The predicted amino acid sequences of open reading frames among six yeast plasmids that resemble 2 microns DNA indicated regional sequence similarities among FLP proteins. Greater similarities were seen among Zygosaccharomyces plasmids (pSB2, pSB3, pSR1, and pSM1) than other combinations. A putative recognition site for the FLP enzyme of a Zygosaccharomyces plasmid also showed some conservation, especially in the 4 nucleotides flanking the central spacer region. From comparative studies of the sequences of putative genes of each plasmid, we propose an apparent phylogenetic relationship among yeast plasmids resembling 2 micron DNA. Among the Zygosaccharomyces plasmids, pSB2 and pSR1 are most closely related, since not only were the FLP enzymes of these two plasmids most closely related, but also the amino acid sequence of the putative P gene of pSR1 showed clear homology with that of open reading frame B of pSB2. PMID- 3680170 TI - Major membrane surface proteins of Mycoplasma hyopneumoniae selectively modified by covalently bound lipid. AB - Surface protein antigens of Mycoplasma hyopneumoniae were identified by direct antibody-surface binding or by radioimmunoprecipitation of surface 125I-labeled proteins with a series of monoclonal antibodies (MAbs). Surface proteins p70, p65, p50, and p44 were shown to be integral membrane components by selective partitioning into the hydrophobic phase during Triton X-114 (TX-114)-phase fractionation, whereas p41 was concomitantly identified as a surface protein exclusively partitioning into the aqueous phase. Radioimmunoprecipitation of TX 114-phase proteins from cells labeled with [35S]methionine, 14C-amino acids, or [3H] palmitic acid showed that proteins p65, p50, and p44 were abundant and (with one other hydrophobic protein, p60) were selectively labeled with lipid. Covalent lipid attachment was established by high-performance liquid chromatography identification of [3H]methyl palmitate after acid methanolysis of delipidated proteins. An additional, unidentified methanolysis product suggested conversion of palmitate to another form of lipid also attached to these proteins. Alkaline hydroxylamine treatment of labeled proteins indicated linkage of lipids by amide or stable O-linked ester bonds. Proteins p65, p50, and p44 were highly immunogenic in the natural host as measured by immunoblots of TX-114-phase proteins with antisera from swine inoculated with whole organisms. These proteins were antigenically and structurally unrelated, since hyperimmune mouse antibodies to individual gel-purified proteins were monospecific and gave distinct proteolytic epitope maps. Intraspecies size variants of one surface antigen of M. hyopneumoniae were revealed by a MAb to p70 (defined in strain J, ATCC 25934), which recognized a larger p73 component on strain VPP11 (ATCC 25617). In addition, MAb to internal, aqueous-phase protein p82 of strain J failed to bind an analogous antigen in strain VPP11. These studies establish that a highly restricted set of distinct, lipid-modified hydrophobic membrane proteins are major surface antigens of M. hyopneumoniae and that structural variants of surface antigens occur within this species. PMID- 3680171 TI - Regulation of beta-galactoside transport and accumulation in heterofermentative lactic acid bacteria. AB - Galactose-grown cells of the heterofermentative lactic acid bacteria Lactobacillus brevis and Lactobacillus buchneri transported methyl-beta-D thiogalactopyranoside (TMG) by an active transport mechanism and accumulated intracellular free TMG when provided with an exogenous source of energy, such as arginine. The intracellular concentration of TMG resultant under these conditions was approximately 20-fold higher than that in the medium. In contrast, the provision of energy by metabolism of glucose, gluconate, or glucosamine promoted a rapid but transient uptake of TMG followed by efflux that established a low cellular concentration of the galactoside, i.e., only two- to fourfold higher than that in the medium. Furthermore, the addition of glucose to cells preloaded with TMG in the presence of arginine elicited a rapid efflux of the intracellular galactoside. The extent of cellular TMG displacement and the duration of the transient effect of glucose on TMG transport were related to the initial concentration of glucose in the medium. Exhaustion of glucose from the medium restored uptake and accumulation of TMG, providing arginine was available for ATP generation. The nonmetabolizable sugar 2-deoxyglucose elicited efflux of TMG from preloaded cells of L. buchneri but not from those of L. brevis. Phosphorylation of this glucose analog was catalyzed by cell extracts of L. buchneri but not by those of L. brevis. Iodoacetate, at a concentration that inhibits growth and ATP production from glucose, did not prevent efflux of cellular TMG elicited by glucose. The results suggested that a phosphorylated metabolite(s) at or above the level of glyceraldehyde-3-phosphate was required to evoke displacement of intracellular TMG from the cells. Counterflow experiments suggested that glucose converted the active uptake of TMG in L. brevis to a facilitated diffusion mechanism that allowed equilibrium of TMG between the extra- and intracellular milieux. The means by which glucose metabolites elicited this vectorial regulation is not known, but similarities to the inducer expulsion that has been described for homofermentative Streptococcus and Lactobacillus species suggested the involvement of HPr, a protein that functions as a phosphocarrier protein in the phosphotransferase system, as well as a presumptive regulator of sugar transport. Indeed, complementation assays wit extracts of Staphylococcus aureus ptsH mutant revealed the presence of HPr in L. brevis, although this lactobacillus lacked a functional phaosphoenolpyruvate-dependent phosphortransferase system for glucose, 2-deoxyglucose, or TMG. PMID- 3680172 TI - Genetic studies of avermectin biosynthesis in Streptomyces avermitilis. AB - A genetic recombination study of an industrial strain of Streptomyces avermitilis which produces avermectin is described. A genetic map has been constructed by analysis of haploid recombinants and linkage relationships of 16 marker loci. Fifteen avermectin-nonproducing mutants, produced by mutagenesis, were classified into two phenotypically different groups, of which one produced avermectin aglycon and the other was able to convert avermectin aglycon to avermectins. Two different mutants were found to map closely to each other. PMID- 3680173 TI - Glyceraldehyde-3-phosphate dehydrogenase gene from Zymomonas mobilis: cloning, sequencing, and identification of promoter region. AB - The gene encoding glyceraldehyde-3-phosphate dehydrogenase was isolated from a library of Zymomonas mobilis DNA fragments by complementing a deficient strain of Escherichia coli. It contained tandem promoters which were recognized by E. coli but appeared to function less efficiently than the enteric lac promoter in E. coli. The open reading frame for this gene encoded 337 amino acids with an aggregate molecular weight of 36,099 (including the N-terminal methionine). The primary amino acid sequence for this gene had considerable functional homology and amino acid identity with other eucaryotic and bacterial genes. Based on this comparison, the gap gene from Z. mobilis appeared to be most closely related to that of the thermophilic bacteria and to the chloroplast isozymes. Comparison of this gene with other glycolytic enzymes from Z. mobilis revealed a conserved pattern of codon bias and several common features of gene structure. A tentative transcriptional consensus sequence is proposed for Z. mobilis based on comparison of the five known promoters for three glycolytic enzymes. PMID- 3680174 TI - Effect of growth conditions on levels of components of the phosphoenolpyruvate:sugar phosphotransferase system in Streptococcus mutans and Streptococcus sobrinus grown in continuous culture. AB - The membrane-bound, sugar-specific enzyme II (EII) component of the phosphoenolpyruvate:sugar phosphotransferase system (PTS) in Streptococcus mutans Ingbritt is repressed by growth on glucose under various conditions in continuous culture. Compared with optimal PTS conditions (i.e., glucose limitation, dilution rate [D] of 0.1 h-1, and pH 7.0), EII activity for glucose (EIIGlc) and mannose (EIIMan) in cells grown at a D of 0.4 h-1 and pH 5.5 with the same glucose concentration was reduced 24- to 27-fold. EII activity with methyl alpha glucoside and 2-deoxyglucose was reduced 6- and 26-fold, respectively. Growth with excess glucose (i.e., nitrogen limitation) resulted in 26- to 88-fold repression of EII activity with these substrates. The above conditions of low pH, high dilution rate, and excess glucose also repressed EII activity for fructose (EIIFru), but to a lesser extent (two- to fivefold). Conversely, growth of S. mutans DR0001 at a D of 0.2 h-1 and pH 5.5 resulted in increased EIIGlc and EIIMan activity. Unlike the EII component, the HPr concentration in S. mutans Ingbritt varied only twofold (5.5 to 11.4 nmol/mg of protein) despite growth at pH 5.5 with limiting and excess glucose. The HPr concentrations in S. mutans DR0001 and the glucose-PTS-defective mutant DR0001/6 were similar. In a companion study, the soluble components of the PTS (i.e., HPr, EI, and EIIILac) in Streptococcus sobrinus grown on limiting lactose in a chemostat were not influenced significantly by growth at various pHs (7.0 and 5.0) and growth rates (D of 0.1, 0.54, and 0.8 h-1). However, growth on lactose resulted in repression of both EIIGlc and EIIFru, confirming earlier results with batch-grown cells. Thus, the glucose-PTS in some strains of S. mutans is regulated at the level of EII synthesis by certain environmental conditions. PMID- 3680175 TI - Cloning of whiG, a gene critical for sporulation of Streptomyces coelicolor A3(2). AB - In whiG mutants of Streptomyces coelicolor A3(2), aerial hyphae do not show any sign of sporulation. A library of S. coelicolor DNA was prepared in a phi C31 temperate phage vector (KC516), and one recombinant phage (KC750) that could restore the wild-type phenotype to a collection of whiG mutants when integrated into their genomes was found. Subcloning experiments with low- and high-copy number Streptomyces plasmid vectors allowed partial localization of whiG in the cloned DNA and revealed that hypersporulation was associated with the presence of extra copies of whiG. PMID- 3680176 TI - A Pseudomonas stutzeri outer membrane protein inserts copper into N2O reductase. AB - Among a set of frameshift mutagen (ICR-191; Polysciences, Inc.)-induced mutations that confer inability to grow anaerobically with N2O as the sole electron acceptor, one class was found that produced an inactive N2O reductase which lacked copper. All of these mutant strains failed to produce a 61,000-Mr protein located in the outer membrane. This protein, termed NosA, seems not to be responsible for bringing copper into the cell because the mutant strains and their parent were similarly sensitive to the copper content of the growth medium and no intermediate copper concentration in the medium permitted the mutant strains (nosA) to grow anaerobically with N2O as the sole electron acceptor. We conclude that NosA is necessary to insert copper into N2O reductase or to maintain it there. PMID- 3680177 TI - Phosphate transport in Halobacterium halobium depends on cellular ATP levels. AB - Freshly harvested Halobacterium halobium cells grown in the presence of 0.5 mM Pi took up phosphate with a low apparent Km. Import depended on intracellular ATP levels; sodium and proton (electro)chemical gradients alone were not competent to drive Pi uptake. Although most of the phosphate accumulated as Pi in the cells, efflux of Pi was difficult to achieve. PMID- 3680178 TI - Nucleotide sequences of the genes for two distinct cephalosporin acylases from a Pseudomonas strain. AB - Two genes, acyI and acyII, for distinct cephalosporin acylases from Pseudomonas sp. strain SE83 (A. Matsuda, K. Matsuyama, K. Yamamoto, S. Ichikawa, and K.I. Komatsu, J. Bacteriol. 169:5815-5820, 1987) were sequenced. Each sequence contained a single open reading frame for two nonidentical subunits, predicting a common precursor. Some homologies at the amino acid level were found between the acyII-encoded enzyme, but not the acyI-encoded one, and other related acylases. PMID- 3680179 TI - Protocatechuate is not metabolized via catechol in Enterobacter aerogenes. AB - Protocatechuate is generally metabolized in bacteria by direct oxygenative cleavage to produce beta-carboxymuconate. An exception to this pattern has been suggested by reports that protocatechuate might be metabolized by nonoxidative decarboxylation to catechol in Enterobacter aerogenes. In the present investigation, analysis of mutant strains indicated that this proposed pathway did not make a significant contribution to protocatechuate metabolism in E. aerogenes because mutations blocking catechol metabolism did not impair protocatechuate utilization. In addition, all the enzymes required for the oxygenative cleavage of protocatechuate and its further metabolism were induced in E. aerogenes during protocatechuate metabolism, and mutations inactivating this oxygenative pathway prevented protocatechuate degradation. The strains of E. aerogenes examined exhibited broad specificities of inductive control over genes associated with protocatechuate and catechol metabolism; it appears that a number of metabolites may trigger the expression of these genes. PMID- 3680180 TI - Agrobacterium tumefaciens virulence locus pscA is related to the Rhizobium meliloti exoC locus. AB - Agrobacterium tumefaciens and Rhizobium meliloti carry related genetic loci which have important roles in virulence and symbiosis. Previously, it was shown that two virulence loci of A. tumefaciens, chvA and chvB, are related to two R. meliloti symbiosis loci, ndvA and ndvB, respectively (T. Dylan, L. Ielpi, S. Stanfield, L. Kashyap, C. Douglas, M. Yanofsky, E. Nester, D. R. Helinski, and G. Ditta, Proc. Natl. Acad. Sci. USA 83:4403-4407, 1986). Here we show that these two phytobacteria possess additional related virulence/symbiosis genes. Results of genetic complementation and DNA hybridization experiments indicate that the pscA virulence locus of A. tumefaciens is structurally and functionally related to the exoC symbiosis locus of R. meliloti. Thus, A. tumefaciens and R. meliloti bear at least three related genetic loci that have crucial roles in establishing the interactions that each bacterium has with its respective host plants. PMID- 3680181 TI - Carbon monoxide-driven electron transport in Clostridium thermoautotrophicum membranes. AB - Membrane vesicles of Clostridium thermoautotrophicum prepared by osmotic lysis after lysozyme treatment contained carbon monoxide dehydrogenase and methylenetetrahydrofolate dehydrogenase with specific activities three- to fourfold higher than the specific activity of the cytoplasm. The membrane associated carbon monoxide dehydrogenase mediated the reduction with CO or the oxidation with CO2 of b-type cytochromes and other electron carriers in the membrane. PMID- 3680182 TI - The reassessment of chronic patients previously diagnosed as schizophrenic. AB - Sixty-one outpatients with clinical diagnoses of schizophrenia or schizoaffective disorder were systematically reevaluated with a structured historical diagnostic interview, the Schedule for Affective Disorders and Schizophrenia-Lifetime Version, and with a review of their charts. Research diagnoses were then constructed by applying Research Diagnostic Criteria (RDC) to the interview data and seven diagnostic systems to the chart data. Of the 61 patients, 43 (70.5%) were again recognized to be schizophrenic by the RDC applied to the interview data and 39 (63.5%) met chart criteria. Fifty-one patients (83.6%) were rediagnosed as schizophrenic by at least one of these approaches (excluding the NHSI chart criteria). There was, however, great variation in rediagnostic assignment because of variations in the diagnostic criteria and chart data. Many of the patients who did not meet criteria for schizophrenia met criteria for affective disorder. Patients were assigned to one of four categories according to whether interview or chart rediagnosis was positive or negative for schizophrenia. This categorization was used to search for factors that might account for patients who did not receive a rediagnosis of schizophrenia. PMID- 3680183 TI - Hyperventilation and panic attacks. AB - The symptoms of hyperventilation syndrome and panic disorder are very similar. A questionnaire was used to assess the incidence of panic disorder in 274 patients; 35% of the patients with hyperventilation and only 5% of the non-hyperventilating patients showed panic disorder. The authors conclude that hyperventilation plays an important role in panic disorder and in generalized anxiety disorder. PMID- 3680184 TI - Treatment and outcome in secondary depression: a naturalistic study of 1087 patients. AB - In a naturalistic study, the treatment response and outcome of 1087 patients with nonbipolar primary (N = 763) and secondary (N = 324) depression were compared by a chart review. The patients were divided into four treatment groups, based on the primary mode of therapy received during the index hospitalization: ECT, adequate antidepressant, inadequate antidepressant, and neither treatment. Primary depressives were more likely to have received ECT, and secondary depressives were more likely to have received inadequate antidepressant or neither treatment. A total of 436 (57.1%) primary depressives received adequate therapy, but only 113 (34.9%) secondary depressives did (p less than .001). Overall, primary depressives responded better to treatment (both ECT and antidepressants) than did secondary depressives. A total of 470 (61.6%) primary depressives but only 140 (43.2%) secondary depressives were recovered at discharge (p less than .001). The conclusion is that secondary depressives are more likely to receive inadequate treatment and are less likely to respond to adequate treatment than are primary depressives. PMID- 3680185 TI - A preliminary study of desipramine in the treatment of cocaine abuse in methadone maintenance patients. AB - Intravenous cocaine use is a major problem in methadone maintenance programs. In this pilot study of 16 cocaine-abusing methadone maintenance patients, 8 received desipramine and 8 received no medication other than methadone. During an 8-week open trial the desipramine patients reported significantly less cocaine craving and had less cocaine use than the other patients. PMID- 3680186 TI - Postcardiotomy confusion and sleep loss. AB - To examine the relationship between sleep loss and confusion after open-heart surgery, 27 consecutive patients were monitored 1 day preoperatively and 5 days postoperatively with the Folstein Mini-Mental State examination, a modified sleep latency test, and a sleep log. Confusion (low Mini-Mental State scores) peaked on postoperative Days 1 and 2 and correlated with insomnia (sleep time) during the following night but not during the preceding night. The results suggest that sleep loss is not the cause but, rather, a consequence of postcardiotomy confusion. Confusion, not insomnia, should be the focus of treatment. PMID- 3680187 TI - Treatment of seasonal affective disorder with morning light. AB - Three subjects afflicted with seasonal affective disorder (winter depression) were treated with 2-hour morning light exposures. Within 2 to 5 days, all responded, and remission of their symptoms was sustained during the 2-month treatment period. PMID- 3680188 TI - Two cases of transient partial amnesia in the course of transient global amnesia. AB - In the course of transient global amnesia, two patients showed symptoms of transient partial amnesia. Close observation showed that at some time during the episode the patients had some degree of nonverbal memory, which recovered earlier than verbal memory. Careful observation of the progression of symptoms during an episode of transient global amnesia may often reveal symptoms of transient partial amnesia. PMID- 3680189 TI - Three cases of overlap between panic disorder, social phobia, and agoraphobia. AB - Panic disorder, agoraphobia, and social phobia are subtypes of the anxiety disorders as defined by DSM-III. Panic disorder and agoraphobia are thought to be closely related, whereas social phobia is considered to be distinct on the basis of demographic characteristics, course, symptoms, biological responsiveness, and treatment specificity. Three cases are presented in which these classificatory distinctions are blurred and the course of the illness seems to involve temporally overlapping manifestations of panic attacks, social phobia, and agoraphobia. Diagnostic and treatment issues and implications for research are discussed. PMID- 3680190 TI - Carbamazepine in frontal lobe syndrome: two more cases. PMID- 3680191 TI - Serum potassium levels and adrenergic activation. PMID- 3680192 TI - Clinical evaluation of three types of plasmapheresis in a patient with type IIa familial hypercholesterolemia. AB - Long-term plasmapheresis (PP) therapy was studied in a 56-year-old patient with homozygous type IIa familial hypercholesterolemia also suffering from severe coronary heart disease. Three different PP techniques, plasma exchange (PE), double-membrane-filtration plasmapheresis (DFP), and the recently developed low density lipoprotein adsorbent column (adsorption plasmapheresis, adsorption PP), were used in an attempt to develop better means of managing the disease. All three techniques showed similar elimination efficiency with respect to plasma total cholesterol level. Adsorption PP with minimal supplemental plasma protein managed the circulatory status of the patient better than DFP during extracorporeal treatment. In the course of PP therapy xanthoma tuberosum markedly regressed, and the cardiac status of the patient was clearly improved. PMID- 3680193 TI - Plasma exchange in the treatment of nonadvanced stages of progressive systemic sclerosis. AB - Ten patients suffering from progressive systemic sclerosis, who responded poorly to conventional therapy, underwent plasma exchange (PE) therapy in conjunction with drug therapy. The frequency of PE was twice weekly for 4-6 weeks, two or three times per year, with a summer interruption, when in our own experience a spontaneous relief of symptoms occurs. To judge the efficacy of our therapeutic device, we assessed several laboratory and clinical parameters before and after therapy. The changes in circulating immune complexes, in IgG and IgA, and in some functional indices were significant (P less than 0.001). Eight of 10 patients improved satisfactorily. The remaining two did not improve sufficiently to continue the apheretic treatment. In conclusion, our study suggests that the PE, together with conventional therapy, can be an effective therapeutic device in the treatment of progressive systemic sclerosis. PMID- 3680194 TI - Rapidly progressive glomerulonephritis associated with amyloidosis: efficacy of plasma exchange. AB - This report describes one case of rapidly progressive glomerulonephritis associated with amyloidosis in a 53-year-old woman with rheumatoid arthritis, successfully treated with intensive plasma exchange and immunosuppression. Amyloid deposits were present in all of 20 glomeruli in the kidney biopsy specimen and eight out of nine nonfibrosed glomeruli contained crescents. With intensive plasma exchange and immunosuppressive drugs, renal function improved, and hemodialysis was discontinued. After 2 years, renal function was stable at a moderate level of impairment, but heavy proteinuria persisted. PMID- 3680195 TI - The effect of plateletpheresis on the Fenwal CS-3000 on donor platelet counts. AB - To evaluate the risk of significant plateletpheresis-induced thrombocytopenia in normal volunteer donors undergoing plateletpheresis less frequently than every 56 days and to help understand factors influencing platelet yield in these donors, pre- and postapheresis platelet counts (X 10(3)/microliter) and platelet yields were analyzed from 916 plateletpheresis procedures (Fenwal CS-3000) on 607 donors (405 men, 202 women). The mean preapheresis platelet count was 265 +/- 59 (SD) (range 155-650) (men 256 +/- 55 [170-444]; women 284 +/- 65 [155-650]; P less than .001, t-test). After an average platelet yield of 4.08 X 10(11), the mean postplatelet count was 185 +/- 46 (range 72-420) (men 184 +/- 42 [80-345]; women 194 +/- 52 [72-500]; P less than 0.1). The percent decrease in platelet count (mean 29.4 +/- 13, range -28.1-65.5) had positive correlations with platelet yield (P less than .01, r = 0.10), predonation platelet count (P less than .001, r = 0.29), and age (P less than .01, r = .10) and a negative correlation with weight (P less than .001, r = 0.18) Both the percent decrease and platelet yield were significantly higher in women than in men (P less than .001, t-test), and platelet yield was best predicted by preapheresis platelet count in both sexes (r = 0.65). The effects of plateletpheresis on donor platelet count thus vary widely among donors. Although a decrease of greater than 50% was not a rare event (5.9% of all procedures), in only three instances (0.3%) was the actual postapheresis platelet count below 100 (72, 94, 95). Thus, plateletpheresis in normal donors appears unlikely to produce clinically significant thrombocytopenia immediately after apheresis. PMID- 3680196 TI - Multiple use of plasmafilters. AB - The practice of multiple use of membrane plasmafilters was examined in six patients receiving intermittent or regular plasmapheresis treatment. The plasmafilters were cleaned by flushing and ultrafiltration using positive pressure in the blood and filtrate compartments of the plasmafilter. Twenty-six plasmafilters were studied and the membrane permeability characteristics were examined during 56 plasmapheresis treatments with reused plasmafilters. The clearances of nitrogen urea and creatinine, and the sieving coefficients of albumin and immunoglobulins remained unchanged with the reuse of plasmafilters. The practice is safe, efficient, and can contribute to cost containment in plasmapheresis treatment. PMID- 3680197 TI - X-ray crystallographic studies of the alanine-specific racemase from Bacillus stearothermophilus. Overproduction, crystallization, and preliminary characterization. AB - To facilitate large-scale purification and crystallographic study, we have subcloned the gene for the alanine racemase of Bacillus stearothermophilus from pICR401 (Inagaki, K., Tanizawa, K., Badet, B., Walsh, C. T., Tanaka, H., and Soda, K. (1986) Biochemistry 25, 3268-3274) and overproduced the enzyme in Escherichia coli W3110 lacIq using the tac promoter of PKK223-3. This system yields alanine racemase as 6% of the bacterial cytosolic protein. Purification by a modification of the procedure of Inagake et al. yielded 75 mg of homogeneous alanine racemase from 30 g of cells (wet weight). Large, well-formed crystals of alanine racemase have been grown from polyethylene glycol 8000 using vapor diffusion. These crystals have unit cell dimensions a = 85.3 A, b = 110.0 A, and c = 89.9 A. The crystals belong to space group P2(1), with beta fortuitously equal to 90 degrees within experimental error; however, they are frequently twinned by second order pseudomerohedry with twin fraction (the ratio of the volume of the smaller twin domain to the total volume of the crystal) ranging from about 0 to 0.5. Fortunately, for crystals with low twin fraction, computational methods have been developed for the analysis and correction of simple twinning (Fisher, R. G., and Sweet, R. M. (1980) Acta Crystallogr. A36, 755-760). The crystals contain two alpha 2 dimers of alanine racemase in the asymmetric unit. We have identified several potentially useful heavy atom derivatives in low resolution screening experiments and are proceeding with high resolution data collection. PMID- 3680198 TI - Calmodulin antagonists inhibit the mitochondrial pyruvate dehydrogenase complex. AB - Calmodulin antagonists, including phenothiazine, sulfonamide, butyrophenone, and imidazolium derivatives, were in vitro inhibitors of pea mitochondrial pyruvate dehydrogenase complex activity. Inhibition was observed both during direct assay of the partially purified complex and during assay of pyruvate oxidation by isolated, intact mitochondria. When tested against the purified complex, the sulfonamide compound N-(6-aminohexyl)-5-chloro-1-naphthalene sulfonamide (W-7) was a competitive inhibitor with respect to coenzyme A and an uncompetitive inhibitor with respect to NAD and pyruvate. Inhibition of a process as crucial as mitochondrial respiration should serve to emphasize the care necessary in interpretation of whole-organism calmodulin antagonist studies. PMID- 3680199 TI - Kinetic pulse-labeling study of Fusarium culmorum. Biosynthetic intermediates and dead-end metabolites. AB - A kinetic pulse-labeling method was utilized in Fusarium culmorum to detect plausible biosynthetic intermediates and differentiate them from dead-end metabolites. The ultimate test to demonstrate a precursor relies on feeding experiments. We now report the detection of four new metabolites, one of them (compound 1) behaves as a dead-end metabolite, whereas compounds 2, 3, and 4 seem to be putative intermediates: they metabolize with time just when 3 acetyldeoxynivalenol (3-ADN) and/or sambucinol (SOL) start to be produced. Feeding experiments confirmed these results: compound 1 is not converted to 3-ADN or SOL, and compounds 2-4 are precursors to 3-ADN. In addition 3 is a precursor to SOL. PMID- 3680200 TI - Structure determination and biosynthesis of a novel metabolite of Fusarium culmorum, apotrichodiol. AB - A novel dead-end metabolite of Fusarium culmorum was isolated and characterized (Zamir, L. O., and Devor, K. A. (1987) J. Biol. Chem. 15348-15353). This 3 alpha, 13-dihydroxy-apotrichothec-9-ene is herein given the trivial name of apotrichodiol to indicate its basic structure. The characterization of apotrichodiol was established through the application of spectroscopic techniques (ultraviolet, 1H-NMR, 13C-NMR, COSY, and DEPT experiments) on the natural product as well as on its diacetate derivative. The mode of folding of its precursor farnesyl pyrophosphate was derived from feeding experiments with 3,4 [13C2]mevalonolactone. 13C-NMR assignments were also made of 3 acetyldeoxynivalenol and sambucinol which were derived from these feedings with enriched mevalonolactone. PMID- 3680201 TI - Characterization and purification of the small 28,000-dalton mammalian heat shock protein. AB - We describe the biochemical characterization and purification of the small 28,000 dalton heat shock protein (28-kDa protein) of mammalian cells. Metabolic pulse labeling of heat shock-treated cells with either [3H]leucine or H3 32PO4 and analysis of the labeled proteins by two-dimensional gel electrophoresis revealed increased levels of three 28-kDa proteins differing only in their relative isoelectric point. Using both peptide mapping and immunological analysis, we demonstrate that all three proteins are related isoforms, with two of the isoforms containing phosphate. Cell fractionation studies revealed that the 28 kDa protein localizes predominantly within the nuclear pellet very shortly after the heat shock treatment. With increasing times of recovery of the heat-treated cells back at 37 degrees C, the majority of the 28-kDa protein was now observed to fractionate within the soluble fraction of the cells. Both gel filtration and velocity sedimentation studies revealed that the 28-kDA protein exists as a higher order structure with an approximate S20,w value of 10-18 S, a Stokes radius of about 60-70 A, and an estimated native molecular mass of at least 500,000 daltons. We describe a relatively simple and rapid purification of the proteins employing both ion-exchange and gel filtration chromatography. PMID- 3680202 TI - Comparison of the organization and fine structure of a chicken and a Xenopus laevis vitellogenin gene. AB - The structural organization and the coding nucleotide sequence of the Xenopus laevis A2 and the chicken major vitellogenin genes have been compared. Both genes show the same exon-intron organization. However, the degree of homology between the nucleotide and derived amino acid sequences varies extensively along the genes. Several of the 35 exons are quite similar, and a unique cysteine motif in the lipovitellin II domain is conserved between the two genes. In contrast, one internal region is quite divergent. Part of this region encodes phosvitin, which appears to have evolved rapidly by both point mutations and duplications of serines or short other amino acid stretches. On the basis of these observations, we discuss the possible mechanism of evolution of phosvitin in vertebrates. PMID- 3680203 TI - Compartmentalization of S-adenosylhomocysteine in rat liver. Determination and characterization of the in vivo protein binding. AB - A method for the determination of S-adenosylhomocysteine (AdoHcy), which is associated with proteins in vivo, was developed. This method involves homogenization of tissue or cells in saturated, ice-cold solution of ammonium sulfate containing adenosine and S-adenosylmethionine to suppress unspecific binding of AdoHcy during sample processing. The homogenate was then extensively diluted, filtered, the precipitated protein washed, and AdoHcy extracted with perchloric acid. With this method it could be demonstrated that 30-50% of AdoHcy in rat liver and isolated rat hepatocytes is associated with proteins. Under physiological conditions, the major fraction of protein-bound AdoHcy resides in the microsomal fraction, whereas most free AdoHcy was recovered in the cytosol. The total AdoHcy content in hepatocytes could be markedly elevated by addition of adenosine or methionine. Under both conditions, protein-bound AdoHcy increased 2 fold and then leveled off, whereas free AdoHcy accounts for a further, massive, rise in intracellular AdoHcy. This suggests that AdoHcy is binding to saturable sites in vivo. AdoHcy in hepatocytes was labeled by incubating the cells with L [35S]methionine, and within the first 60 min, free AdoHcy attained a significantly higher specific activity than protein-bound AdoHcy. Furthermore, chase with excess unlabeled methionine or with cycloleucine, revealed a shorter half-life of radioactive sulfur in free AdoHcy than in protein-bound AdoHcy. This shows that protein-bound and free AdoHcy represent kinetically distinct AdoHcy pools. PMID- 3680204 TI - Isolation and sequence of a cDNA clone for rabbit fast skeletal muscle troponin C. Homology with calmodulin and parvalbumin. AB - The binding of Ca2+ to troponin C (TnC) regulates skeletal muscle contraction. We have isolated a full-length cDNA clone for fast skeletal muscle TnC from a neonatal rabbit skeletal muscle library and determined its nucleic acid sequence. The amino acid sequence deduced from this clone matches the previously reported amino acid sequence (Collins, J. H., Greaser, M. L., Potter, J. D., and Horn, M. J. (1977) J. Biol. Chem. 252, 6356-6362) except at the amino terminus. According to the nucleotide sequence, the first 2 residues of TnC are threonine-aspartic acid, which is the reverse of the order reported previously. The isolation of the adult form of TnC from a neonatal library suggests that there may be no developmental isoforms of fast TnC. The protein coding region of the fast TnC clone has 67% homology with the reported nucleotide sequence for chicken slow TnC (Putkey, J. A., Carroll, S. L., and Means, A. R. (1987) Mol. Cell. Biol. 7, 549 1553). The homologies between the nucleotide sequences of TnC, calmodulin, and parvalbumin provide evidence that all three proteins were derived from a common precursor molecule which had four Ca2+-binding sites. PMID- 3680205 TI - Structural and dynamic properties of a fluorouracil-adenine base pair in DNA studied by proton NMR. AB - An oligodeoxynucleotide duplex containing the chemotherapeutic agent 5 fluorouracil (FU) has been constructed by solid phase phosphotriester synthesis and has been studied in solution by proton NMR. In this study, we provide the first structural characterization of a DNA complex containing a FU.A base pair. It has been determined that the 7-mer duplex containing a central FU.A base pair adopts a normal right-handed configuration and the A residue in the FU.A pair is oriented in the normal anticonfiguration giving a Watson-Crick base pair. The significant difference between T.A and FU.A base pairs is dynamic, not structural: the FU.A base pair opens faster than normal base pairs in the oligonucleotide studied. We provide evidence that the FU.A base pair has a significantly enhanced opening rate resulting form decreased stacking of the 5 fluorouracil residue and not from the enhanced acidity of the 5'-fluorouracil imino proton. PMID- 3680206 TI - GTP regeneration influences interactions of microtubules, neurofilaments, and microtubule-associated proteins in vitro. AB - Interactions of microtubules, neurofilaments, and microtubule-associated proteins were investigated by turbidity and falling-ball viscometry measurements. We found evidence of endogenous GTPase activity in neurofilaments and microtubule associated proteins (MAPs) in preparations that do not include urea or heat treatment, respectively. The absence or presence of either adenyl-5'-yl imidodiphosphonic acid or a GTP-regenerating system markedly influenced observed polymerization and gelation characteristics. Most significantly, the apparent viscosity of neurofilament and microtubule samples did not display a biphasic optimal MAP concentration profile when a GTP-regenerating system was operant. Likewise, GTP regeneration promoted the recovery of gelation following mechanical disruption of neurofilament/MAP/microtubule mixtures. These and other observations require some reassessment of proposed roles for microtubule associated proteins in modulating neurofilament-microtubule interactions in vitro. PMID- 3680207 TI - Tubulin sequence region beta 155-174 is involved in binding exchangeable guanosine triphosphate. AB - Assembly-competent microtubule protein was directly photoaffinity labeled with [alpha-32P]guanosine triphosphate by UV irradiation. The labeled tubulin was digested with trypsin. The radioactive fragments were isolated and sequenced, revealing beta-tubulin residues 155-174 to be the major labeled region. An antibody to a synthetic peptide comprising residues beta 154-165 inhibits GTP incorporation and tubulin polymerization. PMID- 3680208 TI - Influence of intermittent compressive force on proteoglycan content in calcifying growth plate cartilage in vitro. AB - We investigated the effect of mechanical stimulation by an intermittent compressive force (ICF) on proteoglycan (PG) synthesis and PG structure in calcified and noncalcified cartilage of fetal mouse long bone rudiments. Uncalcified cartilaginous long bone rudiments were cultured for 5 days in the presence of [35S]sulfate and [3H]glucosamine under control conditions (atmospheric pressure) or under the influence of ICF. ICF was generated by intermittently compressing the gas phase above the culture medium (130 mbar, 0.3 Hz). During culture, the center of the rudiments started to calcify. ICF stimulated calcification such that, after 5 days, the diaphysis of calcified cartilage was about two times as long as in the control cultures. At the end of the experiment, the rudiments were divided in a central calcified diaphysis and two noncalcified epiphyses. Diaphysis and epiphyses were pooled separately. PGs were extracted with 4 M guanidinium chloride and isolated by cesium chloride density gradient centrifugation. PGs (predigested with proteinase K or chondroitinase ABC) were characterized for hydrodynamic size of aggregates, monomers, and chondroitin sulfate chains by gel permeation chromatography and for degree of sulfation by ion exchange chromatography on high pressure liquid chromatography columns. ICF increased the amount of incorporated sulfate per tissue volume unit in the noncalcified epiphyses, but decreased this parameter in the calcified diaphysis. However, in both calcified and noncalcified cartilage, ICF increased the degree of sulfation of the chondroitin sulfate chains. No effects were found on the hydrodynamic size of the PG aggregates or monomers, but in the epiphyses ICF increased the size of the chondroitin sulfate chains. No other changes of structural characteristics of the macromolecules were observed. This study demonstrates that ICF generally stimulated the incorporation of [35S]sulfate into chondroitin sulfate chains. We conclude from the lowered [35S]sulfate content in calcified cartilage that ICF reduced the number of chondroitin sulfate chains and probably PGs while accelerating matrix calcification. It seems likely that the two effects are linked, indicating that a reduction of the number of chondroitin sulfate chains is part of the complicated process of cartilage calcification. PMID- 3680209 TI - Oligopeptide inhibitors of metalloendoprotease activity inhibit catecholamine secretion from bovine adrenal chromaffin cells by modulating intracellular calcium homeostasis. AB - Synthetic oligopeptide inhibitors of metalloendoprotease activity were found to inhibit catecholamine release from intact bovine adrenal chromaffin cells. The efficiency of these compounds in blocking secretion was dependent on the type and dose of the secretagogues employed. By contrast, catecholamine release from digitonin-permeabilized cells stimulated with micromolar calcium was virtually not affected. Using a different model system mimicking protein-mediated membrane fusion during exocytosis (Bental, M., Lelkes, P.I., Scholma, J., Hoekstra, D., and Wilschut, J. (1984) Biochim. Biophys. Acta 774, 296-300) we found that exposure of chromaffin granules to a genuine metalloendoprotease, thermolysin, impaired their fusion competence with liposomes. The same oligopeptide inhibitors of metalloendoprotease activity that interfered with secretion from the intact cells were also found to cause an increase in 45Ca2+ efflux concomitant with a slight elevation of the free intracellular calcium concentration [( Ca2+]i) to levels not sufficient to elicit secretion. Subsequent stimulation of the cells in the presence of the potent inhibitors resulted in a reduced increase in the cytosolic calcium concentration, as compared to nontreated control cells. The reduction in the secretagogue-evoked rise in [Ca2+]i was also dependent on the time of pretreatment of the cells with the metalloendoprotease inhibitors. Consistently, none of these effects were seen with structurally similar oligopeptides that are not metalloendoprotease substrates/inhibitors. We conclude that potent inhibitors of metalloendoprotease activity and hence, presumably, the enzymes per se modulate stimulus-secretion coupling by interfering with calcium homeostasis rather than directly with membrane fusion. PMID- 3680210 TI - Inter- and intramolecular disulfide bond formation and related structural changes in the lens proteins. A Raman spectroscopic study in vivo of lens aging. AB - Raman spectra have been measured for intact rat lens nuclei at various stages of aging in an attempt to gain further insight into age-related structural changes in the lens proteins, especially changes concerning protein sulfhydryl groups. Two Raman bands at 2579 and 2561 cm-1 were observed to be assignable to SH stretching modes of the cysteine residues. These bands have been attributed to "exposed" and "buried" sulfhydryl groups of the lens proteins, respectively, on the basis of a model compound study. The relative intensities of both SH stretching modes decreased with lens aging, and concurrently the intensity of a S S stretching mode at 509 cm-1 due to disulfide bridges increased, suggesting that not only exposed but also buried protein sulfhydryl groups are converted to disulfide groups as a result of aging. The rate of the intensity decrease in the 2561 cm-1 band was similar to that in the 2579 cm-1 band. Therefore, it seems likely that the sulfhydryl groups in the two distinct environments are nearly equally subjected to the oxidation. Cysteine and cystine residues of the lens proteins gave their C-S stretching modes at 708 cm-1, indicating that they predominantly assume PC and/or PN conformers. The intensity ratio of a tyrosine doublet near 840 cm-1 (I832/I855) changed from approximately 0.86 to approximately 0.81 with the aging of the rat lens. This result implies that some tyrosine residues undergo a change in their hydrogen bonding environments during the course of aging. Of particular importance is that the relative intensity change of the tyrosine doublet with normal aging and that with cataract formation are in opposite directions. PMID- 3680211 TI - Topography of the C terminus of cytochrome b5 tightly bound to dimyristoylphosphatidylcholine vesicles. AB - Cytochrome b5 holoenzyme was bound asymmetrically in the tightly bound form to small unilamellar dimyristoylphosphatidylcholine vesicles. [3H]Taurine, a membrane-impermeant nucleophile, was added to the external medium and was then cross-linked to cytochrome carboxyl residues by the addition of a water-soluble carbodiimide. Nonpolar peptide was isolated after trypsin digestion of taurine labeled apocytochrome b5 and contained 1.7-1.9 residues of taurine. The C terminal tetrapeptide containing residues Thr130-Asn133 was generated by chymotryptic hydrolysis of radiolabeled nonpolar peptide and was purified by gel filtration and ion exchange chromatography. Amino acid analysis of the C-terminal tetrapeptide showed that about 1.6 mol of taurine was cross-linked per mol of peptide. When the experiment was performed with taurine trapped inside the vesicles, no cross-linking was observed. The results suggest that when cytochrome b5 holoenzyme is bound to vesicles in the tight binding form, the C terminus is located on the external surface of the vesicles. PMID- 3680212 TI - The impact of delayed fibrinopeptide-A release on fibrin structure. Studies of an abnormal fibrinogen. AB - The impact of delayed fibrinopeptide-A release on polymerization and structure of fibrin gels was studied utilizing a heterozygously transmitted variant fibrinogen. An arginine to histidine substitution at position 16 of the alpha chain of the abnormal fibrinogen delayed release of an abnormal fibrinopeptide-A (A) by thrombin and completely blocked release of A by reptilase. When clotted with thrombin, patient fibrin formed more slowly than normal fibrin, but clottability was normal and gel fiber mass/length ratios were decreased less than 10%. Gels formed with reptilase clotted slowly, demonstrated reduced clottability, but had normal fiber mass/length ratios. Reptilase clotted the normal but not the variant component of the patient fibrinogen. Thrombin-induced cleavage of fibrinopeptide-B prior to A occurred in these experiments, but polymerization of this species beyond trimers has been reported to be minimal under the conditions used. With time, A is removed by thrombin resulting in the slow production of normal fibrin monomer from the abnormal component. These monomers subsequently polymerize. The minimal change in gel fiber size caused by slow A release implies that fibrin fiber size is primarily a function of ionic environment and not of the sequence of peptide release. PMID- 3680213 TI - Monomer-oligomer equilibrium of bacteriorhodopsin in reconstituted proteoliposomes. A freeze-fracture electron microscope study. AB - An improved freeze-fracture electron microscope procedure has been developed and applied to the study of the association of bacteriorhodopsin in large proteoliposomes reconstituted by reverse-phase evaporation with egg lecithin. Due to the improved accuracy and resolution of this procedure, intramembrane particles, the diameter of which (4.5 nm) closely matched that of bacteriorhodopsin monomer, could be observed at high lipid to protein ratios (greater than or equal to 40 w/w). At lower lipid to protein ratios, larger particles (diameter 7.5 nm) progressively appeared, resulting in bimodal particle size distributions up to a lipid to protein ratio of 1, where the large particles were the sole species present. These large particles were interpreted as corresponding to bacteriorhodopsin oligomers. Because of the large size and homogeneity of proteoliposomes, accurate particle density measurements could be performed. These confirmed the occurrence of a lipid to protein ratio-dependent bacteriorhodopsin monomer-oligomer equilibrium and further allowed us to identify the oligomer as a trimer or a tetramer. In complementary experiments, it was found that the bacteriorhodopsin monomer and oligomer had identical visible CD spectra and light-induced proton pumping rates. However, a large increase of the proton passive leak rate of proteoliposomes was found to be associated with oligomer formation. The appearance of these oligomers may be important as the first step in the formation of two-dimensional crystals of bacteriorhodopsin. PMID- 3680214 TI - The role of protein structure in the mitochondrial import pathway. Unfolding of mitochondrially bound precursors is required for membrane translocation. AB - In order to examine the influence of protein structure on the post-translational import of a protein into mitochondria, the carboxyl-terminal 129 residues of F1 ATPase beta-subunit precursor (511aa) have been replaced with 61 residues of yeast copper metallothionein. Import of the F1 beta-copper metallothionein (beta CuMT) hybrid into mitochondria was as efficient as that of the F1 beta precursor in the absence of copper. Addition of copper to mitochondrial import reactions, which had no significant effect on import of the F1 beta-subunit precursor, blocked import of the beta CuMT protein. This copper-dependent transport block for the beta CuMT precursor occurred after the precursor was bound to mitochondria. Expression of the beta CuMT protein in vivo revealed that beta CuMT would bind copper and allow growth of a copper-sensitive yeast host on an otherwise inhibitory level of the cation as long as it was localized in the cytoplasm. These data indicate that the binding of copper by beta CuMT renders it refractile for partial unfolding which is necessary for its translocation into mitochondria. These observations provide an alternative scheme for the selection of mutants defective in mitochondrial import. PMID- 3680215 TI - Glycoprotein synthesis in Drosophila Kc cells. Biosynthesis of dolichol-linked saccharides. AB - The biosynthesis of dolichol and dolichol-linked saccharide intermediates in glycoprotein synthesis was studied in an embryonic Drosophila cell line (Kc) that lacks the squalene-cholesterol branch of the polyisoprenoid biosynthetic pathway. Kc cells were labeled with [5-3H]mevalonic acid and the radioactive lipids formed were analyzed. Although the major labeled product was coenzyme Q, dolichol and a variety of dolichol derivatives could be readily detected. On the basis of their chromatographic and chemical properties, these derivatives were identified as dolichyl phosphate, glucosylphosphoryldolichol, mannosylphosphoryldolichol, and oligosaccharylpyrophosphoryldolichol. Both short term (4-h) and steady state (4 day) labeling experiments with mevalonate, rather than sugars as previously used, were performed to assess the level of these intermediates. The results of these studies, using a precursor common to all the intermediates, reveal that the early intermediates, N-acetylglucosaminylpyrophosphoryldolichol and N,N' diacetylchitobiosylpyrophosphoryldolichol, are present at very low levels (less than 5%) relative to the other intermediates on the pathway to oligosaccharylpyrophosphoryldolichol. The total amount of dolichol intermediates remained essentially constant during the chase phase of pulse-chase experiments, indicating the absence of a major catabolic pathway for the polyisoprenoid backbone. As expected, however, the sugar moiety, studied with mannosylphosphoryldolichol, underwent rapid turnover. These results are discussed in the context of our current understanding of the pathway whereby dolichol derivatives participate in glycoprotein synthesis. PMID- 3680216 TI - Subcellular calcium and magnesium mobilization in rat liver stimulated in vivo with vasopressin and glucagon. AB - The total Ca2+ content of the endoplasmic reticulum and the total Ca2+ and Mg2+ content of mitochondria were determined by electron probe microanalysis of rat liver rapidly frozen in vivo following brief (5-15 s) stimulation with vasopressin or prolonged (10-12 min) stimulation with vasopressin + glucagon. Brief vasopressin injection into the anterior mesenteric vein released 1.8 +/- 0.3 (S.D.) mmol of Ca2+/kg dry weight, from the rough endoplasmic reticulum (p less than 0.01), reducing Ca2+ content of the endoplasmic reticulum from 4.4 +/- 0.2 (S.E.) (controls) to 2.6 +/- 0.2 mmol of Ca2+/kg dry weight. Following vasopressin injection, endoplasmic reticulum Ca2+ was also significantly (p less than 0.025) lower than that in brief sham injected animals (3.5 +/- 0.2 mmol/kg dry weight). Mitochondrial Ca2+ was between 1.0 and 2.3 (+/-0.2) mmol/kg dry weight of mitochondrion, under all conditions studied, and no significant differences were observed. Both hormonal and brief sham injection into the anterior mesenteric vein increased mitochondrial Mg2+ from 42 (+/-0.8) to 49 (+/ 1.8) mmol/kg dry weight (p less than 0.05). Hormonal stimulation of Mg2+ uptake was further confirmed by injection of vasopressin + glucagon into the jugular vein (to avoid any stimulation of the liver by the anterior mesenteric vein injection itself); mitochondrial Mg2+ increased from 43 (+/-0.9) (10-min sham) to 57 (+/-1.3) mmol/kg dry weight, with 10-min vasopressin + glucagon injection (p less than 0.01). These results demonstrate that hormones can release Ca2+ from the endoplasmic reticulum and modulate mitochondrial Mg2+ content in vivo without causing detectable changes in mitochondrial Ca2+. PMID- 3680217 TI - Isolation of the ryanodine receptor from cardiac sarcoplasmic reticulum and identity with the feet structures. AB - Ryanodine, a highly toxic alkaloid, reacts specifically with the Ca2+ release channels which are localized in the terminal cisternae of sarcoplasmic reticulum (SR). In this study, the ryanodine receptor from cardiac SR has been purified, characterized, and compared with that of skeletal muscle SR. The ryanodine receptor was solubilized with 3-[(3-cholamidopropyl)dimethylammonio]-1 propanesulfonate (CHAPS) in the presence of phospholipids. Purification was performed by sequential affinity chromatography followed by gel permeation chromatography in the presence of CHAPS and phospholipids. The enrichment of the receptor from cardiac microsomes was about 110-fold. The purified receptor contained a major polypeptide band of Mr 340,000 with a minor band of Mr 300,000 (absorbance ratio 100/8) on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Electron microscopy of the purified receptor from heart showed square structures of 222 +/- 21 A/side, which is the unique characteristic of feet structures of junctional face membrane of terminal cisternae of SR. Recently, we isolated the ryanodine receptor from skeletal muscle (Inui, M., Saito, A., and Fleischer, S. (1987) J. Biol. Chem. 262, 1740-1747). The ryanodine receptors from heart and skeletal muscle have similar characteristics in terms of protein composition, morphology, chromatographic behavior, and Ca2+, salt, and phospholipid dependence of ryanodine binding. However, there are distinct differences: 1) the Mr of the receptor is slightly larger for skeletal muscle (Mr approximately 360,000); 2) the purified receptor from heart contains two different affinities for ryanodine binding with Kd values in the nanomolar and micromolar ranges, contrasting with that of skeletal muscle SR which shows only the high affinity binding; 3) the affinity of the purified cardiac receptor for ryanodine was 4-5-fold higher than that of skeletal muscle, measured under identical conditions. The greater sensitivity in ryanodine in intact heart can be directly explained by the tighter binding of the ryanodine receptor from heart. The present study suggests that basically similar machinery (the ryanodine receptor and foot structure) is involved in triggering Ca2+ release from cardiac and skeletal muscle SR, albeit there are distinct differences in the sensitivity to ryanodine and other ligands in heart versus skeletal muscle. PMID- 3680218 TI - The gene for mouse epidermal filaggrin precursor. Its partial characterization, expression, and sequence of a repeating filaggrin unit. AB - Filaggrin is an important keratin intermediate filament-associated protein of terminally differentiated mammalian epidermis. Its aberrant expression has been implicated in a number of keratinizing disorders. We have isolated and sequenced a cDNA clone to mouse filaggrin, of 1.479 kilobase pairs, which represents less than 10% of the full-length mRNA estimated by Northern blot analysis to be 17 kilobases long. The cDNA clone delineates a 744-base pair repeat. This encodes a protein of 248 amino acids or 26,330 Da, which is almost identical to the known properties of mouse filaggrin in size, amino acid composition, and charge. Total mouse genomic DNA and the filaggrin gene isolated from a cosmid library were found to contain a super-stoichiometric repeat of the same size. These data support the hypothesis (Haydock, P.V., and Dale, B.A. (1986) J. Biol. Chem. 261, 12520-12525) that filaggrin is initially synthesized as a polyprotein precursor containing many tandem copies. However, our data suggest that the repeating filaggrin units of the precursor are not separated by "large linker" peptides as suggested by these authors. In situ hybridization was used to show that the filaggrin precursor mRNA is located precisely over the granular layer of the epidermis, indicating that expression of this gene is regulated at the transcriptional level as for the differentiation-specific keratin 1 protein. These probes will now permit detailed studies on the regulation of expression of the filaggrin gene. PMID- 3680219 TI - Tubulin, but not microtubules, is the substrate for tubulin:tyrosine ligase in mature avian erythrocytes. AB - Chicken erythrocytes, which contain a marginal band of microtubules, were used to study the influence of the aggregation state of tubulin on the post-translational incorporation of tyrosine into the alpha-tubulin subunit. We found that the incorporation of [14C]tyrosine occurs almost exclusively into the nonassembled tubulin pool. The marginal band was practically not labeled. The low incorporation into microtubules was not due to the lack of tubulin with acceptor capacity since after cold-induced disassembly, an additional amount of [14C]tyrosine could be incorporated. 14C-Tyrosinated tubulin of the nonassembled pool could not be incorporated into microtubules of the marginal band after prolonged incubation at 37 degrees C or when the marginal band was regenerated after cold-induced depolymerization. In erythrocytes, tubulin:tyrosine ligase behaved as a soluble entity when the cells were lysed under microtubule preserving conditions. PMID- 3680220 TI - The interaction of rat liver carbamoyl phosphate synthetase and ornithine transcarbamoylase with inner mitochondrial membranes. AB - The intramitochondrial localization of the urea cycle enzymes, carbamoyl phosphate synthetase and ornithine transcarbamoylase, has been examined by both in vitro and in situ studies. The following three lines of evidence are presented to establish that significant fractions of the rat liver enzymes are loosely associated with the inner mitochondrial membrane: 1) when the mitochondrion is fractionated, the enzymes partition between the matrix and membrane fractions in the absence of detergent and partition solely to the matrix in the presence of detergent; 2) the purified enzymes associate with purified inner membrane preparations; and, 3) protein A-gold electron microscopic immunocytochemical analysis of rat liver sections reveals a nonrandom arrangement of the enzyme, with the maximal enzyme density adjacent to the inner mitochondrial membrane. These findings serve as the basis for novel potential mechanisms for regulation of the activity of the enzymes and provide additional evidence for the extensive organization of the mitochondrial matrix. The membrane interaction might also serve as the organizing factor for a carbamoyl phosphate synthetase-ornithine transcarbamoylase or other multienzyme complex. PMID- 3680221 TI - Adenosine receptor down-regulation and insulin resistance following prolonged incubation of adipocytes with an A1 adenosine receptor agonist. AB - Adenosine, via interaction with A1 adenosine receptors, increases insulin sensitivity and inhibits lipolysis in adipocytes. To investigate regulation of this system, adipocytes were incubated for up to 72 h with the nonmetabolizable adenosine receptor agonist, N6-phenylisopropyl adenosine (PIA). Adenosine receptors were measured by the binding of 125I-hydroxyphenylisopropyl adenosine to membranes. PIA down-regulated adenosine receptors, decreasing the number of binding sites with no change in affinity. Adipocytes were incubated for 48 h without or with 100 nM PIA to down-regulate the A1 receptors by approximately 60%. The cells were washed, and lipolysis and glucose transport were assessed. The ability of PIA to inhibit lipolysis was markedly attenuated in the down regulated cells. Furthermore, the EC50 of insulin was increased approximately 3 fold in the PIA-treated cells. 125I-Insulin binding to the PIA-treated cells was unchanged, demonstrating that the decreased insulin sensitivity is not due to decreased insulin receptor binding. Pertussis toxin catalyzed ADP-ribosylation of a 41-kDa protein thought to be the alpha-subunit of Gi. This 41-kDa protein was decreased in membranes from cells treated with PIA, with a maximal 50% loss. This suggests that Gi is down-regulated and that loss of both the A1 adenosine receptor and Gi are involved in the metabolic changes observed after PIA treatment. PMID- 3680222 TI - The purification and preliminary characterization of UMP synthase from human placenta. AB - Orotate phosphoribosyltransferase (EC 2.4.2.10) and orotidine 5'-monophosphate decarboxylase (EC 4.1.1.23) are the final two of six enzymatic steps required in the de novo biosynthesis of uridine 5'-monophosphate (UMP). Earlier work of this laboratory showed that, in the mouse Ehrlich ascites carcinoma, both of these enzymatic activities were contained on the single multifunctional polypeptide chain, UMP synthase. We report here that the placenta provided an available human source for UMP synthase with 40-fold higher orotate phosphoribosyltransferase and orotidine 5'-monophosphate decarboxylase specific activities than erythrocytes, a human source previously used by others. By using the placenta as a source of UMP synthase and by developing a novel purification procedure different from that used in the purification of UMP synthase from the Ehrlich ascites carcinoma (the only other homogeneous preparation of a mammalian UMP synthase), we achieved the purification of human UMP synthase to apparent homogeneity. This represents the first publication to homogeneity of UMP synthase from a human source as well as from a source other than malignant cell lines. Contrary to earlier reports human placental UMP synthase was found to be a multifunctional protein containing both enzymatic activities on a single polypeptide of 51,000 molecular weight. Preliminary characterization of the human placental UMP synthase showed it to be similar to UMP synthase from the Ehrlich ascites carcinoma in subunit molecular weight, native molecular weight, isozyme pattern (although not absolute pI values), pH optima of enzymatic activities, and kinetic constants for orotidine 5'-monophosphate (Km) and 6-azauridine 5'-monophosphate (Ki) at the decarboxylase site. PMID- 3680223 TI - Purification of and production of an antibody against a 63,000 Mr stimulus sensitive phosphoprotein in Paramecium. AB - In vivo labeling of Paramecium cells with 32Pi most heavily labels a minor 63-kDa protein that undergoes a rapid, Ca2+-dependent dephosphorylation when the cell is stimulated to release. This stimulus-sensitive phosphoprotein was isolated and purified to apparent homogeneity. A polyclonal affinity purified antibody made against the purified protein recognizes both the phosphorylated and dephosphorylated forms of the protein. The phosphorylated 63-kDa protein is found in the cytosolic fraction; it is slightly acidic with two isoelectric forms at pI 5.8 and 6.2 and probably exists as a monomeric 60-65-kDa polypeptide in the native state. The labeled phosphoamino acid of the protein is phosphoserine. The affinity purified antibody recognizes a third isoelectric form at pI 6.3 that appears unlabeled. The specificity of the antibody was confirmed by showing that it immunoprecipitates the correct protein, i.e. the stimulus-sensitive 63-kDa phosphoprotein. The availability of purified 63-kDa protein as well as an antibody against it will now allow molecular, biochemical, and immunocytochemical studies into the role of this protein in the mechanism of exocytosis. PMID- 3680224 TI - Affinity labeling of the sialoglycopeptide antimitogen receptor. AB - An 18-kDa 125I-sialoglycopeptide growth inhibitor was covalently cross-linked to its binding site on intact cultured Swiss 3T3 cells by three bifunctional cross linkers with short (dimethyl adipimate), medium (disuccinimidyl suberate), and long (bis(2-succinimidooxycarbonyloxyethyl)sulfone) chain lengths. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography demonstrated a band of Mr approximately 168,000 regardless of which cross-linker was used. The labeling of this band was specific in that it was prevented by excess unlabeled inhibitor and the apparent molecular weight of the cross-linked receptor-ligand complex was unchanged by treatment with reducing agent. The efficiency of the cross-linking was increased by increasing pH, and the extent of covalent cross-linking was dependent on the concentration of the bifunctional reagent. Octyl glucoside and sodium dodecyl sulfate were effective in solubilizing the receptor while Triton X-100 did not extract the receptor from the plasma membrane. These observations suggest that the 168-kDa binding species represents the 125I-sialoglycopeptide cross-linked to a specific plasma membrane receptor and that the receptor does not appear to contain interchain disulfide bonds. PMID- 3680225 TI - Mutation of a neutral amino acid in the transit peptide of rat mitochondrial malate dehydrogenase abolishes binding and import. AB - We have investigated the function of a leucine residue in the transit peptide of the rat mitochondrial malate dehydrogenase precursor using in vitro mutagenesis. Amino acid replacement of leucine 13 with glutamic acid and asparagine abolished import into mitochondria, while substitutions with proline, histidine, and arginine severely diminished uptake. In contrast, glutamine, tyrosine, valine, and alanine replacement resulted in normal levels of import, suggesting that there is a requirement for an uncharged residue at this position. Mutants involving rearrangements of the native sequence at positions 12-14 were imported as efficiently as the wild-type mitochondrial malate dehydrogenase, indicating that there was not an obligatory order of amino acid residues. However, deletion of leucine 13 resulted in diminished import. Binding studies with isolated mitochondria revealed that several position 13 mutants were deficient in binding to the mitochondrial surface, accounting for the reduced import of these proteins. This impairment could be distinguished from the effects due to decreased positive charge. We conclude that while translocation depends on the net positive charge, binding to the mitochondrial surface is mediated by uncharged residues within the transit peptides of mitochondrial precursor proteins. PMID- 3680226 TI - Electric birefringence study of the solution structure of chymotrypsin-cleaved Acanthamoeba myosin II. AB - After removal of the 66 COOH-terminal amino acids from each of its two heavy chains by chymotrypsin digestion, Acanthamoeba myosin II forms only parallel dimers under conditions in which native myosin II forms bipolar filaments (Kuznicki, J., Cote, G. P., Bowers, B., and Korn, E. D. (1985) J. Biol. Chem. 260, 1967-1972). We have studied the solution structure of the chymotrypsin cleaved myosin II by electric birefringence. Only two species, known to be monomer and parallel dimer from previous studies, were detected. The contribution to the birefringence decay from dimer increased from about 10 to 70% as the KCl concentration was lowered from 100 mM to 0 in 50% glycerol. At all ionic strengths, the monomer had a relaxation time corrected to water at 20 degrees C of 8.2 microseconds, whereas a relaxation time of 10.3 microseconds was expected for monomers with straight rigid rods. This strongly indicates that the myosin rod in solution is bent. On the assumption that there is a single bend 26 nm from the tip of the tail, as suggested by electron microscopy, it was calculated that the average bend angle would be 110 degrees, in solution, if as seems most likely, the average angle between the two globular heads were 180 degrees. The observed relaxation time of the dimer corrected to water at 20 degrees C was 25 microseconds, independent of ionic strength, which, if the motion of the heads were unrestricted, is consistent with a structure for a parallel dimer in which either the two monomer subunits have straight rigid rods and are staggered by about 28 nm or only one is bent and the stagger is 30 nm. As described in the accompanying Appendix, either of these dimers can be assembled into a bipolar filament compatible with the apparent structure of filaments of native myosin II (Pollard, T.D. (1982) J. Cell Biol. 95, 816-825). PMID- 3680227 TI - Expression of the Duchenne's muscular dystrophy gene in cultured muscle cells. AB - A partial cDNA clone for the Duchenne's muscular dystrophy (DMD) locus was used to investigate the expression of this locus in human muscle in vitro. Hybridization to a 14-kilobase RNA transcript was demonstrated in both fetal and mature human skeletal muscle and four lines of human muscle cells in culture. The DMD transcript was not detected in cultured cells outside the muscle lineage. In cultured muscle cells, gene expression was evident only in myotubes both before and after innervation with mouse spinal cord. Primary cultures of human myoblasts did not show the presence of the DMD transcript prior to fusion to form myotubes. An in vitro model is potentially an excellent system in which to investigate factors controlling expression of the DMD gene in normal muscle and how this expression is altered in cultured DMD muscle. PMID- 3680228 TI - Invertebrate vasopressin/oxytocin homologs. Characterization of peptides from Conus geographus and Conus straitus venoms. AB - The vasopressin-oxytocin family of peptides is of very ancient lineage, found in organisms as diverse as hydra and man. Although these peptides have been intensively studied in vertebrates, the presumably more extensive invertebrate series was defined primarily by immunological methods. In this report, we describe the purification and structures of two peptides of the vasopressin oxytocin family from molluscs ("Conopressins"), which were found in the venom of fish-hunting marine snails of the genus Conus. The biological activity observed when the two snail peptides are injected intracerebrally into mice is very similar to that elicited by the vertebrate neurohypophyseal hormones and presumably reflects their actions upon a common receptor in the brain. The sequences of the purified peptides reveal unique features not found in the vertebrate peptide series, most notably an additional positive charge. These are the first members of the invertebrate series of the vasopressin-oxytocin family to be characterized biochemically. The sequences of these peptides are: from Conus geographus venom, Lys-conopressin-G, Cys-Phe-Ile-Arg-Asn-Cys-Pro-Lys-Gly NH2; and from Conus striatus venom, Arg-conopressin-S, Cys-Ile-Ile-Arg-Asn-Cys Pro-Arg-Gly-NH2. PMID- 3680230 TI - Intracellular accumulation of potent amiloride analogues by human neutrophils. AB - The mechanism of uptake of a series of amiloride derivatives by human neutrophils was investigated using [14C]amiloride and the 14C-labeled 5-(1-hexahydroazepinyl) 6-bromo analogue (BrMM) which is approximately 500-fold more potent than the parent compound at inhibiting Na+/H+ exchange. At an external concentration of 2 microM, the influx of BrMM at 37 degrees C was rapid, reaching a steady state by approximately 20 min. The rate of BrMM uptake (approximately 25 mumol/liter.min) was approximately 90-fold faster than for the same concentration of amiloride, a finding which correlates with differences in lipid partitioning of the two compounds. Uptake was unrelated to specific binding to Na+/H+ exchange transport sites: influx of either drug was nonsaturable whereas amiloride- and BrMM mediated inhibition of Na+/H+ countertransport obeyed Michaelis-Menten kinetics with apparent Ki values of approximately 75 and approximately 0.2 microM. Entry occurred exclusively via the neutral (uncharged) forms (pK'a 8.40-8.55). Influx was markedly pH-dependent: it was enhanced by extracellular alkalinization and reduced by acidification. Influx was, however, insensitive to large changes in membrane voltage, thereby implying the protonated (charged) species to be impermeant. About 75% of the total intracellular pool of amiloride, but only approximately 25% of BrMM, is contained within the lysosomes, an expected consequence of the partitioning and subsequent trapping of a weak base within this strongly acidic subcellular compartment. With BrMM, there was a relative approximately 60-fold enrichment in the internal/external water concentration ratio of the drug; the value for amiloride was much less, approximately 4. This disparity is consistent with substantial binding of BrMM to internal constituents, presumably to proteins and/or nucleic acids. Thus, it is important to recognize that potentially large intracellular accumulations of potent analogues can occur that are not directly involved in inhibition of Na+/H+ exchange. These findings sound a cautionary note in the interpretation of results using these drugs in all cells, especially those of small size with high surface to-volume ratios. PMID- 3680229 TI - Small-angle x-ray scattering study of insect lipophorin. AB - The structure of lipophorin in insect blood (hemolymph) was investigated by a small-angle x-ray scattering method over the temperature range 0-45 degrees C. The small-angle x-ray scattering profile of lipophorin exhibited a symmetrical sphere with heterogeneous internal electron density. Cockroach and locust lipophorins, which contain hydrocarbons, demonstrated centrosymmetrical distribution of electron density inside the particles. A previous study suggested that the hydrocarbon-rich region is located in the core of lipophorin particle (Katagiri, C., Kimura, J., and Murase, N. (1985) J. Biol. Chem. 260, 13490 13495). Distance distribution functions, P (r), calculated for a simulated three layer model (electron-rich shell, middle layer, and electron-deficient core) with radial electron density distribution, show good agreement with those observed experimentally for cockroach and locust lipophorins. The dimensions and electron density obtained for the middle layer reveal that this layer is occupied mainly by diacylglycerol and apolipophorin II. Thus, the present study together with previous reports strongly suggest that insect lipophorin is composed of centrosymmetrical three layers; an outer shell with apolipophorin I and phospholipid, a middle layer with diacylglycerol and apolipophorin II, and a core with hydrocarbons. PMID- 3680231 TI - The effect of 2,3-diphosphoglycerate on the tetramer-dimer equilibrium of carbon monoxide hemoglobin in dilute solution. Correlation between sedimentation and kinetic behavior. AB - The effect of 2,3-diphospho-D-glycerate on the sedimentation coefficient of carbon monoxide hemoglobin was correlated with the fraction of rapidly reacting hemoglobin observed subsequent to flash photolysis at 23 degrees C at pH 7.30 in buffers of 0.1 M ionic strength. Concentrations of the organic phosphate up to about 5 mM resulted in an increase in S20,w, consistent with an increase in the fraction of tetrameric hemoglobin. A decrease in rapidly reacting hemoglobin parallelled the increase in the sedimentation coefficient. Between 5 and 20 mM 2,3-diphosphoglycerate, S20,w decreased, suggesting that dissociation to dimers was enhanced. An increase in rapidly reacting hemoglobin was also observed in this concentration range. Similar sedimentation results were obtained with oxyhemoglobin at pH 7.00 and carbon monoxide hemoglobin at pH 7.06. Assuming single binding sites on each species, the dissociation constants for 2,3 diphosphoglycerate binding to tetrameric and dimeric HbCO are 0.2-0.3 mM and 2-5 mM at pH 7.30. This biphasic effect of this physiologically important organic phosphate on the state of aggregation of R state hemoglobin has not been previously reported, but it is similar to that previously noted with inositol hexaphosphate, which enhanced tetramer formation at low concentrations, while at higher concentrations it promoted hemoglobin dissociation to dimers (White, S. L. (1976) J. Biol. Chem. 251, 4763-4769; Gray, R. D. (1980) J. Biol. Chem. 255, 1812 1818). PMID- 3680233 TI - 1,25-Dihydroxyvitamin D3 modulates bone marrow macrophage precursor proliferation and differentiation. Up-regulation of the mannose receptor. AB - 1,25-Dihydroxyvitamin D3 (1,25-(OH)2D3), the biologically active form of vitamin D3, has been shown to inhibit proliferation and promote monocytic differentiation of leukemic cell lines. In the present communication, we extend these observations to normal bone marrow macrophage precursors, and 1) identify the stage of monocytic maturation wherein the steroid exerts its antiproliferative effect, and 2) demonstrate that 1,25-(OH)2D3 promotes bone marrow macrophage differentiation as manifest by specific up-regulation of the lineage-specific membrane protein, the mannose-fucose receptor. In these experiments, the 1,25 (OH)2D3-mediated inhibitory effect on colony formation was shown to be independent of attendant levels of colony stimulating factor-1 and targeted through the adherent bone marrow macrophage precursor. Examination of this steroid-sensitive adherent precursor population demonstrates that its specific binding of 125I-mannose bovine serum albumin spontaneously and progressively increases with time in culture. Whereas adherent bone marrow macrophages cultured for 2 days express 3 X 10(4) mannose receptors/cell, the number of binding sites increases to 7 X 10(4)/cell by day 4. When bone marrow macrophage precursors are exposed to 1,25-(OH)2D3, an additional stepwise enhancement of 125I-mannose bovine serum albumin obtains with time. Four days of culture with the steroid results in 1.6 X 10(5) mannose receptors/cell, a 100% increase as compared to control cells. Neither duration of culture nor exposure to 1,25-(OH)2D3 alters the KD of 125I-mannose bovine serum albumin which approximates 3-5 X 10(-9) ml-1. Finally, the "specificity" of vitamin D-mediated up-regulation of the mannose receptor was established by demonstrating that the steroid does not alter binding of 125I-alpha-thrombin by bone marrow-derived macrophage precursors. PMID- 3680234 TI - The refined crystal structure of a fully active semisynthetic ribonuclease at 1.8 A resolution. AB - A fully active, semisynthetic analog of bovine ribonuclease A, comprised of residues 1-118 of the molecule in a noncovalent complex with the synthetic peptide analog of residues 111-124, has been crystallized in space group P3(2)21 from a solution of 1.3 M ammonium sulfate and 3.0 M cesium chloride at pH 5.2. The crystallographic structure was determined by rotation and translation searches utilizing the coordinates for ribonuclease A reported by Wlodawer and Sjolin (Wlodawer, A., and Sjolin, L. (1983) Biochemistry 22, 2720-2728) and has been refined at 1.8-A resolution to an agreement factor of 0.204. Most of the structure of the semisynthetic enzyme closely resembles that found in ribonuclease A with the synthetic peptide replacing the C-terminal elements of the naturally occurring enzyme. No redundant structure is seen; residues 114-118 of the larger chain and residues 111-113 of the peptide do not appear in our map. The positions of those residues at or near the active site are very similar to, if not identical with, those previously reported by others, except for histidine 119, which occupies predominantly the B position seen as a minor site by Borkakoti et al. (Borkakoti, N., Moss, D. S., and Palmer, R. A. (1982) Acta Crystallogr. Sect. B Struct. Crystallogr. Cryst. Chem. 38,2210-2217) and not at all by Wlodawer and Sjolin (1983). PMID- 3680232 TI - NADH diferric transferrin reductase in liver plasma membrane. AB - Evidence is presented that rat liver plasma membranes contain a distinct NADH diferric transferrin reductase. Three different assay procedures for demonstration of the activity are described. The enzyme activity is highest in isolated plasma membrane, and activity in other internal membranes is one-eighth or less than in plasma membrane. The activity is inhibited by apotransferrin and antitransferrin antibodies. Trypsin treatment of the membranes leads to rapid loss of the transferrin reductase activity as compared with NADH ferricyanide reductase activity. Erythrocyte plasma membranes, which lack transferrin receptors, show no diferric transferrin reductase activity, although NADH ferricyanide reductase is present. The transferrin reductase is inhibited by agents that inhibit diferric transferrin reduction by intact cells and is activated by CHAPS (3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfate) detergent. Inhibitors of mitochondrial electron transport have no effect on the activity. We propose that the NADH diferric transferrin reductase in plasma membranes measures the activity of the enzyme that causes the reduction of diferric transferrin by intact cells. This transmembrane electron transport system requires the transferrin receptor for diferric transferrin reduction. Because the transmembrane electron transport has been shown to stimulate cell growth, the reduction of diferric transferrin at the cell surface may be an important function for diferric transferrin in stimulation of cell growth, in addition to its role in iron transport. PMID- 3680235 TI - Inhibition of rabbit reticulocyte lysate protein synthesis by heavy metal ions involves the phosphorylation of the alpha-subunit of the eukaryotic initiation factor 2. AB - The effect of heavy metal ions (in particular Cd2+, Hg2+, and Pb2+) on protein synthesis in hemin-supplemented reticulocyte lysates was investigated. Heavy metal ions were found to inhibit protein synthesis in hemin-supplemented lysates with biphasic kinetics. The shut off of protein synthesis occurred in conjunction with the phosphorylation of the alpha-subunit of the eukaryotic initiation factor (eIF) 2, the loss of reversing factor (RF) activity, and the disaggregation of polyribosomes. Addition of eIF-2 or RF to heavy metal ion-inhibited lysates restored protein synthesis to levels observed in hemin-supplemented controls. The stimulation of protein synthesis observed upon the addition of cAMP to heavy metal ion-inhibited lysates correlated with the inhibition of eIF-2 alpha phosphorylation and the restoration of RF activity. The partial restoration of protein synthesis observed upon the addition of MgGTP to heavy metal ion inhibited lysates correlated with a partial inhibition of eIF-2 alpha phosphorylation. Addition of glucose 6-phosphate was found to have no effect on protein synthesis of eIF-2 alpha phosphorylation under these conditions. Antiserum raised to the reticulocyte heme-regulated eIF-2 alpha kinase inhibited the phosphorylation of eIF-2 alpha catalyzed by Hg2+-inhibited lysate. The inhibition of protein synthesis observed in the presence of heavy metal ions correlated with the relative biological toxicity of the ions. Highly toxic ions (AsO-2, Cd2+, Hg2+, Pb2+) inhibited protein synthesis by 50% at concentrations of 2.5-10 microM. Cu2+, Fe3+, and Zn2+, which are moderately to slightly toxic ions, inhibited protein synthesis by 50% at concentrations of 40, 250, and 300 microM, respectively. The data presented here indicate that heavy metal ions inhibit protein chain initiation in hemin-supplemented lysates by stimulating the phosphorylation of eIF-2 alpha apparently through the activation of the heme regulated eIF-2 alpha kinase rather than through inhibition of the rate of eIF-2 alpha dephosphorylation. PMID- 3680236 TI - The control of the urokinase-catalyzed activation of human glutamic acid 1 plasminogen by positive and negative effectors. AB - The urokinase-catalyzed activation of human Glu1-plasminogen (Glu1Pg) has been found to be inhibited by monovalent anions in the following order of effectiveness: I- greater than SCN- greater than Cl- greater than IO3- greater than HCOO- greater than F- greater than OAc-. The inhibition is reversed by epsilon-aminocaproic acid, with its effectiveness in this capacity generally inversely proportional to the strength of the binding of the anion. The physical basis for the anion inhibition and epsilon-aminocaproic acid stimulation lies in the ability of these effectors to cause measurable opposite alterations in the conformation of Glu1Pg, which are revealed through study of the sedimentation velocity of the protein under various conditions. The kinetic mechanism of the chloride inhibition of Glu1Pg activation has been examined in detail. It has been found that the Glu1Pg.Cl complex serves as an alternate substrate to Glu1Pg for urokinase, with a greatly increased Km (25 +/- 3 and 2.2 +/- 0.3 microM, respectively) for activation. The kcat for the urokinase.Glu1Pg.Cl complex is approximately the same as that for urokinase.Glu1Pg (1.6 +/- 0.2 - 2.0 +/- 0.2/s). Similarly, the stimulation by epsilon-aminocaproic acid also results from effects on the Km of the activation, which is reduced to 1.8 +/- 0.2 microM for the Glu1Pg.Cl.epsilon-aminocaproic acid complex. The kcat for the urokinase.Glu1Pg.Cl.epsilon-aminocaproic acid of 2.4 +/- 0.3/s complex is not greatly different from that for urokinase.Glu1Pg.Cl. Nuclear magnetic resonance studies of the Glu1Pg-induced line broadening of the 35Cl- spectra in the presence and absence of epsilon-aminocaproic acid suggest that Cl- and epsilon aminocaproic acid simultaneously bind to the protein and that each of these effectors displays its effects through separate binding sites. PMID- 3680237 TI - Characterization of pyridoxal 5'-phosphate affinity labeling of band 3 protein. Evidence for allosterically interacting transport inhibitory subdomains. AB - Pyridoxal 5'-phosphate (PLP) is a substrate of band 3, the erythrocyte anion transport protein. It competitively inhibits anion transport and labels two exofacial chymotryptic domains (the 17-kDa (CH17) and the 35-kDa (CH35) integral fragments). Two mol of PLP are bound/mol of each fragment at saturation. PLP labeling of both domains is competitive with chloride at constant ionic strength. Addition of DNDS (4,4'-dinitrostilbene-2,2'-disulfonate), protects PLP labeling of CH35 but exposes new, nonoverlapping sites on CH17.4,4'-Diisothiocyanostilbene 2,2'-disulfonate reduces PLP labeling to both domains with time, while NAP taurine (N(-4-azido-2-nitrophenyl)2-aminosulfonate) has no effect on either domain. At low chloride (balance citrate) and high DNDS, we can strongly suppress CH35 labeling and selectively titrate CH17 with PLP. Correlation of fractional transport inhibition with fractional PLP covalent coverage of CH17, quantitatively follows the 1:2 correlation line indicating that full coverage of CH17 sites (which constitute half of the total PLP-labeling sites on band 3) exactly inhibits one-half of transport. PLP labeling of CH35 sites accounts for the other half of inhibition. The inhibition-labeling correlation plots are nonlinear in the absence of DNDS, indicating the presence of allosteric interactions between the domains. We conclude that CH17 and CH35 compose nonoverlapping, functionally equivalent, allosterically linked transport inhibitory subdomains on band 3. PMID- 3680238 TI - Alterations in pyridoxal 5'-phosphate inhibition of human erythrocyte anion transport associated with osmotic hemolysis and resealing. AB - When pyridoxal 5'-phosphate (PLP) is covalently bound to band 3 protein in intact red blood cells and those cells are subjected to the osmotic hemolysis and resealing process, a significant reduction in the original PLP anion transport inhibitory potency occurs. We show that partial deinhibition is not due to the development of a second anion transport pathway in resealed ghosts. Rather, partial deinhibition arises from a hemolysis-induced conformational change in CH17 (17-kDa integral chymotryptic domain of band 3). This change causes the extracellular exposure of new transport inhibitory sites. Exposure of the new sites leads to a 2-fold increase in PLP labeling of CH17 in resealed ghosts compared with CH17 in intact red cells. The hemolysis and resealing process has no effect on the labeling of CH35 (35-kDa integral chymotryptic fragment of band 3). Double-labeling studies show restoration of transport inhibitory potency to near red cell levels when the newly exposed CH17 sites are labeled with PLP in resealed ghosts. The results support the view that CH17 contains PLP transport inhibitory sites. They show that a major conformational change occurs in band 3 with hemolysis. PMID- 3680239 TI - Reconstitution of the malate/aspartate shuttle from mitochondria. AB - The isolated aspartate/glutamate carrier and oxoglutarate carrier from mitochondria were coreconstituted into phospholipid vesicles. Reconstitution of the functionally active carrier proteins with high protein/lipid ratios was achieved by detergent removal on hydrophobic ion-exchange columns. A simplified version of the mitochondrial malate/aspartate shuttle was constructed by inclusion of glutamate-oxaloacetate transaminase and the substrates aspartate and oxaloacetate within the interior of the liposomes. Addition of external glutamate led to internal production of oxoglutarate which could be exchanged against externally added labeled malate. The reconstitution procedure was characterized with respect to the optimum ratio of reconstituted carrier proteins, the lipid concentration, and the concentration of internal substrates. PMID- 3680240 TI - A GDP-fucose:[Gal beta 1----4]GlcNAc alpha 1----3-fucosyltransferase activity is correlated with the presence of human chromosome 11 and the expression of the Lex, Ley, and sialyl-Lex antigens in human-mouse cell hybrids. AB - By fusion of human leukocytes and cells of the murine myeloid cell line WEHI-TG, we produced human-mouse myeloid cell hybrids. Hybrids which contain human chromosome 11 have been demonstrated to express the myeloid-associated carbohydrate antigen Lex (Geurts van Kessel, A. H. M., Tetteroo, P. A. T., Von dem Borne, A. E. G. Kr., Hagemeijer, A., and Bootsma, D. (1983) Proc. Natl. Acad. Sci. U. S. A. 80, 3748-3752). In this paper, we report that the hybrids that contain chromosome 11 also expressed the Lex-related antigens Ley and sialyl-Lex. Glycosyltransferase activities were measured in a panel of six such hybrid cell lines, and the correlation to antigen expression and to the presence of human chromosomes was investigated. GDP-fucose:[Gal beta 1----4]GlcNAc alpha 1----3 fucosyltransferase activity in the hybrids tested correlated with the expression of Lex, Ley, and sialyl-Lex and with the occurrence of chromosome 11. No such correlation was found for several other glycosyltransferases involved in the synthesis of these antigens. These findings suggest that the gene for alpha 3 fucosyltransferase is located on chromosome 11 and that it is through the activity of this enzyme that the expression of Lex, Ley, and sialyl-Lex in human myeloid cells is regulated. PMID- 3680241 TI - Enzyme termini of a phosphocreatine shuttle. Purification and characterization of two creatine kinase isozymes from sea urchin sperm. AB - Two isozymes of creatine kinase have been purified from sperm of the sea urchin, Strongylocentrotus purpuratus. One isozyme was purified from the sperm flagellum, and the other from the head. Both require nonionic detergent for extraction from sperm. The flagellar isozyme is a monomeric species with an Mr of 145,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and 126,000 from sucrose density gradient and gel filtration analyses. Creatine kinase from sperm heads was localized to the mitochondrion by an antibody raised against mouse muscle creatine kinase. This purified mitochondrial isozyme is multimeric, with an Mr of 47,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, but 240,000 for the native enzyme. Peptide mapping indicates that the two isozymes are not related. The following kinetic characteristics were observed for the purified flagellar and mitochondrial isozymes, respectively. In the direction of ATP formation, at pH 6.6 and 25 degrees C, specific activities were 235 and 180 units/mg; pH optima were 6.7 and 6.9 and Michaelis constants were 0.13 and 0.055 mM for ADP and 5.8 and 2.7 mM for phosphocreatine. In the direction of phosphocreatine formation, at pH 7.5 and 25 degrees C, specific activities were 29 and 47 units/mg; pH optima were 7.5 and 7.7 and Michaelis constants were 0.89 and 0.31 mM for ATP and 39 and 62 mM for creatine. These unique isozymes constitute the termini of the phosphocreatine shuttle of sea urchin sperm that is responsible for energy transport from the mitochondrion to the distal flagellum (Tombes, R. M., and Shapiro, B. M. (1985) Cell 41, 325-334; Tombes, R. M., Brokaw, C. J., and Shapiro, B. M. (1987) Biophys. J., 52, 75-86). PMID- 3680242 TI - The crystal structure of ribonuclease B at 2.5-A resolution. AB - The glycosylated form of bovine pancreatic ribonuclease, RNase B, was crystallized from polyethylene glycol 4000 at low ionic strength in space group C2 with unit cell dimensions of a = 101.81 A, b = 33.36 A, c = 73.60 A, and beta = 90.4 degrees. The crystals, which contained two independent molecules of RNase B as the asymmetric unit, were solved by a combination of multiple isomorphous replacement and molecular replacement approaches. The structures of the two molecules were refined to 2.5-A resolution and a conventional R factor of 0.22 using a constrained-restrained least squares procedure (CORELS). Complexes were also investigated of RNase B plus ruthenium pentaamine and between RNase B and a substrate analogue iodouridine. The polypeptide backbones of the two molecules of RNase B in the asymmetric unit were found to be statistically identical and their differences from RNase A to be statistically insignificant. The carbohydrate chains of both molecules extended into solvent cavities in the crystal lattice and appear to be disordered for the most part. The oligosaccharides appear to exert no influence on the structure of the protein. Iodouridine was observed to bind identically in the pyrimidine site of both RNase B molecules and in a way apparently the same as that previously observed for RNase A. Ruthenium pentaamine bound at histidine 105 of both RNase B molecules in the asymmetric unit, but at a number of secondary sites as well. An array of bound ions was observed by Fo-Fc difference Fourier syntheses. These ions were proximal to lysine and arginine residues at the surface of the proteins while a pair of strong ion binding sites were seen to fall exactly in the active site clefts of both RNase B molecules in the asymmetric unit. PMID- 3680243 TI - Purification and characterization of chicken ovalbumin upstream promoter transcription factor from HeLa cells. AB - A transcription factor which binds to the chicken ovalbumin upstream promoter (COUP) sequence spanning between -70 and -90 is required for efficient transcription of the ovalbumin gene. This COUP transcription factor has been purified approximately 200,000-fold by a combination of conventional column and sequence-specific DNA affinity column chromatography. A few polypeptides were identified in the purified preparation on sodium dodecyl sulfate gel. Upon renaturation, all the major polypeptides in the molecular size range between 43 and 53 kDa bound specifically to the COUP sequence. Furthermore, at least one of the renatured polypeptides in the region of 43-45 kDa retained transcriptional activity. The binding of the COUP transcription factor to the ovalbumin promoter cannot be competed by DNA fragments which contain the CCAAT box promoter sequence. Since the COUP and CCAAT binding proteins can be separated on an S300 column, they are distinct molecules. Using band-shifting assays and 3' and 5' deletion mutants and oligonucleotide mutants, the sequence important for binding was mapped. PMID- 3680244 TI - Effects of deletion of the cytoplasmic domain upon surface expression and membrane stability of a viral envelope glycoprotein. AB - The envelope protein (gp52) of Friend spleen focus-forming virus (F-SFFV) is defective in its intracellular transport and accumulates in the rough endoplasmic reticulum of F-SFFV-infected cells. This defect in transport has been attributed to the lack of a cytoplasmic domain, and possible loss of signals required for transport to the cell surface. The mature form of gp52, designated gp65, is also reported to be secreted from SFFV-infected cells. To determine the specific changes in the envelope protein which may lead to its lack of transport and to its lack of stability in associating with membranes, the 3' end of the F-SFFV envelope gene, which encodes the transmembrane domain, was inserted in place of the normal 3' end of the Friend murine leukemia virus genome. This chimeric envelope gene was expressed using the vaccinia virus expression system. The chimeric gp70/p15E glycoprotein molecule lacks the cytoplasmic tail residues and as a consequence is about 3300 daltons smaller. The chimeric PrEnv molecule was found to be cleaved efficiently as indicated by pulse-chase experiments. Immunofluorescence studies demonstrate that the chimeric molecule is efficiently transported to the surface of cells, unlike the SFFV gp52 glycoprotein. The chimeric molecule was found to be unstable in its membrane association and is released into the culture medium. These results indicate that the changes in the membrane spanning region and the lack of a cytoplasmic tail do not determine the defective transport of gp52, but may determine the stability of its association with membranes. PMID- 3680245 TI - Self-association of the low density lipoprotein receptor mediated by the cytoplasmic domain. AB - When the low density lipoprotein (LDL) receptor was solubilized from bovine adrenal cortex membranes and subjected to electrophoresis in the absence of reducing agents, a disulfide-bonded dimeric species was demonstrated. Formation of these covalent bonds was blocked when the tissue was homogenized in the presence of sulfhydryl alkylating agents, indicating that the native receptor was self-associated noncovalently and that the disulfide bond formation occurred only after homogenization. The disulfide-linked dimers were disrupted and the receptor was restored to a monomeric form when inside-out adrenal vesicles were treated with trypsin, suggesting that the disulfide bond formation involved the 50-amino acid cytoplasmic domain of the receptor. When the receptor was solubilized from bovine adrenal cortex membranes and then purified by ion exchange and affinity chromatography, it could be covalently coupled into dimers and trimers in the presence of bivalent cross-linking agents. Receptor dimers could also be demonstrated by chemical cross-linking of intact cells that were transfected with an expressible cDNA encoding the normal human LDL receptor. Dimer formation was markedly reduced in transfected cells expressing mutated cDNAs that had premature termination codons at positions 792, 807, and 812, which produced shortened receptors that retained 2, 17, and 22 of the original 50 amino acids of the cytoplasmic domain, respectively. The first two mutant receptors, which did not form oligomers, did not enter coated pits and were not rapidly internalized by cells. However, the mutant receptor that terminates at position 812 was internalized normally even though oligomer formation was greatly reduced. Moreover, a mutant receptor with a cysteine substituted for a tyrosine at position 807, which internalized very slowly, showed a normal susceptibility to chemical cross-linking. Deletion of external domains of the LDL receptor, including the epidermal growth factor homology region and the O-linked sugar domain, did not alter susceptibility to chemical cross-linking. We conclude that the cytoplasmic domain of the LDL receptor is responsible both for self association into oligomers and for clustering in coated pits, but the available data do not establish a causal connection between these two events. PMID- 3680246 TI - Cyclosporin A inhibits rDNA transcription in lymphosarcoma P1798 cells. AB - Effects of cyclosporin A (CsA) on rRNA synthesis in vivo and in vitro were studied using lymphosarcoma P1798 in culture. Pulse labeling with [3H]uridine indicated that treatment of P1798 cells with 1 microgram/ml of CsA for 24-h reduced rRNA levels by 50-60%, whereas rRNA levels of cells rescued from CsA and grown for 24 h were similar to those of controls. Transcription experiments using nuclei from control, treated, and rescued cells indicated that the reduction in rRNA synthesis in treated cells was due to reversible inhibition of transcription of rDNA. Transcription studies in vitro indicated that S100 extracts from CsA treated cells were unable to carry out faithful transcription of cloned mouse rDNA, even though RNA polymerase I levels of control and treated cell extracts were similar. Mixing experiments indicated that the inability of the CsA-treated cell extract to transcribe cloned rDNA in vitro was not due to the presence of inhibitor(s) or nuclease(s) in such extracts. Supplementation of CsA-treated cell extract with partially or highly purified preparations of a transcription initiation factor for RNA polymerase I, obtained from control cell extracts, conferred transcriptional ability on the CsA-treated cell extract. Extracts from cells treated with cyclosporin H, an inactive analogue of CsA, faithfully transcribed rDNA, indicating the specificity of CsA action. These data indicate that CsA-treated cells lack the ability to initiate rDNA transcription in vivo and in vitro, due to specific, reversible reduction in the amount or activity of transcription factor IC. Significance of these results in understanding the mechanisms of the lymphostatic activity of CsA is discussed. PMID- 3680247 TI - Trigramin. A low molecular weight peptide inhibiting fibrinogen interaction with platelet receptors expressed on glycoprotein IIb-IIIa complex. AB - Trigramin, a highly specific inhibitor of fibrinogen binding to platelet receptors, was purified to homogeneity from Trimeresurus gramineus snake venom. Trigramin is a single chain (approximately 9 kDa) cysteine-rich peptide with the Glu-Ala-Gly-Glu-Asp-Cys-Asp-Cys-Gly-Ser-Pro-Ala NH2-terminal sequence. Chymotryptic fragmentation showed the Arg-Gly-Asp sequence in trigramin. Trigramin inhibited fibrinogen-induced aggregation of platelets stimulated by ADP (IC50 = 1.3 X 10(-7)M) and aggregation of chymotrypsin-treated platelets. It did not affect the platelet secretion. Trigramin was a competitive inhibitor of the 125I-fibrinogen binding to ADP-stimulated platelets (Ki = 2 X 10(-8) M). 125I Trigramin bound to resting platelets (Kd = 1.7 X 10(-7) M; n = 16,500), to ADP stimulated platelets (Kd = 2.1 X 10(-8) M; n = 17,600), and to chymotrypsin treated platelets (Kd = 8.8 X 10(-8) M; n = 13,800) in a saturable manner. The number of 125I-trigramin binding sites on thrombasthenic platelets amounted to 2.7-5.4% of control values obtained for normal platelets and correlated with the reduced number of GPIIb-GPIIIa molecules on the platelet surface. EDTA, monoclonal antibodies directed against the GPIIb-GPIIIa complex, and synthetic peptides (Arg-Gly-Asp-Ser and Tyr-Gly-Gln-Gln-His-His-Leu-Gly-Gly-Ala-Lys-Gln-Ala Gly-Asp-Val) blocked both 125I-fibrinogen binding and 125I-trigramin binding to platelets. Fibrinogen binding was more readily inhibited by these compounds than was trigramin binding. Monoclonal antibodies directed either against GPIIb or GPIIIa molecules did not block the interaction of either ligand with platelets. Reduced, S-pyridylethyl, trigramin did not inhibit platelet aggregation and fibrinogen binding to platelets and it did not bind to platelets, suggesting that the secondary structure of this molecule is critical for expression of its biological activity. PMID- 3680248 TI - Characterization of the promoter region of the human insulin receptor gene. Evidence for promoter activity. AB - Recombinant clones containing the promoter region of the human insulin receptor gene were isolated from genomic libraries derived from nondiabetic persons. A 1.5 kilobase pair fragment of the 5'-flanking region was sequenced. One transcriptional start site, located at 203 bases upstream from the start of translation was identified by nuclease S1 mapping and the primer extension experiment using the human insulin receptor mRNA. The bacterial chloramphenicol acetyltransferase assay revealed that a 573-base pair fragment immediately preceding the ATG has promoter activity and that the transcript initiates from the normal start site of the insulin receptor gene in the COS cells. The promoter region contains neither a "TATA box" nor a "CAAT box," has an extremely high G + C content, and contains seven central components of potential Sp 1 binding sites (GGGCGG or CCGCCC). These features are common to those found in the regulatory regions of a class of constitutively expressed "housekeeping" genes. A comparison between the promoter sequence of the human insulin receptor and those of other "housekeeping" genes revealed the presence of homologous sequences among these genes, in addition to the potential Sp 1 binding sites. PMID- 3680249 TI - Evidence of discontinuous transcription in the trypanosomatid Crithidia fasciculata. AB - In an effort to exploit the advantages of Crithidia fasciculata for detailed analysis of the mechanisms of discontinuous transcription in the trypanosomatid family, we have cloned, sequenced, and characterized the mini-exon gene repeat in Crithidia and mapped the termini of its primary transcript. We find that Crithidia contains approximately 500 mini-exon genes, present almost exclusively as tandemly repeated arrays on a single chromosome. Transcripts derived from these genes are approximately 90 bases in length with heterogeneity at both the 5' and 3' ends. Primer extension experiments reveal a putative splicing intermediate. Specific inhibition of in vitro translation of Crithidia mRNAs by an oligonucleotide complementary to the mini-exon suggests that all Crithidia mRNAs contain the mini-exon at their 5' termini. Comparison of mini-exon gene sequences from various trypanosomatids reveals several regions of conservation that imply functional constraints on the transcription of mini-exon genes and the processing of their transcripts. PMID- 3680250 TI - Characterization of antigen 117. A developmentally regulated cell surface glycoprotein of Dictyostelium discoideum. AB - Antigen 117 is involved in the process of intercellular cohesion in Dictyostelium discoideum (Brodie, C., Klein, C., and Swierkosz, J. Cell 32, 1115-1123 (1983]. The antigen was shown to arise from a 62,000-64,000-dalton precursor. The mature antigen consists of two forms of molecular weights, 69,000 and 72,000. These forms are glycosylated, phosphorylated, acylated, and sulfated. Developmental changes in the cellular and cell surface levels of the antigen reflect changes in its rate of synthesis. All aggregating cells express antigen 117 on their surfaces. Antigen 117 then disappears from the surface of all cells when tip formation occurs. The antigen is re-expressed briefly again on cells undergoing culmination. PMID- 3680251 TI - Diacylglycerol metabolism in mast cells. Analysis of lipid metabolic pathways using molecular species analysis of intermediates. AB - These studies assess the metabolic source and fate of cellular 1,2-diacylglycerol (DAG), an intermediate that increases with physiologic stimulation, participates in the regulation of protein phosphorylation, and acts as a substrate for arachidonic acid release. The quantitation of the molecular species of DAG and one of its metabolic products, phosphatidic acid (PA), was assessed in the purified rat mast cell, a model system with marked quantitative constraints but with rapid and extensive secretion after receptor stimulation. Cellular DAG was extracted, partially purified, radioactively phosphorylated to form [32P]PA, and, after conversion to its dimethyl phosphoric acid ester, molecular species separations were undertaken using reversed phase HPLC and/or argentation TLC. Quantitation of 0.5 pmol of a single molecular species of cellular DAG was achieved, but HPLC was not alone sufficient to resolve all molecular species of interest. More importantly, comparison of mast cell DAG with [32P]PA generated in 32Pi-prelabeled cells revealed that the sub-classes that contained arachidonic acid species represent only 11% of the total DAG, while that of [32P]PA was 41% in resting cells. [32P]PA and, to a variable extent, DAG showed preferential increases in arachidonate-containing subclasses after stimulation (to 50.9 and 13.9%, respectively). These data suggest that a large portion of the increased mass of DAG seen during stimulation was probably not derived by phosphoinositide hydrolysis. This type of molecular species analysis of intermediates of important phospholipid metabolic pathways should help to establish the metabolic origin and fate of these and other compounds. PMID- 3680252 TI - Correlation of agonist-induced phosphorylation of chick heart muscarinic receptors with receptor desensitization. AB - We have determined whether the process of agonist-mediated phosphorylation of the muscarinic receptor correlates with the process of muscarinic receptor desensitization in chick cardiac tissue. Exposure of ventricular slices to the agonist carbachol under conditions previously shown to lead to large increases in muscarinic receptor phosphorylation (Kwatra, M. M., and Hosey, M. M. (1986) J. Biol. Chem. 261, 12429-12432) resulted in decreased affinity of the muscarinic receptor for agonists. The agonist oxotremorine mimicked and the antagonist atropine prevented the effects of carbachol on receptor phosphorylation and agonist affinity. The time courses and concentration dependences for agonists to induce phosphorylation of the muscarinic receptor and decreases in agonist affinity were similar. Treatment of chick atria with acetylcholine under conditions which led to receptor phosphorylation resulted in decreased sensitivity of these preparations to the negative inotropic effect of carbachol. Taken together, the results support the concept that phosphorylation of cardiac muscarinic receptors may be related to the process of receptor desensitization. The mechanism by which agonists induce receptor phosphorylation was also investigated. The phosphorylated amino acids formed in response to agonists were serine and threonine. The protein kinase C activator phorbol myristate acetate had no effect on receptor phosphorylation or agonist affinity, nor did it prevent the effects of carbachol on either of these parameters. Receptor phosphorylation also was unaffected by the calmodulin antagonists W-7 and W-13, by elevation of cyclic nucleotides, and by agonists which activate other cardiac receptor systems. The results suggest that the phosphorylation of cardiac muscarinic receptors requires agonist occupancy of the receptor and/or may involve the participation of a selective protein kinase. PMID- 3680253 TI - The structure of the molybdenum cofactor. Characterization of di (carboxamidomethyl)molybdopterin from sulfite oxidase and xanthine oxidase. AB - A di-(carboxamidomethyl) derivative of molybdopterin, the organic component of the molybdenum cofactor, has been prepared under conditions favoring retention of all of the structural features of the molecule. The specific radioactivity of [1 14C]iodoacetamide incorporated relative to the amount of phosphate indicated two alkylation sites per pterin. Energy-dispersive x-ray analysis of the derivative showed the presence of 2 sulfurs in the derivative. An exact mass corresponding to the molecular formula C14H18N7O5S2 was obtained for the MH+ ion of the alkylated, dephosphorylated compound by fast atom bombardment mass spectroscopy. 1H NMR spectra of the phosphorylated and dephosphorylated forms of alkylated molybdopterin, in conjunction with the other data, have provided strong corroboration of the validity of the proposed structure of molybdopterin (Johnson, J. L., and Rajagopalan, K. V. (1982) Proc. Natl. Acad. Sci. U. S. A. 79, 6856-6860) as a 6-alkylpterin with a 4-carbon side chain containing an enedithiol on C-1' and C-2', a secondary alcohol on C-3', and a phosphorylated primary alcohol on C-4'. As isolated, the di-(carboxamido-methyl)molybdopterin was found to be a 5,6,7,8-tetrahydropterin. PMID- 3680254 TI - Developmental changes of gangliosides of the rat stomach. Appearance of a blood group B-active ganglioside. AB - Rat stomach gangliosides were purified and their distribution in the different tissue compartments was established. Three major monosialogangliosides were found: GM3, GM1, and a ganglioheptaosylceramide carrying a blood group B determinant. This latter structure was characterized by exoglycosidase degradation, immunostaining with a monoclonal anti-blood group B antibody on thin layer chromatogram, permethylation analysis, electron-impact mass spectrometry of the permethylated-reduced and trimethylsilylated molecule, and 1H NMR spectroscopy of the native ganglioside. It was found to be (Formula: see text) i.e. a GM1 structure substituted with the blood group B determinant and was called B-GM1. A similar structure has been previously identified in precancerous rat liver and chemically induced rat hepatoma (Holmes, E. H., and Hakomori, S. (1982) J. Biol. Chem. 257, 7698-7703). Fucosyl-GM1 was also detected as a minor ganglioside in rat gastric mucosa. The ganglioside profile was modified during the postnatal development. The contribution of GM3 and GD3, which accounted for 95% of the ganglioside sialic acid at birth, decreased during the first 3 weeks of life. GM1, fucosyl-GM1, and B-GM1 were not detected at birth. The concentration of the fucogangliosides increased during the 2nd and 3rd weeks after birth, was stable during the 4th week and then decreased, whereas that of GM1 increased steadily between 6 days and 2 months of age. B-GM1, which has been defined as a tumor-associated ganglioside in the rat liver, was found to be a developmentally regulated antigen of the normal rat stomach. PMID- 3680255 TI - Ehlers-Danlos syndrome type VIIB. Deletion of 18 amino acids comprising the N telopeptide region of a pro-alpha 2(I) chain. AB - A patient with Ehlers-Danlos syndrome Type VIIB was found to have an interstitial deletion of 18 amino acids in approximately half of the pro-alpha 2(I) chains of Type I procollagen. Analysis of pepsin-solubilized tissue and fibroblast collagen revealed an abnormal additional chain, alpha 2(I)', which migrated in sodium dodecyl sulfate-5% polyacrylamide gel electrophoresis between the normal alpha 1(I) and alpha 2(I) chains. The apparent ratio of normal alpha 1(I):mutant alpha 2(I)':normal alpha 2(I) was 4:1:1. Procollagen studies and enzyme digestion studies of native mutant collagen suggested defective removal of the amino propeptide. Sieve chromatography of CNBr peptides from purified alpha 2(I)' chains revealed the absence of the normal amino telopeptide fragment CB 1 and the appearance of a larger new peptide of approximately 60 residues (CB X). Compositional and sequencing studies of this peptide identified normal amino propeptide sequences. However, the most carboxyl-terminal tryptic peptide of CB X differed substantially in composition and sequence from the expected and was found to have an interstitial deletion of 18 amino acids corresponding to the N telopeptide of the pro-alpha 2(I) chain. This deletion removes the normal sites of cleavage of the N-proteinase and also removes a critical cross-linking lysine residue. The 18 amino acids deleted correspond exactly to the residues encoded by exon 6 of the pro-alpha 2(I) collagen gene (COL 1 A2), and, therefore, the protein defect may be due to a genomic deletion, or alternatively, an RNA splicing defect. PMID- 3680256 TI - Polyamines stimulate lysosomal cystine transport. AB - Lysosomal cystine transport is a carrier-dependent process that, in isolated lysosomes, is stimulated by proton gradients, membrane potential, and millimolar concentrations of divalent cations. The importance of these regulatory factors in vivo is not well established. Polyamines were found to stimulate cystine transport in Percoll gradient purified rat liver lysosomes with spermidine greater than putrescine = cadaverine greater than spermine in order of effectiveness. Maximal stimulation was achieved with 500 microM spermidine. The effects of optimal concentrations of polyamines and divalent cations on cystine transport were not additive. Spermidine stimulated cystine efflux from lysosomes of cultured human diploid fibroblasts, but had no effect on lysosomes of cystinotic fibroblasts which have defective cystine transport. Spermidine did not accumulate within lysosomes in exchange for cystine, had no effect on lysosomal pH, had only slight effects on the lysosomal membrane potential, and had little effect on either methionine or tyrosine efflux. Polyamines are cellular cytoplasmic components that, in physiologic concentrations, stimulate lysosomal cystine transport. PMID- 3680257 TI - Intrahepatic assembly of very low density lipoproteins. Rate of transport out of the endoplasmic reticulum determines rate of secretion. AB - To identify the rate-limiting step(s) in the hepatic production of very low density lipoproteins (VLDL), we investigated the intracellular distribution and rate of intracellular transport of de novo synthesized apolipoprotein B (apoB). For all secretory proteins examined (i.e. albumin, large molecular weight apoB, and small molecular weight apoB) the rough and smooth microsomes contained the majority of intracellular de novo synthesized protein, while the Golgi subfraction contained 10% or less. Pulse-chase analysis of the intracellular movement of apoB and albumin showed that the first order rate constant (in terms of half-life) describing the rate of movement out of the smooth and rough microsomes determined the overall rate of movement out of the cell. These data suggest that movement out of the endoplasmic reticulum, the site where VLDL is assembled, determines the overall rate of secretion. Furthermore, compared to albumin, the rate of intracellular transport of apoB was approximately two times slower suggesting that processing unique to VLDL apoB occurring in the endoplasmic reticulum was responsible. Additional studies show that essentially all of the de novo synthesized 35S-labeled albumin (produced from a pulse of [35S]methionine) lost from the cell during the chase period could be recovered in the culture medium. In contrast, much less of large molecular weight apoB (36%) and small molecular weight apoB (60%) was recovered in the culture medium. Since these cultured rat hepatocytes do not take up or degrade newly secreted apoB, these data suggest that a significant amount of apoB is degraded intracellularly. PMID- 3680258 TI - Structural studies and isolation of cDNA clones providing the complete sequence of rat liver dihydropteridine reductase. AB - The cleavage of reductively alkylated rat liver dihydropteridine reductase with cyanogen bromide afforded a mixture of peptides, six of which (CB-1 to CB-6) were isolated and purified by C8 reverse-phase high performance liquid chromatography. Portions of peptides CB-1, CB-4, and CB-6 were sequenced by automated Edman degradation and high performance liquid chromatography and the carboxyl-terminal region by conventional procedures. Further proteolytic digestion of CB-6 and isolation of the products afforded a seven-amino acid peptide. A low degeneracy probe comprising 20 nucleotides was synthesized from the sequence of this peptide and was used to screen a rat liver cDNA expression library constructed in the vector lambda gt 10. Positive clones were isolated, and detailed examination of five of these by restriction endonucleases and dideoxy sequence analyses allowed identification of the entire coding region for dihydropteridine reductase. The gene was found to code for a protein of 240 amino acids (excluding the methionine initiator) of Mr = 25,420. Each of the sequences corresponding to the peptides CB 1, CB-4, CB-6, and the carboxyl terminus were identified in the deduced protein sequence. The rat enzyme is highly homologous to the human dihydropteridine reductase; the two proteins differ in only 10 amino acids, and all are conservative substitutions. In contrast, the sequence shows little homology with that of mammalian dihydrofolate reductase: reduced pyridine nucleotide-requiring enzymes with superficial mechanistic similarities. PMID- 3680259 TI - Compartmentation of dCTP pools. Evidence from deoxyliponucleotide synthesis. AB - The nucleotide fraction of cultured 3T6 and 3T3 mouse fibroblasts contains deoxy CDP choline and deoxy-CDP ethanolamine as well as the corresponding riboliponucleotides. In permeabilized cells both deoxyliponucleotides were formed from dCTP. In intact cells they could be labeled from [5-3H] deoxycytidine or cytidine via transformation of the nucleosides to dCTP. Their turnover was slow compared to that of dCTP. When rapidly growing 3T3 cells were labeled during 90 min from deoxycytidine the specific activity of dCDP choline was 2.4 times higher than that of dCTP while after labeling from cytidine both nucleotides (and CTP) reached the same specific activity under steady state conditions. Also dCDP ethanolamine was labeled more rapidly from deoxycytidine than from cytidine. Our results suggest that the deoxyliponucleotides were synthesized from a dCTP pool that was labeled preferentially from deoxycytidine. Earlier work (Nicander, B., and Reichard, P. (1983) Proc. Natl. Acad. Sci. U. S. A. 80, 1347-1351) had demonstrated synthesis of DNA from a dCTP pool labeled preferentially from cytidine. Taken together our results suggest that deoxyliponucleotides and DNA are synthesized from separate dCTP pools. PMID- 3680260 TI - Temporal separation of protein toxin translocation from processing events. AB - Intoxication of Vero cells by ricin, modeccin, diphtheria toxin (DT), and Pseudomonas exotoxin A requires: 1) binding to cell surface receptors; 2) transport to the cytoplasm; and 3) enzymatic inactivation of a component of the protein synthetic machinery. The kinetic profiles of all four toxins consist of a lag followed by the apparent first-order decrease in protein synthesis. Autoradiographic analysis of DT-intoxicated cell populations has demonstrated that two subpopulations of cells exist during the period of decreasing protein synthesis: one population synthesizing at control levels and the other synthesizing little or no protein (Hudson, T. H., and Neville, D. M., Jr. (1985) J. Biol. Chem. 260, 2675-2680). The present study correlates the autoradiographic data with the rates of protein synthesis decline in cells intoxicated with modeccin, ricin, Pseudomonas exotoxin A, as well DT. In all cases, the first time point which exhibits a decrease in protein synthetic activity also exhibits two subpopulations of cells, one synthesizing protein at control rates and the other synthesizing little or no protein. As the intoxication progresses, cells leave the control population by the rapid cessation of all protein synthesis. These experiments demonstrate that transport of all four toxins to the cytosol is the rate-limiting step during the pseudo first-order decline in protein synthesis. Furthermore, the final step in the transport process (translocation) must result in the release to the cytoplasm of a quantity of toxin sufficient to rapidly inactivate all protein synthesis in that cell. The probability of a translocation event occurring in any cell of the population is established during the lag and remains constant throughout the first-order decrease in protein synthesis. The requirement for acidification during the intoxication by DT, Pseudomonas exotoxin A, or modeccin is restricted to the lag period. Acidification is therefore necessary to establish the probability of translocation, but it is not directly involved in the actual translocation of these toxins. The pseudo first-order passage of DT intoxications through antitoxin and NH4Cl- or monensin-sensitive stages are shown to have the same cellular basis as the pseudo first-order decrease in protein synthesis. A kinetic model is presented which defines the DT intoxication process from one of its earliest events (endocytosis) to its penultimate event (translocation of toxin to the cytosol).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680261 TI - Assembly of the endoplasmic reticulum phospholipid bilayer. Transporters for phosphatidylcholine and metabolites. AB - Phosphatidylcholine is synthesized on the cytoplasmic surface of the endoplasmic reticulum and transported to the lumenal monolayer by a protein transporter, a phosphatidylcholine "flippase" (Bishop, W. R., and Bell, R. M. (1985) Cell 42, 51 60). Since the endoplasmic reticulum contains enzymes involved in phosphatidylcholine turnover that have different locations within the organelle, transport systems may exist for phosphatidylcholine metabolites. To test the hypothesis that rat liver microsomes contain a lysophosphatidylcholine transporter, sn-1-monobutyroylphosphatidylcholine was employed. Since this homolog is highly water-soluble, transport of lysophosphatidylcholine could be measured using standard transport methods. sn-1-Monobutyroylphosphatidylcholine entered the lumenal compartment of microsomal vesicles. Transport was saturable and dependent on time and on amount of microsomes and required an intact permeability barrier. sn-1-Monobutyroylphosphatidylcholine transport was inhibited by treatment of microsomes with trypsin, N-ethylmaleimide, and trinitrobenzene-sulfonic acid. These findings suggest that sn-1 monobutyroylphosphatidylcholine transport is protein-mediated. sn-1 Monobutyroylphosphatidylcholine transported into microsomes was degraded to glycerophosphorylcholine. Glycerophosphorylcholine was also transported across the microsomal membrane. Glycerophosphorylcholine transport was also saturable and dependent on time, amount of microsomes, and an intact permeability barrier but was not inhibited by treatment with trypsin or the two protein modification agents. Thus, separate and distinct transport systems exist for phosphatidylcholine metabolites. Molecular events of phosphatidylcholine turnover in the endoplasmic reticulum are discussed. PMID- 3680262 TI - Effect of vitamin B6 on the synthesis and degradation of aspartate aminotransferase in chicken embryo fibroblasts. AB - The effect of pyridoxal depletion and supplementation on the intracellular level of mitochondrial and cytosolic aspartate aminotransferase in cultured chicken embryo fibroblasts was examined. No apoenzyme was detected in cells grown in the presence of pyridoxal, and the specific activity of total enzyme did not vary profoundly from primary to quaternary cultures. Under pyridoxal depletion, up to 40% apoenzyme was found in tertiary cultures which was entirely due to the mitochondrial isoenzyme. Cytosolic apoenzyme was never detected. Total aspartate aminotransferase relative to total protein was increased 2-fold in secondary cultures; only the mitochondrial isoenzyme contributed to the increased specific activity. The cytosolic isoenzyme decreased steadily and was below the limit of detection in quaternary cultures. The changes are attributed to an increased and decreased synthesis of mitochondrial and cytosolic isoenzyme, respectively. No induction of either isoenzyme was observed after incubating the cells with different hormones and substrates. In secondary cultures, no degradation of mitochondrial isoenzyme could be detected under pyridoxal deficiency or supplementation during 4.4 days, an interpassage duration. The cytosolic aspartate aminotransferase was degraded initially with an apparent half-life of approximately 0.9 day under both sets of conditions. The pronounced stability of mitochondrial aspartate aminotransferase, even though one-third of it was present as apoenzyme, excludes the formation of the apoform to be the rate-limiting step in its degradation. The present results show that pyridoxal affects the synthesis of mitochondrial and cytosolic aspartate aminotransferase, but differently. PMID- 3680263 TI - Calcium-dependent regulation of protein synthesis at translational initiation in eukaryotic cells. AB - Evidence that Ca2+ may serve as a physiologic regulator of post-transcriptional protein synthesis was recently reported (Brostrom, C. O., Bocckino, S. B., Brostrom, M. A., and Galuska, E. M. (1986) Mol. Pharmacol. 29, 104-111). To evaluate further the role of Ca2+ in translation, the polysomal contents of Ca2+ depleted and -restored GH3 pituitary cells were compared. Ca2+ depletion of intact cells with 1 mM EGTA resulted in the disappearance of polysomes and an accumulation of 80 S monosomes and ribosomal subunits typical of slowed rates of initiation. Ca2+ repletion rapidly (minutes) restored cellular polysomal contents with an accompanying accumulation of 43 S preinitiation complex (40 S.eukaryotic initiation factor 2.Met-tRNAf.GTP). Comparable polysomal profiles were found for Ca2+-depleted and -restored cells exposed to cycloheximide which apparently slowed polypeptide chain elongation to rate-limiting values in the overall translation process. Ribosomal transit times for both Ca2+-depleted and -restored cells were identical, indicating that elongation is not directly affected by the cation. Transit times were extended in parallel as a function of increasing cycloheximide concentration. Lysates of GH3 cells exhibited incorporation that was proportional to the polysomal contents derived from the original intact cell preparations. Such lysates did not possess the ability to initiate new peptide synthesis and were not affected by Ca2+ or EGTA. Ca2+-depleted cells exposed to cycloheximide provided lysates with identical elongation activity to that of lysates prepared from either comparably treated or control Ca2+-restored cells. Ca2+ is proposed to regulate translation in intact cells through modulation of the rate of initiation rather than either polypeptide chain elongation or termination. PMID- 3680264 TI - Down-regulation of protein kinase C and of an endogenous 80-kDa substrate in transformed fibroblasts. AB - Subconfluent cultures of NIH-3T3 fibroblasts transformed by the Ha-ras, Ki-v-ras, v-src, and v-fms oncogene proteins all possess elevated steady-state levels of diacylglycerol, the endogenous activator of protein kinase C, as compared to the nontransformed parental lines. These oncogene-transformed fibroblasts also exhibit a significantly decreased level of cellular protein kinase C activity as measured by four different criteria: phorbol ester-stimulated phosphorylation of an endogenous 80-kilodalton (80 kDa) substrate; phorbol ester-stimulated changes in 86Rb uptake; enzymatic assay; and [3H]phorbol ester binding. In all cases, the transformed cells demonstrated an attenuated response to phorbol ester addition and a lower phorbol ester binding capacity as compared to the parental lines. Western analysis of the endogenous 80-kDa substrate of protein kinase C revealed a significantly lower level of this protein in the transformed cells than in the untransformed controls, and this decrease could be mimicked in parental cells by long-term incubation with phorbol esters, suggesting that the level of the 80-kDa protein is regulated by the state of activation of protein kinase C. These effects do not appear to be nonspecific responses to autocrine secretions by the transformed cells. They may represent an unsuccessful attempt by the transformed cells to negatively modulate the constitutive proliferative signals generated by the oncogene products. PMID- 3680265 TI - The ban operon of bacteriophage P1. Localization of the promoter controlled by P1 repressor. AB - Repression of a strong promoter localized 5' to the P1 ban gene is a prerequisite for cloning the ban operon in the multicopy plasmid pBR325. Repression is brought about by the binding of P1 repressor to the operator of the ban operon (Heisig, A., Severin, I., Seefluth, A. K., and Schuster, H. (1987) Mol. Gen. Genet. 206, 368-376). Binding of RNA polymerase in vitro overlaps with the operator and is inhibited by P1 repressor as shown by electron microscopy. The mutant P1 bac, which renders ban expression constitutive, contains a single base pair exchange within the operator. As a consequence, more repressor is required (i) for the inhibition of binding of RNA polymerase, and (ii) for the electrophoretic retardation of a P1 bac DNA fragment when compared to the corresponding bac+ fragment. A P1 ban recombinant plasmid containing a 4-base pair deletion close to the operator still allows binding of repressor but not of RNA polymerase. By that means, a repressible promoter is located at the P1 map position 72 in a distance of about 2.5 kilobase pairs to the beginning of the ban gene. PMID- 3680266 TI - Lipoprotein B37, a naturally occurring lipoprotein containing the amino-terminal portion of apolipoprotein B100, does not bind to the apolipoprotein B,E (low density lipoprotein) receptor. AB - In 1979, Steinberg and colleagues described a unique kindred with familial hypobetalipoproteinemia (Steinberg, D., Grundy, S. M., Mok, H. Y. I., Turner, J. D., Weinstein, D. B., Brown, W. V., and Albers, J. J. (1979) J. Clin. Invest. 64, 292-301). Recently, we demonstrated the existence of an abnormal species of apolipoprotein (apo-) B, apo-B37 (Mr = 203,000) in nine members of that kindred (Young, S. G., Bertics, S. J., Curtiss, L. K., and Witztum, J. L. (1987) J. Clin. Invest. 79, 1831-1841; Young, S. G., Bertics, S. J., Curtiss, L. K., Dubois, B. W., and Witztum, J. L. (1987) J. Clin. Invest. 79, 1842-1851). Apolipoprotein B37 contains only the amino-terminal portion of apo-B100. In affected individuals most of the apo-B37 is contained in the high density lipoprotein (HDL) fraction (d = 1.063-1.21 g/ml), where it is the principal apolipoprotein in a unique lipoprotein (Lp) particle, Lp-B37, which contains little, if any, apo-A-I. However, the most abundant lipoprotein in the HDL density fraction is a smaller particle, which contains apo-A-I, but no apo-B. The Lp-B37 particles were isolated from the HDL of affected individuals by immunoabsorption of apo-B37. Selected affinity antibodies specific for apo-B37 were used to prepare an anti apo-B37-Sepharose 4B column. Lipoproteins not bound by the column (unbound HDL fraction) contained apo-A-I, but no apo-B. The Lp-B37, which was eluted from the column with 3 M KI, contained apo-B37 and trace amounts of apo-A-I, but no apo B100. Over a 4-h period, normal human fibroblasts degraded 10-fold more 125I-low density lipoprotein (LDL) than 125I-Lp-B37. Also, whereas addition of excess unlabeled LDL markedly reduced degradation of 125I-LDL, it did not significantly reduce the degradation of 125I-Lp-B37. Unlabeled Lp-B37 did not inhibit uptake and degradation of 125I-LDL by fibroblasts. These data suggest that the amino terminal portion of apo-B100, when expressed on a naturally occurring lipoprotein particle, does not contain a functional apo-B,E(LDL) receptor binding domain. PMID- 3680267 TI - Biological equivalence of natural bovine and recombinant human alpha-endothelial cell growth factors. AB - The cDNA encoding human alpha-endothelial cell growth factor (alpha-ECGF) has been engineered for high-level expression in Escherichia coli. Induction of bacterial cultures harboring the recombinant plasmid pMJ26 results in the appearance of a prominent 16-kDa polypeptide. This protein has been purified from bacterial lysates using a rapid, 2-step procedure employing heparin-Sepharose affinity based chromatography and reversed-phase high pressure liquid chromatography. Recombinant human alpha-ECGF was compared to bovine brain-derived alpha-ECGF in three biological assays: receptor binding on murine lung capillary endothelial cells (LE-II cells), stimulation of [3H]thymidine incorporation in LE II cells, and stimulation of human umbilical vein endothelial cell proliferation. The results demonstrate that the recombinant human mitogen has the same biological potency as the bovine brain-derived material. Fluorescence spectroscopy was used to study the interaction between recombinant ECGF and heparin. Heparin-binding resulted in a 40% reduction in the intrinsic fluorescence of ECGF, consistent with a heparin-induced conformational change. The intrinsic fluorescence of ECGF also varied as a function of pH. PMID- 3680268 TI - Isolation and some characteristics of an adhesive factor of brain that enhances neurite outgrowth in central neurons. AB - Fractionation of octyl glucoside-solubilized proteins from young rat brain was monitored using rat brain neurons, which were cultured in microwells coated with various protein fractions to be studied. An adhesive protein that promotes neurite outgrowth in rat brain neurons was isolated by chromatography on heparin Sepharose followed by Affi-Gel blue. The apparent molecular mass of the protein in sodium dodecyl sulfate-polyacrylamide gel electrophoresis under reducing conditions was about 30 kilodaltons (p30). Under nonreducing conditions a closely spaced doublet band was observed corresponding to 27-28-kilodalton size. Gel filtration in the presence of 4 M urea indicated the molecular size of 58 kilodaltons suggesting a dimeric structure. Western blotting experiments using affinity-purified rabbit antibodies detected p30 as an immunochemically distinct protein in brain and in N18 neuroblastoma cells. The p30 protein was also detected in the N18 cells by lactoperoxidase-catalyzed cell surface iodination. Western blotting of heparin-binding proteins solubilized from brains of rats of various age groups indicated that p30 is clearly more abundant in perinatal brain as compared to adult tissue. The neuron-binding and neurite outgrowth-promoting properties of p30 as well as the developmental regulation of its content in brain tissue suggest a role in neuronal growth. PMID- 3680269 TI - Loss of proteins from digitonin-permeabilized adrenal chromaffin cells essential for exocytosis. AB - Cultured chromaffin cells can be permeabilized with digitonin; the cell interior is then accessible to the cytoplasm, and addition of calcium provokes release of catecholamines. Increasing the incubation time between the permeabilization step and calcium-induced stimulation resulted in a progressive inhibition of secretion reaching 60% after 20 min. Cytosoluble proteins which leak from detergent permeabilized cells were collected, dialyzed, and concentrated. When these proteins were added back to permeabilized cells which were unable to secrete, catecholamine release was fully restored, suggesting that certain proteins necessary for exocytosis had been dialyzed from these cells. One of the released proteins was characterized as calmodulin. However, addition of calmodulin alone was ineffective in maintaining or restoring secretory activity in digitonin permeabilized cells, excluding calmodulin as the sole factor responsible for the loss of release. Protein kinase C was also identified as one of the leaked proteins. This enzyme is known to be retained in cells in the presence of 12-O tetradecanoylphorbol 13-acetate (TPA). However, under TPA-dependent conditions, there was also a loss of secretory activity. The present paper shows that among the proteins leaked from digitonin-permeabilized cells, there are specific proteins crucial to the exocytotic mechanism. PMID- 3680270 TI - Purification and characterization of an Mr 87,000 protein kinase C substrate from rat brain. AB - We (Kligman, D., and Patel, J. (1986) J. Neurochem. 47, 298-303) and others have previously identified a major protein kinase C substrate of apparent molecular weight 87,000 (Mr 87,000). To gain insight into the function of this potentially important phosphoprotein, we have undertaken its purification and characterization from rat brain. We now report a purification scheme involving heat treatment, ammonium sulfate precipitation, anion ion-exchange and reversed phase chromatography. This procedure gave a Mr 87,000 that was homogeneous (based on silver staining), 1,600-fold enriched relative to heat-treated material and at a yield of approximately 58 micrograms/kg wet weight. We also report the amino acid composition to be high in acidic residues and in alanine and show the protein to be phosphorylated on serine residues with a stoichiometry of 2 mol of phosphate/mol of substrate. The subcellular distribution indicates Mr 87,000 is present in two forms, membrane-bound and soluble. The membrane-bound Mr 87,000 represents 45% of the total phosphoprotein content and is enriched in microsomal and synaptic membranes. Ontogenic study has revealed this protein to be developmentally regulated, with the highest concentrations of Mr 87,000 found in prenatal animals. The availability of a purification procedure should greatly facilitate further structural characterization and elucidation of the function of Mr 87,000. PMID- 3680271 TI - Involvement of tyrosine protein kinase in the initiation of flagellar movement in rainbow trout spermatozoa. AB - Initiation of flagellar motility in spermatozoa of the rainbow trout, Salmo gairdneri, is closely related to phosphorylation of a protein of molecular mass 15 kDa (Morisawa, M., and Hayashi, H. (1986) Biomed. Res. 6, 181-184). We have been able to solubilize the protein and its kinase and then construct an assay system in vitro for the phosphorylation of the 15-kDa protein. In vitro, the protein was phosphorylated in a cAMP-dependent manner. The phosphorylation absolutely required the presence of Mg2+ ions. at millimolar concentrations, but not of Ca2+ ions. The amino acid residue which was phosphorylated in the 15-kDa protein was tyrosine. The 15-kDa protein was purified to near homogeneity by affinity chromatography on a column of adenosine nucleotides conjugated to Eupergit and ion-exchange chromatography on DEAE-cellulose. The effects of synthetic inhibitors of protein kinase on the phosphorylation of the 15-kDa protein were also studied. PMID- 3680272 TI - Expression of poriferasterol monoglucoside associated with differentiation of Physarum polycephalum. AB - A glycolipid which was expressed during a differentiation from haploid myxoamoebae to diploid plasmodia of a true slime mold, Physarum polycephalum, has been examined. In the amoeboid stage, cells did not contain this glycolipid, but after conjugation of the haploid cells, this substance appeared and increased in its amount. From structural studies of the purified glycolipid, it has been identified as poriferasterol monoglucoside. PMID- 3680273 TI - Determination of the sites of cAMP-dependent phosphorylation on the nicotinic acetylcholine receptor. AB - The nicotinic acetylcholine receptor is a substrate for cAMP-dependent protein kinase both in vitro and in vivo. Recently, it has been demonstrated that phosphorylation of the nicotinic receptor by this kinase increases its rate of rapid desensitization. We now report the identification of the cAMP-dependent phosphorylation sites on the gamma and delta subunits. Two-dimensional phosphopeptide mapping of the phosphorylated gamma and delta subunits, after limit proteolysis with thermolysin, indicated that each subunit is phosphorylated on a single site. Phosphoamino acid analysis of the 32P-labeled subunits demonstrates that phosphorylation had occurred exclusively on serine residues. Purified phosphorylated subunits were cleaved with cyanogen bromide and the resultant phosphopeptides were purified by reverse-phase high performance liquid chromatography. Shorter phosphopeptides, obtained by secondary digestion with trypsin, were purified and subjected to both automated gas-phase sequencing and manual Edman degradation. The results demonstrate that the gamma subunit was phosphorylated at Ser-353, contained within the sequence Arg-Arg-Ser(P)-Ser-Phe Ile and that the delta subunit was phosphorylated at Ser-361, contained within the sequence Arg-Ser-Ser(P)-Ser-Val-Gay-Tyr-Ser-Lys. Determination of the sites phosphorylated within the structure of the gamma and delta subunits should contribute to the molecular characterization of the regulation of desensitization of the nicotinic acetylcholine receptor by protein phosphorylation. PMID- 3680274 TI - Structural analysis of the temperature-sensitive mutant of bacteriophage T4 lysozyme, glycine 156----aspartic acid. AB - The structure of the mutant of bacteriophage T4 lysozyme in which Gly-156 is replaced by aspartic acid is described. The lysozyme was isolated by screening for temperature-sensitive mutants and has a melting temperature at pH 6.5 that is 6.1 degrees C lower than wild type. The mutant structure is destabilized, in part, because Gly-156 has conformational angles (phi, psi) that are not optimal for a residue with a beta-carbon. High resolution crystallographic refinement of the mutant structure (R = 17.7% at 1.7 A resolution) shows that the Gly----Asp substitution does not significantly alter the configurational angles (phi, psi) but forces the backbone to move, as a whole, approximately 0.6 A away from its position in wild-type lysozyme. This induced strain weakens a hydrogen bond network that exists in the wild-type structure and also contributes to the reduced stability of the mutant lysozyme. The introduction of an acidic side chain reduces the overall charge on the molecule and thereby tends to increase the stability of the mutant structure relative to wild type. However, at neutral pH this generalized electrostatic stabilization is offset by specific electrostatic repulsion between Asp-156 and Asp-92. The activity of the mutant lysozyme is approximately 50% that of wild-type lysozyme. This reduction in activity might be due to introduction of a negative charge and/or perturbation of the surface of the molecule in the region that is assumed to interact with peptidoglycan substrates. PMID- 3680275 TI - Labile proteins are necessary for T3 induction of growth hormone mRNA in normal rat pituitary and rat pituitary tumor cells. AB - Previous studies from our laboratory have shown that ongoing protein synthesis is required for L-tri-iodothyronine (T3) regulation of rat hepatic genes. In this report we have examined the role of ongoing protein synthesis in T3 regulation of the growth hormone gene (GH) in rat pituitary and GC cells. T3 (200 micrograms/100 g body weight injected intraperitoneally or 10(-8) M added to the media) induced a 3-fold rise of GH mRNA concentration after 8 h in rat pituitary (from 5.9 +/- 1% to 17.8 +/- 1.4% of an internal standard (IS), p less than 0.01) and a 5-fold rise in GC cells after 6 h (from 0.1 +/- 0.01% to 0.54 +/- 0.03% of IS, p less than 0.01). Cycloheximide (1 mg/100 g body weight intraperitoneally or 25 microM added to the media) completely blocked the increase in GH mRNA when given before the hormone in rat pituitary (7.5 +/- 0.5% of IS after 8 h) and GC cells (0.095 +/- 0.01% of IS after 6 h). Similar results were observed when emetine and puromycin were used to block protein synthesis. GH transcription rate in pituitaries from hypothyroid animals was 20 +/- 8 ppm and increased to a value of 295 +/- 85 parts per million 2 h after the injection of T3, and a similar 8 fold increase was observed in GC cells after 2 h. However, when cycloheximide was given before the hormone, the T3-induced increase in transcription was completely blocked. We also demonstrate here that the differences observed in GH transcription rate between hypo- and euthyroid rat pituitaries fully account for the differences observed in mRNA concentration. We conclude that short-lived proteins are involved in T3 regulation of the GH gene in rat pituitary and GC cells. PMID- 3680276 TI - The sodium gradient induces conformational changes in the renal phosphate carrier. AB - Phosphate transport across brush border membranes from kidney cortex is very sensitive to inhibition by phenylglyoxal, an arginine modifier. Sodium-dependent phosphate influx into brush border membrane vesicles was inhibited by 60%. In contrast, phenylglyoxal had no effect on passive influx or on sodium-dependent efflux of phosphate. Preincubation of the vesicles with sodium prior to the addition of phenylglyoxal demonstrated a strong protective effect of intravesicular sodium (73% protection). Phosphate also protected the transporter from inhibition, but from the extravesicular side only (63%). Substitution of phosphate by sulfate offered no protection at all, indicating the specificity of protection. Addition of both substrates (sodium and phosphate) offered an additional protection from the extravesicular side compared to that offered by phosphate alone (92 versus 55%). There was no additional protection when both substrates were added to the intravesicular side. Phosphate influx measured in the presence of sodium but in the absence of a sodium gradient was totally unaffected by phenylglyoxal modification. There was no inhibition on phosphate influx measured in equilibrium exchange conditions. We propose a model for the phosphate carrier in which the sodium gradient induces a conformational change and an arginine residue is essential for the coupled flux of sodium and phosphate. PMID- 3680277 TI - Reevaluation of the evidence that an antibody to the insulin receptor is insulinmimetic without activating the protein tyrosine kinase activity of the receptor. AB - The immunoglobulin fraction of a polyclonal anti-insulin receptor antibody (B-10) derived from a patient with severe insulin resistance and acanthosis nigricans was tested for its ability to activate the protein kinase activity of the insulin receptor and to mimic insulin action in Chinese hamster ovary cells expressing either wild type or kinase-deficient human insulin receptors. This antiserum had previously been reported to be insulinmimetic without activating the insulin receptor protein tyrosine kinase. Antibody B-10 bound to both wild type and mutant human insulin receptors, but it induced receptor down-regulation and stimulated hexose transport and thymidine incorporation into DNA only in cells expressing the wild type receptor. Furthermore, this antibody activated the kinase activity of the wild type insulin receptor in intact cells and in vitro. It is likely, therefore, that the biological activities of antibody B-10, like those of insulin, depend upon the protein tyrosine kinase activity of the insulin receptor. PMID- 3680278 TI - Detection of conformational changes in human chorionic gonadotropin upon binding to rat gonadal receptors. AB - After binding to rat testicular or ovarian luteinizing hormone (LH) receptors, human chorionic gonadotropin (hCG) and mammalian LH can be detected with monoclonal antibodies directed against a conserved epitope on the beta subunit of the hormones. Two such anti-hCG/anti-LH monoclonal antibodies, known as B105 and B110, compete with one another for binding to this epitope region on free and receptor-bound hormone. By comparing the affinities of B105 and B110 for these two forms of hCG, we have detected apparent changes in the structure of the hormone which develop subsequent to receptor binding. Whereas the affinity of B105 for receptor-bound hCG is approximately 10-fold lower than that for free hCG, the affinity of B110 for receptor-bound hCG is nearly 20-fold greater than that for free hCG. Both B105.hCG and B110.hCG complexes bind to the receptor; however, they have approximately 25 and 50% lower affinity than hCG. Thus, although B110 binds better to the form of hCG which is bound to receptors, binding of B110 to hCG does not appear to induce a conformational change in the hormone which facilitates hormone-receptor binding. Consequently, both B105 and B110 partially inhibit binding of hCG to its receptors. Fab fragments of B105 and B110 are as effective as intact B105 and B110 in inhibiting the binding of labeled B105 and B110 to hCG-receptor complexes, suggesting that circular complexes which might be formed by the interaction of divalent antibody, two molecules of hCG, and two membrane-bound receptors or one divalent receptor are not contributing to the affinity of the antibodies for receptor-bound hCG. Alternatively, formation of circular complexes can explain an increase in apparent affinity of B105 for ovine or bovine LH-receptor complexes. Data obtained with B105 suggest either that the structure of the epitope is altered following binding or that a portion of the epitope is partially obscured when hCG binds to the receptor. In contrast, the data obtained using B110 are not explained by models in which steric factors reduce the affinity of the antibody for the hormone-receptor complex. Therefore, as a minimal explanation for these observations, we postulate that the conformation of the B105/B110 epitope region is altered following binding of the hormone to receptors. The nature of the conformational change and its relationship to LH/hCG action is unknown. PMID- 3680279 TI - Contribution of the shunt pathway of mevalonate metabolism to the regulation of cholesterol synthesis in rat liver. AB - The modulation of the shunt pathway of mevalonate metabolism (Edmond, J., and Popjak, G. (1974) J. Biol. Chem. 249, 66-71) has been studied in livers from fed, starved, and diabetic rats perfused with a physiological concentration (300 nM) of [5-14C] + [5-3H]mevalonate. Shunt activity was measured by (i) production of 14CO2 (corrected for loss of label by exchange reactions) and (ii) production of 3H2O. Contribution of exogenous mevalonate to total mevalonate production (0.06 0.11%) was assessed in parallel experiments by the incorporation of 3H2O into sterols. Inhibition of non-saponifiable lipid synthesis by starvation and diabetes is not associated with an inhibition of mevalonate production but with a major increase in shunting (7-34%) of sterol-bound mevalonate. The shunt pathway of mevalonate metabolism appears to participate in the regulation of cholesterol synthesis. PMID- 3680280 TI - The sites of thyroid hormone formation in rabbit thyroglobulin. AB - Rabbit thyroglobulin (Tg) was labeled in vivo with 125I and purified by gel filtration. Separation by high performance liquid chromatography (HPLC) of tryptic digests of S-cyanoethylated Tg yielded four major iodothyronine containing peaks, designated A, B, C, and D. These were further purified on HPLC and sequenced for identification of amino acid residues and for location of the iodothyronine by 125I counting. The published primary structure for bovine Tg, derived from cDNA sequencing of the Tg gene (Mercken, L., Simons, M.J., Swillens, S., Massaer, M., and Vassart, G. (1985) Nature 316, 647-651), permitted tentative location of the rabbit hormonogenic peptides within the Tg polypeptide chain. Site A, corresponding to bovine residue 5, contained 44% of Tgs [125I]T4 (thyroxine) and 25% of its [125I]T3 (triiodothyronine); its specific activity of iodine was higher than that for other sites, indicating priority of iodination. Site B, containing 24% of Tgs [125I]T4 and 18% of its [125I]T3, corresponded to bovine residue 2555. Site C, at the third residue from the C terminus (bovine residue 2748), was the major T3 site, accounting for over 50% of Tgs [125I]T3. The amino acid sequence around this site shows less homology among different animal species than do those flanking the other hormonogenic sites. Site D accounted for 17% of Tgs [125I]T4 and corresponded to bovine Tyr-1291, in the midportion of Tgs polypeptide chain. The three major T4-forming sites had the sequence Asp-Tyr (sites B and D) or Glu-Tyr (site A), while the sequence Ser-Tyr Ser appeared to favor T3 synthesis (site C), suggesting an important influence of primary structure on hormonogenesis. We conclude that site A is the major T4 forming site and site C the major T3-forming one, but others are available and offer the opportunity for flexibility in meeting different demands for hormone formation. PMID- 3680281 TI - Alpha-carboxyamidation of antral progastrin. Relation to other post-translational modifications. AB - Using radioimmunoassays for amidated and glycine-extended gastrin before and after trypsin-carboxypeptidase B cleavage and chromatography, alpha carboxyamidation of porcine antral progastrin has been related to tyrosine-O sulfation and proteolytic cleavages. Corresponding to the sequence at the proteolysis and amidation site, -Gly-Arg-Arg-, antrum contained three COOH terminally extended precursor types. The glycine-extended gastrins were present in the highest concentrations (241 +/- 58 pmol/g). The degree of tyrosine-O sulfation was identical for amidated and precursor gastrins irrespective of component size, whereas the component size differed for glycine-extended and amidated forms. For instance, gastrin-34-Gly constituted 54% of the glycine extended gastrins, while gastrin-34 comprised 8% of the amidated gastrins. The results indicate that tyrosine-O-sulfation occurs prior to NH2-terminal cleavages, which again precede carboxyamidation; but a significant correlation between tyrosine-O-sulfation and proteolytic cleavages or alpha-carboxy-amidation of antral gastrin could not be demonstrated. Furthermore, our results suggest that the immediate precursor of the principal hormonal form, gastrin-17, is gastrin-17-Gly rather than gastrin-34 as previously believed. PMID- 3680282 TI - Regulation of cytochrome P-450 messenger RNA and apoprotein levels by heme. AB - 2-Allylisopropylacetamide, a porphyrinogen which decreases the microsomal and cytosolic heme pools, is a phenobarbitone-like inducer of cytochrome P-450(b + e) messenger RNAs in rat liver. The porphyrinogen, however, does not affect the nuclear heme pool and enhances the transcription of cytochrome P-450(b + e) messenger RNAs strikingly. Inhibitors of heme biosynthesis, such as CoCl2 and 3 amino-1,2,4-triazole, which decrease the total heme levels including that of the nuclear heme pool, block the 2-allylisopropylacetamide- or phenobarbitone mediated increase in the transcription of cytochrome P-450(b + e) messenger RNAs. Administration of exogenous heme at a very low concentration (25 micrograms/100 g) is able to counteract the inhibitory effects of the heme biosynthetic inhibitors. Addition of heme in vitro to heme-depleted nuclei leads to a significant increase in the transcription rates for cytochrome P-450(b + e) messenger RNAs. 2-Allylisopropylacetamide, unlike phenobarbitone, fails to increase the levels of cytochrome P-450b protein at 12 h after the drug administration, although there is a striking increase in the messenger RNA levels. Under conditions of 2-allylisopropylacetamide treatment, the cytochrome P 450 messenger RNA is translated, but the newly synthesized apoprotein undergoes rapid degradation. It is concluded that heme is a positive modulator of cytochrome P-450 gene transcription and is also required to stabilize the freshly synthesized apoprotein. PMID- 3680283 TI - The agonist-sensitive calcium pool in the pancreatic acinar cell. Activation of plasma membrane Ca2+ influx mechanism. AB - The purposes of the present study were to investigate the characteristics and regulation of Ca2+ influx across the plasma membrane in pancreatic acini and to demonstrate the role of this Ca2+ influx in the mechanism of reloading of the agonist-sensitive Ca2+ pool. In pancreatic acini, depleted of intracellular Ca2+ by stimulation with carbachol in the absence of extracellular Ca2+, 25 microM LaCl3 inhibited the increase in free cytosolic Ca2+ ([Ca2+]i) and reloading of the agonist-sensitive pool that occurred with the addition of extracellular CaCl2 to the medium. LaCl3 also inhibited the increase in cellular 45Ca2+ uptake that occurred during agonist stimulation and its termination but not cellular 45Ca2+ uptake into unstimulated acini. In acini depleted of intracellular Ca2+, increased cellular Ca2+ influx and reloading of the agonist-sensitive pool occurred even if extracellular CaCl2 was added 10 min after the termination of agonist action. Maximal reloading was independent of the extracellular Ca2+ concentration between 0.5 and 2.0 mM CaCl2. However, the time to maximal reloading was longer at lower extracellular Ca2+ concentrations. These results demonstrate a plasma membrane Ca2+ influx mechanism in the pancreatic acinar cell that is activated during cell stimulation. This transport remains activated as long as the agonist-sensitive pool is not completely loaded with Ca2+ suggesting that the Ca2+ influx mechanism is regulated by the quantity of Ca2+ in the agonist-sensitive pool. The activation of this Ca2+ transport mechanism functions to allow Ca2+ influx across the plasma membrane and Ca2+ reloading of the agonist sensitive pool. Furthermore, these results suggest that during reloading Ca2+ crosses the plasma membrane into the cytosol before entering the agonist sensitive pool. PMID- 3680284 TI - Glycation and inactivation of human Cu-Zn-superoxide dismutase. Identification of the in vitro glycated sites. AB - The nonenzymatic glycosylation (glycation) of Cu-Zn-superoxide dismutase led to gradual inactivation of the enzyme (Arai, K. Iizuka, S., Tada, Y., Oikawa, K., and Taniguchi, N. (1987) Biochim. Biophys. Acta 924, 292-296). The purified superoxide dismutase from human erythrocytes comprises both glycated and nonglycated forms. The nonglycated Cu-Zn-superoxide dismutase was isolated by boronate affinity chromatography. Incubation of the nonglycated superoxide dismutase with D-[6-3H]glucose in vitro resulted in the gradual accumulation of radioactivity in the enzyme protein, and Schiff base adducts were trapped by NaBH4. The sites of glycation of the superoxide dismutase were identified by amino acid analysis after reverse-phase high performance liquid chromatography of the trypsin-treated peptides. Lysine residues, i.e. Lys3, Lys9, Lys30, Lys36, Lys122, and Lys128, were found to be glycated. Three of the glycated sites lie in Lys-Gly, two in Lys-Ala, and one in Lys-Val. The inactivation of the superoxide dismutase on the glycation is due mainly to the glycation of Lys122 and Lys128, which are supposed to be located in an active site liganding loop. The remaining five sites, such as Lys-Glu, Lys-Asp, Lys-His, and Lys-Thr are relatively inactive as to the formation of either a Schiff base or an Amadori adduct. PMID- 3680285 TI - NMR studies of A.C mismatches in DNA dodecanucleotides at acidic pH. Wobble A(anti).C(anti) pair formation. AB - Two-dimensional proton NMR studies were undertaken on the d(C-G-A-G-A-A-T-T-C-C-C G) duplex (designated A.C 12-mer) where the A at the mismatch site is flanked by G residues and the d(C-G-C-G-A-A-T-T-C-A-C-G) duplex (designated C.A 12-mer) where the A at the mismatch site is flanked by C residues in an attempt to elucidate the role of flanking base pairs on the structure of the A.C mismatch. The exchangeable and nonexchangeable proton spectra of these two dodecanucleotides have been completely characterized by two-dimensional nuclear Overhauser enhancement (NOE) experiments in H2O and D2O solution at acidic pH. The NOE distance connectivities demonstrate that both A and C at the mismatch site are stacked into a right-handed helix between flanking G.C base pairs and exhibit anti-glycosidic torsion angles. The proton chemical shifts and NOE patterns are consistent with Wobble A.C pairing for the A.C 12-mer and C.A 12-mer duplexes in solution and demonstrate that the A.C mismatches introduce local conformational perturbations that do not extend to the central AATT segment. We detect that amino protons of adenosine (approximately 9.2 ppm) but not of cytidine at the A.C mismatch site in both duplexes on lowering the pH below 6. PMID- 3680286 TI - Circular dichroism and 1H NMR studies of Co2+- and Ni2+-substituted concanavalin A and the lentil and pea lectins. AB - Visible absorption, circular dichroism (CD) and magnetic circular dichroism spectra have been recorded for the Ca2+-Co2+ derivatives of the lentil (CCoLcH) and pea (CCoPSA) lectins (Co2+ at the S1 sites and Ca2+ at the S2 sites) and shown to be very similar for both proteins. The visible absorption and magnetic circular dichroism spectra indicate similar octahedral geometries for high spin Co2+ at S1 in both proteins, as found in the Ca2+-Co2+ complex of concanavalin A (CCoPL) (Richardson, C. E., and Behnke, W. D. (1976) J. Mol. Biol. 102, 441-451). The visible CD data, however, indicate differences in the environment around S1 of CCoLcH and CCoPSA compared to CCoPL. 1H NMR spectra at 90 MHz of the Co2+ and Ni2+ derivatives of the lectins show a number of isotropically shifted signals which arise from protons in the immediate vicinity of the S1 sites. Analysis of the spectra of the Co2+ derivatives in H2O and D2O has permitted resonance assignments of the side chain ring protons of the coordinated histidine at S1 in the lectins. Differences are observed in the H-D exchange rate of the histidine NH proton at S1 in concanavalin A compared to the lentil and pea lectins. NMR data of the Ni2+-substituted proteins, together with spectra of the Co2+ derivatives, also indicate that the side chains of a carboxylate ligand and of the histidine residue at S1 are positioned differently in concanavalin A than in the other two lectins. These results appear to account, in part, for the differences observed in the visible CD spectra of the Co2+-substituted proteins. In addition, binding of monosaccharides does not significantly perturb the spectra of the lectins. An unusual feature in the 1H NMR spectra of all three Co2+-substituted lectins is the presence of two exchangeable downfield shifted resonances which appear to be associated with the two protons of a slowly exchanging water molecule coordinated to the Ca2+ ion at S2. T1 measurements of CCoLcH have provided an estimation of the distances from the Co2+ ion to these two protons of 3.7 and 4.0 A. PMID- 3680287 TI - Low density lipoprotein (LDL)-mediated suppression of cholesterol synthesis and LDL uptake is defective in Niemann-Pick type C fibroblasts. AB - One characteristic of type C Niemann-Pick (NPC) disease is the substantial intracellular accumulation of unesterified cholesterol. The increased cholesterol content in NPC fibroblasts which are grown in the presence of low density lipoproteins (LDL) has been postulated to be due to a deficiency in cellular cholesterol esterification. We have examined several aspects of LDL metabolism in NPC fibroblasts. We observe that LDL binding, internalization, and lysosomal hydrolysis of LDL cholesteryl esters are normal in NPC cells. As reported by Pentchev et al. (Pentchev, P. G., Comly, M. E., Kruth, H. S., Vanier, M. T., Wenger, D. A., Patel, S., and Brady, R. O. (1985) Proc. Natl. Acad. Sci. U. S. A. 82, 8247-8251), we find that LDL does not stimulate cholesterol esterification. However, we also show that LDL does not down-regulate cholesterol synthesis or LDL receptor activity as normal. In NPC cells, these processes are regulated normally by nonlipoprotein effectors, such as 25-hydroxycholesterol or mevalonate. Since NPC cells are not defective in lysosomal hydrolysis of LDL derived cholesteryl esters, they must exhibit a different defect than Wolman's or cholesteryl ester storage diseases. We conclude that NPC cells are defective specifically in LDL-mediated regulation of cellular cholesterol metabolism. We suggest that the intracellular processing of LDL-derived cholesterol may be defective in NPC fibroblasts. PMID- 3680289 TI - Isolation and purification of a rat liver 3-hydroxy-3-methylglutaryl-coenzyme reductase activating protein (RAP). AB - A protein with an estimated subunit mass of 19 kDa was isolated and purified from perfused rat liver cytosol. This protein activates hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase (NADPH) (EC 1.1.1.34), the rate-limiting enzyme in the cholesterol biosynthetic pathway. The activation process by this HMG-CoA reductase activating protein (RAP) is time-dependent and requires NADPH. Maximal activity of HMG-CoA reductase induced by RAP is comparable to that obtained in the presence of thiols, such as GSH, and can exceed 100-fold the activity obtained when thiols are omitted. Purified RAP lacks ability to reduce 5,5' dithiobis-(2-nitrobenzoic acid). RAP was purified to homogeneity utilizing DEAE- and phenyl-Sepharose CL-4B column chromatography. The purified RAP migrates as a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and shows multiple interconvertible aggregational forms on native polyacrylamide gel electrophoresis. A monospecific antibody against RAP was prepared by immunization of hens and extracted from either their egg yolks or serum. The catalytic activity of RAP might be responsible for the physiological activation of HMG-CoA reductase and regulation of its activity. PMID- 3680288 TI - Factors affecting nucleosome disassembly by protamines in vitro. Histone hyperacetylation and chromatin structure, time dependence, and the size of the sperm nuclear proteins. AB - Histone displaced in vitro from nuclei by protamine competition display a higher degree of hyperacetylation than the residual histones. In addition, hyperacetylated core particle pools are disassembled in vitro with a higher efficiency than control or nonacetylated core particles and when analyzed by electron microscopy display an elongated shape (length/width ratio = 1.52 +/- 0.19) instead of the round compact shape of control nucleosomes (length/width ratio = 1.06 +/- 0.06). In the absence of histone hyperacetylation, the fish protamines, salmine and iridine (32-33 residues), are relatively inefficient in disassembling nucleosomal core particles in vitro as compared to the large (65-70 residues), tyrosine-containing protamines from rooster (galline), squid, and cuttlefish which disassemble nucleosomes in a range of protamine concentrations close to physiological. The fact that an artificially cross-linked salmine dimer acquires the ability of the large protamines from rooster, squid, and cuttlefish to disassemble core particles in vitro and also binds more tightly to the DNA, suggests that the size of the sperm nuclear protamines is a critical factor in this process. Even when the core histones of spermatid chromatin are hyperacetylated in the trout testis, the replacement process by iridine or salmine is slow and time-dependent in vitro. However, since spermiogenesis in trout occurs over several weeks, the slow in vitro nucleosome disassembly process by salmine is sufficient to allow complete displacement, thus supporting the hypothesis that a protamine-mediated displacement of the histones from DNA in vivo may take place in the salmonid fishes by a mechanism similar to that in the rooster, squid, and cuttlefish. PMID- 3680290 TI - The laminin B2 chain has a multidomain structure homologous to the B1 chain. AB - Laminin (Mr = 850,000) is a large basement membrane-specific glycoprotein composed of three chains: A, B1, and B2. Previously, we have reported the primary structure of the B1 chain of mouse laminin deduced from sequencing cDNA clones (Sasaki M., Kato, S., Kohno, K., Martin, G. R., and Yamada, Y. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 935-939). Here we report the isolation of overlapping cDNA clones spanning 7642 bases which encode the entire B2 chain. The nucleotide sequence of the clones contains an open reading frame of 4821 bases coding for a protein of 1607 amino acids including 33 amino acids of a presumptive signal peptide. The mRNA for the B2 chain contains 2.5 kilobases of 3'-untranslated region. The deduced amino acid sequence indicates that the B2 chain consists of six distinct domains, including two domains with alpha-helical, coiled-coil structures, two domains with cysteine-rich homologous repeats, and two globular domains. These structural features of the B2 chain are similar to those of the B1 chain. In addition, the amino acid sequences of the B2 and B1 chains demonstrate considerable homology, suggesting that the genes for these two chains arose from a common ancestor. PMID- 3680291 TI - Purification and characterization of Leydig cell luteinizing hormone receptor. AB - We have purified the testicular luteinizing hormone (LH/human choriogonadotropin (hCG)) receptor by sequential affinity chromatography on hCG-Sepharose. The purified LH/hCG receptor was identified as a single protein of Mr = 90,000 +/- 2,000 on sodium dodecyl sulfate-gel electrophoresis (SDS-PAGE), showed high affinity binding for hCG, and a binding capacity of 3.8 nmol/mg of protein. Electrophoretically blotted receptor retained the ability to bind 125I-hCG on nitrocellulose membrane, and the Mr of radioactive band was consistent with that revealed by silver staining. Autoradiography after SDS-PAGE analysis of cross linked purified receptor-hCG complex showed Mr = 145,000 and Mr = 105,000 bands. These results are consistent with a Mr value for the receptor of 90,000 after accounting for contribution by the intact hormone or its alpha-subunit. Analysis of the free receptor by fast protein liquid chromatography on Superose 12 revealed a single peak of binding activity for 125I-hCG which eluted in the position of Mr = 200,000-240,000 in the presence of Triton X-100. Since a single protein species is observed under reducing or nonreducing conditions in SDS-PAGE, the receptor could exist in the membrane as a dimeric form composed of subunits Mr = 90,000 associated through noncovalent interactions. The pure receptor can be phosphorylated in vitro by the catalytic subunit of cAMP-dependent protein kinase (approximately 0.3 mol of phosphate/mol of receptor). This phosphorylation does not affect the binding characteristics of the receptor. The method described is simple and allows rapid purification of microgram amounts of biological active Leydig cell LH/hCG receptor for structural, functional, and immunological studies. PMID- 3680292 TI - Isolation and characterization of gangliosides with hybrid neolacto-ganglio-type sugar chains. AB - We have previously reported the presence of GM2 as the major ganglioside in the roe of striped mullet, Mugil cephalus, (Li, Y.-T., Hirabayashi, Y., DeGasperi, R., Yu, R. K., Ariga, T., Koerner, T. A. W., and Li, S.-C. (1984) J. Biol. Chem. 259, 8980-8985). In addition to GM2, mullet roe also contain a series of gangliosides with thin-layer chromatographic mobilities slower than GM2. Besides enzymatic hydrolysis and NMR spectroscopy, we have employed the thin-layer chromatography overlay technique using a human monoclonal IgM antibody which recognizes the GM2 epitope to study the nature of these gangliosides. Using these methods we have isolated and characterized three novel mullet roe gangliosides with the following structures: (Formula: see text). These three gangliosides all contain neolacto-series sugar chains. However, the unique feature of gangliosides 5 and 10 is that the terminal portion of the sugar chain is of the ganglio-series while the internal portion is of the neolacto series structure. Due to the substitution of a GalNAc on the internal Gal in 9 and 10 in the inner core, these two gangliosides also contain the gangliotriaosyl structure. Thus, the sugar chains in these gangliosides are of novel type and can be considered a hybrid between the two series which can be defined as the neolacto-ganglio series. PMID- 3680293 TI - Structural characterization of natural human urinary and recombinant DNA-derived erythropoietin. Identification of des-arginine 166 erythropoietin. AB - Recombinant human erythropoietin (rhEPO) has been purified to apparent homogeneity from a Chinese hamster ovary cell line expressing a cDNA clone of the human gene. NH2-terminal sequencing of the recombinant hormone indicates that the 27-residue leader peptide is correctly and consistently cleaved during secretion of the recombinant protein into conditioned medium, yielding the mature NH2 terminus (Ala-Pro-Pro-Arg...). Analysis of the COOH terminus of rhEPO by peptide mapping and fast atom bombardment mass spectrometry (FABMS) demonstrates that the arginyl residue predicted to be at the COOH terminus (based on confirmation of both genomic and cDNA sequences) is completely missing from the purified protein. The truncated form of the recombinant hormone, designated des-Arg166 rhEPO, displays an in vivo specific activity of greater than 200,000 units/mg protein. Structural characterization of natural human urinary EPO (uEPO) by peptide mapping and FABMS reveals that the urinary hormone is also missing the COOH terminal Arg166 amino acid residue, a modification that remained undetected until now. There is no evidence of further proteolytic processing at the COOH terminus beyond specific removal of the Arg166 amino acid residue in either rhEPO or uEPO. On the basis of the FABMS data, we propose that the physiologically active form of the hormone circulating in plasma and interacting with target cells in vivo is des-Arg166 EPO. PMID- 3680294 TI - Analysis of the proteoglycans synthesized by human bone cells in vitro. AB - Proteoglycans were isolated by ion-exchange chromatography from the extracted cell layer and culture medium of human bone cell cultures following incubation in the presence of [35S]sulfate and [3H]leucine. On sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), the synthesized proteoglycans consisted of at least five polydisperse species having median apparent Mr = 600,000, 400,000, 270,000, 135,000 and 40,000. When chromatographed further on octyl-Sepharose CL-4B, the proteoglycans of the cell layer resolved into three peaks. The unbound fraction (peak cell layer-I) contained a 40,000 species consisting of a single glycosaminoglycan chain with or without peptide. Peak cell layer-II contained three sulfated species on electrophoresis: a 600,000 species uniformly distributed across the peak, a 135,000 species enriched in the ascending limb (similar to bone PG-I as described previously), and a 270,000 species (similar to bone PG-I) enriched in the descending limb. Peak cell layer III, eluting at 0.2% Triton X-100, was highly enriched in a 400,000 proteoglycan component. When media proteoglycans were chromatographed on octyl-Sepharose, two labeled peaks were found. Peak medium-I (unbound) contained a species exhibiting electrophoretic mobility similar to that of the 400,000 species present in peak cell layer-III. Peak II of the culture medium (medium-II) was apparently identical to that of peak cell layer-II, containing the 600,000, 270,000 and 135,000 species. No appreciable 40,000 species was observed in the medium. Treatment of the 600,000 species with either chondroitinase ABC or ACII generated a core protein preparation with bands of 390,000 and 340,000 on SDS gels. Neither the intact nor the chondroitinase ABC-treated 600,000 species was immunoprecipitated by a purified, polyclonal antiserum raised against the core protein of the large chondroitin sulfate proteoglycan of human articular cartilage. Treatment of the 270,000 and 135,000 proteoglycans with chondroitinase ABC, but not ACII, generated a core protein preparation with bands of 52,000 and 49,000 on SDS gels, indicating that they were dermatan sulfate-containing species. The 400,000 species contained both heparan sulfate and chondroitin sulfate, in approximately a 3:1 labeling ratio. This species changed in electrophoretic mobility following treatment with chondroitinase ABC, heparatinase, or both enzymes in combination, which suggested that it may be a hybrid proteoglycan (i.e. both types of glycosaminoglycan chain on the same core protein).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680295 TI - Crystallization of human neutrophil elastase. AB - Human neutrophil elastase was inactivated by methoxysuccinyl-L-Ala-L-Ala-L-Pro-L Ala-chloromethane. The modified enzyme was crystallized from 40 mM ammonium phosphate, pH 7.0 in the hexagonal space group P6(3) with unit cell parameters a = 74.53 A, b = 74.53 A, c = 70.88 A, alpha = beta = 90 degrees, gamma = 120 degrees. These crystals were resistant to radiation damage and diffracted beyond 1.84-A resolution. The asymmetric unit contained one 25,000-dalton monomer of human neutrophil elastase. Crystals were also grown from the enzyme modified with the analogous iodinated inactivator, p-iodoanilinosuccinyl-L-Ala-L-Ala-L-Pro-L Ala-chloromethane. These crystals proved to be isomorphous with those of methoxysuccinyl-L-Ala-L-Ala-L-Pro-L-Ala-chloromethane-modified human neutrophil elastase, and served as a single-site, heavy atom derivative for solving the tertiary structure of the enzyme. PMID- 3680296 TI - Thyroid hormonogenesis. Identification of a sequence containing iodophenyl donor site(s) in calf thyroglobulin. AB - The formation of dehydroalanine in thyroglobulin is the result of the side chain elimination of an iodophenyl group during the thyroid hormone formation from two iodotyrosyl residues. This amino acid is easily converted to labeled alanine (upon reduction with [3H] borohydride) or changed to labeled aspartic acid (upon addition of Na14CN and subsequent acid hydrolysis). The cleavage of the protein by CNBr produced many stainable electrophoretic bands, but the autoradiography indicated the presence of a much smaller number of radioactive species. Although three major species raised attention, because they could be all jointly labeled and were present in all preparations, only a species of 15,900 Da was fully studied. It was isolated and its sequence partially determined by Edman degradation. It was established that this species corresponded to the thyroglobulin fragment between methionines 2,432 and 2,578. This peptide contains two hormonogenic sites (positions 2,555 and 2,569) which are either tyrosyl residues or hormone residues arising from them, and five additional tyrosines all potentially involved as donor sites in the hormonogenesis. Upon treatment with N chlorosuccinimide, the fragment was split into three smaller peptides of about 2,900, 8,500, and 4,600 Da containing 1, 2, and 2 tyrosyl residues, respectively. Only the 8,500-Da subfragment contained [3H]Ala. This finding strongly suggests that at least some of the tyrosines involved as donor sites in thyroid hormonogenesis are within this peptide and possibly map at positions 2,469 and/or 2,522. Moreover, at minimum levels of iodination, when thyroglobulin contains the lowest number of hormone molecules, dehydroalanine is mostly found in the 15,900 Da peptide. PMID- 3680298 TI - Purification of phosphatidylethanolamine N-methyltransferase from rat liver. AB - Phosphatidylethanolamine (PE) N-methyltransferase catalyzes the synthesis of phosphatidylcholine by the stepwise transfer of methyl groups from S adenosylmethionine to the amino head group of PE. PE N-methyltransferase was solubilized from a microsomal membrane fraction of rat liver using the nonionic detergent Triton X-100 and purified to apparent homogeneity. Specific activities of PE N-methyltransferase with PE, phosphatidyl-N-monomethylethanolamine (PMME), and phosphatidyl-N,N-dimethylethanolamine (PDME) as substrates were 0.63, 8.59, and 3.75 mumol/min/mg protein, respectively. The purified enzyme was composed of a single subunit with a molecular mass of 18.3 kDa as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Methylation activities dependent on the presence of PE, PMME, and PDME and the 18.3-kDa protein co eluted when purified PE N-methyltransferase was subjected to gel filtration on Sephacryl S-300 in the presence of 0.1% Triton X-100. All three methylation activities eluted with a Stokes radius 2.1 A greater than that determined for pure Triton micelles (molecular mass difference of 27.4 kDa). Two-dimensional analysis of PE N-methyltransferase employing nonequilibrium pH gradient gel electrophoresis and sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicates that the enzyme is composed of a single isoform. Analysis of enzyme activity using PE, PMME, and PDME at various Triton X-100 concentrations indicated the enzyme follows the "surface dilution" model proposed for other enzymes that act at the surface of mixed micelle substrates. Initial velocity data for all three lipid substrates (at fixed concentrations of Triton X-100) were highly cooperative in nature. Hill numbers for PMME and PDME ranged from 3 at 0.5 mM Triton to 6 at 2.0 mM Triton. All three methylation activities had a pH optimum of 10. These results provide evidence that a single membrane-bound enzyme catalyzes all three methylation steps for the conversion of PE to phosphatidylcholine. PMID- 3680297 TI - Accumulation of lysophosphatidylinositol in RAW 264.7 macrophage tumor cells stimulated by lipid A precursors. AB - N2,O3-Diacylglucosamine 1-phosphate (lipid X), a monosaccharide precursor of Escherichia coli lipid A, was used to stimulate RAW 264.7 macrophage tumor cells, and the effects on macrophage phospholipid metabolism were examined. The addition of E. coli lipid X to the medium of cells that had been uniformly labeled with 32Pi resulted in a 4-8-fold increase in the level of lysophosphatidylinositol. This effect was maximal at 5 microM lipid X. Lysophosphatidylinositol levels reached a maximum 45 min after stimulation, followed by a gradual decline to near normal levels within 2 h. The formation of lysophosphatidylinositol was dependent upon extracellular calcium and was almost completely inhibited when cycloheximide was added at the time of stimulation. The addition of the disaccharide lipid A precursor IVA, commercial lipopolysaccharide (1 microgram/ml), phorbol 12 myristate 13-acetate (10(-7) M), or calcium ionophore A23187 (10(-6) M) to these cells resulted in a similar increase in lysophosphatidylinositol levels, but phosphatidic acid was inactive. The stimulation by IVA and phorbol myristate acetate was blocked by cycloheximide, but the stimulation by lipopolysaccharide was only partially blocked. The stimulation by A23187 was unaffected by cycloheximide. The increase in lysophosphatidylinositol levels might be related to the stimulation of arachidonate release and prostaglandin synthesis that is also observed in cells treated with lipid A precursors. The disaccharide precursor, IVA, was at least 100 times more effective than lipid X at stimulating lysophosphatidylinositol formation and prostaglandin release. The relative ability of lipid X and IVA to stimulate these cells correlated well with their effects on other lipopolysaccharide-responsive systems. Macrophage tumor cells also had the ability to inactivate lipid X by dephosphorylating it. PMID- 3680299 TI - The monkey safety test for neurovirulence of yellow fever vaccines: the utility of quantitative clinical evaluation and histological examination. AB - Two different derivatives of the 17D strain of yellow fever (YF) vaccine virus, i.e. ALV-free seed virus 6676 and three consecutive vaccine lots, A, B and C, obtained from another seed, were compared in monkey neurovirulence tests using rhesus and cynomolgus monkeys. In addition the ALV-contaminated seed lot AB 237 was safety tested in rhesus monkeys. According to WHO clinical criteria for acceptability, lots A, B, C and lot AB 237 consistently passed, while lot 6676 passed some tests and failed others. In the same tests, quantitative clinical evaluation and histological examination of CNS gave more definitive and consistent data on the higher degree of neurovirulence of lot 6676. Especially differentiating histological findings were obtained from some anatomical structures of the CNS ('discriminator areas') and almost no difference was found between the products in the structures apparently most susceptible to YF virus ('target areas'). Although some of the target and discriminator areas were different, cynomolgus monkeys were not less susceptible than rhesus monkeys to YF vaccine virus. The use of a quantitative method of scoring specific lesions in CNS of monkeys and the comparison of the average scores of a YF vaccine lot under study with a 'reference' vaccine, which has proven to be safe and effective in humans, should provide for a more reproducible method of assessing vaccine neurovirulence. PMID- 3680300 TI - A comparison of the indirect haemagglutination test with the toxin neutralization test for the estimation of diphtheria antitoxin in mouse sera. AB - Serum samples from 42 groups of mice immunized for different immunization periods with various doses of Adsorbed Diphtheria-Tetanus Vaccine, Adsorbed Diphtheria Tetanus and Pertussis Vaccine and a standard diphtheria toxoid were assayed for their diphtheria antitoxin content by indirect haemagglutination (IHA) and by toxin neutralization (TN) tests. A very good correlation of 0.91 was obtained between the results of the two methods. There was no statistically significant difference between the IHA and the TN titres obtained. Adsorption with sheep red cells and treatment of the sera with 2-mercaptoethanol had no effect on the IHA titres. The minimum level of antitoxin detectable by the IHA test was 0.00039 IU ml-1. IHA proved to be a sensitive, specific and reproducible method which can be used reliably for the assay of diphtheria antitoxin in mouse sera. PMID- 3680301 TI - Studies on yellow fever vaccine. I. Quality-control parameters. AB - Several parameters have been established for the control of yellow fever vaccine produced in embryonated eggs at Fundacao Oswaldo Cruz, Brasil. A Vero cell plaque titration technique was used throughout this study. A local reference vaccine with an infectivity titre of 5.78 log10 ml-1 (standard deviation 0.28) was routinely included in all tests. It was found that, while one cycle of freezing and thawing did not affect the virus titre, a second thawing reduced it. The titres of the embryo pulp and the embryo juice, virus losses during lyophilization cycles, the titre of the final product and the thermodegradation of the virus were measured and these parameters are being currently applied to every step of the production procedures with a view to strict quality control of yellow fever vaccine. PMID- 3680302 TI - The activity of purified Bordetella pertussis components in murine encephalopathy. AB - A murine encephalopathic syndrome can be induced by the administration of BSA and whole-cell pertussis vaccine. The present paper reports studies of the capacity of purified individual pertussis components to induce this effect. Pertussis toxin and endotoxin together with a highly immunogenic sensitizer protein were required to induce the effect. The strength of the antibody response to the sensitizer appeared to be more important than the H-2 type of the recipient in determining the susceptibility of different mouse strains. The relevance of this syndrome to the study of possible vaccine-induced encephalopathy in man is uncertain and requires further investigation. PMID- 3680303 TI - The effects of reductions in the numbers of animals used for the potency assay of the diphtheria and tetanus components of adsorbed vaccines by the methods of the European pharmacopoeia. AB - Forty eight assays of adsorbed diphtheria vaccine and seven assays of adsorbed tetanus vaccine using either a lethal challenge (38 assays) or a serum neutralization test (17 assays) were evaluated for the effects of reductions in the number of animals used at each dilution on the potency values and 95% confidence intervals. The results were assessed in the light of the requirements of the European Pharmacopoeia and the WHO. In the majority of assays, 50% of the number of animals presently required would have sufficed for the determination of a potency within the limits of confidence stipulated by the European Pharmacopoeia and the WHO. Therefore it is concluded that a simplified assay with a reduced number of animals is suitable for the routine potency testing of the diphtheria and tetanus components of the combined vaccines and the monovalent that were examined. Flexibility in the national and international requirements in respect of the numbers of animals used at each dilution is suggested for the routine potency assay of the diphtheria and tetanus components of adsorbed vaccines. PMID- 3680304 TI - [BiologicaL assay of human growth hormone]. PMID- 3680305 TI - The persistence of antibodies induced by meningococcal polysaccharides of groups A and C in human volunteers. AB - Ninety-nine college students (58 males and 41 females) aged 17 to 23 years were each injected subcutaneously with 50 micrograms of meningococcal polysaccharides A and C. Titrations of antisera obtained at various time intervals during the two subsequent years were made by passive haemagglutination microtitration using human O Rh-negative red blood cells from a single source. The percentage of responders (those who developed a fourfold increase in titre) to polysaccharide A was 97.9% and that to polysaccharide C was 94.8%. Pre-immunization titres of 16 to polysaccharide A and 8 to polysaccharide C were considered to be threshold values above which the response might be impaired. There was a significant (P less than 0.01) difference in the geometric mean HA titre between vaccinees and control groups after vaccination at each time interval studied. The majorities of both the vaccinees and the controls had a higher peak titre to polysaccharide A than to polysaccharide C. PMID- 3680306 TI - A modification of the natural killer cell assay by substitution of 111indium for 51chromium. PMID- 3680307 TI - Assessment of an end-point microassay for varicella vaccine. AB - For routine control purposes, a statistical analysis was performed on the results obtained in titrations of varicella vaccine using a cytopathic effect microassay in a continuous line of monkey kidney cells. Although the results were lower than those obtained by conventional plaque assay, the end-point titres were quite reliable. The within-test variation was very small compared with test-to-test differences and the reference and vaccine titres were highly correlated. Expression of titre in relation to the reference is of value in this microsystem. The microassay has the advantage of economy and less labour. Staining of the microplates ensured convenience and reliability of reading comparable with that of plaque counting. PMID- 3680308 TI - The effect of the virus-serum incubation period upon vaccinia virus serum neutralization titers. AB - Rabbit and human vaccinia virus immune sera were titrated by the plaque reduction serum neutralization (SN) method. Titers determined following a 2-h, 37 degree C virus-serum incubation period were not significantly different from those determined following an 18-h incubation period (2-h, 37 degree C incubation followed by a 16-h, 4 degree C period). However, control virus plaque counts decreased significantly after the longer incubation period. Numerous factors affecting SN titer estimation are reviewed. Standardization of SN test conditions may be useful in comparative potency evaluation of vaccinia-vectored recombinant DNA viral vaccines. PMID- 3680309 TI - Effect of variations in pressure and flow on the geometry of isolated canine carotid arteries. AB - A study is described in which the effects of hemodynamics on arterial geometry are investigated in vitro. A novel perfusion apparatus is employed to deliver pulsatile flow through excised canine carotid arteries under carefully controlled conditions. Data of perfused vessel diameter and arterial wall thickness are derived from the radial displacement of the pulsating vessel as measured using a scanning laser micrometer whose accuracy is determined to be 0.0125 mm (0.0005 in). The results of 30 perfusion experiments suggest that the hemodynamic variables of transmural pressure, pulse pressure and flow rate influence vessel size and radial strain. The physiologic implications of these findings are discussed. PMID- 3680310 TI - A mechanical model for the human intervertebral disc. AB - Stress relaxation experiments were performed on specimens from a human intervertebral disc. Specimens were made from the nucleus pulposus and from the external lamellae of the anulus fibrosus in two different orientations. Tests were run with varying moisture content so as to develop a relaxation master curve. A model was developed based on the experimental data. It was found that the short term master curve for the lamellae of the anulus and nucleus are similar, whereas the long term rubbery plateau is different between the lamellae and the nucleus. It was also established that the master curves for different lamellae and the nucleus were shifted relative to each other in the time domain due to changes in water content. The average relaxation modulus of the whole disc was obtained by averaging the properties between the anulus and nucleus. This model was then used for studies of Schmorl's nodes, of degenerated discs and for circumstances in which hydration is considered to be important. PMID- 3680311 TI - Minimization of the gliding index: criterion for the generation of the surfaces of a knee endoprosthesis. AB - Previous studies on removed failed artificial knees revealed significant degradation of the articular surfaces, including pitting and shredding, as well as burnishing accompanied by score marks and scratches, the latter damage group being related to the gliding motion of the joint. In an attempt to introduce an improved version of an artificial knee joint, we have proposed a general model by which the opposing surfaces of the prosthesis components can be synthesized. The criterion applied was that of minimization of a defined gliding index. The femoral condyles in this model were expressed in terms of torus geometry, and the kinematics of motion fed into the model was that of normal motion in the sagittal plane, including angles as well as the displacement vector in the knee joint. Geometry of the tibial component was obtained from the tangents of the femoral surface, in subsequent positions of motion. The optimal surfaces were those for which the gliding index assumed a minimal value. The solutions obtained for various input motions are presented and discussed. PMID- 3680312 TI - The effects of wall thickness, axial strain and end proximity on the pressure area relation of collapsible tubes. AB - Segments of silicone rubber tube were suspended between rigid pipes and subjected to slowly varying transmural pressure covering a range from slight distension to collapse with osculation. The local inside cross-sectional area at a chosen axial site was simultaneously measured via catheter by an electrical impedance method. Pressure-area relations were recorded thus at various axial sites, under varying conditions of axial tube wall tension, in tubes of two different wall thickness (0.3 and 0.4 of mean radius). Unsupported tube segment length was also varied by means of an insert device. The relations were used to calculate the variation of wave velocity with area according to Young's equation. First opposite wall contact during collapse was shown to occur at a smaller fraction of undistended circular cross-sectional area than in the thin-walled tubes investigated previously by others. PMID- 3680314 TI - Abstracts of the eleventh annual meeting of the American Society of Biomechanics. Davis, California, 16-18 September, 1987. PMID- 3680313 TI - A mixture approach to the mechanics of skin. AB - Skin can be considered to be a mixture of a solid and a fluid. A general theory for the description of the behaviour of mixtures is presented and applied to a mixture of a solid and a fluid. A numerical procedure is presented to solve the non-linear field equations describing such a mixture. The abilities of the procedure are demonstrated by means of a confined compression test. PMID- 3680315 TI - Morphological study of biodegradable PEO/PLA block copolymers. AB - A series of PEO/PLA copolymers, covering a wide range of compositions and segmental lengths, was synthesized, and their morphology was investigated by means of DSC and IR studies. For matrices comprising PEO chains with molecular weights below 3400, no soft-segment crystallinity was detected. When long hard segments were present, essentially monophasic, semicrystalline polymers were obtained, with PLA blocks melting around 130 degrees C. Polymers containing longer soft segments (PEO 6000) exhibited a two-phase matrix, with both components being able to crystallize. The relative degree of crystallinity of PEO and PLA blocks was also determined. The thermal history of the sample strongly affected the morphology of the matrix, especially when both blocks were long enough to crystallize. To further explore these polymers, solvent cast films were prepared and their morphology assessed. Casting from acetone, which is an excellent solvent for PLA, resulted in hard blocks exhibiting lower degrees of crystallinity, while methanol had a similar effect on PEO soft segments. PMID- 3680316 TI - Effect of molecular weight (Mw) of N-(2-hydroxypropyl)methacrylamide copolymers on body distribution and rate of excretion after subcutaneous, intraperitoneal, and intravenous administration to rats. AB - A copolymer of N-(2-hydroxypropyl) methacrylamide (HPMA) and N methacryloyltyrosinamide was prepared and fractionated using Sepharose 4B/6B (1:1) chromatography to produce eight HPMA copolymer fractions of narrow polydispersity and mean molecular weight (Mw) ranging from 12 to 778 kD. These fractions were radioiodinated and injected intravenously, subcutaneously, and intraperitoneally into rats. Their bloodstream-concentration profiles were monitored and rates of excretion assessed. Following intravenous administration the circulating blood volume available to the copolymers was not molecular-weight dependent. A molecular-weight threshold limiting glomerular filtration was identified at approximately 45 kD, and preparations greater than this threshold were lost from the bloodstream only slowly by extravasation. Molecular weight did not influence the movement of copolymers from the peritoneal compartment to the bloodstream after intraperitoneal injection. The transfer rates observed could be accounted for by bulk phase lymphatic drainage alone, no transcapillary routes being implicated. Following subcutaneous administration the largest HPMA copolymer fraction (Mw = 778 kD, diameter approximately 30 nm) showed increased retention at the site of the injection, approximately 20% of the dose remaining there after 21 days. This could result from physical restriction of movement or from internalization into local phagocytic cells. The smaller copolymer fractions moved readily into the bloodstream whence they were either lost in the urine or they gradually penetrated into other tissues and organs. Long-term (21 days) body distribution of copolymers following both intraperitoneal and subcutaneous administration showed size-dependent accumulation in organs of the reticuloendothelial system. PMID- 3680317 TI - Geographical mobility and IQ components. PMID- 3680318 TI - Differential paternity in Libya. PMID- 3680319 TI - Continuing fertility transitions in a plural society: ethnic trends and differentials in Peninsular Malaysia. PMID- 3680320 TI - Covariates of age at first birth in Guyana: a hazards model analysis. PMID- 3680321 TI - First intercourse, contraception and first pregnancy in Flanders: changes during the past 30 years. PMID- 3680322 TI - Breast-feeding pattern in an urban Nigerian community. PMID- 3680323 TI - Differential family formation in Great Britain. PMID- 3680324 TI - Effects of education, distance and satellite clinics on the growth of genetic services. PMID- 3680325 TI - Spinal growth. PMID- 3680326 TI - The microsurgical treatment of lumbar disc protrusion. Follow-up of 60 cases. AB - The technique and results of microsurgical techniques for lumbar disc protrusions in 60 patients are presented. All patients were followed up for a minimum of 2.5 years, and 91% had good or excellent results. The only patient with a recurrent disc sequestration had a good result after a second operation. PMID- 3680327 TI - Magnetic resonance imaging of adolescent disc herniation. AB - Magnetic resonance imaging (MRI) was used to compare the appearance of the spine in 20 adolescents with proven symptomatic intervertebral disc herniations with that in 20 asymptomatic patients who acted as controls. Abnormality in the signal from the nucleus pulposus of one or more discs was present in all patients, while only four of the 20 controls had any abnormal signals. In all the patients the symptomatic disc produced an abnormal signal and in most a herniated fragment of the nucleus pulposus was identified. Fifteen of the 20 patients had multiple-disc abnormality: six had three abnormal discs and nine had two. This suggests there was an underlying diathesis in patients who later developed disc herniation. PMID- 3680328 TI - Anterolateral decompression for neural involvement in thoracolumbar fractures. A review of 78 cases. AB - Of a total of 905 patients with fracture or fracture-dislocation of the thoracolumbar spine admitted from 1969 to 1982, a neurological deficit was present in 334 (37%). All unstable injuries were initially treated by reduction and posterior fusion. In 79 of these patients, an anterolateral decompression was undertaken later because of persistent neurological deficit and radiographic demonstration of encroachment on the spinal canal. One patient died of pulmonary embolism; 78 were reviewed after a mean period of four years. Of these 78 patients 18 made a complete neurological recovery while 53 appeared to have benefited from the procedure; 25 remained unchanged. The best results were obtained in burst fractures at thoracolumbar and lumbar levels when a solitary detached fragment of a vertebral body had been displaced into the spinal canal. These results indicate that anterolateral decompression of the spinal canal should be considered, after careful evaluation, for certain injuries of the spine in which there is severe neural involvement. PMID- 3680329 TI - Surgical treatment of late-onset idiopathic thoracic scoliosis. The Leeds procedure. AB - Late-onset idiopathic scoliosis is associated with a rib hump in the thoracic region, and surgery is indicated when this deformity becomes unacceptable. Fifty patients with this deformity were treated by the Leeds procedure, which consists of segmental wiring to a kyphotically-contoured square-ended Harrington rod; this procedure not only derotates the spine but restores the natural thoracic kyphosis, thus avoiding subsequent buckling. All patients were followed up for a minimum of two years. Forty-two of these, who had a pre-operative Cobb angle of less than 60 degrees, were treated by one-stage instrumentation and fusion, while the remaining eight with greater curves underwent preliminary anterior multiple discectomy to provide flexibility with shortening. Postoperative loss of correction was not observed and there were no neurological complications. PMID- 3680330 TI - The conservative treatment of acromioclavicular dislocation. Review after five years. AB - The treatment of acromioclavicular injuries is controversial; few studies document the late results. We have reviewed 53 patients about five years after conservative management, in nine for subluxation and 44 for dislocation. Subjective and objective results were satisfactory in all cases except for one with painful subluxation, who was the only patient to change her occupation because of the injury. At review, joint stability was demonstrated by improvement in position and by the very small increase in the coracoclavicular gap on stress radiographs. PMID- 3680331 TI - Neer total shoulder replacement in rheumatoid arthritis. AB - Forty-two shoulders in 37 patients with polyarthritis were treated with Neer total shoulder replacements and reviewed 12 to 66 months afterwards. There was good pain relief and improvement in function, but the range of movement was less than that seen after replacements for osteoarthritis; this may have been related to the fact that 34 shoulders had abnormal rotator cuff tendons. Although there was a high incidence of radiolucent lines around the glenoid component, there was no clinical evidence of loosening. There were a few complications, but on the whole we feel that the Neer total shoulder arthroplasty is a valuable procedure for a patient with polyarthritis. PMID- 3680332 TI - Galeazzi fractures in children. AB - We have reviewed 41 children under 15 years of age with a fracture of the radius and disruption of the inferior radio-ulnar joint. Despite the fact that the joint injury had not at first been recognised in 41% of cases and a variety of treatments had been used, the final results of conservative management were generally good. The more distal the radial fracture, the greater were the problems encountered. PMID- 3680333 TI - Late reduction of the dislocated lunate. A method using distraction by an external fixator. AB - The management of carpal dislocation after a late diagnosis is difficult. Open reduction is the usual treatment but collapse of the carpus may be hard to overcome without extensive dissection and consequent damage to the blood supply, ligaments and articular cartilage. A technique of distraction by an external fixator followed by semi-closed reduction is described and its successful use is reported in two cases. PMID- 3680334 TI - Open reduction or epiphysiodesis for slipped upper femoral epiphysis. A comparison of Dunn's operation and the Heyman-Herndon procedure. AB - Forty-eight consecutive patients (53 hips) were treated for moderate or severe slips of the upper femoral epiphysis between 1974 and 1984; 46 patients (96%) returned for clinical and radiological assessment at a mean of five years after operation. Twenty-three patients (23 hips) underwent a Dunn's open reduction and 25 patients (30 hips) were treated by epiphysiodesis and surgical osteoplasty as advocated by Heyman and Herndon. The results of the two methods of treatment are compared. Analysis revealed that 11 hips with moderate slip (30 degrees to 50 degrees) treated by the Heyman-Herndon procedure did significantly better than the 18 hips with severe slip (greater than 50 degrees) treated by the same method. Furthermore, when these hips with severe slip were compared to the hips treated by Dunn's open reduction, all of which were displaced greater than 50 degrees, the latter fared significantly better. The authors conclude that the Heyman-Herndon procedure gave consistently good results for moderate slips, but Dunn's open reduction gave better results for hips with severe slips. PMID- 3680335 TI - The osteoblastic response to osteoarthritis of the hip. Its influence on the long term results of arthroplasty. AB - We have followed up a series of total hip arthroplasties performed for secondary osteoarthritis and analysed the results in relation to the osteoblastic response to the disease. This was assessed pre-operatively from the radiographic appearance, according to Bombelli's criteria (1983). Of 63 hips in 55 patients followed up for five to 13 years, 17 were hypertrophic, 24 normotrophic and 22 atrophic in type. The atrophic-type hips showed a high incidence of acetabular loosening, leading to unsatisfactory clinical results in 32%. By contrast, the hypertrophic-type hips had a low incidence of acetabular loosening, while the normotrophic type showed intermediate results. It was concluded that the osteoblastic response to osteoarthritis is closely related to acetabular loosening and to late clinical failure. PMID- 3680336 TI - The Ring uncemented polyethylene cup in the abnormal acetabulum. AB - The results of using the Ring uncemented polyethylene-to-metal (UPM) prosthesis in patients with protrusio acetabuli or dysplasia are reported. Fifty-four cases of protrusio were analysed and a modified method of measuring the deformity is described; after operation, remodelling of the medial wall had improved, on average, by 29.6%. For the dysplastic acetabulum the main difficulty is the lack of lateral support for the cup. In order to test the hypothesis that this support improves with an uncemented prosthesis, 38 hips with an average follow-up of 31 months were studied. Lateral support, measured radiographically, showed an average increase of 21%. The remodelling effect may be attributed to the biomechanical design of the prosthesis. PMID- 3680337 TI - The Bateman bipolar femoral head replacement. A fluoroscopic study of movement over a four-year period. AB - The purpose of this study was to establish if the Bateman prosthesis functions as a bipolar device moving primarily at the inner metal-on-polyethylene bearing as originally proposed, or as a unipolar hemiarthroplasty moving at the outer metal on-cartilage surface as has recently been suggested. One hundred hips were examined at one year follow-up; 78 were examined again at two to four years. The replacement was performed for arthritis in 76 hips and for femoral neck fracture in 24. Movement was assessed both with and without weight-bearing. In 80% of the arthritis group the prosthesis functioned as a bipolar hip replacement with movement occurring primarily at the inner metal-on-polyethylene surface. By contrast, in 75% of the fracture group the prosthesis functioned largely as a unipolar device with movement occurring primarily at the outer metal-on-cartilage surface. In all cases examined serially the movement pattern was the same at two to four years as it has been at one year. Clearly, the action of the prosthesis depends on the condition of the acetabular cartilage. PMID- 3680338 TI - Screening for osteomalacia in elderly patients with femoral neck fractures. AB - In this study 201 elderly patients with femoral neck fractures were compared with 30 osteomalacic patients with the same injury. Hypocalcaemia and a raised alkaline phosphatase level are common biochemical abnormalities in elderly patients with femoral neck fractures. In only a minority of patients, however, were they associated with histologically proven osteomalacia. By using the combination of hypocalcaemia and a raised alkaline phosphatase it is possible to identify a subgroup (approximately 10% of all admissions) in whom osteomalacia is relatively likely. PMID- 3680339 TI - Idiopathic transient osteoporosis of the hip. AB - We have reviewed 11 patients with idiopathic transient osteoporosis of the hip; the six who were women all developed the condition during pregnancy. Both simultaneous and sequential bilateral involvement were seen, but biochemical studies were consistently normal and one synovial biopsy showed only non-specific inflammation. Radioisotope bone scans and CT scans were useful to aid diagnosis. Treatment by limiting weight-bearing relieved symptoms, and spontaneous resolution was paralleled by radiographic remineralisation, usually within a few months. One patient developed a stress fracture of the hip and other areas of transient osteoporosis. A hip involved by the condition should be protected from overloading until bone density has recovered. PMID- 3680340 TI - Idiopathic transient osteoporosis of the hip: brief report. PMID- 3680341 TI - The postphlebitic syndrome following shaft fractures of the leg. A significant late complication. AB - Sixty patients each of whom had a fracture of the lower limb a minimum of five years (median 11 years) previously were studied by photoplethysmography, foot volumetry, popliteal venous reflux and arterial Doppler measurements. The non fractured limb was used as a control. Postphlebitic symptoms were present in 51% and signs in 49% of fractured limbs compared with 4% and 24% respectively in the control limbs. The incidence was greater in patients who had fractured 15 years or more previously than in those who had fractured 5 to 15 years previously. Eleven limbs had clinically disabling postphlebitic symptoms including venous ulceration. The postphlebitic syndrome following lower limb fractures in young patients is more common than generally appreciated and develops after a prolonged latent interval. A prospective randomised study using prophylactic anticoagulation for lower limb shaft fractures may be justified. PMID- 3680342 TI - Osteomyelitis in a general hospital. A five-year study showing an increase in subacute osteomyelitis. AB - We have reviewed 60 patients with primary bone infections; 21 of these (35%) had subacute osteomyelitis, a figure which supports other recent observations that this variant of bone infection is becoming more widespread. In this group open culture and biopsy were necessary in order to exclude bony malignancy, and a raised erythrocyte sedimentation rate proved a useful diagnostic aid. All the patients with acute osteomyelitis or with vertebral infection responded to primary treatment, but five of those with subacute osteomyelitis had recurrences. PMID- 3680343 TI - The penetration of antibiotics into the normal intervertebral disc. AB - The role of antibiotics in the treatment of disc-space infection is controversial. This study assessed the tissue penetration of flucloxacillin and cephradine into the normal intervertebral disc after intravenous administration of a bolus dose of antibiotic. Twenty-five discs were removed from 12 adolescent patients having anterior spinal surgery to correct scoliosis; antibiotic had been administered between 30 minutes and four hours before operation. Despite high blood levels, no antibiotic could be detected by bioassay or by high-pressure liquid chromatography (h.p.l.c.) in any of the specimens from the nucleus pulposus or the annulus fibrosus. PMID- 3680344 TI - Recurrent dislocation of the patella. Histochemical and electromyographic evidence of primary muscle pathology. AB - The role of muscle function in the aetiology of recurrent dislocation of the patella has been examined. Eleven of the 12 patients we studied had joint hypermobility. Muscle biopsies from eight of nine patients treated by surgery had a predominance of abnormal Type 2C fibres, and three of six patients whose quadriceps muscles were studied by electromyography also had abnormal results. Our preliminary findings suggest that there may be a primary muscular defect in many cases of recurrent dislocation of the patella. PMID- 3680345 TI - Arthroscopic surgery for chondral flaps in the knee. AB - A retrospective review of 50 knees in 46 patients treated by arthroscopic removal of chondral flaps is reported. There was a relationship between the site of the flap and the type of symptoms; patellofemoral flaps produced anterior knee pain, posterior condylar flaps produced instability. At review after 18 to 36 months, after a second arthroscopy in eight cases, 44 of the 50 knees had retained significant improvement and 33 were symptom-free. PMID- 3680346 TI - Reflex sympathetic dystrophy affecting the knee. AB - Thirty-six patients with reflex sympathetic dystrophy primarily affecting the knee were reviewed. Injuries or operation about the patellofemoral joint triggered its onset in 64% of patients. Co-existent mechanical derangement of the knee was present in 64% of patients. Those patients who underwent sympathetic blockade or sympathectomy within one year of onset of symptoms had significantly better pain and function scores than those in whom intervention was later. Early diagnosis remains the key to successful management. Surgery for co-existent mechanical derangement in the affected knee should not be performed until the syndrome is controlled. PMID- 3680347 TI - Reflex sympathetic dystrophy of the knee. AB - Reflex sympathetic dystrophy of the knee has been studied in a series of 19 patients. Those diagnosed and treated early (at less than six months) did much better than those diagnosed and treated late. Nevertheless, when these patients were followed up at an average of 3.4 years from onset, not one was completely normal to objective tests with the Cybex II dynameter, an indication of the adverse prognosis with current methods of treatment. PMID- 3680348 TI - Impact-absorbing properties of the human knee. AB - A biomechanical study has been carried out on 20 cadaveric knees to investigate their load-absorbing mechanism. The impact load was applied using a weight falling onto the transected proximal femur and the force transmitted through the knee was measured at the transected distal tibia using a load transducer. The peak force transmitted increased as, sequentially, meniscus, articular cartilage and subchondral bone were damaged or removed. The most striking result was found in an implanted knee replacement where the transmitted force reached 180% of that in the intact knee. The results show that the joint has an impact-absorbing property in each segment and that in the osteoarthritic knee there is less absorption of shock than in the normal knee. The high impact force in an implanted knee suggests that microfractures of the cancellous bone might be expected and may produce loosening. PMID- 3680349 TI - Periosteal division and longitudinal growth in the tibia of the rat. AB - Growth at the proximal tibial epiphyseal plate of the rat has been measured following three different growth-stimulating procedures. These were proximal periosteal release, distal periosteal release and full periosteal stripping of the diaphysis. A new radiographic method using a photographic technique has made it possible to take accurate measurements of the rate of long-bone growth in small experimental animals. From the results of this animal series we conclude that proximal tibial periosteal division is likely to be the most effective of the three procedures when used to correct leg-length discrepancy in the growing child. PMID- 3680350 TI - Circumferential periosteal release in the treatment of children with leg-length inequality. AB - We present the results of 38 children with leg inequality treated by circumferential periosteal release. Leg-length discrepancy was expressed as a percentage of the longer limb. All patients showed a decrease in percentage difference at one year after operation, the mean difference dropping from 7.24% to 5.45%. The size of the response was directly related to the age of the patient at operation, being more pronounced in the younger patients. The response was not related to sex, diagnosis, or rate of growth of the patient immediately preceding operation. PMID- 3680351 TI - Congenital talipes equinovarus: I. Resolving and resistant deformities. AB - Comparisons were made between 54 children with resolving congenital talipes equinovarus deformity and 81 children whose feet required surgical correction. There was a significant difference in the incidence of bilateral deformity, sex ratio and family history of congenital talipes in the two groups. The children with resolving deformity had feet which were indistinguishable from the normal side of unilaterally affected children in their calf muscle measurements at six weeks of age, and in the range of movement and radiographs at four years of age. Those requiring surgery had varying degrees of muscle reduction, and although often well corrected, had a reduced range of movement and altered joint anatomy at four years of age. This suggests that they are two distinct populations. PMID- 3680352 TI - Congenital talipes equinovarus: II. A staged method of surgical management. AB - A staged method of surgical management for congenital talipes equinovarus is described. The hindfoot was corrected and rebalanced early in 125 feet, and in 66 feet a second-stage medial forefoot correction was performed in the second, third or fourth year. The hindfoot relapsed in 19% and the forefoot in 9%; these feet were treated by further soft-tissue surgery. No bony operation was necessary. Assessment before and after operation allows comparison with other series. PMID- 3680353 TI - Residual adduction of the forefoot. A review of the Turco procedure for congenital club foot. AB - Forty-four feet in 28 children previously treated by a one-stage posteromedial release operation (the Turco procedure) were reviewed clinically and radiologically to determine the cause of residual adduction of the forefoot. In 21 clinically adducted feet (48%) the main cause of residual deformity was metatarsus varus alone or metatarsus varus in spite of talonavicular overcorrection; in five feet the cause was talonavicular subluxation. There was no residual adduction in 23 feet (52%) but only 12 had normal radiographic measurements. In the remaining feet, various forms of spurious correction of metatarsus varus and talonavicular subluxation or both were seen, resulting in normal-looking feet. Recession of the origin of abductor hallucis and release of the short plantar muscles and fascia at the time of posteromedial release is recommended. The forefoot adduction was satisfactorily corrected in 91% of the feet subsequently operated on using this modified procedure. PMID- 3680355 TI - Assessment of foot movement. AB - A method of assessing foot movement suitable for use in clinical practice is presented. The method assesses the component of movement in the horizontal plane which is produced by rotating the calcaneum about the axis of the subtalar joint. PMID- 3680354 TI - Dorsal wedge osteotomy of the proximal phalanx for hallux rigidus. Long-term results. AB - Eight women had 10 toes treated for hallux rigidus by dorsal wedge osteotomy of the proximal phalanx and were reviewed after an average follow-up of 22 years. Five toes were symptom-free, four others did not restrict walking, and only one had required metatarsophalangeal fusion. We conclude that dorsal wedge osteotomy affords long-lasting benefits for hallux rigidus in the adolescent female. PMID- 3680357 TI - Stress fracture of the sacrum: brief report. PMID- 3680356 TI - Ingrowing toenails: is there a nail abnormality? A prospective study. AB - Ingrowing of the nail of the hallux has been ascribed to an abnormality of the shape of the nail; our prospective study was planned to test this association. Twenty-three consecutive patients and 23 age-matched controls were assessed by caliper measurement and standard photographs, before a first operation for ingrowing toenail. We found no differences in shape between the toenails of the patients and those of the controls, both groups showing great variation. Our results suggest that the ingrowth is not commonly associated with an abnormal shape of the nail. PMID- 3680358 TI - The elbow fat pad sign: brief report. PMID- 3680359 TI - Treatment of early-acute osteomyelitis in childhood: brief report. PMID- 3680360 TI - Measurement of leg length by computerised tomographic scanography: brief report. PMID- 3680361 TI - Caisson disease of the talus: brief report. PMID- 3680362 TI - Bone scanning for hip fracture in patients with osteoarthritis: brief report. PMID- 3680363 TI - Novel experimental models of human cancer metastasis in nude mice: lung metastasis, intraabdominal carcinomatosis with ascites, and liver metastasis. AB - The ability of RPMI 4788 cells, a human colon cancer cell line, to produce experimental metastases in the lung, intraperitoneal cavity, and liver was studied in nude mice. Injection of 2 X 10(6) tumor cells into the tail vein of nude mice produced metastatic lung tumors, and an intraportal injection of 5 X 10(6) cells produced metastatic liver tumors. An intraabdominal carcinomatosis with ascites was formed after an i.p. injection of 5 X 10(6) tumor cells. The nude mice with lung metastasis or intraabdominal carcinomatosis always died within a few weeks. Macroscopic observation showed that the number of lung metastatic nodules on day 21 after tumor inoculation was 311.3 +/- 78.2 (mean +/- SD) in BALB/C nude mice, and 187.5 +/- 26.7 in ICR nude mice. In survival experiments, the mice with intraabdominal carcinomatosis showed a mean survival of 29.0 +/- 1.7 (mean +/- SD) days in BALB/C nude mice and 43.6 +/- 6.1 days in ICR nude mice. These novel experimental models of metastases in nude mice produced by injection of RPMI4788 cells had high reproducibility and may be useful not only for the study of the metastatic process but also for testing anticancer drugs. PMID- 3680364 TI - Plasma levels of secretory IgA in patients with gastric cancer. AB - The levels of plasma secretory IgA were measured in patients with gastric cancer and found to be slightly higher (9.6 +/- 6.2 micrograms/ml) than those in healthy controls (7.0 +/- 2.6 micrograms/ml, 0.05 less than P less than 0.1). Secretory IgA levels in those with hepatic metastases (19.7 +/- 12.2 micrograms/ml) were significantly higher than those in patients without hepatic metastases (P less than 0.001). In the latter, there was no significant relationship between plasma secretory IgA levels and the deepest layer of cancerous invasion or lymph node metastases. The secretory IgA levels in cases of well differentiated tubular adenocarcinoma were significantly higher than those with poorly differentiated adenocarcinoma (P less than 0.05). Although there is small diagnostic value in the detection of gastric cancer by measuring the levels of secretory IgA, high levels of secretory IgA in gastric cancer patients may be indicative of the presence of hepatic metastases. PMID- 3680365 TI - Plasma cell leukemia with an unusual karyotype and prolonged survival with 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 the idea of a common precursor cell for plasma cells and cells of the myelomonocytic lineage. PMID- 3680366 TI - Morphological predictors of survival in colorectal carcinoma: univariate and multivariate analysis. AB - In 150 curative resected adenocarcinomas of the large bowel we analyzed the morphological parameters of the primary tumor and lymph node involvement which most efficiently expressed the relationship to survival time. Using univariate survival analysis (product limit estimator according Kaplan-Meier), several macroscopical and microscopical parameters of the primary tumor and lymph node involvement significantly correlated with survival time. A multivariate survival analysis of covariates according to the Cox regression model revealed that the significant correlations of all these parameters were expressed by a set of five variables: pT stage, number of inflammatory cells, sex, age, and pN stage. As shown by the Kaplan-Meier test, this set of variables allowed a more precise prediction of survival time than mere staging according to the TNM system. Parametric multiple stepwise survival analysis was inefficient. No distinct relationship was found between the morphology of the primary tumor and the involvement of lymph nodes. PMID- 3680367 TI - Ovarian carcinoma: increase in clinical validity by simultaneous determination of SRA and CA 125. AB - Ovarian carcinomas are distinguished by their polyclonality, i.e., heterogeneity and polymorphism of their tissue. There is no marker available complying with the clinical demands in the case of ovarian carcinoma regarding satisfactory sensitivity and specificity. Therefore, we have simultaneously determined two entirely distinct tumor markers, serum ribonuclease activity (SRA) and cancer antigen 125 (CA 125), recommended in the literature with respect to ovarian carcinoma. After evaluation by logistic regression analysis, we found a specificity of 93% together with a sensitivity of 97% for the simultaneous determination of SRA and CA 125 (37 ovarian carcinomas, 11 cases without pathological findings after treatment, 11 benign tumors of the ovary, 61 controls). The patients are not exposed to increased stress by this simultaneous determination method compared to the determination of a single marker. The increased clinical validity justifies the recommendation of routine simultaneous determinations of SRA and CA 125 for diagnosis and monitoring of patients with ovarian carcinoma. PMID- 3680368 TI - Expression of human cathepsin D in Xenopus oocytes: phosphorylation and intracellular targeting. AB - We have obtained expression of a cDNA clone for human cathepsin D in Xenopus laevis oocytes. Biosynthetic studies with [35S]methionine labeling demonstrated that most of the cathepsin D remained intracellular and underwent proteolytic cleavage, converting a precursor of Mr 47,000 D to a mature form of Mr 39,000 D with processing intermediates of Mr 43,000-41,000 D. greater than 90% of the cathepsin D synthesized by oocytes bound to a mannose 6-phosphate (Man-6-P) receptor affinity column, indicating the presence of phosphomannosyl residues. An analysis of [2-3H]mannose-labeled oligosaccharides directly demonstrated phosphomannosyl residues on cathepsin D. Sucrose-gradient fractionation, performed to define the membranous compartments that cathepsin D traversed during its biosynthesis, demonstrated that cathepsin D is targeted to a subpopulation of yolk platelets, the oocyte equivalent of a lysosome. Xenopus oocytes were able to endocytose lysosomal enzymes from the medium and this uptake was inhibited by Man 6-P, thus demonstrating the presence of Man-6-P receptors in these cells. Therefore, the entire Man-6-P dependent pathway for targeting of lysosomal enzymes is present in the oocytes. Xenopus oocytes should be a useful system for examining signals responsible for the specific targeting of lysosomal enzymes to lysosomes. PMID- 3680369 TI - An anchor-minus form of the polymeric immunoglobulin receptor is secreted predominantly apically in Madin-Darby canine kidney cells. AB - The polymeric immunoglobulin receptor is expressed in a variety of polarized epithelial cells. Newly made receptor travels first to the basolateral surface. The receptor is then endocytosed, transported across the cell in vesicles, and exocytosed at the apical surface. We have now deleted the membrane spanning and cytoplasmic portions of the receptor by site-directed mutagenesis, thus converting the receptor to a secretory protein. When expressed in polarized Madin Darby canine kidney (MDCK) cells the truncated protein is secreted at both surfaces, with a ratio of apical-to-basal secretion of 3.4. In contrast, when the exogenous secretory protein chicken lysozyme is expressed in these cells, it is released at both sides with a ratio of apical-to-basal secretion of 0.43. (Koder Koch, C., R. Bravo, S. Fuller, D. Cutler, and H. Garoff, 1985, J. Cell Biol., 43:297-306). Lysozyme is thought to lack a signal that targets it to one surface or the other, and so its secretion may represent a default, bulk flow pathway to both surfaces. When compared with lysozyme, the truncated polymeric immunoglobulin receptor is preferentially secreted apically by a factor of 3.4:0.43 or 7.8. We suggest that the lumenal portion of the polymeric immunoglobulin receptor contains a signal that targets it to the apical surface. PMID- 3680370 TI - Polarized secretion of a platelet-derived growth factor-like chemotactic factor by endothelial cells in vitro. AB - Cultured bovine aortic endothelial cells secrete a potent migration-stimulating factor for vascular smooth muscle cells (SMCs) and adventitial fibroblasts. Vascular pericytes are 20-fold less responsive, and endothelial cells themselves do not respond at all. Checkerboard analysis of SMC migration in a micro chemotaxis chamber assay shows that the factor is chemotactic. Chemotactic activity for SMCs and adventitial fibroblasts is specifically inhibited by antibodies against platelet-derived growth factor. Endothelial cells cultured on nitrocellulose filters secrete the platelet-derived growth factor-like factor almost exclusively into the basal compartment. We suggest that this factor plays an important role in the recruitment of vascular wall cells during the morphogenesis of blood vessels and pathological conditions, such as atherosclerosis. PMID- 3680371 TI - Regulation of differentiation and polarized secretion in mammary epithelial cells maintained in culture: extracellular matrix and membrane polarity influences. AB - Several previous studies have demonstrated that mammary epithelial cells from pregnant mice retain their differentiated characteristics and their secretory potential in culture only when maintained on stromal collagen gels floated in the culture medium. The cellular basis for these culture requirements was investigated by the monitoring of milk protein synthesis and polarized secretion from the mouse mammary epithelial cell line, COMMA-1-D. Experiments were directed towards gaining an understanding of the possible roles of cell-extracellular matrix interactions and the requirements for meeting polarity needs of the epithelium. When cells are cultured on floating collagen gels they assemble a basal lamina-like structure composed of laminin, collagen (IV), and heparan sulfate proteoglycan at the interface of the cells with the stromal collagen. To assess the role of these components, an exogenous basement membrane containing these molecules was generated using the mouse endodermal cell line, PFHR-9. This matrix was isolated as a thin sheet attached to the culture dish, and mammary cells were then plated onto it. It was found that cultures on attached PFHR-9 matrices expressed slightly higher levels of beta-casein than did cells on plastic tissue culture dishes, and also accumulated a large number of fat droplets. However, the level of beta-casein was approximately fourfold lower than that in cultures on floating collagen gels. Moreover, the beta-casein made in cells on attached matrices was not secreted but was instead rapidly degraded intracellularly. If, however, the PFHR-9 matrices with attached cells were floated in the culture medium, beta-casein expression became equivalent to that in cells cultured on floating stromal collagen gels, and the casein was also secreted into the medium. The possibility that floatation of the cultures was necessary to allow access to the basolateral surface of cells was tested by culturing cells on nitrocellulose filters in Millicell (Millipore Corp., Bedford, MA) chambers. These chambers permit the monolayers to interact with the medium and its complement of hormones and growth factors through the basal cell surface. Significantly, under these conditions alpha 1-, alpha 2-, and beta-casein synthesis was equivalent to that in cells on floating gels and matrices, and, additionally, the caseins were actively secreted. Similar results were obtained independently of whether or not the filters were coated with matrices.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680372 TI - Drosophilia spectrin. I. Characterization of the purified protein. AB - We purified a protein from Drosophila S3 tissue culture cells that has many of the diagnostic features of spectrin from vertebrate organisms: (a) The protein consists of two equimolar subunits (Mr = 234 and 226 kD) that can be reversibly cross-linked into a complex composed of equal amounts of the two subunits. (b) Electron microscopy of the native molecule reveals two intertwined, elongated strands with a contour length of 180 nm. (c) Antibodies directed against vertebrate spectrin react with the Drosophila protein and, similarly, antibodies to the Drosophila protein react with vertebrate spectrins. One monoclonal antibody has been found to react with both of the Drosophila subunits and with both subunits of vertebrate brain spectrin. (d) The Drosophila protein exhibits both actin-binding and calcium-dependent calmodulin-binding activities. Based on the above criteria, this protein appears to be a bona fide member of the spectrin family of proteins. PMID- 3680373 TI - Determination of cell division axes in the early embryogenesis of Caenorhabditis elegans. AB - The establishment of cell division axes was examined in the early embryonic divisions of Caenorhabditis elegans. It has been shown previously that there are two different patterns of cleavage during early embryogenesis. In one set of cells, which undergo predominantly determinative divisions, the division axes are established successively in the same orientation, while division axes in the other set, which divide mainly proliferatively, have an orthogonal pattern of division. We have investigated the establishment of these axes by following the movement of the centrosomes. Centrosome separation follows a reproducible pattern in all cells, and this pattern by itself results in an orthogonal pattern of cleavage. In those cells that divide on the same axis, there is an additional directed rotation of pairs of centrosomes together with the nucleus through well defined angles. Intact microtubules are required for rotation; rotation is prevented by inhibitors of polymerization and depolymerization of microtubules. We have examined the distribution of microtubules in fixed embryos during rotation. From these and other data we infer that microtubules running from the centrosome to the cortex have a central role in aligning the centrosome-nuclear complex. PMID- 3680374 TI - Free calcium increases during anaphase in stamen hair cells of Tradescantia. AB - Changes in free calcium concentration [( Ca]) have been detected during anaphase in stamen hair cells of Tradescantia. Cells have been injected iontophoretically with the calcium sensitive metallochromic dye arsenazo III and changes in differential absorbance have been measured using a spinning wheel microspectrophotometer. The results obtained on single cells progressing from midmetaphase through to cytokinesis show that the free [Ca] first begins in increase after the initial separation of the sister chromosomes marking the onset of anaphase. The increase continues for 10-15 min while the chromosomes move to the poles; thereafter the [Ca] declines with the cell plate appearing about the time that the ion returns to its basal level. The close temporal correlation firstly between the rise in [Ca] and the breakdown of spindle microtubules (MTs) during anaphase and secondly, between the subsequent fall in [Ca] and the emergence of the MT-containing phragmoplast provides evidence consistent with the idea that endogenous fluctuations in [Ca] control the disassembly/assembly of MTs during mitosis. PMID- 3680375 TI - Fura-2 measurement of cytosolic free Ca2+ in monolayers and suspensions of various types of animal cells. AB - The fluorescent indicator fura-2 has been applied to a variety of cell types in order to set up appropriate conditions for measurements of the cytosolic concentration of free ionized Ca2+ [( Ca2+]i) in both cell suspensions and single cells analyzed in a conventional fluorimeter or in a fluorescence microscope equipped for quantitative analyses (with or without computerized image analyses), respectively. When the usual procedure for fluorescence dye loading (i.e., incubation at 37 degrees C with fura-2 acetoxy-methyl ester) was used, cells often exhibited a nonhomogeneous distribution of the dye, with marked concentration in multiple small spots located preferentially in the perinuclear area. These spots (studied in detail in human skin fibroblasts), were much more frequent in attached than in suspended cells, and were due to the accumulation (most probably by endocytosis) of the dye within acidic organelles after hydrolysis by lysosomal enzyme(s). When loading with fura-2 was performed at low (15 degrees C) temperature, no spots appeared, and cells remained diffusely labeled even after subsequent incubation at 32-37 degrees C for up to 2 h. Homogeneous distribution of the dye is a prerequisite for appropriate [Ca2+]i measurement. In fact, comparison of the results obtained in human skin fibroblasts labeled at either 37 or 15 degrees C demonstrated in spotty cells a marked apparent blunting of Ca2+ transients evoked by application of bradykinin. Additional problems were encountered when using fura-2. Leakage of the dye from loaded cells to the extracellular medium markedly affected the measurements in cell suspensions. This phenomenon was found to depend on the cell type, and to markedly decrease when temperature was lowered, suggesting the involvement of a facilitated transport. Calibration of fluorescence signals in terms of absolute [Ca2+]i was complicated by the increased fluorescence of fura-2 in the intracellular environment. To solve this problem we propose an in situ calibration procedure based on measurements carried out on cells in which [Ca2+]i was massively lowered (by loading the probe in a Ca2+-free medium) or increased (by treatment with the Ca2+ ionophore ionomycin, applied in a medium containing 3 mM Ca2+). These results provide explanations and, at least partial, solutions to the major problems encountered when using fura-2, and should thus be of help in clarifying the proper usage of the dye in [Ca2+]i measurements. PMID- 3680376 TI - Characterization and dynamics of cytoplasmic F-actin in higher plant endosperm cells during interphase, mitosis, and cytokinesis. AB - We have identified an F-actin cytoskeletal network that remains throughout interphase, mitosis, and cytokinesis of higher plant endosperm cells. Fluorescent labeling was obtained using actin monoclonal antibodies and/or rhodamine phalloidin. Video-enhanced microscopy and ultrastructural observations of immunogold-labeled preparations illustrated microfilament-microtubule co distribution and interactions. Actin was also identified in cell crude extract with Western blotting. During interphase, microfilament and microtubule arrays formed two distinct networks that intermingled. At the onset of mitosis, when microtubules rearranged into the mitotic spindle, microfilaments were redistributed to the cell cortex, while few microfilaments remained in the spindle. During mitosis, the cortical actin network remained as an elastic cage around the mitotic apparatus and was stretched parallel to the spindle axis during poleward movement of chromosomes. This suggested the presence of dynamic cross-links that rearrange when they are submitted to slow and regular mitotic forces. At the poles, the regular network is maintained. After midanaphase, new, short microfilaments invaded the equator when interzonal vesicles were transported along the phragmoplast microtubules. Colchicine did not affect actin distribution, and cytochalasin B or D did not inhibit chromosome transport. Our data on endosperm cells suggested that plant cytoplasmic actin has an important role in the cell cortex integrity and in the structural dynamics of the poorly understood cytoplasm-mitotic spindle interface. F-actin may contribute to the regulatory mechanisms of microtubule-dependent or guided transport of vesicles during mitosis and cytokinesis in higher plant cells. PMID- 3680377 TI - Microtubule assembly in cytoplasmic extracts of Xenopus oocytes and eggs. AB - We have investigated the differences in microtubule assembly in cytoplasm from Xenopus oocytes and eggs in vitro. Extracts of activated eggs could be prepared that assembled extensive microtubule networks in vitro using Tetrahymena axonemes or mammalian centrosomes as nucleation centers. Assembly occurred predominantly from the plus-end of the microtubule with a rate constant of 2 microns.min 1.microM-1 (57 s-1.microM-1). At the in vivo tubulin concentration, this corresponds to the extraordinarily high rate of 40-50 microns.min-1. Microtubule disassembly rates in these extracts were -4.5 microns.min-1 (128 s-1) at the plus end and -6.9 microns.min-1 (196 s-1) at the minus-end. The critical concentration for plus-end microtubule assembly was 0.4 microM. These extracts also promoted the plus-end assembly of microtubules from bovine brain tubulin, suggesting the presence of an assembly promoting factor in the egg. In contrast to activated eggs, assembly was never observed in extracts prepared from oocytes, even at tubulin concentrations as high as 20 microM. Addition of oocyte extract to egg extracts or to purified brain tubulin inhibited microtubule assembly. These results suggest that there is a plus-end-specific inhibitor of microtubule assembly in the oocyte and a plus-end-specific promoter of assembly in the eggs. These factors may serve to regulate microtubule assembly during early development in Xenopus. PMID- 3680378 TI - The positional stability of thick filaments in activated skeletal muscle depends on sarcomere length: evidence for the role of titin filaments. AB - Electron microscopy was used to study the positional stability of thick filaments in isometrically contracting skinned rabbit psoas muscle as a function of sarcomere length at 7 degrees C. After calcium activation at a sarcomere length of 2.6 micron, where resting stiffness is low, sarcomeres become nonuniform in length. The dispersion in sarcomere length is complete by the time maximum tension is reached. A-bands generally move from their central position and continue moving toward one of the Z-discs after tension has reached a plateau at its maximum level. The lengths of the thick and thin filaments remain constant during this movement. The extent of A-band movement during contraction depends on the final length of the individual sarcomere. After prolonged activation, all sarcomeres between 1.9 and 2.5 micron long exhibit A-bands that are adjacent to a Z-disc, with no intervening I-band. Sarcomeres 2.6 or 2.7 micron long exhibit a partial movement of A-bands. At longer sarcomere lengths, where the resting stiffness exceeds the slope of the active tension-length relation, the A-bands remain perfectly centered during contraction. Sarcomere symmetry and length uniformity are restored upon relaxation. These results indicate that the central position of the thick filaments in the resting sarcomere becomes unstable upon activation. In addition, they provide evidence that the elastic titin filaments, which join thick filaments to Z-discs, produce almost all of the resting tension in skinned rabbit psoas fibers and act to resist the movement of thick filaments away from the center of the sarcomere during contraction. PMID- 3680380 TI - A transient intracellular coupling explains the facilitation of responses in the bioluminescent system of scale worms. AB - Isolated elytra of polynoid worms emit a flash of bioluminescence when stimulated by an electric shock. With repeated stimulation, hundreds of flashes can be elicited which, in typical series, exhibit large and progressive variations. The amount of luminescence emitted by each flash first increases during a period of facilitation and then decreases exponentially during a longer period of decay. Through a microscope and image intensifier, the activity of individual microsources or photosomes was observed, using their fluorescence as a natural probe, in that its intensity is a function of the amount of luminescence previously emitted. Sequential observation showed a progressive and basically intracellular recruitment that correlated with facilitation. Facilitation and/or recruitment depended on the frequency of the stimulation. Recruitment proceeded among the photosomes of each photocyte, beginning with those of the cell periphery and progressing to those of the center. When the repetitive stimulation was interrupted and then resumed, the refacilitation was a function of the duration of the pause, and the pathway of recruitment duplicated that of the preceding sequence. It therefore appears that, within a given cell, individual photosomes can be either coupled and respond to stimulation or uncoupled and quiescent, that the coupled state has a basic lifetime of about 1 s which can be lengthened by reinforcement, and that this state must be established in a matter of milliseconds as a result of the stimulation. In preparing an increased response to a forthcoming stimulation, coupling acts as a short-term memory. PMID- 3680379 TI - Rigor crossbridges are double-headed in fast muscle from crayfish. AB - The structure of rigor crossbridges was examined by comparing rigor crossbridges in fast muscle fibers from glycerol-extracted abdominal flexor muscle of crayfish with those in "natively decorated" thin filaments from the same muscle. Natively decorated thin filaments were obtained by dissociating the backbone of the myosin filaments of rigor myofibrils in 0.6 M KCl. Intact fibers were freeze-fractured, deep-etched, and rotary shadowed; isolated filaments were either negatively stained or freeze dried and rotary shadowed. The crossbridges on the natively decorated actin maintain the original spacing and the disposition in chevrons and double chevrons for several hours, indicating that no rearrangement of the actomyosin interactions occurs. Thus the crossbridges of the natively decorated filaments were formed within the geometrical constraints of the intact myofibril. The majority of crossbridges in the intact muscle have a triangular shape indicative of double-headed crossbridge. The triangular shape is maintained in the isolated filaments and negative staining resolves two heads in a single crossbridge. In the isolated filaments, crossbridges are attached at uniform acute angles. Unlike those in insect flight muscle (Taylor et al., 1984), lead and rear elements of the double chevron may be both double-headed. Deep-etched images reveal a twisted arrangement of subfilaments in the backbone of the thick filament. PMID- 3680381 TI - An optional dyadic junctional complex revealed by fast-freeze fixation in the bioluminescent system of the scale worm. AB - In the bioluminescent system of the scale worm, the facilitation of the successive flashes is correlated with the progressive recruitment, in each photogenic cell, of new units of activity, the photosomes. To characterize morphologically the coupled state of the photosomes, known to decouple within seconds at rest, fast-freeze fixation was applied to stimulated and nonstimulated elytra and followed by substitution with OsO4 in acetone. The results showed striking differences. Photosomes were surrounded by a new type of smooth endoplasmic reticulum (ER) called intermediate endoplasmic reticulum (IER). In nonstimulated elytra, the IER was most often unattached in the cytoplasm. After stimulation, the IER was connected to large terminal saccules that formed dyad junctions with the plasma membrane. Most of these junctional complexes were symmetrical (triads) and occurred in front of narrow extracellular spaces. These spaces were either constitutive, like invaginations or clefts along adjacent cells and adjacent pouches, or resulted from the pairing of long pseudopods which expanded into a wide extracellular compartment and twisted together in a dynamic process. In that the junctional complexes developed progressively under repeated stimulation and coupled more and more photosomes, they must represent a route constituted by the ER for the propagation of internal conduction. The dynamics of coupling involve membrane growth, recognition, and transformation on a surprisingly large scale and in a surprisingly short time. PMID- 3680382 TI - Cone outer segment morphogenesis: taper change and distal invaginations. AB - Because cone outer segments (COS) are now known to be continually renewed, I reexamined COS morphogenesis in retinas of Xenopus tadpoles (prepared by standard histologic techniques and viewed by light and electron microscopy) to clarify how COS incorporate new membrane. I observed that developing COS underwent an unexpected shape change: they were always conical, but their taper (width divided by length) continually decreased. Ultrastructural examination revealed that many of the membrane foldings within distal COS were partial or incomplete, not extending across the full COS width but ending at variable distances from the ciliary side. Because these partial folds represented infoldings of the plasma membrane of an existing lamella, and they occurred at all COS levels except the base, I have termed them distal invaginations (DI). The completion of each DI increased COS length by one lamella but caused no noticeable change in local COS width; thus the formation of many DI throughout the distal COS presumably resulted in the observed decrease in overall COS taper. Based on these findings, I suggest that DI indicate growing membrane fronts and may represent sites where newly synthesized membrane is incorporated into COS. Because DI occur in developing and adult COS of various vertebrate species, I propose that DI formation plays an important role in the generation of COS taper during development and the remodeling of COS taper in mature cones after tip shedding. PMID- 3680383 TI - Cytokinesis is defective in Dictyostelium mutants with altered phagocytic recognition, adhesion, and vegetative cell cohesion properties. AB - Mutants that have been selected for defects in phagocytic recognition, adhesion, and vegetative cell-cell cohesion were found to be larger and more highly multinucleate than their parent strain. This defect is associated with the complex mutant phenotype of these mutants since revertants of the mutants coordinately acquire the wild-type phenotype for all of the defects. The larger size and multinuclearity were due to a high frequency of failure of cytokinesis in cells of wild-type size. This was shown by purifying the small cells in mutant populations and observing their growth and cell division. The mutant phenotype is more penetrant during axenic growth. Most of the mutants are not multinucleate when grown on bacteria. Recently, new mutants have been isolated that are also multinucleate when grown on bacteria by a strong selection procedure for non adhesion to tissue culture dishes. The pleiotropic mutant phenotype and the greater penetrance of the mutant phenotype in axenic culture can be explained by hypothesizing a deficiency in a membrane component of the actomyosin motor that is involved in all of the processes defective in the mutants. PMID- 3680384 TI - Structure and assembly of desmosome junctions: biosynthesis and turnover of the major desmosome components of Madin-Darby canine kidney cells in low calcium medium. AB - Neither stratifying (primary keratinocytes) nor simple (Madin-Darby canine kidney [MDCK] and Madin-Darby bovine kidney [MDBK]) epithelial cell types from desmosomes in low calcium medium (LCM; less than 0.1 mM), but they can be induced to do so by raising the calcium level to physiological concentrations (standard calcium medium [SCM], 2 mM). We have used polyclonal antisera to the major bovine epidermal desmosome components (greater than 100 kD) in a sensitive assay involving immunoprecipitation of the components from metabolically labeled MDCK cell monolayers to investigate the mechanism of calcium-induced desmosome formation. MDCK cells, whether cultured in LCM or SCM, were found to synthesize the desmosome protein, DPI and desmosome glycoproteins DGI and DGII/III with identical electrophoretic mobility, and also, where relevant, with similar carbohydrate addition/processing and proteolytic processing. The timings of these events and of transport of DGI to the cell surface were similar in low and high calcium. Although the rates of synthesis of the various desmosome components were also similar under both conditions, the glycoprotein turnover rates increased dramatically in cells cultured in LCM. The half-lives decreased by a factor of about 7 for DGI and 12 for DGII/III and, consistent with this, MDCK cells labeled for 48 h in SCM had three and six times the amount of DGI and DGII/III, respectively, as cells labeled for 48 h in LCM. The rate of turnover and the levels of DPI were changed in the same direction, but to much lesser extents. Possible mechanisms for the Ca2+-dependent control of desmosome formation are discussed in the light of this new evidence. PMID- 3680385 TI - Identification of a cDNA clone that contains the complete coding sequence for a 140-kD rat NCAM polypeptide. AB - Neural cell adhesion molecules (NCAMs) are cell surface glycoproteins that appear to mediate cell-cell adhesion. In vertebrates NCAMs exist in at least three different polypeptide forms of apparent molecular masses 180, 140, and 120 kD. The 180- and 140-kD forms span the plasma membrane whereas the 120-kD form lacks a transmembrane region. In this study, we report the isolation of NCAM clones from an adult rat brain cDNA library. Sequence analysis indicated that the longest isolate, pR18, contains a 2,574 nucleotide open reading frame flanked by 208 bases of 5' and 409 bases of 3' untranslated sequence. The predicted polypeptide encoded by clone pR18 contains a single membrane-spanning region and a small cytoplasmic domain (120 amino acids), suggesting that it codes for a full length 140-kD NCAM form. In Northern analysis, probes derived from 5' sequences of pR18, which presumably code for extracellular portions of the molecule hybridized to five discrete mRNA size classes (7.4, 6.7, 5.2, 4.3, and 2.9 kb) in adult rat brain but not to liver or muscle RNA. However, the 5.2- and 2.9-kb mRNA size classes did not hybridize to either a large restriction fragment or three oligonucleotides derived from the putative transmembrane coding region and regions that lie 3' to it. The 3' probes did hybridize to the 7.4-, 6.7-, and 4.3 kb message size classes. These combined results indicate that clone pR18 is derived from either the 7.4-, 6.7-, or 4.3-kb adult rat brain RNA size class. Comparison with chicken and mouse NCAM cDNA sequences suggests that pR18 represents the amino acid coding region of the 6.7- or 4.3-kb mRNA. The isolation of pR18, the first cDNA that contains the complete coding sequence of an NCAM polypeptide, unambiguously demonstrates the predicted linear amino acid sequence of this probable rat 140-kD polypeptide. This cDNA also contains a 30-base pair segment not found in NCAM cDNAs isolated from other species. The significance of this segment and other structural features of the 140-kD form of NCAM can now be studied. PMID- 3680386 TI - Expression sequences and distribution of two primary cell adhesion molecules during embryonic development of Xenopus laevis. AB - Studies of chicken embryos have demonstrated that cell adhesion molecules are important in embryonic induction and are expressed in defined sequences during embryogenesis and histogenesis. To extend these observations and to provide comparable evidence for heterochronic changes in such sequences during evolution, the local distributions of the neural cell adhesion molecule (N-CAM) and of the liver cell adhesion molecule (L-CAM) were examined in Xenopus laevis embryos by immunohistochemical and biochemical techniques. Because of the technical difficulties presented by the existence of multiple polypeptide forms of CAMs and by autofluorescence of yolk-containing cells, special care was taken in choosing and characterizing antibodies, fluorophores, and embedding procedures. Both N-CAM and L-CAM were found at low levels in pregastrulation embryos. During gastrulation, N-CAM levels increased in the presumptive neural epithelium and decreased in the endoderm, but L-CAM continued to be expressed in all cells including endodermal cells. During neurulation, the level of N-CAM expression in the neural ectoderm increased considerably, while remaining constant in non neural ectoderm and diminishing in the somites; in the notochord, N-CAM was expressed transiently. Prevalence modulation was also seen at all sites of secondary induction: both CAMs increased in the sensory layer of the ectoderm during condensation of the placodes. During organogenesis, the expression of L CAM gradually diminished in the nervous system while N-CAM expression remained high. In all other organs examined, the amount of one or the other CAM decreased, so that by stage 50 these two molecules were expressed in non-overlapping territories. Embryonic and adult tissues were compared to search for concordance of CAM expression at later stages. With few exceptions, the tissue distributions of N-CAM and L-CAM were similar in the frog and in the chicken from early times of development. In contrast to previous observations in the chicken and in the mouse, N-CAM expression was found to be high in the adult liver of Xenopus, whereas L-CAM expression was low. In the adult brain, N-CAM was expressed as three components of apparent molecular mass 180, 140, and 120 kD, respectively; in earlier stages of development only the 140-kD component could be detected. In the liver, a single N-CAM band appears at 160 kD, raising the possibility that this band represents an unusual N-CAM polypeptide. L-CAM appeared at all stages as a 124-kD molecule.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680387 TI - Nucleated assembly of Chlamydomonas and Volvox cell walls. AB - The Chlamydomonas reinhardtii cell wall is made up of hydroxyproline-rich glycoproteins, arranged in five distinct layers. The W6 (crystalline) layer contains three major glycoproteins (GP1, GP2, GP3), selectively extractable with chaotropic agents, that self-assemble into crystals in vitro. A system to study W6 assembly in a quantitative fashion was developed that employs perchlorate extracted Chlamydomonas cells as nucleating agents. Wall reconstitution by biotinylated W6 monomers was monitored by FITC-streptavidin fluorescence and quick-freeze/deep-etch electron microscopy. Optimal reconstitution was obtained at monomer concentrations (0.2-0.3 mg/ml) well below those required for nonnucleated assembly. Assembly occurred from multiple nucleation sites, and faithfully reflected the structure of the intact W6 layer. Specificity of nucleated assembly was demonstrated using two cell-wall mutants (cw-2 and cw-15); neither served as a substrate for assembly of wild-type monomers. In addition, W6 sublayers were assembled from purified components: GP2 and GP3 coassembled to form the inner (W6A) sublayer; this then served as a substrate for self-assembly of GP1 into the outer (W6B) sublayer. Finally, evolutionary relationships between C. reinhardtii and two additional members of the Volvocales (Chlamydomonas eugametos and Volvox carteri) were explored by performing interspecific reconstitutions. Hybrid walls were obtained between C. reinhardtii and Volvox but not with C. eugametos, confirming taxonomic assignments based on structural criteria. PMID- 3680388 TI - Thrombospondin-induced tumor cell migration: haptotaxis and chemotaxis are mediated by different molecular domains. AB - Thrombospondin induces the migration of human melanoma and carcinoma cells. Using a modified Boyden chamber assay, tumor cells migrated to a gradient of soluble thrombospondin (chemotaxis). Checkerboard analysis indicated that directional migration was induced 27-fold greater than stimulation of random motility. Tumor cells also migrated in a dose-dependent manner to a gradient of substratum-bound thrombospondin (haptotaxis). A series of human melanoma and carcinoma cells were compared for their relative motility stimulation by thrombospondin haptotaxis vs. chemotaxis. Some cell lines exhibited a stronger haptotactic response compared to their chemotactic response while other lines exhibited little or no migration response to thrombospondin. Human A2058 melanoma cells which exhibit a strong haptotactic and chemotactic response to thrombospondin were used to study the structural domains of thrombospondin required for the response. Monoclonal antibody C6.7, which binds to the COOH-terminal region of thrombospondin, inhibited haptotaxis in a dose-dependent optimal manner. C6.7 had no significant effect on thrombospondin chemotaxis. In contrast, monoclonal antibody A2.5, heparin, and fucoidan, which bind to the NH2-terminal heparin-binding domain of thrombospondin, inhibited thrombospondin chemotaxis but not haptotaxis. Monoclonal antibody A6.1 directed against the internal core region of thrombospondin had no significant effect on haptotaxis or chemotaxis. Synthetic peptides GRGDS (50 micrograms/ml), but not GRGES, blocked tumor cell haptotaxis on fibronectin, but had minimal effect on thrombospondin or laminin haptotaxis. The 140-kD fragment of thrombospondin lacking the heparin-binding amino-terminal region retained the property to fully mediate haptotaxis but not chemotaxis. When the COOH region of the 140-kD fragment, containing the C6.7-binding site, was cleaved off, the resulting 120-kD fragment (which retains the RGDA sequence) failed to induce haptotaxis. Separate structural domains of thrombospondin are therefore required for tumor cell haptotaxis vs. chemotaxis. This may have implications during hematogenous cancer metastases formation. PMID- 3680389 TI - Proteoglycan synthesis by primary chick skeletal muscle during in vitro myogenesis. AB - The proteoglycans synthesized by primary chick skeletal muscle during in vitro myogenesis were compared with those of muscle-specific fibroblasts. Cultures of skeletal muscle cells and muscle fibroblasts were separately labeled using [35S] sulfate as a precursor. The proteoglycans of the cell layer and medium were separately extracted and isolated by ion-exchange chromatography on DEAE-Sephacel followed by gel filtration chromatography on Sepharose CL-2B. Two cell layer associated proteoglycans synthesized both by skeletal muscle cells and muscle fibroblasts were identified. The first, a high molecular weight proteoglycan, eluted from Sepharose CL-2B with a Kav of 0.07 and contained exclusively chondroitin sulfate chains with an average molecular weight greater than 50,000. The second, a relatively smaller proteoglycan, eluted from Sepharose CL-2B with a Kav of 0.61 and contained primarily heparan sulfate chains with an average molecular weight of 16,000. Two labeled proteoglycans were also found in the medium of both skeletal muscle and muscle fibroblasts. A high molecular weight proteoglycan was found with virtually identical properties to that of the high molecular weight chondroitin sulfate proteoglycan of the cell layer. A second, smaller proteoglycan had a similar monomer size (Kav of 0.63) to the cell layer heparan sulfate proteoglycan, but differed from it in that this molecule contained primarily chondroitin sulfate chains with an average molecular weight of 32,000. Studies on the distribution of these proteoglycans in muscle cells during in vitro myogenesis demonstrated that a parallel increase in the relative amounts of the smaller proteoglycans occurred in both the cell layer and medium compared to the large chondroitin sulfate proteoglycan in each compartment. In contrast, muscle-derived fibroblasts displayed a constant ratio of the small proteoglycans of the cell layer and medium fractions, compared to the larger chondroitin sulfate proteoglycan of the respective fraction as a function of cell density. Our results support the concept that proteoglycan synthesis is under developmental regulation during skeletal myogenesis. PMID- 3680390 TI - Size-dependent hyaluronate degradation by cultured cells. AB - Hyaluronate degradation was examined in cultures of vascular wall cells (bovine aortic endothelial cells, rat aortic smooth muscle cells) and in nonvascular cells (chick embryo fibroblasts). The three cell types examined all produced hyaluronidase activity in culture which had a strict acidic pH requirement for activity. This suggested that the enzyme was active only within an acidic intracellular compartment and therefore that hyaluronate degradation occurred at an intracellular site. This was supported by the observation that the presence of hyaluronidase activity alone was not sufficient to ensure degradation of extracellular hyaluronate. Rather, the key limiting factor in this process appeared to be hyaluronate internalization, and this was found to be hyaluronate size-dependent and to a degree, cell-specific. The relationship of these results to morphogenesis and tissue remodeling is discussed. PMID- 3680391 TI - Maintenance of periportal and pericentral oxygen tensions in primary rat hepatocyte cultures: influence on cellular DNA and protein content monitored by flow cytometry. AB - Primary hepatocytes were cultured at oxygen tensions similar to those reported to be present in periportal (13% O2) and pericentral (4% O2) regions of the liver lobules. Cellular DNA and protein content of individual hepatocytes were determined simultaneously by two-parameter (DNA/protein) flow cytometry after 1, 4, and 7 days in culture. pO2 tensions monitored on line in conventional plastic culture dishes revealed that the depletion of the pO2 in the culture medium depended on the number of hepatocytes plated. When cultured as monolayer after 4 7 days at periportal (13% O2) and more pronounced at pericentral oxygen concentration (4% O2), up to 90% of the hepatocytes showed degenerated nuclei but normal protein content. By using culture dishes with teflon membrane bottoms the oxygen tension in the culture medium was accurately maintained by the incubator atmosphere. At pericentral oxygen tension the fraction of 2N cells increased by about 20%. That of the 4N cell was not affected, and the contribution of 8N hepatocytes dropped to 70% compared to cultures at periportal oxygen tension. Concomitantly, in the 4% O2 hepatocyte cultures the protein content of the 2N and the 4N cells was better preserved and increased by up to 10%. These results suggest that in vitro at pericentral oxygen conditions (4% O2) ageing of hepatocytes is delayed, regenerating processes are better maintained, and, furthermore, freshly isolated 4N hepatocytes have the potency to adapt their metabolism in vitro to periportal as well as to perivenous oxygen tensions. PMID- 3680392 TI - Regulation of glutathione levels in mouse spleen lymphocytes by transport of cysteine. AB - Cysteine and cystine transport activities of resting and activated mouse spleen lymphocytes were characterized in order to examine the contributions of cysteine and cystine to intracellular glutathione contents. Following stimulation with lipopolysaccharide, the lymphocytes markedly increased their capacity to transport cysteine. The uptake of cysteine was mediated mainly by the ASC system (Na+-dependent neutral amino acid transport system especially reactive with alanine, serine, and cysteine). On the other hand, both the resting and the activated lymphocytes had extremely low cystine transport activities. Because of the instability of cysteine, the culture media usually contained cystine but not cysteine. Therefore, both the resting and the activated lymphocytes rapidly decreased their glutathione contents owing to their poor capacities to take up cystine. The effects of freshly added cysteine on the cellular glutathione contents were examined in the presence of bathocuproinedisulfonate, a nontoxic copper-specific chelator that inhibits autoxidation of cysteine. Cysteine added at 25-400 microM only partially prevented the rapid decrease of the glutathione contents in fresh resting lymphocytes. In the lipopolysaccharide-activated cells, however, cysteine enhanced the cellular glutathione contents in a dose-dependent manner. These results indicate that the enhanced activity of the ASC system increases the level of intracellular glutathione in the presence of cysteine. PMID- 3680393 TI - Induction of alkaline phosphatase in primary cultures of epiphyseal growth plate chondrocytes by a serum-derived factor. AB - Alkaline phosphatase (AP) activity in epiphyseal growth plate cartilage increases markedly during differentiation of the chondrocytes, and reaches high levels in the zone of hypertrophy where vascular penetration and provisional mineralization begin. A proteinaceous factor has been discovered in serum that stimulates the expression of AP in chicken growth plate chondrocytes when these cells are grown in serum-free media. Sera from a variety of vertebrate species (goat, fetal bovine, horse, human, and chicken) all contained detectable levels of the inducing activity. The chondrocyte AP-induction factor (CAP-IF) from fetal bovine serum was precipitated with ammonium sulfate between 33% and 50% saturation, and purified by dye-ligand affinity chromatography. The active fraction, which eluted from an Affi-Gel Blue column between 0.10 and 0.15 M NaCl, was further resolved on a QMA anion exchange column. The most active and almost homogeneous fraction contained primarily a 64.5 kDa protein; about 3 micrograms/ml medium induced 50% of the maximal level of AP induction. CAP-IF is stable to heat (100 degrees C for 3 min) and dithiothreitol (50 mM) treatment, and is only mildly inactivated by 2 h treatment with trypsin. CAP-IF caused no significant effect on cell division as measured by 3H-thymidine uptake. Time-course studies revealed that at least 18-24 h exposure of the chondrocytes to CAP-IF is required to produce major increases in AP activity. Longer exposure time generally further increases the response. Cycloheximide almost completely blocked the increase in AP activity, indicating that de novo protein synthesis is required for induction. PMID- 3680395 TI - Effect of hypertonicity on hexose transporter regulation in chicken embryo fibroblasts. AB - The regulation of hexose transporters of cultured fibroblasts was investigated by exposing chicken embryo fibroblasts (CEF) to hypertonic culture medium, a condition known to enhance hexose transport activity. The effects of hypertonicity and the role of protein synthesis were examined with CEF in the basal (glucose fed) and transport enhanced (glucose starved) states. Glucose-fed CEF exposed to hypertonic conditions developed four-fold enhancement of hexose transport activity within 4 hrs; this declined in the following 20 hrs to a level slightly higher than the fed control. Protein synthesis was required in part for this effect, since the presence of cycloheximide during hypertonic exposure of fed CEF blocked the increase in of transport by almost 50%. Although the increased transport produced by glucose starvation was not further enhanced by hypertonicity, hypertonic treatment of starved CEF during glucose refeeding largely prevented the loss of transport activity to the basal, fed state. The hypertonic effects were concentration dependent (240mOsm optimal) and could be elicited with NaCl, KCl, or sucrose. Hypertonic treatment typically led to a greater than 50% decline in the incorporation of [3H]leucine into acid-insoluble fractions. The changes in transport were evident at the plasma membrane level, and studies of membrane vesicles prepared from hypertonically treated fed CEF showed a doubling of both [3H]cytochalasin B binding and the Vmax of D-glucose transport. These findings indicate that exposure of CEF to hypertonic conditions has some effects similar to those produced by glucose starvation and suggest that protein synthesis is to some extent involved in the regulation of hexose transporters in CEF. PMID- 3680394 TI - Cell cycle and growth factor-dependent phosphoprotein of 78kD differently regulated in normal and transformed mouse fibroblasts. AB - A novel 78kD phosphoprotein (pp78) of BALB/c 3T3 mouse fibroblasts is reported. Its properties of appearance in late G1 phase, dependence on specific growth factors, and altered constitutive kinetics in benzo(a)pyrene-transformed (BPA31) cells suggest its role in growth and transformation. Pp78 phosphorylation is in a dynamic state and is stabilized by inhibitors of protein and mRNA synthesis, possibly because of inhibition of a labile phosphatase or protease. Its disappearance in S phase and its low level in exponential cells also indicate a dynamic control that is dependent on growth conditions. Enhancement by phorbol myristate acetate indicates that phosphorylation of pp78 is a consequence of protein kinase C activation, but it appears much later than does an 80kD phosphoprotein (pp80), which is a recognized substrate of kinase C. No simple relation between the appearance of pp78 and mitogenesis was found. Two other phosphoproteins varied with growth conditions. One is the pp80 kinase C substrate which was found in the untransformed (A31) 3T3 cells early after stimulation but was absent in BPA31 cells. The other is an 18kD phosphoprotein that appeared shortly after quiescent 3T3 cells were stimulated. PMID- 3680397 TI - Altered hormonal responses: markers for embryonal and embryonic carcinoma stem cells and their differentiated derivatives. AB - Teratocarcinoma cells in culture offer an in vitro system for studying certain aspects of embryonic differentiation. To gain some insight into regulatory systems that might be operative during early development, we have characterized the alterations that occur in the hormonal responsiveness of the membrane adenylate cyclase of different embryonal carcinoma cell lines with differentiation. Each undifferentiated embryonal carcinoma stem cell studied (F9, PCC4, PC13, P19) has an adenylate cyclase system predominantly activated by calcitonin. Of great interest is the fact that cAMP production is also enhanced specifically by calcitonin in an embryo-derived stem cell line. Differentiation of the embryonal carcinoma stem cell population toward parietal endoderm results in a decrease in calcitonin activation with a concomitant appearance of sensitivity to parathyroid hormone. Differentiation toward visceral endoderm is characterized by a lack of response of the adenylate cyclase system to both calcitonin and parathyroid hormone. These results indicate that the changes noted in adenylate cyclase hormonal responsiveness might serve as useful markers during early stages of differentiation. PMID- 3680396 TI - Effects of alterations in endothelial cell volume on transendothelial albumin permeability. AB - We examined the effects of alterations in endothelial cell volume on transendothelial albumin permeability. Studies were done using a confluent monolayer of bovine pulmonary artery endothelial cells grown on gelatinized microporous filters. When endothelial cells were exposed to media made hypertonic with 200 mM mannitol, the intracellular volume (measured with 14C-urea) decreased twofold and remained decreased over a 30-minute time-span, thus showing no significant regulatory volume increase (RVI) within this time period. When endothelial cells were exposed to hypotonic media, intracellular volume rapidly doubled within 2 minutes, and then decreased to baseline values within 10 minutes in spite of the sustained hypotonic environment, a process known as regulatory volume decrease (RVD). We also measured the transendothelial flux of 125I-albumin with the cells exposed to the same osmotic changes. We observed that only under hypertonic conditions was there a significant change in the 125I-albumin permeability. These results indicate that the pulmonary artery endothelial cells in culture alter their cell volume when exposed to variations in the osmotic environment, and also show RVD in response to hypotonic conditions but no RVI within 40 minutes after exposure to hypertonic conditions. The transendothelial albumin permeability did not change under hypotonic conditions but increased under hypertonic conditions. Thus, endothelial cells shrinkage may be an important mechanism of increased endothelial macromolecule permeability. These volume changes may occur in endothelial cells in situ and have a role in inducing alterations in the transendothelial permeability to proteins. PMID- 3680398 TI - Transmembrane electrical characteristics of cultured human skeletal muscle cells. AB - Skeletal muscle explants from normal subjects were established from biopsy material on collagen. Cellular outgrowth appeared within 3-4 days, and fusion of myoblasts was observed in 5-10 days. Multinucleated myotubes were impaled under high optical magnification, at 37 degrees C, with conventional glass microelectrodes. The mean resting potential was -44.4 mV +/- 2.4 (n = 399); -33 +/- 2.3 mV at 9 days (n = 10) vs -48 +/- 2.5 mV (n = 15) at 27 days. The average input resistance (Rin) was 9.7 M omega (n = 83). Action potentials could be elicited by electrical stimulation and had a mean amplitude of 55.9 +/- 2.1 mV with a mean maximum rate of rise (Vmax) of 72.1 +/- 7.5 V/s. The mean overshoot was 13.9 +/- 2.3 mV, and the action potential duration determined at 50% of repolarization (APD50) was 8.0 msec (n = 7). The resting membrane potential showed a depolarization of 23 mV/decade for extracellular potassium ion concentration ([K]o) between 4.5-100 mM. Thus, we have established the normal resting potential and maximum rate of rise of the action potential for human myotubes in culture. We have shown that the values for these are less than those previously reported in cultured avian and rodent cells. In addition, we have shown that the response in our system of the resting potential to change in extracellular potassium concentration is blunted compared to studies using isolated muscle, suggesting an increase in ratio of sodium to potassium permeability. Cultured human muscle cells depolarized in the presence of ouabain. PMID- 3680399 TI - Prevention of acute mountain sickness. PMID- 3680400 TI - Halothane and the liver--the present situation. PMID- 3680401 TI - Urinary thioether excretion in nurses at an oncologic department. AB - The excretion of thioethers was determined in urine of nurses who were handling cytotoxic drugs. An occupationally non-exposed group served as control. The results showed a significant difference in urinary thioether excretion between the exposed and control persons (P less than 0.05). In both groups, however, higher thioether excretion was found in smokers; both exposed smoking nurses and smoking controls had significantly higher urinary thioether levels than the non smoking exposed and control persons. The results suggested a synergistic effect of smoking with exposure to cytostatic drugs: thioether excretion of urine from exposed smokers was significantly higher than that of control smokers (P less than 0.05). There was no difference in urinary thioether levels between the non smoking exposed and control persons (P greater than 0.05). In conclusion, smoking nurses handling cytostatic drugs, have a greater risk than non-smoking colleagues and protective intervention methods should be used by smoking as well as non smoking hospital employees. PMID- 3680402 TI - Pharmacy--two views of the future. PMID- 3680404 TI - Assessment of gastric emptying using gamma scintigraphy. AB - Gamma scintigraphy was used to measure the gastric emptying rates of three test meals in human volunteers. Emptying rates were determined for solid and liquid materials alone, and for liquid in the presence of solid material. It was shown that the emptying of solids from the stomach was significantly slower than that of liquid, whether liquid alone or liquid in the presence of solid material. It was concluded from these results that, in the case of a solid test meal from which radio-label could be eluted, the free label would empty considerably faster than the remaining solid material. The emptying rate observed scintigraphically would not, therefore, be a true estimate of the solid emptying rate. PMID- 3680403 TI - Chemical stability of thiopental sodium injection in disposable plastic syringes. AB - The chemical stability of thiopental sodium injection (2.5%) when stored at 25 degrees and 5 degrees in disposable plastic syringes of two manufacturers (Monoject and Becton Dickenson and Co.) has been studied using the USP-NF method. The injection appeared to be stable for five days at 25 degrees and 45 days at 5 degrees with a loss in potency of less than 7%. The thiopental sodium did not adsorb on the syringes. The pH values and the physical appearance did not change. An additional peak was obtained in the chromatogram from both the freshly prepared and the assay solution probably due to an impurity in the powder. PMID- 3680405 TI - Determination of residual solvents in pharmaceutical products by gas chromatography coupled to a head-space injection system and using an external standard. AB - A method of determination of residual solvents in powders using gas chromatography with an head-space injection system has been developed. The chromatographic conditions and parameters of the injection system were optimized to enable the quantification by external standardization of most common solvents in concentrations ranging from a few ppm to a few per cent. PMID- 3680406 TI - Partitioning behaviour of rat bone marrow cells in aqueous two-phase systems. Dependence of cell partition on the interfacial tension and electrical potential difference between the phases. AB - The partitioning of heterogeneous cell populations of rat bone marrow, in comparison with that of homogeneous populations of erythrocytes, has been studied in aqueous two-phase systems containing increasing concentrations of dextran-poly (ethylene glycol) (to increase the interfacial tension) and/or decreasing phosphate concentrations (to decrease both the electrical potential difference between the phases and the interfacial tension). At any polymer and/or phosphate concentration tested the partition is lower for bone marrow cells, reflecting their lower surface charge and hydrophobicity. PMID- 3680407 TI - Application of high-performance liquid chromatofocusing to the study of prostatic androgen receptors. Effect of stabilizing agents on the heterogeneity of receptor structure. AB - Cytosolic androgen receptors from normal rat prostate were analyzed by high performance liquid chromatofocusing. Two ion-exchange columns, AX-300 and AX-500, and two equilibration systems, Tris-HCl and imidazole-HCl, were used. pH gradients ranged between 8.3 and 3.5 for Tris-HCl and from 7.7 to 3.5 for imidazole-HCl. In the absence of sodium molybdate and inhibitors of proteolytic enzyme, six specific radioactive fractions (pH: 7.9, 7.7, 7.0, 5.1, 4.7 and 4.4) were eluted from AX-300 equilibrated with Tris-HCl in a ratio of 28:20:52 for acidic, intermediary and basic forms, respectively; similar results were obtained with AX-500 although this column was less effective in resolving basic forms of the receptor. The buffering capacity of imidazole-HCl was lower than that of Tris HCl, resulting in a steeper elution pH profile. The resolution between acidic and basic forms was thus diminished and only four specific radioactive fractions at pH 7.2, 7.1, 6.5 and 3.6, were observed on AX-500 in a ratio of 23:10:67 for acidic, intermediary and basic forms. In the presence of sodium molybdate, two acidic fractions were found with Tris-HCl at pH 4.3 and 4.7 (47%) on AX-300, whereas the radioactivity of fractions at pH 7.0 and 5.1 (32%) was considerably lowered and intermediary forms remained unchanged (21%). With imidazole-HCl on AX 500, the peak at pH 7.2 disappeared and the acidic form shifted from pH 3.6 to 4.3. In the presence of inhibitors of proteolytic enzyme and sodium molybdate, specifically bound radioactivity was found mostly in a broad acidic fraction (75%) at pH 4.5 on columns equilibrated with Tris-HCl; radioactivity at pH 7.6 disappeared completely but a small amount (15%) remained at pH 7.9. In imidazole HCl, a main radioactive fraction was eluted at pH 7.1 and two other fractions were collected at pH 6.8 and 4.3 respectively. In conclusion, multiple forms of the rat prostate androgen receptor were evinced by high-performance liquid chromatofocusing. Tris-HCl proved to be a more efficient equilibration system than imidazole-HCl for the resolution of rat prostate cytosolic binding proteins. Under the experimental conditions used, sodium molybdate and inhibitors of proteolytic enzyme greatly favored the acidic form to the detriment of the intermediary and basic entities. PMID- 3680408 TI - Improved Stokes radius measurement of the glucocorticoid receptor using TSK G4000SW and TSK G3000SW high-performance size-exclusion columns. Analytical and preparative applications. AB - The Stokes radius of the rat liver glucocorticoid receptor was determined using TSK G3000SW and TSK G4000SW high-performance size-exclusion columns. The accuracy of the calibration graph for proteins larger than 6 nm on the TSK G4000SW column allowed the resolution of a heterogeneous structure for the cytosolic untransformed receptor, giving two forms with Rs values of 8.3 and 7.1 nm, whereas the transformed receptor elutes with an Rs value of 4.7-5.3 nm. The 8.3 nm form was not observed for the highly purified untransformed receptor. Parallel analyses of the cytosolic untransformed receptor on conventional gravity-fed Bio Gel A 1.5-m or Ultrogel AcA-22 size-exclusion columns could not resolve two components. The resolution efficiencies of high-performance size-exclusion chromatography and open-column size-exclusion chromatography were compared. Further, owing to its rapidity, high-performance chromatography allowed the characterization of steroid-receptor complexes having half-lives as short as 90 min and very unstable receptor forms could be detected. Specific applications are considered, such as the resort to a small TSK GSWP guard column for the rapid separation of affinity-purified [3H]TA-receptor complexes from free eluting steroid, and to a preparative TSK G4000SW column for the fractionation of significant amounts of the two untransformed receptor forms. PMID- 3680409 TI - Interaction of proteins with immobilized Cu2+. Quantitation of adsorption capacity, adsorption isotherms and equilibrium constants by frontal analysis. AB - The interaction of lysozyme, ovalbumin, bovine and pig serum albumins with Cu2+ immobilized on Chelating Sepharose Fast Flow or TSK gel chelate-5PW was studied by frontal analysis at various initial concentrations of these solutes. The chromatographic data so obtained served as a basis for evaluating some relevant affinity chromatography parameters by adapting previously reported equations to this system. The TSK-based adsorbent had lower adsorption capacity for all the model proteins compared to the agarose-based adsorbent, due primarily to its lower porosity which has a marked influence on the accessibility of the immobilized ligand to the proteins. On the other hand, the TSK-based adsorbent offers almost ideal conditions for studying adsorption equilibria under column chromatographic conditions. The adsorption capacity of these adsorbents for the model proteins ranges from about 0.6 to 7 mumol/ml, equivalent to 40-100 mg/ml, of adsorbent. The following equilibrium constants for the interaction of the proteins with immobilized Cu2+ were obtained: lysozyme, 1.8.10(4); ovalbumin, 1.5.0(5); BSA, 1.7.10(5); PSA, 3.7.10(5) and imidazole, 8.10(3) M-1. Despite the comparatively low affinity of imidazole for the adsorbent, it is an effective competing ligand, at comparatively high concentrations, for adsorbed proteins primarily because all adsorption sites are available to it. The results obtained suggest that about 1/3 to 1/2 of the potential adsorption sites on the model proteins are involved in forming coordination complexes with Cu2+ immobilized to covalently bound iminodiacetate groups on insoluble gel matrices. PMID- 3680410 TI - Simultaneous high-performance liquid chromatographic analysis of free carotenoids and carotenoid esters. AB - High-performance liquid chromatography using a non-aqueous reversed phase with gradient elution on C18 columns is a powerful tool for investigating the carotenoid composition of natural samples, e.g., flower petals, and for the simultaneous detection of carotenoids of the widest possible polarity range (xanthophylls, diones, hydrocarbons and carotenoid esters). The comparison of sample extracts submitted or not to saponification allows the presence of carotenoid esters to be revealed through the appearance of the corresponding free hydroxycarotenoids. The gas chromatographic analysis of the fatty acids after alkaline hydrolysis of esters provides further confirmation. In most cases, peaks of various carotenoids were identified by comparison with standards. The wavelengths of the visible absorbance maxima of the chromatographed carotenoids as obtained on-line by the stop-flow method in the eluent system and off-line in carbon disulphide are reported. The esters appear to constitute the main carotenoid fraction in flower petals. PMID- 3680412 TI - Rapid and simple determination of sennoside A and B in rhei rhizoma by ion-pair high-performance liquid chromatography. AB - A simple and precise ion-pair high-performance liquid chromatographic method was developed for the determination of sennoside A and B in Rhei Rhizoma. A reversed phase chromatographic system consisting of a chemically bonded ODS silica gel column with an acetate buffer (pH 5.0)-acetonitrile (68:32), containing 5 mM tetra-n-heptylammonium bromide, as the mobile phase was used. Sennoside A and B in this crude drug were separated and determined within 20 min after direct injection of the solution extracted with 70% methanol. The results for various samples are presented. PMID- 3680411 TI - Determination of trace levels of phenol and cresols in rain by continuous liquid liquid extraction and high-performance liquid chromatography. AB - Trace levels of phenol and methylphenols (cresols) in aqueous samples were determined by continuous liquid-liquid extraction and normal-phase high performance liquid chromatography with UV-fluorescence detection. The recovery of phenol from water at a concentration of 1.6 micrograms l-1 was 70 +/- 6%. The method successfully measured traces of phenol and cresols extracted from rainwater without further clean-up. The average reproducibility of the method for rain samples was +/- 16%. The results compared well with those obtained by high resolution gas chromatography-mass spectrometry. PMID- 3680413 TI - Amino acid analysis: the histidine hangover. PMID- 3680414 TI - Spray reagent for the detection of coumarins and flavonoids on thin-layer plates. PMID- 3680415 TI - Increased yield of the phenylthiocarbamyl-amino acids tyrosine, cysteine and phenylalanine using diethylether-based liquid-liquid extraction. PMID- 3680416 TI - Characterisation of carrageenans by high-performance size-exclusion chromatography using a LiChrospher 1000 DIOL column. PMID- 3680417 TI - Purification of allergens by high-performance liquid chromatography. IV. Purification of the allergen of olive pollen (Olea europea). PMID- 3680418 TI - Determination of monosaccharides constituting the glycosides in saponins by high performance liquid chromatography. PMID- 3680419 TI - Micro high-performance liquid chromatography of poly(ethylene glycols) with indirect photometric detection. PMID- 3680420 TI - Determination of the electrophoretic order of 26 nucleotides by isotachophoresis. PMID- 3680421 TI - Separation of novel derivatives from commercial erythromycin samples by thin layer chromatography. PMID- 3680422 TI - Quantification of halothane, enflurane and nitrous oxide by means of a simple gas chromatographic method. PMID- 3680423 TI - Simple gas chromatographic determination of the purity of hydroxyethyl methacrylate. PMID- 3680424 TI - Separation of the phosphono analogues of phosphatidylcholine and phosphatidylethanolamine from related phospholipids by high-performance liquid chromatography. PMID- 3680425 TI - Separation of starch components based on ligand-induced adsorption of amylose on cellulose. PMID- 3680426 TI - Paper electrophoretic study of ion-pair formation. XVI. Resolution of optical isomers of some cobalt (III) complexes with amino acid ligands. PMID- 3680427 TI - Foam counter-current chromatography with the cross-axis synchronous flow-through coil planet centrifuge. AB - A novel coil planet centrifuge system performs efficient foam separation in a long multilayer coil. Potential capability of the method was successfully demonstrated in separations of two sets of test samples using sodium dodecyl sulfate as a foaming agent. Rhodamine B with high foam affinity was quickly separated from Evans blue lacking foam affinity. A high concentration of salts such as disodium hydrogenphosphate in the surfactant solution effectively lowered the foam affinity of basic dyes, yielding complete peak resolution of rhodamine B and methylene blue according to a subtle difference in foam affinity. PMID- 3680428 TI - Determination of the leakage from Phenyl-Sepharose Cl-4B, Phenyl-Sepharose FF and Phenyl-Superose in bulk and column experiments. AB - The release of ligands from Phenyl-Sepharose CL-4B, Phenyl-Sepharose FF and Phenyl-Superose has been studied in bulk and column experiments. The leakage products have been identified and quantified by liquid chromatography, fluorescence spectroscopy and proton NMR spectroscopy. It is demonstrated that the leakage occurs primarily through hydrolysis of the agarose support. However, leakage via ether cleavage of the spacer arm-ligand moiety is also observed especially for Phenyl-Superose. The release of ligands at acidic pH is in agreement with a first-order reaction and correspondingly the rate constants have been estimated for all three gels at pH 1 and 2. These show that 50% of the ligands are intact after 15 years of incubation at pH 2. Phenyl-Superose is the most stable gel at acidic pH, whereas Phenyl-Sepharose CL-4B and Phenyl-Sepharose FF are the most stable at neutral and basic pH. PMID- 3680429 TI - Optical resolution of enantiomeric amino acid derivatives on a naphthylethylurea multiple-bonded chiral stationary phase prepared via an activated carbamate intermediate. AB - A new chiral stationary phase (CSP) was developed for the direct optical resolution of enantiomeric amino acid derivatives. The CSP was readily prepared by a three-step reaction carried out in a pre-packed aminopropylsilyl silica gel column. In the first step, a solution of disuccinimido carbonate (DSC) was delivered through the pre-packed column to give a succinimido carbamyl aminopropylsilyl-bonded, activated-carbamate type silica gel (ACsil) column. Through the column was then delivered a solution of pentaethylenehexamine to afford a polyamine-bonded column. Finally, a solution of optically active succinimido (S)- or (R)-naphthylethyl carbamate was delivered through the polyamine column, to give a naphthylethylurea multiple-bonded CSP. p Bromophenylcarbamyl derivatives of enantiomeric protein amino acids were resolved on these CSPs by elution with an aqueous mobile phase. Simultaneous analysis of these amino acid enantiomers by means of gradient elution was also accomplished. PMID- 3680430 TI - Chiral-phase high-performance liquid chromatography of rotenoid racemates. AB - The high-performance liquid chromatographic (HPLC) behavior of parent rotenoids (type I) and the hydroxy-analogues (type II) on three different chiral stationary phases (CSPs) was studied. Separations of optical isomers were achieved in various degrees depending largely upon the rotenoidal structures and the CSP types employed. Enantiomers of all but elliptone compounds were separable on beta cyclodextrin-bonded silica (CDS). Without exception, the 12a-hydroxyrotenoid antipodes were resolved on Pirkle's phenylglycine-bonded silica (PGS) despite unsuccessful attempts to resolve the type I rotenoidal racemates. Conversely, optical resolution of the latter rotenoids was accomplished by using a helical polytriphenylmethylacrylate-coated silica (TPS) column and the observed separation factors (alpha values) ranged from 1.14 to 1.90. The results from HPLC of type II rotenoids on TPS (alpha = 1.00-1.63) suggested that variations in E ring structures had profound influence on the resolution outcome. Conjugated double bonds on the E-ring and the desisopropylation of the five-membered E-ring of type II rotenoids appeared to be important structural features for chiral recognition involving the TPS substrate. In both reversed-phase (CDS) and normal phase (PGS and TPS) HPLC modes, the less polar enantiomers were the 6a beta,12a beta-rotenoids as observed in most cases, though this relationship was reversed in the cases of deguelin and hydroxyelliptone probably due to conformational effects of rotenoidal ring systems. PMID- 3680431 TI - Dynamic headspace gas chromatography of volatile compounds in milk. AB - A method is described for investigating volatile compounds in milk. The volatiles are removed from milk by a stream of helium swept at 100 ml/min over the surface of the milk at 70 degrees C. They are trapped on 40 mg of NIOSH charcoal and then desorbed by heat and re-trapped on the front of a chromatographic column of Tenax GC coated with 1% OV-275, the column being maintained at room temperature during trapping. An amount of 40 mg NIOSH charcoal under these conditions traps over 90% of the total quantity of the lowest boiling compounds swept from the milk, such as acetaldehyde and ethanol, and retains 100% of the total quantity of acetone, propanol and higher boiling compounds from the gas stream. The volume of milk and its temperature affect the ratios of volatiles collected and these factors are useful in increasing the proportion of a volatile of particular interest. The addition of potassium carbonate increases the yield of volatiles from 100 ml aqueous phase but not from 10 ml. PMID- 3680432 TI - Standardized high-performance liquid chromatography of 182 mycotoxins and other fungal metabolites based on alkylphenone retention indices and UV-VIS spectra (diode array detection). AB - A general standardized method for the analysis of mycotoxins and other fungal secondary metabolites has been developed, based on high-performance liquid chromatography (HPLC) with an alkylphenone retention index and photodiode-array detection combined with thin-layer chromatography (TLC) in two different eluents. Each fungal secondary metabolite is characterized by its bracketed alkylphenone retention time index, its UV-VIS absorption maxima and its retardation factors relative to griseofulvin in two TLC eluents. This system is effective for the comparison of chemotaxonomic data in different laboratories and for a precise identification of fungi based on organic solvent extracts of fungal cultures. All important groups of mycotoxins and other fungal secondary metabolites could be detected in the HPLC system described and data are listed for 182 metabolites. The fungal secondary metabolites separated and characterized include aflatoxin B1, B2, G1 and G2, ochratoxin A, citrinin, penicillin acid, viomellein, penitrem A, patulin, sterigmatocystin, alternariol, tenuazonic acid, trichothecenes, roquefortines, fusarin C, zearalenone, PR-toxin, citreoviridin, viridicatumtoxin, verruculogen, rugulosin, cyclopiazonic acid, penicillin G and many other alkaloids, polyketides and terpenes. PMID- 3680433 TI - High-performance size-exclusion chromatography of polypeptides on a TSK G2000SW column in acidic mobile phases. AB - Polypeptides subjected to high-performance liquid chromatography on a TSK G2000SW column in acidic mobile phases of low ionic strength underwent a combination of size exclusion and ion exclusion from the matrix. The distribution coefficient (Kd) of each polypeptide was dependent upon the concentration of ion-pairing agent present and increased as the concentration of ion-pairing agent increased. The fractionation range of the column could thus be manipulated by altering the concentration of acid in the mobile phase. The nature of the ion-pairing acid, in terms of hydrophilic or hydrophobic ion pairing, also had an effect on the chromatography, such that hydrophobic ion-pairing agents lead to increased Kd values, especially in the case of the most basic polypeptides. To account for these results it is proposed that the TSK GSW matrix is cationic at low pH, and that ion pairing suppresses the ion exclusion experienced by cationic polypeptides under these conditions. PMID- 3680434 TI - Analysis of detomidine in horse blood, plasma and urine samples utilizing a sensitive gas chromatography-mass spectrometry method. AB - Chemical ionization- and electron impact ionization-selective ion monitoring provided a simple and sensitive method for measuring detomidine (Domosedan), a potent sedative-analgesic drug for horses and cattle. Chemical ionization was at least 10 times more sensitive than electron impact ionization. By using propranolol as an internal standard, we found that the recovery of detomidine from the extraction procedure used in this study was greater than 75% for plasma, whole blood, or urine samples. Approximately 68% of detomidine was bound to plasma protein and 53% was bound to red blood cells. PMID- 3680435 TI - High-performance liquid chromatographic separation of noreximide and norendimide in bulk material, tablets and animal feed. AB - Noreximide, a sedative, is generally contaminated to some extent with its endo isomer, norendimide, which produces excitation. A high-performance liquid chromatographic assay was developed to separate and quantitate these compounds on a 5-microns Ultrasphere ODS column with methanol-water (20:30) as mobile phase and detection at 254 nm. Assay of mixtures of these compounds in bulk material and tablets utilized isoniazide as internal standard. Peak area ratios were linear (r = 0.9999) over 1.4-66.2 micrograms of injected noreximide and 0.2-8.4 micrograms of injected norendimide. Overall percent recovery from simulated tablets containing noreximide alone was 99.6 +/- 0.8% (S.D., n = 3). Overall percent recoveries (+/- S.D.) from tablets containing a mixture of these compounds were 98.9 +/- 0.5% and 102.3 +/- 1.1% for noreximide and norendimide, respectively (n = 3). Noreximide in animal feed for long-term pharmacological studies was isolated by ether extraction and after work up, subjected to the same procedure, except that theophylline was the internal standard. Peak area ratios were linear over 0.2-19.3 micrograms of injected noreximide (r = 0.9999). Overall percent recoveries (+/- S.D., n = 3) of noreximide from spiked animal feed were 97.4 +/- 1.4% and 99.0 +/- 0.5% at the 500- and 5000-ppm levels, respectively. Limits of detection at the 95% confidence level (0.01 a.u.f.s., 20-microliters sample volume injected) were 1.67 microgram/ml and 2.56 micrograms/ml of noreximide and norendimide, respectively, in the final test solution. PMID- 3680436 TI - Simple preparation of a Poly-S 179 capillary column for the analysis of polycyclic aromatic hydrocarbons and triglycerides. PMID- 3680437 TI - Determination of binding constants by high-performance gel filtration. PMID- 3680438 TI - Adsorption chromatographic behaviour of 125I-labelled progesterone-11 alpha- and 12 alpha-succinyltyrosine methyl ester. PMID- 3680439 TI - Liquid chromatographic determination of beta-aspartame in diet soft drinks, beverage powders and pudding mixes. PMID- 3680440 TI - Identification and quantification of hydroquinone and some of its ethers in cosmetic products by reversed-phase high-performance liquid chromatography. PMID- 3680441 TI - Determination of beta-asarone, safrole, isosafrole and anethole in alcoholic drinks by high-performance liquid chromatography. PMID- 3680442 TI - Simultaneous isocratic high-performance liquid chromatographic determination of flavones and coumarins in Matricaria chamonilla extracts. PMID- 3680443 TI - Determination of cations at the parts-per-billion level with non-suppressed ion chromatography and indirect photometric detection. PMID- 3680444 TI - Computer analysis of automated Edman degradation and amino acid analysis data. AB - Computer programs are described that allow facile analysis of data from a protein sequencer and amino acid analyzer. The sequencer program provides automated sequence interpretation while requiring minimal user interaction. The program serves as a powerful aid in deciphering mixture sequences and allows routine monitoring of sequencer performance. The computer program for amino acid analysis data provides the following calculations: mole percent, protein concentration and residues per mole with comparison between theoretical and calculated values. A plot of molecular weight versus deviation from integer values is calculated providing a measure of peptide or protein purity. PMID- 3680445 TI - Mechanism of selectivity in ion-pair high-performance liquid chromatography of aminoglycoside antibiotics using perfluorinated pairing ions. AB - The behaviour of perfluorinated carboxylic acids as pairing ions for the chromatography of the aminoglycoside antibiotics was studied. As with perhydrogenated pairing ions, the capacity factor can be modified according to the percentage of organic modifier and the nature and concentration of perfluorinated pairing ion in the mobile phase. The special selectivity effect observed with trifluoroacetic acid was investigated and interpreted as a concerted mechanism involving ionic and hydrophobic interactions. PMID- 3680446 TI - Retention mechanism of lactate dehydrogenase in anion-exchange chromatography. AB - The anion-exchange retention mechanism of lactate dehydrogenase (LDH) isoenzymes was examined under conditions where the muscle (M) subunit was not retained by the sorbent matrix. Using the stoichiometric displacement model of retention to quantitate the number (Zn) of ionic groups on the protein that interact with the sorbent matrix, it was determined that Zn for the LDH isoenzymes increases incrementally as the number of heart (H) subunits is increased up to a total of three H subunits. Both the MH3 and H4 isoenzymes have the same Zn. As the subunits in this tetrameric enzyme are arranged in a tetrahedral structure, these data indicate that steric limitations prevent any more than three subunits from interacting simultaneously with the sorbent surface. The reason why the MH3 and H4 isoenzymes could be separated is apparently that there are multiple equivalent faces in the H4 isoenzyme, and this both increases the probability and rate of adsorption and decreases the probability and rate of desorption for the H4 relative to the MH3 isoenzyme. It was concluded from these studies that the three dimensional structure of a biopolymer will determine those surface residues which are in a position to interact with a sorbent surface and that multiple subunits or domains of a protein may act cooperatively over considerable distances in biopolymer-surface interactions. PMID- 3680447 TI - Automated separation process for radioanalytical purposes at nuclear power plants. AB - Chemical separation processes have been developed to remove the matrix components and thus to determine fission products, especially radioiodine nuclides, in the primary coolant of WWER-type nuclear reactors. Special procedures have been elaborated to enrich long-lived nuclides in waste waters to be released and to separate and enrich caesium isotopes in the environment. All processes are based mainly on ion-exchange separations using amorphous zirconium phosphate. Automated equipment was constructed to meet the demands of the plant personnel for serial analysis. PMID- 3680448 TI - Application of semi-preparative high-performance liquid chromatography to difficult natural product separations. AB - Semi-preparative high-performance liquid chromatography on RP-18 with methanol water as the mobile phase was used for the separation of homologous antifungal chromenes and related homologous dichromenes from Hypericum revolutum Vahl (Guttiferae). In the course of the structural elucidation of new saponins from Phylolacca dodecandra L'Herit. (Phytolaccaceae), two isomeric oleanane saponins were separated on RP-8 with acetonitrile-water as the mobile phase. PMID- 3680450 TI - QA programs: state of the art. PMID- 3680449 TI - Solubility factors established by gas-liquid chromatography. A balance sheet. AB - Dravnieks and Laffort first used a method based on gas-liquid chromatography for establishing solubility factors (or parameters) of solutes. This method has been developed and improved over ten years (1972-1982) and applied to quantitative structure-activity relationships in olfaction. The physico-chemical and biological implications of this approach are reappraised. PMID- 3680451 TI - Developing a unit-based nursing quality assurance program: from concept to practice. PMID- 3680452 TI - The pyramid for quality assurance. PMID- 3680453 TI - QAMUR: a quality assurance model using research. PMID- 3680454 TI - Quality nurse-patient outcomes: a framework for nursing practice. PMID- 3680455 TI - Implementing a successful quality assurance program in the rehabilitation setting. PMID- 3680456 TI - A communitywide quality assurance resource group: benefits in today's environment. PMID- 3680457 TI - Quality assurance: taking a new look at collaboration between education and service. PMID- 3680459 TI - Quality assurance monitoring leads to reduced staff injuries on psychiatric units. PMID- 3680458 TI - Bedside glucose monitoring: an innovative approach. PMID- 3680460 TI - Purification of adenovirus hexon by high performance liquid chromatography. AB - Hexon is the major structural protein of adenovirus, and has significance in studies of virus structure and function, vaccine development, and immunodiagnosis. We describe a simple, single-step, anion-exchange high performance liquid chromatography (HPLC) method for the high yield purification of hexon. Purity of the isolated hexon was assessed by SDS-PAGE and HPLC methods. The isolated hexon was immunologically reactive with anti-hexon monoclonal antibody in a dot-blot assay. It also retained immunogenicity, as polyclonal antisera from rabbits immunized with hexon showed the desired antigen specificity. The enhanced speed of this purification method allows for the efficient isolation of hexon from various serotypes, and thus may facilitate comparative studies of hexon immunobiology. PMID- 3680461 TI - Selective inhibition of protein synthesis by hypertonic medium in Marituba (Bunyaviridae) virus-infected L-A9 cells. AB - Elevation of the NaCl concentration in the growth medium of L-A9 cells caused an inhibition of the protein synthesis accompanied by a complete breakdown of polyribosomes. However, a complete recovery of the rate of protein synthesis was observed when isotonicity was restored. In Marituba virus infected cells, protein synthesis became resistant to hypertonic treatment. Under hypertonic conditions cellular protein synthesis was selectively suppressed and an enhancement of virus proteins was observed. Analysis of the virus specific proteins by polyacrylamide gel electrophoresis revealed that the synthesis of G1 was unalterable, and N was stimulated. PMID- 3680462 TI - Lectins as probes for the assay of rhabdovirus infections in plants. AB - Thirteen different, biotinylated plant lectins were tested for their ability to recognize specifically the glycoproteins of the two different plant rhabdoviruses potato yellow dwarf virus and eggplant mottled dwarf virus. All viruses were propagated on the same plant host species, Nicotiana rustica L. The lectin binding to the viral proteins was tested after electrophoretic separation and transfer to nitrocellulose membranes. Besides purified virus also partially pure virus preparations were used for the tests, in order to determine the specificity. The lectins had been selected for specificities to either one of the following monosaccharides: mannose, glucose, galactose, N-acetyl-D-galactosamine, N-acetyl-D-glucosamine and fucose. In the test panel of thirteen lectins, seven were found to react with the viral glycoproteins. Among these, four (LCA, VFA, PSA, Con A) belonged to the mannosyl- or glycosyl-specific group. However, these four lectins reacted also with other host proteins when partially pure virus preparations were used as samples. The other three lectins (GSA2b, STA, WGA) were specific for N-acetyl-D-glucosamine and detected almost exclusively the viral glycoproteins. Two of these lectins, STA and WGA, were extremely suitable for virus-specific assays, since they did not react with glycoproteins in healthy controls that were identical or comparable in their electrophoretic mobility with the rhabdovirus glycoproteins. No binding to viral glycoproteins was observed with galactose-, N-acetyl-galactosamine- and fucose-specific lectins. The assay for rhabdovirus glycoproteins in plants with the lectins was approximately 8-16 times less sensitive than with virus-specific antibodies. PMID- 3680463 TI - Factors influencing the assay of Inoue-Melnick virus. AB - We describe factors influencing the assay of Inoue-Melnick virus (IMV) and practical comments for its assay. MRC-5 cells at a population doubling level (PDL) of more than 32 were more sensitive than younger cells for demonstrating cytopathic effect (CPE) of the virus. The PDL of MRC-5 cells also influenced the virus yield, particularly when the amount of viral inoculum was small. Cells at younger PDL produced less virus. The appearance of CPE and the virus yield were inhibited by increasing the concentration of NaHCO3 to 0.14% in the maintenance medium. The release of the virus into the medium was also inhibited as NaHCO3 was increased. PMID- 3680464 TI - Rapid isolation and identification of reovirus-3. AB - Mammalian reoviruses are connected with a variety of humans diseases, including gastroenteritis, malabsorption and hepatitis. Recently, reovirus-3 was found to be associated with neonatal biliary atresia. We describe a technique for the rapid isolation and identification of reovirus-3. Mouse fibroblasts (L 929 cells) were grown in monolayers in a RPMI 1640 medium containing 10% calf serum. The cytopathic effects were visualized by the rounding of the L 929 cells and the appearance of fine granulation in the cytoplasm 48 h after the infection. Hematoxylin-eosin staining showed swelling and rounding of the infected cells, diminished chromatin in the nuclei, and the absence of mitoses. The immunohistochemical staining by the avidin-biotin-peroxidase technique was positive in the infected monolayers of the L 929 cells. The positive staining was limited to cytoplasmic inclusions, which were surrounded by a halo and sometimes by vacuoles. We conclude that the described technique is useful for the rapid isolation and identification of reovirus-3. PMID- 3680465 TI - Analgesic use, blood dyscrasias, and case-control pharmacoepidemiology. A critique of the International Agranulocytosis and Aplastic Anemia Study. AB - The International Agranulocytosis and Aplastic Anemia Study (IAAAS) of analgesic induced risks of blood dyscrasias represents the current "state of the art" in case-control pharmacoepidemiology. We present a conceptual framework for examining the goal, methods, and analysis of an epidemiologic study of drug risks and review the IAAAS within this framework. In our view, the new risk estimates reported by the IAAAS are not inherently more accurate than existing ones, nor have they been measured in clinically and sociodemographically relevant groups of patients over the anticipated course of therapy. Thus, the reported risks cannot be used to guide clinical or regulatory decisions concerning available treatment options for such patients. Furthermore, we believe that the IAAAS methods for selection of cases and controls, ascertainment of exposure, and data analysis may well have led to invalid estimates even for those risks that are reported. We hope that closer attention to the conceptual framework we suggest and the methodologic issues we raise will enable future case-control pharmacoepidemiologic studies to provide more useful and accurate answers to questions concerning the adverse effects of drugs. PMID- 3680466 TI - Estimation of exposure-specific rates from sparse case-control data. AB - Several methods for estimation of exposure-specific rates from case-control data have been developed, but none are practical for application to sparse stratifications, such as individually matched case-control data. This paper presents a method for estimating standardized exposure-specific rates that can be applied to sparse data, as well as other (non-sparse) stratifications. An application to a matched-pair case-control study of prostate cancer is given. PMID- 3680467 TI - Is growing old a disease? A study of the attitudes of elderly people to physical symptoms. AB - In a survey of people living at home, aged 77 years and over, a total of 126 women and 77 men were interviewed concerning their attitudes to their physical symptoms. For each organ system the subjects indicated whether their symptoms were considered to be a normal condition for elderly people or a manifestation of a disease. To a large extent symptoms were accepted as a normal condition, however, a highly significant difference in their attitudes to symptoms stemming from different systems was found (p less than 0.001). Generally, compared with severe symptoms, mild symptoms were accepted more readily as a normal condition in old age. Although most of the elderly people had seen a doctor because of their symptoms, a highly significant difference was found in consultation rates among elderly persons with symptoms from different organ systems (p less than 0.001). The attitudes to symptoms influenced the tendency of the subjects to consult a doctor (p less than 0.05). The need for education of elderly people and health professionals is discussed. PMID- 3680469 TI - Identification of non-fatal myocardial infarction through hospital discharge data in Western Australia. AB - The validity of identifying incident cases of non-fatal acute myocardial infarction (AMI) between 1971 and 1982 in Western Australia from routine hospital records was assessed in ages 25-64 years, according to the WHO criteria defined in 1970 and 1983. This was done by reviewing original data sources and by using the Perth Coronary Register of 1971 as an external reference. Events with a coded discharge diagnosis of acute or subacute ischemic heart disease were found to be highly sensitive (97%) for cases of "definite" AMI (WHO 1983 criteria). The specificity of such events was lower (positive predictive value of about 70%) and validation of these events would be necessary for studies requiring high specificity. The sensitivity and specificity of these events for "definite" AMI seemed quite stable over time with similar values being observed in 1971 and 1978. Although the situation for "possible" AMI (non-fatal) is less clear, certainly many more records would need to be reviewed to validate this diagnosis. PMID- 3680468 TI - Time trends in characteristics at diagnosis and subsequent survival for Caucasian, Japanese and Hawaiian women with breast cancer in Hawaii. AB - This study examines whether the improvement in breast cancer survival in Hawaii suggested by an earlier analysis might be explained by concomitant temporal variations in prognostic factors. Characteristics at diagnosis and survival experience were compared for 1251 Caucasian, 1015 Japanese and 505 Hawaiian women diagnosed with invasive breast carcinoma during 1960-1979 and followed until the end of 1982. Time-trends were present for the patients' stage at diagnosis, age and socioeconomic status. A multivariate analysis using the Cox proportional hazards regression model revealed that adjustment for temporal variations in stage and age at diagnosis yielded a positive survival trend of a greater magnitude than that observed without adjustment, indicating that multivariate methods should be considered in time-trend analyses of cancer survival. Further analysis revealed that such improvement in breast cancer survival occurred for certain race-stage groups of patients only. Possible reasons for these trends in breast cancer prognostic factors and survival are discussed, along with potential biases. The data suggest that early detection might explain most of the survival improvement in Hawaii during the period of the study. PMID- 3680470 TI - Smoking and cardiac symptoms as predictors of lung cancer. AB - In 1962, a cohort of 4604 Finnish men was interviewed about their smoking habits and cardiorespiratory symptoms. The cohort was followed up for deaths and incidence of lung cancer from 1963 to 1980 in order to study the effect of smoking and cardiac symptoms on the incidence of lung cancer. When analyzed simultaneously with smoking, the symptoms of angina, possible infarction and shortness of breath were all significantly associated with increased lung cancer risk. For example, the RR of lung cancer among those with possible infarction was 2.4, when age and smoking were adjusted for, and 1.8, when additionally shortness of breath and angina-like chest pain were adjusted for. Among smokers of greater than or equal to 15 g/day, those with symptoms of angina displayed a considerable excess risk (RR 2.5). A broad range of impairments of the cardiopulmonary functions seem to be associated with the carcinogenic processes invoked by smoking. PMID- 3680471 TI - A comparison of Likert and visual analogue scales for measuring change in function. AB - Many controlled trials rely on subjective measures of symptoms or quality of life as primary outcomes. The relative merits of different response options for these measures is an important, but largely unexplored, issue. Therefore, we compared the responsiveness of seven-point Likert vs visual analogue scales (VAS) in a questionnaire measuring quality of life in chronic lung disease. The VAS and seven-point scale versions of the questionnaire were administered to 28 patients before and after completing an inpatient respiratory rehabilitation program of known benefit. For all four dimensions of the questionnaire (dyspnea, fatigue, emotional function, and mastery) the VAS showed a larger improvement than the seven-point scale when both were standardized on a scale of 0-10. However, in each case the variability of the improvement was greater using the VAS. The difference in improvement between the two scales was not statistically significant. We conclude that the two methods of presenting response options show comparable responsiveness. The ease of administration and interpretation of the seven-point scale recommend its use in clinical trials. PMID- 3680472 TI - Craving and the social context: a new interaction model for enhancing recovery from alcoholism. PMID- 3680473 TI - Sample size determination in case-control studies. PMID- 3680474 TI - Misuse of game theory. PMID- 3680475 TI - Differentiated thyroid carcinoma in childhood: long term follow-up of 72 patients. AB - Seventy-two children with differentiated thyroid cancer who were 16 years old or younger at the time of initial treatment were followed for a median time of 13 yr. Initially, 18% had lung metastases, and 74% had palpable lymph nodes. Capsular invasion was found in 67%, and histological lymph node involvement in 90%. The recurrent laryngeal nerve chain and the jugulo-carotid chain were involved with the same frequency (greater than 80%). The anterior superior mediastinum was involved only in patients with involvement of the recurrent laryngeal nerve chain. Forty-three patients had a complete remission after initial treatment. In patients without distant metastases for whom surgery was macroscopically incomplete, relapses occurred 5 times more frequently than in patients whose surgery was complete. Six patients died from thyroid carcinoma at ages ranging from 19-44 yr, 12-33 yr after initial treatment, and 1 died from intercurrent disease. Despite favorable long term survival (90.3% at 20 yr), the standardized mortality ratio was equal to 8.1. This study underlines the need for complete surgical treatment and compulsive follow-up, which should be continued throughout the patient's life, in order to detect and effectively treat relapses of thyroid cancer. PMID- 3680476 TI - Glycosylated prolactin is a major circulating variant in human serum. AB - To determine whether glycosylated human PRL (G-hPRL) is a circulating form of hPRL, serum samples obtained from normal men and women were studied. The PRL was immunoprecipitated from 100-microL aliquots of serum, and the precipitates were subjected to gel electrophoresis in the presence of sodium dodecyl sulfate, electrotransferred to nitrocellulose paper, immunoblotted with anti-hPRL serum and [125I]protein-A, and autoradiographed. The autoradiographs showed an intensely stained G-hPRL band, with a mol wt of 25K, in almost all samples studied. The nonglycosylated PRL (hPRL) band, with a mol wt of 23K, was much more variable in staining intensity from individual to individual. Some samples also had a 27K glycosylated immunoreactive PRL band. Serum samples were also obtained every other day from two women throughout a 28-day period; again, each sample had an intensely stained G-hPRL band and a hPRL band that varied in staining intensity from day to day. In contrast, however, to the G-hPRL/hPRL pattern in serum samples obtained from normal women and men, samples from pregnant women at the onset of spontaneous labor showed opposite results, that is an intensely stained hPRL band but only a faintly stained G-hPRL band. These results indicate that G-hPRL is an important component of circulating PRL in normal men and women and that it may vary in amount in certain physiologic states. PMID- 3680477 TI - High serum sex hormone-binding globulin (SHBG) and low serum non-SHBG-bound testosterone in boys with idiopathic hypopituitarism: effect of recombinant human growth hormone treatment. AB - We measured serum sex hormone-binding globulin (SHBG), total testosterone (T), non-SHBG-bound T, albumin-bound T, free T, and SHBG-bound T in 19 prepubertal boys with hypopituitarism. Serum SHBG decreased with age with a slope similar to that in 91 normal prepubertal boys at higher level, and therefore, it reached similar values at a later age. Serum SHBG was significantly higher in hypopituitary prepubertal boys [mean, 123 +/- 12 (+/- SE) nmol/L] than in normal prepubertal boys (76 +/- 4; P less than 0.001) despite the fact that their mean age was also higher (10.0 +/- 4 vs. 7.1 +/- 4.1 yr; P less than 0.001). In 4 boys with isolated hypogonadotropic hypogonadism (Kallman's syndrome), aged 15.6 +/- 1.5 yr, serum SHBG was 21 +/- 14 nmol/L, a value below the 95% confidence limit of the regression line in GH-deficient boys. The affinity constants of association of the SHBG-DHT complex were similar in hypopituitary and normal boys. Eleven of the 19 hypopituitary boys (mean chronological age, 8.3 +/- 2.5 yr; mean bone age, 4.1 +/- 2.1 yr) were treated with recombinant hGH (0.5 U/kg BW.week) for 1 yr. Their mean serum SHBG level before treatment was 154 +/- 14 nmol/L, and it decreased gradually to 106 +/- 5 nmol/L (P less than 0.01) after 12 months of treatment. The tendency toward normalization of serum SHBG during treatment suggested that GH deficiency was responsible for the high serum SHBG levels. Serum SHBG correlated negatively with age in both treated hypopituitary and normal boys, but the slope of the regression line was significantly steeper in treated hypopituitary boys (P less than 0.01). On the other hand, the mean serum non-SHBG-bound T level was 0.10 +/- 0.02 (+/- SE) nmol/L in hypopituitary boys, significantly lower than that in normal boys (0.21 +/- 0.02 nmol/L; P less than 0.02). Since serum total T concentrations were similar in the two groups, the higher serum SHBG concentration resulted in lower serum bioavailable T levels in the hypopituitary boys. These changes might explain the poor response to T treatment reported in GH-deficient patients. The lower serum non-SHBG-bound T concentrations in the GH-deficient boys suggest there may be delayed exposure of central nervous system structures to increased levels of sex hormones, which, in turn, may slow body maturation. This mechanism might play a role in the delay of puberty that occurs in patients with isolated GH deficiency. PMID- 3680478 TI - Somatomedin-C and growth in children with precocious puberty: a study of the effect of the level of growth hormone secretion. AB - This study was undertaken to investigate the role of GH secretion in the pubertal increase in plasma somatomedin-C (Sm-C) concentrations and its relation to growth in children with true precocious puberty (PP) and normal or deficient GH secretion. We studied 37 children (9 boys and 28 girls), divided into 3 groups according to their pubertal stages and their peak stimulated plasma GH concentration. Group I (n = 20) contained patients with PP and normal GH secretion. In group II (n = 8), PP was accompanied by GH deficiency. Group III (n = 9) patients were GH deficient and prepubertal. The mean plasma Sm-C (RIA) levels in groups I and II were 2.01 +/- 0.17 (+/- SEM) and 0.59 +/- 0.21 U/mL, respectively (P less than 0.001), and it was 0.09 +/- 0.01 U/mL in group III (P less than 0.001 compared to group II). The higher mean plasma Sm-C level in group II compared to that in group III could be related to a significantly higher GH response to arginine-insulin stimulation (P less than 0.02), although this value was in the hypopituitary range. The mean growth rate in group II (6.8 +/- 0.9 cm/yr) was also much higher than the rate in group III (1.9 +/- 0.5 cm/yr; P less than 0.001) and only slightly lower than that in group I (90 +/- 0.8 cm/yr; P less than 0.05). These data indicate that plasma Sm-C values are closely correlated with even small changes in GH secretion. The observed growth rates could, in general, be linked to plasma GH and Sm-C levels, as modulated by sex steroids, in these patients with precocious puberty. PMID- 3680479 TI - Quantitation of urinary somatomedin-C in children with normal and abnormal growth. AB - The renal excretion of radioimmunoassayable somatomedin-C/insulin-like growth factor I (Sm-C/IGF-I) was measured in 12-h overnight urine samples obtained from 88 subjects, aged 3-19 yr. The participants included 34 healthy children (group 1), 29 children with idiopathic growth failure and normal GH stimulation tests (group 2), and 25 GH-deficient subjects (group 3). The mean (+/- SEM) urinary Sm C/IGF-I excretion in group 1 (28.4 +/- 2.1 mU/kg) was significantly greater than that in group 2 (8.1 +/- 1.6 mU/kg) or group 3 (8.6 +/- 1.3 mU/kg). Twenty-two of the 29 subjects in group 2 had urinary Sm-C/IGF-I values less than 8 mU/kg. After the administration of biosynthetic GH to 12 GH-deficient subjects, urinary Sm C/IGF-I excretion rose from 10.3 +/- 2.3 to 21.4 +/- 4.2 mU/kg within 12 h (P less than 0.05), indicating that renal excretion of Sm-C/IGF-I is GH dependent. One woman with acromegaly had markedly elevated urinary Sm-C/IGF-I excretion (420 mU/kg). The authenticity of urinary Sm-C/IGF-I was confirmed by high pressure liquid chromatography (HPLC). Assay of serial dilutions of urinary Sm-C/IGF-I demonstrated a direct proportionality between concentration and dilution. Although it is not possible to identify whether urinary Sm-C/IGF-I reflects local or generalized synthesis of the peptide, we hypothesize that quantitation of Sm C/IGF-I in timed urine collections will yield additional information about GH production and action in children with normal and abnormal growth. PMID- 3680480 TI - Endogenous opioids modulate the inhibitory effects of androgen on the hypothalamic-pituitary axis of normal women. AB - This study was designed to investigate the effect of dihydrotestosterone (DHT) on LH secretion in normal women and the role of endogenous opioids in modulating this effect. Pulsatile LH release and maximum LH responsiveness to exogenous GnRH were determined on 3 consecutive days: basally (day 1), during DHT infusion (day 2), and during DHT plus naloxone (Nal) infusion (day 3). Steady state plasma DHT levels of 6.5 +/- 1.1 (+/- SEM) ng/mL (22.5 +/- 3.8 nmol/L) were achieved by infusion. DHT infusion significantly decreased the maximum LH response to GnRH from 35.5 +/- 8.2 to 11.6 +/- 2.8 IU/L (P less than 0.05). This inhibitory effect was not altered by Nal. In addition, DHT significantly decreased LH pulse frequency (basal, 4.3 +/- 0.3; DHT, 2.8 +/- 0.3 pulses/6 h; P less than 0.05), but not the amplitude of the LH pulses. However, after the addition of Nal to DHT, the pulse frequency increased significantly from 2.8 +/- 0.3 to 4.7 +/- 0.3 pulses/6 h (P less than 0.05). The mean plasma LH level did not change during the infusion of DHT alone, but it did increase significantly when Nal was added (DHT, 4.8 +/- 1.0; DHT + Nal, 7.9 +/- 1.0 IU/L; P less than 0.01). The results of this acute pharmacological study suggest that androgens may have two separate effects on the hypothalamic-pituitary axis: 1) inhibition of GnRH release, which appears to be mediated via opioid peptides, and 2) inhibition of pituitary LH secretion, which is not dependent on opioids. PMID- 3680481 TI - Osmotic and nonosmotic control of vasopressin release in the elderly: effect of metoclopramide. AB - The study was undertaken to define the relationships between the arginine vasopressin (AVP) response to a pressure-volume stimulus (upright posture test), an osmolar challenge, and metoclopramide injection (20 mg, iv) in normal young and elderly subjects. Besides confirming previous findings of increased AVP responsiveness to osmolar challenge and reduced AVP responsiveness to upright posture in the elderly, we found that metoclopramide stimulated AVP release in both young [from 1.09 +/- 0.05 (mean +/- SD) to 1.77 +/- 0.05 pmol/L; P less than 0.05] and elderly subjects (from 1.54 +/- 0.18 to 4.73 +/- 1.82 pmol/L; P less than 0.01). The response was much greater in the elderly (P less than 0.01). The AVP responses to upright posture and metoclopramide were inversely correlated (r = -0.77; P less than 0.01), suggesting that the elderly have increased sensitivity to stimuli, such as metoclopramide, to counteract their reduced sensitivity to baroreceptor stimulation of AVP release. PMID- 3680482 TI - Mechanism of the heparin-induced increase in the concentration of free thyroxine in plasma. AB - The iv administration of heparin causes an increase in the plasma free T4 concentration, as determined by equilibrium dialysis. The mechanism and physiological consequences of this action of heparin are unknown. To explore the possibility that the heparin-induced increase in plasma free T4 is an in vitro artifact due to generation of FFA during equilibrium dialysis, we studied plasma samples from 10 subjects treated with iv heparin. In plasma from 4 of these subjects, free T4 concentrations measured by equilibrium dialysis did not increase above baseline values after heparin administration. In incubations performed in parallel with the equilibrium dialysis measurements, FFA concentrations in these plasma samples were found to increase, but in no subject did they exceed 2.5 meq/L after incubation. In contrast, in plasma from the other 6 subjects treated with heparin, free T4 concentrations rose markedly (by 130 520%) above baseline values after heparin administration. In all of these postheparin plasma samples, FFA concentrations were less than 2.8 meq/L before incubation, but rose during incubation by 80-270% to more than 3.8 meq/L. Treatment of these plasma samples with protamine to inhibit lipoprotein lipase and with specific antiserum to inhibit hepatic triglyceride lipase before equilibrium dialysis or incubation prevented, in parallel, the heparin-induced increases in FFA and free T4 concentrations. From these findings we conclude that the heparin-induced increase in free T4 is usually an in vitro artifact, and that most subjects receiving heparin have a normal plasma free T4 concentration in vivo. We also conclude that this in vitro artifact may account for many of the findings that led to the postulate of an inhibitor of T4 binding to plasma and intracellular proteins in heparin-treated patients and perhaps in patients with nonthyroid illness as well. PMID- 3680483 TI - Evaluation of the nocturnal serum thyrotropin (TSH) surge, as assessed by TSH ultrasensitive assay, in patients receiving long term L-thyroxine suppression therapy and in patients with various thyroid disorders. AB - Circadian variations of serum TSH concentrations have been reported, with higher values occurring in the late evening or early morning. In patients receiving long term L-T4 suppression therapy, it may be important to achieve suppression of TSH secretion throughout the day. To investigate whether undetectable serum TSH values in the morning are associated with undetectable serum TSH levels at night, serum TSH concentrations were measured by an ultrasensitive immunoradiometric assay in 16 normal subjects, 20 hyperthyroid patients, 10 patients with primary hypothyroidism (either untreated or inadequately treated with L-T4), 1 patient with central hypothyroidism, 10 patients with nontoxic nodular goiter, 5 patients with functioning thyroid adenoma, 20 patients receiving L-T4 replacement therapy, and 30 patients receiving L-T4 suppression. In 6 subjects blood was drawn at hourly intervals for 24 h; in 2 normal subjects a major TSH surge occurred between 2300-0100 h, with other minor peaks, and the same pattern was found in two patients receiving L-T4 replacement, whereas in 2 patients receiving L-T4 suppression, serum TSH was constantly below the limit of detection of the assay (i.e. less than 0.07 mU/L). In the remaining patients blood was drawn at hourly intervals between 2300-0200 h and on the next morning before (0830-0900 h) and 30 min after iv TRH administration. In normal subjects, in patients receiving L-T4 replacement therapy, and in hypothyroid patients, serum TSH values at night were higher than in the morning, with normal responses to TRH in the first 2 groups and exaggerated responses in the latter. The patient with central hypothyroidism had no nocturnal TSH surge and no TSH response to TRH. In all hyperthyroid patients, serum TSH was undetectable both at night and during the day, and none had a serum TSH response to TRH. Among patients with nontoxic goiter, 7 had detectable serum TSH in the morning, with higher values at night, and a normal response to TRH; the remainder had undetectable serum TSH both at night and in the morning, and subnormal or absent TSH responses to TRH. All 5 patients with a functioning thyroid adenoma had undetectable serum TSH levels in the morning and during the night, and subnormal or absent TSH responses to TRH. Of the 30 patients receiving long term (greater than 6 months) L-T4 suppression therapy, 28 had undetectable serum TSH both during the night and in the morning and unresponsiveness to TRH.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680484 TI - Renal magnesium wasting in a patient with short bowel syndrome with magnesium deficiency: effect of 1 alpha-hydroxyvitamin D3 treatment. AB - We studied a patient with severe hypomagnesemia due to small bowel resection who had marked renal magnesium (Mg) loss in response to iv Mg infusion. She had an undetectable serum 1,25-dihydroxyvitamin D [1,25-(OH)2D] level before treatment. Although Mg infusion increased her serum Mg levels and enhanced renal PTH action, as evidenced by an elevation in nephrogenous cAMP, the serum 1,25-(OH)2D level remained low. After the administration of 1 alpha-hydroxyvitamin D3, her serum 1,25-(OH)2D level increased, and fractional excretion of Mg decreased. With the elevation in serum 1,25-(OH)2D, serum Mg levels could be maintained without Mg infusion, although they were still subnormal. These results are consistent with the assumption that patients with the short bowel syndrome and Mg deficiency have reduced renal tubular Mg reabsorption which causes renal Mg loss, and that impaired tubular Mg reabsorption is due at least in part to deficient renal action of 1,25-(OH)2D. Because depressed serum 1,25-(OH)2D levels cannot be corrected rapidly by Mg infusion, administration of 1 alpha-hydroxyvitamin D3 or 1,25-(OH)2D3 appears to be the treatment of choice for Mg deficiency in patients with short bowel syndrome. PMID- 3680485 TI - The effect of Danazol on the circulating levels of 34K insulin-like growth factor binding protein (PP12) and endometrial secretory protein PP14. AB - Twenty-four women, 11 with endometriosis and 13 with fibrocystic mastopathy, were treated with a medium dose (300-400 mg daily) of Danazol for 6 months. The circulating level of progesterone, the 34K insulin-like growth factor-binding protein (IGF-bp) and endometrial protein PP14 (placental protein 14) were measured by specific radioimmunoassays before and during treatment. The serum progesterone concentration decreased significantly during Danazol treatment, as did the serum levels of 34K IGF-bp and PP14. By the third month of therapy amenorrhoea was observed in 22 out of 24 women and this was accompanied by a further decline in the IGF-bp and PP14 levels. In light of the previous observations on the IGF-bp and PP14 synthesis by secretory endometrium and the fact that Danazol causes endometrial atrophy, these results suggest that Danazol treatment has an effect on endometrial protein secretion. PMID- 3680486 TI - Sexing of human sperm by discontinuous Percoll density gradient and its clinical application. AB - A discontinuous Percoll density gradient was employed for the selective isolation of human X-bearing sperm. The fraction rich in X-bearing sperm that sedimented through eight steps of a Percoll density gradient was inseminated into healthy volunteers. Six couples achieved pregnancy and each delivered a female baby without abnormality. For further separation, a Percoll density gradient consisting of 12 steps gave a 94% purification of X-bearing sperm (contamination with Y-bearing sperm: 6.4 +/- 1.8%) with a mean recovery of 23.3 +/- 6.4% (n = 6). PMID- 3680487 TI - Study of human sperm chromosomes by sequential transmission and scanning electron microscopy. AB - We describe a method of observing human sperm metaphases by sequential transmission and scanning electron microscopy. This permits the analysis of ultrastructural aspects of sperm chromosomes and allows the relationship between ultrastructure, heterochromatin condensation, and the behaviour and staining properties of sperm chromosomes and heterochromatic regions to be determined. PMID- 3680488 TI - Granulosa cell metabolism and the assessment of oocyte quality in IVF. AB - The progesterone production of the granulosa cells of the cumulus-oocyte complex correlates very well with the cleavage potential of embryos in an IVF system. The method is simple and can be easily performed by any laboratory associated with IVF. Furthermore, high intratubal progesterone levels in the immediate post ovulatory period are probably important in prolonging the intra-ampullary residence of the oocyte or embryo until the uterine endometrium is optimal for implantation. PMID- 3680489 TI - Cryopreservation of human embryos obtained after gamete intra-Fallopian transfer and/or in-vitro fertilization. AB - During a one-year period 636 excess embryos obtained after in-vitro fertilization and gamete intra-Fallopian transfer combined with in-vitro fertilization were cryopreserved using two different protocols. For early stage embryos including the pronucleate stage, 1,2-propanediol was used as cryoprotectant (procedure A, adapted from Renard) and for later stage embryos dimethylsulphoxide was used in protocol B, adapted from Trounson and Mohr. After thawing 288 embryos, half of them were of sufficient quality to be replaced. After cryopreservation, procedure A gave the best survival in embryos having less than or equal to 2 blastomeres; for later stage embryos best survival was obtained using the dimethylsulphoxide protocol. Survival after cryopreservation was also clearly related to the quality of the embryos prior to freezing. Embryos were replaced during endocrinologically monitored natural cycles and were transferred in synchrony between endometrial and embryonic age. After replacement of 126 embryos in 110 patients, 20 pregnancies occurred. So far six healthy children have been born, two patients aborted and 12 pregnancies are ongoing. In this series no statistical difference was observed between the implantation rate of embryos cryopreserved by procedure A or B. Six pregnancies occurred in patients from the oocyte and embryo donation programme. An adequate cryopreservation programme circumvents the difficult problem of synchronizing the ovarian cycles of donor and acceptor patients. PMID- 3680490 TI - In-vitro fertilization results from thirteen women with anti-sperm antibodies. AB - Thirteen infertile women with high titres of spermagglutinating antibodies in their serum and/or in cervical mucus underwent in-vitro fertilization (IVF) and embryo transfer (ET). Fertilization occurred in 68% of the oocytes in a serum free medium. Eight pregnancies were obtained in 22 IVF cycles (36.4%). Anti-sperm antibodies were found in the follicular fluids of 5 out of the 11 women with circulating antibodies. Fertilization results were independent of both the localization and the level of anti-sperm antibodies. From these data we can conclude that IVF-ET is a suitable treatment for long lasting female infertility linked to anti-sperm immunity. PMID- 3680491 TI - Relationship between intrafollicular levels of prolactin and sex steroids and in vitro fertilization of human oocytes. AB - In this study the importance of intrafollicular prolactin (PRL) and sex steroid levels, as indices of the potential in-vitro fertilization and development of human oocytes, was investigated. Oocytes were recovered from 20 normal female volunteers treated with a fixed schedule including norethisterone and clomiphene. The embryos which developed after in-vitro fertilization were graded on a scale of 0 to 10 using morphological criteria. Intrafollicular PRL, oestradiol, progesterone and androstenedione levels did not differ significantly between follicles containing oocytes which fertilized and those which did not fertilize in vitro. Nor did these hormones differ significantly between follicles giving rise to embryos with a bad score (0-5) and those with a good score (6-10). No significant correlation was found between serum and follicular fluid PRL levels. It is suggested that fertilization and developmental potential of human oocytes in vitro cannot be predicted by the intrafollicular levels of PRL and sex steroids at the time of laparoscopic egg recovery. PMID- 3680492 TI - The waiting-list for IVF. The motivations and expectations of women waiting for IVF treatment. AB - We conducted a written survey of a group of women on the IVF waiting-list at the Dijkzigt Hospital in Rotterdam. The objective of the study was to gain an insight into the motivations and expectations of the women involved. It appeared that the respondents were not very well informed on various aspects of the IVF procedure. They were also too optimistic about the chance that the treatment would be successful in their case. Even if the chance of success was very low (2%) most of the women would still choose IVF. Now that IVF exists the women wish to make use of it. They do not want to run the risk of being sorry later if they let 'the chance of having a child of their own' go by. This 'anticipated decision regret' gives IVF a strongly impelling character. Few women said that they needed a form of social guidance. PMID- 3680493 TI - The influence of mouse strain and housing on the immune response. AB - Five strains of mice housed individually (one per cage) or in a group (five per cage) were immunized with sheep erythrocytes (SRBC) to determine if the major histocompatibility complex (MHC) was associated with altered immune reactivity based on housing. Individually housed mice from two strains which shared neither the H2D and H2K loci, produced more antibody forming spleen lymphocytes to SRBC than group-housed mice. Corticosterone levels were not related to the level of the immune response. Thus, genetic factors related to the MHC do not influence alteration of the immune response which occurs with differential housing conditions. PMID- 3680494 TI - The centrifugal effect and other spatial artifacts of topographic EEG mapping. AB - Topographic maps of EEG can contain artifacts that are foreign to clinical electroencephalographers trained to read traditional EEG records. Several spatial artifacts are described and discussed here, including the centrifugal effect, ring enhancement, spatial aliasing, electrode hills and holes, color-step effects, and restriction of minima/maxima to electrode sites. Users of quantitated EEG with topographic maps should be aware of these artifacts and should have a high suspicion for other analogous artifactual spatial phenomena when interpreting individual patient records. PMID- 3680495 TI - Continuous and simultaneous monitoring of EEG spectra and brainstem auditory and somatosensory evoked potentials in the intensive care unit and the operating room. AB - Individual monitoring of EEG and evoked potentials is gradually becoming standard in neurosurgery: compressed power spectra during carotid endarterectomy, brainstem auditory evoked potentials (BAEP) during posterior fossa surgery, and somatosensory evoked potentials (SEP) mainly during spinal cord surgery. In this paper, a new technique is described in which EEG, BAEP, and SEP are recorded and evaluated simultaneously and continuously. This allows a better survey of different neuronal structures and systems in the brain and brainstem. First results from intraoperative and intensive care patient monitoring are reported. PMID- 3680496 TI - American Electroencephalographic Society guidelines for intraoperative monitoring of sensory evoked potentials. PMID- 3680497 TI - Concentration of NADH-cytochrome b5 reductase in erythrocytes of normal and methemoglobinemic individuals measured with a quantitative radioimmunoblotting assay. AB - The activity of NADH-cytochrome b5 reductase (NADH-methemoglobin reductase) is generally reduced in red cells of patients with recessive hereditary methemoglobinemia. To determine whether this lower activity is due to reduced concentration of an enzyme with normal catalytic properties or to reduced activity of an enzyme present at normal concentration, we measured erythrocyte reductase concentrations with a quantitative radioimmunoblotting method, using affinity-purified polyclonal antibodies against rat liver microsomal reductase as probe. In five patients with the "mild" form of recessive hereditary methemoglobinemia, in which the activity of erythrocyte reductase was 4-13% of controls, concentrations of the enzyme, measured as antigen, were also reduced to 7-20% of the control values. The concentration of membrane-bound reductase antigen, measured in the ghost fraction, was similarly reduced. Thus, in these patients, the reductase deficit is caused mainly by a reduction in NADH cytochrome b5 reductase concentration, although altered catalytic properties of the enzyme may also contribute to the reduced enzyme activity. PMID- 3680498 TI - Determination of Krebs cycle metabolic carbon exchange in vivo and its use to estimate the individual contributions of gluconeogenesis and glycogenolysis to overall glucose output in man. AB - Current isotopic approaches underestimate gluconeogenesis in vivo because of Krebs cycle carbon exchange and the inability to measure intramitochondrial precursor specific activity. We therefore applied a new isotopic approach that theoretically overcomes these limitations and permits quantification of Krebs cycle carbon exchange and the individual contributions of gluconeogenesis and glycogenolysis to overall glucose output. [6-3H]Glucose was infused to measure overall glucose output; [2-14C]acetate was infused to trace phosphoenolpyruvate gluconeogenesis and to calculate Krebs cycle carbon exchange as proposed by Katz. Plasma [14C]3-OH-butyrate specific activity was used to estimate intramitochondrial acetyl coenzyme A (CoA) specific activity, and finally the ratio between plasma glucose 14C-specific activity and the calculated intracellular phosphoenolpyruvate 14C-specific activity was used to determine the relative contributions of gluconeogenesis and glycogenolysis to overall glucose output. Using this approach, acetyl CoA was found to enter the Krebs cycle at twice (postabsorptive subjects) and three times (2 1/2-d fasted subjects) the rate of pyruvate, respectively. Gluconeogenesis in postabsorptive subjects (3.36 +/- 0.20 mumol/kg per min) accounted for 28 +/- 2% of overall glucose output and increased twofold in subjects fasted for 2 1/2-d (P less than 0.01), accounting for greater than 97% of overall glucose output. Glycogenolysis in postabsorptive subjects averaged 8.96 +/- 0.40 mumol/kg per min and decreased to 0.34 +/- 0.08 mumol/kg per min (P less than 0.01) after a 2 1/2-d fast. Since these results agree well with previously reported values for gluconeogenesis and glycogenolysis based on determinations of splanchnic substrate balance and glycogen content of serial liver biopsies, we conclude that the isotopic approach applied herein provides an accurate, noninvasive measurement of gluconeogenesis and glycogenolysis in vivo. PMID- 3680499 TI - Contribution of lymphatic absorption to loss of ultrafiltration and solute clearances in continuous ambulatory peritoneal dialysis. AB - The contribution of peritoneal cavity lymphatic absorption to ultrafiltration kinetics and solute clearances in continuous ambulatory peritoneal dialysis was evaluated in patients with normal (group 1) and high (group 2) peritoneal permeability X area during 4-h exchanges using 2 liters 2.5% dextrose dialysis solution with 30 g added albumin. Cumulative lymphatic drainage in all continuous ambulatory peritoneal dialysis (CAPD) patients averaged 358 +/- 47 ml per 4-h exchange and reduced cumulative net transcapillary ultrafiltration at the end of the exchange by 58 +/- 7.2%. The peak ultrafiltration volume was observed before osmotic equilibrium between serum and dialysate was reached and occurred when the net transcapillary ultrafiltration rate had decreased to equal the lymphatic absorption rate. Thereafter the lymphatic absorption rate exceeded the net transcapillary ultrafiltration rate, and intraperitoneal volume decreased. Extrapolated to 4 X 2 liters, 2.5% dextrose, 6-h exchanges per d, lymphatic drainage reduced potential daily net ultrafiltration by 83.2 +/- 10.2%, daily urea clearance by 16.9 +/- 1.9%, and daily creatinine clearance by 16.5 +/- 1.9%. Although lymphatic absorption did not differ between the two groups, lymphatic drainage caused a proportionately greater reduction in net ultrafiltration in group 2 (P less than 0.025), because these patients had more rapid dialysate glucose absorption (P less than 0.05) and less cumulative transcapillary ultrafiltration (P less than 0.01). These findings indicate that cumulative lymphatic drainage significantly reduces net ultrafiltration and solute clearances in CAPD and that ultrafiltration failure in CAPD occurs when daily lymphatic absorption equals or exceeds daily transcapillary ultrafiltration. Reduction of lymphatic absorption may provide a means for future improvement in the efficiency of CAPD. PMID- 3680501 TI - Effects of potassium on ammonia transport by medullary thick ascending limb of the rat. AB - Renal ammonium excretion is increased by potassium depletion and reduced by potassium loading. To determine whether changes in potassium concentration would alter ammonia transport in the medullary thick ascending limb (MAL), tubules from rats were perfused in vitro and effects of changes in K concentration within the physiological range (4-24 mM) were evaluated. Increasing K concentration from 4 to 24 mM in perfusate and bath inhibited total ammonia absorption by 50% and reduced the steady-state transepithelial NH+4 concentration gradient. The inhibition of total ammonia absorption was reversible and occurred when K replaced either Na or N-methyl-D-glucamine. Increasing K concentration in the luminal perfusate alone gave similar inhibition of total ammonia absorption. At 1 2 nl/min per mm perfusion rate, increasing K concentration in perfusion and bathing solutions had no significant effect on transepithelial voltage. With either 4 or 24 mM K in perfusate and bath, an increase in luminal perfusion rate markedly increased total ammonia absorption. Thus, both potassium concentration and luminal flow rate are important factors capable of regulating total ammonia transport by the MAL. Changes in systemic potassium balance may influence renal ammonium excretion by affecting NH+4 absorption in the MAL and altering the transfer of ammonia from loops of Henle to medullary collecting ducts. PMID- 3680500 TI - Carbohydrate heterogeneity of fibronectins. Synovial fluid fibronectin resembles the form secreted by cultured synoviocytes but differs from the plasma form. AB - Large quantities of fibronectin (Fn) are present in inflammatory synovial fluid. Inflammatory synovial fluid Fn, while indistinguishable from plasma Fn on the basis of reactivity to polyclonal antibodies, displays alterations in molecular size and charge. Since biochemical differences between plasma and synovial fluid fibronectins might be in part due to differences in glycosylation we have compared the carbohydrate composition of plasma Fn, synovial fluid Fn, and Fn from synoviocyte conditioned medium by biochemical assay, glycopeptide analysis, and binding to a series of lectins. Synovial fluid Fn has a greater carbohydrate content but contains less sialic acid when compared with plasma Fn. Glycopeptides formed from synovial fluid Fn are smaller than plasma Fn glycopeptides. These data suggest the presence of an additional N-linked oligosaccharide chain on synovial fluid Fn. In addition, synovial fluid Fn contains N-acetyl galactosamine indicating the presence of O-linked oligosaccharides. Synovial fluid Fn and Fn isolated from rheumatoid synoviocyte-conditioned medium display strong reactivity with the lectins wheat germ agglutinin (WGA) and peanut agglutinin (PNA), whereas normal and rheumatoid plasma Fn react weakly. The PNA reactivity of synovial fluid Fn is mediated by terminal beta-galactose residues on the gelatin-binding domain, whereas the enhanced WGA reactivity of synovial Fn is mediated by a sialic acid containing oligosaccharide located on a 27-kD C-terminal fragment. These data demonstrate domain-specific biochemical differences between plasma and synovial fluid fibronectins. These differences suggest a local origin for synovial fluid Fn and may contribute to functional differences between these forms of the protein. PMID- 3680502 TI - Protein synthesis in hepatocytes isolated from patients with gastrointestinal malignancy. AB - To investigate the effect of remote and proximate cancer on hepatic protein metabolism, we determined rates of total protein synthesis by hepatocytes (HPS) isolated from 31 patients undergoing liver wedge biopsy: 7 patients with benign disease, 14 with gastric cancer, and 10 with colorectal cancer (5 of whom had liver metastases). Patients with malignant disease without weight loss had a threefold higher rate of total HPS (4,980 +/- 814 pmol/h per 10(5) viable cells) than patients with benign disease without weight loss (1,278 +/- 318 pmol/h per 10(5) viable cells, P less than 0.001). Among the patients with gastric cancer, eight with preoperative weight loss had lower rates of HPS (380 +/- 90 pmol/h per 10(5) viable cells) than those without weight loss (4,061 +/- 401 pmol/h per 10(5) viable cells, P less than 0.002). The highest rates of HPS were seen in patients with colorectal cancer with liver metastases (8,005 +/- 1,975 pmol/h per 10(5) viable cells) vs. colorectal cancer patients without liver metastases (3,060 +/- 575 pmol/h per 10(5) viable cells, P less than 0.03). These data indicate that modulation of hepatic protein synthesis occurs in malignancy in man. However, the stimulatory influence of the tumor-bearing state may be overridden by the inhibitory effects of cachexia. PMID- 3680503 TI - Human adenine phosphoribosyltransferase. Identification of allelic mutations at the nucleotide level as a cause of complete deficiency of the enzyme. AB - This study reports the first demonstration of specific mutations leading to human adenine phosphoribosyltransferase (APRT) deficiency. The molecular basis of the deficiency was investigated by determining the sequence of both alleles of a patient with a complete deficiency in APRT activity. A trinucleotide deletion, corresponding to phenylalanine on the deduced amino acid sequence, was confirmed on one allele. A single nucleotide insertion, immediately adjacent to the splice site at the 5' end of the fourth intervening sequence, was confirmed on the other allele. This insertion lead to aberrant splicing, as was demonstrated by the absence of exon 4 in the complementary DNA sequence and by altered RNase mapping analysis of the abnormal messenger RNA. PMID- 3680504 TI - An initiation codon mutation (AUG----GUG) of the human alpha 1-globin gene. Structural characterization and evidence for a mild thalassemic phenotype. AB - alpha-globin is encoded by two adjacent genes, alpha 1 and alpha 2. Recent evidence suggests that these genes are not equally expressed and that the alpha 2 globin gene encodes the majority of alpha-globin. This finding would predict that a thalassemic mutation of the alpha 2-globin gene would result in a more severe loss of alpha-chain synthesis than a similar mutation in the alpha 1-globin gene. In a previous study we described a nondeletion alpha-thalassemia defect in the alpha 2-globin gene resulting from an AUG----ACG initiation codon mutation. In the present study we describe a different initiation codon mutation, AUG----GUG, present in the alpha 1-globin gene. The alpha 1- and alpha 2-globin gene initiation codon mutations result in similarly lowered levels of encoded mRNA. Despite the similarity of these two mutations, the alpha 2 mutant results in a more severe loss of alpha-globin synthesis and a more severe clinical alpha thalassemia phenotype than the corresponding alpha 1-globin gene mutation. This difference reflects the dominant role of alpha 2-globin gene in overall alpha globin synthesis. PMID- 3680505 TI - P-31 nuclear magnetic resonance spectroscopic study of obstructive uropathy in the rat. AB - P-31 nuclear magnetic resonance (NMR) spectroscopy of the rat kidney with ureteral ligation resulted in a rapid and major increase in a peak resonating at 7096.63 +/- 0.65 Hz from the reference frequency of phosphorus (32.60 MHz). This corresponded to an increase in the concentration of the substance responsible for peak X from 0.34 +/- 0.04 mumol/g wet weight in normal kidneys to 1.45 +/- 0.27 mumol/g wet weight in unilaterally obstructed kidneys and 2.00 +/- 0.34 mumol/g wet weight in bilaterally obstructed kidneys at 3 h (P less than 0.01). Further NMR studies performed with in vivo kidneys and tissue extracts revealed that inorganic phosphate in the urine, resonating at a lower frequency due to the acid pH environment, was responsible for the increase in this peak. These findings may prove to be of fundamental interest as well as potential clinical significance. PMID- 3680506 TI - Human placental transport of cimetidine. AB - This study addresses the mechanism of transport of the H2-receptor antagonist, cimetidine, by the human placenta. A 4-h recycling perfusion of a single placental cotyledon of normal, term, human placenta was used. At a maternal concentration of 1 microgram/ml, cimetidine clearance from the maternal circulation was 0.58 +/- 0.16 ml/min per g placenta, a rate about one third that of antipyrine. There was no evidence of cimetidine metabolism by the placenta. Transfer of cimetidine from maternal to fetal compartments showed no saturation kinetics and was not inhibited by putative carrier competitors. Cimetidine did not accumulate against a drug concentration gradient. Fetal clearance of cimetidine was similar to maternal clearance. Studies with placental apical vesicles confirmed lack of saturability of cimetidine transport and of its concentration within vesicles. Thus, (a) cimetidine is transported across the human placenta bidirectionally at a rate about one third that of antipyrine, (b) the drug is not metabolized by the placenta, and (c) the transport is a passive one. PMID- 3680508 TI - Apparent tolerance to the acute effect of nicotine results in part from distribution kinetics. AB - Persons exposed to nicotine develop tolerance to many of its effects. When heart rate and forearm venous blood concentration are plotted against time after intravenous administration of nicotine, a greater increase in heart rate is seen for a given nicotine concentration during the rising phase of nicotine concentrations than during the decreasing phase. This could be due to acute tolerance or to more rapid distribution of drug to effect site (brain) than to venous blood. To distinguish between these possibilities, six rabbits were given nicotine intravenously. Blood samples were taken from the internal jugular vein (reflecting brain concentration), and the femoral vein and artery. Brain concentrations peaked before femoral venous concentrations. Seven men received intravenous infusions of nicotine. Peripheral venous blood concentrations and cardiovascular responses were measured. Heart rate peaked before venous concentrations. A physiological kinetic model, fit to the rabbit data, was scaled to humans and used to predict "brain" concentrations in them. Heart rate and predicted brain concentrations peaked simultaneously. We conclude that the rapid development of tolerance to the cardioaccelerating effect of nicotine can be attributed, at least in part, to its distribution kinetics. PMID- 3680507 TI - Rapid formation of large molecular weight alpha-polymers in cross-linked fibrin induced by high factor XIII concentrations. Role of platelet factor XIII. AB - After fibrin polymerization, activated Factor XIII catalyzes the formation of intermolecular cross-links between gamma-chain pairs and also among two or more alpha-chains to form polymers. In this report we characterize the size and heterogeneity of alpha-chain polymers, establish the role of high concentrations of Factor XIII in determining the extent and rate of alpha-polymer formation, and also provide evidence that the Factor XIII required can be provided by platelets. Fibrin prepared from purified fibrinogen or platelet-deficient plasma contained a series of cross-linked alpha-chain polymers with Mr from 140,000 to 770,000 with a mean Mr difference of 32,000 consistent with a staggered, overlapping addition of monomers to the growing alpha-polymer chain. In plasma containing no platelets, alpha-polymer formation was incomplete with residual alpha-monomer remaining, but higher platelet counts facilitated more rapid cross-linking into larger polymers. Purified Factor XIII was equally effective as platelets in facilitating cross-linking. We conclude that cross-linked alpha-polymer chains are heterogeneous in size reaching a molecular weight of several million and that high concentrations of Factor XIII as provided by platelets are required for maximum cross-linking. PMID- 3680509 TI - Activation of terminal components of complement in patients with Guillain-Barre syndrome and other demyelinating neuropathies. AB - In the present study, the role of antiperipheral nerve myelin antibody (anti-PNM Ab) in demyelination by generating the terminal attack complex (C5b-9) of complement was explored in patients with Guillain-Barre syndrome (GBS) and other demyelinating neuropathies. The presence in serum of SC5b-9, an inactive C5b-9 containing S protein, was assessed quantitatively by enzyme-linked immunosorbent assay using an antibody (Ab) to neoantigens expressed on C9 when complexed with C5b-8 or after tubular polymerization. SC5b-9 was detected in all 19 GBS, four patients with paraprotein-associated neuropathy and five of six patients with chronic recurrent polyneuritis. No SC5b-9 was detected in 10 normal controls. Kinetic studies from six GBS patients showed the highest values of SC5b-9 on the 3rd to 5th d of admission; in contrast, the anti-PNM Ab were highest on the day of admission. Anti-PNM Ab fell rapidly to very low levels by the 15th to 20th d. SC5b-9 declined with similar kinetics to undetectable levels by the 30th d. Levels of Ab and SC5b-9 did not quantitatively correlate with soluble immune complexes in these patients' serum. Membrane-bound C5b-9 was also detected by immunohistochemistry in the peripheral nerves from a GBS patient. These results, which show a relationship between levels of complement-fixing anti-PNM Ab and the tissue-damaging C5b-9 complex, suggest that peripheral nerve myelin may serve as the target for Ab-mediated complement attack. PMID- 3680510 TI - Soybean protein diet increases low density lipoprotein receptor activity in mononuclear cells from hypercholesterolemic patients. AB - The effect of two diets containing different protein sources (animal vs. soybean) on the low density lipoprotein (LDL) receptor activity was tested in freshly isolated mononuclear cells from 12 individuals with severe type II hyperlipoproteinemia. The two diets, both taken for 4 wk in a crossover design were of otherwise identical composition. During the soybean protein diet period, total cholesterol was reduced by 15.9% and LDL-cholesterol by 16.4%. The diet containing animal proteins exerted no significant change in plasma lipid levels vs. the baseline findings. The soybean diet regimen dramatically affected the degradation of LDL by mononuclear cells. Degradation was increased 16-fold vs. the basal activity and 8-fold compared with the standard low lipid diet with animal proteins. There was, however, no clear relationship between the reduction of total and LDL-cholesterolemia and the increased LDL degradation. These findings confirm similar data previously obtained in cholesterol-fed rats and suggest that some factor/s, most likely of a protein nature, may regulate the expression of lipoprotein receptors in peripheral cells, particularly when receptor activity is suppressed by experimental diets and/or spontaneous hypercholesterolemia. PMID- 3680511 TI - Potentiated adherence of sickle erythrocytes to endothelium infected by virus. AB - Systemic viral infection is a known precipitant of vasocclusive crisis in sickle patients, but the mechanism underlying this clinical observation is unknown. In the present studies, human umbilical vein endothelial cells were infected with Herpes simplex virus type 1 (HSV) to model systemic viral disease. The already abnormal adherence of sickle erythrocytes to control endothelium is enhanced 1.8 +/- 0.4-fold to HSV-infected endothelium (P less than 0.001). This component of potentiated adherence is eliminated by maneuvers that block Fc receptors, it is prevented by tunicamycin, and it is not seen using a mutant HSV that is unable to express the Fc receptor glycoprotein. Thus, the incremental adherence seen here occurs due to expression of Fc receptor activity on HSV-infected endothelium and the consequent recognition of abnormal amounts of IgG on sickle erythrocytes. We conclude that systemic viral infection potentially can induce a novel mechanism for enhancement of erythrocyte adherence to endothelium and that this may increase the likelihood of vasocclusion during viral infection. PMID- 3680512 TI - Direct evidence of a role for mast cells in the pathogenesis of antigen-induced bronchoconstriction. AB - We measured bronchoalveolar lavage (BAL) fluid histamine levels in allergic asthmatics and nonallergic normal subjects after local airway antigen and cold 22 degrees C normal saline challenges. Immediately after instillation of antigen through a bronchoscope wedged into a subsegmental airway, all 17 allergic asthmatics but none of the nine normal subjects had visible airway constriction. The asthmatics had a concomitant mean increase in BAL histamine of 23% (P = 0.005), whereas the normals had no change in BAL histamine. Among the allergic asthmatics, the change in BAL histamine content in response to antigen directly correlated with the control (baseline) BAL histamine content (r = 0.66, P = 0.003). Moreover, asthmatics with large antigen-induced changes in BAL histamine had greater airway methacholine sensitivity than did asthmatics without measurable increases in BAL histamine (8 +/- 2 vs. 41 +/- 31 breath units). Neither asthmatics nor normal subjects had airway constriction or changes in BAL histamine levels in response to nonspecific challenge with cold saline. Our data suggest that when allergic asthmatics are exposed to relevant antigens they have in vivo lung mast cell degranulation which results in airway constriction and contributes to nonspecific airway hyperresponsiveness. PMID- 3680513 TI - Suppression of hemostatic system activation by oral anticoagulants in the blood of patients with thrombotic diatheses. AB - RIAs for hemostatic system activation were employed to study patients who were anticoagulated with warfarin. The mean prothrombin fragment F1 + 2 concentration in stably anticoagulated individuals without an inherited thrombotic diathesis (mean prothrombin time [PT] ratio [PT of patient/PT of normal plasma pool] = 1.74) was 0.231 nM as compared with a mean plasma F1 + 2 level of 1.68 nM for a nonanticoagulated control group (P less than 0.0001). The initiation of oral anticoagulants in two subjects who did not exhibit protein C deficiency led to a paradoxical increase in F1 + 2 levels during the first day of therapy. We have also shown that a relatively low intensity regimen of warfarin (PT ratio less than 1.2) may reduce elevated concentrations of F1 + 2 into the normal range in patients with a history of recurrent thromboembolism. The mean F1 + 2 level in antithrombin-deficient individuals on warfarin was significantly elevated (mean = 0.714 nM) as compared with that in anticoagulated subjects with protein C deficiency (mean = 0.205 nM) or in those without an inherited thrombotic disorder (P less than 0.01) at equivalent levels of intensity of oral anticoagulation. We therefore conclude that the effect of warfarin on hemostatic system activation is modulated by the endogenous heparan sulfate-antithrombin mechanism. PMID- 3680514 TI - Effects of protein kinase C activation on sodium, potassium, chloride, and total CO2 transport in the rabbit cortical collecting tubule. AB - Several hormones induce phosphatidylinositol turnover in cell membranes and thus activate protein kinase C. Activation of protein kinase C can, in turn, have effects on epithelial transport. These experiments were designed to investigate the effects of two activators of protein kinase C, phorbol 12-myristate,13 acetate (PMA) and L-alpha-1,2-dioctanoylglycerol (L-alpha-1,2-DOG), and two inactive analogues, 4 alpha-phorbol and 4-O-methyl phorbol 12-myristate,13 acetate, on sodium, potassium, chloride, and total CO2 transport in the rabbit cortical collecting tubule. Utilizing in vitro microperfusion techniques, we found that activation of protein kinase C with either PMA or L-alpha-1,2-DOG significantly inhibited net sodium absorption, net potassium secretion and transepithelial voltage in a dose-dependent manner. There was no effect on net chloride or total CO2 transport. In contrast, the inactive phorbol analogues did not alter either sodium or potassium transport. These studies demonstrate that in the rabbit cortical collecting tubule sodium and potassium transport can be inhibited by compounds known to activate proteins kinase C. Thus, hormones that induce phosphatidylinositol turnover in the rabbit cortical collecting tubule may lead to inhibition of sodium transport by activation of protein kinase C. PMID- 3680515 TI - Apolipoprotein CIISt. Michael. Familial apolipoprotein CII deficiency associated with premature vascular disease. AB - A 60-yr-old woman and her brother, products of a consanquinous mating, were chylomicronemic. The chylomicronemia in both subjects was found to be due to the absence of functional apoCII. A mutant form, designated apoCIISt. Michael (apoCIIs), was identified by two-dimensional electrophoresis and Western blot using anti-apoCII antiserum. The isoelectric point of apoCIIs was similar to that of normal apoCII, but its apparent molecular weight was 3,000 greater. Tryptic peptides of apoCIIs were identified that had retention times in reverse-phase high pressure liquid chromatography and amino acid compositions indistinguishable from that of residues 1 to 48 and 51 to 55 of normal apoCII. The complete sequence of apoCIIs was deduced from a combination of the sequence analysis of tryptic peptides corresponding to residues 56 through 96 and the known sequence of the apoCII gene. ApoCIIs differed from apoCII at residue 70 where Gln70 was replaced by Pro70 and the sequence terminated with Pro96. This is consistent with a base insertion in the codon for Asp69 or Gln70 in the apoCII gene and a subsequent translation reading frame shift. Both patients were homozygous for apoE-4. This and the absence of normal apoCII is consistent with homozygozity at the apoE-CII gene locus on chromosome 19. Both siblings and several relatives had premature ischemic vascular disease, in contrast with its apparent absence in other apoCII-deficient families. PMID- 3680516 TI - Abnormal ultraviolet mutagenic spectrum in plasmid DNA replicated in cultured fibroblasts from a patient with the skin cancer-prone disease, xeroderma pigmentosum. AB - A shuttle vector plasmid, pZ189, was utilized to assess the types of mutations that cells from a patient with xeroderma pigmentosum, complementation group D, introduce into ultraviolet (UV) damaged, replicating DNA. Patients with xeroderma pigmentosum have clinical and cellular UV hypersensitivity, increased frequency of sun-induced skin cancer, and deficient DNA repair. In comparison to UV-treated pZ189 replicated in DNA repair-proficient cells, there were fewer surviving plasmids, a higher frequency of plasmids with mutations, fewer plasmids with two or more mutations in the marker gene, and a new mutagenic hotspot. The major type of base substitution mutation was the G:C to A:T transition with both cell lines. These results, together with similar findings published earlier with cells from a xeroderma pigmentosum patient in complementation group A, suggest that isolated G:C to A:T somatic mutations may be particularly important in generation of human skin cancer by UV radiation. PMID- 3680517 TI - Effect of perturbation of specific folate receptors during in vitro erythropoiesis. AB - Although antisera to specific placental folate receptors inhibits the uptake of 5 methyltetrahydrofolate into cultured malignant human cells, little is known of the functional significance of folate receptors in normal human cells. Human bone marrow cells were therefore assayed for erythropoietic burst-forming units in the presence of an antihuman placental folate receptor serum and preimmune serum to determine the role of such a receptor in erythroid differentiation. When marrow cells were assayed in the presence of anti-receptor antiserum, there was (i) a threefold increase in erythropoietic burst formation and a twofold increase in the number of cells per erythroid burst; (ii) morphological evidence for nuclear/cytoplasmic dissociation of orthochromatic normoblasts composing erythroid bursts (megaloblastic erythropoiesis); (iii) intracellular folate deficiency with a 70% reduction of intracellular folate in antiserum treated cells as compared with control cells; and (iv) complete reversal of antiserum induced changes on preincubation of antiserum with purified human placental folate receptor. These data support the conclusion that folate receptors on marrow cells provide an important function in the cellular uptake of folates during in vitro erythropoiesis. This process of folate uptake also appears to play a pivotal role in the differentiation and proliferation of erythroid progenitor cells. PMID- 3680518 TI - Expression of a metalloproteinase that degrades native type V collagen and denatured collagens by cultured human alveolar macrophages. AB - Human pulmonary alveolar macrophages obtained by bronchoalveolar lavage from both normal controls and smokers secreted in vitro a neutral proteinase that degraded denatured collagens. Optimal expression of the proteinase was detected after 3-5 d of culture. The proteinase could not be detected in the media of cultures that had been treated with 0.5 micrograms/ml of cycloheximide. The gelatinase had an Mr of 90,000 and was immunologically cross-reactive with human neutrophil gelatinase. When newly synthesized 35S-methionine-labeled proteins were analyzed, the proteinase appeared to be a major secretion product of alveolar macrophages. Chromatography on gelatin-Sepharose gave a single peak of activity that was predominantly composed of the 90,000-mol-wt proteinase. The proteolytic activity in the gelatin-Sepharose-purified material was inhibited by EDTA and 1,10 phenanthroline, but not by N-ethylmaleimide or phenylmethanesulfonyl fluoride, indicating that the proteinase was a metalloproteinase. The partially purified material was also capable of degrading native type V collagen and this degradation was inhibited in the presence of an antibody to neutrophil gelatinase. The data suggest that human alveolar macrophages in culture elaborate a metalloproteinase that degrades both native type V collagen and denatured collagens. PMID- 3680519 TI - Regulation of pH in rat papillary tubule cells in primary culture. AB - To investigate the mechanisms responsible for urinary acidification in the terminal nephron, primary cultures of cells isolated from the renal papilla were grown as monolayers in a defined medium. Morphologically, cultured cells were epithelial in type, and similar to collecting duct principal cells. Cell pH measured fluorometrically in monolayers grown on glass slides showed recovery from acid loads in Na+-free media. Recovery was inhibited by cyanide, oligomycin A, and N-ethylmaleimide. Cyanide and oligomycin inhibited recovery less in the presence than in the absence of glucose. When cells were first acid loaded in a Na+-free medium and then exposed to external Na+, pH recovery also took place. This recovery exhibited first-order dependence on Na+ concentration and was inhibited by 5-(N-ethyl-N-isopropyl)amiloride. These studies demonstrate that in culture, collecting duct principal cells possess at least two mechanisms for acid extrusion: a proton ATP-ase and an Na+-H+ exchanger. The former may be responsible for some component of the urinary acidification observed in the papillary collecting duct in vivo; the role of the latter in acid-base transport remains uncertain. PMID- 3680520 TI - Glycoconjugate expression in normal, metaplastic, and neoplastic human upper gastrointestinal mucosa. AB - Glycoconjugate structure in upper gastrointestinal epithelium was studied using five lectins to determine the relationship between aberrant differentiation and glycoconjugate expression. Specimens of normal esophagus, stomach, and duodenum were examined and compared with specimens of columnar metaplasia in the esophagus (Barrett's esophagus) and specimens of adenocarcinoma of the esophagus and stomach. Specific terminal glycoconjugate structures were found for the esophagus, stomach, and duodenum. Minor differences were found between the antral and fundic gland mucosae, reflecting their respective cell populations. In biopsies of Barrett's esophagus, gastric-type columnar metaplasia expressed glycoconjugates indistinguishable from those in the normal stomach. In specialized-type columnar metaplasia, a more restricted expression of glycoconjugates was seen resembling the normal duodenum. The presence of low grade dysplasia in Barrett's esophagus associated with adenocarcinoma had no impact on glycoconjugate expression. However, a distinctive difference in glycosylation was seen in high grade dysplasia of the columnar-lined esophagus and in adenocarcinoma of the esophagus and stomach. Barrett's esophagus is a morphological mosaic in which the glycoconjugate expression resembles that seen in the normal stomach and duodenum. However, in high grade dysplasia and carcinoma, variable deletion of glycoconjugate expression can be found. PMID- 3680521 TI - Hypercalcemia induced with an arotinoid in thyroparathyroidectomized rats. New model to study bone resorption in vivo. AB - A model of stimulated bone resorption was developed using a synthetic retinoid in thyroparathyroidectomized rats. The retinoid induced an increase in bone resorption and in the number of vertebral subperiosteal osteoclasts. The resulting increase in plasma Ca could be used as an easily measured index of bone resorption. Three bisphosphonates produced a dose-related prevention and reversal of retinoid-induced hypercalcemia. Their potencies were similar to those previously obtained by histomorphometry. Irradiation (600 rad) of the rats prevented hypercalcemia but failed to reverse it, showing that proliferation of osteoclast precursor cells was important in inducing, but not in maintaining, bone resorption. Calcitonin produced similar effects on calcemia and prevented the increase in osteoclast number but failed to reverse the increase, suggesting that it inhibited precursor proliferation. This model represents a new tool to study mechanisms of bone resorption and the action of inhibitors in vivo. PMID- 3680522 TI - Suppression of apolipoprotein B production during treatment of cholesteryl ester storage disease with lovastatin. Implications for regulation of apolipoprotein B synthesis. AB - Cholesteryl ester storage disease (CESD) is characterized by the deficient activity of lysosomal cholesteryl ester (CE) hydrolase, accumulation of LDL derived CE in lysosomes, and hyperlipidemia. We studied the kinetics of VLDL and LDL apolipoprotein B (apoB), using 125I-VLDL and 131I-LDL, in a 9-yr-old female with CESD and elevated total cholesterol (TC) (271.0 +/- 4.4 mg/dl), triglyceride (TG) (150.0 +/- 7.8 mg/dl), and LDL cholesterol (184.7 +/- 3.4 mg/dl). These studies demonstrated a markedly elevated production rate (PR) of apoB, primarily in LDL, with normal fractional catabolism of apoB in VLDL and LDL. Urine mevalonate levels were elevated, indicative of increased synthesis of endogenous cholesterol. Treatment with lovastatin, a competitive inhibitor of hydroxymethylglutaryl coenzyme A reductase, resulted in significant reductions in TC (196.8 +/- 7.9 mg/dl), TG (100.8 +/- 20.6 mg/dl), and LDL cholesterol (102.0 +/- 10.9 mg/dl). Therapy reduced VLDL apoB PR (5.2 vs. 12.2 mg/kg per d pretreatment) and LDL apoB PR (12.7 vs. 24.2 mg/kg per d pretreatment). Urine mevalonate levels also decreased during therapy. These results indicate that, in CESD, the inability to release free cholesterol from lysosomal CE resulted in elevated synthesis of endogenous cholesterol and increased production of apoB containing lipoproteins. Lovastatin reduced both the rate of cholesterol synthesis and the secretion of apoB-containing lipoproteins. PMID- 3680523 TI - Interaction of murine granulocyte-macrophage progenitors and supporting stroma involves a recognition mechanism with galactosyl and mannosyl specificities. AB - To study the molecular basis of "homing" of granulocyte-macrophage progenitors (CFU-C), we synthesized probes by covalent linking of sugars to bovine serum albumin. Long-term marrow cultures were established in the presence and absence of these probes. In the presence of galactosyl and mannosyl probes, total cell and CFU-C production in the supernate as well as the adherent layer were halted, and cobblestones (representing CFU-C bound to stroma) disappeared. Fucosyl probe and diffusible sugars had no effect on these parameters. These studies suggested membrane lectins with specificity for galactosyl and mannosyl residues may be responsible for the binding of CFU-C to supporting stroma. To determine if CFU-C possesses homing receptors with these specificities, we induced agglutination in marrow cell suspensions with these neoglycoprotein probes. Selective agglutination was observed only by galactosyl and mannosyl probes. The results suggest that CFU-C homing receptors are membrane lectins with specificity for galactosyl and mannosyl residues. PMID- 3680524 TI - Modulation of fibronectin gene expression in human mononuclear phagocytes. AB - Under some conditions, mononuclear phagocytes spontaneously synthesize and release fibronectin, an extracellular matrix glycoprotein with versatile effects on cell-matrix interactions. To gain insight into the processes that modulate the level of fibronectin secretion by these cells, we used monocytes, in vitro matured monocytes and alveolar macrophages as models to compare fibronectin mRNA levels and fibronectin secretion in a variety of circumstances. Using Northern analysis and dot-blot analysis with a 32P-labeled human fibronectin cDNA probe, we evaluated steady-state mRNA levels and a human fibronectin-specific ELISA was used to evaluate fibronectin secretion. In all cases the amounts of fibronectin secreted paralleled fibronectin mRNA levels. Specifically (a) when fibronectin mRNA was undetectable, as in the case of normal blood monocytes, no fibronectin was secreted, but whenever fibronectin mRNA was present, as in normal alveolar macrophages, fibronectin was secreted by the cells; (b) as monocytes matured into macrophages in vitro, the cells began to express fibronectin mRNA and the cells secreted fibronectin; (c) when alveolar macrophages were activated with surface stimuli such as lipopolysaccharide (LPS) or immune complexes, fibronectin mRNA levels decreased and in parallel, the cells secreted less fibronectin; (d) in idiopathic pulmonary fibrosis (IPF), alveolar macrophages contained severalfold more fibronectin mRNA transcripts that normal and the cells spontaneously secreted severalfold more fibronectin than normal; and (e) when IPF alveolar macrophages were placed in culture the fibronectin mRNA levels in the cells decreased with time, and concurrently the amounts of fibronectin produced per unit time continually decreased. The observation of a strict concordance of fibronectin mRNA levels and fibronectin release by mononuclear phagocytes suggests that, at least in many circumstances, fibronectin secretion by mononuclear phagocytes is controlled by steady-state levels of fibronectin mRNA. PMID- 3680526 TI - Quantitation of the pathways of hepatic glycogen formation on ingesting a glucose load. AB - Diflunisal, 5-(2',4'-difluorophenyl)salicylic acid, excreted in urine as its glucuronide, was given to normal humans (n = 6) along with a glucose load specifically labeled with 14C. Glucuronide excreted by each subject was reduced to its glucoside and glucose from it degraded to yield the distribution of 14 C in its six carbons. Randomization of the 14C from the specifically labeled glucose was taken as a measure of the extent to which glucose was deposited indirectly (i.e., glucose----lactate----glucose----6-P----glycogen), rather than directly (i.e., glucose----glucose-6-P----glycogen). The maximum contribution to glycogen formation by the direct pathway was estimated to be 65 +/- 1%, on the assumption that glucuronide and glycogen are derived from the same hepatic pool of glucose-6-P in liver. Evidence that supports that assumption was obtained by comparing the randomization of 14C in the urinary glucuronide with that in glucose in blood from the hepatic vein of four of the subjects before and after they were given glucagon. Other evidence supporting the assumption was obtained by comparing in two subjects 3H/14C ratios in glucose from hepatic vein blood before and after glucagon administration with that in urinary glucuronide, having labeled the uridine diphosphate (UDP)-glucose in their livers with 14C by giving them 1-[14C]galactose and their circulating glucose with 3H by giving a 5 [3H]glucose-labeled load. It is concluded that glucuronide formation in humans can be used to trace glucose metabolism in the liver, and that in humans the indirect pathway of glucose metabolism is active. PMID- 3680525 TI - Recombinant superoxide dismutase reduces oxygen free radical concentrations in reperfused myocardium. AB - It has been proposed that oxygen free radicals mediate damage that occurs during postischemic reperfusion. Recombinant human superoxide dismutase (r-h-SOD) has been shown to be effective at reducing reperfusion injury, but it is not known if this infused enzyme actually reduces oxygen free radical concentrations in the myocardial tissue. Electron paramagnetic resonance spectroscopy was used to directly measure the effect of r-h-SOD on free radical concentrations in the postischemic heart. Hearts were freeze clamped at 77 degrees K after 10 min of normothermic global ischemia followed by 10 s of reflow with control perfusate (n = 7) or perfusate containing 60,000 U r-h-SOD (n = 7). The spectra of these hearts exhibited three different signals: signal A isotropic, g = 2.004, identical to the carbon-centered ubiquinone free radical; signal B anisotropic with axial symmetry, g parallel = 2.033, g perpendicular = 2.005, identical to the oxygen-centered alkyl peroxyl free radical; and the signal C an isotropic triplet, g parallel = 2.000, an = 24 G, similar to a nitrogen-centered free radical such as a peroxyl amine. With r-h-SOD administration the concentration of the oxygen free radical, signal B, was reduced 49% from 6.8 +/- 0.3 microM to 3.5 +/- 0.3 microM (P less than 0.01) and the concentration of the nitrogen free radical, signal C, was reduced 38% from 3.4 +/- 0.3 to 2.1 +/- 0.3 microM (P less than 0.01). The concentration of the carbon-centered free radical, signal A, however, was increased 51% from 3.3 +/- 0.2 to 5.0 +/- 0.2 microM (P less than 0.01). Identical reperfusion with peroxide-inactivated r-h-SOD did not alter the concentrations of free radicals indicating that the specific enzymatic activity of r-h-SOD is required to decrease the concentrations of reactive oxygen free radicals. Additional measurements performed varying the duration of reflow demonstrate a burst of oxygen free radical generation peaking at 10 s of reperfusion. r-h-SOD entirely abolished this burst. These studies demonstrate that superoxide-derived free radicals are generated during postischemic reperfusion and suggest that the beneficial effect of r-h-SOD is due to its specific enzymatic scavenging of superoxide free radicals. PMID- 3680528 TI - Structural relationship of human apolipoprotein B48 to apolipoprotein B100. AB - Although the complete amino acid sequence of human apolipoprotein (apo) B100 is known (4536 amino acids), the structure of apo B48 has not been defined. The objective of our study was to define the structure of apo B48 and its relationship to apo B100. Antibodies were produced against 22 synthetic peptides corresponding to sequences in human apo B100. The levels of immunoreactivity of the antipeptides to apo B100 and apo B48 were used to define the structural relationship between these two species of apo B. Six antibodies from sequences in the amino-terminal half of apo B100, including antipeptide 2110-2129, bound to both apo B100 and apo B48. 15 other apo B-specific antipeptides from sequences carboxyl-terminal to residue 2152 bound to apo B100, but not to apo B48. Immunoblots of cyanogen bromide digests of apo B100 and apo B48 with antipeptides 2068-2091 and 2110-2129 detected a 16-KD fragment (residues 2016-2151) in the apo B100 digest and a fragment of identical size in the apo B48 digest. Because apo B48 appears to contain the apo B100 cyanogen bromide fragment 2016-2151 and because an antiserum specific for the peptide 2152-2168 does not bind to apo B48, we conclude that apo B48 represents the amino-terminal 47% of apo B100 and that the carboxyl terminus of apo B48 is in the vicinity of residue 2151 of apo B100. PMID- 3680527 TI - Peroxisomal fatty acid beta-oxidation in relation to the accumulation of very long chain fatty acids in cultured skin fibroblasts from patients with Zellweger syndrome and other peroxisomal disorders. AB - The peroxisomal oxidation of the long chain fatty acid palmitate (C16:0) and the very long chain fatty acids lignocerate (C24:0) and cerotate (C26:0) was studied in freshly prepared homogenates of cultured skin fibroblasts from control individuals and patients with peroxisomal disorders. The peroxisomal oxidation of the fatty acids is almost completely dependent on the addition of ATP, coenzyme A (CoA), Mg2+ and NAD+. However, the dependency of the oxidation of palmitate on the concentration of the cofactors differs markedly from that of the oxidation of lignocerate and cerotate. The peroxisomal oxidation of all three fatty acid substrates is markedly deficient in fibroblasts from patients with the Zellweger syndrome, the neonatal form of adrenoleukodystrophy and the infantile form of Refsum disease, in accordance with the deficiency of peroxisomes in these patients. In fibroblasts from patients with X-linked adrenoleukodystrophy the peroxisomal oxidation of lignocerate and cerotate is impaired, but not that of palmitate. Competition experiments indicate that in fibroblasts, as in rat liver, distinct enzyme systems are responsible for the oxidation of palmitate on the one hand and lignocerate and cerotate on the other hand. Fractionation studies indicate that in rat liver activation of cerotate and lignocerate to cerotoyl-CoA and lignoceroyl-CoA, respectively, occurs in two subcellular fractions, the endoplasmic reticulum and the peroxisomes but not in the mitochondria. In homogenates of fibroblasts from patients lacking peroxisomes there is a small (25%) but significant deficiency of the ability to activate very long chain fatty acids. This deficient activity of very long chain fatty acyl-CoA synthetase is also observed in fibroblast homogenates from patients with X-linked adrenoleukodystrophy. We conclude that X-linked adrenoleukodystrophy is caused by a deficiency of peroxisomal very long chain fatty acyl-CoA synthetase. PMID- 3680529 TI - Cyclic adenosine monophosphate-dependent kinase in cystic fibrosis tracheal epithelium. AB - Cl-impermeability in cystic fibrosis (CF) tracheal epithelium derives from a deficiency in the beta-adrenergic regulation of apical membrane Cl- channels. To test the possibility that cAMP-dependent kinase is the cause of this deficiency, we assayed this kinase in soluble fractions from cultured airway epithelial cells, including CF human tracheal epithelial cells. Varying levels of cAMP were used in these assays to derive both a Vmax and apparent dissociation constant (Kd) for the enzymes in soluble extracts. The cAMP-dependent protein kinase from CF human tracheal epithelial cells has essentially the same Vmax and apparent Kd as non-CF human, bovine, and dog tracheal epithelial cells. Thus, the total activity of the cAMP-dependent kinases and their overall responsiveness to cAMP are unchanged in CF. PMID- 3680530 TI - Parathyroid hormonelike protein from human renal carcinoma cells. Structural and functional homology with parathyroid hormone. AB - A variety of solid tumors secrete proteins that are immunochemically distinct from parathyroid hormone (PTH) but activate PTH-responsive adenylate cyclase. Such PTH-like proteins have been proposed as mediators of the hypercalcemia and hypophosphatemia frequently associated with malignancies. We purified to apparent homogeneity a PTH-like protein with a molecular weight of 6,000, that is produced by human renal carcinoma cells. The amino-terminal sequence of the PTH-like protein and that of human PTH were found to display at least five identities in the first 13 positions. The purified protein bound to PTH receptors, activated adenylate cyclase in renal plasma membranes, and stimulated cAMP formation in rat osteosarcoma cells. The PTH-like protein reproduced two additional effects of PTH, stimulation of bone resorption in fetal rat limb bone cultures and inhibition of phosphate uptake in cultured opossum kidney cells. These properties are consistent with a role for PTH-like proteins as mediators of the syndrome of malignancy-associated hypercalcemia. PMID- 3680532 TI - Evaluation of repeated immunoassays (mouse intracerebral potency tests) of the second International Standard of Pertussis Vaccine. AB - During one year 27 potency assays of second International Standard of Pertussis Vaccine were performed, when the Indian Standard of pertussis vaccine was being standardized. In all the 27 assays, the 50% immunizing dose (ImD50) was calculated both by Wilson-Worcester method and by probit analysis. The ImD50 of the International Standard varied from 0.022 I.U. to 0.076 I.U. (Mean 0.041 I.U.) when it was calculated by Wilson-Worcester method and from 0.0226 I.U. to 0.0704 I.U. (Mean 0.0402 I.U.) when it was calculated by probit analysis. There were no statistically significant differences between ImD50 values calculated by Wilson Worcester method and by probit analysis. The challenge dose of Bordetella pertussis in terms of LD50 units had no effect on the ImD50 values. The average slope (b) of the assays was 1.92 when calculated by probit analysis and the average homogeneity factor (alpha) in these assays calculated by Wilson-Worcester method was 1.73. PMID- 3680533 TI - Collection and analysis of complex ELISA data using a microcomputer. AB - A system for automatic Enzyme-Linked Immunosorbent Assay (ELISA) data collection and processing is described. Hardware for the system consists of a Dynatech microplate reader and Apple II series microcomputer. Software developed by the authors allows automatic configuration of the reader and direct data input from the microplate reader to the microcomputer. After optical density data is input through the interface, it can be printed out as either optical density values, or as scaled values (from 0 to 9) in a color-coded matrix. Data can be stored and later recalled in either format, allowing several sets of data to be merged into one large, color-coded chart. Results from several different microplates can be combined and sorted in a single printout to expedite interpretation of data. PMID- 3680531 TI - Restoration of endothelium-dependent relaxation by dietary treatment of atherosclerosis. AB - Atherosclerosis results in impaired relaxation to acetylcholine, thrombin, and the calcium ionophore A23187, all agents that require the presence of endothelium. We now report that dietary treatment of atherosclerosis in monkeys not only produces morphological improvement of the atherosclerotic lesion but restores endothelium-dependent vascular relaxation to normal. Because the intima remains thickened after regression of atherosclerosis, these studies suggest that intimal thickening which is present in both atherosclerotic vessels and after regression of atherosclerosis does not prevent the endothelium-derived relaxing factor from reaching the underlying vascular smooth muscle. PMID- 3680534 TI - ELISA for human IgG and IgM anti-lipopolysaccharide antibodies with indirect standardization. AB - A new attempt to standardize ELISAs for the quantitation of human IgM and IgG anti-lipopolysaccharide antibodies (anti-LPS), without the use of a specific standard material, is described. Sandwich ELISAs for total IgG and IgM were combined with indirect ELISAs for anti-LPS IgG and IgM antibodies on a 96-well microtest plate using identical assay conditions. The concentration of specific IgG or IgM anti-LPS was read on the respective standard curve for total IgG or IgM. The results were corrected for residual immunoreactivity remaining unbound in the wells after one sample incubation in the combined assays. The quantitative results of IgG anti-LPS correlated well with results obtained using an ELISA with direct standardization (r = 0.969). 28 mg/l of IgM anti-LPS was found as median value among 121 blood donors using the described ELISA principle. Binding studies demonstrated a lower apparent affinity of donor anti-LPS IgM than anti-IgG. PMID- 3680535 TI - Analysis of paired serum, urine and filter paper blood specimens for presence of filarial antigen by immunoradiometric assay. AB - Paired serum, urine, and finger-prick whole blood dried on filter paper were analyzed by immunoradiometric assay (IRMA) for filarial antigen using Brugia malayi-specific rabbit antibody. Nine sera and 6 urines from the 10 paired serum urine samples obtained from individuals with microfilaremia contained IRMA detectable filarial antigen. In contrast, all serum and urine specimens from patients with chronic infections, endemic and non-endemic controls were negative. Whole blood eluted from filter paper spots contained IRMA detectable material; their degree of positivity agreed well with IRMA binding levels obtained with paired urines. Reduced recovery of antigen dried on filter paper was observed at antigen levels less than 10 ng/ml equivalents, presumably due to irreversible absorption onto the filter paper. Urine and finger-prick filter paper blood specimens can be used in the diagnosis of microfilaremic infections that have been associated with circulating antigen in the blood. PMID- 3680536 TI - Do mothers overestimate the seriousness of their infants' acute illnesses? AB - The purpose of this study was to determine if mothers generally perceive their infants as more ill than do pediatricians, and if the presence of fever has an impact on the perceptions of either the mother or pediatrician. One hundred eighty-seven mothers and their infants, from a primary care clinic (n = 109) and private practice (n = 78), were enrolled at the 2-week well-child visit and were asked to contact a physician participating in the study whenever their infants became acutely ill. The mothers were asked to rate the severity of their infants' illness according to a 3-point scale, first at home and then simultaneously, but independently, with a physician in the office. In general, mothers rated their infants equally as ill at home as in the office (kappa = 0.59). However, both their home ratings (kappa = 0.15) and office ratings (kappa = 0.29) were in poor agreement with the ratings of the physicians. The mothers consistently rated their infants as more ill than did the pediatricians (p less than 0.0001). Both the mothers and physicians perceived infants with higher temperatures (greater than or equal to 38.9 degrees C) as significantly (p = 0.0004) more ill than infants with lower temperatures (less than 38.9 degrees C). We conclude that mothers generally perceive their infants as more ill than do pediatricians, and that it is important for pediatricians to address the perceptions of mothers in order to establish effective communication with them. PMID- 3680537 TI - Reasoning about illness in ill and healthy children and adolescents: cognitive and emotional developmental aspects. AB - Anxiety level, perception of control over illness, stage of cognitive development, and stage of reasoning about illness were examined in pediatric oncology, obese, and healthy children and adolescents. Among the groups, there were no mean differences with regard to any of these measures. Older participants in the higher stages of cognitive development were higher on stage of reasoning about illness in general and their own illness than were younger and less cognitively mature participants. In the pediatric oncology and obese groups, participants higher on perception of control over illness were higher on stage of reasoning about illness in general and their own illness, in particular, than those lower on perception of control. Anxiety level was not related to stage of reasoning about illness, but participants higher on anxiety were lower on perception of control over illness. Clinical implications of the findings are discussed. PMID- 3680538 TI - Physical and psychological effects of aerobic exercise in boys with learning disabilities. AB - Aerobic exercise has been associated with improvements in psychological status and physical fitness in adults, but its effects on children are less clear. The purpose of this study was to evaluate the effects of an aerobic exercise program on the self-concept, academic achievement, motor proficiency, and cardiovascular fitness of boys with learning disabilities. Fifty-four boys were randomly assigned to one of two exercise programs lasting 20 weeks. One program emphasized aerobic exercise and the other consisted of similar but less vigorous activities. The self-concept, academic achievement, motor proficiency, and physical fitness of each subject was assessed before and after the exercise programs. The results from group comparisons demonstrated an association between the aerobic exercise program and improvement of self-concept and physical fitness. No effect on academic achievement or motor proficiency could be attributed to the aerobic exercise program. PMID- 3680539 TI - Infant follow-up programs: their impact on infants and families. PMID- 3680540 TI - Diagnosis of invasive candidiasis in patients with and without signs of immune deficiency: a comparison of six detection methods in human serum. AB - Visceral candidiasis in 56 patients, 39 of whom were thought to be immune deficient, was investigated using three serological detection methods--whole cell agglutination, haemagglutination, and counterimmunoelectrophoresis for antibodies; two determinations of circulating antigens--haemagglutination inhibition and latex agglutination; and determination of the arabinitol:creatinine ratio. Of the 39 patients with suspected immune deficiency, 13 had confirmed invasive candidiasis and 26 were colonised; of those without signs of immune deficiency, 10 patients also had invasive candidiasis and seven were colonised. Twenty three patients with invasive candidiasis were analysed in total. For suspected immune deficient patients the best discrimination between visceral candidiasis and colonisation was obtained by combining the results of haemagglutination inhibition and arabinitol:creatinine ratio. For patients without signs of immune deficiency the best discrimination between invasive candidiasis and colonisation was achieved with counterimmunoelectrophoresis. The results of the serological tests confirmed the classification on clinical grounds of those with and without immune deficiency. PMID- 3680541 TI - Comparison of culture media for detecting methicillin resistance in Staphylococcus aureus and coagulase negative staphylococci. AB - The detection of methicillin resistance was examined in 51 strains of Staphylococcus aureus and 135 strains of coagulase negative staphylococci using Isosensitest, Diagnostic Sensitivity Test (DST), Mueller-Hinton (MH), Columbia, and Sensitest agars. MH agar with 5% added sodium chloride incubated at 35 degrees C was the most effective in detecting resistance in S aureus, and Columbia agar with 5% added sodium chloride incubated at 35 degrees C was most effective for coagulase negative staphylococci. For clinical purposes, a provisional report of sensitivity for S aureus could be issued after 18 hours; with coagulase negative staphylococci, only resistant strains could be reported at this time. For definitive results cultures must be examined after 40 hours of incubation. PMID- 3680542 TI - Rheological effects of bed rest in sickle cell disease. AB - A serial rheological study in two patients with homozygous sickle cell disease whose leg ulcers healed as a consequence of bed rest showed an improvement in erythrocyte deformability (filterability) associated with evidence of decreased haemolysis and a fall in the number of irreversibly sickled cells. This rheological improvement may aid the healing of leg ulcers by increasing blood flow in the ulcer base. The effects of bed rest on the rheology of sickle cell disease should be taken into account in future studies of vaso-occlusive crisis. PMID- 3680543 TI - Production of reactive oxygen metabolites induced by asbestos fibres in human polymorphonuclear leucocytes. AB - The ability of quartz and various asbestos fibres to induce the production of reactive oxygen metabolites in human polymorphonuclear leucocytes was assessed. A chemiluminescence assay showed that the activation of polymorphonuclear leucocytes was induced in the following order of effect: quartz; chrysotile A; crocidolite; chrysotile B; amosite; and anthophyllite. Only slight chemiluminescence was produced by cells exposed to wollastonites and titanium dioxide. A positive correlation was seen between production of chemiluminescence and red cell haemolysis. Our results suggest that the potential of various environmental particles and mineral fibres to induce inflammation, fibrosis, and cancer of the lung could be related to their ability to induce inflammatory cells to produce reactive oxygen metabolites. PMID- 3680544 TI - Nuclear DNA content of non-endemic Burkitt's lymphoma. AB - The nuclear DNA content of 26 non-endemic Burkitt's lymphomas was studied by flow cytometry. Eighteen of the tumours showed a pattern characteristic for diploid chromosome distribution, while eight of the tumours were aneuploid. Six of the aneuploid tumours showed an almost diploid, aneuploid DNA index, while two were tetraploid tumours. Patients with aneuploid tumours had a significantly worse prognosis (p less than 0.005) than those with diploid tumours. One of the aneuploid tumours was positive for Epstein-Barr virus DNA. PMID- 3680545 TI - Cells containing IgA subclasses in bronchi of subjects with and without chronic obstructive lung disease. AB - Necropsy specimens were obtained from the lungs of 10 subjects who had no history of lung disease, 10 who had died with chronic bronchitis, and 10 with bronchiectasis. Tissue sections were stained for IgA1 or IgA2 using the immunoperoxidase technique, and the number of cells in the bronchi stained for these proteins was counted. The total number of IgA positive cells was increased in bronchitic and bronchiectatic lungs compared with those from control subjects. The number of IgA2 positive cells was similar in those with bronchitis and bronchiectasis and significantly higher than in controls. Similarly, cells containing IgA1 were increased in the lungs of subjects with chest disease but were higher in those with bronchitis than in those with bronchiectasis. The proportion of IgA2:total IgA containing cells was similar in sections from controls (mean (SD) 25 (5.0)%) and those with bronchiectasis (mean (SD) 24 (4)%), but lower in those with bronchitis (mean (SD) 19 (5.0)%). The results show that cells containing IgA1 predominate in the major bronchi but that the proportion of cells containing IgA2 is higher than in non-mucosal lymphoid tissues. Bronchitis and bronchiectasis are associated with greater numbers of cells producing IgA in the bronchi, and this is consistent with increased local production of IgA in the lung secretions of bronchitic subjects. PMID- 3680546 TI - Mefenamic acid enteropathy. AB - The clinical, radiological, and histological features of two patients with severe intestinal damage induced by mefenamic acid and mimicking coeliac disease are described. Symptoms rapidly reverted on withdrawal of the drug, and in one case, did not relapse during treatment with other non-steroidal anti-inflammatory drugs. PMID- 3680547 TI - Histological changes associated with wheat protein antibodies in the absence of villous atrophy. AB - A retrospective study was conducted to assess the association of alpha-gliadin antibodies with intraepithelial lymphocyte counts. Twelve subjects with apparently normal small intestinal histology and raised alpha-gliadin antibody titres had significantly increased intraepithelial lymphocyte counts (42 (SEM) 5.9) when compared with 16 subjects with normal alpha-gliadin antibody titres (17 (3.2); p less than 0.001). These findings show that in the absence of gross pathology raised alpha-gliadin antibody titres are associated with increased numbers of intraepithelial lymphocytes and may reflect continuous immunological processes in the small intestine. PMID- 3680548 TI - Light and electron microscopic features of tropical ulcer. AB - The histopathological features of 20 tropical ulcers with the electron microscopic findings on seven biopsy specimens are reported. The main findings were loss of epidermis associated with extensive dermal oedema, infiltration by polymorphonuclear leucocytes, and disruption of collagen bundles. The presence of micro-organisms at the site of tissue damage was shown and compared with the morphology of the organisms grown in culture. The most commonly identified bacteria were pleomorphic rods whose electron microscopic appearances accorded most closely with Fusobacteria grown in vitro. Spirochaetes, identified ultrastructurally as Treponema sp, were also present. There was no evidence of vasculitis to explain the rapid onset of ulceration, but necrotic changes seen in the dermis and the inflammatory cell infiltrate suggest that, associated with cell necrosis, bacteria previously shown in vitro have an important role in the pathogenesis of tropical ulcers. PMID- 3680549 TI - Activation of the alternative complement pathway: clinical application of a new technique to measure fragment Ba. AB - A new laser nephelometric technique for the measurement of the alternative complement pathway fragment Ba has been developed. Activation of the alternative complement pathway was assessed in 16 patients with Gram negative bacteraemia, six with Gram positive bacteraemia, 20 with rheumatoid arthritis, and 18 healthy subjects. Patients with Gram negative bacteraemia had significantly higher values of Ba (median 14.8%) than controls (9.3%) (p less than 0.01), while patients with Gram positive bacteraemia and rheumatoid arthritis had values similar to those of controls (10.1% and 9.5%). The technique proved sensitive and precise, and is suitable for the routine laboratory evaluation of complement activation through the alternative pathway. PMID- 3680550 TI - Detection of asbestos fibres by dark ground microscopy. PMID- 3680551 TI - Use of mefenamic acid. PMID- 3680552 TI - Transport media for fine needle aspiration cytology. PMID- 3680553 TI - Long term freeze storage of Campylobacter pyloridis. PMID- 3680554 TI - Comparative sensitivities to antimicrobial agents of Campylobacter pylori and the gastric campylobacter like organism from the ferret. PMID- 3680555 TI - Hemodynamic and electrophysiologic effects of combined infusion of lidocaine and propafenone in humans. AB - The hemodynamic and electrophysiologic effect of a combined intravenous infusion of lidocaine (100 mg bolus followed by 2 mg/min infusion) and propafenone (1 or 2 mg/kg) in patients with a history of ventricular arrhythmia was studied. Lidocaine infusion alone significantly increased the mean pulmonary artery (+28%) and pulmonary capillary wedge (+17%) pressure, with no effect on cardiac index. Lidocaine alone produced no consistent change in any measured electrophysiologic parameter, except slight QTc shortening (-2%, P less than .05). Propafenone alone, particularly at the higher dose (2 mg/kg), produced significant increases in mean blood pressure (+14%), right atrial pressure (+78%), pulmonary artery pressure (+50%), pulmonary capillary wedge pressure (+65%), systemic vascular resistance (+29%), and pulmonary vascular resistance (+61%) and a decrease in cardiac index (-12%). Significant prolongation of PR (+9%), AH (+29%), and HV (+23%) intervals, atrial functional refractory period (+12%), ventricular effective (+7%) and functional (+6%) refractory period, and Wenckebach cycle length (+13%) also occurred after the administration of propafenone alone. Only the effects on atrioventricular (AV) node were observed at the lower dose of propafenone (1 mg/kg). Combined infusion of lidocaine with propafenone produced a mild, statistically insignificant additional negative inotropic effect but reversed the prolongation in atrial and ventricular refractoriness produced by propafenone alone. Thus, the data show that lidocaine attenuates certain electrophysiologic effects of propafenone, which might alter its antiarrhythmic efficacy, while producing mild additive negative inotropic effects that may be of hemodynamic significance. PMID- 3680556 TI - Alterations in intrauterine pressure, menstrual fluid prostaglandin F levels, and pain in dysmenorrheic women treated with nimesulide. AB - A double-blind crossover study was carried out to evaluate the therapeutic efficacy of nimesulide and its effects on uterine activity, menstrual fluid prostaglandin F, and pain in women suffering from primary dysmenorrhea. Twenty three women entered the clinical pharmacologic study. Intrauterine pressure was monitored with a microballoon-tipped catheter on the first day of menstruation. During the maximal pain period (based on monitoring in six patients), nimesulide significantly decreased intrauterine pressure; the measure of pain relief was consistent with decrease of uterine activity. In another six patients, the registration of intrauterine pressure during the submaximal pain period demonstrated that both in the nimesulide- and placebo-treated cycles, the uterine activity was at a lower mean level than that registered during maximal pain. Furthermore, when two 100-mg oral doses of nimesulide were administered to 11 dysmenorrheic women, in double-blind, crossover conditions with placebo as a blank reference, it brought about a reduction of menstrual fluid prostaglandin F2 levels from 382 to 94 ng/mL, (P less than .001). Fourteen women entered a four cycle, double-blind, crossover therapeutic trial. Each patient was randomly assigned to one of two treatment sequences with nimesulide 200 mg/d PO or placebo. The therapy was judged very effective or good in 22 of 28 cycles treated with nimesulide compared with nine of 27 cycles treated with placebo (P less than .01). The amount of bleeding during the treated cycles did not change, and there were no complaints of untoward signs or symptoms related to the therapies. PMID- 3680557 TI - Unusual absorption profile of phenytoin in a massive overdose case. AB - The pharmacokinetics of phenytoin was evaluated in a nonepileptic adult man after the ingestion of an undetermined amount of the drug following an apparent suicide attempt. A serum phenytoin concentration of 45 micrograms/mL was observed on admission 12 hours after ingestion. Phenytoin concentrations steadily increased, reached a maximum of 114 micrograms/mL four days later, then fluctuated at about 100 micrograms/mL for a week, and slowly declined to undetectable levels within the following week. At 96.5 micrograms/mL, the unbound serum concentration was 2.5 times that observed in therapeutic drug concentrations. Computer fitting of the data indicated that the Michaelis-Menten constants, apparent volume of distribution, and renal clearance of phenytoin were consistent with those parameters reported after therapeutic doses. However, phenytoin absorption was best described by parallel first- and zero-order rate processes, with the latter proceeding for as long as two weeks following drug ingestion. This protracted absorption appears to be a result of the presence of a large concretion of phenytoin in the gastrointestinal tract, having a slow disintegration and dissolution attributable to the limited solubility of the drug in the gastrointestinal tract and to the patient's diminished intestinal motility. PMID- 3680558 TI - Metabolism of desciclovir, a prodrug of acyclovir, in humans after multiple oral dosing. AB - Desciclovir (DCV), a prodrug of the antiherpetic agent acyclovir (ACV), is converted in humans to ACV, presumably by xanthine oxidase. Further metabolism of these two compounds was investigated in six human volunteers given 250 mg DCV orally every eight hours for ten days plus one dose on day 11. The mean percent dose recovered in urine (24 hr) on days 2, 5, and 10 as carboxy-DCV (2%) and as carboxy-ACV (14%) along with recoveries of DCV (6%) and ACV (62%) gave a mean total of 84% cleared over a 24-hour period at steady state. Carboxyl metabolites were not found in the plasma of these same subjects at peak DCV concentration on dose day 11. The ratios of DCV and ACV to their corresponding carboxyl metabolites in urine were 4:1 and 3:1, respectively, suggesting that there is little or no difference in the efficiency of these two substrates for oxidation to their carboxylic acid metabolites. PMID- 3680559 TI - Pharmacokinetics of antituberculosis drugs in patients. AB - The pharmacokinetics of rifampin, isoniazid, and ethambutol were determined in 26 ambulatory male patients (aged 49.5 +/- 9.9 yr) with tuberculosis. Rifampin and isoniazid were given individually or together, with or without ethambutol; studies were done after a single dose and after chronic administration. Under the study conditions, with large variability in the extent of disease and physical status and history of alcohol and tobacco abuse and narrow age range, the pharmacokinetics of these three antituberculosis drugs were not modified significantly by patient age. Furthermore, appreciable drug-drug interactions did not occur when the three drugs were administered concurrently. Self-induction of rifampin clearance by chronic dosing with the drug may lead to subtherapeutic levels of rifampin. Administration of isoniazid and ethambutol in two divided doses resulted in peak plasma concentrations below the accepted therapeutic levels of the two drugs. Our findings indicate that at least in the middle-aged patients with tuberculosis, the current single daily dose, multiple-drug regimen is therapeutically sound pharmacokinetically, and clinicians do not have to make adjustments in dosages of these drugs for age and the extent of disease. PMID- 3680560 TI - Effect of a sustained-release formulation of trimazosin in mild to moderate hypertension. AB - A single-blind study was conducted to evaluate the blood pressure (BP) reduction and side effects of a sustained-release (SR) formulation of trimazosin in patients with mild to moderate hypertension. Eighteen individuals (age, 21-65 yr; mean diastolic BP, greater than 95 mm Hg) with essential hypertension were enrolled into the study. Each patient's dose was titrated to a range of 150-900 mg/d, with polythiazide added as necessary to achieve BP control. Four hours following the maximum titrated dose of trimazosin, mean standing and supine diastolic BPs were significantly lower than baseline readings. Supine systolic BP and supine and standing heart rate were not significantly lower than baseline. At 24 hours after administration of the maximum dose, there were no significant differences in heart rate of BP compared with baseline readings. Five of 16 patients responded to trimazosin therapy alone. Of the 11 treatment failures with trimazosin alone, five were therapeutic failures and six discontinued because of side effects. Only two of these 11 patients achieved satisfactory results with the combination therapy. Trimazosin SR acutely lowers BP three to six hours after administration. It appears to have a duration of action longer than six hours, but it is not sustained for 24 hours. The proportion of patients failing to respond in this sample was very high and suggests that for similar patients, the drug does not appear to be a very useful antihypertensive agent. PMID- 3680561 TI - Pharmacokinetics and pharmacodynamic effects of aqueous diltiazem in healthy humans. AB - Aqueous diltiazem was given to ten healthy male volunteers in a single oral dose of 2.5 mg/kg body weight. Serum diltiazem levels were measured at various intervals up to 24 hours after administration of the drug as were blood pressure, heart rate, and PR interval. The pharmacokinetics followed a one-compartment model in six and two-compartment model in four subjects. The mean distribution half-life in the latter four subjects was 15.8 +/- 3.7 minutes (range, 10.4-18.8 min). In the ten subjects, the peak serum diltiazem level was attained in 20 to 45 minutes (mean, 32.5 +/- 9.5 min) and ranged from 136 to 701 ng/mL (mean, 332 +/- 180 ng/mL). The elimination half-life ranged from 2.8 to 4.8 hours (mean, 3.8 +/- 0.6 hr). The area under the concentration-time curve varied from 508 to 2,245 ng-hr/mL, indicating differing bioavailability. Slight but significant blood pressure reduction was seen only at one to three hours. Changes in heart rate were not significant at any measurement. Transient facial flushing, beginning at ten to 20 minutes after administration, was noted in nine subjects, reflecting the vasodilatory effect of the drug. Significant prolongation (greater than 10%) of PR intervals began at ten minutes in three, at 20 minutes in six, and at 30 minutes in one participant, and progressed to second-degree Wenckebach atrioventricular (AV) block in six subjects 20 to 60 minutes after administration and third-degree AV block in one person 45 minutes after dosing. These AV blocks resolved by the third hour without treatment, and PR prolongation resolved by the fifth to seventh hours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680562 TI - Pharmacokinetics of nilvadipine in healthy volunteers. AB - The pharmacokinetics of nilvadipine, a new antihypertensive and antianginal drug, were examined in healthy male volunteers. In a Latin square, three-way crossover design with a one-day run-in period, six subjects in three groups of two each were given single 2-, 4-, or 6-mg oral doses of nilvadipine after overnight fasting. Nilvadipine plasma concentrations up to 32 hours after drug treatment were determined by capillary column gas chromatography-negative-ion chemical ionization mass spectrometry (detection limit, 0.01 ng/mL). Nilvadipine urinary concentrations were determined by capillary column gas chromatography with electron capture detector (detection limit, 0.5 ng/mL). Nilvadipine plasma concentrations declined in a bi- or triexponential pattern after reaching the maximum plasma concentrations. The mean +/- standard deviation maximum plasma concentrations of 1.48 +/- 0.47, 3.48 +/- 0.53, and 6.69 +/- 1.54 ng/mL were attained from 1.08 to 1.50 hours after doses of 2, 4, and 6 mg, respectively. The elimination half-life was dose-independent and averaged 11.0 +/- 2.3 hours. The area under the plasma concentration-time curve increased in proportion to the dose. Nilvadipine was not detected in the urine. The pharmacokinetics of nilvadipine were generally linear over the dosage range studied. Besides the above model-independent pharmacokinetic parameters, model-dependent parameters were also obtained by curve-fitting the plasma data to a bi- or triexponential equation with zero-order absorption. Nilvadipine decreased blood pressure slightly and in a dose-dependent fashion. PMID- 3680563 TI - Pharmacokinetic implications of lorcainide therapy in patients with normal and depressed cardiac function. AB - The influence of cardiac function as measured by the left ventricular ejection fraction on the pharmacokinetic variables of a new antiarrhythmic drug, lorcainide, was investigated in 20 cardiac patients. Patients were divided into two groups: those with normal (ejection fraction greater than .40) or depressed (ejection fraction less than .40) left ventricular function. The elimination half life, plasma clearance rates, or volume of distribution of lorcainide were not significantly different in patients with either normal or depressed cardiac function. A decrease in arrhythmia frequency could be correlated to plasma lorcainide concentration in the majority of patients, and it was noted that at least 0.1 mg/L of lorcainide was required for the presence of an antiarrhythmic effect. Three unusual cases are presented to illustrate the importance of measuring plasma drug concentrations and calculating the drug pharmacokinetics and to correlate these to the antiarrhythmic response in order to minimize the risk of plasma drug accumulation and side effects. A review of published data shows a three- to sixfold interpatient variation in the elimination half-life of lorcainide with practical implications in its use as an antiarrhythmic drug. PMID- 3680564 TI - Bioavailability evaluation of a controlled-release dextromethorphan liquid. AB - A randomized, two-way, steady-state crossover study was performed in 24 healthy male volunteers to evaluate the bioavailability of a controlled-release (CR) dextromethorphan (DM) suspension. Only slow and intermediate DM metabolizers were allowed to participate in the study; determination of metabolizer status was performed before study enrollment. Each volunteer was administered 30 mg of an immediate-release (IR) DM solution qid or 60 mg DM as a CR suspension bid for two weeks, for a total daily dose of 120 mg. After a two-week washout period, the subjects were administered the alternate treatment. Blood samples were collected over a 12-hour dosing period on the last day of each treatment and analyzed for DM and its active metabolite, dextrorphan (DP). In addition, urine was collected over the 12-hour steady-state dosing interval and measured for DM and two metabolites. Pharmacokinetic determinations were made from plasma DM and DP data, and total urinary excretion was determined. All comparisons made between the two formulations indicated that the CR DM suspension was bioequivalent to the IR DM solution at steady state, while producing a prolonged release of the drug over time. PMID- 3680565 TI - The polymorphic metabolism of dextromethorphan. AB - The ability of healthy male volunteers to metabolize a 30-mg oral dose of dextromethorphan (DM) was studied in 252 Americans. Two blood samples were collected at four and 24 hours after administration of the dose. The resulting plasma was analyzed for unchanged DM. The volunteers were classified as slow, intermediate, or fast metabolizers on the basis of plasma concentrations of DM. Further differentiation of slow and intermediate metabolizers was achieved by comparing the two-point estimates of elimination-rate constants. In the population studied, 84.3% were fast DM metabolizers, 6.8% were intermediate metabolizers, and 8.8% were slow metabolizers. Previous reports have related the slow DM metabolizers to slow debrisoquin metabolizers, but no such correlations have been achieved with intermediate DM metabolizers. These intermediate DM metabolizers may suggest a new polymorphism not related to debrisoquin or may suggest that "debrisoquin gene" regulation is more complex than originally suggested. PMID- 3680566 TI - The bioavailability and pharmacokinetics of oral and depot intramuscular haloperidol in schizophrenic patients. AB - In a four-segment long-term (greater than or equal to 6 mo) study, patients with schizophrenia received oral haloperidol in single daily doses and subsequently depot intramuscular (IM) haloperidol decanoate q28d. For each route of administration, a period of stabilization was followed by a maintenance period. Dosages for both oral haloperidol and IM haloperidol decanoate were determined on the basis of the patient's past psychiatric history and clinical response during the stabilization period. To characterize the concentration-time profile of the two routes of administration, blood samples were obtained on two separate occasions at steady state during maintenance dosing for each route of administration. Examination of values for cumulative area under the plasma concentration-time curves (AUC) to each sampling time indicated a sustained release of haloperidol from the intramuscularly administered haloperidol decanoate. Dose ranges during maintenance periods were 5-35 mg/d for oral haloperidol (mean, 17 mg/d), and 75-500 mg/28 d for IM haloperidol decanoate (mean, haloperidol decanoate was 243 mg equivalents of haloperidol/28 d). The ratio of long-acting to daily oral doses during maintenance therapy ranged from 9.4:1.0 to 15.0:1.0 (mean, 14.1:1.0). At these ratios, plasma concentration data showed that haloperidol decanoate gave lower values than did oral haloperidol for peak plasma, minimum plasma, and mean steady-state plasma concentrations. The absolute concentration swing was significantly less for decanoate than for the oral drug. Dose-normalized AUC values were compared determine the IM dose of haloperidol decanoate that would have yielded haloperidol plasma concentrations equivalent to those resulting from daily oral administration of haloperidol for 28 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680567 TI - Management of cancer pain with oral controlled-release morphine sulfate. AB - Morphine sulfate Contin (MSC) is an investigational matrix delivery system for oral morphine sulfate that allows for prolonged blood levels of morphine. Twenty six patients with inadequately controlled cancer-related pain were examined in an open but controlled study using MSC. Initially, all patients were converted from the prestudy analgesic regimen to an equianalgesic amount of immediate-release morphine sulfate (IRMS) on a q4h dose schedule that was in turn titrated to the level of adequate pain relief. Patients then were switched to MSC q8h and eventually to q12h, starting at doses representing the same total daily amount of morphine that was in the final IRMS dose. Of the 18 patients who completed the study, all achieved satisfactory levels of analgesia on MSC, seven at q8h and 11 at q12h dosing intervals. All patients reported better analgesia while taking MSC compared with their previous regimen. Side effects associated with MSC included sedation and constipation but not nausea or respiratory difficulty. Significant drug tolerance did not develop during a mean follow-up period of four weeks (range, 1-18 weeks). MSC is an effective oral opioid analgesic that allows an increased dose interval without increased side effects or decreased potency. It can improve the quality of life of cancer patients by allowing them to be maintained without frequent dosing or parenteral medication. PMID- 3680569 TI - Drug absorption rate: a critical component of bioequivalence assessment in psychopharmacology. PMID- 3680568 TI - Comparison of the analgesic efficacy and safety oral ciramadol, codeine, and placebo in patients with chronic cancer pain. AB - Ciramadol is a new opioid agonist-antagonist analgesic with low potential for dependency. Forty-three patients with moderate to severe chronic pain from primary or metastatic malignancy of the bone or major organs were enrolled in a randomized double-blind study that compared orally administered ciramadol (30 mg or 90 mg) to codeine (60 mg) and placebo. A single-dose, four-way crossover design, with a randomized Latin-square treatment sequence, was used. Data for 40 patients who received the above four study medications were included in the final statistical analysis of efficacy. Analgesic efficacy was measured at 0, 0.5, 1.0, 2.0, 3.0, 4.0, 5.0, and 6.0 hours, using standard visual and verbal pain relief and pain intensity scales. All active therapies provided greater pain relief than placebo (P less than .05). Ciramadol 30 mg and codeine 60 mg demonstrated equal analgesic activity, whereas ciramadol 90 mg was superior to both therapies. The predominant adverse experiences associated with ciramadol were nausea and drowsiness, which were apparently not dose related. Ciramadol appears to be an effective analgesic at the doses tested, with tolerable gastrointestinal central nervous system side effects at both the 30-and 90-mg dose levels. PMID- 3680570 TI - In consideration of active metabolites. PMID- 3680571 TI - Digoxin levels in prehospital sudden-death syndrome. AB - Digitalis toxicity is common and has been associated with ventricular dysrhythmias. Digoxin levels in patients who suffer prehospital sudden death have never been studied. This study measured digoxin levels in a population of sudden death patients. During the 15-week study period, 252 patients in cardiac arrest were seen by an urban paramedic system. During daytime hours, paramedics were requested to obtain a blood sample from sudden-death patients; the samples were subsequently analyzed for digoxin by means of radioimmunoassay. Thirty-nine patients had measured digoxin levels drawn; 28 (71.8%) were in the therapeutic range (0.5-2.1 ng/mL), and four (10.2%) were in the toxic range (greater than 2.1 ng/mL). The patients with toxic dogoxin levels and those with nontoxic levels had similar resuscitation rates (50.0% vs. 34.3%, P = NS), but none were found in ventricular fibrillation. Emergency medical services personnel should consider digoxin toxicity as a potential etiology of arrest. PMID- 3680572 TI - Effect of congestive heart failure on the pharmacokinetics of cibenzoline. AB - Six patients with chronic congestive heart failure (CHF) (New York Heart Association functional class II or III) and five healthy subjects completed this study designed to determine if CHF alters the pharmacokinetics and absolute bioavailability of cibenzoline when compared with healthy subjects. Each subject or patient was administered a one-hour intravenous infusion of 80 mg of 15N2 cibenzoline and simultaneously received an 80-mg oral dose of cibenzoline that allowed for analytic separation of each route of administration. Resulting plasma concentration-time profiles and urinary excretion rate data were used to determine pharmacokinetic parameters for cibenzoline. There were no statistically significant differences in any pharmacokinetic parameter between patients with CHF and healthy subjects. The absolute bioavailability ranged from 74% to 97% in those with CHF. The volume of distribution following the intravenous dose ranged from 3.4 to 6.1 L/kg, and plasma clearance ranged from 245 to 642 mL/min, with an apparent elimination half-life of approximately ten hours. Approximately 60% of the dose was recovered in the urine. Overall, the pharmacokinetics of cibenzoline in patients with chronic CHF do not differ from those observed in healthy subjects. PMID- 3680573 TI - Oral clonidine for rapid control of accelerated hypertension. AB - Thirty emergency-room patients, 15 men and 15 women, from 27 to 64 years old with diastolic blood pressures (DBP) greater than 115 mm Hg, were admitted to an open label, oral loading trial of clonidine. At this time, their supine mean arterial pressures (MAP) averaged 150 +/- 2 mm Hg. An initial clonidine dose of 0.1 to 0.2 mg was to be followed every hour by another 0.1 mg until the DBP had been lowered to a level allowing treatment to be continued on an ambulatory basis or until a total of 0.5 mg had been given. A satisfactory response--defined as a reduction of the supine DBP to 105 mm Hg or lower if the baseline was between 115 and 135 mm Hg, or reduction of a baseline DBP greater than 135 mm Hg by at least 30 mm Hg -was achieved in all but one of the patients in an average of 118 minutes; the mean dose required was 0.26 mg. The mean reduction from the baseline MAP was 23.1 +/- 0.9%. Drug-related adverse experiences comprised drowsiness and dry mouth in 13 patients. Thereafter, 28 of the patients were chronically treated with clonidine for an average of 73 days. In 24 patients treated for at least 80 days, the daily clonidine dose averaged 0.375 mg. All the patients required concurrent diuretic therapy. A satisfactory response (as defined above) to this maintenance treatment was shown by 85% of the patients, and full blood-pressure control (supine DBP less than 95 mm Hg) was attained in 78%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680574 TI - Dietary salt intake and the clonidine suppression test. AB - We studied the effects of one week of dietary salt restriction and one week of salt loading on hemodynamic and plasma catecholamine responses to clonidine. Among 11 outpatients with essential hypertension, urinary sodium excretion averaged 29 mEq/d during salt restriction and 322 mEq/d during salt loading. Among eight inpatient normotensive subjects, urinary sodium excretion averaged 11 mEq/d during salt restriction and 300 mEq/d during salt loading. Three hours after administration of oral clonidine 300 micrograms, the hypertensive patients had an average (+/- one standard deviation) decrease in mean arterial pressure of 20 +/- 6% while receiving the low salt diet and 19 +/- 9% while taking the high salt diet, with decreases in venous plasma norepinephrine (NE) of 61 +/- 15% and 61 +/- 16%, respectively. The normotensive subjects had a decrease in mean arterial pressure of 16 +/- 8% with the low salt diet and 15 +/- 9% with the high salt diet, with decreases in venous plasma NE of 64 +/- 10% and 66 +/- 8%. Thus, in neither group were the percent decreases in plasma NE or in mean arterial pressure after clonidine affected by diet. Short-term, large-magnitude changes in dietary intake of sodium do not affect the sympathetic contribution to blood pressure as indicated by percent responses of plasma NE or of mean arterial pressure to clonidine administration. PMID- 3680575 TI - Evaluation of the ulcerogenic effect of potassium chloride by endoscopy and fecal blood loss. AB - In a blinded-observer crossover study, 16 volunteers ingested equimolar doses of three different potassium chloride preparations and placebo for nine days in a random order. The irritating effect on the mucosa was evaluated by means of upper gastrointestinal endoscopy and fecal blood loss, measured by reference to the amount of radioactivity in three 24-hour samples after previous injection of 51Cr tagged autologous red cells. The microencapsulated KCl capsule preparation induced three ulcers, but the total endoscopic group score was not significantly higher than the score with placebo. The total endoscopic group score for the wax matrix formulation was significantly higher than the score for placebo (P less than .05) and for a new microencapsulated KCl tablet preparation containing a potent disintegrant (P less than .10). We did not find any significant differences in mean fecal blood loss during the four different treatments. A correlation between endoscopic score and fecal blood loss was found in the placebo group (r = .54) and the microencapsulated KCl capsule preparation (r = .56) group. PMID- 3680576 TI - Elevation of serum aluminum in humans on a two-day sucralfate regimen. AB - Serum aluminum concentrations were determined in ten healthy subjects treated with phenytoin 500 mg and with sucralfate and phenytoin in a crossover fashion. Each subject received four 1,000-mg sucralfate tablets between 8 AM and 10 PM one day before the study, and this was repeated during the study day. A total of eight doses of sucralfate was administered over the two-day period. Serum samples were drawn at 0, 2, 4, 8, 12, 24, 32, and 48 hours after administration. The areas under the serum aluminum concentration-time curves before and after sucralfate (mean +/- SD) were 496.0 +/- 80.9 and 770.9 +/- 146.6 hr-ng/mL, respectively. This increase is statistically significant (P less than .01), indicating that serum aluminum levels are elevated even after two days of treatment with sucralfate. The results from this study are not in agreement with the only other report on this subject. PMID- 3680577 TI - Gentamicin disposition in young and elderly patients with various degrees of renal function. AB - The effect of aging on the total body clearance, volume of distribution, and half life of gentamicin was examined in 99 febrile patients with various degrees of renal function. In the 50 patients who were 18 to 64 years old, clearance of gentamicin was 79.0 +/- 27.0 mL/min (mean +/- standard deviation), creatinine clearance was 98.6 +/- 33.3 mL/min, volume of distribution was 0.242 +/- 0.077 L/kg, and half-life was 2.63 +/- 0.90 hours. In the 49 patients who were 65 to 90 years old, these values were 36.9 +/- 16.3 mL/min, 51.2 +/- 21.2 mL/min, 0.244 +/ 0.102 L/kg, and 5.80 +/- 4.13 hours. Significant differences were observed between the two groups for all parameters except volume of distribution. Linear regression revealed good correlations between the disposition characteristics (clearance and elimination-rate constant) of gentamicin and age as well as creatinine clearance. However, there was no apparent relationship between the ratio of gentamicin clearance to creatinine clearance and age (r = .0731). These findings suggest that the disposition of gentamicin is independent of age but dependent on renal function. PMID- 3680578 TI - Lack of effect of withdrawal from cigarette smoking on theophylline pharmacokinetics. AB - The intravenous disposition of theophylline was determined in 12 healthy young male smokers during periods of smoking and short-term withdrawal (24 to 36 hours), using a crossover design. Median half-life, clearance, volume of distribution, hepatic extraction, and intrinsic clearance of theophylline during withdrawal were within +/- 5% of the corresponding median control (smoking) parameters and were normal in comparison with values published for smokers. The lack of change in the pharmacokinetic profile of theophylline indicates that adjustment of the dosage regimen should not be necessary immediately after smoking withdrawal. PMID- 3680579 TI - The effect of acute withdrawal from cigarette smoking on indocyanine green and antipyrine clearance. AB - The effects of acute withdrawal from cigarette smoking on indocyanine green (ICG) clearance and antipyrine pharmacokinetics were studied in healthy young male volunteers. Two separate crossover clinical trials, each using 12 subjects, were used to compare the disposition of the drugs from 24 to 36 hours after withdrawal to the disposition found under control conditions. The median difference of ICG clearance and all antipyrine pharmacokinetic parameters from smoking control was less than 13%, indicating that short-term smoking withdrawal had no effect large enough to be of clinical significance on hepatic blood flow or hepatic drug metabolizing capacity. Rates of hepatic blood flow were normal in comparison with values published for larger sample populations. The lack of any clinically significant effect of smoking withdrawal on hepatic blood flow or on the disposition of antipyrine, a drug with very low hepatic extraction, indicates that on a pharmacokinetic basis, changes in dosage regimens for most drugs are not necessary on acute withdrawal from smoking. PMID- 3680580 TI - Nalmefene: safety and kinetics after single and multiple oral doses of a new opioid antagonist. AB - The aim of these two studies was to evaluate the safety and pharmacokinetics of oral nalmefene, a new orally effective opioid antagonist. In the first study, single ascending doses of 50, 100, 200, and 300 mg of nalmefene HCl were administered in double-blind fashion to four groups of healthy men. There were six subjects in each group; four received nalmefene and two received placebo. The drug was well tolerated at all dose levels with only mild and transient side effects, such as lightheadedness, at the higher doses. Model-independent pharmacokinetic analysis of the plasma concentration-time data showed that nalmefene was rapidly absorbed and had an elimination half-life that ranged from seven to 15 hours (mean, 10.7 hr). There was a good linear relationship (r = .97) between administered dose and total area under the curve at each dose level. Only about 4% of the dose was excreted in the urine as unchanged nalmefene, whereas up to 60% was excreted as a beta-glucuronidase/sulfatase hydrolysable conjugate(s) of nalmefene. In the second study, six healthy men were initially administered a single 50-mg dose of drug, and plasma samples were obtained at selected time intervals for 48 hours. A dosing schedule of 20 mg q12h was then started and continued for seven days. Plasma samples were collected immediately before each dose and at selected times for up to 48 hours after the last dose. The drug was well tolerated by all subjects, and no clinically significant adverse effects were observed during the seven-day administration period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680581 TI - Cyclosporine kinetics in healthy volunteers. AB - The pharmacokinetics of cyclosporine was studied in five healthy male volunteers following intravenous administration. The subjects received 2.1 mg/kg of cyclosporine as a two-hour intravenous infusion. Blood samples were collected over the subsequent 48 hours. Cyclosporine was extracted from whole blood and analyzed by high-performance liquid chromatography (HPLC) and radioimmunoassay (RIA). Following the intravenous infusion of cyclosporine, the drug exhibited multicompartmental behavior. The harmonic mean distribution half-life based on HPLC data was 0.45 hours, and the harmonic mean terminal disposition half-life was 6.2 hours. The clearance of cyclosporine based on HPLC cyclosporine concentrations was 3.9 mL/min/kg, and the volume of distribution at steady state of cyclosporine was 1.23 L/kg. Cyclosporine has a shorter half-life, lower clearance, and smaller Vss in healthy persons as compared to patient populations. The differences observed in the pharmacokinetics of cyclosporine in healthy persons as compared to patient populations may be due to differences in hematocrit, lipoprotein profiles, and/or concurrent drug therapy between the groups. Cyclosporine concentrations determined by RIA were consistently higher than those determined by HPLC, resulting in a significantly higher area under the blood concentration versus time curve and lower clearance rate for cyclosporine. We conclude that: (1) kinetic parameter estimates for cyclosporine are different in healthy individuals as compared with organ-transplant recipients, and (2) the kinetic parameters for cyclosporine are different, depending on the assay technique used. PMID- 3680582 TI - The relationship of serum albumin level to phenytoin toxicity. PMID- 3680583 TI - International drug registration efforts. PMID- 3680584 TI - Lorcainide for the treatment of refractory ventricular tachycardia: clinical and electrophysiologic results. AB - The electrophysiologic effects and antiarrhythmic efficacy of lorcainide were evaluated using programmed electrical stimulation (PES) in 14 patients with ventricular tachycardia (VT) refractory to conventional drug therapy. Lorcainide was administered orally (200-400 mg/d, eight patients), intravenously (150 mg/d, one patient), or by both routes (250-380 mg/d, five patients) prior to PES. In 13 patients undergoing both control and lorcainide PES, lorcainide increased the QRS duration (102 +/- 28 to 125 +/- 28 ms, P less than .001) and the QTc interval (430 +/- 39 to 471 +/- 32 ms, P less than .01) but had no effect on the RR interval (786 +/- 156 to 780 +/- 172 ms, P greater than .2). The right ventricular effective refractory period increased from 258 +/- 8 to 285 +/- 22 ms (P less than .001). Lorcainide prevented VT induction or resulted in induction of only well-tolerated, nonsustained VT in six of 14 patients (43%). The cycle length of induced VT increased from 264 +/- 32 to 306 +/- 34 ms (P less than .01). Of six patients started on chronic therapy, four still receive lorcainide after 18 +/- 7 months. Adverse effects have consisted mainly of sleep disturbances. Thus, it can be stated that lorcainide is effective in certain patients with VT refractory to conventional therapy. PMID- 3680585 TI - Cibenzoline for high-frequency ventricular arrhythmias: a short-term comparison with quinidine and a long-term follow-up. AB - Cibenzoline, a new class I antiarrhythmic drug, was compared with quinidine in an open crossover study of 20 patients with frequent (greater than 30/hr) premature ventricular depolarizations (PVDs). Eight patients treated with cibenzoline experienced more than 75% reduction in PVD frequency. Cibenzoline completely suppressed ventricular couplets in eight of 17 patients and inhibited ventricular tachycardia (VT) in four of 13 patients. Only four patients (20%) responded to quinidine with a similar reduction in PVDs. Quinidine completely suppressed ventricular couplets in eight of 17 patients and episodes of VT in six of 13 patients. Cibenzoline prolonged PR, QRS, and QTc intervals. Eight patients who had shown more than a 75% reduction of PVDs were treated with cibenzoline for an extended period. At the end of three months, only five of eight patients continued to have 75% or greater reduction of PVDs. At the end of six and 12 months, four of five patients continued to have 75% or greater reduction of PVDs. Cibenzoline was similarly effective in suppressing complex arrhythmias. Thus, cibenzoline was only slightly superior to quinidine in suppressing ventricular arrhythmias. With long-term use of cibenzoline, significant PVD suppression was noted at the end of three months but not afterward. PMID- 3680586 TI - Falsely elevated urinary excretion of catecholamines and metanephrines in patients receiving labetalol therapy. AB - Five patients with essential hypertension who were receiving treatment with the beta- and alpha-adrenoreceptor-blocking drug labetalol had elevated urinary excretion of catecholamines. When measured with a radioenzymatic assay, all five subjects had elevated urinary excretion of norepinephrine and normal urinary excretion of epinephrine; when measured with a fluorometric assay, four subjects had elevated urinary excretion of epinephrine with normal urinary excretion of norepinephrine, and one subject had elevated urinary norepinephrine excretion with normal urinary excretion of epinephrine. In three subjects who could be reevaluated three days to two months after labetalol therapy was discontinued, the urinary catecholamine levels had returned toward normal. Our studies indicate that labetalol produced a false elevation of urinary catecholamine levels. Although labetalol also interfered with the measurement of urinary excretion of metanephrine, it did not interfere with the measurement of urinary excretion of vanillylmandelic acid, homovanillic acid, 5-hydroxyindoleacetic acid, and serotonin, and it probably did not interfere with the measurement of plasma concentrations of dopamine, norepinephrine, and epinephrine. We conclude that labetalol therapy should be discontinued, and another beta-blocking drug, such as propranolol, that does not interfere with these tests should be temporarily substituted at least three days before a patient collects a 24-hour urine for measurement of the urinary excretion of catecholamines and metanephrine. PMID- 3680587 TI - Effect of two different meals on bioavailability of nilvadipine in healthy volunteers. AB - The effect of two different meals on the bioavailability of nilvadipine, a new antihypertensive and antianginal drug, was examined in 16 healthy male volunteers in two separate studies. In each study of eight subjects in a Latin-square, two way crossover design, two groups of four subjects each were given a single 6-mg oral dose of nilvadipine after overnight fasting or 30 minutes after a 464- or 748-kcal meal. There were no significant differences in the area under the plasma concentration-time curve or the maximum plasma concentration between the fasting and fed states for either meal. Although the time to reach the maximum plasma concentration was about the same after a 464-kcal meal and after fasting, it increased slightly but significantly after a 748-kcal meal, indicating possible delay in drug absorption after meals. These studies showed that the extent of bioavailability of nilvadipine appears to be little affected in the presence of food. Although a possible delay in the onset of absorption would occur, such a delay may not have any therapeutic importance in chronic therapy. PMID- 3680588 TI - Disposition of aspirin and its metabolites in the semen of man. AB - The study was undertaken to determine the distribution of aspirin and its metabolites in the semen of humans after an oral dose of aspirin. Each of seven healthy male volunteers was given a single oral dose of 975 mg of aspirin on an empty stomach together with 200 mL of water. Timed samples of blood and semen were obtained from each subject, and the concentrations of aspirin, salicylic acid, and salicyluric acid determined by a specific high-performance liquid chromatographic assay. The mean peak concentration of aspirin was 6.5 micrograms/mL in plasma (range, 4.9-8.9 micrograms/mL), reached in 26 minutes (range, 13-33 minutes). The half-life of aspirin was 31 minutes. The concentration ratio of aspirin (semen/plasma) was 0.12 (except for one subject in whom it was 0.025). The mean peak concentration of salicylate in plasma was 49 micrograms/mL (range, 42-62 micrograms/mL), reached in 2.5 hours (range, 2.0-2.8 hours). Salicylate distributed rapidly into semen and maintained a concentration ratio (semen/plasma) of 0.15. Salicyluric acid (the glycine conjugate of salicylic acid) was found in the semen. Its high concentration in some subjects' semen (four times the concurrent plasma concentration) was attributed to contamination of semen sample with residual urine, containing salicylurate, in the urethra of those who urinated after the dose of aspirin. Possible side effects of aspirin and salicylate in semen include adverse effects on fertility, male-medicated teratogenesis, dominant lethal mutations, and hypersensitivity reactions in the recipients. PMID- 3680589 TI - Dose-finding and pharmacokinetic study of intramuscular midazolam. AB - Ten healthy male volunteers received intramuscular (IM) doses of 0.050, 0.075, and 0.100 mg/kg midazolam hydrochloride or its vehicle (placebo) in a double blind manner until a dose producing adequate preanesthetic sedation was administered. Level of sedation, degree of impairment of psychomotor function, existence of antegrade amnesia, and incidence of side effects were evaluated after each dose. An adequate level of sedation (awake/drowsy or asleep/easily responds to verbal command for at least one hour after drug administration) was produced, beginning shortly after drug administration, in eight of the volunteers by 0.075 mg/kg; the dose producing the same effect (the optimal dose) was 0.050 mg/kg for the oldest volunteer, and the other volunteer required 0.100 mg/kg. Sedation lasted no more than four hours after administration of the optimal dose. The optimal dose in each volunteer produced an impairment of psychomotor function that lasted no more than six hours and antegrade amnesia that lasted no more than two hours. Mild erythema at the injection site occurred infrequently. The pharmacokinetic variables describing the absorption and disposition of midazolam were determined in five of the volunteers. Pharmacokinetic studies indicated that midazolam hydrochloride is absorbed rapidly from IM injection sites; this consistent with the observation of a rapid onset of sedation. The relatively high elimination clearance of midazolam after IM administration is similar to that reported after intravenous administration. The results of this study suggest that midazolam hydrochloride 0.075 mg/kg IM provides sedation and amnesia that is satisfactory for preanesthetic medication but does not last too long into the recovery period. PMID- 3680590 TI - Estimation of the elimination half-life of a drug at any serum concentration when the Km and Vmax of the drug are known: calculations and validation with phenytoin. AB - A method of estimating the elimination half-life of a drug at any selected serum concentration when the Km and Vmax of that drug are known is described. The method was validated in six patients by determining their Km and Vmax values for phenytoin, using data obtained at two serum concentrations and then using the Km and Vmax values to predict the elimination half-life of phenytoin at a third serum concentration. The predicted elimination half-lives at the third serum concentration did not differ significantly (t = 1.16, P = .30) from observed elimination half-lives determined with stable isotope tracer techniques. PMID- 3680591 TI - Determination of the in vivo Km and Vmax of a drug with tracer studies. AB - A method is described for determining the in vivo Km and Vmax values for a drug, utilizing a variant of the Michaelis-Menten equation and the elimination-rate constants of tracer doses of the drug administered at two different serum concentration values. The new method is the most accurate yet devised; unlike older methods, it is dependent on assumptions that generally are true and can be validated empirically. Application of the method is demonstrated by a study of phenytoin in humans. PMID- 3680593 TI - Pharmacokinetic studies of intermediate-to high-dose 1-beta-D arabinofuranosylcytosine in children with acute leukemia and lymphoma. AB - Pharmacokinetic studies of intermediate and high dose 1-beta-D arabinofuranosylcytosine (araC) therapy were performed in 14 children with acute leukemia and four with non-Hodgkin's lymphoma (NHL). AraC administration differed by method, dosage, and time of infusion to obtain the optimal tumorcidal concentration. The toxicity of these regimens was limited to transient severe nausea and vomiting, which were tolerable. Infusion time and dose are important factors to obtain optimal and clinically effective cerebrospinal fluid (CSF) araC concentrations. A concentration of araC above 1 micrograms/mL in CSF, which was lethal to cells in culture, was obtained by intravenous infusion of more than 2,000 mg/m2 of araC for four hours. We propose that araC 2,000 mg/m2 by constant intravenous infusion is preferable in the treatment of leukemia and is associated with the fewest side effects. PMID- 3680592 TI - A multiple-dose pharmacokinetic comparison of naproxen as a once-daily controlled release tablet and a twice-daily conventional tablet. AB - The bioequivalence and absorption kinetics of naproxen in a new controlled release tablet (750 mg or 1,000 mg naproxen) administered once daily were determined relative to an equivalent dose of the conventional naproxen tablet (375 mg or 500 mg naproxen) administered q12h. Naproxen was well absorbed from the controlled-release tablet (about 90%) compared with the conventional tablet. Absorption was dependent on drug release from the tablet matrix. The mean absorption time of naproxen averaged 8.4 hours for the 750-mg controlled-release tablet and 9.2 hours for the 1,000-mg controlled-release tablet. Once-daily administration of the controlled-release tablet resulted in equivalent trough concentrations of naproxen, and steady-state plasma concentrations were maintained within narrower limits than with twice-daily naproxen. PMID- 3680594 TI - Rules governing pharmaceuticals in the European Community. AB - In the interest of public health, the European community has progressively established common scientific criteria for the evaluation of human and veterinary medicines and harmonized the national authorization procedures. One major consequence of this has been that neither the tests and trials carried out to obtain authorization nor batch controls need be repeated within the European community. Henceforth the pharmaceutical industry may benefit from two types of procedures intended to facilitate the registration of their medicinal products in the member states. One, reserved for biotechnology/high technology medicinal products, involves community coordination prior to any national decision together with special protection against copies for ten years, irrespective of the position under patent law. The other enables firms to request the recognition by the other member states of an authorization previously granted by one member state. The experience gained from these two procedures will lead to the choice of the most appropriate European registration procedure for the next decade. In the interests of the European consumer, cooperation between the 12 member states and the Commission of the European Communities has progressively increased within the Committee for Proprietary Medicinal Products (adverse effects of medicines/pharmacovigilance) and the Committee for Veterinary Medicinal Products (residues). In association with these committees, several working groups of experts attempt to approximate and codify practices in the evaluation of the quality, safety, and efficacy of medicinal products (guidelines).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680595 TI - Effect of 5-hydroxytryptamine blockade with ketanserin on myocardial uptake of epinephrine and norepinephrine in patients with congestive heart failure. AB - Serotonin (5-hydroxytryptamine) has multiple cardiovascular actions. The presence of serotonin in the heart suggests it may be an endogenous source of inotropic support during physiologic or pathologic stress. Serotonin may increase cardiac contractility by augmenting release of norepinephrine at sympathetic nerve endings. Norepinephrine release is markedly elevated in patients with heart failure. To explore the role of serotonin in enhancing norepinephrine release in patients with heart failure, ketanserin, a specific serotonin antagonist, was used as a physiologic tool to examine the effect on transmyocardial norepinephrine flux. Ketanserin (10 mg bolus, 4 mg/hr infusion for +/- 40 min) was administered intravenously to nine patients with congestive heart failure (NYHA III or IV) secondary to congestive cardiomyopathy (N = 7), or ischemic heart disease (N = 2). Plasma catecholamines (norepinephrine, epinephrine, dopamine) were measured in the aorta (Ao) and the coronary sinus (CS) of patients at rest and during supine leg exercise before and after administration of ketanserin. Baseline norepinephrine levels were markedly elevated at rest and during exercise in all patients. Norepinephrine levels were significantly higher in the CS than in the Ao (rest, CS 1185 +/- 235, Ao 878 +/- 381 pg/mL, P less than .05; exercise, CS 2239 +/- 697, Ao 1453 +/- 697 pg/mL, P less than .05). Baseline epinephrine levels were within normal limits. In contrast to norepinephrine levels, epinephrine levels were consistently higher in the Ao than in the CS, indicating unimpaired extraction or uptake across the heart. The relationship between norepinephrine and epinephrine concentration in the Ao and CS suggested a net overflow of norepinephrine in the CS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680596 TI - Evaluation of dosing interval and optimum dose of cibenzoline. AB - Fifteen patients with ventricular premature complexes (VPCs) were included in this open study designed to assess the relative efficacy of bid (two times daily) and tid (three times daily) dosing regimens for cibenzoline as compared with qid (four times daily) administration. Patients started therapy with qid administration; this was followed in sequence by tid and bid administration at the maximum effective total daily dose determined during the qid administration. Of the nine patients evaluated for efficacy for suppression of VPCs, eight demonstrated a 75% or greater suppression of VPCs with cibenzoline administered qid (total daily dose of 130-325 mg). This effectiveness was maintained in four patients with a bid regimen and in three with a tid regimen. All four patients who had ventricular tachycardia (VT) had a decrease in the number of VT episodes while receiving cibenzoline (only one of these patients had satisfactory suppression of VPCs at the same dosage regimen). Twelve patients continued to receive extended therapy with cibenzoline for up to two years, as this was considered to be the optimum antiarrhythmic treatment for these patients. Two patients had to be removed from the study and two had the dosage lowered because of adverse reactions (dry mouth, blurred vision, dizziness, congestive heart failure) although in one instance, the congestive heart failure was subsequently considered to be unrelated to cibenzoline. One patient was able to complete the short-term phase of the trial, but was not given extended treatment because of persistent dry mouth. Two patients had treatment discontinued during the extended therapy phase because of adverse reactions (fever, nausea, vomiting, asthenia).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680597 TI - Pharmacokinetic properties of mezlocillin in ambulatory elderly subjects. AB - Twelve healthy ambulatory elderly subjects (mean age, 73-78 years) randomly received either a 4-g or 5-g dose of mezlocillin intravenously. One week later the regimen was repeated and patients crossed over to the other dose. Peak serum concentrations were 165 mg/L and 281 mg/L for the 4-g and 5-g doses, respectively. For both doses, differences in t1/2 beta (1.32 hr vs 1.13 hr), AUC (275 mg.hr/L vs 403 mg.hr/L), CL (207 mL/min vs 174 mL/min), CLR (59 mL/min vs 45 mL/min), CLNR (152 mL/min vs 130 mL/min) were not statistically significant. The differences in Varea (22.4L vs 168.8L, P less than or equal to .01) and Cmax (216.6 mg/L vs 317 mg/L, P less than or equal to .05) were statistically significant. Comparison with pharmacokinetic parameters obtained in younger subjects following the 5-g dose reveals that in the elderly the AUC, Varea, and CLNR are higher whereas the CL and CLR are lower. The elderly demonstrated an increase in nonrenal clearance compared with young subjects that is not fully compensatory. The increased AUC in the elderly group suggests that clinical studies examining mezlocillin doses and dose intervals in the treatment of serious infections are warranted in infected elderly patients. PMID- 3680598 TI - Clinical pharmacology and therapeutics education for senior medical students. AB - In many medical schools instruction of students in clinical pharmacology remains informal and may be inadequate. To determine the short-term efficacy of a mandatory senior medical year course in clinical pharmacology, we compared examination scores of senior students in the College of Medicine, University of Iowa, either prior to or following the Clinical Pharmacology and Therapeutics Lecture Series. A significantly higher (P less than .001) mean score was demonstrated by students taking the examination following the course (75 +/- 4% correct) versus those taking the examination prior to the course (55 +/- 4% correct). To determine student acceptance, postcourse questionnaires were completed. Students surveyed immediately postcourse and alumni surveyed up to four years after graduation highly recommended the course and favored retaining it as a mandatory part of the fourth-year curriculum. This study confirms the efficacy and acceptance of senior medical courses in therapeutics and suggests an effective role for clinical pharmacologists in their design and execution. PMID- 3680599 TI - Phenylpropanolamine: effects on subjective and cardiovascular variables at recommended over-the-counter dose levels. AB - Two controlled clinical studies evaluated the effects of phenylpropanolamine HCL (PPA) on measures of blood pressure, pulse, and subjective state (mood). One hundred fifty subjects participated in a parallel groups design that compared a 75-mg sustained release (SR) preparation with a 25-mg tid. dosing regimen and placebo. Fifty-nine of these subjects participated in an additional cross-over component that compared SR PPA 75 mg with placebo. Measures of blood pressure, pulse, and subjective drug effect were obtained nine times throughout the course of a 12-hour session. Data analysis revealed no clinically and few statistically significant effects due to drug treatment. As expected, most measures showed circadian changes on both the cardiovascular and mood variables, which were not related to drug treatment. No euphorogenic or "amphetamine-like" effects were noted. Although further work is warranted regarding the effects of chronic or higher-than-normal doses of PPA, the current studies suggest that PPA, at currently recommended dose levels, is not associated with adverse effects on either cardiovascular or subjective functioning. PMID- 3680600 TI - Prediction of individual dosage of nortriptyline in depressed elderly outpatients. AB - Individual daily dosages of nortriptyline (NT) can be predicted from administration of a 50-mg or 100-mg single test dose, with a determination of the plasma level 24 hours later. Because the 50-mg or 100-mg test dose used in previous studies may cause unmanageable acute side effects in elderly patients, a 25-mg NT test dose was used to establish a 24-hour plasma level in 18 physically healthy, moderately depressed, geriatric outpatients. Correlations between the 24 hour test dose plasma level and steady state levels were done for maintenance dosages of 50, 75, and 100 mg/day. A nomogram was made from the regression equations to predict the dosage required to achieve a steady state concentration within a 50 to 150 ng/ml range. The importance of the ability to predict NT dosage requirements in geriatric patients is indicated by findings that at daily NT doses of 50 and 100 mg, nearly one-half of subjects had steady state levels below or above 50 or 150 ng/ml, respectively. PMID- 3680601 TI - The effects of caffeine and aspirin on mood and performance. AB - Caffeine, in addition to being a food constituent, is also a common analgesic adjuvant that is used in combination with aspirin in certain over-the-counter preparations. Caffeine has previously been shown to significantly improve certain aspects of human performance, particularly sustained vigilance, when administered in low and moderate doses (32 to 256 mg). We therefore attempted to determine whether caffeine, in the dose (64 mg) found in some over-the-counter drugs, retains this beneficial property when combined with aspirin. We also measured self-reported mood state, using various standardized questionnaires, since caffeine has been reported to have both beneficial and adverse effects on alertness and anxiety. We observed that caffeine (64 mg), when added to aspirin (800 mg), significantly improves vigilance performance and increases self reported efficiency when compared with either placebo or aspirin alone. As previously reported, this caffeine dose alone significantly increased vigilance and decreased reaction time. No adverse effects of caffeine were detected on any of the parameters that were assessed. This study therefore demonstrated that the addition of caffeine to aspirin, in a dose commonly employed in over-the-counter drugs, has significant beneficial consequences with respect to mood and performance. PMID- 3680602 TI - Child and adolescent nortriptyline single dose pharmacokinetic parameters: final report. AB - This is the final report of a study of single dose pharmacokinetic parameters of nortriptyline in children and adolescents 5 to 16 years old (N = 64). The data were analyzed separately for the 5- to 12-year-olds (N = 41) and for the 13- to 16-year-olds (N = 32). The results confirm the preliminary findings of the similarity of the pharmacology of nortriptyline between the pediatric and adult age groups with respect to a logarithmically linear rate of elimination and a wide interindividual rate of metabolism. The 5- to 12-year-olds had a significantly shorter mean half-life and a significantly greater mean apparent oral clearance than the 13- to 16-year-olds. The mean half-life in the 5- to 12 year-olds was 20.8 +/- 7.2 (range, 11.2 to 42.5) hours and in the 13- to 16-year olds was 31.1 +/- 19.8 (range, 14.2 to 89.4) hours. A twice a day dosage regimen is recommended for the entire 5- to 16-year-old group based on their range of half-lives. PMID- 3680603 TI - Alprazolam kinetics following sublingual and oral administration. AB - Thirteen healthy volunteers received 1 mg of alprazolam, as the commercially available oral tablet, by sublingual and oral routes on two occasions in random sequence. Plasma alprazolam concentrations during 48 hours after each dose were measured by electron-capture gas-liquid chromatography. The peak plasma concentration after sublingual dosage was higher than after oral administration (17.3 vs. 14.9 ng/ml), and the time of peak concentration following sublingual administration was reached (1.17 vs. 1.73 hours after dose). However, these differences did not reach statistical significance. The mean total area under the plasma concentration curve for sublingual administration was slightly but not significantly larger than that following oral dosage (203.7 vs. 194.4 hr.ng/ml) and no significant differences between sublingual and oral dosage were found for elimination half-life (11.7 vs. 11.8 hours) or for clearance (86.4 vs. 92.4 ml/min). Thus, alprazolam absorption following sublingual administration is as rapid as after oral dosage on an empty stomach, and completeness of absorption is comparable. In clinical terms, sublingual and oral dosages of alprazolam are likely to be therapeutically equivalent. The sublingual route may be a useful alternative for panic disorder patients who cannot swallow pills or for those who do not have access to a liquid at the time of dosing. PMID- 3680604 TI - A comparative study of the electrocardiographic effects of phenelzine, tricyclic antidepressants, mianserin, and placebo. AB - Although the electrocardiographic effects of the tricyclic antidepressants have been extensively investigated, there are fewer data on the effects of monoamine oxidase inhibitors and tetracyclics on cardiac conduction. This study used high speed recordings of the electrocardiogram to investigate the cardiographic effects of phenelzine and mianserin and to compare these to the effects of imipramine, amitriptyline, and placebo. Phenelzine caused significant slowing of the heart rate, while mianserin showed little effect on heart rate compared to the increases in rate seen with tricyclics. In clinically effective doses, neither phenelzine nor mianserin caused changes in conduction, while both tricyclics studied caused the expected prolongation of conduction. These data suggest that phenelzine and mianserin deserve further study in patients with disease of the cardiac system as they may be less likely to cause heart block in these patients. PMID- 3680605 TI - Reinduction of neuroleptic malignant syndrome by lithium. AB - The psychopharmacologic management of psychotic patients who have had neuroleptic malignant syndrome poses a dilemma for clinicians. Neuroleptic malignant syndrome can recur when neuroleptics are readministered, but there are equal numbers of reports of safe resumption of neuroleptic treatment in patients who have had the syndrome. In an effort to avoid reexposure to neuroleptics, the authors treated two bipolar patients who were clinically recovered from episodes of neuroleptic malignant syndrome with lithium alone. Both patients rapidly developed recurrent neuroleptic malignant syndrome after only 300 and 1,200 mg of lithium, respectively. Possible pathogenetic mechanisms are reviewed, although a definitive explanation for such a sudden and dramatic toxic effect is not available. PMID- 3680607 TI - View from the Nation's Courts. PMID- 3680606 TI - View from the Nation's Capital. FDA challenged successfully on its policies regarding good manufacturing practice inspections of medical drug and device manufacturers. PMID- 3680608 TI - Benzodiazepine-induced hypomania? PMID- 3680609 TI - Use of verapamil to treat negative symptoms in schizophrenia. PMID- 3680610 TI - Prostaglandin E1 treatment of schizophrenia. PMID- 3680611 TI - Increased obstipation in a patient with scleroderma following therapy with lithium. PMID- 3680613 TI - Intravenous lorazepam in psychogenic catatonia. PMID- 3680612 TI - Lack of pharmacokinetic interaction between tranylcypromine and carbamazepine. PMID- 3680614 TI - A panic attack precipitated by opiate blockade--a case study. PMID- 3680615 TI - Interconversion between haloperidol and reduced haloperidol in humans. PMID- 3680616 TI - Failure of high dose naloxone to relieve tardive dyskinesia. PMID- 3680617 TI - Ineffective sublingual lorazepam: considerations. PMID- 3680618 TI - Differential therapeutic response by history during treatment with neuroleptic threshold haloperidol doses. PMID- 3680619 TI - Lithium down-regulates nicotinic receptors in skeletal muscle: cause of lithium associated myasthenic syndrome? PMID- 3680620 TI - Pharmacotherapy of primary obsessional illness. PMID- 3680621 TI - Motoneuronal death during human fetal development. AB - The total number of ventral horn motoneurons throughout the spinal cord was determined for 19 human fetuses ranging in age from 11 to 32 menstrual weeks. There was a significant (approximately 35%) decline in motoneuron number between wks 11 and 25 of gestation, but no further decline from wks 25-32. Counts of pyknotic cells indicated a peak of motoneuronal degeneration between about wks 12 and 16 of age. The normal period of motoneuronal death observed here overlaps with the initiation of functional neuromuscular contact as well as the period of androgen production by the human fetal testes. As in rats, androgen may influence final motoneuron number in the human spinal cord by attenuating cell death in sexually dimorphic motor nuclei. PMID- 3680622 TI - Cell death in the developing retinal ganglion cell layer of the wallaby Setonix brachyurus. AB - The distribution and number of dying cells in the developing retinal ganglion cell layer of the wallaby Setonix brachyurus were assessed by using cresyl violet stained tissue. The density of dying cells has been expressed per 100 live cells for the entire retinal surface, data being presented as a grid of 500 micron squares. For statistical analysis, retinae were divided into 8 regions; dorsal, ventral, nasal, and temporal quadrants, each further divided into center and periphery. This method allowed comparison of the extent of cell death at different retinal locations as the high density area centralis of live cells developed temporal to the optic disk from 60 days onward. Between 30 and 70 days, dying cells were seen across the entire retina; beyond 100 days very few were seen. Initially, there was a significantly higher incidence of dying cells in the central retina compared to the periphery, whereas from 50 days this situation was reversed. Analysis of the central retina before and during area centralis formation consistently indicated a significantly lower number of dying cells per 100 live cells in temporal compared to other retinal quadrants. This differential pattern suggests that cell death lowers live cell densities less in the emerging area centralis than elsewhere, and therefore must play a part in establishing live cell density gradients. However, we cannot exclude the possibility that other factors are also instrumental. Indeed, factors such as areal growth (Beazley et al., in press) presumably operate at later stages since live cell density gradients continue to be accentuated even after cell death is complete. Numbers of dying cells peaked by 50 days, reaching approximately 1% of the live cell population. At this stage, counts were also maximal for live cells with values up to 30% above the adult range. PMID- 3680623 TI - Disappearance of Rohon-Beard neurons from the spinal cord of larval Xenopus laevis. AB - Rohon-Beard neurons are primary sensory cells located in the spinal cord of embryonic lower vertebrates. The kinetics of their normal, gradual, but complete disappearance in Xenopus tadpoles has been followed. Levels of acid phosphatase activity, a common histochemical correlate of cell death, were assayed and found to increase at the time of onset of disappearance of Rohon-Beard cells. Ultrastructural examination revealed the presence of numerous secondary lysosomes, swelling of endoplasmic reticulum and mitochondria, and a decrease in nuclear density. The disappearance of Rohon-Beard neurons may be attributed to autophagic cell death involving lysosomal acid hydrolases. This process begins only a few days after the maturation of voltage- and neurotransmitter-dependent membrane conductances and the electrical uncoupling of these neurons. The loss of Rohon-Beard neurons in embryos whose development was arrested by crowding was appropriate for the developmental stage of the animals rather than their chronological age. PMID- 3680624 TI - Different origins of cochlear efferents in some bat species, rats, and guinea pigs. AB - The origin of olivocochlear efferents was studied in the rat, the guinea pig, and the bats Rhinolophus, Rhinopoma, Tadarida, and Phylostomus by retrograde labeling with HRP and the fluorescent dye fast blue. In all species with the exception of Rhinolophus rouxi two types of cochlear efferents could be found: small neurons located in the lateral superior olive (LSO) and larger ones located bilaterally in the periolivary region. In bats and rats small olivocochlear neurons (OCN) were found only in the ipsilateral LSO. In guinea pigs some small OCN were found also in the contralateral LSO. Large OCN were found in all animals except Rhinolophus. They were organized in a horseshoelike nucleus that extended in a rostrocaudal direction and bent rostrally around the medial superior olive (MSO). This nucleus contains several periolivary nuclei described separately by other authors. In Rhinol. rouxi somata of all olivocochlear efferents are concentrated in a single nucleus between the MSO and LSO, which we therefore call the nucleus olivocochlearis. This nucleus stains for acetylcholinesterase. We consider its neurons to be similar to small OCN, because they are small, associated with the LSO, and only ipsilaterally labeled. This fits well with the fact that Rhinolophus lacks an efferent innervation of outer hair cells (Bishop: Ph.D. Thesis, University of North Carolina, Chapel Hill, '86; Bruns and Schmieszek: Hear. Res. 3:27-43, '80), which are normally innervated by large OCN (Guinan et al: J. Comp. Neurol. 221:358-370, '83). PMID- 3680626 TI - Factors guiding optic fibers in developing Xenopus retina. AB - We have characterized, by electron microscopy, the growth of pioneering axons from the retina into the visual pathway during early development of Xenopus laevis. The subsequent development of following fibers from the growing retinal margin as they accumulated in the ganglion cell fiber layer (GCFL) of the retina was also studied. Extracellular channels bordered by neuroepithelial cells appear in the developing retina in a dorsal to ventral gradient before any pioneering axons are seen. Pioneering axons are subsequently observed in these channels, usually surrounded by neuroepithelial cell processes. Ruthenium red treatment of embryonic retinas reveals extracellular matrix (ECM) within these retinal channels, while extracellular spaces in the proximal optic stalk, just beyond the optic disc, lack this material. ECM is also seen in optic tectum wherever ingrowing retinal and nonretinal axons are found. The channels and the ECM contained within them may provide guidance cues for pioneering retinal axons. The early association of pioneering retinal axons with neuroepithelial cell processes (putative glia) appears to be important in further development of the GCFL. The so-called following fibers of ganglion cells, arising later in development, fasciculate with pioneer axons in extracellular spaces and form fiber bundles of the GCFL on top of the layer of glial cell endfeet. It is not clear whether pioneering axons, glial cell surfaces, or both serve as guidance cues for following fiber migration. PMID- 3680625 TI - Distribution of GABAergic neurons and axon terminals in the macaque striate cortex. AB - Antisera to glutamic acid decarboxylase (GAD) and gamma-aminobutyric acid (GABA) have been used to characterize the morphology and distribution of presumed GABAergic neurons and axon terminals within the macaque striate cortex. Despite some differences in the relative sensitivity of these antisera for detecting cell bodies and terminals, the overall patterns of labeling appear quite similar. GABAergic axon terminals are particularly prominent in zones known to receive the bulk of the projections from the lateral geniculate nucleus; laminae 4C, 4A, and the cytochrome-rich patches of lamina 3. In lamina 4A, GABAergic terminals are distributed in a honeycomb pattern which appears to match closely the spatial pattern of geniculate terminations in this region. Quantitative analysis of axon terminals that contain flat vesicles and form symmetric synaptic contacts (FS terminals) in lamina 4C beta and in lamina 5 suggest that the prominence of GAD and GABA axon terminal labeling in the geniculate recipient zones is due, at least in part, to the presence of larger GABAergic axon terminals in these regions. GABAergic cell bodies and their initial dendritic segments display morphological features characteristic of nonpyramidal neurons and are found in all layers of striate cortex. The density of GAD and GABA immunoreactive neurons is greatest in laminae 2-3A, 4A, and 4C beta. The distribution of GABAergic neurons within lamina 3 does not appear to be correlated with the patchy distribution of cytochrome oxidase in this region; i.e., there is no significant difference in the density of GAD and GABA immunoreactive neurons in cytochrome rich and cytochrome-poor regions of lamina 3. Counts of labeled and unlabeled neurons indicate that GABA immunoreactive neurons make up at least 15% of the neurons in striate cortex. Layer 1 is distinct from the other cortical layers by virtue of its high percentage (77-81%) of GABAergic neurons. Among the other layers, the proportion of GABAergic neurons varies from roughly 20% in laminae 2 3A to 12% in laminae 5 and 6. Finally, there are conspicuous laminar differences in the size and dendritic arrangement of GAD and GABA immunoreactive neurons. Lamina 4C alpha and lamina 6 are distinguished from the other layers by the presence of populations of large GABAergic neurons, some of which have horizontally spreading dendritic processes. GABAergic neurons within the superficial layers are significantly smaller and the majority appear to have vertically oriented dendritic processes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680627 TI - Development of corticogeniculate synapses in the cat. AB - The development of corticogeniculate synapses was studied in 16 cats ranging in age from newborn to adult. Tritiated proline was injected into areas 17 and 18 of the visual cortex in order to label corticogeniculate terminals in lamina A of the dorsal lateral geniculate nucleus. The labeled terminals were then characterized ultrastructurally using electron microscopic autoradiography. Labeled synaptic profiles were found in newborn kittens, indicating that corticogeniculate connections are present in the cat at birth. Morphologically, however, many corticogeniculate endings in newborn and 1-week-old kittens are different from those in older animals in that they do not form well-defined terminal boutons, and their synaptic vesicles are often loosely packed. In kittens 2 weeks of age and older, corticogeniculate axons end as RSD terminals exclusively; i.e., they are relatively small in size and contain round, densely packed synaptic vesicles, and occasionally an electron-dense mitochondrion (Guillery: Z. Zellforsch. 99: 1-38, '69). However, not all RSD terminals in the LGN represent input from visual cortex. Injections of 3H-proline into the mesencephalic reticular formation also label RSD terminals selectively in the lateral geniculate nucleus. At all ages corticogeniculate axons make synaptic contacts with dendrites exclusively, and they are always presynaptic. This suggests that the essential pattern of corticogeniculate synapses is formed early and is not altered during subsequent development. Quantitatively, there is no significant change in the size of corticogeniculate terminals or their synaptic vesicles in kittens 2 weeks of age (the youngest measured) and older. In contrast, the synaptic contact lengths of these terminals decreases about 28% between 2 and 12 weeks. During this same period there is approximately a twofold increase in the density of corticogeniculate terminals in the neuropil of lamina A. Since the volume of neuropil in lamina A increases almost fourfold between 2 and 12 weeks, the doubling of corticogeniculate terminal density represents about an eightfold increase in terminal number. After 12 weeks there is little change in the length, density, or number of corticogeniculate synaptic contacts, which suggests that the morphological development of the corticogeniculate pathway is essentially complete by this age. PMID- 3680628 TI - Effects of prenatal irradiation on the development of cerebral cortex and corpus callosum of the mouse. AB - Defects of the cerebral cortex and corpus callosum of mice subjected prenatally to gamma irradiation were evaluated as a function of dose and of embryonic age at irradiation. Pregnant mice were exposed to a gamma source at 16, 17, and 19 days of gestation (E16, E17, and E19, respectively), with total doses of 2 Gy and 3 Gy, in order to produce brain defects on their progeny. At 60 postnatal days, the brains of the offspring were analyzed qualitatively and quantitatively and compared with those of nonirradiated animals. Mice irradiated at E16 were all acallosal. Those that were exposed to 2 Gy displayed an aberrant longitudinal bundle typical of other acallosals, but this was not the case in those irradiated with 3 Gy. The corpus callosum of animals irradiated at E17 with 3 Gy was pronouncedly hypotrophic, but milder effects were observed in the other groups. Quantitative analysis confirmed a dependence of callosal midsagittal area upon dose and age at irradiation, and, in addition, indicated an interaction between these variables. The neocortex of irradiated animals was hypotrophic: layers II III were much more affected than layer V, and this was more affected than layer VI. Quantitative analysis indicated that this effect also depended on dose and age at irradiation and that it was due to a loss of cortical neurons. Furthermore, a positive correlation was found between the number of neurons within layers II-III, and V and the midsagittal area of the corpus callosum. Ectopic neurons were found in the white matter and in layer I of animals irradiated at E16 and E17, indicating that fetal exposure to ionizing radiation interfered with the migration of cortical neuroblasts. PMID- 3680629 TI - Central projections of the glossopharyngeal and vagal nerves in the channel catfish, Ictalurus punctatus: clues to differential processing of visceral inputs. AB - Transganglionic transport of horseradish peroxidase was used to trace the pattern of medullary terminations of the glossopharyngeal and vagal nerve complex in the channel catfish, Ictalurus punctatus. The glossopharyngeal root terminates centrally in the anterior end of the vagal lobe except for two fascicles that terminate in separate regions of the nucleus intermedius of the facial lobe. Vagal nerve branches innervating regions of the oropharynx terminate in an overlapping, segmental fashion throughout the ipsilateral vagal lobe and the nucleus intermedius of the vagal lobe. The descending branch of the vagus, innervating the abdominal viscera, terminates in the general visceral nucleus and in the nucleus intermedius of the vagal lobe. In addition, abdominal visceral fibers decussate through the commissural nucleus of Cajal and terminate in the general visceral nucleus of the contralateral side. Efferents included in the oropharyngeal and abdominal branches of the vagus also originate from two morphologically separable populations of motor neurons. PMID- 3680630 TI - Topographic representation of the sensory and motor roots of the vagus nerve in the medulla of goldfish, Carassius auratus. AB - The coelomic root of the vagus nerve in goldfish is connected with sensory and motor nuclei of the medulla that are distinct from those serving the orobranchial roots of the same nerve. The primary sensory nucleus for coelomic sensation is itself divisible into medial and lateral subnuclei on the basis of afferent input and immunocytochemistry. The lateral subnucleus receives sensory input from the specialized chewing organ in the posterior pharynx and is poor in both substance P-like and tyrosine-hydroxylase-like immunoreactivities. The medial subnucleus receives input from the subdiaphragmatic gastrointestinal tract and is rich in substance P-like and tyrosine-hydroxylase-like immunoreactivities. The primary sensory fibers that innervate the gastrointestinal tract also project directly to the area postrema and to the vicinity of subdiaphragmatic visceral motor neurons. The vagal motor neuronal pool is divisible into three columns: paramedian (cardiac), medial, and lateral. The paramedian group innervates the heart and is situated in a loosely aggregated column at the boundary zone between the ventricular ependyma and the underlying brainstem. The medial vagal motor neurons innervate the subdiaphragmatic viscera, while the lateral column motor neurons innervate the posterior pharynx and muscles of the chewing organ. The motor neurons in this motor column are arranged in a topographic rostrocaudal order within the motor column according to the muscle of innervation. Thus both the general visceral sensory and general visceral motor nuclei of the medulla are organized into functional domains. Furthermore, in the goldfish, the special visceral (gustatory) and general visceral sensory nuclei form a continuous series in the medulla with the external and oral systems represented anteriorly and the pharyngeal and digestive systems represented posteriorly. PMID- 3680631 TI - Relationship between natural variations in motoneuron number and body size in Xenopus laevis: a test for size matching. AB - During normal development, tadpoles of Xenopus laevis demonstrate large variations in body size that are carried through metamorphosis. This variation in size exists at the stages when lumbar lateral motor column (L-LMC) motoneurons are produced and when neuronal cell death in this neuron population occurs. Body size, hindlimb size, motoneuron number, and motoneuron size (i.e., neuron nuclear cross-sectional area) were measured in animals from three developmental stages: one prior to significant amounts of cell death, one at the peak rate of cell death, and one after cell death. The hypothesis that neuron population size is matched to peripheral size was tested by using the natural size variation found at each of these stages. The ranges of values for the measurements at the three stages were large. Significant correlations between body size and motoneuron number, as well as between motoneuron number and muscle fiber number, were present after cell death. Since these correlations emerged as cell death reduced neuron numbers, size matching may have occurred and cell death may have adjusted the L-LMC motoneuron population's size to variation in body size. In addition to the correlations between body size and motoneuron number at the end of cell death, neuron numbers before and after cell death were significantly correlated among groups of siblings. The possibility that the number of neurons after cell death was also influenced by differences in the number of L-LMC progenitors is discussed. PMID- 3680632 TI - Ultrastructural identification of synaptic terminals from the axon of type 3 interneurons in the cat lateral geniculate nucleus. AB - Synaptic terminals from the axons of type 3 neurons in the A-laminae of the cat LGN impregnated with the Golgi gold-toning procedure were examined at light and electron microscopic levels. The axons were identified by their somatic origin, thin diameter, and, in one of these cells, by dense undercoating beneath the axolemma, which is a known characteristic of the axon initial segment. The axon of one of the analyzed cells was profusely branched and extended throughout most of lamina A within the dendritic domains of the cell, and both types of processes were oriented along projection lines in LGN. This suggests that the dendrites and axons of type 3 cells receive inputs and exert effects, of probably inhibitory nature, within restricted retinotopic regions of LGN. The vast majority of the axon terminals of these cells were distributed in series along axonal branches. In one of the type 3 cells, however, a dense cluster of terminals arising from a secondary axonal branch was observed. Ultrastructurally, the analyzed synaptic terminals of the type 3 cells contained flattened or pleomorphic synaptic vesicles, dark mitochondria, and established synapses that appeared to be of symmetrical type when the membranes were perpendicularly cut. On the basis of these characteristics these terminals are classified as F boutons, following Guillery's (Z. Zellforsch. 96:1-38, '69), nomenclature. The postsynaptic elements to the axon terminals were dendrites of small to medium size, which received "en passant" synaptic contacts in extraglomerular regions of the geniculate neuropil by the terminals distributed in series. The axon terminals located in clusters, however, made synapses with dendrites in glomerular regions of the neuropil, where they were not seen postsynaptic to retinal or other types of terminals. This is in contrast to the postsynaptic nature of F2 boutons in the same glomeruli, which have been identified as dendritic appendages of the GABA positive type 3 neurons in the cat LGN (Montero: J. Comp. Neurol. 254:228-245, '86). On the other hand, the axonal F terminals differ from F1 boutons in terms of synaptic relations and ultrastructure, since the latter have been shown to be presynaptic to F2s and somata and to contain crowded populations of flat synaptic vesicles which give them a characteristic dark appearance. Terminals equivalent to F1 boutons have been shown to originate from perigeniculate cells in the rat LGN. From these observations it is suggested that the geniculate GABAergic interneurons support two morphologically and functionally different type of inhibitory terminals synapsing the dendrites of relay cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680633 TI - Exogenous matrix precursors promote functional nerve regeneration across a 15-mm gap within a silicone chamber in the rat. AB - When silicone regeneration chambers are implanted empty, axonal regeneration fails if the interstump gap length is greater than 10 mm. Previous experiments using the 10-mm gap model demonstrated that regeneration success correlated with the dimension and/or consistency of the naturally formed acellular fibrin matrix. Both spatial and temporal parameters of regeneration could be stimulated through modifications of the fibrin matrix by prefilling the chambers at the time of implantation either with phosphate-buffered saline or plasma dialyzed against phosphate-buffered saline. In the present experiments, similar modification of matrix formation was found to promote successful regeneration across 15-mm and 20 mm interstump gap lengths. In addition, prefilling 15-mm-gap chambers with dialyzed plasma resulted in a 3.5-fold increase in the incidence of functional restitution detected at 8 weeks after implantation over the outcome with chambers prefilled with phosphate-buffered saline. PMID- 3680634 TI - Primary neurons of the lateral line nerves and their central projections in hagfishes. AB - The hagfish lateral line system was studied by horseradish peroxidase transganglionic transport. The anterior lateral line nerve innervates the group of lateral line canals situated anteriorly to the eye, and the posterior lateral line nerve innervates the group of canals situated posteriorly to the eye. Although both nerves pass through the muscle fascia at the same point, each runs a different course to the brain. The anterior lateral line nerve runs near the trigeminal nerve and its ganglion is closely attached to the trigeminal ganglion, but both systems are completely independent. The posterior lateral line nerve runs independently of any other cranial nerve and makes a peculiar U-turn at the point of entry to the brain capsule. The anterior lateral line ganglion contains both cutaneous sensory cells (small to large cells) and lateral line sensory cells (small cells); from this ganglion projections run to both the trigeminal sensory nucleus (fine and thick fibers) and medial nucleus of the area acousticolateralis (fine fibers). The posterior lateral line ganglion contains only small lateral line cells that project fine fibers to the medial nucleus of the area acousticolateralis. There are no efferent components in this lateral line system, and its only afferent terminal field is the medial nucleus of the area acousticolateralis. PMID- 3680635 TI - Cellular and synaptic morphology of a feeding motor circuit in Aplysia californica. AB - The cellular and synaptic morphology of a component of the feeding motor circuit in Aplysia californica was examined with light and electron microscopic techniques. The circuit consists of a pair of inhibitory premotor interneurons, B4 and B5, as well as two motoneurons, B15 and B16, which innervate the accessory radula closer muscle. The neurons have wide, varicose arborizations in the buccal ganglion neuropil. All four of these neurons are cholinergic, and in addition, B15 contains immunoreactivity to sera raised against small cardioactive peptide B. Varicose processes in the accessory radula closer muscle are immunoreactive with antisera against several neuropeptides. We identified specific neuromuscular junctions by visualizing horseradish peroxidase uptake in recycled synaptic vesicles. Direct innervation of the accessory radula closer muscle by B15 and B16 is demonstrated by experiments in which horseradish peroxidase is transported from motoneuronal soma to the terminals on muscle fibers. In addition, specific synaptic contacts between B4 and B5 and each of the motoneurons are observed in the buccal ganglion neuropil. Finally, multiple contacts consistent with peptidergic, serotoninergic, and cholinergic synapses are made onto the neurons, suggesting that a variety of transmitters modulate motor output at each level of the hierarchical circuit. These results support the physiological evidence suggesting the involvement of neuropeptides as well as "classical" transmitters in the modulation of circuitry governing feeding behavior in Aplysia. PMID- 3680637 TI - Response of septal cholinergic neurons to axotomy. AB - In the present study we employed quantitative morphometric techniques to assay the response of septal cholinergic neurons following unilateral transection of the fimbria/fornix and supracallosal stria. Analysis of 50-micron-thick tissue sections with a Quantimet 920 image analysis system demonstrated a reduction in ChAT immunoreactivity as early as 1 day following denervation. This decrease was associated with a drop in the number of labeled cells ipsilateral to the lesion and a decrease in the area of cholinergic perikarya on the lesioned and nonlesioned side of the septum. The response at 1 day, however, was transient, and at 4 days the number of labeled neurons was not significantly different from controls. By 8 days we observed a dramatic reduction in the number and size of ChAT-positive cells ipsilateral to the lesion and a reduction in the size of cholinergic perikarya on the contralateral (i.e., nonlesioned) side. These values persisted throughout the remainder of the study. To assess more completely the morphologic response of neurons to axotomy than can be determined in 50-micron thick tissue sections, we embedded the adjacent immunolabeled tissue section in Epon and then serially sectioned it to a thickness of 0.75-1.0 micron. By using this method, we were able to measure the area, length, and width of the cell, the area of the nucleus and nucleolus, and the position of the nucleus (i.e., eccentricity). Measurements were performed on ChAT-labeled and nonlabeled cells. The results of our studies demonstrate that cholinergic and noncholinergic cells responded to axotomy in a characteristic yet different fashion from each other and that this response could be quantitatively assayed. In general, labeled and nonlabeled cells on the lesioned side of the septum shrink in response to denervation. This shrunken state was reflected in measurements of cellular area, length, width, and nuclear area. Moreover, other measurements of cellular morphology (i.e., area of the nucleolus, position of the nucleus) indicate that none of the neuronal populations examined in the present study displayed morphologic evidence of regeneration. Our results indicate a dramatic loss of cholinergic perikarya ipsilateral to the lesion. Moreover, although a few neurons do persist they do so in a shrunken state. These data provide an essential baseline for the second study in this series, which will evaluate the effect of nerve growth factor on the survival of denervated septal neurons. PMID- 3680636 TI - The entorhinal cortex of the monkey: III. Subcortical afferents. AB - The subcortical afferent connections of the entorhinal cortex of the Macaca fascicularis monkey were investigated by the placement of small injections of the retrograde tracer wheat germ agglutinin conjugated to horseradish peroxidase into each of its subdivisions. Retrogradely labeled cells were observed in several subcortical regions including the amygdaloid complex, claustrum, basal forebrain, thalamus, hypothalamus, and brainstem. In the amygdala, labeled cells were observed principally in the lateral nucleus, the accessory basal nucleus, the deep or paralaminar portion of the basal nucleus, and the periamygdaloid cortex. Additional retrogradely labeled cells were found in the endopiriform nucleus, the anterior amygdaloid area, and the cortical nuclei. Retrogradely labeled cells were observed throughout much of the rostrocaudal extent of the claustrum and tended to be located in its ventral half. In the basal forebrain, retrogradely labeled cells were observed in the medial septal nucleus, the nucleus of the diagonal band, and to lesser extent within the substantia innominata. Several of the cells in the latter region were large and located within the densely packed neuronal clusters of the basal nucleus of Meynert. Most of the labeled cells in the thalamus were located in the midline nuclei. Many were found in nucleus reuniens, but even greater numbers were located in the centralis complex. Additional labeled cells were located in the paraventricular and parataenial nuclei. In all cases, numerous retrogradely labeled cells were observed in the medial pulvinar. In the hypothalamus, most of the retrogradely labeled cells were located in the supramamillary area, though scattered cells were also observed in the perifornical region and in the lateral hypothalamic area. Caudal to the mamillary nuclei there were labeled cells in the ventral tegmental area. There were relatively few labeled cells in the brainstem and these were invariably located either in the raphe nuclei or locus coeruleus. PMID- 3680638 TI - Organization of radial glial cells during the development of the rat dentate gyrus. AB - The temporal and spatial patterns of development of radial glial processes in the rat dentate gyrus have been studied in immunohistochemical preparations stained for the presence of either the glial fibrillary acidic protein (GFAP) or the vimentin-associated antigen R4. Additional electron microscopic (EM) observations were made from material prepared either immunohistochemically or by the Golgi method. R4 immunoreactive radial fibers were observed in the incipient dentate gyrus as early as E13 and by E14 the density of stained fibers was clearly higher in the anlage of the dentate gyrus than in the adjacent hippocampus. By E15 it was possible to identify in the EM the endfeet of radial glial cells that contained numerous glycogen particles. GFAP-positive radial processes were first observed on E17; these processes tended to be of larger diameter than those stained with the R4 antibody, suggesting that they were among the more mature processes. The orientation of both the R4- and GFAP-positive glial processes changed throughout the last week of embryonic life and by the end of the first postnatal week they formed a complex meshwork of intertwined processes. The distribution of their cell bodies also changed with time; initially their perikarya were located in the neuroepithelium at the lateral margin of the hippocampal primordium; later they were found mainly beneath the granule cell layer. Dividing cells that contained GFAP were observed along the trajectory of the migrating granule cell precursors and in the hilus of the dentate gyrus; at later stages some GFAP-positive mitotic figures were seen within and immediately below the granule cell layer. On the basis of these observations, we have attempted to reconstruct the role that radial glial processes play in the morphogenesis of the dentate gyrus. First, radial processes extend from the neuroepithelium to the pial surface prior to the migration of neurons that will form the dentate gyrus. These early generated glia appear to form the boundaries of the developing dentate gyrus and provide an internal lattice that may guide the initial wave of migrating progenitor cells. As the dentate gyrus enlarges, these early formed processes maintain their contacts along the hippocampal fissure and along the pial surface of the dentate anlage. Thus, with time they become increasingly distorted and are ultimately compressed into two bundles; one lies deep to the hippocampal fissure parallel to the granule cell layer and the other is located at the fimbriodentate juncture.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680639 TI - Oculomotor system of the weakly electric fish Gnathonemus petersii. AB - The peripheral and central aspects of the extraocular system were studied in the weakly electric fish Gnathonemus petersii. All six extraocular muscles show a similar composition of large and small fibers grouped characteristically in the proximal and distal regions respectively. The exit of the three extraocular nerves from the brain is similar to that in other vertebrates. However, the intracephalic and intracranial course of the trochlear nerve is unusual, partly because of the extraordinary hypertrophy of the cerebellum. The three nerves course rostrally on the ventral brain surface; the trochlear nerve penetrates the orbital cavity separately from the two other nerves. The fiber-diameter spectrum of each extraocular nerve is bimodal; unmyelinated fibers were not observed in any of the nerves. The location of the extraocular motor nuclei was established by retrograde axonal transport of HRP or cobaltic-lysine complex. The oculomotor nucleus is situated ventral to the posterior pole of the magnocellular mesencephalic nucleus and the trochlear nucleus is found caudal and dorsal to this. The abducens nucleus is situated at the level of the octavolateral efferent nucleus and consists of a single group of cells on each side of the ventral tegmentum. The oculomotor nucleus of G. petersii shows a somatotopic organization. The superior rectus muscle receives a contralateral innervation whereas the inferior rectus and oblique muscles and the internal rectus muscles receive an ipsilateral innervation. The superior oblique muscle is innervated by contralateral trochlear motoneurons and the external rectus by ipsilateral abducens motoneurons. The majority of extraocular motoneurons have piriform perikarya and long beaded dendrites that extend laterally in the oculomotor and abducens nuclei and rostrally in the trochlear nucleus. The terminal dendritic portions of trochlear motoneurons widely overlap with oculomotor dendrites and perikarya. In all three nuclei the axon originates opposite to the main dendrite. Collaterals of the hairpin-bend abducens axons could be identified in a few cases. The oculomotor system of G. petersii appears basically similar to that of other teleosts; the differences observed concern mainly the structure of the abducens nucleus, the intracranial and intracephalic course of the trochlear nerve, and the relatively small number of axons in each nerve. PMID- 3680640 TI - Immunocytochemical studies of vasotocin, mesotocin, and neurophysins in the Xenopus hypothalamo-neurohypophysial system. AB - Mesotocinergic and vasotocinergic neurons, which constitute the principal neurons in the hypothalamo-neurohypophysial system in Xenopus, were studied by immunocytochemical techniques. Antibodies that could unequivocally distinguish mesotocin, vasotocin, and their respective neurophysins were used in these studies. A monoclonal antibody directed at rat oxytocin-associated neurophysin (PS-36) detected an antigen that was colocalized with vasotocin, whereas a monoclonal antibody to rat vasopressin-associated neurophysin (PS-45) crossreacted with an antigen in mesotocinergic cells. As vasotocin is regarded as an evolutionary precursor of vasopressin, and as mesotocin is usually associated with oxytocin, we were surprised to see this apparent eptitope switch in the associated neurophysins. One interpretation of this epitope switch is that the final exons encoding for the carboxy-terminals of the mammalian neurophysins, which contain the PS-45 and PS-36 antibody epitopes, are in reversed positions in Xenopus. Approximately 4,000 mesotocinergic and vasotocinergic neurons and their fibers were topographically mapped in the Xenopus hypothalamus. The two types of neurons were intermingled and scattered throughout a large contiguous region including but not limited to the preoptic recess. Small, medium size, and large cells contained these antigens. Immunoreactive fibers were seen in the preoptic area, the neurohypophysial tract, the median eminence, and the neural lobe of the pituitary. The neurophysin-specific monoclonal antibodies have several advantages as phenotypic markers in development; i.e., high titer, low background, and affinity for the prohormone forms as well as for the fully processed neurophysin polypeptides. Their antigens are related gene products whose expression is central to the identity of the two cell types and whose expression is differentially controlled in development. This characterization of their adult distribution provides a basis for future studies of the development of peptidergic phenotype in the central nervous system of Xenopus. PMID- 3680641 TI - Morphological characteristics of low-threshold primary afferents in the trigeminal subnuclei interpolaris and caudalis (the medullary dorsal horn) of the golden hamster. AB - Intra-axonal recording and horseradish peroxidase (HRP) injection techniques were employed to define the response characteristics of low-threshold, rapidly conducting trigeminal primary afferents and the morphological features of their axon arbors in subnucleus interpolaris and subnucleus caudalis (or the medullary dorsal horn; these last two terms are used synonomously throughout the paper). A total of 61 such afferents were characterized and recovered. Of these, ten gave rapidly adapting (RA) and 17 slowly adapting (SA type I) responses to vibrissa deflection. Twenty were sensitive to guard hair deflection and 14 were responsive to indentation of the hairy skin. The vibrissa-sensitive primary afferents were all quite similar morphologically. Primary collaterals proceeded directly, in a radial fashion, to their zone of termination and gave rise to dense and compact arbors. These tended to be larger in the medullary dorsal horn (MDH) than in interpolaris and they also gave rise to more boutons in the former nucleus. Guard hair afferents generally had smaller arbors and gave rise to fewer boutons than vibrissa-sensitive axons. Like vibrissa afferents, their arbor were generally circumscribed in both interpolaris and MDH, but they were larger in the latter nucleus. Skin-sensitive afferents had arbors that tended to be somewhat larger than those of vibrissa- or guard-hair-related fibers. Unlike the other fiber types, the arbors of skin-sensitive afferents were on average larger in interpolaris than MDH. Quantitative analysis of the morphological data from well filled examples from each of these four functional types verified our qualitative impressions regarding differences between interpolaris and MDH collaterals of a given fiber-type. Statistical comparison of data from different functional classes indicated trends that supported our qualitative impressions, but none of these was statistically significant. The topography of the trigeminal primary afferent input to interpolaris was organized such that the head was inverted and fibers with caudal receptive fields terminated in the lateral portion of the nucleus. This was true for all of the functional afferent types that we examined. Vibrissa-related fibers differed from nonvibrissa afferents in that they tended to avoid the most rostral portion of interpolaris. In the MDH, the primary afferent representation of the head was also inverted, but fibers with caudal facial receptive fields tended to terminate medially rather than laterally.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680642 TI - The laboratory identification of serum antinuclear antibody in the dog. AB - An indirect immunofluorescence test with sections of rat liver as a substrate, proved useful in detecting antinuclear antibodies (ANA) in the dog. A specific anti-canine IgG reagent conjugated with fluorescein isothiocyanate was used. A proportion of normal dogs gave positive reactions at low titres. The presence of ANA was one of the criteria used to diagnose canine systemic lupus erythematosus. Some dogs within a general hospital population were also positive for the auto antibody. The indirect immunofluorescence test with Trypanosoma brucei as a substrate was insensitive. The LE-cell test was laborious and insensitive. A commercial latex slide agglutination test used for detecting ANA in man gave false positive and false negative results in the dog. A commercial radioimmunoassay used in man gave many false positive results. A similar assay with synthetic DNA gave encouraging results and is worthy of further study. PMID- 3680644 TI - A myopathy associated with muscle hypertonicity in the Cavalier King Charles Spaniel. AB - Clinical signs of electrically silent muscle hypertonicity are described in five Cavalier King Charles dogs. Biopsies of the biceps femoris and triceps muscles, when examined with the electron microscope, revealed evidence of sarcotubular and mitochondrial abnormalities. These included enlargement of the sarcoplasmic reticulum, hydropic degeneration of mitochondria, tubular proliferations in the vicinity of the triads and vacuolar invagination of mitochondria. The exact nature of these findings is not clear and it is suggested that utilization of tracer techniques would help to explain them. PMID- 3680643 TI - The laboratory identification of serum rheumatoid factor in the dog. AB - A modified Rose-Waaler test with sheep red blood cells coated with canine IgG was found satisfactory for detecting rheumatoid (antiglobulin) factor (RF) in dog serum. Low titres of RF were found in some normal dogs. Most dogs with rheumatoid arthritis were positive for RF at titres of 1 in 40 or greater. A small proportion of dogs with diseases other than polyarthritis were also positive for RF. A commercial slide agglutination test used for detecting human RF was unsatisfactory for the dog, giving false positive and negative reactions. A latex tube agglutination test with latex particles coated with dog IgG was developed but non-specific agglutination was a constant technical problem. PMID- 3680645 TI - The histological features of the immune system of the equine respiratory tract. AB - The distribution of mucosa-associated lymphoid tissue along the equine respiratory tract was surveyed in light microscopical sections. Intra-epithelial lymphocytes and similar cells scattered in the lamina propria were identified in all sites from the nasal vestibule to bronchioles of 2 to 4 mm diameter. Isolated lymphoid patches, occasionally with nodules, were common in bronchioles, but the density of this bronchiole-associated lymphoid tissue (BRALT) varied between individual horses. Bronchus-associated lymphoid tissue (BALT) was infrequently encountered. In the upper respiratory tract, nodules dispersed within the nasal cavity, nasopharynx and near the auditory tube merit the collective term, nasal associated lymphoid tissue (NALT). Laryngeal- and tracheal-associated lymphoid tissue (LTALT) was also identified, but this was limited to the epiglottis, arytenoid and rostral trachea. At all sites, the discrete lymphoid masses comprise primary or secondary nodules, a parafollicular and a dome area. The airway lining above was frequently modified into a lympho-epithelium and also showed varied patterns of infolding which might enhance antigen trapping. PMID- 3680646 TI - Juvenile renal disease in the Doberman Pinscher: ultrastructural changes of the glomerular basement membrane. AB - Ten cases of juvenile renal disease in Doberman Pinschers were examined by light microscopy and 8 of them additionally by electron microscopy. Two distinct basic ultrastructural lesions of the glomerular basement membrane (GBM) were observed. One is characterized by lamellation of the lamina densa with intramembranous focal areas of lucency containing electron-dense particles, the second by diffuse attenuation of the lamina densa with intramembranous and/or subendothelial deposition of matrix entrapping cross-banded fibres (collagen). Based on similar ultrastructural changes in other hereditary nephropathies in man and dogs, a metabolic or biochemical basis for the structural lesions is suspected. PMID- 3680647 TI - Myopathy with core-like structures in a dog. AB - Core-like structures were seen histologically in many of the fibres of the triceps and biceps femoris muscles of an 18-months-old male Great Dane with muscle weakness and moderate proximal muscular atrophy. The structures were lightly staining and lacked cross-striations. Some contained vacuoles and nuclei. Scattered necrotic and presumably regenerating fibres were also present. Ultrastructurally, the cores contained disarrayed filament bundles attached to thickened Z-lines which were compatible with the rods of rod myopathies. The condition was not fully characterized, but has certain similarities to a group of rare human congenital muscular disorders which includes central core disease. PMID- 3680648 TI - Cystic mucinous hyperplasia in the gallbladder of a ferret. AB - An 8-year-old male ferret had icterus, hepatomegaly and an enlarged gallbladder. Microscopically, the gallbladder had numerous mucinous cysts and papillary hyperplasia of the mucosa, consistent with a diagnosis of cystic mucinous hyperplasia. No previous published reports of this condition in ferrets were found. PMID- 3680649 TI - Ultrastructure of a canine gastrinoma. PMID- 3680650 TI - Cutaneous lymphosarcoma with abnormal chromosomes in a dog. AB - A poorly differentiated cutaneous lymphosarcoma with delayed multicentric anatomical distribution was diagnosed in a dog. The neoplasm had cells with chromosome numbers of 58 or 67 and the former cells lacked the subtelocentric marker chromosome seen in cells of canine transmissible venereal tumour with 58 chromosomes. PMID- 3680651 TI - Polycystic liver disease in golden hamsters. AB - Seven cases of multiple hepatic cysts of varying sizes and shapes were recorded in a closed colony of golden hamsters. Ante-mortem examination failed to show any clinical signs except for abdominal enlargement in one hamster. Multiple, thin walled cysts of varying sizes (0.25 to 3.0 cm) and shape were observed in the liver. The larger cysts protruded from the liver surfaces and contained a colourless, clear, serous fluid and caused pathological change in 5-60 per cent of the hepatic parenchyma. Microscopically, the cysts were uni- or multilocular and lined by low cuboidal or flattened epithelial cells. The hepatic parenchyma around cysts showed pressure atrophy, necrosis, engorged sinusoids or other blood vessels or even haemorrhages, mild to extensive fatty or vacuolar degenerative changes and occasionally proliferation of biliary ducts. PMID- 3680653 TI - Dermatologic findings associated with human immunodeficiency virus infection. AB - Both human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are associated with an increased prevalence of several dermatologic diseases. We studied healthy homosexual men with negative reactivity to HIV antibody, homosexual men without AIDS but with positive reactivity to HIV antibody, and homosexual men with AIDS to compare the prevalence of dermatologic disease in these groups. We found that five cutaneous disorders were increased in persons with HIV infection. Oral hairy leukoplakia was increased both in seropositive subjects without AIDS and in subjects with AIDS. Condylomata acuminata and seborrheic dermatitis were slightly increased in seropositive non AIDS subjects and significantly increased in the AIDS group. Molluscum contagiosum and oral candidiasis were increased only in the AIDS group. PMID- 3680652 TI - Basal cell epithelioma in black patients. AB - The occurrence of cutaneous carcinoma in black patients is an unusual phenomenon, with basal cell carcinoma being particularly uncommon. We present five cases of basal cell epithelioma in black patients collected from the Texas Medical Center to graphically illustrate the varied and often atypical clinical presentations of such tumors. This report supports recent series of basal cell epithelioma in black patients derived from retrospective chart reviews. PMID- 3680654 TI - Photosensitive psoriasis. An epidemiologic study. AB - In this study of photosensitivity among psoriasis patients, a questionnaire was mailed to 2000 psoriasis patients living within the service area of Karolinska Hospital, Stockholm. Of the 88% patients who replied, 4.4% stated that their psoriasis always worsened after sun exposure, and 7.3% stated that this was sometimes so. After telephone interviews with an 80% sample of these allegedly photosensitive patients, half of them were considered nonphotosensitive. Thus an estimated prevalence of 5.5% photosensitivity was obtained. Forty-three percent of the light-sensitive patients had a history of polymorphous light eruption with secondary exacerbation of psoriasis lesions. Comparison between the photosensitive and the nonphotosensitive patients concerning background factors and symptoms showed a statistically significant increase (p less than or equal to 0.001) in the photosensitive group concerning skin type I, psoriasis affecting hands, heredity for photosensitivity, and advanced age. PMID- 3680655 TI - Sporotrichoid leishmaniasis in patients from Saudi Arabia: clinical and histologic features. AB - The clinical and pathologic presentations of cutaneous leishmaniasis in the various countries of the Middle East are well documented. The defined patterns currently encountered in the region emphasize the rarity of local extension of the infection from the bite site. Between 1970 and 1980 we have seen 24 patients with cutaneous leishmaniasis who acquired the infection in Saudi Arabia. In these patients there were several interesting variations from the hitherto described patterns of Oriental sore. The variations include, clinically, the appearance of satellite lesions and the presence of sporotrichoid spread of infection; and histologically, the presence of stellate intradermal abscesses. Such variations in the clinical and pathologic presentations may be due to differences either in the host's immunologic reactivity or in the Leishmania organisms found in Saudi Arabia. Speculative evidence supports the possibility of a different strain and/or species of Leishmania tropica in Saudi Arabia, which in turn may be responsible for this unique clinicopathologic presentation. PMID- 3680656 TI - Use of a combination of chemotherapy and radiation therapy in the management of advanced basal cell carcinoma of the head and neck. AB - A series of patients with massive rodent-type basal cell carcinoma of the head are presented as having therapeutic responses with chemotherapy combined with radiation therapy ranging from partial to complete response. No cases were cured by the regimen. The nature of large basal cell carcinomas of the head and treatment philosophy for surgically unresectable tumor are discussed. PMID- 3680657 TI - Etretinate therapy reduces inpatient treatment of psoriasis. AB - Twenty-six patients with a history of hospitalization for severe psoriasis were evaluated with regard to their use of inpatient therapy before and during therapy with etretinate. The duration of the pretherapy period and the etretinate treatment period averaged 5 and 4 years, respectively. Use of etretinate nearly eliminated inpatient therapy among these patients. Twelve of the patients stopped etretinate; their use of hospitalization for psoriasis remained below pre etretinate levels in the two years after etretinate therapy was stopped. Etretinate therapy represents an effective and economical alternative to hospitalization for psoriasis treatment. PMID- 3680659 TI - Alopecia areata and measles. PMID- 3680658 TI - Blast tattoos resulting from black powder firearms. AB - Blast tattoos occur when fragments of gunpowder are propelled into the skin during a firearm discharge. This unusual type of injury is often associated with accidents involving replica firearms. Some of the more superficially embedded powder fragments may be removed with dermabrasion; however, deeper fragments may cause permanent tattooing. Blast injuries to the face also have the potential of causing permanent eye injury. PMID- 3680660 TI - Melasma occurring in twin sisters. PMID- 3680661 TI - Hair bulb anomaly in a Japanese girl with uncombable hair. PMID- 3680662 TI - Tar: an ultraviolet B screen. PMID- 3680663 TI - Epidermolysis bullosa responds to vitamin E when properly administered. PMID- 3680664 TI - Atypical nevi and melanoma update at American Academy of Dermatology meeting, December 1986. PMID- 3680665 TI - Dysplastic nevus syndrome and cancer risk--response. PMID- 3680666 TI - Toxic epidermal necrolysis due to cephalexin. PMID- 3680667 TI - Ear piercing and sensitivity to nickel and gold. PMID- 3680668 TI - Etretinate and premature epiphyseal closure in children. PMID- 3680669 TI - Fire extinguishing systems and electrosurgery. PMID- 3680670 TI - Sporotrichoid leishmaniasis: report of a case in an American graduate student. PMID- 3680671 TI - Epidermolysis bullosa acquisita associated with lymphoma. PMID- 3680672 TI - Antibiotic choice for pyodermas. PMID- 3680674 TI - Unhook me. PMID- 3680673 TI - Efamol in the treatment of atopic dermatitis. PMID- 3680675 TI - Autofluorescence of clofazimine in discoid lupus erythematosus. AB - A 70-year-old woman developed dark reddish blue pigmentation in scarred areas of discoid lupus erythematosus after taking clofazimine intermittently over a period of 10 years. Although light microscopy of routinely processed tissue failed to define the cause of the pigment, fluorescent microscopy showed vivid red deposits concentrated around larger vessels within the dermis. These deposits were shown to correspond to birefringent red clofazimine crystals on fresh frozen sections. Although the hyperpigmentation may clinically resemble melanin, biopsy specimens from our patient revealed a loss of melanin pigment in lesional skin, suggesting a primary role for clofazimine in producing the color changes observed. PMID- 3680676 TI - Acrokeratoelastoidosis treated with etretinate. AB - Acrokeratoelastoidosis is a chronic condition manifested by acral hyperkeratotic papules. There have been no reports of effective treatment. We report a case that responded to etretinate. PMID- 3680677 TI - Malignant papillary mesothelioma of the tunica vaginalis testes: cutaneous metastases showing pagetoid epidermal invasion. AB - Malignant papillary mesothelioma of the tunica vaginalis testis is an extremely rare tumor arising from the mesothelium of the tunica vaginalis. A total of 14 cases have been reported, with only two exhibiting cutaneous metastases. We present a third case of cutaneous metastases arising from this unusual tumor. In addition, this is the first reported case of the occurrence of pagetoid epidermal invasion in this condition. PMID- 3680678 TI - Agminated neurilemomas. AB - This report reviews two cases of multiple localized (agminated) intradermal neurilemomas that clinically mimicked a granulomatous dermatitis. The cutaneous lesions occurred in the second decade of life as firm papules on the chin and the lower part of the leg, respectively. Features of neurofibromatosis and neurilemomatosis were absent. PMID- 3680679 TI - Immunohistochemical studies of major histocompatibility antigens in a case of the bare lymphocyte syndrome without immunodeficiency. AB - A case of the bare lymphocyte syndrome without apparent immunodeficiency was observed. The patient had, in addition, ichthyosis vulgaris and sinobronchial disease. A pustular lesion developed at first on the anterior aspect of lower part of the left leg. This lesion gradually increased in size and evolved into giant indurated, irregular adjoining plaques. On biopsy, the histologic findings were similar to necrobiosis lipoidica. No human lymphocyte antigen (HLA) class I antigens were detected on peripheral mononuclear cells; however, HLA-DR antigens were present on B lymphocytes. Immunohistochemical studies disclosed defective expression of class I antigens in the non-lesional skin, but positive expression was demonstrated in the lesional area. HLA-DR antigens were expressed on keratinocytes and on most infiltrating inflammatory cells in the affected skin. It is therefore speculated that class I antigen appearance and mononuclear cell infiltrate each induces the other and that together they play an important role in the formation and enlargement of the skin lesion. PMID- 3680680 TI - Nodular secondary syphilis mimicking cutaneous lymphoreticular process. AB - We hereby report a case presenting a rare form of secondary syphilis with an unusual nodular eruption accompanied by pruritus and generalized lymphadenopathy, bearing a striking resemblance to lymphoma. The histologic picture was also misleading and was compatible with lymphocytoma cutis. The diagnosis was eventually made after results of serologic tests for syphilis were found to be positive, with an extremely high titer of VDRL, and dark-field microscopy had demonstrated spirochetes in a nodular lesion. Secondary syphilis should thus be considered in the differential diagnosis of nodular lesions resembling lymphoreticular disease. It is also suggested that syphilis be added to the list of diagnoses belonging to the category of pseudolymphoma. PMID- 3680681 TI - Penicillin-induced generalized pustular psoriasis. AB - We describe a case of penicillin and penicillin-related drugs that induced severe generalized pustular psoriasis on several different occasions in a young patient known to have suffered from recalcitrant psoriasis since childhood. PMID- 3680682 TI - Computed tomography vs barium studies in the acutely symptomatic patient with Crohn disease. AB - Gastrointestinal contrast studies and CT performed on 43 patients with known Crohn disease with acute symptoms were retrospectively reviewed to assess the ability of each study to define the location and extent of disease. In 39 of 43 (91%) patients the contrast studies and CT agreed on the location of active disease. However, in 15 of 43 (35%) patients, contrast studies demonstrated additional areas of mucosal disease remote from the major area of activity that were not suggested by CT. In addition to demonstrating more extensive mucosal disease, contrast studies proved superior in demonstrating enteroenteric fistulae, sinus tracts, strictures, postsurgical anatomy, and relation of recurrence to anastomosis. Computed tomography proved superior in demonstrating mesenteric inflammation, abscesses, enterovesical and enterocutaneous fistulae, fistula to iliopsoas muscle and to sacrum. We conclude that in the patient with suspected abscess, enterovesical or enterocutaneous fistula, CT is the study of choice. In other clinical circumstances both CT and contrast studies should be performed since they are complementary. PMID- 3680683 TI - Pseudomembranous colitis: CT evaluation. AB - The CT findings in five patients with pseudomembranous colitis are presented. The findings consisted of varying degrees of bowel wall and haustral fold thickening. Ascites was noted in three patients. Clinically and radiologically, pseudomembranous colitis can be confused with other inflammatory disorders of the gastrointestinal tract. Although the CT findings were not pathognomonic, they were highly suggestive of pseudomembranous colitis when combined with the clinical information. PMID- 3680684 TI - Distinctive CT-findings of unusual mesenteric cysts. AB - The CT findings of a noncommunicating duplication cyst associated with the large intestine and a chylous cyst of the mesentery are presented. Although these are rare entities, CT findings may suggest the diagnosis by demonstrating peristaltic movement in a duplication cyst and a fat-fluid interface in a chylous cyst. PMID- 3680685 TI - Penetrating renal trauma: CT evaluation. AB - Mandatory surgical exploration of penetrating renal injuries has been advocated for adequate assessment and repair of renal and retroperitoneal injuries. We evaluated 27 consecutive patients with deep stab wounds of the flank and back who were thought to be at risk for renal injury. Twenty-two patients were studied by CT, 11 by excretory urography, and three by angiography. No correlation was found between the presence and amount of hematuria and the extent of renal injury. Excretory urography was also of little use; the extent of renal parenchymal injury was underestimated, overestimated, or indeterminate in many cases. Computed tomography gave an accurate assessment of the extent of parenchymal damage, perirenal hemorrhage, extravasation of urine, and extrarenal injuries. Angiography was rarely required to better define renal vascular injuries. Only seven patients required surgical repair; the 20 patients managed nonoperatively included seven patients with renal lacerations considered minor by CT evaluation. We conclude that most patients with penetrating trauma do not require surgical exploration. The combination of clinical and CT criteria allows confident management in almost all cases. Computed tomography should be the primary diagnostic study in patients with penetrating back or flank trauma judged to be at risk for renal or other retroperitoneal injury. PMID- 3680686 TI - Inferior vena cava pseudothrombus in computed tomography using a contrast medium power injector: a potential pitfall. AB - Of 276 patients undergoing CT using a power injector to deliver contrast material, 71 (26%) demonstrated a pseudothrombus in the suprarenal inferior vena cava. This occurs much more commonly than in patients injected by hand and is a potential pitfall in interpreting these scans. PMID- 3680687 TI - Infratemporal fossa meningioma: CT and MR findings. AB - We report an unusual case of an extracranial meningioma presenting as a large facial mass. The CT and magnetic resonance findings and a brief review of extracranial meningiomas are presented. PMID- 3680688 TI - Primary ectopic meningioma of the neck: MR features. AB - Although meningiomas represent 15% of the tumors of the CNS, primary ectopic meningioma is a very rare finding. Four mechanisms for the formation of ectopic meningioma have been suggested: (a) direct extension of an intracranial lesion; (b) distant metastasis from an intracranial meningioma; (c) origin from arachnoid cells within the sheaths of cranial nerves; and (d) origin from embryonic nests of arachnoid cells. The case we present underwent a complete neuroradiological screening, and, although the neuroradiological findings were nonspecific to provide a correct diagnosis, they were useful for assessment of the tumor extension and for surgical planning. Particularly, magnetic resonance gave a panoramic view of the tumor and suggested its extensive vascularization, which was confirmed later by angiography. PMID- 3680689 TI - MR imaging in a case of Hallervorden-Spatz disease. AB - Magnetic resonance using a 0.5 T system and a T2-weighted spin-echo pulse sequence revealed symmetric areas of marked hypointensity of the globi pallidi in a case with a family history of and presenting with clinical features consistent with Hallervorden-Spatz disease. No such findings were seen in any of 16 normal volunteers of similar age. Magnetic resonance may be useful for diagnosing Hallervorden-Spatz disease. PMID- 3680690 TI - Congested deep subcortical veins as a sign of dural venous thrombosis: MR and CT correlations. AB - Dural venous thrombosis can have a rapidly progressive fatal course if unrecognized; its clinical picture is often confusing. Numerous CT, magnetic resonance (MR), and angiographic findings have been described to help recognize this entity. We present a case of dilated transcerebral medullary veins as a sign of superior satittal sinus thrombosis with CT and MR correlation. PMID- 3680691 TI - MR imaging of thoracic disk herniations. AB - Magnetic resonance (MR) is of value in imaging intervertebral disk disease. We present the MR findings in two patients with thoracic disk herniations who required surgical intervention. The advantages of MR over CT myelography are ease of obtaining sagittal sections, rapid assessment of the entire thoracic spine, and a high rate of patient acceptance related to the noninvasive nature of MR and lack of morbidity and complications. For these reasons, we currently rely, almost exclusively, on MR for evaluating thoracic disk disease. PMID- 3680692 TI - CT demonstration of interlobar fissure calcification due to asbestos exposure. AB - This is the second report of calcification of the major fissure in asbestos related pleural disease and the first in which CT was necessary to visualize its presence. This case illustrates that CT may have an additional important use in the radiologic evaluation of individuals who have had asbestos exposure. PMID- 3680693 TI - MR and CT findings in infected ventricular aneurysm repair. AB - The magnetic resonance findings in a case of infection at a ventricular aneurysm repair site 7 years following surgery are presented. PMID- 3680694 TI - MR imaging of aneurysm of an aberrant right subclavian artery. AB - Magnetic resonance (MR) imaging was performed for evaluation of a right paramediastinal mass in an asymptomatic 84-year-old woman. An aneurysm of an aberrant right subclavian artery was diagnosed. This rare complication of a common congenital anomaly and the use of MR in evaluation is discussed. PMID- 3680695 TI - CT guided interstitial therapy of pancreatic carcinoma. AB - We describe the use of percutaneous CT guidance for localization and placement of 192Ir sources into a patient with pancreatic carcinoma. We have shown the feasibility of this procedure and the lack of complications which are probably due to minimal damage to tissue involved. Computed tomography is ideally suited for percutaneous implantation because it provides the most accurate method for needle placement within the abdomen. PMID- 3680696 TI - CT of false-negative peritoneal lavage following blunt abdominal trauma. AB - The CT findings are presented in a patient with blunt trauma and a false-negative peritoneal lavage due to extraperitoneal insertion of the lavage catheter. Computed tomography correctly identified the presence of hemoperitoneum and the site of injury involving the small bowel mesentery. The diagnostic accuracy in peritoneal lavage and its relationship to abdominal CT is reviewed. PMID- 3680697 TI - Computed tomography of gangrenous appendicitis. AB - In a case of gangrene, CT demonstrated a thin-walled appendix, dilated with gas. Such a presentation has not previously been described in the CT literature. PMID- 3680698 TI - CT diagnosis of primary torsion of greater omentum. AB - The etiology of primary volvulus of the omentum in the absence of other intraabdominal pathology remains obscure. Abdominal pain and tenderness are always present. Computed tomography demonstrates an abdominal mass composed of fatty and fibrous folds. Characteristic for a torsion is the concentric distribution of the fibrous folds at the site of torsion. PMID- 3680699 TI - CT findings in xanthogranulomatous pyelonephritis with coexistent renocolic fistula. AB - A case of diffuse xanthogranulomatous pyelonephritis of the kidney with an associated renocolic fistula is reported. Computed tomography demonstrated typical findings with an enlarged poorly functioning kidney with multiple near water-density masses replacing the renal parenchyma surrounding a central staghorn calculus. A mottled gas collection within the renal parenchyma was secondary to a renocolic fistula rather than a pyogenic abscess. PMID- 3680700 TI - CT and MR demonstration of nabothian cysts mimicking a cystic adnexal mass. AB - The CT and magnetic resonance appearance of prominent nabothian cysts is presented. Although small nabothian cysts are common gynecologic findings, they at times reach 2-4 cm in diameter and may simulate a cystic adnexal mass. PMID- 3680701 TI - MR imaging of post-traumatic pseudoaneurysm of the deep femoral artery. PMID- 3680702 TI - MR appearance of bilateral, spontaneous patellar tendon rupture in systemic lupus erythematosus. AB - Bilateral spontaneous patellar tendon rupture is an unusual complication in patients with systemic lupus erythematosus. The ability of magnetic resonance to detect these tendon abnormalities is demonstrated. PMID- 3680703 TI - CT findings in pulmonary paragonimiasis. PMID- 3680704 TI - Cystic seminal vesiculitis: CT demonstration. PMID- 3680705 TI - Spinal extradural angiolipoma: MR and CT diagnosis. PMID- 3680706 TI - MR findings in normal-pressure hydrocephalus: significance and comparison with other forms of dementia. AB - This study was undertaken to identify findings on magnetic resonance (MR) imaging that might possibly differentiate among several dementia states in the elderly or predict response to shunt therapy in patients with normal-pressure hydrocephalus (NPH). The MR findings were retrospectively reviewed in 54 patients who were divided into four clinical categories: NPH (17 patients), obstructive hydrocephalus (eight patients), Alzheimer disease (eight patients), and non Alzheimer dementia (21 patients). Three MR findings were evaluated in each case: increased periventricular (PVS) and white matter (WMS) signal on T2-weighted images, CSF flow void sign (CFVS) in the aqueduct, and corpus callosum thinning. Neither the PVS/WMS nor corpus callosum thinning patterns were useful for distinguishing among the four clinical groups. At low field strength, the absence of a marked or moderate CFVS, however, may militate against a diagnosis of NPH. All 17 patients with NPH underwent a shunt procedure after the MR study. A better response to shunt therapy occurred in patients without WMS and with more severe PVS. PMID- 3680707 TI - MR imaging of peripheral intracranial neoplasms: extraaxial vs intraaxial masses. AB - In an effort to determine magnetic resonance (MR) features of peripheral brain tumors that allow accurate localization. 11 extraaxial neoplasms were compared with 11 peripheral intraaxial tumors. The MR findings most often seen in extraaxial lesions include interruption of bone, white matter buckling, widening of adjacent subarachnoid space or cistern, and medial displacement of pial arteries or veins. Invasion of the cortex without white matter buckling, as well as flattening and lateral displacement of the surface veins, was most often seen in intraaxial lesions. Neither simple contiguity to a bony or dural surface nor vasogenic edema is a reliable predictor of intra- vs extraaxial masses. PMID- 3680708 TI - Pulmonary function abnormalities in patients with CT-determined emphysema. AB - The CT quantification of both the extent and severity of emphysema was undertaken in 30 subjects. The CT scans at five preselected anatomic levels were analyzed using two methods. Correlation of the results of the CT methods were with pulmonary function results of airway obstruction and alveolar diffusion for carbon monoxide. Analysis by direct observation of the CT scans gave insignificantly different results for a complex grid method of analysis. The emphysema score with the observational method had a positive correlation with airflow obstruction (r = -0.817) as did the score with the grid method (r = 0.873). The diffusing capacity for carbon monoxide also correlated with both emphysema scores. The CT methods for quantifying emphysema correlate closely with functional abnormalities. As previously demonstrated with pathological assessment of lung slices for emphysema, direct observation of CT scans is as precise as a more complex grid method. PMID- 3680709 TI - Evaluation of regional ventricular wall motion by ECG-gated CT. AB - A conventional whole body CT scanner equipped for electrocardiographic gating was used to evaluate regional left ventricular function and the findings were compared with a corresponding analysis by two-dimensional echocardiography and left ventriculography. Twenty-two patients between the ages of 40 and 77 years with a documented anterior or posterolateral myocardial infarction were studied together with a control group comprising 10 patients. The gated CT studies were obtained using three 1 cm levels selected through the mid, apical, and basal regions of the left ventricle. Qualitative analysis of segmental wall motion (p less than 0.0001) correlated with angiography in 82% and with two-dimensional echocardiography in 86% (p less than 0.0001). Computed tomography correctly identified the location of prior myocardial infarction in all but one patient. The results of this study suggest that gated CT may provide an accurate assessment of regional left ventricular function (for anterior and posterolateral myocardial infarction) and that this technique may prove to be clinically useful if these early results are confirmed by further experience. PMID- 3680710 TI - MR evaluation of chronic aortic dissection. AB - Thirty patients with suspected or known chronic aortic dissection were imaged with magnetic resonance (MR), CT, and angiography. Five of these patients had previously undergone surgical repair of the ascending aorta for a type A dissection. Magnetic resonance demonstrated an intimal flap and a double lumen in 25 cases. In four cases with a thrombosed false lumen, proved angiographically, an intimal flap and double channel were not seen. In two of four aortic dissections with a thrombosed false lumen, CT made the diagnosis by showing displaced intimal calcifications not visualized on MR. In one case the aortic dissection was made on CT and angiography but was not supported by MR which showed an aortic aneurysm, subsequently confirmed at surgery. Magnetic resonance, CT, and aortography differentiated between type A (nine patients) or B (20 patients) dissection in all cases and demonstrated extension into the abdominal aorta. Extension into the iliac arteries was seen on MR in three patients but missed in nine patients. Magnetic resonance differentiated the true and false lumen in all but one case. Thrombosis of the false channel was identified in four cases by a decrease in signal intensity on the second echo image. Cardiac gating and longitudinal contiguous sections seemed to be more suitable for appreciation of the relationships with arch vessels. Transverse contiguous slices allowed determination of the origin of celiac, mesenteric, and renal arteries from either the true or the false lumen. This study confirms that MR is an accurate and noninvasive method for the evaluation and follow-up of chronic aortic dissection, obviating the need for iodinated contrast media. PMID- 3680711 TI - MR imaging of complications of aortic surgery. AB - Sixteen patients with a variety of complications of aortic surgery were evaluated with magnetic resonance (MR) imaging. More than one complication occurred in seven patients, resulting in the following types of abnormalities: graft occlusions, two; graft infections; five; pseudoaneurysms or aneurysmal dilatation of graft anastomoses, 10; perigraft hemorrhages, four; and aortoenteric fistulas, two. The MR findings were verified by surgery in 10, by CT in four, and by angiography in 11 patients. The size and extent of pseudoaneurysm or anastomotic dilatation, the presence of thrombus and vessel occlusion, the extent of abscesses, and the effect of pseudoaneurysms and abscesses on adjacent structures were readily demonstrated by MR. The size of the residual lumen in the case of thrombosis could be assessed. Abscesses were identified by their characteristic signal increase with long repetition rates and long echo delays. Magnetic resonance was also able to exclude suspected complications such as perigraft infection, hemorrhage, and graft occlusion in four patients. PMID- 3680712 TI - CT-directed rib biopsy. AB - A retrospective review of 11 cases of CT guided rib biopsy is presented. No complications occurred. In 10 of 11 cases open biopsy was averted. In this group the biopsy result is consistent with the remainder of the patients' test results and subsequent clinical course. Our series includes one false-negative biopsy. The true positive and negative biopsy results led to alterations in clinical management in each case. We conclude that CT-directed rib biopsy is a safe and useful procedure in carefully selected patients. PMID- 3680713 TI - Efficacy of CT following peritoneal lavage in abdominal trauma. AB - Peritoneal lavage and abdominal/pelvic CT are described in the radiologic and surgical literature as alternative techniques in the evaluation of blunt abdominal trauma. The relative merits of each technique have been discussed, and it has been stated that postlavage CT is not useful because of the residual peritoneal fluid. A retrospective study of 48 patients who underwent postlavage CT was performed over 34 months. Despite residual lavage fluid, CT provided specific and clinically useful information in 58% of patients following peritoneal lavage. A variety of intraperitoneal and retroperitoneal traumatic lesions were imaged using postlavage CT. We conclude that postlavage CT is often clinically useful in the patient who has incurred blunt abdominal trauma, irrespective of the peritoneal lavage results. PMID- 3680714 TI - Kimura's disease and angiolymphoid hyperplasia with eosinophilia: two distinct histopathological entities. AB - The relationship between the disorder known in Japanese and Chinese literature as Kimura's disease and that known in Western literature as angiolymphoid hyperplasia with eosinophilia (ALHE) has been the subject of debate. Many reports have used the terms synonymously. We have reviewed the histological and clinical features of 4 cases, all occurring in Caucasians, 2 of which are typical of Kimura's disease and 2 of ALHE. Analysis of the cases indicates that the histological features of the 2 disorders are sufficiently different to warrant their recognition as 2 distinct entities. The histological and clinical features of Kimura's disease are most consistent with an allergic or autoimmune process in which blood vessels, lymphocytes and eosinophils participate. Those of ALHE suggest a primary, probably neoplastic disorder of vascular endothelium with a variable and secondary inflammatory response. Although there is some clinical overlap between patients with the 2 disorders, the histological features are distinctive, and the 2 terms should not be used synonymously. PMID- 3680715 TI - Cutaneous leukocytoclastic vasculitis: correlation of histopathological changes with clinical severity and course. AB - We have examined 61 histopathologic specimens from 54 patients with cutaneous leukocytoclastic vasculitis (LV). They were examined without knowledge of clinical disease for the following characteristics: vessel wall inflammation, erythrocyte extravasation, depth of infiltrate, leukocytoclasis, fibrinoid necrosis, epidermal necrosis and fibrin thrombi. Independent of the histopathological study, the following clinical observations were recorded: type of lesion, severity and the presence and type of systemic disease. The severity score was based on the extent of cutaneous disease, the presence of systemic disease and the difficulty of disease control. The clinical and histological features were then compared using an analysis of variance. Statistically significant results included (1) the relation of clinical severity to vessel wall inflammation, leukocytoclasis, overall histologic severity; and (2) the mildness of histological changes in patients with urticarial lesions. Thus, we have demonstrated that the severity of histopathologic changes seen on skin biopsy is (1) predictive of clinical severity, (2) may correlate with the type of skin lesion observed, but (3) does not correlate with the presence or absence of internal vasculitic involvement. PMID- 3680716 TI - The keratotic tumors of Cowden's disease: an electronmicroscopic study. AB - Cowden's disease is characterized by multiple hamartomas of the skin, breast, thyroid, and gastrointestinal tract. In the past, a viral hypothesis for the keratotic lesions of the skin has led to much controversy. The present study describes the results of a detailed fine structural analysis of 10 hyperkeratotic extremity lesions and 2 keratotic lesions from the face of a patient with Cowden's disease. Increases in the keratinocyte population were primarily confined to the basal and suprabasal regions. Differentiation products characteristic of keratinization were normal in both quantity and appearance. Nuclear remnants and numerous lipid droplets, markers of abnormal keratinization, were noted within horny cells. However, viral particles and/or virus-like particles were not observed in keratinocytes. Melanocytes and Langerhans cells were numerous. The latter contained membrane-bound pigment vacuoles in addition to the characteristic Birbeck granules. These unusual Langerhans cells were observed in the dermis as well as the epidermis. A large number of fully granulated "resting" mast cells was uniformly distributed throughout the dermis, associated with a prominent cellular infiltrate. Our observations do not support the concept of a viral etiology for these tumors. PMID- 3680717 TI - Extra- and intra-cellular digestion of elastic fibers by macrophages in annular elastolytic giant cell granuloma. An ultrastructural study. AB - A case of annular elastolytic giant cell granuloma was studied with the electron microscope using acid orcein stain. Elastic fibers were digested by multinucleate giant cells (MGCs) in 2 steps: the first step was the extracellular digestion and the second was the intracellular digestion. In the first step, the orcein reactive amorphous materials of the elastic fibers surrounded by MGCs at first disappeared, and then the fine filaments appeared in elastic fibers. This process advanced in extracellular spaces of MGCs. In the next step, the fine filaments were phagocytosed by MGCs and were digested in phagocytic vacuoles. PMID- 3680718 TI - The similarity of attitudes towards personal and impersonal types of authority among adolescent schoolchildren. AB - This paper examines the extent to which the attitudes of young adolescents towards personal and impersonal types of authority are differentiated. Reliable measures of attitudes towards personal authorities (parents and teachers) and impersonal authorities (the police and the law) were developed with a preliminary sample of 155 secondary school students. These measures were employed with further samples of (a) third year High School students (n = 77) who also completed the Keeves (1974) Attitudes to School and School Learning Scale, and (b) first year High School students (n = 250) who also completed the Ray and Jones (1983) self-report measures of authority-salient behaviours in relation to their parents and teachers. The attitudes of the students were relatively pro authority and did not differ according to gender. In general, the younger group of students were the more pro-authority, significantly so on the measures of attitude towards personal authorities. For each sample the pro-authority attitude measures loaded substantially (greater than 0.6) on the first factor of a principal components analysis. Correlations between these measures and (a) attitudes to school and school learning and (b) reported authority-salient behaviours were positive and, in general, significant for each sex. Overall, the results provided little support for the view that attitudes towards personal and impersonal type of authority are dissimilar. PMID- 3680719 TI - Friendship and dating relationships among French adolescents. AB - The focus of this study is to analyse, within the same population, the specificity of friendship in comparison with dating relationships among French adolescents. The subjects interviewed (63 boys and 82 girls, aged 15 to 19 years), all volunteers, were recruited from three "classic and modern" senior high schools and three vocational high schools. The data were collected by using a semi-directive interview (recorded) dealing with subjects' friendships and dating relationships. All hypotheses were confirmed: (1) Friendship between partners of the same sex constitutes the main form of privileged interpersonal relationship in early and middle adolescence. (2) The specificity of interactions between partners lies in their mode of relationship: psycho-social exchanges are more intimate between friends than between dating partners. (3) Exchanges between friends are more intimate than between dating partners even when these partners have complete sexual intimacy. PMID- 3680720 TI - Development of self-perceived risk behaviour and psychosomatic symptoms in adolescents: a longitudinal approach. AB - A cohort study on a sample of 327 high school students was carried out between 1983 and 1985. Health and behaviour problems were investigated. During adolescence psychosomatic, depressive and behavioural problems appear to be common. The majority of young people suffer at least one problem at 18 years of age. The type of problems are closely related to gender: among boys behavioural problems (BP), such as alcohol or drug consumption, tobacco smoking and violence, are important; among girls sleep disorders, headaches and depressive symptoms (PDS) are frequent. During adolescence sex differences become clearly established. Between 16 and 18 years of age the average number of behavioural problems rises from 0.5 to 1.5 for boys and remains stable (around 0.5) for girls. During the same period the PDS average rises from 1.6 to 2.0 for girls and remains stable (around 0.7) for boys. Even if there exists a correlation between BP and PDS (this correlation is higher in the early age than later on), one type of problem is always predominant, according to sex. BP as well as PDS are related to the intolerance of frustration. Authors conclude that these problems must be considered as the expression of the inability to metabolize or cope with the conflict. PMID- 3680721 TI - The emergence of work-centred issues in consultative work: an observation. AB - During two separate series of consultative meetings for professionals engaged in direct work with adolescents, the authors noticed that the issues brought to consultation showed a definite and sustained shift away from matters to do with the workers' clientele, and towards matters concerning their working relationships and work settings. The possible causes and effects of this shift in the focus of work is discussed. PMID- 3680722 TI - Partition of lactic streptococcal bacteriophage during the ultrafiltration concentration of milk and whey. AB - Milk and whey inoculated with lactic streptococcal bacteriophages 316, or 322, or both were concentrated by UF using a DDS Mini-Lab 20. The plate and frame unit was fitted with Type GR61PP polysulfone membrane with a 20,000 molecular weight cutoff. The unit was operated at an inlet pressure of .40 MPa and an outlet pressure of .23 MPa with an initial flux of 2.0 to 3.0 L/h. Samples of retentate, permeate, and membrane were analyzed for the presence of bacteriophages. Under the conditions established in this study, phage particles did not pass through the membrane but instead became trapped in the polarization concentration layer or in the membrane. Phages were recovered from the membrane by extraction in sterile buffered water with the Stomacher. The UF concentration of milk containing the host species of Streptococcus cremoris resulted in phage propagation and lysis of the host but did not result in the passage of phages through the membrane. The UF processing of milk or whey should produce a phage free permeate. PMID- 3680723 TI - Methods to assess the propensity of milk fat globules toward lipolysis and the ability of skim milk to inhibit lipolysis. AB - Methods to quantitate factors in milk relevant to cold-induced lipolysis are described. Skim milk was incubated with milk fat globules isolated from a pool of normal milk and a fixed amount of purified lipoprotein lipase. The release of fatty acids in 24 h at 4 degrees C was determined. Most skim milk samples inhibited lipolysis, but the effect varied greatly. Skim milk from milk prone to spontaneous lipolysis was less inhibitory than skim milk from normal milk. In general, both the casein and the serum fractions of skim milk inhibited lipolysis. However, variation was greater in the effects of individual samples of milk serum. In a few extreme cases, with samples from milk with spontaneous lipolysis, the serum fraction actually stimulated lipolysis. Globules were isolated and then incubated with skim milk from normal milk and a fixed amount of purified lipoprotein lipase. This gave a measure of accessibility to lipolysis of milk fat globules in normal skim milk. There was a considerable variation in propensity toward lipolysis between milk fat globules from individual milk samples. Milk showing different levels of lipolysis obtained from five cows revealed that skim milk inhibition of lipolysis and the propensity of milk fat globules toward lipolysis were characteristic for each cow. PMID- 3680725 TI - Effects of treating wheat straw with pH-regulated solutions of alkaline hydrogen peroxide on nutrient digestion by sheep. AB - An experiment using a 4 X 4 Latin square design was to determine effects of treating wheat straw with pH-regulated (pH = 11.5) solutions of hydrogen peroxide on site and extent of nutrient digestion in multiple-fistulated sheep. Regulating reaction pH at 11.5 prevented solubilization of some cell wall hemicelluloses, resulting in improved retention of DM. Diets fed to sheep contained 33 or 70% wheat straw either untreated or treated with alkaline hydrogen peroxide. Sheep fed diets of treated wheat straw digested more DM, NDF, ADF, and cellulose anterior to the duodenum and in the total tract than when fed diets of untreated wheat straw. Apparent CP digestion before the duodenum was highest when sheep were fed the treated 33% wheat straw diet and untreated 70% wheat straw diet. Treatments did not affect apparent nutrient digestibilities in the large intestine. Ruminal pH was lower when sheep were fed the alkaline hydrogen peroxide-treated or diets containing 33% wheat straw. Ruminal ammonia concentrations were highest when sheep were fed the untreated 70% wheat straw diet. Molar proportions of ruminal acetic and propionic acids were unaffected by diet. Alkaline hydrogen peroxide treatment substantially increased susceptibility of structural carbohydrates of wheat straw to microbial degradation in the gastrointestinal tract of sheep. PMID- 3680724 TI - Effect of yeast culture and Aspergillus oryzae fermentation extract on ruminal characteristics and nutrient digestibility. AB - Four nonpregnant and nonlactating Holstein cows fitted with ruminal fistulas were assigned to each of four diets in a 4 X 4 Latin square design. Dietary treatments were 1) basal diet containing 50% concentrate; 2) basal diet plus 90 g/d yeast culture; 3) basal diet plus 2.63 g/d Aspergillus oryzae fermentation extract; 4) basal diet plus 90 g/d of A. oryzae fermentation extract and yeast culture. Cows were fed diets at a rate of 86 g DM/kg BW.75 for 14 d adaptation followed by an 8 d collection period. Digestibility of dry matter was increased by A. oryzae and A. oryzae and yeast culture combination treatments. Digestibility of CP was increased regardless of fungal culture addition. Hemicellulose digestibility, percent ruminal cellulolytic organisms, and acetate to propionate ratio were increased by the addition of fungal supplements. PMID- 3680726 TI - Metabolism of manganese in calves as affected by dietary manganese and intravenous or duodenal manganese-54 dosing. AB - Fifteen intact male Holstein calves averaging 101 d of age were utilized to determine the effects of dietary Mn concentration and routes of administration on its metabolism. They were fed a practical grain diet containing 23 ppm Mn with 0, 100, or 1000 ppm supplemental Mn (MnSO4.H2O) for 7 d prior to intravenous or duodenal dosing with 54Mn. Animals were killed 4 h later. With added Mn there was a significant decrease in 54Mn content of some small intestine parts. However, in most tissue, including organs, bones, intestinal tract tissues, and blood, added Mn did not have a significant effect on 54Mn concentrations. Concentrations of 54Mn in tissues, except in small intestine, were far higher following intravenous dosing than with duodenal dosing. This further confirms that absorption of Mn is very low. Dosing method had a sizable effect on the relative amounts of 54Mn in different tissues. This suggests that intravenously administered Mn, at least initially, is not metabolized in the same way as that absorbed. In most tissues, unlabeled Mn was not affected greatly by supplemental Mn. This is in contrast to earlier results with very young calves and indicates that Mn metabolism changes sharply before 3 to 4 mo of calf age. PMID- 3680727 TI - Performance of calves fed combinations of whole milk and reconstituted skim milk powder. AB - A 52-d study with 24 3-d-old calves compared the effect of feeding whole milk (controls) or milk diluted 1:1 or 1:3 with reconstituted skim milk powder (10%, wt/wt) on calf performance to weaning at 38 d. Skim powder diets were supplemented with vitamins and trace minerals. Liquid diet was fed at 5% body weight twice daily for 24 d, then once daily for 14 d followed by abrupt weaning. Starter was provided for ad libitum intake from 14 to 52 d. For the first 13 d, controls had the greatest weight gains, but at 38 and 52 d, gains were similar for all groups. Three-quarters of the whole milk diet could be replaced with reconstituted skim milk powder (10% wt/wt) without any reduction in calf gain to weaning because starter intake increased 23%. PMID- 3680728 TI - Multitrait estimation of genetic parameters of lactation curves in Holstein heifers. AB - Weekly milk yields of 1022 Holstein heifers from 61 sires were used to derive coefficients of the lactation curves using modified gamma and inverse polynomial functions. The natural logarithm of a modified gamma function was ln(yn) = ln (a) + b ln (n) + cn + u sin (x) + v cos (x), where a, b, c, u, and v are coefficients to be estimated; n is the day of lactation; and x is the day of year. Estimates of a, b, and c were combined to define persistency [-(b + 1) ln c], week of peak yield (b/c), and peak yield [a(b/c)be-b]. The inverse polynomial function was n/yn = A0 + A1n + A2n2, where A0, A1, and A2 are coefficients to be estimated. Variance and covariance components for the coefficients of the lactation curve were estimated by the multitrait restricted maximum likelihood method using canonical transformation. Heritability estimates were ln (a) .11, b .07, c .04 u .01, v .04, A0 .28, A1 .26, A2 .21, persistency .21, week of peak .18, peak yield .23, and 308-d milk yield .41. Genetic correlations indicated that selection for faster rate of increase to peak production would result in higher 308-d milk production, higher peak yield, and greater persistency. PMID- 3680729 TI - Relationships of first lactation milk and type traits to cow survival and a sire index for discounted total milk. AB - The probability of cow survival during each of six consecutive 13-mo periods after first calving was regressed on lactation milk yield and 15 type traits, each recorded during the first lactation. Adjusted coefficients of determination were small (.028 to .081). The ratio of variance in predicted cow survival probabilities due to milk only with that due to the 15 type traits was 12.6:1, 4.7:1, 2.5:1, .5:1, 0:1, and .02:1 for respective herdlife periods. Maximum effect of type traits on herdlife ranged from 11 to 109 d. Prediction equations for cow survival were incorporated into a sire index for discounted total milk yield of progeny. Type traits affected the sire index by their influence on the six predicted survival rates. Milk yield affected the discounted total milk index directly as well as through the survival rates. Simulated variation from milk estimated transmitting abilities for sires accounted for 99.9% of the total variation in the discounted total milk index. Since the effect of the type traits on cow survival rates was greatest during the later herdlife periods, too few animals would have survived to these later periods to reveal any significant effect from type on the discounted total milk index. PMID- 3680730 TI - Reporting of dystocia scores and effects of dystocia on production, days open, and days dry from dairy herd improvement data. AB - Dystocia and livability scores are collected through the Mid-States Dairy Records Processing Center. Thirty-four percent of the cows had dystocia scores reported. Least difficult births were scored 1 and the most difficult births scored 5. Days open in first parity were 14 d greater for births scored 5 versus 1. The differences were larger in later parities. There were 26 more d open in second parity and 19 more d open in third and greater parities for score 5 versus 1. Differences between cows scored 5 versus 1 were 465 kg milk and 20.7 kg milk fat in first lactations, 576 kg milk and 20.9 kg milk fat in second lactations, and 725 kg milk and 25 kg milk fat in third and greater lactations. Cows produced more in lactations following an easy birth. Frequency of difficult births was less in lactations other than the first. PMID- 3680731 TI - Correlations between production traits in first lactation Holstein cows. AB - Genetic and phenotypic correlations between milk yield, fat (yield and percent, protein (yield and percent), and somatic cell count in first lactation Holstein cows were estimated using a multivariate restricted maximum likelihood algorithm. There were 18,189 daughters of 257 sires in 928 herds. Genetic correlations between pairs of yield traits were all positive (.73 to .88), but phenotypic correlations with somatic cell count were small and negative. Genetic correlations between somatic cell count, and fat percent, and protein percent were negative, -.11. Milk yield, fat yield, and protein yield had heritabilities of .36, .38, and .25. PMID- 3680732 TI - Influence of stage of cycle, corpus luteum location, follicle size, and number of large follicles on estradiol-17 beta concentrations in bovine follicles. AB - Concentrations of estradiol-17 beta in follicular fluid were correlated to follicular size, stage of estrous cycle, location of corpus luteum, and presence of large follicles. Paired ovaries were obtained from 481 nonpregnant cows at slaughter and follicles were classified as ipsilateral or contralateral to the corpus luteum. Follicular fluid estradiol-17 beta concentrations from 2494 small, 1485 medium, and 396 large follicles were quantified by radioimmunoassay. Stage of estrous cycle was estimated by visual examination of the corpus luteum. Follicles in stage 1 of the estrous cycle (d 1 to 4) had the highest estradiol-17 beta concentration and the smallest mean follicular diameter. Location of follicles relative to the corpus luteum had no influence on estradiol-17 beta concentrations. As follicular size increased, concentration of estradiol-17 beta also increased. The presence of a single large follicle did not affect the concentration of estradiol-17 beta in medium or small follicles. In contrast, if multiple large follicles occurred in the same cow, concentrations of estradiol-17 beta were significantly lower in medium but not small follicles. PMID- 3680733 TI - Concentrations of high density lipoproteins vary among follicular sizes in the bovine. AB - This study compared lipoprotein phospholipid, cholesterol, protein, and glycosaminoglycans in the lipoprotein fraction among follicular fluid pools derived from 2633 small (less than 6 mm), 1702 medium (6 to 10 mm), and 491 large (11 to 20 mm) bovine follicles subdivided by estradiol-17 beta concentrations. High density lipoproteins were the only lipoprotein class found in follicular fluid when apolipoprotein profile of the less than 1.21 g/ml density fraction was analyzed using sodium dodecyl sulfate polyacrylamide gel electrophoresis and silver staining. Within a follicular size class, concentrations of lipoprotein constituents did not change among follicular fluid pools with varying estradiol 17 beta concentrations. As follicular size increased, follicular fluid lipoprotein phospholipid, cholesterol, and protein significantly increased. The percentage of total follicular fluid glycosaminoglycans in the less than 1.21 g/ml density fraction was highest for small follicles but averaged less than 5% for all follicular size classes. Therefore, bovine follicular fluid contains only high density lipoproteins and concentrations increased with follicular maturation. That increase in high density lipoprotein could be a potentially important source of cholesterol for progesterone production after the LH surge. PMID- 3680734 TI - Individual variation for in vitro fertilization success in dairy bulls. AB - Individual semen samples from 29 bulls in routine artificial breeding service were tested for their capability to achieve in vitro fertilization. Ejaculated semen was diluted, .1 ml of semen in 2 ml of a modified Tyrode's medium with an osmolality of 340 mOsmol/kg, washed thrice, incubated 3 h at 37 degrees C before being used for in vitro fertilization, or incubated 4 h and 8 h before assessment of motility, capacitation, and acrosome integrity. The degree of variability in percentage of oocytes fertilized was assessed along with several factors that might contribute to this variation. Variation among bulls was not significantly different. Variation from one replicate to another was high. Variation was found in motility, capacitation, and frequency of acrosome reaction, but these variables were not significantly correlated to fertilization rate in vitro. PMID- 3680735 TI - Use of concentrations of progesterone and estradiol-17 beta in milk in monitoring postpartum ovarian function in dairy cows. AB - Data from artificial insemination, rectal palpation, and hormone assays were used to characterize postpartum reproductive activity in 54 dairy cows. Progesterone and estradiol-17 beta were measured in milk samples collected for 120 d (Trial 1) or 65 d (Trial 2). Progesterone was higher and estradiol was lower in milk than in serum. Values for both hormones in milk were highly correlated with those in serum. Most cows (64%) had short first luteal phases (less than or equal to 12 d). First rise (28 d) in progesterone was later (33.4 vs. 24.9 d) for cows having short rather than normal (greater than 12 d) luteal phases. Cows were classified as having a short luteal phase followed by a normal luteal phase or as having normal luteal phases for the first two estrous cycles. Estradiol for the 6 d prior to each luteal phase was higher preceding the second phase than the short phase or those preceding both phases of cows with normal phases. Follicular function prior to ovulation, as measured by estradiol, was not responsible for short-lived corpora lutea. Concentrations of progesterone in milk in the late luteal phase prior to insemination were related to fertility. PMID- 3680736 TI - Effects of progesterone intravaginal devices on synchronization of estrus in postpartum dairy cows. AB - Effects of two intravaginal treatments of progesterone on the synchronization of behavioral estrus were compared in three groups of lactating dairy cows at 7 to 8 wk postpartum. Group 1 had progesterone-releasing intravaginal devices with attached estradiol benzoate capsules inserted for 12 d. Groups 2 and 3 had controlled internal drug release devices, containing progesterone alone, inserted for 9 or 12 d. Behavioral estrus was detected as early as 24, 32, and 36 h after removal of the devices in groups 1, 2, and 3, respectively. Estrus was better synchronized and the proportion of cows showing estrus after device removal was greater in group 1 than in groups 2 and 3. After removal of devices, mean milk progesterone of all cows that did not show estrus was higher than that of cows that showed estrus. In groups 1, 2, and 3, 1 of 7, 7 of 12, and 4 of 12 cows not showing estrus had high milk progesterone after removal of the devices, indicating the presence of functional corpora lutea. In cows not displaying estrus milk progesterone concentrations decreased, indicating these cows were cyclic, although behavioral estrus was absent. PMID- 3680737 TI - Occurrence and reoccurrence of clinical mastitis. AB - Clinical mastitis records for 6.5 yr (July 1977 through November 1983) from a large north Florida dairy were analyzed. Observed frequencies of clinical mastitis were calculated in 7240 Holstein and Jersey lactations. Least squares analyses used Holstein and Jersey lactations greater than 200 d and limited maximum parity to 5 (6732 lactations, 5738 episodes). Solutions for number of occurrences of clinical mastitis adjusted for month of parturition and breed effects were .47, .59, .94, 1.27, and 1.50 for parities 1 through 5. Solutions for number of occurrences across lactation in Holsteins was greater than for Jerseys (1.28 vs. .63). Solutions for occurrence of first episode in Holsteins increased from .35 in parity 1 to .71 in parity 5. Occurrence of episodes two through five increased as parity increased. Similar trends were found in Jerseys with the exception of parity 2. Correlation of residuals between specific episodes increased as episode increased. From episode 2 through 5 probability of another occurrence of clinical mastitis was greater than .75. Solutions for proportion of occurrences of clinical mastitis occurring during the first 35 d postcalving were .60, .36, .31, .30, and .28 for parities 1 through 5. Clinical mastitis in first parity cows occurred primarily during the first 35 d postcalving. PMID- 3680738 TI - Drug residues in dairy cattle industry: epidemiological evaluation of factors influencing their occurrence. AB - A random study of 3000 dairy farmers was designed to determine 1) management factors that may be associated with the occurrence of drug residues; 2) the dairy farmers' attitudes and knowledge about residues; 3) how these variables influence the occurrence of residues in dairy cattle. Management factors perceived as having the greatest influence on drug residues in milk were insufficient knowledge about withdrawal periods, errors due to hired help, insufficient identification and record of animals treated for mastitis, metritis treatment, dry cow treatment for mastitis, and not reading the label. Forty-one percent of farms with residue problems used medicated feeds compared with 38.9% of control farms. Factors significantly associated with the occurrence of residues were herd size, increased number of hired persons, increased frequency of use of medicated feeds, category of medicated feed, and producer's attitude toward the public health significance of residues. Farmers needed more information in five areas: likelihood of persistent residues from various types of chemicals (26.8%), consequences of chemicals occurring in livestock products (22.4%), withholding times for specific chemicals (20.4%), disposal of surplus farm chemicals (17%), preparation of products for use in livestock (13.4%). PMID- 3680739 TI - Chickpeas as a substitute for corn and soybean meal in growing heifer diets. AB - Twelve Holstein heifers (average weight 270 kg) were randomly assigned to one of four diets to evaluate the feeding value of chickpeas. Total mixed diets were composed of (dry matter) 40% concentrate mix, 24.5% chopped alfalfa hay, and 35.5% corn silage. Concentrate mixes contained 0, 25, 50, and 75% chickpeas in place of corn and soybean meal. Diets were fed individually for 80 d. Average daily gains (.98, 1.13, 1.14, and .95 kg) were higher for heifers fed 25 and 50% chickpeas than for those fed 0 and 75% chickpeas. Feed per gain (4.72, 4.05, 3.65, and 4.01 kg/kg) was lower for all diets containing chickpeas. Dry matter intake was lowest for heifers fed 75% chickpeas, and dry matter intake as percent of body weight was similar for all groups. Ruminal ammonia, pH, total volatile fatty acid concentrations, and ratio of acetate to propionate were similar for all diets. Serum urea and rumen parameters displayed no trends between diets. Chickpeas were an acceptable replacement for corn and soybean meal in growing heifer diets. PMID- 3680740 TI - Commercial feasibility of embryo transfer technology: a case study. AB - The owner of a 500-cow Holstein herd requested economic assessment of his embryo transfer program. Actual net economic benefit was determined from marginal cost and present value of lifetime milk predicted from first lactations of 24 cows produced by embryo transfer compared with those of their 51 contemporaries sired by artificial insemination. Actual average pregnancy rate was 60% by embryo transfer or AI. An average of 5.5 transferable embryos was obtained per collection, which produced 1.37 cows in first lactation. Additional milk from embryo transfer cows was from more intensive selection of sires. Additional milk from the donor cows did not differ from zero. Actual marginal cost of a replacement by embryo transfer was +215, but it would have been +200 with same +25/unit semen price as contemporaries. If donors had been from the elite 5% for transmitting ability in milk, present value of gain in milk (5% real interest rate) ignoring additional feed costs would have been less than the cost of embryo transfer. For management and costs similar to this case, embryo transfer is not economically justified for producers earning income primarily from the sale of milk. PMID- 3680741 TI - Photographic enhancement of post-treatment results. PMID- 3680743 TI - The management of leg ulcers. PMID- 3680742 TI - Liposuction and anesthesia. PMID- 3680744 TI - Flap elevation and mobilization by blunt liposuction cannula dissection to repair temple defect. AB - After Mohs micrographically controlled removal of a recurrent squamous cell carcinoma, a 6 X 7-cm defect of the temple was closed with a large cheek and neck flap elevated and mobilized by blunt liposuction cannula dissection techniques and rotated into the defect. An excellent cosmetic and functional result was obtained. PMID- 3680745 TI - Mohs surgery report: an approach to cutaneous surgical defects of forehead and eyebrow following Mohs micrographic surgery. AB - Elective excisions of the forehead are relatively easy to plan because of the prominence of horizontal skin folds and vertical glabellar furrows. However, the variety of defects in that region which result from Mohs micrographic surgery for cutaneous tumors frequently present reconstructive challenges. Principles applicable to this anatomic region and illustrative cases are presented and discussed. PMID- 3680746 TI - Argon laser treatment of angiokeratomas. AB - The argon laser, used in either a pulsed or continuous fashion, is highly effective for treatment of angiokeratomas. Local anesthesia is usually not required. Because energy deposition is well localized, wounds heal rapidly with excellent cosmetic results. PMID- 3680747 TI - Phenol cauterization of nail matrix remnants. AB - Incomplete destruction of the nail matrix may result in partial recurrence of the nail. This occurs most frequently at the lateral ends of the proximal nail fold. A procedure that provides permanent, satisfactory results consists of careful dissection of the recurrent nail fragments followed by local phenol cauterization. PMID- 3680748 TI - Liposuction under local anesthesia: a retrospective analysis of 100 patients. AB - Liposuction was used for the purpose of body contouring in 100 patients. Among these patients, three had lipoma, and one had gynaecomastia. The 100 consecutive patients had liposuction surgery performed on an outpatient basis, using local anesthesia. Ninety-one patients were women, and 9 were men. Seventy-one had bilateral procedures and 29 had liposuctions in one region of the body. The most common areas treated were lateral thighs, followed by the neck for treatment of "double chin." The youngest patient was 19 years of age and the oldest 73. There were no significant complications. The most common postoperative complaints were pain, ecchymosis, edema, and temporary hyperethesia. Four patients required "touch-up" procedures. PMID- 3680749 TI - Malignant proliferating trichilemmal tumors--report of three cases. AB - We are reporting three patients with recent history of rapid enlargement of long standing nodular scalp lesions. Histologic sections revealed areas of relatively benign proliferation of pilar sheath epithelium and foci of trichilemmal keratinization characteristic of a proliferating trichilemmal cyst. There were also extensive areas of severe cellular dysplasia and surrounding dermal invasion indicating malignant transformation. PMID- 3680750 TI - The dynamics of flap movement: effect of pivotal restraint on flap rotation and transposition. AB - Flaps that rotate or transpose around a cutaneous pedicle are restrained by the tethering effect of that base of tissue. Flap design that fails to adjust for this force may eventuate in unwanted degrees of tension and/or surrounding tissue displacement. This concept is discussed and illustrated for the rotation, rhombic, and bilobed flap. PMID- 3680751 TI - [Expression of the mutant gene brachypodism-H in mouse aggregation chimeras]. PMID- 3680752 TI - [Effect of highly dispersed iron powder and iron salt on the endogenous level of iron and zinc in animal organs and tissues]. PMID- 3680753 TI - [Kinetics of protein elution during perception of biologically significant signals by the olfactory mucosa of the gray rat]. PMID- 3680754 TI - Differentiating anxiety and depression: a test of the cognitive content specificity hypothesis. PMID- 3680755 TI - A sensory decision theory analysis of anxiety and pain responses in chronic drug abusers. PMID- 3680756 TI - Children of depressed mothers: maternal strain and symptom predictors of dysfunction. PMID- 3680757 TI - Construct accessibility and clinical depression: a longitudinal investigation. PMID- 3680758 TI - Callosal dysfunction in schizophrenia and schizo-affective disorder. PMID- 3680759 TI - Self-disclosure and mental health: a problem of confounded measurement. PMID- 3680760 TI - Use of concurrent verbalization to assess the dissociation of conscious controls. PMID- 3680761 TI - Age of onset in different phobias. PMID- 3680762 TI - Men at high risk for alcoholism: the effect of alcohol on cardiovascular response to unavoidable shock. PMID- 3680763 TI - Role of infant-related stressors in postpartum depression. PMID- 3680764 TI - Greater reinforcement from alcohol for those at risk: parental risk, personality risk, and sex. PMID- 3680765 TI - Autonomy disturbances in subtypes of anorexia nervosa. PMID- 3680766 TI - Preference for alcohol consumption as a function of amount and delay of alternative reward. PMID- 3680767 TI - Anxiety, hunger, and eating behavior. PMID- 3680768 TI - Cultural factors considered in selected diagnostic criteria and interview schedules. PMID- 3680769 TI - Recognition memory in depression. PMID- 3680770 TI - Body-figure preferences in male and female adolescents. PMID- 3680771 TI - On definitions, diagnosis, and DSM-III. PMID- 3680772 TI - Definitions and diagnoses: a brief response to Morey and McNamara. PMID- 3680773 TI - Central to peripheral sound propagation in excised lung. AB - The time it takes audible sound to travel from the trachea to the pleura in five intact, excised horse lungs and one dog lung inflated with several gases was measured. Regression estimates of sound speed at total lung capacity (TLC) using straight line distance from the carina to the pleura are: helium, 775 +/- 60.5 m/s (means +/- 95% confidence limits); air, 282 +/- 23.5; carbon dioxide, 219 +/- 25.5; sulfur hexafluoride, 142 +/- 43.5. With the exception of sulfur hexafluoride, these speeds are 15%-20% less than the free-field speed of sound in each gas. Total airway length did not predict time delay any better or worse than straight line distance, but the high correlation between these two predictors (r = 0.94) prevents showing either to be the more predictive. In one lung, airway length was partitioned according to airway diameter. A regression using partitioned airway lengths significantly improved time delay prediction (p less than 0.001) over an unpartitioned model. Sound speed in the trachea equals free field sound speed. Sound speed in air-filled airways 1 to 25 mm in diameter equals 268 +/- 44 m/s. We conclude that the first sound to reach the surface travels in the airways for at least 90% of the distance, spending at least 87% of the total travel time there. PMID- 3680774 TI - Speech waveform envelope cues for consonant recognition. AB - This study investigated the cues for consonant recognition that are available in the time-intensity envelope of speech. Twelve normal-hearing subjects listened to three sets of spectrally identical noise stimuli created by multiplying noise with the speech envelopes of 19(aCa) natural-speech nonsense syllables. The speech envelope for each of the three noise conditions was derived using a different low-pass filter cutoff (20, 200, and 2000 Hz). Average consonant identification performance was above chance for the three noise conditions and improved significantly with the increase in envelope bandwidth from 20-200 Hz. SINDSCAL multidimensional scaling analysis of the consonant confusions data identified three speech envelope features that divided the 19 consonants into four envelope feature groups ("envemes"). The enveme groups in combination with visually distinctive speech feature groupings ("visemes") can distinguish most of the 19 consonants. These results suggest that near-perfect consonant identification performance could be attained by subjects who receive only enveme and viseme information and no spectral information. PMID- 3680775 TI - Prediction of speech intelligibility for normal-hearing and cochlearly hearing impaired listeners. AB - The word recognition ability of 4 normal-hearing and 13 cochlearly hearing impaired listeners was evaluated. Filtered and unfiltered speech in quiet and in noise were presented monaurally through headphones. The noise varied over listening situations with regard to spectrum, level, and temporal envelope. Articulation index theory was applied to predict the results. Two calculation methods were used, both based on the ANSI S3.5-1969 20-band method [S3.5-1969 (American National Standards Institute, New York)]. Method I was almost identical to the ANSI method. Method II included a level- and hearing-loss-dependent calculation of masking of stationary and on-off gated noise signals and of self masking of speech. Method II provided the best prediction capability, and it is concluded that speech intelligibility of cochlearly hearing-impaired listeners may also, to a first approximation, be predicted from articulation index theory. PMID- 3680776 TI - Identification of intonation contours by normally hearing and profoundly hearing impaired listeners. AB - Fundamental frequency (F0) information extracted from low-pass-filtered speech and aurally presented as frequency-modulated sinusoids can greatly improve speechreading performance [Grant et al., J. Acoust. Soc. Am. 77, 671-677 (1985)]. To use this source of information, listeners must be able to detect the presence or absence of F0 (i.e., voicing), discriminate changes in frequency, and make judgments about the linguistic meaning of perceived variations in F0. In the present study, normally hearing and hearing-impaired subjects were required to locate the stressed peak of an intonation contour according to the extent of frequency transition at the primary peak. The results showed that listeners with profound hearing impairments required frequency transitions that were 1.5-6 times greater than those required by normally hearing subjects. These results were consistent with the subjects' identification performance for intonation and stress patterns in natural speech, and suggest that natural variations in F0 may be too small for some impaired listeners to perceive and follow accurately. PMID- 3680777 TI - Perceptual components of pitch: spatial representation using a multidimensional scaling technique. AB - Paired comparison experiments were carried out on the pitch of 18 computer generated complex tones synthesized by slight modification of the frequency structure of Shepard's endless scale sounds. The results were analyzed by a multidimensional scaling technique, and simple helixes were obtained in which two components of pitch (tone height and tone chroma) were represented. Some individual differences in perception of pitch were observed according to the weight that the subject gives to each component. PMID- 3680778 TI - Auditory temporal processing: two-tone flutter fusion and a model of temporal integration. AB - Auditory temporal processing was examined using a flutter-fusion paradigm in which two tones were separated by a silent interval. The listener's task was to judge when the two tones, presented in a background noise, fused perceptually. The fusion point was studied in a series of six experiments. In the first five experiments, the duration of the first stimulus (T1) was the dependent variable. In the last experiment, the duration of the second stimulus (T2) was the dependent variable. An inverse relationship was found between T1 duration and the interstimulus interval (ISI) such that, when ISI was decreased, T1 duration had to be increased to maintain fusion. When ISI was plotted as a function of T1 duration, the data were represented by a negative exponential equation. Increasing the level of the tones, increasing the bandwidth of the background noise, or presenting the stimuli dichotically lowered the duration of T1 necessary for fusion. Changing the frequency of the tones had no effect on fusion. Decreasing the duration of T2 and holding T1 constant also resulted in fusion. A neurophysiological model implicating ON and OFF neural response interactions is postulated to account for the data. PMID- 3680779 TI - Temporal factors in the discrimination of tonal sequences. AB - Human observers were asked to judge whether or not two sequences of eight or more tones had the same serial pattern of frequencies. The temporal envelopes of the sequences were manipulated by randomly varying the tone durations or intertone gaps. In the correlated condition, the temporal envelopes of the sequences were varied across trials; the two sequences within each trial had the same temporal envelope. In the uncorrelated condition, the temporal envelopes were varied both across and within trials; every sequence had a unique temporal pattern. Performance in the uncorrelated condition decreased with increased variability in the temporal envelope. Performance in the correlated condition was independent of temporal variability, but decreased with increases in the time interval between the onsets of the two sequences. This pattern of results is consistent with an extension of a model of auditory discrimination developed by Durlach and Braida [J. Acoust. Soc. Am. 46, 372-383 (1969)], in which two processing modes are postulated: a trace mode and a context mode. When the tonal sequences had unique temporal patterns, context mode processing was dominant; when the sequences had identical temporal patterns, trace mode processing was preferred. The effect of variables such as the number of tones, the tone duration, the time gap between tones, and the time interval between sequences was consistent with the predictions of the discrimination model. PMID- 3680780 TI - Principal-component amplitude compression for the hearing impaired. AB - Principal-component amplitude compression, a means for matching speech to the reduced dynamic range in sensorineural hearing impairments, is a multiband approach aimed at preserving details of spectral shape while reducing overall level variation. The effect of compression has been studied for the first and second principal components (PC1 an PC2) of the short-term speech spectrum, which are roughly representative of overall level and spectral tilt, respectively. Compression of PC1 roughly equalizes consonant and vowel levels while compression of PC2 provides time-varying high-frequency emphasis. The effect on speech intelligibility of sensorineural hearing-impaired listeners of two principal component compression system implementations, compression of PC1 and compression of both PC1 and PC2, was compared to that of linear amplification (LA), independent compression of multiple bands (MBC), and wideband compression (WC). Results indicate that compression of overall level as provided by compression of PC1 and WC improved intelligibility relative to LA over a 10- to 15-dB range of input levels. While MBC was beneficial in some cases, it did not provide higher intelligibility than WC. Compression of PC2 did not benefit but rather degraded performance relative to LA. Error analyses and band-level measurements indicate that the highest intelligibility is obtained when audibility is improved and the relative spectral shapes of different speech sounds are preserved. PMID- 3680781 TI - Multidimensional tactile displays: identification of vibratory intensity, frequency, and contactor area. AB - Experiments were conducted to determine the ability of subjects to identify vibrotactile stimuli presented to the distal pad of the middle finger. The stimulus sets varied along one or more of the following dimensions: intensity of vibration, frequency of vibration, and contactor area. Identification performance was measured by information transfer. One-dimensional stimulus sets produced values in the range 1-2 bits and, for most subjects, three-dimensional sets produced values in the range 4-5 bits. Of the three dimensions considered, performance on the intensity variable was most affected, and performance on contactor area least affected, by simultaneous variations in the other dimensions. PMID- 3680782 TI - Effect of periodic rest on hearing loss and cochlear damage following exposure to noise. AB - Changes in hearing sensitivity and cochlear damage were determined in two groups of chinchillas exposed to an octave band of noise (OBN) centered at 0.5 kHz, 95 dB SPL on two different schedules: 6 h per day for 36 days, or 15 min/h for 144 days. Hearing sensitivity was measured behaviorally at 1/4-oct frequency intervals from 0.125 to 16.0 kHz before, during, and for a period of 1 to 2 months after the exposure, at which time the animals' cochleas were fixed and prepared for microscopic examination. Cochlear damage was determined by counts of missing sensory cells. Both exposures produced an initial shift of thresholds of 35-45 dB; however, after a few days of exposure, thresholds began to decline and eventually recovered to within 10-15 dB of original baseline values even though the exposure continued. Measures of recovery made after completion of the exposures indicated minimal permanent threshold shifts in all animals. The behavioral and anatomical data indicated that these intermittent exposures produced less temporary and permanent hearing loss and less cochlear damage than continuous exposures of equal energy. PMID- 3680783 TI - Effects of periodic rest on physiological measures of auditory sensitivity following exposure to noise. AB - Whole nerve action potential (AP) and single auditory-nerve fiber thresholds were measured in chinchillas exposed to noise. The exposure stimulus was a 500-Hz octave band of noise presented at 95 dB SPL for 15 min/h, for 4 or 40 days. The AP thresholds were elevated by about 40 dB on day 4, between 0.5 kHz and approximately 8 kHz. On day 40, AP thresholds at the same frequencies were lower by 10-25 dB, even though the noise exposure had continued. Single fiber threshold tuning curves exhibited pathologies similar to those previously observed following noise exposure. Tuning curves measured on day 40 were more normal in appearance. These results confirm that similar recovery of threshold observed in psychophysical experiments [Clark et al., J. Acoust. Soc. Am. 82, 1253-1264 (1987)] can be understood in terms of the sensitivity of the peripheral auditory system. PMID- 3680784 TI - The effect of intermittent noise on vigilance performance. AB - An experiment was conducted to determine the effect of the level of predictability of intermittent noise on performance on a visual vigilance task. Under a quiet condition and three intermittent noise conditions, subjects (Ss) carried out a 55-min task where they were required to detect a change in the brightness of one element of a visual display. The results indicated that Ss were less sensitive, less accurate, and more prone to response failures during intermittent noise, although responses were faster under noise conditions. Measures of response bias and response certainty were not significantly affected by the presentation of noise. Variation in the level of predictability of the noise affected only the accuracy of response measure during the final quarter of the vigilance task, with the group receiving the least predictable noise performing significantly worse than the other three groups. The results are discussed in relation to theories of noise and performance. PMID- 3680785 TI - Interim results of open-set speech discrimination with a wearable multichannel electrotactile speech processor [43.66.Ts, 43.66. Yw]. PMID- 3680786 TI - Dynamic limitation of coronary vasodilator reserve in patients with dilated cardiomyopathy and chest pain. AB - Twenty-six patients with dilated cardiomyopathy and angiographically normal coronary arteries, 12 of whom gave a history of anginal chest pain, underwent noninvasive and invasive hemodynamic study. During treadmill exercise testing, patients with a history of angina demonstrated worse effort tolerance (7.4 +/- 4.9 versus 13.6 +/- 5.1 minutes, p less than 0.005) and a lower end-exercise systolic blood pressure-heart rate product (17.9 +/- 3.4 versus 23.6 +/- 4.9 mm Hg.beats/min x 10(3), p less than 0.005) compared with patients without a history of angina. During rapid atrial pacing after ergonovine, 0.15 mg intravenously, 11 of the 12 patients with a history of angina experienced their typical chest pain, in contrast to only 1 of 12 patients without a history of angina. The angina group, compared with the nonangina group, had significantly lower great cardiac vein flow (118 +/- 24 versus 160 +/- 43 ml/min, p less than 0.01), and higher coronary resistance (0.87 +/- 0.21 versus 0.66 +/- 0.25 mm Hg.min/ml, p less than 0.05), significant widening of the arterial--great cardiac vein oxygen difference and a significant fall in cardiac index during pacing. Further, ergonovine resulted in higher coronary resistance during pacing in the angina group compared with pacing alone (+0.16 +/- 0.16 mm Hg min/ml, p less than 0.01), in the absence of significant reduction in epicardial coronary artery luminal diameter. After dipyridamole, 0.5 to 0.75 mg/kg intravenously, to 21 patients, the 7 patients with a history of angina had significantly lower flow (149 +/- 37 versus 218 +/- 73 ml/min, p less than 0.05) and higher coronary resistance (0.59 +/- 0.09 versus 0.43 +/- 0.17 mm Hg.min/ml, p less than 0.05) than did the nonangina group. It is concluded that patients with dilated cardiomyopathy and chest pain unrelated to epicardial coronary artery disease exhibit impaired vasodilator responses to both metabolic and pharmacologic stimuli, and an increased sensitivity to the vasoconstrictor effects of ergonovine. Whether these findings are of etiologic or long-term prognostic significance is unknown. PMID- 3680787 TI - Quantitative two-dimensional echocardiography in massive pulmonary embolism: emphasis on ventricular interdependence and leftward septal displacement. AB - In 14 patients requiring aggressive therapy for circulatory failure resulting from massive pulmonary embolism, hemodynamic and two-dimensional echocardiographic data were obtained at bedside (acute phase) and again after circulatory improvement (intermediate phase) and during recovery. The acute stage was characterized by a low cardiac output state despite inotropic support (cardiac index 1.9 +/- 0.6 liters/min per m2) associated with increased right atrial pressure (12.4 +/- 4.2 mm Hg), increased right ventricular end-systolic and end-diastolic area (12.4 +/- 3.4 and 15.4 +/- 4.1 cm2/m2, respectively) and reduced right ventricular fractional area contraction (20.1 +/- 8.6%). Two dimensional echocardiography also revealed interventricular septal flattening at both end-systole and end-diastole and markedly decreased left ventricular end diastolic dimensions. Left ventricular fractional area contraction remained normal. Hemodynamic improvement occurred during the intermediate phase as shown by restoration of cardiac index (3.3 +/- 0.6 liters/min per m2), decrease in right atrial pressure (8.3 +/- 4.8 mm Hg), reduction in right ventricular end systolic area (9.0 +/- 3.6 cm2/m2 at the intermediate stage and 6.1 +/- 1.8 cm2/m2 at recovery) and end-diastolic area (10.5 +/- 3.6 cm2/m2 at the intermediate stage and 8.9 +/- 2.9 cm2/m2 at recovery) and improvement in right ventricular fractional area contraction (31.5 +/- 16.4%). The interventricular septum progressively returned to a more normal configuration at both end-systole and end-diastole, and left ventricular diastolic dimension steadily increased. It is concluded that circulatory failure secondary to massive pulmonary embolism was mediated through a profound decrease in left ventricular preload, resulting from both pulmonary outflow obstruction and reduced left ventricular diastolic compliance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680788 TI - Effects of histamine on coronary hemodynamics in humans: role of H1 and H2 receptors. AB - To evaluate whether histamine exerts a direct effect on coronary hemodynamics in humans, and to investigate the role played by H1 and H2 receptors in this response, intracoronary saline solution or histamine (4 micrograms) was administered in 10 patients with normal coronary arteries during diagnostic cardiac catheterization. Histamine injection was repeated after intravenous cimetidine (400 mg) and diphenhydramine (10 mg). The electrocardiogram, arterial pressure and thermodilution coronary blood flow were continuously monitored during and for 40 seconds after each injection. Immediately after histamine injection there was a significant increase in coronary blood flow (65 +/- 6%) and a decrease in coronary vascular resistance (-40 +/- 3%) (both p less than 0.001), with minor changes in the RR interval and the mean arterial pressure. H2 receptor blockade with cimetidine did not affect these changes, while H1 receptor blockade with diphenhydramine significantly reduced the histamine-induced increase in coronary blood flow and the decrease in coronary vascular resistance (26 +/- 6%, p less than 0.005 and -18 +/- 5%, p less than 0.001, respectively). Twenty to 30 seconds after histamine injection, a significant decrease in mean arterial pressure (-17 +/- 2%, p less than 0.001) and in the RR interval (-4 +/- 1%, p less than 0.01) was observed. These changes persisted after H2 receptor blockade with cimetidine, but were completely abolished after H1 receptor blockade with diphenhydramine. In each case coronary and systemic hemodynamics returned to normal within 40 seconds of the injection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680789 TI - Right ventricular infarction: frequency, size and topography in coronary heart disease: a prospective study comprising 107 consecutive autopsies from a coronary care unit. AB - During a 14 month period autopsies were performed on 107 patients with coronary heart disease and the results were evaluated prospectively with special reference to right ventricular infarction. A total of 214 regional infarcts were found, 107 (50%) of which involved the right ventricle. Right ventricular infarction was found in 90 hearts (84%), but only three isolated right ventricular infarcts were seen. Right ventricular involvement was found with equal frequency in anterior and posterior infarction (64 versus 66%), but posterior right ventricular infarcts were much larger (15% of the right ventricle was infarcted versus 1%). Proximal right coronary artery occlusion caused larger right ventricular infarction than did distal occlusion (15 versus 5 g). Right ventricular infarct size was not influenced by coronary artery disease (evaluated angiographically) in noninfarct-related vessels. Anterior right ventricular infarcts were predominantly located near the apex of the heart (to the left of the sternum), whereas posterior right ventricular infarcts were located near the atrioventricular groove (along the right sternal border). Infarct size was equal in patients who died from a first acute anterior or posterior infarct. However, posterior infarcts had more right ventricular involvement (28% of total infarct size versus 7% in anterior infarcts) leaving more of the left ventricular myocardium intact (79 versus 64%). These differences in infarct topography may explain why right ventricular involvement seldom is diagnosed clinically in patients with anterior infarction, and why left ventricular function and prognosis usually are better after posterior compared with anterior infarcts of enzymatically equal size. PMID- 3680790 TI - Coexistent pulmonary and portal hypertension: morphologic and clinical features. AB - Patients with portal hypertension of varying etiology may develop pulmonary artery hypertension. In the present autopsy study, pulmonary and hepatic tissue was studied in 12 patients in whom pulmonary and portal hypertension coexisted. Plexogenic pulmonary arteriopathy was present in 10 patients, 7 of whom had coexistent thromboembolic lesions. One patient had isolated medial hypertrophy, which may be an early stage in the plexogenic category, whereas isolated thromboembolic pulmonary vascular disease was observed in one subject. Hepatic disease was consistent with alcoholic cirrhosis in seven patients, cryptogenic cirrhosis in four and extrahepatic portal hypertension without cirrhosis in one. Thrombocytopenia was present in all 10 patients whose platelet count was determined. This study suggests that pulmonary hypertension associated with portal hypertension commonly has a plexogenic appearance on histologic examination. However, thrombosis (whether embolic or in situ) may also contribute to vascular obstruction. PMID- 3680791 TI - Cardiac iron deposition in idiopathic hemochromatosis: histologic and analytic assessment of 14 hearts from autopsy. AB - In each heart taken from autopsies of 14 men with idiopathic hemochromatosis, the conduction system, atria and 10 sites in the ventricles were histologically graded for stainable iron. Stainable iron was exclusively sarcoplasmic; none was observed in the interstitium. The histologic grade for the same anatomic site varied among hearts and among different anatomic sites in the same heart. Ten hearts had stainable iron in all ventricular sites; one of the three hearts from patients who had undergone therapeutic phlebotomy had no iron at any site. Seven hearts had iron in the atria but at a lesser grade than that found in the ventricles; six hearts had mild focal iron deposition in the atrioventricular conduction system. None of the 14 hearts had stainable iron in the sinus node. Elemental iron was quantitated by atomic absorption spectroscopy in ventricular specimens contiguous to those studied histologically and also in age-matched control hearts. Elemental iron content was markedly increased in hearts with idiopathic hemochromatosis compared with control hearts (p less than 0.01). The quantity of elemental iron varied greatly, similar to stainable iron, but was highest subepicardially. Among the hearts from the 11 patients without prior phlebotomy, three had no stainable iron in the right ventricular septal subendocardium, suggesting that sampling error may be a problem in the evaluation of hemochromatosis by endomyocardial biopsy. The sarcoplasmic location of the iron indicates that cardiac involvement in idiopathic hemochromatosis represents a storage disease and not an infiltrative process; this finding is consistent with the normal ventricular wall thicknesses observed. PMID- 3680792 TI - Comparison of the ventricular response during atrial fibrillation in patients with enhanced atrioventricular node conduction and Wolff-Parkinson-White syndrome. AB - Although ventricular fibrillation is a well known sequel to atrial fibrillation in the Wolff-Parkinson-White syndrome, ventricular fibrillation is not generally associated with supraventricular tachycardia in the presence of enhanced atrioventricular (AV) node conduction without pre-excitation. It was hypothesized that the ventricular response during atrial fibrillation may be less in patients with enhanced AV node conduction than in their counterparts with Wolff-Parkinson White syndrome matched for anterograde effective refractory period. Slower ventricular rates during atrial fibrillation would suggest an increased propensity for concealed conduction in the enhanced AV node conduction group than in the group with an accessory pathway. Three groups of patients aged 16 to 65 years underwent electrophysiologic testing for supraventricular tachycardia or after surgical correction of Wolff-Parkinson-White syndrome. Sixteen patients had enhanced AV node conduction, 16 had Wolff-Parkinson-White syndrome and 16 had normal AV node conduction. Patients with enhanced AV node conduction and Wolff Parkinson-White syndrome were well matched for anterograde effective refractory period (245 +/- 22 versus 258 +/- 25 ms) and minimal cycle length, maintaining 1:1 anterograde conduction (261 +/- 21 versus 260 +/- 40). There was no difference in intervals during atrial fibrillation (average RR interval = 372 +/- 37 versus 346 +/- 66) or shortest RR interval (266 +/- 27 versus 243 +/- 51). Thus, patients with Wolff-Parkinson-White syndrome and those with enhanced AV node conduction matched for anterograde refractory period exhibit similar ventricular rates during atrial fibrillation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680793 TI - Effect of head-out water immersion on cardiorespiratory response to dynamic exercise. AB - Head-out water immersion is known to produce several cardiopulmonary adjustments at rest due to a cephalad shift in blood volume. The purpose of this study was to determine the effect of head-out water immersion on the cardiorespiratory response to graded dynamic exercise. Nineteen healthy middle-aged men performed upright cycling exercise at 40, 60 and 80% of maximal oxygen consumption on land and in water (31.0 +/- 1.0 degrees C) to the shoulders. Cardiac output (measured by the carbon dioxide rebreathing technique) was significantly greater in water at 40 and 80% maximal oxygen consumption. Stroke volume was significantly elevated at all stages of exercise. Heart rate did not differ significantly at 40 and 60% maximal oxygen consumption but was significantly lower in water at 80% maximal oxygen consumption. Total ventilation did not differ significantly in water and on land at any stage of exercise. The results suggest that the central redistribution of blood volume with head-out water immersion leads to an increase in stroke volume. Because there is not a proportional decrease in heart rate with the elevated stroke volume, cardiac output is regulated at a higher level during upright exercise in water compared with that on land. In conclusion, there are serious limitations of available, prerecorded rhythm data bases for designing and testing of automatic external defibrillators. Performance can be adequately assessed only by extensive clinical tests, which seem mandatory for this new and important type of defibrillator. PMID- 3680794 TI - Automatic external defibrillators: importance of field testing to evaluate performance. AB - A new automatic external defibrillator was tested first against a tape-recorded data base of rhythms and then during use by first-responding fire fighters in a tiered emergency system. The sensitivity for correctly classifying ventricular fibrillation and ventricular tachycardia was substantially less during clinical testing in 298 patients than would have been predicted from preclinical results: 52% of ventricular fibrillation analyses in patients were correctly classified versus 88% of episodes in the data base, and 22 versus 86%, respectively, for ventricular tachycardia (p less than 0.001). The detection algorithm was modified and evaluated further in another 322 patients. The modified detector performed substantially better than did the one that had been designed from prerecorded rhythms: with its use, 118 (94%) of 125 patients in ventricular fibrillation were counter-shocked compared with 91 (77%) of 118 similar patients with use of the initial algorithm (p less than 0.001). No inappropriate shocks were delivered. This improvement resulted in a shorter time to first shock (p less than 0.01) and more shocks being delivered for persistent or recurrent episodes of ventricular fibrillation (p less than 0.05). Of 620 patients treated with the automatic defibrillator, 243 (39%) had ventricular fibrillation; 57 (23%) of the 243 regained pulse and blood pressure before paramedics arrived, 141 (58%) were admitted to hospital and 71 (29%) were discharged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680795 TI - Electrophysiologic consequences of the Mustard repair of d-transposition of the great arteries. AB - This study describes the electrophysiologic effects of the Mustard repair of d transposition of the great arteries on the sinus node and on conduction and refractoriness in the atrium, atrioventricular (AV) node and ventricle. Seventy two electrophysiologic studies were performed on 64 patients after the Mustard operation. Standard rest and 24 hour ambulatory electrocardiograms were evaluated. Catheter endocardial atrial mapping, available in 67 of the 72 studies, revealed that sinus rhythm was present in the atria in 33 patients, ectopic atrial rhythm in 26 and junctional rhythm in 8. Intraatrial conduction delays with very late activation of the low medial, low lateral or low right atrium at the AV junction were present in 53 of 59 patients with atrial or sinus rhythm. Sinus node function was normal in only nine patients. Prolonged refractory periods were found in the right atrial portion of the new right atrium when compared with the left atrial portion of the new right atrium. Forty-one percent of the patients had prolongation of atrial refractoriness with shortening of the paced cycle lengths. Fifty-one percent developed sustained intraatrial reentry with programmed atrial stimulation. Forty-eight percent of these patients with inducible atrial tachycardia have since developed clinical episodes of atrial flutter. In summary, electrophysiologic studies revealed significant abnormalities of sinus node function and atrial conduction and refractoriness. Alone or in combination, these abnormalities, which result in severe bradycardia or rapid atrial arrhythmias, may lead to sudden death. The Jatene or arterial switch procedure may provide an appropriate alternative operation in this group of patients. PMID- 3680796 TI - Disharmony between atrioventricular connections and segmental combinations: unusual variants of "crisscross" hearts. AB - Two congenitally malformed hearts are described, one studied in life and the other at autopsy, in which the topology of the ventricular mass was not as expected for the atrioventricular (AV) connection present. In Case 1, studied at autopsy, there was the usual atrial arrangement with a concordant AV connection. The morphologically right ventricle, however, was left-sided and the ventricular mass was of left-hand topology (l loop) rather than the expected right-hand pattern (d loop). In Case 2, studied during life, there was the usual atrial arrangement and a discordant AV connection. Rather than the anticipated left-hand topology (l loop), the ventricular mass was arranged in right-hand fashion (d loop) and the morphologically right ventricle was right-sided. The cases emphasize that for a full description of a congenitally malformed heart, it is often necessary to account for the topology of each segment as well as the connections (or alignment) among the segments. PMID- 3680797 TI - When concordant or discordant atrioventricular alignments predict the ventricular situs wrongly. I. Solitus atria, concordant alignments, and L-loop ventricles. II. Solitus atria, discordant alignments, and D-loop ventricles. PMID- 3680798 TI - Diastolic blood pressure as a determinant of Doppler left ventricular filling indexes in normotensive adolescents. AB - Alterations in left ventricular filling can occur with aging and in patients with hypertension, ischemic heart disease, congestive and hypertrophic cardiomyopathy and congenital heart disease. This study examines the effects of blood pressure on left ventricular diastolic filling indexes measured by Doppler ultrasound technique in 47 young normotensive adolescents (mean age 13 years). Left ventricular filling was assessed by Doppler peak early and late diastolic transmitral flow velocities, early and late diastolic flow velocity integrals and early diastolic deceleration. Systolic blood pressure did not correlate with any of the Doppler filling indexes, although it was related to echocardiographic left ventricular mass (r = 0.44, p less than 0.005). Diastolic blood pressure did not correlate with left ventricular mass; however, it was inversely related to peak early diastolic flow velocity (r = -0.44, p less than 0.005), early diastolic flow velocity integral (r = -0.40, p less than 0.01) and early diastolic deceleration (r = -0.32, p less than 0.05). The ratio of late to early peak filling (A/E) was directly related to diastolic blood pressure (r = 0.48, p less than 0.001). Examination of electrocardiograms showed that there was a stronger correlation between A/E ratio and diastolic blood pressure (r = 0.63) in 22 subjects with bimodal P waves in lead V1 than in subjects with unimodal P waves (r = 0.45).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680799 TI - Sustained hemodynamic improvement during long-term therapy with levodopa in heart failure: role of plasma catecholamines. AB - Long-term therapy with oral sympathomimetic amines in patients with heart failure has been limited by the eventual development of diminished pharmacologic efficacy. However, a previous investigation in five subjects with heart failure suggested that long-term ingestion of levodopa, which is decarboxylated endogenously to dopamine, produces a sustained improvement in cardiac function. In the present study, levodopa was administered orally (1.5 to 2.0 g) to 14 patients with heart failure while hemodynamic responses and plasma catecholamines were monitored. Initially, an increase in cardiac index and stroke volume index was accompanied by a decline in systemic vascular resistance, mean pulmonary capillary wedge pressure and mean right atrial pressure. Heart rate and mean arterial pressure were unchanged. Plasma concentrations of dopamine rose substantially after drug ingestion and correlated significantly with changes in cardiac index (r = 0.73, p less than 0.05). After 12 weeks of treatment with levodopa, the changes in cardiac index, stroke volume index, systemic vascular resistance and plasma dopamine levels persisted (n = 12 patients). Moreover, a significant decrease occurred in the heart rate at rest. Although there was an initial tendency for plasma norepinephrine concentrations to increase, a return to control levels was documented after long-term treatment. Thus, tolerance to the hemodynamic actions of levodopa did not develop during long-term administration of the drug. The hemodynamic responses observed can be ascribed to the activation of beta 1-adrenoceptors and dopamine1 receptors by dopamine generated from levodopa. The dopamine2 activity of dopamine does not appear to be responsible for the improvement in cardiac performance produced by levodopa. PMID- 3680800 TI - Effect of a single oral dose of milrinone on left ventricular diastolic performance in the failing human heart. AB - In 14 patients with severe congestive heart failure, left ventricular pressure (measured by tip manometer) and derived variables were measured before and every 10 minutes after administration of oral milrinone (10 mg) for 50 minutes along with measurements of coronary sinus blood flow and drug plasma levels. Arterial and coronary sinus catecholamines were measured only before and 50 minutes after milrinone. Left ventricular pressure, volume (as determined by angiography) and derived indexes were simultaneously assessed at matched atrial paced heart rate before and 60 minutes after milrinone. Three patients who did not achieve a therapeutic plasma level (less than 150 ng/ml) were excluded. Peak negative first derivative of left ventricular pressure (-dP/dt) progressively and significantly increased (10%) together with a decrease in the two exponential time constants of relaxation, namely, Tau 1 (19%) and Tau 2 (22%), which represent the fit for and after the first 40 ms, respectively. Coronary flow significantly increased by 43% within 30 minutes, whereas the decrease (-13%) in coronary vascular resistance failed to be statistically significant. No change occurred in catecholamine concentrations after milrinone. Peak filling rate significantly increased by 15%. Pressure-volume curves showed a leftward and, in four patients, a downward shift; a significant decrease in minimal left ventricular diastolic and end-diastolic pressures (by 55 and 38%, respectively) and in end-diastolic volume (18%) occurred. The constant of elastic chamber stiffness measured by the simple elastic model tended to decrease, but failed to achieve a statistically significant level. Thus, oral milrinone improved left ventricular early relaxation and filling as well as chamber distensibility. This global improvement of diastolic function makes milrinone a potentially useful drug in the oral treatment of heart failure. PMID- 3680801 TI - A reference data base for multilead electrocardiographic computer measurement programs. AB - In an effort to standardize and evaluate the performance of electrocardiographic computer measurement programs, a 15 lead reference library has been developed based on simultaneously recorded standard 12 lead and orthogonal XYZ lead data. A set of 250 electrocardiograms (ECGs) with selected abnormalities was analyzed by a group of five referee cardiologists and 11 different 12 lead and 6 XYZ computer programs. Attention was focused on the exact determination of the onsets and offsets of P, QRS and T waves. The referees performed their task on highly amplified, selected complexes from the library in a two round process. Median results of the referees coincided best with the median derived from all programs. An analysis of stability proved that the combined program median was a robust reference. However, some individual program results were widely divergent. Paired t tests demonstrated earlier onset for P and QRS (p less than 0.001), as well as later offset for P and T waves in the median 12 lead than in the XYZ results. Significant differences also existed among results obtained by programs analyzing all standard ECG leads at one time, the so-called multilead programs, and those obtained by the conventional standard three lead analysis programs. As a consequence, the derived P, PR, QRS and QT interval measurements varied quite widely among the various programs. Significant differences were also observed among measurements of Q, R and S duration. Some programs showed Q waves that were on the average 6 ms (p less than 0.001) longer than those of others. This may significantly influence diagnostic performance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680802 TI - Profound structural alterations of the extracellular collagen matrix in postischemic dysfunctional ("stunned") but viable myocardium. AB - Ultrastructural studies of the extracellular collagen matrix were made on the "stunned" myocardium using scanning, conventional and high voltage transmission electron microscopy and light microscopy. Regional myocardial dysfunction was produced by 12 sequential 5 minute occlusions of the left anterior descending coronary artery, separated by 10 minute intervals of reperfusion. A final 90 minute reperfusion period documented persistent myocardial dysfunction. At the end of the final reperfusion period, the percent systolic shortening, measured by sonomicrometers, was depressed significantly to 35 +/- 9% of baseline. The heart was then perfusion fixed, and samples were taken from both control and stunned areas. No changes associated with irreversible cellular damage were noted in the stunned region. However, scanning electron microscopy of the stunned area showed that the extracellular collagen matrix underwent profound structural changes. Collagen cables were roughened, uncoiled and discontinuous. Linear grooves on the surface of the myocytes were frequently seen, indicating complete loss of collagen cables. The usual dense collagen weave surrounding myocytes became patchy or absent. Myocyte to myocyte struts were sparse and frequently absent, with remnant nodular or nublike structures indicative of breakage. High voltage electron microscopy of the stunned area showed that the collagen struts were discontinuous and vacuolated with rounded tips. Light microscopy of silver stained sections of the stunned tissue demonstrated large patchy areas that were devoid of silver, indicating absence of the collagen matrix. There was a progressive increase in percent systolic bulging during each sequential coronary occlusion, suggesting increasing myocardial compliance. These results indicate that the myocardial collagen matrix is severely damaged from reversible ischemic cell injury. The greater myocardial compliance and less effective contractile effort in the stunned myocardium might be explained on a structural basis: disruption of the mechanical coupling function provided by the extracellular collagen matrix. PMID- 3680803 TI - Intracoronary ethyl alcohol or phenol injection ablates aconitine-induced ventricular tachycardia in dogs. AB - The hypothesis whether localized ventricular tachycardia could be ablated by myocardial necrosis induced with chemical agents injected into a coronary artery was tested. In 59 anesthetized dogs, a diagonal branch of the left anterior descending coronary artery was cannulated either occlusively or nonocclusively. Localized ventricular tachycardia was induced by injecting approximately 0.01 ml of 30 micrograms/ml of aconitine solution into the left ventricular wall perfused by the cannulated diagonal branch in 54 dogs. In eight untreated control dogs, aconitine-induced ventricular tachycardia lasted 10.2 +/- 2.3 minutes or degenerated into ventricular fibrillation after 7.0 +/- 4.0 minutes. In the remaining 46 dogs, 1 ml of saline solution, 25, 50 or 100% ethyl alcohol or 0.94 ml (mean [range 0.4 to 2.0]) of 25% phenol at room temperature was injected into the occluded coronary artery and 1 ml of 100% ethyl alcohol at body temperature was injected into the nonoccluded coronary artery. Ventricular tachycardia was eliminated in 9 (82%) of 11 dogs receiving phenol, 7 (88%) of 8 dogs receiving 100% ethyl alcohol occlusively, 6 (75%) of 8 dogs receiving 100% ethyl alcohol nonocclusively and 6 (67%) of 9 dogs receiving 50% ethyl alcohol for an entire follow-up period of 10 to 60 minutes. However, saline solution and 25% ethyl alcohol suppressed ventricular tachycardia only transiently in 8 (53%) of 15 and 3 (60%) of 5 dogs, respectively. Left ventricular end-diastolic pressure rose from 8.0 to 11.2 mm Hg (p less than 0.05) immediately after injection of 100% ethyl alcohol in seven dogs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680804 TI - Proarrhythmic effects of ventricular electrical catheter ablation in dogs. AB - Electrical catheter ablation of arrhythmogenic sites is a new therapy for ventricular tachycardia that is still being investigated. Recent studies have shown, however, that the procedure itself can provoke serious ventricular arrhythmias. The incidence, course and mechanism of these arrhythmias were studied in 10 beagles treated with a single R wave-synchronized cathodal shock delivered to the endocardial ventricular wall (5 dogs left ventricular, 5 dogs right ventricular). Shocks were delivered at 30 (four dogs), 80 (two dogs) or 250 J (four dogs). Each dog underwent programmed electrical stimulation at or near the ablation site before, within 1 hour after and 1 week after the shock. Holter electrocardiographic monitoring (24 hours) was performed during day 1 and 7 after the shock in all the dogs, and extended Holter monitoring was done during the first 5 days in four dogs. All dogs survived for 1 week. Within 10 minutes after the shock, a sustained ventricular tachycardia was recorded in nine dogs; deterioration into ventricular fibrillation occurred in two dogs. In nine dogs, 60 to 169 monomorphic ventricular tachycardia episodes (mean 101) occurred on day 1 and 0 to 11 (mean 3) occurred on day 7; Holter monitoring failed for technical reasons in one dog. Extended Holter monitoring showed a marked decline in the incidence of tachycardia during the first 3 days. Early activation during ventricular tachycardia was always derived at or near the ablation site, and the QRS configuration during pre- and postablation pacing at this site was identical to the tachycardia configuration. Ventricular tachycardia was never inducible with programmed stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680805 TI - Thrombolytic therapy of acute myocardial infarction: emerging challenges of implementation. PMID- 3680806 TI - Report of the 1985 American College of Cardiology Survey of Cardiovascular Medicine Manpower. AB - As a first step toward cardiology manpower planning, 3,011 questionnaires were sent to a random sample of 24% of the membership of the American College of Cardiology. The response rate was 53%. The questionnaires covered personal and educational data, geographic aspects of practice, professional activities and sources of professional income. There were differences in these variables according to age. Data were also collected with regard to perceptions of manpower supply and needs. In these categories, regional differences were evident. PMID- 3680808 TI - Conduction system in sudden death. PMID- 3680807 TI - Anatomy versus physiology in the prognosis of coronary artery disease. PMID- 3680809 TI - Percutaneous balloon dilation of rheumatic mitral stenosis by the transarterial approach. PMID- 3680810 TI - A study of the human immune response to Lolium perenne (rye) pollen and its components, Lol p I and Lol p II (Rye I and Rye II). II. Longitudinal variation of antibody levels in relation to symptomatology and pollen exposure and correction of seasonally elevated antibody levels to basal values. AB - This study used a standardized, dialyzed, Lolium perenne (ryegrass) pollen extract and two of its well-characterized components, Lol p I (Rye I) and Lol p II (Rye II), to characterize the longitudinal variation of both IgE and IgG antibody (Ab) levels, as well as total serum IgE levels, in 20 grass-allergic subjects followed for 13 months. Ab levels declined toward a basal level just before, and increased just after, the grass-pollination season, returning to the same basal level just before the next grass-pollination season. The least complex allergen, Lol II, demonstrated the most uniform pattern of variation in both IgE and IgG Ab levels. Total serum IgE levels demonstrated the least regular pattern of variation. Grass-pollen counts were strongly correlated with symptom medication scores for these subjects (rs = 0.87). Initial values were correlated with the rise in total IgE and IgE Ab to Lol II across the grass-pollen season. Skin test results were correlated with initial IgE Ab levels for L. perenne pollen extract and Lol II. Finally, a procedure for correcting IgE Ab levels to basal values was proposed and tested. The correction procedure, for each IgE Ab, was based on the average rise during the grass-pollination season (or average decline after the grass-pollination season) observed for all subjects with that IgE Ab. PMID- 3680811 TI - The prevalence of allergic skin test reactivity to eight common aeroallergens in the U.S. population: results from the second National Health and Nutrition Examination Survey. AB - Immediate hypersensitivity skin tests to eight select allergens were performed on a sample (N = 16,204) of the civilian noninstitutional population of the United States, 6 to 74 years of age, in the second National Health and Nutrition Examination Survey (NHANES II). The eight allergens were house dust, cat, dog, Alternaria, mixed giant/short ragweed, oak, perennial ryegrass, and Bermuda grass. Skin test reactivity was defined as a mean erythema diameter greater than or equal to 10.5 mm at the 20-minute reading. Overall, 20.2% of the participants reacted to at least one allergen. Peak reactivity occurred in the 12 to 24-year old age group. Reactivity was higher in blacks versus whites, but the difference did not reach statistical significance (23.2% versus 19.8%; p greater than 0.05). Male participants had an increased prevalence of reactivity versus female participants in whites (22.0% versus 17.6%), but not in blacks (23.2% versus 23.3%). Skin test reactivity increased in both whites and blacks with increasing income and education. The prevalence of skin test reactivity was higher in urban versus rural areas, but the difference was statistically significant only for whites (whites, 21.6% versus 16.4%; blacks, 23.8% versus 18.4%; p greater than 0.05). With logistic regression, the most important predictors of skin test reactivity in whites were age, sex, urban residence, and poverty status. In blacks, the most important predictors were age, urban residence, and poverty status. PMID- 3680812 TI - In vivo and in vitro human airway responsiveness to leukotriene D4 in patients without asthma. AB - We have examined the in vivo airway responsiveness to leukotriene (LT) D4 in 11 patients without asthma who were to undergo thoracotomy and compared this responsiveness with in vitro sensitivity and in vitro contractility of bronchial smooth muscle to LTD4. In vivo responses were measured by the provocation concentration producing a 10% fall in FEV1, a 30% fall in partial flow rate at 30% of total lung capacity from a partial forced expiratory maneuver, and a 35% fall in specific airway conductance. In vitro sensitivity was measured as the concentration of LTD4 producing a 50% of maximum contraction and maximum-induced tension. The smooth muscle content of the bronchial strip was estimated microscopically, and the absolute quantity of muscle strip was compared with the maximum tension generated by that bronchial smooth muscle sample. In vivo results varied over 2 log units, and in vitro sensitivity, over 1 log unit. The absolute amount of smooth muscle present in bronchial strips correlated with maximal LTD4 induced tension. There was no relationship between in vivo responsiveness and in vitro sensitivity nor between in vivo responsiveness and maximum tension generated, even when this was corrected for the proportion of smooth muscle present in each bronchial strip. These results suggest that in vivo airway responsiveness to LTD4 is not determined by airway smooth muscle sensitivity or its ability to generate tension alone. Other factors must be influencing the response of the airway to LTD4. Nevertheless, the finding of a positive correlation between the absolute amount of smooth muscle present in bronchial strips and maximal LTD4-induced tension suggests that hypertrophy and/or hyperplasia of airway smooth muscle may contribute to in vivo airway hyperresponsiveness. PMID- 3680813 TI - Development of specific IgE antibodies after repeated exposure to snake venom. AB - A patient who had been working with snakes for many years developed urticarial lesions on contact with the venom of the poisonous rinkals (Haemachates haemachatus). More recently, the patient complained of generalized allergic reactions occurring within minutes of exposure to the venom. The patient's serum, but not control sera, contained IgE antibodies that reacted with the specific snake venom in an ELISA and was demonstrated to associate with a 66 kd component of the venom with Western blotting. With an ELISA, the patient's serum was also demonstrated to contain IgG antibodies to the specific snake venom and to venom from three other snakes with which the patient had previously been in contact. The possibility of an acute allergic reaction should be considered in individuals continuously working with snakes or in individuals who have previously been bitten by snakes. PMID- 3680814 TI - Skin test reactivity to histamine from infancy to old age. AB - The skin test reactivity to allergen and histamine differs according to the age of the patients, but complete data from infancy to old age are still lacking. Three hundred sixty-five subjects (1 to 85 years of age, 33.9% atopic, and 50.1% male patients) were prick tested with threefold dilutions of histamine hydrochloride (1 to 243 mg/ml). There was a significant (p less than 0.0001; F test) main effect of age on the skin reactivity to histamine. Age groups were defined and statistical analysis were performed by means of parallel line bioassay. All dose-response curves were linear and parallel. There is a significant increase in the mean wheal size between 4 to 5 and 6 to 9 years of age, 10 to 14 and 15 to 20 years. There was almost no difference between 15 to 20 and 21 to 50 years. No difference was observed between 21 to 30, 31 to 40, and 41 to 50 years, and then, the mean wheal sizes decreased significantly to reach a plateau after the age of 60 years. There was no sex difference, and skin tests with histamine were similar in atopic and nonatopic individuals. PMID- 3680815 TI - Immunologic evaluation of shrimp-allergic individuals. AB - Thirty-three individuals with a history of immediate hypersensitivity reactions after shrimp ingestion and 29 nonshrimp-sensitive control subjects were evaluated for evidence of crustacea-specific immunity by skin prick test titration end point, RAST, and ELISA, with extracts of shrimp, crab, crayfish, and lobster. Individuals were categorized as either atopic or nonatopic on the basis of history and skin test reactivity to common inhalant allergens. Most (28/33) shrimp-sensitive subjects had positive skin prick tests to shrimp extract, whereas skin tests were negative in 27/29 control subjects. Eighty-one percent of atopic and 41% of nonatopic shrimp-sensitive subjects had elevated shrimp-RAST ratios. The RAST ratios of atopic individuals were significantly higher than ratios of nonatopic individuals, and there was a significant correlation between shrimp-RAST ratios and historical clinical symptom scores. RAST determinations of all control subjects were negative. Shrimp-sensitive subjects also had significantly elevated serum levels of shrimp-specific IgG and IgA as compared to control individuals. Both IgG and IgA shrimp-specific reactivity demonstrated a significant positive correlation with shrimp-RAST ratios. These studies indicate that IgE-mediated, type I mechanisms, detected by positive shrimp skin tests and RASTs, appear to be operative in crustacea-sensitive individuals, particularly those with concurrent respiratory allergy. Although the role of shrimp-specific IgG and IgA antibodies in the immunopathogenesis of crustacea allergy remains unclear, such antibodies appear to represent increased immunologic recognition of shrimp allergens/antigens in shrimp-sensitive subjects. PMID- 3680817 TI - Allergen bronchial challenge tests: variability and reproducibility of the early response. AB - We evaluated allergen bronchial challenge tests (ABCTs) variability and reproducibility during 2-week intervals, respectively, in 28 and 14 Dermatophagoides pteronyssinus-sensitized patients. Increasing doses of Dpt (1.25 to 160 X 10(-3) mg) of lyophilized Dpt extract were administered at 20-minute intervals by doubling the previous dose. Dose-response curves (D-RC) were constructed for each test with the logarithm (base 2) of the allergen dose and the FEV1 in milliliters as ordinate. We analyzed different indices: the allergen doses causing a 15% decrease in FEV1 (PD15) and a 20% decrease in FEV1 (PD20), the slope of the curve beyond PD15, the overall slope, and the area under the parabolic curve. We found considerable intersubject variability in early asthmatic responses to Dpt ABCTs. Bronchoconstriction induced by allergen produced a specific D-RC for each individual. PD20 was significantly correlated with all the indices representing the whole D-RC (i.e., overall slope and area); moreover, PD20 was found on the steepest portion of the curve in 24 of 28 D-RCs. With the methodology used, we obtained a satisfactory reproducibility in a 2-week interval: the linear slope obtained by log base 2 transformation of doses was highly reproducible (p less than 0.001), as was area p under the parabolic curve. PD20 is significantly reproducible in a range of one doubling dose (twofold variation). The reproducibility of ABCTs over a short period permits solid arguments for their use in the evaluation of prophylactic treatment and in clinical research. PMID- 3680816 TI - Relationship between rate and extent of absorption of oral theophylline from Uniphyl brand of slow-release theophylline and resulting serum concentrations during multiple dosing. AB - The relationship between a standardized assessment of rate and extent of absorption of slow-release theophylline and serum concentrations during multiple dosing was examined in eight healthy adult volunteers. Each subject received single doses of a reference theophylline solution in addition to single and multiple doses of Uniphyl, a "once-a-day" theophylline formulation, administered after an overnight fast and after a large breakfast. Extent of absorption was similar during single and multiple dosing but was significantly greater when dose was taken after breakfast; 68 +/- 7% (mean +/- SEM) and 61 +/- 4% of administered doses were absorbed during single and multiple dosing, respectively, when breakfast was withheld, whereas 83 +/- 4% and 86 +/- 4% of administered doses were absorbed when single and multiple doses, respectively, followed breakfast. Observed mean serum concentrations during multiple dosing approximated values predicted from the single-dose study; mean peak serum concentrations averaged more than twice the tough for both predicted and observed values after both fasting and postprandial administration. These data demonstrate incomplete absorption of theophylline from Uniphyl with greater extent of absorption when Uniphyl is taken after food. The study also provides further documentation that characterization of rate and extent of absorption from single doses permit prediction of the mean serum concentration-time profile during multiple dosing at defined rates of theophylline elimination. This provides the potential to anticipate fluctuations in serum concentrations at clinically relevant elimination rates that deviate from the mean of samples typically used for study. PMID- 3680818 TI - Studies of the natural history of stinging-insect allergy: long-term follow-up of patients without immunotherapy. AB - This study reports the clinical and immunologic responses of 29 patients who were observed during a prolonged period after insect-sting anaphylaxis without venom immunotherapy. At the time of their initial evaluation, all patients had venom specific IgE, detected by skin test or RAST. Their mean age was 21 years; 16 patients were 16 years of age or less. There were 18 male and 11 female patients. Eleven patients had urticaria and angioedema as their only symptoms of anaphylaxis, and 18 patients had respiratory and/or cardiovascular symptoms. Reassessment was done 5 or more years after the initial evaluation. The average time at reevaluation was 10.1 years after the initial sting reaction. There had been 25 re-stings in 17 patients, with three systemic reactions occurring in two patients, an overall reaction rate of 12%. The time interval between the initial sting reaction and the follow-up sting was 2 to 14 years, mean 7.3 years. In patients with initial urticaria/angioedema symptoms only, there were 11 re-stings with no reactions. In patients with initial cardiovascular/respiratory symptoms, there were 14 re-stings with three reactions. At the time of follow-up evaluation, venom-specific IgE had generally decreased. In six of 25 patients, venom skin tests became negative, and in eight of 24 patients, the RAST became negative. These observations suggest that in many patients, stinging insect allergy is a self-limited process, with loss of clinical sensitivity and immunologic reactivity. PMID- 3680819 TI - Evolution of the hyperimmunoglobulin E and recurrent infection (HIE, JOB's) syndrome in a young girl. AB - The hyperimmunoglobulin E and recurrent infection syndrome is difficult to diagnose in children with markedly elevated IgE and recurrent superficial Staphylococcus aureus infections who have not presented with a severe infection. The patient, the child of a woman with HIE, had elevated cord blood IgE. In early infancy, she had cutaneous colonization with S. aureus followed by frank impetiginous lesions. Anti-S. aureus IgE was easily detected with a highly specific ELISA assay at 2 years of age (2 years before her presentation with a S. aureus subcutaneous abscess). Thus, the measurement of anti-S. aureus IgE by this technique may be a useful laboratory test for the diagnosis of HIE before the appearance of a severe infection. PMID- 3680820 TI - Building partnerships with the food marketing system: an expanding role for dietitians. PMID- 3680821 TI - Competencies of foodservice directors/managers required in health care operations. AB - The purpose of this research was to determine competencies of foodservice directors/managers as required by health care administrators and to ascertain the degree to which dietetic curriculums address those competencies. Validated questionnaires were mailed to a random sample of 376 health care administrators and 154 dietetic educators from various types of educational programs. Each questionnaire included 57 competencies representing the following areas: financial, technical, personnel management, nutrition services, production, and marketing. Health care administrators were asked to rate the degree of importance for each competency. Dietetic educators assessed the degree to which each competency was addressed in their curriculums. Of the 288 returned questionnaires, 243 contained usable data. Health care administrators' mean ratings were compared with dietetic educators' mean ratings. Significant differences were noted in 44 of the 57 competencies. Dietetic educators placed significantly greater emphasis on competencies related to nutrition services and significantly less on financial competencies than did health care administrators. Significant differences also were observed for selected competencies classified as technical and production. Results indicated that dietetic educators must continually evaluate curriculums and respond to the changing needs of the health care industry. PMID- 3680822 TI - Molybdenum, nickel, cobalt, vanadium, and strontium in total diets. AB - The 234 foods from a 1984 collection of the Food and Drug Administration's Total Diet Study were analyzed for the trace elements molybdenum, nickel, cobalt, vanadium, and strontium by plasma emission spectrometry. Daily intakes of these elements were then estimated for eight age-sex groups on the basis of results from national food consumption surveys. The contribution of food commodity groups to the daily intake of the five elements and the distribution of the elements in the 234 foods were also determined. Results from this study were compared with those reported earlier from other laboratories. PMID- 3680823 TI - Sources of sodium, potassium, and energy in the diets of adolescents. AB - Analysis of food diaries of 200 students in two boarding high schools indicated that 30% of their average daily sodium intake was contributed by bakery foods and ready-to-eat cereals. The next most important source of sodium (24%) was a category made up of food adjuncts, snack-type foods, soups, and beverages. The largest proportion of sodium in most foods had been added during food manufacture or preparation. Salt added at the table contributed less than 1% of the sodium in the diets of the teenagers. All students did not eat foods from all categories on their day of recording; 70% or more ate bakery products, dairy foods, food adjuncts, and meat, fish, poultry, and eggs. Changes in recipe formulations can decrease sodium content for a variety of bakery products, cereals, mixed dishes, snack-type foods, soups, and processed meats. It is therefore possible to make large reductions in dietary sodium without disturbing other nutrient values. PMID- 3680824 TI - Nutritional intake from food sources of high school football athletes. AB - Male high school football athletes served as subjects (no. = 134; age = 15.0 +/- 1.2 years, range = 12 to 18 years; weight = 67.7 +/- 13.9 kg) (mean +/- standard deviation) in a dietary survey project to characterize nutritional intake from food sources. Dietary intake data were collected using the recall method for 1 weekday during the summer when athletes participated in unsupervised, informal conditioning. Subjects were grouped by age as junior high (JR-HI: 12 to 14 years) or senior high (SR-HI: 15 to 18 years) students. Absolute mean energy and nutrient intakes, except for vitamin A, were statistically greater for SR-HI relative to JR-HI (p less than .02). These findings are consistent with age related growth on nutritional intake. Mean nutritional intakes from food sources for SR-HI met or exceeded the RDAs. For JR-HI, mean intakes met or exceeded the RDAs except for energy (94% RDA) and zinc (87% RDA). Mean intakes exceeded those of a representative sample of same-age boys in the larger American population. PMID- 3680825 TI - Nutrition knowledge of female varsity athletes and university students. AB - The objectives of this study were to compare the nutrition knowledge, including knowledge about nutrition in relation to physical activity, of female university students and members of varsity athletic teams and to document selected nutrition practices of those groups. Instruments developed for the study were completed by varsity athletes (no. = 70) and students not on teams (no. = 129). The two groups were similar in education, but the athletes were younger, taller, and heavier than the students and were considerably more active. The athletes used more nutritional supplements (especially iron) and were less likely to exclude red meat from their diet than were students. Scores on the knowledge test (which had a possible range of - 100% to 100%) averaged 34% for both team members and students. Both groups scored higher on general nutrition questions than on questions about nutrition in relation to activity. Among students, age, education, dietary pattern, total number of nutrition information sources, and length of time an activity program had been maintained were positively associated with nutrition knowledge. Those relationships were not detected among varsity athletes. It was concluded that female varsity athletes had levels of both general and sports-related nutrition knowledge that were similar to those of female students not participating on varsity teams. PMID- 3680826 TI - The 1990 National Nutrition Objectives: lessons for the future. AB - The 1990 objectives are a first attempt to establish quantified goals in public health nutrition. Lessons from this experience can benefit future efforts. Apparent problems related, for example, to data, methodology, feasibility, and clarity have hindered the implementation and monitoring of progress on several goals. A major step toward improvement is the development of standard criteria for evaluating proposed objectives. Dietitians and nutritionists have a special interest and responsibility in developing the National Nutrition Objectives for the Year 2000. They also have special opportunities for integrating current and future nutrition objectives into programs at the state and local levels. PMID- 3680827 TI - The Fifth World Food Survey: an assessment of food supplies and malnutrition. AB - The methodology and findings of the United Nations Food and Agriculture Organization's Fifth World Food Survey are reviewed. Data compiled from national food balance sheets indicate that per capita energy supplies increased by 14% during the past two decades. The number of undernourished is estimated for the periods 1969 to 1971 and 1979 to 1981 on the basis of a distribution of population food intakes and two alternative estimates of minimal energy requirements. The survey findings indicate that the proportion of undernourished in the developing market economies decreased, although an estimated 335 million to 494 million people fall in this category. In the least developed countries, the proportion of undernourished increased during this period. Elimination of poverty, the fundamental cause of malnutrition, through increased economic and agricultural development, is regarded as the only long-term solution to malnutrition. Short-term solutions are also needed to address interim needs and the diverse environmental, social, and cultural factors implicated in the causation of malnutrition. Short-term solutions include nutrition programs, complementary health measures, food subsidies, population programs, and programs aimed at improving the status of women. Projected future food needs in developing countries also indicate the need for increased international food trade and expanded foreign aid. PMID- 3680828 TI - Adolescent snacks: nutrient density and nutritional contribution to total intake. PMID- 3680830 TI - Iron supplementation in pregnancy: testing a new clinic protocol. PMID- 3680829 TI - Nutritional status of Native American adolescent substance users. PMID- 3680831 TI - Foodservice for the homeless: an innovative approach. PMID- 3680832 TI - Referral sources for dietitians in private practice. PMID- 3680833 TI - Nutritional adequacy of diet and supplements in patients with rheumatoid arthritis who take medications. PMID- 3680834 TI - Dietitians' involvement in research and publication. PMID- 3680835 TI - USDA software must be used onsite. PMID- 3680836 TI - Detection of antigens in Alzheimer cerebrospinal fluid by monoclonal antibodies. AB - Monoclonal antibodies raised against cerebrospinal fluid (CSF) and human ventral forebrain from patients with Alzheimer's disease were tested against CSF pools derived from patients with Alzheimer's disease and normal controls. Antibodies that appeared to distinguish the two pools were subsequently tested against 58 CSF samples from individual Alzheimer patients, normal controls, and individuals with other neurologic diseases. The mean CSF content of two antigens was decreased in patients with Alzheimer's disease compared with controls; the mean CSF content of one of these antigens was also decreased in patients with other neurologic diseases. Although group differences could be detected, the degree of overlap did not follow for the separation of individual patients within these three groups. PMID- 3680837 TI - The examination of physicians' awareness of dementing disorders. AB - Despite a significant increase in the amount of research being conducted on the etiology, diagnosis, and treatment of Alzheimer's disease and other dementing disorders, there has been little assessment of the utilization of this new wealth of information by the primary care physician. It was hypothesized that there would be a wide variation in physicians' knowledge of dementing disorders and the procedures used to diagnose these disorders. To quantitate the present status of primary care physicians' knowledge of dementing disorders and to investigate possible relationships between this knowledge and different physician and practice characteristics, 50 general internists and family practitioners from Winnebago County, Illinois, were interviewed regarding their recall of causes of dementia, procedures used in diagnosing these diseases, treatment recommendations, and comfort in making a differential diagnosis. Results revealed a wide variation in both physicians' familiarity with the causes of dementia as well as the procedures used in making the diagnosis. Although a majority (80%) of the physicians reported some degree of confidence in making a differential diagnosis of dementing disorders, a significant trend was found between physician age and comfort in making the diagnosis, with age being directly correlated with comfort. This was in spite of a significant negative association between physician age and immediate recall of causes of dementia. These data imply that younger physicians are entering the work force with at least better immediate recall of information on dementing disorders, but they have had little opportunity to become comfortable with that knowledge due to a generally smaller geriatric population in their practice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680838 TI - External catheter use and urinary tract infections among incontinent male nursing home patients. AB - In order to examine the relative frequency of urinary tract infection (UTI) and bacteriuria among male nursing home patients managed with and without external catheters (EC), we prospectively followed four cohorts of patients (EC worn continuously, N = 30; EC worn at night only, N = 19; incontinent without catheter, N = 13; and continent, N = 30) for a total of 497 patient months at risk. The proportion of patients with EC worn continuously who had at least one episode of bacteriuria (87%) and at least one UTI (40%), and the incidence of UTI (0.08 episodes per patient-month at risk) was significantly higher than among continent or incontinent patients without EC. Patients with EC at night only had an intermediate frequency of these findings. Differences in clinical and functional status characteristics among the four cohorts, in addition to the use of EC, could have contributed to the higher frequencies of bacteriuria and UTI. None of the clinical characteristics we examined were associated with the development of UTI among patients with EC. Further studies are necessary to identify factors associated with UTI among patients who are managed by EC so that effective preventive strategies can be developed and targeted to patients at high risk. PMID- 3680839 TI - Impact of intracardiac electrophysiologic testing on the management of elderly patients with recurrent syncope or near syncope. AB - Seventy-five patients, 75 years of age and over, experienced recurrent syncope, with the etiology remaining unclear but presumably cardiogenic, after cardiac and neurologic examinations and noninvasive laboratory testing (including an electrocardiogram and ambulatory electrocardiographic monitoring). The mean number of previous syncopal spells was 14 (range, 1 to 64) over a mean of 36 months (range, 1 to 480 months). These patients underwent invasive electrophysiologic testing and a potential cause for syncope was identified in 68%. Abnormal findings at electrophysiologic testing included: sinus node dysfunction (55%); abnormal His-bundle conduction (39%); and ventricular tachycardia (14%), with some patients having more than one abnormality. No major complications were associated with the electrophysiologic testing. Patients were subsequently treated with permanent cardiac pacing or antiarrhythmic drugs or both, depending upon results of the electrophysiologic study. Follow-up examinations (mean of 26 months; range, 1 to 70) were possible in 90% of patients. No further syncope occurred in 84% of patients with an abnormal electrophysiologic study who received subsequent therapy to prevent the identified abnormality. Thus, in this difficult group of patients with recurrent syncope of uncertain etiology, electrophysiologic testing was safe and indicated abnormalities of conduction or rhythm in 68% of patients; treatment to correct these abnormalities prevented recurrent syncope in 84%. PMID- 3680840 TI - Medical education responds to the 20th century's success story. PMID- 3680841 TI - Buddhist teachings on suffering and withholding care. PMID- 3680843 TI - Exploring the sting. PMID- 3680842 TI - Screening for thyroid disease in the elderly. PMID- 3680844 TI - Contact lens wear and the corneal endothelium. AB - Contact lenses produce transient and permanent effects on the corneal endothelium in relationship to the lens oxygen transmissibility and how the contact lenses are worn. There is concern, as well as growing evidence, that contact lens induced corneal endothelial pleomorphism causes a reduction in the endothelial functional capacity. This, in turn, may place an eye at risk for uncontrolled corneal swelling if the eye is under sufficient environmental or surgical stress. Use of lens materials and designs which promote high oxygen transmissibility, and patient wear of lenses during waking hours only, are ways to slow the development of permanent corneal endothelial pleomorphism. PMID- 3680845 TI - A programmed feedback control of solvent vapour concentrations in experimental inhalation chambers. AB - This paper describes a computer-controlled system to regulate solvent vapour concentrations in experimental inhalation devices. This system consists of an exposure chamber, a bubbler with a mass flow-meter, a monitor gas chromatograph and a computer. The frequency of automatic sampling was dependent upon the retention time of test materials. Flow-rate was corrected through a computer regulated bubbler as soon as the mean chamber concentration varied by more than 2.5% of a command level. Regulation coefficients were calculated by relating the concentration of vapours sampled with adsorbent tubes to the mean peak areas given by the monitor gas chromatograph. They were then fed into the computer allowing the actual concentration to be adjusted to the command level. Deliberately induced fluctuations in the level of acetone, ethanol and trichloroethylene, either sudden or progressive, were satisfactorily corrected as were fluctuations occurring normally during repeated exposures to ethanol. Variations were generally inferior to 5% of the command level. PMID- 3680846 TI - Time-course studies of the distribution of [1-14C]acrylonitrile in rats after intravenous administration. AB - Intravenous injection of acrylonitrile (ACN) causes adrenal hemorrhagic necrosis. ACN and its metabolites react with glutathione and bind covalently with macromolecules. Hence the purpose of this investigation was to measure the distribution and covalent binding of radiolabel derived from [1-14C]ACN in order to determine whether binding of ACN or its metabolites may be implicated in the pathogenesis of ACN-induced adrenal injury. Following intravenous injections of ACN, concentrations of total radiolabel were highest in the blood, liver, duodenum, kidneys, and adrenals. Except for blood, there was a time-dependent decrease in total radiolabel in these tissues. Compared with other major organ systems, the levels of covalently bound radiolabel were lower in the adrenal glands. These results do not support a role of covalent binding of ACN or its metabolites in the adrenal toxicity of ACN, but suggest that the initial high concentrations of total radiolabelled compounds derived from ACN could play a role in the action of ACN on the adrenal glands. PMID- 3680847 TI - Acute inhalation toxicity of 3,3-dimethyl-2-butanol in Sprague-Dawley rats. AB - Sprague-Dawley rats were given 15, 70 and 140 min exposures to 15 mg/l 3,3 dimethyl-2-butanol, pinacolyl alcohol (PA), or 6-hour exposures to 0.2, 1.0 and 5.0 mg/l PA (1 mg/l = 240 ppm). A 50% mortality rate was obtained at the longest exposure to 15 mg/l. Sex related differences in the blood levels of PA and pinacolone were noted, and the surviving male rats failed to gain weight normally in the first week after exposure. In rats exposed to 5.0 mg/l for 6 hours, there were reductions in horizontal and vertical activity and the minute volume was 55% of controls at the end of exposure. Like many secondary alcohols, PA poses only a possible inhalation hazard; however, male rats may be somewhat more susceptible than females. PMID- 3680848 TI - Developmental toxicity studies of caprolactam in the rat and rabbit. AB - Caprolactam was evaluated for developmental toxicity potential in both rats and rabbits by the oral route. In rats dosed on days 6-15 of gestation with 100, 500 or 1000 mg/kg/day of caprolactam, the maternal survival rate was significantly lower in the high-dose group and implantation efficiencies were slightly lower in the 100 and 1000 mg/groups (but not the 500 mg/kg) than in the control. The incidence of fetal death was comparable for all groups, and the incidence of fetal viability was considerably lower in the high-dose group (but not the mid or low) than in the control group. Visceral anomalies and one visceral variant were observed in one 100 mg/kg and one 500 mg/kg pup, respectively. The anomalies included exencephaly, an incomplete left eyelid, microphthalmia (right), and a protruding tongue. No skeletal anomalies were observed. It was concluded that caprolactam at levels up to at least 500 mg/kg of body weight produced no teratogenic effects in the Fischer 344 rats. In rabbits receiving 50, 150 or 250 mg/kg caprolactam on days 6-28 of gestation, the pregnancy rate in all groups was at least 80%. The numbers of corpora lutea, live and dead fetuses, resorptions, the sex ratio and the pre- and post-implantation losses were not significantly different among the test and control groups. The incidence of major malformations and of minor skeletal anomalies was unaffected by treatment with caprolactam. Maternal weights were depressed in the group receiving 250 mg/kg. Treatment of a separate group with a positive control substance (6-aminonicotinamide) resulted in significantly (P less than 0.001) increased incidences of major malformations, minor visceral anomalies and minor skeletal anomalies. Maternal toxicity in terms of mortality was observed in pregnant rabbits treated with caprolactam at a dose of 250 mg/kg/day. Fetotoxicity was evidenced by lower fetal weights at the 150 and 250 mg/kg/day levels, and an increased incidence of thirteenth ribs was observed at the 250 mg/kg/day dose level. Neither embryotoxicity nor teratogenicity occurred at any dose level. PMID- 3680849 TI - Subchronic dermal toxicity studies of Alcide Allay gel and liquid in rabbits. AB - Alcide is a germicidal agent which is highly effective in killing a wide range of bacteria and fungi. 2.0 g kg-1 Allay gel or placebo were applied once per day while 3.0 g kg-1 Allay liquid or placebo were administered three times per day over a 30 day period to the skin of albino rabbits. Allay gel and liquid contained either of two concentrations of sodium chlorite and lactic acid as active ingredients. The concentration of active ingredients, sodium chlorite and lactic acid, in the low dose gel was 25% of high dose gel and low dose liquid was 60% of high dose liquid. Moderate to severe erythema was observed only in the high dose gel group after 7 days of treatment, but skin appeared visibly normal by day 18. Histologically fixed skin at day 30, however, showed inflammatory changes in the high and low dose gel groups and hyperkeratosis in all gel groups. At the termination of the study, mean corpuscular hemoglobin concentration decreased significantly in the Allay gel and liquid groups compared to an untreated control group. In all gel treatments, BUN/creatinine levels decreased significantly. Hematology and clinical chemistry parameters, however, were within the normal range of values for the gel and liquid groups, indicating no clinically significant changes due to Allay treatment. Pancreas/body weight ratios were significantly reduced in all gel groups, while spleen, pancreas and ovary/body weight ratios were significantly higher in both liquid dosage groups. No histological changes were observed in any of these organs. PMID- 3680850 TI - Renal and hepatic lesions induced by 2,2,4-trimethylpentane. AB - The renal changes produced by 2,2,4-trimethylpentane, a constituent of unleaded gasoline, are studied in Wistar rats. The compound was given at a dose of 2 ml/kg daily by gavage dissolved in corn oil (2:1) to nine Wistar Albino rats. Nine control male rats received an equivalent dose of corn oil. Six animals were housed in metabowls to allow the collection of urine for enzyme and urinanalysis. The remaining three animals of each group were housed in a normal animal cage. After 2 days of treatment, all the test rats were noted to have lost weight and were killed on this or on the subsequent day. Macroscopic examination of the livers and kidneys revealed no visible lesions on the kidney, but two of the rats had white, slightly raised patches on the liver. Microscopic examination demonstrated centrilobular and confluent necrosis, hydropic degeneration and vacuolation of hepatocytes. Microscopic examination of the kidneys indicated eosinophilic hyaline droplet accumulation in the cells of the tubules, and tubular dilation. Analysis of plasma alkaline phosphatase and aspartate transaminase activity revealed increases consistent with liver damage. Analysis of urinary N-acetyl-beta-glucosaminidase and alkaline phosphatase activity showed increases consistent with renal toxicity. An apparent increase in the amount of cellular debris in the urine was also found, when the sediment was examined microscopically. From this study, it would appear that 2,2,4-trimethylpentane possess hepatotoxic as well as nephrotoxic properties. PMID- 3680851 TI - Inhalation toxicity of ribavirin in suckling ferrets. AB - Ribavirin is a broad-spectrum antiviral agent useful for treatment of infants. To study the effects in developing mammalian lungs, four groups of jill ferrets and their litters were given whole body inhalation exposures for 6 h a day for 10 or 30 consecutive days to concentrations of 0 (vehicle control), 162, 355 or 620 mg/m3. The effects, including special lung observations in suckling kits, were evaluated after exposures at weaning and at puberty. First the high dose, then the mid dose jills developed lactation failure. Probably due to nutritional deficiency, approximately half of the mid dose and three quarters of the high dose kits were found dead or killed whilst moribund. There were no test compound related deaths in the control or low dose level groups. Reductions in body weight gain were observed in both 10 and 30 day exposed kits, and high dose kits actually lost weight as exposure continued. Some recovery was apparent in survivors. Some discoloration of the liver was seen in malnourished kits at necropsy. There were no gross or histopathologic lesions in the lungs or tracheas of suckling ferrets attributable to the test material. Ribavirin exposure had no effect on the lavageable cell pool, while lung DNA to protein ratios showed a mild, reversible, proliferative response in smaller kits. There were no differences in lung function between controls and low dose kits of either group. Effects seen in the higher dose groups are due to differences in size. While there may have been a real dose-related enlargement of alveolar diameters at 40 days of age, this disappeared in males by puberty and did not seem toxicologically significant in females. The low dose, which corresponds to an exposure dose 4 to 6 times that used clinically, appeared to be a no-effect level. PMID- 3680852 TI - Measurement of a glycoprotein with blood group A activity by light scattering. AB - A light scattering method for quantifying glycoproteins is presented. Conditions of ethanol concentration, wavelength, time of reading, and sample and reagent volumes have been examined. The definitive assay involves addition of 9 vol absolute ethanol to 1 vol sample, mixing, and readings at 105 degrees angle at the interval between 10 and 13 min after placing the cell into the photometer. The obtained values are temperature-dependent. Thus, temperature control is essential. In this assay, a concentration range of 10-60 micrograms glycoprotein has been used. As described, the method is independent of the chemical composition of the different glycoproteins and is barely influenced by size and shape of glycoproteins. PMID- 3680853 TI - A simple and rapid procedure for the isolation of intact bovine rod outer segments (ROS). AB - A method is described which allows the rapid isolation and purification of intact rod outer segments (ROS) from cattle eyes. It requires very fresh retinal material and can be completed within less than 2 h of the death of the animals. Cattle eyes are dissected in the usual manner, the retinae are isolated and the ROS are separated from the rest of the retina by gentle vortexing and filtration through a nylon mesh. The resulting crude ROS suspension is purified on a discontinuous sucrose density gradient. Two fractions are obtained, the major one consisting of mostly intact ROS, the minor one of RIS-ROS, i.e. of ROS which are still connected to part of their inner segment. The ROS are washed once and can be stored on ice for several days without loosing their intact plasma membrane. They can be transformed to leaky ROS by a quick freeze/thawing cycle or, if one wants unobstructed access to the interdiskal space, they can be subjected to a mild lysis treatment. The resulting ROS material is characterised using light microscopy, electron microscopy, light scattering, gel electrophoresis and absorption spectroscopy. It contains unusually low levels of 48k-protein and very high levels of G-protein. The latter cannot be washed out in the presence of GTP gamma-S, even in the case of leaky ROS. PMID- 3680854 TI - Purification of human hemoglobin valence intermediates by preparative immobilized pH gradients. AB - We compare three separation techniques for preparative purposes, i.e. ion exchange chromatography on CM-cellulose, conventional isoelectric focusing in polyacrylamide gel slabs and immobilized pH gradients. The biological system used to test the three methods is a solution containing four hemoglobin (Hb) valence intermediates, i.e. metHb, oxyHb, (alpha + beta O2)2 and (alpha O2 beta +)2. The delta pI between the two valence intermediates is 0.04 pH units. Immobilized pH gradients give the best performance in terms of resolving power, total amount of protein which can be loaded and retention of biological activity by the protein (the latter assessed by determination of CO dissociation rates). PMID- 3680855 TI - Automation of protein assays with a microcomputer interfaced to a spectrophotometer. AB - We have developed a system for semi-automatic protein quantitation assays based on an inexpensive, general-purpose microcomputer. A commercial curve fitting program was modified for direct data input from the spectrophotometer via an analog to digital converter. The software provides specific prompts for protein assays resulting in a rapid and user friendly, semi-automated system. A listing of the protein assay results are printed, or stored to a magnetic disk, along with a graphic representation of the standard curve. PMID- 3680856 TI - An iterative method for the deconvolution of microcalorimeter thermograms. AB - An iterative method for the deconvolution of microcalorimetry thermograms suitable for small digital computers is presented. The method employs a measured impulse response function directly as the deconvolution kernel, thus explicit system simulation is not required. Data are presented showing the performance of the method and the exchange of signal-to-noise ratio for time resolution that is made when deconvolution techniques are employed. An improvement in the system time resolution of fifty times is demonstrated with measured data. PMID- 3680857 TI - A spectrophotometric method for following initial rate kinetics of blood platelet aggregation. AB - A double-beam recording spectrophotometer was used to assay platelet aggregation. Agonist-induced turbidity changes, at 540 nm, in dilute suspensions of platelets (1 ml, 6-8 X 10(7) platelets) were recorded differentially against a reference cuvette, also containing platelets, as a function of time. The curves obtained showed downward pen deflections (decrease of turbidity) abolished by preincubation with the aggregation inhibitor, citrate. The turbidity decrease occurred simultaneously with microscopically determined single platelet recruitment into aggregates and its initial slope (r0) was a linear function of platelet concentration upto approximately 1.5 X 10(8) per ml. At a fixed platelet concentration the r0 values of ADP-induced aggregation of calf platelet-rich plasma varied as a hyperbolic function of ADP concentration at both 32 degrees C and 37 degrees C. The kinetic data at 37 degrees C were comparable to those, in the literature, obtained by following single platelet recruitment into aggregates. The increase in turbidity due to ADP-induced shape-change (6 +/- 1%, mean +/- S.E.M., n = 7) measured in the present study was substantially greater than that (3%) measured in the aggregometer. PMID- 3680858 TI - Determination of an immunosuppressive substance in serum by latex particle electrophoresis. AB - The level of immunosuppressive substance (IS), which increases in the serum of patients with cancer, was determined by an assay based on particle electrophoresis. Polystyrene latex particles (PLP) were coated with IS, which was extracted from the ascitic fluid of patients with cancer. The IS was a glycoprotein with a molecular weight of about 52,000, and an isoelectric point in the range pH 2.7-3.3. When the IS on the surface of the PLP reacted with the anti IS antibody, the mean electrophoretic mobility of the PLP changed from -3.16 to +0.21 micron.s-1.V-1.cm in the medium of pH 7.2 and ionic strength I = 0.0154. After preincubation of anti-IS antiserum and tested serum, the PLP coated with IS were added to this solution. It was incubated again and then the surface charge of the PLP was measured by an automatic cell-electrophoretic instrument. This method was used to determine the IS concentration in the serum of cancer patients and pregnant women. When compared to healthy controls, the serum IS level was significantly higher in patients with cancer, and lower in pregnant women. The assay based on latex-particle electrophoresis proved to be a sensitive and rapid method for determining the IS level in serum. PMID- 3680859 TI - Generation of a fast and homogeneous temperature step. AB - A method is described for the fast and homogeneous increase of the temperature of a biological specimen with a volume of 1 mm3 or less. Heating is obtained by joule dissipation from a 30 MHz alternating current. The step quality is determined by measuring the temporal and spatial behaviour of the temperature after a power pulse in and around the biological preparation. With the described equipment a temperature step of 3 degrees C can be obtained in 8 ms. The temperature step inhomogeneity is less than 15%. The compatibility of the method with electrophysiological and mechanical measurement and instrumentation is demonstrated by the detection of transients in transmembrane potential and force of a papillary muscle from the rabbit heart. PMID- 3680860 TI - A novel fluorometric assay for quantitative analysis of dihydrofolate reductase activity in biological samples. AB - In an effort to study the level of dihydrofolate reductase (DHFR), the main molecular target of antifolate drugs, in healthy and malignant tissues of human origin, a new and convenient fluorometric enzymatic assay has been developed. The technique measures the overall decrease in fluorescence emission at 454 nm (lambda ex = 342 nm) due to the contributions from coenzyme oxidation and substrate reduction. This technique was developed by using an enzyme purified from beef liver. All criteria of quality were checked: sensitivity, reproducibility and specificity made it suitable for low activity measurements. It was successfully applied to human tissue crude extracts. PMID- 3680861 TI - Protein determination in materials containing melanin. AB - Strategy of protein determination in melanin containing samples was analyzed, and the prerequisites under which the Lowry procedure could be used were established. (a) Complete solubilization of proteins from melanosomes was not reached until the treatment with 3% sodium dodecylsulfate at 100 degrees C was prolonged to 5 h. (b) It is necessary to correct the data obtained with Folin reaction to eliminate melanin interference. (c) The correction is based upon the determination of the extent of solubilized melanin and subtraction of the corresponding Folin-Ciocalteu reaction values. (d) The extent of correction due to the melanin interference was found to be about 40% of the absorbance value. It was concluded that correction of the data obtained with Lowry assay is possible, but the procedure is complicated and time-consuming. However, a more simple modification has not been developed. PMID- 3680862 TI - Some metabolic changes induced by endosulfan in hepatic and extra hepatic tissues of rat. AB - Effects of three different doses of endosulfan respectively designated as low, medium and high on cytochrome P450(Cyt.P450), glutathione S-transferase(GST) activity and glutathione content (GSH) of hepatic and extra hepatic tissues of rat were determined after 24 hours of treatment. Endosulfan caused induction of cyt. P450 in liver, lung and brain at all the three doses tested while in kidney, spleen and heart either induction or reduction took place and was unrelated with dosages of endosulfan. Similarly, GST activity significantly changed in extra hepatic tissues while liver GST activity did not record any significant alteration under the experimental conditions. The GSH content also showed changes (increase/decrease) unrelated to endosulfan dosages in different organs. Thus, the effects varied with organ and dosages. As these metabolic parameters are involved in biotransformation of many endogenous molecules as well, the study may throw some light on physiological disturbances due to changes in metabolizing system on one side and organ specificity in toxic action of endosulfan on the other. PMID- 3680863 TI - Foot complaints attributed to heel pain. PMID- 3680864 TI - Therapeutic value of hyperbaric oxygen in lower extremity ulcerations. AB - Hyperbaric oxygen is a topical measure that may be an alternative treatment in chronic ulcerative skin lesions. Hyperbaric oxygen, when used with the correct criteria, will increase microcirculation of a lesion and facilitate healing time. The focus of this paper is to review the indications and contraindications, as well as the methods, in use of hyperbaric oxygen therapy. PMID- 3680865 TI - Osteoid osteoma of the hallux. AB - Osteoid osteoma is a benign bone tumor, first reported 50 years ago. Various characteristics of this bone tumor have remained consistent throughout the years. A discussion of the previous literature on osteoid osteoma and its characteristics are presented in this article, with a case report. PMID- 3680866 TI - The Keller-Austin bunionectomy. AB - The authors present the combined use of the Keller bunionectomy with the Austin osteotomy in select cases. Severe degenerative joint disease and metatarsus primus varus with fair to good bone stock are the major criteria. This procedure offers an alternative for the elderly patient who is not a candidate for joint salvage, implant or base osteotomy. Preoperative, intraoperative and postoperative biomechanical evaluations are essential to the success of this procedure. PMID- 3680867 TI - Unusual osteochondroma of the foot and ankle. AB - Osteochondroma, also known as osteocartilaginous exostosis, is by far the most commonly occurring benign bone neoplasm. Its occurrence is the most frequent of all osseous tumors found in the foot. A basic review is discussed along with two case reports. The first case describes an osteochondroma of the third metatarsal shaft that became symptomatic during boot camp. The second case presents an atypical osteochondroma arising from the posterior aspect of the talus. PMID- 3680868 TI - Results of surgical treatment of talipes equino valgus by means of navicular cuneiform arthrodesis with midcuboid osteotomy. AB - The results of naviculocuneiform arthrodesis with midcuboid osteotomy for correction of talipes equino valgus are presented. Criteria for this procedure are developed. Overall efficacy of this technique is questioned. PMID- 3680869 TI - Derotational Akin osteotomy: further modification. AB - The authors discuss further modification of the derotational Akin osteotomy. The results of 20 patients are reviewed and additional procedures listed. They also discuss the reasons for the modification and fixation of the osteotomy. PMID- 3680870 TI - Fibroma of tendon sheath. AB - Fibroma of the tendon sheath is a distinct clinicopathologic entity rarely occurring on the foot. It is a benign tumor derived from the fibroblast that clinically appears as a slow-growing painless mass. Complete surgical excision is curative. Recurrence occurs in 24% of the cases, usually due to inadequate excision. This report describes a 36-year-old man with such a tumor of the foot. PMID- 3680871 TI - Recalcitrant contact shoe dermatitis. AB - Contact shoe dermatitis is a common dermatologic problem. Misdiagnosis of this condition can lead to significant disability. An organized and detailed evaluation of the patient with foot lesions leads to proper diagnosis and treatment. Review of the literature and a case study of contact shoe dermatitis, along with a discussion of its complications and resolution, are presented in this report. PMID- 3680874 TI - Problems with step-wise regression in research on aging and recommended alternatives. AB - The use of step-wise regression techniques in aging research brings with it certain interpretative difficulties. Both geometric and algebraic approaches are used to demonstrate that although step-wise procedures pose little difficulty if predictors are orthogonal, these same procedures, when used with correlated predictors, can lead to poor tests of the predictor regression weights. Techniques that are useful in the detection of multicollinearity are discussed. Principal components regression, ridge regression, and hierarchical regression are evaluated as potential techniques for assessing the relative importance of predictors when these variables are correlated, as is common in aging research. Hierarchical regression is the most recommended technique in that it is theory driven rather than dependent on empirical relations that may be sample-specific and unstable. PMID- 3680873 TI - McCune-Albright syndrome with gigantism and hyperprolactinemia. AB - We describe the case of a 38-year-old man with typical Mc Cune-Albright syndrome and the unusual combination of both growth-hormone and prolactin hypersecretion. The patient was extremely tall, which is unusual in Mc Cune-Albright syndrome, suggesting that he did not have precocious fusion of the epiphysis, a common finding in this syndrome. Unfortunately the patient refused any treatment for his disease. A similar case has been previously described only in a 14-year-old boy. PMID- 3680872 TI - Characterization of differences in insulin receptors from young and old red blood cells. AB - It has been demonstrated that young RBCs (reticulocytes and early mature erythrocytes) possess more insulin receptors than old RBCs (late mature erythrocytes) but it is not yet known whether insulin receptors on young and old RBCs are regulated similarly. In the present investigation insulin receptors on young and old RBCs have, therefore, been studied in five normal male subjects before and after 2 days dexamethasone ingestion (0.5 mg tablet every 6 h) and, in the same subjects, before and 5 h after ingestion of 75 g glucose. The results obtained clearly demonstrate that dexamethasone increases insulin receptor concentration while glucose ingestion increases both insulin receptor affinity and concentration on young RBCs. By contrast, neither stimuli modify insulin receptors on old RBCs. Studies on RBCs are usually performed on the whole RBC population not taking into account this differential responsiveness of receptors on young versus old RBCs; consequently, this phenomenon might be responsible of the fact that some data reported on RBCs are not in agreement with those reported on monocytes or adipocytes and it should be taken into consideration when using RBCs to evaluate insulin receptor regulation. PMID- 3680875 TI - Effects of age, stimulus selection, and retrieval environment on odor identification. AB - Age differences in odor identification were investigated by using relatively familiar and unfamiliar chemical stimuli and enhancing the retrieval environment by restrictive reminding of memories evoked by stimulus during initial presentation. Age differences were seen in initial identification, in learning the labels of items in the stimulus set, in presentation. Age differences were seen in initial identification, in learning the labels of items in the stimulus set, in forgetting over a 24-hr period, but not in forgetting over a 7-day period. Old (n = 20) and young (n = 20) study participants benefitted equally from enrichment of retrieval environment with restrictive reminding of memories evoked at initial presentation. Item analysis indicated that selection of stimuli had a significant effect on age differences in odor identification. PMID- 3680876 TI - Understanding the stress process: linking social support with locus of control beliefs. AB - Although researchers generally agree that social support reduces the impact of stress on psychological well-being, little is known about how this stress buffering effect actually takes place. The purpose of this study was to demonstrate that social support operates by bolstering internal locus of control beliefs. Data from a longitudinal study of older adults suggest that the relationship between support and perceived control is nonlinear. Increases in social support tend to increase feelings of control, but only up to a certain threshold. Beyond this point, additional support tends to decrease feelings of personal control. This nonlinear relationship was observed with emotional support and integration (i.e., support provided to others) but not with informational or tangible support. PMID- 3680877 TI - Optimism and locus of control for health and affiliation among elderly adults. AB - Ninety-two elderly adults ranging in age from 69 to 100 and residing in a retirement community were administered the Life Orientation Test (LOT) (a self report measure of optimism), the Multidimensional-Multiattributional Causality Affiliation Scale (MMC-AF), and the Multidimensional Health Locus of Control Scale (MHLC). It was hypothesized that optimism would be correlated positively with internal locus of control measures and correlated negatively with external locus of control measures in the areas of affiliation and health. Five of nine comparisons between optimism and locus of control measures yielded significant relationships, all in the expected direction. PMID- 3680878 TI - Effects of attrition on relationships between variables in surveys of older adults. AB - Using data from a five-wave panel study of older adults, this study examined the potential for attrition to affect relationships among study variables. There were few differences between those respondents who completed all five waves and those who did not in either their initial matrices of correlations or in the equations that best predicted their Wave 2 health and depression. Relationships among variables also did not differ between respondents and persistent nonrespondents, between respondents and four specific attrition types, or between the original sample and various multiwave samples. In discussing the findings, the limited effects that attrition has on relationships between variables are contrasted to the stronger effects that attrition appears to have on mean levels of those variables, showing that the former does not necessarily follow from the latter. The findings support recent conclusions in the literature that the threat posed by panel loss is not as great as typically assumed. PMID- 3680879 TI - Older adult family stress and adaptation before and after bereavement. AB - As a part of a larger study, interviews were obtained from 63 older adults who had experienced the death of a spouse, parent, or child, and from 387 older adults who had not been bereaved. Three interviews were conducted before the death, one after. The study found that: (a) Bereavement itself did not affect health; (b) family stress increased as the time of death approached but diminished thereafter; (c) before the death, family stress was associated with worsening health; (d) after the death, health worsened if there had been no family stress preceding the death, but otherwise it improved; (e) after the death, however, psychological distress increased sharply, regardless of the level of prebereavement stress. Implications of the study for conceptualizations of grief and for understanding the life experiences of older adults are discussed. PMID- 3680880 TI - Marital status, living arrangements, and the use of health services by elderly persons. AB - Although marriage has been shown to have important health-protective consequences, it is not clear to what extent these effects are due to marriage per se or to the fact that married people are less likely to live alone. The social support literature suggests that living with others may reduce the need for use of formal and informal health care services independently of marital status because of (a) the substitution of home care, and/or (b) enhancement of physical and mental health. This study of elderly persons, based on data from the National Medical Care Expenditure Survey (NMCES), examined the substitution hypothesis. The impact of marital status and living arrangements on the use of formal health services among persons 65 years of age and older was examined using path analysis. These data confirm a substitution effect whereby persons living with others are more likely to stay in bed, but less likely to see a doctor, than are persons who live alone. PMID- 3680881 TI - Sleep-disordered breathing in healthy aged persons: possible daytime sequelae. AB - We assessed the overnight sleep and breathing as well as daytime medical, sleep, and psychological status of a group of 34 healthy older persons. Analyses indicated that sleep-disordered breathing (SDB) was not related to any aspects of daytime functioning as measured in this study and that persons with an apnea + hypopnea index (AHI) greater than or equal to 5 (M AHI = 14.6) were not significantly impaired relative to those with lower levels of SDB (M AHI = 1.0) on any aspect of daytime performance. We conclude that SDB occurring in healthy aged persons is probably not of immediate concern and that the use of a cutting score of AHI greater than or equal to 5 for diagnosis of sleep apnea syndrome is not indicative in healthy aged persons. However, these results may not be applicable to older persons who are not in the excellent state of health that was required for participants in our study. PMID- 3680882 TI - A prospective study of response to stressful life events in initially healthy elders. AB - Behavioral and physiological reactions to the stress of a major life crisis were studied prospectively in a group of healthy elderly individuals. Significant decreases in caloric intake, body weight, and lymphocyte count were found following the stressful event with a return toward baseline levels after a recovery period. Significant increases were found for psychological distress and serum cortisol. The results support the thesis that behavioral and physiological changes occur during an event perceived by an elderly person to be stressful and that such changes can have adverse effects on health. PMID- 3680883 TI - Clinical, functional, and psychosocial characteristics of an incontinent nursing home population. AB - Although urinary incontinence is recognized as a prevalent, disruptive, and costly problem among nursing home residents, the factors associated with this condition have not been carefully studied. We compared clinical, functional, and psychosocial characteristics of 50 incontinent and 50 continent nursing home residents. In spite of a selection bias due to the informed consent process that resulted in the exclusion of many of the most functionally impaired incontinent residents, the incontinent study participants had significantly greater impairments in functional abilities related to toileting and, on average, took longer to perform a timed series of toileting-related tasks than did the continent comparison group. With the exception of bacteriuria, we did not find incontinence to be associated with most of the major clinical conditions and medications we examined, nor did we find differences in morale and most measures of social activities between the incontinent and continent residents. The data highlight the strong association between functional disability and incontinence in the nursing home setting and suggest that a standard functional assessment of toileting skills could make an important contribution to the care of incontinent residents. PMID- 3680885 TI - Age-related change in skeletal muscle blood flow in the rat. AB - Anesthetized adult and senescent male Fischer 344 rats were instrumented for stimulation of in situ plantar flexor muscles and blood flow measurement by the tracer microsphere technique. After determination of optimum length and maximum tetanic force, muscles were stimulated to contract at the rate of 120 tetani/min. Senescent rats displayed significantly lower muscle blood flow and greater muscle fatigue than younger rats. Infusion of a nonspecific vasodilator in resting anesthetized rats also revealed a significantly lower potential to increase muscle blood flow in the senescent rats. Lower muscle blood flow of senescent rats during muscle contractions might be responsible, at least in part, for decreased performance of muscles of senescent male rats. PMID- 3680884 TI - Patterns of use of the emergency department by elderly patients. AB - The spectrum of illness and use patterns of 540 elderly patients (greater than or equal to 65 years) admitted to an emergency department (ED) were compared to an equal number of nonelderly patients. The proportion of visits by the elderly group to the ED was similar to the proportion of elderly residents in the area surrounding the hospital. Elderly patients were more likely than nonelderly patients to have an emergent diagnosis (34.4 vs. 8.3%), to arrive by ambulance (54.6 vs. 23.5%), to be admitted to the hospital (51.1 vs. 14.4%), and to have a medical (as opposed to a surgical) illness (75.0 vs. 53.2%). The spectrum of diseases was different between the two groups. Elderly patients had a higher proportion of cardiac (28.4 vs. 7.2%) and pulmonary disease (5.3 vs. 2.8%). Nonelderly patients had more injuries (30.5 vs. 10.7%) and self-limited infectious disease (11.5 vs. 5.0%). The proportion of psychiatric disease and social problems was low in both groups, about 5%. Elderly patients had a significantly lower proportion of nonurgent diagnoses (19.4 vs. 32.0%) than the nonelderly patients. Use of the ED by elderly patients is different from nonelderly patients in that they are more likely to have a serious medical illness. There is little evidence that elderly persons use the ED for primary self-care or social problems. PMID- 3680886 TI - Increase in life expectancy for mice fed diethylhydroxylamine (DEHA). AB - ICR Swiss strain mice were fed diethylhydroxylamine (DEHA) for life starting at 44 days of age at 10, 30, 100, and 300 mg/kg-day. The 10 and 30 mg/kg-day males and the 10 mg/kg-day females showed an increase in mean age of death of 76 (12.7%), 45 (7.5%), and 51 (7.4%) days, respectively, compared to controls. The respective confidence levels are 99.2, 90.0, and 92.9% that these results are significant by Student's t test. PMID- 3680887 TI - Long-term oral administration of memory-enhancing doses of tacrine in mice: a study of potential toxicity and side effects. AB - Recently, tacrine (1, 2, 3, 4-tetrahydro-9-aminoacridine; THA; TAC) has received international attention as an oral agent capable of relieving some of the cognitive symptoms accompanying Alzheimer's disease (AD). When given acutely and parenterally (by injection), tacrine has also enhanced memory retention in animals and man. This study evaluates the clinical potential of this agent by assessing toxicity and major side effects of a memory-enhancing dose of tacrine in mice. Groups of mice received either tacrine or vehicle (placebo) orally for 4 to 6 months. A lack of toxicity after this prolonged treatment with TAC was indicated by: (a) no significant impairment on a battery of behavioral toxicity tests; (b) improved memory retention; (c) a significant but only slight elevation of ornithine transcarbamylase activity in blood serum; (d) no abnormality as revealed with light microscopy of liver tissue; and (e) no gross organ pathology in visceral organs. PMID- 3680888 TI - Changes in relative weight over a 2-year period among institutionalized elderly people. PMID- 3680889 TI - Older Asians. PMID- 3680891 TI - Dementia--educating the caregiver. PMID- 3680890 TI - Support: a resource during crisis of mate loss. PMID- 3680892 TI - Trauma in the elderly. PMID- 3680893 TI - Documenting patient care needs: do nurses do it? PMID- 3680894 TI - Agitation--behaviors in confused elderly patients. PMID- 3680895 TI - Does all-payer rate setting work? The case of the New York Prospective Hospital Reimbursement Methodology. AB - By 1983, four states had received waivers from the Health Care Financing Administration and adopted experimental reimbursement programs covering all third party payers. In general, these programs were designed to moderate cost growth as well as to promote a number of broader distributive objectives. Among the concerns for equity were financing uncompensated care and spreading the costs across all payers, reducing the differential between hospital charges and costs, and rejuvenating fiscally distressed hospitals. These diverse goals represent a fundamental shift in the role of state rate setting; as a result, broader outcome measures are required to determine their overall impact. The New York Prospective Hospital Reimbursement Methodology (NYPHRM) is evaluated in this broader context. The NYPHRM successfully channeled revenues to fiscally blighted hospitals, increasing the volume of care to the uninsured while maintaining cost growth at national levels. According to this broader set of outcome measures, the NYPHRM would be viewed as a policy success. PMID- 3680896 TI - Confrontation, consent, and corporatism: state strategies and the medical profession in France, Great Britain, and West Germany. AB - The economic disorders of the last decade have compelled European welfare states to seek more stringent controls over costly social policies such as health care, thus circumscribing professional sovereignty. However, several factors- institutional structure, cultural values, political/economic circumstances, patterns of state/professional relations--constrain the policy alternatives available to governments, and make fundamental reform very difficult to achieve. After analyzing these factors and the reform policies adopted in France, Great Britain, and West Germany, this article will examine and compare the strategies pursued to meet professional resistance to change. PMID- 3680897 TI - HMO promotion and the privatization of health care in Chile. AB - Since 1973 the Chilean junta has privatized sectors of the national economy. This paper analyzes the country's policy process of promoting private medical programs through HMO-like plans (ISAPREs, or Institutes of Provisional Health). These plans have captured less than half of their originally anticipated market share. It is argued that the future performance of ISAPREs will be undermined by their limited maternal benefits, their targeting to a small upper-income group which cannot sustain many private medical programs, and competition with less expensive yet equally competent public medical programs. The paper briefly compares privatization in Chile with the experiences of other countries, and specifically contrasts the restructuring of health services under military rule in Chile with those of Argentina and Uruguay. The paper concludes that the Chilean experience with HMOs epitomizes the perils of planning health care during short-term periods of economic prosperity as well as failing to consult medical care providers and consumers. PMID- 3680898 TI - For-profit medicine. "For-profit enterprise in health care." By the Institute of Medicine, Committee on Implications of For-Profit Enterprise in Health Care. Essay review. PMID- 3680899 TI - The significance of gastric bile reflux seen at endoscopy. AB - We evaluated the significance of bile seen in the stomach at the time of endoscopy. Twenty-three percent of 110 consecutive patients undergoing elective panendoscopy were found to have bile in their stomachs. Gastric biopsies were obtained from these patients. To assess the significance of bile reflux, the patients underwent a quantitative gastric bile analysis on two separate days. On day 1, gastric juice was aspirated by nasogastric suction, and bile acid concentrations were measured. On day 2, bile reflux into the stomach was quantitated by scintiscan measurement of gastric nucleotide after intravenous administration of 99mTc-DISIDA. Approximately half the patients with bile reflux showed histologic evidence of mucosal injury. However, fewer than half with histologic injury had significant bile reflux when measured by quantitative methods. There was no correlation among the gastric bile acid concentration, degree of histologic injury, or severity of endoscopic changes. We conclude that finding bile reflux at endoscopy is probably of no clinical significance. PMID- 3680900 TI - Should gastric carcinoid tumors associated with pernicious anemia be treated aggressively? AB - Two patients with pernicious anemia developed gastric carcinoid, one 20 years and the other 1 year after diagnosis of pernicious anemia. One of the patients underwent successful resection of the tumor, while the second, with diffuse gastric carcinoid, was managed conservatively. She is well and asymptomatic 32 months after the diagnosis. We discuss the dilemma in management of gastric carcinoid associated with pernicious anemia. PMID- 3680901 TI - Exclusion diets in irritable bowel syndrome: are they worthwhile? AB - Forty patients with irritable bowel syndrome received an antigen-exclusion diet identical to that previously reported to be highly effective in this condition. Only 15% of the group as a whole showed evidence of food intolerance manifested by an improvement in their irritable bowel symptoms. In a further 12.5% only well being improved and this did not seem to be related to the exclusion of any particular food. Patients whose bowel dysfunction was characterized by diarrhea responded the best (3/8) whereas those with constipation consistently failed to improve. PMID- 3680902 TI - 5-ASA enemas for refractory distal ulcerative colitis. An open trial. AB - We conducted an open trial of 5-ASA enemas to determine the role of this drug in idiopathic distal ulcerative colitis resistant to conventional therapeutic approaches. Fifty-one such refractory patients were given 4 g 5-ASA enemas once nightly for 2 weeks, and the response was then assessed clinically and sigmoidoscopically. Overall, 29 patients (57%) had an excellent response, 11 (21%) had a satisfactory response, and a further 11 (21%) had a poor outcome. Two patients developed adverse reactions. Of the 11 patients with a poor response, nine remained dependent on oral prednisone for remission of their colitis. Although the role of 5-ASA enemas in the treatment of refractory distal ulcerative colitis remains to be determined, it appears that the drug appears to be beneficial for only a minority of patients dependent on systemic corticosteroids. PMID- 3680903 TI - Exquisite sensitivity to small decrements in corticosteroid dose in autoimmune chronic active hepatitis. AB - Symptomatic relapses of autoimmune chronic active hepatitis during steroid withdrawal are well known. However, the exquisite sensitivity of some patients to very small decrements in steroid dose has not been emphasized. Reported here are two patients who developed, during steroid withdrawal, eight relapses of their disease; symptomatic and biochemical relapses occurred within 3 weeks after prednisone had been reduced from 2.5 mg every other day to 1.75 mg every other day in one patient and from 2.5 mg per day to zero in the other. "Physiologic" doses of prednisone may be therapeutic in some patients with autoimmune chronic active hepatitis. PMID- 3680904 TI - Ascitic fluid bilirubin concentration as a key to choleperitoneum. AB - Total bilirubin concentration was measured in the ascitic fluid and serum of 65 patients with various types of ascites to determine the normal range of these parameters. The mean (+/- SD) ascitic fluid bilirubin was 0.7 +/- 0.8 mg/dl, and the mean ascitic fluid/serum bilirubin ratio was 0.38 +/- 0.44. Subsequently, I recognized choleperitoneum in a patient with bile-stained ascites preoperatively, because the ascitic fluid bilirubin was 18.5 mg/dl and the ratio was 7.1. Laparotomy documented a ruptured gallbladder. An ascitic fluid bilirubin concentration greater than 6 mg/dl with an ascitic fluid/serum bilirubin ratio greater than 1.0 appears to be characteristic of choleperitoneum. PMID- 3680905 TI - Wernicke's encephalopathy. Complication of gastric plication. AB - We present a literature review and the description of Wernicke's encephalopathy in a patient who developed neurologic symptoms 2 months after gastric partitioning for morbid obesity. After a prolonged incapacitating illness, autopsy confirmed the diagnosis. We identify characteristic features of the association and discuss possible pathophysiology. PMID- 3680906 TI - Crohn's disease of the duodenum presented as pancreatitis due to persimmon bezoar. AB - Pancreatitis due to Crohn's disease of the duodenum is very rare. It is the result of either reflux of duodenal content into the pancreatic duct or stenosis due to direct involvement of the ampullary region with Crohn's disease. The patient described had isolated Crohn's disease of the duodenum; pancreatitis was the result of persimmon bezoar's constricting the ampullary region. PMID- 3680908 TI - Splenic rupture at colonoscopy. AB - We report splenic rupture a few hours after a colonoscopy. Even though the patient had no previous history of splenic injury or symptoms attributable to splenocolonic adhesions, exploration revealed adhesions between the spleen and the colon at the level of the splenic flexure. Pathological examination revealed capsular thickening and fibrosis. Splenocolonic adhesions may lead to potentially lethal rupture of the spleen. A careful history prior to endoscopy should rule out pathological conditions that may lead to formation of adhesions between the spleen and the colon. In addition, the endoscopist should consider splenic rupture after colonoscopy in the patient who develops abdominal pain and acute anemia without evidence of intestinal perforation or external bleeding. PMID- 3680907 TI - Chediak-Higashi syndrome with intestinal complication. Report of a case. AB - A 21-year-old woman with Chediak-Higashi syndrome developed intestinal lesions similar to those of Crohn's disease. Radiographic findings showed a stenotic lesion with multiple nodular changes in the ascending colon and cecum, and a longitudinal ulceration in the terminal ileum. In addition, multiple oval-shaped ulcerations were seen between the terminal ileum and descending colon. However, serial histological examinations revealed only an infiltration of lymphoid cells, which was a nonspecific finding. Though there are few reports of gastrointestinal involvement in Chediak-Higashi syndrome, such an intestinal complication may develop in patients long surviving with this disease. PMID- 3680909 TI - Isolated metastasis to small bowel from anaplastic thyroid carcinoma. With a review of extra-abdominal malignancies that spread to the bowel. AB - Symptomatic involvement of the small bowel by isolated metastasis from an extra abdominal primary malignancy is rare, most commonly resulting from malignant melanoma and lung cancer. A few other extra-abdominal tumors, not including thyroid cancer, have been documented on rare occasions to present with small bowel involvement as the first evidence of metastasis. We report a case of anaplastic thyroid carcinoma with isolated symptomatic metastasis to the small intestine. We review the literature regarding the frequency and origin of extra abdominal malignancies developing small-bowel metastases and the spectrum of clinical manifestations resulting from this syndrome. PMID- 3680910 TI - The Cronkhite-Canada syndrome with focus on immunity and infection. Report of a case. AB - A 64-year-old man developed diffuse gastrointestinal polyposis, protein-losing enteropathy, skin pigmentation, hair loss, and unique nail changes. He also exhibited pulmonary tuberculosis and impaired immunity with skin anergy, poor lymphocyte mitogens stimulation test, and low serum immunoglobulin. We discuss the relationship of infection, nutrition, immunity, and the Cronkhite-Canada syndrome. PMID- 3680911 TI - Pneumatosis cystoides intestinalis. Presentation as an acute abdomen. AB - It is rare for pneumatosis cystoides intestinalis to give rise to abdominal pain. We report a patient with signs and symptoms of a perforated viscous in whom abdominal exploration was negative, but in whom biopsy of various intraabdominal cystic structures revealed only pneumatosis cystoides intestinalis. PMID- 3680912 TI - Tetracycline-induced pancreatitis. AB - A 21-year-old man developed acute pancreatitis on two separate occasions after a short-term course (less than 10 days) of tetracycline in the presence of normal liver and renal function. Although tetracycline is frequently listed as a cause of pancreatitis, this is only the second documented case of tetracycline-induced pancreatitis in an otherwise healthy person. We review the pertinent literature. PMID- 3680913 TI - Nicotinic acid-induced fulminant hepatic failure. AB - A 46-year-old man began taking nicotinic acid, 3 g daily, for hypercholesterolemia. A month later, he developed clinical and biochemical evidence of modest hepatocellular injury, and therapy was stopped. It was restarted 6 weeks later, and 10 weeks after that, the patient presented with fulminant hepatic failure, which resolved rapidly after cessation of nicotinic acid therapy. We suggest that nicotinic acid was the cause of his liver disease, that this case is of particular note because of the rather short period of therapy before the onset of liver injury and the severity of the hepatic failure, and that the probable increased use of nicotinic acid for serum cholesterol control makes it especially important for physicians and their patients to be alert to the signs of hepatotoxicity. PMID- 3680914 TI - Flow cytometry. A new technique in the diagnosis of malignant ascites. AB - The diagnosis of peritoneal carcinomatosis is often dependent on the finding of malignant cells in ascitic fluid analysis by a trained cytologist. Other methods are needed to increase the current diagnostic yield of 60-90%. Abnormal DNA content is characteristic of most malignancies. In an attempt to detect aneuploidy, we used high-resolution DNA histogram analysis with fluorescent DNA specific stains and flow cytometry to evaluate 33 ascitic fluid samples. Of 13 patients with malignant ascites, aneuploidy was demonstrated in 10. Six patients with proven peritoneal carcinomatosis and normal cytologic examination had abnormal DNA histograms. DNA quantitation and cytologic examination agreed in 24 of 33 cases. These findings suggest that flow cytometry is a rapid and useful technique in the diagnosis of malignant ascites. The presence of aneuploidy in cells from ascitic fluid is highly suspicious for peritoneal carcinomatosis and suggests the need for further evaluation for malignancy. PMID- 3680915 TI - Half-filled pages in mental health research. PMID- 3680916 TI - Prognostic conflict in life-and-death decisions: the organization as an ecology of knowledge. PMID- 3680917 TI - Social psychological aspects of reporting behavior: lifetime depressive episode reports. PMID- 3680918 TI - The work-family role system and physician productivity. PMID- 3680919 TI - Change in student physicians' views on authority relationships with patients. PMID- 3680920 TI - A multivariate model of the determinants of cigarette smoking among adolescents. PMID- 3680922 TI - Family status and health behaviors: social control as a dimension of social integration. PMID- 3680921 TI - Sex differences in distress: the impact of gender and work roles. PMID- 3680923 TI - Personal efficacy, income, and family transitions: a longitudinal study of women heading households. PMID- 3680925 TI - Autosomal recessive inheritance of goiter in Dutch goats. AB - The inheritance of congenital goiter due to a thyroglobulin synthesis defect in a strain of Dutch goats has been studied by Mendelian and biochemical methods. Mendelian analysis of 301 matings, resulting in 591 kids, showed an autosomal recessive mode of inheritance. A restriction fragment length polymorphism (RFLP) in the thyroglobulin gene also was used to confirm the recessive mode of inheritance of the defect. In a pedigree consisting of 27 goats, spanning four generations, the genotype determined by RFLP study was in accordance with the observed phenotype and the autosomal inheritance of the defect. Although phenotypically no differences were detected between normal and heterozygous animals, the use of RFLPs allowed the diagnosis of the three genotypes. PMID- 3680926 TI - Estimating erosion of phenotypic variation in a French goat population. AB - A survey was made on a sample of 45 flocks of the goat population in Provence France in 1982. The sample included 56 male goats and 757 breeding females within a 30 km radius of the town of Forcalquier (Alpes-de-Haute-Provence). The visible phenotypic profile was established for the following characters: ear length, ear curling, ear erectness, presence of horns, type of horns, presence of wattles, presence of beard, length of hair, hair coat pigmentation pattern, type of eumelanin in hair, pigment alteration of hair, and white spotting (36 different phenotypes). The visible genic profile is based on 23 various alleles at eight loci. This high degree of genetic variability comes from the traditional local population that is in the process of being upgraded to standardized breeds such as Saanen, Rove and, mainly, Chamois Alpine (95 percent of upgraded flocks). The average coefficient of phenotypic erosion ep had a value of 32 percent among the breeding females in 1982. At the present rate of upgrading the estimate is 90 percent for the male and 85 percent for the female coefficient of genotypic erosion eg by the year 2002. A small nucleus of purely traditional Provence goat (5 percent of the present size of the population: about 1500 goats for the PACA (Provence-Alpes-Cote d'Azur region) will probably have disappeared by that time. Phenotypic and genic profiles of this Provence population have been compared to the profiles of other traditional goat populations in Central Asia, Norway, Sardinia, and Corsica. The available data show profiles that are very similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680924 TI - Genetics of grain amaranths. II. The inheritance of determinance, panicle orientation, dwarfism, and embryo color in Amaranthus caudatus. AB - The genetic control of four developmental characters was studied in Amaranthus caudatus L. Determinant panicle growth was determined by one recessive gene. Two major genes governed panicle orientation, with erect panicles incompletely dominant to drooping panicles. Additional modifier genes appeared to alter expression of panicle orientation. A single recessive gene determined dwarfism. Pleiotropy or tight linkage was responsible for abnormal growth of dwarf plants. Pink embryo color was under the control of two complementary epistatic genes with one locus determining the presence or absence of red betalain pigment and the other locus regulating the expression of pigment in developing embryos. PMID- 3680927 TI - Tardy feathering locus (t) located on chromosome 1 in the chicken. AB - The locus for tardy feathering (t), a recessive autosomal rate of feathering mutation, had been previously suggested to be on chromosome 1 in the chicken. Tests using both pea comb (P) and the breakpoint (B) of a chromosome translocation involving chromosome 1 (MN t(Z;l] verify that t lies on the long arm of chromosome 1, and shows linkage of 41.7 +/- 2.2 map units, with P located on the short arm. PMID- 3680929 TI - Program in BASIC for computing unbiased F statistics. PMID- 3680928 TI - A discriminant analysis program. PMID- 3680930 TI - Reactivation of inhibited bone acid phosphatase and its significance in bone histomorphometry. AB - Despite biochemical demonstration of acid phosphatase (AcP) activation or reactivation in bone, few attempts have been made to show similar effects histochemically. Bones from growing rats, when fixed in 4% buffered formaldehyde at room temperature and demineralized in 5% formic acid, exhibited expected inactivation of AcP. The inhibited AcP, however, was reactivated by pre incubation of sections for 1 hr at 37 degrees C in the following buffers: 0.2 M Tris, 0.2 M glycine, 0.2 M NaHCO3, or 0.1 M borax, as well as in alkaline water, but not in 0.2 M Na2HPO4 (all at pH 9). The reactivation was (a) site-specific (e.g., osteoclasts, osteoblasts, osteocytes, and cement lines), (b) temperature- and pH-dependent, (c) unaffected by OH- or SH--binding agents or by an alkaline phosphatase inhibitor, and (d) inhibited completely by 10 mM Na2HPO4. The reactivation process, much simplified and/or more effective than with the methods previously reported, was observed in all 83 human biopsy bones embedded in methyl methacrylate and in human bones stored in cold buffered formaldehyde for 7 months. This study demonstrates a unique method for reactivating and thus localizing the inhibited AcP in bones, and suggests possible applications in bone histomorphometry. PMID- 3680931 TI - Use of cytofluorometry to evaluate binding of antibodies to the cytoskeleton of cultured cells. AB - Immunocytochemistry is routinely used to examine the occurrence and distribution of cytoskeletal proteins in cells, but the results are usually evaluated visually and subjectively. Little use has been made of the potential the method offers for quantitative work. Here we report on application of cytofluorometry to quantify binding of antibodies to the cytoskeleton of U-251 MG human malignant glioma cells in culture. The results show that cytofluorometry is a simple and reliable procedure for: (a) determining the optimal concentrations of primary and secondary antibodies and other labeling reagents; (b) evaluating the binding specificity of commercial secondary antisera; and (c) evaluating the effect of different preparatory procedures on preservation of and binding of antibodies to cytoskeletal structures. Experiments with a monoclonal antibody to tubulin show that preservation of tubulin is very sensitive to the preparatory procedures used. Maximum labeling of tubulin in intact cells was obtained when the cells were pre-fixed with formaldehyde before permeabilization with solvent. Maximum labeling of tubulin in Triton-extracted cytoskeletons was achieved by pre-fixing the cells with the bifunctional protein crosslinking reagent dithiobis (succinimidyl propionate), extracting with Triton in a microtubule-stabilizing buffer, and post-fixing with formaldehyde. GTP was not required to preserve tubulin in cytoskeletons. PMID- 3680932 TI - Freeze-fracture cytochemistry of rat glomerular capillary tuft. Determination of wheat germ agglutinin binding sites and localization of anionic charges. AB - We propose here the use of freeze-fracture to gain access and to label in vitro glomerular components and locate WGA receptors and anionic sites. Tissues are frozen, fractured under liquid nitrogen, and thawed. Freeze-fracture rendered all glomerular structures directly accessible to the reagents. This made possible study of the nature and topology of cationized ferritin and WGA binding sites. WGA-gold complexes were observed over plasma membranes of podocytes and of endothelial and mesangial cells. Labeling of podocytes and endothelial cells was similar in the mesangial area and in the peripheral part of the capillary loop. Cross-fractures of extracellular matrices showed that WGA bound uniformly to the glomerular basement membrane (GBM) as well as to mesangial matrix. In fractured specimens treated with neuraminidase, WGA was no longer observed over podocytes but it consistently labeled the surface of endothelial and mesangial cells. Whereas in GBM cross-sections WGA binding was greatly reduced or even abolished, it remained unmodified in the mesangium. This shows that only NeuNAc (sialic acid) might account for the binding of WGA to podocytes, whereas GlcNAcs appear to be the main WGA binding sites on endothelial and mesangial cells and in the mesangial matrix. Both NeuNAc and GLcNAc residues are probably associated in GBM. With cationized ferritin (pI 8.3) at pH 7.4, intense, continuous labeling was seen all over the different plasma membranes, denser in podocytes than in endothelial cells. CF was also observed in cross-fractured profiles of extracellular matrices and never appeared agglutinated in discrete sites. PMID- 3680933 TI - Linearity in dehydrogenase reaction rate studies in tissue sections is affected by loss of endogenous substrates during the reaction. AB - We studied the effect of section thickness on the reaction rate of glucose-6 phosphate dehydrogenase (G6PD) activity in unfixed sections of rat liver by use of continuous monitoring by microdensitometry of the reaction product as it formed in the section during incubation. Tetranitro BT or nitro BT was used as final electron acceptor and polyvinyl alcohol as tissue stabilizer. Each test minus control reaction curve deviated from linearity during the first 2 min of incubation. This was mainly due to loss of low molecular weight endogenous dehydrogenase substrates from the surface of the section. For any given reaction, the same absolute amount of endogenous substrate was lost from each section, and hence a much greater proportion was lost from the thinner sections. Such losses lead to a deficit in (nonspecific) formazan production. There was a greater loss from, and hence a greater deficit in, formazan production in sections incubated at 30 degrees C than at 37 degrees C and when nitro BT was used instead of tetranitro BT, but the greatest loss of endogenous substrates occurred in sections incubated in control media. Therefore, greater losses seemed to occur when the reactions were slower because of failure to overcome the critical supersaturation level of the formazan. A consequence of this was a non-linear test minus control response during the first minutes of the incubation. PMID- 3680934 TI - Parathyroid ultrastructure after aldehyde fixation, high-pressure freezing, or microwave irradiation. AB - Parathyroid cell variants, commonly observed in parathyroid glands fixed by immersion in glutaraldehyde, are believed to be the result of cyclic changes in the course of parathyroid hormone secretion. Immersion of bovine parathyroid glands in a mixture consisting of 1% glutaraldehyde, 1.5% formaldehyde, and 2.5% acrolein, followed by post-fixation in 1% osmium tetroxide, resulted in high uniformity with only one cell variant, whereas the same fixation procedure led to disruption of cell membranes and formation of cell variants in rat parathyroids. Parathyroid glands of both cattle and rats prepared by high-pressure quick freezing and subsequent freeze-substitution contained only one cell variant. Excellent preservation of the ultrastructure of bovine and rat parathyroids, also exhibiting only one cell variant, was achieved by microwave irradiation in the presence of 2.5% glutaraldehyde in Na-cacodylate followed by post-fixation with OsO4 in Na-cacodylate or s-collidine, both containing Ca2+ and Mg2+. Use of the appropriate buffer, as well as osmication, is essential for successful fixation utilizing microwave energy. The main effects are considered to be heating specimens within sufficient short periods and enhancement of subsequent osmium fixation. The results support the idea, arising after examination of perfusion fixed parathyroid tissue, that parathyroid cell variants occur during improper aldehyde fixation rather than that they express functional diversity. PMID- 3680935 TI - Absolute quantitative autoradiography of low concentrations of [125I]-labeled proteins in arterial tissue. AB - We developed a method for absolute quantitative autoradiographic measurement of very low concentrations of [125I]-labeled proteins in arterial tissue using Kodak NTB-2 nuclear emulsion. A precise linear relationship between measured silver grain density and isotope concentration was obtained with uniformly labeled standard sources composed of epoxy-embedded gelatin containing glutaraldehyde fixed [125I]-albumin. For up to 308-day exposures of 1 micron-thick tissue sections, background grain densities ranged from about two to eight grains/1000 micron 2, and the technique was sensitive to as little as about one grain/1000 micron 2 above background, which correspond to a radioactivity concentration of about 2 x 10(4) cpm/ml. A detailed statistical analysis of variability was performed and the sum of all sources of variation quantified. The half distance for spatial resolution was 1.7 micron. Both visual and automated techniques were employed for quantitative grain density analysis. The method was illustrated by measurement of in vivo transmural [125I]-low-density lipoprotein [( 125I]-LDL) concentration profiles in de-endothelialized rabbit thoracic aortic wall. PMID- 3680936 TI - Ten years of freedom from smallpox: lessons and experiences. Dedicated to the tenth anniversary of worldwide freedom from smallpox. AB - Many lessons and experiences were learned during the global programme of smallpox eradication, the most important being those which could be generalized and applied to other health programmes. This does not mean imitating or implementing smallpox eradication techniques to other diseases, since each infection requires its own strategy. It is difficult to dissect out the single key element or to equate the various factors responsible for the success, as these always worked together, in combination, depending one on others. For global eradication, the element of essential importance was international cooperation and close coordination of activities between nations. This would be impossible without proper mechanisms dedicated to international cooperation in the field of health, provided by the World Health Organization, which also assured mobilization of world resources for national programmes and application of appropriate techniques across international borders. The established specific, practical and measurable goals, objectives and targets made every programme worker clearly understand what was to be accomplished and to find his own role in achieving these objectives. Operational techniques had to be flexible, modified appropriately from country to country to make them suitable to present epidemiological situations, local administrative and health structures as well as to demographic and geographic patterns. It was the effective system of surveillance and outbreak-containment that ultimately proved to have been the key to eradication. However, application of skillful management, sound epidemiological principles, advanced technology and adequate logistic support contributed significantly to the achievement of the final goal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3680937 TI - The effect of CdCl2 and AgNO3 pretreatment on the distribution of 110mAg+ in rat liver. AB - The distribution of 110mAg in the elution fractions obtained from gel filtration (Sephadex G-75) of the supernatants of rat liver homogenates was studied. 110mAgNO3 was administered i.v. at the doses 0.183 and 0.912 mg Ag+ . kg-1 . b . wt.and rats were killed 30 min after the administration. Differential centrifugation of the homogenates was performed to determine 110mAg+ distribution in subcellular structures of hepatocytes. The effect of CdCl2 and AgNO3 pretreatment (2 s.c. injections of 2.5 mg . kg-1 during 48 h) was investigated and results were compared with those obtained without pretreatment. It was found that AgNO3 pretreatment does not affect 110mAg+ distribution in the elution fractions and the major part of the metal is concentrated in the high-molecular weight protein fraction. On contrary, after CdCl2 pretreatment almost all 110mAg+ is bound in the metallothionein (MT) fraction. Differential centrifugation revealed the main portion of the metal in nuclei and cell membranes and only small amount in lysosomal supernatant. After CdCl2 pretreatment the content of 110mAg+ in supernatant considerably increases. Results confirm the affinity of silver to MT and moreover show that this metal probably does not significantly induce the MT synthesis in the liver tissue. PMID- 3680938 TI - Basic carriers of Trichophyton mentagrophytes var. gypseum in the Sverdlovsk region. AB - Tests for myococarriers were made on 4.297 wild small mammals. Clinical examinations only were carried out on 1,204 animals, both clinical and laboratory examinations on 3,093 animals. The suppurative form of trichophytosis was diagnosed in only one specimen of Microtus oeconomus out of 1,204 animals examined. T. ectothrix microides was found in the hair taken from the focus. T. mentagrophytes var. gypseum was obtained by culture on nutrient media. No clinical signs of mycosis were found in 3,093 animals, but seeding of the hair 175 animals (5.65%) on Sabouraud's agar with chlortetracycline and acti-dione produced cultures of T. mentagrophytes var. gypseum. The fungus was most frequently isolated in clinically healthy water rats, common field voles and field mice (Arvicola terrestris, Microtus arvalis, Apodemus agrarius). Mycocarriers were most frequently found among small mammals living in corn fields (5.9%), less frequently in water meadows (0.9) and sporadically in forests and bushes (0.1%). The possibility of bringing mycocarriers from the fields into inhabited areas during the transport of forage was reported. PMID- 3680939 TI - Resistance to antibiotics in humans and animals on the Cape Verde Islands. AB - From the Cape Verde Islands no studies are known about an efficient treatment with antibiotics and chemotherapeutics. Because of this human samples and samples of domestic animals were collected, the different bacterias were isolated and the antibiograms were analyzed by agar-diffusions-test. The human samples consisted of wound-, eye-, anal-, vaginal- and throat-smears, the animal samples consisted of jaw-, anal- and wound-smears. the aim of these investigations was to make efficient treatment with antibiotics and chemotherapeutics possible. The best efficacy had Cefotaxim, Gentamicin and Trimethoprim + Sulfonamid. Very poor were Penicillin G, Aminopenicillin and Cephalexin. PMID- 3680940 TI - The role of Ureaplasma urealyticum in urinary tract infections. Demonstration of antibodies against ureaplasmas in the urine. AB - This study reports the presence of antibodies against Ureaplasma urealyticum in the urine in 17.2% (85) of 493 patients with chronic pyelonephritis. At the same time in 37 of antibody-positive urine samples evidence was found of cultivated Ureaplasma urealyticum, other bacterial germs were isolated infrequently. These culturally and serologically positive urine samples mostly showed pathologic findings of urine sediments. These results led us to believe in a possible involvement of the Ureaplasmas in keeping inflammation processes in the upper urinary tract. PMID- 3680941 TI - Skin reactivity to mycobacterial antigens in children living in an area of Mycobacterium xenopi endemicity. AB - Intradermal skin tests with a 2TU dose of PPD-RT 23 prepared from M. tuberculosis and 0.1 ug/0.1 ml of PPD-RS 631 from M. xenopi were simultaneously carried out in 378 7-year-old children from two localities in North-Bohemian region's capital Usti n. Lab., a focus of M. xenopi endemicity repeatedly confirmed since its disclosure in 1980 by positive M. xenopi isolations from humans and public water supply network. A further group 157 children serving as controls was from Prague district 4 where no presence of M. xenopi strains was ever recorded. All of these children had received routine immunization at birth with Czech BCG vaccine. The children from the two endemic localities were found to give a positive 6 mm or greater reaction to M. xenopi mycobacterin in 43.3% and 22.3%, to human tuberculin in 12.8% and 12.6%, respectively. The frequency histogram clearly separated a group of reactors with 8-18 mm indurations from a group of nonreactors showing a skin induration of 4-8 mm. The higher reactivity of this exposed child population was also reflected in a larger proportion of reactions greater to M. xenopi PPD than to human tuberculin antigen: the reactions greater by 1-5 mm accounted, respectively, for 25.1% and 20.6%, reactions greater by 6 mm or more for 23.7% and 15.9%. Among a group of children from Prague district 4, 6.4% had medium-sized and 3.8% large-sized reactions to M. xenopi antigen; the proportion of reactions greater to M. xenopi antigen than to human tuberculin accounted for only 5.1%, reactions greater to tuberculin than to sensitin were here in slight predominance. The evidenced skin sensitization to M. xenopi mycobacterin is suggested to result from the different degrees of exposure to infection by environmental mycobacteria. PMID- 3680942 TI - Drug resistance and pathogenicity of S. aureus isolated from patients. AB - Over the period 1983-1985, investigators from the Institute of Hygiene and Epidemiology, Prague, and the Central Research Institute of Epidemiology, USSR Ministry of Public Health, Moscow, carried out a joint study of drug resistance in S. aureus strains in relation to their enterotoxigenic properties and phage group specificity. Altogether 277 strains were explored which had been isolated at random from the clinical material from infant and adult inpatients. Most of the isolated strains featured multiple resistance to antibiotics: PNC (77.9%), CMP (52.7%), TET (21.6%), ERY (17.6%) and LIN (11.9%). The strains isolated from infants were most frequently resistant to TET and ERY. No correlation was found between the incidence of antimicrobial drugs resistance and toxigenic properties of the isolated strains. PMID- 3680943 TI - Cationization of protein antigens. III. Abrogation of oral tolerance. AB - The immunoregulatory effects of oral pretreatment of BDF1 mice with cationized bovine serum albumin (cBSA) and native bovine serum albumin (nBSA) have been compared. Oral administration of nBSA suppressed the antibody response to both forms of the antigen. In contrast, oral pretreatment with cBSA greatly enhanced the anti-BSA response in animals subsequently challenged i.p. with either the cationized or native form of the molecule. The enhancement observed with cBSA pretreatment was more pronounced than the suppression observed with the same amount and number of feedings of nBSA. As little as a single oral dose of 10 mg of cBSA produced a significant increase in antibody concentration. Cell transfer of spleen cells into irradiated syngeneic recipients demonstrated that both T cells and B cells were involved in the generation of the response, with a greater degree of enhancement provided by cBSA-pretreated T cells. These data extend our previous findings and demonstrate that administration of cBSA by a normally "tolerogenic" route results in enhancement rather than suppression of the immune response. PMID- 3680944 TI - Gene induction by gamma-irradiation leads to DNA fragmentation in lymphocytes. AB - An early event in death of interphase lymphocytes exposed in vivo or in vitro to low doses of gamma-irradiation is the degradation of DNA into nucleosome-sized fragments. Induction of fragmentation required RNA and protein synthesis because actinomycin D and cycloheximide, respectively, are able to inhibit DNA fragmentation in irradiated lymphocytes. Studies adding cycloheximide and actinomycin D at various times postirradiation suggest that once the metabolic process is initiated within an individual cell it proceeds to completion. The reversible RNA synthesis inhibitor, 5,6-dichloro-1-beta-d ribofuranosylbenzimidazole inhibits DNA fragmentation in irradiated thymocytes. When this drug is removed after 6 hr, irradiated thymocytes proceed to fragment their DNA; this suggests that an inducing "signal" that is not simply mRNA persists within the irradiated cell for at least 6 hr after irradiation. In contrast to mitogen-activated T and B lymphoblasts, resting T and B cells show significant DNA fragmentation after exposure to 100 to 500 rad. At 2000 rad, all of the splenic subpopulations die rapidly via a different mechanism. By studying the mechanism of DNA fragmentation induced during the interphase death of lymphocytes, we hope to understand better the extreme sensitivity of resting lymphocytes to radiation and what may be the common final pathway of programmed cell death. PMID- 3680945 TI - A peptide secreted by human alveolar macrophages releases neutrophil granule contents. AB - A monoclonal antibody was developed against an 8,000-kDa enzyme-releasing peptide (ERP) released from human alveolar macrophages. ERP was isolated on an immunoaffinity column containing the antibody bound to staphylococcal protein A Sepharose. Release of ERP from the macrophages is not changed by plastic adherence, phagocytosis, calcium ionophore, or phorbol esters. The peptide was not antigenically similar to interferon-gamma, tumor necrosis factor, or interleukin 1 alpha or 1 beta. The release of constituents from azurophilic and specific granules was the main identified biologic function of ERP. ERP was a more effective secretagogue in the untreated neutrophils and f-met-leu-phe was more effective in the cytochalasin B-treated neutrophils. Absorption of ERP from macrophage-conditioned medium removed a small amount of the chemotactic activity; however, the immunopurified peptide was not chemotactic or chemokinetic for neutrophils, and at high concentrations, it suppressed base line chemokinesis. Treatment of washed macrophages with trypsin released active ERP of approximately the same m.w. of spontaneously secreted ERP. These studies showed that human alveolar macrophages release a peptide which is a secretagogue for human neutrophils under conditions which may be encountered in the lungs during certain disease states. Proteolytic enzymes which are free in the lungs may release the peptide and lead to the secretion of neutrophil enzymes. PMID- 3680946 TI - Cardiac myosin induces myocarditis in genetically predisposed mice. AB - After infection with coxsackie virus B3 (CB3), H-2 congenic mice on an A- background develop immunologically mediated myocarditis associated with an increased titer of myosin autoantibody, part of which is specific for the cardiac myosin isoform. The present study demonstrates that cardiac myosin itself induces severe myocarditis and high titers of myosin autoantibodies in A/J, A.SW/SnJ, and A.CA/SnJ mice. As in CB3-induced myocarditis, one population of these autoantibodies was specific for cardiac myosin. A.BY/SnJ and B10.A/SgSnJ mice also developed the disease after immunization, but the prevalence and the myosin autoantibody titers were lower. In contrast, C57BL/6J and C57BL/10J mice were resistant to myocarditis induced by cardiac myosin and did not develop increased myosin autoantibodies or cardiac myosin-specific autoantibodies. Immunization with skeletal muscle myosin had no effect compared with controls injected with complete Freund's adjuvant, thereby suggesting that the immunogenic epitopes are unique to the cardiac myosin isoform. Furthermore, we found that susceptibility to myocarditis induced by cardiac myosin is influenced by the major histocompatibility complex and by genes not closely linked to the major histocompatibility complex. Because there are parallels between myocarditis induced by cardiac myosin and that induced by CB3, this new animal model can be used to analyze the pathologic mechanisms in autoimmune heart disease. PMID- 3680947 TI - Abrogation of the capacity of delayed-type hypersensitivity responses to alloantigens by intravenous injection of neuraminidase-treated allogeneic cells. AB - BALB/c or C3H/He mice were inoculated i.v. with allogeneic spleen cells untreated or treated with neuraminidase. Appreciable or potent anti-allo-delayed-type hypersensitivity (DTH) responses were observed when mice were inoculated i.v. with untreated allogeneic cells or inoculated i.v. with those cells followed by s.c. immunization with untreated allogeneic cells. In contrast, i.v. inoculation of neuraminidase-treated allogeneic cells (presensitization) not only failed to induce any significant anti-allo-DTH responses but also abolished the capability of the animals to develop DTH responses after s.c. immunization, indicating the tolerance induction. This tolerance was alloantigen-specific, and rapidly inducible and long lasting. The induction of suppressor cell activity was demonstrated in tolerant mice. However, this activity was associated only with the tolerant state around 4 to 7 days after the i.v. presensitization, but was no longer detected in mice more than 14 days after the presensitization, although these mice exhibited complete tolerant state. When spleen cells from such tolerant mice were transferred i.v. into 600 R x-irradiated syngeneic recipient mice alone or together with normal syngeneic spleen cells, these tolerant spleen cells themselves failed to induce DTH responses but did not exhibit suppressive effect on the generation of DTH responses induced by normal spleen cells co transferred. These results indicate that i.v. administration of neuraminidase treated allogeneic cells results in the induction of alloantigen-specific tolerance which is not always associated with the induction of suppressor cell activity but rather with the elimination or functional impairment of alloantigen specific clones. PMID- 3680948 TI - Heterogeneity in cellular antigen retention structures. AB - The mechanism of presentation of foreign antigens to helper T lymphocytes and the nature of the structures involved in this process are not totally understood. It is well documented that this event is carried out by antigen-presenting cells (APC) (e.g., macrophages, dendritic cells, and B lymphocytes) that internalize the antigen, process it, reexpress it on their membrane surface, and present it to the T cell in the context of major histocompatibility complex class II (Ia) molecules. Recent evidence supports the hypothesis that peptide antigens associate directly with Ia molecules on the APC surface membrane. However, the characteristics of other APC membrane structures potentially involved in antigen presentation are not entirely clear. Previous studies in our laboratories identified a guinea pig macrophage membrane-bound, non-Ia-containing antigenic complex (peak A) formed upon incubation of APC with the octapeptide antigen angiotensin (AII). This complex was capable of stimulating AII-immune guinea pig T cells and thus appeared to contain the immunologically relevant form of the antigen. For this reason it was important to establish whether such complex formation with peptides occurs with other cell types and with other peptide antigens. In the present study we found that other types of cells are also capable of forming such a membrane complex with antigen (peak A) and that this event is not unique to AII. Two other peptides, alpha-melanocyte-stimulating hormone and human fibrinopeptide B, both of which are antigenic in mice, were found to form peak A with a number of murine cell lines. As in our earlier studies with guinea pig macrophages, there was no evidence from these experiments for a role for major histocompatibility complex Ia antigens in the peptide binding observed. Differences in both the amount of peak A formation and the pattern of peptide antigen degradation were found from cell line to cell line for a given peptide, and from peptide to peptide for a given cell line, suggesting cellular heterogeneity in peptide processing and retention. In addition, cross inhibition studies indicated that there was peptide specificity in the formation of peak A perhaps suggestive of molecular heterogeneity in the structure of peak A. These results indicate that there may be several types of cell surface molecules that specifically bind and retain peptide antigens.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680949 TI - Strain-dependent IgG subclass response patterns. AB - Previous studies have shown that antigens preferentially stimulate IgG subclasses. However, the immunologic processes responsible for the patterns of IgG subclasses stimulated by antigens are probably complex and are certainly unclear. To define some of the genetic controls of IgG subclass expression in mice, we have studied the patterns of IgG subclasses elicited by antigens in BALB/cAn, C57BL/6N, derived recombinant inbred strains, and derived Ig congenic strains. This study shows that both thymus-independent antigens and thymus dependent antigens stimulate different patterns of IgG subclasses in BALB/cAn and C57BL/6N. Furthermore, analysis using recombinant inbred strains and Ig congenic strains shows that the patterns of IgG subclasses stimulated by all antigens are linked to Ig allotype. In contrast, only the IgG subclass patterns stimulated by thymus-dependent antigens are linked to major histocompatibility complex haplotype. This study also shows that the Ig allotype-linked controls of IgG subclass response patterns are located telomeric to a BAB14 intra-heavy chain variable region recombinant site. Therefore, this region of mouse chromosome 12 may contribute to the control of IgG subclass selection in the B cell. PMID- 3680950 TI - Carboxypeptidase A in mouse mast cells. Identification, characterization, and use as a differentiation marker. AB - By using a conventional spectrophotometric assay with hippuryl-L-phenylalanine as the substrate, 10(6) BALB/c mouse serosal mast cells possessed 1.5 +/- 0.43 U (mean +/- SE, n = 5, range = 0.48 to 2.5) of carboxypeptidase A activity, while T cell factor-dependent, mouse bone marrow-derived mast cells (BMMC) had barely detectable levels of 0.01 +/- 0.001 U/10(6) cells (mean +/- SE, n = 3). In order to characterize the carboxypeptidase A present in the BMMC, a sensitive assay was developed that used angiotensin I as the substrate and reverse phase-high performance liquid chromatography to separate and quantify production of the cleavage product des-leu-angiotensin I. Using this assay, mouse BMMC carboxypeptidase A had a neutral to basic pH optimum and hydrolyzed angiotensin I with a Km of 0.78 mM. The antigen-induced net percent release of carboxypeptidase A from IgE-sensitized BMMC was proportional to that of the secretory granule component beta-hexosaminidase which indicates a secretory granule location for the exopeptidase. As defined by exclusion during Sepharose CL-2B chromatography, carboxypeptidase A was exocytosed as a greater than 1 X 10(7) m.w. complex bound to proteoglycans. Because BMMC cocultured with mouse skin-derived 3T3 fibroblasts are known to undergo an increase in histamine content and biosynthesis of 35S labeled heparin proteoglycans, carboxypeptidase A activity was measured during BMMC/fibroblast coculture for 0 to 28 days. The carboxypeptidase A activity increased progressively during 28 days of co-culture from 0.004 +/- 0.002 U/10(6) starting BMMC (mean +/- SE, n = 3) to 0.36 +/- 0.10 U/10(6) co-cultured mast cells. These findings indicate that carboxypeptidase A, a neutral protease, is exocytosed from the secretory granules of mouse mast cells bound to proteoglycan and is increased during the in vitro differentiation of mouse BMMC from mucosal like mast cells to serosal-like mast cells. PMID- 3680951 TI - Differential expression of the amyloid SAA 3 gene in liver and peritoneal macrophages of mice undergoing dissimilar inflammatory episodes. AB - The three active serum amyloid A (SAA) genes of mice, SAA 1, SAA 2, and SAA 3, are coordinately expressed in liver during acute and chronic inflammatory stimulation and experimental amyloidosis. The genes, primarily SAA 3, are also expressed extrahepatically. The apoprotein SAA 2 is the precursor of the amyloid A (AA) fibril protein that is deposited as insoluble fibrils extracellularly in spleen and other organs when amyloidosis occurs secondarily to inflammation. The exact cause of AA fibril formation is unknown. Amyloid enhancing factor is a high m.w. glycoprotein extracted from amyloidotic organs. Administration of amyloid enhancing factor alters experimental inflammation to bring about accelerated deposition of amyloid A fibrils first in spleen and later in other organs. In this study, hepatic and extrahepatic expression of the SAA genes were compared during accelerated amyloidosis relative to inflammation uncomplicated by amyloidosis. Differences in kinetics and pattern of SAA gene expression by resident peritoneal macrophages and liver were detected during four dissimilar inflammatory episodes. Macrophages expressed the SAA 3 gene solely, and to a greater extent in chronic than in acute inflammation. In accelerated amyloid induction, macrophage SAA 3 expression increased as SAA 1 and SAA 2 expression in liver decreased. However, alpha-1-acid glycoprotein expression remained elevated throughout the course of amyloid induction. The greatly increased expression of the SAA 3 gene by macrophages and decreased expression of the SAA 1 and SAA 2 genes in liver during amyloidosis, suggests that altered SAA gene expression may play a pathogenetic role in experimental amyloid deposition. PMID- 3680952 TI - DNA sequence analysis of the C3H H-2Kk and H-2Dk loci. Evolutionary relationships to H-2 genes from four other mouse strains. AB - We generated nucleotide sequences for H-2Kk and H-2Dk from the C3H mouse, as well as for a genomic clone of H-2Db, in order to conduct an evolutionary analysis of the H-2 genes from three haplotypes, k, d, and b. H-2Kk from both the C3H and AKR strains, H-2Kd, H-2Kb, H-2Dk, H-2Ld, H-2Dd, H-2Db, and H-2Dp DNA sequences were aligned, and the alignments used to construct phylogenetic trees inferring the evolutionary relationships among the nine genes by two independent methods. Both approaches yielded trees with similar topologies. In addition, the sequence alignments revealed patterns of nucleotide substitutions which implicate both point mutation and recombination in the divergence of the H-2 genes. Future considerations for evolutionary analysis of class I genes are discussed. PMID- 3680953 TI - ELISA determination of IgG antibodies to pneumococcal capsular polysaccharides in a group of children. AB - An enzyme-linked immunosorbent assay (ELISA) was developed to measure specific IgG antibody levels to pneumococcal polysaccharide antigens in 300 children attending various hospital departments. By expressing the results as a specific binding index (SBI) of given high and low controls, good reproducibility was obtained. Serum levels of the antibodies were found to fall rapidly during the 1st year of life, plateau during the 2nd and then rise steadily, reaching adult levels by the 7th year. PMID- 3680954 TI - Software for the quantitative evaluation of in vitro monoclonal antibody production from ELISA data. AB - Software has been developed which permits the quantitation of monoclonal antibodies secreted by B cell hybridomas. This program does not require the user to enter a large number of complex parameters and can be easily used without any previous computer experience. It fits all the experimental and standard curves by determining overlapping linear domains using the linear least-squares method. The program is based on logarithmic interpolations for determining Ig concentrations comparing experimental samples to Ig concentrations in standards. It provides a complete print-out of the data with editing options and is written in BASIC EDEX 4.0 Commodore computer language. It permits the accurate quantification of minute amounts of monoclonal antibodies and can be used to detect the inhibitory or enhancing effects of lymphokines or cytokines on Ig secretion by hybridoma B cells. PMID- 3680956 TI - Extraction of leucocytes from human decidua. A comparison of dispersal techniques. AB - Functional studies of human utero-placental tissues have been limited by poor characterisation of the morphology and antigenic phenotype of the cells under investigation. The present study documents the effect of dispersal methods on the viability and cellular composition of cell suspensions prepared from decidualised endometrium in early human pregnancy. First trimester decidua was subjected to both mechanical disaggregation and digestion with various enzyme combinations in an attempt to optimise the yield of infiltrating decidual leucocytes. Cell types were characterised with monoclonal antibodies using an alkaline phosphatase immunolabelling method. Mechanical disaggregation resulted in suspensions containing many large decidual cells and much cell debris but few leucocytic cells. Overall viability was low, although the viability of small leucocytes common antigen-bearing cells remained high. Enzymic digestion yielded cell suspensions rich in leucocytes with high viability and minimal contamination by other cell types. Collagenase produced a high yield of leucocytes with high viability and minimal disruption of surface antigens in contrast with pronase which caused extensive antigenic loss. The disaggregation method determines the yield of bone marrow derived cells in decidual cell suspensions and the extent of contamination by true decidual cells and epithelial cells. PMID- 3680955 TI - An enzyme-linked lectin-binding assay on cells (CELLBA) for the comparison of lectin receptor expression on cell surfaces. AB - Lectins can be used to specifically detect some cell surface glycans. Their expression on different cells or on cells of a given lineage throughout differentiation or following treatment with drugs can be compared using lectins labelled with radioactive, fluorescent or enzymatic probes. We describe a new method which, by analogy with CELISA (ELISA on cells), is called CELLBA (or ELLBA on cells) for cellular, enzyme-linked lectin-binding assay. It permits the comparison of the expression of specific glycans in a large number of different cell samples. As an example, it was able to detect alterations of cell surface glycan expression caused by inhibitors of N-linked oligosaccharide trimming. PMID- 3680957 TI - A novel covalent modification of antibodies at their amino groups with retention of antigen-binding activity. AB - A novel method of covalent modification of antibodies at their amino groups with retention of antigen-binding activity is described. The procedure is as follows: (a) blockade of those amino groups of antibodies whose integrity is essential to their antigen-binding activity with 2,3-dimethylmaleic anhydride, a reversible amino group-blocking reagent; (b) modification of residual amino groups with reagents reactive with the amino groups; and (c) removal of dimethylmaleyl groups by hydrolysis. This procedure was used for covalent conjugation of methotrexate (MTX) with two monoclonal antibodies against human melanoma-associated antigens using MTX N-succinimidyl ester. MTX attached to the antibodies at sites other than the amino groups via less stable bond(s) was removed by treatment with hydroxylamine. PMID- 3680958 TI - Highly sensitive biotin-avidin sandwich ELISA for the rapid detection of pneumococcal capsular polysaccharide antigens. AB - The immunological detection of soluble pneumococcal polysaccharide antigens in pathological products is of importance in the direct diagnosis of meningitis or pulmonary infections. We have developed a double antibody sandwich ELISA method using a biotin-avidin system using antibodies constituted with a mixture of IgGs from pooled and/or monospecific antipneumococcal sera provided by the Danish Statens Seruminstitut. The sensitivity of this rapid ELISA method was optimized with purified capsular polysaccharides of the 24 main pneumococcal serotypes. With incubation steps of 30 min at 37 degrees C for the antigens and the conjugates, the detection limit was close to 1 ng/ml for 75% of the purified polysaccharides. A retrospective study of 46 CSF samples established the validity of the assay. This type of modified ELISA system represents a specific, sensitive and rapid procedure for the potential detection of capsular soluble antigens of all pneumococcal serotypes. PMID- 3680959 TI - The detection of heat-aggregated IgG (as a model for immune complexes) by reverse passive haemagglutination using a human monoclonal rheumatoid factor coupled to erythrocytes. AB - A human monoclonal IgM rheumatoid factor (RF) produced in vitro by an Epstein Barr virus (EBV)-immortalized cell line was purified by protein A-Sepharose adsorption and coupled by the chromic chloride method to human erythrocytes. The RF-coupled cells were incorporated in reverse passive haemagglutination (RPH) assays to detect immune complexes (IC) using heat-aggregated human IgG as a model system. The sensitivity of the RPH was comparable to an enzyme-linked immunosorbent assay (ELISA) using sheep C1q for the detection of ICs. PMID- 3680960 TI - A novel method to investigate the heterocliticity of antibodies. AB - Monoclonal and anti-dinitrophenyl and anti-trinitrophenyl IgE antibodies were used to measure heterocliticity using competitive inhibition assays with homologous and heterologous haptens. The antibodies or antibody-containing ascites fluids were diluted to give 50% of the maximum binding to wells of antigen-coated microtiter plates. The % inhibition of binding of the antibody to the antigen by various concentrations of homologous and heterologous haptens at a standard dilution of antibody can then be compared. The advantages of this method of determination of heterocliticity are that it is fast, simple, quantitative and does not need radiolabeled reagents. PMID- 3680961 TI - The rapid and sensitive enumeration of antibody-secreting cells using immunogold/silver staining (SIG-blot assay). AB - A simple and robust method has been developed for the enumeration of antibody secreting cells. Secretion is assessed on the surface of 96-well microtitre plates using immunogold/silver staining techniques. The method is sufficiently straightforward to allow, for the first time, assessment of secretory cells in the clinical laboratory. This approach has great potential for enumerating cells that secrete other products, such as the interleukins. PMID- 3680962 TI - Monoclonal antibodies evoked by the free oligopeptide (Gly)5 reacting specifically with peptidoglycan from staphylococci. AB - Murine monoclonal antibodies reactive with the Staphylococcus aureus peptidoglycan (PG) epitope (Gly)5 were obtained using the synthetic oligopeptide (Gly)5 in its free form as immunogen. The selected monoclonal antibodies were of the IgM kappa isotype and reacted specifically with PG from S. aureus and Staphylococcus epidermidis, but gave no reaction with PG from Streptococcus pyogenes, Bacillus subtilis and Micrococcus lysodeikticus. Affinity chromatography showed that the antibodies were reactive with the N-terminus of the (Gly)5 peptide. These monoclonal antibodies can be used for the detection of staphylococcal PG in solution. PMID- 3680963 TI - Quantitation of C3 nephritic factor of alternative complement pathway by an enzyme-linked immunosorbent assay. AB - We have developed an enzyme-linked immunosorbent assay (ELISA) for the quantitation of C3 nephritic factor of the alternative pathway of complement (NeFA). Incubation of the NeFA-positive serum (patient KS serum) with normal human serum (NHS) in Mg-EGTA resulted in the formation of C3-B-IgG complex. No complex was formed in EDTA. At first this was detected as three types of complexes: C3-IgG, B-IgG and B-C3, by the combination of antibodies. The reaction mixture in Mg-EGTA was filtered through an ACA 22 column, from which the complexes were eluted in the same part as the first protein peak. When IgG purified from KS serum was incubated with NHS in Mg-EGTA, B-C3 complex increased in proportion to the dose of IgG. These results indicated that only one kind of complex consisting of IgG, C3 and B (IgG-C3-B) was generated by the addition of NeFA to NHS. Serum NeFA could be quantified as the titer of B-C3 complex formed after its incubation with NHS in Mg-EGTA. Using the ELISA method, NeFA was positive in five out of six patients with membranoproliferative glomerulonephritis (MPGN) type II and in only one of 17 with MPGN type I. Titers obtained by the new method were in good accordance with those by C3 conversion and C3bBb stabilization assays for NeFA, and the new method was more exact and simple than the conventional methods. PMID- 3680964 TI - An enzyme-linked immunosorbent assay for the detection of platelet antibodies using detergent-solubilized platelets immobilized on nitrocellulose discs. AB - A method is detailed for the solubilization of human platelets using a dialyzable detergent, decanoyl-N-methylglucamide (Mega-10). At a detergent/protein ratio of 1:12, the efficiency of solubilization was 27%. This platelet lysate (PLy) was then bound to nitrocellulose (NC) discs to assay retention of the native immunological functions of the platelet membrane antigens. Using alkaline phosphatase-coupled anti-IgG, the major platelet membrane glycoproteins GPIb, GPIIb, and GPIIb/IIIa were detectable with as little as 20 ng of monoclonal antibody. Antisera to the class I histocompatibility antigens HLA-A1, B7, B8, the PlA1 allodeterminant, and serum from multiply transfused, alloimmunized patients were reactive even after 100 days storage of the discs at 4 degrees C, and with as little as 1.0 micrograms of NC-bound PLy. The binding of the same antisera to intact, immobilized platelets as well as specific complement-mediated lymphocytotoxicity was also inhibited by PLy. PLy from HLA-A3- or B44-positive donors, however, did not inhibit cytotoxicity of lymphocytes expressing either antigen using several different antisera. Our results indicate that Mega-10 is an excellent solubilizing agent for the immunological study of platelet membranes. The fact that clinically relevant platelet membrane antigens are preserved, immunologically reactive, and stable over long periods of storage, makes this assay amenable to a routine crossmatching procedure for platelet transfusions. PMID- 3680965 TI - Isolation of lymphocytes from clotted blood. AB - A problem often faced in clinical cell-mediated immunology research is to obtain peripheral blood lymphocytes (PBLs) in sufficient numbers to carry out cellular immune assays. Obtaining sufficient amounts of blood for serum is usually more practical than for PBLs. Blood is usually drawn easily for serum, but obtaining PBLs from clotted blood has not been very practical. In this report we describe a procedure whereby PBLs can be recovered from clotted blood and used in functional immune assays. Using the enzyme streptokinase (SK) blood clots were dissolved and viable PBLs recovered up to 24 h post clotting. Concentrations of SK from 250 to 500 SK U/ml gave maximum recovery of PBLs. PMID- 3680966 TI - [Contribution of cytological punctures to the diagnosis of kidney tumors]. AB - Analysis concerned 47 kidney tumours. Puncture was under ultrasonographic control using 22 G needles. The sample was obtained by suction. The authors then describe the technique of fixing and reading of smears. Four types of indications were adopted; diagnostic uncertainty between benign and malignant nature (22 cases), high risk surgical patients in whom a pre-operative histological diagnosis is very desirable (10 cases), search for a primary neoplasm in the presence of metastatic spread (5 cases), routine puncture of tumours seen by ultrasonography (10 cases). Puncture material was uninterpretable in 6 cases. In 26 cases of puncture-cytology could be compared with those of histological examination (nephrectomy or surgical biopsy). 3 puncture-cytology results were un interpretable, whilst in 21 cases the correlation was perfect (17 malignant tumours and 4 benign tumours). In 1 case puncture-cytology led to suspicion of the malignant nature of the lesion. Puncture cytology was erroneous in one case (a malignant tumour confused with an angiomyolipoma). In 21 cases no sample was obtained and it was not possible to establish the correlation between cytological and histological results. Amongst these 21 cases 3 were uninterpretable whilst in 18 there was no evidence of error on the basis of the subsequent clinical course. No complications were seen and in particular no abdominal wall dissemination. Sensitivity of the method was of the order 80 to 87%. Interpretation of puncture cytology is difficult in urothelial carcinomas, renal adenoma and oncocytoma. By contrast puncture-cytology is particularly reliable in angiomyolipoma and metastatic lesions of the kidney. PMID- 3680967 TI - [The collector system of the kidney. Applied anatomy based on the analysis of 3 dimensional casts]. AB - The kidney collector system were studied in 120 three-dimensional casts obtained by the injection-corrosion method. To the procurement of the first hundred casts, we made use of a polyester resin; however on the preparation of the last twenty we made use of a mixture containing latex and radiographic contrast as we intended to obtain, besides the casts, the roentgenograms. Two anatomic details, which have a great importance for endourology, were observed: a. the calices' cross draining the meso-renal region and the consequent inter-pelvis-calice (space (IPC) formation which is seen in the roentgenograms, b. a smaller calice which penetrates perpendicularly the surface of the renal pelvis or into the surface of a great calice. The urologists must appreciate these two anatomic structures, before the surgical procedures on the collector system. PMID- 3680968 TI - [The course of renal function in vesicorenal reflux. Study using I-123 Hippuran]. AB - Fifty-two patients with vesicoureteral reflux (age: 6.4 +/- 6.2 years) were examined by IVP, voiding cystouretrography and 123 I-Hippuran studies. 17 patients were not operated; 26 had an antireflux, 9 an urethral surgery. The follow-up was 2 years for 39 of these patients, with at least one evaluation per year. The observations were: Unoperated patients were younger, had a lower radiological grade of reflux and renal functional impairment was less frequent. Functional impairment was initially equally distributed in unilateral (53%) and bilateral (54%) reflux. Radiological grade of reflux had an unsatisfactory predictive value for functional renal status. Functional renal status at 2 years was unchanged in 82% of patients. Improvement was observed in 8%, deterioration in 10%. These results were not influenced by the choice of treatment. However, reflux persistence was more frequently observed in the un-operated group (50% versus 5%). Renal transit times of 123 I-Hippuran did not correlate with the functional status or the radiological grade of reflux. PMID- 3680969 TI - [Spontaneous renal arteriovenous fistula. Apropos of a case of presumed acquired fistula]. PMID- 3680970 TI - [Diagnostic and therapeutic problems of bladder endometriosis. Apropos of 5 cases]. AB - Five cases of bladder endometriosis are reported with special emphasis on diagnostic methods and therapeutic possibilities. In all five cases a large resection of the lesion have been necessary without the need for postoperative hormonal management. PMID- 3680971 TI - [Intrinsic endometriosis of the ureter]. AB - Two cases of ureteral endometriosis are reported and the literature is reviewed with special emphasis on symptoms and therapy. New diagnostic methods such as computer assisted tomography, ultra-sonography and urinary cytology are discussed and evaluated. Intrinsic ureteral endometriosis should be treated with local resection, and reimplantation with the psoas-hitch technique. The need for post operative hormonal management must be adapted to each case. PMID- 3680972 TI - [Vesico-urethral fibroscopy. Reflections after 4 years' practice]. AB - The visualisation of the lower urinary tract by the mean of a fiberscope makes an advance when compared to rigid endoscopy mainly in male patient. Technical features of the fiberscopes suitable for urology thus basic technique of the examination are described. Main advantages are painfree and total visual scanning of the mucosa. Disadvantages are very low. PMID- 3680973 TI - [Prevention of infectious endocarditis following manipulations of the urogenital tract]. AB - Instrumentation of the genito-urinary tract may cause transient bacteremia, it can result in bacterial endocarditis in predispose subject. We studied the incidence of transient bacteremia following urogenital procedure and discovered a 2.6% rate in 196 patients. Therefore we studied antimicrobial prophylaxis against strains isolated from urocultures (35 strains) and blood cultures (6 strains). The strain's minimal inhibitory concentration (MIC) confirms antibioprophylaxis suggested by American Heart Association (AHA). Mean-while, according to our results, netilmicin is the best choice. PMID- 3680974 TI - [Perineo-transpubic approach in the treatment of traumatic rupture of the posterior urethra. Apropos of 14 cases]. AB - Traumatic lesions of posterior urethra pose a problem in management because of the difficult access behind the pubic position. Twelve successful results among fourteen patients are treated by perineum transpubic surgery. The direct attack upon the lesion constitute the superiority of this approach. PMID- 3680975 TI - [A transglandular tunnel in the treatment of hypospadias]. AB - A technique and the results of the creation of a transglandular tunnel for the more aesthetic repair of hypospadias is reported. The tunnel is not trocardisized through the glans but really excised. This reduced considerably the risk of stenosis, as this occurred only 9 times in 112 cases. In only three of them a reoperation was necessary. Sensibility of the glans remains normal after the operation while the appearance is a nearly normal. PMID- 3680976 TI - [Vesico-ureteral reflux after radical prostatectomy]. PMID- 3680977 TI - [Percutaneous endoscopic resection of a pelvic papilloma]. PMID- 3680978 TI - [The double J catheter. An alternative to ureterostomy in inoperable pelvic cancers]. PMID- 3680979 TI - [Nephrogenic metaplasia of the bladder. Apropos of a case]. PMID- 3680980 TI - Differential hypermelanosis induced by allergic contact dermatitis. AB - In moderately colored guinea-pig skin, UVB, PUVA (psoralen plus UVA), and allergic contact dermatitis were shown to induce visibly well-defined hyperpigmentation that resembled the pigmentary changes observed in Mongoloid human skin. To clarify mechanisms of allergen-induced hyperpigmentation, we compared the effects of allergic contact dermatitis on pigmentation by using 6 different allergens: dinitrochlorobenzene (DNCB), 1-phenylazo-2-naphthol (PAN), benzyl salicylate (BS), jasmine oil (JO), hydroxycitronella (HC), and ylang ylang oil (YYO). The PAN-, JO-, HC-, and YYO-induced allergic reactions caused a definite visible hyperpigmentation that began to appear within 14 days, reaching maximum intensity about 40 days after the induction of the allergic reaction. These hyperpigmentations were accompanied by a significant increase in the population of dopa-positive melanocytes on day 24 following allergic reactions. In contrast, BS- and DNCB-induced allergic reactions did not give rise to visibly distinct hyperpigmentation in spite of the intensive allergic reactions following their challenge application. In a nonsensitized group, primary irritant reactions were induced by the application of 100% JO, but no distinctive hyperpigmentation was found 40 days after the last application. Quantitative analysis of the number of melanophages in the dermis showed that there was a marked increase in the number of melanophages in PAN, YYO, and HC allergy-induced hyperpigmented areas, with PAN showing a significant increase compared with those in non-treated areas of the same animals, whereas JO was associated with no such increase in hyperpigmented area, despite the stimulated pigmentation. In the case of the lack of induced hyperpigmentation, as seen in BS and DNCB allergy and JO irritation, there was also no substantial increase in the number of melanophages. Our findings indicate that allergic contact dermatitis is a unique melanogenic stimulant different from UV irradiation. PMID- 3680981 TI - Thrombospondin in early human wound tissue. AB - We examined partial thickness incised human wounds of 2, 3, 5, 7, and 14 days of age for the presence of thrombospondin by immunostaining and light microscopy. At 2, 3, 5, and 7 days after wounding, thrombospondin is present primarily at the cut edges of the lateral and deep margins of the wound. It appears to be cleared from these extracellular matrix sites, and is no longer detectable in those sites in most 14-day-old wounds. Thrombospondin staining is present, however, in increased amounts around the vascular channels within and adjacent to the 7- and 14-day wounds in increased amounts relative to vascular channels distant from the wound. Our observations are consistent with known in vitro data regarding the binding of thrombospondin to fibrin and components of the extracellular matrix, as well as with data showing that proliferating endothelial cells secrete more thrombospondin than quiescent endothelial cells. These data support the hypothesis that thrombospondin plays a role in the early organization of the extracellular matrix of wounds. PMID- 3680982 TI - Development of MoAb HMSA-3 and HMSA-4 against human melanoma melanosomes and their reactivities on formalin-fixed melanoma tissues. AB - To elucidate the nature of melanosomal protein in normal and malignant melanocytes, two mouse monoclonal antibodies (MoAbs), designated MoAb HMSA-3 and MoAb HMSA-4, were developed by the solubilized melanosomes of human malignant melanoma. The specificity of the two MoAbs was characterized immunohistochemically by comparison with that of MoAb HMSA-2 in various forms of melanoma tissues. MoAb HMSA-3 and MoAb HMSA-4 were IgM, k subclass while MoAb HMSA-2 was IgG1, k subclass. The three MoAbs possessed many similarities; (a) positive reactivity in formalin-fixed and paraffin-processed specimens, (b) identification of cytoplasmic antigen(s) in melanoma cells, (c) negative reactivity with normal epidermal melanocytes on paraffin-sections, and (d) intense reaction with amelanotic melanoma cells, particularly in superficial spreading and acral lentiginous melanoma and in metastatic lymph nodes. The three MoAbs, however, identified the different cells on the same serial sections, suggesting that the three may recognize the different epitopes. Thus in 32 cases of primary and metastatic melanomas examined, one of the three MoAbs always showed a positive reactivity, though the other two were negatively or weakly reacted. Our study indicated that the melanosomal protein may provide a unique source to develop MoAbs which identify malignant melanocytes on routine paraffin sections. PMID- 3680983 TI - Adult cutaneous hemangiomas are composed of nonreplicating endothelial cells. AB - Thirty-four human "cherry" dermal hemangiomas were studied by electron microscopy, immunohistochemistry, and cell culture to assess the neoplastic nature of these lesions. Electron microscopy of nine hemangiomas revealed a pronounced thickening of the basement membrane (0.6 to 14 micron) in 93% of the total 158 vascular structures examined within the lesions. This increase was caused mainly by multiple layers of basal lamina, which were irregular in outline and frequently associated with pericytes. Basement membrane changes were present both in the periphery of the hemangiomas, as well as in the center of the lesions. Immature vessels could not be identified and mitoses were absent in all endothelial cells. Using an immunohistochemical marker (Ki67) specific for proliferating cells in G2 and S phases, positive staining was not found in the endothelial cells lining the hemangiomatous vessels, whereas basal epidermal keratinocytes in the same preparations and cultured microvascular endothelial cells expressed the antigen. Endothelial cells of nine hemangiomas did not stain with an activation-related antibody (E12) specific for endothelial cells. When endothelial cells from 14 hemangiomas were isolated and cultured under conditions that support the growth of normal human skin microvascular endothelial cells, the cells of hemangiomatous origin failed to grow. We conclude that the adult hemangiomas may not be true neoplasms, but a tissue overgrowth composed of mature vessels resembling dermal venules, lined by endothelial cells with virtually no turnover. PMID- 3680984 TI - Measurement of the stratum corneum drug reservoir to predict the therapeutic efficacy of topical iododeoxyuridine for herpes simplex virus infection. AB - A rapid, in vivo measurement of the penetration of antiviral compounds into the skin would improve our ability to predict the therapeutic efficacy of topical treatments for herpes simplex virus (HSV) infection. We have studied the concentration of iododeoxyuridine (IDU) in the stratum corneum of guinea pig skin by tape stripping at different time points after single and multiple topical doses of the drug. These results were correlated with the efficacy of topical IDU against an experimental cutaneous HSV infection. Ten adhesive tape strippings were performed on depilated guinea pig dorsum in vivo at serial intervals after a single topical dose of [3H]IDU. Iododeoxyuridine levels in the stratum corneum peaked at 1-3 h (67-70 mg/g of tissue) and then gradually declined over the next 3-24 h. We hypothesized that the peak IDU stratum corneum concentration would correlate with therapeutic efficacy. Accordingly, we determined the quantity of IDU in guinea pig stratum corneum 2 h after a topical application of seven different concentrations of IDU in dimethylsulfoxide (DMSO) and examined the in vivo efficacy of these formulations in an experimental dorsal cutaneous HSV-1 infection in guinea pigs. The results showed an excellent correlation between the quantity of IDU in the stratum corneum and reduction in lesion severity (r = 0.95 0.97). Fifteen percent IDU in DMSO provided the highest therapeutic efficacy (90 94%). We also studied the relationship between the clinical efficacy of different dosing frequencies and the amount of IDU in the stratum corneum. Serial IDU stratum corneum concentrations were measured over 24 h following 1, 2, 3, or 4 applications per day of 1, 3, and 15% IDU in DMSO treatments and parallel efficacy studies of the different regimens were conducted in the animal model. Within each dosing frequency, the cumulative amount of drug in the stratum corneum correlated with the strength of the test formulation and with efficacy in the animal model. For each of the three formulations, increasing the number of daily doses from one up to three led to progressive increases in cumulative stratum corneum IDU levels and clinical efficacy. An increase in the number of daily applications to four had little effect on drug efficacy and was associated with a plateau in stratum corneum IDU levels. Stratum corneum IDU concentrations were rapid and easy to determine and correlated well with clinical events.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3680985 TI - Environmental wavelengths of ultraviolet light induce cytoskeletal damage. AB - The ultraviolet component of sunlight is the major cause of skin cancer and is responsible for accelerating the aging of human skin. It is therefore important to determine the mechanisms by which ultraviolet light alters normal cellular functions. The potential importance of ultraviolet light-induced damage to non DNA targets has received little attention. Since the cytoskeleton is an important participant in the control of normal cell growth, the microfilaments and microtubules of UV irradiated human skin fibroblasts have been studied using fluorescence microscopy. Polychromatic ultraviolet light, composed of environmentally relevant wavelengths, was found to disrupt the cytoplasmic microtubule complex in a dose dependent manner. The induction of microtubule disassembly did not correlate with the cytotoxicity of ultraviolet light of varying composition. PMID- 3680986 TI - Modification of 5-methoxypsoralen phototumorigenesis by UVB sunscreens: a statistical and histologic study in the hairless albino mouse. AB - Sunscreen preparations containing 5-methoxypsoralen at 25 micrograms/ml and 50 micrograms/ml, and the appropriate vehicle only, sunscreen only, and 5 methoxypsoralen only controls, were assessed for tumorigenic potential in hairless albino mice exposed to solar simulated radiation for a period of 44-46 weeks. Some animals were observed for a 15 week post-irradiation period. A wide range of statistical analyses has shown that, during the course of irradiation, the inclusion of sunscreens eliminates the enhancement of phototumorigenesis and malignancy that is normally observed with 5-methoxypsoralen. There was, however, some indication of increased risk at the end of the postirradiation follow-up period. Possible reasons for the protective effect of the sunscreens and the relevance of these data to the assessment of human risk are discussed. PMID- 3680987 TI - Disseminated Kaposi's sarcoma in AIDS: histogenesis-related populations and influence of long-term treatment with rIFN-alpha A. AB - Lesions (n = 19) of cutaneous Kaposi's sarcoma in different stages of development were obtained from 13 patients with acquired immunodeficiency syndrome (AIDS), and studied by light and electron microscopy. Six additional biopsies from 4 patients treated with recombinant alpha A interferon were obtained after treatment. Varying amounts of two proliferating cell populations were found: (1) Large cells showing cytologic and histochemical characteristics of endothelial cells. They were seen in close proximity to normal vessels, forming new vascular structures and large aggregates found in papular and nodular lesions. (2) Smaller spindle-shaped cells, probably of pericytic origin. They appeared in bundles and fascicles in the papillary dermis of the cutaneous Kaposi's sarcoma lesions and, in part, gave origin to thin-walled, bizarre-shaped vessels that show incomplete lumina proliferating from the upper to the deep dermis and are surrounded by extravasate erythrocytes and siderophages. After long-term systemic treatment with recombinant alpha A interferon, the endothelial type of tumor cell aggregates mostly disappeared, whereas most of the spindle-shaped pericytic-like cells were still present. Our findings lead us to suggest that some cellular product may, as a promoter factor, induce the proliferation and growth of endothelial cells. This factor may be blocked by alpha A interferon and cause regression of endothelial cell proliferation observed in AIDS patients undergoing long-term systemic therapy. PMID- 3680989 TI - Malnutrition as a risk factor for severe visceral leishmaniasis. PMID- 3680988 TI - Characteristics of humoral and cellular immunity to Salmonella typhi in residents of typhoid-endemic and typhoid-free regions. PMID- 3680990 TI - Plasmid profiles of Clostridium difficile isolates from patients with antibiotic associated colitis in two community hospitals. PMID- 3680991 TI - Adenosine deaminase activity as a diagnostic aid in tuberculous meningitis. PMID- 3680992 TI - Pentamidine pharmacokinetics in patients with AIDS with impaired renal function. AB - In patients with normal renal function, pentamidine elimination half-life and plasma clearance (mean +/- SD) were 6.22 +/- 1.17 hr and 411 +/- 55 liters/hr, respectively. With creatinine clearances from 35 to 145 ml/min, neither the elimination half-life (P = .47) nor the plasma clearance (P = .40) was correlated with renal function. Plasma concentrations in patients receiving dialysis ranged between 5.9 and 582 ng/ml and appeared not to be significantly affected by dialysis. The number of prior doses and the elimination half-life estimated from the terminal slope were correlated (r = .81, P = .025), and the results suggested that the current assay technology is still not sensitive enough to detect true elimination half-life. Trough plasma concentrations ranged between 4.3 and 67.5 ng/ml (28.4 +/- 26.6 ng/ml) in patients who had received prior doses of pentamidine, a result suggesting that drug accumulation occurs with multiple dosing. The data suggest that dosage adjustments are not necessary with creatinine clearances of greater than 35 ml/min. Because multiple dosing leads to increased trough concentrations and drug accumulation, lower dose regimens may still be efficacious, yet associated with reduced toxicity. PMID- 3680993 TI - In vivo glycocalyx expression by Staphylococcus aureus phage type 52/52A/80 in S. aureus osteomyelitis. AB - Osteomyelitic rat tibiae were examined by scanning electron microscopy for the extracellular glycocalyx of Staphylococcus aureus. S. aureus and fractured tibiae from normal rats were incubated together in vitro and examined similarly. Low magnification of endosteal Haversian portals from tibiae studied in vivo and in vitro disclosed adherent S. aureus exuding glycocalyx that buried the organism in dense, coccoid-studded biofilms. The biofilm became progressively more dense over time in vitro and was exuberant at day 70 in vivo. S. aureus incubated in vitro without tibiae disclosed no glycocalyx. Bone chips studied in vitro disclosed staphylococci more commonly near the endosteal Haversian portals than on the intervening endosteal surfaces (mean +/- SE, 280 +/- 75 vs. 12 +/- 3 per 2,500 micron 2 field; P less than .002 by Student's t test). Organisms within ostia were not counted, although they occluded 10%-40% of the ostium. Staphylococci were adherent to exposed woven material, perhaps collagen. PMID- 3680995 TI - Comparison of Chlamydia trachomatis serovars causing rectal and cervical infections. AB - We used monoclonal antibodies capable of distinguishing serovars of Chlamydia trachomatis to compare 314 cervical isolates with 150 rectal isolates from homosexual men. The isolates were obtained from patients attending a sexually transmitted diseases clinic over a two-year study period. The serovar distribution of cervical and rectal isolates differed significantly. Serovar D/D' was found in 53% of the rectal isolates but in only 18% of cervical isolates (P less than .0001). Serovar E was the predominant serovar in cervical isolates (32%) but was found in only 6% of rectal isolates (P less than .0001). Serovars B, I/I', H, and K were isolated from 2%-7% of cervical specimens but were not found in rectal isolates. There was a significant decline in the proportion of rectal infections caused by serovar D/D' over the study period, and clustering of infections caused by other serovars was observed. Serotyping using monoclonal antibodies provides a powerful tool for investigating the epidemiology of sexually transmitted C. trachomatis infections. PMID- 3680994 TI - Expression of capsular polysaccharide during experimental focal infection with Staphylococcus aureus. AB - In vivo expression of the type 8 capsular polysaccharide (CP) of Staphylococcus aureus was studied by using the Becker strain, the prototype type 8 strain, in a guinea pig model of persistent subcutaneous infection. At 24 hr after infection, supernatants of aspirates from the site of infection contained low levels of CP (median, 0.53 ng/ml; range, less than 0.16-6.30 ng/ml). CP levels increased at day 3 to a geometric mean level of 47 ng/ml, at day 6 to 389 ng/ml, at day 8 to 537 ng/ml, and thereafter persisted in that range. On days 1, 3, and 6, CP was not detectable (less than 0.16 ng/ml) in the serum, but on days 8, 10, or 13, CP was present in 15 (58%) of 26 animals; the median peak level of serum CP among these animals was 2.00 ng/ml (range, 0.31-5.90 ng/ml). These studies document that the type 8 CP of S. aureus is produced and released during a focal, suppurative infection and can be detected in the serum of infected animals. PMID- 3680996 TI - Risk factors for surgical-wound infection following cardiac surgery. AB - In a prospective study of 1,009 adult patients undergoing elective cardiac surgery at The Johns Hopkins Hospital, we determined the association between a variety of preoperative and operative parameters and the risk of postoperative sternal- or mediastinal-wound infection. Of the parameters reflecting nutritional state, only one, reduced level of albumin in serum, was significantly associated with sternal- or mediastinal-wound infection by univariate analysis. The final multiple logistic regression analysis indicated that four variables were significant (P less than .05) independent predictors of sternal- or mediastinal wound infection: obesity (relative odds = 3.8; 95% confidence limits = 1.9-7.5), diabetes mellitus (relative odds = 2.6; 95% confidence limits = 1.4-4.8), length of hospital stay before surgery greater than five days (relative odds = 2.0; 95% confidence limits = 1.2-3.5), and current cigarette smoking (relative odds = 1.8; 95% confidence limits = 1.1-3.1). Of these variables, perhaps only smoking will lend itself routinely to attempts at intervention. PMID- 3680997 TI - Experimental human infections with Giardia lamblia. AB - Fifteen healthy volunteers were inoculated enterally with trophozoites of two distinct human isolates of Giardia lamblia, GS/M and Isr. Each of two groups of five volunteers were inoculated with 50,000 (GS/M or Isr) trophozoites. All of the volunteers inoculated with GS/M and none of the volunteers inoculated with Isr became infected. Three of five volunteers infected with GS/M became ill, including two who had diarrhea and typical symptoms of giardiasis. In the second study, three patients who were previously infected with GS/M and treated were rechallenged 12 weeks after the first inoculation, together with five new control volunteers. All of the latter group became infected, and two developed loose stools; two rechallenged volunteers became reinfected but were asymptomatic, and a third was retrospectively found to be infected at the time of challenge. Serum IgM, IgG, and IgA antibody responses to Giardia and intestinal fluid IgA antibody responses to Giardia occurred in 100%, 70%, 60%, and 50%, respectively, of infected volunteers. These studies fulfill Koch's postulates and demonstrate strain variation in the pathogenicity of Giardia infections in humans. PMID- 3680998 TI - Armadillo exposure among Mexican-born patients with lepromatous leprosy. PMID- 3680999 TI - Incidence of salmonellosis in patients with AIDS. PMID- 3681000 TI - [The First Conference on Mitral Valve Prolapse. Tokyo, August 3, 1984]. PMID- 3681001 TI - [Prognosis of mitral valve prolapse related to the changes in the grade and ventricular arrhythmias]. AB - Eighty-four cases with idiopathic mitral valve prolapse (MVP) were followed for 3.1 years in average (1 to 6 years). Left ventricular end-diastolic and end systolic dimensions and/or left atrial dimension increased in 72.4% of the cases with severe grade of MVP, while in only 14.3% of the cases with mild grade of MVP during follow-up period. Incidence of ventricular arrhythmias was 70% including about 10% each of grade III, IVa, and IVb in Lown's classification. Repeated examination using 24-hour Holter monitoring showed ventricular arrhythmias of long duration in a majority of the cases, and 66.7% of the cases with III and IV in Lown's classification revealed IVa and IVb frequently including one case of sudden death occurred during follow-up period. PMID- 3681002 TI - [Panel discussion: diagnostic criteria of mitral valve prolapse]. PMID- 3681003 TI - [Right ventricular endomyocardial biopsy findings in idiopathic mitral valve prolapse: comparison with clinical findings]. AB - Right ventricular endomyocardial biopsies were performed in nine patients with mitral valve prolapse (MVP), and the histological features were compared with the clinical findings. All of them had atypical anterior chest pain and/or dangerous ventricular arrhythmias, but the grade of MVP was mild. Five patients had non specific ST-T changes on resting 12 leads ECG, four had ischemic ST depression on treadmill exercise ECG, and five had dangerous arrhythmias on 24 hour Holter monitoring ECG. Resting echocardiography showed normal left ventricular function in all, but exercise echocardiography revealed reduced increment of % fractional shortening (delta % FS) in five patients. Right ventricular endomyocardial biopsy findings disclosed endocardial thickening and interstitial myocardial fibrosis in eight patients, myocardial hypertrophy in two, myocardial degeneration in five, and myocardial disarray in five, although these changes were mild. These results suggest that in patients with MVP, there is a subgroup with endomyocardial abnormalities, and these might have some relations to the variety of clinical findings in MVP. PMID- 3681004 TI - [Diagnosis of mitral valve prolapse by X-ray CT and MRI]. AB - To evaluate the usefulness of enhanced X-ray CT and gating magnetic resonance imaging (MRI) for diagnosing mitral valve prolapse, three patients with this abnormality and several controls were examined by these two methods. The mitral valve was not recognized by X-ray CT except a few cases with thickened mitral valve. However, MRI could demonstrate clearly the mitral leaflets and annulus in many subjects. In transverse MR imaging of the subjects without valvular disease, the closed mitral valve showed V-shaped appearance in the left ventricle during systole. In a patient with marked mitral valve prolapse, MRI revealed buckling of the posterior mitral leaflet into the left atrium, and in two other patients with mild mitral valve prolapse, MRI demonstrated displacement of coaptation of the anterior leaflet toward the left atrium. These results suggest MRI is a useful method for diagnosing mitral valve prolapse. PMID- 3681006 TI - [Pathologic aspects of mitral valve prolapse syndrome]. AB - To comprehend clinical pictures of mitral valve prolapse syndrome (MVP), specific pathoanatomical knowledge is required. There is no definite structure of the anterior mitral valve ring. The mitral valve ring is not flat; the anterior segment of the ring tilts up superiorly. The number of scallops of the posterior leaflet depends on the definition of the incisura. The term "rough zone chorda" (Lam et al., 1970) is a misnomer. From the pathological point of view, more than two subgroups of MVP are present. In isolated MVP, pathological lesions are restricted to the local ballooned segment. However, in MVP with connective tissue disorders (for example, Marfan syndrome, etc.), the lesions are principally diffuse. Mitral valve changes in hypertrophic cardiomyopathy with obstruction are caused by torsion and the relatively elongated anterior leaflet due to narrowing of the mitral orifice, septal hypertrophy and displacement of the papillary muscles. MVP in atrial septal defect is caused by the turbulence of a large shunt flow or by the torsion of the mitral ring due to right ventricular volume overload. Further investigation of surgical and necropsied cases will be required to clearly the subgroups of MVP. PMID- 3681005 TI - [Association of anorexia nervosa and mitral valve prolapse]. AB - Four cases of anorexia nervosa recently encountered were reported in respect to their cardiovascular manifestations including prolapse of the cardiac valves and other poorly recognized cardiac findings. All four patients, aged 13 to 32 years, were women and had marked emaciation (35 to 44% weight loss of the ideal body weight) with typical hormone abnormalities. Chest radiographs showed a small cardiac shadow, and sinus bradycardia with low voltage was present in their electrocardiograms. One case, 13-year-old, had a mid-systolic click and occasionally a late systolic murmur, and also an abdominal continuous hum. Echocardiography including two-dimensional color flow-mapping disclosed mitral valve prolapse in all, and tricuspid valve prolapse in two. Mild to moderate pericardial effusion was noted in all between the right ventricle and diaphragm, and pericardiocentesis in one case had no effect on the valve movements. No inflammatory changes were observed in the specimen of the pericardium and also of the fluid. An association of mitral valve prolapse and anerexia nervosa was discussed based on the previous studies, but the final conclusion remains unknown. PMID- 3681007 TI - [Clinical problems in mitral valve prolapse: an electrocardiographic review]. AB - Electrocardiographic signs of mitral valve prolapse are essentially non-specific. Diagnosis must be based on the other methods, but whenever the diagnosis was established, the electrocardiographic abnormalities may have a certain significance to predict the natural course and prognosis. The reported results and those of our series of 111 cases were compared in detail. Resting and exercise electrocardiography of our series revealed no definite tendency of ST-T changes, arrhythmias and other abnormalities in cases with prolapse except a few signs. When the abnormalities were present, they were not related to the severity of prolapse, but premature ventricular contractions were more frequently observed in severe cases. Atrial fibrillation was observed in higher frequency in cases with mitral regurgitation. The other abnormalities were not conclusive to verify previous studies. When compared to 19 cases with neurocirculatory asthenia comfirmed by clinical tests including angiography, the similarity of electrocardiographic abnormalities was observed in many aspects, but arrhythmias were much more common in cases with mitral valve prolapse. On the other hand, exercise test was positive more frequently in cases with neurocirculatory asthenia. No conclusion was established as to the sites of prolapse and electrocardiographic abnormalities. PMID- 3681008 TI - [Mitral valve prolapse: surgical approaches]. AB - Surgical approaches currently used for the complication of mitral valve prolapse; i.e., for mitral regurgitation (MR), are either replacement or repair of the mitral valve. Recently, the latter has proved to be superior in view of the late results, and should be recommended thereafter. Repair of the mitral valve in cases without MR has been attempted in some Repair of the mitral valve in cases without MR has been attempted in some institutions. The results had benefit to relieve the prolapse, but symptoms and signs were not always abolished completely. PMID- 3681009 TI - [Two-dimensional echocardiographic diagnosis of mitral valve prolapse]. AB - In recent years, echocardiography has become the standard method of diagnosing mitral valve prolapse. There is a few criteria of diagnosing mitral valve prolapse with two-dimensional echocardiography. In general, the definition of mitral valve prolapse with two-dimensional echocardiography is the motion of a bodily part of the anterior or posterior mitral leaflet superior to the annulus during systole. However, the patients with characteristic phonocardiographic findings of mitral valve prolapse were overlooked by the currently used criteria. I proposed, therefore, an essentially different two-dimensional echocardiographic criterion of diagnosing mitral valve prolapse. The criterion included the systolic dislocation of the anterior and posterior mitral leaflets at the coaptation zone in the parasternal long-axis view. This diagnostic criterion enabled us to obtain a systematic view of the mitral valve abnormality. Quantitation of mitral valve prolapse is necessary to evaluate the severity of the mitral regurgitation and the degree of mitral valve lesion. The grade of severity of mitral valve prolapse was assessed by measuring the distance of dislocation between the anterior and posterior leaflets at the area of coaptation. Analyzed data using this method showed that the degree and extent of mitral valve prolapse increased with age. PMID- 3681010 TI - [Two-dimensional echocardiographic criteria in diagnosing mitral valve prolapse]. AB - Diagnostic accuracy and reproducibility of the two-dimensional echocardiographic criteria for mitral valve prolapse were evaluated in 68 cases with phonocardiographic features of mitral valve prolapse. Intraobserver difference for the diagnosis of mitral valve prolapse was also evaluated by reviewing the same videotapes from these 68 cases on two different occasions (five years apart). Of 45 cases who had been interpreted as having anterior leaflet prolapse, the same interpretation was made in 37 cases (82.2%), involvement of the posterior leaflet was suggested in four cases, and prolapsing leaflets were not identified in four cases. Of 21 cases with anterior and posterior leaflets prolapse, the diagnosis agreed in only 13 cases (61.9%). The follow-up echocardiography performed in the mean period of three years revealed the reproducible findings in 19 of 20 cases. PMID- 3681011 TI - [Comments on the diagnostic criteria of mitral valve prolapse]. AB - Two-dimensional echocardiography has been the reference standard for establishing the clinical diagnosis of mitral valve prolapse. Superior systolic displacement of the mitral leaflets, however, is not necessary abnormal. Whether and at what point leaflet displacement uniquely describes a pathologic process should not be accepted without defining the pattern of normal mitral leaflet motion. One should combine informations from phonocardiograms, Doppler color flow mapping and two dimensional echocardiograms in an effort to avoid the artifice of using two dimensional echocardiography as a categoric reference standard and to establish new clinical guidline or criteria that distinguish pathologic mitral valve prolapse from normal superior systolic displacement of the mitral leaflets. Mitral valve prolapse is a dynamic disease that results in varying clinical and morphologic presentations depending upon the degree of structural abnormality. Therefore, clinical and morphologic studies are required in not only severely symptomatic patients but also perfectly asymptomatic patients. PMID- 3681012 TI - Color superposition: a new modality for contrast echocardiography. AB - To improve the estimation of endocardial borders in echocardiography, a technique has been developed to combine images from contrasted and noncontrasted echocardiograms of the same heart-phase using a color superposition mode. This method allows both experienced as well as less experienced examiners to define the endocardial borders more reproducibly and objectively. This is achieved by displaying tissue structures as gray level images while the ventricular cavity is marked selectively by the color display of the contrast material zone. Results of volume estimations of the left ventricle by different examiners using several imaging modes including color superposition display are presented. PMID- 3681013 TI - Phase mapping of radionuclide gated biventriculograms in patients with sustained ventricular tachycardia or Wolff-Parkinson-White syndrome. AB - Accuracy of Fourier phase mapping of radionuclide gated biventriculograms in detecting the origin of abnormal ventricular activation was studied during ventricular tachycardia or preexcitation. Group I included six patients suffering from clinical recurrent VT; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right ventricular pacing, and induced sustained VT Group II included seven patients with Wolff-Parkinson-White syndrome and recurrent paroxysmal tachycardia; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right atrial pacing and orthodromic reciprocating tachycardia. Each acquisition lasted 5 min, in 30 degrees-40 degrees left anterior oblique projection. In Group I, the Fourier phase mapping was consistent with QRS morphology and axis during VT (5/6), except in one patient with LV aneurysm and LBBB electrical pattern during VT. Origin of VT on phase mapping was located in the right ventricle (n = 2) or in left ventricle (n = 4), at the border of wall motion abnormalities each time they existed (5/6). In Group II, the phase advance correlated with the location of the accessory pathway determined by ECG and endocardial mapping (n = 6) and per-operative epicardial mapping (n = 1). Discrimination between anterior and posterior localisation of paraseptal pathways and location of intermittent preexcitation was not possible. We conclude that Fourier phase mapping is an accurate method for locating the origin of VT and determining its etiology. It can help locate the site of ventricular preexcitation in patients with only one accessory pathway; its accuracy in locating multiple accessory pathways remains unknown. PMID- 3681015 TI - Is natural human leukocyte interferon still needed? PMID- 3681014 TI - Viral oncolysis in the A2G mouse revisited: monoclonal antibody-mediated tumor rejection. AB - A2G mice can be immunized against the Ehrlich ascites tumor (EAT) by influenza virus oncolysis or with influenza virus oncolysates. To facilitate studies of the cellular antigens immunopotentiated by viral oncolysis, monoclonal antibodies (mAbs) against EAT cells were produced from postoncolytic EAT-immune A2G mice. Reciprocal competitive binding on EAT cells was used to classify the mAbs into epitope-related groups. One mAb, 198.9, could fully protect A2G mice against EAT cell challenge, could rescue A2G mice from an established EAT, and could mediate lysis of EAT cells in vivo. mAb 198.9 provides a new tool for studying the biochemical characteristics and immunological properties of a cellular antigen centrally involved in this model. PMID- 3681016 TI - Expression of a pseudogene for interferon-alpha L. AB - The human leukocyte interferon-alpha L (IFN-alpha L) appears to be a pseudogene because it contains a termination codon in the DNA coding for the precursor peptide (signal peptide), but the remainder of the gene codes for an interferon protein of normal length. To determine if this gene codes for an active interferon molecule, an expression plasmid was constructed for IFN-alpha L that was produced in Escherichia coli. The IFN-alpha L is active on human and bovine cells, and exhibits a trace of activity on mouse cells. PMID- 3681017 TI - Influenza virus resistance of wild mice: wild-type and mutant Mx alleles occur at comparable frequencies. AB - The laboratory-reared progeny of wild Mus musculus domesticus from several places in Europe and from California were tested for resistance to experimental infection with influenza viruses and for the ability of their explanted macrophages to synthesize Mx protein in response to type I interferon. About 75% of these mice were resistant to influenza viruses and were able to synthesize Mx protein, as expected for mice carrying the influenza virus resistance allele Mx+ in either homozygous or heterozygous form. Resistance of wild mice was inherited as a single autosomal dominant trait which cosegregated with the ability to synthesize Mx protein. About 25% of the randomly bred wild mice failed to synthesize Mx protein and died after infection with influenza virus, very much like inbred mice homozygous for the Mx- allele. We conclude that Mx+ and Mx- alleles occur at roughly equal frequencies in wild mice and that some selective advantage for heterozygous individuals exists in the wild. This finding raises new questions about the physiological role of the Mx locus. PMID- 3681018 TI - Ultrarapid freezing reveals that skeletal muscle caveolae are semipermanent structures. AB - Rat myofibers in the resting state and under imposed conditions of moderate to severe physiological, pharmacological, and mechanical stress were prepared by ultrarapid freezing and examined by freeze fracture. In rapidly frozen rat myofibers, caveolae morphology and distribution were found to be unchanged by brief or prolonged rest, brief direct electrical stimulation and concomitant contractile activity, prolonged direct electrical stimulation (to fatigue), myofiber stretch (within normal myofiber limits), or careful compressive scission. However, caveolae were greatly reduced or eliminated in number and size by severe mechanical disruption (shredding and/or tearing) of myofibers. Thus, we conclude that unlike apparently similar surface specialization in other cell types, skeletal muscle caveolae are not transient stages in a caveolae----vesicle endocytotic-exocytotic cycle, nor are they a membrane reservoir for normal stretch/contractile activity. Rather, they are (semi)permanent structures in the muscle plasma membrane with as yet undetermined function and kinetics. PMID- 3681020 TI - The submucosa of the human colon. AB - Full-thickness specimens of colon were obtained at operation or autopsy from 20 patients. The submucosa was isolated from the mucosa and muscularis externa, with confirmation by light microscopy. Submucosal specimens were then fixed and prepared for scanning and transmission electron microscopy, with preservation of their orientation. The submucosa was found to consist of a series of layers of collagen fibres, each layer 0.5-2.0 microns thick. The fibres within each layer were co-directionally orientated. The autopsy specimens were comparable in appearance with the operative ones. The mean diameter of the collagen fibrils was 69 +/- 13 nm, and the mean fibril count per unit area was 159 +/- 58/microns2. PMID- 3681019 TI - Extracellular matrix-sarcolemmal surface interconnections: a quick-freeze deep etch study. AB - Using ultrarapid freezing and deep-etch fracture techniques, the extracellular matrix in unfixed rabbit papillary muscles is seen to consist of an extensive network of collagen, microfibrils, and microthreads. The microfibril-microthread lattice appears to weave around collagen fibers connecting them to each other and to the external lamina of the sarcolemma. The external lamina appears to insert into the bilayer via trabeculae. With 10 min exposure to zero-Ca solution, the external lamina of the myocytes detaches from the membrane surface but is held from complete removal by some remaining trabecular attachments. This detachment of external lamina affords a view for the first time of the surface of the myocardial sarcolemma. Particles of varying sizes (6-13 nm) may represent the external portions of some integral proteins or protein molecules associated with the membrane surface. They can also represent attachment sites of the external lamina. The serious risks for the fibrous network structure representing an artifact caused by precipitation of matrix proteins during deep etching are discussed. PMID- 3681021 TI - Interpretation of electron micrographs of adenovirus hexon arrays using a crystallographic molecular model. AB - Two types of two-dimensional arrays of purified adenovirus type 2 hexon have been obtained and analyzed by Fourier filtration of their electron micrographs. One array contained continuously close-packed hexons, distributed on a hexagonal p3 lattice, with a unit cell dimension of 94 +/- 2 A. The other array contained close-packed hexons with a regular absence, so that rings of six hexons related by sixfold symmetry formed a p6 unit cell. The cell dimension of the hexagonal array was 153 +/- 3 A, with neighboring hexons separated by 88 +/- 2 A. Smaller p6 arrays were also formed by hexons freed from complete virions on the microscope grid by treatment with distilled water. A molecular model of hexon, known from the X-ray crystallographic structure, was used to interpret Fourier filtered images of the arrays, and to determine the relative orientations of the hexon molecules. The hexon-hexon interaction in the p3 array is that found in the virion facet, whereas that in the p6 array is a planar form of the interaction between peripentonal hexons around the vertex. PMID- 3681022 TI - Membrane changes in Chinese hamster spermatozoa during epididymal maturation. AB - Chinese hamster spermatozoa during epididymal maturation were examined by thin sectioning, freeze-fracture, and surface replica. Membrane-limited vesicles and tubules (MVTs) attach to the plasma membrane over the acrosome of the spermatozoa in the distal caput through proximal cauda epididymidis. The origin of these MVTs is likely to be spermatozoa degenerating in the epididymal lumen. The attachment of MVTs to the plasma membrane seems to be mediated by a paste-like substance covering the plasma membrane. A parallel striation pattern of intramembranous particles (IMPs) is seen in the plasma membrane of almost the entire postacrosomal region of the epididymal spermatozoa. The patterned domain begins to appear in the proximal caput epididymidis. The number and density of IMPs in the plasma membrane of the postacrosomal region increases with the development of striated pattern of IMPs in this region. In the cauda epididymidis, the redundant nuclear envelope elongates to form a shirt-like membrane covering the mitochondrial sheath. The elongated portion of the nuclear envelope is devoid of nuclear pores and has few IMPs. PMID- 3681023 TI - What do we know about the effects of trypsin inhibitors on the pancreas? PMID- 3681024 TI - Hypertriglyceridaemia and abnormalities of triglyceride catabolism persisting after pancreatitis. PMID- 3681025 TI - Complex evaluation of secretin-pancreozymin test data by multivariate statistical pattern recognition methods. AB - Complex evaluation of secretin-pancreozymin test data with multivariate statistical methods was performed in patients with pancreatic insufficiency and in controls. The centroid, the nearest neighbour methods and the linear discriminant analysis led to the correct diagnosis in 84, 77 and 92%, respectively, when the overall responses to synthetic secretin plus cholecystokinin-octapeptide were evaluated. Results of individual stimulations were less precise. The linear discriminant analysis also successfully separated the patients with mild chronic pancreatitis from the healthy subjects, and seems to provide a useful support in medical diagnosis, particularly in controversial cases. PMID- 3681026 TI - Peroxidised linoleic acid and experimental pancreatitis. AB - High concentrations of lipid peroxidation (free-radical oxidation) products have been found in bile from patients with recurrent pancreatitis, and the principal component, after hydrolysis, has been identified as an isomerised form of linoleic acid -- typical concentration 25 mmol/l, compared with 4 mmol/l in controls. Chromatographically identical products can be generated by peroxidising linoleic acid using an ultraviolet (UV) source in the presence of albumin, whereas peroxidation by lipoxidase without albumin results in a constellation of products that bear no resemblance to those in biological fluids. These facts, and the suspicion that reflux of abnormal bile may be an initiating mechanism in acute pancreatitis, led us to investigate the effects of linoleic acid peroxidation products in the rat pancreas. Two concentrations of ultraviolet peroxidised linoleic acid were used (3.6 mmol/l or 25 mmol/l, in a 2.09% solution of bile salts containing albumin 10 g/l) to simulate the human findings and, for comparison, the effects of lipoxidase-peroxidised linoleic acid, 25 mmol/l (in the 2.09% bile salt solution but without albumin), were also studied. 100 microliter of test solution was infused retrogradely into the pancreatic duct using a syringe pump. The results were assessed microscopically at 3-h intervals, and histologically at 12 h: if the animal died before the end of the experiment, the time of death was recorded. Both forms of peroxidised linoleic acid, 25 mmol/l, caused a greater degree of pancreatic injury than that produced by bile salts alone (e.g., macroscopic score at 3 h: ultraviolet, P less than 0.001; lipoxidase, P less than 0.05). Non-peroxidised linoleic acid 25 mmol/l caused less damage than ultraviolet-peroxidised linoleic acid 25 mmol/l, both macroscopically (3 h: P less than 0.01; 12 h: P less than 0.05) and on histology (P less than 0.01). Pancreatic haemorrhage was not a feature. PMID- 3681027 TI - Preserved exocrine function in patients with acute cholera and acute non-cholera diarrhoea. AB - Exocrine pancreatic function was assessed by means of the Lundh test in 14 patients with acute cholera and 18 patients with acute infectious non-cholera diarrhoea within the first 24 h of their admission. Mean tryptic activity amounted to 39.8 +/- 4.8 microEq/min/ml in the cholera group and to 64.4 +/- 11.0 microEq/min/ml in the non-cholera group. None of these patients shared a value below the lower limit of normal. In fact, the mean tryptic activity per 2 h was significantly higher than that reported previously in a control group from the Bengal area. It is therefore concluded that the exocrine pancreatic function is preserved and responds to food stimulation in various types of acute infectious diarrhoea, including cholera. These findings provide the pathophysiological background for the recent observation that oral rehydration solutions containing high-molecular-weight nutrients such as rice powder are at least as efficient or even more potent than the WHO-recommended glucose-electrolyte formula in acute diarrhoea. PMID- 3681028 TI - Inactivation of cholecystokinin octapeptide by normal and cirrhotic liver in rats. AB - In anesthetized rats, a marked decrease in CCK-OP activity and, to a far lesser extent, in the pancreatic secretory effect of CCK-33 were found after portal administration, compared to the femoral route. Changes in the biological activity of CCK-OP were further investigated after 30 min incubation with different subcellular liver fractions (1000 X g, 12,000 X g, microsomal fraction with or without NADPH). All the subcellular liver fractions caused an approximately 70% decrease in the CCK-effect, as calculated from dose-response relationships. The inactivation of CCK-OP after incubation with microsomal fractions of thioacetamide (TAA)-induced cirrhotic liver did not differ from that of control rats. The CCK-OP dose-response curves were similar in cirrhotic and control rats, but the pancreatic secretion was sustained to a greater extent and the inhibitory effect of supramaximal stimulation was delayed in cirrhotic rats. It was concluded that CCK-OP can be inactivated by liver proteins present in microsomal fractions, by a NADPH-independent mechanism. This inactivation did not diminish in liver cirrhosis. There were no changes in CCK-OP elimination in cirrhotic rats in vivo, thus pancreatic hypertrophy in experimental cirrhosis must be explained by other mechanisms. PMID- 3681029 TI - Visualization of c-Ki-ras-2 oncogene sequences in human pancreas, a chemically induced transplantable carcinoma, and carcinomas of pancreas by in situ hybridization. AB - c-Ki-ras-2 sequences were visualized in paraffin-embedded sections from normal fetal and adult human pancreases, a chemically induced transplantable human pancreas carcinoma (PT-1) and three carcinomas of pancreas by in situ hybridization technique. A biotinylated 1-kilobase-pair (kb) EcoRI fragment of pHiHi3 DNA was used as probe and the oncogene was visualized as one or two large grains of reaction products produced by streptavidin-peroxidase complex and diaminobenzidine tetrachloride in more than 9% of normal pancreas nuclei. Its amplification in the chemically induced cell line was detected as one or more large grains in 72% of the nuclei and numerous cytoplasmic grains. The detection of oncogene in normal pancreases and its amplification in PT-1 cells was validated by Southern analysis of EcoRI digests of genomic DNA extracted from normal pancreases and PT-1 cell line. The oncogene was also demonstrated to be equally amplified in two adenocarcinomas and one undifferentiated carcinoma of human pancreas by in situ hybridization. PMID- 3681030 TI - Hypersecretion of biliary fatty acids in patients with exocrine pancreatic disease. AB - The fatty acid composition of bile secreted into the duodenum in the first 10 min after an intravenous (i.v.) injection of Boots secretin (2 CHRu kg-1) has been analysed by gas liquid chromatography in 11 healthy volunteers, 8 patients without pancreatic disease, 27 patients with exocrine pancreatic disease who had not altered their diet substantially (acute pancreatitis 8; chronic pancreatitis 16; cancer 3) and 11 patients with exocrine pancreatic disease on low fat intakes (40 g/day) for at least 6 months. The mean values for total fatty acid outputs (after back transformation of the logged data) were significantly higher in each subgroup of patients with pancreatic disease on their usual diets (acute 134, chronic 189, cancer 235 mg) than in the two subgroups of controls (30 and 55 mg), due to significant increases in the outputs of every fatty acid, C16:0 through to C22:5. This finding, which was usually not apparent in patients with pancreatic disease on low-fat diets, may reflect the combined influence of dietary fat intakes and hepatic enzyme induction. Comparison of the fatty acid outputs in endoscopically collected bile and duodenal juice after separate injections of secretin three hours apart indicate that: (a) analysis of duodenal juice within 10 min of stimulation by Boots secretin provides valuable information on the composition of hepatic bile; (b) the increased phospholipid output in the untreated patients is due to hypersecretion and does not merely represent a 'washout' phenomenon. PMID- 3681031 TI - Etiology of chronic calcifying pancreatitis in Brazil: a report of 329 consecutive cases. AB - The authors observed 329 consecutive cases of chronic calcifying pancreatitis (CCP) from January 1963 to January 1986. Alcoholism was the etiological agent in 282 cases (86%). In 34 patients (10%) no cause was detectable (idiopathic). Malnutrition was responsible for 10 cases (3%) and chronic familial pancreatitis was diagnosed in 3 cases (0.9%). The mean age at the apparent onset of symptoms was 36.5 +/- 10.5 for the alcoholics, 22.6 +/- 15.4 in the idiopathic cases and 7.3 +/- 3.0 for the nutritional etiology patients. Mean age differences are statistically significant for the 3 groups. Pancreatic calcifications were found in 224 alcohol-induced cases (79%), in 32 idiopathic cases (94%), in 8 patients with malnutrition (80%) and in one patient with familial pancreatitis (33%). All cases of nutritional etiology presented severe protein-caloric deficiencies with edema, and none complained of pain, but 9 had pancreatic insufficiency. Mean daily ethanol intake for the alcohol-addicted patients was 396.6 +/- 286 g (range 80-1664 g) with the onset of alcoholism at 19.1 +/- 6.8 yr old and 20.8 +/- 8.3 (4-44) yr of alcohol indulgence. Pancreatic carcinoma developed in 7 cases. Six cases of chronic pancreatitis were seen among relatives in the group with CCP of alcoholic etiology. PMID- 3681032 TI - Endoscopic retrograde cholangio-pancreatography in pancreatitis with persistent or recurrent pain. AB - We have reviewed the endoscopic retrograde cholangiopancreatograms (ERCPs) of 115 patients already known to have pancreatitis, who were referred because of persistent or recurrent pain, in order to determine the prevalence of those lesions that have been regarded as amenable to conservative surgery. Such lesions were seen on the pancreatograms of 35 patients and on the cholangiograms of 29 patients. In all, 53 patients (46.1%) had 'treatable' lesions demonstrated at ERCP. Preoperative ERCP is helpful in demonstrating operable features in both pancreatic and biliary systems, and should be part of any prospective long-term study of pain relief in pancreatitis. PMID- 3681033 TI - The morphological changes of the pancreas in hypovolemic shock and the effect of pretreatment with steroids. AB - Previous reports from this laboratory have described the effect of hypovolemic shock of varying duration on the exocrine function of the pancreas, and the ability of steroids to reverse the inhibition of secretion observed. This report is a study of pancreatic morphology in prolonged hypovolemia, as well as the effect of steroid pretreatment on the pathology observed. Twelve mongrel dogs were divided into two groups, one with and one without steroid pretreatment. The animals were bled until at least 30-35% of their blood had been withdrawn, or until mean blood pressure (BP) dropped to around 60 mmHg. When BP dropped to 80 90% mmHg, six animals received intravenous (i.v.) prednisolone in 50 cc of 0.9% NaCl, at the rate of 10 cc/min, for a dosage of 30 mg/kg. Of the twelve dogs, six were exposed to 120 min of hypovolemia, and six to 180 min. At the end of the observed hypovolemic period, the blood withdrawn was quickly retransfused. After an hour of recovery, the animals were killed and their pancreases removed. The pancreases were weighed, fixed and examined by light microscopy. Three pancreases were obtained as control from animals not subjected to shock or steroids. The steroid-treated animals displayed an insignificant (5%) increase in pancreatic weight following prolonged hypovolemia. Untreated canine pancreases, on the other hand, showed a significant weight gain (37%, P less than 0.001) after 3 h of hypovolemia. Microscopically, the untreated group revealed marked interstitial edema, hemorrhage and inflammation, as well as focal acinar cell necrosis and fat necrosis, while in the steroid group only very mild edema and inflammatory changes were seen. This study indicates a beneficial effect of steroids on the morphological changes seen in shock-induced pancreatitis in canines and a possible use in the therapy of acute pancreatitis in man. PMID- 3681034 TI - Pancreatic morphology and function in relationship to pain in chronic pancreatitis. AB - The correlation of pancreatic pain and the degree of morphological and functional changes was prospectively investigated in 64 patients (45 males, 19 females) with chronic pancreatitis. All patients underwent clinical examination and diagnostic investigations by means of endoscopic retrograde pancreatography (ERP), computed tomography (CT) and exocrine pancreatic function test (secretin-ceruletide; SC). The individual tests were performed within 4 weeks in all patients. No significant correlation was found between the degree of pain and the severity of ERP and CT findings. Severe pain was found in 62% of patients with advanced ductal changes, and in 41% of patients with advanced parenchymal lesions. 58% of patients with severe pain had marked exocrine insufficiency. Ductal changes characterized by obstruction of the main pancreatic duct were most frequently associated with severe pain (58%). Less often, severe pain was associated with duct dilatation (34%) or with slight duct changes (26%). Among parenchymal lesions as revealed in CT, large cysts were most frequently related to severe pain (62%). A notable finding was that 89% of patients presenting with calcifications in CT still experienced pain and 39% of them had severe pain. The combined diagnostic approach is useful for the individual therapeutic management, but does not provide insight into the mechanisms of pain in chronic pancreatitis. PMID- 3681035 TI - On the pathogenesis of chronic alcoholic pancreatitis from the viewpoint of experimental results in rats. AB - To elucidate the pathogenesis of chronic alcoholic pancreatitis, light microscopic and electron microscopic observations of pancreases from Wistar strain rats given 20% ethanol ad lib, instead of water, were performed. Results were as follows: (1) In 3 (11%) rats, focal lobular unit acinar cell damage was observed under light-microscopy. In these cases, the intercalated ducts and centroacinar cells showed proliferation independently of protein plugs in ducts. (2) After ethanol intake, several degenerative changes in the acinar cells and ductular cells were observed under electron microscopy. The earliest and most consistent change was the irregular formation of microvilli and interdigitation between the parenchymal cells, accompanied by widening of the intercellular space, especially between the acinar and centroacinar cells. After three months of ethanol intake, an increase in the lysosomes and mitochondrial alteration occurred in acinar cells, and after six months of ethanol ingestion, there was tortuous ductular proliferation accompanied by the degeneration of the ductular cells. In addition to these parenchymal changes, the capillary endothelium and nervous tissue of the pancreas showed occasional degenerative changes after three to six months of ethanol intake. These results suggest that repeated degeneration and regeneration of the ductular cells results in deformation of ductular structures, with subsequent stenosis, and represents the primary event in the development of chronic alcoholic pancreatitis in rats. PMID- 3681036 TI - Pancreatic acinar cell regeneration following copper deficiency-induced pancreatic necrosis. AB - Rats maintained on a diet deficient in copper for up to 8-10 weeks exhibit marked necrosis and depletion of acinar cells in the pancreas. When these animals are subsequently fed a copper-supplemented diet, foci of hepatocyte differentiation emerge by about 12 weeks. The present study deals with pancreatic changes during copper depletion and determines the extent of regenerative capacity of the pancreas during the early phases of copper supplementation. During the period of copper depletion, the pancreas gradually decreased in size, and by eight weeks of deficiency weighed approx. 30% as much as the control pancreas. Light-microscopic examination showed focal necrosis of acinar cells at 4 weeks, loss of lobular architecture by six weeks and loss of 85-90% of acinar tissue by eight weeks. Regeneration of the pancreas was initiated by feeding copper-supplemented diet at the end of eight weeks of copper deficiency. The wet weight of the pancreas increased gradually, and by 17 days it weighed 50% more than on the first day of regeneration. Mitotic activity was observed mainly in the acinar cells, beginning at 24 h and reaching a maximum of 19 +/- 1/1000 acinar cells at 72 h, and decreasing steadily thereafter. [3H]Thymidine autoradiography showed a labeling index of 51 +/- 1.7/1000 acinar cell nuclei at 24 h, reaching a peak value of 261 +/- 5.5/1000 acinar cells at 96 h. By 17 days, pancreatic regeneration was only partially complete; however, the proliferative activity was still persistent, albeit at a slower pace. Morphometric analysis of the pancreas on the 17th day of regeneration showed that acinar tissue occupied only 37% of the volume, as compared to 84% in the normal pancreas. These studies clearly demonstrate that acinar tissue of the pancreas following copper deficiency is capable of regeneration, but that the recovery of the pancreas is only partial. Additional studies are necessary to establish the role of this early acinar cell regeneration in pancreatic hepatocyte differentiation. PMID- 3681037 TI - DC plasma emission spectroscopic analysis of pancreatic calculi. AB - Previous studies on pancreatic calculi (PC) from alcoholic pancreatitis and our recent studies on calculi from tropical pancreatitis have shown them to consist mainly of CaCO3 with minute quantities of Mg. However, no attempt was made to look for other elements in PC. This is because of the difficulty in obtaining adequate samples of PC, coupled with the technical limitations in analyzing multi elements from small samples. In this study, our aim was to analyze the major, minor and trace elements of PC from different parts of the world. DC plasma emission spectroscopy, a modern method that permits determination of multiple elements from small samples, was used in elemental analysis. We identified 17 elements in addition to calcium. Selenium was looked for but was absent. It was interesting that the elemental composition of PC in four patients from different geographical areas with divergent etiological factors remained the same. Absence of Se is of interest, as Se deficiency is associated with pancreatic fibrosis in experimental animals and it is often noted in chronic alcoholics and the malnourished. This preliminary study emphasizes the need for analysis of the elemental composition of pancreatic juice in normals and in conditions predisposing to chronic pancreatitis, to understand lithogenesis and possibly also the etiology of, at least, some types of pancreatitis. PMID- 3681038 TI - Progression in a chemically induced transplantable human pancreas carcinoma. AB - A methylnitrosourea (MNU)-induced transplantable human pancreas carcinoma was examined, at 3, 12, 18 and 36 months after its development, for growth and invasiveness in nude mice, karyotypic alteration and the evolution of marker chromosomes. Progression in tumorigenicity and invasiveness of cells were evident by a significant increase in tumor diameters produced within 8 weeks by the cells at 36 months as compared to those developed by cells from 3-month-old cell lines. Chromosome analysis at 3 months showed normal 46 XX karyotype in about 80% and minor anomalies in 20% of the cells. At 12, 18 and 36 months, all cells were hyperdiploid with 53-61 chromosomes and several abnormal marker chromosomes. Marker chromosomes showed non-reciprocal translocations, deletions, inversion and isochromosomes. The absence of chromosome 13 from the earlier stage onward may have resulted in the loss of genes which suppress tumorigenicity. The increase in homogeneously staining regions of marker chromosome 3 at later stages appears to parallel the augmentation in tumor growth and mitotic indices. PMID- 3681039 TI - The value of preoperative imaging techniques in patients with chronic pancreatic pleural effusions. AB - Four patients with chronic pancreatitis and internal pancreatic fistulae to the left pleura are presented. ERCP was done in three of the patients and demonstrated the fistulae in all. In the forth patient CT gave valuable information. In patients with suspicion of internal pancreatico-pleural fistulae we recommend preoperative ERCP for demonstration of the internal demarcations of the ductal and fistula systems and CT for delineation of the external boundaries and relationships of the pathological lesions. PMID- 3681040 TI - Microwave-induced hyperthermia and radiotherapy in human superficial tumours: clinical results with a comparative study of combined treatment versus radiotherapy alone. AB - Eighty-five evaluable superficial recurrent malignant tumours, mainly adenocarcinomas (78 per cent), in 38 patients were treated with either combined local hyperthermia (41-45 degrees C for four sessions) and low dose radiotherapy (30.0 Gy) or the same low dose radiotherapy alone. The treatment was given for two weeks. Hyperthermia was induced externally with 2450 MHz or 915 MHz microwaves. Totally 57 tumours were given combined treatment with a complete and partial response rate of 46 and 30 per cent, respectively (duration 1-38 months). In 18 patients with 2-10 superficial tumours each, 56 tumours were used in a comparative study, comparing the effect of combined hyperthermia and low dose radiotherapy versus the same low dose radiotherapy alone, the patients acting as their own controls. The total response rates were 89 and 50 per cent, respectively, in the two treatment modality groups. The difference in response rates is significant (p = 0.0039) in favour of the combined treatment, and this is also found when comparing complete remissions only (p = 0.0027). Local pain and normal tissue reactions presented problems during and after 2450 MHz microwave-induced hyperthermia treatment, performed without a coupling water bag system. Introduction of 915 MHz microwave-induced hyperthermia with a coupling deionized water bag system and refinement of microwave applicators, as well as the temperature control system considerably reduced these problems. PMID- 3681041 TI - Design of a clinical deep-body hyperthermia system based on the 'coaxial TEM' applicator. AB - The design of a clinical deep-body hyperthermia system based on the 'coaxial TEM' applicator is presented. The 'coaxial TEM' applicator produces a radiative circumferential RF field, and the adjustable aperture width of this applicator allows the optimization of field dimensions and penetration depth. A new type of open water bolus, in which the patient is almost freely floating, avoids physical stresses on the patient, provides an optimal coupling of the EM energy into the patient, and may limit aberrant heating. A convenient patient position is possible with this system and discomfort is expected to be minimal. Preliminary phantom experiments with the clinical applicator resulted in typical SAR distributions of a radiative circumferential field applicator with the central interference at maximum. PMID- 3681042 TI - A 500 KHz localized current field hyperthermia system for use with ophthalmic plaque radiotherapy. AB - Ophthalmic plaque radiotherapy has been demonstrated to be a useful alternative to enucleation in the treatment of small choroidal melanomas. The prognosis for tumours larger than 8 mm in height, however, continues to be poor. Treatment complications limit the radiation dose which may be delivered to these larger tumours. Hyperthermia has been shown to enhance the effectiveness of radiotherapy for many tumours, particularly malignant melanoma. The use of hyperthermia in conjunction with plaque radiotherapy may improve local tumour control for larger choroidal melanomas, allowing patients to maintain useful vision. We have developed an instrument which enables the combination of localized current field hyperthermia with radiotherapy using an episcleral plaque. The system is simple and inexpensive. We have measured temperature distributions in tissue-like phantoms, in excised bovine eyes, and in vivo in normal rabbits. In each of the cases studied, temperature varied by less than 1 degree C within 3 mm of, and across the concave surface of the plaque. At distances greater than 3 mm, the temperature gradient was approximately -0.3 degree C per millimetre. PMID- 3681043 TI - Thermotolerance induced by fractionated hyperthermia: dependence of the interval between fractions. AB - The induction of thermotolerance by fractionated hyperthermia was investigated in the mouse ear. Ears were heated at 43.5 degrees C by immersion in water. One to ten treatments of 20 min were followed by test treatments. Thermotolerance was assessed as the increase in the duration of the test treatment required for a thermal response in 50 per cent of the ears (NT50). A single treatment induced thermotolerance which reached a maximum at 24 h when the NT50 was increased by a factor of 2.4. The same maximum was observed after each fractionated treatment used in the present study. The time course of development, however, depended on the interval between fractions. (1) When the interval was too short to allow development of thermotolerance after a single fraction (4 h), thermotolerance was not induced during fractionated treatment but it developed during the first 24 h after treatment. (2) When the interval between fractions allowed the maximal development of thermotolerance (24 h), this maximum was maintained during fractionated treatment and persisted for 24 h after treatment. (3) When the interval allowed some decay of thermotolerance (72 or 168 h) there was a further increase to maximal thermotolerance after each fraction. The decay of thermotolerance from the maximum did not depend on the interval between fractions. These results indicate that the degree of thermotolerance may fluctuate during fractionated hyperthermia. PMID- 3681044 TI - Effects of 434 MHz microwave hyperthermia applied to the rat in the region of the cervical spinal cord. AB - Hyperthermia was applied in the region of the vertebral column between the cervical vertebrae 5 and thoracic 2, using a ring-shaped applicator operating at a microwave frequency of 434 MHz. This region was focally heated, including spinal cord, vertebrae, intervertebral discs and nerve roots. In all experiments temperature was measured at a 'reference' thermocouple probe which was placed against one of the cervical vertebrae 6, 7 or thoracic 1. Temperatures inside the vertebral canal were measured separately and proved to be below the 'reference' temperature: at 42 degrees, 43 degrees, 44 degrees and 45 degrees C (+/- 0.1 degree C) respectively the temperature in the canal was 41.2 degrees, 42.3 degrees, 42.9 degrees and 43.2 degrees C (+/- 0.4 degree C). Temperatures in tissues close to the vertebrae (e.g. within 2 mm lateral to the vertebrae, in the region of the brachial plexus) did not differ significantly from the temperature inside the canal. The temperature inside the intervertebral disc was as high as the 'reference' temperature. Temperatures measured at other sites, e.g. in the oesophagus, rectally and in the cervical muscles 5 or 10 mm lateral from the vertebral column showed that these sites were only slightly heated. The effects of hyperthermia at temperatures inside the spinal canal ranging from 41.2-43.2 degrees C for 30-120 min were investigated. One day after treatment at 41.2 degrees C for 120 min or 42.3 degrees C for 60 min neither neurological symptoms nor deaths were observed. Minor neurological symptoms were observed one day after 75 min at 42.3 degrees C. The incidence and severity of the neurological symptoms (ranging from unco-ordinated use of the forelegs to paralysis) increased with increasing temperature and duration of the hyperthermic treatment. Thermal damage even resulted in lethality: 74 per cent of the rats that died did so between 2 and 42 h after treatment. The LD50 value at 60 days at 43.2 degrees C was 30 min, at 42.9 degrees C, 41 min, and at 42.3 degrees C, 92 min. In most rats with neurological symptoms after treatment, recovery from motor dysfunctions took place within about two weeks. Even severe neurological symptoms which did not lead to lethality recovered completely. At day 60 no neurological symptoms were observed. PMID- 3681045 TI - Effect of thermochemotherapy on the development of spontaneous lung metastases. AB - Effect of local hyperthermia given alone or in combination with cyclophosphamide and/or hyperglycaemia on the development of lung metastasis was studied using a non-immunogenic mouse fibrosarcoma, FSa-II. Incidence of lung metastasis was dependent upon the tumour size, and was increased when tumour-bearing mice were restrained in animal holders which were used for heat-treatment of animal tumours. The frequency of the metastatic spread was decreased following local hyperthermia at 41.5 degrees and 45.5 degrees C when compared to that following sham treatment. This decrease was independent of the heat dose. Similar reduction in the incidence of metastasis was observed after hyperthermia given following glucose administration. The administration of cyclophosphamide effectively inhibited the development of lung metastasis. However, the magnitude of the inhibition was identical to that following hyperthermia alone. In conclusion, hyperthermia given alone, or in combination with hyperglycaemia or cyclophosphamide, inhibited the development of lung metastasis. PMID- 3681046 TI - Heat-induced nuclear protein binding and its relation to thermal cytotoxicity. AB - When nuclei were isolated from exponentially growing HeLa S3 cells immediately after a treatment with hyperthermia and/or procaine-HCl, an increase in nuclear protein binding was observed. The extent of this increase, however, did not correlate with cell survival under all conditions of the various treatments. For example, an increase up to 40 per cent in nuclear protein binding as a result of procaine treatment did not lead to a decrease of survival, while a 40 percent increase of nuclear protein binding as a result of hyperthermia corresponded with over 90 per cent cell killing. In addition the extent of heat-induced enhancement of nuclear protein content was approximately equal for thermotolerant and heated control cells, or for cells heated in the presence of procaine. The rate of decay in nuclear protein binding upon post-heat incubations at 37 degrees C of the cells, however, was enhanced in tolerant cells and retarded in cells heated in the presence of procaine as compared to heated control cells. These results show that, in spite of suggestions in other reports, neither the initial rate of enhanced protein binding nor the extent of the protein bound to the nucleus seems a reliable measure for heat toxicity. The capacity of the cell to reverse this heat-induced protein binding must be considered. PMID- 3681047 TI - Rat mammary adenocarcinoma heat-stress proteins in vivo. AB - Rat 13762NF mammary adenocarcinoma cells (clone MTC) were heated to 42 degrees C either in vivo as a subcutaneous tumour in the rat mammary fat pad or in vitro as attached cells. Labelling in vivo or in vitro detected very similar heat-stress proteins (hsp) at 160, 112, 90, 70 and 56 kDa. Syngeneic rat endothelial and macrophage cells synthesized several cellular proteins in vitro differently than did the tumour cells in vitro, but both types of normal cells were similar to tumour cells in the hsp synthesized. Although the quantitative aspects of induction and repression of hsp may depend on cell type and microenvironment, the major tumour hsp being studied for function in vitro were qualitatively similar to those produced and labelled in vivo in response to a similar heat dose. Hsp were similar in both normal cells and tumour cells from the same host. These observations support the concept that hsp function in fundamental processes in the different microenvironmental and metabolic conditions found in vivo and in vitro. In addition, these observations suggest that prediction of tumour thermal response by measuring hsp levels may be influenced by host cell components. PMID- 3681048 TI - Difficulties in using two-dimensional models for calculating the energy deposition in tissues during hyperthermia. PMID- 3681049 TI - Regional hyperthermia device evaluation. PMID- 3681051 TI - [Data-processing program for radiochromatography]. PMID- 3681050 TI - [Structures and possible functions of fish egg polysialoglycoproteins: molecular exploitation in glycoconjugate research]. PMID- 3681052 TI - [Steroid metabolism in the cellular components of the rat ovarian follicle]. AB - Steroid metabolism by different cellular components of preovulatory follicles was studied. Granulosa cells(G), theca cells (T), recombination of granulosa and theca cells (G + T), and cut follicles (F) were isolated from proestrus rats. Each component was then incubated for 3-24h with or without androstenedione (5 X 10(-7) M), 14C-androstenedione or 14C-progesterone. Steroid accumulations were measured by RIA. Metabolites of 14C-steroid were separated by TLC and radioassayed. Estradiol was accumulated in a several fold greater amount in F than in G, T or G + T. In 14C-androstenedione metabolites, testosterone was the major metabolite of G and G + T and 5 alpha-androstane-3 alpha, 17 beta-diol was the second metabolite. Androsterone was the major metabolite of T, and 17 beta-OH compounds were detected in small amounts. Androsterone and 5 alpha-androstane-3 alpha, 17 beta-diol were major metabolites of F. In 14C-progesterone metabolites, 5 alpha-pregnane-3 alpha,20 alpha-diol was the major metabolite of G and G + T after the 24h incubation. 5 alpha-pregnane-3 alpha,20 alpha-diol and 3 alpha hydroxy-5 alpha-pregnane-20-one were the major metabolites of F, and androsterone was also produced. Smaller amounts of 17 beta-OH and 20 alpha-OH compounds were produced in F than in G + T, and 5 alpha-reduced compound production was considerable. Therefore, 17 beta- and 20 alpha-hydroxysteroid dehydrogenase activity were lower in F than in G + T, and/or 5 alpha-reductase activity was higher in F than in G + T.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681053 TI - [Successful application of in vitro fertilization and embryo replacement in the treatment of infertile women with sperm immobilizing antibody]. AB - Thirteen infertile patients (18 cycles) with sperm immobilizing antibodies were subjected to in vitro fertilization and embryo replacement (IVF-ER) therapy during 12 months from January to December 1985. Four patients became pregnant, two of them delivered healthy babies at term and 2 had abortions at 5 weeks and 12 weeks of gestation, respectively. In the same duration, 24 patients (28 cycles) with tubal factor and 4 patients (5 cycles) with male factor for infertility were subjected to IVF-ER, and two patients with tubal factor became pregnant and delivered healthy babies at term. In the patients with immunological factor, fertilization and cleavage rates per mature oocyte were 85.9% (55 fertilized/64 oocytes) and 81.3% (52 cleaved/64 oocytes) respectively, while the fertilization rates in patients with tubal factor and male factor were 70.5% (62 fertilized/88 oocytes) and 50.0% (6 fertilized/12 oocytes) respectively and all fertilized eggs in these patients developed to the cleavage stage. Thus fertilization and cleavage rates for mature oocytes from the patients with the immunological factor were slightly better than those with the tubal factor and much better than those with the male factor. The antisperm antibody titers (SI50) in sera determined by the quantitative sperm immobilization test ranged from 20 to 243 units while those in follicular fluids ranged from 21 to 160 units in the patients with the immunological factor. The follicular sperm immobilizing antibodies could be detected in any patient who had the antibodies in the serum. Immunoglobulin (IgG, IgA, IgM) concentrations in follicular fluids were not significantly different from each other in the patients with immunological, tubal and male factor for infertility. PMID- 3681054 TI - [The character of human placental glucose and amino acid transport activity (using microvillous membrane vesicles)]. AB - To elucidate the character of human placental D-glucose and L-alanine transport activity, we investigated the uptake of D-glucose and L-alanine into microvillous membrane vesicles prepared from human early and term placenta using the rapid filtration technique. 1. The uptake of D-glucose into microvillous membrane vesicles did not depend on the Na+ gradient (extravesicular greater than intravesicular). The uptake of D-glucose into vesicles was three times as great as that of L-glucose. And phloretin prominently inhibited the uptake of D-glucose into vesicles. So, it was indicated that the transport mechanism of D-glucose across microvillous membrane was facilitated diffusion. 2. The uptake of L alanine into microvillous membrane vesicles depended on Na+ gradient (extravesicular greater than intravesicular), so that the transport mechanism of L-alanine across microvillous membrane was a secondary active one. The transport of L-alanine into vesicles prepared from term placenta increased prominently compared to that of early placenta. On the other hand, the transport activity of D-glucose into vesicles prepared from term placenta did not differ from that of early placenta. PMID- 3681055 TI - [Hypergonadotropic ovarian failure in three patients with pituitary hyperplasia]. AB - Three patients with ovulatory disturbances associated with increased production of gonadotropins and normal excretion of estrogen were endocrinologically examined. Patient A was 25 years old and had irregular menstruation of 13 years' duration. Patients B and C were 32 and 36 years old, the former with secondary amenorrhea of 19 years' duration and the latter with one of 2 months. Endocrinological analyses revealed a markedly increased plasma concentration of both LH (greater than 117 mIU/ml) and FSH (greater than 113 mIU/ml) in all three patients. The plasma concentration of estradiol was over 56 pg/ml in A and C before medication, and in the other patient (case B) the plasma estradiol level rose to 53 pg/ml after the administration of clomiphene. There was excessive LH and FSH response in the LH-RH stimulation test. Episodic gonadotropin secretions were observed and two weeks' administration of estrogen plasma concentrations of LH and FSH were suppressed. Computerized tomography revealed a high density area about 9-11 mm in diameter in the sella turcica of all three patients. Patient A underwent surgery via the transsphenoidal approach. Histology shows pituitary hyperplasia. After operation, the elevated LH and FSH concentration decreased to below 30 mIU/ml and the plasma concentration of estradiol and progesterone was increased to 260 pg/ml and 2 ng/ml, respectively. PMID- 3681056 TI - [Gap junction formation in the myometrial muscle cells of ovariectomized mid pregnant rats during premature labor induced by estradiol]. AB - In order to obtain a better understanding of gap junction (GJ) formation in the myometrial muscle cells of rats during the time of premature delivery, the myometrial GJs and nuclear estradiol receptor (nE2R) levels, as well as serum estradiol (E2) and progesterone (P) levels were simultaneously determined in mid pregnant ovariectomized (OVX) rats both with and without E2 administration. Artificial premature deliveries were not induced in either the rats which were OVX on day 15 of gestation with the E2 treatment, or which were OVX on day 16 with the vehicle treatment. However, there were significant decreases in serum P and significant increases in the number of myometrial GIs in these rats compared to the levels of the non-OVX pregnant rats treated with the vehicle. These results suggest that serum P withdrawal and GJ formation are not sufficient to induce premature delivery, and that other factors are involved. Artificial premature delivery was induced in the rats which were OVX on day 16 with the E2 treatment. They were given 2.5 micrograms E2 twice daily, for two days. A significant decrease in serum P, a marked increase in the number of GJ and a significant correlation between the myometrial GJs and serum E2 levels were found in both the "premature" delivery rats and the "prior to" delivery rats. A significant difference between the nE2R levels of the two groups was found, however. These profiles closely resembled those of the full-term rats during spontaneous delivery as we reported earlier. PMID- 3681057 TI - [Studies of fetal lung maturity of maternal spontaneous diabetes in the Chinese hamster]. AB - Females of Chinese hamsters with spontaneous diabetes (CHAD), which have been developed as a genetic strain of type I diabetes, were mated with males of non diabetic Chinese hamsters (CHA). According to the grade of glucose intolerance, the females of CHAD were divided into four groups, i.e. normal, chemical and diabetic group such as mild and severe group. In the diabetic groups, hyperglycemia in fetuses and in the severe group a significant high incidence of fetal abnormalities were observed. The lung phospholipids of fetuses were analyzed. No changes in phosphatidylcholine content but a decrease in the percentage of its dipalmitoyl species was observed in the fetal lungs from the diabetic groups as compared to the normal group. Phosphatidylglycerol content was also found to be decreased in the severe group by the results of thin-layer chromatography and immunological semiquantification with an AmnioStat-FLM kit. These results of lipid analysis revealed that the diabetic pregnancy in this animal model showed typical feature of delayed fetal lung maturity. Therefore, this animal model should be useful for studying the mechanism of delayed fetal lung maturity as well as the development of respiratory distress syndrome in fetuses from dams with diabetes. PMID- 3681058 TI - [Morphological and clinical studies on the chorionic vessels--a proposal of a vascular type]. AB - The subchorionic artery is usually thinner than the vein (A less than V) in term placenta. However, this may not hold true in some areas (A greater than or equal to V, A much less than V). In A greater than or equal to V areas, vasculo syncytial membrane (VSM) formation became poorer in peripheral villi, and stromal fibrosis was observed. VSM formation was also poor in the placenta with A much less than V, but stromal fibrosis was not seen. Birth weight, placental weight, urinary E3 and serum hPL levels and Apgar score became lower as the scope of distribution of A greater than or equal to V areas was increased. When subchorionic ramal arteries were markedly thinner than veins over almost all the placenta (A much less than V), birth weight and urinary E3 levels were low but placental weight, Apgar score and serum hPL levels did not decrease, and the incidence of cardiac diseases was definitely high in infants. This suggests that the observation of the placental vascular type may serve as an effective and convenient method of screening for newborn with cardiac diseases. These findings suggested that A much less than V is mainly related to the fetus, while A greater than or equal to V is mainly related to the placenta. PMID- 3681059 TI - A study of anti-progestational compound RU38486 action on the estrogen-induced enlargement of the rat pituitary gland. AB - Long term administration of estradiol to intact and ovariectomized female rats caused enlargement of the pituitary gland. This process was partially antagonized in intact animals when antiprogestational compound RU38486 was given concomitantly. In ovariectomized rats, however, this effect of RU38486 was not apparent. Since administration of the compound to ovariectomized animals did not alter estrogen-receptor translocation or estrogen induced hypervascularity in the pituitary gland, this inhibitory effect of RU38486 seems not to be exerted through estrogen-receptor binding antagonism but rather due to a progesterone receptor blockade at the hypothalamic-pituitary axis. PMID- 3681060 TI - [Evaluation of anti-Chlamydia trachomatis IgA antibody in the treatment of female genital tract chlamydial infections]. PMID- 3681061 TI - [Detection of c-myc mRNA in developing human placental villi by in situ hybridization with a biotin-labelled probe]. PMID- 3681062 TI - Identification of a human sperm antigen to sperm-immobilizing antibodies. PMID- 3681063 TI - 1-Deoxyglucose (1,5-anhydro-D-glucitol) concentration during pregnancy and puerperium. PMID- 3681064 TI - [Management of premature rupture of the membranes]. PMID- 3681065 TI - [Recent problems in the diagnosis and therapy of carcinoma of the endometrium]. PMID- 3681066 TI - [Chlamydia trachomatis cervicitis with right upper quadrant pain]. PMID- 3681067 TI - [Surgical treatment of elderly women with ovarian cancer]. PMID- 3681068 TI - [Effects of pathological synovial fluids on the metabolism of chondrocytes]. AB - The purpose of this study was to clarify the mechanism of joint destruction in rheumatoid arthritis and osteoarthritis by observing the effects of the pathological synovial fluids on proteoglycan (PG) and collagen metabolism of chondrocytes. When chondrocytes from chick embryo were cultured with pathological synovial fluids, especially RA synovial fluid, biosynthesis of both proteoglycan and collagen of chondrocytes were found to increase in proportion to the amounts of pathological synovial fluids applied to the culture medium. Chondrocytes began to synthesize PG of small molecular size, approximately 70,000 in addition to PG of normal molecular size. It is noteworthy that the PG of small molecular size shows a shortening of the glycosaminoglycan link and core protein on undersulfation. These findings indicate that pathological synovial fluids disturb the biochemical regulation of the articular cartilage matrix by altering both PG and collagen metabolisms of chondrocytes. PMID- 3681069 TI - [Anatomical observation of the bony and ligamentous structures around the wrist- comparative study of the crab-eating monkey and the human]. AB - So far as we surveyed in the literature, no articles had been published on precise studies on the bony and ligamentous structures around the wrist joint in crab-eating monkey. The authors made an observation about these particular anatomical structures by careful dissection of the 40 crab-eating monkeys, and the results were compared with those of three fresh human cadavers. The most significant differences were that the monkey had nine carpal bones (os centrale in addition), quite different configuration of the pisiform bone, no radio-scapho capitate ligament, hypoplastic or no radio-scapho-lunate ligament, and different structure of the triangular fibro-cartilage complex. We discussed these differences from the view point of functional anatomy. PMID- 3681070 TI - [The effect of physical exercise in experimental osteoporosis rats]. AB - The effect of physical exercise on the growth of bones was studied. Male rats 8 weeks old were divided into 3 groups, a sedentary group and 2 exercise groups (RUN 1, RUN 2). Rats in the exercised groups were conditioned by a treadmill running program for 8 weeks (RUN 1, 1 hr X 1/day; RUN 2, 1 hr X 2/day). Animals in the RUN 2 group showed remarkably increased cortical thickness and density by the microdensitometry method and greater dry weight. Female rats in the similar running program showed the effective change in only RUN 1 group. To evaluate the protective effect of physical exercise on the loss of bone mass in experimental osteoporosis, 6 week old rats were bilaterally ovariectomized, fed a low Ca diet and exercised on a treadmill. Ovariectomized-exercised bones were higher in cortical thickness, density, area and dry weight than the ovariectomized unexercised group. These results support the view that suitable physical exercise may be a valuable treatment for postmenopausal osteoporosis in human beings. PMID- 3681071 TI - [Experimental study on the role of the growth cartilage around the greater trochanter in the growth of the proximal femur]. AB - An experimental study was carried out to clarify the role of the growth plate around the greater trochanter in the growth of the proximal femur. Four-week-old rabbits were grouped into five. The lateral half of the trochanteric growth plate was resected in Group 1, the growth plate of the apophysis of the greater trochanter was resected in Group 2, the gluteus medius and minimus muscles were dissected from the trochanter in Group 3, the anterior half of the trochanteric growth plate was resected in Group 4, and the posterior half of the same growth plate was resected in Group 5. The length of the femur was the same in all groups, but the neck shaft angle increased in Group 1 and decreased in Group 3. The growth of the trochanter was inhibited in Group 1 and 2. The retroversion of the femoral neck was decreased in Group 3 and increased in Group 4. These results indicate that surgery to the growth cartilages around the greater trochanter influences the growth of the proximal femur, and suggest a usefulness of resection of the growth plate of the apophysis in prevention of the growth of the trochanter. PMID- 3681072 TI - [Experimental study on pedicle fat grafts after laminectomy: comparison of pedicle fat and free fat grafts]. AB - Scar formation adherent to the dura and nerve roots causes recurrent symptoms following laminectomy. Free and pedicle fat grafts have been performed in low back surgery as a preventive measure. An experimental study in rats was designed to compare pedicle fat grafts and free fat grafts after wide laminectomy, for efficacy in preventing scar formation and for effects on the spinal cord. The following results were obtained. 1) Dense scar formation over the dura and degeneration of the cord were seen at control laminectomy sites. 2) Free fat grafts, examined at 2 and 4 weeks postoperatively, showed death of portions of the graft, whereas pedicle fat grafts always demonstrated the presence of living fat. 3) At 4 months postoperatively, pedicle fat grafts were statistically superior to free fat grafts, which showed scarring over the dura and degeneration of the cord. In conclusion, pedicle fat grafts were more effective in preventing dural scar formation and protecting the cord than free fat grafts. PMID- 3681073 TI - [Catalase activity of synovial fluid leukocytes in rheumatoid arthritis]. AB - Catalase activity of rheumatoid synovial fluid measured by a gasometry was higher than that of osteoarthritic fluids, suggesting a possible origin of the catalase activity from synovial fluid leukocytes. Isoelectric focusing polyacrylamide gel electrophoresis of the extract from polymorphonuclear leukocytes (PMN) of rheumatoid synovial fluid exhibited two to four achromatic bands and one dark band of catalase activity. Catalase staining of synovial fluid cells with diaminobenzidine revealed a marked activity in PMN, no or weak activity in monocytes and negative activity in lymphocytes. Catalase scores of the PMN in rheumatoid synovial fluid were lower than those of osteoarthritic fluid and of normal peripheral blood PMN. Ultrastructural localization of catalase activity in leukocytes of rheumatoid synovial fluid was examined by diaminobenzidine staining. Electron dense deposits were observed in granules, probably peroxisomes and in cytoplasm of the PMN and also in microperoxisomes of the monocyte. PMID- 3681074 TI - [Fluorescence microscopic study of capillary density in the rat skeletal muscle during and after contraction]. AB - Fluorescein isothiocyanate-albumin conjugate was intravenously injected into the rat. The biceps femoris muscles were fixed by snap freezing with isopentane cooled to -150 degrees C. In histological sections infused capillaries were visualized under fluorescence microscopy. Perfused capillary density and number of capillaries per muscle fiber were determined at rest, during and after contraction of the muscle. Capillaries per muscle fiber ratios were 0.73 +/- 0.03 (mean +/- SE) at rest, 0.84 +/- 0.03 during weak contraction, 0.85 +/- 0.02 during strong contraction, and 0.85 +/- 0.02 in postcontraction hyperemia. During strong contraction, muscle blood flow measured by heated thermocouple technique showed a decrease and was not proportional to the increased capillary density. From these results it was assumed that additional factors such as increased velocity of the flow might play an important part in the increase in muscle blood flow during and after contraction. PMID- 3681075 TI - [Effect of pregnancy and delivery in HBe antigen positive carrier]. PMID- 3681076 TI - [Clinical aspects of autoimmune neutropenia: relation to chronic idiopathic neutropenia]. PMID- 3681077 TI - [Significance of anomalous muscular band in human right atrium on supraventricular arrhythmias]. PMID- 3681078 TI - [Prognosis of medically treated coronary artery disease]. PMID- 3681079 TI - [A case of exophthalmos, pretibial myxedema and hypertrophic osteoarthropathy (EMO) syndrome associated with hyperthyroidism--successful treatment with local injection of triamcinolone acetonide in pretibial myxedema]. PMID- 3681081 TI - [A case of basic calcium phosphate crystal deposition disease with Monckeberg's arteriosclerosis]. PMID- 3681080 TI - [Distal renal tubular acidosis of voltage dependent type following renal infarction in a patient with unilateral hydronephrosis]. PMID- 3681082 TI - [Hemichorea-hemiballism caused by lacunar infarction in the caudate nucleus]. PMID- 3681083 TI - [A case of primary biliary cirrhosis with seroimmunological abnormalities]. PMID- 3681084 TI - [A case of necrotizing lymphadenitis associated with aseptic meningitis]. PMID- 3681085 TI - [A case of pituitary dwarfism with hyperlipemia, factor XII and XI deficiency, and low level of NK activity]. PMID- 3681086 TI - [IgG (kappa) benign monoclonal gammopathy, IgG (kappa) multiple myeloma and Bence Jones (lambda) multiple myeloma in 3 brothers]. PMID- 3681087 TI - [Diagnosis of old anterior myocardial infarction and evaluation of left ventricular function by QRST isointegral map]. PMID- 3681088 TI - [An autopsy case of congenital hepatic fibrosis and medullary sponge kidney with secondary gout]. PMID- 3681089 TI - [Vasculo-Behcet disease complicated with pulseless features in the upper extremities and panperitonitis; an autopsy case report]. PMID- 3681090 TI - [Amyotrophic lateral sclerosis]. PMID- 3681091 TI - [Clinical studies of hepatic coma]. PMID- 3681092 TI - [Diffuse neuroendocrine system]. PMID- 3681093 TI - [Plasma cell kinetics in monoclonal gammopathy with special reference to its clinical significance]. PMID- 3681094 TI - [Relation between the complement sensitive red cells and the frequency of exacerbation of hemoglobinuria in paroxysmal nocturnal hemoglobinuria]. PMID- 3681095 TI - [Noninvasive detection and prognosis of coronary artery disease in elderly patients; usefulness of dipyridamole-loading myocardial scintigraphy]. PMID- 3681096 TI - [A case of IgD multiple myeloma associated with abnormal plasma cells and paraprotein in the pleural fluid]. PMID- 3681097 TI - [A case of intestinal pseudo-obstruction complicating systemic amyloidosis with multiple myeloma]. PMID- 3681098 TI - [An autopsy case of renal adenocarcinoma associated with systemic amyloidosis]. PMID- 3681099 TI - [A case of relapsing polychondritis with Schonlein-Henoch purpura]. PMID- 3681100 TI - [A case of autoerythrocyte sensitization syndrome]. PMID- 3681101 TI - [A case of Cushing's syndrome associated with severe exophthalmos]. PMID- 3681103 TI - Hospital information systems: past, present, future. PMID- 3681102 TI - [A case of truncal ataxia due to vitamin E deficiency by malabsorption syndrome]. PMID- 3681104 TI - An introduction to programming in BBC BASIC. AB - The rudiments of programming in BASIC for the BBC microcomputer are outlined. The topics covered are input to and output from the computer, variable names, loops, arithmetic operations, data statements, arrays, branching, string variables and an introduction to structured programming. The topics are illustrated by simple programming exercises based on the calculation of stroke volume indices. In conclusion a brief review is given of some of the additional facilities which are available on the computer together with references for further reading. PMID- 3681105 TI - Carola, a computer system for automatic documentation in anesthesia. AB - A computer system has been designed for documentation and data acquisition during open heart surgery. This computer system (called 'Carola') processes all patient data during cardiac surgery. More than 50 analogue or digital signals are scanned. These are derived from a monitoring rack, a Siemens Servo 900B ventilator with its accessory devices and a heart lung machine. All these values are plotted as well as offline data, such as medications, fluids, laboratory results and user comments, on an A3 format anesthetic record using an eight pen flat bed plotter. Simultaneously all data is written onto a cassette tape. These tapes are then transferred to a database for storage and statistical processing. The sampling frequency is every 10 seconds, averages being calculated over one minute periods. The chart is updated once a minute normally or every 15 minutes for slowly changing signals e.g. temperatures. Hardware and software of the computer have modular design. The hardware consists of two Motorola 6809 based microprocessor systems. The software is entirely written in Pascal. The user interface is implemented on a menu driven basis. A terminal with a keyboard is used for the communication with the users, namely anesthetic nurses and anesthesiologists. The system was readily accepted by the users. The menu structure proved to be easy to learn and allowed fast entries, even when the users were not previously accustomed to the use of a keyboard. The clear and detailed presentation of the data on the plotted chart helped to detect trends early and facilitated therapeutic decisions. From december 1983 the first prototype was used on a routine basis, followed by a second unit in June 1984 and a third in December 1985. Up to now more than 12.500 anesthetic hours have been recorded. Since then almost 100% of all anesthetics performed in our cardiothoracic unit have been documented by the computers, including all short procedures without invasive monitoring and all emergencies. PMID- 3681106 TI - NAPROS: a semiautomatic user-friendly anaesthetic record system. AB - NAPROS is a semiautomatic, inexpensive, and easy-to-use anaesthetic record system. It is based on an ACORN (BBC-Model B) microcomputer that is linked to a non-invasive arterial pressure monitor (DIN-AMAP 845a) and an inhalation anaesthetic monitor (Engstroem EMMA) for automatic collection of measured data. The following functions have been implemented: Automatic registration of cardiovascular data and concentration of anaesthetic inhalation agents. Graphical or numerical representation of fluid-balances. Possibility to recall dosage information for drugs and drops. Printing of a final anaesthetic report at the end of anaesthesia. Definite advantages of NAPROS are: The number of hours saved by the computer record over manual data entry is 8 hours. - Better acceptance by users. PMID- 3681107 TI - Data collection and analysis from a respiratory inductance plethysmograph. AB - A respiratory inductance plethysmograph, Respitrace, was used to assess the respiratory effects of narcotic analgesia for the first 24 hours after surgery. Data were collected on-line from the plethysmograph with an Apple][+ microcomputer and stored on disc for later analysis of respiratory rates and tidal volumes, and also periods of central or obstructive apnoea using the difference in phase angle between the abdominal and respiratory components. This involved the measurement of, on average, more than 20,000 breaths per patient and techniques of data compression were required to store this amount of information on a single floppy disc. Frequent nursing interventions reduced the accuracy of tidal volume and phase angle measurements, but respiratory rates were obtained accurately breath by breath. PMID- 3681108 TI - Ca2+, vitamin D, parathyroid hormone, and blood pressure: why should it matter? PMID- 3681109 TI - For want of a protein. PMID- 3681110 TI - Blood-material interactions: the necessity of a multidisciplinary approach. PMID- 3681111 TI - Calcemic response to parathyroid hormone in spontaneously hypertensive rats: role of calcitriol. AB - Spontaneously hypertensive rats (SHR) display lower ionized calcium (Pca++) concentrations when compared with normotensive Wistar Kyoto rats (WKY). This could be attributable to renal wasting of calcium, decreased intestinal calcium absorption, or decreased bone resorption, processes that are integrated by the parathyroid hormone (PTH) and vitamin D systems. We have studied the calcemic response to PTH infusion (3 U/hr/100 gm) for 5 hours in 13-week-old SHR and WKY. Pre-PTH Pca++ concentration of nonfasted SHR (4.68 +/- 0.06 mg/dl, N = 8) was significantly lower than that of WKY (4.84 +/- 0.03, N = 8, P less than 0.05). Pca++ concentration rose in both nonfasted WKY and SHR at the end of PTH infusion, but the increment of Pca++ in SHR (0.29 +/- 0.05 mg/dl, N = 8) was lower than that in WKY (Pca++, 0.60 +/- 0.07 mg/dl, N = 8, P less than 0.01). Urinary calcium excretion (UcaV) and creatinine clearances (Ccr) before and after PTH infusion were not different between WKY and SHR. Despite an increased filtered load of calcium, UcaV was not greater in either WKY or SHR during the PTH infusion. Pretreatment of SHR with calcitriol 50 ng intravenous bolus injection, which had no effect on Pca++ concentration (0.02 +/- 0.03 mg/dl, N = 7), corrected the lower calcemic response to PTH in SHR, and the Pca++ increment was no longer different between WKY (0.57 +/- 0.07 mg/dl, N = 7) and SHR (0.62 +/ 0.09, N = 7).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681112 TI - Hereditary hypotransferrinemia with hemosiderosis, a murine disorder resembling human atransferrinemia. AB - A newly reported spontaneous mutation in mice resembles human atransferrinemia. Both the human and murine forms have a Mendelian recessive mode of inheritance, and both are early onset lethal diseases in which homozygotes have refractory iron-deficient hypochromic anemia. Their plasma transferrin levels are less than 4 mg/dl, and extensive deposits of iron are found in the livers and other organs of afflicted individuals. Although heterozygotes are not anemic, they have half normal levels of circulating transferrin, and they become siderotic late in life. In the mouse, weekly injections of mouse or human serum, or of highly purified transferrin, permit survival and alleviate the anemia. The pattern of inheritance, clinical features, time course and distribution of parenchymal iron, and nature and stability of the endogenous transferrin are presented. The data indicate that the gene hpx produces wholly normal strain-specific transferrin but in small amounts. The hpx gene is closely linked with the transferrin locus, Trf, on chromosome 9. PMID- 3681114 TI - Removal of transferrin from fetal bovine serum. AB - An antiserum against purified fetal bovine serum (FBS) transferrin was produced in rabbits. The isolation of anti-bovine transferrin IgG fraction was achieved by ammonium sulfate precipitation of rabbit hyperimmune plasma followed by ion exchange chromatography on diethylaminoethanol (DEAE) cellulose, at both an acidic and basic pH. The various antibody fractions were analyzed by fast protein liquid chromatography (FPLC) on a high-resolution mono-Q column. The specificity and efficiency of the antibody fractions obtained were tested by titration of a constant amount of fetal bovine serum with increasing amounts of antibody. The completeness of removal of the fetal bovine serum transferrin resulting from the formation of the highly stable antibody antigen complex was monitored by immunologic and radioisotope methods. The removal of FBS transferrin by this antibody precipitation technique did not interfere with the ability of added iron 59-tagged human transferrin to deliver iron to rat reticulocytes, as shown in an in vivo incubation model. The method proved to be effective for the fast and complete removal of bovine transferrin from fetal bovine serum in vitro and will be a prerequisite for more detailed studies of the interaction of transferrin of different species with tissue receptors on cell lines in culture without resorting to completely defined culture media. PMID- 3681113 TI - Characterization of a tubular flow chamber for studying platelet interaction with biologic and prosthetic materials: deposition of indium 111-labeled platelets on collagen, subendothelium, and expanded polytetrafluoroethylene. AB - A plastic (Plexiglas) chamber for evaluating platelet deposition under controlled hemodynamic conditions has been developed. The perfusion chamber has been designed to retain the cylindrical shape typical of the vasculature, to be flexible enough to accept a variety of biologic and prosthetic materials, and to simulate a broad range of physiologic flow conditions in either an ex vivo or in vitro perfusion system. Three type of surfaces were exposed to blood flowing directly from the carotid artery of a heparinized pig through the perfusion chamber: de-endothelialized pig aorta, collagen strips from rabbit Achilles tendon, and an expanded polytetrafluoroethylene material (Gore-Tex). Platelets, previously radiolabeled with indium 111 and injected into the animal, were quantified on the material surface, and the total number of deposited platelets determined for a range of blood flow rates (5 to 40 ml/min) and exposure times (0.5 to 20 minutes). The deposition rates were correlated with theory for describing the mass transport of platelets to the test surface. At the wall shear rates investigated (105 to 850 sec-1), the deposition of platelets on subendothelium was strongly dependent on the local flow conditions. Values of deposition on Gore-Tex obtained at similar flow conditions (105 to 425 sec-1) were reduced compared with that observed on subendothelium and showed a markedly weaker dependence on the shear rate. In contrast, deposition of platelets on collagen was more than an order of magnitude greater than on subendothelium and showed a dependence on flow only at the lowest flow rate studied (10 ml/min). The results indicate that collagen is much more reactive than subendothelium and Gore Tex with respect to the growth and stability of platelet aggregates and moreover suggest that flow mechanisms for depositing platelets on various surface may be substantially different. PMID- 3681115 TI - Adequacy of iron supply for erythropoiesis: in vivo observations in humans. AB - The adequacy of tissue iron supply was examined with ferrokinetic techniques in subjects with decreased plasma iron concentration and in subjects with a normal plasma iron concentration but with increased tissue iron requirements. The competition by transferrin receptors for diferric vs monoferric transferrin was measured in eight normal persons and eight with iron deficiency. There was a highly significant (P less than 0.001) decrease in receptor preference for diferric transferrin in subjects with iron deficiency, indicating an insufficient amount of iron-bearing transferrin to saturate tissue receptors. The adequacy of the plasma iron supply was also examined by determining the number of iron bearing transferrin molecules with receptors at normal and elevated plasma iron concentrations. Significant increases were found at the higher plasma iron concentration, not only in patients with iron deficiency, but also in patients with sickle cell anemia and thalassemia. Furthermore, the increase in the latter two groups was shown to be proportional to the degree of erythroid hyperplasia. These data indicate that tissue iron supply must be evaluated in terms of both plasma iron supply and erythropoietic requirements and that a relative iron deficiency is frequent in patients with erythroid hyperplasia. PMID- 3681116 TI - Detection of Krabbe disease using tritiated galactosylceramides with medium-chain fatty acids. AB - Galactocerebrosidase (galactosylceramidase) assays using tritiated galactosylceramides with saturated, medium-chain fatty acids (C6-C11) were found to be more sensitive and more reliable than the commonly used assays with long chain and very long-chain substrates (C16-C26). Galactosylsphingosine (psychosine) was tritiated by a modification of the galactose oxidase-sodium borohydride method, and 19 galactosylceramides were synthesized by the direct coupling of galactosylsphingosine with fatty acids of varying lengths (C6 to C24). The highest specific activities of normal prenatal and postnatal enzyme preparations were obtained with the C6 and C8 derivatives, which were six and five times more sensitive, respectively, than the C16 substrate. The residual activities in enzyme preparations from fetuses and children with Krabbe disease were proportionally increased. Our experience indicates that these substrates can provide a sensitive and reliable means for the prenatal and postnatal detection of Krabbe disease. PMID- 3681117 TI - Extracellular killing of inhaled pneumococci in rats. AB - Early clearance of inhaled Staphylococcus aureus is believed to be caused by phagocytosis by alveolar macrophages. In murine models inhaled pneumococci are cleared even more rapidly than S. aureus. Conventional opsonins appear to play no role in this clearance, and recently it has been shown that murine alveolar lining material contains free fatty acids and other soluble factors that are directly bactericidal for pneumococci. To determine whether non-phagocytic factors are involved in pneumococcal clearance, we compared the site of killing of inhaled pneumococci and S. aureus in rats using histologic methods and bronchoalveolar lavage. Spontaneous lysis of pneumococci was prevented by use of autolysin-defective pneumococci or by substitution of ethanolamine for choline in the cell wall. Histologic studies showed that the percent of inhaled staphylococci associated with alveolar macrophages always exceeded the percent of staphylococci cleared, whereas there was little association of pneumococci with macrophages during clearance. Analysis of the intracellular or extracellular location of iron 59 in bronchoalveolar lavage fluid of rats that had inhaled aerosols of 59Fe-labeled bacteria suggested that staphylococci were killed predominantly in macrophages and pneumococci in the extracellular space. When 59Fe-labeled pneumococci or staphylococci were ingested and killed by macrophages in vitro, the 59Fe remained with the macrophages, suggesting that the extracellular location of 59Fe during pneumococcal killing in vivo was not caused by rapid turnover of 59Fe in macrophages. Studies of the site of killing of inhaled type 25 pneumococci labeled exclusively in the cell wall with carbon 14 ethanolamine confirmed the results obtained with 59Fe-labeled pneumococci. Thus, early killing of inhaled pneumococci, unlike staphylococci, appears to take place outside of macrophages. PMID- 3681118 TI - Megakaryocytopoiesis and granulopoiesis in W/Wv mice: comparisons between bone marrow and spleen. AB - To determine how megakaryocyte progenitor cells (CFU-M) of W/Wv mice are affected by the hematopoietic stem cell abnormality, megakaryocytopoiesis was studied in the spleen and marrow of these genetically anemic W/Wv mice. CFU-M were assayed in the soft gel colony-forming system. Megakaryocyte colony size was determined by counting the number of megakaryocytes per colony, and megakaryocyte diameter was determined on acetylcholinesterase-stained cytocentrifuged cell preparations with use of an eyepiece micrometer. In spite of normal blood platelet levels, megakaryocyte level was reduced in the spleen and humerus to about 60% that of +/+ littermates. Megakaryocyte diameters were increased in W/Wv mice. CFU-M in W/Wv mice were reduced to 40% the number seen in the spleen of +/+ mice and to 62% in the humerus. In cell cycle studies, significantly fewer marrow CFU-M were in DNA synthesis in W/Wv mice compared with +/+ animals, but similar numbers of cells were in cycle in the spleen for both genotypes. No difference was observed between W/Wv and +/+ CFU-M in their requirement for exogenous colony-stimulating activity or in the distribution of colony sizes. However, CFU-M-derived colonies cloned from adherent cell-depleted marrow cells were significantly smaller compared with those cultured from unfractionated marrow cells. Results for granulocytes and granulocyte-macrophage progenitor cells (CFU-GM) were similar to those obtained for the megakaryocyte series, indicating that the abnormalities are present in different cell lineages. These results suggest that the macromegakaryocytosis of W/Wv mice appears to be a compensation for the megakaryocytopenia. Cells in the progenitor cell compartment appeared not to be involved in this compensation. Furthermore, adherent cells appear to elaborate a factor regulating megakaryocyte development. These findings are compatible with two-level regulation of megakaryocyte formation and a complex mechanism of blood platelet level regulation. PMID- 3681120 TI - Conservative surgery and irradiation in the management of early breast cancer. PMID- 3681119 TI - Conversion of MM creatine kinase isoforms in human plasma by carboxypeptidase N. AB - This study was undertaken to identify the carboxypeptidase(s) (CPase) in plasma mediating sequential conversion of the tissue isoform of the MM isoenzyme of creatine kinase (MM3 CK) to MM2 and MM1 isoforms and to elucidate relationships between CPase activity measured in plasma and observed rates of isoform conversion in vitro. Purified MM3 was incubated at 37 degrees C in plasma from normal subjects and patients with acute myocardial infarction. Isoforms were quantified by chromatofocusing. Preincubation with antiserum to CPase N prevented conversion of added MM3 to MM2 and MM1. Isoform conversion rates in the absence of antibody were proportional to plasma CPase N activity assayed spectrophotometrically by hydrolysis of furylacryloyl-L-alanyl-L-lysine substrate (r = 0.89, n = 8). Plasma CPase N activity varied by nearly 300% among individuals, but average activity was similar in samples from normal subjects (267 +/- 45 [SD] U/L, n = 18), those from outpatients with angina (289 +/- 43 U/L, n = 9), and those obtained at hospital admission from patients with acute infarction (Q wave: 279 +/- 70 U/L, n = 16; non-Q wave: 272 +/- 61 U/L, n = 14) or unstable angina (280 +/- 71 U/L, n = 11). In patients with Q wave infarction, CPase N activity increased by 43% +/- 25% between 48 hours and 72 hours (P less than 0.005 compared with admission) with a concomitant change in the rate of conversion of isoforms. Thus, the rate of conversion of isoforms in individual subjects can be estimated by assay of CPase N activity in plasma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681121 TI - Diffuse hemorrhage of the breast caused by underlying carcinoma of the breast: a case report. PMID- 3681122 TI - Compartment syndromes and the use of fasciotomy. PMID- 3681123 TI - Intratympanic ototoxicity: influence of post-injection survival period. AB - Many studies have been reported on the intratympanic ototoxicity of different drugs in animal models. The recovery periods of the animals following intratympanic drug applications varied among these studies. The present study compares the cochlear damage caused by intratympanic kanamycin following short (4 days) and long (30 days) post-injection survival periods, using the guinea pig as the animal model. The degree of cochlear damage 4 days after kanamycin injection was consistent among the tested animals. The degeneration was mainly confined to the outer hair cells and almost all inner hair were spared. The change 30 days after kanamycin injection was more variable among the animals and both inner and outer hair cells were damaged. This shows that, although the damage to the cochlea after intratympanic aminoglycoside injection is progressive, a short post injection recovery period is suitable for comparative intratympanic ototoxicity studies. PMID- 3681124 TI - Haemostatic disorders in habitual nose-bleeders. AB - Ninety-one habitual nose-bleeders were screened for haemostatic disorders. 46 screening results in 38 nose-bleeders were outside the normal range. After extended investigation, it was found that 25 (27 per cent) habitual nose-bleeders had haemostatic disorders, all except one in the primary haemostasis. The disorders found could be classified as mild bleeding disorders (MBD) and compared to the estimated frequency of MBD in the population there was an increased incidence of haemostatic disorders in the habitual nose-bleeders. Abnormal vessels in the nasal mucosa were present in 85 per cent of the investigated nose bleeders, equally distributed between nose-bleeders with and without haemostatic disorders. This indicates that abnormal vessels and haemostatic disorders in habitual nose-bleeders, it is possible to detect previously unknown but clinically important disorders. PMID- 3681125 TI - How acceptable is outpatient proof puncture of the maxillary sinuses? (The patient's viewpoint). PMID- 3681126 TI - Antroscopy via the inferior meatal route under local anaesthetic: a practical guide to technique. AB - Antroscopy has been shown to have a significant role to play in the management of chronic sinus disease. A technique, performed via the inferior meatus, is described which has been used successfully in 103 patients under local anaesthetic. Particular attention has been paid to the practical problems and pitfalls which may be encountered and how they may be overcome. Vasovagal symptoms were the commonest adverse effect, occurring in 15 patients; otherwise the associated morbidity was encouragingly low. It is concluded that antroscopy performed with a good technique can be a rewarding procedure suitable for use in the outpatient department. PMID- 3681127 TI - The sympathetic innervation of the vocal cord. An experimental study in the guinea pig. AB - Formaldehyde-induced fluorescence and electron microscopy have been used to show the sympathetic innervation of the vocal cord in the guinea pig. The topographical distribution and morphology of the sympathetic fibres and endings are commented upon. PMID- 3681128 TI - Advanced laryngeal cancer: a management perspective. AB - A retrospective study of 197 T3 and T4 squamous cell carcinomas of the larynx presenting between 1969 and 1978 has been undertaken. These patients have in the main been treated by primary radiotherapy with back-up salvage surgery. The aim of the study was to examine survival, and to try to identify reasons for failure of control. Various prognostic factors have been analysed and are discussed. Overall 5-year survival was 53 per cent but patients with nodal disease responded poorly. Subglottic tumours have a better survival than usually reported. Failure to pick up recurrence was the main problem, and in particular a persistently fixed cord carried a very poor prognosis if laryngectomy was delayed. PMID- 3681129 TI - An endoscopic silastic keel for anterior glottic webs. AB - The use of a specially designed silastic keel endoscopically inserted into the larynx to prevent restenosis after division of anterior commisure webs of the larynx is described. The treatment of such webs is discussed. PMID- 3681130 TI - Serum enzymes in head and neck cancer III. AB - Serum adenosine deaminase (ADA) levels were estimated in a group of 40 patients with head and neck cancer. The mean value was significantly higher in patients compared to controls. The increase was higher in cases of ulcerative growths than of proliferative growths, and activity was increased with advancement in the stage of the cancer. After radiotherapy, a gradual and significant decrease in serum ADA activity was observed. PMID- 3681131 TI - Late presentation of bilateral congenital cholesteatomas of the middle ear. PMID- 3681132 TI - Monostotic fibrous dysplasia of the temporal bone. AB - Fibrous dysplasia is a rare but interesting benign condition of the bones which affects either a single bone or multiple bones, with or without endocrine abnormalities. Only 75 cases affecting the temporal bone have been reported in the world literature, and to these we add another case. Although systemic involvement in the form of endocrine abnormalities and skin pigmentation has been reported in the past, no case has yet been reported with a congenitally absent kidney in the monostotic form of the disease. PMID- 3681133 TI - Downbeat nystagmus during eye closure. AB - Two patients with dizzy spells demonstrated downbeat nystagmus during eye closure. The eye movements were examined by simultaneous horizontal and vertical electro-oculography. As the eyeballs were depressed to the midline position during eye closure, downbeat nystagmus appeared. There were no remarkable neurological findings in either patient. The pathophysiology of this nystagmus remains to be defined. PMID- 3681134 TI - Autosomal dominant osteopetrosis (a family study). AB - Osteopetrosis is a rare metabolic disorder, characterized by an abnormal accumulation of bone mass probably caused by diminished bone resorption. Symptoms are directly and indirectly derived from the increased amount of bone. A family study was made, starting with a proband presenting with symptoms of trigeminal neuralgia. The pedigree indicated an autosomal dominant inheritance through three generations, comprising four affected subjects, of whom two were free of symptoms. PMID- 3681135 TI - The successful closure of a colono-cutaneous fistula in the neck. AB - A case is presented of the successful closure of a colono-cutaneous fistula in the neck, which developed twenty-one years after pharyngo-laryngectomy. A pectoralis major muscle flap and a delto-pectoral skin flap were used. PMID- 3681136 TI - Pathology as it relates to ear surgery. VII. Tympanoplasty. AB - The surgical anatomy and pathology of the middle ear have been reviewed in relation to tympanoplasty. The results of tympanoplasty in providing a disease free and functional middle ear varies widely with the pathology involving the eardrum, ossicles, mucoperiosteum, mastoid air cells and eustachian tube. Post tympanoplasty changes in the eardrum graft, ossicular grafts, and middle ear have been described in six cases which underwent surgery one to eleven years before death. Proper understanding of the pathophysiology of the different diseases of the middle ear is mandatory in planning tympanoplastic procedures. The causes of graft failure and of post-operative conductive hearing loss are discussed and the ways to avoid technical complications are emphasized. PMID- 3681137 TI - Intestinal cholesterol absorption in the chyluria model. AB - Isotopic methods for the measurement of dietary cholesterol absorption were compared with the lymph cholesterol balance procedure in filarial chyluria patients. After a single intravenous injection of radioactive cholesterol, absorption was found to be 746 +/- 136 mg/day by method I, which is based upon the fecal endogenous neutral steroid mass measurement, and 471 +/- 135 mg/day by the simultaneously measured lymph/plasma ratio of cholesterol specific activity (dpm/mg). The corresponding value, determined as the difference between lymph cholesterol transport on a cholesterol-containing diet (1500 mg) and on a cholesterol-free diet, was 622 mg/day. When radioactive cholesterol (1487 mg/day) was fed daily to a second patient, absorption determined by isotopic fecal recovery (353 mg/day) matched that obtained by the lymph balance procedure (326 mg/day). Transudation of plasma cholesterol into the intestinal lymph, estimated by the single intravenous injection of radioactive beta-sitosterol, was independent of both the luminal content of plant sterols and the absorption of dietary cholesterol. The absorption of endogenous cholesterol was calculated by: 1) subtracting the cholesterol originating from plasma (transudation) together with the absorbed dietary cholesterol found in lymph from the total mass of cholesterol transported in lymph, and 2) the lymph balance method, i.e., after interrupting the endogenous cholesterol mucosal uptake by beta-sitosterol feeding (9 g/day) while on a cholesterol-free diet. Endogenous cholesterol was preferentially absorbed compared to dietary cholesterol, but there was no competition for absorption. The major portion of dietary cholesterol found in lymph was esterified, but esterification was not a prerequisite for absorption. PMID- 3681138 TI - Correlation between serum levels of some cholesterol precursors and activity of HMG-CoA reductase in human liver. AB - The possibility that the serum concentrations of various cholesterol precursors may reflect the activity of the hepatic HMG-CoA reductase was investigated in humans under different conditions. The serum levels of squalene, free and esterified lanosterol, (4 alpha, 4 beta, 14 alpha-trimethyl-5 alpha-cholest-8, 24 dien-3 beta-ol), two dimethylsterols (4 alpha, 4 beta-dimethyl-5 beta-cholest-8 en-3 beta-ol and 4 alpha, 4 beta-dimethyl-5 alpha-cholest-8, 24-dien-3 beta-ol), two methostenols (4 alpha-methyl-5 alpha-cholest-7-en-3 beta-ol and 4 alpha methyl-5 alpha-cholest-8-en-3 beta-ol), two lathosterols (5 alpha-cholest-7-en-3 beta-ol and 5 alpha-cholest-8-en-3 beta-ol) and desmosterol (cholest-5, 24-dien-3 beta-ol) were measured in untreated patients (n = 7) and patients treated with cholestyramine (QuestranR, 8 g twice daily for 2-3 weeks, n = 5) or chenodeoxycholic acid (15 mg/kg body weight daily for 3-4 weeks, n = 8) prior to elective cholecystectomy. The activity of the hepatic microsomal HMG-CoA reductase was measured in liver biopsies taken in connection with the operation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681139 TI - Thermodynamic and molecular determinants of sterol solubilities in bile salt micelles. AB - We examined, by reverse-phase high performance liquid chromatography (HPLC), the hydrophilic-hydrophobic balance of cholesterol and 12 non-cholesterol sterols and related this property to their equilibrium micellar solubilities in sodium taurocholate and sodium glycodeoxycholate solutions. Sterols investigated exhibited structural variations in the polar function (3 alpha-OH, 3 beta-OH, 3 beta-SH), nuclear double bonds (none, delta 5, or delta 7), side chain length (C27, C28, C29) and side chain double bonds (none, delta 22, or delta 24). In general, a sterol's hydrophilic-hydrophobic balance became progressively more hydrophobic (as exemplified by increasing HPLC retention values, k') with additions of side chain methyl (C28) and ethyl (C29) groups and with 3 beta-SH substitution of the 3-OH polar function. Side chain delta 22 and especially delta 24 double bonds rendered the sterols appreciably more hydrophilic, whereas a single nuclear double bond had little influence. Sterol solubilities (24 degrees C, 0.15 M Na+) were uniformly greater in 50 mM solutions of sodium glycodeoxycholate (range 0.15 to 2.5 mM) than in equimolar solutions of the more hydrophilic bile salt, sodium taurocholate (range 0.07 to 0.67 mM). For each bile salt system, a strong inverse correlation existed between micellar solubilities of sterols and their HPLC k' values, indicating that more hydrophilic sterols had greater micellar solubilities than the more hydrophobic ones. Based upon the aqueous monomeric solubilities of cholesterol (C27) and beta-sitosterol (C29) at 24 degrees C, we derived free energy changes associated with micellar binding and found that solubilization of both sterols was more energetically favored in glycodeoxycholate solutions. Although cholesterol exhibited a higher binding affinity than beta-sitosterol in glycodeoxycholate micelles, solubilization of beta-sitosterol in taurocholate micelles was more energetically favored than cholesterol by -0.6 kcal/mol. Based upon these results we offer a thermodynamic explanation for the greater micellar solubilities of more hydrophilic sterols and suggest that the high affinity, but low capacity, of a typical phytosterol for binding to trihydroxy bile salt micelles may provide a physical-chemical basis for its inhibition of intestinal cholesterol absorption. PMID- 3681140 TI - Fatty acid metabolism and lipid secretion by perfused livers from rats fed laboratory stock and sucrose-rich diets. AB - To assess the possible role of altered hepatic processing of free fatty acids in dietary sucrose-induced accumulation of triglyceride in the liver and blood plasma, livers from rats fed commercial laboratory stock and high sucrose diets were perfused both with and without oleic acid substrate. Consumption of the sucrose diet exerted a multiplicity of effects on oleic acid metabolism, characterized by decreased conversion to both ketone bodies and carbon dioxide, increased esterification into liver triglyceride, and increased secretion in triglyceride-rich lipoproteins. During the infusion of oleic acid, livers from sucrose-fed rats also exhibited decreased ketogenesis, and increased secretion of triglyceride from endogenous sources. Since oleic acid uptake from the perfusion medium was identical in both groups, the observed effects of sucrose feeding are ascribed to altered rates of intracellular metabolic processes. Mass and radiochemical analyses of perfusate ketone bodies and triglycerides were indicative of greater mobilization of triglycerides from hepatocellular lipid droplets in the livers from sucrose-fed rats. These livers contained more triglyceride and secreted more triglyceride even in the absence of infused oleic acid. In summary, the sucrose-rich diet increased the esterification:oxidation ratio of intracellular free fatty acids derived from both the circulation and endogenous sources within the hepatocyte. In response, secretion of triglyceride rich lipoproteins by the liver and deposition of triglyceride within the liver were promoted. It is concluded that alterations in the processing of free fatty acids by the liver contribute significantly to the liver and plasma triglyceride accumulation following sucrose consumption. PMID- 3681141 TI - Abnormal cholesterol metabolism in renal clear cell carcinoma. AB - The clear cell form of renal cell carcinoma is known to derive its histologic appearance from accumulations of glycogen and lipid. We have found that the most consistently stored lipid form is cholesteryl ester. Clear cell cancer tissue contained 8-fold more total cholesterol and 35-fold more esterified cholesterol than found in normal kidney. Cholesteryl ester appeared to be formed intracellularly since it was not membrane-bound and since oleate was the predominant form, as opposed to linoleate in lipoprotein cholesteryl esters. The cholesterol in clear cell tumors did not appear to be a result of excessive synthesis from acetate since HMG-CoA reductase (EC 1.1.1.34) activity was lower in cancer tissue than in normal kidney (2.9 +/- 0.8 vs. 7.2 +/- 1.2 pmol/mg of protein per min). In contrast, intracellular activity of fatty acyl-coenzyme A:cholesterol acyl transferase (ACAT, EC 2.3.1.26) was higher in tumor tissue than in normal kidney (2405 +/- 546 vs. 1326 +/- 301 pmol/mg of protein per 20 min) while cytosolic cholesteryl ester hydrolase activity appeared normal. Cholesteryl ester storage in clear cell renal cancer may be a result of a primary abnormality in ACAT activity or it may be a result of reduced release of free cholesterol (relative to cell content) with a secondary elevation in ACAT activity. PMID- 3681142 TI - Human lactation: maternal transfer of dietary triglycerides labeled with stable isotopes. AB - A stable isotope tracer method was utilized to measure quantitatively the secretion of diet-derived fatty acids (FA) into human milk. A mixture of [2H6]tripalmitin, [2H18]-triolein, and [2H12]trilinolein was administered to three healthy, lactating women 22 to 30 years of age. Milk and blood samples were collected sequentially for 72 hr. The FA composition and concentration of total plasma, lipoprotein, and milk triglycerides were determined by gas-liquid chromatography (GLC) and the isotopic enrichment was determined by gas-liquid chromatography-mass spectrometry (GLC-MS). There were no statistically significant differences in mammary secretion of the individual fats, either by a single individual or between subjects. The mean secretion of fat by one breast was 5.11 +/- 1.26% of the dose (CV = 25%). There was a significant 6.0-hr delay between peak occurrence of the tracer in plasma and its occurrence in milk. The lipids are transported to the mammary gland primarily by the chylomicron and very low density lipoprotein triglycerides. PMID- 3681143 TI - Polymorphism of human plasma apolipoprotein C-III at birth and in early neonatal life. AB - Studies were carried out to investigate potential changes in apolipoprotein C-III (apoC-III) polymorphism from birth through the first month of life. Maternal serum at term and neonatal serum at birth, 3, 14, and 28 days were analyzed for the three principal polymorphic forms of apoC-III: apoC-III-0, apoC-III-1, and apoC-III-2. A two-dimensional electrophoretic procedure combining isoelectric focusing and electroimmunoassay was developed for this purpose. In maternal serum (n = 28), apoC-III-1 to apoC-III-2 ratios (1.45) were typical of normolipidemic adult serum, while the corresponding cord sera (n = 32) had a reversal of the apoC-III-1 to apoC-III-2 ratio (0.55). Basic polyacrylamide gel electrophoretic patterns of isolated cord sera lipoprotein density classes confirmed the reversal of the apoC-III-1 to apoC-III-2 ratio in each class. Following birth, the apoC III-1 to apoC-III-2 ratio reached unity (1.04) at 3 days and did not change significantly thereafter. It can be concluded that the apoC-III-1 to apoC-III-2 ratio in the normal newborn increases shortly after birth primarily due to an increase in apoC-III-1, and this change appears to be associated with oral feeding, suggesting that intestinal factors may play a role in controlling the ratio of plasma apoC-III-1 to apoC-III-2. PMID- 3681144 TI - Endogenous sterol synthesis is not required for regulation of 3-hydroxy-3 methylglutaryl coenzyme A reductase by low density lipoprotein. AB - It has been proposed that an endogenously synthesized oxysterol mediates the regulation of cholesterol biosynthesis by low density lipoprotein in cultured mammalian cells. Studies in this report demonstrate that under conditions in which squalene conversion to sterols is blocked either by inhibition of squalene cyclization or lanosterol demethylation, or both, low density lipoprotein regulates 3-hydroxy-3-methylglutaryl coenzyme A reductase normally. These observations rule out the hypotheses that either an endogenously synthesized oxygenated cholesterol biosynthetic intermediate or epoxysterol is required to mediate the inhibition of this enzyme by low density lipoprotein. PMID- 3681145 TI - New substrate for determination of serum lecithin:cholesterol acyltransferase. AB - Serum lecithin:cholesterol acyltransferase (LCAT) was estimated by enzymatically measuring the decrease in unesterified cholesterol after incubation of serum with liposomes. A high-performance liquid chromatography (HPLC) study showed the uptake of the lipids of liposomes by serum high density lipoprotein. Of all the examined liposomes prepared from cholesterol and various synthetic phosphatidylcholines, liposomes with dimyristoylphosphatidylcholine (DMPC) were found to be the most reactive in the LCAT reaction. When serum was used as an enzyme source, addition of purified apolipoprotein A-I, which is known to be an endogenous activator of LCAT, to the assay mixture resulted in a slight decrease in enzyme activity. Using DMPC-cholesterol liposomes as the substrate, the LCAT activities in 120 human sera showed a mean value of 485.4 +/- 64.6 nmol/hr per ml (mean +/- SD), which is 4.4- to 5.4-fold higher than the values obtained by self substrate methods. LCAT activity was a linear function of the serum sample volume up to 670 nmol/hr per ml and coefficients of variation (CV) less than 4% were obtained under the standardized conditions. Moreover, when partially purified LCAT was added to various heat-inactivated sera, the activity was efficiently recovered. These results suggest that this method is sensitive, reproducible, and not greatly influenced by serum components. PMID- 3681146 TI - Enzyme-linked immunosorbent assay for human plasma apolipoprotein B. AB - A noncompetitive enzyme-linked immunosorbent assay (ELISA) has been developed for measuring total plasma apolipoprotein (apo) B using affinity purified polyclonal and monoclonal antibodies. Microtiter plates from different manufacturers were tested with regard to their IgG binding characteristics; only one plate yielded consistent coefficients of variation of less than 5%. The optimal plasma dilution in this assay was 1:3000. IgG anti-apoB antisera conjugated to alkaline phosphatase was used as a second antibody. p-Nitrophenyl phosphate was utilized as substrate for color development, and the absorbance (410 nm) was read utilizing an ELISA reader interfaced with a microcomputer for data processing. Plasma apoB levels in plasma have been determined in 1115 male and female participants in the Framingham Offspring Study. Mean (+/- SD) plasma concentrations were 89 +/- 28 mg/dl. Significant age and sex related differences in apoB levels were noted. PMID- 3681147 TI - Use of nile red for the rapid in situ quantitation of lipids on thin-layer chromatograms. AB - We describe the use of the fluorescent dye nile red, 9-diethylamino-5H benzo[alpha]phenoxazine-5-one, as a general-purpose reagent for the rapid detection and quantitation of a wide variety of lipids and other hydrophobic compounds separated by thin-layer chromatography. After samples are applied to silica gel plates and chromatographed, the plate is briefly dipped into a nile red solution (8 micrograms/ml of methanol-water 80:20, v/v). Background fluorescence of nile red dye adsorbed to the silica gel is then preferentially destroyed by dipping the plate in a dilute aqueous solution of bleach. After drying, lipid bands are visualized under ultraviolet light. Reflectance fluorometry (Ex: 580 nm; Em: 640 nm) is utilized for in situ quantitative analysis of the fluorescence of the lipids on the nile red-stained plate. Neutral lipids, phospholipids, sphingolipids, and fatty acids can be examined, although the nile red fluorescence intensity varies significantly among the lipid classes. Also, staining is stronger for unsaturated lipids than for saturated lipids. The lower detection limit of the assay is 25-100 ng for cholesterol, cholesteryl esters, triacylglycerols, and phospholipids. PMID- 3681148 TI - Single spin density gradient ultracentrifugation method for the detection and isolation of light and heavy low density lipoprotein subfractions. AB - A single spin density gradient ultracentrifugation method in a swinging bucket rotor has been applied for the detection and isolation of low density lipoprotein (LDL) subfractions. The visualization of the LDL heterogeneity was facilitated by prestaining the serum with Coomassie Brilliant Blue R prior to density gradient ultracentrifugation for 19.5 hr. A total of 13 human serum pools was analyzed. In each pool, two LDL subfractions, a lighter LDL1 subfraction, occasionally showing a subdivision into two bands, LDL1A and LDL1B, and a heavier LDL2 could be clearly distinguished by the banding pattern in the density gradient. Physicochemical characteristics of the isolated LDL subfractions were determined. The simple method for detection and isolation of these subfractions presented here may facilitate future studies on LDL heterogeneity. PMID- 3681149 TI - Health maintenance for your money. PMID- 3681150 TI - The practical matters of practicing medicine. PMID- 3681151 TI - The medical professional as an individual investor: often misunderstood and forgotten. PMID- 3681152 TI - Retirement: is it for you? PMID- 3681153 TI - The way it is. PMID- 3681154 TI - Common techniques for overpaying estate taxes. PMID- 3681155 TI - Legislative remedies to the liability crisis. PMID- 3681156 TI - AIDS policy. PMID- 3681157 TI - The golden years. PMID- 3681158 TI - Anna's story. PMID- 3681159 TI - The implications of AIDS. PMID- 3681160 TI - Wesley Woods Geriatric Hospital. PMID- 3681161 TI - Evaluating the disabled elderly for placement in a skilled nursing home. PMID- 3681162 TI - Geriatric psychiatry--options and opportunities. PMID- 3681163 TI - Physician and counselor: teamwork in geriatric care. PMID- 3681164 TI - Arthroscopic synovectomy in the rheumatoid metacarpophalangeal joint. PMID- 3681165 TI - Multiple pulmonary nodules with pleuritic chest pain. PMID- 3681166 TI - Aspiration cytology in the evaluation of breast masses. PMID- 3681167 TI - Screening program for gestational diabetes mellitus: a preliminary report. PMID- 3681168 TI - Medical intensive care: management and cost. PMID- 3681169 TI - Prospective study of adverse reactions of anticancer drugs in Thai patients. PMID- 3681170 TI - Hepatitis-B virus infection in hospital personnel: an epidemiological study. PMID- 3681171 TI - A comparison between the efficacy of passive-active and active immunization for prevention of perinatal transmission of hepatitis B virus. PMID- 3681172 TI - Microbial contamination in some common fresh and preserved foods in Bangkok. PMID- 3681173 TI - The XY gonadal agenesis: a case report. PMID- 3681174 TI - Hyperkalemia-induced sick sinus syndrome. PMID- 3681175 TI - Gestation age assessment by using symphysial-fundal height measurement in a provincial hospital. PMID- 3681176 TI - Three-day therapy of vulvovaginal candidosis with econazole. PMID- 3681177 TI - Antibiotic prophylaxis in cardiovascular surgery. PMID- 3681178 TI - Thai National Reference Preparation in blood coagulation. I. Preparation of Thai Reference Thromboplastin (NRP), human, plain. PMID- 3681179 TI - In vitro susceptibilities of common gram negative bacilli to aminoglycosides and cephalosporins. PMID- 3681180 TI - Serum zinc levels in Thai cancer patients. PMID- 3681181 TI - Cerebrospinal fluid C-reactive protein. PMID- 3681182 TI - Cerebral acute angiitides and extensive hemorrhages associated with clinically silent acute bacterial endocarditis. PMID- 3681183 TI - The syndrome of diabetes insipidus, diabetes mellitus, optic atrophy, deafness and other abnormalities (DIDMOAD, Wolfram syndrome). PMID- 3681184 TI - Controlling relations in conditional discrimination and matching by exclusion. AB - Normally capable adults learned two-choice identity matching of three-digit numerals and arbitrary matching of physically dissimilar nonsense syllables. The stimuli were displayed on a computer terminal, and responses consisted of typing on the terminal's keyboard. In Experiment 1, every trial displayed a sample numeral, a comparison numeral, and three equal signs (= = =). The comparison stimulus was to be selected if it was identical with the sample; otherwise the equal sign was to be selected. This "single comparison" method was then used to show that arbitrary matching could be based upon either sample-S+ or sample-S- relations. In Experiment 2, a series of probe trials displayed a novel sample, a comparison stimulus from the arbitrary matching baseline, and = = =. Subjects typically selected = = =; they apparently were excluding the baseline comparison stimulus. Experiments 3 through 5 investigated which variables in training would lead to the selection of baseline comparison stimuli in response to novel samples. Behavior was usually unchanged when baseline training included relating comparison stimuli to as many as four different samples. Punishment contingencies were effective, but performance did not generalize unless those contingencies were applied in relation to more than one baseline comparison stimulus. PMID- 3681185 TI - Molar optimization versus delayed reinforcement as explanations of choice between fixed-ratio and progressive-ratio schedules. AB - In a discrete-trials procedure, pigeons chose between a fixed-ratio 81 schedule and a progressive-ratio schedule by making a single peck at the key correlated with one or the other of these schedules. The response requirement on the progressive-ratio schedule began at 1 and increased by 10 each time the progressive-ratio schedule was chosen. Each time the fixed-ratio schedule was chosen, the requirement on the progressive-ratio schedule was reset to 1 response. In conditions where there was no intertrial interval, subjects chose the progressive-ratio schedule for an average of about five consecutive trials (during which the response requirement increased to 41), and then chose the fixed ratio schedule. This ratio was larger than that predicted by an optimality analysis that assumes that subjects respond in a pattern that minimizes the response-reinforcer ratio or one that assumes that subjects respond in a pattern that maximizes the overall rate of reinforcement. In conditions with a 25-s or 50 s intertrial interval, subjects chose the progressive-ratio schedule for an average of about eight consecutive trials before choosing the fixed-ratio schedule. This change in performance with the addition of an intertrial interval was also not predicted by an optimality analysis. On the other hand, the results were consistent with the theory that choice is determined by the delays to the reinforcers delivered on the present trial and on subsequent trials. PMID- 3681186 TI - Within-session meal-size effects on induced drinking. AB - As a control for the effects of session duration and hunger on the relation between food magnitude and induced drinking, four food-deprived rats were exposed to a variable-time 50-s schedule of food delivery in which the size of each food delivery varied randomly within sessions. Food-related behavior and schedule induced drinking per opportunity were examined as functions of meal size and postfood time. All rats showed an inverted-U-shaped relation between drinking per opportunity and meal size. This relation was caused by variation in the percentage of intervals that contained drinking and by variation in the number of drinking bouts per interval, rather than by bout duration or by the amount of drinking within those intervals that actually contained drinking. Head-in-feeder time increased linearly with meal size. Schedule-induced drinking was entrained by food delivery in 3 of 4 subjects; the entrainment was due to regulation of the starting time of each drinking bout rather than to regulation of bout duration. PMID- 3681187 TI - Interaction of methadone, reinforcement history, and variable-interval performance. AB - In the present study, we examined how a reinforcement schedule history that generated high or low rates of responding influenced the effects of acute (Experiment 1) and chronic (Experiment 2) methadone administration. Initially, key-peck responses of pigeons were maintained under a variable-interval 90-s schedule of food presentation, and a methadone dose-response curve was determined with doses of 0.6, 1.2, and 2.4 mg/kg. The pigeons were then exposed, for at least 40 sessions, to either a fixed-ratio 50 schedule or a differential reinforcement-of-low-rate 10-s schedule, or were given continued exposure to the variable-interval schedule. The methadone dose-response curve was redetermined after all pigeons again were responding under the variable-interval schedule. The effects of two different daily methadone doses (9.0 and 12.0 mg/kg/day) and withdrawal precipitated by naloxone also were assessed. Experience with a fixed ratio or differential reinforcement of low rate schedule did not result in significantly different response rates under the variable-interval schedule and, in general, the acute effects of methadone did not have differential effects correlated with schedule history. However, for 2 of 4 subjects the rate decreasing effects of methadone on rates of key pecking were greater following a history of low-rate responding, suggesting a possible interaction between schedule history and effects of methadone. Daily methadone administration under the variable-interval schedule revealed that pigeons with experience under the differential reinforcement of low rate schedule developed more rapid and complete tolerance to the rate-decreasing effects of methadone. Three of the 4 subjects in this group showed rate increases above drug-free baselines during chronic methadone dosing. Pigeons with a history of fixed-ratio responding also developed tolerance to the rate-decreasing effects of methadone but without the subsequent rate increases seen by subjects with low-rate histories. No subjects with variable-interval histories showed complete recovery of drug-free baselines, suggesting that interpolated training under other schedules may attenuate the rate-altering effects of chronically administered drugs. Naloxone (1.0 mg/kg), administered during the chronic methadone phase, resulted in greater disruption of responding by pigeons with a history of low-rate responding, as compared to subjects in the other two groups.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681188 TI - Characterization of avirulent mutant Legionella pneumophila that survive but do not multiply within human monocytes. AB - Legionella pneumophila, the causative agent of Legionnaires' disease, is a Gram negative bacterium and a facultative intracellular parasite that multiplies in human monocytes and alveolar macrophages. In this paper, mutants of L. pneumophila avirulent for human monocytes were obtained and extensively characterized. The mutants were obtained by serial passage of wild-type L. pneumophila on suboptimal artificial medium. None of 44 such mutant clones were capable of multiplying in monocytes or exerting a cytopathic effect on monocyte monolayers. Under the same conditions, wild-type L. pneumophila multiplied 2.5 4.5 logs, and destroyed the monocyte monolayers. The basis for the avirulent phenotype was an inability of the mutants to multiply intracellularly. Both mutant and wild-type bacteria bound to and were ingested by monocytes, and both entered by coiling phagocytosis. Thereafter, their intracellular destinies diverged. The wild-type formed a distinctive ribosome-lined replicative phagosome, inhibited phagosome-lysosome fusion, and multiplied intracellularly. The mutant did not form the distinctive phagosome nor inhibit phagosome-lysosome fusion. The mutant survived intracellularly but did not replicate in the phagolysosome. In all other respects studied, the mutant and wild-type bacteria were similar. They had similar ultrastructure and colony morphology; both formed colonies of compact and diffuse type. They had similar structural and secretory protein profiles and LPS profile by PAGE. Both the mutant and wild-type bacteria were completely resistant to human complement in the presence or absence of high titer anti-L. pneumophila antibody. The mutant L. pneumophila have tremendous potential for enhancing our understanding of the intracellular biology of L. pneumophila and other parasites that follow a similar pathway through the mononuclear phagocyte. Such mutants also show promise for enhancing our understanding of immunity to L. pneumophila, and they may serve as prototypes in the development of safe and effective vaccines against intracellular pathogens. PMID- 3681189 TI - Elastase and cathepsin G activities are present in immature bone marrow neutrophils and absent in late marrow and circulating neutrophils of beige (Chediak-Higashi) mice. AB - Elicited peritoneal neutrophils of beige (Chediak-Higashi) mice essentially lack activities of the neutral serine proteinases elastase and cathepsin G, which may explain the increased susceptibility to infection of beige mice and Chediak Higashi patients. We have examined neutrophils of beige mice at earlier points in their development to determine if the proteinase genes are never expressed or whether they are expressed and then lost during neutrophil maturation. Surprisingly, bone marrow of beige mice had significant elastase and cathepsin G activity (approximately 60% of normal). The results of several experiments indicate that neutrophils were the sole source of elastase and cathepsin G in bone marrow. Neutral proteinase activity was readily demonstrable by histochemical procedures in beige marrow neutrophil precursors up to and including the metamyelocyte stage. However, mature neutrophils of beige marrow had greatly decreased activity. Also mature neutrophils (PMNs) of the peripheral circulation, like peritoneal neutrophils, had very low elastase and cathepsin C activities. Thus we conclude that beige neutrophil precursors express neutral proteinase activity, which is largely and irreversibly depleted by the time they fully mature in marrow. PMID- 3681190 TI - Somatically mutated forms of a major anti-p-azophenylarsonate antibody variable region with drastically reduced affinity for p-azophenylarsonate. By-products of an antigen-driven immune response? AB - The pivotal role played by antigen in the clonal selection of B cells for initial participation in an immune response is well established. Antigen selective mechanisms ensure that antigen-binding antibodies are produced during all stages of the immune response. However, antibodies that lack specificity for the immunogen might also be produced during the course of an antigen-driven immune response . It has been suggested that, through idiotype-antiidiotype network interactions within the immune system, production of antibodies that lack specificity for the immunogen but that share idiotopes with antigen-binding antibodies could result (1). In addition, data obtained by a number of investigators suggest that somatic mutation of antibody V region genes occurs at a rate of 10(-3)/basepair/cell division in B cells participating in an immune response (2, 3). One outcome of such V region structural alteration could be antibodies that lack, or have drastically reduced affinity for the immunogen . We sought to identify and characterize some of the antibody by-products of the antigen-driven immune response that are expected to be created by the mechanisms described above. PMID- 3681191 TI - Vi capsular polysaccharide-protein conjugates for prevention of typhoid fever. Preparation, characterization, and immunogenicity in laboratory animals. AB - The Vi has proven to be a protective antigen in two double masked, controlled clinical trials in areas with high rates of typhoid fever (approximately 1% per annum). In both studies the protective efficacy of the Vi was approximately 70%. Approximately 75% of subjects in these areas responded with a fourfold or greater rise of serum Vi antibodies. In contrast, the Vi elicited a fourfold or greater rise in 95-100% of young adults in France and the United States. Methods were devised, therefore, to synthesize Vi-protein conjugates in order to both enhance the antibody response and confer T-dependent properties to the Vi (and theoretically increase its protective action in populations at high risk for typhoid fever). We settled on a method that used the heterobifunctional crosslinking reagent, N-succinimidyl-3-(2-pyridyldithio)-propionate (SPDP), to bind thiol derivatives of the Vi to proteins. This synthetic scheme was reproducible, provided high yields of Vi-protein conjugates, and was applicable to several medically relevant proteins such as diphtheria and tetanus toxoids. The resultant conjugates were more immunogenic in mice and juvenile Rhesus monkeys than the Vi alone. In contrast to the T-independent properties of the Vi, conjugates of this polysaccharide with several medically relevant proteins induced booster responses in mice and in juvenile Rhesus monkeys. Clinical studies with Vi-protein conjugates are planned. This scheme is also applicable to synthesize protein conjugates with other polysaccharides that have carboxyl functions. PMID- 3681192 TI - Sequence analysis and expression of an X-linked, lymphocyte-regulated gene family (XLR). AB - The XLR gene family consists of approximately 10 X-linked genes, the expression of which is regulated in lymphocyte development. Certain members of the gene family are closely linked to the murine xid immune deficiency mutation. Sequence analysis of a cDNA clone pM1 derived from the plasmacytoma MOPC167 showed an open reading frame capable of coding for a protein of 208 amino acids and mol wt 24,000. The lack of a signal peptide or transmembrane region indicates a probable cytoplasmic or nuclear localization for the predicted pM1 protein. The predicted protein shares significant homology with lamins A and C and other members of the intermediate filament family of proteins, and shares features important for the coiled-coil structure proposed for these proteins. Analysis of cDNA clones derived from a presecretory lymphoma and from adult thymus indicates that B and T lymphocytes transcribe a common major mRNA identical to pM1, while other rare transcripts were also identified by these studies. A series of clonal T lymphoma lines representing distinct stages of thymic differentiation showed that, as with B lymphoid tumors, XLR expression is correlated with the maturation of the thymomas. PMID- 3681193 TI - Elastase-mediated fibrinogenolysis by chemoattractant-stimulated neutrophils occurs in the presence of physiologic concentrations of antiproteinases. AB - Plasma levels of the HNE-derived fibrinopeptide A alpha 1-21 reflect in vivo enzyme activity. To provide a possible explanation for the presence of circulating A alpha 1-21 in individuals with normal plasma antiproteinase concentrations we investigated whether PMN-associated HNE is more resistant to inhibition than the free enzyme. PMN were stimulated to migrate across 125I fibrinogen-coated nitrocellulose filters in response to 10(-7) M FMLP, and the extent of fibrinogenolysis was determined by measuring release of A alpha 1-21 and 125I-labeled fibrinogen degradation products. The fibrinogenolytic activity of migrating PMN was then compared with that of free HNE present in PMN lysates or secreted by PMN stimulated with FMLP. Whereas the fibrinogenolytic activity of soluble HNE was completely inhibited by low concentrations (1%) of plasma or serum and macromolecular antiproteinase (alpha 1 proteinase-inhibitor and soybean trypsin-inhibitor), even in the presence of undiluted plasma or serum the activity of the migrating PMN was incompletely blocked (81-85%). Further, concentrations of alpha 1 proteinase-inhibitor and soybean trypsin-inhibitor that totally inhibited free HNE activity also incompletely blocked (88-89%) the fibrinogenolytic activity of migrating PMN, indicating that FMLP-stimulated PMN demonstrate significant fibrinogenolytic activity in the presence of antiproteinases as small as 20,000 mol wt. A specific low molecular weight HNE inhibitor (MeO-Suc-Ala2-Pro-ValCH2Cl), however, totally blocked PMN-mediated fibrinogenolysis without affecting intracellular HNE activity, HNE secretion from PMN, or PMN migration in response to FMLP. These findings support the hypothesis that PMN migrating on a fibrinogen-coated surface form zones of close contact with fibrinogen, thus preventing access of plasma antiproteinases to HNE released at the cell-substrate interface. The occurrence of this phenomenon in vivo would explain the presence of circulating A alpha 1-21 in individuals with normal antiproteinase concentrations. PMID- 3681195 TI - Estimation of the production rates of serum aminoterminal propeptide of type III procollagen and laminin in human fibrotic liver. AB - The concentrations of laminin, a high molecular weight non-collagenous glycoprotein of basement membranes, and of the N-terminal propeptide of type III procollagen were determined in the serum of the liver outflow vascular region (hepatic vein) and of a peripheral vein (cubital vein) in patients with chronic liver diseases (fibrosis, cirrhosis, unspecified histology; n = 173), in order to determine their secretion rates from the injured livers. The mean levels of laminin (1.84 kU/l) and of procollagen peptide (28.0 micrograms/l) in hepatic vein were significantly higher (about 9.5% at p less than 0.02, and 37% at p less than 0.001, respectively) than those in the periphery (1.68 kU/l and 20.4 micrograms/l, respectively). In chronic liver diseases, however, laminin and procollagen peptide concentrations in the hepatic vein were lower than or equal to those in the cubital vein in 18% and 27% of patients, respectively. The highest regional differences of the concentrations were noted in cirrhotic subjects. The serum levels of laminin (rs 0.93) and of procollagen peptide (rs 0.73) in hepatic and in cubital vein are highly positively correlated (p less than 0.001), but the levels of procollagen peptide in hepatic vein are only weakly but still significantly statistically related with those of laminin (rs 0.446, p less than 0.001). Similarly, the hepatic-cubital venous concentration differences of both proteins are weakly (rs 0.312) but significantly (p less than 0.001) correlated. On the basis of several assumptions we estimated secretion rates from the livers of 120 U.min-1 for laminin, and 5.7 micrograms.min-1 for procollagen peptide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681196 TI - Kinetic enzymatic method for automated determination of HDL cholesterol in plasma. AB - A sensitive fixed-time kinetic enzymatic method for the measurement of high density lipoprotein cholesterol is described, as adapted for the Cobas Bio centrifugal analyser (Hoffmann LaRoche). The Boehringer Mannheim cholesterol esterase/cholesterol oxidase/peroxidase/3,4-dichlorophenol kinetic reagent was modified by the inclusion of 2,4,6-tribromo-3-hydroxybenzoic acid which reacts with hydrogen peroxide and 4-aminophenazone to produce a quinone-imine dye with a greater molar absorptivity than that produced with phenol. The method has been developed for the determination of HDL fractions isolated with polyethylene glycol 6000, for which a reagent of high sensitivity is required. The method is linear to at least 3.88 mmol/l of HDL cholesterol and the coefficients of variation for within-run and day-to-day precision were less than 3.0%. Correlation of the kinetic HDL cholesterol method with an equilibrium method was good (R = 0.9980). The assay is rapid, inexpensive and large numbers of specimens can be processed conveniently. PMID- 3681197 TI - Cystatin C, alias post-gamma-globulin: a marker for multiple sclerosis? AB - Cystatin C, alias post-gamma-globulin or gamma-trace protein, has been shown to be a potent inhibitor of cysteine proteinases; this protein is normally present in different biological fluids, but particularly so in cerebrospinal fluid. The concentration of cystatin C was determined by radial immunodiffusion in cerebrospinal fluid from patients affected with multiple sclerosis, patients affected with various neurological diseases and in controls; it was also determined in brain tissue from 2 patients affected with multiple sclerosis and 3 control brains. Cystatin C cerebrospinal fluid levels were undetectable or depressed in many multiple sclerosis cases and the median value differed significantly from the control one. Its low concentration in multiple sclerosis suggests that the regulation of cysteine proteinases is impaired in this disease; hence enhanced activity of cysteine proteinases could initiate, or increase the breakdown of myelin. Although it is perhaps a little premature to consider cystatin C as a marker for multiple sclerosis, this protein is nevertheless associated to demyelination; consequently its biochemical assay in cerebrospinal fluid is recommended as a complementary diagnostic tool. PMID- 3681198 TI - Specificity of the amidase and kininogenase methods for the determination of rat urinary kallikrein. AB - The specificity of the amidase and kininogenase methods for determining rat urinary kallikrein was studied. Male and female rat urine was employed. Esterase A1, A2 and kallikrein were separated by DEAE-Sephadex A-50 chromatography. Esterase A1 showed no amidase activity towards the substrate H-D-Val-Leu-Arg-p nitroanilide. In contrast, esterase A2 and kallikrein attacked the substrate, and the activity of kallikrein was especially inhibited by aprotinin, while esterase A2 was more sensitive to soybean trypsin inhibitor. Esterase A1 did not show kininogenase activity, whereas esterase A2 showed this activity, but only towards the dog plasma substrate. Kallikrein possessed kininogenase activity towards both dog and rat plasma kininogen. We believe that the most specific method for measuring rat urinary kallikrein activity is the kininogenase method using partially purified rat plasma kininogen. PMID- 3681199 TI - Childhood and adolescent depression. PMID- 3681194 TI - Differential expression of MHC class I antigens on the placenta of the rat. A mechanism for the survival of the fetal allograft. AB - In some mating combinations in rats, there is a maternal antibody response to the maternal antigenic components of the placenta without any previous immunization of the mother. The highest response occurs in the WF (u) female mated to the DA (a) male, and it is against a unique MHC-encoded class I antigen, the Pa antigen, and not against the major allele-specific transplantation antigen of the DA strain, RT1.Aa. The development of mAbs to the Pa and Aa antigens allowed us to localize these antigens on the placenta and to explore the reason for the differential antibody response to them using immunohistochemical and biochemical techniques. Both antibodies reacted with the WF X DA placenta and stained the endovascular and interstitial trophoblast of the decidua, the basal trophoblast, Reichert's membrane, and the yolk sac epithelium, but they did not stain the labyrinthine trophoblast. Blocking studies showed that each antibody reacted with a separate molecule in the placenta. Anti-class II mAbs reactive with the a or u haplotype did not stain the WF X DA, DA X DA, or WF X WF placenta; hence, there are no class II antigens in the placenta. Electron microscopic studies of the semiallogeneic WF X DA placenta using the immunogold technique with both single- and double-labeling showed that only the Pa antigen was expressed on the surface of the basal trophoblast, but that both the Pa and Aa antigens were in the cytoplasm of these cells; neither antigen was found in the labyrinthine trophoblast. By contrast, the placenta from the syngeneic DA X DA mating expressed both the Pa and Aa antigens on the surface of the basal trophoblast as well as in the cytoplasm; neither antigen was found in the labyrinthine trophoblast. These observations were quantified morphometrically using electron photomicrographs of single-labeled tissues. Both the Pa and Aa antigens isolated from the plasma membrane of lymphocytes have heavy chains of 46 kD, but those antigens isolated from the plasma membrane of basal trophoblast cells have heavy chains of 43 kD. Based on densitometric measurements of autoradiographs, the Pa/Aa ratio in the basal trophoblast membrane is 23.5, whereas it is 0.46 in lymphocyte membranes. These studies show that there is differential regulation of the expression of class I antigens on basal trophoblast cells in semiallogeneic pregnancies, but not in syngeneic pregnancies, such that the major allele specific transplantation antigen is scarcely expressed on the surface of the basal trophoblast.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681200 TI - Elder abuse. PMID- 3681202 TI - Case management and gatekeeping. PMID- 3681201 TI - Treatment of pruritus. PMID- 3681203 TI - Diagnosis of ectopic pregnancy. PMID- 3681204 TI - Diagnosis and management of pneumonia. PMID- 3681205 TI - Childhood depression: an overlooked problem in family practice. AB - To investigate the incidence and correlates of childhood depression in a family practice clinic, Kovacs Childhood Depression Inventory (CDI) was administered to 64 patients, aged 6 to 12 years. Accompanying parents completed the short form of Beck's Depression Inventory (BDI) and reported on the children's behavior problems. One half of the children studied scored within the depressed range on the CDI. Thirty-nine percent of the parents scored at least mildly depressed on the BDI. Depression appeared to cluster in families. Every parent who scored in the severe depression range was accompanying a child who rated himself or herself as depressed. All parents who scored above the cutoff for mild depression rated their children as having behavior problems. Children's self-reported depression was also related to negative parental rating of the children's behavior. PMID- 3681206 TI - Improving the periodic health examination: use of a screening flow chart for patients and physicians. AB - An attempt was made to improve periodic health examinations in a family practice department. Both physicians and patients were instructed in the use of a screening flow sheet that listed the clinic's minimum recommendations for the periodic health examination. Both groups were also educated about the evidence against ordering other tests routinely, such as x-ray examinations and blood tests. Audits were performed before and after physician and patient education on a total of 384 charts. Compliance with all of the screening flow-sheet recommendations improved with education. Significant improvements occurred with the ordering of the tetanus-diphtheria booster and proctosigmoidoscopy examinations. Compliance for most procedures, however, remained well below the recommended level. Unnecessary testing was not decreased by the educational effort. The complete blood count was actually ordered significantly more often after patient education despite the lack of evidence of its value in screening. Although physician and patient education in the use of the screening flow sheet did result in some improvement in the ordering of recommended tests, the optimal method of improving periodic health examinations has yet to be found. PMID- 3681207 TI - Drug interactions in the elderly. AB - Polypharmacy and its dangers in the elderly are of increasing concern. The purpose of this study was to determine the incidence of drug with drug, drug with food, and drug with alcohol interactions in a population aged 60 years or greater. Four hundred patients were randomly selected from a university family medicine outpatient clinic population of 4,483 in this age group. A total of 292 drugs were involved for a total of 1,052 potential interactions: 310 drug-food, 316 drug-alcohol, and 426 drug-drug. Interactions were analyzed using The Drug Master computer program and rated as to their clinical significance. Chart review revealed no serious actual interaction for any patient even though potential interactions could be categorized as highly significant for 27 percent of the drug-drug, 11 percent of the drug-alcohol, and 3 percent of the drug-food. Thirty two percent of the total population were taking five or more drugs concurrently. The mean number of drugs for men was 3.75 and for women 4.22 (P less than .05). Age and race differences were also noted in the number of drugs taken. The most common drugs and their interactions with drug, food, and alcohol are reviewed. PMID- 3681208 TI - Adverse effects of faculty practice on diagnostic content of residents' outpatient experience. AB - The outpatient experience of two cohorts of family medicine residents was compared. Those who worked at a site with an existing faculty practice had fewer pregnancy-related patient encounters and proportionately more encounters for acute self-limited care compared with residents at a site without a faculty practice (P less than .001). More important, the faculty-associated residents also cared for fewer patients with a variety of chronic diseases and saw them less frequently. These findings suggest that a coexistent faculty practice may have adverse effects on outpatient training in primary care. PMID- 3681209 TI - Cat-scratch disease. AB - Cat-scratch disease is a self-limited disease associated with contact with cats that causes regional lymphadenopathy in children and young adults. Recently identification of the probable causative organism, a gram-negative, non-acid-fast coccobacillus, has been achieved through special staining techniques from skin inoculation sites and involved lymph tissue. Differential diagnosis includes a variety of other infectious diseases and neoplasms. Diagnosis of cat-scratch disease can be made by presence of typical clinical findings, history of exposure to cats, results of skin testing to cat-scratch antigen, and in some circumstances, biopsy or fine-needle aspiration from skin inoculation site or involved lymph nodes. Future developments awaiting culture of the suspected bacterium include a vaccine for prevention, rapid diagnostic methods, and antimicrobial testing. PMID- 3681210 TI - Secondary syphilis presenting with arthritis, hepatitis, and glucose intolerance. PMID- 3681211 TI - Does the dipstick meet medical needs for urine specific gravity? PMID- 3681213 TI - Patients' expectations and family conferences. PMID- 3681212 TI - Attitudes, experience, and knowledge of family physicians regarding child sexual abuse. PMID- 3681215 TI - Toward more effective recognition and management of somatization disorder. PMID- 3681214 TI - Sports medicine curriculum and rehabilitation exercises. PMID- 3681216 TI - Screening for family dysfunction. PMID- 3681217 TI - Religion, magic, and medicine. PMID- 3681218 TI - Screening for gestational diabetes in a high-risk population. AB - One hundred eighty-one pregnant Navajo women were screened for gestational diabetes. The 50-g oral glucose screening test was greater than 7.2 mmol/L (130 mg/dL) in 44 of 181 subjects (24.3 percent) and greater than 8.3 mmol/L (150 mg/dL) in 23 of 181 subjects (12.7 percent). The incidence of gestational diabetes in the study population was 6.1 percent of all pregnancies by standard oral glucose tolerance testing. Incidence of gestational diabetes was 9.5 percent in 21 subjects whose screening test was 7.2 to 8.3 mmol/L (130 to 149 mg/dL) and 39.1 percent in 23 subjects whose screening test was 8.3 mmol/L (150 mg/dL) or greater. Using equal to or greater than 7.2 mmol/L (130 mg/dL) of glucose as the definition of an abnormal screening test yielded a 0.80 specificity and a 0.25 positive predictive value, while the cost for each case of gestational diabetes detected was $114. Using equal to or greater than 8.3 mmol/L (150 mg/dL) of glucose as the definition of an abnormal screening test yielded a 0.81 sensitivity, 0.58 specificity, and 0.39 positive predictive value, while the cost for each case of gestational diabetes detected was $106. Logistic regression analyses demonstrated that the screening test was more strongly associated with the diagnoses of gestational diabetes than any other risk factor for gestational diabetes. Universal screening of gestational diabetes is recommended in this high risk population using equal to or greater than 7.2 mmol/L (130 mg/dL) of glucose as the definition of an abnormal screening test. PMID- 3681219 TI - Somatization disorder in a university hospital. AB - Somatization disorder is a condition characterized by multiple unexplained complaints. To characterize this disorder as it occurs in a university hospital, a sample of 213 patients admitted to adult medical and surgical services was studied. Nineteen of these patients (9 percent) met the Diagnostic and Statistical Manual of Mental Disorders, ed 3, criteria for somatization disorder. A significantly higher proportion of the women compared with the men interviewed had the disorder (14 percent vs 3 percent, P less than .01). Fourteen percent of the divorced, separated, or widowed subjects qualified for the diagnosis, compared with 7 percent of the married subjects and 5 percent of the never married subjects (P less than .05). Likewise, 32 percent of single patients with children at home had somatization disorder, compared with 4 percent of subjects in all other household configurations (P less than .001). When compared with matched controls, patients with somatization disorder had hospitalizations of roughly equal duration and expense, but had a much higher proportion of negative findings on workup for their presenting complaints (74 percent vs 21 percent, P less than .01). Nevertheless, these patients perceived their health as significantly worse than those without the disorder (P less than .001). None of the patients enrolled in this study had the diagnosis of somatization disorder at admission or discharge. This study documents that patients with somatization disorder are common, are unrecognized, and are admitted to the hospital for nonproductive workups. PMID- 3681220 TI - Nerve-entrapment syndromes from lower abdominal surgery. AB - Patients with a complaint of lower abdominal pain and a history of lower abdominal surgery, particularly inguinal herniorrhaphy, appendectomy, and procedures incorporating a Pfannenstiel incision, should have nerve entrapment considered in the differential diagnosis. Careful history and physical examination in conjunction with selected use of the ilioinguinal-iliohypogastric nerve block can confirm the diagnosis of nerve entrapment and preclude an unnecessary workup of these patients. Of the patients with nerve entrapment, most will experience complete relief of symptoms following serial injections and require no further treatment. The remainder will experience only temporary relief and require surgical interruption of the nerve involved. In those patients who obtain no relief from the nerve block, further workup for a source of their pain is warranted. Most of these patients were found to have a subclinical recurrence of an inguinal hernia. PMID- 3681221 TI - Sex differences in depression symptoms among adult family medicine patients. AB - Beck Depression Inventory factor structures for men and women were compared to determine whether there are sex differences in self-reported depression symptoms. Subjects were 131 white men and 223 nonpregnant, white women presenting for health care at the University of Missouri-Columbia Family Medical Care Center. Dysphoric mood and performance difficulty were the two major components of depression in both men and women. A third component, unique to men, was labeled interpersonal behavior change; it was characterized by social withdrawal, indecisiveness, and irritability. Health care providers should be alert to interpersonal behavior changes signaling depression in their male patients even in the absence of dysphoric mood. PMID- 3681222 TI - The incidence of severe trauma in small rural hospitals. AB - Trauma is the third leading cause of death in the United States, and yet relatively little is known about its epidemiology, especially in rural areas. A retrospective study was done in five Washington and Idaho communities to determine the incidence of severe trauma seen in small rural hospitals. Records were reviewed for the year 1983 on all trauma patients (565 cases) who were either admitted to or transferred from these hospitals. The study area included five hospitals and 30 physicians, serving a population of 57,600 people over 7,396 square miles. Each patient's injuries were rated according to the Injury Severity Score (ISS), a standardized trauma index. Of the cases reviewed, 3.4 percent of the cases had an ISS greater than or equal to 20, reflecting severe multisystem trauma, 14.7 percent had an ISS of 10 to 19, ie, severe trauma limited to one body system or multisystem trauma of a less-critical nature. There were 30 patients (5.3 percent) with critical head injuries, 24 patients (4.2 percent) with major chest injuries, and 21 patients (3.7 percent) with serious abdominal injuries. The results showed that each individual physician or hospital did not see the severe cases often, but that when they occurred, these types of injuries necessitated an experienced, rapid response on the part of the hospital staff. This finding has significant implications for trauma management in rural communities. PMID- 3681223 TI - Screening flexible sigmoidoscopy: is it worthwhile? An affirmative view. PMID- 3681224 TI - Screening flexible sigmoidoscopy: is it worthwhile? An opposing view. PMID- 3681225 TI - Fecal occult blood screening in northern Idaho. PMID- 3681226 TI - All-terrain vehicle accidents in a rural family practice. PMID- 3681227 TI - Primary care physician attitudes about gatekeeping. PMID- 3681228 TI - Periodic changes in the organs involved in the erythropoiesis of anemic newts. AB - In Triturus cristatus carnifex (Laurenti) newts rendered totally anemic by treatment with acetylphenylhydrazine (APH) diluted in their tank water (25 mg/liter for 48 hours, with four changes) the recovery of erythron occurs through periodic cycles of mitotic activity in the erythropoietic tissue. These cycles determine a marked increase in blood erythrocyte concentration at regular intervals of about 1 month. The consequence of this trend is the alternation of ferritin and hemosiderin accumulation phases during periods of stasis with iron mobilization phases during periods of erythropoietic activity, which is particularly evident in the Kupffer cells of the liver. Iron mobilization and erythropoietic activity are strictly related to the periodic hypertrophy of some Bowman's capsule cells in the renal corpuscle, which were previously denominated "lactate sensitive cells" (LSC). The histochemistry, location, and behavior of LSC indicate that they are probably the site of erythropoietin production in the newt. PMID- 3681229 TI - Role of carbohydrates in cell-substrate interactions during newt epidermal cell migration. AB - The effect of several solubilized monosaccharides on epidermal cell migration from skin explants of the adult newt was examined. The ability of epidermal cells to migrate on substrates coated with these same sugars or with wheat germ agglutinin (WGA) was also determined. Adding 0.05 M N-acetyl-glucosamine (GlcNAc) to the medium inhibited epidermal cell migration in dishes coated with either type I collagen or fibrinogen. The same concentration of fucose, galactose, or mannose had no effect. In contrast to type I collagen, which supported considerable migration when dried onto the bottom of plastic dishes, epidermal cells were unable to migrate on dishes coated similarly with WGA, mucin (a protein high in sialic acid residues), or bovine serum albumin (BSA) conjugated to galactose, mannose, or GlcNAc. Red blood cell (RBC) binding assays showed that drying WGA onto plastic did not destroy its GlcNAc binding sites--nor did it damage the GlcNAc residues of BSA-GlcNAc. The RBC assay also verified that for both these proteins, substrates with distinctly different cell binding capacities had been tested in the migration experiments. In dishes coated with either WGA or BSA-GlcNAc, red cells bound to dish bottoms in a GlcNAc-specific manner right up to the margins of explants. Other control experiments showed that the failure of migration in WGA- and BSA-GlcNAc-coated dishes could not be explained by competition between adsorbed and desorbing protein for cell surface receptors. This work shows that adhesive bonds between epidermal cell surface GlcNAc and a GlcNAC-specific lectin on the substrate are not by themselves adequate to support cell migration. Nor is GlcNAc, sialic acid, galactose, or mannose alone on the substrate sufficient. In conjunction with our earlier work (Donaldson and Mahan: J. Exp. Zool., 231:211-219, '84; Donaldson, Mahan, Hasty, McCarthy, and Furcht: J. Cell. Biol., 101: 73-78, '85), these observations suggest that factors other than carbohydrate content or capacity to act as a lectin determine whether a given extracellular protein will support migration. PMID- 3681230 TI - Ontogeny-related changes in the peptide profiles of the germinal epithelium: analysis by sodium dodecyl sulfate gradient gel electrophoresis. AB - The premise that one manifestation of the nexus between Sertoli cells and germ cells may be an orderly and sequential change in their protein profiles has been examined in relation to the ontogeny of spermatogenesis in the colony-bred albino rat. Viable "Sertoli cell-germ cell associations" isolated from the testes of animals of defined postnatal age and incubated in an appropriate medium were separated into a Sertoli cell and a germ cell fraction and processed for analysis by sodium dodecyl sulfate gradient gel electrophoresis. The resulting stained bands were "mapped" and assigned relative mobility values by comparison with standard marker proteins. This enabled identification by serial number of individual bands from an overall total of 163. For purposes of detailed analysis, they were classified into high, medium-high, medium, and low molecular weight bands. Two major categories were delineated: 1) those associated uniquely with a specified day of ontogeny and 2) those appearing intermittently. Significantly enough, not one of the bands was encountered on all days examined. The relevance of the patterns observed to the possible exchange of "information" between Sertoli cells and germ cells during spermatogenesis is mooted. PMID- 3681231 TI - Role of peanut-lectin-affinity molecules (PLAM) on primordial germ cells in the initial determination of sex in anura. AB - Peanut lectin (PNA) or N-acetylgalactosamine (galNA, a part of the disaccharide unit which is recognized by PNA) was injected into the coelomic cavity of anuran larvae at the developmental stages during which the genital ridges were growing, and the effect of these compounds on the initial determination of gonadal sex was examined. The treatment with PNA tended to inhibit (or perturb) the expression of feminizing gene(s) in Rana japonica, and of both feminizing and masculinizing genes in R. nigromaculata. In contrast, treatment with galNA suppressed the expression of masculinizing gene(s) considerably. In terms of the initial determination of gonadal sex during normal development, these results suggest that the PNA-affinity molecule (PLAM) of primordial germ cells acts as a trigger for the expression of genes that control sexual differentiation of somatic cells. Furthermore, the somatic cells (perhaps mesenchymal and/or epithelial cells), which respond to the stimulus via the PLAM of primordial germ cells, may differ in terms of the threshold for such a response between genetic males and females. This result suggests the mesenchymal and/or epithelial cells are not sexually predetermined, but rather that sexual determination follows the response to some signal(s) mediated by the PLAM. PMID- 3681232 TI - Human immunodeficiency virus testing: the Palm Beach County alternative test site experience. PMID- 3681233 TI - Perspective on chemotherapy for cervical cancer. PMID- 3681235 TI - Medical negligence and the tort system: what are the options? PMID- 3681234 TI - Florida neurosurgical lawsuit profile--1987. PMID- 3681236 TI - PL 94-142 and PL 99-457: challenges for pediatrics. PMID- 3681237 TI - The terminal agony and final moments of a physician-owned HMO: a postmortem. PMID- 3681238 TI - Acetylcholinesterase activity in rectal suction biopsy for the diagnosis of Hirschsprung's disease. PMID- 3681239 TI - Clinical experience with interposition mesocaval shunt. PMID- 3681240 TI - [Phthalate esters: chemical carcinogens existing in the water from a well in a blackfoot disease endemic area]. PMID- 3681241 TI - [Clinical manifestations and laboratory findings of cases in an outbreak of carbon tetrachloride-induced hepatic injury at a printing factory]. PMID- 3681242 TI - [Severe diphenylhydantoin hypersensitivity: analysis of 11 cases]. PMID- 3681243 TI - [Serum level of N-terminal peptide of procollagen type III in chronic liver disease]. PMID- 3681244 TI - [Correlation of carcinoembryonic antigen (CEA) content in the resected tissue with the serum CEA levels in patients with colorectal carcinoma]. PMID- 3681245 TI - [131I-MIBG scintigraphy in diagnosing pheochromocytoma]. PMID- 3681246 TI - [Evaluation of pre-operative disinfection of ophthalmic surgery]. PMID- 3681247 TI - A case of endometrial stromatosis with pulmonary metastasis: remission following surgical and hormonal treatment. PMID- 3681248 TI - Confirmation of thyrotropin decrease in nonthyroidal illness by sensitive immunoradiometric assay for thyrotropin. PMID- 3681249 TI - Isolation of human immunodeficiency virus from the first autopsy-proved case of acquired immunodeficiency syndrome in Taiwan. PMID- 3681250 TI - In vitro immune responses of patients with pulmonary tuberculosis to BCG and its active components. PMID- 3681251 TI - M-mode, two-dimensional and pulsed Doppler echocardiographic abnormalities in systemic lupus erythematosus. PMID- 3681252 TI - Hepatitis delta virus infection among chronic hepatitis B surface antigen carrier patients of a general hospital in northern Taiwan. PMID- 3681253 TI - Efficacy of the national hepatitis B vaccination program in the Republic of China: preliminary observations from Taoyuan area. PMID- 3681254 TI - [Efficacy of the national hepatitis B vaccination program in the Republic of China: preliminary observations of high risk infants from Taipei Municipal Women and Children Hospital]. PMID- 3681255 TI - [Diagnosis of suspected chest tumor by percutaneous needle aspiration biopsy]. PMID- 3681256 TI - [Cryptosporidiosis in children]. PMID- 3681257 TI - Cystic fibrosis: report of a Chinese case with suggestive family history. PMID- 3681258 TI - IgM nephropathy after D-penicillamine therapy: report of a case. PMID- 3681259 TI - Mechanisms contributing to the cardiac inotropic effect of Na pump inhibition and reduction of extracellular Na. AB - Reduction of the transsarcolemmal [Na] gradient in rabbit cardiac muscle leads to an increase in the force of contraction. This has frequently been attributed to alteration of Ca movements via the sarcolemmal Na/Ca exchange system. However, the specific mechanisms that mediate the increased force at individual contractions have not been clearly established. In the present study, the [Na] gradient was decreased by reduction of extracellular [Na] or inhibition of the Na pump by either the cardioactive steroid acetylstrophanthidin or by reduction of extracellular [K]. Contractile performance and changes in extracellular Ca (sensed by double-barreled Ca-selective microelectrodes) were studied in order to elucidate the underlying basis for the increase in force. In the presence of agents that inhibit sarcoplasmic reticulum (SR) function (10 mM caffeine, 100-500 nM ryanodine), reduction of the [Na] gradient produced increases in contractile force similar to that observed in the absence of caffeine or ryanodine. It is concluded that an intact, functioning SR is not required for the inotropic effect of [Na] gradient reduction (at least in rabbit ventricle). However, this does not exclude a possible contribution of enhanced SR Ca release in the inotropic response to [Na] gradient reduction in the absence of caffeine or ryanodine. Acetylstrophanthidin (3-5 microM) usually leads to an increase in the magnitude of extracellular Ca depletions associated with individual contractions. However, acetylstrophanthidin can also increase extracellular Ca accumulation during the contraction, especially at potentiated contractions. This extracellular Ca accumulation can be suppressed by ryanodine and it is suggested that this apparent enhancement of Ca efflux is secondary to an enhanced release of Ca from the SR. Under conditions where Ca efflux during contractions is minimized (after a rest interval in the presence of ryanodine), acetylstrophanthidin increased both the rate and the extent of extracellular Ca depletions. Thus, acetylstrophanthidin can increase both Ca influx and Ca efflux during the cardiac muscle contraction. These results can be explained by a simple model where the direction of net Ca flux via Na/Ca exchange during the action potential is determined by the changes in reversal potential of the Na/Ca exchange. Reduction of the [Na] gradient may well lead to net cellular Ca uptake (via Na/Ca exchange) and may also elevate the resting intracellular [Ca].(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681260 TI - Characterization of the reverse Na/Ca exchange in squid axons and its modulation by Cai and ATP. Cai-dependent Nai/Cao and Nai/Nao exchange modes. AB - We have used dialyzed squid axons to characterize the ouabain- and bumetanide insensitive Na efflux components and their relation to the operation of the Na/Ca exchange mechanism. In axons dialyzed with solutions containing nearly physiological concentrations of K, Na, and Mg, three components of the Na efflux can be distinguished: Cai-activated, Cao-dependent Na efflux ("reverse" Na/Ca exchange); Cai-activated, Nao-dependent Na efflux; and Cai-independent, ATP activated, Nao-dependent Na efflux. We have studied the effects of internal alkalinization, Mgi, Cao, and the ATP analogue [gamma-thio]ATP (ATP gamma S) on the different components of the Na efflux. The results show the following: (a) internal alkalinization activates both Cao- and Nao-dependent Na efflux components provided that Cai is present; (b) Mgi inhibits both the Cai-activated, Cao- and Nao-dependent Na efflux components; (c) Cao inhibits the Nao-dependent component by competition for a common site; (d) ATP gamma S activates both Nao- and Cao-dependent Na efflux components only in the presence of Cai; and (e) ATP activates the Nai/Nao and Nai/Cao exchanges, causing a 10-fold increase in the affinity of the reverse Na/Ca exchange toward Cai. In the absence of Cai, ATP stimulates an Nao-dependent Na efflux that is not affected either by internal alkalinization or high Cao. The ATP analogue does not activate the Cai independent Na/Na exchange system. These experiments demonstrate that the Cai activated Na/Na exchange is a mode of operation of the Na/Ca exchange mechanism that substantially contributes to Na movement during the activation of the Na/Ca antiporter. The experimental evidence obtained on the Cai-independent Na/Na exchange component shows that this system is not part of the Na/Ca exchange. PMID- 3681261 TI - Equilibrium properties of mouse-Torpedo acetylcholine receptor hybrids expressed in Xenopus oocytes. AB - This study used messenger RNA encoding each subunit (alpha, beta, gamma and delta) of the nicotinic acetylcholine (ACh) receptor from mouse BC3H-1 cells and from Torpedo electric organ. The mRNA was synthesized in vitro by transcription with SP6 polymerase from cDNA clones. All 16 possible combinations that include one mRNA for each of alpha, beta, gamma, and delta were injected into oocytes. After allowing 2-3 d for translation and assembly, we assayed each oocyte for (a) receptor assembly, measured by the binding of [125I]alpha-bungarotoxin to the oocyte surface, and (b) ACh-induced conductance, measured under voltage clamp at various membrane potentials. All combinations yielded detectable assembly (30 fold range among different combinations) and ACh-induced conductances (greater than 1,000-fold range at 1 microM). On double-logarithmic coordinates, the dose response relations all had a slope near 2 for low concentrations of ACh. Data were corrected for variations in efficiency of translation among identically injected oocytes by expressing ACh-induced conductance per femtomole of alpha bungarotoxin-binding sites. Five combinations were tested for d-tubocurarine inhibition by the dose-ratio method; the apparent dissociation constant ranged from 0.08 to 0.27 microM. Matched responses and geometric means are used for describing the effects of changing a particular subunit (mouse vs. Torpedo) while maintaining the identity of the other subunits. A dramatic subunit-specific effect is that of the beta subunit on voltage sensitivity of the response: gACh( 90 mV)/gACh(+30 mV) is always at least 1, but this ratio increases by an average of 3.5-fold if beta M replaces beta T. Also, combinations including gamma T or delta M usually produce greater receptor assembly than combinations including the homologous subunit from the other species. Finally, EACh is defined as the concentration of ACh inducing 1 microS/fmol at -60 mV; EACh is consistently lower for alpha M. We conclude that receptor assembly, voltage sensitivity, and EACh are governed by different properties. PMID- 3681262 TI - Nontransducing rhodopsin. AB - Rhodopsin is converted by light to an active photoproduct that triggers the transduction cascade. The active photoproduct must then be inactivated by some kind of chemical modification. The question addressed here is whether photoconversion of the inactive photoproduct to rhodopsin creates a modified form of rhodopsin that is unable to support transduction. This question was investigated in ultraviolet receptors of Limulus median eye by measuring the relative quantum efficiency of excitation after photoregeneration of rhodopsin from the inactive photoproduct. The results show that when this newly created rhodopsin absorbs a photon, no receptor potential is generated; i.e., the pigment is nontransducing. A dark process requiring 30-60 min returns rhodopsin to its transducing form. PMID- 3681263 TI - Strain variation of respiratory syncytial virus. AB - Western blotting and immunoperoxidase staining with monoclonal antibodies were employed to analyse epitopic and polypeptide molecular weight variation among isolates of respiratory syncytial (RS) virus collected in Newcastle between 1965 and 1986. One group of isolates resembled the A2 and Long prototype subgroup A strains of RS virus in possessing a P protein of Mr 34,000. Isolates in this subgroup showed two patterns of reactivity with subgroup A-specific monoclonal antibodies to the G glycoprotein and 22K protein. Isolates with both reactivity patterns were isolated throughout the period studied. Isolates in the second group resembled the 8/60 subgroup B prototype strain in their lack of reactivity to subgroup A-specific monoclonal antibodies but were heterogeneous in P protein molecular weight. The earliest isolate only, made in 1965, possessed a P protein of Mr 31,000 resembling the prototype strain. All subsequent subgroup B isolates possessed a higher Mr, 33,000, P protein. Overall, subgroup A viruses were isolated most frequently although subgroup B strains may have predominated in some epidemics. PMID- 3681264 TI - Molecular cloning and sequencing of the F and 22K membrane protein genes of the RSS-2 strain of respiratory syncytial virus. AB - The nucleotide sequences of the adjacent genes coding for the F protein and 22K protein of the RSS-2 strain of human respiratory syncytial (RS) virus were determined from cDNA clones of genomic RNA. Comparison of these sequences and the inferred amino acid sequences of the F and 22K proteins with the corresponding published sequences of another subgroup A virus, the A2 strain of RS virus, reveals extensive overall homology (greater than 95%) at both the nucleotide and amino acid levels, even though these two viruses were isolated 15 years apart in different continents. The intergenic region and the hydrophobic amino-terminal signal sequence of the F proteins of the two viruses, however, are much less conserved. PMID- 3681265 TI - Augmentation of natural immune defence mechanisms and therapeutic potential of a mismatched double-stranded polynucleotide in cutaneous herpes simplex virus type 2 infection. AB - We studied the effect of an analogue of polyinosinic acid:polycytidylic acid, the mismatched poly(rI).poly(rC12U), on herpes simplex virus type 2 (HSV-2)-induced cutaneous disease in the guinea-pig. Recurrence patterns and HSV-2-induced immune responses were also defined. Intranasal administration (1.5 micrograms/g body weight, five doses at 48 h intervals) of poly(rI).poly(rC12U) during initial HSV 2 infection caused a significant (P less than 0.05) reduction in virus titres in the skin and decreased (P less than 0.01) the duration and severity of the primary cutaneous lesions. The incidence and frequency of subsequent recurrent episodes were also significantly (P less than 0.01) reduced. Titres of serum neutralizing antibody were identical in treated and untreated animals. Interferon (IFN) activity was detectable in the sera from poly(rI).poly(rC12U)-treated animals. Peripheral blood mononuclear (PBL) and spleen cells from treated animals had enhanced cytotoxic activity for HSV-2-infected and uninfected target cells. The cytotoxic activity of the PBL was enhanced by treatment in vitro with poly(rI).poly(rC12U) or IFN. PMID- 3681266 TI - Structural proteins of bovine coronavirus and their intracellular processing. AB - The Quebec isolate of bovine coronavirus (BCV) was found to contain four unique major structural proteins. These proteins consisted of the peplomeric protein (gp190/E2, gp100/E2), the nucleocapsid protein (p53/N) and its apparent trimer (p160/N), a family of small matrix glycoproteins (gp26/E1, gp25/E1 and p23/E1) and the putative haemagglutinin (gp124/E3). Pulse-chase experiments utilizing polyclonal antiserum and monoclonal antibodies indicated that the unique BCV E3 protein had its primary precursor an N-linked glycoprotein with an Mr of 59,000 (gp59) which underwent rapid dimerization by disulphide bond formation to yield gp118. Further glycosylation of gp118 produced gp124/E3 which incorporated fucose. Thus gp124/E3 was probably a homodimer. The processing of the E2 and E1 proteins of BCV was similar to that shown previously for mouse hepatitis virus. A large N-linked precursor glycoprotein, gp170, underwent further glycosylation to yield gp190/E2 before subsequent proteolytic cleavage to yield gp100/E2. The glycosylated E1 (gp26, gp25) proteins arose as a result of O-linked glycosylation of p23/E1 as indicated by the resistance of these species to tunicamycin. PMID- 3681267 TI - Activation of endogenous retroviral genomes in Mov strains of mice. AB - A collection of Mov mouse strains, each carrying in their germ line a Moloney murine leukaemia virus (M-MuLV) proviral genome at a different chromosomal location, was used to study expression of endogenous retroviruses. No M-MuLV specific RNA was detected in the non-viraemic Mov strains studied, indicating that less than two copies of RNA are transcribed per cell. Virus expression was seen in three viraemic Mov strains. In Mov-3 mice the provirus was activated shortly after birth, whereas proviruses in Mov-9 and Mov-14 were activated at different stages of embryogenesis. The results suggest that the chromosomal position influences proviral expression during development. The first appearance of virus particles was not accompanied by detectable amounts of viral transcripts, suggesting that viraemia is a consequence of provirus activation in a small, as yet unidentified, population of cells, followed by virus spread and infection of susceptible cells. PMID- 3681268 TI - AIDS in Louisiana. Epidemiology and current trends. PMID- 3681269 TI - AIDS in Louisiana. Projections and implications. PMID- 3681270 TI - AIDS in Louisiana. LSMS action: subcommittee on AIDS. PMID- 3681271 TI - AIDS in Louisiana. Programs at Charity Hospital. PMID- 3681272 TI - AIDS in Louisiana. Blood transfusions. PMID- 3681273 TI - AIDS in Louisiana. Your role in the AIDS epidemic: guidelines and resources for the Louisiana physician. PMID- 3681274 TI - AIDS in Louisiana. Transference and countertransference issues in the treatment of persons with AIDS. PMID- 3681275 TI - AIDS in Louisiana. Louisiana legislation. PMID- 3681276 TI - Attitudes toward narcotic addiction. AB - In an effort to isolate the major dimensions of attitude and expectation regarding narcotic addiction and its treatment and to compare different groups of addict/clients and agency staff on these factors, a comprehensive questionnaire was administered to 900 addict/clients and 237 agency personnel in 25 drug treatment clinics in six states. Results of a factor analysis, which used questionnaire data from all of the 1137 subjects so that direct group comparisons could be made, indicated the presence of 10 major dimensions of attitude and expectation. Results also suggested considerable variation, particularly by status (client vs. staff) and ethnic group, on these dimensions. An additional analysis of staff attitudes and expectations revealed correlations with years of education, ex-addict status, and years of work experience. Such findings suggest the need to consider client/staff characteristics and attitudes in the planning of treatment services for narcotic addicts. An abbreviated (53-item) attitude and expectation questionnaire was developed for this purpose. PMID- 3681277 TI - Histamine receptor antagonism of intolerance to alcohol in the Oriental population. AB - The Oriental flushing reaction is an adverse response to alcohol that appears to be genetically determined. In this study, the Oriental flushing reaction that was produced with ingestion of small amounts of alcohol was antagonized by antihistamine administration. A group of 17 subjects was tested. Each subject received placebo, diphenhydramine 50 mg (H-1 receptor antagonist), and cimetidine 300 mg (H-2 receptor antagonist) singularly and in combination. Alcohol was then administered orally. Most subjects given placebo experienced the typical flushing reaction that included a cutaneous flush, increase in skin temperature, decrease in blood pressure, increase in pulse rate and subjective symptoms such as dizziness, sleepiness, anxiety, headache, generalized weakness, and nausea. The flush, temperature and systolic hypotension were significantly blocked by the combined antihistamine administration. Cimetidine given alone blocked the flush, temperature increase, and systolic hypotension significantly more than diphenhydramine but less than the combined antihistamines. Diphenhydramine was similar to placebo in its effect on the flushing reaction. The role of histamine in the expression of tolerance to alcohol is not known. Antihistamine antagonism of the adverse flushing reaction suggests that histamine receptors may participate in the intolerance to ethanol in Orientals. Histamine may be an important protective factor in the low prevalence of alcoholism in Orientals. PMID- 3681278 TI - Is death from natural causes still excessive in psychiatric patients? A follow-up of 1593 patients with major affective disorder. AB - A follow-up of 1593 Iowans with major affective disorder showed excessive mortality from unnatural causes in primary and secondary depression, and bipolar depression, but not mania, compared with age- and sex-matched controls from the general population. Excessive death from natural causes was found in women with secondary unipolar depression and bipolar depression and in manics (men and women combined) who had concurrent organic mental disorders or serious medical illnesses. Natural death was not excessive in the absence of these conditions. We conclude that excessive natural death reported in psychiatric patients is due to complicating physical disorders and not to the primary psychiatric disorder per se, whereas excessive unnatural death is due to the psychiatric disorder. Also, psychiatrically ill persons are probably referred for hospitalization more frequently when complicating physical disorders are present. Finally, we conclude that mortality patterns were similar in patients with primary and secondary unipolar depression, but bipolar patients were at lower risk for unnatural death than were unipolar patients. PMID- 3681279 TI - Recovery style from mental illness and long-term outcome. AB - Integration and sealing over have been identified as clinically distinct recovery styles from schizophrenia. Specific definitions and scales of these styles were applied reliably to 231 patients from the Chestnut Lodge follow-up study at long term outcome (15 year average). Data were analyzed for the entire sample and for diagnostic subgroups: schizophrenia, schizoaffective and unipolar affective disorders, and schizotypal and borderline personality disorders. Results find that integration and sealing over are strongly correlated with functional outcome. While linked somewhat to type of psychopathology, these styles are best conceived as enduring personality trait characteristics in the nature of predictors. PMID- 3681280 TI - Preadolescent friendships recalled by the young adult. AB - Recall of a preadolescent chumship was studied in two groups of young adults of different socioeconomic status. In both groups a preadolescent chum of the same sex was the norm (65.7% to 71.4%). For a substantial minority (3.4% to 11.4%), a chum of the opposite sex was reported. PMID- 3681281 TI - Munchausen's syndrome: a reconceptualization of the disorder. AB - The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) delineates three categories of factitious disorders: chronic with physical symptoms (Munchausen's syndrome); factitious disorder with psychological symptoms; and other factitious disorders with physical symptoms. Munchausen's syndrome served as the prototype for all factitious disorders at the time DSM-III was drafted, partly due to the disproportionate attention given to this variant of the disorder. Clinical experience suggests that existing categories do not adequately provide for commonly seen forms of factitious illness. It is now recognized that factitious disorder is the result of a complex interaction of personality factors and psychosocial stressors that often present with both medical and psychiatric symptomatology. Proposed changes in the revised edition of the diagnostic manual DSM-III-R include separate categories of factitious disorder with psychological, physical, and both psychological and physical symptoms. A case report of a patient for whom extensive records and thorough psychological assessment were available is exemplary of a more common course of the disorder (both psychological and physical symptoms) that by current classification would be considered "atypical." A reconceptualization of the disorder that gives emphasis to course and clinical features is suggested. PMID- 3681282 TI - Adult psychosocial assets and depressive mood over time. Effects of internalized childhood attachments. AB - This paper discusses contrasting assumptions in psychiatric epidemiological research regarding the relative significance of childhood and adult social experiences as etiological factors in adult psychopathology. It delineates a set of hypotheses that relate internal parental representations to subsequent depressed mood and to psychosocial assets assumed to mediate the relationships between parental representations and mood states. These hypotheses were prospectively tested using a cohort of medical students surveyed at medical school entrance and 7 months later. The data show that earlier paternal affectivity perceived at time 1 is inversely predictive of time 2 depressed mood, holding time 1 mood constant, whereas earlier maternal and paternal overprotection perceived at time 1 are directly predictive of time 2 depressed mood, holding time 1 mood constant. In addition, parental representations at time 1 are significantly linked to particular personality characteristics at time 1 and 2. However, it is not clear whether these personality characteristics are antecedents or consequences of depressed mood. The paper concludes with a discussion of theoretical and methodological issues involved in the retrospective assessment of remote social experiences as etiological factors in adult psychopathology. PMID- 3681283 TI - Genital examination and exposure experienced as nosocomial sexual abuse in childhood. AB - Three pediatric cases of girls, one with idiopathic precocious puberty and two with a birth defect of the sex organs, exemplify the proposition that genital exposure and the physical examination of the genitals may be experienced subjectively as nosocomial sexual abuse. Negative sequelae persisted into adulthood. The dogma of the new victimology industry is that children never lie about sexual abuse. Consequently providers of pediatric and ephebiatric (pubertal and adolescent) sexual health care already are progressively at risk of being falsely accused of nosocomial (from the Greek nosokomeion, from nosos, disease, + komeion, to take care of: pertaining to or originating in a hospital, as nosocomial disease) sexual abuse. PMID- 3681284 TI - "The battered fetus syndrome". Preliminary data on the incidence of the urge to physically abuse the unborn child. AB - Recently published reports of physical assault by women in late pregnancy upon their unborn children have elicited a response of incredulity in many professionals. This response is identical to that which followed the publication of the first cases of child abuse in the 1960s. The present paper attempts a preliminary exploration of the incidence of the urge to "hurt or punish" the unborn child using a sample of 112 normal pregnant women and their male partners. Eight percent of the women and 4% of the men acknowledged experiencing such an urge. The male partner appeared to be aware of the woman's aggressive feelings toward the fetus and the male's reports tend to validate the female findings. Despite some methodological shortcomings, the findings suggest that the urge to physically assault the fetus is not rare. The need for further investigation of the phenomenon is highlighted, as it may well represent the earliest precursor of later physical child abuse. PMID- 3681285 TI - Comorbidity among childhood anxiety disorders. AB - This paper reports on 73 consecutive admissions to an outpatient anxiety disorder clinic for children and adolescents. Patients were evaluated with a structured diagnostic interview for primary and secondary disorders with DSM-III criteria in order to examine patterns of comorbidity. The most common primary diagnoses for the sample included separation anxiety disorder (33%), overanxious disorder (15%), social phobia of school (15%), and major depression (15%). Children with a primary diagnosis of separation anxiety disorders were most likely to receive a concurrent diagnosis of overanxious disorder. Alternatively, children with a primary diagnosis of overanxious disorder were most likely to receive an additional diagnosis indicative of a social anxiety problem, either social phobia or avoidant disorder. Children with a primary major depression most often exhibited social phobia and/or overanxious disorder. No clear-cut pattern of comorbidity emerged for the social phobic (school) group. These findings are discussed in terms of their comparability with results recently obtained from an adult anxiety clinic population. PMID- 3681286 TI - An approach to the delineation of adult attachment. Scale development and reliability. AB - The authors present the results of a project to develop scales to measure the features of adult attachment using a construct-oriented approach. Adult attachment is defined in terms of eight features: proximity seeking, secure base effect, separation protest, feared loss of the attachment figure, reciprocity, availability, responsiveness of the attachment figure, and use of the attachment figure. Each feature was defined and a large item pool to tap all dimensions was derived from item nominations by clinicians, researchers, and lay subjects. The resultant scales were administered to a small sample for preliminary empirical testing. Analyses of internal reliability for each scale resulted in the elimination of items that detracted from reliability. After editing, all scales had satisfactory internal consistency. A discriminant-functions analysis provided suggestive evidence that this method of defining and measuring adult attachment would have relevance for identifying psychopathology. PMID- 3681287 TI - Amino acid levels in human CSF after generalized seizure. AB - We studied the possible role of excitatory and inhibitory amino acids and their balance during generalized convulsions. The levels of amino acids in postictal cerebrospinal fluid (CSF) were compared with amino acid concentrations in interictal CSF of ten patients with generalized tonic-clonic convulsions. Glu, Gln, Asp, Asn, Tau, Gly, total GABA (t-GABA), free GABA (f-GABA), and homocarnosine levels and Glu/Gln, Asp/Asn, t-GABA/Glu, f-GABA/Glu, f-GABA/Asp, and Glu/Asp ratios were similar in both samples (Student's paired t-test). Our results suggest that in humans possible changes in amino acids in brain tissue during the ictal stage are not reflected in the lumbar CSF. PMID- 3681288 TI - Sex difference in the turnover of GABA in the rat substantia nigra. AB - The turnover of GABA (estimated from the post-mortem accumulation of GABA), and the activity of glutamic acid decarboxylase and GABA transaminase, along with the saturation of both enzymes by cofactor pyridoxal phosphate, were studied in the substantia nigra of rats of both sexes. Although no sex differences were found in the in vitro measured characteristics of both enzymes involved in GABA metabolism, the turnover of GABA was greater in males. This finding is consistent with our previous reports showing the greater resistance of male rats to GABA related convulsions. PMID- 3681289 TI - Are periodic movements in sleep a basal ganglia dysfunction? AB - Muscle activity during sleep is a new area of interest in sleep research. No precise brain structures are known to be involved in sleep movement. The etiology of periodic movements during sleep is unknown. The present study was dedicated to evaluate involvement of basal ganglia in periodic movements of the legs during sleep (PMS) in Parkinson's diseased patients. Sleep was monitored in 3 patients suffering from Parkinson's disease and PMS (PMS/PD) and in 3 patients suffering from restless legs syndrome and PMS (PMS/non PD). Following treatment, the six patients were monitored again during sleep. It was found that only the PMS/PD group of patients had improved significantly with appropriate treatment. Improved motor function in PD patients is associated with decreased PMS, regardless of wether the patients are treated with dopaminergic or anticholinergic agents. This is consistent with our previous data. It may be suggested that the striopallidal system is involved in periodic sleep movements of Parkinson's diseased patients. PMID- 3681290 TI - Do tetrahydroaminoacridine (THA) and physostigmine restore acetylcholine release in Alzheimer brains via nicotinic receptors? AB - In the presence of 9-amino-1,2,3,4-tetrahydroacridine (THA) 10(-4) M or physostigmine 10(-4) M, the in vitro 3H-Acetylcholine (3H-ACh) release from control cortical slices was significantly reduced. In contrast, THA 10(-4) M and physostigmine 10(-4) M significantly increased the release of 3H-ACh in AD/SDAT brain tissue. This facilitating effect on 3H-ACh release was partially blocked (50%) in the presence of the nicotinic antagonist d-tubocurarine 10(-6) M indicating a possible interaction via nicotinic receptors. The muscarinic antagonist atropine 10(-5) M significantly increased the 3H-ACh release both in control and AD/SDAT brains, thus indicating preservation of muscarinic autoreceptors in the AD/SDAT cortical tissue. In receptor competition studies with 3H-nicotine, 3H-ACh and 3H-quinuclidinyl benzilate (3H-QNB) as receptor ligands, THA interfered with both nicotinic and muscarinic receptor ligand binding, while physostigmine had much less effect. PMID- 3681291 TI - Histochemistry of MAO-A and MAO-B in the locus coeruleus of the Mongolian gerbil. AB - A coupled peroxidation technique for localization of monoamine oxidase (MAO-A and MAO-B), applied to post-mortem fixed tissue of the locus coeruleus of the Mongolian gerbil is demonstrated. Tyramine hydrochloride, beta-phenylethylamine and 5-hydroxytryptamine creatinine sulphate were used as substrates, 1-deprenyl and clorgyline served as specific inhibitors. All three substrates stained the neurons of locus coeruleus in the absence of inhibitor. In the presence of 1 deprenyl, tyramine hydrochloride and 5-hydroxytryptamine creatinine sulphate were metabolized, whereas in the presence of clorgyline no reaction with either substrate could be observed. Immunocytochemical staining of tyrosine hydroxylase (TH) was employed as comparison. PMID- 3681292 TI - Histamine affects release and biosynthesis of opioid peptides primarily via H1 receptors in bovine chromaffin cells. AB - Histamine is a potent secretagogue for opioid pentapeptides (Met- and Leu enkephalin) in adrenal chromaffin cells in vitro. This effect is dependent on extracellular Ca2+ and is reduced by Ca2+ channel blockers such as Co2+, D 600, and nifedipine. Moreover, histamine also produced a profound compensatory increase in cellular peptide content after 48 h of exposure, most likely caused by a four- to fivefold increase in the mRNA levels coding for the proenkephalin A precursor. All the histamine-induced effects (acute release, changes in peptide cell content, proenkephalin A mRNA levels) are antagonized by the H1-receptor antagonist, clemastine, whereas the H2-receptor antagonists, ranitidine and cimetidine, were less effective (approximately 20% inhibition). PMID- 3681293 TI - Phosphorylation of proteins in normal and regenerating goldfish optic nerve. AB - Within 6 h after radiolabeled phosphate was injected into the eye of goldfish, labeled acid-soluble and acid-precipitable material began to appear in the optic nerve and subsequently also in the lobe of the optic tectum, to which the optic axons project. From the rate of appearance of the acid-precipitable material, a maximal velocity of axonal transport of 13-21 mm/day could be calculated, consistent with fast axonal transport group II. Examination of individual proteins by two-dimensional gel electrophoresis revealed that approximately 20 proteins were phosphorylated in normal and regenerating nerves. These ranged in molecular weight from approximately 18,000 to 180,000 and in pI from 4.4 to 6.9. Among them were several fast transported proteins, including protein 4, which is the equivalent of the growth-associated protein GAP-43. In addition, there was phosphorylation of some recognizable constituents of slow axonal transport, including alpha-tubulin, a neurofilament constituent (NF), and another intermediate filament protein characteristic of goldfish optic axons (ON2). At least some axonal proteins, therefore, may become phosphorylated as a result of the axonal transport of a phosphate carrier. Some of the proteins labeled by intraocular injection of 32P showed changes in phosphorylation during regeneration of the optic axons. By 3-4 weeks after an optic tract lesion, five proteins, including protein 4, showed a significant increase in labeling in the intact segment of nerve between the eye and the lesion, whereas at least four others (including ON2) showed a significant decrease. When local incorporation of radiolabeled phosphate into the nerve was examined by incubating nerve segments in 32P-containing medium, there was little or no labeling of the proteins that showed changes in phosphorylation during regeneration. Segments of either normal or regenerating nerves showed strong labeling of several other proteins, particularly a group ranging in molecular weight from 46,000 to 58,000 and in pI from 4.9 to 6.4. These proteins were presumably primarily of nonneuronal origin. Nevertheless, if degeneration of the axons had been caused by removal of the eye 1 week earlier, most of the labeling of these proteins was abolished. This suggests that phosphorylation of these proteins depends on the integrity of the optic axons. PMID- 3681294 TI - Effects of nucleus basalis lesions on the muscarinic and nicotinic modulation of [3H]acetylcholine release in the rat cerebral cortex. AB - Presynaptic muscarinic and nicotinic receptors in the cerebral cortex reportedly inhibit and increase acetylcholine (ACh) release, respectively. In this study, we investigated whether these receptors reside on cholinergic nerve terminals projecting to the cerebral cortex from the nucleus basalis magnocellularis (nbm). Adult male rats received unilateral infusions of ibotenic acid (5 micrograms/1 microliter) in the nbm. Two weeks later, cerebral cortical cholinergic markers (choline acetyltransferase activity, high-affinity choline uptake, and coupled ACh synthesis) were significantly reduced in synaptosomes prepared from the lesioned hemispheres compared to contralateral controls. The depolarization induced release of [3H]ACh from these synaptosomes was also reduced in the lesioned hemispheres, reflecting the reduced synthesis of transmitter. However, the nbm lesions had no effect on the inhibition of release induced by 100 microM oxotremorine. Synaptosomal [3H]ACh release was not altered by nicotine or the nicotinic agonists anabaseine and 2-(3-pyridyl)-1,4,5,6-tetrahydropyrimidine. Nicotine (10-100 microM) did increase [3H]ACh release in control and lesioned hemispheres in cortical minces, but to a similar extent. These results suggest that neither muscarinic nor nicotinic receptors modulating ACh release reside on nbm-cholinergic terminals. PMID- 3681295 TI - Biosynthesis and expression of gangliosides during differentiation of chick embryo retina cells in vitro. AB - Cells from neural retina from 7-day chick embryos were cultured on polylysine coated dishes up to 7 days. The small, round-shaped cells at seeding differentiated progressively, and after 4 days in vitro the majority had enlarged bodies and abundant processes. The content of protein and DNA was essentially unchanged during the entire period of culture. The incorporation of radioactivity from [3H]glucosamine into gangliosides declined slightly, reaching about 65% of the initial values at the end of the culture period. The proliferating activity measured by the incorporation of [3H]thymidine into DNA decreased to 10% or less of the initial value after 3 days in vitro. Almost at the same chronological times as in ovo, the synthesis of GD3 and of a ganglioside partially identified as GT3 decreased from 70 and 19% of the total incorporation into gangliosides in the first 20 h of culture to about 7 and 5%, respectively, after 3 days in vitro. Conversely, the synthesis of GD1a increased from about 6% at the beginning to about 70% at the end of the culture times. Immunocytochemical analyses of the expression of gangliotetraosyl gangliosides in cultured cells showed that these gangliosides appeared in the bodies and processes of cells having neuronal morphology; very little immunostaining of the scarce flattened cells, probably Muller cells, was found. The results indicate that the changes in ganglioside metabolism, which lead to decreased synthesis of gangliosides lacking the galactosyl-N-acetyl-galactosaminyl disaccharide end and to increased synthesis of gangliotetraosyl gangliosides, occur in cells that in culture differentiate into neurons. PMID- 3681296 TI - Large alterations in ganglioside and neutral glycosphingolipid patterns in brains from cases with infantile neuronal ceroid lipofuscinosis/polyunsaturated fatty acid lipidosis. AB - Lipid composition was studied on cerebral tissue from nine children who had died of a progressive encephalopathy called the infantile form of neuronal ceroid lipofuscinosis (INCL) or polyunsaturated fatty acid lipidosis (PFAL). In the terminal stage of the disease, the concentrations of all lipid classes were found to be significantly reduced in the cerebral and cerebellar cortex and white matter. The concentration of gangliosides of the cerebral cortex was 15% and that of cerebrosides (galactosylceramide) in white matter 0.2-5% of the normal values for the children's ages. The reduction of gangliosides mainly affected those of the gangliotetraose series, particularly GD1a. The fatty acids of the linolenic acid series were strongly reduced in ethanolamine and serine phosphoglycerides. A very large increase up to 100-fold of oligoglycosphingolipids of the globo series and two fucose-containing lipids of the neolacto series was found in the forebrain of the three advanced cases examined. The brain tissue also contained very high concentrations of mono-, di-, and trisialogangliosides of the lacto and neolacto series, gangliosides with type 1 chain dominating. The structures of the gangliosides were tentatively identified by gas chromatography-mass spectrometry and monoclonal antibodies with carefully determined epitope specificity. The gangliosides and neutral glycosphingolipids had very similar fatty acid composition, consisting of about 40% stearic acid and 40% C24-acids. PMID- 3681297 TI - Presence of the novel pituitary protein "7B2" in bovine chromaffin granules: possible co-release of 7B2 and catecholamine as induced by nicotine. AB - We observed the presence of the novel pituitary protein "7B2" and its release in the bovine adrenal medulla. The 7B2 concentration (mean +/- SEM) in extracts of the bovine adrenal medulla was 952 +/- 155 pg/mg tissue (n = 6). 7B2 was distributed in the chromaffin granule fraction prepared from the bovine adrenal medulla and was released by high K+ and/or nicotine from cultured cells of the bovine adrenal medulla. Co-release of 7B2 with catecholamine induced by nicotine from the cultured bovine chromaffin cells was also observed. In an analysis of the bovine adrenal medulla chromaffin granule fraction on gel permeation chromatography, there was a major peak with an apparent molecular weight of 45,000, whereas a major peak with an apparent molecular weight of 20,000 was found in that on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. On reverse-phase HPLC, a major peak with a retention time of 35 min was observed in the bovine chromaffin granule fraction and in the bovine anterior pituitary extract. These findings indicate that 7B2 is a secretory protein in the bovine adrenal medulla. The possibility that 7B2 might be released with catecholamine, possibly in response to stress, warrants investigation. PMID- 3681298 TI - Mutations affecting acetylcholine levels in the nematode Caenorhabditis elegans. AB - Gene cha-1.unc-17 of the nematode Caenorhabditis elegans is a complex gene, consisting of at least two complementation groups. One part (cha-1 region) of the gene encodes the enzyme choline acetyltransferase (ChAT), but the function of the other part (unc-17 region) is still unclear. We measured the ChAT activity and ACh levels of the cha-1 and unc-17 complex gene mutants. We show here that alterations in ACh levels, rather than the ChAT activity, reflect abnormal phenotypes accompanying cha-1.unc-17 mutations, that is, the decreased ACh levels in cha-1 mutations and abnormal accumulation in unc-17 mutations. Our results suggest that the unc-17 region may encode functions necessary for storage and/or release of ACh at the presynaptic level. PMID- 3681299 TI - Peptide E and its products, BAM 18 and Leu-enkephalin, in bovine adrenal medulla and cultured chromaffin cells: release in response to stimulation. AB - Peptide E is a 25 amino acid opioid peptide which, if cleaved at the sole double basic (Lys-Arg) typical processing site, would generate two opioid fragments, the amino-terminal fragment BAM 18 and the carboxy-terminal fragment Leu-enkephalin. We have analysed extracts of bovine adrenal medulla in order to quantify these three opioid peptides (peptide E, BAM 18, and Leu-enkephalin). Here we present evidence that BAM 18 and Leu-enkephalin were present in similar amounts, whereas peptide E was present at a higher concentration. This is consistent with previous observations showing a preferential accumulation of larger peptides in the bovine adrenal, and also with the Lys-Arg bond being the principal site of cleavage of peptide E. However, when bovine adrenal chromaffin cells were maintained in culture for several days, Leu-enkephalin was found to be present in much greater amounts than was BAM 18-like immunoreactivity. The molar amounts of peptide E still exceeded the estimated levels of BAM 18 and Leu-enkephalin. We provide evidence that under conditions of basal release BAM 18 and peptide E were released, whereas Leu-enkephalin was released in much smaller amounts, if at all. On stimulation with nicotine results were consistent with an increased release of all three peptides with a preferential stimulation of Leu-enkephalin release. Under all conditions, the molar amounts of peptide E released apparently exceeded that of the other peptides. The results are discussed in terms of the regulation of partial proteolysis and the fate of peptide E. PMID- 3681300 TI - Complex carbohydrate composition of large dense-cored vesicles from sympathetic nerve. AB - Highly purified noradrenergic, large, dense-cored vesicles were isolated from bovine sympathetic nerve endings by sucrose-D2O density gradient centrifugation. Their concentration of glycoprotein hexosamine and sialic acid was 6.6 and 3.9 mumol/100 mg lipid-free dry weight, respectively, values which are similar to those previously found in bovine chromaffin granules. However, whereas chromaffin granule glycoproteins are characterized by their high proportion of N acetylgalactosamine-containing O-glycosidically-linked oligosaccharides (present in the chromogranins), such oligosaccharides accounted for only 17% of those in noradrenergic synaptic vesicle glycoproteins. Fractionation of N-3H-acetylated glycopeptides by sequential lectin affinity chromatography demonstrated that approximately two-thirds of the oligosaccharides were of the tri- and tetraantennary complex type, accompanied by 14% biantennary oligosaccharides and 3% high-mannose oligosaccharides. The vesicles had a relatively low concentration of chondroitin sulfate (less than 5% of that in chromaffin granules) but significant amounts of heparan sulfate (0.4 mumol N-acetylglucosamine/100 mg lipid-free dry weight). No hyaluronic acid was detected. The concentration of ganglioside sialic acid in the noradrenergic vesicles was approximately 1 mumol/100 mg lipid-free dry weight, which is significantly higher than that of a crude membrane mixture from which the vesicles were prepared; the ratio of N acetyl- to N-glycolylneuraminic acid was 0.8. Several molecular species of gangliosides were detected by thin-layer chromatography, but most of these did not exactly comigrate with bovine brain gangliosides. Cholera toxin binding indicated that approximately half or less of the gangliosides belong to the gangliotetraose series. PMID- 3681301 TI - Rapid degradation of neurotensin by intact murine neuroblastoma cells (clone N1E 115). AB - Murine neuroblastoma clone N1E-115, which possesses receptors for neurotensin mediating the formation of intracellular cyclic GMP and the stimulation of inositol phospholipid hydrolysis, exhibited only partial desensitization to neurotensin. This result led to the observation that neurotensin was very rapidly degraded by intact N1E-115 cells. In experiments measuring the time course of [3H]neurotensin degradation, a minimum of six major tritiated products were found, with the breakdown peptides formed and the degree of proteolysis of [3H]neurotensin being dependent upon the length of incubation and the concentration of cells. Clone N1E-115 degraded [3H]neurotensin in an apparently sequential fashion; the primary initial cleavage of intact neurotensin was at the peptide bond between residues Arg8 and Arg9. Initial degradation peptides from the active carboxyl-terminal portion of neurotensin were more rapidly degraded, after formation, than were the peptides from the inactive amino-terminal half of neurotensin. The final two degradation products found were tyrosine, from the carboxyl-terminal portion of neurotensin, and an as yet unidentified peptide from the amino-terminal half of neurotensin. [3H]Neurotensin(8-13) was more rapidly hydrolyzed under identical conditions than was [3H]neurotensin itself. A combination of the protease inhibitors 1,10-phenanthroline and Z-Pro-Prolinal was able to inhibit almost completely the degradation of neurotensin by clone N1E 115. PMID- 3681302 TI - Increased concentrations of 3-hydroxykynurenine in vitamin B6 deficient neonatal rat brain. AB - Increased concentrations of the endogenous tryptophan metabolite 3 hydroxykynurenine (3-HK) were measured in the brains of vitamin B6 deficient neonatal rats. Mean concentrations of 3-HK in B6 deficient cerebellum, corpus striatum, frontal cortex, and pons/medulla ranged from 9.7 to 18.6 and 102 to 142 nmol/g of wet tissue at 14 and 18 days of age, respectively. 3-HK was not significantly increased in control neonatal or adult rat brain, vitamin B6 deficient rat brain at 7 days of age, or in brains from adult rats deprived of vitamin B6 for 58 days. The administration of daily intraperitoneal injections of vitamin B6 from the 14th to the 18th day of age decreased the concentration of 3 HK to control levels. 3-HK has been shown by other investigators to produce seizures when injected into the cerebral ventricles of adult rodents. Thus, our studies show the accumulation in brain of a putative endogenous convulsant as the result of a nutritional deficiency. PMID- 3681303 TI - The location of descending fibres to sympathetic preganglionic vasomotor and sudomotor neurons in man. AB - Evidence is given of the location in the spinal cord of man of the central sympathetic fibres supplying vasomotor and sudomotor neurons of the body caudal to the head and neck. The evidence is based on anterolateral cordotomies. The fibres lie within the medial part of the equatorial plane, extending from the base of the posterior horn and the lateral horn across the medial half of the white matter. The evidence from a previous paper together with that of the present paper is that the pathway maintains this position throughout the spinal cord as far as the L2 segment. The sympathomotor fibres caudal to the head and neck are supplied from both sides of the cord: sympathetic activity is not removed, although it may be slightly diminished, by a hemisection of the cord. The evidence suggests that sympathetic fibres for vasomotor control leave the cord cranial to the Th 7 segment. The knowledge of the location of the pathways is of value to neurosurgeons so that they may be avoided in the operation of anterolateral cordotomy. PMID- 3681304 TI - Psychomotor slowing and subcortical-type dysfunction in depression. AB - Elderly patients with major depression and normal controls completed the Sternberg short-term memory scanning procedure and WAIS Digit Symbol. Depressed patients demonstrated psychomotor slowing on both tasks, but normal response latency as a function of memory set size on the Sternberg procedure. While cognitive-behavioural slowing may be observed in both depressive illness and subcortical neurological disorders, a normal rate of processing information centrally appears to distinguish depression from certain of these disorders. Psychomotor slowing in the presence of normal information processing speed might be explained by a deficit in motivational state associated with depression. PMID- 3681305 TI - Programming and execution of sequential movements in Parkinson's disease. AB - In separate blocks of a simple reaction time (RT) task, eight Parkinsonian and eight control subjects executed finger press sequences with one (index finger), two (index finger-ring) or three (index finger-ring-middle) components. Programming was inferred from the increase latency to initiate the first component as a function of the length of the entire sequence; and from the systematic decrease in inter-response latencies for the second and third components. Overall RT was slower in the Parkinsonians but the programming effects were comparable in the two groups. Intact basal ganglia function appears not to be necessary for programming sequential finger movements, or retrieving subprograms for execution. PMID- 3681306 TI - Performance of a bimanual load-lifting task by parkinsonian patients. AB - Normal subjects and Parkinsonian patients performed a bimanual load lifting task. In this task, one "postural" forearm, held in a horizontal position while supporting a 1 kg weight, was unloaded either by the experimenter's hand (imposed unloading) or by the subject's other hand in response to a tone burst (voluntary unloading). The variables recorded were reaction time (RT: time interval between the tone and beginning of unloading) and movement time (MT: duration of the change in force measured by a force platform on the "postural" forearm). Elbow angle changes were also measured with a potentiometer. The EMG activity from brachioradialis of the "postural" arm and that from the biceps of the "active" arm were recorded. The Parkinsonian patients showed an increase in both RT and MT and an impairment of the co-ordination between movement and posture which was reflected in an increase in amplitude of the elbow rotation after voluntary unloading. Moreover, the decrease in EMG activity in the brachioradialis of the postural arm during unloading was less in Parkinsonian patients than in the normal group. This disorder of postural command was often accompanied by a lack of anticipatory EMG changes. Comparison between treated and non-treated patients showed that dopamine agonists brought about recovery of both RT and MT but did not improve postural co-ordination. The co-ordination was less impaired when the voluntary unloading was performed by the preferred hand. Several hypotheses are discussed concerning the mechanism underlying this impaired co-ordination. PMID- 3681307 TI - Magnetic resonance images related to clinical outcome after psychosurgical intervention in severe anxiety disorder. AB - Postoperative verification of radiosurgical lesions in white matter has been difficult to obtain with CT. With magnetic resonance (MR) imaging, however, lesions could be demonstrated in patients undergoing a psychosurgical procedure, gamma capsulotomy, for anxiety disorder. The appearance and location of the lesions were related to the irradiation dose and to the long-term clinical outcome studied prospectively by two independent evaluators who had not been involved in the selection or the treatment of the patients. Seven consecutive cases were examined. CT was also included for comparison reasons. Lesions were clearly visible with MR in patients who improved after surgery. Conversely, lesions were inadequate in cases who did not benefit. MR proved to be more accurate than CT both in detecting the lesions and in defining their configuration. The observations argue for the use of MR for post-operative verification of radiosurgical lesions. MR may facilitate the determination of a clinically effective radiation threshold estimate for radiosurgical lesions, which should be of value for the planning of studies of this type of limbic system surgery. PMID- 3681308 TI - Correlations between cerebral blood flow variations and clinical parameters in temporal lobe epilepsy: an interictal study. AB - Regional cerebral blood flow (rCBF) measurements were determined by the intravenous Xenon 133 technique in 80 patients suffering from temporal lobe epilepsy. All the patients had a normal CT scan. Three subgroups were differentiated, according to EEG and all-night polygraphic recordings: temporal lobe epilepsy with left (N = 25) or right (N = 25) EEG epileptic abnormalities and temporal lobe epilepsy with EEG abnormalities in both temporal regions with asynchronous occurrence (n = 30). In comparison with a control group (n = 20), there was (1) a marked reduction of blood flow in the temporal region corresponding to the site of the epileptic focus and (2) a reduction in blood flow in distant brain areas and the contralateral hemisphere. The rCBF decrease was highly correlated (p less than 0.001) with the disease severity (taking into account the complex partial seizure frequency and the number of secondary generalised seizures). Differences were found in the rCBF decrease between left and right temporal lobe epilepsy. PMID- 3681309 TI - A comparative evaluation of the short orientation memory concentration test of cognitive impairment. AB - In order to assess the relative sensitivity and specificity of Katzman's short orientation memory concentration test (OMCT), 89 non demented patients and 44 patients affected by vascular or degenerative dementia were consecutively evaluated by three different mental status tests. The OMCT appeared equivalent to the Mini Mental State Examination in identifying dementia. Optimum sensitivity and specificity, respectively 88% and 94%, were achieved by a 10/11 cut-off score, giving a 11% false positive rate. Among patients with Alzheimer's disease, the OMCT score was correlated with mean values of a simple reaction time. It was also correlated with the Wechsler global MQ and the orientation, logical memory and paired associates items of the scale. There was no relationship between the OMCT score and the coloured Progressive Matrices IQ. The OMCT was reliable when given at 1 month interval. Serial evaluations did not show any significant practice effect. PMID- 3681310 TI - Brainstem auditory evoked potential abnormalities in myelomeningocoele in the older child. AB - Brainstem auditory evoked potentials and clinical findings were examined in 18 children over the age of 5 years who were born with myelomeningocoele which was closed at birth, and whose hydrocephalus was managed by long term shunting in most of them. The potentials were compared with age and sex matched normal subjects and with four patients with hydrocephalus only. All but one had an abnormal brainstem auditory evoked potential with 72% showing a delay in the II-V and I-V interpeak latencies of more than three standard deviations. It is proposed that the abnormalities are a reflection of brainstem dysgenesis which is part of an associated Arnold-Chiari malformation, though the malformation was clinically asymptomatic in all. The usefulness of the brainstem auditory evoked potential for assessing the course of hydrocephalus and for predicting symptomatic Arnold-Chiari malformation is questioned. PMID- 3681311 TI - Intracranial stimulation of the trigeminal nerve in man. III. Sensory potentials. AB - Percutaneous electrical stimulation of the trigeminal root was performed in 18 subjects undergoing surgery for idiopathic trigeminal neuralgia or implantation of electrodes into Meckel's cave for recording of limbic epileptic activity. All subjects had normal trigeminal reflexes and evoked potentials. Sensory action potentials were recorded antidromically from the supraorbital (V1), infraorbital (V2) and mental (V3) nerves. In the awake subject, sensory potentials were usually followed by myogenic artifacts due to direct activation of masticatory muscles or reflex activation of facial muscles. In the anaesthetised and curarised subject, sensory potentials from the three nerves showed 1.4-2.2 ms onset latency, 1.9-2.7 ms peak latency and 17-29 microV amplitude. Sensory conduction velocity was computed at the onset latency (maximum CV) and at the peak latency (peak CV). On average, maximum and peak CV were 52 and 39 m/s for V1, 54 and 42 m/s for V2 and 54 and 44 m/s for V3. There was no apparent difference in CV between subjects with trigeminal neuralgia and those with epilepsy. A significant inverse correlation was found between CV and age, the overall maximum CV declining from 59 m/s (16 years) to 49 m/s (73 years). This range of CV is compatible both with histometric data and previous electrophysiological findings on trigeminal nerve conduction. Intraoperative intracranial stimulation is also proposed as a method of monitoring trigeminal function under general anaesthesia. PMID- 3681312 TI - A calcium blocking and anticholinergic agent (terodiline) in the treatment of detrusor hyperreflexia: a placebo-controlled, cross-over trial. AB - In 25 neurological patients with detrusor hyperreflexia terodiline reduced the number of total micturitions during daytime. Bladder capacity was increased and amplitude of the bladder contractions was reduced. An increase in residual urine was also observed. Mild anticholinergic side-effects were measured on pupillary motility and on heart rate variation. It is concluded that terodiline is a useful alternative in treatment of patients with detrusor hyperreflexia. PMID- 3681313 TI - Peripheral nerve function in patients with painful diabetic neuropathy treated with continuous subcutaneous insulin infusion. AB - In order to study the effects of improved metabolic control on painful diabetic polyneuropathy, 15 patients were treated with continuous subcutaneous insulin infusion over a 12 month period. Polyneuropathy was assessed by pain score, neurological examinations, nerve conduction studies and determination of sensory thresholds and cardiovascular reflexes. Improved metabolic control was confirmed by significantly improved levels of glycosylated haemoglobin (11.7 +/- 0.3% at entry to the study, to 8.7 +/- 0.3% after 12 months; mean +/- SEM). Symptomatic relief was confirmed by significantly improved pain scores. Thresholds for thermal cutaneous sensation improved significantly from 6.0 +/- 0.8 degrees C at entry to the study to 2.7 +/- 0.7 degrees C after 12 months (mean +/- SEM). These findings suggest a selective improvement of peripheral small nerve fibre function after continuous subcutaneous insulin infusion. The importance of quantitating thermal cutaneous sensation in longitudinal studies of patients with diabetic neuropathy was confirmed. PMID- 3681314 TI - Biochemical studies in mitochondrial encephalomyopathy. AB - The alpha-keto acid dehydrogenase complex and its component enzymes, lactate dehydrogenase, pyruvate carboxylase, cytochrome c oxidase, succinate-cytochrome c reductase, NADH-cytochrome c reductase, and the concentration of cytochromes and enzymes of beta-oxidation in muscle from a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes were studied and no specific defect was found. These results raise the possibility that the mitochondrial changes in the patient may be secondary. PMID- 3681315 TI - Proximal weakness of the extremities as main feature of amyloid myopathy. AB - Two patients with muscle weakness caused by amyloid myopathy are described. Characteristic features such as pseudohypertrophy and abnormal firmness, and tumours of muscles were absent. It is suggested that muscle weakness in amyloid myopathy is caused by layers of amyloid covering muscle fibres. In middle aged or elderly patients with proximal muscle weakness the diagnosis of amyloid myopathy should be considered. PMID- 3681316 TI - Erections on walking as a symptom of spinal canal stenosis. AB - Two patients reported that on walking they developed tingling and weakness of the legs and penile erections. The symptoms proved to be due to stenosis of the lumbar were canal, and were relieved by operative decompression. PMID- 3681317 TI - ECG abnormalities in patients with subarachnoid haemorrhage and intracranial tumours. AB - The incidence of and possible factors influencing ECG abnormalities were analysed in one patient group with subarachnoid haemorrhages (n = 406) and another with intracranial tumours (n = 400). The highest incidence of each ECG abnormality was always found in the patients with subarachnoid haemorrhages. In this group an ECG pattern, possibly attributable to the cerebral disease and comprising abnormalities of the T and U waves and prolongation of the Q-Tc interval, was frequently identified. PMID- 3681318 TI - Ligature injury to the accessory nerve. PMID- 3681319 TI - Smoking and dementia of Alzheimer type. PMID- 3681320 TI - Listeria monocytogenes infection with rhombencephalitis. PMID- 3681321 TI - Asymmetry of pathology in Alzheimer's disease. PMID- 3681322 TI - 74 year old lady who developed bilateral parkinsonism secondary to an intrinsic cerebral tumour. PMID- 3681323 TI - Computed tomographic findings of brain and skull in myotonic dystrophy. PMID- 3681324 TI - Aphemia as a first symptom of multiple sclerosis. PMID- 3681325 TI - Palatal myoclonus influenced by neck posture. PMID- 3681326 TI - Adult adrenoleukodystrophy: a sporadic case? AB - This is a report of a case of the adult cerebral form of X-linked ALD. The 27 year-old patient presented with psychiatric disturbances. NMR was performed and compared to CT scan to define cerebral demyelination. The level of hexacosanoate was found to be increased in the patient's serum. Biochemical analysis of the patient's mother's serum and cultured fibroblasts and of serum samples from 10 other members of the family who could have been carriers of this X-linked disease, produced negative results. Hence, it is most likely that this case has occurred sporadically. HLA determination revealed the DR2 antigen which is often associated with multiple sclerosis. PMID- 3681327 TI - Reversible capsulo-tegmental locked-in state as first manifestation of multiple sclerosis. AB - An 18-year-old girl developed a reversible locked-in state with bilateral ptosis and almost complete ophthalmoplegia. She later presented with a relapsing and remitting course suggestive of multiple sclerosis. Autopsy findings demonstrated bilateral capsular and tegmental demyelinating lesions. In addition to this unusual aetiology, this is the first report with pathological evidence of a locked-in syndrome due to lesions outside the ventral brainstem. PMID- 3681328 TI - The numbers of unmyelinated and myelinated axons in normal and regenerated rat saphenous nerves. AB - Counts have been made of the numbers of unmyelinated and myelinated axons in the proximal and distal stumps of regenerated rat saphenous nerves and from equivalent sites in normal nerves. In the proximal part of normal nerves there were averages of 1,045 myelinated axons and 4,160 unmyelinated ones. Regenerated nerves contained the same number of myelinated axons in their proximal stumps but there was a 40% reduction in the unmyelinated axon count. In the distal stumps of these nerves the myelinated axon count had increased by an average of 620; this comes about because some regenerated myelinated axons support more than one process in the distal stump. In contrast, the number of unmyelinated axons was reduced further, from a mean of 2,476 in the proximal stump to one of 2,219. The sizes of Schwann cell units in the normal and regenerated nerves were also noted. Schwann cell units in the proximal and distal stumps of the regenerated nerves were smaller than those in the normal ones. These changes associated with unmyelinated axons in regenerated nerves are likely to contribute to the sensory, vasomotor and sudomotor abnormalities that sometimes occur after peripheral nerve injury and regeneration. PMID- 3681329 TI - Isolation of the insoluble straight fibrils of Pick's disease. AB - This paper describes the isolation and partial purification of the straight fibrils that occur in the neurons of Pick's disease. Pick fibrils are highly insoluble in a variety of solvents. These fibrils were shown to be sodium dodecyl sulfate insoluble even in the presence of a reducing agent at elevated temperatures. This allowed the selective isolation of the fibrils using the SDS boiling procedure and sucrose gradient centrifugation that have been described for isolation of paired helical filaments of Alzheimer's disease. The isolated fibrils retained the native morphology seen in tissue sections, but some appeared to become unraveled to yield a paired helical appearance. These results indicate that the Pick fibrils have many chemical and structural characteristics in common with Alzheimer paired helical filaments, and suggest that these two diseases may be closely related. PMID- 3681330 TI - The epidemiology of multiple sclerosis in Queensland, Australia. AB - An epidemiological survey of multiple sclerosis (MS) in the State of Queensland was undertaken with its prevalence day being the national census day on June 30th, 1981, 20 years after a regional survey within the State. The relationship between increasing prevalence of MS and increasing south latitude within the State of Queensland which was suggested by the 1961 study was confirmed in the present study. The prevalence rate had increased significantly over the 20-year period between the studies but the State remained a medium frequency zone for MS (prevalence rate between 5 and 29 per 100,000 of population). Although a real increase in disease frequency could not be excluded as a contributing factor to the rise in prevalence, it was most likely due predominantly to an increase in life expectancy amongst the MS population and also in differential migration of a population at a greater risk of developing MS than the indigenous population. The proportions of Australian-born patients who had migrated to Queensland from the higher risk southern regions of Australia or travelled overseas to countries known to be high-risk for MS prior to disease onset, had fallen between the two surveys thus exerting, if anything, a negative influence on the change in prevalence. Analysis of MS prevalence rates amongst migrant populations in Queensland as compared to the more southerly city of Perth in Western Australia, suggested that the risk of acquisition of MS may extend over a wider age range than is generally accepted. Finally, there was an absence of MS cases amongst the Aboriginal population in Queensland but it can only cautiously be concluded from this study that the disease is rare in these peoples. PMID- 3681331 TI - Specific and nonspecific regeneration of motor axons after sciatic nerve injury and repair in the rat. AB - The pattern of motor axon regeneration following unilateral sciatic nerve lesions (freezing or transection) was studied in adult rats. Transected nerves were repaired with epineurial or fascicular sutures. Four months after the lesion, the motor neuron cell body localization in the spinal cord of plantar or common peroneal nerve axons were examined bilaterally with retrograde transport of horseradish peroxidase. Motor neuron cell body localization was similar bilaterally after freezing, indicating that regenerating axons had reached their original peripheral innervation territory. However, after nerve transection, irrespective of whether epineurial or fascicular sutures were used, motor neuron cell body distribution on the operated side was abnormal with numerous labeled cell bodies located outside the area of the normal motor neuron pool. This finding indicates that after nerve transection the normal pattern of motor axon innervation is not restored even after fascicular nerve repair. PMID- 3681332 TI - Cardiac abnormalities in myotonic dystrophy. Electrocardiographic and echocardiographic findings in 65 patients and 34 of their unaffected relatives. Relation with age and sex and relevance for gene detection. AB - Sixty-five patients with a definite diagnosis of myotonic dystrophy (MD) and 34 of their presumably unaffected relatives were examined cardiologically, including ECG in all and echocardiography in 61 and 32 persons respectively, in order to investigate the frequency of cardiac abnormalities, their clinical importance and their potential value as a preclinical marker in the diagnosis of MD. Atrioventricular conduction (AVC) abnormalities were found in 18/33 (54%) of affected males and in only 5/32 (16%) of affected females (P = 0.0025). Intraventricular (IVC) conduction abnormalities were encountered with similar frequency in both sexes: in 12/33 (36%) of affected males and 10/32 (31%) of affected females. Mitral valve prolapses (MVP) were seen more often in affected females: 9/31 (29%) of affected males vs 15/30 (50%) of affected females have MVP (P = 0.16). A previously undescribed finding was that of pericardial effusions in 5 affected and in 1 unaffected person. All affected males with MVP also had conduction abnormalities, but cardiac findings were not interrelated otherwise. None of the cardiac abnormalities mentioned were age-related. Only 8/65 (12%) of patients had cardiac symptoms, all of which were the result of conduction defects. As far as can be judged from a transversal study, the value of cardiac examination of this kind as a preclinical test for the diagnosis of MD is modest. It is argued that IVC-abnormalities, but not AVC-disturbances or MVP, in clinically unaffected relatives may indicate that they are preclinical heterozygotes. The significance of pericardial effusion for the diagnosis of MD awaits further evaluation. PMID- 3681333 TI - Sensory information processing in patients with nonalcoholic cirrhosis. Short latency visual, auditory, and somatosensory event-related potentials. AB - Visual, auditory and brainstem event-related potentials were obtained from patients with hepatocellular and cholestatic disease and a control group of normal subjects. The results did not reveal systematic neurophysiologic disturbances in persons with well compensated cirrhosis. It is concluded that short-latency event-related potentials are rather insensitive for detecting subclinical hepatic encephalopathy. PMID- 3681334 TI - Functional aspects of the regeneration of unmyelinated axons in the rat saphenous nerve. AB - Electrophysiological experiments have been carried out to investigate aspects of unmyelinated axon regeneration in a transected cutaneous nerve. Some comparisons with regeneration of myelinated axons in the same nerve have also been made. By 3 months after injury approximately 80% of the unmyelinated axons that had survived in the proximal stump had regenerated into the distal stump. About the same proportion of myelinated axons had regrown into the distal stump by this time. With both groups of axons there was no marked increase in the amount of regeneration across the injury site with longer recovery times. Conduction velocities in the regenerated unmyelinated axons tended to be slower across the injury site than proximally; the proximal conduction velocities did not differ from those in control nerves. The unmyelinated axons seemed to take longer to resupply the skin than did the myelinated ones, but in both cases the extent of skin innervation had reached about 60% control values by 6 months after the injury. PMID- 3681335 TI - Secretion of plasminogen activator by cerebral astrocytes and its modulation. AB - Plasminogen activator (PA) has been related to the neuron migration during brain development. PA has also been shown to degrade myelin basic protein. We present data to show that neonatal Balb/c astrocytes show PA activity on 125I-fibrin coated plates. Secreted and cell associated fibrinolytic activity is detected only in the presence of plasminogen. Modulants like concanavalin A and phorbol myristate acetate enhance PA production and this function involves a transcriptional event. Dexamethasone inhibits baseline as well as concanavalin A induced enhancement of PA activity. These results raise the possibility that astrocytes may have an active role in myelinoclastic disorders and CNS developmental defects. PMID- 3681336 TI - Sensory involvement in distal myopathy (Welander). AB - Eleven patients with Welander distal myopathy were subjected to detailed sensory testing including measurements of perception thresholds for vibration and temperature in both hands and feet. The threshold values were compared with normal, age-corrected values and also with data from an age-matched control group consisting of patients with antecedent poliomyelitis with the same degree of paresis. The screening examination indicated impaired thermal sensibility in all 11 patients and impairment for at least one other sensory modality in 9 patients. In comparison with age-corrected normal values, the measured warm-cold difference limen was abnormal in the feet of 9 patients and the vibratory threshold at least at one test point in 6 patients. When compared with the data from the paretic controls, the thermal abnormality was significant with regard to warm and cold thresholds, the warm-cold difference limen and the heat pain threshold. The vibration threshold abnormality was significant in the feet. It is concluded that sensibility impairment is present in Welander's myopathy indicating a peripheral sensory neuropathy involving both unmyelinated (C-fibers) and myelinated fibers. PMID- 3681337 TI - Cortical evoked potentials and somatosensory perception in chronic spinal cord injury patients. AB - The correlation between somatosensory evoked potentials (SEPs) and sensory perception was studied in 110 patients with traumatic chronic spinal cord lesions. Perception thresholds over the legs for light touch, vibratory sensibility, temperature and thermal pain were tested together with recordings of tibial and peroneal SEPs. Tibial nerve SEPs correlated better with sensory perception than peroneal nerve SEPs. Normal tibial nerve SEPs were not present with absent or trace vibratory sensibility and vice versa. However, we found many exceptions to the correlation between temperature and pain perception and SEPs. Light touch, vibratory sensibility, and SEPs were highly correlated between each other, while temperature and pain perception correlated poorly to these other modalities. This represents an evident segregation of touch perception, vibratory sensibility and SEPs, which are thought to share dorsal columns as a common ascending pathway, and temperature and pain perception known to be related to the spinothalamic system. PMID- 3681338 TI - The prevalence of locally-synthesized virus antibodies in various forms of multiple sclerosis. AB - In 125 patients with multiple sclerosis, intrathecally synthesized antibodies against measles, rubella and zoster viruses were determined with an ELISA. 70% of patients with chronic progressive disease synthesized measles antibodies in comparison to 50% with a relapsing course. Women suffering from chronic progressive multiple sclerosis exhibited zoster antibodies 3 times as frequent as the other patients. These data indicate that relapsing and chronic progressive forms of multiple sclerosis exhibit different antiviral responses within the central nervous system which remain stable during the course of the disease. PMID- 3681339 TI - Benign juvenile focal muscular atrophy of upper extremities--a familial case. AB - A 53-year-old man and his 18-year-old son, both suffering from benign focal muscular atrophy of upper extremities are described. To our knowledge this is the first familial case of this disease in Caucasians. PMID- 3681340 TI - The C57BL mice: an animal model for inflammatory demyelinating polyneuropathy. AB - Recently it has been reported that the C57BL mice can be used as a model of benign monoclonal gammopathy (MG). Since experimental models have until now failed to reproduce specific lesions of human dysglobulinemic polyneuropathies, we decided to investigate the peripheral nerve of these mice. The sciatic nerve and the serum from 14 C57BL mice were examined: 9 of these animals were found to have an IgG, kappa light chain MG, while in the other 5 no abnormalities were detected in the serum. In the 14 mice, features of demyelination were found in certain fibers, as well as onion-bulb formations around other myelinated fibers. Features of active demyelination were found in 10 animals and it must be underlined that three of these had no serum abnormalities. The decrease of the conduction velocities and the temperature coefficients Q10 of the C57BL mice suggest a good correlation between morphological and functional parameters. This strongly suggests that this strain of mice provides a suitable model for inflammatory demyelinating polyneuropathy (IDPN). PMID- 3681341 TI - Diagnostic value of abdominal fat tissue aspirate in familial amyloid polyneuropathy. AB - To confirm amyloid deposition we performed aspiration biopsy of abdominal fat tissue in 14 patients with type I familial amyloid polyneuropathy (FAP). All patients, about half of whom were at an early stage of disease and lacking severe neurological disabilities, showed positive amyloid deposition in preparations stained with Congo red. On light and electron microscopic examinations deposits of amyloid were observed around fat cells and small vascular walls, and among collagen bundles. All patients in the study were demonstrated to have a variant transthyretin in their sera by radioimmunoassay. Abdominal fat tissue aspiration can be easily performed with an ordinary syringe and is very sensitive for detecting amyloid deposition. The procedure is valuable in the diagnosis of type I FAP patients with actual deposition of amyloid substance, even at an early stage. PMID- 3681343 TI - Analysis of unsaturated fatty acids of endoneurium and perineurium from normal and degenerating rat sciatic nerve. Morphological correlations. AB - The major portion of the endoneurial lipids is found in myelin. Since perineurial cells differ morphologically from endoneurial cell components, we attempted to determine whether these morphological differences also extended to a difference in fatty acid (FA) composition. Under normal circumstances, unsaturated FAs are more abundant than saturated ones (55-60% of total FAs) in endoneurium and perineurium. A characteristic biochemical difference between these two structures lies in the distribution of linoleic acid (C18:2(n-6)) which represents 20% of total FAs in perineurium and only 2% in endoneurium. Wallerian degeneration takes place after injection of pure glycerol into the endoneurium. This is followed by regeneration characterized by a proliferation of perineurial cells infiltrating the center of the nerve fascicule forming microcompartments. The changes in linoleic acid content reflect these morphological changes. A marked increase in linoleic acid is detected in the endoneurial fraction in parallel with the observed infiltration of perineurial cells into the nerve fascicule. PMID- 3681342 TI - Formalin fixed brains are useful for magnetic resonance imaging (MRI) study. AB - We carried out magnetic resonance imaging (MRI) studies on human brains which had been fixed in formalin solution for over 2 years and had been proven neuropathologically to be cases of multiple sclerosis (MS), progressive multifocal leukoencephalopathy (PML), and Balo's concentric sclerosis (Balo). Using spin echo (SE) and inversion recovery (IR) pulse sequences to detect demyelinated lesions in a living person with MS, the demyelinated lesions of the fixed brains in cases of MS, PML and Balo definitely re-appeared, although T1 and T2 in the gray and white matter were reduced following fixation. High signal areas on the SE images corresponded not only to the characteristic distribution of demyelinated lesions in the white matter but also to sparse myelin, gliosis and mild perivascular cuffing in the white matter around the demyelinated foci in cases of the fixed MS, PML and Balo brains. On the IR images, only MS plaques were evident. This MRI study of fixed brains proved useful to elucidate clinicopathological correlations. PMID- 3681344 TI - Recombinant human tumor necrosis factor depresses serum iron in mice. AB - Recently many findings about the physiological and biochemical functions of recombinant human tumor necrosis factor (rHu-TNF) have been reported. In the present study, the effect of rHu-TNF on serum iron in C3H/HeN and C57BL/6 mice was determined. Blood samples were obtained before intravenous injection of rHu TNF, and also at various times after the injection. Results from five experiments showed that the serum iron was depressed between 1/3 to 1/5 of that of untreated mice 4 to 24 h after injection of 5 or 10 micrograms of rHu-TNF. The low level persisted for 33 h, rebounded at 48 to 72 h, and returned to normal by 96 h after the injection. Serum iron was determined by the colorimetric method using the sensitive reagent, ferrozine (3-(2-pyridyl)-5,6-bis(4-sulfophenyl)-1,2,4 triazine. We believe that this is the first report of depression of serum iron in mice by intravenous injection of rHu-TNF. The physiological role of repressed serum iron in the in vivo response to TNF remains to be established. PMID- 3681345 TI - Role of in vivo scavenger function of macrophages in priming for endogenous production of tumor necrosis factor. AB - The effects of systemic administrations of immune complex, complement activators, and insoluble particles on endogenous production of tumor necrosis factor (TNF) were investigated in mice. Production of serum TNF was triggered by i.v. injection of OK-432, a streptococcal preparation, and measured by in vitro L-929 cytotoxicity assay. Intravenous injection of IgG-opsonized sheep red blood cells (10(8)/mouse) enhanced OK-432-triggered TNF production significantly. This effect was maximal (about 30-fold enhancement) 1.5 to 3 h after the injection and disappeared within 10 h. Complement activators other than immune complex also possessed this activity. Zymosan (0.1 mg/mouse) enhanced OK-432-triggered TNF production maximally (about 25-fold) 3 to 6 h after its i.v. injection, its effect lasting for 10 h, and disappearing within 24 h. Heat-aggregated IgG and cobra venom factor also had similar enhancing effects. In addition, systemic pretreatment with insoluble particles enhanced OK-432-triggered TNF production. The enhancement by latex beads (2 microliters volume of solid/mouse) was maximal (about 60-fold) 3 to 6 h after their i.v. injection, was sustained for at least 20 h, and disappeared within 48 h. Glass beads, dextran beads, alum, silica, and carbon particles all had similar enhancing effects. Based on these results, the in vivo scavenger function of macrophages, as well as direct activation with cytokines, may participate in priming for endogenous production of TNF; alternatively, particles or macromolecules which can be scavenged by macrophages may activate macrophages and prime for TNF production. PMID- 3681346 TI - Augmented antitumor effect of combined human natural interferon-alpha and mismatched double-stranded RNA treatment against a human malignant melanoma xenograft. AB - The antitumor effect of combined natural human interferon-alpha (IFN) and mismatched double-stranded RNA (dsRNA) treatment against the human malignant melanoma cell line, BRO, was studied. In vitro results, using a tissue culture antiproliferative assay, indicated that these cells were moderately sensitive to IFN-alpha. In contrast, mismatched dsRNA had no antitumor effect, and a minimal stimulation of cell growth, over part of the concentration range tested, was observed. Mismatched dsRNA did not potentiate the antitumor effect of IFN-alpha in cells receiving combination treatment. Xenografts of BRO cells, inoculated subcutaneously into nude mice, were used to evaluate the antitumor effects of IFN alpha and mismatched dsRNA. Growth of the primary tumor was inhibited by both drugs alone or in combination (p less than 0.001), but the combined treatment was most effective and appeared to be additive. The number of spontaneous lung metastases was also inhibited (p less than 0.02) in all treatment groups. Survival, however, was significantly increased only in the IFN-alpha/mismatched dsRNA group (p less than 0.02 compared to controls, p less than 0.05 compared to mismatched dsRNA alone). Determination of splenic natural killer (NK) cell activity against BRO cells demonstrated that significantly augmented NK activity to the same extent, but that the IFN-alpha alone had no effect. These results indicate that IFN-alpha worked through direct antiproliferative mechanisms while mismatched dsRNA stimulated host immunomodulatory effects. The increased tumor growth inhibition and survival in the dual treatment group appears to result from the combined direct antiproliferative and indirect immunomodulatory effects. PMID- 3681347 TI - Cell junctions and membrane specializations in the ventricular zone (germinal matrix) of the developing sheep brain: a CSF-brain barrier. AB - Cell junctions in the ventricular zone (germinal matrix) of the embryonic and foetal sheep brain were examined with thin-section and freeze-fracture electron microscopy. Neuroependymal cells in the early ventricular zone (days 19-40 of embryonic development, gestation period 147 days) exhibit a novel arrangement of cell junctions that connect adjacent neuroependymal cells at their lateral cell membranes next to the ventricular system. Small but typical gap junctions were also identified from the earliest stages examined. In serial thin sections and using a goniometer with a tilting device, the cell contacts showed a tight junction-like appearance of close and continuous fusion between neighbouring cell membranes. However, they were not arranged in a belt-like fashion close to the ventricular surface, but spiralled from the ventricular pole of the cells along the lateral cell membrane towards the deeper parts of the ventricular zone. Their freeze fracture appearance was different from that of single-stranded tight junctions in that the dimensions of their ridges and grooves were generally greater and the E-face grooves contained many particles. The junctions were especially prominent where more than two cells made contact. At mid-gestation they were less prominent than earlier and at 125 days gestation the neuroependymal layer was replaced by a mature-looking normal ependymal layer in which individual ependymal cells were connected by zonulae adherentes and large gap junctions; orthogonal arrays were also prominent. The close contact between gap junctions and single-stranded junctions found early in gestation suggests that there may be some developmental relation between these two membrane specializations. The transient single-strand junctions presumably form the morphological basis for a recently described CSF-brain barrier in the early foetal sheep brain. They may also have some mechanical function in anchoring neighbouring cells together in the region of the developing brain where cells are continuously dividing and migrating. PMID- 3681348 TI - Nuclear pores in rat hypothalamic arcuate neurons: sex differences and changes during the oestrous cycle. AB - The numerical density of nuclear pores was assessed on freeze-fracture replicas of hypothalamic arcuate neurons from adult male and female rats. In females the nuclear pore density fluctuated during the oestrous cycle and was higher in oestrus than in pro-oestrus, metoestrus and dioestrus. Nuclear pore density in males and in metoestrus and dioestrus females was similar. The nuclear pore density in male rats was significantly less than that in oestrus and pro-oestrus females. The variation of the number of pores per unit nuclear volume and the total number of pores per nucleus was similar to the variation of the numerical density of nuclear pores. These results provide morphological evidence of cyclic changes in neuronal nucleocytoplasmic traffic during the ovarian cycle. PMID- 3681349 TI - Non-pyramidal hippocampal projection neurons: a light and electron microscopic study. AB - Following injections of horseradish peroxidase conjugated with wheat germ agglutinin into the medial nucleus accumbens of the rat, a large number of projecting pyramidal neurons in the hippocampus were retrogradely labelled. In addition to this major projection, a few retrogradely labelled cells were tentatively identified at the light microscopic level as non-pyramidal neurons. These presumptive non-pyramidal neurons were found in all hippocampal layers, although they were mainly outside the stratum pyramidale, in the stratum oriens. Ultrastructurally, in serial sections, the non-pyramidal nature of 20 of these neurons was confirmed by their characteristic features such as deeply indented nuclei, occasional intranuclear inclusions, and symmetric and asymmetric synaptic contacts with their somata. Possible transmitters used by these neurons are discussed. PMID- 3681350 TI - Morphological and proliferative responses of cultured Schwann cells following rapid phagocytosis of a myelin-enriched fraction. AB - Cultured Schwann cells were found to phagocytose exogenously applied myelin membranes within 1 h. However, the resulting proliferative response required an additional 9 h of incubation. Treatment with ammonium chloride, a lysosomal inhibitor, delayed the appearance of the proliferative response to the myelin membranes by 12 h. Processing of myelin within the Schwann cells was followed by the appearance of immunocytochemically detectable myelin basic protein which was first visible at 4 h. Similar to the proliferative response, the appearance of immunoreactive material was delayed by the addition of ammonium chloride. Schwann cells were observed initially to ingest myelin fragments at their distal-most tips after which time the myelin phagosomes collected in the perinuclear region and fused with lysosomes. Phagocytic Schwann cells had a notable increase in Golgi membranes and microfilaments and contained widely dilated, rough endoplasmic reticulum cisternae. In purified cell cultures, Schwann cells phagocytosed myelin slower than macrophages, but displayed phagocytic abilities much greater than fibroblasts. The ability of cultured Schwann cells to phagocytose myelin rapidly suggests that these cells may aid in the breakdown and removal of myelin during Wallerian degeneration. These data further confirm the mitogenic effect of myelin and its possible role during nerve regeneration. PMID- 3681351 TI - Abnormal axoglial junctions in the myelin-deficient rat mutant. AB - Although the myelin-deficient rat displays a gross deficiency of myelin in the CNS, occasional myelin segments of moderate thickness can be found. The typical lamellar pattern, consisting of alternating major dense and intermediate lines, is present in some regions of such segments, but the pattern is abnormal elsewhere. Redundant folds are common, and astrocyte processes occur frequently between the myelin sheath and axolemma or within the sheath. In the paranodal region, myelin lamellae occasionally form a palisade of 'terminal loops' against the axolemma, but discrete transverse bands occur only rarely and regular arrays of transverse bands over an extended length have not been seen. 'Reversed' paranodal junctions occur more often. Here the outermost layer of myelin, instead of being closest to the node, is furthest from it, and successive layers form terminal loops that approach the node progressively. These loops face away from the axon and do not contact it. At paranodal junctions of this kind only the innermost loop, or a small number of inner loops, adjoins the axolemma and, as a result, the size of the paranodal axoglial junction is markedly restricted. These defects in the paranodal junction may underlie the intrusion of astrocyte processes from either end of a myelin segment into the internodal periaxonal space and between myelin lamellae. Thus, one of the normal functions of the paranodal junction may be to restrict extension of astrocyte processes into and beneath myelin segments. The myelin-deficient rat also exhibits node-like specializations of the axolemma in association with glial cell processes. PMID- 3681352 TI - De novo neuromuscular junction formation on human muscle fibres cultured in monolayer and innervated by foetal rat spinal cord: ultrastructural and ultrastructural--cytochemical studies. AB - Ultrastructural features of neuromuscular junction formation and transverse tubule development were studied utilizing a newly developed model in which human muscle fibres cultured in monolayer are innervated by foetal rat spinal cord with dorsal root ganglia attached. At early innervation (7-10 days), when distinct 'boutons' are contacting muscle fibres, the contacts of nerve terminals with the muscle fibres are, ultrastructurally, superficial and unorganized, and there is no basal lamina-like material between nerve terminals and muscle fibres. A bouton consists, ultrastructurally, of a cluster of small nerve terminals contacting the muscle fibre. At 2-3 weeks of innervation, shallow 'beds' are formed on the muscle fibre just beneath nerve terminals, and occasionally there are irregular and miniscule fragments of basal lamina-like material in the cleft. There is no Schwann cell apposing the nerve terminal at this stage of innervation. After 4-5 weeks of innervation there is more definite basal lamina material in the cleft and suggestive postsynaptic plasmalemmal densities and invaginations. However, there is no Schwann cell apposing the nerve terminal at this stage. At 6-8 weeks of innervation, deep postsynaptic folds are present, a Schwann cell apposes the nerve terminal, and basal lamina surrounds the entire muscle fibre. At all four stages of innervation examined, ultrastructural cytochemistry of alpha bungarotoxin binding reveals that nicotinic ACh receptors are located exclusively at the neuromuscular junctions. After 1-2 weeks of innervation, very few lanthanum-positive transverse tubules are observed and only in close proximity to the surface membrane. After 3 weeks of innervation, more lanthanum-positive tubules are present, and they are located deeper within the muscle fibre. Five weeks after innervation, somewhat more elaborated tubules (but no lateral sacs) appear, and honeycomb structures are often present. After 6-7 weeks of innervation the tubular system is very elaborate and lateral sacs are present. Hence, this study describes consecutive stages of the formation of neuromuscular junctions and transverse tubules in innervated cultured human muscle, and provides an important basis to which similar studies related to the diseased human muscle can be compared. PMID- 3681353 TI - Comparison of the Schwann cell surface and Schwann cell extracellular matrix as promoters of neurite growth. AB - The ability of Schwann cells to influence the direction and rate of neurite growth was investigated in a tissue culture model of the bands of Bungner of injured peripheral nerve. The arrangement of this culture system allowed testing of the growth-promoting properties of the Schwann cell surface and extracellular matrix (ECM) assembled by Schwann cells rather than soluble substances secreted into conditioned medium. Various components of peripheral nerve were examined separately as substrata for regenerating neurites: (i) Schwann cells and their ECM; (ii) Schwann cells alone; (iii) Schwann cell ECM alone; (iv) Schwann cells, fibroblasts, and their assembled ECM; (v) Schwann cells, their ECM and neurites; and (vi) purified laminin. Regenerating peripheral neurites were from explants of foetal rat dorsal root ganglia, which had been cultured for several weeks to rid them of accompanying non-neuronal cells, or from explants of foetal rat superior cervical ganglia, which contained non-neuronal cells. CNS neurites from the somatosensory cortex of embryonic rats were also studied; these neurites may be either first growing or regenerating. Neurites from all types of explants studied grew longer and were guided on a substratum of Schwann cells or Schwann cell ECM compared with a collagen substratum. The presence of fibroblasts during ECM assembly did not enhance the neurite growth-promoting activity. The design of the experiments suggested that the factors by which the Schwann cells or their ECM promoted and guided neurite outgrowth were surface-bound rather than medium borne. Electron microscopic examination showed that neurites grew on either Schwann cell surfaces or basal lamina material. Attempts to define the chemical nature of the neurite growth-promoting effect of ECM by partial enzymatic digestion did not identify any single component as essential. Purified laminin was a more effective promoter of outgrowth of peripheral neurites than were Schwann cells or Schwann cell ECM. Cortical explants also grew on laminin, but neurites were accompanied on this substratum by a massive migration of non neuronal cells; the neurites appeared to extend primarily on the non-neuronal cells rather than by direct attachment to the laminin substratum. This characteristic outgrowth of cortical non-neuronal cells on laminin was not consistently seen on Schwann cell ECM. In conclusion, either the Schwann cell surface or the ECM produced and assembled by Schwann cells promotes neurite outgrowth and guides that outgrowth from the several types of peripheral and CNS neurons studied in this report. PMID- 3681354 TI - Organization of axoplasm in crayfish giant axons. AB - Distributions of subcellular organelles in medial giant axons (MGAs) and segmental lateral giant axons (SLGAs) of crayfish were evaluated as part of an ongoing effort to understand and explain differences in distal stump survival following axonotomy. Both axons were able to endocytose tracer proteins placed extracellularly, and horseradish peroxidase injected by cannulation into MGAs could transfer into adaxonal glial cells. Concentrations of tubulovesicular organelles near axonal cell membranes were measured as a possible index of the relative level of axonal endo- and exocytosis, and concentrations in MGAs were found to be twice those in SLGAs. In both axons, microtubule concentrations were highest near the axolemma and lowest in the central core of axoplasm. In thoracic and abdominal regions of MGAs, microtubules and other organelles were located only in a thin layer of subaxolemmal axoplasm. Overall, MGAs contained fewer microtubules per cross-section than did SLGAs, although MGAs are five to ten times as long as SLGAs and support more synapses. Total numbers of microtubules per cross-section varied with distance from the cell body of an MGA, whereas microtubule numbers were similar in proximal and distal cross-sections of SLGAs. In addition to a layer of subaxolemmal mitochondria which was observed in MGAs and SLGAs and which is characteristic of crayfish axons, mitochondria were also concentrated in the central core of SLGA axoplasm. PMID- 3681355 TI - Computer model analysis of the radial artery pressure waveform. AB - Simultaneous measurements of aortic and radial artery pressures are reviewed, and a model of the cardiovascular system is presented. The model is based on resonant networks for the aorta and axillo-brachial-radial arterial system. The model chosen is a simple one, in order to make interpretation of the observed relationships clear. Despite its simplicity, the model produces realistic aortic and radial artery pressure waveforms. It demonstrates that the resonant properties of the arterial wall significantly alter the pressure waveform as it is propagated from the aorta to the radial artery. Although the mean and end diastolic radial pressures are usually accurate estimates of the corresponding aortic pressures, the systolic pressure at the radial artery is often much higher than that of the aorta due to overshoot caused by the resonant behavior of the radial artery. The radial artery dicrotic notch is predominantly dependent on the axillo-brachial-radial arterial wall properties, rather than on the aortic valve or peripheral resistance. Hence the use of the radial artery dicrotic notch as an estimate of end systole is unreliable. The rate of systolic upstroke, dP/dt, of the radial artery waveform is a function of many factors, making it difficult to interpret. The radial artery waveform usually provides accurate estimates for mean and diastolic aortic pressures; for all other measurements it is an inadequate substitute for the aortic pressure waveform. In the presence of low forearm peripheral resistance the mean radial artery pressure may significantly underestimate the mean aortic pressure, as explained by a voltage divider model. PMID- 3681356 TI - Clinical assessment of the neonatal Dinamap 847 during anesthesia in neonates and infants. AB - Direct measurements of systolic, diastolic, and mean arterial blood pressure and electrocardiogram-derived heart rates were compared with indirect arterial blood pressure measurements using the Dinamap 847XT noninvasive monitor. A total of 260 paired comparisons from 16 patients were analyzed. A regression analysis of paired data over a wide range of blood pressure values gave the following results: for heart rate r = 0.97, for systolic arterial pressure r = 0.84, for mean arterial pressure r = 0.73, and for diastolic arterial pressure r = 0.52. The 95% confidence limits for systolic, mean, and diastolic arterial pressure were +/- 16 mm Hg, +/- 18 mm Hg, and +/- 21 mm Hg, respectively. The Dinamap monitor was found to be an accurate trend recorder of heart rate and blood pressure during anesthesia in neonates and small infants. PMID- 3681357 TI - Hypoxemia during ambulatory gynecologic surgery as evaluated by the pulse oximeter. AB - Pulse oximetry was used to determine the incidence of intraoperative hypoxemia in 108 patients undergoing ambulatory gynecologic operation. Eleven (10%) experienced moderate desaturation (arterial oxygen saturation less than 90%), and 5 (5%) suffered severe hypoxemic episodes (arterial oxygen saturation less than 85%). Among patient risk factors--including operation, body habitus, smoking habits, history of asthma, age, and airway characteristics--an association with moderate hypoxemia was found only with nonlaparoscopic gynecologic operation, obesity, and age over 35 years, and an association with severe hypoxemia was found only with obesity and age over 35. Among operative events--including inspired oxygen concentration, position, mode of ventilation, and anesthesia phase--an association with moderate hypoxemia was found only with the lithotomy position, manual ventilation, and arousal. The cost per patient of monitoring with a pulse oximeter is about +1.35. A cost-benefit analysis reveals that a mortality rate of 1 in 40,000 among patients who actually become moderately hypoxemic would justify the cost of monitoring arterial oxygen saturation. We conclude that pulse oximetry should be part of routine anesthetic monitoring. PMID- 3681358 TI - Methylene blue and indocyanine green artifactually lower pulse oximetry readings of oxygen saturation. Studies in dogs. AB - The effects of fluorescein, methylene blue, and indocyanine green on hemodynamic variables and on pulse oximetry and co-oximetry measurements of arterial hemoglobin oxygen saturation (SaO2) and oxyhemoglobin percentage (% HbO2) were evaluated in 16 anesthetized dogs in vitro by co-oximetry (% HbO2) and in vivo by pulse oximetry (SaO2). The light absorbance (optical density) in plasma (range 500 to 800 nm) was measured by a spectrophotometer. Fluorescein did not affect oximetry measurements, plasma light absorbance in the range measured, or hemodynamic variables. Methylene blue caused dose-dependent decreases in measurements made with both forms of oximetry for up to 30 minutes, the decrease being greater and longer lasting with pulse oximetry (P less than 0.05). Hemodynamic measurements in 5 dogs showed that methylene blue (1 to 5 mg/kg) increased arterial pressure transiently, after which cardiac output, stroke index, and left ventricular stroke work index decreased and left ventricular end diastolic pressure and systemic and pulmonary vascular resistances increased (P less than 0.05 with 5 mg/kg). Methemoglobin concentration measured by co-oximetry increased significantly (to 19.9 +/- 1.4%, P less than 0.05) 1 minute after 5 mg/kg of methylene blue was injected. Methylene blue had a dose- and time dependent effect on plasma light absorbance, and this effect peaked in the 660- to 670-nm range. The data do not distinguish the relative contributions of physiology (hemodynamic change), chemistry (methemoglobin production), and physics (optical properties) to the decrease in pulse oximetry and co-oximetry measurements that follows injection of methylene blue. Indocyanine green affected neither hemodynamic variables nor co-oximetry readings but decreased pulse oximetry readings for up to 10 minutes dose dependently.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681359 TI - Pulse oximetry fails to accurately detect low levels of arterial hemoglobin oxygen saturation in dogs. AB - The accuracy of two commercially available pulse oximeters (the Ohmeda Biox 3700, software version "J," and the Nellcor N-100) in detecting low levels of arterial hemoglobin oxygen saturation (SaO2) was evaluated in 10 dogs in which hypoxia was induced by stopping the fresh gas flow into the anesthesia machine circle system. Measurements made in vivo with the pulse oximeters, with detectors placed on the tongue, were compared with measurements made in vitro using an IL 282 CO-Oximeter as SaO2 decreased toward zero. Measurements from the two oximeters correlated poorly over the range from 0 to 100% SaO2 (r = 0.69). In this range, the correlation between Nellcor N-100 measurements and those of the CO-Oximeter had an r of 0.82, a regression line slope of 0.82, and a y intercept of 14.8; the correlation between the Ohmeda Biox 3700 and the CO-Oximeter had an r of 0.83, a regression line slope of 0.66, and a y intercept of 32.7. The correlation with the CO-Oximeter was similar for both the Ohmeda and the Nellcor pulse oximeters at an SaO2 of 80% or more. However, when SaO2 was less than 80%, measurements by pulse oximetry correlated less well with CO-Oximeter measurements (r = 0.62, slope = 0.64, and y intercept = 21.0 for Nellcor; r = 0.71, slope = 0.67, and y intercept = 32.4 for Ohmeda). When SaO2 was less than 60%, both oximeters inaccurately indicated the co-oximetry values (r = 0.36 and y intercept = 26.1 for the Nellcor; r = 0.48 and y intercept = 33.2 for the Ohmeda).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681360 TI - Use of pulse oximetry as a noninvasive indicator of intravascular volume status. AB - The use of pulse oximetry as a noninvasive method to assess intravascular volume status is described. Pulse oximeters providing a continuous display of the pulse waveform offer a new method of estimating relative volume status during positive pressure ventilation. Like intraarterial pressure tracings, the peaks of the pulse waveform demonstrate increased variation in response to positive-pressure ventilation when a patient becomes hypovolemic. Pulse oximeter waveform tracings were compared with central venous pressure and intraarterial pressure tracings in 12 patients undergoing major operative procedures. A significant correlation (r = 0.61) was seen between pulse waveform variation and systolic pressure variation, which has previously been shown to be a sensitive indicator of hypovolemia. When data from individual patients were analyzed separately, the correlation between pulse waveform variation and systolic pressure variation was as high as 0.88. PMID- 3681361 TI - Loss of intraoperative evoked responses during dorsal column surgery associated with isolated postoperative sensory deficit. AB - Two patients underwent surgery for the removal of dermoid tumors that involved the dorsal aspect of the spinal cord. Both patients were monitored with intraoperative posterior tibial nerve somatosensory evoked potentials (SSEPs). In each case, the surgical procedure was nearly complete when an abrupt and persistent loss of SSEPs occurred. Although minor recovery of waveforms was present by the end of the operation, the SSEP waveforms remained strikingly abnormal. Neither patient had a postoperative motor deficit, although both had evidence of dorsal column dysfunction. These observations suggest that, during dorsal column surgery, even dramatic SSEP loss may not be associated with motor pathway injury, but rather, may correlate better with postoperative dorsal column dysfunction. The possible implications for intraoperative monitoring of SSEPs during dorsal column surgical procedures are discussed. PMID- 3681362 TI - Continuous, real-time, noninvasive monitor of blood pressure: Penaz methodology applied to the finger. AB - The finger blood pressure monitor measures blood pressure continuously and noninvasively by means of a technique described by J. Penaz. The size of the artery is measured when its internal pressure (arterial pressure) equals the external pressure. (At this point, transmural pressure equals zero and the arterial wall is said to be "unloaded.") This unloaded condition is maintained by continuous, automatic adjustments of external pressure on the artery, adjustments that are made simultaneously with and parallel to intraarterial pressure variations. The external pressure then constantly equals internal pressure (arterial blood pressure) and is reported by the monitor as values for systolic, mean, and diastolic pressure. A finger cuff with a built-in light source and detector is used to measure finger artery size, and an inflatable bladder is used to apply the external pressure to the artery. The monitor is microprocessor based; algorithms determine the unloaded artery size approximately every minute and automatically correct for changes possibly induced by smooth muscle contraction or relaxation, and a high-speed electropneumatic servo control system enables automatic calibration and adjustment. PMID- 3681363 TI - Mass spectrometer failure: an unusual cause. AB - A potentially serious problem is inherent in the current design of the mass spectrometer multiplex system. In spite of the filter on the sampling tube, foreign material can be aspirated into this tube, causing malfunction of the system. Prevention of this problem is discussed, and precautions are given. PMID- 3681364 TI - Abstracts of scientific papers: Seventh Medical Monitoring Technology Conference. March 9-12, 1987, Vail, Colorado. PMID- 3681366 TI - Cell kinetic-based scheduling of chemotherapy: hypothesis versus reality. PMID- 3681365 TI - Abstracted proceedings: Symposium on Central Nervous System Monitoring. May 28 30, 1987, Gmunden, Austria. PMID- 3681367 TI - Detection of estrogen receptor in bone marrow from patients with metastatic breast cancer. AB - We devised a method of detecting estrogen receptors (ER) in bone marrow metastases from patients with breast cancer. The method involves a sequential double-staining immunocytochemical technique, with a monoclonal antibody to ER and a polyclonal antibody recognizing epithelial membrane antigen to confirm the epithelial nature of suspected tumor cells. Twenty-seven patients were assessed: ten were found to have ER-positive tumor cells in the bone marrow; ten had ER negative cells; and the remaining seven patients had no tumor cells in the bone marrow smears. Of the ten patients with ER-positive cells, eight (80%) either had a response to endocrine therapy, implying that they possess ER-positive breast cancers, or had ER-positive primary tumors as determined by the dextran-coated charcoal biochemical assay (DCC). Of the ten patients with ER-negative cells in the bone marrow, eight failed to respond to endocrine therapy. This technique therefore provides a means of predicting which patients will respond to endocrine therapy, and is particularly important in those patients whose ER status is unknown. PMID- 3681368 TI - Mycosis fungoides: management with topical nitrogen mustard. AB - The technique of treatment, response rate, freedom from relapse, survival, and complications of therapy in 123 patients treated with topical nitrogen mustard (HN2) for cutaneous mycosis fungoides (MF) at Stanford University Medical Center are reviewed. Patients were treated with HN2 in an aqueous or ointment base with equal efficacy. Response rates depended on the extent of skin involvement. In limited plaque (T1) disease, complete and overall response rates were 51% and 88%, respectively, while in generalized plaque (T2) disease they were 26% and 69%. No patients with tumorous involvement (T3) achieved complete skin clearance and all 13 of these patients developed progression of disease. Only two of nine patients with erythrodema (T4) achieved a complete response (CR), and both later relapsed. After achieving a CR, 40% of patients with T1 disease and 60% with T2 disease later relapsed; however, subsequent therapies, including repeat courses of topical HN2, often were successful in achieving later skin clearance. Overall, 42% of T1 patients and 31% of T2 patients were without evidence of MF at last follow-up. When death occurred, it was usually unrelated to MF in the T1 group. However, half of the deaths of patients with T2 disease were attributable to MF. Among the 22 patients with T3 or T4 disease, 80% of deaths were attributable to MF. The most common complication observed was a cutaneous hypersensitivity reaction, which occurred much more commonly with the aqueous than the ointment preparation. Fourteen patients (11%) developed subsequent cutaneous malignancies. PMID- 3681369 TI - Solitary plasmacytoma of bone: treatment, progression, and survival. AB - Twenty patients with solitary plasmacytoma of bone were treated by radiation therapy. Local control was achieved in 19 and most patients developed systemic myeloma. To evaluate disease progression, 65 patients, including 45 from published series, were analyzed. Younger patients seemed less likely to progress (P = .06), but other clinical characteristics including site of involvement and paraprotein status did not influence progression. After dissemination, patients had a clinical course similar to patients with stage I myeloma, with a median survival of 47 months. Overall, patients with solitary plasmacytoma of bone had an indolent course of disease, with a median survival of 10.7 years and a 5-, 10 , and 20-year survival of 75%, 52%, and 37%, respectively. PMID- 3681370 TI - Tumor and liver drug uptake following hepatic artery and portal vein infusion. AB - Anatomic dye injection studies of the blood supply of colorectal hepatic metastases suggest that tumors are supplied predominantly by the hepatic artery. Using 13N amino acids with dynamic gamma camera imaging in patients with colorectal hepatic metastases, it has been shown that hepatic artery infusion results in a significantly greater nutrient delivery to tumor compared with portal vein infusion. However, direct measurements of drug levels in tumor following hepatic artery and portal vein infusion in humans have not previously been reported. Patients with metastatic colorectal cancer confined to the liver received fluorodeoxyuridine (FUdR) through the hepatic artery or through the portal vein. All patients had previously failed systemic chemotherapy. Five patients with hepatic artery catheters were matched (by age, serum lactic dehydrogenase levels, percent hepatic replacement, and tumor size) with five patients with portal vein catheters. At operation, 3H-FUdR (1 microCi/kg) and 99mTc-macroaggregated albumin (MAA) (6 mCi) were injected into the hepatic artery or portal vein. Liver and tumor biopsies were obtained two and five minutes later. 3H and 99mTc were measured per gram tissue by scintillation and gamma counting. The mean liver levels following hepatic artery infusion (23.9 +/- 11.4 nmol/g) and portal vein infusion (18.4 +/- 14.5 nmol/g) did not differ. However, the mean tumor FUdR level following hepatic artery infusion was 12.4 +/- 12.2 nmol/g, compared with a mean tumor FUdR level following portal vein infusion of 0.8 +/- 0.7 nmol/g (P less than .01). This low level of tumor drug uptake after portal vein infusion of FUdR predicts minimal tumor response to treatment via this route. Thus, regional chemotherapy for established colorectal hepatic metastases should be administered through the hepatic artery. PMID- 3681371 TI - Hyperprolactinemia and hypothyroidism following cytotoxic therapy for central nervous system malignancies. AB - Endocrinologic dysfunction including hyperprolactinemia and hypothyroidism are recognized complications of irradiation to the hypothalamic-pituitary axis or thyroid gland in the course of treating CNS malignancies. However, the frequency of these adverse effects in both short- and long-term survivors may be underestimated. Sixty-five patients treated in the University of Rochester Cancer Center since 1968 with radiation with or without BCNU chemotherapy for CNS tumors not involving the hypothalamic-pituitary axis were evaluated for thyroid, prolactin, and gonadal disturbances regardless of clinical symptomatology. Prolactin values were elevated in 19 of 47 patients (40%). For males and females treated with greater than 55 Gy, abnormal values were present in nine of 11 (82%) and seven of 14 (50%), respectively. For males and females treated with less than or equal to 55 Gy, two of nine (22%) and one of 13 (8%), respectively, were abnormal (P = .0001). Six of six patients who also received BCNU chemotherapy were hyperprolactinemic, as compared with six of ten (60%) who did not receive BCNU. Seven of eight females with elevated prolactin levels had menstruation abnormalities, and five of seven adult males noted a decrease in libido. Mild abnormalities in testosterone concentration were found in three of nine men evaluated, all of whom had normal gonadotropins. Of 47 patients who did not receive irradiation to the spinal axis (and thus the thyroid gland), ten (21%) had a decreased thyroxin (T4) value. Only one of these patients had an elevated thyroid-stimulating hormone (TSH) value. Of 32 patients who received greater than 55 Gy, ten (31%) had a low T4, compared with zero of 15 who received less than or equal to 55 Gy (P = .0001). Four of eight patients (50%) who also received BCNU had low T4 values, as compared with three of 14 (21%) who did not receive BCNU. Of 15 patients who were treated with 4 to 10 MV photon irradiation to the spinal axis, five patients (33%) had elevated TSH values. The mean spinal axis dose in these patients was 33 Gy. Two euthyroid children in this group manifested the early onset of puberty. The complex of endocrinologic abnormalities observed in several patients receiving only cranial irradiation, that is elevated prolactin, decreased thyroid, and gonadal hormone secretion in the presence of otherwise normal pituitary hormone levels, suggests a radiation-induced insult to the hypothalamic regulation of pituitary function. PMID- 3681372 TI - Malignant melanoma in the elderly. PMID- 3681373 TI - Improved methodology for chemosensitivity testing? PMID- 3681374 TI - Antibody-guided irradiation of advanced ovarian cancer with intraperitoneally administered radiolabeled monoclonal antibodies. AB - Twenty-four patients with persistent epithelial ovarian cancer after chemotherapy with or without external beam irradiation, were treated with intraperitoneally administered 131I-labeled monoclonal antibodies HMFG1, HMFG2, AUA1, H17E2, directed against tumor-associated antigens. Acute side effects were mild abdominal pain, pyrexia, diarrhea, and moderate reversible pancytopenia. One patient developed a subphrenic abscess requiring surgical drainage. Eight patients with large volume disease, ie, greater than 2 cm tumor diameter, did not respond to antibody-guided irradiation and died of progressive disease within 9 months of treatment. Sixteen patients had small-volume (less than 2 cm) disease at the time of treatment with radiolabeled antibody. Seven patients failed to respond, and of nine initial responders, four patients remain alive and free from disease 6 months to 3 years from treatment. Analysis of the data on relapse indicated that doses greater than 140 mCi were more effective than lower doses. We conclude that the intraperitoneal administration of 140 mCi or more of 131I labeled tumor-associated monoclonal antibodies represents a new and potentially effective form of therapy for patients with small-volume stage III ovarian cancer. PMID- 3681375 TI - Comparison between clinical response and in vitro drug sensitivity of primary human tumors in the adhesive tumor cell culture system. AB - The newly described adhesive tumor cell culture system (ATCCS) offers a distinct advantage over other assays in that it has a high plating efficiency requiring low cell inoculum, it affords workable assays in approximately 70% of specimens from the heterogenous tumor types, and it has the ability to assay up to nine drugs at four different concentrations. Clinical correlations based on the ATCCS were obtained in 65 patients undergoing 71 clinical trials. Patients with melanoma, lung cancer, and sarcoma dominated the group. The most active in vitro drug was correlated per clinical trial. Thirteen of 17 (76%) sensitive in vitro predictions and 51 of 54 (94%) resistant in vitro predictions were accurate. The assay in this study had a sensitivity of 81% and specificity of 93%. These preliminary results are encouraging and warrant prospective trials to establish the true value of this assay to patients. PMID- 3681376 TI - Intrinsic drug resistance in human kidney cancer is associated with expression of a human multidrug-resistance gene. AB - The cloning of the cDNA for the mdr1 gene, whose expression is associated with the development of multidrug-resistance in cultured cells, has made it possible to explore the mechanism of multidrug resistance in human tumors. We have found that normal human kidney, six of eight adenocarcinomas of the kidney, and four cell lines derived from kidney adenocarcinomas express high levels of mdr1 mRNA. Two criteria suggest that primary multidrug resistance in human adenocarcinomas of the kidney results, at least in part, from expression of the mdr1 gene: (1) mdr1 mRNA levels are elevated in four unselected kidney adenocarcinoma cell lines that show a multidrug-resistant phenotype; and (2) multidrug resistance in these kidney cancer cell lines is reversed by verapamil and quinidine, agents known to reverse mdr1-associated drug resistance in cell lines selected for multidrug resistance in vitro. These results suggest that appropriate pharmacological intervention to reverse multidrug resistance might make adenocarcinomas of the kidney more sensitive to chemotherapy with agents such as Adriamycin (Adria Laboratories, Columbus, OH) and the vinca alkaloids. PMID- 3681377 TI - Clinical pharmacology of recombinant human tumor necrosis factor in patients with advanced cancer. AB - Twenty-six patients with advanced cancer refractory to standard therapy were treated with recombinant human tumor necrosis factor (rTNF) in a study aimed at determining the toxicity and tolerance of rTNF and at seeking evidence of antitumor activity. The study design involved two treatments per week for 4 weeks with alternating subcutaneous and intravenous (IV) administration, and weekly dose escalation through four levels in each patient. The dose range was 1 to 200 micrograms/m2 for IV bolus injection, and 5 to 250 micrograms/m2 for subcutaneous injection. Thirteen patients completed the full course. Early discontinuation of treatment was related to rTNF toxicity in seven cases. The major side effects were rigors, fever, headache, fatigue, and hypotension. Acute changes in granulocyte, lymphocyte, and monocyte counts, changes in serum zinc levels and plasma cortisol levels consistent with an acute phase response, and inflammation at the site of subcutaneous injection were also seen. At doses of 125 to 250 micrograms/m2, inflammation at the subcutaneous injection site was unacceptably severe. Minor changes were seen in hemostatic parameters. Hypotension was corrected by fluid administration and did not require treatment with vasopressors. Initial serum concentrations of rTNF were measured at five minutes after IV administration and were found to range from 2.5 ng/mL after a dose of 35 micrograms/m2 to 80 ng/mL after a dose of 200 micrograms/m2. The half-life of rTNF in the blood was 20 minutes. A decrease in lymph node size was observed in a patient with B cell lymphoma. PMID- 3681379 TI - Effects of socioeconomic and clinical factors on survival in multiple myeloma. AB - It was recently reported that low socioeconomic status (SES) in multiple myeloma (MM) patients is associated with a poorer prognosis. To reassess this finding in another group of MM patients, we used data from interviews of 153 MM patients seen at Duke University Medical Center over a 6-year period. Medical records were also reviewed for data on traditional clinical prognostic factors. Using proportional hazard survival analysis, no SES variables were associated with survival. Current income, highest income, occupation, type of dwelling, years of education, and crowding did not enter the stepwise regression model at alpha = .10. In contrast, many clinical factors predicted prognosis (calcium, P = .019; percent plasma cells on initial bone marrow, P = .019; history of transfusions, P = .015; WBC count, P = .007; pathologic fractures, P = .001; and urate, P less than .001). Thus, we do not confirm the previously reported association between social class and myeloma survival. PMID- 3681378 TI - Sequential cisplatin/VM-26 and vincristine/cyclophosphamide/doxorubicin in metastatic neuroblastoma: an effective alternating non-cross-resistant regimen? AB - We report the results of a French multicentric pilot study of remission induction therapy in metastatic neuroblastoma. Thirty-five successive unselected patients entered the study over 1 year and were treated by alternating sequences of cisplatin/VM-26 (PE) and vincristine/cyclophosphamide/doxorubicin (CADO). Three courses of each sequence were delivered. Disease reevaluation was extensive, with special focus on bone marrow status. Using strict criteria, 24 patients (68%) achieved a good partial response (GPR), which comprised normalization of bone marrow, and ten (28%) achieved a partial response (PR), and one progressed. The overall response rate was 96%. Thirty-two patients underwent surgery, and complete macroscopic removal of the primary was achieved in 21 (65%). After completion of induction and surgery, six patients (17%) were in complete remission (CRm), without evidence of any residual disease; nine (26%) were in very good partial remission (VGPRm; same as CRm except persistence of nonpathologically evaluable improved bone scan), and 19 (51%) were in partial remission (PRm). Toxicity was acceptable, and no treatment-related deaths occurred. These results show no substantial improvement compared with those previously reported with similar but nonalternating regimens. We advocate a two category concept (response, remission) to describe initial therapy results in metastatic neuroblastoma and emphasize the need to assess bone marrow by an extensive evaluation. PMID- 3681380 TI - Favorable outcome of invasive aspergillosis in patients with acute leukemia. AB - During a 2-year period, 15 of 110 patients (14%) admitted for intensive therapy of acute leukemia associated with prolonged deep granulocytopenia developed documented invasive aspergillosis (IA). Antemortem diagnosis was accomplished in 14, and 13 of 15 (87%) survived the infection. Because of the high success rate, we reviewed the courses of the 15 patients to assess factors associated with this favorable outcome. Eleven presented with pulmonary IA; early symptoms occurred at a mean 21.6 days of granulocytopenia (less than 100/muL) and included refractory fever in 14 and pulmonary signs or symptoms in 11. Primary necrotic chest wall lesions associated with Hickman catheters developed in four at a mean 11 days of granulocytopenia, followed by pulmonary involvement. All 15 patients had chest radiographs during granulocytopenia, with 14 (93%) demonstrating pulmonary infiltrates and/or nodules at a mean 20.6 days of aplasia. Nine patients had lung computerized tomography (CT) scans, revealing nodular infiltrates in one patient and a characteristic zone of low attenuation surrounding a mass-like infiltrate in seven other patients, which was found to be diagnostic of IA. Subsequent CT scans performed during and following bone marrow recovery showed progression to cavitation followed by either complete resolution or minimal pulmonary scarring. Eleven patients developed IA during empiric amphotericin B (Amp-B) therapy (0.5 mg/kg/d) for fever refractory to antibacterial antibiotics. Fourteen patients received high-dose Amp-B (1.0 to 1.5 mg/kg/d), which was started within a mean of 2.2 days of first clinical findings; 13 survived. Ten patients received 5 fluorocytosine in addition to high dose amp-B. Survival was similar regardless of presentation, as 91% with primary pulmonary IA and 75% presenting with chest wall lesions survived. All 13 surviving patients had complete granulocyte recovery at a mean 33.8 days. Nephrotoxicity (creatinine greater than 2.0 mg/dL) was observed in seven patients during therapy for IA, but was transient in all seven. We conclude IA can be successfully treated in the deeply granulocytopenic patient provided that it is recognized and treated early, and provided that antifungal therapy is aggressive and is continued until granulocyte recovery occurs. PMID- 3681381 TI - Hemostatic abnormalities in untreated cancer: incidence and correlation with thrombotic and hemorrhagic complications. AB - Over a 2-month period, 40 patients with untreated malignancy were studied for protein-C (PRC), antithrombin-III (AT-III), fibrinopeptide A (FPA), routine hemostatic screens, and presence of liver metastases to determine pretreatment changes of hemostasis and relate them to subsequent development of thrombotic or hemorrhagic complications. These patients were observed for a mean period of 18 months. There were 23 males and 17 females with a median age of 64 years. Nine patients had lung carcinoma, 8 colon carcinoma, 7 lymphoma, 5 breast carcinoma, 5 head and neck carcinoma, 2 acute leukemia, 2 prostate carcinoma, 1 adenocarcinoma of unknown primary, and 1 sarcoma. Eight patients had liver metastases. PRC was measured by ELISA, AT-III by radial immunodiffusion, and FPA by RIA. Four patients had decreased AT-III, 28 had decreased levels of PRC, and 39 had elevated levels of FPA. All patients with liver metastases had low PRC. Albumin levels were lower in patients with low PRC (mean 3.3 g/dL v 4.0 g/dL for others). Eight patients, five with liver metastases, developed thrombotic (4), hemorrhagic (3), or both (1) complications. Statistically significant associations were found between (1) presence of liver metastases and development of thrombotic and hemorrhagic complications (P less than .001), (2) presence of liver metastases and decreased PRC (P = .001), and (3) lower albumin levels and decreased PRC (P = .0001). Our study documents early changes of hemostasis in untreated malignancy. We extend previous observations that decreased PRC levels in malignancy may be due to poor synthetic functions of liver. Presence of liver metastases was the only factor associated with subsequent development of thrombotic and hemorrhagic complications. Biochemical markers of hemostatic abnormalities, even though encountered frequently at the time of presentation, are of little predictive value for development of thrombotic and hemorrhagic complications. PMID- 3681382 TI - Appropriate endpoints for superficial bladder cancer clinical trials. AB - Many protocols for treatment of superficial bladder cancer include periodic cystoscopic examinations with resection of visible lesions. This allows pathological restaging of the disease at each examination. For example, this type of follow-up is common in clinical trials evaluating intravesical therapies. In such trials, clinical outcome is typically summarized using end-points that measure failure to control superficial disease. Alternative endpoints measuring failure to prevent progression to invasive disease are often ignored. In this report, the rationale for ignoring the invasive disease endpoints is given and flaws in the rationale are described. Evidence from actual data sets support the view that superficial disease endpoints may not be appropriate surrogates for invasive disease endpoints. It is recommended that time to invasive disease should be considered a major endpoint when designing and analyzing trials in superficial bladder cancer. PMID- 3681383 TI - Preventing amsacrine-induced cardiac arrhythmias. PMID- 3681384 TI - Intracarotid infusion of PCNU (NSC: 95466): preclinical toxicological study in dogs. AB - The prognosis of patients with unresectable intracerebral primary and metastatic tumours that recur following cranial irradiation is poor. Chemotherapy agents have been of limited value. PCNU--a new nitrosourea, has been shown to have the optimum log P for treatment of murine intracerebral tumours. We conducted a preclinical toxicological study of intracarotid injection of PCNU in dogs. Our results show that there was no major neurological or retinal toxicity from the drug, suggesting that PCNU may be less toxic than the presently available BCNU. PMID- 3681385 TI - Brain metastases from ovarian cancer. AB - Brain metastasis from ovarian carcinoma is a relatively rare phenomenon. At NYU Medical Center five patients were treated for this entity from 1982 to 1985. The stage at presentation ranged from stage I to stage III, and all patients had received or were receiving chemotherapy. Two patients had active disease elsewhere at diagnosis of brain metastasis, but three patients were otherwise NED. Three patients had solitary cerebellar disease, and two patients had multiple lesions. All patients were treated with whole brain radiotherapy to 3,000 cGy, with neurological improvement in three of the five patients. The central nervous system may need special consideration for prophylactic treatment in those patients with ovarian cancer who receive adjuvant chemotherapy. PMID- 3681386 TI - PCNU and recurrent childhood brain tumors. AB - PCNU, the latest nitrosourea analogue to be subjected to clinical trials, held promise as a superior chemotherapy agent for brain tumors because of more favorable biochemical and cytotoxic characteristics in laboratory studies. Thirty nine children with a variety of recurrent primary CNS tumors, all of whom had evaluable disease, participated in a phase II PCNU trial. Their mean age was 9.7 (3-20) years. PCNU was administered as a 2 hour intravenous infusion in one of 2 dose schedules at 6-7 week intervals; 100-125 mg/m2 for minimally treated patients and 70-90 mg/m2 for heavily treated patients. Response was assessed after 2 courses of chemotherapy after attempting to taper the steroid dose. The overall objective response rate was 18% (7/39) for a mean of 5.9 months (2+ -12). Only partial responses were observed. Disease-specific responses rates were: brainstem glioma--18% (3/17); cerebral glioma--27% (3/12); ependymoma--1/1; and primitive neuroectodermal tumors--(0/9) including 5 medulloblastomas, 2 pineoblastomas and 3 cerebral primitive neuroectodermal tumors. Toxicity was primarily hematologic and clinically significant thrombocytopenia (less than 50,000 mm3) was encountered in 30/38 (79%) patient trials. Modest activity of PCNU in recurrent childhood gliomas is confirmed. Our response rates, using objective CT criteria, are somewhat lower than those reported for BCNU and CCNU. Because of comparable hematologic toxicity and efficacy, intravenous PCNU does not appear to offer a clinical advantage to existing nitrosoureas for children with recurrent brain tumors using a 2 hour intravenous infusion schedule. PMID- 3681387 TI - Phase I study of intracarotid PCNU. AB - A phase I study of the intracarotid administration of PCNU was conducted in patients with intracerebral tumors recurring after cranial radiation. Seventeen patients were treated including 16 with recurrent gliomas or glioblastomas and 1 with recurrent brain metastases from adenocarcinoma of the lung. An additional patient received a vertebral artery infusion of PCNU for a recurrent glioblastoma. Seven of 17 patients receiving intracarotid PCNU responded for a response rate of 41%. If only evaluable patients with gliomas are considered, the response rate was 44%. Tumor grade at time of initial diagnosis, exposure to prior chemotherapy, and dose of PCNU did not appear to have a major impact on response rate. Zubrod performance status 3 patients had a lower response rate (25%) than did patients with performance status 1 or 2 (response rate 63%). Thrombocytopenia and reversible central nervous system toxicity were dose limiting at a PCNU dose of 110 mg/m2. Two patients had possible permanent central nervous system toxicity. Three patients had permanent ipsilateral visual impairment, including one at the lowest dose used into the carotid artery (60 mg/m2). Orbital pain appeared to be substantially less than that seen with intracarotid BCNU but headaches may have been somewhat more common. The single patient receiving a vertebral artery infusion developed marked headaches and restlessness after receiving 25 mg/m2 of a planned 75 mg/m2 treatment into the vertebral artery and the treatment had to be discontinued. Symptoms were rapidly reversible upon stopping the medication. Our overall impression is that intracarotid PCNU causes less ocular pain but more transient central nervous system toxicity than does intracarotid BCNU.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681388 TI - Effect of differentiation inducers on growth characteristics of human glioma cell lines. AB - The effect of dimethylsulfoxide (DMSO) and iododeoxyuridine (IUdR) on the growth characteristics of two established human glioblastoma cell lines (FG and HMCN-1) was studied. The FG cell line has been characterized. The HMCN-1 cell line, established in our laboratory, consisted of fibroblastoid and polygonal cells that grew without contact inhibition. Subcutaneous injection of these cells into weanling athymic nude mice induced slowly growing, solid tumors that were histologically spindly with areas that were similar to the original tumor. Chromosomal analyses revealed a human heteroploid pattern with a modal number of 69. The cells of the original human glioma contained S-100 protein and glial fibrillary acidic protein (GFA protein), whereas the established cells failed to express markers. Prolonged treatment of glioma cells with DMSO generated a more adherent, normal human fibroblastoid phenotype that grew with contact inhibition. The new phenotype and proliferative restriction of these cells was evident as late as 50 days after discontinuation of treatment. The chemical induction of cell differentiation resulted in decreased tumorigenic potential in athymic nude mice. PMID- 3681389 TI - The personalized auditory cortex of the mustached bat: adaptation for echolocation. AB - 1. In the mustached bat, Pteronotus parnellii, the "resting" frequency of the constant-frequency component of the second harmonic (CF2) of the orientation sound (biosonar signal) is different among individuals within a range from 59.69 to 63.33 kHz. The standard deviation of CF2 resting frequency is 0.091 kHz on the average for individual bats. The male's CF2 resting frequency (61.250 +/- 0.534 kHz, n = 58) is 1.040 kHz lower than the female's (62.290 +/- 0.539 kHz, n = 58) on the average. Females' resting frequencies measured in December are not different from those measured in April when almost all of them are pregnant. Therefore, the orientation sound is sexually dimorphic. 2. In the DSCF (Doppler shifted CF processing) area of the auditory cortex, tonotopic representation differs among individual bats. The higher the CF2 resting frequency of the bat's own sound, the higher the frequencies represented in the DSCF area of that bat. There is a unique match between the tonotopic representation and the CF2 resting frequency. This match indicates that the auditory cortex is "personalized" for echolocation and that the CF2 resting frequency is like a signature of the orientation sound. 3. If a bat's resting frequency is normalized to 61.00 kHz, the DSCF area overrepresents 60.6-62.3 kHz. The central region of this overrepresented band is 61.1-61.2 kHz. This focal band matches the "reference" frequency to which the CF2 frequency of a Doppler-shifted echo is stabilized by Doppler-shift compensation. 4. Since DSCF neurons are extraordinarily sharply tuned in frequency, the personalization of the auditory cortex or system is not only suited for the detection of wing beats of insects, but also for the reduction of the masking effect on echolocation of consepecific's biosonar signals. 5. Because the orientation sound is sexually dimorphic and the auditory cortex is personalized, the tonotopic representation of the auditory cortex is also sexually dimorphic. PMID- 3681390 TI - Effects of hypothalamic stimulation on activity of dorsomedial medulla neurons that respond to subdiaphragmatic vagal stimulation. AB - 1. Effects of hypothalamic stimulation on activity of dorsomedial medulla neurons that responded to subdiaphragmatic vagal stimulation were investigated in urethan anesthetized rats. 2. Extracellular recordings were made from 231 neurons in the nucleus of the tractus solitarius (NTS) that fired repetitively in response to single-pulse subdiaphragmatic vagal stimulation and from 320 neurons in the dorsal motor nucleus of the vagal nerve (DMV) that responded antidromically to subdiaphragmatic vagal stimulation. The mean latencies of responses to subdiaphragmatic vagal stimulation were 90.3 +/- 17.1 ms (mean +/- SD) for NTS neurons, and 90.8 +/- 11.2 ms for DMV neurons. This indicated that both afferent and efferent subdiaphragmatic vagal fibers were thin and unmyelinated and had a conduction velocity of approximately 1 m/s. 3. In extracellular recordings from 320 DMV neurons, marked inhibition preceded the antidromic response and subdiaphragmatic vagal stimulation evoked orthodromic spikes in only a few neurons. 4. Intracellular recordings from 66 DMV neurons revealed inhibitory postsynaptic potentials (IPSPs) before the antidromic responses. These IPSPs suppressed spontaneous firing and prevented excitatory postsynaptic potentials (EPSPs) from generating action potentials. 5. Stimulation in all hypothalamic loci studied, the ventromedial hypothalamic nucleus (VMH), the lateral hypothalamic area (LHA), and the paraventricular nucleus (PVN), induced responses with similar characteristics of excitation alone or excitation followed by inhibition in most NTS and DMV neurons. 6. No reciprocal effect of VMH and LHA stimulation was observed on NTS and DMV neurons. 7. Intracellular recordings from DMV neurons revealed monosynaptic EPSPs in response to stimulation of the VMH, the LHA, and the PVN. 8. PVN stimulation evoked significantly more responses in NTS and DMV neurons than VMH stimulation and more responses in DMV neurons than LHA stimulation. This suggests a difference in the number of connections between each hypothalamic site and the dorsomedial medulla. 9. The same dorsomedial medulla neurons were tested with VMH and LHA stimulation. The respective mean latencies of the antidromic and the orthodromic NTS neuron responses were 37.3 +/ 3.2 and 39.6 +/- 12.9 ms for VMH stimulation and 29.8 +/- 5.3 and 31.8 +/- 8.7 ms for LHA stimulation. The mean latencies of the orthodromic DMV neuron responses were 39.4 +/- 8.3 ms for VMH stimulation and 31.1 +/- 5.2 ms for LHA stimulation. The estimated conduction velocity from the VMH to the dorsomedial medulla was approximately 0.25 m/s and from the LHA it was approximately 0.33 m/s, which was significantly faster.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681391 TI - Inputs from regularly and irregularly discharging vestibular nerve afferents to secondary neurons in the vestibular nuclei of the squirrel monkey. I. An electrophysiological analysis. AB - 1. The electrical excitability of vestibular nerve afferents is related to their discharge regularity (23). Irregular (I) afferents are more excitable than regular (R) afferents. We explored the possibility that the differences in electrical excitability could be used to determine the profile of monosynaptic inputs from the ipsilateral vestibular nerve (Vi) to secondary neurons of the vestibular nuclei. The growth of monosynaptic Vi excitatory postsynaptic potentials (EPSPs) as shock strength is increased should reflect the kinds of afferent input that a secondary neuron receives. We were particularly interested in seeing if cells in the vestibular nuclei could be distinguished as R or I neurons depending on whether they received predominantly regular or irregular inputs. Barbiturate-anesthetized squirrel monkeys were used. 2. Recordings were made from vestibular nerve afferents. Shock strength was expressed as multiples of T, the value needed to recruit 10% of the afferents or, as determined empirically, to evoke a detectable field potential in the vestibular nuclei. Most I afferents (85/87 = 98%) were recruited below 4 X T, whereas most R afferents (197/212 = 93%) were first activated above 4 X T. The relation between latent period and electrical excitability was flat for units with thresholds in the range 1-4 X T. Latent periods increased for units with higher thresholds, especially those first activated above 8 x T. The threshold differences between I and R afferents are maximal if the shock falls at approximately half the mean interval after a naturally occurring action potential. The same results were obtained by having each unit fire to a maximal (16-32 X T) conditioning shock and then determining the threshold to a test shock presented 4 ms later. The latter stimulus configuration was used to study the Vi monosynaptic inputs to secondary neurons. The test shock was raised by successive doublings from 1 X T to the strength of the conditioning shock (16-32 X T). 3. Intracellular recordings were made from neurons located in the superior vestibular nucleus or the rostral parts of the medical or lateral vestibular nuclei. Amplitudes and latent periods of Vi EPSPs were measured from averages of several repetitions of each stimulus pair. Each EPSP was calculated by subtracting the extracellular from the intracellular averaged response. Of the 122 neurons sampled, 115 were judged to be monosynaptically related to the ipsilateral vestibular nerve because their Vi EPSPs had latent periods in the range of 0.7-1.4 ms.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681392 TI - Models of synchronized hippocampal bursts in the presence of inhibition. I. Single population events. AB - 1. We constructed model networks with 520 or 1,020 cells intended to represent the CA3 region of the hippocampus. Model neurons were simulated in enough detail to reproduce intrinsic bursting and the electrotonic flow of currents along dendritic cables. Neurons exerted either excitatory or inhibitory postsynaptic actions on other cells. The network models were simulated with different levels of excitatory and inhibitory synaptic strengths in order to study epileptic and other interesting collective behaviors in the system. 2. Excitatory synapses between neurons in the network were powerful enough so that burst firing in a presynaptic neuron would evoke bursting in its connected cells. Since orthodromic or antidromic stimulation evokes both a fast and a slow phase of inhibition, two types of inhibitory cells were simulated. The properties of these inhibitory cells were modeled to resemble those of two types of inhibitory cells characterized by dual intracellular recordings in the slice preparation. 3. With fast inhibition totally blocked, a stimulus to a single cell lead to a synchronized population burst. Thus the principles of our epileptic synchronization model, developed earlier, apply even when slow inhibitory postsynaptic potentials (IPSPs) are present, as apparently occurs in the epileptic hippocampal slice. The model performs in this way because bursting can propagate through several generations in the network before slow inhibition builds up enough to block burst propagation. This can occur, however, only if connectivity is sufficiently large. With very low connection densities, slow IPSPs will prevent the development of full synchronization. 4. We performed multiple simulations in which the fast inhibitory conductance strength was kept fixed at various levels while the strength of the excitatory synapses was varied. In each simulation, we stimulated either one or four cells. For each level of inhibition, the peak number of cells bursting depended sensitively on excitatory synaptic strength, showing a sudden increase as this strength reached a critical level. The critical excitation, which depended on the level of inhibition, corresponded to the level at which bursting can propagate from cell to cell at the particular level of inhibition. 5. We performed an analogous series of simulations in which the strength of excitatory synapses was held constant while the strength of fast inhibitory synapses was varied, stimulating a single neuron in each case. These simulations correspond to experiments that have been done in the hippocampal slice as low doses of picrotoxin are washed into a slice, gradually abolishing fast inhibition.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681393 TI - Models of synchronized hippocampal bursts in the presence of inhibition. II. Ongoing spontaneous population events. AB - 1. We extended our computer model of the CA3 region of the hippocampal slice in order to study spontaneous activity occurring in the presence and absence of synaptic inhibition. This was done by providing a steady inward current to the excitatory neurons, whose value was randomly chosen for each cell. With the parameters used, many of the excitatory cells would, if synaptically isolated, remain quiescent, whereas others would burst periodically with periods as brief as 750 ms. Simulations were run for as long as 10 s of neural activity. 2. In the presence of synaptic inhibition, neural activity became organized into recurring, partially synchronized events: clusters of neurons (6% to 12% of the population) would discharge together, with a period averaging 340 ms, shorter than the burst period of any individual neuron. A consequence of periodic clusters of cellular bursts was the widespread occurrence of periodic synchronized synaptic potentials, as have been observed in hippocampal slices and human temporal neocortical slices. The periods between these synaptic potentials are similar in the model to those observed experimentally. 3. The period could be slowed by either increasing the time constant of the slow inhibitory postsynaptic potential (IPSP), or by making the excitatory synapses more powerful. The period seems to be generated in part as follows. Consider those cells with rapid spontaneous discharge rates. An upper bound for the period corresponds to the interval between 1) such a cell's becoming responsive enough to an excitatory synaptic input to burst, and 2) such a cell's bursting spontaneously (i.e., in response to its own intrinsic inward current). For cells with rapid spontaneous discharge rates, the interval defined in this way is approximately 350 ms. 4. Different cells participated in each cluster. A given cluster was initiated by one cell or by two cells bursting together, and spread via excitatory synapses. Excitatory synaptic paths could be traced from the initiating cell(s), directly or through other participants, to all cells participating in a cluster. Spread of activity was limited by two mechanisms, so that not all cells synaptically excited by a participating cell would themselves participate. First, cells might be refractory from having participated in a recent cluster (since the intercluster period was less than the refractory time from a cellular burst to its responsiveness to a synaptic stimulus). Second, some cells might be synaptically inhibited. Synaptic inhibition in this model did not act rapidly enough to suppress the cluster totally.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681394 TI - A functional role of cholinergic innervation to neurons in the cat visual cortex. AB - 1. Effects of microionophoretic application of acetylcholine (ACh) and its antagonists on neuronal responses to visual stimuli and to electrical stimulation of the lateral geniculate nucleus were studied in the cat striate cortex. 2. Responses elicited visually and electrically were facilitated by ACh in 74% of the cells tested, whereas the responses were suppressed in 16%. These ACh effects were blocked by a muscarinic antagonist, atropine, but not by a nicotinic antagonist, hexamethonium, indicating that the ACh effects are mediated through muscarinic receptors. A single application of atropine suppressed visual responses of cells facilitated by ACh, whereas it enhanced those of cells inhibited by ACh, suggesting that endogenous ACh may tonically modulate visual responsivity of cortical neurons. 3. In most cells with the facilitatory ACh effect, responses with single spikes to the electrical stimulation became more consistent, often with double spikes, during the ACh application. The suppressive effects of ACh were noted most often in cells with a longer response latency to electrical stimulation of lateral geniculate nucleus. 4. In most of the facilitated cells the spontaneous activity remained null or very low during ACh application, in spite of marked enhancement of visual responses, suggesting that ACh may improve the signal-to-noise ratio (S/N) of cortical neuron activity. To confirm this suggestion, we calculated a S/S + N index by counting the total number of spikes in the responses (S) and that in peristimulus time histogram (S + N) and found that it was improved during the ACh application in about a half of the cells, whereas it became worse in about one-fifth. 5. In most of the facilitated cells, ACh enhanced visual responses not only to optimal but also to nonoptimal stimuli, resulting in no improvement or even worsening of the orientation selectivity. This was also the case in the selectivity of direction of stimulus movement. 6. The laminar location of the facilitated cells was biased toward layers V and VI of the cortex, although they also made up the majority in layers II + III and about half the tested cells in layers IVab and IVc. 7. In the light of recent understanding of cortical circuitry, these results suggest that the cholinergic innervation to cortical neurons may play a role in improvement of the S/N ratio of information processing in the striate cortex and in facilitation of sending processed informations to other visual centers. PMID- 3681395 TI - Effects of cholinergic depletion on neuron activities in the cat visual cortex. AB - 1. Unilateral lesions of the nucleus basalis magnocellularis (nBM), a source of cholinergic projection to the cerebral cortex, were produced by injection of kainic acid in the cat. The lesions caused a significant reduction in density of choline acetyltransferase-immunoreactive terminals in the visual cortex ipsilateral to the lesions. 2. In the primary visual cortex ipsilateral to the lesions [acetylcholine (ACh)-depleted cortex], about half of the cells had weak or undetectable visual responses, whereas in the contralateral visual cortex almost all the cells had normal responsivity. The response selectivity, such as orientation and direction selectivities, of cortical cells was not affected by the depletion of ACh. 3. The microionophoretic application of ACh to cells under observation facilitated visual responses in 83% of the cells recorded from the ACh-depleted cortex, whereas it suppressed the responses in only 9%. The application of a muscarinic antagonist, atropine, to cells in the ACh-depleted cortex was ineffective, suggesting no residual ACh activity. 4. The mean current required to induce facilitation in the cortex ipsilateral to the lesion was significantly smaller than that required in the contralateral cortex and the visual cortex of the normal cat, suggesting a supersensitivity of receptors mediating the effect or a reduction in catabolism of exogenous ACh in the ACh depleted cortex. 5. More than half of the cells that had been unresponsive to visual stimuli became clearly responsive during the ACh application. The response magnitude of cortical cells, as a whole, increased to the same degree as that observed during the ACh application in the normal cat. 6. In addition to the decrease in the average response magnitude, there was a remarkable variability in responses of cells to motion of the slit from sweep to sweep in the ACh-depleted cortex. The application of ACh to cortical cells decreased the variability of responses and consequently made the responses much more consistent. 7. These results suggest that without ACh supplied from the nBM, most of the cortical neurons could not respond briskly and consistently to excitatory inputs and that exogenously applied ACh could reverse such an impairment of cortical neurons through intact or even supersensitive postsynaptic receptors. PMID- 3681396 TI - The period of susceptibility of visual cortical binocularity to unilateral proprioceptive deafferentation of extraocular muscles. AB - 1. The electrophysiological effects of section of extraocular muscle proprioceptive afferents have been investigated in kitten area 17. Extraocular proprioceptive afferents were interrupted by cutting the ophthalmic branch of the fifth trigeminal nerve (V1 nerve) unilaterally in 15 normally reared kittens (NR) between 3 and 12 wk postnatal, in 3 NR adult cats, and in 7 dark-reared (DR) kittens at 6 wk postnatal. Bilateral sections of the V1 nerve were performed in two kittens at 6 wk postnatal. NR kittens were maintained in a normal environment after the section. DR kittens were returned to the darkroom until the recording session. Receptive-field properties of area 17 neurons were studied after a postsurgical delay of 4-7 wk in most NR kittens and of 4 days to 5 wk in DR kittens. In one NR kitten and in the operated adult cats, the delay was 1-2.5 yr. This study is based on a total sample of 1,190 visual cortical units. 2. When performed in NR kittens between 4 and 8 wk of age, the unilateral section of extraocular proprioceptive afferents significantly reduced the proportion of binocular cells: 1 mo after the section of the V1 nerve, half of the visual cortical cells were monocularly activated. A similar reduction in the proportion of binocular cells was also observed in DR kittens operated at 6 wk of age and then maintained in the dark for 5-7 wk. In contrast to the unilateral section, the bilateral section of the V1 nerve performed in 6-wk-old NR kittens did not disrupt cortical binocularity. 3. In 10 of the 22 kittens that had undergone unilateral sections, there was a strong asymmetry in the ocular dominance distribution in favor of one eye. This asymmetry was not related to the side of the section and was the same in both hemispheres for a given kitten. 4. The postsurgical delay played an important role in the appearance of the cortical deficit: binocularity loss was not found within the week following the section but was present 1 mo after the section. This functional impairment appeared to be permanent, since it was still observed 2.5 yr after the section. 5. Cortical cells were classified in two ways on the basis of their receptive-field organization: 1) into S- or C-types (38, 73), and 2) into small area slow (SAS), large area slow (LAS), or Fast (F)-types (42, 57).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681397 TI - Role of extraocular muscle proprioception in the development of depth perception in cats. AB - 1. The ophthalmic branch of the trigeminal nerve (V1), which carries extraocular proprioceptive afferents, was sectioned unilaterally or bilaterally in kittens and adult cats. Depth perception was measured behaviorally in these sectioned cats, as well as in control cats. 2. For kittens that underwent unilateral V1 sections at 6-11 wk of age, postsurgical values of binocular depth perception- measured 1.5-3 mo later--were 2-3 times worse than in normal control animals. Cats that underwent unilateral V1 sections as adults, however, showed no postsurgical deficits in binocular depth perception. 3. For kittens that underwent bilateral V1 sections at 6.5-7.5 wk of age, similar longterm impairments were found in binocular depth perception. No impairment was found in two kittens bilaterally sectioned at 11.5 wk of age. A cat that underwent bilateral sections as an adult also showed no binocular depth perception deficits. 4. Although these behavioral effects were observed only when unilateral and bilateral V1 sections were performed up to a certain age in development, they differed in two ways. 1) Imbalance of extraocular proprioceptive inflow produced by unilateral section had a deleterious effect at an age when the final adult level had been reached. At that stage, complete suppression of inflow produced by the bilateral section failed to impair the final level of binocular performance. 2) Short-term effects observed during the week following the section appeared in bilaterally operated animals as a transient freezing of the presurgical binocular performance whatever the age of the section during the sensitive period. In contrast, short-term effects produced by unilateral section were found to be age dependent: a progressive slowing down in the normal rate of improvement of binocular thresholds was observed following a section performed at 5 wk of age; an arrest in development was found when surgery was done at 6-7 wk of age. A significant impairment appeared within 2 days when the section was performed at 11 wk of age. 5. In all experimental kittens, monocular depth perception thresholds were unaffected or impaired only to a minor extent (less than 15% change) following the unilateral or bilateral section. In unilaterally operated kittens, there were no consistent differences associated with the side of the section. 6. A sham-operated kitten, in which the V1 was visualized but not cut, showed no impairments in binocular or monocular depth perception.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681398 TI - Implications of rotational kinematics for the oculomotor system in three dimensions. AB - 1. This paper develops three-dimensional models for the vestibuloocular reflex (VOR) and the internal feedback loop of the saccadic system. The models differ qualitatively from previous, one-dimensional versions, because the commutative algebra used in previous models does not apply to the three-dimensional rotations of the eye. 2. The hypothesis that eye position signals are generated by an eye velocity integrator in the indirect path of the VOR must be rejected because in three dimensions the integral of angular velocity does not specify angular position. Computer simulations using eye velocity integrators show large, cumulative gaze errors and post-VOR drift. We describe a simple velocity to position transformation that works in three dimensions. 3. In the feedback control of saccades, eye position error is not the vector difference between actual and desired eye positions. Subtractive feedback models must continuously adjust the axis of rotation throughout a saccade, and they generate meandering, dysmetric gaze saccades. We describe a multiplicative feedback system that solves these problems and generates fixed-axis saccades that accord with Listing's law. 4. We show that Listing's law requires that most saccades have their axes out of Listing's plane. A corollary is that if three pools of short-lead burst neurons code the eye velocity command during saccades, the three pools are not yoked, but function independently during visually triggered saccades. 5. In our three dimensional models, we represent eye position using four-component rotational operators called quaternions. This is not the only algebraic system for describing rotations, but it is the one that best fits the needs of the oculomotor system, and it yields much simpler models than do rotation matrix or other representations. 6. Quaternion models predict that eye position is represented on four channels in the oculomotor system: three for the vector components of eye position and one inversely related to gaze eccentricity and torsion. 7. Many testable predictions made by quaternion models also turn up in models based on other mathematics. These predictions are therefore more fundamental than the specific models that generate them. Among these predictions are 1) to compute eye position in the indirect path of the VOR, eye or head velocity signals are multiplied by eye position feedback and then integrated; consequently 2) eye position signals and eye or head velocity signals converge on vestibular neurons, and their interaction is multiplicative.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681399 TI - Postsynaptic membrane shifts during frequency potentiation of the hippocampal EPSP. AB - 1. In some classes of central neurons, repetitive synaptic stimulation induces substantial changes in the postsynaptic membrane, in conjunction with robust frequency potentiation of the excitatory postsynaptic potential (EPSP). However, the nature and time course of these postsynaptic membrane shifts, or their possible contributions to EPSP frequency potentiation (e.g., by altering driving force or current pathways), have not been examined extensively. We therefore studied the simultaneous patterns of change in composite EPSP amplitude, postsynaptic input resistance (Rin), and postsynaptic membrane potential during a 4-min train of 10-Hz monosynaptic stimulation in CA1 neurons of hippocampal slices. Slices were maintained in media containing either control (4 mM) or high (6.5 mM) concentrations of K+. 2. Potentiation of the EPSP, hyperpolarization of the membrane, and a decline of Rin, all developed rapidly during 10-Hz synaptic stimulation; these responses reached maximal levels by 5-15 s of the stimulation train. In most cells, a membrane depolarization phase occurred between 15 and 45 s of stimulation, followed by rehyperpolarization by 1 min of stimulation. During the depolarization phase, both EPSP potentiation and the decline in Rin remained near maximal. No significant differences were seen as a function of K+ concentrations. 3. These results show that hyperpolarization is not invariably associated temporally with EPSP frequency potentiation. Moreover, if driving force and membrane conductance changes are assumed to be approximately similar in large dendrites and soma, then the increase in driving force due to membrane hyperpolarization was not sufficient to account for the three- and fourfold increases in EPSP amplitude seen during frequency potentiation. Further, based on similar assumptions and on dendritic models of EPSP attenuation, the decline in Rin should reduce EPSP amplitude at the dendritic synaptic site and, to a proportionately greater extent, at the soma. 4. Studies in which the membrane was hyperpolarized with injected current to approximately the IPSP reversal potential, or in which bicuculline methiodide was applied to the slices, indicated that depression of the IPSP by repetitive stimulation did not account for frequency potentiation of EPSP amplitude. 5. These data are therefore consistent with the conclusion that the frequency potentiation of composite EPSPs in central neurons depends on presynaptic mechanisms, rather than on generalized postsynaptic changes. However, our findings do not rule out localized postsynaptic changes in receptors or spines as possible contributing factors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681400 TI - Effects of occipital lobectomy upon eye movements in primate. AB - 1. Eye movements were recorded before and after bilateral occipital lobectomy in six rhesus monkeys trained to fixate and to follow small targets. Striate cortex was completely removed in two animals; small islands islands remained in the others. In all animals portions of extrastriate cortex were also removed but the medial superior temporal area in the superior temporal sulcus was largely spared. Optokinetic nystagmus (OKN) was markedly altered but not abolished in all animals. The immediate pursuit component of OKN was eliminated leading to a poor response to stimuli comprised of high frequencies. The velocity-storage component of OKN was present, but the maximum value of OKN that could be achieved was decreased to 6 and 16 degrees/s in the two most severely affected animals (preop, 65-116 degrees/s). The residual OKN was similar to that of afoveate animals with a diminished response to high velocities of retinal-image motion and a temporal to nasal predominance during monocular viewing. 2. In the initial postoperative period all animals appeared completely blind. Within 1-6 mo, however, they regained an ability to make visually guided saccades to, and smooth pursuit of, small targets. Saccades were nearly as accurate as preoperatively, but saccade amplitudes were more variable and saccade latencies increased. In the two animals with a complete removal of striate cortex, gains (eye velocity/target velocity) of smooth pursuit during sinusoidal tracking (60 degrees/s, 0.5 Hz) were 0.9 and 0.95. During tracking of step-ramp (Rashbass) stimuli with 60 degrees/s ramps, the average acceleration of the eyes during the first 120 ms of smooth pursuit was 189-278 degrees.s-1.s-1 (preop range, 154-418 degrees.s-1.s-1). In other respects, though, smooth pursuit was not normal. Latencies were increased two- to threefold, and tracking was more variable. 3. Paradoxically, as visually guided saccades and pursuit recovered, some other ocular motor functions deteriorated. Spontaneous and gaze-evoked nystagmus developed 3-6 mo after occipital lobectomy; the time constant of the neural eye-position integrator dropped to values as low as 2.6-4.8 s. The maximum slow-phase velocity of OKN also decreased. 4. The findings immediately after occipital lobectomy indicate that in normal primates occipital cortex is necessary for visually guided saccades and smooth pursuit as well as for the immediate component of OKN. Occipital cortex also makes the predominant contribution toward the generation of the velocity-storage component of OKN.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681401 TI - Diurnal rhythmicity and hypothalamic deficits in glucose utilization in aged ovariectomized rats. AB - Aging is associated with a loss of cyclic gonadotropin release in female animals. This deficit may reflect dampened circadian rhythmicity of neuroendocrine events and/or altered function in hypothalamic nuclei important to regulation of cyclic female reproduction. The purpose of this study was to determine if diurnal periodicity and glucose metabolism in the hypothalamus are altered with age and whether such changes could help to explain the age-related deficits in gonadotropin release. Young (3-4-month-old) and old (18-21-month-old) rats were ovariectomized and subjected to the 2-deoxy-D-1-14C-glucose technique to measure rates of cerebral glucose utilization (GU), an index of neural function (Sokoloff et al., 1977) in various brain areas and in the pineal gland. We measured GU during the light (1400 hours) and the dark (2200 hours) in 17 anatomical regions including the following hypothalamic areas: medial preoptic nucleus, suprachiasmatic preoptic nucleus, suprachiasmatic nucleus, paraventricular nucleus, arcuate nucleus, and median eminence. Serum concentrations of luteinizing hormone (LH) and prolactin were measured in the same rats to determine the effect of age on both of these hormones. Diurnal periodicity of GU was observed in the suprachiasmatic nucleus and the pineal gland in young and old rats. Although there was no age difference in GU of the pineal gland, GU was reduced during the light and dark in the suprachiasmatic nucleus and all other hypothalamic areas examined except the suprachiasmatic preoptic nucleus and the median eminence. Ovariectomy induced an attenuated increase in concentrations of LH in old, compared to young rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681402 TI - Nucleus basalis magnocellularis and medial septal area lesions differentially impair temporal memory. AB - Functional dissociations between the medial septal area (MSA) and the nucleus basalis magnocellularis (NBM) were examined using the concepts and experimental procedures developed by scalar timing theory. Rats were tested in variations of a signalled discrete-trial peak-interval schedule of reinforcement in which the response rate functions identified the time when the rats expected reinforcement. The variations assessed aspects of both reference and working memory for information obtained from prior trials and from the current trial. A double dissociation was found in reference memory. Rats with NBM lesions, like those with frontal cortex (FC) lesions, remembered the time of reinforcement as having occurred later than it actually did; rats with MSA lesions, like those with fimbria-fornix (FF) lesions, remembered the time of reinforcement as having occurred earlier than it did. A single dissociation was found in working memory. MSA lesions and FF lesions impaired working memory, while NBM and FC lesions had no effect on it. These data begin to identify the brain mechanisms underlying temporal memory; they indicate that the frontal and hippocampal systems are both involved, but in complementary ways; and they provide information that helps specify more clearly the functions of the frontal and hippocampal systems. PMID- 3681403 TI - The interaction of ionic currents mediating single spike activity in retinal amacrine cells of the tiger salamander. AB - We investigated the ionic interactions responsible for the characteristic nonrepetitive spike activity of amacrine cells. First we measured 4 pharmacologically separable ionic components: a voltage-gated, transient inward sodium current, a voltage-gated, sustained inward calcium current, a calcium gated, sustained outward potassium current, and a voltage-gated, transient outward potassium current. The measurements provided the time course and magnitudes of the underlying conductances as functions of voltage. Each current was simulated following conventional Hodgkin-Huxley theory. A composite of the simulated currents was analytically reassembled to generate an approximation of the voltage response to a current step. By artificially varying the magnitude and kinetics of the different conductances in the simulation, we determined the range of values that supported the nonrepetitive spike-like response. Amacrine cells tend to remain refractory following an initial spike because (1) the entire activation range for potassium is located at positive potentials with respect to sodium inactivation, so sodium inactivation is never fully extinguished, and (2) the fully activated sodium conductance is of insufficient magnitude to subsequently reach threshold, given this residual inactivation. Shifting the sodium inactivation range by 10 mV, or increasing sodium conductance by 5 times, leads to a more repetitive form of activity. Changes in the magnitude, time course, or activation range of the potassium conductance cannot alter these conditions. PMID- 3681404 TI - Pineal transplants in oculo: limitations on the ability of collateral sprouts of foreign neurons to establish normal function. AB - The pineal gland is innervated by sympathetic neurons whose cell bodies are located in the superior cervical ganglia. This pathway, which carries information concerning environmental lighting to the gland, is important for maintaining a circadian rhythm in the activity of the pineal enzyme serotonin N acetyltransferase (NAT). Lesioning this pathway blocks the normal nighttime increase in NAT activity. Following transplantation of the pineal gland to the anterior chamber of the eye, the gland becomes reinnervated by collateral sprouts of sympathetic neurons that innervate the iris. In addition, a day-night rhythm in NAT activity is restored to the transplanted glands (Moore, 1975; Backstrom et al., 1976). These findings raise the possibility that the neural regulation of pineal function may be restored to normal by collateral sprouts of foreign neurons. To determine whether this is the case, other aspects of the neural regulation of NAT activity were examined in transplanted and in situ pineal glands. When the dark period was extended into the normal light period, NAT activity decreased to daytime values in both groups, suggesting that, in both cases, darkness is only effective in maintaining high levels of NAT activity at certain times during the day-night cycle. In contrast to their similar responses to extended darkness, the 2 groups of pineal glands responded differently to a brief pulse of light during the dark period. While the light exposure caused a dramatic decrease in nighttime NAT activity in in situ pineal glands, it produced no change in this enzyme activity in transplanted glands.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681405 TI - Dye-coupling in taste buds in the mudpuppy, Necturus maculosus. AB - Electrical coupling in taste buds and in non-taste lingual epithelium in the mudpuppy was examined by injecting cells with a fluorescent dye, Lucifer yellow. Lucifer yellow coupling has been shown to indicate the presence of electrical junctions between cells. Lucifer yellow-filled taste cells usually have an elongate shape. Cells were an average of 111 microns long and were 13 microns in diameter at the widest region (nucleus). In taste buds, from a sample of 105 impalements we detected Lucifer yellow coupling in 21 cases: dye-coupled pairs of cells were observed in 17 cases, and trios of cells in 4 cases. Larger subsets of coupled cells (greater than 3) were not observed. Dye-coupled cells were usually equally intensely stained. In non-taste epithelium, we examined dye-coupling in the superficial and basal layers. Extensive Lucifer yellow coupling was found in the basal layer (15/15 cases). The number of cells coupled to the dye-injected cell varied from 3 to 5. In the superficial epithelium, dye-coupling was rare (1/45 cases). No dye-coupling was observed between epithelial cells and taste cells at the taste pore region. We conclude that strong electrical coupling in groups of 2-3 cells occurs in the mudpuppy taste buds. Coupling may occur selectively between identical types of taste cells (dark, light, etc.), but this remains to be determined. Electrical coupling also exists among basal epithelial cells but not in the superficial epithelial layers. PMID- 3681407 TI - Induced disruption in the connectivity of an identified neuron in the Drosophila ts mutant shibire. AB - Temperature-sensitive mutants permit the selective expression of mutant genotype. The Drosophila ts mutant shibire (shi) is paralytic at 30 degrees C; the probable primary effect of the mutation is disruption of membrane recycling. In studying the development of the giant fiber (GF) pathway during the pupal period, we find that shi flies exposed to heat pulse during early pupal states exhibit perturbation in the development of an identified neuron that links giant fibers to motoneurons of indirect flight muscles. Concomitantly, latency in activation of these muscles by the giant fiber pathway is significantly increased. Flies exposed to heat pulse during the late pupal period remain similar to control shi and wildtype flies in giant fiber pathway anatomy and muscle latency. Thus, the critical period of development of an identified neuron in a known motor pathway can be defined by its period of sensitivity to the shi defect. The time-dependent defect is apparently specific for cells that are at a developmental stage that is greatly dependent on membrane recycling processes. Use of this mutant will allow us to investigate the possible role of membrane recycling in development and to establish critical periods of neuronal development. PMID- 3681406 TI - Electrically and chemically mediated increases in intracellular calcium in neuronal growth cones. AB - In the present report we used the calcium indicator fura-2 to compare intracellular levels of free calcium in growth cones of isolated Helisoma neurons under a variety of experimental conditions. We tested whether 2 different signals that inhibit growth cone motility--action potentials and serotonin--changed calcium levels in growth cones. Electrical stimulation of the cell body caused a rise in calcium levels at the growth cone. After brief stimulation, calcium levels quickly recovered to normal values, whereas longer stimulation periods required longer recovery times. The application of serotonin to growth cones caused an increase in calcium levels that was selective for growth cones of neurons whose outgrowth was inhibited by serotonin, but not for neurons whose outgrowth was not affected. We also found that motile growth cones had higher free calcium levels than growth cones that had spontaneously stopped growing. Furthermore, the distribution of calcium in neurons that contained motile growth cones was heterogeneous; calcium levels were always higher in the growth cone than in the neurite or soma. These data indicate that calcium levels in growth cones vary in different states of outgrowth and that calcium levels can be modulated by both electrical and chemical signals. PMID- 3681408 TI - Changes in the dendritic geometry of mouse superior cervical ganglion cells following postganglionic axotomy. AB - The dendritic geometry of mouse superior cervical ganglion cells was studied over periods of up to 3 months after postganglionic axotomy. Intracellular injection of HRP showed that total dendritic length and complexity were reduced by 60-70%, on average, among cells whose postganglionic axons had been crushed 2 weeks before. Both parameters gradually recovered in parallel with ganglion cell reinnervation of the periphery. These results indicate that neuronal interactions with peripheral targets influence the configuration of ganglion cell dendrites throughout life. The implications of this conclusion are discussed. PMID- 3681409 TI - Immunocytochemical properties of Alzheimer straight filaments. AB - In addition to paired helical filaments (PHF), the Alzheimer neurofibrillary tangle (NFT) contains straight filaments measuring 10-15 nm in width, as well as amorphous material. In previous immunoelectron microscopic studies, we have demonstrated that PHF and the amorphous material share antigens with the microtubule associated protein, tau, and the 200 kDa subunit of neurofilaments (NF). The present immunoelectron microscopic study focuses on the antigens present in the straight filaments contained in the NFT. Indirect and direct immunogold staining of Vibratome sections of Alzheimer hippocampus with a monoclonal antibody to NF200 kDa (1.1.1.) and polyclonal antibodies to NF, tau, and to PHF yielded intense and specific reaction with NFT. Within the same NFT both straight filaments and PHF were decorated by all the antibodies. Similarly decorated within NFT were filaments displaying a transitional form between straight filaments and PHF. Both PHF and straight filaments were also recognized by all the antibodies after extraction with an ionic detergent. These findings show that straight filaments contain most, if not all, of the antigens known to be present in PHF and share with PHF insolubility in ionic detergents. It is suggested that straight filaments result from alternative pathways of organization of the same components as form the PHF. PMID- 3681410 TI - Relationship between differentiation and terminal mitosis: chick sensory and ciliary neurons differentiate after terminal mitosis of precursor cells, whereas sympathetic neurons continue to divide after differentiation. AB - A population of undifferentiated cells has been characterized during the early development of nodose and ciliary ganglia. This population is defined by the absence of surface markers specific for neurons (tetanus toxin receptor, Q211 antigen) and for glial cells (O4 antigen). These undifferentiated cell populations were isolated from the ganglia and were shown to contain neuronal precursor cells that were able to differentiate in vitro into neurons, as characterized by morphology and surface antigens. Undifferentiated cells were detected during the period of neuronal birth, indicating that dividing neuronal precursor cells do not express neuron-specific surface markers. This was directly shown by 3H-thymidine-labeling studies using nodose ganglia, ciliary ganglia, and dorsal root ganglia. In sympathetic ganglia, however, no undifferentiated neuronal precursor cells were detectable at developmental stages when sympathetic neurons are born. 3H-Thymidine injected during that stage at E7 was incorporated into cells expressing the neuronal markers tetanus toxin receptor and Q211 antigen. Quantitative fluorimetric determination of the DNA content of dissociated sympathetic ganglion cells demonstrated the presence of a population of Q211-positive sympathetic ganglion cells in the G2 phase of the cell cycle. E7 sympathetic ganglion cells expressing neuronal surface markers were also shown to be able to divide in vitro. We have concluded that the relationship between terminal mitosis and the onset of differentiation differs between ganglia of the chick peripheral nervous system: Sympathetic ganglion cells continue to divide after the acquisition of neuronal properties, whereas neuronal precursor cells from other autonomic and sensory ganglia start to differentiate after a terminal mitosis. PMID- 3681411 TI - Healing and growth of half-eye "compound eyes" in Xenopus: application of an interspecific cell marker. AB - Surgically constructed compound eyes have been widely used to examine the development of retinotectal projections in amphibians. Such studies have been limited, however, by the lack of an adequate cellular marker with which to assess the contributions of grafted and host tissues to the later larval and adult retina. We have followed the growth of graft- and host-derived ocular tissues in interspecific compound eyes prepared by orthotopic and heterotopic exchanges of half-eye fragments between pigmented Xenopus borealis and albino Xenopus laevis embryos. This genotypic combination allowed the growth of graft-derived choroid and pigment epithelium to be studied in the living animal, and permitted cell-by cell resolution of graft- and host-derived neurons in quinacrine-stained paraffin sections. At mid- and late-larval stages graft-derived neurons occupied large and usually coherent territories of retina in all classes of orthotopic and heterotopic compound eyes. In successfully healed cases, sample means of the percentage of the total retina occupied by graft-derived neurons ranged from 43 to 51%. Graft-derived territories originated near the optic nerve head and extended into the germinal neuroepithelium at the retinal periphery. As compared to orthotopic compound eyes, graft-derived territories in all classes of heterotopic compound eyes were slightly smaller and significantly more variable. Despite this variability, the correlation between graft-derived pigment epithelial and retinal territories was quite good in heterotopic compound eyes. While graft-host borders were generally sharp, there was also evidence of local cell mixing over distances of several cell diameters in the inner nuclear and ganglion cell layers. Single displaced cells, isolated from other members of their genetic cohort by 5 or more cell diameters, were also present in the inner nuclear and ganglion cell layers. PMID- 3681412 TI - Spontaneous dissection of the vertebro-basilar system. A study of 18 cases (15 patients). PMID- 3681413 TI - Chemoembolization of malignant facial tumours. A preliminary study in 47 patients. PMID- 3681414 TI - Esthesioneuromas. Contribution of CT and NMR to the study. PMID- 3681415 TI - Computerized tomography and nuclear magnetic resonance imaging in Marchiafava Bignami disease. PMID- 3681416 TI - Subcellular localisation of gadolinium in the rat brain. PMID- 3681417 TI - Endovascular treatment of intracranial AVMs. Combined embolization with a multi purpose mobile-wing microcatheter system. PMID- 3681418 TI - Spinal arteriovenous malformations: a comparison of dural arteriovenous fistulas and intradural AVM's in 81 patients. AB - The medical records and arteriograms of 81 patients with spinal arteriovenous malformations (AVM's) were reviewed, and the vascular lesions were classified as dural arteriovenous (AV) fistulas or intradural AVM's. Intradural AVM's were further classified as intramedullary AVM's (juvenile and glomus types) and direct AV fistulas, which were extramedullary or intramedullary in location. Dural AV fistulas were defined as being supplied by a dural artery and draining into spinal veins via an AV shunt in the intervertebral foramen. Intramedullary AVM's were defined as having the AV shunt contained at least partially within the cord or pia and receiving arterial supply by medullary arteries. Of the 81 patients, 27 (33%) had dural AV fistulas and 54 (67%) had intradural AVM's. Several dissimilarities in clinical and radiographic findings of the two subgroups were evident. The patients with intramedullary AVM's were younger; the age at onset of symptoms averaged 27 years compared to 49 years for dural AV fistulas. The most common initial symptom associated with dural AV fistulas was steadily progressive paresis, whereas hemorrhage was the most common presenting symptom in cases of intramedullary lesions. No patients with dural AV fistulas had subarachnoid hemorrhage. Activity exacerbated symptoms more frequently in patients with dural lesions. Associated vascular anomalies occurred only in cases of intradural AVM's. In 96% of the dural lesions the AV nidus was in the low thoracic or lumbar region; in only 15% did the intercostal or lumbar arteries supplying the AVM also provide a medullary artery which supplied the spinal cord. In contrast, most intradural AVM's (84%) were in the cervical or thoracic segments of the spinal cord and all of them were supplied by medullary arteries. Transit of contrast medium through the intradural AVM's was rapid in 80% of cases, suggesting high flow lesions. Forty-four percent of the patients with AVM's of the spinal cord had associated saccular arterial or venous spinal aneurysms. No dural AV fistulas displayed these characteristics. A good outcome occurred in 88% of patients with dural AV fistulas after nidus obliteration, while 49% of patients with intramedullary AVM's did well after surgery or embolization. These findings suggest that dural and intradural AVM's differ in etiology (acquired vs. congenital) and that they have different pathophysiology, radiographic findings, clinical presentation, and response to treatment. PMID- 3681419 TI - Growth rate of human pituitary adenomas. AB - The immunohistological detection of a proliferation-associated nuclear antigen by the monoclonal antibody Ki-67 allows the determination of the growth fraction in human cell populations. In this study, biopsy specimens of 31 pituitary adenomas representing all major endocrine types were examined. All adenomas contained proliferating cells and the percentage of nuclei that were immunoreactive to Ki 67 ranged from 0.1% to 3.7%. Low values (0.1% to 1.0%) were present in 11 endocrine-inactive adenomas and higher values (1.1% to 1.5%) were found in six acromegalic patients. The percentages of Ki-67-positive cells in 12 prolactinomas and two adenomas from patients with Cushing's disease covered the entire range (0.1% to 3.7%). Preoperative bromocriptine treatment of prolactinomas did not influence Ki-67 expression. Invasive adenomas, as determined by preoperative computerized tomography, surgical observation, and histological examination of the sella dura demonstrated significantly higher Ki-67 values (average 1.15%) than noninvasive adenomas (average 0.60%). Determination of the incidence of proliferating cells by Ki-67 immunoreactivity represents a new tool for intraoperative quantitative assessment of tumor growth characteristics and may aid in the planning of adjuvant therapy and estimation of prognosis. PMID- 3681420 TI - Short-term preoperative treatment of macroprolactinomas by dopamine agonists. AB - During a period of 3 years, 25 patients with intra- and extrasellar macroprolactinomas were pretreated with dopamine agonists for a period of 2 to 6 1/2 weeks prior to transsphenoidal microsurgical tumor resection. Dopamine agonists were administered orally to 17 patients, intramuscularly to three patients, and both orally and intramuscularly to five patients. Repeated computerized tomography (CT) examinations revealed that all neoplasms except one cystic tumor were reduced in size during the course of dopamine-agonist administration. No complications attributable to medical pretreatment were observed. Tumor shrinkage increased the efficacy of surgery, especially in cases with considerable extrasellar extension of the adenomas. Within 3 months following adenomectomy, prolactin levels were adjusted to normal levels in 19 patients by additional low-dose treatment with dopamine agonists. Thin collimation CT assessments performed at least 3 months after surgery showed no evidence of residual tumor tissue in 23 patients. It is concluded that administration of dopamine agonists for some weeks prior to surgery is a useful adjunct to transsphenoidal microsurgery for macroprolactinomas. The new injectable form of bromocriptine is particularly valuable for this purpose. PMID- 3681421 TI - Prolactin-secreting adenomas: the preoperative response to bromocriptine treatment and surgical outcome. AB - Controversy exists regarding the effects of bromocriptine on the success of transsphenoidal surgery for patients with prolactinomas. Various studies on this drug have reported adverse effects, improvement, and no effect upon the subsequent surgical outcome. The authors have retrospectively reviewed the case histories of 55 patients with immunocytochemically confirmed prolactin-secreting pituitary adenomas operated on by a transsphenoidal approach between 1981 and 1985. All patients had received bromocriptine in a variety of doses and for variable durations prior to surgery. Thirty-nine patients were women and 16 were men, with an age range of 8 to 72 years. Basal prolactin levels prior to bromocriptine treatment ranged from 38 to 100 ng/ml in 11 patients, from 101 to 200 ng/ml in 12, and greater than 200 ng/ml in 29. The "cure" rates were 54%, 58%, and 38%, respectively. Thirty-one patients had microadenomas, with a postoperative cure rate of 68%; 12 had diffuse expansive adenomas, with a 17% cure rate; and 12 had grossly invasive tumors, with a 17% cure rate. A response to preoperative bromocriptine therapy was defined as a return of the basal prolactin level to normal: 18 patients were responders and 29 were hyporesponders; in eight the data were not available. The postoperative cure rate was 50% for the responders and 31% for the hyporesponders. Taking into account the distribution of tumor type, there was no actual difference in outcome between the responder and the hyporesponder groups. The total bromocriptine dose received preoperatively was nearly identical for all groups. No significant differences in the frequency or extent of fibrosis, calcification, or prolactin immunoreactivity were observed in the 55 patients when compared with 26 control prolactinomas not treated with bromocriptine. It is concluded that short-term bromocriptine treatment does not adversely affect surgical outcome in any of the prolactin secreting adenoma groups, nor does response or lack of response to bromocriptine predict surgical outcome. PMID- 3681423 TI - A comparison of intraparenchymatous and intraventricular pressure recording in clinical practice. AB - A comparison of intraventricular pressure (IVP) and intraparenchymatous pressure was performed in 11 patients with severe traumatic brain lesions. Intraparenchymatous pressure was measured with a Honeywell microtransducer placed intracerebrally. Before the microtransducer was used in clinical practice, basic data on drift and temperature sensitivity were tested in experiments in vitro. Under clinical conditions the correspondence between the measured IVP and intraparenchymatous pressures appeared to be better than previously reported for different devices for epidural or subdural pressure recording. It is concluded that intraparenchymatous pressure monitoring is reliable in clinical practice and that such measurements are valuable in patients with compressed and/or distorted ventricles that preclude possibilities for IVP recording. PMID- 3681422 TI - Pressure-volume index in head injury. AB - The authors studied intracranial pressure (ICP) and intracranial compliance as defined by the pressure-volume index (PVI) in 34 severely head-injured patients with a Glasgow Coma Scale score of 8 or less. The objective of the research was to determine if there was a correlation between the pressure-volume status and subsequent increase in ICP. The PVI and ICP measurements were obtained serially, and the temporal course of the pressure-volume status and ICP was determined during the 5-day period following injury. Aggressiveness of ICP was quantified by a therapy intensity level scale. A clear relationship between the PVI measured soon after injury and subsequent development of ICP emerged. Following mechanical trauma the PVI is reduced, and the degree of reduction and extent of biomechanical recovery are closely related to outcome and development of raised ICP. PMID- 3681424 TI - Efficacy of irradiation for incompletely excised acoustic neurilemomas. AB - The records of 124 patients treated for acoustic neurilemoma at the University of California, San Francisco, from 1945 through 1983 were reviewed. Patients were classified by the extent of surgical resection: total, nearly total (90% to 99% resection), subtotal (less than 90% resection), or biopsy. Thirty-one patients received irradiation as part of their primary treatment. Total resection of tumor, without irradiation, was associated with a 3% chance of local recurrence. One of 15 patients who had nearly total resection of their tumor and did not receive postoperative irradiation suffered a recurrence, compared with neither of the two patients who received postoperative irradiation (greater than 45 Gy) following nearly total resection. Postoperative irradiation (greater than 45 Gy) decreased the recurrence rate after subtotal resection from 46% (six of 13 cases without irradiation) to 6% (one of 17 cases: p = 0.01). All three patients treated by biopsy alone received postoperative irradiation (greater than 45 Gy), and none had a recurrence. Six patients were treated with preoperative irradiation because of excessive tumor vascularity; four are without evidence of disease 12 to 23 years later. Only three of seven patients treated with irradiation for tumor recurrence after surgical resection survived. It is concluded that postoperative irradiation significantly decreased the chance for local tumor progression following subtotal resection of acoustic neurilemoma, and that postoperative irradiation may be effective therapy following treatment by biopsy. Patients with total or nearly total resection appeared not to benefit from postoperative irradiation. PMID- 3681425 TI - Vascular permeability induced by protein product of malignant brain tumors: inhibition by dexamethasone. AB - Serum-free conditioned medium derived from confluent monolayer cultures of malignant human astroglial tumors contains a substance that rapidly increases capillary vascular permeability after intradermal injection into guinea pigs. Accumulation of vascular permeability factor (VPF) activity occurs with increasing duration of tumor incubation in vitro. Expression of this activity is inhibited by incubation of cell cultures with cycloheximide or dexamethasone. This VPF is an acid-stable heat-labile macromolecule that is inactivated by trypsin and pepsin and binds immobilized heparin. Activity is retained by ultrafiltration with 30,000-dalton cut-off microconcentrators. Pretreatment of test animals with systemic dexamethasone prior to intradermal injection of VPF diminishes microvascular permeability. Furthermore, VPF activity is not inhibited by antihistamines. Secretion of VPF may cause the vasogenic brain edema that is frequently associated with malignant primary and metastatic intracerebral tumors. Inhibition by dexamethasone of both VPF expression in tissue culture, and VPF activity at the microvascular level in test animals, is in keeping with the known efficacy of this agent in treating the vasogenic edema associated with brain tumors. PMID- 3681426 TI - Drug cytotoxicity at elevated temperature. In vitro study on the U-87MG glioma cell line. AB - The malignant glioma cell line U-87MG was used for 1,3-bis(2-chloroethyl)-1 nitrosourea (BCNU), aziridinylbenzoquinone (AZQ), cis-diaminodichloroplatinum (II) (cis-DDP), and spirohydantoin mustard (SHM) treatments at 37 degrees and 42 degrees C. With the exception of SHM, all drugs killed a greater proportion of cells at the higher temperature, as assessed by the colony-formation assay. Drug dose enhancement ratios were 1.6, 2.8, 2, and 1:1 for BCNU, AZQ, cis-DDP, and SHM, respectively. Because methods to heat discrete volumes of brain are now available, we conclude that hyperthermic increase of BCNU, AZQ, and cis-DDP cytotoxicity might have therapeutic application for malignant gliomas. PMID- 3681428 TI - The effect of 125I interstitial radiotherapy on blood-brain barrier function in normal canine brain. AB - Blood-brain barrier (BBB) function was studied in 14 normal dogs at time periods from 7 to 717 days after permanent insertion of 5- to 7-mCi seeds of iodine-125 (125I) for interstitial radiation. The BBB function was measured with carbon-14 labeled alpha aminoisobutyric acid (AIB) and quantitative autoradiography, and expressed as a unidirectional blood-to-brain transfer constant, K. The 125I radiation lesions consisted of three concentric histologically and functionally distinct zones: 1) a central zone of calcified necrosis; 2) a spongy fluid-filled zone; and 3) a narrow rim (2.6 +/- 0.6 mm wide) of viable brain tissue with increased permeability. Within this rim, the mean value of the K of AIB was 5.8 times that of normal cortex. Over the 7- to 392-day time period the value of K remained rather constant, and by 716 days K values had returned to normal. There was moderate regional variation in the value of K; it was highest in the white matter and lowest in the gray matter surrounding the radiation lesion. The radiation lesion progressively increased in size from 7 to 80 days, after which there was little change. This study illustrates that the geographically circumscribed radiation from 125I seeds is accompanied by similarly well-defined changes in BBB function, which may persist for over 1 year following insertion of the 125I seed. This altered BBB function is probably responsible for the cerebral edema associated with 125I interstitial radiotherapy. PMID- 3681427 TI - Interstitial laser photochemotherapy of rhodamine-123-sensitized rat glioma. AB - The effect of interstitial laser photochemotherapy with the mitochondrial specific intravital dye rhodamine-123 (Rh-123) was studied using a malignant rat glioma model system (RT2). Tumors were transplanted subcutaneously into the flank of athymic mice and into the cerebrum of adult rats. The Rh-123 photosensitization was produced by direct intratumoral injection of Rh-123 into the mouse RT2 flank tumors and by intravenous Rh-123 administration to adult rats with implanted RT2 intracerebral tumors. Intratumoral irradiation with 150 mW of argon laser light for an exposure time of 15 minutes was performed using a conical sapphire-tipped quartz optical fiber. Control groups of animals received either no treatment, Rh-123 injections, or administration of 150 mW of argon laser light for 15 minutes. Both flank and intracerebral tumors showed progressive diminution in size after treatment with Rh-123 photochemotherapy. There was no evidence of tumor recurrence in 60% of Rh-123 photochemotherapy treated tumors. Recurrences in tumors treated with Rh-123 photochemotherapy usually appeared at the periphery of the original tumor at 10 days after treatment. Histologically, photochemotherapy-treated intracerebral tumors showed progressive shrinkage with increasing tumor necrosis over time. The finding of residual or recurrent tumor at the periphery of the original tumor mass suggests that the lack of penetration of the blue-green (argon) light was responsible for preventing complete tumor ablation. Our results suggest that Rh-123 photochemotherapy can destroy malignant gliomas in vivo; however, the poor penetrability of the photoactivating blue-green light may limit the effectiveness of this treatment for large or extensively invasive tumors. PMID- 3681429 TI - Experimental induction of cerebral aneurysms in monkeys. AB - Saccular cerebral aneurysms were successfully induced in two monkeys treated with ligation of the common carotid artery, experimental hypertension, and beta aminopropionitrile feeding. The cerebral aneurysms developed on the large arteries at the base of the brain, such as the anterior communicating artery and the internal carotid artery at the origin of the posterior communicating artery. Because of the similarity of the monkey to man as a species, the present results strongly suggest the significance of postnatal aggravating factors in the development of cerebral aneurysms in man. PMID- 3681430 TI - The sympathetic nervous system and atherosclerosis. AB - Morphometric and chemical changes in the arterial wall were studied after 12 months of diet-induced atherosclerosis in rhesus monkeys treated with either bilateral surgical thoracic sympathectomy or propranolol. There was a marked reduction in the progression of atherosclerosis in the carotid arteries and a moderate reduction in the disease found in the thoracic aorta of monkeys treated initially with a sympathectomy, in comparison to control monkeys fed an atherogenic diet alone. Propranolol at a dose of 40 mg/12 hrs also seemed to reduce the progression of atherosclerosis in the carotid arteries and thoracic aorta, although the differences were less dramatic. There were minimal differences in the extent of atherosclerosis in the abdominal aorta or femoral arteries of animals in either treatment group as compared with the control group. Similarly, the chemical composition of these same major vessels showed no significant differences. Therefore, in the face of severe atherogenic stimuli, chemical or surgical sympathectomy may be useful in controlling atherosclerosis in specific arterial beds. PMID- 3681431 TI - Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa. Report of three cases. AB - Intracerebral cavernous hemangiomas are relatively easy to remove surgically, but extracerebral cavernous hemangiomas attached to the cavernous sinus are extremely difficult to treat. The authors report three cases of extracerebral cavernous hemangioma in the middle fossa that were treated with radiotherapy. The follow-up studies with serial computerized tomography (CT) scans during and after irradiation are described. In Case 1 radiotherapy after partial removal of the tumor decreased the tumor size on the contrast-enhanced CT scans, reduced its Hounsfield units on the nonenhanced CT scans, and facilitated later total tumor removal. In Case 2 the tumor responded to irradiation with approximately 3000 rads, showing significant reduction in size and Hounsfield units of the tumor. Subtotal removal was then possible. In Case 3 the tumor responded to irradiation, and the patient's vertigo improved after delivery of approximately 3000 rads. The CT scan showed significant reduction in the size and Hounsfield units of the tumor. No surgical intervention was deemed necessary. It is concluded that, in cases of extracerebral cavernous hemangioma with massive hemorrhage, irradiation with up to 3000 rads may be the treatment of choice. Radiation therapy offers an increased probability of total removal of the tumor and the possibility of eliminating surgery. PMID- 3681432 TI - Melanoma arising in a spinal nerve root. Case report. AB - Melanotic neoplasms of the spinal nerve root are rare but well-documented occurrences. The authors report the case of a 68-year-old woman with a malignant melanotic neoplasm containing premelanosomes and melanosomes and lacking a basal lamina. This tumor was found in a lumbar nerve root and is believed to represent an instance of a primary melanoma arising in a spinal nerve root. The differential diagnosis of pigmented lesions of spinal nerve root includes melanoma, pigmented nerve sheath tumor, blue nevus, melanotic clear-cell sarcoma, and meningeal melanocytoma. Surgeons should be aware of the potential for encountering unexpected malignant lesions involving spinal nerve roots. PMID- 3681433 TI - Cystic schwannoma of the trochlear nerve mimicking a brain-stem tumor. Case report. AB - A case is reported of a rare cystic schwannoma of the fourth cranial nerve which was interpreted as a probable intrinsic brain-stem lesion. The clinical approach to brain-stem tumors in terms of empirical treatment or surgical biopsy is discussed. PMID- 3681434 TI - Sparganosis of the brain. Report of two cases. AB - Cerebral sparganosis is a rare disease; to date only eight cases have been described. Two new cases of cerebral sparganosis occurring in Chinese patients living in a metropolitan area are reported. Their clinical presentation and investigative results are presented and the operative and histological findings detailed. A brief review of the condition is given and the possible source of infection discussed. PMID- 3681435 TI - Pseudoaneurysm of the extracranial vertebral artery. Case report. AB - The unusual association of a giant extracranial vertebral artery pseudoaneurysm, intracranial aneurysms, and extracranial carotid occlusion in a woman with neurofibromatosis is presented. Pain as a result of expansion of the mass in the soft tissue of the neck led to her seeking evaluation. Herniation of the mass intraspinally between the occiput and C-1 resulted in myelopathy. Following balloon occlusion of the vertebral artery, the mass and associated symptoms resolved without the need for direct resection. The salient features of these unusually associated problems are discussed. PMID- 3681436 TI - Elusive cauda equina tumor. PMID- 3681437 TI - ICP monitoring in severe head injury. PMID- 3681438 TI - Utility of carotid endarterectomy. PMID- 3681439 TI - Cutaneous melanosis and hydrocephalus: further comment. PMID- 3681440 TI - Hydrocephalus and periventricular white matter water content. PMID- 3681442 TI - The effect of previous thoracic surgery on gallium uptake in the chest. AB - To determine the frequency, average duration, and characteristic patterns of persistent gallium uptake caused by thoracotomy, serial postsurgical scans of 51 patients were reviewed. In each of these cases a thoracotomy had been performed for resection of lung cancer, and there had been no evidence of recurrent tumor for at least 2 yr following surgery. Postoperative gallium activity due to non neoplastic postoperative changes occurred in 15 patients. Five of six patients scanned within 3 mo of surgery and six of 21 scanned 3 to 6 mo following surgery showed persistent uptake at the operative site. All 13 patients who had subsequent scans demonstrated eventual clearing. Activity persisted more than 18 mo postoperatively in only one patient. Patterns of gallium accumulation included both focal chest wall uptake at the incision site and diffuse pleural activity. PMID- 3681441 TI - Scintigraphy and treatment of medullary carcinoma of the thyroid with iodine-131 metaiodobenzylguanidine. AB - We report our experience using [131I]metaiodobenzylguanidine (MIBG) to image nine patients with proven medullary carcinoma of the thyroid (MCT). Positive uptake was seen in four patients, equivocal uptake in one patient, and no uptake in four patients. Data is presented to demonstrate the pharmacokinetics of [131I]MIBG in three of the patients studied. Two patients, with diarrhea and severe pain from known bone metastases and positive uptake on [131I]MIBG diagnostic scanning, subsequently received therapeutic doses of [131I]MIBG, with marked improvement in both pain and diarrhea, but no evidence of significant biochemical response. Iodine-131 MIBG uptake in patients with MCT is variable, and gives a higher false negative rate than is found when using [131I]MIBG to image other neuroectodermally derived tumors. The therapeutic potential of [131I]MIBG in patients with MCT warrants further evaluation, in view of the symptomatic relief experienced following therapy doses in two patients with extensive disease. PMID- 3681443 TI - Bone scanning in the adductor insertion avulsion syndrome ("thigh splints"). AB - Shin splints is a defined clinical entity resulting from extreme tension on muscles inserting on the tibia, resulting in periosteal elevation which is detectable by bone scanning. The clinical equivalent in the thigh has been described. We found scintigraphic changes in the femurs of seven short, female, basic trainees at the Fort Dix Army base, most of whom were referred for stress fractures elsewhere in the lower extremities. The scan findings were generally noted in the upper or mid femurs, always involved the anteromedial cortex, and were bilateral in five of the seven subjects. The abnormalities were linear and suggested periosteal elevation, and did not have the typical appearance of stress fracture. Since the findings correspond to the insertion of one or more adductor muscle groups, the descriptive term "adductor insertion avulsion syndrome" or "thigh splints" is proposed for this entity. PMID- 3681444 TI - Development of nonreducible technetium-99m(III) cations as myocardial perfusion imaging agents: initial experience in humans. AB - A series of 15 nonreducible technetium-99m(III) complexes of formula tr [99mTcL(Y)2]+ has been prepared by a general synthetic route based on reductive addition of Y to the technetium-99m (99mTc) intermediate [99mTcL(O)]+. In these complexes, selected for potential use as myocardial imaging agents, L represents one of the two tetradentate Schiff base ligands N,N'-ethylenebis(acetylacetone iminato), (en), or N,N'-propylene-1,2-bis(acetylacetone iminato), (pn), while Y represents a monodentate phosphine, phosphite or isonitrile ligand as exemplified by P(CH3)3, P(OCH3)3 and CN-C(CH3)3. Of these 15 complexes, several with octanol/saline partition coefficients in the range 0.04-20 exhibit significant myocardial uptake in rats and dogs. Of these, none exhibit detectable myocardial washout, providing strong support for the hypothesis that myocardial washout occurs only for those 99mTc(III) cations that undergo in vivo reduction to the neutral 99mTc(II) form. Evaluation of the prototypical complex tr [99mTc(en)(P(CH3)3)2]+ in seven normal volunteers and patients establishes that it is only a mediocre myocardial imaging agent in man. PMID- 3681445 TI - Therapeutic doses of iodine-131 reveal undiagnosed metastases in thyroid cancer patients with detectable serum thyroglobulin levels. AB - Serum thyroglobulin (Tg) measurements in patients with treated differentiated thyroid cancer are usually well correlated with the presence or absence of residual or metastatic thyroid tissue. However, it is not rare to find a patient with detectable serum Tg levels but negative 131I whole-body scan (WBS) and no evidence of disease activity. To clarify the reason for this discrepancy, we decided to perform the WBS after the administration of a therapeutic dose of 131I in 17 consecutive patients in whom serum Tg was detectable while the WBS performed with a 5 mCi tracer dose was negative (12.6% of 135 patients studied with both WBS and serum Tg). The result of this study demonstrated that after this procedure the WBS became positive for significant residual or metastatic areas of radioiodine uptake in all patients but one. Such data indicate that in our patients the presence of circulating Tg is not a false-positive Tg result, but is due to the presence of residual or metastatic tissue that is not detected in the conventional WBS, that can be visualized using therapeutic doses. Preliminary follow-up data indicate that this procedure may also have therapeutic effect, although the relevance of this aspect remains to be established. PMID- 3681446 TI - Effect of bronchodilation on the deposition and clearance of radioaerosol in bronchial asthma in remission. AB - Radioaerosol inhalation lung cine-scintigraphy and lung function tests were performed on ten patients with bronchial asthma in remission before and after inhalation of salbutamol following intravenously administered aminophylline. Radioaerosol inhalation lung cine-scintigraphy was very useful in revealing the changes not only in the deposition patterns of inhaled aerosol in the lungs but also in the dynamic transport of mucus on the airways. The bronchodilating effect of the combined treatment was significant; the inhaled aerosol deposited more homogeneously and less centrally in the lungs, the "penetration index" and the alveolar deposition ratio (ALDR) increased from 31 +/- 3 to 49 +/- 7%, and from 29 +/- 2% to 39 +/- 1%, respectively, while the airway deposition ratio (ADR) decreased from 72 +/- 2 to 61 +/- 1% immediately after the treatment. Lung function data including FVC, FEV 1.0, FEV 1.0%, MMF, V50 and Vp significantly improved after the treatment. There was, however, little visual or quantitative improvement in mucociliary clearance after the treatment. PMID- 3681447 TI - Imaging of carcinoid tumors with iodine-123 metaiodobenzylguanidine. AB - Scintigraphy with 123I-radiolabeled metaiodobenzylguanidine (MIBG) was performed successfully in two patients with metastatic carcinoid tumor. The scintigraphic findings show diversity of the tumor deposits in the uptake of [123I]MIBG in the same patient and between patients. PMID- 3681449 TI - Biodistribution of indium-111-labeled monoclonal antibodies. PMID- 3681448 TI - Functional oncocytoma of the kidney: evaluation by dual tracer scintigraphy. AB - We report a case of renal oncocytoma with a unique scintigraphic pattern. The tumor showed strong avidity for [123I]iodohippurate, but no affinity for [99mTc] glucoheptonate. We offer an explanation for such exceptional scintigraphic finding, which may potentially enable us to make a pre-operative diagnosis of renal oncocytoma in the future. PMID- 3681450 TI - Sex and menopausal status of subjects in gastric emptying studies. PMID- 3681451 TI - Contract learning in orientation. PMID- 3681452 TI - Developing and maintaining a climate of support for staff development. PMID- 3681453 TI - Test construction techniques. PMID- 3681454 TI - Chemotherapy certification in the small community hospital. PMID- 3681455 TI - Overcoming the dilemma of continuing education. PMID- 3681456 TI - Developing the inexperienced nurse educator. PMID- 3681457 TI - Adapting to change: a staff nurse workshop. PMID- 3681458 TI - Education day for new graduates. PMID- 3681459 TI - Perspectives on research. The Nursing Research Committee. PMID- 3681460 TI - Male nurses: do they belong in obstetrics? PMID- 3681461 TI - Use of research based knowledge in clinical practice. AB - The authors describe three research utilization projects that used a knowledge driven approach to nursing practice. The activities involved in developing and implementing these research utilization projects included: (1) preparing nurses to read, critique, and use research; (2) identifying and reviewing research studies in a common area to develop a research base; (3) transforming the research based knowledge into a protocol to be used in the clinical area by nurses caring for patients; and (4) evaluating the protocol to see whether it is being implemented as expected and whether it is producing the predicted results. This practical utilization is discussed and illustrated in a systems theory model. PMID- 3681462 TI - Health care for low income. PMID- 3681463 TI - Gambling away absenteeism. AB - Current conditions in health care make the battle against absenteeism critical. Of all the various methods devised, one seems to be consistently effective: positive reinforcement through a simple lottery incentive system. The authors describe this system's impact on reducing absenteeism. PMID- 3681464 TI - Nursing 1987: a look back and a look ahead. PMID- 3681465 TI - Mandatory reporting: legal and ethical issues. AB - What legal and ethical dilemmas do nurse executives face when laws and practice acts require mandatory reporting of incompetent behavior? The authors discuss the ramifications of mandatory reporting including barriers to intraprofessional reporting and suggested guidelines for responsible reporting of incompetent practice. Also included are suggestions for creating an environment which will foster openness and discussion of critical legal and ethical dilemmas resulting from mandatory reporting obligations. PMID- 3681466 TI - Head nurses: their practice and education. AB - The head nurse has become a critical link in managing successful hospital units in this post-DRG (Diagnosis Related Group) era. As more nursing services move to a decentralized model, the head nurse role has grown in complexity and accountability far beyond entry level nursing preparation. This study explores the patterns of use of head nurses in United States hospitals and how they should be educated. PMID- 3681467 TI - Leadership in a changing environment. PMID- 3681469 TI - Social and demographic challenges. Nurse-midwifery education must respond. PMID- 3681468 TI - Outcomes of shared governance on staff nurses. PMID- 3681470 TI - A task analysis of American nurse-midwifery practice. PMID- 3681471 TI - Postpartum thyroiditis: a new challenge in nurse-midwifery. PMID- 3681472 TI - An American look at midwifery in Iceland. PMID- 3681473 TI - Differing effects of arginine deficiency on the urea cycle enzymes of rat liver, cultured hepatocytes and hepatoma cells. AB - We have confirmed that arginine-deficient diets increase the liver activities (units per 100 g) of the first four arginine biosynthetic enzymes of the urea cycle in Wistar rats, but not the activity of arginase. In contrast, rat liver cells cultured in monolayers for 48, 72 or 96 h in arginine-free L-15 or minimum essential medium showed no changes in carbamoyl-phosphate synthase (EC 6.3.4.16), ornithine transcarbamylase (EC 2.1.3.3), argininosuccinate synthase (EC 6.3.4.5), argininosuccinase (EC 4.3.2.1) or arginase (EC 3.5.3.1) activities. The arginine content of the cells grown on deficient medium was 36% of that of cells grown on 2.9 mM arginine-sufficient L-15, yet the urea excretion rate into the medium was reduced to 7% of the rate in control cells and the excretion of orotic acid was 400% of that in control cells. A Morris rat hepatoma cell line, 7800C1, which maintains activities of all five urea cycle enzymes, showed no consistent increases in the activities of the first four enzymes when the arginine in the medium was varied between 0 and 2 mM. Thus, in spite of severe arginine deficiency, cultured rat liver cells and hepatoma cells do not show the derepression-like response seen by other investigators when nonliver cells were cultured in arginine-deficient media. The difference between in vivo and in vitro effects of arginine deficiency on urea cycle activities remains unexplained. PMID- 3681474 TI - Effect of excess dietary methionine on weight gain and plasma amino acids in kittens. AB - Four groups of five kittens each were individually fed for 6 wk either a purified control diet containing 0.5% methionine (Met) (based on 18% casein supplemented with arginine, cystine and threonine) or one of three experimental diets containing an additional 2, 3 or 4% L-Met. The diets with added Met caused a reduction in food intake (FI) on the second day and a negative body weight gain (BWG), in proportion to the level of added Met. After 10 d, kittens fed the 2 and 3% Met diets increased their FI and had positive BWG. During the last 10 d of the experiment, the control, 2% Met and 3% Met groups had BWG of 28, 15 and 0 g/d, respectively. Kittens given the 4% Met diet showed no adaptation and continued to lose weight. In these kittens plasma concentration of Met was 50-70 times and cystathionine about three times greater than in control kittens. Four male kittens were fed the same 4% Met diet for 6 wk and then switched to a diet containing 4% L-Met plus 4% glycine (Gly) for 12 d. Average daily FI was 21.4 +/- 1.3 g with 4% Met and 48.5 +/- 2.5 g after the addition of Gly, and BWG went from negative to positive. These results indicate that growing kittens are more sensitive than rats to excess Met and have a limited adaptive capacity. Kittens did not grow normally when the diet contained 2% or more dietary Met, which was equivalent to 0.6 g Met/(kg body wt.d). PMID- 3681475 TI - Effects of maternal and long-term postnatal protein malnutrition on brain size and composition in rhesus monkeys. AB - Rhesus monkeys consumed purified diets that supplied either low or adequate levels of protein (3.8 vs. 13.9% of energy as casein) from birth until approximately 10 yr of age. A subgroup (PN) was born of mothers that also received low or control levels of protein throughout pregnancy. The deprived groups weighed significantly less than corresponding control groups. Weights of the total brain, cerebellum and brain stem were significantly reduced in the PN deprived group. Analysis of variance also indicated that low protein diets produced a significant reduction in cerebral weight. The concentrations of DNA, protein and eight different lipids from seven different sites in the central and peripheral nervous system were not greatly affected by diet. The total content of lecithin and phosphatidylethanolamine was significantly depressed in some parts of the deprived monkey brains. The deficits in brain weight of the PN group (10% for the cerebrum, 13% for the cerebellum and 18% for the brain stem) were very similar to those observed previously in 1-mo-old monkeys born of protein-deprived mothers and fed low protein diets postnatally. On the other hand, monkeys born of adequately nourished mothers and then fed low protein diets from birth up to 12 yr showed no deficit in brain weight despite reduction in body weight to less than half of control values. PMID- 3681476 TI - Identification of volatile sulfur derivatives released from feathers of chicks fed diets with various levels of sulfur-containing amino acids. AB - Physical changes are observed in the feathers of chickens fed diets with high levels of methionine or cysteine. Chicks were fed diets chemically analyzed to contain 21% crude protein, 0.35% methionine and 0.37% cystine (basal) supplemented with DL-methionine [0.063 (control), 0.25 or 1.45%] or L-cysteine (0.203%). At 3 wk of age, the birds were weighed and the feathers scored for softness. Feather strength (i.e., force-displacement curves) was determined on feathers from the pectoral tract. A significant (P less than 0.05) reduction in body weight and an increase in feather softness were seen when chicks fed the control diet and those fed the diet with 1.45% added methionine were compared. Chicks fed the diet supplemented with 0.203% L-cysteine produced the strongest feathers; those fed diets supplemented with 1.45% DL-methionine produced the weakest feathers. Volatile sulfur compounds released from the feathers were trapped as dinitrophenyl (DNP) thioethers and were analyzed by thin-layer chromatography, high pressure liquid chromatography and mass spectrometry. More bound sulfide (P less than 0.05) was recovered from feathers of chickens fed the diet supplemented with 1.45% methionine than from feathers of chickens fed the other diets. The feather softness score was correlated (r = 0.5; P less than 0.05) with bound sulfide. Thus, consumption of a diet with a level of methionine that is approximately three times the requirement resulted in decreased growth, elevated sulfide bound to the feathers and soft, weak feathers. PMID- 3681477 TI - Vitamin B-6 metabolism in the pregnant rat: effect of progesterone on the (re)distribution in maternal vitamin B-6 stores. AB - Parameters of vitamin B-6 metabolism were studied in pregnant rats, nonpregnant control rats and progesterone-supplemented ovariectomized rats. Plasma pyridoxal 5'-phosphate (PLP) and pyridoxal concentrations in pregnant rats were 20 and 40% of those of nonpregnant rats, respectively. Excretion of 4-pyridoxic acid in the urine in pregnant rats was about 40% of that of nonpregnant rats. Liver PLP content was also lower during pregnancy, but liver pyridoxamine 5'-phosphate (PMP), kidney PLP and PMP and muscle PLP contents did not change significantly. Progesterone administration to ovariectomized rats resulted in slightly lower plasma, liver and kidney PLP levels than in intact untreated control rats. Liver and kidney pyridoxal kinase (PK) and pyridoxamine 5'-phosphate oxidase activities were similar in pregnant and nonpregnant rats. Progesterone treatment resulted in a significantly lower PK activity in the kidney of the treated rats than in untreated controls. It is concluded that the pregnancy-induced changes in vitamin B-6 metabolism were unlikely to be related directly to progesterone. However, progesterone may secondarily affect maternal vitamin B-6 stores during pregnancy, by temporary deposition and increased retention of vitamin B-6. PMID- 3681478 TI - Iron and zinc concentrations and 59Fe retention in developing fetuses of zinc deficient rats. AB - Because disturbances in iron metabolism might contribute to the teratogenicity of zinc deficiency, we examined the effect of zinc deficiency on fetal iron accumulation and maternal and fetal retention of 59Fe. Pregnant rats were fed from mating a purified diet containing 0.5, 4.5 or 100 micrograms Zn/g. Laparotomies were performed on d 12, 16, 19 and 21 of gestation. Maternal blood and concepti were analyzed for zinc and iron. Additional groups of dams fed 0.5 or 100 micrograms Zn/g diet were gavaged on d 19 with a diet containing 59Fe. Six hours later maternal blood and tissues, fetuses and placentas were counted for 59Fe. Maternal plasma zinc, but not iron, concentration was affected by zinc deficiency on d 12. Embryo zinc concentration on d 12 increased with increasing maternal dietary zinc, whereas iron concentration was not different among groups. On d 16-21 plasma iron was higher in dams fed 0.5 micrograms Zn/g diet than in those fed 4.5 or 100 micrograms/g, whereas plasma zinc was lower in dams fed 0.5 or 4.5 micrograms Zn/g than in those fed 100 micrograms Zn/g diet. On d 19 zinc concentration in fetuses from dams fed 0.5 micrograms/g zinc was not different from that of those fed 4.5 micrograms/g zinc, and iron concentration was higher in the 0.5 microgram Zn/g diet group. The increase in iron concentration in zinc deficient fetuses thus occurs too late to be involved in major structural teratogenesis. Although whole blood concentration of 59Fe was not different in zinc-deficient and control dams, zinc-deficient dams had more 59Fe in the plasma fraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681479 TI - Zinc deficiency increases the osmotic fragility of rat erythrocytes. AB - Zinc deficiency in rats causes increased osmotic fragility of their erythrocytes. This study was designed to determine the relationship of food intake and dietary sulfur amino acid level to the effect of low zinc status on fragility. Immature rats were fed for a 3-wk period a low zinc diet (less than 1 mg/kg) based on isolated soybean protein or a similar control diet (100 mg Zn/kg diet) supplied either ad libitum or by pair feeding. Fragility was measured by the degree of hemolysis in hypotonic saline solutions. In the first experiment, zinc deficiency resulted in higher fragility than in ad libitum controls; pair-fed controls were intermediate and not different from either. Experiment 2 included two levels of methionine, 0.4 and 0.9%, and two of zinc, 0 and 100 mg Zn/kg diet. At the 0.4%, but not at the 0.9% methionine level, hemolysis of red blood cells from the zinc deficient rats was significantly greater than those from either pair-fed or ad libitum controls. Repletion for 1 or 2 d completely alleviated the increased fragility, but in vitro addition of zinc had no effect. Restricted intake of the zinc-adequate diet reversed the fragility within 1 d as readily as did ad libitum intake. Thus, the osmotic fragility induced by zinc deficiency was prevented by high sulfur amino acid intake and was readily reversed by dietary zinc. It is postulated that extracellular or membrane-bound zinc protects a component of the membrane that is essential to its function, and that reversal of the defect requires an in vivo metabolic process. PMID- 3681480 TI - Oxalic acid decreases calcium absorption in rats. AB - Calcium absorption from salts and foods intrinsically labeled with 45Ca was determined in the rat model. Calcium bioavailability was nearly 10 times greater for low oxalate kale, CaCO3 and CaCl2 than from CaC2O4 (calcium oxalate) and spinach (high in oxalates). Extrinsic and intrinsic labeling techniques gave a similar assessment of calcium bioavailability from kale but not from spinach. PMID- 3681481 TI - Magnesium-induced catharsis in chicks. AB - High magnesium (Mg) diets induce diarrhea in chicks. Addition of 0.3, 0.5 or 0.9% Mg (as MgO) to a corn-soy basal diet caused a dose-related lower gut passage time (GPT) (the first appearance of colored markers from feed in excreta), with the threshold for catharsis being approximately the 0.3% addition. Supplementation of the high Mg diets with a water-absorbent clay did not change the chicks' GPT. The beta-adrenergic blocking agent propranolol (1.68 mg/kg body wt) or the alpha adrenergic blocking agent phenoxybenzamine (0.28 mg/kg body wt) did not effect the GPT of chicks fed high Mg diets. However, both the muscarinic blocker methscopolamine (0.12 mg/kg body wt) and the serotonergic blocker methysergide (0.2 mg/kg body wt) resulted in a higher GPT of chicks fed high Mg diets compared to corn-soy fed control chicks. Analysis of the osmotic load of excreta or intestinal contents of high Mg-fed chicks showed no differences from osmotic loads of control-fed chicks. When the osmotic loads observed were partitioned into mineral cationic and anionic components, the Mg content was found to be higher in intestines of chicks, but this higher Mg was paralleled and/or surpassed by chloride (Cl) content. From these data the authors conclude that Mg induced cartharsis is due not simply to the hyperosmotic effect of Mg per se but to neural or endocrine arcs that affect the secretion or absorption of Cl as well. PMID- 3681482 TI - Dietary conditions influencing relative zinc availability from foods to the rat and correlations with in vitro measurements. AB - Zinc availability from a series of foods was determined using 65Zn-labeled test meals fed to rats. Zinc availability relative to zinc chloride depended on the amount of the zinc source in the test meal. Zinc availability from several foods was similar to that from zinc chloride when tested in smaller amounts, but enhanced when fed in larger amounts. The range of zinc availability was similar for foods of plant and animal origin. Rats retained significantly more zinc from pork, chicken, peanut butter, egg or milk than from rice, beef, soybean flour or navy beans. Foods with intermediate zinc availability were sweet corn, whole wheat bread, cheese and oysters. Several food characteristics were examined for possible relationships with zinc availability, including the solubility or molecular size of zinc compounds after an in vitro enzymatic digestion and the contents of phytic acid, minerals, amino acids, carbohydrate and fatty acids relative to the zinc content of the food. Protein and several amino acids predicted about half of the variance in zinc availability. Following in vitro enzymatic digestion, neither zinc solubility nor the partitioning of zinc between low and high molecular weight substances was a strong predictor of zinc availability. PMID- 3681483 TI - New method for formulation of amino acid concentrations and ratios in diets of rats. AB - Parameters derived from the application of the saturation kinetics model (SKM) to rat growth experiments were used to formulate a complete dietary amino acid mix for weanling rats. Dietary ratios and concentrations for indispensable amino acids (IAA) and arginine were calculated using the parameter K0.5. A curve shift technique was used to determine dietary concentrations for conditionally indispensable amino acids (CAA) and dispensable amino acids (DAA). The model was also used to determine a dietary ratio of (IAA + Arg)/(CAA + DAA). Using the dietary amino acid concentrations suggested by the model and an (IAA + Arg)/(CAA + DAA) ratio of 1, a growth response curve was constructed and compared to a similar curve using the amino acid mix of Rogers and Harper. The modeling approach produced a 10-15% improvement in growth over the Rogers and Harper mix. The SKM is discussed in terms of calculating an ideal nutrient ratio and choosing a desired response level. It is demonstrated that the model can rapidly produce accurate estimates for dietary amino acid levels, while minimizing required numbers of laboratory animals. PMID- 3681484 TI - Effect of dietary taurine on plasma and blood cell taurine concentrations in cats. AB - Taurine levels were measured in adult cats consuming casein-based diets supplemented with 0.2, 0.05, 0.02, 0.01 or 0% (wt/wt) taurine or with 0% taurine plus 5.0% L-cystine. Taurine concentrations in plasma, platelets, granulocytes and erythrocytes declined significantly with decreased dietary taurine. In the cats that did not receive the 5.0% cystine supplement, the relationship between dietary taurine intake and plasma and blood cell taurine level was nonlinear. The greatest increment in taurine concentrations occurred between the 0.02 and 0.05% taurine intakes. These findings suggest that the dietary taurine requirement for adult cats may be between 0.02 and 0.05%. Supplementation of the 0% taurine diet with 5.0% L-cystine raised taurine levels above those of the taurine-deficient diets in plasma and all blood cell types. The result of this study therefore suggest a close relationship between dietary taurine intake and blood cell taurine levels in cats. Five percent L-cystine stimulates taurine synthesis in these animals. PMID- 3681485 TI - Effect of repeated reproductive cycles on pregnancy outcome in ad libitum-fed and chronically food-restricted rats. AB - To evaluate the combined effects of repeated, closely spaced reproductive cycles and dietary intake on maternal nutritional status and pregnancy outcome, rats were fed ad libitum or 75 or 60% of ad libitum intake. Dietary treatment began 28 d before breeding and continued through two reproductive cycles. Underfed rats gained less weight during pregnancy and had fewer and lighter pups at parturition. During the third week of the first lactation and between weaning and the second conception, underfed rats gained weight, whereas the controls lost weight. Underfed dams gained more weight in the second pregnancy and retained more weight than in the first pregnancy. Dams and pups in all groups were larger at the second parturition. The results indicate that net weight gain both during pregnancy and between reproductive cycles contributed to the ability of underfed dams to produce larger young at the second birth. PMID- 3681486 TI - Effect of repeated reproductive cycles on maternal nutritional status, lactational performance and litter growth in ad libitum-fed and chronically food restricted rats. AB - To evaluate the combined effects of repeated, closely spaced reproductive cycles and dietary intake on maternal nutritional status, lactational performance and litter growth, rats were fed ad libitum or 75 or 60% of ad libitum intake. Dietary treatment began 28 d before breeding and continued until d 14 of the first (L1) or second (L2) lactation. Body weight and carcass fat concentration of dams and their litters were affected in the 75% group; milk yield, milk protein and lactose concentrations and energy content were affected only in the 60% group. Dams and their litters were heavier, had more total carcass protein and higher plasma albumin values in L2 than L1. There was no effect of reproductive period on milk yield or composition. These results indicate that repeated reproductive cycles did not compromise maternal nutritional status, lactational performance or litter growth. Improved outcomes in L2 among the restricted rats appeared to result from gains during the interval between reproductive periods and early in the second pregnancy. PMID- 3681487 TI - Human P(3)450: cDNA and complete protein sequence, repetitive Alu sequences in the 3' nontranslated region, and localization of gene to chromosome 15. AB - P(1)450 and P(3)450 are the two members of the dioxin-inducible P450 gene family, one of at least eight families in the entire P450 gene superfamily. The human P(1)450 gene has been previously sequenced. In this report the human liver P(3)450 protein is shown to migrate as a 54-kDa band on NaDodSO4-polyacrylamide gel electrophoresis. The human P(3)450 cDNA (3,064 bp) and complete P(3)450 protein (515 residues; Mr = 58,294) were determined. The human P(3)450 mRNA (3.3 kb) has an unusually long 3' nontranslated region (1,509 bp) primarily due to the inclusion of four copies of Alu repetitive sequences. Comparison of human P(3)450 cDNA with human P(1)450 cDNA and mouse (or rat) P(3)450 cDNA with mouse (or rat) P(1)450 cDNA suggests that an intra-exonic gene conversion event (in the region between 100 and 400 nucleotides from the 5' end of the translated region) most likely occurred between 20 and 80 million years ago. Analysis of 32 human X mouse and 23 human X hamster somatic cell hybrids confirm unequivocally that both P(3)450 and P(1)450 reside on human chromosome 15. PMID- 3681488 TI - Expression of the mouse P(1)450 gene during differentiation without foreign chemical stimulation. AB - Transcriptional activation of the P(1)450 and P(3)450 genes, mRNA accumulation, and induction of the P(1)450 and P(3)450 enzymes are known to be stimulated by foreign chemicals such as tetrachlorodibenzo-p-dioxin and 3-methylcholanthrene. It has been established that this induction process is dependent on trans-acting factor(s) that include a complex between the environmental chemical inducer and the aromatic hydrocarbon (Ah) receptor. In this report we show that constitutive P(1)450 mRNA but not P(3)450 mRNA is elevated in 7-day-old mouse embryos and following retinoic acid-induced differentiation of F9 embryonal carcinoma cells. In both instances it is shown that P(1)450 gene activation can occur in the absence of a foreign chemical stimulus. These data suggest that the P(1)450 gene may serve an important developmental function during differentiation. PMID- 3681489 TI - The validity of questionnaire-reported work history in live respondents. AB - The ability of subjects to recall their year of hire, year of termination, and job title was studied by comparing reported information to that recorded in personnel records. Former shipyard workers were interviewed in 1982. A majority was first employed in one of two shipyards during the early 1940s and 1950s. kappa statistics and crude and adjusted measures of percent agreement were derived to determine whether reported work history agreed with what was recorded in the subjects' personnel record and to determine whether recall was associated with race, age of the respondent at the time of interview, years since leaving the yard, length of employment, and year of hire. After adjusting for other covariates, only the number of years since leaving the yard was associated with recall of year of hire and termination, but not job title. In addition, however, there were several other noteworthy findings. Individuals who were 65-69 years of age at the time of interview had the poorest recall. Recall of both the year of hire and the job title appears to improve with increasing length of employment. PMID- 3681490 TI - Performance differences between males and females on simulated firefighting tasks. AB - Males and females were compared on several physical performance test items. The tests included five tasks used by the City of Chicago to select firefighters as well as four new test items that were designed to reflect recent changes in firefighting procedures. Sixty-two subjects (37 males, 25 females) 17-31 years of age were tested twice with 1 week intervening on a battery of tests that included measurements of body size and composition and the nine physical performance tests. Results indicated that the tests were reliable, but substantial improvement was observed on all items from the first test to the second test. Also, fatness was found to have a negative influence on physical tasks in which the body weight was translocated either vertically or horizontally; conversely, fat-free weight had a positive influence on performance in tasks requiring application of force such as lifting, carrying, and striking activities. Finally, females demonstrated lower scores than males on all physical performance items. PMID- 3681491 TI - Establishing clinical and immunologic criteria for diagnosis of occupational immunologic lung disease with phthalic anhydride and tetrachlorophthalic anhydride exposures as a model. AB - Using a questionnaire and serum antibody studies, we evaluated 13 workers exposed to phthalic anhydride (PA) and tetrachlorophthalic anhydride (TCPA). The questionnaire was designed to identify symptoms compatible with anhydride-induced immunologic or irritant syndromes. Specific IgG and IgE for both PA-human serum albumin (PA-HSA) and TCPA-HSA were determined by enzyme-linked immunosorbent assay in two different laboratories. In addition, 11 workers had cutaneous testing with PA-HSA and TCPA-HSA, and nine workers were interviewed. One worker was found to have PA-associated asthma and rhinitis. We conclude that a questionnaire and serologic assays for specific IgG and IgE are helpful to identify workers who have or are at risk for developing occupational immunologic lung disease such as those induced by anhydrides. However, additional evaluation may be necessary in those workers with such diseases as intrinsic asthma that may be difficult to differentiate from occupational immunologic lung disease. PMID- 3681492 TI - Mental health care utilization and costs in a corporate setting. AB - This article presents the mental health care utilization and costs among 14,162 employees and their families, covered under a major medical policy of a large multinational corporation for the 1984 policy year. Mental health care costs comprise a substantial portion of the total health care dollars expended (8.1%) for a relatively small fraction of the total number of claims (2.8%). The average hospital stay for mental disorders (20 days for employees; 15 days for spouses; 43 days for dependents) was significantly longer than for other illnesses (6.1 days for employees; 6.2 days for spouses; 4.4 days for dependents). Although the average daily hospital cost for mental disorders was less than that for non mental conditions, total expenditures per admission were approximately three times higher due to the long lengths of stay. Case management, peer utilization review, and day treatment are recommended to reduce these costs. PMID- 3681493 TI - Polymer-fume fever associated with smoking and use of a mold-release spray containing polytetrafluoroethylene. AB - An ephemeral and debilitating flu-like illness experienced by stamp-makers prompted them to solicit assistance from the National Institute for Occupational Safety and Health. It was determined that a combination of the use of a mold release spray containing a fluorocarbon polymer (polytetrafluoroethylene), poor general hygiene, and smoking during and after use of the spray was responsible for the workers' symptoms, commonly referred to as "polymer-fume fever." Recommendations made, and which resulted in the abatement of illness included: ventilating the vulcanizing furnace, cessation of smoking in the workplace, or using a mold-release spray that does not contain fluorocarbon. PMID- 3681494 TI - Some effects of cigarette smoking, arsenic, and SO2 on mortality among US copper smelter workers. AB - Previous studies of the relationship between arsenic levels and respiratory cancer among copper smelter workers have not directly accounted for possible effects of SO2 exposure and cigarette smoking. This is a report on the 1949-1980 mortality experience of 6,078 white male workers who worked at least 3 years between 1 January 1946 and 31 December 1976 at one or more of eight US copper smelters. The completeness of the cohort was verified statistically, and worker exposures to arsenic, SO2, dust, nickel, cadmium, and lead were estimated from retrospective industrial hygiene surveys reported elsewhere. By using internal controls, a dose-response relationship for lung cancer was observed with exposure to arsenic and SO2. When cigarette smoking data were included with arsenic and SO2 exposure data in a nested case-control analysis, only smoking and arsenic were statistically significant factors. The arsenic-lung cancer relationship was confined to a single smelter associated with high content feed. In the remaining smelters mortality for all causes of death and for all cancer was not high based on comparisons with national, state, and local rates. PMID- 3681496 TI - Comment on spirometry. PMID- 3681495 TI - A cohort mortality study of four plants of the Allied Corporation. AB - A historical cohort mortality study of Allied production workers at four plants who were employed between 1955 and 1961 for at least one year was conducted. This study was undertaken to determine whether mortality patterns in production facilities were similar to those of a separately studied group of research laboratory personnel working with similar materials. White male production workers from all plants combined experienced lower mortality for all causes of death combined than would be expected on the basis of the US population. Cancer of the rectum was significantly elevated among white males and cancer of the stomach was significantly elevated among black males at one plant. There were significant deficits among all white males for nonmalignant digestive system diseases and all external causes of death. PMID- 3681497 TI - Drug testing ethics. PMID- 3681498 TI - Body burden profiles of single and mixed solvent exposures. AB - The dynamics of inhaled solvents have not been studied extensively for exposure conditions involving combinations of chemical agents. An ongoing laboratory study examining psychomotor performance effects on human volunteers exposed to spray paint agents offered an opportunity to gather data on the body burden profiles produced by the inhalation of two solvents alone and in combination. Breath and blood samples were collected from 70 male and female subjects who were randomly assigned to four treatment conditions: chemical placebo, 250 ppm acetone, 200 ppm methyl ethyl ketone, or 125 ppm acetone/100 ppm methyl ethyl ketone. The exposures lasted for four hours. No interaction between the two solvents affecting uptake or elimination was noted. There were no significant differences between the uptake and elimination in males and females. The results are discussed in relation to physiological simulation modeling of the exposure. PMID- 3681499 TI - Mental health and work stress: a comparison of response patterns in executives and clerical workers in Hong Kong. AB - Mental health and work stress among 344 clerical (and secretarial) workers and 185 executives (96 managers and 89 executives) in Hong Kong was studied. No overall difference was found between clerical workers and executives in mental health and coping ability when sex was controlled for. Clerical workers, however, reported fewer interests, more problems in accepting others' values, and more dissatisfaction with work context. Female managers/executives were shown to be a high risk group, reporting more problems in mental health, coping, and work context than their male counterparts. Mental health was strongly associated with each of the work stress factors studied. A significant interaction between sex and nature of job was noted in predictors of mental health. The interaction of coping, context, and mental health is discussed. PMID- 3681500 TI - Environmental and biological monitoring of workers occupationally exposed to dimethylacetamide. AB - Exposure to dimethylacetamide was measured in a plant where a prefabricated synthetic product was handled and mechanically processed. Stationary monitoring, personal ambient monitoring, and biological monitoring were employed to evaluate exposure. Personal exposure in the breathing zone varied considerably in comparison with a relatively constant level observed with stationary monitoring. No correlation between personal airborne exposure and excretion of mono methylacetamide in urine was detected during a full workshift (5 days). Most (n = 6) workers studied (n = 8) excreted about 13% of the calculated inhaled dose as metabolite in urine. For two workers this parameter was about 30%. It is concluded that for a substance like dimethylacetamide, which is easily absorbed through the skin, biological monitoring is superior to airborne concentration monitoring in determining total uptake and (possible) health risk. PMID- 3681501 TI - Occupational exposure and lung function measurements among workers in swine confinement buildings. AB - Previous studies have demonstrated that air in swine confinement buildings contains large amounts of dusts, highly contaminated with microorganisms and bacterial endotoxin. A study was undertaken to investigate the respiratory function of workers before and after the work shift in swine confinement buildings. Questionnaires were mailed to workers on swine farms. Dust levels were measured by personal sampling, and the micro-flora in the dust was determined. Work-related symptoms from the lung were frequent. Several workers who were smokers had forced expiratory volume in 1 second (FEV1) values lower than expected when they started work. Among a group of life-long nonsmoking workers the baseline forced vital capacity and FEV1 were not decreased. Changes in the FEV1 over the working shift were generally not found. It is suggested that exposure to dust in swine confinement buildings may lead to respiratory impairment but further studies on larger population samples and different exposure conditions are required. PMID- 3681502 TI - Cancer mortality among workers exposed to chlordane. PMID- 3681503 TI - Vietnam veterans and soft tissue sarcoma. PMID- 3681504 TI - Incidence and characteristics of McCollough aftereffects following video display terminal use. AB - After using video display terminals (VDT), some persons notice that achromatic patterns appear faintly colored hours after terminal use. We investigated the incidence of this effect, the McCollough effect (ME), among 125 VDT users. Subjects completed a questionnaire regarding work habits and certain life-style aspects. They were shown photographs of varying spatial frequencies to identify the adapting stimulus responsible for the ME. The incidence of ME after routine use of VDTs was 19.1%. The adapting stimulus was the repeating character lines of the VDT. No aspect of life-style investigated appeared to predispose an individual to develop the ME. Those subjects who developed the ME did not differ from those who did not in age, sleep, caffeine consumption, use of medication, refractive errors, or computer usage, nor did they have a higher incidence of ocular defects or eye strain. PMID- 3681505 TI - Occupation-related burns: five-year experience of an urban burn center. AB - Mortality from burns in the United States has not improved appreciably since 1955 among men, and the rate of decline among women appears to be slowing. Although one-quarter of all serious burns result from occupational accidents, few systematic epidemiologic studies of occupational burns have been conducted. We reviewed 232 cases of occupational burns among the 1,076 civilians seen as outpatients or admitted to the Regional Burn Treatment Center of the University of California Medical Center in San Diego from 1977 to 1982. Scalds were the most common type of burn overall and in women, but flame-related burns resulted in the highest average percent body surface area burned and were more common in men; tar related, flame-related, chemical, and electrical burns affected men almost exclusively. Electrical burns were disproportionately severe, as measured by time lost from work, fatalities, and permanent disability, in relation to their frequency and amount of body surface area involved. Contact burns were more frequent in younger persons. Hispanics were overrepresented compared with their representation in the general population. Occupational associations included scalds due to hot grease among restaurant workers, tar burns among roofing workers, electrical burns among farm workers, and injuries reflecting hazards to firefighters and electricians. The number of days off work after hospitalization correlated closely with the number of days hospitalized, which in turn correlated significantly with percentage of body surface area burned.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681506 TI - Smoking as a risk factor in noise-induced hearing loss. AB - We studied the relationship between cigarette smoking and hearing loss among 2,348 noise-exposed white male participants in a hearing conservation program at an aerospace company. Comparisons of risk factors were based on two definitions of hearing loss. In the first, cases were defined as those subjects in the top third of the hearing loss distribution (at 3, 4, and 6 kHz) for their age category, and controls were those subjects in the lowest third of the distribution. The crude relative risks for smokers were significantly elevated (ever smoker: odds ratio = 1.27, p = .02; present smoker: odd ratio = 1.39, P = .002) compared with never smokers. Simultaneous evaluation of several risk factors using multiple logistic regression methods indicated that the effects of smoking, having a noisy hobby, and years worked at the plant were independent factors for hearing loss. Statistically significant trends in risk were observed for the number of pack-years of smoking (P = .007) and current packs per day consumption in present smokers (P = .009). In the second definition, hearing loss cases were defined according to National Institute for Occupational Safety and Health criteria for beginning impairment. By using multiple logistic regression, present smoking was a statistically significant independent predictor of impairment. These results suggest that smokers are at increased risk of noise induced hearing loss. PMID- 3681507 TI - An outbreak of fume fever in an electronics instrument testing laboratory. AB - An apparent outbreak of fume fever was identified among six workers in an electronics instrument testing laboratory during a routine thermal evaluation of conductivity on electrical cable. The employees experienced characteristic symptoms of fume fever. Three employees required hospitalization; they demonstrated fever, leukocytosis with a left shift, and significant arterial alveolar oxygen gradients, all of which resolved over several hours. To prevent future occurrences, an attempt was made to delineate the etiologic agent by exactly reproducing the circumstances of the event and analyzing for the evolution of metal fumes or pyrolysis products of polymers. The pertinent findings included overall poor ventilation in the laboratory and the development of significant chloride air contamination during the test. This latter finding raises the possibility that a chloropolymer contaminant was the etiologic agent. PMID- 3681508 TI - Excessive lead absorption resulting from exposure to lead naphthenate. AB - There are no reported studies of the relationship between exposure to lead naphthenate and lead absorption in humans. In an aluminum forging operation where lead naphthenate was sprayed without local ventilation, the mean concentration of lead in air was 96 micrograms/m3 with a range of 12-430 micrograms/m3. The 29 forge operators who worked in this area had a mean blood lead concentration of 63 micrograms/dl, which was statistically significantly (P less than .001) higher than the mean blood lead concentration of 17 micrograms/dl among the 103 unexposed workers. Similarly, the mean zinc protoporphyrin concentration among the forge operators was 265 micrograms/dl, which was statistically significantly (P less than .001) higher than the mean concentration of 26 microgram/dl among the unexposed workers. Nineteen workers, all of whom worked in the forge areas, had blood lead concentrations in excess of 60 micrograms/dl, with the highest concentration being 108 micrograms/dl. This is the first reported instance in which the use of lead naphthenate has been associated with increased lead absorption in humans. PMID- 3681509 TI - Thermal degradation products from an ethylene methacrylic acid copolymer-partial metal salt as the cause of industrial bronchitis. AB - A self-employed physician developed industrial bronchitis due to the inhalation of fumes arising from the heating of a molded ethylene methacrylic acid copolymer partial metal salt (Surlyn) in the basement of his home. Symptoms resolved following removal from exposure. A number of known irritants are given off as degradation products of Surlyn ionomer resin, including acrolein, aldehydes, and methacrylic acid. This case is unusual because of the nature of exposure and an unexpected fall in forced expiratory volume in 1 second after provocation testing. PMID- 3681510 TI - Allergic contact dermatitis from a nonbisphenol A epoxy in a graphite fiber reinforced epoxy laminate. AB - An employee of the Composites Division of an aircraft engine manufacturing firm developed dermatitis associated with the handling of a graphite fiber reinforced epoxy laminate (epoxy prepreg). Patch test investigation demonstrated that the responsible causal agent was the nonbisphenol A epoxy binder, 4-glycidyloxy-N, N diglycidylaniline. A patch test with bisphenol A epoxy from a standard patch test screening series was negative. Subsequent interviews with employees of the Composites Division suggested that a relative lack of awareness of the cutaneous hazards of fiber reinforced epoxy laminates, compared with liquid epoxy resin systems, may be an important risk factor for allergic sensitization to these composite materials. PMID- 3681511 TI - Risk of lung cancer among iron ore miners: a proportional mortality study of 1,075 deceased miners in Lorraine, France. AB - A proportional mortality study of 1,075 iron ore miners in Lorraine, France, who died between 1960 and 1976 showed a significant excess of lung cancer mortality (proportionate mortality ratio = 2.25). Moreover, proportionate lung cancer mortality increased with the duration of work underground (proportionate mortality ratio = 4.24 for subjects who worked underground for more than 30 years) and was higher among pneumoconiotic (siderotic) miners (proportionate mortality ratio = 3.85) than among nonpneumoconiotic miners. These results were confirmed by a case-control study nested in the mortality study. Smoking habits could not be estimated retrospectively with sufficient accuracy to be taken into account. Although the proportion of smokers among contemporary iron ore miners is larger than in the French male population, occupational factors may also play a role; radiation exposure can be ruled out because there is no detectable radioactivity in the Lorraine mines, but dust exposure may be considered as an etiologic factor owing to the relationship between siderosis and lung cancer. PMID- 3681512 TI - Lessons learned from operating an Academic Occupational Health Program. PMID- 3681513 TI - Intravenous drug therapy in premature infants: practical aspects. AB - Most decisions regarding the methods used for intravenous drug delivery are made by nurses. For this reason, neonatal nurses must recognize the unique problems associated with drug delivery to the low birth weight infant. A review of the associated problems is presented along with suggested solutions to aid the nurse in choosing a therapeutic method for intravenous drug administration. PMID- 3681514 TI - The development and management uses of a patient classification system for a high risk perinatal center. AB - A patient classification system for a labor and delivery unit, a maternal-fetal intensive care unit, and an antepartum monitored unit is a complex but necessary component for staffing units with frequently changing patient census and varying patient acuity. This article describes the processes used to develop such a classification system and to predict staffing needs, in advance, in four-hour time blocks in the labor and delivery unit and in eight-hour time frames in the maternal-fetal intensive care unit and the antepartum monitored unit. The article also identifies direct nursing care and indirect nursing care activities and defines the levels of care needed. PMID- 3681515 TI - Neonatal jaundice in the home: assessment with a noninvasive device. AB - Hyperbilirubinemia continues to be the major reason for hospital readmissions of neonates. This is particularly true for neonates who are discharged before the 72 hour physiological jaundice occurs. A small descriptive study reveals that use of a noninvasive bilirubinometer can be of assistance in screening for elevated bilirubin levels of newborns visited at home. PMID- 3681516 TI - Biventricular support is superior to univentricular support for mechanical circulatory assistance in patients after cardiotomy. PMID- 3681517 TI - Finite-length line-spread function. AB - In this paper we derive a formula for calculating the point-spread function (PSF) of a rotationally symmetric imaging system from measurements along a line through the image of an arbitrary separable input object. An important special case of this formula is when the input object is a finite-length slit. The set of measurements in this case is called the finite-length line-spread function (FLSF). The FLSF differs from the infinite-length line-spread function (LSF) only in the assumed finite length of the line that is input into the system. This difference between the FLSF and the LSF becomes important for imaging systems for which the PSF is large in extent and in which the isoplanatic patch is relatively small. The usual LSF-to-PSF conversion formulas cannot be applied accurately to such systems. PMID- 3681518 TI - Component analysis of spatial and spectral patterns in multispectral images. I. Basis. AB - A new (to our knowledge) theory of component pattern analysis in multispectral images is developed by using the methods of principal component analysis and nonlinear optimization with a nonnegativity constraint. Given images of a scene in different color bands, we estimate both the spectral curves of components included in the image and the spatial pattern corresponding to each spectral curve. In this method, neither spatial nor spectral features of the components are necessary, but the physical rule of nonnegative absorptivity and density nonnegativity is used for any material of any optical frequency at any position in the image. Experimental results of component analysis with real microscopic image data are shown to demonstrate the effectiveness of the proposed method. PMID- 3681519 TI - Initial field and energy flux in absorbing optical waveguides. II. Implications. AB - We present here numerical estimates of the density and flux of energy based on physical parameters associated with the absorption properties of certain types of absorbing optical waveguides. These results are based on a theoretical formalism established previously for the initial field incident upon the entrance pupil of an absorbing optical waveguide. Based on these results, the mechanisms of confined energy transmission and possible cross talk between neighboring waveguides are discussed. Some comments on the behavior of Bessel functions with complex arguments are also included in the discussion. PMID- 3681520 TI - Apparent phase reversal during stabilized image fading. AB - A pattern with a horizontal luminance profile described by the difference of Gaussians (DOG) was viewed under conditions of retinal image stabilization. When a uniform increment was applied after the image had disappeared, the pattern reappeared, but with the reversed phase. This phenomenon of apparent phase reversal (APR) is indicative of changes in local sensitivity. It was studied as a function of the time at which the increment was applied and the space constant of the DOG pattern. It was found that the threshold increment necessary to evoke an APR was an exponential function of time. A slight dependence on the spatial dimensions of the stimulus was also demonstrated. The data were examined according to a model of spatial vision that includes a gain that is inversely proportional to a spatially and temporally filtered version of the stimulus. The data provided estimates of the time constant and the spatial extent of the gain mechanism. PMID- 3681521 TI - Mechanical behavior of the human lumbar spine. I. Creep analysis during static compressive loading. AB - The in vitro viscoelastic "creep" behavior was examined in 18 cadaveric human lumbar motion segments subjected to static axial compressive loads. Axial deformation was followed for 30 min under constant applied load. Compressive material constants (moduli and viscosity coefficients) were then determined for each intervertebral disc using a linearization method based on a Taylor series expansion of experimental data for the "three parameter" viscoelastic creep model. The degree of disc degeneration and bone mineral content (BMC) were also assessed. Good correlation between the experimentally determined and model predicted strain values were found, with the average error less than 1%. We found that motion segments from older and more degenerated lumbar discs were less stable and had lower material constants than segments from younger and less degenerated discs. Material constants and BMC correlated closely, suggesting that an interdependency of disc and vertebral body properties exists. No correlation between the creep characteristics and disc height, disc area, segment level, or sex were noted. PMID- 3681522 TI - Mechanical behavior of the human lumbar spine. II. Fatigue strength during dynamic compressive loading. AB - Seventeen cadaveric human lumbar motion segments from eight spines were cyclically loaded in vitro under axial compression. Loading frequency and magnitude were chosen to simulate rigorous activity within an in vivo physiological level. The load magnitude was determined as a percentage of the ultimate compressive load, the latter estimated from the bone mineral content (BMC) of lumbar vertebrae determined by dual-photon absorptiometry. Following testing, the degree of macroscopic disc degeneration was assessed and the type of fracture in each specimen was determined from serial sagittal sections. Fractures were found in all but one specimen. Three types of fractures were formed: the node of Schmorl and Junghanns (type I), central endplate fracture (type II), and a crush or burst fracture (type III). The results suggested that type I fractures were predominantly associated with segments with normal discs, type II fractures were found primarily in segments with moderately degenerated discs, and type III fractures were associated with segments that failed on the first cycle. Segment stiffness and fatigue strength (cycles to failure) were correlated with disc degeneration, age, and segment BMC, the latter an in vivo measure of bone density. Fatigue strength also decreased in proportion to a power coefficient with increasing relative stress (cyclic stress range/ultimate stress). PMID- 3681523 TI - Load displacement behavior of the human lumbo-sacral joint. AB - The three-dimensional load displacement behavior of nine fresh adult L5-S1 spine motion segments was studied. Static test forces up to 160 N in anterior, posterior, and lateral shear, test forces up to 320 N in compression, and test moments up to 15.7 Nm in flexion, extension, lateral bending, and torsion were used. The six displacements of the center of the inferior L5 endplate were measured 15 and 60 s after the load was applied. Specimens were then retested after posterior element excision. The results show that at the maximum test force, intact specimen mean (SD) displacements ranged from 1.65 mm (0.63 mm) in lateral shear to 2.21 mm (0.87 mm) in posterior shear. Posterior element excision resulted in an average 1.66-fold increase in shear translations. At the maximum moment, rotations ranged from 3.38 degrees (1.03 degrees) in torsion to 7.19 degrees (1.77 degrees) in flexion. Posterior element excision resulted in an average 2.09-fold increase in bending rotations and a 2.74-fold increase in the average torsional rotation. In general, these L5-S1 joints were stiffer than more cranial lumbar segments in flexion, extension, and lateral bending and were less stiff in torsion tests. PMID- 3681524 TI - Streaming potentials: a sensitive index of enzymatic degradation in articular cartilage. AB - Under physiological conditions, the extracellular matrix of articular cartilage contains a high fixed-charge density, associated with its ionized proteoglycan (PG) molecules. Compression of the highly charged cartilage matrix within the physiologic range leads to the production of electrical streaming potentials. We observed significant changes in the potential response due to chemical modifications of the matrix, such as extraction of PG and glycosaminoglycan (GAG) moieties using chondroitinase-ABC adn trypsin. The streaming potential was a sensitive index of the degradative loss of these matrix constituents and of the kinetics of the enzymatic degradative process. PMID- 3681525 TI - Chondrons in cartilage: ultrastructural analysis of the pericellular microenvironment in adult human articular cartilages. AB - A combination of scanning and transmission electron microscopy was used to investigate the morphology and ultrastructure of normal human articular cartilage sampled from adult amputation specimens. This study confirms our previous observations on canine articular cartilage, which showed middle and deep layer chondrocytes surrounded by a pericellular matrix and enclosed within a pericellular capsule composed of filamentous and fine fibrillar materials. Pores in the "felt-like" organization of the capsular weave progressively decreased in size from the inner to the outer border of the capsule. Matrix vesicles were found embedded within the capsular weave and distributed throughout the territorial matrix. It is suggested that the chondrocyte, its pericellular matrix, and capsule together constitute the "chondron," a primary functional and metabolic unit of cartilage that acts hydrodynamically to protect the integrity of the chondrocyte and its pericellular microenvironment during compressive loading. PMID- 3681526 TI - Obesity and decreased femoral anteversion in adolescence. AB - The degree of femoral anteversion in a group of obese adolescent children and a group of adolescent children of normal weight was determined by either magnetic resonance imaging or computerized axial tomography. Compared with the children of normal weight, the obese children showed a significantly reduced angle of femoral anteversion. Increased biomechanical forces generated across the hip joint of obese children leads to increased remodeling of the femoral neck. This may account for the association of slipped capital femoral epiphysis, reduced femoral anteversion, and obesity in the adolescent population. PMID- 3681527 TI - Electromyographic analysis of muscles across the elbow joint. AB - An electromyographic (EMG) technique was developed to study simultaneously the eight major elbow muscles in five normal subjects. Recordings of EMG activity in elbow muscles were obtained while the elbow joint was subjected to resisted flexion, extension, abduction, and adduction functions. The results indicate that activity in the major elbow muscles is determined by the size of the resultant flexion and extension moments created about the elbow joint, but not by varus and valgus moments. These results support the hypothesis that determination of muscle force about a joint depends on joint constraint, namely, the degree of freedom, the resultant joint forces and moments due to externally applied load, and also the function of the muscle, i.e., the line of action of the muscle that crosses the joint. The data may be used to further refine the calculation of muscle force distribution across the elbow joint. PMID- 3681528 TI - Interaction between intrinsic knee mechanics and the knee extensor mechanism. AB - The ability of the quadriceps muscles to extend the knee was studied relative to the intrinsic mechanical features of the knee joint. The quadriceps mechanical efficiency changed by nearly 50% between 0 and 90 degrees of knee flexion. The peak efficiency occurred at approximately 20 degrees of knee flexion. The mechanical efficiency of the quadriceps was dependent on the movement of the net anteroposterior (AP) tibiofemoral contact center of pressure, the change in patellar ligament angle, and the change in the quadriceps-to-ligament force transfer ratio. The average net AP tibiofemoral contact center of pressure moved posteriorly on the tibial plateau as the knee flexed from 0 to 90 degrees. The excision of both cruciate ligaments reversed the posteriorly directed movement of the net AP tibiofemoral contact center of pressure at flexion angles from 60 to 90 degrees, resulting in a reduction in extension moment. PMID- 3681529 TI - Contact finite element stress analysis of porous ingrowth acetabular cup implantation, ingrowth, and loosening. AB - Two-dimensional linear and contact finite element analyses were conducted of total hip arthroplasty using metal-backed, porous ingrowth acetabular components. The stress transmission characteristics from the component to the surrounding bone were given special attention. Resultant loads of 20 and 40 degrees medial of vertical were studied, and the influence of adding a metal flange to the rim of the cup was evaluated. The results indicated that when a conventional metal backed component (without a flange) is initially implanted and subjected to normal loading, these components may experience distraction between the component and the surrounding bone at inferior sites. Compressive stresses in the superior dome cancellous bone, however, will be substantial. If complete porous ingrowth is achieved, the superior dome compressive stresses will be reduced and substantial shear stresses created. In addition, high local bone stresses were found at the component rim. If bone ingrowth is achieved only in specific locations, stress transmission will be dictated by those locations and may differ markedly from the case of complete bone ingrowth. In the event that no porous ingrowth is achieved and a fibrous layer forms around the component, the interface stresses will be similar to those calculated for the natural hip. The addition of a flange to the rim of the cup will reduce the magnitude of the radial stresses transmitted to the cancellous bone superiorly and medially by directly transferring some of the load to the lateral wall of the pelvis. The flange will also help to relieve the high local stresses that are found at the component rim. PMID- 3681530 TI - Extent of artificial limb use following rehabilitation. AB - The extent of prosthesis use is reported for 104 lower limb amputees from the onset of gait training up to 2 years later. Subjects were divided into groups according to age (greater than or equal to 65 years or less than 65 years) and amputation level. An analysis of variance including the factors of age and level of amputation was done. Unilateral trans-tibial (UTT) amputees progressed more quickly during the inpatient gait training program that did unilateral trans femoral (UTF) subjects (p less than 0.05). UTT subjects also walked more than UTF subjects just prior to discharge (p less than 0.05), during the first year after discharge (p less than 0.01), and during the second year after discharge (p less than 0.01). Similarly, younger patients progressed more quickly in gait training (p less than 0.05) and walked more than older subjects throughout the study period (p less than 0.05). There were no significant interactions between age and amputation. The extent of walking of these amputees is compared with the minimal levels required for them to function in different living environments. At the time of discharge from the inpatient gait training program, older unilateral amputees and trans-femoral amputees were not able to walk the 600 steps a day necessary to manage with a moderate level of support in a one-level apartment or home. The declining number of steps taken in the follow-up period indicated that the UTF subjects might benefit from some special attention paid to their community support needs. These findings are also viewed in the context of limited data available on the extent of walking of non-amputees. PMID- 3681531 TI - Changes in bone marrow blood flow with aging. AB - We investigated changes in bone marrow blood flow and histology with aging in rabbits. Bone marrow blood flow was measured by the hydrogen washout method, which was performed in the proximal tibia of Japanese white rabbits, 3-42 months of age. Bone marrow blood flow was found to decrease with age. Histological observations of the proximal tibia identified a decrease in the number of osteoblasts and hematopoietic cells, an increase of the number of empty lacunae, a reduction in bone formation rate, and a degeneration of marrow fat with aging. These results suggest that the decrease of bone marrow blood flow is related to histological changes found with aging. PMID- 3681532 TI - Limb lengthening by epiphyseal distraction. An experimental study in the caprine femur. AB - Epiphyseal distraction of the left distal femur was accomplished in 10 goats (aged 3-4.5 months). A modified Hoffmann external fixation device was used as a unilateral distraction frame. A distraction rate of 1.5 mm/day was applied for 5.5 weeks. Epiphysiolysis occurred after 3-7 days of distraction. After the lengthening procedure, the growth plate had reduced in height in eight animals on radiographic examination. In two animals the growth plate was fused. Three animals were killed at 4 (Group 1) and 8 (Group 2) weeks and four animals at 16 (Group 3) weeks after the end of the distraction period. The gain in leg length obtained by distraction was reduced owing to growth retardation in the distal femur of the operated limb. The average final lengthening was 24.9, 19.4, and 13.4% in Groups 1, 2, and 3, respectively. Femur and tibia from both sides were tested mechanically in torsion. Only one femur fractured in the elongation area. All but one elongated femur fractured in the area of the diaphysis subjected to distractional force. The torsional strength of the elongated femur compared with control was reduced to approximately 50% in all groups. The corresponding torsional strength of the tibia on the elongated extremity compared with control was reduced to approximately 75% in all groups. The difference in relative strength of femur compared with that of tibia was statistically significant. This finding can be explained by a stress-protective effect on the femur in the distraction area caused by the external device. PMID- 3681533 TI - Pin tract infections: a canine model. AB - The purpose of this study was to examine three issues: the relationship between the length of time of skeletal pin insertion and bacterial infection, the connection between skin organisms and the intramedullary infecting agent, and the length of time necessary for the medullary canal to sterilize itself after pin removal. Skeletal pins were inserted in a group of dogs, and a direct correlation was found between the duration of time that the pins remained in the bone and positive intramedullary cultures. The infecting agent in 88% of the medullary cultures was also cultured from the skin. In a second group of dogs, the pins remained in place for 1, 2, 3, or 4 weeks, respectively. The pins were removed, and the pin tracts were permitted to heal for varying periods of time. The medullary canals were then cultured. No medullary canal was infected when the pin tracts were allowed to heal for greater than or equal to 3 weeks. Therefore, if pin tracts are allowed to heal for at least 3 weeks prior to performance of osteosynthesis, the chances of deep infection are probably lessened. PMID- 3681534 TI - Apparent absence of local response to bone screws in guinea pigs with contact sensitivity. AB - Guinea pigs sensitized to nickel, cobalt, or chromium were used to study if impaired fixation occurred as a result of allergy against metal implants in bone. Screws made from stainless-steel (ASTM F55, F138-139) or cobalt chromium (ASTM F75-76) were inserted in the right and left proximal tibiae, and the mechanical strength of the fixation to the bone was evaluated after 4 months. In addition, we studied the histology on decalcified sections of the implant bone interface from the distal femur where the same type of screws had been inserted. To see if changes in bone density occurred in the proximal tibia as a result of allergy, the amount of ash was determined. Although the animals maintained their contact sensitivity throughout the experimental period, there were no differences between allergic and control animals for any of the parameters studied. All screws were well fixed in the tibia at the end of the experiment, and histologically we did not find any significant differences between allergic and control animals by qualitative examination. The experiment supports our earlier results from a 6 week experiment and indicates that contact allergy may be unimportant for the fate of orthopedic implants. PMID- 3681535 TI - 3-D finite element model of isotropic and anisotropic fixation plates. PMID- 3681536 TI - [Application of the electrogustometry in the soft palate as a topographic diagnostic method of facial paralysis]. PMID- 3681537 TI - [Hearing disturbance in patients with hypoparathyroidism]. PMID- 3681538 TI - [Nasal allergy and leukotriene. 1. Extraction and measurement of LTC4, and LTD4 in nasal secretion induced by antigen challenge, and the effect of LTC4 and LTD4 on nasal mucosa]. PMID- 3681539 TI - [Assessment of pure tone hearing induced by direct oscillation of auditory ossicle using piezoelectric ceramic bimorph vibrator]. PMID- 3681540 TI - [SCC antigen to squamous cell carcinoma of the head and neck region]. PMID- 3681541 TI - [Evaluation of cochlear damage in kanamycin administered hamster and protective effect of cepharanthine against KM induced ototoxicity. An experimental study]. PMID- 3681542 TI - [Electron microscope studies of human tracheal glands, with special reference to oncocytes and oncocytic cells]. PMID- 3681543 TI - [Long-term observations on ceramics implants (CORP)]. PMID- 3681544 TI - Consequences of starting whole cow milk at 6 months of age. AB - Two groups of infants, one fed whole cow milk commencing at 6 months of age (n = 69) and the other continuing to receive iron-fortified infant formula (n = 98), were closely observed over their second 6 months of life. At 12 months of age, infants fed cow milk had significantly lower mean serum ferritin levels and mean corpuscular volume, higher free erythrocyte protoporphyrin values, and greater incidence of hemoglobin values less than 11 g/dl than did formula-fed infants. There were no significant differences in frequency of otitis media, wheezing episodes, nasal discharge or congestion, diaper dermatitis, constipation, guaiac positive stools, or hospital admissions between the two groups. These data suggest that, to avoid iron deficiency, infants should continue to receive iron fortified formula throughout the first year of life or a daily iron supplement if they are fed whole cow milk before their first birthday. PMID- 3681545 TI - Bacterial cholangitis after surgery for biliary atresia. AB - We retrospectively studied the incidence of bacterial cholangitis in 129 infants operated on because of biliary atresia over 5 years. Forty-six of the 101 children who underwent hepatic portoenterostomy had a total of 105 episodes of cholangitis (range one to eight episodes per child). Most episodes occurred within 3 months of the operation. Factors associated with cholangitis included good or partial restoration of bile flow, abnormal intrahepatic bile ducts or cavities at the porta hepatis, and routine postoperative use of antibiotics. External jejunostomy was not effective in preventing cholangitis. In addition to fever and decreased bile flow, increased erythrocyte sedimentation rate and signs of shock were frequently observed. The responsible organisms, most often gram negative bacteria, were identified in 79 (75%) episodes by blood or liver cultures. Most were susceptible to trimethoprim-sulfamethoxazole and third generation cephalosporins during the first episode, but only to cephalosporins during later episodes. The incidence of signs of portal hypertension in children with normal serum bilirubin values at age 5 years was not higher in those who had previously experienced one or more episodes of cholangitis. PMID- 3681546 TI - Tocopheryl polyethylene glycol 1000 succinate therapy for vitamin E deficiency during chronic childhood cholestasis: neurologic outcome. AB - Treatment of the vitamin E deficiency neurologic syndrome in children with chronic cholestasis is hampered by the very poor intestinal absorption of available forms of vitamin E, thus requiring prolonged treatment with intramuscular injections of vitamin E in many patients. D-alpha-tocopheryl polyethylene glycol 1000 succinate (TPGS) is a water-soluble investigational form of vitamin E that is well absorbed during cholestasis. We studied the effect of TPGS therapy on the neurologic function in 12 children with vitamin E deficiency (aged 9 months to 6 years) with prolonged forms of neonatal cholestasis. Each child had failed to respond to up to 100 to 200 IU/kg/d of standard oral preparations of vitamin E. Treatment with 15 to 25 IU/kg/d TPGS for a mean of 19.3 months normalized the biochemical indices of vitamin E status and was well tolerated by all patients. Neurologic function, assessed by serial neurologic examinations, remained normal during therapy in the two children with no neurologic symptoms younger than age 3 years at onset of therapy. Neurologic function, which had deteriorated before this study, improved in six of seven patients with symptoms who were younger than 3 years and in all three with symptoms older than 3 years. TPGS appears to be a safe and effective form of orally administered vitamin E for use in children with chronic cholestasis who are unresponsive to available oral preparations of vitamin E. PMID- 3681547 TI - Neurotoxic complications of contrast computed tomography in children. AB - Four children with brain tumors had marked alterations in levels of consciousness and vital signs after contrast-enhanced cranial computed tomography (CT). Each had clinical evidence of increased intracranial pressure but was alert and coherent before CT. During the procedure, 2 to 2.5 mL/kg 60% diatrizoate meglumine was administered intravenously, and within hours the patients became progressively lethargic and disoriented and bradycardia and hypertension developed; two had generalized seizures. Two children died immediately after the CT procedure. Contrast-enhanced CT may produce grave neurologic complications in children with brain tumors, and this study should be reserved for those patients in whom the probability of obtaining additional information is high. Use of low osmolality agents or nonionic contrast agents may decrease the morbidity and mortality associated with the procedure. PMID- 3681548 TI - What is a "pulmonary exacerbation" in cystic fibrosis? PMID- 3681549 TI - Errors in formula concentration in an outpatient population. PMID- 3681550 TI - Bacterial infections in children with glucose-6-phosphate dehydrogenase deficiency. PMID- 3681551 TI - Glucose-6-phosphate dehydrogenase deficiency, neutrophil dysfunction and Chromobacterium violaceum sepsis. PMID- 3681552 TI - Hypophosphatemic rickets in linear sebaceous nevus sequence. PMID- 3681553 TI - Large thrombotic strokes in hemolytic-uremic syndrome. PMID- 3681554 TI - Altitude and birth weight. AB - The effect of altitude on birth weight was measured with data in U.S. natality records from 1978 to 1981 after correlation with the mean altitude of the mother's resident county. For comparison of the low birth weight (LBW) rate at different altitudes, certain socioeconomic risk factors known to affect birth weight were controlled by the selection of an idealized subpopulation of singleton births. With 500 m gradations for altitude, a curvilinear dose-response relationship of birth weight reduction with increasing altitude was demonstrated (P less than 0.001). In comparison with neonates born at sea level, neonates born at higher altitudes (greater than 2000 m) had a twofold to threefold increase in LBW rate, mainly related to a higher incidence of intrauterine growth retardation. Comparison of the LBW rate on the basis of small geographic divisions in the mountain states showed a positive correlation between the LBW rate and the high altitude. The birth weight frequency distribution curves of the idealized subpopulation at each altitude approximate normal distributions and parallel one another, indicating that altitude has a general effect on all births. Such nearly normal birth weight distributions allowed the determination of altitude-specific LBW cutoff limits that can be used to detect areas of greater risk for LBW but independent of the altitude effect. PMID- 3681555 TI - Transplacental leakage of HBeAg-positive maternal blood as the most likely route in causing intrauterine infection with hepatitis B virus. AB - Thirty-two HBeAg-positive carrier mothers and their 32 babies were investigated to elucidate the mechanism involved in intrauterine infection with HBV. Five mothers had symptoms and signs of threatened abortion and/or threatened preterm labor. Three mothers gave birth more than 6 weeks after the episodes, and their babies were those infected in utero. The other two gave birth within 1 week after the episodes, and the two babies were treated with HBIG immediately after birth; HBV infection was successfully prevented. Therefore we suggest that transplacental leakage of HBeAg-positive maternal blood, which is induced by uterine contractions during pregnancy and the disruption of placental barriers, is the most likely route to cause HBV intrauterine infection. PMID- 3681556 TI - Green light phototherapy in newborn infants with ABO hemolytic disease. AB - The efficacy of fluorescent green light phototherapy was compared with that of blue light phototherapy in the treatment of full-term infants with hemolytic disease and jaundice caused by ABO incompatibility. The efficacy of the treatment was expressed as actual (milligrams per hour) and quantum (milligrams per hour per square centimeter per megawatt) efficiency, taking into account the differential emission of energy from the green versus the blue fluorescent tubes. No statistically significant difference in the rate of serum bilirubin photodegradation was found between the two groups after treatment for 84.6 +/- 14.1 hours versus 81.5 +/- 14.2 hours with the green and the blue phototherapy, respectively. These results, coupled with the known effects of the blue light on the genetic apparatus of mammalian cells, support the application of the green light phototherapy for the treatment of neonatal hyperbilirubinemia caused by ABO incompatibility. PMID- 3681557 TI - Energetics and mechanics of nutritive sucking in the preterm and term neonate. AB - Energetics and mechanics of sucking in preterm and term neonates were determined by simultaneous records of intraoral pressure, flow, volume, and work of individual sucks. Nine term infants (mean postconceptional age: 38.6 +/- 0.7 SD weeks; mean postnatal age: 18.4 +/- 6.1 SD days) and nine preterm infants (mean postconceptional age: 35.2 +/- 0.7 SD weeks; mean postnatal age: 21.9 +/- 5.4 SD days) were studied under identical feeding conditions. Preterm infants generated significantly lower peak pressure (mean values of 48.5 cm H2O compared with 65.5 cm H2O in term infants; P less than 0.01), and the volume ingested per such was generally less than or equal to 0.5 mL. Term infants demonstrated a higher frequency of sucking, a well-defined suck-pause pattern, and a higher minute consumption of formula. Energy and caloric expenditure estimations revealed significantly lower work performed by preterm infants for isovolumic feeds (1190 g/cm/dL in preterm infants compared with 2030 g.cm/dL formula ingested in term infants; P less than 0.01). Furthermore, work performed by term infants was disproportionately higher for volumes greater than or equal to 0.5 mL ingested. This study indicates that preterm infants expend less energy than term infants to suck the same volume of feed and also describes an objective technique to evaluate nutritive sucking during growth and development. PMID- 3681558 TI - Oral breathing in response to nasal trauma in term infants. PMID- 3681559 TI - Resolution of acquired lobar emphysema with dexamethasone therapy. PMID- 3681560 TI - Diminished chemiluminescent responses of polymorphonuclear leukocytes in severely and moderately preterm neonates. PMID- 3681561 TI - Pharmacokinetics of inhaled salbutamol in patients with cystic fibrosis versus healthy young adults. AB - We studied the disposition of inhaled salbutamol in adolescents with cystic fibrosis (CF) and compared it with the pharmacokinetics of the drug given by the intravenous and inhaled routes in healthy adults. After inhalation of salbutamol, CF patients had a significantly larger area under the concentration-time curve derived from amounts of drug in the systemic circulation. The differences in serum concentration of salbutamol were not reflected in differences in change of heart rate. We conclude that the rate and extent of pulmonary absorption of inhaled salbutamol in patients with CF differ from those in healthy adults. PMID- 3681562 TI - Effect of resistive training on plasma lipid and lipoprotein levels in male adolescents. AB - We studied fourteen 14 to 17-year old male adolescents before and after a 9-week resistive exercise program and compared the changes in lipid and lipoprotein profiles with those in 14 non-exercising control subjects. Studies included determination of weight, body mass index (weight for height2), percent body fat, blood pressure and resting heart rate, maximum heart rate and maximum oxygen consumption, and plasma lipids and lipoproteins. No significant differences were present between the two groups before training except that percent body fat was lower in the control subjects. After training, low-density lipoprotein cholesterol in the exercising subjects decreased from 120 +/- 15 to 95 +/- 13 mg/dL (P less than 0.001), high-density lipoprotein cholesterol increased from 35 +/- 12 to 45 +/- 8 mg/dL (P less than 0.01), and high-density lipoprotein cholesterol/total cholesterol ratio increased from 0.2 +/- 0.06 to 0.27 +/- 0.05 (P less than 0.001). Control subjects showed a significant increase in weight (P less than 0.01) and body mass index (P less than 0.01) and a decrease in maximum heart rate (P less than 0.01) at the end of the 9 weeks. Adjustment for body mass index resulted in no alteration in the favorable response of the lipoprotein profile. No change occurred in body composition or maximum oxygen consumption with training. These findings indicate that resistive training is associated with a favorable alteration in the lipoprotein profile in adolescent males. PMID- 3681563 TI - Association between behavioral and school problems and fatherhood in a national sample of adolescent youths. AB - The relation between fatherhood and behavioral and school problems was studied in a nationally representative sample of adolescent youths. Data were obtained from the National Longitudinal Survey of Work Experience of Youth (NLSY). Of the 6400 youths interviewed in 1980, 367 (5.7%) reported that they had fathered a child before the age of 19 years. This group was compared with 1000 non-fathers selected at random from the same data set. The groups differed by race and family socioeconomic characteristics. Academic, drug, and conduct problems were significantly more common among adolescent fathers than among non-fathers. Race and family income, and fatherhood status were independently related to various problem behaviors. These results confirm previous findings demonstrating a relation between delinquency and adolescent fatherhood. PMID- 3681564 TI - LSD: patterns of use by chemically dependent adolescents. PMID- 3681565 TI - Detection of adolescent substance abuse in a pediatric outpatient department: a double-blind study. PMID- 3681566 TI - On classifying otitis media as suppurative or nonsuppurative, with a suggested clinical schema. PMID- 3681567 TI - Risk of SIDS in siblings. PMID- 3681568 TI - Necrotizing enterocolitis and staphylococcal sepsis. PMID- 3681569 TI - Effects of cyclosporine in severe systemic lupus erythematosus. AB - Thirteen patients with severe steroid-resistant or steroid-dependent forms of systemic lupus erythematosus were treated with cyclosporine (average dose 5 mg/kg/d) for an average period of 12 months. In eight patients the disease activity decreased, as substantiated by the reduction in the amount of steroid required to control the clinical manifestations. Interruption of cyclosporine treatment was associated with relapse or worsening of disease in five subjects. These favorable clinical results occurred in the absence of changes in the levels of antinuclear, anti-double-stranded deoxyribonucleic acid autoantibodies or plasma complement components; plasma IgG concentration increased significantly. Six patients had signs of moderate cyclosporine nephrotoxicity that disappeared when the administration of the drug was discontinued. Hypertension was the most serious side effect observed in eight subjects; in every case it was controlled by antihypertensive medicine. These data indicate that cyclosporine may be beneficial in the treatment of some patients with severe forms of systemic lupus erythematosus. PMID- 3681570 TI - Effect of pH on fecal recovery of energy derived from volatile fatty acids. AB - We assessed the effect of pH on volatilization of short-chain fatty acids during lyophilization. Acetic, propionic, valeric, and butyric acids were added to a fecal homogenate in amounts sufficient to raise the energy density by 18-27%. Fecal homogenate samples were either acidified (pH 2.8-3.2), alkalinized (pH 7.9 8.7), or left unchanged (4.0-4.8) prior to lyophilization and subsequent bomb calorimetry. Alkalinizing the fecal samples prevented the 20% loss of energy derived from each of these volatile fatty acids observed in samples either acidified or without pH adjustment. These data suggest that in energy balance studies involving subjects with active colonic fermentation, fecal samples should be alkalinized prior to lyophilization and bomb calorimetry. PMID- 3681571 TI - Amino acid abnormalities in infants with extrahepatic biliary atresia and cirrhosis. AB - We measured fasting plasma amino acids in 26 children aged 6 months to 5 years with extrahepatic biliary atresia and cirrhosis and compared them with fasting values in 95 normal control children aged 4 months to 12 years. We found that the cirrhotic children had elevations of total free plasma amino acids implying reduced hepatic metabolism of amino acids and that the molar ratio of the branched chain amino acids (isoleucine, leucine, and valine) to the aromatic amino acids (phenylalanine and tyrosine) was significantly depressed. Methionine was also markedly elevated, and taurine concentrations were significantly decreased. Manipulation of the amino acid distribution in dietary protein to normalize plasma amino acids prior to orthotopic hepatic transplantation may be helpful in improving amino acid utilization. PMID- 3681572 TI - Syndromic paucity of the intrahepatic bile ducts: diagnostic difficulty; severe morbidity throughout early childhood. AB - The clinical, biochemical, and histological features of 27 children with syndromic paucity of the interlobular bile ducts are described. All presented in the first 5 months of life, 21 with jaundice, two with spontaneous bleeding due to vitamin K malabsorption in addition to jaundice, two with pruritus, and two with failure to thrive. Interlobular bile ducts were abundant in liver biopsies from five (18% of cases) in the first 6 months of life. The degree of portal fibrosis and cellular infiltrate was mild in all except three patients. Clinically significant heart lesions occurred in 52% but only 22% had peripheral pulmonary stenosis. Characteristic facial appearances were present in only 70%; embryotoxon and vertebral anomalies were present in 56 and 33%, respectively. Two infants died of cardiovascular complications, one of alimentary bleeding and one of progressive liver disease. Complications of vitamin K deficiency occurred in 15%, vitamin D deficiency in 30%, and vitamin E deficiency in 37%. Survivors at ages of 19 months to 16.5 years had considerable morbidity with pruritus occurring in 70%, jaundice in 48%, xanthomas in 30%, 74% having hepatomegaly and 63% splenomegaly. All had abnormal biochemical tests of liver function, 90% had growth retardation, and 50% developmental delay. We conclude that differentiation from extrahepatic biliary atresia can be difficult if biliary flow cannot be demonstrated. Prevention of fat-soluble vitamin deficiency is essential. Further research is required to decrease the morbidity associated with this syndrome in infancy. PMID- 3681573 TI - Plasma and urine zinc in infants and children with extrahepatic biliary atresia. AB - The objective of this study was to undertake a pilot assessment of zinc status in infants and children with extrahepatic biliary atresia. Plasma zinc concentrations and urine zinc excretion rates were measured longitudinally in 45 infants and young children with this disorder. The mean (+/- SD) plasma zinc (298 observations) was 56.8 +/- 17.9 micrograms/dl (controls 85.6 +/- 10.8). Plasma zinc was not correlated with age and did not appear to be related to repeated surgical procedures or to episodes of cholangitis. Plasma zinc was only weakly correlated with serum albumin (r = 0.27, p less than 0.001). The 24-h urine zinc excretion rates were correlated with age but not so strongly as for normal children. Hyperzincuria was evident from the linear regression equation of 24-h urine zinc on age. On a body weight basis, urine zinc excretion rates were approximately 6 times normal for the first 2 years and remained high across the entire age range. To replace these losses, net zinc absorption would need to increase by 40%. The relationship of these data to the zinc nutritional status of these patients and to their underlying hepatic disease remains to be clarified by more definitive studies. PMID- 3681574 TI - Disorders of upper esophageal sphincter motility in children. AB - Dysfunction of the upper esophageal sphincter was found in five out of 44 children with gastroesophageal reflux. Three of the five children had mental retardation associated with Silver Russell syndrome, 5p syndrome, or minimal change myopathy. The five patients had swallowing disorders, vomiting, and failure to thrive; four also had pulmonary aspiration. Esophageal manometry showed incomplete upper esophageal sphincter relaxation in two patients, upper esophageal sphincter relaxation incoordinated with pharyngeal contractions in two other patients, and both incomplete and incoordinated upper esophageal sphincter relaxation in the last patient. Intensive and successful treatment of gastroesophageal reflux did not improve swallowing or symptoms of pulmonary aspiration in four children. The fifth patient underwent cricopharyngeal myotomy, with complete resolution of respiratory and swallowing symptoms. It is suggested that a dysfunction of the upper esophageal sphincter, either primary or secondary to neuromuscular disorders, may play a role in the swallowing disorders and respiratory symptoms of pediatric patients. PMID- 3681575 TI - Gastric intrinsic factor hypersecretion stimulated by pentagastrin in cystic fibrosis. AB - The gastric pentagastrin-stimulated secretions of acid (peak acid output) and of unsaturated intrinsic factor in eight cystic fibrosis patients (1.4 +/- 0.5 mEq/kg/h and 0.27 +/- 0.12 nmol/kg/h, respectively) were significantly enhanced (p less than 0.05) when compared with six normal controls (0.27 +/- 0.16 mEq/kg/h and 0.10 +/- 0.02 nmol/kg/h, respectively). Despite the gastric hypersecretion of intrinsic factor, no significant physicochemical modification of this glycoprotein was observed in cystic fibrosis when using gel filtration and isoelectrofocusing. Haptocorrin (a cobalamin glycoproteic binder that does not promote the assimilation of cobalamin) also increased in gastric juice after stimulation. Since the sequestration of cobalamin to haptocorrin is pH dependent, the gastric acid hypersecretion observed in cystic fibrosis may explain that the malabsorption of crystalline cobalamin is much more frequent in cystic fibrosis than in chronic pancreatitis. PMID- 3681576 TI - Serum pepsinogen I in childhood duodenal ulcer. AB - To delineate possible genetic factors involved in the pathogenesis of childhood duodenal ulcer (DU), serum pepsinogen I concentrations were measured in 14 patients and their parents. Sixty-five normal subjects were simultaneously studied to determine normal values in relation to age. Hyperpepsinogenemia occurred in six of 14 patients and 13 of 28 parents. Hyperpepsinogenemic patients invariably had hyperpepsinogenemic parents, four of six having both parents affected. Hyperpepsinogenemic parents (10 of 13) usually but not invariably gave birth to hyperpepsinogenemic patients. Most hyperpepsinogenemic parents (11 of 13) were asymptomatic. Our findings suggest a genetic basis (hyperpepsinogenemia) for the predisposition to childhood DU in nearly half the patient population, the inheritance being likely to be autosomal dominant with incomplete penetrance. In addition, the existence of normopepsinogenemic families suggests that childhood DU is a heterogeneous entity and not a single disease. A high familial incidence of DU is also present in the normopepsinogenemic subgroup (four of eight) but whether genetic factors or socioenvironmental factors are responsible here will require elucidation from studies with other markers. PMID- 3681578 TI - The steatocrit: a simple method for monitoring fat malabsorption in patients with cystic fibrosis. AB - Steatocrit was determined through microcentrifugation of fecal homogenate from 110 pediatric controls and 107 patients with cystic fibrosis (CF). For 74 CF patients, steatocrit was determined in the same fecal material collected to determine a fat balance. In controls, steatocrit value was 0.7 +/- 1.0%, which was significantly lower than values found in CF patients with a coefficient of fat excretion less than 10% of intake (1.7 +/- 1.2%). Significantly increased values were found in CF patients with a coefficient of fat excretion ranging between 10 and 25% of intake (4.7 +/- 1.7%) and in those whose coefficient of fat excretion was greater than 25% of intake (11.3 +/- 4.3%). In the 74 CF patients, steatocrit was directly correlated to the coefficient of fat excretion (r = 0.93; P less than 0.001). We performed steatocrit several times in the course of the 1st year of life in 33 infants with CF diagnosed by means of CF screening. Values obtained at the time of diagnosis, before starting enzymatic therapy, were relatively high; they showed a progressive decrease when, using steatocrit as a guide, the dose of pancreatic enzymes had been increased. The normalization of steatocrit values was accompanied by a better growth rate in the majority of these infants, confirming the importance of an optimal early correction of pancreatic insufficiency. We propose that this simple semiquantitative test can be usefully performed for the frequent monitoring of fat absorption and for checking the response to enzymatic therapy in patients with CF. PMID- 3681577 TI - Factors responsible for persistence of childhood constipation. AB - In this study 56% of children with chronic constipation and encopresis were unable to defecate rectal balloons. Most of them had an abnormal contraction of the external and sphincter during defecation trials. Eighty-six percent were still unable to defecate balloons 1 year later after having complied with a conventional treatment program. Only 14% of patients unable to defecate balloons had recovered by 1 year, whereas 64% of patients able to had recovered (p less than 0.02). Only 13% of patients unable to relax the external sphincter had recovered by 1 year, whereas 70% of those able to do so had recovered (p less than 0.01). In addition, none of the patients with an abdominal fecal mass present during the initial examination independent of ability or inability to defecate balloons had recovered (p less than 0.001). This study shows that abnormal defecation dynamics and the severity of constipation are predictors for persistence of chronic constipation and encopresis. PMID- 3681579 TI - Lowered serum Ca, blood ionized Ca, and unresponsive serum parathyroid hormone with oral glucose ingestion in infants of diabetic mothers. AB - Oral glucose ingestion may lower serum Ca in infants of diabetic mothers (IDMs). Six metabolically stable IDMs were studied following ingestion of 1.7 +/- 0.1 g/kg (mean +/- SE) of glucose over 20 min and serum Ca, Mg, P, blood iCa, serum PTH, and CT were measured at 0, 1/2, 1, and 2 h. Data obtained in IDMs were compared with previously reported findings in 10 normal neonates. In IDMs as in normal neonates, serum Ca, Mg, P declined significantly after oral glucose ingestion. Blood Ca2+ was significantly lower at +1/2 h in IDMs versus normal neonates, and by analysis of covariance, trends in blood Ca2+ were significantly different in IDMs versus normal neonates, (p less than 0.05). Serum PTH concentrations were unaltered in IDMs versus a significant rise in serum PTH noted in normal neonates. The difference between the two groups was significant statistically (p less than 0.05). Baseline serum CT was elevated in both groups and did not change. Thus, in IDMs responses to oral glucose ingestion differs from that seen in normal neonates as follows: blood Ca2+ is lowered in IDMs versus normal neonates, and serum parathyroid hormone (PTH) does not respond to a decline in blood Ca2+ in IDMs, whereas in normal neonates serum PTH rises and blood Ca2+ is maintained. We speculate that relative parathyroid gland unresponsiveness occurs in IDMs, which may result in lowered blood Ca2+ after oral glucose ingestion in these infants. PMID- 3681580 TI - Milk composition of insulin-dependent diabetic women. AB - The macronutrient, trace mineral, and immunological contents of milk of five moderately controlled, insulin-dependent diabetic women were studied at 3 months postpartum. Concentrations of total nitrogen, lactose, fat, and energy were not distinguishable from those in milk of nondiabetic women. Glucose concentrations in milk from diabetic women were significantly higher (p less than 0.001) and more variable. The macro- and trace minerals (Ca, P, Mg, K, Zn, Cu, and Fe) were within normal ranges with the exception of Na which was higher in milk from the diabetic women (p less than 0.05). The concentrations of lactoferrin and secretory IgA were not statistically different from reference norms. Milk composition of five insulin-dependent diabetic women was not distinguishable from that of the reference population, with the exceptions of Na and glucose concentrations, which were slightly elevated. PMID- 3681581 TI - Effect of amino acid containing dialysis solutions on plasma amino acid profiles in children with chronic renal failure. AB - Our previous studies demonstrated that, over single peritoneal dialysis cycles, amino acid-based dialysis solutions (AAD) were effective in dialyzing children with chronic renal failure (CRF) and offered metabolic advantages over traditional glucose dialysis solutions. The AAD, however, resulted in undesirable elevations of certain plasma amino acids, notably methionine. To further investigate the relationship between dialysate and plasma amino acid levels, we assessed the plasma amino acid response to a new AAD with relatively low methionine content (Vamin-based) over separate 5-h cycles with 1.3 and 2.3% AAD in eight patients with CRF (age 1-9 years) on continuous ambulatory peritoneal dialysis (CAPD). There was a net absorption of 70-73% of the amino acids, the net absorption of individual amino acids corresponding with the AAD composition. Plasma amino acid levels rose with AAD, peaking by 1 h postinfusion. Although most amino acids fell to preinfusion levels at the end of the cycle (including methionine), isoleucine with the 1.3% AAD and isoleucine, leucine, phenylalanine, and tyrosine with the 2.3% AAD remained significantly elevated. Having demonstrated in children that amino acids are absorbed from the peritoneal cavity in proportion to the AAD profile, modification of the current AAD is suggested. PMID- 3681582 TI - Short-term malnutrition in neonatal rabbits. I. Brush border enzymes. AB - Seventy-two hour starvation in neonatal rabbits was studied. Fasted animals received no feeds, only water every 8 h for 72 h. Fed animals were suckled by the dam. There was no difference in birth weight, serum albumin, blood urea nitrogen, electrolytes, or urine specific gravity between fed and fasted animals. Weight at 72 hr was less in fasted (p less than 0.01) than fed rabbits. Serum cortisol (p less than 0.05) and corticosterone (p less than 0.01) levels were higher in the fasted group. Proximal and distal small bowel homogenates had less DNA and protein (p less than 0.01) in the fasted group, but the protein/DNA ratio was the same in the proximal and distal small bowel homogenates from both groups. Sucrase (E.C.3.2.1.26) specific activity was significantly increased in proximal small bowel homogenates from the fasted group (p less than 0.01) but was the same in distal small bowel homogenates from both groups. Sucrase total activity per proximal segment was the same in fed and fasted animals but was significantly less per segment in distal small bowel homogenates from fasted animals. Alkaline phosphatase (E.C.3.1.3) total and specific activity was decreased in proximal (p less than 0.01) and distal (p less than 0.05) small bowel homogenates from the fasted group. Lactase (E.C.3.2.1.23) total activity was decreased in proximal and distal (p less than 0.01) small bowel homogenates from the fasted group but lactase specific activity was unchanged. Thus, a brief period of malnutrition in neonatal animals can result in a variety of regional functional changes in the gastrointestinal mucosa. PMID- 3681583 TI - Dysfibrinogenemia in obstructive liver disease. AB - Acquired dysfibrinogenemia was documented in a 4-year-old child with obstructive jaundice of 1-month duration, secondary to a choledochal cyst involving the distal common bile duct. It was characterized by decreased thrombin coagulable protein with elevated immunoassayable fibrinogen resulting in abnormal thrombin and reptilase times. The liver morphology was compatible with extrahepatic obstruction, without evidence of cirrhosis or hepatocyte abnormality. All the coagulation abnormalities promptly resolved after surgical correction of the obstruction. Dysfibrinogenemia has been associated with serious liver disease in adults, including tumors, chronic active hepatitis, and cirrhosis, but never with isolated obstructive jaundice. This report documents a case of acquired dysfibrinogenemia due to extra-hepatic biliary obstruction and also emphasizes the importance of the consideration of this disorder in coagulation abnormalities associated with hepatobiliary disease. PMID- 3681584 TI - Renal abnormalities in paucity of interlobular bile ducts. AB - Paucity of interlobular bile ducts is a common histologic characteristic in persistent conjugated hyperbilirubinemia of infancy. It occurs in two forms: the syndromatic and the nonsyndromatic types. The syndromatic form is also called arteriohepatic dysplasia. The nonsyndromatic type of paucity of interlobular bile ducts occurs less frequently and is usually associated with more severe disease and a less favorable prognosis. We present two unusual renal anomalies in association with paucity of interlobular bile ducts. In the first case, juvenile nephronophthisis was diagnosed in a 4-week-old infant with arteriohepatic dysplasia; the patient died from severe renal disease by 2 months of age. The second case presented with severe bilateral hydronephrosis and hydroureter secondary to posterior urethral valves associated with the nonsyndromatic form of paucity of interlobular bile ducts. He, however, improved after corrective surgery of the urethral valves. Other renal abnormalities previously reported in the literature in association with chronic liver disease are also reviewed. PMID- 3681585 TI - Idiopathic hepatic copper toxicosis in a child. AB - A 10-year-old Italian boy with chronic liver disease and copper overload is described. Biological and histopathological findings are similar to those described in children with Indian childhood cirrhosis. This report suggests that a disease akin to Indian childhood cirrhosis but different from Wilson disease can be found in non-Indian children probably representing a new, possibly inherited, disease of copper metabolism leading to copper overload in the liver. PMID- 3681586 TI - Neonatal hemochromatosis: failure of deferoxamine therapy. AB - We describe a premature neonate with severe hepatic dysfunction from birth which progressed to fatal hepatic failure at 3 months of age. The diagnosis of a familial disorder, neonatal hemochromatosis, was made, and therapy was attempted with deferoxamine. Features of iron metabolism are presented, and this infant's illness is contrasted with other liver diseases of infancy associated with hepatic iron overload. PMID- 3681587 TI - Exercise-induced gastroesophageal reflux in an athletic child. AB - Exercise-induced gastroesophageal reflux (GER) is described in an athletic child with chronic abdominal pain and vomiting in conjunction with strenuous exercise. Although continuous 24-h pH probe monitoring was negative for GER, simultaneous pH probe and exercise stress testing (treadmill) showed a prolonged, continuous episode of acid reflux throughout exercise and the 30-min recovery phase. The authors are unaware of other cases of exercise-induced GER in children and suggest that simultaneous pH probe and exercise stress testing may be a useful technique to evaluate exercise-induced symptoms in children. Moreover, the presence of acid reflux during stress may warrant exercise restriction during the early management of reflux esophagitis. PMID- 3681589 TI - Dietary long chain polyunsaturates for premature infants. PMID- 3681588 TI - Successful management of an acquired gastric outlet obstruction with endoscopy guided balloon dilatation. AB - Antral-pyloric strictures and gastric outlet obstruction are known complications of caustic ingestions. These lesions can develop even in the absence of overt signs of potentially serious upper gastrointestinal tract pathology such as oropharyngeal burns, dysphagia, vomiting, or abdominal pain at the time of ingestion. The development of radial balloon catheters, which can be endoscopically guided into narrow strictures and inflated, offers an alternative therapy to surgical resection of obstructing lesions. We report the successful management of a pyloric stricture secondary to a caustic ingestion by sequential endoscopically guided balloon dilatations and offer guidelines for the use of this procedure. PMID- 3681590 TI - Antibody response to hepatitis B virus vaccine. PMID- 3681591 TI - Primary sclerosing cholangitis in children. PMID- 3681592 TI - Human values and cocaine use. PMID- 3681593 TI - The drug education-drug use dilemma. PMID- 3681594 TI - Prevalence and patterns of smokeless tobacco use in a southeastern university. PMID- 3681595 TI - An impact evaluation of a rural youth drug education program. PMID- 3681596 TI - Psychopathology as an antecedent to, and as a "consequence" of, substance use, in adolescence. PMID- 3681597 TI - Drinking, sex, and violence on television: the cultural indicators perspective. PMID- 3681598 TI - Relationship between alcohol consumption and alcohol problems in young adults. PMID- 3681599 TI - A longitudinal study of infant vocalization in the first year. PMID- 3681600 TI - Infant vocalization: an index of maternal attitude toward the child. PMID- 3681601 TI - Transactional relationships between perceived family style, risk status, and mother-child interactions in two-year-olds. PMID- 3681602 TI - An analysis of long-term maintenance of effective toothbrushing by head start schoolchildren. PMID- 3681603 TI - Effects of viewing high versus low aggression cartoons on emotionally disturbed children. PMID- 3681604 TI - Children's attitudes about health care: initial development of a questionnaire. PMID- 3681605 TI - Screening criteria for the detection of retinopathy of prematurity in patients in a neonatal intensive care unit. AB - We examined the eyes of 2986 neonates admitted to the Magee-Womens Hospital Neonatal Intensive Care Unit from January 1, 1977, through December 31, 1985, who weighed less than 2000 g at birth or were exposed to added oxygen and later discharged. Fifty-six of these patients had grade III, IV, or V retinopathy of prematurity as defined by Kingham (stage III or IV in the International Classification of Retinopathy of Prematurity system) in at least one eye. All 56 patients were exposed either to added oxygen for more than 50 days or had a birthweight less than 1600 g. We propose that these are more realistic screening criteria than those proposed by the American Academy of Pediatrics (exposure to any added oxygen, birthweight less than 2000 g). Their use will avoid many unnecessary eye exams, while allowing detection of all significant retinopathy of prematurity. PMID- 3681606 TI - Contrast sensitivity functions in normal children with the Vistech method. AB - The Vistech Contrast Sensitivity Function tester (VCTS 6500-1) for distance was evaluated to determine the minimum age of children who could complete the test and to determine changes in the CSF as a function of age. A total of 72 normal children between the ages of 24 and 84 months were tested twice with each eye. The results revealed that no child below 36 months of age could complete the test and by 48 months of age 50% could complete the test. By 60 months all children could complete the test. It was also found that age increased the CSF increased equally at all spatial frequencies. A comparison between the eyes of the CSFs revealed a highly statistically significant correlation of 0.78, which showed that the eyes were very similar. Test-retest correlations (0.78) also were highly statistically significant, which demonstrated that the test was very reliable. The results are discussed within the context of screening young children for visual disorders and the evaluation of patching therapy for amblyopia. PMID- 3681608 TI - Superimposition of a cartoon program as an aid in recording pattern visual evoked potentials in children. AB - Superimposition of a television program onto the black and white checkerboard stimulus used in performing the pattern visual evoked potential (P-VEP) has been found useful in testing adults and children. This study tested normal-vision children under two conditions: with the cartoon superimposition and with the standard black and white checkerboard. P100 amplitudes were decreased slightly with the superimposition, but the variability was not significantly different. Waveforms and latencies were not altered by the addition of the cartoon. The use of cartoon superimposition therefore can be helpful in maintaining attention during P-VEP testing in children, as long as the diminished amplitude characteristic is taken into account. PMID- 3681607 TI - Binocular Polaroid Test for vision screening of pre-school age children. AB - We report the results obtained with the Binocular Polaroid Test in a large population screening devised to detect vision disturbances in pre-school age children. The Binocular Polaroid Test is a new test for rapid detection of small unilateral scotoma in the binocular visual field. The test was performed on 1566 children age 3 to 6 years in a field examination. The reliability of the test was controlled in a study examination. A complete study examination was performed in 60 of the 96 subjects with a positive response to the test. One hundred subjects selected at random among those with a negative response were used as controls. The study examination disclosed vision disturbances in 41 of the 60 children with a positive response to the Binocular Polaroid Test. The remaining 19 results were normal. No vision disturbances were detected in the control group. The predictive value and the "phi" coefficient were calculated. The results indicate that the Binocular Polaroid Test appears very suitable for vision screening in pre-school age children for whom an early diagnosis is of paramount importance for treatment and prognosis of a vision alteration. PMID- 3681609 TI - Parental understanding of strabismus. PMID- 3681610 TI - Cyclic esotropia with central nervous system disease: report of two cases. AB - Two cases of cyclic esotropia with associated central nervous system lesions are presented. One had a 48-hour cycle and the other a 24-hour cycle. In the first child, the condition developed after a third ventricular astrocytoma removal and in the second with the advent of an epileptiform disorder. Both were non accommodative, non-paralytic in nature, and not associated with fusion disrupting factors. These patterns persisted uninterruptedly in one child for 22 months and in the other for more than 8 months until lost for follow-up. PMID- 3681611 TI - Severe visual loss resulting from occlusion therapy for amblyopia. AB - Two children developed profound visual loss in the eye being patched full time because of strabismic amblyopia in the fellow eye. The first had been patched for 13 days at age 18 months. Complete resolution was noted on the 40th day of reverse occlusion. The second had been patched for 1 month at age 9 months. After 3 months without treatment, reverse occlusion was instituted and was continued for 3 years. Mild amblyopia persists in both eyes of the second child. Although rare, occlusion amblyopia can occur in young children being patched full time. We usually avoid full-time occlusion and monitor patients at intervals at least as frequent as 1 week per year of age. PMID- 3681612 TI - Prolonged survival of a child with metastatic retinoblastoma. AB - A boy was discovered to have retinoblastoma in his right eye at age 29 months. The eye was enucleated and showed invasion of the choroid and optic nerve on examination. Bone marrow aspiration was negative in January 1981. Orbital recurrence was noted 1 month later and bone marrow aspiration was positive 2 months later. MAD-DOC chemotherapy and radiation therapy to the right orbit and brain were initiated immediately. The tumor has remained in remission since completion of the chemotherapy 18 months later. A preleukemic syndrome occurred in July 1984, and a successful bone marrow transplantation was performed in November 1984. He resumed normal growth and has remained well. Metastatic retinoblastoma should no longer be thought of as invariably fatal. PMID- 3681613 TI - Epibulbar tumors in children: a survey of 282 biopsies. AB - The histopathology of 282 consecutive clinically diagnosed epibulbar tumors excised from children age 15 years and younger was reviewed at a major ophthalmic hospital over a 20-year period. The most common epibulbar tumors of childhood are nevi, choristomas, epithelial inclusion cysts, and papillomas. There was only one malignant tumor among the 282 orbital tumors of childhood. PMID- 3681614 TI - Epibulbar osseous choristoma and ectopic lacrimal gland underlying a dermolipoma. AB - A 6-month-old girl underwent surgical excision of an epibulbar mass which had the clinical appearance of a dermolipoma. Intraoperatively, a separate underlying mass was uncovered which was firmly adherent to the sclera. Histopathologic examination confirmed the superficial lesion to be a typical dermolipoma, and the underlying lesion to be an epibulbar osseous choristoma with associated adherent ectopic lacrimal gland tissue. The clinical features, management, and histopathology of this new association are reviewed. PMID- 3681615 TI - Stargardt's disease: the evolution of a diagnosis. AB - In Stargardt's disease, a gradual loss of vision may precede both the appearance of paracentral or peripheral retinal flecks as well as funduscopically obvious macular changes. This latency delayed a diagnosis of Stargardt's disease in a young girl who underwent neurologic testing for what eventually turned out to be a retinal problem. At one stage in evolution, when retinal flecks and only subtle changes in the maculae were present, a diagnosis of a pure form of fundus flavimaculatus was considered likely. When severe granularity and atrophy of the maculae later developed in the presence of the retinal flecks, a more appropriate diagnosis of Stargardt's disease was made. As the degenerative and atrophic changes in the maculae became more pronounced in early adulthood, the flavimacular retinal flecks had all but disappeared. PMID- 3681616 TI - Ocular findings in the velo-cardio-facial syndrome. AB - Velo-cardio-facial syndrome is a common genetic syndrome of cleft palate, learning disability, heart disease, and abnormal facial appearance. Ocular findings include retinal vascular tortuosity, posterior embryotoxon, narrow palpebral fissures, suborbital discoloration, small optic nerves, iris nodules, and cataracts. Retinal vascular tortuosity was found to be associated intrinsically with the syndrome and not secondary to the heart disease. The ocular and systemic findings suggest a primary developmental anomaly of neural crest derivatives in the pathogenesis of the syndrome. PMID- 3681617 TI - Ocular motor apraxia associated with intracranial lipoma. AB - Congenital ocular motor apraxia is rarely associated with brain tumors. A 10 month-old girl with normal vertical eye movements and head thrusting to initiate horizontal saccades is presented. CT brain scan revealed a midline posterior fossa mass and histopathology confirmed the clinical diagnosis of lipoma. Unlike previously described cases of posterior fossa brain tumors associated with congenital ocular motor apraxia, this patient showed persistent ocular motor apraxia despite complete resection of the tumor. PMID- 3681618 TI - Hematuria in the burned child. AB - Hematuria is a frequent complication in burn patients, but its clinical significance has not been reported. The incidence, etiologies, treatment, and outcome of hematuria in 1,785 burn patients treated from 1964 to 1983, have been reviewed. Ninety-one patients had hematuria (greater than 15 RBC/HPF with unspun urine). There were five main causes: urinary infections (UTI), 50 cases; renal calculi (RC), 14 cases, including 3% and 5% total body surface area burn patients; catheter trauma, 7 cases; renal vein thrombosis (RVT), 5 cases; and acute renal failure (ATN), 4 cases. Ten patients died in the UTI group, five with Candida as the infecting organism. No RC patients died, but two required surgical extraction of their stones. This incidence of RC may be due to large intake of dairy products and antacids and to prolonged immobilization. The catheter trauma group had no deaths and was the youngest group. One RVT patient was diagnosed clinically and successfully treated surgically. The other three were diagnosed at necropsy. The ATN patients all developed renal failure late as part of multiple organ system failure and all died. We conclude hematuria is a serious finding in burn patients and prompt diagnosis of its etiology and treatment are essential for maintaining renal function and patient survival. PMID- 3681619 TI - Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report. AB - A pectus index can be derived from dividing the transverse diameter of the chest by the anterior-posterior diameter on a simple CT scan. In a preliminary report, all patients who required operative correction for pectus excavatum had a pectus index greater than 3.25 while matched normal controls were all less than 3.25. A simple CT scan may be a useful adjunct in objective evaluation of children and teenagers for surgery of pectus excavatum. PMID- 3681620 TI - Surgical management of proboscoid herniae. AB - The management of a large proboscoid umbilical hernia presents challenging problems to the surgeon. As children and parents are concerned with the appearance of the actual hernia they are also intensely interested in the postsurgical result. Presented is a simple one-stage umbilicoplasty that allows repair of the fascial defect and the management of the redundant skin in such a way as to produce a "scarless" and natural-appearing umbilicus. PMID- 3681621 TI - Esophageal replacement with whole stomach in infants and children. AB - This is a report of ten patients in whom the esophagus is replaced by the whole stomach brought through the chest. It was used for children with long gap or previously failed esophageal atresia repair. It documents complications (anastomotic leak and stricture) and morbidity, and highlights precautions that must be taken. PMID- 3681622 TI - Etiologic factors in long-term respiratory function abnormalities following esophageal atresia repair. AB - Recurrent respiratory illnesses are frequent in infants following repair of esophageal atresia and functional abnormalities of respiratory and esophageal function are often seen in older children. Recurrent aspiration is a potential cause of these respiratory abnormalities, but a relationship between abnormalities of gastrointestinal and respiratory mechanics has not been adequately investigated. We sought an association between lower esophageal sphincter (LES) incompetence, gastroesophageal reflux (GER), and respiratory function abnormalities in 18 subjects (age 12 to 21 years) following repair of esophageal atresia (Vogt type 111B). In each subject, measurements were made of spirometry, lung volumes assessed by plethysmography, esophageal manometry recorded using a constantly infused fluid-filled trilumen catheter to assess LES pressure and esophageal motility, and esophageal pH monitoring to detect GER. Subjects were grouped according to the presence or absence of a radiologically supported diagnosis of pneumonia in the first 4 years of life. Lung volumes were mildly but significantly decreased in the "pneumonia" group compared with the "nonpneumonia" group. There was no association between abnormalities of respiratory function and abnormal LES pressure or the presence of GER. These data suggest that pneumonia in esophageal atresia infants is associated with mild long term lung damage. LES dysfunction and GER do not appear to play a major role in this process. PMID- 3681623 TI - Gastric emptying in children with gastroesophageal reflux. I. An estimate of effective gastric emptying. AB - The association of gastroesophageal reflux (GER) and gastric emptying has been observed, but its importance is poorly understood. We compared 18- to 24-hour esophageal pH recordings with gastric emptying of radionuclide in apple juice in 109 children (2 weeks to 16 years old) referred for an evaluation of GER. A pH score and the pattern of GER (type I, II, and III) were obtained by esophageal pH monitoring. Gastric emptying was measured at 30 minutes (%GE30) and at 60 minutes (%GE60). The measured gastric emptying of apple juice was similar for the normal child and for those with GER regardless of pattern type. An inverse linear correlation between postcibal reflex and measured gastric emptying was demonstrated only by the eight asymptomatic children with a normal pH score (%GE30, r = -.9603, P less than .001; and %GE60, r = -.8263, P less than .05). If the contribution of postcibal reflux on gastric emptying was eliminated, then the effective gastric emptying was increased in many children with the type I (44%, P less than .05), type II (46%, P less than .05), or type III (60%, P less than .05) pattern of GER as compared with children with a normal reflux pattern (7%). In conclusion, measured gastric emptying of clear liquids is not necessarily decreased in most children with GER. Furthermore, many children with GER demonstrate an increased effective gastric emptying even though measured gastric emptying may not appear increased. PMID- 3681624 TI - Gastric emptying in children with gastroesophageal reflux. II. The relationship to retching symptoms following antireflux surgery. AB - Following antireflux surgery, children with persistent retching symptoms are presumably more likely to have delayed gastric emptying. We report 66 children between 2 weeks and 16 years of age who had an operation to control gastroesophageal reflux (GER). All patients had GER confirmed by 18- to 24-hour esophageal pH monitoring. Preoperative gastric emptying studies were performed in each patient with 99m-Tc sulfur colloid in apple juice. In addition to the percent gastric emptying (%GE), an effective gastric emptying was estimated by correcting the %GE for postcibal reflux (corrected %GE). Repeat 18- to 24-hour esophageal pH monitoring was performed postoperatively in all patients, and a repeat gastric emptying study was performed in 32 patients. After an average postoperative follow up of 6 months (range of 1 to 18 months), persistent retching was present in 12 (18%) patients. The retching was associated with dumping symptoms in six patients. Retching was seen in patients with a preoperative increase in effective gastric emptying (10/34, 29%, P less than .05) or a decrease in effective gastric emptying (2/15, 13%, NS), and not in patients with an effective gastric emptying within the control range (0/17, 0%). Postoperatively, retching with dumping symptoms was associated with an increased effective gastric emptying, and retching without dumping symptoms with a decreased effective gastric emptying. In conclusion, persistent retching followed anti-reflux surgery in children is related to extremes in effective gastric emptying. The preoperative measurement of corrected %GE identifies children at increased risk for this postoperative problem. PMID- 3681625 TI - Esophageal pH assessment of gastroesophageal reflux in 18 patients and the effect of two prokinetic agents: cisapride and metoclopramide. AB - Foregut drug receptors permit inotropic manipulation of the dysmotility pattern associated with gastroesophageal reflux (GER). Two prokinetic agents, ie, Metoclopramide and Cisapride were assessed in 18 infants with severe GER (mean age 6.5 months) by means of 18-hour continuous intraesophageal pH monitoring. Six parameters were recorded, and the results compared before and during pharmacologic stimulation. Both agents improved the parameters measured, but Cisapride was found to be more effective in enhancing lower esophageal sphincter competence and esophageal motor function. Long-term assessment of both agents in the management of GER in infants is indicated. PMID- 3681626 TI - Fundoplication and pediatric esophageal manometry: actuarial analysis over 7 years. AB - Sixty-one children and infants who had significant gastroesophageal reflux and associated complications underwent 73 surgical procedures to control the reflux. In order to evaluate the procedure, several esophageal manograms were obtained from each patient, before, during, and after the operation. Delayed follow-up reports were also obtained from follow-up visits, letter and telephone contact, in order to assess how the patient had progressed. The results were evaluated by actuarial analytic methods. Ninety-four percent of the patients remained alive over the 7-year follow-up period. At the completion of the seventh year, 62% of these patients (actuarially calculated) remained event free. All events occurred within 18 months of surgery. One patient could not be traced at long-term follow up, which was therefore 92% complete. The 7-year actuarial probability of failure of the fundoplication at this institution is 24% when performed using this technique in these patients. These findings support that manometric calibration of the antireflux procedure tends to give uniform results in pediatric patients, but, compared with other published series has not proved to be superior to procedures that employ only a rubber bougie in the esophagus as an obdurator to prevent a repair that will be too tight. PMID- 3681627 TI - Visceral ischemia secondary to gastric dilatation: a rare complication of Nissen fundoplication. AB - Antireflux operations are now commonly performed for severe gastroesophageal reflux with life-threatening presentations like recurrent aspiration pneumonia and apnea. We report a child who presented 2 years after Nissen fundoplication with jejunal volvulus resulting in massive gastric dilatation, gastric rupture, pneumoretroperitoneum, pneumomediastinum, and severely compromised circulation to the lower extremities. Because of the intense intraabdominal pressure from the gastric dilatation, there was severe ischemia of the pancreas, duodenum, small bowel, colon, and gallbladder. We suggest that gastrointestinal symptoms in a child who has had Nissen fundoplication should be promptly evaluated to avoid delay in recognition of acute gastric dilatation and to prevent a fatal outcome. PMID- 3681628 TI - Gastric infarction secondary to small bowel obstruction: a preventable complication after Nissen fundoplication. AB - Two infants who required a Nissen fundoplication for severe gastroesophageal reflux developed small bowel obstruction 5 and 21 months postoperatively. Their inability to belch or vomit, coupled with inappropriate airway management during resuscitation led to massive gastric dilation, and eventual infarction of their stomach, duodenum, and small intestines. These complications are preventable with appropriate management. PMID- 3681629 TI - Gastric volvulus in childhood. AB - Gastric volvulus is a rare surgical emergency in infancy and childhood. Only 51 cases have been reported. We describe four new cases. The classical features of the condition are discussed. PMID- 3681630 TI - Prepyloric antral diaphragm: delays in treatment. AB - Six cases of prepyloric antral diaphragm were encountered at Children's Hospital Medical Center of Akron between 1965 and 1985, with approximately 150 cases reported in the literature during this time. In our series, a delay from onset of symptoms to treatment existed for a period of 4 months to 6 years. We suggest that prompt endoscopic confirmation and surgical therapy for this lesion, when suspected by clinical and radiologic abnormalities, would decrease the physical and psychologic morbidity of unexplained recurrent vomiting in these children. PMID- 3681631 TI - Infantile hypertrophic pyloric stenosis: the changing trend in treatment in a Danish county. AB - From 1950 to 1984, 679 patients were treated for infantile hypertrophic pyloric stenosis (IHPS) in the County of Funen, Denmark. Medical treatment was performed in 114 patients and pyloromyotomy in 565. A pyloric tumor was palpated in 80% and a barium meal examination was performed in 24% of the patients. A shift toward intravenous fluid and general anesthesia is seen during the study period. Complications occurred in 17% of medically treated patients and in 8% of surgically treated patients. Six deaths occurred among the medically treated and four among the surgically treated patients. During the study period, a shift toward centralization and surgical treatment took place. PMID- 3681632 TI - Variation in the course of vessels in the vicinity of the hepatic port in biliary atresia. AB - Among 114 patients with biliary atresia, the type of obstruction of the extrahepatic bile duct and the course of the hepatic artery, cystic artery, and portal vein were determined and analyzed from the view point of their mutual relationships and in comparison with postoperative bile excretion. As a result, the following findings characteristic of biliary atresia were obtained: (1) The course and location of the extrahepatic bile duct did not deviate greatly from normal conditions, excluding some exceptional cases, but the site of the origin of the cystic artery differed from that in normal cases. (2) The pattern of the course of the vessels varied among different types of obstruction of the extrahepatic bile duct. (3) There was a difference in postoperative bile excretion in relation to the type of obstruction of the extrahepatic bile duct, the course of the vessels, and their combinations. PMID- 3681633 TI - Endorectal pull-through with conservation of the rectal mucosa: experimental study. AB - The present experimental work was designed to study an abdominoanal pull-through technique, with conservation of rectal mucosa. Continence was evaluated from clinical, radiologic, and histopathologic standpoints. The animals defecated normally. A good retention of barium was seen in the radiologic enema. On the reexploration of the animals, we found a distal dehiscence with elevation of the intussuscepted stump towards the rectum in all. A reepithelization process of serosa of the intussuscepted segment was noted. PMID- 3681634 TI - Long-term management of chronic constipation in children. AB - A retrospective clinical study was conducted to determine the success of a strict regimen employing the prolonged use of daily enemas in 203 children with chronic constipation. This study confirmed that the use of long-term daily enemas did eliminate constipation as well as the primary complaint of fecal soiling. The majority of children treated had an excellent to good result (85.8%) over an extended period of time. Patients with a past medical history of imperforate anus or Hirschsprung's disease required longer treatment periods (32.6 and 20.1 months, respectively) than children with other medical problems (rectal prolapse, rectal stricture, malrotation, spina bifida, mental retardation, psychological; 13 months) or patients with functional constipation (5.9 months). PMID- 3681635 TI - Intimacy motivation and subjective mental health in a nationwide sample. AB - Over 1,200 adults in a representative nationwide sample were administered the Thematic Apperception Test (TAT) and an unstructured interview which produced 25 measures of subjective mental health and ultimately six factor scores: unhappiness, lack of gratification, strain, feelings of vulnerability, lack of self-confidence, and uncertainty. The TATs were scored for intimacy motivation (McAdams, 1980)--a recurrent preference or readiness for experiences of warm, close, and communicative interaction with others. Controlling for age, education, and their interaction, high intimacy motivation in women was associated with greater happiness and gratification, whereas in men it was associated with lack of strain and lack of uncertainty. Women high in intimacy motivation who were living alone reported lower levels of gratification and more uncertainty in their lives than other women. Intimacy motivation also declined significantly over the life span for women, but not for men. Finally, demographic effects on intimacy motivation were examined. Controlling for age, education, and their interaction, professional men (e.g., doctors, lawyers, and teachers) scored higher on intimacy motivation than did men in other occupational categories, while among women the occupational groups with highest intimacy motivation were service workers and craftspersons. PMID- 3681636 TI - Peer group antecedents of severe love-shyness in males. AB - Love-shyness is a degree of inhibition and reticence with the opposite sex that is sufficiently severe to preclude participation in courtship, marriage and family roles. Love-shyness is believed to be the result of a genetic-biologically rooted temperament and learning experiences with peers and family. Two love-shy groups (an older one and a younger one) were compared to a nonshy group on several variables pertaining to past peer group history, recreational proclivities, etc. The Eysenck Personality Questionnaire was also administered to all subjects. The love-shys recalled going through life as social isolates and outcasts and experienced very stressful and nonsupportive relationships with agemate peers. In contrast to the non-shys who recalled suffering very little bullying at the hands of agemate peers, the love-shys' formative years were recalled as having been fraught with victimization by bullies. The implications of these findings are discussed and recommendations are offered. PMID- 3681637 TI - MMPI response-set characteristics among adolescents. AB - This study examined the Minnesota Multiphasic Personality Inventory (MPPI) profile characteristics for five different response sets in adolescent populations employing adolescent MMPI norms. In general, findings for "all-true" and "all-false" adolescent profiles were highly similar in shape and elevation to those reported in the adult literature (Graham, 1977; Lachar, 1974), whereas random profiles on adolescent norms differed substantially from adult-norm random profiles in shape but not elevation. The characteristics of "fake good" or "fake bad" response sets were investigated by the use of adolescent subjects in two settings. Ninety-four public high-school students were administered the MMPI with standard and "fake bad" instructions, and 24 adolescents in inpatient psychiatric treatment were administered the MMPI under standard and "fake good" instructions. The MMPI profiles generated by special instructional sets were analyzed in relation to the subject's age, sex, race, and actual MMPI profile features. Findings indicated that although sex and race effects were evident in normal adolescents' attempts to simulate psychopathology on the MMPI, teenagers generally produce profiles containing grossly exaggerated symptom patterns that are relatively easy to detect as invalid. In contrast, it was found that a substantial number of psychiatrically disturbed adolescents may effectively simulate normal profiles and that effectiveness in these attempts was related to greater age and lower actual MMPI T-score values on the Hs and Hy scales. PMID- 3681638 TI - Correspondence between MMPI PTSD measures and clinical diagnosis. AB - Correspondence of the Minnesota Multiphasic Personality Inventory (MMPI) posttraumatic stress disorder (PTSD) subscale and the clinical scale decision rules reported by Keane, Malloy, and Fairbank (1984) with clinical diagnoses of PTSD was measured on a sample of 595 veterans. The measures demonstrated good sensitivity and selectivity, but the false-positive rate was high. It is suggested the MMPI measures be used to rule out, but not to establish, the diagnosis of PTSD. The construct validity of the PTSD subscale was supported by the finding of a higher mean score in combat than noncombat veterans. PMID- 3681639 TI - Invariance in the MMPI's component structure. AB - Bernstein and Garbin (1985b) suggested that the Minnesota Multiphasic Personality Inventory's major clinical scales (excluding Scales ? and 5) can be approximated by an oblique three-component structure: (a) Profile Elevation, (b) Test-taking Attitudes, and (c) Optimism-Pessimism, collectively termed the salient weight model. In this study, we found that both this model and the MMPI's principal component structure remain invariant across race, sex, and, as previously noted, context of testing (job applicants vs. inmates in correctional institutions). We further noted that several alternative definitions of Profile Elevation provide equally satisfactory representation of the relations among the scales. This factor invariance is necessary, but not sufficient, for the MMPI to be viewed as unbiased. PMID- 3681640 TI - Self-ideal discrepancies as indicators of self-derogation and enhancement: formalization of theoretical claims and a method for assessment. AB - Empirical research shows that persons scoring low on psychological adjustment (PA) generally experience large ideal self (IS) versus actual self (AS) discrepancies whereas the reverse is true for high-PA persons. A particularly interesting interpretation of this phenomenon, consistent with a large body of clinical and experimental literature, ascribes it to self-derogation processes in low-PA persons and self-enhancement processes in high-PA persons. This article points out that this derogation/enhancement (D/E) interpretation assumes that people differing in PA level relate and organize the AS and IS judgments in qualitatively different ways. This results in a nonlinear relationship between PA, AS, and IS. Following a definition of the derogation/enhancement interpretation in terms of the relationship between AS, IS, and PA, a methodology for testing this interpretation is presented, and its implications are discussed. It is also shown that the methodology developed with regard to AS, IS, and PA can be used to examine D/E hypotheses involving other variables. PMID- 3681641 TI - The Myers-Briggs type indicator and coronary heart disease. AB - Researchers have for many years attempted to establish a relationship between coronary heart disease (CHD) and personality type. In our study, 103 subjects completed Form G of the Myers-Briggs Type Indicator (MBTI). Comparisons were made between 93 CHD patients and an age-appropriate control group (Group C) on each of the four MBTI dimensions: Extraversion-Introversion, Sensing-Intuition, Thinking Feeling, and Judging-Perceiving. The comparison between CHD patients and Group C showed that CHD patients were significantly more likely to prefer sensing and feeling. PMID- 3681642 TI - Type A behavior and stress in college males. AB - Substantial inconsistency can be noted among studies that have considered the relationship between Type A status and subsequent cardiac pathology. This erratic prediction pattern could be partially explained by the failure to consider level of stress in Type As, because only Type As that experience excessive and sustained stress should be at special risk. A stress-vulnerability model for young Type A college students was proposed involving selected Type A characteristics and other personality moderator variables serving to elicit, augment, and sustain stress. We considered self-preoccupation as a stress moderator in Type A college males and found evidence that it serves this function. Self-preoccupied Type As reported excessive stress over the previous year, whereas less self-centered Type As did not. Self-preoccupation was of no importance in moderating stress in Type Bs. PMID- 3681643 TI - The relationship of the Depression Adjective Check List to positive affect and activity level in older adults. AB - The Depression Adjective Check List (DACL) and a battery of mood and activity measures were administered to 49 older adults who were members of a senior citizens day center. Higher depression scores were negatively associated with avowed happiness on the Affect-Balance Scale and the Bradburn Happiness Scale and with participation in active recreational and social activities, assessed by the Activity Pattern Indicators. DACL scores were uncorrelated with measures of passive and quiet activity. The results are viewed as providing tentative support for the DACL's appropriateness with older populations, and future research directions are suggested. PMID- 3681644 TI - Development and validation of an adjective check list to assess the Millon personality types in a normal population. AB - A 405-item experimental Personality Adjective Check List (PACL) was refined into a 153-item form to assess the personality types outlined by Millon (1969, 1981) in a normal population. Scale construction and validation followed a method outlined by Loevinger (1957, 1972). Nine scales were developed based on the responses of 459 men and women, one for each of Millon's eight basic personalities plus an Experimental scale measuring aspects of his three more severe types. Extensive reliability and validity analyses were conducted involving over 2,200 men and women from across the United States, including a factor analysis of scales. These revealed good internal consistency for each scale, good test-retest reliability over a 3-month period, adequate factor structure, and good convergent and discriminant validity based on self-report data. Results indicated that Millon's basic types exist in normal form much as they are postulated to exist as disorders. Research efforts focusing on Millon's theory as it applies to normals may bring a more complete understanding of the entire spectrum of personality. PMID- 3681645 TI - Factor structure of the MCMI basic personality scales and common-item artifact. AB - The eight basic personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were derived from Millon's theory of personality, but the adequacy of the MCMI for measuring Millon's personality constructs has never been assessed. One major problem with using factor analysis to illuminate the structure of the MCMI personality scales is that artifactual structure may result from item overlap among the scales. To analyze this, item-overlap coefficients were factored and compared to the factor structures of five subject samples. For the eight basic personality scales, three factors emerged for the overlap matrix and each of the five sample matrices: Aloof-Social, Aggressive-Submissive, and Lability Restraint. It was concluded that these three factors are inconsistent with Millon's theory and that they will be found artifactually across a wide variety of populations due to overlapping items. PMID- 3681646 TI - Scales for measuring fear of AIDS and homophobia. AB - Two scales, one for measuring attitudes toward the fear of Acquired Immune Deficiency Syndrome (AIDS) and one for measuring attitude toward homosexuality, were constructed using Thurstone's method of equal-appearing intervals. After construction, the scales were given to 528 students at the University of Texas at Austin in the fall of 1985 to determine their respective reliabilities. Factor analyses were also done to determine what factors underlie the attitudes measured by the two scales and to determine if fear of AIDS and homophobia are in fact simply two facets of the same attitude: fear of homosexuals. The results indicated high reliabilities of both scales and a relatively low correlation between the two scales suggesting that the scales do measure different attitudes. PMID- 3681647 TI - "Eating lightly" and the self-presentation of femininity. AB - In Experiment 1, male and female subjects were given an opportunity to snack as they participated in a "get-acquainted study" with a same-sex or opposite-sex partner (confederate) whose social desirability was manipulated. Consistent with the hypothesis that women may eat less when motivated to present themselves in a feminine light, female subjects ate significantly less with a desirable male partner than in the remaining three conditions. In contrast, male subjects did not eat more (or less) with a desirable woman, although they did show an overall tendency to eat less with female (vs. male) partners. In Experiment 2, female subjects snacked as they got acquainted with a desirable male partner (confederate). Before this interaction, subjects received feedback indicating that they had either very masculine or very feminine interests. In addition, subjects believed either that their male partner was aware of their gender feedback or that he was unaware. Consistent with predictions derived from Schlenker's (1982) analytic-identity theory of social conduct, subjects in the partner-aware conditions ate less when they had received masculine (vs. feminine) feedback, whereas subjects in the partner-unaware conditions ate less when they had received feminine (vs. masculine) feedback. Implications for understanding eating disorders such as anorexia and bulimia are discussed. PMID- 3681648 TI - Universals and cultural differences in the judgments of facial expressions of emotion. AB - We present here new evidence of cross-cultural agreement in the judgement of facial expression. Subjects in 10 cultures performed a more complex judgment task than has been used in previous cross-cultural studies. Instead of limiting the subjects to selecting only one emotion term for each expression, this task allowed them to indicate that multiple emotions were evident and the intensity of each emotion. Agreement was very high across cultures about which emotion was the most intense. The 10 cultures also agreed about the second most intense emotion signaled by an expression and about the relative intensity among expressions of the same emotion. However, cultural differences were found in judgments of the absolute level of emotional intensity. PMID- 3681649 TI - Cognitive specificity in emotional distress. AB - Cognitive approaches to emotional distress posit that specific cognitive factors are critically linked to the etiology, course, or treatment of dysfunction. Although a number of empirical studies have assessed cognitive factors in emotional disorders such as depression and anxiety, research has yet to assess these variables simultaneously and with identical cognitive measures. Using depression and test anxiety as models of dysfunctional affective states, we examined cognitive specificity on measures of information processing, attributions, automatic thinking, and cognitive interference. Results indicated a pattern of specificity showing several differences and similarities in depression and anxiety. Specifically, "purely" depressed individuals showed evidence of selectively processing depressive information, making dysfunctional attributions, and engaging in more negative automatic thinking. "Purely" anxious individuals, on the other hand, showed evidence of selective anxious information processing and increased cognitive interference. Results are discussed in terms of a taxonomy for classifying depressive and anxious cognition. PMID- 3681650 TI - Cognitive operations associated with individual differences in affect intensity. AB - There are wide individual differences in the characteristic intensity of affective response to the same emotion-evoking event. The processes whereby individuals come to experience strong or mild emotional responses when exposed to the same affect-provoking stimuli are still unclear. In these studies, we propose that individual differences in affect intensity are associated with certain cognitive operations used during exposure to emotion-relevant stimuli. Specifically, cognitive operations that involve personalizing, generalizing, and selective abstraction were hypothesized to discriminate subjects high and low in affect intensity. Two studies replicated support for the hypothesis that subjects high on the affect-intensity dimension engage in more personalizing/empathic and more generalizing/elaborative cognitive operations than do subjects low on the affect-intensity dimension. The same cognitive operations discriminated groups high and low in affect intensity in response to both positive and negative emotional stimuli. Also, the cognitions that discriminated subjects high and low in affect intensity occurred only in response to affective stimuli; neutral stimuli did not evoke divergent cognitive operations for these two groups. Finally, a high degree of consistency was found in the use of emotion-relevant cognitive operations across positive and negative affective stimuli. PMID- 3681651 TI - Personality, type A behavior, and coronary heart disease: the role of emotional expression. AB - The nature of the relation between personality factors and coronary heart disease (CHD, the nation's greatest killer) is one of the most important if controversial issues in the field of psychology and health. Although there is still a great deal of conceptual confusion, progress is being made in refining the key components of a predisposition to heart disease. In this article we examine the construct of a coronary-prone personality in the context of the relations among personality, emotional expression, and disease. Special consideration is given to mode of measurement of the Type A behavior pattern--Structural Interview (SI) versus Jenkins Activity Survey (JAS)--and to components and non-Type A correlates of the general coronary-prone construct. Fifty middle-aged men who had had a myocardial infarction were compared with 50 healthy controls in terms of relevant aspects of their psychological functioning. Results indicate that the SI is better than the JAS as a predictor of coronary heart disease (CHD) because of its attention to emotional expressive style. Traditional emphases on hurry sickness in coronary proneness are deemed wholly inadequate. Furthermore, the results indicate that depression, anxiety, or both may relate to CHD independently of and in addition to Type A behavior. Other aspects of personality and social support are also discussed in the context of improving the construct of coronary proneness. PMID- 3681652 TI - Social networks: we get by with (and in spite of) a little help from our friends. AB - Studies of social support networks have almost exclusively measured only their positive aspects. In this research, we investigated both the helpful or positive and the upsetting or negative aspects of social networks in a longitudinal study of spouses caring for a husband or wife with Alzheimer's disease, a progressive senile dementia. Measures of helpful and upsetting aspects of the care givers' networks, derived from interviews and daily interaction ratings, were studied for their relations with overall network satisfaction and depression at an initial interview period (n = 68) and at a follow-up period about 10 months later (n = 38). Results from hierarchical multiple regression analyses, in which care givers' age and sex and a measure of the spouses' health status were controlled, showed that the care givers' degree of upset with their networks was strongly associated with lower network satisfaction and increased depression at both time periods. Helpful aspects bore little or no direct relation to either depression or network satisfaction. Helpful aspects of the network did, however, interact with network upset in predicting network satisfaction, and depression (combined probabilities test, p less than .05). Longitudinal predictions of follow-up depression, after age, sex, care givers' health status, and initial depression levels were controlled, showed that changes in upsetting aspects of one's network were predictive of changes in depression over time. We interpreted these results within an attributional framework that emphasizes the salience of upsetting events within a social network. PMID- 3681653 TI - Motivational effects in the social comparison of opinions. AB - Four experiments were executed to test the effects of different epistemic motivations on subjects' tendency to compare with agreeing or disagreeing others. We found that under high (vs. low) fear of invalidity, subjects tend more to compare with disagreeing (vs. agreeing) others. By contrast, under high (vs. low) need for self-confirmation or a high (vs. low) need for cognitive structure, subjects tended more to compare with agreeing others. These results are discussed in reference to social comparison formulations (Festinger, 1954; Goethals & Darley, 1977) and the theory of lay epistemology (Kruglanski & Ajzen, 1983; Kruglanski & Freund, 1983). PMID- 3681654 TI - Causal chunking: memory and inference in ongoing interaction. AB - We propose that people simplify their perceptions of their interactions by organizing them into discrete casual chunks. Once formed, these chunks presumably influence the extent to which people are aware of their influence on others, as well as their impressions of others. We anticipated that people would form self causal chunks (e.g., my action causes my partner's action) when they possessed an offensive set and other-causal chunks when they possessed a defensive set. We also expected that a self-causal chunking strategy would make salient people's influence on their partners and thereby discourage them from concluding that their partner's behaviors reflected underlying dispositions. In contrast, we anticipated that an other-causal chunking strategy would obscure people's influence on their partners, thereby encouraging them to infer that their partners' behaviors reflected underlying dispositions. We tested these hypotheses by inducing participants to develop either a defensive or an offensive set prior to interacting with another person in a simulated arms race. After the interactions, we assessed the manner in which participants chunked their interactions, as well as their impressions of partners. The results supported our predictions. The implications of these findings for understanding conflict and misunderstanding in interpersonal relations are discussed. PMID- 3681655 TI - Use of the maximal-operant principle to motivate children's intrinsic interest. AB - The present research examined the hypothesis that in contrast to theory and research indicating that tangible reward decreases subsequent interest in enjoyable academic activities, rewards are perceived by adults as effective techniques to maximize long- and short-term subsequent interest for academic tasks of both high and low initial interest level. The results of our first three studies demonstrated that college students and parents view tangible reward as more effective than other less controlling techniques to enhance intrinsic motivation and value rewards more for intrinsically interesting academic behaviors in comparison with others (e.g., prosocial behaviors). Our fourth study supported the hypothesis that adults do not subscribe to the minimal-sufficiency analysis of increasing intrinsic motivation but prefer a maximal-operant principle in which the likelihood of producing long-term interest in academic tasks is assumed to vary positively with the size of a reward. Our fifth and sixth studies investigated illusory correlation as one mechanism that may perpetuate beliefs about the assumed positive relation between tangible reward and intrinsic interest in academic tasks. PMID- 3681656 TI - Television violence and children's aggression: testing the priming, social script, and disinhibition predictions. AB - The effect of television violence on boys' aggression was investigated with consideration of teacher-rated characteristic aggressiveness, timing of frustration, and violence-related cues as moderators. Boys in Grades 2 and 3 (N = 396) watched violent or nonviolent TV in groups of 6, and half the groups were later exposed to a cue associated with the violent TV program. They were frustrated either before or after TV viewing. Aggression was measured by naturalistic observation during a game of floor hockey. Groups containing more characteristically high-aggressive boys showed higher aggression following violent TV plus the cue than following violent TV alone, which in turn produced more aggression than did the nonviolent TV condition. There was evidence that both the violent content and the cue may have suppressed aggression among groups composed primarily of boys low in characteristic aggressiveness. Results were interpreted in terms of current information-processing theories of media effects on aggression. PMID- 3681657 TI - Need for achievement and women's careers over 14 years: evidence for occupational structure effects. AB - Previous research has demonstrated that achievement-motivated people perform better under working conditions of challenge, autonomy, and rapid feedback. These achievement-congenial conditions characterize entrepreneurial business and, among those occupations traditionally filled by women, teaching. Achievement motivation was measured in 117 women as college seniors and again 14 years later. Senior year achievement motivation predicted later employment in teaching (including college). Career-involved women who had been highly achievement-motivated in college valued status mobility and working with people and reported job satisfaction from competition with a standard of excellence; however, women in different career situations differed in the relations between their achievement motivation in college and their later work values, job perceptions, and sources of satisfaction. Women highly achievement-motivated in adulthood valued achievement-congenial working conditions and status mobility and described job satisfaction from competition with a standard of excellence, especially if they were supervisors. Professors and businesswomen showed larger increases in achievement motivation over 14 years than did women otherwise employed. Thus, achievement motivation predicts women's career outcomes when their values and work situations, along with sex-differentiated occupational structures, are considered. Occupational structure effects on motives over time are discussed. PMID- 3681658 TI - Goal-directed fantasy, hypnotic susceptibility, and expectancies. AB - We conducted an initial screening session in which hypnosis was presented as a "test of imagination" and administered with other imagination measures. In a second session, we instructed high- and low-hypnotizable subjects to imagine along with suggestions but to resist responding to motoric suggestions. Subjects received either instructions to use goal-directed fantasies (GDFs) or no facilitative instructions. Sizable individual difference effects were secured. Hypnotizable subjects exhibited more suggestion-related movements and reported greater involuntariness than did low-hypnotizable subjects. With GDF instructions, low- and high-hypnotizable subjects reported equivalent GDF absorption and frequencies. However, hypnotizable subjects exhibited greater responsiveness and reported greater involuntariness than did those low in hypnotizability, even when their GDFs were equivalent. Thus, no support was generated for the hypotheses that sustained, elaborated suggestion-related imagery mediates response to suggestion (Arnold, 1946) or that absorption in suggestions is of particular importance for low-hypnotizable subjects (Zamansky & Clark, 1986). Our finding that measures of response expectancy paralelled responding and reports of nonvolition support the hypothesis that expectancies mediate the relation between imagination, involuntariness, and responding (Kirsch, 1985; Spanos, 1982). Hypnotizable imagining subjects in the study discussed here exhibited greater responsiveness than a comparable sample of subjects did in a previous countersuggestion study (Lynn, Nash, Rhue, Frauman, & Stanley, 1983) in which no attempt was made to foster an association between imagining and involuntary responding in the initial screening session. PMID- 3681659 TI - Multiple predictors of hypnotic susceptibility. AB - In this article, we report two experiments in which various measures thought to be related to hypnotizability were analyzed by stepwise discriminant analysis techniques. Absorption (Tellegen, 1981, 1982; Tellegen & Atkinson, 1974) and preference for an imagic style of thinking (Isaacs, 1982) were robust predictors of hypnotizability; each variable accounted for significant variance in hypnotizability at their respective steps in two samples and correctly classified a significant proportion of low- and high-hypnotizable subjects in the discriminant analyses. The addition of two other variables in Experiment 2--a Sleep-Dream score derived from Evans's (1977) Cognitive Control of Sleep Mentation subscale and Gibson's (1985) Dream Questionnaire, and the Belief in the Supernatural subscale of the Taft (1969) Experience Questionnaire--increased the correct classification of the medium-hypnotizable subjects from chance levels to 74%. It is argued that a confirmatory and hierarchical approach is needed in future studies to explore correlates of hypnotizability more fully. PMID- 3681660 TI - [Studies on positive inotropic agents. III. Synthesis of 6-(substituted 1 oxoalkyl)-2(1H)-quinolinone derivatives]. PMID- 3681661 TI - [Effects of inulins from crude drugs on phagocytic activity of mouse reticuloendothelial system]. PMID- 3681662 TI - [Pharmacokinetics of oxaprozin after multiple doses]. PMID- 3681663 TI - [Effects of beta- and dimethyl beta-cyclodextrins on release and percutaneous absorption behaviors of prednisolone from some ointment bases]. PMID- 3681664 TI - Physiologically based pharmacokinetic model for the renal clearance of phenolsulfonphthalein and the interaction with probenecid and salicyluric acid in the dog. AB - Plasma kinetics and renal excretion of intravenous phenolsulfonphthalein (PSP, 1.0 g), with and without concomitant administration of probenecid or salicyluric acid (SUA), were studied in the Beagle dog. Pharmacokinetic analysis revealed that tubular secretion is the predominant route of excretion, and that secretion is inhibited by probenecid and SUA. A physiologically based kidney model was developed that incorporates the functional characteristics of the kidney that determine the excretion of PSP, i.e., renal plasma flow, urine flow, nonlinear protein binding, glomerular filtration, tubular secretion, and tubular accumulation. The model enabled an accurate description and analysis of the measured plasma levels and renal excretion rates. The interaction with probenecid and SUA could be adequately described with the model by inhibition of the carrier mediated uptake of PSP into the proximal tubular cells. However, both compounds clearly differed in their inhibitory action. Whereas probenecid showed simple competitive inhibition, for SUA a considerably more complex interaction (two-site competitive system) had to be taken into consideration. Especially in the interaction experiments, only satisfactory fits to the model were obtained when secretion was assumed to be dependent on unbound PSP concentrations. Model calculations showed that in the control experiments tubular secretion was accompanied by a pronounced accumulation of PSP within the proximal tubular cells, which was clearly diminished in presence of probenecid or SUA. The predicted accumulation ratios were in good agreement with previous studies. PMID- 3681665 TI - The phenomenon and cause of the dose-dependent oral absorption of chlorothiazide in rats: extrapolation to human data based on the body surface area concept. AB - The reported incomplete and dose-dependent absorption of chlorothiazide in humans was demonstrated in six rats after five oral solutions at doses of 0.93, 2.55, 9.23, 25.6, and 70.2 mg/kg. Mean 48-hr urinary recoveries of intact drug were 57.3, 50.4, 36.7, 22.8, and 15.3%, respectively. A similar degree of dose dependency in absorption was found in rat, dog, and human when the doses were related to unit body surface area (BSA) but not on unit body weight, indicating similar interspecies absorptive capacity in terms of unit BSA. This finding may be partly rationalized by marked similarities in the reported solution transit time (2-3 hr) in the small intestine as well as in the calculated gross surface area of the small intestine per unit BSA (0.163 for rat and 0.132 for human). Contrary to the previous postulation of a specific absorption site, the drug was absorbed from different regions of the GI tract with apparent 1-hr absorption rates, studied by the in situ closed-loop method, in the following rank order: jejunum (34.6%) greater than duodenum (32.7%) greater than large intestine (20.1%) greater than ileum (18.0%) greater than stomach (12.4%). Different from the commonly assumed first-order absorption process, the intestinal loop absorption was concentration-dependent, suggesting a saturable mechanism. For example, the absorption rate at 0.008 mg/mL was higher than that at 0.2 mg/mL in ileal loops (61%, p less than 0.01) and jejunal loops (22%, p less than 0.1). In addition, the absorption rates at pH 6 and 7.4 were statistically identical, indicating a lack of ionization effect that is important in the passive absorption process. The solubility-limited absorption could probably be ruled out at doses below 2.55 mg/kg for rat and 125 mg for human in view of higher aqueous solubilities at 37 degrees C (e.g., 1.3 mg/mL at pH 7) found in the present study. Contrary to the previous hypothesis of low membrane permeability as a limiting factor for absorption, the "intrinsic" partition coefficient in 1 octanol/aqueous buffer was moderate, 0.6. Furthermore, the absorption in ileal and jejunal loops was enhanced by an apparent increase in mesenteric blood flow by caffeine. The existence of prolonged oral absorption in rats and humans is discussed. PMID- 3681666 TI - Relationship between the ocular and systemic disposition of flurbiprofen: the effect of altered protein dynamics at steady state. AB - The differences in flurbiprofen disposition in the aqueous humor and the plasma were examined after systemic doses. Steady state plasma concentrations of flurbiprofen (20-60 micrograms/mL) were achieved via intravenous infusion to albino rabbits. Flurbiprofen demonstrated linear systemic kinetics throughout the dosing range, with constant body clearance and unbound fraction in plasma. At steady state, aqueous humor drug concentrations depended on the corresponding plasma drug concentration. Two clearance terms--CLS----O, the systemic clearance to ocular tissues, and CLO----S, the ocular clearance to systemic circulation- were used. After systemic doses, the drug concentration in the aqueous humor was related to that in the plasma as well as to the ratio of these two clearances. Flurbiprofen was extensively bound to plasma proteins and showed limited ocular distribution; its CLS----O to CLO----S ratio was very small. Thus, the concentration of flurbiprofen in the aqueous humor after systemic doses was lower than that obtained after ophthalmic doses. A plasmapheresis technique was utilized to lower the plasma protein concentrations to 60% of normal levels. As a consequence, flurbiprofen demonstrated reduced aqueous humor protein concentrations, increased unbound fractions in the plasma and the aqueous humor, elevated aqueous humor drug concentrations, and elevated total body clearance. The unbound body clearance stayed unchanged. Our study indicated that a drug should present a significant CLS----O/CLO----S ratio in order to achieve therapeutic concentrations in the eye via systemic doses. The drug-protein binding kinetics can be different between the plasma and the aqueous humor circulations. Because the ocular compartment is very small compared to the overall systemic distribution of flurbiprofen, it has little effect on the steady state systemic concentrations. PMID- 3681667 TI - Effect of a diffusional barrier to a metabolite across hepatocytes on its kinetics in "enzyme-distributed" models: a computer-aided simulation study. AB - The effect of a diffusional barrier to a metabolite between the blood and hepatocytes on elimination kinetics of formed and preformed metabolites was predicted under various enzymic distributions in the liver by computer-aided simulation. Sequential metabolism by which the primary metabolite (MI) is generated from the parent drug (D) and further metabolized to the terminal metabolite (MII) by enzymes A and B, respectively, was chosen for the simulation. Moreover, four models of enzyme distribution patterns were defined with regard to the hepatic blood flow path. The extraction ratios for the preformed and formed metabolites (designated as Em and Ep----m, respectively) were simulated by varying both the average intrinsic clearance of enzyme B (CLint,B) and the permeability of hepatocytes for MI (Pm), while keeping the average intrinsic clearance of enzyme A (CLint,A) equal to hepatic blood flow (Q). When a rapid equilibrium of MI between the blood and hepatocytes held, i.e., Pm was large relative to Q, Em was equal to or higher than Ep----m for all models, as previously shown by Pang and Stillwell. By contrast, it was found that when a diffusional barrier for MI existed, i.e., Pm was small relative to Q, Em was equal to or lower than Ep----m. Furthermore, it was observed that the smaller Pm became, the larger the difference between Em and Ep----m became. We further simulated the effect of the intrinsic clearance (CLint,C) for a metabolic pathway, which competes for that by enzyme A, on the Ep----m value. In the model assuming even distribution of all the enzymes along the flow path, irrespective of the CLint,C value, a similar effect of Pm on Ep----m was observed when the Pm value was relatively small (Pm less than Q). By contrast, in the case of uneven enzymic distributions of enzymes A and B, the effect of the CLint,C value on the relationship between Pm and Ep----m occurred to some extent. From these simulations, it was concluded that lower membrane permeability (Pm) both diminishes the entry of preformed metabolite into the hepatocytes and accelerates the removal of intracellularly formed metabolite (through sequential metabolism) by diminishing its efflux, yielding lower Em than Ep----m. When Pm becomes small (Pm less than 1/10Q), these mechanisms for lower Em than Ep----m predominate over other mechanisms such as the presence of a competing metabolic route and uneven distribution of enzymes. PMID- 3681668 TI - Mean residence time in peripheral tissue. AB - The published methods for determining the mean residence time for drugs in peripheral tissue are reviewed in terms of assumptions involved, advantages and disadvantages. A method for determining mean transit time in peripheral tissue is proposed; this may be a more useful indicator of the tissue retention properties for drug compounds. PMID- 3681669 TI - Pediatric metatarsus adductus angle. PMID- 3681670 TI - Lentigo simplex. PMID- 3681671 TI - Radiographic anatomy of the calcaneus. Part I: Inferior surface. PMID- 3681672 TI - Acral lentiginous melanoma. A report of a case and a review of the literature. PMID- 3681673 TI - Giant cell tumor of the plantar fascia. A case report. PMID- 3681674 TI - Giant cell tumor of the extensor tendon sheath of the foot. A case report. PMID- 3681675 TI - Implanted gentamicin beads in the treatment of osteomyelitis. A case report. PMID- 3681676 TI - The benefit of weight training for hamstring strains. Two case reports. PMID- 3681677 TI - Nutrition and the podiatric physician. Results of a survey. PMID- 3681678 TI - Capsular bag implantation of the hydrogel lens. AB - Fifty hydrogel lenses were implanted in the capsular bag. Six months after surgery, 96% of eyes had visual acuities of 20/30 and 40% had acuities of 20/15. The age range of patients was 65 to 92 years (mean 76 years). Such visual satisfaction is rarely achieved in this age group and appeared to be related to the low incidence of uveitis and capsular fibrosis associated with these lenses. Excellent lens centration was maintained in 82% of eyes. Despite the small number of cases and short follow-up, these preliminary results merit attention from the medical profession. PMID- 3681680 TI - Optical resolution of silicone and polymethylmethacrylate intraocular lenses. AB - The optical resolution and contrast of 18 silicone and 18 polymethylmethacrylate (PMMA) intraocular lenses were determined before implantation in and after removal from rabbit eyes. A specially designed microphotographic system that allows documentation and comparison of the image quality of different lens types was used. Silicone intraocular lenses showed a mean axial resolution of 1.25, PMMA lenses showed 1.60, of an optotype analogous resolution target (1.0 = 20/20) at a 3 mm pupil opening preoperatively. At one to 16 weeks postoperatively, both types of IOLs demonstrated nearly unchanged resolution. Contrast, however, decreased to between 60% and 85% of the preoperative 100% standard. This decrease was due to precipitates deposited on the lens surface, to posterior capsule opacification, and to lens decentration. PMID- 3681679 TI - Clinicopathologic findings after in-the-bag implantation of open-loop polymethylmethacrylate and silicone lenses in the rabbit eye. AB - Two lens models, one all silicone with J-loop haptics, the second with PMMA optics and angled polypropylene C-loop haptics, were implanted in the capsular bag of 36 rabbit eyes following extracapsular lens extraction. Technical ease of implantation, inflammatory response, lens position, and fibrin exudation as well as precipitate formation were examined. Biomicroscopy, light and phase-contrast microscopy were used. Differences in haptic vulnerability, lens position, and fibrin clot formation were found between the two lens types. Lens-specific differences in precipitate formation could not be substantiated. PMID- 3681681 TI - Evaluation of 50 silicone posterior chamber lens implantations. AB - This study presents our experience with 50 silicone intraocular lens (IOL) implants (STAAR Surgical Company, model AA-4004) in the posterior chamber. In the relatively short-term mean postoperative follow-up of seven months, the following complications were observed: iris chafing - pigmentary dispersion, 15 (30%); IOL tilt and decentration, 7 (14%); pseudophakodonesis, 6 (12%); fibrinous exudate, 3 (6%); luxation of one haptic in the anterior chamber, 1 (2%); IOL tears, 5 (10%). Visual acuity of 20/20 to 20/40 was obtained in 40 patients (80%). Although no severe consequences were noted, the long-term effects of the complications are unpredictable at present. PMID- 3681682 TI - Posterior capsule opacification after silicone lens implantation and its management. AB - The incidence and time of onset of posterior capsular opacification in a consecutive series of 147 silicone lens implants and in 585 polymethylmethacrylate (PMMA) lens implants were compared. Silicone lenses, sulcus and capsular bag fixated, had an opacification rate of 27.9%, while PMMA had a rate of 7.0%. In the silicone lens series, 65.9% of the opaque capsules required YAG laser posterior capsulotomies in the first four months. In the PMMA implants, only 28.6% required YAG laser capsulotomies in the first four months. The mean follow-up time was nine months. Management of capsular opacification in silicone lenses required early YAG laser capsulotomy, with focusing posterior to the capsule to avoid pitting the implant. PMID- 3681683 TI - Endothelial cell loss after phacoemulsification and insertion of silicone lens implants. AB - Central corneal endothelial cell loss was compared following primary insertion of folded posterior chamber silicone intraocular lenses (IOLs) in 29 eyes and Sinskey-style polymethylmethacrylate posterior chamber IOLs in 20 eyes. Cataracts were removed by phacoemulsification and sodium hyaluronate was used in all cases. The mean follow-up time was greater than seven months. The average cell loss was 9.6% and 10.9%, respectively. There was no significant difference in cell loss or visual results in the two groups. The amount of cell loss compares favorably with other series in which cell loss was determined following cataract surgery with and without IOL implantation. PMID- 3681684 TI - Complications associated with STAAR silicone implants. AB - We compared the incidence of various complications in consecutive series of cases in which 76 eyes received STAAR silicone intraocular implants and 76 eyes received small incision IOLAB G708G polymethylmethacrylate (PMMA) intraocular implants. All surgeries were performed by the same surgeon employing the same phacoemulsification technique. A higher incidence of lens subluxation, lens repositioning, corneal edema, and elevated intraocular pressure was observed in the eyes receiving STAAR silicone implants than in the eyes receiving IOLAB PMMA implants. In addition, a YAG laser posterior capsulotomy could not be performed through several STAAR silicone RMX 1 model implants. An invasive pars plana posterior capsulotomy was necessary in these eyes. We also found that the STAAR silicone RMX 3 model implants were often pitted by the YAG laser during successful posterior capsulotomies. Despite these problems, the STAAR silicone intraocular lens group achieved corrected vision similar to the PMMA lens group. PMID- 3681685 TI - Comparative histopathologic study of various lens biomaterials in primates after Nd:YAG laser treatment. AB - A Nd:YAG laser was used to perform posterior capsulotomies on primates in whom one-piece silicone or three-piece polymethylmethacrylate intraocular lenses were in place for more than one year. The eyes were followed for eight weeks after treatment before enucleation. Histologically, no toxic effects caused by the dispersion of any of the biomaterial within the eyes and no significant inflammatory reactions were seen. The silicone lenses used in this study compared favorably with traditional polymethylmethacrylate lenses when posterior capsulotomies with a Nd:YAG laser were performed. PMID- 3681686 TI - Neodymium:YAG laser interaction with Alcon IOGEL hydrogel intraocular lenses: an in vitro toxicity assay. AB - The objective of this study was to determine the potential toxicity generated by the interaction of the Nd:YAG laser and Alcon IOGEL intraocular hydrogel lens material. The IOGEL lens is composed of poly 2-hydroxyethylmethacrylate, containing 38% water, previously shown to be highly biocompatible in a wide range of tissue culture and implantation experiments. In this study, intraocular lenses (IOLs) immersed in serum-free cell culture medium were purposely exposed to exaggerated doses of laser energy to cause extensive damage. An IOLAB polymethylmethacrylate (PMMA) lens served as a control lens material. The resultant solutions were assayed for cytotoxicity in a bioassay system using fourth passage human corneal endothelial cells. No cytotoxicity was seen in the bioassay for the IOGEL hydrogel IOLs or the PMMA control IOL at any laser range/dosage tested over a 72-hour incubation period. Hydrogel lenses exhibited decreasing yellowing with decreasing energy levels, and no lens discoloration was apparent at the lowest level of irradiation, 5 mJ/50 laser bursts; the PMMA control lens exhibited moderate yellowing at 15 mJ/50 bursts. Lens marking was moderate for all IOGEL IOLs; the PMMA lens marking was severe at the power level tested. PMID- 3681687 TI - Phacoemulsification devices: a consumer's update. AB - This report extends a previous paper on the various characteristics of the most popular phacoemulsification devices. An evaluation of 11 devices by ten different manufacturers was attempted. Only five manufacturers of six devices agreed to critical evaluation or reevaluation. As in the previous report, the devices were compared for level of patient safety, dependability, efficiency, ease of usage, and operating cost for the first 1,000 cases. At the completion of this study, we ranked the nine devices evaluated over the past 17 months as follows: (1) United Surgical (Optikon) Systems Plus, (2) Optical Micro Systems (OMS), (3) United Surgical (Optikon) Phacotron, (4) CooperVision 10,000, (5) Site XTR, (6) CooperVision KCP, (7) CooperVision 9001, (8) Phakosystems CES 4000 and (9) United Sonics. To enhance the usefulness of this consumer's guide, we asked 40 experienced cataract surgeons what they wanted in the "ideal" phacoemulsification device. The opinions of 27 who responded are included. PMID- 3681688 TI - Folding and inserting silicone intraocular lens implants. AB - A two-forceps system for folding and inserting silicone lens implants and the method for using them is described. Other methods and instruments currently available are reviewed, and requirements for folding and inserting silicone intraocular lenses are discussed. PMID- 3681689 TI - Unexplained intraocular toxicity after cataract-intraocular lens surgery. PMID- 3681690 TI - Midazolam as a sedative for cataract surgery. PMID- 3681691 TI - Prolapse of a rigid anterior chamber lens through an iridectomy. PMID- 3681692 TI - Recertification vote. PMID- 3681693 TI - Differential effects of pimozide and clozapine on schedule-controlled and scheduled-induced behaviors after acute and chronic administration. AB - The present study reports the comparative effects of pimozide (PMZ; 0.1, 0.3 and 1.0 mg/kg) and clozapine (CZP; 1.0, 3.0 and 10.0 mg/kg) on fixed-interval 60-sec responding after acute and chronic administration and on the acquisition of schedule-induced drinking (SID) during a chronic dosing procedure. Both the 0.3 and the 1.0 mg/kg of PMZ groups responded significantly less than vehicle controls after acute dosing without disrupting the operant response patterns as measured by index of curvature (IOC), and these effects persisted for 38 days of treatment. Acute treatment with 3.0 and 10.0 mg/kg of CZP significantly suppressed operant response rates and disrupted the pattern of operant responding, in that the IOC was significantly lower for these subjects than for vehicle controls. The CZP-treated animals gradually developed tolerance to the drug effects and were performing at vehicle control levels after Day 7 of treatment. SID was assessed from Day 19 through Day 38 of neuroleptic treatment. PMZ suppressed the acquisition of SID. Animals treated with 1.0 and 0.3 mg/kg of PMZ consumed less water than controls and did not develop the postpellet drinking pattern characteristic of SID. Both the vehicle and 0.1 mg/kg of PMZ groups increased the amount of water they consumed across the 10 blocks of sessions. A dose-related suppression of SID also was noted for CZP-treated rats. Vehicle controls and three of the subjects treated with 10.0 mg/kg of CZP acquired the SID behavior. These animals gradually increased the amount of water they consumed across sessions and drank in a temporal pattern consistent with SID.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681694 TI - Hemodynamic pharmacology of p-chloroamphetamine, a serotonin agonist, in conscious rats. AB - The hemodynamic effects of p-chloroamphetamine (PCA), an indirect serotonin (5 HT) agonist, were studied in conscious, unrestrained rats. PCA caused an immediate hypotension and bradycardia followed by a dose-dependent increase in mean arterial pressure (MAP), which lasted for 15 to 60 min, associated with variable effects on heart rate. An intermediate dose increased MAP and resistance in hindquarter and mesenteric, but not renal, vascular beds. The pressor effect of PCA was blocked by prazosin and by 6-hydroxydopamine plus adrenal demedullation, but not by 6-hydroxydopamine or adrenal demedullation separately. Ganglionic blockade with chlorisondamine or beta adrenoceptor blockade with propranolol potentiated the pressor response to PCA, whereas several manipulations of central 5-HT systems (fluoxetine, methysergide and 5,7 dihydroxytryptamine) reduced but did not eliminate the hypertension observed after PCA. The initial bradycardia and hypotension were abolished by chlorisondamine or atropine but not reduced by any other pretreatment, whereas the variable heart rate response was converted to a marked, sustained tachycardia by ganglionic blockade or atropine and to a consistent bradycardia by propranolol and peripheral sympathectomy. The data suggest that PCA causes an immediate central or reflex vagal activation to decrease heart rate and MAP, followed by a central 5-HT-mediated increase in sympathetic activity that increases MAP. Most of the pressor effect observed between 5 and 30 min after PCA appears to be mediated by a direct effect on release of norepinephrine and epinephrine from sympathetic nerve terminals and the adrenal medulla, respectively. Only a minor part of the hemodynamic response to PCA appears to be attributable to its effect on release of 5-HT in the brain. PMID- 3681695 TI - Effect of norepinephrine uptake blockade on contractile responses to adrenergic nerve stimulation of isolated rat blood vessels: influence of age. AB - It has been shown previously that vascular adrenergic responsiveness is maintained with age in the face of reductions in norepinephrine (NE) content. To test the hypothesis that a concomitant decrease in neuronal NE uptake is responsible for maintenance of contractile responses with age, isolated blood vessel segments from Fischer 344 rats aged 6, 12, 20 and 27 months were studied. Renal artery and vein, femoral artery and vein and tail artery were stimulated with transmural nerve stimulation (TNS) with and without cocaine (3 X 10(-5) M). Similar to previous findings, frequency response curves for 200 pulse trains of TNS did not differ significantly with age, except for the 6 months tail artery at 1, 2 and 4 Hz and the 6 months renal artery at 1 Hz. After addition of cocaine, TNS responses for trains of 200 pulses were increased substantially. Comparison of responses to TNS in the presence of neuronal uptake blockade with cocaine demonstrated no significant differences with age except for the renal vein, where responses at 1 Hz were smaller at 6 months compared to 12 months. Thus, except for the tail artery at 6 Hz, the effect of cocaine on responses to adrenergic nerve stimulation did not vary with age. In the tail artery at 6 months, because control responses were significantly smaller, the effect of cocaine was greater than at other ages. These findings suggest that a decrease in NE uptake with advancing age cannot account for the maintenance of adrenergic responses in the face of a fall in tissue NE content. PMID- 3681696 TI - Phenobarbital induction and acetaminophen hepatotoxicity: resistance in the obese Zucker rodent. AB - The obese Zucker rodent appears to lack a significant induction response after phenobarbital pretreatment. Induction of the hepatic cytochrome P-450 system with phenobarbital is known to enhance acetaminophen hepatotoxicity. The purpose of this study was to evaluate the influence of phenobarbital enzyme induction on acetaminophen hepatotoxicity in the obese and lean Zucker rodent. A preliminary study was performed evaluating the pharmacokinetics of acetaminophen in both the obese and lean Zucker rats. Data were utilized to calculate appropriate loading doses of acetaminophen during the subsequent hepatotoxicity study. Phenobarbital enzyme-inducing regimens were administered p.o. to achieve similar steady-state phenobarbital plasma concentrations. Control rats received appropriate placebo solutions. Serum hepatic transaminase enzymes and histologic evidence of hepatocellular necrosis were utilized to evaluate hepatic damage after p.o. administration of 1300 mg of acetaminophen to both obese and lean Zucker rats. Obese Zucker control animals had approximately 2.5 times the total hepatic glutathione content compared to their lean control (164.9 +/- 43.2 vs. 65.3 +/- 18.4 mumol/whole liver). Obese Zucker animals receiving only acetaminophen showed a trend toward a reduced incidence of hepatocellular necrosis compared to similarly treated lean littermates. Obese Zucker rodents pretreated with phenobarbital had an even more pronounced resistance to acetaminophen-induced hepatocellular necrosis (P less than .01) when compared to similarly treated lean littermates. Thus, acetaminophen hepatotoxicity is reduced in the obese Zucker rat and pretreatment with phenobarbital offers further protection against hepatocellular damage. We suggest that the previously unrecognized increase in hepatic glutathione plays a major role in the resistance of the obese Zucker rat to acetaminophen hepatotoxicity. PMID- 3681697 TI - Unmasking of thrombin vasoconstriction in isolated perfused dog hearts after intracoronary infusion of air embolus. AB - Effects of intracoronary thrombin and acetylcholine administration on coronary vascular reactivity were studied in isolated perfused (Langendorff) dog hearts before and after air embolus treatment. Under constant flow condition with control coronary perfusion pressure of 71.4 +/- 5.4 mm Hg (mean +/- S.E.M. of eight hearts), infusion of thrombin (0.1 U/ml) resulted in an immediate decrease (-32.8 +/- 2.7 mm Hg) in coronary perfusion pressure, reaching a maximum in approximately 20 to 25 sec. Similar vasodilatory response (-30.5 +/- 1.9 mm Hg, M +/- S.E.M. of six hearts) also was observed with administration of 0.1 microM acetylcholine. Introduction of 0.3 ml air embolus into the coronary circulation before thrombin or acetylcholine testings, however, showed a 100 and 63% decrease in their respective coronary vasodilatory responses. More importantly, infusion of thrombin into these previously air embolus-treated hearts actually resulted in a potent vasoconstriction by increasing the coronary perfusion pressure (+48.2 +/ 5.7 mm Hg, mean +/- S.E.M. of six hearts) above the control level. The coronary vasoconstrictory effect of thrombin was reversible upon cessation of thrombin infusion or with concurrent administration of sodium nitroprusside (1 microM). Similarly, synthetic thrombin inhibitor phenylalanyl-prolyl-arginine chloromethyl ketone (0.1 microM) also was capable of both inhibiting and reversing thrombin induced vasoconstriction. The present finding of a potent thrombin-induced coronary vasoconstriction in intact hearts after air embolus infusion further supports the hypothesis that an activation of thrombin in certain pathological states with injured endothelium may have an important role in the genesis of coronary vasospasm. PMID- 3681698 TI - Specific actions of gallium on norepinephrine-induced tension and associated 45Ca movements in rabbit aortic smooth muscle. AB - Gallium ion (Ga) dose-dependently (60-360 microM) inhibited contractions induced by norepinephrine (NE, 1 microM) in rabbit aortic (and media intimal) strips, but did not affect contractions elicited with high K+ (80 mM) solution. The initial phasic portion of the NE-induced response was either unaffected or only slightly (less than 10%) reduced, but the tonic portion of the response was inhibited completely by higher concentrations (greater than or equal to 300 microM) of Ga . In resting muscles, the equilibrated (90 min) 45Ca uptake was not altered by Ga (360 microM). Also, 45Ca efflux from either high- or low-affinity Ca++ binding sites was unaltered by Ga . The effects of Ga (360 microM) on 45Ca retained after a subsequent 60-min washout at 0.5 degrees C in an isosmotic (80.8 mM) La solution were also examined. High affinity La -resistant 45Ca released by NE (1 microM) was not altered by Ga . Under conditions favoring low affinity Ca++ uptake, 45Ca retention in control and K+-treated muscles was not changed by Ga , but the additional incremental 45Ca uptake associated with NE (in the presence of high K+) was blocked. Thus, Ga appears to have a selective inhibitory action on NE-associated 45Ca uptake without affecting either resting and high K+-induced 45Ca uptake or that 45Ca fraction released by NE. This action may result from a selective blockade by Ga of receptor-linked Ca++ channels in rabbit aortic smooth muscle. PMID- 3681699 TI - Nicotine-induced release of vasopressin in the conscious rat: role of opioid peptides and hemodynamic effects. AB - Nicotine has been shown to stimulate the release of vasopressin and to cause significant hemodynamic changes. The mechanisms leading to enhanced vasopressin secretion and the vascular consequences of the high plasma vasopressin levels during nicotine infusion have not yet been determined. Therefore, the purposes of the present study were 1) to examine in normal conscious rats the role of opioid peptides in the nicotine-induced increase in plasma vasopressin levels and 2) to assess the role of vasopressin in the hemodynamic effects of nicotine (20 micrograms/min for 15 min) using a specific V1 antagonist of the vascular actions of vasopressin. Plasma vasopressin levels were significantly increased in the nicotine-treated animals (39.5 +/- 10 vs. 3.7 +/- 0.6 pg/ml in the controls, P less than .01). Pretreatment with naloxone, an antagonist of opioids at their receptors, did not reduce the vasopressin levels (47.7 +/- 9 pg/ml). Nicotine also increased mean blood pressure (122.5 +/- 2.5 to 145.2 +/- 3.3 mm Hg, P less than .01) and decreased heart rate (461 +/- 6 to 386 +/- 14.5 beats/min, P less than .05). Administration of the vasopressin V1 antagonist before the nicotine infusion did not affect the systemic hemodynamics or the regional blood flow distribution, as assessed by radiolabeled microspheres. Thus, these results suggest that the nicotine-induced secretion of vasopressin is not mediated by opioid receptors and that the high plasma vasopressin levels do not exert any significant hemodynamic effect on cardiac output or blood flow distribution. PMID- 3681700 TI - Acetylation of acetylhydrazine, the toxic metabolite of isoniazid, in humans. Inhibition by concomitant administration of isoniazid. AB - The effect of isoniazid and its metabolites on the disposition of acetylhydrazine, a toxic metabolite formed from isoniazid, was studied in humans. Acetylhydrazine was administered i.v. with and without prior ingestion of 300 mg of isoniazid. In the studies with isoniazid, 15N2-acetylhydrazine was administered in order to distinguish exogenous acetylhydrazine from the unlabeled acetylhydrazine formed from isoniazid. In each subject (two fast and three slow acetylators) the rate of elimination of acetylhydrazine was similar to the rate of elimination of isoniazid suggesting that the two compounds are subject to the same acetylation polymorphism. In the presence of isoniazid the rate of elimination of acetylhydrazine was consistently lower than in the absence of isoniazid, and the urinary excretion of diacetylhydrazine and the ratio of diacetyl/acetylhydrazine in urine decreased. The data indicate that therapeutic concentrations of isoniazid and its metabolites inhibit the acetylation of acetylhydrazine in humans. The inhibition of this detoxification pathway could contribute to the hepatotoxicity of isoniazid. PMID- 3681701 TI - Selective and long-lasting inhibitory actions of the dihydropyridine derivative, CV-4093, on calcium currents in smooth muscle cells of the rabbit pulmonary artery. AB - Effects of CV-4093, a newly synthesized dihydropiridine type of Ca antagonist, on membrane currents in enzymatically dispersed single smooth muscle cells of the rabbit main pulmonary artery were investigated using the single electrode voltage clamp method. Three types of membrane currents were evident, i.e., Ca and Na inward and K outward currents. CV-4093 potently inhibited the Ca inward current, as compared to findings with other currents. When the potential was at -60 mV, CV 4093 consistently inhibited the Ca current evoked by depolarization to 0 mV. However, a low concentration of CV-4093 (1-3 nM) enhanced the Ca current evoked by the depolarizing pulse of -20 mV, when the membrane potential was held at -80 mV. Inhibition of the Ca current induced by CV-4093 developed slowly and over 10 min was required to reach the maximum inhibition. Changes in the frequency of the depolarizing pulse did not modify the rate of inhibition induced by CV-4093. The inhibition was not restored by washout of the drug for over 40 min, and hyperpolarizations of the membrane did not accelerate the recovery. The IC50 of CV-4093 obtained for the K outward current was 3000 times larger than that obtained for the Ca inward current. CV-4093 apparently has highly selective and long-lasting inhibitory actions on the Ca current in smooth muscle cells of the rabbit main pulmonary artery. PMID- 3681702 TI - Inhibition of cholesterol-induced atherosclerosis in rabbits by dimethyl sulfoxide. AB - The effect of dimethyl sulfoxide (DMSO) on cholesterol-induced atherosclerosis in the rabbit was investigated. Two groups of rabbits were studied: a Control group which received regular chow and an Experimental group which received an atherogenic diet containing 1% cholesterol. DMSO was either omitted or added to the drinking water of both groups in amounts of 2, 4, 5 and 6%. After 3 months all animals were autopsied; the thoracic aorta was examined for atheromatous lesions and the abdominal aorta assayed for total cholesterol content. As expected the thoracic aortas of all rabbits in the Control group were free of atheromatous lesions. With the exception of one rabbit in the Experimental group, all rabbits on the atherogenic diet which did not receive DMSO had extensive aortic lesions covering 82 +/- 5% of the surface area of the thoracic aorta. Aortic lesions were inhibited by about 50% in rabbits on 2% (dose, 1.5 g/kg) DMSO and virtually absent in the majority of rabbits on 4 (dose, 3.5 g/kg), 5 (dose, 5.5 g/kg) and 6% (dose, 9.1 g/kg) DMSO. The food intake of rabbits on the atherogenic diet was not suppressed by DMSO. Changes in the cholesterol content of the abdominal aortas paralleled the presence or absence of lesions in the thoracic aorta. Blood cholesterol levels were greatly elevated in all rabbits on the atherogenic diet and not lowered by DMSO. In conclusion, cholesterol induced atherosclerosis in the rabbit was inhibited by DMSO. This action of DMSO was independent of the hypercholesterolemia and not due to a suppression of food intake. DMSO may provide a useful probe for investigating the underlying mechanism(s) in the development of cholesterol induced atherosclerosis. PMID- 3681703 TI - Cell death of axotomized motoneurones in neonatal rats, and its prevention by peripheral reinnervation. AB - 1. Motoneurone death induced by axotomy in the rat was studied following section of the medial gastrocnemius nerve near the muscle 4 days after birth. 2. The maximum twitch tension of the medial gastrocnemius muscle achieved by motor reinnervation after section of its nerve was about 70% of that measured on the contralateral, intact side. 3. The number of motor units counted at 35-45 days of age in the animals whose medial gastrocnemius nerves had been sectioned on day 4 was 62% of that observed in normal rats. 4. The number of medial gastrocnemius motoneurones retrogradely labelled with horseradish peroxidase (HRP) 30-40 days after section of the medial gastrocnemius nerve was 77% of that labelled on the contralateral, intact side. 5. When the medial gastrocnemius nerve had been sectioned on day 4 and prevented from peripheral reinnervation, the number of medial gastrocnemius motoneurones labelled with HRP was, on the average, only 18% of that labelled on the control side. 6. Decreased number of medial gastrocnemius motoneurones labelled with HRP following prevention of peripheral reinnervation was associated with a decrease in the neurone density of the motor cell column, indicating the occurrence of motoneurone death. 7. The majority of medial gastrocnemius motoneurones axotomized 4 days after birth appear to maintain their survival for about 2 weeks without target contact. 8. The area of the compound action potential of medial gastrocnemius motor fibres once decreased after axotomy on day 4 began to recover from the 12th day after the operation if reinnervation by the cut peripheral nerve had been allowed, whereas the compound action potential continued to decrease in those axotomized motoneurones whose reinnervation had been prevented. 9. It is concluded that target dependence of motoneurone survival previously observed at embryonic stages is still present during the early post-natal period. PMID- 3681704 TI - Stumbling reactions in man: significance of proprioceptive and pre-programmed mechanisms. AB - 1. Electromyogram (e.m.g.) responses of the leg musculature and the corresponding joint movements were studied following a perturbation of the limb during walking on a treadmill, produced by a randomly timed treadmill acceleration impulse, either predictable, or unpredictable in its amplitude and rate of acceleration. 2. The rate of rise of ipsilateral gastrocnemius e.m.g. response following a perturbation was dependent on the rate of treadmill acceleration. For a given acceleration rate the amplitude of the e.m.g. response and the timing of its peak was dependent on the amplitude of the impulse and the rate of rise of the gastrocnemius response was the same for impulses of both small and large amplitude. The onset latency was shorter (65 ms) for high accelerations and longer (85 ms) for lower ones. 3. The amplitude of the ipsilateral biceps femoris response was much smaller than the gastrocnemius response but was larger following unpredictable than predictable impulses. 4. The initial gastrocnemius response was followed by a tibialis anterior activation associated with a gastrocnemius depression and sometimes with a second, weak gastrocnemius activation. The gastrocnemius depression ended within a fixed time range relative to the onset of the response. The tibialis anterior activation was most pronounced when unpredictable impulses with high acceleration but a small amplitude were induced. 5. It is concluded that generation of the first gastrocnemius response is obviously under continuous control by muscle proprioceptive information and can be best described in terms of a stretch reflex response. It is suggested that, on the evidence of the diphasic or triphasic e.m.g. pattern, a close interaction occurs between a central programme and muscle proprioceptive input in order to generate the appropriate e.m.g. pattern. 6. On the basis of earlier work (Berger, Dietz & Quintern, 1984a) and on the present results it is suggested that the e.m.g. responses may be mediated mainly by muscle proprioceptive input from group II afferents. This input is modulated and processed by spinal interneuronal circuits, closely connected with spinal locomotor centres. The mode of processing depends on various factors, such as the predictability of the nature of the impulse. PMID- 3681705 TI - Actions of neuropeptide Y on innervated and denervated rat tail arteries. AB - 1. Neuropeptide Y caused a dose-dependent contraction and depolarization of the smooth muscle of the rat tail artery. 2. 30 nM-neuropeptide Y increased the contraction caused by either nerve-released noradrenaline or smooth muscle action potentials. 3. 30 nM-neuropeptide Y did not change the amplitude or rate of rise of the smooth muscle action potential. It did not change the amplitude of small excitatory junction potentials, suggesting that it did not affect neurotransmitter release. 4. 30 nM-neuropeptide Y increased the contraction caused by exogenous noradrenaline, 5-hydroxytryptamine and K in concentrations that gave submaximal contractions. It did not affect the response to higher concentrations that gave maximal or near-maximal contractions. PMID- 3681706 TI - Gradual and stepwise changes in the membrane capacitance of rat peritoneal mast cells. AB - 1. The membrane capacitance of mast cells was monitored under voltage clamp, using sinusoidal excitation and a lock-in amplifier. 2. Degranulation was accompanied by stepwise capacitance increases that presumably represent the fusion of single secretory granules with the cell membrane. Besides capacitance steps, we also observed gradual changes in capacitance that occurred even in the absence of degranulation, were independent of the presence of nucleotides in the pipette, and were steeply dependent on cytoplasmic [Ca2+]. 3. Cytoplasmic Ca2+ at concentrations of 0.3-3 microM stimulated a decline in capacitance, with a dose response curve suggesting control by the binding of Ca2+ to high-affinity intracellular sites. When maximally activated, this mechanism could lead to a loss of about 6% of the cell membrane capacitance, at an average rate of 0.1-0.2% s-1. 4. At even higher cytoplasmic [Ca2+] (greater than 3 microM), the reverse effect was observed. The capacitance increased gradually by up to 40%, at an average rate of 0.4% s-1. Evidently gradual changes in membrane capacitance can occur by two mechanisms, and both are influenced by cytoplasmic [Ca2+]. 5. Ca2+ frequently stimulated an inward current accompanied by an increase in membrane conductance. 6. The effects described above were observed also when only trace amounts of Ca2+ and chelator were added to the cytosol, and when increases in cytosolic [Ca2+] could have occurred only by endogenous mechanisms. It is suggested that these effects occur also in intact cells during the large [Ca2+] increases known to occur before and during degranulation. PMID- 3681707 TI - The dynamics of the cat retinal X cell centre. AB - 1. The dynamics of the centre mechanism of individual cat X retinal ganglion cells is investigated. The visual stimuli consist of temporal contrast modulation of stationary patterns. In order to study the response of the centre mechanism, patterns were either sine gratings of high spatial frequency or small circular spots positioned over the receptive-field centre. 2. Responses to contrast reversal are approximately linear. However, as the modulation depth of the stimulus increases, responses become more transient. Ganglion cell responses show this phenomenon at moderate contrasts (e.g. 0.1), which do not elicit discharges that approach the maximum firing rate of the ganglion cell. 3. A sequence of dynamical models are constructed from responses elicited by sum-of-sinusoids modulation of the spatial pattern. The first model is strictly linear. It consists of a series of low-pass filters and a single high-pass filter. The linear model predicts the approximate shape of the step response, but does not account for the change in shape of the response as a function of modulation depth. 4. The second model, a quasi-linear model, allows the 'linear' dynamics to vary slowly with a neural measure of contrast. The main effect of high contrast is a shorter time constant in the high-pass filter. This model accounts qualitatively for the increased transience of the response, but fails to predict the magnitude of the effect at higher modulation depths. 5. In the third model, the transfer characteristics of the centre response adjust rapidly as contrast changes. This intrinsically non-linear model provides excellent agreement with observed response to steps and more complex modulation patterns. 6. The non linearity necessitated by a voltage-to-spikes transduction is analysed quantitatively. In most ganglion cells, a simple truncation at 0 impulses/s (and no saturation) explains the changes in apparent gain and mean firing rate that occur as modulation depth is increased. A non-linear voltage-to-spike transduction per se cannot account for the observed effect of contrast on dynamics. 7. The parameters of the dynamical model are measured for a population of twenty-seven X ganglion cells (nineteen on-centre and eight off-centre). The low-pass stage and the strength of the high-pass stage are relatively uniform across the population. The over-all gain and the dynamics of the high-pass stage vary substantially across the population, but show no consistent dependence on the on-off distinction or on retinal location. Some implications of this variability for retinal function are discussed. PMID- 3681708 TI - Maintenance of constant arm position or force: reflex and volitional components in man. AB - 1. Normal subjects, with closed eyes, attempted to keep constant either the force exerted at the wrist or the position of the wrist against an elastic load. The load was attached to the wrist 275 mm from the axis of rotation of the elbow joint. During recording, the far end of the elastic load was displaced slowly enough that it was not immediately perceived but far enough for perception to occur before its completion. 2. The over-all relation between wrist force and position for the two conditions was approximately linear and could be described in terms of effective stiffness. The effective stiffness for the constant position task averaged 2.8 N/mm (210 N m/rad), while for the constant-force task the mean effective stiffness was -0.028 N/mm (-2.1 N m/rad), indicative of slight over-compensation. 3. Averaging the performance at the onset of the imposed disturbance indicated that the subjects' behaviour consisted of two parts: an initial, small-range response followed by a second phase over the remainder of the displacement. The transition corresponded to the subjects' threshold for detection of the disturbance. 4. The stiffness measured for the response prior to perception was taken as a measure which included the tonic stretch reflex. The stiffness was altered appropriately for the two tasks, being lower when the subjects tried to maintain the force exerted constant (average 1.1 N/mm, 83 N m/rad) than when they attempted to keep the position constant (average 2.3 N/mm, 170 N m/rad). A small degree of co-contraction occurred but could be dissociated from the stiffness changes. 5. Scaling the results allowed comparison of the initial stiffness with values for the decerebrate cat. When analysed in this way, the values recorded in man during the constant-position task were similar to those reported for short-range stiffness in the decerebrate cat. 6. The thresholds for detection of the disturbance were much lower than those reported for subjects with relaxed muscles. 7. The stretch reflex in man has a direct role in compensating for small disturbances during motor tasks. It may also function to improve detection of applied disturbances by magnifying the corresponding force change. Once the stimulus is perceived and voluntary intervention is possible, a greater contrast is seen between the subjects' performance of the two tasks. PMID- 3681709 TI - Phase coherence in vibration-induced responses of tactile fibres associated with Pacinian corpuscle receptors in the cat. AB - 1. In pentobarbitone-anaesthetized cats, responses were recorded in peripheral nerves or cervical dorsal columns from sensory fibres associated with Pacinian corpuscle (P.c.) receptors in the forelimb footpads. Factors affecting the phase of response to cutaneous vibration in individual P.c. fibres, and the extent of phase coherence in the responses of different P.c. fibres were examined when sinusoidal vibratory stimuli at 100-400 Hz were delivered using a 1 mm diameter probe. 2. Increases in vibration amplitude from the absolute to the 1:1 threshold for the P.c. fibre led to phase advances in the response, often of about 60 deg, in over 85% of fibres tested at 200 and 300 Hz, but further increases had little effect. 3. Variations in stimulus position within the receptive field led to unpredictable changes in the response phase that ranged from minimal change to shifts of 180 deg. As the response phase was unrelated to the distance from the point of peak sensitivity it is likely that at high vibration frequencies (greater than or equal to 100 Hz) the recruited population of P.c. fibres will respond over the whole range of phase angles. 4. The calculated phase of spike initiation in different pairs of P.c. fibres that shared coincident points of best sensitivity on the skin ranged from near synchrony to maximum asynchrony indicating that there is little phase coherence even in the subpopulation of somatotopically related P.c. fibres recruited by high-frequency cutaneous vibration. 5. Paired recordings from P.c. fibres within the cervical dorsal columns revealed a broad range of phase discrepancies in the responses of P.c. fibres to vibration at 200 and 300 Hz. 6. Several hypotheses are considered to explain the known presence of phase-locked responses to high-frequency (greater than or equal to 100 Hz) vibration in the central neurones of dorsal column nuclei. PMID- 3681710 TI - Temporal patterning in the responses of gracile and cuneate neurones in the cat to cutaneous vibration. AB - 1. Recordings were made in decerebrate cats from gracile and cuneate neurones responding to vibration-induced inputs from Pacinian corpuscle (P.c.) receptors of the hind-limb and forelimb footpads. The two groups of neurones were compared, in particular for their capacities for responding to cutaneous vibration with phase-locked impulse patterns. 2. In both nuclei the P.c. neurones were most sensitive to vibration in the range 80 to greater than 600 Hz. Stimulus-response relations were similar for the two groups, as were measures derived from these relations such as response levels, absolute thresholds and the dynamic range (defined as the vibration amplitude range over which responses were graded). 3. At frequencies up to 300-400 Hz, responses for some neurones in both nuclei remained well phase locked to the vibration; however, quantitative analysis using a factorial analysis of variance indicated that the phase locking was poorer in gracile than cuneate neurones. 4. In both nuclei there was marked variability from neurone to neurone in measures of phase locking which may reflect variations in the extent of convergence of P.c. fibres upon different target neurones. For neurones in either nucleus that had comparatively tight phase locking of responses to vibration it is proposed that their output is functionally dominated by one or a few of their convergent P.c. input fibres. PMID- 3681711 TI - Actions of single sensory fibres on cat dorsal column nuclei neurones: vibratory signalling in a one-to-one linkage. AB - 1. The synaptic linkage between single, identified sensory fibres associated with Pacinian corpuscle (P.c.) receptors and central neurones of the dorsal column nuclei was examined in decerebrate or anaesthetized cats. Paired recordings were made from individual neurones in the gracile division of the dorsal column nuclei and from the hind-limb interosseous nerve in which it is possible to identify and monitor the activity of each P.c. fibre activated when recording from the intact nerve with a platinum hook electrode. Individual P.c. fibres were activated by vibration delivered with an 0.2 mm diameter probe to the interosseous P.c. receptors. 2. Thirty-five P.c. fibre-gracile neurone pairs were isolated in which activity in the single, identified P.c. fibre evoked suprathreshold responses (mean latency +/- S.D., 10.3 +/- 1.5 ms) in the gracile neurone. A single impulse arriving over one P.c. fibre could generate pairs or triplets of output spikes from several target neurones thus revealing a potent synaptic organization within the dorsal column nuclei for the transmission and amplification of weak sensory signals. 3. The potency of the linkage for some pairs resulted in post-synaptic response levels of up to 400 impulses s-1 when a single input fibre was discharging one impulse on each vibration cycle at 200-400 Hz. 4. Gracile neurones driven by single P.c. fibres had phase-locked responses to vibration at frequencies of up to 400-500 Hz. However, the responses displayed much greater phase dispersion than those of P.c. fibres, indicating that a major component of phase dispersion in the vibration-induced responses of dorsal column nuclei neurones is attributable to the properties of the synaptic linkage between an individual fibre and the target neurone. 5. The potent actions of single, identified P.c. fibres on their target neurones are consistent with the hypothesis that phase-locked responses in dorsal column nuclei neurones to vibration at 100-400 Hz may reflect the functional domination of the target neurone's output by one or a few of its converging fibres. PMID- 3681712 TI - An electrophysiological and morphological study of the innervation and reinnervation of cat dentine. AB - 1. Experiments were carried out to determine which, if any, of the cellular processes in cat dentine are nerves. This was done by examining in the electron microscope the contents of the dentinal tubules in control teeth and in teeth that had been denervated 56 h previously. The extent of any reinnervation, and associated return of neural responses to dentine stimulation were investigated 12 weeks after denervation. 2. In five cats, the inferior alveolar nerve was sectioned on one side and the cut ends reapposed. 3. Each of the tubules in the predentine of control teeth contained one process with a cross-sectional area of 0.21-1.14 micron2 and up to eight other, secondary processes which were generally smaller. The proportion which contained secondary processes was highest (83%) near the tip of the pulp and decreased further down the side of the crown of the tooth. 4. 56 h after denervation, almost all the secondary processes had disappeared, leaving just one of the larger processes in each tubule. It is concluded that these larger processes are odontoblast processes and that all the secondary processes are nerve terminals. 5. 12 weeks after denervation, small processes were again present in some tubules. Recordings in three cats showed that inferior alveolar nerve fibres had regenerated into the canine pulp and that some of these had re-established receptor properties similar to those in normal teeth. PMID- 3681713 TI - Integrative processing of vibratory information in cat dorsal column nuclei neurones driven by identified sensory fibres. AB - 1. In decerebrate or anaesthetized cats, the vibration-induced responses of dorsal column nuclei neurones were examined, first, when their input came from simultaneously recorded pairs or other combinations of identified Pacinian corpuscle (P.c.) afferent fibres of the interosseous nerve, and secondly, when different convergent sets of P.c. fibres were engaged by footpad vibration. 2. Suprathreshold actions were observed on individual dorsal column nuclei neurones from two or more identified P.c. fibres. Recruitment of these convergent fibres usually led to summation in the dorsal column nuclei neurone as reflected in higher response levels compared with those evoked by single-fibre inputs. 3. When the input was increased from one to two or more identified P.c. fibres the dorsal column nuclei neurones could retain a single, dominant phase of response to high frequency (greater than 100 Hz) vibration even though these fibres, in isolation, evoked responses in the target neurone at substantially different latencies. However, on average, phase locking was significantly tighter in response to single-fibre input than to multiple P.c.-fibre input. 4. Dorsal column nuclei neurones were also able to retain phase-locked responses to high-frequency vibration when phase differences between different convergent inputs were systematically introduced to alter the degree of synchrony in the activity arriving over convergent, identified P.c. fibres. 5. When the input to dorsal column nuclei neurones came from the skin it was found that with the recruitment of two converging sets of P.c. fibres the dorsal column nuclei neurones were able to retain phase-locked responses to high-frequency vibration even when phase shifts were introduced between the two sets of P.c. inputs. 6. In conclusion, the observed integrative processing by dorsal column nuclei neurones of vibration induced inputs arriving over identified, convergent P.c. fibres, or sets of P.c. fibres, is consistent with our hypothesis that the retention of phase-locked responses to vibration at frequencies greater than or equal to 100 Hz may reflect the functional domination of the target neurone by just one or a few of its convergent input fibres. PMID- 3681714 TI - Rat muscle during post-natal development: evidence in favour of no interconversion between fast- and slow-twitch fibres. AB - 1. It was confirmed that in the fourth deep lumbrical muscle of the rat the number of muscle fibres at birth is about half that in the adult. 2. The average number of slow-myosin-containing (S) fibres (as determined by specific antibody binding) remains constant from birth to adulthood. Therefore it is likely that all the muscle fibres generated post-natally are type F (i.e. slow-myosin-free). 3. A comparison in the electron microscope between transverse mid-belly sections from new-born (day 0) and 4 day muscles showed many muscle fibres or myotubes to be intimately associated with other fibres and cells of other types in the new born, but to be much less closely grouped at 4 days. 4. A full cell count was obtained from electron microscopy of a mid-belly section of a lumbrical muscle at birth. 5. Cross-sectional area measurements in the light microscope at 3-5 days and in the adult showed that at 3-5 days on average the S fibres have a greater cross-sectional area than the F fibres. This is reversed in the adult where the S fibres are the smaller. At 3-5 days the range of cross-sectional areas of F fibres is much wider than for S fibres. Some F fibres are among the largest fibres in the muscle. 6. It is argued from the data that the motor units of adult muscle, which are homogeneous with respect to muscle-fibre types, are produced by selective withdrawal of neonatal motor-unit contacts during developmental synapse elimination. PMID- 3681715 TI - Are ninhydrin-positive substances volume-regulatory osmolytes in rat renal papillary cells? AB - 1. A study has been made of the concentrations and contents of ninhydrin-positive substances (n.p.s.), presumed to be predominantly but not exclusively amino acids, in the cells of rat renal papillary slices incubated in variously modified Krebs phosphate-bicarbonate Ringer solution. 2. When the medium osmolality was increased from 710 (control) to 2000 mosmol/kg H2O by additional NaCl and urea, the steady-state cellular n.p.s. concentration rose from 42.3 +/- 0.6 (mean +/- S.E. of mean; n = 36) to 105 +/- 2 (n = 68) mmol/l (glycine equivalent). Cell fluid content fell from 5.11 +/- 0.09 (n = 36) to 4.16 +/- 0.11 (n = 68) microliter/mg solute-free dry weight. Hence cell n.p.s. content increased from 211 +/- 4 (n = 36) to 421 +/- 10 (n = 68) nmol/mg solute-free dry weight. 3. A comparable loss of cell fluid was observed when urea was replaced by sucrose or sorbitol. No increase in cell n.p.s. occurred, and there was a marked cell Na+ for-K+ exchange. 4. The extent of the increase in cell n.p.s. in the presence of 2000 mosmol/kg H2O (NaCl + urea) was sensitive to the presence of external anions in the sequence acetate less than Cl- less than NO3- less than or equal to SCN-. 5. Cell n.p.s. concentration increased progressively as the medium osmolality was increased by the addition of urea, but Na+ at a concentration above 330 mmol/l had an inhibitory effect. The increase in n.p.s. concentration was also significantly reduced in hyperosmotic media in which Na+ was replaced by choline. 6. The increase in cell n.p.s. content due to hyperosmotic NaCl + urea was completely inhibited by pre-incubation in control medium containing trimethylamine N-oxide. 7. On transference of slices from control to hyperosmotic media (NaCl + urea) the steady-state increase in cell n.p.s. concentration was complete within 20 min and followed a time course similar to that for cell fluid loss. The n.p.s. concentration and cell fluid content returned to control levels, with similar time courses, following re-immersion in control medium. 8. Efflux of alpha-amino[1-14C]isobutyric acid (AIB) from slices pre-loaded in control medium containing 1 mmol AIB/l was slightly but significantly slower into AIB-free hyperosmotic NaCl + urea than into AIB-free control medium. The rate of efflux was greatly increased by the presence of hyperosmotic sucrose or very high Na+ (935 mmol/l).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681716 TI - Lung reflexes and nasal vascular resistance in the anaesthetized dog. AB - 1. In pentobarbitone-anaesthetized dogs the nasal vasculature was perfused on both sides, and nasal vascular and airflow resistances were measured together with blood pressure, heart rate and tidal airflow. 2. Capsaicin was injected intravenously to stimulate lung C-fibre receptors, and veratrine to stimulate pulmonary stretch receptors and cardiac receptors. Injections with both drugs were repeated after pulmonary denervation and after cervical vagosympathectomy. 3. Intravenous capsaicin caused hypotension, bradycardia and rapid shallow breathing, together with a decrease in nasal vascular resistance and little change in nasal airways resistance. Denervation showed that these effects came from lung reflexes, presumably from C-fibre receptors. 4. Intravenous veratrine caused similar effects to capsaicin before denervations, presumably due to stimulation of slowly adapting pulmonary stretch receptors. Left atrial injections of veratrine caused hypotension, bradycardia and hyperpnoea, together with an increase in nasal vascular resistance and little change in nasal airways resistance. Thus cardiac receptors seem to increase nasal vascular resistance. 5. Injections of capsaicin and veratrine into the nasal circulation decreased nasal vascular resistance, with a stimulation of breathing and changes in blood pressure. Denervations indicated that these were a combination of local and reflex actions. PMID- 3681717 TI - The effects of in vitro application of purified botulinum neurotoxin at mouse motor nerve terminals. AB - 1. Purified botulinum neurotoxin type A (10 nM) was applied in vitro to mouse diaphragm muscles. Intracellular micro-electrode recordings were made continuously in single fibres. 2. This treatment reduced end-plate potential (e.p.p.) amplitudes with a time to half-maximal effect of about 75 min at 22-25 degrees C. E.p.p. rise-times remained fast and unaffected by the toxin. 3. Miniature end-plate potential (m.e.p.p.) frequency was reduced by the toxin to less than 5% of control frequency, and followed a similar time course to the block of e.p.p. amplitudes. The m.e.p.p. rise-time and coefficient of variation (c.v.) of m.e.p.p. amplitude distributions both increased, but the time course of these increases lagged significantly behind the change in frequency. 4. A population of slow rise-time m.e.p.p.s was present in controls at low frequency. This population was found to be unaffected by the toxin. 5. The above-detailed in vitro changes could be explained by the toxin acting by a single common mechanism to inhibit the release process underlying both fast rise-time m.e.p.p.s and e.p.p.s. A distinct release process, which leads to slow rise-time m.e.p.p.s, was unaffected by the toxin. PMID- 3681718 TI - Climbing fibres projecting to cat cerebellar anterior lobe activated by cutaneous A and C fibres. AB - 1. Climbing fibre responses evoked on stimulation of the ipsilateral superficial radial nerve were examined in the forelimb area of the C3 zone in the barbiturate anaesthetized cat. Climbing fibre responses were recorded in sixty-five Purkinje cells and as field potentials from the surface of the cerebellum. 2. In addition to the previously described A beta-fibre-evoked climbing fibre response, late climbing fibre responses were consistently evoked in all Purkinje cells studied when C fibres were stimulated. The latencies of the A beta- and C-fibre-evoked climbing fibre responses were 11-20 ms and 110-220 ms, respectively. In most experiments climbing fibre responses with an intermediate latency (20-30 ms) were evoked. It was demonstrated that this response depended on A delta fibres. 3. The long-latency climbing fibre response generated by electrical stimulation at C fibre strength was evoked also during selective anodal block of conduction in A fibres (Brown & Hamman, 1972). Hence, impulses in C fibres were sufficient for generation of climbing fibre responses. 4. The distribution within the forelimb area of the C3 zone of the A beta- and C-fibre-evoked climbing fibre field potential was similar. No climbing fibre response was evoked in this area of the C3 zone by stimulation of A and C fibres in the contralateral superficial radial nerve or in the plantar nerves of the hind limbs. 5. It can be concluded that climbing fibres projecting to the forelimb area of the C3 zone in the cerebellum receive a somatotopically organized input from both A beta and C fibres. PMID- 3681719 TI - Stimulation of cat cutaneous nociceptive C fibres causing tonic and synchronous activity in climbing fibres. AB - 1. The input from cutaneous nociceptors to climbing fibres projecting to the forelimb area of the C3 zone in the cerebellar anterior lobe was examined in barbiturate-anaesthetized cats. Climbing fibre responses were simultaneously recorded in single Purkinje cells and as field potentials from the cerebellar surface close to these cells. 2. The cutaneous receptive field of the climbing fibres studied were located on the ipsilateral forelimb. All climbing fibres were activated by both non-noxious tactile stimulation and noxious pinch of the skin. The location of the receptive field and the distribution of sensitivity in the receptive field appeared to be identical for noxious and tactile stimuli. 3. A phasic response in the climbing fibres was evoked by either short- or long lasting non-noxious pressure applied to their cutaneous receptive field. By contrast, all climbing fibres studied were strongly and tonically activated (up to 4-11 Hz for the duration of the stimulation) by sustained noxious pinch in the most sensitive area of their receptive fields. 4. Experiments with anodal block of impulse conduction in myelinated fibres indicated that a major input to climbing fibres during sustained noxious pinch originates from nociceptive C fibres. 5. Sustained noxious pinch of the skin evoked large field potentials on the cerebellar surface. These field potentials were evoked simultaneously with climbing fibre responses in single Purkinje cells and were due to synchronous activation of many climbing fibres. These field potentials and discharges in single climbing fibres were elicited from the same area of the skin suggesting that many of the synchronously discharging climbing fibres have the same receptive field on the skin. PMID- 3681720 TI - The role of joint receptors in human kinaesthesia when intramuscular receptors cannot contribute. AB - 1. Kinaesthetic acuity was tested at the distal interphalangeal joint of the middle finger when the hand was postured so that the joint was effectively disengaged from its muscular attachments. Subjects were required to detect the direction of 5 deg movements applied at different angular velocities from a mid position under control conditions, after intra-articular injection of a plasma expander and after intra-articular injection of a local anaesthetic. 2. Kinaesthetic performance was enhanced after the injection of a plasma expander and deteriorated after injection of local anaesthetic. This deterioration could not be explained by spread of the local anaesthesic from the injection site on the dorsum of the joint. 3. The results suggest that the discharge of joint receptors can produce perceived signals of joint movement. Under normal conditions these receptors may duplicate the kinaesthetic input from muscle spindle endings. PMID- 3681721 TI - Inhibitory interactions in the human vision system revealed in pattern-evoked potentials. AB - 1. Visual evoked potentials (v.e.p.s) were recorded from human adults to investigate orientation-specific neural interactions. The stimuli were the sum of two gratings, sinusoidally modulated in space and time at different frequencies. Recordings were made for one grating (test) alone, and with another superimposed grating (mask), oriented parallel or orthogonal to the test. The amplitude and phase of the v.e.p.s at twice the test modulation frequency (second harmonic) was measured as a function of test contrast to produce contrast-response curves. 2. Orthogonal masks attenuated considerably the amplitude of v.e.p.s. The attenuation at any given contrast was approximately proportional, or multiplicative, lowering the slope of the contrast-response curve, without affecting significantly the extrapolated threshold. Parallel masks also attenuated v.e.p. amplitudes but in a different way, leaving the slope of the contrast-response curves unchanged, while elevating threshold. 3. The attenuation by orthogonal masks occurred over a wide range of test spatial frequencies, from 0.8 to 8 cycles/deg. For any given test spatial frequency, the most effective masks were those of spatial frequency similar to or lower than the test. Masks of spatial frequency 1.5 octaves higher than the test did not attenuate v.e.p. amplitudes. 4. The mask temporal frequency for maximal attenuation of v.e.p. amplitude was around 12 Hz, with stationary masks having little effect. 5. Under most conditions, the phase of the second harmonic of the v.e.p., increased with increasing contrast (phase advance). Superimposition of a parallel mask abolished phase advance, while orthogonal masks increased it. 6. Comparisons with single cortical unit and evoked potential recordings in cats suggest that the attenuation by orthogonal masks reflects intracortical inhibitory interactions between cell populations of different orientation preference. PMID- 3681722 TI - Predictive velocity estimation in the pursuit reflex response to pseudo-random and step displacement stimuli in man. AB - 1. Eye movements have been recorded in man in response to various forms of continuous and discontinuous target motions in the horizontal plane in an attempt to establish the mechanisms of prediction in the pursuit reflex. 2. In an initial experiment the target motion was composed of four sinusoids, each of peak velocity +/- 3.3 deg/s. The three lowest frequencies (0.11, 0.24 and 0.37 Hz) remained constant whereas the highest frequency (F4) was varied from 0.39 to 2.08 Hz. When F4 was 0.39 Hz, all frequency components had a high level of eye velocity gain (mean 0.92) but as F4 was increased there was a significant (P less than 0.001) decline in gain for all three low frequencies which reached a minimum (mean 0.53) when F4 was 1.56 Hz. However, the gain for F4 always remained at a high level, comparable to that evoked by a discrete frequency sinusoid of the same frequency. 3. When the highest-frequency sinusoid was replaced by a square wave of identical amplitude a similar decline in gain for the low frequencies was observed. Eye velocity exhibited a quasi-sinusoidal modulation at the frequency of the square wave even though the rapid steps did not constitute a suitable stimulus to the visual velocity feed-back mechanisms. 4. When only two sinusoids were mixed to form the pursuit stimulus a similar break-down in gain of the lower frequency component was observed which reached a minimum (mean gain 0.58) when F2 was between 1 and 2 Hz. This implies that the predictability of stimulus motion is dependent, not on the complexity of the stimulus, but on its highest-frequency component. 5. Presentation of square-wave target displacements alone confirmed that smooth eye movements could be evoked by such a stimulus. Eye velocity was at a maximum between 1.0 and 1.5 Hz and was predictive of ensuing target displacement. Responses to staircase step sequences of varying duration indicated that prediction was based on an assessment of the duration of the preceding sequence. 6. Tachistoscopic presentation of targets during low-frequency sinusoidal oscillation indicated that illumination of the target for very short periods (10-320 ms) as few as two times per cycle during minimum velocity phases enhanced the perception of continuous movement. A predictive eye movement was evoked with a high level of peak velocity which then decayed until the subsequent exposure of the target.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681723 TI - Spinal inhibition of phrenic motoneurones by stimulation of afferents from leg muscle in the cat: blockade by strychnine. AB - 1. Phrenic nerve responses to stimulation of calf muscle receptors or their afferents were studied in paralysed high (C1) spinal cats whose phrenic nerve activity was evoked by activation of the intercostal-to-phrenic reflex. End-tidal PCO2 was maintained at a constant level by means of a servo-controlled ventilator. 2. Physical stimulation of calf muscles or electrical stimulation of the tibial nerve uniformly caused inhibition of phrenic activity evoked by facilitatory conditioning stimuli. The degree of inhibition gradually decreased as muscle stimulation continued, and there was a post-stimulus augmentation of phrenic activity. 3. Pre-treatment with subconvulsive doses of strychnine, an antagonist of the neurotransmitter glycine, partially or completely blocked the inhibitory effects on phrenic activity of muscle-afferent stimulation. The blockade was reversible with time. 4. Pre-treatment with a subconvulsive dose of bicuculline, an antagonist of the neurotransmitter gamma-aminobutyric acid (GABA), had no effect on the inhibitory mechanism. 5. We conclude that glycine is an important transmitter of the inhibition of phrenic motoneurones induced by muscle-afferent stimulation, but that GABA is not involved in this inhibitory mechanism. PMID- 3681724 TI - The role of myogenic relaxation, adenosine and prostaglandins in human forearm reactive hyperaemia. AB - 1. Forearm blood flow was measured bilaterally in healthy young male and female volunteers, in the basal state and after upper-arm occlusion of arterial or venous blood flow for 1-20 min. The investigations were repeated after pre treatment with drugs affecting vascular prostaglandins and/or adenosine. 2. Simultaneous arterial occlusion in one arm and venous occlusion in the contralateral arm for up to 20 min elicited a considerable reactive hyperaemia in the arm subjected to arterial occlusion, but completely failed to elevate the post-occlusive flow in the arm subjected to venous occlusion above the pre occlusive level. 3. When the arterial occlusion was increased from 1 to 20 min there was a progressive increase in the subsequent reactive hyperaemia, up to 30 ml 100 ml tissue-1. The time dependence following 1-3 min of arterial occlusion was based on a facilitation of the peak post-occlusive flow, while prolongation of the arterial occlusion from 3 to 20 min augmented the reactive hyperaemia mainly by increasing its duration. 4. Inhibition of prostaglandin synthesis with ibuprofen reduced the total reactive hyperaemia following 3-5 min of arterial occlusion by up to 70%. This attenuation was due both to a reduction of peak post occlusive flow and to a shortening of the duration of the post-occlusive hyperaemia. 5. The adenosine receptor antagonist theophylline reduced the reactive hyperaemia following 5 min of arterial occlusion by about 35%. Combined treatment with ibuprofen and theophylline did not reduce the reactive hyperaemia more than either drug alone. 6. Infusion of dipyridamole, a drug which inhibits the elimination of adenosine, reinforced the reactive hyperaemia by about 45%. This effect of dipyridamole was completely inhibited by administration of theophylline, and also by ibuprofen. 7. Plasma levels of adenosine, hypoxanthine and uric acid were maintained during the reactive hyperaemia, indicating increased production of purines during or immediately after the ischaemia. 8. It is concluded that the adequate stimulus for vascular relaxation in response to interruption of blood flow is omission of vessel wall distension. Local metabolic factors like endogenously formed prostaglandins and adenosine may act synergistically to this myogenic response but seem to be inactive alone. The lack of additive effects of ibuprofen and theophylline suggests a link between vascular relaxation induced by prostaglandins and by adenosine. PMID- 3681726 TI - Change in optical activity of a lobster nerve associated with excitation. AB - 1. To record the change in optical rotation of a nerve fibre associated with excitation, an optical apparatus was constructed using a polarizer, a photo elastic modulator, an analyser and a lock-in amplifier. The apparatus was calibrated with the sucrose solution as the standard. 2. When a lobster leg nerve was dissected and mounted on the sample stage of the apparatus, stimulation elicited a transient change in the lock-in amplifier output. The signal (here called the 'R-signal') had a rapid time course, formed a peak during the rising phase of the birefringence signal, and often quickly returned to the base line, but sometimes showed a long-lasting later phase. 3. The R-signal arose at about the time when the compound action potential of slowly conducting fibres passed through the window of the chamber for the optical experiment, suggesting that it originates mainly in the smaller fibres. 4. The R-signal reversed its sign when the azimuth of the polarizer was changed by 90 deg, indicating that the R-signal was not due to electrical artifacts. Simultaneously recorded changes in the intensity of the transmitted light had a different time course and an amplitude too small to explain the appearance of the R-signal. 5. When the azimuth of the nerve was changed, the later phase of the R-signal changed its amplitude and direction, but the initial phase of the R-signal was much less influenced, suggesting that the birefringence signal was a component of the later phase. 6. The later phase of the R-signal could be reconstructed as a sum of an R-signal at a different azimuth and the birefringence signal, if the amplitude and direction of the latter were adjusted by multiplication of a factor. 7. Assuming that the nerve is a homogeneous, linearly and circularly birefringent and linearly and circularly dichroic material, the lock-in output was described by mathematical equations. From one of them the birefringence signal could be deduced from a series of R-signals observed at various nerve azimuths. The time course of the calculated birefringence signal agreed well with that of the experimentally recorded birefringence signals. 8. Utilizing the same equations, the contribution of the birefringence change to the R-signal was estimated and subtracted. The remaining part was independent of the nerve azimuth, and could be regarded as representing the time course of the change in optical rotation of the nerve.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681725 TI - Reciprocal Ia inhibition between ankle flexors and extensors in man. AB - 1. Reciprocal inhibition between antagonist muscle groups at the ankle has been investigated in sixty healthy subjects. Hoffmann reflexes (H reflexes) in the soleus and tibialis anterior muscles were used to assess changes in reciprocal inhibition evoked by electrical stimulation of antagonist muscle nerves. 2. Inhibition of the soleus H reflex was evoked by a single conditioning stimulus to the common peroneal nerve, and inhibition of the tibialis anterior H reflex was elicited by one conditioning stimulus to the posterior tibial nerve. Symmetrical central connections between the antagonist flexors and extensors were assumed and under this assumption the central delay for the inhibition, in addition to the delay for monosynaptic Ia excitation, was calculated to be about 1 ms. The inhibition was evoked by weak stimuli to the nerves from antagonist muscle groups; the threshold for the inhibition was around 0.6 X threshold for a direct motor response (M-threshold). Furthermore, tendon taps to the Achilles tendon facilitated the soleus H reflex and inhibited the tibialis anterior reflex at short latencies. The short central delay, the low electrical threshold and the.actions of Achilles tendon taps strongly suggest that the early reciprocal inhibition is homologous to the disynaptic Ia inhibition previously studied in animal experiments. 3. With the test soleus H reflex kept at 15-25% of the maximum directly evoked motor response (M-response) and the strength of the conditioning peroneal nerve stimulation kept at 1.0 X M-threshold, the inhibition from the peroneal nerve ranged between 0 and 40% (mean, 14.9%) at rest. 4. Changes in the amount of reciprocal inhibition from the peroneal nerve were studied both during tonic and dynamic dorsi- and plantarflexion. During tonic dorsiflexion there was no significant change of inhibition as compared to rest, while inhibition decreased during tonic plantarflexion. However, during ramp-and hold dorsiflexion there was a transient increase in reciprocal inhibition of the soleus H reflex. This increase in inhibition from the peroneal nerve could be seen 50 ms prior to the onset of contraction. The increase in inhibition before and at the very beginning of the contraction cannot be due to sensory feed-back during contraction, but must depend on a supraspinal control of the spinal cord. 5. At conditioning-test intervals of 4-6 ms, the inhibition of the soleus H reflex from the peroneal nerve was considerably larger during tonic dorsiflexion than at rest. Thus, tonic dorsiflexion revealed an inhibition with long latency from the peroneal nerve, which was not seen at rest.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681727 TI - Differential control of cardiac and vasomotor activity by neurones in nucleus paragigantocellularis lateralis in the cat. AB - 1. In cats anaesthetized with chloralose, neuronal cell bodies were excited by micro-injection of DL-homocysteic acid (DLH). 2. Injections made into the ventrolateral medulla in the region of nucleus paragigantocellularis lateralis (p.g.l.) produced a rise in blood pressure accompanied by either an increase or decrease in heart rate according to the precise site of the injection. The tachycardia was blocked by propranolol (0.15-0.5 mg kg-1 I.V.) whilst bradycardia was abolished by vagotomy or atropine (0.2-1.5 mg kg-1 I.V.). 3. Recordings were made of blood flow to the hind-limb, renal and mesenteric vascular beds in order to study the haemodynamic changes separately in each region. 4. Vasoconstriction was seen in the renal and mesenteric beds and either vasodilatation or vasoconstriction could be evoked in hind-limb muscle. The vasodilatation in hind limb muscle was resistant to atropine but significantly reduced by propranolol (0.15-1.5 mg kg-1 I.V.) and therefore was probably mediated mainly by circulating adrenaline. 5. The relative contribution by each vascular bed to the rise in peripheral resistance produced by micro-injection of DLH at any one site varied according to the site of the injection and there was a degree of topographical organization within p.g.l. The neuronal pools which elicit tachycardia, renal vasoconstriction and hind-limb dilatation were located at the rostral end of the nucleus whilst those which produced vasoconstriction in the hind-limb muscle and mesenteric vascular beds were represented further caudally. PMID- 3681728 TI - Two types of acetylcholine receptor channels in developing Xenopus muscle cells in culture: further kinetic analyses. AB - 1. Further developmental changes in acetylcholine (ACh) receptor channel function were examined in Xenopus muscle cultures using the cell-attached patch-clamp technique. 2. Two types of acetylcholine (ACh) receptor channel events, low- and high-conductance channel events, were distinguished as reported earlier. Apparent open-time histograms for high-conductance channel events were well fitted by a single exponential but those for low-conductance channel events were sometimes fitted better by two exponentials. 3. In low-conductance channel events when the open-time histogram was well fitted by two exponentials, successive open times were correlated: an event with a long open time tended to be followed after a brief interval (less than 1 ms) by another long-duration event. A short-duration event was less frequently followed by an event within a short interval (1 ms) with a long-duration event. 4. Closed-time histograms for the interval between successive low-conductance channel events and between successive high-conductance channel events were both fitted by two exponentials. The fast time constant was 0.36 ms for the high-conductance channel event and 0.31 ms for the low conductance channel event. There was an indication that a third and faster component was hidden in the first bin (0-200 microseconds) in the closed-time histogram of both types of channel events. 5. Defining a burst as successive openings separated by closures briefer than 1 ms, the number of gaps per burst was different for the two types of channel events. They were 0.16 for high- and 0.37 for low-conductance channel events. In both types of channels, neither the fast component in the closed-time histogram nor the number of gaps per burst changed with time in culture. 6. The apparent open time of both types of channels increased progressively as ACh concentration was increased, suggesting an increasing number of unresolved closures at higher concentrations. At 100 microM ACh the apparent open time became shorter probably due to channel blockade by ACh molecules. Closed-time histograms were fitted by two exponentials. The time constant of the fast component remained similar to that at low concentration (0.2 microM) up to 20 microM, but the relative number of closures belonging to this component increased with ACh concentration. In contrast, the slow component shortened its time constant as ACh concentration increased and the relative frequency decreased. Again, there was an indication that another faster component existed in the closed-time histogram.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681729 TI - Heterotopic activation of A delta and C fibres triggers inhibition of trigeminal and spinal convergent neurones in the rat. AB - 1. Extracellular recordings were made from fourteen non-noxious only and nineteen convergent neurones in trigeminal nucleus caudalis of halothane-anaesthetized rats. All the neurones studied were excited by the continuous micro electrophoretic ejection of an excitatory amino acid, DL-homocysteic acid (DLH), with mean currents of 38.0 +/- 7.2 and 39.8 + 6.5 nA producing steady discharges of 35.0 +/- 3.3 and 31.8 +/- 1.3 spikes/s from the non-noxious only and convergent neurones respectively. 2. The repeated percutaneous application (100 trials; 0.66 Hz) of single square-wave stimuli (10 mA; 2 ms) to the tail always induced a biphasic depression of the activity of the convergent, but never of the non-noxious only, neurones. Both the early and late components of this inhibition occurred at shorter latencies when the base rather than the tip of the tail was stimulated. Differences in latencies from the two sites of stimulation (100 mm apart) were used to estimate the conduction velocities of the peripheral fibres which were triggering the inhibitions. 3. The cumulated results showed that, for the onset of the earlier component of the inhibition, the mean difference between the latencies from the two sites of stimulation was 13.6 +/- 1.9 ms, corresponding to a peripheral conduction velocity of 7.3 +/- 0.3 m/s, which is in the A delta-fibre range. For the onset of the late component of inhibition, the mean difference was 147.7 +/- 14.9 ms, corresponding to a peripheral conduction velocity of 0.68 +/- 0.07 m/s, which is in the C-fibre range. 4. When currents of different intensities were applied percutaneously to the two stimulation sites, the thresholds for obtaining the A delta component were in the range 0.25-0.5 mA whereas the C component appeared with currents 1-2 mA. A clear relationship between current intensity and magnitude of inhibition was observed in the 0.25-2 mA range for the A delta component and in the 1-5 mA range for the C component. 5. In an additional series of experiments recordings were made from eleven convergent neurones in the dorsal horn of the lumbar spinal cord. By using essentially the same experimental procedure the effects of repetitive application (100 trials, 0.66 Hz) of percutaneous electrical stimuli (1 or 10 mA, 2 ms) applied to the muzzle, were studied on the steady discharges (42.3 +/- 5.4 spikes/s) induced by DLH. The application of the 10 mA stimuli induced a biphasic depression of activity, whereas only an early component was observed following 1 mA stimuli.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681730 TI - Mapping calcium transients in the dendrites of Purkinje cells from the guinea-pig cerebellum in vitro. AB - 1. A 10 X 10 photodiode array was used to detect stimulation-dependent absorbance changes simultaneously from many positions in the dendrite field of guinea-pig Purkinje cells which had been injected with the calcium indicator Arsenazo III in thin cerebellar slices. Signals from each element of the array were matched to positions on the cells by mapping them onto fluorescence photographs of Lucifer Yellow which had been co-injected into the cells with the Arsenazo III. 2. In response to intrasomatic stimulation the rising phase of the absorbance signals corresponded in time with the calcium spikes recorded with an intracellular electrode. There was no increase in absorbance during bursts of fast sodium spikes. Absorbance signals persisted after the sodium spikes were blocked by tetrodotoxin (TTX). In addition, the signals were largest at 660 nm and small signals of opposite polarity were found at 540 nm. These results indicate that the absorbance signals came from calcium entry into the cell resulting from the turning on of voltage-dependent calcium conductances. 3. In these experiments signals were usually seen all over the dendritic field and were weak or totally absent over the soma. In some cases signals were seen over a more restricted area. With a spatial resolution of 25 microns we were not able to see any evidence for highly localized sites of calcium entry. 4. Sometimes the rising phase of the calcium signals was separated by almost 13 ms in different parts of the dendritic field, too long to be explained by active propagation delay. This suggests that calcium spikes causing these signals can be evoked separately in different regions of the Purkinje cell dendritic field by long-lasting potentials which may reach local threshold at different times. 5. Calcium signals resulting from slow plateau after-potentials and the calcium spikes produced by them were also detected in all locations in the dendritic field. The relative distribution of amplitudes from these plateau signals was different from the distribution of evoked signals during current injection. 6. Climbing fibre synaptic activation produced calcium signals which were distributed over the dendritic arborization, but larger at the main dendritic tree where most of the synaptic contacts are located. 7. Calcium signals were also detected from the dendrites of other neurone types in the in vitro slice preparation. Thus, it is likely that these kind of measurements can be used to analyse the electroresponsiveness of many kinds of neurones in the mammalian brain. PMID- 3681731 TI - Relative displacements in muscle and tendon during human arm movements. AB - 1. X-ray, cine and video recordings were made of the movement of radio-opaque markers injected into the musculo-tendinous junctions of biceps brachii muscle. 2. In strong isometric contractions, the distal tendon of the long head of biceps lengthened by about 2% of its estimated rest length. 3. During voluntary isotonic elbow flexion-extension movements at frequencies up to 5.5 Hz there was no detectable phase shift between intramuscular and joint displacements. 4. In the fastest alternating movements (5.5-6.7 Hz) small phase advances developed in the muscle. 5. We conclude that human tendons do stretch during muscle contraction, but not enough to cause intramuscular phase reversals in rapid unloaded movements. This in turn means that muscle spindles shorten and lengthen virtually in phase with joint movements under most conditions. PMID- 3681732 TI - Heterogeneity of amino acid transport in horse erythrocytes: a detailed kinetic analysis of inherited transport variation. AB - 1. Thoroughbred horses were divisible into five distinct amino acid transport subgroups on the basis of their erythrocyte permeability to L-alanine, measured uptake rates ranging from 5 to 625 mumol l cells-1 h-1 (0.2 mM-extracellular L alanine, 37 degrees C). 2. Erythrocytes from animals belonging to the lowest L alanine permeability subgroup (5-15 mumol l cells-1 h-1) (transport-deficient type) exhibited slow nonsaturable transport of this amino acid. In contrast, cells from horses of the four transport-positive subgroups possessed additional high-affinity (apparent L-alanine Km (Michaelis constant) congruent to 0.3 mM) and/or low-affinity (apparent L-alanine Km congruent to 13 mM) Na+-independent transport routes selective for L-neutral amino acids of intermediate size. The two transporters, designated systems asc1 and asc2, respectively, also possessed a significant affinity for dibasic amino acids. 3. Amino acid transport activity in horse erythrocytes behaved as if controlled by three co-dominant alleles (s, h and l), where s is a silent allele, and h and l code for the functional presence of systems asc1 and asc2, respectively. 4. At physiological temperature, system asc1 operated preferentially in an exchange mode. In contrast, system asc2 did not participate in exchange reactions at 37 degrees C, but did exhibit significant trans-acceleration at 25 degrees C. 5. Reduction of the incubation temperature also resulted in dramatic decreases in apparent Km and Vmax for L alanine uptake by system asc2, whereas the effects of temperature on system asc1 were much less marked. At 5 degrees C the two transporters exhibited equivalent kinetic constants for L-alanine influx. L-Alanine uptake by transport-deficient cells was relatively insensitive to temperature. Influx by this route may represent the ground-state permeability of the lipid bilayer. 6. The effects of low temperature on system asc2 suggest a preferential impairment of the mobility of the unloaded carrier relative to that of the loaded transporter. Similarly, the different kinetic properties of systems asc1 and asc2 at physiological temperature are attributed to a difference in the mobilities of the empty carriers, this difference being minimized at 5 degrees C. PMID- 3681733 TI - Electrophysiological and dye-coupling studies on secretory, myoepithelial and duct cells in human eccrine sweat glands. AB - 1. Electrophysiological properties and dye-coupling status of secretory, myoepithelial and coiled duct cells in isolated human eccrine sweat glands have been assessed by single-micro-electrode studies and intracellular micro iontophoresis of the fluorescent naphthalimide dye Lucifer Yellow CH (molecular weight 457). Treated glands were embedded in LKB HistoResin and examined by transmission fluorescence microscopy, first as wholemounts and then as 5 microns serial sections. Sections positive for Lucifer Yellow were photographed and then stained with Toluidine Blue for observation by conventional microscopy to confirm the site of penetration. 2. Out of forty-five successful micro-iontophoreses, three were confirmed in secretory cells, twelve in myoepithelial cells and thirty in cells of the coiled duct wall. The latter were identified as the most penetrable in the coiled part of the isolated human eccrine sweat gland. 3. Of the three secretory cells labelled (resting potentials -40, -52 and -63 mV), all demonstrated dye coupling to neighbouring secretory cells although in one case this was found to be selective. Not every secretory cell was involved in coupling. No fluorescent label spread to the myoepithelial cells which form a network on the basal surface of the secretory tubule. 4. When myoepithelial cells were penetrated, they demonstrated dye coupling to neighbouring myoepithelial cells but not to secretory cells with which they also made contact. Basal resting potentials of -35 to -65 mV were recorded (mean = -52 mV, S.E. of mean = +/- 2.4 mV, n = 12) and, in eight out of the twelve cells penetrated and labelled, spontaneous depolarizing transients were also observed whose amplitude but not frequency increased with increasing membrane polarization. Administration of acetylcholine to produce a final concentration of 10(-6) to 10(-7) M produced either depolarization or micro-electrode dislodgement. 5. Of the thirty cells labelled in the coiled duct, twenty-six showed obvious dye spread to neighbouring cells in both layers of the wall. There was no relation between dye-coupling status and basal resting potential which lay in the range -40 to -82 mV (mean = 60 mV, S.E. of mean = +/- 2.4 mV, n = 30). Repeated doses of acetylcholine produced either no response from cells in this range or depolarization in cells with resting potentials more negative than -70 mV and hyperpolarization in cells with resting potentials more positive than -70 mV. In addition, there was a biphasic response, depolarization followed by hyperpolarization in a cell of resting potential -67 mV.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681734 TI - Activation patterns of embryonic chick lumbosacral motoneurones following large spinal cord reversals. AB - 1. Embryonic chick motoneurones were caused to innervate inappropriate hindlimb muscles by rotating the presumptive lumbosacral region of the neural tube in stage 15-16 embryos which is prior to the outgrowth of motoneurone axons. 2. The activation patterns of motoneurones in control and spinal cord reversal embryos were analysed from electromyographic (e.m.g.) recordings of stage 36 limb muscles during evoked movement sequences in an isolated spinal cord-limb preparation. Histograms representing the frequency of activation were constructed for each muscle. The muscle's pattern of activation was classified as flexor-like or extensor-like and compared to the activation patterns of control muscles. 3. A series of control operations was performed in which the prospective lumbosacral region of the neural tube was removed and replaced in its original orientation. Muscles in these embryos were innervated by their normal motoneurone pools and they were activated normally, indicating that the neural tube operation per se does not alter the activation pattern of motoneurones. Furthermore, some muscles (twelve out of sixty-one) in spinal cord reversal embryos had normal activation patterns and appeared to be innervated by their original motoneurones. Based on these results and the result of a previous study (Landmesser & O'Donovan, 1984 b), it is concluded that motoneurones in reversed spinal cords are activated in a manner appropriate for their original identity. 4. The majority of muscles (thirty-three out of sixty-one) in large spinal cord reversal embryos were activated during an appropriate phase of the kicking cycle. Of the remaining muscles, 16% were activated inappropriately (i.e. extensor muscles were activated as flexors, and vice versa), and 30% had a novel 'mixed' flexor- and extensor like activation pattern. However, the activation pattern of most muscles differed markedly from that of any other control muscles regardless of whether the muscle was activated appropriately or inappropriately as a flexor or extensor. The abnormal activation patterns are a likely consequence of the diffuse distribution of inappropriate motoneurones projecting to foreign muscles in embryos with large spinal cord reversals. Since it is likely that motoneurones are still activated according to their original identity, the activation patterns of individual foreign motor units projecting to a muscle sum in e.m.g. recordings to produce a novel abnormal activation pattern.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681735 TI - Inhibition of secretory granule discharge during exocytosis in sea urchin eggs by polymer solutions. AB - 1. We have investigated the effects of the osmotic pressure exerted by polymer solutions on exocytosis in sea urchin eggs. 2. Exocytosis is prevented by including a variety of polymers of different chemical composition and molecular weight in the sea water surrounding the eggs. Inhibition is complete at a polymer osmolality of 250 mosmol/kg. 3. The increase in membrane capacitance which occurs during exocytosis and which corresponds to the fusion of secretory granules with the plasma membrane is not substantially altered by inhibitory concentrations of polymer. 4. In the absence of the ions present in sea water, these polymers inhibit exocytosis at an osmolality of 950 mosmol/kg. 5. Calcium, magnesium and sodium ions reduce the polymer osmolality required to prevent exocytosis. 6. A comparison of the effects of monovalent and divalent ions indicates that the divalent ions bind to and stabilize the secretory granule contents. 7. These results demonstrate that polymers prevent exocytosis by preventing dispersal of the granule contents once fusion of the secretory granule with the plasma-lemma has occurred. The ions present in sea water do not promote dispersal, rather, they hinder it. The contribution of ionic fluxes to granule swelling during exocytosis is discussed. PMID- 3681736 TI - Cardiovascular and phrenic nerve responses to stimulation of the amygdala central nucleus in the anaesthetized rabbit. AB - 1. The cardiovascular responses to electrical stimulation of the central nucleus of the amygdala (c.n.) have been studied in chloralose-anaesthetized rabbits. A pattern of response involving bradycardia, hypotension and hind-limb vasodilatation, accompanied by an increase in the rate of phrenic nerve discharge, was evoked only in response to stimulation within the medial portion of the c.n. 2. The cardiovascular responses were not secondary to the changes in respiratory activity since they were unaffected by altering central respiratory drive by either hypo- or hyperventilation of the animal. 3. The bradycardia was attenuated by the administration of atropine sulphate and abolished by the subsequent administration of propranolol, which when given alone attenuated the bradycardia. Atropine or propranolol given alone also attenuated the hypotension evoked by medial c.n. stimulation but the concurrent hind-limb vasodilatation was unaffected. 4. Atenolol, which unlike propranolol does not cross the blood-brain barrier, had little effect on the bradycardia in response to medial c.n. stimulation, but the subsequent administration of atropine abolished it. The hypotension in response to medial c.n. stimulation was also unaffected by atenolol. 5. The vasodilatation in response to medial c.n. stimulation was abolished by administration of guanethidine even after restoration of hind-limb perfusion pressure to control values by the infusion of angiotensin II into the hind-limb perfusion circuit. 6. Electrical stimulation of areas within 0.5 mm of the medial c.n. also resulted in bradycardia but then it was accompanied by hypertension and hind-limb vasoconstriction. Stimulation of areas 1.0 mm distant to the medial c.n. resulted in small and inconsistent cardiovascular responses. 7. These results show that hind-limb vasodilatation, mediated by withdrawal of sympathetic tone, occurs in response to stimulation within the medial c.n. of the rabbit and is in part responsible for the observed hypotension. It has also been confirmed that the bradycardia in response to medial c.n. stimulation is mediated by the vagus nerves. PMID- 3681737 TI - Cardiovascular, ventilatory and catecholamine responses to maximal dynamic exercise in partially curarized man. AB - 1. In ten young men the ventilatory, cardiovascular, catecholamine and metabolic responses to maximal dynamic leg exercise on a stationary bicycle were followed during partial neuromuscular blockade with tubocurarine. Maximal exercise was performed when the drug effect was at its maximum as well as during the subsequent reduction in the effect allowing a gradually increasing work intensity. The results were compared with those obtained during submaximal and maximal exercise performed without tubocurarine. Partial neuromuscular blockade decreased hand-grip strength to 41 +/- 1.1% (S.E. of mean) and the maximal work load to 27 +/- 2.4% of control values. Voluntary effort was maximal and the rate of perceived exertion was high at all levels of exercise with tubocurarine indicating a maintained intense central nervous motor command. 2. During maximal action of the drug oxygen uptake was 1.67 +/- 0.11 l/min while only 0.91 +/- 0.13 l/min (P less than 0.01) at the same work intensity without neuromuscular blockade. This difference may reflect a dominant reliance on fast-twitch muscle fibres when work was performed under the influence of tubocurarine. 3. Compared at a given oxygen uptake ventilation was higher during work with tubocurarine than during control exercise (e.g. 55 +/- 4.2 and 40 +/- 2.2 l/min, respectively (P less than 0.01), at a mean oxygen uptake of 1.9 l/min), while heart rate did not differ significantly (146 +/- 4.4 and 139 +/- 3.0 beats/min). With decreasing drug effect both variables increased towards the maximum values of 138 +/- 4.5 l/min and 183 +/- 3.9 beats/min, respectively, achieved in control experiments at an oxygen uptake of 3.8 +/- 0.2 l/min. Like heart rate the mean arterial blood pressure increased with increasing work load and was similar at a given oxygen uptake with and without tubocurarine. 4. During maximal exercise at peak tubocurarine effect plasma adrenaline and noradrenaline concentrations were smaller than during control maximum, 1.6 +/- 0.27 versus 3.4 +/- 0.55 nmol/l (P less than 0.01) and 7.5 +/- 1.3 versus 12.6 +/- 1.8 nmol/l (P less than 0.05), respectively. However, comparisons at identical oxygen uptake rates revealed that catecholamine responses were markedly enhanced during tubocurarine treatment. Also, blood lactate concentrations were smaller at peak tubocurarine action than during control maximum, 1.9 +/- 0.42 mmol/l and 6.1 +/- 0.49 mmol/l (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681738 TI - Stimulus selectivity and functional organization in the lateral suprasylvian visual cortex of the cat. AB - 1. We have examined the responses of cells in the postero-medial and postero lateral lateral suprasylvian areas (p.m.l.s./p.l.l.s.) in the medial and lateral banks of the middle suprasylvian sulcus of the anaesthetized, paralysed cat. 2. Visual responses were assessed qualitatively (for projected spot and bar stimuli) and quantitatively (for drifting, high-contrast gratings of optimum spatial and temporal frequencies, but varying in orientation and direction of drift). There was excellent agreement between qualitative and quantitative estimates of preferred direction of motion. 3. Comparison of responses to motion in the preferred direction and the opposite direction confirmed that the percentage of units with strong directional preference is higher in this region of cortex than in other cortical and subcortical visual structures so far investigated. 4. Cells were comparatively well 'tuned' for the direction of motion of a grating: on average the half-width at half-amplitude for the variation in response around the principal preferred direction was 23.2 deg for p.m.l.s. and 25.3 deg for p.l.l.s., thus falling within the range found for complex cells in area 17. In this and other aspects of their direction selectivity, neurones in p.m.l.s. and p.l.l.s. were very similar to each other. 5. Quantitative analysis of the direction-response functions revealed them frequently to be more complex than previously described. For many cells there were subsidiary response peaks in addition to the main peak at the principal preferred direction. Often there was an accessory peak 180 deg from the optimum direction (i.e. directional preference was incomplete), but there was also a clear tendency for responses to be specifically elevated for directions orthogonal to the principal direction. 6. Tests with stationary, contrast-modulated gratings of the optimum spatial frequency, but differing in orientation, revealed that neurones responsive to such stimuli (though limited to about half the population) were orientation selective, their preferred orientations for stationary and drifting gratings being very similar. 7. The functional architecture of the lateral suprasylvian cortex was studied by means of single and multiple penetrations at different angles to the cortical surface: in most penetrations in p.m.l.s. the preferred directions of cells tended to shift progressively in small steps across the cortex, at a maximum rate of about 360 deg mm-1. However, there were occasional 180 deg differences between neighbouring recording sites or between cells recorded at different depths within a single radial column.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681740 TI - Post-synaptic actions of midlumbar interneurones on motoneurones of hind-limb muscles in the cat. AB - 1. The hypothesis that interneurones in the 4th lumbar segment (L4) are interposed between group I and group II afferents and hind-limb motoneurones has been tested. Action potentials of single interneurones were induced by ionophoretically applied homocysteate and recorded in parallel with post-synaptic potentials in motoneurones; the latter were recorded from motor axons in the ventral root of the first sacral segment as population potentials, using the sucrose gap technique. 2. The action potentials of twenty-four L4 interneurones were found to be followed by either e.p.s.p.s. or i.p.s.p.s in motoneurones. The latencies of the majority of these p.s.p.s were consistent with monosynaptically evoked excitation or inhibition of motoneurones since they exceeded the latencies of antidromic activation of the interneurones from the S1 motor nuclei by only a fraction of a millisecond. 3. The dominant input to both the excitatory and the inhibitory interneurones was from group II muscle afferents, in particular from the quadriceps nerve. The latencies of excitation of the interneurones by these afferents indicated a monosynaptic coupling between them. The same interneurones were co-excited by group I and cutaneous afferents and by descending fibres. 4. We conclude that not only excitation but also inhibition of hind-limb motoneurones from group II afferents may be mediated disynaptically and that interneurones in the 4th lumbar segment contribute to both. PMID- 3681741 TI - Assessing changes in presynaptic inhibition of I a fibres: a study in man and the cat. AB - 1. A method to assess changes in presynaptic inhibition of I a afferent terminals in man is proposed. The soleus H reflex was facilitated by a heteronymous I a volley from quadriceps and the amount of reflex facilitation was used to estimate the size of the conditioning I a excitatory post-synaptic potential (e.p.s.p.). It is argued that the size of this e.p.s.p. as measured by the resulting amount of reflex facilitation reflects the amount of presynaptic inhibition on the corresponding I a fibres. A decrease in the reflex facilitation may then be ascribed to an increase in presynaptic inhibition of the I a fibres mediating the conditioning volley. 2. That the heteronymous I a facilitation from quadriceps to soleus is caused by a purely monosynaptic e.p.s.p. is a prerequisite for the validity of the method. Experimental evidence is therefore given in an Appendix that in man the earliest part (first 0.5 ms) of this heteronymous I a facilitation is mediated through a monosynaptic pathway. Evidence is also given that this earliest facilitation is not yet contaminated by any polysynaptic effects from I a or I b afferents. 3. The validity of the method was established in animal experiments in which presynaptic inhibition of I a fibres and post synaptic events in motoneurones could be assessed by direct tests. It was found that the amount of test reflex facilitation produced by a conditioning I a volley was decreased when I a fibres were subjected to presynaptic inhibition but remained unchanged when the motoneurone pool in which the test reflex was elicited received pure post-synaptic inhibition. 4. In man, presynaptic inhibition of I a fibres was evoked by a short-lasting (three shocks at 200 Hz) vibration applied to the tibialis anterior tendon. Such a vibratory burst reduced the efficiency of the heteronymous I a volley in facilitating the soleus H reflex. By contrast, during a pure post-synaptic inhibition of soleus motoneurones the efficiency of the conditioning volley in facilitating the test reflex remained unchanged. It is therefore argued that the amount of heteronymous I a facilitation can indeed be used to assess the amount of ongoing presynaptic inhibition exerted onto heteronymous I a fibres from the quadriceps muscle to soleus motoneurones. 5. The short-lasting tibialis anterior vibration used here evoked a long-lasting (300-500 ms) depression of soleus and quadriceps H reflexes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681742 TI - Changes in presynaptic inhibition of Ia fibres at the onset of voluntary contraction in man. AB - 1. Two independent methods were used, in man, to assess changes in presynaptic inhibition of I a terminals at the onset of selective voluntary contractions: (1) measurement of the amount of heteronymous monosynaptic I a facilitation (from the quadriceps muscle to soleus motoneurones) to provide an assessment of the amount of ongoing presynaptic inhibition exerted on the I a fibres responsible for the facilitation; (2) measurement of the inhibition of H reflexes 40-60 ms after a short vibration to the tibialis anterior tendon to estimate the excitability of the interneurones mediating presynaptic inhibition from tibialis anterior I a afferents to the I a afferents of the test H reflex (soleus or quadriceps). 2. At the onset of an isolated voluntary plantar flexion of the foot (gastrocnemius soleus contraction) the heteronymous facilitation from quadriceps to soleus was increased, reflecting a decreased presynaptic inhibition of the quadriceps I a terminals on soleus motoneurones. Vibratory inhibition of the soleus H reflex was decreased, reflecting an inhibition of transmission of presynaptic inhibition to homonymous soleus I a afferent terminals. 3. At the onset of the same gastrocnemius-soleus contraction there was, on the contrary, an increased vibratory inhibition of the quadriceps H reflex indicating a facilitation of transmission of presynaptic inhibition to homonymous quadriceps I a afferent terminals. 4. At the onset of an isolated voluntary knee extension (quadriceps contraction) the opposite pattern was seen: the heteronymous facilitation from quadriceps to soleus was decreased and the vibratory inhibition of a soleus H reflex was increased, whereas the vibratory inhibition of the quadriceps H reflex was decreased. 5. These results indicate that presynaptic inhibition of I a afferent terminals on motoneurones of contracting muscles is decreased, permitting I a activity to contribute to excitation of voluntarily activated motoneurones. On the contrary, presynaptic inhibition of I a fibres to motoneurones of muscles not involved in the contraction is increased. It is argued that the former must be supraspinal in origin. 6. It is concluded that the control of presynaptic inhibition of I a fibres at the onset of movement may be organized so as to aid in achieving selectivity of muscle activation, i.e. so as to increase motor contrast. PMID- 3681739 TI - An interneuronal relay for group I and II muscle afferents in the midlumbar segments of the cat spinal cord. AB - 1. The properties of interneurones located in the 4th lumbar segment of the cat spinal cord (L4 interneurones) have been investigated by intracellular and extracellular recording from individual neurones. The study focused on interneurones projecting to hind-limb motor nuclei and/or interposed in pathways from group II muscle afferents. The projection to motor nuclei was assessed from antidromic activation of the neurones by stimuli applied in the motor nuclei of the 7th lumbar (L7) segment. 2. Interneurones which projected to gastrocnemius soleus or hamstring motor nuclei were found in laminae VI and VII and at the border between laminae VII and VIII. The dominant peripheral input to most of them was from group II muscle afferents, but they were also influenced by group I muscle afferents and by afferents in cutaneous, joint and interosseous nerves. Both excitatory post-synaptic potentials (e.p.s.p.s) and inhibitory post-synaptic potentials (i.p.s.p.s) were evoked from all of these fibre systems. 3. The same kind of multimodal input was also found in other interneurones in laminae VI and VII. However, their axonal projections were not identified and they might have included neurones projecting to motor nuclei (though outside the areas which were stimulated) as well as neurones with more local actions. 4. Interneurones located in laminae IV and V of the dorsal horn appeared to constitute a separate functional population since both their projections and their input differed from those of the more ventrally located interneurones; none of the dorsal horn interneurones were found to project to motor nuclei and none had input from group I afferents, although they were influenced by group II muscle afferents and by afferents in cutaneous, joint and interosseous nerves. 5. Many of the excitatory actions from group I and II afferents upon L4 interneurones were found to be evoked monosynaptically. A high proportion of L4 neurones synapsing upon motoneurones would thus be interposed in disynaptic reflex pathways from these afferents. In comparison to actions evoked via interneurones of the caudal lumbar segments, any post-synaptic potentials (p.s.p.s) evoked via L4 interneurones would be delayed. These delays would amount to 0.4-0.9 ms for p.s.p.s. from group I afferents and by 0.5-2.5 ms for group II p.s.p.s. 6. In many interneurones, particularly those located ventrally, i.p.s.p.s. were evoked by group I and II muscle afferents at latencies which indicated that they were evoked disynaptically. They may therefore reflect inhibitory interactions between subpopulations of L4 interneurones.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3681743 TI - [Mechanism of exercise-induced hyperuricemia]. AB - This study was designed to make clear why increases and decreases in serum uric acid levels after vigorous exercise were delayed. Eight healthy male subjects who were given allopurinol before exercise participated in this study. We performed exhaustive exercise test on bicycle ergometer, and investigated the changes in purine metabolites levels in blood and urine. Results were summarized as follow; 1) Serum uric acid concentrations did not change significantly. Urinary excretions of uric acid decreased from 30 minutes to 1 hour after exercise, and recovered thereafter. 2) Plasma oxypurines concentrations exhibited the maximum level at 1 hour after exercise, and maintained the higher levels until 7 hours after exercise. Urinary oxypurines excretions exhibited the maximum level at 1 hour after exercise, and maintained the higher levels until 24 hours after exercise. 3) Plasma inosine concentrations increased only in one subject. Plasma hypoxanthine concentrations increased significantly in all subjects. Plasma xanthine concentrations did not change. 4) Blood ammonia concentrations exhibited the maximum level at 5 minutes after exercise, and returned to basal levels at 2 hours after exercise. These observations suggest that the delays of increases and decreases in serum uric acid levels are due to that the prolonged release of hypoxanthine from skeletal muscle lead to the prolonged production of uric acid in liver. PMID- 3681744 TI - Conservative management of traumatic vesico-cervical fistula (a case report). PMID- 3681745 TI - Thrombotic thrombocytopenic purpura (a case report). PMID- 3681746 TI - Malignant hypertension (a clinico-pathologic study of 43 cases). PMID- 3681747 TI - Carbuncle--a conservative approach. PMID- 3681748 TI - Use of CSF C-reactive protein in differentiating bacterial and non-bacterial meningitis. PMID- 3681749 TI - Post-operative irrigation in the management of amoebic peritonitis. PMID- 3681750 TI - Effect of calcium channel blockers on serum lipid profile. PMID- 3681751 TI - Effect of vitamin C deficiency on testicular structure in the guinea pig. PMID- 3681752 TI - Mycoplasmal pelvic inflammatory diseases. PMID- 3681753 TI - Mobilization of knee-joint injuries by a continuous passive motion machine. PMID- 3681754 TI - Gall stones in a child (a case report). PMID- 3681755 TI - Squamous cell carcinoma of the breast (a case report). PMID- 3681756 TI - Cystic variety of osteogenesis imperfecta with ununited fractures (a case report). PMID- 3681757 TI - Schatzki's ring: an obscure cause of dysphagia (a case report). PMID- 3681758 TI - A Markov model for predicting levels of psychiatric service use in borderline and antisocial personality disorders and bipolar type II affective disorder. AB - This study examines the relationship between borderline personality disorder (BPD) and the use of psychiatric services in a naturalistic follow-up comparison with antisocial personality disorder and bipolar type II affective disorder. In the first follow-up series, borderline psychopathology was associated with higher levels of psychiatric service use (emergency, daycare, and inpatient). Markov analyses indicated that the transition between levels of psychiatric service use followed a stationary, second order process (i.e. the immediate past and current service use, predicted use on the next follow-up, and the relationship did not depend on the point in time examined in the follow-up series). Further, the transition probabilities generated from this model did not depend significantly on diagnosis. Predictions from the Markov model about the cumulative probability that subjects would use the highest level of psychiatric services were tested on a second series of follow-ups on the same subjects 20 months later. The model based predictions (starting from the observed levels in the first two follow-ups of the second series) clustered into three groups, of high, middle, and low predicted probabilities. The subject group with the lowest predicted likelihood had a cumulative probability of 0.19 for using emergency, daycare, or inpatient hospitalization by 22 months of follow-up, whereas the group with the highest likelihood (containing a disproportionate number of BPD subjects) had a cumulative observed probability of 0.80. The Markov model generated from this second series supported the stationarity of the transition process. BPD subjects began using high levels of psychiatric services, but their transition from one level to another over time followed a process similar to that of non-BPD subjects. PMID- 3681759 TI - Lactate infusions in major depression without panic attacks. AB - Sodium lactate infusion provokes panic attacks in panic disorder patients but not in normal controls. We have previously shown that patients who develop panic disorder during a major depressive episode are similar to panic disorder patients in their rate of panic attacks with lactate. In the present pilot study, nine patients with major depression without panic attacks underwent lactate infusions. These patients differed significantly from panic disorder patients but not from controls in their response to lactate. This argues for the specificity of lactate sensitivity for the phenomenon of panic attacks and gives further evidence for biological differences between panic and depression. PMID- 3681760 TI - A family study of patients with temper outbursts. AB - To evaluate the heritability of a personality trait, "having temper outbursts," and of associated diagnoses, we obtained histories of first degree relatives on two groups: (1) patients with temper outbursts (N = 33), and (2) diverse psychiatric patients without temper outbursts (N = 12). Family interviews were conducted blind to patient (temper or not) status, using a modified version of the Family History RDC. Though Ns are relatively small, and results therefore require confirmation, the data indicate familial transmission of temper problems; an average of 18.2% of Group 1 relatives had temper problems, compared to 4.3% for Group 2. The trait of having temper outbursts was more strongly transmitted than were specific diagnoses (e.g. Intermittent Explosive Disorder, Antisocial Personality Disorder or Residual Attention Deficit Disorder) associated with temper outbursts. Patients with neurological conditions apparently related to their temper outbursts were less likely to have positive family histories. PMID- 3681761 TI - The spectrum concept of schizophrenia: evidence for a genetic-environmental continuum. AB - Family data from 84 chronic schizophrenic, 11 schizotypal and 90 normal control probands were analyzed by multivariate-multifactorial genetic models using morbid risk statistics. The results were consistent with multifactorial inheritance whereby chronic schizophrenia and schizotypal personality disorder represent different phenotypic manifestations of the same underlying process; that is, the two disorders were found to have different thresholds on a single continuum of genetic-environmental liability. When subclassified according to Taylor and Abrams' criteria, chronic schizophrenic subjects who met these criteria (narrow schizophrenia) had a higher threshold of liability than those who did not (broad schizophrenia). The hypothesis of separate liabilities for the different disease states was rejected. Overall, the results suggest a gradation in multifactorial liability from schizotypal personality disorder (mild) to broad schizophrenia (moderate) to narrow schizophrenia (severe). PMID- 3681762 TI - Lithium: long-term effects on the kidney--II. Structural changes. AB - Forty-six patients treated with lithium for an average of 8 yr participated in a follow-up study involving a kidney biopsy. The results were compared with renal biopsy specimens from an age-matched group of controls never treated with lithium. The average number of totally scelerotic glomeruli and atrophic tubuli was higher in lithium-treated patients. The histopathological changes showed significant correlations with lithium dosage schedule. Both the proportions of sclerotic glomeruli, atrophic tubuli and focally distributed interstitial fibrosis were higher in patients receiving their lithium two or three times a day than when lithium was given in a single daily dose. PMID- 3681763 TI - Prediction of outcome by historical, clinical and biological variables in schizoaffective disorder, depressed type. AB - The usefulness of several historical, clinical and biological variables as possible predictors of outcome was tested in a sample of patients with a cross sectional diagnosis of schizoaffective disorder, depressed type. Four historical items were found to be successful: a family history of chronic schizophrenia, the occurrence of schizophrenic symptoms at some stage of the illness in the absence of depression and an onset of the index episode as exacerbation of previous symptoms (all associated with a relatively poor outcome), and a personal history of previous manic episodes (associated with a relatively good outcome). The various aspects of the clinical picture during the index episode, as well as the response on dexamethasone suppression test, were not found to have any predictive value. These findings confirm that, in patients with a cross-sectional diagnosis of schizodepressive disorder, the previous course of the illness is of crucial importance for prognosis, and support the usefulness of a multiaxial classification of schizoaffective states, taking into account not only cross sectional symptomatology but also course. PMID- 3681764 TI - Diagnosing depressive disorders in patients with alcohol and drug problems: a comparison of the SADS-L and the DIS. AB - The DIS and the SADS-L diagnostic procedures occupy an important position in psychiatric research. We compared these procedures for assessing depressive disorders in patients with substance abuse problems. The two instruments agreed poorly, and the SADS-L produced a considerably higher proportion of cases than the DIS. A number of factors were examined to determine their influence on the agreement obtained for Major Depression. These factors included (1) recency of the disorder, (2) the primary/secondary distinction, (3) clinical experience of the DIS interviewers, (4) numerous subject characteristics and (5) the DIS procedure for differentiating organic from non-organic affective symptomatology, which relies on subjects' attributions of the cause of symptoms. The first four factors did not influence agreement. However, removal of the influence of the fifth factor did increase agreement between the instruments appreciably. Validation evidence favored the SADS-L, although not definitively. Implications of the findings are discussed. PMID- 3681765 TI - The dexamethasone suppression test and antidepressant response in major depression. AB - We conducted a prospective open pilot study of 34 consecutively admitted patients with the DSM-III diagnosis of MD who were admitted to a general psychiatric unit. Patients underwent a 1 mg DST and were randomly assigned to treatment with either maprotiline or trazodone. Antidepressant dosages were increased as tolerated clinically and according to treatment response. RESULTS: mean final oral doses were 193 mg for maprotiline and 328 mg for trazodone. The mean treatment duration was 4.5 weeks for maprotiline and 5.9 weeks for the trazodone group. Of these 34 patients 44% showed DST nonsuppression (41% maprotiline, 45% trazodone). Seventy six per cent of the patients responded to treatment (76% for both drugs) as defined by GAS. Eighty-seven per cent of the nonsuppressors responded to treatment (86% maprotiline, 88% trazodone) and 68% of the suppressors responded (70% maprotiline, 67% trazodone). Of the eight treatment nonresponders six showed DST suppression. The implications of these findings are discussed. PMID- 3681766 TI - Platelet imipramine binding in patients with panic disorder and major familial depression. AB - Platelet 3H-imipramine binding was investigated in 15 normal subjects, 17 patients with major depressive disorder and 43 patients with panic disorder, to further study the relationship between depressive and anxiety disorders. Whereas patients with major depression had a significantly lower mean Bmax value than healthy volunteers, mean Bmax values in patients with panic disorder did not differ significantly from normal controls. Furthermore, apparently normal Bmax values were observed even in those panic disorder patients who had concurrent major depression or a past history of depression. Thus, despite previous findings of an overlap between panic and depressive disorders, the present results suggest that the two syndromes may have distinct neurochemical substrates. PMID- 3681767 TI - Mental health, belief deficit compensation, and paranormal beliefs. AB - The present study examined the relationship between religious and nonreligious paranormal beliefs and mental health, as well as the possibility that nonreligious subjects compensate for a lack of identification with traditional religion by increased nonreligious paranormal beliefs. Subjects were 80 undergraduates categorized as religious or nonreligious on the basis of scores on the Traditional Religion subscale of the Paranormal Belief Scale. Religious subjects had significantly higher total paranormal belief scores than nonreligious subjects. Those adopting religious paranormal beliefs were actually somewhat more likely to adopt other nonreligious paranormal beliefs. The failure of nonreligious subjects to compensate fully for this traditional religious belief deficit was reflected in their mental health ratings on the Langer's Mental Health Scale (Langer, 1962). Paranormal beliefs were found to be negatively correlated with reported symptoms of psychopathology, supporting the formulation that paranormal beliefs may serve to ensure psychic integrity by acting as "self-serving cognitive biases." PMID- 3681768 TI - Assessment of death attitudes: an empirical approach. AB - The Threat Index and the Death Anxiety Scale were administered to 228 subjects. Based on the high/low criterion scores, 105 subjects were assigned to the following four groups: (a) high death threat/high death anxiety, (b) high death threat/low death anxiety, (c) low death threat/high death anxiety, and (d) low death threat/low death anxiety. During the experimental phase of the study, subjects viewed a filmstrip on death rituals in various cultures. A recall test was then administered. Results indicated no significant group differences on recall performance. Initial no-show rates for the second part of the experiment were observed in the four groups reflecting a significant negative relationship between death anxiety and initial no-show rates. The possibility of defensive responding on the Death Anxiety Scale was suggested. PMID- 3681769 TI - Evaluation of optical motion information by movement detectors. AB - The paper is dealing in its first part with a system-theoretical approach for the decomposition of multi-input systems into the sum of simpler systems. By this approach the algorithm for the computations underlying the extraction of motion information from the optical environment by biological movement detectors is analysed. In the second part it concentrates on a specific model for motion computation known to be realized by the visual system of insects and of man. These motion detectors provide the visual system with information on both, velocity and structural properties of a moving pattern. The last part of the paper deals with the functional properties of two-dimensional arrays of movement detectors. They are analyzed and their relations to meaningful physiological responses are discussed. PMID- 3681770 TI - Neural correlates of auditory filial imprinting. PMID- 3681771 TI - Central processing of sensory information in electric fish. AB - Comparative studies of neural mechanisms underlying the perception of natural stimulus patterns and the control of adaptive behavioral responses have revealed organizational principles that are shared by a wide spectrum of animals. Mechanisms of perception and motor control are commonly executed in a distributed network of neurons that lack 'pontifical' elements. Individual neurons even at an organizational level as high as the optic tectum may still have very general response characteristics, and the recruitment of individual neurons reveals little about the nature of the stimulus situation outside. Only the joint evaluation of messages from large populations of such neurons yields unambiguous pictures of the outside world. Stimulus variables are commonly mapped continuously within a stratum of neurons so that their variation over time can be monitored by mechanisms similar to motion detection in a retina. The ordered representation of a stimulus variable within an array of broadly tuned elements allows for a degree of stimulus resolution that by far exceeds that of individual elements in the array. Neural systems are burdened by their evolutionary history and suffer from imperfections that are overcome by a patchwork of compensations. The existence of multiple neuronal representations of sensory information and multiple circuits for the control of behavioral responses should provide the necessary freedom for evolutionary tinkering and the invention of new designs. PMID- 3681772 TI - Synaptic responses produced in lobster abdominal postural motor neurons by mechanical stimulation of the swimmeret. AB - 1. Intracellular recordings were obtained from the somata of identified abdominal postural motor neurons in lobster to examine their subthreshold and suprathreshold responses to tactile stimulation of the swimmeret. 2. Pressure stimulation of the swimmeret surface evoked abdominal extension by producing tonic spiking in the extensor excitors and the synergistic flexor inhibitor (f5) and hyperpolarizing responses in the extensor inhibitor and antagonistic flexor excitors. These responses often continued for several seconds following the termination of the stimulus. The receptive fields of these motor responses extended over most of the swimmeret surface. 3. More localized tactile stimulation of the swimmeret surface elicited EPSPs in f5 and the extensor excitors, and IPSPs in the flexor excitors. The amplitude of these synaptic potentials decreased as the stimulus intensity was reduced. 4. Stimulation of feathered hair (both sexes) and smooth hair (female only) sensilla produced responses characteristic of extension whereas bristly spines on the male accessory lobe excited only two flexor excitors without affecting any of the other postural motor neurons. 5. Summed synaptic responses recorded from the motor neurons differed in their amplitudes and latencies according to the type of mechanoreceptor stimulated-cuticular receptors, feathered hairs or smooth hairs. Stimulation of the swimmeret cuticle produced the strongest responses (shortest latency, largest amplitude), while feathered hair stimulation initiated the weakest responses (longest latency, smallest amplitude). 6. The relatively long latencies (greater than 35 ms) and the complex form of the EPSPs and IPSPs indicate the involvement of multisynaptic interneuronal pathways in the reflex arcs. PMID- 3681773 TI - Invitation to compliance. The Prolixin brunch. PMID- 3681774 TI - Bibliotherapy. Using literature to help children deal with difficult problems. PMID- 3681775 TI - Women partners of Vietnam vets. PMID- 3681776 TI - Faith: an untapped health resource. PMID- 3681779 TI - Recruiting psych nurses. PMID- 3681777 TI - Little boy lost. PMID- 3681778 TI - Fire on the unit. PMID- 3681780 TI - Birthdays. A special kind of anniversary reaction. PMID- 3681781 TI - Social skill building with chronic patients. PMID- 3681782 TI - Lesbian stress and coping methods. PMID- 3681783 TI - The physician immunologist. Planning for the future. PMID- 3681784 TI - The prevalence of reaction to food additives in a survey population. PMID- 3681785 TI - A follow-up study of childhood food additive intolerance. PMID- 3681786 TI - The hospital management of community-acquired pneumonia. Recommendations of the British Thoracic Society. PMID- 3681787 TI - Deaths in the first 20 years and problems of the sex ratio at birth. PMID- 3681788 TI - Low sex ratio in children of men in alcohol-related occupations. PMID- 3681789 TI - Blood transfusion and colorectal cancer. PMID- 3681790 TI - Cancer of the alimentary tract in a West Indian population: a Trinidad study. PMID- 3681791 TI - The Angelchik prosthesis: experience with the anti-reflux device. PMID- 3681792 TI - Management of surgical disorders of the biliary tract in infancy and childhood. PMID- 3681793 TI - Adolescent Hirschsprung's disease. PMID- 3681794 TI - An assessment of an orthopaedic pre-admission clinic. PMID- 3681795 TI - Concomitant ipsilateral femoral shaft and femoral neck fracture. PMID- 3681796 TI - Phenolisation as an adjunct to Zadik's procedure for ingrowing toenail and onychogryphosis. PMID- 3681797 TI - Aortic aneurysmorraphy without blood transfusion or ileus: the exclusion operation. PMID- 3681798 TI - Axillary lymph node metastases from clinically occult breast carcinoma. PMID- 3681799 TI - Experience with a pyloric dilator in patients with delayed gastric emptying. PMID- 3681800 TI - Ureteroscopy facilitated by stenting. PMID- 3681801 TI - A new endo-oesophageal tube. PMID- 3681802 TI - Improved abdominal aortic aneurysmectomy exposure with the use of a self retaining retractor. PMID- 3681803 TI - Herniation through a donor site for iliac bone graft. PMID- 3681804 TI - Epididymal involvement in Henoch-Schonlein purpura mimicking testicular torsion. PMID- 3681805 TI - Complicated colonic diverticular disease in two young adult brothers. PMID- 3681806 TI - Testicular tumours--a 15 year study. PMID- 3681807 TI - Vagotomy confined to the acid-secreting mucosa of the stomach. PMID- 3681808 TI - The Ellison Procedure for antero-lateral instability of the knee. PMID- 3681809 TI - Combined Pes Anserinus and Ellison procedures for co-existing antero-medial and antero-lateral instability of the knee. PMID- 3681810 TI - Drug treatment of local cold injuries. PMID- 3681811 TI - An elective exchange at USUHS. PMID- 3681812 TI - The first Antarctic winter in tents: the Joint Services Expedition to Brabant Island. PMID- 3681813 TI - Life on a ventilating machine. PMID- 3681814 TI - A Banyan in Aden. PMID- 3681815 TI - Interventional radiology. PMID- 3681816 TI - [Quantitative vertebral x-ray computed tomography. Results in 105 women consulting for osteoporosis]. AB - Quantitative vertebral CT scan imaging is a method developed to provide direct measurements of mineralization of vertebral body spongy tissue, and is presently the most precise procedure for the early detection of spinal osteoporosis. A fracture threshold has been defined below which are found 95% of patients with a crushed vertebra: it is situated at 70% of the value for mineralization normal for the age of patients. Patients with marked reductions in their level of mineralization can be kept under surveillance before the onset of fracture. In patients with vertebral collapses the density is correlated significantly with the number of crush fractures. In addition, measurement of vertebral spongy bone density has allowed the importance of the vertebral lesion to be determined in various osteoporotic disorders, including those with only cortical fractures, and in this way to differentiate them. PMID- 3681817 TI - [Osteonecrosis of the femoral head. MRI study of 60 cases]. AB - Normal and pathologic femoral heads have been studied by MRI at 1.5 Tesla. The study was centered upon avascular necrosis (53 lesions). Twenty normal subjects and three patients with algodystrophy were examined. The osteonecrosis patterns were established from known lesions. A low signal rim surrounds an upper polar zone of conserved (Type I) or decreased (Type II) signal. The lesions age correlates significantly with their type: amongst type I lesions, 6 are asymptomatic and the 21 others have a mean age of 5.5 months; Type II lesions have a mean age of 12.7 months. Fourteen lesions were not seen on plain radiographs and six were not detected by bone scan. The older lesions with femoral head deformation are better depicted by standard radiologic techniques. Conservatively MRI is the most efficient examination for recent avascular necrosis lesions. PMID- 3681818 TI - [Dorsal spinal cord compression caused by vertebral subperiosteal chondroma. Apropos of 2 cases]. AB - The authors report 2 cases of vertebral subperiosteal chondroma causing thoracic spinal cord compression. Total excision of this benign cartilaginous neoplasm is usually sufficient treatment. PMID- 3681819 TI - [Osteoblastoma of the 1st metatarsal bone. Apropos of a case]. AB - Metatarsal localisation of osteoblastoma is rare. We report a case of a sixteen years old girl. The foot was swollen but unpainful. The plain film showed an extensive, osteolytic tumor of the whole of the first metatarsal bone. The radiological diagnosis could be discussed with an aneurysmal cyst, a chondroma, a desmoplastic fibroma, a fibrous dysplasia, an angioma. The total resection was possible without opening of the tumor and reconstruction was possible with a tibial graft. The pathological diagnosis was benign osteoblastoma. Recovery was uneventful. PMID- 3681821 TI - [Mediastinal lymph node extension in primary bronchial cancer: correlation of x ray computed tomography, magnetic resonance imaging and mediastinoscopy. Apropos of 50 cases]. AB - Based on a homogeneous series of 50 cases investigated within less than a week by CT scan and NMR imaging with mediastinoscopic correlation, and in 32 of theses cases with correlation with operative findings, a critical study was carried out of modern imaging methods for detection of mediastinal gland invasion from primary bronchial cancer. Axial mediastinoscopy presented absolute specificity and very high sensitivity (93%) markedly superior to those of CT scan and NMR imaging. The two latter examinations were practically of equal efficacy: sensitivity of NMR (80%) was somewhat higher than that of CT scan (70%) whereas specificity of CT scan was 83% as against 70% for NMR. Lack of efficacy of axial mediastinoscopy was in cases with extra-axial lymphatic extension (anterior mediastinal chains) from primary cancer. These results suggest that, in view of current inconveniences of NMR imaging, the best means for local and regional exploration of primary bronchial cancer preoperatively is combined CT scan and mediastinoscopy. The diagnosis of glandular enlargement of anterior mediastinal lymphatic chains should lead to performance of an anterolateral mediastinoscopy. PMID- 3681820 TI - [Rectosigmoid hemangioma: diagnostic value of associated phleboliths. Apropos of a case]. AB - When confronted with rectorrhagia in a young patient, combining a straight abdominal examination with a barium enema investigation may reveal the presence of phleboliths, atypical by their large number and central localization, and orientate towards the rare diagnosis of a colorectal hemangioma. PMID- 3681822 TI - [Castleman's disease with thoracic localization. Apropos of a case with x-ray computed tomography. Review of the literature]. AB - Castleman Disease is a rare benign condition of uncertain etiopathogeny. The most frequent localization is thoracic, often discovered by a routine chest radiography. The diagnosis is histological. We report one case, characterized by his very long course (25 years) and calcifications. Ct scanning showed enhancement after contrast material administration, and proved the adherence with the adjacent soft tissues, justifying surgery. PMID- 3681823 TI - [Arteriovenous fistulas complicating in situ venous femoropopliteal bypass. A sample case]. AB - Arteriovenous communications are a rare but specific complication of in situ saphenous vein arterial bypass. In this bypass procedure, some collaterals of the saphenous vein may remain patent. In this report, a characteristic example illustrates this complication. Local and general manifestations secondary to the development of these fistulas must be prevented by complementary surgical or radiological obliteration. PMID- 3681824 TI - [Opacification of the arterial system during phlebography of the leg for blue phlebitis]. PMID- 3681825 TI - Effect of irrigation fluids on arterial and venous endothelium after ischemia. AB - This study examines the extent of endothelial damage following a period of irrigation with various crystalloid irrigation fluids. Both arteries and veins were evaluated after irrigation with normal saline, lactated Ringer's, Balanced Salt Solution (BSS), and Balanced Salt Solution Plus (BSS+). The arterial and venous endothelia were examined with the scanning electron microscope. Using a randomized blind observer scoring system, micrographs were evaluated for changes in nuclear shape, cell junction integrity, cytoplasm changes, and sloughing of the endothelial cell layer. BSS+ and BSS produced statistically significant (P less than .001) improvement over the other two irrigation fluids in the arteries. BSS+ and BSS were statistically superior (P less than .001) in the venous vessels. The compositions of BSS and BSS+ tend to maintain a physiologic environment in the presence of ischemia. These fluids maintained a morphologic appearance closer to that of perfusion-fixed controls. The data suggest a protective effect of such physiologic preparations on the endothelium. The preservation of intact endothelium may play a role in decreased platelet activation, continued production of prostacyclin, and maintenance of an intact barrier between the intracellular and extracellular spaces. This could enhance the survival of transplanted or transferred tissue, by helping to maintain nearly normal endothelium during surgery. PMID- 3681826 TI - Polytetrafluoroethylene microprosthesis in the arterial system of the rat. AB - The experimental behavior of a 1-mm internal diameter (i.d.) polytetrafluoroethylene (PTFE) microprosthesis, as a substitute for an abdominal aortic segment in the rat, was reviewed. Fifty Wistar rats were divided into four groups: Group I--12 rats with autotransplant of an abdominal aortic segment (AAS); Group II--12 rats with allotransplant of an AAS obtained from Long-Evans rats; Group III--12 rats with xenotransplant of an AAS taken from rabbit femoral arteries; and Group IV--14 rats with substitution of an AAS by a 1-mm i.d. PTFE microprosthesis. The rats were sacrificed at different time intervals ranging from five to 360 days, with previous aortography. In Group I, there was a 100 percent patency at a mean of 152.41 days; in Group II, a 91.6 percent patency at a mean of 100.08 days; in Group III, an 83.3 percent patency with a 75 percent aneurysmal dilation at a mean of 107.58 days; in Group IV, a 71.42 percent patency with two anastomotic aneurysms at a mean of 105 days (P less than 0.05, chi square) between Groups I and IV, autotransplant vs. PTFE). The 1-mm PTFE microprosthesis placed in the arterial system of the rat proved to be a reliable alternative for microvascular substitution. PMID- 3681827 TI - Ear replantation: a case report. AB - This paper presents the fifth reported case of replantation of a traumatically amputated ear and its management. The ear was amputated in an automobile accident and was revascularized microsurgically. Replantation, when possible, offers the ultimate result; however, shortcomings include the length of operation, prolonged hospitalization, and postoperative management of venous congestion. PMID- 3681828 TI - Use of the surgical glove in microsurgery. AB - The disposable surgical glove can serve as a model for toe-to-hand transfer, as a template for flap design, and as a ring tourniquet for the finger. The low cost, effectiveness, and easy handling of the glove warrant its role in reconstructive microsurgery. PMID- 3681829 TI - Microvascular anastomosis using carbon dioxide (CO2) laser: evaluation by SEM after corrosion cast. AB - In order to compare the carbon dioxide laser-assisted microvascular anastomosis (CO2 LAMA) with conventional microvascular sutured anastomosis (CMSA), 40 microarterial anastomoses were performed in Wistar albino rats. At different time intervals from zero to four weeks after the procedure, the anastomoses were examined under the scanning electron microscope (SEM) after resin corrosion cast (Mercox). CO2 LAMA was easier and less time-consuming than CMSA, with the same patency rate. Healing of the lumen surface was similar in both procedures, suggesting that CO2 LAMA can be reliably used in microvascular anastomosis. PMID- 3681830 TI - Chemotactic arrangement of axons inside and distal to a venous graft. PMID- 3681831 TI - Successful replantation of ten digits in China. PMID- 3681832 TI - Microvascular determinants of blood flow. PMID- 3681834 TI - On the use of group therapy in non-combat military psychiatry. AB - The application of group therapy with hospitalized Israeli soldiers and with their parents reveals specific dynamic themes whose elaboration plays a significant role in the treatment of the crisis and in the subsequent extramural adaptation, including, on occasion, reintegration into the army. PMID- 3681833 TI - John Hull Grundy memorial lecture, 1987. Warfare, disease and the survival of arthropods in the desert. PMID- 3681835 TI - Ethnic variations in birth weight--a study of British, Chinese and Gurkha babies. AB - All births at BMH Hong Kong during one year were analysed retrospectively according to ethnic group, birthweight, length and head circumference. Significant differences in birthweight were found between the groups and also between British babies born to service and civilian expatriate families. PMID- 3681836 TI - Spirit possession and bewitchment presenting as physical illness: report of four cases in Nepalese males. PMID- 3681837 TI - Biliary peritonitis following the removal of a T-tube. PMID- 3681838 TI - Injuries by wild animals in the African bush. AB - The author's personal experience of the management of wild animal injuries in the southern African bush over a period of 4 years is presented. Injuries were sustained from attacks by hippopotamus in 4 cases, buffalo in 2 cases and a lion in one case. The types of injuries and their management are presented. Causative factors, prevention and possible complications are reviewed. Twenty-one cases of snakebite are also discussed. PMID- 3681839 TI - Transection of the retrohepatic vena cava in a case of total situs inversus following blunt trauma. AB - Total transection of the retrohepatic inferior vena cava from blunt trauma is a rare and usually fatal injury. Such an injury in a patient with total situs inversus and previous surgical correction of great vessel transposition is described. A possible mechanism for the injury is suggested. PMID- 3681840 TI - Acute salivary gland enlargement following instrumentation of the upper airway. AB - A case of sudden enlargement of the submandibular and parotid salivary glands following endotracheal intubation is described. The literature concerning this condition is reviewed, and the possible causes are discussed. PMID- 3681841 TI - Rupture of angiomyolipoma of the kidney presenting as puerperal collapse. AB - We report an unusual presentation of angiomyolipoma of the kidney. Whilst a conservative surgical approach is ideal, the greatly increased cardiac output in pregnancy makes haemorrhage more severe and hence more radical surgery is often required. The difficulty in reaching a correct pre-operative diagnosis can lead to an unusual approach to nephrectomy, of which the surgeon should be forewarned. PMID- 3681842 TI - Cervical cytology screening in the army. PMID- 3681843 TI - Audit of serum theophylline concentrations in patients from general practice. AB - From the repeat prescription register of a British general practice, 37 patients regularly taking theophylline preparations were identified. Measurement of their serum theophylline concentration showed that less than 25% of these patients were achieving a theophylline concentration in the therapeutic range. Reasons for this are discussed. PMID- 3681844 TI - Upper respiratory tract infection: predisposing factors and duration of symptoms in patients over 12 years of age. AB - Some patients suffer greatly from upper respiratory tract infections, while others suffer much less. Various factors, such as allergy and nasal injury, have been suggested in the literature to predispose patients to infection. Predisposing factors and patterns of disease were examined in a prospective, controlled study of 238 patients attending two general practices. A questionnaire, designed to study the development and duration of upper respiratory symptoms and the occurrence of factors which predispose patients to disease, was completed for index and control patients when they presented with symptoms. A follow-up card was completed by index patients one month later.Family history of catarrh was found to be a significant predisposing factor to upper respiratory tract infection. However, no significant differences between index and control patients were found for any of the other generally accepted factors. Heavy smoking and increased age were associated with prolonged symptoms lasting 60 days or more.It is concluded that traditional theories of the causes of upper respiratory tract infections may need to be revised. PMID- 3681845 TI - Rural-urban variations in service provision for elderly people. AB - Findings reported from a survey of 997 people aged 75 years and over living at home in a rural and an urban area showed that the two areas were similar in overall levels of support and in levels of perceived need. The rural area enjoyed rather more generous support from district nurses and health visitors than the urban area, a finding which challenges the widely-held view that rural areas suffer from lower levels of support and have higher levels of felt need. The few differences between the areas that did emerge were not necessarily a consequence of location; other explanations may be found in the operating styles of the services, and in the amount and type of informal support to be found in the two areas. Overall, the findings question the validity of a simple rural-urban dichotomy in studies of elderly people. PMID- 3681846 TI - A survey of the management of psychosocial illness in general practice in Manchester. AB - As part of a larger study 201 urban general practitioners from five health districts provided information on 6870 consultations with patients recorded as having psychosocial disorders, 5610 of which were concerned solely with psychosocial problems. The results showed a lower percentage of consultations for such conditions than other studies, although the age and sex distribution of the patients was similar. There was a wide variation in the proportion of such disorders in the case-mix of the 201 general practitioners, a higher proportion being associated with longer consultation times. The pattern of prescribing and referral is described and discussed. Referral to non-medical agencies played a small part in the overall care of patients with psychosocial disorders. Questions are raised as to the extent of team care in this wide cross-section of practices. PMID- 3681847 TI - Epilepsy in a Doncaster practice: audit and change over eight years. AB - The results of active management and the findings of repeated audits of epilepsy care over the period 1978-86 in a general practice are described. It was found that about one-fifth of epileptic patients continued to have frequent seizures, usually complex partial, about half had few seizures, and many with mild epilepsy remitted early.By 1980 attempts to reduce polypharmacy, change treatment and achieve optimal use of anticonvulsant drugs in epileptic patients with frequent seizures or side effects had led to an overall improvement in seizure control in 27%, a reduction of polypharmacy in 24% and an improvement in well-being in many patients. Subsequently it proved possible to maintain this improvement, to achieve similar results in epileptic patients joining the practice and to avoid misdiagnosis and polypharmacy in newly diagnosed patients.General practitioners can make a considerable contribution to the care of patients with epilepsy but improved overall care requires better collaboration between neurologists and other clinicians. A district epilepsy service, based on a local clinic, which actively pursues a collaborative approach is suggested as the model for providing optimum care to epilepsy patients. PMID- 3681848 TI - Audit of work at a medical centre for the homeless over one year. AB - An audit of one years' work at a voluntary health care service for the homeless involving doctors, a chiropodist, nurses and social workers was carried out. It was found that although certain health problems are more common among the homeless than in the general population, the range resembles that in any general practice. However, registration with general practitioners was much less common among the homeless than in the general population, and a high proportion of referrals to hospital did not lead to appropriate treatment. The value of a special primary health care service for the homeless is discussed. PMID- 3681849 TI - Use of the objective structured clinical examination for assessment of vocational trainees for general practice. AB - General practice training schemes currently have no structured methods of assessment and most rely on a variety of subjective ratings of performance. In West Cumbria the ;objective structured clinical examination' has been used to assess training performance in areas covered by small group teaching during the preceding terms. Consultation skills, interpretation of clinical data and a number of aspects of practice management were tested. The examination was conducted in the local postgraduate centre and assessed 20 trainees. Each trainee received feedback of his performance on each problem set and also an overall comparison with his peers.This method of assessment appeared to be well received by trainees and was practicable within the limited resources available. In addition, the variety of problems set allowed for a broad range of trainees' performances to be assessed. PMID- 3681850 TI - Experimentation: the next step. AB - General practice has entered a period of accelerating change, and those responsible for planning its development now put forward a variety of promising proposals. Unless provision is made for large scale experimentation and scientific evaluation, the direction of future change will be determined not by evidence but by rhetoric. A framework for creating and evaluating a substantial programme of experimentation is suggested. The programme is the logical next step in the process of change which was given impetus by the publication of the government green paper. It should be seen as a professional, moral and political priority. PMID- 3681851 TI - Differential response to job loss. PMID- 3681852 TI - Clinical psychology and primary care: patients views on the venue for appointments. PMID- 3681853 TI - Computers in practice--whither goest we? PMID- 3681854 TI - HIV infection in a rehabilitation unit. PMID- 3681855 TI - Treatment of otitis media. PMID- 3681856 TI - Hospitals for the mentally handicapped--run down or reform? PMID- 3681857 TI - Preventive care of the elderly. PMID- 3681858 TI - Murine pregnancy-associated modulations in lymphocyte reactivity to mitogens: identification of the cell populations affected. AB - Lymphocytes from the thymus, spleen and inguinal lymph nodes of syngeneically pregnant and non-pregnant mice were compared in their responsiveness to polyclonal stimulation by mitogen. Pregnancy-associated changes in mitogen reactivity were detected, on a cell-per-cell basis, in thymocytes (increased) and spleen cells (decreased) but not in lymph node cells. The hyperreactivity of thymocytes during pregnancy correlated with physiological involution of the thymus occurring through the selective loss of relatively immature, non-mitogen reactive, Lyt 1+2+ cells. The remaining cells were found largely to be mature Lyt 1+2- T cells with the capacity to respond to mitogenic stimulation. It is most likely the relative increase in the proportion of these Lyt 1+2- cells that causes the hyper-responsiveness of thymocytes to mitogens observed during pregnancy. On the other hand, while spleen cells from pregnant animals gave lower responses to mitogens than those from control virgin females, isolated splenic T cells from the two groups proved equally reactive to T cell mitogens. This supports the contention that at least some aspects of immunity during pregnancy are down-regulated by inhibitory cells within the non-T cell compartment. The results demonstrate the importance of identifying the reactive cell population in studies on changes in lymphocyte responsiveness in pregnancy. PMID- 3681859 TI - Frequency of low molecular weight IgM in human cord blood. AB - Thirty cord blood sera from healthy neonates and five sera from still-born infants (two with suspected infections and high IgM) were assessed for the presence of low molecular weight (LMW) IgM using two independent sensitive techniques, viz. filtration chromatography and immunoblotting. The first technique revealed this LMW moiety in 4 of 22 sera, all from healthy full-term infants, and it constituted 4-25% of the total IgM. LMW IgM was not found in any of the 30 sera using the immunoblotting technique or in 15 healthy adult sera, but was found consistently in rheumatoid sera used as positive controls. PMID- 3681860 TI - Effect of peritoneal washings from women with endometriosis on sperm velocity. AB - In a prospective study the author measured the "before" and "after" effects of in vitro washing and capacitation on sperm characteristics in 25 normospermic men using a microcomputerized system for semen analysis. Each fresh semen sample was divided into aliquots and assigned to one of four groups: group I--untreated sperm; group II--sperm capacitated with Ham's F-10 medium enriched with 20% decomplemented human serum (HHS); group III--sperm capacitated with HHS to which had been added 10% peritoneal washings in 5% dextrose and lactated Ringer's injection obtained from women of proven fertility at the time of laparoscopic tubal ligation; and group IV--sperm capacitated with HHS to which had been added 10% peritoneal washings in D5RL obtained from women with endometriosis (American Fertility Society stages I and II) diagnosed at the time of diagnostic laparoscopy. Semen characteristics, including sperm velocity, percent motility and motility index, in group II were all significantly improved over those in group I. The addition of peritoneal washings to the capacitation medium (group III) did not further improve the indices except for percent motility, which was significantly increased over that in group II (P less than .01). The addition of peritoneal washings from women with proven endometriosis to the capacitation medium, however, had a marked and statistically significant (P less than .0001) detrimental effect. These results suggest that the adverse effect of endometriosis on fertility may be biochemically mediated. PMID- 3681861 TI - Standardizing microcolposcopy. Assessing the criteria for evaluating the presence and degree of cervical intraepithelial neoplasia. AB - We established criteria for the detection and grading of cervical intraepithelial neoplasia with microcolposcopy. These criteria were assessed for their accuracy through comparison with the histologic evaluation of cone biopsy or hysterectomy specimens in 26 highly selected cases. There was a positive correlation of 88.5% and no false-negative cases. Microcolposcopy, performed in a standardized manner, may be a valuable adjuvant to colposcopy. PMID- 3681862 TI - Schistocytosis, aminotransferase elevation and thrombocytopenia in preeclampsia/eclampsia. AB - Some preeclamptic patients have schistocytosis, abnormal liver function tests and thrombocytopenia. To determine how strongly these three abnormalities cluster with each other, a sequential series of 49 preeclamptic or eclamptic patients was analyzed for the presence of schistocytosis, serum aminotransferase elevation and thrombocytopenia. These three abnormalities were found less often together (the HELLP syndrome) than singly or in pairs. These data do not clearly separate HELLP patients from other preeclamptic patients. PMID- 3681863 TI - Hepatic dysfunction, thrombocytopenia and late-onset preeclampsia. A report of three cases. AB - The diagnosis of preeclampsia near term is seldom difficult, even when complicated by altered liver function, hemolysis and thrombocytopenia. Three patients recently presented before term with thrombocytopenia, abnormal liver function tests and hemolytic anemia (two cases), with development of hypertension and proteinuria after days to weeks. Numerous disease processes during pregnancy are characterized by a similar presentation. Many of these cases may represent severe preeclampsia, previously unrecognized. PMID- 3681864 TI - Peripartum congestive cardiomyopathy and endocardial fibroelastosis associated with ritodrine treatment. A case report. AB - Congestive cardiomyopathy from endocardial fibroelastosis occurred in a 24-year old primigravida with a twin gestation and preeclampsia. The patient was taking ritodrine for premature labor. Cardiovascular evaluation should be performed during the course of ritodrine treatment, and no patient should be discharged if she does not have normal cardiovascular function. PMID- 3681865 TI - Should patients read their own medical records? PMID- 3681866 TI - Alcohol, seizures and epilepsy. PMID- 3681867 TI - An inner-city general medical ward round in the mid-1980s. AB - Few patients seen in 1983 on a general medical ward round in an inner-city hospital presented difficulty in diagnosis or management. Most had major social problems, especially from alcohol, self-neglect and dementia. PMID- 3681868 TI - Five-year follow up of patients treated with inpatient psychotherapy at the Cassel Hospital for Nervous Diseases. AB - Twenty-eight patients who were admitted consecutively to a single-adult unit of the Cassel Hospital in 1977/8 were followed up 5 years after discharge. Those who were found to have improved at the end of treatment remained well 5 years later. These could be distinguished by their combination of neurotic psychopathology, considerable depression, superior intelligence, and lack of a chronic outpatient history. Patients who had improved 5 years after discharge did not show these characteristics, but had all spent at least 9 weeks on the waiting list and had the capacity to form close and helpful relationships. Patients who were judged to have improved were less dependent on the Health Service and their economic productivity was improved, often as a consequence of returning to education or training. Those who did not improve clinically continued to be admitted to hospital and tended to become less economically productive. PMID- 3681869 TI - Indices of disease activity in psoriatic arthritis. AB - Psoriatic arthritis (PA) may respond to disease-modifying antirheumatic therapy. The value of assessing disease activity with indices devised for rheumatoid arthritis (RA) was investigated in 72 patients with seronegative PA. Thirty patients had a peripheral polyarthritis including the distal interphalangeal joints (DIPJs) and 15 a symmetrical arthritis sparing DIPJs (RA-like). Significant correlations (Spearman rank test) were seen between the clinical variables (pain score, grip strength, Ritchie articular index and a summated index of disease activity) in these two groups. Ten patients with a markedly asymmetrical arthritis showed a poor correlation between clinical variables. Although the objective indices - erythrocyte sedimentation rate (ESR) and C reactive protein - correlated together in the first two groups, the ESR correlated solely with clinical indices, and then only in RA-like patients. These results cast some doubt on the value of assessment methods based on RA when evaluating subgroups of PA other than RA-like disease. PMID- 3681870 TI - Haematuria analysed--a prospective study. AB - One hundred consecutive cases of haematuria were studied prospectively. The results showed a high proportion (52%) of serious urological disease. The need for thorough investigation of even minor degrees of haematuria is again emphasized. PMID- 3681871 TI - Intractable trigeminal neuralgia. AB - In 49 cases of trigeminal neuralgia seen at the Abingdon Pain Relief Unit, Oxfordshire, the average time between initial onset of pain and first referral to the unit was 9.8 years. The pattern of presentation and distribution was no different from previously published studies, indicating that the more intractable cases cannot be predicted at first presentation. PMID- 3681872 TI - Diphtheria in an elderly woman: unexpected sequelae. PMID- 3681873 TI - Tunnel vision presenting as reading disability. PMID- 3681875 TI - Autologous blood transfusion. PMID- 3681874 TI - Hypercalcaemia in primary squamous cell carcinoma of the stomach. PMID- 3681876 TI - Hypotension and blood loss. PMID- 3681877 TI - Porokeratosis and immunosuppression. PMID- 3681878 TI - Harmful aspects of keeping pet birds. PMID- 3681879 TI - Third Faculty Day, Faculty of Veterinary Science, University of Pretoria: opening speech. PMID- 3681880 TI - Faculty of Veterinary Science, Medical University of Southern Africa: the first five years. PMID- 3681881 TI - National disasters and the veterinarian. AB - A general introduction detailing background information concerning the term "disaster" is presented. A discussion of pertinent legal guidelines and an overview of the possible role of the veterinarian, firstly as a paramedical assistant and secondly as a veterinary public health official, is presented. PMID- 3681882 TI - Antibiotic serum activities against bacterial isolations from cases of bovine pneumonic pasteurellosis in feedlot calves. AB - The serum bactericidal activity test was carried out in two groups of 7 calves each suspected to be suffering from pneumonic pasteurellosis. The diagnosis was based on clinical signs, endoscopic examination and bacteriological investigations. The first group of seven calves received oxytetracycline at a dosage rate of 10 mg kg-1 once a day. A second similar group received penicillin at 30,000 IU kg-1 once a day. Results showed that the correlation between antibiograms, serum bactericidal activity and clinical response may be good for oxytetracyclines and poor for penicillin. The serum bactericidal activity test may be a good method to establish effective dosages for certain antibiotics in the treatment of pneumonic pasteurellosis. PMID- 3681883 TI - Bovine brucellosis in the Highveld Region. 1. Effect of delay in transit on rose bengal test results. AB - Although the incidence of false negative rose bengal plate test (RBPT) results on sera which were delayed in transit for one to 17 days was greater than 0.65%, up to 7.2% of such reactions occurred in one infected herd. Since no correlation between the incidence of false negative RBPT results and delay in sera in transit could be found, it was postulated that this type of reaction should be attributed to animals in the early incubation stage of the disease or to individual variation in the rate of response to the RBPT; a problem which should resolve itself during consecutive tests. Blood samples taken from herds to be sold at sales or public auctions, however, should all be tested by the complement fixation test. No correlation between the serum agglutination test and complement fixation test results were noted except where serum agglutination test titres exceeded 134 IU ml-1. PMID- 3681884 TI - Thoroughbred blood serum inorganic phosphate concentrations in relation to feeding regime and racing performance. AB - Horses receiving a pelleted or cubed dietary supplementation with roughage, have serum inorganic phosphate (SIP) concentrations consistently below an accepted mean of 1,032 mmol l-1 or 3, 1 mg dl-1. Further, it has been reported that the best eight, two-year-old Irish Thoroughbred track performers of 51 horses tested over a 10 month period, had significantly lower SIP concentrations than the worst eight track performers. In an endeavour to assess any nutritive effect on SIP concentrations and also to assess any effect of SIP concentrations on track performance, metabolic blood profiles from 303 horses in training at the Summerveld Training centre in Natal, were evaluated for various blood parameters over a two year period. Of these 303 profiles, 264 were analysed for SIP concentrations. These horses were on three known feeding regimes viz. Feed 1- cube feeding plus hay; Feed 2--oats, wheaten bran and greens plus hay; Feed 3- Mixed feeding regime of feeds 1 and 2; Feed 4--unknown regime. Dry matter intake varied between 2 and 2.5% of estimated bodymass and in the Feed 1 regime, the proportion of cubed supplement in the diet was increased from 30 to 70% as the training programme progressed. Statistical analysis of SIP concentrations showed that horses on the Feed 1 regime had significantly lower SIP concentrations than horses on the other feed regimes. Of the 303 profiles, 224 could be identified with actual races.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3681885 TI - The pathology of a case of biliary atresia in a foal. AB - The pathological features of biliary atresia in a foal are described. A 4-week old American Saddler foal was presented for autopsy following an illness characterised by clinical features indicative of hepatic failure. The significant macroscopical lesions occurred in the liver which was extremely enlarged, mottled in appearance and indurated. Bile stasis was evident. Lobular distinction was absent and on sectioning, large bile ducts were absent. A moderate ascites, hydrothorax and hydropericardium and a mild anasarca and intermuscular oedema accompanied the hepatic lesion. The diagnosis of biliary atresia was determined by the histo-pathological features of bile duct proliferation and extensive replacement fibrosis. The condition is compared to extrahepatic and intrahepatic biliary atresia of man and evidence is presented for regarding this case to be one of extrahepatic origin. PMID- 3681886 TI - Haemonchus contortus resistance to ivermectin. PMID- 3681887 TI - Synthesis of antimicrobial agents. 1. Syntheses and antibacterial activities of 7 (azole substituted)quinolones. AB - A series of 6-fluoro- and 6,8-difluoro-7-(azole substituted)-1,4-dihydro-4-oxo-3 quinolinecarboxylic acids were prepared. Structure-activity relationship studies indicated that the antibacterial potency was better when the 6,8-substituents were fluorine atoms and the 7-substituent was either 1-imidazolyl, 20, or 4 methyl-1-imidazolyl, 25. From the results of studies on pharmacokinetic profile and toxicity, 20 and 25 were found to possess excellent antibacterial activities and to show high blood levels after oral administration to mice with low toxicity. PMID- 3681888 TI - Antitumor activity of bis(diphenylphosphino)alkanes, their gold(I) coordination complexes, and related compounds. AB - Bisphosphines related to bis(diphenylphosphino)ethane (dppe) and their gold complexes are described that are active in a spectrum of transplantable tumor models. When administered ip on days 1-5 at its maximally tolerated dose (MTD) of 40 mumol/kg, dppe reproducibly gives 100% increase in life span (ILS) in mice bearing ip P388 leukemia. Coordination of chlorogold(I) to each phosphine in dppe gave a complex that had similar activity but at a much lower dose level than dppe; the MTD for the gold(I) complex was 7 mumol/kg. Among other metal complexes of dppe, the Au(III) complex was active (greater than 50% ILS) whereas Ag(I), Ni(II), Pt(II), Pd(II), and Rh(I) complexes were inactive. Among dppe analogues, replacement of phenyl groups with ethyl or benzyl groups resulted in inactivity for both ligands and the corresponding gold complexes whereas substitution with cyclohexyl or heterocyclic ring systems yielded ligands and/or gold complexes with antitumor activity. Among substituted-phenyl dppe and dppe(AuCl)2 analogues, 3-fluoro, 4-fluoro, perdeuterio, 4-methylthio, and 2-methylthio analogues were active; 4-methyl, 3-methyl, 4-methoxy, 4-dimethylamino, and 4-trifluoromethyl analogues were marginal or inactive. Analogues in which the ethane bridge of dppe or dppe(AuCl)2 was varied between one and six carbons, unsaturated or substituted, revealed that activity was maximal with ethane or cis-ethylene. Compounds with good P388 activity were also active in other animal tumor models. PMID- 3681890 TI - Inhibition of phenylethanolamine N-methyltransferase (PNMT) by aromatic hydroxy substituted 1,2,3,4,-tetrahydroisoquinolines: further studies on the hydrophilic pocket of the aromatic ring binding region of the active site. AB - In a continuation of studies directed toward characterizing the hydrophilic pocket within the aromatic ring binding region of the active site of phenylethanolamine N-methyltransferase (PNMT), 5-, 6-, 7-, and 8-hydroxy-1,2,3,4 tetrahydroisoquinoline were prepared and evaluated as substrates and inhibitors of PNMT. In order to discern the necessity of an acidic hydrogen for interaction at this pocket the corresponding methyl ethers were also evaluated. The enhanced affinity of 7-hydroxy-1,2,3,4-tetrahydroisoquinoline (16) versus tetrahydroisoquinoline (13) itself indicates that a hydrophilic pocket exists off of carbon C7 in bound tetrahydroisoquinolines. The diminished affinity of the corresponding methyl ether is consistent with a requirement for the acidic hydrogen of 16 for interaction of the aromatic hydroxyl at this site. From the relative activities of the other regioisomeric aromatic hydroxyl-substituted tetrahydroisoquinolines, their corresponding methyl ethers, and 6,7-dihydroxy 1,2,3,4-tetrahydroisoquinoline, it appears that the hydrophilic pocket is spatially compact with respect to bound tetrahydroisoquinolines and is surrounded by larger areas of lipophilic character. To allow a comparison of the results of this study with previous data on bound beta-phenylethylamines, the methyl ethers of 5-, 6-, 7-, and 8-hydroxy-exo-2-aminobenzonorbornene and of 5- and 6-hydroxy anti-9-aminobenzonorbornene were also evaluated for their activity as substrates and inhibitors for PNMT. The results of this study are in agreement with previous findings for bound beta-phenylethylamines and support the conclusion that the natural substrate for PNMT, norepinephrine, has a different active site binding orientation than most known substrates and competitive inhibitors of the enzyme. PMID- 3681891 TI - Novel 1H-benzimidazol-4-ols with potent 5-lipoxygenase inhibitory activity. AB - The synthesis and structure--activity profile of 2-substituted benzimidazol-4-ols as inhibitors of cell-free RBL-1 5-lipoxygenase are discussed, and their potency is compared with that of the standard inhibitors phenidone, AA 861, BW 755C, and nordihydroguaiaretic acid. In contrast to the standard compounds, most did not inhibit the release of slow-reacting substance of anaphylaxis (SRS-A) in vivo when administered at 200 microM ip to rats subjected to peritoneal anaphylaxis, although five compounds containing a methoxylated benzyl group (compounds 36, 39, 42, and 43) or hydroxylated benzyl group (41) showed similar activity to that of phenidone, nordihydroguaiaretic acid, and AA 861. Of the many compounds tested, two, 5-tert-butyl-7-methyl-2-(trifluoromethyl)-1H-benzimidazol-4-ol (57) and 2-(4 methoxybenzyl)-7-methyl-1H-benzimidazol-4-ol (36), like dexamethasone, inhibited monocyte accumulation in a pleural exudate model of inflammation. Standard lipoxygenase inhibitors such as phenidone, BW 755C, and AA 861 were inactive in this system. PMID- 3681889 TI - Binding orientation of amphetamine and norfenfluramine analogues in the benzonorbornene and benzobicyclo[3.2.1]octane ring systems at the active site of phenylethanolamine N-methyltransferase (PNMT) AB - In a continuation of studies directed at characterizing the conformational basis of binding beta-phenylethylamines at the active site of phenylethanolamine N methyltransferase (PNMT), anti-10-amino- (12) and syn-10-amino-5,6,7,8-tetrahydro 5,8-methano-9H-benzocycloheptene (13) were prepared and evaluated as substrates and inhibitors for PNMT. These conformationally defined amphetamine analogues mimic a low energy half-chair form of 2-aminotetralin (2AT). Further, in order to determine the active site binding orientation of beta-phenylethylamines bearing aryl lipophilic substituents, the aryl trifluoromethyl-substituted derivatives of 12 and 13 (20-27), as well as anti-9-amino-5-(trifluoromethyl)-(18) and anti-9 amino-6-(trifluoromethyl) benzonorbornene (19), were prepared and evaluated. The competitive inhibition displayed by the fully extended analogue 12 coupled with the uncompetitive kinetics exhibited by the folded isomer 13 supports previous findings that a fully extended side chain conformation is optimal for binding to the active site of PNMT. In addition, the fact that 12 displayed enhanced affinity as an inhibitor over its beta-phenylethylamine counterparts in the benzonorbornene and 1,4-ethanonaphthalene ring systems suggests that a half-chair conformation is preferred when 2AT analogues interact at the active site of the enzyme. This would be consistent with previous results that PNMT preferentially binds molecules with a more coplanar relationship between the aromatic ring and the amino nitrogen. The lack of activity as a substrate in 12 indicates that the negative steric interactions of the ethano bridging unit prohibits it from binding in a manner consistent with the known PNMT substrates exo-2-amino- (6) and anti-9-aminobenzonorbornene (8). Given the emergence of activity as a substrate in 20 and 21 (the 1-trifluoromethyl- and the 2-trifluoromethyl substituted derivatives of 12), it appears that the positive interaction of the trifluoromethyl group orients these analogues in a manner in which the ethano bridge lies in regions of steric bulk tolerance. This would suggest that the region of steric intolerance has a degree of directionality. Finally, although the aromatic ring binding region of the active site of PNMT contains a large degree of lipophilic character, only specific spatial orientations between the trifluoromethyl group and the amino nitrogen of aryl trifluoromethyl-substituted beta-phenylethylamines allow both to interact simultaneously in a manner that allows the amine to bind in a region of the active site in which methylation can occur. PMID- 3681892 TI - N-substituted oxopyrimidines and nucleosides: structure-activity relationship for hypnotic activity as central nervous system depressant. AB - N3-Benzyluridine (3-(phenylmethyl)-1-beta-D-ribofuranosyluracil) (1f) and its related compounds were synthesized and evaluated for hypnotic activity as central depressants. The primary structural modification has been carried out at the N3 position of the pyrimidine ring in uridine. N3-Benzyl-substituted uridine exhibited hypnotic activity as well as pentobarbital (PB) induced sleep effect on mice when administered by intracerebroventricular (icv) injection. From this result, the secondary modification was performed, namely, converting the benzyl group into a benzyl analogous group. These compounds also showed hypnotic activity, but their intensities were varied. Thirdly, changing the sugar moiety was investigated; however, it was found to be necessary for hypnotic activity. In general, introduction of benzyl analogous groups at the N3 position of uridine increased the hypnotic activity, and modification of the sugar moiety decreased the activity. Intravenous (iv) administration failed to indicate hypnotic activity in most of the compounds tested. However, modified sugars such as 2',3',5'-tri-O-methyl or -acetyl derivatives of 1f elicited hypnotic activity by iv injection. The majority of compounds were found to show potentiation of the PB induced sleep, and their effects were in parallel with the hypnotic activity. The result clearly indicates that the benzyl group and beta-D-ribofuranosyl, at the N3 and N1 positions, respectively, are necessary for hypnotic activity. The critical portion of the chemical structure for both effects appears to be the uridine moiety. PMID- 3681893 TI - New antifilarial agents. 1. Epoxy sulfonamides and ethynesulfonamides. AB - Two series of 2-substituted 1,2-epoxyethanesulfonamides 2 and ethynesulfonamides 5 were synthesized and evaluated for their antifilarial activity. The trans epoxides 2T were stereospecifically prepared by a Darzens reaction between aldehydes and halomethanesulfonamides. The cis isomers 2c were obtained from ethynesulfonamides 5 by semihydrogenation followed by KOCl epoxidation. 2 Substituted ethynesulfonamides 5 were synthesized from appropriate trans ethenesulfonamides by a bromination/dehydrobromination sequence. These products, as well as several synthetic intermediates, were evaluated for antifilarial activity against Molinema dessetae either in vivo in its natural host, the rodent Proechimys oris, or in vitro by a new test using cultures of the infective larvae. Most of the epoxides 2T and acetylenic derivatives 5 bearing a 2-aryl substituent were active in vitro. Among these compounds, four epoxides 2T and one acetylenic derivative 5 showed marked macrofilaricidal activity in vivo without any microfilaricidal activity. The differences between the in vivo and in vitro results may be due, in part, to the low chemical stability of the epoxy sulfonamides 2T. Despite this limitation, the activities observed in this reliable animal model suggest further development and testing of both series 2T and 5 as macrofilaricides. PMID- 3681894 TI - Synthesis of new antiinflammatory steroidal 20-carboxamides: (20R)- and (20S)-21 (N-substituted amino)-11 beta,17,20-trihydroxy-3,21-dioxo-1,4- pregnadiene. AB - The synthesis and antiinflammatory activities of new steroidal 20-carboxamides, (20R)- and (20S)-21-(N-substituted amino)-11 beta,17,20-trihydroxy-3,21-dioxo-1,4 pregnadiene are described. These compounds were prepared from the respective isomer of 20-dihydroprednisolonic acid, (20R)- and (20S)-11 beta,17,20-trihydroxy 3-oxo-1,4-pregnadien-21-oic acid, by coupling with primary amines after the activation of the steroid acid with N,N1-dicyclohexylcarbodiimide (DCC) and 1 hydroxybenzotriazole. Confirmation of the configurational assignment at C-20 of the 20-carboxamides was achieved by reduction of methyl (20R)- and (20S)-11 beta,17,20-trihydroxy-3-oxo-1,4-pregnadien-21-oate to the known stereochemistry at C-20 of (20R)- and (20S)-11 beta,17,20,21-tetrahydroxy-3-oxo-1,4-pregnadiene The topical antiinflammatory activities of these steroidal 20-carboxamides were assessed by the croton oil induced ear edema assay and their local and systemic antiinflammatory activities by the cotton pellet granuloma bioassay. Results of these investigations suggest a structure-activity relationship where carboxamide derivatives with the 20(R)-hydroxy configurations exhibit higher potency than those with the 20-(S)-hydroxy configurations. The amides of steroidal 21-oic acids with high local antiinflammatory potency exhibited systemic activities unlike the corresponding esters of steroidal 21-oic acids, which are devoid of systemic activities. PMID- 3681895 TI - Synthesis and 5-hydroxytryptamine antagonist activity of 2-[[2 (dimethylamino)ethyl]thio]-3-phenylquinoline and its analogues. AB - A series of 2-[(2-aminoethyl)thio]quinolines substituted at the 3-position with alkyl, aryl, or heteroaryl groups has been prepared in the search for novel and selective 5-HT2 antagonists. The affinity of the compounds for 5-HT1 receptor sites was measured by their ability to displace [3H]-5-HT from rat brain synaptosomes whereas the affinity for 5-HT2 receptor sites was measured by their ability to displace [3H]spiperone from synaptosomes prepared from rat brain cortex. The 5-HT2 antagonist properties of the compounds were measured in vivo by their antagonism of 5-hydroxytryptophan-induced head twitches in the mouse and by their antagonism of hyperthermia induced by fenfluramine (N-ethyl-alpha-methyl-m (trifluoromethyl)phenethylamine hydrochloride) in the rat. The structure-activity relationships in this series are discussed and the properties of 2-[[2 (dimethylamino)ethyl]thio]-3-phenylquinoline hydrochloride (70) are highlighted. PMID- 3681896 TI - Synthesis and cardiac electrophysiological activity of 2- and 3-[(substituted phenyl)alkyl]quinuclidines. Structure-activity relationships. AB - The syntheses and cardiac electrophysiological effects of 21 2- and 3-substituted quinuclidines and some quaternary ammonium derivatives are described. The 2 substituted quinuclidines 2-8 were prepared by alkylation of 2-methylene-3 quinuclidinone. The Wittig reaction with 3-quinuclidinone afforded the 3 substituted derivative 9, which was subsequently converted to 10 and 11. The electrophysiological profiles of the compounds were determined in canine cardiac Purkinje fibers and ventricular muscle strips. The 3-[(substituted phenyl)alkyl]quinuclidines selectively increased action potential duration (Vaughan Williams class III activity). In the 2-substituted series some of the compounds both increased action potential duration and decreased conduction velocity (class I activity). For some of the 2-substituted quinuclidines, appropriate substitution of the phenyl ring was shown to be a requirement for significant class III electrophysiological activity. Selected compounds were efficacious in a programmed electrical stimulation model in the anesthetized dog. PMID- 3681897 TI - 2-Oxo-1,8-naphthyridine-3-carboxylic acid derivatives with potent gastric antisecretory properties. AB - The syntheses of 2-oxo-1,8-naphthyridine-3-carboxylic acid derivatives having potent gastric antisecretory properties in the pyloric-ligated (Shay) rat model are described. Two of the more potent compounds tested that were selected for more detailed dose-response evaluation were 4-amino-1-ethyl-1,2-dihydro-2 oxonaphthyridine-3-carboxylic acid ethyl ester (35) and 1-ethyl-1,2-dihydro-7 methyl-4-(4-methyl-1-piperazinyl)-2- oxo-1,8-naphthyridine-3-carboxylic acid ethyl ester (77). These compounds lowered total acid output in the rat in a dose related fashion. Both compounds were more potent than cimetidine when tested in the rat. Both 35 and 77 showed inhibitory activity in food-stimulated acid secretion in the Pavlov-pouch, conscious dog. The mechanism of action for this series is not known. Details of structure-activity relationships are described. PMID- 3681898 TI - Thromboxane synthetase inhibitors and antihypertensive agents. 4. N-[(1H-imidazol 1-yl)alkyl] derivatives of quinazoline-2,4(1H,3H)-diones, quinazolin-4(3H)-ones, and 1,2,3-benzotriazin-4(3H)-ones. AB - The quinazolinedione, quinazolinone, and 1,2,3-benzotriazinone title compounds were prepared as analogues of N-[(1H-imidazol-1-yl)alkyl]-1H-isoindole-1,3(2H) diones which were the subject of a previous report from our laboratories. These compounds were evaluated as thromboxane (TX) synthetase inhibitors and as antihypertensive agents. While each series of compounds had activity both as TX synthetase inhibitors and as antihypertensives, the best compounds were N-[(1H imidazol-1-yl)alkyl]quinazoline-2,4(1H,3H]-diones (V). In general these compounds were all selective enzyme inhibitors at least equipotent with the standard dazoxiben. These compounds were also very active antihypertensive agents as determined in SHR. The SAR is discussed for both types of activity. Compound 20a was further evaluated for TX formation inhibiting properties in several other platelet types both in vitro and ex vivo and is between 100 and 1000 times more potent than dazoxiben. PMID- 3681899 TI - [(6,7-Dichlorobenzo[b]thien-5-yl)oxy]acetic acids and 1,1-dioxides. 1. A structurally novel class of diuretics with hypotensive activity. AB - A series of [(6,7-dichlorobenzo[b]thien-5-yl)oxy]acetic acids and their corresponding 1,1-dioxides were synthesized and evaluated for diuretic activity in the acute saline loaded mice (ASLM) and hypotensive activity in the spontaneously hypertensive rat (SHR). A significant number of compounds were found to display potent activity in one or both assays, and preliminary structure activity relationships with respect to each assay were delineated. Compound 94, the 1,1-dioxide of [(6,7-dichloro-2-n-propylbenzo[b]thien-5-yl)oxy]acetic acid was markedly active in both the ASLM and SHR by oral administration. The combined diuretic/hypotensive profile of this compound was further substantiated by its good saluretic response in water loaded conscious dogs and a moderate to good activity in renal hypertensive rats and sinoaortic-deafferented hypertensive dogs. PMID- 3681900 TI - Synthesis and antiarrhythmic activity of novel 3-alkyl-1-[omega-[4 [(alkylsulfonyl)amino]phenyl]-omega- hydroxyalkyl]-1H-imidazolium salts and related compounds. 2. AB - Novel analogues of the class III antiarrhythmic agent 1-[2-hydroxy-2-[4 [(methylsulfonyl)amino]phenyl]ethyl]-3-methyl-1H- imidazolium chloride, 1 (CK 1649), were prepared and investigated for their class III electrophysiological activity on isolated canine cardiac Purkinje fibers and ventricular muscle tissue. Structure-activity relationships are discussed for a series of 11 compounds. One compound, N-[4-[1-hydroxy-2-(4,5-dihydro-2-methyl-1H-imidazol-1- yl)ethyl]phenyl]methanesulfonamide hydrochloride, 9, was comparable in activity to 1 in vitro and prolonged the functional refractory period in anesthetized dogs when given intraduodenally. Unlike 1, compound 9 was ineffective at preventing ventricular tachycardia induced by programmed electrical stimulation in anesthetized dogs 24 h after an acute myocardial infarction. PMID- 3681901 TI - Design and synthesis of peptide derivatives of a 3-deoxy-D-manno-2-octulosonic acid (KDO) analogue as novel antibacterial agents acting upon lipopolysaccharide biosynthesis. AB - On the basis of the knowledge that the amino acid 3 (8-amino-2,6-anhydro-3,8 dideoxy-D-glycero-D-talo-octonic acid) is a potent inhibitor of 3-deoxy-manno octulosonate cytidylyltransferase, attempts were made to design derivatives that would act as antibacterials against Gram-negative bacteria by inhibiting lipopolysaccharide biosynthesis. Compound 3 and the derivatives 15 and 16 containing an additional amino acid were not lethal to bacteria. However, compounds 17-22, which contain a N-terminally linked dipeptide, exhibited good antibacterial activity in vitro on testing against strains of the Gram-negative bacteria Escherichia coli and Salmonella typhimurium. They have no activity against Gram-positive bacteria such as Staphylococcus aureus. PMID- 3681902 TI - Plant antitumor agents. 28. Resolution of a key tricyclic synthon, 5'(RS)-1,5 dioxo-5'-ethyl-5'-hydroxy-2'H,5'H,6'H-6'-oxopyrano[3' ,4'- f]delta 6,8-tetrahydro indolizine: total synthesis and antitumor activity of 20(S)- and 20(R) camptothecin. AB - The resolution of the tricyclic ketone (3a + 3b) by the separation of diastereomeric adducts 4a and 4c of the precursor ketal 5 is described. The regenerated enantiomers 3a and 3b of 100% optical purity represent the key intermediates from which 20(R)-camptothecin (1a) and 20(S)-camptothecin (1b), respectively, have been prepared. The 20R analogue 1a was 10-100 times less active than the natural 20(S)-camptothecin (1b) in 9KB and 9PS cytotoxicity assays and almost inactive in in vivo L-1210 leukemia tests as compared to the highly potent and active natural compound 1b. PMID- 3681903 TI - The effect of hydroxyurea on the expression of the common fragile site at 3p14. AB - Hydroxyurea (HU) is an inhibitor of DNA synthesis, which can inhibit the enzyme ribonucleotide reductase, reduce the syntheses of all four deoxyribonucleoside diphosphates (dNDP), and disturb the balance of the dNTP pool. We have studied the effect of HU on the common fragile site at 3p14 (FRA3B) and have found that G2 treatment with HU increased not only the frequency of chromosomal aberration but also the expression of FRA3B in both complete and folate deficient media. There is a synergistic effect between HU and growth in folate deficient medium on the induction of FRA3B. Our results suggest that the inhibition of DNA repair, including the inhibition in G2 phase, plays an important role in the expression of FRA3B, supporting other authors' data on the effect of other DNA repair inhibitors, such as aphidicolin, caffeine, 1-beta-D-arabinofuranosylcytosine, and 5-fluorodeoxyuridine, on the expression of FRA3B. PMID- 3681904 TI - A family with spondyloepimetaphyseal dwarfism: a 'new' dysplasia or Kniest disease with autosomal recessive inheritance? AB - We present an Arab family with some features of Kniest disease. The proband was a six year old boy with rhizomelic short limbed dwarfism, 'dish-like' facies, cleft palate, deafness, and camptodactyly. Most radiological changes were compatible with Kniest disease. Two younger sibs, similarly affected, had died at a few months old, and the pedigree shows strong evidence of autosomal recessive inheritance, unlike previously reported cases of Kniest disease which have shown autosomal dominant inheritance. PMID- 3681905 TI - Epiphyseal dysplasia of the femoral head, mild vertebral abnormality, myopia, and sensorineural deafness: report of a pedigree with autosomal dominant inheritance. AB - A family is presented with short stature, femoral epiphyseal dysplasia, mild vertebral changes, and sensorineural deafness inherited as an autosomal dominant trait. Myopia and retinal detachment presenting in adult life were also present in some affected members. We suggest that this disorder may be a distinct entity within the spondyloepiphyseal dysplasia group of disorders. PMID- 3681906 TI - Association of tetra-amelia, ectodermal dysplasia, hypoplastic lacrimal ducts and sacs opening towards the exterior, peculiar face, and developmental retardation. AB - A male child with tetra-amelia, hypotrichosis, upward slanting palpebral fissures, lack of lacrimal openings, hypoplastic lacrimal ducts and sacs opening towards the exterior, prominent and bulbous nose, large downturned mouth, high narrow palate, bilateral preauricular pits, sacral dimple, bilateral undescended testes, and developmental retardation is reported. The parents were second cousins. His karyotype on cultured blood lymphocytes was normal. Since the next fetus conceived by the mother was found on prenatal ultrasonography to have no limbs, abortion was induced. The face of the abortus closely resembled that of the proband. It is postulated that this malformation syndrome was due to the homozygous state of a rare autosomal recessive mutation. PMID- 3681907 TI - Hydatidiform mole: parental chromosome aberrations in partial and complete moles. AB - The relationship between parental constitutional chromosome abnormalities and the development of hydatidiform mole was evaluated in series from four institutions. Karyotype analysis was performed on blood samples from 237 patients with a pathological diagnosis of complete mole and 217 of their spouses. One patient was found to have a constitutional balanced translocation, t(11;18), while one spouse was found to have a balanced translocation, t(4;20). Among 125 patients with partial mole and 106 of their spouses, one male was found to be a translocation carrier, t(13;14). No significant increase in the frequency of translocations in the parents of complete moles was found in any of the series considered separately or together. Data from the combined series show no evidence of constitutional parental chromosome aberrations as an aetiological factor in the development of molar pregnancies. PMID- 3681908 TI - Goldenhar syndrome and overlapping dysplasias, in vitro fertilisation and ovopathy. AB - In contrast to the opinion of Yovich et al, who documented Goldenhar syndrome in one of possibly monozygous twin brothers conceived by in vitro fertilisation and embryo transfer, I suggest that ovopathy is the cause of this anomaly. The eight criteria which have to be met before a condition can be said to be caused by overripeness ovopathy are shown to be satisfied. My conclusion remains that, in general, sporadically occurring Goldenhar variants, as distinct from familial cases, should be considered to be just casualities in the broad 'continuum of reproductive wastage' seen in high risk conceptions, one of which is IVF. This concept increases our understanding of human variation not satisfactorily explained by Mendelian inheritance. PMID- 3681909 TI - Brachmann-de Lange syndrome in sibs. AB - We report an Arab family of phenotypically normal first cousin parents with two offspring showing variable manifestations of Brachmann-de Lange syndrome. The proband, who had many diagnostic symptoms of the syndrome with apparently normal chromosomes, died at the age of three months. His sister was less severely affected and lived for six years. The genetic basis of Brachmann-de Lange syndrome is discussed and homozygosity for an autosomal recessive allelle is suggested as an underlying cause in some cases. PMID- 3681910 TI - Prenatal diagnosis of haemophilia B in the first trimester. PMID- 3681911 TI - An unbalanced t(X;10) mat translocation in a child with congenital abnormalities. PMID- 3681912 TI - Abstracts of the meeting of the Clinical Genetics Society. 2 and 3 April 1987, Leicester. PMID- 3681913 TI - IVF and Goldenhar syndrome. PMID- 3681914 TI - Use of MCAT data in selecting students for admission to medical school. AB - In the spring of 1986, medical school admissions personnel were surveyed on their institutions' admissions practices and the use of Medical College Admission Test (MCAT) data in student selection. The admissions officers listed sources of information considered in processing applications. The variables accorded high importance were: overall and science undergraduate grade-point averages, quality of degree-granting institutions, letters of evaluation, interview ratings, MCAT scores, extracurricular activities, work in areas related to health care, breadth and/or difficulty of course work, and state of legal residence. Variables judged of medium importance were: nonscience grade-point average, graduate study, narratives supplied through the American Medical College Application Service or supplemental narratives, demographic factors, and undergraduate research. The respondents divided the 15-point MCAT scale into exemplary, acceptable, and unacceptable ranges of performance. These responses varied widely among institutions. The mean response for the bottom of the acceptable range was a score of seven, and the mean for the beginning of the exemplary range was 11. In considering individual MCAT subtest scores, 34 percent of the admissions officers regarded the six scores individually and equally, 51 percent weighted the areas in ways related to their curricula, and 43 percent summed or averaged scores with equal weights at some point. Thirty-one percent used MCAT scores to adjust grade point averages across undergraduate institutions. PMID- 3681915 TI - History of not completing courses as predictor of academic difficulty among first year students. AB - The study reported here was undertaken to determine whether the prediction of academic difficulty in the first year of medical school is enhanced by a consideration of the number of courses withdrawn from, repeated courses, and incomplete courses on a student's undergraduate academic record. All students enrolled from 1981 through 1985 at Southern Illinois University School of Medicine who experienced academic difficulty in the first year were selected for the study. Successful students were matched with these students in terms of minority or majority status and served as a control group. Discriminant and classification analyses were performed in a hierarchical stepwise manner to predict success or difficulty in the first year. The variables that were significant in discriminating between minority students who had academic difficulty and those who did not were the science grade-point average (grades in biology, chemistry, physics, and mathematics), the score on the reading subtest of the Medical College Admission Test (MCAT), and the number of withdrawals from courses. For majority students, the significant discriminating variables were the score on the MCAT biology subtest and the number of incompletes taken for courses. The results of this study have implications for medical school admissions committees, premedical advisers, and premedical students. PMID- 3681916 TI - Evaluation and redesign of a system to rank applicants for surgical residencies. AB - The present paper is a report of the evaluation and subsequent revision of a selection system for surgical house officers. The authors conducted a series of studies to determine the content validity, concurrent validity, and predictive validity of the system used by the surgery department prior to 1982. The results did not support the validity of that ranking system. In particular, the system was found not to evaluate candidates on criteria considered important by the faculty. Based on these findings, the department adopted a new ranking system organized around a multimethod-multitrait matrix (that is, using multiple methods to assess multiple traits) and based on a new set of traits that had been identified as important in the earlier validity studies. The new system has been used for five years, since 1982, with acceptance and favorable evaluation by the faculty. During that period, the median and mean rank of candidates who were matched to the residency program improved. PMID- 3681917 TI - Gender differences in practice characteristics of graduates of family medicine residencies. AB - A survey of 310 graduates of eight university-affiliated family medicine residencies in the northwestern United States conducted in 1985 revealed several significant differences between male and female graduates. The female graduates were significantly (p less than .05) more likely than male graduates to practice in urban settings, taking salaried positions, and work in nonprivate practice. With regard to practice content the women spent significantly (p less than .01) more time in the office setting, worked fewer hours per week in direct patient care, and reported doing fewer complex procedures in their practice than did the men. The women were more satisfied than the men with their income but equally satisfied as the men with their professional and personal lives. There were no significant gender differences with regard to concerns about liability and hospital privileges. The women felt significantly (p less than .05) less well prepared in several subject areas, especially surgical areas; hierarchical multiple-regression analysis showed that this difference persisted when analysis controlled for community size and practice setting. Possible explanations and implications are proposed. PMID- 3681918 TI - Impact of workshop on students' and physicians' rejecting behaviors in patient interviews. AB - The "dehumanization" process is often documented among medical students during their clinical clerkship and among physicians. This dehumanization is characterized by an increase in rejecting behaviors (manifested by sarcasm, verbal rejection, contempt, evading eye contact, and ignoring patients' verbal or nonverbal cues) and a decrease in supporting, empathic behaviors. In the study reported here, the authors observed rejecting behaviors during medical interviews and determined that participation in a workshop on supporting behaviors in the medical interview resulted in long-term decrease or abolishment of rejecting behaviors among medical students and physicians. PMID- 3681919 TI - Effect of early exposure to family medicine on students' attitudes toward the specialty. AB - In the study reported here, the authors examined the influence of clinical experiences of students on their choice of family medicine as a specialty. Attitudes toward family medicine were investigated among 172 first-year and 174 second-year students at the University of Minnesota Medical School--Minneapolis. Neither early exposure to role models in family medicine nor the order in which specialty clerkships were taken had a significant effect on the students' choice of family medicine as a specialty. PMID- 3681920 TI - Physical fitness of first-year medical students at the University of British Columbia. PMID- 3681921 TI - Prevalence of type A behavior among undergraduate students with medical and nonmedical career plans. PMID- 3681922 TI - A survey of journal clubs in U.S. family practice residencies. PMID- 3681923 TI - Attitudes of faculty members, residents, students, and community physicians toward health promotion. PMID- 3681924 TI - Effect of role-model clinicians on students' attitudes in a second-year course on introduction to the patient. PMID- 3681925 TI - Impact of several variables on physical examination skills of medical students. PMID- 3681927 TI - Fitness programs for medical students and faculty members. PMID- 3681926 TI - Effect of sleep deprivation on first-year residents' response times, memory, and mood. PMID- 3681928 TI - Counseling medical students. PMID- 3681929 TI - Baccalaureate-M.D. programs. PMID- 3681930 TI - An assessment of the consistency and accuracy of standardized patients' simulations. PMID- 3681932 TI - The 'half-life/turnover time' of medical information: discussion of an error. PMID- 3681931 TI - Deans' attitudes toward teaching psychopharmacology and rational prescribing in medical schools. PMID- 3681933 TI - Medicine-pediatric programs. PMID- 3681934 TI - Medical research. PMID- 3681935 TI - Predictive validity of specialty choice data from AAMC graduation questionnaire. Association of Medical Colleges. AB - Several previous studies have used data from the Association of American Medical Colleges' annual graduation survey to address questions about medical students' specialty preferences. Only recently, however, has it become possible to test the validity of these data as indicators of the specialties in which students will actually receive training. Comparisons of 1983 graduation questionnaire data with data on the third-year residencies for the same cohort reveal that the specialty preferences indicated on the questionnaire were good predictors of the residency programs the respondents were in during the third year following graduation. PMID- 3681936 TI - Illnesses and other causes of unexpected absences from work during residency training. AB - Unexpected absences from work due to illness and other reasons among residents in training cause scheduling difficulties and stress among residents. In 1986, 134 University of Rochester internal medicine and pediatric residents recorded the number of days they had been absent from work during their residency training and provided their opinions regarding the stress these absences caused and the effectiveness of the sick-call system for residents then in use in reducing such stress. They recorded a total of 469 days of absence from work due to illness and 140.5 days lost from work for other reasons. These 609.5 days represented 1.1 percent of the residents' scheduled workdays. According to the residents' responses, the sick-call system helped to provide coverage for the residents who were absent and reduced their stress and feelings of guilt because of the absence. The system also helped meet the programs' objective of teaching residents the importance of supporting their colleagues when circumstances require them to be absent from work. PMID- 3681937 TI - Understanding and teaching continuity of care. AB - Although continuity of care occupies a central position in the definition of primary care and is invoked as having evident importance in practice, research on the value of continuity has produced confusing and conflicting results. These results may be due to a lack of clarity in the definition of continuity of care. In this paper, the authors suggest that continuity includes three elements- cognitive, management, and relationship. Exploration of each of the elements expands the understanding of continuity in medical practice. Continuity of care can be evaluated in both undergraduate and residency programs by the application of criteria offered in this paper. PMID- 3681938 TI - Nursing home rounds as a format for teaching residents and medical students. AB - The nursing home has become a focus for education as well as patient care. A format was devised for nursing home rounds that provides for discussion among staff members and specialists and is aimed at teaching and the resolution of specific patient-care and administrative issues. This format is outlined, and records from these twice-weekly rounds are reviewed. The nursing home rounds were consistently attended by members of the nursing and medical staffs, trainees, and nursing and medical directors. As is apparent from the records of these rounds, many complex medical problems were handled without transferring the patients to an acute-care facility. The discussion among participants of specific clinical problems at nursing home rounds has proven invaluable as a tool for education and delivery of patient care. PMID- 3681939 TI - An elective in primary care internal medicine for students in the preclinical years. AB - A two-week elective to introduce first- and second-year medical students to primary care internal medicine was developed and evaluated. Course time is divided between conference sessions (25 percent) provided by full-time clinical faculty members and office experience (75 percent) provided by volunteer clinical faculty members (general internists in private practice and in prepaid health plans). Evaluations by the students (n = 58) who took the elective consisted of a questionnaire assessment of the conference session topics, the student's ability to carry out course objectives, and the preceptor's teaching activities. The conference topics were highly rated, with a mean score of 4.1 on a rating scale ranging from 1 (unfavorable) to 5 (favorable). The course objectives and teaching activities were also well rated, with a mean score of 4.1 and 3.9, respectively, on a rating scale ranging from 1 (none) to 5 (outstanding). PMID- 3681940 TI - Validity of MCAT scores as predictors of preclinical grades and NBME Part I examination scores. Medical College Admission Test. National Board of Medical Examiners. PMID- 3681941 TI - A four-year longitudinal study of personality changes in medical students. PMID- 3681942 TI - Evaluation of an interviewing skills course for second-year medical students. PMID- 3681943 TI - A one-week clinical elective taught in an ambulatory setting. PMID- 3681944 TI - A feasibility study of a robot manipulator for the disabled. AB - A robotic manipulator system appears to offer much potential for a severely handicapped person who has little or no hand function. Existing environmental control systems fulfil an important role, but are limited to preselected tasks. The robotic system described here aims to overcome such limitations by providing a user-controlled manipulative device, which is not restricted to preselected tasks. The paper describes the development of a system based on a relatively cheap desk-top mounted robotic device controlled by a microcomputer, in order to investigate the feasibility of such a system. The problems which have been encountered are the provision of user input commands from a person with limited control function, and also the progression from general control of the robot to the performing of useful domestic tasks. The paper also describes and discusses the results of a user survey and user trials. PMID- 3681945 TI - A method for testing volumetric pumps. AB - This article describes a convenient method of checking the delivery rate of volumetric pumps at low flow rate settings. The method employs a tester previously described for use with syringe pumps. PMID- 3681946 TI - Evaluation report: nursing incubators. PMID- 3681947 TI - A simple device for the direct measurement of mean arterial pressure and for calibration of arterial pressure monitors. PMID- 3681948 TI - An investigation into the role of antigen presenting cells in immunoglobulin synthesis in vitro. AB - Controversy surrounds the respective roles of the monocyte-macrophage series of cells and dendritic (veiled) cells (DC) in the processes involved in antigen presentation. To try to examine this question we have investigated the influence of these accessory cell populations in vitro on pokeweed mitogen (PWM) driven IgG synthesis by peripheral blood mononuclear cells (PBM). Macrophages and dendritic cells obtained by Percoll and hypertonic metrizamide density gradient centrifugation respectively were cultured with lymphocytes and their role in inducing IgG synthesis examined. Additionally phenotypic analysis of the cell populations based both on cell size and cell surface antigen characteristics using the monoclonal antibodies OKM1 and HLA-DR was performed by FACS. Whilst macrophage-depleted lymphocytes secreted negligible amounts of IgG, DC depletion of PBM had little impact on IgG synthesis. When these DC-depleted lymphocytes were further depleted of macrophages by Percoll gradient centrifugation their IgG secretion was dramatically reduced. This response could be minimally reconstituted by adding back DC but was more successfully reestablished with the add back of a population of macrophage-enriched cells. Phenotypic analysis of the cell populations involved did not allow clear discrimination of the various cell groups. On the basis of the functional studies the macrophage cell series would seem to have the central role in driving PWM reduced IgG synthesis though the possible "contamination" of these cells by DC can still not be excluded. Until such time as reliable markers are available for the clear discrimination of these 2 cell populations it is difficult to envisage resolution of the controversy on their respective roles. PMID- 3681949 TI - Class II MHC antigen (HLA-DR3) predisposes to sarcoid arthritis. AB - Recent studies indicate that the susceptibility to various inflammatory rheumatic diseases is an inherited trait determined by gene products of the class II histocompatibility complex (HLA-DR determinants). In a study designed to evaluate the concept of inherited susceptibility to sarcoid arthritis (SA), 42 patients with histologically proved acute disease underwent typing of HLA-A, -B, -C and DR antigens. Using the microdroplet assay of human serum cytotoxins, we employed 156 antiserums to identify 52 antigens on A, B and C loci and 35 to identify 7 DR antigens on the surface of B cells. An ethnically matched control group consisted of 134 healthy volunteers. The frequency of B cell isoantigen DR3 specificity was significantly increased in patients with SA (relative risk, 4.8); HLA-DR3 was found in 25 (60%) of the patients, compared with 31 (23%) of the controls. This study lends further support to the hypothesis that the putative role of an infectious agent triggering SA cannot be judged without considering genetic cofactors. PMID- 3681950 TI - Effects of PSK, an antitumor protein-bound polysaccharide, on the surface charge of lymphocytes in X5563-bearing mice. AB - Spleen and thymus cells from X5563 plasmacytoma-bearing mice treated with PSK (krestin) were analyzed by cell electrophoresis and flow microcytometry. A splenocyte electrophoretic pattern showed that an intermediate mobility peak (IMC), which appeared between the low (B cells) and high (T cells) peaks as the tumor developed, was depressed by the administration of PSK. Thy-1+ cells and asialo-GM1+ (aGM1+) cells decreased with tumor growth, and null cells without a marker of Ig, Thy-1 nor aGM1 increased. However, these changes were corrected by the administration of PSK. As the tumor grew, a thymocyte electrophoretic pattern showed that the incidence of low mobility cells, corresponding to immature cells, decreased, and that of high mobility cells, corresponding to mature cells in the medullary zone, increased. However, PSK suppressed the changes. The tumor did not disappear but life span was prolonged (121%) by the administration of PSK. These results lead to the conclusion that the administration of PSK prevented the changes in surface charge and markers of lymphocytes due to tumor burden, and restored the immunological responsiveness even in the syngeneic system. PMID- 3681951 TI - Functional heterogeneity of human monocytes--with a special reference to flow cytometric assays. AB - A large number of human mononuclear cells were simultaneously separated into fractions enriched in B cells, T cells, large granular lymphocytes (LGL) and monocytes by centrifugal elutriation. Lymphocyte populations were analyzed using monoclonal antibodies. In particular, highly enriched natural killer cells, Leu7+ cells, were collected in the intermediate fractions. Monocytes, which were identified as esterase positive cells, and Leu M3 cells were collected at higher counterflow rates and in the final fraction. The purity of monocytes in the final fraction was 81%. The oxidative metabolic activity (H2O2 production) and non specific esterase activity of individual monocytes was estimated in the analysis of functional heterogeneity of monocytes using flow cytometry. 2',7' dichlorofluorescein diacetate (DCFH-DA) and fluorescein diacetate (FDA) were used as indicators in the measurement of H2O2 generation and esterase activity. Intracellular generation of a fluorescence product (H2O2 Production; average percentage of fluorescence positive cells) of monocytes in the stimulation of phorbol myristate acetate (PMA, 100 ng/ml) was greater in larger than smaller cells. H2O2 production gradually increased from 6% and 25-38% and 60% in the intermediate and final fractions respectively. Furthermore, the average fluorescence intensity of the large monocyte population in the final fraction was 1.13-1.31 fold more active than that of the smaller cells. Thus, the functional heterogeneity of human monocytes was further confirmed in the assays of H2O2 production exposed to PMA and FDA hydrolysis using flow cytometry. Furthermore, the CCE system can isolate lymphocyte subsets and LGL. PMID- 3681952 TI - Laterobasal membranes from intestinal epithelial cells: isolation free of intracellular membrane contaminants. AB - A simplified method for isolating highly purified laterobasal membranes (LBM) from enterocytes is based on treatment of membranes with 8 mM CaCl2 concentration in order to aggregate intracellular membrane contaminants. The resultant LBM showed an average 15-fold enrichment and constituted 8% of the original K stimulated phosphatase in the initial crude homogenate. It showed typical LBM migration on counter-current distribution (CCD) and was essentially free of contamination with endoplasmic reticulum and Golgi membranes. This method is highly efficient and yields sufficient purified LBM to allow comprehensive analysis of enterocyte membrane events. PMID- 3681953 TI - Collagen receptors mediate early events in the attachment of epithelial (MDCK) cells. AB - Madin-Darby canine kidney (MDCK) cells kept in suspension culture for 12-15 hr displayed high-affinity binding sites for 125I-lathyritic (soluble) collagen (120,000/cell, KD = 30 nM) and preferred collagens types I and IV over laminin or fibronectin as substrates during the first hour of attachment. On the other hand, after 4 hr, attachment to all four substrates was equally efficient. Upon challenge with a collagen substrate, the high-affinity sites were rapidly recruited on it (T1/2 = 6 min). Their occupancy by soluble collagen triggered the exocytosis of a second large population of low-affinity collagen binding sites that included laminin and seems to be involved in a second cell-attachment mechanism. These results are compatible with a two-step model of MDCK cell attachment to the substrate: first, via high-affinity collagen binding sites, and second, via laminin of cellular origin. PMID- 3681955 TI - Psycho-social assessment of 36 de Lange patients. AB - Thirty-six de Lange patients aged 5-47 years with a median age of 16 years were tested by the Vineland Social Maturity Scale. Significant physical handicaps affecting the scoring were found in six patients. The social quotients varied from 2.2-99.5. Eighty-one per cent of the patients scored less than 52. Specific retardation was found in verbal communication. Other cognitive skills also showed low scoring, while the patients showed relatively high scores in self-help items. Fifteen patients lived in large institutions for the mentally retarded, three patients lived in hostels or boarding-schools, and one patient lived in her own home. Only two patients, both severely retarded, did not attend any regular daily activity. It is concluded that de Lange patients will not be able to live without support in the community, that they are particularly retarded in verbal communication but that they function relatively well in everyday self-help skills. PMID- 3681954 TI - Thiol-dependent passive K/Cl transport in sheep red cells: VII. Volume independent freezing by iodoacetamide, and sulfhydryl group heterogeneity. AB - The sulfhydryl (SH) reagent iodoacetamide (IAAM) inhibits stimulation of Cl dependent K transport in low K (LK) sheep red cells by another SH reagent, N ethylmaleimide (NEM), without itself activating this transport pathway (J. Membrane Biol., 1983, 73:257-261). We now report that IAAM alone, acting with a kinetic slower than NEM, sharply reduced the capability of the Cl-dependent K transport system to regulate its activity in response to cell volume changes. This effect of IAAM did not depend on the cell volume maintained during chemical treatment, a fact ruling out that the reactivity of the SH groups with IAAM was a function of the volume-dependent turnover rate of the transporter. On the other hand, the prevention of the NEM-stimulatory effect on Cl-dependent K transport was found to be volume-dependent since 1) the rate with which IAAM blocked the subsequent NEM action was twice as fast in cells swollen in 250 mOSM as opposed to cells shrunken in 370 mOSM media, and 2) the dose response of the IAAM effect was different in swollen and shrunken cells. The action of IAAM with or without subsequent treatment with NEM seemed to be independent of cellular ATP which is required for full expression of the stimulatory modification of Cl-dependent K transport by NEM (Am. J. Physiol., 1983, 245:C445-C448). Clusters of SH groups on the Cl-dependent K transporter apparently react differently with IAAM and NEM when separately applied but, used in combination, reflect a complex volume dependent effect that may reveal a "volume-sensing" component of the transport molecule. PMID- 3681956 TI - Computer-assisted linguistic analysis of an autistic adolescent's language: implications for the diagnosis of Aspberger's syndrome and atypical psychoses. AB - This study illustrates the use of a computer-assisted linguistic analysis technique to compare the spoken language of an adolescent, diagnosed in childhood as autistic, with that of normal and schizophrenic individuals. A distinctive profile, in keeping with accounts in the literature of autistic speech, was noted to be radically different from that found in linguistic analysis of schizophrenic speech. This distinctive profile was mirrored by her written linguistic analysis. Changes indicative of some improvement in language function were seen on re recording after 5 years. Implications of this technique for differential diagnosis of Aspberger's syndrome and atypical psychoses are mentioned. PMID- 3681957 TI - Partial trisomy 2p. AB - A 4-year-and-10-month-old girl was referred to the Child Development Center, Rhode Island Hospital, Providence, Rhode Island, USA, for evaluation because of mental retardation. She was found to have short stature, congenital heart disease and dysmorphic facial features. A chromosome analysis revealed an unbalanced translocation with trisomy of the distal part of the short arm of chromosome 2 (2p21----2pter). A balanced reciprocal translocation was identified in the maternal karyotype 46,X,t(X;2)(q28;p21). The phenotype of partial trisomy 2p is discussed. PMID- 3681958 TI - Cystathioninuria in a profoundly mentally retarded woman with spastic tetraplegia, deafness and abnormal liver function tests. AB - This article describes a profoundly mentally retarded woman with spastic tetraplegia, deafness and abnormal liver function tests with a secondary cystathioninuria. The cystathioninuria could be corrected with vitamin B6 supplementation. PMID- 3681959 TI - Comparison of the daily lives of four young adults who are mentally retarded. AB - Least restrictive environments are assumed to be ones in which high-quality care is to be found. The quality of care provided for four adult males living in hospitals and hostels is described. The data indicate that there are not only differences in the quality of care provided between hospitals and hostels, but variation within both types of setting. Attention is drawn particularly to the differences in care provided within the hostel settings. The use of simple monitoring devices to assist in better practices is recommended. PMID- 3681960 TI - Time lapse video microscopy using an animation control unit. AB - A system for time lapse video microscopy incorporating an edit recorder and animation control unit is described, allowing both colour recording, forward and reverse playback without synchrony bars, and the identification of each individual frame recorded. This is achieved by using the edit recorder, controlled by the animation unit to produce continuous series of insert edits using the preroll facility of the recorder. A feature of this system is the preview of the last hour's recording which is constantly played as the preroll of the edit recorder. Tissue culture flasks modified for stable focus are also described. PMID- 3681961 TI - Low-temperature scanning electron microscopy of particle-exposed mouse lung. AB - Inflated frozen mouse lungs were examined using low-temperature scanning electron microscopy (LTSEM) following bulk fracture under vacuum. Various aspects of pulmonary architecture were identified and correlated with structures revealed by SEM following conventional fixation and preparation techniques. Surface etching of selected samples was performed by radiant heating, revealing characteristic cytoplasmic, nuclear and extracellular lattice patterns resulting from ice crystal formation during freezing. These patterns aided in distinguishing between intra- and extracellular spaces. Pulmonary fluids such as mucus and surfactant were identified. Iron oxide particles were introduced into the lungs of some animals by intratracheal instillation and were subsequently identified in frozen hydrated lung tissue using characteristic X-ray identification and mapping techniques. Particles were observed both intra-and extracellularly and were commonly found in large deposits. These observations confirm the utility of LTSEM techniques for examination of particles within pulmonary tissue. Particle exposure by intratracheal instillation was found to result in a non-uniform distributional pattern. PMID- 3681962 TI - A new technique for obtaining large platinum-carbon replicas. PMID- 3681963 TI - A simplified 'sandwich' technique for in situ embedding and perpendicular sectioning of monolayer cultures of human skin fibroblasts. AB - In the processing of cell cultures, grown as a monolayer in tissue culture dishes for electron microscopy, the sectioning of the monolayer is an essential step. The monolayer can be sectioned either parallel or perpendicular to the plane of growth. Several methods for the perpendicular way of sectioning have already been described. We propose a simplified method in which the monolayer is sandwiched between two layers of resin, one of which is a prepolymerized block, the other being a layer of resin, applied at a second stage. Sectioning of this 'flat embedded' specimen yields thin sections perpendicular to the plane of growth of the monolayer without elaborate orientating procedures. The advantage of this procedure is that it can be done using only routine embedding techniques, avoiding special materials or complex manipulations. This sandwich technique provides an excellent mechanical fixation of the monolayer and protects it against external damage. PMID- 3681965 TI - Can a state medical society effectively sponsor a managed care delivery system? Issues for consideration. PMID- 3681964 TI - Regional differences in Mississippi's postneonatal mortality, 1980-1983. PMID- 3681966 TI - Organ donor law has deficiencies. PMID- 3681967 TI - Analysis of RNase-A-resistant regions of adenovirus 2 major late precursor-mRNA in splicing extracts reveals an ordered interaction of nuclear components with the substrate RNA. AB - An RNase A protection assay was employed to investigate the interaction of nuclear components with a precursor-mRNA derived from the adenovirus 2 major late transcription unit in a splicing extract from HeLa cells. Upon incubation in the extract, two regions in the precursor-RNA become resistant to digestion with RNase A. After short incubation times (5 min) at 30 degrees C, fragments mapping upstream from the branch point in the intron are obtained. After ten minutes or more, additional oligonucleotides, derived from the 5' splice site, are protected. RNase A protection of different RNA substrates demonstrates that a 5' splice site is not required for the binding of components to the branch point region. For interaction with this site, the polypyrimidine stretch just upstream from the 3' splice site is essential. Binding to the 5' splice site occurs only in the presence of an intact 3' end of the intron. Preincubation of the extract with excess unlabelled RNA containing only a 3' splice site leads to efficient competition of binding, both in the branch point region and at the 5' splice site, whereas an RNA that contains only 5'-splice-site sequences has no effect on the interaction with the mRNA precursor. This indicates that stable association with the 5' splice site requires prior binding of components in the branch point region. When splicing complexes are digested with RNase A, it becomes apparent that only the branch point region is sequestered into a ribonucleoprotein (RNP) structure in the 35 S complex. The 5' splice site becomes resistant to RNase A only when a 50 S splicing complex has been assembled. Degradation of specific regions in U1, U2 and U4 RNA with complementary oligodeoxynucleotides and RNase H has been used to analyse involvement of the U small nuclear RNPs (snRNPs) in the protection reaction. The 5' end of U2 RNA is essential for protection of the branch point region. RNA sequences in a loop of U2 RNA (nucleotides 65 to 78) are required for the formation of an RNase-A-resistant structure at the 5' splice site. Taken together, these results suggest that U2 snRNP participates in the formation of a pre-splicing complex, the 5' end of its RNA being involved in the observed binding. Conversion to a 50 S splicing complex is obtained after the binding of U1 and U4/U6 snRNPs, which also requires sequences in a loop of U2 RNA. Possible interactions between the individual snRNPs and between snRNPs and precursor-mRNA are discussed. PMID- 3681968 TI - Structure of microtubules with reduced hydration. Comparison of results from X ray diffraction and electron microscopy. AB - A recent model for the structure of microtubules is used to interpret X-ray fiber diffraction patterns from microtubules, obtained under various conditions. The results suggest that tubulin may undergo conformational changes under conditions of reduced water-activity. Such changes could account for some of the differences in the structure of tubulin as determined by electron microscopy and X-ray diffraction. PMID- 3681969 TI - Effect of Z-DNA on nucleosome placement. AB - Histone octamers were reconstituted on plasmids carrying the alternating nucleotide sequence (G-C)15. The plasmids, radioactively labeled at one of two neighboring sites near the (G-C) insert, were digested with micrococcal nuclease. Nucleosome core particles were isolated and the monomer DNA subjected to restriction analysis. Quite different results are obtained if the reconstitution is carried out with relaxed plasmids, in which the (G-C) insert is in the B form, or with supercoiled plasmids, where it is in the Z form. With supercoiled plasmids, there is a marked reduction (compared with relaxed plasmids) in the abundance of labeled monomers, the result of a large decrease in core particles carrying any (G-C) sequence. Some core particles formed on supercoiled (Z) plasmids are positioned either just outside the (G-C) sequence, or with the sequence occupying the terminal position within the core particle. In contrast, monomers obtained from relaxed plasmids incorporate the (G-C) sequence in the B form more or less randomly in the interior of the core particle; species showing discrete positioning make only a minor contribution. We conclude that DNA in the Z form cannot be incorporated within core particles, except at their termini, and that a transition from the B to the Z form in vivo might result in a significantly altered local placement of nucleosomes. PMID- 3681970 TI - Interior and surface of monomeric proteins. AB - The solvent-accessible surface area (As) of 46 monomeric proteins is calculated using atomic co-ordinates from high-resolution and well-refined crystal structures. The As of these proteins can be determined to within 1 to 2% and that of their individual residues to within 10 to 20%. The As values of proteins are correlated with their molecular weight (Mr) in the range 4000 to 35,000: the power law As = 6.3 M0.73 predicts protein As values to within 4% on average. The average water-accessible surface is found to be 57% non-polar, 24% polar and 19% charged, with 5% root-mean-square variations. The molecular surface buried inside the protein is 58% non-polar, 39% polar and 4% charged. The buried surface contains more uncharged polar groups (mostly peptides) than the surface that remains accessible, but many fewer charged groups. On average, 15% of residues in small proteins and 32% in larger ones may be classed as "buried residues", having less than 5% of their surface accessible to the solvent. The accessibilities of most other residues are evenly distributed in the range 5 to 50%. Although the fraction of buried residues increases with molecular weight, the amino acid compositions of the protein interior and surface show no systematic variation with molecular weight, except for small proteins that are often very rich in buried cysteines. From amino acid compositions of protein surfaces and interiors we calculate an effective coefficient of partition for each type of residue, and derive an implied set of transfer free energy values. This is compared with other sets of partition coefficients derived directly from experimental data. The extent to which groups of residues (charged, polar and non-polar) are buried within proteins correlates well with their hydrophobicity derived from amino acid transfer experiments. Within these three groups, the correlation is low. PMID- 3681971 TI - Structure of the ColE1 rop protein at 1.7 A resolution. AB - Structural details of the Rop protein from plasmid ColE1 are presented, with a description of the X-ray crystal structure determination and refinement at a nominal resolution of 1.7 A. The 63 amino acid protein is a dimer. Each monomer consists almost entirely of two alpha helices, the whole molecule forming a highly regular four-alpha-helix bundle. This may be approximated by a four stranded rope with a radius of 7.0 A, a left-handed helical twist and a pitch of 172.5 A. The packing constraints for this novel type of coiled-coil structure are given. The protein acts in the control of plasmid replication via regulation of an RNA-RNA interaction in a manner not yet understood in atomic detail. PMID- 3681972 TI - An approach to the multiple-minima problem in protein folding by relaxing dimensionality. Tests on enkephalin. AB - An algorithm for locating the region in conformational space containing the global energy minimum of a polypeptide is described. Distances are used as the primary variables in the minimization of an objective function that incorporates both energetic and distance-geometric terms. The latter are obtained from geometry and energy functions, rather than nuclear magnetic resonance experiments, although the algorithm can incorporate distances from nuclear magnetic resonance data if desired. The polypeptide is generated originally in a space of high dimensionality. This has two important consequences. First, all interatomic distances are initially at their energetically most favorable values; i.e. the polypeptide is initially at a global minimum-energy conformation, albeit a high-dimensional one. Second, the relaxation of dimensionality constraints in the early stages of the minimization removes many potential energy barriers that exist in three dimensions, thereby allowing a means of escaping from three dimensional local minima. These features are used in an algorithm that produces short trajectories of three-dimensional minimum-energy conformations. A conformation in the trajectory is generated by allowing the previous conformation in the trajectory to evolve in a high-dimensional space before returning to three dimensions. The resulting three-dimensional structure is taken to be the next conformation in the trajectory, and the process is iterated. This sequence of conformations results in a limited but efficient sampling of conformational space. Results for test calculations on Met-enkephalin, a pentapeptide with the amino acid sequence H-Tyr-Gly-Gly-Phe-Met-OH, are presented. A tight cluster of conformations (in three-dimensional space) is found with ECEPP energies (Empirical Conformational Energy Program for Peptides) lower than any previously reported. This cluster of conformations defines a region in conformational space in which the global-minimum-energy conformation of enkephalin appears to lie. PMID- 3681973 TI - Metal co-ordination in rat liver metallothionein-2 prepared with or without reconstitution of the metal clusters, and comparison with rabbit liver metallothionein-2. AB - Possible origins of the different metal co-ordination topologies in the recently determined structures of rat metallothionein-2 (MT2) in single crystals and rabbit MT2 in solution were investigated. A complete structure determination for rat MT2 in solution by nuclear magnetic resonance (n.m.r.) showed that the differences in the spatial structures cannot be attributed to the different primary structures of the two species. Comparison of [113Cd7]MT2 obtained by reconstitution of the apoprotein in vitro with preparations using a different procedure showed, moreover, that the metal co-ordination observed in solution by n.m.r. is not an artefact of the protein reconstitution. Solutions of high pressure liquid chromatographically homogeneous biosynthetic preparations of [113Cd, Zn]MT2 were obtained from rat liver following injection of 113Cd into rats in vivo, without further metal exchange after protein isolation. They contain a mixture of several forms of MT2 with different relative metal compositions, giving rise to an increased number of 113Cd resonances. For the components of the four-metal cluster, the major one of these different forms exhibits patterns in the two-dimensional [1H, 113Cd]-correlated spectra that are indistinguishable from those of [113Cd7]MT2, thereby implying identity of cluster coordination and topology. These results are discussed with regard to continued investigations into the differences between the solution structure and crystal structure of MT2. PMID- 3681974 TI - Ordered assemblies of myosin minifilaments. AB - Electron microscopic observations of negatively stained myosin minifilaments in a solution containing 10 mM-citrate buffer (pH 8.0), 4 mM-MgCl2 reveal ordered assemblies. They reveal bundles of parallel minifilaments of about 330 nm in length, aggregated into periodic linear and hexagonal structures. These structures are formed by means of interaction between myosin heads, arranged at the ends of minifilament bundles. The addition of 1 mM-ATP to the above solution causes dissociation of minifilament bundles into individual minifilaments without preventing the latter from association into linear "end-to-end" assemblies. Phosphorylation of myosin light chains does not exert any noticeable effect on the structure of the ordered minifilament assemblies but significantly increases their quantity. The interaction between minifilaments observed by us should be taken into consideration in studies on the properties of myosin which make use of minifilament systems. PMID- 3681975 TI - Non-additivity in protein-protein interactions. AB - The energy of binding between proteins may be seen as the sum of the contributions of the individual amino acid residues. These contributions are additive when the binding energy, due to different amino acid residues, is independent of the interactions between amino acids in the same polypeptide chain. A measure of non-additivity is the coupling free energy. In this communication it is shown that: (1) the coupling free energy is the sum of intramolecular and intermolecular contributions; and (2), when additivity exists, experimentally determined values for the free energy of transfer of amino acids from water to the hydrophobic protein-protein interface are a very good approximation of their contribution to the energy of binding. Additivity cycles can be useful in determining the precise conditions where this approximation holds. PMID- 3681976 TI - Preliminary X-ray study of crystals of human C-reactive protein. AB - Two different crystal forms of human C-reactive protein have been grown from solutions of 2-methyl-2,4-pentanediol. Both crystal forms are tetragonal, the space group for form I is P4(1)22 (or P4(3)22), and that for form II is P4(2)22. The unit cell parameters for form I are a = b = 103.0(5) A, c = 308.5(7) A and for form II are a = b = 103.1(2) A, c = 312.7(6) A. The crystals of form II diffract to at least 3.0 A resolution, and are suitable for detailed structural studies. PMID- 3681977 TI - Determination of a functional ancestral sequence and definition of the 5' end of A-type mouse L1 elements. AB - The complete nucleotide sequence of L1Md-A13, a 6372 base-pair (bp) member of the L1Md repetitive family isolated from a BALB/c mouse genomic DNA library, is reported. The nucleotide sequence of 4331 bp from the 5' end of L1Md-9, which is located in the beta-globin complex of the C57BL/10 mouse, is also reported. Parsimony analysis of these sequences plus two previously reported L1Md sequences allows the determination of an ancestral L1Md sequence. Analysis of the L1Md population indicates that this ancestral sequence is likely to represent a functional L1 sequence. This ancestral sequence confirms that the length (1137 bp and 3900 bp) and relationship (14 bp overlap) of the two large open reading frames previously reported are conserved features of the L1Md family. It also allows the determination of an ancestral amino acid sequence for these two open reading frames. Full-length L1Md elements have one of two sequences tandemly repeated at the 5' end. These two monomers are called A-type and F-type. Our data define the 5' end of A-type full-length L1Md elements. L1Md elements of the A type have varying numbers of tandemly repeated 208 bp monomers, but each element ends about 78 bp from the 5' end of the terminal 208 bp monomer. PMID- 3681978 TI - Structural organization of the 5' region of the thyroglobulin gene. Evidence for intron loss and "exonization" during evolution. AB - More than one third of thyroglobulin (1190 residues out of 2750) is made of one peptide motif repeated ten times in tandem. Segments unrelated to the motif interrupt this structure at various places. The corresponding gene region, which extends over 40 x 10(3) bases, was studied in detail. All exon borders and exon/intron junctions were localized precisely and sequenced, and their positions were correlated with the repetitive organization of the protein. When intron positions were compiled on a consensus sequence of all repeats, three categories of introns were observed. Except between repeats numbers 5 and 6, an intron was invariably found within the Cys codon making the limit of each motif. This category of intron most probably reflects the serial duplication events responsible for the evolution of this region of the gene. All other introns, except no. 2, are found at positions were the repetitive structure is disrupted by "inserted" peptides. We present the hypothesis that this second category of introns was already present in the original unit before the first duplication. Thereafter, they would have experienced either complete loss (some units do not contain any intron) or partial or total exonization, resulting in the slipping of intronic material into coding sequence. Intron no. 2, finally, separates motif no. 1 at a position on the boundary between two segments presenting sequence homology. This last type of intron probably reflects an initial duplication event at the origin of a primordial thyroglobulin gene motif. With all these characteristics, the thyroglobulin gene is presented as a paradigm for the analysis of the fate of introns in gene evolution. PMID- 3681979 TI - A complex array of sequences enhances ribosomal transcription in Xenopus laevis. AB - The ribosomal DNA spacer in Xenopus laevis was shown in previous studies to be involved in regulating the expression of the ribosomal genes. Here transcription enhancement by this spacer has been studied in some detail, to fully identify the sequences involved and to determine their relative importance in this phenomenon. It is shown that the 60/81 base-pair (bp) repeats, which were reported to be enhancer elements, act as part of a mode of enhancement whose effect is amplified by the spacer promoters or Bam islands. The "Bam super repeat", a combination of spacer promoter and 60/81 bp elements, is the major enhancer unit. Within a Bam super repeat, a near linear correlation between the number of 60/81 bp elements and enhancer activity is observed. Thus, there is no significant co-operativity in the binding of transcription factors to an array of these elements. Multiple Bam super repeats do not act additively and may actually interfere with each others action. Surprisingly this effect is observed both in the presence and absence of active spacer promoters. Sequences between the 3' end of the 28 S coding region and the first spacer promoter may also be involved in enhancement but only in a very minor fashion. In confirmation of recent studies, the presence of the unique ribosomal termination sequence, 213 bp upstream from the pre-rRNA initiation site, is essential for efficient promotion, as deletion of this sequence virtually abolishes pre-rRNA- transcription. These data are discussed in terms of the possible mechanisms of transcription enhancement. PMID- 3681980 TI - Structure of the extrachromosomal ribosomal RNA chromatin of Physarum polycephalum. AB - Isolated nucleoli from exponentially growing microplasmodia of Physarum polycephalum were digested with micrococcal nuclease or DNAase I, or were photoreacted with trimethyl psoralen. In the coding region for the precursor of the ribosomal RNA, micrococcal nuclease and DNAase I digestions show predominantly a smear, and treatment with psoralen leads to a fairly continuous crosslinking of the DNA. All three assays are compatible with the absence of a typical nucleosomal array in most of the gene copies. In contrast, in the central non-transcribed spacer, except in the immediate 5'-flanking region, micrococcal nuclease and DNAase I digestions yield fragments that are multiples of a basic repeat, compatible with a nucleosomal packing of this region. The crosslinking pattern with psoralen confirms this conclusion. In addition, there are three sites over 400 base-pairs long that are inaccessible for psoralen crosslinking. Two of these sites have been mapped to the putative origins of replication. In the terminal non-transcribed spacer, except in the immediate 3'-flanking region, digestions with micrococcal nuclease and DNAase I give a smeared repeat. The crosslinking pattern after treatment with psoralen suggests that this region is packed in nucleosomes, except for about 900 base-pairs constituting the telomere regions of the linear extrachromosomal palindromic rDNA. Micrococcal nuclease digestion of the immediate 5'-flanking region shows a complete absence of any nucleosomal repeat, but digestion with DNAase I leads to a faint ten base-pair repeat. In contrast, in the 3'-flanking regions both nuclease assays indicate a chromatin structure similar to the coding region. Both flanking regions are unusual with respect to psoralen crosslinking, in that crosslinking is reduced both in chromatin and deproteinized DNA. On the basis of the known sequence dependent psoralen crosslinking and the established sequences in these regions, crosslinking should be expected to occur. However, it does not and we therefore propose the presence of an unusual DNA conformation in these regions. PMID- 3681981 TI - Canonical structures for the hypervariable regions of immunoglobulins. AB - We have analysed the atomic structures of Fab and VL fragments of immunoglobulins to determine the relationship between their amino acid sequences and the three dimensional structures of their antigen binding sites. We identify the relatively few residues that, through their packing, hydrogen bonding or the ability to assume unusual phi, psi or omega conformations, are primarily responsible for the main-chain conformations of the hypervariable regions. These residues are found to occur at sites within the hypervariable regions and in the conserved beta sheet framework. Examination of the sequences of immunoglobulins of unknown structure shows that many have hypervariable regions that are similar in size to one of the known structures and contain identical residues at the sites responsible for the observed conformation. This implies that these hypervariable regions have conformations close to those in the known structures. For five of the hypervariable regions, the repertoire of conformations appears to be limited to a relatively small number of discrete structural classes. We call the commonly occurring main-chain conformations of the hypervariable regions "canonical structures". The accuracy of the analysis is being tested and refined by the prediction of immunoglobulin structures prior to their experimental determination. PMID- 3681982 TI - Preliminary X-ray fiber diffraction studies of cucumber green mottle mosaic virus, watermelon strain. AB - Fiber diffraction patterns have been obtained for cucumber green mottle mosaic virus, watermelon strain (a distant relative of tobacco mosaic virus), and two heavy-atom derivatives. These patterns and the similarity between the cucumber and the tobacco virus offer the potential of a full structure determination of the cucumber virus. PMID- 3681983 TI - Unusual ribosomal RNA gene organization in copepods of the genus Calanus. AB - Ribosomal RNA genes in the nuclear genomes of eukaryotes are generally found in tandemly repeated units encoding 18 S, 5.8 S and 28 S rRNA (in that order). 5 S rRNA genes typically lie outside these units, most often in tandem clusters coding exclusively for 5 S rRNA. Inclusion of 5 S genes within the 18 S-5.8 S-28 S repeat unit is known only for certain protozoa and fungi. Here we report that, in the copepod Calanus finmarchicus, single 5 S genes are included within many or all of the 18 S-5.8 S-28 S repeat units. Sequence analyses of regions cloned from two of these repeat units show that they indeed include 5 S genes (which are distal to 28 S genes) and that these are transcribed from opposite strands. PMID- 3681984 TI - At least six nucleotides preceding the AUG initiator codon enhance translation in mammalian cells. AB - Sequences flanking the AUG initiator codon influence its recognition by eukaryotic ribosomes. From a comparison of several hundred mRNA sequences, CCA/GCCAUGG emerged as the consensus sequence for initiation in higher eukaryotes. Systematic mutagenesis of a cloned preproinsulin gene confirmed the facilitating effect of A or G in position -3 (i.e. 3 nucleotides upstream from the AUG codon), C in positions -1 and -2, and G immediately following the AUG codon. The analysis of a new set of mutants now reveals that sequences slightly farther upstream are also influential, the optimal context for initiation being (GCC)GCCA/GCCAUGG. Possible mechanistic implications of the repeating GCC motif are discussed. PMID- 3681985 TI - Crystallization and X-ray diffraction studies of a 434 Cro-DNA complex. AB - Crystals have been obtained of the bacteriophage 434 Cro protein bound to a synthetic DNA operator. An analysis of the packing shows that the complexes stack end-to-end along crystallographic axis, forming long rods with non crystallographic 11(3) screw symmetry. The average number of DNA base-pairs per turn is 10.27, which is somewhat more overwound as compared with the 434 repressor-DNA crystals of Anderson et al. Diffraction extends to 3 A along the rod direction and to 5 A in perpendicular directions. PMID- 3681986 TI - Myosin binding to actin. Structural analysis using myosin fragments. AB - The actin-binding property of the myosin head 20 K (K = 10(3) Mr) fragment has been examined by a structural assay. A new fragment is produced by digestion of scallop myosin synthetic filaments with a lysine-specific protease. This fragment consists of the rod together with two "nubs" corresponding to the 20 K fragment, which retain both the regulatory and essential light chains. Myosin filaments, digested for different lengths of time, were mixed with F-actin and visualized by electron microscopy after negative staining. When the head is cleaved, but the head fragments remain associated, the filaments bind actin in an ATP-sensitive manner. Filaments made primarily of the nub-containing fragments, however, bind actin very poorly. In addition, electron microscopic characterization of actin binding by the isolated tryptic 20 K fragment from chicken myosin indicates that binding of this fragment to actin is probably non-specific. These results suggest that interactions between the 20 K region and the other peptides in the head are essential for actin-binding. PMID- 3681987 TI - Crystallization and preliminary X-ray diffraction studies of tobacco necrosis virus. AB - Tobacco necrosis virus is a spherical plant virus consisting of 180 copies of coat protein and a single-stranded RNA. The virus has been crystallized in cubic space group P4(2)32 with a = 338 A. The locations and the orientations of the two virus particles in the unit cell have been determined on the basis of the symmetries of both the particle and the crystal. The crystal diffracts X-rays to at least 2.5 A resolution and is quite stable to X-ray beams (1 A = 0.1 nm). PMID- 3681988 TI - Evidence for a coiled-coil structure in the spike proteins of coronaviruses. AB - The amino acid sequences of the spike proteins from three distantly related coronaviruses have been deduced from cDNA sequences. In the C-terminal half, an homology of about 30% was found, while there was no detectable sequence conservation in the N-terminal regions. Hydrophobic "heptad" repeat patterns indicated the presence of two alpha-helices with predicted lengths of 100 and 50 A, respectively. It is suggested that, in the spike oligomer, these alpha-helices form a complex coiled-coil, resembling the supersecondary structures in two other elongated membrane proteins, the haemagglutinin of influenza virus and the variable surface glycoprotein of trypanosomes. PMID- 3681989 TI - Characterization of the L1NH repeat family of Novikoff hepatoma. AB - Long interspersed repeated sequences of the Novikoff hepatoma rat tumour cell genome were cloned and studied. No basic differences were found when the genomic organization of the Novikoff hepatoma was compared with that of other mammalian L1 families. The nucleotide sequence of the central approximately 4 kb (1 kb = 10(3) bases) part of the Novikoff hepatoma LINE (L1NH) appeared to be more highly conserved than the sequences found at the 5' and 3' ends. Moreover, the central approximately 4 kb core fragments were not always associated with the same end sequences. Thus, the occurrence of the more-conserved and more-abundant central portion in L1NH suggest that: (1) besides reverse transcription, other DNA- and/or RNA-mediated mechanisms might be involved in the dispersal of LINE families; and that (2) L1 sequences can sometimes consist of a compound unit made up of members of different L1 subunits and sequences with different genomic copy numbers. PMID- 3681990 TI - Structural and electronic properties of the liver fluke hemoglobin heme cavity by nuclear magnetic resonance: hemin isotope labeling. AB - Reconstitution of liver fluke (Dicrocoelium dendriticum) apo-hemoglobin with hemins selectively deuterated at specific positions has permitted the assignment of several heme resonances in the proton nuclear magnetic resonance spectrum of the Met-aquo and Met-cyano forms of the holoprotein. It was established that in the Met-aquo form the meso protons resonate at positions characteristic of a six co-ordinated in-plane iron. From this, we deduced that the Met-aquo species retains a bound water molecule at pH values as low as 4.5. The orientation of the proximal histidine imidazole ring with respect to the heme group in the cavity was determined through the identification of the heme methyl signals and the analysis of the hyperfine shift pattern in the Met-cyano hemoglobin proton nuclear magnetic resonance spectrum. Compared to sperm whale myoglobin, the heme appears to be rotated by 180 degrees about the alpha, gamma meso-axis. Protein isomers with the heme group in a reversed orientation were not detected, even shortly after reconstitution. In the Met-cyano form, the resonances most affected by the Bohr transition were shown to arise from the heme propionates. PMID- 3681991 TI - The potentially Z-DNA-forming sequence d(GTGTACAC) crystallizes as A-DNA. AB - (GT)n/(CA)n sequences have stimulated much interest because of their frequent occurrence in eukaryotic DNA and their potential for forming the left-handed Z DNA structure. We here report the X-ray crystal structure of a self-complementary octadeoxynucleotide, d(GTGTACAC), at 2.5 A resolution. The molecule adopts a right-handed double-helical conformation belonging to the A-DNA family. In this alternating purine-pyrimidine DNA minihelix the roll and twist angles show alternations qualitatively consistent with Calladine's rules. The average tilt angle of 9.3 degrees is between the values found in A-DNA (19 degrees) and B-DNA (-6 degrees) fibers. It is envisaged that such intermediate conformations may render diversity to genomic DNA. The base-pair tilt angles and the base-pair displacements from the helix axis are found to be correlated for the known A-DNA double-helical fragments. PMID- 3681992 TI - Crystals of Lumbricus erythrocruorin. AB - Lumbricus terrestris erythrocruorin, a 3.9 X 10(6) Mr respiratory protein, has been crystallized in four different forms. Despite the high molecular symmetry apparent from images in electron micrographs, only one crystal form expresses any molecular symmetry as crystallographic symmetry. The lattice parameters provide upper limits on the molecular dimensions of 267 A X 308 A X 172 A (1 A = 0.1 nm), which agree well with dimensions obtained from electron micrographs of negatively stained molecules. We have collected diffraction data to 5.5 A from type III crystals and have begun a structural analysis. PMID- 3681993 TI - Refined structure of southern bean mosaic virus at 2.9 A resolution. AB - The T = 3 capsid of southern bean mosaic virus is analyzed in detail. The beta sheets of the beta-barrel folding motif that form the subunits show a high degree of twist, generated by several beta-bulges. Only 34 water molecules were identified in association with the three quasi-equivalent subunits, most of them on the external viral surface. Subunit contacts related by quasi-3-fold axes are similar, are dominated by polar interactions and have almost identical calcium binding sites. There is no metal ion on the quasi-3-fold axis, as previously reported. Subunits related by quasi-2-fold and icosahedral 2-fold axes have different contacts but nevertheless display almost identical interactions between the antiparallel helices alpha A. A dipole-dipole type interaction between these helices may produce an energetically stable hinge that allows two types of dimers in a T = 3 assembly. The temperature factor distribution, the hydrogen-bonding pattern, and the contacts across the icosahedral 2-fold axes suggest that one of the dimer types is present in the intact virion and probably also in solution; the other is produced only during capsid assembly. Interactions along the 5-fold axes are mainly polar and possibly form an ion channel. The beta-sheet structures of the three subunits can be superimposed with considerable precision. Significant relative distortions between quasi-equivalent subunits occur mainly in helices and loops. The two dimeric forms and the subunit distortions are the consequence of the non-equivalent subunit environments in the capsid. PMID- 3681994 TI - Non-enzymatic transcription of an oligodeoxynucleotide 14 residues long. AB - The 14-mer oligodeoxynucleotide d(C3GC3GC3GC2) acts as a template to facilitate the cooligomerization of guanosine 5'-phospho-2-methylimidazolide and cytidine 5' phospho-2-methylimidazolide. The predominant products are a series of 3'-5' linked oligonucleotides, complementary to the template, ranging in length from GGC to GGCGGGCGGGCGGG. Thus simple, non-enzymatic template-directed reactions can result in the accurate transfer of substantial amounts of information from template to products. The 15-mer oligodeoxynucleotide d(C3GC3GC3GC3) is also an efficient template, but directs the synthesis of the same family of products that are formed on the 14-mer template. This unexpected finding is explained by the preferential conversion of the dimer GG to GGC rather than to GGG. These results are interesting in the context of molecular evolution. They suggest that the detailed kinetics of template-directed synthesis could form the basis for the selection of one replicating oligonucleotide from a family of closely related oligonucleotides. PMID- 3681995 TI - X-ray diffraction patterns from microtubules and neurofilaments in axoplasm. AB - Freshly extracted axoplasm from giant axons of the marine fan worm Myxicola infundibulum and the squid Loligo can be pulled into fibres that contain highly oriented cytoskeletal elements suitable for X-ray diffraction. A major advantage of studying axoplasmic components by this technique is that it allows essentially native structures and their interactions to be examined. We describe here the analyses of the X-ray diffraction patterns. We show that in Myxicola the pattern can be explained by diffraction from both neurofilaments and microtubules, whilst in Loligo the pattern arises solely from microtubules. At low resolution, X-ray patterns obtained from dehydrated axoplasmic microtubules resemble strongly the Fourier transforms generated from electron micrographs of negatively stained specimens. Hydration of axoplasmic fibres produced reversible changes in the X ray pattern intensities, although the layer-line positions were unaltered. On the 4 nm layer-line, the intensity of the J3 reflection was dramatically reduced on hydration, though its position was unchanged. Hydration also affected the J10/J16 reflections, which increased in intensity, though here again the positions of the peaks were little altered. The X-ray patterns from our hydrated fibres resemble those produced by others from fibres of purified microtubules, though in our patterns contrast is generated towards the centre of the wall. We interpret our findings in the light of current ideas about microtubule structure as determined by X-ray diffraction and electron microscope techniques. PMID- 3681996 TI - Structure of myohemerythrin in the azidomet state at 1.7/1.3 A resolution. AB - The molecular model of myohemerythrin, an oxygen-carrying protein from sipunculan worms, has been refined by stereochemically restrained least-squares minimization at 1.7/1.3 A resolution to a conventional R-value of 0.158. The estimated positional standard deviation is better than 0.15 A for most of the 979 protein atoms. The average isotropic displacement parameter, B, for the protein atoms is 23.1 A2. This high average B parameter appears to be due to the overall motion of the molecule, which correlates with the observed anisotropic diffraction. The side-chains of seven residues were modeled in two conformations, i.e. the side chains were discretely disordered, and B parameters for several lysine and glutamate side-chains indicate that they are poorly localized. Of the residues in myohemerythrin, 66% are helical, with 62% occurring in four long alpha-helices with mean values for the backbone torsion angles of phi = -65 degrees, psi = -42 degrees, and for the hydrogen bonds distances of N ... O, 3.0 A and H ... O, 2.1 A, and angles of N ... O = C, 153 degrees, N-H ... O, 157 degrees, and H ... O = C, 147 degrees. For two-thirds of the alpha-helical residues, the torsional rotation of the C alpha-C beta bond, chi 1, is approximately -60 degrees, and for one-third chi 1 is approximately 180 degrees. Although most turns in myohemerythrin are well-categorized by previous classification, two do not fit in established patterns. Also included in the refined model are three sulfate ions, all partially occupied, and 157 water molecules, 40% of which are modeled fully occupied. Only one water molecule is internal to the protein, the remainder occur on the surface and are observed principally between symmetry-related molecules contributing, along with van der Waals' contacts, most of the interactions between molecules. There are eight intermolecular protein-protein hydrogen bonds, of which only four are between well-located atoms. PMID- 3681997 TI - Structural studies of mutants of the lysozyme of bacteriophage T4. The temperature-sensitive mutant protein Thr157----Ile. AB - To understand the roles of individual amino acids in the folding and stability of globular proteins, a systematic structural analysis of mutants of the lysozyme of bacteriophage T4 has been undertaken. The isolation, characterization, crystallographic refinement and structural analysis of a temperature-sensitive lysozyme in which threonine 157 is replaced by isoleucine is reported here. This mutation reduces the temperature of the midpoint of the reversible thermal denaturation transition by 11 deg.C at pH 2.0. Electron density maps showing differences between the wild-type and mutant X-ray crystal structures have obvious features corresponding to the substitution of threonine 157 by isoleucine. There is little difference electron density in the remainder of the molecule, indicating that the structural changes are localized to the site of the mutation. High-resolution crystallographic refinement of the mutant lysozyme structure confirms that it is very similar to wild-type lysozyme. The largest conformational differences are in the gamma-carbon of residue 157 and in the side chain of Asp159, which shift 1.0 A and 1.1 A, respectively. In the wild-type enzyme, the gamma-hydroxyl group of Thr157 participates in a network of hydrogen bonds. Substitution of Thr157 with an isoleucine disrupts this set of hydrogen bonds. A water molecule bound in the vicinity of Thr155 partially restores the hydrogen bond network in the mutant structure, but the buried main-chain amide of Asp159 is not near a hydrogen bond acceptor. This unsatisfied hydrogen-bonding potential is the most obvious reason for the reduction in stability of the temperature-sensitive mutant protein. PMID- 3681998 TI - Analysis of sequence-similar pentapeptides in unrelated protein tertiary structures. Strategies for protein folding and a guide for site-directed mutagenesis. AB - From the most recent Brookhaven Protein Co-ordinate Databank, 229 sequence identical pentapeptide pairs, each found in two unrelated protein structures, were collected; 9115 such pairs differing in only one residue were also gathered. For both samples the main-chain fold was conserved about 20% of the time, despite the different atomic environments presented by the unrelated protein architectures. An analysis of the substituted residues as well as the composition of the sequence-similar pentapeptides allowed several suggestions regarding protein folding mechanisms. An examination of the most frequently observed residue substitutions and their correlation with structural changes in the oligopeptide pairs yields a possible guide for site-directed mutagenesis experiments, especially when no tertiary structural information is at hand. PMID- 3681999 TI - A crystal form of ribulose-1,5-bisphosphate carboxylase/oxygenase from Nicotiana tabacum in the activated state. AB - A new crystal form of ribulose-1,5-bisphosphate carboxylase/oxygenase (EC 4.1.1.39) from Nicotiana tabacum has been obtained at alkaline pH with polyethylene glycol 8000 in the presence of a non-ionic detergent, beta-octyl glucoside. The crystals are grown at room temperature by the hanging-drop vapor diffusion technique from a protein solution containing enzyme complexed with CO2, Mg2+, and the transition state analog 2-C-carboxy-D-arabinitol-1,5-bisphosphate. The crystals belong to the the space group P3(1)21 (or P3(2)21) with the cell parameters a = 204.6 A, and c = 117.4 A (1 A = 0.1 nm). The asymmetric unit contains half (L4S4: L, large subunit, 53,000 Mr; S, small subunit, 15,000 Mr) of a hexadecameric molecule (L8S8, 540,000 Mr). The crystals diffract to at least 2.6 A Bragg spacing and are suitable for X-ray structure determination. PMID- 3682000 TI - Preliminary crystallographic study of a complex between an heteroclitic anti-hen egg-white lysozyme antibody and the heterologous antigen pheasant egg-white lysozyme. AB - We report the preparation, crystallization and preliminary X-ray crystallographic study of the Fab fragment from a heteroclitic murine (BALB/c) monoclonal anti-hen egg-white lysozyme antibody complexed with a heterologous antigen, pheasant lysozyme. The complex between the heterologous antigen and the antibody has been crystallized from polyethylene glycol 8000 solutions in a form suitable for X-ray crystallographic studies. The crystals are monoclinic, space group C2 with a = 158.2 A, b = 49.1 A, c = 177.6 A, beta = 92.0 degrees (1 A = 0.1 nm). PMID- 3682001 TI - Crystallization and a preliminary X-ray diffraction study of isozyme 3-3 of glutathione S-transferase from rat liver. AB - Crystals of the homodimeric isozyme 3-3 of glutathione S-transferase from rat liver have been obtained with the hanging drop method of vapor diffusion from ammonium sulfate solutions. The successful crystallization of the enzyme required the presence of both the enzyme inhibitor (9R, 10R)-9, 10-dihydro-9-(S glutathionyl)-10-hydroxyphenanthrene and the detergent beta-octylglucopyranoside. The crystals belong to the monoclinic space group C2, with cell dimensions of a = 88.24(8) A, b = 69.44(4) A, c = 81.28(5) A, beta = 106.01(6) degrees, and contain four dimeric enzyme molecules per unit cell. The crystals diffract to at least 2.2 A and are suitable for X-ray crystallographic structure determination at high resolution. PMID- 3682002 TI - Mesodermal metamerism in the teleost, Oryzias latipes (the medaka). AB - Previous studies of the metameric pattern in mesodermal tissues of chick, mouse, turtle, and amphibian embryos have indicated that segmental characteristics exist along the entire length of the embryo. This paper describes this phenomenon in a fish embryo, for some differences in the cranial segmental plan exist between the anamniote and the amniote embryos hitherto studied. Embryos of the cyprinodont, Oryzias latipes, were fixed at various times, the examined by means of stereo scanning electron microscopy. As in other vertebrate embryos, the first indication of mesodermal metamerism in this fish embryo is the occurrence of somitomeres, which are orderly, tandemly arranged units of uncondensed mesenchymal cells in the paraxial mesoderm. As many as ten somitomeres can be observed caudal to the last formed somite to the elongating tail region. In addition, 7 somitomeres are present rostral to the first definitive somite, which is segment number eight. As in other vertebrate embryos examined, somitomeres in Oryzias embryos are circular, bilaminar arrays of paraxial mesoderm that form before any indications of segmentation can be seen with the light microscope. In the trunk region these mesodermal units condense to give rise to definitive somites, but in the head they eventually disperse. Despite a fundamentally different mode of gastrulation and a relatively small number of cells in the newly formed somitomeres, cranial segmentation in Oryzias embryos was found to be more similar in number to the metameric pattern of the embryos of the bird, reptile, and mammal than to the situation found in the two amphibians studied thus far. PMID- 3682003 TI - The development of acellularity of the vertebral bone of the Japanese medaka, Oryzias latipes (Teleostei; Cyprinidontidae). AB - Among vertebrates, some teleosts are unique in having bone which lacks osteocytes embedded in the matrix. The fate of cells that secrete the matrix of these acellular bones has not been investigated thoroughly. Histological and fluorescent microscopic analysis of the vertebral bone of Oryzias latipes demonstrated that acellularity is not a secondary appearance of an early cellular bone during ontogeny. Vertebral bone is devoid of cells embedded in the matrix throughout development. Cells that secrete bone matrix do not become trapped in their own secretion. Instead, they always remain as a surface layer over the outer surface of the bone. Fluorescent microscopic visualization of tetracycline injected into growing fish demonstrated that bone was only deposited by osteoblasts lining the outer surface of the bone; no deposition of bone took place on the inner surface. PMID- 3682004 TI - Functional characteristics of rat gastrocnemius and tibialis anterior muscles during growth. AB - Several morphological and functional characteristics of the rat gastrocnemius medialis and tibialis anterior muscle were studied in young, adult, and old rats to assess the influence of growth. Antagonist muscles were studied to determine how changes of muscle architecture and functional characteristics are influenced by the demands of increased body weight and by the specific roles of these muscles in locomotion. Both muscles change drastically, for instance, in muscle length, volume, physiological cross-sectional area aponeurosis length, and their muscular geometry changes allometrically for both muscles. The relationships between muscle length, distance between origin and insertion, tendon length, and tibial length also change with growth. Both muscles are rather pennate, so that the increase of physiological cross-sectional area is a major factor in the determination of muscle length. No significant difference could be shown for fundamental physiological characteristics (i.e., functional characteristics normalized for muscular dimensions such as maximal work per unit volume). The changes of morphological and functional variables of both muscles parallel each other as is apparent from the index of antagonist characteristics, which is constant for all variables studied with the exception of muscle volume and tendon length. Consequently, the considerable and similar changes of TA and GM morphology and functional characteristics that take place during growth from approximately four weeks postnatally is not caused by changes of muscular material but by changes of the amount and architectural arrangement of the material involved. PMID- 3682005 TI - Origin of mesenchymal tissue in the septum primum: a structural and ultrastructural study. AB - A structural, ultrastructural and histochemical study in chick embryos indicates that the septum primum mesenchymal tissue originate between 3 and 5 days of development and that their origin may be related to an activation of endocardial cells that cover the septum primum. By day 3, endocardial cells display migratory appendages, cell hypertrophy and an increase in secretory and mitotic activity. In later stages (day 4) hypertrophic endocardial cells undergoing division seem to delaminate and translocate toward the subendocardial space to give rise to free mesenchymal-type cells. These results suggest that the endocardium makes up the bulk of the septum primum mesenchymal tissue as has been demonstrated during mesenchymal tissue formation in the atrioventricular canal and outflow tract. Before and during mesenchymal tissue formation an accumulation of extracellular matrix components like proteoglycans can be visualized using tannic acid. These extracellular components might be related to the promotion of cellular events described during endocardial activation. The fusion of the septum primum with the atrioventricular (AV) endocardial cushions which would obliterate the foramen primum, occurs between mesenchymal tissues. Therefore, any alteration in the normal development of these mesenchymal tissues could be related to pathological cases of persistent atrial communications. Light microscopy preliminary observations of embryonic mouse heart indicate that septum primum mesenchymal tissue formation occurs similarly between mouse and chick embryos. PMID- 3682006 TI - New aspects of the kinetics of isoenzyme CK-MB during myocardial infarction: discontinuous release? AB - Intermittent liberation of the serum marker myoglobin is found in acute myocardial infarction, and the ST segment of the electrocardiogram also shows a phasic rise and fall. We therefore measured the serum marker CK-MB at close intervals of time and recorded an oscillation in the serum level. The peaks are not as high as in the serum myoglobin time curve, and it is not easy to decide if they represent the intermittent liberation of the serum marker. It was possible to distinguish between a "high release" and a "low release" group of patients: the former having a maximum CK-MB value of greater than 100 U/l and the latter of less than 100 U/l. Most patients showed 2-3 "initial peaks" within the first 8 h. The highest of these immediately preceded the climb to the definitive maximum value. We conclude that the small size of the peaks in the CK-MB time curve is due to a different mechanism of enzyme release. PMID- 3682007 TI - Quantitative analysis of myofibrillar protein subunits: demonstration of large molar excesses of myosin light chains in rabbit ventricular myocardium. AB - We describe a method for the complete solubilization and quantitative analysis of individual myofibrillar proteins in whole tissue homogenates of ventricular myocardium using gradient dodecyl sulfate polyacrylamide gel electrophoresis and staining with 125I-labeled Coomassie brilliant blue. The procedure allows for the simultaneous quantification of myosin heavy chain, myosin light chain, phosphorylatable myosin light chain and actin from as little as 50 mg of tissue. Within-assay and between-assay variations range from 8.0% to 12.6% for each protein subunit. The method was applied to the determination of the subunit stoichiometry of purified myosin, and to the measurement of myosin and actin concentrations in the neonatal and adult rabbit heart. Furthermore, we provide quantitative biochemical evidence for the existence of large molar excesses of myosin light chains in tissue homogenates of both neonatal and adult rabbit ventricular myocardium. PMID- 3682008 TI - Changes in the messenger RNA population from the heart of cardiomyopathic hamsters. AB - Messenger RNAs were extracted from the heart of cardiomyopathic hamsters at different phases of the disease and from age-matched control hamsters. They were translated into proteins in a rabbit reticulocyte lysate in the presence of [35S]methionine, the translational products were fractionated by two-dimensional polyacrylamide gel electrophoresis and analyzed by fluorography. No difference between cardiomyopathic and control hamsters could be detected when comparing the spots corresponding to the major contractile proteins. However, we observed that three translational products of minor abundance were reproducibly decreased in cardiomyopathic hamsters at 60 days (necrotic phase) and 200 days (final phase) but not at 30 days (prenecrotic phase). At 120 days (hypertrophic phase), the decrease could also be detected but was much less pronounced. PMID- 3682009 TI - Molecular biology of the cardiovascular system. Ninth annual meeting of the International Society for Heart Research, American Section. September 8-12, 1987. Boston, Massachusetts, U.S.A. Abstracts. PMID- 3682011 TI - Cancer in blacks and other minorities. PMID- 3682010 TI - Inquisition, peer review, and black physician survival. PMID- 3682012 TI - Sympathetic ganglia neural blockade. PMID- 3682013 TI - Thiocyanate in sickle cell anemia. PMID- 3682014 TI - Atrial septal defect in the adult. AB - This is a case report of a woman with congenital atrial septal defect, untreated surgically, who survived to the age of 87 years. Only two patients with longer survival were found in the literature. PMID- 3682015 TI - Occupational cancer risk associated with the storage and bulk handling of agricultural foodstuff. AB - The cancer mortality experience of 2649 Swedish grain millers was followed during the period from 1961 to 1979. Although the overall cancer incidence was not elevated, the risk of primary liver cancer was significantly elevated for this group (standard incidence ratio = 238). The Swedish data is compared to the cancer mortality experience of workers in the Netherlands and the United States who are also involved in the bulk handling and storage of agricultural foodstuffs (e.g., peanuts, grains). The varying occupational exposures in this international comparison help establish etiologic hypotheses in the absence of comprehensive exposure information. Agents of potential concern include metabolic products of fungal contaminants (e.g., aflatoxins) and pesticides used to protect grain from insect infestation. PMID- 3682016 TI - Critical concentration of cadmium for renal toxicity in rats. AB - To evaluate a critical concentration concept of cadmium (Cd) toxicity on the kidney, relationships of renal Cd level with urinary excretion of various substances--i.e., metallothionein, alkaline phosphatase, lactate dehydrogenase, N acetyl-beta-D-glucosaminidase, total protein, Cd, copper, and zinc--were studied in Cd-injected rats. At the renal Cd concentration of 100-200 micrograms/g tissue, a dramatic increase of all these substances in urine was observed, supporting the idea of the critical concentration proposed by Friberg and co workers (1974). The significance of increase of urinary metallothionein below this level is also discussed. PMID- 3682017 TI - Glutathione redox status of control and cadmium oxide-exposed rat lungs during oxidant stress. AB - Activities of enzymes responsible for the maintenance of reduced glutathione (GSH) levels have been shown in a previous study to be increased in rat lungs following a 3-h exposure to cadmium oxide aerosols at 5.0 mg/m3. In this study, the ability of the lung to maintain levels of GSH during challenge with tert butyl hydroperoxide (tBuOOH) was evaluated in isolated perfused lungs from control and cadmium oxide-exposed rats. Changes in glutathione redox status were indicated by measurements of nonprotein sulfhydryls (NPSH), total glutathione (1/2 GSH + GSSG), and glutathione disulfide (GSSG) in liquid nitrogen freeze clamped lungs after 3-min infusions with 0-0.6 mM tBuOOH. In control and cadmium oxide-exposed lungs, levels of 1/2 GSH + GSSG remained constant over the range of 0-0.6 mM tBuOOH, indicating that no loss of glutathione from the system had occurred. In experiments with control lungs, levels of NPSH fell from 8.04 +/- 0.22 to 3.09 +/- 0.40 mumol/g dry weight when tBuOOH concentrations were increased from 0 to 0.6 mM (n = 20-23). In cadmium oxide-exposed lungs, NPSH levels also decreased proportionally to increases in GSSG. However, at concentrations of 0.075 and 0.15 mM tBuOOH, significantly smaller decreases in NPSH levels were observed in cadmium oxide-exposed lungs compared with controls. This protection against the GSH-depleting effects of tBuOOH might be explained by increased tissue levels of GSH-related enzymes. PMID- 3682018 TI - Effects of intermittent inhalation exposures to mixed atmospheres of NO2 and H2SO4 on rabbit alveolar macrophages. AB - Rabbits were exposed (2h/d) to atmospheres consisting of 0.5 mg/m3 (0.3 micron) H2SO4 plus NO2 at either 0.3 (low) or 1 ppm (high). Animals were sacrificed 24 h after 2, 6, or 13 exposures, and cells were recovered from the lungs by bronchopulmonary lavage. Exposure to high NO2 with acid resulted in an increase in neutrophils at all time points and an increase in phagocytic capacity of macrophages after two or six exposures. On the other hand, exposure to the low NO2 with acid resulted in depressed phagocytic capacity and mobility. The results were compared with those for NO2 or H2SO4 given alone. PMID- 3682020 TI - Lung hydrolases in paraquat poisoning: early response of alkaline phosphatase. AB - In order to evaluate the early response of the alveolar epithelium following lung injury, male Long-Evans adult rats (280-350 g) were treated with a single dose (30 mg/kg, ip) of the herbicide paraquat. No animal died during the 72 h that followed the acute administration of the herbicide. When compared to control, total lipid, phosphatidylcholine, and disaturated phosphatidylcholine contents of lung homogenates from the paraquat-treated rats were significantly reduced 48 h postdose (respectively 10, 24, and 37%). Comparatively, the total lung alkaline phosphatase activity was significantly reduced as early as 12 h postdose, and by 48 h the activity had decreased by approximately 50%. Although a significant decrease in total lung acid phosphatase activity was observed 24 and 48 h after the treatment, the effect was much less than with the alkaline phosphatase activity (15% versus 50%, respectively). The lysosomal beta-N acetylglucosaminidase and the cytoplasmic lactate dehydrogenase activities were not affected by the herbicide treatment. A subcellular fractionation of the treated lungs showed that 48 h postdose, the total alkaline phosphatase activities associated with lamellar body and surfactant fractions were decreased respectively by 60% and 49%. Due to the intrinsic association of a strong alkaline phosphatase activity with the pulmonary surfactant system, these data suggest that the monitoring of the alkaline phosphatase activity in lung fractions could represent an early and sensitive indicator of toxicity to the alveolar epithelium, most probably to type II cells. PMID- 3682019 TI - Mucus protection and airway peroxidation following nitrogen dioxide exposure in the rat. AB - In the current study, biochemical measures of lipid peroxidation following 4-h inhalation exposure to 76 mg/m3 (40 ppm) nitrogen dioxide were correlated with measures of deposition and tissue antioxidant levels in the nasal cavity and the trachea of the Fischer rat. In addition, respiratory-tract mucus samples were collected via esophageal cannulation and nasopharyngeal lavage over known time periods, and were analyzed for phospholipid (PL) content to provide an index of the unsaturated lipids (UL) that they may contain. UL are thought to be important in the scavenging of oxidants by the mucous lining layer. Nasal deposition efficiency, as measured in the surgically isolated upper respiratory tract under unidirectional flow conditions, averaged 25%, corresponding to an absolute deposition rate of 41 nmol/min. Vitamin E levels averaged 1.7, 5.9, and 0.7 nmol/mumol PL in nasal, tracheal, and pulmonary tissues, respectively. The level in the trachea was significantly (p less than 0.005) higher than in the other tissues. As estimated from the increase in lavage PL content over 1 h, the overall mucous PL transport rate was less than 0.013 nmol/min, suggesting the PL of the mucous lining layer could not offer significant protection against the inhaled NO2. Conjugated dienes were detected in two of four pooled nasal tissue samples. Thiobarbituric acid-reactive material levels in tracheal tissues were significantly elevated over control levels by NO2 (p less than 0.05). Thus, despite the relatively high vitamin E levels, 4-h NO2 exposure appeared to result in lipid peroxidation in the trachea and, perhaps, in the nasal airways of the rat, a result that correlated with the apparent lack of oxidant-scavenging species in the mucus lining these airways. PMID- 3682021 TI - Metabolism of 1,2,3,4-, 1,2,3,5-, and 1,2,4,5-tetrachlorobenzene in the squirrel monkey. AB - The metabolism of three tetrachlorobenzene isomers (TeCB) was investigated in the squirrel monkey. The animals were administered orally 6 single doses of 14C labeled 1,2,3,4-, 1,2,4,5-, or 1,2,3,5-tetrachlorobenzene over a 3-wk period at levels ranging from 50 to 100 mg/kg body weight (b.w.) and kept in individual metabolism cages to collect urine and feces for radioassay. Approximately 38% (1,2,3,4-TeCB), 36% (1,2,3,5-TeCB), and 18% (1,2,4,5-TeCB) of the doses were excreted respectively in the feces 48 h postadministration. In monkeys dosed with 1,2,3,4-TeCB, unchanged compound accounted for 50% of the fecal radioactivity; its fecal metabolites were identified as 1,2,4,5-tetrachlorophenol (TeCP, 22%), N acetyl-S-(2,3,4,5-tetrachlorophenyl) cysteine (18%), 2,3,4,5-tetrachlorophenyl sulfinic acid (3%), 2,3,4-trichlorophenyl methyl sulfide (0.6%), and 2,3,4,5 tetrachlorophenyl methyl sulfide (0.2%). As was the case with 1,2,3,4-TeCB, unchanged compound accounted for more than 50% of the fecal radioactivity found in the monkeys dosed with 1,2,3,5-TeCB. The fecal metabolites of 1,2,3,5-TeCB consisted of 2,3,4,5-TeCP (2%), 2,3,4,6-TeCP (14%), 2,3,5,6-TeCP (9%), and 2,3,5,6-tetrachlorophenyl sulfinic acid (15%). No metabolites were detected in the feces of monkeys dosed with 1,2,4,5-TeCB. While the fecal route represented the major route of excretion for 1,2,3,4-TeCB, the other two isomers were eliminated exclusively in the feces. The above data in the squirrel monkey are different from those obtained with the rat and the rabbit, and demonstrate the different metabolic pathways for the isomers. PMID- 3682023 TI - Neuroimmunomodulation. PMID- 3682022 TI - Effects of purified (AIN-76A) and natural-ingredient (NIH-07) diets on responses of BALB/c and B6C3F1 female mice to estradiol. AB - Female BALB/c and B6C3F1 mice were examined after a 3-wk exposure to dietary estradiol (0, 400, 800, 1600, and 3200 ppb) in a purified (AIN-76A) or a natural ingredient (NIH-07) diet. The use of AIN-76A was associated with a 9-13% greater (p less than 0.001) body weight and a 36-43% higher (p less than 0.001) serum cholesterol in both mouse genotypes when compared to mice fed NIH-07. Conversely, when fed NIH-07, both mouse genotypes had a 20-22% higher (p less than 0.003) serum urea nitogren and 2-3.5% higher erythrocyte count (p less than 0.001) and hemoglobin concentration (p less than 0.04) than when fed AIN-76A. Reduced erythrocyte parameters suggest that chronic feeding of the purified diet might result in anemia. No significant compound or diet-related differences were noted for serum creatinine, alanine aminotransferase, aspartate aminotransferase, or gamma-glutamyl transferase. Although there was no diet effect on absolute or differential white blood cell count, estradiol caused a decrease in the total white blood cell count (p less than 0.014) and an increase in the percentage of polymorphonuclear leukocytes (p less than 0.014) in BALB/c and decreased the percentage of lymphocytes (p less than 0.005) in B6C3F1 females. In addition, estradiol increased uterine weight and inhibited thymic and splenic weights in one or both genotypes. Spleen and thymus weight responses to estradiol were not significantly influenced by diet. However, the uterine weight responses to estradiol were apparently influenced by diet in both genotypes. In B6C3F1 mice, the uterus weighed more at each level of estradiol when mice were fed AIN-76A compared to NIH-07 diet. In BALB/c mice, this was true only at the two lower dietary concentrations of estradiol. In conclusion, mice fed the purified diet, AIN-76A, differed from those fed the cereal-based diet, NIH-07, in hematology, clinical chemistry, and uterine weight response to estradiol. PMID- 3682024 TI - Vasoactive intestinal peptide 1-12: a ligand for the CD4 (T4)/human immunodeficiency virus receptor. AB - A five-amino-acid (TDNYT) sequence of vasoactive intestinal polypeptide (VIP) shares homology with the proposed attachment sequences of the human immunodeficiency virus (HIV). Synthetic peptides with these sequences have previously been shown to block viral envelope (gp120) binding and HIV infectivity and to serve as agonists of the CD4 (or T4) receptor. Utilizing an in vitro human monocyte chemotaxis bioassay we examined novel synthetic VIP and gp120 sequences and characterized their pharmacological activities on monocyte chemotaxis. CD4 receptor activity is primarily specified by N-terminal (VIP [1-12]) amino acids. The profound immunosuppression of AIDS is not easily explained solely by virus infection. Recently described immunological functions of VIP are similar to some of the immunological abnormalities shown by patients with AIDS. An overproduction of a VIP-like molecule from viral sources (e.g. gp120) could explain some of the immune system impairments which have been described in AIDS. PMID- 3682025 TI - Development of innervation within syngeneic thymus tissue transplanted under the kidney capsule of the nude mouse: a light and ultrastructural microscope study. AB - The developing thymus, prior to the onset of its functional and structural organization, is innervated by the autonomic nervous system (ANS). The present study extends these earlier findings by analyzing at the light and ultrastructural microscope level the distribution of ANS nerves within normal 18 day-old embryo thymus, adult thymus, and thymic tissue transplanted under the kidney capsule of syngeneic nude mice. The results of this study showed that prior to birth the murine thymus is innervated by AChE-positive fibers that are distributed at the corticomedullary boundaries and throughout the adjacent cortex, as well as to cells beneath the thymic capsule. This pattern of distribution remains constant during adult life. The examination of the various thymic tissues by ultrastructural analysis demonstrated that myelinated and nonmyelinated fiber bundles penetrate the thymic capsule and the interface between the kidney and the thymus transplant. The myelinated fibers measured 2 micron or less in diameter; the nonmyelinated fibers were 1 micron in diameter. Myelination did not accompany the nerves into the parenchyma of the normal gland but was observed in the intralobular trabeculae of the transplanted thymus. Subcapsular nerves form a network that terminates among the thymocytes, whereas intrathymic nerves enter the parenchyma in bundles along the vasculature and interlobular septa before penetrating into the deeper layers of the thymic cortex. Some larger nerve fibers terminate in the corticomedullary boundaries and in the interlobular septa. Smaller fibers form en passant boutons near parenchymal cells. The innervation of both the normal thymus and the transplanted thymus prior to the onset of thymic immune function supports a role for ANS innervation in the development of thymic competency. PMID- 3682026 TI - Glial fibrillary acidic protein in chronic relapsing experimental allergic encephalomyelitis in SJL/J mice. AB - The gliotic scar in the demyelinated plaque is a prominent feature of the pathology of multiple sclerosis. Chronic relapsing experimental allergic encephalomyelitis (EAE) in the SJL/J mouse has many characteristics in common with multiple sclerosis in the human, including the development of intense gliosis during the course of the demyelinating disease. With the use of antibody to the astrocyte marker glial fibrillary acidic protein (GFAP) we have measured the increase of GFAP over an 11-month course of chronic EAE. Intense staining of astrocyte fibers was seen around EAE lesions, which were most frequently observed in the cerebellum, periventricular areas, and in the spinal cord. The relative amount of GFAP was estimated by preparation of cytoskeletal proteins from the affected CNS areas, separation of proteins by polyacrylamide gel electrophoresis, and quantitation of GFAP in relation to the 70-kD neurofilament protein (NF) in gel scans. The ratio GFAP/70-kD NF protein in control animals did not change significantly over 11 months, whereas this ratio gradually increased to 2.54 in animals with chronic relapsing EAE 6 months after immunization. Although some decrease of neural fibers may have contributed partially to this change in ratio, the amounts of GFAP were greatly increased. These results indicate that the SJL/J mouse with chronic relapsing EAE provides an excellent model with which to investigate the formation and development of the gliotic plaque analogous to that seen in demyelinated areas in multiple sclerosis tissue. PMID- 3682027 TI - Noradrenergic sympathetic innervation of the spleen: III. Development of innervation in the rat spleen. AB - The ontogeny of noradrenergic innervation and its compartmental development were studied in the rat spleen using glyoxylic acid histofluorescence and high performance liquid chromatography (HPLC). Noradrenergic nerves were present at birth in bundles adjacent to the splenic artery and vein. On days 1-3, fluorescent profiles largely were associated with the vasculature and with the perivascular zone. By day 6, these fibers formed increasingly elaborate and tortuous plexuses around the central arteries and their branches. By day 10, fibers were present along the marginal sinus and extended into the developing marginal zone. Between day 10 and day 13 the largest increase in norepinephrine (NE) levels (per mg protein) were noted, and the periarteriolar lymphatic sheath (PALS) achieved its adult form, with increased innervation of the parenchyma. In contrast, the venous/trabecular system developed relatively late. The first trabecular fibers were evident at day 10, and the capsule was not innervated until day 13. From 13 days to adulthood, there was a gradual refinement and extension of existing patterns with no change in NE levels as measured by HPLC (per mg protein), suggesting that the innervation was keeping pace with rapid increases in spleen growth. The pattern of growth and development for noradrenergic nerves in the PALS remarkably parallels changes in T cell compartmentation during this period. We propose that norepinephrine is available for interaction with T cells at the earliest stages of development and could play a role in such processes as lymphocyte packing and the onset of immunocompetence. PMID- 3682028 TI - Noradrenergic sympathetic innervation of the spleen: IV. Morphometric analysis in adult and aged F344 rats. AB - Noradrenergic postganglionic sympathetic innervation of the spleen in 8-month-old (adult) and 27-month-old (aged) Fischer 344 (F344) rats was examined using fluorescence histochemistry for catecholamines coupled with stereologic point counting analysis for quantitation of noradrenergic varicosities. Noradrenergic varicosities in the spleen were evaluated in four compartments: (1) vascular-, (2) trabecular-, (3) capsular-, and (4) parenchymal-associated fibers. The 27 month-old rats were subdivided further into two groups based upon behavioral testing for gustatory neophobia, a condition reported to be associated with acute locus coeruleus lesions in young rats and with diminished norepinephrine (NE) levels in central noradrenergic neurons in aged rats. In the 8-month-old rats, spleens displayed abundant innervation. Noradrenergic plexuses entered the spleen with the splenic artery and its branches, distributed into capsular and trabecular compartments, and followed the vasculature and trabeculae into splenic white pulp. Noradrenergic fibers entered the white pulp mainly in association with the central artery and its branches; liner and punctate varicosities branched mainly from vascular plexuses into the large, well-defined parenchyma of the white pulp, ending primarily among fields of T lymphocytes. Some fibers extended along the inner edge of the marginal zone and the parafollicular zone. Few noradrenergic varicosities were found in the red pulp. In both groups of aged rats, sympathetic noradrenergic innervation was diminished markedly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3682029 TI - Noradrenergic sympathetic innervation of the spleen: V. Acute drug-induced depletion of lymphocytes in the target fields of innervation results in redistribution of noradrenergic fibers but maintenance of compartmentation. AB - Sympathetic noradrenergic fibers follow the vasculature into the white pulp of the spleen and branch from the periarteriolar plexuses into T lymphocyte zones. These lymphocytes, reported to express adrenergic receptors, are contacted directly by norepinephrine (NE) terminals and are putative targets of the locally released NE. Although this splenic innervation has been studied extensively, the functional interdependence of the lymphocytes and the sympathetic innervation is not well understood. To assess the effect of acute lymphocyte loss on the splenic innervation, T and B lymphocytes were depleted through treatment with cyclophosphamide (CY) or hydrocortisone acetate (HC). Despite reductions in spleen weight and cellularity, the total NE content (pmol) per spleen did not change. However, the NE concentration increased in the treated spleens. Although the general compartmental organization of the noradrenergic fibers in the treated spleens was similar to that of controls, the NE fibers redistributed and increased in density around the smaller central arteries in lymphocyte depleted spleens. The accommodation of these NE fibers to the changing environment of the white pulp suggests that the innervation to the spleen remains chemically stable despite a large disruption to the normal splenic milieu, but is capable of plasticity in the face of a shrinking white pulp. PMID- 3682030 TI - Dopamine receptors on isolated membranes of rat lymphocytes. AB - Using [3H]-dopamine (DA) as the ligand of choice, we have shown that rat lymphocytes possess DA binding sites. The binding of [3H]-DA was specific, saturable, and of high affinity. The specific binding in membranes obtained from Con A-activated lymphoblasts was greater than the binding in respective unactivated lymphoid cells, and displaced by lower concentrations of unlabeled ligand. [3H]-DA was displaced specifically by DA, norepinephrine, and apormorphine. The binding sites were insensitive to neuroleptic drugs such as sulpiride, bromocryptine, and haloperidol. On the basis of these findings, we have suggested that lymphocytes possess a receptor site for catecholamines and the receptor for DA might be a D-3 receptor type. PMID- 3682031 TI - Intussusception following abdominal trauma. AB - We reviewed the charts of 21 patients on the Trauma Service who were operated on for intestinal obstruction for the years 1983 through 1985. Six (28.6%) of the 21 patients had intussusception as the cause of their obstruction post-laparotomy for trauma. All were males ages 17 to 25 years. The mechanisms of injury were gunshot wounds in three, stab wounds in two, and blunt trauma in one. Five patients were hypotensive on admission with systolic BP less than 70, and two patients received uncrossmatched blood preoperatively. Injuries at exploration included liver laceration (six patients), gastric perforation (two patients), and diaphragmatic lacerations, splenic laceration, renal injury, and ventricular injury, one each. No patient suffered small intestinal injuries and we cannot explain the occurrence of intussusception. Intussusception occurred in the first 8 postoperative days in four patients and at 21 days, and 10 months, in the remaining two. The diagnosis was made twice by CT scan preoperatively. Jejunojejunal intussusception was common (five patients), jejunoileal in one and ileocolic in one (who also had a jejunojejunal intussusception). All patients were treated with manual reduction alone and none recurred. There were no postoperative complications and all patients were discharged by the eighth postoperative day. Our study suggests that early postoperative obstruction is caused by intussusception with unexpected frequency in trauma patients, and can be diagnosed by CT scan in some cases. Treatment with operative reduction has an excellent prognosis. PMID- 3682032 TI - Aggressive trauma care benefits the elderly. AB - Few past studies have examined the long-term functional outcome of geriatric patients who survive trauma. To evaluate factors that determine the long-term potential for recovery in this population, we studied 63 survivors of blunt trauma over age 65 years between 9 and 38 months after hospital discharge. The overall level of injury was moderate, with a mean Injury Severity Score of 15.8 +/- 1.1. Thirty-nine patients (62%) had two or more body regions injured. Forty five patients (71%) had pre-existing cardiopulmonary disease. Surgery was required in half of the patients, one third experienced complications, and nine (14%) required ventilatory support for 5 or more days. Only two patients did not live independently before trauma. Immediately after discharge, 21 patients (33%) were independent, 23 (37%) were dependent but living at home, and 19 (30%) required nursing-home care (NH). NH patients were older, more severely injured, had more severe head and neck trauma, and required surgery more frequently after trauma than patients discharged directly home. Twelve of the 19 NH patients (63%) returned home 3.1 +/- 0.9 months after discharge, and 13 of the 23 dependent patients (57%) became independent. Ultimately, 56 patients (89%) returned home after trauma. These patients were younger, had a shorter hospital stay, and experienced fewer complications than patients who required permanent NH care. Among 12 patients 80 years old and over, eight patients eventually returned home. Overall, 38 patients (57%) returned to independent living after trauma. Aggressive support of the elderly trauma victim appears justified, since few patients require permanent NH care and the majority return to independent living after trauma. PMID- 3682033 TI - Continuous epidural fentanyl analgesia: ventilatory function improvement with routine use in treatment of blunt chest injury. AB - The safety and effectiveness of continuous epidural fentanyl analgesia (CEFA) in the treatment of blunt chest injury was evaluated by reviewing its use in 40 patients with multiple rib fractures or flail chest. Ventilatory function tests were performed before and after the institution of CEFA and mean changes calculated. The use of CEFA was associated with significant improvement in vital capacity and maximum inspiratory pressure (p less than 0.05). Minute ventilatory volumes and tidal volumes also showed slight improvement. There was no significant change in arterial CO2 tension with the institution of CEFA, and 85% of patients had good pain relief with CEFA. None of these patients required any other narcotic administration. Documented complications associated with CEFA included pruritus, urinary retention, and transient hypotension. There were no major associated complications. The results suggest that CEFA is a safe, effective method of pain control that acts to improve ventilatory function in patients with blunt chest trauma. PMID- 3682035 TI - Colostomy closure after colon injury: a low-morbidity procedure. AB - One justification for expanding the indications for primary repair of colonic injuries is the high morbidity classically associated with colostomy closure. Our impression that this morbidity is overstated prompted us to review our experience with closure of colostomies constructed for treatment of colon trauma for the 5 year period 1979-1984. During this period 75 colostomies created for treatment of colorectal injuries were closed. Complications were frequent after colostomy creation, but few could be attributed to the colostomy. Following colostomy closure, however, complications were infrequent (5%) and generally minor. If morbidity of colostomy closure is cited as a factor justifying expanded indications for primary repair of colon injuries, current morbidity rates should be borne in mind. PMID- 3682034 TI - Glucose infusion arrests the decompensatory phase of hemorrhagic shock. AB - Waning of hyperglycemia has been shown to be closely associated with the deterioration of mechanisms supporting homeostasis during hemorrhagic shock. However, the mechanisms which link plasma glucose levels to maintenance of homeostasis during hemorrhagic shock are not clear. The goal of the present study was to evaluate the importance of glucose to maintenance of compensatory mechanisms. This was undertaken by maintaining plasma glucose levels through infusion of hypertonic glucose (2-3 M) starting at the onset of decompensation during persisting hypovolemia. Administration of glucose at a rate of between 60 and 80 mumoles/min X kg arrested the fall in glucose concentration and significantly slowed or arrested the decompensatory phase. All of the saline infused control animals (n = 6) died within 3 hours after reaching their maximum shed blood volume, averaging 145 +/- 25 minutes, while two of the eight animals in the glucose infusion group died less than 4 hours after reaching the maximum shed blood volume. The remaining six animals were sacrificed between 270 and 397 minutes (average, 340 +/- 22 minutes) after reaching the maximum shed blood volume since decompensation was arrested. Compared to the saline-infused control group, animals receiving glucose infusion exhibited a more moderate acidosis, and the hemoconcentration which normally accompanies decompensation was also prevented. Since the increase in plasma osmolality and the fraction of the total osmolality change accounted for by glucose was less in the glucose-infused animals, these results suggest that the effect is not mediated through a glucose related maintenance of a transcapillary osmotic gradient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3682036 TI - Prediction of arterial blood gases by transcutaneous O2 and CO2 in critically ill hyperdynamic trauma patients. AB - The management of severe adult respiratory distress syndrome in critically injured patients requires the frequent measurement of arterial blood gases for adjustment of cardiovascular and ventilatory support. Since these require blood withdrawal and laboratory determinations, a noninvasive method of assessment of arterial gas tensions would permit more frequent assessment of the patient as well as permitting rapid changes in the patient's ventilatory status to be detected earlier in the clinical course. The role of transcutaneous O2 and CO2 tension in providing these measurements was evaluated in 92 studies in 38 critically ill patients with ARDS due to trauma and/or sepsis. All patients were normodynamic or hyperdynamic at the time of study (cardiac index 2.5 to 7.6 L/min/m2) and were intubated and on increased inspired oxygen fractions (FIO2 = 30 to 100%) delivered by mechanical ventilation, had a range of body temperature from 35.0 to 39.5 degrees C and pH from 7.29 to 7.57 The data from a transcutaneous O2 and CO2 sensor applied to the skin of the anterior thorax were analyzed by multiple regression analysis of variances. Prediction of the arterial oxygen tension (PaO2) from 52 to 253 torr was possible from regression-corrected measurements of the transcutaneous O2 (TcO2): [PaO2 = 1.1 (TcO2) - 0.28 (FIO2) + 45.5]. The arterial carbon dioxide tension (PaCO2) from 26 to 57 torr was predicted from the transcutaneous CO2 (TcCO2):[PaCO2 = 0.76 (TcCO2) + 0.06 (FIO2) + 0.035 (TcO2) + 4.1]. With these corrections, a noninvasive Respiratory Index was computed for assessing ARDS severity, and dynamic changes in arterial gases could be followed in response to postural changes, ventilatory alterations, or cardiovascular perturbations. These data suggest that a reasonable estimate of the arterial blood gases can be obtained from a regression-corrected measurement of the transcutaneous O2 and CO2 tensions in critically injured normodynamic or hyperdynamic ARDS patients. PMID- 3682037 TI - Effect of fibronectin therapy and fibronectin deficiency on wound healing: a study in rats. AB - Rats with standardized 3rd-degree burns of 1% body surface were treated intraperitoneally with different doses of human fibronectin or swine gelatin immediately after injury and on the following days. Controls received bovine albumin or no further treatment. Wound healing was assessed by planimetry (days 0, 2, and 7); additionally, plasma fibronectin was determined (days 3 and 7). On day 3 fibronectin levels were significantly elevated after albumin and the highest dosage of fibronectin (3 X 16 mg) and decreased after gelatin and the lowest dosage of fibronectin (3 X 4 mg). Wound healing was neither affected by albumin nor by human fibronectin, but it was significantly impaired by gelatin induced lack of fibronectin. The data support the opinion that fibronectin is an essential factor for the post-traumatic clearance of gelatin-like tissue debris via the reticuloendothelial system (RES). Overload by gelatin results in fibronectin deficiency and RES dysfunction with risks of infection and poor wound healing. PMID- 3682038 TI - Pediatric gunshot wounds. PMID- 3682039 TI - Early medical care and mortality in polytrauma. AB - This study attempts to objectively estimate the efficiency of early medical care. It is based on the comparison of two series of multiple injured patients. Ten years separated the two groups and during this period, an Emergency Medical Aid Service (SAMU 94) was created. The positive effect of early medical care was established through the variations of injury severity indices currently used in polytrauma: after the institution of Mobile Intensive Care Medical Units on the site of accidents cardiac arrests were ten times less numerous although lesions were more serious in the second series. Without taking into account the mortality rate of lower-limb trauma, where crush syndromes were very numerous, mortality rate decreased as far as spinal, chest, abdominal, and pelvic traumas were concerned. An estimation of the cost of such a system raised the problem of maximizing the efficiency of improved early medical care. PMID- 3682040 TI - Early bronchoscopy as a predictor of ventilatory support for burned patients. AB - Twenty-seven burned patients who had facial burns, hoarseness, or evidence of carbonaceous sputum or had been in a smoke-filled enclosed space underwent fiberoptic bronchoscopy at the time of admission. Airway severity was indexed (grades 1-5, grade 5 being the most severe). Fifteen nonsurvivors had a bronchoscopic index of 3.2 +/- 1.6 and 12 survivors an index of 3.4 +/- 1.2 (p greater than 0.05). No patient died of respiratory complications. Bronchoscopic index correlated poorly with the level of positive end expiratory pressure required to maintain oxygenation in any patient (r = 0.50). Likewise, bronchoscopic index did not correlate with duration of intubation in any survivor (r = 0.33). Immediate bronchoscopy after burn injury neither indicates the level of respiratory support that will be required nor predicts its duration. PMID- 3682041 TI - A posterior arthroscopic approach to bullet extraction from the hip. AB - A 22-year-old male sustained a gunshot injury to the left hip region. The bullet lodged in the articular surface of the femoral head posterosuperomedially. The location of the bullet within the hip joint stimulated the performance of an arthroscopy of the hip through a posterior approach. The authors are unaware of any other report in the literature describing such an approach. To minimize the dangers, a limited posterior incision was made and deepened through the short rotators. The arthroscope was introduced through the incision to perforate the posteroinferior portion of the hip joint capsule. The bullet was easily visualized with a 70 degree arthroscope. Positioning at the joint and traction are vital components to visualization. The use of three-dimensional CT scanning is an aid to the graphic understanding of the bullet's pathway and relations to the surfaces of the hip joint. PMID- 3682042 TI - Pseudomonas cervical osteomyelitis in a polytrauma patient. AB - Cervical osteomyelitis, an uncommon disease, is rarely associated with Pseudomonas organisms in non-drug-users. This report describes a case of cervical vertebral osteomyelitis associated with Pseudomonas aeruginosa pneumonia following panfacial trauma and closed head injury. Delays in diagnosing vertebral osteomyelitis are common because of the nonspecific nature of the history and the initial absence of clinical evidence, both of which may help to foster a generally low index of suspicion. PMID- 3682044 TI - Open reduction and internal fixation of vertical shear pelvic fractures. PMID- 3682043 TI - Triple dislocation in the upper limb. AB - A case of dislocation of the elbow and index finger PIP joints, in association with a fracture dislocation of the radiocarpal joint in the same limb, is presented. We found no previous reports of this combination of injuries. There were no neurovascular complications. PMID- 3682045 TI - Management of burned long bones. PMID- 3682046 TI - Visceral pleural thickening in asbestos exposure: the occurrence and implications of thickened interlobar fissures. AB - We evaluated fissural (ie, visceral pleural) thickening on radiographs in two asbestos-exposed study populations and a control group. Asbestos workers had an incidence of fissural thickening of 54.5% compared with 16.0% in the unexposed control group, with a strong positive statistical effect due to asbestos exposure beyond that attributable to age. Fissural thickening occurred in 85% of workers with parietal plaques and in 36% without pleural plaques. Fissural thickening occurred in 45% without radiographic evidence of pulmonary fibrosis, but it was very common (85%) in those with pulmonary fibrosis. Data analysis showed that fissural thickening responds more strongly to asbestos exposure than does plaque formation, with 21 years of asbestos exposure needed for a 50% chance of developing fissural thickening, while 31 years of exposure were needed for a 50% chance of forming pleural plaques. From a second group of 57 asbestos workers evaluated clinically, 8 were diagnosed as having asbestosis with radiographically clear lungs and fissural thickening. We conclude that visceral pleural thickening is common in asbestos exposure, that it is related to the years since first asbestos exposure, and that its presence may indicate the presence of pulmonary asbestosis, even with radiographically normal lungs. PMID- 3682047 TI - Mediastinal distortions from focal masses: a CT and radiographic study. AB - Fifty-seven mediastinal masses were studied by computed tomography (CT) and chest radiographs to determine how their specific site of origin affected their direction of expansion and the distortion of contiguous structures. Forty-four masses arose anterior to the heart and great vessels (precardiovascular compartment). When these masses arose on the right, they extended posteriorly only as far as the coronal plane of the trachea. Left-sided masses were not similarly limited in their posterior extension. Thirteen masses arose around the trachea and esophagus or in the subcarinal space (tracheoesophageal compartment). Masses in the upper part of this compartment caused tracheal and great-vessel displacement. The mobile superior vena cava (SVC) was more often distorted than was the aortic arch. Subcarinal masses always expanded to the right, displacing the right lower lobe. The heart and great arteries were more resistant to displacement and distortion than were the systemic veins. The trachea and mediastinal bronchi were intermediate in their displacement. The hila were effective barriers to the expansion of mediastinal masses. PMID- 3682048 TI - Pre-implant evaluation of speech and hearing. AB - This paper describes an approach taken to predict, in advance of invasive surgery, whether a permanent cochlear prosthesis will serve as an aid to hearing in postlingually deaf adults. Nine subjects were implanted transtympanically with a temporary single-channel round window electrode. Over the course of one week a number of tests were conducted, including (1) the measurement of current thresholds over a range of frequencies for sine, square and biphasic pulse waveforms and minimum detectable gap between a pair of short bursts; (2) the discrimination of elementary speech features of live voice such as interruption, intonation, and stress placement; (3) the recognition of consonants, and (4) speech tracking. Eight subjects were able to appreciate changes in loudness, pitch, duration and temporal gap for frequencies below 1 kHz. All showed significant improvements over listening with high-power hearing aids in discriminating a variety of changes in elementary speech features. It was found that the recognition of consonants and speech tracking was heavily dependent on lipreading. PMID- 3682049 TI - The University of Toronto cochlear implant study: a clinical overview. AB - The process of patient selection for a cochlear implant varies significantly from center to center. The University of Toronto Cochlear Implant Study Group has adopted a protocol which is unique in this regard. This overview highlights our selection process, details aspects of temporary electrode insertion and describes clinical findings considered to be of relevance. PMID- 3682050 TI - The nucleus implant: rehabilitation and results. AB - Improvements in hearing and speech perception were studied in three postlingually deaf adults who had received a Nucleus multi-channel intracochlear implant. Over the course of one year the repeated testing of hearing and speech perception were interspersed with sessions of speech processor adjustment, rehabilitation and video recording of performance. The data indicated that, while subjects were able to discriminate simple changes in acoustic patterns (e.g., noise versus voice), they were unable to recognize words taken from an open set. Learning effects were as high as 20-30%. Psychophysical experiments indicated a wide range of performance across individuals, in some instances close to values observed for individuals with normal hearing. PMID- 3682051 TI - Cochlear implant experience at the University of British Columbia. AB - The authors review their experience with 13 totally deaf patients implanted with the House/3M cochlear implant. The preoperative evaluation, operative procedure, postoperative rehabilitation and hearing results are presented. PMID- 3682052 TI - Cochlear implants in children. AB - This is a review of 183 children who have been implanted in various centers throughout the United States and Canada. There is a description of the surgical technical differences in the child as compared to an adult. The results discussed are the etiology of deafness, the years of profound deafness, the condition of the cochlea at the time of surgery, and the audiological results. As of January 1, 1986, the cochlear implant program in children had been functioning for three years. The results have been good. The goals of the children's implant program and future recommendations are listed. PMID- 3682053 TI - Technical development of an implantable cochlear prosthesis in Canada. AB - A new cochlear implant device is currently being developed by a group of research teams in Canada. This is an update on the progress of this development, including a brief description of the cochlear electrode array, the implantable stimulator, and the software development for the speech processor. PMID- 3682054 TI - The future of cochlear implants: a summary of the national forum. PMID- 3682056 TI - Air transport of critically ill. PMID- 3682055 TI - Pulsion hernias of tympanic membrane. PMID- 3682057 TI - Sonographic evaluation of pericholecystic abscess with intrahepatic extension. PMID- 3682058 TI - Prenatal detection of left atrial isomerism by ultrasound. PMID- 3682059 TI - The duck hepatitis B virus pre-C region encodes a signal sequence which is essential for synthesis and secretion of processed core proteins but not for virus formation. AB - Analysis of the serum of duck hepatitis B virus (DHBV)-infected ducks has revealed the presence of C-terminally truncated viral core proteins (e antigens). These proteins are glycosylated and therefore were not released from infected cells by lysis but rather by active secretion, indicating that the DHBV core protein can be synthesized alternatively as a cytoplasmic or a secretory protein. Transient expression of cloned wild-type DHBV DNA and of a specifically designed viral mutant in a human hepatoma cell line (Hep-G2) showed that the DHBV core gene promoter is active in differentiated human liver cells and that synthesis and secretion of the processed core proteins are dependent on the expression of the pre-C region, a small open reading frame which precedes the core gene. In addition, these experiments showed that the mechanism of core protein processing and secretion is conserved between DHBV and the human hepatitis B virus and therefore might be important for the hepatitis B virus life cycle in general. In spite of this, intrahepatic injection of the pre-C mutant into uninfected ducks resulted in viremia without concomitant e-antigen synthesis, indicating that virus formation is independent of pre-C expression. PMID- 3682061 TI - Immune therapy of a persistent and disseminated viral infection. AB - The mechanism of viral clearance was studied by using the mouse model of chronic infection with lymphocytic choriomeningitis virus. Distinct patterns of viral clearance and histopathology were observed in different organs after adoptive immune therapy of persistently infected (carrier) mice. Clearance from the liver occurred within 30 days and was accompanied by extensive mononuclear cell infiltrates and necrosis of hepatocytes. Infectious virus and viral antigen were eliminated concurrently. This pattern of viral clearance was also seen in most other tissues (i.e., lung, spleen, lymph nodes, pancreas, etc.). In contrast, a different pattern of clearance was observed in the brain. Infectious virus was eliminated within 30 days, but viral antigen persisted in the central nervous systems of treated carrier mice for up to 90 days. The urinary system was the most resistant to immune therapy. Elimination of infectious virus and viral antigen from the kidney took greater than 200 days and even then was not complete; trace levels of infectious virus were still present in the kidneys of some treated carrier mice. After immune therapy, viral antigen in the kidney was located within renal tubules that costained for intracellular mouse immunoglobulin G. This unusual staining pattern, coupled with the observation of large numbers of plasma cells within the kidney, suggests that virus immunoglobulin G complexes found in the tubules may represent in situ immune complex formation as opposed to deposition of circulating immune complexes. In conclusion, these results suggest that the site (organ) of viral persistence is an important consideration in developing treatment strategies for controlling chronic viral infections. PMID- 3682060 TI - Initiation and termination of duck hepatitis B virus DNA synthesis during virus maturation. AB - We characterized a number of important features of the structure of the cohesive overlap region of the DNA genome of duck hepatitis B virus. The 5'-terminal nucleotide of minus-strand DNA was localized to nucleotide 2537, a G residue within the 12-base repeat sequence DR1. This G residue was shown to be the site of a covalent linkage to a protein, consistent with speculation that this protein is the primer of minus-strand synthesis, which occurs by reverse transcription. The 3' terminus of the minus strand was heterogeneous, being mapped to nucleotides 2530 and 2531, indicating that the minus strand is terminally redundant by seven or eight bases and ends at the putative 5' end of the transcribed RNA template (pregenome) for reverse transcription. We previously demonstrated that the presumptive RNA primer of plus-strand synthesis remains attached to plus-strand DNA during virus maturation; moreover, the sequence of this primer suggested an origin from the 5' end of the pregenome (J.-M. Lien, C. E. Aldrich, and W. S. Mason, J. Virol. 57:229-236, 1986). We show here that over 75% of plus-strand primers are capped, further supporting the idea that these primers are uniquely derived from the 5' end of the pregenome. Finally, we found that seemingly mature duck hepatitis B virus genomes are incomplete by at least 12 bases, in that the 12-base repeat sequence DR2 is not copied into plus-strand DNA during virus maturation. Since DR2 in virion DNA is duplexed with the RNA primer of plus-strand synthesis, it is possible that the failure to make complete plus strands is due to an inability of the viral DNA polymerase to carry out a displacement of the bound RNA primer. PMID- 3682062 TI - Translational requirement for La Crosse virus S-mRNA synthesis: a possible mechanism. AB - Ongoing protein synthesis is required for La Crosse S-mRNA synthesis in vivo, and complete S-mRNA can be made in vitro only in the presence of an active rabbit reticulocyte lysate. Using in vitro systems based on the polymerase activity of purified virions, we further support the notion that it is translation of the nascent mRNA that is required for complete transcription. Since replacement of guanosine with inosine in the nascent mRNA substitutes for the translational requirement, it appears that translation is required to prevent interactions of the nascent chain from taking place, which, if not prevented, lead to premature termination. These interactions appear to be between the nascent mRNA chain and its nucleocapsid template. A model for the translational requirement for complete S-mRNA synthesis is presented. PMID- 3682063 TI - Effect of NH4+ ions on phi 29 DNA-protein p3 replication: formation of a complex between the terminal protein and the DNA polymerase. AB - Ammonium ions stimulated the formation of the phi diameter 29 protein p3-dAMP initiation complex by decreasing the Km value for dATP in a purified system containing the viral terminal protein p3, the viral DNA polymerase p2, and the phi 29 DNA-protein p3 complex as a template. In addition, NH4+ ions stimulated the amount of p3-dAMP complex elongation and increased by about twofold the rate of elongation. The stimulatory effect of NH4+ ions on in vitro phi 29 DNA replication is probably related to the formation of a stable complex between the terminal protein and the DNA polymerase, which was detected only in the presence of NH4+ ions. PMID- 3682065 TI - Quality of life survey of urinary diversion patients: comparison of ileal conduits versus continent Kock ileal reservoirs. AB - There has been a recent marked increase in interest in continent urinary diversions. While considerable time has been spent on the technical aspects of these diversions the psychological impact has not yet been fully explored. We describe an extensive survey that was conducted among 100 consecutive adults (87 respondents) who had undergone urinary diversion via an ileal conduit and 100 consecutive adults (85 respondents) in whom a continent Kock ileal reservoir was created during the last 3 to 5 years at our university by the same surgeons. The Kock pouch patients were stratified further into 63 with primary diversion and 22 who underwent conversion from previous conduit diversions. The survey consisted of a questionnaire that included a social and sexual survey, the Beck Depressive Inventory, the Profile of Mood States and a physical impact study. The results revealed that all patients surveyed generally were satisfied with the diversions and they had adapted reasonably socially, physically and psychologically. The key to adaptation seemed to be a detailed, realistic preoperative education about the type of diversion used. Patients with ileal conduit diversions had the lowest expectations of the form of diversion as defined by the preoperative awareness of the need to wear an external ostomy appliance with its associated inconveniences and change in the external body image. Postoperatively, ileal conduit patients also had the poorest self images as defined by a decrease in sexual desire and in all forms of physical contact (sexual and nonsexual). The subset of patients who underwent conversion from conduit diversions to Kock pouches, however, were statistically the most satisfied, and they were the most physically and sexually active. We conclude that the Kock continent urostomy offers an important alternative to noncontinent forms of diversion. PMID- 3682064 TI - Fistulas of the upper urinary tract: percutaneous management. AB - We treated 40 patients with urinary fistulas by interventional radiology. The antegrade percutaneous route, catheterization of the ureter and bypassing of the fistula enabled ureteral stenting in 36 patients (90 per cent). Criteria for successful treatment were healing of the fistula, normal renal function (evaluated by excretory urography and radionuclide studies) and absence of secondary stenosis at 6 months. Of the patients 28 (70 per cent) were treated successfully. The number of nephrectomies after failure of percutaneous techniques (5 of 40, or 12.5 per cent) seems lower than in the case of surgery. The results were excellent for fistulas occurring after endourology (all 9 successful) or after ureterointestinal anastomoses (7 of 8). On the other hand, the results appear disappointing in patients with fistulas in transplanted kidneys (3 of 4 failures). PMID- 3682066 TI - Malignant vesical tumors following spinal cord injury. AB - We present 11 male patients with spinal cord injury and neurogenic bladder disease in whom malignant vesical tumors developed. The incidence of these tumors in our spinal cord injury unit was 2.3 per cent. We investigated retrospectively the clinical, endoscopic and radiographic diagnoses, and analyzed the treatment. The most common presenting symptoms were recurrent urinary infections, hematuria and stone disease. Two patients presented with abdominal symptomatology (a large abdominopelvic mass and peritonitis). Endoscopic evaluation was nonspecific in 8 patients (72 per cent). Squamous cell carcinoma was present in 9 patients (81 per cent). One patient had pure transitional cell carcinoma, and 1 had mixed squamous and transitional cell cancer. Cytology was of no value in these patients. The presence of local invasion and bulky disease suggests that ultrasonography or computerized tomography of the abdomen and pelvis should be included during followup. Radical cystoprostatectomy with pelvic lymphadenectomy is the recommended therapy for localized disease. The presence of active or recurrent urethral disease in 55 per cent of the patients indicated that urethrectomy also should be performed. PMID- 3682067 TI - Neuroanatomical approach to radical cystoprostatectomy with preservation of sexual function. AB - The technique for radical cystoprostatectomy has been modified to avoid injury to the branches of the pelvic plexus that innervate the corpora cavernosa. Although the course of the neurovascular bundles in the region of the prostate and urethra has been well charted, the exact relationship of the cavernous nerves to the seminal vesicles and bladder has remained unclear. In an effort to delineate this anatomy more clearly, detailed anatomical dissections were performed on 9 male human cadavers. This study demonstrated that the pelvic plexus is located retroperitoneally on the lateral wall of the rectum 5 to 11 cm. from the anal verge with its midpoint related to the tip of the seminal vesicle. The cavernous branches travel in a direct route from the pelvic plexus toward the posterolateral base of the prostate, gradually coalescing from a group of fibers approximately 12 mm. wide to a more organized bundle approximately 6 mm. wide at the level of the prostate. Because the bulk of the pelvic plexus and its important branches are located lateral and posterior to the seminal vesicles, the seminal vesicles can be used as a landmark intraoperatively to avoid injury to the pelvic plexus when ligating the posterior pedicle. During the last 5 years 25 men have undergone radical cystoprostatectomy. Pathological evaluation of all specimens demonstrated negative surgical margins and no patient has had locally recurrent tumor. Of the patients undergoing cystectomy alone 83 per cent are potent. Although all patients undergoing urethrectomy were able to have erections postoperatively, only 40 per cent have erections that are sufficient for intercourse. These data indicate that to date it is possible to perform radical cystoprostatectomy with preservation of sexual function in the majority of patients without compromise to the curative aspects of the radical operation. PMID- 3682068 TI - Postoperative radiotherapy for patients with carcinoma of the prostate undergoing radical prostatectomy with positive surgical margins, seminal vesicle involvement and/or penetration through the capsule. AB - Between 1970 and 1983, 442 patients were treated for carcinoma of the prostate at our university medical center. Of the patients 319 underwent radical prostatectomy and 159 (50 per cent) had positive surgical margins and/or seminal vesicle involvement. Of these 159 patients 46 received postoperative irradiation and the actuarial survival was 96, 90 and 90 per cent at 5, 10 and 15 years, respectively. Among the remaining 113 patients who were treated with an operation alone the corresponding figures were 82, 62 and 21 per cent, respectively (p equals 0.02). Considering deaths only of cancer, the surgery only patients had a 15-year actuarial survival of 25 per cent compared to 90 per cent for those who underwent postoperative radiotherapy (p equals 0.07). Actuarial survival free of disease for the surgery plus postoperative irradiation group at 15 years was 40 per cent compared to 28 per cent for the surgery only group (p equals 0.34). Actuarial local control in the irradiated patients was 96 per cent at 15 years versus 32 per cent for the surgery only group (p equals 0.009). Actuarial survival free of distant disease at 15 years was 42 per cent in the irradiated versus 72 per cent in the nonirradiated groups (p equals 0.104). Severe complications attributable to radiation included 3 cases of radiation cystitis, 1 patient with urinary incontinence and leg edema in 9 per cent of the patients undergoing postoperative irradiation compared to 2 per cent of those treated with radical prostatectomy only. Postoperative irradiation appears to be indicated in patients with carcinoma of the prostate who undergo radical prostatectomy and who have positive margins and/or seminal vesicle involvement. Local control is markedly improved (p equals 0.009) and actuarial survival also is benefitted. There was a trend toward decreased deaths of cancer with postoperative irradiation that approached statistical significance. Postoperative irradiation did not improve survival rates free of disease and free of distant disease over those achieved with surgery alone. This finding suggests that while postoperative irradiation may not improve the ultimate cure rate by controlling local disease, early deaths of cancer are reduced resulting in a meaningful increase in survival for these patients. PMID- 3682069 TI - Neurofibroma of the ureter. AB - We report a case of neurofibroma of the ureter without other clinical signs of von Recklinghausen's neurofibromatosis. The patient presented with flank pain, and excretory urography, retrograde urography and computerized abdominal tomography demonstrated a ureteral mass. The light and electron microscopic characteristics, as well as the histogenesis of ureteral neurofibroma, are discussed. PMID- 3682070 TI - Adjuvant radiotherapy after radical prostatectomy: is it indicated? PMID- 3682071 TI - A clinically "silent" pheochromocytoma with spontaneous hemorrhage. AB - We report a case of an abdominal mass that had hemorrhaged spontaneously into the retroperitoneal space and presented as an acute abdominal catastrophe. The pathological diagnosis was pheochromocytoma, although the patient had no suggestive symptoms preoperatively. The management of this silent pheochromocytoma and its atypical presentation are discussed. PMID- 3682072 TI - Mechanical gastric outlet obstruction after continent urinary diversion. AB - A number of complications have been associated with complex continent urinary diversions. We report a case of postoperative mechanical gastric outlet obstruction after continent urinary diversion with distal ileum and ascending colon. Following adequate urinary reservoir drainage gastric outlet obstruction resolved. Such mechanical effects from distended urinary reservoirs must be considered in any patient undergoing continent urinary diversion. PMID- 3682073 TI - Diagnostic nomenclature for prostate cancer. PMID- 3682074 TI - Mechanics and neurophysiology of intestinal segments as bowel substitutes: an editorial comment. PMID- 3682075 TI - The impact of detubularization on ileal reservoirs. AB - For many years, parts of the large or small bowel have been used for bladder augmentation and substitution. Recent controversy over the advantages and disadvantages of continent urinary diversion using detubularized ileum (the Kock pouch) and tubular ileum (the Camey procedure) focussed on how a highly compliant urinary reservoir should be formed. We compared the compliance of isolated intact ileal segments and ileal pouches constructed after transection of the antimesenteric border. Hydrodynamic data was obtained at four different points in time: acute (immediately after pouch construction), and after two, six and twelve weeks. Over the first six weeks the reservoirs were connected to the bladder for drainage. At six weeks, subtotal cystectomy and separate anastomosis of the tubular ileal loop and the detubularized ileal pouch to the trigone was performed to study the influence of cyclic reservoir distention. Statistical analysis of the pressure-volume curves revealed significantly better compliance of the detubularized ileal pouch as compared to the intact ileal segments. The area under the pressure curve values (AUC) were p less than 0.025, p less than 0.02, p less than 0.005 and p less than 0.02 for the acute experiment, after two weeks, after six weeks, and after 12 weeks respectively. Our findings suggest that transection of the circular intestinal wall is an important step in the creation of a good-compliant urinary reservoir. PMID- 3682076 TI - Testicular tumors in mice exposed in utero to diethylstilbestrol. AB - Treatment of pregnant women with diethylstilbestrol (DES) is associated with the subsequent development of reproductive tract abnormalities such as epididymal cysts, retained hypotrophic testes and sperm abnormalities in their male offspring. It recently has been suggested that prenatal DES exposure is associated with development of testicular seminoma in humans. Studies of in utero exposure of laboratory animals to DES are few, but previous reports from our laboratory have described several abnormalities in the reproductive tract of the mouse following prenatal DES exposure. To study the possible association of testicular tumors and prenatal DES exposure in mice, pregnant outbred CD-1 mice were injected subcutaneously with daily doses of DES (100 micrograms./kg.) on days nine through 16 of gestation. DES-exposed and age-matched control male mice were sacrificed at 10 to 18 months of age and examined for testicular lesions. In addition to the nonmalignant abnormalities reported in previous studies such as 91% cryptorchidism and degenerative changes, interstitial cell tumors were observed in nine mice among 277 mice treated prenatally with DES. Two of these lesions were benign tumors and five were interstitial cell carcinomas. Rete testis adenocarcinoma was seen also in 5% of these DES-treated animals and is described in another report. The overall incidence of testicular tumors is 8% in DES-exposed male mice. No comparable lesions were seen in 122 control male mice. These results suggest that the testicular lesions that can occur following prenatal DES exposure include neoplasia. The combined prevalence of DES-induced tumors of the corpus testis and rete testis in mice suggests the male offspring may be more at risk for developing carcinoma of the reproductive tract than the female offspring. PMID- 3682077 TI - Bladder outflow obstruction--a cause of denervation supersensitivity. AB - Eighteen Landrace pigs and 12 Gottingen mini-pigs were evaluated in a study of experimental bladder outflow obstruction. Twenty-two of the animals underwent partial bladder outflow obstruction for periods up to 12 months. The subsequent changes were assessed using cystometric, physiological and morphological means. There was a consistent increase in the voiding pressures and a concomitant reduction in the flow rates in all the obstructed animals. Seventy-seven per cent of the obstructed animals showed cystometric evidence of bladder instability. In vitro studies showed an increase in sensitivity to exogenously applied agonists and a reduction in sensitivity to intramural nerve stimulation. Morphological studies showed an inverse correlation between neuronal density and the duration of obstruction. These changes are typical of post-junctional supersensitivity secondary to partial denervation. These results suggest that agents capable of stabilising the bladder smooth muscle membrane may be useful in the treatment of detrusor instability secondary to bladder outflow obstruction. PMID- 3682078 TI - The veno-occlusive mechanism of the canine corpus cavernosum: angiographic and pharmacologic studies. AB - Studies were designed to document the normal angiography and pressure-volume characteristics of the canine corpus cavernosum, evaluate the effects of various vasoactive agents, and characterize a veno-occlusive mechanism. In fourteen dogs, baseline cavernosography demonstrated venous drainage via six to ten tributaries arising from the crura and entering the deep penile veins. Control cavernosometry during infusion of saline at 0.33 ml./sec. led to a rise in intracavernosal pressure (ICP) from 24.9 +/- 7.9 mm. Hg to 68.4 +/- 21.1 mm. Hg. Intracavernosal injection of a number of vasodilators, including papaverine, nitroglycerin, acetylcholine, and prostaglandin E2, raised baseline ICP significantly, caused extreme elevation of pressure during saline infusion (greater than 450 mm. Hg), and narrowed or obliterated the venous lumena at the site of tunica perforation, as judged angiographically. These effects could be reversed with phenoxybenzamine or norepinephrine. Our results further support the current understanding of the canine veno-occlusive mechanism. PMID- 3682079 TI - The efficacy of chemotherapeutic agents against murine bladder metastasis. AB - Three chemotherapeutic agents, methotrexate, cyclophosphamide and cis diamminedichloro-platinum (cis-platinum), were examined for their effectiveness against metastases in a murine transitional cell carcinoma model. Systemic treatment of the drugs was applied against a MBT-2 derived subline which generates 100% incidence of lung metastases in C3H mice by five weeks. The drugs were examined for their effect against the number of metastases, incidence of metastasis and size of the subcutaneously implanted primary tumor. All three compounds significantly reduced both the number of lung metastases and the incidence when compared to untreated animals. None of the agents proved 100% effective against metastatic tumors. These results suggest the existence of a chemotherapeutic resistant population of metastatic cells. Administration of methotrexate and cis-platinum effectively reduced the size of the primary tumor as compared to untreated animals. Cyclophosphamide did not significantly affect primary tumor size. The response of the antineoplastic agents against the metastatic tumor cells indicates that the L3F2 metastatic cell line is an effective model to study agents against metastatic bladder cancer. PMID- 3682080 TI - First isolation of a calicivirus from the Steller sea lion (Eumetopias jubatus). AB - A calicivirus was isolated from the rectum of a Steller sea lion (Eumetopias jubatus) pup on Rogue Reef, off the southern Oregon coast. Based on the results of neutralization tests with specific typing antisera, the isolate was identified as San Miguel sea lion virus serotype 6 (SMSV-6). Blood obtained from nine of 37 pups (24%) during virus sample collection procedures had specific neutralizing antibodies to SMSV-6. The isolation of SMSV-6 from a Steller sea lion represents, to our knowledge, the first isolation of any virus from this widely distributed marine mammal species, and serves to reconfirm the host-nonspecificity of yet another calicivirus of marine origin. PMID- 3682082 TI - Prevalence of Giardia sp. in a beaver colony and the resulting environmental contamination. AB - The prevalence of Giardia sp. in a beaver (Castor canadensis) colony in Colorado was determined by the collection and analysis of fecal samples over a period of 14 mo. Environmental contamination was monitored through the use and analysis of water filter samples. Beaver shed cysts of Giardia sp. in their feces throughout the year with temporal variations in the prevalence, and became infected as kits and remained infected as juveniles and adults. Beaver served as amplification hosts for Giardia sp. and contaminated surface waters downstream from their dams in late spring and early fall. In slow moving waters the cysts of Giardia sp. settled rapidly. Muskrats (Ondatra zibethicus) were the only other species of wildlife shedding cysts of Giardia sp. on the study area. PMID- 3682081 TI - Immunization of salmonids against Yersinia ruckeri: significance of humoral immunity and cross protection between serotypes. AB - Brook trout (Salvelinus fontinalis) were immunized with bacterins containing either Serotype 1 or 2 isolates of Yersinia ruckeri to determine the relative degree of cross-protection afforded when the fish were challenged with the homologous or heterologous serotype. While fish immunized with pH-lysed bacterins produced highly specific agglutinins that did not cross-react with antigens derived from a heterologous serotype of Y. ruckeri all fish were protected against experimental challenge, regardless of which serotype was used for bacterin production and experimental challenge. Other experiments indicated that brook trout injected intraperitoneally with highly specific antibodies could not be passively immunized against experimental challenge. PMID- 3682083 TI - Mass stranding of Odontoceti caused by parasitogenic eighth cranial neuropathy. AB - Hearing organs of the Odontoceti from two mass strandings in 1983 and 1986 were examined histopathologically. In the 1983 stranding, two of three pilot whales (Globicephala macrorhynchus) were necropsied and numerous Nasitrema sp. were found close to the eighth cranial nerve (nervus vistibulo cochlearis) in both animals. Patchy degeneration of the eighth cranial nerve in and out of the modiolus of the cochlea was observed. In the 1986 stranding, five of 125 false killer whales (Pseudorca crassiclens) were examined and numerous trematodes (Nasitrema gondo) were found in the tympanic cavities. Severe degeneration of the eighth cranial nerve was discovered and there were many trematode eggs in the nervous and surrounding tissues. Parasitogenic eighth neuropathy is proposed again as the cause of mass stranding of the Odontoceti. PMID- 3682084 TI - Unusual finding of encapsulated nematode larvae (Spiruroidea) in Bartramia longicauda and Numenius americanus (Charadriiformes) in western Canada. AB - Third-stage spiruroid larvae were found encapsulated on the serosa of the small and large intestines and in the mesentery of one of 15 adult upland sandpipers (Bartramia longicauda) from Manitoba, Canada, and three of 18 adult long-billed curlews (Numenius americanus) from Alberta, Canada. The larvae resemble third stage larvae of Physocephalus sexalatus and birds may serve as a paratenic host of this unidentified spiruroid species. PMID- 3682085 TI - Effects of Cephenemyia spp. (Diptera: Oestridae) on the nasopharynx of black tailed deer (Odocoileus hemionus columbianus). AB - A study was conducted to determine gross and microscopic tissue changes in the nasopharynx of black-tailed deer (Odocoileus hemionus columbianus) infected with nasal bot fly larvae (Cephenemyia spp.). Paired retropharyngeal recesses were the preferred sites for the growing second and third stage larvae of two species of Cephenemyia (C. apicata and C. jellisoni). Retropharyngeal recesses distended into "pouches" that harbored up to 30 larvae. Pouches were oriented caudal laterally toward the basisphenoid bone of the cranium. Lateral support of the pouch mass was provided by the stylohyoid bone. The laryngeal orifice was never occluded by the enlarged recesses. The distal pouch wall was relatively thin and remained uniform in thickness as expansion progressed. Occasionally, aberrant larvae were found protruding through the distal wall of the pouch. Disruption of the epithelium and submucosa by larval mouth hooks and integumentary spines were examined by scanning electron microscopy. Histological examination of infected recesses revealed substantial loss of epithelium and mucous glands. Enlargement of recesses into pouches resulted from fibrosis. Healing occurred after larvae egressed from the pouches. Degenerating mucous glands, epithelial metaplasia, epithelial desquamation, and intense inflammation were found near larvae. An eosinophilic exudate with a mixture of macrophages and erythrocytes was present in the lumen of the pouch. The presence of larvae within the pouch inhibited secondary bacterial infection and suppuration. Infection by larvae caused severe local trauma and intense tissue response. PMID- 3682086 TI - Effects of diets containing sodium fluoride on mink. AB - Mink (Mustela vison) kits still nursing, and adult male mink were fed diets containing various levels of fluorine (as NaF) to determine the effects on health, growth and pelt quality. Different groups were fed diets containing 25.5 (control), 46.0, 111.5 or 287.0 ppm fluorine (on a wet basis) for 7-8 mo. Gross, radiographic and microscopic changes were seen in bones from some animals ingesting the higher levels of fluorine. Chemical analyses for fluorine generally reflected levels ingested. Fluorine caused no detectable differences in pelt quality. After data were evaluated, tolerance levels in the feed of not more than 50 ppm fluorine for breeding stock and 100 ppm fluorine for animals being raised only for pelts are recommended. PMID- 3682087 TI - Prolonged and multiple immobilizations of the southern elephant seal using ketamine hydrochloride-xylazine hydrochloride or ketamine hydrochloride-diazepam combinations. AB - Thirty seven southern elephant seals (Mirounga leonina) were singularly or repeatedly immobilized with combinations of ketamine hydrochloride (HCl) and xylazine HCl or ketamine HCl and diazepam. Atropine sulphate was included in the drug combinations. To permit experimental procedures the seals were immobilized for periods of 30-330 min. The mean induction dose of ketamine HCl was 8.71 +/- 0.25 mg/kg (mean +/- SE). The mean induction time was 16.02 +/- 2.62 min. For the elephant seals immobilized for periods in excess of 180 min, the mean dose of ketamine HCl used per hr was 3.31 +/- 0.13 mg/kg/hr and the mean dose of ketamine HCl used per hr postinduction was 1.31 +/- 0.15 mg/kg/hr. The mean dose of diazepam used was 0.09 +/- 0.01 mg/kg and the mean dose of xylazine HCl was 0.41 +/- 0.01 mg/kg. Elephant seals were weighed on 20 occasions (weight range: 897 1,932 kg) and the relationship between standard length and weight was found to be: Weight = 9.98 length - 2,317.63 (r2 = 0.724). Adverse reactions to seals immobilized only once or twice were not observed. Two seals immobilized on three occasions developed abscesses at the site of injection. PMID- 3682088 TI - Immobilization of white-tailed deer by etorphine and xylazine and its antagonism by nalmefene and yohimbine. AB - White-tailed deer (Odocoileus virginianus) were immobilized with either 4.0 mg etorphine hydrochloride (ETOR) or 3.5 mg ETOR and 50.0 mg xylazine (XYL). Deer immobilized with ETOR only were given 4.0 mg nalmefene hydrochloride (NAL), a new opioid antagonist, 20 min after induction. Deer immobilized with ETOR and XYL received 3.5 mg NAL and 0.125 mg/kg yohimbine hydrochloride (YOH). The dose of 4.0 mg ETOR did not provide acceptable immobilization and was discontinued. A NAL:ETOR ratio of 1:1 was insufficient for complete and sustained antagonism of ETOR. Subsequently, deer were immobilized with ETOR and XYL as before which was then antagonized with 35.0 mg NAL and 0.125 mg/kg YOH. The 10:1 ratio of NAL:ETOR appeared to provide complete antagonism with no evidence of renarcotization. Although more study is required, NAL could become a useful antagonist for opioid induced immobilizations. PMID- 3682089 TI - Chemical immobilization of free-ranging North American bison (Bison bison) in Badlands National Park, South Dakota. AB - Twenty-six free-ranging North American bison (Bison bison) (22 adult bulls, one yearling male and three adult females) were immobilized using a combination of carfentanil and xylazine. For carfentanil the dose range (mean +/- SD) was 1.8 5.0 micrograms/kg (2.4 +/- 0.7 micrograms/kg) and for xylazine 0.004-0.125 mg/kg (0.07 +/- 0.03 mg/kg). Induction time (mean +/- SE) was 14.2 +/- 2.9 min (median 8 min), while the total mean reversal time after administration of a narcotic antagonist was 9.0 +/- 1.4 min (median 8 min). Only one animal that received the highest initial dose of carfentanil (2.5 mg) showed evidence of becoming "re narcotized." Five animals required two or more doses of carfentanil before becoming immobilized. Overall, small volumes of drug used (mean = 0.62 ml for carfentanil, 0.53 ml for xylazine) enabled the use of 1 to 2 ml darts, increasing both accuracy and impact safety. Darting success approached 100%. PMID- 3682090 TI - Capture methods in five subspecies of free-ranging bighorn sheep: an evaluation of drop-net, drive-net, chemical immobilization and the net-gun. AB - Six hundred thirty-four bighorn sheep (Ovis canadensis) were captured in the western United States between 1980 and 1986, using four different methods: drop net (n = 158), drive-net (n = 249), chemical immobilization (n = 90) and net-gun (n = 137). The net-gun was found to have considerable advantages over the use of ground nets and chemical immobilization methods for capturing bighorn sheep. Evaluation of specific outcome categories for individual sheep, including normal, compromised (stress-induced), mortality from capture myopathy (CM), and accidental mortality, revealed significant differences in these rates between capture groups (P less than 0.05). The use of the net-gun resulted in the lowest proportion of compromised sheep at 11% (15/137), had no CM mortality, and resulted in a 2% (2/137) accidental mortality. The use of drop-nets resulted in 15% compromised sheep (24/158), a CM mortality rate of 2% (3/158), and an accidental mortality rate of 1% (2/158). A similar proportion of sheep were compromised with the drive-nets (16%, 39/249). This method also had the highest CM mortality rate at 3% (7/249), and an accidental mortality rate of less than 1% (2/249). Chemical immobilization resulted in the most compromised sheep at 19% (17/90), had a CM mortality rate of 2% (2/90), and caused the most accidental deaths at 6% (5/90). Drop-nets and drive-nets were comparable when combining total mortality with rates for compromised bighorn sheep, 18% and 19%, respectively (29/158 and 48/249). Chemical immobilization had the highest combined measure of risk at 27% (24/90) and net-gun lowest at 12% (17/137).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3682091 TI - Effects of capture on biological parameters in free-ranging bighorn sheep (Ovis canadensis): evaluation of drop-net, drive-net, chemical immobilization and the net-gun. AB - Blood samples and physiological data were collected from 634 bighorn sheep captured between 1980 and 1986 in the western United States. Bighorn sheep were evaluated for physiological parameters (temperature, pulse and respiration), selected biochemical parameters (cortisol, creatine phosphokinase (CPK), serum glutamic oxaloacetic transaminase (SGOT), lactic dehydrogenase (LDH), alkaline phosphotase (AP), potassium, sodium, chloride, creatinine, blood urea nitrogen (BUN), selenium, glucose, total protein, plasma pH and plasma PCO2), and selected hematological parameters (packed cell volume (PCV), hemoglobin (HB), red blood cell count (RBC), and white blood cell count (WBC]. These parameters were compared among bighorn sheep captured by four different methods: drop-net (n = 158), drive-net (n = 249), chemical immobilization (n = 90) and the net-gun (n = 137). Biological parameters affected by stress, including temperature, respiration, cortisol, CPK, SGOT, potassium, glucose and WBC revealed significant differences among capture methods (P less than 0.05). Some blood parameter differences, including temperature, respiration, cortisol, glucose and WBC could be explained partially by the distribution of age and sex within capture method groups. Drop-net and net-gun methods of capture appeared to produce the least amount of alteration to biological parameters related to capture stress or compromise and capture mortality. Drive-net was similar to the former methods while chemical immobilization caused the greatest changes in the above physiological, biochemical and hematological parameters. PMID- 3682092 TI - Effects of capture on biological parameters in free-ranging bighorn sheep (Ovis canadensis): evaluation of normal, stressed and mortality outcomes and documentation of postcapture survival. AB - Blood samples and physiological data were collected from 634 bighorn sheep (Ovis canadensis) captured by four different methods between 1980 and 1986 in the western United States. These parameters were evaluated for selected physiological, biochemical and hematological values. Postcapture biological parameters were compared among bighorn sheep according to four different outcomes; normal, stressed or compromised, capture myopathy (CM) mortality, and accidental mortality. Significant differences (P less than 0.05) were noted between outcome groups relative to certain parameters: temperature, respiration, creatinine phosphokinase (CPK), lactic dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), blood urea nitrogen (BUN), glucose, white blood cell count (WBC) and plasma pH. Such differences between groups may help in evaluating the clinical status of bighorn sheep at capture, enabling one to predict those animals that might develop CM at a later date, indicate candidates for preventive medical treatment prior to release, and/or which should be followed closely to determine long-term survival. Evaluation of follow-up data (n = 77) related to outcome status and long-term survival of bighorn sheep indicated that less than 4% (3 of 77) were dead within 1 mo of capture (one of these had been classified as normal and two as stressed or compromised at capture); less than 3% (3 of 77) were dead greater than 1 mo, and less than 6 mo after capture two were classified in the stressed outcome and one as diseased. Eighty-eight percent (68 of 77) were alive from 1 mo to 5 yr after capture (53 were classified as normal, 12 as stressed or compromised and 3 as diseased), and 2% (1 of 77) had chronic CM but was still alive (this animal had been classified as normal). Of 77 sheep in the follow-up group, less than 3% (2 of 77) were not observed following capture (one was classified as normal and one as stressed and diseased). Of the fatalities, less than 3% (2 of 40) had been captured by the net-gun and less than 4% (1 of 27) by drive-net. Those two unobserved in the follow-up group also had been caught with the net-gun, 5% (2 of 40). The single surviving CM case had been captured by the net-gun. Although the net-gun appears to be one of the safest methods of capturing individual bighorn sheep, based on evaluation of capture data and biological parameters, it may not be associated with the best long-term survival in some bighorn sheep.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3682093 TI - Prevalence of Ife virus infection in wild rodents and birds from Zaria, Nigeria. AB - One hundred eighty-three wild rodents and 38 wild birds trapped near Zaria were screened for virus and complement fixing (CF) antibody to Ife virus. Virus was not isolated but CF antibody was detected in 8% Cricetomys gambianus and 31% Arvicanthis niloticus tested. The presence of Ife virus has been documented now in three ecological zones of Nigeria. PMID- 3682094 TI - Vibrio damsela infection in a stranded leatherback turtle (Dermochelys coriacea). AB - Necropsy of a stranded adult leatherback turtle (Dermochelys coriacea) determined that the animal died as a result of valvular endocarditis and septicemia. Vibrio damsela was isolated from the endocardial thrombus. The route of entry for infection probably was through the gastrointestinal tract. PMID- 3682095 TI - Fatal case of salmonellosis (Salmonella pullorum) in a chimpanzee (Pan troglodytes) in the Jos Zoo. AB - A case of salmonellosis in a captive chimpanzee (Pan troglydytes) is reported. Confirmatory diagnosis was based on clinical signs, necropsy and histopathological examination, and the isolation of Salmonella pullorum from the lung, liver, kidney and intestines of the animal. The source of infection was not ascertained. PMID- 3682096 TI - Parasitic ulcerative ventriculitis in mallards (Anas platyrhynchos). AB - Natural infections of Streptocara crassicauda and Streptocara incognita were diagnosed in four mallards (Anas platyrhynchos) from Red Rock Lakes National Refuge, Beaverhead County, Montana. Lesions at the junctions of the gizzard and proventriculus were associated with the nematodes, and resulted in debilitation, emaciation and death. PMID- 3682098 TI - Parasites of the Great Plains narrowmouth toad (Gastrophryne olivacea) from northern Texas. AB - Forty-nine adult and 14 immature Great Plains narrowmouth toads (Gastrophryne olivacea) from Johnson and Somervell Counties of northcentral Texas were examined for parasites. Sixty-four percent of the toads were infected with one or more species of parasites. New host records are reported for an isosporan similar to Isospora neos, and for Cylindrotaenia americana. The most common parasite in G. olivacea was the nematode, Cosmocercoides dukae. Prevalence was high among the adult G. olivacea (82%); however, none of the immature toads were infected. PMID- 3682097 TI - Parelaphostrongylus tenuis in New Brunswick: the parasite in white-tailed deer (Odocoileus virginianus) and moose (Alces alces). AB - Research was initiated in 1983 to investigate the ecology of Parelaphostrongylus tenuis in New Brunswick. The objectives were to determine the prevalence and intensity of infection in white-tailed deer, and to determine whether or not moose feces contained first stage larvae, signifying the completion of the life cycle of P. tenuis in this host. Forty-nine percent of deer pellet samples were positive and 60% of deer heads contained adults of P. tenuis. None of the moose pellet samples contained first stage larvae. PMID- 3682099 TI - Pathology of pentastomid infections (Sebekia mississippiensis) in fish. AB - Differential pathogenesis was observed in two species of fish naturally infected with the pentastome Sebekia mississippiensis. Mosquitofish (Gambusia affinis) showed a mild inflammatory response to developing nymphs, whereas swordtails (Xiphophorus helleri) had an extensive granulomatous inflammatory reaction with accompanying hemorrhage, myositis, and myodegeneration. This suggested that certain species of tropical fish reared in the southeastern United States may be at risk to potentially harmful infections with this parasite. PMID- 3682101 TI - A lymphosarcoma in an Atlantic salmon (Salmo salar). AB - A lymphosarcoma that appeared to be of thymic origin and of lymphoblastic type was found in a 3.5-yr-old Atlantic salmon (Salmo salar). The fish was from a population of 60 broodfish maintained at a research fish laboratory. A large tumor mass was found under the left operculum. Small tumor nodules were found on the swim bladder and in the abdominal adipose tissue. The location of this neoplasm differed from those of previously described tumors in this fish species. PMID- 3682100 TI - Visceral and subcutaneous acariasis caused by hypopi of Hypodectes propus bulbuci in the cattle egret. AB - Twenty-one of 24 adult male and female cattle egrets (Bubulcus ibis ibis) collected in Geneva County, Alabama had numerous white cyst-like structures (1,466 microns X 354 microns) found within the loose connective tissues of the skeletal muscles of the inguinal region, beneath the serosa of the proventriculus and in the heart beneath the epicardium (one adult male bird). These were identified as hypopi of Hypodectes (Hypodectoides) propus bulbuci. Histologic sections were prepared from the subcutis, proventriculus and heart. The histopathologic changes consisted of cross sections of mites surrounded by macrophages often containing basophilic or clear intracytoplasmic vacuoles and by plasma cells. A minimal fibrous encapsulation was rarely seen surrounding the mites. PMID- 3682102 TI - Omphalitis and peritonitis in a young West Indian manatee (Trichechus manatus). AB - Mortality data for the West Indian manatee (Trichechus manatus) indicates that from 1979 to 1984 16% of the recorded deaths involved young juveniles. Necropsy of a young manatee from the west coast of Florida revealed an active infection of the umbilical area (omphalitis) extending down the umbilical artery and veins. A generalized peritonitis was present. Bacterial cultures revealed Streptococcus faecium, Plesiomonas shigelloides, Pseudomonas putrefaciens and Escherichia coli. PMID- 3682103 TI - Cervical dorsal spondylosis with spinal cord compression in a black swan (Cygnus atratus). AB - Cervical dorsal spondylosis with spinal cord compression in a black swan (Cygnus atratus) was confirmed radiographically and morphologically. Clinically ataxia was associated. Noninflammatory, degenerative changes of the synovial joint cartilage were associated with the spondylosis. PMID- 3682104 TI - Plasma marking of arctic foxes with iophenoxic acid. AB - Six arctic foxes (Alopex lagopus) were marked with iophenoxic acid (IA), a substance which elevates concentrations of protein-bound iodine in blood plasma. Buccal absorption of IA was determined by placing 20 mg IA dissolved in 100% ethyl alcohol on the tongue. Blood samples collected from 1 to 36 wk following exposure showed that all foxes were marked already at 1 wk and continued until 13 wk; two foxes were still marked at 36 wk. Clearance rates for iodine varied with initial dose response, and those foxes with high 1-wk iodine concentrations excreted iodine more rapidly than those with lower initial concentrations; by 13 wk excretion rates were similar. PMID- 3682105 TI - An alternate method of descenting skunks. AB - Striped skunk (Mephitis mephitis) scent glands were ligated closed with waxed dental floss to allow them to be handled during toxicological studies without fear of scenting. This descenting technique was more rapid and less traumatic than scent gland removal. Thirty-four skunks were kept for less than or equal to 127 days and did not display behavioral or physical abnormalities due to this procedure. PMID- 3682106 TI - Inescapable problem: AIDS in prison. PMID- 3682107 TI - Medical libraries undergoing dramatic changes. PMID- 3682108 TI - An 'elegant' radiotherapy comes of age. PMID- 3682109 TI - Leads from the MMWR. Premature mortality due to breast cancer--United States, 1984. PMID- 3682110 TI - Leads from the MMWR. Substance abuse prevention program--Albuquerque, New Mexico. PMID- 3682111 TI - Cause of death. PMID- 3682112 TI - The epidemiologic necropsy. PMID- 3682113 TI - Scintigraphic evaluation of patients with suspected pulmonary thromboembolism. PMID- 3682114 TI - The scientists' campaign against the Strategic Defense Initiative. PMID- 3682115 TI - Strongyloidiasis in veterans. PMID- 3682116 TI - Failure to compensate decreased dietary sodium with increased table salt usage. AB - This study tested the extent to which individuals placed on a lowered sodium diet would compensate for the reduced dietary sodium by adding table salt to their food. Eleven students, unaware that their use of saltshakers was being studied, consumed all their meals and snacks in a clinical research center for 13 weeks. During the first three weeks and the last week (week 14), the diet contained approximately 135 mmol/d (135 mEq/24 h) of sodium, which was reduced to approximately 70 mmol/d (70 mEq/24 h) during weeks 4 through 13. A preweighed saltshaker was available for use throughout the entire 14-week period. Evaluations of salt taste preference and intensity scaling were conducted at regular intervals. Subjects compensated only slightly for the reduction of dietary sodium, making up less than 20% of the decrement with increased saltshaker usage. No changes in taste function were found. A substantial reduction in dietary sodium is possible if lowered-sodium foods are consumed in conjunction with ad libitum table salt. PMID- 3682117 TI - The deprofessionalization of medicine. Causes, effects, and responses. AB - In this article, we examine the components of medical professionalism; identify the roots of the loss of professional autonomy by physicians in the United States -a process that, in effect, is leading to the deprofessionalization of American medicine; discuss why such deprofessionalization is undesirable for the society; and explore three health care delivery systems and their effects on deprofessionalization. We suggest that a system based on organizations set up and directed by physicians will be the system that best preserves medical professionalism and serves the public interest. PMID- 3682118 TI - Treatment INDs: research for hire? PMID- 3682119 TI - Clinical investigation and JAMA. PMID- 3682120 TI - Tuberculosis and body build. PMID- 3682121 TI - Supreme Court case, federal 'initiative' put focus on alcoholism. PMID- 3682122 TI - Education effort emphasizes blood supply, use. PMID- 3682123 TI - International study looks at trace elements in diet. PMID- 3682124 TI - Radioimmunoguided surgery joins cancer war. PMID- 3682125 TI - Cardiopulmonary resuscitation: new approaches. PMID- 3682126 TI - Leads from the MMWR. Regional variation in smoking prevalence and cessation: Behavioral Risk Factor Surveillance, 1986. PMID- 3682127 TI - Leads from the MMWR. Hepatitis B in an extended family--Alabama. PMID- 3682128 TI - Leads from the MMWR. Influenza A isolates--United States, 1987. PMID- 3682129 TI - The role of anal/genital warts in HIV infection. PMID- 3682130 TI - Male-to-female transmission of HIV. PMID- 3682131 TI - HIV infection in Cuba. PMID- 3682132 TI - A safe approach to respiratory resuscitation. PMID- 3682133 TI - Nicardipine and urinary retention. PMID- 3682134 TI - Sigmoidoscopy: rigid or flexible? PMID- 3682135 TI - The Heimlich maneuver and drowning. PMID- 3682136 TI - Worlds apart. PMID- 3682137 TI - Prevalence of antibody to human immunodeficiency virus and hepatitis B surface antigen in blood samples submitted to a hospital laboratory. Implications for handling specimens. AB - The prevalence of hepatitis B surface antigen (HBsAg) and antibody to human immunodeficiency virus (HIV) was determined in serum or plasma specimens of 506 patients submitted to the clinical chemistry laboratory of an urban teaching hospital, and the results were correlated with "biohazard" warning labels on the specimens. Hepatitis B surface antigen, HIV antibody, or either of these were present in 32 (6.3%), 15 (3.0%), and 44 specimens (8.7%), respectively. Ten (67%) of 15 specimens with HIV antibody and nine (28%) of 32 with HBsAg bore biohazard labels. Among 473 unlabeled specimens, HIV antibody was present in five (1.1%), HBsAg was present in 23 (4.9%), and 27 (5.7%) contained either or both of these markers. All clinical and laboratory personnel should be vaccinated against hepatitis B and should handle all blood specimens as if they were infected, regardless of biohazard labeling. By fostering complacency in handling unlabeled specimens, the use of biohazard labels may paradoxically increase the risk that health care workers will be exposed to HIV and hepatitis B virus. PMID- 3682138 TI - Chronic respiratory failure in infants with prolonged ventilator dependency. AB - One hundred one infants with chronic respiratory failure (CRF) who required prolonged mechanical ventilation were cared for in the pediatric intensive care unit at The Children's Hospital of Philadelphia between January 1967 and December 1984. Chronic respiratory failure of infancy is a condition that requires mechanical ventilation for more than 28 days in the first year of life. Thirty six children had severe bronchopulmonary dysplasia, 50 had congenital anomalies, and 15 had neuromuscular disorders. The mean duration of mechanical ventilation for the 101 patients was 12.3 months. Seventy-one children were alive, and 53 (75%) of the 71 had been weaned from mechanical ventilation as of Dec 31, 1984. Pulmonary insufficiency and cardiac failure were the predominant causes of death in 17 of 22 infants in the first two years after the onset of CRF; four of eight deaths that occurred beyond two years were caused by airway- and ventilator related accidents. Mechanical ventilatory support was emphasized for as long as necessary to provide normal blood gas tensions, nutrition, growth, and development rather than weaning as rapidly as possible. This clinical experience demonstrates that it is feasible to save over 70% of infants with the severest forms of CRF and prolonged ventilator dependency. PMID- 3682139 TI - Evaluation of physical examination skills. Reliability of faculty observers and patient instructors. AB - Effective teaching of physical examination skills requires an evaluation system that can identify trainees who need further instruction. To study the evaluation of physical examination skills by faculty observers and patient instructors, the reliability of their observation of medical students performing a general physical examination was measured. Faculty observers did not reliably evaluate 32% of examination skills. Faculty agreement was lowest when observing components of the head, neck, and abdominal examinations. Patient instructors, with limited faculty training, reliably evaluated 83% of those skills that were reliably assessed by the faculty. These findings demonstrate limitations in the current methods of evaluating performance and point out the need to examine systems of trainee assessment. PMID- 3682140 TI - Bluefish-associated scombroid poisoning. An example of the expanding spectrum of food poisoning from seafood. AB - Five persons who attended a medical conference developed symptoms suggestive of an intoxication after a common meal. Although the symptoms were recognized as typical of scombroid poisoning, no fish of the Scrombridae family had been served. However, food histories implicated bluefish (Pomatomus saltatrix). The initially frozen bluefish had been improperly handled in storage and thawing. Elevated levels of histamine, putrescine, and cadaverine were detected in uncooked samples. This outbreak emphasizes that scombroid-type poisoning (1) can be caused by nonscombroid fish such as bluefish, (2) is probably more common than currently recognized, and (3) may become even more widespread as fish become a larger part of our diet. Physicians who work in conjunction with public health officials can help prevent additional cases and outbreaks. PMID- 3682141 TI - Ensuring integrity in biomedical publication. PMID- 3682142 TI - Reporting provocative results. Can we publish 'hot' papers without getting burned? PMID- 3682143 TI - Care of the infant with prolonged ventilator dependency. PMID- 3682144 TI - Information processing enters medical classroom. PMID- 3682145 TI - Fat cells pose weighty question. PMID- 3682146 TI - Leads from the MMWR. Diabetes in Pregnancy Project--Maine, 1986-1987. PMID- 3682148 TI - Decibeldome. PMID- 3682147 TI - Research on humans published in JAMA. PMID- 3682149 TI - Endarterectomy in carotid artery disease. PMID- 3682150 TI - Smoking and radon. PMID- 3682151 TI - Don't mix miso with MAOIs. PMID- 3682152 TI - Treatment of AIDS with transfer factor. PMID- 3682153 TI - Dyspnea in cyanotic congenital heart disease treated with air at 70 psi. PMID- 3682154 TI - Nifedipine in biliary and renal colic. PMID- 3682155 TI - Change in physician perspective on cholesterol and heart disease. Results from two national surveys. AB - The National Heart, Lung, and Blood Institute sponsored national telephone surveys of practicing physicians in 1983 (N = 1610) and 1986 (N = 1277) to assess attitudes and practices regarding elevated serum cholesterol levels. The 1983 survey was conducted just before the release of the results of the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease. In 1986, 64% of physicians thought that reducing high blood cholesterol levels would have a large effect on heart disease, up considerably from 39% in 1983. Whereas in 1983, physicians attributed considerably less preventive value to reducing the cholesterol level than to reducing blood pressure or smoking, this disparity was substantially smaller in 1986. The median range of blood cholesterol at which diet therapy was initiated was 6.21 to 6.70 mmol/L (240 to 259 mg/dL) in 1986, down from 6.72 to 7.21 mmol/L (260 to 279 mg/dL) in 1983; the median for drug therapy was 7.76 to 8.25 mmol/L. (300 to 319 mg/dL) in 1986 and 8.79 to 9.28 mmol/L (340 to 359 mg/dL) in 1983. In 1986, 87% of physicians surveyed felt that medical evidence warranted the recommended treatment levels set forth in the 1984 National Institutes of Health Consensus Conference on Lowering Blood Cholesterol. These changes indicate that by 1986, physicians were more convinced of the benefit of lowering high blood cholesterol levels and were treating patients accordingly. The data also suggest areas for continued educational initiatives. PMID- 3682156 TI - Change in public perspective on cholesterol and heart disease. Results from two national surveys. AB - The National Heart, Lung and Blood Institute, Bethesda, Md, and the Food and Drug Administration, Washington, DC, sponsored two national probability telephone surveys (N = 4000) of adults to assess attitudes and knowledge about heart disease risk from high blood cholesterol levels and the public's efforts to lower blood cholesterol levels. The first survey was conducted in 1983, before release of the results from the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease; the second survey was conducted in 1986. The percentage of adults who believed that reducing high blood cholesterol levels would have a large effect on heart disease increased from 64% in 1983 to 72% in 1986, so that the importance attached to reducing high blood cholesterol levels approached that attributed to reducing smoking and high blood pressure. In 1983, 35% of adults reported that they had their cholesterol level checked vs 46% in 1986. In both years, diet changes were most frequently chosen (greater than 60%) as ways to control the blood cholesterol level; reducing dietary fat was believed to be as important as reducing dietary cholesterol. By 1986, 23% of adults reported that they made dietary changes specifically to lower their blood cholesterol level, up from 14% in 1983. These comparative data show gains in public awareness and action relating to high blood cholesterol level risk. The data can be used to develop education programs. PMID- 3682157 TI - The torch is passed. PMID- 3682158 TI - Continuing medical education: past, present, and future. PMID- 3682159 TI - Diagnostic and therapeutic technology assessment. Chorionic villus sampling. AB - Chorionic villus sampling has a promising future as a means of early detection of fetal abnormalities. It has widespread application in Europe, and more than 6000 procedures have been performed in the United States. Universal acceptance of the procedure has been delayed because of uncertainties over the true fetal loss rate. Information available today indicates that the fetal loss rate should be in the same range as that for amniocentesis--approximately 1% or less. Confirmation of these estimates awaits release of the data from the large clinical trials currently under way. Modifications of the sampling technique are also under investigation. Transabdominal CVS can also be performed early in pregnancy (six to 15 weeks) with a fine-bore needle and cannula under ultrasonic guidance. It remains to be seen if this offers any advantages or incurs additional risks over transcervical CVS. PMID- 3682160 TI - Proceedings of the 51st annual scientific meeting of the Japanese Circulation Society. March 1987, Tokyo. Abstracts. PMID- 3682161 TI - [Direct action of enflurane on the contractile element in skeletal muscle of guinea-pig]. PMID- 3682162 TI - [Effect of isoflurane anesthesia on hepatic circulation and hepatic oxygen metabolism in the presence of hypoxia]. PMID- 3682163 TI - [Significance of pulmonary vascular resistance in patients with esophageal carcinoma in intensive care periods after radical surgery]. PMID- 3682164 TI - [One-lung anesthesia for synchronous bilateral pulmonary operations in supine position]. PMID- 3682165 TI - [The respiratory effects of sevoflurane in dogs]. PMID- 3682166 TI - [Effect of modified NLA on thyroid functions in man]. PMID- 3682167 TI - [Effect of modified NLA with flunitrazepam and buprenorphine and surgery on adrenocortical function in man]. PMID- 3682168 TI - [The effect of anesthesia and surgery on human erythrocyte insulin receptors]. PMID- 3682169 TI - [Free and conjugated catecholamines in blood during dopamine infusion in patients with chronic renal failure]. PMID- 3682170 TI - [Effects of halothane and ketamine on the canine duodenal paraneurons]. PMID- 3682171 TI - [Effect of Neurotropin on the excitability of peripheral nerves]. PMID- 3682172 TI - [Optimum dose of epidural buprenorphine for post-operative analgesia]. PMID- 3682173 TI - [Changes in forehead and lower abdominal deep body temperature during transurethral resection]. PMID- 3682174 TI - [Management of the difficult endotracheal intubation; advantages of the Miller blade and a facilitated nasotracheal intubation with a fiberoptic bronchoscope]. PMID- 3682175 TI - [Anesthesia and primary hyperparathyroidism complicated with hyperparathyroid crisis--a case report]. PMID- 3682176 TI - [Persistent atrial fibrillation during insertion of central venous catheter with the catheter-over-guidewire device]. PMID- 3682177 TI - [A case of venous air embolism during neurosurgery in the sitting position--the effect of superimposed HFJV on the postoperative pulmonary edema]. PMID- 3682178 TI - [Anesthetic vaporizers used in Japan--present status based on questionnaire survey]. PMID- 3682179 TI - [Pharmacokinetic and clinical studies on latamoxef in the field of obstetrics and gynecology]. AB - Latamoxef (LMOX) 1 g was administered twice daily for 5 days to patients undergoing operation for myoma uteri and the time course of tissue concentrations of the drug and the prophylactic effect of the treatment on postoperative infection were studied. 1. Area under concentration-time curve (AUC) of LMOX was the highest in the perimetrium (45.3%), followed by the cervix uteri (39.2%), endometrium (35.9%), oviduct (35.1%), myometrium (29.5%), and ovary (24.4%). 2. Cmax was the highest in oviduct (46.9 micrograms/g), followed by Cmax's in perimetrium (44.2 micrograms/g), cervix uteri (35.8 micrograms/g), myometrium (26.9 micrograms/g), endometrium (25.6 micrograms/g), and ovary (24.3 micrograms/g). 3. Serum half-lives were T1/2(alpha) = 0.27 hour and T1/2(beta) = 1.81 hours. 4. Prophylactic efficacy against postoperative infections was 94.3%, and febrile morbidity was 5.7%. The preoperative and postoperative laboratory tests did not show appreciable changes, no adverse reaction was observed. In the present study, LMOX showed good transfer into gynecological tissues, suggesting its very high usefulness in the treatment of infection and in the postoperative management. PMID- 3682180 TI - [Prophylactic effects of a combined use of a cephem antibiotic, latamoxef, and tobramycin on postoperative infection in obstetrics and gynecology]. AB - To prevent postoperative infection in obstetric gynecology, latamoxef (LMOX) and tobramycin (TOB) were intravenously administered to 81 patients at daily doses of 2 g and 120 mg, respectively, for 5 postoperative days, and the preventive effect of the combined drugs on postoperative infection were evaluated in terms of the clinical effects and safety. 1. The fever index was low as a whole; 3.38 +/- 2.30 degree hours in patients receiving simple panhysterectomy (n = 61), 3.21 +/- 3.84 degree hours in those given cesarean section (n = 12), and 3.53 +/- 2.78 degree hours in those given other surgical procedures (n = 8). 2. There were no abnormalities in hematological findings or liver and kidney functions 14 days after the surgery. PIVKA-II was observed in 3 of 32 patients 14 days after the operation, at a rate of 9.4%. 3. Except mild diarrhea which was observed in 7 of the 81 patients (8.6%) in 4 to 6 days after the operation, no subjective or objective side effects or postoperative complications were observed. The combined use of LMOX and TOB seems useful for preventing postoperative infection in obstetrics and gynecology in terms of its efficacy and safety. PMID- 3682182 TI - [Effect of cefotaxime on hemostasis]. AB - We conducted hemostatic studies with 1,043 adult patients with various diseases who were treated for their infection with cefotaxime (CTX) in 368 hospitals throughout Japan. Underlying diseases in 1,012 patients were nonhematological disorders and those in 31 were hematological diseases. Thirteen (1.2%) out of 1,043 patients showed some abnormal results in blood coagulation tests following the administration of CTX. All the 13 cases with abnormal blood coagulation tests had poor dietary intake, and appeared to have liver damage before or during the drug administration, but in none of the cases which had abnormal laboratory findings were clinical bleeding symptoms observed. Consequently, we have concluded that the incidence of abnormal hemostatic tests following CTX administration is low, and that the appearance of abnormal tests is most likely dependent upon the condition of the patient. PMID- 3682181 TI - [Pharmacokinetic and clinical studies on ceftriaxone in the field of obstetrics and gynecology]. AB - Ceftriaxone (CTRX) was studied regarding its penetration into the adnexa uteri and uterine tissues, as well as its utility and safety in the treatment of patients with obstetric and gynecologic infections. The results obtained are summarized below. 1. When 1 g of CTRX was administered by intravenous bolus injection, Cmax in tissues of adnexa uteri and uterus ranged from 42.2 to 80.5 micrograms/g, Tmax ranged from 0.42 to 0.81 hour, and the AUC ranged from 314.9 to 606.9 micrograms.hr/g. Thus, drug penetration into these tissues was good. 2. Clinical efficacy of CTRX was evaluated in 29 obstetric and gynecological patients. The clinical efficacy was good in all cases. 3. Bacteriological effects of CTRX were very good, and 90% of the organisms isolated before treatment were eradicated. 4. Laboratory testing revealed an occurrence of mild eosinophilia in 1 case. PMID- 3682183 TI - [Clinical study of astromicin administered by intravenous drip infusion against chronic complicated urinary tract infections]. AB - Astromicin (ASTM) was administered by intravenous drip infusion (i.v.d.) to 22 patients with chronic complicated urinary tract infections and the clinical efficacy and safety of this drug were evaluated. The overall clinical efficacy rate obtained was 71.4% (excellent 6; moderate 9) of 21 evaluable cases by the UTI committee's criteria. Concerning the response on clinical isolates, the drug was highly effective especially against strains of Escherichia coli, indole positive Proteus and Serratia marcescens. It was not effective, however, against 2 strains of Pseudomonas aeruginosa. As for adverse reactions, there was one case which complained of headache on the 3rd day after starting treatment. In this case the drug administration was discontinued at the 5th day. The symptom disappeared within 24 hours without any treatment. No any other adverse reactions were noted. With regard to clinical test values for peripheral blood, liver and renal functions, no abnormality was observed in any of the cases treated with the drug. In conclusion, ASTM was found to be a highly effective and safe drug when administered by intravenous drip infusion in the treatment of chronic complicated urinary tract infections. PMID- 3682184 TI - [Fundamental study of piperacillin sodium in term and premature neonates]. AB - Piperacillin sodium (PIPC) is a semisynthetic penicillin displaying high antibacterial activities against Gram-positive and Gram-negative bacteria including Pseudomonas sp., Proteus sp., etc. It acts bactericidally and is stable against beta-lactamases. The usefulness of PIPC in the treatment of infections in mature and premature neonates was investigated and the following results were obtained. The pharmacokinetics (half-life, distribution volume, total body clearance) of PIPC after 50 mg/kg intravenous drip infusion in 10 cases of neonates were examined. Relationship between T1/2 and hours after birth was clearly determined. Adverse effects and abnormality in laboratory test values were not observed. It is considered from the above results that PIPC may be an useful antibacterial agent for the treatment of infections in neonates. PMID- 3682185 TI - Impaired right ventricular filling in old myocardial infarction. AB - To evaluate ventricular filling and interactions between right and left ventricles in patients with old myocardial infarction, right and left ventricular time-volume curves were analyzed from a cineangiographic study of 10 normal subjects (Group 1), 10 patients with old anterior myocardial infarction (Group 2) and 10 patients with old inferior myocardial infarction (Group 3). Volumes of both ventricles were calculated from each frame over an entire cardiac cycle using Simpson's method. From time-volume curves, peak ejection rates, peak filling rates and atrial kick rates were obtained for both ventricles and these parameters were normalized by end-diastolic volume. All patients were in sinus rhythm with heart rates less than 80 beats/min. There were no significant differences among the 3 groups in end-diastolic pressure of both ventricles and mean pulmonary artery pressure. Left ventricular ejection fractions were significantly lower in Groups 2 and 3 than in Group 1 (p less than 0.001, p less than 0.005, respectively), although there were no significant differences in end diastolic volume indexes of either ventricle among the 3 groups. Peak left ventricular ejection rate and peak filling rates of the left and right ventricles were lower in Group 2 than in Group 1 (p less than 0.01, p less than 0.05, p less than 0.01, respectively) and peak filling rate of the right ventricle in Group 2 correlated with the peak filling rate of the left ventricle and left ventricular ejection fraction (r = 0.64, r = 0.64, respectively). Peak filling rate of the right ventricle in Group 2 correlated inversely with left ventricular peak negative dp/dt (r = -0.72), but no correlation was found between peak filling rate of the right ventricle and left ventricular end-diastolic volume index or mean pulmonary artery pressure. Peak ejection rate of the left ventricle and peak filling rates of both ventricles in Group 3 were lower than in Group 1 (p less than 0.02, p less than 0.02, p less than 0.01, respectively) and no correlation was found between peak filling rates of both ventricles. Wall motion of the right ventricular septal portion was slightly reduced in 5 patients in Group 2. In all patients in Group 3, right ventricular wall motion centering around the right ventricular diaphragmatic portion was reduced. These results suggest that in old inferior myocardial infarction, right ventricular wall motion abnormality results in impaired right ventricular filling, whereas in old anterior myocardial infarction, right ventricular filling is reduced indirectly due to impaired left ventricular filling. PMID- 3682186 TI - Effects of nifedipine on left ventricular systolic and diastolic function in patients with ischemic heart disease. Radionuclide angiocardiographic studies at rest and during exercise. AB - The purpose of this study was to evaluate the acute effects of sublingual nifedipine (10 mg) on left ventricular systolic function (ejection fraction, peak ejection rate, time to peak ejection rate) and diastolic function (peak filling rate, time to peak filling rate, filling fraction during rapid filling) at rest and during exercise using radionuclide angiography in 17 patients with ischemic heart disease. The results of the study were as follows. Diastolic indexes in the patient group were significantly different from the values in the control group at rest and during exercise. Peak filling rate and filling fraction improved significantly after nifedipine administration. These values did not show significant differences from the values in normal subjects which were obtained before nifedipine administration. The peak filling rate during exercise after nifedipine administration increased significantly, although the value was lower than that in the control group. At rest, systolic indexes in the patient group showed abnormal values, although the differences from the control values were not significant. Ejection fraction and peak ejection rate were significantly lower than those in the control group during exercise. After nifedipine administration, peak ejection rate at rest and during exercise, and ejection fraction at rest in the patient group improved significantly. Seven of 17 achieved the same exercise workloads as control conditions without symptoms or ECG changes. These data suggest that nifedipine improved left ventricular systolic and diastolic dysfunction, as well as exercise tolerance in patients with ischemic heart disease. PMID- 3682187 TI - Quadrivalvular rheumatic heart disease. AB - Three cases of chronic rheumatic heart disease with involvement of all four valves are presented. The involvement of tricuspid and pulmonary valves was suspected clinically and was confirmed by two-dimensional echo, Doppler, hemodynamic and angiographic findings. These findings were also verified surgically and histopathologically in 2 cases. One of the cases died after cardiac catheterization; the other 2 cases were treated surgically with success. PMID- 3682188 TI - Effects of dichloroacetate on the mechanical function of the isolated ischemic heart. AB - The effects of sodium dichloroacetate (DCA) on the activity of the pyruvate dehydrogenase complex (PDH) and the mechanical function of the isolated ischemic rat heart were investigated. Ischemia was induced by restriction of coronary flow. Perfusion with DCA caused a decrease in the tension developed (DT) and the maximal rate of tension development (+ dT/dt max), and an increase in the resting tension (RT) at low flow rates (0.6 and 0.15 ml/min). However, it did not affect the DT or +dT/dt max of normoxic hearts (3 ml/min) or hearts at zero flow rate. DCA increased PDH activity in hearts at all flow rates. It was concluded that this effect of DCA was associated with a decrease in lactate production, rather than an increase in the lactate/pyruvate ratio. PMID- 3682189 TI - Swallowing-induced paroxysmal supraventricular tachycardia. AB - A 54-year-old man had palpitations on swallowing without any esophageal or heart disease. Electrophysiological findings, including an A wave in the high right atrial leads appearing prior to the A wave on His bundle electrogram, revealed that the arrhythmia was paroxysmal supraventricular tachycardia originating in an ectopic focus of the atrium with intraventricular aberration. Treatment with verapamil, 120 mg/day, reduced his symptoms in spite of an insignificant decrease in the arrhythmia observed with Holter dynamic electrocardiography. PMID- 3682190 TI - The spontaneously hypertensive rat (22). Proceedings of the XXII annual scientific meeting of the Society for the Spontaneously Hypertensive Rat (SHR). September 12-13, 1986, Tokyo. PMID- 3682191 TI - [The diagnostic value of immunoglobulin G in the cerebrospinal fluid of brain tumor patients, particularly in malignant tumors]. AB - The diagnostic value of immunoglobulin G in cerebrospinal fluid (CSF-IgG) has been evaluated in patients with brain tumors. The (CSF-IgG) level in patients with malignant brain tumors was found to be significantly elevated when compared to the level in control patients without a disorder of the central nerve system. Especially significant was high level of CSF-IgG found in patients whose tumor had invaded into ventricles. The CSF-IgG level was found to decrease to a normal range by a total or subtotal resection of the tumor, but not by partial resection. On the other hand, CSF which contained large amount of IgG inhibited the lymphocyte proliferative response to phytomitogen. These results suggest that CSF-IgG seems to correlate with the tumor volume, and is important as a tumor marker in patients with a malignant brain tumor. PMID- 3682192 TI - [Radiotherapy of nasopharyngeal carcinoma]. AB - The results of irradiation on fifty seven patients with nasopharyngeal carcinoma, treated from 1964 to 1985 at the Shinshu University Hospital, were studied. Forty two percent of the patients had T3-4 primaries and 68% had N1-3 regional nodes; 86% had Stages III-IV of the disease. Of the 57 patients, 32 had squamous cell carcinomas, and 25 had lymphoepitheliomas. The overall 5-year survival rate was found to be 57%. Primary size (T) and histology influenced the survival of patients; the 5-year survival rate was 70% for T1-2 primary and 39% for T3-4 primary, and 39% for squamous cell carcinoma and 80% for lymphoepithelioma. PMID- 3682194 TI - [Suppressive effect of lentinan on pulmonary metastases in murine tumors]. AB - Lentinan has been shown to have a suppressive effect on the natural pulmonary metastasis of Lewis lung carcinoma, though its effect seems to depend on the timing of the administration. Administration of lentinan after the amputation of tumor was found to be more effective than before administration. Additionally, lentinan also has shown a marked suppressive effect on the pulmonary metastasis of MC-CS-1 fibrosarcoma, a high sensitive tumor for lentinan in any administration examined. These date suggest the usefulness of lentinan in suppressing tumor metastasis. PMID- 3682193 TI - [Bone damage of mandibles after radiotherapy of carcinoma of the tongue]. AB - At Osaka University Hospital, the 5-year survival rate for carcinoma of the tongue, treated by radiotherapy, is almost 60% and in early cases, around 80%. However, with this improvement in the survival rate, an increase in the incidence of various complications (xerostomia, soft tissue ulcer, bone damage, etc.) has been observed. Because of these circumstances, a radiographic analysis on the bone damage of the mandibles after radiotherapy was made. Only those patients whose progress had been followed for more than one year and whose disease was well controlled were selected for this study. Early radiographic signs of bone damages showed an enlargement of the periodontal space and a loss of lamina dura. From the results of the study it has been found that bone damage is less common in patients treated by interstitial radiotherapy alone. Bone damage seems to develop more frequently in patients who receive about 30 Gy by external radiotherapy, followed by more than 2,000 mgh. Ra. eq. of interstitial radiotherapy. PMID- 3682195 TI - [Continuous intra-arterial infusion chemotherapy by implantable catheter access connected with a continuous infusion pump]. AB - Eleven non-resectable cancer patients have been successfully treated by means of a one-shot and continuous intra-arterial infusion chemotherapy, utilizing an implantable vascular access device (Catheter Access) connected to a continuous infusion pump (Nipro portable syringe infusion pump) via a non-corning needle (Nipro coreless needle set). This result suggests that this simple and inexpensive method can be applied not only for cancer chemotherapy but also for intravenous hyper-alimentation and for treatment of epidural anesthesia. PMID- 3682196 TI - [Pathomorphological study of metastatic liver tumors]. AB - Pathomorphologic features of metastatic liver tumors were studied in 362 autopsy cases at the Pathology Department of Kurume University Hospital for 7 years, from 1979 to 1985. The incidence of metastasis in cirrhotic liver was found to be 50%, and 45.1% for non-cirrhotic livers. Metastatic liver tumors were roughly classified into 4 categories: a small nodular type, a large nodular type, a mixed small and large nodular type, and an infiltrative type. The large nodular type tumor seemed be the most frequent in a metastasis via the portal vein, and the small nodular type was frequent in a metastasis via the artery. The gross characteristics of a metastatic tumor nodule could be grouped into 3 classifications: a solid type, a central necrosis type, and a mosaic type. The tumor of central necrosis type was frequent in cases of adenocarcinoma, and the solid type tumor was more prevalent in squamous cell carcinoma and free-cell type carcinoma. PMID- 3682197 TI - [An analysis of pain associated with cancer of various origins]. AB - The authors retrospectively investigated the incidence and duration of pain associated with cancer of various origin by means of a multivariate analysis in 444 patients who have died of cancer. The author also examined the correlation of severity of pain with the number of days from last admission to the hospital to the day of death. Results have indicated that the incidence of severe pain of long duration is high in relatively younger patients, those who are 55-years-old or under, and also in patients with rectal, uterine or ovarian cancer. Patients with a severer pain tended to be admitted to the hospital in a much earlier stage of the disease. In patients with risk of severe pain, an advanced plan to control cancer pain is helpful, as are analgesic approaches which can help the patient to remain at home as long as possible is desirable. PMID- 3682198 TI - [A report of a resected case of malignant lymphoma combined with follicular carcinoma of the thyroid]. AB - A 66-year-old female administered with complaining of cervical mass. All of the thyroid function tested were within normal limits. A diagnosis of Malignant lymphoma was done by fine aspiration cytology. Total thyroidectomy and dissection of bilateral regional lymph nodes were performed. And additional chemotherapy is continued. The histological findings revealed diffuse lymphoma, mixed type (LSG), but there is no invasion of the lymphoma cell to the lymph node. There are also two follicular carcinomas with metastasis to the dissected regional lymph nodes. In the residual thyroid tissue, the findings of chronic thyroiditis was shown histopathologically. PMID- 3682199 TI - [An autopsy case of a so-called carcinosarcoma of the pancreas]. AB - A case of a "so-called carcinosarcoma" of the pancreas that occurred in a 48-year old female is reported. At autopsy, the pancreatic tumor was seen to have deeply invaded the gastric wall, causing ulceration. The pancreatic tumor consisted of two different histological components: a squamous cell carcinoma and spindle-cell sarcomatous tumor cells. Transitional areas between the two different tumor cells were also present. Since there were transitional areas and a lack of definitive electron microscopic evidence favoring a sarcoma in the sarcomatous tumor cells, the pancreatic tumor was considered to represent a "so-called carcinosarcoma". PMID- 3682201 TI - [Significance and classification of bronchial asthma]. PMID- 3682200 TI - [An endometrial carcinoma occurring in both horns of a uterus bicornis unicollis- a case report]. AB - A case of an endometrial carcinoma occurring in both horns of a uterus bicornis unicollis in a 50-year-old women is described. This diagnosis can be easily missed unless both endometrial cavities are curetted simultaneously in cases of an either right or left affected fundus of a divided uterus. The correct diagnosis and a prompt definite treatment in this rare combination are emphasized. PMID- 3682202 TI - [Autonomic nervous system control of smooth muscles of the human airway--1) Stimulation receptors and vagus nerve reflex]. PMID- 3682203 TI - [Autonomic nervous system control of smooth muscles of the human airway--2) Sympathetic nervous system and distribution of adrenaline receptors]. PMID- 3682204 TI - [Bronchial asthma and airway hypersensitivity--1) Theory of vasotonia and hypersensitivity of irritant receptors]. PMID- 3682205 TI - [Bronchial asthma and airway hypersensitivity--3) Disorders of non-adrenergic inhibitory nervous system function]. PMID- 3682206 TI - [Bronchial asthma and airway hypersensitivity--4) Relation between airway hypersensitivity and chemical mediators]. PMID- 3682207 TI - [Bronchial asthma and airway hypersensitivity--5) Test methods of airway hypersensitivity--reality and evaluation of bronchial provocation tests]. PMID- 3682208 TI - [Physiopathology of asthma and the role of arachidonic acid metabolites]. PMID- 3682209 TI - [Bronchial asthma related to the mechanism of allergy--2) Immediate asthmatic response and late asthmatic response]. PMID- 3682210 TI - [Bronchial asthma related to the mechanism of allergy--3) Main allergens and confirmation of reagins of atopic-type asthma]. PMID- 3682211 TI - [Bronchial asthma due to non-allergic mechanisms--pathogenesis and clinical characteristics--2) Aspirin-induced asthma]. PMID- 3682212 TI - [Occupational asthma: classification of asthma according to causative substance and etiological mechanism]. PMID- 3682213 TI - [Lung function in bronchial asthma]. PMID- 3682214 TI - [Classification of asthma according to severity]. PMID- 3682215 TI - [Differential diagnosis of COPD: with special reference to bronchial asthma]. PMID- 3682216 TI - [Diagnosis, therapy and prevention of severe cases of bronchial asthma]. PMID- 3682217 TI - [Therapy and control of intractable bronchial asthma]. PMID- 3682218 TI - [Sodium iodide 131I treatment of patients with skeletal metastases from differentiated thyroid carcinomas]. PMID- 3682219 TI - [Appraisal of the clinical value of bone scintigraphy for benign bone tumors and tumor-like lesions]. PMID- 3682220 TI - [Results of radiotherapy of nasopharyngeal cancer]. PMID- 3682222 TI - [Dumbbell-shaped thymus with normal tissue in the posterior mediastinum]. PMID- 3682221 TI - [Radiation therapy of the paraaortic lymph nodes in carcinoma of the uterine cervix. I. Survival and prognostic factors--retrospective review of 86 patients based on a survey of the Kansai Cancer Therapist Group]. PMID- 3682223 TI - [RI angiography of hepatic angioma]. PMID- 3682224 TI - [A case of cysticercosis cellulosae hominis]. PMID- 3682225 TI - [A case report of esophageal cancer with meningeal carcinomatosis]. PMID- 3682226 TI - [A case of isolated left-sided inferior vena cava with abdominal aortic aneurysm]. PMID- 3682227 TI - [Pseudoaneurysm after angiography]. PMID- 3682228 TI - [A case of submucosal lipoma of the colon detected by computed tomography]. PMID- 3682229 TI - [Catheter device for use in selective right adrenal venography]. PMID- 3682230 TI - Oxalate loading test for screening steatorrhoea in diabetics. AB - Data presented here showed that oxalate loading test--a technique for diagnosis of steatorrhoea is not applicable if the patient is also suffering with diabetes. In vitro experiments showed that sugar interferes in oxalate assay. PMID- 3682231 TI - Augmentation by OK-432 of generation of culture-induced killer cells. AB - A streptococcal preparation, OK-432, injected intraperitoneally, potentiated rejection of L1210 leukemic cells in semiallogeneic BALB/c mice. This increased rejection was further enhanced by a transfer of peritoneal exudate T (PET) cells, but not of spleen cells. Spleen cells incubated in vitro for 3 or more days were as effective as PET cells in stimulating tumor rejection, and were cytotoxic in vitro as tested by a 4-hr 51Cr-release assay. This cytotoxicity was closely related to the OK-432-mediated augmentation of L1210 rejection in vivo. In vitro treatment with OK-432 of spleen cells from intact mice generated nonspecific cytotoxic cells. The cells were nonadherent to plastic, radioresistant, and of Thy-1+, Lyt-1,2-, and asialoGM1+ phenotypes, and were tentatively named OK-432 induced killer (OIK) cells. They were cytotoxic to tumor cells resistant to natural killer (NK) cells, and different from NK cells or lymphokine-activated killer cells. For their generation, macromolecular synthesis and participation of plastic-adherent cells (probably macrophages) were needed. The in vivo growth of L1210 leukemic cells could not be inhibited by simultaneous administration of PET cells primed in vivo with OK-432, of spleen cells primed in vivo with OK-432 and then cultured, or of spleen cells primed in vitro with OK-432 and then cultured (OIK cells). However, a prophylactic adoptive transfer of these cells was effective in immunocompetent mice as well as in athymic nu/nu mice, but not in mice irradiated with 400 rad. The in vivo activity was attributable mainly to Lyt 1+, -2- cells radioresistant and adherent to nylon wool, which were probably amplifier/helper T cells. PMID- 3682232 TI - Light microscopic observations of the vomeronasal organ of Habu, Trimeresurus flavoviridis. AB - Light microscopic observations of the vomeronasal organ (VNO) (Jacobson's organ) of Habu, Trimeresurus flavoviridis, revealed that the organ was encased in the os vomeris and the vomeronasal cartilage on either side of the nasal septum. Habu VNO was divided into a dome-shaped portion mainly composed of a sensory epithelium (SE) and a hemispherical mushroom body covered with a ciliated epithelium. A narrow lumen, leading to the oral cavity via the vomeronasal duct, was made between the mushroom body and the SE. The SE consisted of a supporting cell layer facing the lumen and the underlying sensory cell layer where a large number of cells piled up in columns. Vascular plexuses were found around the neck and bottom of the columns. Along the antero posterior axis of the VNO, the height of the columns reached its maximum in the middle of the dorsal and the median parts (over 300 micron), and gradually decreased toward lateral. Each column contained undifferentiated basal cells, sensory cells and satellite cells. Sensory cells had a round nucleus and prominent lipofuscin granules. The sensory cells were arrayed in a string-like arrangement. Cells situated in the neck region of columns contained a larger amount of lipofuscin granules. Distal processes of sensory cells passed through the cytoplasmic meshwork of supporting cells and terminated as small swellings. Aggregates of heterogeneous cell populations were observed in the antero lateral region of the dome. A number of pigment cells were seen in the epineurium and the perivascular regions of the dorsal and lateral VNOs. Goblet cells were present in the lateral boundary between the dome portion and the mushroom body. Present findings clarify the complex organization of the Habu VNO, and the occurrence of the sensory columns similar to those reported in other snakes. PMID- 3682233 TI - Characterization of concanavalin A induced peritoneal exudate cells in infant mice. AB - Con A induced peritoneal exudate (PE) cells were characterized in 9-12 days old infant mice. It was observed that 100-200 micrograms of Con A induces two peaks viz. first at 48 hrs post inoculation (PI) and second on 8-10 days PI. Majority of the induced cell population was adherent macrophages (75-80%) and non adherent population was 20-25%. During 2nd peak of induction non adherent population increased upto 40%. The macrophage population was heterogenous. However, majority of them were 8-12 micron in size. The cells showed strong non specific esterase and acid phosphatase activities. Subsequently, there was vesicle formation in this population. Con A also induced vesiculation in PE cells markedly when compared with normal unstimulated mice. PMID- 3682234 TI - [The effect of omeprazole, a proton pump inhibitor, on ontogeny of rat gastric mucosa, with special reference to cell proliferation and DNA synthesis]. PMID- 3682235 TI - [Studies of superoxide dismutase in rat gastric mucosal damage (2d report)- Pathogenesis of indomethacin-induced gastric ulcer]. PMID- 3682236 TI - [The influence of smoking on the onset and relapse of inflammatory bowel disease]. PMID- 3682237 TI - [Studies of the differentiation between rats and guinea pigs in immunoglobulin-A excretion into the bile]. PMID- 3682238 TI - [Studies on the relationship between HLA-class I displays on the hepatocyte membrane and liver injury in patients with chronic hepatitis type B]. PMID- 3682239 TI - [An experimental study of the function of the papillary sphincter and the pancreatic duct-acinar system as the regulatory mechanism of the pancreatic ductal pressure in the Japanese monkey]. PMID- 3682240 TI - [Effect of ethanol on exocrine pancreatic function in rats]. PMID- 3682241 TI - [A case of congenital tracheo-esophageal fistula in the adult]. PMID- 3682242 TI - [A case of Behcet's disease with diffuse colonic involvement]. PMID- 3682243 TI - [A case of common hepatic artery aneurysm with hepatic artery-to-portal vein fistula]. PMID- 3682244 TI - [A case of papillomatous cholesterosis of the gallbladder associated with anomalous arrangement of the pancreaticobiliary duct]. PMID- 3682245 TI - [Studies on the healing process of peptic ulcer using the fluorescence electronic endoscope]. PMID- 3682246 TI - [Changes in enzyme activities for scavenging oxygen radicals in the rat gastric mucosa around an experimental ulcer]. PMID- 3682247 TI - [Urinary pepsinogen I in patients with liver cirrhosis]. PMID- 3682248 TI - [Nucleation time of cholesterol monohydrate crystals from gallbladder bile of patients with gallstones]. PMID- 3682249 TI - [Protective effect of camostat mesilate and allopurinol in acute edematous pancreatitis in the rat induced by excessive doses of caerulein]. PMID- 3682250 TI - [Changes of SOD (superoxide dismutase) in the development of endotoxin-induced pancreatic lesion in mice]. PMID- 3682251 TI - [Malignant neoplasms in the aged]. PMID- 3682252 TI - [Effect of age on left ventricular performance]. PMID- 3682253 TI - [Pathogenesis of cardiac dysfunction in aged diabetics]. PMID- 3682254 TI - [Left ventricular function and diabetes mellitus]. PMID- 3682255 TI - [The significance of lipid metabolism in young and aged patients with myocardial infarction]. PMID- 3682256 TI - [The effect of risk factors on the structure of coronary arteries in ischemic heart disease--multivariate analyses of lipids and apoproteins]. PMID- 3682257 TI - [Metabolic disorders in the development of macroangiopathy]. PMID- 3682258 TI - [Platelet aggregabilities, plasma prostanoids and cyclic nucleotide levels in old people]. PMID- 3682259 TI - [Absorption and excretion of zinc in the aged]. PMID- 3682260 TI - [Clinical investigations on the recurrence of gastric ulcer in the aged: from the viewpoint of G.I. bleeding]. PMID- 3682261 TI - [The relationship between prognosis, regional cerebral blood flow (rCBF) and brain atrophy in dementia]. PMID- 3682262 TI - [Studies on centenarians in Fukuoka prefecture (II). Serum levels of biochemical components, lipids and pituitary, adrenal and gonadal hormones]. PMID- 3682263 TI - [Mucosal blood flow as a cause of pseudomembranous colitis]. PMID- 3682264 TI - [Effects of cerebral blood flow, arterial blood pressure and serum total cholesterol values on age-related brain atrophy]. PMID- 3682265 TI - [Intravenous short-term coronary thrombolysis by a high-dose urokinase in aged patients with acute myocardial infarction]. PMID- 3682266 TI - [Reevaluation of radionuclide cisternography in the elderly, with special reference to frequent occurrences of pseudo NPH]. PMID- 3682267 TI - [Aspiration pneumonia in the aged]. PMID- 3682268 TI - [Studies on negative U waves in patients with aortic regurgitation]. PMID- 3682269 TI - [Relationship between cerebral blood flow measured by 133Xe inhalation method and pulmonary function in the normal elderly volunteers]. PMID- 3682270 TI - [Effects of smoking on asbestos-related pulmonary and pleural changes]. AB - A radiologic study was made on 184 male asbestos workers in order to determine the effects of smoking on asbestos-related pulmonary and pleural changes. The effects of smoking on the prevalence of pleural changes could not be demonstrated, but the prevalence of pulmonary changes significantly increased with length of smoking history (p less than 0.01). It was found that smoking elevated the prevalence of asbestos-related pulmonary changes. These findings are of great importance in the health management of asbestos workers. PMID- 3682271 TI - [A simple determination method of bromide ion in plasma of methyl bromide workers by head space gas chromatography]. AB - An improved method for the simple determination of bromide ion in plasma is described. It was modified from the method by Kawai, Sugiyama et al. (1985). In the improved method, 200 microliters of plasma and 800 microliters of distilled water were placed in a reaction vial to which 100 microliters of dimethyl sulfate was added. The reaction vial was immediately sealed, placed in an incubator at 85 degrees C, and shaken for 10 min. At the end of the reaction, a gas-tight syringe was used to draw out the head space gas of 1 ml. The methyl bromide gas was then injected into a gas chromatograph and methyl bromide was determined with F.I.D. A good linear relationship was obtained between the peak area of methyl bromide and the concentration of bromide ion within the range of 0.5 to 500 ppm. Bromide ion in the range of 0.5 to 500 ppm in standard solution was added to the plasma samples. After 10 repeated measurements, the relative standard deviation was found to be in the range of 2.8-3.6% and recovery was over 96%. The analytical results of this method were compared with those obtained by spectrophotometry. The analytical results obtained by the two methods were in good agreement (r = 0.9669) in plasma samples of 10 methyl bromide workers. A study to determine bromide ion concentration in 39 methyl bromide workers was made and the results were compared with those observed in 100 workers (control group) not exposed to methyl bromide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3682272 TI - [Evaluation of diving stress implication of analysis of work loads]. AB - An investigation was conducted on the actual diving conditions of 2,996 divers in Japan except those engaged in fishery. Results of analysis made on the diving profiles and actual working conditions showed that some of their jobs required heavy load and that the burden was excessively large. Little study has been made for the proper evaluation of diving stress or work loads, but it has been assumed from these limited studies that the load is not so heavy. The load has been generally estimated to be about 1.8l/min STPD of oxygen consumption (VO2) during 40 l/min STPD of expiratory gas volume/min (VE). In our examination of their actual diving work, their work load was far greater than our expectation. It was in practice not only difficult to obtain the actual VO2 but also very difficult to determine their actual fatigue. Instead of these, it is necessary to establish an adequate index for evaluating diving work load. Studies have been made in our laboratory since 1981 and regression equations have been finally obtained, by which load during diving work can be determined using heart rate as index. Seven healthy males were chosen as subjects of the present study having a mean age of 34.4 yr and a mean diving history of 7.3 yr. First, performance time was acquired in each subject by bicycle ergometer exercise and the maximalen oxygen consumption (VO2-max) was obtained. In the second step, VO2-max was obtained by using the regulator apparatus for breathing during SCUBA diving. This value was 86.1% of the first step. The third step was made in a swimming pool.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3682273 TI - Enhancement of renal lysozyme activity in cadmium-treated rabbit. PMID- 3682274 TI - [Evaluation of chronologically arranged health examination report for health education in the workplace]. PMID- 3682275 TI - [Frequency of X-ray exposure by pre-employment chest X-ray examination]. PMID- 3682276 TI - Alteration of catecholamine metabolism in rat brain produced by inhalation exposure to methyl bromide. PMID- 3682277 TI - [A case of lung cancer associated with chronic arsenic poisoning caused by neighborhood exposure of As2O3 from Toroku mine]. PMID- 3682279 TI - [A study of eustachian tube function in fishermen (oikomi-gyohoh) divers]. AB - The intranasal pressure at the opening of the auditory tube was compared by Valsalva's method with that of normal adults under atmospheric pressure to find the auditory tubal function of divers often exposed to hyperbaric conditions. It was found that the mean auditory tube opening pressure was higher in professional divers than in normal adults who had never been exposed to hyperbaric pressure. There are two ways of accommodating human auditory tubal ventilation: active opening and passive opening--the former is predominant in adults, the latter in children. The function of professional divers resembles the child type. This finding suggested that they were frequently exposed to a hyperbaric environment, and their auditory tube might not be opened and closed with each swallowing movement under atmospheric pressure, or the auditory tube and the middle ear themselves have been changed into a condition whereby they no longer needed the opening with each swallowing movement might under atmospheric pressure. Moreover, divers take various postures while they are diving, and in rapid dive, they often take a head-down posture. It was obvious that the auditory tube opens less readily in the head-down position. This phenomenon appears to represent the effect of hydrostatic venous pressure in water. PMID- 3682278 TI - [Immunological study of beryllium workers]. AB - Immunological health surveys of Beryllium (Be) workers in a copper-beryllium casting factory were made 10 times during the 5-year period from 1981 to 1985. The total number of Be workers was 150. 1) Macrophage migration inhibition test was performed by an agarose plate method using Be as antigen with peritoneal cells from guinea pigs and small amounts of Be worker's blood. We found that 1 out of 22 healthy Be workers (4.5%) that migration index (MI) was below 80% after 24 h and 5 (22.7%) after 48 h. The mean of MI in Be workers showed significant low value as compared with that of the control group (p less than 0.01). 2) It was found that the serum complement titer tended to be lower in Be workers than in the control group. The serum complement titer of 3 to 6 subjects showed to be less than 30 U/ml every survey. 3) Although a few showed the abnormal levels in serum immunoglobin (IgG, IgA and IgE), the means of these immunoglobin levels were not markedly changed and they were in the normal ranges, respectively. 4) MI values significantly correlated with IgE level in Be workers, that is y= -8.9 x + 997.8 (r = -0.473, p less than 0.05). These results suggest that macrophage migration inhibition test and serum complement titer were of value for assaying of sensitivity to Be and immune responses in Be workers. PMID- 3682280 TI - [Research on the incidence of decompression sickness in compressed air works. The development of its recent five years' study]. AB - Compressed air works have been used as the safest construction work for the basic underground or underwater compressed shield or caisson works in Japan; however, the workers who were exposed to the compressed fields must have put themselves at risk of decompression sickness. Decompression sickness is generally considered to be due to the bubble effects and the bubbles originate from the supersaturated gas dissolved in the blood and other tissues. The standard decompression schedule by the Ministry of Labor has been practically applied at the end of compressed air works, and the laborers decompress slowly from the bottom pressure to the surface according to the schedule. It is difficult to completely prevent the sickness and the average percentage of contracting "bends," using the Japanese standard decompression schedule, is considered to be 0.54%. But previous papers reported higher incidences from 1.42 to 3.3% or more. We have continued an actual investigation on the incidence, and the number of the exposed trials amounted to nearly a hundred thousand. These data were compared between recent five years' group and before. Eventually, it was ascertained that the incidence has been significantly decreased in the recent five years; however, greater care in occupational safety control is still needed. PMID- 3682281 TI - [A simplified method for the determination of lead and cadmium in biological materials by flameless atomic absorption spectrometry using toluene extraction]. PMID- 3682282 TI - [Effect of serum CPK activity on energy expenditure in healthy men]. PMID- 3682283 TI - [Two cases of decompression sickness with delayed cure by inappropriate recompression treatment]. PMID- 3682284 TI - [Current-voltage characteristics and changes in membrane resistance in Millipore DOPH model membranes]. PMID- 3682285 TI - [New induction method for heating deep-seated tumors]. PMID- 3682286 TI - [Measurement of auditory evoked fields and location of signal sources]. PMID- 3682287 TI - [Fabrication of CMOS custom LSI for an implantable telemetry system]. PMID- 3682288 TI - [Movie display based on the imaging of MCG data with spline function]. PMID- 3682289 TI - [Automatic contour detection of the left ventricle on cineangiograms and its application to the analysis of cardiac function]. PMID- 3682290 TI - [Optical biotelemetry using indirect light transmission]. PMID- 3682291 TI - [Gait analysis of cerebral palsied children using temporal and distance factors]. PMID- 3682292 TI - [Age estimation using the racemization of aspartic acid on human dentin]. PMID- 3682293 TI - [Experimental pathological study on starvation]. PMID- 3682294 TI - [Cross-reactivity of human and animal serum proteins detected by the precipitin ring test--forensic immunological studies on human specificity, Report-XIX]. PMID- 3682295 TI - [Identification of human serum proteins by enzyme-linked immunosorbent assay- forensic immunological studies on human specificity, Report-XX]. PMID- 3682296 TI - [Detection of anti-horse serum antibody produced by injecting antivenin or antitoxin (Report 1)]. PMID- 3682297 TI - An attempt on removal of haloperidol in plasma by use of anti-haloperidol immunoadsorbent. PMID- 3682298 TI - [The proteolytic activity of prostate specific antigen gamma-seminoprotein (gamma Sm)--forensic immunological studies of body fluids and secretions, Report XXVII]. PMID- 3682299 TI - [An analysis of intracranial pressure change caused by an impact to the head--an experimental study with a physical model of the head and neck]. PMID- 3682300 TI - Radiologic identification of human skeletal remains: a case report. PMID- 3682301 TI - [Preparation of an outline for clinical training of midwifery students]. PMID- 3682302 TI - [New development in clinical training in midwifery--an attempt at the Aiiku Hospital. An outline of instructions on nursing during delivery]. PMID- 3682303 TI - [New development in clinical training in midwifery--an attempt at the Aiiku Hospital. On the table for self-evaluation by clinical instructors]. PMID- 3682304 TI - [New development in clinical training in midwifery--an attempt at the Aiiku Hospital. Application of clinical training based on the teaching outline: a discussion]. PMID- 3682305 TI - [An open letter to the President of the Japanese Society of Midwifery]. PMID- 3682306 TI - [The quality and role of teachers]. PMID- 3682307 TI - [A survey on the attitude toward breast feeding at obstetrical facilities]. PMID- 3682308 TI - [Childbirth--my theory (2). A discussion]. PMID- 3682309 TI - [Obstacles and the sense of satisfaction in ambulatory practice of midwifery]. PMID- 3682310 TI - [An essay by a midwife. Professional satisfaction in the practice]. PMID- 3682311 TI - [Changes in the professional practice of midwifery. 27. Separation of the Midwifery Association from the nursing organization]. PMID- 3682312 TI - [Obstetrical immunology. 7. Incompatibility and immunity: with special reference to immunotherapy in habitual abortion]. PMID- 3682314 TI - [Introduction to a personal computer. 7. Preparation of a program. 1]. PMID- 3682313 TI - [Midwifery technics practiced by Ms. Aiko. 7. Prevention of hemorrhoids]. PMID- 3682315 TI - [Questions and answers on breast feeding. Dietary restrictions for the mother in the treatment of diaper rash]. PMID- 3682316 TI - [Early diagnosis of diabetes mellitus in pregnancy]. PMID- 3682317 TI - [Gynecological surgery: the importance of preoperative processes]. PMID- 3682318 TI - [Physical and psychological characteristics of pre- and postoperative patients and psychosomatic approaches]. PMID- 3682319 TI - [20 questions and answers for patients before and after gynecologic surgery]. PMID- 3682320 TI - [Instructions to be given to gynecologic patients at discharge after surgery]. PMID- 3682321 TI - [My experience with uterine myoma. A patient's description]. PMID- 3682323 TI - [Discussion: childbirth, my theory (I)]. PMID- 3682322 TI - [Questions and answers on breast feeding. Problems concerning self-care of the breast]. PMID- 3682324 TI - [A 3-step-natural childbirth: for safer childbirth controlled by the patient]. PMID- 3682325 TI - [Midwifery technics practiced by Ms. Aiko. Management of uterine muscle and the perineum]. PMID- 3682326 TI - [The role of physicians and the role of midwives]. PMID- 3682327 TI - [Gynecological immunology. 6. Blood group incompatibility in pregnancy]. PMID- 3682328 TI - [Overseas experiences in my 20's]. PMID- 3682329 TI - [For more effective professional education. 6. Methods for understanding man]. PMID- 3682330 TI - [Introduction to a personal computer. Compilation of tables using a personal computer]. PMID- 3682331 TI - [Changes in midwifery practice. 26. Postwar legislative guideline concerning family planning]. PMID- 3682332 TI - [Carcinoembryonic antigen]. PMID- 3682333 TI - [Mesangial injury associated with renal lymph stasis and blood congestion]. PMID- 3682335 TI - [Thromboxane A2 metabolism and clinical effects of selective thromboxane A2 synthetase inhibitor in patients with chronic glomerulonephritis]. PMID- 3682334 TI - [Murine autoimmune interstitial nephritis. II. Genetic control of induction of interstitial nephritis]. PMID- 3682336 TI - [Phosphate transport by renal brush border membrane in chronic renal failure]. PMID- 3682337 TI - [Treatment of autonomic nerve dysfunction in uremia with special reference to its normalisation by methylcobalamin]. PMID- 3682338 TI - [Study on dietary factor of hypertension with special reference to dietary protein and salt intake]. PMID- 3682339 TI - [The role of the action of angiotensin II on the sympathetic nervous system in blood pressure regulation: investigated with 1-sarcosine, 8-isoleucine angiotensin II in essential hypertension]. PMID- 3682340 TI - [A case of irreversible renal failure showing giant nuclei in the renal tubuli in the course of rheumatoid arthritis]. PMID- 3682341 TI - [Thrombus scintigraphy with Ga-67 DFO-DAS-fibrinogen. I. A basic study on the capacity to detect a thrombus by Ga-67 DFO-DAS-fibrinogen in rats with venous thrombi]. PMID- 3682342 TI - [Thrombus scintigraphy with Ga-67 DFO-DAS-fibrinogen. II. Clinical applications of Ga-67 DFO-DAS-fibrinogen]. PMID- 3682343 TI - [Ejection fraction measured by MUGA, LVG and UCG using a dynamic cardiac phantom]. PMID- 3682344 TI - [Home nursing. 9. Dilemma of a nurse--as a nurse and as a volunteer]. PMID- 3682345 TI - [Nursing theory. 23. On "humanistic nursing" by J. Paterson and L. Zderad]. PMID- 3682346 TI - [The role of nursing in medication. Reflection on the care associated with medication]. PMID- 3682347 TI - [Medication and involvement of nurses]. PMID- 3682348 TI - [Interactions between medication and food]. PMID- 3682349 TI - [Introduction of a medication wagon to improve drug administration procedures]. PMID- 3682350 TI - [Nursing of a patient who has become drug-dependent]. PMID- 3682351 TI - [Removing the psychological and physiological tensions--bioenergetics theory and nursing]. PMID- 3682353 TI - [Profile of a nurse, Ms. Yasuko Ishigaki, a nursing director at Higashi Sapporo Hospital who is involved in hospice care]. PMID- 3682352 TI - [Assistance in independent urination by patients with sequelae of stroke]. PMID- 3682354 TI - [A diary of a physician assigned to a hospital]. PMID- 3682355 TI - [Welfare and medical care of the aging society. 16. The "life" model and care planning. 1]. PMID- 3682356 TI - [Self-help theories. Lessons in self-help groups. 18. The medical profession and self-help groups]. PMID- 3682357 TI - [Report by a nurse visiting England. 12. Elegant summer vacations]. PMID- 3682358 TI - [Problems of immunodepression by various causes and a risk of infection]. PMID- 3682359 TI - [Nursing problems in immunodepressed patients requiring isolation]. PMID- 3682360 TI - [The use of a standard for the prevention of hospital infection--examination for carelessness and oversights due to familiarity]. PMID- 3682361 TI - [Nursing for the prevention of infection in patients during cancer chemotherapy]. PMID- 3682362 TI - [Use of new immunosuppressive agents]. PMID- 3682363 TI - [Response to individuals requesting AIDS serodiagnosis]. PMID- 3682364 TI - [A trial plan in the prevention of infection in leukemia patients at a general ward--evaluation of a plan to prevent respiratory tract infections]. PMID- 3682365 TI - [Keypoints in urinary catheterization]. PMID- 3682366 TI - [Nursing during urinary catheterization]. PMID- 3682367 TI - [Training in geriatric nursing technology--at the Geriatric Nursing Training Center]. PMID- 3682368 TI - [A blind spot in the patient care at the department of pediatric surgery]. PMID- 3682370 TI - [Social support research: a perspective from the United States]. PMID- 3682369 TI - [Keypoints in geriatric nursing. 9. Troubles among roommates]. PMID- 3682371 TI - [Overview of research on social support network of psychiatric patients]. PMID- 3682372 TI - [Pediatric nursing and social support network]. PMID- 3682373 TI - [Framing and testing of the questionnaire on "Amae" network. 3]. PMID- 3682374 TI - [Research on nurses' satisfaction for their profession]. PMID- 3682375 TI - [Research critique on "Research on nurses' satisfaction for their profession"]. PMID- 3682376 TI - [The approach to the English monograph. Discussion about review writing (1)]. PMID- 3682377 TI - [Grounded theory approach in nursing research]. PMID- 3682378 TI - [Toward nursing with love and delicate consideration]. PMID- 3682379 TI - [Sensitivity originating from mental latitude: function of education]. PMID- 3682381 TI - [Sensitivity and science]. PMID- 3682380 TI - [Various encounters with students through reading]. PMID- 3682382 TI - [Reflections on past year's activities and library committee members]. PMID- 3682383 TI - [A conceptual model for quality control of nursing care: with an example in nursing care and the process of the establishment of self care]. PMID- 3682384 TI - [A survey on the attitudes of nursing students toward clinical training]. PMID- 3682385 TI - [Introduction to logical therapy for humanity in nursing. 2. Logical therapy and I]. PMID- 3682386 TI - [Discussion group on a patient's record toward recovery]. PMID- 3682387 TI - [On receiving a doctorate in medicine: an experience by a former nursing instructor]. PMID- 3682388 TI - [The current status and future of graduate schools of nursing]. PMID- 3682389 TI - [Symposium: the future form of the graduate school of nursing--through personal experiences]. PMID- 3682390 TI - [Survey on the attitude toward senior citizens: the concept and images of the aged held by 3 generations]. PMID- 3682391 TI - [Clinical training in obstetrics at private practitioners' offices]. PMID- 3682392 TI - [Analysis of the status of clinical training in obstetrical nursing: analysis of hesitation in the attitude of nursing students]. PMID- 3682393 TI - [Classroom activities in the study of geriatric health care]. PMID- 3682395 TI - [Young generation and their view on nurses--notes on the public image of nurses]. PMID- 3682394 TI - [Introduction to logical therapy and humanity in nursing. 1. Prologue: attempted suicide of a college student]. PMID- 3682396 TI - Effects of temporal trachea-occlusion at the end of expiration on internal intercostal muscle activity in the rabbit. AB - The effects of temporal trachea-occlusion at the end of expiration on internal intercostal muscle activity (IIMA) and diaphragmatic activity (DMA) were studied in the vagi-intact rabbit. This tracheal occlusion caused a marked prolongation of inspiration time due to a diminution of the vagally mediated inspiratory inhibition but the significant change in the next IIMA was not observed after releasing tracheal occlusion. In addition, the effects of temporal trachea occlusion on pulmonary stretch receptor activity (PSRA) and DMA were also studied in the unilaterally vagotomized rabbit. The procedures remarkably inhibited the respiratory modulation of PSRA from inspiration to expiration. These results indicate that the change of PSRA in response to temporal trachea-occlusion does not significantly affect the next IIMA. PMID- 3682397 TI - 31P NMR studies on the isolated perfused mandibular gland of the rat. AB - Phosphorus nuclear magnetic resonance (31P NMR) was used to study energy metabolism in the rat mandibular gland. The gland was isolated, perfused arterially and set in the NMR tube. At rest, 7 resonance peaks were observed and 6 peaks identified from low field as: 1) sugar phosphates (SP) and nucleotide monophosphate (NMP), 2) inorganic phosphate (Pi), 3) creatine phosphate (PCr), 4) gamma-nucleotide triphosphate (NTP) and beta-nucleotide diphosphate (NDP), 5) alpha-NTP, alpha-NDP, NAD+, and NADH, 6) an unknown peak, and 7) beta-NTP. From the results of high performance liquid chromatography (HPLC), NTP consisted mainly of ATP and GTP, and UTP was not detected. The tissue contents of ATP and GTP in the perfused gland were determined by HPLC as 1.86 +/- 0.03 and 0.37 +/- 0.01 mmol/kg wet tissue (S.E., n = 5). From 31P NMR and HPLC data, the tissue levels of creatine phosphate, ADP, and sugar phosphates were estimated as 3.3, 0.4, and 4.2 mmol/kg wet tissue, respectively. The cessation of perfusion decreased the tissue levels of PCr and ATP and increased those of Pi and SP. On the other hand, administration of acetylcholine (1 microM), which is an optimal dose for secretion, decreased PCr and increased Pi but did not change SP. The ATP was unchanged initially and slowly decreased to the lower level during sustained secretion. These findings suggest that a sustained secretion requires more energy from ATP hydrolysis rather than initial secretion. PMID- 3682398 TI - Neurogenic factors affecting ventilatory and circulatory responses to static and dynamic exercise in man. AB - The possible influence of neurogenic factors on respiratory and circulatory responses to continuous static (CSE), rhythmic static (RSE), and dynamic (DE) exercises was studied in 15 healthy young men. Ventilation (VE), oxygen uptake (VO2), cardiac output (Q), and blood pressure (BP) were measured during the steady-state of the exercise. For a given VO2, VE, and respiratory frequency (f) enhanced significantly with increasing frequency of RSE, and for the same frequency, the responses of these variables to RSE were significantly higher than those for DE. Although a similar trend was observed in heart rate (HR) and Q responses to exercises, it was not as strong as for ventilatory responses. These results lead to the conclusion that ventilation and circulation during exercise may be influenced by some neurogenic factors mediated either centrally or peripherally. PMID- 3682399 TI - Effect of hypoxia and hyperoxia on cardiorespiratory responses during exercise in man. AB - To clarify the role of the carotid body in the mechanism governing exercise hyperpnea, the effect of hypoxia and hyperoxia on ventilation and cardiac output was studied in four healthy men. The VE increased 10.7% in hypoxia and decreased 10.1% in hyperoxia from normoxia as judged from the steady-state values during exercise. On the contrary, Q showed only a slight reduction of -3.2% in hyperoxia. The hypoxic hyperpnea and hyperoxic hypopnea led to a concomitant alteration in PETCO2. An overshoot following the onset of exercise was observed during the first 30s of VE response in hypoxia, which damped progressively in normoxia and hyperoxia. No remarkable difference was observed in the early transient responses of Q between hypoxia and hyperoxia. The discrepancy in the dynamics between VE and Q led to a phasic deviation in PETCO2; an isocapnic transition from the control to stimulus period in normoxia, hypocapnic in hypoxia and hypercapnic in hyperoxia. The time constant representing the kinetics of VE and that for VCO2 prolonged significantly in hyperoxia. These results support the cardiodynamic consequence of exercise hyperpnea, i.e., the carotid body is the first to respond to the increase in CO2 flow into the lungs. PMID- 3682400 TI - Arsenazo III Ca2+-transients of Xenopus skeletal muscle during repetitive stimulation in hypertonic solution. AB - The arsenazo III Ca2+-transients (AZ signals) were measured in hypertonic solution. The muscle fiber of Xenopus was stimulated at the frequency of 0.1/s. The AZ signal responding to the first stimulus in hypertonic Ringer solution was nearly similar to that in normal Ringer solution. After 8 repetitive stimuli, however, time to peak was increased to 3 times and decay time constant was up to 4 times as long as the control. The apparent inhibition of Ca2+ uptake into sarcoplasmic reticulum was supposed to be the origin of the prolongation in time to peak and decay time course. PMID- 3682401 TI - Effect of metabolic acidosis on pulmonary microcirculation in the cat. AB - Using a new X-ray TV system, we studied the effects of metabolic acidosis, produced by intravenous injection of lactic acid, on internal diameter (ID; 100 500 micron), flow velocity, and volume flow in pulmonary microcirculation of anesthetized cats. We found that metabolic acidosis decreased the ID of arteries by 21%, whereas it increased flow velocity by 28% but not volume flow. PMID- 3682402 TI - Hypothermia enhances acetylcholine-induced contraction of isolated rat ileum. AB - The amplitude of acetylcholine (ACh)-induced contraction of isolated rat ileum was enhanced at medium temperatures lower than normal body temperature. Maximum enhancement was achieved between 30 and 25 degrees C. Changes in medium pH and activities of the enteric nervous system due to temperature changes were not essential for this enhancement. PMID- 3682403 TI - Does endogenous adenosine modulate the release of acetylcholine from motor nerve during single and repetitive stimulations in the mouse diaphragm? AB - In order to elucidate the physiological role of endogenous adenosine in regulating the release of acetylcholine, the effects of 8-phenyltheophylline, an antagonist of adenosine receptors and dipyridamole, an uptake inhibitor of adenosine, on the contractile response and quantal release of acetylcholine during single and repetitive stimulations of isolated mouse phrenic nerve diaphragm preparations were studied. The curves relating the concentration vs. inhibition of contractile response to added adenosine and ATP were shifted parallel to the left by dipyridamole, but were shifted to the right by 8 phenyltheophylline at concentrations with little Ca2+-mobilization or phosphodiesterase inhibition. In the absence of exogenously added adenosine, 8 phenyltheophylline increased the quantal content of end-plate potentials (1 Hz), whereas dipyridamole decreased the quantal content. Successive decrease of the amplitude of end-plate potentials (e.p.p. run-down) evoked at 50 Hz was not changed either by 8-phenyltheophylline or by dipyridamole, suggesting that adenosine or ATP released from the motor nerve does not accumulate to an effective concentration even after repetitive stimulation for a feed-back regulation of the transmitter release. It is concluded that endogenous adenosine does inhibit the release of acetylcholine from motor nerve. However, the source of adenosine may be mostly from the muscle and is probably not involved in the feedback autoregulation. PMID- 3682404 TI - Antagonistic activity of etizolam on platelet-activating factor in vivo experiments. AB - The ability of etizolam, 6-(o-chlorophenyl)-8-ethyl-1-methyl-4H-s-triazolo[3,4 c]thieno[2,3-e] [1,4]diazepine (Y-7131), an anti-anxiety drug, to inhibit platelet-activating factor (PAF)-induced reactions was investigated in experimental animals in vivo. Etizolam (0.01-0.3 mg/kg, i.v.) dose dependently inhibited PAF (0.3 microgram/kg, i.v.)-induced bronchoconstriction (Konzett and Rossler's method) in guinea pigs, but even at doses as large as 3 mg/kg, i.v., it had no effect on bronchoconstriction induced by histamine, serotonin, acetylcholine, arachidonic acid, bradykinin, angiotensin l or leukotriene D4. Etizolam (0.1-1 mg/kg, i.v.) also dose-dependently reversed PAF (1 microgram/kg, i.v.)-induced hypotension in anesthetized rats. Injection of PAF into the tail veins of mice produced lethal shock within 10-30 min. Etizolam (0.1-3 mg/kg, i.v. and 1-10 mg/kg, p.o.) protected against the lethal effect of PAF (75 micrograms/kg, i.v.) in a dose-dependent manner. These results indicate that etizolam specifically inhibits the action of PAF in vivo. PMID- 3682406 TI - Effects of RS-2232, a potential antidepressant, on the levels of monoamines, precursor amino acids and their related metabolites in mouse brain. AB - The effects of RS-2232, a new antidepressant, on the levels of monoamines, precursor amino acids and their related metabolites in mouse brain were investigated and compared with some clinically effective antidepressants. RS-2232 (3, 10 and 30 mg/kg, p.o.) increased the levels of norepinephrine (NE), dopamine (DA) and 5-hydroxytryptamine (5-HT) dose-dependently, 60 min after administration. Tyrosine (TYR) levels were not changed, but tryptophan (TRP) was significantly increased by 20% at 30 mg/kg of the compound. On the other hand, DA metabolites such as 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were significantly reduced at all doses. 5-Hydroxyindoleacetic acid (5 HIAA), a 5-HT metabolite, was decreased by 32% at 10 mg/kg. These changes caused by RS-2232 administration were similar to those of the classical inhibitor of monoamine oxidase (MAO), isocarboxazid (ISO), but rather different from those of imipramine (IMP) and mianserin (MIA). RS-2232 and ISO antagonized against reserpine (2 mg/kg, s.c.)-induced changes in the contents of monoamines and their metabolites. Furthermore, time-course experiments clearly showed that increase in the levels of monoamines by 10 mg/kg of RS-2232 was restored to the control levels within a few hours. These results suggest that RS-2232 has reversible MAO inhibiting properties in vivo in mouse brain. PMID- 3682405 TI - Effect of long-term dosing with tiapride on brain dopamine receptors and metabolism in rats. Comparative study with sulpiride and haloperidol. AB - The effects of long-term dosing with tiapride for 21 days on barin dopamine receptors and dopamine turnover were compared with those of sulpiride and haloperidol. Haloperidol caused an increase in both antagonist (3H-spiperone) labeled receptors and agonist (3H-N,n-propylnorapomorphine) labeled ones, whereas tiapride acted on the agonist binding sites and sulpiride acted on the antagonist binding sites. The increases induced by sulpiride were only observed in the striatum, while those induced by tiapride and haloperidol were observed in both the striatum and limbic area. Dopamine and dopamine metabolites in the brain tissues were measured at 2 hr and 3 days after long-term dosing with the drugs as an indicator of dopamine turnover. They were higher at 2 hr and lower at 3 days than those of the saline treated controls; however, the increase at 2 hr was much less than that after single acute dosing with drugs. This suggested that all drugs induced tolerance with regard to dopamine turnover. In these studies, tiapride and sulpiride were less active than haloperidol in the effects on brain dopamine receptors and dopamine turnover. This generally weaker activity of sulpiride and tiapride suggest that the benzamide drugs have fewer side effects such as a tardive dyskinesia, than does haloperidol, even after long-term dosing. Furthermore, a slight difference between the effects of tiapride and sulpiride on the dopamine receptor subtypes in the brain subdivision was suggested. PMID- 3682407 TI - RS-2232, a compound with a reversible and specific type-A monoamine oxidase inhibiting property in mouse brain. AB - Effects of RS-2232 on monoamine oxidase (MAO) activities in mouse brain and liver were investigated with 5-hydroxytryptamine (5-HT), beta-phenyl-ethylamine (PEA), and in some cases, kynuramine as substrate. IC50s of RS-2232 for 5-HT (100 microM) and PEA (20 microM) deaminations in brain mitochondrial preparations were 0.14 microM and 52 microM, respectively. RS-2232 was found to be a competitive inhibitor of 5-HT deamination in the preparation, and its Ki was 0.054 microM. The inhibitions of MAO in both brain and liver homogenate by RS-2232 in vitro measured with kynuramine (100 microM) were independent of the prolonged preincubation. 5-HT deaminations in the brain homogenates of mice treated with RS 2232 were decreased significantly by 15% and 59% at 10 and 30 mg/kg (p.o.) of the compound, respectively. On the other hand, PEA deaminations were not changed at the same doses. Pressor responses induced by intravenous tyramine (0.1-1.0 mg/kg) in anesthetized rats was little affected by oral administration of RS-2232 (3-30 mg/kg) once daily for two weeks. These results reveal that RS-2232 has a reversible and specific type-A MAO inhibiting property in mouse brain, and they suggest that RS-2232 is relatively safe in tyramine-potentiation. PMID- 3682408 TI - Effect of change of hepatic drug-metabolizing activity on plasma concentrations of major metabolites of the new sleep inducer 450191-S, a 1H-1,2,4-triazolyl benzophenone derivative. AB - Plasma concentrations of the major metabolites of 450191-S, a new sleep inducer which is a 1H-1,2,4-triazolyl benzophenone derivative, were determined in rats. Under the HPLC conditions employed, several major metabolites were detected in plasma, and thus the plasma concentration-time profiles for these metabolites were checked in rats in various states. When the animals were pretreated with high doses of 450191-S (200 or 600 mg/kg for 5 or 3 days, respectively) to induce hepatic drug-metabolizing enzymes, plasma concentrations of the metabolites after oral administration of a dose of 200 mg/kg of 450191-S decreased markedly depending on the induced enzyme activity. Pretreatment of rats with phenobarbital also caused decreased plasma levels of metabolites, which were almost the same as those in 450191-S-pretreatment. On the other hand, administration of beta naphthoflavone to rats led to higher plasma levels of metabolites, and slower elimination compared with those in the control and 450191-S- or phenobarbital pretreated rats. These results indicate that plasma levels of metabolites are regulated by the drug-metabolizing enzymes in the liver. It also suggests the participation of some specific forms of cytochrome P-450 in the biotransformation of 450191-S and its metabolites. PMID- 3682409 TI - The amino acid sequence of a smooth muscle-contracting peptide from chicken rectum. Identity to chicken neurotensin. AB - Previous studies have demonstrated that chicken rectum contains a peptide which exerts a potent, excitatory action on the smooth muscle of chicken rectum, and this peptide is most likely to be chicken neurotensin isolated recently from chicken small intestine. In the present study, the peptide was extracted from 2 kg of chicken rectums, and then it was isolated by gel filtration, ion exchange chromatography, high voltage paper electrophoresis and HPLC. Amino acid analysis of the peptide revealed that it is a tridecapeptide composed of aspartic acid (Asp), glutamic acid (Glu), proline (Pro), alanine (Ala), valine (Val), isoleucine (Ile), two residues of leucine (Leu), tyrosine (Tyr), histidine (His), lysine (Lys) and two residues of arginine (Arg). Its amino acid sequence was determined to be pGlu-Leu-His-Val-Asn-Lys-Ala-Arg-Arg-Pro-Tyr-Ile-Leu-OH. The molecule is identical to chicken neurotensin. PMID- 3682411 TI - Effects of intraseptally injected dopamine and noradrenaline on hippocampal synchronized theta wave activity in rats. AB - To clarify the functional role of catecholamine in the septal area, we investigated the effects of dopamine (DA) and noradrenaline (NA) injected into the medial septum (MSN) on hippocampal synchronized theta wave activity (TWA) in immobilized rats. The injection of DA (1-4 micrograms) into the MSN dose relatedly enhanced hippocampal TWA, i.e., an increase of the total power in 3-7 Hz bands and little modification of the peak frequency. An enhancing effect of DA on TWA was also observed by the application into the diagonal band, but not into the lateral septum, nucleus accumbens, and lateral ventricle, indicating a selective effect of DA on the MSN and diagonal band. Furthermore, the enhancing effect of DA was blocked with the systemic treatment of haloperidol. Apomorphine (2 micrograms) injected into the MSN also increased the total power. NA (1-4 micrograms) enhanced TWA; however, NA, unlike DA, increased the peak frequency without modifying the total power, and the effect was not blocked by haloperidol, suggesting that the effect of NA on the septo-hippocampal neurons is different from that of DA. Muscimol (0.1 microgram) and baclofen (0.05 microgram) injected into the MSN depressed TWA, as indicated by a decrease of the total power. These results suggest that DA and NA, when injected into the MSN, heighten the functional level of the hippocampus. PMID- 3682410 TI - Effect of N-methyltetrazolethiol on liver microsomal gamma-glutamylcarboxylation: modification of the in vitro action of N-methyltetrazolethiol. AB - Vitamin K-dependent gamma-glutamylcarboxylation activity in rat liver microsomes was monitored using the incorporation of 14CO2 into exogenous pentapeptide and endogenous protein substrates as indicators. Detergent solubilization of the microsomal enzymes was required for the activity to develop, but higher concentrations of detergent inhibited the enzymatic reaction. Pyridoxal-5' phosphate (PAL-P) and dithiothreitol (DTT) stimulated the enzyme activity. The enzyme activity was observed when the hydroquinone form of vitamin K or the quinone form plus NADH was employed as the cosubstrate, but little activity was detected in the reaction system containing vitamin K-epoxide plus NADH plus DTT. N-Methyltetrazolethiol (NMTT), the substituent at the 3'-position of several beta lactam antibiotics, inhibited the enzyme activity in vitro only in the reaction system containing NADH. Addition of DTT diminished the in vitro action of NMTT, while PAL-P and detergent did not affect it. The results indicate that the in vitro inhibitory action of NMTT is observable under some specific and restricted assay conditions. This paper also discusses the differences between the in vitro action and the in vivo effect of NMTT. PMID- 3682412 TI - Changes in membrane potentials and currents of ventricular cells of the guinea pig heart by a new cardiotonic drug, MCI-154. AB - Effects of MCI-154, a newly synthesized cardiotonic drug with vasodilator property, on the membrane potential and currents of the isolated papillary muscles and the single ventricular cells of the guinea pig were examined. MCI-154 (10(-7)-10(-4) M) increased the developed tension in a dose-dependent manner without significant changes in the action potential configuration of the guinea pig papillary muscle. The slow response action potential obtained by increasing the extracellular K+ concentration to 24 mM was augmented by MCI-154 (10(-6) and 10(-4) M). This effect of MCI-154 was not blocked by atenolol (10(-6) M). In voltage clamp experiments on single ventricular cells, the slow inward current was not affected, but the inward rectifier K+ current was reduced by higher concentration of MCI-154 (10(-4) M). Considering the "run down" phenomenon of the slow inward current, the possibility that MCI-154 might have a slight increasing effect on the slow inward current could not be ruled out. From these results, it can be concluded that the positive inotropic action of MCI-154 can be explained partially by the decrease in the inward rectifier K+ current, and probably by the increase in the Ca2+ sensitivity of the contractile protein system. PMID- 3682413 TI - Effects of physostigmine on AF64A-induced impairment of learning acquisition in rats. AB - Ethylcholine aziridinium ion (AF64A), a putative cholinotoxin, was administered into the cerebroventricles of rats, and the effects on learning behaviors were observed. AF64A caused the impairment of learning acquisition in both passive and active avoidance responses. Physostigmine, a cholinesterase inhibitor, antagonized these changes at the doses of 0.03 to 0.1 mg/kg. Our behavioral study may indicate that the central cholinergic system might play a role in AF64A induced impairment. PMID- 3682414 TI - Changes in vascular responsiveness to vasoactive agents in the hindlimb of DOCA salt hypertensive rats. AB - The responsiveness to vasoactive agents in the perfused hindlimb of DOCA-salt hypertensive rats was examined and compared with that of normotensive rats. The vasoconstrictor responses in the femoral vascular bed to norepinephrine and serotonin were markedly potentiated in DOCA-salt hypertensive rats as compared with those in normotensive rats, and no change was found in the responses to angiotensin II. On the other hand, the vasodilatory response in DOCA-salt hypertensive rats to isoproterenol was attenuated without any marked changes in responsiveness to acetylcholine, nitroprusside and papaverine. These results suggested that the reduced vasodilator responses as well as the increased vasoconstrictor responses occur to some specific vasoactive agents in DOCA-salt hypertensive rats. PMID- 3682415 TI - Effects of prostaglandin E1 and dipyridamole on disposal of colloidal carbon via glomerular mesangial channels. AB - We investigated the effects of prostaglandin E1 (PGE1) and dipyridamole on the disposal of macromolecules via mesangial channels to understand the antinephritic effect of PGE1. To increase glomerular carbon, rats were injected i.v. first with anti-glomerular basement membrane (GBM) serum and then with 30 mg/100 g body weight of carbon. Carbon in the glomerulus was detected with an image analyzer. Administration of anti-GBM serum resulted in about a 2 to 3-fold increase in glomerular uptake of carbon in the normal rats. To investigate the day-to-day situation of glomerular carbon, the right kidney was removed the day after carbon injection, and the left kidney was isolated on days 7, 14 and 21. By day 21, glomerular carbon had decreased significantly. Rats with carbon received PGE1 0.1 x 2 and 1.0 x 2 mg/kg, s.c., and dipyridamole 200 and 400 mg/kg, p.o., for 10 days after the isolation of the right kidney. PGE1 administration did not cause a decrease in the amount of glomerular carbon compared with that of the control. However, the dipyridamole group showed a more rapid decrease of glomerular carbon. It is concluded that PGE1 has no effect on the mesangial channels, but dipyridamole can accelerate the disposal of glomerular carbon by way of the mesangial channels. PMID- 3682416 TI - Drug oxidation activities of horseradish peroxidase, myoglobin and cytochrome P 450cam reconstituted with synthetic hemes. AB - Drug oxidations by horseradish peroxidase (HRP), myoglobin (Mb) and cytochrome P 450cam (P-450cam) reconstituted with synthetic hemes were studied in comparison with a form of cytochrome P-450 purified from liver microsomes of polychlorinated biphenyl (PCB)-treated rats. N,N-Dimethylaniline (DMA) and 7-isopropoxycoumarin were hardly dealkylated by the heme-substituted proteins in the presence of NADPH cytochrome c (P-450) reductase and NADPH, while substantial activity of this kind was observed in the presence of hydrogen peroxide or cumene hydroperoxide as oxygen donors. Specific activity varied, depending on the substrates, oxygen donors, heme derivatives and apoproteins employed. Very high levels of activity were observed in hydrogen peroxide-dependent DMA N-demethylation with HRP substituted with certain hemes. The highest level of activity was about two hundred times as high as that of rat liver cytochrome P-450. The relationship between such activity and the chemical structure of heme derivatives was discussed. PMID- 3682417 TI - Effects of beta-lactam antibiotics on the acetaldehyde-metabolizing system in germ-free rats. AB - Effects of several beta-lactam antibiotics on the acetaldehyde-metabolizing system were studied using germ-free rats. Administration of cefamandole (CMD) to the rats caused a decrease in liver mitochondrial low Km aldehyde dehydrogenase activity and an increase in blood acetaldehyde level during ethanol metabolism, similar to the case in conventional rats. Oral administration of CMD produced a pronounced increase in blood acetaldehyde level compared to the subcutaneous administration of the antibiotic. When the animals were given various beta-lactam antibiotics subcutaneously, only the antibiotics having an N methyltetrazolylthiomethyl group at the 3-position of the cephalosporin nucleus exhibited the disulfiram-like effects on the acetaldehyde-metabolizing system. The results indicate that intestinal bacteria do no participate in the development of the disulfiram-like reaction of several beta-lactam antibiotics. PMID- 3682418 TI - S1-receptor participation in serotonin-induced pulmonary edema in the dog. AB - A canine lung-perfusion preparation was used to evaluate the role of serotonin receptor subtype in the development of serotonin-induced pulmonary edema. Ketanserin, an S2-receptor antagonist, blocked an increase in pulmonary arterial pressure caused by serotonin, but not the development of pulmonary edema. Methysergide, an S1- and S2-receptor antagonist, prevented the increase in pulmonary arterial pressure and edema formation caused by serotonin. These results suggest that the S1-receptor may participate in the development of pulmonary edema. PMID- 3682419 TI - Effects of malotilate on rat erythrocytes. AB - Rats developed anemia during treatment with high doses of malotilate, a hepatotropic agent. A repeated dose of 1,000 mg/kg caused a 20-30% decrease in the number of red blood cells and in hematocrit and hemoglobin values within the first week. In response to the anemia, the reticulocyte count increased, and target cells, acanthocytes and Howell-Jolly bodies appeared in the peripheral blood. In the spleen, hemosiderin deposition was enhanced. The life span of 51Cr labelled erythrocytes was shortened from 15 to 2 days in the high-dose group, whereas plasma iron disappearance and hemoglobin synthesis were significantly potentiated. Hemorrheological examinations revealed an increase in blood viscosity. Hemolytic resistance to mechanical stimuli was reduced, but that to osmotic stimuli was enhanced. At the same time as the onset of the anemia, serum and red cell membrane cholesterol and phospholipid began to increase on day 4 or 6. Incorporation of cholesterol into red cell membranes in vitro was significantly potentiated when serum obtained from rats after a single administration of 1,000 mg/kg was added to the culture. These results suggest that malotilate causes an increase in the surface area of the erythrocytes by accelerating the incorporation of cholesterol into their membranes, and such erythrocytes might be rheologically impaired and captured more easily by the spleen. PMID- 3682420 TI - In vivo effects of gamma-aminobutyric acid on the urinary bladder contraction accompanying micturition. AB - We studied the effects of the gamma-aminobutyric acid (GABA) receptor agonists, diazepam and muscimol, on the urinary bladder contraction induced by infusion of Tyrode's solution into the bladder in anesthetized rats. Diazepam (1 mg/kg, i.p.) completely inhibited bladder contraction, causing the bladder pressure to rise until solution leaked from the penis. The inhibitory effects of diazepam were reversed by picrotoxin (1 mg/kg, i.v., twice with an interval of 10 min), and the effects were potentiated and attenuated by pretreatment with aminooxyacetic acid (AA, 10 mg/kg, i.v.) and semicarbazide (200 mg/kg, i.v.), respectively. Only pretreatment with AA inhibited the bladder contraction induced by infusion of Tyrode's solution into the bladder in six out of eight rats. Diazepam abolished efferent discharges recorded from the left pelvic nerve, but hexamethonium facilitated the generation of efferent discharges after inhibition of bladder contraction. After complete inhibition of bladder contraction by diazepam, electrical stimulation of the left pelvic nerve at 5 Hz for 30 sec was able to induce bladder contraction, and this resulted in micturition. Intracerebroventricular injection or intrathecal injection into the sacral part of the spinal cord of 1 microgram muscimol completely inhibited the bladder contraction. It was considered that the inhibitory effects of GABA receptor agonists on bladder contraction were mainly induced through the GABA receptors in the micturition center of the sacral cord, as well as the brain stem. PMID- 3682422 TI - [Nursing and daily life activities. 8. Independent and assisted movements (1)]. PMID- 3682421 TI - [Health education of the future. Panel discussion]. PMID- 3682423 TI - [Nursing roots in land reclamation projects in Hokkaido. 18. Health education of thinking farmers]. PMID- 3682424 TI - [Conditions for the development of regional programs: an experience with planning of the activities associated with the "rehabilitation" class held at the Tama Clinic, Kawasaki City. 2. Analysis of the approach by public health nurses]. PMID- 3682425 TI - [Focal area activities in public health nursing. 13. Comprehensive public health activities at Sada-cho, Shimane Prefecture]. PMID- 3682426 TI - [Survey on patients with senile dementia and subsequent nursing activities--an attempt by a public health clinic in cooperation with a local government]. PMID- 3682427 TI - [Nursing of a patient with occlusion of Wills' circle]. PMID- 3682428 TI - [Screening tests for language development of 18-month-old infants at routine health examinations]. PMID- 3682429 TI - [Impression of the 1st International Conference on Occupational Health Nursing: in search of new forms of occupational health nursing]. PMID- 3682430 TI - Assessment of the percentages of maximum static pressure in the anal canal for postoperative continence in patients with imperforate anus. AB - The maximum static pressure in the anal canal was measured using an open-tip manometric method with a continuous infusion system. The values obtained from 49 postoperative patients with imperforate anus were expressed as a percentage of those values obtained from 108 aged-matched controls. The value was observed to be 50 per cent or more in those patients with translevator type, showing normal defecation, 30-50 per cent in those with supralevator type, showing normal defecation or constipation, and 30 per cent or less in those with supralevator type, showing incontinence, and 30 per cent or less in those who had undergone surgery on the anal area at another hospital and required re-operation at our department, showing normal continence or incontinence. PMID- 3682431 TI - Natural killer activity of peripheral blood lymphocytes and its relation to histopathological factors of lung cancer. AB - This investigation was intended to determine whether the natural killer (NK) activity of peripheral blood lymphocytes (PBL) correlated with the histopathological factor, which is thought to be a result of a balance between tumor aggression and host resistance. The NK activity of PBL from 60 patients with lung cancer was measured by the lysis of 51Cr-labelled K562 target cells. The activity was significantly decreased with advancing stages of the disease, and inversely correlated with increased immunosuppressive substance levels of the serum. Histopathological factors, such as low grade pleural invasion of the tumor and abundant lymphoid cell infiltration around the tumor, were significantly associated with the high NK activity of PBL. These results show that a decrease in NK activity may play a role in identifying those individuals with a greater risk of cancer development. PMID- 3682432 TI - Immunohistochemical demonstration of estrogen, progesterone, CEA and ferritin in breast cancer and their clinical value for the prediction of early postoperative recurrence. AB - The aim of this paper is to determine whether the incidence of estrogen-, progesterone-, CEA-, and ferritin- positive staining of primary tumors, by using the PAP method, is related to the prognosis of breast cancer status. A significantly higher incidence (71 per cent) of CEA-positive tumors was observed in patients who had a recurrence of breast cancer within 2 years after radical operation. Patients, whose tumors were positive in estrogen or negative in CEA, showed a relatively good prognosis, even after a recurrence of the disease. Distant metastases were seen in most of the patients positive in CEA (78 per cent). Before the recurrence of breast cancer, those patients positive in progesterone had a good prognosis. After the recurrence, however, there was no relationship between the prognosis of recurrent disease and the progesterone staining of primary tumors. Our data suggest that the immunohistological staining of estrogen, progesterone and CEA might offer the effective prognostic indices in breast cancer patients. PMID- 3682433 TI - Prognostic factors of early gastric cancer--results of long-term follow-up and analysis of recurrent cases. AB - The prognosis of early gastric cancer (EGC) is generally excellent, however, EGC is not an exception to recurrence. In order to know what type of EGC is liable to recur, long-term results were studied in 304 cases of resection. The cumulative 10-year survival rate was poorer in patients with positive lymph nodes than in those with negative nodes (52.8 +/- 15.8 per cent vs 94.1 +/- 2.4 per cent; p less than 0.05). It was also less favorable when the EGC was greater than 5 cm in diameter (61.5 +/- 13.2 per cent vs 92.9 +/- 2.4 per cent; p less than 0.05). Among 50 cases which died postoperatively, six deaths were due to recurrence. A predominant mode of recurrence was hematogenous metastasis (4/6). The characteristics of EGC which recurred later included large cancer (greater than or equal to 5 cm) (6/6), macroscopically combined-type cancer (5/6), cancer of depth invasion to the submucosa (4/6) and histologically differentiated cancer (6/6). Lymph node dissection was not carried out in two of these patients at their primary operation. Adjuvant therapy should be added in the EGC bearing risk factors depicted above. Primary cancer in other organs, either metachronous or synchronous, was found in 13 cases (4.3 per cent). Colonic cancer, in particular, was seen in three, and it was 4.8 times as frequent as the expected number of the general population, calculated using the person-year method. PMID- 3682434 TI - A transparent over-tube for endoscopic injection sclerotherapy and results in patients with esophageal varices. AB - This report describes our data regarding repeated injection sclerotherapy using a newly designed over-tube. We treated 17 consecutive patients with esophageal varices, (3 acute, 6 elective and 8 prophylactic). An intravariceal injection of 5 per cent ethanolamine oleate was administered, using a newly designed transparent over-tube containing a second lumen for a flexible injection needle. This over-tube provides an easier, safer, shorter-in-time method of sclerosing esophageal varices. One of the 17 patients died as a result of liver failure associated with advanced cirrhosis and a concomitant hepatoma. Eradication of esophageal varices was attained in the remaining 16 patients, after an average of 5.0 injections over an average period of 5.8 weeks (range: 3-7 injections during 3-11 weeks). No complications, such as esophageal perforation or aspiration pneumonia were encountered. Recurrent variceal bleeding has not occurred during the 9 months follow-up. PMID- 3682435 TI - The usefulness of CEA as an indicator for early detection and a guide to the treatment of recurrent gastric cancer. AB - The usefulness of carcinoembryonic antigen (CEA) as an indicator for recurrence and a guide to the treatment was evaluated from a retrospective analysis of 88 patients with recurrent gastric cancer. Sixty-two of these patients (70.5 per cent), 25 of whom had a preoperative positive assay, and 37 a negative assay, had elevated levels of CEA after disease progression. Averaged CEA level in patients with liver metastasis was significantly higher (872 ng/ml) than in those with peritoneal metastasis (68 ng/ml), with lymph node metastasis (103 ng/ml) or with local metastasis (93 ng/ml) (p less than 0.01). An elevation of CEA was found prior to the clinical manifestation of recurrence, and the average lead time was 4 months. In 25 patients with a lead time of more than 4 months, survival time after CEA elevation was 13.3 months, which was longer than the 6.5 months of 28 patients with less than 4 months. Thirty-seven of the 88 patients were treated after recurrence. The average survival period after the detection of recurrence was 9.4 months in patients with surgical treatments followed by chemotherapy, 5.9 months in those with chemotherapy alone and 3.8 months in those with surgery alone. The average survival period of 26 patients with positive CEA assays in recurrence was 5.1 months longer than of patients with negative assays. This fact suggested that early detection of recurrence followed by various treatments, in the elevated CEA group, contributes to favorable results. PMID- 3682436 TI - Intestinal metaplasia of the stomach confined to the fundic gland area. Report of two cases. AB - Two patients with intestinal metaplasia of the stomach, whose distribution was exclusively confined to the fundic gland area, are presented herein. The first, a 51-year-old male, had been treated for pernicious anemia for 14 years when he was found to have gastric cancer. His serum gastrin level was quite high, whereas his gastric acid output was markedly low. The polypoid cancer in the fornix of the stomach, which had been removed endoscopically, revealed tubular adenocarcinoma with its invasion limited to the mucosa. The resected stomach showed no residual carcinoma but had numerous minute foci of intestinal metaplasia, diffusely distributed but exclusively confined to the fundic gland area, by macroscopic observation using the leucine aminopeptidase-alkaline phosphatase double staining method. The intestinal metaplasias were all of the complete type, and the parietal and chief cells were almost completely lost. The second patient, a 76 year-old male without pernicious anemia, underwent total gastrectomy for two polypoid cancers in the body of the stomach. The resected specimens, in addition to two hyperplastic polyps in the transitional area, showed the same distribution of intestinal metaplasia as seen in the first patient. PMID- 3682437 TI - Two cases of rectal carcinoma associating aorto-iliac occlusive disease. AB - Two cases of rectal carcinoma associating aorto-iliac occlusive disease are presented. These two cases had complete obstruction of the affected vessels, but many collateral pathways from the aorta to the legs had developed, mainly through the superior rectal artery or parietal vessels. Changes in blood flow to the legs, following the radical operation for rectal carcinoma, were examined by both preoperative angiography and perioperative Doppler flow meter. Vascular reconstruction was carried out in one case prior to resection of the rectum, in order to prevent the ischemic legs from becoming worse, or necrotic. The indications for supportive vascular surgery in the case of rectal carcinoma with aorto-iliac occlusive disease are discussed herein. PMID- 3682438 TI - The syndrome of inappropriate secretion of antidiuretic hormone by rectal cancer- a case report. AB - The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is commonly observed in patients with bronchogenic carcinoma. We report here a rare case of SIADH induced by rectal cancer. Laboratory findings showed that the serum sodium concentration and serum osmolarity were low, and that the ADH level was high. Resection of the rectal cancer resulted in a complete correction of the associated inappropriate ADH. The titer of the rectal cancer tissue proved to be high (80 pg/g). PMID- 3682439 TI - Gastric cancer with synchronous unresectable hepatic metastasis and a positive response to chemotherapy--report of two cases. AB - We report herein the clinical events seen in two longterm survivors of gastric cancer with unresectable synchronous hepatic metastases. Partial gastrectomy was performed against the primary lesion and continuous intra-arterial infusion of anti-tumor drugs, followed by prolonged systemic antitumor drug treatment, were prescribed. A 43-year-old man with moderately-differentiated tubular adenocarcinoma had an uneventful course during his first 21 postoperative months. However, multiple liver metastases became manifest at 24 months and enlargement of the intrahepatic foci led to death 27 months after gastrectomy. A 51-year-old woman with moderately-differentiated tubular adenocarcinoma had an uneventful postoperative course and is now well with no signs of recurrence 6 years and 6 months after gastrectomy. PMID- 3682440 TI - [Clinical effects of low-dose long-term erythromycin chemotherapy on diffuse panbronchiolitis]. PMID- 3682441 TI - [Two cases of pulmonary embolism associated with iliac compression syndrome]. PMID- 3682442 TI - [A case of intractable sarcoidosis, beginning with Heerfordt syndrome, and accompanied with arrhythmia, hepatosplenomegaly and pulmonary aspergilloma]. PMID- 3682443 TI - [A case of clinically suggested Wegener's granulomatosis complicated by diabetes insipidus]. PMID- 3682444 TI - [A case of lupus pneumonitis monitored by serial transbronchial lung biopsy and bronchoalveolar lavage]. PMID- 3682445 TI - [Immunohistochemical study of a case of solitary benign squamous cell papilloma of the bronchus]. PMID- 3682446 TI - [A case of diffuse large cell type pulmonary lymphoma possibly arising within endobronchial mucosal lymphoid tissue]. PMID- 3682448 TI - [Trans-pulmonary artery valvotomy with right ventricular outflow occlusion in pulmonary atresia with intact ventricular septum]. PMID- 3682447 TI - [A case of milk of calcium fluid in a mediastinal bronchogenic cyst]. PMID- 3682449 TI - [A late corrective repair following takedown of the Fontan procedure--pulmonary atresia with intact ventricular septum and hypoplastic right ventricle]. PMID- 3682450 TI - [Removal of a cardiac catheter entrapment by a snare type catheter]. PMID- 3682451 TI - [Forceps with the function of a needle holder]. PMID- 3682452 TI - [Reconstruction of the thoracic aortic aneurysm under separate brain circulation using profound hypothermia]. PMID- 3682453 TI - [Esophageal cyst: a case report]. PMID- 3682454 TI - [A case of pulmonary valve replacement after the corrective operation of double outlet right ventricle]. PMID- 3682455 TI - [Modified Fontan's procedure using a curved conduit]. PMID- 3682456 TI - [Successful repair of Taussig-Bing malformation associated with membranous ventricular septal defect]. PMID- 3682457 TI - [A surgical case of right partial anomalous pulmonary venous return to the superior and the inferior vena cavae (incomplete type of scimitar syndrome)]. PMID- 3682458 TI - [Oxygen test and tolazoline test in patients with ventricular septal defect and/or patent ductus arteriosus and pulmonary hypertension]. PMID- 3682459 TI - [Experience with successful surgical repair of DeBakey type I dissecting aneurysm at early acute stage: case reports and controversial problems]. PMID- 3682460 TI - [Hemodialysis for acute renal failure after open heart surgery]. PMID- 3682461 TI - [Application of epicardial approach technic to the left free wall type Wolff Parkinson-White syndrome]. PMID- 3682462 TI - [Application of deep ligation method by Sakihara in thoracic surgery]. PMID- 3682463 TI - [A new approach to infusion of cardioplegic solutions in Cabrol technic]. PMID- 3682464 TI - [Rupture of mediastinal teratoma associated with germinal center formation in the thymus]. PMID- 3682465 TI - [A case of unilateral giant bulla complicated by severe respiratory failure successfully treated by surgery]. PMID- 3682466 TI - [Anomalous origin of the left coronary artery from the pulmonary artery: successful correction in an adult by reimplantation procedure]. PMID- 3682467 TI - [A case report of Cabrol's operation for annuloaortic ectasia with aortic insufficiency]. PMID- 3682468 TI - [Successful repair of double outlet right ventricle with l-malposition of the aorta, pulmonary stenosis and subaortic ventricular septal defect]. PMID- 3682469 TI - [A surgical case of congenital absent pulmonary valve syndrome with double aortic arch and absent thymus]. PMID- 3682471 TI - [A case of aortic arch aneurysm with successful resection utilizing balloon catheter for distal occlusion]. PMID- 3682470 TI - [Pulmonary embolectomy using Fogarty catheter with a suction cannula as a guide]. PMID- 3682472 TI - [Clinical study on cardiac pacing in infants and children]. PMID- 3682473 TI - [The functional indication for the operation of aged patients with lung cancer and their peri-operative managements]. PMID- 3682474 TI - [Surgical treatment of advanced lung cancer involving pleural carcinomatosis- from the viewpoint of panpleuropneumonectomy]. PMID- 3682475 TI - [Open heart surgery in patients associated with severe chronic renal disease]. PMID- 3682476 TI - [Surgical treatment of massive pulmonary embolism--an experience of using ECMO in cardiopulmonary failure]. PMID- 3682477 TI - [Clinical evaluation of pulsatile bypass with counterpulsation method in myocardial protection in infants]. PMID- 3682478 TI - [Cryoanalgesia--a new approach to pain relief after thoracotomy]. PMID- 3682479 TI - [A new IABP balloon for Japanese to prevent the abdominal complication]. PMID- 3682480 TI - [A new catheter for retrograde coronary perfusion]. PMID- 3682481 TI - [A successful surgical case of total anomalous pulmonary venous connection- diagnosis on the site of drainage and postoperative cardiac function by two dimensional echocardiography]. PMID- 3682482 TI - [Two surgical cases of large aneurysm of the right sinus Valsalva with aortic regurgitation]. PMID- 3682483 TI - [Atypical bronchial carcinoid tumor of the left pulmonary hilus resected by cardiopulmonary bypass--a case report]. PMID- 3682484 TI - [A case report of type B WPW syndrome after AVR division of Kent bundle by endocardial approach]. PMID- 3682485 TI - [A surgical case report of isolated congenital tricuspid regurgitation in the aged]. PMID- 3682486 TI - [Elementary components of the recto-anal reflex observed in decerebrate dogs and cats]. AB - The electrical activities of three peri-anal muscles; internal anal sphincters, external anal sphincters and anal longitudinal muscles in decerebrate dogs and cats, were recorded by single, bipolar, macro-electrodes with identical methods, as those described by Ihara & Takahira (1984) and by Tamura & Takahira (1985). The overwhelming activity could vary in different experiments, however, the activity of internal sphincters-slow spikes, was mostly revealing in majority of experiments. The waxing and waning amplitudes of internal sphincter-slow spikes were seen in almost all records, but their waxing cycles were not synchronized between different recording foci in single animals. Further, such alteration of spike size did not directly correlate with detectable change of anal canal pressure. Rather, the waxing and waning of slow spikes seem to be due to a 'beating' of pacemaker waves, originated from multiple generators in internal sphincters. Intravenous injection of 'somatic' neuro-muscular blocking agent; suxamethonium chloride, did not cause any alteration of pressure level and of internal sphincter-slow spike rate, indicating that the anal canal pressure was primarily dependent on sustained activity of internal sphincters, not on tonic discharge of external sphincters. The graded increase of distension volume in rectum brought about progressive lengthening of inhibition of internal sphincters, in turn, causing prolongation of falling phase of pressure in the recto-anal reflex. Although the tonic discharge of external sphincters in decerebrate animals was also completely inhibited by rectal distension, this silence did not induce any significant change in anal canal pressure. It is concluded that the external sphincter is not a tonic pressure-yielding element except a transient squeeze of anal canal, instead, it is a resistive element against complete relaxation of tonic pressure-yielding internal sphincter. PMID- 3682487 TI - [The effect of cisapride on gastric emptying time and release of gastrointestinal hormones]. AB - Cisapride is a novel gastrointestinal prokinetic drug. The aim of the present study was to investigate gastric emptying time and secretion of gastrointestinal hormones (Gastrin, Motilin, Glucagon) after single oral intake of 5 mg or 10 mg cisapride. The healthy men aged 23-55 years participated the study. The gastric emptying time and gastrointestinal hormones were measured by gamma-camera radioisotopic technique and radioimmunoassay, respectively. The half time of emptying phase was reduced from 31.78 min to 29.88 min, and emptying rate increased in 10 mg cisapride group. There was a tendency that cisapride accelerated a stimulation of Motilin secretion. PMID- 3682488 TI - [Ultrastructures of smooth muscles of the choledochus at the choledocho-duodenal junction]. AB - The inner circular muscle (ICM) of the cat duodenum at the choledocho-duodenal junction is thickened, surrounding the choledochus at its proximal portion within the duodenal wall. Such a thickened portion of ICM is considered to be a main part which serves as a sphincter of the choledochus. This portion of the ICM was referred to as 'sphincter of choledochus' in the present study. The sphincter of choledochus and the adjacent ICM were studied by freeze-fracture and conventional thin sectioning methods by electron microscopy in order to clarify the morphological characteristics of smooth muscle cells in the sphincter of choledochus in comparison with ICM. Smooth muscle cells of the sphincter of choledochus were smaller (3-5 microns in diameter) in size, and had less developed dense patches and dense bands. However, they were richly innervated and had numerous gap junctions for electric coupling between cells. These findings indicate that sphincter of choledochus, though its contraction ability may be weaker than the ICM, can exhibit a highly synchronized contraction needed for the sphincter function. PMID- 3682489 TI - Studies on isolated smooth muscle cells. IX. Application of papain for isolation of single smooth muscle cells from guinea-pig taenia coli. AB - To prepare single smooth muscle cells from the taenia coli of guinea pig, the application of papain to the enzymatic solution was examined under two conditions: 1) the isolation in a modified Tyrode solution (containing 0.18 mM Ca2+: 0.18 mM Ca2+-Tyrode solution) and 2) the isolation in a high-K+ Tyrode solution (Na+ was replaced by K+, and Ca2+ was not added: high-K+ Tyrode solution). The presence of papain during collagenase digestion reduced contamination of broken cells and cell debris. In the case of the high-K+ Tyrode solution, papain increased the yield of single cells significantly. The cells were contracted in a dose-dependent manner by Ca2+ in the high-K+ Tyrode solution and by carbachol in 0.18 mM Ca2+-Tyrode solution; furthermore, the contractions were antagonized by verapamil and atropine, respectively. Treatment with papain did not affect cell sensitivity to the stimulants. Therefore, our results suggest that the addition of papain is useful for the isolation of single cells to investigate the physiological and pharmacological characteristics of smooth muscle. PMID- 3682490 TI - The properties of a high K+-induced contraction in the ileal longitudinal and circular muscles of cat. AB - Hypertonic 60 mM KCl (H 60K+) solution induced a phasic contraction followed by tonic one in the longitudinal (long.) and circular (circ.) muscles of cat ileum. Verapamil inhibited the tonic contraction in the long. or circ. muscle with IC50 of 2.0 X 10(-8) M or 1.0 X 10(-7) M, respectively. The sensitivity of the long. muscle to verapamil was higher than that of the circ. muscle. Ouabain (10(-5) M) increased or did not change the tonic contraction, and increased intracellular Na+ contents in the long. and circ. muscles in H 60K+ solution. Li+-substituted (1/5-1/2) solutions decreased the H 60K+-induced contraction in the long. muscle, but potentiated or did not change the contraction in the circ. one. The results with glucose removal, hypoxia, DNP application and a measurement of oxygen consumption showed that the H 60K+-induced contractions in the long. and circ. muscles are probably dependent on aerobic metabolism utilizing external glucose as well as endogenous substrates. In summary, properties of the H 60K+-induced contraction in the ileal long. of cat was not entirely similar to those of circ. muscles, but they were different from those of the ileal of other animal species and had some similarities to those of the guinea-pig portal vein. PMID- 3682491 TI - [Isometric detrusor pressure in the female patient]. PMID- 3682492 TI - [Clinical result of bilateral antireflux operations in unilateral vesicoureteral reflux]. PMID- 3682493 TI - [The effects of the oxalate precursors on the experimental calcium oxalate urolithiasis]. PMID- 3682494 TI - [The role of Candida species as an etiological factor of sexually transmitted diseases in men]. PMID- 3682495 TI - [Ten years survival rate of patients with bladder tumors]. PMID- 3682496 TI - [Clinical features of asymptomatic microhematuria--first report]. PMID- 3682497 TI - [Clinical analysis of the small kidney with VUR]. PMID- 3682498 TI - [Growth and progression patterns of papillary superficial bladder cancer]. PMID- 3682499 TI - [Clinical study of 131I-meta-iodobenzylguanidine on pheochromocytoma]. PMID- 3682500 TI - [Studies on the function of the prostatic epithelial cell. I. Isolation and tissue culture of epithelial cell derived from rat prostate]. PMID- 3682501 TI - [Effect of immunotherapy on bladder cancer]. PMID- 3682502 TI - [Studies on the application of microexplosion to medicine and biology. VIII. Kinetic research on recovery process of the injured urinary bladder in rats]. PMID- 3682503 TI - [Clinical evaluation on treatments in 70 cases of neurogenic bladder]. PMID- 3682504 TI - [Magnetic resonance imaging in the staging of renal cell carcinoma]. PMID- 3682505 TI - [Urinary low molecular promoter of calcium oxalate monohydrate crystal aggregation, preliminary report]. PMID- 3682506 TI - [Disuse urinary bladder. II. Effect of disuse on muscarinic receptor density of canine bladder with and without distension]. PMID- 3682507 TI - [Morphological study of congenital hydronephrosis in reference to its pathogenesis]. PMID- 3682508 TI - [Early phase of prostatic carcinoma, correlation between tumor size and histopathological characteristics]. PMID- 3682509 TI - [The renal hemodynamic response to acute renal-pelvic pressure elevation]. PMID- 3682510 TI - [Studies on vascular invasion of tumor cells in bladder cancer]. PMID- 3682511 TI - [Evaluation of arterial infusion therapy of metastatic lesions of renal cell carcinoma]. PMID- 3682512 TI - [Postoperative complications and long-term results of transurethral prostatic resection]. PMID- 3682513 TI - [Clinical evaluation of serum placental leucine aminopeptidase (P-LAP) activity in renal cell carcinoma]. PMID- 3682514 TI - [Clinical study of urinary tract infection after treatment with extracorporeal shock-wave lithotriptor. Extracorporeal shock-wave lithotriptor]. PMID- 3682515 TI - [Extracorporeal renal stone disintegration using chemical explosive pellets. Effects of underwater shock wave on various organs]. PMID- 3682516 TI - Separation of bovine erythrocytes infected with Theileria sergenti by "Percoll Conray" density gradient. PMID- 3682517 TI - Fluctuations in peripheral plasma androgen levels in peripubertal dogs. PMID- 3682518 TI - Thermophilic campylobacters in seagulls and DNA-DNA hybridization test of isolates. PMID- 3682519 TI - A new quantitative method for oral vaccination of killed cells and persistence of the vaccination against fecal excretion of Yersinia enterocolitica. PMID- 3682520 TI - Oscillatory potential in the chicken ERG. PMID- 3682521 TI - Bacteriophage typing of Staphylococcus aureus isolated from laboratory and wild rodents. PMID- 3682522 TI - Histometric studies on mucus secretion of the sublingual gland of the perinatal rat. PMID- 3682523 TI - Plasma and tissue radioactivity of 3H-digitoxin in dogs with experimental acute renal failure. PMID- 3682524 TI - Outbreak of anemia associated with chicken anemia agent in young chicks. PMID- 3682525 TI - Leptospiral attachment to four structural components of extracellular matrix. PMID- 3682526 TI - Two-dimensional echocardiographic diagnosis of bovine congenital heart disease: echocardiographic and anatomic correlations. PMID- 3682527 TI - Survey for antibodies to Chlamydia psittaci in cattle in Hokkaido. PMID- 3682528 TI - Histamine receptor bearing lymphocytes in dogs. PMID- 3682529 TI - Bioavailability of oral ivermectin in dog. PMID- 3682530 TI - False coccidioidomycosis in a cow. PMID- 3682531 TI - In vitro excystment of Fasciola sp. metacercariae. PMID- 3682533 TI - An experimental study of the cortical somatosensory evoked potentials in the cat. PMID- 3682532 TI - X-ray microanalysis of mineralization in the thalamus of aged mice. PMID- 3682534 TI - Effects of temperature during exposure on inhalation toxicities of chlorfenvinphos and fenthion in rats. PMID- 3682535 TI - Histopathology of spontaneous intimal thickening in the aorta of dogs. PMID- 3682536 TI - Transformation of cultured rat cells by three animal adenovirus DNAs. PMID- 3682537 TI - An outbreak of Moraxella (Pasteurella) anatipestifer infection in ducklings in Japan. PMID- 3682538 TI - Relationship between adrenocortical function test and morbidity in three herds of cow. PMID- 3682539 TI - The necessary evil. PMID- 3682540 TI - Quality of care. PMID- 3682541 TI - Partial duodenal obstruction secondary to Meckel's diverticulum. PMID- 3682542 TI - The five-session quit-smoking clinic. PMID- 3682543 TI - Malpractice '87: status and solutions. PMID- 3682544 TI - The liability of drug manufacturers and physicians. PMID- 3682545 TI - Male contraception and AIDS prevention. PMID- 3682546 TI - Malpractice '87: status and solutions. PMID- 3682547 TI - How to avoid the 'failure to diagnose' claim. PMID- 3682549 TI - Dilemma du jour. PMID- 3682548 TI - Proximal tibial valgus osteotomy. The Veterans Administration Hospital experience, Wichita, Kansas, 1977-82. PMID- 3682550 TI - Collateral source statute held unconstitutional. PMID- 3682551 TI - Endocrine therapy of metastatic breast cancer. PMID- 3682552 TI - Study on anti-phospholipid antibodies in chronic idiopathic thrombocytopenic purpura. PMID- 3682553 TI - Clinical effects of Bifidobacterium preparations on pediatric intractable diarrhea. PMID- 3682554 TI - Adult respiratory distress syndrome caused by inhalation of oxides of nitrogen. PMID- 3682555 TI - Abstracts: meetings of the Keio Medical Society. 1986 and 1987. PMID- 3682556 TI - [Biological and biochemical characteristics of slowly growing scotochromogenic Mycobacteria and differentiation among their species]. PMID- 3682557 TI - [A study on drug regimens against Mycobacterium avium-intracellulare infection. (2). The therapeutic effects of aminoglycosides on a murine airborne infection model]. PMID- 3682558 TI - [In vitro and in vivo activities of cefoxitin alone or in combination with antituberculosis drugs against the Mycobacterium fortuitum complex]. PMID- 3682559 TI - [A case of prolonged atelectasis after pneumonia with Mycobacterium fortuitum isolated from bronchoalveolar lavage fluid]. PMID- 3682560 TI - Pain--an African perspective. PMID- 3682561 TI - Surgical conscience and the true believer: ethical problems for the operating theatre nurse. PMID- 3682562 TI - Maxillo facial surgery--trauma and infection. PMID- 3682563 TI - Functional health education in total child care: the illiterate mother of a sickler. PMID- 3682564 TI - Possible reasons for failure of measles vaccine. PMID- 3682565 TI - Infertility a social stigma? PMID- 3682566 TI - [Dilated cardiomyopathy in bronchial asthma treated with corticosteroids]. PMID- 3682567 TI - [The ascending aorta in aortic valve stenosis and various hemodynamic indicators of the degree of stenosis]. PMID- 3682568 TI - [A 3-year echo- and polycardiographic evaluation of left ventricular contractility in disorders of intraventricular conduction]. PMID- 3682569 TI - [Effect of long-term rehabilitation on personality reactions in patients with type A and B behavior]. PMID- 3682570 TI - [Echocardiographic picture of pulmonary embolism]. PMID- 3682571 TI - [Residual hypertension after removal of a pheochromocytoma (morphologic study of the kidneys)]. AB - Renal parenchyma, and the juxtaglomerular apparatus in particular, was studied in 23 patients with verified diagnosis of pheochromocytoma. Intraoperative renal biopsy was performed in 21 cases, and kidneys obtained at nephrectomy or autopsy were examined in 2 cases. Twenty-one patients were examined following the removal of pheochromocytoma (2 patients died). Arterial BP returned to normal in 86.4%, and residual hypertension due to continuous hyperfunction of the juxtaglomerular apparatus in the presence of hypertensive angiosclerosis was recorded in 13.6%. Tubular epithelial atrophy of varying markedness, associated with renal ischemia, was detected in all cases. The pathogenetic contribution of the renin-angiotensin system to pre- and postoperative hypertension in pheochromocytoma patients is discussed. PMID- 3682572 TI - [Possibilities of predicting the hypotensive effect of surgical treatment of vasorenal hypertension]. AB - The results of long-term (1 to 6 years) follow-up of 43 patients operated on for vasorenal hypertension were compared to preoperative data. The predictive value of the duration of arterial hypertension, patient's age, plasma renin activity coefficient and quantitative intrarenal flow data obtained at angiography with a simultaneous droperidol test, was determined. Intrarenal flow of the contralateral kidney was shown to be the most valuable predictive parameter for the prognosis of the hypotensive effect of the operation. Predictive use of other parameters, such as the duration of arterial hypertension, patient's age, plasma renin activity coefficient yielded higher rates of false-positive and false negative results. PMID- 3682573 TI - ["Inner picture of the disease" in persons with borderline arterial hypertension and in patients with hypertension]. AB - Individual attitude to disease was evaluated in 249 individuals with marginal arterial hypertension and patients with essential hypertension (EH). Anxiety, hypochondriac and neurasthenic types of response to raised arterial blood pressure were predominant. Hypertensive patients, prone to crises, mostly showed anxiety and neurasthenic response to arterial hypertension, while anosognosic response was less common, as compared to people with occasional hypertensive crises. In hypertensive males, as opposed to females, anosognosic perception of the disease prevailed, while the cardiophobic variant was less common. PMID- 3682574 TI - [Should antihypertensive pharmacotherapy have occupational limitations?]. AB - Neurophysiologic effects of a course of treatment with reserpin (0.5-0.75 mg/day), dopegyt (750-1500 mg/day), clophelin (0.3-0.6 mg/day), anaprilin (80-160 mg/day), hydrochlorothiazide (25-100 mg/day) were examined in 294 patients with first- and second-stage essential hypertension (EH), using the correction test and the numbers-finding test, determination of the highest data processing rate by the Diagnoz-2 device, and the time of response to sound and light stimulation under monotonous conditions. There were no significant differences in test results between EH patients treated with the above-mentioned drugs and the placebo-treated ones. Neither single doses, nor courses taken in hospital (1 to 3 weeks) or outpatient clinic (6 to 36 months) produced any regular suppressive effect on the neurophysiologic status of EH patients. PMID- 3682575 TI - [Psychological characteristics related to arterial hypertension and smoking (data of a population study)]. AB - An epidemiologic study of psychosocial variables, related to arterial hypertension and smoking, was carried out in 2039 men and women between 25 and 60 years of age. A relationship has been established between coronary risk factors and psychosocial characteristics, particularly social and psychologic adaptation. The data obtained can be useful for planning future studies of psychosocial features of individuals with arterial hypertension and smoking as coronary risk factors as well as the choice of psychosocial intervention methods. PMID- 3682576 TI - [Prospective epidemiologic study of arterial hypertension in an organized population of Novosibirsk]. AB - Dependence of the incidence and detectability of arterial hypertension on some risk factors was examined in middle-aged males in a three-year prospective study of a random representative sample of an organized Novosibirsk population. Age at first examination, arterial BP rise to a marginal level, excessive body weight and aggravated heredity affected considerably the detectability of recent arterial hypertension. PMID- 3682577 TI - [Interrelations of pulmonary and systemic hemodynamics in hypertension]. AB - A comprehensive study of the systemic and pulmonary hemodynamics, performed in 198 hypertensive patients showed them to have reduced volume of blood circulating in the lungs due to enhanced postcapillary tone. Impairment of arterial blood flow in the lungs and development of pulmonary hypertension fail to keep pace with changes in the systemic circulation. PMID- 3682578 TI - [Relation of the levels of thyroid hormones and cortisol and the degree of systolic arterial pressure in 11- and 12-year-old boys]. AB - An epidemiologic evaluation of relationships between arterial BP changes, and thyroid and adrenocortical hormones was carried out in eleven- and twelve-year old boys. Different patterns of correlation were demonstrated between plasma thyrotropic hormone, thyroid hormones and cortisol levels, on one hand, and systolic BP variation, on the other. There was a correlation between thyroid hormones and cortisol in these groups. The results suggest that even slight changes in thyroid and adrenal function may promote disorders of BP regulation. PMID- 3682579 TI - [Changes in erythrocyte volume in relation to characteristics of protein phosphorylation of the membrane cytoskeleton in hypertension: role of protein kinase C]. AB - Shape, volume and protein phosphorylation of RBC were studied in normal subjects and patients with essential hypertension. Mean volume of RBC of hypertensive patients was reduced by 3-4%, as compared to the control group. The level of band 4.9 phosphorylation was simultaneously increased in RBC of hypertensive patients. Activation of protein kinase C with phorbol ester produced volume reduction and shape changes in RBC. These changes are accompanied with phosphorylation of bands 4.1 and 4.9. It is suggested that RBC volume reduction in essential hypertension may be related to an alteration in the regulation of cytoskeleton proteins phosphorylation. PMID- 3682581 TI - [Various hemodynamic mechanisms of the hypertensive reaction in immobilization induced stress in rabbits and rats]. AB - The radioactive microsphere technique was used to measure the cardiac output, regional blood flows and resistances in conscious rabbits and rats before and after 30-minute immobilization. Immobilization evoked blood pressure rise in both species. Cardiac output was reduced and total peripheral resistance increased in rabbits. Reverse changes of these parameters were observed in rats. Blood flow was reduced in the liver and the right ventricle in rabbits, and in the testes in rats. In immobilized rats, regional blood flow increased in skeletal muscles, the heart, the adrenals and the liver. These experiments demonstrate different hemodynamic mechanisms of immobilization-induced hypertension in rabbits and rats. PMID- 3682582 TI - [Increased arterial pressure in negative emotions as one of the functions of the baroreceptor reflex]. AB - An experimental study in conscious rats with intact and denervated sinoaortic baroreceptor zones has been concerned with arterial BP changes in response to negative and positive emotions. Negative emotions are shown to suppress both the cardiochronotropic and the vasomotor components of the baroreceptor reflex. The role of the baroreceptor reflex in the provision of BP changes in response to negative and positive emotions is discussed. PMID- 3682580 TI - [Erythrocyte membrane permeability of monovalent cations in rats with spontaneous arterial hypertension]. AB - Intraerythrocyte Na and K concentrations were not different in spontaneously hypertensive rats (SHR) from those of normotensive rats (WKY). During incubation of the cells in LiCl solution for 24 h at 2-4 degrees C Li accumulation and K efflux in erythrocytes of SHR were higher as compared to WKY. A positive linear correlation was found between influx of Li and efflux of K in the erythrocytes. Li efflux from the erythrocytes at 37 degrees C was independent of the presence of a Na medium that indicated the absence of Na-Li countertransport in rat erythrocytes. There was no difference in Li efflux in both rat groups. The results provide further evidence in favor of the hypothesis of increased passive permeability for monovalent cations in erythrocytes of SHR. PMID- 3682583 TI - [Effect of angiotensin II on the parasympathetic regulation of cardiac activity]. PMID- 3682584 TI - [Effect of immunization on cardiopathogenic manifestations of acute stress in monkeys]. PMID- 3682585 TI - [Changes in the indicators of central hemodynamics in patients with hypertension after dynamic and isometric loads (data of radionuclide ventriculography)]. PMID- 3682586 TI - [Characteristics and pharmacologic prevention of cardiovascular system reactions in blood donors with borderline arterial hypertension]. PMID- 3682587 TI - [Local and reflex reactions of the blood vessels of the skin and muscles in persons with various forms of hypertension]. PMID- 3682588 TI - [Characteristics of the treatment of patients with hypertension associated with cervical osteochondrosis]. PMID- 3682589 TI - [Evaluation of the effectiveness of hypotensive therapy in hypertensive crises in older patients at the pre-hospital stage]. AB - Volumetric blood flow of the head and chest was assessed by multichannel impedance plethysmography, and central hemodynamics, by tetrapolar integral rheography, in 110 patients with essential hypertension. The measurements were made during crises and 60 minutes after the onset of hypotensive treatment. It is demonstrated that the assessment of the efficiency of treatment for hypertensive crises should be based on studies of regional circulation, cerebral and central thoracic flow, in particular, as well as the BP fall in patients of advanced age. PMID- 3682590 TI - [Critical analysis of the membrane theory with regard to the etiology and pathogenesis of hypertension and the Lang's psycho-emotional concept]. PMID- 3682591 TI - [Cephalhaematoma neonatorum--puncture or spontaneous healing? An old controversy from the current pediatric viewpoint]. PMID- 3682592 TI - [Lyophilization of breast milk]. PMID- 3682593 TI - [Anorexia nervosa and bulimia nervosa as syndromes of disturbed eating behavior in puberty and adolescence]. PMID- 3682594 TI - [What does ergometric diagnosis contribute in the pre- and postoperative assessment of children with congenital angiocardiopathies? 1. Aortic stenoses, aortic isthmus stenoses. 2. Pulmonary stenoses, atrial septal defect, tetralogy of Fallot]. PMID- 3682595 TI - [Legionella pneumonia in a 3-year-old child]. PMID- 3682596 TI - [Encephalopathies related to the incidence of seizures in anticonvulsive therapy]. PMID- 3682597 TI - [Successful treatment of diphenhydramine (AH3) poisoning in childhood with hemoperfusion]. PMID- 3682598 TI - [Current principles of surgical treatment of stomach ulcer]. PMID- 3682599 TI - [The condition of the gastric mucosa in patients after selective proximal vagotomy]. PMID- 3682600 TI - [The motor-emptying function of the gallbladder in duodenal ulcer before and after selective proximal vagotomy]. PMID- 3682601 TI - [Gastric resection for the exclusion of ulcer]. PMID- 3682602 TI - [Value of electrogastrography in selecting the method and extent of gastrectomy in peptic ulcer]. PMID- 3682603 TI - [Results of the surgical treatment of gastrointestinal hemorrhage in peptic ulcer]. PMID- 3682604 TI - [Electrogastrographic characteristics of gastric function in acute gastric bleeding]. PMID- 3682605 TI - [Complex treatment of patients with acute bleeding erosions and ulcers of the stomach and duodenum]. PMID- 3682606 TI - [Risk factors for the development of acute erosions and ulcers of the digestive organs in surgical patients]. PMID- 3682607 TI - [Surgical treatment of stomach ulcer]. PMID- 3682608 TI - [Clinico-morphologic substantiation of mobilization of the duodeno-jejunal flexure in surgical treatment of gastroduodenal ulcers]. PMID- 3682609 TI - [Surgical correction of chronic disorders of duodenal patency in patients after cholecystectomy]. PMID- 3682610 TI - [Anatomico-functional variants of the duodenum and their significance in blunt abdominal injury]. PMID- 3682612 TI - [Blood flow in the stomach and duodenum after truncal vagotomy conducted during bloodletting]. PMID- 3682611 TI - [Evaluation of the effectiveness of selective proximal vagotomy with seromyotomy in parasympathetic denervation of the secretory part of the stomach]. PMID- 3682613 TI - [Selection of the method of surgical treatment of benign stomach ulcer]. PMID- 3682614 TI - [Clinical use of transgastric selective proximal vagotomy in the treatment of pyloroduodenal ulcers]. PMID- 3682615 TI - [Surgical treatment of inveterate and age-related complicated ulcers of the stomach and duodenum]. PMID- 3682616 TI - [Treatment of duodenal ulcer using new variants of denervation of acid-producing areas of the stomach]. PMID- 3682617 TI - [Surgical treatment of patients with pyloroduodenal stenosis caused by ulcer]. PMID- 3682618 TI - [Results of endoscopic examination of the surgically-treated stomach]. PMID- 3682619 TI - [Prognostic evaluation of endoscopic data in the surgical treatment of peptic ulcer hemorrhage]. PMID- 3682621 TI - [Role of endoscopy in the diagnosis and treatment of lesions of the digestive system in patients with uremia]. PMID- 3682620 TI - [Local infiltration of gastric and duodenal ulcers with the preparation aevit during gastroduodenofibroscopy]. PMID- 3682622 TI - [Incompetence of duodenal stump sutures after gastrectomy]. PMID- 3682623 TI - [Rare complication of duodenal ulcer]. PMID- 3682624 TI - [Menetrier disease simulating pyloric stenosis and gastric bezoar]. PMID- 3682625 TI - [Duodenogastric reflux after vagotomy in duodenal ulcer]. PMID- 3682626 TI - [Treatment of trans- and supracondylar fractures of the humerus in children]. PMID- 3682627 TI - [Fibrous septa of the spinal canal in children with developmental anomalies of the locomotor system]. PMID- 3682628 TI - [Comparative evaluation of the dressing- and dressing-free methods of managing postoperative wounds in children]. PMID- 3682629 TI - [Microsurgical treatment of ischemic Volkmann contracture in children. I. Variants of the blood supply in the arm]. PMID- 3682630 TI - [Value of microfocus REIS-radiography in the diagnosis of bone diseases in children (preliminary report)]. PMID- 3682631 TI - [Treatment of acute bilateral suppurative destructive pneumonia with pulmonary and pleural complications in children]. PMID- 3682632 TI - [Diagnosis and treatment of acute secondary exudative pericarditis in children]. PMID- 3682633 TI - [Use of the CRP test in the diagnosis of destructive processes in children with surgical forms of acute suppurative diseases]. PMID- 3682634 TI - [Perforated appendicitis in an infant]. PMID- 3682635 TI - [Splenic rupture vein spontaneous arrest of bleeding and rupture of the right dome of the diaphragm in a child]. PMID- 3682636 TI - [Fibrous suppurative pericarditis in 2 children]. PMID- 3682637 TI - [Recurrent intestinal invagination in children]. PMID- 3682638 TI - [Recurrence of intestinal invagination in children]. PMID- 3682639 TI - [Intestinal obstruction in an infant]. PMID- 3682640 TI - [Suppurative mediastinitis in children]. PMID- 3682641 TI - [Abnormal position of the ureter complicated by urodynamic disorders]. PMID- 3682642 TI - [Treatment of cicatricial stenosis of the esophagus and stomach after chemical burns in children]. PMID- 3682643 TI - [Use of thymalin in appendicular peritonitis in children]. PMID- 3682644 TI - [Localized forms of appendicular peritonitis in children]. PMID- 3682645 TI - [Endovascular occlusion of the blood vessels in the treatment of various surgical diseases in children]. PMID- 3682646 TI - [Acute appendicitis in children]. PMID- 3682647 TI - [Algorithm of the differential diagnosis of the syndrome of palpating tumor-like masses in the projection of the abdominal cavity in newborn infants]. PMID- 3682648 TI - [Clinical course and diagnosis of Hirschsprung disease in children and adults]. PMID- 3682649 TI - [Volvulus of the small intestine in Meckel's diverticulum in children]. PMID- 3682650 TI - [Clinico-morphological parallels in Meckel's diverticulum in children]. PMID- 3682651 TI - [Conservative methods of treatment of intestinal invagination in children]. PMID- 3682652 TI - [Value of syndromological studies in pediatric surgery]. PMID- 3682653 TI - [Congenital duodenal and small-intestinal obstruction in newborn infants]. PMID- 3682654 TI - [Omentitis in children]. PMID- 3682655 TI - [Temporary terminal ileostomy in emergency abdominal surgery in children]. PMID- 3682656 TI - [Role of operative interventions in the treatment of active liver cirrhosis in children]. PMID- 3682657 TI - [Tactics in external intestinal fistulas in children]. PMID- 3682658 TI - [A method of examination of the functional segment of the large intestine in children]. PMID- 3682659 TI - [Electromyography in the evaluation of local signs of acute inflammatory diseases of the abdominal cavity in children]. PMID- 3682660 TI - [Combined treatment of cavernous hemangiomas in children]. PMID- 3682661 TI - [Pathogenesis of varicose veins in the spermatic cord]. PMID- 3682662 TI - [Endoscopy of the ureter and the pyelo-calyceal system in children]. PMID- 3682663 TI - [Thyroid lymphography in the surgical treatment of goiter in children]. PMID- 3682664 TI - [Leg replantation in children after amputation in traffic accidents]. PMID- 3682665 TI - [Tricuspid stenosis with a hypoplastic right ventricle--clinical problems and possibilities of surgical treatment]. PMID- 3682666 TI - [Skin-muscle flaps in reconstructive surgery of the female breast in 4 cases]. PMID- 3682667 TI - [Surgical or conservative treatment in acute gastroduodenal hemorrhage of peptic origin]. PMID- 3682668 TI - [Surgical complications seen in operations on the thyroid]. PMID- 3682669 TI - [Reflux enteritis]. PMID- 3682670 TI - [Recurrent carcinomas of the bladder--treatment problems]. PMID- 3682671 TI - [Microbiological aspects of suppurative surgical infections]. PMID- 3682672 TI - [Retractile mesenteritis--its clinical picture and diagnosis]. PMID- 3682673 TI - [Acute surgical abdomen and its clinical masks in patients with a history of myocardial infarct]. PMID- 3682674 TI - [A defect in a Bjork-Shiley heart valve prosthesis]. PMID- 3682675 TI - [Malignant hemangiopericytoma of the stomach]. PMID- 3682676 TI - [Malignant melanoma of the omentum majus simulating acute appendicitis]. PMID- 3682677 TI - [Perforation of the appendix by a foreign body]. PMID- 3682678 TI - [Characteristics of the shape and size in bilateral ureteral calculosis]. PMID- 3682679 TI - [Clinical use of biological antiseptic dressing materials]. PMID- 3682680 TI - [Clinical use of biological hemostatic preparations]. PMID- 3682681 TI - [Criteria for the appropriate surgical treatment of the Budd-Chiari syndrome]. PMID- 3682682 TI - [Correction of astigmatism with the Excimer laser]. AB - Excimer laser corneal T-excisions for the correction of astigmatism in eight eyes followed up for three months postoperatively revealed an effective change in refraction of up to 4.2 diopters. The effect depends on the depth of the excision. Although the clinical results agree with astigmatism theory predictions from a biomechanical model of the cornea, some features are not explained by the model. The temporal behavior of the changes in refraction subsequent to excimer laser excisions differ from those produced by blade incisions, indicating a different repair mechanism. The keratectomy technique employed did not result in any serious side effects. PMID- 3682683 TI - [Quantification and progression of the visual field defect in glaucoma without hypertension, glaucoma simplex and pigmentary glaucoma. A clinical study with the Delta Program of the 201 Octopus perimeter]. AB - Visual field defects of stages I-IV, in 451 eyes of 451 glaucoma patients, were examined with the Octopus 201 perimeter: 83 patients with low-tension glaucoma (LTG), 316 patients with primary open-angle glaucoma (POAG), and 52 patients with pigmentary glaucoma (PG). Program 31 or 33 was used, with an eccentricity range of up to 30 degrees, 73 test points, and a 6 degrees grid. The mean total field loss (TL) as well as the mean loss per test point (TL/TP) in the 30 degrees field, in the field quadrants, and in the eccentricity ranges from 0-10 degrees, 10-20 degrees, and 20-30 degrees were calculated for each patient with Program Delta. In addition, for each visual field the quotient of total loss and of the number of disturbed test points was calculated, providing a measurement of the mean depth of the field defects. For definition and comparison of visual fields in the different glaucomas at identical stages of the disease according to the amount of TL, the 3 patient groups were subdivided into 4 stages of sensitivity loss: Stage 1: TL less than or equal to 100 dB; Stage 2: TL 101-400 dB; Stage 3: TL 401-800 dB; Stage 4: 801-1600 dB. The results of a comparison of eyes with LTG, POAG, and PG at the same stage of disease were as follows: I. Location of scotomas: 1. Defects more frequent in the lower field in LTG as compared to POAG in stage 2. 2. Defects more frequent in the upper than in the lower field in POAG. 3. Almost equal number of defects in the upper and lower halves in PG. 4. In all 3 glaucoma types the defects are more frequently found in the nasal than in the temporal half of the visual field. 5. In LTG and POAG of all stages the defects are most frequently found in the upper nasal and most seldom in the lower temporal quadrant. 6. In all glaucoma types the defects occur on average most frequently between 10 degrees and 20 degrees of eccentricity. 7. With increasing IOP in POAG the scotomas tend to be equally distributed in the upper and lower quadrants. II. Depth of scotomas: 1. Scotomas are deepest in LTG; they are less deep in POAG, and least deep in PG. 2. In PG the mean scotoma depth depends significantly on maximum IOP.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3682684 TI - [Endocapsular cataract surgery and endocapsular artificial lens implantation]. AB - This paper describes a simple procedure for endocapsular cataract extraction followed by implantation of an artificial lens with endocapsular fixation. The special instruments required, as well as a new endocapsular artificial lens, are also described. The advantages of this safe and gentle procedure are pointed out and the author's experience in 4700 cases is communicated. PMID- 3682685 TI - [Development of cell polymorphism in human corneal endothelium]. AB - The development of cell polymorphy in human corneal endothelium was investigated by vital staining. Endothelial cell coalescence, cell loss and amitotic nucleus division are possible causes of endothelial cell polymorphy. These possible causes are differentiated by various temporary stages, the number of nuclei in polymorphous cells, their relation to the number of adjacent cells and their different sizes. PMID- 3682686 TI - [Effect of corticosteroids in antimycotic therapy of Candida keratitis]. AB - The effect of corticosteroid treatment in addition to antimycotic therapy was studied on the basis of a newly developed keratomycosis model. Forty-eight hours after intracorneal injection of a defined strain of Candida albicans, Amphotericin B drops were administered at one-hour intervals ten times a day. To improve penetration of the drops abrasion of the corneal epithelium was performed every three days. In addition, 4 mg of dexamethasone phosphate was injected subconjunctivally into one eye every two days. The results showed that in this low dosage dexamethasone did not worsen the course of the infection in a single case. On the contrary, there was significantly less neovascularization (p less than 0.05) than in the group not treated with dexamethasone. It therefore appears that combination thereby is the best form of treatment for keratomycosis; this is also supported by clinical observations. PMID- 3682687 TI - [Effect of diabetes mellitus on light scattering of the human lens]. AB - Long-term changes in the light-scattering in clear lenses of diabetic patients were documented with the Scheimpflug camera. The initial cataract formations within defined layers of the lens were analyzed by standardized digital area densitometry. There was no statistically significant variation of the light scattering between the individual layers. The results differ from other investigations based on the linear densitogram of the optical axis beam. PMID- 3682688 TI - [Special indications for endocapsular artificial lens implantation]. AB - Report on the successful endocapsular fixation of a posterior chamber lens in two young patients with ocular anomalies (lamellar cataract and large total iridectomy; nuclear cataract and normotensive congenital glaucoma), in whom lens with chamber angle or sulcus fixation lens would have been contraindicated. Further special indications for endocapsular IOL implantation--in patients with congenital coloboma, traumatic defects of the iris, aniridia, megalocornea with enlarged anterior segment, glaucoma, and following glaucoma surgery, cystoid macular edema of the fellow eye, diabetes mellitus, blood dyscrasias, anticoagulation therapy, and progressive atrophy of the iris--are discussed. PMID- 3682689 TI - [Eye injuries caused by eyeglass lenses]. AB - Among a group of 452 patients treated for eye injuries between 1979 and 1983, there were 66 with injuries due to broken spectacle lenses. These accidents accounted for 7.1% of all penetrating lacerations and 18.2% of all superficial ones. The trend in the period reviewed was toward an increase in such injuries. Altogether, 86.3% of the accidents occurred during free time, with most of the patients being male and between 11 and 30 years of age. The number of injured children is very low. The number of patients with lid lacerations was equivalent to 40.9%, the same as for injuries to the cornea. Most of the patients wore concave lenses, of which 48.5% were shattered by hitting or being hit by another object, and 36.4% by the patient falling. PMID- 3682690 TI - [Hema socket expander in primary conservative treatment of congenital anophthalmos]. AB - In anophthalmos the forces which stimulate development and growth of the bony orbit are absent. As a result these cases have not only a tiny socket but also an underdeveloped bony orbit, which cannot retain an artificial eye. The small conjunctival sac and bony orbit can be mechanically enlarged by means of Hema socket expanders. This hydrophilic material can be manufactured in different forms and sizes and expands the socket and orbit by increasing in volume after hydration. After expanding the conjunctival sac to a certain size the next-larger form is fitted to the socket; the procedure is repeated until an artificial eye can be worn. PMID- 3682691 TI - [A new temporary keratoprosthesis]. AB - A new keratoprosthesis made of silicone rubber has been developed. It permits pars plana vitrectomy to be performed in eyes with corneal opacities. PMID- 3682692 TI - [Vitrectomy in ocular complications of diabetes mellitus. 1. Indications]. PMID- 3682693 TI - [Vitrectomy in ocular complications of diabetes mellitus. 2. Remarks with regard to surgical procedures]. PMID- 3682694 TI - [Remote results of the treatment of uveal melanoma]. PMID- 3682695 TI - [A method of continuous measurement of intraocular pressure using an invasive technic]. PMID- 3682696 TI - [Effect of using soft contact lenses on intraocular pressure in patients with post-traumatic aphakia]. PMID- 3682697 TI - [A case of rare complications of abscess of the eyelid]. PMID- 3682698 TI - [Selected cases of inflammation of retinal vessels]. PMID- 3682699 TI - [Fluorescein angiography in acute retinal embolism]. PMID- 3682700 TI - [Difficulties in filling prescriptions for ophthalmologic drugs at pharmacies]. PMID- 3682702 TI - [Organ failure and multiple organ failure]. PMID- 3682701 TI - [Organ failure within the scope of intensive care therapy--the cardiovascular system--new possibilities in diagnosis]. PMID- 3682703 TI - [Case report: multiple organ failure following esophageal resection]. PMID- 3682704 TI - [Case report: multiple organ failure in cholangitis]. PMID- 3682705 TI - [The kidney--single organ failure within the scope of intensive therapy]. PMID- 3682706 TI - [Assessment of liver function by metabolic parameters]. PMID- 3682707 TI - [Case report: multiple organ failure following trauma]. PMID- 3682708 TI - Hypoxic ischaemic encephalopathy: correlation between ultrasound and computed tomography. AB - Hypoxic ischaemic encephalopathy (HIE) is a major cause of motor and mental retardation. There ist no doubt that the haemorrhagic form of HIE can be detected by cerebral sonography, but it is of great interest to recognize non-haemorrhagic HIE as well. We demonstrate the follow-up of three patients with different types of non-haemorrhagic HIE: Periventricular leukomalacia in a critical ill premature infant 35 weeks gestational age, multicystic encephalopathy in a term newborn with severe perinatal asphyxia and circumscript ischaemic leukomalacia in a five month old infant with near miss event for sudden infant death. Correlation between ultrasound and computed tomography proved that non-haemorrhagic HIE produces global or circumscript high echogenicity in the first week after the hypoxic event whereas computed tomography shows pathologic hypodensity in the same areas. Cerebral sonography is a very helpful and harmless method for the difficult diagnosis HIE. In the case of periventricular leukomalacia, CT scan gives no further information and can be avoided. Concerning HIE of term newborns and small infants, CT scan remains necessary, to evaluate the extension of cerebral injury. PMID- 3682709 TI - [Blood propionic acid with hyperammonemic coma]. AB - We report on a mature male newborn who presented clinically on the 2nd day of live with poor feeding and acidotic breathing. Laboratory findings like severe metabolic acidosis, hyperammonemia, hyperglycinemia, ketonuria and elevated urinary excretion of lactate and propionate suggested the presence of organoacidopathia. Propionic acidemia, however could be diagnosed definitively only when the characteristic urinary and blood metabolites were found during the state of a hyperammonemic coma provoked by a fully oral protein regimen. The diagnosis was affirmed by reduced propionate fixation and by reduced propionyl CoA-carboxylase shown in the patient's skin fibroblasts. PMID- 3682710 TI - [Reference values for the concentration of free thyroxine and free triiodothyronine in the serum of euthyroid children]. AB - Concentrations of free thyroxine (n = 341, male = 205, female = 136) and free triiodothyronine (n = 318, male = 198, female = 120) were determined using the radioimmunoassay method in blood serum of euthyroid children. Beyond the 30. day of life no significant differences were found in different age groups for the free thyroxine and free triiodothyronine concentration. The free thyroxine values of the infants in the range of 16.5-19.5 pg/ml decreased after the 30. day of life to the range of 15-17.5 pg/ml. In opposition to this trend free triiodothyronine values increased after the 30. day of life from the range of 2.5 3.3 pg/ml up to the range of 4.7-5.5 pg/ml. PMID- 3682711 TI - [Blue rubber bleb nevus syndrome with CNS involvement]. AB - We report a child with Blue Rubber Bleb Nevus Syndrome (BRBNS) and marked CNS involvement and complex neurological impairment. Computed tomography showed intracerebral calcification and vascular malformations. The patient is microcephalic, his psychomotor development is delayed and he has a deficit of motor coordination and visual function. We know of only one report of a child with BRBNS and such CNS involvement. PMID- 3682712 TI - [Diagnosis and treatment of a generalized form of yersiniosis]. PMID- 3682713 TI - [Clinical characteristics of leptospirosis and various indicators of liver function]. PMID- 3682714 TI - [Clinical picture of diabetes mellitus associated with opisthorchiasis]. PMID- 3682715 TI - [Peripheral circulation in chronic alcoholism]. PMID- 3682716 TI - [Malignant neoplasms in patients on scheduled hemodialysis]. PMID- 3682717 TI - [A case of sarcoma of the spinal cord]. PMID- 3682718 TI - [Localization of metastases of stomach cancer]. PMID- 3682719 TI - [Foreign body of the stomach simulating wide pedunculated polyp]. PMID- 3682720 TI - [Foreign body as a cause of pneumonia]. PMID- 3682721 TI - [A case of post-traumatic hydronephrosis]. PMID- 3682722 TI - [Generalized herpetic infection in an adult patient]. PMID- 3682723 TI - [Eastern-Siberian tick-borne fever]. PMID- 3682724 TI - [Rheumatoid arthritis with predominantly muscular lesions]. PMID- 3682725 TI - [Diagnosis of various spinal diseases]. PMID- 3682726 TI - [Vitamin supply]. PMID- 3682727 TI - [Palpation of the liver]. PMID- 3682728 TI - [Ways of reorganizing therapeutic services]. PMID- 3682729 TI - [False satisfactory signs of ECG in acute myocardial ischemia]. PMID- 3682730 TI - [Anti-arrhythmic effect of pharmacokinetics of quinidine in middle-aged and elderly patients with a stable form of atrial fibrillation]. PMID- 3682732 TI - [Segmental autonomic disorders in patients with chronic gastritis]. PMID- 3682731 TI - [Experience using the color television camera for endoscopic studies in gastroenterology]. PMID- 3682733 TI - [Various unsolved problems of the secondary prevention of peptic ulcer]. PMID- 3682734 TI - [Permeability of erythrocyte membranes in patients with chronic liver diseases]. PMID- 3682735 TI - [Early diagnosis of cholestasis in chronic liver diseases]. PMID- 3682736 TI - [Lipid metabolism in patients with cholelithiasis]. PMID- 3682737 TI - [Differential diagnosis of acute appendicitis and typhoid under the conditions of increased incidence of abdominal typhus]. PMID- 3682738 TI - [Selective lactose malabsorption]. PMID- 3682739 TI - [Neurocirculatory asthenia in patients with food poisoning]. PMID- 3682740 TI - [Tactics in complex radiologic examination of the thyroid gland]. PMID- 3682741 TI - [Extra hospital care. Testing a form for recording of procedures performed. Statistics are not enough]. PMID- 3682742 TI - [Training for the professional role in basic nursing education. An obscure reality or the reality of everyday?]. PMID- 3682743 TI - [Quality of care. Nursing service and marketing--a quiet revolution]. PMID- 3682744 TI - [Social reintroduction of psychiatric patients. To revive by working the soil?]. PMID- 3682745 TI - [Psychological assistance for the oncologic patient--respect for the patient's feelings]. PMID- 3682746 TI - [Accidents and their sequelae have psychosomatic characteristics. Do accidents happen by chance?]. PMID- 3682747 TI - [The nursing personnel too is in danger of somatizing psychological stress. Burnt out in nurses]. PMID- 3682748 TI - [The theoretical basis of psychophysiology: disease as an escape valve]. PMID- 3682749 TI - [Balint groups are an instrument to recognize psychosomatic disorders and to deal with them. From a mechanistic to an holistic viewpoint]. PMID- 3682750 TI - [The stethoscope as an instrument for biofeedback: peculiar intestinal sounds]. PMID- 3682751 TI - [Healing with peace of mind and empathy. Interview by Jean-Claude Keusen]. PMID- 3682752 TI - [Unnecessary hazards]. PMID- 3682753 TI - [Maid for all work?]. PMID- 3682754 TI - [The computer on the ward. Reality in the U.S.A. ... promise for our future?]. PMID- 3682756 TI - [Working conditions: Geneva acts as pioneer]. PMID- 3682755 TI - [Computerization of nursing care: one more step]. PMID- 3682757 TI - [Cooperative for nursing care of the Swiss Nursing Association, Geneva. "We are working in the direction of a defense of the profession.". Interview by Brigitte Kocher]. PMID- 3682758 TI - [Geneva and patients rights: a strong vote for nursing care]. PMID- 3682759 TI - [Basic education in nursing: towards a new European agreement]. PMID- 3682760 TI - [Reflexology nurses: an intended research project]. PMID- 3682761 TI - [AIDS patients in the hospital: caring in a knowledgeable way and without fear]. PMID- 3682762 TI - Perineurial cells can be grown in culture! PMID- 3682763 TI - Collagen polymorphism in cultured rat kidney mesangial cells. AB - Studies have been performed to evaluate both the relative amounts and the molecular forms of the collagens synthesized by cultured rat kidney mesangial (RKM) cells. The collagens secreted into the culture medium and extracted from the cell layers of cultured RKM cells were isolated after limited pepsin digestion and differential salt fractionation. Polyacrylamide gel electrophoresis under denaturing conditions of the RKM cell collagens indicated the presence of components corresponding to the chains present in types I, III, IV, and V collagen. Analysis of each fraction by carboxymethyl-trisacryl chromatography revealed that approximately 95% of the total collagen synthesized by the cultured mesangial cells was type I and that approximately one-half of this genetic type of collagen was present as type I trimers. The type IV molecules synthesized by RKM cells exhibited the molecular structure [alpha 1(IV)]3, whereas the type V molecules had the molecular composition [alpha 1(V)]2 alpha 2(V). Furthermore, in contrast to the type I and V collagens which were identified in both the secreted and cell-associated fractions, no type III or type IV components were detected among the collagens retained by the cells. These data establish the relative proportions of the collagens synthesized by cultured mesangial cells and suggest that the process of cell culture may induce a wound-healing or sclerosing phenotype in the glomerular mesangial cell. PMID- 3682764 TI - Experimental arthropathy induced in rhesus monkeys (Macaca mulatta) by intradermal immunization with native bovine type II collagen. AB - Over a 6-month time course, polyarticular arthritis was induced in 7 male rhesus monkeys by 3 intradermal injections of bovine type II collagen emulsified in complete Freund's adjuvant, followed later by 2 intradermal injections of type II collagen in incomplete Freund's adjuvant. All animals exhibited delayed-type hypersensitivity to type II collagen by skin test and had serum anti-type II collagen titers of greater than 10,000 (at 1 month) and 20,000 to 160,000 (at 6 months) by enzyme-linked immunosorbent assay. Gross joint changes were observed in 6 of 7 monkeys, especially in the knee and elbow; synovial cell hyperplasia, increased vascularization and a focal mononuclear cell infiltrate were the most frequent findings. Chronic arthritis with destructive cartilage lesions was most prominent in the phalangeal joints of the hands (7 of 7 animals). Microscopically, these changes consisted of fibrosis of the synovium with increased vascularization, villous synovial membrane hyperplasia and focal mononuclear cell infiltration, as well as fibrous metaplasia of the articular cartilage adjacent to pannus formations. Also evident was a loss of safranin O staining intensity in the cartilage and loss of continuity of the articular surface. The 7 control monkeys (received Freund's adjuvant without collagen) were delayed-type hypersensitivity-negative, had no serum anti-type II collagen antibodies, and had grossly and microscopically normal joints. This primate model resembles collagen-induced arthritis seen in rodents and, to some degree, human rheumatoid arthritis. PMID- 3682765 TI - Pathology of dietary carbonyl iron overload in rats. AB - Serial light microscopic and ultrastructural studies were performed in rats with experimental iron overload produced by dietary supplementation with carbonyl (elemental) iron over a 12-month period. Hepatic iron increased rapidly to concentrations approximately 40 to 90 times those of control rats by 3 months. Within the liver, iron deposition was initially confined to periportal (zone 1) hepatocytes but subsequently extended to midzonal (zone 2) and centrilobular (zone 3) hepatocytes. Reticuloendothelial cell deposits of iron increased gradually and became prominent after 3 months. At this time, morphologic evidence of hepatocellular injury was mild and subtle with occasional foci of spotty necrosis and ultrastructural subcellular organelle damage. By 8 months, iron deposition was massive. Portal areas were enlarged with collections of iron loaded macrophages and increased collagenous tissue. This portal fibrous tissue extended between periportal (zone 1) hepatocytes at sites of maximal iron deposition and around iron-loaded Kupffer cells and macrophages. At 12 months, the periportal (zone 1) fibrosis was more pronounced. These serial morphologic studies are the first to demonstrate the production of hepatic fibrosis by chronic dietary iron overload. This experimental model may reproduce important components of the pathophysiologic sequence of chronic liver damage seen in iron overload states in humans. PMID- 3682767 TI - Loss of 51chromium, lactate dehydrogenase, and 111indium as indicators of endothelial cell injury. AB - Injury to endothelial cells appears to be an important initial event in the pathogenesis of many diseases such as acute lung injury, venous and arterial thromboembolism, and atherosclerosis. Different methods for detecting damage to cultured endothelial cells have been described. However, their relative sensitivity as markers of endothelial cell damage has not been adequately determined. We compared the loss of 51Chromium (51Cr), the cytoplasmic enzyme lactate dehydrogenase (LDH), and 111Indium (111In) from endothelial cells upon exposure to several injurious agents. Cultured bovine pulmonary artery endothelial cells in confluent monolayers were labeled with 51Cr or 111Inoxine and exposed to increasing concentrations of the nonionic detergent, Triton X-100 (0.2 to 1%), hydrogen peroxide (1 to 500 microM), or neutrophils stimulated with phorbol myristate acetate. With all forms of injury, loss of 51Cr occurred earlier and to a greater extent than LDH loss which in turn was greater than loss of 111In. Substantial loss of 51Cr was observed in the absence of appreciable ultrastructural damage to endothelial cell external membranes. The findings may reflect the relative ease with which small molecules such as adenine nucleotides (51Cr-labeled) escape whereas larger molecules such as LDH and proteins binding 111In are retained intracellularly. Thus, 51Cr loss appears to be a more sensitive indicator of sublytic endothelial cell injury than either 111In or LDH release. PMID- 3682766 TI - Site-specific renal cytotoxicity and cell proliferation in male rats exposed to petroleum hydrocarbons. AB - The pathologic significance of intracytoplasmic protein droplet accumulation within renal tubular epithelial cells induced experimentally in male rats after exposure to various environmental chemicals, such as unleaded gasoline (UG), is poorly understood. 2,2,4-Trimethylpentane (TMP), a component of UG, also is a potent inducer of protein droplets in male rats. This study documents a strong correlation between protein droplet accumulation, single cell necrosis, and regeneration of the male F344 rat nephron during a 3-week exposure regimen to a wide dose range of inhaled UG or gavaged TMP covering several orders of magnitude (2 to 2000 ppm of UG and 0.2 to 50 mg/kg of TMP, respectively). Autoradiographic analyses of various segments of the nephron were conducted after continuous administration of [methyl-3H]thymidine via osmotic pumps implanted during the last week of UG or TMP exposure. The P2 segment of the proximal tubule of control rats from both experiments had a higher rate of cell turnover (approximately 11%) than the adjacent P1 (approximately 2%) or P3 segments (approximately 3%). The P2 segment of rats exposed to UG or TMP responded with additional dose-related (up to 6-fold) increases in cell turnover. The extent and localization of cell proliferation closely paralleled the extent and severity of accumulation of crystalloid protein droplets and single cell necrosis. Biochemical and immunohistochemical studies have shown that protein droplets in male, but not female rats, consist primarily of alpha-2u-globulin, a low molecular weight protein synthesized by the liver under androgenic control. Increased cell turnover in the P2 segment of male rats may be related to altered catabolism of alpha-2u-globulin. This accelerated cell proliferation may be an essential factor in the development of renal cancer in male rats exposed to UG or other volatile hydrocarbons. PMID- 3682768 TI - Melanocytic differentiation. PMID- 3682769 TI - Elementary school principals' perceptions of childhood obesity. AB - This survey assessed school principals' perceptions regarding childhood obesity and the schools' role in dealing with the problem. A randomly selected group of 300 school principals was obtained from the National Association of Elementary School Principals; 227 (76%) administrators returned the questionnaire. Fifty-one percent of the principals believed normal weight was important to child health. Although 35% believed schools were not doing enough to alleviate childhood obesity, responses suggested principals oppose schools becoming obesity treatment centers. They do not believe teachers or parents would support such programs. They perceived the school's role to be educational and referral in nature. However, they supported elimination of "junk food" machines (71%) and provision of low calorie lunches (60%). They believed school nurses play the most important role in treating childhood obesity at school. PMID- 3682770 TI - Self-esteem, health locus of control, and health attitudes among Native American children. AB - Self-esteem and health locus of control have been postulated as predictors of attitudes and behaviors related to child health. The association among these variables has not been assessed adequately among Native American children. This study measured the relationship among self-esteem, health locus of control, and health attitudes of Native American fourth, fifth, and sixth grade students. A statistically significant relationship was found between self-esteem and positive attitudes toward health. Self-esteem was a modest predictor of health attitudes and health behavioral intentions among Navajo and Pueblo children. PMID- 3682771 TI - Correlates of blood pressure in elementary schoolchildren. AB - This cross-sectional study determined which anthropometric, dietary, and physical fitness variables were best predictors of blood pressure (BP) in 323 white elementary schoolchildren. Height, weight, triceps, and subscapular skinfold thickness were measured, followed by two resting BP measurements. Cardiorespiratory fitness was assessed by time in a one mile run. A food frequency questionnaire measured habitual dietary intake. Correlational analysis revealed height, weight, body mass index (wt/ht2), and skinfold thicknesses were anthropometric variables associated significantly with both systolic and diastolic blood pressure. Physical fitness was not correlated with BP and, among dietary variables, only estimated daily caloric intake, dietary cholesterol, and nondiscretionary sodium were related to blood pressure. A multiple regression analysis selected weight, body mass index (BMI), and total caloric intake as factors explaining the greatest amount of BP variability. For some individuals, hypertension may originate in childhood, thus, these results could have implications for primary prevention of high blood pressure. PMID- 3682772 TI - American teens: sexually active, sexually illiterate. PMID- 3682773 TI - That's what friends are for... PMID- 3682774 TI - Health-related issues and political elections: activities for the classroom. PMID- 3682775 TI - Adolescents' response to menarche. PMID- 3682776 TI - A method for documentation in school health services. PMID- 3682777 TI - Site dependence of drug concentrations in postmortem blood--a case study. AB - A 25-year-old female died from a suicidal overdose of imipramine, acetaminophen, codeine, diphenhydramine, and ethanol. Blood samples from ten segregated arterial and venous sites, twenty-four tissue samples, cerebrospinal fluid, vitreous humor, and bile were analyzed. Imipramine and desipramine, which were highly concentrated in the liver and lungs, each showed marked site dependent differences in blood concentrations. The highest concentrations were in pulmonary venous blood and the lowest in peripheral venous blood. Imipramine concentrations in the ten blood samples differed by as much as 760% (range 2.1 to 16.0 mg/L). Blood desipramine concentrations ranged from 1.4 to 10.6 mg/L. In contrast, blood concentrations of acetaminophen differed by less than 20% (55 to 65 mg/L) and blood ethanol concentrations ranged from 151 to 175 mg/100 mL. Blood concentrations of diphenhydramine ranged from 0.34 to 2.07 mg/L and codeine from 0.33 to 0.89 mg/L. The data illustrates that a marked site dependent variability in postmortem blood concentrations exists for some drugs but not others. PMID- 3682778 TI - A comparison of postmortem heart blood and femoral blood ethyl alcohol concentrations. AB - Recent research has indicated that substantial differences may exist between the concentration of organic bases in heart blood specimens and that in peripheral blood specimens. This study was designed to determine the distribution characteristics of ethyl alcohol in postmortem blood. The heart blood/femoral blood ethyl alcohol ratio was determined for 100 cases. In the majority of cases exhibiting alcohol concentration differences greater than 0.02 mg/dL, the specimens were suspect because of their physical appearance, trauma to the decedent in the area of specimen collection, gross differences in hematocrits, or large volume differences in the two specimens. An additional set of experiments was conducted to illustrate that the volume of blood and the amount of sodium fluoride preservative placed in the collection tube can have a substantial effect upon the subsequently measured ethyl alcohol concentration. These factors can adversely affect the observed heart blood/femoral blood alcohol ratio and must be considered when evaluating the distribution characteristics of ethyl alcohol in postmortem specimens. PMID- 3682779 TI - A simplified procedure for the isolation, characterization, and identification of weak acid and neutral drugs from whole blood. AB - The presented method utilizes commercially available Chem Elut columns for the extraction of weak acid and neutral drugs. The residue from this extraction is purified by partitioning between hexane and acetonitrile. The drugs are analyzed using a gas chromatograph equipped with a 0.53-mm i.d. dimethyl silicone capillary column, a packed column inlet adapter, and a flame ionization detector. The drugs are characterized by their retention index. The procedure is rapid, and clean chromatograms are the rule with essentially no lipid interference for flame ionization or mass spectrometer detection systems. The retention index has proven to be a very reliable parameter for describing chromatographic behavior. For probarbital, the internal standard, the calculated retention index averaged 1529.70 with a standard deviation of 1.27 index units (n = 115). PMID- 3682780 TI - A retention index library for commonly encountered drugs and metabolites using tri-n-alkylamines as reference compounds, nitrogen-phosphorus detectors, and dual capillary chromatography. AB - The retention index system is a reproducible means for the identification of drugs in toxicology samples analyzed by gas chromatography with flame ionization detectors. Nitrogen-phosphorus (NP) detectors do not respond well to the standard n-alkanes, which lack nitrogen and phosphorus groups and which are used to obtain the Kovats index. A method is presented that creates a retention index library based upon a homologous series of tri-n-alkylamines for a series of 125 drugs and metabolites. Standards were analyzed under temperature programmed conditions by simultaneous dual column chromatography using a 5% phenyl and a 50% phenyl methyl silicone fused-silica capillary column. By increasing the hydrogen and air flows to the NP detectors, the Kovats indices were calculated on the system using the n alkanes C8 through C32. Tri-n-alkylamine indices calculated under the same conditions were compared to the Kovats indices for 14 drugs on the 5% phenyl column and for 12 drugs on the 50% phenyl column. The correlation was found to be linear. The Kovats indices on the 5% phenyl column were compared to previously reported values and found to be consistent. PMID- 3682782 TI - The determination of propoxyphene, norpropoxyphene, and methadone in postmortem blood and tissues by high-performance liquid chromatography. AB - This paper describes the quantitative analysis of propoxyphene (PPX), its major metabolite, norpropoxyphene (NPPX), and methadone (METH) in blood and tissue specimens taken at autopsy in cases of suspected drug ingestion. Specimens are extracted into an organic solvent, back-extracted into acid, then reextracted into organic solvent and evaporated to dryness. The reconstituted extracts are subjected to analysis by reversed-phase ion-pair chromatography. The method is linear from 0.1 to 10 mg/L. Recoveries from blood are 86%, 93%, and 91% for PPX, NPPX, and METH respectively. Within-run coefficients of variation are 4.5%, 4.8%, and 2.6% and day-to-day coefficients of variation are 4.7%, 6.8%, and 3.7% for PPX, NPPX, and METH respectively at 1.0 mg/L for each drug. PMID- 3682781 TI - Oleandrin distribution in a fatality from rectal and oral Nerium oleander extract administration. AB - In a fatal (cardiotoxic) case of oleander extract poisoning of a young female, ethanol extracts of blood and tissue homogenates were purified by lead acetate. After removal of excess lead by ammonium sulfate, oleandrin was extracted into chloroform. Oleandrin in the extract concentrates was detected by thin-layer chromatography, with location by fluorescence and chromogenically by means of p anisaldehyde. Quantitation was performed on dried extracts reconstituted in water/methanol, reacted with hydrogen peroxide, ascorbic acid, and hydrochloric acid, and analyzed by fluorescence spectrophotometry. Excitation was at 355 nm, and fluorescence scanning from 340 to 580 nm. The fluorescence peak at 460 nm was used for the quantitative measurement. The concentrations of oleandrin measured in blood, stomach wall, colon tissue, liver, heart, lung, brain, spleen, and kidney ranged from 10 to 39 micrograms/g, with 200 micrograms/mL in the total gastric content residue submitted for analysis. PMID- 3682783 TI - Determination of trazodone in serum by instrumental thin-layer chromatography. AB - A simple and specific method for trazodone that uses high-performance thin-layer chromatography (TLC) plates for chromatography and the Camag TLC Scanner for fluorescence-reflectance measurements is described. The quantitative method employs quinidine as an internal standard and the calibration line is linear between 0.2 and 2.0 mg/L serum, the usual range encountered in patients treated with the drug. Replicate analyses of single serum specimens demonstrated reproducibility of better than +/- 3% coefficient of variation for concentrations of trazodone in the midrange of the test line. PMID- 3682784 TI - Evaluation of TDx cocaine metabolite assay. AB - The TDx cocaine metabolite fluorescence polarization immunoassay (Abbott Laboratories) for the detection of benzoylecgonine (BE) in urine was evaluated. The threshold concentration for BE detection was 0.3 mg/L. The within- and between-run precision of the assay gave coefficients of variation less than 2.3% and 3.5%, respectively. One hundred twenty clinic urines positive for BE by high pressure liquid chromatography (HPLC) were analyzed by the TDx and EMIT-dau cocaine metabolite assays. All three methods were positive for BE in 116 samples, 96.7%. Two samples were positive by TDx and negative by EMIT-dau, and two samples were positive by EMIT-dau and negative by TDx. Cocaine and ecgonine methyl ester cross reactivity with the TDx assay was less than 2%. One hundred drugs and drug metabolites were added to drug-free urine resulting in no false positive reactions. The same drugs and drug metabolites were also added to urine with 3.0 mg/L BE and analyzed by the TDx. No false positive reactions or inhibition of BE detection occurred. PMID- 3682785 TI - Fatality resulting from metoprolol overdose. AB - A death due to an intentional overdose of metoprolol is described. The drug was quantified by gas chromatography, and identification was confirmed by gas chromatography/mass spectrometry. Metoprolol concentrations in blood, bile, urine, and vitreous humor were 19.8 mg/L, 83.1 mg/L, 1.6 mg/L, and 15.1 mg/L, respectively. A blood ethanol concentration of 0.25 g/100 mL was the only other significant toxicologic finding. PMID- 3682786 TI - Simultaneous identification of cocaine and benzoylecgonine using solid phase extraction and gas chromatography/mass spectrometry. AB - A procedure for the simultaneous detection and quantitation of cocaine and benzoylecgonine from urine is described. Using solid phase extraction, cocaine, benzoylecgonine, deuterated cocaine, and deuterated benzoylecgonine (2 internal standards) are extracted from urine. Benzoylecgonine and the deuterated benzoylecgonine are derivatized to their trimethylsilyl esters. The underivatized cocaine and derivatized benzoylecgonine are detected by electron impact mass spectrometry in the selected ion monitoring mode. Both cocaine and benzoylecgonine are detected at concentrations of 50 ng/mL. In addition, the procedure is simple, rapid, and suitable for a large number of specimens. PMID- 3682787 TI - Distinguishing cyclobenzaprine and amitriptyline. PMID- 3682788 TI - Anger, anticipated opportunity to retaliate, and interest in video violence. PMID- 3682789 TI - The relationship between the needs for achievement, affiliation, power, and scientific productivity among Nigerian veterinary surgeons. PMID- 3682790 TI - The relationship between Army families' financial well-being and depression, general well-being, and marital satisfaction. PMID- 3682791 TI - Twenty years of neurological prosthesis-making. AB - The UK Medical Research Council's Neurological Prosthesis Unit was formed on 1 October 1968. In this review, Peter Donaldson, who has been with the unit from the beginning, reflects on what seem to him to be the most important contributions to implant technology from the unit, and suggests some possible developments for the future. PMID- 3682792 TI - Arterial system configuration and wave reflection. AB - On the assumption that the arterial segments between branching points are cylindrical, the relationship between total arterial cross-sectional area and the distance from the heart for the entire length of the arterial system is derived. Based on this relationship, a model of the whole arterial system is proposed; it is composed of three tubes of common origin and of unequal lengths and cross sectional areas. This model may be useful for simulation purposes, with particular reference to pulse wave reflections. PMID- 3682793 TI - Comparison of the Wright ataxiameter and the Kistler force platform in the measurement of sway. AB - A comparison has been made between two methods of measuring body sway during quiet standing. In the first method a Wright ataxiameter was used to measure the trunk movement in the anteroposterior direction; whilst in the second method a Kistler force platform was used to monitor the locus of the resultant ground reaction force. The good correlation between the two sets of data has resulted in a regression equation to convert one set into the equivalent other set. This equation should be useful while comparing the sway data from various research centres. PMID- 3682794 TI - An electronic processor for use with a whole body plethysmograph to determine specific airways conductance. AB - The panting manoeuvre traces produced by a whole body plethysmograph during the measurement of specific airways conductance (sGaw) are traditionally analysed by hand. Since this technique is tedious and time consuming it is prone to error, as well as suffering from considerable inter-observer variability. We describe a new inexpensive analogue electronic processor which rapidly produces readouts of sGaw and overcomes many of the problems associated with hand analysis. The system takes as its inputs the mouth flow and plethysmograph volume outputs from a pressure-corrected flow-displacement whole body plethysmograph, but it could be adapted for use with other types of plethysmograph. Since the processor is intended mainly for use during serial measurements of sGaw it does not carry out an unnecessary correction for flowmeter resistance. Using an electronic simulator of sGaw signals the output of the processor was found to be linear to better than 2% of full scale and to be insensitive to drift on the volume signal. The system has been comprehensively evaluated using signals from both normal subjects and patients. The processor output was found to agree well with the results of hand analysis, an agreement which was comparable with that obtained from computer based systems. For the normal subjects the equal value line adequately described the relationship between the processor and hand estimates of sGaw. However, for patients the slope of the best fit line was 18% less than unity but the correlation coefficient was high: 0.95. Reproducibility was found to be better than 3%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3682795 TI - Variation of finger forces in maximal isometric grasp tests on a range of cylinder diameters. AB - An investigation of maximal isometric cylindrical grasping actions of the hand is reported. A dynamometer is described which allows simultaneous measurement of both the normal forces and the tangential shear forces imposed by each of the three phalangeal segments of a finger during a test. Seventeen subjects were tested, grasping cylinders 31-116 mm in diameter. Normal grasp forces decreased significantly as cylinder size increased, while with large diameters, shear forces moved the skin towards the finger tip. In all cases the distal segments of the fingers imposed forces significantly larger than those of the middle and proximal segments. The mean contributions of fingers from index to little were: 30, 30, 22 and 18%, proportions that did not vary significantly for the range of grasp diameters. Forces acting during grasping activities are reported in greater detail, for a wider range of hand gripping postures, than previously available. These data are useful in the design of hand operated controls or in the prediction of tendon and joint forces in vivo for the design of implants. PMID- 3682796 TI - Non-invasive method of measuring resonant frequency of a human tibia in vivo. Part 1. AB - We describe a method for measuring resonant frequency of a human tibia in vivo. Although the main reason for this measurement is the assessment of a fractured tibia, we emphasize the special instrumentation required; in particular the novel techniques which are used to overcome the difficulty of obtaining results through skin and soft tissue. PMID- 3682797 TI - Non-invasive method of measuring the resonant frequency of a human tibia in vivo. Part 2. AB - Part 1 describes the special instrumentation used in the non-invasive measurement of tibia resonance in vivo. Here we discuss some of the problems which arise when real fractures are measured and comment on accuracy repeatability and the effects of muscle tension. PMID- 3682798 TI - Pericardial heterograft valves: an assessment of leaflet stresses and their implications for heart valve design. AB - Bovine pericardium, stabilized with glutaraldehyde, is used widely in the construction of heart valve substitutes, but the design and construction of valve substitutes from this material are empirically based. Collagenous tissue can support tension, but experimental evidence indicates that flexure-induced compressive stresses can lead to fatigue failure. This study uses experimental results obtained from cyclic uniaxial load tests to predict the type and magnitude of operational stresses which occur in pericardial heterograft leaflets. Both Young's modulus and Poisson's ratio varied with uniaxial loading in pericardium, chemically modified free of tension. Leaflet stresses were analysed in using effective incremental representations of these parameters. In leaflets with unrestricted rotation at the point of attachment to the stent, the mid-plane tensions always exceeded the bending stresses, and no zones of leaflet compression were predicted. In contrast, with totally restricted leaflet rotation induced by clamping (possibly between a male and female frame) the bending stresses were greater than the mid-plane tensions at the hinge line and significant compressive stresses were predicted at this site. If elastic boundary conditions were introduced at the stent (possibly by wrapping the stent in pericardium) then the compressive stresses were reduced as the degree of elasticity was increased. Glutaraldehyde fixation of the pericardium under load produced a stiffer material; higher compressive stresses at the stent and significant increases in total stress were predicted for this tissue. The application of elevated pressure loading also increased the compressive and total stresses in the leaflet. Finally, it was shown that bicuspid leaflets were likely to experience higher stresses than tricuspid leaflets. This simple stress analysis should help valve designers of pericardial heterografts to identify those conditions which lead to tissue compression, high total stress, and ultimately material fatigue. PMID- 3682799 TI - Three-dimensional curved beam stress analysis of the human femur. AB - We discuss an analytical approach to the investigation of the normal, shear, and principal stresses transmitted to the human femur. Two cases are considered: in the first the femur is treated as a three dimensional isotropic curved beam, and in the second as a three dimensional anisotropic composite curved beam, consisting of two different materials, the spongy bone and the cortical bone. The composite beam theory is used to investigate stresses in the femur, in which the spongy bone is surrounded by a cortical bone jacket; compatibility of stresses and strains being introduced at the interface of the two bones in order to derive the stress equations at any point in the cross section. General loading conditions are considered in the analysis, in which the femur is subjected to normal and shear forces, and to biaxial bending and twisting moments. PMID- 3682800 TI - Measurement of pulsatile limb and finger blood flow by electrical impedance plethysmography: criteria for the diagnosis of abnormal flow. AB - The range of pulsatile arm and finger blood flow, measured by electrical impedance plethysmography, has been investigated in a hospital ward. The range of absolute blood flows, in ml min-1, was found to be too wide to be used as a standard for identifying single blood flow readings as being abnormal. A blood flow ratio was calculated by dividing the blood flow in the right forearm or middle finger by the blood flow in the left forearm or middle finger. This ratio was found to have a clearly defined range. A blood flow in a unilaterally injured or otherwise abnormal arm or finger was considered to be significantly altered if the blood flow ratio fell outside the previously defined normal range. The diagnosis of significantly altered arm and finger blood flow from abnormalities in the blood flow ratio was tested in a series of experiments, in which artificial changes in upper limb flow were created by high elevation of the right hand. The ratio was measured in 11 patients with unilateral upper limb injuries and in 3 patients who required an urgent assessment of the upper limb circulation. Abnormalities in the ratio were identified in 12 out of 18 subjects after high elevation of the hand and in 8 out of the 14 patients. PMID- 3682801 TI - Three-element model for total systemic circulation: emphasis on the accuracy of parameter estimates. AB - In this study, the accuracy achievable in the parameter estimates of a three element linear model for the systemic vascular bed is considered. The model neglects inertial effects and includes only three elements representing arterial compliance, peripheral resistance and venous compliance, in agreement with recent sensitivity investigations. Parameter estimation starts from arterial and right atrial pressure signals generated by a closed-loop simulator of the cardiovascular circulation and corrupted with normal noise to account for measurement errors. In this way, the influences of a wide variety of circulatory conditions were investigated. The results achieved give evidence that arterial compliance is generally well estimated, while venous compliance is more variable, particularly at high peripheral resistance when measured signals appear to be less sensitive to this parameter. However, presence of cardiac disease, such as heart failure and valvular stenosis has minimal influence on compliance estimates. These results suggest that this simple model can be conveniently applied even under noisy conditions. PMID- 3682802 TI - Analysis of pulsatile blood flow: a carotid siphon model. PMID- 3682803 TI - Pancreatic response to crystalloid resuscitation in experimental pancreatitis. AB - Restoration and maintenance of intravascular volume is crucial in acute pancreatitis to prevent hypotension and ensure normal organ perfusion. This study evaluated the hemodynamic and metabolic effects of adequate versus inadequate fluid replacement on the pancreas in a canine model of acute experimental pancreatitis. Bile-trypsin pancreatitis (BTP) was induced in 14 conditioned mongrel dogs. Lactated Ringer's solution was administered intravenously at high (HIR) and low (LIR) infusion rates (6.5 and 1.75 ml/kg/hr, respectively) to 7 dogs each for 4 h. Seven sham-operated controls (CON) received lactated Ringer's at 6.5 ml/kg/hr for 3 hr. Mean arterial pressure remained unchanged in all groups. Central venous pressure decreased in the LIR group (P less than 0.05) and remained unchanged in the other groups. Cardiac index fell uniformly (P less than 0.05) in all groups. Pancreatic blood flow (Qp) decreased in the LIR group (73%) to a significantly greater extent than in the HIR (23%) and CON (8%) groups, and in the HIR group significantly more than in the CON group. The fall in pancreatic oxygen consumption (O2Cp) in both the pancreatitis groups was significant compared to the rise in the CON group. Final changes in Qp and O2Cp from baseline were significant only in the LIR group. We conclude that inadequate crystalloid replacement after BTP results in a progressive fall in Qp and O2Cp. Vigorous fluid replacement incompletely prevents these effects. PMID- 3682804 TI - Impaired neutrophil function during anesthesia and surgery is due to serum factors. AB - Neutrophil function was assessed in patients undergoing anesthesia and surgery using a chemiluminescence (CL) assay. With the anesthetic agents enflurane and nitrous oxide, peroperative CL (99.1 mV; 13.8 SEM: postinduction but prior to surgery) was significantly lower than the preoperative value (146.5 mV; 14.1 SEM) with a mean fall of 30% (P less than 0.001). CL measurements taken 24 hr postoperatively were significantly increased (193.9 mV; 16.4 SEM) over the pre- and peroperative values, showing mean increases of 32 and 96%, respectively (P less than 0.001 in both cases). The inhibitory influence on CL appeared to be due to serum factors since peroperative patients' sera inhibited control neutrophils. Significantly depressed levels of the complement component C3 and IgG detected during the peroperative period (P less than 0.05) may explain this phenomenon. Postoperatively, C3 and IgG levels returned to normal. The transient decrease in peroperative neutrophil function may be a contributory factor to the establishment of postoperative sepsis in surgical patients. PMID- 3682805 TI - Relocation of nonalbumin proteins after albumin resuscitation. AB - Prior work showed that albumin (5% A) resuscitation lowered serum globulins and coagulation protein activity levels compared to balanced electrolyte solution (BES) resuscitation. In this experiment, the effect of 1.25% A in BES (A-BES) on serum and lymphatic levels of nonalbumin proteins was studied in 20 splenectomized dogs subjected to reservoir shock and then treated with (a) BES or A-BES, (b) shed blood, and (c) autogenous bank blood. Serum levels of albumin, globulin, and coagulation protein activity were measured preshock, postshock, and daily for 3 days; skin lymph levels were measured on Day 3. Compared to BES, A BES resuscitation significantly decreased serum globulins and coagulation protein activity of fibrinogen, Factor VIII, and antithrombin III. In contrast, skin lymph globulins and coagulation protein activity levels increased significantly with A-BES compared to BES resuscitation. These data suggest that the serum protein changes seen with albumin-supplemented resuscitation result from extravascular relocation of nonalbumin proteins, possibly, due to an oncotic homeostatic factor. PMID- 3682806 TI - Suppression of delayed cutaneous hypersensitivity and inflammatory cell delivery by sterile barium peritonitis. AB - We have previously shown that experimental peritonitis secondary to fecal bacteria plus barium sulfate suppresses delayed cutaneous hypersensitivity (DCH) in rats. We examined herein the role of barium sulfate. In a series of experiments presensitized rats were simultaneously skin tested with intradermal keyhole limpet hemocyanin and given an intraperitoneal injection of either (1) a mixture of four fecal bacteria in their nutrient broths, (2) bacteria and broths plus barium sulfate, (3) sterile broths plus barium, (4) sterile barium alone, (5) nutrient broths, or (6) saline. In rats given sterile barium we measured phagocyte delivery to subcutaneous polyvinyl alcohol sponges. We found that (1) the coadministration of barium sulfate was necessary for rats given bacteria to die (P = 0.03) or develop abdominal abscesses (P less than 0.005), (2) suppression of DCH occurred in 70% of rats receiving sterile barium sulfate vs 0% in saline controls (P = 0.0001), (3) early suppression of DCH was associated with subsequent death and abscess formation in rats given bacteria plus barium (P = 0.00002) and with intraabdominal barium collections in rats given barium alone (P less than 0.02), (4) barium sulfate administration caused suppression of phagocyte delivery to subcutaneous sponges: 23.2 X 10(6) cells/site vs 43.1 X 10(6) cells/site in saline controls (P less than 0.005). We conclude that barium sulfate itself has profound systemic effects in the rat model of intraabdominal sepsis. Early suppression of DCH is associated with a poor outcome in septic rats. PMID- 3682807 TI - Heparin inhibits fibrin, but not leukocytes, in a model of deep-vein thrombosis. AB - Previous studies with models of deep-vein thrombosis (DVT) have demonstrated that leukocyte (PMN)-mediated vein injury may be an initiating event in DVT (14, 17). Since heparin (H) can prevent DVT, we studied its effect on vascular injury and thrombosis in our model. Three groups of rabbits were treated with H either sc (73 and 147 U/kg) or iv (662 U/kg). Scanning electron microscopy revealed that the 73 U/kg sc dose was ineffective. All veins had PMN accumulation, fibrin deposition and complex thrombus formation. There was no increase in anti-Xa activity; activated partial thromboplastin times (APTT) and whole blood clotting times were normal. The 147 U/kg sc and the intravenous dose did not inhibit PMN mediated vein injury. The endothelium was sloughed by migrating PMNs, basement membrane was exposed, and platelets adhered to it. Thrombosis was completely absent in the iv dose group. This correlated with increased anti-Xa activity and prolonged APTT and whole blood clotting times. Our results indicate that heparin does not inhibit the PMN adhesion and migration which produces vascular injury. However, the anticoagulant activity of heparin effectively reduces fibrin deposition and complex thrombus formation. PMID- 3682808 TI - Primary malignant melanoma of pineal region. PMID- 3682809 TI - Dissecting aneurysm of the coronary artery. PMID- 3682810 TI - A case of rhabdomyolysis. PMID- 3682812 TI - Birth certificate changes. PMID- 3682811 TI - Come to my office in the morning. PMID- 3682813 TI - The heat-stable cytosolic factor that promotes glucocorticoid receptor binding to DNA is neither thioredoxin nor ribonuclease. AB - Treatment of rat liver cytosol containing temperature-transformed [3H]dexamethasone-bound receptors at 0 degree C with the sulfhydryl modifying reagent methyl methanethiosulfonate (MMTS) inhibits the DNA-binding activity of the receptor, and DNA-binding activity is restored after addition of dithiothreitol (DTT). However, transformed receptors that are treated with MMTS and then separated from low Mr components of cytosol by passage through a column of Sephadex G-50 have very little DNA-binding activity when DTT is added to regenerate sulfhydryl moities. The receptors will bind to DNA if whole liver cytosol or boiled liver cytosol is added in addition to DTT. The effect of boiled cytosol is mimicked by purified rat thioredoxin or bovine RNase A in a manner that does not reflect the reducing activity of the former or the catalytic activity of the latter. This suggests that the reported ability of each of these heat-stable peptides to stimulate DNA binding by glucocorticoid receptors is not a biologically relevant action. We suggest that stimulation of DNA binding of partially purified receptors by boiled cytosol does not constitute a reconstitution of a complete cytosolic system in which the dissociated receptor must associate with a specific heat-stable accessory protein required for DNA binding, as has been suggested in the "two-step" model of receptor transformation recently proposed by Schmidt et al. (Schmidt T.J., Miller-Diener, A., Webb M.L. and Litwack G. (1985) J. biol. Chem. 260, 16255-16262). PMID- 3682814 TI - Analysis of the 4-hydroxytamoxifen (4-OHTAM) bound nuclear estrogen receptor from MCF-7 cells by limited proteolysis. AB - The assumption that a different conformational form was induced in the nuclear estrogen receptor following binding by antiestrogens compared to estrogens was studied by analysing the proteolytic fragments of the receptor following limited digestion with chymotrypsin and trypsin. Nuclei were isolated from MCF-7 cells previously exposed to [3H] 4-OHTAM. The proteolytic digestion was performed either on the micrococcal nuclease hydrolysate or on intact nuclei. The molecular weights (Mr) were calculated from the sedimentation coefficients (S) determined on a sucrose gradient and from the Stokes radii (Rs) estimated by gel filtration. Digestion of the nuclei with micrococcal nuclease solubilized a receptor form of Mr = 155,000. This receptor form was degraded by chymotrypsin to a receptor of Mr = 63,000 which could not be further dissociated by 0.4 M KCl and 3 M urea. A similar receptor molecule was released by chymotrypsin from intact nuclei. Digestion of the micrococcal nuclease hydrolysate with trypsin degraded the receptor to a form of a Mr = 67,000 which could not be further dissociated by 0.4 M KCl and 3 M urea. Digestion of intact nuclei with trypsin followed by micrococcal nuclease, solubilized a receptor form of Mr = 80,000 which could be further dissociated with 0.4 M KCl and 3 M urea to a receptor form of Mr = 67,000. This trypsin degraded receptor form seems to be similar in Mr to the chymotrypsin degraded form. On the other hand different receptor fragments of Mr = 33,000 and Mr = 60,000 were excised by chymotrypsin and trypsin respectively from the estradiol ligated estrogen receptor. (Geier et al., J. steroid Biochem. 26 [1987] 35-40.) These results support the assumption of a different conformational form for the antiestrogen ligated receptor, compared to the estrogen ligated receptor since they were differentially susceptible to proteolytic degradation by chymotrypsin. PMID- 3682815 TI - Regulation of 24-hydroxylase activity in mouse skin fibroblast by cholecalciferol derivatives, triamcinolone acetonide and a calcium modulating agent, nicardipine. AB - Mouse skin fibroblasts in culture were used to study the regulation of 1,25 dihydroxycholecalciferol (1,25(OH)2D3) induced 24 hydroxylase (24-OH-ase) under the influence of 3 agents: (1) 24,25-Dihydroxycholecalciferol (24,25(OH)2D3), 62.5 10(-9) M, which led to a significant decrease in the 1,25(OH)2D3-induced 24 OH-ase, probably acted through a nuclear effect mediated by the 1,25(OH)2D3 receptor protein. (2) Triamcinolone acetonide (10(-6)M) which was found to increase the 24-OH-ase enhancement induced by 1.25 and 6.25 nM 1,25(OH)2D3 whereas it did not alter the effect of 31.2 nM 1,25(OH)2D3. (3) A factor which is likely to induce changes in the cell calcium transport or in the Ca pool sizes, i.e. a calcium channel blocker, nicardipine. The effect of 1.25 nM 1,25(OH)2D3 on 24-OH-ase activity was increased by nicardipine (20 microM) which was found to reduce the effect of 6.25 nM 1,25(OH)2D3. The rate of DNA synthesis (measured by [3H]thymidine incorporation) was increased after incubation of fibroblasts with 1,25(OH)2D3 (1.25 nM) plus triamcinolone acetonide (10(-6) M), although it was reduced by nicardipine in comparison with 1,25(OH)2D3 alone. So the effects of these agents on the 1,25(OH)2D3 induced 24-hydroxylase were shown to be independent of the rate of DNA synthesis. PMID- 3682816 TI - ATP-induced activation of purified rat hepatic glucocorticoid receptors. AB - We have utilized unactivated rat hepatic glucocorticoid receptor complexes purified to near homogeneity by a three-step scheme which includes affinity chromatography, gel filtration and anion exchange chromatography, to demonstrate for the first time that ATP can interact directly with the receptor protein in stimulating activation. This stimulation is reflected by an increase in DNA cellulose binding as well as by a shift in the elution profile of the purified receptor complexes from DEAE-cellulose. A concentration of 10 mM Na2MoO4 is able to block both of these effects. ATP stimulates activation in a dose-dependent manner (maximally at 10 mM), and elicits maximal activation within 30 min at 15 degrees C. There appears to be no nucleotide specificity since GTP, CTP and UTP, as well as ADP and GDP also stimulate activation. All of these observations closely parallel data obtained from similar activation experiments performed with crude rat hepatic receptors. ATP does not appear to stimulate activation of receptors (crude or purified) by initiating a phosphorylation reaction since hydrolysis-resistant analogues of ATP are also effective. Pyrophosphate (PPi) is as effective as ATP in promoting receptor activation, since it elicits similar increases in DNA-cellulose binding, shifts in elution patterns from DEAE cellulose, and dose-response relationships. None of the compounds tested stimulate activation indirectly by pH or ionic strength effects. Despite the fact that high ATP concentrations (3-4-fold higher than those present in vivo) are necessary to stimulate maximal activation, a physiological role of ATP in directly regulating in vivo activation of glucocorticoid receptors cannot be ruled out. PMID- 3682817 TI - RU486 is not an antiprogestin in the hamster. AB - The biological activity and progestin receptor binding activity of the synthetic steroid RU486 (RU38486; 17-beta-hydroxy-11-beta-(4-dimethylaminophenyl)-17-alpha (1-propynl++ +)- estra-4,9-diene-3-one) were investigated in the hamster. RU486 demonstrated no antiprogestational activity in the female hamster in that it was ineffective in blocking decidualization or interrupting early pregnancy. Competitive binding assays showed RU486 did not compete from hamster uterine progestin receptor. It is concluded that hamster uterine progestin receptor has unique steroid binding specificity. PMID- 3682818 TI - Estrogen-2/4-hydroxylase activities in rat brain and liver microsomes exhibit different substrate preferences and sensitivities to inhibition. AB - NADPH-dependent estrogen-2/4-hydroxylase activities in rat brain and liver microsomes were compared with respect to the utilization of different estrogens as substrates and the inhibitory effects of alpha-naphthoflavone, metyrapone and steroids. Of 6 different estrogens used as substrates, only 17 beta- and 17 alpha estradiol were transformed relatively effectively by brain microsomes. In contrast liver microsomes utilized these two estrogens as well as ethynyl estradiol, estrone and diethylstilbestrol effectively. Estriol was a poor substrate for estrogen-2/4-hydroxylase activity in both tissues. With 40 microM 17 beta-estradiol as substrate the estrogen-2/4-hydroxylase activities in brain and liver were inhibited by alpha-naphthoflavone, metyrapone, progesterone, 17 alpha-hydroxyprogesterone and testosterone. The brain enzyme activity appeared to be more sensitive than the liver enzyme to inhibition by alpha-naphthoflavone and metyrapone. Testosterone propionate (50-100 microM) stimulated the brain enzyme activity significantly. Progesterone and 17 alpha-hydroxyprogesterone were the most effective steroidal inhibitors of brain estrogen-2/4-hydroxylase activity. In the liver the inhibitory potencies of 3 different steroids varied, depending on the estrogen used as substrate. With 17 beta-estradiol, for example, progesterone was the most potent steroidal inhibitor, while corticosterone was the most potent inhibitor when diethylstilbestrol was used as substrate. These findings indicate that rat liver microsomes can utilize a wider range of different estrogens for catecholestrogen formation than brain microsomes and suggest that the profiles of catecholestrogen-forming P-450 isozymes in the two organs differ. PMID- 3682819 TI - Convertibility of a saponifiable lipoidal derivative of 18-hydroxycorticosterone. AB - Metabolic properties and subcellular localization of the biosynthesis of SM, a saponifiable 18-OH-B (18-Hydroxycorticosterone) derivative, were investigated. Homogenates biosynthesized SM at a nearly constant rate of 463 pmol/50 mg tissue during 30 min. This biosynthesis was more efficient at pH 7.4 than at pH 4.8. Not only 18-OH-B but also its less polar anhydride 18-DAL (18-Deoxyaldosterone) were good precursors. SM was reverted to these precursors both enzymatically and spontaneously, 4.8 being a more suitable pH for this reversion than 7.4. Trapping experiments demonstrated a sequence comprising, in this order, the following echelons: SM, 18-OH-B, 18-DAL, Aldosterone. The first two steps are reversible and the last two ones depend on proton concentrations. It is postulated that SM could be on a dead-end to which 18-OH-B could be deviated if Aldosterone biosynthesis became temporarily unnecessary. Also, that 18-OH-B may convert to either 18-DAL or SM for selective membrane transports, according to homeostatic requirements. PMID- 3682820 TI - Studies on rat liver microsomal steroid metabolism using 18O-labelled testosterone and progesterone. AB - In order to investigate the possible involvement of oxygen functions in the rat liver microsomal metabolism of progesterone and testosterone these steroids were specifically labelled with 18O in their oxo-functions and incubated with NADPH supplemented 105,000 g sediments. Gas chromatography-mass spectrometry was used to identify the metabolites formed as well as to quantitate the losses of 18O label. With 18O-labelled testosterone as substrate two of the major monohydroxylated metabolites, i.e. 2 beta- and 6 beta-hydroxytestosterone were shown to have lost about 25 and 50% of their 18O respectively. A complete retention of label was found in 7 alpha- and 16 alpha-hydroxytestosterone. None of the monohydroxylated progesterone metabolites, i.e. the 2 alpha-, 6 beta- and 16 alpha-hydroxyprogesterone had lost any 18O following incubation with 3,20-18O labelled progesterone. Control incubation (30', 37 degrees C) with buffer and 18O labelled progesterone and testosterone revealed no exchange of 18O. Thus the partial loss of 3-18O-label during 2 beta- and 6 beta-hydroxylation of testosterone may indicate a covalent interaction between the steroid 3-oxo-group and one or more cytochrome P-450 species in the rat liver microsomes. In view of the potentiating effect of a 3-imine group in spontaneous 6 beta-hydroxylation the present in vitro data suggest that a steroid protein-interaction may occur via a 3-imine group during 6 beta-hydroxylation of testosterone in rat liver microsomes. Analysis of 5 alpha-reduced metabolites of both progesterone and testosterone showed significant losses of 3-18O, but due to the ease with which 3 oxo-5 alpha-steroids exchange their 3-18O with aqueous media an enzymatically induced loss of 3-18O could not be safely established. The 20-oxido-reductase which converted progesterone did not induce a loss of 20- or 3-18O thus indicating that the oxofunctions were not covalently engaged in the enzymatic binding of the steroid. PMID- 3682821 TI - Roles of neonatal and prepubertal testicular androgens on androgen-induced proliferative response of seminal vesicle cells in adult mice. AB - Male mice were castrated at 0, 10, 20, 30, 40 and 60 days of age; daily injections of testosterone propionate (TP, 4 micrograms/g b. wt) were started from day 90. On various days after starting the TP injections, the incorporation of 5-[125I]iodo-2'-deoxyuridine into the whole seminal vesicles was determined as an index for proliferation. The seminal vesicle cells in mice castrated on days 0 and 20 were characterized by low weight (0.5-1 mg) before TP injection, long duration of androgen-induced proliferation (greater than 20 days) with a low peak, and involvement of both epithelial and fibromuscular cells (neonatal castration type). The seminal vesicle cells in mice castrated on days 60 and 40 were characterized by relatively high weight (5-10 mg) before TP injection, short duration of androgen-induced proliferation (10 days) with a high peak, and involvement of only the epithelial cells (adult castration type). In mice castrated on days 0 and 20, the neonatal castration type of androgen-induced proliferation was completely changed to the adult castration type when TP pretreatment (2 micrograms/g b. wt per 12 h) had been given from day 20 to day 40. However, the TP pretreatment given from day 90 to day 110 instead of days 20 40 had no such effect in 140-day old mice castrated on day 0. The present findings suggest that testicular androgens secreted from day 20 to day 40 play an indispensable role in the induction of irreversible proliferative response of the mouse seminal vesicle. The activity of the prepubertal androgens may not be completely compensated by androgen activity at adulthood. PMID- 3682822 TI - Isolation and identification of androstanediol glucuronide from human plasma. AB - [3H]Dihydrotestosterone (50 microCi) was infused into normal men and women for 8 h. It was previously shown that this was sufficient time for this material to reach a steady state. Venous plasma was obtained at 6 and 8 h, pooled, and the unconjugated steroids removed by ether extraction. The remaining plasma was adjusted to pH 4.9 and the steroid conjugate was extracted first with ethyl acetate and then with an ether-ethanol mixture. The extracts were combined and taken to dryness. Steroid sulfates were solvolyzed using dioxane, and the mixture partitioned between ether and 1% NaOH. The aqueous phase was acidified and added to an XAD-2 column, washed with water, and the glucuronide fraction eluted with methanol. The solvent was concentrated and the methanol extract was passed through a C18 Sep-Pak, filtered through an Acrodisc CR and then subjected to gradient high performance liquid chromatography [HPLC] (Nova-Pak C18, KH2PO4, pH 3, and methanol). The fractions containing steroid glucuronides were collected and esterified with diazomethane and then acetylated with acetic anhydride in pyridine. The glucuronide triacetyl methyl ester (GAME) derivatives were then run in a second HPLC system (3 Lichrosorb 5 mu columns, 4 mm x 25 cm) using a gradient of ethanol-heptane and heptane. We clearly established that this system separates 3 alpha-diol GAME conjugated at the 17 and 3 positions (44 vs 50 min) with authentic samples previously synthesized in our laboratory. We concluded that the pooled plasma contained only the 17-GAME conjugate. No significant activity of the 3-glucuronide was detected. The natural compound in circulation, therefore, is 5 alpha-androstane-3 alpha, 17 beta-diol 17-glucuronide. PMID- 3682823 TI - Growth inhibition by danazol in a human endometrial cancer cell line with estrogen-independent progesterone receptors. AB - Since we recently found that danazol, an isoxazol derivative of ethinyltestosterone, has a growth-inhibitory effect on human endometrial cancer cells in primary culture, the effects of danazol on a human endometrial cancer cell line (IK-90 cells), which contains estrogen-independent progesterone receptors (PR), were investigated in the present study. The addition of danazol (1 nM-1 microM) in culture medium caused a decrease in the growth of IK-90 cells in a dose-dependent manner. Competitive binding studies showed that danazol effectively binds to PR in IK-90 cells, and the binding affinity for PR was estimated to be 6.0% of that of R5020. The addition of 1 microM danazol in culture medium resulted in a rapid and significant increase in nuclear PR with a concomitant decrease in cytoplasmic PR in the cells. These findings suggest that danazol has a growth-inhibitory effect on human endometrial adenocarcinoma cells directly through PR system in the cells. PMID- 3682824 TI - The effects of l-thyroxine and dexamethasone on steroid dynamics in male cynomologous monkeys. AB - Male cynomologous monkeys (M. fascicularis) were infused with [3H]androgens, [14C]estrogens and [3H]cortisol before and after the administration of l thyroxine, (l-T4) 150 micrograms/day for 6 wk, dexamethasone 8 mg every 8 h for 3 doses and dexamethasone 1.0 mg/day for 8 days. Blood samples were obtained before each of the infusions and analyzed for endogenous T, A, E1, E2 and F concentrations, % free T and % free E2, sex hormone-binding globulin (SHBG) and cortisol binding globulin (CBG) capacity. When l-T4 was being administered, T4 and triiodothyronine (T3) concentrations were also measured. Blood samples were obtained during the infusions and analyzed for radioactivity as testosterone (T), androstenedione (A), dihydrotestosterone (DHT), estradiol (E1), estrone (E2), and cortisol (F). All urine was collected for 96 h and an aliquot of the pooled urine was analyzed for radioactivity as estrone and estradiol glucuronide. The administration of l-T4 for 6 wk to 3 monkeys resulted in a marked rise in T4 and T3 levels, from 4.8 +/- 0.4 micrograms/dl and from 136 +/- 6 to 515 +/- 71 ng/dl, respectively. MCRT, MCRE2 and MCRE1 did not change, but MCRA values increased slightly and MCRF increased 2-3 fold. [rho]T.E2 did not change but [rho]A.E1BM showed a slight but significant increase. The inter-conversions between the androgens and between the estrogens were not altered. There was a 2-3-fold increase in SHBG and a decrease in %FT but no change in %FE2 or CBG. The concentrations of T, A and DHT rose but there was no trend in the levels of the estrogens. The administration of dexamethasone 8 mg every 8 h for 3 doses or 1 mg/day for 8 days caused no changes in the MCRs for T, A, E1 and E2 but did cause a significant decrease in MCRF. Measurement of splanchnic and peripheral tissue extractions before and after acute dexamethasone administration in 1 monkey showed that the decrease in MCRF was the result of a marked decrease, 11-2%, in splanchnic extraction of F. The extractions of T and E2 were relatively unaffected. The concentrations of T and F fell but E2 remained the same. % FT and % FE2 rose slightly and the concentrations of SHBG and CBG were unchanged. The androgen interconversions and estrogen interconversions were not affected but [rho]T,E2BM and [rho]A,E1BM showed slight decreases.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3682825 TI - Personality traits in subtypes of alcoholics. AB - Earlier studies have identified at least two distinct subgroups of alcoholics: Type II with early onset and high genetic loading and Type I with late onset in which genetic factors seem to be of minor importance. In the present study, type I and type II alcoholics are compared on stable personality traits determined by the Karolinska Scales of Personality. Both groups were found to have high scores on scales that measured somatic anxiety, psychic anxiety, muscular tension, impulsiveness, detachment, psychastenia, suspicion, guilt and inhibition of aggression. Both groups had low scores on the scale that measured socialization. Type II alcoholics had significantly higher scores than type I alcoholics on Somatic Anxiety and Verbal Aggression scales and significantly lower scores on Socialization and Inhibition of Aggression scales. On the Impulsive Sensation Seeking Psychopathy factor (Impulsiveness + Monotony Avoidance - Socialization), type II alcoholics were significantly differentiated from both type I alcoholics and healthy volunteers. Results of this study were consistent with those of other studies indicating that alcoholism accompanied by antisocial behavior should be kept separate from alcoholism that is unrelated to antisocial behavior. PMID- 3682826 TI - Substance use and mental health problems among sons of alcoholics and controls. AB - Data from a questionnaire sent to 864 university male students and nonacademic staff were used to compare self-reports of substance intake patterns and problems as well as family histories of depression and substance abuse across four groups: Group 1, 682 men (79%) who had no alcoholic first or second-degree relative; Group 2, 101 men (12%) who reported an alcoholic second-degree relative only; Group 3, 59 men (7%) who reported an alcoholic first-degree relative only and Group 4, 22 men (3%) with alcoholism in both first- and second-degree relatives. Although few men were already alcoholics or drug abusers and the groups did not differ significantly on the quantity and frequency of alcohol intake, there was an increase in the personal history of alcohol-related problems from Group 1 to Group 4. There were no significant differences across the groups on the proportion of nonalcoholic relatives demonstrating drug abuse or depressive disorders. PMID- 3682827 TI - The influence of altered tryptophan availability on ethanol intoxication in normal men. AB - Because of evidence that altered 5-hydroxytryptamine function may modulate ethanol intoxication, we investigated this in normal social drinkers. Using amino acid mixtures, 5-hydroxytryptamine was influenced by altering levels of its precursor tryptophan. Neither raising nor lowering tryptophan affected alcohol intoxication as measured by a self-report scale and memory and motor tasks. Our data do not support the idea that 5-hydroxytryptamine can modulate alcohol induced intoxication. PMID- 3682829 TI - Cross-cultural comparisons of Irish and American adolescent drinking practices and beliefs. AB - The drinking behavior and alcohol expectancies of 168 Irish adolescents aged 15 18 were compared with those of a group of American adolescents matched on age and sex. The Irish adolescents reported less frequent social drinking and less problematic drinking. However, unlike American adolescents, those Irish youth who did drink in a social, frequent manner also reported drinking-related problems Irish adolescents expect less social benefit, less improvement of cognitive and motor functioning and less sexual enhancement, but greater increase in aggression as a consequence of drinking. These findings are discussed as possible etiological clues to established differences between Irish adult drinking and drinking by adults in other countries. PMID- 3682830 TI - Comparison of chemically dependent and nondependent nurses on familial, personal and professional characteristics. AB - The characteristics associated with professional impairment due to chemical dependency in nurses are examined. A sample of 139 recovering chemically dependent nurses was compared with a random sample of 384 registered nurses not identified as chemically dependent on familial, personal and professional characteristics. Respondents completed an extensive mailed questionnaire requesting information on demographic variables, family history (past and present), education, employment, medical history, lifestyle characteristics and alcohol- and drug-related behaviors. Significant differences between the two groups were found in gender, familial alcoholism and depression, sexual trauma and functioning, sexual preference, parenthood status, marital history, physical health, depressive illness and alcoholism in spouse. No differences were found in sibling rank, basic nursing education, nursing school class rank, highest educational degree held, academic achievement and length of nursing experience. Recommendations for future study include improved methodology, study of recovery variables and longitudinal follow-up of recovering nurses. PMID- 3682828 TI - Psychosocial factors in adolescent drinking contexts. AB - A number of environmental and personality characteristics of adolescent students and their relationship to types of drinking contexts were examined using a series of canonical correlation analyses. The strongest relationship was defined by the perceived normative support for drinking, which accounted for 55% of the variance in the drinking context items for males (58% among females). Positive functions of drinking, personal attitudes and values, and environmental contexts were also associated with drinking context items but accounted for smaller proportions of the variance. The contribution of important environmental, personality and drinking context variables to each canonical relationship is discussed. Consistency of studies relevant to the major finding is reviewed and possible bases for discrepancies are explored. Further studies relating to antecedent networks of access to various drinking contexts are identified as areas deserving more intensive and extensive research efforts. PMID- 3682831 TI - Women in treatment: beyond the stereotype. AB - A sample of 1776 adult women in treatment for chemical dependency was divided into two age groups: 30 or under and over 30. The two groups were compared for substance use histories and other psychosocial variables. Significant differences emerged in the use of illicit drugs, social use patterns and familial histories. Findings suggest that differences may be related to generational as well as age effects. The study highlights the heterogeneity of women in treatment and emphasizes the need to assess and respond to women's chemical dependency in the context of sociocultural transitions. PMID- 3682832 TI - Accessible and affordable health care for alcoholism and related problems: strategy for cost containment. AB - Dr. Gordis outlines the health consequences of alcohol consumption and the economic costs of alcohol abuse and alcoholism. He defines alcoholism and discusses alcoholism treatment and the problems inherent in its evaluation and financing. Dr. Gordis stresses the importance of rational alcoholism outcome research in future efforts to contain health care costs. PMID- 3682833 TI - Factors associated with motor vehicle accidents among male alcoholics. AB - Male alcoholics (N = 260) presenting for inpatient treatment were given a structured psychiatric interview that included questions about previous motor vehicle accidents while intoxicated. The histories of 57 patients who reported personal injury accidents were compared with those of 131 patients who did not report accidents. Patients reporting accidents were more severely ill and had an earlier onset of heavy drinking. Also, more patients with accidents belonged to a subgroup of alcoholics with antisocial personality. The identification of high risk alcoholics may contribute to motor vehicle accident prevention. PMID- 3682834 TI - Comparison of court-referred DWI arrestees with other outpatients in substance abuse treatment. AB - Outpatient treatment based on the "Minnesota Model" as one alternative for alcoholics arrested for driving while intoxicated (DWI) was examined. DWI arrestees (N = 543) who were court referred for chemical abuse treatment were compared with 827 non-DWI and non-court-referred patients in the same outpatient treatment programs. Results indicate that DWI arrestees tended to be younger and unmarried but were more likely to complete treatment. Their drinking was characterized more as an episode use in a social context with less solitary use, continuous use or use as a response to negative feelings. Although the DWI patients in this study were all alcoholics, as a group they appear to represent a generally less advanced stage of alcoholism than the non-DWI sample. Posttreatment follow-up measures at 6 months on subsamples of the patients demonstrated improvement for both DWI and non-DWI patients in virtually all areas assessed. Few outcome differences between DWI and non-DWI groups were found. The results indicate that outpatient substance abuse treatment may be a viable and vital component in any integrated policy on drunken driving. PMID- 3682835 TI - Testicular seminoma: histological findings and their prognostic significance for stage II disease. AB - Risk factors, their interrelationship, and prognostic relevance for seminoma stage II disease have been examined. The size of the primary tumor was significantly correlated with the pT category, as was the presence of tumor invasion of small vessels. The pT category was correlated neither with clinical substage nor relapse rate. There was a poorer 3-year survival for anaplastic seminomas as compared to that of classical seminomas; the difference was not significant. The 5-year survival for seminomas rich in lymphocytes was better than those of poor lymphocytic infiltration, but this difference also was not significant. No difference in survival or relapse rate was found between HCG producing and HCG-nonproducing seminomas. PMID- 3682836 TI - Improved survival of patients with stage II melanoma of the extremity using hyperthermic isolation perfusion with 1-phenylalanine mustard. AB - Between 1964 and 1983, 65 patients with Stage II extremity melanoma were treated in a nonrandomized fashion with wide local excision, lymph node dissection, and hyperthermic perfusion with 1-phenylalanine mustard at 1.0-1.5 mg/kg. Southwest Oncology Group Stage II criteria were used, including IIA (node positive), IIB/C (recurrent local/regional), or both. During the study interval, literature reports of 5-year survival for Stage II melanoma ranged from 6% to 50% and averaged approximately 26% to 30%. In this study group, 40% of patients had recurrent disease confined to regional lymph nodes, 33% had recurrent cutaneous disease, and 26% had recurrent disease in both locations. Survival for all Stage II patients at 5 years was 56.6%, and 40% at 10 years. When recurrent disease was confined to regional nodes only (IIA), survival at 5 years was 70.5%, and 40% at 10 years. Survival for patients with Stage IIB/C disease at 5 and 10 years was 58% and 43.7%. When recurrent melanoma was present in both skin and nodes, 5-year survival was 29%. The present study indicates that aggressive treatment of Stage II extremity melanoma, which includes hyperthermic isolation perfusion, can prolong survival in these high-risk patients. PMID- 3682837 TI - Two-dimensional immunoelectrophoretic analysis of urinary ultraconcentrates: antigenic differences between bladder cancer positive patients, normal individuals, and patients with urinary tract infections. AB - Urine ultraconcentrates (100-fold) from bladder cancer patients, patients suffering from urinary tract infection, and normal individuals were analyzed using polyacrylamide gel electrophoresis (PAGE) and two-dimensional immunoelectrophoresis. A combined sample of normal urine was resolved into 1 to 3 protein bands by PAGE, whereas a single concentrated bladder cancer urine was resolved into 10-12 protein bands. Yet, this same concentrated urine sample was resolved into 17-20 antigen peaks by two-dimensional immunoelectrophoresis (2DIEP) against antihuman serum. A significant (P less than 0.05) increase was observed in the relative antigen concentration when comparing 2DIEP profiles of bladder cancer urines to normal controls. A significant increase in the relative antigen concentration and the number of antigen peaks was also found when comparing immunoelectrophoretic patterns obtained from ultraconcentrated urine specimens of bladder cancer positive urine and normal controls using a rabbit antibladder cancer urine antisera (P less than 0.002 and P less than 0.02, respectively). In addition, significant (P less than 0.02) antigenic differences were found when comparing concentrated urine samples from bladder cancer positive individuals to those with urinary tract infection. The bladder cancer group demonstrated 8/9 positive results for relative antigen concentrations greater than 3.0. Fifteen of 16 normal or urinary tract infected individuals combined had relative antigen concentrations less than 3.0. These differences were highly significant (P less than 0.001). No differences were found between concentrated bladder cancer and normal urine specimens tested against rabbit antinormal urine antisera. PMID- 3682838 TI - Tumor-induced osteomalacia: long-term follow-up of two patients cured by removal of their tumors. AB - Two patients with mesenchymal tumors had osteomalacia associated with marked hypophosphatemia and renal phosphate wasting. Their serum calcium and parathyroid hormone levels were normal. The first patient also had aminoaciduria and glucosuria in addition to phosphaturia. Both patients were treated with very large doses of vitamin D2 and phosphate without improvement in the osteomalacia or normalization of the serum phosphate. Complete removal of a low-grade fibrosarcoma in the second patient and removal of an ossifying fibroma in the first patient resulted in a cure in both patients despite no further therapy with vitamin D or phosphate. The excessive aminoaciduria and glucosuria of the first patient also remitted. During a 14-year follow-up period, there has been no evidence of tumor recurrence, hypophosphatemia, or osteomalacia in either patient. The levels of 1,25-dihydroxycholecalciferol remain within the normal range in both patients. PMID- 3682839 TI - Autotransplantation of colonic tumors into the colonic wall of the rat. AB - Colonic tumors were induced in Sprague-Dawley rats by weekly subcutaneous injections of 1,2 Dimethylhydrazine (DMH) for 4 months. The animals were thereafter laparotomized and a palpable tumor was transplanted into the same animal in a tumor-free area of the transverse colon. Autotransplanted tumors were considered those tumors growing in the wall of the transverse colon, covered by intact colonic mucosa. The frequency of autotransplanted tumors was 34%. The possibility that autotransplantation may also occur in humans by accident, during procedures to remove a colorectal adenocarcinoma, is discussed. PMID- 3682840 TI - Chylous ascites following retroperitoneal lymph node dissection successfully treated with peritoneovenous shunt. AB - A massive lymphatic leak developed following radical retroperitoneal lymph node dissection for recurrent extragonadal seminoma. Chylous ascites persisted for over 3 months, with an average daily external drainage of 1.5 liters, and was successfully treated with a peritoneovenous shunt. PMID- 3682841 TI - The evaluation and application of a radioimmunoassay for the measurement of diphenoxylic acid, the major metabolite of diphenoxylate hydrochloride (Lomotil), in human plasma. AB - Antibodies to diphenoxylic acid, the pharmacologically active metabolite of Lomotil, were successfully used to develop a precise and specific radioimmunoassay for the measurement of diphenoxylic acid in human plasma. The observed cross-reaction of the antiserum with Lomotil (23.5%) and p-hydroxy diphenoxylic acid (2.9%) was not considered to affect significantly the accuracy of the direct determination of diphenoxylic acid in plasma from human volunteers after ingestion of Lomotil tablets. Within-day and between-day coefficients of variation were better than 3 and 6%, respectively, over the concentration range of 3.4 to 255 ng ml-1. Comparable precision could be achieved at 2 ng ml-1 by doubling the volume of sample analyzed. The assay was used to measure plasma concentrations of diphenoxylic acid in 12 human volunteers for up to 24 hr after ingestion of Lomotil (10mg) tablets. Plasma diphenoxyllic acid levels rose to a mean (SE) maximum level of 87.8 (2.7) ng ml-1 3.3 (0.3) hr after dosing. By 24 hr after dosing plasma levls had decreased to 14.26 (1.67) ng ml-1. The appearance and elimination of plasma diphenoxylic acid could be described by a biexponential function. The appearance half-life was calculated to be 0.82 (0.09) hr, and the elimination half-life was 7.24 (0.73) hr. PMID- 3682842 TI - A modified single sucrose gap. Junction potentials and electrotonic potentials in gastrointestinal smooth muscles. AB - Modifications were made to a rubber membrane type of single sucrose gap apparatus, which facilitated recording of isometric tension in smooth muscle preparations and which allowed electrotonic potentials and junction potentials to be evoked simultaneously. Nonadrenergic, noncholinergic inhibitory junction potentials were recorded from the circular muscle of the rat cecum. The amplitude of the inhibitory junction potential was linearly dependent on membrane potential, and inhibitory junction potential reversal potential was consonant with the expected potassium equilibrium potential. Cholinergic excitatory junction potentials were recorded in a preparation of the guinea pig cecum. It has been discussed as to how this type of modified single sucrose gap will be useful for pharmacological investigations into neuromuscular transmission, in addition to being a useful technique for examining actions of drugs and chemicals on smooth muscles. PMID- 3682843 TI - An in vitro approach to study cellular kinetics of drugs. AB - We adapted different existing techniques in order to optimize the methodology for studying kinetic interactions between drugs and cells in vitro. Using the polymorphonuclear leukocyte as a target cell, we measured the binding of various ligands and intracellular drug concentrations. We also studied pharmacological modulation of drug transport under normal and inflammatory conditions. Our approach allows reproducible measurements on ligands with low affinity for association sites on polymorphonuclear leukocytes. We present data for various nonsteroidal antiinflammatory drugs and other ligands to validate our methodological approach. On the basis of the results thus obtained, we proposed a tentative model to fit data and concepts of drug-cell interactions. PMID- 3682845 TI - An in vitro brain slice preparation to study the pharmacology of central vestibular neurons. AB - The purpose for development of this preparation was to allow detailed studies of the pharmacological and electrophysiological properties of individual central vestibular neurons. The pharmacology of the central afferent synapses of the vestibular system has not been examined at the level of the neuronal membrane, and as a result few definitive reports are available. The best studies have used in situ extracellular recording techniques that are difficult to interpret. For instance, recent literature still supports the concept that excitatory transmission at the N. VIII to vestibular nuclei synapse is cholinergic. Our data refute this hypothesis and suggest that an excitatory amino acid is the most likely candidate for the eighth nerve to medial vestibular nucleus in the rat. We believe this preparation combined with an intracellular electrophysiological approach will shed information of value to both the basic scientist and the clinician with interest in the vestibular system. PMID- 3682844 TI - Influence of some variables in the Triton X-100 method of skinning the plasmalemmal membrane from guinea pig trachealis muscle. AB - Electron microscopy showed that the process of skinning guinea pig trachaelis muscle using Triton X-100 destroys the plasma membranes and causes some retraction of the myofibrils toward the center of the cells. Seven days represents an optimal period for the low temperature storage of the skinned fibers. Increasing the imposed tension from 0.25 to 1.0 g reduces the size of the maximal response to Ca2+. Some sensitization of the skinned fibers to Ca2+ follows the construction of the initial Ca2+ log concentration-response curve. Exogenous calmodulin is not essential for Ca2+-induced tension development and, at 20 degrees C, does not potentiate Ca2+. Useful economy can be achieved without compromising Ca2+ sensitivity or responsiveness by using ATP (a component of the relaxing solution) of purity 99% rather than of 99-100%. PMID- 3682846 TI - Traditional medicine of Baja California Sur (Mexico). II. AB - Continuing our studies of traditional medicine, as used in rural areas of Baja California Sur, now we wish to report on the medicinal uses of 49 more plants. Some of the more complex recipes of these medicinal plants, are discussed in the present paper. The information presented here was collected in the Municipio of Los Cabos and part of the Municipio of La Paz, B.C.S., Mexico. PMID- 3682847 TI - Screening of antimicrobial activity of plants popularly used in Guatemala for the treatment of dermatomucosal diseases. AB - Ethnobotanical surveys were conducted among traditional healers and local market vendors; about 200 plants used in Guatemala for the treatment of dermatomucosal diseases were detected. By literature review and according to local availability, 89 plants were selected for in vitro screening for antimicrobial activity against the microorganisms usually causing skin and mucosal infections. Ethanolic macerations were prepared and impregnated in absorbent paper; once dried, these were applied over standardized inocula of Candida albicans, Escherichia, coli, Pseudomonas aeruginosa and Staphylococcus aureus. After incubation, inhibition zones were measured, demonstrating that 28 of the plants exhibited some in vitro inhibition of the tested microorganisms. PMID- 3682848 TI - Antihepatotoxic actions of Cochlospermum tinctorium rhizomes. AB - The antihepatotoxic activity of the rhizomes of Cochlospermum tinctorium was investigated using carbon tetrachloride- and galactosamine-induced cytotoxicity in primary cultured rat hepatocytes. Because the methanol and ethanol extracts of C. tinctorium rhizomes exhibited antihepatotoxic effects, the former was fractionated in order to elucidate the active constituents. Polyphenol compounds (gallic and ellagic acids) were detected in the active fractions and may account for much of the antihepatotoxic activity. Carotenoids could also be implicated in the activity of the total extracts. PMID- 3682849 TI - Repertory of drugs and medicinal plants used in traditional medicine of Afghanistan. AB - The traditional uses of plants for medicine were studied in Afghanistan. To date, 215 medicinal plants have been identified and are presented in a table with the vernacular name (in Dari, Pashto and Kati), the geographical and ecological distribution, and the medicinal use. This study of traditional medicine demonstrates a close relationship between the kinds of medicinal plants used and pathology, and thus may serve as an indicator of the major health problems of the people. PMID- 3682850 TI - Immunoregulation: the key to transplantation and autoimmunity. AB - Immune responses depend on a unique set of recognition structures, namely, antibody molecules embedded in the B cell membrane for antibody formation and alpha-beta chain heterodimers of the T cell receptor for cellular immune receptors. These structures are coded for by genes, which undergo rearrangements during the differentiation of B- and T-lymphocytes known as somatic translocations. The end result of this process is the creation of separate repertoires of B and T cells, each single cell displaying a unique receptor. Antigen acts by selecting preexisting antigen-reactive cells for division and further differentiation. Accessory cells such as macrophages are essential for the initiation of most immune responses. Different subsets of T-lymphocytes play a vital regulatory role, not only in controlling cell-mediated immunity as such, but also in guiding B cell function. Understanding the roles of accessory cells, regulatory T cells, and the molecules on their surface is essential for understanding immunoregulation. At present, immunosuppression in organ transplantation and therapy of autoimmune diseases are largely nonspecific and empirical. As the rules of the interactive immunoproliferative cascade are progressively unraveled, more targeted immune manipulation will become possible, and some future avenues of this sort are described. PMID- 3682852 TI - Partial cardiopulmonary bypass, hypothermic circulatory arrest, and posterolateral exposure for thoracic aortic aneurysm operation. AB - Partial cardiopulmonary bypass, profound hypothermia, and circulatory arrest were used in the treatment of 25 patients with thoracic aortic aneurysms exposed through left posterolateral incisions. Indications included aortic clamp laceration (4 patients), pulmonary artery tear (1), treatment of ruptured aneurysm without clamping (5), right-sided arch (2), exposure of proximal aorta in a patient with a large aneurysm (1), inability to expose the proximal aorta for clamping (3), to permit removal of both arch and distal aorta (4), and to avoid distal arch clamping because of atheromatous disease (5). Aortic segments ranging from the upper descending thoracic aorta to most of the aorta were replaced, with early survival in 21 patients. Cerebral protection was satisfactory. PMID- 3682851 TI - A comparison of aortic valve replacement with viable cryopreserved and fresh allograft valves, with a note on chromosomal studies. AB - We examined the long-term clinical function and fate of allograft aortic valves, preserved by two differing methods, for aortic valve replacement: (1) fresh allografts stored at 4 degrees C refrigeration (group I) and (2) viable allografts cryopreserved in liquid nitrogen at -196 degrees C (group II). A total of 316 aortic valve replacement operations were performed, 124 in group I (December 1969 to May 1975) and 192 in group II (June 1975 to December 1986). Concomitant surgical procedures (eg, coronary artery bypass grafting and mitral valve replacement) were necessary in 120 operations. The overall immediate 30 day mortality was 6.0% (confident limits 4.6% to 7.7%), and the survival rates were 83% at 4 years and 60% at 15 years. Endocarditis and technical factors concerning reoperation showed no difference between the two groups according to parametric estimates and hazard function analyses. However, there was a marked difference in reoperation for valve degeneration: 23 patients in group I and 0 patients in group II. The freedom from reoperation for valve degeneration at 10 years was 89% for group I and 100% for group II, and at 15 years it was 59% for group I. The hazard function for group I reflected the late rising risk of degeneration. The freedom from thromboembolism of both groups (aortic valve replacement with or without bypass grafting) was 97% at 10 years and 96% at 15 years. Group II explanted valves (operation for technical malalignment reasons) has consistently shown evidence of persisting viability on tissue culture, on metabolic studies, and on histologic appearances. Chromosomal studies have shown the donor origin of these cells. The superior results with the cryopreserved valve is considered to be due to persisting viability, which appears to be the key to durability. PMID- 3682853 TI - Care of infants with esophageal atresia, tracheoesophageal fistula, and associated anomalies. AB - One hundred consecutive patients with esophageal atresia or tracheoesophageal fistula, or both, were treated at The Children's Mercy Hospital during the past 14 years. Each patient was evaluated and a plan for therapy was formulated depending on the type and urgency of concomitant disease. Healthy patients were treated by primary repair. Those with respiratory disease were treated before repair by gastrostomy, upper pouch suction, and antibiotics. In the small premature infant and the patient with major associated anomalies, repair of the esophageal atresia and tracheoesophageal fistula was postponed by gastrostomy, upper pouch suction, and parenteral nutrition while the concomitant disease was treated. Fifteen patients with life-threatening associated anomalies required operation before esophageal repair and 13 of them survived. During the initial hospitalization two deaths related to esophageal atresia occurred, whereas three prerepair and two late (2 1/2 and 3 months) postrepair deaths related to associated anomalies occurred. Thus, 93 of the 100 patients left the hospital alive. The increased survival is due not only to improved care of esophageal atresia and tracheoesophageal fistula, but also to a more aggressive approach to the treatment of the serious associated anomalies. PMID- 3682854 TI - Sequential endocardial resection for the surgical treatment of refractory ventricular tachycardia. AB - The optimal surgical therapy for refractory ventricular tachycardia is controversial. The usual operation involves induction of tachycardia and endocardial mapping during normothermic cardiopulmonary bypass, followed by systemic hypothermia, aortic cross-clamping, and resection of the identified site of origin of the tachycardia. Our initial experience with this technique in 20 patients (mean age 60 years, mean ejection fraction 29%, mean number of failed antiarrhythmic drugs three) resulted in five (25%) surgical deaths, three caused by ventricular tachycardia and two by respiratory or heart failure. Electrophysiologic study showed that 11 of 15 survivors were free from ventricular tachycardia after operation, for a success rate in the survivors of 73%. Most failures occurred in patients with multiple tachycardia morphologies that were not eradicated by initial resection. Thereafter, the technique of sequential endocardial resection was used. After completion of endocardial mapping, directed normothermic endocardial resection is performed; more attempts to induce ventricular tachycardia are made and followed by further mapping and resection until tachycardia can no longer be induced. Fifty patients (mean age 59 years, mean ejection fraction 33%, mean number of failed antiarrhythmic drugs three) were treated by this method, with a mean of two resections per patient (range one to six). Mean perfusion time in the sequential resection group (101 +/ 28 minutes) was not significantly different from that of the earlier patients (101 +/- 40 minutes). There were four (8%) surgical deaths, one caused by persistent arrhythmia and three caused by respiratory or heart failure. Electrophysiologic study after operation showed that 40 of 46 survivors (87%) were free of ventricular tachycardia. Symptoms in the six with inducible tachycardia on postoperative electrophysiologic study were well controlled with medication. These data suggest that sequential endocardial resection guided by intraoperative mapping is a highly effective operative approach for patients with ventricular tachycardia. PMID- 3682856 TI - Surgical options for treating ventricular tachyarrhythmia and sudden death. AB - From 1981 to 1987, 62 patients with ventricular tachyarrhythmias and associated sudden death required treatment after unsuccessful initial medical therapy (51 patients) and previous surgical therapy (11 patients). Surgical options included direct revascularization (group I, 11 patients), endocardial resection (group II, 7 patients), automatic internal cardiac defibrillators (group III, 18 patients), and these combinations of operations: revascularization and endocardial resection (group IV, 18 patients), revascularization and insertion of automatic internal cardiac defibrillators (group V, 5 patients), and endocardial resection and insertion of cardiac defibrillator (group VI, 3 patients). Five underwent repeat revascularization (4) or endocardial resection (4) with mitral valve replacement (1) or papillary muscle reconstruction (2). The overall operative mortality of 8.1% (5/62) has been acceptable (2.8% or 1/36 for the simple procedures [groups I, II, and III] and 15.4% or 4/26 for the combined procedures [IV, V, and VI]; p less than 0.074). Operative risk factors included recent myocardial infarction (4/5 deaths) and depressed ejection fraction of 23% or less (5/5 deaths). These operative risks were highest in group IV and, thus, the highest mortality was in group IV (4/18 patients or 22%, p less than 0.022). Six late deaths (4 patients in group III) brought the overall survival rate to 82% or 51/62 patients at a mean follow-up of 30 months. Surgical treatment of sudden death ventricular tachyarrhythmias requires a planned, combined operative approach, since initial medical or surgical failures can occur. The optimal surgical approach requires complete revascularization, resection of the localized subendocardial arrhythmogenic focus, and ventricular reconstruction. An automatic defibrillator is a palliative alternative for less favorable surgical anatomy and for patients who are poor operative candidates for these combined or reoperative procedures. PMID- 3682855 TI - Direct operations for the management of life-threatening ischemic ventricular tachycardia. AB - Between June 1978 and 1986, 93 consecutive patients underwent electrophysiologically guided operations for life-threatening recurrent sustained ventricular tachycardia mostly associated with other surgical procedures, such as left ventricular resection (aneurysmectomy) and coronary artery bypass grafting. DATA: Eighty-seven percent of the surviving patients were free of spontaneous ventricular tachycardia return or sudden death 1 year after the operation and 77% at 5 years. The instantaneous risk of ventricular tachycardia return was highest immediately after operation, declined rapidly, and by 2 weeks postoperatively had merged with the constant hazard phase, which persisted as long as the patients were observed. Endocardial resection, rather than encircling endocardial myotomy, increased the risk of spontaneous ventricular tachycardia return/sudden death. Survival rates, including hospital deaths, were 95% at 30 days, 89% at 1 year, and 70% at 5 years after operation. The most prevalent mode of death was heart failure. The absence of anterolateral left ventricular aneurysms and the use of more extended encircling incisional techniques for ventricular tachycardia ablation increased the risk of early and late death. Survival was particularly poor in that subset of patients in whom recurrent sustained ventricular tachycardia returned after operation; the most prevalent mode of death in this group was also progressive left ventricular failure. Inferences: (1) Complete and partial encircling endocardial myotomy incisions are the most effective surgical techniques for malignant ventricular tachycardia ablation. (2) Because of their adverse effects on left ventricular structure and function, the arrhythmogenic tissues have to be localized as precisely as possible, and the encompassing incisions should be kept as limited as possible. (3) The late return of ventricular tachycardia may be more related to a progressive ischemic left ventricular cardiomyopathy than to an inadequate operation. PMID- 3682857 TI - Hemodynamics of protamine administration. Comparison of right atrial, left atrial, and aortic injections. AB - Protamine administration for heparin reversal after cardiopulmonary bypass on occasion is associated with mild to severe hemodynamic deterioration. The route of administration may modify these reactions. A prospective randomized study was done in 68 patients undergoing isolated coronary artery bypass grafting. The route of protamine administration was randomized in a balanced fashion between right atrium, left atrium, and aorta. The preoperative and operative characteristics of the three groups were similar. Hemodynamic measurements were recorded before cannulation, after removal of the venous drainage catheter, and 1 minute, 5 minutes, and 10 minutes after protamine administration. Hypotension occurred in 11 patients with no significant difference among the three groups. The hypotension was immediate in three patients in whom route of administration was the aorta. The overall hemodynamic changes observed for the three treatment groups were not significantly different. An analysis for type II error indicated that it was unlikely that an important difference had been missed. We conclude that the route of administration does not affect the hemodynamic changes associated with protamine administration. We did not observe a case of severe hemodynamic deterioration, so that we cannot assess the effect of route of administration on the severity of an anaphylactic reaction. PMID- 3682858 TI - Protection of the pediatric myocardium. Differential susceptibility to ischemic injury of the neonatal rat heart. AB - Myocardial protection during pediatric cardiac operations has been suggested to be less successful than in adult hearts. In the present study we have compared the resistance of adult, infant, and neonatal rat hearts to various periods of ischemic arrest with normothermic (37 degrees C) crystalloid cardioplegia. Isolated hearts with intraventricular balloons, from adult (50 to 60 days of age, heart weight 865 +/- 13 mg), infant (20 to 25 days of age, heart weight 251 +/- 3 mg), and neonatal rats (3 to 5 days of age, heart weight 40 +/- 1 mg) were subjected to 10, 20, 30, 40, 50, 60, 80, and 100 minutes of ischemia (n = 6 hearts for each time point and for each age group). St. Thomas' Hospital cardioplegic solution was infused at the onset of the period of arrest. With increasing durations of ischemia there was a declining postischemic recovery of function. Up to 40 minutes of ischemia there was no significant difference between the three age groups in postischemic recovery of left ventricular developed pressure: 40.3% +/- 4.4%, 45.4% +/- 6.5%, and 44.4% +/- 2.2% of preischemic control for adult, infant, and neonatal hearts, respectively. Beyond 40 minutes adult and infant hearts showed an identical deterioration with effectively no recovery beyond 60 minutes of ischemia. By contrast, neonatal hearts were much more resistant to ischemia. After 100 minutes of ischemia the mean recovery of left ventricular developed pressure was 20.9% +/- 1.1%, whereas in infant and adult hearts the values were 0.6% +/- 0.3% after 80 minutes of ischemia and 0% after 100 minutes, respectively. Analysis of creatine kinase leakage also indicated that with ischemic durations in excess of 40 minutes, the neonatal heart was far more resistant to ischemia, and creatine kinase leakage per gram dry weight was much less than in infant or adult rats. Analysis of the rates of recovery during reperfusion again revealed differences between neonatal hearts and hearts from the other two age groups. We conclude that in the normal rat the neonatal heart has a greater inherent tolerance to ischemia than that of the infant or adult rat. PMID- 3682859 TI - Surgical anatomy of left ventricular outflow tract obstruction in complete atrioventricular septal defect. A concept for operative repair. AB - An integral part of the heart with an atrioventricular septal defect and a Rastelli type A valve configuration is left ventricular outflow tract obstruction. Current surgical techniques do not cater to this particular anatomic facet, and left ventricular outflow tract obstruction has been reported as a postoperative problem. The present study has focused on the surgical anatomy of the mode of attachment of the left superior atrioventricular valve and its relationship to the left ventricular outflow tract. It appeared that the anchoring of the superior leaflet was a major factor in limiting the excursions of the superior leaflet, contributing also to the tightness of the subaortic left ventricular outflow channel. On that basis a surgical repair is proposed in which the greater part of the tightly bound superior leaflet is detached from the septal crest, so that the left ventricular outflow tract is widened. PMID- 3682860 TI - Correction of pulmonary atresia with ventricular septal defect in the absence of the pulmonary trunk and the central pulmonary arteries (so-called truncus type IV). AB - A child with pulmonary atresia and ventricular septal defect and no extraparenchymal pulmonary arteries had all the bronchopulmonary arterial segments connected to naturally occurring systemic-pulmonary collaterals. A three staged surgical correction was performed. At the first and second stages, the arteries of each hilus were interconnected with synthetic arteries. At the third stage, the ventricular septal defect was closed, and continuity between the right ventricle and the bilateral pulmonary circulation was established with a valved conduit giving rise to a side arm. Postoperative evolution was good, with acceptable postrepair per right ventricular--left ventricular pressure ratio. PMID- 3682861 TI - Coverage of the open sternotomy wound with Biobrane dressing. AB - Massive edema accumulated after prolonged cardiopulmonary bypass for coronary grafting such that neither the sternum nor the presternal skin could be closed after insertion of a left ventricular assist device. To protect the mediastinum from infection, we applied Biobrane synthetic temporary wound dressing and placed a moist gauze dressing over it. When the dressing was removed 4 days later, the wound was pink, granulating, free from infection, and suitable for closure. Use of Biobrane biologic dressing should be considered when the mediastinum must remain exposed after median sternotomy. PMID- 3682862 TI - Simultaneous resection of synchronous bilateral bronchogenic carcinoma using median sternotomy. AB - Despite the increasing use of median sternotomy for pulmonary resection, only two successful cases of simultaneous resection of bilateral primary bronchogenic carcinoma by this approach have been reported. We report the third case of successful resection of synchronous primary bronchogenic carcinoma by median sternotomy, and the fourth successful case of simultaneous resection, as the first reported case of simultaneous resection was accomplished via bilateral anterolateral thoracotomy incisions. We believe at present that the ideal surgical approach for patients with bilateral primary bronchogenic carcinoma is simultaneous resection by median sternotomy. PMID- 3682863 TI - Retrosternal adhesions after pericardiotomy. PMID- 3682864 TI - The Gorlin syndrome: a genetically determined disorder associated with cardiac tumor. PMID- 3682866 TI - Antileukemic activity against L1210 leukemia, pharmacokinetics and hematological side effects of 5-hydroxymethyl-2'-deoxyuridine. AB - The chemotherapeutic potential of 5-hydroxymethyl-2'-deoxyuridine (5HmdUrd) was examined in vitro and in vivo. The compound was toxic in 2-day cultures; 7, 66 and 88% inhibition in the growth of L1210 cells was achieved with 1, 10 and 100 microM 5HmdUrd, respectively. The maximal plasma concentration of 5HmdUrd at 15 min after a single i.p. injection (100 mg/kg) in DBA/2 mice was 193-244 mumol./l and the compound had a logarithmic disappearance curve with a half-life of 20 min. Chemotherapy given as two daily i.p. injections of 5HmdUrd (100 mg/kg) for five successive days resulted in a 239% increase in median lifespan and 2/6 long term survivals among DBA/2 mice bearing leukemia L1210. This treatment resulted in temporary neutropenia and thrombocytopenia, which were followed by rebound thrombocytosis and neutrophilia of short duration. Our data indicate that 5HmdUrd can successfully be used in experimental cancer chemotherapy in vivo. PMID- 3682865 TI - Effects of N,N-dimethylformamide and sodium butyrate on enzymes of pyrimidine metabolism in cultured human tumor cells. AB - Effects of a 7-day treatment with the maturational agents DMF and sodium butyrate on enzymes of pyrimidine metabolism, growth rate and cell maturation were assessed in 5 human tumor cell lines, ARH-77 (myeloma), K-562 (chronic myeloid leukemia), KG-1 (myeloid leukemia), HL-60 (promyelocytic leukemia) and RWLy-1 (non-Hodgkin's lymphoma). DMF lengthened the doubling times of all five cell lines while sodium butyrate lengthened only those of K-562, HL-60 and RWLy-1. Full maturation was induced only in HL-60 by either agent and in K-562 by butyrate. Exposure resulted in a decreased activity of the anabolic enzyme orotate phosphoribosyltransferase (EC 2.4.2.10) and increased activities of the catabolic enzymes thymidine phosphorylase (EC 2.4.2.4) and dihydrouracil dehydrogenase (EC 1.3.1.2). Changes in the amphibolic enzyme, uridine phosphorylase (EC 2.4.2.3) did not follow any apparent pattern. This study indicates that the pattern of pyrimidine metabolism differs between the differentiated and slowly growing, and undifferentiated rapidly growing counterpart of several human tumors, suggesting that enzymes of pyrimidine metabolism can be used as markers for cellular growth and/or maturity. PMID- 3682867 TI - Scottish validation study of Cancer Registration data childhood leukaemia 1968 1981--I. AB - This study attempted to validate central registration data on all childhood leukaemia cases in Scotland between 1968 and 1981 in line with the Black Enquiry concerning West Cumbria. Missing files precluded a complete verification, but minor errors of registration were found in 44% of cases. A small number of important mistakes of omission (eight cases), wrong diagnosis (six cases) and postal code errors (nine cases) were found which might affect epidemiological studies of these relatively rare diseases. Precise and verified prospective data collection at the time of diagnosis is essential if the spatial distribution of childhood cancers is being studied. PMID- 3682868 TI - Scottish validation study of Cancer Registration data childhood leukaemia 1968 1981. Bone marrow review--II. AB - Following a review of central leukaemia registration data for Scottish children 1968-1981 a retrospective assessment of leukaemia type was made by inspection of bone marrow slides. Only 57% of slides were still available and in 72% of these the review panel confirmed the initial diagnosis of leukaemia and its type. In eight cases the panel disagreed with the diagnosis or the type of leukaemia designated. Central slide review at diagnosis in childhood leukaemia is essential if subsequent epidemiological studies are to be meaningful. PMID- 3682869 TI - Hairy cell leukemia: in-vitro proliferation and pseudo-colony formation. AB - In an established double layer clonogenic assay, the PHA-leukocyte feeder colony assay, hairy cell leukemia (HCL) cells formed strong aggregates simulating colonies. After irradiation with 50 Gy, colony formation persisted. Even in a modified colony assay consisting of agar 0.5% overlayered by methylcellulose 0.9%, cell aggregation was still possible due to increasing fluidity of the methylcellulose during the culture period. Time-lapse video recordings confirmed prominent cell motility leading to pseudo-colony formation. Studies with bromodeoxyuridine incorporation showed a low proliferation index (up to 13%) of hairy cells. In conclusion, any assay that facilitates cell motility is unsuitable to study HCL colony growth. PMID- 3682870 TI - A multiple-contact EMG recording array for mapping single muscle unit territories. AB - The glycogen-depletion technique has become a well-established method for determining histologically the cross-sectional distribution of a single muscle unit. A major drawback of this method is its low yield of one depleted unit per experiment. Furthermore, this technique is particularly unsuited for determining the longitudinal distribution of single muscle units in long, broad muscles because of the formidable serial sectioning job that would be required. Our alternative, electrophysiological method utilizes a multiple-contact, two dimensional EMG recording array to map efficiently the cross-sectional and longitudinal distributions of numerous single muscle units in anatomically diverse muscles. Additionally, architectural information on muscle fiber lengths, end-plate locations, motor subunit (MSU) arrangements and muscle conduction velocities can be determined. PMID- 3682871 TI - Measurements of regional glucose metabolism in studies of motor control. AB - We used the incorporation of tracer quantities of radiolabeled glucose analogues into muscle and CNS tissues to determine, first, whether unilateral dorsal root deafferentation affects hindlimb flexor and extensor muscles of that side equally. For this we compared the incorporation of [3H]fluorodeoxyglucose into selected muscles in the intact and the deafferented side. The muscles were dissected out after exercise on a treadmill, and tracer incorporation was measured by scintillation counting. Second, we used the [14C]2-DG radioautographic method of Sokoloff to seek confirmation of the involvement of certain CNS structures in locomotor control. We found fascinating side to side asymmetries in glucose metabolism, in the cervical spinal cord, motor cortex, and caudate nucleus. There is still debate about the manner in which "neuronal function", regional blood flow, and glucose metabolism, may be coupled (or even on the existence of such coupling). However, these methods can be useful by their anatomical resolution, and the possibility of making multiple regional measurements from a single subject. PMID- 3682872 TI - Ultrasound transit time gives direct measurement of muscle fibre length in vivo. AB - The movement occurring in whole muscle during contraction is divided between the muscle fibres, the tendon and the longitudinal change in length due to a change in pennation angle. The relative importance of each of these components varies between muscles and with how they are being used. To date it has not been possible to measure each of these movements. By suturing piezoelectric crystals to each end of a small group of muscle fibres in cat medial gastrocnemius muscle, the transit time of ultrasound between the crystals was measured. Assuming a constant velocity of sound in muscle of 1580 m/s, the transit time was used to calculate the muscle fibre length. In "isometric" tetanic contractions the muscle fibres shortened by up to 25% at the expense of the tendons. Lengthening the muscle by 4 mm between each two tetanii, produced less than 4 mm stretch of the muscle fibres as some of the movement was taken up by a change in pennation angle. Except at long lengths, when passive tensions were present, none of this movement between tetanii could be accounted for by stretch of the tendon. PMID- 3682873 TI - Individual muscle force estimations using a non-linear optimal design. AB - In order to estimate individual muscle forces during human movement a mathematically underdetermined system, representing the human musculoskeletal system, was solved using a non-linear optimization algorithm. The load sharing between muscles was made to depend upon the instantaneous contractile conditions of the muscles, a feature not incorporated in comparable non-linear optimal designs reported in the literature. The optimization algorithm was formulated as a convex system which guarantees a unique solution at the global minimum. The strengths and weaknesses of the present optimization algorithm were evaluated and compared to the classical algorithm reported by Crowninshield and Brand (J. Biomech., 14 (1981) 793-801). PMID- 3682874 TI - Inferring limb coordination strategies from trajectory kinematics. AB - This paper discusses the method of kinematic modeling and matching to human arm trajectories in order to ascertain the motor control system's coordination strategy. The planning variables of joint angles and endpoint Cartesian coordinates are contrasted, under linear and staggered interpolation strategies. It is shown that distinguishing the two variable planning sets depends critically on the region of the workspace in which movement takes place. PMID- 3682875 TI - Dipole-tracing method applied to human brain potentials. AB - A new computer-aided method was developed to estimate the location of an electric source generator (e.g. a current dipole) in the human brain. Brain activity such as somatosensory evoked potentials was recorded with 21 surface electrodes over the scalp. To solve the inverse problem, it was assumed that only one dipole is elicited at a given time, and that the head is embedded in an infinite and homogeneous conductor. The exact geometry of the human head was measured from 17 slices of CT-images of a real head to arrange a human head model. A dipole with a given moment and location is assumed in the head model. Potential distribution elicited by the dipole is compared with potential distribution which was the actual recorded one. The optimal dipole location was calculated, using the simplex method. Hence, the optimal dipole moment was obtained. The accuracy of estimation as an equivalent dipole was expressed in terms of dipolarity. PMID- 3682876 TI - Correlation and spectral analysis of relations between single unit discharge and muscle activities. AB - Correlation and spectral analysis was used to study functional linkages between single-cell discharge in the magnocellular red nucleus and the electromyographic activity of several limb muscles. Long sequences of unit discharge and EMG activity were recorded while feline subjects performed a food retrieval task. Unit discharge and muscle activity were patterned in bursts that corresponded to different phases of the task. There was sufficient variability in the parameters of these bursts to regard the signals as pseudorandom variables, thus facilitating a correlation analysis. Cross-correlation functions computed between unit discharge and each muscle EMG served to characterize the strength and reliability of linkages between a single unit and various limb muscles. Auto correlation and auto-spectral density functions provided summary measures of the temporal and frequency characteristics of the signals. Power in the signals was concentrated in a behaviorally relevant range (0.2-8 Hz). Coherence functions showed peaks that indicated which frequency components were well correlated with unit discharge. Two-sided impulse responses served to characterize the dynamic properties of the linkages. These methods are shown to be valuable in characterizing noncausal, as well as causal, linkages through multisynaptic pathways in the nervous system. PMID- 3682877 TI - Cross-correlation of EMG reveals widespread synchronization of motor units during some slow movements in intact cats. AB - It is commonly assumed that the motor units comprising a single mammalian muscle will be recruited asynchronously at subtetanic firing rates to produce smoothly modulated force output. However, electromyograms from certain neck muscles, recorded by implanted bipolar "patch" electrodes having large contacts, often exhibited a rhythmic clustering of spike activity whose patterns suggested that motor-unit firing was synchronized both within and across muscles. We have developed a computerized processing system that digitizes EMG activity and calculates auto- and cross-correlation products of selected segments. The presence or absence of synchronization caused by neural mechanisms can be identified and differentiated from that due to the rhythmicity of the behavior itself (e.g. shaking) or due to cross-talk, according to the shapes of the resultant correlograms. These methods have so far been applied to the study of hindlimb and neck muscle EMG during various natural motor behaviors, but they provide a general, quantitative tool for the study of an important aspect of motor control that may be overlooked by conventional sampling and smoothing techniques. PMID- 3682879 TI - A myocybernetic model of the jaw system of the rat. AB - A dynamic model of the jaw system of the rat has been formulated. The model consists of several units: (1) A static muscle fiber model, relating force with fiber length, based on sarcomere morphometric information. (2) A static skeletal muscle model, relating muscle force with muscle length based on myomorphometric information and the static fiber model. (3) A dynamic skeletal muscle model, relating muscle force with muscle length, contraction velocity and stimulation rate, based on fiber type data, calcium dynamics and velocity-force relations and on the static skeletal muscle model. (4) A kinematic model of the jaw system, relating the possible movements of the jaw system with the morphometrics of the bones, joints and connective tissue. (5) A three-dimensional reconstruction package, devised to analyze and display the morphometrics of the jaw system and to show the model results in terms of force vectors, positions and movements of the jaw system. EMG data of chewing rats and myomorphometric data (from unit 5) are fed into unit 3 resulting in muscle forces. The trajectories of the lower jaw and hyoid resulting from these velocity-dependent forces are calculated using unit 4, taking inertias and gravity into account. The calculated movements are remarkably similar to those that have been observed experimentally. The force velocity relation of the muscles is highly important in stabilizing the velocities of the elements. PMID- 3682878 TI - A technique for measuring the mechanical actions of heterogenic (intermuscular) reflexes in the decerebrate cat. AB - Two muscle pullers were used to study the natural mechanical actions of autogenic reflexes, which arise from muscle receptors and feed back to the muscle of origin, and heterogenic reflexes, which feed back to muscles other than the muscle of origin. In the study reported here, the reflexes associated with muscles which act about the ankle joint of the decerebrate cat were investigated. Actions of autogenic pathways were measured by imposing length changes on the muscle and recording the resulting changes in force and EMG (electromyogram). Actions of heterogenic reflexes for pairs of muscles were measured by imposing appropriate combinations of length changes on the muscle of origin and on the muscle receiving the heterogenic reflex. In some cases, length changes were applied in such a way as to mimic normal mechanical coupling to evaluate the physiological importance of the reflexes, while in other cases the tests departed from normal coupling to address questions about mechanisms of reflex action. It was found that several pairs of muscles could be studied in a single experiment so that supraspinal influences on the pattern of spinal reflex connectivity can be conveniently evaluated. PMID- 3682880 TI - Application of autoradiographic analysis of 2-deoxyglucose in the study of locomotion. AB - Trace amounts of [14C]2-deoxyglucose (2-DG) were used to detect regions of the brainstem involved in forelimb stepping in thalamic and low spinal cats. Under ether anesthesia, cats were transected at the stereotaxic A12 level and T10 segment. Two hours later, 50 microCi/kg of 2-DG was infused i.v. and one of 4 procedures was followed: 3 cats stepped on a motor-drive treadmill (Stepping), 3 were kept in a stationary standing position (Rigidity), 2 were anesthetized with sodium pentobarbital (Anesthetized), and 2 were stimulated in the mesencephalic locomotor region (MLR-induced). Absolute optical densities of the autoradiograms corresponding to identified anatomical structures of the brainstem were generally in the following order: Stepping greater than Anesthetized greater than MLR induced greater than Rigidity. The 2-DG uptake relative to the pyramidal tract (2 DG ratio) also was compared for each of the 4 experimental procedures. In the Stepping cats, the 2-DG ratio was highest in the vestibular nuclei, periaqueductal gray, red nucleus and thalamic nuclei. In the Rigid cats, the 2-DG ratio was highest in the medial vestibular nucleus and subthalamic and thalamic nucleus. These findings suggest that the 2-DG tracer method can be useful in associating neural structures with specific kinds of motor functions within a cat. This is particularly true when using the relative activities of different neural structures and in comparing specific neural structures across cats under different experimental conditions when the amount of 2-DG infused is standardized and the optical densities of the autoradiograms are calibrated to a specific level of 2-DG. PMID- 3682881 TI - A computer-controlled system to perturb the ankle joint of freely standing cats trained to maintain a given force. AB - A computer-based system was developed to (1) train freely standing cats to match various target forces with the left hindlimb, (2) perturb the left ankle joint when the cat was maintaining a desired force and (3) compare reflex responses before and after decerebration. Cats quickly learned to stand unaided on 4 pedestals. During a training session, a range of target force windows was presented to the cat. A successful trial consisted of maintaining the force applied on the left rear pedestal within the target window for a preset time period. To assist the cat, a light was turned on whenever the force was within the target window. A food pellet reward was delivered by the computer after each successful trial. To test reflex responses, the position of the left hindlimb could be briefly perturbed by activating a servo-controlled printed motor configured to rotate the pedestal about the axis of the ankle joint. Perturbations that either flexed or extended the ankle joint were presented pseudo-randomly by the computer. This approach has been used to quantify the magnitude of muscle afferent volleys and the reflex EMG in ankle extensor muscles of normal and decerebrated cats, in response to similar mechanical perturbations. It has also been used to study dynamic features in the electroneurogram recorded from a cutaneous nerve by implanted nerve cuff electrodes, and the correlations among the electroneurogram, the vertical contact force applied on the pedestal and the force recorded from muscle tendons by implanted transducers. This approach may have general applications in the study of postural control, including the study of the discharge patterns of individual motor, sensory or spinal cord neurons in freely standing cats. PMID- 3682883 TI - Intracellular recordings from interneurons and motoneurons in intact flying locusts. AB - A preparation is described in which it is possible to record intracellularly from identified motoneurons and interneurons during flight in intact tethered locusts. Intracellular recordings could be obtained from either the large somata of the motoneurons or from the neuropil processes of interneurons and motoneurons in either the meso- or metathoracic ganglion. Intracellular recordings from motoneuron somata were sufficiently stable to allow surgical manipulations, e.g. deafferentation, of the nervous system without the loss of penetration. Recordings from neuropil processes required stabilizing the ganglion by sandwiching it between two supports. The preparation is suitable for the cellular analysis of many aspects of motor patterning in the flight system of the locust. So far we have used it to make a direct comparison between the patterns of synaptic activity in intact and deafferented animals. This comparison shows that sensory feedback from wing proprioceptors strongly influences the activity in elevator motoneurons and flight interneurons. From these and other observations we conclude that proprioceptive feedback is essential for generating important features of the intact motor pattern and that wing receptors are integral elements of the intact flight pattern generator. PMID- 3682882 TI - A paradigm for determination of direct drug-induced modulatory alterations in Purkinje cell activity during treadmill locomotion. AB - This paper describes a paradigm employing chronic single unit recording techniques and videotape analysis of treadmill locomotion in order to determine drug-induced modulation of sensorimotor neuronal activity. Animals implanted with a chronic headstage microdrive unit and an indwelling jugular cannula are trained to walk on a treadmill (10 s on, 10 s off). Characteristically, cerebellar Purkinje cells recorded 1-1.5 mm from midline, exhibit increased rates of discharge in phase with movement of specific limbs during a particular stage of the step-swing cycle, as assessed by video analysis of locomotor patterns. Drug induced alterations in this movement-correlated discharge relative to changes in the spontaneous firing rate can then be determined to assess drug-induced neuromodulatory effects beyond general non-specific excitatory or inhibitory actions. PMID- 3682885 TI - Novel approaches to the study of motor systems. Proceedings of a satellite symposium to the XXX International Congress of Physiological Sciences. Banff, Alberta, Canada, 10-13 July, 1986. PMID- 3682884 TI - A method for simulating the reflex output of a motoneuron pool. AB - An analysis of the reflex output of a motoneuron pool in response to a Ia afferent input is presented. The analysis is based upon a model of the motoneuron pool which includes the subthreshold behavior of motoneurons (integration of synaptic inputs) and the statistical distribution of the motoneurons according to their resting conductance. The latter feature allows for the orderly recruitment of the motoneurons in the order of low resting conductance to high resting conductance. The number of active motoneurons (i.e. the excitation level) is determined by the balance of the excitatory and inhibitory conductances acting on the pool. The reflex output in response to a Ia-EPSP is computed at various excitation levels and with different amounts of presynaptic inhibition. The reflex output is the same for a given excitation level, regardless of the mixture of excitatory and inhibitory postsynaptic conductances used to produce that excitation level. In contrast, presynaptic inhibition markedly affects the relation between reflex output and excitation level. PMID- 3682886 TI - [Clinical and endocrinologic aspects of corpus luteum insufficiency in early spontaneous abortion]. PMID- 3682887 TI - [The effect of fetal hypoxia and acidosis on changes in the fetal electroencephalogram during labor]. PMID- 3682889 TI - [The duration of contraception protection with copper intrauterine devices]. PMID- 3682888 TI - [The attitude of women to the use of early amniocentesis and chorionic villi technics--psychologic aspects]. PMID- 3682890 TI - [Surgical approach to the treatment of urinary stress incontinence and factors which contribute to manifestations of recurrence]. PMID- 3682891 TI - [Umbilical endometriosis]. PMID- 3682892 TI - [Delivery after prior cesarean section]. PMID- 3682893 TI - [Views on the public health and economic aspects of fertilization in vitro]. PMID- 3682894 TI - [Legal problems in artificial reproduction]. PMID- 3682895 TI - [Cellular and humoral immunity in women with endometrial cancer]. PMID- 3682896 TI - [Mental health and music]. PMID- 3682897 TI - [A learning experience in the preparation of an outline of nursing sequence at an outpatient clinic for temporary substitute nurses]. PMID- 3682899 TI - [Patients' refusal and instructions in clinical training in nursing--students' attitude at patients' refusal]. PMID- 3682898 TI - [Human engineering in nursing schedules: in search of better working patterns. 9. Comparison of the extents of fatigue among married and single workers on double shifts (at a psychiatric department)]. PMID- 3682900 TI - [Data collection in nursing studies. 3. On questionnaires (1)]. PMID- 3682901 TI - [Worrisome nursing term, "restraint"]. PMID- 3682902 TI - [Questions and answers on nursing management: seminars for nursing studies to be based on personal experiences and held as often as needed in a hospital]. PMID- 3682903 TI - [Current trends in debates on brain death]. PMID- 3682904 TI - [Home nursing: limited remuneration by the National Health Insurance policy and consequent financing by the hospital]. PMID- 3682905 TI - [Questions and answers on management of nursing schools. The problem of the number of students trained at each ward: synergistic effects in group dynamics]. PMID- 3682906 TI - [Questions and answers on clinical training. Discrepancies in the teaching contents pointed out by students: the importance of discoveries by students]. PMID- 3682907 TI - [Questions and answers on clinical training. Extreme emotional responses by nursing students facing death of patients: meaning of self control and emotional stability]. PMID- 3682908 TI - [Current problems concerning prevention of hospital infection]. PMID- 3682909 TI - [Prevention of hospital infection: several problems concerning disinfection using gases]. PMID- 3682910 TI - [Prevention of hospital infection: the use of disinfectants]. PMID- 3682911 TI - [Prevention of hospital infection: improvement in nursing technics and hospital environment]. PMID- 3682912 TI - [Prevention of hospital infection: prevention of infection by blood-borne viruses]. PMID- 3682913 TI - [Prevention of hospital infection: the compromised host and drug-resistant bacteria]. PMID- 3682914 TI - [Prevention of hospital infection: factors in the development of hospital infections and their control]. PMID- 3682915 TI - [Prevention of hospital infection: duties of hospital personnel in the preventive measures]. PMID- 3682916 TI - [Prevention of hospital infection. Systems of training of nursing personnel in prevention]. PMID- 3682918 TI - [Collection of information and assessment of patients with chronic rheumatoid arthritis]. PMID- 3682917 TI - [Physiopathology, diagnosis, and treatment of chronic rheumatoid arthritis]. PMID- 3682919 TI - [Nursing plan for a patient with chronic rheumatoid arthritis]. PMID- 3682920 TI - [Nursing of a patient with chronic rheumatoid arthritis following implantation of a prosthetic hip joint]. PMID- 3682922 TI - [Rehabilitation of a patient with subarachnoid hemorrhage based on daily activities]. PMID- 3682921 TI - [Liaison between nursing shifts for continuous nursing care: a study by nursing students]. PMID- 3682924 TI - [Test yourself: nursing of patients with cerebral and nervous system diseases]. PMID- 3682923 TI - [Nursing of a patient in the terminal stage of cancer]. PMID- 3682925 TI - [Errors in your nursing practice: cleansing of the patient on the first postoperative day]. PMID- 3682926 TI - [Errors in your nursing practice: meal time assistance of a hemiplegic patient]. PMID- 3682927 TI - [Introduction to medical electronic equipment. 2. Resuscitators]. PMID- 3682928 TI - [Expanding possibilities in the nursing profession]. PMID- 3682929 TI - [Regional health education by nurses]. PMID- 3682930 TI - [A role of nurses in international exchange: a nurse working in Peru]. PMID- 3682931 TI - [A nurse acting as a housemaster to institutionalized delinquent boys]. PMID- 3682932 TI - [An experience as a nurse assigned to a ship on a European route]. PMID- 3682933 TI - [A nurse active in organizing regional health care networks]. PMID- 3682934 TI - [A nurse assigned to a health service at a department store]. PMID- 3682935 TI - [Induced abortion]. PMID- 3682936 TI - [Patients facing death. 6. Peace after expression of anger by the patient]. PMID- 3682937 TI - Structural and functional properties of initial lymphatics in the rat tongue: scanning electron microscopic findings. AB - The luminal and outer wall morphology of the initial lymphatics in the rat tongue were demonstrated using scanning electron microscopy (SEM) after tissue perfusion with pressures up to 300 torr, topical heat and histamine administration. The findings emphasize the structural and functional importance of the reticular fiber network of the basement lamina (in contradistinction to single "anchoring filaments") as a supportive framework for lymphatic endothelium and a major regulatory role in tissue volume control. Increased tissue pressure was associated with dilatation of initial lymphatics which was maximal at approximately 60 torr. Higher pressures (up to 300 torr) did not damage the vessels. This vasodilatory response of the initial lymphatics was even more evident when tissue swelling was hindered by externally applied plaster "bandage". Under SEM, protruding and branched cells were conspicuous in otherwise flat lymphatic endothelium. These cells may have contractile properties and with pronounced dilatation, thermal injury and application of histamine these cells probably contract, thereby creating large gaps at the site of open junctions. PMID- 3682938 TI - Lymph drainage originating from the lower esophagus and gastric cardia as measured by radioisotope uptake in the regional lymph nodes following lymphoscintigraphy. AB - Lymph drainage originating from the lower esophagus and gastric cardia was determined using uptake of radioisotope (RI) in the regional lymph nodes in 19 patients with primary cancer at these sites. On the day prior to operation, 99m Tc colloid solution was injected submucosally in the distal esophagus or gastric cardia during endoscopy. The regional lymph nodes were removed at operation and RI uptake of individual nodes was measured in a well-type scintillation counter. Uptake was expressed as the amount per nodal weight. After radioactive colloid was injected into the lower esophagus, high RI uptake was common in both the mid mediastinal and abdominal nodes, suggesting that lymph originating from the lower esophagus drains in both a superior and inferior direction. On the other hand, after radioactive colloid was injected into the gastric cardia, high RI uptake was never demonstrated in mediastinal lymph nodes suggesting that direct mediastinal lymph flow from the gastric cardia is rare. These results support clinical observations on the distribution of lymph nodal metastases in patients with lower esophageal and gastric cardia malignancies. As a diagnostic tool for lymph nodal metastases, however, lymphoscintigraphy is unreliable. PMID- 3682939 TI - Contractile response in isolated human groin lymphatics. AB - Lymphatics from the human superficial groin removed at operation in 21 patients (one with lymphedema) were examined in vitro. Histochemically no nerves were identified with either specific catecholamine fluorescence or immunoreactivity to tyrosine hydroxylase or dopamine beta-hydroxylase. Ring preparations of the lymphatics were mounted in tissue baths and isometric induced contractions were recorded after administration of K+ (124 mM), acetylcholine, selected amines and prostanoids. Noradrenaline (NA), adrenaline, dopamine, and acetylcholine had no or only weak contractile effects. In some segments, serotonin induced contractions. Prostaglandin E2 showed no contractile effect and prostaglandin F2 alpha induced contraction in most of the tested lymphatics. The prostaglandin endoperoxide analogue U44069 uniformly elicited marked concentration-dependent contraction. In the lymphatic segment from the patient with lymphedema, a slightly greater contractile response to NA and serotonin was observed. The results overall suggest an absence of sympathetic innervation and contraction mediating alpha adrenergic receptors in human superficial groin lymphatics, and support that certain prostanoids may be important regulators of human lymphatic contractility. PMID- 3682940 TI - Reliability of diagnostic imaging after orchiectomy alone in follow-up of clinical stage I testicular carcinoma: excessive cost with potential risk. AB - From 1981 to 1984, 86 consecutive patients with previously untreated nonseminomatous testicular carcinoma were classified as clinical radiological stage I and treated with orchiectomy alone. The follow-up program included chest x-ray and lymphangiography (LAG) every month and abdominal computed tomography (CT) bimonthly. All patients were followed for 15 to 63 months after orchiectomy (median 32 mo.). Metastases developed in 23 patients (26.7%) and in 13/23 there was retroperitoneal lymphadenopathy. Time of relapse after orchiectomy ranged from 2 to 36 months (median 7 mo.) with a shorter interval for chest (4 mo.) compared with retroperitoneal metastases (7 mo.). Lung metastases were readily identified at an early stage (less than 2 cm) whereas more than one-third of retroperitoneal nodal metastases were greater than 5 cm at time of diagnosis. LAG detected metastases in 8/11 patients (72.7%), abdominal CT in 8/10 (80%), and both together (LAG and CT) 7/8 (87.5%). In clinical stage I nonseminomatous testicular carcinoma, the high incidence of concomitant but often asymptomatic regional and distant metastases and the relatively high cost and inconvenience of follow-up using abdominal CT imaging, LAG and chest x-ray suggest that orchiectomy is best combined with retroperitoneal node dissection at time of initial presentation to insure more accurate and safe staging of tumor dissemination. PMID- 3682941 TI - Prolonged disease-free survival in refractory acute nonlymphocytic leukemia using mitoxantrone. PMID- 3682942 TI - Molecular biology--basic aspects. PMID- 3682943 TI - Malignant neoplasms at the Universiti Kebangsaan Malaysia 1980-1984. PMID- 3682944 TI - Childhood neuroblastoma in the University Hospital, Kuala Lumpur: a study into features of prognostic value. PMID- 3682945 TI - Kimura's disease. PMID- 3682946 TI - The osmotic fragility of red cells in hereditary stomatocytic elliptocytosis. PMID- 3682947 TI - The meaning for mothers of a new infant: relationship to maternal experience. AB - The meaning for mothers of having an infant was explored during the first 3 months using Lewin's life space concept in terms of four aspects: (a) encountered change, (b) desired change, (c) difficult things, and (d) satisfying things. The influence of parental experience (time since the infant's birth and parity of the mother) on these aspects was examined. The 83 mothers of healthy newborns responded to the open-ended items of a questionnaire at approximately 7, 30, and 90 days. Themes or categories of responses were grouped into topical classes for analysis. Initially desired change concerned both reality-bound circumstances and maternal qualities, but later primarily the former. Although some infant care tasks were difficult things and others satisfying, the infant's growth, development, and interaction were clearly satisfying. The effects of both time and parity varied with the aspect and class of meaning assessed. Meaning for primiparous mothers may have more to do with sense of self than it does for multiparous mothers. Other factors that may influence meaning, including social economic status, should be examined. PMID- 3682948 TI - Fathers' motives for birth attendance. AB - Thirty-seven couples expecting their first child served as subjects in an open ended interview and questionnaire study concerning fathers' motives for birth attendance. Both interview and questionnaire data confirm the fact that motives, beliefs, and expectations concerning paternal participation in labor and delivery are widely distributed across a variety of social contexts. Results indicate that fathers have multiple motives for and expectations about birth attendance. Implications for childbirth educators, health care providers, and parent support leaders are discussed. PMID- 3682949 TI - Infant temperament and the quality of the childrearing environment. AB - The purpose of this study was to determine the relationship between infant temperament and the quality of the childrearing environment by examining (a) maternal ratings of infant's behavior utilizing questionnaire category scores, (b) maternal impressions of infant's behavior, (c) the relationship of maternal ratings of infant's behavior to the quality of the childrearing environment, and (d) the relationship of maternal impressions of infant's behavior to the quality of the childrearing environment. Mothers of 20 normal, full-term infants with a mean age of 5.2 months were involved in the study. During a home visit, the Revised Infant Temperament Questionnaire (RITQ) and the Home Observational Measurement Evaluation Inventory (HOME) were completed. Pearson Product Moment Correlation, chi-square, and Z tests were used to analyze the data. The findings of the study suggested no significant difference in the quality of the childrearing environment with difficult or easy temperament infants as measured by the questionnaire category scores. There was a significant positive relationship between infants perceived as "easier-than-average" on the maternal impression responses and maternal organization and stimulation as measured by the HOME. PMID- 3682950 TI - Effects of education on breastfeeding success. AB - This study investigated effects of a prenatal breastfeeding education program on the success of breastfeeding among low-income pregnant women. The sample population was comprised of 64 subjects who delivered at a university hospital in the Midwest. A pretest and posttest were used to measure breastfeeding knowledge in the treatment group. Six weeks following delivery the subjects completed the Telephone Interview Survey (TIS) to determine their method of infant feeding and their perception of success at breastfeeding. Subjects in the treatment group were more knowledgeable about breastfeeding after instruction. However, there was no difference in breastfeeding duration and perception of success between subjects in the treatment and control groups. PMID- 3682951 TI - Approaches of health caregivers to young children in a pediatric intensive care unit. AB - This study explored the frequency of health caregiver approaches to 12 toddlers and preschool children in a pediatric intensive care unit. Using a time-sampling methodology, 3 hours of observation per child were obtained; half occurred between 7 A.M. and 7 P.M. and half were between 7 P.M. and 7 A.M.. Data were analyzed using descriptive statistics. Caregiver approaches involved either direct or indirect contact. Indirect contacts occurred three times more frequently than direct, with registered nurses initiating more contacts than any other caregivers. The greatest number of direct contacts were categorized as intrusive, while the least number were comforting contacts. The findings suggest that nurses are in optimal positions to promote rest and comforting contact for children in the pediatric intensive care unit. PMID- 3682952 TI - The association of stroke and coronary heart disease: a population study. AB - In a 20-year population-based study (1960 through 1979), we estimated the cumulative probability of (1) the occurrence of stroke after a diagnosis of angina pectoris, (2) the occurrence of stroke after a diagnosis of myocardial infarction, and (3) the occurrence of myocardial infarction or sudden unexpected death after a diagnosis of cerebral infarction. In patients in whom angina had been diagnosed, no significant difference was noted between the observed and the expected probability of stroke throughout 10 years of follow-up. In patients with a diagnosis of myocardial infarction, a significant difference was noted between observed and expected probabilities of stroke at 1 month and at 2 months. This early excess in probability of stroke was especially pronounced in the subgroup of patients with transmural myocardial infarction but not evident in those with subendocardial myocardial infarction. Among patients with a diagnosis of cerebral infarction, the difference between observed and expected probabilities of myocardial infarction or sudden unexpected death was not significant until 5 years after the cerebral infarction and showed no change thereafter. PMID- 3682953 TI - The effects of intraoperative blood salvage and induced hypotension on transfusion requirements during spinal surgical procedures. AB - Spinal surgical procedures, such as placement of Harrington rods for correction of scoliosis, are associated with considerable perioperative blood loss and, hence, with the risks associated with homologous blood transfusions. To test the hypothesis that intraoperative autologous blood transfusions could decrease the amount of homologous blood needed in such operations, we conducted a two-part study: (1) a retrospective review of 142 patients in whom blood salvage was not used and (2) a prospective review of 28 patients who received autologous transfusions. Intraoperative autologous transfusion reduced the amount of homologous blood required by more than 50% (5.1 versus 2.0 units; P less than 0.001). The total amount of homologous blood required during the hospital stay was also significantly reduced by intraoperative autologous transfusion (6.0 versus 3.4 units; P less than 0.001). Induced hypotension in 81 of the 142 patients who did not receive autologous transfusions did not decrease the homologous blood transfusion requirements from those needed by the normotensive patients. We conclude that intraoperative autologous transfusion significantly reduces the need for homologous blood products in patients who undergo spinal surgical procedures. Induced hypotension, which did not affect transfusion requirements in our study, should be further evaluated in a blinded, prospective study. PMID- 3682954 TI - Autosomal dominant familial Mediterranean fever-like syndrome with amyloidosis. AB - We report a pedigree in which a syndrome that resembled familial Mediterranean fever occurred in four family members over three successive generations. All four patients had systemic amyloidosis. Typically, patients with familial Mediterranean fever show an autosomal recessive inheritance pattern. The disorder commonly afflicts Sephardic Jews, Arabs, and persons of Turkish descent. Colchicine therapy dramatically reduces the attack rate of serositis. The family described herein is unique because of their European ethnicity and the autosomal dominant inheritance pattern. Unlike typical familial Mediterranean fever, colchicine had no influence on the attacks and did not prevent amyloidosis in the three patients who received this treatment. PMID- 3682955 TI - Heparin therapy for recent transient focal cerebral ischemia. AB - The Mayo Clinic medical records and records linkage system were used to identify stroke-free residents of Rochester, Minnesota, who were examined within 30 days after the first transient cerebral ischemic attack (TIA) during the period 1955 through 1979. The patients were divided into two groups: those given heparin within 30 days after the first attack and those not given heparin. Death, stroke, and either stroke or TIA were separate endpoints in Kaplan-Meier analyses of data from the day of initial examination through the 30th day thereafter. The probabilities of survival, survival free from stroke, and survival free from TIA for the heparin-treated group were not significantly different from those probabilities for the comparison group. The rate of hemorrhagic complications was 3.2 per 100 person-days of heparin therapy. Retroperitoneal hemorrhage, the most serious complication, was the cause of one death and one case of femoral neuropathy. PMID- 3682956 TI - Antifungal agents used for deep-seated mycotic infections. AB - The main antifungal agents used for deep-seated mycotic infections are the broad spectrum antifungal drug amphotericin B, the narrow-spectrum agent flucytosine, and the newer broad-spectrum agents ketoconazole, miconazole, and itraconazole. Amphotericin B remains the cornerstone of antifungal therapy. For the treatment of cryptococcal meningitis, the current recommendation is for the combined use of amphotericin B and flucytosine. Published clinical experience with the newer agents is limited. Not all patients from whom fungal agents have been isolated require treatment; the extent of the fungal infection should be determined, when possible, for evaluation of the need for treatment. PMID- 3682957 TI - Antituberculous agents. AB - Antituberculous agents have radically improved the prognosis of patients with active tuberculosis. Generally, 6-month and 9-month regimens have been successful, and surgical therapy is rarely necessary. Extrapulmonary tuberculosis should be managed with the drug regimens outlined for pulmonary tuberculosis. The major cause of therapeutic failure is poor compliance of the patient in taking the medication regularly. The second major cause of treatment failure is resistance of tubercle bacilli to the antimicrobial agents used. When treatment failure is apparent, careful reassessment by physicians experienced in the treatment of tuberculosis is indicated. A single drug should never be added to a failing regimen. For prophylaxis, isoniazid, given for 6 to 12 months, is effective in most cases. PMID- 3682958 TI - Prophylactic use of antimicrobial agents in adult patients. AB - Prophylactic antimicrobial agents are recommended for prevention of a variety of conditions, including tuberculosis, endocarditis, rheumatic fever, recurrent cellulitis and lymphangitis in patients with lymphedema, meningococcal meningitis, bite wounds, and herpes virus infections. In addition, prophylactic antimicrobial agents have proved effective in certain surgical procedures such as a variety of abdominal operations, hysterectomy, and head and neck operations for cancer. Except for oral bowel preparations, administration of antimicrobial agents for prophylaxis should be limited, in general, to the perioperative time period. Doses given more than an hour before or 3 hours after a surgical procedure have not been shown to increase effectiveness, and such an approach increases the cost and the probability of toxicity and superinfection. Investigation of antimicrobial prophylaxis necessitates adequate evaluation of potential advantages and disadvantages in prospective double-blind fashion. PMID- 3682959 TI - Antimicrobial agents in adult patients with renal insufficiency: initial dosage and general recommendations. AB - The dosage or the time interval of administration (or both) of many antimicrobial agents must be adjusted in anephric patients or those with compromised renal function. Antimicrobial agents that must have adjustment of dosages include most, but not all, of the penicillins and cephalosporins, the aminoglycosides, vancomycin, and trimethoprim-sulfamethoxazole. The maximal doses of these agents generally should be decreased in proportion with the extent of reduction in renal function. The dosage of chloramphenicol, clindamycin, rifampin, nafcillin, and ceftriaxone probably need not be adjusted if hepatic function is essentially normal. The suggested doses are relatively crude guidelines to initial antimicrobial therapy. Serum antimicrobial assays are frequently indicated for accurate adjustment of the dosage, especially with the amino-glycosides. The efficacy of therapy and the possible occurrence of toxicity should be monitored in all patients but particularly in those with renal insufficiency. Recommendations for patients undergoing peritoneal dialysis are not included in this article. PMID- 3682961 TI - Heart-brain interactions: neurocardiology or cardioneurology comes of age. PMID- 3682960 TI - Ovarian dysgerminoma: a retrospective analysis of results of treatment, sites of treatment failure, and radiosensitivity. AB - Thirty-five patients with a diagnosis of pure ovarian dysgerminoma underwent assessment at our institution between 1950 and 1984. The median age of these patients was 21 years (range, 8 to 41 years). The surgical pathologic stages of the tumors were as follows: stage IA1 in 18 patients, stage IA2 in 2, stage IB1 in 2, stage IC in 1, stage IIB in 2, stage III in 9, and stage IV in 1. The overall survival at 5, 10, and 20 years was 94.3%, 82.9%, and 82.9%, respectively, for all 35 patients and 100%, 83.9%, and 83.9%, respectively, for the 18 patients with stage IA1 lesions. The maximum interval from diagnosis to relapse was 3.7 years. All patients were under surveillance for a minimum of 2 years (median follow-up, 15.9 years). Of the 18 patients with stage IA1 disease, 16 did not receive prophylactic radiation therapy to the para-aortic lymph nodes, and in 6 of the 16 (38%) recurrent disease developed in this region. Five of these patients were salvaged with radiation therapy and one with radiation therapy and subsequent chemotherapy. No definite correlation was noted between the size or mass of the resected unilateral encapsulated tumor and the risk of development of recurrent disease. For patients with stage IA1 dysgerminoma who have undergone unilateral oophorectomy, two treatment options seem reasonable: (1) observation, with radiation therapy reserved for subsequent recurrence, or (2) prophylactic radiation therapy (2,000 cGy) to para-aortic and ipsilateral common iliac lymph nodes, which would preserve fertility. PMID- 3682962 TI - Retinoids in dermatology. PMID- 3682963 TI - [Fine-needle puncture-aspiration of solitary thyroid nodules. Evaluation over a 5 year period]. PMID- 3682964 TI - [Functional hyperprolactinemia: pituitary function and natural course]. PMID- 3682965 TI - [Metoclopramide plus diphenhydramine compared with chlorpromazine in cisplatin induced vomiting. Randomized, crossed and double-blind study]. PMID- 3682966 TI - [The physician and the certification of cause of death]. PMID- 3682967 TI - [Recurrent herpes simplex encephalitis and acyclovir]. PMID- 3682968 TI - [Esophageal candidiasis: criteria for acquired immunodeficiency syndrome]. PMID- 3682969 TI - [Methodological problems in work evaluating the ingestion of sodium using reactive strips]. PMID- 3682970 TI - [Carpal tunnel syndrome]. PMID- 3682971 TI - [Treatment of thrombotic thrombocytopenic purpura]. PMID- 3682972 TI - [Antibiotherapy or antibioticotherapy?]. PMID- 3682973 TI - [Myositis and granulomatous lymphadenitis of probable tuberculous origin]. PMID- 3682974 TI - [Prevalence of serum markers of hepatitis B virus in homosexual males. Risk factors]. PMID- 3682975 TI - [Control of hypertension in a rural environment: 18-month follow-up (the CRONICAT program)]. PMID- 3682976 TI - [Estrogen and progesterone receptors in cancer of the breast]. PMID- 3682977 TI - [Influence of altitude on arterial pressure. Analysis of changes in arterial pressure at different altitudes during a walk (trekking) in the Himalayas]. PMID- 3682978 TI - [Hepatitis B and male homosexuality]. PMID- 3682979 TI - [Effects of pituitary apoplexy and its treatment on the hormonal picture. Apropos of 5 cases]. PMID- 3682980 TI - [Abdominal computerized axial tomography compared with gallium-67 isotopic scanning in the staging of lymphomas]. PMID- 3682982 TI - [Chronic disorders in a small rural community]. PMID- 3682981 TI - [Prevalence of human immunodeficiency virus infection in risk groups. Our experience]. PMID- 3682983 TI - [Is tuberculosis a complication of methylprednisolone pulses?]. PMID- 3682984 TI - [Treatment of cysticercosis with praziquantel]. PMID- 3682985 TI - [Intense symptomatic bradycardia caused by sinoauricular block: severe adverse reaction caused by propafenone]. PMID- 3682986 TI - [Histocompatibility antigens and primary hemochromatosis]. PMID- 3682987 TI - [Cancer and acromegaly]. PMID- 3682988 TI - [Treatment of renal colic with intramuscular diclofenac sodium. Evaluation of a regimen]. PMID- 3682989 TI - [Legionella pneumophila pneumonia. Clinical characteristics of 52 cases]. PMID- 3682990 TI - [Epididymitis as a complication of non-gonococcal urethritis]. PMID- 3682991 TI - [Influence of diet and intensive physical exercise on plasma concentrations of different lipoprotein fractions isolated using ultracentrifugation]. PMID- 3682992 TI - [Esophageal motor disorder in patients with primary biliary cirrhosis. A prospective study]. PMID- 3682993 TI - [Non-Hodgkin's lymphoma of the tonsils. Apropos of 8 cases]. PMID- 3682994 TI - [Paradox around the treatment of idiopathic thrombocytopenic purpura with danazol]. PMID- 3682995 TI - [Auto-exclusion of blood donors in relation to human immunodeficiency virus infection: a problem not yet resolved]. PMID- 3682996 TI - [Efficiency of tests for the detection of human immunodeficiency antiviral antibodies]. PMID- 3682997 TI - [Antiphospholipid antibodies as markers of systemic lupus erythematosus]. PMID- 3682998 TI - [Pseudothrombophlebitis and Baker's popliteal cyst]. PMID- 3682999 TI - [Leukocytoclastic vasculitis as the first manifestation of immunoblastic sarcoma]. PMID- 3683000 TI - [Primary hyperthyroidism caused by supernumerary and hyperfunctioning mediastinal parathyroid gland]. PMID- 3683001 TI - [Reversible exogenous psychosis during oral treatment with mexiletine]. PMID- 3683002 TI - [Remote development of transient ischemic attack, reversible ischemic neurologic deficit and infarct with minimum residual damage. Prospective study of 149 patients treated medically]. PMID- 3683003 TI - [Validity of the primary diagnosis at discharge from the hospital]. PMID- 3683004 TI - [Knowledge and beliefs in relation to diseases preventable by vaccination and their prevention. Study in the community of Elche (Alicante)]. PMID- 3683006 TI - [Histopathology of erythema nodosum]. PMID- 3683005 TI - [Disseminated gonococcal infection in patients over 5 years of age]. PMID- 3683007 TI - [Fraudulent publications]. PMID- 3683008 TI - [Carcinoid of the thymus: presentation of a case]. PMID- 3683009 TI - [Erythema nudosa or erythema "nodosa"?]. PMID- 3683010 TI - Building a relational database for a physician document index. AB - We show how three existing medical knowledge bases: Medical Subject Headings (MeSH), Standardized Nomenclature of Medicine (SNOMED) and Current Medical Information and Technology (CMIT) are mapped into a relational data model and stored on an Apollo workstation and an Intelligent Database Machine. Since two of these knowledge bases have been used in the indexing of medical literature and patient records, they can be useful not only as direct views on the organization of medical concepts but also as tools for the retrieval of documents. In order that the concepts from one knowledge base can be connected to those of the other knowledge base, a method has been developed for the semi-automatic merging of MeSH, SNOMED and CMIT. This method takes advantage of the relational model and the synonyms that are given in SNOMED and CMIT, in order to recommend concepts to be merged. An expert interacts with the system to accept or reject the recommendations of the computer. The method would apply equally well to other knowledge bases and is particularly well-suited for knowledge bases that contain tens of thousands of concepts. PMID- 3683011 TI - A specialized hospital information system. AB - Modern information technology offers new opportunities for the storage and manipulation of hospital information. A computer-based hospital information system dedicated to urology and nephrology was designed and developed in our centre. It involves in principle, the employment of a program that allows the analysis of non-restricted non-codified texts, for the retrieval and processing of clinical data, and operation by non-computer specialized hospital staff. This Hospital Information System now plays a vital role for the provision of an efficient, good quality service and is used now in daily routine and research work in this hospital. This paper describes this specialized hospital information system. PMID- 3683012 TI - A computer system applying the face method to represent multiphasic tests. AB - The results of medical examinations have recently become multiphasic with few exceptions, and various graphical methods exist to represent the results concisely. One of these graphical methods is reported here, utilizing a computer system for applying the so-called 'face method'. This displays the condition of an individual's health by erythrocyte count, leucocyte count, haemoglobin, erythrocyte sedimentation rate, systolic blood pressure and diastolic blood pressure, all the information being accessible via a database system. Only keywords are necessary to display faces representing the health condition. Graphical methods are useful for providing data features because they appeal to the eye. The face method is more practical than other graphical methods in that its features give easily recognizable indications. The face method can be utilized in various ways, for example in differential diagnosis of anaemia, and to comprehend time-based changes in an individual's health condition based on multiphasic tests. PMID- 3683013 TI - A beat-to-beat calculator for the diastolic pressure time index and the tension time index. AB - We have developed a beat-to-beat calculator which can calculate in real-time the ratio of the diastolic pressure time index (DPTI), and the tension time index (TTI) as an index of the myocardial oxygen supply/demand balance. Physicians set up presumed value for the left ventricular endodiastolic pressure, a search area for the dicrotic notch, a threshold for the onset of the up-slope and the corresponding value of the calibration signal on the digital switches of the calculator. Next, the arterial pressure analog signal is input into the calculator. The calculator searches automatically for both the onset of the up slope and the dicrotic notch. The arterial pressure curve is displayed beat-to beat with the recognized onset and the dicrotic notch on the CRT to be confirmed by physicians. When physicians do not agree with the automatic recognition they can fit the automatic recognition to the observation. If the recognition of the onset is inadequate, the threshold can be re-adjusted to trigger the onset. If recognition of the dicrotic notch is inadequate, the physician can adjust the search-area. Therefore, physicians who operate the calculator can rely on the calculated DPTI/TTI. This calculator can continuously monitor the myocardial oxygen supply/demand balance in patients with acute myocardial infarction or just after open-heart surgery. PMID- 3683014 TI - A comparative study of usefulness of quantitative parameters in the description of cardiotocogram records. AB - This study was an attempt to choose the optimized set of the features obtained from cardiotocogram records, which could explain in the best way the variability of foetal acid-base status parameters at labour. We prepared a package of the procedures in FORTRAN language which provides the possibilities for automatic detection and recognition of the long-term variability such as accelerations and decelerations and assessing some parameters connected with short-term variability (among other things oscillation bandwidth and number of baseline crossings). The acquired variables were subjected to multivariate statistical analysis to estimate the predictive power of a particular parameter. We used the described method to predict the variation of the foetal scalp blood pH and base deficit. This let us construct a set of variables which explains the maximal part of the variability of gasometric parameters. It affords possibilities for the estimation of the relative power of a particular component calculated from the cardiotocogram pattern. We obtain 41.7% of the explained variance for pH and 38.3% for base deficit. PMID- 3683015 TI - Antiulcerogenic activity of zinc acexamate in different experimental models. AB - The antiulcerogenic activity of zinc acexamate (ZAC; Laboratorios Vinas, S.A.) has been tested in several models of gastric injury induced by acid hypersecretion, prostaglandin blockade and disruption of the gastric barrier. Lowest doses which have demonstrated to significantly prevent gastric damage ranged from 10 to 100 mg/kg depending on the experimental model used. The benefit obtained with this compound was always dose-dependent. These findings would support the hypothesis that ZAC acts by a complex inhibition of several of the mechanisms involved in the development of peptic diseases. PMID- 3683016 TI - Suc-Tyr(SE)-Met-Gly-Trp-Met-Asp-beta-phenethylamide(410): a competitive antagonist of cholecystokinin-induced contractions in smooth muscles in vitro. AB - Suc-Tyr(SE)-Met-Gly-Trp-Met-Asp-beta-phenethylamide(410) has been studied for its ability to antagonize contractile responses of guinea pig gall bladder, ileum and stomach muscle strips to desamino-cholecystokinin-octapeptide (CCK-7) and cholecystokinin octapeptide (CCK-8). Both CCK-7 and CCK-8 at concentrations of 10(-11)M to 10(-7)M produced dose-dependent tonic contractions in all muscle strips. Suc-Tyr(SE)-Met-Gly-Trp-Met-Asp-beta-phenethylamide (10(-8)M-10(-5)M) inhibited reversibly in a dose-dependent manner the contractile responses to CCK 7 and CCK-8. At the same concentrations the antagonist shifted to the right in parallel to the dose-response curves for CCK-7 and CCK-8 without decreasing their maximum response. Analysis of the data after Schild gave pA2 values (410 potency as antagonist) of CCK-7 in gall bladder, ileum and stomach of 8.36; 8.0 and 7.56, respectively, and pA2 values of CCK-8 of 7.64; 8.94 and 8.52, respectively. The slope of the Schild plots for both CCKs did not differ significantly from the unity, which suggests that 410 is a competitive antagonist. The antagonistic action of 410 is reversible and appeared to be specific since at concentrations of 5 X 10(-6), it had no effect on contractile responses of the gall bladder, ileum and gastric muscle strips to acetylcholine or histamine. PMID- 3683017 TI - Protein binding characterization of a novel antiestrogen (Analog II) in the rat. AB - The present study examined the protein binding of a novel antiestrogen, Analog II, in rat serum and amniotic fluid. Binding experiments were conducted both in vitro and in vivo using a tritiated derivative of Analog II to measure total protein binding. Free and bound drugs were separated using the dextran-coated charcoal method. It was determined that 80-90% of Analog II in the circulation is bound to plasma protein in both mature and immature rats. The in vitro study indicated that the binding of Analog II to protein is nonspecific except in amniotic fluid and serum from 10-day old rats, where Analog II binding could be partially reversed by the addition of tamoxifen. The results suggest that Analog II binds to a specific triphenylethylene-associated binding site on neonatal rat serum and amniotic protein. PMID- 3683018 TI - The value of comparative bioavailability studies of marketed drugs in drug control. An example with erythromycin stearate. AB - As a part of the quality control of drugs The National Medicine Control Laboratory in Finland has started comparative bioavailability studies of synonym preparations in human volunteers by taking all the products containing the same active ingredients for absorption studies at the same time. The first study, which is presented as an example of the importance of these studies, covered three erythromycin stearate preparations containing 250 mg of erythromycin. 12 volunteers took 2 tablets of every product at one week intervals in a cross-over fashion, and the serum erythromycin levels were measured microbiologically for 12 hr. Disintegration and dissolution tests were also performed. One of the products was coated with an acid-resistant film and was not dissolved in pH 1.2, whereas the conventional tablets lost all antimicrobial activity after 15 min in pH 1.2. In phosphate buffer, pH 6.6, all the tablets dissolved rapidly and retained antimicrobial activity. One of the conventional tablets showed only a 50% bioavailability as compared to the two others and was subsequently withdrawn from the market. Thus, it is important to conduct comparative post-marketing bioavailability studies with drugs which earlier have shown good bioavailability. PMID- 3683019 TI - Aspects of bioavailability and bioequivalence revision: possible implications on clinical pharmacology. PMID- 3683020 TI - Aspects for bioavailability and bioequivalence revision: possible implications on clinical pharmacology. PMID- 3683021 TI - Gastric irritation of oxaprozin, a new nonsteroidal, antiinflammatory drug, in comparison to acetylsalicylic acid and indomethacin: a gastric potential difference analysis. AB - For the evaluation of gastric irritation of oxaprozin in comparison to indomethacin and acetylsalicylic acid, a study was carried out with eight healthy male volunteers, investigating doses of 600 and 1200 mg of oxaprozin compared to therapeutical equivalents of 50 mg indomethacin and 1000 mg acetylsalicylic acid. Gastric irritation was checked with the model of the transmural gastric potential difference. The model is based on the assumption that a change in electric tension caused by a lesion of the gastric mucosa, which leads to an increasing permeability of the cell membrane for electrolytes, is a sensitive parameter for cell disintegrity. The results of the study show that oxaprozin has less irritative potency than indomethacin and can thus be qualified as an antiinflammatory drug with a minimum of gastric irritation. PMID- 3683022 TI - [A special mobile unit system in Gothenburg: early treatment outside the hospital in acute myocardial infarction or heart arrest]. PMID- 3683023 TI - [Parotid tumors in Jamtland county 1972-1981: Surgical therapy and follow-up of benign tumors]. PMID- 3683024 TI - [Neck masses in children--presentation of 3 years' material and a suggestion on management]. PMID- 3683025 TI - [Surgical laser treatment--types of laser, tissue interaction and technical aspects]. PMID- 3683026 TI - [Herpes simplex encephalitis--a therapeutic failure with acyclovir?]. PMID- 3683027 TI - [Extended brachial plexus injury after traumatic shoulder joint dislocation]. PMID- 3683028 TI - [Castration as a better alternative to estrogen in the treatment of prostatic cancer]. PMID- 3683029 TI - [Acute urinary retention in herpes genitalis infection]. PMID- 3683030 TI - [Pelvic bone cysts and normocalcemia in severe hyperparathyroidism]. PMID- 3683031 TI - [Foot gangrene--septicemia and ergotamine synergism]. PMID- 3683032 TI - Causes of the nursing shortage in NSW: a framework for discussion. PMID- 3683033 TI - The Babington Roster: rostering 10 hour shifts--one unit's experience. PMID- 3683034 TI - [Effect of endoscopic hydrothermo- and laser coagulation on the human stomach wall in vivo]. AB - Effect of thermic and laser energy applied onto human in vivo gastric wall has not yet been reported in literature. In our study we evaluated the maximum amount of energy not harming the patient as well as principles for secure and sufficient therapy. In 8 patients hospitalized for gastric resection we applied vaporization by laser- and hydrothermosounds in this part of the stomach which should be resected. Endoscopic pictures were taken. We used a NdYAG laser (maximum performance 70 W, time of application 1-3 s) and hydrothermosounds (maximum performance 170 W, time of application 1-3 s). The stomach was resected 3-8 days following application. Comparing laser- and hydrothermosounds marks we observed a bigger area of necrosis at hydrothermosounds marks using the same amount of energy. In histological investigation correlation between depth and diameter of necrosis was found. After the same application time both depth and diameter of necrosis were bigger by hydrothermosounds than by laser. Lesions reached serosa at the maximum time of application of 3 s. Serosal lesion itself did not appear. Endoscopic treatment of tissue lesion by laser and thermic irradiation (vaporization of bleeding polyp pedicles, treatment of tumors) is secure using the maximum energy mentioned above. Serosal lesion did not appear. Bleeding lesions must be treated by higher energy because of absorption of energy by escaped blood. PMID- 3683035 TI - [The ligament system of the spleen and its significance for surgical interventions]. AB - The anatomy of the splenic ligaments was examined in twenty cadavars. Histologic sections were taken from ten. In one of these twenty cases the entire ligamentous structure was studied by serial sections using a polarizing light microscope. There are four principal ligaments of the spleen: the gastrosplenic ligament, the colicosplenic ligament, the phrenocolic ligament and the phrenosplenic (splenorenal) ligament. There are two portions to the gastrosplenic ligament. In the upper portion where the spleen is very close to the stomach, the collagen fibers appear more dense. The term splenorenal ligament is vague. This is because there are three structures between the spleen and the kidney besides the peritoneal layer: collagenous tissue with fat (pararenal fat), the prerenal fascia and a fat capsule (perirenal fat). The vascular anatomy is of interest. Running through the gastrosplenic ligament are small branches from the short gastric and left gastroomental vessels. The colicosplenic ligament receives little branches from the left gastroomentalic vessels and the lower pole vessels. The other ligaments have mainly venous vascularisation which can develop into a collateral network within splenomegaly. The direction of the collagen fibers in the splenic ligaments is important. In all the ligaments most of the fibers come from two directions: laterocranial to mediocaudal and mediocranial to laterocaudal. Splenic capsular tears are a recognized complication of upper abdominal surgery. This is because traction in the mediocaudal direction during gastric and colon surgery and in the mediocranial direction during gastric surgery is oriented in the same direction as the collagen fibers in the splenic ligaments and thus tears the splenic capsule. PMID- 3683036 TI - [Surgical therapeutic concept of immune thyropathy]. AB - 73 patients with Graves' disease, surgically treated from 1975-1986, were investigated retrospectively. 43 patients, treated by subtotal thyroidectomy (Enderlen-Hotz) and a bilateral thyroid remnant of a total of about 8-12 g, were compared with 30 patients, treated by a modified subtotal thyroidectomy leaving a unilateral thyroid remnant of about 4-8 g, with respect to preoperative duration of disease, indications for surgical treatment, weight of resected specimens, operative complications and postoperative thyroid function. Surgical complications were similar in both groups. After subtotal thyroidectomy 14/43 patients (33%) displayed either recurrent hyperthyroidism (9/43, 21%) or local recurrence of Graves' goiter (3/43, 7%) or both (2/43, 5%). The modified subtotal resected group showed no recurrences of the disease. After subtotal thyroidectomy 11 patients were euthyroid without thyroid medication (26%) compared to only two patients (7%) after the modified procedure of subtotal thyroid resection. To prevent recurrences of goiter as well as hyperthyroidism and, on the other hand, to achieve euthyroid function postoperatively without need for thyroid replacement therapy, subtotal thyroidectomy with a small thyroid remnant of about 4-8 g is recommended for all patients with large goiter and a chronic recurrent course of the disease or with iodine induced thyrotoxicosis. Patients with non recurrent Graves' disease but large goiter probably benefit from subtotal thyroidectomy with a larger thyroid remnant of about 8-12 g. PMID- 3683037 TI - [Pretherapeutic testing of cytostatic drugs in head and neck cancers]. AB - In experiments with an in vitro cultured squamous cell carcinoma line of the head and neck the usefulness of multiparametric flow cytometry is demonstrated. With this method fast determinations of the different reaction profiles from various cytotoxic agents are feasible in short as well in long term incubation periods. For the first time the effects on tumor cells and on non malignant cells may be compared in the same analysis. As in each experiment local immunocompetent cells are present, their influence is in addition well documentable. Thus as soon as a direct clinical correlation will be demonstrated, multiparametric flow cytometry will allow an individual cytotoxic drug testing for chemosensitivity and resistance in autologous serum giving pretherapeutically further insights in the non-malignant biologic characteristics of the tumor cells and of the cells within a solid tumor. In the present study the advantages of the multiparametric flow cytometry towards other approaches for chemosensitive drug testing will be discussed. PMID- 3683038 TI - [Effectiveness of the radiosensitizer cisplatin. A pilot study]. AB - 18 patients with advanced squamous cell carcinoma of the head and neck region were treated via chemotherapy and radio therapy. In this regimen cisplatinum was used as a radiosensitizer. The total remission rate was 94% while remission duration and survival could not be calculated. Severe clinical local toxicity occurred as a side effect. PMID- 3683039 TI - [Personal catheter technic for intra-arterial chemotherapy in cancers of the head and neck]. AB - Regional intraarterial chemotherapy can display its advantages as augmented concentrations of effective substances within the tumour tissue and lower systemic side effects, only if tumour perfusion can be carried out superselectively. For different reasons, the present techniques have not been accepted for extensive clinical use. A new catheter technique is, therefore, presented that is appropriate for both clinical routine and superselective tumour perfusion. PMID- 3683040 TI - [Tumors of the ceruminous glands]. AB - Tumours originating from the ceruminous glands can be classified into five types: adenomas, adenocarcinomas, adenoid-cystic carcinomas, pleomorphic adenomas and mucoepidermoid carcinomas. The diagnosis is based on histological findings and can be quite difficult if the tumour status has to be determined. Classification into one of the five types of tumours may be facilitated at times by studying the clinical pattern. Three case reports are quoted as examples to illustrate that neoplasias originating from the ceruminous glands can assume considerable proportions and must be considered in differential diagnosis when assessing space occupying growths in the soft tissue of the neck. Whereas prognosis of adenomas and pleomorphic adenomas can be considered to be good, it must be regarded as likely to be infaust in the case of adenocarcinomas, adenoid-cystic carcinomas and mucoepidermoid carcinomas. The use of cytostatics resulted in a marked reduction of the tumour in one of the described cases of adenocarcinoma. PMID- 3683041 TI - [Vascular reaction in tumors in the area of the head and neck]. AB - The vascular system possesses a variety of possibilities to respond to noxious events. Particularly the "morphological reaction" can first be observed in ultrastructural changes of the endothelial cell. In the present study we report on endothelial cell reactions in various carcinomas of the head and neck (carcinoma of the auricle, carcinoma of the maxilla). It is shown that the endothelial cell develops cytoplasmatic processes projecting into the vascular lumen. Occasionally cell edemas can be observed. The use of the scanning electron microscope allows to visualize three-dimensional aspects of the excised specimen. Tumor cells, endothelial cells and erythrocytes are obviously mixed, so that a regular vascular lumen can be found within the tumor tissue only occasionally. The results are compared and discussed, basing on available references. PMID- 3683042 TI - [Clinical aspects of bilateral facial paralysis]. AB - Facial diplegia is a rare disease. 18 patients suffering from bilateral facial palsy were examined. The clinical findings and therapeutic possibilities of ENT surgeons are demonstrated. Common and rare causes of the lesions are discussed. PMID- 3683043 TI - [Worm infection (Dirofilaria conjunctivae) in the ENT area]. AB - In 1984 was detected a 5 cm long worm in the eyelid of a 49 year old woman. This worm was classified as Dirofilaria conjunctivae. The woman had spent her holidays previously in Italy, Spain and Yugoslavia and in one of these countries she might be worm-infected by a mosquito bite. No further nodules were seen in the subskin after the operation and the blood control parameters remained normal. Only the persistent antibodies convey the idea of a previous worm infection. Today the patient is considered to be healthy. PMID- 3683044 TI - [Tonsillectomy in factor XII deficiency]. AB - A case of tonsillectomy in a 22-year-old female patient suffering from isolated deficiency of factor XII is presented. The importance of close cooperation of surgeon and haemostaseologist is pointed out. Preoperative, intraoperative and postoperative precautions are discussed. PMID- 3683045 TI - [Effect of radiotherapy on the function of the parotid gland]. AB - The incidence of adverse effects on radiotherapy in head and neck cancer is quite common. Some irradiation doses affecting parotid gland have been investigated. 38 irradiated cases and 12 non-irradiated cases constituting the control group have been included in the study. Histologic examination, sialography, scintigraphy and sialometry have been performed in all cases. The impairment of parotid gland is evident in the early stage and is aggravated with time. Glandular function is not reduced significantly by irradiation doses of 2000-3000 r. A marked functional reduction has been noted with irradiation doses of 5000-6000 r., and is variable in each individual. The reduced glandular function was particularly reduced in the early postirradiation period. The subsequent functional improvement is related to the remainder of less affected parenchyma, reduced inflammatory process and rapid growth of goblet cells in the walls of the outlet system compensating mucus deficit. PMID- 3683046 TI - [Free microvascular rib transplant]. AB - The transfer of a free ventral and dorsal rib graft by microvascular anastomoses enables the plastic surgeon to effect bony reconstruction if the recipient site is defective. However, since this is a technically complicated procedure and associated with only partial recovery, this type of bone graft can be employed only in selected problem cases. PMID- 3683047 TI - Obliteration of mastoid and middle ear for severe trauma to the temporal bone. AB - A review of four cases of severe trauma to the temporal bone involving fracture of the external auditory canal indicates that adipose obliteration of the mastoid and middle-ear cleft with closure of the external auditory canal is the optimal method of repair. In two of four patients, one-stage repair was successful using this technique, and in the other two patients, obliteration was required as a revision operation after cholesteatoma developed from previous procedures. PMID- 3683048 TI - Toxic shock syndrome in nasal surgery: a physiochemical and microbiologic evaluation of Merocel and NuGauze nasal packing. AB - A prospective comparison of the microbiologic safety of Merocel versus NuGauze nasal packing in 119 surgical patients is presented. Presurgical and postsurgical nasal cultures were obtained, analyzed, and compared. The importance of a preoperative nasal culture isolate of Toxic Shock Syndrome Toxin Number 1 (TSST 1) producing Staphylococcus aureus in predicting postoperative toxigenic S. aureus isolation and Toxic Shock Syndrome symptomatology is demonstrated. An in vitro comparison of the ability of NuGauze and Merocel to amplify TSST-1 production was performed. PMID- 3683049 TI - Epistaxis: medical versus surgical therapy: a comparison of efficacy, complications, and economic considerations. AB - A retrospective review of 4 years experience with over 32 epistaxis patients requiring hospitalization and using a standard medical or surgical therapy for control is presented. Medical therapy included the use of anterior nasal packing alone or in association with intranasal and nasopharyngeal balloon tamponade. Surgical therapy, for the most part, consisted of ethmoid and/or internal maxillary artery ligations. Most patients were treated initially with packing and balloons. Fifty-two percent of the group failed this therapy and required ligations for control. The patients who did not come to operation had fewer complications, a shorter average hospital stay, and lower average cost of hospitalization without increased risk of future epistaxis. An analysis is made comparing the results, complications, and financial implications of these two approaches. PMID- 3683050 TI - Neodymium-YAG laser intranasal photocoagulation in hereditary hemorrhagic telangiectasia: an update report. AB - Hereditary hemorrhagic telangiectasia is a challenging problem for the otolaryngologist since frequent, often severe epistaxis is the major symptom. Options for therapy in the past have included nasal packing, electrocautery, systemic estrogens, septal dermatoplasty, arterial embolization, and arterial ligation. Although successful treatment has been achieved with some of these methods, particularly septal dermatoplasty, other forms of therapy are needed prompting the use of laser photocoagulation. The neodymium yttrium-aluminum garnet (Nd-YAG) laser was used to treat a group of 19 patients with hereditary hemorrhagic telangiectasia over a 4-year period without complications. Endonasal laser photocoagulation was effective in decreasing epistaxis in patients not requiring frequent transfusions prior to laser therapy. Three patients with the most severe epistaxis received minimal or no benefit from Nd-YAG laser photocoagulation. In most patients Nd-YAG photocoagulation is successful in treating epistaxis associated with hereditary hemorrhagic telangiectasia and should be a therapeutic option for this chronic disease having no available cure. PMID- 3683051 TI - Sublabial transseptal repair of choanal atresia or stenosis. AB - Bilateral choanal atresia in newborns and infants carries significant morbidity and mortality, therefore, prompt correction is required. The transnasal route is usually preferred in the infant age group. This approach, however, carries significant incidence of restenosis. The transpalatal correction of choanal atresia has been the definitive approach in older children and adults. We are introducing a new procedure for correction of choanal atresia or stenosis that can be used at any age. The sublabial transseptal repair was performed in four infants without complications or restenosis. Two of our patients previously underwent different types of repair with persistent choanal stenosis. The sublabial transseptal approach provides wide exposure to the nasal cavity and the floor leading to the choanae. The operating microscope and various otologic micro instruments were used in the surgical dissection. Preservation of the anterior inferior cartilaginous septum and the maxillary crest and spine is mandatory in order not to disturb the nasal growth pattern of the nose and premaxilla. The infants were evaluated with a computed tomography (CT) scan, preoperatively. The posterior inferior portion of the vomer is uniformly wide, increasing the degree of stenosis or atresia. Removal of the vomer is an essential part of this procedure in order to open and enlarge the choanae. Both choanae were stented with polyvinyl tubes. Every attempt was made to keep the stents in position for a minimum of 8 to 10 weeks. Follow-up has been for 2 to 4 years, and no recurrent choanal stenosis has been experienced. PMID- 3683052 TI - Surgical complications of bedside tracheotomy in an otolaryngology residency program. AB - A prospective analysis of 124 consecutive adult patients undergoing tracheotomy was performed to examine the incidence of resulting complications. All tracheotomies were performed by a junior otolaryngology resident under the supervision of a member of the attending staff or a chief resident. The vast majority were performed at the bedside in an intensive care unit. The complications were divided into two groups: early (within 2 days) and late (2 to 14 days). Seven patients had complications directly related to tracheotomy. Four of these complications occurred in three patients and were considered significant. There were no mortalities. Despite the fact that our tracheotomies were routinely performed by residents at the bedside, our complication rate was comparable to those reported from other centers. We believe that bedside tracheotomy, properly supervised and performed, is a safe procedure. PMID- 3683053 TI - Condylomatous lesions of the upper aerodigestive tract. AB - Condyloma acuminatum is one of four types of common human verrucous lesions that are of viral etiology. Also known as "moist wart," condyloma acuminatum is most often seen on the mucosal surfaces of the anogenital area. However, occurrences in the mucosal lined areas of the head and neck region are quite rare. Since 1901, 30 cases of condylomatous lesions have been reported in the upper aerodigestive tract, occurring mainly in the various regions of the oral cavity. Eighteen of the cases were confirmed by histopathologic documentation, while the remainder were anecdotal. We have recently encountered six new cases of condyloma acuminatum, verified by histologic examination. One occurred on the tongue, another in the tonsillar fossa, one in the hypopharynx and three on the vocal cords. We present these cases and review the previously reported cases. In addition, we will discuss the differential diagnosis of these lesions, and their importance to the practicing otolaryngologist. PMID- 3683054 TI - The use of sialodochoplasty in the treatment of benign inflammatory obstructive submandibular gland disease. AB - One of the most common causes of submandibular gland enlargement is benign inflammatory disease. The usual cause is ductal outflow obstruction due to either a calculus or stenosis allowing stasis and retrograde movement of the saliva into the acinar structures leading to an inflammatory response and gland enlargement. Faced with a submandibular mass, a work-up that will rule out neoplastic causes of submandibular enlargement is instituted. This includes clinical assessment, probing of the gland, radiocontrast sialography, and CT scanning. The treatment should reflect the obstructive nature of the disease. Plastic reconstruction of the duct allows the removal of calculi, shortening of the duct, and enlargement of the outflow opening preventing recurrence and allowing healing of the gland. The procedure is performed intraorally as an outpatient, does not disrupt oral functioning, or subject the patient to the risks of gland removal or loss of that organ's function. Our experience with 27 patients over a 7-year period is presented with a detailed description of the technique and an analysis of the results. The procedure was successful in 22 of the 27 patients. PMID- 3683055 TI - A computerized data management system for head and neck oncology. AB - Medical information, diagnostic technology, and modes of therapeutic intervention available for treatment of head and neck cancer have increased exponentially. The concurrent explosion of microcomputer technology has created an ideal instrument for organizing, storing, and reporting the expanded data the head and neck oncologist must now consider. This paper presents the principles, design, and operation of a recently developed head and neck oncological database program (HNODB). Details of implementation on a microcomputer are also described. A historical review of currently used prominent cancer registration programs is presented. It defines the fundamental elements of cancer registration. A review of cancer registration in the United States shows that current systems have various deficiencies and have not kept pace with the evolution of diagnostics, treatments, and computer technologies. The HNODB database program, however, is a valuable model for cancer data management, for it can be applied to small or extensive data collection needs, and it provides an accurate system to identify risk factors, numbers of patients treated and types of treatment given. The program allows for rapid analysis of treatment, results, follow-up, and survival rates of patients with carcinoma of the head and neck. PMID- 3683056 TI - Prognostic value of vocal cord fixation with respect to treatment in cancers of the supraglottis and pyriform sinus. AB - Vocal cord fixation in supraglottic and pyriform sinus cancers has, in the past, precluded management by radiotherapy alone. Ninety-eight patients were reviewed to determine the prognostic effect of vocal cord fixation. The predictive value of cord mobility status after 50 Gy was evaluated with respect to treatment modality. For patients treated with radiotherapy alone, cord mobility status was predictive of recurrence, yielding 3 year recurrence rates of 33.3% (mobile) versus 80% (fixed) [p = 0.04]. Mobile cords after 50 Gy had similar recurrence rates (33.3% vs. 40.0%, p = 0.60) whether treated by radiotherapy or radiotherapy/surgery. Radiotherapy alone may be used in cases when fixed cords become mobile after 50 Gy without compromising cure rates or laryngeal function. Combined modality provides the best results when cords remain fixed. PMID- 3683057 TI - Biostimulative effects of Nd:YAG Q-switch dye on normal human fibroblast cultures: study of a new chemosensitizing agent for the Nd:YAG laser. AB - Kodak Q-switch II is a new chemical with an absorption maxima at 1,051 nm, designed to be used as an Nd:YAG dye laser. The potential for this dye as a new chemosensitizing agent in the treatment of connective tissue diseases and wound healing with low energy Nd:YAG laser was examined. Two normal fibroblast cell lines were tested for sensitivity to various levels of this dye in vitro. These cells were exposed to Q-switch II dye at concentrations of 0.01, 0.1, 1, 10, 50, and 100 micrograms/ml for 1 and 24 hours. Cell viability was assessed by the trypan blue exclusion test. Cell duplication and DNA synthesis were measured by the incorporation of [3H]-thymidine at 6 and 24 hours postexposure to Q-switch II dye. At concentrations up to 10 micrograms/ml, both cell lines tested showed no changes in cell viability. However, at concentrations equal or higher than 50 micrograms/ml, more than 40% of the fibroblasts incorporated trypan blue after 24 hours of exposure to this dye, indicating significant cell destruction. The results indicate that Q-switch II dye is nontoxic to normal human fibroblast cultures and showed significant biostimulative effects on cell duplication at concentrations equal to or lower than 10 micrograms/ml. Further studies will be required to determine the usefulness of Q-switch II dye as a new photochemosensitizing agent for potential biostimulation of wound healing and/or treatment of connective tissue diseases with the Nd:YAG laser (near infrared, 1,060 nm) at "nonthermal" levels of energies. PMID- 3683058 TI - Reconstruction of the soft palate after jaw, tongue, neck dissection with subtotal palatectomy (velopharyngoplasty) PMID- 3683059 TI - Custom-made nasopharyngeal airway. PMID- 3683060 TI - Resection of abdominal hollow organs by laser. AB - During a ten-year period 642 abdominal hollow organ resections have been performed by means of a new, original technique--that is, CO2 laser irradiation combined with specially designed instrumentation. This resulted in a remarkable decrease in postoperative morbidity and mortality. The article describes the laser procedure. PMID- 3683061 TI - CO2 laser in decubitus ulcers: a comparative study. AB - This is a comparative study of conventional surgery (knife/electric knife) and CO2 laser surgery and their effect on the outcome of stage III (including muscle) and stage IV (including bone) decubitus ulcers with an average area of 400 cm2. It is a prospective clinical study done with two groups of patients of similar age, economic and social background, as well with similar types of decubitus ulcers. Thirty patients were studied in each group. The study demonstrated a statistically significant difference in favor of the patients treated with CO2 laser with regard to operative blood loss, 0.5 cc/cm2 or 20% (P less than .01), infection rate (chi 2 test, P less than .01), and difference (60%) in recovery time (P less than .01). This translated into an average saving of 23 hospitalization days per patient. It also showed a difference, though not statistically significant, favoring the group treated with laser with respect to survival and full recovery. This probably is attributable to the lowered blood loss and infection rate as well as improved operative time and analgesia. PMID- 3683062 TI - Tissue interactions and measurement of ablation rates with ultraviolet and visible lasers in canine and human arteries. AB - Ablation rates measured as the depth of tissue excavation per unit time were determined in human and canine aortas subjected to radiation with ultraviolet (UV) excimer (ArF 193 nm, KrF 248 nm, XeF 351 nm) and visible lasers [continuous wave (cw) and 50-ms chopped argon ion, 478 nm-514 nm; pulsed double-frequency Nd:YAG, 532 nm]. For UV and pulsed double-frequency Nd:YAG lasers ablation rates were constant in time and depended linearly on average laser power, but for cw and chopped argon lasers ablation rates varied with irradiation time and were nonlinearly dependent on laser power. In human aortas, atherosclerosis without gross calcification had no influence on ablation rates. Charring and tissue disruption were observed with cw and chopped argon ion, whereas excimer and pulsed Nd:YAG lasers produced only minimal injury to surrounding tissue. We conclude that the determination of ablation rates is useful for the selection of laser wavelengths and power densities applicable to angioplasty and that UV and pulsed visible laser permit a better control of ablation compared to continuous wave lasers. PMID- 3683063 TI - Discrimination of normal and atherosclerotic aorta by laser-induced fluorescence. AB - Precise targeting of laser energy to atherosclerotic plaque is crucial for the safe performance of laser angioplasty. The present study was designed to evaluate whether laser-induced fluorescence could distinguish atherosclerotic from normal aorta. Segments of human aorta obtained at necropsy were classified grossly and histologically as normal aorta (n = 7), thin yellow fatty plaque (n = 5), and thick white atheromatous plaque (n = 9), and analyzed by laser-induced fluorescence spectroscopy using a pulsed nitrogen laser. Fluorescence spectra were recorded over a wavelength range from 385 to 725 nm. Normal specimens had maximal fluorescence intensity at 514 nm. A prominent fluorescence peak at 448 nm was present in specimens characterized as white atheromatous plaque and at 538 nm in specimens characterized as yellow fatty plaque. The ratios of fluorescence intensity at 448 nm/514 nm and at 538 nm/514 nm correctly classified all specimens according to their gross and histologic type (p less than .001). Thus, a "smart" laser angioplasty catheter system might incorporate low-power laser radiation for arterial fluorescence spectroscopy to guide delivery of high-power laser radiation for plaque ablation. PMID- 3683064 TI - Comparison of the optical transmission properties of pulsed and continuous wave light in biological tissue. AB - The purpose of this study is to compare the optical transmission of the pulsed gold vapor laser (628 nm) to that of the continuous wave argon-pumped dye laser (630 nm) in a homogenous tissue model. Gluteal muscle was taken from a rabbit, and sections of varying thicknesses were made. The tissue samples were positioned at the aperture of an integrating sphere. The laser light was passed through an optical attenuator, coupled to a 600-microns fiber, and then directed onto the surface of the tissue. Transmitted light was collected by the integrating sphere. Light measurements were made with a radiometer. This procedure was repeated for samples of differing thickness using the gold vapor laser as the light source. The identical procedure was performed using the argon-pumped dye laser. No significant difference was found in percent transmission of light using the gold vapor laser as compared to the argon-pumped dye laser. PMID- 3683065 TI - NADH in situ laser fluorimetry: effect of pentobarbital on continuously monitored myocardial redox state. AB - NADH laser fluorimetry was applied to in situ monitoring of pentobarbital overload effect on myocardial redox state in rats. Experiments were carried out on open-chest rats anesthetized with pentobarbital. Use of very thin optical probes allowed measurements of NADH fluorescence directly within the myocardial wall. Quantitative analysis of fluorescent and backscattered light signals was made possible on-line. In 8 animals, a slow IV infusion of 6% pentobarbital (2 mg.min-1 for 10 min) induced an average twofold increase in NADH fluorescence, with constant return to baseline level prior to injection after a maximum period of 50 min. Thus, pentobarbital overload strongly affects the myocardial energetic state, and this effect was precisely evaluated with NADH fluorescence monitoring. In situ-monitored myocardial redox state variations during pentobarbital infusion can constitute a reference for similar studies on pharmacological agents aimed at protecting tissues against ischemic biochemical damages. PMID- 3683066 TI - Dental pulp exposed to the CO2 laser beam. AB - Traumatic inflammation due to application of CO2 laser beam on teeth (dentin and pulp) of Beagle dogs and Macaca Monkeys, stimulate in dentino-pulpal tissue morphological phenomena studied after 5 days, 1, and 3 months by microscopy and microradiography. After a dentin exposure to a density of energy from 2 X 10(3) J/cm2, the first cell layers of the pulp tissue show a rarefaction and a cellular degeneration, followed by a neoformation of calcified dentin, of about 300 microns thick in 3 months, due to the excitation of odontoblasts or produced by pulpal cells functioning before. A density of energy of 10(3) J/cm2 order applied to the pulp beads to its partial necrosis, to various inflammatory aspects and to a quasi-constant regeneration by a neo-dentin bridge of 200 microns at 1 month. The analysis of cell activity seems able to be investigated from this method. PMID- 3683067 TI - Silver oxide in YAG sclerostomy. AB - YAG sclerostomy is a filtering procedure performed entirely with the neodymium:YAG laser through a goniolens as an alternative to trabeculectomy in the treatment of glaucoma. Extremely large pulse powers have been required in the past to complete the procedure. We found that an injection of silver-stabilized protein intrasclerally prior to the procedure makes it possible to perform the procedure with low total power. PMID- 3683068 TI - Comparison of the maximum coagulation depth in human skin for different types of medical lasers. AB - The values for the maximum coagulation depth (MCD) of various types of lasers which are specified in the literature are not comparable, because often different irradiation times were used. MCD depends not only on the wavelength of laser light, but also on the time of action of the laser beam, because of heat transfer. In excised human skin MCD was determined histologically for irradiation with the argon laser, Nd:YAG laser, and CO2 laser. Extending the irradiation time from 0.2 s to 10 s results in a 4-6-fold increase in MCD. Coagulation experiments performed with a soldering iron have shown results similar to those obtained with the CO2 laser. Enlargement of the laser-beam diameter from 1 to 2 mm leads to a 50% increase in MCD. Additional chilling of the skin with water during laser irradiation protects the skin from evaporation, and the values for MCD increase to 3.5 mm for the argon laser and 5.5 mm for Nd:YAG laser. Detailed knowledge of the MCD is necessary to obtain the desired therapeutic effect, and also to avoid unwanted effects. PMID- 3683069 TI - Dosimetry study of Nd:YAG laser damage to canine renal cortex. AB - A dosimetry study of factors affecting the extent of tissue damage inflicted upon the canine renal cortex by the Neodymium:Yttrium Aluminum Garnet (Nd:YAG) laser was undertaken. Laser parameters and renal tissue conditions were varied independently in duplicate in the following manner: (1) power - 5, 10, 20, 50, 75, 100 watts with a spot size of 1.2 mm; (2) exposure duration - 1, 2, and 4 seconds; (3) kidney perfusion and temperature--renal artery unclamped (perfused) without cooling; renal artery clamped (non-perfused) without cooling; and renal artery clamped with cooling. Five days following application of the laser, the animals were sacrificed and serial sections of the renal cortex were examined for maximum depth and width of tissue damage and ablation. Multiple linear regression analysis of the data indicated a direct linear relationship between the joules (watts X seconds) of energy delivered to the renal cortex and the depth and width of tissue damage and ablation (p less than 0.001 for joule regression coefficient for each variable). Seconds and/or watts alone were not major predictors of the outcome after accounting for joules. Clamping the main renal artery significantly reduced the depth and width of laser damage when compared to the perfused kidney (p less than 0.001 for each variable). The depth of damage was similar in the cooled and the non-cooled non-perfused kidney. These data suggest that increased laser energy and kidney perfusion significantly increase renal cortical laser induced damage. Adjustment of these parameters may permit controlled tumor ablation or tissue incision with minimal damage to adjacent normal tissue. PMID- 3683070 TI - Hyperthermia from interstitial laser irradiation in normal rat brain. AB - This study examined both the effect of variations in optical fiber tip and in light wavelength on laser-induced hyperthermia in rat brain. Normal rat brains were exposed to argon laser light (454-514.5 nm) delivered through an intracerebral end-emitting (bare-tipped) or a diffusion-emitting (sapphire tipped) optical fiber probe. Interstitial thermistor probes recorded temperatures after thermal equilibration at varying distances from the emitting source. The end-emitting fiber produced significantly (P less than 0.05) higher elevations in tissue temperature than the diffusion-emitting fiber at the same laser power output. This is due to the smaller surface area (1.2 mm2 versus 7.8 mm2) of the end-emitting fiber, which results in a greater rate of energy delivery to tissue adjacent to the fiber tip. Changes in intracerebral temperature measurements were also recorded at similar distances from a diffusion-emitting fiber at a continuous total laser power output of 150 mW for light wavelengths of 454-514.5 nm, 700 nm, and 750 nm and at a total laser output of 1.1 W for 1,060 nm. Variations in brain tissue temperature with distance from the laser emission source were compared for each laser group with the tissue temperature profile generated by a radiofrequency (wavelength 600-625 m) interstitial probe. Similar temperature changes were found for all visible wavelengths near the probe, suggesting that the thermal response of brain adjacent to an interstitial laser fiber is primarily dependent upon the rate of energy delivery and not upon wavelength. The thermal profile versus distance from the light source depends mostly upon the level of temperature rise near the interstitial laser fiber tip and not the wavelength of laser light used. These results have important implications in interstitial applications of laser for hyperthermia and photochemotherapy. PMID- 3683071 TI - Smoke from laser surgery: is there a health hazard? AB - The composition of plume produced during carbon dioxide laser endoscopic treatment for endometriosis was examined to determine whether it represented a hazard to the surgical staff. A total of 32 plume samples were collected from 17 women undergoing laser laparoscopic treatment for endometriosis and/or adhesions. The smoke was found to consist of particles having a median aerodynamic diameter of 0.31 micron with a range of 0.10-0.80 micron. The size range has two consequences: 1) using a human red blood cell as a model for all cells, it can be stated with greater than 99.9999% certainty that no cell-size particles, including cancer cells, are present in the plume; 2) particles in this size range are too small to be effectively filtered by currently available surgical masks. PMID- 3683072 TI - [Complications of endoscopy of the upper gastrointestinal tract]. AB - An inquiry in FRG and Switzerland concerning complications in upper G.I. panendoscopy showed a total complication rate of 0.081% and a mortality of 0.007%. This complication rate is diminishing three to four times in comparison to publications ten years ago. The different kind of complications are discussed (perforations, complications of premedication respiratory and cardiovascular complications and infections). It is postulated that in future more attention is given to the problems of complications: treatment of perforations (conservative or surgical), oxygen saturation of blood and transmission of infectious disease, especially AIDS. The major complication is the diagnostic error. PMID- 3683073 TI - [Colonoscopy in advanced age: cardiac arrhythmias]. AB - 62 in- and outpatients (65-89 years) with an average age of 76 +/- 5.6 years were investigated with Holter-ECG during colonoscopy to find out whether an endoscopy increases the tendency for cardiac arrhythmias. 50 per cent of the inpatients had a compensated cardiac insufficiency and 57.9 per cent had a coronary heart disease. Cascara-Salax and gut lavage were used for cleansing of the gut. 15 patients with a premedication of 5 mg Diazemuls an 50 mg Dolantin got an analysis of the blood gas before and after the premedication from a hyperaemic lobe of the ear. During endoscopy the number of patients with arrhythmias of a high degree was lower compared to the control period. With regard to the ventricular premature beats there was the following observation: (Table: see text). During the control period 6 patients had some supraventricular premature beats, during colonoscopy there were 14 patients with such arrhythmias. One female patient had a transitory atrial fibrillation. Before premedication the pO2 is 76.9 +/- 9 mmHg, afterwards 68.4 +/- 12.0 mmHg. Three patients showed a decrease of the pO2 down to 55 mmHg, three other patients down to 65 mmHg. The colonoscopy in the elderly does not essentially increase the cardiac arrhythmias, the severe premature beats do not increase. It is concluded that the cardiac risk is not increased by the endoscopy. The importance of the preparation for cleansing and the premedication is discussed. PMID- 3683074 TI - [Pedunculated polypoid gangliocytic paraganglioma of the afferent jejunal loop of a Billroth II stomach]. AB - A mobile pedunculated polypoid tumor was endoscopically removed from the afferent jejunal loop after gastrojejunostomy of a 54-year-old patient with anamnestic evidence of intestinal bleeding. Histologically epithelial carcinoid-like as well as mesenchymal paraganglioma- and ganglioneuroma-like patterns are mixed in varying portions, characteristic for gangliocytic paraganglioma. Immunohistochemically, serotonin, neuron-specific enolase, cytokeratin, vimentin S-100 protein and neurofilament were demonstrable. Gangliocytic paragangliomas are almost exclusively observed in the second portion of the duodenum, especially around the papilla Vateri and only two have previously been reported in the jejunum. The histogenesis of the tumors is unclear, but they may probably be either hamartomas, hyperplastic or neoplastic proliferations of so called endodermal-neuroectodermal complexes. Although gangliocytic paragangliomas contain a carcinoid-like component, they behave in a benign fashion, and metastases or recidives have not been noticed. Tumors with a pedicle may be endoscopically removed without complications. PMID- 3683075 TI - Effect of cysteamine on suckling-induced prolactin secretion in the rat. AB - We have examined the effects of the thiol agent cysteamine on physiological prolactin secretion in the female rat. Administration of cysteamine completely abolishes suckling-induced prolactin secretion in a dose-dependent manner. Cysteamine treatment does not alter nursing behavior of the mothers. Further, we have found that the prolactin-depleting ability of cysteamine is not altered by a prior suckling stimulus. These results indicate that cysteamine administration inhibits physiologically-induced prolactin secretion with similar potency and efficacy as previously reported for cysteamine effects on basal and pharmacologically-induced prolactin secretion. Furthermore, the effect of cysteamine is not compromised by a previous suckling stimulus, suggesting that "depletion-transformation" of pituitary prolactin stores does not protect against the effect of cysteamine. PMID- 3683077 TI - Correlation of adenosine receptor affinities and cardiovascular activity. AB - Binding affinities of 28 adenosine analogs at A1 adenosine receptors (rat whole brain membranes, [3H]N6-cyclohexyladenosine, CHA), and at A2 adenosine receptors (rat striatal membranes, [3H]NECA) were compared to their EC25 values for decreasing heart rate and increasing coronary flow in the isolated rat heart. Heart rate (an A1 response) correlated with A1 binding affinity (r2 = 0.71, p less than 0.0001) but not with A2 binding affinity (r2 = 0.007, n.s.); conversely, coronary flow (an A2 response) correlated with A2 binding affinity (r2 = 0.83, p less than 0.0001) but not with A1 binding affinity (r2 = 0.05, n.s.). These results confirm that the brain A1 and A2 receptors, studied by binding methods, bear close similarities to their respective counterparts in the heart, studied by means of functional responses. PMID- 3683076 TI - The intracellular calcium antagonist, TMB-8, inhibits prolactin gene expression in GH3 cells. AB - We examined the effects of the drug, TMB-8, which promotes sequestration of intracellular Ca2+, on the ability of extracellular Ca2+ to stimulate prolactin gene expression in GH3 cells. TMB-8 inhibited prolactin mRNA levels in a dose dependent manner in the concentration range of 2.5-10 microM. Prolactin mRNA levels were increased about 18-fold by the addition of 0.1 mM CaCl2, and about 25 fold by the addition of 0.4 mM CaCl2. Addition of 10 microM TMB-8 reduced these levels to about 4-fold and 7-fold, respectively. At 10 microM TMB-8 did not effect total protein synthesis or the Ca2+-induced aggregation of the cells, indicating a selective inhibition by the drug of prolactin gene expression. Both TMB-8 and the calmodulin inhibitor, calmidazolium, reversed the effects of Ca2+ on prolactin mRNA levels in cells that had been pretreated for 2 days with 0.4 mM CaCl2. PMID- 3683078 TI - beta-Casomorphins induce apnea and irregular breathing in adult rats and newborn rabbits. AB - Bovine beta-casomorphin, beta-casomorphin, morphiceptin or morphine were administered systemically (i.v. or i.p.) and intracerebroventricularly (lateral or IVth ventricles) to anesthetized adult rats and preterm newborn rabbits. All agents caused dose-related depressions of respiratory frequency and tidal volume. Morphiceptin and beta-casomorphin were approximately equipotent to morphine while beta-casomorphin was 10 times as potent after intracerebroventricular injection. The beta-casomorphins decreased inspiratory drive and prolonged the expiratory phase by delaying the setpoint for inspiration. A respiratory depression could be elicited by systemic administration of morphiceptin but not by beta-casomorphin or beta-casomorphin. All ventilatory effects induced by the beta-casomorphins could be readily reversed or prevented by naloxone. Intracerebroventricular but not intraperitoneal injection of beta-casomorphin depressed ventilation in preterm newborn rabbits in a similar pattern with apnoic periods to that seen in the adult rats. In addition, an irregular breathing pattern was elicited. Thus, the bovine beta-casomorphins possess potent central respiratory depressive effects. However, after systemic administration, only morphiceptin which is more metabolically stable induced a shortlasting effect on ventilation in adult rats. PMID- 3683079 TI - Effects of human growth hormone on immune functions: in vitro studies on cells of normal and growth hormone-deficient children. AB - We have studied the in vitro effects of human growth hormone on cell surface markers and mitogenic responses of peripheral blood lymphocytes (PBL) of normal and growth hormone-deficient children before, during and after treatment with growth hormone. Growth hormone resulted in a decrease in B cell expression but it did not affect expression of T cell subsets. Growth hormone depressed the proliferation of PBL of normal and untreated growth hormone-deficient children. The proliferative responses to phytohemagglutinin (PHA) versus PHA with growth hormone were not statistically different, though the responses of most normal and on treatment children were diminished by the addition of growth hormone. PBL derived from growth hormone-deficient children during treatment with human growth hormone exhibited significantly greater spontaneous proliferation then the PBL of normal children. Growth hormone further significantly enhanced their proliferation. PHA and PHA with growth hormone resulted in significantly greater proliferation of these patients' PBL when compared to those of normal children. We demonstrated that human growth hormone had substantial in vitro effects on immune functions. These effects, some of which depend on the treatment status of the children, may need to be considered in the clinical use of human growth hormone. PMID- 3683080 TI - Castanospermine blocks the hyperglycemic response to carbohydrates in vivo: a result of intestinal disaccharidase inhibition. AB - Castanospermine is a potent inhibitor of rat intestinal glycohydrolases in vitro and prevents the hyperglycemic response to an oral sucrose challenge in vivo. Among the glycohydrolases tested, castanospermine was most effective against sucrase with an IC50 of 1.1 x 10(-7) M. In vivo, a significant effect was seen at doses less than 1 mg/kg in both normal and streptozotocin-treated rats. Castanospermine has a prolonged duration of activity in vivo with significant activity when administered 4 hours before sucrose. PMID- 3683081 TI - MTP-1307, a novel antidiabetic agent, improves the glucose intolerance of viable yellow obese-diabetic mice. AB - MTP-1307 is an oral antidiabetic agent with a unique profile. It improves the glucose intolerance of viable yellow obese-diabetic mice at 25 mg/kg whereas at 300 mg/kg, it only marginally lowers the basal glucose levels of the same mice. This selective activity on exogenous glucose makes MTP-1307 potentially a useful agent to treat postprandial glucose intolerance without causing hypoglycemia. PMID- 3683082 TI - The lack of a physiologic effect of the stress-induced decrease of the proestrous prolactin surge in the rat. AB - Experiments were performed to determine whether the restraint stress-induced decrease in the proestrous prolactin (PRL) surge blocked luteolysis of the corpora lutea (CL), affected ovulation, or prevented the induction of pregnancy/pseudopregnancy in the next cycle. In all experiments rats were either stressed on proestrus and estrus, administered daily sc injections of 1 mg/day of 2-Br-alpha-ergocryptine (CB-154) for 4 days starting on diestrus II or not treated. In one experiment animals were sampled on the afternoon of proestrus to determine the effect of restraint stress on plasma PRL values and sacrificed on the morning of proestrus in the next cycle. Ovaries were removed, weighed, fixed and examined for number of CL. Restraint stress resulted in a significant increase in ovarian weight when compared to controls; CB-154 resulted in significant increases in ovarian weight when compared to stress and control animals. However, only CB-154-treated animals had a significant increase in the number of CL when compared to controls. In another experiment, animals were sacrificed on estrus of the next cycle and the oviducts examined for the number of ova. There were no differences among groups. In the final experiment, animals were placed with males of proven fertility on proestrus of the next cycle and examined for evidence of sperm in the vaginal lavage and/or vaginal plugs. CB-154 prevented the induction of pregnancy or pseudopregnancy due to a carry over effect of the drug on PRL surges. Restraint stress had no significant effect on the induction of pregnancy or pseudopregnancy. We conclude that there is no physiological significance to the stress-induced decrease of the proestrous PRL surge with respect to ovarian function or fertility. PMID- 3683083 TI - Hypotensive effect of naloxone on high blood pressure induced by stress in the rat. AB - A naloxone-reversible enhancement of systolic blood pressure (BP) was induced in rats by application of three different types of stressor, i.e. intense light and sound, cold and foot-shock. In the case of labile high BP provoked by short-term isolation, the opiate antagonist naloxone (1 mg/Kg, i.p.) was also found to reverse hypertension. Naltrexone (2.5 mg/Kg, i.p.) also diminished high BP readings of briefly isolated rats. Conversely, blockade of the opiate receptor with naloxone did not alter elevated BP in cases of established hypertension (spontaneously hypertensive rats, deoxycorticosterone (DOCA)-salt rats and long term isolated rats). These data can be taken as an evidence of opioid involvement at the onset of high BP readings induced by stress. However, once hypertension becomes established, the opioid system appears to recover its silent features. PMID- 3683084 TI - A comparison of the central gastrointestinal antitransit effects of morphine and bombesin in the mouse. AB - The gastrointestinal motor effects of centrally-given morphine and bombesin were compared in mice. Both compounds produced a dose-related decrease in the propulsion of a marker along the gut when given by the intracerebroventricular (i.c.v.) or intrathecal (i.th.) routes. Co-administration of the same compound by both routes was found to produce a marked increase in potency for morphine, but only a slight increase in potency for bombesin. Isobolographic analysis of the gut effects of these compounds revealed a multiplicative brain-spinal cord interaction for morphine, but an additive interaction for bombesin. These results are consistent with the interpretation that morphine can act at either the level of the brain or the spinal cord, activating independent pathways which ultimately converge to alter gut propulsion. In contrast, spinal bombesin requires communication to supraspinal sites in order for its gut effects to occur, suggesting activation of a common outflow pathway from the central nervous system. PMID- 3683085 TI - Cocaine inhibits extraneuronal O-methylation of exogenous norepinephrine in nasal and oral tissues of the rabbit. AB - Nasal mucosa (respiratory and olfactory) and lingual gingiva of the rabbit were depleted of their sympathetic nerves by superior cervical ganglionectomy. In the innervated nasal mucosa, exogenous tritiated norepinephrine (3H-NE) was metabolised mainly to tritiated 3,4-dihydroxyphenylethylene glycol (3HDOPEG) and 3,4-dihydroxy mandelic acid (3HDOMA), whereas after denervation it was metabolised mainly to tritiated normetanephrine (3HNMN). In the denervated mucosa, cocaine (30 umol/1) inhibited 3HNMN formation by 50-60%. Cocaine also inhibited 3HNMN formation by 60% in the denervated lingual gingiva. It is concluded that the tissues metabolise 3H-NE via a cocaine-sensitive extraneuronal uptake and O-methylating system similar to that which has been shown to be present in dental pulp. PMID- 3683086 TI - Adrenaline in various organs of the rat: its origin, location and diurnal fluctuation. AB - In order to examine the origin and location of adrenaline in peripheral organs of mammals, adrenaline and noradrenaline were measured in several organs of the rat after adrenalectomy, guanethidine treatment and imipramine injection. One week after bilateral adrenalectomy, adrenaline disappeared almost completely from the heart, spleen and submaxillary gland. Chronic administration of guanethidine caused decreases in both noradrenaline and adrenaline in the peripheral organs. Injection of imipramine induced a reduction of adrenaline concentration in the spleen and submaxillary gland. It is considered that adrenaline in the peripheral organs of mammals is mostly derived from the adrenal gland and that circulating adrenaline is taken up by sympathetic nerve endings in the organs. The adrenaline content of the peripheral organs increased after electric foot-shock and changed according to the time of day. The peak of the circadian rhythm appeared about 6 hours after the peak of the urinary adrenaline rhythm. These findings suggest that adrenaline in body organs plays some role in the responses of the sympathetic nervous system to stressful conditions or even to daily activities. PMID- 3683087 TI - Serotonin 5-HT2 receptor binding on blood platelets--a peripheral marker for depression? AB - Several methods of platelet membrane preparation and binding conditions were screened in order to optimize the labeling of serotonergic 5-HT2 receptors on previously frozen human platelet membranes with tritiated ketanserin. Under optimal conditions, 5-HT2 receptors in normal subjects (5 males, 7 females, age range 21 to 71) have a Kd of 1.5 +/- 0.2 nM and a Bmax of 33.9 +/- 5.3 fmole/mg protein. In a group of patients with major depressive disorder exactly matched for age and sex with the normal control group, we find a significant increase in receptor density, to 66.8 +/- 11.4 fmole/mg, with no significant change in the affinity (2.3 +/- 0.5 nM). Four weeks of treatment with antidepressant drugs result in a significant decrease of Bmax, down to control levels (29.4 +/- 3.9). Thus, ketanserin can be used to monitor changes in platelet serotonin 5-HT2 receptors which may be a relevant marker for the state of depression. PMID- 3683088 TI - Hemodynamic effects of different preparations of stroma free hemolysates in the isolated perfused rat kidney. AB - We have examined the effects of Stroma Free Hemolysate (SFH) solutions in the isolated perfused rat kidney. Three types of SFH, stored for 6 to 8 months at 4 degrees C, were tested: 1) unmodified, 2) glyoxalated and lightly cross linked and 3) pyridoxalated and polymerized. All three SFH solutions, added to the perfusate at a concentration of approximately 420 mg/100ml, increased renal vascular resistance (RVR) and reduced glomerular filtration rate (GFR). Unmodified, glyoxalated and lightly cross linked and pyridoxalated polymerized SFH resulted in a rise in RVR of 55%, 38% and 33% respectively and a fall in GFR of 42%, 57% and 83% respectively. In order to determine whether storage had altered the effect of SFH on renal function, one of the forms of SFH (glyoxalated and lightly cross linked) was studied only 4-6 weeks after preparation. While this preparation caused an increase in RVR of 41% it did not alter GFR; filtration fraction (FF) rose. However, after further storage of this preparation for 6-7 months, the solution resulted in a marked decrease in GFR of 47% as well as a rise in RVR of 23%. We conclude that three different SFH preparations resulted in marked vasoconstriction and reductions in GFR. These deleterious effects on renal hemodynamics were noted at a concentration of hemoglobin well below that necessary to effectively improve oxygen content. Storage of the SFH solutions may cause or contribute to their effects on renal function. SFH solutions intended for use as blood substitutes should be tested for vasoconstrictor activity. PMID- 3683089 TI - Partial characterization of a novel endogenous opioid in human cerebrospinal fluid. AB - Human cerebrospinal fluid (CSF) contains many uncharacterized endogenous opioids, in addition to the known enkephalins, endorphins, and dynorphins. These opioids may be separated by gel filtration chromatography and identified by radioreceptor assay for opioid activity. One region of the chromatographic elution profile, designated "Peak B" has previously been shown to be related to the pain status of chronic pain patients. We now report that human Peak B isolated from the CSF of pain-free elective surgery patients is present at a typical concentration equivalent in activity to 1.4 pmol of morphine sulfate per ml of CSF measured by radioreceptor assay. At a dose of 0.06 and 0.12 pmol morphine sulfate equivalents of CSF (MSE), injected into the cerebroventricular system of the mouse, Peak B produced an antinociceptive effect, the intensity and duration of which was dose dependent and which was antagonized by naloxone. The mouse vas deferens (MVD) preparation was inhibited by Peak B in a manner that was sensitive to antagonism by naloxone only at low (less than 1.0 microM) but not at higher (greater than 6.0 microM) concentrations of the antagonist. Peak B activity in the MVD assay was unaffected by treatment with trypsin or alpha-chymotrypsin. PMID- 3683090 TI - Markedly reduced blood pressure responsiveness in endotoxemic rats; reversal by neuropeptide Y. AB - This study in conscious normotensive rats was performed to assess the effect of the vasoconstrictor peptide, neuropeptide Y (NPY), on blood pressure responsiveness to exogenous norepinephrine in endotoxaemia. NPY and endotoxin were infused at doses which had no effect on blood pressure, whether given alone or in combination. Endotoxin markedly reduced the pressor responses to bolus injections of norepinephrine. However, blood pressure responsiveness could be enhanced by infusing NPY simultaneously with the endotoxin. It is suggested that low dose NPY infusions may be clinically useful in reversing the reduced vascular responsiveness to pressor amines in shock. PMID- 3683091 TI - Leiomyosarcoma of the inferior vena cava presenting as Budd-Chiari syndrome. AB - A case of a 72-year-old male with a leiomyosarcoma of the inferior vena cava causing Budd-Chiari syndrome is described. Percutaneous decompression of the portal system was attempted but with no success. At autopsy, a large tumor arising from and completely obstructing the inferior vena cava was found, histologically proven to be a leiomyosarcoma. Over 50 cases of leiomyosarcoma of the inferior vena cava have been reported in the literature, the majority of which occurred in women and 1/3 of which were associated with the Budd-Chiari syndrome. Histologically up to two mitotic figures per 10 high power fields have been scored. This case indicates the unreliability of a low mitotic index as an indicator of benign behavior of smooth muscle neoplasms of the venous system. PMID- 3683092 TI - Elements in normal and cirrhotic human liver tissue. II. Potassium, sulphur, chlorine and bromine measured by X-ray fluorescence spectrometry. AB - Elements (K, S, Cl, Br) were measured by X-ray fluorescence spectrometry in normal liver tissue obtained at autopsy from 74 subjects (44 male, 30 female), median age 62 years (range 20-87), and in cirrhotic liver tissue from 27 subjects (14 alcoholic, 13 non-alcoholic cirrhosis). The element content (median and 5-95 percentile interval) in normal livers in mmol/kg dry tissue was: K, 198.75 (150.95-256.42); S, 147.60 (73.86-233.97); Cl, 98.73 (69.51-163.55); Br, 0.1101 (0.0701-0.4205). None of the elements displayed any sex difference. There were correlations between the content of Br and Cl (r = 0.26, P less than 0.05) and Br and K (r = 0.24, p less than 0.05). In both groups of cirrhotic livers, K, S and Cl content was within the normal range. Median Br content was above normal both in alcoholic (0.2265 mmol/kg, P less than 0.01) and non-alcoholic cirrhotic livers (0.2228 mmol/kg, P less than 0.01). PMID- 3683093 TI - Cyanamide hepatotoxicity. Incidence and clinico-pathological features. AB - Ground-glass hepatocytes resembling those seen in HBsAg carriers on hematoxylin and eosin and on trichrome stained sections, but giving a negative reaction to orcein and a positive one to PAS, were found in liver biopsy specimens from nine asymptomatic former alcoholics who were on treatment with cyanamide, in one of four who had been treated with cyanamide several months before the liver biopsy procedure, in none of 15 treated with disulfiram, and in one of eight who had apparently not received aversive drugs. Portal and periportal inflammatory changes and fibrosis were more frequently observed in biopsy specimens containing PAS-positive ground-glass hepatocytes than in those without, but cirrhosis was found with a similar frequency. It is concluded that periportal PAS-positive ground-glass hepatocytes are a histological marker of cyanamide treatment. PMID- 3683094 TI - Lack of effects of nifedipine on hepatic hemodynamics in patients with HBsAg positive cirrhosis. AB - The acute effects of Nifedipine on hepatic venous pressure gradient (HVPG) and estimated hepatic blood flow (EHBF) were investigated in six patients with HBsAg positive cirrhosis and portal hypertension by simultaneous hepatic venous catheterization. The mean arterial pressure significantly decreased by 18% at 1 h after sublingual administration of 10 mg Nifedipine. Significant increases in heart rate (13%) and cardiac output (20%) were also demonstrated in our patients 1 h after administration of Nifedipine. However, there were no significant changes in HVPG and EHBF after Nifedipine. We conclude that in patients with HBsAg-positive cirrhosis who receive Nifedipine, EHBF is maintained despite a substantial change in systemic hemodynamics, and that Nifedipine is not effective in acutely reducing HVPG. PMID- 3683095 TI - Hepatitis B core and surface antigen expression in HBeAg and HBV DNA positive chronic hepatitis B: correlation with clinical and histological parameters. AB - The interrelationship between hepatitis B virus (HBV) infection, hepatic injury and clinical activity in chronic HBV infection is incompletely understood. We have scored histologic activity, the expression of hepatitis B core (HBcAg) and hepatitis B surface antigen (HBsAg) and assessed HBV replication to correlate HBV antigen expression with histologic disease. Forty-seven formalin-fixed, percutaneous liver biopsies from HBeAg carriers were studied. Twenty-nine were Black, 16 Caucasian and two Oriental. Fifty-nine percent had chronic active, 35% chronic persistent hepatitis and 14% cirrhosis. None were positive for antibodies to Human Immunodeficiency Virus (HIV). HBsAg and HBcAg in tissue were detected by immunochemical staining. Diffuse HBsAg staining was observed in 10/15 patients with CPH, but there was no correlation between histologic score and HBsAg expression. Intracytoplasmic HBcAg was observed in patients seroconverting to anti-HBe, but was also detected in patients with minimal hepatitis. An inverse correlation between histologic score and HBcAg expression was observed. HBcAg expression was more widespread in patients with CPH (mean 37%) than in CAH (mean 18%). A positive correlation was observed between serum aminotransferase concentrations and histologic score. Although no consistent pattern can be discerned, HBcAg expression and hepatic injury are frequently dissociated in patients with chronic HBV infection; complex host responses may determine the variable degree of disease activity and hepatic injury. PMID- 3683096 TI - Lack of evidence for increased lipid peroxidation in ethanol-induced centrilobular necrosis of rat liver. AB - The pathogenetic role of lipid peroxidation in ethanol-induced liver injury was previously supported by demonstration of increased formation of diene conjugates and decreased hepatic levels of reduced glutathione in ethanol-fed animals and alcoholic patients with liver injury. The present study was carried out to investigate whether these findings can be extended to a rat model that was shown to produce a spontaneous ethanol-induced liver injury progressing from steatosis to necrosis and fibrosis (Hepatology 6: 814, 1986). Despite the histological evidence of progression from hepatic steatosis to centrilobular necrosis in these animals, diene conjugate formation in mitochondrial and microsomal lipids was not enhanced when compared to pair-fed controls. In addition, hepatic levels of neither methionine nor glutathione were decreased in the ethanol-fed animals. The fatty acid composition of mitochondrial phospholipids from these animals was similar to that in the controls. However, in the microsomal phospholipids, the level of arachidonate (20:4) was depressed by about 50% as compared to the controls. These results demonstrate the lack of evidence for a pathogenetic relationship between lipid peroxidation and ethanol-induced liver injury progressing to centrilobular necrosis. They further suggest that the decreased levels of 20:4 commonly seen after chronic ethanol intake may not be due to a peroxidative loss. PMID- 3683097 TI - Diabetes education at a community hospital. PMID- 3683098 TI - A health-care industry trend analysis. PMID- 3683099 TI - Change and choice: new dimensions of private practice. PMID- 3683100 TI - Point: guidelines for emergency CT head scans. PMID- 3683101 TI - Counterpoint: to scan or not to scan. PMID- 3683102 TI - Management of head and neck tumors: Part I. PMID- 3683104 TI - Kawasaki syndrome: HUS and HSP complicating its course and management. PMID- 3683103 TI - HIV infection in Baltimore: antibody seroprevalence rates among parenteral drug abusers and prostitutes. PMID- 3683105 TI - Acute pancreatitis caused by biliary ascariasis. PMID- 3683106 TI - The utility of thresholds and the threshold utility. PMID- 3683107 TI - Clinical reasoning and cognitive processes. AB - Expected utility theory, and the Bayesian probability theory on which it is based, form the normative basis of most work in medical decision analysis. Recent work in the psychology of judgments and decisions indicates that people do not conform to the axioms of this theory and that these deviations occur in clinical reasoning as well as in the psychology laboratory. At issue is what to do now. The authors argue that the important next steps lie at the interface between descriptive, prescriptive, and normative accounts, all of which affect each other. They point to examples in which the simplest application of supposedly normative theory seems inappropriate, and suggest ways in which the tension between normative and descriptive models may be resolved. PMID- 3683108 TI - The importance of considering single testing when two tests are available. AB - When considering two dichotomous tests in combination for reaching a treatment decision, the choice between single and multiple testing depends, in part, on the pretest probability of disease. The authors show that two tests are never preferred to a single test for all disease probabilities, regardless of whether the two tests are performed in parallel or in series. PMID- 3683109 TI - Solid recommendations from soft numbers: the test/treatment decision. AB - The authors review the probability threshold approach to test/treatment decisions developed by Pauker and Kassirer, emphasizing that certain aspects of the nature of medical decisions call for a new approach. The utility threshold approach, while maintaining all the advantages of threshold methods in general, brings improvements. It diminishes the need to accurately assess one of the decision's parameters: the patient's utility for the outcome states. For a simple case of one disease with three outcome states (cured, diseased, dead) and one test, three utility thresholds are derived. The treat/no treat threshold, denoted by u, separates the utility space in two. If the patient's value for the diseased state is greater than u, the analyst can feel confident in recommending the patient forego treatment. Similar interpretations are developed for u1, the no treatment/test utility threshold (the value u must take, given a positive test result, for the patient to be indifferent between foregoing and receiving treatment), and u2, the test/treatment utility threshold (the value u must take, given a negative test result, for the patient to be indifferent between foregoing and receiving treatment. PMID- 3683110 TI - Multiple classification and receiver operating characteristic (ROC) analysis. AB - The receiver operating characteristic (ROC) curve was applied to observer performances in a multiple-alternative decision task. It was shown that the probability of correct classification, a performance criterion often maximized in multiple-classification procedures, corresponds to the area under an appropriately constructed ROC curve. Degrees of confidence in the observer's judgment of 0, 1, ..., 10 were used for both classification and ROC rating. To demonstrate the validity of the method, 1,190 photofluorograms were examined by experienced staff radiologists to identify four cardiovascular conditions distinguishable on the basis of images of structural elements of the contours of the heart and great vessels. The classification matrices for three radiologists who achieved high, medium, and low performance ratings in this experiment are reported. The ROC curves are symmetric, with their points located around the off diagonal. Differences between the overall probability of correct classification and the ROC curve index calculated from the same evaluator's data were very small, 0.004 to 0.011. PMID- 3683111 TI - ROC steady: a receiver operating characteristic curve that is invariant relative to selection bias. AB - This paper describes a simple method for constructing receiver operating characteristic (ROC) curves based on boundary conditions that restrict its theoretical shape. The resultant curve is identical to that for logistic distributions with equal variance. Although the underlying assumptions are highly restrictive, this method nevertheless possesses several attractive properties which are illustrated by its application to 2,567 patients undergoing a variety of noninvasive diagnostic tests for coronary artery disease: 1) the area under the curve is defined by a single parameter; 2) the associated standard deviation is analytically defined and readily computed; 3) the curve is completely invariant with respect to selection bias. PMID- 3683112 TI - Response to ROC steady. PMID- 3683113 TI - ROCky III. PMID- 3683115 TI - Graphic and tabular expressions of Bayes' theorem. PMID- 3683114 TI - Competing rates of risk in a patient with subarachnoid hemorrhage and myocardial infarction: it's now or never. PMID- 3683116 TI - [Use of re-infusions of isolated irradiated auto-blood for the correction of hematopoietic disorders]. AB - The effectiveness of re-infusions of auto-blood after isolated irradiation used for the correction of hemocytopenia developing during cancer chemotherapy was studied in 77 patients. 200 ml of the patient's blood was taken into a flask with a preservative and irradiated at an absorbed dose of 220 Gy on the RUM-17 x-ray apparatus. After irradiation the blood was reinfused to a patient. Posttransfusion reactions in the patients were absent. The efficacy and technical simplicity of the method of re-infusions of auto-blood after isolated irradiation make it applicable in clinical practice for the correction of hemopoietic disorders in cancer patients. PMID- 3683117 TI - [Effect of multi-fractionation in radiotherapy of rectal cancer]. AB - The paper is concerned with the substantiation of multifractionated gamma-beam therapy and the results of the use of this regimen in radiotherapy of rectal cancer. The authors have proposed the following scheme of irradiation: a single focal dose of 2 Gy is delivered not once a day as in routine fractionation but twice a day with a 4-hour interval. A radiotherapeutic course has been divided into 3 stages of 5 days each with 5-day intervals in-between. The course total focal dose was 60 Gy, "time-dose-fractionation" factors--140, the equivalent total dose--83 Gy. Statistically significant improvement of immediate results and a decrease in the number and expression of radiation reactions were noted. Earlier (as compared to routine fractionation) appearance of a symptomatic effect and the reduction of a time-period of a radiotherapeutic course in bed-days by 30% were also noted. PMID- 3683118 TI - [Hemostatic homeostasis following radio-synovectomy in rheumatoid arthritis]. AB - Platelet functional activity, plasma coagulation and fibrinolysis were studied in patients with rheumatoid arthritis (RA) against a background of various therapeutic modalities. Therapy with non-steroid anti-inflammatory agents resulted in an increase in platelet and plasma coagulating activity and inhibition of fibrinolysis. An insignificant rise of disaggregation of platelet aggregates was noted 2 weeks after intraarticular administration of 198Au against a background of therapy with non-steroid anti-inflammatory agents. Mydocalm incorporated in a dose of 1-2 mg/kg in the therapeutic scheme did not change significantly blood coagulation indices. PMID- 3683119 TI - [Computerized evaluation of the informativeness of radioimmunologic tests in the diagnosis of stomach cancer]. AB - Solution rules in the form of differential-diagnostic tables with coefficients of weight and threshold values of 16 different signs were obtained with the help of a computer EC-assisted algorithm of a generalized picture. These signs included tumor antigens, cyclonucleotides and hormones determined in the blood serum of healthy individuals, stomach cancer patients and patients with diseases of nonmalignant origin. These signs being of low informative value by themselves, in a combined use provided an opportunity to differentiate between "stomach cancer not cancer" with a sufficiently high degree of significance. PMID- 3683120 TI - [Advances and unsolved problems in the treatment of Hodgkin's disease]. PMID- 3683121 TI - [Study of the hepatobiliary system using 75Se-methionine in chronic hepatitis in remission]. AB - The investigation of 43 patients with diffuse liver diseases in remission has shown that the results of studies on the hepatobiliary system using 75Se methionine possess the highest informative value. These results were compared with those of a biochemical blood analysis and echolocation. In the absence of evident deviations from the results of biochemical blood tests and suspected diseases of the liver and biliary tracts the authors recommended first an investigation with methionine, and then depending on results, the use of other methods. PMID- 3683122 TI - [Lymphatic scanning in the diagnosis of tuberculosis of the male genital organs]. AB - Lymphoscanning was performed in 149 patients with tuberculosis and chronic non specific inflammatory diseases of the male sex organs. The patients were divided into 3 groups: I--73 patients with an active tuberculous process, II--22 patients with an inactive process, III--54 patients with chronic non-specific inflammatory diseases of the male sex organs. Intrafunicular (in the affection of the external sex organs) and paraprostatic (in the affection of the internal sex organs) administration of 198Au-comisole was developed and employed for lymphography followed by lymphoscanning 1 day after RP administration. The results of lymphoscanning have shown that the indices of the visualization of the groups of regional lymph nodes and the intensity of RP accumulation in them were the most informative. PMID- 3683123 TI - [Calibration of spectrometers for measuring irradiation of humans from incorporated potassium-40]. AB - Combined calibration of 3 spectrometers of human radiations of various design and control measurement of potassium in one and the same group of persons were performed. Causes of divergence were analysed and readings of instruments within +/- 5% were summarized. The importance of selection of a calibration phantom which was radiometrically adequate to the human body and a necessity of establishing correlations between phantom parameters and anthropometric data on man were shown. PMID- 3683124 TI - [Barrier function of the placenta and micro-distribution of 238Pu in the fetus placenta complex in the rat]. PMID- 3683125 TI - [Improving the retrieval of information from scientific research works in the field of medical roentgenoradiology]. AB - A subject thesaurus covering investigations pursued at the Moscow Research Institute of Roentgenoradiology (Ministry of Health of the RSFSR) has been worked out for data retrieval. Each subject heading is provided with indices of the International Classification of Inventions (MCI), national classifications of inventions (NCI), Universal Digital Classification (UDC), Branch Automated System of Scientific Medical Information (BASSMI), Medinform, and the State Automated System of Scientific-Technical Information (SASSTI). The subject thesaurus is necessary for the detection of relevant information in the BASSMI and Medinform data banks and in patent forms. PMID- 3683126 TI - [Radioimmunodetection of human colonic cancer transplanted into thymus-deficient mice using antibodies to the intestinal antigen]. AB - 131I-antibodies (Ab) to human organ-specific intestinal antigen--beta 1-MA (maconial antigen) were injected intravenously to nude mice to whom various human tumors including colon tumors had been transplanted. Ab distribution in recipient tissues and in tumors was determined over time with the help of a gamma-counter. Ab to beta 1-MA was shown to localize specifically in colon tumors. 131I-Ab accumulation in this tumor exceeded the background level in tumor-bearing tissues. The excess increased with time as a result of slower Ab clearance of colon tumors as compared to normal tissues. beta 1-MA was detected immunohistochemically in the mouse colon epithelium however elevated accumulation of Ab to beta 1-MA injected into the blood flow in the intestine was undetectable. PMID- 3683127 TI - [Effect of physical exertion on the status of the heart and central hemodynamics as affected by external (60Co) and internal (239PuO2) irradiation]. AB - Experiments were conducted on mongrel dogs aged 2 to 4 with the body mass of 15.1 +/- 0.9 kg. The animals were exposed to combined and isolated gamma-irradiation at a dose of 51.6 mC/kg and submicron 239PuO2 in the amount not less than 7 kBq/kg. Single circular irradiation was provided from 60Co gamma-sources at a dose rate of 1.03-1.3 mA/kg. 239PuO2 was inhaled 6 days after irradiation. 20 min. running on a treadmill with the speed of 4.7 km/h served as a physical exercise model. The dogs were examined 0.5, 1, 1.5 and 4 yrs. after the initiation of the experiment at rest and within 1 h after physical exercise. Methods of tetrapolar chest rheography and electrocardiography were employed. It was shown that in the combined effect of two radiation factors the rates of increase in the cardiac index were inhibited at the expense of physical exercise influence as compared to those in the isolated radionuclide effect and resulted from less "economical" heart action. PMID- 3683128 TI - [Use of the Elektronika B3-34 programmable microcalculator for radioimmunologic studies]. PMID- 3683129 TI - [Increasing the metronidazole content of tumors using pyrogenal hyperthermia]. PMID- 3683130 TI - [Search for optimum composition of radiopharmaceuticals for liver scintigraphy]. AB - The paper considers an opportunity of using a method of design based on a scheme of a complete factor experiment to find an optimum drug composition, citing by way of example, a process of development of a diagnostic agent for liver scintigraphy on the basis of the calcium-phytate complex labelled with 99mTc taking into account biological behavior of drugs of various composition. PMID- 3683131 TI - [Small-size betatron for electron therapy of surface tumors and its clinical evaluation]. AB - The paper is concerned with the physicotechnical characteristics of a small-size betatron (with the energy of 7 MeV) designed in the Tomsk Polytechnical Institute for therapy of patients with superficial malignant tumors. An electron beam with the energy of 7 MeV was produced on the small-size betatron, irradiation fields were formed, and absorbed dose distribution was studied. The efficacy of the use of the beam in 110 patients with superficial malignant tumors was analyzed. The use of electron beam radiation was found promising for therapy of patients with locally spread types of skin and lower lip cancers and breast cancer local recurrences. Complete tumor regression was noted in 75-90% of the patients. Intraoral cone electron therapy combined with 60Co-therapy of surgery was employed for early cancer of the oral cavity. PMID- 3683132 TI - [X-ray diagnosis of early radiation changes in intestines]. AB - X-ray examination of the colon in 102 patients and of the small intestine in 62 was performed during combined radiation therapy of cervical cancer and at different time after its discontinuation. Early radiation functional and morphological changes in the ileum and colon were detected. Radiation changes in the iliac mucosa were noted in 52% of the patients, changes of various degree in the rectal, sigmoid and cecal mucosa were noted in 41.2%. Moderate radiation changes in the ascending, descending and horizontal parts of the colon were noted in 10.7%. Early radiation intestinal injuries in the form of erosions and ulcers were revealed in 5.8% of the patients. In most of the patients radiation intestinal changes were without noticeable clinical manifestations. All these patients could be defined as a group at risk of developing late radiation changes. PMID- 3683133 TI - [Plutonium localization in the nuclear fraction of lung cells]. AB - Pu localization in the nuclear fraction isolated from rat pulmonary tissue cells was studied by histoautoradiography. It was found out that 24 h after intratracheal administration of Pu, 93.8% of the radionuclide (of the total number of tracks) were bound with nuclei. It was also shown that 64.8% of Pu were fixed by large nuclei, 42.2% by small nuclei. Pu content in nuclei varied within broad ranges: from single tracks up to high density "stellae". PMID- 3683134 TI - The present state of medical education in Britain. PMID- 3683135 TI - Self-directed learning to educate medical educators. Part 1: How do we use self directed learning? PMID- 3683136 TI - A writing curriculum for physician faculty members. PMID- 3683137 TI - Teaching medical students about other health professionals: an experiment in self directed learning. PMID- 3683138 TI - The case-based learning day: introducing problem-based learning into a traditional medical curriculum. PMID- 3683139 TI - The case presentation: teaching medical students writing and communication skills. PMID- 3683141 TI - The way we teach: topographical anatomy. PMID- 3683140 TI - Case presentation format and clinical reasoning: a strategy for teaching medical students. PMID- 3683142 TI - The organisation of clinical paediatric examinations. PMID- 3683143 TI - The finals examination in conservative dentistry. PMID- 3683144 TI - The potential use of the discouraging random guessing (DRG) approach in multiple choice exams in medical education. PMID- 3683145 TI - An inexpensive predictor of student performance on licensure examinations. PMID- 3683146 TI - Embryopathy: sowing the seeds of rejection. PMID- 3683147 TI - Effects of physical conditioning on the heart size and wall thickness of college women. AB - M-mode echocardiograms were obtained from 40 sedentary college women, 8 sprinters, 6 distance runners, 10 swimmers, 9 basketball players, 8 dancers, and 10 sedentary men (ages 19 to 31 yr). Treadmill stress tests were performed by all groups except the basketball players. The aerobic capacities of the athletes were 30 to 48% greater (P less than 0.05) than the sedentary subjects. The athletes exhibited trends toward higher than average left ventricular (LV) end-diastolic dimensions (7 to 25%), LV end-diastolic volumes (12 to 53%), stroke volume (13 to 52%), LV mass (11 to 42%), and left atrial dimensions (6 to 31%) when data were standardized for body surface area. A correlation (r = 0.323, P less than 0.05) was noted between LV mass index and maximal oxygen uptake when data were pooled. Ten sedentary women and ten age-matched sedentary men were endurance-conditioned by 10 wk of running. Both sexes increased maximal oxygen uptake approximately 20% (P less than 0.05) and exhibited similar changes in LV wall thickness, end diastolic dimension, end-diastolic volume, and mass. These changes regressed within 10 wk after the termination of conditioning. This study suggests that women athletes exhibit cardiac morphologic features which resemble that reported for their male counterparts and that the cardiac response of sedentary men and women to modest levels of endurance conditioning is similar. PMID- 3683148 TI - Comparison of ventricular volumes in normal and post-myocardial infarction subjects. AB - In an effort to determine left ventricular volume changes between upright rest and exercise, 15 male late post-infarction patients (group A) and 13 normal matched volunteers (group B) were studied. Patients were at least 12 months post cardiac event. Upright two-dimensional echocardiographic recordings were performed by the same cardiac sonographer using the apical four-chamber view at rest and immediately post-exercise after the subject reached 85% of measured maximal heart rate. Single-plane planimetry of the cross-sectional area was used for calculation of left ventricular volumes. Two subjects in each group failed to demonstrate adequate (i.e., measurable) echocardiograms and were excluded from the statistical analyses. Two-way analysis of variance for repeated measures was followed by the Newman-Kuels multiple comparison procedure to determine statistically significant differences between means (P less than 0.05). The results indicated no differences in any of the measured parameters at rest between the groups. Exercise values demonstrated a significant increase in end diastolic volume, stroke volume, and ejection fraction with exercise only in group B. End-systolic volume did not change in either group. Cardiac output and heart rate increased in both groups. These data suggest that in the upright position, cardiac output increases in normal males due to an increase in heart rate and stroke volume (increases in end-diastolic volume) and by increases in heart rate alone in the post-infarction group. PMID- 3683149 TI - Effect of muscle tension on the cardiovascular responses to lower body negative pressure in man. AB - The purpose of this investigation was to evaluate the effect of moderate (non hypertensive) levels of muscle tension on the cardiovascular responses to progressive lower body negative pressure (LBNP) in eight healthy male volunteers. Subjects were presented with progressive LBNP to -50 torr or the occurrence of vasovagal symptoms during three different levels of electromyographic activity in the lower limbs represented by the relaxed state, 5 and 10% maximal voluntary contraction. The same procedure was also performed at the same three levels of electromyographic activity in the arms with concomitant relaxation of the abdomen and lower extremities. In 75% of the subjects, pre-syncopal reactions were observed during the relaxed state while no pre-syncopal responses occurred during the elevated muscle tension levels. Both levels of muscle tension in the legs attenuated the LBNP-induced decrease in blood pressure (P less than 0.05). The effect of the 5% maximal voluntary contraction tension level appeared to be due to a compressive effect on the vascular tree, because similar levels of tension in the forearm had minimal effect on the blood pressure response to LBNP. In addition to a compressive effect, the 10% maximal voluntary contraction tension level appeared to induce a reflex stimulation of the heart as evidenced by an augmented heart rate response to LBNP and an increase in cardiac output. The muscle tension appeared to induce a mechanical compression of the vascular tree which was accompanied by somatopressor reflex responses, resulting in a maintenance of blood pressure that was primarily mediated by a maintained cardiac output. PMID- 3683150 TI - Plasma volume changes and cardiovascular responses associated with weight lifting. AB - Ten experienced weight lifters were studied to determine the influence of strenuous, free-weight, squat lift exercise on changes in plasma volume, mean arterial pressure, and the rate pressure product. After a 40-min postural adjustment prior to upright exercise, each subject completed eight sets of eight repetitions of the squat exercise at 55% of the one-repetition maximum. Electrocardiogram heart rate was monitored throughout the test, and blood pressure was determined at the completion of each exercise set. Arterialized capillary blood was drawn during sitting and standing pre-exercise and at the end of the second, fourth, sixth, and eighth sets for the measurement of hemoglobin, hematocrit, and plasma protein concentration, and after the last set for blood lactate. Five additional subjects participated in a postural control comparison. The results of the ANOVA showed a significant loss in plasma volume over the trials which was 2 1/2 times greater than for the control subjects (17.9 vs 7.7% loss) over the same period of time. Exercise rate pressure product increased by 2.85 times resting while only 1.1 times resting for the control subjects. An elevation in mean arterial pressure was found to be correlated to changes in plasma volume, r = -0.98. This study found that plasma volume is reduced while the rate pressure product is increased during the squat lift exercise. PMID- 3683151 TI - The effect of external pressure on intramuscular blood flow at rest and after running. AB - Local blood flow in the thigh was measured with 133Xe clearance technique in eight male distance runners after compression with a foam rubber compress and a standard elastic bandage. Two degrees of compression were tested, and an initial experiment with rested subjects was followed by a similar experiment immediately after running. Maximum compression exerted a cutaneous pressure of 85 (+/- 8) mm Hg and caused an immediate cessation of intra-muscular blood flow in the compressed area. Moderate compression gave a cutaneous pressure of 40 (+/- 5) mm Hg and resulted in a reduction of blood flow by approximately 50%. During compression, there were no significant differences in the blood flow of rested subjects compared to subjects immediately after running. In acute soft tissue injuries, a maximum compression bandage should effectively reduce or eliminate the formation of an intra-muscular hematoma, and an additive effect on blood flow of ice should not be expected. PMID- 3683152 TI - The effect of aerobic conditioning on venous pooling in the foot. AB - Nineteen fit college-age men were studied using foot (mid-arch) mercury-in silastic strain gauge plethysmography before and after an 8-wk aerobic conditioning (running) program. Foot volume changes were followed through two maneuvers: a 15-s Trendelenburg procedure (passive leg elevation with subsequent relaxation in the dependent position) and a 15-s dynamic dorsi-flexion/plantar flexion exercise and subsequent relaxation. The conditioning regimen consisted of running 40 min, 3 d.wk-1 and resulted in a 10% (P less than 0.01) increase in VO2max. Following this regimen, subjects exhibited an increased blood volume drainage during the Trendelenburg procedure (mean delta VT = 3.3 ml.100 ml-1 pre training, 3.8 ml.100 ml-1 post-training, P less than 0.05), but no significant change in delta VE (2.7 ml.100 ml-1 for all subjects). Muscle pump efficacy, defined as the ratio between delta VE and delta VT, did not change (64%). These data suggest that increased aerobic power via weight-bearing exercise training results in an increased foot venous pooling, but does not affect relative muscle pump function. This apparent increase in vascular pooling may be a physical response to the hypervolemia induced by endurance training, aiding in maintaining the constancy of vascular pressures. PMID- 3683153 TI - Exercise endurance time as a function of percent maximal power production. AB - To develop and validate a mathematical model of the relationship between endurance time (T) and power production, 15 male subjects were first tested for maximal power on an instrumented cycle ergometer at 60 rpm. On subsequent days, they were tested for T at various percentages of maximal power. Curves of T as a function of percent maximal power were curvilinear, and could be made to overlap among subjects by individual abscissa scaling, which resulted in the appearance of horizontal stretching or compression of the curves. The degree of stretching compression was defined by a statistically obtained scaling factor (F) which served to quantify each subject's endurance ability at fractions of maximal power. F was used to transform percent of maximal power to a scaled power variable (Psc). A curve of the form T = a(Psc)b was developed on 10 of the subjects and validated on the remaining five. Correlation between predicted and actual T was 0.967 for the fitting group and 0.980 for the validation group. A maximal power test and a single endurance test at 40 to 50% of maximal power were found to establish individual endurance-power curves fairly well, with a correlation of 0.828 between actual and predicted T. The combination of F and maximal power for a given physical activity provide a useful profile of an individual's ability to perform at constant exercise intensity. PMID- 3683154 TI - Effect of reduced training on muscular strength and endurance in competitive swimmers. AB - Following 5 months of competitive training (approximately 9,000 yards.d-1, 6 d.wk 1), three groups of eight male swimmers performed 4 wk of either reduced training (3,000 yard.session-1) or inactivity. Two groups reduced their training to either 3 sessions.wk-1 (RT3) or 1 session.wk-1 (RT1), whereas the third group (IA) did no training. Measurement of muscular strength (biokinetic swim bench) showed no decrement in any group over the 4 wk. In contrast, swim power (tethered swim) was significantly decreased (P less than 0.05) in all groups, reaching a mean change of -13.6% by week 4. Blood lactate measured after a standard 200-yard (183 m) front crawl swim increased by 1.8, 3.5, and 5.5 mM over the 4 wk in groups RT3, RT1 and IA, respectively. In group RT1, stroke rate measured during the 200-yard swim significantly increased (P less than 0.05) from 0.54 +/- 0.03 to 0.59 +/- 0.03 strokes.-1 while stroke distance significantly decreased (P less than 0.05) from 2.50 +/- 0.08 to 2.29 +/- 0.13 m.stroke-1 during the 4-wk period. Both stroke rate and stroke distance were maintained in group RT3 over the 4 wk of reduced training. Group IA was not tested for stroke mechanics. Whereas maximal oxygen uptake decreases significantly (P less than 0.05) over the 4 wk in group RT1 (4.75 to 4.62 l.min-1), no change in maximal oxygen uptake was observed in group RT3. These results suggest that aerobic capacity is maintained over 4 wk of moderately reduced training (3 sessions.wk-1) in well-trained swimmers. Muscular strength was not diminished over 4 wk of reduced training or inactivity, but the ability to generate power during swimming was significantly reduced in all groups. PMID- 3683155 TI - Specific characteristics of speed skating: implications for summer training. AB - Fourteen well-trained speed skaters performed all-out exercise tests during ice speed skating, low walking (walking-like movement in skating position), and dry skating (side to side deep sitting push-offs). These dry land training activities, widely used by speed skaters during the summer period, are compared to speed skating in relation to the concept of training specificity. Relevant physiological and biomechanical variables (derived from film and video analysis) were measured. The maximal oxygen uptake achieved in low walking (60.0 +/- 5.8 ml.kg-1.min-1) was not significantly different to that achieved during speed skating (62.1 +/- 6.9), but the maximal level attained in dry skating (48.4 +/- 5.5) was significantly less than both of these. The biomechanical differences measured are substantial. The forward directed push-off, the more dynamic movement pattern in hip and knee joints, and the use of plantar flexors during low walking are essentially different from speed skating. In dry skating, a more convulsive movement pattern due to the fixed push-off position compared to speed skating was found. The consequences of the typical skating position on the physiological responses is discussed. It is concluded that neither low walking nor dry skating can be considered as specific training activities for speed skaters. PMID- 3683156 TI - The assessment of children's physical activity: a comparison of methods. AB - The authors assessed the convergent validity and the sources of error in an electronic single-plane accelerometer (i.e., Caltrac Personal Activity Computer (Hemokinetics, Inc., Vienna, VA). The device was validated against observed all day physical activity levels of children in their natural environment. Thirty pre school children were observed in non-structured activity for periods of approximately 9 h while wearing the accelerometer. The results revealed moderately high but variable Spearman rank-order correlations between hourly readings of the accelerometer and the observational system (range of correlations = 0.62 to 0.95). An all-day accelerometer reading significantly correlated with the observational instrument (rho = 0.54). A step-wise regression analysis revealed that the best behavioral predictor of the all-day accelerometer reading was the observed behavior of walking, explaining 32% of the total variance. Older vs younger children (i.e., greater than 32.5 months), females vs males, and overweight (i.e., 75 percentile or greater) vs normal weight children tended to show higher correlations between direct observation and accelerometer readings. Implications of these findings and the utilization of the accelerometer in epidemiologic research are discussed. PMID- 3683157 TI - Provocation of epicondylalgia lateralis (tennis elbow) by power grip or pinching. AB - The etiology of epicondylalgia lateralis humeri (tennis elbow) is not fully understood. A biomechanical model is introduced for those types of epicondylalgia where damage at the origin of the wrist and finger extensor muscles is caused by overloading. It shows that grasping and pinching always cause a flexing moment at the wrist joint. To avoid flexion of the joint, there must be equilibrium of moments, which is attained by activity of the extensor muscles. Simultaneous measurements of force and electromyograms support the biomechanical model. PMID- 3683158 TI - Endurance training-induced hypervolemia in the horse. PMID- 3683159 TI - Does exercise stimulate protein breakdown in humans? Isotopic approaches to the problem. AB - Protein metabolism in exercise has been investigated for 100 yr, yet it is still unclear if exercise induces an increased rate of protein breakdown. We have recently addressed this general question in a series of experiments in human subjects using stable isotopic tracers. In this paper, the results of those studies are reviewed. We have found that in light exercise the de-carboxylation of leucine is increased. However, urea production is not increased correspondingly, nor is the rate of incorporation into urea of nitrogen from either leucine or lysine. Further complicating the picture is the fact that lysine de-carboxylation is not markedly elevated in exercise. From these studies, we must conclude that isotopic techniques which have achieved general acceptance in other circumstances cannot reliably be used to answer the question of whether exercise stimulates protein breakdown in humans. However, these methods do provide results which enable a better understanding of the metabolism of the individual amino acids in exercise. PMID- 3683160 TI - Vitamins and exercise--an update. AB - Although no conclusive evidence exists to suggest that vitamin supplementation improves athletic performance in nutritionally adequate individuals, exercise may increase requirements for certain vitamins in individuals with marginal vitamin stores. This review summarizes results from recent research studies of vitamins and exercise. Exercise increased the requirement for riboflavin and vitamin C; however, vitamin supplementation improved the ability to train only in vitamin C depleted individuals. No measurable effect of supplemental thiamin, riboflavin, or vitamin B6 on performance was observed in any of the reported studies. Exercise acutely affected vitamin B6 metabolism. Confusion regarding vitamin supplementation and exercise performance may stem from a lack of adequate research data. Recommendations for future research are presented. PMID- 3683161 TI - Sport psychology in the eighties: some current developments. AB - This symposium was designed to address a few of the more topical areas in the rapidly developing field of sport psychology. The areas represented (psychological aspects of sport participation in young athletes, self-regulation of sport behavior, and the psychophysiology of exercise) denote theoretical and methodologically sound contemporary sport psychology questions and methods. The symposium is overviewed in this paper and each topic briefly introduced. PMID- 3683162 TI - The effects of a static magnetic field on DNA synthesis and survival of mammalian cells irradiated with fast neutrons. AB - The effects of a static magnetic field (0.75 T) on DNA synthesis and survival were examined with Chinese hamster V79 cells in cultures with and without fast neutron irradiation. We found that the magnetic field applied alone for up to several hours did not cause a significant effect in either the rate of DNA synthesis or cell viability; the latter was assayed by colony formation. When cells were exposed simultaneously to the magnetic field and fast neutrons, the effects resembled those observed with neutrons alone. This was the case for both inhibition of DNA synthesis and cell killing. Cells irradiated first with neutrons followed immediately by 1 h of magnetic field exposure showed a dose survival response curve indistinguishable from that of neutrons alone. These data suggest that the biological effect due to the magnetic field is negligible and that the presence of the magnetic field either during or subsequent to fast neutron irradiation does not affect the neutron-induced radiation damage or its repair. PMID- 3683163 TI - A complication in prescan strategy when using surface coils. AB - The "prescan" process for setting the gain of an MRI scanner can be confounded by an effect arising from the spatial variation of the angle between the vector reception field of a local or surface coil and the excitation field of a whole body coil. It is most pronounced when the phase-encoding direction is parallel to the plane of the coil but not along the magnetic field. The largest signal is shown to reside in a data row that is shifted from the one that corresponds to zero phase-encoding gradient. The effect depends on the field-of-view and the dimensions of the receiving coil. Strategies are suggested by which manufacturers of scanners can cope with this intrinsic problem. In the meantime, users of surface coils should be aware of the difficulty. PMID- 3683164 TI - Measurement of lactate accumulation by in vivo proton NMR spectroscopy during global cerebral ischemia in rats. AB - In vivo 1H NMR spectral editing techniques were used to monitor cerebral lactate production during remotely controlled temporary forebrain ischemia in rats. The lactate/N-acetylaspartate (NAA) ratio correlated with survival after ischemia and subsequent reperfusion. The lactate/NAA ratio that predicted death after ischemia in rats was estimated to be approximately 1.3. PMID- 3683165 TI - Effects of slice selection and diffusion on T2 measurement. AB - This study examines slice selection and diffusion as sources of systematic error in T2 estimates obtained from imaging experiments. The selective refocusing pulses in a multislice, two-echo, spin-warp experiment cause slice profiles of sequential echoes to change in shape. This results in bias in T2 images calculated from the two-echo data set. A method to correct the bias is presented. The effect of diffusion on T2 images obtained with typical two-echo imaging sequences was found to be negligible. PMID- 3683166 TI - T2-weighted contrasts in rapid low flip-angle imaging. AB - Expressions for the contrast-to-noise (C/N) behavior in images obtained from rapid low flip-angle excitation pulses are derived, taking into account both T1- and T2-dependent contrasts. It is shown, and demonstrated experimentally, that images with T2-weighted contrasts can be efficiently acquired with such sequences, by a suitable choice of TR, TE, and tip angle. PMID- 3683167 TI - A phospholipid spin label used as a liposome-associated MRI contrast agent. AB - Given current clinical use of phospholipid bilayer structures (liposomes/vesicles) as nontoxic drug delivery vehicles, we have addressed the possibility of employing the phospholipids themselves as MRI contrast agents. To this end we have synthesized phosphatidylcholine with a nitroxide spin label replacing one methyl residue of the choline headgroup. This material was mixed with natural phosphatidylcholine in mole ratios from 1:50 to 1:1 and used to prepare sonicated unilamellar vesicles in saline. Expected structural features of these vesicles were verified by freeze-fracture electron microscopy. Proton T1 values of saline were readily decreased to less than 0.3 s by such preparations, yielding a net relaxivity of 0.6 M-1 s-1. The approach seems to be a realistic way of firmly associating a contrast agent of minimal toxicity with ordinary liposomes/vesicles in a manner that is not subject to leakage. PMID- 3683169 TI - Fast three-dimensional imaging of cerebrospinal fluid. AB - The RARE method is based on the principle of echo imaging to generate images with high T2 contrast. Since RARE is a fast imaging method, it can be used to acquire a high-resolution three-dimensional data set in less than 15 min. Thin slices from such a three-dimensional data set provide detailed information about the ventricular system. PMID- 3683168 TI - Natural abundance 13C NMR spectrum of glycogen in humans. AB - In vivo NMR has focused on using 31P and 1H to study metabolism in humans. Comparable 13C NMR studies have not been undertaken, presumably, because of its insensitivity. We report herein that the natural abundance 13C signal from C1 glycogen is observable. The ability to observe the signal opens new opportunities to noninvasively study glycogen metabolism in man. PMID- 3683170 TI - Localized imaging using stimulated echoes. AB - Stimulated-echo localized spectroscopy was combined with phase- and frequency encoding gradients to obtain "zoom" or magnified images of specific organs in situ. The technique requires neither surface coils nor an imaging coil arrangement that exclusively isolates the target organ. This technique can be readily applied to conventional spectrometer imagers that have limited computational capabilities. PMID- 3683171 TI - 31P magnetic resonance spectroscopy of traumatic spinal cord injury. AB - 31P magnetic resonance spectroscopy (MRS) was applied in vivo to study metabolic changes in spinal cord after experimental traumatic injury. Severe trauma, resulting in spastic paraplegia, caused an early and sustained loss of high energy phosphates with profound intracellular acidosis. Early metabolic changes after traumatic spinal injury may predict irreversible tissue damage. PMID- 3683172 TI - Detection of malignant tumors: water-suppressed proton nuclear magnetic resonance spectroscopy of plasma. AB - Average linewidths of methyl and methylene proton resonances of plasma lipoproteins from healthy controls and untreated cancer patients were measured in water-suppressed proton spectra obtained at 400 MHz. In contrast to a previous report (E. T. Fossel, J. M. Carr, and J. McDonagh, N. Engl. J. Med. 315, 1369 (1986] no statistically significant difference (P greater than 0.5) was found between the average linewidths in plasma samples from 20 normal controls (36.0 +/ 6.4 Hz) and 17 untreated cancer patients (34.6 +/- 6.3 Hz). When the effect of lactate was removed by graphical extrapolation, a small but marginally significant (P = 0.08) difference was observed between the average linewidths of the normal controls (35.1 +/- 5.8 Hz) and untreated cancer patients (31.8 +/- 5.2 Hz). However, there was still a large overlap between the two groups. In addition, substantial day to day variations in the linewidths of samples from the same individuals were observed. We conclude that these measurements cannot be used to detect cancer. PMID- 3683173 TI - Immunoproliferative small-intestinal disease: clinical features and outcome in 30 cases. AB - Experience with 30 patients with immunoproliferative small intestinal disease followed prospectively between 1971 and 1986 is described. All presented with malabsorption or growth retardation and had similar clinical, biochemical, and radiological features, irrespective of the presence of lymphoma or immunological abnormality. Alpha-chain disease protein was detected in 4 of the 11 patients who had a non-lymphomatous, predominantly plasmacytic infiltration of the small bowel; and in 5 of the 19 cases with diffuse intestinal lymphoma. The importance of exploratory laparotomy to include full-thickness intestinal biopsy in patients who have a benign infiltrate on peroral biopsy is demonstrated by the finding of lymphoma in operative specimens in 9 of 15 patients with mature, lymphoplasmacytic cells, and 5 of 8 patients with atypical, lymphoplasmacytic cells. The majority of patients with fully established benign disease, even those elaborating alpha-chain disease protein, appeared to have a good prognosis. No patient with immunoproliferative small intestinal disease developed immunologically demonstrated alpha-chain disease or frank lymphoma, when this was not found initially at explorative laparotomy. PMID- 3683174 TI - Semantic and spatial factors in environmental memory. PMID- 3683175 TI - Interevent differences in event memory: why are some events more recallable than others? PMID- 3683176 TI - Organization in autobiographical memory. PMID- 3683178 TI - The relationship between memory performance and the number of rehearsals in free recall. PMID- 3683177 TI - The effects of natural category size on memory for episodic encodings. PMID- 3683179 TI - The generation effect with homographs: evidence for postgeneration processing. PMID- 3683180 TI - The subjective familiarity of English homophones. PMID- 3683181 TI - Further explorations of the consistency effect in word and nonword pronunciation. PMID- 3683182 TI - Recall of common and distinctive features of verbal and pictorial stimuli. PMID- 3683183 TI - Exogenous growth hormone treatment alters body composition and increases natural killer cell activity in women with impaired endogenous growth hormone secretion. AB - In order to assess the potential relationship between human growth hormone (GH) and body composition (BC) and natural immunity (NI), we measured the effects of exogenous GH on fat weight (FW), fat-free weight (FFW), and the cytotoxic activity of natural killer (NK) cells in women with impaired GH secretion. Mean peak serum concentrations of GH in response to L-dopa/arginine stimulation were 6.2 +/- 1.1 (SEM) ng/mL in 6 untreated subjects (US) and 5.4 +/- 1.5 ng/mL in 6 GH-treated subjects (TS). Moreover, the pretreatment circulating levels of IGF-I were low in both groups (US 684 +/- 121 mU/mL and TS 583 +/- 83 mU/mL), and they correlated with pretest levels of NK cell activity (r = .59, P less than .05) when both groups were combined. The TS were given 700 micrograms of human GH IM for an average of 14 days while the US were studied in parallel without GH treatment. As measured by hydrodensitometry or skinfold anthropometry, FW decreased (26.1 +/- 6.8 kg to 23.8 +/- 6.3 kg, P less than .05) and FFW increased (44.9 +/- 3.3 kg to 46.2 +/- 3.8 kg, P less than .05) in the TS. In the US, there were no significant (P less than .05) changes in either FW or FFW. Using a standard 51Cr release assay to measure the specific lytic (SL) activity of NK cells, mean SL activity increased from 24.4 +/- 7.0% to 44.1 +/- 8.9% (P less than .05) in the TS, whereas levels in the US were not altered significantly (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683184 TI - Bone turnover and balance evaluated by a combined calcium balance and 47calcium kinetic study and dynamic histomorphometry. AB - Bone resorption and formation rates were evaluated at the organ level using calcium kinetic methods and at the trabecular bone tissue level using dynamic histomorphometry in 20 patients with various metabolic bone diseases (primary hyperparathyroidism (N = 9), hyperthyroidism (N = 6), and hypothyroidism (N = 5). Highly significant correlations were demonstrated between resorption and formation rates at organ level (r = .90, P less than .001) and at tissue level (volume referent) (r = .93, P less than .001), indicating a high degree of coupling between resorption and formation within the three disease states. Tissue level resorption rates (surface referent, as well as volume referent) both correlated significantly (P less than .01) to organ level resorption rate (r = .60 and r = .63, respectively). Fractional active resorption surface and cellular level resorption rate did not reveal significant correlations to calcium kinetic estimates. No correlation could be demonstrated between organ level mineralization rate and formative or labeled trabecular surfaces. However, all tetracycline based tissue level formation rates revealed highly significant correlations (P less than .01) to organ level mineralization rate (calcification rate, r = .71; surface referent bone formation rate, r = .59; volume referent bone formation rate, r = .68). Based on histomorphometric parameters for resorption and formation, actual and predicted tissue level trabecular bone balances were calculated. Both the actual and predicted bone balance correlated significantly to the organ level calcium balance (P less than .05). Correction for skeletal size based on BMC measurements did not improve any of the correlations significantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683185 TI - Protein metabolism in obese patients during very low-calorie mixed diets containing different amounts of proteins and carbohydrates. AB - To assess long-term nitrogen sparing capacity of very low-calorie mixed diets, we administered two isoenergetic (2092KJ) liquid formula regimens of different composition for 8 weeks to two matched groups of massively obese patients (group 1: proteins 60 g, carbohydrate 54 g; group 2: proteins 41 g, carbohydrates 81 g). Weight loss was similar in both groups. Daily nitrogen balance (g) during the second month resulted more a negative in group 2 with respect to group 1. However, within the groups individual nitrogen sparing capacity varied markedly; only a few in group 1 and one in group 2 were able to attain nitrogen equilibrium throughout the study. Daily urine excretion of 3-methylhistidine fell significantly in group 1 but did not change in group 2. Unlike total proteins, albumins, and transferrin, serum levels of retinol-binding protein, thyroxin binding globulin, and complement-C3 fell significantly in both groups but per cent variations of complement-C3 were more pronounced in the first group. Prealbumin levels fell persistently in group 1 and transiently in group 2. The results indicate that even with this type of diet an adequate amount of dietary protein represents the most important factor in minimizing whole body protein catabolism during long-term semistarvation in massively obese patients. Moreover, they confirm the possible role of dietary carbohydrates in the regulation of some visceral protein metabolism. PMID- 3683186 TI - Urinary excretion of 1-methylhistidine: a qualitative indicator of exogenous 3 methylhistidine and intake of meats from various sources. AB - In order to investigate whether the urinary excretion of 1-methylhistidine (1MH) might serve as an objective indicator of meat ingestion and exogenous 3 methylhistidine (3MH) intake, healthy subjects were fed an ovolactovegetarian diet. At five-day intervals they were given meat of different origin and 24-hour urinary excretions of 1MH and 3MH were determined. After beef intake there was a marked increase of 3MH and 1MH excretion. The elimination curves were found to follow first-order kinetics and to indicate similar elimination rates. 1MH was present in ten different types of meat analyzed. A strong linear relationship was found between increase in 3MH and 1MH excretion and the amount of chicken, pork, or plaice ingested. IMH may serve as an objective indicator of meat and exogenous 3MH intake, since it is present in meat, and, regardless of source, shows similar dose-independent kinetics, and has similar half-life to 3MH. PMID- 3683187 TI - Effect of cystine dimethylester on renal solute handling and isolated renal tubule transport in the rat: a new model of the Fanconi syndrome. AB - The effect of cystine dimethylester on the renal handling of phosphate, glucose, alpha-amino nitrogen, amino acids, and protein in vivo and on the uptake of lysine, glycine, taurine, and alpha-methyl glucoside by isolated renal tubules in vitro was studied in adult male rats. Parenteral administration of 400 mumol twice a day for four days of cystine dimethylester led to an increased urine volume, and excretion of phosphate, glucose, alpha-amino nitrogen, and the amino acids glutamine, proline, alanine, 1/2 cystine, ornithine, lysine, histidine, and glycine. Cystine dimethylester treatment did not affect the creatine clearance nor were any renal anatomic abnormalities noted. Intracellular cysteine, but not cystine, was increased in the kidney after the four days of treatment. Pre incubation of isolated renal tubules with 2 mmol/L cystine dimethylester for ten minutes markedly inhibited the uptake of 0.025 mmol/L lysine, 0.1 mmol/L glycine, 0.01 mmol/L taurine, and 2 mmol/L alpha-methyl glucoside. Incubation with 2 mmol/L cystine dimethylester for ten minutes did not affect the ability of the renal tubule to exclude trypan blue dye, although longer incubation times did lead to significant staining. The intracellular cystine concentration of the renal tubule did rise significantly after incubation with cystine dimethylester, a biochemical correlate of the human disease cystinosis. These studies indicate that cystine dimethylester can induce an experimental form of the Fanconi syndrome both in vivo and in vitro and offers a new model for investigating the mechanisms underlying this enigmatic disorder. PMID- 3683188 TI - L-carnitine treatment in the hyperlipidemic rabbit. AB - A study was designed to examine the hypolipidemic effect of L-carnitine treatment (4 weeks, 170 mg/kg/d) in rabbits fed a high fat diet (5% corn oil/0.5% cholesterol, w/w). Eight weeks of exposure to the high fat diet significantly increased plasma total cholesterol and triglycerides. VLDL associated triglycerides, cholesterol, apo-B, and total protein were also significantly increased with the diet. There was no change in HDL-cholesterol levels. Plasma concentration of carnitine (free, acyl, and total) all increased significantly with the high fat diet. The content of free, short-chain, and total carnitine were decreased in the liver whereas the content of long-chain acylcarnitines was increased. The diet generated a significant steatosis within the livers of these animals. Four weeks of treatment of L-carnitine reduced the extent of the liver steatosis and significantly decreased plasma total cholesterol, triglycerides, VLDL associated triglycerides, cholesterol, and total protein. HDL-cholesterol levels were unaffected by the treatment. All plasma fractions of carnitine (free, acetyl, acyl, and total) were significantly increased above those levels seen after 8 weeks of the high fat diet alone. The content of liver carnitine and its esters was normalized following treatment. The high fat diet decreased liver HMG CoA reductase activity and increased the activities of 7-alpha-hydroxylase and acylcholesterol acyltransferase (ACAT). L-Carnitine treatment blunted the magnitude of the diet induced increase in 7 alpha-hydroxylase activity, yet overall the activity still remained elevated relative to controls. ACAT activity increased (1.5 times) with the high fat diet and increased further (4.5 times) following carnitine treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683189 TI - Immobilized enzymes and cells. Part C. PMID- 3683190 TI - Immobilized and soluble site-to-site directed enzyme complexes composed of alcohol dehydrogenase and lactate dehydrogenase. PMID- 3683191 TI - Deblocking in peptide synthesis with immobilized carboxypeptidase Y. PMID- 3683192 TI - Application of immobilized aminopeptidases to the sequential hydrolysis of proline-containing peptides. PMID- 3683193 TI - Coimmobilized system of NAD with dehydrogenases. PMID- 3683194 TI - Immobilized active coenzymes. PMID- 3683195 TI - Polymerizable NAD derivative and model enzyme reactor with recycling of polyethylene glycol-bound NAD. PMID- 3683196 TI - Alcohol dehydrogenase coimmobilized with its coenzyme. PMID- 3683197 TI - Recycling of NAD(P) by multienzyme systems immobilized by microencapsulation in artificial cells. AB - Multistep enzyme systems can be immobilized in solution within semipermeable microcapsules. With the ability to recycle cofactors, a number of potentially useful systems have been made possible. Furthermore NAD+ can be retained inside the microcapsules by two approaches. (1) NAD+ can be linked to macromolecules such as dextran or polyethyleneimine. However, in this form, there are significant increases in steric hindrance and diffusion restrictions. (2) "Artificial cells" consisting of lipid-polyamide membrane microcapsules containing multienzyme systems, cofactors, and substrates can retain NAD+ in the free form. Analogous to the intracellular environments of red blood cells, free NAD+ in solution inside the microcapsules is effectively recycled by the multistep enzyme systems which are also in solution. Enzymes in the microcapsules are in high concentrations and in close proximity to one another. Any number and any concentration of different enzyme systems can be microencapsulated all within one artificial cell, within the limit of solubility of the total amount of enzymes. Products of sequential reactions inside the microcapsules are at much higher concentrations than outside. All these factors result in an optimal intracellular environment for multistep enzyme reactions. External substrates in the form of lipophilic or small hydrophilic molecules can equilibrate across the membrane to participate as initial substrates in the multistep reactions in the microcapsules. A number of potential applications are possible using this approach. The lipid-polyamide membrane artificial cell can also be used in basic research as a biochemical cell model for the simpler types of biological cells such as erythrocytes. PMID- 3683198 TI - Bioluminescent assays using coimmobilized enzymes. PMID- 3683199 TI - Continuous enzymatic transformation in an enzyme-membrane reactor with simultaneous NADH regeneration. PMID- 3683200 TI - Peptide growth factors. Part A. PMID- 3683201 TI - Isolation of the BSC-1 monkey kidney cell growth inhibitor. PMID- 3683202 TI - Solid-phase synthesis of insulin-like growth factor I. PMID- 3683203 TI - Derivation of monoclonal antibodies to human somatomedin C/insulin-like growth factor I. AB - Somatomedin C, also called insulin-like growth factor I (Sm-C/IGF-I), is a highly conserved polypeptide required for the proliferation of many cell types. Since several attempts in our laboratory to recover monoclonal antibody-secreting hybrids to this peptide by the direct fusion of hyperimmunized splenocytes with myeloma cells had been unsuccessful, we modified our approach by coculturing hyperimmunized BALB/c splenocytes and a small amount of the antigen for 5 days prior to fusion with the P3X63Ag.8.653 myeloma cell line. Of 88 microcultures at risk, specific antibody was detected in 24. Two clones were expanded in ascites fluid and characterized as to isotype, affinity, and specificity. Both were IgG1,kappa and bound human Sm-C/IGF-I with affinity constants of 1.09 and 1.01 X 10(10) liter/mol, respectively. Both clones were quite specific for Sm-C/IGF-I with inconsequential binding to insulin-like growth factor II, multiplication stimulating activity, any of the chymotryptic fragments of Sm-C/IGF-I, insulin preparations, hGH, hTSH, mEGF, or mouse albumin. In vitro boosting after primary in vivo immunization appears to provide monoclones of an IgG isotype in contrast to primary in vitro immunization, which reportedly favors an IgM isotype. The antibodies produced in this study have proved to be extraordinarily useful in defining the physiologic role of Sm-I/IGF-I with immunoneutralization techniques and in the purification of human Sm-C/IGF-I by affinity chromatography. PMID- 3683204 TI - Estimation of tissue concentrations of somatomedin C/insulin-like growth factor I. PMID- 3683205 TI - Human insulin-like growth factor I and II messenger RNA: isolation of complementary DNA and analysis of expression. PMID- 3683206 TI - Preparation of cartilage-derived factor. PMID- 3683207 TI - Purification of cartilage-derived growth factors. PMID- 3683208 TI - Assay of growth factor-stimulated tyrosine kinases using synthetic peptide substrates. PMID- 3683209 TI - Separation of multiple phosphorylated forms of 40 S ribosomal protein S6 by two dimensional polyacrylamide gel electrophoresis. PMID- 3683210 TI - Phosphopeptide analysis of 40 S ribosomal protein S6. PMID- 3683211 TI - Growth factor effects on membrane transport: uptake studies using cell cultures and isolated membrane vesicles. PMID- 3683212 TI - Biosynthesis of the epidermal growth factor receptor in cultured cells. PMID- 3683213 TI - Investigation of virus-like particles in Leishmania hertigi. AB - The promastigote forms of an isolate of Leishmania hertigi contain large numbers of virus-like particles (VLPs) in paracrystalline arrays. The VLPs are not present in the amastigote form and it was not possible to purify them from large amounts of the promastigotes. PMID- 3683215 TI - Health care delivery in Nicaragua and the effects of the war. PMID- 3683214 TI - Standardized nursing education: realization of a vision. PMID- 3683216 TI - Chemical properties of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton. AB - The aqueous layer was isolated from Leptospira interrogans serovar canicola strain Moulton by the hot phenol-water method. After ultracentrifugation, the precipitate was designated as lipopolysaccharide-like substance (LLS) fraction and the chemical composition was compared with that of bacterial LPS. The LLS fraction consists of 35.2% carbohydrate, 3.8% amino sugar, 36.4% lipid, 15.2% protein, and 0.3% phosphorus. Neutral sugars were detected as rhamnose, arabinose, xylose, 4-O-methylmannose, mannose, galactose, and a small amount of erythrose, fucose and glucose by gas-liquid chromatography (GLC), but 2-keto-3 deoxyoctonic acid was not detected in the LLS by thiobarbituric acid test and high voltage paper electrophoresis. Fatty acids detected by GLC were decanoic acid (C10: 0), dodecanoic acid (C12: 0), dodecenoic acid (C12: 1), tridecenoic acid (C13: 1), tetradecanoic acid (C14: 0), hexadecanoic acid (C16: 0), hexadecenoic acid (C16: 1), and octadecenoic acid (C18: 1). With SDS polyacrylamide gel electrophoresis, bacterial LPS showed many orderly bands, while the banding pattern of the leptospiral LLS was very simple. These findings demonstrate that the physicochemical properties and chemical composition of LLS fraction from Leptospira are different from those of LPS extracted from gram negative bacteria such as Enterobacteriaceae, and suggesting that Leptospira has no typical LPS. PMID- 3683217 TI - Effects of FLONLIZER, ultraviolet sterilizer, on Legionella species inhabiting cooling tower water. AB - Legionella pneumophila in sterile distilled water was not detected after ultraviolet irradiation by FLONLIZER, a new-type sterilizer, at a flow rate of 82.5 to 364.8 liters/hr. When irradiated by FLONLIZER at a flow rate of under 324.0 liters/hr, no viable cells of legionellae, other heterotrophic bacteria and bacterivorous protozoa were detected in the cooling tower water, which was found to contain L. pneumophila. No viable cells of L. pneumophila and L. bozemanii suspended in sterile distilled water were detected after the irradiation with UV doses of over 6.16 X 10(3) micro W.sec/cm2. At the irradiation of low UV-doses under 1.06 X 10(4) micro W.sec/cm2, the viable count of legionellae recuperated by photoreactivation from UV-damage increased with the exposure time under a white fluorescent lamp. However, in the samples irradiated with UV-doses of over 3.52 X 10(4) micro W.sec/cm2, equal to the FLONLIZER, legionellae did not recuperate even after 18 hr illumination with a white fluorescent lamp. FLONLIZER is thus expected to act as a sterilizer which can control the legionellae inhabiting cooling tower systems placed in outdoor space. PMID- 3683218 TI - Quantitative evaluation of colonizing ability of Vibrio cholerae O1. AB - A new method to evaluate the adhesive ability of Vibrio cholerae O1 was proposed. Broth cultured V. cholerae O1 and a piece of formalin-fixed rabbit intestinal wall were incubated together in KRT buffer and the number of adhered organisms was counted under a scanning electron microscope. This method was much less laborious than other methods that have been used so far, and most significantly, constant results were obtained in repeated experiments. The adhesive properties of toxigenic V. cholerae O1 evaluated by this method correlated well with its observed experimental pathogenicity. PMID- 3683219 TI - Oral immunization in adult mice to live and heat-killed Vibrio cholerae. AB - Effects of systemic and intestinal local immune responses in mice fed ad libitum and forcedly with live or heat-killed Vibrio cholerae on the elimination of vibrios from the intestine were investigated. In mice fed with live vibrios, ad libitum feeding could induce potential delayed-type hypersensitivity and rapid production of vibriocidal antibody in the serum whereas forcedly feeding suppressed the delayed-type hypersensitivity and retarded the antibody production. In contrast, when killed microorganisms were used as antigens, significant delayed-type hypersensitivity and rapid response of vibriocidal antibody were induced in forcedly fed mice although ad libitum feeding suppressed the induction of the delayed-type hypersensitivity and retarded the production of vibriocidal antibody. The elimination of vibrios from the intestine of mice was promoted in both mice groups fed ad libitum and forcedly with live vibrios but not with killed microorganisms. Total IgA in the intestinal contents of mice fed with live vibrios both ad libitum and forcedly were higher than those of mice fed with killed antigens. In addition, when the extracts of intestinal contents were absorbed by live antigens, IgA contents in mice fed with live vibrios were reduced more markedly than those in mice immunized orally by the feeding with killed antigens. These findings suggested that the elimination of vibrios from the organ was closely related to local IgA antibody response to heat-labile substance of live Vibrio cholerae. PMID- 3683220 TI - Antigenic variation of Newcastle disease viruses isolated from wild ducks in Japan. AB - Nineteen strains of Newcastle disease virus (NDV) isolated from wild ducks in Japan were placed into 4 distinct antigenic groups on the basis of their reactivities to 8 monoclonal antibodies against the HN molecule of NDV in hemagglutination inhibition tests. The NDV strains of duck origin were antigenically distinct from NDV-B1 and NDV-Miyadera originated from chickens, and varied in their virulence to chicken embryos. No apparent correlation was found between the antigenicity of the HN molecule and virulence. PMID- 3683221 TI - Mothers still a subject class. PMID- 3683222 TI - Pregnancy induced hypertension. PMID- 3683223 TI - Monitoring fetal heart rate by telephone. PMID- 3683224 TI - Threadworms. PMID- 3683225 TI - Perineal management--a midwifery skill under threat. PMID- 3683226 TI - Vitamins and minerals in the diet of the pre-school child. PMID- 3683227 TI - Early experience of a birthing room. PMID- 3683228 TI - Study of a couple's planned labour. PMID- 3683229 TI - Assessment of information given to mothers in labour. PMID- 3683230 TI - Influence of certain aspects of management of labour upon time and mode of delivery. PMID- 3683231 TI - A midwife's experience of active birth. PMID- 3683232 TI - From RCM Headquarters: new career structure proposed for clinicians. PMID- 3683233 TI - Influences on the examination performance of medical students: the pressure of other examinations. AB - Third-year medical students in Birmingham sat two examinations at times varying from 10 days apart to the same day. The influence of the proximity of two examinations on performance in the second examination is explored, together with other influences on examination performance. The sex of the student is the most significant discriminating factor, but proximity of examinations also affects marks in the second examination. We recommend, as did Birmingham students 10 years ago, that examinations should be separated by at least 5 days. PMID- 3683234 TI - Teaching in medicine: an elective course for third-year students. AB - An elective course titled 'Teaching in Medicine' was given to eight third-year medical students in response to the policy of the University of British Columbia medical school to expand its elective offerings. Course objectives focused on the skills that doctors need to fulfil their role of teacher of patients, students or colleagues. Instructional methods included directed reading, group discussions, microteaching, evaluation of videotaped samples of teacher behaviour, role play, demonstration and practice in developing and using audiovisual materials, and analysis of research in teaching and learning in medicine. The course culminated in each student presenting a major teaching session which was videotaped and assessed by the student and course teachers. All students rated the course as excellent. This paper describes the course and the teacher and student perceptions of it. The experience of this medical school is that a course of this nature is extremely worthwhile. PMID- 3683235 TI - A circulation model for teaching fluid dynamics in laboratory courses in physiology. AB - Medical students in Germany do not usually have a strong enough basis in physics to understand the mechanical and fluid dynamic problems involved in the physiology of the circulation. To alleviate this situation we developed a circulation model for use in laboratory courses in physiology. The following parameters can be varied: stroke volume, heart rate, systemic filling pressure, compliance of the arterial system (Windkessel), and total peripheral resistance. Arterial and venous pressure are recorded as a function of time. The following points are worked out by the students by adjusting the parameters of the model and by calculation: static equilibrium, transient and steady state in flow, compliance of the arterial and venous system, arteriovenous pressure difference, cardiac output, total peripheral resistance, regulation of cardiac output, pulse pressure amplitude, volume stored periodically in the arterial Windkessel, diastolic pressure decay of arterial pressure, diagnosis of arterial hypertension at different Windkessel compliances. PMID- 3683236 TI - Determination in rejected medical school applicants: a 10-year follow-up. AB - In view of low admission rate to medical schools, a large number of applicants are rejected annually. This population is denied the fulfillment of its occupational goal and must decide either to reapply to medical school or to choose a different occupational path. The present study focused on the possible career paths of rejected applicants, their persistence in reapplication and eventual admittance. The closeness to medicine of the alternative career was examined by two dimensions: the situs and the status. The career paths were viewed with respect to pre-admission cognitive criteria and occupational status of the alternative choices as compared to medicine. The study's random sample comprised one-third of the unaccepted applicants to the Tel-Aviv University School of Medicine for the 1970 academic year. The research follow-up (n = 208) of the applicants was conducted in 1981. The results showed a strong determination on the part of the unaccepted applicants to persist in their choice of medicine: 59% of the subjects reapplied and graduated from medical school either in Israel or in other countries. This group was found to be significantly more persistent in its number of reapplications than subjects who turned to an alternative career path. Thus, persistence was rewarding. When an alternative occupation was chosen, the tendency was towards careers unrelated to medicine but with a similarly high occupational status. No significant differences were found in the pre-admission cognitive criteria between those who studied medicine and those who chose an alternative career. Motivation and determination seemed to be the dominant factors in the attainment of one's choice of medicine as a profession. PMID- 3683237 TI - How do supervising doctors construe the medical student in clinical training? AB - Basing the prediction of student performance in medical school on intellective cognitive abilities alone has proved to be more pertinent to academic achievement than to clinical practice. A major obstacle to the development of adequate measures has been the elusive nature of requirements for successful clinical performance. The present study aimed at defining the relevant variables through an analysis of the concept of the medical student held by supervising doctors. With the aid of a methodology derived from cognitive-social psychology, the components of how training doctors of a large medical school evaluate their students were first explicated in structured interviews. In a second phase of the research, 18 supervisors in five major clinical departments rated their student supervisees on 15 obtained traits. Findings of trait correlations with an overall evaluation, as well as Guttman's 'Smallest Space Analysis' (1968), indicated a clear priority of cognitive-motivational traits in supervisors' judgements and reduced relevance of personal and interpersonal variables. Certain inconsistencies between avowed ideology of medical training and actual supervising practice could be detected. PMID- 3683238 TI - Pliable but not receptive: concerning the marginal influence of a medical psychology course on the socialization process of doctors. AB - Growth into a professional role requires absorption of knowledge, the learning of skills and the adoption of behavioural patterns and values which are part of a particular profession. In sociological literature this is described as the socialization/professionalization process. In this article the research literature which describes the process is reviewed. However, apart from the many positive aspects of adjusting and conforming, there are also more negative developments in the learning behaviour and attitudes of the future doctor. The Department of Medical Psychology in Amsterdam has structured its teaching programme--in part--to overcome or to decrease such tendencies. This article deals with those parts of the course which attempt to influence medical students' interviewing and interpersonal skills. Research into the effects of this teaching points to a marginal influence in both areas. The author looks for explanations for this, in the light of the research literature. In conclusion, the direction is indicated which could further increase the influence of the medical psychology course on future doctors. PMID- 3683239 TI - Performance of a dangerous answer subtest within a subspecialty certifying examination. AB - Previous studies have been reported suggesting that a population of candidates for specialty board certification can be identified who pass the certification examination but who give an unduly high number of 'dangerous' responses, indicating their acceptance of actively harmful actions. To confirm these results, a retrospective analysis was undertaken of a Subspecialty Board of Nephrology certification examination. Experts identified a subtest of 75 dangerous answers. The performance of candidates on this subtest was compared with their performance on the total examination. The subtest was moderately reliable, ranked criterion groups appropriately, had a correlation with the total test of 0.71, and using the standard used for the total examination, identified the certification status of 84% of candidates. However, when the correlation was corrected for unreliability, the correlation became 1.0, indicating that a dangerous answer subtest, at least in this examination and population, does not identify a unique population of certified but 'dangerous' doctors. PMID- 3683240 TI - Teaching of primary health care in practice: a model using local health centres in undergraduate medical education. AB - In Finland primary health care has a long historical background. The local communities, the state and the church have at various times and places been responsible for primary health care during the last few centuries. In 1972, a major reform took place when a new Primary Health Care Act came into force. In the same year two new medical faculties, at Kuopio and Tampere Universities, began to educate undergraduate medical students. In both of these new medical schools special attention was focused on the teaching of primary health care. Today practical teaching, which takes place at a primary health care centre, forms an important part of medical education at Kuopio University. This teaching of undergraduate students is part of the regular duties of general practitioners and public health nurses in the primary health care centres of eastern Finland that have agreed to collaborate in the teaching programme. The main principles are presented for the teaching programme in primary health care at the University of Kuopio. PMID- 3683241 TI - Practice preferences of primary medical care and traditional internal medicine house officers. AB - In an academic medical centre between 1980 and 1985, the attitudes, preferences and career goals of house officers in a primary medical care residency training programme were assessed at entry and at the end of each house officer year. Primary care trainees who went on to practise in a general medicine setting were compared to primary care trainees who subsequently received subspecialty training and also to traditional internal medicine trainees. House officers in the primary care programme generally maintained attitudes and preferences central to the practice of primary care, and scored significantly higher than traditional track house officers on attitudes and preferences compatible with the practice of medicine in a primary care setting. However, primary care house officers who later went into subspecialty training received scores similar to those of traditional track house officers on practice preferences relating to specialty care. There were no significant differences between primary care and traditional track house officers on standard measures of knowledge and clinical skill. PMID- 3683242 TI - Comparing modes of assessment. PMID- 3683243 TI - Arteriosclerosis in East Asians. AB - Arteriosclerosis is remarkably common in East Asians, both in the greater subcontinent and in their adopted countries after migration. Since arteriosclerosis is an acquired disease, East Asians must possess and preserve a common cultural practice related to the cause of arteriosclerosis and its complications. Therefore, an unusual opportunity is provided to examine East Asian migration and customs, especially diet, searching for a clue to the etiology of this disease. The result of this analysis provides additional support for a new theory proposing arteriosclerosis as an infectious disease caused by Cyanobacteria. PMID- 3683244 TI - The gamma loop, a model of glomerular hemodynamics. AB - A model of rubber tubing which imitates the vascular system of the glomerulus shows two flow anomalies: Partially closing down a clamp at the outlet increases perfusion. An increase in input pressure reduces perfusion. These anomalies are used to explain regulation of renal perfusion and autoregulation. PMID- 3683245 TI - Does the human body produce a substance similar to caffeine? AB - The idea that the human body probably produces a substance similar to caffeine came to my mind after reviewing the literature on the "restless legs syndrome". This syndrome is a disorder in which the afflicted individual feels an irresistible urge to move the legs, generally when sitting or lying down, and especially in bed, at night, just prior to getting to sleep. The patient has an extremely unpleasant deep discomfort inside the calves, requiring that the legs be moved(1). The "restless legs syndrome" has been described in persons who consume a lot of caffeine(2,3), in patients with iron deficiency anemia(4), and in patients with chronic renal failure(5). Since this syndrome occurs in persons who indulge in caffeine consumption as well as in patients with iron deficiency and patients with chronic renal failure, it is tempting to postulate that the human body- in cases of iron deficiency and chronic renal failure -produces a substance similar to caffeine. The following discussion entertains the hypothetical route that might be involved in the formation of this substance. PMID- 3683246 TI - Energy metabolism in the brain, adaptation towards starvation. AB - It is hypothesized that the brain's incapacity to utilize energy sources other than glucose and ketone bodies, constitutes a mechanism of protecting it from self degradation, at the expense of the rest of the body, during periods of starvation. This protection is based upon the brain's inability to catabolize substances of which it is built, for energy production. PMID- 3683247 TI - Identifying and circumventing the defect in Duchenne muscular dystrophy: clinical and biochemical restoration after practical intervention. AB - Both direct and indirect experimental evidence independently confirms that inadequate muscle purine biosynthesis is the basic lesion in Duchenne muscular dystrophy (DMD), and indicates the presence of a partial defect at adenylosuccinate synthetase. Purine conservation by oral allopurinol gives only limited improvement, but continuous infusion of adenylosuccinate causes an immediate and lasting increase in physical strength, with restoration to normal of the abnormal serum enzyme elevations, creatine/creatinine metabolism, heart rate and ECG. Mass screening of male infants by a blood-spot test is proposed for early detection and treatment of all DMD cases, including the mutant one third with no family history. Prospects of the eventual disappearance of clinical DMD now appear possible. PMID- 3683248 TI - Multiple sclerosis: a survey of alternative hypotheses concerning aetiology, pathogenesis and predisposing factors. AB - There is abundant evidence that both environmental and genetic factors play a role in the aetiology and pathogenesis of multiple sclerosis. Currently, a virus infection and an abnormality of T-cell function are favoured candidates for the environmental and genetic factors, respectively. However, as long as convincing evidence for a specific viral infection and for a pathogenetic role for T-cells in multiple sclerosis is lacking, it may be worthwhile to consider alternative hypotheses that have been proposed in recent years. These have been classified in this review under the headings Toxins, Dietary and Metabolic Abnormalities, Embolism, Infection, and Immunological Mechanisms. PMID- 3683249 TI - A proposed mechanism for the production of skeletalmotor positioning movements by the basal ganglia. AB - A programming function for the Basal Ganglia is suggested by implicating them in the production of positioning movements during directed skeletalmotor movements. The Association Cortex (especially the Prefrontal) sends a signal which is an internal representation of the desired end position of a movement to the Caudate. The Sensorimotor Cortex sends feedback from the commands for the primary movement to the Putamen, this representing the end position to be attained by the primary movement. These two signals are integrated in the Lateral Pallidal Segment producing a signal coding the magnitude and possibly the timing of positioning movements. This signal is sent to the Subthalamic Nucleus, which distributes it to the two main output areas of the Basal Ganglia and hence to affect motor and postural pathways. PMID- 3683250 TI - A model for metal selenide formation under biological conditions. AB - The essential trace element selenium is known to be capable of reducing the toxicity of heavy metals like cadmium(II), mercury(II) and silver(I). One mechanism by which this occurs is through the formation of an inert metal selenide like silver selenide. It is not clear why selenide should react in the body preferentially with silver(I) over other metals such as zinc(II), an ion which is capable of forming zinc selenide, and which is present at relatively high levels. A reaction is discussed which can account for the ability of mercury(II) and silver(I) to lead to metal selenide formation in preference to zinc(II). Metal ions which have a sufficiently large formation constant for the metal selenide can induce the disproportionation of elemental selenium to produce the metal selenide; both mercury(II) and silver(I) can induce such reactions, whereas zinc(II) cannot. If this model is accurate, it should provide a basis to predict which metal ions can produce metal selenides in the body, and which ions are unlikely to result in metal selenide formation. PMID- 3683252 TI - Is the effectiveness of cardiac ventricular defibrillation dependent upon polarity? AB - Studies involving 240 fibrillation-defibrillation episodes via epicardial patch electrodes in 21-27-kg dogs and 480 transthoracic episodes in 100-kg calves are reported. In dogs, 120 episodes involving shocks by a 3.7-A, 5-ms unidirectional rectangular wave of one polarity were interlaced with 120 similar episodes of the reverse polarity. When the upper right ventricular patch was positive with respect to the left ventricular apex patch, 85% of the episodes yielded defibrillation; 78% defibrillated with the reverse polarity. In one series in calves, 120 episodes involving shocks by a 42-A, 4-ms unidirectional rectangular wave of one polarity were interlaced with 120 similar episodes involving the reverse polarity. In a second series, 59-A, 4-ms shocks were employed. In the 42 A series, 38% of the episodes were successful when the upper right electrode was positive with respect to the electrode over the apex, and 28% were successful with the reverse polarity. Corresponding results in the 59-A series were 80% and 68%, respectively. On an unpaired basis, the three p values were 0.19, 0.14, and 0.04, respectively. On a paired basis, all three comparisons yielded significant differences (p less than 0.05). We conclude that in these cases, at least, there is a moderate dependence upon electrode polarity and that our results appear to warrant clinical studies. PMID- 3683251 TI - Transcranial stimulation of the motor cortex to produce motor-evoked potentials. AB - Monitoring of the nervous system using evoked potentials is a developing tool. A new evoked potential, the motor-evoked potential (MEP), based on a traditional test, uses brain stimulation to monitor the motor system. The MEP complements the existing modalities, which are wholly sensory. The MEP can be prompted by direct stimulation of the motor cortex, but, in a more general way, by transcranial stimulation. Electric or magnetic means can be used. One electric system involves placement of an electrode on the scalp over the motor cortex, paired with a cathodal plate on the roof of the hard palate. Recording electrodes are placed over the spinal cord, peripheral nerves, and muscles. Signals are recorded with a standard, evoked-potential, signal-averaging computer. Animal studies indicate that the electric stimulus activates primarily the pyramidal system to produce a descending evoked potential in the ventral and dorsolateral spinal cord. It is more sensitive than the sensory-evoked potential to spinal cord injury produced by the weight-drop method in cats. The peripheral nerve responses, much more sensitive to injury than the cord responses, can be altered by metabolic abnormalities. To date, the MEP has been an accurate indicator of ambulation in chronic spinal cord injury in animals. Parallel clinical development in the operating room has shown that the test is valuable; and it monitors brainstem or cortex manipulation, as well as cord manipulation. Safety studies are encouraging. The MEP is developmentally and technically demanding, but it has produced high quality signals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683253 TI - A survey of anesthesia support personnel in teaching programs. AB - Although the amount and complexity of equipment and supplies used in the practice of anesthesia have sharply increased in the past decade, the role of technical support personnel dealing with this technology has not been assessed. In an effort to determine that role, a questionnaire survey was conducted of the apportionment, direction, duties, and training of anesthesia technicians in teaching departments. Two-thirds of the inquiries were returned, disclosing a typical allocation of three anesthetizing locations (or 2000 annual anesthetics) per technician. A large majority of these departments have direct control of their technicians. Virtually all of these personnel are responsible for the routine upkeep and setup of anesthesia machines and monitors, although about one third perform more specialized clinical functions. The preparation of these technicians for their duties varies widely, with almost 60% high school graduates and virtually all reporting training as on-the-job. The authors conclude that the term "anesthesia technician" remains poorly defined and unstandardized, and that current diverse efforts to address this issue deserve attention. PMID- 3683255 TI - Problem-knowledge coupling. PMID- 3683254 TI - Laserthermia: a computer-controlled contact Nd:YAG system for interstitial local hyperthermia. AB - Contact Nd:YAG laser surgery is assuming a role of greater importance in endoscopic and open surgery, allowing coagulation, cutting, and vaporization with greater precision and safety. A synthetic sapphire probe allows a wider angle of irradiation and diffusion of low power laser energy (less than 5 W) using an interstitial technique for producing local hyperthermia. Sensors placed directly into surrounding tissue or tumor continuously monitor temperature, and a pertinent computer program produces a controlled and stable temperature (e.g., 42 degrees C) over a period of time (e.g., 20-40 min). The Laserthermia system (Surgical Laser Technologies, Inc., Malvern, PA), using the Nd:YAG laser, offers many advantages in the experimental and clinical treatment of carcinoma by local interstitial hyperthermia. PMID- 3683256 TI - Monitors, connectors, and electrocution. PMID- 3683257 TI - High failure rates in in-vitro fertilization treatments. PMID- 3683258 TI - Skin cancer--childhood protection affords lifetime protection. PMID- 3683259 TI - Disturbed behaviour in dementia--psychiatric or medical problem? AB - A retrospective clinical analysis of 70 demented patients who were admitted with disturbed behaviour to an acute psychogeriatric assessment and treatment centre revealed that 34.4% of patients had a significant untreated physical illness, 8.5% of patients were suffering from drug-induced toxicity and 11.4% of patients had a superimposed psychiatric illness. In only 39% of patients was progressive dementia alone considered an adequate explanation for their behavioural disturbance. The condition of the majority of patients improved significantly and they returned to the community. This study suggests that all patients with dementia with disturbed behaviour should be assessed carefully. In the majority, a clear treatable cause can be found and a good response can be attained with appropriate management. PMID- 3683261 TI - Does Australia need a centre for disease control? PMID- 3683260 TI - Acute diarrhoea in adults: a prospective study. AB - A prospective study of 74 adults with acute diarrhoea was carried out in Sydney in 1984-1985 to determine the infective agents that were involved and their relationship to clinical, epidemiological and laboratory features. Thirty-four potential pathogens were identified in 32 (43.2%) patients. These included, in order of frequency: Campylobacter spp., rotavirus, Clostridium difficile, Salmonella enteritidis, Aeromonas hydrophila, Vibrio parahaemolyticus, adenovirus, a small round virus and Giardia lamblia. A seasonal trend was noted; the majority of Campylobacter isolations occurred in summer. The patients with Cl. difficile infection formed a distinct group, and experienced a subacute onset of diarrhoea after antibiotic administration, with few systemic symptoms. Except in these patients, the clinical and epidemiological features, together with results of faecal microscopy, were not a reliable predictor of the nature of the pathogens that were identified. While most patients with diarrhoea can be treated supportively, stool culture is an important procedure in patients with severe or protracted illness when specific antimicrobial therapy is contemplated. PMID- 3683262 TI - The length of a piece of string. PMID- 3683263 TI - AIDS and insurance. PMID- 3683264 TI - Nutritional information and misinformation. PMID- 3683265 TI - Overinvestigation of aboriginal children with urinary tract infection? PMID- 3683266 TI - AIDS and the ethics of disclosure. PMID- 3683267 TI - Smoking-cessation programme. PMID- 3683268 TI - Epidural anaesthesia. PMID- 3683269 TI - Intrathecal baclofen for severe spasticity. PMID- 3683270 TI - Patients and transport. PMID- 3683271 TI - Playing dice with expert evidence. PMID- 3683272 TI - Gilbert's syndrome in identical twins. PMID- 3683273 TI - Postviral syndrome. PMID- 3683274 TI - SMR estimations in "prevalent" cohorts and "incident" cohorts. PMID- 3683275 TI - [Health risks in the biotechnology industry]. PMID- 3683276 TI - [Asbestos pollution in the Prato textile cycle: epidemiologic evidence]. PMID- 3683277 TI - [Asbestos pollution in the Prato textile cycle: environmental study]. PMID- 3683278 TI - [Community control of arterial pressure in industry: the Necchi project for the control of hypertension in the workplace]. PMID- 3683279 TI - [Occupational exposure to noise and hearing injury: estimation of the frequency of hearing loss among workers in Emilia-Romagna]. PMID- 3683280 TI - [Cardiorespiratory parameters and indices of renal function during a maximal exertion test]. PMID- 3683282 TI - [Data representation]. PMID- 3683281 TI - [Hydrofluoric acid poisoning: a proposal for therapy]. PMID- 3683283 TI - [Aromatase antagonists in breast cancer]. PMID- 3683284 TI - Prevention of bacterial endocarditis. PMID- 3683285 TI - Suction-assisted lipectomy. PMID- 3683286 TI - International Society of Pediatric Oncology. SIOP XIX meeting. Jerusalem, Israel, September 13-18, 1987. Abstracts. PMID- 3683287 TI - [Clinical evaluation of immunoglobulinemia E and the level of circulating immune complexes in the blood serum of patients with parasitic diseases. 2. Eosinophilia, blood immunoglobulin E and the levels of circulating immune complexes in onchocerciasis]. PMID- 3683288 TI - [Distribution of the ABO blood group system in onchocerciasis]. PMID- 3683289 TI - [New confirmation of the endemicity of visceral leishmaniasis in Eastern Crimea]. PMID- 3683290 TI - [Interrelations of Phlebotomus papatasi Sc. with different species of Leishmania]. PMID- 3683291 TI - [Essential problems in studying the epidemiology of malaria in the USSR]. PMID- 3683292 TI - [Distribution of Diphyllobothrium latum at the southern border of its areal]. PMID- 3683293 TI - [Predilection and localization of Nippostrongylus brasiliensis and Hymenolepis nana in mixed and single invasions of white mice]. PMID- 3683294 TI - [Isoenzyme analysis of the causal agent of toxoplasmosis (RH strain)]. PMID- 3683295 TI - [Pharmacokinetics of mebendazole in man]. PMID- 3683296 TI - [Blood-sucking mosquitoes (Culicidae, Diptera) in the Kindia district (Republic of Guinea). 1. Aedes genus]. PMID- 3683297 TI - [Hemolytic stability of erythrocyte membranes in patients with tropical malaria]. PMID- 3683298 TI - [Repellent action of Mannich bases on Ixodes persulcatus ticks]. PMID- 3683299 TI - [Analysis of the distribution by journal of publications concerning the principal parasitic diseases of man]. PMID- 3683300 TI - Scanned-projection digital mammography. AB - The effectiveness of film-screen mammography is limited by tradeoffs between latitude and contrast, film granularity, and the need to increase dose when antiscatter methods are used. We are currently developing a scanned-projection digital mammography (SPDM) system to overcome these limitations. The system consists of a pair of scanning slits, a high-resolution x-ray image intensifier tube, a linear photodiode array, and a digital display. The detective quantum efficiency of the SPDM system at spatial frequencies up to 3 cycles/mm is similar to that of mammographic film-screen combinations, but is lower at high frequencies. For low-contrast objects as small as 0.1 mm in diameter, the signal to-noise ratio is currently equal to that of optimally exposed mammographic film screen images for equal dose to the breast and superior for regions which would be underexposed or overexposed on film. This is achieved by the use of a low noise detector system, geometric magnification, and scatter elimination. Images of a contrast-detail phantom and excised breast tissue illustrate the superior contrast sensitivity of SPDM. PMID- 3683301 TI - Performance characteristics of a dual-energy detector for digital scan projection radiography. AB - An energy discriminating x-ray detector has been developed for dual-energy, scan projection digital radiography. The detector is comprised of a pair of x-ray intensifying screen/linear photodiode arrays, aligned one behind the other. Energy discrimination is achieved by employing a low atomic number phosphor in the front screen and a high atomic number phosphor in the back screen. The x-ray response, modulation transfer function, and defective quantum efficiency of the detector are reported along with the experimental methodology utilized for the measurements. Also presented is an analysis which indicates that in a typical patient's lung field, the detector can resolve the projected density (g/cm2) of a 3-mm-thick, 1-cm2 area of bone to better than 1.5%. PMID- 3683302 TI - Investigation of basic imaging properties in digital radiography. 11. Multiple slit-beam imaging technique with image intensifier-TV digital system. AB - We are developing a digital x-ray imaging system using a multiple slit assembly (MSA) and an image intensifier (II)-TV digital system. The advantage of this approach is that the scatter from an object and the veiling glare in the II-TV system can be reduced significantly while the x-ray utilization is maintained much better than that with a single slit-beam technique. The quality of reconstructed images is related to many parameters such as the slit width, the lead spacer, the number of image frames, and the reconstruction algorithm. In this study, reduction of scatter and veiling glare was measured quantitatively, and image artifacts were analyzed. It was found that the fraction of scatter and veiling glare can be reduced to approximately 0.01-0.1 by use of the MSA imaging technique, and that the magnitude of the fractions is strongly dependent upon the slit width and the lead spacer of the MSA used. The artifacts are caused by inaccuracies in the slit width, lead spacer, and scan motion, and by undersampling of image data. The overlap scanning technique was effective in reducing the magnitude of these artifacts in the reconstructed image. PMID- 3683303 TI - Imaging performance of a digital storage phosphor system. AB - The imaging performance of a storage phosphor system (SPS) for digital projection radiography is studied in which the x-ray image is temporarily stored in a light stimulable phosphor plate which is subsequently read out by a scanning laser beam. The imaging performance of this system has been analyzed for two types of imaging plates. The spatial resolution is described by the modulation transfer function and the signal-to-noise (S/N) ratios of the recorded image data are measured in terms of noise-equivalent quanta and detective quantum efficiency. Their dependence on detector entrance dose and spatial frequency is discussed. A detailed analysis of the different sources of image noise is given to outline the intrinsic features and limits of the system. Finally, the S/N behavior of the SPS is compared with published data of screen-film systems. PMID- 3683304 TI - X-ray attenuation properties of radiographic contrast media. AB - A systematic study has been carried out to assess the x-ray attenuation properties of various elements when used as radiographic contrast enhancing media. This study examines the effects of solutions of molecules with effective atomic numbers from 40 to 92 on the signal-contrast ratio of radiographic images formed with various input x-ray spectra on suitable phantoms. A variety of x-ray spectra were used including monoenergetic spectra, constant potential x-ray tube spectra, and computed tomography spectra. In addition, a computer model was used to predict the effects studied. In general, the computer model is able to accurately predict the resulting signal-contrast ratio for a given combination of contrast media, input x-ray spectra, and phantom composition. From these data and calculations, it may be possible to design new contrast media which are tailored to specific diagnostic imaging tasks. PMID- 3683305 TI - Effective atomic numbers for low-energy total photon interactions in human tissues. AB - A new method is introduced in which the total photon interaction cross sections per electron of human tissues are used to define effective atomic numbers for blood, bone, brain, fat, heart, kidney, liver, lung, muscle, ovary, pancreas, spleen, and water. These effective atomic numbers are equal within 4% from 10 to 200 keV in each soft tissue, whereas for bones of different chemical compositions the variation ranges from 2.86% to 5.03%. This effective atomic number definition is less energy dependent than a previous definition based on the total photon interaction cross section per atom averaged over all elements in the tissue, from which the computed effective atomic numbers varied by as much as 50% (in bone) as a function of photon energy over the energy range from 10 to 200 keV. PMID- 3683306 TI - Dosimetric evaluation in heterogeneous tissue of anterior electron beam irradiation for treatment of retinoblastoma. AB - A dosimetric study of anterior electron beam irradiation for treatment of retinoblastoma was performed to evaluate the influence of tissue heterogeneities on the dose distribution within the eye and the accuracy of the dose calculated by a pencil beam algorithm. Film measurements were made in a variety of polystyrene phantoms and in a removable polystyrene eye incorporated into a tissue substitute phantom constructed from a human skull. Measurements in polystyrene phantoms were used to demonstrate the algorithm's ability to predict the effect of a lens block placed in the beam, as well as the eye's irregular surface shape. The eye phantom was used to measure dose distributions within the eye in both the sagittal and transverse planes in order to test the algorithm's ability to predict the dose distribution when bony heterogeneities are present. Results show (1) that previous treatment planning conclusions based on flat, uniform phantoms for central-axis depth dose are adequate; (2) that a three dimensional heterogeneity correction is required for accurate dose calculations; and (3) that if only a two-dimensional heterogeneity correction is used in calculating the dose, it is more accurate for the sagittal than the transverse plane. PMID- 3683307 TI - The direct determination of dose-to-water using a water calorimeter. AB - A flexible, temperature-regulated, water calorimeter has been constructed which consists of three nested cylinders. The innermost "core" is a 10 X 10 cm right cylinder made of glass, the contents of which are isolated from the environment. It has two Teflon-washered glass valves for filling, and two thermistors are supported at the center by glass capillary tubes. Surrounding the core is a "jacket" that provides approximately 2 cm of air insulation between the core and the "shield." The shield surrounds the jacket with a 2.5-cm layer of temperature regulated water flowing at 51/min. The core is filled with highly purified water the gas content of which is established prior to filling. Convection currents, which may be induced by dose gradients or thermistor power dissipation, are eliminated by operating the calorimeter at 4 degrees C. Depending upon the power level of the thermistors, 15-200 microW, and the insulation provided by the glass capillary tubing, the temperature of the thermistors is higher than that of the surrounding water. To minimize potential errors caused by differences between calibration curves obtained at finite power levels, the zero-power-level calibration curve obtained by extrapolation is employed. Also the calorimeter response is corrected for the change in power level, and therefore thermistor temperature, that follows the resistance change caused by irradiation. The response of the calorimeter to 4-MV x rays has been compared to that of an ionization chamber irradiated in an identical geometry.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683308 TI - Dose distributions in regions containing beta sources: plane interface in a homogeneous medium. AB - An analytic model to calculate dose distributions in regions containing beta sources is developed along with a solution for the dose distribution in an infinite, homogeneous medium in which there is a uniform, monenergetic, isotropic source distribution on only one side of a plane. Comparisons with published Monte Carlo calculations are made. PMID- 3683309 TI - Dose distributions in regions containing beta sources: small scale nonuniformities. AB - An analytic model for the calculation of dose in regions containing slightly nonuniform distributions of beta sources, and a solution for the dose distribution in an infinite, homogeneous medium with a uniform, monoenergetic source distribution and a sinusoidal perturbation of the source are presented. PMID- 3683310 TI - Dose distributions around cylindrical 241Am sources for a clinical intracavitary applicator. AB - Encapsulated, cylindrical sources containing 2, 5, and 8 Ci of 241Am have been designed and fabricated for intracavitary irradiation of uterine cancers. Exposure rates in air and dose rates in water around these sources have been measured using an ionization chamber and a lithium fluoride thermoluminescent dosimetry system. Dose rates in water at a distance of 2.5 cm from the source center along a direction transverse to the source axis were found to be 10.4, 24.3, and 23.3 cGy/h for the 2-, 5-, and 8-Ci sources, respectively, using an ionization chamber. Under the same conditions, the thermoluminescent dosimetry system yielded the values of 10.3, 23.1, and 22.3 cGy/h. It was observed that the ratio of dose-to-water and exposure in air is sensitive to the scattering geometry and source geometry in the case of 241Am photons. This ratio was found to increase substantially as conditions of full scattering were approached. A three-dimensional integration model was employed for the determination of dose distributions around these sources. Results of this dose computation model have been compared against the measured data and were found to be in good agreement with each other. Average deviations of calculated data from measured data were in the range of 0.2 to 0.5 cGy/h and larger deviations were observed in the paraxial region, where the effects of oblique filtration are more severe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683311 TI - Advances in analytical techniques for neutron capture therapy: thin layer chromatography matrix and track etch thin layer chromatography methods for boron 10 analysis. AB - A new track etch autoradiographic technique for quantitating boron-10 containing compounds used for neutron capture therapy is described. Instead of applying solutions of Cs2B12H11SH and its oxidation products directly to solid-state nuclear track detectors, diethylaminoethyl cellulose thin layer chromatography (TLC) plates are utilized as sample matrices. The plates are juxtaposed with Lexan polycarbonate detectors and irradiated in a beam of thermal neutrons. The detectors are then chemically etched, and the resultant tracks counted with an optoelectronic image analyzer. Sensitivity to boron-10 in solution reaches the 1 pg/microliter level, or 1 ppb. In heparinized blood samples, 100 pg boron 10/microliter are detected. This TLC matrix method has the advantage that sample plates can be reanalyzed under different reactor conditions to optimize detector response to the boron-10 carrier material. Track etch/TLC allows quantitation of the purity of boron neutron capture therapy compounds by utilizing the above method with TLC plates developed in solvent systems that resolve Cs2B12H11SH and its oxidative analogs. Detectors irradiated in juxtaposition to the thin layer chromatograms are chemically etched, and the tracks are counted in the sample lane from the origin of the plate to the solvent front. A graphic depiction of the number of tracks per field yields a quantitative analysis of compound purity. PMID- 3683312 TI - Wobbler facility for biomedical experiments. AB - A system for spreading relativistic heavy ion beams into large uniform radiation fields has been developed. The charged particles passing through the system are deflected into azimuthally symmetric distributions which can then be superimposed to produce dose distributions as large as 30 cm in diameter with less than +/- 3.5% variation in uniformity. PMID- 3683313 TI - Total attenuation coefficients and scattering phase functions of tissues and phantom materials at 633 nm. AB - Measurements have been made of the total attenuation coefficient sigma t and the scattering phase function, S(theta), of 632.8 nm of light for a number of animal model tissues, blood, and inert scattering and absorbing media. Polystyrene microspheres of known size and refractive index, for which sigma t and S(theta) can be calculated by Mie theory, were used to test the experimental methods. The purpose of the study was to define typical ranges for these optical properties of tissues, as a contribution to the development of experimental and theoretical methods of light dosimetry in tissue, particularly related to photodynamic therapy of solid tumors. The results demonstrate that, for the representative tissues studied, the total attenuation coefficients are of the order of 10-100 mm 1, and that the scattering is highly forward peaked, with average cosine of scatter in the range 0.6-0.97. PMID- 3683314 TI - A stimulated echo artifact from slice interference in magnetic resonance imaging. AB - When multiple slices are imaged with a short time between slice acquisitions, a disturbing line artifact along the direction of frequency encoding is often seen across the center of the images. The artifact consists of alternating bright and dark pixel intensities. In this paper, we show that the artifact is due to slice interference, and is caused by stimulated echoes that are produced in the regions of overlap between slices. A theoretical analysis of the formation of these stimulated echoes leads to ways of reducing the artifact, which are verified experimentally. The artifact can be suppressed most conveniently by extending the duration of the read gradient beyond the sampling window. PMID- 3683315 TI - Constrained least-squares restoration of nuclear medicine images: selecting the coarseness function. AB - Image restoration using the constrained least-squares (CLS) method theoretically adapts to the image being processed. In addition, it only requires knowing the modulation transfer function of the imaging system when applied to nuclear medicine images. Prompted by these observations, a systematic evaluation of the effects of the form of the "coarseness function" [C(f)] used by the CLS method has been conducted. Nine C(f)'s are evaluated using an observer preference and a normalized mean-squared error (NMSE) criterion. This evaluation is conducted for three modulation transfer functions and a wide range of count levels. The results of the subjective studies support using the form of C(f) which has been most widely employed in previous studies, i.e., the form designed to minimize the energy in the second derivative of the restored image. A different form of C(f) is generally found to be optimal by the mean-squared error criterion. The CLS method is then compared to: (1) no processing, (2) count-dependent smoothing, and (3) count-dependent Metz restoration. When evaluated using objective measurements of error and contrast, the CLS method is found to be slightly inferior to the best method, Metz restoration. However, CLS restoration is found to be equal to or better than the other methods when judged by the results of observer preference studies. PMID- 3683316 TI - Reduction of pulsed gradient settling time in the superconducting magnet of a magnetic resonance instrument. AB - The implementation of electronic compensation for eddy currents to reduce the gradient settling times on a superconducting magnet is described. Field plots inside the magnet indicate the importance of assessing the field changes at several positions in the magnet. The effect of an asymmetry between the gradient coil system and the cryostat is demonstrated. A modified compensation circuit is described to overcome this mechanical asymmetry. PMID- 3683317 TI - A new calibration phantom for quantitative computed tomography. AB - We report on a new calibration phantom for quantitative computed tomography which has been improved with respect to reference materials and geometrical setup. Instead of liquid calibration solutions, we use polyethylene-based water- and bone-equivalent plastics. The size of the phantom is considerably reduced by using only two samples. This design guarantees long-term stability and it offers advantages with respect to radiation geometry. PMID- 3683318 TI - The development of a xenon/computed tomography cerebral blood flow quality assurance phantom. AB - A simple, easy to use, quality assurance and performance test phantom was developed for the xenon/computed tomography (CT) cerebral blood flow method. The phantom combines an inhalation system which allows for the simulation of xenon buildup or washout in the arterial blood as well as a multisection translatable cylinder in which several sections can be scanned during a preselected protocol to simulate the CT enhancement in brain tissue during a study. The phantom and scanning protocol are described and their use is demonstrated. The results compare favorably to the theoretically expected fast, intermediate, and slow "flow" values designed into the phantom. PMID- 3683319 TI - Patient dose measurements in photon fields by means of silicon semiconductor detectors. AB - Semiconductor detectors based on p-type silicon and designed for in vivo measurement of entrance dose at the reference point from photon radiation fields, are described. To estimate the absorbed dose at the reference point from measurements with a thin detector, field-size dependent correction factors must be applied to the reading, as the shape of the dose buildup curve varies with field size. To decrease or avoid field-size dependent correction factors, the detector can be covered with a buildup cap. The presence of such a detector will cause perturbation of the radiation field. Therefore, the design of a detector, irrespective of its type, intended for patient dosimetry involves a compromise between minimizing the radiation field perturbation and minimizing field-size dependent correction factors. Detectors with three different buildup caps were designed to cover the energy range from cobalt-60 to 16-MV x rays. The three different detector types were investigated with respect to their signal dependence on field size, field perturbation, and directional dependence. A summary of radiation damage effects on sensitivity, and of sensitivity variation with temperature is also presented. PMID- 3683320 TI - Performance characteristics of an orthovoltage x-ray therapy machine. AB - Performance characteristics sufficient to provide physical data base specific to the Siemen's Stabilipan 2 orthovoltage x-ray therapy machine are presented. Operating conditions covering the working range of the unit from 100 to 300 kVp are selected. Beam quality, output, the central axis depth dose, relative output factors, field flatness, uniformity index, and filtration characteristics of the beams are studied. Selected results are reported. PMID- 3683321 TI - Dosimetric aspects of a rotating beam splitter used in tangential field breast treatment. AB - A rotating beam splitter was designed and fabricated for use in treating tangential breast fields on an AECL Theratron-80 cobalt teletherapy unit. Its dosimetric properties were studied using a 0.6-cm3 Baldwin-Farmer ionization chamber with Keithley electrometer and a Scanditronix RFA-3 three-dimensional water phantom scanner with semiconductor detector. An aluminum plate, which held the semicircular rotating 5-HVL (half-value layer) lead block, extended to the phantom surface (80-cm source-surface distance). The beam was blocked directly along the central axis and also at distances up to 7.5 mm off-axis, corresponding to the projected extent of the 1.5-cm-diam source. The penumbra at the central ray and at each off-axis point was measured at dmax and at 5-cm depth in water. A reduction in the penumbra from 8 to about 2 mm for 20 X 20 cm2 beam was observed regardless of the off-axis distance of the block. Isodose distributions obtained for various field sizes indicated that the percent depth doses of the split fields agree well with the equivalent squares of the irradiated field sizes. Output measurements in water and in air indicated that scatter from the aluminum plate more than compensates for the reduction in backscatter factor, due to the decrease in irradiated area when the beam splitter is used. Isodose curves in various planes were obtained at clinically useful rotational angles of the beam splitter. Computer generated isodose curves have been obtained that match the measured curves to be used in treatment planning. PMID- 3683322 TI - [Course and treatment of patients with acute transmural myocardial infarct (Q infarct) in a community hospital. II: Results and acceptance of a standardized intensive therapy protocol]. PMID- 3683323 TI - [Rare differential diagnosis of chronic inflammatory bowel disease: Kohlmeier Degos syndrome (papulosis atrophicans maligna)]. PMID- 3683324 TI - [Limits of intensive care medicine]. PMID- 3683325 TI - [Candida infection with tricuspid valve endocarditis and glomerulonephritis]. PMID- 3683326 TI - [Clinical significance of the ISA (intrinsic sympathomimetic activity) of the beta blocker carteolol]. PMID- 3683327 TI - [Effect of Clostridium difficile toxin on human large intestine motility. In vitro studies]. PMID- 3683328 TI - [Conduction anesthesia by cold block. A new possibility in the treatment of chronic pain]. PMID- 3683329 TI - [Chronic upper abdominal pain with iron-deficiency anemia and analgesic-induced hemorrhaging stomach ulcers: duodenal wall carcinoid without flush symptoms]. PMID- 3683330 TI - [Small primary rectal cancer]. PMID- 3683331 TI - [Genetics of Crohn disease. A family study of 265 patients with Crohn disease]. PMID- 3683332 TI - [Clinicopathologic conference. Acute abdomen with a space-occupying lesion in the area of the epigastrium: primary stenosing duodenal cancer with spontaneous gastrorrhexis]. PMID- 3683333 TI - [Naturopathy and natural science medicine]. PMID- 3683334 TI - [Alkaptonuria and ochronosis]. PMID- 3683335 TI - [Endoscopic laser ablation of a stomach neurinoma]. PMID- 3683336 TI - [Conservative treatment of peptic esophageal stenoses with endoscopic bougienage- an effective and safe procedure]. PMID- 3683337 TI - [Oral iron therapy: preparations with rapid or delayed iron liberation?]. PMID- 3683338 TI - [Thoughts on the phenomenon of diagnosis]. PMID- 3683339 TI - [Is primary hyperparathyroidism a risk factor for osteoporosis]. PMID- 3683340 TI - [Recurrent thrombophlebitis, pneumonia and neurologic focal symptoms in a 48-year old male]. PMID- 3683341 TI - [Therapy of sinus thrombosis in congenital protein C deficiency]. PMID- 3683342 TI - Homeless women: a context for health planning. AB - Although the growth and spread of homelessness in America is beginning to receive sustained public attention, few professional contributions acknowledge--much less deal with--gender differences. This analysis of an array of current literature explores dimensions of homelessness among women as an exceedingly complex sociological phenomenon with devastating effects. The health problems of these women are profound and multivariate events. Health planning must address the comprehensiveness and continuity of their needs. PMID- 3683343 TI - Primary care delivery in the United States and four northwest European countries: comparing the "corporatized" with the "socialized". AB - Primary care--often considered the weak link in the United States health care delivery system--is the focal point of several European systems. Thoughtful analysis of structural and service differences and similarities among these approaches--whether "corporatized" or "socialized"--reveals areas for helpful innovation in the United States. Matters of access to and continuity of services, preventive care for children, long-term care, and accountability are especially relevant for primary care in an American context. PMID- 3683344 TI - Nerve growth factor influences neurobehavioral development of newborn mice. AB - Thirty-six male pups of the CD-1 outbred strain received from postnatal day 2 to day 10 a daily subcutaneous injection of either highly purified murine Nerve Growth Factor (NGF; 5 mg/kg), cytochrome c (5 mg/kg), or saline solution. NGF treated pups showed a slight, but significant, reduction in body weight gain and a concomitant acceleration in the appearance of early signs of neurobehavioral maturation such as righting reflex, cliff aversion, and response to tactile stimulation of the perioral area. Other responses, including the ultrasonic vocalization pattern on day 7, were unaffected or affected to a lesser extent. PMID- 3683345 TI - Prenatal alcohol exposure and thermotaxic behavior in neonatal rats. AB - The effect of prenatal alcohol exposure on thermotaxic behavior was investigated in 5-day-old rat pups. Pregnant dams were administered a liquid diet which contained 35% ethanol-derived calories (35% EDC) on days 6 to 20 of gestation. Two control groups were included: a liquid diet control which was pair-fed and had sucrose substituted for ethanol (0% EDC), and a group fed standard lab chow (LC) throughout pregnancy. Pups from each of these prenatal treatments were tested on a thermal gradient (thermocline). On each of 5 trails, pups were placed in the cool end of the thermocline and their position along the gradient was measured after 10 min. All prenatal treatment groups displayed thermotaxic behavior by moving towards the warm end. However, pups in the 35% EDC treatment group moved significantly further towards the warm end in the later trials. Despite their position on a warmer surface, their body temperature did not rise concurrently. Thermoregulatory deficits caused by prenatal alcohol exposure might account for these results. PMID- 3683346 TI - Cocaine use in pregnancy: perinatal morbidity and mortality. AB - With the increasing use of cocaine in the United States, there has been growing concern regarding its effects on the fetuses and neonates of pregnant cocaine abusers. Fifty-two cocaine-using women enrolled in a comprehensive perinatal addiction program were evaluated and compared with 73 women who had used narcotics in the past and were maintained on methadone during pregnancy. The groups were similar in maternal age, socioeconomic status, number of pregnancies and cigarette, marijuana and alcohol use. The cocaine-using women had a significantly higher rate of premature labor, precipitous labor, abruptio placentae, fetal monitor abnormality and fetal meconium staining than the women in the methadone group. Neonatal gestational age, birth weight, length and head circumference were not affected by cocaine use compared to methadone use. However, the Brazelton Neonatal Behavioral Assessment Scale revealed that infants exposed to cocaine had significant depression of organizational response to environmental stimuli (state organization) when compared to methadone-exposed infants. In another aspect of the study, an increased rate of SIDS (15%) was found for 66 cocaine-exposed infants as compared to a 4% rate of SIDS in 50 methadone-exposed infants. PMID- 3683347 TI - Cocaine abuse in pregnancy: effects on the fetus and newborn. AB - The outcome of infants born to cocaine-using drug dependent women was compared to that of infants of non-cocaine using drug dependent and non-drug dependent women. The study population included 150 pregnant women: 50 women used heroin and methadone plus cocaine, 50 used heroin and methadone minus cocaine, and 50 were non-drug dependent women. Significant differences were found between the cocaine and drug-free groups in infant birth weight, length, head circumference and Apgar scores, with the cocaine group having lower values for each variable. Average gestational age did not vary between the 3 groups. The cocaine group included 1 spontaneous abortion and 4 fetal deaths; non-cocaine drug dependent women had 2 fetal deaths, with none in the control group. Mean abstinence scores for 19 of the physiological and behavioral parameters were lower in the cocaine group than in the non-cocaine drug dependent women with the exception of vomiting and convulsions. These data suggest that: (1) infants born to drug dependent women have a poorer general outcome than those born to non-drug dependent women; (2) maternal cocaine use does not appear to increase the incidence of severe neonatal abstinence symptomatology; (3) pregnancies complicated by cocaine abuse have a greater chance for fetal loss resulting from both spontaneous abortions and fetal death; (4) infants born to cocaine abusing women had infants with decreased birth weight, head circumference, length and Apgar scores. PMID- 3683348 TI - Abnormal heart rate tracings and serum creatine phosphokinase in addicted neonates. AB - Continuous cardiorespirographic (CRG) monitoring was done during the first five postnatal days in 12 infants of drug dependent mothers (IDDM) and 19 normal infants (control). Abnormal heart rate patterns in the IDDM included: (1) significantly (p less than 0.01) higher baseline heart rate (129 +/- 15 vs. 118 +/- 8), beat-to-beat variability (4.4 +/- 2.4 vs. 2.6 +/- 1.6) and long-term variability (15.5 +/- 6.6 vs. 7.0 +/- 3.9), as compared to control and (2) frequent and spontaneous occurrences of large (40 beats per minute), brief rise and fall in heart rate giving a striking "wave-like" appearance to the tracing. These changes were more intense in the IDDM with moderate to severe, as compared to mild withdrawal. Treatment of the infant's withdrawal with drugs resulted in a clinical improvement, but the abnormal heart rate tracings persisted. Serum creatine phosphokinase (CPK) was also elevated (greater than 450 IU/l) in the IDDM (mean +/- SE = 984 +/- 299 IU/l) and 89% of the total CPK was the MM fraction. These infants exhibited tremors and hypertonicity. PMID- 3683349 TI - Perinatal and developmental outcome of infants exposed to methadone in-utero. AB - The purpose of this research is to delineate the effects of methadone exposure in utero. Subjects were 141 infants born to drug dependent women maintained on methadone during pregnancy and 127 non-drug exposed comparison infants matched for race, maternal age, and socioeconomic status. Methadone exposed infants had smaller birth weights than comparison infants. Differences were also found in head circumference. However, this difference was not clinically significant but rather reflects the relationship between birth weight and head circumference. No difference was found between groups in mental development. One hundred and five methadone exposed infants and 63 comparison infants were evaluated with the Bayley Scale of Mental Development at 6 months of age. Mean Bayley Mental Development scores for methadone exposed infants and comparison infants were 103 and 105 respectively. These data suggest that while methadone exposure in-utero is associated with lower birth weight and head circumference, by six months of age, these infants do not exhibit any general developmental sequelae. PMID- 3683350 TI - Infants of drug addicts: at risk for child abuse, neglect, and placement in foster care. AB - In a methadone maintenance program for pregnant, drug dependent women, an investigation was undertaken (1) to study the occurrence of violence experienced by the women as children and as adults and (2) to lean whether those who report past violence/abuse are more likely to neglect and/or abandon their children to the care of others. Subjects included 178 drug dependent women who completed a Violence Questionnaire and 70 comparable, but drug-free women. Results revealed that a history of violence or abuse is related to drug abuse and also to the placement of one's child(ren) in foster care. PMID- 3683351 TI - Mental health care for medical students and residents. Current problems and evolving resources. PMID- 3683352 TI - Emergency room use and abuse. How it varies with payment mechanism. PMID- 3683353 TI - What is, and what is not, COPD? PMID- 3683354 TI - The control of warfarin anticoagulation. A University of Minnesota medical conference. PMID- 3683355 TI - Drug-drug interaction with the use of antirheumatic drugs. PMID- 3683356 TI - Risk management in practice. Maintaining defensible medical records (Part Three). MMIE Risk Management Committee. PMID- 3683357 TI - An overview: model programs for the schizophrenic patient. PMID- 3683359 TI - Issues in identifying and treating the homeless mentally ill. PMID- 3683358 TI - The chronic mental patient with substance abuse problems. PMID- 3683360 TI - Asylum for chronic mental patients. PMID- 3683361 TI - Continuity of care. PMID- 3683362 TI - Deinstitutionalization in the United States: promises and prospects. PMID- 3683363 TI - General hospitals and CMHCs: a commentary. PMID- 3683364 TI - Inhibition of phosphoinositide-specific phospholipase C by manoalide. AB - Manoalide is a novel sesterterpenoid which has previously been shown to be a potent inhibitor of venom phospholipases A2. To determine whether manoalide inhibited other phospholipases, the sensitivity of phosphoinsitide-specific phospholipase C (PI-PLC) to inactivation by manoalide was examined using crude cytosolic PI-PLC and a PI-PLC purified to homogeneity from guinea pig uterus cytosol (PI-PLC I). Manoalide inhibited both cytosolic and purified PI-PLC I in a concentration-dependent fashion, exhibiting an IC50 of 3-6 microM. Inactivation of PI-PLC I was calcium- and pH-dependent, with greater inactivation occurring at alkaline pH. Manoalide inhibited hydrolysis of all three phosphoinositides by purified PI-PLC I. The substrate kinetics of PI-PLC I suggest that manoalide does not inhibit purified PI-PLC I by simple competitive or noncompetitive inhibition. Enzyme activity was not recovered after dialysis of manoalide-treated PI-PLC I, indicating that inactivation of PI-PLC I was irreversible. To determine whether manoalide inhibited PI-PLC in cells, the effects of manoalide on norepinephrine (NE)-stimulated phosphoinositide hydrolysis and calcium mobilization were investigated in a smooth muscle-like cell line, DDT1MF-2. Manoalide inhibited NE induced inositol 1,4,5-trisphosphate and inositol 1-phosphate formation in a concentration-dependent manner. The IC50 for inhibition of inositol 1-phosphate formation was 1.5 microM. Manoalide also inhibited NE-induced calcium transients in DDT1MF-2 cells, exhibiting an IC50 of 2 microM. These data suggest that inhibition of PI-PLC may account, in part, for the anti-inflammatory actions of manoalide. PMID- 3683365 TI - Propidium binding to a ribonuclease-DNA complex: X-ray and fluorescence studies. AB - Propidium iodide, an antitumor compound, was diffused into crystals of a complex between RNase A and deoxytetraadenylate (dpA)4). This complex has four deoxyoligomers bound per protein molecule. A difference Fourier analysis at 2.9 A showed that the principal binding site for the propidium in the crystals was a hydrophobic depression on the side of RNase away from the active site and apparently involves methionine 13 and phenylalanine 8. Binding of propidium at this site produces small conformational changes that effect binding of nucleotides at the active site of the enzyme. Fluorescence titrations in the presence and absence of nucleotide inhibitors suggested that propidium iodide is a competitive inhibitor of the enzyme with a Kl of approximately 1 mM. No significant binding of propidium to the 16 nucleotides of single-stranded DNA associated with each protein molecule was observed. PMID- 3683366 TI - The muscarinic antagonists aprophen and benactyzine are noncompetitive inhibitors of the nicotinic acetylcholine receptor. AB - Certain muscarinic antagonists (e.g., atropine, aprophen, and benactyzine) are used as antidotes for the treatment of organophosphate poisoning. We have studied the interaction of aprophen and benactyzine, both aromatic esters of diethylaminoethanol, with nicotinic acetylcholine receptor (AChR) in BC3H-1 intact muscle cells and with receptor-enriched membranes of Torpedo californica. Aprophen and benactyzine diminish the maximal carbamylcholine-elicited sodium influx into muscle cells without shifting Kact (carbamylcholine concentration eliciting 50% of the maximal 22Na+ influx). The concentration dependence for the inhibition of the initial rate of 22Na+ influx by aprophen and benactyzine occurs at lower concentrations (Kant = 3 and 50 microM, respectively) than those needed to inhibit the initial rate of [125I]-alpha-bungarotoxin binding to the agonist/antagonist sites of the AChR (Kp = 83 and 800 microM, respectively). The effective concentration for atropine inhibition of AChR response (Kant = 150 microM in BC3H-1 cells) is significantly higher than those obtained for aprophen and benactyzine. Both aprophen and benactyzine interact with the AChR in its desensitized state in BC3H-1 cells without further enhancing agonist affinity. Furthermore, these ligands do not alter the value of Kdes (equilibrium concentration of agonist which diminishes 50% of the maximal receptor response) in BC3H-1 muscle cells. The affinity of aprophen and benactyzine for the allosterically coupled noncompetitive inhibitor site of the AChR in Torpedo was determined using [3H]phencyclidine as a probe. Both compounds were found to preferentially associate with the high affinity (desensitized) state rather than the resting state of Torpedo AChR. There is a 14- to 23-fold increase in the affinity of aprophen and benactyzine for the AChR (KD = 0.7 and 28.0 microM in the desensitized state compared to 16.4 and 384 microM in the resting state, respectively). These data indicate that aprophen and benactyzine binding are allosterically regulated by the agonist sites of Torpedo AChR. Thus, aprophen and benactyzine are effective noncompetitive inhibitors of the AChR at concentrations of 1-50 microM, in either Torpedo or mammalian AChR. These concentrations correspond very well with the blood level of these drugs found in vivo to produce a therapeutic response against organophosphate poisoning. PMID- 3683367 TI - omega-Hydroxylation of 15-hydroxyeicosatetraenoic acid by lung microsomes from pregnant rabbits. AB - 15-Hydroxyeicosatetraenoic acid (15-HETE) was converted by lung microsomes from pregnant rabbits to a polar metabolite that was identified by mass spectrometry as the 15,20-dihydroxyeicosatetraenoic acid. The formation of the 20- or omega hydroxylated product was NADPH dependent, with a specific activity of 1.87 +/- 0.53 nmol/min/mg of microsomal protein. Other hydroxylated derivatives of eicosatetraenoic acid that possessed hydroxy groups at the 5- and 12-carbon atoms were not metabolized by the lung microsomes. This hydroxylation of 15-HETE was observed in lung microsomes of pregnant rabbits and only minor amounts were formed by nonpregnant rabbits. The specific activity for 15-HETE omega hydroxylation was similar to the value obtained for prostaglandin E1 (1.48 +/- 0.33 nmol/min/mg). It is known that rabbit lungs possess a cytochrome P-450 that is induced during pregnancy and catalyzes the 20-hydroxylation of prostaglandins. The addition of the antibody to cytochrome P-450 prostaglandin omega-hydroxylase or prostaglandin E1, a substrate of this enzyme, resulted in potent inhibition of 15-HETE omega-hydroxylation, providing strong evidence that a common cytochrome P 450 catalyzes the omega-hydroxylation of both prostaglandins and 15-HETE. PMID- 3683368 TI - Regio- and stereoselective metabolism of dibenz[a,h]anthracene: identification of 12 new microsomal metabolites. AB - Incubation of the carcinogenic polycyclic aromatic hydrocarbon dibenz[a,h]anthracene (DBA) with liver microsomes of Sprague-Dawley rats, pretreated with Aroclor 1254, yielded more than 30 metabolites. Fifteen of these could be identified, and they account for 95% of the ethyl acetate-extractable metabolites of DBA. Twelve metabolites were identified for the first time, by chromatographic and spectroscopic methods: these were DBA-5,6-oxide, 1-, 2-, 3-, 4-, 5-, 6-phenols, 3,4:12,13-bis-dihydrodiol, 1,4/2,3-tetrol, 1,3/2,4-tetrol, 3,4 catechol, and a phenol dihydrodiol derived from the 2-phenol. Quantitative determination revealed that the attack of cytochrome P-450 dependent monooxygenases occurs at the 1,2-, 3,4- and 5,6-positions of the DBA molecule in the ratio 1.7:1.9:1.0. Evidence is presented which indicates that the phenols of DBA are formed by aromatization of the initially generated arene oxides, rather than by direct hydroxylation. The index Ni obtained by refined perturbational molecular orbital calculations was found to be superior to the reactivity number Nt in predicting the predominant phenols, i.e., 2-, 4-, and 5-phenols, formed by aromatization of the corresponding arene oxides. Their enzymatic hydrolysis leads to the formation of trans-dihydrodiols, of which the 3,4-isomer dominates the microsomal metabolites of DBA accounting for more than 22% of the total metabolic conversion, compared to the 1,2-dihydrodiol with 11-16% and the 5,6-dihydrodiol with 2%. These metabolites were obtained as enantiomeric-enriched mixtures in which the R,R enantiomer of the 1,2-dihydrodiol prevailed with 84%, of the 3,4 dihydrodiol with 79% and of the 5,6-dihydrodiol with 96%. The metabolic pathway via the 1,2-dihydrodiol proceeds to the vicinal diol epoxides, as indicated by the products of hydrolysis the 1,4/2,3- and 1,3/2,4-tetrols. No evidence for the formation of vicinal dihydrodiol epoxides from the 3,4-dihydrodiol, one of the most mutagenic and carcinogenic metabolite of DBA, could be found. In this case, tetrol epoxides have been proposed as ultimate reactive metabolites. Tetrol epoxides can also be formed from DBA-5,6-dihydrodiol via the identified 3,4:12,13 bis-dihydrodiol. This unprecedented metabolic behavior of a carcinogenic polycyclic aromatic hydrocarbon could have its cause in the high molecular symmetry of DBA which permits subsequent metabolic attacks at discrete, but structurally equivalent sites of the molecule. PMID- 3683369 TI - Structure and function of eukaryotic RNP. Heidelberg, October 22-24, 1987. PMID- 3683370 TI - [Effect of bases noncomplementary to the template on the effectiveness of primer interaction with DNA-polymerase alpha from the human placenta]. AB - The comparison of the Km and Vmax values for the various primers was carried out. The primers were either completely complementary to the template or contained the non-complementary bases in different positions from the 3'-end. The number of the bases from the 3'-end to the noncomplementary nucleotide but not the primers length was supposed to determine the efficiency of the interaction of the primers containing noncomplementary bases with the enzyme. The Km values for d[(pC) (pT)7] (1.2 microM), d[(pC)3(pT)7] (2.5 microM, d[(pT)2pC(pT)7] (1.4 microM)d[(pT)4pC(pT)5(4.3 microM); d[(pT)7pC(pT)2] (11 microM) are comparable with the Km values for d(pT)7 (1.4 microM); d(pT)5 (4.2 microM) and d(pT)3 (15 mkM), respectively, but not for the decathymidilate d[(Tp)9T] (0.23 microM). The complementary interaction between the first nucleotide from the 3'-end of the primer and the template appear to play the particular role in the interaction of the enzyme with the primer. The Km values for d[(pT)10pC] and d[(pA)9pC] (with the corresponding templates) are 38 and 6 times the ones for d[(Tp)10T] and d(pA)10. However, the Km values for d[(pA)9p(rib)] (0.56 microM) which contains the deoxyribozylurea residue at the 3'-end is practically equal to the Km for d(pA)9 (0.56 microM). The Vmax values for d[(pT)10pC] and d[(pA)9pC] are 1.7 and 2.3 times the values for d[(Tp)10T] and d(pA)10, respectively. The primer affinity decreases, just as its conversion rate increases when the noncomplementary base in the primer is transferred from the 5'-to 3'-end; that results in the rate of primers elongation decrease in total. PMID- 3683371 TI - [Dna organization in histone-free nuclei at various stages of rat spermatogenesis]. AB - Electron microscopy analysis of DNA organization in histone-depleted nuclei of rat spermatogonial cells was performed. It was shown that the rosette-like structures are one of the forms of the loop organization of the meiotic cell nuclear DNA. Ions of bivalent metal play an important role in stabilizing the rosette-like structures of meiotic cells. A scheme for the restructuring of the mitotic organization of nuclear DNA into the meiotic one is suggested. PMID- 3683372 TI - [DNA-bound proteins mediate attachment to the nuclear skeleton of transcriptionally active DNA fraction]. AB - The proteins tightly bound to DNA are non-randomly distributed along the DNA chain and are concentrated within the transcriptionally active areas. The distribution of tightly bound proteins along the DNA reflects the type of cell differentiation and does not depend directly on transcription. In functionally active nuclei, the DNA-tightly bound proteins complexes are fixed at the nuclear matrix which is therefore associated with the whole transcriptionally active DNA fraction. PMID- 3683373 TI - [Supramolecular organization of enzymes of the tricarboxylic acid cycle]. AB - In virtue of analysis of data on the interaction of tricarboxylic acid cycle enzymes with the mitochondrial inner membrane and data on the enzyme-enzyme interactions, the spatial structure for the tricarboxylic acid cycle enzyme complex (tricarboxylic acid cycle metabolon) is proposed. The alpha-ketoglutarate dehydrogenase complex, adsorbed on the mitochondrial inner membrane along one of its 3-fold symmetry axes, plays the key role in the formation of metabolon. Two association sites of the alpha-ketoglutarate dehydrogenase complex located on opposite sides of the complex participate in the interaction with the membrane. The tricarboxylic acid cycle enzyme complex contains one molecule of the alpha ketoglutarate dehydrogenase complex and six molecules of each of the other enzymes of the tricarboxylic acid cycle, as well as aspartate aminotransferase and nucleosidediphosphate kinase. Succinate dehydrogenase, the integral protein of the mitochondrial inner membrane, is a component of the anchor site responsible for the assembly of metabolon on the membrane. The molecular mass of the complex (ignoring succinate dehydrogenase) is of 8.10(6) daltons. The metabolon symmetry corresponds to the D3 point symmetry group. It is supposed, that the tricarboxylic acid cycle enzyme complex interacts with other multienzyme complexes of the matrix and the electron transfer chain. PMID- 3683374 TI - [A stereochemical model of codon-anticodon interactions, in which bases bind via water bridges]. AB - Analysis of available experimental data has allowed us to conclude that upon codon-anticodon interaction there is a functional asymmetry between the third nucleotide of the codon and the first nucleotide of the anticodon. We suggest that this phenomenon would be due to the differential codon and anticodon conformation mobilities, which are somehow restricted. Two postulates are proposed to restrict these mobilities respectively: (1) In the codon-anticodon complex the codon is in the fixed A-RNA conformation, and the rearrangement of the sugar-phosphate backbone, that is necessary for any wobble-pair formation occurs only in the anticodon. (2) This rearrangement does not alter the specific system of contacts between the universal uridine and other nucleotides in the anticodon loop, observed in tRNA crystals. Stereochemical analysis revealed that these restrictions make the construction of any Crick's wobble-pair sterically impossible. To resolve this contradiction we propose that two bases in the third position of the codon-anticodon complex can mate not only according to the Crick's scheme, but also with the help of water bridges. Consequently, besides the standard pairs, the following pairs become permitted: UG, UI, UU, CU, GU and AI (it should be noted that GU and AI are weaker that the other ones). All other pairs appear sterically impossible. These conclusions are in good agreement with the literature date. PMID- 3683375 TI - [Determination of enthalpy of B-A transition of DNA in aqueous-ethanol solutions]. AB - The enthalpies of the guanidinium chloride (Gu.HCl) with sodium DNA salt in the solutions in B- and A-conformations in the mixtures of ethanol-water at 298.15 K and the enthalpies of solution of guanidinium chloride in the mixtures of ethanol water at 298.15 K in a whole range of the compositions of mixed solvents were measured calorimetrically. It was established that in a field of B-A-transition of DNA the values of interaction enthalpies of Gu.HCl with DNA practically do not depend on the composition of the solvent. The concentrations of Na-ions in water ethanol solutions of DNA containing Gu.HCl were determined by the potentiometric method. It was revealed that the interaction of the equimolar quantities of Gu.HCl and DNA leads to the complete replacement of Na-cations, which are naturally linked with DNA, into solution. From the results obtained the enthalpy of B-A-conformation transition DNA at 298.15 K was determined (-2.50 +/- 0.10 kJ/mole). PMID- 3683376 TI - [The role of Hpi-hydrogen bonds in the stabilization of spiral structures of oligopeptides]. AB - Different possibilities of H-bonds formation for formamide-water complexes and dimers of formamide were studied. Potential energy maps were calculated for di-, tri- and tetrapeptides. The maps provide necessary data to explain the relative stability of different oligopeptide conformers and Ramachandran maps for peptides. PMID- 3683377 TI - [Isolation and properties of the initiation of DNA replication in the sea urchin embryo]. AB - Using the instability of replication loops as a method for the isolation of double-stranded nascent DNA from embryos of the sea urchin Strongylocentrotus intermedius, extruded DNA enriched for replication origins was obtained. The average length of the fragments of the DNA of this fraction was estimated to be about 800 base pairs. The origin-enriched nascent DNA strands were assayed for the presence of inverted repeats. The results show that the origin-enriched DNA is also enriched in inverted repeats. The bulk of palindromes in the total nuclear DNA was estimated to be 200 base pairs in length and from the origin enriched DNA-150 base pairs. PMID- 3683378 TI - [Study of conformation characteristics of "X-form" of alternating polynucleotides by the method of slow 1H----3H transition]. AB - The rate constants of 1H----3H exchange between water and C8H-groups of purine residues of alternating polynucleotides: poly[d(A-C)].poly[d(G-T)] and poly[d(A T)].poly[d(A-T)], as well as Escherichia coli DNA, dAMP and dGMP, in solutions with high concentration (4.3 or 6 M) CsF, in water ethanol (60%) solution and (in comparison) in 0.15 M NaCl were determined at 25 degrees C. The 1H----3H exchange rate exchange rate constants for adenylic (kA) and guanylic (kG) residues of polynucleotides were compared with the corresponding constant for DNA and mononucleotides. It was shown that at conditions when poly[d(G-T)] and poly[d(A T)].poly[d(A-T)] exhibit the "X-form" CD spectrum, alteration of exchange rates in polynucleotides (approximately 2-fold increase in kA in CSF and approximately 1.5-fold decrease in kA and kG in 60% ethanol with 0.15 M NaCl) is due to the effect of solvents on the chemical reactivity of purine residues, but does not reflect a conformational transition. The analysis of these results allows us to conclude, that alternating polynucleotides under the above mentioned conditions retain roughly the conformations inherent in them in 0.15 M NaCl: poly[d(A C)].poly[d(G-T)] conformation in 4.3 m CsF or 60% ethanol differs only insignificantly from the "canonic" B-DNA, whereas the poly[d(A-T)].poly[d(A-T)] conformation in 6 M CSF corresponds to B-alternating DNA. PMID- 3683379 TI - [The small RNP acceptor of glucocorticoids bound to chromatin in liver cell nuclei]. AB - The buoyant density in the CsCl gradient of the small nuclear RNP tightly bound to chromatin has been studied. It was shown that the buoyant density of alpha-RNP is characteristic for ribonucleoproteins (p = 1.36-1.50 g/cm3). The alpha particles are of extraordinary stability. These RNP were shown to remain stable under drastic conditions (high ionic strength, SDS, 6 M urea) and resist unfixed caesium chloride density centrifugation. The alpha-RNA hybridizes with total rat liver DNA at C0t1/2 = 10(3). The oligonucleotide analysis of the alpha-RNA shows that the alpha-RNA is heterogeneous. PMID- 3683380 TI - [Comparison of the effectiveness of the interaction of ribo- and deoxyriboprimers with DNA-polymerase from the human placenta]. AB - The Km and Vmax values for primers d(pA)n, d(pT)n, r(pA)n, r(pU)n where n = 1-16, were compared. The Km values for minimal primers dTMP, dAMP, rUMP, rAMP were found to be 48, 71, 602 and 602 microM, respectively. The Vmax value for any NMP made up approximately 7% of that for (pN)10. The lengthening of any primer per one mononucleotide unit for n from 1 to 10 resulted in the decrease of the Km value 1.8-fold and the increase of the Vmax value 1.35-fold. The ratios of the Km values for primers r(pA)n-d(pA)n and r(pU)n-d(pT)n were 7.5 and 12.5, respectively, for any n. The Km value for [d[pT)8]r(pU) primer was the same as for r(pU)9, but not for d(pT)9. Decanucleotide [d(Tp)9]ddT interacted with the polymerase competitively to the template, but not to the primer. The primer's 3' OH group was supposed to form the hydrogen bond with the enzyme. The absence of 3'-hydroxygroup in [d(Tp)9]ddT resulted in its inability to compete effectively with the primer. The difference of the affinity of ribo- and deoxyriboprimers is due, apparently, to the existence of the different conformation of the furanose rings in the ribose and deoxyribose. PMID- 3683381 TI - [2 types of temperature transitions in liquid crystals formed from poly(I).poly(C) molecules]. AB - The small-angle X-ray scattering curves, CD spectra and textures of the liquid crystalline phase formed from poly(I).poly(C) molecules in a water-salt solutions containing poly(ethylene glycol) at different temperatures were obtained. It was found that the heating of poly(1).poly(C) liquid-crystalline phase is accompanied by two types of transitions, the first one--a "cholesteric----"compensated" structure----cholesteric", the second--a "cholesteric----isotropic state" transition. The latter transition takes place at a temperature that corresponds to that of the separation of chains of the double-stranded poly(I).poly(C) molecule. PMID- 3683382 TI - [Study of the process of chromatin condensation using light scattering and stop flow technics]. AB - We have studied the condensation of calf thymus chromatin induced by NaCl by static light scattering at 90 degrees and showed that the increase of NaCl concentration up to 120-170 mM results in a large increase of scattering intensity of the total chromatin. H1-depleted and trypsinized chromatin preparations do not reveal such a large increase of scattering intensity. The increase of the scattering intensity reflects folding of the chromatin filaments, but not their aggregation. We have used this effect to monitor the kinetics of the chromatin condensation in response to a jump to higher NaCl concentrations by means of a stopped-flow technique. The results show that the condensation is a fast complex process consisting of at least two steps. The first step is only partially resolved by the stopped-flow apparatus. The second step has a time constant in the range of 20-50 ms and does not depend on chromatin concentration. PMID- 3683383 TI - [Linear dichroism of chromatin fibers]. AB - The optical anisotropy of chromatin with different length of the linker DNA isolated from a variety of sources (Friend erythroleukemia cells, calf thymus, hen erythrocytes and sea urchin sperm) has been studied in a large range of mono- and bivalent cations by the use of flow linear dichroism and electric dichroism. We have found that all chromatins studied displayed negative LD values in the range of 0.25 mM EDTA--2 mM NaCl and close positive values in the range of 2-100 mM NaCl. Mg2+ cations, in contrast to Na+ cations, induce optically isotropic chromatin fibers. All chromatin samples exhibit positive form effect amounting to 5-10% of LD amplitude observed at 260 nm. This form effect is determined by the anisotropic scattering of polarized light by single chromatin fibers. The conformational transition at 2 mM NaCl leads to the distortion of chromatin filament structure. The reversibility of this distortion depends on the length of the linker DNA--for chromatins with linker DNA 10-30 b.p. it is partially reversible, while for preparations with longer linker DNA it is irreversible. Relatively low electric fields do not have an effect on chromatin structure, while higher electric fields (more than 7 kV/cm) distort the structure of chromatin. PMID- 3683384 TI - [Interaction of polyamines with chromatin and DNA: formation of compact structures]. AB - We have used flow linear dichroism (LD) and light scattering at 90 degrees to study the condensation of both DNA and calf thymus chromatin induced by spermine, triamines NH3+(CH2)iNH+(CH2)jNH3+, designated as much less than i, j much greater than: much less than 3, 4 much greater than (spermidine), much less than 3, 3 much greater than, much less than 2, 3 much greater than, much less than 2, 2 much greater than; the diamines putrescine and cadaverine and MgCl2. It is found that the different polyamines affected DNA and chromatin in a similar way. The degree of compaction of the chromatin fibers induced by spermine, triamines except much less than 2, 2 much greater than and Mg2+ has been found to be identical. The triamine much less than 2, 2 much greater than and the diamines studied do not condense either chromatin of DNA. Such a big difference in the action of the triamines indicates that not only the charge, but also the structure of the polycations are important for their interactions with DNA and chromatin. The stoichiometry of polyamine binding to chromatin at which condensation occurred is found to be 2 polyamine molecules per DNA helical turn. Polyamines are supposed to bind to the exposed sites of core DNA every 10 b.p. The extent of DNA phosphate neutralization by the histones is estimated to be about 55%. It has been shown that a mixture of mono- and multivalent cations affected DNA and chromatin condensation competitively and not synergistically, as claimed in a recent report by Sen and Crothers. PMID- 3683385 TI - Variations in template protection by the RNA polymerase II transcription complex during the initiation process. AB - Preinitiation complexes (complex 0) or complexes which either made 2 or an average of 10 phosphodiester bonds (complexes 2 and 10, respectively) were assembled in vitro on the adenovirus 2 major late promoter. Each of the complexes was digested extensively with DNase I; the protected DNAs were purified and hybridized in a series of end-labeled oligonucleotides homologous to sequences on the coding or noncoding strands near the initiation site. The hybrids were then extended with reverse transcriptase to map the extent of template protection conferred by proteins in the complex. The downstream protection edge revealed by this approach was approximately +30, +25, and +35 for complexes 0, 2, and 10, respectively. We subsequently found that the apparent inward movement of the downstream protection boundary on initiation could be produced by satisfying the energy requirement for transcription initiation (i.e., by treating with ATP or dATP). The downstream boundary change occurred as rapidly as we could perform the test (less than 60 s) and was not blocked by alpha-amanitin. DNAs from trimmed complexes 0, 2, or 10 all supported extension to a single upstream edge at about position -42. Upstream protection was stable in the preinitiation complex, but when postinitiation complexes were incubated for extended periods, protection of the entire upstream region was lost. This decay of upstream protection, like the movement of the downstream boundary, was found to result from exposure to ATP or dATP. Unlike the downstream boundary movement, however, the upstream change was relatively slow; about 15 min was required to lose one-half of the protection. PMID- 3683386 TI - Isolation of the human gene that complements a temperature-sensitive cell cycle mutation in BHK cells. AB - We have cloned the human genomic DNA and the corresponding cDNA for the gene which complements the mutation of tsBN51, a temperature-sensitive (Ts) cell cycle mutant of BHK cells which is blocked in G1 at the nonpermissive temperature. After transfecting human DNA into TsBN51 cells and selecting for growth at 39.5 degrees C, Ts+ transformants were identified by their content of human AluI repetitive DNA sequences. Following two additional rounds of transfection, a genomic library was constructed from a tertiary Ts+ transformant and a recombinant phage containing the complementing gene isolated by screening for human AluI sequences. A genomic probe from this clone recognized a 2-kilobase mRNA in human and tertiary transformant cell lines, and this probe was used to isolate a biologically active cDNA from the Okayama-Berg cDNA expression library. Sequencing of this cDNA revealed a single open reading frame encoding a polypeptide of 395 amino acids. The deduced BN51 gene product has a high proportion of acidic and basic amino acids which are clustered in four hydrophilic domains spaced at 60- to 80-amino-acid intervals. These domains have strong sequence homology to each other. Thus, the tsBN51 protein consists of periodic repetitive clusters of acidic and basic amino acids. PMID- 3683387 TI - Reconstitution of cell-type-specific transcription of the rat prolactin gene in vitro. AB - We present evidence for the existence of prolactin upstream factor 1 (PUF-1) in rat pituitary-derived cells and demonstrate its interaction with a symmetrical DNA element located in the 5' flanking region of the gene. An in vitro expression system developed from pituitary-derived GH3 cells was used to determine that 420 base pairs (bp) of 5' flanking DNA was sufficient for cell-specific, accurate, and efficient RNA polymerase II transcription of the rat prolactin gene. Reconstitution of in vitro transcription with pituitary and nonpituitary nuclear extracts suggested that the presence of GH3 cell-specific factors mediated the activation of prolactin gene expression. We also demonstrated that a functionally stable transcription complex assembled on the prolactin promoter. Using DNase I protection procedures, we have identified the DNA-protein binding area in the prolactin 5' flanking region. GH3 nuclear extracts contain a cell-specific protein (PUF-I) that binds to a 28-bp region (-63 to -36)which contains an 18-bp imperfect palindrome (-63 to -46). The role that the interaction between PUF-I and the imperfect palindrome plays in in vitro pituitary-specific prolactin gene expression is discussed. PMID- 3683388 TI - Effects of intercistronic length on the efficiency of reinitiation by eucaryotic ribosomes. AB - Simian virus 40-based plasmids that direct the synthesis of preproinsulin during short-term transfection of COS cells have been used to probe the mechanism of reinitiation by eucaryotic ribosomes. Earlier studies from several laboratories had established that the ability of ribosomes to reinitiate translation at an internal AUG codon depends on having a terminator codon in frame with the preceding AUG triplet and upstream from the intended restart site. In the present studies, the position of the upstream terminator codon relative to the preproinsulin restart site has been systematically varied. The efficiency of reinitiation progressively improved as the intercistronic sequence was lengthened. When the upstream "minicistron" terminated 79 nucleotides before the preproinsulin start site, the synthesis of proinsulin was as efficient as if there were no upstream AUG codons. A mechanism is postulated that might account for this result, which is somewhat surprising inasmuch as bacterial ribosomes reinitiate less efficiently as the intercistronic gap is widened. PMID- 3683389 TI - Retrovirus-mediated gene transfer of human adenosine deaminase: expression of functional enzyme in murine hematopoietic stem cells in vivo. AB - Simplified Moloney murine leukemia virus-based recombinant retrovirus vectors have been constructed which transduce human adenosine deaminase (ADA) cDNA. ADA transcription is under the control of the constitutive promoter for the human X chromosome phosphoglycerate kinase (pgk) gene. In these simplified vectors, dominant selectable markers are not included and selection is dependent on overproduction of functional ADA enzyme. Primary murine hematopoietic cells were infected with helper-free recombinant ADA virus generated from Psi-2 packaging cells. Protein analysis revealed that human ADA enzyme was expressed in progenitor-derived hematopoietic colonies in vitro and CFU-S-derived spleen colonies in vivo. Enzyme expression was dependent on transcription from the pgk promoter. ADA expression in primary murine hematopoietic cells directed by the internal promoter was not adversely affected by the presence of the Moloney virus long terminal repeat enhancer sequence. Use of these vectors allows systematic evaluation of the effects of specific sequences in recombinant retrovirus vectors on expression in primary murine hematopoietic cells in vivo. PMID- 3683390 TI - Promoter and enhancer elements from the rat elastase I gene function independently of each other and of heterologous enhancers. AB - An elastase-human growth hormone (hGH) fusion gene containing 205 base pairs of elastase 5' flanking region is expressed exclusively in pancreatic acinar cells of transgenic mice. This paper shows that the promoter region (-72 to +8) and the enhancer (-205 to -73) function independently of each other. The elastase enhancer can activate the heterologous mouse metallothionein gene and the hGH gene promoters; conversely, enhancers from the thymocyte-specific murine leukemia virus MCF13 and the metal regulatory elements from the metallothionein gene can activate the elastase promoter in a variety of cell types. Combinations of immunoglobulin and elastase enhancers with a heterologous promoter and the hGH gene result in expression in all of the tissues predicted by the sum of each enhancer acting alone. Thus these enhancer elements act independently of each other, suggesting that they do not have silencing activity in cells in which they are normally inactive. PMID- 3683391 TI - Transcriptionally inactive oocyte-type 5S RNA genes of Xenopus laevis are complexed with TFIIIA in vitro. AB - An extract from whole oocytes of Xenopus laevis was shown to transcribe somatic type 5S RNA genes approximately 100-fold more efficiently than oocyte-type 5S RNA genes. This preference was at least 10-fold greater than the preference seen upon microinjection of 5S RNA genes into oocyte nuclei or upon in vitro transcription in an oocyte nuclear extract. The approximately 100-fold transcriptional bias in favor of the somatic-type 5S RNA genes observed in vitro in the whole oocyte extract was similar to the transcriptional bias observed in developing Xenopus embryos. We also showed that in the whole oocyte extract, a promoter-binding protein required for 5S RNA gene transcription, TFIIIA, was bound both to the actively transcribed somatic-type 5S RNA gene and to the largely inactive oocyte type 5S RNA genes. These findings suggest that the mechanism for the differential expression of 5S RNA genes during Xenopus development does not involve differential binding of TFIIIA to 5S RNA genes. PMID- 3683392 TI - Long-term effects of estrogen on avian liver: estrogen-inducible switch in expression of nuclear, hormone-binding proteins. AB - The stimulation of chicks or embryos with estrogen results in transient, hepatic expression of the vitellogenin gene, as well as long-term, propagatable alterations in the rapidity with which the gene can be reactivated. We examined the possibility that nuclear, type II estrogen-binding sites are involved in this long-term change in response characteristics. We demonstrate that the primary induction kinetics of type II sites in embryos and chicks correlated with the expression of the vitellogenin gene and that once their induction was triggered by estrogen, they accumulated, were propagated, and persisted for months after withdrawal of the hormone. We also show that their accumulation in the embryo was accompanied by prolonged expression of both the vitellogenin and very low-density apolipoprotein II genes, in the absence of elevated levels of type I receptor, and that the type II sites, like the classical receptor, appear to be preferentially associated with active or potentially active chromatin. Finally, we describe a regulatory mechanism, tested by computer modelling, that simulated the behavioral characteristics of these nuclear estrogen-binding sites and which may explain their role in mediating the long-term effects of estrogen. PMID- 3683393 TI - Intermolecular homologous recombination between transfected sequences in mammalian cells is primarily nonconservative. AB - Intermolecular recombination in mammalian cells was studied by coinfecting African green monkey cells in culture with two shuttle vector plasmids, each carrying an incomplete but overlapping portion of the gene for neomycin resistance. The region of homology between the two plasmids was about 0.6 kilobases. Recombination between the homology regions could reconstruct the neomycin resistance gene, which was monitored by analysis of progeny plasmids in bacteria. The individual plasmids carried additional markers which, in combination with restriction analysis, allowed the determination of the frequency of formation of the heterodimeric plasmid which would be formed in a conservative recombination reaction between the homologous sequences. Reconstruction of the neomycin resistance gene was readily observed, but only 1 to 2% of the neomycin resistance plasmids had the structure of the conservative heterodimer. Treatment of the plasmids which enhanced the frequency of the neomycin resistance gene reconstruction reaction did not significantly increase the relative frequency of conservative product plasmids. The results support nonconservative models for recombination of these sequences. PMID- 3683394 TI - Metal-dependent binding of a factor in vivo to the metal-responsive elements of the metallothionein 1 gene promoter. AB - Using the technique of genomic footprinting, we demonstrate cadmium-inducible protection from dimethyl sulfate (DMS) modification of guanine residues in vivo in five metal-responsive elements (MREs) in the promoter of the rat metallothionein 1 (MT-1) gene. We also identify a site of extreme DMS hyperreactivity which, like the MRE protection, occurs only after metal ion induction. With this hyperreactive site as an indicator, we can measure the kinetics of induction and deinduction. Changes in the intracellular metal ion concentrations are reflected in alterations in the reactivity with DMS of guanine residues in the MT-1 gene promoter. Lastly, for both control and metal-induced cells, we observe DMS protection and enhancement of a binding site (located 5' of the distal MRE) which is a consensus sequence for the Sp1 transcription factor. Transfection experiments with deletion mutations of a fusion gene construct indicate both that a sequence region which includes this GC box regulates the basal level of expression of the MT-1 gene and that increasing the number of MREs in the promoter increases the induced level of transcription. Our genomic footprinting and transfection data together suggest that (i) a transcription factor, possibly Sp1, plays an important role in regulating the basal level of expression of the MT-1 gene and (ii) metal induction involves the metal-dependent binding to a sequence-specific binding factor which responds to changes in intracellular metal ion levels. PMID- 3683395 TI - Multiple topogenic sequences determine the transmembrane orientation of the hepatitis B surface antigen. AB - To investigate the mechanism by which complex membrane proteins achieve their correct transmembrane orientation, we examined in detail the hepatitis B surface antigen for sequences which determine its membrane topology. The results demonstrated the presence of at least two kinds of topogenic elements: an N terminal uncleaved signal sequence and an internal element containing both signal and stop-transfer function. Fusion of reporter groups to either end of the protein suggested that both termini are translocated across the membrane bilayer. We propose that this topology is generated by the conjoint action of both elements and involves a specifically oriented membrane insertion event mediated by the internal sequence. The functional properties of each element can be instructively compared with those of simpler membrane proteins and may provide insight into the generation of other complex protein topologies. PMID- 3683396 TI - Specificity of RNA maturation pathways: RNAs transcribed by RNA polymerase III are not substrates for splicing or polyadenylation. AB - To analyze the specificity of RNA processing reactions, we constructed hybrid genes containing RNA polymerase III promoters fused to sequences that are normally transcribed by polymerase II and assessed their transcripts following transfection into human 293 cells. Transcripts derived from these chimeric constructs were analyzed by using a combined RNase H and S1 nuclease assay to test whether RNAs containing consensus 5' and 3' splicing signals could be efficiently spliced in intact cells, even though they were transcribed by RNA polymerase III. We found that polymerase III-derived RNAs are not substrates for splicing. Similarly, we were not able to detect poly(A)+ RNAs derived from genes that contained a polymerase III promoter linked to sequences that were necessary and sufficient to direct 3'-end cleavage and polyadenylation when transcribed by RNA polymerase II. Our findings are consistent with the view that in vivo splicing and polyadenylation pathways are obligatorily coupled to transcription by RNA polymerase II. PMID- 3683397 TI - A cloned human ribosomal protein gene functions in rodent cells. AB - Cloned fragments of human ribosomal protein S14 DNA (RPS14) were transfected into cultured Chinese hamster (CHO) cells. Transient expression assays indicated that DNA with as little as 31 base pairs of upstream flanking sequence was transcribed into a polyadenylated, 650-base mRNA that is largely bound to the polyribosomes. In these respects the exogenous human S14 message appeared to function normally in CHO cells. Interestingly, transcription of human RPS14 did not require the TATA sequence located 26 base pairs upstream of exon 1. Stably transformed clones were selected from cultures of emetine-resistant CHO cells (Emr-2) after transfection with pSV2Neo-human RPS14 constructs. Human RPS14 complemented the mutationally based drug resistance of the Chinese hamster cells, demonstrating that the cloned human ribosomal protein gene is functional in rodent cells. Analysis of transformed cells with different amounts of integrated RPS14 indicated that human S14 mRNA levels are not tightly regulated by CHO cells. In contrast, the steady-state S14 level fluctuated only slightly, if at all, in transformed clones whose S14 message contents differed by more than 30-fold. These data support the conclusion that expression of human RPS14 is regulated, at least partially, posttranscriptionally. PMID- 3683398 TI - Proviral sequences that restrict retroviral expression in mouse embryonal carcinoma cells. AB - Embryonal carcinoma (EC) cells are nonpermissive for retrovirus replication. Restriction of retroviral expression in EC cells was studied by using DNA transfection techniques. To investigate the activity of the Moloney murine leukemia virus (M-MuLV)enhancer and promoter sequences, the M-MuLV long terminal repeat and the defined long terminal repeat deletions were linked to neo structural gene sequences that encode resistance to the neomycin analog G418. Transient expression data and drug resistance frequencies support the findings that the M-MuLV enhancer is not active in EC cells but that promoter sequences are functional. In addition, a proviral DNA fragment that encodes the leader RNA sequence of a M-MuLV recombinant retrovirus was found to restrict expression specifically in EC cells. Deletion analysis of the leader fragment localized the inhibitory sequences to a region that spans the M-MuLV tRNA primer binding site. It is not known whether restriction occurs at a transcriptional or posttranscriptional level, but steady-state RNA levels in transient expression assays were significantly reduced. PMID- 3683399 TI - Developmentally regulated expression of a truncated myosin light-chain 1F/3F gene. AB - Fast skeletal muscle myosin light-chain I (MLC1f) and myosin light-chain 3 (MLC3f) mRNAs are both derived from a single rat MLC1/3f gene. MLC1f mRNA begins at the first exon of the gene, while MLC3f mRNA begins with exon 2, 10 kilobases downstream. Both mRNAs require alternate splicing of internal exons for accurate expression. We showed that a truncated rat MLC1f/3f gene lacking exon 1 and the first 6.3 kilobases of the intron separating exons 1 and 2 produced rat MLC3f mRNA in a developmentally regulated manner after introduction into myogenic mouse cells, thus demonstrating in vivo the presence of a functional promoter associated with exon 2. Correctly spliced mRNA was produced after transfer of this truncated gene into both myogenic and nonmyogenic cells, indicating that the pattern of splicing of this complex transcript was due to a structural features of the RNA and was independent of cell type. PMID- 3683400 TI - Posttranslational translocation of influenza virus hemagglutinin across microsomal membranes. AB - The biosynthesis of influenza virus hemagglutinin (HA) and its translocation across microsomal membranes were studied in a mammalian cell-free system. All forms of HA could be cotranslationally translocated with high efficiency. However, only truncated forms of HA were translocated after protein synthesis has been terminated. The efficiency of this posttranslational translocation was dependent on the extent of the truncation. Posttranslational translocation was ribosome dependent and occurred only in the presence of a functional N-terminal signal sequence. The molecular mechanism of protein targeting and translocation across the membrane of the endoplasmic reticulum is discussed. PMID- 3683401 TI - Purification and characterization of recombinant human IgE Fc epsilon fragment produced in mouse L cells. AB - A human IgE Fc epsilon fragment was isolated from the supernatant of the culture fluid of a recombinant mouse L cell line, L-IS11IgE-9. The purification procedure consisted of salting out from the supernatant with ammonium sulfate, immunoaffinity chromatography on a monoclonal antibody (E235I63)-Affi Gel 10 column, and gel filtration chromatography on a Sephacryl S-200 column. The final preparation represented a 5825-fold purification from the original culture fluid with a 25% recovery and about 3.1 mg of Fc epsilon fragment was obtained from 201 of culture fluid. The sp. act. of the purified preparation measured by the use of commercial human IgE determination kits was 0.93 x 10(6) units/mg protein. The purified preparation was homogeneous as judged by the end group analyses. The amino acid composition of the preparation coincided with that deduced from DNA sequence. The mol. wt of our preparation was about 110,000 under non-reducing conditions and 55,000 under reducing conditions on sodium dodecyl sulfate polyacrylamide gel electrophoresis. These results showed that our preparation was a dimeric form having high reactivity against anti-human IgE antibodies. PMID- 3683402 TI - Complement-mediated solubilization of rat IgA immune precipitates. AB - The complement-mediated solubilization (CMS) of immunoprecipitates (IP) consisting of DNP-rat serum albumin (RSA) and rat monoclonal anti-DNP antibodies of the IgA [both polymeric (p-) and monomeric (m-)] or IgG2b (sub)class was studied. In contrast to IgG2b IP, solubilization of IgA IP was only observed in an autologous system, with rat serum as the source of complement. IP prepared using m-IgA were solubilized faster than those prepared using p-IgA. Analysis of both affinity and avidity of the antibodies, indicated that this difference may be due to the lower avidity of the m-IgA antibodies as compared to p-IgA. Analysis of the solubilized IP revealed deposition of C3 and C4 on IgG2b, and only C3 on IgA IP. These results point toward a role of the alternative pathway in the solubilization of IgA IP. Size analysis of the solubilized IgA IP employing sucrose density gradient ultracentrifugation, indicated that these were heterogeneous, with a size generally larger than 19 S. PMID- 3683403 TI - Modification of an ELISA-based procedure for affinity determination: correction necessary for use with bivalent antibody. AB - A recently described procedure for the evaluation of the affinity of monoclonal antibodies [Friguet et al., J. Immun. Meth. 77, 305-319 (1985)] uses an ELISA system to determine the quantity of free antibody present in a mixture of antigen and antibody. However, an intact IgG may bind antigen by either of two binding sites, and an IgG can bind to a solid-phase antigen whether one or two of its binding sites are free. Therefore, this procedure does not directly provide the concn of liganded binding sites, the quantity necessary for calculation of the thermodynamic association constant. A binomial probability distribution relates the fraction of liganded binding sites to the concn of unliganded, singly liganded, and doubly liganded IgG assuming that the binding of each Fab to antigen is independent. Simulated experiments were used to compare the apparent binding characteristics of bivalent IgG and monovalent Fab and to calculate apparent association constants in each case. It was found that the affinity of binding sites on intact IgG was underestimated by a factor of at least 2 and that the error was inversely related to the fraction of liganded binding sites. Binding site affinity of an antibody may be underestimated by several orders of magnitude. On the basis of binomial analysis, it is possible to convert apparent concns of bound IgG to actual concns of liganded binding site resulting in the calculation of valid association constants for intact IgG without alteration of the experimental protocol. PMID- 3683404 TI - Production of monoclonal antibodies to thyroglobulin by in vitro immunization with a free synthetic peptide. AB - A synthetic peptide corresponding to amino acids 1-19 of thyroglobulin was used to test the possibility of generating protein-reactive monoclonal antibodies by immunization in vitro with a synthetic peptide as antigen. Splenocytes from non immunized Balb/c mice were cultured in serum-free medium for 3 days in the presence of thymocyte-conditioned medium and the synthetic peptide prior to fusion with SP2/0 murine myeloma cells. The synthetic peptide was used in its free form, i.e. not coupled to a protein carrier. Hybridomas secreting monoclonal antibodies reactive with the synthetic peptide were obtained after immunization in vitro with as little as 10 ng/ml of the synthetic peptide. Between 50 and 70% of the primary clones obtained in different experiments produced monoclonal antibodies also reactive with the intact protein. Six stable hybridomas were isolated; all produced antibodies of the IgM class. We conclude that immunization in vitro with a free synthetic peptide is an efficient method for the generation of monoclonal antibodies reactive with the intact protein. PMID- 3683405 TI - Role of processing of N-linked oligosaccharides in control of immunoglobulin secretion from rat hybridomas. AB - The effects of inhibition of N-linked oligosaccharide processing by glucosidase and mannosidase activities upon secretion of rat hybridoma IgM and IgG have been investigated. The inhibitor of glucosidase I, castanospermine, prevents conversion of the N-linked carbohydrate groups of IgM to a complex form as assessed by resistance to digestion by endo H. The rate of secretion of IgM or IgG from the treated cells is not diminished relative to controls. Similar data are obtained for studies employing the inhibitor of glucosidase I and II activities, 1-deoxynojirimycin. Inhibition of processing by the mannosidase inhibitors 1-deoxymannojirimycin and swainsonine leads to alteration of the qualitative structure of the oligosaccharide groups present on IgG molecules, but again has no effect upon the rate of export of IgG or IgM molecules from treated cells. In each case studied the mu or gamma heavy chains isolated from lysates or culture supernatants of cells treated with glucosidase inhibitors had a higher Mr than the equivalent chains isolated either from control cultures or cultures exposed to either mannosidase inhibitor. PMID- 3683406 TI - Epidemiology of allergic diseases. PMID- 3683408 TI - [Blunt abdominal trauma caused by child abuse]. AB - We report about 3 boys under 4 years of age with abdominal blunt trauma following child abuse admitted to our clinic with different diagnoses. Common were fresh or older haematomas, burn wounds, for which the parents had no plausible explanation. The children had no skeletal or intracranial lesions, but they developed abdominal pain, which became worse in the absence of the parents. X-ray and the clinical course lead us to laparatomy. In all cases we found lesions of the intestines, especially near the duodenojejunal flexure, hepatoduodenal ligament, root of the mesentery, mesocolon and retroperitoneum, in one case a pancrease rupture. All these lesions were caused by child abuse. We want to point out the problem in the diagnosis of battered child syndrome, especially of the abdominal blunt trauma. PMID- 3683407 TI - [High postneonatal mortality of infants in North Rhine Westphalia]. AB - Infant mortality in North-Rhine Westphalia was increased above the national average throughout the postwar period until today. To clarify the underlying causes the official death certificates of infants who died during their first year were linked to their respective birth certificates. Thus, the amount of data about each individual case was increased considerably. The information collected was then evaluated. An especially high mortality was associated with the maternal risk factors illegitimacy, age below 20 and Turkish nationality. Perinatal mortality was high in the groups of Turkish nationals, and unmarried mothers. Socially underprivileged groups on the whole proved to contribute a high amount of postneonatal mortality. Predominant causes of postneonatal mortality were infections, injuries and the diagnosis "sudden infant death syndrome". PMID- 3683409 TI - [Treatment of congenital varicella with acyclovir]. AB - We describe three newborns who developed varicella six hours, five or eight days after delivery. Because of the high lethality rate of congenital varicella treatment with acyclovir appeared to be indicated. Acyclovir was administered intravenously in a dosage of 3 X 5, 3 X 7.5, and 3 X 10 mg/kg/day for three to five days. All patients showed prompt clinical improvement and the skin lesions disappeared. Side effects were not observed. Dependent on the dosage radioimmunological determination of acyclovir serum levels revealed basic values between less than 0.34 to 13.9 mumol/l; peak levels ranged from 14.0 to 70.2 mumol/l. Our preliminary results demonstrate that acyclovir can be successfully used to treat congenital varicella. A dosage of at least 3 X 7.5 mg/kg/day is recommended. PMID- 3683410 TI - [Kala-azar with marked ferritinemia in a German school child]. AB - We report on a case of visceral leishmaniasis acquired during a summer holiday in Spain. Apart from therapeutic aspects some mechanisms for the development of anaemia are discussed with regard to changes of the red blood cell counts, serum iron and ferritin concentrations measured before, during and after therapy. PMID- 3683411 TI - [Mucolipidosis type II (I-cell disease) with unusually severe heart involvement]. AB - Mucolipidosis II (I-cell disease), an autosomal recessive inborn error of mucolipid metabolism with defective transport of lysosomal enzymes is described in a young infant. Besides the typical findings as a result of the "lysosomopathy", this case presented an unusual and distinct cardiac involvement: a cardiomyopathy with dilatation of the left ventricle and signs of an endocardfibroelastosis. PMID- 3683413 TI - [17th annual meeting of the Working Group for Pediatric Nephrology. 12-14 March 1987, Krefeld. Abstracts]. PMID- 3683412 TI - [Treatment of an asthmatic child becomes more effective when the mother is well informed, auscultates her child and keeps a diary]. AB - The asthmatic child himself can do nothing against his illness. It is the task of the mother, assisted by the physician, to prevent the child suffering from his asthma. To achieve this purpose it is not sufficient to prescribe medicaments only. But a comprehensive information of the mother about asthma bronchiale, the auscultation of the child by his mother and a daily record of the symptoms make the medicaments effective. PMID- 3683414 TI - Effect of levamisole on binding of immune complex to mouse peritoneal macrophages. AB - Levamisole at the concentrations of 240 and 500 micrograms/ml increased DNA-anti DNA immune complex (IC) binding to thioglycollate-stimulated mouse (CBA) peritoneal macrophages. Reduced IC binding by macrophages of (NZB/NZW)F1 a mouse model for systemic lupus erythematosus occurs as a consequence of disease and was partially corrected after inclusion of levamisole into the reaction mixture in vitro. However, in vivo administration of 2.5 mg/kg of levamisole, the therapeutic dose, did not alter IC binding to CBA macrophages. PMID- 3683415 TI - Tumor progression in vitro: the paradoxical natural antibody and complement selected phenotype. AB - An in vitro model of tumor progression was employed to investigate the contribution of natural antibody (NAb) to antitumor resistance in vivo. Repeated cycles of L5178Y-F9 and SL2-5 tumor growth in the tumor promoter 12-O tetradecanoylphorbol-13-acetate (TPA) followed by the selective elimination of sensitive variants through complement-dependent syngeneic NAb lysis yielded tumors with a reduced sensitivity to NAb and complement, natural killer (NK) cells and the rapid elimination assay of natural resistance (NR). A dissection of the resistant phenotype revealed a reduction in the binding capacity of complement-fixing NAb and NK cells, a reduced susceptibility to hypotonic lysis and, paradoxically, increased fluorescence-detected NAb binding that correlated inversely with a reduced tumor frequency of threshold subcutaneous tumor inocula. The data distinguish tumor binding of NAb that leads to complement activation from other NAb binding and expose a difference between NR measured as the tumor frequency of threshold tumor inocula versus the rapid radiolabelled tumor elimination assay. Complement-dependent NAb lysis may not contribute significantly to the defense against small tumor foci; however, NAb-mediated processes associated with high fluorescence-detected NAb binding likely provide resistance. PMID- 3683416 TI - Limiting dilution clonal assay of human bone marrow hematopoietic progenitors (granulocytes-macrophages). AB - We have developed a limiting dilution assay for human bone marrow hematopoietic precursor (granulocytes-macrophages) in microwells. Bone marrow cells were fractionated by discontinuous Percoll gradients and diluted in culture medium containing colony-stimulating factors. They were diluted and cultured in medium containing colony-stimulating factor and 10(-5) M hydrocortisone in microwells over a range of cell densities that allowed calculation of the frequency of growth-inducible precursors. After 10 days, the wells were examined for clonal growth. Clonal proliferation followed the single-hit model of the Poisson distribution. More progenitors were detected in this assay than in simultaneous methylcellulose colony assays or agar cultures. Thymidine suicide experiments led to an increase in the frequency of progenitors detected in this assay, but a decrease in the frequency of methylcellulose colonies. This system may detect additional, less mature progenitors than are detected in semisolid culture systems. PMID- 3683417 TI - Neurobiology of drug abuse. PMID- 3683418 TI - Infant search and object permanence: a meta-analysis of the A-not-B error. AB - Research on Piaget's stage 4 object concept has failed to reveal a clear or consistent pattern of results. Piaget found that 8-12-month-old infants would make perserverative errors; his explanation for this phenomenon was that the infant's concept of the object was contextually dependent on his or her actions. Some studies designed to test Piaget's explanation have replicated Piaget's basic finding, yet many have found no preference for the A location or the B location or an actual preference for the B location. More recently, researchers have attempted to uncover the causes for these results concerning the A-not-B error. Again, however, different studies have yielded different results, and qualitative reviews have failed to yield a consistent explanation for the results of the individual studies. This state of affairs suggests that the phenomenon may simply be too complex to be captured by individual studies varying 1 factor at a time and by reviews based on similar qualitative considerations. Therefore, the current investigation undertook a meta-analysis, a synthesis capturing the quantitative information across the now sizable number of studies. We entered several important factors into the meta-analysis, including the effects of age, the number of A trials, the length of delay between hiding and search, the number of locations, the distances between locations, and the distinctive visual properties of the hiding arrays. Of these, the analysis consistently indicated that age, delay, and number of hiding locations strongly influence infants' search. The pattern of specific findings also yielded new information about infant search. A general characterization of the results is that, at every age, both above-chance and below-chance performance was observed. That is, at each age at least 1 combination of delay and number of locations yielded above-chance A not-B errors or significant perseverative search. At the same time, at each age at least 1 alternative combination of delay and number of locations yielded below chance errors and significant above-chance correct performance, that is, significantly accurate search. These 2 findings, appropriately elaborated, allow us to evaluate all extant theories of stage 4 infant search. When this is done, all these extant accounts prove to be incorrect. That is, they are incommensurate with one aspect or another of the pooled findings in the meta-analysis. Therefore, we end by proposing a new account that is consistent with the entire data set. PMID- 3683419 TI - [Nickel accumulation and/or release in acute myocardial necrosis]. PMID- 3683420 TI - [Botryoid-myxomatous rhabdomyosarcoma of the larynx in an adult]. PMID- 3683421 TI - [Unusual leiomyoma of the prostate]. PMID- 3683422 TI - [Diabetes mellitus in the case material of our hospital]. PMID- 3683423 TI - [Thyroid and spleen involvement in acute sarcoidosis. Rare pathological findings in a young woman having died under unusual circumstances]. PMID- 3683424 TI - [Cases of mycosis in a tropical practice]. PMID- 3683425 TI - [Experience with HLA studies in paternity cases]. PMID- 3683426 TI - [Characteristics of dissociation in cultures of Aspergillus brasilense Sp7]. AB - Peculiarities of dissociation in the cultures of nitrogen-fixating soil microorganism Azospirillum brasilense have been studied. The possible transfer among colony-morphology variants is established. The relations between variants are described by the following scheme: R in equilibrium with SR----S Electrophoretic analysis of plasmid contents in different variants of Azospirillum brasilense supposes the possible participation of plasmid DNA in the dissociation process in this microorganism. PMID- 3683427 TI - [Cloning and expression of genes of the luminescence system in Photobacterium leiognathi]. AB - The genes of Photobacterium leiognathi luminescence system were cloned in plasmid pUC18. Escherichia coli cells harboring a recombinant plasmid pPHL1 are luminescent. pPHL1 contains luciferase genes and genes responsible for aldehyde biosynthesis. The luminescence of Escherichia coli is subject to autoinductor regulation similar to the one existing in luminescent bacteria. The 2.7 kb fragment of Photobacterium leiognathi DNA containing the genes for alpha- and beta-luciferase subunits were cloned in pUC19. PMID- 3683428 TI - Dynamics of the genome. Selected papers of the 16th annual meeting of the European Environmental Mutagen Society. Brussels, 25-30 August 1986. PMID- 3683429 TI - Abstracts of the 16th annual meeting of the European Environmental Mutagen Society (EEMS). 25-30 August 1986, Brussels (Belgium). PMID- 3683430 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Topic No. 1. Are somatic mutations involved in atherosclerosis? PMID- 3683431 TI - The cytonucleus test in the rat: a combined metaphase and micronucleus assay. AB - The suitability of the rat as a species choice for the micronucleus assay and the possibility of combining both metaphase and micronucleus analysis using one set of animals were investigated. Cyclophosphamide, trenimon, vinblastine sulphate and dimethyl benzanthracene were used to optimise the study design and experimental procedures. The sample times ranged from 12 to 72 h after a single dose of the compound. A maximal response in both micronucleus and chromosome aberration induction was observed 24 h after dosing. This sample time is recommended as the single sample time for the screening of all classes of compound. Using the optimal conditions, a number of different mutagens/carcinogens were then analysed for the induction of both micronuclei and chromosome aberrations in the same animal. The compounds selected were mitomycin C, methotrexate, 5-fluorouracil, hexamethyl phosphoramide, benzo[a]pyrene, benzidine and diaminoterphenyl. The results show that the rat is a responsive test species and that it is possible to combine both metaphase and micronucleus analysis in the same animal. PMID- 3683432 TI - Chromosomal abnormalities and sister-chromatid exchange in bone marrow cells of mice and Chinese hamsters after inhalation and intraperitoneal administration: I. Diepoxybutane. AB - Diepoxybutane (DEB), a direct-acting animal carcinogen, was found to increase the frequency of structural chromosomal abnormalities (CA) and sister-chromatid exchange (SCE) in bone marrow cells of mice and Chinese hamsters, when inhaled from an aerosol during a 2-h head-only exposure or administered as a single intraperitoneal injection. For the purpose of comparing the genotoxicity in the 2 species, both after inhalation and intraperitoneal administration, the systemic DEB dose obtained by inhalation was determined on the basis of blood concentrations and inhalation duration after the investigation of the blood kinetics. The bone marrow cells of male and female NMRI mice were found to be more sensitive than those of Chinese hamsters to the genotoxic activity of DEB. PMID- 3683433 TI - Effect of concentration-time parameters on sister-chromatid exchanges induced in rabbit lymphocytes by ethylene oxide inhalation. AB - To evaluate the effect of exposure pattern on induction and persistence of SCEs in peripheral lymphocytes and formation and persistence of the specific adduct N 3'-(2-hydroxyethyl)-histidine in hemoglobin, groups of male New Zealand white rabbits were exposed to ethylene oxide (ETO) at 200 ppm or 400 ppm for 6 h a day, 5 days a week or to 1500 ppm twice a day for 15 min until all groups reached an equal concentration-time (Ct) product of 4.8 X 10(4) ppm.h. Results show that both induced SCEs and the specific histidine adduct in hemoglobin reflect cumulative ETO exposure whether it occurs chronically at a concentration of 200 ppm or to brief exposures at the 7.5 times higher concentration of 1500 ppm. Haber's rule appears to be in effect over this range of exposure concentrations and times. Persistence of these effects appears not to be related to exposure concentration nor exposure pattern. These results contribute to further understanding of alkylating chemical mutagen dosimetry and of SCE and hemoglobin adducts as indices of exposure. PMID- 3683434 TI - Chromosome aberrations in workers at a tannery in Iraq. AB - Blood samples were collected from 17 healthy chromium-exposed workers at a tanning plant near Baghdad city and 13 controls matched for age, period of service and social background. For each individual more than 100 lymphocyte metaphases were examined. The results showed no significant differences in the per cell frequencies of chromatid and isochromatid gaps, single chromatid breaks, various chromosome-type aberrations and all aberrations combined. However, smoking workers exhibited statistically higher frequency of chromosome-type aberrations than non-smoking workers and smoking controls. PMID- 3683435 TI - Chromosome aberrations, micronuclei and sister-chromatid exchanges in blood lymphocytes after occupational exposure to low levels of styrene. AB - Chromosome aberrations, micronuclei and sister-chromatid exchanges were analysed in blood lymphocytes of 21 reinforced plastic workers, exposed to styrene from 1 to 25 years, and 21 control persons. Occupational hygienic measurements showed personal exposure to styrene to range from 34 to 263 mg/m3 air, the average was 98 mg/m3. Urinary mandelic acid levels of the workers varied from below detection limit to 7 mM/1 l urine. No increase was detected in the frequency of any of the cytogenetic endpoints studied. No correlations between the number of aberrations, micronuclei or SCEs on one hand and the extent or duration of exposure to styrene on the other could be detected. PMID- 3683436 TI - The genotoxic effect of beta-propiolactone on mammalian oocytes. AB - beta-Propiolactone (beta PL) has been tested on preimplantation mouse embryos for possible genotoxic effects. Tests were performed at different stages of meiosis (late prophase I, diakinesis/metaphase I, anaphase I, telophase I/prophase II and metaphase II) by injecting females at various times after the induction of superovulation. Male and female derived chromosome complements from first cleavage embryos were analysed before syngamy for cytogenetic abnormalities. A higher proportion of diploid oocytes, produced by the non-extrusion of the first or second polar body, was found after fertilization when the compound was administered immediately before metaphase I or II. No obvious effect was detected at any other time of beta PL exposure. Based on these results, several possible modes of action for beta PL are postulated. PMID- 3683437 TI - Circadian reduction of chromium in the gastric environment. AB - Samples of gastric juice from variously treated subjects efficiently reduced hexavalent chromium and decreased its mutagenicity. Chromium reduction was due to thermostable components of gastric secretions and was favoured by the acidity of the intragastric environment. The circadian monitoring of pH and of chromium reduction, as assessed by colorimetric analysis at hourly intervals, showed a basal activity (less than 10 micrograms/ml gastric juice) during the night and interdigestive periods, and peaks (tens of micrograms/ml) during the 3-4-h periods after each meal. Assays in the Ames reversion test confirmed that the decrease in mutagenicity of sodium dichromate produced by gastric juice was significantly enhanced after meals. This physiological mechanism is expected to provide an important protective barrier against the oral toxicity of this metal, and may explain its lack of oral carcinogenicity. PMID- 3683438 TI - Micronucleus test in bone marrow of mice treated with 1-nitropropane, 2 nitropropane and cisplatin. AB - Micronucleus tests were carried out in bone marrow of mice treated with 1 nitropropane, 2-nitropropane and cisplatin. For 1-nitropropane and 2-nitropropane the results were negative. With cisplatin a dose-dependent increase in the number of polychromatic erythrocytes with micronuclei was observed. The lowest positive dose was 0.1 mg/kg (P less than 0.001, Mann-Whitney-Wilcoxon test). The hepatocarcinogen 2-nitropropane showed clastogenic activity in human lymphocytes in vitro in the presence of S9 (Bauchinger et al., 1987). The negative results in bone marrow suggest that short-lived genotoxic metabolites may be formed in the liver but do not reach the bone marrow. PMID- 3683439 TI - Genotoxic effects of fluoride evaluated by sister-chromatid exchange. AB - The purpose of this investigation was to study the genotoxic potential of fluoride (in the form of sodium fluoride, NaF) using in vitro and in vivo sister chromatid exchange (SCE) assays with Chinese hamster cells. The NaF concentrations used in cultures of Chinese hamster ovary (CHO) cells ranged from 0 to 6.3 mM, both with and without S9 activation. Fluoride analysis of the culture medium demonstrated that it contained little indigenous fluoride, and the concentration of added fluoride was not affected by the components of the medium or the S9 mix. The CHO cells cultured in 6.3 mM NaF almost vanished, and at the concentration of 5.3 mM NaF in cultures without S9 microsome, only M1 cells were observed. In in vivo studies, Chinese hamsters were intubated with NaF dosages of 0, 0.1, 1.0, 10, 60 and 130 mg/kg, and the bone marrow (CHBM) cells were examined for SCE frequencies. Bone fluoride data showed that the intubated NaF was effectively absorbed. Death occurred in 3 of the 8 animals given 130 mg NaF/kg. The results indicated that NaF, in dosages up to 5.3 mM in CHO cell cultures and 130 mg/kg in in vivo CHBM cells, did not significantly increase the SCE frequencies over those observed in the negative (distilled water) controls. However, examination of the cell cycle revealed an inhibitory effect of NaF on cell proliferation with doses of NaF at or greater than 1.0 mM in cultured CHO cells and at or greater than 60 mg NaF/kg in in vivo CHMB cells. The results of the present study indicated an inhibition of the cell cycle and death of the cells with increasing concentrations of fluoride but not effect of fluoride on SCE frequency in CHO and CHBM cells. PMID- 3683440 TI - Inhibition of O6-alkylguanine-DNA-alkyltransferase by metals. AB - The activity of the DNA-repair protein O6-alkylguanine-DNA-alkyltransferase was found to be strongly inhibited by a number of metal ions. Cd2+ was the most active followed by Cu2+, Hg2+, Zn2+ and Ag2. This inhibition is likely to result from the interaction of the metals with the cysteine-acceptor residue on the protein since the inhibition was reduced by increasing the concentration of dithiothreitol in the assay buffer. These results raise the possibility that exposure to Cd2+ could increase the mutagenicity and carcinogenicity of alkylating agents by retarding the rate of repair of alkylated DNA. However, other metals or metallic compounds which are known to be carcinogenic (such as compounds containing arsenic, lead, nickel or chromium) did not interfere with DNA repair by this protein. PMID- 3683441 TI - Enhancement of plasminogen activator activities by N-methyl-N'-nitro-N nitrosoguanidine in tuberous sclerosis fibroblasts. AB - The alkylating agent N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) enhanced the levels of plasminogen activator (PA) activity in fibroblast cells derived from the skin of patients with tuberous sclerosis. The enhanced enzyme levels were not correlated with those of cloning efficiency nor those of DNA synthesis after MNNG treatment. Enzyme enhancement was also observed in fibroblasts of ataxia telangiectasia and in human neoplastic glia cells, but not in fibroblasts of normal children. The PA induction test may be sufficiently sensitive for the detection of the cellular defects of tuberous sclerosis. PMID- 3683442 TI - Effect of exogenous thymidine on sister-chromatid exchange frequency in Chinese hamster ovary cells with bromodeoxyuridine- and chlorodeoxyuridine-substituted chromosomes. AB - There are conflicting reports on the effect of exogenous thymidine (dThd) on the frequency of sister-chromatid exchanges (SCEs) in Chinese hamster ovary (CHO) cells. Thymidine has been reported either to increase or to have no effect on SCE frequency under similar experimental conditions. To resolve this controversy, we have carried out a series of experiments to examine the effect of dThd on CHO cells cultured with 5-bromodeoxyuridine (BrdUrd). In addition, we have examined the effect of dThd on CHO cells cultured with 5-chlorodeoxyuridine (CldUrd), a much more potent inducer of SCEs than BrdUrd. The addition of 100 microM dThd to the culture medium caused a consistent decrease in the yield of SCEs in cells grown in BrdUrd for two cell cycles. The decrease was even greater when cells were grown in dThd and CldUrd. Analysis of twin and single SCEs indicated that dThd must be present during the first cell cycle to reduce the frequency of SCEs. Because excess dThd is thought to have an effect when DNA replicates on a template substituted with a halogenated nucleoside, dThd at concentrations from 100 microM to 9 mM was added to cultures for the second cell cycle after a first cell cycle in BrdUrd. In this experiment, the presence of dThd increased SCE frequency in a dose-dependent manner. The results suggest that if dThd competes with halogenated nucleosides and thus decreases their incorporation into DNA, SCEs are suppressed in the subsequent cell cycle, whereas if excess dThd creates a dNTP pool imbalance, SCEs can be increased. PMID- 3683443 TI - AAEE case report #13: diabetic amyotrophy. AB - A case fulfilling the criteria for the diagnosis of diabetic amyotrophy is reported. Based on the clinical and electrodiagnostic features, it is concluded that diabetic amyotrophy is a recognizable clinical entity that can be differentiated from other diabetic neuropathies. The site of the lesion and the pathogenesis in diabetic amyotrophy remain controversial. The usual course of the illness is one of gradual improvement over weeks to months. PMID- 3683444 TI - Interactions of vitamin E and penicillamine in the treatment of hereditary avian muscular dystrophy. AB - Our prior work demonstrated that penicillamine treatment of dystrophic chickens delayed the onset of symptoms, partially alleviated contractures, improved muscle function, and lowered serum creatine kinase. Penicillamine, a sulfhydryl compound with reducing properties, also prevented inactivation of glycolytic enzymes by protecting thiol groups. The present study shows that vitamin E enhances the therapeutic effects of penicillamine. Interaction of these two reductants is dose related. With vitamin E as adjunct therapy, the dosage level of penicillamine could be lowered by 50%, thereby minimizing side effects. The therapeutic rationale for two antioxidants is that penicillamine may act primarily in the cytoplasm to prevent oxidative damage, whereas the more hydrophobic vitamin E may protect membrane bilayers. Additionally, penicillamine may prevent collagen cross linking and, deposition of insoluble collagen in muscle and thus decrease contracture formation. General applications of combined penicillamine and vitamin E therapy are discussed regarding prevention of free radical and oxidative damage in Duchenne dystrophy and a wide range of human diseases. PMID- 3683445 TI - Increased skeletal muscle acetylcholinesterase activity in porcine malignant hyperthermia. AB - The content and distribution of acetylcholinesterase (AChE) activity in the skeletal muscle disorder malignant hyperthermia (MH) was examined. The AChE activity of sarcolemma membranes isolated from MH-susceptible (MHS) swine was increased twofold when compared with normal sarcolemma. The total AChE activity of muscle extracts was also doubled in MHS tissue; however, the relative distribution between low-salt extractable (globular forms) and high-salt extractable (asymmetric forms) AChE activities were similar in MHS and normal muscle. Our results suggest that, for as yet unexplained reasons, both the sarcolemmal and total AChE activity of skeletal muscle is increased in porcine MH. PMID- 3683446 TI - The effect of temporal dispersion on compound action potential area in human peripheral nerve. AB - In 32 ulnar nerves of healthy volunteers, the mean area of the compound muscle action potential recorded over abductor digiti minimi was reduced by 7.4% when comparing above-elbow with wrist stimulation and by 1.9% when comparing above elbow with below-elbow stimulation. In 20 of these nerves, the mean area of the compound nerve action potential (CNAP) recorded over the fifth digit was reduced by 36% when comparing above-elbow with wrist stimulation. Area reduction of the compound action potential, especially of the CNAP, appears to be a characteristic effect of temporal dispersion in peripheral nerve when utilizing the bipolar recording technique routinely employed in clinical neurophysiology. A thorough understanding of the effects caused by temporal dispersion and of their quantitative limits in normal peripheral nerve is important for the proper interpretation of nerve conduction studies. PMID- 3683447 TI - Nature and properties of cytotoxic plasma activity in amyotrophic lateral sclerosis. AB - Cytotoxic activity of plasma towards normal red blood cells in patients with amyotrophic lateral sclerosis (ALS) has been studied as a function of progressive plasma dilution and compared with plasma from patients with Charcot-Marie-Tooth's disease (CMT). At progressive dilution the hemolysis by ALS-plasma showed a specific pattern that differed qualitatively and quantitatively from that of normal plasma as well as CMT and persisted up to a dilution of 1:6561. Differences in dilution pattern were found when comparing different clinical types of ALS. There was evidence for a partial complement dependency of the reaction that brings about the hemolysis provoked by ALS plasma. Experiments with plasma fractionated by gel filtration and with isolated immunoglobulins produced evidence for cytotoxic properties of IgA and IgG from ALS plasma. The observations speak in favor of a consistency between the observations of plasma cytotoxicity in ALS and earlier observations on immunological abnormalities in the disease. PMID- 3683448 TI - Changes in contractile speed of cat motor units during activity. AB - Experiments were conducted to measure the extent of contractile changes during phasic activity of different motor units. Motor units of cat medial gastrocnemius were isolated and classified by their mechanical properties as fast and fatigable (FF), fast and fatigue resistant (FR), or slow (S). Single stimuli interpolated between stimulus trains of the fatigue test produced twitches whose shapes were measured at different times during this test. After 30 seconds of fatigue testing, twitch contraction times of 33% of FF units fell into the slow range, i.e., 5 of 17 units had become slower than the fastest slow units. Mean twitch contraction time of FF units increased by 11.8 msec, whereas that of S units decreased by 16.2 msec. We conclude that the mechanical properties of rested motor units change markedly with use and are a poor index for determining the contractile speed of active muscles. PMID- 3683449 TI - Neuralgic amyotrophy. PMID- 3683450 TI - Temperature dependence of contraction characteristics in developing rat muscles. AB - Contractions of rat extensor digitorum longus (EDL, a fast muscle) and soleus (SOL, a slow muscle) muscles of different ages (1-4 weeks) were recorded in vitro with direct stimulation and at different temperatures (range 35-10 degrees C). Twitch tension in 4-week-old EDL muscle increased in cooling from 35 to 20 degrees C (cooling potentiation); the tension decreased in further cooling below 20 degrees C. This pattern of temperature dependence of twitch tension was seen in fast muscles of all ages (1-4 weeks). Twitch tension in 4-week-old SOL muscle decreased monotonically in cooling from 35 to 10 degrees C (cooling depression). This pattern of cooling depression was not clearly evident in younger SOL muscles. There was a marked hysteresis in the temperature dependence of twitch tension in the 1-week-old SOL muscles. Tetanic tension was depressed by low temperature in both EDL and SOL muscles at 1 week and at 4 weeks of age. Results show that the processes concerned with contractile activation are nearly fully developed in the fast muscle fibers at an early age (1 week), whereas they develop later in the slow muscle fibers. PMID- 3683451 TI - Rods in the terminal cisternae of skeletal muscle. AB - The purpose of the study was to investigate rod-like structures (rods) in the terminal cisternae membrane of freeze fracture replicas of fast- and slow-twitch mammalian muscle. The 9 X 50 nm rods crossed the junctional gap perpendicular to the T-tubule membrane and terminated near indentations. Rods are likely to have a structural basis because (1) grooves were seen in the complimentary membrane leaflet, (2) rods were seen in tissue fixed in 0.5, 5, or 6% glutaraldehyde or 5% acrolein, (3) rods were seen in tissue fractured over a range of temperatures from -40 to -196 degrees C, (4) the number of rods was correlated with the contractile properties of fibers, and (5) the density of rods increased when fibers were depolarized before fixation. The rods are in a unique location that would allow them to participate in excitation-contraction coupling, perhaps by transmitting an electrical signal from the T-tubule membrane to calcium release sites in the terminal cisternae. PMID- 3683452 TI - Effects of fatiguing exercise on high-energy phosphates, force, and EMG: evidence for three phases of recovery. AB - Experiments were designed to evaluate the relative contribution of impulse propagation failure, high-energy phosphate depletion, lowered pH, and impaired excitation-contraction coupling to human muscle fatigue and recovery. 31P nuclear magnetic resonance spectroscopy measurements were made on adductor pollicis muscle, together with simultaneous measurements of M-wave, force, and rectified integrated EMG (RIEMG). During fatigue, maximum voluntary contraction force (MVC) fell by 90%, pH fell from 7.1 to 6.4, and phosphocreatine was almost totally depleted. Neuromuscular efficiency (NME = force/RIEMG) was reduced to 40% of control at the end of the fatiguing contraction, and the M wave was reduced in amplitude and prolonged in duration. Following exercise, the M wave returned to normal within 4 minutes. pH, high-energy phosphates, and MVC recovered within 20 minutes. By contrast, neuromuscular efficiency did not recover within 60 minutes. These findings indicate three different components of fatigue. The first is reflected by the altered M wave and indicates impaired muscle membrane excitation and impulse propagation. The second, associated with reduced MVC, correlates with the metabolic state of the muscle (PCr and pH). The third, indicated by reduced NME, is independent of changes in high-energy phosphates and pH and is probably due to impaired excitation-contraction coupling. PMID- 3683453 TI - Trial of ganglioside therapy for diabetic neuropathy. AB - The efficacy of daily intramuscular injection of mixed gangliosides (Cronassial) for highly symptomatic diabetic neuropathy was investigated in a randomized double-blind trial. There were 37 patients treated with 40 mg of gangliosides or placebo for 12 weeks and studied with physical examination, symptom scales, and electrophysiologic parameters. There was no demonstrated benefit of therapy. Given the spontaneous variation in the measurements employed, larger numbers of patients would have been needed to identify a significant change of 10% owing to therapy. PMID- 3683455 TI - SFEMG in myasthenia gravis. PMID- 3683454 TI - A computer model of denervation-reinnervation in skeletal muscle. AB - A computer model of the process of denervation and complete reinnervation of skeletal muscle has been developed for the purpose of exploring underlying mechanisms and for use in the development of new clinical and research tools for evaluating neuromuscular disease. Progressive motor neuron death and reinnervation in this model reproduces the fiber-type grouping, increased fiber density, and minimal increase of motor unit size seen in human chronic denervating diseases. Studies using the model suggest that (1) preferential involvement of motor units of one type could account for the abnormal fiber-type proportions observed in some diseases, (2) reinnervation by axons innervating adjacent fibers is compatible with single fiber multielectrode study results in that it does not produce a large increase in motor unit area, and (3) such reinnervation is sufficient to account for the increases in motor unit density that have been observed. The model has also been used in the development and testing of the Codispersion Index, a measure of the codistribution of two fiber types, which is useful in detecting fiber-type grouping. PMID- 3683456 TI - Normal supraspinatus muscle. PMID- 3683457 TI - Reanalysis: impulse activity and fiber type transformation: a reply. PMID- 3683459 TI - The course and prognosis of different forms of chronic airways obstruction in a sample from the general population. AB - We examined the course and prognosis in subjects selected from the general population who had chronic airflow obstruction at the time of their enrollment in a longitudinal epidemiologic study. Mortality and the rate of change in lung function were analyzed in relation to the initial clinical characteristics of the subjects. Twenty-seven subjects with symptoms and signs of asthma (Group I) had a higher survival rate and a much lower rate of decline in pulmonary function than the 45 subjects in Group III, whose clinical characteristics were more compatible with an emphysematous form of chronic obstructive pulmonary disease (COPD). The 10-year mortality among subjects in Group III (non-atopic smokers without a history of asthma) was close to 60 percent, whereas it was only 15 percent in Group I (atopic subjects or nonsmokers with known asthma). The mean overall rate of decline in forced expiratory volume in one second was 70 ml per year in Group III but less than 5 ml per year in Group I. Forty-five patients (Group II) who did not clearly fit into either Group I or III had intermediate values for survival and decline in pulmonary function. Previous data on mortality from COPD and the rate of progression of the condition, although compatible with our findings in patients who had an emphysematous form of disease, are not applicable to those with an asthmatic-bronchitic form. Better control of the progression of asthmatic bronchitis with therapy may explain its more favorable prognosis. PMID- 3683458 TI - Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. AB - We prospectively examined the incidence of coronary heart disease in relation to cigarette smoking in a cohort of 119,404 female nurses who were 30 to 55 years of age in 1976 and were free of diagnosed coronary disease. During six years of follow-up, 65 of the women died of fatal coronary heart disease and 242 had a nonfatal myocardial infarction. The number of cigarettes smoked per day was positively associated with the risk of fatal coronary heart disease (relative risk = 5.5 for greater than or equal to 25 cigarettes per day), nonfatal myocardial infarction (relative risk = 5.8), and angina pectoris (relative risk = 2.6). Even smoking 1 to 4 or 5 to 14 cigarettes per day was associated with a twofold to three-fold increase in the risk of fatal coronary heart disease or nonfatal infarction. Overall, cigarette smoking accounted for approximately half these events. The attributable (absolute excess) risk of coronary heart disease due to current smoking was highest among women who were already at increased risk because of older age, a parental history of myocardial infarction, a higher relative weight, hypertension, hypercholesterolemia, or diabetes. In contrast, former smokers had little, if any, increase in risk. These prospective data emphasize the importance of cigarette smoking as a determinant of coronary heart disease in women, as well as the markedly increased hazards associated with this habit in combination with other risk factors for this disease. PMID- 3683460 TI - Effects of treatment on fertility in long-term survivors of childhood or adolescent cancer. AB - In a retrospective cohort study of survivors of cancer and of controls, we estimated the risk of infertility after treatment for cancer during childhood or adolescence. We interviewed 2283 long-term survivors of childhood or adolescent cancer diagnosed in the period from 1945 through 1975, who were identified at five cancer centers in the United States. Requirements for admission to the study were diagnosis before the age of 20, survival for at least five years, and attainment of the age of 21. In addition, 3270 controls selected from among the survivors' siblings were interviewed. Cox regression analysis showed that cancer survivors who married and were presumed to be at risk of pregnancy were less likely than their sibling controls to have ever begun a pregnancy (relative fertility, 0.85; 95 percent confidence interval, 0.78 to 0.92). Radiation therapy directed below the diaphragm depressed fertility in both sexes by about 25 percent. Chemotherapy with alkylating agents, with or without radiation to sites below the diaphragm, was associated with a fertility deficit of about 60 percent in the men. Among the women, there was no apparent effect of alkylating-agent therapy administered alone (relative fertility, 1.02) and only a moderate fertility deficit when alkylating-agent therapy was combined with radiation below the diaphragm (relative fertility, 0.81). Relative fertility in the survivors varied considerably according to sex, site of cancer, and type of treatment; these factors should be taken into consideration in counseling survivors about the long-term consequences of disease. PMID- 3683461 TI - Plasma R binder deficiency and neurologic disease. PMID- 3683462 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 47-1987. A 79-year-old Cuban native with asthma, weight loss, vomiting, eosinophilia, and past meningitis. PMID- 3683463 TI - Smoking and women: tragedy of the majority. PMID- 3683464 TI - Pain in the neonate. PMID- 3683465 TI - Ten-year longitudinal study of children at high risk of insulin-dependent diabetes mellitus. PMID- 3683466 TI - Ethical dilemmas in the early detection of malignancy by NMR spectroscopy of plasma. PMID- 3683467 TI - Malpractice and the quality of care. PMID- 3683468 TI - Doctors and the dispensing of drugs. PMID- 3683469 TI - Fibrin and fibrinogen-related antigens in patients with stable and unstable coronary artery disease. AB - Coronary-artery thrombosis may be important in the pathogenesis of unstable angina at rest. To study this possibility, we measured the serum concentrations of fibrin-related antigen, D dimer (the principal breakdown fragment of fibrin), and fibrin monomer (an intermediate product of fibrin formation) in the serum of five groups of subjects. These included 10 healthy controls, 10 controls with noncardiac pain, and three groups of 10 patients each with chronic stable angina, unstable angina at rest, or acute myocardial infarction. The concentration of fibrin-related antigen (normal range, 48 to 184 ng per milliliter) was normal in the control patients with noncardiac pain (63 to 202 ng per milliliter) and in patients with chronic stable angina (95 to 186), but it was increased in patients with unstable angina (401 to 2507) or acute myocardial infarction (470 to 1930) (P less than 0.001). D dimer concentrations in patients with unstable angina (178.3 to 310.6 ng per milliliter) or acute myocardial infarction (103.9 to 321.6) were higher than those in patients with chronic stable angina (28.6 to 52.1), in controls with noncardiac pain (44.7 to 53.1), and in healthy controls (40.4 to 50.3) (P less than 0.001). Concentrations of fibrin monomer were highest in patients with acute myocardial infarction (247.5 to 571.3 ng per milliliter) (P less than 0.001), intermediate in those with unstable angina (54.7 to 241.7) (P less than 0.001), and normal (normal range, 14.5 to 19.8 ng per milliliter) in controls with noncardiac pain (12.0 to 18.4). and patients with chronic stable angina (10.7 to 17.6). These findings suggest the presence of an active thrombotic process in patients with unstable angina at rest or acute myocardial infarction. The data do not prove that the coronary arteries were the site of the thrombotic process, but the observations are consistent with the hypothesis that thrombus formation may have an important role in the pathogenesis of these conditions. PMID- 3683470 TI - Impaired forearm vasodilator reserve in patients with microvascular angina. Evidence of a generalized disorder of vascular function? AB - In previous work, we described a group of patients with angina-like chest pain and normal coronary arteries. These patients had impaired coronary vasodilator responses to the stress of rapid atrial pacing and to the administration of dipyridamole, a potent vasodilator of coronary arterioles. This abnormality appears to be localized to the prearteriolar microvascular bed. To determine whether these patients have a more generalized abnormality of vasodilator reserve, we used mercury-in-Silastic strain-gauge plethysmography to compare their hyperemic responses to forearm ischemia with those of normal controls. After 10 minutes of ischemia, peak forearm flow was 39.9 +/- 5.0 ml per minute per deciliter in the controls [corrected] and 31.7 +/- 10.5 in the patients [corrected] (21 percent reduction; 95 percent confidence interval, 4 percent to 37 percent). Flow responses were also significantly reduced after three and five minutes of ischemia. Correspondingly, the vascular resistance after ischemia was also consistently higher in the patients with microvascular angina. The degree of vasodilator impairment in the peripheral circulation correlated well with the degree of vasodilator impairment in the coronary circulation (r = 0.74; P less than 0.004). Thus, patients with microvascular angina appear to have an impairment of vasodilator reserve that affects not only their coronary circulation but also their peripheral arterial bed. PMID- 3683471 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 48-1987. A 27-year-old man with a pulmonary mass of 3 1/2 years' duration. PMID- 3683472 TI - When the patient is a physician. PMID- 3683473 TI - Generic drugs. PMID- 3683474 TI - Dopamine in dopamine-beta-hydroxylase deficiency. PMID- 3683475 TI - Campylobacter pylori and antral gastritis in children. PMID- 3683476 TI - Medical-specialties matching program, 1988-1989. PMID- 3683477 TI - Ethics by committee? PMID- 3683478 TI - Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. AB - To study the effectiveness of adenoidectomy and of the placement of tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 children, aged four through eight years, to receive bilateral myringotomy and no additional treatment (Group 1), placement of tympanostomy tubes (Group 2), adenoidectomy (Group 3), or adenoidectomy and placement of tympanostomy tubes (Group 4). The 491 children who underwent one of these treatments were examined at six-week intervals for up to two years. The mean time spent with effusion of any type in either ear over the two-year follow-up in the four groups was 51, 36, 31, and 27 weeks, respectively (P less than 0.0001), comparing Group 1 with each of the other groups. Hearing was equivalent in Groups 2, 3, and 4, and was significantly better than in Group 1. The most frequent sequela, purulent otorrhea, occurred one or more times in 22, 29, 11, and 24 percent of the subjects in Groups 1, 2, 3, and 4, respectively (P less than 0.001). Adenoidectomy plus bilateral myringotomy lowered the overall post treatment morbidity (as measured by hearing acuity in the most severely affected ear [P = 0.0174] and the number of surgical retreatments required [P = 0.009]) more than did tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. We conclude that adenoidectomy should be considered when surgical therapy is indicated in children four to eight years old who are severely affected by chronic otitis media with effusion. PMID- 3683479 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 49-1987. A 48-year-old woman with a history of nephrolithiasis, ureteral narrowing, and an adnexal mass. PMID- 3683480 TI - Treatment decisions in the mentally impaired. Limiting but not abandoning treatment. PMID- 3683481 TI - Neurosyphilis and HIV infection. PMID- 3683482 TI - Prevention of predictable Raynaud's phenomenon by sublingual nifedipine. PMID- 3683483 TI - Potentiation by light of lithium-induced retinal injury in rats. PMID- 3683484 TI - Prognostic importance of thallium uptake by the lungs during exercise in coronary artery disease. AB - We studied the value of thallium imaging as compared with clinical and exercise test variables in predicting cardiac events occurring over five years in 525 consecutive patients referred for thallium-exercise testing in 1979. Follow-up was obtained on 467 patients (89 percent). There were 105 cardiac events--25 cardiac deaths, 33 myocardial infarctions, and 47 coronary bypass procedures. A Cox survival analysis identified increased thallium uptake by the lungs, a marker of left ventricular dysfunction during exercise, as the best predictor of a cardiac event (relative risk ratio = 3.5; 95 percent confidence interval, 2.2 to 5.4). The next most powerful predictors were a history of typical angina, a previous myocardial infarction, and ST-segment depression during exercise (relative risk ratios = 2.1, 1.8, and 1.7, respectively). No combination of variables made up for the loss in prognostic power when the variable of increased thallium uptake by the lungs was removed from the model. Cardiac events occurred over five years in 10 (5 percent) of 192 patients with a normal thallium scan, 41 (25 percent) of 163 patients with an abnormal thallium scan but normal thallium activity in the lungs, and 54 (67 percent) of 81 patients with increased thallium uptake by the lungs (P less than 0.0001). We conclude that increased uptake of thallium by the lungs during exercise predicts a high risk of subsequent cardiac events. PMID- 3683485 TI - Improving the quality of life during chemotherapy for advanced breast cancer. A comparison of intermittent and continuous treatment strategies. AB - Since chemotherapy for metastatic breast cancer is not curative, consideration of the quality of life is important in selecting a treatment regimen. We conducted a randomized trial comparing continuous chemotherapy, administered until disease progression was evident, with intermittent therapy, whereby treatment was stopped after three cycles and then repeated for three more cycles only when there was evidence of disease progression. Each approach was tested with doxorubicin combined with cyclophosphamide or with cyclophosphamide combined with methotrexate, fluorouracil, and prednisone. Intermittent therapy resulted in a significantly worse response (P = 0.02 by Mann-Whitney test), a significantly shorter time to disease progression (relative risk based on proportional-hazards model, 1.8; 95 percent confidence interval, 1.4 to 2.4), and a trend toward shorter survival (relative risk, 1.3; confidence interval, 0.99 to 1.6). The quality of life was expressed as linear-analogue self-assessment scores for physical well-being, mood, pain, and appetite and as a quality-of-life index. It improved significantly during the first three cycles, when all patients received treatment. Thereafter, intermittent therapy was associated with worse scores for physical well-being (by 23 percent of scale; 95 percent confidence interval, 11 to 35 percent), mood (25 percent; 13 to 37 percent), and appetite (12 percent; 0 to 24 percent) and for the quality-of-life index as indicated by the patient (14 percent; 5 to 23 percent) and the physician (16 percent; 7 to 26 percent). Changes in the quality of life were independent prognostic factors in proportional-hazards models of subsequent survival. We conclude that, as tested, continuous chemotherapy is better than intermittent chemotherapy for advanced breast cancer. PMID- 3683486 TI - Altered cardiac repolarization in some victims of sudden infant death syndrome. AB - Abnormal prolongation of cardiac repolarization, as reflected by a long QT interval with respect to the RR interval on the electrocardiogram, is known to be associated with ventricular tachyarrhythmias. To test the hypothesis that prolonged cardiac repolarization may characterize some babies who die of sudden infant death syndrome (SIDS), we studied the dependence of the QT interval on the preceding RR interval in 10 babies with SIDS and 29 healthy control babies. We analyzed approximately 5000 pairs of QT and RR intervals in each subject over a wide range of RR intervals. We found that the QT intervals demonstrated less dependence on the preceding RR intervals in 5 of 10 babies who subsequently died of SIDS than in normal controls. No ventricular arrhythmias were observed, however, during the six-hour recording period. Our data suggest that in some babies with SIDS the ability to shorten the QT interval as the heart rate increases is impaired. These observations are consistent with the hypothesis that relatively prolonged cardiac repolarization may predispose such babies to ventricular arrhythmias. PMID- 3683487 TI - Lung uptake of thallium as a prognostic indicator. PMID- 3683488 TI - Treating the patient, not just the cancer. PMID- 3683489 TI - Thyroid function in premenstrual syndrome. PMID- 3683490 TI - More on bone mineral screening for osteoporosis. PMID- 3683491 TI - Complement in the pathophysiology of human disease. PMID- 3683492 TI - Ear-clicking "tinnitus" responding to carbamazepine. PMID- 3683493 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 51-1987. Progressive abdominal distention in a 51-year-old woman with polycythemia vera. PMID- 3683494 TI - Powerful prions? PMID- 3683495 TI - Geographic variations in mortality from motor vehicle crashes. PMID- 3683496 TI - Progressive nemaline (rod) myopathy associated with HIV infection. PMID- 3683497 TI - Butyl nitrite in the induction of Kaposi's sarcoma in AIDS. PMID- 3683498 TI - Incidence of ambulatory pulmonary embolism. PMID- 3683499 TI - Compensatory enlargement of human atherosclerotic coronary arteries. PMID- 3683500 TI - Aluminum and dihydropteridine reductase in dialysis patients. PMID- 3683501 TI - The Behrhorst Foundation. PMID- 3683502 TI - Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. AB - There have been numerous studies of post-traumatic stress disorder in trauma victims, war veterans, and residents of communities exposed to disaster. Epidemiologic studies of this syndrome in the general population are rare but add an important perspective to our understanding of it. We report findings on the epidemiology of post-traumatic stress disorder in 2493 participants examined as part of a nationwide general-population survey of psychiatric disorders. The prevalence of a history of post-traumatic stress disorder was 1 percent in the total population, about 3.5 percent in civilians exposed to physical attack and in Vietnam veterans who were not wounded, and 20 percent in veterans wounded in Vietnam. Post-traumatic stress disorder was associated with a variety of other adult psychiatric disorders. Behavioral problems before the age of 15 predicted adult exposure to physical attack and (among Vietnam veterans) to combat, as well as the development of post-traumatic stress disorder among those so exposed. Although some symptoms of post-traumatic stress disorder, such as hyperalertness and sleep disturbances, occurred commonly in the general population, the full syndrome as defined by the Diagnostic and Statistical Manual of Mental Disorders, third edition, was common only among veterans wounded in Vietnam. PMID- 3683503 TI - A fatal thrombotic disorder associated with an acquired inhibitor of protein C. PMID- 3683504 TI - The great American roundup. PMID- 3683505 TI - Suppressive therapy with levothyroxine for solitary thyroid nodules. PMID- 3683506 TI - Improved survival after acute myocardial infarction. PMID- 3683507 TI - Aortic-root dilatation in Noonan's syndrome. PMID- 3683508 TI - A word about prisons: "desmoteric". PMID- 3683509 TI - Hospital inpatient mortality. Is it a predictor of quality? AB - Various potential measures of quality of care are being used to differentiate hospitals. Last year, on the basis of diagnostic and demographic data, the Health Care Financing Administration identified hospitals in which the actual death rate differed from the predicted rate. We have developed a similar model. To understand why there are high-outlier hospitals (in which the actual death rate is above the predicted one) and low-outlier hospitals (in which the actual death rate is below the predicted one), we reviewed 378 medical records from 12 outlier hospitals treating patients with one of three conditions: cerebrovascular accident, myocardial infarction, and pneumonia. After adjustment for the severity of illness, the death rate in the high outliers exceeded that predicted from the severity of illness alone by 3 to 10 percent, and in the low outliers, the actual death rate fell short of the severity-adjusted predictions by 10 to 15 percent (P less than 0.01). Reviews of the process of care using 125 criteria revealed no differences between the high and low outliers. However, detailed reviews by physicians of the records of patients who died during hospitalization revealed a higher rate of preventable deaths in the high outliers than in the low outliers. For the three conditions studied, we project that 5.7 percent of a standard cohort of patients admitted to the high-outlier hospitals would have preventable deaths, as compared with 3.2 percent of patients admitted to the low-outlier hospitals (P less than 0.05). A meaningful comparison of hospital death rates requires adjustment for severity of illness. Our findings indicate that high outlier hospitals care for sicker patients. However, these same hospitals or their medical staffs may also provide poorer care. Our results need confirmation before death-rate models can be used to screen hospitals. PMID- 3683510 TI - Rhinosporidiosis in bovines of Kanyakumari district, Tamil Nadu, India. AB - A survey on rhinosporidiosis in animals was conducted in Kanyakumari (K.K.) district of Tamil Nadu, India. Among 103 animals (40 bullocks, 45 cows, 15 heifers, 2 bulls and a buffalo), 19 (9 bullocks, 8 cows, 1 heifer and a she buffalo) were found to be infected with Rhinosporidium seeberi. The study revealed the endemic nature of the disease in bovines of K.K. district. Agastheeswaram taluk contributed 52.6 per cent of positive cases followed by Kalkulam (26.2 per cent). The disease was also found in exotic cattle (1 Holstein Friesien (HF) cow, 1 Swiss Brown cow and 1 HF heifer). The rest 16 were indigenous non-descript cattle. There was no sex variance as the cases were evenly distributed between both sexes. One of the infected animals was a she buffalo. A case of recurrence of growth was observed in a bullock. Another bullock had concurrent infection of both rhinosporidiosis and nasal schistosomiasis. All the animals were adults and aged except the heifer. All were nose-roped. Cows were stall fed but bathed in ponds. PMID- 3683511 TI - Mycotoxins, mycotoxicoses, mycotoxicology and Mycopathologia. AB - Mycotoxins are fungal poisons. This definition does not stipulate whether fungi are the targets of poisoning or are the producers of the poisons. The following is suggested as a useful working definition: Mycotoxins are natural products produced by fungi that evoke a toxic response when introduced in low concentration to higher vertebrates and other animals by a natural route. Some mycotoxins have multiple effects, and may cause phytotoxic and antimicrobial syndromes in addition to animal toxicity. By convention, mushroom and yeast poisons are usually excluded from discussions of mycotoxins. The eclectic nature of the discipline and the international scope of the problem has attracted scientists from many different backgrounds. The publishers and editors of Mycopathologia intend for this journal to become a major forum for mycotoxin research. PMID- 3683512 TI - [Good and bad energy utilization: possibilities of diagnostic determination, preventive considerations and therapeutic influences on the efficiency of energy utilization in obesity, diabetes mellitus and fatty acid metabolic disorders, cardiovascular diseases and other metabolic syndromes. 10-12 December 1985, Brandenburg, East Germany. Proceedings]. PMID- 3683513 TI - [Quality changes in the storage of vegetable peas (Pisum sativum L.). 2. Nutritional physiologic quality]. AB - In tests extending over several years the typical changes in the nutritional quality as occur during storage at defined temperatures (0 ... 18 degrees C) were determined in dependence on the duration of storage (chi in days). Due to the nutrient transfer from the pods to the seeds, a temporary major rise of the dry matter content (DM) is recorded in the latter together with a strongly inhibited reduction of the mono- and disaccharide content. Green peas stored without pods show a linear decrease in the DM content, degressively increasing DM losses and a more distinct reduction of saccharides. When stored with the pods, the typical decline of the vitamin C (ascorbic acid + dehydroascorbic acid) [changes in the content according to the equation y = alpha 0 + beta 1e-c theta chi and losses according to y = beta 1(1 - e-c theta chi)] goes back, mainly owing to an essentially lower coefficient for c theta. In addition, there are smaller losses in the total carotene content of such crops in the first stage of storage (losses of y = beta 1 chi 2). When storing peas without pods, we observe a a faster accumulation of the titratable total acid (up to 160%). The greatest influence on range and degree of the changes in the chemical constituents is exerted by the storage temperature. The form of the harvested crop, varietal characteristics and annual growing conditions have less bearing. Relationships and physiological causes are discussed. PMID- 3683514 TI - Relations between enzyme activities connected with energy metabolism and parameters of food energy utilization in young and adult rats. Part 1. Studies on dietary effects on weight, body composition and energy gain. AB - Weaned male Wistar rats were fed ad libitum besides standard pellets a normal protein (NP), a low-protein (LP) and a high-fat (HF) diet for different periods of time. In comparison to rats on the NP diet the body weight of the LP group was significantly lower after seven weeks feeding, not after a duration of about forty weeks. No remarkable diet-related differences were detected by determination of the mean body composition and of the relative gross energy content of the body neither after seven nor forty weeks. Total gross energy intake was practically identical both for the NP and LP rats irrespective on the duration of the feeding period. A significantly lower quotient of body energy gain/total gross energy intake under the protein-restrictive LP diet after seven weeks suggests the expression of an energy dissipation obviously no longer visible after a long time feeding period. PMID- 3683515 TI - Relations between enzyme activities connected with energy metabolism and parameters of food energy utilization in young and adult rats. Part 2. Enzyme activities related to alpha-glycerophosphate shuttle in various tissues. AB - The possible significance of food composition connected with the alpha glycerophosphate (alpha GP) shuttle, a putative metabolic pathway of energy dissipation, was investigated at the level of enzyme activities. Liver, adipose tissue, slow-twitch and fast-twitch muscle of weaned male Wistar rats fed ad libitum for seven and for forty weeks a normal-protein (NP), a low-protein (LP), and a high-fat (HF) diet were examined. No striking dietary influences on cytosalic (NAD-linked glycerophosphate dehydrogenase, glyceraldehyde-phosphate dehydrogenase) and mitochondrial (succinate dehydrogenase, cytochrome c oxidase) enzyme activities could be detected, but mitochondrial alpha-glycerophosphate dehydrogenase (m-GPDH) showed an about twofold increase of its activity in the liver of LP-fed animals after seven weeks. A relationship between the "gross efficiency of food energy utilization" and tissue m-GPDH levels could not be established in general. The proposed inducing effect of a LP diet on the magnitude of the GP shuttle observed in the liver of young and adult rats seems to be interconnected reciprocally with the degree of metabolic energy dissipation only under the conditions of growth. The calculated capacities of the alpha GP shuttle are compatible with the assumption of its function as an energy dissipating pathway which is restricted in its magnitude. PMID- 3683516 TI - [Cross-over comparison of fava bean protein and HLP diet in patients with hypercholesterolemia (HC)]. PMID- 3683517 TI - [Networking as social action to assist each other]. PMID- 3683518 TI - [Networking as a social action: an unassuming campaign blended into social lives- the basis and responses to the campaign to build broad human relations]. PMID- 3683519 TI - [Participation by professionals in volunteer actions--a view by a nurse]. PMID- 3683520 TI - [Global networking of nurses superseding individual affiliations]. PMID- 3683521 TI - [Networking in corporation with the people striving for health]. PMID- 3683522 TI - [Active nursing activities after retirement from public health nursing: my networking activities]. PMID- 3683523 TI - [Networking by nurses: sincere approach and close cooperation. A discussion]. PMID- 3683524 TI - [A letter from a scene of regional welfare activities to a public health nurse- in search of a true form of cooperation]. PMID- 3683525 TI - [From "minimum consumption" to "maximum expression" of life potentials: networking in public health nursing]. PMID- 3683526 TI - [The importance of awareness of one's professional responsibility in networking]. PMID- 3683527 TI - [Prediction of intraoperative complications and nursing planning using a table showing numerical points assigned to various physiological signs--with an example of a poor risk]. PMID- 3683528 TI - [Sensitivity in nursing]. PMID- 3683530 TI - [Respect for the patient's desire in nursing]. PMID- 3683529 TI - [A nurse and naivete]. PMID- 3683531 TI - There but for fortune go you or I. PMID- 3683532 TI - The role of the theatre staff in the development of a new knee prosthesis. PMID- 3683533 TI - External fixation--a successful development. PMID- 3683535 TI - The use of cryosurgery in the treatment of dysfunctional uterine bleeding. PMID- 3683534 TI - Dynamic axial fixation--a nursing viewpoint. PMID- 3683536 TI - The developing role of the theatre sister. PMID- 3683537 TI - Practical computing in operating departments--an overview. PMID- 3683538 TI - Optimised theatre utilisation. PMID- 3683539 TI - Ultrasound for gallstones? PMID- 3683540 TI - Bavarian AIDS case to go to highest West German court. PMID- 3683541 TI - Call for government to re-think on radiation dose limits in Britain. PMID- 3683542 TI - AIDS report update. PMID- 3683543 TI - Circadian rhythms: hamsters without jet-lag. PMID- 3683544 TI - Evolutionary biology: gut reactions of lysozyme. PMID- 3683545 TI - Nuclear installations and childhood leukaemia. PMID- 3683546 TI - Why cystic fibrosis is on the increase. PMID- 3683547 TI - Anucleolate mutant due for re-examination. PMID- 3683548 TI - Small is beautiful. PMID- 3683549 TI - The first interferon. PMID- 3683550 TI - Karolinska Institute. PMID- 3683552 TI - Nobel prizes: no expense or effort spared. PMID- 3683551 TI - After Chernobyl. PMID- 3683553 TI - A behavioural method for accelerating re-entrainment of rhythms to new light-dark cycles. AB - The idea of ameliorating jetlag with drugs has received considerable attention. Melatonin has been found to reduce feelings of jetlag in people after transatlantic flights. In hamsters, injections of triazolam, a benzodiazepine, increase the rate of adjustment of activity rhythms to an 8 h advance of the light-dark (LD) cycle. But melatonin can make people drowsy and triazolam often induces hamsters to run in their wheels. Therefore, it is not clear whether these chemicals exert their chronotypic effects by acting directly on circadian pacemakers or because they first alter behavioural states. Non-photic behavioural events (for instance, social interactions) are capable of entraining rhythms and causing phase shifts. Thus, it is possible that behavioural events alone could alter the rate of adjustment to new LD cycles. To investigate this possibility, we studied the rate of re-entrainment of hamsters in a testing paradigm similar to that used with triazolam. We found that the rate of adjustment could be more than doubled simply by making the animals active on a single occasion in the middle of their normal rest period, immediately after the shift in the LD cycle. PMID- 3683554 TI - Characterization of beta-thalassaemia mutations using direct genomic sequencing of amplified single copy DNA. AB - Direct sequencing of specific regions of genomic DNA became feasible with the invention of the polymerase chain reaction (PCR) which permits amplification of specific regions of DNA. Recently, human mitochondrial DNA was amplified and directly sequenced. Using a thermostable DNA polymerase of T. aquaticus (Saiki, R.K. et al., manuscript in preparation) in the PCR, we have applied a combination of PCR and direct sequence analysis of the amplified product to a human single copy gene. We studied the genomic DNA of five patients with beta-thalassaemia whose mutant alleles were uncharacterized, and found two previously undescribed mutations, along with three known alleles. One new allele is a frameshift at codons 106-107 and the other is an A-C transversion at the cap site (+1) of the beta-globin gene. This latter is the first natural mutation observed at the cap site and it occurs in a gene which is poorly expressed. PMID- 3683555 TI - Characterization and molecular cloning of a bovine lentivirus related to human immunodeficiency virus. AB - An infectious virus which causes persistent lymphocytosis, lymphadenopathy, lesions in the central nervous system (CNS), progressive weakness and emaciation was previously isolated from the leukocytes of cattle. Our present studies show that this virus encodes a reverse transcriptase (RT) with Mg2+ cation preference, replicates and induces syncytia in a variety of embryonic bovine tissues in vitro, and has a morphology most similar to the human immunodeficiency virus (HIV). Moreover, serologic analyses have demonstrated a conservation of epitopes between the major core protein of this bovine retrovirus and HIV. Shared antigenic determinants were also observed with other pathogenic retroviruses of the lentivirus subfamily. To resolve the phylogenetic relationship of this virus, proviral molecular clones were derived and used to determine the nucleotide sequence of the highly conserved RT domain. The sequence data and serologic analyses together show that this bovine retrovirus is a novel lentivirus related to HIV and other lentiviruses. We propose that this virus be tentatively named bovine immunodeficiency-like virus (BIV) to reflect its genetic relationship and biological similarity to HIV. PMID- 3683556 TI - The Drosophila developmental gene snail encodes a protein with nucleic acid binding fingers. AB - Pattern formation in the Drosophila embryo requires the concerted expression of maternal and zygotic genes. At least nineteen genes, twelve of which are maternally expressed, are involved in the establishment of dorsal-ventral polarity. Mutations in any one of these genes result in distinct alterations of cell fates and in the formation of an abnormal dorsal-ventral pattern. Mutants of the 'dorsal group', eleven of the maternal genes, have a common recessive phenotype similar to that described for dorsal, in that cells located at ventral and lateral positions assume dorsal fates and ventral structures fail to develop. Thus the dorsal group gene products may be involved in the establishment of a gradient of positional information along the dorsal-ventral axis. We have cloned snail (sna), a zygotic gene, whose expression is essential for the correct specification of dorsal-ventral pattern. In this report, we present evidence that the complementary DNA-deduced protein product of sna contains five copies of a nucleic acid-binding finger motif previously identified in two transcription factors, and in the protein product of several putative regulatory genes. PMID- 3683557 TI - Britain hazards embryo research. PMID- 3683558 TI - Togetherness by debate. PMID- 3683559 TI - British government hedges bets on embryo research. PMID- 3683560 TI - Voluntary authority sighs with relief. PMID- 3683561 TI - Soviets ponder AIDS vaccine. PMID- 3683562 TI - Incubation period for AIDS. PMID- 3683564 TI - AIDS report produced early. PMID- 3683563 TI - Ultrasound backscatter microscopy images the internal structure of living tumour spheroids. AB - Ultrasound microscopes have the potential for imaging structure at depth in thick specimens, yet this is not possible in biological specimens using conventional ultrasound transmission or reflection methods. But, subsurfacing imaging is possible with ultrasound if a backscatter (pulse-echo) technique, similar to that used in medical imaging, is used. The central problem of extending backscatter imaging to ultrasound microscopy has been the development of high frequency (greater than 100 MHz) transducers with sufficient bandwidth and sensitivity to detect the low levels of backscatter from biological materials. We recently reported the development of such a transducer which we have now incorporated into a new ultrasound backscatter microscope capable of providing tomographic images at depths of up to 4 mm in biological specimens. Here we present the first ultrasound backscatter micrographs of living biological specimens. The benefits of this technique are demonstrated by its application to imaging the internal structures of living tumour spheroids showing striking contrast between the necrotic core and the viable rim of the spheroid. PMID- 3683566 TI - Another AIDS vaccine. PMID- 3683565 TI - NCI and Pasteur reveal details of AIDS foundations. PMID- 3683567 TI - Orphaned embryos to be implanted. PMID- 3683568 TI - Darwinism stays unpunctured. PMID- 3683569 TI - Growth-hormone receptor cloned. PMID- 3683570 TI - Neural networks. Implementation and analysis. PMID- 3683571 TI - Microwaves: the risks of risk research. PMID- 3683572 TI - Sonoluminescence from non-aqueous liquids. AB - Our understanding of the chemical effects of high-intensity ultrasonic irradiation of liquids is still quite limited. It is generally accepted that sonochemistry results from acoustic cavitation: the creation, growth, and implosive collapse of bubbles in ultrasonically irradiated liquids. The mechanism of sonoluminescence in aqueous systems has been a matter of some dispute; recent discussions have suggested at least three possible origins: black-body emission, chemiluminescence from radical recombination, and electric discharge. Few studies of non-aqueous sonoluminescence, however, have been conducted. We present here the first spectrally resolved sonoluminescence spectra from hydrocarbon and halocarbon liquids. These spectra originate unambiguously from excited-state molecules created during acoustic cavitation. These high-energy species probably result from the recombination of radical and atomic species generated during the high temperatures and pressures of cavitation. PMID- 3683573 TI - Parallel gradualistic evolution of Ordovician trilobites. AB - There are very few high-resolution studies of the fossil record from which to assess the relative frequency of gradualistic and punctuated evolution. Here I report some of the first detailed evidence of phyletic gradualism in benthic macroinvertebrates, based on a study of approximately 15,000 trilobites from central Wales. Over a period of about three million years, as many as eight lineages underwent a net increase in the number of pygidial ribs, a species diagnostic character. The end members of most lineages have previously been assigned to different species and, in one case, to different genera. In view of intermediate morphologies and temporary trend reversals, however, practical taxonomic subdivision of each lineage proved impossible. The apparent success of earlier Linnean nomenclature (with its implications of discrete species) could easily have been misinterpreted as evidence of punctuation and stasis, and it is probable that detection of many other gradualistic patterns has been hindered by ready application of binominal taxonomy to fossils. PMID- 3683574 TI - Targetted correction of a mutant HPRT gene in mouse embryonic stem cells. AB - Two recent developments suggest a route to predetermined alterations in mammalian germlines. These are, first, the characterization of mouse embryonic stem (ES) cells that can still enter the germline after genetic manipulation in culture and second, the demonstration that homologous recombination between a native target chromosomal gene and exogenous DAN can be used in culture to modify specifically the target locus. We here use gene targetting functionally to correct the mutant hypoxanthine-guanine phosphoribosyl transferase (HPRT) gene in the ES cell line which has previously been isolated and used to produce an HPRT-deficient mouse. This modification of a chosen gene in pluripotent ES cells demonstrates the feasibility of this route to manipulating mammalian genomes in predetermined ways. PMID- 3683575 TI - Who pays for health? PMID- 3683576 TI - Maintaining anencephalic babies causes consternation in USA. PMID- 3683578 TI - West German health care reform hazards pharmaceutical research. PMID- 3683577 TI - Soviet psychiatry. PMID- 3683579 TI - Medical Research Council cuts inevitable in coming year. PMID- 3683580 TI - More nuclear safety. PMID- 3683581 TI - UK nuclear operators unhappy with radiation dose advice. PMID- 3683582 TI - Biosynthesis of morphine in the animal kingdom. PMID- 3683583 TI - Genetics cracks bone disease. PMID- 3683584 TI - Roaring by red deer stags advances the date of oestrus in hinds. AB - Some male mammals call loudly and repeatedly during the breeding season. Although the song of male birds is known to have effects on male-male competition, mate selection and ovulation, until now the loud calls of male mammals have been shown to affect only competition between males. Although it has been suggested that loud calling could also serve to attract females, the possibility that it has a direct effect on reproduction in females has not previously been investigated for any mammal. Here I report that roaring in red deer (Cervus elaphus) advances ovulation and that harem-holding males can improve their mating success by regular calling. PMID- 3683585 TI - Occurrence and extracellular actions of inositol pentakis- and hexakisphosphate in mammalian brain. AB - Although inositol 1,3,4,5,6-pentakisphosphate (InsP5) and hexakisphosphate (InsP6) have been recognized for some time as naturally-occurring metabolites of inositol, their occurrence in mammalian cell types, including one of neural origin, has only recently been documented. This is of interest because of the recognized second messenger role of inositol 1,4,5-trisphosphate (InsP3) in intracellular signalling; coupling surface stimuli to cytoplasmic calcium discharge. The metabolism, existence in normal mature tissues, and possible functional roles of these inositol polyphosphates are unknown. Here we report evidence that InsP5 and InsP6 are synthesized in intact brain after labelling with [3H]inositol in vivo. We also show that local infusion of InsP5 and InsP6 into a discrete brain stem nucleus implicated in cardiovascular regulation, results in dose-dependent changes in heart rate and blood pressure. PMID- 3683587 TI - A new petunia flower colour generated by transformation of a mutant with a maize gene. AB - Petunia hybrida is one of the classical subjects of investigation in plants in which the pathway of anthocyanin biosynthesis has been analysed genetically and biochemically. In petunia cyanidin- and delphinidin-derivatives, but no pelargonidin-derivatives are produced as pigments. This is due to the substrate specificity of the dihydroflavonol 4-reductase of petunia, which cannot reduce dihydrokaempferol. The petunia mutant RL01, which accumulates dihydrokaempferol, shows no flower pigmentation. RL01 served as a recipient for the transfer of the A1 gene of Zea mays encoding dihydroquercetin 4-reductase, which can reduce dihydrokaempferol and thereby provided the intermediate for pelargonidin biosynthesis. Transformation of RL01 with a vector p35A1, containing the A1 complementary DNA behind the 35S promotor leads to red flowers of the pelargonidin-type. Thus a new flower pigmentation pathway has been established in these plants. PMID- 3683586 TI - Synthesis of the skeleton of the morphine molecule by mammalian liver. AB - The possibility that morphine could be synthesized in animals has long been considered and a pathway in mammalian brain analogous to that in the opium poppy has been proposed. Substances have been detected in mammalian brain that are recognized by antisera raised against morphine. Recently we reported the presence of three such immunoreactive substances in bovine hypothalamus and adrenal, and in rat brain, and the definitive identification of two of them by gas chromatography-mass spectrometry as morphine and codeine. Incorporation of a labelled precursor has demonstrated the biosynthesis of morphine in the opium poppy from tyrosine-derived units (see Fig. 1). Intramolecular coupling of reticuline to form salutaridine is the critical step that generates the morphine skeleton (morphinan) and the stereochemistry of the morphinan series. We now report the conversion in vivo and in vitro of reticuline to salutaridine by rat liver, but this conversion is not detectable in rat brain and bovine adrenal. This is the first direct demonstration of the synthesis of a morphinan in an animal tissue and also supports the hypothesis that morphine and codeine in brain and adrenal are of endogenous origin. PMID- 3683588 TI - Rapid FLASH NMR imaging. AB - Nuclear magnetic resonance (NMR) spectroscopy and imaging provide new tools for non-invasive investigations of living systems. Recent developments in rapid NMR imaging now offer considerable improvements for both scientific applications and medical diagnosis. Using fast imaging sequences cross-sectional images may be recorded within seconds and, therefore, become free from motional artifacts due to breathing or peristalsis. New functional imaging experiments include dynamic studies of the application of paramagnetic contrast agents or ECG-synchronized recordings of cardiac NMR movies. Superior anatomical information is achieved by three-dimensional NMR imaging with measuring times of minutes rather than hours. PMID- 3683589 TI - Magnetic effects on tail-fin melanophores of Xenopus laevis tadpoles in vitro. PMID- 3683590 TI - Oscillatory mechanisms in human reaction times? PMID- 3683591 TI - Interaural time and intensity difference thresholds of the pigeon (Columba livia). PMID- 3683592 TI - The activity of the neuronal and extraneuronal catecholamine-metabolizing enzymes of the perfused rat heart. AB - In a comparative study the neuronal and extraneuronal metabolism of several 3H catecholamines (all of which were tritiated in the C-7 position of the side chain only) was determined in isolated rat hearts perfused at a concentration of the 3H amines of 50 nmol/l. While the neuronal MAO activity was determined after inhibition of extraneuronal uptake (100 mumol/l OMI) and COMT (10 mumol/l U 0521), the extraneuronal MAO activity was estimated after inhibition of neuronal uptake (30 mumol/l cocaine) and COMT. The extraneuronal COMT activity was determined under conditions of inhibition of both neuronal uptake and MAO (pretreatment with pargyline). Hearts were perfused with the 3H-catecholamines until the rate of appearance of the various 3H-metabolites in the venous effluent has reached a steady state. From these rates (vst-st) and the steady-state content of the unchanged 3H-catecholamines in the tissue (Si), the rate constants (Vmax/Km) for the unsaturated intracellular enzymes COMT (kCOMT) and MAO (kMAO) were calculated. The kCOMT values for all four catecholamines, (-)-noradrenaline, dopamine, (-)-adrenaline and (+/-)-isoprenaline exhibit a range from 0.24 to 0.78 min-1; the metabolism of the catecholamines by the COMT differs: (-) noradrenaline = dopamine less than (-)-adrenaline less than (+/-)-isoprenaline. The extraneuronal MAO activity was low for all three catecholamines, (-) adrenaline, (-)-noradrenaline and dopamine (range of kMAO from 0.05 to 0.28 min 1) and declined in the order.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683593 TI - Characteristics of the cocaine-sensitive accumulation and O-methylation of 3H-(-) noradrenaline by rabbit endometrium. AB - 1. The extraneuronal uptake and O-methylation of 2,5,6 3H-(-)-noradrenaline was studied in segments of uterine endometrium from rabbits pretreated with 17 beta oestradiol and progesterone. 2. The uptake of 3H-noradrenaline was measured in MAO- and COMT-inhibited tissues and obeyed Michaelis-Menten kinetics with an apparent Km of 78 mumol/l and a Vmax of 5.4 nmol/g min. Uptake was inhibited by low Na+, and by potential substrates in the order dopamine greater than ( )adrenaline greater than (-)isoprenaline = 5-hydroxytryptamine. 3. Following uptake at 1.2 mumol/l, efflux of 3H-noradrenaline was slow and appeared to be from two compartments, of which the first (I) had a t1/2 of 53 min and a capacity of 1.8 nmol/g. The presence of the second compartment (II) was inferred from the tissue content of 3H after 60 min of efflux, which was 3-4 times greater than predicted if the 3H was present in compartment I only. Following incubation with 3H-noradrenaline in the presence of cocaine 30 mumol/l the 3H efflux was rapid and the combined capacities of compartments I and II were greatly decreased. 4. 3H-NMN formation, measured in MAO-inhibited tissues, obeyed Michaelis-Menten kinetics with a half-saturating outside concentration of 12 mumol/l and a Vmax of 0.9 nmol/g X min. The formation was inhibited by the neuronal uptake inhibitors, desipramine 3 mumol/l and metaraminol 100 mumol/l (each by 80%), but was unaffected by the extraneuronal uptake inhibitor, NMN 100 mumol/l, and by oxytetracycline 100 mumol/l and methoxamine 10 mumol/l. 5.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683595 TI - Inhibition of noradrenaline release via presynaptic 5-HT1B receptors of the rat vena cava. AB - In the rat inferior vena cava preincubated with 3H-noradrenaline, the effects of nine serotonin (5-HT) receptor agonists and of eight antagonists (including two beta-adrenoceptor blocking agents) on the electrically evoked 3H overflow were determined. 1. 5-HT, 5-carboxamido-tryptamine, 5-methoxy-3(1,2,3,6 tetrahydropyridine-4-yl)-1H-indole (RU 24969), 5-methoxytryptamine, N,N-dimethyl 5HT, tryptamine and 5-aminotryptamine inhibited the evoked 3H overflow. The potencies of these agonists in inhibiting overflow were significantly correlated with their affinities for 5-HT1B binding sites, but not with their affinities for 5-HT1A, 5-HT1C or 5-HT2 binding sites. 8-Hydroxy-2-(di-n-propylamino)tetralin (8 OH-DPAT), a 5-HT1A receptor agonist, and ipsapirone, a partial agonist at these receptors, did not inhibit overflow. 2. Cyanopindolol facilitated the evoked 3H overflow, an effect which was abolished by propranolol. The maximum inhibition of overflow obtainable with 5-HT was diminished by cyanopindolol. 3. The concentration-response curve for 5-HT was shifted to the right by metitepine, metergoline, quipazine, 6-chloro-2-(1-piperazinyl)pyrazine (MK 212) and propranolol which, given alone, did not affect 3H overflow. The apparent pA2 values of these antagonists tended to be correlated with their affinities for 5 HT1B (but not 5-HT1A, 5-HT1C or 5-HT2) binding sites. Ketanserin, a 5-HT2 receptor antagonist, and spiperone, which blocks 5-HT2 and 5-HT1A but not 5-HT1B or 5-HT1C receptors, failed to antagonize the effect of 5-HT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683594 TI - Characterization of the effects of histamine on the transmembrane electrical activity of guinea-pig and rabbit SA- and AV-node cells. AB - The effects of histamine on the transmembrane electrical activity of cells of small preparations (0.5 X 0.5 mm) of guinea-pig and rabbit sinoatrial- and atrioventricular-nodes were studied. Histamine at concentrations above 10(-7) mol/l increased the firing rate, the rate of diastolic depolarization, the maximum diastolic potential, the amplitude and the maximum rate of depolarization of the action potential of pacemaker cells of rabbit and guinea-pig sinoatrial cells and rabbit atrioventricular cells. These effects were antagonized by the H2 receptor blocker cimetidine (2.5 X 10(-6)mol/l) but they were not modified by the H1-receptor blocker chlorphenamine (2.5 and 5 X 10(-6)mol/l). Small preparations of guinea-pig atrioventricular node did not exhibit spontaneous activity, but it was induced by histamine and blocked by cimetidine. Histamine increased the maximum upstroke velocity of propagated action potential of cells of the central part of complete atrioventricular node in both species studied. These effects were blocked by cimetidine, but not by chlorphenamine. It is concluded that the increase in automaticity induced by histamine in guinea-pig and rabbit sinoatrial and atrioventricular nodes was due to stimulation of H2-receptors. Histamine did not depress electrical activity of atrioventricular node cells, but rather increased it. This effect was due to H2-receptor stimulation. PMID- 3683596 TI - Conditioning of behavioural effects produced by an intermediate dose of apomorphine: hypokinesia, ptosis and stereotypies. AB - Apomorphine, in an intermediate dose (0.18 mg/kg s.c.) decreased dopamine turnover and produced signs generally attributed to a decrease in dopaminergic neurotransmission, e.g. ptosis and yawning, as well as signs of an increased stimulation of dopamine receptors in dopaminoceptive target neurones, e.g. stereotyped sniffing. In contrast, the former signs were exclusively observed after smaller doses and the latter after larger doses of apomorphine. Since it had been shown in previous studies that these signs, except yawning, could be conditioned in association with discriminative stimuli in the environment, the present study using conditioning experiments with this intermediate dose aimed at determining, 1. the time course of each conditioned response, 2. the interaction of conditioned and unconditioned responses, and 3. the conditions under which hypokinesia occurred. In each series, conditioned animals were compared with pseudoconditioned controls. Rats were conditioned for 8 days with apomorphine, and on day 9, treated with saline in presence of the conditional stimuli (a test cage in combination with acoustic and olfactory stimuli). In contrast to pseudoconditioned controls, ptosis and stereotyped behaviour were observed in conditioned rats, sometimes occurring alternatingly. These signs closely resembled the direct, unconditioned pharmacological effects. In addition, akinesia occurred after conditioning, although it was never manifest as a pure drug response, nor during the conditioning period. In contrast, yawning was observed in pseudoconditioned as well as in conditioned rats, although slightly more frequently in the former animals. Subsequently, the rats were again conditioned (or pseudoconditioned) on days 10-14 with apomorphine and both groups tested with the same dose (0.18 mg/kg) of apomorphine in the presence of the conditioned stimuli.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683597 TI - Peripheral effects of opioid drugs on capsaicin-sensitive neurones of the guinea pig bronchus and rabbit ear. AB - The effect of a potent opioid agonist, [D-Met2, Pro5]-enkephalinamide was investigated on two responses involving capsaicin-sensitive afferent neurones, namely, atropine-resistant contractions of the guinea-pig bronchus evoked by electrical field stimulation and the nociceptor stimulation to intraarterial injections of acetylcholine or capsaicin into the vascularly isolated rabbit ear. The hypotheses to be tested were whether (a) opioid receptor activation may inhibit mediator release from primary afferent neurones and (b) the opioid could exert an analgesic effect at a peripheral site of action. Non-cholinergic contractions of the guinea-pig isolated main bronchi due to electrical stimulation were concentration-dependently inhibited by [D-Met2, Pro5] enkephalinamide (10 nM-1 microM). This effect was abolished by naloxone (1 microM). Naloxone alone induced no change in the stimulation-evoked contractions of the bronchus, indicating that no endogenous opioid control was present. Substance P and neurokinin A induced bronchial contractions that were not influenced by [D-Met2, Pro5]-enkephalinamide. This indicates that [D-Met2, Pro5] enkephalinamide inhibits electrically-evoked bronchial contractions by reduced mediator release from capsaicin-sensitive sensory nerve endings, since these contractions are most probably brought about by tachykinins, released from afferent neurones. Capsaicin-induced bronchial contractions were in contrast to electrical stimulation not influenced by [D-Met2, Pro5]-enkephalinamide which suggests a different site of action. The activation of sensory neurones in the rabbit ear by i.a. injection of acetylcholine and capsaicin was not reduced under infusion of [D-Met2, Pro5]-enkephalinamide (1 and 10 microM) or lofentanil (1 and 10 microM).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683600 TI - [Boys and incest: a silent minority]. PMID- 3683599 TI - Choline increases endogenous GABA release in rat hippocampus by a mechanism sensitive to hemicholinium-3. AB - The effects of choline (Ch) on the spontaneous release of endogenous gamma aminobutyric acid (GABA) and of 3H-GABA were studied in superfused rat hippocampal synaptosomes. Choline enhanced in a concentration-dependent way the release of endogenous GABA but did not affect that of the radioactive aminoacid. The effect of Ch was not antagonized by atropine or mecamylamine; moreover, it was not mimicked by acetylcholine, oxotremorine or carbachol. The Ch-induced GABA release was counteracted by hemicholinium-3. Thus the release of endogenously synthesized GABA (but not that of the aminoacid taken up) may be regulated by Ch through a mechanism involving penetration into the releasing terminal through a Ch uptake system. PMID- 3683601 TI - [Iatrogenic confirmation of unrecognized conversion]. PMID- 3683598 TI - Intracellular free calcium concentration in rat anterior pituitary cells as indicated by fura-2: effect of arginine-vasopressin. AB - Arginine-vasopressin (AVP) stimulates adrenocorticotropin and beta-endorphin release from corticotrophs of the anterior pituitary gland through mechanisms which are not initiated by an elevation of the cellular levels of adenosine-3',5' cyclic-monophosphate. In the present study the effect of AVP on the cytoplasmic concentrations of free calcium ions in rat anterior pituitary cells was examined. Cytosolic free Ca2+ concentrations were monitored directly using the new, intracellularly trapped fluorescent indicator fura-2. In cells incubated in medium containing 1.3 mmol/l Ca2+, AVP (100 nmol/l) caused an immediate elevation of the cytoplasmic Ca2+ concentration by about 50 nmol/l (P less than 0.001). The intracellular Ca2+ levels remained elevated during the observation period of 2-3 min. This effect of AVP was blocked by a specific vasopressin antagonist. By contrast, the glucocorticoid dexamethasone did not affect the AVP-induced elevation of cytosolic Ca2+ concentration. When the cells were incubated in Ca2+ free medium (Ca2+ omitted, EGTA 2 mmol/l), the AVP-induced as well as the K+ depolarization-induced increase in free cytoplasmic Ca2+ were abolished, whereas the ionophore ionomycin evoked a rapid transient elevation of free Ca2+. The increase in cytoplasmic Ca2+ concentration induced by AVP was preserved in medium containing the calcium channel blockers Mg2+ (Mg2+ 31.2 mmol/l; Ca2+ 1.3 mmol/l) or nifedipine (1 mumol/l). The potassium-evoked calcium signal was blocked by Mg2+ (31.2 mmol/l). We conclude that vasopressin induces a rapid rise in the cytoplasmic concentration of free calcium ions in corticotrophs. Vasopressin may mobilize calcium through mechanisms that neither are glucocorticoid-sensitive nor involve the influx of extracellular calcium through voltage-dependent calcium channels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683602 TI - [Rabies in bats]. PMID- 3683604 TI - [Decrease in dental caries in industrialized countries]. PMID- 3683603 TI - [Acupuncture as a therapeutic method; facts and perspectives]. PMID- 3683605 TI - [Compartment syndrome of forearm and wrist]. PMID- 3683606 TI - [Health care on Saba as reflected in mortality statistics]. PMID- 3683607 TI - [Acute kidney insufficiency and hypertensive encephalopathy following the taking of Baralgin]. PMID- 3683609 TI - [Gastroesophageal reflux disease--reflux esophagitis]. PMID- 3683608 TI - [Diagnosis of primary hyperparathyroidism]. PMID- 3683610 TI - [Splenectomy: from life-saving to life-threatening intervention!]. PMID- 3683611 TI - [Cholesterol consensus in The Netherlands]. PMID- 3683612 TI - [Antiseptic application of disinfectants]. PMID- 3683613 TI - [Bacterial arthritis]. PMID- 3683614 TI - [Control of fever due to infections in children; useful or dangerous?]. PMID- 3683615 TI - [Functional capacity of geriatric patients during and following admission to a geriatric department of a general hospital]. PMID- 3683616 TI - [Failed pain control with sublingual application of buprenorphine]. PMID- 3683617 TI - [Lymph nodes 1987]. PMID- 3683618 TI - [Anthelmintics]. PMID- 3683619 TI - [Pain treatment, recommendations by the Public Health Council]. PMID- 3683620 TI - [Hearing during anesthesia]. PMID- 3683621 TI - [Kahler's disease?]. PMID- 3683623 TI - [Ophthalmological examinations in patients with diabetes mellitus]. PMID- 3683622 TI - [Treatment of long-lasting post-spinal puncture headache]. PMID- 3683624 TI - [Breast cancer and alcohol consumption in perspective]. PMID- 3683625 TI - [Headache following lumbar puncture]. PMID- 3683626 TI - [Breast carcinoma and oral contraceptives: the disadvantage of doubt]. PMID- 3683627 TI - [The prostatic coil as an alternative to the indwelling catheter]. PMID- 3683628 TI - [Surgical treatment of lung metastases; results in patients operated on 1964 1983]. PMID- 3683629 TI - [Hemodynamic complications following the use of bone cement]. PMID- 3683630 TI - [The methadone program of the Amsterdam Municipal Medical and Health Care Service]. PMID- 3683631 TI - [Ophthalmological examination in patients with diabetes mellitus]. PMID- 3683632 TI - [Wilkie's syndrome]. PMID- 3683633 TI - [Promotion of lactation with pharmaceutic agents]. PMID- 3683634 TI - [Lithium]. PMID- 3683635 TI - [Interstitial radiotherapy using iridium-192]. PMID- 3683636 TI - [Intragastric balloon in the treatment of morbid obesity]. PMID- 3683637 TI - [Results of a multicenter study of the efficacy of recombinant alpha-2c interferon in hairy cell leukemia]. PMID- 3683639 TI - [Space for Health; a new initiative]. PMID- 3683638 TI - [Fatal liver damage during use of diclofenac]. PMID- 3683640 TI - [The incompetent adult patient]. PMID- 3683641 TI - [Antiemetics]. PMID- 3683642 TI - [How useful is screening in pregnancy?]. PMID- 3683643 TI - [Initial experiences with iodine-125 implantation in 41 patients with prostate carcinoma]. PMID- 3683644 TI - [The 12-minute walking test in patients with chronic expiration disorders. I. Relation to the outcome of lung function tests]. PMID- 3683645 TI - [Salivary stones]. PMID- 3683646 TI - [Repeat abortion, an accidental occurrence or a disease?]. PMID- 3683647 TI - [Chance of survival of newborn infants after a pregnancy period of less than 26 weeks]. PMID- 3683648 TI - [Clinical trials; the admissibility of generalization of outcome]. PMID- 3683649 TI - [Methods in molecular genetics]. PMID- 3683651 TI - [Influenza in the winter of 1986-87; modification of influenza vaccine for the 1987-88 season]. PMID- 3683650 TI - [Current viewpoints on the diagnosis and treatment of bacterial skin infections in childhood]. PMID- 3683652 TI - [Prevalence of HIV, Treponema and hepatitis B infections at a neighborhood health center for sexually transmissible disorders]. PMID- 3683653 TI - [Outcome of a conservative policy in prolonged pregnancy]. PMID- 3683654 TI - [The ultimate prognosis in repeat abortion]. PMID- 3683655 TI - [Prospective study of the course of functional abdominal symptoms]. PMID- 3683656 TI - [Skin necrosis following administration of vasopressin]. PMID- 3683657 TI - [A patient with many physical symptoms: what to do and what not to do?]. PMID- 3683658 TI - [The relation between low body weight and amenorrhea in anorexia nervosa]. PMID- 3683659 TI - [The use of light in the treatment of season-connected mood disorders]. PMID- 3683660 TI - [Association of constitutional eczema and allergic contact eczema (hybrid eczema)]. PMID- 3683661 TI - [Is AIDS an occupational risk for (para)medical professional groups?]. PMID- 3683662 TI - [Prevention of puncture accidents]. PMID- 3683663 TI - [Incidence of puncture accidents with hepatitis B virus-contaminated blood by hospital personnel in 15 hospitals in Amsterdam and surroundings in 1985]. PMID- 3683664 TI - [Potential of magnetic resonance tomography in malignant tumors of the urinary bladder]. PMID- 3683666 TI - [Results of the laboratory for in-vitro fertilization of Erasmus University in Rotterdam]. PMID- 3683665 TI - [Results of in-vitro fertilization at the Rotterdam-Dijkzigt University Hospital in 1986]. PMID- 3683667 TI - [Late-onset type congenital rubella syndrome]. PMID- 3683668 TI - [The professional secret]. PMID- 3683669 TI - [Thrombosis of mechanical heart valve prostheses]. PMID- 3683670 TI - High frequency ventilation in neonatal pulmonary interstitial emphysema. PMID- 3683671 TI - The role of radiotherapy in the treatment of biliary tract neoplasms. PMID- 3683672 TI - Avulsion fracture of the patella with quadriceps rupture--a frequently missed diagnosis. PMID- 3683673 TI - [Structure of the cerebral organic psychosyndrome]. PMID- 3683674 TI - [Depressive symptoms and the dexamethasone suppression test in the course of inpatient treatment of anorexia nervosa]. PMID- 3683675 TI - [Hyponatremia--an underrated complication in psychiatric patients]. PMID- 3683676 TI - [Psychogenic polydipsia. Differential diagnosis and clinical relevance]. PMID- 3683677 TI - [Clinical and computerized tomography follow-up of self-induced water intoxication]. PMID- 3683678 TI - [Psychogenic depression in involution. Social medicine significance]. PMID- 3683679 TI - [Hemispheric laterality and early childhood autism. A case study of the etiologic and nosologic problem of the autistic syndrome in childhood]. AB - Most studies on childhood autism emphasize a left hemispheric disturbance. In the presented case a primary right (and only secondary left) hemispheric dysfunction seems to be obvious. This seems to be true also for other reports in the literature. Supported by the hypermasculine aspect of our patient a pathological intrauterine testosterone level is suggested to be responsible for the observed altered cerebral asymmetry and consecutive hemispheric dysfunction. The advantage of such neuropsychologic findings and hypothesis should stimulate further studies on autism and other psychiatric disturbances. PMID- 3683680 TI - [Psychiatric aspects of Prader-Willi syndrome]. PMID- 3683681 TI - Chemotherapy with doxorubicin and CCNU in advanced undifferentiated carcinoma of the nasopharynx. A retrospective report on five patients. PMID- 3683682 TI - Dextrothyroxine induced hyperthyroidism in a patient with heterozygous familial hypercholesterolaemia. PMID- 3683683 TI - Renal infarction: diagnosis and treatment of renal infarction and presentation of a case with unusual aetiology. PMID- 3683684 TI - Intra-abdominal lymphangiomatous cysts in adults. PMID- 3683685 TI - Combined therapy for selected chronic uremic patients: infrequent hemodialysis and nutritional management. AB - The results are described of a combined nutritional (supplemented diet) and dialytic (once a week hemodialysis) therapy, employed in 17 selected chronic uremics for a mean period of 18.2 months/patient. The clinical findings, blood chemical abnormalities and changes of renal function were examined and compared with those of patients on the standard thrice-a-week dialysis schedule and free diet. The clinical findings were not significantly different in the two groups. The residual renal function of patients on combined therapy declined faster than in patients on conservative treatment, but at a slower rate than in those on thrice-a-week dialysis. The time averages of serum urea, methylguanidine and phosphate concentrations and their postdialytic rebounds were lower in the patients on combined therapy than in those on thrice-a-week dialysis, whereas the time averages of the serum creatinine concentration were higher, and those of serum bicarbonate and serum oxalate were not significantly different in the two groups. It is concluded that this combined therapy is a valid alternative to the conventional thrice-a-week hemodialysis and free diet for selected patients and for periods of time whose duration is conditioned by the rate of decline of the residual renal function. PMID- 3683686 TI - Effect of dopaminergic blockade on plasma aldosterone in acquired hypoaldosteronism. AB - The pathogenesis of acquired hypoaldosteronism, a frequent cause of hyperkalemia in patients with chronic renal failure, is poorly understood. The present studies were undertaken to investigate the role of dopamine in suppressing mineralocorticoid secretion in this syndrome. We studied the plasma aldosterone response to dopaminergic blockade with metoclopramide in 11 patients with chronic renal failure (5 of whom were hyperkalemic) and 7 normal controls. Following repetitive doses of metoclopramide, the normokalemic chronic renal failure patients showed an exaggerated aldosterone response (peak aldosterone 50 +/- 5 ng/dl or 1,385 +/- 138 pmol/l) compared to normal controls (24 +/- 4 ng/dl or 665 +/- 110 pmol/l). In the hyperkalemic chronic renal failure patients, however, metoclopramide failed to induce a significant increase in plasma aldosterone (peak aldosterone 13 +/- 3 ng/dl or 360 +/- 83 pmol/l). By contrast, metoclopramide stimulated prolactin secretion in both normokalemic and hyperkalemic chronic renal failure patients. The plasma renin activity and serum potassium values were unchanged in all 3 groups. Our data show that dopaminergic blockade with metoclopramide fails to stimulate aldosterone secretion in patients with acquired hypoaldosteronism. Thus this syndrome does not result from enhanced dopaminergic inhibition of aldosterone, but rather from an independent abnormality in aldosterone biosynthesis. PMID- 3683687 TI - Mesangial IgA nephropathy and idiopathic nephrotic syndrome. AB - A 17-year-old male presented with nephrotic syndrome associated with microscopic hematuria. Renal biopsy showed only minor glomerular abnormalities (light microscopy). Immunohistology demonstrated strong mesangial deposition of IgA. Electronmicroscopy disclosed widespread effacement of foot processes in combination with isolated osmiophilic mesangial deposits. The patient responded to standard corticosteroid therapy with complete disappearance of proteinuria. Microscopic hematuria, however, persisted. Five months after steroid therapy was stopped, the nephrotic syndrome relapsed. It was again steroid-responsive with persisting microhematuria. From clinical and morphological data we conclude that the patient has concomitant idiopathic nephrotic syndrome (minimal change glomerulonephritis) and mesangial IgA glomerulonephritis. The simultaneous presence of these two diseases may give some hint as to their pathogenesis. In both, abnormalities in T cell regulation have been found. If these were indeed involved in the pathogenesis of the two glomerular diseases, a higher than expected probability for the two entities to coexist in the same patient is to be expected. PMID- 3683688 TI - Extreme hypermagnesemia due to ingestion of Dead Sea water. AB - We describe 3 patients who developed extreme hypermagnesemia due to ingestion of water of the Dead Sea, which would have been fatal were it not for the protective effects of the accompanying hypercalcemia. We emphasize the clinical features of this condition and the importance and effectiveness of early hemodialysis as the main modality of treatment. PMID- 3683689 TI - Hyperosmolal state associated with rhabdomyolysis. AB - We report a case of nonketotic hyperosmolal state associated with rhabdomyolysis. None of the known predisposing factors for rhabdomyolysis, e.g. coma, potassium or phosphate depletion, were present in this patient. We propose that severe hyperosmolality per se may represent another predisposing factor for nontraumatic rhabdomyolysis. PMID- 3683690 TI - Minimal-change nephrotic syndrome in adults treated with alternate-day steroids. AB - Fifty-eight previously untreated adults with minimal-change nephrotic syndrome (MCNS), who had a mean follow-up period of 35.8 months, were studied with regard to their response to alternate-day steroid therapy. The nephrotic syndrome in 54 patients (93%) remitted by 12 weeks and patients continued to be in remission at 16 weeks. Of the 54 patients, 8 (14.8%) had frequent relapses and 9 (16.6%) had infrequent relapses. No serious complications as a result of steroid therapy were encountered. PMID- 3683691 TI - Protection against acute renal failure by prior acute renal failure: differences between myohemoglobinuric and ischemic models. AB - Prior acute renal failure (ARF) induced by either glycerol (G) or mercury provides protection against rechallenge with the same agent or the other. To ascertain whether the widely employed ischemic renal failure model also shares a similar pathogenesis, two protocols were designed. In the first protocol, unilaterally nephrectomized rats with or without a prior episode of G-induced ARF two weeks previously were subjected to an ischemic insult [60-min total left renal artery clamp (LRAC)]. At 24 or 48 h after LRAC there was no difference in renal function in the rats with or without prior ARF. In the second protocol the sequence of G and ischemia was reversed. In rats having undergone LRAC two weeks prior to G, glomerular filtration rate was virtually identical from the right (control) and left (prior ARF) kidney (right, 138 +/- 30; left, 101 +/- 22 microliter/min/100 g body weight), and not different from rats receiving G alone. We conclude that protection against ARF conferred by prior insult is not a feature of all models. PMID- 3683692 TI - Reappraisal of femoral vein cannulation for temporary hemodialysis vascular access. PMID- 3683693 TI - Silicosis associated with crescentic IgA mesangial nephropathy. PMID- 3683694 TI - Carnitine levels and hypertriglyceridemia in undialyzed patients. PMID- 3683695 TI - Osteoporosis and vitamin D metabolites. PMID- 3683697 TI - Re:Steroids in the treatment of idiopathic membranous nephropathy. PMID- 3683696 TI - Can cyclophosphamide pulse therapy change the natural course of idiopathic glomerulopathy resistant to steroids? PMID- 3683699 TI - Perioperative morbidity associated with operative resection of craniopharyngioma: a review of ten years experience. AB - A ten-year review of perioperative morbidity after operative resection of craniopharyngioma is presented. From 1974 to 1983, 23 patients underwent a total of 34 operations. Patients were subdivided into 95% or greater resection and partial resection groups. Features compared between the two groups included sodium, glucose, temperature, diabetes insipidus, major complications, neurological deficits and death. Patients undergoing 95% or greater resection had significant fluctuations in sodium, temperature and glucose (p less than .01). Diabetes insipidus and major postoperative complications were also significantly elevated in the 95% or greater resection group (p less than .05). Therefore, the extent of surgical resection correlated well with the degree of metabolic dysfunction and major postoperative complications. Careful assessment of surgical morbidity is warranted in the management of patients with craniopharyngioma. PMID- 3683698 TI - [Portions of the ophthalmic nerve and its branches adjacent to the orbital roof and margin]. AB - The nerves in the vicinity of the orbital roof, their length, anastomoses and the distribution at the supraorbital margin are described. Included is the length of the trigeminal nerves between the orbital margin and the entrance area of the trigeminal nerve in the pons. PMID- 3683700 TI - Computed axial tomography versus NMR for the diagnosis of neurocysticercosis. AB - A case of generalised neurocysticercosis in a 45-year-old woman is presented with CT and NMR findings. The great additional value of NMR for the diagnosis of this disease is stressed. PMID- 3683701 TI - [Hydrocephalus following spontaneous subarachnoid hemorrhage]. AB - In the period 1980-1985 221 patients presenting with subarachnoid haemorrhage were operated on at the Department of Neurosurgery of the University of Innsbruck. 26 patients (11.7%) of them required a ventriculoatrial or ventriculoperitoneal shunt. The relationship between the incidence of this complication and the various clinical features of subarachnoid haemorrhage is discussed. Computed tomography is the most important investigative tool for diagnosis and follow-up of hydrocephalus. The results after shunt operation are correlated with the site of the aneurysm and the pre-operative grade of the patient. PMID- 3683702 TI - Persistent hypoglossal artery associated with basilar artery aneurysm. AB - A saccular aneurysm at the tip of the basilar artery in a patient with a persistent hypoglossal artery is reported. The persistent hypoglossal artery was arising from the left internal carotid artery. Both vertebral and posterior communicating arteries were absent bilaterally. The combination of a persistent hypoglossal artery and a basilar bifurcation aneurysm is a very rare occurrence. The anatomy of the cerebral circulation in this unique case is important for surgical planning. PMID- 3683703 TI - [36th congress of the French Language Neurosurgery Society. Tours, 17-19 June 1986. Aneurysms of the ampulla of Galen. Proceedings]. PMID- 3683704 TI - [Embryology of the cerebral veins]. AB - Formation of cerebral veins can be retraced through eight embryologic stages: before the 4 mm stage, neither arteries nor veins can be distinguished within the primitive network of the head; the 5 mm stage, when three dural plexuses can be identified; the 6 to 12 mm stage, marked by development of anterior dural plexus and lateralization of veins in relation to future cranial pairs; the 12 to 16 mm stage, with development of the anastomosis between anterior and middle dural plexus, and of the pial veins; the 16 to 21 mm stage, marked by regression of primitive sinus of the head and appearance of the anlage of straight sinus and of transverse and sigmoid sinuses; the 21 to 29 mm stage, with appearance of a temporary prosencephalic median vein, possibly implicated in the etiopathogenicity of so-called aneurysms of Galen's ampulla; the 40 mm stage with elaboration of the deep cerebral venous networks; the 60 to 80 mm stage during which the basal veins and Galen's ampulla are formed. After 3 months, the fetal encephalic venous system has attained its adult appearance. PMID- 3683705 TI - [Microsurgical anatomy of the ampulla of Galen]. AB - Anatomic study of 20 injected specimens dissected under operating microscope allowed evaluation of anatomic site of Galen's ampulla, venous confluents of Galen's ampulla, and internal cerebral veins' terminations and their arterial connections in this region. Findings demonstrated that even the wall of the great vein of Galen was supplied by arterioles, as though it was vascularized in the same way as durameter. PMID- 3683706 TI - [Histopathology of the vein of Galen]. AB - Histology of cerebral arteries and veins are reviewed to show variances with extracerebral blood vessels. Muscles fibers even in large cerebral veins are easily overlooked. The thick wall of the vein of Galen grossly and microscopically resembled dura mater fed by microscopic blood vessels and capillaries. The authors reported 4 cases of arteriovenous aneurysms of the great vein of Galen. When compared to the rest of the histological reports on this subject published till now, it is obvious that this new cases bring new facts. First is the presence of an irregular muscle coat in the aneurysmal wall suggesting early hemodynamic troubles. The second and most important data is the association of multiple malformations of the pineal gland, of the vascular elements of the tela choroidea of the third ventricle between which the aneurysm of the great cerebral vein is found. These unusual data suggested complex congenital malformation in the early stages of development. PMID- 3683707 TI - [Clinical symptomatology in aneurysm of the ampulla of Galen. Results of a national survey]. AB - Results of a national survey of clinical symptomatology revelatrice of an aneurysm of Galen's ampulla are analyzed and compared with documented data. Three large groups can be distinguished as a function of age at diagnosis: the neonatal period: cardiac insufficiency; childhood: macrocrania; adolescence and adult life: various clinical symptoms and signs but fortuitous discovery not exceptional. PMID- 3683708 TI - [Dilatation of the vein of Galen. Anatomoclinical forms and endovascular treatment apropos of 14 cases explored and/or treated between 1983 and 1986]. AB - The authors report 14 cases of vein of Galen dilatation explored and/or treated between 1983 and 1986. Three anatomic types have been individualized: the vein of Galen arterio-venous malformation (AVM) (7 cases); the cerebral AVM with vein of Galen ectasia (6 cases); the varix of the vein of Galen without AV shunt (1 case). When an AVM is present the shunt is located either in the venous wall (vein of Galen AVM) or in the brain parenchyma; in the latter the AVM drains into a tributary of the vein of Galen (cerebral AVM with vein of Galen ectasia). However in all the 14 cases downstream to the draining vein, a venous (dural) anomaly could be demonstrated. This anomaly suggests the secondary nature of the dilatation proximal to a developmental obstacle. Clinically the vein of Galen AVM reveals early in neonates by cardiac complications; the other types are usually seen later following hydrocephalic or bleeding episodes. As far as therapeutic aspect, we can technically stabilize the hemodynamic problem, by occluding most if not all the shunts by endovascular approach, and make most of the neonates survive. However the quality of survivance and the future neurological development is impossible to predict yet. Nevertheless the short term follow-up is very encouraging. The combined per operative embolization through the vein must be exclusively reserved to vein of Galen AVM. The torcular approach is contraindicated in brain AVM with Vein of Galen ectasia. The vein of Galen varix do not require any type of morphological correction. PMID- 3683709 TI - [Aneurysm of the ampulla of Galen. Anesthetic problems]. AB - Anesthetic management of patients with arterio-venous malformations of the vein of Galen needs to be adapted to the physiopathology of the affection. Massive blood less before clipping and congestive heart failure after clipping may be avoided by using adequate transfusion and light arterial vasodilators preserving diastolic perfusion of the heart. PMID- 3683710 TI - [Aneurysm of the ampulla of Galen. Therapeutic results of a national multicenter study]. AB - A national survey was conducted to assess modalities and results of therapy for aneurysm of Galen's ampulla. Analysis of date showed variations as a function of age at diagnosis. Prognosis appears to improve with increasing age of diagnosis of the lesion, but remains poor generally despite improvement in treatment methods. PMID- 3683711 TI - [Arteriovenous malformations in the region of the ampulla of Galen. Anatomical and clinical aspects and the course of endovascular treatment (1979-1986). Apropos of 10 cases]. AB - Technological progress has resulted in embolization being adapted as treatment of choice for arteriovenous malformations in the region of Galen's ampulla. To ensure recovery it is essential to conduct treatment at an early stage, to adapt it to the morphologic type of malformation and to investigate possible associated thrombosis requiring anticoagulant therapy. A shunt operation may be necessary if hydrocephalus fails to regress. PMID- 3683712 TI - [Aneurysm of the ampulla of Galen. Nosologic reflections and endovascular therapy]. AB - Nosologic concepts distinguish three types of aneurysm of Galen's ampulla: true aneurysms, related aneurysms, false aneurysms, whatever the type the majority of these malformations can be treated by the endovascular approach, frequently the most effective alternative therapy. Experience acquired during treatment of intracerebral arteriovenous angioma allows perfect control of direct, high output arteriovenous fistula by injection of pure isobutyl cyanoacrylate. Occlusion of shunts should be combined with prevention of consequences, that is to say extensive venous thrombosis. Two cases are reported that demonstrate the value of post-embolization heparin therapy. PMID- 3683713 TI - Multi-centre versus single-centre trials in migraine. AB - Migraine trials often have to be performed at many centres, which creates a number of methodological problems. The present paper discusses single-centre versus multi-centre designs and also comments on the design of multiple independent trials (MIT). From a methodological standpoint, the single-centre design should virtually always be preferred. When it is impossible to recruit enough patients in a single centre within reasonable time, a multi-centre design has to be used. The major advantage of multi-centre trials, apart from recruitment, is that they may yield a more representative basis for conclusions regarding the whole population. Multiple-independent trials give an opportunity to summarize information from different sources. It has not the same methodological strength as the single- or multi-centre trial, but could be valuable, especially for evaluation of side effects. PMID- 3683714 TI - Migraine trials: crossover or parallel group? AB - This paper evaluates the relative merits of the crossover design and the parallel group design for the evaluation of migraine therapy, focussing on prophylaxis. Three issues are highlighted which lead to a preference for the parallel group trial: changes in the treatment effect with time, the possibility of carry-over effects, and the handling of withdrawals and protocol deviations. These have to be weighed against the greater power of the crossover design. It is shown that the difference in power is relatively small when baseline or run-in assessments are available. It is therefore concluded that the parallel group trial is the design of choice for prophylaxis, and that it has a place in the evaluation of acute therapy. PMID- 3683715 TI - Clinical trials in migraine: parallel versus crossover studies. AB - Most prophylactic drug studies for migraine utilize parallel or crossover formats. Both study designs have disadvantages and advantages. The pros and contras of each study are discussed. The majority of headache investigators seem to favor the parallel study and reasons for this preference are discussed. PMID- 3683716 TI - Patient numbers needed in prophylactic migraine trials. AB - Based on a multicenter double-blind crossover prophylactic migraine trial (n = 96), the relative effectiveness of the crossover design versus group comparison was evaluated. If a 'time effect' is taken into account in the statistical model, the crossover design was estimated to be 10-11 times more effective than the group comparison. With more traditional statistical methods using paired and unpaired t tests, the crossover design was estimated to be 4 times more powerful than the group comparison. Based on the t test, sample size tables for numbers of patients needed for detecting effect differences from 10 to 50% with powers from 0.6 to 0.9 in a crossover and a group comparison are presented. These calculations are based on only one trial, and it is recommended that similar estimations of sample variability should be done in other previous trials. PMID- 3683717 TI - Some comments on the use of statistics in the evaluation of drug trials in migraine. AB - Statistical aspects need particular attention in reporting on drug studies in migraine. It is important to report on all patient and disease characteristics which have contributed to the diagnosis and on all variables used for the evaluation of the result; the use of median values, accompanied by the extremes, is recommended in this context. Comparability of the study groups should be examined and possibly repeated after exclusion of the defaulters, if their number is substantial. As regards the presentation of the results, it does not suffice to give p values only: the magnitude of the response should be given and the use of techniques estimating the reliability of this magnitude (e.g. confidence intervals) and/or its reproducibility (e.g. power calculations) is recommended. An analysis of three unrelated groups of migraineurs demonstrates that most pertinent variables show a non-Gaussian distribution, and this includes the distribution of treatment results. For this reason, the use of nonparametric tests is advocated. PMID- 3683718 TI - Drug trials in migraine. The clinician's view on end points. AB - The definition of efficacy parameters in drug trials of migraine has received little attention and the tendency has been to take into account many parameters, which leads to the possibility of some positive results being obtained purely by chance. In trials of prophylactic drug treatment, the major parameter is the frequency of attacks. Patients with frequent interval headache should preferably be excluded from such trials since there is no satisfactory way to distinguish interval headache from mild migraine attacks. Severity and duration of attacks are important parameters but they are difficult to interpret since they are modified by symptomatic medication. The mean score of each attack by consumption of symptomatic medication gives a good estimate of the severity and duration of attacks, but the problem of equalizing different medications in order to obtain a single estimate has not been solved. In trials of abortive drug treatment, there is at present no agreement upon the single most important parameter. Severity of headache, severity of associated symptoms, global efficacy and duration of attacks are all modified by escape medication. The need for escape medication is a better parameter but its power to discriminate ineffective and partially effective drugs is low. It is suggested that the major parameter could be the number of attacks aborted in 2 h or less, which is a simple quantitative and clinically relevant criterion. PMID- 3683719 TI - Problems in childhood migraine. AB - There are differences between childhood and adult migraine which justify clinical research. First, inessential differences, such as prominence of systemic upset, indicate need for clinical drug trials. Second, some paroxysmal phenomena of childhood such as paroxysmal torticollis, vertigo, and hemiplegia may be migraine precursors, and need therapeutic trials. Third, some proposed equivalents of migraine in childhood need study and definition, followed by clinical trials. PMID- 3683720 TI - Short-term memory, exploration and locomotor activity in aged rats. AB - Behavioral profiles of young (3-6 months) and aged (24-27 months) rats were compared in three respects: (1) short-term memory, (2) exploration and (3) locomotor activity. Compared to young rats, aged rats were impaired in the 8-arm radial maze acquisition, but not in the delayed reinforced alternation acquisition. They had lower scores of spontaneous alternation, of exploration of a novel object and of a novel environment. Their exploratory activity was lower in a simple environment but similar in a complex environment. Their spontaneous locomotor activity was lower during the dark part of the cycle (8 p.m.-8 a.m.) but not different during the light part of the cycle (8 a.m.-8 p.m.). These results suggest that with respect to short-term memory and exploration, differences between aged and young rats may be influenced by a "complexity" factor and may be secondary to differences in motivation and reactions to novelty. PMID- 3683721 TI - Effect of phosphatidylserine on acetylcholine release and content in cortical slices from aging rats. AB - Cortical slices were prepared from male rats 3 to 28 months old. The slices were superfused with choline-enriched Krebs solution containing physostigmine and electrically stimulated at frequencies of 1, 2 and 5 Hz for 5 min periods preceded and followed by rest periods. The amount of acetylcholine released during the stimulation periods was quantified by bioassay. In some experiments acetylcholine content was measured at the end of the superfusion period in stimulated and unstimulated slices. The evoked acetylcholine release was constant between 3 and 11 months of age at each frequency tested and showed a 50% decrease between 11 and 14 months of age with no further decrease up to 28 months. No difference in the evoked acetylcholine release was detected between 3 and 16 month old rats if the old rats were pretreated with phosphatidylserine 15 mg/kg IP for at least 7 days. The effect of phosphatidylserine lasted for 5 days after interruption of the treatment. There was no difference in acetylcholine content between the stimulated and unstimulated slices in 3 month old rats. In 16 month old rats stimulation brought about a 44% decrease in acetylcholine content. This decrease did not occur in rats pretreated with phosphatidylserine for 7 days. Phosphatidylserine appears to restore acetylcholine release in aging rats by maintaining an adequate acetylcholine supply in the slices. PMID- 3683722 TI - Correlation of behavioral and cerebrovascular functions in the aging rat. AB - Regional cerebral blood flow (rCBF), maze performance and the influence of environmental enrichment on these parameters were studied in Sprague-Dawley rats aged 6, 12 and 24 months. Learning ability in a complex sequential T-maze (Stone maze) progressively declined with increasing age in rats which were normally housed in standard caging. Environmental enrichment significantly improved maze performance but did not prevent the age-dependent impairment. Following completion of the learning studies, rCBF was measured in each of 13 brain regions in conscious, unrestrained, resting animals. In the absence of any significant change in cardiac output over the entire age range, rCBF was lower in all brain regions by an average of 16% in 12-14 month old rats and 8% in aged rats (24-26 months old); the occipital cortex, inferior and superior colliculi and hypothalamus were particularly affected regions in both age groups. The sharp reduction of rCBF that occurred between 6 and 12 months of age did not reflect, and probably preceded the progressive decline in maze performance. Such highly significant age-related changes in rCBF were not affected, however, by environmental enrichment procedures. This contrasts with the substantial influence of enrichment on maze performance. Finally, mean brain blood flow and mean cortical blood flow correlated inversely and significantly with average daily numbers of errors made by 24 month old rats during Stone maze acquisition. PMID- 3683723 TI - Effect of age on behavioral and enzymatic changes during thiamin deficiency. AB - Open field behavior and whole brain enzymatic activities were determined during thiamin deficiency in two strains of young, as well as in aged mice. In young CD 1 mice, thiamin deficiency reduced total distance traveled and vertical movements after 7 days and the decline was more than 50% by day 9. The behavioral deficit was highly correlated to decreases in 2-oxoglutarate dehydrogenase activity (KGDH). The open field behavior of Balb/c mice was about 40% less than in CD-1 mice and responded in a qualitatively different manner to thiamin deficiency. The activity of the Balb/c mice increased and then decreased with thiamin deficiency. The activity of 3 month old mice peaked on day 6 (126% of initial score), whereas 10 and 30 month mice showed a much greater increase (about 175% of initial scores), but on day 7. Although the activity of the thiamin dependent enzyme transketolase (TK) was affected similarly at all ages, the activity of KGDH in the aged brain was more sensitive to thiamin deficiency than in the young; KGDH activity declined 41%, 57% or 74% at 3, 10, or 30 months, respectively. Thus, the current mouse model is an attractive one to study the interaction of thiamin deficiency with aging. PMID- 3683724 TI - Age differences in recognition memory of the rhesus monkey (Macaca mulatta). AB - Aging is accompanied by a gradual decline in memory in both humans and nonhuman primates. To determine whether the impairment in nonhuman primates extends to recognition memory, which is a sensitive index of the integrity of the limbic system, we trained rhesus monkeys of four different age groups (3-6, 14-17, 20 24, and 25-29 years of age) on a delayed nonmatching-to-sample task with trial unique objects. After the animals had learned the task, which required recognition of single objects presented ten seconds earlier, memory demands were increased by gradually lengthening delay intervals (to 120 seconds) and list lengths (to ten objects). With increasing age, only marginal impairments in learning the basic task were observed. However, clear age-related differences did emerge when either delays or list lengths were increased, with the oldest group of monkeys demonstrating the greatest impairments. The decline in visual recognition ability in aging monkeys parallels the decline in memory observed with advancing age in humans. PMID- 3683725 TI - Recovery from GABA-mediated hemiplegia in young and aged rats: effects of catecholaminergic manipulations. AB - We investigated the participation of catecholaminergic mechanisms in the functional recovery from motor cortex lesions in young (9 months) and aged (26 months) rats. The animals were studied during the recovery period from an hemiplegic syndrome secondary to small motor cortex lesions potentiated by the localized, chronic (7 days) infusion of GABA into the lesion site. Acute administration of haloperidol (0.1 mg/kg IP) to these recovered animals induced a re-emergence of the contralateral motor syndrome in both groups. In the young group, the haloperidol-induced hemiplegia lasted one day whereas in the aged animals the deficit was significantly prolonged lasting three days. Apomorphine administration (0.5 mg/kg IP) prior to or immediately after haloperidol injection failed to prevent or reverse the reappearance of the motor deficit. Adult animals recovered from motor cortex aspirations performed 7 to 12 months prior were refractory to haloperidol effects. Amphetamine administration to young rats treated chronically with saline or GABA infusion into the somatomotor region also failed to alter the clinical evolution of the motor deficit. The evidence suggests that dopaminergic mechanisms are involved in the functional recovery from brain lesions and that these mechanisms are most susceptible to neuroleptic blockade during the early post-lesional period. The deleterious effects of dopaminergic blockade are heightened in aged populations. The use of dopaminergic antagonists in brain-lesioned subjects, and particularly in geriatric populations, is considered potentially harmful, particularly in the early stages of the recovery process. PMID- 3683727 TI - Modifications in cerebral lipid metabolism by severe glucose deprivation during aging. AB - Severe glucose deprivation causes extensive derangement of phospholipids, fatty acids and free fatty acids in cerebral cortex of rats of different ages. The hypoglycemia-induced cerebral loss of phospholipids and fatty acids persists after 60 min recovery. Changes in individual classes of lipids are largely affected by aging. In fact, during glucose deprivation and recovery, in adult animals no preferential loss of polyunsaturated fatty acids and ethanolamine phosphoglycerides occurs, suggesting that the loss could be related to oxidative rather than to peroxidative degradation. On the contrary, in senescent rats the quoted events occur, suggesting the hypothesis of a possible peroxidation of cerebral lipids. Pretreatment with some agents is performed to elucidate the aging mode of action. Papaverine (acting on macrocirculation) is uneffective, while raubasine (acting on microcirculation and metabolism) and almitrine (acting on oxygen availability) interfere with the phospholipid and fatty acid metabolism, their action being different according to the rat age. PMID- 3683726 TI - Gender and chronic stress effects on the neural retina of young and mid-aged Fischer-344 rats. AB - Young (5 months) and mid-aged (11 months) male and female Fischer rats were exposed to daily (5 days/week) chronic escapable foot-shock stress for 6 months. Following a subsequent 1-month rest period, by which time the animals were 12 and 18 months old, neural retinas were evaluated histopathologically and morphometrically. A significant reduction in the thickness of the retina occurred in the mid-aged, as compared to the young animals. A severe age-related loss in photoreceptor cells, particularly in the peripheral zones of the retina, occurred in a pattern resembling that described for aging humans. The effect of stress was to increase photoreceptor loss in a pattern resembling that of age-related cell loss. Stress-associated photoreceptor cell death was observed in males and females of both ages, but was more pronounced and statistically significant for mid-aged males (a five-fold increase in cell loss over females). The results demonstrated that exposure of rats to chronic escapable foot-shock stress exacerbates retinal changes commonly associated with aging and that the deleterious effects of chronic stress exposure were greater in the older age, male group. PMID- 3683728 TI - Restoration of sexual function and fertility by fetal hypothalamic transplant in impotent aged male rats. AB - The purpose of this study was to observe whether fetal hypothalamic transplant can restore the neuroendocrine and reproductive function in impotent aged male rats. Eighteen to 20 month old impotent male rats received an anterior hypothalamus removed from a 17-19 day old fetus and placed into the anterior third ventricle. Controls were either without surgery (UC) or grafted with cerebral cortex (CG). Before and 2 to 3 months after transplantation, blood samples were collected from the aged rats for testosterone and LH measurement. Before and one to two months after transplantation, each hypothalamic grafted animal (HG) or control rat was put overnight into a cage which contained four, 10 to 12 week old proestrous female rats. Vaginal smear of each female was monitored early the next morning. Sperm seen in the vaginal smear was regarded as copulation and ejaculation. The test was repeated twice, one week apart, and the higher score represented the sexual function and fertility of the males. Seven of 10 HG males restored their sexual function, impregnated 9 females and fathered 106 pups. None of 7 UC restored their reproductive function and only one of 4 CG males impregnated one female which delivered 6 pups. Serum testosterone, LH and pituitary LH in the HG rats, which showed restoration of reproductive function, were significantly higher than those of the controls (UC and CG). These results indicate that the fetal hypothalamic grafts can survive and develop in the brain of impotent aged male rats and restore neuroendorince and reproductive function in senescent rats. PMID- 3683729 TI - Effect of L-homocysteine and derivatives on the high-affinity uptake of taurine and GABA into synaptosomes and cultured neurons and astrocytes. AB - The effect of L-homocysteine and selected derivatives on the high-affinity uptake of the inhibitory neuroeffectors, GABA and taurine, was investigated in synaptosomes, and in cultured neurons and astrocytes. High-affinity uptake of taurine into synaptosomes was inhibited most effectively by L-homocysteine, DL homocysteine and homocystine whereas neuronal uptake was unaffected by any of the compounds tested. The high affinity uptake of taurine into astrocytes was markedly inhibited by L-homocysteine, L-homocysteic acid and L-homocystine. High affinity GABA uptake into astrocytes was notably inhibited by L-homocystine, none of the other compounds tested causing appreciable inhibition below a concentration of 5 mM. Neuronal and synaptosomal high-affinity uptake of GABA was not significantly affected by any of the test compounds at concentrations below 5 mM. The implication of these results to the study of the mechanism of homocysteine-induced seizures and their relevance to the genetic disorder homocystinuria is discussed. PMID- 3683730 TI - Stereoselective uptake of the GABA-transaminase inhibitors gamma-vinyl GABA and gamma-acetylenic GABA into neurons and astrocytes. AB - The cellular uptake of the GABA-transaminase inhibitors gamma-vinyl GABA (GVG) and gamma-acetylenic GABA (GAG) was studied in cultured neurons and astrocytes. By the use of the individual enantiomers R- and S-GVG and R- and S-GAG it could be shown that in both cell types only the S-enantiomers could be actively transported. Comparing neurons and astrocytes only neurons exhibited a high affinity uptake system for S-GVG (Km 78.2 +/- 20.3 microM; Vmax 0.71 +/- 0.06 nmol.min-1.mg-1 cell protein). In case of S-GAG it could not be established with certainty whether the neuronal uptake was of the high affinity type. Both GVG and GAG were studied as inhibitors of GABA uptake into neurons and astrocytes. S-GVG and S-GAG were found to be weak inhibitors of GABA uptake suggesting that S-GVG is not transported by the GABA carrier in neurons. The finding of a much more efficient uptake of S-GVG into neurons than into astrocytes is in line with the previous observation that neuronal GABA-T is more sensitive than astrocytic GABA T to S-GVG. PMID- 3683731 TI - Calcium ions in the presence of exogenous phosphatidylserine interfere with GABA diffusion through the Deiters' neuron membrane. AB - Diffusion of GABA through the plasma membrane of GABA-acceptive neurons might be a mechanism of importance for the termination of its synaptic action. In the present investigation we studied the effects of phosphatidylserine (PS) (10(-4) 10(-3) M), Ca2+ 2 mM and PS + 2 mM Ca2+ on such a process. The method involved the use of single microdissected Deiters' membranes which were put between two small microchambers in order to study the passage of GABA across the membrane. The results show that whereas PS and Ca2+ by themselves have no effect on such a process, PS + 2 mM CaCl2 give a significant, although slight, inhibition. The hypothesis that Calcium ion + PS effect is due to a disturbance of the interaction between GABA and endogenous PS molecules of the membrane is discussed. PMID- 3683732 TI - Cholesterol ester hydrolase(s) in mammalian brain: is there a myelin-specific cholesterol ester hydrolase? AB - The present study compared the properties of cholesterol ester hydrolase(s) in myelin and microsomes from rat, mouse and human brain. The results indicated that the enzyme activity in both myelin and microsomes from rat, mouse and human brain was optimal at pH 6.5 and required Triton X-100 for optimal activity. The enzyme activity in myelin was 3- to 4-fold higher in the presence of Triton X-100 than taurocholate. Addition of phosphatidyl serine enhanced (2 to 4 fold) the hydrolase activity in both myelin and microsomes. The properties of the enzyme in solubilized preparation of myelin were also similar to the properties of the enzyme in partially delipidated and solubilized preparations of microsomes. The activity was again optimal at pH 6.5, required Triton X-100 for optimal activity and was stimulated by phosphatidyl serine. These results indicate that the properties of cholesterol ester hydrolase in myelin are similar to those of the microsomal enzyme and that this is true for the fractions from both human and rodent brain. The data thus lead us to believe that the hydrolase activity in mammalian brain myelin and microsomes may reflect the distribution of a single enzyme in the two fractions rather than two distinct enzymes, one being specific to each fraction. PMID- 3683733 TI - Ca2+-dependent phosphorylation by endogenous kinases of Mr 95 K and 50 K-55 K proteins in PC12 pheochromocytoma cells. AB - Endogenous protein phosphorylation of PC12 cells was investigated with the homogenate as well as intact cells. In the case of the homogenate, the major proteins that were phosphorylated in the presence of Ca2+ were found to be of Mr 95 K and Mr 50 K-55 K. Ca2+/calmodulin-dependent protein kinase appeared to be responsible for phosphorylation of Mr 50 K-55 K proteins and partly of Mr 95 K protein. The apparent Km's for Ca2+ of Mr 95 K and 50 K-55 K protein phosphorylation were 2.2 x 10(-7) M and around 1.5 x 10(-6) M, respectively. Since several cell lines of neuroblastoma exhibited Mr 95 K protein phosphorylation of similar type, the protein phosphorylation may be a common process shared by neuronal cells. Depolarization of intact PC12 cells by high K+ concentrations induced Mr 95 K protein phosphorylation. The results suggest that a physiological increase by excitation in the intracellular Ca2+ concentration triggers phosphorylation of Mr 95 K protein in neuronal cells and this phosphorylation may play a role in the regulation of transmitter release. PMID- 3683734 TI - Compartmentation in the blood-brain barrier: a correction. PMID- 3683735 TI - Exogenous fibrin matrix precursors stimulate the temporal progress of nerve regeneration within a silicone chamber. AB - The silicone chamber model permits the investigation of the cellular and molecular events underlying successful regeneration of the rat sciatic nerve across a 10 mm gap. When 25 microliter chambers are implanted prefilled with phosphate-buffered saline (PBS), it takes 5-7 days before sufficient fibrin matrix (derived from plasma precursors) accumulates naturally to form a complete bridge across the chamber gap; at 1 week postimplantation, cellular migration into the matrix from the nerve stumps is just beginning. The temporal progress of regeneration might be stimulated if a fibrin matrix, conducive to cell migration, was provided to the nerve stumps at or shortly after the time of chamber implantation. To test this hypothesis, chambers were prefilled, at the time of implantation, with different preparations of homologous plasma. A solution of 90% platelet-free plasma dialyzed against PBS (DP) formed a fibrin matrix by 24 hours postimplantation that, like the naturally formed matrix, had a predominantly longitudinal orientation. The temporal progress of regeneration was stimulated in the DP-prefilled chambers; at 17 days postimplantation, the extents of Schwann cell migration and axonal elongation were significantly greater than in the control system. In contrast, prefilling chambers with either non-citrated plasma or DP + calcium resulted in the generation of a matrix within 8 minutes that was composed of randomly oriented fibrin polymers. These matrices significantly retarded the progress of regeneration. PMID- 3683736 TI - Rapid regulation of neuronal growth cone shape and surface morphology by nerve growth factor. AB - Scanning electron microscopy was used to study regulation of growth cone shape and surface morphology by nerve growth factor (NGF). The growth cones of cultured rat sympathetic neurons and neuronally-differentiated PC12 cells were observed under conditions of continuous NGF exposure, NGF withdrawal, and NGF readdition. Growth cones of cells cultured in the continuous presence of NGF were mostly spread in shape and about 60% possessed surface ruffles. Ruffles appeared to be largely restricted to growth cones in that few were observed on cell bodies and neurites. Withdrawal of NGF for 4-5 hr caused most of the growth cones to take on a non-spread or contracted appearance and to lose their ruffles. Readdition of NGF promoted rapid changes in growth cone properties. Within 30 sec, ruffling was again evident on the growth cones and remained prominent there throughout the course of treatment (up to 5 hr). This was in contrast to cell bodies on which, as previously reported, ruffling also occurred following NGF readdition, but only transiently (for less than 15 min). Respreading of growth cones also occurred under these conditions. This was evident within 1 min of NGF readdition and reached the levels observed in continuously-treated cultures within 1-2 hr. Neurites were also examined. Ruffles were only rarely present in the continuous presence of NGF and were absent after NGF withdrawal. NGF readdition elicited ruffling along neurites within 30 sec; the prevalence of such ruffles diminished to that seen in continuously-treated cultures within about an hour.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683737 TI - De novo synthesis of NGF subunits in S-180 mouse sarcoma cell line. AB - It is an accepted hypothesis that the nerve growth factor protein (NGF) plays an important role in the development of vertebrate sympathetic and sensory ganglia and has effects on some central neurons. The best known NGF species is that isolated from mouse submaxillary gland, MSG-NGF. MSG-NGF can be isolated as a subunit containing protein, 7S-NGF, made up of three dissimilar subunits called alpha-, beta-, and gamma-NGF. Beta-NGF is the biologically active subunit and its synthesis in vivo and in vitro has been demonstrated. Less is known about the synthesis of the alpha- and gamma-NGF or the assembly of the subunits into the 7S complex. In order to develop a clonal model system for the study of NGF synthesis, processing and secretion, affinity chromatography techniques were applied to cell extracts of S180 mouse sarcoma, a cell line known to synthesize NGF. After incubating S180 cells in 35S-Methionine, cell extracts were exposed to antibody directed against alpha-NGF, gamma-NGF or beta-NGF covalently bound to Sepharose beads in order to elute and characterize the desired NGF subunits. Parallel experiments using immunoabsorbed [35S]Methionine-beta-NGF were carried out in the presence or absence of excess NGF, in order to demonstrate the specificity of this procedure. Affinity chromatography with a substrate analogue to arginine ester bound to Sepharose beads was also used to isolate de novo synthesized gamma-NGF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683738 TI - High-affinity uptake of gamma-[3H]aminobutyric acid by isolated mouse oligodendrocytes in culture. AB - Oligodendrocytes were isolated from mixed glial cultures of neonatal mouse forebrain and further grown in serum-free hormone supplemented culture medium. Cell populations were identified by indirect immunofluorescence using a range of specific antibodies, revealing a predominantly immature population of oligodendrocytes, the majority expressing the myelin glycolipids galactocerebroside and sulfatide on their plasma membrane. Astroglial contamination was found to be minimal. Simultaneous autoradiography and immunofluorescence demonstrated the presence of a transport system for the major inhibitory neurotransmitter GABA in the oligodendrocytes. The transport system was found to be energy, sodium and temperature dependent. Kinetic analysis revealed a high affinity system, with a Km of 6.27 microM and Vmax of 0.714 nmol/min/mg protein, which is comparable to that found previously for CNS neurons and astrocytes. PMID- 3683739 TI - Nerve growth factor modulates tubulin transcript levels in pheochromocytoma PC12 cells. AB - We report that nerve growth factor (NGF) can elevate tubulin transcript levels in cultured rat pheochromocytoma PC12 cells in a manner which correlates with its capacity to enhance neurite formation. The elevation is due, at least in part, to transcript stabilization. We have previously shown that insulin and its homologs can similarly enhance neurite outgrowth and tubulin mRNA levels in human neuroblastoma cells. Insulin by itself can neither induce neurite formation nor increase tubulin transcript levels in PC12 cells. However, both responses are potentiated in cells treated with the combination of insulin and NGF. The results together support the generalization that tubulin transcript levels are specifically elevated whenever neurite elongation is initiated by polypeptide neuritogenic factors. PMID- 3683740 TI - Long-term support by injured brain extract of a subpopulation of ciliary ganglion neurons purified by differential adhesion. AB - Ciliary ganglion neurons and nonneurons can be separated from each other, based on the greater adhesivity of the nonneurons to untreated tissue culture plastic in the presence of serum. When the separation was carried out in the presence of Serum Plus (a commercially available supplemented serum), two populations of neurons were distinguished. Neurons in the first class (50-60% of total) adhered to plastic within 15 min, tended to aggregate into clumps, and were not well supported in long term culture by brain extracts. Neuronal adhesion to plastic was inhibited by heparin but not by chondroitin sulfate. Neurons in the second class did not attach to plastic for up to 90 min (and could thus be purified), were not as prone to aggregation, and were quantitatively supported for long periods (greater than 2 weeks) by the neurotrophic factor(s) present in extracts of injured brain. Although no direct evidence is provided, these populations may correspond to the well characterized ciliary and choroid neurons. PMID- 3683741 TI - Depolarization of brain synaptosomes activates opposing factors involved in regulating levels of cytoskeletal actin. AB - Depolarization of mouse brain synaptosomes elicits transmitter release and modifies factors that regulate cytoskeletal actin (C-actin) levels. We previously reported (Bernstein and Bamburg, J. Neurosci. 1985. 5:2565-2569) that depolarization causes a release of about 25% of the actin associated with the cytoskeleton of synaptosomal lysates. From our current studies we conclude that depolarization only transiently perturbs the balance in opposing factors which regulate C-actin levels in lysates. Prolonged incubation of the lysates permits the actin to reequilibrate so that no difference between C-actin levels of resting and depolarized synaptosomes is observed. Both the initial transient release of actin from the cytoskeleton and its reassociation with the cytoskeleton during prolonged incubation are calcium dependent and involve factors in both the cytoskeletal and soluble fractions. Depolarization initiates modifications that both increase and decrease the C-actin level probably through mechanisms involving calcium sensitive actin binding proteins. PMID- 3683742 TI - Nerve growth factor stimulates the phosphorylation of a 250 kDa cytoskeletal protein in cell-free extracts of PC12 cells. AB - Nerve growth factor (NGF) rapidly stimulates the phosphorylation of a 250 kDa cytoskeletally-associated protein (pp250) by a protein kinase which is also associated with structural elements of the cell. We have solubilized these proteins and demonstrated that NGF-stimulated phosphorylation can be observed in cell free extracts of cytoskeletons from NGF-treated PC12 cells. The pp250 substrate and the 250-kinase were solubilized from PC12 cytoskeletons by treatment with 2 M urea. Phosphorylation of pp250 was maximally stimulated following treatment of the cells for 5 min with NGF. This effect was transient, diminishing with longer exposure of the cells to hormone. The 250-kinase preferred Mn2+ over Mg2+ and was inhibited by both Na+ and K+. The phosphorylation of pp250 was not affected by Ca2+. Upon fractionation of the urea soluble cytoskeletal proteins by gel filtration, the 250-kinase eluted in two peaks; one peak of enzyme activity coeluting with the pp250 substrate, and a second peak of enzyme activity eluting with an apparent Mr of approximately 60 kDa. Treatment of the PC12 cells with the phorbol ester TPA also stimulated the phosphorylation of pp250, although this effect was not as great as that produced by NGF. This cell free system should be a valuable tool in the investigation of the mechanisms of NGF action. PMID- 3683743 TI - Examination of a nerve injury-induced, 37 kDa protein: purification and characterization. AB - Following traumatic injury to the adult rat sciatic nerve the synthesis and accumulation of soluble, extra-cellular, 37 kDa protein is increased. This protein, which accumulates in the extracellular space of the injured nerve, accounts for nearly 5% of the total soluble pool of protein in an injured nerve 3 weeks after injury. 8 weeks after injury, when regeneration is nearly complete, this accumulated pool returns to control levels, yet if regeneration is blocked synthesis of the 37 kDa protein remains high. Recently this 37 kDa protein has been shown to be nearly identical to apolipoprotein E, the protein component of various lipoprotein particles. This finding suggests a role for the 37 kDa protein in cholesterol and lipid transport and metabolism during nerve repair within the nervous system, functions that have been ascribed to apo E in serum. Results are presented here describing the purification of the nerve injury induced 37 kDa protein and the subsequent production of specific rabbit antisera directed against it. By centrifugation analysis in a sucrose gradient, a native mass of 37 kDa was determined, revealing the 37 kDa protein's monomeric, native structure. Additionally injections of [35S]methionine directly into the injured nerve allowed 1) a comparison of 37 kDa synthesis in vivo versus in vitro and 2) an examination of the presence or absence of retrogradely transported 37 kDa protein. The in vitro and in vivo collected material were found to share identical 2-dimensional electrophoretic mobilities, and no appreciable amount of transported 37 kDa protein was found in proximal regions of the injured nerve. PMID- 3683744 TI - Long-term persistence of GAD activity in injured crayfish CNS tissue. AB - Crayfish CNS fibers were isolated in vivo from their cell bodies, from cellular connections in the CNS, and from peripheral sensory and effector cells. The glutamic acid decarboxylase (GAD) activity of the experimental tissues was about half of that of the sham-operated and unoperated control tissues by two weeks after surgery and remained at about that level during the ensuing six weeks. During that time, there was no significant behavioral, electrophysiological, or histological evidence of regeneration of nerve fibers across the lesion sites. The crush-isolated connectives possessed many intact axon profiles and non neuronal cell nuclei. The long-term persistence of GAD activity in the injured CNS tissue may reflect the involvement of glial cells in maintaining neurotransmitter levels. PMID- 3683745 TI - NGF effects on developing forebrain cholinergic neurons are regionally specific. AB - Nerve growth factor (NGF) has been shown to have an effect on neurons in the central nervous system (CNS). A number of observations suggest that NGF acts as a trophic factor for cholinergic neurons of the basal forebrain and the caudate putamen. We sought to further characterize the CNS actions of NGF by examining its effect on choline acetyltransferase (ChAT) activity in the cell bodies and fibers of developing neurons of the septum and caudate-putamen. ChAT activity was increased after even a single NGF injection. Interestingly, the magnitude of the effect of multiple NGF injections suggested that repeated treatments may augment NGF actions on these neurons. The time-course of the response to NGF was followed after a single injection on postnatal day (PD) 2. NGF treatment produced long lasting increases in ChAT activity in septum, hippocampus and caudate-putamen. The response in cell body regions (septum, caudate-putamen) was characterized by an initial lag period of approximately 24 hr, a rapid rise to maximum values, a plateau phase and a return to baseline. The response in hippocampus was delayed by 48 hr relative to that in septum, indicating that NGF actions on ChAT were first registered in septal cell bodies. Finally, developmental events were shown to have a regionally specific influence on the response of neurons to NGF. For though the septal response to a single NGF injection was undiminished well into the third postnatal week, little or no response was detected in caudate-putamen at that time. In highlighting the potency and regional specificity of NGF effects, these observations provide additional, support for the hypothesis that NGF is a trophic factor for CNS cholinergic neurons. PMID- 3683747 TI - Neuropathology and neurovirulence of canine distemper virus plaque isolates in the hamster. AB - The relationship between neuropathological abnormalities, antibody response and neurovirulence of plaque isolates has been studied in an experimental model of canine distemper in the hamster. Genetic virus variance influenced neurovirulence and the experimental evidence supports the hypothesis that the mechanism of this effect may be through the modulating effect of circulating antibody. Large plaque virus (LPV) produced severe encephalitis with little early antibody response and a high degree of pathological abnormality. Small plaque virus (SPV) produced mild chronic encephalitis and early antibody response. Microscopically, histological abnormalities in this group were qualitatively similar to those seen with LPV but generally of lesser degree. Immunosuppression in SPV infected animals increased the severity of the encephalitis, reflected by the increase in inflammation and inclusion formation. Combined SPV and LPV infection produced high antibody levels and less severe disease than LPV infection alone with an intermediate pattern of histological abnormality. PMID- 3683746 TI - Survival, morphology, and catecholamine storage of chromaffin cells in serum-free culture: evidence for a survival and differentiation promoting activity in medium conditioned by purified chromaffin cells. AB - Adult bovine and young rat chromaffin cells cultured in serum-free medium were examined for their survival and differentiation following exposure to various additives, trophic agents and conditioned media. Adrenal chromaffin cells dissociated from 8 day old rats were maintained by dexamethasone, NGF and CNTF or without any additives in an N1-supplemented medium in similar numbers as in serum containing medium for up to 6 days. Neuritic growth elicited by NGF or CNTF was enhanced in the absence of serum. Medium conditioned by purified bovine chromaffin cells improved cell survival and caused neurite outgrowth in a dose dependent manner. The activiti(es) was sensitive to heat and trypsin and not blocked by the addition of anti-NGF antibodies. Bovine chromaffin cell survival was reduced by 30% when cells were maintained for one week in the absence as compared to the presence of serum. Addition of insulin, the N1 supplement, dexamethasone or dbcAMP single or in combinations improved the survival to different extents. A combination of insulin (5 micrograms/ml) and dexamethasone (5 X 10(-6) M) proved to be optimal in this respect. However, these supplements failed to restore the cellular catecholamine, noradrenaline and adrenaline contents to levels seen in the presence of serum. This was also true for a chromaffin cell-conditioned medium, which improved survival without elevating the catecholamine contents. Conditioned medium, however, partly restored a more physiological adrenaline-noradrenaline-ratio. PMID- 3683748 TI - 1,3-Dinitrobenzene-induced encephalopathy in rats. AB - Exposure to 1,3-dinitrobenzene (1,3-DNB) in humans induces methaemoglobinaemia, nausea and nervous symptoms. When given to conventional rats, twice-daily oral doses of 10 mg kg-1 1,3-DNB produce methaemoglobinaemia and frequently ataxia after four or five doses. In germ free rats given only a single oral dose of 20 mg kg-1, similar symptoms occur but are of more rapid onset. Light and electron microscope examinations reveal an acute thiamine deficiency-like lesion in the brain stems of both ataxic and apparently normal rats. Bilaterally symmetrical vacuolated lesions involve cerebellar roof, vestibular and superior olivary nuclei and the inferior colliculi. Frequent petechial haemorrhages are associated with these lesions, the erythrocytes usually being limited to enlarged Virchow Robin spaces but sometimes spreading more widely. The primary cellular targets appear to be astrocytes, oligodendrocytes and vascular elements with secondary neuronal involvement. It is suggested that 1,3-DNB interferes with intracellular redox mechanisms resulting in impaired glucose oxidation. PMID- 3683749 TI - Sinus histiocytosis with massive lymphadenopathy presenting as a meningioma. AB - This report documents a case of sinus histiocytosis with massive lymphadenopathy (SHML) which was unusual in that it produced a localized mass on the intracranial dura, simulating a meningioma. The clinical, histological and ultrastructural features of this case are presented. PMID- 3683750 TI - Reduced optimality as an indicator of developmental status at 18 months and school achievement at 8 years. AB - Birth records of 97 children assessed at 18 months and found to be developmentally delayed were scored according to the optimality concept developed by Prechtl. These children were compared to a control series of 81 children. In order to evaluate the predictive validity of the parental developmental assessments performed at 18 months the children had been screened for school achievement problems at the age of eight years, yielding a distribution of true and false positives and true and false negatives. Rates of reduced optimality were compared to investigate firstly, the relationship between reduced optimality and developmental delay at 18 months and secondly, whether the follow-up distribution of true and false positives at eight years could be related to reduced optimality. The overall relationship between reduced optimality and developmental delay at 18 months and reduced optimality and school achievement problems at eight years was also investigated. The 15 low scoring cases registered as mentally retarded differed significantly from controls on total mean reduced optimality. Retarded and non-retarded low-scorers differed significantly on post partum sub-scores only. When the eight-year follow-up groups were compared both retarded and non-retarded true positives differed significantly from true negatives on total mean reduced optimality. The difference in post-partum reduced optimality between retarded and all other follow-up groups but non-retarded true positives reached statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683751 TI - Continuous 4-channel EEG monitoring: a guide to interpretation, with normal values, in preterm infants. AB - A system is described for the rapid analysis of the extensive EEG data produced by continuous 4-channel monitoring. Using this system, the initial EEGs of 44 low risk preterm infants between 26 and 37 weeks gestation have been analysed and quantified in order to establish standard values. This provides a basis for assessment of the acute EEG as an index of cerebral function in high-risk or abnormal preterm infants. PMID- 3683752 TI - CKBB-enzyme activity in serum in neonates born after vaginal delivery and cesarean section. AB - Creatine kinaseBB has been analysed in blood from the umbilical cord and from venous blood within 24 hours after birth in infants without any signs of perinatal asphyxia. S-CKBB activity was found to be much higher than in adults and older children. 25% of the children born after normal vaginal delivery showed very high S-CKBB activities, higher than any of the children born by elective cesarean section. There were, however, no signs of neurological disturbances to be found in any of these children with high neonatal CKBB activities at follow-up after four years. PMID- 3683753 TI - Schilder's disease: additional aspects and a therapeutic option. AB - An 8-year-old boy presented with large diffuse myelinoclastic bifrontal and right parietal peripherally enhancing white matter lesions with high intracranial pressure. Intravenous treatment with ACTH and high dose cyclophosphamide (cytoxin) resulted in shrinkage of the lesion, loss of peripheral enhancement and clear clinical improvement. After nine months following the onset of the first episode, an isolated left frontal enhancing lesion appeared along with a new right hemiparesis and speech difficulty. The same therapy again resulted in prompt definitive improvement of the CT scan and reversal of the clinical course. This case was extensively investigated and characterized as the 1912 variety of Schilder's disease, to be distinguished from post-infectious encephalopathy and other forms of white matter disease such as adrenoleukodystrophy. No elevation of CSF IgG, oligoclonal bands, or characteristic abnormality of T-cell subset distribution were identified. However, the pathological picture most closely resembled that of multiple sclerosis. A striking feature of this child's clinical history was the relatively rapid clinical improvement with immunosuppression. PMID- 3683754 TI - Paralytic poliomyelitis in vaccinated children. AB - Paralytic poliomyelitis were observed in two healthy children who both had previously received four doses of standard inactivated poliovaccine (IPV). These children, whose immune defenses were normal, failed to respond to IPV. This absence of antibody response might be related to an insufficient antigenicity of inactivated vaccines, justifying the extensive use of the more potent IPV, now produced on continuous cell lines. PMID- 3683755 TI - Heredity in febrile convulsions: is it HLA-dependent? AB - One hundred children consecutively treated for simple febrile convulsions (FC) were investigated with respect to hereditary factors. Twenty-five of the children had parents or siblings with FC. HLA-typing was performed in all available members of ten families with one or two FC children and one FC parent, and in one family with two FC children but no FC parent. There was no clear association with a particular HLA haplotype in any of these families. PMID- 3683756 TI - Neurological findings in the fetal alcohol syndrome. AB - Five children with fetal alcohol syndrome (FAS), ranging in age from 2 1/4 to 10 years, were noted to have abnormal neurological findings. These were mainly cerebellar. Others were attention deficit disorder in three, mental retardation in two, and epilepsy in one. The neuropathology seen in FAS provides a more than adequate basis for the clinical findings. Children with FAS, or a history of in utero alcohol exposure, and abnormal neurological signs, do not need investigation. PMID- 3683757 TI - Dendritic spine anomalies in fetal alcohol syndrome. AB - Neuropathological findings in the brain of a 4-month-old child born to a chronic alcoholic mother were microcephaly, uncovered rostral region of the insula, disordered arrangement of nerve cells in the cerebral cortex, cerebellar abnormalities, and glial meningeal heterotopies. In addition, impregnantion of neurons by means of the Golgi method showed decreased numbers of dendritic spines and predominance of spines with long, thin pedicles on cortical pyramidal cells. A significant reduction in the number of DS (Student t test; p less than 0.001) on the apical dendrites of layer V pyramidal neurons was demonstrated in this patient when compared with similar counts performed in the brain of controls aged newborn, three months and four months. Reduced numbers of DS and abnormal geometry of spines observed in this child suggest that an abnormal maturation of nerve cells may occur in children, like it has also been demonstrated to occur in rodents, as a consequence of chronic ethanol consumption during gestation. PMID- 3683758 TI - A syndrome with juvenile cataract, cerebellar atrophy, mental retardation and myopathy. AB - Four patients of two families with clinical characteristics resembling those in Marinesco-Sjogren syndrome are presented. All patients had infantile hypotonia as the presenting sign. In preschool age ataxia, cataract and mental retardation manifested. CT scan revealed cerebellar atrophy. Muscle biopsy showed myopathic changes with vacuolar degeneration and marked adipose tissue proliferation. Electron microscopy showed myelin bodies and autophagic vacuoles. The conclusion is that the peculiar myopathic and degenerative findings in the muscle biopsy are a consistent morphological feature in the clinical entity of the patients and the syndrome is distinctive from Marinesco-Sjogren syndrome. PMID- 3683759 TI - Diagnostic difficulties in infantile neuroaxonal dystrophy. A clinicopathological study of eight cases. AB - The clinical features of eight children with infantile neuroaxonal dystrophy are presented. Diagnosis was established by brain biopsy (4 cases), conjunctival biopsy (1 case), and the family history (2 cases), while in one case a presumptive diagnosis was made on the combination of clinical and neurophysiological findings without histopathological confirmation. The pleomorphic clinical picture and variable neurophysiological findings make a firm diagnosis difficult without histopathological confirmation. However, in the appropriate clinical context, serial neurophysiological investigations (ERG, VEP, EEG, ENMG) may suggest the diagnosis after the age of 2 years. Conjunctival biopsy is not invariably helpful, and neuroaxonal spheroids are not always demonstrated in brain biopsies by conventional techniques. However, they were consistently identified using a non-specific esterase stain and by electron microscopy. This technique is described, and the significance of ultrastructural and neuropathological findings in infantile neuroaxonal dystrophy is discussed. PMID- 3683760 TI - Late infantile Krabbe leukodystrophy: MRI and evoked potentials in a Japanese girl. AB - A Japanese girl showed deterioration in development from the age of 13 months. At the age of 16 months, there were mild spastic diplegia, increase in cerebrospinal fluid protein to 61.5 mg/dl and deficient galactosylceramidase I. Magnetic resonance imaging (MRI) demonstrated a high signal intensity with increased T2 in the centrum semiovale. Short latency somatosensory evoked potentials (SSEPs) showed a prolonged N13-N20 interpeak latency followed by abolition of N20. Brainstem auditory evoked potentials (BAEPs) were normally followed by prolonged interpeak latencies of wave I-V. This may be the first report of what we consider to be the late infantile form of Krabbe disease with MRI and evoked potential examinations. PMID- 3683761 TI - The value of MRI in tuberous sclerosis. PMID- 3683762 TI - Evidence that dopamine mechanisms in the nucleus accumbens are selectively involved in the effect of desipramine in the forced swimming test. AB - Bilateral injections of 5 or 1 (but not 0.5) micrograms sulpiride into the nucleus accumbens reduced the effect of a 7-day treatment with 10 mg/kg/day desipramine in the forced swimming test. Bilateral injections of 5 or 1 micrograms sulpiride in the caudate-putamen did not modify the anti-immobility effect of desipramine. The data support the hypothesis that dopamine mechanisms in the limbic regions of the brain of the rat are involved in the effect of repeated treatment with desipramine in the forced swimming test. PMID- 3683763 TI - Injections of deuterated tryptamine into the nucleus accumbens of the rat: effects on locomotor activity and monoamine metabolism. AB - Previous studies have shown that the systemic injection of tryptamine stimulates locomotion in rats and that the nucleus accumbens, a region involved in locomotion, contains the largest concentrations of binding sites for tryptamine in the brain of the rat. The present study examined the behavioral and neurochemical effects of bilateral injections into the accumbens of a deuterated analog of tryptamine, a,a-[2H]tryptamine. Injections of 25 micrograms a,a [2H]tryptamine increased movements in rats at 25-70 min after injection and increased vertical (rearing) activity at 25-40 min. Injections of 50 micrograms of a,a-[2H]tryptamine produced a transient suppression of movement and vertical activity at 5-15 min, followed by increases in these activities at 40-65 min after injection that were comparable to the increases elicited by 10 micrograms of d-amphetamine. At 30 min after the injection of 50 micrograms a,a [2H]tryptamine the concentration of dopamine in the nucleus accumbens was increased by 87%, and was preceded by a transient decrease in the level of the metabolite of dopamine homovanillic acid. The levels of 5-hydroxytryptamine and its major metabolite, 5-hydroxyindoleacetic acid in the nucleus accumbens were not changed. Thus, a,a-[2H]tryptamine may interact with tryptamine receptors in the nucleus accumbens to modulate locomotor behavior through mesolimbic dopamine neurons. PMID- 3683764 TI - Clonidine and the hyper-responsiveness of dorsal horn neurones following morphine withdrawal in the spinal cat. AB - In barbiturate-anaesthetized spinal cats, exaggerated responses of dorsal horn neurones to impulses in unmyelinated primary afferents, were produced by administering naloxone after iontophoretic administration of morphine in the substantia gelatinosa. Clonidine, given both intravenously (5-10 micrograms/kg) and iontophoretically into the substantia gelatinosa, reduced cell responses to pre-naloxone values. The action of clonidine was reversed by idazoxan. This spinal action of clonidine may be an important component in the suppression of the opiate withdrawal syndrome observed in the whole animal. PMID- 3683765 TI - Investigation of the development of tolerance to the actions of zolpidem and midazolam. AB - It is well established that tolerance can develop very rapidly to the behaviour suppressing effects of benzodiazepines. In previous studies, however, the depressant action of zolpidem, a novel hypnotic acting at the benzodiazepine receptor, on operant behaviour in rats was maintained after many injections. An experiment was carried out, therefore, to compare the effects of acute and chronic administration of zolpidem and midazolam. Rats were trained to press a lever in standard operant test chambers to obtain 45 mg food pellets on an FR 10 schedule. Dose-response curves were then established, before, immediately after and 4 weeks after the daily administration of midazolam (3.0 mg/kg s.c.) or zolpidem (1.0 mg/kg) for 10 days. In confirmation of previous work, marked tolerance developed to the response-rate-decreasing effect of midazolam, the dose response curve being shifted to the right by a factor of 6 and also flattened. No significant dissipation of this tolerance occurred during a period of 4-6 weeks. In contrast, repeated administration of zolpidem produced only a small degree of tolerance, the dose-response curve being shifted by a factor of two. There was little evidence for cross tolerance between the two drugs, zolpidem-treated rats being sensitive to a dose of midazolam and midazolam-treated rats sensitive to a dose of zolpidem. Although the explanation for the development of tolerance to midazolam is unknown, these results suggest that the mechanisms of action of midazolam and zolpidem in reducing response rates are different. PMID- 3683766 TI - Participation of GABAergic mechanisms in the hypotensive and bradycardic effects of clonidine: experimental study in conscious normotensive and hypertensive rats. AB - In conscious rats with normal arterial blood pressure or with spontaneous or DOC induced hypertension, effects of drugs increasing (cycloserine, ethanolamine-o sulphate, piracetam, chlordesmethyldiazepam) or depressing (bicuculline, Ro 15 1788, PK 11195) GABAergic reactivity were evaluated on the arterial hypotension and sinus bradycardia induced by clonidine. Clonidine was administered orally by gastric gavage (0.1-1 mg/kg). Pretreatment with cycloserine, ethanolamine-o sulphate, piracetam or chlordesmethyldiazepam increased the hypotension and sinus bradycardia induced by clonidine. On the contrary, pretreatment with bicuculline or Ro 15-1788 reduced the cardiovascular effects of clonidine. These results suggest that the GABAergic system is involved in cardiovascular effects of clonidine in normotensive and hypertensive rats. PMID- 3683767 TI - Castration and tolerance induces changes in the levels of the activity of acetylcholinesterase in the isolated vas deferens of the rat. AB - Changes in the activity of acetylcholinesterase (AChE) of the isolated vas deferens from normal, castrated, morphine and ethanol-tolerant rats were studied. Three days after the termination of treatment with morphine and on the last day of treatment with ethanol, a significant inhibition of the activity of AChE was detected. This reduction in the enzymatic activity persisted in morphine-tolerant rats for 15 days, but not for 30 days, at which time the levels of AChE were determined to be normal. However, in ethanol-tolerant rats, there were no significant changes found at days 15 or 30. The activity of AChE was decreased significantly in castrated rats, but this effect was reversed by treatment with testosterone. During withdrawal from morphine or ethanol, the levels of AChE were significantly increased. The results indicate that morphine and ethanol may be inducing changes in the feedback mechanism which regulates the levels of AChE at post-synaptic sites, and these changes could play an important role in the development of tolerance to morphine and to ethanol. PMID- 3683768 TI - Noradrenaline releasing effect of an ouabain-like compound on pulmonary artery. AB - The effect of ouabain and an endogenous ouabain-like compound (OLC) was studied on (3H)noradrenaline [3H)NA) release from rabbit pulmonary artery. Similarly to ouabain, OLC enhanced the release of (3H)NA in response to electrical stimulation. These findings are the first evidence that OLC is able to act presynaptically and enhance the amount of (3H)NA release per impulse. It is suggested that this mechanism might be involved in the physiological regulation of blood pressure or in the genesis of hypertension. PMID- 3683769 TI - Anxiety-like subjective effect of ethanol antagonist RO 15-4513 demonstrated in pentylenetetrazol discrimination. AB - Ro 15-4513, a benzodiazepine-receptor ligand which antagonizes ethanol, was tested in the pentylenetetrazol discrimination, a bioassay for anxiogenic drugs. Rats were trained with food reward to discriminate pentylenetetrazol (PTZ) from saline in a two-lever operant task. In lever-selection tests, rats selected the PTZ lever both after PTZ and after Ro 15-4513. The PTZ-like stimulus produced by Ro 15-4513 was blocked by diazepam and by the benzodiazepine receptor blocker Ro 15-1788. Substitution for the anxiogenic drug PTZ, and blockade by the anxiolytic diazepam, support the hypothesis that Ro 15-4513 is anxiogenic; blockade by Ro 15 1788 suggests that the PTZ-like stimulus produced by Ro 15-4513 occurs through its action at the benzodiazepine receptor. PMID- 3683770 TI - Amnesic action of FMRFamide in rats. AB - The effects of FMRFamide on passive avoidance behaviour and electroshock-induced amnesia following intracerebroventricular administration were studied in rats. FMRFamide given immediately after the learning trial, or 20 min before the retention trial, attenuated the avoidance response, thereby impairing the consolidation and retrieval processes. Electroshock induced amnesia when applied immediately after the learning trial. Treatment with FMRFamide facilitated the amnesia of the passive avoidance response. The results indicate that FMRFamide peptide belongs in the class of neuropeptide which are amnesic. PMID- 3683771 TI - Systemically administered cholecystokinin affects an evoked potential in the hippocampal dentate gyrus. AB - Cholecystokinin was administered systemically while recordings were taken of the evoked action potential in the hippocampal dentate gyrus to stimulation of the medial entorhinal cortex. The sulphated octapeptide and t. BOC CCK-4, but not the unsulphated octapeptide or tetrapeptide, increased the amplitude of the evoked action potential in a dose-dependent manner, whereas the unsulphated octapeptide decreased it. Bilateral vagotomy did not block the effect of the sulphated octapeptide. CR 1409 was also found to increase the amplitude of the evoked response and did not block the effect of subsequent administration of sulphated octapeptide. These results are consistent with action at a central receptor locus. PMID- 3683772 TI - Increased cortical serotonin-2 (5-HT-2) receptors in the iminodipropionitrile (IDPN)-model of persistent dyskinesia in the rat. AB - Chronic treatment with IDPN causes a persistent behavioral syndrome which is reminiscent of the head shakes, backward locomotion, and hyperactivity observed after acute injection of 5-HT agonists in rodents. Evaluation of the characteristics of 5-HT receptors, using mianserin to label 5-HT-2 receptors, revealed a significant increase in the number of binding sites in the cortices of rats which demonstrated the IDPN-induced syndrome. There was an associated decrease in the affinity of the receptors. These results add more evidence to support the idea that the serotonergic system may play a significant role in the manifestation of the persistent abnormalities induced by IDPN. PMID- 3683773 TI - Morphine action on cholecystokinin octapeptide release from rat periaqueductal grey slices: sensitisation by naloxone. AB - Cholecystokinin (CCK) has potent antinociceptive properties when given either peripherally or centrally. An interaction between opiate and CCK-induced antinociception is indicated as CCK-induced analgesia is potentiated by naloxone. Since CCK cells in Periaqueductal grey (PAG) are known to be sensitive to both noxious stimuli and i.v. morphine, the possibility that the PAG was the site of such an interaction was investigated by an in vitro study of the effects of morphine and naloxone on CCK release in PAG. The K+-evoked release of CCK from tissue slices of PAG was unaffected by a wide range of concentrations of morphine. However, after pretreatment with naloxone (10(-9) M), morphine (10(-7) 10(-6) M) caused a significant, dose dependent attenuation of CCK release (70% inhibition at 10(-6) M). These results suggest that the release of CCK in PAG is modulated by opioid systems. PMID- 3683774 TI - The chronic administration of dopamine antagonists and methamphetamine changed the [3H]-cholecystokinin-8 binding sites in the rat frontal cortex. AB - The specific cholecystokinin (CCK) binding in the slide-mounted tissue sections of the rat frontal cortex was measured with [3H]-CCK-8. The binding was saturable, reversible, high in affinity, and inhibited by caerulein. The chronic administration of dopamine (DA) antagonists and methamphetamine (MAP) showed a tendency to increase the [3H]-CCK-8 binding sites (Bmax) in the frontal cortex. Long-term treatments with DA antagonists led to the depletion of CCK-8 and may have caused an observed proliferation of CCK-8 receptors in the frontal cortex. PMID- 3683775 TI - Presence of immunoreactive alpha-bag cell peptide[1-8] in bag cell neurons of Aplysia suggests novel carboxypeptidase processing of neuropeptides. AB - alpha-bag cell peptide (alpha BCP) is a putative neurotransmitter released from bag cell neurons of the marine mollusc Aplysia. alpha BCP is present in bag cell extracts and releasate from bag cells in two neuroactive forms: alpha BCP[1-9] and alpha BCP[1-8]. alpha BCP[1-8] is 30 times as potent as [1-9] in inhibiting target neurons, suggesting that both forms of the peptide serve as neurotransmitters. However, biochemical and molecular genetic data suggest that only alpha BCP[1-9] is originally cleaved directly from a larger precursor protein and that generation of alpha BCP[1-8] would require an unusual C-terminal leucine cleavage of alpha BCP[1-9]. To further ascertain which forms of alpha BCP are normally present in bag cells, we generated highly specific antisera to each peptide. We found intense immunostaining for both peptides in bag cell somata and nerve terminals. Moreover, both forms were stable in bag cell extract for at least 1 hr, which suggests that proteolysis in the extracts had been effectively inhibited. These results suggest that both alpha BCP[1-8] and [1-9] are normally present in bag cell somata and terminals and that a small amount of alpha BCP[1 9] is processed to alpha BCP[1-8] in vesicles before release. The results support the interpretation that the activity of an intravesicular carboxypeptidase generates alpha BCP[1-8] and thereby regulates the amount of inhibitory activity released during a bag cell discharge. PMID- 3683776 TI - Proenkephalin-A derived peptides do not modulate cardiovascular effects of epinephrine on the isolated rat atrial preparations. AB - The catecholamines and the opioid peptides are found to be co-localized in the adrenomedullary chromaffin cells. They are co-secreted from the chromaffin granules in response to various stimuli. The stress-induced released of epinephrine is known to exert its effect on the cardiovascular system resulting in the changes in heart rate and blood pressure. However, the role of the co released proenkephalin-A derived peptides has not been extensively characterized. Previous work from several investigators suggested that the peptides modulate cardiac functions of the catecholamines. There is considerable conflicting results among these reports. Results from the isolated rat atrial preparation indicated that enkephalins attenuated the increase in atrial rate induced by norepinephrine through restriction of the calcium fluxes. Nonetheless, others reported insensitivity of the enkephalins in similar or different test systems. We further re-examined these discrepancies using the isolated rat atrial preparation to investigate the opioid peptide modulatory effect on the cardiovascular changes induced by exogenous epinephrine. Alterations in rate and force of contraction resulting from epinephrine and the peptides were both studied in parallel. The opioid peptides used in this study were [Met5] enkephalin (ME), [Leu5]-enkephalin (LE), FMRFamide, [Met5]-enkephalyl-Arg6-Phe7 (MEAP), peptide E, and the non-selective opioid agonist, etorphine. We report here that none of the opioid peptides were effective in alleviating or attenuating the increase in heart rate and developed tension caused by epinephrine. The peptides did not affect the basal beating rate nor the force of contraction. Thus, the present results clearly demonstrate the insensitivity of the enkephalins in modulating the cardiac effects of epinephrine. They further indirectly support the prejunctional synaptic nerve endings as the potential peripheral site of action of the peptides. PMID- 3683777 TI - Optical properties of human brain tissue, meninges, and brain tumors in the spectral range of 200 to 900 nm. AB - Considering the increasing use of lasers in neurosurgery and the increasing number of wavelengths of laser light becoming available, we evaluated optical properties between 200 and 900 nm of meninges, normal human brain tissue, and brain tumors. We used a two-beam spectral photometer with an integrating sphere as the measuring instrument. The material consisted of 13 brains and 1 specimen each of dura mater, falx, and arachnoid obtained at autopsy and 30 samples of brain tumors removed during operation. In tissue samples more than 5 mm thick, the relative levels of absorption and scattering were estimated from the relative level of reflection measured according to the Kubelka-Munk theory. In thin tissue slices, penetration depth was calculated according to Beer's law from measurements of reflection and transmission. Generally, in all tissues there was an increase of reflection, scattering, and penetration depth and a decrease of absorption from the ultraviolet up to the near infrared spectral range interrupted by the absorption bands of hemoglobin. Within the ultraviolet spectral range, no major differences of optical properties were observed. Within the visible and near infrared spectral range, white matter reflected most of the incident power and showed the lowest level of absorption and the shortest penetration depth. Low grade gliomas revealed optical properties similar to those of gray matter. In comparison with normal brain tissue, meningiomas and glioblastomas showed significantly higher levels of absorption calculated according to the Kubelka-Munk theory from reflection measurements in thick tissue samples, but also deeper penetration obtained from measurements of reflection and transmission in thin slices, especially within the near infrared spectral range. PMID- 3683778 TI - Reversible somatosensory evoked potential changes with neodymium: yttrium aluminum-garnet laser use. AB - Reversible prolongation and dissolution of the tibial somatosensory evoked potential (SEP) was observed with operative use of the neodymium:yttrium-aluminum garnet (Nd:YAG) laser during extirpation of a foramen magnum meningioma. Rapid normalization of the SEP followed irrigation with cool saline. The absence of postoperative dorsal column deficit suggests that heat-related physiological changes occurred before the point of irreversible tissue injury. Should intraoperative SEP monitoring prove a reliable index of tissue temperature, it could enable safer use of the Nd:YAG laser in the vicinity of the spinal cord and brain stem. PMID- 3683780 TI - Supraorbital-pterional approach to skull base lesions. AB - A surgical approach to the skull base is described. It allows excellent exposure of the cranial base with minimal brain retraction. Deep lesions can be handled via subfrontal, transsylvian, or subtemporal routes during the same operation. This approach is most suitable for large lesions in the suprasellar, parasellar, and retrosellar areas and for those that extend into the cavernous sinus, along the tentorial notch, or into the orbit. After the single bone flap is replaced, there is little or no functional, anatomical, or cosmetic deficit. Our experience in 16 cases and suggestion for the use of this approach are presented. PMID- 3683779 TI - Activity of phthalocyanine photosensitizers against human glioblastoma in vitro. AB - In vitro studies utilizing an established human glioblastoma cell line (U87MG) were undertaken to compare the light absorption spectra and photocytotoxicity characteristics of hematoporphyrin derivative (HpD), metal-free phthalocyanine tetrasulfonate (PcS), and aluminum phthalocyanine tetrasulfonate (AlPcS). The peak absorption wavelengths for the compounds studied were: HpD = 630 nm, PcS = 630 nm, AlPcS = 677 nm. Seven different concentrations of each compound (0 to 20 micrograms/ml) were subjected to five different energy levels (40 to 640 joules/cm2) of broad band light (wavelength = 650 +/- 40 nm). Control experiments employing each drug alone and photoactivation alone were also performed. HpD showed a consistent dose-dependent photoactivated cytotoxicity with an abrupt decrease in cell survival when energies of 160 joules/cm2 or more were administered and a drug concentration dependency that resulted in a progressive decline in cell survival beginning at 1.0 microgram/ml. The metal-free PcS had a 10 times greater absorption of light at 675 nm, but only a very weak cytotoxic effect, which occurred at concentrations in excess of 10.0 micrograms/ml and energy levels greater than 320 joules/cm2. AlPcS, however, displayed a 100-fold increase in light absorption at 675 nm when compared to HpD. This was coupled with a decrease in cell survival similar to the HpD curves, but with a much steeper slope of percentage cell kill at lower drug concentrations and energy dosages. The control studies did not result in any appreciable cytotoxic effect. The data suggest that AlPcS holds promise as a second generation photosensitizer in the photodynamic treatment of human gliomas. PMID- 3683781 TI - Long term intrathecal administration of morphine: a comparison of bolus injection via reservoir with continuous infusion by implanted pump. AB - Twenty-six cases of chronic intrathecal morphine administration are described: 19 cases utilizing the Spinalgesic injectable subcutaneous reservoir and 7 cases utilizing the Infusaid implanted infusion pump. In 25 cases, the morphine was delivered into the spinal subarachnoid space, and in 1 case of thalamic pain it was delivered into the temporal horn of the ipsilateral cerebral ventricle. The average duration of usage of the system was 132 days. The efficacy of the method was excellent: 23 of 26 patients used no other analgesics or only minor ones such as aspirin, paracetamol, or dextropropoxyphene. The complication rate was low, with no infections under the author's care, and only 4 catheter blockages (1 by tumor). There have been no complications in the 7 patients with implanted pumps. From this experience, the author concludes that the implanted pump is now the method of choice in all patients who can afford it and for whom the life expectancy outside an institution is in excess of 60 days. A special and relatively absolute indication for the pump is the situation of pain in the arm, head, or neck areas, in which case the constant morphine levels likely to be achieved with the pump may prevent failure of the method due to intractable nausea or emesis. The subcutaneous reservoir is otherwise to be preferred if the patient's disease is progressing rapidly, if the patient is already institutionalized and likely to remain so, or where the cost of the implanted pump would cause hardship. Either method of delivery of morphine to the subarachnoid space can provide incomparable analgesia without clouding of consciousness, with a very low complication rate. PMID- 3683782 TI - Somatosensory evoked potential monitoring of temporary middle cerebral artery occlusion during aneurysm operation. AB - Somatosensory evoked potentials (SEPs) in response to median nerve stimulation were used as a guide to cortical function during temporary occlusion of the distal M1 segment of the middle cerebral artery (MCA) in the surgical treatment of five large aneurysms of the MCA bifurcation. MCA occlusion times ranged from 8 to 19 minutes under moderate hypothermia at 28.8 degrees to 30.3 degrees C. SEPs were preserved for variable times during MCA occlusion, ranging from no increase in latency after 13 minutes of occlusion to severe deterioration after 6 minutes. In no case was MCA occlusion maintained for longer than 3 minutes in the presence of a severely disturbed SEP. Recovery of the SEP to its preoperative relationship with that of the nonoperated hemisphere was seen in all cases before the end of operation. All patients were awake after rewarming at the end of operation without any neurological deficit. Monitoring the SEP pertaining to the territory of a cerebral artery during its temporary occlusion can help avoid ischemic damage and will allow the surgeon to take advantage of the several benefits of this technique in aneurysm surgery. PMID- 3683783 TI - Latency of the cortical component of the somatosensory evoked potential in relation to cerebral blood flow measured in the white matter of the cat brain during focal ischemia. AB - In a focal model of cerebral ischemia (middle cerebral artery (MCA) occlusion in the cat), the existence of a relationship between the latency from the onset of stimulation to the appearance of the cortical component of the somatosensory evoked response and blood flow was explored. White matter blood flow was determined in the left and right hemispheres under control conditions. During left MCA occlusion, the blood flow and the latency of the cortical component recorded from the right hemisphere deviated from their preexisting linear relationship obtained from plotting latency as a function of blood flow. In an effort to increase flow during focal ischemia, hemodilution and volume expansion with dextran 40 was used. Application of this technique only mildly increased blood flows and did not restore the correlation of latencies of the cortical component of the evoked response and blood flows observed before MCA occlusion. This finding suggests that latencies and blood flows are not correlated in the contralateral hemisphere during focal ischemia and only show a mild degree of relationship in the unperturbed brain. During ischemia, flow and electrical activities may not respond to the same stimuli and, if they do respond, it may not be unidirectionally. These findings are discussed in light of other reports on the Significance of the evoked response in monitoring cerebrovascular insults and the observation of diaschisis. PMID- 3683784 TI - Measurement of regional cerebral blood flow and somatosensory evoked potentials in a canine model of hemispheric ischemia. AB - Regional cerebral blood flow (rCBF) was studied using the radiolabeled microsphere technique in a canine model of hemispheric ischemia that others have previously examined morphologically with carbon perfusion. It was our goal to ascertain whether this ischemic model, which involves easily accessible occlusions of the ipsilateral circle of Willis, could produce reproducible and significant reduction of hemispheric cerebral blood flow. Seven animals underwent the surgical procedure with measurements of rCBF at base line, after arterial microdissection and brain retraction only, and finally after creation of the lesion. Simultaneous somatosensory evoked potential recordings were also obtained. Bilateral symmetrical flow decreases were referable to anesthetic normalization and maintenance alone before creation of the lesion. The arterial occlusions, however, produced further significant decreases in flow on the ipsilateral side only, sparing all contralateral structures and sparing the brain stem and cerebellum bilaterally. Evoked responses, which had shown no changes in latency or amplitude after dissection and retraction procedures, were completely abolished 15 minutes after the arterial occlusion. Control animals that underwent surgical positioning and anesthesia alone did not show concomitant decreases is rCBF. This model of open craniotomy and direct vascular occlusion is suitable for studies of cerebral ischemia where the therapeutic intervention proposed (such as cerebral revascularization) involves similar surgical manipulations. By this method, a standard and reproducible ischemic lesion is achieved through the surgical field without the need for exposure of the basilar artery. PMID- 3683785 TI - Barrier disruption in the major cerebral arteries after experimental subarachnoid hemorrhage in spontaneously hypertensive and normotensive rats. AB - The effects of experimental subarachnoid hemorrhage (SAH) on the blood-arterial wall barrier in the major cerebral arteries were studied in 24 spontaneously hypertensive rats (SHR) and 13 Sprague-Dawley rats (SDR). Horseradish peroxidase (HRP) was given intravenously before killing the animals to assess the integrity of the barrier. In the acute experimental group, transient elevation of intracranial pressure (ICP) and systemic arterial pressure produced by cisternal injection of whole blood, saline solution, or Elliott's B solution resulted in extensive disturbance of the blood-arterial wall barrier. In the chronic group, only the cisternal injection of whole blood in SHR brought about an extensive and marked disturbance of the arterial permeability. These results suggest that: (a) early breakdown of the blood-arterial wall barrier seems to be due to a sudden rise in the ICP or arterial pressure; (b) in the chronic experiments, the subarachnoid clot is the most important factor responsible for the permeability changes; and (c) in the chronic SAH experiments, the blood-arterial wall barrier seems to be more vulnerable in SHR than in Sprague-Dawley rats. Due to the well known similarities between SHRs and hypertensive human beings, patients with chronic hypertension should be considered at high risk after SAH for extensive blood-arterial wall barrier disturbances. PMID- 3683787 TI - Correlation of admission fibrin degradation products with outcome and respiratory failure in patients with severe head injury. AB - It has been suggested that concentrations of fibrin degradation products (FDPs) after head injury reflect the extent of brain tissue destruction. In addition, elevated FDP concentrations have been associated with the development of the adult respiratory distress syndrome (ARDS). Coagulation variables, including a FDP screen, were measured on the admission of 33 patients with severe closed head injury (Glasgow coma score 8 or less) to define the prognostic value of FDP concentrations. A Glasgow outcome score was assigned to each patient 6 months after injury, and those patients with higher FDP concentrations had poorer functional outcomes. This correlation of outcome with admission FDP concentration was statistically significant, as was the correlation between outcome and the admission Glasgow coma score. Of 22 patients with FDP concentrations of less than 64 micrograms/ml, only 1 developed early respiratory failure, whereas 9 of 11 patients with FDP concentrations of 64 micrograms/ml or more developed ARDS. These findings were not affected by the presence of multiple system trauma. FDP concentrations seem to have prognostic value similar to the Glasgow coma score and seem to identify those patients with head injury who are at high risk for ARDS. PMID- 3683786 TI - Pharmacodynamic evaluation of human cerebral arteries in the genesis of vasospasm. AB - Experiments were performed on isolated human cerebral arteries to evaluate the role desensitization and tachyphylaxis might play in preventing certain agonists from producing prolonged vasoconstriction after subarachnoid hemorrhage. In addition, the antiproteases leupeptin and pepstatin were studied to ascertain whether these peptides might inhibit contraction as does antithrombin III. The maximal contraction to KCl was used as a standard for comparing the responses elicited by the agonists, the decay of the responses to the agonists over 15 minutes was used as an index of desensitization, and the percentage of decrease in response to a second application of the agonist over the first was a measure of tachyphylaxis. The results showed that desensitization and tachyphylaxis greatly reduced or abolished the contractile responses to norepinephrine, serotonin, angiotensin II, arginine vasopressin, substance P, neuropeptide Y, neurotensin, thrombin, uridine triphosphate, linoleic acid, melittin, and cathepsin D. Moreover, some arteries failed to respond to some of these agonists, and no contractile response was elicited by acetylcholine or bradykinin. In contrast, prostaglandins E2, D2, and F2 alpha, as well as plasmin, produced sustained contractions, without tachyphylaxis, but only prostaglandin E2 and plasmin produced contractions at concentrations of 10(-7) M or less that were comparable to those of KCl. None of the antiprotease peptides inhibited the responses to KCl whereas small concentrations (6 X 10(-8) M) of antithrombin III did. The results support the hypotheses that the phenomenon of desensitization and tachyphylaxis would prevent many diverse agents from acting as spasmogens and that substances like antithrombin III present in the cerebrospinal fluid after hemorrhage could immediately protect patients from cerebral vasospasm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683788 TI - Sciatica and epidural gas. AB - Epidural gas in the patient with sciatica can sometimes provide a clue that there is a surgically treatable lesion. Our patient had the sudden onset of sciatica at night, which was relieved by walking. An intraspinal synovial cyst was associated with epidural gas. PMID- 3683789 TI - Large pituitary gland adenomas evaluated with magnetic resonance imaging. AB - Magnetic resonance imaging (MRI), computed tomographic (CT) scanning, and angiography or digital subtraction angiography (DSA) were used preoperatively to evaluate 16 surgically proven cases of sellar tumor with extrasellar extension. There were 15 pituitary tumors and 1 schwannoma. The capabilities of MRI in evaluating these tumors were compared with CT scanning and angiography. Bone destruction and tumor calcification were better detected by CT scanning than by MRI. MRI was as effective as CT scanning in detecting a cyst or variation in tumor consistency. Neither MRI nor CT scanning was capable of distinguishing specific tumor types. In every case, MRI was superior to CT scanning for delineating spatial relationships of the tumor to the 3rd ventricle, the optic apparatus, adjacent brain, and parasellar vasculature. Vessel encasement by tumor was clearly seen on MRI when there was no direct indication of this on other studies. Cavernous sinus invasion was not demonstrated by CT scanning, but was indicated by MRI in 5 cases and was surgically confirmed in 3. MRI can provide more precise spatial information on extrasellar tumor extension. Vascular encasement and cavernous sinus invasion may be determined preoperatively. Treatment expectations and operative approaches can be guided by this information. When MRI is available, it is the test of choice for the preoperative evaluation of patients with suspected large pituitary gland (sellar region) tumors. Contrast-enhanced CT scanning and angiography can be used as supplementary studies to add information inherently unique to these techniques. PMID- 3683790 TI - Cerebellar abscess: the impact of computed tomographic scanning. AB - Thirty-four cases of cerebellar abscess, diagnosed by computed tomographic (CT) scanning, were managed according to a standard protocol during a 4-year period. Triple high dosage intravenous antibiotics were used, open catheter drainage of the abscess was instituted, and external ventricular drainage was added if obvious hydrocephalus was present. Seventeen patients made a good recovery, and five remained minimally disabled. Ten patients died, and two were left severely disabled. A relationship between the level of consciousness on admission and final outcome was established. In addition, two particular CT scan features (viz. the presence of hydrocephalus and the stage of the abscess) were significant adverse prognostic factors. PMID- 3683791 TI - Intramedullary fibrosarcoma of the cervicomedullary junction: a case report. AB - A 17-year-old girl presented with signs of increased intracranial pressure. On computed tomography, an enhancing intraaxial lesion in the region of the foramen magnum was demonstrated. Surgical excision was performed. The pathological diagnosis was low grade fibrosarcoma. Her subsequent course was complicated by cerebrospinal fluid seeding, a posterior fossa recurrence, and repeated subarachnoid hemorrhage with cerebral vasospasm. A combination of radiotherapy and intraventricular chemotherapy has left the patient symptom-free 2 years after operation. The intramedullary appearance of fibrosarcoma and the unusual subsequent clinical course are discussed. PMID- 3683792 TI - Spinal cord compression from metastasizing cicatrial carcinoma: a case report. AB - Spinal cord compression from a metastasizing burn scar cancer has not previously been reported. A patient with rapidly progressive paraparesis associated with vertebral collapse and an extradural soft tissue mass of undetermined origin is presented. The clinical history, radiological diagnosis, and histological features of cicatrial carcinoma are discussed along with a brief review of the relevant literature. PMID- 3683793 TI - Gliosarcoma with chromosome abnormalities in a neonate exposed to heptachlor. AB - A neonate with a cerebral gliosarcoma was found to have chromosome abnormalities in tissue culture of the tumor, but normal karyotyping of peripheral blood. Similarities to and differences from chromosome abnormalities found in other human gliomas are noted. Unusual exposure of the child to heptachlor during prenatal development and the neonatal period suggests the need for further studies on the role of toxins in oncogenesis. PMID- 3683794 TI - Solitary plasmacytoma of the calvarium: two cases treated by operation alone. AB - Two cases of solitary plasmacytoma of the calvarium operated on with radical removal are reported. The two patients were not submitted to postoperative radiotherapy, unlike other cases reported in the literature. The authors stress that solitary plasmacytoma of the calvarium may have a good prognosis if radically removed, and in these cases radiotherapy is not necessary. PMID- 3683795 TI - Idiopathic massive osteolysis of skull bones: a case report. AB - A rare case of idiopathic massive osteolysis involving cranial bone is reported. Radiological and computed tomographic findings are discussed, along with a brief review of the literature. PMID- 3683796 TI - Unilateral normal perfusion pressure breakthrough after carotid endarterectomy: case report. AB - The authors report a case of unilateral malignant cerebral edema that occurred after the removal of a high grade atheromatous lesion of the ipsilateral internal carotid artery. A form of unilateral normal perfusion pressure breakthrough caused by postischemic impairment of cerebrovascular autoregulation and exacerbated by systemic hypertension is thought to have contributed to this complication. Control of the hypertension and treatment of the cerebral edema with mannitol and dexamethasone led to a complete neurological recovery. PMID- 3683797 TI - Anterior inferior cerebellar artery aneurysm, carotid bifurcation aneurysm, and dural arteriovenous malformation of the tentorium in the same patient. AB - An exceptional combination of intracranial vascular malformations is reported: distal anterior inferior cerebellar artery (AICA) aneurysm, carotid bifurcation aneurysm, and dural arteriovenous malformation (DAVM) of the tentorium. The AICA aneurysm was the source of recurrent subarachnoid and cerebellar hemorrhage, revealed only after repeated vertebral angiography. After external drainage of associated hydrocephalus, both aneurysms were successfully clipped and the dural malformation was subtotally embolized. The literature concerning AICA aneurysms, DAVMs, and combined intracranial vascular malformations is reviewed and discussed. PMID- 3683798 TI - Intracerebral hemorrhage and hematoma in Behcet's disease: case report. AB - The authors describe a patient with Behcet's disease who suffered from intracerebral hemorrhage 2 1/2 years after the initial diagnosis. There is strong evidence that this situation is not merely a coincidence; rather, these two abnormalities have a cause and effect relationship. PMID- 3683800 TI - A new type of prehensile suction device. AB - The authors describe a new suction device with prehensile properties that has proved itself particularly useful in the removal of certain types of tumor, especially extramedullary. PMID- 3683799 TI - Proposal for bipolar coagulation of the sella turcica wall during pituitary tumor operation. AB - Convoluted morphology, limited visualization, and the lack of appropriate instruments limit the surgical approach to the walls of the sella turcica. They are, however, a site of local invasion and retained tumor fragments in cases of pituitary lesions. Effective bipolar coagulation within the sella turcica could reduce recurrence from local invasion, but it is made difficult because rigid bipolar forceps cannot fit effectively or safely against the complex contours of the walls there. Effective coagulation and thorough tumor removal are further frustrated by the lack of direct visualization of either the sella walls or the part of the floor adjacent to the surgical opening. It would be desirable, however, to coagulate the dura mater and retained tumor fragments. As an aid in this problem, we are reporting the use of a flexible bipolar coagulation system in two forms and of a mirror system for visualization in the sella without requiring the removal of one hand from surgical maneuvers. A pair of parallel flexible wire extensions to the standard bipolar forceps can be shaped by the surgeon into a contour that will coagulate the specific local terrain. A web of wire woven into one surface of a cotton patty, which is a bipolar coagulation system, supplements the wire loops. This allows the walls of the sella turcica to be coagulated more effectively where the contours are difficult to gauge and not well visualized. For visualization of the sella turcica walls and floor, we have used a small front surface mirror 1.0 mm thick.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683801 TI - Does long-term lithium treatment induce diabetes mellitus? AB - Fasting blood sugar was determined in manic-depressive patients before the start of lithium treatment and at intervals during treatment for up to 6 years. The total exposure time to lithium was 495.5 years. Even though the patients gained significantly in age and body weight during the treatment, their mean blood sugar values remained the same as before treatment was started, and only 1 patient developed manifest diabetes. There is no reason to believe that long-term lithium treatment leads to increased risk of developing diabetes mellitus. PMID- 3683802 TI - Efficacy and safety of fezolamine in depressed patients. AB - Forty-two outpatients with major depressive disorder were treated with oral fezolamine in a 6-week, three-center open-label study. Therapy was initiated at 100 mg/day; thereafter dosage was increased based on the response of the patient. Maintenance dosage usually ranged between 100 and 450 mg/day. Clinically significant improvement relative to the patient's prestudy state was observed after 2 weeks in both patient and physician-rating scales. Fifty-five percent of patients improved their Hamilton Psychiatric Rating Scale for Depression (HAM-D) scores by more than 50%. The median dose associated with a clinically significant response was 245 mg/day. Five of the 6 patients who dropped out did so because of gastrointestinal adverse effects. The most common adverse effects were nausea (36%), headache (29%), constipation (26%), and dry mouth (24%). PMID- 3683803 TI - Comparative study of the effects of 9 antidepressants on several physiological parameters in healthy volunteers. AB - Effects on physiological parameters were compared among 9 antidepressants (amitriptyline 50 mg, imipramine 50 mg, nortriptyline 50 mg, amoxapine 50 mg, maprotiline 50 mg, mianserin 20 mg, zimelidine 100 mg, nomifensine 50 mg, and Y 8894 50 mg) after a single oral administration in healthy volunteers. Critical fusion frequency of flicker, body sway distance, salivary flow rate, near blurred point, and pulse rate were employed as parameters. The degree of the drug effects on the physiological parameters could be roughly classified into two to four groups according to maximum percent deviation of each parameter. PMID- 3683804 TI - Rapid information processing and concomitant event-related brain potentials in smokers differing in CO absorption. AB - The present study relates subject-paced rapid information processing to different components of event-related brain potentials in an attempt to gain more information about changes in mental performance in relation to alveolar smoke absorption as assessed by expired air CO measurement. The task consisted in the presentation of pseudorandom sequences of single digits, and the subjects had to respond to each sequence of three odd or three even digits. The triplets evoked a typical late negativity in the event-related potential between the second and third digit as well as a P300 component following the third digit. In 21 smokers, task performance, event-related potentials and tidal air CO concentration were measured before and after smoking a cigarette. The results revealed increases in performance and P300 magnitude from pre- to postsmoking which were unaffected by the amount of CO absorption. A differential trend was seen, however, with the late negativity, which increased from pre- to postsmoking only in subjects with a large amount of CO absorption. The results support the assumption of the distraction arousal model used as an interpretation of these effects on contingent negative variation and suggest that high CO absorbing smokers possibly depend more on neuropharmacological effects of smoking than smokers with a low amount of CO absorption. PMID- 3683806 TI - Hemispheric asymmetry in memory for pictorial semantics in normal subjects. AB - Effects of presence versus absence of semantic organization in pictorial scenes were investigated in a memory hemi-field tachistoscopic paradigm in order to assess the hemispheric status of long-term semantic memory (LTSM). Forty normal subjects were asked to remember a series of pictorial scenes which were organized either in common configurations or were unorganized with respect to real-world configurations. Memory for these scenes was measured by hemi-field presentations of detail probes and whole scene probes. The results showed that there were no differences between the two visual fields in accuracy scores. Latency of positive responses showed that memory for the common/organized scenes was better in the left (LVF) than in the right visual field (RVF) and a dissociation between the two types of pictorial organization was present only in the LVF, with the slower latencies for unorganized scenes. The effect of probe-type was also different in the two visual fields: detail and whole scene probes were undifferentiated within the LVF but were differentiated in the RVF, with whole scenes remembered more quickly. The findings are discussed in terms of asymmetries in storage/retrieval of schemata in LTSM. PMID- 3683805 TI - Forgetting in H.M.: a second look. AB - Forgetting was assessed in the amnesic patient H.M. using forced-choice and yes no picture recognition at four delay intervals: 10 min, 24 hr, 72 hr, and 1 week after learning. In order to make H.M.'s initial recognition performance comparable to that of control subjects who viewed each slide for 1 sec, H.M. viewed each slide for 20 sec. H.M. displayed normal forgetting in forced-choice and yes-no recognition, although he was impaired in yes-no recognition at the 24 hr delay interval. These data contradict Huppert and Piercy's hypothesis that medical temporal-lobe pathology is associated with rapid forgetting. PMID- 3683807 TI - When priming persists: long-lasting implicit memory for a single episode in amnesic patients. AB - This experiment investigated the durability of implicit memory for a single episode in normal and amnesic subjects. The target materials consisted of sentence puzzles that were difficult to comprehend in the absence of a key word or phrase. Sentences were re-presented at delays ranging from one minute to one week, and implicit memory was indicated by facilitation in solving previously incomprehensible sentences on subsequent exposures. Patients with severe memory impairments on tests of explicit recall and recognition showed substantial and robust facilitation, or priming, from a single prior presentation and there was no evidence of a systematic decay of facilitation over retention intervals up to one week. The long-lasting implicit memory observed in the sentence puzzle task contrasts with previous findings of rapid decay of priming effects in amnesic patients. PMID- 3683808 TI - A signal detection procedure eliminates priming biases in dichotic listening. AB - Dichotic digit names were presented to normal right-handed adults in two experiments, the first of which used a standard free report procedure and the second of which used a signal detection procedure. Prior to each test, a priming bias was generated by having subjects monitor either the left or right ear for 30 selective listening trials. The expected priming effect was found in Experiment 1: ear asymmetry and order of report were altered according to the ear previously monitored. In contrast, no priming effect was observed with the signal detection procedure used in Experiment 2. There was a right-ear advantage in sensitivity irrespective of the ear previously monitored. The findings suggest that priming biases act by altering the order in which multiple stimuli are processed and reported. PMID- 3683810 TI - The effects of word orientation and imageability on visual half-field presentations with a lexical decision task. AB - Two studies examined the effects of word orientation and word imageability in a visual half-field procedure. The studies involved a lexical decision task in which items were presented in either a horizontal or vertical orientation randomly intermixed in Experiment 1 and blocked in Experiment 2. Overall, a RVF advantage resulted with horizontal items, yet no visual-field asymmetries were found with the vertical items. These results indicate that altering the orientation can affect visual-field superiority. It is proposed that the novelty of vertical displays leads to greater involvement of the right hemisphere. Imageability was related to performance only for horizontal displays; but there were no significant differences in imageability effects between the two visual fields. It is concluded that word imageability has little effect on visual-field differences, at least not for lexical decisions. PMID- 3683809 TI - Impaired speech shadowing after early lesions of either hemisphere. AB - Patients with unilateral (right, left), non-progressive cerebral lesions incurred in infancy (prior to age one) or childhood (ages one to fifteen) were asked to shadow (rapidly repeat) passages of speech either in the form of syntactically correct sentences or random word order (RWO) sentences presented at varying rates. Both patient groups and same-age controls made more errors with faster rates of presentation. Error frequency was significantly higher for all patient groups than for controls, but did not significantly differ among the patient groups themselves. The abnormal performance of the group with later childhood right hemisphere lesions was remarkable in view of that group's normal function on other language tests and normal verbal IQ score, and suggested that the cause of the problem in this group was either a specific linguistic factor not assessed by the other tests or a general factor brought out by speech shadowing. PMID- 3683811 TI - Visual field effects for processing content and function words. AB - This study investigated the processing of content and function words when input to the left vs right hemispheres. For both lexical decision and naming there was a larger RVF advantage for function as compared to content words: function words were processed more slowly than content in the LVF, but not in the RVF. These results do not replicate the previous report of Bradley and Garrett, Neuropsychologia 21, 155-159, 1983, and provide some support for the view that function words are less accessible to the right hemisphere. In a second experiment, there was no difference in VF asymmetry when acceptability judgments were required for function vs content word phrases. Grammaticality judgments, of any sort, may be predominantly processed in the left hemisphere. PMID- 3683812 TI - Endogenous potentials after anterior temporal lobectomy. AB - The scalp topography of endogenous potentials was studied in patients who had previously undergone unilateral anterior temporal lobectomy (ATL). These excisions include medial temporal lobe (MTL) structures that have been shown to generate large potentials during tasks that evoke P3 at the scalp. Following right or left ATL, patients showed no differences from unoperated control subjects in overall amplitude of P3 or any other potential measured. The topography of P3 was very similar in both ATL groups and the control subjects, with no differences in laterality. These results suggest that the MTL is not the major generator of the P3 recorded at the scalp in the tasks studied here. PMID- 3683813 TI - The dual task paradigm: speech dominance or manual dominance? AB - Two hundred and sixty monolinguals divided into subgroups based on gender, handedness, and familial left-handedness, were given a concurrent task, verbal manual interference paradigm. The primary purpose of the study was to test whether the dual task interference effects were more related to hemispheric speech or manual dominance factors. The dominant hand, regardless of handedness, underwent relatively more tapping interference than the nondominant hand. The obtained results seriously question the basic assumptions underlying the interpretation of the dual task paradigm as an assessment index for hemispheric language lateralization. A possible explanation of this result that is in keeping with known hemispheric language representation proportions in left-handers is offered based on left hemisphere ipsilateral control of the left hand. PMID- 3683814 TI - The measurement of foot preference. AB - Foot preference has been given only superficial attention in studies of hemispheric lateralization, although it has potential utility for predicting hemispheric dominance. This paper reports the development of a reliable (alpha = 0.89) 11-item behavioral inventory of foot preference. Since footedness and handedness are only partially related, both must be measured reliably to identify individuals who have a consistent right or left side preference. It has yet to be determined whether footedness or handedness has the stronger relationship to other aspects of cerebral lateralization and whether both measures together predict lateralization better than one of them alone. PMID- 3683815 TI - Patterns of lateral preference: an American-Chinese comparison. AB - Lateral preference patterns of Chinese and Anglo-Americans were assessed to examine the influence of gender and family history for each group. Ninety-two Chinese and a like number of Anglo-Americans were presented with a Chinese and English version of the Lateral Preference Schedule, respectively. Results indicated that Anglos were significantly less right oriented on measures of general handedness and strength. An interaction for the visually guided motor factor indicated that Anglo males were significantly more bilateral than females of their Chinese counterparts. When family history was investigated, it was found that Chinese parents were significantly more right lateralized than their Anglo cohorts. A step-wise discriminant analysis indicated that scores on both parents' lateral preference and the visually guided motor factor best predicted group membership. It was concluded that performance on the visually guided motor factor concomitant with familial lateral preference patterns best represented ethnic group differences. PMID- 3683816 TI - Shift of visual field advantage by learning experience of foreign words. AB - Effects of Hebrew words learning on visual field advantage were examined with Japanese subjects. Subjects who showed no visual field advantage to Hebrew words in the first testing were assigned randomly into four experimental groups; learn pronunciation only, learn meaning only, learn both pronunciation and meaning, and learn nothing. After then, subjects were re-tested for Hebrew words discrimination. A right visual field advantage appeared in both pronunciation only and pronunciation plus meaning groups. These results suggest that mastery of pronunciation seems to be a crucial factor in producing a shift of visual field advantage. PMID- 3683817 TI - I. S. Beritashvili's theoretical concepts in the physiology of higher nervous activity. PMID- 3683818 TI - Influence of emotional tension on spatial-temporal organization of prestimulus potentials in neocortex of human operator during recognition of meaningful light stimulus. PMID- 3683819 TI - Role of adrenergic mechanisms in the regulation of the reproduction of memory engrams and the energy metabolism in the structures of the rat brain. PMID- 3683820 TI - Disturbance of developed motor coordination after injury of parietal and premotor associative regions in dogs. PMID- 3683821 TI - Interaction between learning and paradoxical sleep in cats. PMID- 3683822 TI - Development of afferent function of striatum in rabbits during early ontogenesis. PMID- 3683823 TI - Predatory aggression of rats after intraventricular administration of individual brain-specific proteins of group S-100 and their peptide fragments. PMID- 3683824 TI - Formation and development of temporary connections involving unperceived and perceived acoustic stimuli. PMID- 3683825 TI - Effect of neocortical electrical stimulation on systemic organization of brain processes during conditioning in cats. PMID- 3683826 TI - Effect of tryptophan and its metabolites on conditioned reflex activity of the honey bee. PMID- 3683827 TI - Effect of cortisol on a model of stereotyped behavior of rabbits in the form of thumping. AB - Experiments conducted on 10 adult male Chinchilla rabbits showed that single 5 sec electrostimulation of the region of the medial hypothalamus induces a series of stereotyped behavioral responses in the form of synergic thumping on the floor of the experimental chamber. When the stimuli are repeated every 1.5-2 min adaptation to stimulation is observed, which is expressed in a gradual decrease of the number of thumps. To study the pharmacological and hormonal effects on the described behavior, an experimental model is proposed which consists of two series of stimulation, each of which consists of 10 successive stimuli. The investigated pharmacological agent (cortisol [hydrocortisone] hemisuccinate) was injected into the animals in the interval between the two series of stimulation. A statistical analysis of the experimental results showed that intraperitoneal injection of cortisol in doses of 10 and 20 mg/kg enhances the simulation-induced behavioral response and shortens the latent period of its manifestation compared with the control. Key words: rabbit, electrostimulation, medial hypothalamus, stereotyped behavior, cortisol. PMID- 3683828 TI - Electron-cytochemical study of acetylcholinesterase in the cerebral cortex in Alzheimer's disease. PMID- 3683829 TI - Influence of thymosin on the formation of the functional activity of the adrenals in mice. PMID- 3683830 TI - Computed tomographic studies of the basis pedunculi in chronic hemiplegic patients: topographic correlation between cerebral lesion and midbrain shrinkage. AB - A computed tomographic method for analyzing the shrinkage of the basis pedunculi (BP) due to the secondary degeneration of the descending fibers was applied in correlation to the site of cerebral lesions in 89 chronic hemiplegic patients. Cerebral lesions in the anterior corona radiata or the anterior limb of the capsula interna caused shrinkage of the medial BP. Lesions in the central corona radiata or the genu and posterior limb of the capsula interna caused shrinkage of the central BP, while lesions of the posterior corona radiata or the posterior limb of the capsula interna caused shrinkage of the lateral BP. These results suggested that CT images are able to reveal the principle sites of atrophy of the descending fiber tracts in chronic hemiplegia. PMID- 3683831 TI - Magnetic resonance imaging of the cerebral aqueduct. AB - 1.5 Tesla MRI examinations were evaluated for aqueductal configuration, hydrocephalus and flow-related signal void in 70 patients with juxtaaqueductal pathology and in 20 normal controls. In the 70 cases with pathology, the aqueduct was obliterated or distorted in 34, dilated in 3, normal in 29 and not evaluable in 4. A definite flow-related signal void indicated CSF movement within the aqueduct in all normal examinations. Flow-related signal void was absent in some, but not all, patients with aqueductal obliteration and distortion. CSF turbulence can create an intra-aqueductal signal void in the dilated proximal aqueduct, despite more distal obstruction. Thus hydrocephalus related to aqueductal obstruction is frequently, but not always, associated with absence of signal void. PMID- 3683833 TI - Computed tomography in management of medulloblastomas. AB - The neuroradiological studies of 116 patients with histologically verified medulloblastomas, which had been examined with plain and contrast-enhanced computed tomography (CT), were reviewed. The typical CT appearances of a well defined, hyperdense enhancing mass in the vermis, with surrounding oedema, occurred in 60% of this series. Atypical features include calcification (17%), cystic or necrotic regions (47%) or poorly defined margins and lack of enhancement (7%). Such features in a vermis mass presenting in the first decade, especially in a boy, should not be considered against the diagnosis of medulloblastoma, but may be misleading when the tumour predominantly involves a cerebellar hemisphere. PMID- 3683832 TI - MRI evaluation of tuberous sclerosis. AB - The authors present four cases of tuberous sclerosis examined with MRI. The patho anatomic aspects are reviewed and analysed with respect to MRI data. MRI appears superior to the CT particularly for imaging of cortical tubers, cystic lesions, and heterotopic clusters; these last two features were never described with MRI before. Here is also presented the second progressive case of giant intracranial aneurysm associated with tuberous sclerosis. PMID- 3683834 TI - Pericerebellar fluid collections in infancy, sequelae of birth injury? A retrospective CT study. AB - Retrospective analysis of axial CT scans from 600 consecutive pediatric patients revealed 37 patients (6%) with abnormal low density pericerebellar spaces. Fourteen of these 37 patients (38%) were diagnosed as cerebellar atrophy, whereas 23 of the 37 patients (62%) were diagnosed as mass-like pericerebellar fluid collections. Detailed analysis of the morphology of these spaces suggests that the CT criteria proposed in this paper distinguish between (a) those low attenuation pericerebellar spaces that represent cisternal dilatation caused by cerebellar atrophy (Group I - Atrophy) and (b) those low attenuation pericerebellar spaces that represent low density mass-like collections of fluid which distort a relatively normal cerebellum (Group II - Collections). Analysis of the medical records of the patients in Group II - Collections reveal a high incidence of prematurity, developmental delay, difficult birth and head trauma, possibly indicating that such collections represent sequelae of birth. PMID- 3683835 TI - Invasive v non-invasive assessment of the carotid arteries prior to trans sphenoidal surgery. AB - Imaging studies in 47 patients who were to undergo trans-sphenoidal surgery were analysed with reference to the vascular structures in the parasellar region. The results of cavernous sinography, dynamic contrast enhanced Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed good correlation with each other and with the appearances found at operation. CT and MRI, both non-invasive investigations, are therefore reliable preliminary screening methods for identifying the small proportion of patients on whom other imaging techniques need to be performed. PMID- 3683836 TI - Roentgenological investigation of cavernous sinus structure with special reference to paracavernous cranial nerves. AB - We have evaluated the anatomical structure of cavernous sinuses in parasellar blocks obtained from adult cadavers to gain clinically useful information. Ten microdissectional studies of parasellar blocks (20 sides of cavernous sinus) were carried out with special emphasis on the course of paracavernous cranial nerves (3rd to 6th). These were also examined on plain radiographs. Secondly, CT investigations of the cavernous sinuses (notably as to paracavernous cranial nerves) were undertaken in twenty clinical cases having presumed parasellar lesions and in three parasellar blocks from cadavers. The results from microdissectional studies and plain radiographs were as follows. It was found that the 3rd cranial nerve entered the lateral wall of the cavernous sinus close to the antero-inferior part of the posterior clinoid on lateral projection. The 4th cranial nerve, on the other hand, entered near the postero-inferior portion of the posterior clinoid on the same view. Variations in Parkinson's triangle were fairly often noted, although marked asymmetry was not seen in individual cases. From CT findings, it was found that a postenhanced, magnified direct coronal study was essential for identifying paracavernous cranial nerves more clearly. The 3rd and 5th cranial nerves were fairly well identified on axial and coronal projections. Careful radiological investigation including plain skull radiographs & CT seems to be of value for those who diagnose or treat parasellar lesions. PMID- 3683837 TI - Nucleolysis and diskography--an experimental study on interaction of chymopapain and contrast medium. AB - A test was carried out on 11 young, full sized mongrels to determine whether there is an interaction between chymopapain and the contrast agents iotrolan and iopamidol. A total of 75 intervertebral disks were punctured: nucleolysis alone was performed on 20, diskography with iotrolan and subsequent nucleolysis on 20, and diskography with iopamidol and subsequent nucleolysis on 10. Diskography alone was performed 10 times with iotrolan and 5 times with iopamidol. Aqua dest. was given intradiskally 5 times, and puncture was carried out 5 times without the administration of any substance. Following puncture, x-rays of the lumbar vertebral column were taken laterally: daily for the first 10 days, then weekly. Disk space narrowing typical of nucleolysis with chymopapain was found among the disks that were nucleolyzed only to the same extent as among those that had undergone diskography previously. There was no evidence of narrowing of the other disk spaces which had been punctured but not treated with chymopapain. On some of the dogs, CT and MRI examinations were carried out. The CTs showed a homogenous hypodensity in all of the disks, in which chymopapain had been injected. The MRI revealed a signal loss in all of the nucleolyzed disks. The results of short and long term follow up demonstrate that inhibition of chymopapain by iotrolan or iopamidol is not to be expected and therefore diskography prior to chemonucleolysis can be performed without danger of enzyme inactivation. PMID- 3683838 TI - Spontaneous regression of pituitary mass in temporal association with pregnancy. AB - We have encountered a case of a pituitary mass which emerged and enlarged during pregnancy in a 29-year-old woman. On CT scaning the mass disappeared over the course of four months postpartum and was followed by pituitary hypofunction. The hypofunction was restricted to ACTH, GH, and PRL. The visual field defects, bitemporal hemianopsia, disappeared with disappearance of the pituitary mass on CT scanning, indicating that such deficits during this period were reversible. Based on the clinical course and laboratory data, this case is thought to have been lymphocytic adenohypophysitis. It was concluded that among pituitary tumors developing during pregnancy there are some such cases which do not require surgical therapy. PMID- 3683840 TI - Air in extradural hematomas. PMID- 3683839 TI - Post-operative intracranial foreign body granuloma: a case report. AB - The authors report and discuss some clinical, radiological, histological and ultrastructural aspects of an intracranial foreign body granuloma. This granuloma, which simulated a cavernoma, was due to a surgical swab forgotten during a previous neurosurgical evacuation of an intracerebral hematoma. PMID- 3683841 TI - Man-in-the barrel syndrome: first CT images. PMID- 3683842 TI - Growing skull fracture--rupture of coronal suture caused by vacuum extraction. PMID- 3683843 TI - The distribution of axons according to diameter in the optic nerve and optic tract of the rat. AB - The distribution of axons according to diameter was examined in the optic nerve and optic tract of adult hooded rats. Observations were made on semithin sections, and measurements of axonal diameters were made on electron micrographs taken from various locations across thin sections through the optic nerve and tract. The distribution of axons by size differs markedly in the optic nerve and tract. Coarse (greater than 2 microns) and fine (less than or equal to 2 microns) axons are distributed throughout all regions of the optic nerve. In the optic tract, in contrast, coarse axons are especially dense dorsally, at the deep border of the tract, while they are absent ventrally, subjacent to the pial surface. No regions of the optic nerve contain densities of coarse axons as high as the deep nor as low as the superficial extremes of the optic tract. Nevertheless, even at the deep (dorsal) border of the optic tract, the coarse axons make up only a small minority (roughly 15%) of the total number of axons in that region. The axons 2 microns or smaller may be divisible into two overlapping, fine and intermediate, diameter classes, that are partially segregated within the optic tract, but not in the optic nerve: the distributions of axon diameters smaller than 2 microns are skewed to distinctly smaller diameters at the dorsal and ventral extremes of the optic tract, while in between, at mid-positions along the deep-to-superficial axis of the optic tract, the axon size distributions contain many more axons greater than 1 micron in diameter. These different axon diameter groups may arise from the morphologically distinct retinal ganglion cell types, and may underlie the components of the trimodal compound axon potential seen in the rat's primary optic pathway. Their partial segregation within the tract anticipates the partial segregation of their terminal arborizations within the laminae of the dorsal lateral geniculate nucleus. The rearrangement of axons into a partial segregation by size within the optic tract may indicate a chronology of axonal arrival during early development, proximity to the pial surface being an index of recency of arrival. As axonal outgrowth and neurogenesis appear to be directly related within the retinal ganglion cell population in mammals, the relative birthdates of the retinal ganglion cell types giving rise to the axon diameter classes in the rat may be inferred from the present results. PMID- 3683844 TI - The position of the crossed and uncrossed optic axons, and the non-optic axons, in the optic tract of the rat. AB - The position of the crossed and uncrossed optic axons, and of the non-optic axons, within the optic tract was determined in the adult hooded rat. Horseradish peroxidase histochemistry and lesion-induced degeneration of axonal profiles were independently used to study the position of the three relevant populations of axons within the optic tract. The boundaries of the optic tract are distinct at all but its caudomedial border, where it abuts the supra-optic commissures running parallel to the fibres of the optic tract. Labelling the crossed population of optic axons, or inducing their degeneration, both demonstrate a clear caudomedial border of the optic tract, although a number of optic axons stray out of the optic tract and course within the supra-optic commissures immediately caudomedial to the tract. The uncrossed optic axons are, as a population, positioned relatively deep in the optic tract, towards its dorsal border. A few occur at further ventral positions, but their density is greatly reduced there. There is also a very thin region along the dorsalmost edge of the optic tract free of uncrossed optic axons. The relative position of the uncrossed to the crossed optic axons is discussed in the context of the mammalian optic tract as a chronological map: spatial position in the tract may reflect temporal order of axonal arrival during early development. A large population of non-optic axons belonging to Gudden's commissure courses within the boundaries of the optic tract at a relatively ventral position. They are most frequent caudomedially, and are absent rostrolaterally. Hence, axons of the optic tract and Gudden's commissure are substantially intermingled in the caudomedial half of the optic tract. These non-optic axons greatly outnumber the uncrossed optic axons, and will consequently distort counts of uncrossed optic axons based on intact profiles that remain after removal of the opposite eye. However, they are still a minority in comparison to the crossed optic axons in this region. PMID- 3683845 TI - Cytoskeletal organelles and myelin structure of beaded nerve fibers. AB - Freshly removed cat peripheral nerves and lumbar spinal cord roots were prepared by freeze-substitution to study the form changes, cytoskeletal alterations and myelin structure in beaded nerve fibers. Fibers of unstretched nerves so prepared were close to cylindrical. When lightly stretched with tensions of 2-10 g before being rapidly frozen, beading appeared as a series of constrictions between the more normally expanded regions of the internodes with the paranodal regions spared. Beading also was seen in the fibers of sciatic and radial nerves fast frozen in situ with the limbs placed in full extension to cause stretching. The cross-sectional area of the axon in the constrictions of beaded fibers was reduced by as much as 95%. The compaction of the microtubules and neurofilaments in the constructions was accounted for by the movement of axoplasmic fluid from the constrictions axially into the nearby regions where the axon and fiber diameters are close to normal. The electron-lucid area approximately 5 nm thick around the microtubules appeared to hinder their close approach in the constrictions although some microtubules touch. The neurofilaments are generally separated at a mean distance of 8-10 nm and approach to a mean distance of 4 nm in the constrictions. Neither the beading nor the reversal of beading, which occurs on relaxation from stretch, was blocked by periods of anoxia lasting several hours. Deletion of calcium from the incubating medium initiated some small amount of beading and additionally greatly augmented the beading on stretch. Beading also was present in some of the myelinated fibers of the dorsal columns of the spinal cord where stretch would not be present. These findings suggest that beading is due to a contractile process in the axon initiated by stretch and by other changed states of the fiber. Concomitantly with the contraction of the axon in the beading constrictions, the myelin sheath in that region was greatly reduced in circumference, to as much as 1/3 to 1/5 of normal. The decrease of the sheath diameter was not accompanied by a change in its thickness or in its lamellar fine structure. A repeat distance of the dense lines of 14 nm was measured in both the constricted and nonconstricted regions. To account for these findings lipid, and most likely other components of the myelin lamellar membranes, must move longitudinally from the constrictions in the plane of the lamellar membranes, and do this within 5-10 s.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3683846 TI - Ultrastructure of the central gray region (lamina X) in cat spinal cord. AB - The central gray region (lamina X) of the lumbar spinal cord in cat was examined by electron microscopy. This region consisted of three morphological zones. Medially, the first zone was comprised of ependyma which surrounded the central canal. The ependyma in the cat spinal cord was similar to most vertebrate spinal ependyma. Secondly, a subependymal zone consisted of glial processes arranged parallel to the long axis of the spinal cord. This glial zone was widest lateral to the central canal and extended approximately 75 microns. The lateral edge of the glial zone intermingled with a neuropil zone, the third zone. The components of the neuropil zone consisted of dendrites, myelinated and unmyelinated axons, synaptic terminals, astrocytes and neurons. The dendrites and neurons generally were oriented parallel with the long axis of the spinal cord. Three synaptic terminal types were categorized according to vesicular morphology, i.e. small round vesicles, flattened vesicles and dense core vesicles. The central gray region has been implicated in nociception and has been shown to receive both primary afferent and supraspinal input. The results from this study are consistent with the central gray region being an area of multiple synaptic inputs which may form the morphological basis of nociceptive processing that ascends to brainstem nuclei. PMID- 3683848 TI - Regenerating retinal fibers of the goldfish make temporary and unspecific but functional synapses before forming the final retinotopic projection. AB - Many investigators have examined the retinotectal projection following regeneration, but the mapping technique used in these studies mainly involved recording action potentials from presynaptic terminals. Hence it was not possible to analyse the postsynaptic phenomena underlying the target finding process of the retinal fibers. In the present study, the process of making functional synapses was examined using field potentials generated by small spots of light fixed in the visual field. The results show that regenerating retinal fibers first make functional but temporary, unspecific and diffuse synapses before reaching the target area to form a sharpened retinotopic projection. It is suggested that the formation of synapses subserves an important role in the target finding process. PMID- 3683847 TI - Na+/H+ exchange is the major mechanism of pH regulation in cultured sympathetic neurons: measurements in single cell bodies and neurites using a fluorescent pH indicator. AB - The regulation of intracellular pH in single cell bodies and in neurites of cultured neurons from rat superior cervical ganglion was studied by continuous monitoring of pH transients using the fluorescent indicator bis(carboxyethyl)carboxy-fluorescein. Intracellular pH was 7.03 +/- 0.05 (n = 8) in bicarbonate-free media at pH 7.4 and was not affected by depolarization with high potassium. Brief exposure to NH4Cl caused rapid cytoplasmic acidification followed by an exponential return of intracellular pH to the resting value. The apparent first order rate constant for recovery from an NH4Cl-induced acid load was 0.2 +/- 0.03 min-1 (37 degrees C) and was similar in media at pH 6.5 or 7.8. Recovery from an acid load was blocked by removal of extracellular Na+ or by amiloride but was not dependent on extracellular Cl- or phosphate or blocked by inhibitors of anion transport, in the presence or absence of bicarbonate. Addition of 5-10 mM bicarbonate at pH 7.4 resulted in a slight alkalinization of the cytoplasm and enhanced complete restoration of pHi after an NH4Cl-induced acid load. Nerve growth factor did not affect intracellular pH of either growing cells deprived of nerve growth factor up to 6 days or of newly isolated neurons left at 4 degrees C for a week before exposure to nerve growth factor. Phorbol 12 myristate 13-acetate had no effect on the pH of cell bodies of growing cells and increased pH of cells deprived of nerve growth factor by less than 0.05 pH units. It is concluded that: pH regulation in cultured sympathetic neurons is largely achieved by Na+/H+ exchange; Bicarbonate may also participate in pH regulation, but not by its exchange with Cl-. PMID- 3683849 TI - Immunocytochemical evidence for the GABAergic innervation of the stretch receptor neurons in crayfish. AB - The GABAergic innervation of the stretch receptor neurons of the crayfish Orconectes limosus has been investigated by means of light- and electron microscope immunocytochemistry using an antibody to GABA. Both whole-mount preparations and post-embedding semithin sections revealed a massive GABAergic innervation of both the slowly and the fast adapting receptor neurons. The stretch receptor organ is supplied by one principle GABA-immunoreactive axon, which gives off several branches that innervate the receptor neurons. Cell body, initial axon segment and dendritic region of the sensory neurons are covered by numerous GABA-immunoreactive varicose fibers. Electron microscopy revealed that the GABA-immunoreactive varicosities establish specialized synaptic contacts with the sensory neurons. The functional significance of the occurrence of GABA immunoreactive varicosities on the different parts of the sensory neurons is discussed. The results support the physiological and pharmacological evidence that GABA is a transmitter substance of the efferent inhibitory neurons which innervate the crayfish stretch receptor neurons. PMID- 3683850 TI - Uptake and axonal transport of horseradish peroxidase isoenzymes by different neuronal types. AB - The uptake and transport of basic and acidic horseradish peroxidase isoenzymes was compared in the neuromuscular, visual and olfactory systems of Xenopus larvae and postmetamorphic frogs. The concentration (w/v) of the two preparations was corrected to compensate for their difference in enzymatic activity (unit/w), which was seven-fold higher in basic horseradish peroxidase. Uptake and transport of horseradish peroxidase isoenzymes could be demonstrated with 7% basic horseradish peroxidase, but not with equal amounts of 49% acidic horseradish peroxidase in all systems investigated: retrograde transport from terminals of retinal ganglion cells, isthmotectal neurons and spinal motoneurons, as well as anterograde transganglionic transport along olfactory neurons. A very weak labelling of the same neuronal pathways by acidic horseradish peroxidase was obtained only after increasing the amount injected by approximately two-fold. Basic horseradish peroxidase isoenzymes were also preferentially taken up and transported retrogradely by broken axons of the optic nerve. When tested, similar results were obtained in both larvae and frogs suggesting that preferential uptake and transport of basic horseradish peroxidase is a general feature of all neurons and of all developmental stages. Electron microscopical analysis of the outer layers of the optic tectum revealed that, in the same experimental conditions producing no retrotrade labelling of optic axons, acidic horseradish peroxidase was rarely found to enter nerve terminals. It appears that interactions between horseradish peroxidase and neuronal membranes occur during uptake and transport and that molecular charge plays an important role, beyond non-specific fluid-phase endocytosis. We suggest that differences between horseradish peroxidase isoenzymes as neuronal tracers reflect a process of adsorptive endocytosis related to general characteristics of neuronal membranes (regardless of age) and not to specific receptor-mediated interactions characteristic of neuronal specificity. PMID- 3683851 TI - 'Neurosecretion' by aminergic synaptic terminals in vivo--a study of secretory granule exocytosis in the corpus cardiacum of the flying locust. AB - Most nerve terminals forming typical synaptic junctions contain both synaptic vesicles and larger 'secretory granules' with electron-dense contents. Visualization of granule exocytosis from within terminals in the corpus cardiacum is facilitated by injection of tannic acid which immobilizes granule cores as they are discharged. The process of discharge is stimulated by flight-induced activation of the neurones and there is a correlated response by the innervated cells. In contrast to synapses with their vesicle clusters, granule discharge is not targeted upon the postsynaptic cells. These findings have general implications for mechanisms of discharge of neuropeptides and other transmitters from synaptic terminals. PMID- 3683852 TI - Immunocytochemical localization of dopamine in the prefrontal cortex of the rat at the light and electron microscopical level. AB - In the present study the dopaminergic innervation of the prefrontal cortex was studied by means of a recently developed anti-dopamine serum. This method can demonstrate endogenous dopamine in a specific way, and offers the opportunity to study the distribution of dopaminergic fibres in the cortex in detail in counterstained sections. Furthermore, dopaminergic nerve endings can be visualized at the electron microscopic level. Light microscopic observations demonstrated that the highest density of dopaminergic fibres in the frontal cortex is found in the prefrontal cortex and the infralimbic cortex. Within the prefrontal cortex, a good correlation is found between regional differences in distribution of dopaminergic fibres and the cytoarchitectonic parcellation of this part of the cortex. Outside the prefrontal cortex dopaminergic fibres were observed in adjacent frontal areas, the cortex surrounding the entire rhinal sulcus and the retrosplenial cortex. Electron microscopic observations demonstrated dopaminergic terminals through all cortical layers. The majority of dopaminergic terminals in the prefrontal cortex from synaptic contacts with dendritic processes. The synaptic profiles were usually symmetric and were characterized by the presence of many clear vesicles and an occasional dense-core vesicle. PMID- 3683853 TI - Anatomical localization of cortical beta rhythms in cat. AB - Beta electrocorticographic rhythms (40 Hz) develop during motionless focused attention in two distinct cortical foci in cats. A cytoarchitectonic study was performed to determine the precise location of these foci. Electrode tips recording beta rhythms were found: (i) in motor areas 4 gamma and 6a beta, in a band extending from the postcruciate cortex to the walls of the presylvian sulcus, crossing the frontal pole (anterior beta focus); (ii) in the posterior parietal associative area 5a, along the divisions of the ansate sulcus, extending to the mesial aspect of the hemispheres (posterior beta focus). The two foci are separated by areas 3, 2 and 1, where beta rhythms were never recorded. The fact that both these areas, containing giant pyramidal cells, develop a specific type of activity during immobility may have a functional meaning: area 5 may be involved in the cat as it is in the monkey in the control of motor behaviour. PMID- 3683854 TI - Cellular activity of intracerebrally transplanted fetal hippocampus during behavior. AB - Hippocampal tissue derived from 12-, 20-, 25- and 34-mm rat fetuses was placed in a cavity formed by unilateral aspiration of the fimbria-fornix and the overlying neocortical tissue in adult rats. From 4 to 6 months after transplantation the rats were equipped with chronic recording and stimulating electrodes. Single cell activity of the transplant was monitored during running in a wheel, drinking, and sleeping. Both complex-spike cells (n = 151) and single-spike cells (n = 80) were recorded from the graft. A portion of the neurons changed their firing rates and discharge patterns as a function of ongoing behavior. About half of the single spike cells increased their firing frequency during running. Fifteen per cent of the single-spike cells fired rhythmically at about 8 Hz during running, and the paradoxical phase of sleep and the discharge pattern correlated with rhythmic slow activity (theta) recorded concurrently from the contralateral (intact) hippocampus. These patterns were most frequently obtained from grafts of 20- and 25-mm (16 to 18 embryonic days) fetuses. Graft neurons could be activated by stimulating the ipsilateral hippocampus or the ipsilateral perforant path, with latencies of 8-30 ms. The most common electrical pattern in grafts of all groups was the synchronous bursts of several neighboring cells and concurrent electroencephalogram sharp-waves. Sharp-waves occurred during all behaviors. Large amplitude, high-frequency electroencephalogram spindles (14-18 Hz and 30-50 Hz) and associated neuronal bursts were recorded in grafts of 12-, 20-, and 25-mm fetuses. Based on these findings we suggest that both subcortical afferents and host hippocampal afferents send axons to hippocampal grafts and form viable synaptic connections with a portion of the neurons in the graft. The frequently encountered population bursts are explained by assuming that excitatory collaterals in the graft are more potent in the graft than in the normal hippocampus, and/or GABAergic inhibition is less efficient in the graft. PMID- 3683855 TI - Glycine immunoreactivity localized in the cochlear nucleus and superior olivary complex. AB - Polyclonal antibodies were made in rabbits against glycine conjugated to bovine serum albumin with glutaraldehyde and were used for immunocytochemical studies in the cochlear nucleus and superior olivary nucleus of the guinea-pig. Antibodies selective for glycine were prepared by affinity chromatography. By dot-blot analysis this preparation showed a strong recognition of glycine conjugates and relatively little recognition of conjugates of most other amino acids tested. However, there was a significant reaction with conjugates of alanine and beta alanine, and this cross-reaction could not be removed by affinity chromatography without eliminating the preparation's recognition of glycine. The affinity purified preparation showed only a weak recognition of conjugates of gamma aminobutyrate (GABA) which was detectable at high concentrations of primary antibody. Immunocytochemical studies showed several intensely staining cell bodies in the cochlear nucleus and superior olivary complex. Most immunoreactive cell bodies in the cochlear nucleus were in the dorsal cochlear nucleus, being present in both the superficial and deep layers. Scattered immunoreactive cells were present in the ventral cochlear nucleus. Intense staining of cell bodies was seen in the medial nucleus of the trapezoid body, and these cells appear to correspond to the principal cells of that nucleus. Punctate labelling, suggestive of immunoreactive presynaptic terminals, was also apparent, particularly in the ventral cochlear nucleus and lateral superior olive. In the ventral cochlear nucleus, immunoreactive puncta were found around unlabeled cell bodies, at times nearly covering the perimeter of the cell. A population of glycine-immunoreactive cell bodies in the superficial dorsal cochlear nucleus also labeled with anti GABA antibodies as determined through double-labeling studies. However, glycine positive cells in the deep dorsal cochlear nucleus were not labeled with anti GABA antibodies, and some populations of GABA-positive cells in the superficial layers were not labeled with anti-glycine antibodies. In the hippocampus intense staining of cell bodies and puncta was seen with anti-GABA antibodies while essentially no staining was seen with anti-glycine antibodies. These results suggest that anti-glycine antibodies can be useful for immunocytochemical identification of glycinergic neurons. From this study several populations of putative glycinergic neurons are identified in the auditory nuclei of the brain stem using these antibodies. Some populations of GABA-containing neurons also contain high levels of glycine or a related molecule. PMID- 3683856 TI - The role of dopamine released from distal and proximal dendrites of nigrostriatal dopaminergic neurons in the control of GABA transmission in the thalamic nucleus ventralis medialis in the cat. AB - Halothane-anaesthetized cats implanted with push-pull cannulae were used in this study. Amphetamine was applied in the pars reticulata or pars compacta of the substantia nigra in order to determine the role of dopamine released from distal or proximal dendrites of dopaminergic cells in the control of GABAergic transmission in the nucleus ventralis medialis of the thalamus. When applied for 30 min in either the pars reticulata or the pars compacta, amphetamine (10(-6) M) enhanced to a similar extent the local release of [3H]dopamine synthesized from [3H]tyrosine, these effects being seen mainly during the drug application. The amphetamine-evoked release of dopamine in the pars reticulata produced a long lasting reduction in the release of [3H]GABA synthesized from [3H]glutamine in the nucleus ventralis medialis as well as in the paralamellar zone of the nucleus ventralis lateralis. Opposite effects were observed when amphetamine (10(-6) M) was applied in the pars compacta. In complementary experiments, single unit recordings were made in the intermediate part of the pars reticulata, some of the cells being identified by antidromic activation from the nucleus ventralis medialis. Whether applied in the pars reticulata or pars compacta, amphetamine (10(-6) M, 10 min) evoked a reversible decrease in the firing rate of most recorded cells whether or not they were identified as projecting to the nucleus ventralis medialis. Therefore, the decreased release of [3H]GABA in the nucleus ventralis medialis seen following application of amphetamine in the pars reticulata of the substantia nigra could result from an inhibition of nigrothalamic GABAergic neurons. Since the nucleus ventralis medialis is also innervated by GABAergic neurons originating in the entopeduncular nucleus, single unit recordings were made from cells in this nucleus during the application of amphetamine (10(-6) M, 10 min) into the pars compacta of the substantia nigra, some of which were identified antidromically as projecting to the nucleus ventralis medialis. Most cells identified or not were found to be activated during this treatment. These results suggested that the increased release of [3H]GABA seen in the nucleus ventralis medialis following application of amphetamine in the pars compacta of the substantia nigra might be linked to the enhanced firing rate of entopeduncular-thalamic GABAergic neurons. PMID- 3683857 TI - The dendrites of single brain-stem motoneurons intracellularly labelled with horseradish peroxidase in the cat. Morphological and electrical differences. AB - The geometrical differences between individual dendrites of a given motoneuron were investigated in the cat. We chose two brain-stem motoneurons involved in different motor activities. One abducens and one laryngeal motoneuron were selected from two series of experiments which had combined intracellular recording and horseradish peroxidase staining. Three-dimensional reconstructions were made using a computer-aided microscope to obtain high-resolution measurements from serial histological sections. Each dendrite was characterized by computer dissection. Comparisons between dendrites were made on the basis of the following parameters: spatial projections, length, diameters, tapering, branching pattern, daughter--branch ratio and branching power. The present findings show that each dendrite projects to specific terminal fields for both motoneurons and are different in the complexity of their geometry and branching structure. The consequences of this complexity for the cable properties of the motoneurons were analysed. The dendrites of the two motoneurons were partitioned into a series of contiguous regions deemed short enough to be considered an isopotential cylinder and the steady-state properties were calculated for each segment. The properties of each segment were then combined for each dendrite for the following parameters: electronic distance, somatopetal and somatofugal voltage attenuation, input resistance and charge transfer effectiveness ratio. The present results show significant differences in the electrical behaviour of individual dendrites. Branch-to-branch computation reveals low attenuation pathways between branches suggesting the possibility of local influences within the distal branches of the dendritic arborization. It is proposed that the individual dendrites of the motoneuron function as distinct channels and/or integrators for afferent inputs. PMID- 3683858 TI - The dendrites of single brain-stem motoneurons intracellularly labelled with horseradish peroxidase in the cat. An ultrastructural analysis of the synaptic covering and the microenvironment. AB - Two laryngeal motoneurons intracellularly stained with horseradish peroxidase were studied ultrastructurally. The precise position of the ultrastructural observations made along the dendrites was obtained from the computer reconstruction of the motoneurons in three dimensions. The shape and the size of the synaptic boutons, the percentage of membrane covered by bouton appositions and active zones, the number of boutons per 100 microns2 (packing density) were analysed on the soma and on the labelled dendrites at different distances from the soma up to 1000 microns. The results revealed no important regional differences in the mean length of synaptic apposition. The packing density was in the range of 9.3-14.9 boutons per 100 microns2 and was not correlated with the distance from the soma. The percentage apposition covering was higher on the soma and the proximal part of the dendrites than on the remaining part of the dendritic arborization. Close appositions between labelled dendrite and unlabelled somata and/or dendrites together with dendro-dendritic synapses suggested the possibility that the dendrites may be involved in local cell-to cell communication. Microdendrites emerging from the soma or the proximal dendrites were contacted by synaptic boutons which may be more efficient as revealed by computation. PMID- 3683860 TI - Distribution of neurotensin binding sites in the caudal brainstem of the rat: a light microscopic radioautographic study. AB - Specific high-affinity neurotensin binding sites were labeled in sections of the rat caudal brainstem using a monoiodinated ligand, and their distribution was examined by light microscopic radioautography after fixation with glutaraldehyde. In the medulla, labeled binding sites were mainly concentrated within the dorsal motor nucleus of the vagus, the nucleus of the solitary tract, the external cuneate nucleus, the lateral reticular nucleus, the medial vestibular nucleus, the retrofacial nucleus, the linearis nucleus, the paragigantocellular nucleus and the nucleus raphe pallidus. Within the pons, neurotensin binding sites were detected in the reticulotegmental nucleus, the pontine nuclei, the dorsal tegmental nucleus, the laterodorsal and pedunculopontine tegmental nuclei and the nuclei raphe dorsalis and medianus. Most nuclei found here to contain high densities of neurotensin binding sites have been shown to stain intensely for acetylcholinesterase, suggesting a possible association between this enzyme and neurotensin receptors. PMID- 3683859 TI - Organization of the projections from the subiculum to the ventral striatum in the rat. A study using anterograde transport of Phaseolus vulgaris leucoagglutinin. AB - The projections of the subiculum, as the main output structure of the hippocampal formation, to the striatum were studied in the rat using the anterograde tracer Phaseolus vulgaris leucoagglutinin. It appears that not only the entire nucleus accumbens, part of the so-called ventral striatum, receives fibres from the subiculum, but that the hippocampal projection area in the striatum includes also the most medial, ventral, rostral and caudal parts of the caudate-putamen complex. Moreover, a relatively small number of fibres and terminals are present in the striatal elements of the medial part of the olfactory tubercle. The projections to the ventral and caudal parts of the caudate-putamen are predominantly derived from the ventral subiculum, whereas the projections to the rostral part of the caudate-putamen are derived from the dorsal subiculum. Furthermore, with respect to the subiculum-accumbens pathway a topographical organization could be established. Thus, the ventral or temporal part of the subiculum projects predominantly to the caudomedial part of the nucleus accumbens, and to a lesser degree to its rostromedial portion, whereas progressively more dorsal or septal parts of the subiculum send fibres to successively more lateral and rostral portions of the nucleus accumbens. Very sparse projections are found to the contralateral nucleus accumbens, arranged in a topographical manner similar to the ipsilateral projections. An important observation with respect to the structure of the nucleus accumbens is that the subicular terminations are inhomogeneously distributed, although a relation with earlier described mosaic patterns in the connectivity and neurochemical composition of the nucleus is not yet clear. Subicular fibres have their densest terminations in relatively cell-poor regions of the nucleus accumbens, and in particular tend to avoid small cell clusters. PMID- 3683861 TI - Cerebellar afferents from the lateral reticular nucleus in the rat. AB - The projection from the lateral reticular nucleus to the cerebellum was examined using the retrograde fluorescent double labelling method in the rat. A quantitative analysis of the extent of axonal branching and of nucleotopic (topographic) organization in this projection was carried out. It was shown that lateral reticular nucleus neurons show axonal branching both within and between parasagittal zones of the cerebellar cortex, but that branching within zones is more common. Neurons projecting to different zones were found to be significantly spatially separated, but those projecting to different sites within the same zone were intermingled. Thus a limited degree of nucleotopic organization was found. The results are discussed in relation to the parasagittal zonation in the olivocerebellar projection. PMID- 3683862 TI - Subdivisions of the dopamine-containing A8-A9-A10 complex identified by their differential mesostriatal innervation of striosomes and extrastriosomal matrix. AB - The mesostriatal projections from the dopamine-containing cells groups A8, A9 and A10 have been studied in the cat in relation to the histochemical compartments known to exist in the striatum. In order to do this, we made stereotaxic injections in the substantia nigra of either [3H]proline-[3H]leucine, [35S]methionine, wheat germ agglutinin-horseradish peroxidase, or the two last tracers combined, and compared the location of anterograde labeling in the striatum to the locations of striosomes and extrastriosomal matrix identified by their low or high content, respectively, of the enzyme acetylcholinesterase. A discrete innervation of dorsolateral striosomes by a caudal densocellular subdivision of the substantia nigra pars compacta was found. This densocellular zone of the pars compacta was readily identifiable in sections stained for tyrosine hydroxylase-like immunoreactivity and corresponded to the uniquely acetylcholinesterase-poor zone detected in the substantia nigra pars compacta in serially adjacent sections stained for this enzyme. Selective anterograde labeling of the extrastriosomal matrix occurred in cases with injection sites centered in cell group A8. Tracer deposits in cell group A10 also elicited a preferential labeling of the extrastriosomal matrix, but this innervation was sparse compared to the prominent labeling of fibers in the ventral striatum. An almost exclusive innervation of caudal and ventral striosomes of the head of the caudate nucleus occurred after a deposit of tracer in the pars lateralis of the substantia nigra. Mixed labeling of striosomes and matrix occurred with injection sites centered in the rostral, cell-sparse part of the pars compacta of the substantia nigra. Clusters of tyrosine hydroxylase-immunoreactive neurons within this zone, most likely representing finger-like extensions of the caudal densocellular zone of the pars compacta, might have accounted for part of the striosomal labeling in these cases. We conclude that different subdivisions of the A8-A9-A10 dopamine-containing cell complex of the cat's mesencephalon project preferentially to striosomes or to extrastriosomal matrix. On this basis we suggest that there may be different functional channels in the mesostriatal projection, including, from cell group A8, a channel providing dopaminergic modulation of sensorimotor processing in the striatal matrix, and, from the densocellular zone of the substantia nigra pars compacta, a channel leading to limbic-related mechanisms represented in the striosomal system. PMID- 3683863 TI - Substantia nigra influences on the reticulospinal neurons: an electrophysiological and ionophoretic study in cats and rats. AB - The influences exerted by the substantia nigra on reticulospinal neurons and the nature of the synaptic transmitter subserving these projections have been studied in adult cats and rats. Nigral stimulation evokes discharge changes in a significant number of reticulospinal cells (32.4% in cats and 39.1% in rats) on both ipsi- and contralateral sides. The responses were short-latency inhibitions (69.5% in cats and 76.5% in rats), short-latency excitations (22.2% in cats and 23.6% in rats) and in the remaining few cases long-latency excitations. Short latency excitations, quite similar to the nigra-induced ones, were the predominant response pattern (95.2% in cats and 96.9% in rats) elicited on reticulospinal cells following stimulation of cerebral peduncle. The stimulation of substantia nigra in rats submitted to chronic ablation of sensorimotor cortex elicited only inhibitory responses while stimulation of nigral area in rats with intranigral injection of kainic acid was still capable of evoking short-latency excitations but not short-latency inhibitions. Therefore, the former can be ascribed to activation of corticoreticular fibers running in the cerebral peduncle whereas the latter can be considered as depending on activation of nigral efferents. The nigra-influenced cells were both 'fast' and 'slow' reticulospinal neurons and resulted mainly located in most rostral regions of reticular formation. Ionophoretic application of GABA suppressed the spontaneous firing of reticulospinal cells while no effect was observed following application of dopamine. The nigra-induced inhibitions were abolished by GABA-antagonist bicuculline and not by dopamine-antagonist fluphenazine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3683864 TI - The mechanism of action of capsaicin on sensory C-type neurons and their axons in vitro. AB - The selective excitant and neurotoxic action of capsaicin on vagal sensory neurons in the rat has been investigated in vitro using three techniques: extracellular recording of compound spike potentials from the whole nerve; intracellular recording from ganglion cells using single-electrode current and voltage clamp; and electron microscopy of the nerve and nodose ganglion. Capsaicin (0.1-10 microM) depolarized vagal sensory C fibres and cell bodies, and produced an increased conductance. The conductance increase appeared to be due to an increased permeability to sodium and calcium, plus a secondary increase in potassium (and perhaps chloride) conductance consequent upon calcium entry. The early entry of calcium seems to be a significant priming event in the neurotoxic process, since dramatic ultrastructural changes take place within a few minutes of capsaicin application, which are minimized by removing extracellular calcium ions. The observations indicate that in sensory C neurons capsaicin opens a conductance of limited specificity and that a resultant large calcium entry is closely involved in the rapid development of cell injury. PMID- 3683865 TI - Immunohistochemistry of tryptophan hydroxylase in the rat brain. AB - An antiserum raised against tryptophan tetrahydropterine oxygen oxidoreductase was used to examine in rat brain the immunohistochemical localization of this rate-limiting enzyme catalysing the biosynthesis of serotonin. Tryptophan tetrahydropterine oxygen oxidoreductase was detected in numerous nerve cell bodies, proximal dendrites and axon varicosities or terminals corresponding to those of serotonin neurons as judged by their anatomical distribution and concomitant immunoreactivity to an antiserum against serotonin. In hypothalamus, a serotonin-containing nerve cell group previously visualized in the pars ventralis of the nucleus dorsomedialis by radioautography after serotonin uptake, and by serotonin immunohistochemistry after tryptamine loading, remained tryptophan tetrahydropterine oxygen oxidoreductase-unreactive even in rats treated with colchicine. On the other hand, a small group of tryptophan tetrahydropterine oxygen oxidoreductase-positive cells was identified in the rostrolateral portion of nucleus dorsomedialis, which could play a part in the intrinsic serotonin innervation of hypothalamus. There was no overlap between tryptophan tetrahydropterine oxygen oxidoreductase immunostaining and the cellular distribution of N-acetyl serotonin as reported in earlier studies. It is therefore likely that the synthesis of N-acetyl serotonin from tryptophan does not take place in N-acetyl serotonin-containing neurons. PMID- 3683866 TI - Electron microscopy of serotonin-immunoreactive neuron branches and terminals in the locust central nervous system. AB - Using a pre-embedding peroxidase technique, we have investigated the ultrastructure of elements that react with antibodies to 5-hydroxytryptamine in the central nervous system of the locust. Reactive neuron profiles are widespread, and contain a variety of vesicle types: small lucent vesicles, some of which are stained only on their outer membranes while others are stained internally, and large dense granules that again differ in the staining properties of their cores. Some of the reactive profiles contain synaptic specializations, while others receive synaptic inputs from unlabelled elements. The heterogeneity of reactive profiles makes it impossible to define ultrastructural characteristics of putative serotonergic terminals that might be generally applicable. The differential reactivity both of small vesicles and of large dense granules may indicate functional differences within these categories. PMID- 3683867 TI - Olfactory marker protein is present in olfactory receptor cells of human fetuses. AB - Light microscopic observations indicated that cellular differentiation of the primary olfactory pathway in human fetuses was relatively advanced by the end of the first trimester. However, immunohistochemical staining showed that olfactory marker protein was present in the receptor cells only at about 28 weeks post conception. At about 32 weeks, modest amounts of the protein could be found in the peripheral olfactory nerve layer and a few glomeruli, with increased staining observed in subsequent weeks. The results show conclusively that human fetal olfactory neurons synthesize olfactory marker protein during the later half of gestation. PMID- 3683868 TI - Organization of arm movements. Motion is segmented. AB - A kinematic analysis of human arm trajectories which underlie the production of learned, continuous movements (such as drawing of 'figure 8s' and stars) in free space is presented. The objective of this investigation was to see if a set of rules, which had been identified previously and which are appropriate for generating circular or elliptical motion of the wrist in an arbitrary plane, also hold true for arbitrary, learned trajectories provided one additional assumption is made: that apparently continuous complex movements are composed of unit segments. The results presented in this paper are consistent with this hypothesis. Furthermore, as predicted by the hypothesis, the wrist trajectory deviates little from planar motion in each segment while the plane of motion can change abruptly from one segment to the next. PMID- 3683869 TI - Organization of arm movements in three-dimensional space. Wrist motion is piecewise planar. AB - It is shown that human subjects are incapable of producing with the arm, in free space, planned or extemporaneously drawn trajectories in which the plane of wrist motion changes smoothly or continuously. The three-dimensional nature of these movements results from the fact that the plane of motion changes abruptly from one segment of the trajectory to the next, being confined to one plane during each segment (i.e. piecewise planar). PMID- 3683870 TI - "Learned" changes in the responses of the rat barrel field neurons. AB - The effect of pairing two vibrissa stimulations on unit responses of the barrel field of the somatosensory cortex were studied in partially restrained but awake and undrugged rats. Before pairing, one of the stimulations (S2) evoked a stable, short-latency and excitatory response from the recorded unit. Depending on the neuron, the other stimulation (S1), preceding S2 by 500 ms, did or did not have an effect before pairing. In a number of cases, the S1-S2 association produced significant changes in the unit responses: (1) the appearance of an excitatory response to S1 when that stimulus was ineffective before pairing; (2) the modification of pre-existing responses to S1 and/or S2. In all instances these modifications consisted in the decrease or disappearance of the "afferent inhibition" and/or the appearance of long-latency excitatory components. These effects appeared after some 30-100 trials and persisted in some cases up to 20 min after interruption of pairing. Our observations provide the first physiological data on the plasticity of the vibrissa projections in the chronic adult rodent. Though the underlying plastic neural elements and mechanisms remain to be specified, these phenomena suggest that "learned" changes in unit activity may occur in sensory systems and not only in "non-specific" ones. PMID- 3683871 TI - Gabaergic neurons of the hippocampus: development in homotopic grafts and in dissociated cell cultures. AB - The hippocampus taken from E18-E19 rat embryos was dissociated into a cell suspension and was either grafted into the hippocampus of adult rats or cultured. The growth of GABAergic neurons was examined using a GABA directed antiserum. The implanted tissue was capable of survival and growth without exhibiting a laminar organization. Most of the various morphological neuronal types could be observed, establishing different types of synapses; however, granule neurons were rarely encountered. A substantial proportion of GABA-positive neurons was detected within the graft with profuse labelling of the neuropil. In cultures issued from the same cell suspension, GABA-immunoreactive neurons were numerous and had different morphologies. Altogether these data suggest that GABA neurons express a high potential for growth and sprouting in vitro and in vivo. PMID- 3683872 TI - Conditioning to time: evidence for a role of hippocampus from unit recording. AB - Unit activity of the dorsal hippocampus was recorded in partially restrained but awake and undrugged rats during a "conditioning to time". In this type of conditioning, only one stimulus, the equivalent of the unconditioned stimulus of the usual procedures, is used. It is delivered at a constant interval which, in principle, is the conditioned stimulus. In our experiments, the unconditioned stimulus was a mechanical stimulation of a vibrissa; two successive unconditioned stimuli were separated by a 24-s interval. In 11/18 rats, anticipatory movements of a "trained" vibrissa developed at the end of the interstimulus interval. In a number of cases, in parallel to this conditioned behavior, there was a significant change in unit activity, either an increase or a decrease, during the last third of the interstimulus interval. Controls showed that these changes in unit activity did not merely reflect modifications of arousal state or of vibrissa and body movements. From autocorrelograms, it appeared that anticipatory increases in unit activity were associated with the development of a bursting mode of discharge. These data constitute one of the rare examples of a neurophysiological correlate of a "conditioning to time" at the unit level and the first recorded from the dorsal hippocampus of rats. PMID- 3683873 TI - Exteroceptive suppression of temporalis muscle activity in chronic headache. AB - Early (ES1) and late (ES2) exteroceptive suppression periods elicited by electrical stimulation of the labial commissure during teeth-clenching were recorded over the temporalis muscle in 45 headache patients (25 tension headaches and 20 migraines) and 22 controls. Mean duration of ES2 for single shocks was significantly reduced in tension headache when compared with migraine or controls. At a stimulation rate of 2 Hz, ES2 was abolished in 40% of tension headache sufferers, but in none of the migraineurs. EMG analysis of temporalis late exteroceptive suppression might be a helpful diagnostic tool in functional headaches. Reduction of ES2 suggests that there is deficient activation or excessive inhibition of pontobulbar inhibitory interneurons which receive a strong input from limbic structures. ES2 might thus represent an interface between psychogenic and myogenic factors putatively involved in the pathogenesis of tension headache. PMID- 3683874 TI - Characterization and classification of neonatal seizures. AB - To characterize and classify neonatal seizures, we studied 349 neonates, using a portable, cribside EEG/polygraphic/video monitoring system. We recorded 415 clinical seizures in 71 infants; 11 other infants had electrical seizure activity without clinical accompaniments. Each seizure was analyzed in terms of its clinical character and its relationship to the presence of EEG seizure activity. Focal clonic seizures, some forms of myoclonic seizures, and focal tonic seizures were consistently associated with electrical seizure activity. Most "subtle" seizures, all generalized tonic seizures, and some forms of myoclonic seizures were either not associated with EEG seizure activity or had an inconsistent relationship with such activity. Seizures that were consistently and coherently related to focal EEG seizure activity had a high correlation with focal brain lesions and a favorable short-term outcome. Seizures with no relationship or an inconsistent relationship to EEG seizure activity were correlated with diffuse processes such as hypoxic-ischemic encephalopathy and a poor short-term outcome. The clinical and background EEG features of infants whose seizures were not accompanied by EEG seizure activity suggest that these seizures may not be epileptic in character. PMID- 3683875 TI - "Crack" cocaine-associated stroke. AB - We present three cases of "crack" cocaine-associated stroke, together with a review of cocaine-associated cerebrovascular complications. Unlike previously reported cases tentatively associating ischemic stroke with cocaine, our patients had no other potential causes for their strokes. Although the exact mechanism of cocaine-related stroke remains uncertain, both disordered neurogenic control of the cerebral circulation as well as systemic factors (ie, acute hypertension) may play a role. PMID- 3683876 TI - HLA antigens in narcolepsy. AB - Eighteen black patients with narcolepsy underwent human leukocyte antigen (HLA) typing. Eleven of the 18 had cataplexy. Twelve patients (66.6%) had HLA-DR2; 7 patients with cataplexy had DR2. All patients had DQw1. In contrast to white and Japanese patients studied to date, not all black narcoleptics have DR2. PMID- 3683877 TI - Phenacemide therapy of complex partial epilepsy in children: determination of plasma drug concentrations. AB - We used monotherapy with phenacemide to treat complex partial seizures in 13 children who were refractory to conventional antiepileptic drug therapy. Twelve patients responded with a reduction in seizure frequency, and 5 have been totally seizure free since the start of therapy. Phenacemide therapy was well tolerated with a minimum of untoward side effects and no evidence of irreversible drug toxicity. We developed a rapid and sensitive assay for the determination of plasma phenacemide concentrations by high performance liquid chromatography to monitor drug levels during therapy. Seizure control was achieved at plasma drug levels that ranged from 16 to 75 micrograms/ml. The median effective dose in our series was 52 micrograms/ml. The recurrence of seizures in three patients was, in each case, associated with trough plasma phenacemide levels below 50 micrograms/dl. PMID- 3683878 TI - Heterogeneous phenotypes of mitochondrial encephalomyopathy in a single kindred. AB - Five patients with mitochondrial disorders in a single family showed marked heterogeneity of clinical signs and symptoms. Two patients had the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes; one had blepharoptosis, seizures, and diabetes insipidus; and two had a nonspecific encephalomyopathic disorder. This family supports the concept of a "mitochondrial cytopathy." PMID- 3683879 TI - Intravenous adenosine selectively increases blood flow to xenotransplanted intracerebral gliomas. AB - Adenosine was infused intravenously at 10 mumol/(kg.min) into athymic ("nude") rats with intracerebral D-54MG xenotransplanted brain tumors, in an attempt to increase tumor blood flow. Cerebral blood flow (F) was measured with 14C iodoantipyrine and quantitative autoradiography. Mean arterial blood pressure was 95 +/- 9.4 (SE) mm Hg in the adenosine group and 112 +/- 6.0 mm Hg in the controls. Averaged mean whole tumor F was significantly higher in adenosine treated brain tumors (117.6 +/- 20.8 ml/[hg.min]) than in controls (62.2 +/- 9.7 ml/[hg.min]). Regionally, there were significant increases of F in tumor periphery and brain around tumor, but not in tumor center or any tumor-free brain regions. Focal values of F less than 5 ml/(hg.min) were present in some necrotic regions of adenosine-treated tumors. These results, obtained in unanesthetized rats with transplanted gliomas from a human cell line, confirm our earlier observations in avian sarcoma virus-induced brain sarcomas in dogs, and suggest that adenosine or perhaps other vasodilators could be used to selectively increase the delivery of lipid-soluble chemotherapeutic drugs to brain tumors. PMID- 3683880 TI - Intermittent negative pressure ventilation in the treatment of respiratory failure in progressive neuromuscular disease. AB - Five men with degenerative neuromuscular diseases (three with amyotrophic lateral sclerosis [ALS] and two with Duchenne's muscular dystrophy [DMD]) who had respiratory failure were treated with intermittent negative pressure ventilation (NPV). One patient with ALS in severe acute respiratory failure was successfully treated with NPV alone. This patient and two other ALS patients in chronic respiratory failure with PaCO2 elevation stabilized or improved their vital capacity (VC) and lowered their PaCO2 after 5 to 11 weeks of therapy. Finally, intermittent NPV was used to replace 24-hour positive pressure ventilation in two patients with DMD. It is concluded that intermittent NPV may stabilize or temporarily improve the respiratory status in patients with progressive neuromuscular diseases. PMID- 3683882 TI - From the National SSPE registry. PMID- 3683881 TI - Automatic respiratory failure: sleep studies and Leigh's disease (case report). AB - A 34-year-old woman with a history of chronic nephropathy, kidney transplant rejections, and repeated hemodialysis developed symptoms of automatic respiratory failure during all states of sleep. The neuropathologic examination revealed symmetric brainstem lesions, explaining the sleep-related respiratory failure. Histology affirmed the diagnosis of Leigh's disease. PMID- 3683883 TI - Intraventricular alpha 2b interferon for SSPE. PMID- 3683884 TI - Transient neurologic deficit as a presentation of tuberculosis of the central nervous system. PMID- 3683885 TI - CSF IgG synthesis rate in multiple sclerosis. PMID- 3683886 TI - AIDS encephalomyelitis. PMID- 3683887 TI - Cervical root stimulation. PMID- 3683888 TI - Nicotine and CNS. PMID- 3683889 TI - Amaurosis fugax and thrombocythemia. PMID- 3683890 TI - EEG monitoring. PMID- 3683891 TI - Transient global amnesia. PMID- 3683893 TI - [Diabetes mellitus and myocardial infarct in the elderly: role of the age factor]. PMID- 3683892 TI - [Value and limitations of echocardiography in the diagnosis of primary and secondary dilated cardiomyopathies]. PMID- 3683894 TI - [Acute myocardial infarct: value of the doses of analgesic required on the in hospital prognosis]. PMID- 3683895 TI - [Angina pectoris with angiographically normal coronaries: a heterogenous syndrome]. PMID- 3683896 TI - [Aortic insufficiency associated with mitral prolapse]. PMID- 3683897 TI - [Prolapse of the mitral valve in the interatrial defect of the ostium secundum type. Hemodynamic considerations]. PMID- 3683898 TI - [Mycotic aneurysms. Description of a case of pseudoaneurysm of the thoracic aorta in systemic candidiasis]. PMID- 3683899 TI - [75 cases of obstruction of the juxtarenal aorta]. PMID- 3683900 TI - [Current status of medical and surgical therapy of ulcer]. PMID- 3683901 TI - [Proceedings. The International Congress of the Italian Section of the International College of Surgeons and the 4th National Seminar on Technics in Surgery. Cortina d'Ampezzo, 30 January-1 February 1986]. PMID- 3683902 TI - [Endoscopic evaluation of gastric and duodenal peptic ulcer]. PMID- 3683903 TI - [Current status of the medical therapy of gastric and duodenal ulcer]. PMID- 3683904 TI - [The monitoring of the gastrectomized patient]. PMID- 3683905 TI - [Surveillance of gastric ulcer and associated lesions]. PMID- 3683906 TI - [Reinterventions in patients operated on for gastric and duodenal ulcer]. PMID- 3683907 TI - [Use of a metoclopramide-carbenoxolone combination in duodenal reflux pathology]. PMID- 3683908 TI - [Gastro-esophageal reflux disease: indications and limitations of surgical interventions]. PMID- 3683909 TI - [Surgical therapy of duodeno-gastric reflux (primary and postoperative)]. PMID- 3683910 TI - [Morpho-functional aspects of isoperistaltic Billroth II by the Moynihan method studied with HIDA-Tc 99m]. PMID- 3683911 TI - [HIDA imaging in the morpho-functional study of anastomosis by the Roux method after partial and total gastric excision]. PMID- 3683912 TI - [Iatrogenic vascular injuries]. PMID- 3683913 TI - [Enucleation and hypothermia of a synchronous renal carcinoma in a subject with a single kidney after previous nephrectomy for adenocarcinoma]. PMID- 3683914 TI - [Reconstructive surgery of the vena cava]. PMID- 3683915 TI - [Traumatic arterial lesions of the arm]. PMID- 3683916 TI - [Vascular injuries caused by stab wounds]. PMID- 3683917 TI - [Traumatic lesions of the extremities. Findings on the importance of a multidisciplinary intervention]. PMID- 3683918 TI - [Changes in the therapy of cancer of the esophagus]. PMID- 3683919 TI - [Neoplasms of the left colon]. PMID- 3683920 TI - [Prognostic significance and therapeutic strategy of the loco-regional recurrence of breast carcinoma]. PMID- 3683921 TI - [Neoplasms of the pancreas and periampullar region. Results of surgical treatment]. PMID- 3683922 TI - [Our experience on the subject of bronchial adenomas]. PMID- 3683923 TI - [Biomarkers in the control of the treatment of gastrointestinal carcinomas]. PMID- 3683924 TI - [Follow-up of colorectal neoplasms: use of TPA]. PMID- 3683925 TI - [Prognostic role of telethermography in breast cancer]. PMID- 3683926 TI - [Primary lymphomas of the stomach]. PMID- 3683927 TI - [Carcinoma of the breast in elderly women]. PMID- 3683928 TI - [A new access route to neoplasms of the medio-distal rectum]. PMID- 3683929 TI - [The Hartmann intervention in carcinoma of the rectum]. PMID- 3683930 TI - [A case of synchronous tumor of the colon]. PMID- 3683931 TI - [Ambulatory surgery, in local anesthesia, of stomal pathologies]. PMID- 3683933 TI - [Local recurrence following radical intervention for neoplasm of the sigmoid and rectum]. PMID- 3683932 TI - [Initial evaluation of a follow-up program in surgically treated colorectal cancer]. PMID- 3683934 TI - [Gastric carcinoma. The "in principle" adoption of total gastrectomy is conditioned to the individualization of prognostic factors]. PMID- 3683935 TI - [Ambulatory oncologic surgery. Experience in a general hospital]. PMID- 3683936 TI - [Tumors of the stomach. Is the increase in occurrence of the non-epithelial forms real or merely relative to the effective decrease of cases of adenocarcinoma?]. PMID- 3683937 TI - [Conservative surgery of tumors of the lung]. PMID- 3683938 TI - Femoral artery pressure criteria in the assessment of the aorto-iliac segment obtained by means of a receiver operator characteristic curve analysis. AB - The hemodynamic importance of aorto-iliac arteriosclerotic obstructive disease is hard to assess when multiple level lesions are present. Therefore, direct blood pressure measurement in the femoral artery during increased blood flow is a promising technique. Criteria for aorto-iliac disease could be defined by means of a retrospective study in which preoperative blood pressure parameters were compared with the results of arterial reconstruction. These criteria were then prospectively assessed as to their value in the diagnosis of hemodynamically significant aorto-iliac disease. As in the retrospective study, results of arterial reconstructions, and not angiography, were used as the gold standard for the blood pressure criteria. The criteria appeared to be 95 percent accurate, 95 percent specific and 95 percent sensitive in the detection of significant aorto iliac lesions when multiple level disease is present. The positive predictive value and the negative predictive value were both 95 percent. The method is described in detail and reference is made to other studies with similar good results. PMID- 3683939 TI - Abdominal pain as a first symptom of iliac vein thrombosis. AB - Two patients are described with abdominal pain as a first symptom of primary iliac vein thrombosis. This phenomenon can be regarded to be analogous to the calf tenderness when thrombosis arises from the venous sinusoids in the calf muscles which is the usual localisation. When one is aware of this clinical entity, thrombotic occlusion will be recognized as the cause of the complaints, instead of being regarded to be a complication of another, yet unknown disease. PMID- 3683940 TI - Infectious complications of simultaneously inserted central venous and pulmonary artery catheters. AB - Infectious complications associated with simultaneously inserted pulmonary artery and central venous catheters via the same internal jugular vein were studied prospectively in 622 patients undergoing open-heart surgery under cephalothin prophylaxis. Successful insertion of the catheters was achieved in 650 (98.3%) of 661 attempts, while puncture complications occurred in 51 (8.2%) patients. One (0.2%) patient developed a local infection and 24 (3.9%) patients had one or more positive catheter-tip cultures without complications related to the positive cultures. Patients with puncture complications had no significantly different incidence of positive tip cultures. The incidence of positive catheter-tip cultures for pulmonary artery and central venous catheters was 2.6% and 1.7% respectively. Monitoring with a pulmonary artery and central venous catheter inserted via the same internal jugular vein is associated with a low rate of infectious complications. PMID- 3683941 TI - The carcinoid of the intestine. AB - From 1956 to 1985, 38 patients with a carcinoid of the intestine were treated. Tumours originating from the duodenum, ileum and colon had the worst prognosis. Fourteen out of 15 patients showed lymph-node metastases, and eight liver secondaries. Metastatic spread was rare (9%) if the primary tumour was small or an incidental finding (appendix). Even with metastatic spread there may be a longer survival due to the slow growth pattern of carcinoid metastases, which often become manifest several years after resection of the primary tumour. Metachronous liver metastases should be considered for surgical resection. Three of the 38 patients suffered from a carcinoid syndrome. PMID- 3683942 TI - Indications and results of osteosynthesis by plate fixation of femoral shaft fractures in children. AB - In a group of 316 children with 318 femoral shaft fractures, 28 had been treated operatively (8.8%). Twenty children treated with plate-osteosynthesis came for follow-up. The indications for operation were polytrauma (6 X), unacceptable position after conservative treatment (6 X), severe head injury (3 X), serial fractures of the same limb (3 X) and open fractures (2 X). The average follow-up after trauma was four years and six months. Direct postoperative complications were a transient peroneal nerve palsy and a broken plate. In 17 children the difference in leg length was less than or equal to 1 cm. One boy with serial fractures of the same limb had an overgrowth of 3.3 cm and problems during walking. CONCLUSION: plate-osteosynthesis was a good method of treatment in this study on 20 children with femoral fractures and accompanying complicating conditions. PMID- 3683943 TI - Glomus tumors of the digits. AB - A painful subungual tumor in a digit with a cold intolerance is characteristic of a glomus tumor. Lack of recognition often unnecessarily delays therapy. Surgical excision, utilizing an operating microscope for identification of tumor vascularisation and tourniquet control is the therapy of choice. Multiple tumors may be present in the same digit. No malignant transformation of the tumor has been described. PMID- 3683944 TI - Tension pneumoperitoneum, an unusual complication of perforation of the stomach. PMID- 3683945 TI - Surgical treatment of cholecystosis--report of 43 patients and review of the literature. AB - The results of cholecystectomy have been studied in a series of 43 patients with pain suggestive of biliary origin in the absence of gallstones. The most probable diagnosis in these cases is cholecystosis of the gallbladder usually to be ascertained by careful scrutiny of the gallbladder periphery on a good cholecystogram. Based on the present results and those reported in the literature, cholecystectomy can be advocated as treatment of patients with adenomyomatosis and other forms of cholecystosis of the gallbladder. PMID- 3683946 TI - Tibial tuberosity fracture in adolescents--report of a case and review of the literature. AB - Avulsion fracture of the tibial tuberosity usually caused by sudden violent contraction of the quadriceps muscles is uncommon and predominantly occurs in adolescents. Illustrative is the case history of a 16-year old boy with an Ogden I-B avulsion fracture successfully treated by open reduction and internal screw fixation. In these cases, anatomic reduction should be the primary goal. In specific cases this can be achieved by closed reduction, however, usually open reduction and fixation is indicated. PMID- 3683947 TI - Shoulder injury caused by electric shock. AB - Shoulder injury and more in particular bilateral dislocation of the shoulder joint after electric shock is rare. Three patients are presented with dislocation and fracture of the shoulder and serious muscle contraction. After an accident involving electric current potential shoulder injuries should be considered. Early diagnosis improves the functional results of adequate treatment. PMID- 3683948 TI - An unusual cause of acute appendicitis. AB - A case is presented of a patient with a metastasis of cardia carcinoma to the appendix, causing acute appendicitis. Survey of the literature shows that metastasis to the appendix is very rare. When present, it is likely to be the cause of appendicitis by obstruction of the lumen. PMID- 3683949 TI - Saccular intrahepatic artery aneurysm. AB - A patient is presented with a bleeding intrahepatic artery saccular aneurysm. The patient had for years complained of intermittent abdominal pain and was admitted with acute colicky pain in the left upper abdomen, followed by acute severe anemia. She survived after ligation of the right hepatic artery and partial resection of the right liver lobe. The postoperative course was uneventful. These lesions are rare and the diagnosis and best methods of treatment are complicated. The classic triad-pain, obstructive jaundice and bleeding-occurs only in 33 percent of cases and is in general caused by trauma. Bleeding intrahepatic saccular aneurysms cause pain and anemia as primary symptoms. The success rate of operation is still low. A possible alternative to surgery is given by selective trans-catheter embolization. PMID- 3683951 TI - Abstracts of papers presented at the meeting of the Dutch Society for Vascular Surgery, a section of the Association of Surgeons of The Netherlands. Utrecht, 11 April 1987. PMID- 3683950 TI - A complication five years after wrapping of an abdominal aortic aneurysm. PMID- 3683952 TI - [Experience with regard to the use of plasmapheresis in pathologies of resuscitative importance]. AB - After a report on the basic techniques and clinical significance of plasmapheresis, personal experience of the application of the technique on 6 patients with various pathologies is described. The overall results were satisfactory. PMID- 3683953 TI - [A case of severe combined immunodeficiency]. AB - The case described presented notable problems of diagnosis and treatment. The rapid onset of a massive tumoral syndrome in an infant with bronchiolitis dramatically worsened the clinical picture and led to the infant's death, posing the problem of the forms of congenital immune deficiency that may be associated with various aplastic and dysplastic haemopoietic alterations. The possibilities of treating such early hyperacute cases are limited given the lack of knowledge about the effects of drugs in such young children and the rapid deterioration of the patient's condition. PMID- 3683954 TI - [Computerized management of the Chemico-Clinical and Microbiological Analysis Laboratory of U.S.S.L. No. 47 in Biella]. AB - The current degree of computerisation in the chemical, clinical and microbiological analysis laboratory in USL 47, Biella, is reported with a description of the system employed. Future plans for further computerisation are described with particular reference to the random acceptance of samples and the direct link-up of analysts that will further improve a situation that is already highly satisfactory. PMID- 3683955 TI - [Primary gastric non-Hodgkin's lymphomas. Presentation of 8 cases]. AB - Eight cases of primary gastric lymphomas encountered in a series of 164 cases of extranodal NHL are analysed. The clinical aspects, the modality of onset and diffusion of the lymphoma, its macroscopic and histopathological features and the different therapeutic approaches are discussed. In particular while the distinction between localised and diffuse forms remains valid, it is pointed out that it is not always possible to treat the former by gastric resection, the latter by chemotherapy. In fact the choice of treatment will often be influenced by the patient's age, the presence of a bulk disease, the inoperability of the lymphoma and its degree of malignancy. PMID- 3683956 TI - [The emergency service physician and acute abdominal pathology. Comparative study on 1500 cases]. AB - 1436 cases of recent abdominal pain encountered in the Casualty Department of Biella Hospital over 18 consecutive months are examined. The incidence of the various abdominal pathologies, the diagnostic and therapeutic procedures adopted in the first hours after admission and any differences between original diagnosis by the general practitioner of the First Aid post, diagnosis on admission and diagnosis on release from hospital are examined. PMID- 3683957 TI - [Hypothesis for a pre- and post-natal relationship between mother and child]. AB - The increasing interest in prenatal life triggered this study of the hypothetical possibilities of communication between mother and foetus. In this context, sound in the general sense is of capital importance since it permits the creation of an affective-cognitive bond between mother and child. The possibility of assessing this echographically adds extra interest to a problem that is already stimulating and open to a variety of horizons. PMID- 3683958 TI - [Scintigraphy of bone marrow for the evaluation of injuries caused by antiblastic radiotherapy]. AB - A nanocolloid marked with 99mTc was used to perform 100 bone marrow scintiscans in 72 patients given radiotherapy for tumours. The compound is taken up by the cells of the phagomonocytic system whose distribution in the bones is similar to that of the erythropoietic marrow. With doses over 30 Gy a more or less marked reduction in captation by the marrow involved in radiation was always noted. The damage remains even for years after radiation, though recovery is possible especially in young patients given moderate doses of up to 40-45 Gy. Bone marrow scintigraphy using a nanocolloid is noninvasive and inexpensive, involves only tiny radiation doses and appears to be useful in the study of cancer patients subjected to radiation treatment either alone or in combination with chemotherapy. PMID- 3683959 TI - [Aspecific granulomatous prostatitis. Our experience]. AB - The clinical and anatomopathological features of 7 personally observed cases of granulomatous prostatitis are described. The possibility of confusion between this pathology and cancer of the prostate is pointed out. This is particularly the case when the entire gland is inflammed and only bioptic examination will confirm the diagnosis. The symptoms mostly related to the cervicourethral obstruction, the diagnostic procedure and the treatment, prevalently medical, adopted in each are described. PMID- 3683960 TI - [Evaluation of the efficacy of cefoperazone sodium in the treatment of infections in intensive therapy]. AB - The efficacy and tolerability of Cefoperazone sodium in the treatment of infections primarily of the lower respiratory and/or urinary tract were assessed. The drug was given to 16 intensive care patients encountered over a period of a few months. The results appear to be satisfactory and suggest that the drug is suitable for use in the treatment of intensive care infections. PMID- 3683961 TI - [Relation of the psychotherapist to the general practitioner]. AB - The paper is divided into two parts. The first briefly examines the way patients react to distress and to the therapist. Common therapist attitudes to patients are then examined. The network of support the depressed patient should be surrounded by is then described as is the directive role to be played by the therapist. The second part presents cases of depression personally treated in collaboration with the patient's GP and family. The paper ends with a brief assessment of the attempt to combine the prescription of drugs, instruction to the doctor and the use of short advisory and autogenous psychotherapy session. PMID- 3683962 TI - [Activity of psychiatric consultation in the D.E.A. of the hospital of Biella in the 4-year period 1-15-83/1-15-87]. AB - The paper analyses the work of the psychiatrist in Biella Hospital D.E.A. between 15-1-83 and 15-1-87. The general outlines of the study are described under Material and Method. This is followed by a description of the way patients arrive at the D.E.A. during which it is pointed out that both the general practitioner and the local psychiatric service are generally excluded from the emergency circuit. The reasons for the emergency, the diagnosis arrived at and the types of treatment proposed by the psychiatrist are then reviewed. One section is dedicated to recurrences with particular emphasis on the so-called major users of the psychiatric emergency service. PMID- 3683963 TI - [Serum ferritin in the evaluation of iron metabolism in pregnancy]. PMID- 3683964 TI - [Histocompatibility antigens and gestosis]. PMID- 3683965 TI - [A case of fibroma of the recto-vaginal septum]. PMID- 3683966 TI - [Effect of ovariectomy on bone mass. Transverse study using photon densitometry]. PMID- 3683967 TI - [Axillary exenteration in cancer of the breast. Notes on surgical technic]. PMID- 3683968 TI - [Cervical dysplasias. Comparative study of the cytological picture, anatomo pathologic and age stage]. PMID- 3683969 TI - [Relations of life environment and work and pregnancy. Preliminary results of a transverse epidemiologic study]. PMID- 3683970 TI - [Evaluation of complications caused by intrauterine devices]. PMID- 3683971 TI - [Instability of the detrusor muscle and urethral hypermotility]. PMID- 3683972 TI - Growth of neural transplants in rats: effects of initial volume, growth potential, and fresh vs frozen tissues. AB - Interactions between growth potential (as related to the age of donor embryos and type of tissue), initial volume, and fresh vs frozen conditions of neural transplants were studied in rats. Neural tissues with high growth potential (16 day gestation neocortical tissue) when used fresh yielded the best growth of the transplants, which was positively related to the initial volume of the tissue. At the other extreme, neural tissues with very low growth potential when used following their freezing and thawing yielded the poorest results. Changes in the initial volume of transplants did not seem to improve the final growth. Combination of these variables in between these two extremes yielded transplants of variable sizes. PMID- 3683973 TI - Cholinergic neurons in the rat nodose ganglia. AB - Presence of acetylcholine (ACh) in the vagal afferent fibres of the rat was investigated. In the nodose ganglion, which contains the cell bodies of this sensitive contingent, a choline acetyltransferase (ChAT) activity, a choline (Ch) uptake and an endogenous content of acetylcholine were detected. These data were confirmed by ChAT immunohistological visualization. PMID- 3683974 TI - A direct neural projection from the nucleus of the solitary tract to the subfornical organ in the rat. AB - A direct neuronal projection from the nucleus of the solitary tract (NTS) to the subfornical organ (SFO) in rats was demonstrated using the Phaseolus vulgaris leucoagglutinin (PHA-L) anterograde tracing technique. Small deposits of PHA-L were iontophoretically placed within the caudal parts of the nucleus of the solitary tract. Brain sections were processed for visualization of PHA-L using the avidin-biotin immunoperoxidase technique. PHA-L immunoreactive beaded axons were observed within the subependymal and central parts of the SFO. The results demonstrate an anatomical substrate for direct feedback from cardiovascular regions of the NTS to the SFO. This pathway may be important for relaying blood pressure and associated body fluid volume changes to the SFO. PMID- 3683975 TI - Exposure to calcium-free medium protects sensory fibers by capsaicin desensitization. AB - Capsaicin (1 microM) produces a tetrodotoxin-resistant contraction of the rat isolated urinary bladder ascribable to neuropeptide release from sensory nerves. A second application of capsaicin (1-10 microM) up to 5 h from the first one was ineffective, indicating complete desensitization. However, if the first exposure to capsaicin was made after a prolonged incubation in a Ca-free medium containing EDTA (0.1 mM), a second application of capsaicin (1 microM) was still able to induce a contraction, thus indicating protection from desensitization. PMID- 3683976 TI - High concentration of cholecystokinin neurons in the newborn human entorhinal cortex. AB - Numerous cholecystokinin (CCK)-immunoreactive cells are detected in the newborn human entorhinal cortex. They are located essentially in layer II and in the superficial part of layer III. Their shape and size indicate that they are interneurons. Most of them are vertically oriented and have beaded processes reaching layer I and the deep part of layer III. The cell type most frequently observed are bipolar cells with an ovoid cell body measuring 8-10 microns across and 15 microns in length. No CCK immunoreactivity is seen in the large stellate and pyramidal cells. PMID- 3683977 TI - Electrical and chemical stimulations of the pontine micturition center. AB - In an acute decerebrate cat, electrical stimulation of the pontine micturition center (PMC) resulted in micturition. Carbachol injection into the PMC also resulted in micturition. The pattern of changes in bladder pressure and the sphincter activity observed during carbachol-induced micturition was almost identical to that observed during reflex micturition. The injection site corresponded to the nucleus locus coeruleus alpha (LC alpha). These results suggest that activation of cholinoceptive neurons in the LC alpha presumably becomes a trigger to recruit any one of a number of neuronal circuits involved in micturition. PMID- 3683978 TI - Dorsal root ganglion neurons with central processes in both dorsal and ventral roots in rats. AB - Axonal transport of fluorescent dyes, Diamidino yellow dihydrochloride (DY) and Fast blue (FB), applied to the cut distal ends of dorsal and ventral roots, respectively, was studied in order to determine whether any dorsal root ganglion (DRG) neurons have processes in both dorsal and ventral roots. A total of 359 DRG neurons are double labeled in 14 ganglia (L6 and S1) from 6 different animals, thus suggesting a possibility of many DRG neurons having multiple central processes. The somata of the double-labeled DRG neurons are small to medium in size with a mean diameter of 29 microns. These data are consistent with findings that the majority of ventral root afferent fibers are unmyelinated or small myelinated axons. PMID- 3683979 TI - The catecholamine uptake inhibitor nomifensine depresses impulse activity of dopamine neurons in mouse substantia nigra. AB - Systemic administration of the catecholamine uptake inhibitor nomifensine (NOM) in doses of 20-36 mg/kg strongly depressed the discharge rate of dopamine (DA) neurons in the substantia nigra of mice for more than 2-3 h. This effect was fully reverted by the systemically administered DA receptor antagonist haloperidol. Impulse activity of most neurons showed a reduced rhythmicity under the influence of NOM, as assessed by autocorrelograms. It is suggested that the depression of discharge activity of DA neurons by NOM represents an indirect agonist action on the DA receptor, probably via reduced elimination of DA from the extraneuronal space. PMID- 3683980 TI - Systemically administered adenosine increases caudate blood flow in rabbits. AB - Adenosine has been proposed to be a chemical link between cerebral metabolism and blood flow. In the present study, we investigated whether the intravenous or intracarotid administration of adenosine could influence regional cerebral blood flow in anesthetized rabbits. The study was performed with the [14C]ethanol tissue sampling technique which enables quantitative, instantaneous, multiregional blood flow measurements. With either mode of adenosine administration, no change in cerebral blood flow was observed, except in the caudate nucleus in which a significant vasodilation took place. These data indicate that, in rabbits exogenous adenosine increases blood flow in highly specific brain areas, by mechanisms that are discussed. PMID- 3683981 TI - Magnetic responses of the trigeminal nerve system of the bobolink (Dolichonyx oryzivorus). AB - Extracellular recordings using glass microelectrodes were made from the ophthalmic and supraorbital nerves of a transequatorial migratory bird, the bobolink. The rate of electrical activity was modified in 15% of the spontaneously active units by earth-strength alterations of the horizontal or vertical component of the ambient magnetic field using box coils. Responses to magnetic stimulation included augmentation or inhibition of spontaneous activity, or an ON-OFF or OFF response. Responses to magnetic stimulation were also recorded from the optic tectum and the pineal gland. The responses of the trigeminal system are probably independent of the visual system and indicate the presence of two separate magnetic receptor systems in one avian species. The responses from the trigeminal receptor may involve magnetite for transduction of magnetic field information. PMID- 3683982 TI - Natural seric anti-fatty acid antibodies in multiple sclerosis. AB - Naturally occurring anti-oleic acid conjugate antibodies were detected in human sera using an adapted direct immunoenzymatic assay. They were present to a higher level in the sera of patients with multiple sclerosis in acute relapse compared to patients with other neurological diseases or healthy subjects and even patients with multiple sclerosis in progressive form. PMID- 3683983 TI - Ultrastructural demonstration that melanin-concentrating hormone-like and alpha melanocyte-stimulating hormone-like immunoreactive molecules coexist in the same neurosecretory granules. AB - Using immunocytochemical methods at the electron microscope level, immunoreactivity for both melanin-concentrating hormone (MCH) and alpha melanocyte-stimulating hormone (alpha-MSH) has been demonstrated in the carp neurohypophysis. A double-labelling technique, using colloidal gold probes of different sizes showed that immunoreactivity to both molecules coexists within the same neurosecretory granules in some neurones, while in other neurones the granules exhibit only MCH-like immunoreactivity. These observations suggest that the two immunoreactivities are attributable to separate molecules; if they are derived from the same precursor molecule, then this must be cleaved differently in the two sets of neurones. The absence of adrenocorticotropic hormone (ACTH) like immunostaining in any neurosecretory granule might suggest the alpha-MSH like molecule is not derived from the conventional pro-opiomelanocortin precursor. PMID- 3683984 TI - Intrathecal vasoactive intestinal polypeptide modulates spinal reflex excitability primarily to cutaneous thermal stimuli in rats. AB - The effect of intrathecally (i.t.) injected vasoactive intestinal polypeptide (VIP) on spinal nocifensive flexor reflex excitability was examined in decerebrate, spinalized, unanesthetized rats. The hamstring reflex was evoked by intense cutaneous mechanical or thermal stimulation of the ipsilateral foot. I.t. VIP increased the excitability of the spinal cord to thermal much more than to mechanical stimuli. It is suggested that this neuropeptide is released by thermosensitive cutaneous afferents that respond poorly to mechanical stimuli. PMID- 3683985 TI - Levels of prodynorphin mRNA in rat dentate gyrus are decreased during hippocampal kindling. AB - The effect of hippocampal kindling on the levels of prodynorphin mRNA in rat hippocampus was examined by in situ hybridization using a synthetic oligonucleotide probe. Cryostat tissue sections were hybridised with a 32P labelled 100 mer DNA probe complementary to the coding region of rat prodynorphin mRNA, and exposed to X-ray film. In rats exhibiting stage 4 seizures, the levels of prodynorphin mRNA in the dentate gyrus were dramatically reduced compared to control animals. This suggests that the development of kindling is accompanied by a reduction in the rate of synthesis of peptides derived from prodynorphin. PMID- 3683986 TI - The electrophysiological effects of nicotine in the rat cerebellum: evidence for direct postsynaptic actions. AB - The agonistic actions of nicotine in the cerebellum were dependent on the type of cerebellar neuron studied. Purkinje cells were inhibited and cerebellar interneurons were excited by pressure-ejected nicotine. The simultaneous iontophoresis of Mg2+ failed to block nicotine agonistic actions on either cell type. Since Mg2+ reduces presynaptic release of neurotransmitters, our findings suggest that the pharmacological actions of nicotine on cerebellar neurons are due to direct postsynaptic mechanisms. PMID- 3683987 TI - Prevention of an increase in susceptibility to calcium in a neuroblastoma cell line. AB - An increase in susceptibility of neuroblastoma cells to calcium was inhibited when the cells were treated with hypothermia, diphenylhydantoin, chlorpromazine or pentobarbital; all of these treatments affect membrane permeability to calcium or membrane-associated cell metabolism. Diphenylhydantoin and chlorpromazine were found to have positive effects only when they were administered before the addition of calcium. This was in contrast to flunarizine, which showed a protective effect only in combination with calcium. However, leupeptin did not show any positive effect, indicating that calcium-activated neutral protease may be only slightly involved in this type of calcium-induced cell damage. PMID- 3683988 TI - Hyperprolactinemia reduces vasoactive intestinal peptide in the anterior pituitary glands of rats. AB - The concentration of vasoactive intestinal polypeptide (VIP) in the anterior pituitary gland of female rats was significantly reduced by pituitary implants, prolactin-secreting tumours or dopamine blockade-induced hyperprolactinemia. Oestradiol implants increased plasma prolactin (PRL) to 12 times and increased pituitary VIP to 3.5 times that of controls after one week. The dopamine agonist bromocriptine significantly reduced pituitary VIP at doses within the clinically used range. These results provide evidence for a suppressive effect of plasma PRL on pituitary VIP, which may be effected by a dopaminergic mechanism, but is over ridden by oestrogen. PMID- 3683990 TI - Delayed spontaneous alternation in Purkinje cell degeneration mutant mice. AB - Purkinje cell degeneration (pcd) mutant mice lose cerebellar Purkinje cells. It was found that pcd mice, contrary to normal mice, did not alternate spontaneously at any of 3 inter-trial intervals (15 s, 3 or 6 min). Deficits in spontaneous alternation are typical of animals with brain damage in areas important in spatial learning. Results are discussed in terms of a role for the cerebellum in spatially mediated behavior and behavioral inhibition. PMID- 3683989 TI - Plasma concentration of acetylcholine in young women. AB - A sensitive and specific radioimmunoassay was applied to the determination of acetylcholine (ACh) in plasma. The concentration of ACh in plasma sampled from 32 young women was 456.1 +/- 53.1 (mean +/- S.E.M.) pg/ml. No significant correlations were observed between plasma concentration of ACh and acetylcholinesterase (AChE) activity, or gonadal hormones. These data demonstrate that an amount of ACh measurable by radioimmunoassay is present in plasma and plasma ACh is not regulated by AChE activity and the menstrual cycle in young women. The origin and physiological as well as pathophysiological significance of ACh in plasma remain to be clarified. PMID- 3683991 TI - Putting master's programs to the test. PMID- 3683992 TI - Decision-making tool homes in on program performance. PMID- 3683993 TI - Building success on success stories. PMID- 3683994 TI - Balancing wishes with wisdom: sustaining infant life. PMID- 3683995 TI - Using television to teach. PMID- 3683996 TI - Costs of nursing services: are the assumptions valid? PMID- 3683997 TI - A comparison between salaries of nurses and other professionals in hospitals. PMID- 3683998 TI - Comparable worth: litigation and legislation. PMID- 3683999 TI - Financial equity for nurses. PMID- 3684000 TI - From salary measurement to equity measurement through uniform data reporting. PMID- 3684001 TI - Conflict and resolution: strikes in nursing. PMID- 3684002 TI - Maximizing the use of the clinical nurse specialist as consultant. PMID- 3684003 TI - Preparing nurse executives for financial management. PMID- 3684004 TI - Determining the cost and value of nursing. PMID- 3684005 TI - Should men be actively recruited into nursing? PMID- 3684006 TI - Regional differences in the cat caudate nucleus as to the effectiveness in inducing contraversive head-turning by electrical stimulation. AB - An attempt was made to re-examine regional differences in the cat caudate nucleus as to the effectiveness in inducing contraversive head-turning by electrical stimulation and to analyze the time course of head-turning quantitatively. In 5 of the total 9 cats, the right sensorimotor cortex and its surrounding areas had been ablated chronically. While the awake, unrestrained cat maintained a stable standing posture facing forward, stimulation was applied systematically to various points in and around the caudate nucleus with a movable stimulating electrode. Trains of stimulating current pulses of less than 300 microA were given, mostly at a rate of 100 Hz for 5 s. In most experiments in which stimulation was given to the side of the intact cerebral cortex, stimulation of caudal portions of the head of the caudate nucleus was effective in inducing contraversive head-turning, but that of its rostral portions was ineffective. In experiments on the side of chronic cortical ablation, similar results were obtained. These results suggested that head-turning induced by stimulation of the caudate nucleus was brought about not by the activation of the corticofugal fibers from these cortical areas by a current spreading to the internal capsule, but by the activation of caudate neurons. Hence, it was demonstrated that there were regional differences in the cat caudate nucleus as to the effectiveness in inducing head-turning. The mean of the shortest latencies of the onset of head turning for individual stimulation points was 396 ms (S.D., 210 ms) for the side of the intact cerebral cortex, and 454 ms (S.D., 289 ms) for the side of the cortical ablation. Statistically, there was no significant difference between them. Therefore, it was further revealed that the elimination of the sensorimotor cortex did not affect the caudate-induced head-turning in terms of the latency of its onset. PMID- 3684007 TI - Proactive marketing in nursing education. PMID- 3684008 TI - Faculty as primary nurses on a model inpatient unit. PMID- 3684009 TI - Formula funding: an approach to financing nursing schools. PMID- 3684010 TI - Strategies for ensuring a successful curriculum consultation. PMID- 3684011 TI - Faculty sabbatical. PMID- 3684012 TI - Teaching i.v. therapy: getting closer to reality. PMID- 3684013 TI - International nursing: guidelines for core content. PMID- 3684014 TI - A strategy for teaching communication. PMID- 3684015 TI - Learning to develop a curriculum can be fun. PMID- 3684016 TI - Nursing service and education--winners! PMID- 3684018 TI - The student as a consumer of nursing research. PMID- 3684017 TI - Quality assurance: a process for teaching the concept. PMID- 3684019 TI - Managing your academic career: what is a dean? If I knew then what I know now. Part I. PMID- 3684020 TI - Solution may be diet and antifungal therapy. PMID- 3684021 TI - Diagnosis and management of acute bronchitis and pneumonia in the ambulatory setting. AB - Acute bronchitis and pneumonia are frequently encountered by primary care providers in an outpatient setting. The primary care nurse practitioner plays an active role in the diagnosis and management of acute bronchitis and pneumonia. Certain elements of the history and physical examination help separate infectious causes of acute cough from non-infectious causes. If an infectious cause is established by etiology, history and physical factors also help to identify whether acute bronchitis or pneumonia is present. Certain diagnostic tests are necessary to aid in making the diagnosis and in establishing the causative agent upon which the appropriate therapy is based. The primary care nurse practitioner must also be attuned to identifying those clients in whom respiratory illness can be a severe syndrome necessitating hospitalization and those for whom vaccination is recommended. This article addresses the practice needs of the clinician. PMID- 3684022 TI - Protocol for administration and management of chrysotherapy (gold therapy). AB - Rheumatoid arthritis is a chronic, systemic inflammatory disease, characterized by polyarticular inflammation, joint destruction, deformity and loss of function. Chrysotherapy is indicated in documented cases of rheumatoid arthritis in which other methods of treatment including rest, physical therapy, analgesics and non steroidal anti-inflammatories have failed. Clinical guidelines for the administration and management of chrysotherapy are presented for the nurse practitioner providing care for patients in which gold therapy has been prescribed by a rheumatologist. Careful initial assessment, follow-up and education are necessary for the effective treatment of patients receiving gold therapy. PMID- 3684023 TI - Vietnam vet exposure to Agent Orange. PMID- 3684024 TI - Myths & facts about nosocomial infections. PMID- 3684025 TI - Another look. PMID- 3684026 TI - CO poisoning. Action stat! PMID- 3684027 TI - Recognizing the multisystemic effects of embolism (continuing education credit). PMID- 3684028 TI - Turf wars: time for a truce? PMID- 3684029 TI - A man alone--and afraid: caring for a patient with Guillain-Barre syndrome. Nursing grand rounds. PMID- 3684030 TI - Take the first step toward reducing medication errors. PMID- 3684031 TI - Catheter-related U.T.I.s: what's the best way to prevent them? PMID- 3684032 TI - Venous blood samples: sharpen your drawing skills. PMID- 3684033 TI - Lessons learned from a lawsuit. PMID- 3684035 TI - Human sexuality: an introduction. PMID- 3684034 TI - The gift. PMID- 3684036 TI - Overview of human sexuality. PMID- 3684037 TI - Communication. PMID- 3684038 TI - Sexual problems and their treatment. PMID- 3684040 TI - Drugs and sexual function. PMID- 3684039 TI - Prejudice, differences and deviations. PMID- 3684041 TI - AIDS in psychiatry. PMID- 3684042 TI - Immunization of travellers in Oxfordshire. PMID- 3684044 TI - What's it like to be an infection control practitioner? PMID- 3684043 TI - Injection equipment. PMID- 3684045 TI - Going back to school: learning to balance your priorities. PMID- 3684046 TI - The nursing shortage: how it's helping us. PMID- 3684047 TI - Death & dying. PMID- 3684048 TI - The perils of "shop talk". PMID- 3684049 TI - Understaffing: do you know all your legal risks? PMID- 3684050 TI - When Dr. Scott appeared we tried to disappear. PMID- 3684051 TI - Good & mad: making anger work for you. PMID- 3684052 TI - Time crunch: how one nurse avoids the squeeze. PMID- 3684053 TI - How informed are you about consents? PMID- 3684054 TI - Diary of a hospice nurse. PMID- 3684055 TI - Unmasking depression (continuing education credit). PMID- 3684057 TI - An hypothesis about redundancy and reliability in the brains of higher species: analogies with genes, internal organs, and engineering systems. AB - The phenomena of behavioral resistance to massive brain damage and behavioral recovery from brain damage suggest there is redundancy in neural tissue. This paper uses basic concepts from probability theory and reliability engineering, as a first step toward more rigorously establishing the plausibility of the redundancy hypothesis. Exponential effects in the relevant formulas lead to results that are intuitively surprising. Thus, within a broad range of parametric assumptions related to lifespan and number of neurons or neural subsystems, it appears that the human brain may be at least twice as large as it would have to be for short-term survival. Simple reliability models suggest that redundancies are in parallel connections of smallest subsystems, such as individual neurons. Other implications of the basic formulas concern the relation between backed-up subsystem reliability and lifetime usage frequency for each subsystem, and the evolution of approximately equal allocation of lifetime reliability among components of a system. In addition, the paper briefly reviews more complex reliability engineering approaches. Redundancy as a reason for neural mass action is compared to other theoretical reasons for mass action in sensorimotor function and learning. Relationships of the present hypothesis to other theories of recovery from brain damage and to theories of regressive trophic phenomena in ontogeny are briefly discussed; it is suggested that as stages of ontogeny progress, both redundancy and flexibility in simpler behavioral functions are traded away for a larger, more differentiated repertoire of complex functions and memories. PMID- 3684056 TI - The problem of probable cause. PMID- 3684058 TI - Daytime sleepiness: quantification of a behavioral state. AB - A neurophysiological technique that quantifies drowsiness as the speed of falling asleep at intervals across a day is used to identify patterns of sleepiness/alertness. The Multiple Sleep Latency Test (MSLT) reveals a daily biphasic organization of sleepiness that is affected in predictable ways by the length and continuity of nocturnal sleep on one or several nights, and by maturation, aging, sleep pathology, and drug ingestion. The systematic nature of these relationships provides impetus to efforts examining the neurobiological mechanisms subserving the delicate balance of sleep and wakefulness. PMID- 3684059 TI - Effect of excess intracranial amino acids on memory: a behavioural survey. AB - Nineteen naturally occurring amino acids were administered intracranially to day old chicks at various times before and after a single trial passive avoidance learning task. The results suggest a consistent and simple difference between essential and non-essential amino acids. Except for arginine, phenylalanine, tryptophan and tyrosine, the essential amino acids had no effect on memory formation when administered 5 min before or immediately after learning. However, arginine, phenylalanine and tryptophan yielded amnesia after 60 min following learning, when given between 5 min before and 2.5 min after learning. In the case of tryptophan, amnesia was only temporary, lasting from 60 min to 240 min post learning. All non-essential amino acids, when administered between 5 min before and 5 min after learning yielded amnesia by 60 min post-learning, with no evidence of recovery by 24 hr post-learning. Alanine-, asparagine-, cysteine- and glutamate-treated chicks, however, showed signs of generalized avoidance shortly after administration. The retention time courses after injection of glutamine, proline, serine and taurine were similar to that obtained with the non metabolizable amino acid alpha-amino-isobutyric acid, and amnesia arising from administration of these amino acids was counteracted by diphenylhydantoin, as was amnesia induced by phenylalanine and tyrosine. The retention function obtained with tryptophan was similar to that obtained with 5-hydroxytryptamine, and DPH had no effect on the action of tryptophan or the actions of arginine, alanine or asparagine. The findings were interpreted in the context of a three-stage model of memory formation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3684060 TI - [The liver's meandering]. PMID- 3684061 TI - [Geriatrics]. PMID- 3684062 TI - [Occupational deafness and rehabilitation. Two nurses at work]. PMID- 3684063 TI - [The monitoring of nursing care. A nurse's obligation]. PMID- 3684064 TI - A tempting trap for the nurses. PMID- 3684065 TI - [Choosing abortion]. PMID- 3684066 TI - [Self evaluation: what nurses say]. PMID- 3684067 TI - Cot death: what's being done about it?. Interview by Christine Andrews. PMID- 3684068 TI - Cot deaths. Monitoring at home. PMID- 3684069 TI - Cot deaths. Just a breath away. PMID- 3684070 TI - Cot deaths. Can home monitors prevent cot death? PMID- 3684071 TI - Cot deaths. Under hospital control. PMID- 3684073 TI - Involuntary hospitalisation. PMID- 3684072 TI - Hazards to nurses. PMID- 3684074 TI - Sense and sensitivity. PMID- 3684075 TI - Assessment + diagnosis = care planning: a tool for coordination. PMID- 3684076 TI - Is enough, enough? PMID- 3684077 TI - Orientation: graduates' perception of initiation. PMID- 3684079 TI - Situational Leadership for nurses. PMID- 3684078 TI - Management committees make dynamic units. PMID- 3684080 TI - Effect of a written nurse/patient contract on the practice of primary nursing. PMID- 3684081 TI - Developing "participative leaders". PMID- 3684082 TI - Managing conflict in hospitals. PMID- 3684083 TI - Release with love. PMID- 3684084 TI - Board of Nursing has authority to establish standards for programs. PMID- 3684085 TI - Documentation evaluation system: streamlining quality of care and personnel evaluations. PMID- 3684086 TI - Verbal abuse in nursing: report of a study. PMID- 3684087 TI - Medical day care: outpatient services with a personal touch. PMID- 3684088 TI - Hospital nurses as entrepreneurs. PMID- 3684089 TI - Employment setting barriers to professional actualization in nursing. PMID- 3684090 TI - Role development for the nurse midwifery director and for the clinical nursing director. PMID- 3684091 TI - Face-to-face contacts: exploring their meaning. PMID- 3684092 TI - ICON I--the future model. ICON II--the transition model. PMID- 3684094 TI - The health care industry ... is nursing management missing the mark? PMID- 3684095 TI - Morale: management's mirror. PMID- 3684093 TI - Emergency department care: many perceptions. PMID- 3684096 TI - Orientation: the critical period. PMID- 3684097 TI - Modular nursing: nurses rediscover nursing. PMID- 3684098 TI - The random walk function in the analysis of time-activity curves from dynamic radionuclide studies. AB - The random walk function is a mathematical function derived from studies of the mass transport and flow of diffusible materials through tubes. Approximations to the function were first used some time ago in the field of cardiac tracer dilution curves, but in the absence of rapid and reproducible curve fitting the method never became commonplace. The current study uses the latest curve-fitting techniques and shows how the method may be used with precision in the analysis of time-activity curves from dynamic oesophageal and blood flow studies. The physiological basis of the method is given and parameters obtained which relate to both the rate of flow and the local dispersion of the bolus. PMID- 3684099 TI - The influence of glucose on the myocardial time-activity curve during 17-iodo-123 heptadecanoic acid scintigraphy. AB - The lipid pools of the heart (i.e. the triglyceride and phospholipid pool) participate in the free fatty acid metabolism. The degree of involvement, for instance will be determined by the available substrate in the blood. Scintigraphy with 17-iodo-123 heptadecanoic acid was performed to study free fatty acid kinetics in the normal human myocardium during control and glucose infusion (n = 9). In both situations the derived time-activity curves, measured during a period of 75 min, obeyed a monoexponential plus a constant curve fitting [A(t) = A(o)exp(-tln2/T1/2)+C]. During glucose infusion the half-time values did not change but the lipid storage increased in favour of the oxidation pool. In the three protocols used, hypoglycaemic responses were observed, therefore these protocols cannot be advocated. PMID- 3684100 TI - Phagocytosis and dynamic RES scintigraphy: an evaluation of commercial colloids in rats. AB - Reticuloendothelial system (RES) phagocytic function or capacity can be measured by clearance studies with test substances. This study in the rat examines three commercially available 99Tcm-labelled test substances, and different methods of calculating RES capacity. Albures size 500 nm and sulphur colloid size 600 nm used for liver scintigraphic imaging and Nanocoll size 50 nm used for bone-marrow scintigraphic imaging were tested. The rats were examined under a gamma camera and the uptake by the liver, clearance from the heart and clearance from blood samples were recorded. Different amounts of substances were tested. The final uptake in different organs was recorded after the animals were sacrificed. Colloid size and stability were tested with a polycarbonate filter. (Nanocoll was found to have at least 10 times smaller colloid diameter, leading to a thousand times more particles per milligram). RES function was calculated as the uptake rate or clearance rate, k. In a logarithmic plot, the relationship between uptake or clearance and time was found to be linear between 90 and 300s and calculations of k in this interval are recommended. k-values selected from blood sample curves were 11 +/- 5 S.E.M. lower than those calculated from heart clearance curves or liver uptake curves. Increasing amounts of Nanocoll caused a decrease in uptake rate k. Albures and sulphur colloid could not be given in amounts that caused any change in k. Only Nanocoll could be given in sufficiently large amounts (above the critical dose) to challenge RES and avoid complete extraction from the circulation during first passage through RE organs. Nanocoll seems suitable for use in tests of RES function and the optimal amount was 0.03 mg per rat (0.6 X 10(12) particles). PMID- 3684101 TI - 99Tcm-MDP uptake by lymph nodes following tracer infiltration: clinical and laboratory evaluation. AB - Uptake of bone scanning agents in non-osseous sites has been described in a variety of pathologic conditions including tumor metastases. We have seen several patients in which such uptake was proximal and ipsilateral to the injection site of 99Tcm-methylene diphosphonate, apparently in normal lymph nodes. To further investigate this phenomenon, it was studied in a rat model. Activity in popliteal nodes ipsilateral to the injection site was over 60-fold greater in the animals that received subcutaneous (s.q.) footpad injection compared to femoral IV injection. Ipsilateral popliteal node activity in the s.q. group was 159 times that of contralateral popliteal nodes, with an ipsilateral node to liver ratio of 184:1. In summary, dramatically increased uptake of 99Tcm-MDP in normal lymph nodes ipsilateral and proximal to an extravasated injection has been demonstrated. An awareness of this phenomenon in the clinical setting can avoid confusion with pathologic forms of soft tissue uptake. PMID- 3684102 TI - Measurement of right ventricular volumes from ECG-gated steady-state krypton-81m angiocardiography. AB - The physical characteristics of krypton-81m makes it particularly suited for the study of right ventricular function, but its ultrashort half-life (13.3 s) precludes in vitro measurements of blood pool specific activity needed for count based determination of ventricular volumes. A combined geometric count based method was developed to measure absolute right ventricular volumes during steady state krypton-81m angiocardiography: background corrected ventricular count rates were converted to volumes using a count to volume calibration factor calculated in an 'internal reference ROI' located in the right ventricular outflow tract. Stroke volumes calculated with this method were shown to be comparable to thermodilution determined stroke volumes and the ability of the method to monitor changes in right ventricular volumes was demonstrated during intervention studies. PMID- 3684103 TI - Automated processing of first-pass radionuclide angiocardiography by factor analysis of dynamic structures. AB - A method for automatic processing of cardiac first-pass radionuclide study is presented. This technique, factor analysis of dynamic structures (FADS) provides an automatic separation of anatomical structures according to their different temporal behaviour, even if they are superimposed. FADS has been applied to 76 studies. A description of factor patterns obtained in various pathological categories is presented. FADS provides easy diagnosis of shunts and tricuspid insufficiency. Quantitative information derived from the factors (cardiac output and mean transit time) were compared to those obtained by the region of interest method. Using FADS, a higher correlation with cardiac catheterization was found for cardiac output calculation. Thus compared to the ROI method, FADS presents obvious advantages: a good separation of overlapping cardiac chambers is obtained; this operator independant method provides more objective and reproducible results. A number of parameters of the cardio-pulmonary function can be assessed by first-pass radionuclide angiocardiography (RNA) [1,2]. Usually, they are calculated using time-activity curves (TAC) from regions of interest (ROI) drawn on the cardiac chambers and the lungs. This method has two main drawbacks: (1) the lack of inter and intra-observers reproducibility; (2) the problem of crosstalk which affects the evaluation of the cardio-pulmonary performance. The crosstalk on planar imaging is due to anatomical superimposition of the cardiac chambers and lungs. The activity measured in any ROI is the sum of the activity in several organs and 'decontamination' of the TAC cannot easily be performed using the ROI method [3]. Factor analysis of dynamic structures (FADS) [4,5] can solve the two problems mentioned above. It provides an automatic separation of anatomical structures according to their different temporal behaviour, even if they are superimposed. The resulting factors are estimates of the time evolution of the activity in each structure (underlying physiological components), and the associated factor images are estimates of the spatial distribution of each factor. The aim of this study was to assess the reliability of FADS in first pass RNA and compare the results to those obtained by the ROI method which is generally considered as the routine procedure. PMID- 3684104 TI - Detection of intracavitary masses on gated scans: a phantom study. AB - A series of 1.5, 2.0 and 3.0 cm diameter paraffin balls were placed on a 3 cm tether within a simulated left ventricular balloon phantom to determine the maximal balloon volume that permitted identification of the lesion. When images were recorded with the phantom stationary, the lesions could be detected at 100, 280 and 360 ml volumes, respectively. When the phantom was set in motion with a fixed 80 ml stroke volume, the lesions were detected at 120, 320 and 360 ml, respectively. These findings suggest that gating does not decrease lesion detection even when the lesion is freely mobile, and a 1.5 cm lesion would be difficult to detect in an enlarged ventricle, but 2 and 3 cm lesions could be detected even in the presence of moderate ventricular enlargement. PMID- 3684105 TI - Measurement of lung volume with 81Krm in a dynamic scintigram. AB - The meaning of 81Krm counts obtained in a dynamic series of gated lung ventilation scans was evaluated in terms of flow rate, lung volume, or the flow/volume ratio. Flow and volume signals were recorded together with scintigraphic events in 29 subjects breathing 81Krm and after its decay, 127Xe as a tracer of lung volume. Gated ventilation scans and respiratory signals were reconstructed. Statistical analyses were carried out for linear regressions between total normalized counts detected by the gamma camera and (1) flow rate, (2) lung volume and (3) flow/volume ratio. Inspiration and expiration were analysed separately. For both isotopes, the best correlation was obtained between counts and lung volume (r greater than 0.93). No correlation was obtained between counts and flow rate or flow/volume ratio. Thus, we conclude that 81Krm count variations in gated scans correlate well with tidal volume. PMID- 3684106 TI - Monitoring radiation dose to the hands in nuclear medicine: location of dosemeters. AB - The relatively high radiation dose which can be received by the hands of staff in nuclear medicine departments means that in many departments it is necessary to monitor such doses. A convenient method is to use a TLD sachet in a plastic strip around a finger. This study was done to determine whether a dosemeter worn at the base of the middle finger was adequate to monitor the dose to the surface of the whole hand. Dosemeters were worn at the finger tips, finger base and palm of both hands, on two people while preparing and dispensing radio-pharmaceuticals, and two others while giving injections using syringe shields. The pattern of distribution of radiation does to the hands was similar for all workers and for both types of work. A single, convenient site (base of middle finger) may therefore be used for monitoring radiation dose to the hand. PMID- 3684107 TI - Bone mineral measurements in neonates. PMID- 3684108 TI - The clinical application of cerebral blood flow. December 12th 1986. Institute of Nuclear Medicine, Silver Jubilee meeting. London. Proceedings. PMID- 3684109 TI - Hevesy memorial medal lecture 1985 (September 4th, 1985). Some call it laziness: I call it deep thought (with apologies to Garfield). PMID- 3684110 TI - Micturition detection switch. AB - Micturating renograms often need to be carried out on children, with whom difficulty may be experienced in synchronizing onset of micturition with camera and computer acquisition. A flow detection system has been developed which will automate these acquisitions, resulting in far fewer false starts or lost studies. The unit was developed specifically for the camera/computer system in our department (IGE 400T and DEC 11/34) but with only minor modifications would be suitable for interfacing to other equipment. It is a free standing unit which requires no modifications of the camera or computer circuitry apart from access to the remote start buttons. PMID- 3684111 TI - Optimizing selection of in vitro tests for diagnosing thyroid disorders. AB - The optimal utilization of the thyroid related radioimmunoassays T3, T4, and TSH RIA is derived from analysing the clinical and laboratory data for 974 patients with functional thyroid disorders. A statistical computer analysis of the contribution of each of the three tests, and in combination, to the final diagnoses of hypothyroid, euthyroid, and hyper thyroid states was designed. The best contributing test for hypothyroidism and euthyroidism was TSH-RIA (98.5 and 93%, respectively). T4/T3 + TSH-RIAs were the optimal dual combination for diagnosing euthyroidism (98.0%). For diagnosing hyperthyroidism T4-RIA was the best single test (82.5%) followed by T3 + T4 as an optimal dual combination (95%). Using all three tests was of no significant additional value over dual combinations. It is concluded that the work and cost of randomly performing three tests routinely is not justified without clinical basis. An algorithm is proposed to guide thyroid studies based on computer analyses of the above-mentioned single or dual-test combinations to establish accurate diagnosis at the lowest laboratory cost. PMID- 3684112 TI - Percutaneous nephrostomy: current indications and potential uses in obstetrics and gynecology. Literature review and report of a case. AB - Percutaneous nephrostomy offers a rapid and relatively safe means of short- or long-term management of urinary obstruction, irrespective of the underlying cause. It is particularly useful in patients who cannot undergo general anesthesia or surgery because of potential major risks. At present, the most common indication for percutaneous nephrostomy in OB/GYN is probably urinary tract obstruction secondary to pelvic malignancy. It is not indicated in terminal patients, but can be used to temporize renal function to allow palliative therapy and to assess the residual functional capacity of the obstructed kidney. Percutaneous nephrostomy will most likely be used even more frequently in the future as current roles are expanded particularly in areas such as perinatology. PMID- 3684113 TI - Ectopic pregnancy mortality in the United States, 1970-1983. AB - Ectopic pregnancy is now the second leading cause of maternal mortality in the United States. We describe changes in ectopic pregnancy mortality and characterize the risk of death from ectopic pregnancy for different groups, using ectopic pregnancy deaths identified by the national Vital Statistics System for 1970-1983, ectopic pregnancy-related deaths investigated by the Centers for Disease Control for 1979-1982, and ectopic pregnancy cases estimated from the National Hospital Discharge Survey for 1970-1983. During both 1970-1976 and 1977 1983, women of black and other races were at significantly increased risk of death from ectopic pregnancy compared with white women. This increased risk held for all ages and all geographic regions. Little variation existed in the risk of death from ectopic pregnancy by age and geographic region. From 1970-1983, the risk of death from ectopic pregnancy declined among all races and ages in all regions. These data suggest that black women, and in particular teenagers and older women, may have inadequate access to gynecologic and prenatal services. Active outreach may reduce the risk of death from ectopic pregnancy. PMID- 3684114 TI - The contralateral corpus luteum and tubal pregnancy. AB - One hundred fourteen cases of tubal pregnancy were examined for evidence of active or chronic salpingitis, other anatomic and functional etiologies, and the side of the corpus luteum relative to the pregnancy. A corpus luteum was found ipsilateral to the tubal pregnancy in 80 cases (70%) and contralateral in 18 (16%). In 16 cases (14%), the position of the corpus luteum could not be identified by inspection. No differences were noted among the groups in days from last normal menstrual period or the incidence of irregular bleeding. Of the 98 cases in which a corpus luteum was identified, 53 women (54%) had at least one condition that could be considered etiologic for tubal pregnancy, including 38 (39%) who had microscopic evidence of chronic salpingitis. No association was found between the laterality of the corpus luteum and the presence of risk factors, including mechanical factors. Possible explanations for absent corpora lutea in association with tubal pregnancies are discussed. PMID- 3684115 TI - Fetal deaths in Alabama, 1974-1983: a birth weight-specific analysis. AB - Birth weight-specific fetal death rates were evaluated for Alabama for the years 1974-1983. The fetal death rate for the total low birth weight group improved less than 20% during the decade, whereas the fetal death rate for the 2500-3999-g birth weight group improved 40%, and the fetal death rate for the group of 4000 g or more improved 71%. By 1983, 76% of all stillbirths weighed less than 2500 g, compared with 66% in 1974. In contrast, in both years, only about 7% of live births weighed less than 2500 g. This study suggests that increased reporting of stillbirths of less than 500 g has contributed to the recent apparent lack of improvement in stillbirth rates in Alabama. PMID- 3684116 TI - Comparison of three wash techniques for the removal of microorganisms from semen. AB - The objective of this study was to compare the effectiveness of three sperm separation techniques for producing samples free of seminal fluid microbes. Each of 11 semen samples were separated by the following techniques: wash, with centrifugation only; swim-up, with undiluted semen layered beneath medium; and wash and swim-up, with centrifuged sperm cells overlain with medium. Microbiology for both aerobic and anaerobic organisms of semen and washes was determined by standard methods. The microbes isolated from semen were similar to those found in previous reports. However, the swim-up technique proved more successful than either the wash or the wash and swim-up methods for the recovery of sterile spermatozoa (ten of 11 versus four of 11, P less than .05). It is recommended that the swim-up technique, with medium supplemented with penicillin and streptomycin, be used when preparing sperm samples for placement into the female reproductive tract. PMID- 3684117 TI - An evaluation of the Gore-Tex surgical membrane for the prevention of postoperative peritoneal adhesions. AB - The Gore-Tex surgical membrane, expanded polytetrafluoroethylene, has been used as a pericardial graft with minimal adhesion formation reported. The purpose of this study was to assess its efficacy as a barrier method for diminishing postoperative peritoneal adhesions in an animal model. Fifteen New Zealand white rabbits underwent laparotomy, with scrape and cut lesions created bilaterally on the uterine body and horns, respectively. On one side, the lesions were covered with the graft using 7-0 Gore-Tex suture; the contralateral side served as an internal control. After four weeks, the adhesions were graded and mean adhesion scores were calculated. The Gore-Tex score was 4.1 times higher than the control for scrape lesions and 1.9 times higher for cut lesions, but the difference was not statistically significant in either case. Overall, the Gore-Tex mean adhesion score was 2.3 times higher than the control, a statistically significant difference. The Gore-Tex surgical membrane did not appear to be an effective adjuvant for postoperative adhesion prophylaxis in this animal model. PMID- 3684118 TI - Increased concentrations of arachidonic acid lipoxygenase metabolites in amniotic fluid during parturition. AB - This study was undertaken to examine whether spontaneous labor at term is associated with changes in the amniotic fluid concentrations of arachidonate lipoxygenase metabolites. Amniotic fluid was obtained from 15 women at term in active labor (with cervical dilatation of at least 6 cm) and from 15 nonlaboring control women matched for maternal age, parity, and gestational age. Cultures of amniotic fluid for bacteria and mycoplasma were negative. Products of arachidonate lipoxygenase metabolism--12-hydroxyeicosatetraenoic acid (12-HETE), 15-hydroxyeicosatetraenoic acid (15-HETE), and leukotriene B4--were measured by radioimmunoassay. The median concentrations of 12-HETE, 15-HETE, and leukotriene B4 in the amniotic fluid of nonlaboring women were 11.50 ng/mL, 0.45 ng/mL, and 21 pg/mL, respectively, and in the amniotic fluid of laboring women, 24.63 ng/mL, 4.34 ng/mL, and 96 pg/mL, respectively. The differences between labor and nonlabor amniotic fluid concentrations of all three lipoxygenase products were significant (P less than .05, Wilcoxon test). These observations are consistent with involvement of products of the lipoxygenase pathway of arachidonic acid metabolism in the mechanism of human parturition. PMID- 3684119 TI - Circadian incidence of labor onset hour in preterm birth and chorioamnionitis. AB - Normal labor begins most frequently between midnight and 2 AM, presumably because of an unidentified circadian labor-activating mechanism. We used records of the Collaborative Perinatal Project to determine whether such a circadian mechanism is present with intrauterine growth retardation (IUGR) or preterm birth, and whether chorioamnionitis is associated with alternative patterns. In the absence of chorioamnionitis, both preterm births and term births with IUGR demonstrated nocturnal labor onset distributions like those of control term deliveries, which had a peak incidence at 1:45 AM and an amplitude of 35%. With chorioamnionitis, in contrast, there was a different circadian distribution of term labor onset hour, with a peak at 7:45 PM and a 32% amplitude. A similar trend was found among preterm births. These data suggest the presence of the normal nocturnal labor activating mechanism in both growth-retarded term deliveries and a defined subset of preterm deliveries. Chorioamnionitis appears to be associated with a prominent, unidentified alternative labor-activating mechanism that is maximal in the evening. PMID- 3684120 TI - Histologic chorioamnionitis in pregnancies of various gestational ages: implications in preterm rupture of membranes. AB - A retrospective review of placental material derived primarily from preterm deliveries was conducted and inflammatory changes graded on a scale of 0-3. Reviewers were blind as to the clinical outcomes. Other reviewers, unaware of the pathologic results, surveyed the clinical data, and results were combined for analysis. The findings suggest that placental and membrane inflammation probably precedes preterm spontaneous rupture of membranes in 8-30% of cases without labor. The duration of ruptured membranes and labor enhance the frequency of inflammation. Inflammation is not associated with significant puerperal infection unless cesarean delivery occurs. Perinatal morbidity and mortality were not significantly enhanced nor associated with conservative management of spontaneous preterm rupture of membranes in this population beyond the influence of fetal weight and gestational age. PMID- 3684122 TI - Bromocriptine in an injectable retard form for puerperal lactation suppression: comparison with Estandron prolongatum. AB - Intramuscular injection of a single 50-mg dose of long-acting bromocriptine microspheres was compared with a single intramuscular dose of an estradiol/testosterone ester combination in a single-blind, randomized study of 54 subjects. Bromocriptine was significantly more effective than the steroid drug in preventing milk flow, and rebound lactation was not observed in any bromocriptine-treated patients. Neither group showed deleterious side effects or significant biologic changes in coagulation parameters. There were no blood pressure or electrocardiographic alterations. Postpartum prolactin suppression was more intense after bromocriptine administration than after steroid therapy. PMID- 3684121 TI - A comparison of intrapartum versus immediate postpartum treatment of intra amniotic infection. AB - There are no reported randomized trials to determine the ideal timing of antibiotic treatment for intra-amniotic infection. We evaluated the effect of intrapartum versus immediate postpartum treatment of intra-amniotic infection on maternal and neonatal morbidity and mortality. Two hundred fifty-seven women with clinically diagnosed intra-amniotic infection who had amniotic fluid cultures were evaluated. Patients received treatment with penicillin and gentamicin, but the timing of the treatment was determined at the physician's discretion. Most patients (82%) received intrapartum treatment; the remaining women (18%), mainly those with an anticipated short interval before delivery, received the same antibiotics immediately postpartum. As expected, the postpartum treatment group had a significantly shorter diagnosis-to-delivery interval (1.9 +/- 2.1 versus 4.7 +/- 4.3 hours; P less than .001) and a lower maximum temperature during labor (100.8 +/- 0.7 versus 101.0 +/- 0.8F; P = .038). The two treatment groups did not differ in distribution of low birth weight infants, frequency of maternal bacteremia, mode of delivery, or organisms isolated from the amniotic fluid. There were no differences in maternal outcome, but the incidence of neonatal sepsis was significantly lower in the intrapartum treatment group (2.8 versus 19.6%; P less than .001). Neonatal mortality from sepsis was also lower in the intrapartum treatment group (0.9 versus 4.3%), but this difference was not statistically significant. The reduced frequency of neonatal septicemia observed in the intrapartum-treated group might reflect early intrauterine therapy for the infected fetus. PMID- 3684123 TI - Serum prolactin levels during contraction stress test done by the breast pump. AB - Maternal serum prolactin (PRL) levels were evaluated in patients having contraction stress tests (CST) by nipple stimulation. Of 79 CSTs, 14 failed and 65 were successful. Poststimulation PRL levels in failed cases were significantly lower than those in gestational age-matched successful cases, despite longer duration of nipple stimulation in the failed cases. PMID- 3684124 TI - Nutrition and hydration: relationship to preterm myometrial contractility. AB - Although the mechanisms responsible for the onset of preterm labor in human pregnancy are unclear, animal studies have demonstrated that decreased nutrient intake is associated with increased uterine prostaglandin F metabolite production and spontaneous uterine contractions. The purpose of this study was to assess the association of maternal nutrition and dehydration with preterm uterine contractility. Pregravid weight-for-height, pregnancy weight gain at 30 weeks' gestation, urine specific gravity, ketonuria, and dependent and generalized edema were measured in 30 women who had preterm uterine contractions and in 30 women matched for race, gestational age, socioeconomic status, and smoking who reported no symptoms of preterm contractility. Data were analyzed with the paired difference t test, Fisher's exact test, and the Cochran-Mantel-Haenszel test. No statistical association was found for dehydration (high urine specific gravity) and preterm contractility. However, pregravid weight below standard body weight for-height was statistically associated with preterm contractions (P less than .001), as was low weight gain at 30 weeks' gestation (P = .04). There was an association between preterm contractions and both ketonuria (P less than .0001) and the absence of edema (P = .02). Inexpensive clinical measurements of nutritional status may help to identify women at risk for preterm uterine contractility. PMID- 3684125 TI - The influence of intravenous solution content on ritodrine-induced metabolic changes. AB - To examine the influence of intravenous (IV) solution content on ritodrine induced metabolic changes, 25 patients treated with various IV solutions were studied before and after a bolus of fluid, and during IV drug therapy, for the effect of hematocrit, pH, lactate, glucose, and electrolyte concentrations. Results were viewed on a mg/kg/minute ritodrine dosage basis. Dextrose-containing fluids caused a significant elevation of glucose after bolus therapy, and 5% dextrose in water also significantly altered lactate and potassium levels. Dextrose enhanced drug-mediated changes in potassium, sodium, chloride, pH, and lactate. The CO2 content dropped in all patients, regardless of IV content. The best IV solution would appear to be plain lactated Ringer's, and the least desirable, 5% dextrose in water. PMID- 3684126 TI - External cephalic version at term: is a tocolytic necessary? AB - This prospective investigation evaluates the benefit of a beta-mimetic tocolytic for external cephalic version. From July 1, 1984 to May 15, 1987, 58 patients who had breech presentations between 37-41 weeks' gestation were considered for external cephalic version. The patients were randomly assigned to one of two groups: tocolytic or no tocolytic. An ultrasound examination, serum alpha fetoprotein (AFP), Kleihauer-Betke test, and nonstress test (NST) were performed before and after the attempt at version. A version was not attempted if there was evidence of intrauterine growth retardation (IUGR), oligohydramnios, or a nonreactive NST. Patients in the tocolytic group received 200 micrograms/minute of ritodrine hydrochloride for 20 minutes via continuous intravenous infusion before a version was attempted. Twenty of the 30 patients (66.7%) in the tocolytic group and 19 of the 28 patients (67.8%) in the no-tocolytic group had successful versions, a nonsignificant difference. The nine patients with unsuccessful version attempts in the group without a tocolytic then received intravenous ritodrine and underwent a second attempt. Only one of these nine attempts was successful. There were no serious maternal or fetal complications associated with the attempts at version. In our patient population, use of a tocolytic did not significantly increase the probability of a successful version. PMID- 3684127 TI - Low prevalence of Toxoplasma infection in a Rocky Mountain prenatal population. AB - Congenital toxoplasmosis is rarely diagnosed in Colorado. To better determine whether this was the result of under-reporting or a valid observation, the sera of 120 consecutive prenatal patients from a lower-income clinic population were tested for antibodies to Toxoplasma gondii. Four of the patients had positive Sabin-Feldman dye tests, for a 3% incidence of past infection. None had immunoglobulin M (IgM) antibody. This rate is considerably lower than that in other populations, perhaps because the high-altitude, arid environment shortens oocyst survival in soil. A questionnaire designed to detect risk factors for Toxoplasma infection, such as exposure to cats or undercooked meat, did not indicate any differences between the antibody-positive and antibody-negative groups. PMID- 3684128 TI - Bladder training after surgery for stress urinary incontinence: is it necessary? AB - Eighty-nine consecutive patients with a clinically and urodynamically proved diagnosis of genuine stress urinary incontinence entered this study. Forty women had a revised Pereyra procedure and 49 had a Burch retropubic urethropexy. All had a suprapubic Bonnano catheter for postoperative bladder drainage. Postoperatively, patients were randomly allocated to "bladder training" (N = 44) or "nonbladder training" (N = 45) protocols. "Bladder training" consisted of scheduled clamping and unclamping of the catheter, whereas the "nonbladder training" patients had continuous bladder drainage throughout their postoperative period. Postvoiding residual urine volume was measured twice daily after the patient had voided with a symptomatically full bladder. The catheter was removed once residual volume was 50 mL or less. The bladder training protocol had no effect on resumption of spontaneous voiding after surgery. There was no significant change in length of postoperative bladder catheterization or in urinary tract infection rate among women with or without bladder training. PMID- 3684129 TI - Radical hysterectomy as surgical salvage therapy for gynecologic malignancy. AB - Fourteen patients with recurrent or second primary gynecologic malignancies after pelvic irradiation underwent radical hysterectomy as surgical salvage therapy. Six patients had microscopic regional metastatic disease at the time of surgery. All of these patients died of recurrent tumor. Overall disease-free actuarial survival at five years was 27%; excluding patients with regional metastatic disease, five-year survival was 54%. Complications requiring subsequent major surgical intervention occurred in 29% of patients. There appears to be a limited role for radical hysterectomy as surgical salvage therapy in patients with centrally limited invasive disease after pelvic irradiation. PMID- 3684131 TI - An assessment of pathologic features and treatment modalities in ovarian tumors of low malignant potential. AB - Sixty-eight patients with epithelial ovarian tumors of low malignant potential treated at the University of Michigan Medical Center were reviewed for clinical and pathologic features related to recurrence or death. The ovarian tumor of low malignant potential represented 12.6% of all ovarian cancers and 22% of all serous or mucinous tumors. Thirty-four patients were stage I (50%), 13 were stage II (19%), 17 were stage III (25%), two patients could not be staged, and two patients developed ovarian tumor of low malignant potential in a residual ovary. The risk of recurrence was significantly related to stage III disease (P = .023), high nuclear atypia (P = .020), and high grade (P = .017); and was unrelated to capsular status, the presence of psammoma bodies, nucleoli, cribriform pattern, stratification, cystadenofibroma, tumor size, or spillage at surgery. Therapy in all stages included observation, chemotherapy, or radiotherapy. There was one recurrence in 47 patients with stages I-II, and 11 recurrences in 17 patients with stage III disease. The ovarian tumor of low malignant potential carries an extremely favorable prognosis in stage I and II regardless of therapy. Radiotherapy appeared to extend disease-free survival in stage III disease, and future randomized studies should consider this treatment modality. PMID- 3684130 TI - The significance of residual tumor after preoperative pelvic irradiation for stage II endometrial carcinoma. AB - The prognostic significance of residual endometrial carcinoma in the hysterectomy specimen after preoperative radiotherapy is controversial. Sixty-two patients with stage II endometrial carcinoma were treated with a standardized program of preoperative radiotherapy, followed in six weeks by an extrafascial hysterectomy. Twenty patients (32%) had no residual carcinoma in their hysterectomy specimens and 42 (68%) had residual carcinoma. There were no significant clinical, surgical, or pathologic differences between patients with or without residual carcinoma. Patients with no residual carcinoma had a 25% recurrence rate and a 53% actuarial five-year survival rate. Patients with residual carcinoma had a 21% recurrence rate and a 78% actuarial five-year survival rate. The presence of residual endometrial carcinoma in the hysterectomy specimen does not imply a compromised prognosis in patients with stage II endometrial carcinoma treated by the described method. PMID- 3684132 TI - Obstetrics and gynecology in the emergency room: a teaching opportunity. PMID- 3684133 TI - Autologous blood donation during pregnancy: analysis of safety and blood use. AB - Forty-eight women in the third trimester of pregnancy who requested autologous blood donations were enrolled in an experimental protocol to evaluate the safety of this procedure. Risk factors suggesting the possible need for postpartum transfusion were present in 17 women, including previous history of transfusion, scheduled cesarean section, placenta previa, and previous pregnancy-induced hypertension. Nine women were unable to meet donation criteria. Thirty-nine participants donated one to three units each. There was one vasovagal reaction among 61 donations. Fetal monitoring performed during each donation to assess cardiovascular and neurologic effects of maternal hypovolemia revealed no abnormalities. Three women with symptomatic postpartum anemias were transfused with autologous blood; two of these patients were identified antepartum as being at risk for possible transfusion. Autologous donation during pregnancy was safe for both mother and fetus. However, the likelihood of postpartum transfusion, while possibly predictable based on antepartum history, was low in this study. PMID- 3684134 TI - Measurement of fetal shoulder width with computed tomography in diabetic women. AB - We conducted a feasibility study of the use of computed tomography (CT) to measure the width of the fetal shoulders and to predict large birth weight in infants of diabetic mothers. Computed tomography pelvimetry using low-dose digital radiographs was performed before delivery at term in 22 diabetic women. Shoulder width was estimated by direct electronic measurement on a single axial section through the shoulders of the fetus, and by orthopedic calipers within 48 hours of birth. Shoulder width by CT was 11.4-16.5 cm, and correlated significantly with postnatal measurements (r = 0.66, P = .01). Shoulder width by CT also correlated well with birth weight (r = 0.84, P less than .01), and measured more than 14 cm in all seven infants with birth weights more than 4200 g. Using 14 cm as a positive test and birth weight 4200 g as an abnormal result, the predictive value of a positive test was 78% and the predictive value of a negative test was 100%. This technique deserves further evaluation in assessing the risk of shoulder dystocia in potentially macrosomic infants. PMID- 3684135 TI - Simultaneous colpo-recto-sacropexy. AB - The literature concerning coexisting massive genital and intussuscepting rectal prolapse is reviewed, two cases in point are presented, and the rationale for concurrent surgical management is offered. The technique of combined colporecto sacropexy is described in detail. PMID- 3684136 TI - Management of incurable urinary fistulas by percutaneous ureteral occlusion. AB - Women with large urinary tract fistulas in the presence of advanced incurable gynecologic cancer are a difficult problem. In the past, treatment has usually been either inadequate or highly morbid. We have palliated three women with large incurable urinary tract fistulas by occluding the distal ureters with isobutyl-2 cyanoacrylate (Bucrylate) and implanting permanent bilateral percutaneous nephrostomies. This technique is easily performed and effective, and has few complications. PMID- 3684138 TI - Reproductive outcome. PMID- 3684137 TI - Offshore medic training: a university initiative. PMID- 3684139 TI - Hazards to female reproduction. PMID- 3684140 TI - Women and chemicals. PMID- 3684142 TI - OH in the construction industry. PMID- 3684141 TI - Neighbourhood nursing--out of focus? PMID- 3684143 TI - OH nursing and the primary care team. PMID- 3684144 TI - Research and OH nurses. PMID- 3684145 TI - AIDS and counselling. PMID- 3684146 TI - COSHH. Rumour and reality. PMID- 3684147 TI - OH--'given rightful priority at last'. PMID- 3684148 TI - Policies assist health professionals in obtaining information from employees. PMID- 3684149 TI - Nurses have indispensable part in smooth health care operations. PMID- 3684150 TI - Health care coalitions, businesses assess costs for employees, insurers. PMID- 3684152 TI - Problems of mild brain injury victims now more recognized in workplace. PMID- 3684151 TI - Grain fumigation hazards invoke nationwide protective measures. PMID- 3684153 TI - Job modification relieves problems of head-injured persons at work. PMID- 3684154 TI - Technology blends computers, books for comparing protective materials. PMID- 3684155 TI - Semiconductor workers face unique health risk in manufacturing sector. PMID- 3684156 TI - Chemical toxicity damages liver; greatest danger is from inhalation. PMID- 3684157 TI - Hazmat protection improves with equipment documentation. PMID- 3684158 TI - Administration of hazardous waste reduces problems of compliance. PMID- 3684159 TI - Knowing air sampling methods helps hygienists choose proper equipment. PMID- 3684160 TI - Joint, several liability used to target companies responsible for toxic waste. PMID- 3684161 TI - Adequate first aid supplies, training can lessen effects of emergencies. PMID- 3684162 TI - Limb replantation most effective following proper emergency care. PMID- 3684163 TI - Oncology nurses: enablers of hope. PMID- 3684164 TI - Keeping a suicidal patient safe while hospitalized. PMID- 3684165 TI - Resurgence of rheumatic fever. PMID- 3684167 TI - The future of medical education: the view from the Dean's office. PMID- 3684166 TI - Ronald L. Fletcher, MD: a profile of Ohio's new health director. Interview by Deborah Athy. PMID- 3684168 TI - The future of medical education: a student's perspective. PMID- 3684169 TI - Reducing the stress of a medical education: two approaches. PMID- 3684170 TI - Continuing medical education--is it worth it? PMID- 3684171 TI - AIDS: recommendations & guidelines (Nov. 1982-Nov. 1986). Health-care workers and laboratory personnel. United States Department of Health and Human Services, Centers for Disease Control. PMID- 3684172 TI - Funding education after tax reform. PMID- 3684173 TI - High-dose cytosine arabinoside, daunomycin and 6-thioguanine in relapsed or refractory acute nonlymphocytic leukemia. AB - Fifteen patients with relapsed (10) or primarily refractory (5) acute nonlymphocytic leukemia were treated with a combination of cytosine arabinoside (3 g/m2 i.v. every 12 h, 12 doses, days 1-6), 6-thioguanine (100 mg/m2 orally every 12 h, 12 doses, days 1-6) and daunomycin (60 mg/m2 i.v. on days 5 and 6 only). Complete remission was achieved in 11 patients. Eight of 10 relapsed patients and 3 of 5 primarily refractory patients entered remission. Median remission duration was 7.5 months (2-36+ months). Ten of the 11 remissions resulted from a single induction course. The time to hematologic recovery was comparable to that seen with 'standard'-dose cytosine arabinoside regimens. Nonhematologic toxicity, although considerable, was not greater than that seen with high-dose cytosine arabinoside alone. The most significant problem was gastrointestinal toxicity with diarrhea occurring in the majority of patients. Mild neurologic toxicity (reversible cerebellar dysfunction) occurred in 2 patients. PMID- 3684174 TI - Hepatic acetylator polymorphism in breast cancer patients. AB - Hepatic acetylator phenotype has been determined, using sulfamethazine, in 81 white Spanish women with histologically proven breast cancer and in 75 adequate female controls. No differences were detected in the distribution of acetylator phenotype between the two groups of slow acetylators, 49 patients (60.5%) and 45 controls (60%). The percentage of acetylated sulfamethazine in plasma for each phenotype was not different either. Our results suggest that there is no relationship between the hepatic acetylator polymorphism and the risk of developing breast cancer in women. PMID- 3684175 TI - Correlation of breast tumour aromatase activity and response to aromatase inhibition with aminoglutethimide. AB - Tumour aromatase, oestrogen (E) and progesterone (P) receptor (R) measurements were carried out in biopsies from 29 patients with advanced or recurrent breast cancer. Patients were then treated with aminoglutethimide according to one of two dosage regimens: (a) aminoglutethimide 1000 mg/day + hydrocortisone 20 mg/day, and (b) aminoglutethimide 250 mg/day. Tumour aromatase values varied from 0.05 to 2.07 pmol ER produced/mg protein/h and ER and PR values from less than 1 to 249 and less than 1 to 132 fmol of steroid bound/mg protein, respectively. There was no correlation between aromatase values and either ER or PR and also no correlation between ER and PR and response to aminoglutethimide. Tumour aromatase values did however correlate with response to treatment. Mean aromatase levels for responders (1.18 +/- 0.64 pmol E produced/mg protein/h) were significantly higher than those of non-responders (0.34 +/- 0.27) (t = 5.20, DF 27; p less than 0.005). Ten out of fourteen patients with aromatase values greater than 0.5 pmol ER produced/mg protein/h responded, whereas 0 out of 15 patients with tumour aromatase values less than this responded. Responses were seen at both dosages of aminoglutethimide. It is concluded that tumour aromatisation will be a useful measurement in predicting response to aromatase inhibitors. PMID- 3684176 TI - Significance of plasma retinol binding protein levels in recurrence of breast tumors in women. AB - Plasma retinol-binding protein (RBP), prealbumin, vitamin A (total) and beta carotene levels were studied in premenopausal women with node-positive breast carcinoma receiving adjuvant chemotherapy. Plasma levels were measured prior to chemotherapy and at monthly intervals during the chemotherapy course. The results showed that significantly lower RBP levels during the course of the study were associated with early tumor recurrence. Patients who maintained a disease-free status for 24 months or longer had significantly higher plasma RBP levels than those who had tumor metastasis at distant sites within 24 months after beginning chemotherapy. RBP levels were not associated with adjuvant chemotherapy (CMF) induced hormonal changes (amenorrhea vs. no amenorrhea), or family history of breast cancer. In contrast, breast cancer patients with a prior history of benign breast disease had significantly lower RBP levels than did healthy, premenopausal women. Reduced RBP levels in these patients are due to neither an inadequate dietary intake of beta-carotene, nor to severe protein malnutrition. PMID- 3684177 TI - Effect of vitamin A compounds on DNA biosynthesis in murine tumor models in vitro. AB - The effect of vitamin A compounds on the DNA biosynthesis inhibition of murine ascites tumor models such as P388 lymphocytic leukemia, L1210 lymphoid leukemia, sarcoma 180 and Ehrlich ascites carcinoma was found to be concentration- and time dependent. The results of the experiments carried out in vitro for 4 h measured by the extent of 3H-thymidine incorporation into the DNA of these tumor cells permit us to conclude that (a) at the given concentration and time, the metabolic role of vitamin A compounds influences the regulation of processes leading to DNA biosynthesis inhibition; (b) the effect of vitamin A is uniform irrespective of tumor cells heterogeneity; (c) vitamin A does not affect transport of thymidine, and (d) the dose-dependent increase in the inhibition of these tumor cells by vitamin A is characterized by undifferentiated morphology showing uniformity in the given tumor cell population associated with a total lack of differentiation. PMID- 3684178 TI - Investigation of the procoagulant activity present in ascitic fluid and serum of mice bearing the Landschutz ascites carcinoma. AB - The direct procoagulant activity (PCA) of murine tumour cells was found to be more than three orders of magnitude greater than an equivalent concentration of either resident or Corynebacterium parvum-elicited, exudate peritoneal cells. Similarly, a soluble PCA was detected in the extracellular culture medium of only the tumour cells. Studies on the procoagulant nature of the serum and ascitic fluid of tumour-bearing animals suggested that the ascitic fluid may contain a unique PCA factor(s). This activity could not, however, be resolved from inherent procoagulant factors, either by gel filtration or ammonium sulphate fractionation, and a more specific assay for, say, a single enzymic reaction in the coagulation cascade would be required to identify the tumour-associated activity. PMID- 3684179 TI - Further studies of a transplantable rat pheochromocytoma. AB - Additional histopathological and immunocytological studies were completed on the serially transplanted Warren rat pheochromocytoma. Special efforts were made to characterize features of the primary tumor common to pheochromocytomas, as well as features of the primary tumor commonly found in neuroblastoma. In summary this study found evidence for a composite primary tumor exhibiting a dual differentiative expression of both pheochromocytoma and neuroblastoma. We feel this reflects a possibility that this primary tumor arose from a common progenitor cell in the neural crest. PMID- 3684180 TI - Factors influencing the toxicity of diethylaminoethylreserpine to tumor cells: studies with four transplantable tumors. AB - The toxicity of 1-[2-(diethylamino)ethyl]reserpine (DL-152) has been measured for 4 transplantable mouse tumors. DL-152 was found to be toxic to cells of all the tumor models tested (KHT fibrosarcoma, RIF-1 fibrosarcoma, EMT-6 adenocarcinoma and Lewis lung carcinoma) when the drug was given by intraperitoneal injection to the tumor-bearing mouse and cell survival was measured by excision assay. For the KHT tumor, hypoxic cells were found to be more sensitive to the drug in vivo than were aerated cells, and a similar response to hypoxia was observed in vitro, suggesting that sensitization occurred at the cellular level. Neither EMT-6 nor RIF-1 tumors showed increased sensitivity to the drug when cells were exposed under hypoxic conditions in vivo or in vitro. However, when the response of aerated cells of the 3 tumors was compared, the relative sensitivities for tumors exposed in vivo did not show the same ranking as the results of in vitro toxicity assays. This difference in in vitro and in vivo response in the different tumor models did not appear to be related to pharmacokinetic factors since the maximum tissue concentration and the rate of clearance of the drug were similar for all the tumors studied. PMID- 3684182 TI - Postoperative astigmatism using the McIntyre needle. AB - We performed 30 consecutive cataract extractions using two different needle types to assess postoperative astigmatism. In each case, we used a standard corneal incision followed by an extracapsular cataract extraction and the insertion of a posterior chamber intraocular lens. The incisions in group A were closed with the McIntyre needle and in group B with a standard curve needle. We compared the postoperative astigmatism in each group with sutures in at 3 weeks, and when removed selectively by 12 weeks, and found no significant difference. PMID- 3684181 TI - Enlargement of melanocytic iris lesions. AB - We evaluated the natural history of 175 melanocytic lesions (nevus or melanoma) of the iris which were managed initially by observation without surgical intervention. Only eight of the 175 lesions (4.6%) enlarged during a median follow-up interval of 3.9 years. Univariate Cox regression analysis revealed that tumor location in the medical portion of the iris (P = 0.047) and pigment dispersion from the lesion onto the adjacent iris and trabecular meshwork (P = 0.056) were the only significant clinical conditions predictive of tumor enlargement. Based on these findings, we recommend conservative management of most melanocytic lesions of the iris. PMID- 3684183 TI - Plus meridian incision for secondary implantation. AB - We studied 25 consecutive secondary implantations with a minimum of 4 months follow-up to learn the effect on astigmatism of passing or not passing the incision through the most plus corneal meridian. Eighteen of the 19 cases having a most plus meridian incision had postoperative astigmatism of 1 diopter or less, and their average astigmatism was reduced by surgery. All six of the cases with the incision not passed through the most plus meridian had postoperative astigmatism greater than 1 diopter, and their average astigmatism was doubled by surgery. The astigmatic difference between the two patient groups was highly significant. A most plus meridian incision is recommended. PMID- 3684184 TI - Limbus-based versus fornix-based conjunctival flaps in trabeculectomy. AB - Forty consecutive trabeculectomies were performed by one surgeon, utilizing a limbus-based conjunctival flap in the first 20 eyes and a fornix-based flap in the remaining 20. A success rate of 90% was achieved in both groups, although eyes with limbus-based flaps had slightly better postoperative intraocular pressure control. PMID- 3684185 TI - Macular pucker and retinal angioma. AB - A 44-year-old white female had a macular pucker associated with a peripheral retinal capillary angioma. Following successful destruction of the angioma with cryotherapy, the macular pucker regressed and visual acuity returned to normal. This is the first report documenting the regression of a macular pucker following successful treatment of a peripheral retinal angioma. PMID- 3684186 TI - A clinical comparison of two methods of glare testing. AB - We evaluated two methods of glare testing, the Miller-Nadler Glare Tester (M-NGT, Titmus Optical, Inc.) and the Brightness Acuity Tester (BAT, Mentor O & O, Inc.). Resulting Snellen visual acuities both for a control group of normal volunteers and for a study group with cataract or posterior capsule opacification were compared using the two glare testers. The decreases in Snellen visual acuities were comparable in the eyes with cataract. No glare disability was measured in the control group. There was greater glare disability using the BAT compared with the Miller-Nadler test when eyes with posterior capsule opacities were compared. PMID- 3684187 TI - Congenital retraction of the upper lid. AB - A 6-year-old boy with congenital retraction of the left upper lid was treated with guanethidine without result. Recession of the levator with release of the lateral expansion of the levator resulted in the normal position of the left upper lid. PMID- 3684188 TI - A simplified method for preparing rabbit eyes for experimental surgical procedures. PMID- 3684189 TI - Coated intraocular lenses. AB - We found that an intraocular lens with a bonded coating of sodium hyaluronate caused less cell damage than an uncoated lens. We also found that an intraocular lens bonded with sodium hyaluronate will provide not only better adherence to viscoelastic materials and endothelial protection, but also may allow for better manipulation of the lens intraocularly. This is the first report of a sodium hyaluronate-coated intraocular lens used to prevent cell damage. PMID- 3684190 TI - Peripheral retinal visualization in pseudophakic and phakic vitrectomy. PMID- 3684191 TI - Irreducible lagophthalmos and appropoiate technology for the prevention of blindness in developing countries. PMID- 3684192 TI - Intraoperative IOP monitor. PMID- 3684193 TI - Intraocular lens data. PMID- 3684194 TI - Enhancement of fundus photographs taken through cataracts. AB - Image-enhancement techniques can aid the clinician in evaluating fundus pictures taken through cataracts. The degradation of the fundus image by cataracts has been described as low-pass filtering. Means to partially overcome this degradation using homomorphic filtering and adaptive enhancement are presented. The clinical value of these enhancement techniques is demonstrated with two cases of progressive glaucoma and cataracts. PMID- 3684195 TI - Evaluation of posterior subcapsular cataracts. With spatial contrast acuity. AB - A new microcomputer-controlled instrument that tests contrast acuity is described. It displays a range of Sloan optotype sets at five different levels between 3 and 95% contrast. The spatial contrast acuities of two groups were compared with this instrument. The first group consisted of 68 eyes of patients with posterior subcapsular cataracts whose conventional, high-contrast visual acuity was 20/60 or better. The second group was comprised of 146 eyes with normal vision. The posterior subcapsular cataract group had greater variation in visual performance and a more pronounced decrease in spatial acuity at lower contrasts than did the normal group. This study indicates that high-contrast acuity measurements, in patients with posterior subcapsular cataracts, do not predict acuity at other contrast levels. PMID- 3684196 TI - Television retinoscopy with a slit-aperture retinoscope and a highly sensitive camera. AB - The low light level of the retinoscopic reflex and the small aperture required to obtain the customary shape of the reflex make it difficult to photograph the actual reflex for teaching or permanent recording. We describe the design and application of a television retinoscopy system that solves this problem. The system uses a standard streak retinoscope modified to gather more light, a highly sensitive television camera, and an image processor. The system can be used for live demonstration of retinoscopic techniques or for videotape recordings for teaching or research. PMID- 3684197 TI - A teaching attachment for retinoscopy. AB - A teaching attachment for a conventional streak retinoscope allows a second observer to view the retinoscopic reflex during retinoscopy. The device weighs 200 grams and is attached to the retinoscope by a semi-flexible, rotatable linkage. A beam splitter, one-power telescope, and erecting mirror form a displaced aerial image of the retinoscope peephole for the observer. With identical retinoscopic reflexes observed through the actual peephole and its aerial image, the device can be used to teach basic retinoscopy techniques to new refractionists, or to demonstrate subtle reflexes to more experienced observers. PMID- 3684198 TI - Multiple evanescent white-dot syndrome. A report of eight cases. AB - Multiple evanescent white-dot syndrome (MEWDS) is a newly described clinical disease entity. The authors report on eight patients with findings characteristic of this syndrome. All of the patients were women and relatively young, with an average age of 28.2 years. Patients complained of unilateral black spots in their vision, with an initial visual acuity of 20/25 to 20/60. Examination showed characteristic small, white dots at the level of the retinal pigment epithelium (RPE). Fluorescein angiography demonstrated patchy hyperfluorescent defects at the level of the RPE with some late staining. All patients had good recovery of visual acuity with eventual fading of the white dots. PMID- 3684199 TI - Rhegmatogenous retinal detachment after YAG laser posterior capsulotomy. AB - Twenty-five eyes in 24 patients with rhegmatogenous retinal detachment (RD) after YAG laser posterior capsulotomy were treated during 1984 and 1985. The average time from extracapsular cataract surgery to YAG capsulotomy was 15 months. The average interval from capsulotomy to RD was 6 months (median time, 3 1/2 months). In 8 of the 25 eyes, a risk factor for RD (i.e., high myopia, lattice degeneration, or a history of RD in the fellow eye) was present. All but one of the detachments was successfully repaired. PMID- 3684200 TI - The association of iris color with eye disease in diabetes. AB - Iris (eye) color was examined for its effect on eye disease in a population-based study of diabetic retinopathy in Wisconsin. Eye color was determined by comparing the iris in a red reflex photograph with standard photographs. In younger-onset diabetic persons (N = 996), macular edema was more prevalent in persons with blue or grey eyes (12%) compared with intermediate (9%) or brown (6%) (P = 0.04). Cataracts were more prevalent in blue or grey eyes (32%) compared with intermediate (22%) or brown (20%) in the younger-onset group (P less than 0.001). In older-onset persons (N = 1370), intraocular pressure (IOP) was higher in persons with brown eyes (17.8 mmHg) compared with blue or grey (17.1 mmHg) or intermediate (16.6 mmHg) (P = 0.012). Eye color was not associated significantly with diabetic retinopathy in either the younger- or older-onset group or with age related macular degeneration or glaucoma in the older-onset group. PMID- 3684201 TI - Traumatic hyphema in children. AB - The authors reviewed the medical records of 316 children admitted between January 1977 and March 1985 with a diagnosis of traumatic hyphema. In this group of patients, 1 to 17 years old treated without antifibrinolytics, the incidence of secondary hemorrhage was 7.6% (24 of 316 patients) of whom three required surgical evacuation of the clot. The risk of rebleeding did not correlate with the patient's age, use of topical steroids, or cycloplegics. Of 176 patients followed from 1 month to 7 years post-hospital discharge, 91% achieved 20/30 vision or better, but only 77% of the patients with secondary hemorrhage attained this level of vision. Amblyopia, a potential threat in young children, occurred in only two children both of whom also required cataract extraction. From our captive pediatric population of 228,000 the incidence of traumatic hyphema is 17 per 100,000 children per year. PMID- 3684202 TI - Prognostic factors in the uveitis of juvenile rheumatoid arthritis. AB - Risk factors for significant visual loss were investigated in 51 patients with iridocyclitis associated with juvenile rheumatoid arthritis (JRA). Average follow up was 12.7 years. Of 89 eyes with uveitis, 22% had visual loss to 20/200 or worse, 46% had cataracts, 30% had band keratopathy, and 27% had glaucoma. Severity of visual loss and complications correlated with the degree of inflammation found on initial ocular examination. Of 58 eyes that were initially normal or had signs of mild inflammation (cells, flare, keratitic precipitates), 3% had final vision of 20/200 or worse, 28% had cataracts, 5% had band keratopathy, and 17% had glaucoma. Of 31 eyes with posterior synechiae on initial examination, 58% had final vision of 20/200 or worse, 81% had cataracts, 77% had band keratopathy, and 45% had glaucoma. When arthritis clearly preceded uveitis, 6% of patients had a poor visual outcome compared to 67% of patients whose initial manifestation of JRA was uveitis. Systemic corticosteroid administration used primarily for arthritis correlated with cataract formation. PMID- 3684203 TI - Epibulbar choristomas containing lacrimal tissue. Clinical distinction from dermoids and histologic evidence of an origin from the palpebral lobe. AB - Three new cases of epibulbar choristomas, all containing lacrimal tissue, are presented and compared with those reported previously in the literature. The first and second cases were unilateral, complex choristomas, consisting of ectopic lacrimal tissue, smooth muscle, and cartilage; the first case was also remarkable for the presence of lesional tissue in the peripheral cornea and evidence of progressive growth during puberty. The third case was a bilateral, complex choristoma, manifesting epibulbar lacrimal tissue, cartilage, and smooth muscle; also associated were bilateral optic nervehead colobomas and a uniocular focus of posterior scleral cartilage demonstrated by computed tomography (CT) scanning. On clinical examination, all three lesions displayed highly vascularized thickenings of the conjunctiva with diagnostically useful gelatinous elevations, which corresponded microscopically to lobules of lacrimal tissue. In addition, all three cases had the interesting diagnostic feature of superficial corneal scarring or sclerosis, with a fine vascularity adjacent to the conjunctival lesional tissue. Electron microscopy of the third case demonstrated completely normal cytoarchitecture of the lacrimal tissue. Because of the frequent presence of Muller's smooth muscle in epibulbar lacrimal choristomas, the authors propose that these lesions represent embryologic ectopias or overly extensive field effects of the palpebral lobe of the lacrimal gland. PMID- 3684204 TI - Tricholemmoma of the eyelid. AB - Tricholemmoma is a benign cutaneous tumor that shows differentiation characteristic of the outer hair sheath. The usual site of occurrence is the face, including the nose and eyelid. Four cases of tricholemmoma involving the eyelid margin to a variable extent are presented and the clinical and pathologic findings are reviewed. In three of the four cases, a histopathologic misdiagnosis of squamous cell carcinoma was initially made. In one case, this resulted in a greater sacrifice of normal lid tissue than was necessary, although the reconstruction yielded a good result. In the subsequent cases, the entity of tricholemmoma was well appreciated before definitive oculoplastic surgery and the referring diagnosis of squamous cell carcinoma was refuted. PMID- 3684205 TI - Growth of the conjunctival fornix and orbital margin in term and premature infants. AB - Knowledge of the growth of the neonatal conjunctival fornix and anterior orbit will aid development of neonatal prosthetic conformers and conjunctival sensors for oxygen determinations, as well as help define orbital malformation syndromes. These data are not available in any prospective series in the literature. The authors studied 55 premature and term neonates and determined horizontal and vertical dimensions of the conjunctival fornix and orbital margin and palpebral fissure width. Each of the ocular parameters had statistically significant correlation coefficients in relation to weight and gestational age (P less than 0.05). Linear regression analysis showed significant relationships which predict conjunctival fornix, orbital margin, and palpebral fissure dimensions from body weight (P less than 0.05). Statistically significant correlation coefficients and linear regression relationships were found for horizontal, but not vertical, diameter measurements of the conjunctival fornix in relation to orbital margin and palpebral fissure dimensions (P less than 0.01). PMID- 3684206 TI - Malignant melanoma of the conjunctiva. Report of a case. AB - Malignant melanomas of the conjunctiva are extremely rare in children. The authors report an 11-year-old boy who had a nodule at the limbus in a pigmented area since early childhood. The lesion was excised and the diagnosis of atypical compound nevus was made. Five months later, the patient returned with multiple nodules in the bulbar and palpebral conjunctiva. One of the lesions was excised, and the diagnosis was malignant melanoma. He was lost for follow-up for 6 months; then he presented a large pigmented, vascularized mass protruding through the palpebral aperture. Results of systemic workup for metastatic disease were negative, and an exenteration was performed. A few months later, cervical lymphadenopathy developed followed by extensive metastatic disease. PMID- 3684207 TI - An experimental study to compare methods of eyelash ablation. AB - Epilation, electrolysis, cryotherapy, and argon laser thermal ablation were used to remove eyelashes of rabbits. Epilation and electrolysis were done in the standard fashion. Nitrous oxide cryotherapy was applied in a double rapid freeze/slow-thaw manner for either 30 or 60 seconds. Argon laser settings were 1 W, 50-micron spot size, and durations of 0.2, 0.5, or 1.0 second. The rabbits were euthanized immediately, 24 hours, 2 weeks, or 3 months after the procedure. Epilation was followed by total regrowth of eyelashes within 2 weeks. Electrolysis showed focal destruction of follicles with variable regrowth. Cryotherapy resulted in moderate-to-severe eyelid scarring with minimal regrowth. Argon laser thermal ablation produced focal necrosis and variable follicle destruction. Argon laser thermal ablation may be a suitable alternative to electrolysis or cryotherapy in selected cases of trichiasis. PMID- 3684208 TI - Spoilage of hydrogel contact lenses by lipid deposits. Tear-film potassium depression, fat, protein, and alcohol consumption. AB - "Jelly-bump" deposits, which are composed mainly of lipids, on high water content, extended-wear hydrogel lenses, are a clinically significant problem of unknown etiology. The authors explored the effect of nutrition on the frequency of deposition of these jelly bumps. Forty-three patients were included in this masked case-control study from five contact lens practices in North America. Thirty patients were lipid-depositor cases and 13 were controls. Tear specimens were drawn and analyzed for potassium by atomic-absorption spectrophotometry. Detailed dietary histories were conducted and diet nutrient composition was computed. Patients with diminished tear-potassium concentrations have an increased risk of jelly-bump deposition. Elevated intake of protein, alcohol, and cholesterol also appeared to be correlated significantly with increased jelly bump deposition. The authors found that diabetics and the use of diuretics, anticholinergics, sympathomimetics, were associated with tear-film potassium depletion and lipid deposit formation.